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HomeMy WebLinkAbout020-1116-00-000 n N p-0 n d ~1 o Co o v CD n O p W W CCD C (D ~N `C • wo 2 a K) m 3 a In p n. Z C7 U! O j j N ~p (D O n m o S O0 v O U7 3 (D 7 Co CD 3 F m V o 0o C p m -4 ~ C/) - C D a CD Cn (D W c c c 3 o cD- n N) cc N ' N CD ~ r N (n 00 00 N O c c !1 m v v o c v CT D Ln b (D m O (D m ° v O- M" rn l a N m o O a ~l Z o y m o 7 O m O m o' (D v m m co • m ~+l CD Cl) C. m w m a a 3 Z (D O Z m Cl) i ~ N 0 i j~ Cs ~ a A Z O W m N CO CL t Z 0 3 o Z 3 m N CD A W pj n (D CD U) O d 3 X CD (D 5)' (D 7 _a (n ~ 3 - 0' w "n _ C o O d Z C v 9 v v cn ~o a o' m w S aa: 4 CD CD v X e o w b a co O m m a cc 31 v a i =m a C N N 0 5 ~ CD Q °o o O v o m I Parcel 020-1116-00-000 12/19/2005 03:45 PM PAGE 1 OF 1 Alt. Parcel M 19.29.19.478 020 - 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 MICHAEL R & LOIS TERVO O - TERVO, MICHAEL R & LOIS 877 WILLOW RIDGE I HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 877 WILLOW RIDGE RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 0.730 Plat: 2626-WILLOW RIDGE ADDITION SEC 19 T29N R19W WILLOW RIDGE ADDITION Block/Condo Bldg: LOT 3 LOT 3 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 19-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 2005 SUMMARY Bill M Fair Market Value: Assessed with: 92348 207,400 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.730 38,700 172,800 211,500 NO 05 Totals for 2005: General Property 0.730 38,700 172,800 211,500 Woodland 0.000 0 0 Totals for 2004: General Property 0.730 19,700 143,600 163,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 218 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Total Special Assessments Special Charges Delinquent Charges 27.00 0.00 0.00 I AS BUILT SANITARY SYSTEM REPORT / eR." SEC.fT2N-RW OWNER (1 TOWNSHIP 4QP ADDRESS ST. CROIX COUNTY, WISCONSIN. _t ' 'd~, ) SUBDIVISION LOT LOT SIZE -o PLAN VIEW Distances and dimensions to meet requirements of H63 _ 9HnW FiVF,RYTHING WITHIN 100 FEET OF SYSTEM 4i. . .,•.,.i r1.,4,raf lill{1►ek NJ'.INN .rn r'...;al ' .~~Jp qJ } f 44 y- I di a e otthl Arrow ISCALt: FF + BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical reference point: Slope at site: SEPTIC TANK: Manufacturer: Liquid Capacity: Number of rings on cover : Tan manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: PUMP CHAMBER Manufacturer: Number of gallons _ Dumber of gal. pump set or a cycle gallons; total capacity of 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: 14,4,c- Number o pits feet diameter feet liquid depth So seepage pit in et pipe-elevation bottom of seepage pit elevation feet. SEEPAGE BED SIZE: number of lines width length tile depth SEEPAGE TRENCH width length _ PERCOLATION RATE_ AREA REQUIRED (,n) AREA AS BUILT INSPECTOR DATED PLUMBER ON JOB _ LICENSE NUMBER fi, REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM Sanitary Permit State Septic kfD9 _ A M E TOWNSHIP St. Croix County OCATION MS V_ Sectionz?