HomeMy WebLinkAbout030-2054-10-000
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Parcel 030-2054-10-000 03/08/2005 10:28 AM
PAGE 1 OF 1
Alt. Parcel 27.30.20.534C 030 - TOWN OF SAINT JOSEPH
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
" RICHERT, JARED
JARED RICHERT GRINSTEAD LISA
GRINSTEAD LISA
1353 STATE ST
HOULTON WI 54082
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 1353 STATE ST
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 0.000 Plat: 2111-HOULTON
S 30N R20W NLY 102 FT OF LOT 2 BLK Block/Condo Bldg: 3 LOT 2
EXC E 30 FT VIL HOULTON
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
3, ~i 27-30N-20W
al- 113 S y w 1Z
Notes: Parcel History:
Date Doc # Vol/Page Type
07/06/1998 582417 1337/550 PR
07/23/1997 1083/188 WD
07/23/1997 1083/186 TI
07/23/1997 589/246
2004 SUMMARY Bill Fair Market Value: Assessed with:
6166 154,400
Valuations: Last Changed: 07/09/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.000 50,000 101,900 151,900 NO
Totals for 2004:
General Property 0.000 50,000 101,900 151,900
Woodland 0.000 0 0
Totals for 2003:
General Property 0.000 23,000 76,400 99,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 , 0.00
Parcel 030-2053-90-000 03/08/2005 10:47 AM
PAGE 1 OF 1
Alt. Parcel 27.30.20.534A 030 - TOWN OF SAINT JOSEPH
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
* DULON, JEANNE M
JEANNE M DULON
1354 HWY 35
HOULTON WI 54082
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 1354 HWY 35
SC 2611 SCH D OF HUDSON / -
SP 1700 WITC I ~ J" ~G(.fiK tti) LO
Legal Description: Acres: 0.000 Plat: 2111-HOULTON
SEC 27 T30N R20W N 102 FT OF E 130 FT OF Block/Condo Bldg: 3 LOT 2
LOT 2 BLK 3 VIL HOULTON
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
27-30N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 762/177
2004 SUMMARY Bill Fair Market Value: Assessed with:
6165 148,300
Valuations: Last Changed: 07/09/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.000 50,000 95,900 145,900 NO
Totals for 2004:
General Property 0.000 50,000 95,900 145,900
Woodland 0.000 0 0
Totals for 2003:
General Property 0.000 23,000 88,500 111,500
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 505
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT
. ER~~ TOWNSHIP~y ~ SEC i
:C). ADDRESS i T N, R.~'c: W
- / ST. CROIX COUNTY, WISCONSIN.
'BDIVI'SION LOT Q~ LOT SIZE 1~5
PLAN VIEW 6-3 yC (A",,:-:; 3yA) 0 3o-o?as~-iv-~
53 yc
Distances & dimensions to meet requirements of H62.20
DoT Z~ 3
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
I -
ne ~j~t~G6'y
✓ i )
I
' PTIC TANK~~_ MFGR. ~kC t~' ~L r3 t c~ ~ , ' CONCRETE STEEL-
NO. of rings on cover_ r si De th
P 3 DRY WELL &L..,
-',"NCHES NO. of - width - length - area
no. of lines. width 2r length area
depth to top of pipe 'f
:RELATE X14 k~
RK RATE-/4!~. AREA REQUIRED L AREA AS BUILT
.claimer: The inspection of this system by St. Croix County does not imply complete
.,pliance with State Administrative Codes. There are other areas that it is not possible
inspect at this point of construction. St. Croix County assumes no liability for
-:item operation. However, if failure is noted the County wil ke ever effort to
rermine cause of failure.
_ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYST
"INSPECTOR , ~oe
DATED PLUMBER ON J kQ L
I 2
LICENSE NUMB R
I
y ,
RFP0P, IIIS1)_TJ I0_1--INDIVIDUAL -C-" S LT,
Sanitary Permit 1 -
State Septic
. ME
w T&WNSHIP a
St. Croix County
`"'TIC TA'?j'
Size gallons . 'umber of Compartments
Distance Front: Tell ft. 12% or greater slope ft.
Building` ft. Wetlands f.
