HomeMy WebLinkAbout040-1036-30-110
0M0 !.Cvn d
0 m f c lu 0 co LO)
v n
.r
3
C) O ~C ~O1
` N O O_ O CCD y `G W o
a m n CL N O
N 0=1 CO CO N = ! "k
N) CL
1
'I W
o cnD CD CD n m o D Q
3 0 0
O o p
n cn x CD co m U) a s m
C a n 'd H Q W co Io o W
G~
N C3 W -3 (D Q N l\~ -4 X
rt K z j f n (0 f.0 0 r. (n
tz~
ul H z O O O !rl
Z!Ui d O n -0
£ r / 0 as Vi vi r,
H
0 -0 CD
d D O)
I~ 1 3 r N
f7l v ~ O N
z M N
N f~ Z
U~ o D m co z
O O
n m
r
_ CD C
N
00 H H ` CD N
p O N c (D O
3
00 CL
W
z z a
3
O z CD ip fB
cn
n, H !D v a a z
G O 0
a ? c 00 W v ::E " 00
00
a z
0
0 _
a 3 cD
F ' A
IW
7 O -0
O 7 CD 6 d c
-,1 g d G
r. O
O 7 7 't1
! n'OOC N C
O A3 -
N NW 0 a
a,
CD m m
CL a m
vv
I ~
d_ III 0.
I o ~
I ~y
N N A
CD d A
N
N
3 ti
am
I m~ N
01 °o
O v
(~D A
3
O O
:3 i OOJ
AO
A
'69 O
O (D ~a
O ti
.A
1 Farm - S 'f C - 104
. t
AS BUILT SANITARY SYSTEM W- PORT
OWNER Da , 1-0Vl TOWNSH1.1SEC. N-R
ADDRESS /3 U x S~ T ST. CR01X COUNTY, WI SCONSI.N
r ~ ~ g
~{ycyp h w 5~-~41b~ n i~
7, `
SUBDIVISION LOT LOT SIZE
PLAN VIEW ~s
V~
Distances and dimensions to meet requirements of II 63
"SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
.5 G` n
I~mt~ l,UU~ a*cjapt-
A i
P, 6
•~..~a
I~ eat a ('e
t, ~ ~ ~ f 4 1-h c` ~
V
i
/V 07 ~C ct l
1 g' _t-
V E ~ _gy
I:NDICn''f; NOR'T'H ARROW
<fu to I t r - PJ
BENCHMARK: Describe the vertical reference point used /71~)Y s"~i~ 15 St`s 0/,~
Elevation of vertical reference point: Proposed slope
at 5 i t c~ :
SEP'T'IC TANK: Manufacturer: W A 1,iquid Cal itV: I00o
Number of rings used: Tank manhole cover elevation: l
Tank Inlet Elevation: ~i Tank Outlet Elevation:
Number of feet from nearest Road: Pr,,;l c t.dc~ Rerzr L
,Q S
+ Q^~L____ f t et
From nearest property ling, runt QSIde, eZ ir, feet-
- Q -
Number of feet from: well. ' hui I(Iin);: /
(Include this information of the above ploC plan)( 2 reference dimensiun.~ tO ~ioptic tank)
PUMP CHAMBER
Manufacturer: l.i.yuid C:ap;W ity:
Pump Model: Pump/Siphon Manufacturer: Pump Size
Elevation of inlet: Bottom of tank elevation:
Pump off switch elevation: Gallons per cycle:
Alarm Manufacturer: A harm Switch Type:
Number of feet from nearest prol)crty 11.11e: front CSiofc 0kc'.r1,0 1't .
