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CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road ' Hudson, WI 54016-7710 (715) 386-4680 76 -m i May 5, 1995 ~b"~1'~' Ms. Mary Gall 775 130th Street Roberts, Wisconsin 54023 RE: Water Results for Residence Located at 1009 99th Street, Roberts, Wisconsin Dear Ms. Gall: Enclosed is the original test results from Commercial Testing Laboratory, Inc. for water inspection of the above property. If you have any questions regarding these results, please do not hesitate in contacting our office. 'nc ely, ames K. Thompson Assistant Zoning Administrator mz Enclosure COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 800 - 962 - 5227 Cj!:: FAX-715-962-4030 Si.CROIX CTY GOV*LTR REPORT DAi'E1 5/01/'> 1141 CARMICHAEL ROAD LOCATION: 1009 99th st., Rcoci COLLECTOR: Jim Thompson ate` DATE COLLECTED: 4-25-95 TIME COLLECTED: 3130pm SOURCE OF SHNI''sra J . 7 C.i {'j DATE ANALYZE[[ 4 2 - W TIME ANALYZED a2.00Nsr; COLIFORM,MFCC11J~~~ J~ INTERPRETATION: Bacteriologicai.ty SA'. 3 ppm Above 10 ppm exceeds the recommended Public ~~JU OF.\NDEP FNpFNJ J O O ~ d ~ A J 'd y 1n. PROFESSIONAL LABORATORY SERVICES SINCE 1952 ST. CROIX COUNTY WISCONSIN ZONING OFFICE pNNI1g1101111 ST. CROIX COUNTY GOVERNMENT CENTER .L 1101 Carmichael Road r Hudson, WI 54016-7710 (715) 386-4680 May 5, 1995 Mary & Joseph Gall 775 130th St. Roberts, WI 54023 Dear Ms. Gall: At your request, I have conducted an inspection of the septic system serving your residence located at 1009 99th St. in the Town of Warren. This inspection was conducted on April 25, 1995. While conducting this inspection I obtained a water sample from the property and submitted it to Commercial Testing Laboratory for analysis. The results are enclosed. The system appears to be a below grade, gravity fed drainfield which does not exhibit any outward signs of malfunctioning. However, you have stated that the property has been vacant since February of this year. I assume that the septic system has not been used since that date or if so, has received very little use. In trying to determine the condition of the system, a thorough evaluation would require that we observe the system while in operation. The system's lack of use would mask any apparent evidence that the system is not working properly. Accordingly, I cannot conclusively state that there are or will be problems associated with the system. Based upon the above considerations I cannot warrant that this system will function properly when used on a daily basis. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of the system. It is recommended that the system be pumped once every three years when in use. The prolonged life of this system may be dependent upon proper maintenance. Should you have any questions or concerns that I can clarify for you please feel free to contact me. Sincer 1 es Thompsoy Assistant Zoning Administrator cc: file 91 ST. CROIX COUNTY WISCONSIN _`L ZONING OF MWE nrrST. CROIX COUNTY G~*{f C t 1101 CarAad1 Road Hudson, 164016-'710" (71)11`m-469b- m-469b-' Vol f SEPTIC INSPECTION / WATER TEST REQUEST,FORM Please specify desired test(s) & remit appropriate fee with application. Outside water lines are often turnect.off during, winter months, making access to the home necessary. Please--make arrangements with this office to insure that entry can be gained. _7 l D j ~tC ❑ Water (VOC's) $185.00 ❑ Septic $50.00 ❑ Water (Nitrate & Bacteria) v/ 45.00 ❑ Nitrate & Bacteria / retest $15.00 Owner: Requested by: d,4 :1 ~~a& Address: /0 - Q 1& Address: -77 - / J 0 9 ZIP fu C4 6 4 ZIP Telephone N4: ( ) Telephone N4: ( l.