HomeMy WebLinkAbout040-1191-90-000 r
n O 9 "o n r1
o a m o
C CD 0
CD d
U) o N o ° W D A °C ex•
C1 3 [ 11
CD 7 fD cn = co O ►.j
o Q CD 0 CD N)
N_ CD
n
d ~
N O O c j
ff 7 O Ln O
O O
O C N CL A9
CJ7 3 7 N On O C
Q 01 A N
w Cn D a w
m o of W CL _0
3 m c - m
W m" l~
C7 (n ~ b n ^ N o F
o Q
N W W CD Q
to 'b Q t~ ' ~1 ~
c~l• J• Z O O O
-4 -4 -A m n rye
3 QC: CA (6 (6
. -0 vaN o 1/q
H ~ CC X
0 CD
C7 ,0)~ tll O O
Z C!'t Q N ~ ~ N
r a N
rrn z 0
d ° z z
D CD O
C') Z
0 0 ?
i oo cn
~ e+l
i m c
N W 'O N
_ c
00 W (D O CD
w oo CJ (n n (D -i cn
oz O o p Z M
Z 0 n A Z 70,
7- j N y A
C-• O W v 00
a z
co 2 ~ o ~ 'a ~
co co o co o
n -I -i c`t C
~n>a
c
Z a
CCD
D O
CD
N
A
N ~
O A-
N b
7
s i
(D o-
fn ! Z
U1 ti„
X .A
i N
t O
A
O
(D A
O
N
,ug O o
° a
S
Parcel 040-1191-90-000 12/14/2005 10:26 AM
PAGE 1 OF 1
Alt. Parcel 24.28.20.855 040 - 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
MARK E & MARY A HALLER O - HALLER, MARK E & MARY A
228 PLAINVIEW DR
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 228 PLAINVIEW DR
SC 4893 SCH D OF RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 2.100 Plat: 0234-CROIXRIDGE
SEC 24 T28N R20W PLAT OF CROIXRIDGE LOT Block/Condo Bldg: LOT 09
9
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
24-28N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1057/565 WD
07/23/1997 995/90 QC
07/23/1997 767/206
2005 SUMMARY Bill Fair Market Value: Assessed with:
103542 354,500
Valuations: Last Changed: 07/21/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.100 72,600 268,600 341,200 NO
Totals for 2005:
General Property 2.100 72,600 268,600 341,200
Woodland 0.000 0 0
Totals for 2004:
General Property 2.100 72,600 268,600 341,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 220
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
4
AS BUILT SANITARY SYSTEM REPOR'T'
,l'(.c TOWNSHIP / 51 C . G y>,i ,l - K%c W
OWNER
ADDRESSc ST. CROIX COUNTY, WISCONSIN.
L,
IK 01 e 0-3
P
SUBDIVISION- LOT el LOT SIGE
PLAN VIEW
Distances and dimensions to meet requirements of H63
yEMTHING WITHIN 100 FEET OF SYSTEM
e Al ;
-1 ;J4 l {
1
r.
I di a de No th Arrow I
BENCHMARK: (Permanent reference Point) Describe:
Elevation of vertical reference point: Slope at site:
SEPTIC TANK: Manufacturer: GJ.,- t S Liquid Capacity: IZc
Number of rings on cover : Z Tan manhole cover elevation:
Tank Inlet Elevation: Tank Outlet Elevation:
PUMP CHAMBER
Manufacturer: Number of gallons
Number of gal. pump set or a cyc e gallons- total capcity- o~
distribution lines gallon: size of pump J head-
gallon per minute horsepower franc-naive 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 Hameter
feet liquid d'' pth seepage pit inl-et pipe-elevation
bottom of seepage pit elevat on feet.
