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HomeMy WebLinkAbout032-1087-40-000 ro v ro ~ ~ ro C J. -I 2 Ian N J Z Z S c J Z Ch W O O W W Nv~ N N O N W C` N "a~ J A N O I_ m C N X O n O i'a O O O C f! (T Z O _ N N O CO 7 O O co J - J ;C C ~ V1 7 N 7 f/ O to In W N f/I W 'h¢M N C N CD N G D m a w z" m R- w ip N I:n Ll V D GIs Q V_ Ul T .~7 ~ W; 3 ` - = O Cl) N O O 0 (D J (n N In O Z J p r c co co a ad co N w-ft N "0 0 0 0 0 0 0 "h 0 co F i'c tin N Ln u N y cn p D 4f N U O o m v 0 O a o N ~ tp _ ro N ro ro O d N 7 d 7 w ro ro O z co pZ ZD OJ z V D ° c a (D 0 o IT T (D (p m ( (D ro tiM m N CD N Q Jl a cn ti a v Or~ m m - co m CD- - a 19 Z u o s o c c ~a a Z cn i w m Co m f l w N z 0 3 0 O - O " m 3 3 y z N Z (D (D A ~ Nip C _5 ;D C CL 'iCl. 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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 - KOONCE, JOHN P & NANCY A JOHN P & NANCY A KOONCE 1821 37TH ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 1821 37TH ST SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 5.000 Plat: N/A-NOT AVAILABLE SEC 32 T31 N R1 9W 5A IN SE SE LOT 8 CSM Block/Condo Bldg: VOL 1/130 EXC TO TN IN 616/174 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 32-31N-19W Notes: Parcel History: Date Doc # Vol/Page Type 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/24/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 58,000 104,100 162,100 NO Totals for 2006: General Property 5.000 58,000 104,100 162,100 Woodland 0.000 0 0 Totals for 2005: General Property 5.000 58,000 104,100 162,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 115 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 R rCy~r' l u -~ti ~ , TOWNSHIP SEC. T ~ N, R J~ - W C ,.7. Al?L'RESS< 7~1V L>h_\' !;',._e• , ST. CROIX COUNTY, WISCONSIN. PC_ Z LOT LOT SIZE CS O r 11 3 PLAN VIEW -Distances b dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 1 _5 . y6 _ r ^TIC TANK (S)_1_ rff GR. ~ CONCRETE ` STEEL NO. of rings on cover Depth DRY WELL INCHES NO. of width length area no. of lines width length > area ,r depth to top of pipe ' REGATE _ i RATE AREA REQUIRED AREA AS BUILT ci :claimer: The inspection of this -system by St. Croix County does not imply complete j 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 -tem operation. However, if failure is noted the County will make every effort to .ermine cause of failure. ]ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. DATED r PLUIfBER' ON JOB LICENSE NU,fBER 4 i z . REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM ► San.itatcy Petcm,it- State Septic NAME Township St. Ctco.ix County Location -41 o4 Section - T N,R W SEPTIC TANK Size gattons. Numb etc 4 Compatttmentts ~ F Dots ance Ftcom: UleZZ it. 12% otc gtceatett 6tope --it Buitd.ing it, Wettand~s j Highwatett it. DISPOSAL SYSTEM Distance Ftcom: WeZt 120 on gtteazetc zZope it. Bu.itd.ing it. Wettands Ft. H.ighwatetc FIELD DIMENSIONS: width o6 ttcench-/, it. Depth o6 ,cock b eZow tite / ` in. Length o6 each tine it. Depth of tcock ovetc tite .in. Numbetc: o6 tine/s Depth o4 tif.e betow gtcade in. Toxat length o6 Z ine6s ` it. Sto pe o6 ttcench in pets 100 it. '7 % D.is Lance between Z inez At. Depth to b edtto ck it. ~ Totat abs otcbtion attea -/i t 2 Depth to gtcou_ndwatcrc _6t. Requined atcea it 2 PIT DIMENSIONS: Numbetc of pitz Gtcavet astound pith yet6 no Outts,ide diame et/ 11i Depth below -intet ~ . T o t a.2 ab s o tcb t i,o ntt e a; it 2. z 2 Anea ttequitced it rn INSPECTED BY TITLE ~i APPROVED ~L} ,'SATEC, 197. REJECTED DATE / 197 State Permit PLB67 State and County Permit Application County Permit # for Private Domestic Sewage Systems County s > ' r *DENOTES STATE APRROVAI) REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER r6jF PROPERTY Mailing Address: B. LOCATION: '/4, Section J, TN, RJ-9fO(or) W Lot# City _ Subdivision Nam( nearest road, lake or landmark Blk# Village .,~r ` Township C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family -I-Ik- Duplex No. of Bedrooms No. of Persons D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste GrinderYES NO # of Bathrooms-- Automatic Washer- A-YES NO Other (specify) E. SEPTIC TANK CAPACITY /J71;, Total gallons No. of tanks _ *Holding tank capacity -Total gallons No. of tanks New Installation Addition Replacement_ Prefab Concrete-- *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) ~ 3) Total Absorb Area sq. ft. New X Addition Replacement *Fill System Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Length Width Depth Tile Depth ~y No. of Lines Seepage Pit: Inside diameter Liquid Depth Tile Size Percent slope of land S - >t Distance from critical slope I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, a that I have sized the effluent disposal system from the EH-115 prepared by the Certified/ foil • Tester, NAME ` UC C.S.T. # and other information obtained from (owner/builder). ~P/MPRSW# Phone Plumber's Signature Plumber's Address' PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). 