Loading...
HomeMy WebLinkAbout040-1186-50-000 N -0 n 0 o d ,v o o v Cl) O • m o o o w a) m o rn N a n CD CO cn CO Z In O CY 0 CO ~D *(0 N) CL 0 =3 COOJ7 N :3 ~00 O N O 3 00 C 0 N N C 0 ~ C n A a o D C N 2 Z) w co n a (D n. c _ n0 r\ o CC m i N ` ! li lz ::z w tD < n O C (D N CC) Co w W Q -Tl rn z oooo~, ~i C fy _ -p G G G N N fo Crt J ai ch w m O rt m M a p CD o COD A 0' rv rn N D ~O R 77 v v 0 A n a m 7 (n _ 01 o Z co o z a~ Z o ti Q n O D° 7 ~ o• (D CD CD Cti j, v c COD N. CD O N w a _ I N n ~ 7 z 0 Z CD Oki G) Q fV W o f_iS Qi Z -1 ca O N 1 W M co ~O 7~y v O_ , z 3 a a " o z m R rn y z W y`~ O a a CO o (z N E3 T z a m. o m v o a 8 1 x rn ~ Q b fD CL N 0 N 0 0 ~n A iz 0 N (A O o g b CD a C) Parcel 040-1186-50-000 04/20/2005 04:49 PM PAGE 1 OF 1 Alt. Parcel M 36.28.19.782 040 - 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): Current Owner PEDRETTI, LORI A LORI A PEDRETTI 88 W WOODRIDGE DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description ' 88 W WOODRIDGE DR SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 0.000 Plat: 2237-OAK RIDGE ACRES SEC 36 T28N R19W LOT 29 OAK RIDGE ACRES Block/Condo Bldg: LOT 29 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 36-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 09/08/2004 773691 2651/241 PR 07/23/1997 981/529 QC 07/23/1997 702/620 2004 SUMMARY Bill M Fair Market Value: Assessed with: 27577 212,000 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 47,200 165,200 212,400 NO Totals for 2004: General Property 0.000 47,200 165,200 212,400 Woodland 0.000 0 0 Totals for 2003: General Property 0.000 25,300 152,800 178,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 218 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS B ILT SANITARY SYSTEM REPORT OWNERI~ 9. TOWNSHIP SEC TGr~-N-R_r,t W ADDRESS ST. CROIX COUNTY, WISCONSIN. ro 8 SUBDIVISION ; LOT \j LOT S /Q c9 PLAN VIEW y~ /,9 Distances and dimensions to meet requirements of H63 A~'`~ryc ~st - ~nL ~yERYTHING WITHIN 100 FEET OF SYSTEM L I di a fe otth Arrow 41 I SCL-.--- i BENCHMARK: (Permanent reference Point) Describe :L,,,,- Elevation Elevation of vertical reference point: '1 Slope at site: 0-4 SEPTIC TANK: Manufacturer:~1 Liquid Capacity: Number of rings on cover J~ 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 oT pump head; gallon per minute horsepower ran 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 -of--Pits feet iameter-- feet liquid deppti - seepage pit in epipe-elevation bottom of seepage pit e e~ vation feet. SEEPAGE BED SIZE: number cf s -width- lerggth]:,rtethe depth-~ SEEPAGE TRENCH: width kOfine length PERCOLATION RATECI,4 ; , _ AREA REQUIRED REA AS BUILT Vic.-; INSPECTOR DATED V'. `Ifi PLUMBER ON JO LICENSE NUMBER,,,, i j C5 i z . 't i21 ul , ct _ QV -l; F l L + _..