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Parcel 020-1152-00-000 01/18/2005 09:45 AM
PAGE 1 OF 1
Alt. Parcel 29.29.19.828 020 - 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
* DEGRAFF, JOHN R & DEANNE
JOHN R & DEANNE DEGRAFF
713 GLENNA DR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 713 GLENNA DR
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 1.010 Plat: 2356-PRESIDENTIAL ESTATES
SEC 29 T29N R19W PRESIDENTIAL ESTATES Block/Condo Bldg: LOT 19
LOT 19
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
29-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
'
2004 SUMMARY Bill Fair Market Value: Assessed with:
48914 246,800
Valuations: Last Changed: 07/21/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.010 27,100 163,800 190,900 NO
Totals for 2004:
General Property 1.010 27,100 163,800 190,900
Woodland 0.000 0 0
Totals for 2003:
General Property 1.010 27,100 159,000 186,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 202
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
a
c .A
AS BUILT SANITARY SYSTEM REPORT
OWNER. JOHN DeGRAFF TOWNSHIP- HUDSON SEC . SE4TSW~Tw-Rp1• 2
9 X
ADDRESS % Paul Paulson, Route 5 -East-
ST. CROIX COUNTY, WISCONSIN.
River Falls, Wisc. 54022
SUBDIVISION PRESIDENTIAL ESTATES- LOT-- 19 LOT SIZE
PLAN VIEW
Uis trances and dimen:a iou;s Co utc-c,i rrrilt, i r~ uu tti 1 1103
:aTiOW_ 1SV"Y''11 NG W l'lil t IJ I()() SYs'
44
- -
1.
t
_ 4, T VC,
2 7T
I f
I - - - - - - I
- - L1. -E - -
hortli' A r, I-( 11"I
BENCHMARK: (Permanent reference Point) Describe:
~ 01`` LU'T
Elevation of vertical reference point:
Slope at: sitr.: Ylo _
-
W z. ,
SEPTIC TANK:- Manufacturer: <'O-EV~,
~ - l-
Number of rings on cover Liquid Capacity:
Tank manhole cover elevation:%Tank Inlet Elevation -'F
~y 'lank Outlet: Elevation:
PUMP CHAMBER
Manufacturer: Number: of gal-ions
Number of ga 1 . P umP s e t To-r- - a- -c-yc --l-
e -
totrj c_apa~ its of
distribution lines llarl----.- size o._gallons; pump
ga-
gallon per minute head;
- horsepower -
and -
model number - brand name of pump
Type of warning device
HOLDING TANK: Manufacturer
g ~1It:>ns
Elevation of manhole cover Norther of
Type of warning device Y -
SEEPA~E PIT SIZE: ---Num er o-its -
seepage liquid depth - r . e e t iamet-er_- `
page pit- inlet. pipe-elevation
bottom of seepage pit elevation feet.
SEEPAGE BED SIZE: number of lines - width_~ 1e-1igth S.,Z rile depth q;2
SEEPAGE 'T'RENCH: width- len i:}1
PERC ZRATE
- ----D-
-AREA REQUIRE_ L- 9 _--AREA AS BUILT--Z,-A-
i
Il r J /~~r y INSPI:C'm1O
PL.UMBL k ON JO
LICE'NSE NUMBE1
DEPARTME1\'1 OF INDUSTRY, INSPECTION REPORT FOR ' C) SAFETY & BUILDINGS
LABOl HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS " ° DIVISION
P.O. 94 7969 ~ BUREAU OF PLUMBING
MAD( Oe~, WI 53'707
® CONVENTIONAL O ALTERNATIVE State Plan LD Number.
~
(II assigned) 7:1
E Holding Tank ❑ In-Ground Pressure ❑ Mound
NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER. INSPECTION DATE
H A,1
BENCH MARK (Permanent reference pond DESC B F DIFFERENT FROM PLAN. REF. PT. ELEV.. CST REF. PT. ELEV.
