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HomeMy WebLinkAbout040-1041-60-000 N ° D ~ a ti c o y 0 o °5 N 0 M O M O -AZ c v 0 Q 0 N Q CO i ~ GZ, _o v 0 c z LL C 00 m L c 0 v CNCI 3 `r v N z H 4 rn 3: ! o J 00 d d 0) U) rr c - v c t7 0 0 z :!t _0 aUi z v ° Y o E '2 "O E co O N ,3 \ ! o C t 142 •,ft, c o qC - x M -0 t5 O O Q z co z _ I ~ 16 z CD I)j V (0 P_ d r = LU O. R ~ ! O N d ~ N C p ! J o o a .a Y - J Z> H H co c3o w d = o - C/) ~N O O O z Z a a a a 0 "4 N z o N -o N M cay X ~j ti 7 N 00 ~ r- `l = rn 0) O I a~ o N N '!V N C O 0 a) :3 CLO, d r C I.. M 0 = n' O lyV~' 7 O 0 0 0 O p_ ~V O N O 0 Y 0 E O O O O H U) M O z 1-0 CO O 4.; V T E d N a ~r 3 ik G L: a '2 d y = c c L) a O ~ A v V Parcel 040-1041-60-000 12/30/2005 10:07 AM PAGE 1 OF 1 Alt. Parcel 09.28.19.139B-1 040 - 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 C/O COUNTYWIDE O - ANDERSON, TODD D & ERIKA C TODD D & ERIKA C ANDERSON 4500 PARK GRANDA BLVD CALABASAS CA 91302 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 421 N GLOVER RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.340 Plat: N/A-NOT AVAILABLE SEC 9 T28N R19W 3.34 AC IN SE SW LOT 1 Block/Condo Bldg: OF CSM VOL III PAGE 660 ORD Tract(s): (Sec-Twn-Rng 401/4 1601/4) 09-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 12/03/2004 781576 2708/173 WD 07/03/2002 683458 1922/380 WD 06/27/2001 649587 1669/546 WD 07/23/1997 787/343 2005 SUMMARY Bill Fair Market Value: Assessed with: 102333 297,000 Valuations: Last Changed: 07/19/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.300 66,000 219,900 285,900 NO Totals for 2005: General Property 3.300 66,000 219,900 285,900 Woodland 0.000 0 0 Totals for 2004: General Property 3.300 66,000 219,900 285,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 s AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP Ls SEC. TL,N-Rri W ADDRESS ST. CROIX COUNTY, WISCONSIN. SUBDIVISION 5105 LOT V' LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 EVERYTHING WITHIN 100 FEET OF SYSTE - _ 1 cc v - _ _ - - - - - - _ - - - or,_ h A roe 4 - - - - - - SCALE . I - - = - - BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical reference point: Slope at site: Liquid Capacity: l Z Q) Q 1 SEPTIC TANK: Manufacturer : t` Tan cmanhole cover elevation Number of rings on cover Tank Inlet Elevation: Tank Outlet Elevation: PUMP CHAMBER Number of gallons - Manufacturer: r a cycle gallons; o capacity o N tta uialaer of gal. pump set for-a- = head; distribution lines gallon: size of pump brand name ea pump gallon per minute horsepower s- and model number - ' Type of warning device Number of gallons HOLDING TANK: Manufacturer Elevation of manhole cover Type of warning device um er o pits - :Fee- iameter SEEPAGE PIT SIZE: feet liquid depth - seepage pit inlet pipe-elevation it elevation feet.. bottom of seepage -T ~ 1 - th the depth SEEPAGE BED SIZE: number of lines-_ _width g SEEPAGE TRENCH: Width - length AREA REQUIRED________ AREA AS BUILT PERCOLATION RATE_ INSPECTOR DATED- PLUMBER ON LICENSE NUMBER V\, DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS L,4BOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.U. ;4nX 706y BUREAU OF PLUMBING MACiSON, WI 53707 C~CONVENTIONAL ❑ALTERNATIVE (If assigned )n.Number. ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER: INSPECTION DATE. BENZ H MA manent refere ce point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV.. J LL) ) I I. N-,, of Plumber. IMP/MPRSW No.. CSanitary Permit Number. SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. V K INLET ELEV.. TANK OUTLET ELEV. WLABLOKI G R ( ~ ED: PRO E Ulm . o U L YES ENO YES NO BEDDING: VENT DIA.. VENT MATL. JHIGH WATER. NUMBER OF ROAD- IPROPERTY WELL- ~)DINGAFEET FROM' LINE~f JA~NT IN E YES NO O NEAREST - 2 6-C r~ I - ; - DOSING CHMBER: DOSING CT H4 BEDDING. LIOUIO CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROV IDED. PROVIDED: EYES ENO DYES ENO EYES ENO GALLONS PER CYCLE: TMP AND CONTROLS OPERATIONAL. NUMBER OF PIiOPERTV WELL BUILDING (VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM I INE AIR INLET PUMP ON AND OFF) EYES ENO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing III TA1,1FTER MATERIAL AND MAHKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enouqh to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH LENGTH NO. OF DISTR. PIPE SPACING COV EH INSIUE DIA xPITS LIQUID BED/TRENCH TRENCHES MATERIAL: PIT DEPTH. DIMENSIONS (;RAVE I. DFPiH FILL DEPTH DISTR. PIPE UISTR. PIPE DISTR. PIPE. MATERIAL. NO. DISTH NUMBER OF PH OPERTY WELL. BUILDING'. VENT TO FRESH BI I 1 v PIPES ABOVE COVER ELEV INLET ELEV. END PIPES. ! LINE LET'. a~ FEET FROM T S NEAREST s~ 725-7 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- E meets the criteria for medium sand. TIONS MEASURED. YES ENO SOIL COVER TEXTURE PERMANENT MARKERS. OBSEH VATION WELLS EYES ENO EYES ENO DEPTH OVER TRENCH BED DEPTH OVER TRENCH; BED UEPTH OF TOPSOIL. SODDED SEEDED MULCHED CENTER EDGES EYES ENO EYES ENO EYES ENO PRESSURIZED DISTRIBUTION SYSTEM: 6VIUTII LENGTH NO. OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER. BED/TRENCH TRENCHES DIMENSIONS MANIC Ot.D PUMP MANIFOLD DI STR PIPE MANIFOLD MATERIAL. NO. DISTR. DISTR. PIPE DISTHIBUT ION PIPE MATERIAL & MARKING. FI_EV.. ELEV. DIA. ELEV. PIPES DIA.: ELEVATION AND DISTRIBUTION INFORMATION MI_E SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL. VERTICAL LIFT CORRESPONDS TO APPROVED PLANS DYES ENO EYES ENO COMMENTS:^ PERMANENT MARKERS: JOBSERVATION WELLS NUMBER OF PROPERTY WELL: JBUILDING FEET FROM LINE C. 41- EYES ENO EYE ENO NEAREST- ~ IC ~2c. 7 (f e t' > 7 Sketch System on Re ain in county file for audit. Reverse Side. ~.p_~ 61 GNAj UHE TITLE. DIL_HR SBD 6710 (R.01/82) ~G. .DEPARTMENT OF APPLICATION SAFETY & BUILDINGS INDUSTRY, FOR SANITARY DIVISION LA.BOR AND PERMIT P.O. BOX 7969 HUMAN RELATIONS (PL13 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. The owners copy or a legible reproduction of the soil test report must be included. P'r~erty caner: Mailing Address: 75 `L r ' 4 4 4 h~ Property Location: City, Village or Township: Co nty: /4S ` ~T fP~ NCR E (or W )--Q~ Lot Num ber: Blk No.: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number: s (If assigned) TYPE OF BUILDING Number of ❑ Public* ❑ Variance* ❑ Other (specify)* Bedrooms: 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 HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER MANUFACTURER: EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (5L(7U" re feet X New ❑ Replacement ❑ Experimental Seepage Bed E:1 Seepage Pit ;x El Alternative (specify) El Seepage Trench ikb Water Supply: O ner's IN la gas Listed on Soil Test Re rt (If other than present owner): ~y Private ❑ Joint ❑Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of P Umber: Si nature: ^ MPNo.: Phone Number: Plumber' dress: Name of Designer: COUNTY/DEPARTM USE ONLY gnat a of Issui Agent Fee: D te/ APPROVED I nitary Permit Number: / 0 i DISAPPROVED f- x 02 eason 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 D;-HR-SBD-6398 (N.03/81) v i ter-r ~ " 97- k f i 14 bv- ti~ t?'