HomeMy WebLinkAbout012-740-30-3106-SAN-1972-037� �;t�
r �� �� �
��, - (� C>
��` � � f l� I
� � � J
_� �� o
�3 �,,
�� �?� o
,
� W
♦��� 0
`f �
� •
C/'� � /�/ D TFN� S
- - - . APPLICATION F'OR SAWYER COUI✓TY
SANITARY PERIGZT
� Application #�� Date 11�3d'�Z
Fee of $ ZOo00 received ' t� �.cr ✓ '2a_�J�„"�
� - Date County Clerk
� -
A 1 " Application is hereby made for a Sawyer County Sanitary
AV Permit for work to be done on the premises described herein.
1 � �,rlr��l F-h� �.5�2.T
NORM DETRY HP_YWlu�tD� WI9CONSiN St�gt�3
Oraner Address Telephone
The S. ap rt o f the 5. W, u Sec . 3p Tmn. t�q N R. 7 W
of N.F.4 or '
;r, Lot BZock Sub- division �pWN o� NL1NTc�'
� ADDI'PION TO 4 SYST�S CLAI2IIVCE MEPCi�LF
GJork contemplated To be performed by
3- 2 bedrooms
ldumber of Bedroomsl-"i bedroomNum'ber of Bathrooms 1-bathroom per ��
Dish�asher NO Garbage Grinder NO �t i
Automatic Wctsher NO �
Soil Description TOP30IL i�ivil Si�TullY GLEIY
Septic Tank Size N�NE gal .
Seepage Pit Height Diameter �
Seepage /I��f¢�=ll Length �j5 ' Width _ 10� Depth 1�, n !
Septie Tank Permit i} — �p� �+ 3pu i
1 trench 30� 6� 40° I
Percol¢tion Test Form PLB 43 attached % j
' Yes No �
i
Contemplated completion date i
,
Apptication Ap rov d Permit #
Sanitarian �� � � Jl�-7.� I
� Omrzer Agent ;:�ota 2e Date *
Remarks
�
�
`
i
Final Inspection '
Sanitarian /' �3Q—�Z, �
Owner/Agent IVotified (Date ) �
Remarks �k i
* * * Send original a,nd thxee copies mith . * * '�
fee of SZ0 . 00 to Caunty Clerk
! S(G � io �
._-- _ r_ ' - . - • f
;
� I
� :. , � : •
r
.
` , �
.
. '
� ; � � �
� i
�
!
. �
. �`
!
;.-" _ _..__ --- -
! �
�
I
. �
i ; �
� I . I .
;
1
I�dicate Tot stize and shape , Zoeation of dwelling ( D) � septie tank
(ST) 9 septic fieZd (SF) or seepage pit (SP) and distance of anr�
portion of septie system from dwellingy r�eZZ and propert� Zine .
If prop,ertr� Zies wit,'zin 50 feet of a Zake, river or a stre �m so
indieate and s ;zotv distance there from.
If anz� portion of the contempZated construction r�iZZ Zie raithin
25 feet of du�elling, �eZZ, septie tanky septie fieZd or seepage
pit o,f abbuttting o�aner so indicate .
Tlze undersigned agrees that aZZ u�ork performed and equipment
instaZZed shaZl be iiz accordanee r�ith the Sanitary Code of Sawyer
Count� and aZZ app Zicab Ze Za�s and regulations o f tlae State o f
Wiseonsin and recommendations of the Sau�r�er Countr� Sanitarian .
O�uner9 Agent (Signature )
Plb. •k '60- • • ' �Z— �J7
i,..:�..��°v�u:iJ
3�70 PROJELT DETAIL DATA SHEET SEP 27 1972
NAME OF BUSINESS „(�lu,,, �w �y;�; „�,,�_� _` PLUMB{PiG SECTIQi�
LOCAT I ON T�::t� v -L�':�i_, ;nnr„Y;�st —
���highway �g,�y��r township county
LEGAL DESCRIPTION�. pprt of F_.:•: of t•Y. �.r.._ ��p� 3p �40„�___�_
- a--,----------
OWNER Y�:v: .;i.l'.1 Mailing address rt»;f��
--- a—'�__
r1,;�„„� ZIP
ARCHITECT OR ENGINEER Address
-- `- ZIP
PLUMBER 4uiti,�n:.; :�i�::l.} Address�.::;,�: _�_��T� ZIP ^
-- Yi„1,.f;a�y-�...�....e.�. ---�--
l. Check appropriate building usage(s) and fill in the information requested opposite
each usage listed:
Existing building yyly New building Addition _
If addition to existing building attach detailed memo for each.
O Drive in restaurant ......... Car spaces
( ) Restaurant .................. Seating capacity (10 sq. ft./person)
( ) Dining hall ................. Per meal served Toilet waste Yes No
( ) Motel ( ) Hotel � ) Lottages .. Number of units: 2 persons/unit
4 persons/unit �_ TOTAL NUMBER OF UNITS �
( ) Churches .................... Number of persons Kitchen Yes No
O Bar or cocktail lounge ...... Seating capacity (10 sq. ft./person) ^_
( ) Nursing or rest home ........ Number of beds
{ ) Mobile home park .....:...... Nu'mber of urrits - dependent (camper trailer)
- nondependent (mobile home)
( ) Retail s[ore ................ Number of employees
Number of customers r0 sq. ft./person)
O Service sdation ............. Number of cars served (daily)
( ) School ...................... Number of classrooms Meals served Yes
. No
Shawers provfded Yes No
( ) Factory or office building .. Number of persons (total all shifts
( ) Apartments .................. Number of bedrooms
� ) Other ....................... Specify ----_------------ —
2. Indicate whether or not the following facilities are connected:
food waste grinder Yes No Y Dishwasher Yes No�__
Automatic clothes washer Yes No �_ Automatic potato peeler Yes
Other . . . (Specify) _ ____i______ No �__
3. Fill in the appropriate informati� for�}t—he f/p ilowing as indicated:
� [�t�v� "t"��`"L ���-✓
Se tic tank ca acit lanned �L
P P Y P p�j,r�� cn�� il:l6,TA"i_.L.:. JE�iY
Percolation test results - ATTACH PERCOLATION TEST AND SOIL BORINGS REPORT SHEET
COMPLETE OTHER SIDE
Seepage [rench bottom area planned width
linear feet depth
Seepage bed area planned SEE SEI,OW width
FOR SF.EPAGE BED SIZE "�
linear feet depth
Seepage pit planned outside diameter '
depth below inlet depth
4. See approved plan for specifications and de[ails.
Signature of person completing form: STATE DIVISION OF HEALTH, PLUMBIPJG SECTION
P. 0. Box 309 Madison, Wisco i 537�1
/� Zt-�v-c��� App roved: __ � � ���f
CLARE'.NCE 'MECCAI.F `
Address: ROUTE� � METCe1S,F sZOAD Date: �*'''• ''
HAYwARD, wISCUT15I1�LY I P �+3 TH I S APPROVAL I 5 BASED ON STATE PLUMB I NG
CODE REQUIREMENTS AND DOES NOT EXEMPT THE
Date: SEFT. 18. 197z INSTALLATION FROM CITY, VILLAGE, TOWNSHIP
OR COUNTY PERMIT REQUIREMENTS AND SHALL BE
VOID IF REVISED WITHOUT THE WRITTEN APPROVAL
OF THE DIVISION OF HEALTH.
i':115 APP70'!AL SHALL BE V61D IF
NOT INSTALLED WIiHIN TWO YEARB
FROM THE DATE OF APPROVAI,
DEPARTMENTAL USE ONLY
OFFICE & OWNER�3 SUI�R HOME � 20' x 15' 30" to bottom of bed 300 sq. ft.
� CABIN & UWNER�S WIIVTER HOME_ 30� x 20� $0" to bottom of bed 500 sQ• ft•
�y. CABSN ����#�� 15� x 10� 44" to bottom o£ bed 150 sq. ft.
