Loading...
HomeMy WebLinkAbout040-1219-00-000 ti ^ w o ° o p our 0 o C c I ao 0. 0 `e I _o © c N ~ I 1 o fd i m O O O f ~ O y a ~ I N I o c c D -0 LL C x T3 C < U I v ~ m I z E rn z _ o ~ v 00 d co Co - z FN I o z c U o w m z ~ c C o o N Q N N N N O O O • N d ~ _C U Q Z co z O O O Z Z O N H 3 L ~ E I o O d of o yti m LO • a a a !S: ° N ►i o N ' rn a) tq ~ V = rn rn } m ~i o C) o E N x U.) Lo Y O O U O Q m m n N N O ~i N d ~ Q ~ c0 00 O N C _ o E CD It O •`C p O o 'L7 U C N a 00) O O C w O C 0) O N o Q C q Lo N = Co O N -Oj '00 •'-iVTI _ m W -0 0 i` l0 O 0 o F cn o z cA I O L rA ) m m a v ~ I EL L: 0. w `ti E 'c c AS BUILT SANITARY SYSTEM REPORT TOWNSHIP ~d L OWNER J'Mf-d 5--Azjn14 I' SECTION _T cOo N-R~W Z r ADDRESS ST. CROIX COUNTY, WISCONSIN D; SUBDIVISION LOT LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM if Pd fpjcl- ed, 3 ~ed l ~e m e gbv Q 7 , to fa'x6a` BQ~. i AM -r-- ~ INDICATE NORTH ARROW Il BENCHMARK:Elevation and description: ~D.Dn j ~~.rr~li 71 Alternate benchmark SEPTIC TANK: Manufacturer: ~fs d f~~SLiquid Cap. QOQ Rings used: Manhole cover elev: Final grade elev: Tank inlet elev.: Tank outlet elev.: No. of feet from nearest road:Front±-, Side , Rear Ft.,l9R5-'l From nearest prop. line:Front , Side, Rear Ft. 34f-" No. of feet from: Well Building: A~. (Include this information in the above plot plan) S (2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufact.: Pump Size Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons/cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop. line: Front_, Side, Rear_Ft. Distance from: Well Building SOIL ABSORPTION SYSTEM Bed: Trench: Seepage Pit: Width: l~! Length Z40 Number of Lines:,~_Area Built Exist. Grade Elev. Ay-zD Proposed Final Grade Elev. ~16-d Fill depth to top of pipe: No. feet from nearest prop. line:Front , Side, Rear Ft.&L No. feet from well: No. feet from building HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of bottom tank. Elevation of inlet: No. feet from nearest prop. line:Front , Side , Rear Ft. No. feet from: Well , building , nearest road Alarm Manufacturer: INSPECTOR: ~J DATE: PLUMBER ON JOB: v LICENSE NUMBER: ~~31 6/90:cj I' LOCATION: HUDSON,8.28.19.1061, NW,NW, RED BRICK RD. LOT 4 Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: LabbrandilumanRelations INSPECTION REPORT Safety and Buildings Division ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: 149328 Permit Holder's Name: ❑ City ❑ Village)] Town of: State Plan ID No.: SMITH, ALFRED TROY CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: D~ C5 71- 0401219--000 TANK INFORMATION ELEVATION DATA A9200174 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ? f1 / Benchmark I[~3iY- 3.1s /o Dosing Aeration Bldg. Sewer Holding St/Ht Inlet 33 TANK SETBACK INFORMATION St/ Ht Outlet Vent TANK TO P/ L WELL BLDG. AirIto ntake ROAD Dt Inlet Air Septic (30 ~ >50 ' C2o NA Dt Bottom Dosing NA Header/ Man. S/(,a '?7,53 Aeration NA Dist. Pipe , 76 9 -7,'/ 5 Holding Bot. System ,70 6, YS' PUMP/ SIPHON INFORMATION Final Grade a 99,75 Manufacturer Demand c, o /0 0, 3 S Model Number GPM TDH Lift Friction System TDH Ft oss Head Forcemain Length Dia. I Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS /oZ DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK Model Number: INFORMATION Type O i CHAMBER / OR UNIT System: `t'~-t-R /Q / & g / '7 Sb N DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s)/ r x Hole Size x Hole Spacing Vent To Air Intake Length _L_ Dia. Length Dia. t, `I Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COI {VIENTS: (Include."e discrepancies, persons present, etc.) } # ; b f I F t ~t c~ Plan revision required? ❑ Yes ❑ No _ Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: 9 (may D' SANITARY PERMIT APPLICATION ~L ,LHR In accord with ILHR 83.05, Wis. Adm. Code COUNTY TAT SANI YXERMLI# -Attach complete plans (to the county copy only) for the system, on paper not less than I 8% x 11 inches in size. Check if revision