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HomeMy WebLinkAbout020-1134-10-000 0 w o C v n d _ 1 o f c d o ' o 3 v m CD c til • m # iD C/~ ^ 3 _ \ 1 3 # '1 Q n N O O CD C O° • 3 CL N ° - (D Q ST 'n N c O CD 0 w O W "h 1 N CD w A N 5 7 O t_ CA O CD = CD s O O rn 3 c° o o° w to c LU CD CD Cn C: CD C CD N W 3 O 7 (D N N CD n ~K co co a o r cn CD 00 0 En co to 2 cn O r- AF~ v v o w Uz O O O ? . y N trl 0 3 cn fn Vl U N M Q j w n~ m (DD N is 7 N r i rt a N I z co Z a W D CD j a w p m O 1 ° m m A+. _ N C N N C w CL r a 3 y z rN\ pnj d A z o U 8 0o v m p a z 3 A r 00 r: m co N z CD w ~ x D C, i ~ a N o OOn ~ c w z p N O CD w N CD O y O v b CD S Cn O I ~ t j > W N O O ((DD A n ~ N O O ti O 4 a ST. CROIX COUNTY WISCONSIN ZONING OFFICE } ST. CROIX COUNTY COURTHOUSE 9-11 F6ttR - TREET ♦ HUgSON, WI 54016 3A,6-4680 SEPTIC INSPECTION / WATER TEST REQUEST FORM Specify desired test(s) & remit appropriate fee with application. Outside water lines are often turned off during winter months, making access to the home necessary. Please make arrangements with this office to insure a time when entry can be gained. ❑ Water (VOC's) $185.00 (Septic $25.00 ❑ Water (Nitrate & Bacteria) $35.00 (Visual inspection) Owner: L r! J ~ hequested by: j ` Address: / t,011) u a1 ddress : t--11 c~_, City & State:,' ttD_;6z~-; City & St. , Zip Code: Zip Code Telephone N°: ("7/5'~ 'telephone N°: Property address (Fire NQ & Street Location: Sec. T N, R_L~_W, Town o f UnSjsj),\ St. Croix Co., WI. Tax ID N2 Parcel- D N2 S-1 House color: _ Realty firm: Lock Box Combo: Water sample tap location: TO BE COMPLETED BY PROPERTY OWNER *PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORMS Is the dwelling currently occupied? Yes ❑ No If vacant, date last occupied: Septic system installed by: Year: _j Septic tank last serviced by: L 1G/ r,tS 69?r- Date: 7 l~ - `_5 Previous Owner's Name (s) : 7.v z `3c 1?1A yy;a,,e-r Have any of the following been observed? ❑Y -15N Slow drainage from house. ❑Y -NN Sewage Back-up into dwelling. - ❑Y 40'N Sewage discharge to ground surface, / road ditch or body of water. ❑Y gN Slow drainage from the dwelling. 3 -7 ❑Y ON Foul odors. Other comments relative to system operation: I certify that the above information is complete and true to the best of my knowledge. OWNERS SIGNATURE: DATE: 4/93 r s OWNERS DRAWING OF ROUSE & SEPTIC SYSTEM LOCATION t _ IN TO BE COMPLETED BY INSPECTION AGENCY System design &/or permit on file? []Yes []No Soil series per SCS Soil Survey: sheet # Type of soil absorption system: UB•e^low grd ❑At-Grd []Mound Approx. size 'X '7 Cgjavity []Dose []Pressurized Ft. Z ped []Trench []Dry Well []Holding Tank ❑outfall pipe OBSERVED DEFICIENCIES []Other []Unknown Septic tank Setbacks: []House ❑Well'~ []Prop. line' []Other Dose tank Setbacks: ❑House[]Well []Prop. line _ []Other -OLocking cover []Warning label []Pump/Floats []Alarm []Elec. wiring Soil Absorption System Setbacks: []House OWell ":OProp. line` OOther ❑Ponding: []Discharge: r),,, General comments: INSPECTORS SKETCH OF SYSTEM LOCATION 1 Inspector - ' 3. Title f 8T. CROIX COUNTY WISCONISM PLANNING & DEVELOPMENT PLANNING SOLID WASTE REAL PROPERTY ZONING 715-386-4674 715-386-4623 715-386-4677 715-386-4680 October 28, 1993 Heritage Title Co. 502 2nd St. Hudson, WI 54016 To Whom It May Concern: An inspection of the septic system serving the home of LaVerne & Mary Van Beek, located at 911 Willow Ridge Rd. in Hudson, was conducted on Oct. 28, 1993. This inspection was based upon a surface inspection