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HomeMy WebLinkAbout020-1447-04-000 0 cn O II 3 v 0 d 0 0 o co~ 0 0 c d # G~ >v o O W °C O• O U) O CO C (P N n y N ? a z a N CO W= p Co 'O C: Ei *t W 00 ~p 3 N W a " J O d N d N Cn S/\\ n H _ N 1 CD :E O O n 7 m < O O 0 o 0 n 0 I 00 N c CD 7 O O O 10 _ N ~ N O lV C i C D d a CO m n' (D cn ;7 a n x 4~ td ? W m (D c =3 C) c w G N 9 n ~ o 0 PN 3 O O O N d ~~I W (D b O CrJ cn (D W Oz 03 03 c 0 r N rt ri rt w o- fn O c a G ~r 0 o N• ~ cn ~ G rt F-H Cn H • w rt CrJ oa o O O O N w n c o ~ ~ A n 00 m t~ N v ~ to N cn o o o 9. v O' v v 0) rt o o' (D fD d y (D X ~ Z I d _ o - (D N (p N - ~1 CL N rn w ° z d I n I co o ~O rt 0 p n co p m W rh H H ~ m v 00 O N m P) c CD m oa p Z Z ~ a I -p N I t=] n ~ ~ r O 7u z ? cp (n tr hti O A Z O I- n G n 0 O' fD ty - i-} N Ul m cn H N• w d O \ r- W co CD M n d w Ul a z b n o w n ° z rt cCfl (D w M Z < CD w ~ I o a n d I ~ ~ v n N n o ° O < N a o o m N o m t 0o m Q I ~a I CD N < a CD o 03 _0 0 3 m of (D G I ~ a 0 o I o ~ b m m 0 p a ° * I ° i I 'r Parcel 020-1447-04-000 05/26/2006 10:58 AM PAGE 1 OF 1 Alt. Parcel 15.29.19.2835 020 - TOWN OF HUDSON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 07/27/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - BAKKEN, STEVEN J & CAYE L STEVEN J & CAYE L BAKKEN 947 BAKKEN RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 947 BAKKEN RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 5.370 Plat: 10/17-COYOTE RIDGE 020/04 LOTS 1/29 SEC 15 T29N R19W PT NE SE BEING COYOTE Block/Condo Bldg: LOT 04 RIDGE ('04) LOT 4 (5.37AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 15-29N-19W NE SE Notes: Parcel History: Date Doc # Vol/Page Type 07/27/2004 769938 10/17 PLAT 01/07/2004 750940 2487/120 WD 01/07/2004 750939 2487/118 WD 08/20/2002 687523 1952/549 LC more... 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.370 162,400 173,200 335,600 NO Totals for 2006: General Property 5.370 162,400 173,200 335,600 Woodland 0.000 0 0 Totals for 2005: General Property 5.370 162,400 173,200 335,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 020-1027-20-000 05/26/2006 10:57 AM PAGE 1 OF 1 Alt. Parcel 15.29.19.119A 020 - TOWN OF HUDSON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 07/27/2004 00 4 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner RETIRED BAST O - BAST, RETIRED Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 19.000 Plat: N/A-NOT AVAILABLE SEC 15 T29N R19W NE SE EXC THE EASTERLY Block/Condo Bldg: 693' AS IN 659/506 NKA PT COYOTE RIDGE ('04) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 15-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 01/07/2004 750940 2487/120 WD 01/07/2004 750939 2487/118 WD 08/20/2002 687523 1952/549 LC 07/23/1997 861/278 more... 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 03/04/2005 Description Class Acres Land Improve Total State Reason Totals for 2006: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Dorm - S T C - 104 A~ 1)UIIA' SANITARY ')'i,) LM I'll F PO 1-11T . TOWNSHIP %t t/'= ✓~ia,k~E:,- ~y' SEC I S l_ N-K OWNER -Zlw ADDRESS r ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet regrrirc~m('ntS of H 6) SHOW EVERYTHIP;t. WITHIN 100 FEET OF SYSTEM i Ivf.iT f: P Tv cf,. T c> r w lt_ C..{T/N y INDICATE NORTH ARROW 13ENCHMARJ.: Describe the v+:!rtical reference point uS(.d] ~ r Elevation of vertical reference point: -)0 Proposed slope at site: SEPTIC T-NK: Manufacturer: Liquid Capacity: Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Numb( r of feet from nearest Road: Front, Side,0 Rear, 0~, feet From nearest property 1i.ne Front,0Side, 0Rear, feet Number of feet from: well building: (Include this informat-iou of the above plot plan)( 2 reference d:imensious to septic tank) R + PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off swatch elevation: Gallons per cycle: Alarm Manufacturer: _ Alarm Switch Type: Number of feet from nearest property line: Front, 0 Side, 0 Rear, 0 Ft. Number of feet from