Loading...
HomeMy WebLinkAbout040-1186-20-000 o c d o CD CD m v 3. F 0) 0) CD i i 3 (X ID (D w CD 0)0@m CD~ c n U) (n N O. = O ? 7 v N O C) 00 CD co Z3 v C O J O off" N N Q V O C lV m a a C c 7 , W ~ fn 7 o A C• rn ° 0C 3 0 I C Z O 6 CT) -4 "ftwA CY, a CL co Z C~ • Z O A? 0N Z 0 !t r (V V I d O O O m H O < w C1's c~ D Q v o o 11 N A Z7 0 CD T ( N (D (n O 7 U N ° zwz~ Q A m O D a o' ti • CD CD U "0 (D c c (D w m -i G Z a c, (o n 3 (D cn -4 cn 7 a w O A n C: 1 (ry o D i~ z 3 0 c~ -icy N 7 ~(M o c A w Oo co c a z (o c" w 0 3 a ;a (v o z m H z (D a Cl) o 0 D O N a I o O n ~ arn~ c CL C~) CL Z) -n Q - - 0 c 3 o a (n fl. (D 0' m m 0 (no N N D O 'a 0 y 7 ~ O a ty o o S n O o Cl. N CD (D O O (n O O O O O (D Oq ~ N ffl O v A ti Parcel 040-1186-20-000 12/15/2005 08:14 AM PAGE 1 OF 1 Alt. Parcel 36.28.19.776.777 040 - 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 O - STENEMAN, RUTH V RUTH V STENEMAN 98 E WOODRIDGE DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 98 W WOODRIDGE DR SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 0.918 Plat: 2237-OAK RIDGE ACRES SEC 36 T28N R19W NW NW LOTS 23 & 24 OAK Block/Condo Bldg: LOT 23 RIDGE ACS AND COM NE COR LOT 23 N 89 DEG W75 FT S 200 FT S 89 DEG E 75 FT TO SW Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) COR LOT 24 N 200 FT TO POB INCLUDES 36-28N-19W P565E Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 871/498 07/23/1997 861/276 07/23/1997 689/395 2005 SUMMARY Bill Fair Market Value: Assessed with: 103470 355,300 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.918 74,200 267,800 342,000 NO Totals for 2005: General Property 0.918 74,200 267,800 342,000 Woodland 0.000 0 0 Totals for 2004: General Property 0.918 74,200 267,800 342,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 137 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP SEC. -T ;N-R W ADDRESS PIERCE COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 SHOW WITHIN 100 FEET OF SYSTEM 1 I i / j s, :LT- I di a e o~thl Arrow SC LE: BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical reference point: Slope at site: SEPTIC TANK: Manufacturer: Liquid Capacity: Number of rings on cover : Tank manhole cover elevation:)- Tank Inlet Elevation: Tank Outlet Elevation: PUMP CHAMBER Manufacturer: Number of gallons Number of gal. pump set or a cyc e gallons; total capacity o distribution lines gallon:. size of pump head; gallon per minute horsepower ran 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: , um er o pits feet diameter feet liquid dept seepage pit in e ipe-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 KR-EA AS BUILT HEADER LINE ELEVATION DIST. PIPE ELEV. INLET ELEV. END DATED PLUMBER ON JOB LICENSE NUMBER DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR at HU11i RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 XX CONVENTIONAL ❑ ALTERNATIVE State Plan I ,D Number ~ (If assigned) E:1 Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER'. INSPECTION ATE. Round Steneman Hwy 65 N., RiveA FaM , W1 9-64# l/R3p SQL BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV. NW NW, See.36, T28N-R19W, Lat6 23 9 24,Oak Ridge Aetc.en,Tvwn a6 Ttoy Name of Plumber. MP/MPRSW N... C- my Sanitary Permit Number_ Eugene Gnvve 5569 St. C)Loix 49453 SEPTIC TANK/HOLDING TANK: MANUFACTURER. / LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED ,./.ago /0-0 L} ❑YES ❑NO ❑YES ❑NO BEDDING: VENT DIA VENT MAT L. HIQH WATER NUMBER OF ROAD: IL ROPERTY_ L LBUILDINGVENT TO FRESH ALARM FEET FROM I JAIR INLET ❑YES NO 1 ❑YES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER J BE DUING. LIQUID CAPACITY PUMP MODEL jP11MP,SIPHON WARNING LABEL LOCKING COVER PROVIDED. PROVIDED'. C ❑YES NO ~ ~❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: 1PUM P AND CONTROLS OPERATIONAL. F PROPERTY WELL BUILDING VENT TO FRESH (DIFFERENCE BETWEEN LINE AIR INLET PUMP ON AND OFF) ❑YES ❑NO SOIL ABSORPTION SYSTEM. Check the soil moistureat the depth of plowing - DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH. LENG TH NO. OF DISTR. PIPE SPACING COVER JINSIDE DIA SPITS LIQUID BED/TRENCH TRENCHES /T MAr~rt*ALL, PIT - - DEPTH DIMENSIONS Z CO / GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL. NO. NUMBER OF PROPERTY WELL. BUILDING. VENT TO FRESH . BELOW PIPES- ABO E COV R ELEV. INLET ELEV. END. PIPES" FEET FROM LINE' AIR INLET NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ❑YES ❑NO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH BED DEPTH OVER TRENCH BED DEPTH OF TOPSOIL SODDED SEEDED. MULCHED CENTER EDGES. ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH. NO.OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER. BED/TRENCH TRENCHES. DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO DISTR. DISTR. PIPE DISFF3IBUTION PIPE MATERIAL & MARKING. ELEV.. ELEV. DIA. ELEV.. PIPES. DIA.'. ELEVATION AND DISTRIBUI ION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL pLA NSCAL LIFT CORRESPONDS TO APPROVED ❑YES ❑NO ❑YES ❑NO COMMENTS: PERMANENT MARKERS: JOBSERVATION WELLS: 7NUMBER OF PROPERTY WELL: BUILDING. FEET FROM LINE ❑YES ❑NO ❑YES ❑NO NEAREST 717 '1 n / 1J S c In g3 Sketch System on 'cj, Retain in county file fgrlI Reverse Side. I . `1~ ~ ,{^yyv SIGNATURE. TITLE DILHR SBD 6710 (R. 01/82) J jjjy/ J1► ~jy I 7InDU-7m consln APPLICA TION FOR SANITARY PERMIT ®I L H R t+-1 COUNTY (PLB 67) UNIFORM SANITARY PERMIT # S1RV,LRBOR&HumRn RELRTIOnS -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8%x 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER [1 MAULING ADDRRESS _z .f7 ; 91 t /V A PROPERTY LOCATION e1-T-Y: E 11 /4'k'~14, S T"/t. N, R E (or W~ VILLAS'i TOWN OF:i/o? LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER Af Al TYPE OF BUILDING OR USE SERVED f 1 or 2 Family Number of Bedrooms. 15 Public (Specify): THIS PERMIT IS FOR A: LIT New System ❑ Tank Replacement ❑ Repair ❑ Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. lk 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 f),Fi j ✓ Lift Pump Tank/Siphon Chamber / Holding Tank capacity Manufacturer: 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): IJ Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the i to sewage system shown on the attached plans. Name of Plumber (Print). Signature: MP/MPRSW No.: Phone Number: Plumber's Address: _ Name of Designer: COUNTY/ DEPARTMENT USE ONLY Signa u e of Issuing Agent: Fee: Date: ❑ Disapproved Qr1 / El Owner Given Initial "7 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 f 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. Form - S T C 100 Owner of Property_ /V,/-71 9'A Location of rProperty &jQ `4_,y(~ Section 1V~, ,1'_,W_N R_I~IW Township-._. (1%'' - - . - Mailing Address -Af T-- Subdivision Name l ~w Lot Number r7 Previous Owner of Property_ S( Total Size of Parcel ' - ~ f i X Date Parcel Was Created Are all corners identifiable? Yes No Include with this application one of the following: .Certified Survey Map VID e e d .Land Contract, or .Other Legal Document which describes 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. 9.- and that I (we) pre- ty own the proposed site for the sewage disposal system (or I (we) have obt,imed 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 ' SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DArE Sl ~tt U r~ U L-: S T C - 105 r y H SKI'T I C TANK MA I N'1'ENANCE. ACh I-:FMI?N'1' C) 5l . CCU IX Coullt y u 0 W N 1? k / 1111 Y 1S l: _ ~~E! h-~' J~ls►l!~-r~~~/~~ _ rn ROUTE/BOX NUMBER - Fire Number C1'1'Y/:;'fA'I'1j_u L11' YR0PERTY 1,0CA`1'10 N: Y 7 14> t4 Suction L N, 1t W, Town of SC Ce'u}x CounLY, Subdivision__.__DAY ~ Do, F- LoL number23+24. Improper use -,and utainlenance of your Sopti-c Systeut could result in its premature failure Co handle wastes. Proper uutiutenauce cun - sists of pumping out the Septic tank every three years or sooner-, if [seeded, by a licensed s- t•plic t ank j-ulitper. What you pttt into Cite SyStent can affect the tuncCion of the Septic tank as a treat- ment stage in the waste disposal system. St. Croix County I S i d C nts uuty be eligibl -e t o receive a grant Cur a Ilia xiIll it Ill of 60"/„ of the cost of repl.acemunt of a failing systelit , which was in operaLioit prior to July 1, 1978. St. Croix County accepted this program i-u Au1;uSt 01' 1980, with the reyuiremunt that owners of all new systems agree to keep their systems properly maintained. The 1>rol)e rty owner agrew Lo subutit to St. Croix County "Lon -fng a certification brut, signed by the owner and by a masLcr plumber, journeyman plumber, restricted plit Ili ber or a licensed pit lit per verf- tying C has (l) the ort - site w astewater disposal- sysleIli is in proper operating conditlon and (2) after inspection and pumping, (ff tlec- essary), ttie septic tank fs less than i_/3 full of slu(ige and scum. Certification form will be sent approximately 30 days prior to three year ex1tfralfon. 