Number of- feet frog well:
Number of feet from build (Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed : I X 3,5-1 Trench
Width: f Length: Number of Lines: > Area Built:
Fill depth to top of pipe:
Number of feet from nearest property line: Front, O Side, O Rear, O Ft
Number of feet from well.: >
'Number of feet from building:
(Include distances an plot plan),
SEEPAGE PIT
Size" plumber of pits: Diameter: r--_--_---_-
Liquid depth: Bottom of seepage pit elevation:
Area Built: Has either'a drop box Q or distribution box een used on any of the above soil
e~
absorbtion sytems. (Check one). I
~.L .7S
HOLDING TANK IVA
Manufacturer: Capacity:
Number of rings used: Elevation of bottom of tank:
Elevation of-inlet:
Number of feet from nearest property line: Front, Side, O O kear, O i;t•
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
i
Alarm Manufacturer:
Inspector : - _
Dated:
Plumber on _job: Q
License Number: .~_.11;Z.7
1/f14:mj
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O. BOX 7969 BUREAU OF PLUMBING
MADISON, VI 53707 Ny~,,
CONVENTIONAL ❑ALTERNATIVE State PlanID.Number
(
❑ Holding Tank [I] In-Ground Pressure El Mound if assigned)
NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER'. INSPECTION DATE.
David Knighton R. R. 3, Box 157, Hudson, WI 12_3'_&-'l 'UCH
BENCH MARK (Permanent referen-e point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV..
NW NW, Section 8, T28N-R19W, Town of Troy
Name of Plumber. JMP/MPHSW No.. County. Sanitary Permit Number
Pau? Cudd 2739 St. Croix 54952
SEPTIC TANK/HOLDING TANK:
MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. JWARNING LABEL LOCK( G C
S P O ED. PROV ED
YES NO S NO
BEDDING: VENT DIA.. VENT MATL. HIGH WATER NUMBER OF ROAD'. IPROPERTY WEL 111JIL1111. VENT TO FRESH
ALARM .
f LIN AIR INLET.
FEET FR
EYES ENO ( OYES LINO NEAR ESTOM
DOSING CHAMBER:
MANUFACTURER 7ING:ITV PUMP MODEL JPUMPi SIPHON MANUACTURER WARING LBEL LOCKING COVER
PROVDEDPROVIDEDES ENO EYES ENO EYES ENO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PNOPERTV WELL BUILDING (VENT TO FRESH
(DIFFERENCE BETWEEN FEET FROM LINE AIR INLET
PUMP ON AND OFF) EYES ENO NEAREST
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing ILFN(;TLl DIAMETER MATERIAL AND MARKING
or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE
MAIN
the soil is dry enough to continue.)
CONVENTIONAL SYSTEM:
WIDTH LENGTH JNO01 IDISTR PIP SP LING C INSIDE DIA. =PITS LIQUID
BED/TRENCH l TRENCHES M PIT DEPTH
DIMENSIONS Tf
GRAVEL DF PTH FILL DEPTH DISTH PI h UISTR PIPE DISTR. PIPE MATERIAL . NO. DISTR. NUMBER OF PR OPERTV WELL. BUILDING'. VENT TO FRESH
BELOW PI S ABO C VER EI Fv.INLEr ELEV. END \ PIPE FEET FROM AIR INLET.
?j 121 2Z-T NEAREST----s -~'~1 1U
11 MOUND SYSTEM:
Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM
and furrows thrown upslope: mound systems to make certain that it N REVERSE SIDE. SHOW ELEVA-
meets the criteria for me m and. TONS MEASURED.
EYES ENO
SOIL COVER TEXTURE PERMANENT RKERS 1BSERVATION WELLS
YES NO EYES NO
DEPTH OVER TRENCH BED DEPTH OVER TRENCH;BED DEPTH OF TOPSOIL SODDED SMULCHED
CENTER EDGES
Y LINO EYES ENO EYES ENO
PRESSURIZED DISTRIBUTION SYSTEM:
WIDTH. LENGTH . NO. OF LATER SP CING. JGRAY /TH BELOW PIPE FILL DEPTH ABOVE COVER
BED/TRENCH TRENCHES
DIMENSIONS
MANIFOLD PUMP MANIFOLD DIS PIPE IMANIt/MATERIAL. NO. DISTR. JD~STRPIPE DISTRIBUTION PIPE MATERIAL & MARKING
ELEVATION AND ELEVELEVDIAEL PIPES DA.'.
