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HomeMy WebLinkAbout032-2060-20-000 i ti O d o ~ O d f a C1 N 3 = ~ ~ ` 1\ o w o_ p~ o (D cn o v ow °C• 7' Al 3 C N S W N om m 3_ O (D O= (D O N Oo O. Z CL_ N 5' CD M O co N O 1 N (D 7 7 (D c0 O N O- O N G7 V = O N ~cn z o~L O C) M CD L 7 W O O p O O 3 O~ CD 0 ((D CD H N a o O !V O (D oo (D (o (D (n a rt ri (D .9 O (n W p ~O pC G7 3 m 1: CD F~ Z r W G~ o m U) n r cq 4- 00 if i> a CD 00 cc) 0 cn w 3 M Q H O r t-j D U m h• r z O O O rrJ t O U o d C) S 3 cn (n en Ul D V R 0) m 41. CD 00 p K (D (D N Cn I I m V cn ty N W O (D N !V to 00 O M 00 r z ul (D 00 CL w w.~1~ N y rn o ,.o D W co z o O 0 CD C7 1 O r\ D Ni ry N v tz) ~ (D CC N CD CD w CD U) O U C!] rt n (D n z CD --I C/) O O' rt rt O O A? Q H. n O 0 A rt O C m Z 3 i t o o m m CD w ~ D CL O- o O7 C z o. 0 (D (n y m A. m i a ' m z yA N O O a A ti CD DAp 6,9 O A p * C p (D O 0- Parcel 032-2060-20-000 10/23/2006 01:02 PM PAGE 1 OF 1 Alt. Parcel 17.30.19.7396 032 - TOWN OF SOMERSET 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 - SCHILLING, GAYLEN D & CHERYL T GAYLEN D & CHERYL T SCHILLING 498 150TH AVE SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 498 150TH AVE SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 6.200 Plat: N/A-NOT AVAILABLE SEC 17 T30N R19W 6.24A SE SE LOT 1 CSM Block/Condo Bldg: 5/1255 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 17-30N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 662/224 Bill Fair Market Value: Assessed with: 2006 SUMMARY 0 Valuations: Last Changed: 07/23/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 6.200 64,000 178,300 242,300 NO Totals for 2006: General Property 6.200 64,000 178,300 242,300 Woodland 0.000 0 0 Totals for 2005: General Property 6.200 64,000 178,300 242,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 304 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ~ r AS bull-T AN1'1'AKY SYS'1'tat Icl:l'uicl r3~1~ 1</Yw ~A Y 5; /LGl" - ruWNSi11. P5crrE/?,.W- 12 UWN1::K~` / ADUKESS ST. CROIX COUNTY, W 1 ,t,uN:~ 1N 6ubDIVlS1UN LU'1' LU'1' S1'L1 -a2, c s PLAN V I L W 01ULancae 4+nd (iiLWnaione Lo UueeL rcc{uLreu►unLL, of 11t):i _-1y11 LL WITHIN IOU FLEA' oil' SYSTI-A o - - I ~ s t fi d: ,t ~ li dt a e o th Arrow i Fj I Eii/' UL.NCHMAKK: (1'arluYnanL ratmrance Yo1llL) UeuLrlbc : TA ~ Gam' N /~°sT 11V F01VrcGr 411V-E uR/q*ba Qg~. klevdLion of vsrtlcwj ratarunca po1nL ._-_-.Slupc at jlt_c SEPTIC TANK: Manutaccurar.~~ LiL1uld LapuclLy /OoQ Mu"ar of rinj,a on cover _~S[QZ(,~.____ Tunk ,uanl~ulu cover clCvur Lou /aa:dZ. Tank Inlet >rlavaLion. Tuiik Out 1Ct. LIevaLlull LG13• - YUKI' bUt a i lui,5 Ml,nuta er : NuuiUu! it Number of uutp aaL for a cycle J~,u I I IL b , L d :alja( i t y of diULr1buL1o0 lino _ F;ui Ioil U i cu of L,w I1c,ld. gallon par adnuLai~ t►urr,~:~,uwut 6ratid L►amc o pump and auuda 1 nutubmr Typo of warnlnK d~vica HULUING TANK; Kaflutac c HLuuL,c, u1 8,111oiiz, Elevation of e cover '1'y ,c of nit►ij device :;LL:Y T SIZE: Nuuihur (A Iji t l out ct ur t:CL 11 Utd d6pch~ c,ucl,a6u plt. ltllcl 1,11,u clcvaLlui, boLLpu► a aanpa4e PIE e HV"L uu _ [cc[ SLLI'AGE WA) SYLK: numl►ar ut 1 loco - w l~lo Ii ~8 1 t ll 6y L I 1 I, p t 1i SLI,NAGL TRENCH. widLh Lciii;0k PLitGULATIUN blpT1 iUtLA 'R1 QUTNI p_11Z6" ARLA AS BUILT IN:;1'I l 1'UIt UATLU UN 1011 /qQ7ti L1l:LIV:;L- NUMISI~tI a.