HomeMy WebLinkAbout042-1076-20-000
0 M
d f m o
~ CD 0 -0a 14.
o \ 1
3
O
(n 7> Z 0 00 CD < A ~
n D~ ~ cn O CD N N N
_ N 7 3 (D (D W C (p O
00 O a z n = C
CD 00 -4
N° Q o D o wNo O
. O CD -L =0 = n
00 O 0 C 0
cn N cn CD O 00 O Z
N C - Z
d
F
2 Cl) N co
(D (o D m C
N u:l 7
ODD M < V
O w cD
m c O
(D (0 a
m co co ;u n r -
CD N N N m 2:
N O ri
O CY 70 fl-0 T N h•
w n N o o z v~
rt rt r' fD A A o Z E7 Z
CD cn
E7 >
C n n ? a
m N N N
00 p
rn H n cn cn D A
S y
N
n w Vl r 3 m
-2 CD
N
N
O~ W o z co z O
O D n
O CD N
N Z 'O c
N O7
c N N
CL
w co _
n ~
1 v7
((D Z 0 p Z CD
C) o
A Z 3
O
~ o
:D N
N W -0 N) CO
00 a m z
'3 A
°o " z
W 0
I m
3
X o a m
co ~ c
c Z a
CND N C
N I~
v
o
Ay
x a
m
C
CD ~o
N
N
O p
O
A
~ ~ lv
N
to O ~
o ~
C) a
Parcel 042-1076-20-000 07/19/2005 02:32 PM
PAGE 1 OF 1
Alt. Parcel M 28.29.18.432 042 - TOWN OF WARREN
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
" DENUCCI, ARCHIE & ELLA TRUST
ARCHIE & ELLA TRUST DENUCCI
1171 80TH AVE
ROBERTS WI 54023
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description " 1171 80TH AVE
SC 2422 ST CROIX CENTRAL
SP 1700 WITC
Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE
SEC 28 T29N R18W NW NE 40A Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
28-29N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
06/07/2004 765184 2591/048 TI
12/14/2000 635257 1567/199 QC
11/09/2000 633325 1558/70 QC
2005 SUMMARY Bill Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 07/11/2003
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 37.000 4,900 0 4,900 NO
UNDEVELOPED G5 1.000 100 0 100 NO
OTHER G7 2.000 15,000 149,000 164,000 NO
Totals for 2005:
General Property 40.000 20,000 149,000 169,000
Woodland 0.000 0 0
Totals for 2004:
General Property 40.000 20,000 149,000 169,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 305
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
` AS BUILT SANITARY SYSTEM REPORT
n r
L TOWNSHIP SEC . T_N-R W
OWNERZt- -
ADDRESS / ST. CROIX COUNTY, WISCONSIN.
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of 1163
OW. LVLRYTHING W LTHIN 100 Fl%'L'T OF SYSTI,Al
I
I
I di ate or, r.hjjA row
SCAL i - - I j-
BENCHMARK: (Permanent reference Point) Describe: C4,"
Elevation of vertical reference point: X11) Slope at site: Y
SEPTIC TANK: Manufacturer: lt)oj ~.,,~Oae~pd, Liquid Capacity: 9&Kk,
Number of rings on cover : ~c~tic Tank manhole cover elevation: >q,,,
Tank Inlet Elevation c `31 Tank Outlet Elevation: t:::g"Lo t
PUMP CHAMBER
Manufacturer:- A Number of gallons
Number of gal; /P set r a cycle gallons; total capacity o
distribution gallon: size of pump head;
gallon per m' horsepower branname of pump
and model n b ;
Type of war ing device
HOLDING TANK: Man act er Number of gallons
Elevation of ma of cover_
Type of warnin ev ce
SEEPAGE PIT SIZE Fi m per o pits 'feet diameter
feet liquid ept epage pit in et pipe-elevation
bottom of s epag" pit eva fee t.
SEEPAGE BED SIZE: number of lines Width le,i thtile depth?
SEEPAGE TRENCH: _,w~aidth length
PERCOLATION RATE . AREA REQUIRED ~_AREA AS BUILT
INSPECTOR
DATED PLUMBER ON JOB o
LICENSE NUMBER
DE; s,-~TMIENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
LAB'OR,& HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O. BOX 7969 BUREAU OF PLUMBING
MADISON, WI 53707
CONVENTIONAL ❑ALTERNATIVE IS,,,, Plan LD. Number
0, assign
Holding Tank El In-Ground Pressure ❑ Mound $ 33~ g
NAME F PERMIT HO R. ~TE~~S OF PERMIT HOLDER: INSPECTION DATE.
BE_ (Permanent reference 11-0 DESCRIBE IF DIFFERENT FROM PLAN. REF. PL ELEV.'. CST REF. PT. ELEV
TA W' 2S -T,LJ
Name of Plumber. IMP/MPRSW No.. jCuumy_ Sanitary Permit Number:
SEPTIC TANK/HOLDING TANK: `t
MANUFACTURER LIQUID CAPACITY. TANK INLET ELEV.. TAN KOUTLET ELEV. WARNI IDENG LABEL LOCKING COVER
P
C O,V D. PROVIDED
YES ❑NO ❑YES ❑NO
BEDDING: VENT DIA. VENT MATL. JHIGH WATER NUMBER OF ROAD. PROPER V WELL. BUILDING: IVENTTO FRESH
ALARM LINE: AIR INLET
ET FROM ;!.I I ❑YES ❑NO I ❑YES ❑NO NEAREST _
DOSING CHAMBER:
MANUFACTURER BEDDING. 11-11111111 CA ACTT' PUMP MODEL PUMP/SIPHON MANUFAC1l1HEH. WARNING LABEL LOCKING COVER
1PROVIDED. PROVIDED:
❑YES ❑NO 1 ❑YES ❑NO ❑YES ❑NO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PRUPE TV WF-4 BUILDING IV NT TO FRES. `
(DIFFERENCE BETWEEN FEET FROM "E AIR INLET
PUMP ON AND OFF) ❑YES ❑NO _ NEAREST
SOIL ABSORPTION SYSTEM. Check thesdImoistureatthedepthofplowing iI'-Ti, F,IA>1ETER ATERIAL.ANDMARKING
or excavation. (Ifrsoii can be rolled into a wire, construction shall cease until FORCE
the soil is dry enough to continue.) MAIN
CONVENTIONAL SYSTEM:
WIDTH LENGTH NO. OF DISTR PIPE SPACING COVER INSIDE DIA , JILR LIQUID
BED/TRENCH TRENCHES MAT RIA/,
. L PIT / j li DEPTH
DIMENSIONS 2)__5 T: G fi.'~I FILL DEPTH DISTR. PIPE DISTR PIPE DISTR. PIPE MATERIAL: NO DISTR NUMBER OF PROPERTY WELL. BUILDING.
