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HomeMy WebLinkAbout020-1120-40-000 0 to O v o tl rte. O 3 q -0 IMD o c • .o 0 CD 0 d z N N O m COO CD C v N °C • CD 7 a 0 d g 00 W Cn m N ° rr 00 C j = O~ L (D d to 7 O CO EL p C-D CD W N O NO Q O n S CD O N) O O O C CD O CD p CD O. O 71 = O :3 N A O CD O. U) C) O d a 0) :.1 d U) z D m 4 Co CD m o m O. 0 CD co ~ CD a c _ O c 0 N N lot CD F~ O z CD (D < co °o n r y CD N o a N) C) m T m y K O h • Z O O O I o N n '0 N f~/7 N O ~f d m O O O Q ("D O Cn O W =r CD 0 d A d p a 7 p Z Q D CD o 0 CD O o' CD N -D (n C CD W N C1 CL 7 (D ~ cn O N o j Z CD c - CL a F! 0 ca -0 :Z:E~J CL z p A _U O cn c0 I N z ~ ~ CD W F A i j CD S S d CD C1 j C r: Cp O. C d Cp CD N' O T CL Q -d v O O S Z :3 CD M CD -0 P- Cc: a E3 U) CD 0-0 Z CD In CD CD N < D_ ~ N d p - I O J a- 7 a c t CL_ A NO d (n CL -0 0- CD 0 N d ti N ~ Ali N a U) p 0 0 :03 m a CD dv o°o p ~ it ,r o ba 0 00 a Parcel 020-1120-40-000 08/11/2006 03:32 PM PAGE 1 OF 1 Alt. Parcel 17.29.19.521 020 - 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 ROY HERBERT & JODY M OSCARSON O - OSCARSON, ROY HERBERT & JODY M 406 BROOKWOOD DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 406 BROOKWOOD DR SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 1.870 Plat: 2553-TROUT BROOK WOODS ADDITION SEC 17 & 18 T29N R19W TROUT BROOK WOODS Block/Condo Bldg: LOT 18 ADDITION LOT 18 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 17-29N-19W Notes: Parcel History: Date Doc # Vol/Page CJ~C Type 07/23/1997 875/24 - 07/23/1997 864/271 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.870 73,900 229,100 303,000 NO Totals for 2006: General Property 1.870 73,900 229,100 303,000 Woodland 0.000 0 0 Totals for 2005: General Property 1.870 73,900 229,100 303,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 203 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 • REPORT OF INSPECTION - INDIVIDUAL SEWAGE- SYSTEM • San~.tar y Permit O~ State Se.ptic.~~~i ? C - St. C&oix County cation /40, S4 Section,17Lo.t # Subdivi.6ion IPTIC TANK S~ ze__ gattond Numbers o6 compaAtment.e 5 tancc 40 m: Wet Building- 12% exar~e Highwaten - IIMPING CHAMBER S.E ze__ gattq nd Pump Manu 6ae.tunen_ Mu dek Number OLDING TANK Si ze gatton.6 Number u6 Com,pantments Pumper- Atahm Syetem 5tane.e 64om: Wett Building 12% 4tope Highwater. IiSORPTION SITE Bed Tne.neh 5tanee Oom: Wett But..Eding t2% etope H.i ghwater. (,)SORPTION SITE DIMENSIONS W-i'dth o6 tr.eneh _6t Required area At Length oA each tine____ 6t Depth oA toch below tc.Ye c,n Numbe.h o6 ineb_ Depth u6 'Loch over t<ke ~n Tuta.e Length u6 einee _6t Depth u6 take. below ygade 4n Dietanee between t.cne.b 6t Stope u6 t&ench_ .c.n. pen 100 6t I,,.~ aLovirpt~un anew 6t Type o6 Coven: PapeA on st4aw IT DIMENSIONS Number u6 pate - G&avet around p4't6_ Nee_!__-.__.__vru Ou-t5.i de d.i.ameten 6t Depth betow Tutat ab4o4ption a4ea 6t AAea q.egUi4ed 6t NSPECTED BV TITLE I'I'ROVED DATE 19 I JE CTED DATE 19 B IASON FOR REJECTION 0NO F: -0 u 3 ry CD (D v v `D :v • . ~ rf; 3 - s z= N(.0 Z z o o v CO CWD (D E o CO N a r l o 0 0 1 (D d Cn O W ~ ~ N N N O j A O u O 10 O O O Ui C d C 10 00 if'°+4 Fc n r ° O tom, G ° CD z (A o "*F C O <n O a Z G M I N (5 N N A ' O 1~ O O O O L \ P m J Z o r cn co co o cn ~ .D *sa o v v o O O O ° ►r O _ '0 W 0 N m C0 0 0 a O O = = pr~y D ;_o m n Q m ~Z , rv -6 v, o W-A O 3 N O O w F°1 C CD - C p C O IA ~ A (n ~I Z V> z D D W (o m (D AM I c (D 3 Z 0 0 to Z 0 N c n z O n O Z -i J Q O (n Z O A W Cn