to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNf.H ) PROPERTY LOCATION yt t~fT'd S,4_1 i' il-ivni Y. V1 S T c*, N, R E (orb PROPERTY O E'MAILING rR ~ISSS LOT # BLOCKSClJ ~ TE ZIP CODPHONE NUMBER SUBDIVISION NAME OR CSM NUMBER II. TYPE OF BUILDING: (Check one pI ) State Owned ❑ CITY VILLAGE: K Y : ! , 7 NEAREST R AD rle, to' p ❑ Public 191 or 2 Fam. Dwelling-# of bedrooms AR ( ) 111. BUILDING USE: (If building type is public, check all that apply) D~/v n / ~,_C/~t)O / 1 ❑ Apt/Condo _ I d 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 50 Hotel/Motel 9 ❑ Office/Factory 130 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. 14 New 2. ❑ Replacement 3. ❑ Replacement of 4.0 Reconnection of 5.0 Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit # - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ® Seepage Bed /!?''k90el g1-~-#Neua6 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench /-'X 60' 220 In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) / ELEVATION O e ~j ji L1 L Feet /d0, 0 Feet CAPACITY VII. TANK Site in gallons Total #of Prefab. Fiber- Exper. INFORMATION Manufacturer's Name Con- Steel Plastic New istin Gallons Tanks Concrete structed glass App. Tanks Tanks Septic Tank or Hold! n Tank 60J ,vT'C(WC~ eg t Lift Pump Tank/Siphon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumb is Name (Print): Plumps ' ignature: (No Srm~ ps) ri;Z~PRSW No • Business Phone Number: 4C gas ( &4 ( 5" y'- Plumber's Address (Street, City, S e, Zip ode): , 7 l~ / J f l- l ll , 5 ecnqc~) IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued I ng Agent Signat o Stamps) INA Approved ❑ Owner Given Initial -•f!L Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety a Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit .,nay be renewed before the expiration date, and at the time of :renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this p:;rmit must be approved by the permit issuing authority. 4. Changes in orinership or plumber requires a Sanitary Permit Transfer/Renewal Form (5B0 6399) to be submitted to the county prior to instalialion. 5. Onsite sev age systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. i To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in #1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only it tanks received experimental product approval from DILHR. Vlll. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s1, septic tank(s) or other .reatment tanks; building sewers; weiis; water maians,'water service; streams and !ekes; pump or siphon tanks; distribution boxes; soii absorption systems; replacement system areas; and the 11-.cation of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; frict°on loss; pump performance curve; purnp model and pump manufacturer; D) cross section of the soil ab:=ovation system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1083 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The rno ties doilecte'.'.s th glt tI!a::i~ surcharges ar[ I; ifscd.'". for monitoring CY€'oondwater, Cgrot rld- water contamination investigations and establishment of standards. I S8D-6398 t,R.11 /88) • STC -loo . This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor,(spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property ALFWC-P q:~- AA' Y,4 A,'Al 5 1 Location of propertyXC 1/4 -1/4, Section -2, T-,~~Ft-R W .Township _T'K 0 V Hailing address 16 -7-17 A yc h f4Z A € VVA Address of site Subdivision nameA,eyiCL A Z')i7'1ojV Lot no. -I . other homes on property? yes <1FOK:> Previous owner of property _ PA y1P R K .ti e 2-o ,,V Total size of parcel _ Z,1g: 11CI7 g,4 rg 1-T . Date parcel was created Are all cornors and lot lines identifiable? NO Is thin property being developed for (spec house)? Yes -SAD Volume and Page Number as recorded. with the Register of Deeds. INCLUDE WITH THIS APPLICATION TIIE rOLLOWING: A WARILMITY DEED which includes a DOCUMENT NUIIDER, VOLUHE AND PAGE. numuI R & TILE SEAL OF TILE ItEGISTLit OF DEEDS. In