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CD m m 0 v o o= s o w J 3 a CD cD p ti p N CD dQ W 0 W yti O 0 'i ~ L ti Parcel 038-1096-20-000 05/26/2006 12:43 PM PAGE 1 OF 1 Alt. Parcel 23.31.18.400F 038 - TOWN OF STAR PRAIRIE 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 THOMAS G & KAREN L CAMPEAU O - CAMPEAU, THOMAS G & KAREN L 2017 124TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 2017 124TH ST SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 2.480 Plat: N/A-NOT AVAILABLE SEC 23 T31 N R1 8W PT SE SW LOT 3 OF CSM Block/Condo Bldg: 5/1318 AND THE N 25' OF LOT 1 OF CSM 2/494 EXC THAT PT CONVEYED FOR RD Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) PURPOSES IN 973/400 23-31 N-1 8W Notes: Parcel History: Date Doc # a e Type 07/23/1997 973/4 07/23/1997 8 300 07/23/1997 711/250 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/14/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.480 35,400 145,200 180,600 NO Totals for 2006: General Property 2.480 35,400 145,200 180,600 Woodland 0.000 0 0 Totals for 2005: General Property 2.480 35,400 145,200 180,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 222 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 p d ~1 v v v C CD 3 - # \ 1 • S 0, 0 v z ° N p~j W W c co CD m o c ro W p r W rn I s m w m v cn p ~ Q 0 o ° ro °o o C. c N N O0 m o N o p' m to ~ ~ tr _ o tv cn ( D m n ro a m ~ (D U) c c _ 3 0 °m °W L ~o j Z ro W W CO, O c w CO ED Z O O O !~1 o D < N Z. ~ Qf~ 3 z° D v I p' ro fD H j Cli J N ~ Cf O CD (D r'j N fD a W N Z j ZWZ / c v o D a D o ro ro N N to N ~ C (D CD co Q OZ D ,p Z f9 <n l0 s A Z O I v ~ O F! Z3 U 1 W M W ' z o U CWC N < W vQ ~LAJ ~D w a ~ E3 _ VV 3 o=i c Z O o m ro I a o fi I y Ar I ~y A ti ti i N o 0 ~ a I A (=D D O 0 w 69 O ti r O {G a 6 Q ti Parcel 038-1096-10-000 05/11/2006 08:45 AM PAGE 1 OF 1 Alt. Parcel 23.31.18.400E 038 - TOWN OF STAR PRAIRIE 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 - PRACHT, LYNDA LOU LYNDA LOU PRACHT 2021 124TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 2021 124TH ST SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 2.590 Plat: N/A-NOT AVAILABLE SEC 23 T31 N R1 8W PT SE SW LOT 2 OF CSM Block/Condo Bldg: 5/1318 EXC THAT PT CONVEYED FOR RD PURPOSES IN 973/396 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 23-31N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 12 5 TI 07/23/1997 973/39 QC 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/14/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.590 36,100 142,800 178,900 NO Totals for 2006: General Property 2.590 36,100 142,800 178,900 Woodland 0.000 0 0 Totals for 2005: General Property 2.590 36,100 142,800 178,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 313 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 r AS BUILT SANI'T'ARY SYSTEM REPORT 1 TLS N-"R/ W OWNER , rti -L TOWNSHIP Utz f J•~ ~.~,k. SEC ADDRESS ST. CROIX COUNTY, WISCONSIN. SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of h63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM i I di at N r h ~rrc w~ BENCHMARK: (Permanent reference Point) Describe:'// Elevation of vertical reference point: ILI ' -Slope at site: SEPTIC TANK: Manufacturer: L _ Liquid Capacity - Number Number of rings on cover -Tank manhole cover elevation: Tank Inlet Elevation: U Tank Outlet Elevation:/per PUMP CHAMBER Manufacturer: Number of gallons Number of-",gal. pump set for a cycle gallons; Total capacity of distribution lines- gallon: size of pump head; gall~ci per minute-- horsepower- ;brand name of pump and model number ; Type of warning device HOLDING TAN Manufacturer _ Number of gallons Eleva-t'ioon of manhole cover ; `-yp of warning device SEEPAGE P1j!