`z`- I ~t i - v~,~_.wil DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS 'P.O. BOY, 7969 PRIVATE SEWAGE SYSTEMS DIVISION MADISON, WC 53707 BUREAU OF PLUMBING ®CONVENTIONAL ❑ALTERNATIVE state Plan l.D. Number: ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound (lf assigned) NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER INSPECTION DATE Matey Weizz RR#5,MiTacaz6a AptZ#201,Riven Fa2~ % r0a rit BENCH MARK IPermanem reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. IT. ELEV.: CST REF. PT. ELEV NW NW, Section 36,T28N-R19W,Lot 29,Oak Ridge,Tawn o6 T&o Name f Plumbe or. 7=~-- Sanitary Permit Number: Mike HawFinls S~. Ct oix 43680 SEPTIC TANK/HOLDING T!~NK• MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUT ET ELEV.. WARNING LABEL LOCKING COVER P O%HDED: PROVIDED -.~ES LINO ❑YES LINO BEDDINGVENVENT MATL HIGH WATER NUMBER OF ROAOJ. PR OP ERTV WE L BUIDINGVENT TO FRESH / ALARM FEET FROM C / LINE. ~ AIR INLET. ❑YES LINO ❑YES LI NO NEAREST t DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL 4PUMPISIPN TURER. y WARNING LABEL LOCKING COVER PROVIDED. PROVIDED: ❑YES LINO ❑YES LINO ❑YES LINO GALLONS PER CYCLE: PUM P AND CO NTRO Ls OPE ATI ON ABER OF ROPRTY WELL BUILDING VENT TO FRESH (DIFFERENCE BETWEEN FROM NE AIR INLET PUMP ON AND OFF) ❑YES;' NREST SOIL ABSORPTION SYSTEM. Check the soil moistureat the deptl~of plowing ~ It FNCrH 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: WIDT LEV TH NO. OF DISTR. PWE SPACING COVER INSIDE DIA #PITS. LQUID BED/TRENCH r TRENCHES M, TER DEPTH DIMENSIONS ER OF ~ . PITDEPTHGRAVEL DEPT FIL DEP H P DISTRPIPE DISTR. PIPE ATERIALNODISTRNUMB PROPERTY HF LOW PIPFS AB VE COVER NLET ELEV. END. PIPES WELLBUI DINGVENT TO FRESH ` FEET FROM LI~h AIR INLET NEAREST-s 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- ❑YES LI NO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE PERMANENT MARKER OBSERVATION WELLS i DEPTH OVER TRENCHeED ❑YES LINO ❑YES LINO DEPTH OVER TRENCH :BED DEPTH OF TOPSO=LSO D ED SEEDED CENTER EDGES MULCHED. ❑YES ❑N ❑YES LINO ❑YES LINO PRESSURIZED DISTRIBUTION SYSTEM: f TRENCHES: BED/TRENCH JHOLESIZE NGTH NO.OF LATERAL SPACING GR VEL DEPTH BELOW PIP FILL DEPTH ABOVE COVER DIMENSIONS MP MANIFOLD DISTR. PIPE MA F nMATERIA L. NO DISTR. DISTR. PIPE DISTHIBUTION PIPE MATERIAL & MARKING ELEVATION AND EV DIA ELEV' PIPES DIA: DISTRIBUTION INFORMATION LE SPACING DRILLED CORRECT LY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS Y ES LI NO _ ❑YES LINO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF P LIRNEOPERTY WELL BUILDING: FEET FROM ' D ❑YES LINO ❑YES LINO NEAREST v L) C1 h System on . Retain in county file for audit. Side. SIGNATURE. ! TITLE. l 3D 6710 (R. 01/82) 77 4 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: Mailing Address: M ~P 406 s S !?T 3- tirr 2 6/~S,S,¢ /f/~J-s Property Location: City, Village or Township: County: ti t/a iV le) %S 3 T IV Ni R E (or W Lot Number: Blk No.: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number: Z QA-1<' X/1 FU el ~ ~1 (If assigned) A/,f- TYPE OF BUILDING Number of ❑ Public* ❑ Variance* ❑ Other (specify)* Bedrooms: '4 1 or 2 Family *State Approval Required. TOTAL NUMBER PREFAB POURED-IN NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE STEEL FIBERGLASS INSTALLATION MENT (Specify) x SEPTIC TANK CAPACITY Zonp HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER MANUFACTURER: EFFLUENT DISPOSAL SYSTEM N/ PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): New ❑ Replacement ❑ Experimental FN Seepage Bed ❑ Seepage Pit &30 ❑ Alternative (specify) ❑ Seepage Trench wner's Name as Listed on Soil Test Report (if other than present owner): Water Supply: Of- __1 Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber: Si ature: MP/ No.: Phone Number: Plumber's Address: S3 ~j~~r~-~ c• Na e of Designer: 31714,'f4'0 CK L UIII/3i~ G- J J COUNTY/DEPARTMENT USE ONLY Signatur of Issuing Agen : FDate: 17i Permit Number: Y3 / / Ufa APPROVED G~ i d_ ❑ DISAPPROVED Reason for Disapproval: Alternate course(s) of Action Available: Change of ownership, building use or plumb~equires 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) . Owner of Pi olie rty--v"A41e.-T_- Location of Propertyj, _`~'-4-~.~' S'ectio-, 1 N It W - - 1_ _ _ Township- - O Township_ - - - Mailing Address C~--~ ~Q ✓ _ Subdivision Name Lot Nuwber Previous Owner of Property _'`J~ V- Total Size of Parcel OA'r"A-G(= ~ 4 Date Parcel Was Created 4EG' _ep .1...9 Are all corners ident i f i ab Le? yes No SY Lnc]_uclt with this ah~~Lic_ itiou one of the IotIow iLi .Certified Survey Map .Deed .Land Contract, or Other Legal Document which describes the property 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 re rded in the Office of the County Register of Deeds as Document No-gff _ ; 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. _ SIUNA TUR OF OW Y~~ R SIGNATURE OF CO-OWNER (IF APPLICABLE) _-_/_n ~f 3 LIATE SIGNED' / UAI-ESIVNED OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS DIVISION INDUSTRY LABOR AND PERCOLATION TESTS (115) MADISP.O. BOX ON WI 7969 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) LOCATION: SECTION:HIP/MUNICIPALITY: OT NO.:BLK. NO.SUBDIVISION NAME: • I O y z ~3gk ~iOG E N W 1/ 1/ s36 /Tz,' N/R f 9 E (r MTOWN COUNTY: • OWNER'S/BUYER'S NAME: MAILING ADDRESS: /Ut~ 5 { Cl ~UIX MA XIS S ~E'~ ° 5~ Mi,gC AS°S~ ~~T 1 c &."/S , S--"C) i 2 USE DATES OBSERVATIONS MADE NO. BE)RMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence / / ,d X New ❑ Replace j 1 t/ ~~s l I /~i~~G~ T Si C T S~,~y s~ b s-r,~~T~s RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) &IC- Si;S 10C ®S ❑U N S ❑U ®S ❑U ❑S ®U ❑S n❑U o~vE~riav~G 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, cate Floodplain elevation: h~- ,N rT• PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-IN CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) p 6 ' / t7' IMF ,6~ 3,L , .6/' 4,11 S"Z-, /.a' oR. X67 /341, 54. B 1 ° /J 62 2zo-- / tv;'0-f, •7,P5fNs1qWT,-v . 5.. c~ / /7 'A& ,4,v e f ',6u ~~.16~ . / l a3 ' v,P. B- o~ • ~ ~ ~ avpf6 15. ~7 ' ' . Sc 3 s .k,`x ~;,,!•ti c'a 3 . D P,9.v v,~y hiE~ s B- B-3116.0 >/n d ° s. ti;,r W, d-f E Co 13 s y T s - • 2 ' Db OA) 4 , 33 ' ,SAI 5',Y , o,P. 4;6z~S-e L 5 > 74V *4. S / . B-J C9.Za~VI " > lLli V C0/3 ~al G~ 1.3' Q.U. /3*'G61"ke- /Q,J. GS w•dL~ L~4 -.7 5 PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER IN -r. AFTERSWELLING INTERVAL-MIN. PERIOD t PERIOD 2 PERIOD 3 PER INCH P_ Z 2- P_ kfT' 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. 