4f I 1 ~ i 1 I Do No Write in Space Below FOR DEPARTMENT USE ONLY Date of Application S ~ i • ~Fees Paid: State ~ County, ~ Date;, Permit Issued/Rejecwd (date) Issuing Agent Name ~i r c/ Inspection Yes 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) PLB6 State and County State Permit # Permit Application County Permit # - 7 V for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. LOCATION: '/4 '/4, Section T N, R_ E (or) W Lot# City _ Subdivision Name, nearest road, lake or landmark Blk# Village Township C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family Duplex No. of Bedrooms No. of Persons D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES NO # of Bathrooms-- Automatic Washer YES NO Other (specify) E. SEPTIC TANK CAPACITY Total gallons No. of tanks *Holding tank capacity Total gallons No. of tanks New Installation Addition Replacement _ Prefab Concrete *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) 3) Total Absorb Area sq. ft. New Addition Replacement *Fill System Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches _ Seepage Bed: Length Width Depth Tile Depth No. of Lines Seepage Pit: Inside diameter Liquid Depth Tile Size Percent slope of land Distance from critical slope 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. # and other information obtained from (owner/builder). Plumber's Signature MP/MPRSW# Phone # s Plumber's Address PLAN VIEW: Provide . sketch below of system (include direction of slope and all distances in accord with H62.20, including well). Do Not Write in Space Below FOR DEPARTMENT USE ONLY Date of Application Fees Paid: State County Date Permit Issued/Rejected (date) -Issuing Agent Name Inspection Yes 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 t . . State and County State Permit # Perm' PLB67 Permit Application County l for Private Domestic Sewage Systems County t *DENOTES STATE ,.PPI'OVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: ~p5 5 2.- B. LOCATION: °j_~'/. yt.~., Y4, Section N, R_L!l I (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township C TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family_ Duplex No. of Bedrooms _ No. of Persons D. TYPE OF APPLIANCES: Dishwasher _ YES NO Food Waste Grinder YES_XNO # of Bathrooms Automatic Washer YES NO Other (specify) E. SEPTIC TANK CAPACITY Total gallons No. of tanks *Holding tank capacity Total gallons No. of tanks New Installation Addition Replacement Prefab Concrete *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) -2►+ 3) Total Absorb Area sq. ft. New Addition Replacement *Fill Sy m Seepage Trench: No. Lin. Feet Width A Depth Tile Depth No. of Trenches Seepage Bed: Length. Width Depth ~C! r Tile Depth b No. of Lines Seepage Pit: Inside diameter Liquid Depth Tile Size Percent slope of land. C~ Distance from critical slope 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 TeI NAME C.4L- v 1 C.S.T. # and other information obtained from (ow wilder). _ Plumber's Signature: /M RS # S^~-Phone # Plumber's Address &.,t r PLAN VIEW: Provide sketch below of system Include direction of slope and all distances in accord with H62.20, including well). 1 r , ,y e Pia t. lot) t ( .ti I , t f~4 103 I'J O _ Do Not Write in Spa e . Below FOR DEPARTMENT USE ONLY Date of Application A - Fees Paid: State /0, e' Cou Date Permit Issued/R jecte (dat) - Issuing Agent Name e Inspection YeAite No Valid# Date Recd 1. county (w 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 II I EH 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 • REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: 1/4, '/4, S?ctio"n TtN, R 11 (or) W, Township or Municipality Lot No. Block No. Z 41 14 County "ST Ilea Subdivision Name Owner's Name: 6~~/ ; 4.2 /y Sig Mailing Address: No. of Bedrooms - ~ Other TYPE OF OCCUPANCY: Residence EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS ~~ry PERCOLATION TESTS SOIL MAP SHEET SOIL TYPE_2/Y~'~~' PERCOLATION TESTS r TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN I SONCHILES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN 7 I Ld- P- . C t S S- <77 P 3 ' 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) j t 1 RKS PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy. 6:1 Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. I ~ 111 ~ i { I tj4 { ( i II a n' .n.) i h - t- t µ..w.._.__1 f t} i I .F- f --S ._.w_ _ j - ± - f - t I I i j 1 i { f 1 I I 1 J ' i I } ~ I I ~ f r I , 1 f I i 1 { I i i I I, the undersigned, he by 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 my knowledge and belief. Name (print) Certification No._ " Address Name of installer if known CST Signature COPY A LOO-P-1. AUTHORITY 3 '4 • f 4 •