---SIZE; _ -----,-Number of pits__ feet diameter few Iquid depth____ seepage pit inlet pipe-elevation ottom of seepage pit elevation _ feet. SEEPAGE BED SIZE: number of lines width length,',-)' the depth SEP BENCH: width - length PERCOLA`T'ION RA'Z'E AREA RE UIRED r- AREA BUILT INSPECTOR DA`Z'ED PLUMBER 0 JOB LICENSE NUMBER ~~l- C ~ - c ~%1 j ' . ~ , l~t~ i ~ ~ ~ i DEPARTMENT OF'INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 5d CONVENTIONAL ❑ALTERNATIVE State Plan l.D.Number. (lf assigned) E] Holding Tank ❑ In-Ground Pressure El Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE. Lorn Pracht RR#2, New Richmond BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV SE SW, Sec. 23, T31N-R18W, Lot 2, Town of Star Prairie Name of Plumber. MP/MPRSW No.. county Sanitary Permit Number_ Gary Steel 3254 St. Croix 38545 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY. TANK INLET ELE V.. TANK OUTLET ELE V.. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED. n A'kv /()I. 5. Q~. 2 YES ❑NO ❑YES ❑NO BEDDING: VENT DIA VENT MATL. fGH WATER NUMBER OF ROAD: PROPERTY , / WELL. BUILDING VENT TOO JFRESH d` L❑YES ❑NO INEARESTOM L ve w ~i 5 I IAIRyyLV YES ❑NO / aJ I !,C DOSING CHAMBER: MANUFACTURER. BEDDING JLIQUID CAPACITY PUMP MODEL. PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED. PROVIDED. ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PROPERTY WELL BUILDING VENT T FFRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) ❑YES ❑NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing NGnI DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE ILE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH LENG TH NO. OF _r7 PIPE SPACING. COVER INSIDE DIA xz PITS LIQUID BED/TRENCH / P,O THE HIS ( M IAL: PIT DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH IDISTH PIPF DISTR PIPE DISTR. PIPE MATERIAL. NO. TR. NUMBER OF PROPERTY WELL/ I BUILDING. VENT TO FRESH fi/}fyLElr BELOW PIPFS ABOVE I ELIV. INLET ELEV. END. C PIPE FEET FROM LIN Al V ,O /6179 P V - NEAREST------m-1 //l'~J✓~ 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. ❑YES ❑NO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH .'BED DEPTH OVER TRENCH; BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES. ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO 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. ELEV.. ELEV.'. DIA. ELEV.- PIPES. DIA.: ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED ❑YES ❑NO ❑YES ❑NO COMMENTS: PERMANENT MARKERS: JOBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE ❑YES ❑NO ❑YES ❑NO NEAREST Sketch System on etain in county file for audit. Reverse Side. r A_ A TE . DILHR SBD 6710 IR. 01/82) DEPAkTMENT OF APPLICATION INDUSTRY, , FOR SANITARY SAFETY & BUILDINGS DIVISION LABOR AND PERMIT P.O. BOX 7969 HUMAN RELATIONS (PL13 67) MADISON, WI 53707 Attach plans for the system on paper not less than 8'h x 11 inches in size. Include a plot plan that is dimensioned or drawn to scale. Horizontal and vertical elevation reference points must be shown. All appropriate separating distances and physical characteristics as specified in chapter H-63, Wis. Adm. Code, must be shown. An index page or each page must be signed, sealed and dated by the designer. If designed by a Master Plumber, the date, signature and license number must be shown. A legible reproduction of the soil test report or the owner's copy must be included. Property 07er: Mailing Address: Property Location: Etp, Villnue or Township: County: 56 %SI0'/4S--- 3 /Te/ N/R JS A (or) W r~ I 'IS Lot Number: Blk No:: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number: YZ (If assigned) TYPE OF BUILDING Number of ❑ Public* ❑ Variance* ❑ Other (specify)* Bedrooms: ~1 or 2 Family *State Approval Required. TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER MANUFACTURER: 3 EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feed: C•New ❑ Replacement ❑ Experimental Seepage Bed ❑ Seepage Pit Jb ❑ Alternative (specify) ❑ Seepage