# 3 CABIh1 30' x 6' 40" to bottom of bed 180 sq. ft.
� onK RT �� af' qNu �`Ce7 's
�hl —.�"
lii�oonain Departaant of Nealth and Sonial Servio�s
._ '� Division of Health �� ���
� ..�.l.L,��Y 6:L/
.r SEPTIC TANR PERMIT APPLICATION
SEP 2 "! 1972
TYPE OR USE BIACK INK - PLEASE PRINT S;
A, . OWNER OF PROPERTY
� Addrese (Str�et, Cit9. Zip Cods)
tdo�t�t »u ,u;�rr.; r � x�.Y,�.,:.�, ,,x.::�.;:x:..t. 3,+g43
H, L�ATION OF PROPERTY 51FiEAE SYST WILL BE CONSTF3ICTED ALTERED OR EXPEND6D COUNTY
CITYk �Be LEGAL OESCRIPTZON J. ��{, p= ���L.p UF� TKG �.7. k. q
Tormsxir� ��� (eio�rc, wt, sao,) ��' 30 2 40 11. �i. � iJ
C, IS [ACAL PEAMIT REuUIRED FOA THIS NOHt(7 �_YES No PERMIT Nt7�PA
D, SEPTIC TANK CAPACITY `��`�' GALLONS NEV1 INSTALLATION REPLACHIENT� ADDITION j
HATERIALSi PeiEFAB CONCRETE POURED IN PLAC6��57EEL� OPH&R��
NIMBER OP TANKS RO BE INSTALLEDt � - •
E. TYPE OR OCCUPANCY
Cheok One� One or 1ko Family Reeldsnae i Comseraial Induatrial Othar (Spenlfy)
;ti ':.:�;, G:"r,..—:, �t if(i:� Iai Tli:: oUFr,t•fr,.i
Number of persoav to be Acco�nodated �1 Number of Bedrooms�
�'7'�
F, APPLICANCES, ETC� Food Waste Grinder YES Y NO Automatic Clother washer YES }• ;d0
Diskefasher YES TNO Automatio Potato Peeler YBS i.. NO
OTHER (speciPy) YES _yL70
G. Nu15TEA PLUMBER NAKING ITISTALLATION
t+emet CL+E2�dC:: h:EPCxLF addrsss�tI]i�'+Uy`i� *,= 6 Fi:.12'�i:i.1.F' :t0, i.
/ ..
aYileYH�LJ• .tAJN�t1�..11s �j3
SI6NATUA6 OF APPLICANTs '�:''�' �' - --- '"
. License Numbert riP 1�1'�
aonxess� i° 6 kir:Ynn-_:. -I.>i;�::._�1iv 54::4? na asi+
}{, (TO BE COMPLETED HY ISNING AGENf�
Dete of Appllontion 11���—�� Fea Pa3d
Ps'miL Iseued (deLe '� � � P�rmit N�mD�r
Ageni (aene) Port rU' t� �
tam� VS �, o1Ly� aouaE �ta. speolty)
NOTEt The Applloatio annot be oonaide»d for Piling wrtil all ot the ebwe quesLlons • onsw�»d
and the fea d, Agents will foeward applioation� the fse oP =1.00 for saoh septio tenk and
the thi�d oopy of LM ps�it -(aanary) Lo Lha Divi�lon ot H�alth. Cheoks and eoney ordara shwld
b� mad� pnyabl� to tM Divlsion of Health,
C�[iTE OTHER SIDC
Q F��; LdT J`
��m � 3 G=� 32S
P��L . 9.�0
--�� ' NAI4'it
COiA7fYi ` -�
SEP7IC TANK PEHIIIT NUMB6Rt \• �
REPORT ON SOIL PERCOLA'fION TEST
AND SOIL SORINGS ,
TO
DIYISION OF HEALTH — PWttBING SECTI@1
P.O,BO% 3p9, tlndison� Nis, 53701 � �
Pursusnt Lo H 62,20, uis, Administravivs Cpd�
P 6 A C 0 L A T I 0 N T E S ?
TEST DSPTN CHARACT6R OF SOIL HOURS NAT@i TEST TIl� DAOP IN HA7ER I,EV6L INCF�S PIIIJUTES
MRBEA INCHES TNICI(NESS IN INCNES SINCY HOLE II7 HOL6 IMERYAL SECOND 70 EXT TO LRST 40 FALL
let NETTED OVEANIGHT IN MINOTES LAST PBRIOD LAST PEAIOD PERIOD ONS INCH
E7CAM�LE
P - 0 36�� ?OP SOIL 10^ CWY 26^ 25 YES Op NO 30 60
1 �F." ].�" tOpsoil 24" s. C• 18 � 20 3 3'z 3
z <"='� l i�' t , i•1}'� S•.::':: ie 1� p'� ZU '�' �
3 'S" 12"t s �i:° g & � � ]$ PuC '_Q '
REC�iD DATA PROPl MiNIl'NM OF 3 T€ST HO185
COf1PUTE SIZE OF ABSORPTION AREA IN ACCORD NITH H 62,20 NIS. ADM3f7I5TAATION CODE.
5 0 I L B 0 R I N G S - MINIMUCI 36" BEI.0+1 PROPOSED AflSORPTION SYSTIII
BORING TOTAL DEPTH �&PTH TO GROUND WATER DEP75i TO BEDAOCK
NUMBER INCHES OHSERVED ESTIIIATEO OaScRVED ESTIMATm CHARACTEA OF SOIL VlITH :HICKNESS IN INCf$S
EXAP�
g � p n n K 0 OZ n � u, rt p u
,1 r.�.:. �`.J � 1 "JI i;. •n ._ -
2 ...� `i II _ �• QII _
3 rn tl lY(� � 1 �tl M �,.
RECORG DATA FAOM tlIH
'fYPE OF OCCUPANCYt
AESIDENCE; NUMi3ER OF BIDft00H5 2 OTF1CRi (SPSCIFY) U"`�"--�- '- --"' - '� - NOtID&R OF P6RSW7S 3
F000 HAS1'E GRINUER: YES_�N0�_DISFWASF�Rs YES� NO��_ AU70MATIC Clpff�5 NASF�Rt YES� NO �
6FFLUENT DISPOSAL SYSTEMt NL57 EXTENSION ADDITI09. � REPLACFT�NT
TIIE SIZE_ N0, LIN, FEET TRENCH WIDRH DEPTH� NUHBCR OP LINES�
SEFPAGE HfiD; LENGTH 7(�f HIDTH�y��[�1 DEPTH���_•. . TILE SIZE�� N0, LINES_�
SEEPAGE PZTt INSIDE OIAMETFA LIW7ID DE�TH�
� �o �oC;on, • f Sed
1� the undersigned, hereby oertSry SMt Lhe percolation Leats reported on Lhit form ware made by me or under � super-
vislon Sn aoaord with the prooedures and method apecified in Chepter A 62,20 (3 ), Nleconsin AynlnisSraLlve Code� and
thei the data recorded md location af tesL holes ara correot to the beet ot rt�y Imowledge md beli�f.
NAME Gi...ti�u�V.: �-!��:�..LN RITIE liV1Yl.�tw1�. .
TYPE or PRINT
AEGISTRATION N0, OR MASTER PLIRSBEA LICENSE NO.�_
ADDRESS �,w'�a.. �:i ....: 1.etr. .iL: . i.�, i�1�'Ll;
^� -�� s. _ _.., � . f / r / / .
DA7E •iL.i '.� 1`z. 1 �7�� SIGNATUAC ,� .?-` ��t r %;� � •' /.+ . .
DO NOT HRITY IN SPaCE BCI.bW - f'OA D&PARTMCNS U56 ONLY
� GA2E J2ECSIYED ACCfiPIED BY pg7yq}�p
PEE RECEIYED YALID N0, p�p Np,
RSYIEMED BY AppROVLD D��
NI7'IALS YCS OR NO
��{��_ _ o � � `�+ �
T ♦ .� � ( � y�'�y 4_4 +Y • " � y . .y� �� 'fv` �"�F {�iy �.
F
y��*� r � � y��. � 2�1 31 r� . . .
