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HomeMy WebLinkAbout030-2004-70-000 Qo o 03 °64). o 0 'r Y O C y Y O I p O L O O O O O� GO M i tO0 O da)ik N N c c 0 Gc E O N x 2'O N NfV u2 m > O c M 7i o�VM N E U O O U a0.. v z a N'o 8 N c m �m d m LL O N Lo c a `n ss _ N._ NVM Q H d w L)5 c � y 3 E T y 0 Z a m o M IM- (n i O Z $ c 0 N F :z j Q' aci N N CL O) O O 0 0 0 N . fn L_ cc tC N li d .O 0 i� `~ N j Z co Z Z Z o N I IL o aa 9 d Q o °vv� v� m > 0 Z > � 6:1 ° Al 1p c CL M IL O a v u' } 1 ao ao U S p> rn �n n rn o M A ° 0 0 0 0 O 0 0 - ' N N C il-- 01 O) O M L d Q O C N c O ?i N O � 0 OD O m O E N D c C a 0 0 0 0 N N N l Q n O N N N a L N o y C d O n �V N V � O i � C m N 7 !\ N W p fOA 'O Z 'O O a OOH r O f7 O C (O Vl c_ N C N O o N w O O E V O M 0 N m O O vi O O O rO rte+ V] d CL y a 3 , u a te CL 7S 2 A U a O N U c'3( 030- aoz) U -0�v AS BUILT SANITARY SYSTEM' REPOR TONSHIP,S] rj� _ oj SEC.OWNER �T N-RaW ADDRESS ST. CROIX COUNTY, WISCONSIN. SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 EBTHING WITHIN 100 FEET OF SYSTEM / e /S/ S I di a e v th Arrow ' I JA 11 A SC L �= i aus.cr X vi-)4 BENCHMARK: (Permanent refer nce Point) Desc ibe: Elevation of vertical reference point : Slope at site : A46TIC TANK: Manufacturer: g u6a - Liquid Capacity : Number of .rings on cover : �Tank manhole cover elevat oi Tank Inlet Elevation: Tank Outlet Elevation: PUMP CHAMBtR Manufacturer: Number of ,gallons Number of gal. pump set for a cyc a gallons ; total capacity o distribution' lines gallon: size of pump head; gallon per minute horsepower brand name of pump and model number ; Type of warning device HOLDING TANK: Manufacturer : Number of gallons Elevation of manhole cover Type of warning device .SEEPAGE PIT SIZE: um er ot pits eet diameter feet liquid depth seepage pit inlet pipe-elevation bottom of seepage pit elevation feet . SEEPAGE BED SIZE: number of ;lines width lerigthZo tile depth SEEPAGE TRENCH: idth length PRCOLATION RATE ' QUI BUIL R410 INSPECTOR %,f &-#I L DATED ���, /_ PLUMBER N J B LICENSE NUMBER -4> . � >� � `� ., ,, * ..did.� .,�fit, ��. 3 �, ,� �. << r ;. f� w • .�� �`' d s�� �� REPORT OF INSPECTION INDIVIDUAL SLWAGE SYSTEM S a n i t a it cy P v i►rn-i Sfiaty. Sep-ti.c%�WoOolry - NAMI �4Aff—,bWTown,6hip S#. Crt.ac x Cuunfir► L t.icin Section Lot N Subdiv.ceion SF PTIC TANK S4, z e �jog-_`I�T g 2 umb en o6 eampahtmen is Dt'tanee 6no.m: Wet. Sv Bui.1'ding 120 6 tope__11.10--- H.tghwaten PUMPING CHAMBER S.i v -V gaQton,s Pump M a n u 6 dc.-tune.it Model Numbe.4. HOLDING TANK S4 zv_ gattons NumbeA oA Compa4tment�s Ptimpe.k Atan.m System . D4',s t a n e e *wrw ` ' ""„ �., �t� ,� �" d n g 12.o, .�I o e ... Highwa.ten ADSORPTION SITE 8,0d T it.e.n c h. - Ur ti toncv Atlrom: WelX__ Buitding 677 t20 �stope.­L� — --_-- Highwateen� AhtiORPl`[ON SITE DIMENSIONS GJ i rlth tne.neh t Re uine.d area I. I ength o6 each , fin e-_� v 6t Depth o6 , ttoek beeow tile. Nambvn o6` � i. eb �/ Depth o6 hoeh overt t4.Qv Total teng.th o4 tine.e I 6t Depth o6 tite below yha.de. D.i6t.anee between tines ( 6t Stope oA -tne.neh._+ 7/4-n .— pen 100 6t Totaf ab6onp,tion anew 6t Type oA Covet: Papv,A' un 6 tytaw ' I V/ T DIM ENS IONS GitJ Numbem (YA pitA GA.avv P an.oan•d r)its ye,5 nu Outside d-%-amete.n.