IN am mber JMPIMPRSW No jC..my. Sanitary Perm, N,m//be,
4
Di R 1 r
CA _ V ~f
SEPTIC TANK/HOLDING TANK: Z
MANUFACTURER LIQUID CAPACITY. TANK INLET ELEV.'. TANK OUTLET ELEV. WARNING LABEL LOCKING CO EkF'
f ~y^~ PROV ED'. PROV ED
YES ONO ES NO
BEDDING. VENT DIA.. VENT MATL. HIGH WATER / NUMBER OF ROAD~. JPROPERTIY W/~j BUILLDING. VENT TO FRESH
ALAR 1" r~' FEET FROM L" % Q~ /,{J - ,y Q AIR INLET:
OYES ONO ~r'f❑❑O NEAREST r
DOSING CHAMBER:
MANUFACTURER BEDDING. jloUID P V MP MODEL 1PUMP,SIPHON MANUFACTURER WARNING LABEL LOCKING COVER
PROVIDED. PROVIDED.
OYES O OYES ONO OYES ONO
GALLONS PER CYCLE: PUMP AND CONT ROLS OPERATIONAL NUMBER OF PIII11 TV WELL BUILDING (VENT LE FRESH PER (DIFFERENCE BETWEEN FEET FROM LNE AIR
INLET
PUMP ON AND OFF) DYES 01\11_ NEAREST ]IN
SOIL ABSORPTION SYSTEM. Check thesoil m istureat the depth of plowing L ~NrI rII AMIIE11 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 LENGTH INOOF IDISTR PIPE SPACING CUVfR - INSIDE Dln -PITS LIQUID
BED/TRENCH F TRENCHES MA1-1-AL PIT DEPTH.
DIMENSIONS
773, .I I 7 IF PTH` K ILL DEPTH DISTR. PIPE pISTR. PIPE DISTR. PIPE MATERIAL. NO. DISTR NUMBER OF PROPERTY WELL BUI VENT TO E
EF ~IPF ; ABOVE COVER ELEV. INLF T EL V. END PIPE LINE AIR INL
d 1 FEET FROM C"
NEAREST--s
MOUND SYSTEM: 5 c~ . 0
Mound site plowed perpendicular to slope CXhe ure of the fill material for PROVIDE A DIAGRAM OFSYSTEM
and furrows thrown upslope: mmake certain that it ON REVERSE SIDE. SHOW ELEVA-
mi or medium sand. TIONS MEASU RED.
OYES NO
SOIL COVER. TEXTURE PERMANENT MARKE RS. OBSERVATION WELLS
I OYES ONO OYES ONO
DEPTH OVER TRENCH BED DEPTH OVFH TF N HBE DEPT F T PSOI ISODDED SEEDED MULCHED.
CENTER EDGES
OYES ONO OYES ONO OYES NO
PRESSURIZED DISTRIBUTIONS TEM:
WIDTH LENGTH NO. OF LATERAL CI AVEL DEP PIPE FILL DEPTH ABOVE COVER
BED/TRENCH TREN iES.
DIMENSIONS
MANIFOLD PUMP /,11ANIF LID DIST IPE MANIFOLD MA=MATERIAL DISTR. PIPE DISTRIBU710N PIPE MATERIAL & MARKING
ELEV. ELEV. DIA FILE DIA.:
ELEVATION AND
DISTRIBUTION
HOLE SIZE HOLES ING ED CURRIE LV COVER VERTICAL LIFT CORRESPONDS TO APPROVED
INFORMATION PLnnls
❑Y S NO OYES ONO
COMMENTS: r ANENT MARKERS JOBSERVATION WELLS NUMBER OF PROPERTY JWELL: BUILDING:
s FEET FROM LINE
✓f EYES ONO OYES ONO NEAR ST-'
e'~ f
Sketch System on Ret n county file for audit.
Reverse Side. -
SIGNATURE. TE-.