DISTRIBUI ION
INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
PLANS
EYES ENO EYES NO
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING.
FEET FROM LINE
EYES ENO EYES ENO NEAREST
10
Sketch System on Retain county file for audit.
Reverse Side.
SIG R TITLE.
DILHR SBD 6710 (R. 01/82)
Muria C 100
Owner of Property '0~ l (j~
.Location of Property-&A ~ /W Section T N R W
Township
Mailing Address 3 So
Subdivision Name
Lot Number
Previous Owner of Property-46a /(,CS
Total Size of Parcel__ ?ef P
Date Parcel was Created
Are all corners identifiable? -OK _Yes No
Include with this application one of the fullowing:
.Certified Survey Map
.Deed
.Land Contract, or
.Other t:egal Document which describer the property
PROPERTY OWNER CERTIFICATION
I (We) certify that all statements on this form are true to the best of my (our)
knowledge; that I (we) am (are) the owner(s) of the property described in this
information form, by virtue of a warranty deed recorded in the Office of the
County Register of Deeds as Document No. 37'f .J~42 4-*' ; and that I (we)
presently own the proposed site for the sewage disposal system (or I (we) have
obtained an easement, to run with the above described property, for the
construction of said system, and the same has been duly recorded in the Office
of the County Register of Deeds, as Document No.
SIGNATURE OF OWNER SIG RE.._ Wr A LICAeIE)
~y ~/may/y
OA SIGNED DATE SIGNED
E ~ W,sConsln APPLICATION FOR SANITARY PERMIT
D I L H R St . Croix OUNTY
W OE~RR-nMEnT OF (P L B 67 )
UNIFORM SANITARY PERMIT #
In OUSTRY. LRROR 6 RUMAn RELFITIOnS
-Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8/2x 11 inches in size.
-See reverse side for instructions for completing this application. PLEASE PRINT
PROPERTY OWNER MAILING ADDRESS
David Knighton Rt. 3, Box 157, Hudson, WI 54016
PROPERTY LOCATION
NW 1/4 NW 1/4, s 8 , T28 N, R 19 Ey~y W ~+~L~~: Troy
TOWN OF:
LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER
Red Brick Road
TYPE OF BUILDING OR USE SERVED 46
Q~ l d
Y 1 or 2 Family Number of Bedrooms. 2 ❑ Public (Specify): - V
THIERMIT IS FOR A:
New System ❑ Tank Replacement ❑ Repair
❑ Replacement Soil Absorption System ❑ Revision ❑ Privy
❑ Alternate System L-1 Reconnection ❑ Petition for Modification
IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK.
i-1 Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank
❑ System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy
❑ Existing, For Which A Previous Permit Is On File, Permit # issued
❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions.
Total #of Prefab. Site Steel Fiberglass Plastic
Gallons Tanks Concrete Constructed
Septic Tank Capacity 1000 1 X
Lift Pump Tank/Siphon Chamber
Holding Tank capacity
Manufacturer: Wieser Concrete
IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure
Total #of Prefab. Site Steel Fiberglass Plastic
Gallons Tanks Concrete Constructed
Septic Tank Capacity
Lift Pump/Siphon Chamber
Manufacturer:
PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY:
(Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet):
Class 2 30 ® Private ❑ Joint ❑ Public
I, the undersigned, hereby assume responsibility fo allation of the private sewage system shown on the attached plans.
Name of Plumber (Print): ignat e: MP/MPRSW No.: Phone Number:
Paul R. Cudd 2739 1(715)425-2049
Plumber's Address: Name of Designer:
Rt. 5, Box 364, River Falls, WI 54022 Art Wegerer (576)
COUNTY/ DEPARTMENT USE ONLY
Signature of Issuing Agent: Fee: Date: ❑ Disapproved
V d t ❑ Owner Given Initial
6' . /L{/~~~ , L) 1 9 a Approved Adverse Determination
Reason for Disapproval:
Alternate course(s) of Action Available:
DILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber
INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398
To be complete and accurate the permit application must include:
1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in
a city, village or town);
2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant,
etc.);
3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks.