Highwater ft.
DISPOSAL SYSTL:1 Tile Field or Seepage Pit(s)
Distance From: dell ft. 12% or greater slope' ft
Building ft. Wetlands f:.
FIELD t..
'Xighwater ft.
Total length of lines ft. Number of lines Length of
each line ft. Distance between lines ft. Width of the
trench -f t -
ft. Total absorption area sq• ft. Depth
of rock below tile in. pp-pth of rock over the in. Cover
:Over rock,, Depth of tile below grade in. Slope of
trench in ner 100 ft. Depth to Bedrock ft. Depth to
ground water £t.
PITS
Number of pits Outside diameter ft. Depth below inlet
-ft. Gravel around pit: __-_yes no. Total absorption area
sq. ft.
Square feet of seepage trench bottom area required
Uquare feet of seepage nit area required
Inspected by: Title:
Approved Date 197
Rejected Date 197`
TRANSFER FORM
PLB 671111111111111T SANITARY PERMIT
State Permit # 002q
Sanitary Permit #
County
Sanitary Permit Transfer Date Original Permit Issuance Date
A. Property Location: w Section -2 7 , T _3O N, R 2 ;E (ar+ W Lot # a City
Subdivision Name, Nearest Road, Lake or Landmark BLK # --3 Village 116. « /fa -n
Township 5 T:°se=
B. TYPE of Occupancy: Commercial Industrial Other (Specify)
Single Family Duplex No. of Bedrooms Z Variance
C. SEPTIC TANK CAPACITY Total gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab Concrete Poured-in-place - Steel - Fiberglass - Other(Specify)
New Installation -IJ/ Replacement
LIFT PUMP TANK/SIPHON CHAMBER Total gallons Prefab Concrete Poured-in-place -Other(Specify)
D. EFFLUENT DISPOSAL SYSTEM: Percolation Rate / 6, Total Absorb Area 61 1-c) sq. ft. e-ecj ;4t' - v,4
New "f Replacement Alternate (Specify) 6-; '>c`_= 12
Seepage Trench: No.Lineal Ft. Width Depth - Tile Depth(top)~No. Trenches
Seepage Bed: Length Width '74 Depth `70- Tile Depth(top) %~.No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. Seepage Pits
Percent slope of land
Distance from critical slope 160
E. WATER SUPPLY: ET Private ❑ Joint ❑ Community ❑ Municipal
Present Sanitary Permit Holder Phone No. ~ ' Sanitary Permit Transferred To: Phone No. tint- ' Y
Name t, _ ~'1 art ~ti %f /G Name a tLt:~ 'C,
Address c c~ ~e, i_ ~4 C Address n '~Z 'J, 6;v-
y z~
dip Zip S 1
I, the undersigned, do hereby certify that I have reported all revisions to the sanitary permit and that all revisions are in accord with
section H 62.20, Wisconsin Administrative Code and that I have sized the effluent disposal system according to the EH-115 prepared
by the Certified Soil Tester and/or any ad 'tional soil tests that may have been required.
Plumber's Signature 'iNFI PRSW # _ Z ? Phone IL } { `f
Plumber's Address r •yc 7
Y
Information obtained from (owner or agent) rT7_ 'r--Z4
PLAN VIEW: Provide sketch below of any revisions to original sanitary permit. Include direction of slope and all distances in accord
with H 62.20. Well location shall be included on the sketch. Indicate or dimension location of all wells, on the property or neigh-
bor's ropert If well has not been r~lle0pleaW in j. ~
~ g 3 _„_.C`y
i
l 3 ~ i
r Lt
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i
Signature of Issuing Agent
1. County (Yellow copy) 3. Owner (Pink copy) DIVISION OF HEALTH
2. State (White copy) 4. Plumber (Green (copy) P.O. BOX 309, MADISON WI 53701"
TRANSFER FORM
SANITARY PERMIT
PLB 67-T State Permit #
Sanitary Permit #
County
Sanitary Permit Transfer Date Original Permit Issuance Date
A. Property Location: '/4 Section , T N, R E (or) W Lot # City
Subdivision Name, Nearest Road, Lake or Landmark BILK # Village
Township
B. TYPE of Occupancy: Commercial Industrial Other (Specify)
Single Family Duplex No. of Bedrooms Variance
C. SEPTIC TANK CAPACITY Total gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab Concrete Poured-in-place Steel Fiberglass Other(Specify)
New Installation Replacement
LIFT PUMP TANK/SIPHON CHAMBER Total gallons Prefab Concrete Poured-in-place -Other (Specify)
D. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 'Total Absorb Area sq. ft.
