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Parcel 020-1150-70-000 03/25/2005 04:24 PM
PAGE 1 OF 1
Alt. Parcel 29.29.19.815 020 - 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): = Current Owner
STONE, JAMES A & THEODORA B
JAMES A & THEODORA B STONE
714 GLENNA DR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 714 GLENNA DR
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 1.062 Plat: 2356-PRESIDENTIAL ESTATES
SEC 29 T29N R19W PRESIDENTIAL ESTATES Block/Condo Bldg: LOT 6
LOT 6
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
29-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 683/126
2004 SUMMARY Bill Fair Market Value: Assessed with:
48901 207,700
Valuations: Last Changed: 07/21/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.062 27,800 132,900 160,700 NO
Totals for 2004:
General Property 1.062 27,800 132,900 160,700
Woodland 0.000 0 0
Totals for 2003:
General Property 1.062 27,800 131,400 159,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 116
Specials:
User Special Code Category Amount
018-RECYCLING SPECIAL ASSESSMENT 27.00
Special Assessments Special Charges Delinquent Charges
Total 27.00 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT
OWNER /,[1 kj) j~1 ~/l1Jl, TOWNSHIP //1'v_>0"L/ SEC .2`r Tel,
ADDRESS ST. CROIX COUNTY, WISCONSIN.-
dob 561.:, 5 YQ
41
SUBDIVISION ZsfA9 5 LOT LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of H63
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
JL
-44- --H I X--
v
I diva e No th Arrow
SC LE : IN
BENCHMARK: (Permanent reference Point) Describe:, r jw;rti
t ,
Elevation of vertical reference point: lope at site:'
i
SEPTIC TANK: Manufacturer: Liquid Capacity: /000. Ch'//off
Number of rings on cover : Tank 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 capacity o
distribution lines gallon: size of 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 o pits feet diameter
feet liquid dept seepage pit in et pipe-elevation
bottom of seepage pit elevation feet. ~
SEEPAGE BED SIZE: number of lines _3width 4,el leiigth 3S° tile depth
SEEPAGE TRENCH: width length
PERCOLATION RATE AREA REQUIRED g/ RE S BUILT
INSPECTOR
DATED PLUMBER ON JOB
LICENSE NUMBER
DEP,49TMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
LABCt& HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O. BOX 7969 BUREAU OF PLUMBING
MADISON, WI 53707
1 CONVENTIONAL ❑ ALTERNATIVE Stare Plan 1 D.Number
(If assigned)
❑ Holding Tank ❑ In-Ground Pressure ❑ Mound'
NAME OF PERMIT HOLDER. JADDRESS OF PERMIT HOLDER. INSPECTION DATE:
`n A }
BENCH MAFIZ (Permanenr reference pomc) DESCRIBE DIFFERENT FROM PLAN. REF. PT. ELEV.. CST HEE. PT. ELEV
Sec" n iq Li) LAA ~ rt
Name ul Plumber. MP/MPRSW No. County Sanitary Permit Number.
-To in t tv CL 1
SEPTIC TA /HOLDIN ANK:
MANUFACTURER LIQUID CAPACITY TANK INLET rE LEV TANK OUTLET ELEV. WARNING LABEL PH VVE
PR V
ED'. PR~~Z~~~ 10.34,A( YES NO NO
BEDDING. VEN A. VENT MATL I HIGH WA ER NUMBER OF ROAD: PROPERTY WEL BUILDING VENT TO FRESH
LFlRM LINE ~'~f' / LAIR Ifyl
I ~
C A FEET FROM
YES ][-]:NO U NEAREST
DOSING CHAMBER:
MANUE ACIURFH REDOING '1001() CAPACI IV U MODEL PUMP,SIPHON MANUE ACTUHEH WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED.
EYES DNOi' EYES NO OYES ENO FRE
SH
GALLONS PER CYCLE: P'MPA CONTHOLSOPERATIONAL NUMBER OF Hrv WELL BuuDING ~vEN I NL'E T
LINE AIR NL
(DIFFERENCE BETWEEN } FEET FROM
PUMP ON AND OFF) ! EYES L_iN0_ _ NEAREST
SOIL ABSORPTION SYSTEM. Check the soil moisturqlat the depth of plowing FORCE - olnraF Ti R ArERIAL AND MAHKw(,
_j_____ 1'H M
or excavation. (If soil carAe rolled into a wire, construction shall cease until MAIN
the soil is dry enough to continue.)
