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HomeMy WebLinkAbout020-1147-50-000 ` n v, p 3 -o 0 d r~ CD ` 1 C cn N ° ICI CD 7 CD (D I N w o \ z w CD U) :1 7 1 w U) N 0- 0 N 7 p n ~ 7 CC) O O N_ N Fo r. m (A D Cp f - N J 711,7- _ CD C? N W G III CD C J J i 3 r. - - CD O O C 4( i co CO 0 o r N CD co 00 -0 M 0 0 0 j tlvl i o to Cl) cn m co O CD N fu 'a CD (D CD CL d N T~~ Jl N CD N zco z c u, D i a o Z v ~ O CD Z S 7 N '0 (n _ c L) C CD N c". w m n n CD CD --I Oz p Z CND W c ;o a Z O Y = N ca -0 m CD CD Z 0 " m co z A CD w ~ I ~°7ovo a a~ 3 m N z a p) N CD O CD N o In- CD - co CL _ CD N N 3 a Qom i O C :3 3 Q 0 0 O O N ~CL a N N CD CD N O O C7 a O CD A 0 ti =3 "I t1i CD A Oo En 0 r O O :E O O ti t • AS BUILT SANITARY SYSTEM REPORT OWNER /,k01t TOWNSHIP HWP S 011,1 SEC. ~TL'/N-R/yW --r ADDRESS / ST. CROIX COUNTY, WISCONSIN. 1`I Q DSO AI, W S jVIO r ~z SUBDIVISION 4 :FA b0tll-S LOT # / LOT SIZE --r PLAN VIEW Distances and dimensions to meet requirements of 1163 SHQW- LVERYTHING WITHIN 100 FLIT OF SYST1,11 y v f ~7 6 7 - - - - - [17 - I I di_ attt, or, thi A row SCA ALL i I BENCHMARK: (Permanent reference Point) Describe: #0xz 'Iufi t Aa 1. AC17-Elevation of vertical reference point: Slope at site: SEPTIC TANK: Manufacturer: S Liquid Capacity: lode Number of rings on cover : Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: PUMP CHAMBER Manufacturer: Number of gallons Humber of gal. pump set or a cycle gallons; tota 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: um er o pits feet diameter feet liquid depth seepage pit in et pipe-elevation bottom of seepage pit elevation feet. SEEPAGE BED SIZE: number of lines 3 _wi th /,F1 length 5 tile depth SEEPAGE TRENCH: width length PERCOLATION RATE _ AREA REQUIRED AREA AS BUILT3 t? _ INSPECTOR _ DATED PLUMBER ON JOB _ LICENSE NUMBER Parcel 020-1147-50-000 05/26/2006 11:22 AM PAGE 1 OF 1 Alt. Parcel 26.29.19.784 020 - TOWN OF HUDSON 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 - QUINLAN, CINDY J & TERENCE CINDY J & TERENCE QUINLAN 787 MEADOW DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 787 MEADOW DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.004 Plat: 2077-HIGH MEADOWS SEC 26 T29N R19W HIGH MEADOWS LOT 19 Block/Condo Bldg: LOT 19 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 26-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 12/23/2002 703382 2089/086 QC 07/23/1997 764/177 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.004 75,000 123,700 198,700 NO Totals for 2006: General Property 2.004 75,000 123,700 198,700 Woodland 0.000 0 0 Totals for 2005: General Property 2.004 75,000 123,700 198,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 206 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 DEPARTMENT OF INDUSTRY, INSPECTION REPORT FORs SAFETY & BUILDINGS LARIj,9 & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P-O. bOX 7969 r~ BUREAU OF PLUMBING MADISON, WI 53707 (CONVENTIONAL OALTERNATIVE statePlaolD.Nomber III assigned) O Holding Tank E In-Ground Pressure El Mound NAM OPERMIT HOLDER: ADDRESS OF PERMIT HOLDER: L INSPECTION DATE ♦ ' Ih BENCH MARK (Permanent refer e point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV. r) ~l' ct