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HomeMy WebLinkAbout030-2060-80-000 ° o _ ~ \ N U 7 a_ N C E ~ • ~ U ILc o a b ?tea L C x o Q C r Q 0 C Y O C U CO U CL) 7 Q C O N U. c m_ U_ T - N L C U ~ C - 3 a U U Co N Q U 7 ~ N O E N ` N H Z O Z c c : CC u 2 o d z ~ ~ - cn F- r c _ .3 a ZI m z Z co 5 v O N c ~ - v o co 1° E N m Wft _ m O ? N CL M 6 _ d - s ' O O d c ~ 0) U) 0ooo •v = a a a N a MAN N 3 o cn J U = m a } V r M OD O O L N C Q ` 7 ` ~ c 0°3 r H ► e u, c LO H U u y ° O I C U O C? Loo -.i a C~ c c b p ON N C° o c rni a Z y co 0) '7~ It_ v E ,;n m~.a ya LCL Q y V y y c 0 7 ; U d o iN n U O j Itll l l.'I' .`.'~fJ l l'ANY ::Y:,''I';I°1 . I ~ 1'vJ I : ~ I I I I ~-~-Cx-c.c~C •a-c ()WNI.H WI!;':O11:~111 nl)I~RKas per' s - a, v S1I ICI) I V I `.1 ON I'I."~.rd 11,4J~ L z86~ ZONMR I t s OFFI(I •'t I)I ;I.~iIt't',i dull ,IIIIIe.IIS11~i~ to nii•.•1 I r,lllr I Ir,~ il! AI. h ~ 'r. __T_,STTOw t`:VERYTH1.Nr: WITHIN I' I t.l,'r c►1 T- i I i ~r ! l .Yj A - I dihaRe Ith Arrow I - f I{~~ _ 1 . Lr-+~ Alf 74 I'.I:iV(;l{MAKK: (Permanent reference Point) Describe h,Jevnt ion of vertical reference point - - :;vI''I't(: 'I'A"(K: Mtt<nul`ac rurer: :.`r1t Liquid (:apai~it_y `e' - -Gt/ Tank -Manhole ether 1 evat 1(111 Nlunl/er- 11,11 rings on cover Trrnk [uleC_ Eleval-ion: Tank Uut_Tf•t h:levat.ic,n I'I IMI' r:IlA~11iK:R _ Number of ga 11 ons M;tnII I rte r Ltrer : rte..., Ilumhc.r of gal . Jptrrnli set for a c•yC hal IotI -i t of a ca1mc• i t y of he<ttl ; 1 t s I r i httl. 1 ()it 1 1 Ilea 1,d 1 1 un . 5 i Zt-, 01 1)IUtup Itclr-sclower Tiran(j- name of I)nmI) 1.~,iI I I nn per nIi nut_r 1 - ,IIiIi rni►11e1 nt.unber I yl,r• c,f warning; ~1ev~ce r-- Number of- gallon-,-4 H0)1,11)IN(. 'T'ANK: Manufacturer _ VJvvarion o f manhoT.e cover T'y )e of warning device Ct~cifTi~~mc~~er - { NiiinT e r c) I) T c S SK: K:i'A~:I•: f'['1' 5LLh: t Seepage 111i e tnTe-t pipe-0. levatit~ti _ t-c-t I iquld tiept~i----- 3- e t evation ie;,tl ti le (itpt.h but toot of seepage p ~ wj c~rli g ';K'F VA(.K: W-.D SIZE.: number of lines , TRENCH wi d(.I, len};t_11 - I1K:kCO1.1 TI ON RAT< t1'fT r' INSPECTOR 1 _7_ to C~: J Cjjst - 1'LUMBE':K ON DA'I'1:1) LICENSE llMltKa - Ftrr  rl ....,,,r_~._,---._. _ . _ _ _ _ _ _ _ _ _ KLPOKI OF INSPECTION - INDIVIDUAL SHWAGE SYSTEM ~ 44r~A J Sanitary Pe it it~3Q State Sept i • - '10WNS1411) OAU-n, St. Croix ui-tnt y NAME' 94~ .OCATION- fe~~lLv__ --Sectio~ Lot 4i - Cubdivision LPTIC TANK Size i gallons Number of compartments Ii,-,t, 1tct' frOPI: Well 1 Kit ilding 12% slope-v Highwater !'UMPINC CIEAMBEk Size_ gallons Pump 14nufac firer Model Number 11OLD1-NC TANK Size -Y-`-gallons Nulnber'of Comprtm -nts_ - r ~ Pumper Alarm Sy- em Distance front: Well BuiIdit IZi sLupo Highwater ABSORPTION SITE Bed 'T'rench )istance from: Well Building f 1?"