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HomeMy WebLinkAbout020-1077-20-000 0 y O 3-0 n d _1 C d f a ol C <o _1 3 A CD v 9 _ C v m CD n 3 cn~ ==N z rj C: o `C y N N N (c) N w a. ao o m o o m m = (D° a n n:z y o o CD 11) N CL? {11 N N O~ CD C m CD CD D 3 o° O p~ 3 N 7 W 00 7 N CT O CC (O _n m GI a a ~ 7 Cn a W PO CD C --z m CO CO C n r N o o a m N o a t~ z o O O * * * a < z w ° o D O N r3. v v v C, 7 D w 7 00 a 3 ~l z co Z O D O n" O CD 7 N ~1 C CD I N (I~ 7. 1♦ C-1f c COD N n 3 7 z (D -i cn Z m Cn O n• v C A O F 7 z v m N ONo CD C z 3 c " z CO 3 m g N A Lo 7 C S_ 2Q C N N G N 0 -n o z Co N 3a a O CD S CD CD Cn 7 ~ COD O - CD O O O A 3 3 fi Cp A n ' N j N cz O V A O CD DAQ V A 69 O q O Cp ~ 'a Parcel 020-1077-20-000 01/03/2007 11:33 AM PAGE 1 OF 1 Alt. Parcel 28.29.19.310B 020 - TOWN OF HUDSON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner THOMAS H FARRILL O - FARRILL, THOMAS H 599 CTY RD UU HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 599 CTY RD UU SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 2.720 Plat: N/A-NOT AVAILABLE SEC 28 T29N R19W NE NE LOT 1 OF CERT Block/Condo Bldg: SURVEY MAP IN VOL III PAGE 862 ORD Tract(s): (Sec-Twn-Rng 401/4 1601/4) 28-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 09/22/2003 740846 2416/103 EZ-U 601/313 2006 SUMMARY Bill Fair Market Value: Assessed with: 161648 268,400 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.720 71,900 183,900 255,800 NO Totals for 2006: General Property 2.720 71,900 183,900 255,800 Woodland 0.000 0 0 Totals for 2005: General Property 2.720 71,900 183,900 255,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 106 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT OWNER lf{~/~ TOWNSHIP llo 5 ~ OtuU SEC.,;?-'g T `I N , R /qW -011 ADDRES 41t'~--T-5 4+ ; ST. CROIX COUNTY WISCONSIN. SUBDIVISION LOT LOT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM s I di ate o~thj Arrow SCAL SEPTIC TANK(S) MFGR. It' CONCRETE STEEL NO. of rings on cover Depth PUMPING CHAMBER SIZE PUMP MFGR. MODEL NO. GALLONS Per Cycle TRENCHES NO. of width - length area BED NO. of lines ~ width length area o dept to top of pipe NUMBER OF SEEPAGE PITS outside i.ameter total pit area AGGREGATE Gt►H S jA 6 iltz-11 re-llr-K PERK RATE o AREA REQUIRED AREA AS BUILTs 0 Disclaimer: The inspection of this system by St. Croix County does not imply complete compliance with State Administrative Codes. There are other areas that it is not possible to inspect at this point of construction. St. Croix County assumes no liability for system operation. However, if failure is noted the County will make every effort to determine cause of failure. GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYTEM. INSPECTOR DATED PLUMBER ON JOB LICENSE NUMBER ~i3~1l1N 3SN30i'I ROf NO uaqimia Galva uoZozasm,, • t •MISIS SIM 110floul Z a3SOaSIQ Sq ION TMOHS S'II0 QN7 S3SV3+' •asnTTe3 3o asneo auv=av! 03 a.zo33a XJaAa axem TTTM Xjunoo aqa paaou sT ainTTe3 3T 'ZanaM.oH •uoTaeaado maaSt a03 AITTTg2TT ou samnsse Aauno0 xTozO -IS •uoTjonzasuoo 3o auTod sTga Zu aoadauT 01 aTgTssod aou sT aT auga sea-Tv iaipo a_ie ajagy •sapo0 aATaezasTUTtupy aquas gaTM aousTTd"' aaaTdmoo AT T Sou saop n00 -IS Aq majs Tqz 3 L oTaoadsuT aqZ :aamTuF0S+j I ZI SX d33id Q3?i alva :i ' 3ZX932i9~ adid 3o doa o1 gadap Ease ga2?uaT gapTM sauTT 3o •ou r sacs ga3uaT gapTm 30 *OK S3H0NJt; 'I'I3M XI&I gada(I .ianoo uo sSuTJ zo •OH Za3is aZ CV3, "HDJid (s))Lgvl mial arIvos N oaav iulpaom a jEazpul .f I r_ . i 1- j r- I I I - - xaisks 30 2333 ooi .IIH,LIM o.,zuukdaAa moHS 0Z•Z9H 3o sauamaaTnbaa aaam o4 suoTsuamTp q sa0u92sTG- MKA ima s • HZIS 101I ZO'I NOIS:(AIQE-- ' NISN00SIr1 `,ZNnOO XIOND 'IS ` ssau(i(Iy '0 M H `N J. '03S dIHSNMOZ ` ?ISlaM MOM Nalsis XUVIINVS Ilinq SB • REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM ~ Sani:t.1 ~l.y PF,... t(al'i V`..0 / State Sept.(.c 'A .AM r Towns hi r St. C n u -i x C o u vi y t uvi N.6 1YL Sec-tion_ 9_ko t 0 Subd.iv.i.a4 ovt 1111C TANK S,i ze_ gaftona Numbers o6 eompantmenta tr4rce AI n.