----_ _At Depth betow i.nfet �t To.tae absanpt 'on a4ea 6t An e a neq u,i.ne A 6t 1NSPFCTE'D B.y IltLt- AI'I'ROVED DATE G 0 19 RI J C I 1 'D DATE 19 x RI ASON FOR Rf:JCCTION . State Permit # / State and County PLB 67 Permit.Application County Permit # 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 (� Mai(liny� Address: TOM IZ AN B. LOCATION: 1/4 5 Ya, Section , T N, R f `K or) YV Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township C. TYPE OF OCCUPANCY: Commercial *Industrial *Other (specify) *Variance Single family _ Duplex No. of Bedrooms 7� No. of Persons_ D. SEPTIC TANK CAPACITY /��Z1 Total gallons f of tanks �_ HOLDING TANK�APACITY Total gallons No. of tanks Prefab concrete 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 Rate tal Absorb Area sq.ft. New Replacement—Alternate (Specify) Seepage Trench: No.of Lineal Ft. Width Depth Tile depth (top) No.of Trenches Seepage Bed:— 'S Length '70 Width /'P._Depth�—Tile depth (top) No.of Lines Seepage Pit: Inside diameter Liquid Depth No.of Seepage Pits �Q Perceni slope of land /0 V Distance from critical slope WATER SUPPLY: Private 5C 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 Cert ied Soil Tee er, NAME � l z C.S.T. # � '_� and other information /1L�) pj obtained from (owner/builder). Plumber's Signature MP/MPRSW# ���fL? Phone #-7 Plumber's Address 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. E S e e «t . i 4 1 r t t ,q. t i i "s r r P i x. ...3 ._.._... <... t s.� E j F., r a a S E i E E n i 1 � tk F w { E .., ... ._ .tom._ 1 Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY NNLLY, -� Date of Application 6 � ��� Fees Paid: State County L=_—Date Permit Issued/iRejemd (date) �,2 Issuing Agent Name Inspection Yes State Valid# Date Recd county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 e (pink copy) 4. plumber (canary copy) Revised Date 7/1/78 ,, _. ,� . .. '; � .r ,_ � _ -i�"� � .,_ _ _ �> r i _. _-. ^; w . .�.' ,,, ♦ __ t 5 _ _��,. `, ` _ t 3 _, _ �. ___ ��s �' -=�.'� 4 �� ���� .. �a i -. c r EA *115 Revs 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O.BOX 309,MADISON,WISCONSIN 53701 ; LOCATION:-5e y.,Se:y.,Section ,T, N,R IQ X(or)W,Tgwip or MrwieipQkty CL Lot No. ,Block No. County Subdivision Name Owner's%Buyers Name: -710 i� Mailing Address: TYPE OF OCCUPANCY: Residence No.of Bedrooms COMMERCIAL- EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS 1- 17-21 PERCOLATION TESTS ' /*? -81 SOIL MAP SHEET_ Aref. <I r-64- NAME OF SOIL MAP UNIT no'Me PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL,INCHES NUM- INCHES THICKNESS IN INCHES SINCE HOLE LE AFTE INTERVAL RATE BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN P—.2 40 N oat S— ( P-3 110 P— P— P— SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER,INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, NUMBER INCHES TEXTURE,MOTTLING AND DEPTH TO BEDROCK OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B— gY 0—> W I r B— B— B— PLAN VIEW(Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location r square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy Q -Indicate scale or distances. Give horizontal and vertical reference points.Indicate slope. IT _. -- .