addition, a certified survey, if available', ;would be helpful so as to avoid delays of the reviewing process. If the deed description refeiencess to a certified survey map, the certified Survey Hap shall also be required. PROPERTY OWNER CERTIFICATION I(wc) certify that all statements on this form are true to the best of ny (our) knowledge that I (we) am (are) the owner(s) of the'rroperty described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document Ito. .Jk/-03t, , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of County Register of deeds as Document No. Sig ature of 'a licant p~ 40Pc ant i D ate of S gnature Date of signature ee-raTE TRANSFER RETUtT PH 1s Pnma~y Use DOCUMENT NO. THIS SPACE RESERVED FOR RECORDING DATA WARRANTY DEED 481430 STATE BAR OF WISCONSIN FORM 2 - 1982 L r re 9 13PAGF ')Or' REGISTER'S OFFICE David R. Knighton St CROIX CO., WI r Recd for Record APR 4 21992 conveys and warrants to Alfred D. Smith and Mary Ann Smith at 2:45 P. M husband and wife Survivorship Marital Pr r Register of Deeds RETURNSQ_ j. • SYiI the following described real estate in St. Croix County, LAAr XV7 yy State of Wisconsin: Tax Parcel No: Lot No. 4, Clearview Addition Subject to Declaration Establishing of record Protective Covenants and other easements . 7. 7P S-1- -ft" F~ This is not homestead property. (is) (is not) Exception to warranties:. Dated i day of 19 9?. (SEAL) (SEAL) (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGEMENT Signature(s) STATE OF M-W9N~6~Fpd rA AF~0%40' ye A/ ss. , County. Personally came before me this 25th day of authenticated this day of , 1 g March , 19 9 2 the above named Dave R. Knighton TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person who executed the authorized by § 706.06, Wis. Stats.) foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY David J. Butler, Attorney, 6625 Lyndale Ave So, Suite 618, Richfield, MN 55423 Notary Public _ County,A%. M (Signatures may be authenticated or acknowledged. Both My Co i s perman expiration ~ft are not necessary.) date: BOB I NOR , 1 ) Names of persons signing in any capacity should be typed or printed below their signatures. my I WARRANTY DEED STATE BAR OF WISCONSIN WISCONSIN REALTORSO ASSOCIATION FORM No. 2 - 1982 4801 Hayes Road, Madison, Wisconsin 53704 L SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER f}L. X17 t4l AX AIA~ ,41 6 0 5- 7.iy ,a vc ADDRESS: ~~svc~ ~~5 47q.cf FIRE NO: S' LOCATION : /V W. 1/4 , &W 1/4, SEC. :r _Z $ R WIP TOWN OF: 7-A n y, ST.•CROIX COUNTY SUBDIVISION:- C2- Ei9Z Y1, V 4,lPP/r/e - LOT NO.-I' Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system St. Croix County residents may be eligible to receive a grant to help with the cost of the replacement of a failing system, which was in operation prior to July 1, 1978. St Croix County accepted this program in August of 1980, with the re uirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to the St. Croix Count zoning a certification form, signed by the.owner and by a master plumber, journeyman. plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating 'condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification from will be sent approximately 30 days prior to three year expiration. I/WE, the undersigned have read the above requirements and agree to maintain the private sewage disposal system-in accordance with the standards set forth, ,herein, as set by the Wisconsin DNR. certification form must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: DATE: St. Croix County zoning office 911 4th St. Hudson, WI 54016 . DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, C DIVISION LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 P.O. BOX 76 HUMAN RELATIONS (H63.090) & Chapter 145.045) LOCATION: SECTION: OWNSHI MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: 1V w f~/a /T R / E (or < QCWNT OWNE BUYER'S MAILING ADDRESS: USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFI E DESCR PTIONS: ER AT N