,�_a r +'. . : � _
" . �" , > ' :, � Y�." S > �: �- : A y .t . � w , e y
, , r . '� . � _ i � .� � . _. y�, Q4.
�r� {:. � .��.^ � ,� � �"} � v .
� s �.�si� '... � Y '^'7g an a .E.�c�R ? .`a� �+A� '� '_ i ,4 S.. i 'v.: . ,tr^� r. . C` , j:
,.�r<�..,-.n. � y�.�.+..,�F _�. k �� � �., y;.r ,$T . y 1„� e ,,��4 " .
, ,� •� . � 'Y .,4 y� •7,�a . � yya.. FeY r:r. . � �'_
� r y r. t � �
? �� ;. th �..an � �t t T'� .y�t � �i � {' f` � r
. y+�e`�' .� _ "'S- .', h »
iy n�G �f "�`t '��F L t � x �� �
l . � �$ � .R � ' i ' � ^ �� . ,.
` ��.Ai��. '.�i' � x"#` A � ... - .. . � ; . .. V �¢� �� 4 �.
R � t
y -_. �F / � _ (� ' - ' . - . � c��
r '. "
� . . n . c. .' '� � T
�. '♦ J� �5^t .., . ' _ -�
Y �` �: , .. � � � � t
F . � �. , . Y� # °^y-&-,
�"+Y' � .- �. a ��y 4 �t�y,, +R 6 4. '� � �e .�.:+ � �,- �y,.r .
,���... N�_. � �.. �"��������rv��!M1Ybl��^'�(�'y'AX'Ak��.� $R,��:.. �Y„ 'ef.� '}µ��•'a•�j s��(i+��5� ..� i �
t.•li "t ' .i_ .
��i�, ' �` . .,
Y
'R
��# n . , ., �or�ll f � e,IPrf — /v � .
.�
: - - --- _-- - � --- -_ - - - - �e�_ __
.
. �-` �
--- - �L - � 3d- -��� --
.
;
-- - --- ----
_ � �J
. _ �1 ' - - . _
� +t �:. G i �
;.
------ —�= Ife -- — --- - --
- �,�� n__ _--
_ r ---- ------
I � �
_ _� _ _ � __ -- —
, , - --- -
; ��
;
:; . _ ---- --�-
--- - - - - ---- --- - -
,
i. -- -e� ir . - -'-- --- - -- - -
� i
-- --
_ _ _ _ _
- ----- -
Su mc.R�
--- - - -�t��G��
4 i � . , �
,. � �� �G�_ i
,,
. --_ _- ----- - __ _ _ - -- -- —- --
' l.
�
fff� - - -- -- - - - - - - - - - - --- -- � - - -
9 =}� .
er. `
�
�
+ x •�„'�� � . ij('
N� f e • y- � i'I __ _.___—
AE, — --- --- -- ----- - -- - .. --- - ------ - j - -
� iR
—_�� _ ps� __.�--aT � _ �_�t_ 3 ' 3� _
_ _ �� � . R. �a --- -
__ _.. - -- — - --
I
�
- -- - -- _ _ -- - - -- - -
_ - --- -�- ---- - - - -- -- --- -- ---- -
.�.�. , �
� � ,
�
��.
>
�;t.
�q �',e � _.,- '� '
`k
: y "' ' : ' .�_�
_ _ a * , r ,f.-
. - :'>
� ,
�-. e: �. - � . � . � '� �" -
- ` �
- .
, . , :�a.
� � „ .. ., . _ . _ .. .. . - . . . :
' , . ,., ;.� '- +'�, ' t �� . � :, .. � .; . . . . ..�. , ,a' �"'
� 3 N �
''�',�'"`$�S...S'a k�"f' ' . ' � a4'}r`�' � � '� � '�'x,f a� , 't:^��"�.' . . � - � � � r �.
dnr� �Ta� • .s . . . i , . , � . . . .. . , ,,.`�.�,',i..
�hi ' ;
, , ' .. . MUooruin Departsant oP Health and Soo1a1 SerViou
. �- � Divieion of Health ���
, .�., �._.. .�:,�
SEPTIC TANR PERMIT APPLICATION S�� 2 j ��72
' TYPE OR USE BIACK INK - PLEASE PRINT P6UiSBi1�C'a SEC7��=''�
A, O1MEA OF PAOPERTY
'� Addrees (Str�et, City� iip Cod�)
ivv:u-. .,._.�:1 _. ;r tL,�iwriw, .,l-x',:,...;1.. 5t+-°,t�3
B, LOCATION OF PHOPERTY HNERE SYST WILL BE CONSTFNCTED ALTERED OR EXTENPHD COUNTY ��t�•�t��
Cheok Onet -
CITY YILLAGE LEGAL OESCRIPTION `�• yt� OF N.�. -y U.t•� �iliG J. W. =y
rowNsx�p X nUi.T::i� (elcox, ws, seo.) ..�.�.. 3C T, riC i�, '� 7 • .
C, IS LOCAL PnAMIT REuUTAED FOR THIS WONK7 YES No PfiAMIT NII�IDi
5co ga1 :aisti.g
D, SEPTIC TANK CAPACITY GALIANS NEW INSTAI,LATZON� RCPLACFYIENT� A➢DITION x
t7ATERIALSi PREFAB CONCAETE POURED IN PWCfi_S?CEL�_07'HER�
NIl�IDER OF TANKS PO BY INSRALLEDt
E,- TWE OP OCCUPANCY
Cheok Onee Ona or 7ko Fami�y Reeidanoe�_Caooeraisl�Industrial OEher_(Speolfy)
,2�o:c: �..::;�;� � g
Numher of perso�to be Aoca�odated�� Num6er of Bedraome�_
F, APPLICANCES, 3TCt Food Waste Grinder_YES �_NO Automatic Clother Nasher YE5 �_:10
Disiarasher YES �NO Automatio Potato Peeler YES �NO
OTHER (specify� YES �_SIO
G. MASTER PLUMBER MAKING IN5TALWTION
laemat CI,:,ttEiv:;� ,j';;iI'Lt:LF ndarsestROUT� # 6 1+�li1l;t�i.F itUr.J
�'"C�� .../e " �,5:�.;-:L�� r�1Jl:.:,._.L, Sl}�y..�-
5ICNATUPS OF APPLICAN'Ptr.�'%F/te^ -� 6 :,
Ltoense Numert P@ 14�8
aDn�ss:x � 6 ,�.:.!`�aik' n�.;D rinYa.+uw. .�,l.,i:i,u.,�,, sq;''4j t�e t�su
H, (TO BE COI�LETED BY ISNING AGfiNf) �
i`
Date of Appllontion J I ���<< ��-= Fee Pa1d '
Parmit Iewed (dsLt . '� _ P�e'mit Nwebv �—"
! 4
AgenS (nme) ' � � �� � Por� � � �
" town� villag�, aity� nount��ta. tpeolfy) '�.
NOTE� Rhe Applioati oennot Ds ooneidend for Pillag u}rtil all of the ebwe questiona nr�nnsw�»d '
end the !�e peid, Agents w111 Ponrard appllaation� ths fse of=1,00 for eaoh septio teNc and �
the third oopy ot tM p��it (carary) to Sha DSviHon of H�alth. Cheoks and wney oM�re should .
b�meds peyabl�So the Diviaion ot H�slth.
C�LETS OTHEA SIDY
�oT '� c.s Vo� 3 R-� 5�.5
p���� .�.8
NAT�t
COVNfYt •
SEPTIC TANK PEAMTT NUMB6Rt
REPORT ON SOIL PERCOLAiION TEST
AND SOIL BORINGS
TO '
DZYISION OP HEALTN � PIIJMBING SECTZCQ7
P,O.BOX 309� lMdieon� 1fis, 53701 - �
. PursuenL to H 62,20� Nis, Ayeinistraviva Cod�
P B R C 0 L A T I 0 N T S S T
TEST DSPTN CHAAACTER OF SOIL HOUPS NATQi TEST 2II'lE DA�JP ZN NAT R I�VLL INCF�S MINUTES
NUlIBER INCHES THICI(NESS IN INCHES SINC& NOIE II7 HOLE INf&RYAL SECOND 70 F�C7 i0 LAST ?0 FALL
let 4fETTED OYEANIGHf IN MINUTES LAST PERIOD LAST PERIOD PERIOD ONS INCH
fiXAMPLE
P - 0 36^ TOp SOIL 10" CLAY 26^ 25 YES OR NO 30 60
1 i�v��l �M }'��� <,�•1 ..• ��f' �i• �N .�.J �O J 'L �l J
'1L {.
