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HomeMy WebLinkAbout012-1075-60-000 n co O 3'D n d r~ 7 3 3 r/1 C sv w m v d N o ° w m m o Q O W N • S E3 N N c N O 1 = S (D 0- 0- a Cjl O O U CCDD CD CD n fD (~J7 A7 O cn 0) co td Z, 3 0 O Iv _ p ~D rc) N N O 7 O Q C "i a ro ~d £ N CD (n a a u, ~ N. rt ~ ~ rn W o rt n p d CD =r ° 00 D N ~ p - O " • v m A j l~ p rt a 0- ~ W n r c CD co n ri N co a N c :E 3 tT w ri I Z ON O O O " ca Ul r' £ a tin tin o m_ a v 3 v v v N CD cQ 7 G4 Ip I M Q C fD [U W cn I 3 y ~ I (D C1 z N N N I y o 0 00 o D CD o U) £ 0 C1 0 tr !r . w o CD 0 o N (V CD v rr, Z Z I m N' ~ ~f LTJ c CD CD by ~ I W a C~ rj r-I fl. 3 ~ I • r• ~ Cn z CD -1 cn z CD =3 z O b CL A o ~ w = z w rn rt N• ~ I ~-i W A Z Fl- CL 3 C A rr z 3 m V N z CD I ~ g I I a CL I ~ c z a 0 CD Cn I I t A I C I ~ I ~ I ti I ~ N O I o V I A o ° p W CD A I M O v, O *2 V °o a a Parcel 012-1075-60-000 01/12/2007 09:31 AM PAGE 1 OF 1 Alt. Parcel M 36.30.17.5458 012 - TOWN OF ERIN PRAIRIE 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 SHERRY WALKER O - WALKER, SHERRY 2051 130TH AVE BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 2051 130TH AVE SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 21.000 Plat: N/A-NOT AVAILABLE SEC 36 T30N R17W NW NE THE N 693' OF NW Block/Condo Bldg: 1 /4 NE 1 /4 21 AC 671/427 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 36-30N-17W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 671/427 2006 SUMMARY Bill Fair Market Value: Assessed with: 156302 409,800 Valuations: Last Changed: 11/21/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 33,000 321,300 354,300 NO UNDEVELOPED G5 5.000 2,000 0 2,000 NO PRODUCTIVE FORST LANDS G6 14.000 44,800 0 44,800 NO Totals for 2006: General Property 21.000 79,800 321,300 401,100 Woodland 0.000 0 0 Totals for 2005: General Property 21.000 79,800 321,300 401,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 220 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 . i. Y*' ~98~ AS BUILT SANITARY SYSTL;M REPORT ~°1\ 9% UWNER -0-f ~rF TOWNSHIP AGURESS ,y ✓ % _ ST. CROIX COUN'T'Y, WISCUNSliV SUBDIVISIUN % LOT LO'T' SIZE PLAN VIEW Uiatancea end diwenaiona to weer regUiretl►e[lt5 of H63 ' 1Lf;tiYTHING WI'T'HIN 100 FEE'r OF SYSTEM L 71~ r- l - I 4: - - - I di a e o th Arrow - - - _ _ - - sc .1~ BENCHMARK: (Permanent reference Point) bedcrlbe Elevation of vertica reference Point: Slu1'e- at bite. _ `7/ SEPTIC TANK Manufacturer. Li.y uld C:apac r L y Number of rings on cover Tdnk 111dJ1l1ole cover elevation 7' Tank Inlet Elevation: ~3y•~` 'batik Outlet Elevat.l.Ull PUMP CHAMBER or Nuutber ul ~;al Tunb ✓ Manufacturer: ~ tTor- g P.um_~P ae. --a cyale i~ iis Lot dl ;ap,t4 , i y ()F Number of al. r dlatribULion linau NZ 6a l lull b 1 LC cir pu►up " liu~i~l , gallon per minute_, hurdePuwel /✓✓brand nanic of pump and model number _ Type of warning device HULDING TANK: Manufacturer 1f Nu►ub..i of gziiluii~, Elevation of manhole cover- of warning device % ' rype SEEPAGE PIT SIZE- Nuwbc, r u t ~i i t r feet liquid de ute u c pit 1111.:1 ,i Ulr.vatioii bottom of aeapa4e pft elItvat io~~ S1.E1'AGE BED SIZE. number of Hued wiEh I/~:~. .tt•~ 1; "t L I TRENCH. Width r~,itt:ul.A`T'lUN KATE AREA RE QUTIlEU r~ 7 3e"11 V./-/ _r DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS P.O. BOX 7969 PRIVATE SEWAGE SYSTEMS DIVISION BUREAU OF PLUMBING MADISON, yii'153707 EN CONVENTIONAL ❑ALTERNATIVE StatePlan l.D.Number Holding Tank ❑ In-Ground Pressure ❑ Mound (lf assigned) NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER INSPECTION DATE: Sherry Walker A Baldwin, WI ~ BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF PT. ELE V.. NW NE, Sec. 36, T30N-R17W, Town of Erin Prairie Y l" 11 Name of Plumber. MP/MPRSW No.. County. Sanitar Perron Number. Everett Boldt 4489 St. Croix 43646 SEPTIC TANK/HOLDING TANK: MANUFACTURER . LIQUID CAPACITY. TANK INLET ELEV. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED. I,/IV/ 7_J! /Y• a• ` YES ENO DYES ENO BEDDING. VENT DIA.: VENT MAT L.. HIGH WATER NUMBER OF ROAD: PROPERTY WELL. BU ILDING . JVENT TO FRESH ~l LINE AIR INLET. ALARM FEET FROM YES ENO DYES ENO NEAREST DOSING CHAMBER: MANUFACTURER. BEDDING. LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROV IDED. PROVIDED: DYES DNO DYES ENO RYES ENO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY JWELL BUILDING VENT TO FRESH DIFFERENCE BETWEEN FEET FROM LINE I AIR INLET' PUMP ON AND OFF) EYES NO NEAREST ' SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing Nc,TH 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 LENGTH NO. OF DISTR. PIPE SPACING COVER INSIDE DIA. -PITS. LIQUID BED/TRENCH ?L rRENCH~s ERIAL PIT DEPTH DIMENSIONS ^ J°f ~ GRAVEL DEPTH FILL DEPTH DISTH PIPE DISTR. PIPE DISTR. PIPE MATERIAL. N ISTH. NUMBER OF PR OPERTV WELL. BUILDING'. VENT TO FRESH BELOW PIPES ABOVE COVER. ELEV. INLF T ELF VEND AIR INLET. FEET F l S 7 . 0J /O'/ Y c - PI s N EARESTO---►LIN 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 systelrs to make certain that it ON REVERSE SIDE. SHOW ELEVA- D YES E NO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE PERMANENT MARKERS JOBSERVATION WELLS _ DYES ENO DYES ENO DEPTH OVER TRENCH; BED DEPTH OVER TRENCH BED DEPTH OF TOPSOIL. SODDED SEEDED MULCHED CENTER EDGES. DYES ENO DYES DNO DYES ENO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH TRENCHES LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER : DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. JNO DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING. ELEV.. ELEV.. DIA. ELEV.. PIPES DIA.: ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS DYES ENO DYES ENO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE: DYES ENO DYES ENO NEAREST Sketch System on Retain in county file for audit. Reverse Side. ISIGNI,AURE DILHR SBD 6710 (R. 01/82) TITLE DEPARTMENT OF APPLICATION SAFETY & BUILDINGS INDUSTRY, FOR SANITARY DIVISION LABOR AND PERMIT P.O. BOX 7969 HUMAN RELATIONS (PLB 67) MADISON, WI 53707 Attach plans for the system on paper not less than 8'/2 x 11 inches in size. Include a plot plan that is dimensioned or drawn to scale. Horizontal and vertical elevation reference points must be shown. All appropriate separating distances and physical characteristics as specified in chapter H-63, Wis. Adm. Code, must be shown. An index page or each page must be signed, sealed and dated by the designer. If designed by a Master Plumber, the date, signature and license number must be shown. A legible reproduction of the soil test report or the owner's copy must be included. Property r Mailing A ss: o c von ~ r/ GC>A L l~~,e ~ ~ d w ~ ~ C~•° S Property Location: City, Village or T-oowwns~hip County: NW t/a 11/014S 3(~ iT 30 N/R 17 (or) W ERi,.~ /-AAA R~ 5f CRS i ~c Lot Numb er: Blk No.: Subddi/vision Name: Nearest Road, Lake or Landmark: / State Plan I.D. Number: ?s r v A- 0,1g5e t9 ke- Rai- (If assigned) TYPE OF BUILDING Number of ❑ Public* ❑ Variance* ❑ Other (specify)* Bedrooms: I~ 1 or 2 Family *State Approval Required. TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY 00 ~~V x HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER MANUFACTURER: j c, p- e EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet)i New ❑ Replacement ❑ Experimental Seepage Bed ❑ Seepage Pit a ®i~ / ❑ Alternative (specify) ❑ Seepage Trench Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): X Private ❑ Joint ❑Public I, the undersigned, hereby assume responsibility for i allation of the private sewage system shown on the attached plans. Name of lumber: Signat MP/MPRSW No.: Phone Number: ✓a~ e_~-f dG vi nn P 4~~~g (77/616 ~-337 Plum ddress: Name o Designer: COUNTY/DEPARTMENT USE ONLY Signatur of Issuing Agent: Fee Date: APPROVED Sanitary Permit Number: ~'DISAPPROVED Reason for Disapproval: Alternate course(s) of Action Available: Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to in- stallation. Failure to comply will void the sanitary permit. DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber DILHR-SBD-6398 (R.07/81) 1'orw - S C C 100 Owner of Property -_~('L~_{T~'!