-Lot # Subdivision EPTIC TANK Size G,1 gallons Number of compartments istance from: 11 e Building 12% slope ig ter llMPING CHAMBER Size gallons P p Manufactur`r Model Number OLDING TANK 'Size gallons/'`Nu ber of Co'par ents a Pumper Ala System _ iistance from: Well Bu fling 12% slope High ater :BSORPTION .-I 1 B Trench i tan a from: Well Building 's 12% slope ' r Highwater ,BSORPTION SITE DIMENSIONS Width of trench f~t R qu'red area ft. Length of each line /ft ept of rock below tile in. Number of lines De of rock over tile -in. Total length of lines t Dep h of tile below grade in. Distance between line ft Slo e of trench in. per 100 ft. ~ i r Total absortptton a ea ft Type of Cover: _ ,IT DIMENSIONS tt umber of pits Gravel around pits yes_______no -Ltit Outside diameter ft Depth below inlet ft Total absorption area _ ft Area required ft ~ [ NSPECT-- TITLE .1PPROVED DATE _198-1 iZEJECTED DATE 198 v - ~1 REASON FOR REJECTION State and County State Permit # PLB 67 w Permit Application County Perm 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: ~iA/ Ti~,<L)0 KT~ -~~5- NU osov, w~ s~o t ~ B. LOCATION:'/4'/4, Section , T,,;~q N, R E (or) W Lot# City -59 Subdivision Name, nearest road, lake or landmark Blk# Village Township IV/,row e,(Pe. e / 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 CAPACITY 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 / Total Absorb Area sq. ft. New Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed:~~ Length Width Depth Tile depth (top) No. of Lines Seepage Pit: JK: Inside diameter 7_Liquid Depth No. of Seepage Pits k h OtiZ Percent slope of land- Distance from critical slope WATER SUPPLY: Private 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 Certified Soil Tester, / C.S.T. # S_(; - nZ 492-and other information NAME F)n L-V 69 1 r tA _ obtained from 14/,l~ "7- r /eije) (owner/builder). ` Plumber's Signature' M # / Phone #3~j - Plumber's Address 4 At)n Of Ud 5n iti f Cd / ~ S~cx 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. ~IInSS S ~C"i ~ol~ 1~ ►~t~ : D 2~ LA) IS 1,0 n~ CAP UeAM Pit P 411 . s ps AM Lcr a 1 ulo'~ 0 1& 0' C> 0 JAU NJ) f6,V 0 0) 3 0 r~ Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT U E/ gN 9-a D Date of Application Fees Paid: State" q( County / Da J*IZI Permit Issued/4 ireted (date) Issuing Agent Name Inspection YesA_No 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) Revised Date 7/1/78 PEDM OF REPORT ON SO RINGS AND SAFETY & BUILDINGS I~~IDUS USTRY, DIVISION LABOR AND PERCOLA ~S• P.O. BOX 7969 HUMAN RELATIONS (115) MADISON, WI 53707 3707 LOCATION SECTION: TOWNSHI JMUNIC,IPLtL .L y OT NO.: BLK. NO.: SUBDIVISION AM E: sE /a q /T2~ N/R / E (or) W COUNTY: OWNER'S BUYER'S NAME: MAILII ESS'. USE DAT S OBSERVATIONS MADE JNCOMMERCIAL DESCRIPTION: PROFFLE DESCRIPTIONS: jPERCb_E_A_TI_5'N TESTS: Residence e ! Ra e 6 - `0 ~~d O S,9Tl,E~ S~ GCa~9~y - w'tl, RATING: S= Site suitable for system U= Site unsuitable for system S~ C'C Sc 1 O e/QT/¢-s CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) S ❑U [ZS DU ©S ❑U ❑S ~U 0S ~U -ds~~;71 If Percolation Tests are NOT required DESIGN RATE: SYSTEM EL V. If any portion of the lot is in the under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) r / Fr. ~/6'1 Si L~ Z/ C~ 6Al L . a+~+cQ e- ,u '6474 Af B-2 fT At rr L t /J 4J. 1-04 --1 0 ZO ?fry. l~iY, ' B 3 b ~l~ Fl % /7"A.t' 130. 