Trench Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): V4-Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of mber: Signature: P 1'1mPRSW No.: Phone Number: Plur's A dress: Name of Designer: COUNTY/DEPARTMENT USE ONLY Si natyre of Issuing Age(np1t~: Daatt~ gppROVED Sanitary Permit Number: rj v V O LJ DISAPPROVED yam Reason for Disapproval: Alternate course(s) of Action Available: Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to in- stallation. Failure to comply will void the sanitary permit. DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber DILHR-SBD-6398 (R.07/81) horns - S T C 100 Owner of Property Yl C5' Location of Property_zSV1/ ' Section-3__,`'__3J_N KW Township- V PC -r Mailing Address 2 Subdivision Name Lot Number r~ Previous Owner of Property t' It p (k n~ ~,rs i,~ Total Size of Parcel ' Date Parcel Was Cx44"-ed of 1 p Are all corners identifiable? Yes No Include with this application one of the following: .Certified Survey Map .Deed .Land Contract, or .Other legal Document which describes the property PROPERTY OWNER CERTIFICATION 1 (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 de d recorded in the Office of the County Register of Deeds as Document No~-I ' ~Z--- ; 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 Co my R r of Deeds, as Document No. SI URE OF O NER SIGNATUR F CO-OWNER (IF APPLICABLE) 16 '111 DATE SIGNED DATE GPIE 0/ DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOIR AJN BOX HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 539069 (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNS HIP/?M17NT'CTPA-M-r/: LOT NO.:BLK. NO.: SUBDIVISION NAME: Se_.- 1/4-0/4 ~,7,3 /Tj 1 N/R 199(dr) W -7 COU TY- OWNER'S/.B _S E: MAILING ADDRESS: yz' !0 Z~ rv~ ,J .Gtr i , o /7 f- USE DATES OBSERVATIONS MADE 1 7- NO. BEDRMS.: COMMERCIAL DESCRIPTION: I~:' (PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence yehvew ❑Replace Il RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) S ❑U L,S ❑U - [AS DU D S C~,U D S a [un:d ercation Tests are NOT required DESIGN RIf any portion of the tested area is in the er H63 .09(5)(b), indicate: Flood plain, indicate Floodplain elevation: lm 011 i PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPT f_+i , ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 5-3 39 , b3 "v o~ 0 A.) 77- ,41 B-2 to z- no > r3 E , c 4b4 V B-3 ~`33~0/vim 33 Sv 5g yz 33 17~ ea 17 B 100 /ICU` /0'_4 B- 7ESi mom) i PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER ffd@FFES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD3 PER INCH P- ) '3 Y-Y ) 0 AC) P Z. L2- '3 7 /0 0 /0 3 ,3 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.i SYSTEM ELEVATION' _!x Ls+ 10 S, ~N 34` S~c E 1, 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: 04~ ADDR S: CERTIFICATION NUMBER: PHONE NUMBER (optional): t r1 I - ~CJ£7 L~~ tGZIJ~ CST SIGN E / DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil TeS,e DILHR-SBD-6395 (R. 02/82) - OVER - AS; Mac; nicks AK; L.twwAzfwu Fun To 1 cvnThnp am! as,, a , E u in o swl e< r L r H R SY,s @_W AME RULED ~ ~3, try Ofv' -,`,Jll_ ¢"'`INF) PLEASE an setf, , I It"i , pr.. ,x' , ~ t WK °ti`i W E "rt< t u ..`,i "iUs< r, s,;;Li we Yo€,"Cn" rianw, , . _ F "stn , a,p9_, cobvi n to" w, 51 qV0, r it ` °,5"; d N1, Or_E_ r'a ec s £m x"Y J<m3= 14 ~ e rr e7 t<. W O Nam am! strT r ..,_°W r wh t,_ V W0 m "K Ai, 1 fS' BP B F LS Lwvw~ t .rail, ` l (,i 1 P d h`, t 3 ' _ (many s inci Gam, Nywarn S"10 Kynv Sam B, CKV L; a,, slivy ~ ,t.1 Inn rs,ki`, W 01lie C ..Fir 'D .5w-rt ..nt any rvwSf .y , Ott, y,. V ` I N / SEp ~ ~pyScs. /n 5. E . 1 0~• S}~rrl~E, 4-w i ~ iv 2-, 17 Z- ? 1„ ~ 12yr K Gz-K i/ 954 I'!