�i�� ZL�� e�:i• �...� 3• �` C• t�� �iC IQ ZL 13 2 �
2
3 1Kiu �tt L�9• LC.:ir S• � �.:• �t'(1 i:. 1�J � �� 4 G '
REC�iD DATA PAOM Mi.NIMUM OF 3 TSST HOLES
COt�@UTE SIZE OF ABSORP7ION AR6A IN ACCOStD NI7H H 62.20 AIS., ADMINISTHATION CODZ.
S 0 I L $ 0 R I N G 5 - MINIMUM 36" BELOIr PROPOSEO ABSORPTION SYSTIII �
HORING T07AL DEPTH DEPTH TO GROUND NATEA DEPTN TO BEOROCK � -
NUMBER INCHES OBSEAVED ESTIMATED OBSERYED ESTIMATm CHARACTER OP SOIL wITH :HICKNE55 IN INCF$S
EXANP
g � p n n lS 0 I ^ C n: v A
1 (���1 �J, q Y �il �+�' �dl'..�h. C'Li...
Y (vn �•�� 1 � �n t.0 ..90� U4�� Sii7: Q
3 ;n i,.� � n ; �i
pECOR� DAT& PROI�i t1I
TYPE OF OCCUPANCYt .
AESIDENCE: NUMi3ER OF BIDROOMS? OT{IERt (SP&CIFY) `i"''v'•.` "• ".• � � .� �.� NOtIDBR OP P6RSWiS� �
POOD iJASTE GRINUER: YES NO .� DISF6IASHEFis Y65 N0:{ AU?OMATIC CIA7'F�S HASF�Rt YES NO X
6FFLUENT DISPOSAL SYSTEMt NE57 EJCTF775ION ADDITION �l REPLACFI'�NT
TZLE SIZ&r� N0, LIN, FEET TRENCH WIDSH DEPT}I� lA1MBER OP LIN6S„_
SEFPAGE B&Dt LEN('iTH���'� . NIDTH(Z!� �EPTHL[.n TILE SIZE�� N0, LINES��
SEEPAGE PIT� INSIDE GIAl�TF7i LIQUID DEPTH_�
I, the underelgned, herehy certity SMt the yercolation tests reported an thie form were made by ma o� under � super—
vision 1n aaaord .rith the prooedures and meLhod specified in Chnpter H 62,20 (3 ), xisconain Adminietrative Code� and
Lhet the date recorded end location at test holee ara correot to the bast of vy la�owledge and be11sl.
NAl9E :�i.�..�,.,..�.::, .!..at..�i•'' TITIE v��.:..:t
TYPE or PRINT liy.;.��,,
REGISTRATION N0, OR MASTER P(AINBER LICEN56 N0,
AD�RE55 �✓:..� . �, .._...� ._ ...,..._ :t.�l,.._�_-� ..s_.._.:.__. J:. ... ;.
DATE •'""` 1• 1`'� i��!�" SIGNAfURC . � . . .
DO NOT NRITT At SPACE BCIDM � f'OA DEPARTM6NT U56 ONLY
DATE R6CfiZVED ACC6P7CD HY AE7VRNEC
PEE R£CENEO YALID N0, P6HM1! N0.
REYIEF'ED BY �PPROVLD DA7'L
INITIAIS YYS OA NO
I �
� �
_ �q� I
I
�
_; ___ �Z�
� — �� eP (
�
- - Gabia �`
_ � _ , exr '
. __ . I �j�A I : .
_ l — —
� � — �
� �—oT G �l —
j f �"Il 3 � �Z,5 i
� _; �A L �9.8
� i I
. , �
�
� �
, -- _ _
�
; � - ,
rti I
z;
-�:':
. }'.��� . Y .� � .: . ' . . . . . . .
• , � _ .
G.
�.., . � . Y•,� . , . .
•-
.�. : .
.d2r : . . . �•1 a ., _ _
1'� ' ' . . ,s � . ' . . _
)_ ' . � _... � � . . � ..
>. . . ` F, - . . . , .
-,•s.1' . ' � y,��. t . �
s� 1 , . . � � , , . . . . . . . .
.. t . ' "' " . . � .. _ . . � . . ' _ . .
,'.F� . � . . - � - . � � � . . � .. ' . _ . � ' .
- � 2 - . . . . .. . , _ { " . .. .. ,
� - . . . . , . . �, .
.. . .. � ' . . . e . . i Y,, .. '
i . . . . . � � ' ' . . . �� ;f� . ..
} . �' �� t � <y
. '.. " ..' r ," ;� !.
. xs �. � . .E�-Y '�i� ,. 'f- � .
� '
- - � � . .. -:. •r R �..;, . . .
.,s.�' ., .e i :.,v.- s. . � r i.. _
� r
� � _ �`S.� a ..� G ": *��., y�_. �r ' �, ", .
^�.g5,1�'w s., =7 ,� �„nY� t �a �f��s«.'A � "" 1C`�" E,`,,, ,+` . .
. �xT:m . . . =if ^ ' "t; � f+ '. . • . - . .
. . . . . . . .. , r'�t..�w`I"
�hi . . - '
Nisoomin Departn•nt of Health and Saoisl Servio�e
�_ _ � � � Divlsion of Health .7 Z_��
L�W ti:.-c ur ��,:J ���
SEPTIC TANK PERMIT APPLICATION I
SEP 27 �972
' TYPE OR USE BIACK INK - PLEASE PRINT ECi:C"�'
�, OiMER OP PROPERTY
' � Addreas (SLr�sL, Cit9. Zip Cod�)
B, LOCATION OF PAOPERTY NFIERE SYST NILL BE CONSTHIICTED ALPERm OR EATENDED COUNTY
Cheok Onee
CITY VII.WGE LEGAL DESCRIPTION _ . , ,
TOWNSHIP (Bloak� Wt, Seo,) .
C, IS LOCAL P6AMIT REuUIRED FOR TNIS NOAK7 YES No P&AMIT NUIDFR
D. SEPTIC TANK CAPACITY � GALLONS •NEW INSTALLATION_� REPWCII�NT� ADDITION:�' _
!]ATERIALSt� PAEFAB CONCRETE POURED IN PLACfi S1fEL�OTHER�_
NIMBER OF TANKS 70 B& INSTALLEDi ' ' ' • -
E,. T1PE OF OCCUPANCY
Cheok Of�es One or 'Ma Pemi�y Residenoe�Commercisl�_Industrial_ Other_(Speolty)
Number of pereona to be Accomnodated�_ Number oC Bedrooms�_�` "-ry-- �
F, APPLICkNCES, ETC� Food Waste Grinder YES •� NO Automatic Clother washer YES . No
Oislasshar YES -_NO Automatla Potato Peeler YES ND
OTfiER (specif�r� YES ; T]0 �
G• MASTER PL[R�IDEA hfAKING ItJSTALLATION
Namef Address[
SIGNATUAE OF APPLICANT7 � ' '� �V � �— � I
� License Nweberi riP - I
ADORESSs �''� ' '� - � � � I
I
N, (TO BE COMPISTED HY ISNING AGENT)
i
ilete oC Applioation J�� �O— /� . Fea Paid
Parmit Issued (dets ,� � P�rmit tiunb�r ��
Agent (asse) Por� , �/, !�� � `7~�
Lwm� vl �, a1LY� aou� .� �ta. �peairy)
NOT6t The Applioatio eanot ba ooneid�nd for filing wrtil ell ot the nbwe questions �• answ�rsd i
nnd the L�� d, Igants xill PorMard appllcation� Lhe f�� oP $1.00 for aaoh septia tetilc and
the third oopy of Lhe p�+mit (canary) Lo Sha Uivi�ioa of H�alth. Cheoks and noney oM�ra �hwld
bs md� psyabl� to the Divleion ot Health,
COTffLBTfi OTHER SIDC
L o-r 3 �s \la� 7j Pq 325
pRk.c�i. . 9•Z
� NATS i
COUNfYt ��`�
��
SEVTIC TANK PEPMTT M7M8II2�
REPORT ON SOIL PERCOLA'lION TEST
AND SOIL BORINGS
TO '
DIVISION OP HEALTH � PIIJMBINfi SECTI�7
P,O.BOX 309� lhdleon� 571s. 53701 - .