SEEPAGE BED SIZE: number of lines w t lefigth _ -tile depth
SEEPAGE TRENCH: width length / ;3 w-. ~1 C*-,,z
PERCOLATION RATE c t~s / AREA REQUIRED- ARE- AFB -1LT 70
INSPECTOR
DATED PLUMBER ONN JbB
LICENSE NUMBER -
.
rEPARTM ENT 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. A legible reproduction of the soil test report or the owner's copy must be
included.
ailing Owner: MAddress:
Lk CY Q T' 4_4
Property Location: City, Village or Township County.
l ~T1 NCR l (or
Lot Number: Blk Nc : Subdivision Name: Nearest Road, Lake or Landrgark: State Plan I.D. Number:
(If assigned) /
14
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 r~ " - u - - -
HOLDING TANK CAPACITY
LIFT PUMP TANK/SIPHON CHAMBER
MANUFACTURER: ',t ? 7
EFFLUENT DISPOSAL SYSTEM
PERCOLATION RATE ABSORPTION AREA
(Minutes per inch): PROPOSED (Square feet): New ❑ Replacement ❑ Experimental ❑ Seepage Bed ❑ Seepage Pit
❑ Alternative (specify) -f~ Seepage Trench
7' 6,17o 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:
Signature:. MP/MPRSW No.: Phone Number:
O(A _4' I/ ,w t-pq ELI
1 2:,e
Plumber' Address: Name of Designer:
COUNTY/DEPARTMENT USE ONLY
Number:
Signat a of Issuing AgeFee:/~ n~ Date: Xf~ 7 APPROVED Sanitary Permit
DISAPPROVED tG 0
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)
DEPI.'R;MENTOF INDUSTRY, INSPECTION REPORT FOR SAFETY& BUILDINGS
LABOR'& HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
*P.O. BOX 7969 BUREAU OF PLUMBING
MADISON, WI 53707
IN CONVENTIONAL ❑ALTERNATIVE State Plan L D. Number:
(If assigned)
❑ Holding Tank ❑ In-Ground Pressure ❑ Mound
NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER: INSPECTION DATE.
Ch.atte,5 Cudd Co. Ptaza 94, Hud,5can, W1 _ 3 g
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV
SAJ% SWU4,Section 24,T28N-R20W, Lot 9,CtLoix RidgejowMn o~
Na,- of Plumber. MP/MPRSW No. County D w (1 Sanitary Permit Numher.
Ra en Timm 3224 St. CnLokx 43650
SEPTIC TANK/HOLDING TANK:
MANUFACTURER. ILIOU)D CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL LOCKINGCOVER
v ' PRQVIDED. PROVIDED.
DYES LINO ❑Y;ES ENO
BEDDIDIG'. VENT 'QIA VENT MATL.. HIGH W TER NUMBER OF , Ro/jp PROPERTY AWELL JBUILDING. VENT TO FRESH
M+' f+ AIR IN LET
,I ALARM` FEET FROM INE
❑~YES NO EYES ENO NEAREST
DOSING CHAMBER:
MANUFACTURER. JBEDDING. LIQUID CAPACITY PUMP MODEL PU MP,'SIPH ON MANU FACTURER WARNING LABEL LOCVKING COVER
PROVIDED. PROIDED:
EYES ENO EYES ENO OYES ENO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY [FILL JBUILDING I VENT TO FRESH
(DIFFERENCE BETWEEN FEET FROM LINE AIR INLET
PUMP ON AND OFF) EYES ❑N'O NEAREST
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENC;TH DIAMETER MATERIAL 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:
WIDTH. LE NGTH NO. OF DISTR. PIPE SPACING : COVER INSIDE DIA #PITS LIQUID
BED/TRENCH TREIyCNES MATERIAL: PIT DEPTH.
DIMENSIONS ,
GRAVFL DEPTH FILL DEPTH JOISTH PI F DISTR. PIPE DISTR. PIPE MATERIAL. NO. DISTR. NUMBER OF PROPERTY r WELL. BUILDING. VENT TO FRESH
BF LOW PIPFS ABOVE COVER EL, V. INLFI t ELEV~END. , PIPET; FEET FROM jLINEI AIR INLET:
NEAREST
MOUND SYSTEM:
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.