of said system and did not involve any excavating or chemical analysis. Accordingly there may be hidden defects in the system not discoverable by this inspection. Most septic systems consist of a septic tank which traps the solids and greases from the sewage stream and then allows the remaining liquid to seep into a subsurface drainage area. Once the liquid reaches this point it seeps away by percolating through the soil surrounding the system. Failure is caused by the soil surrounding the system becoming plugged with microscopic bacteria and sludge, among other things, which form a clogging mat. As time goes on, this clogging mat becomes progressively thicker, allowing less and less liquid to drain away from the system. When this clogging becomes severe enough, liquid sewage is trapped in the drainage area, a condition known as ponding, and results in backup of sewage into the structure or the discharge of sewage to the ground surface. At the time of inspection, this system appeared to be functioning, but not at full capacity. I noted that there was sewage effluent ponded within the drainfield area. Because a systems failure is a progressive process, I cannot predict how long this system will continue to properly dispose of sewage effluent nor how soon the system will reach complete failure. With proper care, this system could conceivably last for several years. However, I cannot guarantee or warrant that this system will function properly in the future. In an effort to prolong the system's life, I recommend that steps be taken to minimize the wastewater flow from the house which enters the system. For example, repair any leaking water fixtures and/or replace them with water conserving fixtures, reduce time spent in the shower, wash clothes and dishes only when there is a ST. CROIX COUNTY GOVERNMENT CENTER 9 1 101 CARMICHAEL ROAD 0 HUDSON, WI 54016 full load, use a washing machine with a suds saver feature, etc. I would also recommend that you have the septic tank pumped at a minimum of once every three years. Should have any questions or concerns that I can clarify, I can be reached at this office between 8:00 am.- 5:00 pm. , Monday - Friday. Sincer ly, James K. Thompson Assistant Zoning Administrator cc: file 'Parcel 020-1134-10-000 12/13/2005 07:49 AM PAGE 1 OF 1 Alt. Parcel 18.29.19.651 020 - TOWN OF HUDSON 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 - GOTTSCHE, BRUCE L BRUCE L GOTTSCHE C - SHERRILL BILLY R SHERRILL BILLY R 911 WILLOW RIDGE RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ` 911 WILLOW RIDGE RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.570 Plat: 2624-WILLOW RIDGE 2ND ADD SEC 17 & 18 T29N R19W WILLOW RIDGE 2ND Block/Condo Bldg: LOT 42 ADD LOT 42 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 18-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 05/08/2003 720554 2234/279 WD 1048/286 WD 853/431 681/150 2005 SUMMARY Bill Fair Market Value: Assessed with: 92523 275,400 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.570 66,700 214,200 280,900 NO 05 Totals for 2005: General Property 1.570 66,700 214,200 280,900 Woodland 0.000 0 0 Totals for 2004: General Property 1.570 34,400 171,000 205,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 135 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 ` AS BUILT SANITARY SYSTEM REPORT OWNERS ~E Fd 111~1<C HW K TOWNSHIP &~O/L,) SEC . LX TdN-R/~W ADDRESS ST. CROIX COUNTY, WISCONSIN. 