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HomeMy WebLinkAbout040-1036-10-000 n cn O v 0 C7 r~ c m f M ° `+1 Z, 0 r. rn O V ° • CD CD OD Q N _ ~I 03 N e ro Z C) y CD O (D Cj CD ° ° w ° n = N CL 3 ° CD N F ►s O 3 N Co O f/I N ~ 7~ V] q d m ~ O G rr v v> D a CD t~ W a CD CD (c CD m G a m :3 W W' CL o rr ((D 3 O c\ ° x F~ n a t o o a ~r rt `C V N W W C N O C r H w w a 3 Q [r W (D j cn 00 °Z O O O ryh~~ H 4- O _ =1 v 41 0 w Z > _ N cn cn D cr 'D w Cj Cn 01 !n H Z y cn N trJ a 3 N O co r\ Z z O O I o Z co o o0 0 p D a Li F- -b o CD m m h• CD N W ~ (D CD ( C N N W Cp a C a (D 00 1 s _t Z CD (D C) = O P -j n A z S ~ a S o -7j H 1 W -0 m N (b C co CD CD Z T1 Z 00 0 (0 W -4- y Z CD W D CL a o' - Z3 c oZ a CD m I A S i A a 0 w ti 0 0 a A O b Q os p O ti a O S~ O CD 0 a Parcel 040-1036-10-000 01/03/2006 07:52 AM PAGE 1 OF 1 Alt. Parcel 8.28.19.115F 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 O - DURBIN, JOHN R & SHARON M JOHN R & SHARON M DURBIN 442 RED BRICK RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 442 RED BRICK RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.214 Plat: N/A-NOT AVAILABLE SEC 8 T28N R19W 2.214 AC NE NW LOT 3 OF Block/Condo Bldg: CERT SURVEY MAP VOL III PAGE 659 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 08-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 09/03/1998 586477 1354/474 WD 07/23/1997 717/359 Bill Fair Market Value: Assessed with: 2005 SUMMARY 102282 225,100 Valuations: Last Changed: 07/19/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.200 51,000 165,700 216,700 NO Totals for 2005: General Property 2.200 51,000 165,700 216,700 Woodland 0.000 0 0 Totals for 2004: General Property 2.200 51,000 165,700 216,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 217 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 I ` AS BUILT SANITARY SYSTEM REPORT OWNER ~r 3 h '-e` TOWNSHIP SEC . c, TAN-R ADDRESS ST. CROIX COUNTY, WISCONSIN. SUBDIVISION ~~2T LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of 1-163 ROW- EVERYTHING WITHIN 100 FEET OF SYSTE14 ti IF A U - - -7 ,y - - - _ - - - - - I Z- - - - - c, "I a fir, t 0 SCALE BENCHMARK: (Permanent reference Point) Describe: 5~' t c~rrrr, CTS P) Elevation of vertical reference point: 16i0 Slope at site: SEPTIC TANK: Manufacturer: (ji' SLiquid Capacity: j0cx'D Number of rings on cover : '2- Tank manhole cover elevation: 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: Number o pits feet diameter feet liquid depth seepage pit inlet pipe-elevation bottom of seepage pit elevation feet. SEEPAGE BED SIZE: number of lines width le-agth 3~, the depth s/z'/ SEEPAGE TRENCH: width length PERCOLATION RATE ,C us 5 AREA REQUIRED L-1:) AREA AS BUILT yg INSPECTOR DATED -5- 2-,.~ -S3 PLUMBER ON JOB - LICENSE NUMBER 3 z Y- X,3 DEPARTMENT OF.- INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS 3,, IWO DIVISION P.O. BOX 7A69 BUREAU OF PLUMBING MADISON, WI 53707 ®CONVENTIONAL ❑ALTERNATIVE State Plan I.D. Number: F-1 Holding Tank ❑ In-Ground Pressure 1:1 Mound 11/ assigned) NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Terry Stobber RR#3, Hudson, WI BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF, PT. ELEV. NE'-4 NW-14, Section 8, T28N-R19W, Troy Township Name of Plumber: PRSW No.: County: Sanitary Permit Number: Roger Timm 3224 St. Croix 34784 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING C VER P OyIDED: PROyVIIDE Wtv-L . V.,_7.4 )O U.C(I IUU 1Z L~IYES ❑NO 1S" JNO BEDDING: VVENT MATL.: HIGH WA R NUMBER OF ROAD: PROPERTY WELL: BUILDING: TO FRESH AIR INLET ALARM FEET FROM ~I LINE: / ~j IVENT ❑YES ❑YES~❑NO NEAREST '~J y[ DOSING CHAMBER: MANUFACTURER. 7YIN G LIQUID CAPACITY PUMP MODELPUMP/SIPHON MANUFACTURERWARNIN LABEL LOCKING COVER PROVIDED: PROVIDED: ES ❑NO DYE$ ❑NO ❑YES ❑NO WE L 8UILDING. V NT TO FRESH GALLONS PER CYCLE: PUMP AND CONTROLS OPERAT ONAL. NUMBER OF ROPERT`r,'' J 1 (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) ❑YES ❑N0 NEAREST' SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of pl wing LENGTH r7TER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction' shall cea a until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH. LENGTH ND. OF DISTR. PIPE SPACING. COVER JINSIDEWIA~ S ITS LIQUID BED/TRENCH TRENCHES MATERIAL: PIT o DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH IDISTII PIPE DISTR. PIPE ISTR. PIP MATERIAL . NO. DISTR. NUMBER OF PROPERTY.., WELL BUILDING. V NT TO FRESH BELOW PIP S. ABOVE COVER. ELEV. INLF I ELEV ENU PIPES LINE AIR INLET. FEET FROM f / 41 ) 9`1.85 7`b 27 k ` NEAREST / . co J 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 t~ make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria f'or medium sand. TIONS MEASURED. ❑YES ❑NO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS 17 ~t ❑YE Y ❑NO ❑YES ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL,' SODDED SEEDED MULCHED CENTER. EDGES. ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH LENGTH NO. OF L TERAL SPACING GRAVEL DEPTH BE,F.OW PIPF LL DEPTH ABOVE COVER. BED/TRENCH TRENCHES DIMENSIONS r MANIFOLD PUMP MANIFOLD D TR. PIPE rANIfOLD MATE IAL NO U TH UI TR. I DISTHIBUIION PIPE MATERIAL & MARKING Z 1. ELEVATION AND ELEV. ELEV.. DIA `LEV. PIPES` DI A.: ~ DISTRIBUTION INFORMATION HOLE SIIP HOLE SP~TM OHILLEU CA),RECILV COVER MATEHI L VERTICAL LIFT CORRESPONDS TO APPROVED ~~,,((.YES PLANS _ U COMMENTS: PERMANENAR LJ KE RS: OBSERVATION WELLS. NUMBER OF PROP ❑EYRTYES WELL: ❑NO BUILDING. { EYES I _ I NO DYES ❑ NO _ NEARESTOM LINE C,A q.A 9~4 7L9, (o. 4 Sketch System on - "Retain in county file for audi Reverse Side. SIGNATUR FW r' TITLE ,.r DILHR SBD 6710 (R. 01/82) 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% 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: Mailin dress: / Ieri fib &>r ~ 4 Property Locat , City, , Village or Townsh County: 4),E% /Uf /aS iT Z N/R (or / L! Lot Number: Blk No.: Subdivision Name: arest Road ~Lake,pr Landmark: State Plan I.D. Number: p 1? 6t- (if assigned) TYPE OF BUILDING Number of ❑ Public* ❑ Variance* ❑ Other (specify)* Bedrooms: 1 or 2 Family *State Approval Required. 