EYES NO
SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS
EYES ENO EYES ENO
DEPTH OVER TRENCH BED DEPTH OVER TRENCH,BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED
CENTER EDGES
EYES ENO DYES ENO EYES ENO
PRESSURIZED DISTRIBUTION SYSTEM:
WIDTH LENGTH. NO. OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER
BED/TRENCH TRENCHES.
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO. DISTR DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING
ELEV.. ELEV.. DIA.'. ELEV.. PIPES DIA.:
ELEVATION AND
APPROVED
DISTRIBUTION VERTICAL LIFT L'ORRESPON DS TO
INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL.
PLANS
EYES ENO EYES NO
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: IBUILDING:
FEET FROM LINE
q p ` OYES ENO EYES ENO NEAREST
a. /
f II/
Yf
5 _ f
i
Sketch System on Retain' in couvtjile;for audit.
f
Reverse Side. i f y y TITLE
f ) SIGNATURES.
4
DILHR SBD 671Jf3 fRL01/82) -
JOB x v~ ? ~y d. l Pr
ROHL & TIMM EXCAVATING
~r L
310 Arch Street SHEET NO. OF
?
HUDSON, WIS. 54016 CALCULATED BY DATE
(715) 386-8664
CHECKED BY -DATE"- Ste`
SCALE
i.
- r
r.
:2s
-
f-A
ti F -
1
-15
~I
j
!
;
PRODUCT20416 lnc., Groton, Manz 01471
.
T /
JOB t t-~l Yr I~ C 1.~ t,: E 6-
ROHL & TIMM EXCAVATING SHEET NO. OF 7-
310 Arch Street
HUDSON, WIS. 54016 CALCULATED BY Y}C J~ DATE ` c,
(715) 386-8664 rr
CHECKED BY -DjJ E_ -2'" z"}•
SCALE
tl
11
f A
L sc
a Gr' ~ ~ I ~ ~~J
I
WZ;
g', 30
r
PRODUCT2041 ~ Inc., Groton, Mass. 01471
- I
Form - S T C 100
Owner of Property -
Location of Property - = Section wMr T N R W
Township.:.
Mailing Address
y .
Subdivision
Lot Number-
Previous
Owner of Property I{.44, ;M.(y_
Total Size of Parcel,
Date Parcel Was Cx.o.t~.Cecl, F~) ,4
Are all corners identifiable? ~_~~-Yes ~t~o
Include with this application one of-the following:
.Certified Survey Map
.Deed
.Land Contract, or
.Other Uega,l Document which describes the property
CwtH'I+ate of Property t er"s Agent
I, James E. Rusch, Certified Soil Tester, be.reby certify that all statements on
this foam are true to the, rj= .t of niy profess onal knowledg, , understanding and
belief; that the above statcd is ommer by virtue f,)f the fol.l-o• ing, legal_ document
recorded in the Register of Deeds Offic:c as
instrument. document number
James E. Rusch C.S.T.F 568 Date
corl
a/4
r}
\/i I 1 G~ .ll•PLAT TED L A.`AS P---ED d'! THE PL/TT TFR -
t 25-
ff n` E-
o O
/ P
r ~
z i r r
-5 1,00 $ [ AL
zz177 a v \w\ f~ .
r ' U y
w 6'02•:4-[ 7 r
zc6oo IO i i-• _ rs
Ar.
° T
lp P.
_ `YA- z - t J ~t1; ' ~ may-'
w oci ze-[
Z&GOO
IL,
`Y l
o tL S - Gta t_
E - 1c ! J J r 2S 7,i• KG Op .r`sr
0 C'40 3C) C
/
f•) tL
W
jig-
• ~ 1It13
t • t' --p~ 4-0
810.