$") 749- (s _S_ Property address (Fire W & Street) 6( S f; Location: Sec. l T1,- N, R W, Town of (U/~/2~~V Realty firm: Din%%►Lock Box Combo: Closing Date: A,' lTO BE COMPLETED BY PROPERTY OWNER PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORMS Water sample tap location: Is the dwelling currently occupied? ❑ Yes XNo If vacant, date last occupied: 7',6 119S- Age of septic system: 1;, _ Septic tank last pumped by: f i- Date: Previous Owner's Name(s): Have any of the following been observed? ❑Y ~N Slow drainage from house. ❑Y NON Sewage Back-up into dwelling. ❑Y ,5rN Sewage discharge to ground surface or road ditch. ❑Y JTN Foul odors. Other comments relative to system operation: I certify that the above infor ation is complete and true to the best of my knowledge. OWNERS SIGNATURE Y~C JC'S' L DATE: I0I OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION IN z 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: [below grd ❑At-Grd []Mound Approx. size /_2- ' X 52` ~ 2am>rvity []Dose []Pressurized Ft.' ed []Trench []Dry Well []Holding Tank ❑Outfall pipe OBSERVED DEFICIENCIES []Other []Unknown Septic tank Setbacks: []House CT/< ❑Well~ []Prop. lin~y~[]Other D s nk Setbacks: []House []Well []Prop. line []Other []Locking cover []Warning label []Pump/Floats []Alarm []Elec. wiring Soil Absorption System Setbacks: []House j~~ []well U-MProp. line []Other ❑Ponding: []Discharge: =gypuP_ General comments: q/~/ 614,ZaAe C-1/ D. r INSPECTORS SKETCH OF SYSTEM LOCATION 0 Insq ector - Titl V r a AS BUILT SANITARY SYSTEM REPORT OWNER S TOWNSHIP t~V(~Yl"'~v~ -SEC. T .:'-1V-R ADDRESS ST. CROIX COUNTY, WISCONSIN. C? hsw~ WfS : 4v1 ~ Cfm SUBDIVISION LOT LOT SIZE J PLAN VIEW Distances and dimensions to meet requirements of H63 OW-E-VERYTHIN.G WITHIN 100 FEET OF SYSTEM I Ell r ~ - i - . 1 I di a e o thI Arrow - - - -1 - - SC L: I 1 I BENCHMARK: (Permanent reference Point) Describe: [,,'I-evation of vertical reference point: Slope at site: / c SEPTIC TANK: Manufacturer: ~ e Jc Q Liquid Capacity : /00C~ y Number of rings on cover - Tank manhole cover elevation: Tank Inlet Elevation: iJi Tank Outlet Elevation: PUMP CHAMBER Manufacturer: Number of gallons Number of gal. pump set or a cycle gallons; total capacity o distribution lines gallon: size of pump head; gallon per minute horsepower bran 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 pits feet diameter feet liquid dept seepage pit in et pipe-elevation bottom of seepage pit 1~ evation feet. SEEPAGE BED SIZE: number of lines wi th / length (_tile depth /4 SEEPAGE TRENCH: width length PERCOLATION RATE AREA REQUIRED1. AREA AS , i-r INSP. DATED PLUMBER ON JOB T_ LICENSE NUMBER ST. CROIX COUNTY WISCONSIN ZONING OFFICE A a x u n u r ■ - ,,,,,d ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road _ Hudson, WI 54016-7710 (715) 386-4680 February 16, 1994 Coldwell Banker ? / O y / G~ 126 Second Street y~ Hudson, Wisconsin 54016 3 6- ATTN : Don Sukowatey CAD T C -l1 y~j zj RE: Septic Inspection and Water Results for ITT Address: 1009 99th Street, Roberts, WI Dear Mr. Sukowatey: An inspection of the septic system on the property of ITT located at 1009 99th Street, Roberts, Wisconsin, was conducted on February 9, 1994. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. Also, enclosed is the original test results from Commercial Testing Laboratory, Inc. for water inspection of the above property. Should you have any questions, please contact this office. Sincerely, /s/ James K. Thompson James K. Thompson Assistant Zoning Administrator mz ` COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 i 800 - 962 - 5227 FAX - 715 - 962 - 4030 Ui OIX CTY GOV*CTR REPORT DATE; 2/1- 1 CARMICHAEL ROAD ;_;ATION: 1009 99th ;'7. "-LECTOR: Jim Thor... .E COLLECTED. 