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1983/10/18 - SANITARY - SAN - New HT - 11122
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1983/10/18 - SANITARY - SAN - New HT - 11122
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Last modified
11/6/2024 12:00:34 PM
Creation date
11/6/2024 11:07:59 AM
Metadata
Fields
Template:
Property Files v2
Document Date
10/18/1983
Document Type 1
SANITARY
Document Type 2
SAN
Document Type 3
New HT
County Permit Number
11122
State Permit Number
45644
Tax ID
18213
Pin Number
07-028-2-40-14-19-5 05-003-012000
Legacy Pin
028411903800
Municipality
TOWN OF SCOTT
Owner Name
BETTY A PASKAUSKY DIANE M GILBERTSON
Property Address
3078 KILSTROM RD
City
WEBSTER
State
WI
Zip
54893
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INSTRUCTIONS FOR COMPLETING FORM 11 - SBD - 639 <br /> To be,a complete and accurate soil test,your report must Include: <br /> 1. Complete legal description; <br /> 2. The use section roust clearly indicate whether this is a residence or corns-nercial protect; <br /> 1 MAXIMUM number of bedrooms or commercial use planned; <br /> 4. Is this a new or reNacement system; <br /> 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL <br /> OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; <br /> 6. PLEASE use the abbreviations shown here for writing protiile descriptions a+ad completing the plot plan; <br /> 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A <br /> separate sheef rnay.bel used if desired; <br /> 8. Make sure your benchmark and vertical elevation reference point are clearly shown,and are permanent; <br /> 9. Complete all appropriate boxes as to dates, names,addresses, flood plain data, percolation test: exemp- <br /> tion, if appropriate; <br /> 10. If the information (such as flood plain,elevation)does not apply, place N.A.in the appropriate box; <br /> 1 1. Sign the form and place your current address and your certification number; <br /> 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE <br /> LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. <br /> ABBREVIATIONS FOR CERTIFIED SOIL TESTERS <br /> Soil Separates and Textures Other Symbols <br /> st -- Stone (over 10") BR - Bedrock <br /> cob - Cobble (3- 10") SS - Sandstone <br /> gr - Gravel (under 3") LS - Limestone <br /> "s - Sand HGW - High Groundwater <br /> cs - Coarse Sand Perc - Percolation Rate <br /> coed s - Medium Sand Ud -- Well <br /> fs Fine Sand Bldg Building <br /> Is - Loamy Sand > - Greater Than <br /> "sl - Sandy Loarn < - Less Than <br /> "I Loam Bn _.- 13vown <br /> �sil - Silt Loam BI - Black <br /> si - Silt Gy - Cray <br /> "c.l - Clay Loanr Y - yelloty <br /> sc - Sandy Clay Loarn R - Red <br /> sicl - Silty Clay Loam rnot - Mottle's <br /> sc - -Sandy Clay vV t11 <br /> -. sic.- Silty Clay fft - few, fine, fain- <br /> ' Y <br /> c Clay CC comnaort, coarse <br /> pt Pevat Warn ma€ay, rare=rliur� <br /> rn Muck d - distinct. <br /> p proinm r"I <br /> HVVL - High b5ew- level, <br /> Six general soil textures surface water <br /> for liquid waste disposal BM - Bench (lark <br /> VRP Vertical Reference Point <br /> TO THE OWNER: <br /> This soil test report is the first step in securing a sanitary permit. The county or the Department may request <br /> verification of this sail test in the field prior to permit issuance. A €'otnplete set of platys for the private <br /> sewage system and a permit application must be submitted to the appropriate local authority in order to <br /> obtain a permit. The sanitary permit must: he obtained and posted prior to the start of any construction. <br />
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