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HomeMy WebLinkAbout020-1044-20-000 m o m f r c d c 0 Lon ~ m 3 0 v 7! c (D m ^ r: (n 0 0 2 0 O A C O • ~ o m 0 0 O a CL z d N co ? (n (0 L, O ry C] (o 0) N W V) 3 K (J~ p N a 0 O w O v N O O G O H O-0 0 7 Q (D w * v o C) c p G U) Ul 3 ° y W o 00 b C U-k (D (D rt n H m (n m N M G a W V (D (O N CL w CD G ~ 0 3 O o~ n V to CD W w x <D y 00 In m co 00 a Ct) O c ON N w w D cr 00 3 Jc vii ai ai m m rn sa. G o (D m o a ! Q° d (D !1 a, W m (D r. ° o c~ m rn c I rt co C N E a CIA N Lo CL N ~ l z o I v ° z -I z GO d y D m o w c~ o v O =3 n ~ H cn o ~ s ~ • G N Csi c) N r 9 ~o (~D m `i 4r 'O N U) t I C :a) N It w m c a O x r~ n 3 d H G z z CD U) z o m G r o 0 73 ~ m N U W 0 m ~w 1 ' z p ! C co (D A W N N 7 (o S (D N O d 3 ' n a C 77 a aim C_ O (D `G O= O O T N N c 7C - g (h 0 z a W m N o W :3 ' v ~c nSi N v CD (D Q a a Q 02 $ x it o + CL cz p O O I ~Z5 a i A O Dq O 73 O ~ A En O v O 4* b O O y O (D v .1 Parcel 020-1044-20-000 08/24/2006 04:15 PM PAGE 1 OF 1 Alt. Parcel M 19.29.19.177B 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 O - COTY, TIMOTHY D TIMOTHY D COTY 335 BAER DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 335 BAER DR SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 1.800 Plat: N/A-NOT AVAILABLE SEC 19 T29N R19W PT SE NW COM INT E LN & Block/Condo Bldg: N R/W RR TH SWLY ON R/W 517.8 FT TO POB SWLY 282.2'N TO S LN HWY A NELY ON RD Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) TO NW COR LAND IN VOL 498 P529 TH S TO 19-29N-19W POB & AS DESC IN WD 1524/121 Notes: Parcel History: Date Doc # Vol/Page Type 07/03/2000 625844 1524/121 WD I 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.800 64,400 99,700 164,100 NO Totals for 2006: General Property 1.800 64,400 99,700 164,100 Woodland 0.000 0 0 Totals for 2005: General Property 1.800 64,400 99,700 164,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 105 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT s OWNER TOWNSHIP- _ '-SEC . `1' - N-R W C ADDRESS ST. CROIX COUN'T'Y, WISCONSIN. s t SUBDIVISION LOT LOT SIZE CE~VF .4 y 7983 PLAN VIEW tiR ~011#611 ~ Ald t~ Distances and dimensions to meet requirements of 1163 t SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM sL , I dic at N r h rr w FT BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical reference point:_ Slope at site: SEPTIC TANK: Manufacturer: Liquid Capacity: Number of rings on cover 11 Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: PUMP CHAMBER Manufacturer: Number of gallons Number of gal. pump set for 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- ; •`1i 118, warning device- _ GE \SIZE; Number of pits feet diameter tcli4luld depth seepage pit inlet pipe-elevation eepage pit. elevation feet. SEE~'A D 'i_ ZE: number of lines width length < Mile depth ~Wy ~9'D SETRE width- - length- RCOATION,` ATE AREA REQUIRED AREA AS BUILT i ,.Try INSPECTOR DATED PLUMBER ON JOB- r LICENSE NUMBER DEPARTMENT'DF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 [ate Pla 1 St f asslgn-grin LO. Number ERCONVENTIONAL ❑ALTERNATIVE (edl ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER: INSPECTION ATE. Tim Coty Box 154, RR# 5, Hudson, WI BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.. CST REF. PT. ELEV. SE NW, Section 19, T29N-R19W, Town of Hudson Name