2-09- ^4E COLLECTEDI 2W, =RCE Of E ANAL '4E ANAL ' 1 FORM, MFCC 2 0 ERPRETATIONS BacterioToaicaLLY SAFE 1 pptt, hove 10 ppm exceeds the Dr i * i ng Water Standar 1 ~ J TECHNICIAN; Pam gary~ r oF,,NDEGENOF,yl. L ~ roved Lab Nor A +p 0 PROFESSIONAL LABORATORY SERVICES SINCE 1952 ST. CROIX COUNTY y ' / WISCONSIN ZONING OFFICE LINgN11NNN NNNNd ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 SEPTIC INSPECTION / WATER TEST REQUEST FORM Please 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 that entry can be gained. ❑ Water (VOC's) $185.00 ;W1 Septic $50.00 Water (Nitrate & Bacteria) 45.00 0 Nitrate & Bacteria retest $15.00 Owner:. Requested by:~~; Address: c;c, Address: ZIP ZIP Telephone N°: ( ) Telephone NQ: Property address (Fire N2 & Street) Location: 1 ' Sec. , TN, RW, Town of Realty firm•t Lock Box Combo: Closing Date: - ,S Ll n 1 TO BE COMPLETED BY PROPERTY OWNER *PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORMS Water sample tap location: Is the dwelling currently occupied? 0 Yes K No If vacant, date last occupied: a--!5 Age of septic system: Septic tank last pumped by: Date: Previous Owner's Name(s): Have any of the following been observed? ❑Y ❑N Slow drainage from house. OY ❑N Sewage Back-up into dwelling. OY ON Sewage discharge to ground surface or road ditch. OY 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: \-T\ DATE : -(7 ; 1/94 OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION 1N TO BE COMPLETED BY INSPECTION AGENCY System design &/or permit on file? []Yes ONo Soil series per SCS Soil Survey: sheet # Type of soil absorption system: []Below grd ❑At-Grd []Mound Approx. size 'X []Gravity []Dose []Pressurized Ft.' []Bed []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 []Locking cover []Warning label []Pump/Floats []Alarm []Elec. wiring Soil Absorption System Setbacks: []House []Well []Prop. line []Other ❑Ponding: []Discharge: General comments: INSPECTORS SKETCH OF SYSTEM LOCATION N Inspector Title A MEMBER OF THE SEARS FINANCIAL NETWORK i"M 1S1 CHOICE 1262ND STREET REALTY, INC. HUDSON. W154016 BUS.(715)386-3942 FAX (715) 386-6741 ~q,9o0 PRICE: jj_9-z-j~ ADDRESS: 1009 99TH ST. ROBERTS i I ~ II f'f~ /~y I Al,~, 7 I °T 1 I yy I l ;fir ,r.~ 3A 71~J 1 t aA I T' tllfl!'~ ,Da ~ r at4Pt sc . k' r,1`" y '~-s. 4%4 DIY e `+§,G' "l x is ''+'a+b x I Y M1 fQ ~~,,a,jy „ems o'~^r S_ yNlA* T" R J ~~'I~ .N ~ Ac r'~ 4~ ~ I I ~ h~.7d ~a r a h'S~ ro~~1 Q "~a'"a t Y-. *Cr.~.°°~ vk r d, 1 1 d a x'~ a I .~7 rr, 1 °t ~ari n .d ~'7~wq`~ .yt a t'4 7 ~ n e4 ~n `I Eba.$tic I - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1 HIGHLIGHTS:Large 3 bedroom ranch style home located 4 1/2 miles east of Hudson. Built in 1981 by Charles Cudd Co. Bea.(_itiCul fireplace in Living room with Oak mantel, screened in proch, hobby room main floor Private location on 14 wooded acres LOCATION: DIMENSIONS: MECHANICS: 194 East to Highway LR: 18 x 12.2 TOTAL SQ. FT: 1118 12 take left on cty. DR: 9.5x 10.7 HEAT:j"lect. F/A Rd. A go North to KIT: 9.5x 10.9 TAXES:2671 -1992 McCutcheon turn right MBR: 13.2 x 10.2 LOT: 14 Acres go East to 1.00th stay BR: 10.1 x 9.1 SIDING: Cedar to left to 99th turn BR: 10.6 x 11.1 APPLIANCES:Rang_e BR: Refr.i-g, Drapes FAM RM : HEAT COST 1 "'~o - tS c FINANCING: ADD FAM: SOFTNER: PORCH : Screen Porch GARAGE:None MASTER BATH: FIREPLACE:Yes YEAR BULIT 1981 BROKER: DON SUKOWATEY OFFICE: (715) 386-3942 Information is considered accurate, but we. Car: (715) 425-1884 accept no liability for error. Listing may HOME: (715) 386-6790 be cl4anged or withdrawn without notice. An Independently Owned and Operated Member of Coldwell