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HomeMy WebLinkAbout040-1059-30-000 n ca Q v n d 7 N CCD AA: H. A C y. 0 d # fD A 3 ' Al ` 1\ 3 O hi o m v o 0 C,) c o p cn o CD CD Ili r- , - 00 00 a Z a :z y cn -i o O W CO } N a v w N zr Z N. i O N 7 w O (D ~ 1 i CD = n d co O y (D n v O 7 N A O b C rr (D A G) o r• n H v v> C D m a o O r' C] CD cn W fl m p F- 3 ° U) N a°o °w a N h~, CD Cl C) W t7 L ~ -K N) x 110 Z m H 'TJ l1i H O w co T (n 0 Cl) Z E N Ivy ~ v 3 :•f Q ~i 9 n oz 0 0 0 Lr-' n o ~ ciii vi vi o m CD a- -0 0 a d r 00 m CD m CD 90 I iv .d. N o In I N 3 d a W N W H H a 0o O Iv Z W W o Z i Z Q Z U] . n -0 D m O 7 O O O y 7 cn N CD CD M~ H v N CrJ rj 7 D CD N O CL ER CD O4 C N CD -I N N GD f7 OZ O A Z <D (D O 0 a p z t C r~ (D V, 0 W "a m ~ z CL 3 0 ? :i Z m (D w ~ 0 CD ~n D 3 C) a CD N m o' o CD m :3 V) a Z a CD n o `D j y N I Q I m o II ~ 0 A ~ O A N O to Ir-I zz A V CJ1 N (D ~ N 7 00 7c' V O Av O_ (D En 0 ti O o CD L I O ti ti . Parcel 040-1059-30-000 01i24i2007 04:58 PM PAGE 1 OF 1 Alt. Parcel 15.28.19.227B 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 - KASTEN, STEPHANIE L STEPHANIE L KASTEN 694 GLOVER RD RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 694 GLOVER RD SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 0.440 Plat: N/A-NOT AVAILABLE SEC 15 T28N R19W.44 AC IN SE NE COM Block/Condo Bldg: 3175W FROM E1/4 COR, TH N 183'TH W 105' TH S 183', TH E 105' TO POB Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) INCLUDES P227M 15-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 09/21/2004 774848 2659/488 QC 05/28/2004 764231 2584/41 SD 05/03/2004 761484 2563/522 WD 04/24/2001 643467 1623/271 WD more... 2006 SUMMARY Bill M Fair Market Value: Assessed with: 158179 174,000 Valuations: Last Changed: 07/19/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.060 38,000 120,700 158,700 NO Totals for 2006: General Property 1.060 38,000 120,700 158,700 Woodland 0.000 0 0 Totals for 2005: General Property 1.060 38,000 120,700 158,700 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 w L~ ~ Gr fl. IJ AS BUILT SANITARY SYSTEM REPORT y74 ,L T-N-Ri W 1 TOWNSHIP SEC. OWNER. ADDRESS P_-TERCt COUNTY, WISCONSIN ,r SUBDIVISION f LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 SBOW EVERYTHING WITHIN 100 FEET OF SYSTEM MAM i.l t may' { t i I di irz a e oT`th Arrow SCAL # - - - - t f 4 BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical reference point:, Slope at site: SEPTIC TANK: Manufacturer: Liquid Capacity: Number of rings on cover Tank manhole cover elevation: _ Tank Inlet Elevation: ~q~-~7 Tank Outlet Elevation: ~i f PUMP CHAMBER Manufacturer: Number of gallons Nutiiber of gal. pump set or a cycle gallons; total capacity o distribution lines gallon:. size o pump head; gallon per minute horsepower bran name of pump and model number Type of warning devices HOLDING TANK: Manufacturer Number of gallons Elevation of manhole cover,; Type of warning device, SEEPAGE PIT SIZE: um er o pits eet iameter; feet liquid depth seepage pit inlet epipe-elevation bottom of seepage pit elevation ,feet. SEEPAGE BED SIZE: number cf lines ~ ' t- with leiigth r file depth