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HomeMy WebLinkAbout020-1148-20-000 i 0) O y C O II n O o v 0 4, CD A c c w 0 C • o < fl- N (D 3 C p m o ~ ca co N ~ ~ O A O O 00 _ O ! O_ a/ N N (D i V p ~S 10 CO (D 0 awn O O Cn c p O 3 N ~ ~ O O N N ccn C (J Cl) m m u? m (n a C) m c~ a N c o m rn C CD CD lot x7yd ~ O N w G o O CD 0 r cn G a G N co w s 3 0 c r. to UQ ' a n rr o " 8 o w G H z o o 'D 'D CD o t-i C 1-11 C 5 cn v_ * * * a n ~y (D ? 3 cn en cn ° o p b H rh (D G a m coo (D v n A.. N !r H. O In (D CD , A N r• 0 ~ ° w rh o tJ CD Co z Q O N o IV O Z C cc) o ~ D n n o' • O O Cl) C, G ~ m m N c CD C. Cl) n w m a- rt rt a 3 rt r• Z CD -i C/) O 0 o A Z M N c ~a 4- En, r. n :0 a a 0 W p.. W Iv (D W O Z N w C W m D r. O Z FJ p Cl) I G 3 m m w a N m (D O ~ w o Q c v n a CD 3 ff CD o o m c a 3 7 0 ° N (D N CO Q a v - I (D ~ y n = A N d 77 A D = Q (D 7C Q N N N 7 W N n ~ N ? (D O CD a N A O (D GQ n O n` W of ti b O N 0 Parcel 020-1148-20-000 02/23/2006 08:14 AM 1 PAGE 1 OF 1 Alt. Parcel 33.29.19.790 020 - 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 - SEVERUDE, DOUGLAS & APRIL DOUGLAS & APRIL SEVERUDE 650 COUNTRYSIDE CIR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 650 COUNTRYSIDE CIR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.060 Plat: 0215-COUNTRYSIDE VILLAGE SEC 33 T29N R19W COUNTRYSIDE VILLAGE LOT Block/Condo Bldg: LOT 4 4 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 33-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 2005 SUMMARY Bill Fair Market Value: Assessed with: 92658 186,000 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.060 75,200 114,500 189,700 NO 05 Totals for 2005: General Property 2.060 75,200 114,500 189,700 Woodland 0.000 0 0 Totals for 2004: General Property 2.060 30,300 92,700 123,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 105 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 l AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP' -SEC.,_- T N-R/ ADDRESS rf✓`ST. CROIX COUNTY, WISCONSIN. SUBDIVISION a LOT ' LOT SIZE PLAN VIEW Distances and dimensions-to meet requirements of H63 1; 0 hL__EyEBYTHING WITHIN 100 FEET OF SYSTEM -17 i r- I di a e No thl A ro i SC LE: I BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical reference point: '7-/ Slope at site: SEPTIC TANK: Manufacturer: Liquid Capacity: Number of rings on cover : Tan manhole cover elevation:, _/.,r Tank Inlet Elevation: f:=r 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 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 ccver Type of warning device- SEEPAGE PIT SIZE: Number o pits feet diameter feet liquid depth- seepage pit in et pipe-elevation bottom of seepage it E e~vation feet. SEEPAGE BED SIZE: number cf lines ___2 _width le-agth the depth " SEEPAGE TRENCH: width length - 2 "AREA AS BUILT PERCOLATION RATE s~ s z AREA REQUIRED INSPECTOR DATED PLUMBER ON JOB LICENSE NUMBER 1 DEPARTVENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR &J1UMAN'RELATIONS PRIVATE SEWAGE SYSTEMS / DIVISION P.O. BO'X 7969 BUREAU OF PLUMBING MADISON, WI 53707 CONVENTIONAL DALTERNATIVE IS,,,, Plan LID, Number (If assigned) ❑ Holding Tank D In-Ground Pressure ❑ Mound NAME PERMIT HOLDER. ADDRESS OF PERMIT HOLDER. INSPECTION DATE. 0 S er BENCH MARK (Permanent reference pomt) DESCRI E IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV. S _cc -3 Nam Pof Pl.mbe IMP/MPRSW No.. ou my