✓ ~ ~ .Location of Property Section ~ T N It W Township ej- f, Mailing Address Subdivision Name Lot Number Previous Owner of Property _./I + I f.t Y I ~d p'~ 11 ~l L~~1 K~ t Total Size of Parcel ,,n~ Date Parcel Was Created Are all corners identifiable? Yes No Include with this application one of the following: .Certified Survey Map .Deed .Land Contract, or .Other I:egal Document which describes the property PROPERTY OWNER CERTIFICATION i I (We) certify that all statements on this form are true to the best of my (ourl knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty dead recorded in the Office of the County Register of Deeds as Document No, ; 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 ~e County Register of Deeds, as Document No. SIGNATURE OF NER SIGNATURE OF CO-OWNER (IF APPLICABLE) 1 SCg ~ ~ DATE SIGNED j DATE SIGNED • M F p,~X. r 1! ~ 35~ ~~.*~.r2rta4f~ A~~ha wt 1 644 le-pit- w. t7 Fr a ~2 ` , S,f 'kA w 7 4, 5 1- , App, (21oveoq m44- 3a, ~6~~- .'gym"), over P~p'04 wo p~ 5a 4 p r , r1 p~ t-, d TAB?. JAI 9 , F pPC S l J-~ fk fJ ~ ~ ~ ~ E I co !a v h o to 5 ~k r /Uc'o 1 AN, i Q la F 7 \A/ 5 X l7 ~J FF e ~~a C i Fa 7 L,t.) /V' '`-l t F I~C7 (A _j r4 R c..P L ! 1 , ~C' ° j _ s✓ ~C' f . > j , j lr r 35~ ~ ' .x µ CGVF.tL W t~ n oFr ~t L APB (2.ova re /r)4+ Al' pvr, F, Op't, 14 9,t / g tom` ffous ~ ~ i~ it t o' a1 6,b00 ~ 5 3e}' C? iqC. rte fyx J C31 - ~'9, ~S ° ,r j r 73c,r,- t r~ t» = o it 1 / a 1ti lee 14 1,,,. r4 , DEPAR. TMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDIN i"NDUSTR`* DIVISI LABOR AND PERCOLATION TESTS (115) MADISP.O. BOX 7 HUMAN RELATIONS ON, WI 537 (H63.09(1) & Chapter 145.045) LOCATION: I SECTION: TOWNSHIP/MUNICIPALITAlf • LO„T/N^O.:BLK. NO.: SBDIVISIf1ON NAME: NW '/a 36 /T.SoN/RJ tor)R !Q1" A/1Q1e I /t R /r ~r7 . COUNTY: OWNER'S BUYER'S NAME: MAILIJUQ ADDRESS: CRS i x /->lD~~ .e~ GtJH Ke K /5a ql w , L~ S USE D!4- e'RR AL e R DATES OBSERVATIONS MADE NO. BEDRMS.: COMME IAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence New ❑Replace [ 0 '7- d, - ?3 RATING: S= Site suitable for system U= Site unsuitable for system ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) S DU IS DU [ZS DU []S ©U D S ZU If Percolation Tests are NOT required DESIGN RATE: LF'loodplain, any portion of the tested area is in the under s.H63.09(5)(b), indicate: indicate Floodplain elevation: Fi PROFILE DESCRIPTIONS BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH JW OBSERVED ES . IGHES TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- / a. F3 99.65 A/c v e_ > ~ . '5 /y/ s.'6 7 FAv3e- 6 7 G.'1 sl V B- F. 9 9.90~V0^.j G > r p ~ 2511,'?4,5711- 76r✓5GL ~•~33~JN5~~~~Z r B- /Yaws e. g:5'RL. S, 33L 7.j ~'7 6'VSLQ. 2 B- `r 9 `J, 9 No.v > 92- si L / m 'la ~8,V ,.Se... L 3 z IQN r B- 6.0 (377 A/c.%j G , 913 ~9,vSc. ~N"5 ~ a B- ,'5 A 15c / L. S '(SR-jflA~Jo) PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER 4NOW AFTER SWELLING INTERVAL.-MIN. PERT D t PERIOD 2 P RI PER INCH P_ _'5,6 0 9 i6' ` % P- . 67 ® o l 7// (a . P- C2 a 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. SYSTEM ELEVATION 7. i I , I i . 1 I, the undersigned, hereby certify that the soil tests reported on this form were made by mein 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): T SI TURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER -