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HomeMy WebLinkAbout030-2006-20-000 `I N o v 0 C7 y m o o c c iD (D n 3 tti, m v Z o a~ • v' vt c v 3 d (ID O. 3 O C> N L • O Q 7 d N O- ~ N O NO r`3 c (D C N N N N S W N 1 O p 7 Q N N O O1 O C A O N O co O l~~l • 7 N j O C• lr C C/1 C!) N 7J d C C) O D o W rt w m U> N o t C H cn r _ V (D d Q H z x ~ 2 3 ::t O o p) a rt ti W L N rt o 0 H• ' o O H. m ~ 9 I o 00 ono ' N o c n N 7~ w w Q p rt W ~C v cn I n' H w 0 0 0 Z z rn l+~1 z O rt ° o ZZ A s -3 cn cn cn £ ~ T v v o O CD rr y 'O ~y d w^ CJ co N C O z N N i O ~ N O Z W O w 00 ~ p > CD a 00 H H z o • W O W M CD N w rim E O CD z z C Q N ~I d cD / O w CD Cl~ 1-h F- 3- 3 5' rt l0 M z CD z rt Cl~ trJ O N 0 o rt C") Z) p z o f-3 ° G? o o +c Z W co m rt :z m y m o N a " t z cy W 3 A , o m c0 Z- ° 3 V) CD w ~ O_ v a v a ~ O 3 T 3 v ~ Z 0 0 CD 0 N a CL Z 7 h a Z W O N O O a A Q b ti A W O A < LL ft ti v) 0 O N ` yb y O CL Parcel 030-2006-20-000 11/30/2006 01:16 PM PAGE 1 OF 1 Alt. Parcel 34.30.19.372B 030 - TOWN OF SAINT JOSEPH Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - BRINK, JEROLD W & KRISTINE D JEROLD W & KRISTINE D BRINK 1265 CTY RD I HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1265 CTY RD I SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 3.840 Plat: N/A-NOT AVAILABLE SEC 34 T30N R19W PT NE NE BEING LOT 1 Block/Condo Bldg: CSM 3/816 4AC EXC HWY PROJ 8939-03-000 (0.164AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 34-30N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1223/520 WD 07/23/1997 784/111 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.840 85,700 130,700 216,400 NO II Totals for 2006: General Property 3.840 85,700 130,700 216,400 Woodland 0.000 0 0 Totals for 2005: General Property 3.840 85,700 130,700 216,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 123 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT 0WNER_ PI i TOWNSHIP % l ✓ , ~l SEC. 34- T UN-R/ W ADDRESS C y /~id/P`1 S S~ ST. CROIX COUNTY, WISCONSIN. t'~l~Lf%o~c^ ~l4(Yl SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimL:nsions to meet requirements of H63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 0 r ' I 17 Ii di at N r h rrc w BENCHMARK: (Permanent reference Point) Describe: F44 ( n 14 /Z Elevation of vertical reference point: Y ('v ' Slope at site: - SEP'T'IC TANK: Manufacturer: W 5~ Liquid Capacity: Number of rings on cover 0 Tank manhole cover elevation: `lank Inlct Elevaric Tank Outlet Elevation; PUMP CHAMBER Manufacturer :Jlf _ Number of gallons Number of gal. pump set for a cycle gallons; To$al capacity of distribution lines gallon: si.zc of pump- /f head; ;brand name of gallon per minute ~ tiorsepowc.a pump and model number _ - Type of warning device HOLDING TANK: Manufacturer Number of gallons 1414 Elevation of manhole cover Type of warning device _Al -/V 4 feet diameter I SEEPAGE PIT SIZE;___ZV_ _ Number of pits A~ feet liquid depth- seepage pit inlet pipe-elevation _lIZ17- bottom of seepage pit elevation y-t feet. SEEPAGE BED SIZE: number of lines width-'-__./_ length3 (_tile dept SEEPAGE TRENCH: width length- AREA REQUIRED ~l AREA AS BUILT-_- PERCOLATION INSPECTOR- DATED ~.Rc/__------ PLUMBER ON JOB--_ LICENSE NUMBER 114 100 a >l w w ~ Gv n !l ~ -mot, t ~ ~ ! V`4 Q ~S, e Az- Q c a e. i AS BUILT SANI'T'ARY SYSTEM REPORT SEC- .J L. T. N -11 W OWNER - I ~ '1------ - T O W N S H I P ADDRESS xj6 IVST. CROIX COUNTY, WISCONSIN. 6yd SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimonsious to meet requirements of H63 SHOW EVERYTHING WITHIN 100 Ft,ET OF SYSTEM L I ~ t e it di at N r h rr w BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical reference. point: Slope at site: SEPTIC TANK: Manufacturer: Liquid Capacity:- Number of rings on ('over : Tank manhole cover elevation j,, 9,e lank Inlet Elevation: 'lank ou-tIc t. Elevation: PUMP CHAMBER Manufacturer: _ Number of gallons ~ >allons; Number of gal. pump set for a Total capacity of cycle _ __b distribution lines gallon: size of pump head; gallon per minute horsepower _ ;brand name of pump and model number Type of warning device--- HOLDING TANK: Manufacturer--- Number of gallons Elevation of manhole cover > Type of warning device_ SEEPAGE PIT SIZE; Number of pits-- feet diameter _ feet liquid depth- i seepage pit :inlet pipe-elevation - bottom of seepage pit elevation feet. SEEPAGE BED SIZE: number of lines width _1~_ length J6 tile dept ya SEEPAGE TRENCH: width length- PERCOLATION RATE AREA REQUIRED J, AREA AS BUILT (o~ IN SPECTOIi - D ATE ll ` ~ ' - - PLUMBER ON JOB Z tL - ' . LICENSE N U M B E It - /1? f~,h - 11 bEFARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADI,~,ON, WI X3707 C~,,CONVENTIONAL ❑ALTERNATIVE State Plan ID.Number (If assigned) ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE'. Cary Frisk 236 N.Owens St. Stillwater, MN `/^If~, 1,17 ff'7 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.'. CST REF. IT ELEV NE NE, Section 34, T30N-R19W, Lot 1, Town of St.Joseph A~10 Na-, of Plumber. MP/MPRSW No. County. anitary Permit Number. Doug Strohbeen 5432 St. Croix 43701 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV. TANK OUTLET ELEV. WARNING LABEL LOCKING COVER . PROVIDED: PROVIDED'. YES LINO ❑YES LINO BEDDKG" VENT DIA.. VENT MATL. JHIGH WATER NUMBER OF ROAD'. PROPERTY WELL'. BUILD ING. VENT TO FRESH ALARM FEET FROM LINE J AIR INLET ❑YES LINO ❑YES LINO NEAREST 30. /00 160 S' ,Z~ DOSING CHAMBER: MANUFACTURER BEDDING'. LIOUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED. PROVIDED: ❑YES LINO ❑YES LINO ❑YES LINO GALLONS PER CYCLE: PUMPANDCO NTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING V(DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) ❑YES LINO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing I FN(ITH DIAMFrER MATERIAL AND MARKING t1 J or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE he soil is dry enough to continue.) MAIN T CONVENTIONAL SYSTEM: WIDTH. LENGTH NO. OF DISTR. PIPE SPACING; C _ INSIUE DIA. -PITS LIQUID BED/TRENCH / TRENCHES., / Mai IAL: PIT DEPTH DIMENSIONS tJ GRAVE I_ DEPTH FILL DEPTH UISTH PIPE DISTR. PIPE DISTR. PIPE MATERIAL. NO. DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BF LOW PIPES ABOVE COVER ELEV INILE T IF LEV. END PIPES ~f FEET FROM LIN~Op AIR/QINLET I'rp jI J NEAREST--► ( MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ❑YES LINO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS ❑YES NO ❑YES LINO DEPTH OVER TRENCH.BED DEPTH OVER TRENCH. BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES ❑YES LINO ❑YES LINO ❑YES LINO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH LENGTH NO. OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING. ELEVATION AND ELEV. ELEV. CIA. ELEV.. PIPES DIA.: DISTRIBUI ION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED ❑YES LINO ❑YES LINO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY 17LL'. BUILDING: FEET FROM LINE: ❑YES LINO ❑YES LINO NEAREST Sketch System on Retain in county file for audit. Reverse Side. 9E: E DI E LHR SBD 6710 (R. 01/82) 4wa":~~ s~ wisconsin APPLICATION FOR SANITARY PERMIT ~-DJLHRN COUNTY 1T \ P LR / 7 anno~ inousTRY,LReoR6trumanRE!_RTIons UNIFORM SANITARY PERMIT # -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 81/2x 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER ,v r MAILING ADDRESS PROPERTY LOCATION 64-~ 1V r.1 /41UT1 /41 S T ~i dN R Ems) TOWN OF: S T e LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST RO D, LAKE OR LAND ARK STATE PLAN I.D. NUMBER TYPE OF BUILDING OR USE SERVED ~ I or 2 Family Number of Bedrooms: 3 ❑ Public (Specify): THIS PERMIT IS FOR A: 2 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. 1~ Seepaye 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 Gallons Tanks Concrete Constructed Steel Fiberglass Plastic Septic Tank Capacity 0 O U Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure Total #of Prefab. Site Gallons Tanks Concrete Constructed Steel Fiberglass Plastic Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): WATER SUPPLY: ~i7 fly ~ 7? "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: SAS 5rv~j6~~-c~ y X32 (,2~7! "3L3 Plumber's Address: ,t,7 ,Lr 4- .0 G / Name of Designer: /lei 5 t11 COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: A ❑ Disapproved r, v ❑ Owner Given Initial Approved Adverse Determination eason 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 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. Form - S '1' C 100 Owner of Property .Location of Property, Section _,T N R -W Township --I _ Mailing Address- j.~:'~ti Subdivision Name Lot Number j Previous Owner of Property 11 , Total Size of Parcel Date Parcel Was Created Are all corners identifiable? Yes No Include with this application one of-the following: .Certifier) Survey Map .Deed .Land Cont i .x, , .Other I;egal DULUIRellt which describes the property PROPERTY OWNER CERTIFICATION i I (We) certify that all statements on this form are true to the best of my (our) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the Office of the County Register of Deeds as Document No. 