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HomeMy WebLinkAbout042-1053-30-000 c N O C m o m `+1 0 3 ^r ~ •D ^ •a' sk ~ \ 1 -3 ` ;w Z o D o • W V) N cn (r (r (y ~ CD n (n O ~ ~ O M rn rn O (D IO Cp W O O W W B O 0 CD co , CD C(Dr N) 0 3 n ; o o 3 N O cn U) (n z D m C. m co: D N a co m v 3 a c j w _ O N Nj CO D 7P O O :1 O w co D nor, a N O W © ~ v v v o h• b W Z O O O ~Eo --)l C-l' N p co D `i rt n ~k x o o (C) Cn Q • ° © O K (D CD N (D ID E; 0 CD C) cc I- C O m y w m td W i N. ~ N H Z Q N 7 o N Z _ Z co Z ~d IV D o- j y f Q b O .i.: o CD 0 Cn t a c CC d CD CD n N t'~ Z O A 2 N O c 0 00 N m N N n A P ON (D d co V (D Lo N Coo cn t!, a z d o L, 0 3 A O " Cn Cp CD 0 '0 coo r ~O O w 0 n Qd CD V Q m rr \ m Q W c~ 6 my 3 = - c Cl ?<z a N m o N m o I~ m 3 a o ~ m. O !n X. O T Cn O EY CL c N O O v C V N CD N O O a o C a CT) p A H9 0 O ~ O b O a O Parcel 042-1053-30-000 06/17/2005 01:20 PM PAGE 1 OF 1 Alt. Parcel 19.29.18.302 042 - TOWN OF WARREN 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 ROBERT L & SANDRA J ALBRIGHT ALBRIGHT, ROBERT L & SANDRA J 962 80TH AVE ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 962 80TH AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 37.000 Plat: N/A-NOT AVAILABLE SEC 19 T29N R18W NW SE EXC PT TO CSM Block/Condo Bldg: 13/3746 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 19-29N-18W NW SE Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 947/31 2005 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/20/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 25,000 252,100 277,100 NO AGRICULTURAL G4 20.000 900 0 900 NO AGRICULTURAL FOREST G5M 15.000 22,500 0 22,500 NO Totals for 2005: General Property 37.000 48,400 252,100 300,500 Woodland 0.000 0 0 Totals for 2004: General Property 37.000 48,400 252,100 300,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 205 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 042-1053-50-000 06/17/2005 01:15 PM PAGE 1 OF 1 Alt. Parcel 19.29.18.3038 042 - TOWN OF WARREN 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 ROBERT L & SANDRA J ALBRIGHT ALBRIGHT, ROBERT L & SANDRA J 962 80TH AVE ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 6.200 Plat: N/A-NOT AVAILABLE SEC 19 T29N R18W PT SW SE THAT PART OF Block/Condo Bldg: SW1/4 OF SE1/4 SEC 19 LYING N OF TOWN RD MKA BADLANDS ROAD & EXC CSM 13/3746 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 19-29N-18W SW SE Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 947/31 07/23/1997 653/267 2005 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/19/2002 Description Class Acres Land Improve Total State Reason PRODUCTIVE FORST LANC G6 6.200 18,600 0 18,600 NO Totals for 2005: General Property 6.200 18,600 0 18,600 Woodland 0.000 0 0 Totals for 2004: General Property 6.200 18,600 0 18,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 o o c F. -0 0 m o t/1 C 2. d m 03 T mm s Q --i 