Banker Residential Affiliates, Inc. MLS Parcel 042-1048-70-000 04/20/2006 08:18 AM PAGE 1 OF 1 Alt. Parcel 18.29.18.273G 042 - TOWN OF WARREN 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 - SCHENDEL, JEFFREY D & SARAH J JEFFREY D & SARAH J SCHENDEL 1009 99TH ST ROBERTS WI 54023 f Districts: SC = School SP = Special Property Address(es): = rim Type Dist # Description ` 1009 99TH ST SC 2422 ST CROIX CENTRAL / SP 1700 WITC Legal Description: Acres: 5.526 Plat: N/A-NOT AVAILABLE SEC 18 T29N R18W NE NE THAT PART OF NE Block/Condo Bldg: NE INCLUDED IN LOT 1 CSM 4/1112 5.526AC 1/4 ASSESSMENT INCLUDES P112D Tract(s): (Sec-Twn-Rng 1/4 160 18-29N-18W V,2 b~ ` i Notes: Parcel History: L / Date Doc # Vol/Page pe 07/23/1997 1123/568 WD 07/23/1997 1070/173 WD 07/23/1997 1046/521 SD 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/22/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.526 50,000 133,200 183,200 NO Totals for 2006: General Property 5.526 50,000 133,200 183,200 Woodland 0.000 0 0 Totals for 2005: General Property 5.526 50,000 133,200 183,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 115 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 042-1019-90-000 04/20/2006 07:43 AM PAGE 1 OF 1 Alt. Parcel 07.29.18.112D 042 - TOWN OF WARREN 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 - SCHENDEL, JEFFREY D & SARAH J JEFFREY D & SARAH J SCHENDEL 1009 99TH ST ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE SEC 7 T29N R18W SE SE THAT PART OF SE SE Block/Condo Bldg: INCLUDED IN LO 4-Of-Q~M 4/1112. ASSESSED WI 273G Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 07-29N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1123/568 WD 07/23/1997 1070/173 WD 07/23/1997 1046/521 SD 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 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 Parcel 042-1019-60-000 04/20/2006 07:42 AM PAGE 1 OF 1 Alt. Parcel 07.29.18.112A 042 - TOWN OF WARREN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner O - SCHENDEL, JEFFREY D & SARAH J JEFFREY D & SARAH J SCHENDEL 1009 99TH ST ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC k~ Legal Description: Acres: 9.151 Plat: N/A-NOT AVAILABLE 5~n✓ h SEC 7 T29N R18W SE SE, THAT PART SE SE Block/Condo Bldg: l INCLUDED IN LOT 2 CSM 4/1112 ASSM'T INCLUDES P273A EXC THAT PT OF PARCEL Tract(s): (Sec-Twn-Rng 40 1/4 16 DESC 973/134 & EXC PT TO PARCEL DESC 07-29N-18W 1070/186 Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 .1 123668 WD 07/23/1997 1070/173 WD 07/23/1997 ''1•N&6 f SD 07/23/1997 973%134 SD 2006 SUMMARY Bill Fair Market Value: Asses 0 Valuations: Last Changed: 10/19/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 9.151 27,500 0 27,500 NO Totals for 2006: General Property 9.151 27,500 0 27,500 Woodland 0.000 0 0 Totals for 2005: General Property 9.151 27,500 0 27,500 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 I REPORT O INSPECTION - INDIVIDUAL. SEWAGE SYSTEM Sanitary Permit1 State Septic DAME - - T0WNS111P _ St. Croix County i,()CATION Section/I Lot iI Subdivision RP''1T . 7 C TA>N~ Size gallons Number of compartmentsi-_- Oistance from: Well Building - ! _ 12% slope Highwater PUMPING CHAMBER - - - Size gallons Pump Manufactu er Model Number IIOLDI_NC TANK Size gallons Number of om artments Pcimper Al~rm, System 1) i stance f rom: We11 4 Bu,%ilding_ - 12% slope - Highwater \BSOIZPT'ION SITE Bed Trench c, instance from: Well_ Building 12% slope Hi ghwater --J _ - ABSORPTION SITE DIMENSIONS / Width of trench ft Regi!