DILHR SBD 6710 (R.01/82)
DEPARTMV.NT OF APPLICATION SAFETY & BUILDINGS
INDUSTRY, 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'/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. The owners copy or a legible reproduction of the soil test report must be
included. rJ
20 - (5 &)6 0 D
Propert er: U Maili Address: 4 /
22 A- A
Property Location: City, Villa e Township: ounty:
Lot Number: Blk No.: Subdivision Name: / Nearest Road, Lake or Landmark: State Plan I.D. Number:
r / (if assigned)
/ rte: ,
TYPE OF BUILDING
Number of
❑ Public* ❑ Variance* ❑ Other (specify)* Bedro
❑ 1 or\Family *State Approval Required. I
TOTAL NUMBER PREFAB POURED-IN NEW REPLACE- OTHER i
GALLONS OF TANKS CONCRETE PLACE STEEL FIBERGLASS INSTALLATION MENT (Specify)
SEPTIC TANK CAPACITY
HOLDING TANK CAPACITY
r
LIFT PUMP TANK/SIPHON CHAMBER
MANUFACTURER: 6A ae.&L,
EFFLUENT DISPOSAL SYSTEM
PERCOLATION RATE ABSORPTION AREA
(Minutes per inch): PROPOSED (Square feet): New ❑ Replacement ❑ Experimental Seepage Bed ❑ Seepage Pit
❑ Alternative (specify) ❑ Seepage Trench
Water Supply: Owner's Name as Listed on Soil Test Report (if other than present owner):
Private ❑ Joint ❑ Public
E
I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
e o N7l Signature: MWMPRSW No.: Phone Number:
C • J
Plu Address: Name Flesig er:
f
tZI
COUNTY/ DEPARTMENT USE ONLY
Si n ture of Issuing Agent: F e: Date: Sanitary Permit Number:
~(Jj,
❑ APPROVED
i ❑ DISAPPROVED `l t' I
4
Reason for Disapproval: : J
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 (N.03/81)
INDUS
DEF"ARTMET OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
NDUSTRYY,, DIVISION
LABOIP AND PERCOLATION TESTS (115) MADISP.O. BOX ON WI 7969
HUMAN RELATIONS
p (H63.09(1) & Chapter 145.045)
L~ ~ I ~/~/a ~ ~10/~~ N~R ~ (o TOWNSHIP. Y: LOT NO.:BLK.NO.: SP,f.~~0as7r,~t ME:
dl~fgr/
C~OUNeY~'~~,K J /BU„~E NAME: MAILING ADDRESS:
l~ ~~J/ A' Kit : ~~C3 ~s I f e 7 ~~E3
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: PERCOLATION TESTS:
Residence New ❑Replace
51; /'tire l f e~ i f 1 ~G+-.
RATING: S= Site suitable for system U= Site unsuitable for system %or
'"t
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING -rXN R COMMENDED SYSTEM:(optional)
RIS ❑U ZS ❑U ~ S ❑U S 'XU S XU If Percolation Tests are NOT required DESIGN RATE:. If any portion of the tested area is in the
under s.H63.09(5)(b), indicate: I Floodplain, indicate Floodplain elevation: IOV/10,V
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.)
B- ~•fw~,?r` `•y ' 0-
B- 'T 1,0S1' j "-.2 s"V1W.1C 7 /fi) S-" ~ a /3! S / + r 3 rr C s
B- a✓ / Yi
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH
P- ! 0'' /V c 3
P_ W14" 'gzo .2
P-
P_ .
P_
2..
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.
SYSTEM ELEVATION
r
fie
t~~e
eA
r
-A Y /t7A.' le~ W~ 01040 4 -9-
IlRd"c'41 /641A t ~44~ 4
01
70/0 A N.