\f{ I MENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS ivUUSf ft Y, DIVISION IUMAN R[ LATIONS PERCOLATION TESTS (115) MADIP.O.SONBOX W 53707 M63.09(1) & Chapter 145.045) nt ATIgN SECTION TOWN HIP/MUNI(,IPALITY. OT NO.:BLK. NO.: SUBDIVISION NAME: /T.:/ N/R/~rE(o,) W - - - - - - ~1 - H IY1 , 1 OWNER S)/I1LJ Ft'S NA E: MAILING ADDRESS: t z_ 12 2, z2~~~ t= _ DATES OBSERVATIONS MADE NO,[SCDflIV1S,. COMIVICRCIALDESCfIPTION PROFILE DES~RIPTIONS: PERATIONTESTS: ttsidenle - /In-New ORe lace h k f ING: S- Site suitable for system U= Site unsuitable for system ,VI NTIONAI MO(JND IN-GHOUNDPRE`SURE: SYSFFM IN-CII.LFCof_: NG TANK. ECOMMENDED SYSTEM: (optional) " S DU I ~~_SU U_ _~_EI S MU 1 EIS Q0 ~R ~Ial wn Iests art NOl ret aired DESIGN RATE f It any portion of the tested area is in the ,J163.090)) (b) indicate: - Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS ,Iluvt; fO7At )_LPTIi 1-0 GROUNDWATER INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH Ivnsl It Hl.I ILf Il~t, ELEVATION OB-EI'?VFD f`>T. I-1161-iES.I" TO 13EDFiOCK IF OBSERVED (SEE ABBRV. ON BACK.) -~v ILL, - - - i- I) cl ly,PERCOLATION TESTS TEST DEPTH WATER IN HOLE TFST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES "JUIVIBEH fNCHES AFTERSWELLING INJERVAL--MIN. PE RT-OD1~ _ P~NIOD2 PERIOD 3 PER INCH I' I• LOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hor`t- ntal and vertical elevation reterenee points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent I Find slope- / '*YSTEM ELEVATION I I i i f ' 1 i r i I ~ I i I ~ I ~ i. ~ I ~ 1 I I I I 4 i ~ 1 uniJ-r Igned• Hereby collity Ilan Ihn ,oil lest, iel,ort,al nn tlu, fotin vvere rrwde by nu: in accord with the procedures and ir,ethod, ol.,ecifiad In the Wisconsin ~ni,n :~~ivi. Cotlu, ❑n~J that Ih,. dal', wco'da"I "'0 tin: n..:'IjU- of OLr, tests a„• cot t to the best of my knowledge and belief ~T6STS WFHE COMPI F I LIJ ()1\, ' it. F H I Il litj', I MN iV ilvl!;r 11 ~ ItJI ~?t-~~•~pi;~,n•tll.~ Icsi ~•~>~riiltr: ~I nnl •u,~l i i , ~i, X11. uUN~i '~y ~)vv nt'i .in~~_ I.. l P/\ [I I IVIf N"F OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS '.,~UU:;1FtY, DIVISION AfiOR AND PERCOLATION TESTS (115) P.O. BOX 7969 iUMAN RI LATIONS \ / MADISON, WI 53707 0A63.090) & Chapter 145.045) rx nTION , SECTION - TOWN~ HIP/MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: '/4a l~/4 N/R ,(1E(~t)W nJNT . OWNS S~BtJ fEFd S NARgE: MAILING ADDRESS 112 f DATES OBSERVATIONS MADE NO. BEDRMS. COMMf RCIAL DESCRIPTION. PROFILE DESCRIPTIONS: P eRCOLATION TESTS: JHesldence -7INew ❑Replace , tATING: S= Site suitable for system U= Site unsuitable for system (f~[N'TION-p1JNp-NGf\NLlPftfSl)RE TF_JS /E YSTEN1INl=11_LHO0INNK.fRECOMMENDEDSYSTEM:(optional) _1U _j t Percolation lestsareNOI 1e uired DESIGN RATE ~f j~f 4 If any portion of the tested area is in the let s.l_IG3 09(b)(b) indicate' Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS ' - NCI TO1AID PTH TO GROUNDWATER INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH 1r1P.1M-Al F4L.1 IH IN.. ELEVATION OBSERVED EST, HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) jq 7, i 33 j i ,':;I r~1t}I PERCOLATION TESTS I r' ;T I WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES 1ttNtItL11 INCHC9 AI I I WIELL.ING INI ERVAL-MIN. PERIOD 1 PEtj10D 2 PER OfS~ PER INCH tI' 1-OT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- ,mal 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 .f land slupc. >YSTEM ELEVATION I _ I r!U r,~y~F, ~r 'rC1 t u. L: /Q I , t ~ I ~ ! I t ~ f j I ~ ~1\ I I ~ ! I I ! ~ i I C I + i , I i I I i I i 1 I I ~ I 1 I I L ' . 1 I 1 the undersigned, hereby certify (11,11 the soil lusts reported on this forrn were made by me in accord with the procedures and methods specilied in the Wisconsin tdlnnlistraLive Code, and that the data recorded and he location of the tests are correct to the best of my knowledge and belief. - - - - AM[ (tl in( [ ) tJ TESTS WERE COMPLETED ON d)I)HFSS: / CEHI lFll A(ION 1JUMBER: PHONE NUMBERIoptional►: ]CST SIGNF1`URE: IISI IIIBUTION: 01 igmal and one c•ul)y to Local Awhnl ity, Property Owner and Soil Tester. ,11 Ill( SBl)-(1:595 (11.02/82) OVEH