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HomeMy WebLinkAbout038-1124-80-000 v n(n p g v n C r_ i O `r1 7 O f7 3 0. O CD a # c ~ i m m 1 n ZJ O N Ni O r j A N N O C l• (D 3 O p m co , C l O n. F z fl- ro N W C O W p 0' N. Oo ro O A cn N p~ N j "S \ 1 C:) co (D 0 O C ( 3 p O O (n CL J (D ~ m N Q co O rn c\ cn C m N NCO Z y 0 r- cn C CD O' 1 ~ ~ ~ ~ 'O ~ Z1 fl;. h ~ Vii. p 0000 J fn fn cn ° D ' \CD CT -0 O O o (D m cn t~ CD (D CD N o N) o m - 3 N J T. p N ~ O ~ Dz m z {~y cD o h • G'. o (D n~ m v c (D (D ~~1y1 ~1p\~1 W co ~ pR. o CD --I A Z (D v p ? G) z F), r Cn W co CD m o a 1 t z o C/) ~ x l/ N Z A j? CD N D d ] C N G (D N - T (D C 7 Co O 'a N N o uD T. 3 ti N L` N-. A. O q 7 O (D ~ O O O O ~ b N O O a A O (D hA Owo o 0 O O C ti Parcel 038-1124-80-000 02/09/2006 04:33 PM PAGE 1 OF 1 Alt. Parcel 30.31.18.514J 038 - TOWN OF STAR PRAIRIE Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner 0 - KING, RENEE P RENEE P KING 1908 90TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description ' 1908 90TH ST SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 1.170 Plat: N/A-NOT AVAILABLE SEC 30 T31 N R1 8W PT SE SE FORMERLY PT OF Block/Condo Bldg: LOT 1 OF CSM 5/1295 N/K/A LOT 2 CSM 8/2372 1.17 AC Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 30-31N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/19/2004 769189 2619/247 WD 05/13/2003 721270 2240/016 WD 10/03/1997 566376 1268/156 WD 07/23/1997 911/01 more... 2005 SUMMARY Bill Fair Market Value: Assessed with: 119742 93,800 Valuations: Last Changed: 10/15/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.170 26,200 66,000 92,200 NO Totals for 2005: General Property 1.170 26,200 66,000 92,200 Woodland 0.000 0 0 Totals for 2004: General Property 1.170 26,200 66,000 92,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 214 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 r f AS BUILT SANITARY SYSTEM REPORT f OWNER TOWNSHIPS ADDRESS i? ST. CROIX COUNTY, WISCONSIN. SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 vE.RYTHING WITHIN 100 FEET OF SYSTEM f' I d i a e o th A r0 - - - - - 11, C L BENCHMARK: (Permanent reference Point) Describe: I `lo `t , P`' Elevation of vertical reference point: Slope at site: o SEPTIC TANK: Manufacturer: 11,'7 Liquid Capacity: 16) q'" Number of rings on cover Tan manhole cover elevation: q, Tank Inlet Elevation: ] q Tank Outlet Elevation: efC 12 PUMP CHAMBER Manufacturer: _ Number of gallons l-`- Number of gal. pump set or a cycle gallons; tots capacity or- distribution lines gallon: size o- pump head; gallon per minute horsepower ran name of pump and model number ; Type of warning ev ce HOLDING TANK: Manufacturer- Number of gallons Elevation of manhole cover Cype of warning device- SEEPAGE PIT SIZE: Number o pits eet iameter feet liquid depths seepage pit in er_ pipe-elevation bottom of seepage pit evasion _ feet. SEEPAGE BED SIZE: number of lines ~wi th leiigth_7 tile dept0d SEEPAGE '1'R13NCH: width length PERCOLATION RATE 1CQUIRED RLA AS BU LT _ _ INSPECTOR____ DATED PLUMBER ON JO_,,)~ /Uj LICENSE NUMBER_ V ~ ro 't 14 ~f A It 6- ~ 1- kC2- DEPARTME"T OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LAFOR R' HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX'75459 