~~ • .T ~d#z fit.~`4 YTr f F...i . f ly r elf f YY It ~ r• 4` {,,y, \ ~ ~ ~ ~._..4 -'T` J _ . lug K~ 1 9 i' d 8 V 3 3 E 4 l f~? tl3 CKI ,t? + ~j _J 7 rte, W 4 Pip , e'-f j J Y? 1J.. , j6 f7 • j i/v.y S~/~Tic TA,v,~ ~~1 ~ s~TF I o~ PLB " U ~7 PLOT- and CRO55 //-2- ' z -11--/ 51A'~E- ~PI~~'GtIFv /J~D ~.9L 0, It. - - - - - - - - - 3 %-T - o i3a,2E-3 ~ L C'ov d ,T 34 -2 3-0 ~A heoiez . Jc,vGAA0i>7iC' Sol L TES ~2EC• E F StJ~ .t?S Q UE, Oelf L if'EFE,PE~vC E" PO/.J l :T 5 13As~ o~ /P ' w y; fE- SPEC L /(/a,2~'Cv ~r /6 UFiP ~D . ~~0~ % l,~,v t~ . / a vArm j aC 13,9, 1.5 l©0,0 FT' G-AIED 0 z `/CEi1/S,E- ~ ~o Fresh Air Inlets And Observation Pipe ,N ~0 ~4, `~'0 JAR 5~0~5o M Co E~ ~Q~Q~ Approved Vent Cap Minimum 12'1 Above Final Grade I Above Pipe 4" Cast Iron ~16VATIox) 50it, To Final Grade Vent Pipe Marsh Hay Or Synthetic Covering ~~•~d Min. 2" Aggregate Over Pipe Distribution Tee Pipe 0 0 0 0 0 Agrge agthePite ° Perforated Pipe Below Be e p 0 Coupling Terminating At' Bottom Of System -vj `may ~ w ~ Y DEPARTgT OF REPORT ON SOIL BORINGS AND SAF S INDUSTR`, , ~ y~IV15'10 LABOR ANC• PERCOLATION TESTS (115) MAD'FS©114;/Y~17~7 HIJN; AN RELATIONS / l (1-163.090) & Chapter 145.045) VOL , 3 LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIV N NAMkt.,, COUNTY: OWNER'S/BUYER'S N)AME• MAI LING ADDRESS: USE DATES OBSERVATIONS MADE I X Residence COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOL ESTS: L,A(Residence i 0 New ❑Replace i/~11/~ /let , RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDI NGTSYSTEM: (optional) ~7 S ❑U 7 S ❑U S ❑U EIS ©U ❑ S 4vIA~ (0%_1 s . y portion of the tested area is in the If Percolation Tests are NOT re =q.iedDESIGN RATE: If an under s.H63.09(5)(b), indicateFloodplain, indicate Floodpla n elevation: PROFILE DESCRIPTIONS {3c__Wk- f/a/-) BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSSEE.R~VED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- F / W ' 4. L5, J 5 yr' Pp 17 A,3, CS CS F ~,v .f~'5L, / "1_N• SL, 7/" B 7 J~ a s ft Av 6 - fl U 13 SL Gipo ~-r "~o G if FT g „ At- 94. 5'L-, ' " 13.u. I- O,p-j6A). -5 16 rr S'. B / 99 J~ > / 3:, A,0y Q,0C Ro. SL FROM S-.2 " -/o SS;' Pad 20 L Ole- 54 / X-/~ ~ B-y y3o yy /3A;. -a,). es - r B ~/'~(fr > y P4, s~, 6 rr~~ SLR 7yPAee T N B- ga( rP-fll /.V 1~tr' PERCOLATION TESTS TEST DEPTH WATER HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTE WELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH P_ Cv U ,U0 2- " CU £ v i' Ess ~ctw 3 P_ u /cl P P- 2 3 P- _ P- Z_ Z- 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- ~~oQQn the plot plan. Show the surface elevation at all borings and the direction and percent zontal and vertical elevation reference points and show their location - LX4KTLy Ji0 fr R61-0 k~ /3c PE# 3 6r E/g-uATk1•V of land slope. (3~TTDAr Br- seep Pv-d t/~ SYSTEM ELEVATION OF y~ 7 /J,1, 2- FT /3.e%r U r/cg~ ~PE-~E,Pr~re~ f~0~~~• I - 13f P,-17,471W Of w LOT' F j f ae r y I