Name n Plumber- MP /MPRSW No.. Coumy. Sanitary Permit Number. SEPTIC TA /HOLDING ANK: 7 MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV. WARNING LABEL LOCKING COVER PROVIDED. PROV}DED.. / -7 .7 cc; "'"✓Yti1. V ;r.' [ S~ DYES ENO CTYES r❑NO PROPERTY WELLBUILDINGVENT TO FRSH BEDDING. VHIGH WATER NUMBER OF ROADj2/.g ALARM FEET FROM ~0 LINE ) LAIR I L T YES ENO ( DYES ENO NEAREST-- I DOSING CHAMBER: MANUFACTURER BEDDING. LTV P P M EL PU MPi SIPH ON MANUFACTURER WARNING LABEL " "LOCKING COVER PROVIDED. PROVIDED: EYES ENO EYES ENO OYES ENO GALLONS PER CYCLE: PUMP 7ROLS OPERATIONALNUMBER OF I'R" ERTV BUILDING VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM NE AIR INLET PUMP ON AND OFF) S ENO NEAREST 11. SOIL ABSORPTION SYSTEM. Chec the s it ist eat the epth of plowing f v:;7.~ ulnr,~t TER MATERIAL AND MARKING or excavation. (If soil can be Tolle into w e, co, structio shall cease until FORCE the soil is dry enough to continue. MAIN CONVENTIONAL SYSTEM: WIDTH LENGTH NO. OF DISTR. PIPE SPACING, COVER INSIDE DIA =PITS LIQUID BED/TRENCH - TRENCHES , MATEHIAL PIT DEPTH DIMENSIONS Ll J 1 3 p GRA~:fI .>FfII, FILL DEPTH UISTH PIPLEF DISTR. IPE DISTR PIPE MATERIAL NO DIS NUMBER OF PROPERTY WELL BUILDING- VENT TO FRESH 8k Lf]W PIPS.- ABOVE COVER ELEV NT V. N PIPES LINE AIR INLET- FEET FROM w: r l r NEAREST--s~ In MOUND SYSTEM: 7-53 - 7 Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. DYES NO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS DYES ENO DYES ENO DEPTH OVER TRENCH BED DEPTH OVER TRENCH; BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED. CENTER EDGES OYES ENO DYES ENO DYES NO 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. ELEVATION AND ELEV. ELEV. DIA. ELEV. PIPES DIA.'. DISTRIBUTION HOLE SIZE HOLE SPACING; DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION PLANS OYES ENO OYES ENO COMMENTS: PERMANENT MARKERS. JOBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE - ~L OYES ENO OYES ENO NEAREST cl DE; I _ uNry~~ Sketch System on Retain i ounty file for audit. Reverse Side. SIG ' TITLE DILHR SBD 6710 1R. 01/82) DEPARTKENT OF APPLICATION SAFETY & BUILDINGS INbUSTRY, FOR SANITARY DIVISION LABOR AND PERMIT P.O. BOX 7969 HUMAN 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. 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: County: / *r % SE %S ZI~T Z~ N/ R l9 E (or) W /~vDSO.t~ 77 ' ~O/)( Lot Number:Q Bilk No:: S/u~bdi/v~ision Name: p~ Nearest Road, Lake or Landmark: State Plan I.D. Number: (if assigned) /V /9' 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 /DVO HOLDING TANK CAPACITY I LIFT PUMP TANK/SIPHON CHAMBER NA MANUFACTURER: W )Se CD.UCe 0GK EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): A New ❑ Replacement ❑ Experimental g Seepage Bed ❑ Seepage Pit <3 ❑ Alternative (specify) ❑ Seepage Trench 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. Na a of Plumber: Sign e: MP/MPRSW No.: Phone Number: AV K (7151' 3X-24- Plumber's Address: Name of Designer: COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ APPROVED Sanitary Permit Number: ❑ 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) r DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS IND4JSTRY`, DIVISION LA60R AND PERCOLATION TESTS (115) MADISP.O. BOX ON WI 53907 HUMAN RELATIONS (H63.090) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: NE '/a '/a 2-6 /T 4 N/R /9 E (or) W &Jae v COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: ~ ,s~ USE DATES OBSERVATIONS MADE $ S D NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence 3 ~//d New ❑Replace 13 1 fe~ 13 'vim/ L s1/ s .9Js oor /s RATING: S= Site suitable for system U= Site unsuitable for system SAS SAtj,PE wije• .5;W0 SUB Sj,P.fTAS. CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: R COMMENDED SYSTEM: (optional) / J S❑ U ~J S❑ E:]U XS [_]U ozr ( If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the 1J _ under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: 176 PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED_ EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 54 " AW.Gi ° G/-/.~A~ 14-a s4-, /G , " /-;'•,(3.V -0,0? R B- o cP Fr - > 9 ' fr ly G SL to ,Wt- fk 7„L/ 8,v __oR 13- . . S~'G 8° 'e-1a&) ~CL qv D Fr i3 Pw~F Y"6AI%L,JO~,G •~3n1 v /O GY Al B-3 l/d / d,d ~4c- „ 3s a,dx 1..,- ~is7;.ucr Mors vN rvp.sr o ~y 8 a: I A 13- PJ_x-U Fr /~'./3v-Gy. I-,1F'41f,1 , 20 t/ B B- 1I2 9 9, y > Fat- a ) , es B /2-3 y~ 0 Sys'/. "ZY-8AJ 30"~~ . 5/e- v PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD1 PERIOD2 PERIOD 3 PERINCH P- 7fkl c_ < < P_ 4igri~gD 0.29%,v o P- < /iV L S ,N u ' ~S /.J < f" P- I 9&~A r.0- 5r P_ l 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. &TT,0, J Elf D,PA/.u/'/~~D eX6,4VhT10l 719 6!'6 4r 461EV4j1ON 0f SYSTEM ELEVATION 9, Fr OR /,v r,, °Ros •~2- ~r (3 tow VERrie,4 44r.. Pol VT. 2 o ~Ri U6 ~ 13M ' Rid - 3S r~Y Sy N_, ar LE9~ T ro' IROW Posr ALrEkl►!970 ~ ~►,popos~~ ~ VRoPasE1~ I ~ ~ c'G{DME I 3 o p Pi 3'3 Pi O J u. q jig 13 1 CS, R v 5~of a ~'C G ti io A5 f lad Q 1,13 ku ac i © LINE y 10PO 10 fined, he ert' at the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin ';ode, 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: CERT~ION NUMBER: PHONE NUMBER (o ti tional): SIGNATURF I 7 I 5 .dE x96 v i 3 is his a i-my no - , "a' m m t'- ~ x ;1e. yo:.. Y a i~ TAN E F0,-1, A T, Nil f.~im!I F ,A',,_L PLEASE w o le W A,. Am m Mm" "5° or w l€' desc I;pvr ns a(Yd f t.') T}}~ zff"t~ tE' o pin plan; .itt£rwn c5wma: y k+E,<i kri au t W N.nnn # ._,7kq to wMe 4 pet„umL f g. rr'tf ti oa1F:3 , ,ia. a t;, ,3 .:13 o'. b'1 - }V;' t o crown; shf t'rtr tii"s, a[c rA..a "t.„..£'lt 1° Mv '00 Bum , 4 60w :.Eou_ r,'t` n 0")" C ' .art i a ti_ iY" V,c oma';J[°. hL%; ' sf ° '°i__= ' e n r Pi mai ANNO" Sam A" byw s t . ' f. 01 r ; (pay tit vv, K14 SO lun rem, , , t 3 c er r e- - F hvia e - _ PLB ~7 pi-or and CR O 5 5 SECTION PIANS '15 D`T~5 «sED ~y ~T x 30 CIO 1; ~,u,~no N Q i n ~(ZoMWIdrI S6 vtR 3e y M6 JiE67 GvT 51,0PE S%6,'Al, D o ~a ~O pQ o oy ~lE~~~rJ Fresh Air Inlets And Observation Pi: ~Y Approved Vent Cap GAG - Minimum 12" Above Final Grade 4Cast Iron ➢ ~ TESL 30" Above Pipe 011, -To Final Grade Vent Pipe i5 Marsh Hay Or Synthetic Covering Min. 2" Aggregate Over Pipe Distribution Tee l P' Pipe 0 0 0 0 0 f T' gat o~ / Be eagtheP pe Perforated Pipe Below So~L, I o Coupling Terminating At VBottom Of System