Pur�uent to H 62,P0� Nis, Administraviva Cod�
P B R C 0 L A T I 0 N T S 5 T
TEST DBPTH CHARACTER OF SOIL HOURS HATIIi TESY TII'� DROP IN 41ATER IEV6L WCF�S MINUTES
MRIBER INCHES THICIO7E55 IN IIQCNES SINCY HOLE IN HOLE WI'EAYAL SECOND TO E7(? TO LAST TO FALL
let HEPTEU OVEANIGHT IN MINUTES LAST PEAIOD LAST P£RIOD PERIOD ONS INCH
IXAh1PLE
P — 0 36^ 10P SOIL 10^ CLAY 26'� 25 YES OR NO 30 60
1 40" ]2't t.S• 28" S• & C 20 NO jQ 1
2 n n n & NO 1
3 40" 12" t s 28" s & � NO 1 �
RECORD DATA FROt4 MINTiA1M OF 3 T6ST HOLES
CIX'�UTE SIZE OF ABSORPTION AAEA IN ACCORD Y7I7H H 62,20 HIS. ADMINISTiiATION COD6.
S 0 I L H 0 R I N G S - MINIMUM 36" BELOtr PROPOSEO ABSORPTION SYSTSM
BORING TOTAL DEPTH DEPTH TO GROUN� NATER DEPTH TO BEOROCK
NU[1BER INCHES OgSERVED ESTiMATED 035F,RYED ESTIMATm CHAAACTER OF SOIL �7ITH :NICI(NESS IN INCF$S
EXAM�
g � p n n K 0 OI n � gn, n u
1 6" � ' " t o' "
2 " NO t u n
3 " NO � ^ u
C A
TYPE OF OCCUPANCYt
AESIDENCE: NUMi3ER OF BEOAOOHS 2 OTFSRt (SPECIFY) �S��T C�� �y NOlIDSR Op p6RSON5 �'
P000 NASTE GRINDEAt YES�N0�_DISFbiASHEHt YES_N0�_ AU70MATIC CLOTNES NASHER� YES� NO
EFFLUENT DISPOSAL SYSTEMt N�i_� EXTIIiSION� ADDITIOH�_REPLACFSfENT_
TILfi SIZE�� N0, LIN, FEET TRENCH NIDRH DEPTN�� MRIDER OP LINES�
SEFPAGE BfiD: LENGTH lKt HIDTH in! DEPTH �� TI{.E SI2E l�u N0, LINES_�
SEEPAGE PITt INSIDE DIAN�TFA LIGtUI� DEPTH� t0 bottom of bed
I� the undersigaed, hereby oertlty that the percolation tests reported on thie form xere made by me or under �r super
vision in soaord rrlth Lhe prooedurea end meShod epecified Sn Chapter H 62,20 (3 ), Hiaconein AdmSnisLrative Coda� and
thnt the data reeorded md location of tesL holee are correat to the �est of �y lmowledge and Del1aY.
Nuae ��N�� �T�� 7ITIE CONTRACTOR
TYPE or PRIN7
RECISTRATION N0, OR MASTER PWMBER LICENSE N0. Y��
nnnaEss ��� � 6 METC�ILF ROAD FiAYw�, WISC;O1vsIN
/
DATE $'�j'. 1R � l '� SIGNATIIIiE tx-t t'-Y_� -� � -
DO NOT i1RI1T IN SPACE BCLOW - FOA D&PARTHBIP! 56 ONLY
DATE jtECfiIVED ��gpryp gy
AE711Ati6D
FEE A£CE NED yALIO N0, pyphp Np�
REYIENED BY APPROVCD DA1'L
�IT�� , YGS OR NO
fy�:_y` Y�""+.�11' � � Sq . g � ,.,�r. �� .
_ ,: '@' �.. �� �7x .... S� .iY �- . . .. .
.R V Y� j . "A.�n 1
. . � ,. ny,, !: . r�'v+ y�24Ja,.Y.- ,p � / ::.{� �vi � t 3`}�... .'l. � ' x•�,w;�';.' -.; . . :
�f _ �k� r . ,.f, � ,., Fv+ :�.�y` , e� � _ � � . ' ' _
� yY,
�� - ... r f� •� r.,-' r� ,ry-tY,'„r ���i . �e . " � 1. � ' � � � '¢ '' . .y! , .
� ' � y s T �' • � C �< .?` '.rry . -- ''K.�' �4�. � �-
3#os . '`�' � t ` � . . . ,� } ,. . ' .. . � r T�r 1 • . y .; .a„
�a E:-� �... .. � . . r<. �". � :�,�' _ . . ' . � � .� '�. ; f. , a�' ., � �*- ,ir:: 3,.
vtl:`zs. '�y - , t - , " a,'S': . :,y . . . . . , .. � � x -..• ,� _._.-�fa.
s � �` � . .• ,``. . - , �_ : { • .. ¢ s k:e r ':# ,�•.."� 'ir -
r�. a Y k , . - . .+� e. -.. � - . . i . � . .:i�.'�€. � .� � ¢ L
s ' . __
�' . . .
�'y�� .-.. � . ��� + . . ~;.�"�.i . _ ' ' . - _- . ,. ,�y�P�r�"`-`�' �'��:: �MA *F '
�',. �`iy,, e.�, ` � ea' � .hq . .. , . . ' � .. - � A���'�,�`�� ... ,
".� c ''C!. - y - - ` ��`` S!"'` • - . . . - � 6 ^"� . ._
•t� ti • � s. .. ' � N ;�..�. •�d f x �("' �p,�
AW4 ` . tP . Y (Y�Y .,y, .-.i�A q=. . � �. . .�.
�S ♦"`' s ,n Q'U M � � ^ " . . . `."'Y'srn 'a b . . . . .. :
��,,, q;. .. , 'S'� Y; � 'w,��J4a . . �.::,}�s�� .. _ ..�f ` ` '. ' .
�� � �� . � ' .. 'i b �c�
...,
a 7 ty , . . - . . . 4' m �.
. `� l � �.. . " � . �. - � "�+^� .'dY
� ' P
T�{�t ' �. � t ..� �~ � � ' • av
- � M ~..f:� _. '���
�e�_ . T t aq. � "' , .. ~ . ' . '�?
�'�' J �.r.�. . .. 4�r.
. . . , . . � . . .i.. � .
. �
_�. . �� �/py/� _�� � �17�
, �
_ . ,
a :� � . _ _ __ _ _. - --C -- -- ' - - ----- - - --- - -
. - -- - �9 �---- -- -- ---
. � , -- -- - - I _-_
_, ,�
------ -- -- �
---
- - -- ,
--- ----
- -- -- -
_ _ --- -- -
, ------ --
�--�b -� -
; � �
- — - -- � ,
-� - � - - - _ _
� �
: � � er- ' j� --- -_--i
,.;; ti -- - _ --- --- _ 11'F �
. , fT - �� '--
. -- � -- - �
:�� --- � - - =- - -- --
;�� � ;
: : _----- �
?��' : - - - - ----
���; , ------- -- - -----
- - -- -
;i, , I -
j;� � _ - i
�,� - - - - -- - -- - _ 1 - ---- _
,
- �� i
,;:
?�; - ------ ---- --- a
,�� ` -- — - — -- -- ---- -- --— - � -- _
I
:;
f;
�� — -- - --- — —___ _ ___ _ — - ----- -- ------ �___ -- -_
,
;
�'. _ �T 3- --� _ i� _ 3 � � ------ � _ -- -
:: - - i� �'—_ �9;. Z a-
- --
: --- -- - -----
�
----- — -- -- --- --�---- ----
�� ---- =- - ---- -- ------ -- ----- � -- _
.��\ �
,�
a.�_
- � - . . �. f ' � � . .. . ��'' . . �`+6 f^is .�;s,� .