_ -urea f t Length of each line ft Depth of rock below tile in. Number of lines- Depth of rock over file in. Total length of -lines ft Depth of the below grade in. Distance between lines L( ft Slope of trench, per 1.00 ft. i Total absor.tptton area - ft Type of Cover: PIT DIMENSIONS Number of pits Gr0we around pits ----yes.- - no Outside diameter ft I-"Depth below inlet ft i Total absorption area ft Area required ft I NSPEC`CE1)--'6- 7 ';~~X APPROVED - DAT'I: / (c?.- - - 198 RI?.IECThD DA'I'S 198 REASON FOIL REJECTION APPLICATION SAFETY & BUILDINGS DEPARTMENT OF INDUSTRY, 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% 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. The owners copy or a legible reproduction of the soil test report must be included. Property Owner: Mailing Address: roperty Location: City, Village or Townshi County, jd~ NCR ' of Number: Blk No.: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number: l C 5w\- (If assigned) i TYPE OF BUILDING Number of ❑~Public* ❑ Variance* ❑ Other (specify)* Bedrooms: PN y1 or 2 Family *State Approval Required. j TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY i ~J X HOLDING TANK CAPACITY I LIFT PUMP TANK/SIPHON CHAMBER & ,do MANUFACTURER: I EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): ;S New ❑ Replacement ❑ Experimental Seepage Bed ❑ Seepage Pit e I "s 1:1 Alternative (specify) ED Seepage Trench ~i'y~ Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): 9 Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of PI tuber: Signature MP/MPRSW No.: Phone Number: Plumber' Ad ss: Name of Designer: J COUNTY/DEPARTMENT USE ONLY ign t E. of Issui g eft: Fee: Date: APPROVED Sanitary Per i/Number: ~p g mar ❑ DISAPPROVED v ea on for Disapproval: Alternate course(s) of Action Available: i 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 (N.03/81) /OAGC-1 of= f~s1(r~S DEPARTMENT OF - R ORT ON SOIL BORINGS AND SAFETY & BUILDINGS ,INDUSTRY, DIVISION LABOR AND P.O. BOX 7969 Ef(COLATION TESTS (115) MADISON, WI 53707 HUMAN RELATIONS CO n~ Z LOCATION: SECT NSHIP/MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: - 11 A1W r~1lX~ 1c? Tl y 0_1 r) ~~/~E~I/ ~PvN s A//s~.~ f/E•v~ YE,c~ MAILINGADDRESS: COUNTY: OWN BU . Sf • l~4/~{ ~D 7*F-S~j ~~~17.J~' / ~~~X9.ul~E~ ~Gf' • /t~d,dt~°T~ CC!/ S USE DATES OBSERVATIONS MADE TONS: 1PERCOLATION TESTS: NO. BE J%AV~ rQA& IA ;YIJ ESCRIPTION: 0O New DESC Residence 21 I' r CONew ❑Replace :YLuLI/ 23 1~ JO L/ RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: JI L HOLDING TANK: RECOMMENDED SYSTEM:(optional) s ❑u ©s ❑u ®s ❑u ❑ s au ❑ s ©u If Percolation Tests are NOT required DESIGN RATE: SYSTEM EL V. I If any portion of the lot is in the under s.H63.09(5)(b), indicate: 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.) 4 Ga Z 34 4/8"j, 5C f g,.- di'S r i Nc r 40 - t c.o+.w- C'4 Al .,,y. B- 0 1 rc , a " G . A") oof. s po 6e L 7~ l 9 1 FT B- a 'La - 5" 44 o c Kc 5C L /a 4-1. CA.) . Sc L Z-ow '""14- /'•u - p"p. ~fa¢s fg t' 70 S- B 3 7Z 013,, SiL, z~ "L,t13.0- : 33 Q/P 5L /L" &/•8+V• SC J0 '.S rl u c r- "to C p Av w~P o. No T B- T 7e0 72 PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD1 PERI002 PERIOD 3 PERINCH P- l Z norms 20w y4 X0 Ew /3 P- P- L P- _ P / / w -P P PLAN VIEW: 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 a d show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slop. _7/= 4 Rev. of UEiQT. ~E /C, P j = for r ~ 144,v i3o rta-i °E 13Ep Si<&zt SYSTEM ELEVATION Ar RN tcu. e ; , • N x ' 1 _ I I ~ I I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wisconsin Admimistrative 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- A,96 6,Ck -2411h'l 4 7` Z s / 0/ ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER optional): ~v~jL • yv~sQA.) kj3 d a Y,?2- ^'F/'F C SIGNATURE:::eIZ DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. DI LHR-8B D-6395 (N. 03/81) P7R OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AN P.O. BOX 76 HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 LI ,/~/,{j SECTION: ~Z 1~~ (or) W ITOWNSS M UN PALITY: LOT NO.: BLK. NO.: SUBVIS)ON NAMCOUNTY: T O/WdN`)ER'S BUYER'S NAME: ,l MMAILING ADDRESS: T/J !