LC .1"
1,4
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
ministrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
E (print): TESTS WERE COMPLETED ON:
f +V
DRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional):
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-/l_,~u►. ,mod /S-9g/
ST G TUBE:
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CROSS SECTIDKA OF A BED SYSTEM
SOIL FILL 2 OF AGGREGATE
DISTRIBUTION PIPE-
APPFZCOVED 5y3KITHE7IC COVE
MATERIAL OR 9u OF STRP.In/
OR MARSH HAb
",yrt
oho on
° lo'0FAGGREGATE
ELEV. OF 96sgFEET_~
DISTRIBUTIO►J PIPE TO BE AT LEAST = IUC..HES BELOW ORIGIIJAL GRADE
A►JD AT LEAST?-0 INCHES BUT 1.70 MORE THA1J tit IMCHES BELOW FIAIAL GRADE
MAXIMUM UEP-I H OF 1=XCAVATIOKI FROM ORIGIQAL GRADE WILL BE WC.HE5
MINIMUM DEPTH OF EXCAVATIOM FROM ORIGIUAL GRADE WILL BE INCHES
51G1JED:
LIGEIJSC FIUMBERAlw. k ~
II ✓
'i
DAT E : ---.1_~~1_ -
l
l -
Owr?'s r l s name NO.
w
H63.05 PWT 111,t"N
Show:
(~-7 Location of bu?-ldinq servt-cd DcsLn,; CCGli?t~u_'Y
Septic tank Vertl c.1l r t f~>r < 1 - r ~i nt:
~ Building sewer Horizontal ref(-Fnce FxAnt
Effluent system Well.
Replacement system area Property lines vil'in 50, of sy: ter.
Distribution boxes
:-ca1E_ -1 , or dz ens nt~1
F A
Pump and controls:
Mfr. & Model No. V~ rtica l Lift Si•r.e EOI e ,
Friction Loss T. D. H. Vol. Dist. Pipe Gal, per Min. Gal, n,-r Cvcl-o
Place check mark in appropriate box, indicating item is shown on plot plan c•~rlow:
i
f
` I
1 ~ t
1
i
j
N ,
1-
~1) ' I
r
L
By the granting or approvinq of the al.,,ve plan, or ufx~n the event of a sub~Ii-quen±
c'tlTilt being lssued'a , _ ~•')e County and thl-, ;'~~LLnty 7.eni rig AdmLnistratOr, cj i`
r:_ t assume or hold its 1 liable for airy do-fee*s 'f! plan or. specifications, p1~3..
~h ("~C :'~f t-UCtI!iil, or ~r^y ddt ~•ecj that m,ly reSUlt In w
r In atlon.
n.
t
1
IIL
PAGE OF
W TJ ~j. S ~ A F1 C
CROSS SECTIOIJ OF A BED SYSTEM
Roo~a= ~IU~SH~D Gr~~
F11.7N.t~ G~u,y'.,~
W\xo 14Z,
SLUP~ 12 ~2AINi4 _ 1 Attic
SOI 2 OF AGGREGATE
_ a- L FILL-~
PVC
DISTRIBLITIOK3 PIPE APPROVED SYQTHETIC COVEF
1'IATERIAL OR 9" OF STRAW
OR MARSH HAy
1o'OF%2-2~~ `AGGREGATE
FEET--,-
ELEV. OF
6~TTD YI of T✓'L`
DISTRIBUT1OM PIPE TO BE AT LEAST 4 - UCHE5 BELO-J ORIGIIJAL GRADE
AOD AT LEAST 20 I"LHE5 BUT FJO MORL THAL] 92- IUCHES BELOW FWAL GRADE
MAXIMut,% DEP-1 H DF LXCAVATIOU FROM ORIGIQAL GRADE '-JILL 6E IQC-HE5
p'WJMUM DEPTH DF EXCAVATIOU FROM ORIGI►._1AL GRADE WILL BE INCHES
516 FJ E D : I lt~ce - J~5
LIGE►JSE 1JUMBER:
DATE:
` ST. CROI X COUNTY
y`` ;art{ WISC0NSI N
s
ZONING OFFICE 796-2239
I'
HAMMONDf WI 54015
November 30, 1982
State of Wisconsin, DILHR
Division of Safety and Buildings
Bureau of Plumbing
P.O. Box 7969
Madison, WI 53707
Dear Sir:
Enclosed please find the corrected copy of the PLB 67 form for
Mr. John DeGraff.
When it was sent in before, one of the section was not completed.
If you have any questions on this matter, please feel free to
contact this office.
Sincerely,
THOMAS C. NELSON
Assistant Zoning Administrator
wjo
Enclosure: PLB 67 for John DeGraff
1
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