well: Number of feet from bui.l.ding: _ (Include distances on plot plan). SOIL ABSORB`I' LON SYSTEM Bed. T---_--~- Trench:- Width: - Length: Number of Lines: ~ Area Built: Fi Fill depth to top of pipe; Number of leet lroui nU hest property line: Frout, Side, O Rear, 0 Ft i~q . Number of feet from well:_ Number of feet from building: (Include distances on plot plan). ;;H-'PAGE PIT Size: Number of pits: Ukami'ter: Liquid depth: Bottom of seepage pit ea_evation: Area Built: Has either a drop box O or distribution box 0 been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Mallllfacturer: Capacity Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: FY.ont, O Side, 0Rear, nFt._ Number of feet from well: Number of feet from building: Number of feint from rtearest road: Alarm tanufacl-urer: D=i t ed : Plumber on job: License Number: 3/84:mj DEPARTMENT,OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING `i/IADISOiJ, WI 53707 LX CONVENTIONAL ❑ALTERNATIVE State Plan I D. Number lf assigned) ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound ( NAME OF PERMIT HGZIJER-'IIIIII ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Steve Bakken 527-13th St.,Hudson, WI-/"_~~ BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.' CST REF. PL ELEV.. SW NE, Sec. 15, T29N-R19W, Town of Hudson(part of a 21 A Name of Plumber: MP/MPRSW No.. TS parc Sanitary Permit NumberAnthony Zappa 1614 . Croix 38539 SEPTIC TANK/HOLDING TANK: MANUFACTURER LIQUID CAPACIT .j TANK INLET ELEV.. TANK OUTLET ELE V.. WR~Nl G LABEL LOCKING COVER PEOPOVIDED ✓0ES ENO ❑A DNO " BUILDING: VENT TO FRESH BEDDING. NT DlA VENT MATL: HIGH WATE - NUMBER OF ROAD: PROPERTY W(z9 A LARM. LINE. AIR INLET. FEET FROM ~ c~ EYES NO EYES ENO NEAREST % ` / DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED. PROVIDED: EYES ENO EYES ENO OYES ENO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING I VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET 10 PUMP ON AND OFF) EYES ENO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing ILINGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH. LENGTH NO. OF pISTR PIPE SPACING COVER INSIDE CIA. =PITS LIQUID BED/TRENCH / 3 TRENCHES MArIAL: PIT DEPTH DIMENSIONS / J GRAVEL DEPTH FILL DEPTH JDISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL. NO. NUMBER OF PROPE TV WELL. BUILDING. VENT TO FRESH BE LOW PIPES 7j "`V COVER ELEV hLEt ELEV/END. PIPE FEET FROM LINE R q~ AIRINLET: 60 1 L ^I , V 27 L7 NEAREST-----o- MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. DYES ENO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS DYES ENO EYES ENO DEPTH OVER TRENCHBED DEPTH OVER TRENCH,BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES. EYES ENO EYES ENO DYES ENO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH Na OOCHES LATERAL SPACING: GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING. ELEV.'. ELEV.. DIA. ELEV.' PIPES. DIA.: ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS. DYES NO EYES ENO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY rLL: BUILDING: / Z FEET FROM LINE: lD ❑ YES F11 NO ❑ YES El r, NEAREST Sketch System on vV Ret' in cou xy file for audit. Reverse Side. SIGNATURE TITLE. I,te-~- l F ,.•'`..1,/ DILHR SBD 6710 (R. 01/82) 1 Wisconsin APPLICATION FOR SANITARY PERMIT ®I L H RCOUNTY - oEPF1FiT1"nEnTOF (PLB 67) UNIFORM SANITARY PERMIT # In OUSTRV, LABOR 6 HUMAn RELRTIOnS r -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8/2x 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER MAILING ADDRESS PROPERTY LOCATION CITY: VILLAGE: U PfC3.