Sanitary Permit Number: .;2 jo 5- L SEPTIC TANK/HOLDING TANK: r n MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV. WARNING LABEL LOCKING O i PROVIDED: PROkID T1".7 ) 18.2e YES ONO t3 ES NO BEDDING. VENT DIA.. VENT MATL. HI(;H WATER NUMBER OF ROAD: PROPERTY. WELL. BUILDING VEN TO FRESH ALAHM !j FEET FROM LINN l , AIR INLET. ~ES ONO DYES N NEAREST rJ J'' DOSING CHAMBER: MANUFACTURER BEDDING. ILIOUID CAPtCITV PUMPUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER / PROVIDED: PROVIDED. DYES ONO DYES ONO DYES ENO /I Z_ - - GALLONS PER CYCLE: 17Z7ERATIONAL NUMBER OF PIIOPERTY WELL BUILDING ( VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM I NE AIR INLET PUMP ON AND OFF) ONO INEAREST SOIL ABSORPTION SYSTEM. Che then ilmo ureat edepth of lowing InC.1FIEH IMATIRfALANOMARKING or excavation. (If soil can be roll d into a wi , construction shall ce se until FORCE the soil is dry enough to contin - MAIN CONVENTIONAL SYSTEM: WIDTH' LENGTH NOOF DI STR PIPE SPACING; LOVER JINSIDE DIA i1P LIQUID BED/TRENCH TREN HES LAA~RIAI PIT DEPTH. DIMENSIONS I O; -5'- ( f, J- CH,','A ( I`F PTII FILL DEPTH DISTR PIPE DfSTR PIPE DISTR. PIPE MATERIAL - IN H. NUMBER OF PROPERTY WE L'. BUILDING. VENT TO FRE BFI ( PIPES ABOVE COVER ELEV.LNLEr ELE/-END. PIPE FEET FROM , uNE,,- AIR INLET- Q1 ,rl 9 .7 NEAREST-s- MOUND SYSTEM: i .1 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 pertain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for mediy, sand. TIONS MEASURED. DYES ENO SOIL COVER. TEXTURE PERMANENT MARKERS OBSERVATION WELLS I, t' DYES ONO DYES NO DEPTH OVER TRENCH: BED DEPTH OVER TRENC ;BED 11111TH OF TOPSOIL. .'SODDED SEEDED MULCHED CENTER EDGES F` OYES ONO DYES ONO DYES ONO PRESSURIZED DISTRIBUTION SYSTEM: `INIDIH LENGTH NO. OF LATERAL SPACING . GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER BED/TRENCH TREY iEs DIMENSIONS MANIFOLD PUMP ANIFOLD DISTR PIPE MANIFOLD MATERIAL. NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING. F LFv.. + ELEV. DIA. ELEV. PIPES DIA.: ELEVATION AND INFORMAT I ON HOI E i17E HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED DISTRIBUTION PLANS. EYES ONO DYES ONO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF 1PR OPERTY WELL: BUILDING. FEET FROM LINE -1 YES ❑ NO ❑ YES ❑ NO NEAREST-~rI - - - / 2, S~ o 13, 7y' Sketch System on Retain in county file for audit. Reverse Side. ' ~SIGNATURE. TITLE DILHR SBD 6710 (R. 01 /82) ' I 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. Proper Owner: ~ Mailidress: r' Pr rty Loca n: City,, Village or Townshp: / County: '/4 5~ '/4S ~J iT Z N/R < i iyGl%iC Lot KILumber: Blk No.: Subdivision Name: - Nearest Road, Lake or Landmark: State Plan I.D. Number: ` l (If assigned) ru _k 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 i HOLDING TANK CAPACITY A) a LIFT PUMP TANK/SIPHON CHAMBER _Aig MANUFACTURER: I EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): New ❑ Replacement ❑ Experimental Seepage Bed ❑ Seepage Pit - ❑ Alternative (specify) ❑ Seepage Trench ` ~S S i0 Water Supply: Owner's Name as 4isted oil Teeport (If other than present owner): Private El Joint ❑Public r- t I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of PI er: Signature: / MP_/MPRSW No.: Phone Number:: a q -Z ( ✓ fv `O~i ~ Plumber's Addre : Name of Designer: M, r COUNTY/DEPARTMENT USE ONLY ignat a of Issuing gent Fee: Date: 1 