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004-1034-20-000
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CROIX COUNTY, WISCONSIN Creation Date ate Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - KOENNING, DOUGLAS W & DIANNE F DOUGLAS W & DIANNE F KOENNING 3068 CTY RD N WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 3068 CTY RD N ] SC 5586 SPRING VALLEY SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 15 T28N R1 5W 40A NW NE INCLUDING ALL Block/Condo Bldg: LAND NORTH OF COUNTY TK N & EAST OF THE TN OF CADY ST CROIX CO CREEK Tract(s): (Sec-Twn-Rng 40 1 /4 160 1/4) 15-28N-15W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 946/21 07/23/1997 857/336 07/23/1997 796/352 07/23/1997 569/196 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/07/2005 Description Class Acres Land prove Total State Reason RESIDENTIAL G1 2.000 28,000 240,000 268,000 NO PRODUCTIVE FORST LANDS G6 18.000 54,000 0 54,000 NO ENTERED BEFORE'05 CLOSE W8 20.000 64,000 64,000 NO Totals for 2006: General Property 20.000 82,000 240,000 322,000 Woodland 20.000 64,000 64,000 Totals for 2005: General Property 20.000 82,000 240,000 322,000 Woodland 20.000 64,000 64,000 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 511 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 CADY T.28N.-R.15W 23 S4 :M/T • . 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SO., WOODVILLE, WISC. 5402,3 METAL STAMPINGS - TOOLS& 0/ES East Highway 12 - Menomonie, Wisconsin 54751 SUB-ASSEMBLIES PHONE: 715 - 235-7909 ~.REPOkT OF INSPECTION - INDIVIDUAL St-WALL SYSTEM SaVI i tarry Penal State S e r t lc, CC fO_6-__ NAME_ Towns hip ~ St. Cnotix County Locat'onNWAr -Sec ion Lot _ -Su d~v~) i,an_ SEPTIC TANK Size ga tons Numbers o6 eompantmen~~ DcIstanee nom: Wei Bu~~d~n g- _120 ~~ope ff,tGhwaten PUMPING CHAMBER 9afeon-5 Pump Manu~ac_tune-n M~ideX Numbers HOLDING TANK St ze- gaNXon,5 Numbelc o(I Compan-tmen=t3 umpen. A.2an.m System D~~~ance ~harn: Welt`_ Bui.Edin ---v-__~___--- - g 12 o a E o e. Hig hw a t e n ABSORPTION SITE Tied Tneneh Dilstanee fjnom: W(?- fZ- Buitdin 9 _12a bane H,tghwaten ABSORPTION SITE DIMENSIONS Width o o toe-nch Req u-T,),Le.d aneaV- ~ T. Length oo each Stine. -t Depth o6 4ock below tiee <n Numbers of in.u Depth o6 nock oven -ti. e. c n To,taf teng.th o6 ine/~ 6t Depth o6 -ttife. below ghade -n D,t6tance between ti-ne,5 4,t Shope o6 tAench in. pe.n 100 ()t Totae ab6o4pt,Lon area ft Type oA Coven: Papot on A thaw PIT DIMENSIONS Numb e n o o pi t,5--- _ GlLave~ aAound pi t/5 -yep no Outls~de, diamete. _ bt Depth below Totaf ink-e- abaonpt(on anea {t Ahe.a nequined 6t I INSPECTED BV TITLE APPROVED DATE _ 198 REJECTED - DATE----- 198 REASON FOR REJECTION REPORT ON INSPECTION OF SANITARY PERMIT # -10 (1) Name and Address of Permit Holder Person/Persons at Site 2 Date of Inspection c" Time of Inspection ame, r~ss, icen . OT ins a Ong Plumber (3)INSTALLATION CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber ❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System BEN ermanent reference Point) Describe: Elevation of vertical reference point: Slope at site: (5)MATERIAL AND DEPTH OF SEWER: (6)SEPTIC TANK: Manufacturer: Liquid Capacity: Tank Inlet Elevation: Tank Outlet Elev: # ft to lot or property line: # ft to well: M DOSING TANK: Manufacturer: # of gallons: # of gallon pump set for a cycle gallons; total capactiy of distribution lines gallon; size of pump head; gallon per minute horsepower ; brand name of pump and model number Is the warning device installed? ❑ YES ❑ NO Wired? ❑ YES ❑ NO 8 HOLDING TANK: Manufacturer o ga ons construction ; depth to the cover ft; If septic tank is being used are baffles removed? ❑ YES ❑ N0; ft from residence; ft from well; ft from property line. Type of warning device Is the warning device installed? ❑ YES ❑ N0; Wired? ❑YES ❑ N0; Locking device on cover? ❑ YES ❑ NO; Diameter of vent and material Distance from building to vent (9) SEEPAGE PIT SIZE: # of pits; ft diameter; ft liquid depth; ft to residence; ft to well; ft to property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than seepage pit inlet pipe-elevation ft; bottom of seepage pit elevation ft. (10) SEEPAGE BED SIZE: ft width; ft length; tile depth; lineal feet tile; ft to residence; ft to well; ft to lot or property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches Elevation of tank discharge line entering bed ft. 11 SEEPAGE TREN H: Total length of seepage trench ft; width ft; tile depth ft; ft to well; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches; elevation of tank discharge line entering seepage trench ft. 12) Has system been installed in area indicated on EH 115? ❑ YES ❑ NO ~(13) Has system been installed in floodway? ❑ YES ❑ NO Floodplain? ❑ YES ❑ NO DILHR-SBD-6095 N.05/80 Signature of Inspector: _ PLB State and County State Permit #7 a Permit Application County Permit # for Private Domestic Sewage Systems County` *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. LOCATION: /0-1% IC Section T N, RL;~- (or)\~L Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family A Duplex No. of Bedrooms No. of Persons 21 D• SEPTIC TANK CAPACITY /000 Total gallons No. of tanks OlYe, HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete-_ Poured-in-Place Steel Fiberglass Other (specify) New Installation Replacement Lift Pump Tank or Siphon Chamber X29 Total gallons Prefab concrete A Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area sq. ft. New X Replacement Alternate (Specify) - /Y~a:~i✓ d Sys 7- ,YJ Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: Length Width Depth Tile depth (top) No. of Lines Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land- .--S 14- Distance from critical slope WATER SUPPLY: Private XI Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Certified Soil Tester, NAME Z-✓ CIE G'f 06 C.rf~ C.S.T. # $ 74`f and other information obtained from Ccl J (owner/builder). Plumber's Signature MP/MPRSW# jTjP y ff Phone -;3 7,f Plumber's Address LAJI"IIJ PLAN VIEW- Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. i r U 4c aes J~ FIT P! vU$ao Q- 63 o~l t. (P \ tk I 2L S\2(~ Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application As Fees Paid: Stat County Date 7 Permit Issued/.Re' (date) C.~ Issuing Agent Name Inspection Yes ' No State Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 7/1/78 t 115 Rev. 9178 REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION: N"'/4,6_14, Section 15 T~U N,R~r(or)N, Township or AAt~~ Lot No. , Block No. 40 A GRe, j aRC L County bdivision Name Owner's/Buyers Name: ~d c.