~J S~ 114N-'_1 /4, S IS TJ- , N, R 1Y E (or F: LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER /''$)e T of- z / ,q yr t oWe e-z- Cu f M AEA )OW . ii/- 4-TYPE OF BUILDING OR USE SERVED 1 or 2 Family Number of Bedrooms. ❑ Public (Specify): THIS PERMIT IS FOR A: X New System ❑ Tank Replacement ❑ Repair ❑ Replacement Soil Absorption System ❑ Revision ❑ Privy Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. Z Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank ❑ System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total # of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity a Lift Pump Tank/Siphon Chamber Holding Tank capacity manufacturer: &,Q C- e a'_~- ' X 112e--J } W S IF THIS IS AN ALTERNATIVE SYSTE[d COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure Total # of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): < 6 (9 j 6 /T "r3S Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (Print): Signature: MP/MPRSW No.: Phone Number: Plumber's Address: Name of Designer: 7 2 oeJ/p~ Si IV04 ~ ~iS COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ~y Disapproved -3 ❑ Owner Given Initial u ly Approved Adverse Determination Reason for Disapproval: Alternate course(s) of Action Available: DILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber f_ f ,t INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable. 10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system, depth of the system, type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan, drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin. 1~'o rm - S 7' C 100 Owner of Property Location of Property St-'cti.n ; j ~N R ~9 W Township 5t Q_AO ( Mailing Address q ~14- A~CC-- Subdivision Name Lot Number _ Previous Owner of Property Total Size of Parcel` ( Date Parcel Was Created- c ll~ Are all corners identillable7 Yes No Include with this awl icar_ion one of the followi : .Certified Survey Map Deed .Land Contract, or Other Legal Document which describes the property PROPERTY OWNER CERTIFICATION 1 I (We) certify that all statements on this form are true to the best of my (our) icnowiedge, that I (we) din (are) the owner(s) of the propel ty described in this information form, by virtue of a warranty de d recorded in the Office of the County Register of Deeds as Document No., - (6 - ; and that I (we) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has been duly recorded in the Office of the County Re~ister of Deeds, as Document No. Iii ,i SIGNATURE OF OWNER SIGNAT ke OF CO-OWNER (IF APPLICABLE) 1 , . _ a DATE SIUNLD DATE SIUNED, r 4 I A parcel of land in the NE 4 of the SE 14- and the Southeast Quarter of the Northeast Quarter (SE; of NF}4) of Section 15, Township 29 North, Range 19 West described as: The Easterly 693.0 feet of the Northeast Quarter of the Southeast Quarter (NE-; of SE34), including an easement for travel over a road extending from the above described parcel northward through the SE; of the NE-14 to the Town Road as now opened and traveled, described as: A strip of land, 66.0 feet in width, lying parallel with and 33 feet an both sides of the following described centerline: Beginning at a point an the north line of said Southeast Quarter of the Northeast Quarter N 89106' W from the Northeast corner of said quarter-quarter a distance of 484.5 feet; thence along said centerline S 00°54' W a distance of 455.8 feet; thence S 13°36' E a distance of 371.57 feet; thence S 28016" W a distance of 417.0 feet; thence S 00054' W distance of 137.85 feet to the end of the roadway herein described. Subject to and reserving an easesrent for travel 66 feet wide located in the North 100 feet of the West 157.60 feet of the parcel herein conveyed. Subject to any easements, reservations, rights of way, and covenants of record. The parcel The parcel herein conveyed constitutes 21 acres, more or less. 4 PIS S Y.L.' CROP YR, r 3 'a .ag. x x , k' F a w t'i .'l. b ~ , .d.. e. 7" Y ~S.t•$ - i~: ~c ;5Y^ ` ,co 12 z ..a s M NpIk koil FW r r y a ,ys°r s d'YY ,e' Y ^~§q 'tom M # r" ' d^ A lo~ a 77 A", $ ~ . 5 Y 3 T+ck q"ib t w+t x" } .r u a Tyr s° ,q.i, ~s / tk WIF F ~ ,w, e ~ ub' #a a +y. g,7Y~n4sG.' aYrn t~~ .s;~~~a74v^~yRa ..~•ytr < Y ~ S °~t- ar ~ a * t r t ~ kg, IWA* t ' r fr' f^ y~g r x. , j: i/'9~~t= T 3/ 9Q»rl~? ~,c~.