002-940-36-5605-CST-1992-256 INDEX o 0 (j\
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Soi1 Test Data Sheet ��
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Owner Lois E. and David T. Wade x n 1
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Address 15731 Highland Avenue NW ��
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Prior Lake, MN 55372 x v�
Certified Soil Tester Ronald Spreckels �
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Date soil test received 20 August 1992 �
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Land Use Permit 92-486 G C
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Date issued 30 December 1992 ar', a
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Sanitary Permit 92-313 0' £
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22 December 1992 �D
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Plumber Ronald Spreckels �
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Tank size 3,000 HT No of bedrooms 3 �
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Zone District RR-2 Acres .53 � i r
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Volume 457 Records Page 186 ;
Certified Survey Volume 9 Page 389 `�
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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, DIVISION
LABOR AND PERCOLATION TESTS (1�J) MADISON Wi 53707
HUMAN RELATIONS
� � � (ILHR 83.0911) & Chapter 145) �
L CATION: SECTION: TOWNSHIP/Ml�W+6�PA.iekTY: LOT NO.:BLK.NO.: SUBDI ISION NAME:
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COUNTY: MAILING A D E S: ry�� �
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USE DATES OBSERVATIONS MADE �
NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFI LE DESCRIPTIONS: PER r1LATION TESTS:
�Residence '�7 �New ❑Replace �
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RATING:S=Site suitable for system U=Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHO� ING TANK:RECOMMENDED SYSTEM:loptional)
�J �J �J � �J � J �Y � `
If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the �
under s. ILHR$3.0915)ibl,indicate: Flo dplain, indicate Floodplain elevation:
PROFILE DESCRI ; IONS
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARLIC ER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATIGN OBSERVED EST. HIGHEST TO BED IF OBSERVED (SEE ABBRV.ON BACK.)
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PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. pERIOD 1 PERIOD 2 PERI PER INCH
P-
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PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope.
SYSTEM ELEVATION
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I, the undersigned, here� certify that the soil tests reported on this form were made by me i�accord with the procedures and methods specified in the Wisconsin
Administrative Code,an at the data recorded and the location of the tests are correct to the best of my knowledge and belief.
N E (print): TESTS ERE COMPLETED ON: -
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D S : CERTIFICATION NUMBER: PHONE NUMBERIoptional):
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CS IGNATURE:
DISTRIBUTION: Origfnal and one copy to Local Authority,Property Owner and Soil Tester. t*d_Z�-4 �
DILHR-SBD-6395 (R. 10/83) —OVER — ��
� INSTRUCTIONS FOR COMPLETING FORM 115-SBD-6395
To be a complete anC accurate soil test,your report must mclude:
1. Complete legal description;
2. Tha use soCtion must Cleerly in0icate whether this is e residenCe or commerciel projeCt;
3. MAXIMUM numbei of bedrooms or commercial use plannetl;
4. Is this a new or�eplacement system;
�S Complete the suitability rating boxes.A SITE IS SUITABLE FOR A HOLDING TANK ONLV IF ALL OTHER
SVSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS;
6. PLEASE use ihe abbreviations shown here for writing profile Aescriptions and completing the plot plan;
7. MAKEALEGIBLEaiagramaccmatelylocatingyourtestlocations.DrawingscaleisprefareC.Aseparates�eet
mey be used if OesireA:
8. Meke sure your benchmark end vertical elevation reference point are clearly shown,and a�e permanent;
9. Complete ell ap�opriate bozes es to detes.nemes,eAdre55e5,flOod plain data,percolation�est exemp�ion,i�
appropriate;
10. II Ne�nbrmation(such as IIooA plain,elevation)does not apply,place N.A.in the epproprie�a bOx;
11. Sign t�e lorm and place your current atldress antl yur certification number,
12. Make IegiDle copies an0 dis�ribute as required.ALL SOIL TESTS MUST BE FILED WITH THE�OCAL
AUTHORITV WITHIN 30 DAVS OF COMPLETION.
ABBREVIATIONS FOR CERTIFIED SOIL TESTERS
Soll S�p�nt���nA T�atum Othar Symbolt
st — Stone (over 10") 8R — Bedrock
cob — Cobble (3- 10") SS — Standstone
gr — Gravel (untler 3") LS — Limestone
's — SanC HGW — High Grountlwater
cs — Coarse SenC Perc — P�ecolation Rate
meAs — MeCium Sand W — Well
Is — Fine Sand Bldg — BuilOing
Is— Loamy Sentl > — Greater Than
'sl — Loamy Sand � — Less Than
'I — Loam Bn — B�own
'sil — Silt Loam BI — Black
si — Slit Gy — Gray
cl — Clay Loam V — yellow
scl — Santly Clay Loam R — Red
9it1 — Sllty Clay Loam mol — Mottles
sc — Sandy Clay w/ — with
sic — Silty Clay Ift — tew, tine, taint
'c -- Clay cc — wmmon, coarse
pt — Peat mm — Many, Medium
m — Muck d — distind
p — OromineM
HWL — High water level,
surlace water
' Siz gene�al soil�extwes BM�— Bench Mark
for liquid waste dlsposal VRP — Vertical Reference Point
TO THE OWNER:
This 6oil test report is Ihe tirst slep in securing a senitary permlt.T�e county or t�e DeDariment may request
venficetion ol t�is soll test m ihe lield prior to Dermil Issuance.A complete set of plans for ihe pnvate sewage sysfem
and a0ermitapplication musl besubmiltedtotheappropnatelocal aWhonrylno�Oerloobtaina permit.Thesanrtary
permd must be oCtemed antl Dosted prior to the srort o�any constru�Uon.
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LAC COURT OREILLES
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INDIAN TRAILS
OI�E I L L E S � SUBDIVISION
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0 0 0 ` � _ _ � 4„ia SI/4CocSec.36,T40N,R9
� U v� Sovi� ❑ne Sec 36-40-9 Fd.3�
Fd. 21/2��9ross Cpd Iron Ft�
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( Rcd..lo C.SM Va1.3 Pq. 220Q21)
� FOUND MONUMENT
� SET II/4��X 30�� IRON PIPE �T
. �,\���i�lysl,{� Note ! The North line of this parcel was originally �
. �`.,` , -���_��y . surveyed as shown hereon, and not parallel to �'
� " ;�QNALD L. � , � the South line as called for in the deed . T1�is `
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1'ETL-'RSON �i}�'� survey was performed by Richard Andrews, surveyor,
BEARINGS ARE BASED ON SOUTH LINE OF I� ��I, in 1941, and has been accepted to this date .
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SEC.36, T40N,R9W, RECORDED TO BEAR \ �, NAvwrRD � � �
N82°43�40°E IN C,S. M. 576 \ l„� .. ""S � O`�'
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SEPTEMBER15, 1983 . ..
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I, Ronald L. Peterson, Wisconsin Registered Land Surveyor, hereby state that
in compliance with Chapter 236 . 34 of the Wisconsin Statutes , and under the
direction of Hayward Lakes Realty , agent , I have surveyed and mapped the land
herein described , that to the best of my knowledge and ability, this map is
a correct representation of the survey msde , and that said land is located in
� Govt . Lot 6 , Section 36 , T 40 N, R 9 W, described as follows :
Commencing at the meander corner on the South line of said Section 36 , on the
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East shore of Lac Court Oreilles , Thence N 82 °43 ' 40" E, along the South line
of Section 36 and the South line of Govt . Lot 6 , 163 . 66 feet , to the South '�
corner of Section 36 , Thence N 87 ° 15 ' 00" E, along the South line Section 36
and the South line of Govt . Lot 6 , 36 . 50 feet , Thence N 3 °O1 ' 20" W, parallel
to the N- S 4 line , 100 . 21 feet , Thence S 86 °58 ` 40" W, 246 . 92 feet , to a
meander corner on the Easterly shore of Lac Court Oreilles , Thence S 25 °50 ' S2" E,
a �.ong the meander line of Lac Court Oreilles , 121 . 70 feet to the point of
beginning and including all the land between the meander line and the waters ,
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edge of Lac Court Oreilles , between the parcel lines extended . �
Subject to all existing easements and reservations .
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;' RONALD \
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HA'i'rYARD
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This instrument drafted by � sUR�j�'
Ronald L. Peterson �- - - I
Sept . 15 , 1983
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