14 Lb SUBDIVISION 1LOT LOT SIZE PLAN VIEW Distances and dimensions to ineet requiremer-Its of H63 IHO41_ LVLRYT {ING WLTHIN 100 OF 5YS'11,11 w - - alul. e or, th, A row I d a tt _ SCAL.F - - 1~R7- BENCHMARK: (Permanent reference Point) Describe: 5 f3A 5r or o4~e--h 5fvo~L F,4w:r Fbs7° 5'r-t v br~x Elevation of vertical reference point: _IM., C7 FT Slope at site: Ir. 10 SEPTIC TANK: Manufacturer: %rxe-5 Liquid Capacity: /Occ Number of rings on cover Tank manhole cover elevation: ~sfl~ to Tank Inlet Elevation: Tank Outlet Elevation: PUMP CHAMBER Manufacturer: Number of gallons 14uuiber of gal. pump set or a cycle gallons; tota capacitdistribution 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 o pets feet diameter feet liquid depth seepage pit in e~ t pipe-elevation bottom of seepage pit elevation feet. SEEPAGE BED SIZE: number of lines _width 1,yJ length 35 the depth ,-~I?EPAGE TRENCH: width length PERCOLATION RATE 3 -----AREA REQUIRED 61e AREA AS BUILT INSPECTOR ~f iAA't'Ell - a ~ PLUMBER -ON JOB-- ~ ~7 - - LICENSE NUMBER DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUWAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 E CONVENTIONAL D ALTERNATIVE State Plan UD Number. Ilf assigned) ❑ Holding Tank E In-Ground Pressure E Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE. t L . BENCH MAR Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV c-r C~ t~ r S Name of Plumber. MP/MPRSW N. Count Samtary Permit Number. SEPTIC T NK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV. WARNING LABEL LOCKING C ` ".41V -S YES ENO ES NO BEDDING'. VENT DIA: VENT MATL. HIGH WATER NUMBER OF ROAD. 1PROEPERT1 WELL'. BUILDINGVENT TO FREFEET FROM IN' A AO AIR J IT LEr'T DYES ENO DYES NO NEAREST L DOSING CHAMBER: MANUFACTURER [EDDING. ILIGUID C PACITV PUMP MODEL PU MPjSIPHON MANUF ACTUR'ER RNING LABEL LOCKING COVER OVIDED. PROVIDED: EYES ENO EYES ENO DYES ONCE 11 fF V WELL BUILDINGVENT TO FRESH GALLONS PER CYCLE: UMP DCO NTROLS OPERATIONAL N M IL R '16 (DIFFERENCE BETWEEN F AIRINLET PUMP ON AND OFF) EYES ENOT SOIL ABSORPTION SYSTEM. Check the soi oisture t the depth of plowing €N-;TMATERIAL AND MARKING or excavation. (If soil can be rolled into a w We, cons, Liction shall cease until FORCE I j MAIN V the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH LENGTH NO.OF DISTR. PIPE SPACING. COVER INSIDE CIA LIQUID AL' PIT DEPTH BED/TRENCH QQ C TRENCHES ( X DIMENSIONS p, 7 GHA lr I)I P[ II FILL DEPTH UIST H. PIPF DISTR. PIPE DISTR. PIPE MATERIAL H NUMBER OF ~PL IHNOPEERTV E BUILDING- AIR NT INLET RESH BFI (Al P PI S ABOVE COVER EV INLET EL FEET FROM II 2 C "t(~i NEAREST--sl_ MOUND SYSTEM: Mound site plowed perpendicular to slop Chec teSctur of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: / m nd systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- eets fie cri fa for medium sand. TIONS MEASURED. DYES ❑NO// SOIL COVER. TEXTURE PERMANENT MARKERS. OBSERVATION WELLS I DYES ENO DYES ENO DEPTH OVER TRENCH. BED DDEPTH OF PSOIL SODDED SEEDED MULCHED CENTER EDGES fi DYES ENO DYES ENO DYES ENO PRESSURIZED DISTRIBUTION SYSTEM: T b'vID1 H LENGTH NO. OF LATERAL SPACING. GRAVEL DEPTH / LL DEPT ABOVE COVER OW i BED/TRENCH TRENCHES DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR PIPE MANIFOLD MATfc AL. O. DIST DIST PIPE IBUTION PIPE MATERIAL & MARKING FIFV.. ELEV. DIA. ELEV. PIPES DI ELEVATION AND i' DISTRIBUTION _ HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVE MA RIAL VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION PLANS DYES ENO OYES ENO COMMEpITS: PERMANENT MARKERS OBSE VTION WELLS XFEIT BER OF PROPERTY WELL BUILDING').l' FROM LINE 5. ❑ YES ❑ N YES ❑ NO REST- q 7% 55 I J 13.0 1 112. 