5'_Z- Q,v- SICs /0 4- - S - B- 4/0 IhAoxelkef B- TES 7- ~9 PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES WI NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD, PERIOD2 PER D PER INCH P- l to - Z 2 / P- P- r r, ` 69 6 P- P_ t r r r( P ax;g 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 p• !cent of land slop. rOp _TAUC-l /2/,SIC 3y, Ae,-p revs e& 0Wy4vE11 z.. SYSTEM ELEVATION E1611,fof %37 y FT 7-A,4j r 4 41 14_4 Nc 10 s r of LS i Co (J~ tT~ Sj£/~ (7VIC 9A 4*e_ ~Et7 FA I i r 60 5's~ Doi/~ 13El7 Ca nQRE~~ K 4 eC/1- v12 b/9 C9 _571 ;P AWPIE use// fl~f IZT/ i, the undersigned, hereby certify that the soil tests reported on this form were de by mein accord with the procedures methods specified in the Wisconsin Admimistrative Code, and that the data recorded and the location of the tests re t to t e b 1st of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: ADDRESS: /t / 3 D ',0/~ CERTIFICATION NUMBER: PHONE NUMBER optional): CST SIGNATURE: DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. DILHR-SRD-6395 (N. 03/81` f ' V 1 R r--Fu K v0 2-1 S ~ `I p ~"r s~Pric 3 N ~ ~uTo (30~ (o~~~sTi6 0{' St (votir 1 \ 1~ o a f r~ o CD Z v m c T 3 o \ 1 -i = N z i t :E ~ • chi o W m o 000 00 m Q ° 3 o N m p o N t'J CD .7+ z d` N O' 1 3 p 0 !D W (D W N ~D in D! N n -I A "'Z N N O' 7 O 7' O v O O O CD 7 N W ao O (o Cn C • _ O 3 N co O N N V .7 (D C/) N N CL o 7 W cri (D C: w e n o 0 3 p n "Woo O N O N (D i c N a(D~o o(D~o n r o c N C V V N O O O ~ _0 I cn W ~ Orq 0~CD vovp e~ (D O V) O D I 3 D n N O Z Z z (n z t, O O D (D O !V N O M =3 ° H N v ; (D C) (D (o • m rn 3CD c N (D CL CD 3 7 i fn 3 1 p Z (D N c 0 7 A Z O CL G) 7 00 m N) (D (D CL I z 3 a o z O m (O N (D A W p~ O (D D 3 N y o_ W o> j n C'- n C CD C (DS(O ~ OWD ~73r0 Q Q (D (D (D o' O (D o f o' 4 --1 N N' n y 7 S ID 7 T n m (D n 7 C In CD oc:> Z CL X V a 0N W 0 J N O -O N Q O W N ' d N~ NOA N N m nW 80. w n W CO (D y (D W = CD (D Gov>,^a(n~(D~ i N (D 7" W "O O - 77 W 7. w C)- CD 7 7 N 7 (D O (D n' V (o c (D (D N X (D CD 3 T N n O_ F. - - O 7 n (O 7 p (D ~ 00 ~(o O'er W N 00 CO p p W p1 (D (D O N A (D pa O 7 v so p O a O fl. r s'. ST. CROI X COUNTY WI SC0 N S I N :e ,->a ZONING OFFICE 1` I 796-2239 (HAMMOND) 425-8363 (RIVER FALLS) HAMMOND, W 154015 May 14, 1984 Mn. Richard Evgen R. R. 3, CaAntichaet Rd. Hudson, Wl 54016 Dean Mn. Evjen: This o 6 6-iee has nev.iewed the pt o.t ptan and the soit .ta to u nepoAt on the Mike Tenvo pnopWy, which nevea,('ed that the pnopobed addition wit not inte46ene with the wa6-te di,pozat 6ybtem, and -theAebone any nequ,iAed building penmLt6 may be i6sued on this pro jee t. Shoutd you have any que6ti.ona neganding .thi.6 aubjeet, please beet 6nee to contact this o66ice. SineeAet y, Thomas C. Nee6 on A6ziz tart Zoning Adm.in.zttaton TCN: mj cc: Mike TeAvo g 7 may.' D APPKL)vle, Ou.