of Plumber. JMPIMPRSW No.. County. Sanitary Permit Number. Roger Timm 3224 St. Croix 38468 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY. TANK I~ LE ANK OUTLET ELEV.. WARNING LABEL LOCKING CGIV P VIDED. PROV EEY} YES ❑NO C£ NO ' PROPE TV WELL. BUIING. JVENT TO FRESH BEDDING: VENTDA EN.Aj L.. HA II, Rh A T UMBER OF R LIN AIR INL~- 11 1111//JJ FEET FROM ~ ❑YES IV O ❑ N NEAREST DOSING C AMBER: MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL. PU IP ON MANUFACTURER ARNI LABE LOCKING COVER PROVE PROVIDED: ❑YES ❑NO ES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERA L. NU R OF PERTV WELL BUILDING I VENT TO FRESH ` INE AIR INLET. (DIFFERENCE BETWEEN F T FR PUMP ON AND OFF) ❑YES N EARE SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of wing FORC LENCITII DIAME TE MATERIAL AND MARKING { or excavation. ( If soil can be rolled into a wire, construction shall ase until MA the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH. LENGTH NC. OF DISTR. PIPE SPACING COVER INSI E DIA/ -PITS LIOUID BED/TRENCH ! ~-7 G~ TRENC ES M LAL PIT DEPTH DIMENSIO GRAVEL DEPTH FILL DEPTH DISTH. PIPE DISTR PIPE DISTR. PIPE MATERIAL. NO. DI NUMBER OF PNOPE TV WELL. BUI D~VE FRESH BELO ABOV COVER Ev, NLEr PIPS FEET FROM LIN T]/ C~ ~ 9 NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of he fill material for PROVIDE A DIAGRAM OFSYSTE pe~b ake certain that it EVE RSE SIDE. SHOW. A and furrows thrown upslope: mound syste meets the c eria r medium sand. TI S MEASURED. ❑YES ❑NO PER ENT M KERS. OHSEHVATION WELLS SOIL COVER TExTURE ES NO ❑YES ❑NO . DEPTH OVER TRENCH, BED DEPTH OVER TRENCH BED DE H OF TOPS IL SODDED EDED M CENTER EDGES Y NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH N OF LATERA SPACING. RAVEL TH BELOW PIPE FILL DEPTH ABOVE COVER. BED/ TRENCH ENCHES. DIMENSIONS MANIFOLD PUMP MAN OLD DIST PIPE MANIF LD MATERIAL NO. STN. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING. ELEV.. ELEV. DI ELEV PIP DIA.: ELEVATION AND DISTRIBUTION VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MAT IAL PLANS ❑YES ❑NO ❑YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPE RTV WELL. BUILDING. FEET FROM LINE: ❑YES ❑NO ❑YES ❑NO NEAREST G Sketch System on Ret in county file for audit. Reverse Side. ATURE TITLE DILHR SBD 6710 (R. 01/82) DEPARTMENT OF APPLICATION 3 SAFETY & BUILDINGS INDUSTRY, FOR SANITARY DIVISION LABOR, AND PERMIT P.O. BOX 7969 HUMAN RELATIONS (PL13 67) MADISON, WI 53707 Attach plans for the system on paper not less than 8% 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 Owner: Mailing Address: 4 t) Y, Property Locatio~~: G City, Village or Township: County: 1%s 6 ! T Z,. ' N R &t (or) Lot Number: Blk No.: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number: - 4- I ( (If assigned) - TYPE OF BUILDING ~J Number of ❑ Public* ❑ Variance* ❑ Other (specify) Bedrooms: 1 or 2 Family *State Approval Required. 