~J ,,~11 e- n> F.vA Mailing Address: CIS. (J1 LS ,,J CJ S TYPE OF OCCUPANCY: Residence X No. of Bedrooms 3 COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW X REPLACEMENT ALTERNATE SYSTEM X OTHER DATES OBSERVATIONS MADE: SOIL BORINGS 9- _ 7`' PERCOLATION TESTS -~4~ - 2a /Y) A u , /A 0A16 SOIL MAP SHEET SL NAME OF SOIL MAP UNIT ~y gnv PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME 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 PERIOD 2 PERIOD 3 P- / Aip, S;7- Q d 12- 12- 60 Av P 1;Z 54 A10 _31~ -31,11- 40 P-3 ~r cc, I/ NO 3a /z Goo Zr, f tVo 13- 1/2- 1/2- 01010 P- a~ a 0 3a s s- ' z ya P-6 04, 30 / .3 ~d 9 ' 79 o re5 + IQ~S 4,4 S /g~,~, SOIL BORING TESTS FR. E"ti sv , ~Q~ CW-1/S" 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- ~T /Yd,/ C, 5•" /11o .+.s/ II r S L~~3 ip.VJ~i~ - ~"s~C ~4Lrrm~ s J"r e- " oW e- CAA" MQfs X /g 1"me,4.S. B- o e /31( r►7 o -ft " Cz K SQL 6%S, c. - 6'6 5L ~ -7 " med S B- ~F orve 1,26 rc CreS'L. S/c- /Jr'rr 543" ScL - B- `5' 6" If 0" 4!0 " Sc1 /3" McV, S, B- {o ~ ~ ` SAD -01, if I x'r , , 546 St,; j r r 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. Give horizontal and vertical reference points. Indicate slope. -540 CQ CI -L~rJR~ / "leS M(l,vi/ Avc+-(Y1~e, o(L CAA/ !1)ots- v ~n- p.L y e_4 S a' Q L y f 7-c, 5cd$ Q N s t a ~r. r r cl a P i x~ ~ boo E 7F 8'0 1, the undersigend, 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 location of test holes are correct to the best of my knowledge and belief. 11 Name (print) & f t~ G clT Certification No. Address X4T r S .Name of installer if known dLd j' Copy A -Local Authority CST Sigs,at~ a WTSC;O"~S'N e:"/1RT N? INDUSTRY, LABOR & HUMAN RELATION'S {;_1R1-_A1) 0~-- PLUMBING, P! ATTII!G & FIRE PROTECTION rl,9X 7969, r'+A!)rS N, CONS IN 5370 nrI , ~_X- ration Sl-;fit for an Alternative Private Sewage System 4.r1 1-he Count nq 1/4 /4 S T ~ N, R (or) W gown or Municipality Street Address a Block Subdivision "rrr. r1r~ I : r ;o. P " /l Y• !`nv I:o serve a new construction use. _ replacement system use. Tf this is a NEW CONSTRUCTION USE, the alternative private sewage system is to be " as: r part of -the, 3%/5", ? - m-i tati on. This is numbers" (-'fl- of the applications rnr?cie t~irnwwoh "s'a'i~, offic('. one additional homesi"e on a farm to he occupied by a parent, child, gri,ndch';`(!, t~Yi-a, n4ece, nephew, or first cousin. "In individual lot xor which a sanitary permit was issued but was later "ul eel unsv is tap' e due to n( rldv or changed so i i cri i-er; a established by a. lot that meets the criteria for a convention(' private sewage system. v.t 1 4e1r r? VPL/1(;FMN"I° rY! 1C1A USE, the !Bound i`_7 replacino: a. failing conventional soil absorption system. holdinrl dank that was installed, and in use prior to February 1, 1980. ~E °!v'-"9!\r .itry'~ i,Al~c, +}tM1.f_13t rfe/." ra1?( -art r J, ,'o nr-rnr 1 f"r:.