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 Register of Deeds, as Document No. ) SIGNATURE Of NER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED - DATE SIGNED /3 10 3 3 3 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, R DIVISION LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN RELATIONS \ / MADISON, WI 53707 (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOTNO.:BLK.NO.: SUBDIVISION-NAME: ~fE '/a 3Y /Tf~N/R11 E (or W s% ✓s/~~`f- e.5~ COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: 23 (e V U)4~_4)5 USE DATES OBSERVATIONS MADE NO. B DRMS.: COMMERCIAL DESCRIPTION: 9-36-93 OFILE DESCRIPTIONS: PERCOLATION TESTS: Residence New 1:1 Replace ~,,~,r 9- 7 -R 3 RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND PRESSURE:SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional)6QU~ ^,7~Wv ©s ou co s au '-ES ❑u ❑ s ©u o s au ~'3- ~r/r~ x3rD . L ~ If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.HH663.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: SC_ 5 YZ ~M x x 'TL PROFILE DESCRIPTIONS BORING TOTAL ELEVATION DEPTH TO GR NUMBER DEPTH OUNDWATER-IN CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- `~~yv=i~,/^ , -y~"ti'v-~y s;G, P ,a,~.s,t, X13-'s/-, ftX. a' /31-1. 5 O S' ox2' 4 5 B- 99, l 9 ~ - • y ,~~-6 X. o,a-~v. sc , /d - -13N 5L A3 . ~ ~ L -5 B_ 3 /F 7' 6,V-6Y'- 5, L, 5 ' 1341 S.'L , /34 3 3 '111Y. OF '0 0,0 P, I n L J3'~ s 7 ` /3N Cy. I- l 5 ' 3t . L , ~O.y3 ` d,0 -16'0 -5 L a, A f. t.:... ~9 1411A C B- , j~ /y ` F Y. d 0 S~f ' RAJ J/ ~ 13A) 5 ~ p3 ' 4o--T v S'cL r°t L ' PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER IN AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PE IOD 3 PER INCH P- r <y Z P P- P- ( %y 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 the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION e_ ,y~,~6~ ~49 F , , e 7, 91, /~,~'Pr ,T~1,~cl c~►,c<° Y' -7' 3 `c /`'ifs' / St10 . Ge~E (d~l~'"-t~ Tim r~-f G~,cy ~'7 5<c 6 /`:W '0_='0GP /Ir a[! !y / J - ~0~~/~"L>L - l~ ~ rte- A/4- ~ s V rrr 6 Cwp e &71A1 r ;oool , I, the undersigned, hereby certify that the soil tests reported on this form were made by me in 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): TESTS WERE COMPLETED ON: OMESITE TESTING CO. e 0 ADDRESS: 9 CERTIFICATION NUMBER: PHONE NUMBER (optional): 5f- Wis. 54016 CST SIGNATURE: M~W"~W41 DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/32) - OVER - i , h# and ~icc }rate seal test, ~iOft . ~ ttt3=7 tY~ .~a. b t;,?i l f a_t _ef~ iyt - Th use t''€ tr3 F €r.-yc rp~'6;;'yrti3F,:`-;l"~ ill S it at, ~F~t, A . .,s =ta € . F u = ~ _ - €.k{3"4'o. SITE IS PLEASE gas 0-t= ~,lt0 file descriptions and compioing th~3 3 E1fa`Al" L A LEGIBLE :i:T l :Yt1 accurately y .",u st 9ocatio,,s , Dr3vving 0 Sscal , is pre t ; € x,c_1 3ra shEt; ? If h&)V3Yt% W e L n Lines, E r ,rc r~, co< e 61 G, 'r "air ilt" Clay `p, v ;e c;,, E.• gat m rsl PSa Et4a E4:}TC;1 a~r [.'G the Cd€lrany of tile Dopep ntnk, ~ for Y lki 2. tx,... of x31;5 „t,€: ti',~ .,t r£1 ar= i. 1, NI-W;- eti'S =..3 i`1C1£„ A a .~.5 fT°gl ii DEPARTMENT ENT OF SAFETY& BUILDINGS INDUS REPORT ON SOIL BORINGS AND LABOR AN P.O. BOX 7969 PERCOLATION TESTS ( / 115l DIVISION HUMAN'RELATIONS (H63.09(1) & Chapter 145.045) ` MADISON, WI 53707 LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.: BILK. NO. SUBDIVISION NAME: '/a 3 /T-7e) N/R Iq E (a) 5;~ To COUNTY: Y OWNER'S/BUYER'S NAME: MAILING ADDRESS: USE NO. BEDRMS.: COMMERCIAL DESCRIPTION: DATES OBSERVATIONS MADE 3 - 49 Ix 7~ Residence y New ❑Replace PROFILEDESC~PTIONS: TRCOLATIONTESTS: _ 'If ~~j 7 `7 -per RATING: S= Site suitable for system U= Site unsuitable for system _ 7 c", 7 y / - P - J3 CONVENTIONAL: MOUND: IN-GROUND PRESSURE:SYSTEM-IN-FILL HOLDING TANK:RECOMMENDEDSYSTEM: (optional) ©s ou ❑s au as ❑u as au as au d7x ccr~ec~~ ~Q If PTests are NOT required DESIGN RATE: unH63.09(5)(b), indicate: If any portion of the tested area is in the Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-IN NUMBER DEPTH ELEVATION s CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B ' • (r ~ ` A1' ' ~ 5~.