ctt"iet a 7 ~ x 4 5 6 . _ 1 _TN , 1 a 7 y AaC q 'l RrtERN , , N~ 13R.t4j 1aarn / ' cWet of ' (jam y~ ' k a.,~ GG) ST r Z ff n 2~ _ ~ ~ ~ Sou-Fly.. LcrT' L r'ut 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): TES IS WERE COMPLETED,QN: 9167r. 49 Cl 2-- ti : PHOE NUMBE (opti nal): DDRESS: ` °e a i3 -ST G CO CE,T FICATION NUMBER N p~ ' S5 °®zy~~ 3~ ° l i~311 ~iyNIL ROAD_._ NATUR Ai(~iCJI UDSON, WIS. 54016 . j~j #.._Ci 1 r.;t{w1 ~r £ a.r y' €4s b' d... S,. -ho: v t.. 3'I t{~Elt' u!e a f 4-ons rind f'd7ndUlot ng the p!wl ,-'r., .:aid ~lv l. .e3 "tz}~e W RII,st et;' at S~.9i ?i sF- y zf,LE~fl rj id L'i r r'3tl FC. .r ni' .°'t# E.i' Fra to a,+E ~ ~'kLs I' „ I f ~Er C15 Fh ~ a 10, _ t e cC Z f-~5 p~c~~~rt/3i D,EPARTI~rENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY., DIVISION LABOR AND PERCOLATION TESTS (115) MADISP.O. BOX ON, WI 7969 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: 1/ 1/ /T N/R E (or) W ~ G COUNTY: O~WNER'SS/^BUYERR'SjNA~M9E: MAILING ADDRESS: USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: V Residence 3 ~ Ue] New ❑ Replace 1(/ ,(~2- RATING: S= Site suitable for system U= Site unsuitable for system C ] U CONVENTIONAL: MOUND: IN-GROUND PRESSURE:'SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM:(optional) ❑sNu Zs❑u ❑s[xu ❑sXu ❑❑U 3,01-'~k-t' If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the ]A under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: ra- PROFILE DESCRIPTIONS SAS 1~~9,FOt'~ w S4c7P' CGAy STitsf%fS~ BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DE%PTTHH' IN, OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- / l~ I6J " F°k! t'~a/, ~ " G ~ % " Lf- ~v L (y ' .Hip ~v~l'~ aF .Z Al. ..S c~i. f~oL,FE7s 3~`~o M~f~/~1~ SCL f~oc tT~ cbvrAi _e.o Ef B- ,y„dx.,a~. ,y.' sip, ' f ><4 0,r. 56, 6" B- tJ r~y~i,/ ~7 33 "$CL WdA `D;'Sii4: -7 aAO-6r • Nat w'S~T 7-6 3 70 " AF A) ) ~v 2 !S v • s' L, , j a.-1 S L ) Z~- B- ytJ z i MA h /FD 134.-IP5 c; 5 cL 9AJ B- ~ ✓~L J ~ " L~• ,/-~,V, i~r n .Si4Nl~S rl` ~ S ~4Jt T Wr ~ rv~s PERCOLATION TESTS St E- TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD1 PERIOD2 PERIOD3 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. SYSTEM ELEVATION ~ Nppoposup ~~~cs~7E I 61F~ATiau ~3 t co Y ~Nh 13 N W 3 , ~T i 3 . ~ j fl ~f,CA-'R TE E , i I l ( _ Q ~ 26 5m vs - ~ . • , -S tl LET" L%c~E~ S« ~A Fs ~ I, the underst'gned, 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. 'q NAME (print): - - TESTS WERE COMPLETED ON: (optional): 4D DRESS: rJ:w CO. CERI~CATION NUMBER: PHONE NUMBER 3, O'NEIL ROAD "vR P WIS. 514016 CST SIGNATURE: I _I and nn,,, copy to I-oral Authori y, Prca'r i./ Owner ar,-' va CEsWL 3 :"£_A VIA m;.roe, (S LW d `sAh , e i,aWO • i'MW MAX P t,1,?,nV of b . , or tcitn,F . A U. ,lei, i .ii".z; 3, ,.f €r, au _,"l li 5 ; he .vs, S11 - IS FR i.AlDLE Ai A QU NVU TANK U SLY IF , LA- L S S S I R E .U € p ? U C S i SO'! L e f.S Ett S. .7. LT ASE w w abhos• sl ,3 . Show, 43 for wri i`I wa • cins ,i.Ep:4m, and GcbrnNa, "n 1 ow Ep{.A pKin; ww r,.. WSW; if cvowd; a, • +6 , 0.. 0-d _ v 4 e a e E}.dCfu p~€, 1j,d "`£t%; r, 4 , e f POW t.,r€ -m (CIO, POOL .'_se l,h &I 3t3,: [ a:= fm; PQC W, „ NE F fE zK DAYS OF N EDT'J'11 p a e / g a 9 t a a, T E S OR :0 b q at, nlti r Cam"n SO-! x k row! S A .E t. Wi' j g v 1. LOA TNI t . ..z i i... t4 W t r g p E F il ='t lbnlwa; r . , E .,v P E,