New Replacement Alternate (Specify)
Seepage Trench: No.Lineal Ft. Width Depth Tile Depth(top) No. Trenches
Seepage Bed: Length Width Depth Tile Depth(top) No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. Seepage Pits
Percent slope of land Distance from critical slope
E. WATER SUPPLY: ❑ Private ❑ Joint ❑ Community ❑ Municipal
Present Sanitary Permit Holder Phone No. Sanitary Permit Transferred To: Phone No.
Name Name
Address Address
Zip Zip
I, the undersigned, do hereby certify that I have reported all revisions to the sanitary permit and that all revisions are in accord with
section H 62.20,, Wisconsin Administrative Code and that I have sized the effluent disposal system according to the EH-115 prepared
by the Certified Soil Tester and/or any additional soil tests that may have been required.
Plumber's Signature MP/MPRSW # Phone # -
Plumber's Address
Information obtained from (owner or agent)
PLAN VIEW: Provide sketch below of any revisions to original sanitary permit. Include direction of slope and all distances in accord
with H 62.20. Well location shall be included on the sketch. Indicate or dimension location of all wells, on the property or neigh-
bor's ro ert . If well has not been d i I
--Q R
I l ,
I
~ i
i +
Signature of Issuing Agent
1. County (Yellow copy) 3. Owner (Pink copy) DIVISION OF HEALTH
2. State (White copy) 4. Plumber (Green copy) P.O. BOX 309, MADISON WI 53701
TRANSFER FORM
SANITARY PERMIT
PLB 67-T State Permit #
Sanitary Permit #
County
Sanitary Permit Transfer Date Original Permit Issuance Date
A. Property Location: '/4 Y4, Section , T N, R E (or) W Lot # City
Subdivision Name, Nearest Road, Lake or Landmark BLK # Village
Township
B. TYPE of Occupancy: Commercial Industrial Other (Specify)
Single Family Duplex No. of Bedrooms Variance
C. SEPTIC TANK CAPACITY Total gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab Concrete Poured-in-place Steel Fiberglass Other(Specify)
New Installation Replacement
LIFT PUMP TANK/SIPHON CHAMBER Total gallons Prefab Concrete Poured-in-place Other(Specify)
D. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area sq. ft.
New Replacement Alternate (Specify)
Seepage Trench: No.Lineal Ft. Width Depth Tile Depth(top) No. Trenches _
Seepage Bed: Length Width Depth Tile Depth(top) .No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. Seepage Pits
Percent slope of land Distance from critical slope
E. WATER SUPPLY: ❑ Private ❑ Joint ❑ Community ❑ Municipal
Present Sanitary Permit Holder Phone No. Sanitary Permit Transferred To: Phone No.
Name Name
Address Address
Zip Zip
I, the undersigned, do hereby certify that I have reported all revisions to the sanitary permit and that all revisions are in accord with
section H 62.20,, Wisconsin Administrative Code and that I have sized the effluent disposal system according to the EH-115 prepared
by the Certified Soil Tester and/or any additional soil tests that may have been required.