/, slope---- - - Highwater ABSOkPT]ON SITE DIMENSIONS Width of trench it Required area - J 1t. 4. it. Length of each line It Depth of rock below tile- 3a Number of lines Depth of ruck over the in total length of lutes ft Depth of tile below grade in. Distance between lineti - f.t Slopu of trench In. per 100 1t f[ Type of Cover: 'T'otal absortption area i'I' D IMENS I ONS Nttnthct of uiLS Cravel around pits Ver; no 01t~idc dtarteter ft Depth below !itIk-•t It Total absorption!"'i rea ft Area required - tt INSPECfE[) BY TITLE: - APPROVED 1)AT E I ,Ity ItKJECTED 1) 111. lt)8 RL'ASO`. FOk i~F. I ECT tON  i . j State and County State Pcr it # PLB 67 Count rmit # Permit Application Y ca to, Private Domestic Sewage Systems County 'DE.%OTES STATE APPROVAL REQUIRED Date Approval Received from State it Required State Plan I.D. # A. OWNER OF PROPERTY Ma ling Address: R LOCATION Section T,'L- N, 'R` E (ori W Lot# _City S_bd vis on N3,n, , rEea'est cad, bike c)lanrimark Rlk4: Village ~Lyr ~ C. TYPE OF OCCUPA%CY 'Cori rrlerLlal 'Indu -nal her (specify} •Vari nee Single family Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY f' Total gallons No of tanks HOLDING TANK CACITY Total gallons No. of tanks Prefab concrete ~AP/ Poured-in-Place Steel Fiberglass Other (specify) New Installation Replacement Lift Pump Tank or Siphon Chamber Total gallons P efab concrete -Poured - in -Place E. EFFLUENT DISPOSAL SYSTEM: Pelation RateTotal Absorb Area sq. ft. New Replacement Alternate (Specify) Seepage Trench: No. of Lin``d''Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: ~Length Jr, Width 1~ , Depth ~Tile depth (top) No. of Lines Seepage Pit: Inside c;iiLmeter Liquid Depth No. of Seepage Pits Percent slope of land ,z l Distance from critical slope 'dATER SUPPLY: Private Joint ❑ Community ❑ Municipal F7 Owners name as listed on EH 115 if other than present owner: J 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 Certified oil Test r, / NAME C.S.T. # 21/1 and other information obtained from (owneribuilder). G-y/. -~1 -1 - Plumber's Signatur '>biQ!MPRSW# P one # ~X chi Plumber's Address 442 ZZ 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 naighhors property. If well has not been drilled please indicate. . . _ - - t--r--r --t-- t i l r- E } Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application le) Fees Paid: Statefy~ Coup Ay Date Permit Issued/ Rejected (date) ZO' J-4/ Issuing Agent Name I  Ins CIaIVII ,cz~ivu oldie vdiiu» vdU: nec u 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copyl 4. plumher (canary copy) Revised Date 711178 DEPCrR- 1ENT OF SAFETY & BUILDINGS, JNDUSTRY, REPORT ON SOIL BORINGS AND DIVISION LABOWAN P.O. BOX 76 HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 3707 L ATION: SECTION TIDMUNICIPALITY: LK, NO.: SUBDIVISION NAME: 4kT /T3n N/R~~, W ter, COUN"f Y: OWNER'S/BUYER'S NAME: 1 LING AUDR F55: Si .CpolX .,__ACE+E ~Ie_z tJ1.