4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of
square feet to be installed;
5. Complete the section on water supply;
6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi-
fication, place your license number in the space provided and sign the permit in the signature block;
7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the
permit;
8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation.
Failure to comply will void the sanitary permit.
9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable.
10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system,
depth of the system, type of system.
11. All revisions to this permit must be approved by the permit issuing authority.
12. A complete plan including a plot plan, drawn to scale or with complete dimensions.
13. Horizontal and vertical elevation reference points that are permanent and clearly shown.
14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s)
to system, building sewer and vent observation pipe(s).
15. The permit issuing agent may require a cross section drawing of the effluent disposal system.
TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems
must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning
your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin.
T C - 105
SEPTIC TANK MAINTENANCE ACREEMENT
C,
St. Croix County
0
OWNf?R/BUYEi:- ,1 -
ROUTE/SOX NUMBEk ~zj Fire Number, y.3
C I 11' Y / STATE- _ --GIP 'T_QlG • - -
i
PkOPEit'1'y' LUCA'1'1(?N:Vv a> & ~a> Section 1 -N k--IT__W
town of St. Croix County,
- 7- _
Subdivisivr Lot number /v
i
f
Improper use and maintenancu 01 your su})tic system could result in
its premature failure to handle wastes. Proper maintenance con-
sists of pumping out the septic tank every three years or sooner,
if needed, by a licensed septic tank pumper. What you put into
the system can affect the function of the septic tank as a treat-
ment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant lOr
maximum of 607 of the cost of replacement of a failing system,
which was in operation prior to July 1, 1978. St. Croix County
accepted this program in Au~2,ust of 1980, with the requirement that
_Ysteuis a};ree to keep their systems properly
owners of all new S
maintained.
The property owner agrees to submit to St. Croix County Gomm,' a
certification form, signed by the owner and by a master plumber,
journeyman plumber, restricted plumber or a licensed pumper veri-
fying that (1) the on-site wastewater disposal system is in proper
operating condition and (2) after inspection and pumping (if nec-
essary), the septic tank is less than 1/3 full of sludge and scum.
Certification form will be sent approximately 30 days prior to
three year expiration.
L
I/WE, the undersigned, have read the above requirements and agree U~
to maintain the private su:wage disposal system in accordance with x
r,
the standards set forth, herein, as set by the Wisconsin Depart- ~o
meat of Natural Resources. Certification form must be completed
and returned to the St. Croix County Loninq:, Office within 30 days
of the three year expiration
S I G N E D-
DATE
St. Cf oix County Zon-nb Off ice
P.O. Lox 98
lfanuuoi d, W1 54015
715-7~ 6-2239 or 715-425-8363
Sign, date and return to above address.
A Dj ,.,Mary, ILHR SANITARY PERMIT
Coun
-GROUNDWATER SURCHARGE
rusrrr~ rx~usTSar.~~tyacr~~nw~geurr~ory~ Sanitary Permit No.
On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more com-
monly known as the groundwater protection law. This change in statutes was the result of over
2 years of steady negotiation and public debate. The groundwater bill included the creation of
surcharges (fees) for a number of regulated practices which can effect groundwater. The
surcharge took effect on July 1, 1984. All of the water that is used in your building is returned to
the groundwater through your soil absorption system or the disposal site used by your holding
tank pumper.
The monies collected through these surcharges are credited to the groundwater fund adminis-
tered by the Department of Natural Resources. These funds are used for monitoring ground-
water, groundwater contamination investigations and establishment of standards. Groundwater,
it's worth protecting.