Plumber's Signature MP/MPRSW # Phone
Plumber's Address
Information obtained from (owner or agent)
PLAN VIEW: Provide sketch below of any revisions to original sanitary permit. Include direction of slope and all distances in accord
with H 62.20. Well location shall be included on the sketch. Indicate or dimension location of all wells, on the property or neigh-
bor's ro ert If well has of been drilled
_a P._ Q . n - ipd~o
E
k
I
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g
Signature of Issuing Agent
1. County (Yellow copy) 3. Owner (Pink copy) DIVISION OF HEALTH
2. State (White copy) 4. Plumber (Green (copy) P.O. BOX 309, MADISON WI 53701"
State and County State Permit #
PLB67 Permit Application County Pe ~ it # S
for Private Domestic Sewage Systems County I`_
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
3 d
-Tb kv se .%-i
B. LOCATION: SE Y4 rtIW Section o2~ T 30 N, R,2C a (or) & Lot# ~ City
Subdivision Name, nearest road, lake or landmark Blk# - Village /X4u11yV
Township ,S/, c4SC~/i
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms .Z No. of Persons /
D. TYPE OF APPLIANCES: Dishwasher ( YES NO Food Waste Grinder YES XNO # of Bathrooms_A~_
Automatic Washer X YES NO Other (specify)
E. SEPTIC TANK CAPACITY 1000 Total gallons No. of tanks /
*Holding tank capacity Total gallons No. of tanks
New Installation X Addition _ Replacement _ Prefab Concrete X
*Poured in Place Steel Other (specify) _
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) /,0 2) _/6 3) Total Absorb Area ~sq. ft. New_ Addition Replacement *Fill System fu: rcpt
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length 41c ` Width ~Zy' Depth '3o " Tile Depth IR,• No. of Lines I
Seepage Pit: Inside diameter Liquid Depth Tile Size
Percent slope of land e 1q/AS fir/ y Distance from critical slope
`ICJ SY s f @ ~q r g
I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared
by the Certified Soil Tester/
NAME C.S.T. # 5 5 - /S-`/r/ and other information
obtained from C E d L, 0o, owner/builder)..
Plumber's Signature MP/MPRSW# 4'e/A7 Phone #71S-
Plumber's Address i
Ay/PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
' ~ YI' a~~SE. ~ G✓E~C~
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Do Not Write in Space 'Below FOR DEPARTMENT USE ONLY
Date of Application Fees Paid: State Coun y-- " Date
Permit Issued/RdOCZW- (date) Issuing Agent Name
Inspection Yes_X_No Valid# Date Recd
1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) 4. plumber (canary copy)
Revised Date 6/1 /76
EH 1.15
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
'VISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309
MADISON, WISCONSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
LOCATION: Section TAN, R iit(or W Township or Municipality -r' Cd ( L~i4> > E d~ 11*1',i~
Lot No., Block No._-_,/ ~~i9 G • //7~' 4,~T~!✓ County < < L i~}C
S division Name
Owner's Name: Z'I ,t1 3V.4-1
Mailing Address: l3c~oC r~ S/~ l~Lut9 r~r /~`l o`er u<
TYPE OF OCCUPANCY: Residence No. of Bedrooms Z~ Other
EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS - 2 -2
SOIL MAP SHEET
SO ILTYPE PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
P-
P- 3 L/ 1A.
I 121ey
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
r.
B_ / /
/eq L ~~~~/~rl~]f S,O.rt yG, "S•.r"
,
Q C 1,2,,5-,u
B- r Ice" >/C1 S- -`rte 33" 4-C,, S-?" Cd.e.ir~j}c7~r tl Sh7 Wy0,
y w
B- S /c WON ~ r- 3 y,. ,~.S, 3-6 00-/W r S,0-4r C'j / A S j c
/14/11/111 It- 7/a ~..ILr~ y~ ~0-Zzio~~~fRns~y C' Z,2 -S PLAN VIEW (Locate perco [at ion tests,soi I bore holes and suitable soil areas.) C"
Indicate on the plan the location and squar~ei feet of suitable areas. Indicate nuTber of square feet of absorption area
needed for building type and occupancy. a2, occ S« fa~~ 4 --N /21- Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope.
i I'• q i
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t f I jjj f i ~ I
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- -
74 I
777- 71_
ySI i t ! ~ ! { i
4 ~ i f I/ I I I ~ f ~ I C~~I s I i~ 4 < - f Iy~ j.
- - _ - fTZ ~C ~J
l s t 1 vI>/ y' IL
i ✓ i i l
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i
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 location of test holes are correct
to the best of mjy~knowledge and belief.
Name (print) '4 ~ A c l~ d_ l e I. Certification No.
Address /l ~c t'_ CC ke <S
Name of installer if known
ppqq P CST Signature -