~4i. r _ , -rt y 1, 1980. r..eify that the ra'!)ovo ►~rr,rrr~<~?: on is true and accurate to the best QfJay Knowledge. P c, C"1 I ~ o t) r ~ loA o i ~~r~ SW e V4Y' X_ _no t, i July 25, 1980 Mr. Everett Boidt Baldwin, Wisconsin 54002 Plan Identification No. 80-02752 Dear Mr. Boldt: Re: Edward J. Greenway - Residence Alternative System NW 1/4, NE 1/4, Sec. 15, T28N, R15W, Town of Cady, WI St. Croix County The Bureau of Plumbing, Platting and Fire Protection has reviewed plans, site survey information and installation details for the construction of an alternative private sewage system to be installed at the above-mentioned location. The plans and specifications were prepared by Mr. Everett A. Boldt, Plumbing Designer, and received for approval on July 7, 1960. The soil and site evaluation was conducted by Mr. Thomas C. Nelson of St. Croix County. The site meets the soil and site requirements specified in ch. H 63, Wis. Adm. Code, for the use of a mound system. The proposed system is for a 3 bedroom residence. Wastes from the building will discharge to a 975 gallon capacity septic tank which will discharge to a 750 gallon capacity pump chamber from which a pump having a capacity of 65 gallons per minute minimum against a total dynamic head of 14.2 feet will discharge through a 3 inch diameter pipe to the soil absorption system. It is of utmost importance that the system be Installed in complete accord with the plans and installation details and the conditions of approval con- tained in this letter. The licensed plumber responsible for the installation shall notify the county inspector when the Installation of the system will commence so that the county Inspector shall be able to inspect this Instal- lation. The installer shall not deviate from this approval and shall follow the directions or orders issued by the appropriate local or state authorities. "i`~l1Yai.I"l.~t'O.ilC13 fr:ri ~~#en.~+a •'1t\~~fsi~f`)J~'Eli a,'!~ l°3ifit~lff)~'£'!f ~")YY £f7 a.. :V 7 ii 9OJ I a `<..13~ G,, 'i't1 t3~ 7'3.#~ r 3vixa1;3~ k:V 9 t f ?i E ?"i t9s r °37~V. 1A . lai: i *'t t i tJt. `['t ~:;iJ~~'i~•.~., °!tl ~ t`l,SV S'-t')..°1 i:»±: s `S 3z`fy3S ~ s : ~)£l~ CP6ti!1 ~'1 t:~s2 ~f)°i t ;t~f}:r c .e tt # $`>f1 ~+dz? ,)fit? }sip !t)4 +3t ti 4i:3? } 4~a i£?f~i YJ !)'!d "t#~t ftikla •-);l ?t'i 3l .g 1~~ 3ii V3ltls~ tr,t"{:P s , , . ,'t?V~ ;'£f'€LS'~J~i7 f3 fi) `3u~i,! -!i' j `9{"t~ t .3Ja-.~ a .~1!+: a s? 1 ~ e•,. .3a;; il! !J3es . 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"U , q G jlrt' t'i5~}. ia. ej L i k t k4 ~ €'L (IS f pJ ~ ks~F c n. 2C?t' :I L cv to ~fI",u 1:,t l ~ 2 t'ji I Z. ±jL,{, P. ' k > f k; s :41 Ud.'• : a_ } ~ z'Jt; ' ~ tE `ch f ~ c' :,t': E; 'txL i.' c•: <,t ; r qU:x psi jC.L,fm 917)1 ! V, C c- IL, ! ~ 's (C L,~ ~ 4~ ~ V~~..tJ Sa c,"F- ~ i t {'b t✓!'~ {lr° Kf~r.# L 4 P ~~.:3~k lC~~ ~~F i,- j;C j+Si?, UC CCz1Xi}-fj?'C' ?'g}Z.+ll A< ~taL tL.t~ Sif r ( ! e. ;(i F C,L'k: e,~, t".r~ ~.~!a=U2 y,£r•~L.I s r'rt;d,i f.tt r,s ~~,.;3•'y tt~. ~1 le" .r ~ f- y~ a > 1, d . f l G; N` = k Gr"11 i; ~ i,°- 4• E i. L LC C f V 1 C)s i L . k. O L t : f ! . W s LKS'L.`i f1J t ' ilk€' Lcl;. it'll, €f L CifE ~3 Me Gr?Ci'c :ff!is1'~a+ C~ 1s( COLE fAIf15 CPC, •~~i~i~l::r* 1 t: f' i C~ , • , ~r7•► s t: .;-eb lzF~• GS.,• rf5i.; ±..1 rl?iie _'liii?~; qu,7 5. 106 - Plan IJun [ification No. O Construction Inspection of Alt42rnate Dc sign Sc~,age Disposal Sy stcins Wisconsin Department of Health G Social Services Ser_tion of Plumbing b fire Protection Systems 0.•,ner' s Name Mailing Address A. Site Investigation at onset of construction 1. Name of Installer 2. County Ins ector Date 3. Package' 4. Preliminary on site made by Date 5. Depth to limiting factor (50% unconsolidated rock or estimated ground ti,ater level) 6. Percolation rate County installation permit nuin be r 8. Are percolation and soil boring holes evident? Yes No 9. Is system located in area of soil tests? Yes No 10. 