CO O_ N N .O• (p _ -n x O QO O N !D CD if,, C CD C 0 f2 O Q C i~ (D O O C O (D p c CD- CD O' O Q C ~ O C _ C CD T v Q d ^ N CD O Z D 08 p (n -0 O (D 7 N > v ~ N N ~ O C) Q COO ~ 7 T O ea 10 O ti O Q u,OIWMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 800 - 962 - 5227 C~i~~Ix Zur. > CROIX COUi't t i }iii iatt i l hi C: lr 3URTHQt1SE DATE RE _ E11" sSON, WI 5mi" 2,~, s-~r _L E ,R'ETATION: BdCt@1° i r o Ca i. e r•:F'= .J. OF.,NDEVENDEH Jd` 9d O s Zd O o PROFESSIONAL LABORATORY SERVICES SINCE 1952 A oI-C COUNTY ZONING OFFICE St. Croix County Courthouse 911 4th Street Hudson, WI 54016 Telephone - (715)386-4680 The St. Croix County zoning of septic and water inspections to Lending office Institutionst,e Realty service Firms, and private individuals. ~ ~~olet;on of this form is essential no that the vrocerty can be_ bated • Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. WATER TESTING---- -----------FEE: $ 25.00 (For nitrates and coliform bacteria)FEE: $175.00 WATER TESTING (For VOC'S) SEPTIC SYSTEM INSPECTION---- FEE: $25.00 (Determines if syst m is properly functioning at time of inspection) 1~• ~Property owner's name~~ f - CIL Property owner's address Legal Description 1/4 of the 1/4 of Section , T N-R Town of Lot Number Subdivision Name-RR MMMER- BOX ER Color of house Realty sign by house? If so, list firm: PLBABL► INCLUDE, IF AT ALL POSSIBLE, A MAP, .e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. % WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. °r~ Firm or individual requestinq_ services: Telephone Number C .a l F3 c x Gl. REPORT TO BE SENT TO: ~ - Closing date- X Signature - F ~ I now, ' - r ST. CROIX COUNTY WISCONSIN ZONING OFFICE = v=x ST. CROIX COUNTY COURTHOUSE Pr. j 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 June 15, 1990 Tom Sitz Farm Credit Service P.O. Box 199 River Falls, WI 54022 Dear Mr. Sitz: An inspection of the septic system at 406 Brookwood Dr., Hudson, WI, was inspected on June 14, 1990. At the same time I also obtained a water sample for testing. The results of that testing will be sent to you as soon as we receive them back form the laboratory. 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 o chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspections. 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 is totally dependent upon proper maintenance of the system. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, Mary J. Jenkins Assistant Zoning Administrator cj PLB 6 7 State and County State Permit # Permit Application County Perm. # vl~e 'e" 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: /T 0 - 2602- B. LOCATION: /l/'/4SGU /a, Section J T ~ N, R E (or) W Lot# /-City Subdivision Name, nearest road, lake or landmark Blk# Village G "ri oor 1-MnOk IeP.Township 11VQre-v C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family x Duplex No. of Bedrooms No. of Persons 2- D. SEPTIC TANK CAPACITY /Cr,'J-7 Total gallons No. of tanks / HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete x Poured-in-Place Steel Fiberglass Other (specify) New Installation Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rat Z Total Absorb Area T ! sq. 'f _ ft. kk New- Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: Length Width De,Pth Tile depth (top) No. of Lines Seepage Pit: X Inside diameter.7 ft' Liquid Depth s y" No. of Seepage Pits 3 Percent slope of land Z %c7 Distance from critical slope ~6AEIP /~d WATER SUPPLY: Private 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 oheiQ/ C.S.T. #j-62-41,f2- and other information obtained from C T Cs~E (owner/builder). Plumber's Signature c MP/MPRSW# Phone # Plumber's Address .fJ E /JVSo 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. 