HomeMy WebLinkAbout026-1022-50-000
C E N o
3 CD
v 'W
l ,
Ict) s p Ccn/ OZ ° ww -0 ;u O O q
CD 0)
0) [ID 3 O co .4 N)
Lo - z A pp 3 ~3 0) 5 'o
° o W o
(D O n c 7- c 0
o a 'I o° Q
C) A~
O y C N ~ ~ O .`S
O1 _ ~1
TJ ~ t D Z. cD rn ro G v
7
O ~ (D 7O fD i T1 m ti W fl. ~ '
C 4_ C 3 W D
r* 7y (D m
rt 1 O CO
~ 7y ~ co 013 ~ 3 0 Q
c
0
~ o o <o
p, z v 3 m
I- a o 0 0 0' .
~a
H 00 v I3 N y y O ' D
rZ (D H j (CD 0 Q c °
cn 4-2 y m ID
< N V
t cn no 5' 3 m
t-' O :2~ a 3 CA
tz) V
I z O7 z O
ON r" f~ m p
D a
W o~
0 -b
(n
m
00
V N• Cn (rop ti •
f) N co c
CO N N hr~
W W N a y
O a, a _
z N
C1. H = o "I U)
W in p 2
n C J
I~ rY
rD O o' a a C)
b Uri F- W Z7 c W 0
O Oo ro ro °
(D N. ~ c 3 I z
U c ;o
3 C 00
H z
ro
A
co
Q. D
v a
I m a
o
0
3 o=i T
C
p z 3
o a
fD
v
a
A
i A
I ~
w
I, O
kli
O ti
Z) A
ro
b
ao w
C O
C) ~
i `o b
Parcel 026-1022-50-000 01/23/2007 04:43 PM
PAGE 1 OF 1
Alt. Parcel 6.30.18.81 D 026 - TOWN OF RICHMOND
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
MARVIN F & LORRAINE FREY O - FREY, MARVIN F & LORRAINE
912 170TH AVE
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 912 170TH AVE
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 3.490 Plat: N/A-NOT AVAILABLE
SEC 6 T30N R18W 3.49A SW SW LOT 1 OF CSM Block/Condo Bldg:
5/1251
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
06-30N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
04/21/1998 577652 1316/594 WD
07/23/1997 1130/428 WD
07/23/1997 661/21
2006 SUMMARY Bill Fair Market Value: Assessed with:
176764 239,600
Valuations: Last Changed: 06/19/2002
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.490 47,300 139,500 186,800 NO
Totals for 2006:
General Property 3.490 47,300 139,500 186,800
Woodland 0.000 0 0
Totals for 2005:
General Property 3.490 47,300 139,500 186,800
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 214
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
{
AS BUILT SANITARY SYSTEM REPORT
OWNERS TOWNSHIP ~r SEC . _N-R~W
ADDRESS ST. CROIX COUNTY, WISCONSIN.
SUBDIVISION LOT LOT SIZE
' PLAN VIEW
Distances and dimensions to meet requirements of 1163
~HDW_ EVERYTHING WITHIN 100 1 l?E`1' OF SYSTEM
i
-
I di ate or, the A rol,4
sCALI
BENCHMARK: (Permanent reference Point) Describe:, A'/
Elevation of vertical reference point: 162.0L Slope at site:
SEPTIC TANK: Manufacturer: -•Liquid Capacity:
Number of rings on cover : Tank manhole cover elevatio :
Tank Inlet Elevation: Tank Outlet Elevation:
PUMP CHAMBER
Manufacturer: Number of gallons
Number of gal. pump set or a cycle gallons; total capacity o
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
Type of warning device
SEEPAGE PIT SIZE: um er o pits feet diameter
feet liquid depth seepage pit inlet pipe-elevation
bottom of seepage pit elevation feet.
SEEPAGE BED SIZE: number of lines_Z;Z~widthleigthtile depth
SEEPAGE TRENCH: width length PERCOLATION RATE_ 11,AREA REQUIRED= AREA AS BUILT
INSPECTOR
DATED Z7f ' PLUMBER ON JOB Ji 1..7 ' ~5
LICENSE NUMBER S
/ c2'
I
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O. BOX 7969 BUREAU OF PLUMBING
MADISON, WI 53707
UCONVENTIONAL ❑ALTERNATIVE State Plan l.D.Number:
Ilf a..iQned)
❑ Holding Tank ❑ In-Ground Pressure ❑ Mound
NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE:
Ron Pepper RR#4, New Richmond, WI 54017 -1V-S 3 /1j
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.
SW4 SW-4, Section 6, T30N-R18W, Richmond Township
Name of Plumber: "PRSW No.. County: Sanitary Permit Number:
Calvin Powers 1563 St. Croix 34788
SEPTIC TANK/HOLDING ANK:
MANUFACTURER: LIQUID I"„APACI TY. TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LAB L LOCKING COVER
j PR ID,EU: PROVIDED
YES ❑NO ❑)YES ❑~O
ptG: VENT TO FRESH
BEDDING: VENT DIA. VENT MATL_ HIGH WATER ROAD:
' ' ALARM: f FEETBFROM LIN j 1PROPERTY _ WELL BUI _ ~,.L D ,I
AIR IN E 1
IS ~ 0 ❑YES C3N NEAREST __j z
❑YES
DOSING CHAMBER: r
MANUFACTURER. BEDDING i: LIQUID CAPACITY PUMP M EL. PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
❑YES ❑NO ❑YES ❑NO ❑YES ❑NO.