CONVENTIONAL SYSTEM:
\NIDTH LENGTH NO OF DISTN PIPE SPA(~INr, COVER INSIDE DIA - TS LIQUID
BED/TRENCH / RENC~ES MAT r I _ j PIT DEPTH
DIMENSIONS l
L3 T 1 _
DEPTH )I` II '11'I DISiH PIPf DISTR. PIPE MATERIAL. N Ir NUMBER OF PHOPEHTY WELL BUILDING VENT TO FRESH
COVER tl E I.EV END
f 7 2- / PIPE FEET FROM A 1 ~T
9?•q b NEAREST _L--
MOUND SYSTEM:
Mound site plowed perpendicular to slope Che he xture of the fill material for PROVIDE A DIAGRAM OF SYSTEM
and furrows thrown upslope: m nd s ms make certain that it ON REVERSE SIDE. SHOW ELEVA-
eets e la for medium sand. - TIONS MEASURED.
EYES NO _
SOIL COVER TESTORE PFRMANFNT MAHKEHS OB~VIISJ WELLS
_ EYES ENO NO
t)EPTHr)VFH IHENCH BED DEPIHOVFH THE ;H BF ) D- TO OF )PS()IL sODDEn SEEDED MULCHED
CENTER E.DGFS
EYES ENO EYES NO EYES ENO
PRESSURIZED DISTRIBUTION SYSTEM:
WIDTH LENGTH NO. OF LA L SPACI , GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE (,()VEH
BED/TRENCH TRENCHES
DIMENSIONS
IU1ION PIPE EtAIEIiIALS MAHKIN(,
',~ANIFOLU PUMP MANIF ()lD T PIPE N OLD TEHIAL NO DISTR DISTR PIPE DIS7H B
F LEV. ELEV. DIA E E PIPES DIA.-
ELEVATION AND
vERnc AL LIFT CORRESPONDS TO APPROVED
DISTRIBUTION I- I
INFO RMATION HOLE SIZE HOLE SPACING DRILLED CO H - :I Y COVER MATERIAL
PLANS
❑ S N _ DYES ENO
COMMENTS PERMANENT MARKERS: OB RVATION WELLS- NUMBER OF PROPERTY WELL-. BUILDING.
FEET FROM LINE
EYES NO EYES ENO NEAREST-
z t 4
tc•~~`~
cI
Sketch System on Retain ounty file for audit.
Reverse Side. TITLE
SIGNATURE
DILHR SBD 6710 lR. 01/82)
DEPARTMENT OF APPLICATION SAFETY & BUILDINGS
4NDUS'AY, FOR SANITARY DIVISION
LABOP 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:
CsA~ I~ MGlit1 C/a '1f~P ,~5. 61640,47/-0 6~- IV0.40d~ 7~/vl~se,J 60
Property Location: City, Village or Township: County:
SE '/a S W '/aS 29 ~T 2-1 N, R E (or) W #UPSOtiY S?• 4,01 X
Lot Number: Blk No.: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number:
(If assigned) N
60 1
TYPE OF BUILDING /7 cr
Number of
❑ Public* ❑ Variance* ❑ Other (specify)* Bedrooms:
154, 1 or 2 Family *State Approval Required. 2-
TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER
GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT ISpecif )
SEPTIC TANK CAPACITY
HOLDING TANK CAPACITY A)
LIFT PUMP TANK/SIPHON CHAMBER
MANUFACTURER: LUEI. E eA,' O L r` /S
EFFLUENT DISPOSAL SYSTEM
PERCOLATION RATE ABSORPTION AREA
(Minutes per inch): PROPOSE (Square feet): New ❑ Replacement ❑ Experimental LJ Seepage Bed ❑ Seepage Pit
l❑ Alternative (specify) ❑ Seepage Trench
Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner):
9 Private ❑ Joint ❑ Public
I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
Name of Plumber: Sig~pjure: MP/MPRSW N Phone Number:
T zAp + _ (71S') -.2-!' d
Plumber's Address: Name of Designer:
1401464- 57-- No
COUNTY/DEPARTMENT USE ONLY
Si n ture of Issuing Agent: Fee: Date: ❑ APPROVED Sanitary Permit Number:
kOA (D El DISAPPROVED W
C ,
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)
,~}17!%~.~>v~► ~',E,~'~~' I~ S~G~`CT/.t~f' ~ 1~i~~c~~Pc,cr 1" S~'TE" ~~PF~4 . ,
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
W. DUST*Y, DIVISION
LABOR AND P.O. BOX 7969
PERCOLATION TESTS (115 MADISON WI 53707
HUMAN RELATIONS `
(H63.09(1) & Chapter 145.045) X7
LOCATION: ! SECTION: T N R/ Q [ TLOT NO.: BLK. NO.: SUBDIVISION NAME:
/ I ca
1/4 'eI4 1 / C l or) w 71j~~i~~'J~~i 6 01,nrlPeo / -1y L-
S
COUNTY: OWNER'S/BU
-A y YER'SNAME: MAILING ADDRESS: n~s~~~ ~0~ ~Upwo~ S
G a`v N1 L%Il 6-- ' o / ~G
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: /PROFILE DESCRIPTIONS: 1PERCOLATION TESTS:
Residence -3 N)+ + IWINew ❑
RATING: S= Site suitable for system U= Site unsuitable for system
RECOMMENDED SYSTEM:(optional) j SQ
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING Al
O S ❑U ®S ❑U ~ S ❑U ❑ S .®u ❑ S f70c1
~ u7/~.co,9G & A
If Percolation Tests are NOT required DESIGN RATE: If an ~j -
q y portion of the tested area is in the
under s.H63.09(5)(b), indicate: ~0J `s-41 ";7 Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS SC (D6 rN`1E/Q si9~t1
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.)
B- 5zE /6'/,1/.41- ArIU Go qkL W w 13o&5
13
B- 7 1z0 /0-6 r ~ > 1-2-0 ''AilL J- a.-OA' c~.
B-
B-
PERCOLATION TESTS ,4;1/ED SCQ Ael'6-1Al Z_ .eC~/ -
TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD I PERIOD 2 PERIOD 3 PER INCH
P-
P_ 690 ~ o - /a 2__
P-
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. 1-30T10NI $ /jell TO L/P 4dl ~iy~rtip,p~„t SANU(~-~I Q 444,0 SrT'l~T+--)
SYSTEM ELEVATION ria,,1 94,W- I 46.6,6 Fr. ~(3e6 ~
ot4
I37 /.y,
;A) 0+7D 132: 13C
~p5 ~I pkU~l , ~ _ F/El/AT/OU = /t30~d f r
t?r 39
i . _ f(,4uv /30,6P r
-0 i4L-
8~ y2 /Sr TN
Mv5r 4F- gr GE s sFr
63 'o
DoT pv fxoA4 ft,- airAAE,gs
fh ~o ~Ti~a/1L5E/~ lv6GL ~IUS 1'.
APPS B 1-i r 4645r 3,0 fr.
PA tom All TtsT A&ws .
0
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.
NAME (print):AOOha7- ~/hi h7 ~ TESTS WERE COMPLETED ON:
e-z3-eZ
ADDRESS: f CE T FICATION NUMBER: PH NE /NUMBER (optional):
ST SIGNATURE- -
otaocA s 13vAL1) o2 Dov,T lv,wr To P1 S7v~e13
IN 0 k 4l L- IT-57- G a 6,"t 71o A)S , ~
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a raw to _ t. o I ua
r, _t E ?tF € b F,,. r .,r. S. AM -F 1"J" UNLY IF AL
R SYS! ,..s RE , . E W OUT HASH,. ON S Aeta Q= NS„
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Fresh Air Inlets And Observation Pipe
Approved Vent Cap
Minimum 12" Above
Final Grade
~&V,4110k) 6
~imv#1-10N 411 Cast Iron
~o'' Above Pipe
G)~, (1,(y ro Final Grade Vent Pipe
1 ~~~y( Marsh Hay Or Synthetic Covering
Min. 2" Aggregate
f Over Pipe
Distribution Tee
Pipe 0 0 0 0 0
12- " Aggregate _ o Perforated Pipe Below
Beneath Pipe 0 Coupling Terminating At
Bottom of System