BUREAU OF PLUMBING MADISON, WI 53707 VCONVENTIONAL ❑ALTERNATIVE State (If Pl assigannedLD Number ) ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound NAME F PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: 17 f, I ~j 2 3 Wezll BENCH RK (Permanent refereuc-point) DESCRIBE IF DIFFERENT F M PLAN. REF. PT. ELEV.. CST REF. PT. ELEV Name 6 1 lumber JMP/MPRSW Na JCounty Sanitary Permit Number: 1/6 z; s IZ SEPTIC TANK/HOLDING TANK:D -7 (o, 4 9v MANUFACTURER. LIQUID CAPACITY: ~N~El ELEVTANK OUTLET ELEVWARNING LABEL LOCKIN ~O / P ov EDPROVIEt ~C •~p O- ES ❑NO S NO BEDDING: TENT DIA.. VENT MATL. HIGH WATER NBER OF ROAD: 11ROPERTY / WELL BUILDING: JVENVTOFRESH ALARFROM LIB AIR INLET 1„©/ YES ❑ NO ❑ E O REST D SING CHAMBER: MANUFACTURER BEDDING: LID D CAP AC V PUMP MODEL PUMP; SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER _ PROVIDED: PROVIDED: ❑Y ❑NO ❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF I'H`;PERTV WELL BUILDING I VENT TO FRESH T uNE j 39 AIR INLET (DIFFERENCE BETWE N FEE F ROM 2, 1 PUMP ON AND OFF) ❑YES ❑NO NEAREST-I- SOIL ABSORPTIOrhl. ST Check the soil oisture at the depth of plowing a TER MATERIAL AND MARKING; or excavation(lf an be rolled into a wide, construction shall cease until FORCE the soil is dry-en ou conti nue.) MAIN CONVENTIONAL SYSTEM: WIDTH LENGTH NO. OF DISTR. PIPE SPACING COVER INSIDE DIA ;/TS LIQUID BED/TRENCH TRENCHES MATERIAL PIT DEPTH DIMENSIONS I a r (P C1P,I F I (`T I' FILL DEPTH IDISTR. PIPF DISTR. PIPE DISTR. PIPE MATERIAL. NO. DISTR NUMBER OF PROPERTY WELL BUILDING: VENT TO FRESH BF LU b "'ill S ABOVE COVER ELEV. INLF T E~LjEV. END PIPES I LINE AIR INLET FEET FR < ` J4.47 -I~p.3(v ( V C NEARESTO--►1_ 2 -14 MOUND SYSTEM: (o " Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: f ound systems to make rtaK that it ON REVERSE SIDE. SHOW ELEVA- 1 eets the criteria for me sand. TIONS MEASURED. ❑YES ❑NO~ / SOIL COVER TEXTURE IPERMANE NT MARKERS OBSERVATION WELLS ❑YES ❑NO ❑YES ❑NO OFPTH OVER TRENCH BED DEPTH OVFR THEN-H;BED DDDED SEEDED MULCHED CEM ER EDGES f ~ ❑ ❑ ❑YES ❑NO ❑YES ❑NO YES NO PRESSURIZED DISTRIBUTION SYSTEM: V'JIDTH LENGTH NO.O ATERAL SPACI JG~EL DEPTH BELO PIPF: FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES DIMENSIONS MANIFOLD PUMP MANIF.OL DISTR PE MANIFOLD MATERIAL NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV. ELEV. DIA. ELF PIPES DIA.'. ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING; D LED CORRECTLY COVE MATERIAL PE RTICAL LIFT CORRESPONDS TO APPROVED ❑YES ❑NO ❑YES ❑NO COMMENTS: PERMANENT MARKERS: JOBSERVATION WELLS NUMBER OF PROPERTY WELL: BUILDING. FEET FROM LINE ❑YES ❑NO ❑YES ❑NO NEAREST- , 100.1$ Sketch System on Retain in county file for audit. Reverse Side. ISIGNATURE"i --]TITLE DILHR SBD 6710 (R. 01/82) - f` ✓ State Permit # LB 7 ~~i Lstemsrj State and Co rrty P Permit Applica ier1County Pf-77,7 1 or Private Domestic Sew~e County e *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. LOCATION: % Section 3, T3 N, R (or) W Lot# City 40 Subdivision Name, nearest road, lake or landmark Blk# Village n Township,] ,ice. / 1-11 C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family Duplex No. of Bedrooms 4.2- No. of Persons D. SEPTIC TANK CAPACITY 1100 Total gallons No. of tanks HOLDING