�ni .
� Nisoonain DeparLaant of Health and Sooisl Sarvio�s
— '� . Divlsion of Nealth
� L.�.r.,...a�r ton/
SEPTIC TANR PERMIT APPLICATION
S E P 2 7 1972
TYPE OR USE BI.ACK INR — PLEASE PRINT PLUiABlNG SECYi'CS�:
A,- ONNER OF PAOPERTY
}�yIDe Addrese (Str�et, Clty� Eip Cods)
..r... . .� iC ;J Clf,ti...�i✓� -.1..%N���.i�.�1:. �j('*}�
B, LOCA?ION OF PROPERTY tiE�RE SYST NILL BE CONSTF6ICTED ALTERID OR E%TENDED COUNTY �, ���
Cheok Ones
CI77 VILWGE LE6AL DESCRIPTION �-• jJSI't OP li• �. 4 UI' �'t1-'. .�. -�. �,
TOtiNSHIP n :ibi!i.<. (Block, Lot, Seo.) �,:.-.�.. �i i, 40 :� Y�� 7 r,�
C, IS LOCAL PEAMIT REuUIRED FOA THIS NOAICP �_YES No PEPMIT NI2�TA
,�.IL` '<�� �d�� _'I���. � � . .
- 1
D. SEPTIC TANK CAPACITY GALLONS NEF�INSTALUTZON�_ RCPLAC}S]ENT� ADDITION;_
MATEFi1AISt PREFAB CONCAETE POURED IN PLACfi_S?6EL�_OTFfER�
NItIDER OP TANKS TO BY INSTALLEDt �
E. TYPE OF OCCUPANCY
Cheok One� Oae or 1tro Pamily Reeidanae_Comoercial�_Industrial Other_(SpeolPy)
�SGR: ..cS1i, �P C. [.. ...V �;, .i: Ti'.�..
Number oP perso�to be Acoovmodated_(� Number ot Bedrooms�_ �� -
..i:.l:
F, APPLZCANCES, ETC� Food Waste Grindar YES X NO Automatic Clother Washer YES X NO
Diskefasher YES ]l NO Automatia Potnto Peeler YES �_NO
� - � OTEiER (specify� YES �•j_MO
G. MASTER PLUMBER NJKING INSTALI.ITION
Lkmes v1.-...:�.��� ._. .._ Add1'e9sr.�.�.�i_; ��. ::61v:._ir �..-:..
L 1'
5I�3NATUiiE OP APPLICANTs
Lioense Nu�eri HP i•-`::, '.
ADDRESS� % G � - -✓ � �- j�'11i,'S MP HSA' ',
H, (TO BS COMPI,ETED SY ISSl1INC AGEN[) ,
Date ot Appliontion �,����� Fes Psid
PermiL Ieeusd (date �� P�rmit tiunb�r ��
Agent (nms) Pori�
Lown�v� ��� aity� ao �So. epeoity) �
N01'6t 'Phe Applloatio oannot be oonsidsred for Piliag wrtil ell ot tha ebwe que�Lions •aaex�r�d
end the t�e p d, Agents will fotward appllcstlon� the fse oP j1,00 for eaoh saptlo teNc end
the third oopy ot the ps�it (canary) to ths �iviiion of H�a1Lh. Cheoks and woney ord�ra �hould
bs mde pnyabl�to LM Division of Health,
�«,��T:o�5me �oT � �.s Vo� 3 R, Z53
�RR.c�� .9.1a
_ _ _ , I
. !
NAlS s
COIAffYt � ��"
SEP7IC 7ANK P6HI1TT NUMBSAt �
REPORT ON SOIL PERCOLAiION TEST
AND SOIL BORINGS .
TO
DIYISION OF HEALTH � PllJMBING SECTI($7
P,O.BO% 309� lhdleon� 1fis, 53701
. � Purntsnt to H 62,20� W1�, Administraviva Cod� �
P E A C 0 L A } I 0 N T H S T
TEST DBPPN . CHAR TER OF SOIL . NOURS l7ATCR TE51 ?I!� DROP IN NAT&R LEVEL INCHES MINIJTES
MMBEA IHCHE THICKNESS IN INCHES SINCY HOLE III HOLE IMERVAL SECOND TO EX7 TO LAS? TO FALL
� let 1IE'I'TED OVEANIGHf IN MINUTES LAST PEAIOD LAST P&RIOD PERIOD ON6 INCH
E7(N1PLE
P - 0 36^ ROP SOIL 10" CWY 26^ 25 YES OR NO 30 60
1 50" �" t.s. 38" ' k o 20 �0 3 � 3 3
2 r a w �
3 0" " L.a. " e � O 20
RECORD DATA FROti HiPIl'II1M OF 3 TBST HOLES
CIX'�UTE 5I2E OF ABSORPTION AR6A IN ACCOFiD NI4H H 62,20 AIS• ADMINISTHA?ION CODZ.
S 0 I L B 0 R I N G 5 — MINIMUM 36" BELOIr PROpOSF.� ABSORPTION SYST6M
BORING TOTAL DEPTH DEPTH TO GROUND WATER DEPTH TO BEDAOCK
NUMBER INCHES OBSERVED ESTIIIATED OBSERVED ESTIMATm CHARACTER OR SOIL NITH :NICXNES$ IN INCF�S
EXAMP
g � p n n K 0 0 n � m u y
], � ]rQ / M a M
p j;6� � � N r
3 86� 110 � e w
C A
TYPE OF OCCUPANCYt
RESZDENCE; NUHi3£A OP BIDROOHS 3 OTHCFit (SPECIFY) ��� C'�� �/ '�`'� NOlIDSH OF PCNSONS G
— 5 ,v `Tnh
POOD NASTE GRINDEAt YES�NO $ DISKKASHEFis YCS� N0� AU?OMATIC CI.07'F�5 NAStIERt YES� NO
EFFUJENT DISPOSAL SYSTII1e NEN__ EXTFNSIOtf_ ADDITIOG._REPI,ACEP�ti1'�_
TIiE SI2E�� N0, LIN, FEE1' TRENCH WIDRH DEPTH_ NUlIDCR OF LINES��
SEFPAGE HfiDs LENCTH�� NIDTH '1�iT DCPTH • TILE SI2E��,N0, LINES���
SEEPAGE PITt INSIDE DIAN'�TF7t LIDUIO DEPTH � =O 86�OY1 of B��
I� the undersl�ed, hereby oertity Shat the percolation tests reported on thie farm were made Dy me or under apr super
vision in a000rd with Lhe prooedures end method epecitied in Chapter H 62,20 (3 )� WieoonaSn Adm3niatrative Code� and
tMt the data recordad end loastion of test holes are correot to the besL of Ry la�owledge snd belist.
NAME L"�R++�iiu .NL'�1.'�.ir' TISIE i��
TYPE or PRINY
REGISTAATION N0. OR MASTER PIAIHBER LICENSE NO,�
n�D�Ess RotTPE � 6 N�TCALF ROI:D HaYwaRD. �, � oN�Ia Si+gt+3 - -
� �
nAae 5FE'T. 18. 1972 siaNaxuae ' ��-t.�'c'�c.�e,-�'l- . (��'_'
DO NOT HRITT IN SPaCE B61DN — PoR DEPARM1TI6NT US ONLY
�ATE RECSIVED ACC6PT6D BY pE711HNEp
PEE RECEIVED YALID N0, p6WlIT N0,
REYIEMED BY APPROVP,D DATL
INITIALS 1TiS OR NO
. . . �r _� ,yu,�°,+`_;; .. . . .
i`�14'7�t . .. "�4 o-. ' 't ' � , � .