7 z o w D (o °a < • C) v 3 o v (D N (n (ten ° m Z n ^ o ~ N N c O p 00 I~ ` N Q~ O O w W \ 7 O O O Q CC) O rp ( N D u ( =3 'p K O) cn J ;L O O 7 N Q° O Q el~~ (/1 cn G D m a m n a m W v v 3 n CD C a) N (D r Co !1 O p CD cc) C o D n o c v, Cl) w < r! v v z O O O m ~ -j N < 00 Z (n cn to cn D C° vv2 o l< (D 'm v cn o 0 _ (D o (o N (O 3 W D W z Q O D (WD O c~ O a ~ m o C CD CD U) N (D m ~ to m w ~ a z 1° p Z N ° c _ M O A Z O CL O w - * o CL , z , 3 i~ O cn 3 m H ~ (D A CT p) O O v D m (D o O (D n - T n- u c z o CD a m ° N N ~ d CD o r ft A a x a rn w ` fi CD b N O O cn A o b ti (D e A [9 O n o CD o ° O a r AS BUILT SANITAKY SYSTLM REJ! 1K1 TOWNSHIP Gc/ ~d11___ SL c vy VV OWNL* ST. CROIX COUNTY, WISCONSIN. AUUKL:SS LOT LU'1' 5I'LE SUBDIVISI.UN PLAN VIEW pidtancee and d naiona to weeL requireIOIII of H63 y YTHING WITHIN loo FE'L'1 OF SYSTEM I di a e o th Arrow I _ tl-r BENCHMARK: (Permanent refrarence PoiriL) Dea sib f Sri ve-wa'rr L :i I L e -p - - Elevation of verticaj,.,reteronce poinL : ".,Slu SEPTIC TANK: Manufacturer. _ A) Liquid Cupuc 1 Ly 175 Number of ringa on cover : 0Tank _i;ian ►ole cover elevL►L tu►► QT p_ Tank Inlet Elevation: L. 17 Tank ouLICL ElevaLlun PUMP CHAMBER _ Ma~~ufacturer: - - _ Nuu►ber -J galiuri6 ae~r a cycle bul lunki b _ , Lul al cupz,ci t y of Number of &&I. p amp, distribution lines _gullun: bi-Le ur pump-__- - huad. gallon per minute hursepower brand nau►e of pinup and modal number Typo of warning ev cc HOLDING TANK: A' lanufacturerNuu►ber ut l;alluny Elevation of manhole cover , Cyp e of Warning device 54EPAGE PIT SIZE: _-Nuu►ber of pits Feet diau►elur Feet liquid d6ph`'` ticspage LL inlet piE>e --elevaLiul► t' - P IL y. bottom of seepage PT7 e~v tlut►___ - SEEPAGE BED SIZE: number of 11ned - / _-writ h 2 lu,181h III L L lu LICPL t► SEEPAGE TMNCH: width let►l;tl~ - ARL:A A_ BUILT PLACULATIUN RATS INSPECTOR UA'rEL) S^ Z 6 PLUMBLK ON TSB f r - LICENSE NUMBER 3Z~.7► wt ~S~ ICI 1 t 71 Y. i ~ E M If Isj F ~ f _ - t f i DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR 8y HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS f DIVISION P.O. BOX 7969 MAGISON, WI 53707 BUREAU OF PLUMBING *CONVENTIONAL ❑ALTERNATIVE State Plan l.D. Number: ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound (lf aaaigned) NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPEC I DATE: Bob Albright 10895 Brookview Rd. Woodbury, MN BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF, PT. ELEV. SW SE, T29N-R18W, Section 19, Warren Township Name of Plumber: 73561 SW No. County: Sanitary Permlt Number: Dave Fogerty St. Croix 34820 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPAC TY. TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOC ING R of ~.~.~.+_.l C~ +4ry„T~J~ J P OVIDED: PRO ID BEDDING: VENT DIA.: VENT MATL: HIGH WA R _ YES ❑ NO Eg NO ALARM NUMBER OF Ro .PROPERTY WELL: BUILDING: VENT TO FRESH ``ii FEET FROM n LINE: _ ) IAIq IN E ❑YES ❑NO ~ ~ 7 ❑>FE~$. N NEAREST ~ U 2 (J / ~r ~ • % I l` DOSING CHAMBER: MANUFACTURER: BEDDING. LIQUID CAPACITY PUMP MODEL. PUMP/S ON MANU TURER: BEL LOCKING COVER PROVIDED: YE❑NO ❑NO ❑YES ❑NO GA LLONS PER CYCLE: PUMP AND CONTROLS OPE NL NUMBER OROPBUILDING: V NT TO FRESH (DIFFERENCE BETWEEN FEET FROMF P LINE I AIR INLETPUMP ON AND OFF) ❑YES O NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of owi g LENGTH DIAMETEAND MARKING 7.AT~.IA~ or excavation. (If soil can be rolled into a wire, construction shall ce se u F RCE the soil is dry enough to continue.) AIN CONVENTIONAL SYSTEM: BED/TRENCH WIDTH LENGTH NO.OF DISTR. PIPE SPACING V INSIUE DIA #PITS LIQUID DIMENSIONS I (a TH E'NC- M IA L: PIT DEPTH GRAVEL DEPTH FILL DEPTH UISTR PIPE OISTR PIPE ISTR. PIP MATERIAL . Nq BELOW PIPE ABOVE COVER ELEV INLF T ELEV. NU. NUMBER OF R E TV WELLBUILDING: V NT TO FRESH PIE R INLET AI . FEET J7- -.5 NEA STOM r C `p 5 -S. MOUND SYSTEM: ~3 3 Mound site plowed perpendicular to slope Check the texture of 4he fill m eri I for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems make cert in that it ON REVERSE SIDE. SHOW ELEVA- meets the crit 'a f r medium nd. TIONS MEASURED. ❑YES ❑NO SOIL COVER TEXTURE PERMANf NT MARKERS. OBSERVATION WELLS DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED / YES ❑NQ ❑YES ❑Np CENTER EDGES DEPTH OF TOPSIL SODDE SEEDED ULCHED. YE N OYES ONO DYES PRESSURIZED DISTRIBUTION SYSTEM: J BED/TRENCH WIDTH LENGTH NO.OF LATE fj L SPACINGr GHAV DEPTH BE LOVI? FPIPF FILL DEPTH ABOVE COVER TRENCHES-. DIMENSIONS MANIFOLU PUMP MANIFOLD STR. PIPE ANIF D MATERIAL) UISTR DISTR. IP DISTHIBUI ION PIPE MATERIAL & MARKING ELEVATION AND ELEV ELEV CIA LEV. PIPES DIA: DISTRIBUTION INFORMATION HOLESIIF HOLE SPACING D14ILLUO COH ECitY COVER MATERIAL VERTICAL LIFT CORRESPONDS 70 APPROVED / PLANS COMMENTS: PERMANENT MARKER ES LINO ❑YES ❑NO OBSERVATION WELLS. NUMBER OF PROPERTY WELL BUILDING: 83 0C. FEET FROM LINE L..,•. L` DYES INO OYES ❑NO NEAR T X3.23 `15 s ~ d n Sketch System on Reverse Side. tain in county file for audit. SIGNATURE TO LE DILHR SBD 6710 (R. 01/82) APPLICATION SAFETY & BUILDINGS DEPARTMENT OF FOR SANITARY DIVISION INDUSTRY,. LABOR AND PERMIT P.O. BOX 7969 HUMAN RELATIONS (PLB 67) MADISON, WI 53707 Attach plans for the system on paper not less than 81/2 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. , Property Owner: ~Mailing Address: Property Location: City, Village or Township: C nty: 1/4 1/4S ~T 2 f NCR IF E (or Gas 571, Lot Number: Blk No.: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number: (If assigned) TYPE OF BUILDING Number of Bedrooms: ❑ Public* El Variance* ❑ Other (specify) [B 1 or 2 Family *State Approval Required. s TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify) SEPTIC TANK CAPjj ✓ HOLDING TANK C- LIFT PUMP TANK/MBER MANUFACTUREREF FLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): New ❑ Replacement ❑ Experimental Seepage Bed Seepage Pit ❑ Alternative (specify) ❑ Seepage Trench Water Su ply: Owner's Name as Listed on Soil Test Report (If other than present owner): Private ❑ Joint ❑ Public V I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber: Si nature: MP/MPRSW No.: Phone Number: Plumber's Address: Name of Designer: COUNTY/DEPARTMENT USE ONLY : APPROVED Sanitary Pelt Number: Fee: Date 'I /7 Signature of Issuing Ag t: 'le -,f a ~ CJ3 ❑ 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) ` LFaBOR AND v • ` s %.#I V JV t - DIVISION HL''~^,.AN RELATIONS PERCOLATION TESTS (115) P. 0. BOX 7969 (H63.09(1) & Chapter 145.045) MADISON, WI 53707 ' - r LO` 11 ~ S~j S E C TQI pj~ ~ ~N If OWNSHIP/fvALITY: LOT NO.: BLK. NO.ESuB(b I - VISION NAME COUNTY: OWNER'S BUYER~N~M (or S^ MAILING ADDRESS: o r USE - t t.1!12~ - - - lften - NO. BEDRMS.' COMMERCIAL DESCRIPTION - DATES side ce OB_SERVATIONSZADE I T - ( PROFILE DESCRIPTIONS: PEROOLATION TES -----L- - rL_ ew -Replace LL IL I S. RATING 2 z - 3 y_~ S_ Site suitable for Y system U) i - 3 - -Ste unsuitable for system CONVENTIONAL MOUND: IN-GROUNcQPF3EfUTRE:SV8T-EM------ A-FJ--Q-LXSEJU1 ECOMMt J nJ YST - EM-:(ofuonal) If Percolation Tests are NOT required DESIGN RATE: under s.1-163A9(b)(1)), indicate: If any Portion of the lested area is rn the Floodplain, indicate FloodPlain elevation: BORING TOTAL - PROFILE DESCRIPTIONS 33 - NUMBER DEPTH IN. ELEVATION D PTH TO GROUNDWATER-INCHES CHARACTER OF OBS E RV E EST. HIG SOIL,W~~ ICKNESS, COf~'C'7 AND DEPTH HEST TO BEDROCK IF OBSERVED ISEE ABBRV. ON -~---r y( fY~ - '-Z2 J 1 4, A/ -J :f - 7 - - - PERCOLATION TESTS TEST DEPTH WATER IN HOLE NUMBER fL AFTER SWELLING INTTEST TIME ERVAL MIN. DROP IN WATER LEVEL-INCHES If e-w Y PEaloo2 PFt~Trso. RATE MINUTES - PFH INCH P - - - ~L ,o_ .rr _ P- 2 - P- Z P Z0ntd LOT PLAN: Show locations percolation tests, soil borings and the dimensions of swtable soil rreas Indicate s: c(ii:ues E)crrwli,rt ,r,. the an dsl cpe. of Idil and vertical elevation refe fen'nce Points and show their location on the plot plan. Show the surface elevation at all borings and the, direction 'Ind peicent Iwri SYSTEM ELEVATION ` T r s~-E- -,-o ~~FEr TN 1, the undersigned, hereby ce Adnu nrst rtify that the soil tests reported on this form were madt.• by me in accord with the procedwes and methods specified in the r<tt i vc Code , and that the data recorded and the location of the test: are Corr _ mY knowledge and beliet. Wisconsin ~N$ME (pant) - - SLsr`-- TESTS ERE 'OMPL-E TFD - 6Q~ CERIIf- AI ION NUMBFf pIIONE NUMEiER(opironal): _~o - - - - csT ai~;IVATUitt- _ -9~ 41 L ~nre lto~F' yr/ © perk /r /e p I ~ y efF~ r~/~ sir ~ . r7 f Clem. ,~7crava l`~:►~ t ! ~ ( ~'G7Y })~ir is L QO o *o •"I I /p / 7 1 s4e j I It n to I f i I rh- i ~ ~w in I ! I g ~ . f I - I I I 41 l w I I I{ r r I i : r ! ~ i I I i 71r - - ~ i I i i h 1 I i ' i i I ~ - I