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) f ~f f. ~ rf X - 5~z- I , may- /~J p ~ `1 - _ ~ µ ~ I ~ w ~ ~ ° _ { ~ ~ _ ( ~ y ~ ~ ~ ~ ' ~ ~ ~ ~ ~ ~ C ~ ~ ~ i ~ ~ r C\V . ~ ~ ~ > ~ ! ~ ~ ~ ~..J,~ ~ ~ r f ~ ~ r _ „P t ` / ~ ~ ~ I ` e ~ ~ l j j ~ l h r (!U Y Trf- / ~/AFEIT & BUILDINGS INDU8 TMENT OF REPORT ON SOIL BORINGS AND""' NDUSTRY, ©~'V DIVISION LABO~ AN, $ 1' P.O. BOX 76 HUMAN REDLATIONS PERCOLATION TESTS (11 0*11 / - ISON W 53707 76-6 LOCATION: SECTION: TOWNSHIP/ LOT NO.:BL `I I NAME: NE ~4SE~/4 33 /T29 N/1119 b) W Hudson 4 r side Villa-,e COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: St. Croix Francis H. Ogden 1123 E. Elm St., River Falls, Wi. 54022 USE DATES OBSERVATIONS MADE NO. BEDRMS.: ICOMMER(-,!/-\L DESCRIPTION: R OFI LE R TONS: ER A ION TESTS: Residence 3 ®New ❑Replace 1154/22/82 None NjA RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) ES ❑U ZS ❑U 11 ❑ S Eli ❑ S ©U ❑ S ❑ U Conventional Bed 18x55 If Percolation Tests are NOT required 7SIGN RATE: SYSTEM ELEV. ~If any portion of the lot is in the 411X under s.H63.09 ' dicate: 10 913.5 Floodplain, indicate Floodplain elevation: NO CLASS 2 PROFILE DESCRIPTIONS PG 66 Bx D2 BORING DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEF'-iH IN, ELEVATION OBSERVED EST. IGH_EST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 6, Bl sil; 24, Bn sl; 32, Bn cs; 18, light Bn s; B 6 124 920.4 None > 124 34, light Bn s w/small pockets & streaks of dark sl. 2, B1 sl; 30, Bn sil; 12, Bn s; 12, Bn si; 48, Bn B-7 114 917.8 None 114 & Bn si layered w/ pockets of P G $ orange MOT. B-7A 116 918.8 None 7 116 Z, B1 sl; 42, Bn sil; 62, Bn s & gr. 2, B1 sl; 48, Bn sil; 42, Bn s & Bn si layered B-8 1102 917.0 None 7 102 AT/Pockets of P G and orange MOT. B 8A 114 1 8, BI sl; 36, Bn sil; 60, Bn s layered. None B- 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 PERT D PER INCH P- P- P- P- P- P- PLAN VIEW: 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 slop. SYSTEM ELEVATION 913.5 NE CORNER OF LOT 4 OTE: ALTERNATE SITE WAS TESTED PREVIOUSLY AND DATED 7/17/81 LEGEND C D BORING SITE 918.0 Ex. Gr. rG~ O 1 IRON PIPE - I - 917.0 Fin. Gr. 1#121 B-7 SCALE 1" = 401 B~7A 6~ 91$ _ _ 140.' 4 ° Q SIG I xis r o 917.*0 Ix. Gr• off' To of 1" Iron I a7 B-g~ n, Gr• LOT CORNER w Pipe 919.50' B_6 7° 91 919.5 Ex.Gr. 1131 3,9-30, 917.5 Fin.Gr. a 919, 3 BENCH MARK - TOP OF I" IRON PIPE ~ . 917. S x G~ , ELEV. 925.83 _ r• ' GOG~~G i, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures thods specified in the Wisconsin Admimistrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print)alter J. Gregory TESTS WERE COMPLETED ON: 4/26/82 ADDRESS: 123 E. Elm Street CERTIFICATION NUMBER: PHONE NUMBER optional): Job No. 76-665 55-588 1(715)425-763-1 CST SI1 G R : ,~CVCC~' DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. DILHR-SBD-6395 (N. 03/81) REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS DEPAR1rMENT OF DIVISION I, '969 LABOR AND ~ X 3707 'A PERCOLATION TESTS (115) ' S~O '1l43707 LABOR MADI HUMAN RELATIONS Job ? fNie+ AtIT-V- LK. NO.: SU ~O ISIQIp~~ N) LOCATION: SECTION: TOWNSHZMD 1 1 O T. N R ) W F Idq 'Si /L /4 / / WNER'S BUYER'S NAME: A LI A COUNTY: N/ 8 ;t Croix Fru leis H. Cr=:°n 123 E. Elm St . , River Falls , i~'i. d220fFj N~ DATES OBSERVATIO DE USE S: NO.BEDRMS.: COMM R AL S R TION: ®New Replace 4/22/$2 111 ; A OResidence 3 A11,4 liat RATING: S= Site suitable for system