TESTS: Residence NNew ❑Replace ~1 RATING: S= Site suitable for system U= Site unsuitable for system p/ 115d S ONVENTIONAL: rinsi UN: ❑ UIN-GROUND URE: S -I LHa K]RECOM E DED SYS~T~ M (o tion~)I ~y f S U ❑ S ®U I Eunde:r:s#H63:.09(5)(b), Tests are NOT required DESIGN RATE: FFIloodplain, any portion of the tested area is in the indicate: indicate Floodplain elevation e PROFILE DESCRIPTIONS BORING TOTAL ELEVATION PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, OBSERV ) s ED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.d's - 70p N6 l? U /.S~ s ' s d 0 B-3 /e0.0 1.0~Pisi .60 hS; ~.M,s e)S B- ~I 00 tai, 1"4 y'52) t n )4 B- 7 D b 166, D r4C1~~S i .C3o bjs i s1 bo th hied S B- PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD I PERT D 2 PERIODN PER INCH P- ra ~ it d S 3 ~ P- S a a1G / P P- P- 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 96. Sp o N. . p.~. i _ A rol, I Pj o` i( I - 7' 190 t_ 5 j I ~ r € ~ I 3 { I E .6 6 Cc _ I I ~m E 3 F i Ad It z ee isr;e I, the undersigned, hereby certify that the eported on this form were made by me in ac ord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print II&S TESTS WERE COMPLET D O : S 3 o2 ADDRESS: CERTIFIC TION N1111: PHONE NUMBER optional): CST SIGN E: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - INSTRL'I'TIONS FOR COMPLETING FORM 115 - -6395 T(- a complete ate soil test, your report must irlClUde: 1. rv; legal de 2_ .>ction {r indicate wh ~r this is a residence or co{nme ~)ject; 3. UM numh,- e ms or, rcial use plannrd; 4. or , r , system; the sr:i ng boxes. A -'TE IS SUIT FOR A HC _3 TANK ONLY IF ALL ;YSTEM , ULED OU , SED ON ADITIONS; I tl ions shover for writi{ descriptions and complet ii _ plot plan; ac locating y locations. P -wing to scale `erred. A desi{ 8 elevatic once point a{. town, and manent; 9. G axes as to dates, names, flood PI. -1 rcolat' ,xemp- til apply, place N.. the app i box; n floes ; ,elevation} 11 ri, 11. your cur 1 dress and ification number; 12, M ' cod ~ istri! required. TESTS MUST BE FILED `WITH THE L, 'Ho 11-IIN ,,,1 S OF COMPLLI ~ i - VIA'. IC FOR CERTIFIED SOIL TESTERS nd- 4 Symbols s Y FAR - rock Cob ; (3 - r SS - idstone gr - Gr: eel (unr= LS - Limestone s - sand HGW - High G, ry„, - Coarse Sat Perc - Pereola Medium S Well s- Fine Sand - Boil Is - Loarny Sand - G 'sl - Sandy Loam LL, 'I Loam Bn - Brewn ~sii t Loarn BI - Black Gy-G q ~cl - C ay Loam Y 1 sci randy Clay I R sicl - Silty Clay L= mot - Mott'=~s sc Sandy Clay w - with sic - ity Clav - few, lit y cop"", t~ - Ma M - -`uck - p pro,. Fn,... _ Hil°{ Anil textures d vvaste disposal - Ber v ~ference Point i TO THE in sec!~ri _ }I's F~ --i,trn, MAYregclest r <<::;t -'W Id c rf 'a e private ~i in order to IFI't d i1lS ~1~~1° oi, M;h Cevrr w/ s 0 b ` 0 3 tl Pei- T P,~,~ Cter. ~ rya ~1 ( a'X 6d Bel ivy Al ~-o 6t 5Ca rrm s vs. V PAC )1000 Q lk } Se Pt'o~os~a 3 germ Il' P,~.. iron oeD w. t ` ' i' i ~ i i 1 _ _ - _ ! . ~ _ _ 'y _ _ ii i ~i i~ ii j _ I~ ~.i li ii ,i _i~ _ _ ii 1 ii T 1~ 4 i 1 it 1' _ _ ~I 'i - s .1 - _ _ ?1 i I _+7 _ _ t':, _ t ti _ _ _ _ _ s !i !Al REPT131 TROY ST. CROIX COUNTY ZONING PAGE 1 05/14/92 10:47 REQUESTS FOR INSPECTION WORK SHEETS FOR: 5/14/92 AREA: MJ * * * * INSPECTION REQUEST SUMMARY Address Time Activity Type HUDSON,8.28.19.1061, NW,NW, RED BRICK RD. LOT 4 02:05 A9200174 CONVSEP Item: 00012 FINAL INSPECTION REPT131 TROY ST. CROIX COUNTY ZONING PAGE 1 05/14/92 10:47 REQUESTS FOR INSPECTION WORK SHEETS FOR: 5/14/92 AREA: MJ Activity: A9200174 5/14/92 Type: CONVSEPT Status: PENDING Constr: Address: HUDSON18.28.19.1061, NW,NW, RED BRICK RD. LOT 4 Parcel: 040-1219----000 Occ: Use: Description: 149328 Applicant: SMITH, ALFRED Phone: Owner: SMITH, ALFRED Phone: Contractor: WANG, TOM Phone: 425-9958 - - Inspection Request Information..... Requestor: TOM WANG Phone: Req Time: 02:05 Comments: Items requested to be Inspected... Action Comments C~' Time Exp 00012 FINAL INSPECTION_ Inspection History..... Item: 00012 FINAL INSPECTION