/7f X17/ USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: R TONS: JPE❑Residence 7 j ❑New ❑Replace I RATING: S= Site suitable for system U=/Site unsuitable for system CONVENTIONAL: MOUND: ''II IN-GROUND-PRESSURE: SYSTEM-IN-FIII'LL HOLDING TANK: RECQM~MENDED SYSTEM: (optional) OS OU OS ~Y OS [:]u OS ~Y El S El U / If Percolation Tests are NOT required DESIGN RATE: SYSTEM EL I If any portion of the lot is in the under s.H63.09(5)(b), indicate: 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.) B- 72- /ov' L F J Z s", L>' AM Si'L y " cl /3 -6/. 1,-4 B- Fr. o>~L_ ~O„ Sic f ~~'.13a S;/_ - L rl z Z2„ L1•/3~, -oR . 5 L . 20" & B 1•11AJ- 5L wjd(. Few- fa 1,., - Low C #AA Af A- /,jAj. /ko s A T ( O B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD t PERIOD 2 PERIOD PER INCH P- P- P- P- P- P- PLAN VIEW: 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 slop. /Ydi4~ 1 p/~apast a /fd,yt "et SYSTEM ELEVATION J c_ ,GRo.~r _resr _ t~E~ M 051- 444_ P1 To r ~ TN 1tv 13 13 T 5 LOT #Z Gar f,;t- / z ` ,Qo. Difr.~ I 30 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wisconsin Admimistrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): /o 1-7 r TE TS W 25- M /f E /ON: ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER optional): vDSca,v 4V/'5'- 3 yai y°5 =o~y~'2- -~r~s- CST SIGNATURE: DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. DILHR-SBD-6395 (N. 03/81) ~t `tea` I i - fs- / T \ \ I\ n to LA t C ~e n ~ (L ~ i Eft x.1.5 Rev. 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS 2- 3; WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATIO ~f~ % W ' ^ N' " /o, Section ` f! N,R/ E (or) W, Township or Municipality Lot No.Block No. County S)l Gt 0/ u 'k4sion Name Owner's/Buyers Namee,:/ llek Mailing Address:- I ~ 4~ 4:1 TYPE OF OCCUPANCY: Residence n No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW X REPLA EMENT p ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS SOIL MAP SHEET NAME OF SOIL MAP UNIT PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TESTTIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 P 2 PERIOD 3 P- P- P_ j - P- pfr P_ SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B- j it'fi iv,Ep Gtvz i LO~itT~~ B- B_ yy „ „ /~6.J. sfL ~jAl -~y'. .j,L ' Zy. B- O • ~L G~` S SD S* ;Z PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy Indicate scale or distances j. Give horizontal and vertical reference points. Indicate slope. c OF Sly - - Ixlrc~ RPPrQY . Qi I-let At'-~j 46 •¢,1 30 ZY S~ 4574,4If -7 *G'~Rep { ~r,ur•o,~- ~i'S ~ivc:7` Gocv c ~ tijr9-- ~ , h / ` w~ e3 N i Ae' S Q- l I 41~ ke, (6) Rz:PA?o 7 -7 , I, the undersigend, hereby certify that t e soil tests repo ed on thi form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. Name (print)_1~~ Certification No. Address rrL-/T 3 tJ. 4W Name of installer if known - i Copy A-Local Authority CST "S 258.09 - - - 210.0 4 184.84' 403.07 a^ Lc) 00- `c~~ I12 F _ (M ~ 473~13y-(~ 112 A • '',moo SE /r - SE /r4 OD 112 C wu` 101,, 129 112 6 - S L DT 2 0 29742' ti LOT 4 N i II"2 E L 242.47 \ LOT 3 LOT I Z \ \ ~ 112 D SE \L ! J I< T p) G. 200 SEC. L 8 2 15 0 973 134 a i o 273 1 SEC C 74 A ~s. ~,j 273 G 273 C v~ 999g LOT I h 3 V01 / I PG \ j 273 F 2 ` ' 263 \ 40 2 73 E i \ 273 D \ N$ 114 - NE l/4 - 4 i1E. - - Cr G~~ viz by y rod-i z ` 9-7 31 /0-6 t,> T) 164 ~ 3 t~'I I 0 f