f. SEEPAGE TRENCH: width lengL,A__ PERCOLATION RATE AREA REQUIRED ARr,:1S BUILT HEADER LINE ELEVATION DIST. PIPE ELEV. INLT ELEV. END; DATED PLUMBER ON JOB LICENSE NUMBER rL= 03/3'3 DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, :NI, 53707 CCONVENTIONAL ❑ALTERNATIVE State Plan l.D.Number: (I/ assigned) ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER: INSPECTION DATE. 11 r Richard Wolf R. R. 5, River Falls, W1 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: J CST REF. PL ELEV. SE4 of NE14, Section 15,T28N-R19W, Town of Troy Sanitary Permit Number. Name of Plumber: IMP/MPRSW No.. County-. Eugene Grove 5569 St. Croix 38525 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER 7~ PROVIDED. PROVIDED Ul/, q ! 1. 7Z S v ❑ YES ❑NO ❑YES ❑NO PERTY WELL: BUILDING. AIR NL.OT RESH REDOING. VENT DIA. VENTMATL.. HIGH WA NUMBER OF ROAD PRO INE : ALARM FEET FROM ❑ YES Q NO D YES ONO NEAREST DOSING CHAMBER: MANUFACTURER BEDDING: LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER PWAORNIIN GLABEL LOCKING OVER W Q~(/JCl~ ❑YES O 7 S Z) YES ONO ❑YES ONO GALLONS PER CYCLE: PUMP AND NTR L OPERA IoNAL NUMBER OF PROPERTY WELL BUILDING V N TO RE H LINE AIR INLET (DIFFERENCE BETWEEN FEET FROM PUMP ON AND OFF) ❑YES ONO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH UTAMf TER MATERIAL AND MARKING excavation. (if soil can be rolled into a wits, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: - uoul0 WIDTH J LEN H N DISTR. PIP( SPACING INSIDE DIA BED/TRENCH / THE►fCHES I 7N AL: PIT DEPTH DIMENSIONS L H FILL DEPTH UIS i I DISTR PIPE IS 1 MATERIAL [ H NUMBER OF PROPERTY WELL BUILDING- V NT TO F ESH 'ii BE LOW PIRES 9UVECOVEH ELEV,,dNLF ELE CE, FEET FROM - LINE (1„`~~ Alp~r[yE i ]2 I L) (f 4~ f 5c.' 2i INEAREST 1 MOUND SYSTEM: F Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM 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 DNO SOIL COVER TEXTURE PERMANENT MAHKERS OBSERVATION WELLS ❑YES ONO ❑YES ONO o f PTH OVER TRENCH/BED DEPTH OVER TR N H/ ED DEPTH OF TOPSOIL SODDED ED MULCHED CENTER EDC:E❑YES ONO SDYES 11 NO [:]YES ONO PRESSURIZED DISTRIBUTION SYSTEM: _ WIDTH LENGTH NO. OF LATERAL SPACIN('~ GRAVEL DEPTH BELOW PIPE FILL DE TH AB V COVER BED/TRENCH TRENCHES DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR PIPE MANIF OLD MA EHIAL NO i11STH DISTH I DISTHIBUtIDN PIPE MATERIAL ~ MARKING ELEV ELEV D[A ELEV PIPES DIA. ELEVATION AND DISTRIBUTION HOLE SI/F HOLE SPACING HILLEU COHHECILY COVFH MATERIAL VERTICAL LIFT CORRESPONDS TO APPHUVEU INFORMATION PLANS _ Y - L_]NO ❑YES 1:1 NO WELL DEiiMAN N MA K OBSEFIV ATION WELLS NUMBER OF PHOPERTV BUILDING FEET FROM LINE S-60 DYES LINO DYES L_JNUEAREST .R tfQo x c er U t/t w/ an.C ri w e- CR 0 5 L-~ g.ti nq L813 G.SS ,17 00 411 (A I -Cp(~' ~1 311~,PQ S.qs Z. 10 I~-y3 Sketch System on Retain in county file for audit. Reverse Side. 4o SI LE , JILHR SBD 6710 (R. 01/82) APPLICATION SAFETY & BUILDINGS DEPARTMENT OF INDUSTRY FOR SANITARY DIVISION , LABOR AND PERMIT P.O. BOX 7969 HUIVIAN, 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. The owners copy or a legible reproduction of the soil test report must be included. Property Owner: Mailing Address: Property Location: 8ity, ViFf~ge er Township: County: SX t/4 N,F'/4S l~ /T2 NiR E (o e C OI I Lot Number: Blk o.: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number: 'if assigned) A14. wtl TYPE OF BUILDING Number of ❑ Public* ❑ Variance* ❑ Other (specify)* Bedrooms: or 2 Family *State Approval Required. TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHE~s GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specif, SEPTIC TANK CAPACITY p ✓ A/ - HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER ✓ +o MANUFACTURER: B EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED IS ware feet(: New ©'Replacement ❑ Experimental ❑ Seepage Bed ❑ Seepage Pit Lh. 2• D` 2 ZM14 ❑ Alternative (specify) W13-Seepage Trench As 7S Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): Liz Private ❑ Joint ❑ Public S/Q the undersigned, hereby assume responsibility for installation of the privat ewage system shown on the attached plans. A-f Name of Plumber: Signature: h6p MP/fv?PftStla'M1fo.: Phone Number: Plumber's Address: Name of Designer: i~ 5 ~ti LO/ -6.r COUNTY/ DEPARTMENT USE ONLY T APPROVED Sanitary Permit Number: Signa)ure of Issuing A t: Fee: Date: YA 4''r ~ 43 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 (N.03/81) F urIII - S T C 100 Owner of Pro pert Location of Prope rty_S~___`'4__~„ Seeeiun_ ,TN k~-W '1' ~Y o w n s h i p ~ Mailing Addruss '96LY ~ Subdivision Name 11ir. f - Lot Number Previous Owner of Property_ Total Size of Parcel r~ ~~D6 ~d~'~5 Date Parcel Was Created..` ky0 AJ-~~- Are: n11 c~rrller:; ills+n( ilic Inc]-udc WILh this j1,11I i c IL iuu uIIe t) I Lllc 1 l I owing: .Certified Survey Map ✓.Deed .Land Contract, or .Other Legal Document which describes Lilo property I 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 t Office of th 3D 9~~ 9 County Register of Deeds as Document No.3a-7' ?I/- d that I (we) presently own the proposed site for the sewage dispo:dl 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. -I- TU - OF OWN k All, SIGNATURE OF CO-OWNER (IF APPLICANLE) OATS bIG -0 DATE 51GNLD NGS REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS IN6US iTM'ENT OF NtiUSTRY, P.O. BOX 7969 LABOR AND. PERCOLATION TESTS (115) MADISON, WI 53707 HUMANiREL`ATIONS (H63.09(1) & Chapter 145.045) OCATION: SECTION: TOWNS HIP/M16~41F ttTi : LOT NO.: BLK. NO.: SUBDIVISION NAME: s~/a~/a s /TN/RI E (aW COUNTY: OWNER'S/BtiY-ER'S NAME: TMAILING ADDRESS: DATES OBSERVATIONS MADE USE PROFILE DESCRIPTIONS: PERCOLATION TESTS: NO.BEDRII COMMERCIALDESCRIPTION: Residence - ❑ New Replace Il I 7 - J y ' RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM:(optional) E'S ❑U ID'S ❑U ~ ~ S ❑U D S DU ❑ S OU TT 4r a If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the v under s.H63.09161(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INFsN~S R OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH VED (SEE AB. ON BACK.) NUMBER DEPTH Ind; ELEVATION OBSERVED EST. HIGHEST TO CHARACTEBEDROCK IF OBSER BRV 1 -7 -Z,} r~ICF 7JJr s 1.L/°I3~ j 3•~ LhS'~~ O. 6i i . r Jr JS J. B- Y Z' 13r1 He ~n s) vv/ r'c r? u. Sf'OJ_S_ B- 6-3' ~D,-4•b i . 