~ y0t1 /-,j 7/0 ,jA 7:~j F-v)-m-,1 PL t=- SE aA~L .vlE Ai 7/ 5- -3A- .~95c 0(j, , A u i midi w G rp ~FC7o {L /5 ~i aK t- U T Q BE 90 0 Fol- ,x'11 KG 7-F- 0) a6x i~~OSLiJ L~ 1. 5vu/` Fo rm - S T ONE AND TWO FAMILY The existing sysr_em must he inspected for compliance to bedrock and high groundwater requirements of the code. This, in many instances, will require a soil tc:_;t to be conducted by a Certified Soil Tester or an on site by this office. If the existing system does meet minimum requirements for groundwater and ')edrock depths and if it is functioning, an addition can be added in most instances without updating the existing system. If the existing system is i,ri_lized for the addition, every attempt should be made to locate and reserve an area which is suitable for a code complying replacement system for when the system fails I.f_ the addition will substantially increase the wastewater discharge, the existing system shall be replaced with a code complying private sewage system*L,,, 1_r~c ft~y.~ F,¢Spl %W-F N„ = Ali 2 ► % &U4-7%4-1 :)4 ~2Ty~ ~Ut 14 k4~• Uc~1,446;r 3 cr ~W w ~5i 11&c gmt;.T -it 24~ 311 ViLLa W P-106 ApPi /o Lai 3 H wOsa,~ !/4 1/4 (Subdivision & Lot Section Township S >~~Dsz N~ ~ i ~ti~ i Rural Route # Address Post Office Zip Code (I) We M IL~~I- F . I L-o1S AA • TEA J Q , plan to (build an addition to, r.emo el) the building at the above named location. The present private sewage system has been working satisfactorily as far as disposing of wastes. If the present private sewage system does fail, it will be replaced with one that i.s code comn' lt'G~ /i-ti (Owner's Signature) - Date ' Subscribed and sworn to before me this ,,4 h day of Mav ]_9 ~M} du~ -I Notary Public Audrey R. Larson "t,_ Croix County, Wisconsin My Commission Expires April 27 1986 ST. CROIX COUN'!'Y (County Authority) Plot plan attached (.slow location of building addition to drainfield and septic tank). Include soil, testers report form. u Z ~3 ~i \ v C~ 4- J 1 ~ J rifle W\ 3 y ~ v 3 ~ j 7 {n {r to d ~ {,n l s - !ter P Gib tL~ ~ _ I I ' o ~ J • J ~ _ v v J 7 7 -a v J T 3 2 In nWa r c t J ~ lr _ c.s J ~ C -Pfl ~ ~ o T I o.. ~ o 3 s J_ 1~ ~ o J r W PLB 6 7 State and County I State Permi # /9 O- _ Permit Application ' Z County Per it # 1 for Private Domestic Sewage Systems County T; .9, nV 'DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. LOCATION: ??o `>~i Ulj ~v; W J, `7-/U16 Section Ta N, R-L~- E (or) W Lot# Subdivision Name, City nearest road, lake or landmark Blk# Village tt 1 )LL- Iw f) rr)Gfi ~ t 1 - j Township 7 50.", C. TYPE OF OCCUPANCY: Commercial 'Industrial `Other (sped Single family Duplex fi') `Variance No. of Bedrooms- No. of Persons D. SEPTIC TANK CAPACITY Jae01- Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete Poured-in-Place Steel New Installation Fiberglass Other (specify) Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation E. New-Replacement. Total Absorb Area sq. ft. - Alternate (Specify) Seepage Trench:__No. of Lineal Ft. Seepage Bed: Width Depth