04 / 1f/310,- G.t'mw-: d>,'d G- v~tL Cr'iP 9/~E = a ~r~ S/o~'t S o Vdit /4 tthj 5EE A1-154cy~v~ ~H "o/A V A 5 . cl~ Q v n o c3 a 0 r> File _ 1P^~ Q C 0 V a e 010-4-A/ Bellrlelm 10 36 ~7EP,yi~►/GE G'~-~cQ- ~iP • S~i9( E ~f'cM 6// Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application Fees Paid: State County ate Permit Issued/R!eMc"d ( ate) c) Issuing Agent Name Inspection YesYNo 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 e i ~n P rc~ k1G Got 4o p All, kly S~R1M ER 1/ f /7 CIAO SS, .~i o ~ v N ~ o/~Po Si7E /f of Z' REPORT ON INSPECTION OF SANITARY PERMIT # 9 (1) Name and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection game, r s, icense No. 'Instal ling plumber Time of Inspection 16141- Ln~ 3 INSTALLATI ~QNAJFS 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: (7)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 gallons 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 ❑ NO; Wired? ❑ YES ❑ NO; 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. I1 SEEPAGE TRENCH: 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.05/85) Signature of Inspector: I N D DI PA II I -M IN 1 01 HEALTH AND SOCIAL SERVICES DIVISlt)N OF III:AI 1 rl, 130111-A0 OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION:/~'~%,5L'"'/, Section !I T ~[N, R f f E (or) W, Township or Municipality U_ s'.0 V Lot No. i Block No.- Count /~j• Subdivision Name G";vrrer'T Name: hC1u T- - / Mailing Address: TYPE OF OCCUPANCY: Residence No. of Bedrooms-_... Other EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS 'P-9 LLI'2f /M PERCOLATION TESTS'VOO' X26 //000 SOIL MAP SHEET SOIL TYPE PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE VUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL ISER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 31 MIN/IN IP I I I ;P SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES ~ i CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER j INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED') / c. - ~l f•~V si126"L--/3v SL y" G~.SCL' fox- G/. Not S /61 "Z-/ - .v •eS T a.51 1,2 '131 Si/ /3,u-6Sd 16 SC ~c 'L~•ljv- Sc L 6 . tirofS " L .13,v. cS F-,e . L „ Z/. 12,V, -Z; Y. 5,1l "Z 8N. 16 " L/• Q e L ~u - G~ . /`10 7~S Z y „ a,P. SL 70 " « l3N . CS 44 6=X . PLAN VIEW (Locate percolation tests,soiI bore holes and suitable soil areas.) Indi, ite on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needod for building type and occupancy. :~ia :3 Indicate scale /ord,srance,.- Give horizontal a7n~d' vertical reference point'. Indicate slope. I ~ I I ' I I~ , i ~ j ! ~ + I Il~~r I i I I i V ~ j - I ~ ~ I I i ~ i IT~c~` j I 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 location of test holes are correct to the best of my knowledge and belief. Name (print) Certification No. Address-l~,t- Name of inst3;ltjr if known 9 CST Signatwe -t~~c/GtitXl r. 0~,, AU t ~ t.1 1 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: ~lU'/4,54_0 '/a, Section T~N, R/-t E (or) W, Township or Municipality yVJDf Lot No. !:2Block No. L/OOt~T r1GaK C~Oc?mss County 5- e'AOI X 6044T AZ~Z-' oO `0' Subdivision Name Owner's Name: Mailing Address: TYPE OF OCCUPANCY: lie,Jdenca No. of [Iodsunms. _ Other EFFLUENT DISPOSAL SY', I EM: NLW AI)UIlION REPLACEMENT GATES OBSERVATIONS MADE: SOIL BORINGS_..