0 ti OWE, the undersigned, have rr_ad the above reyuirewents and agree U) x to maintain the private sewage disposal system in accordance with r-+ the standards set forth, hcrei-n, as set by the Wisconsin Depart- n ment of Natural kN_S0UFCes. Cet L it icat ion Iorill, must: be completed and returned to the St. Croix County Zoning Olfice w-LOI iu 30 days of the three: year expiration dale. DAT L: St. Croix Courtly •l.oniug i)1I i(e Y.O. Box 9ij 11 anunoad, Wl 5401.5 71.5-796-2239 or 115-425-8363 Sign, (late and return to ;ihovu ,tddrur;s DWARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX N WI 7969 HUMAN RELATIONS ` (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/M-IJ*fCfFA4t4-TY: LOT NO.:BLK. NO.: SUBDIVISION NAME: 1/ 1/ /T N/R E (orl - x ; COUNTY: OWNER'S/B-EIYER'S NAME: MAILING ADDRESS: USE DATES OBSERVATIONS MADE NOi BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: ❑Residence a ❑rNew ❑Replace I - _ a . RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUNND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) ®S EIU EIS~U QS DU DSZU DSEU If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b), indicate: F~.• Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-hS CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTHtBt, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) ! 1 ~'h 71 B- J: yy y B- PERCOLATION TESTS ETEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES I~+IES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH bb~ JJ S~%b i 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. J, j SYSTEM ELEVATION l„ Nth ~ G • ; 'fir _ CSI l1fJ ,1 l? E Q* ELI- - F i Z 99. g' ec~nhor~ I ` T- dJ ~ x `::5 N'b.tl-1W~3 FJt1 TZ), (s1 i ~ ~ ~ r t , 75 I t » ) E r~ f V ld j' r\ Y ~~►'~€i _ f~~ _ loop m. _ } i 7_11 t , jj j t ! 3 ~ »t t 3 Z _ L_iJY 1 LL L t 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) e TESTS WERE COMPLETED ON: fl PHONE NUMBER (optional): ADDRESS: ^ PRTIFICATION NUMBER: ty 0H1#S T SIGNATURE: Offl i DISTRIBUTION: Original and one copy to Local Authority, Property Own y U!LHR-SBD-6395 IR. 02/82; - OV 4 ~ M A a.r e a a., m 4 £ l i A a G e_ ter. r.t :'tc...Jt ri3 ,C} i "y, t. yaw w w :c e. E 'Ei"a ,"ectloi"3ma %>EtM0 ivi Fpm _M1 Wis ia_ Y'€{ i3 Il ~ t r n't t ,f°u, P cJ r_ 1HU=3`' ONL'Y'IF ALL . - we WsY, `.a ft I My An s,. .fit,, . ° rh .lfz W. wid xt, J.i fr : n the of i , 0 ' HI E ih-3m oK ,.,3 P € u- too Awvcnrs~ xa` ,..,Ji•.t _u. 3. .ONE y rs a { ~e= € t M_ sun t r" hunt. "s~,lci71 ti < . ['t f . € xcyi€ i ! Wrun ; joint aio C l£a vl n Lei fT „t ot; f i. f,,,:;", <s..'ial S.o 14A )d sib can i.f , test vxernp W; 4 Ef , u We 11 1 Ka € , . . s`Y' , as Oyu! C 110 tQ'°t; , wom p ii. ' %..t _ f irii? "iCFx; A56 R Ell AT Sao Nyack, M_. S="£I .t'o shne over a-.;.. e. y Cobve (3 W, HS -l 11 t ~ s ` . MrGhvimo Alt, in .Fri, ..F c>F _ _ )i Lp"ry Son,' ? ' bP to ..E At F ,.wx T41 UMV inn 11 M, via nn' W's SAY v"J t. f.J. C if ;Ltl~i Qp~ Nn L a ~it lick Wel, 0; Ono BOVA NW, r,., 100 iS <t J, .;i , :ri J u so n p>=t€t ,c. FrW CM M" M e M err i M ='fM MW r £ l :w:, € o" ,J., ;r.? ! J€i'tJ ! i""„€ n; on,-ii! so, F p'ans ? ,r i f~i.. and a d _,.6 iii, ;.t n i-:, 1- :c' t.3i. .a i.. W, own E. i.,. Me S f f ztJ, nm 'ct,.?ri€, no ('f€.. inky 0) Qw tal of .Pry m, orrinn ,m, I ~ _ 1 T2 s , ♦ 1' I f E.~. t rr a 3 b , e,n l~S9u1v1E /ve~euR BI ICJ-g9•~, 3t ►ul x C33 ~4•° L3 -4 ~ s q9.~ l 5~ I+ /niiTl~L BkU Ut 97•q A17~ FD ~L 9 ~.v i i~oo ~ ~aoa G{AL ~'T C p fc N.F~`: 7 So A tv. ~ ~v1 R is p' ~ ff 1'7 % F I?nt' Z vT 23 pi e, F' pqi~r 70 A p_3 /z I ~ ~ ti I VENT afl'? MRW ~~yniF~{ TIC -tb CRAVF / r~ Cev ~,t g 1 0 a. yl X38