~ 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 7CONVENTIONAL ❑ALTERNATIVE State Plan I.D. Number: U, aeeipnral ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECT N ATE: Gaylen Schilling RR# , Box 284A, Somerset, WI BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELE V.. SE-4 SE4, Section 17, T30N-R19W, Somerset Township Name of Plumber: /MPRSW No. County: Sanitary Permit Number: Donavin Schmitt 3205 St. Croix 34802 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID T TANK INLET ELEV. TANK OUTLET ELEV.: WARNING LA L ILOCKING COVER • PROVIDED: PROVIDED J/1 ❑YES ❑NO ❑YES D-No BEDDING: V N DIA.: VENT MATT HIGH WA NUMBER OF IRO PROPERTY WE BUIL7N~GJJV ENT O ES A ALARMFEET ❑YES ❑NO ❑YES ❑NO NEARESTM Lzc AIR( LE DOSING CHAMBER: E J MANUFACTURER: BEDDING. LIQUID CAPACITY I J PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARN NG LA LOCKING COVER PROV ED PROVIDED: ❑YES ❑NO ' S ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PR P RTV ELL BUILDING. VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM L E AIR INLET PUMP ON AND OFF) ❑YES ❑NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH DIA T H MATER AL 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: BED/TRENCH WIDTH: LE GTH NO.O DISTR PI ;PACING V INSIDE DIA SPITS LIQUID TRENCHES M AIAL: PIT DEPTH DIMENSIONS l 4 GRAVEL DEPTH FILL DEPTH UISTH PIPE DISTR. PIPE ISTfi. PIP A RIA No. OF R P V WELL BUILDING: V _ENT TO FRESH BELOW PIPES AB 'ECOVEH. ELE V. INLET ELEV.ENp.~~~~// PI NUMB E R P FEET FROM LI AIR INLET. C ( 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' EASURED. ❑YES ❑NO t 11 SOIL COVER TEXTURE V ) / If ERMANENT MARKERS OBSERVATIONWELLS ❑YES NO ❑YES ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED C ENTER EDGES. DEPTH OF TO OIL SOUD D SEE ED MULCHED / 6YE ❑NO-' ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH NO.OF LA E AL SPA NG GRAY DEPTH B LOW IPF FILL DEPTH ABOVE COVER _ TRENCHES: DIMENSIONS i MANIFOLD PUMP MANIFOLD DI PIPE PD MATERIAL NO DIST JD:ASTR I P DISTHIBUI ION PIPE MATEHIA L& MARKING ELEVELEVDIA ELE PIPES D: ELEVATION AND DISTRIBUTION INFORMATION HOLE SI/F HOLE SPACING DRILLED COHHECILt COVER MATE VERTICAL LIFT CORRESPONDS TO APPROVED PLANS ❑YE ONO ❑YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS. IN UMBER OF PROPERTY WELL: BUILDING t FEET FROM LINE DYES I_]NO DYES ❑NO NEAREST Sketch System on R tain in county file for audit. Reverse Side. SIGNATURE ITITLE DILHR SBD 6710 (R. 01/82) DEPARTMENT OF APPLICATION SAFETY & BUILDINGS INDUSTRY, FOR SANITARY DIVISION LABOR AND PERMIT P.O. BOX 7969 HI4MAN RELATIONS (PLB 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: Property Location: City, Village o owns ip County: G t/o 5~ %S i' iT 3C% N/R /y E (or)t v c= C Pi Cy k Lot Number: Blk No:: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number: (If assigned) TYPE OF BUILDING Number of ❑ Public* ❑ Variance* ❑ Other (specify)*~~jz.,_ gyj 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 r IVA HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER MANUFACTURER: - - ' _ G' cP(' 1 _S EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): New ❑ Replacement El Experimental R~ S epage Bed ❑ Seepage Pit E] Alternative (specify) ❑ Seepage Trench Y i5,,2_ Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): Private ❑ Joint ❑ Public li' I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber: Sign L e: P/MPRSWfIo.: Phone Number: Plumber's Address: Name of Designer: COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: Sanitary Permit Number: O G APPROVED El DISAPPROVED 3 AlGo°1-11 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) Fo rw - 5 '1' C 1 00 Owner of Property C:- C "('iF~ i~- t' I 1 I C j f- Location of Property Section Township k:' 'r el.. Mailing Address x Subdivision Name Lot Number l7C--'- F Previous Owner of Property C-hLmlc%,-~ Total Size of Parcely•, Date Parcel Was Created '2cv, _-9 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 rile propert", 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. 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 the County Register of Deeds, as Document No. 1 SIG A URE OF OWNER C` L ~ SIGNATURE OF CO-OWNER (IF APPLICABLE) 11 7 DATEGNED DATE SIGNED DEPARTMENT OF / i~'! FETY & BUILDINGS REPORT ON SOIL BORINGS AD INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (1, P.O. BOX 7969 HUMAN RELATIONS 1~1(aDISON, WI 53707 (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/~: LO JI:BLK:,VI~' S _QD1 0, ME: 7 /T30 N/R/ &(o So,,?ev- COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: a~/ A O~ Cwyley ~(c ex f s` , ~y USE DATES O MADE [NOBEDRMS.COMMERCIAL DESCRIPTION: PROFILEDESCRIPTIONS: PERCOLATION TESTS: e New ❑Replace I /©,-'z f-Xy /v..3(J / S'v, N741' Olt' C RATING: S= Site suitable for system U= Site unsuitable for system Ott q Q ,FA - /~vIr G0 C0,-, l CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: ITIS TE MIN-FILLHOLDING TANK: RECOMMENDED SYSTEM:( optional) .®S❑U ❑SXU AS❑U Pa ❑SxU If Percolation Tests are NOT required DESIGN, /RATE: I If any portion of the tested area is in the / under s.1163.09(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.) B- 14%11- 0~~ 0^ C A' 70 B- 70 v3'4XION •e, c 64S4 " s sl B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH 1410 P_ /_4) 30 4K P- 116., v " 0 I d 30 20 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 P.2- - 1.2 " 91S1, .2 yoao u ~~l ny N !~~f ora,l•~~ _ ~ v Fri wo 960 I -ple 6,.1 P 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): TESTS WERE COMPLETED ON: ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): 1,6 i`=ST SI- TURE: - s, or a a o _ a a 6 of ~ ax ♦ ~ ~ ,)7€ t,;; " ,.°si E6' I'M J t.. c'o is tc d 'u 11a 1. ..3i:ii . ~ 9 s:.i C'• ti:=l.'i 'i 3 n3 o ~ ~aii „E„ f -Ev... V. A € iVie S Fs 1p E t t ~ \ g r - It t , 15 n., t sl ; r t 1:; t E 3 € a € ! r t 3<$`„/~. i4S' ~I.: t A • d~ yG4 ~ . i l /till qi t. 1~ i 1 ' ~n~t'nd'( CP'r d L"Cc cl PFr~~/, o a _'cc:E i y a T"/-t i tL N ~GVV C`',X 5" y t% 13ex ,28Y/ 71 401 - ~ ~C:z ~