~ ~ 7' Sal. L -2 -3 9 -P-CAJ S ~ B B- 5', :a r~,+ e/S sag!pie T ® ~9 Sy ' 0 B- B_ PERCOLATION TESTS TEST VVA 7ER IN NUM ER DCHES AFTERSWEL~NG INTERVAL~MIN. DROP IN WATER LEVEL-INCHES RATE MINUTES PERIOD 1 PERIOD2 PERIOD 3 PER INCH P- P- P- 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 the surface elevation at all borings and the direction and percent of land slope. 13 OF /~r 4l T X ~4 ~-T7c~~l SS~/~}-zL G~~ ,L X ~~.T y SYSTEM ELEVATION 7. 3 AO/V /7 F E /V 0T _ - - , (13 5,f 7 ~9 i its q'S ,S 7 _5 A 4, 13 Z_le s I, the undersigned, hereby certify that the soil tests reported on this form were made by me in 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 (printl: TESTS WERE COMPLETED ON: NOMESITE TESTING CO. f- P.-" ADDRESS: RT.3, O'NEIL ROAD CERTIFICATION NUMBER: PHONE NUMBER optional): 0.,) 3F6 -211!1 CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - ` r s°r°Cf3 dsaCrS Ca ~P. at7ll fit., rr , v C3'~~C??9 1 ~ 4;1,9 .z ~<#€a e ~ rat s-`i nuCT13l-wr of [))n 3?`cmi)-i'a .3£ - jhe pit iy at q x oxr s. ICE I s : A BL t) t ii o` t)LEi OIJI € BASED £.ON ITIC EASE M ¢gas€ hl CIESctip" , Is y, it test I~rca'?;,ifons, ta ?C ~„,t, ~iads? locating - c l'ekt Ss f t i tl"YI 1 a C. i r nib e s ca t k £ t -4{' t _Ets~ a,`£ (i ai p - i.i1 gir orp iatc, ti,axcs as to LdL~,S, E r 33 ~'~t iCltA~ t~ s ,)od ri „ T data, p £,I .olat lcrl t.£ ~ I "I A. n taias ~ a < ;<< 3 _ l~Intn a is ; as r?cryl grain, €,k vation? ("O "is riot pp y, j z e) 0"A'I S, S sand L { ' T.I'tox 9C'ci VO "e11 2Jq - But ; , tsapd h= a i 3g Y Y - sal'id y t~-Ji - - i!v C kw 3eCi is ?I'z 1, 5t ,E;t s j c : y ,s I?? t+ho fi(+. s=t)l tri s `h---, , .t of plans for Lh(,, t}°. I (;~;.€3qj i £ , %'t~fTS ti7g s EoC"r`1l HOMESITE SEWER & SEPTIC CO. Route 3, O'Neil Road • Hudson, Wisconsin 54016 • (715) 386-8185 ' SMALL COMMUNITY TREATMENT SYSTEMS • ON SITE COMMERCIAL TREATMENT SYSTEMS ON SITE RESIDENTIAL SYSTEMS SITE TESTING & EVALUATION - PLANNING & DESIGN - COMPLETE INSTALLATION COMPLETE MAINTENANCE SERVICE v ' jA C 6 2-k- S., L` yC;e_ / i - R~II~'~- I~~r j~ SERVING MINNESOTA & WISCONSIN Certified, Minnesota P.C.A. Certified & Licensed Wisconsin D.N.R. and D.I.L.H.R. REPORT ON SOIL 80~1;~ PER COLATIC)tV T-Ez--:)TS PLo T PLAN PROTECT U. D. Der- OZ -~j /3v/r7' % I10MES 'ITE TESTING Co. 0'jN1-aL ROAD BO.B Ul,1', ' PROP05ED HNSE MOST LIF Z.' Fr ",1.41 , 1-4 7-Z-5r 15,PE,45, 4,t Te~`sT r9~'~~95 &-X,sr.,) G- zveLL X ~E.QG /OCg~'/d~lf s f/Avp R v g EAev o,e Sl v~lfL 13, 0, ee S yv,Piz . 13M R~ F u c p V£RTicAL 6-,eAu;r~ 5~ T 7 Sau a LE GE M !V c'/1 G o% L (l U tl v~ A - N ~ p o CY o G Ecy _ 60, l3 r f J g~ 133 Y3 x ^ ` f moor 3 Wl~Qt ,r'F,VCG L~%tl,~ ~ . 4 t, L i •r ' `t ) s r SLi ..1 c, Q . 4 ~I 6 t v ct. v M ~ ~ c.. C ,J v ~ v • n 4e H ~ V ~ to V V r Ilk, J ti ~l J •