51 TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY ( ' C`7 1 HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER MANUFACTURER: l Lek EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): ❑ New X Replacement ❑ Experimental ❑ Seepage Bed ❑ Seepage Pit A wJ ❑ Alternative (specify) A Seepage Trench Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber: e- Signa MP/MPRS, No.: Phone Number: rte, , z z ryk /Y__ Plumber's A .Jess: ! Name of Designer: fir' J Div °rcA ' COUNTY/DEPARTMENT USE ONLY Signatur of Issuing Agent„ Fe : Date: Sanitary Permit Num er: APPROVED 0 LC, 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) > Form - S T C 100 Owner of Property Location of P/roperty SC 4 ALUL/ Section 1~> ,T_2:j N R l J W Township ~G~Scsr~ Mailing Address a,, ~ 1~rlllo 1'1.. Subdivision Name Lot Number Previous Owner of Property Total Size of Parcel 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 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 1 (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. 4624 7- ; and that I (we) presently own the proposed site for the sewage disposal system (or 1 (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 SIGNATURE OF CO-OWNER (IF APP ICABLEI DATE SIGNED DATE SIGNED DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS ,DEPARTMENT c DIVISION LABOR AND ~ P.O. BOX 76 HUMAN' RELATIONS PERCOLATION TESTS (115) MADISON WI 53707 LOCATION: SECTION: OWNSHI%MtJf+H_ RL : LOT NO.:BLK. NO.: SUBDIVISION NAME: Se '/*d~/a 19 /T 9N/R/ D(o W drov COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: cro 7,4,'3?y '0 Box Irv xx #-s- wl o~ lr USE DATES O SERVATIONS MADE TB. EDRMS.: COMMERS?NL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence `O ❑New Replace I 5~ ~~3 S'2 p y ' s 7 E a J RATING: S= Site suitable for system U= Site unsuitable for system No L: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) ❑S~u iS❑u ❑s®u ❑SZu _rt 'x vo' If Percolation Tests are NOT required DESIGN RATE: SYSTEM EL V. If any portion of the lot is in the under s.1163.09(5)(b), indicate: I Floodplain, indicate Floodplain elevation: PROFI E DESCRIPTIONS BORING TOTAL., ELEVATION DEPTH TO GROUNDWATER414?" CrIl CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH I OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 7 4F B-.Z- 7, 6' oAkc, a D' , fo B! C~ do C~ • B/~s . B~1 /s ,gh s` B B- B- B- PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER i"Ir'!16 AFTERSWELLING INTERVAL-MIN. PERIOD1 PERIOD2 PERIOD PERINCH P_ / 3.o' do -3 'L fn's- J P- 3- 3.0' © 3 .3 P- -3 V, P_ 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 percent of land slop. SYSTEM ELEVATION 9 $0' 6 ' '4e6 e"'d /0' Ftv... rfa z ~u v A^- Q /'s ]~j2 /i'tr f /L e/'. gyp. s41 04 l ~~o cv A(o~l: !/rJvewAY. fj SS(,~~,ucl da iL e- F, O N P / ` ( ~fe _ A fires c~ /0 fL) 3b' ,A CS : a &ace- wed' ces.`.AG- 1, the undersigned, hereby certify that the soil tests reported on this form were made by mein accord with the procedures methods specified in the Wisconsin Admimistrative 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: 'V& t le 5=~2J__ 003 ``ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER optional): 1116 ~ .-/_9 2Z! E 06 CS NATURE: STRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. 9-SBD-6395 IN. 03/81) JOB ROHL & TIMM EXCAVATING w 310 Arch Street SHEET No. OF HUDSON, WIS. 54016 CALCULATED BY lnl2j DATE (715) 386-8664 C CHECKED BY BATE. SCALE j_ _ _ la LA _ W ~ t• I ~i. i I (f - cx, 40 r LN v . . _ - D G T7 CT a: r „a \ e vrr; inc Groton. Mass 01471. JOe / I m cc r4 ROHL & TIMM EXCAVATING SHEET NO. OF Z 310 Arch Street - HUDSON, WIS. 54016 CALCULATED BY- rr'-VATE L L ~r ` 4 (715) 386-8664 z 01 CHECKED BY DATE _ L . l SCALE 1~ rlI J I` ou~ v . y, L X PROW MI [j k., G.W, Mm. 01471 .