+.'t• '''� . .
.� � . . .. .. . � ..
, , � _:.�%,, .. - � F.. - � A ,
".`�� - . ` - .
4
�
. I I I
._ _ _ ._ - _.__ __._I_. . _______ _ ._..._ . _. _. 7 _
_ � - I I
_ • ._______I_.. . . _.
�
____ ._ ". __-__- — r '/ `I V I _ - _
i �
�
L_ - - - - -
_ _ �_ -�---�- ----_- _ --�
-- - - -- '
I
- I � ,
� � ;
� � �t�(� I ' � �
�
j � �t�r� �dT G - - ---_
� � -�� Li _- �
_ � _ + _ -- - ---- .
_ _ -
. , .
s 5p0 �
� � .
��� ._ — ----
� _ _ _ _ i i —
i �
� I
�- -- - � . . i . _-- - �- --�- - . _�. - .
f ��� --� j �
� - - -- -- - --- - _ - -
, - -
� --- _ _ - -- --- � 3��
_ - -- - - _ � i
- -- - -
� � �
�
�
.
� �-- - - - -- -- ----- ; ___ _ i
_ _ _ -- , -
r� �- ---- - ; �.z� ,
� � � .
� �
� _ _ - .
�` _____- ---- - ----
- -------- - , �
=� �
,
-- -- -- -- �
_ - ---
:
R - -- - - ;
. �
- -LoT _I_ cs �l _ � 3_ P�- - _
, -- — — i�53 I
:
� _�_��.��_ e�'. � - .
,,3
� �#------- ---- —-- —__— — —
---- --
> I
: � � ���
_ t �w �Q 5 _�_) 1 N�_�__.--- --_ .
_ , ..
i j _ I
:Vi
`Y ��
' e`��*. ,� �'..•
f
- - . � � �' f. 1Ne:
. ' ' • ♦ � • • J' . 1 Y-•-
' �. . � � • - .. . f. �7 =l}..'.
.,. . . . . . . . . . .. � M f . � . « . .. � � . • .
� � Tr V�.
rn^ �,ik t , . ._ • �.0 ' � ~ : ,t. � r* �� k � � 'y �� � A�, �'.
' '
.
. ,;�#�_ -"� ... .�� ; � :, �� _. `« r! i.."y �' ^ys s�- x,:,x. �i ' M
* ' A `
R� � ' � - ° .a; ' as � '� ' .�• ��Yx � .r � p t.. .-• t.` t ' 4'
.. �.
, �
. -. . �.
�` - �., . . . ,.
. , y ,�-. .. . . ' . Y .• . ; •... ,�'.' .�'. ' E.t. '�'k ,�. '
".. , , �=' . ,� .., .A' ,,;°. . ,. ^ _- =':t . . _y . - . . . x � *'.o- ' % #s�.
.:x . u
... - :. . . e -.. - -: . � ,.. r _ • . > A` • /x
,. �,,.. .1 • �. , � ,a �.-� _ .
,
�.
,
. �b
� � t. �` �: • y .. . ;
. .. . � . . a ry ei�,. r ' . .. .' � ` fi� 'i-. ��w u . • � ..
� .� I- ,y'���*�' n.. . �'s '- .� s ; �'� ��' ,+ Y • �*,(.• � .3�hT{5� �:� � s`� },; .. . � t �^`'..,� M•' ' .
. day^ r'� 't < . 'u„ . , 'F' .
q P . A K.: �1 � ' .. . .f�'.�. . � . < ys� .,t . . ,r . . y
�y - �'c.� ' Y 1 ".` . .�y sy r x � ; Q s =��°ii'' .
f :7_F � y, �'Fy . . r iQ.`'.. 1 t [ rl r y. ': �y.. t�y��?F�� � _ . yi'�'�y. • • . .
,� u
�w w ,.� ,�^ }� p
ax � i� N t y �/� � �'1 . t" ��"� ,j,'�% .� '{ ri.'.. aS 4r s . . � r .�t '�
�,.� � r,C l -._ . � �*In". "1 " . . $ � �0'sn•. .i. . T � . _�
>:>, . . ... �;,x,;r,�,,;i�",�s��
, ;..,
N
�
� �1 � �, .
� ����. :���, �
Ri. N \V' � '
' Zj � � � �\ � �•� -��-A
� � � (� ♦ `'�__
� �' T � ti;30�
n %L.o
r m �
� D
o � � � � ,
�
o r� �
� - - �30� _ � g --- 30
�D •`°
/ G O N ,y� n� ,� 30
'� � ���, � sa L �O �o
i � o
61 �. ` ��A p fi � � L
�
� / a _3 � � �p 3o s.
�
� \��p ol
1 � �30. `�. � ' \� / 30
V ,- � - - , :30 , �
O "=' � � � � -A � � - � ' �
� ;��" �`� m ,a
i/.' �� � � 30. 3 � A
'// iu .tn
\3 '0 � � L �L ' b
� -G �3 D.� I \ Y �.
p , .b30
' � z G � V�
� �� � •
_ ` � �
i
�J - � /
� " - -
— ,i � _ �,
i
��=:� � ��
l'1 � i
� ',
�l � � 30
� A A
m `q'L p , ����� C�
•, 'i ,��. 1 .
�
Z �. �
n � ,
� \
u i
o �; ; i ,,,
o �� ; , 1, ,
�,_�
m ' ' � �
; ,
R ' � I �i„ 3 P
y %_ �� \[%
i � � — ��T� � �� _ � �,
�
i � �30 ���� �
/ � \`
� � � �� 1�
/ : �
/ � �� � '
:
/ \\
�
I
� �'V y' �
� �, I I
,
i ; i;
� I
SCALE /" = /oo FEET "'��
.��:;� � Cl,'Sf�.
o IRoN P/PE /N PLACE =�`\`'� ••� �,,�=
N i AO°ERT � :
� IRoN P/PE PLAGED 'T�� S�s�ae�v � �=
i ; N:.�tcv.tap, _
ALL LoTS yoME oCC�P/ED + `�'�"'S Tve�o�',`
..�....����•` �
�'�-i-�" ,e. �.�.�,,��-r�
_ 4-27-75 AD
� R � o /
�y 3.4
OR'v��/AY �O� N 5. ,6^ag W
p, o.8.