____ _ PERCOLATION TESTS SOIL MAP SHEET SOIL TYPE PERCOLATION TESTS TEST ;DEPTH CHARACTER OF SOIL -HOURS _ WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- !NCHESI THICKNESS IN INCHES SINCE HOL1 HOLE AFTER INTERVAL MIN/fNi BED 1ST WETTF 1) SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 I ! IV07 ci X!,'E li J' 4 L/46 E o v' 74_ 3'1 • zF s 1410-6 (JOT C9/T,ig/~~ FU f'f> (J£.v~iL 1 P f 1'~D • ~CLi~X ~i~/?J/tiC~2~ i UE % J /1 P- f~sTE~J f;E~~ys~ rg _yF 0f= /t/ 0 SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES I NUMBER I INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) 6j~LyGQN.G~ Si'G~ ~~W SLR I ,G c1. ~S sC L cv o - .~foyS 22 B- I B I ra~ ~,auv ,anu ayuaic ICCL UI bu iauie areas. inalcate numoer of square feet of apsorption area needed for building type and occupancy. 1-67" A;OF a p Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. , f I . 1 / 41115- -ell 0?LL,'f11 N Ali,; -911 Vi 4o 9Z_' !tj /r~2r1(i .~i~ I ©G?'✓! CG~i1T i 141iS - - r9- - V ,7' 10,4 777, ell, -t ?Y~=- - ~Ly? /.~C~~~✓'1~ r`sc~~i9~ S~~iL_ t- y/0 1-574.6 0~ 77" - t-- i Lll~vll ✓//ifs GU S f u j 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 location of test holes are correct to the best of my knowledge and belief. Name (print) Certification No. 1K_L"2_ 1/r2- Address Name of installer if known /~,15:n~2S • ~1'h+9L!Ti Ali--~- CST Signature ["&d C0,11YA -LOCAL /;Y; a `r:t9:'.i fY l J 3 s WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: Section T ZEN, R/? E (or) W Township or Municipality (~I Sn'tJ l~ Lot No. Block No. County Subdivision Name ClJ7S G/ 0~%ner's Name: ~_c°vv7 /t~t'~ C-Cs t ~T. 2 l X yl U.USd s.~ '1; Fs : Ufj~ r' . j y' fj! if/o • G,g,~t~10 t~srL • SSo Ma inc Address: CC c G>?~SOnJ ~,Z(aCj Z G~ . TYPE OF OCCUPANCY: ResidenceNo. of Bedrooms -3 Other EFFLUENT DISPOSAL SYSTEM: NEW ~C ADDITION REPLACEMENT DATES OBSERVATIONS MADE:: SOIL BORINGS /UN', Zy,'2> /G?O PERCOLATION TESTS 710U._~ /v~f'~' SOI L MAP SH EET ~G j _5 7 SOI L TYPE PERCOLATION TESTS TEST r DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, iNCHEtaj R j CHARACTER OF SOIL B ER NCE HOLE HOLE AFTER INTERVAL i -•r i NUM-i I SI INCHES! THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2' PERIO0 3'M A? Il-13A.) 5)7 Y.00 74, L/.,O v. S, 1 13 7Z 15L /0 "54L w P-8N - Mot. 21 „ C f ly"r, -1,2 Y B'0 12- 04 1 51 0 S, ~G/VQTEf Ra°ERs wh~RE ~iQ r><LFG SOIL BORING TESTS ~L, Cg5 TEST T TOTAL DrPTII DEI III -I 0 Glir i0NDWA I Lii Irt' CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED F_SI IMAI ED HI(dIE.;I (DEPTH TO BEDROCK IF OBSERVED) 1141 NZ ~Ju EE~r 3. e 5i/ 0'e I z «.,✓C/vE r ^C'`i ~S /.G ~'~,U. si r p- ~y Sr G w/ a,P-~Y '`'c tS F/C'y"r 3Q- '/C~ " SP" C = B- i f.POM 3 j le S „ /i "Li~• v s c 9C; " 13-t: ~s PLAN VIEW (Locate percolation tests,soil bore holes and .uitable soil areas.) ylJf SGf ff' 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. - ~O --/'7£MnOM 11014e- y9~ Ff Indicate scale W or, distances. Give horizontal and vertical reference points. Indicate slope. st6 :WC/- -L CD,UIJi7/'pA✓3 o'/ 00 P/ 2. I i 7T730~1 Ixe 0, i-AM11- ~r r'1 Az ' ! = iz3 lMr I on I l ~ i i I, rile tiiAi!r>i,j,,o I, I ,,:M/ certify that the soil tests retorted on thi' form were made by me in accord with the procedures and mr ihods ,'.:clfP I +n the Wisconsin Administrative Code, and 11 i the data recorded and location of test holes arty corract to the hc;l ui my kn rk.6ge and belief. ' S:S = c z y~.L Name (print) t t-!I i~~lJ/~/~ r Certification No. Address Name of installer if known ' p p' y~ CST Signature _ CC.