Ground floor
Sign ture of Issuln Agent: Groundwater Fee: Date: WISCo sin's
Ltd buried tr urea
I, Jel
DILHR SBO-7289 (N. 05/84) e
i
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
I (~.~D UST.RY, c DIVISION
LABOR AND, PERCOLATION TESTS (115) MADISON WI 53707 P.O. BOX 76
HUMAN RELATIONS
(H63.09(1) & Chapter 145.045)
LOCATION: SECTION: TOWNS HIP/MRAI=JTY: LOT NO.:BLK. NO. SUBDIVISION NAME:
COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS:
USE DATES OBSERVATIONS MADE
NO. BEDRMS•: COMMERCIAL DESCRIPTION: I PROFILE DESCRIPTIONS: PERCOLATION TESTS:
QResidence - yv ONew ❑Replace Il 7 - r
RATING: S= Site suitable for system U= Site unsuitable for system
CONV
EIS EA ENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLD=1jNGTANK:R COM MENDED SYSTEM:(optional)
If Percolation Tests are NOT required DESIGN RATE: [Fflloodplain, an
y portion of the tested area is in the
under s.H63.09(51(b), indicate: indicate Floodplain elevation: y
PROFILE DESCRIPTIONS
BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-FNe++ES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH rN, OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
Jti. ~l'7J t. ~ 7.' C~.`,~J ~..,uY`- , 1.~'~(•.. Jai )S
B
3'`~•o' ?~ua~L > ~,3 cam' z. y \3n cs
B- 9~•3 1•p' p'
3r ;
S ~ L'1^.1 S E S) Z' ~ ~ ~ h S
B- -l 1 ~S . ' tin oT '0 2.0- 2 1. 3 ' 131 S { 1 ? Z . 3 ' i 3 • S b-5 h S
_Z3 V) Y TS j- J `l
B- 77 '4
3.5 T~ n s
B-
B_
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH
P
P-
P-
P-
P-
P-
PLOT PLAN: 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 slope. 1y~,ll?,`•_ y y~',~ 1 FO_,~ 7`; ~5U14C1 f1t ,
SYSTEM ELEVATION
' _ Q t_ GC~..~ ~ ~C.1 ~Z? ~V i=a ~ t•-Q Cta
i~.~ts`r~~C F=rr.izr~iS~LZ ~ _ eitiuPUS+ve l-1_RP t_S co~)v~ OF Al,p~•~__
F ~ ~uT3c~Lt~r,us5 ~t,~~~e ;,i~S 5friiwty -
3
(25F -fie I,J L-,)
wr~►-~~ s~~ $Z nl~ S~T~dt~
,I ir`Xt sT, - ~ - - A i
E
N
I E
` e E ~o~ ~ I I
. i
PiSt~~1~ U40GM t:Jt
:
E i
I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin
Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NAME (print): TESTS WERE COMPLETED ON:
ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional):
CST SIGNATURE:
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
F)'' !-'P QP )-(~"2QF (R 0?/3?! - OVER -
a t a3 ,j,
Thl~l
_d iYOe o
SY'7 k'lNA ,..s(d
S A 11 E- HA-D -",J BASED ON (`C4 ~-,Fl
n, E P, ' hh x,x, . <e ?k, sf}i >l`k ~zx }sit ,.e the .,3 ivii;c,.ns and t
NAIA K E x=, _ d.C. LE c ~3r~r _r, OC H M IV 10 ~i(iilg y = . . ,S,
t.°, r tie :.d e d e red:
1",i ;v id, ver tica' uk1 at, n d efrr:=.€,i,.e pK"9e[3a a. e clear€y a}"iUL`vn, and are fic s , e-
-FS`3" e C2Yt'.$, .u,, =SL;trZ'{ 1:3 € idu a, pF:T'colif tf3t7 tf'z
C°-jd plE tdr,, dow"' rd., Irfl , , acll N t t h" alp roplia",
Yo M
a- cw
L
G "J f" .3LS
C- VV H~O-t '01
z k;
N4 ~~te
a
i i
t',
r: B
yt
5
t
s
r c:
°ja it T.