~1 7~ti,T~ k ~k C~Z STjLLJ-0AT_E Z, F-&3. SSoe Z USE DATES OBSERVATIONS MADE NO.BEDRrAR - [oIN0MF_H(_,1AL DESCRIPTION _FR_ZF!ILE : 6ESCl 1`I_074S]FERCOLATION TESTS: 151pesidence, ` ❑New Replace RATING: S= Site suitable for system U= Site unsuitable for system [UNVENHON AL MOUN D: IN-GROUND-PRESSURE SYSTEM-IN-FILL HOLDING TANMMENDED SYSTEM: (optional) ®s❑u Esau ❑s❑u Esau as❑Sk35-~~ If Percolation Tests are NOT requitacE SIGN RATE: S STEM_9LEV. If any portion of the lot is in the under s.H63.09(5) (b), indicate: ulvz ] "l 9L, S l ( Floodplain, indicate Floodplain elevation: ,f PROFILE DESCRIPTIONS HURING TOTAL DEPTH TO GROUNDWA I ER INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NLAIRER DERIH IN. ELEVATION OBSERVED E HEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 1 loo )1 Doa - -7 roo F3 s i) T`S lZ n S bx GI~ 8 13- z 2 lOS X00 - > IuS /3 ' 9 i B- 31 1~3 1~1 Z > X03 1~ . c, B_ PERCOLATION TESTS A TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES UTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD -1 PERIOD 2 I +P INCH P- P- P- P- P- P- PLAN VIEW: 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 slop. '73. Z, I soI1L ' ~`~Q1CHg1~T 5 1 SYSTEM ELEVATION 9~ 4`LI? VOF `+Z"Cep nve1Z Pf1Z~L-7AJG, / Brn - VC)Q - eti 1 _ %S't RT CUR, o F 410u si~ 1 ~I I I - 3 . I i sv i~ f1~t Soy I w) ~ ~ g 1•'1tP1~ I \°lo t7i SHE LoT 31 Sao - ~T M ~ >s I vj - . I I c~~~'ttr.twel La s►~cN a7w C_ ~e► _ t 8F'1 SCf'~ l,~ +tt 3d' sic, z~ I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wiscor'., Admimistrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: ADDRESS: CERTIFICATION NUMBER: PHOcNE NUM13E-1,op io CA -7/ CST SIGNA-TURE: n  DISTRIBUTION: Original-Local Autho'i'y, 2nd page Bu a a .If PlurtC1ing, ri pagn-Prn; e ty (~:•;n. i, 4th Rage-Snu I c::ci. DI L H R-S B D-6395 IN. 01,81) , ^ nroA rI`t--' f I~~~'~I.i~ r~l-'i,y.~~~,,.~.A...T~~1..`i'^".J ~,'~h;Arl.°Y"'Z'"r :,.~/T ~s 17 k - f 75 ST CROIX COUNTY PLANNING ~ ZONING FAx MEMO D / ATE. To: Ilr\ Co inislralion FAX NUMBER: 715-386-4680 Land Infonnalion Planning FROM: .Q 6C.jj--) 71,55-386-4674 FAx NUMBER: 715-386-4686 Real Properly PHONE NUMBER: J15 j 7~ Z_ 715-386-4677 Recycling 715-386-4675 NUMBER OF PAGES, INCLUDING COVER SHEET: RE: AA y~ ST..CFcWCOU`ITr!;O VEF-.'IV.'.ic%T '-'L-,,V TER i i 0! CaRe-fiC. rgEL keOAD. HUD~5Or; W 540 6 7!5.386-4686FAx PPZaW.-.~AINI_-CRUIX.VJLIIS WWW.CU.SAINT-cRUIX W'I US Parcel 030-2060-80-000 04;0&,2005 02:41 PM PAGE 1 OF 1 Alt, Parcel 27.30.20.585 030 - 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 ' LEE. CHARLES V CHARLES V LEE 1399 MAIN ST HOULTON WI 54082 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ` 1399 MAIN ST SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 0.600 Plat: 2111-HOULTON SEC 27 T30N R20W LOT 31 BLK 7 VIL Block/Condo Bldg: 7 LOT 31 HOULTON Tract(s): (Sec-Twn-Rng 401;4 1601,4) 27-30N-20W Notes: Parcel History: Date Doc # Vol/Page Type 07;23;1997 975!461 TI 07!23)'1997 697/350 2004 SUMMARY Bill Fair Market Value: Assessed with: 6215 17,400 Valuations: Last Changed: 07109;2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.600 50,000 65,500 115,500 NO Totals for 2004: General Property 0.600 50,000 65,500 115,500 Woodland 0.000 0 0 Totals for 2003: General Property 0.600 24.300 54,200 78,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 211 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00