1s system located in area shown on state approved plans? Yes +o Il. Ground slope in area of system 12. Site data is correct as presented by C.S.T. and system desianer? Yes No B. InSDectIon of Construction I: Disposal site plowed and properly prepared? Yes No 2. Disposal site conditions wet or camp? Wet Damp Dry 3. Type of fill material 4. Depth of fill (1' Minimum) 5. Is a crawler type tractor used? Yes No a. Blade Bucket 6. Has site been driven on by any vehicles? Yes No If yes, explain y rj 7. Trench w; dth as indicated on approved plans? Yes No 8. Trench spacing as indicated on approved plansl Yes No 9. (lave -trench bottoms been properly leveledl Yes No_ 10. Trench length and number as shown on approved plans? Yes No ll. Distribution piping proper diameter? Yes No )2. boles in distribution piping properly sizedl Yes No 13. Boles in distribution piping properly spacedl Yes No 14. Boles in distribution piping in a straight linel Yes No 15. Distribution holes drilled straight into piping? Yes No 16. Depth of gravel below distribution piping 17. Depth of gravel above distribution piping 18. Thickness of marsh hay covering 19. Permanent marker at end of each trench 20. Depth of fill over center of system 21. Depth of fill over outer trenches 22. Side slopes 23. Type of fill used above trenches 24. Depth of top soil 25. Seeded? Yes No if no, has mulch been Placed over mound? es No _ C. Pumpino Chamber I. Diameter of inlet 2. Diameter of outlet 3. Head ~ - - 4. Size of pump tank oallons 5. Draw down or oallons pumped per cycle 6. Manufacturer and type of pump same as that indicated on approved plans? Yes No If no, indicate Mfg.. ands Model r of pump used. 7. Quick disconnect provided? Yes No 2 8. Diameter of manhole - r 9. Height of manhole above finished grade 10. Diameter of vent 11. Height of vent above finished grade 12. Pump tank located as sho,,m on approved plans? Yes - ~Jo - - - - D. Septic rank 1. Properly installed? Yes No C01111FNTS I, the undersigned, hereby certify that the questions Were answered on the basis of my personal inspection or knowledge of the construction of this alternate system and further that all data and answers recorded on this form are correct and to the best of my knowledoe and belief. Name: _ Signature: Title: WE HAVE INCLUDED TWO COPIES OF THIS FORM FOR COMPLETION BY YOUR OFFICE. WHEN INSPECTION OF CONSTRUCTION IS CC,`1PLETE, ONE COMPLETED FORM SHALL BE RETURNED TO THIS OFFICE WITHIN TEN ()0) DAYS AFTER YOUR FINAL INSPECTION OF THIS ALTERNATE SYSTEM. Date received by Section of Plumbing b Fire Protection Systems 3 EH- 1 5 Rev. 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS Z pj}GE$ WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 NE. LOCATION: ~W '/4, '/4, Section /S T Z N,R IS E (or) W, Township or Municipality Ci9oy Lot No. , Block No. %0 Accer pheca'L County Sf C-oPo~X ubdlvlslon ame Owner's/Buyers Name: ED Mailing Address: TYPE OF OCCUPANCY: Residence X No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW )e REPLACEMENT ALTERNATE SYSTEM DATES OBSERVATIONS MAD • SOIL BORINGSZpj 7, /4, Oc? /9 PERCOLATION TESTS OCT / / SOIL MAP SHEET (99) NAME OF SOIL MAP UNIT 14fA PERCOLATION TESTS TEST HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES NUM- DEPTH CHARACTER OF SOIL SINCE HOLE HOLE AFTER INTERVAL RAT' BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/Ilv P- / G" Al Gy SIl, /3 "l3rv y / y 9 it SO 2q g „ 30 -0- -0- -0- P-4 L~ 7"(3N-G 5►1, l "Zf BW s,.. 