~J ~0~ fgPe, Z, DEPARTMENT OF REPORT ON SOIL BORINGS ND SAFETY & BUILDINGS INDUSTRY, ~ I1 DIVISION P.O. BOX 76 LAEJQR HUMAN REELATIONS PERCOLATION TESTS (115) MADISON WI 53707 (H63.090) & Chapter 145.045) LOCATION: /SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: 51V 422 N/R/ E (or # uvs6 ~i qc'~s ,as~x~~~ /•s-~~ COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: 51401A - 5-) 7 13 H-1 Y;"- USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: ® New ❑R IPROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence 3 41~ eplace ` Z '71" D RATING: S= Site suitable for system U= Site unsuitable for system 13 MIZANCTffEl : MOUND: IN- GROUND PRESSURE: SYSTEM-IN-FILL HOLDING TANK:RECOMMENDEDSYSTEM: (optional)('O,UIe,0j--1eU L © s ❑u s au EIS ®u oau )3ed IR X3s- o,70 sC?.rj- If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the / under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: FT' PROFILE DESCRIPTIONS BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-fY1re::4-I.ES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH hN. OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) , B- / /d v Yq 7 ' - "JIV. Sc , • yi • 13.4;. SL, 13,x, sz- • SL - (®y'r fld sL ~ 9. y B-2-11-2.0 103.92' ?,,7 0 •7~' ~u 92 si-, Via' Of P&Ze-13,V, v c vR 3 ~P•c~ V - ?~',c~ •~y'%3A?-6y.st, .67-13f,sL, .~7'13N•~-~ ~.0' B- -~3~v Dk ~ CS B- > y, -Pex"v. Sc , A. SL, ~:y O-g_Q 3A) C S . tt,, q V441 ,Q G ' tv£I' .47- 3,(-) 1,S' I.,3 ,6A 51'G, -.0 ' 2-11'1i11VSC4CrfT> B- 163,1 3,0'-A 5_0 w 4t, C ,t.~ a1c 0,4-6,t a/ eT 3, fr. o p ~ FT PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER NCH_ES AFTERSWELLING INTERVAL-MIN. PERIOD1 PERIOD2 PERIOD3 PERINCH P- I 2- 1 1.0.4 E JAI Pf_jQC_0,Afjpr7CX Gv fLL- P- r,-srs eocze /3 P- P_ - PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show t~henn surface elevation at all borings and the direction and percent of land slope. /3O17011 Q` 13.-,o EXC!9f~gj~~f/ ~.1NQ.u LiE Ar 0 oy`G1. SYSTEM ELEVATION t-y I ~ I , i , i _ . P/_ 0 E , TN , t F E I 4 S/e1e-~Z 100 duo ,cis ~opE , . i 1, the undersigned, hereby certify that the soil tests reported on this form were made by mein accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): d w . ,"Z TESTING CO. TESTS WERE COMPLETED ON: ADDRESS: ~Wo I _ CERTIFICATION NUMBER: PHONE NUMBER (optional): 54016 -02- 3 R6 CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) OVER - d nev" 0 C:o `w ,Y` or t ivy i=4, 1; SO P 15 S . Ho PL6. .y ihn , MAKE A OC OE w ' ?y ,w aFl ; F. m km, n. D mi£ a€?i3ie, a p, 'ir , tt£L , t? N e , ..r b `ak Ad „IM :LIEU.€F.Mn , i`£'?U (iO aT CioWlyy ....1.. b14~ s_::£? a![ ix;>q:.fu ,.,,_e° ,)F "s as r h r t..,`.. H , IF,,,,y, t his, " ci.a 0..t air' ;3}.. €::4£7ffz (!oe> .i. q fly' plat. N.r, 1 L S}£,'F t,a _ off s ind 6.. y. mr, „ t . .s and .t-,ar w„ , 1 H SOPMOOS _ Odor SyMbAs cv Como So o E x, - M"Aw- &W ~ 111 Foy Wd c< L . icI q Lamm land Qvauq m f ..3 F ..I `e! So 1 `t :'Ps1 `E 18, .y 5 R r i Coy m - t' 1 Sky ,._'.t' i Viet, 104 fZy o "No 1 f REPO T ON SOIL GDRI PERCOLATION TEST5 ll.- 'r / pry Pia T A~1 PRcaT c i I'. D. sw l~Ul~~ GN TGC ',tir SH . DA rE- + r a HOME iTE TESTING CO, O'NEIL ROAD BOB WiS•.._ 54016 CST C1.2 y~z PROPOSED HbVSi: mUSr 41E 2~ FT 04 MORE ",oM qLL TEST t}~QE~4S. PRo POSE D WIELL M v6r LIE So r-T Off' J`fD~PF Fi~OH AFL T£ST e = sweloas- f 11-3 O = zyi57bV LC>ELL LEGEND llar pr /0 o, o 9 n Ok y~ R~ ;S YI t I,,a C q 'y U/t ~r ~n f~,?2 • i3~, SEA I ~ ~pc Pf!'~ ~J. 4i r I - 30 3 30 43 , 15 ~ f~; ~ w ~ I if h 1~5 13p' (3 X02, p` Pe To p 3 oo~ PL 7 PLOT an8 'SR 055 sa S6CT1 O N P ANS P for .o~ 0 s 0- ~ o' PR°P° I I ,f'~F fT r " 35, I I i ` rlo,oc /,5~~ Pi~O7G1- 5 ,j y y If I I ' S 1'GAIFD , .l .l I ~ l 00 A0 p Fresh Air Inlets And Observation Pipe SOIL TF-sTI" By ' q HOMES1TE TES i~.NG 0:0. ® R°RC Approved Vent Cap RT.-.-, O't'. E"L Rd, ) Ni DSON, WIS. 4016 _ ry Z7 Ufa 4~" Cast Iron ~ ° Vent Pipe ~oj 411 )A71QA) Marsh Hay Or Synthetic Covering Min. 21° Aggregate C v Over Pipe %,JTaf /S Oistribi.ition Tee pips, / 0 0 0 0 0 Aggregate 0 perforated Pipe Below Beneath Pipe 0 Coupling Terminating At Bottom Of System