3 TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION ME T (Spe ;f ) SEPTIC TANK CAPACITY HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHA BER MANUFACTURER: EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): New ❑ Replacement ❑ Experimental Seepage Bed ❑ Seepage Pit ! / ~1 ❑ Alternative (specify) ❑ Seepage Trench Water Supply: (L Owner's Name as Liste it Test Report (If other than present owner): A Private ❑ Joint ❑ Public 1, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Nam Plumber: Signatu - MP/.WRCW Mo.: Phone Number: V69 ' ZZY (715 6' Plumber' ddress: Name of Designer: COUNTY/DEPARTMENT USE ONLY Signature f Issuing Agent: Fee: f) Date: APPROVED Sanitary Permit Number: s ~3 ❑ 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) EH 115 Rev. 9/78 S ! ~ 7/ REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES if. P.O. BOX 309, MADISON, WISCONSIN 53701 ;r,ee) co LOCATION: '/4, '/4, Section T_N,R_L.E (or) I~l Township or Municipality f _VK Lot No. , Block No. County ul !~4~ivision z,o~ne Owner's%Buyers Name:^ S ti ACa~SS Jli~___ Mailing Address:Y- x /30 x ~l y14 d~~0~171} W/ S. -71f-- 2-6P- PS 7 5 TYPE OF OCCUPANCY: Residence X No. of Bedrooms 3 COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW "S REPLAC[,E~MENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MAD IL BORINGS Ndo" / I~~O PERCOLATION TESTS Woy• 7 SOIL_ MAP SHEET_ NAME OF SOIL MAP UNIT 12011X4914delt PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P_ ,vd • OAS C*f /1/ ov,s > > ~ > P- Z. E y P- P- 10 E>67 SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, MOTTLING AND DEPTH TO BEDROCK NUMBER INCHES OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B- 72- Al PUE > 72- /y`%,Vv L 0,2031j:5 oR,-v .s 3 0"0/P Cs B- 2- IV I/ A1dA)E 'lop. S'L 301,ev. sv-49•5' 32- 0e. CS B- 7'2- AJOA)E sL /5- I- I~ 'C3iP S Z " p~ C_ B- N0,06 > Q ~.,/3a 5L / „0~ cs d.,P B- S~ 2- 1,L 7 ' /3w SL z/ „c/• a. -j. L ',V • o,P- 5. /J0„ y,e. B- 7 L N O,ve > 7 ' S t / ' 'G f 13 S~ / ~ • caP• s „ CS 2- 0. PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy Co/ 5~ 4'Q• /7* /Cot Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. 3 13 x'A 061-j 110,,/E' P~ E v ta i IGVATio.v of Q. = ,"~f3ao~ ° ay _ Q 3 - ly !a (3oot Am y3, N N Ilk, V3 (3 B s E pjAi 3y P3 7 Fl YG 6, • E r _YZ e ,PEI /C ..e 1, the undersigend, 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 location of test holes are correct to the best of my knowledge and belief. f ~o Name (print) X~017E1 T Z~'/ 6410117_ Certification No. S g 7 Address /f; r,3 0 ue&- M 0,95-0.v Name of installer if known - Copy A - Local Authority CST Signat~fre~/_ ` JOB L / lJ O r. ROHL & TIMM EXCAVATING SHEET NO. / OF Z 310 Arch Street /J , HUDSON, WIS. 54016 CALCULATED BY ~'y--TTATE / - 3 (715) 386-8664 CHECKED BY DATE_ SCALE A ~ r G h''f T N f 7J x C' ~.J_.. . \vv . PRODUCT 204-1 /M~ es~ Inc., Groton, Mass. 01471. JOB ~<j~ 1)e'►' ROHL & TIMM EXCAVATING 2 Z 310 Arch Street SHEET NO. OF HUDSON, WIS. 54016 CALCULATED BY K2 S_eA~- rn'~' DATE 3 7 (715) 386-8664 CHECKED BY DATE_ SCALE r fi i PRODUCT 2041 LiVee~ Inc.. Gmtm M-01471 .