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HomeMy WebLinkAbout022-1077-60-000 Q e 3 0 ti? ti p v~ d cw o e h o •-NC-O co (D N (j)S] N O c cM0 cr- Q O L X O V N r 'O N N a 0-0C . C C0 .0y N 4l N .U N OO O N > N a CD ' 9 O O d QI Z N O C - - O LL U) 7 C O- - O ~ 3 Ncu°)E C Q O O N o = O Z N m °0~ m am r- CN N H Z C 0 O Z d V o N N Z ~ 'I c 0 N N cn ~j N N N ICI N ~ N (D • U) t a ~ o z° co z '7V E W C) N v 0 0 a a D> Z > Lr) H H o ►i 00 O •►v N a a a a a g LL ° 00 N o cn to J U j 0) ~ (D f~ M m I- O Y- O a C) C) ~i N a - O C) 0 N O ED v c o rn w N N 21 2 U Q (n co O ° m c ~j O o 3 N c ~l °o o Fes (1) - ~ o (.0 _ o c_o O C) -.4- ~j O (D 4) cf, C V 0- O O O C Z' ao O_ co c co N = a) r- cal m o rn r/ 4. o _2 v Z m 75 C 06 .U U) N N • o N Y Y r Z N 2 FO- cn [ l ee ` a ac ) • eC O 7aj U L: CL d 0 c r A u(L Oinci A S B U I L T S A N I T A R Y R / E P O R T OWNER: Township I a ►r i C , Sec.)%._ 0 N. RWW. P.O. ADDRESS: County, Wisconsin Subdivision Lot , Lot size PLAN =I Distances & dimensions to meet requirements of Sec. N62.20 A i , i ~kfl 0 Septic tank(s)~lfgr.AJo ringsDept to cover__1 ate Covered with Type of An ~gre g Dry well size Depth of seepage system G~ Vent caps in place ` number used / DISCI.AI.E.R: The inspection of this system by Pierce County does not imply complete co,x)liance rrith State Administrative Codes. There are other areas that it is impossible to inspect a-;; this point of construction. Pierce County assumes no liability for system operation. PLUMBER ON JOB : DATED : a' LICFZVSE TIMER: r r REPORT OF ITTSPECTIO t--I 1DIJIllUAL SET]AC,E llISP ~ OPAL SY.~ _TF,Ii r Sailitary Permit y State Septic ".A: IE~? T&MISHIP t. Croi;z County Si.PTIC TA'?T: Size gallons. 'umber of Compartments Distance Frori: *.7ell ft. 12% or greater slope ft. Building ft. Wetlands f: I'Lighwater ---.____.ft. ' DISPOSAL SYSTE:1 _Tile Field or Seepatrge Pit(s) Distance From: hell ft. 12%.or greater slope ft Building -_______`ft. Wetlands ~ f:. FIP,Ln Highwater ft , Total length of lines ft. Humber of. lines Length of each line ---Ft. Distance between lines ft. Width of the trench `ft. Total absorption area sq. ft. Depth of rock below the in. Dp-pth of rock over file in. Cover raver .rock,, Depth of file below grade in. Slope of trench in per 100 ft. Depth t,o Bedrock . ft. Depth to ..'round water ft. PITS ' Number of pits Outside diameter ft. Depth below inlet ft. Gravel around pit: ___yes no. Total absorption area sq. ft. Square feet of seepage trench bottom area required wquare feet of seepage nit area required Inspected by: Title':. Approved Date 197 . Rejected Date ~ 197 . EH 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: NW'/,, t: Section ~ , T?cN, RH?-7 E- ;94W, Township OP Mt11!i1ipdIiLr/ ~I►.iNiL. L_ liiti ~L _ Lot No. , Block No. QCIQk County -f~ Ik+ Owner's Name: 1-• A Al u 1 Subdivision Name ~ ~ ~ Mailing Address: lfC 4 ?"1r Z lU~?~ i5 / i Sc~~,> LZ TYPE OF OCCUPANCY: Residence )r- No. of Bedrooms Z Other EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS- PERCOLATION TESTS SOI L MAP SHEET SOIL TYPE "`Ei<r.4 iw~~ Ssat~ t~Y (~vl~vl.1 _ PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL RATE BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN P- .~t: 0 L ly--~~ . ID 4 Tt!T -0 L i k; 0 c, 'rtz-0. 4e, ~ 0 Pe ~ a 4- Nnl (m ~ t'+ 1 #Il) 1.112 t~ So ?c(2cOLA-fI d ?_A-L 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) B_ 1 '7Z" NC NV `7 ' Z" 7,S. LN I L- sw` 1 f s I i.