3g3� oa' S °
00
��S Zg' o
EASE M�NT4S� E' p o� o /16 �°. t�
��oTD � oo.°° �^' s�Zi 16ry • ` r ^ � �
.h � `9s. �- /y�� o. d°, . �.— �v �
ro _ r N. 3•s ;a o
'� �,. So.O' S'w. � r_ W �
z � N�6"4S'E' n
/o w �w " 3 �
I� �o W �,z S
vo
` ° ° `^. a� S;qi � •\ M
� 9° Z58 � � Z
� 12.o Z Q' � �. !I r Q Z �
£ 3 _ � `,� � --���;�(��� , ��;a�� h � i-
�
o + '" o �
ro t ''" i y f io2 F, • v� �
J f�� iO . �V V 1
o �„h, > _ l. � �s.�'— — � y
a 'r`' —3�5.i5 �. "' h
°� .o�� a,, o. yo�°-� N �
�r � �
�' n2 9 .Z
b� ��o D��. �
• 5
0
/ `�
L f{ t E F L'�'�E
- 151195
no�r.o�a�a )
� Sawyec County I�
(�� ��-��- Recefvcd far:�r_-rd Lke �.Q'�T� day of
_� ' D 13�atg'3a o'clocc
��'/-(.1 /1 � ��/ �.5 �..�. _,_._�.d i� vcl. 3
c/ / �/ oE �}. ,�^�-.• _:-,' .7,7�f=G
�_ / lXJ ��n"�j �1.GGr._ . .�2_�Lc�_�'l— /�IS�"�
�
w•-
N
Page 1 of 2 nage■ h
c�� �;�,�., � L �t`!-
I , Robert K . Swanson , `1`isconsin ec;istered La ;id Surveyor , do
hereb. certify th �t i*� f�ll co��lia � ce rrith �ha�ter ?36 .34 of the
r'isco�si3 � t3t�stes a �d unc?er the �' irection of �' . N•adea � and
r�or�an Detry , ow^er�: of �aid l�nd , I tzave ���rve ;,:ed , divided a��
na�ned the lu�c? herei7 �? e .:cribed a -�d t�; :�t suc:2 la ::d lies i :� the
r+ortheast # of the Soutnrre �t # of Seetio � 30 , '�'on�as!�i :� 4� '�orth ,
!ta��e 7 �est , To�: � of �-:•anter , Sa.�yer �o�iat �, �';iFco �.sia de �eribed
as follo�� s : •
Com�eici:k; at a �as pi �e on the '`orth—Sout� � lir_e of Sectiou
30-40-7 l � =�id ra.s pi-;e bei�lg o� the hic;h fv� ter Zi :;e of �hief La'�ce ) :
the �ce ^orth «lo �F said �`� .5 •� li:-e 472 .'�� feet to � ri_>e : tne :�ce
Go�ith ?6° i;5 ' ��e .t 76j .4n ��et to aa iro _t �iz ��,_�_i�:. i� tne _oi �t—
of—be�i�~=i�:,�
The ;ce :�out`� 0° 1 6 .5 ' ��e :t 27� ��0 �eet to � .� iro� _�i�;e l��i^�
or the z e�._�der li :e a �:d �-3°00' ' �ort�-; of t:e nort:� y�.ore oi C;i.ef
La::e .
'"hP�;ce �outii `j7�29 � .:e�t 375 .1 j feet alo�:�; the zne ��.�cier li�e
of' �hief L:>'.:� to a �� iron ��,ine l��i:� 3� � ��='t': oi tr,e �7�tEY' ' s ed,e �
T'�e ._ee :�rt{1 3°j4�5 � ;-;c :t 270 .'�0 £Fet to a : i�o :� ::i -�e .
'1'he�:�e ,�o_rth 'J6°�5 ' e .-�.�t 395 .�0 fe � t to the iro = nin_ ; hic:�
is the roi_�t—of—be :iri�i�:; ►
�'�.r�els are to ir�lare the l�rd lyi :�- hetr;e� :� t?�e ��e.a.��cier
lir_e a:� t�:e r,:ter ' � ed ,e bet� een tne rarcel li.es eltendec? .
P;..rcel:� � �^e �lwo s�� bject to t:�e joi�_t �t:e of t'ie 2 , 5 ' ro;d
ea.�e_.ent extr� -.3i����� Wo�.�t�.:•,.�.tE- rl�� froxi t�e ��o�t�� ��t �or__er of
lot 3 �.s �ho�::_i o-. t?�e �.�n .
P: r�el: 3 � .-_d !� �- re -� 1�o t �+ t�;- -� c;_ nt �i: e � � t'��� 16 ' d ":�_v2t,.��
^•`; =-l'•�'i;.'. O': tt`.E' .=" '7 �
�_'_';E�� � re _;.1�0 •.'l�"' � E?Ct t0 ±"_� � , :"V-:� +�_0 :1:: ' , � ., _ ^ .E' :':t� Of
ti � �,: � .
`.'e �0i� ..
�`,��eiil n r►r�
�`����J�''�r'�S'�h�
..v� ♦���.....,�
f �.
. �.�
:' �'• '
•' * �
' ' ROBERT Rs: =
=�� " StiVAi3SON ; �'_
- ; 5-1048 • _
� . HAYv�A.�D. : �
� :� FVIS. 0 :
'�I� 00
a��o���t���� O��`
♦
.,���'�I,S' „ e�`��
-� �,
,
,
���,�-�� �- , � . , , � �--r-�� ���
. � _ -- - r
� 7 7, 5
W
!�
� Fa�e 2 6`
�I
�
(
f
• •
pHNN4b
,����gCOIV�a,���
SCALE / " = So �EET ,�
' ROBERT S c
O IRoiV STAKE /N PLACE :Y.� SK'y�SOH {��
= sAYw�,Au. �
� IRoN P/PE PLftGED : 'R'+� "
:
;�� � ��.
N• ,��'�.�d Sur'�e4�`��,
••.,.f,:,,,,.,,.,
Q.1�«� � �,���^�„`' T o y,� N
��.�,� .
9-/5- 74 ,63 ¢o
p �.B 5 � 6° �9��' R�AD
h
2o3. ozo p- �`�c N � po, . ,
� / p0. Q � — �
N ��� ¢5 £5 EASEMEN�� � ' ' � o
� o3.° y a' , � Q �i
.� RoAD ' 1b , , �
� �
o ��'., � �
o . �
�a �, (n �
v W �
� � � r
o ^ � c
r*, d
!� .p � �
C
O O, j T
^i ^3 0
� � � +r� 2
v o , Q
a
�6' 2 0 }x. 1�
c., - � u
� o oW
N � �
. s
Z O
0 ,�
O ' \ ``i\; �
�
�..
t�l ,;'� /�/•
j .: 3R.
� QO/
O , 3�� W
N �/ o
b 5'�i ,
o �o �� 6`� �
a 5i
5 `'� `r.rJ., b �
a
o� � �,3�z�
�516¢5� r . N E
���
w
0
iEF
G � PaFQ 1 of 2 paF¢• �
� 4
Cerlilicd 5u.�vep Rar��
7
� •
I, Robert 3. STTcr.s�n, 1':iccossin Re�irterec Lar.d Surveyor�
do hereby certify th:t in full compliance �,itb Chapter 236.34 of
the 7:ircor.cin �tatutec and un8er the direction o£ II. f:�dear. and
7vorr.an Detry, ownerc of e:.id land, I haae surveyed, divided� �nd
r.;a�ned the land herein described :nd th:t sueh land liee in the
^�ort�aeact � of the Southwect } of Section 30, Townchip 40 2;orth� .
RanFe '7 l;'eet, ToNn of Hunter, Sax,yer Count�, Yi�consin deccribed
ac folloac:
Commer.ciag at n gas pipe on the l:orth—South } line of
Section 30-40-7 (��id gar pipe being on the high r:ater lir_e of
Chief Lake ); T�er.ce north along s�id 2I—S } line 4�2.00 feet to
a ripe: thence south 76°45' �eet 763.40 feet to an iron pin�
thence south 76°b5' xest 394.Z8 feet to an iron pipe ghich ic
the �oint—of—beginning.
Thence couth 3°31' eaet 2']0.30 feet to an iron nine on the
ne�nder line of Ghief Lake and j0' fror the x�ter'c edge.
1'herc2 south 64°55' Rezt along the seander line of Chief
L�ke 130.00 feet to an iron pipe l�ing j2' from the Rater'c edge.
'Phence south 76°45' �est zlonfi the neander line of Chief
Lake 103.02 feet to �n iron nipe lying 30 feet from the water'c
edge.
Thence north 0��0.5� east 302,00 feet to �n anele iron
cemented in concrete.
'i'hence north 76°45' eaet 203.02 feet to the P.O.B.
The �arcele are to ir.clude zll the la�nd betn�een the �^eacder
line a.nd the water'z edEe between the psrcel lir.es er.teaded.
7'he parcels are subject to the 3oint use of the 25 foot
road e��ement ss shor,n on the n�p; easterl, to the 1'o�rn Road.
2'?�e narcels are al�o subject to e�cements �nd reeervationss
o: record,
=i �: `;i �f
&�.�;��o:;;c< �.
. n_w>.>'�_r. ,
�r��.: �:-� --... . 1.�� �_,�
�,
��PZP— ;n: 1�;:/-��__.:i
n (.�.:_.._r..:.:-��-.,�: .3 ^;s�
�tnt^=��� .���c3 --,3�s
�` _���,.
�.T.,
F.�Q z
�
�
-