TANK CAPAC Y Total gallons No. of tanks Prefab concrete Poured-in-Place Steel Fiberglass Other (specify) New Installation Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate- Total Absorb Area sq. ft. New t~ Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. idth ~ o D'epth Tile depth (top) No. of Trenches Seepage-Bed: Length41-7 idth Depth Tile depth (top) No. of Lines Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits r Percent slope of land ;_7 'y" 917/111 Distance from critical slope WATER SUPPLY: Private Joint El Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: 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 0,11 A ✓ L r r f" C.S.T. # 7 and other information obtained from (own bed. 7 Plumber's Si nature y 7 g MP/MPRSW#r I~ Phone #2r Plumber's Address PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. a i E 3 .e,-... wo, .m ~~m m x va m.... s. _ s.. .y..a ..~«.....e m ..e.. n.. a . , P ...m.i~.~a.«...®p.m 3 3 € r 3 F j , E 3 € I ~ e Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT US ONLY _ Date of Application Fees Paid: State 6,10 ~1 County Dat ~ cg " 09 Permit Issued/Rejected (date) ._r-Issuing Agent Name Inspection Yes _X__No State 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 7/1/78 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABG'jk AN P.O. BOX 76 HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 3707 LOCATION: SECTION: goNSHIP/ WLOT NO.:BLK. NO.: SUBDIVISION NAME: S 7'A- -V COUNTY: OWNER'S BUYER'S NAME: L MAILING ADDRESS,: g,cj S'7+ Clo I'A r J'.4a~r/i~•~~-~C 4 /ff 'ei "S 's USE DATES OBS RVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE D R TONS: ER LA ION TESTS: XPesidence ,New ❑Replace J Ly! / 7V7 J .f eLf - r~9 f~~ RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE:SYSTEM-IN-FILLHOLDINGTANK:RECOMMENDEDSYSTEM:(optional) NS ❑U XS ❑U ®S ❑U ❑ S XU ❑ S -9 U COAJ v eAl 1~41AIA ~If Percolation Tests are NOT required DESIGN RATE: SYSTEM EL V. If any portion of the lot is in the under s.H63.09(5)(b), indicate: I Floodplain, indicate Floodplain elevation: Al PROFILE DESCRIPTIONS BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 13- 07 B y' !r / ,`«C (iy y C'1 J S i n' .5- I~iY S3 l Agri As 4 ; '/3 "Bh s fj i r B-_3 h"' „`Rc 1C_ 7 t . ~ v. Si ~•s ~Y ~~3., / S s`/" Bk ~s +~rr~ d It Ir ~ss N/ J/ 55 SA S,/J /S *,p-'9q"0nCS141e B-4( ? G B +r~« ~:r _ 7 j', 8o s/ rsd 7., 8h S7, 3.700 /s •:~+~,3E"h6 B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES I NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD t PERIOD2 PERIOD PER INCH P- " L'' G gy A/c 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 6" t7 00 J_ C e' Z i C'0 e v ~ o OiO-C,q. -10- ~lft~ fr~le ,f~•-tom Z' p a /c, qit . u1! Pr'r Mr ~ foAe'iz jot'-z` v r.qat ~ e 4 `y y y►eN Rest-~-~` rl~M~A~' L` t' pr- o-M 0fv9.( tf@~Y Y 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methocs specified in the Wiscoi;_1 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): TESTS WERE COMPLETED ON: ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER optional): CSJ-S+ISNATURE: ~ r- DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. nu IR-SRfI-F.3Q~. !N nl!~ IZZAN Tj t v. ti R o o T A 1 t tL c ~ u ~.V ~a Z s .r C ~ f1 ~ F IN, T ~ V C Tt r \ i r 1 r n vc c d a y