' ISTRY, { DIViSIu'yj
;U i tAidU 3, J i. ~.J LA I T E6 ~..,S (.iib)
t{ 01AN RELATIONS ` IMADISCIN,LJI 53707
(1-163.09(1) & Chapter 145.045)
LOCATION:
SECTION- TOLVNSI-1I~" r1UNICIPALITY: LOT NO.: 3LK. NO.: SUBDIVISION NA;,IE'
L
~4 T-z- il R E.
1000NTY: 6SJNEW-7E3UYER'S NAD1E: MAILING AODREb,a
USE DATES OBSERVATIONS MADE
C10. BEDRMS : COMhI - IAL DESCRIPTION ~ PROFILPDESCTTIPTOii1JS: PERCOLATION TESTS:
IIResidence tt~~-~~
-3 [ New ❑Replace 13v -r
-a
RATING: S- Site suitable for system U° Site unsuitable for system
` ONUENTIONAL ^tOUND: IN-GROUNaPREURE SYSTEM-IN-FILL HOLDING TANK RECOMMENDED SYSTEM: (optional)
IF] s ou as
p __ssaos rU oS
L4J
I f Pe rotation Tests are NOT required DESIGN RATE:
~ If any portion of the tested area is in the
iu<<der s,H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS
'BORING TOTAL DEPTH TO (-;ROUND`NATER INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
`2.tRER DEPTH t:,s. ELEVATION OBSERVED EST. HI HE5 TO BEDROCK IF OBSERVED {SEE ABBRV. ON BACK.) -
-~3 ,r I•J? ~wU~J'_V°- t :~U r ~r car,
'3 L . c~~ • nl J-1- S w` , _ - r J < . (7 4-o'
[ ~ - ~3 l`r. - - ~ r ~ L V N v i t- ~ ~ • So' 4u' r.i J ~ 5
I p / ♦ ` J
i J. 33 dLL} z.33' Et uN v iS' x,67' dn/ O• 1 4~"6
Y
n .t r~ •:.1/ a 0.4.0'uY ?~.1 J•~, :v~ ^nnMON _,NJG ve-"A ti- •T ZEO
i U' 'f'- .r ( j •,t -a ~^...a' ~ , I N - S ' n Ca ~ r3 v' 1. ~ u nJ ~ G" ~ r7 ~ J
3nJL)
1~ / 0.33 5L I-; /'SU` DN v=s, D,-IT k0 3r/ c f I.? > r-
;ate 5 y3.~c) I~1 y Q I,4~' 3>1 ` /C.~- -2:
t
i$
I -
PERCOLATION TESTS
TEST DEPTH VJATER'4N HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
,."a9FH r tS AFTERSWELLING INTERVAL-MIN. PERIOD t PERIOD2 PERIOD P`R INCH
SLOT PLAN. Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. D-~scriha .chat are the hori-
zontal and vertical e!evation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
land slope. ~1~(UC.t', M 11'PI P n- ^J /J
SYSTEM. ELEVATION ~ In V . ~ V.
- - - _ t_ p- rN - - - _I -
~ t r I I ~ t- ~ ' i. lI
` I
1
I I s ~t P
J y
r
--r - - - . 1. -r ~ --^,.r. , ' i -
~L-1-,!P:'•l!, Nrj ) 10
1, the undersigned, her_hy certify that the soil tests reported on this form were made by me in accord vvith the proredures an thods specified in the Vnsmrsln
Administrative Code, and that the data recorded and the location of the tests are correct to the oast of my knovJledge. and t,elief.
91-. (print}; TESTS !,jtcCt~MPI f'1 . ON
f
_=3S:
L'r-4 Tlc ti,.(LJi"! '\iI;JABER ?Hrim'? i"itR()otwn-rid i
1 I
P&- `5
C)!STRIBUTION' Orn±u,~i Inn n-rnpy ro t err:,' Aurh,)rjty, Property Owner and Soii Tester.