(; m: We H4.ghwaten IMPI NG CHAMBER --gak'-kans Pump Ma,vtuactunen ( Model- N u m b e n. 0-I N AN -Ze - ----------gaUona Number o6 Cumpa_n.tmv.n.tA Pumpetc Atanm Syatem 5taylec 440m: weft Bu4 din 12o' akope Highwaten. ;;SORPTION SITE r - . Ged T,'tench ti tanee nom: WClt Buifd~n 9_-=_ f 2 0 ~ ~o p e High.wate( SORPTION SITE DIMENSIONS Width o A trench --~.t Requ.~ned anea t Lv!igq th o A each tine- 6 t Depth o4 h Cl Ck b e~ U W Numbest (,A ki-r~ea - Depth o6 rock -oven tif(, ~jIotak length o6 tinea- At Depth a tife betow grade 4n 04-5tance between Z4.nes -6t S.Eupe of tnevtch tin. pest 100 At 1..t~°;ta . ab,1.vh.r~t.o.yy:: ahea 6,t Type oA Coven: Papers on ntn.aw 1 DIMI N,~ IONS Numbers u6 p4ts Gnavef an.ound p~ta yea nu ,''(},;its c ~ d c ccm e t e n . . 6t Dopth betow inket- _ -~.t I 1 u ::4T, a b!t o 4p o n a n e a '6t Al(ea ne.qu.<_ked-; 6t j i d 7 ' E C T I D B Y 71 T L E '!'ROVED 19 8 J1 C T E D DATE 19 8 IASON FOR REJECTION EN 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL LTH P.O. BOX 309 ► I j`/ p wFr/ MADISON, WISCONSIN 53701 !1 REPORT ON SOIL BORINGS AND PERCOLATION STS IOC ~r1979 LOCATION: ✓y~'/4,/~l~'/, Sectiort; Tr_2-& R/j It (or)(jQI'ownship or Municipality L j G ~ Lot No. , Block o. , County`., -y- Subdivisioq Name Owner's Name: / tl"titfJ S /Ciq r- r I Mailing Address: if 9 ~ Ao~l also (_J TYPE OF OCCUPANCY: Residence x No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT DATES OBSERVATIONS MAD/E: SOIL BORINGS PERCOLATION TESTS G?f_/ ? J9 _ SOIL i,:,lAPSHEET SOILTYPE I lq T<770L PERCOLATION TESTS r TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- CHARACTER OF SOIL SINCE HOLE HOLE AFTER INTERVAL INCHES THICKNESS IN INCHES ' BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN P- / F , SQ 0r•e_ j TA es, P- ~ 3 e~ ~P Are 404A4 ~y /1/Q 3 C SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) j fy«~S ti d j_ _ L 9G~, /tad 7 c r cfr Q s Z « S~ ( C4 r-f S B_ N / 1?,, /e" S'/, fear" C04)-se PLAN VIEW (Locate percolationtests,soiI bore holes and suitable soil areas.) Indicate on the plan the location and square feet of s itable areas. Indicate number of square feet of absorption area n:eded for building type and occupancy. / ALM I~ndic a scale or distances. Give horizontal and vertical reference points. Indicate slope. ~f 1~'7L 121, Lcy I i {Q i --..__I.___ 3 \ I.. ...r - - - L . ~ f I p 10 -04 I I I - r ~ -L-~_~_. _ I, the undersigned, hereby certify that the oil tests reported on this form were made by me in accord with the 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) ~~5 = 4 e Certification No. Address a-14 1-44f: t-3e Name of installer if known ,I R Y CST Signat C bbh1iiiilixCAL AUTHORITY PLB State and County State Permit # 7/ 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 Mailing Address: B. LOCATION: A)-F-'14 Section 2-Y, T!jLZ N, R E (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township 111410 C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family- Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY ( Total gallons No. of tanks HOLDING TANK CAAPACITY Total gallons No. of tanks Prefab concrete Poured-in-lace 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- Total Absorb Area sq. ft. New Replacement- -Alternate (Specify) Seepage Trench: No. of LineaN Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: -Length- Width Z Z' Depth z~ Tile depth (top)/ "H ` No. of Lines 3 Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land- 'T IC's (Ajgc;Tg-K LI Distance from critical slope WATER SUPPLY: Private PS Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: 1, 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 Soil Tester E7 NAME l1/ ( 5 'A) C.S.T. # t4E;j` 5"?5 and other information obtained from (owner/builder). Plumber's Signature MP/MPRSW# ~G ! Phone #3006 Plumber's Address -72-7 a L 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. i .a~ 3 E E ~ Am i F € i r F . c 3 e E 7 , as a.r. _ e a e.ed . i ,s e.. . . ..}mom _~}..,.....o . . e a E t t Do Not Write in Space Below C` FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application Fees Paid: State t~ County Date 6 Permit Issued/&efestecJ (date) IQ j? - b Issuing Agent Nam - Inspection YesXNo State Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) ~L Revised Date 7/1 /78 I s t too l