3"Sc/ 1 - o - 3o 12 rz iz yo P-.; L& 9"G. fib 13,1aQ#1 Sit ls"o. $i Zy .0- 30 8 !o 60 P- Z7 d "AV y s;/ ~3" L7~ ~IV s;L . 21 IV - 0- 30 ` h & 2 Z -L P- 2y 'Av-G 60 54 3,. Sc/ Zy _ 0- 30 1 4 r~ 01 I o P- / "/3~/-6 it "L1 (3~t Sal"Sc/ •Z _ O ' 30 y y y 20 Auf SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B- / 8y /yaNF 2 "Ma is C"aw-~y.s,,13"!/iv.s►~ y ~'sc/ zy"'W-A s. - B- 2 8 NONE 22" dtS B- 3 NONE otS B*-~~ 0. 13 "/3,4 f;/ « "7riEr7• S B- NONE 24" ()VatS 7`13,V-6y _ s w I S'' 3-i / SC B- Py coo 3C (M iS) /0"~3N-r Id, IS 9N- s9/ y6" S/* 13 "QED.S B- U O" WOts 11212W-61X-571, IP"St 1 * 36" S/ * /2"7V W PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy NOT QVR/iFfeD Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. * 40V Y, X5Iixcf, 'KrPiWAl Of-6Y Af07'`S 1W_1 _1,V7- ~ DEIVO TES Nm eN E/Pvt0o^►r PANS NOT To SC41E, s ~ 3 /3ty L = /oo Di5 ?/tNGE$ f} CG vRJ9T~', F~3 - 99 5 . = /.~.t~/~h~oE PITS ma boo p = /~EiP~ SITES ,95 _ L PU m a , T N a i I 1A1 off` 40, 4 4 ,c Couw7"Y ROAD S, the undersigend, 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 location of test holes are correct to the best of my knowledge and belief. Name (print) ACD ERL 46,?,c,6r Certification Noss~OL 0 -c- Address ft 3 QW,111- )eD• #UJOSOw AUIS • I XO/4 Name of installer if known RE L) CE DA 12 P LO /l) Copy A- Local Authority EM 115 Rev. 9/78 19/AT GE Z o F REPORT ON SOIL BORINGS AND PERCOLATION TESTS 2)PAfE5 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 or LOCATION: Nom'/4, Section s CA J N,R L5 E (or) W, Township or Municipality yv it Lot No. , Block No. Ave =r/ Subdivision 5Y CA96,I X ame County Owner's/Buyers Name: 664rv wAy Mailing Address: TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT 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 TEST TIME 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 PERIOD 2 PERIOD 3 P- P- <rAkAl W S U/~ lL O e-a v s Div A/ S iE'~fT P- le s 13 (aarE 3). 2U L c.aL Tiow P- SiT 40--A74- Ev .t~©F Q i ' o e A7 z T P_ it Poe i' mff, (0 s~ , - s T s L ED /r1 £ Uhf ODE P- ~E / MErvTS ~tJ- ~T Aell 1A -Fif LD, 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- B- v R B- DR / ► e c. B- B- B- PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the 4 cation and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy .Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. NO~ ~T Li.VE R ~J 1 ADDI PPA1R L BA~W#0415 &VE iPiTS A.A 5110OL I "Pi ff lvE?r ozeEc-tLy To ZAfr W O1 1-1,41f 14P 1161v p al~lrav ~ ~ 1a~~v~ ~MvTf~i of S~Aso,v,4L /fI I r ~N V • i._. _ wW. )PANDOM V% 13OR9 .5 M; - vv ARM NW s ~_..mw .Z • a rI I~AVfplRy +d 6REENW,4j Y,6 Cowj),y RoAp I, the undersigend, 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 location of test holes are correct to the best of my knowledge and belief. 3-3--02- Name (print) RM40?.- WhR C-47- Certification No.'/PL' Address kr- .3 yp50lN A)K Name of installer if known AV> GVM 12IN4 M~Nv E~ ul1S Copy A -Local Authority CST Signature L