Tile depth (top) No. of Trenches -Length Width_ De th Seepage Pit:~_Inside diameter r-7 p Tile depth (top)-- L,- .2 of Lines -~-Liquid Depth__ 5- ~'T No. of Seepage Pits 3 ( ~ k 0c;4~) Percent slope of land ~ Distance from critical slope WATER SUPPLY: Private 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, NAME Cizz, ji l.iL obtained from C.S.T. # and other information 1l! im-i-~ (owner/builder). Plumber's Signature V fii`i~ Plumber's Address MP/MPRSW# J~/ Phone # 7{j -3Y~ p 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. t , r ; V 1 k ul~~(Aj 1 f~ ~ 0 I 1 P,efsFw ~ Ncyj,~,E ~ tx ! ~Tj,vb ~ C ~m 1~ C T (3 00 (opt ~xl ST/,c~6 D 1 S+ 0 ti C lx~U~C Low LT ST WAS( (tOAIT i.v I I -1 oP o' -~Q r~ ~ c S 1 DLL-?ARTMENT OF SAFETY & BUILDINGS REPORT ON SOIL BORINGS AND INLABORDUSTRANYD PERCOLATION TESTS rli5l P.O. DIV BOX ISION HUMAN RELATIONS 7969 ~ \ / ` / MADISON, WI 53707 3707 LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.'BLK. NO.: SUBDIVISION NAME: --,r-_- SF /T a9 N/R i9E (or) W ii ,w COUNTY: OW_ NI:H-,;S BUYER'S NAME: IMATET19-TTUDRESS: USE % DATES OBSERVATIONS MADE NO. BEDRMS.: COMM A DES R PTION: X Residence STS: ❑New Replace 7f~/-~7 !7 RATING: S= Site suitable for system U= Site unsuitable for system s( d s5Arl e 7,1 LC~',J-j 7~- 5 CONVENTIONAL: MOUND: IN-GROUND•PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENdED SYSTEM: (optional S❑ U 0 S❑ U x S D U ❑ S D U ❑ S D U ~f' If Percolation Tests are NOT required DESIGN RATE S T under s.H63.09(51(b), indicate: If any portion of the lot is in the Floodplain, indicate Floodplain elevation: / YT PROFILE DESCRIPTIONS BORING TOTAL PTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICK,, ESS, CO O LR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELJEVATIION OBSERVED E GHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- ~ C3~' / rlJ1'~~. ~ 1~ i ~ i./i% • 51 ,~J. • ,y„~v 4 ' .t,,r . O!f --r B ~CZ, t T ~Lp zQ ? ¢ /1r /Y'v. ~xz L f ~N. GGA Z p Gs < B )*"41 17IfV- L y~ <3v SAC z B - 17 f'•utr F ` ~z~~r s C`~( C>S~ "L / 1/4 C. 61 v J`__ B- T ~ PERCOLATION TESTS NUMBER IDN PTH AFTER I HOI E INTEST T ME DROP IN WATER LEVEL-IN HES I D P RI Q P RAPER (INCH ES P P- P- o d P- /2p1 r 1-7 'LAN VIEW: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- ,ontal and vertical elevation reference points and show their location on the plot plan. Show a surface elevation t all born9and he di e c i and )f land slop. Tp [ f p v A 1 7 percent f J2 SYSTEM ELEVATIQ X~ ~ 4 y y5, y 7tiAi A t E - - 9 /r✓ovvr f E,j ~,;F;-=-'~ - ~yi~~-~E~ t-;- ~'#~-fit - , - - .1--•- ; . _ I f^ ,ege, ! - - ' iF L ? %o S ~ ? w _ I 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 Wisconsin Admimistrative Code, and that the data recofded and the location of the tests are correct to the best of my knowledge and belief. NAME print :~D TE TSg~ OMPLETE ~ fy L7 , Si~_ j !f LJ_J Y ~7 ADDRESS: Cr~TIFIC TIgN M8ER: PH?d~yr U tional): y ..~c CST SIGNATLIgE: 31STRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th Pape-Soil Tester., . DILHR-SBD-6395 (N. 03/81)