-I I' LO, L F".;'.,ltT J E~ EH 115 '3 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES 4i 8 • DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS Ip s o LOCATION: Section Z Z, T!0N, Rd E (or)W, Township or Municipality UPS pl y/y~' ,98 Lot No. 1, T'f~U~ /3`Poo,F lGfaC~Os County Block No. Subdivision Name Oar's Name: Z 90 X Mail ing fdd ess, ~7 ~70/3E~T ~ /J(OA) e .2w 2- .7V/~{ ' -4ll' A . Z-4~ ~ I~1~1 Lyt32~ • C~ ~Z TYPE OF OCCUPANCY: Residence _ No. of Bedrooms -3 Other EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGSM00 zy,42-4 fa PERCOLATION TESTS AO~" SOIL MAP SHEET _~7 SOIL TYPE 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_ ~'J~vV• ~N 5 , Z,V 7 (E' 7 y~ /,C7 2 Z ~2 5L , /0'"SeL w/R-'0P a~atsj 1/ Z Y 3'? /3N. 50,Z0"0 s,./, 12"oR, P- 72- 5-~ /1'0,'LL w R'I~N M®fS /"C owe-- j 2, Z DEivQTEf f~k'£As cv~£ipE Mc~ ~fLcO SOIL BORING TESTS ~,y ERS EX~EEL~ /L" T!.'~,C TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) B_ 410N45' ~TuEEnr 3 _ C5%/ if '"L/✓1N; 5i/ y.'_5-Iwvy Gi //"44" A-, Z- CAP- 6'y J 7O MO If /00 ~P' 41A.) C5 !S? B2- J~j/~/ G>~cJE Cs~1 JS~7~G/6 " '4v511._/0 '20 8"). F L>l 80: st w d -G MO tS FoPo^, - B_ 0.(lE eu O,Q - G 'Ifvff )910M z 0-57 PLAN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.) y7J~ s4f F~ ~C, Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area G0/ needed for building type and occupancy.JM FAR 3 &-Me)0!'`1 IICM,6 4 915' f Indicate scale t}1 or distances. Give horizontal and vertical reference points. Indicate slope. SL>< /ECi~L CD.t1l~rT/"DAIS 'A/ i - _ 10, I 0 Ak 5i Z/6 vex - d y i j 12-3 i V - - - r } l r - - s i i I ~ I„ 3 I 77 1 I 83 I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures Hp~j2 and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct 01, to the best of my knowledge and belief. Name (print) Certification No. 2 Address A71r Name of installer if known Z'f'o,~l COPY A - LOCAL AUTHORITY CST Signature EH 115 1.6~r z ~ ? /~~9G S WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: Section /Z, T_}N, R I E (or) W, Townshi or Municipality AfaV Lot No. M_ Block No. , WOO/- 13,000111r 1x11''baps County V.r"V0f X /3~rER Subdivision Name Name: hl! w - /t) _4_/S© ,v Mailing Address: TYPE OF OCCUPANCY: Residence No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS ~1J4V, 0-2T d© PERCOLATION TESTS SOIL MAP SHEET SOI L TYPE ! 1 A- Si4Tl/p-` 511-7- /a4--l PERCOLATION TESTS TEST DEPTH OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE CHARACTER NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 _PERIOD 3 MIN/IN P- P- P- SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) B- 97'.,8`'~~y21'~3~. y''Lf./3~..-G~.StL kr/o,Q- 6. Me1`S/6 "L j v,cR GCE' - 141 ?e T V5' '-/o S/ " Il /3,u Id 17" t f 13,'.'' -(Sy, S'd, L1./3^' s t G~ `JA., - B 5c L w ©R -G. tirQtS " G .110- C3' 4.,e9_ 6_e . ' B,. / ~Jawz, T If' rho y '4N '51L 5;`/ "L>•/3N /-/-!3 G L 4ul R. . ~o fs y oR. S~ yo " L~ ~N . es G.P PLAN VIEW (Locate percolation tests,soi I 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. oS`7_ E - I f f ,I 1 f 3 I 4 ! I I i 1 ~ I I I ~ i I I ' ` I - t y t ~ ( f 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 location of test holes are correct to the best of my knowledge and belief. jL Name (print) Lnh-kr Certification No. 70 Address d' 3 rT A~J 01 Ss S^ylS~ Name of installer if known ~;ZAI COPY A -LOCAL AUTHORITY CST Signature