GALLONS PER CYCLE: PUMP AND C r TR LS OPE TIONAL: NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH
(DIFFERENCE BETWEEN FEET FROM LINE AIR INLET
PUMP ON AND OFF) YES ❑NO NEAREST
7=~
SOIL ABSORPTION SYSTEM. Check the soil moistureat 0) depth o lowing LENGTH DIAMETER MATERIAL AND MARKING
or excavation. (If soil can be rolled into a wire, construcifon shall"cease until ORCE
the soil is dry enough to continue.) MAIN
CONVENTIONAL SYSTEM:
WIDTH. LENGTH IND. OF ETR. PIPE SPACING - INSI E DIA #PITS _ LIQUID
BED/TRENCH - TRENCHES MATERIAL: PIT DEPTH
DIMENSIONS
GRAVEL DEPTH FILL DEPTH DISTR PIPE DISTR PIPE lots TR. PIPE MA ERIAL. NO. DISTit NUMBER OF ROPE TV WELL 1 BUILDING: V NT TO FRESH
BELOW PIPES ABOY,E COVER ELEV. INLFT E.] END PIPE ' LINE: AIR INLET `
a~• FEET FROM
J 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 S ODDED. SEEDED MULCHED
CENTER. EDGES.
❑YES ❑NO ❑YES ❑NO ❑YES ❑NO
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 MATEHIAL NO. DISTR DISTR. POPE DISTHIBUIION PIPE MATERIAL. & MARKING
ELEVATION AND ELEV. ELEV.. DIA. ELEV. PIPES DIA.:
DISTRIBUTION
INFORMATION HOLE SIZE HOLE SPACING DRILLED C014HE CT I Y COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
PLANS
❑YES ONO ❑YES ❑NO
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: L NE ERTV WELL: BUILDING.
NUMBER OF
_T FEET FROM -
DYES I_]NO DYES L7N0 NEAREST
1
i .7 ..r
N1:
Sketch System on R n ounty file for audit.
Reverse Side. -
SIC. _ ULFA Jo- TITLE
DILHR SBD 6710 (R. 01/82) GJ
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. The owners copy or a legible reproduction of the soil test report must be
included.
Property Owner: Mailing Address:
Y' f \ YY1 V'., t (.P ti 1. 4' f
Property Location: %11 ilage o Townshi County: _
k;t/o `54.S /T - ~N/R ~ (or) W
Lot Number: Blk No.: Subdivision Name: Barest Road, Lake or Landmark: State Plan I.D. Number:
1 A (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 Zoe-10
HOLDING TANK CAPACITY
LIFT PUMP TANK/SIPHON CHAMBER
MANUFACTURER:
EFFLUENT DISPOSAL SYSTEM
PERCOLATION RATE ABSORPTION AREA
(Minutes per inch): PROPOSED (Square feet): New ❑ Replacement ❑ Experimental S Seepage Bed ❑ Seepage Pit
~f ❑ Alternative (specify) ❑ Seepage Trench
Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner):
Private ❑ Joint El Public
V1W I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
Name of Plumber: Sign ure:n "F'fMPRSW No.: Phone Number:
Plumber's Address: l Name of Designer:
j 1
COUNTY/DEPARTMENT USE ONLY
S77; of Issing Ag nt:
De: Saniar Permit Number:
PPROVED y
ED
6; El DISAPPROVED
1 3 41 78Y
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 (N.03/81)
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, c DIVISION
LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX N WI 7969
HUMAN I#ELATIONS
LOCATION: SECTION: TOWN IP/Mtftt'f_ P7TtITY: LOT NO.:BLK. NO.: SUBDIVIS ON NAME:
COUNTY: OWNER'S BIYER'S NAME: MAILING ADDRESS:
5 C1 U i~ ~
USE DATES O SERVATIONS MADE
NO. BEDRMS.: 1COMMERCIAiL DESCRIPTION: R F DESCRIPTIONS: 1PERCOLATION TESTS:
Residence New El Replace I - ' L
RATING: S= Site suitable for system U= Site unsuitable for system 1
(:ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL LDING TANK: RECOMMENDED SYSTEM: (optional)
5QS ❑U ®S ❑U RS ❑U ❑S [9111 EIS CCU
If Percolation Tests are NOT required DESIG RATE: SYSTE EL If any portion of the lot is in the
under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
-
Al~ B- ! ~ •r/ 7 '3 2 _ al's 4 ~ 1
qr
1
:B S_" -fail Y- 12"
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD t PERIOD 2 PERIOD 3 PER INCH
r
e P}
b P- •r• i
P-
P-
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 I
s
V .
JCS
J .T
i - '
a,,~~:r, .
= L V 7, > r Y
~N
Y ~ C -'21
I, the undersigne , hereby certify that the soil tests reported on this form were made by me in 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 (Pr'nt): TESTS WERE COMPLETED ON:
ADDRE41 CERTIFICA4TpION NUMBER: PHONE NUMBER optional):
CST SZA E-
LDILSTRIBUN: TIOOriginal-Local Authority, 2nd page-Bureau of Plumbing, 31d page-Praperiy Owner, 4th page-Soil Tester.
D-6395 (N. 03/81) _Idd
r~
✓i1~G w~~N
I „
r rr JV~~R~LYely
Ali~
Ada
f
\ n
w
R/W
-
w ~ .
~ n
r