U= Site unsuitable for system ONVENTIONAL: MOUND: IN-GROUNDPRESSUR_ ' SYSTEM. i N I LLOLDING TANK: RECOMMENDED SYSTEM: (optional) c ❑u S Qu S ❑u ❑ S ®u ❑ S QU Copven::ion l Ded 18X55 J RATE: If any portion of the lot is in the F rcolation Tests are NOT required DESI GN 9-,?.s CVO r s.H63.091511b1, indicate: , Floodplain, indicate Floodplain elevation: r, PROFILE DESCRIPTIONS PG 66 BX D BORING TOTAL PTH 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.) F;i: sl; i]~:_ i.:..S> 15, IiT11-: a^ B '4, li r,~ br: s 11 pet hers streaks of dark - 19 12, Bl s1; 30, Ian sil; 12, 3n s, 12, In si, 4~, 7 B- ' , i- • ; ~ 114 F q si 14vered w/pockets of F U r oran A14 i s i , 4 ~ , bn s it ; fit liTi s (r . g 116 1. 4, ,51. ~ , 1;a s Z jr 3 0' i CN' x1d Or 1n _ 1cr1 . B- 1 TO S:l , 36, Itl sil; 60, hr, s ?avered. ,1. B PERCOLATION TESTS TEST NUMBER INCH S AFTERSWELOL NG INTERVAL-MIN. P I p 1 DROP IN WPERI LDZ LIN HESP RAPER INCHES P- P- P- P- P- P- PLAN VIEW: 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 stop. 0-, i'YL: CLi l : 01' Lr%i SYSTEM ELEVATION .0 1- T - - • l I x* l } I ; I 3 i IN _7V - . 4 4'o t € I, the undersigned, hereby certify that the soil tests reporOd on this form were made by me in accord wkh the procedures methods specified in the IKRconsin Admimistrative Code, and that the data recorded and the location of the tests are correct to the best of my imow{edw and belief. TESTSWERE COMPLETED ON: NAME (Print):. - CERTWICATION NUMBER: PHONE NUMBER optional): ADDRESS: ; , - CST W-NATUR E: DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th par4oil Tester. DI LHR-SBD-6395 IN. 03/81) ON SOIL BORINGS AND SAFETY & BUILDINGS REPORT DIVISION DEPARTiVIENT OF P.O. BOX 7969 INDUSTRY, PERCOLATION TESTS (115) MADISON, WI 53707 LABOR AND HUMAN RELATIONS n • I T BLK NO.: SUBDIVISION NAME TOWNSHIP/MUNICIPALITY: ~3 I 4 v.,:. 1 FCOUNITY: SECTION: ..1/4orl W n R MAILI OWNER'S BUYERS NAME: ,.fir T 12~ jJ~., 't tam r* ` DATES OBSERVATIONS MADE " TS: ,,r~,m USE - NO. BEDRMS. COMM R AL D S RI TION: New Replace ` ❑ R esidence - - - ! RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GR0111, F~SURE: S STEccM-IN-FILL OLDINNG TANK: RECOMMENDED SYSTEM:loptional ❑c ❑u ~J ~J ~v 0J QU OS [3 v DESIGN RATE: If any portion of the lot is in the lain elevation: ; rurnpd,,~:s.1466'33.09(5)(tb), rolaton Tests are NOT required t; _ Floodplain, indicate Floodp indicate: ABBESS ON BACK TEXTURE, AND DEPTH PROFILE DESCRIPTIONS r CO OR, TAL PTH TO GR UNDWATER-INCH SES TCHARACTER O BEDROCK IOF OOIL WIT (SETHICKN . HE D E ±-_I BORING TO ELEVATION OBSERVED E T ? "T NUMBER DEPTH I N, - } €111"Cry O_ 511: Im J 3 r-v i L PERCOLATION TESTS RATE MINUT TEST TIME PIN WATER LEVEL-INCHES PER INCH Ts- TEST DEPTH WATER IN HOLE P RIOD NUMBER INCHES AFTERSWELLING INTERVAL-MIN. RI D1 P- P P- P- P- P=_ PLAN VIEW: 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 an percent of land slop. / / i SYSTEM ELEVATION ..r -ID, 17 TP N r 77 Lr~ 21 Hit j_ I specified in the Wisconsi undersigned, hereby certify that the soil tests reported on this form were rude by me in accord with the procedures metfiods Admimistrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belie I, the :qE ST S WERE COMPLETEDON: NAME (print RTIFICATIONNUMBER: P'HONENUMBER optional): ADDRESS: CST SIGNATURE: rty Owner, 4th page-Soil Tester. DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-PirWe