~`' t wl%.dt sA jL- Z / Z a NL' A L '7 Z B- '31 •7-7:' NO+Jc 7-~ . .T S. i Z"L z~. B_ 5 ea PC 60 C, 7 -7v" s (0" `7 L o~ " Jti .rte ~7i. S. •45, 47" CS )e°' PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet,of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy. I~ a~ 'r- rv 3cr 5Q , F; Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. `pt ~ z Z 4~ 5 ` "r k - ~ a I i II ~ ~ ~V I ~ I ~ I _ i i~~ tt yy! I J ) d- I # -'A f f I 1 { I f I~ ~ ; t i j f ~ I I i I € f ~ ~ f ,a ~ I I f l4 e,, rt . i 5 i I f i 3 I I i C= 1, the undersigned, hereby certify that the soil 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) AN''1'M L • u P-P.4; Certification No.__ 55 -52-1 Address 1 003 . IAA--LaL_ . 12lVEl~ IC -S, S 540 LIL Name of installer if known 'Ngax~v els l%, 1 4, 7 FTLI- N CST Signature PLB67 State and County State Permit # 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: may, '/4 Section / Tom'. N, R E- W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village -f Township: TYPE OF OCCUPANCY: 'Commercial 'Industrial 'Other (specify) *Variance Single family Duplex No. of Bedrooms No. of Persons D. TYPE OF APPLIANCES: Dishwasher YES I- ENO Food Waste Grinder YES NO # of Bathrooms_ Automatic Washer r- YES NO Other (specify) E. SEPTIC TANK CAPACITY Total gallons No. of tanks *Holding tank capacity - Total gallons No. of tanks New Installation Addition Replacement_ Prefab Concrete *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1)M 4 2)' 3) ? Total Absorb Area s q. New Addition Replacement- q' 'Fill System Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches _ Seepage Bed: Length ? Width Z Depth Tile Depth No. of Lines Seepage Pit: Inside diameter Liquid Depth Tile Size i~ Percent slope of land 5 " s w. Distance from critical slope 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 Tester, NAME C.S.T. # and other information obtained from (ownerfbcrier). Plumber's Signature - = , MP/j fffsw# Phone # X.' / Plumber's Address r PLAN VIEW: Provide sketch below of system (include direction of slope an all distances in accord with H62.20, including well). 3 , e_ r II ~ ~ Icon 1 , 1 t~ vill 'S F/ ~ Do Not Write in Space Below - ' FpR DEPARTMENT USE ONLY Date of Application .1 5/ Fees Paid: State %O, 00 Count Y Date Permit Issued/Rejected (date)/ Issuing Agent Name Inspection Yes_,X No 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) Revised Date 6/1 /76 Parcel 022-1077-60-000 02/08/2006 08:36 AM PAGE 1 OF 1 Alt. Parcel 27.28.18.P430E 022 - TOWN OF KINNICKINNIC 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 FRANK C & MEGAN M LINN O - LINN, FRANK C & MEGAN M 150 CTY RD JJ RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 150 CTY RD JJ SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 3.110 Plat: N/A-NOT AVAILABLE SEC 27 T28N R18W 3.11 AC IN N 1/2 SE 1/4 Block/Condo Bldg: LOT 1 OF CSM 4/ 961 ALSO BEG. SE COR LOT 1 CSM 4/961 TH S88DEG E442.29' TH N5DEG Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) E 208.70' TH N88DEG W 443.29' TO NE COR 27-28N-18W LOT 1 TH S5DEG W 208.70'663/167 Notes: Parcel History: N n Date Doc # Vol/Page t ~o Type vl 'IT 10/18/2005 809612 2910/391 1~► Q WD 0023/1997 998/556 QC 07/23/1997 918/107 07/23/1997 917/363 more... 2005 SUMMARY Bill Fair Market Value: Assessed with: 143808 225,600 JJ Valuations: Last Chan ed: 08/11/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.110 50,000 178,100 228,100 NO Totals for 2005: General Property 3.110 50,000 178,100 228,100 Woodland 0.000 0 0 Totals for 2004: General Property 3.110 25,000 138,700 163,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 218 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00