- - _ / 4------ a r i 4 E S d -4 _ — r o do e 5 n # )A 4 t 3 mme _ Jo' Tv I,the undersigend,hereby certify that the soil tests reported an this form were made by me in accord wi*;Ie 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) J Pry Certification No..� Address .Name of installer if known Copy A—Local Authority CST Signature �.� via F 1 `r LED 404012 '� AUG 6 31985 bo�bSyf r w of Lp, CRS 1/4 COR. small tracts 64 OXON ftftty, ------------Section 32 Co. Mon N00°14'45 E 00°14'45'IE 701.27' 700.14'r N \ „ • d 616.351 E) 219.821 rt w 448.211 y o O �.. O-. co n -t7 -n tD rr Cn N - W W O S ri' co I tp � CO N �--• C.77 N P N - y y V 00 O C) O w w m f+y'I O CO Ir VIN � O r CO 13 1. p Lnn \ co - ~ T r z -I N f A `O C'07�5 I er m s I O�\ y r ♦♦ m r C7 Cn N I,NJ V f�'L r- p W •D Co m r o n m 1 N T \ - tiro ��Gi v' c° ” o° r� a .rt• o I m ` \� rar0 can o07 oyo V) to O Z I�•-' V \ n C'f O CM) CT1 .♦ N o M I w 14n- N 1N \ � \ ° ' r r W O r°r7 7 1 Cl O r t0 ° 1 rr CO N W �--• N d rn w a\ n 305.63' L" 306.58' 306.48'r •_� a S01 04414 V cn w n n m m M m CO rn r N m rt small-tracts w y r Il n o CA O o z - �--� t= ,c D Z ° M r D ° C7 o U3 O M Q z r + Cn —) N z d O ° it7 S C N s m BEARINGS REFERENCED TO THE SOUTH LINE n ` '`°' w o rn W R"I m m OF THE SE 1/4 ASSUMED TO BEAR rn r s "' 0 3 Ln °o°o � m S89°581131IW. ro :3> Q' N •.Ii. 07 y = y Cr Cn r• C-> o co m V7 C.) CT N CD 07 r'.) co Z O w NO W M r r O to Cn n .--1 O O O O O ° N r ►+ 7-+(.T7 r N r p y+ Cn N to Na N Cn r D C••) r O r Cn C77 ►+ W r z p r m --1 C7 -� o x w c m o z z N W a-• r rn - rn �--• N r N r r co m y - v v r + N 0o ,r m N N .- .- x ►. .-` r x x -4 C:) x t-. V V W 07 m D - - C rr x x (A 4- D N rn D o r- N o M �' rn M ° E cn rn cn w m Cu r z z rn w a a a y o C) O m r r x O N O r r ° -+ � -ry –{ rn O m Z m y r 0 . Cn V O W rn t7 -C7 rt �7 Z r (t 1-r t- a T cn �* �- C» o V N o, .- m IV i--7 a -v O r co r w Cn N Cr o7 .-. z • C= o r. 1 z rn rn w r o rn = O N O r OD N •-a E N O r» cn co _ - m ° Z Z Z Cn Cn W Cn y N V O V r aD O W V r = M S N of r y Ul N U7 r O N N 07 N m x O O O O O O O -.4- �7 C7 C7 C) r'f :z y V N CO CO CO V_ N tD CD N fD N A ` 61 .. N Cn W►+ N W Cn m rn .N. n W }� APPROVED W O W N V 07 W W n m 7H m H �.�y + ' X Z X Z sy 0, m m m � cn cn E ► C-> c-) n C� x ;1 rt z x z x �°� S rJ �► -� � � �.� �c CROIX COUNTY ENSIVE PARKS K004IN13 r 0 Vol. 6 Page 1557 i �a ����%� �• A* IOPMNG COMO t txTI ':' s. b f ki'�' .•.:F . 1 'i� ov •, t� , r� r �tl" a 44- F �� 5; +� ,'S!`arva� r3uitl �2 19W + ♦' 9► E/-!9'/r✓wrac„�s ;Y tfwr' Jit fir, `� ,., � t ,� ,fi 1 ����?��.` � � �.. .AH,-1 t ��, :�,.'�'f4,y,:ir f .,,o, 'rr,•, . x 1 #? VIII Y { { r e p at ° , ��� -I�t i ;•sips .,. __} r. Nt ;1 i ( 1 Alafoe ktr, 1. ' ! h :^r � -�,•��: -a, �`[ j r 1�d r r,n�!�y r 01 3���p�. 404012 AUG '.7 1985 S 1/4 COR. small tracts 84 Orobe Lowy, rt Section 32 ------------ Co. Mon. \ NOOo14'45'E o L' T N00014145 11E 701.27' 700.14'r 219.82' 616.35' Q 448.211 o 00 'f, I I f.. - N W W L O S N ya N .•' CT1 N rt co t0 O t0 N s r- �. _ _ CA vl - o w w N m cn oho oo Io O o r co rn - Ir V N --1 _ \ _I O r z 0 0 N N I m O w• a r 01 f.J1 N CD \ 0o r r i0 o C-) r CD o m m V v - ��ti�� O to o N o's C, N a .rt• �o i • `�ti 0��' —i coil ooi CO N m Cl) 0 0 . . - - o rn cn � cl > 0 o - o rt m i w m w w O p o w m in) r' r 305.63' 306.58' 306.4 v Z 1N--1 o w N d rt --.