3' J~6'b~cc~y~a5 ITS Y- n HeFliLy5t, Z S Z6 Jl~enuV S~ . ; i (~.ti 1~9 74, V J.J -Bu s, l',!. 7-5 B z.8 ~rl s 2, r un sjl7`S J•6°Ei x. J bh S' t:'LriV L ~ :~iJ 41 3 S~tGttT Sc~ r~A ' - 2 13- o + r Lan B- PERCOLATION TESTS DROP IN WATER LEVEL-INCHES RATE MINUTES TEST DEPTH WATER IN HOLE TEST TIME PER INCH NUMBER IN6#E& AFTERSWELLING INTERVAL-MIN. PERIOD t PERIOD 2 PERIOD 3 3l 3i'{ 3/y P P- P- P- `ter. c. 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. Tr 4 SYSTEM ELEVATION ~ d C? iaoOITl 0F 140l S' l U G IPE , , 93 ,k , ( r _ eu. 995 ~ } I I ~-CL~T.IC. ~s ~ M, ^v I I ) ~ _ x E E ~ ~ , X17 SO _ _ _ _ - , m 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. TESTS WERE COMPLETED ON: NAME( rint): v . CERTIFICATION NUMBER: PHONE NUMBER(optional): ADDRESS: _ - _ .L- ~~fJ'J~ j; ? CST SIGNATURE: `I DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 102/82) - OVER - and ~gai ' t 7` I z t~, ads r r 3 4 t( c aj ( j inr r L €1 p}(r r, ~ i' 'k, L cfe=ate, :-{3 t~~?-, e5 t3C@, i?f? a^a £ t 5h ~ r gyp. z, ~g r _tti.~~r3 (W Sr UWHI - t EI Y } G , ro £ ^ .a ' sic - 1 , ~i't~E .rte i ~ r 3. 'P'3 Y, C)' . cgs r. Vr _ - t - Locat_i or, of I,u i ldi nc; server: t Ve I. tI Cal I-E erence poll L L~ Septic tank i/ tiorizontcl i eierence r)oirit F~j~ Building sewer ( Effluent system,_ i L _ r rr.n o 6-menslone- A- L y ' CCTj7 7, Ja U r - or, L _ laCe che0-. mar}: in appropriate box, indicating itc_11+ is, stloim on plot plan t>~lo»: I 7 7 i `I ~Il / ps grantlna OI aDl?l r,0 Ur thE d~Yv)VE- rin, of L:•=iri In& F-'V( .1~ Of a sub-ecgoen CC.ir+LV Lor,1nC; AciirdnasLrat.ar, noes mit being i ~suc:d, Cou~,t j' arid r_1,~ _ r i:E._.L"Tnp US -loll C- 4 ilc'~+]Er IOr ~n'J C7 :iE'c*s an plans Ol SpecIf1cat]Orls' J"c x.107: E>:61r('_7ir1t1On C~~-r'I``-., c:ri" C")LISL'"UC..tC?;., C,l can]' Cr,iT,agE: tr,at ]T+d]' 2"E",lllt in A ni 5 I c J n I 1 gn J lkvT"3 I g o r y 1 1 Iy_ F, ' ~TL E~ 1c4'.3 i- 2~ A8u OE Pi Y L C I I F.II_ _ = ^,~~IJ i PIPE I I WEr,Hr' f r.. ~,r__ i joiLTI: COY. I r RG/ DDOR, -ml L3. L h a t K r S H - i ! I - t j i I I It I I I hf A. k DvEp JoWT f EY,TEUpIUG PIPE I I i I I AL AK I" `EtJDIUG 3' I I II c GUG SD! L E I t I - i I I I I I i _.r F; - f `rl v \r - F{ISER EXIT PEKMITfED OIJL`_i IL Ar~~'. 1~~ uFh--~ Sr: C FI AT!~D t~l } ? PLP. Da. IJUMBEi OF UUSC A -S- h ~!u•- N IJUFACTUG_ E L`~\ c-CZ_ CST J L` i t` D, jC) M ~i ALLC !JS Ir.!Ci_UPIIJG lyhCr_ C'~ !'.A.IJUFAC`-Uk ,y ' Tli r,= - I~I~I,LS OF _ u 'DI 1rJ CP^r MODEL ►JUM.BEF;' &ALLDQS SWiTCH TYPE: !FJ AU•S (,ALLDLE _C WE 5 OF - 1NCH[.~GVt GAL DPI N,ODEL IJl1MBER. IJG= PUM"r AtJD ALAkM ARE TO BL 5'WI-rCH TYPE. - INSTALLED D~1 56Ph~hTE CIRCUIT _GPM mWitAUT-, D15CHARGE RATE ltb F ELT VF_KTICAL DIFFEREFJCE P~ETWEE►J PUMP OFF AIJD D157RIBU710FJ PIPE-- L T Y MIIJIMUM 1JETWORK SUPPLY PR[-55L3 L . . . . . _ _ . . . . - -1.~ F,~ tKlc-rlo►J F~.L~o~____°'y FELT 3 52 FEET OF FORCE MAIIJ X floc Ft TOTAL_ DUIJAMIC HEAP = D E T H IG 1D FJ7ERtv1A_ DIME►1S1U1J5 GF TAk) K: LEtJ&TH - wI~TH L1 7 - _ G F - -L i it ` % L it r ` i d j ~Y w-•., }i N) iN) CD N) C) CD -LLL I CD . U, cli CD :-10 CO . t ' rg d r- ° M Ml C> C CIO t _ W. H. Hdrhs Supply Ca. r'!urri;i.iq Ox Hooting Division hurOfs Eau Cljire, '.`.'ucon5ir 547G ■