5 SJ~ ti C t2, q +31 ti'L I .2 okq ' S 13.11 Sketch System on 3.ILO Re in in county file for audit. Reverse Side. SIGNATUTU R_- `DILHR SBD6710 (R. 01/82) r DEPART AAENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABo,R & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.0. BOX 7969 BUREAU OF PLUMBING MADe1SON, Wl 53707 CONVENTIONAL ❑ALTERNATIVE State Plan l.D.Number: (if assigned) El Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.. r ~ j J} 3 j Name of Plumber: MP/MPRSW No.i county: Sanitary Permit Number: tA (A SEPTIC TANK OLDING ANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: DYES ONO DYES ONO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM: FEET FROM LINE: AIR INLET. DYES ONO OYES ONO NEAREST DOSING CHAMBER: MANUFACTURER. BEDDING: LIQUID CAPACITY PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: DYES ONO i 1 DYES ONO DYES ONO GALLONS PER CYCLE: PUMP AND CONTROL OPERATIONAL. NUMBER OF PROPERTY WELL BUILDING. IVENTTOFRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) OYES ONO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH IDIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: _TN_0_.75_F______T_ J ATERIAL: PIT INSIDE DIA *PITS LD PTHD BED/TRENCH WIDTH LENGTH THENCHES UISTR, PIPE SPACING MCOVER IIQUI DIMENSIONS GRAVEL DEPTH FILL DEPTH UIIT PIPF DISTR. PIPE DISTR. PIP MATERIAL . NO. DISTR. NUMBER OF R TY WELL BUILDING: VENT TO FRESH BELOW PI PIES. ABOVE COVER ELEV. INLF 1 ELEV. END PIPES FEET FROM LINE: AIR INLET. 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- D meets the criteria for medium sand. TIONS MEASURED. YES NO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS DYES ONO OYES ONO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL- SODDED SEEDED MULCHED CENTER: EOGES. DYES ONO OYES ONO OYES ONO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH LENGTH. NO.OF LATERAL SPACING (iHAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER. BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE IMANIFOLDMATEHIAL JNO. UI STH UISTR. PIPE DISTHIBUI ION PIPE MATERIAL & MARKING ELEVATION AND ELEV. ELEV. DIA. ELEV. PIPES DA, DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED COHHFCTI Y C )VFR MATERIAL PLANS LIFT CORRESPONDS TO APPROVED LANS ❑YESLINO DYES ONO COMMENTS: PEAMANENTMAR K E FI: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING. FEET FROM LINE DYES [--.]NO YES ❑ NO NEAREST _ Sketch System on Retain in county file for audit. Reverse Side. SICiNA TUNE TI LE DILHR SBD 6710 (R. 01/82) DEPAQ.TMENT OF APPLICATION SAFETY & BUILDINGS INDIJSTRY, FOR SANITARY DIVISION LABOR AND PERMIT P.O. BOX 7969 HUMAN RELATIONS (PLB 67) MADISON, WI 53707 Attach plans for the system on paper not less than 8'/2 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. Prop ty Owner: Mailing Address: 5 Ek'c? a.~..~ 2-31 13 j~' So vf~So >'S 5 yof (p Property Location: City, Village or Township: County: JJ! x 5,e % St -_%S l iT -2q / N/R /9 E (or c N 0j>5c) S? " Lot Number: Blk No.: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number: / / t;P 9- D0 &D (If assigned) N~ TYPE OF BUILDING KJ ! Number of ❑ Public* ❑ Variance* ❑ Other (specify)' Bedrooms: 5k1 or 2 Family *State Approval Required. -3 TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY ~j HOLDING TANK CAPACITY A1,4 LIFT PUMP TANK/SIPHON CHAMBER N14- MANUFACTURER: 112el C04)" _e_ OG K / EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): >4 New ❑ Replacement ❑ Experimental Seepage Bed ❑ Seepage Pit ❑ Alternative (specify) ❑ Seepage Trench Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber: Signa e: /MPRSW No.,: Phone Number: Z~s -7 1 Ac Plumber's Address: Name of Designer: COUNTY/DEPARTMENT USE ONLY Signa ure of Issuing Agent: Fee: 00 Date: p ®APPROVED Sanitariy+Permit Number: r r I ❑ DISAPPROVED ~J~ ,5 6 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) DEPJIST R OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INR.USTY, e DIVISION HUMAN RFDLATIONS PERCOLATION TESTS (115) MADISP.O. BOX ON WI 53707 (H63.09(1) & Chapter 145.045) LOCATION: - SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: Sc% '/a '/a /T241 N/R IqE (or) W /~t/ Stj COUNTY:, OWNER'S/BUYER'S NAME: MAILING ADDRESS: S et)IX aS ~t~ c~A,I 2- A So Vt - ~ UPSO 0., G~~► S .:S V61 (a USE DATES OBSERVATIONS MADE N.: COMMERCIAL DESCRIPTIO (PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence 113 1 .t/~ N: PQNew ❑Replace I ?6 r) / RATING: S= Site suitable for system U= Site unsuitable for system MM~~T-S_4`,CV /J CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) os ❑u ❑s au Zs ❑u ❑s ou ❑s au o4)otar.,a~~~ Be)) lpXis- If Percolation Tests are T required DESIGN RATE: -2- -55 S If any portion of the tested area is in the under s.H63.09(5)(b), indicate: /Q00"-1 Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) w -1*11,J,SL, /,k•' 434;./_ 5, 16z' 5~ lc~f`' ~e-Q,J CS F 4J. /dj r' 13'()'z- SI /(y tdxLyQ SG. z. V. LS B- > yJ' 3•'Pk-131)2/ .'134,L5, .25"O; , 5C 4., GS At;x . ~reE C>' - AS N . C's; ~r `S ,r " fl',v L5, 36 rr,O , L5, B- /Cr/yr } 90 3 •,D,f l3nY,L5j 2 .,13 N.Gs, 6o°Fat_-ai).cs B_ PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH P- T 46 C , c r3 / VA) 5 " P P- Do r s Acec) S5 ES ~,E'E r( i T~ P- Sri: S, 5116 of CooEp/ .'A) e5TiA1<4 7_1-P eLA. ,a P- / 5 4p, Hx 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 ysurface elevation at all borinnggs,and the direction and percent of land slope. &,-Tb,4 of 13L) 54,at t L iE E4 9t 7i-/ ~ rI `e7v- A j - 3, A r SYSTEM ELEVATION FT 7 F,r.- l1E,QricA/ PEf£vcE f_ Cf_rR~lu foP_ `NOME T,pEF ` • = ,8,9c,ildE /_~,Pc Pos r SST vExT To G G OAk l5 1VV /,V 0 AL L7 , 9~-a ID/ E ~ 14 f i` EN ~ ~ f~ovSE MvST" GiE Mo;PE l~a.t~ iT-j - *A4 . BEST` J3,etA. MlJSf 6rE' yoR~ t t r :r slow a 112-. 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): BOB VOURF l TESTS WERE COMPLETED ON: /V00 . 2-- ADDRESS: HOMEMTE ' -S' mq . CERTIFICATION NUMBER: PHONE NUMBER (optional): 'E"I. 3, O'NEIL MOAT) CST SIGNATU E: I DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. 'iR-SBD-6395 (R. 02/82) - OVER - -to and ~J~ h a ~ r ~'°S° 3•-"S1 i3.~Y fj 3~ Sf ~l F:~ 3vS ~ e 3 S C ~ _ t= v PL L A` "'bC. P ONO, t1' Csc a.i slmv,- . ar"d <rk=;. E i a P ! ~ r~ G ~7""r` t I a'C ,)(:E 1eE4; t'a =.F t3 WS 1 de, Ws ~ 1 Ff~ I iC"3r I c, L77 P21 50 i L Ti's t - /c~EG t y~RPr E~~~ct ~~~,JT /.S /3,gsc PL B (o7 raF ~Ep STEED ~ „ 055 z P1.0T and L. ~ Si /S /vim, p Fr ~ • r`~' , 0~ f - --.__y a ~Ut P Ric r - - - - _ _ 4? r r TC-5 T 19RV,6 S' . r , r r f A I-T~k'N/1TE~ oV4 y ,F, rr ,r r PjfO S267- 115 , A r evil/~cJ ~v Y2- 6.0. C-(3 r`S Fresh Air Inlets And Observation Pipe - Approved Vent Cap Minimum 1211 Above Final Grade i i~ 1414 Y/ 14 M 0 " Above Pipe 4" Cast Iron To Final Grade Vent Pipe fEURf led Marsh Nay Or Synthetic Covering 5e,' Min. 211 A re ate D ~ eo 9 9 g TOver Pipe f CT Distribution Tee Pipe 0 0 0 0 0 Aggregate o Beneath Pipe Perforated Pipe Below © Coupling Terminating At Bottom Of System