© SOlo44'46"W c �+ m V u1 w .. cl C-) = m ao r N ` small_t�acts o 1�-1 < CD rn c °o o M r d �e D L o d D -h N 1--• N h� '� O m O .rt D to ° 0 Z S = p.. — N C N z I� n ~ BEARINGS REFERENCED TO THE SOUTH LINE -o rn� y r T m D>• r U3 w o rn N rn rn rn OF THE SE 1/4 ASSUMED TO BEAR rn 0 3 F °o°o m S89058113 11W. 4- -" CA G'l O O _ CD -i ? o n ,* _ r• � 74 o Cl) o 0 m (l1 O N OD O IV OD Z = rew a, r r O :n rn -••1 1 O 0 0 0 0 0 0 0 N . , h"•Ln r N ►"` a r X r Ln o_ o_1.1 T r o_ r w °t Ln N ►+ V1 N N Ln ►+ D O ~' rorrnrn wrz M -� c-) -1 m o w ►+ r W .-+ r rn N •-• N r N N r r (p m --4 l0 r ►+ CJ1 �! 01 r r - �''1 �'' -rn n+ ►+ f+ r x -� 0 to V .. V Vw 01 r o z rn Oo D rn co D m - c ;' o T. O r•. N OD 01 M C co X H O N D Z -/ r D D V1 N 01 7 N rn °m = to rn rn cn w m arD r Co Z v m 0 •O •p Cn w .- r w .- r �' z C' r" N z O N O N N W r r v CO o IJ - N 01 .- m N M CD ro tD r w Ol N O, 01 p.. Z T -v Z m O rn rn _ O co O r Oo N 4 S O 0 au u1 CD n1 0 Z Z Z N N Vl N N (•7 N 01 V O ,--t W N V r OD OD W V r S N cn r Lr'V1 N (n r 0 d d d d H N O O O O O O O O ::0 0 0 O n 2 V1 O r r N O ►+ r v M CD O V N c0 t0 t0 N l0 f9 A r-• N- to w.- N w to m o=yv• `' fj!}� APPROVED w o w N V F w w n m rn m m m v1 cr1 z r- r- � � ^ X o c c o /� .ta Z Z Z Z CROIX COUN11 1 1 0 :"Pt' FIENSIVE PARKS EUINNINO ZONG coMMITIEE NI Vol. 6 Page 1557 >� . � • ywnfrt.'y !�� Parcel #: 030-2004-70-000 03/24/200508:1 oAM Alt. Parcel M 33.30.19.366B 030-TOWN OF SAINT JOSEPH Current ;X, ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): ' =Current Owner DAVID A&TAMARA A JOHNSON JOHNSON, DAVID A&TAMARA A 1218 52ND ST HUDSON WI 54016 Districts: SC=School SP=Special Property Address(es): "=Primary Type Dist# Description ' 1218 52ND ST SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 4.290 Plat: N/A-NOT AVAILABLE SEC 33 T30N R19W THAT PART OF LOT 1 OF Block/Condo Bldg: CSM 6/1557 ASSESSED WITH P355B Tract(s): (Sec-Twn-Rng 401/4 1601/4) 33-30N-19W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 905/270 07/23/1997 774/338 07/23/1997 737/542 2004 SUMMARY Bill M Fair Market Value: Assessed with: 5703 287,800 Valuations: Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.290 116,000 167,100 283,100 NO Totals for 2004: General Property 4.290 116,000 167,100 283,100 Woodland 0.000 0 0 Totals for 2003: General Property 4.290 68,100 138,800 206,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 128 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel #: 030-1097-50-000 03/24/20PAGE:1 A Alt. Parcel#: 32.30.19.355B 030-TOWN OF SAINT JOSEPH Current X ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): "=Current Owner * DAVID A&TAMARA A JOHNSON JOHNSON, DAVID A&TAMARA A 1218 52ND ST HUDSON WI 54016 Districts: SC=School SP=Special Property Address(es): "=Primary Type Dist# Description " 1218 52ND ST SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE SEC 32 T30N R1 9W PT SE SE THAT PT OF LOT Block/Condo Bldg: 1 CSM 6/1557 ASSESS WITH P366B Tract(s): (Sec-Twn-Rng 401/4 1601/4) 32-30N-19W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 905/270 07/23/1997 774/338 07/23/1997 737/542 2004 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: Description Class Acres Land Improve Total State Reason Totals for 2004: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2003: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00