S i 3E1f
°i s.. i, .hu fhsl, t fi
.C, 'hP, +..ld ° (,I F:2i,,.s for thrk pi"ivatu
,r$~'t'
Lw,nt-~r's name San. Permit No.
1!63.05 PLOT PLAN
Show:
EA Location of building served N//l Dosing chamber
Septic tank Vertical reference point
Building sewer Horizo-tal reference point
Effluent system Well
i Replacement system area N/q Property lines w/in 50' of system
Distribution boxes [ Scale = \~~=4'J or dimensioned
FN Pump and controls:
Mfr. & Model No. Vertical Lift Size Force Main
Friction Loss T. D. H. Vol. Dist. Pipe Gal. per Xn. Gal. per Cycle
Place check mark in appropriate box, indicating item is sh:,--,,-n on plot plan below:
r- k\\
\I
' ~O~O 6RL. Ip~eF4C2
f`. ~ `~\E`u~F2 -_.G7.+.=. ' 1 1~i9~PaLl. 'O1 STS .J•' ~.-1 ';i \
SCAT C ~NK > N ; C\
~`~UEr, c•s_
Ipvc
so '
a y PVC • sl S J In
u' 1 r
ebb i
J
- U OD :6 - - T L 1p 1 b
UC-t,1"r ~ ~I
By the granting or approving of the above plan, or upon the event of a subsequent
permit being issued,' ~•c oix County and the nT.caoix County Zoning Administrator, does
not assume or hold itself liable for any detects in plans or specifications, plan
omission, examination oversight, construction, or any d oe that may result in or
after installation.
r J Plumb_r's signature
PA&E Ur
> V-1 v C~ S 1J h h C
CROSS 5ECT1DQ OF A BED S~STEN~
V E1JT t i~E \ Z" ~~30V
C T
a- SOIL FILL 2 OF AGGREGATE
Lill PN C
DISTR)13UTIDK3 PIPE APPROVED SyUTHETIC COVER
!'IATI=RIAL OR 9" OF STRAW
OP, MARSH HAt
(oOF %Z-21/Z AGGRF- GATI=
e I ice,
ELEV. OF FEET T
' T'ER ~01~ ATEn PIPE To
t rDM OF BEp
"J INCHES BELOv-' ORIG1►JAL GRADE
RIBUTIOU PIPE TO BE AT LEAST
DIST
AUD AT LEAST 20 IAICHES BUT MO MORE THAQ `-12 IUCHES B=LOW FIAIAL GRADE
MAYIMLJ/'~ DEPTH OF LXCAVATIOM FROM ORIGIIJAL GRADE. VJILL BE _ 5Z WC-HES
t.%INIMtiM DEPTH OF EXCAVATIOU FROM ORIG11.1AL GRADL WILL BE LO INCHES
SIGUED,
L IG E U SC UUMBE R
ti '
Parcel 040-1036-30-110 01/31/2007 10:39 AM
PAGE 1 OF 1
Alt. Parcel 08.28.19.116A-10 040 - TOWN OF TROY
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
LAYTON D,& NOLA K WALTER TRAVER O - TRAVER, LAYTON D,& NOLA K WALTER
404 RED BRICK RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 404 RED BRICK RD
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 5.500 Plat: N/A-NOT AVAILABLE
SEC 8 T28N R19W PT NW NW BEING PT OF LOT Block/Condo Bldg:
1 CSM 8/2292 INCLUDES P75A-10 5.5ACRES
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
08-28N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 887/296
2006 SUMMARY Bill Fair Market Value: Assessed with:
157975 288,600
Valuations: Last Changed: 07/19/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.500 74,500 188,800 263,300 NO
Totals for 2006:
General Property 5.500 74,500 188,800 263,300
Woodland 0.000 0 0
Totals for 2005:
General Property 5.500 74,500 188,800 263,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 126
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00