13,, 13,, 7 T©M aF dtU --/c -4, w jL SYSTEM ELEVATION /k lnw VCA7- kf~ AT_ -f- E I CAI • Cfi- Ck, i Mss r ~~f~' ~ c(OR IN ACE t-, ~ - E o 13 E 1J ~~czt,R.. / S~ 1 1 Cr r iwCeS441~lv s p/,f iv lpl~,4 2f I, the undersigned, hereby certify that the soil tests reported on this form were made by mein 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. I NAME (print): HOMSSIT9 T CO- TESTS WERE COMPLETED ON: 'NEIL ROAD 5,519 • 3 U "e3 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): HUDSON, Wis. 5"16 13F CST SIGNATUR : DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. -)ILHR-SBD-6395 (R. 02/82) - OVER - a . ~ I 3tiU G..F HAM =,e , H 0I'dP 6 iRvib.s rite i 1 he Ud c 3 .{.F=) :.'i t" i , a s; , kJ C.ciLc Mt i OA ti a C 4,e=s'nc JY df i7T ne 6al j?I'ojct; 3v,,,AXIlVRJ(tl numbcr of !"t£'(jroorns or t,.3 { icka use g'1;:3t net %:>mM e No suiu 3 lity a nq Won. in SITE IS St-fl FABLE FOR A HOLDING, 'T',600< OI`,JLY IF ALL i =°3 HF SYSTEMS ARE RULE`s U-1- BASED O?-l `-;OIL CCC°NDITICY'gS, PLEASE use the .ac}i;9"f v ms shown hap Ar U1fh't3 ig of e Ca'esc hpWris mu C;C)m€t(E',E ing the plat pi<:{°;' rIrt I i~~~~E a t i <1~i id ki A L~..~~s'~_ - ~ r~~~,, n ;.mt cmin!7 }!(mt fiaE locataon,,. Cia%;Eng to scale is prt;Wrtzd. Me s we Yam C.: ; _ '°a al! non .r.i mW 3 s~ lr,,xf. =r =t, = i?~ty.' n=' `r ufp.>,t ~ Sam buy W) BR B Wowe is W) SS Env, ~ n~ t H[ 1 cl u i 3-1 J ow I. E k `,.i Map smd pm p €f "W ON t raa--"~~ ~ - W, €_omn E I „ . Oaq j Smmv C 30 F! Fin u why Coy ko, Qay - , { 1Ugh u , m:`t wo Honda, of On mW No 5, Ow NAM p7m b) parivi mwio~ whi ah, .a I3.= in The snowy „11: pm*,j he t _ _ md s, s..e r- .c P REPORT ON SOIL 60R I N &S L O ~ TESTS I I I /_0 PLOT PLAM PROTECT -r- D. DArE_ S:~,q, 3v, / HOMESITE TESTING CO. O';NESL ROAD BOB ,lif 1,1r t.;. SON, MS. 54016 c57- PROPOSED HoosE Mosr Ltd' 2- ~ Fr o,~ ~rd;~~ ~,Q®af ALL TEST ~}~~~~5, plzo PosF r> WELL M vsr LIE- 50 FT o -i~? s~.~Ov! ,q« TEST ~A°~/35. 9( = PE.QG /oC~1"~DAJf A = AJP c►9£RfD o,Q 54Gd£L Bowr5 3 11o; z. E3 ~£,?1'%Ch L ~Ef~'Rt:UL'~- POiJ T 5 r 5 w 4 o T Sa av.Q 145 illa rs Z-o~r " coQ~ ,e y C . S . T - ~ 4, E r 7- - iV o S~~ tlf y /,E~o c~ ~a LE GE N fl ~~EV~rioN a~ t1ar. /06 o Fi Ii fr I ~ i Q ! 7f R R~ /off F7- i S>AKrO Oor i II //0 A-fE 5'1 7_ h ' f V I 60 v 63 a, . 30 3S M i-- 'J I , W pj ,M i P 41 ~ 7 . > t_ryol P, /1 » li . 7 > ) /T PAM Sf/STt,. ~4 - V PL~19Po;16-U PLOT any CROSS Sr-CTION FIANS ' ~ I ' ~UzTt1 ~ t`. V c y /33 C~ I I 3 ~t LdX~{S t~ ~ I I spvE'~ O + M I I 3~ ~30 I ,d a„ a -------N ,/3 r Go r oK S/6N D L/c'E't/St" 7~&- I cd C4 Zi4 TE 1 C~ - Fresh Air Inlets And Observation Pipe soiL TMsrlag By HOMCSITE TES l''HG r'G• Approved Vent Cap RT.-3, C'NEiL RCS., HUDSON, WIS. '44016 Minimum 12° Above Final Grade ,0,41 t A U1A "/off' " Above Pipe 4" Cast Iron To Final Grade Vent Pipe f,V Marsh Hay Or Synthetic Covering GAU~~I~ Min. 2" Aggregate r7I-- Ov er Pipe ~ Distribution n _ Tee <1D pipe 0 0 0 0 0 l S rr Aggregate o Perforat?d Pipe Below Beneath Pipe y(Y• y~ o Coupling Terminating At Bottom Of System