VENT TO FRESH
BFI III FS ABOVE COVER ELjEV. INLF T ELEV END - PIPES FEET FROM LINE . N AIR INLET_
1 'yy ~ C. ~t ~ ')c_..' r~ ~ , aP ~ iJ ✓ `r
l Ii _ NEAREST
-i 1
MOUND SYSTEM:
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 certain that it ON REVERSE SIDE. SHOW ELEVA-
meets the criteria for medium sand. TIONS MEASURED.
❑YES ❑NO
SOIL COVER. TEXTURE PERMANENT MARKERS. OBSERVATION WELLS
I ❑YES' ❑NO ❑YES ❑NO
DEPTH OVER TRENCH BED DEPTH OVCR TRENCH; BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED.
CFNTER EDGES
❑YES ❑NO ❑YES ❑NO ❑YES ❑NO
PRESSU_R_IZED DISTRIBUTION SYSTEM:
WIDTH LENGTH NO. OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER
BED/TRENCH TRENCHES
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR PIPE IMAN110 -D MATERIAL. NO. DISTR DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING
ELEV.. ELEV. DIA. ELEVe:': f PIPES DIA..
ELEVATION AND
DISTRIBUTION
INFORMATION - ROLL SIZE HOLE SPACING; DRILLED CORRECT V COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
1 PLANS
_ ❑YE # ❑NO ❑YES ❑NO
COMMENTS? PERMANENT MARKERS-. JOBSERVATION WELLS: NUMBER OF IPROPE RTY WELL: BUILDING:
FEET FROM LINE
jl ❑YES ~NO ❑YES ❑NO NEAREST-
57
Sketch System on Retain in county file for audit.
Reverse Side.
SIGNATURE..." - TITLE -
DILHR SBD 6710 (R. 01 B2)
-16 & BUILDINGS
DEPAFi #AENT OF APPLICATION SAFET
INDUSTRY, FOR SANITARY DIVISION
LABOR AND PERMIT P.O. BOX 7969
HUNAN 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.
Property Owner: Mailing Address:
f C_A'E Cc_ ~ erg
Property Location: City, Village or Township: County:
Nw' '/4 ,''/4S 2-e /T.,'Zti N/R / E (or) W cLJrc/J 1 Sr roix
Lot Nu ber: Blk No.: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number:
/ (If assigned) ,Q
&L d C2 Il GL lrOcuQ
TYPE OF BUILDING
Number of
❑ Public* ❑ Variance* ❑ Other (specify)* Bedrooms:
['Qor 2 Family *State Approval Required. --3
TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER
GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specif )
SEPTIC TANK CAPACITY y1a
ZZ:
HOLDING TANK CAPACITY /
LIFT PUMP TANK/SIPHON CHAMBER
MANUFACTURER: AFer_r-_711_ EFFLUENT DISPOSAL SYSTEM
PERCOLATION RATE ABSORPTION AREA
(Minutes per inch): PROPOSED (Square feet): ❑ New Replacement ❑ Experimental Seepage Bed ❑ Seepage Pit
❑ Alternative (specify) ❑ Seepage Trench
-3 d. _30.'i WatteerS'pply: Owner's Na a as Listed on Soil Test Report (If other than present owner):
W private ❑ Joint ❑ Public / ~--G i.,- -^'u c c /
I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
Name of Plumber: Signature: MP RSW~La? Phone Number: AL Yi , ~3 _5-~; ) 7f 59 Z
Plumber's Ad ess: Name of Designer:
COUNTY/ DEPARTMENT USE ONLY
/7
Signa re f Issuing n e: G-O Daj APPROVED Sanitary Permit Number:
c~A~ .4 &
l1 q ' O B 2- DISAPPROVED ~+0 13
R so or 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.
V!STRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber
DiLHR-SBD-6398 (N.03/81)
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
DIVISION
gaol -i4Y,
P.O. BOX 76
LABOR AND PERCOLATION TESTS (11 $ MADISON WI 53707
HUMAN RELATIONS
LOCATION: / SECTION: TOWNSHIP/MUNICIPALITY: T, O.: BL N NAME:
'i'Gv ~/a '/a /T zyN/R/*E (or) W /uf1k;PE~t/ GA W 70A ' f
COUNTY: - OWNER'S BUYER'S NAME: MAILING ADDRESS: j
J1.6,01A AIU [
USE TES ERVA IO►~L DE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: F R T ER OLA ION TESTS:
~A!Resiclence ❑New Replace
SCS
-s p
RATING: S= Site suitable for system U= Site unsuitable for system 5og- s:fAr,,2ts
CONVENTIONAL: MOUND: IN-GROUND PRESSURE:SYSTEM-IN-FILLHOLDING5: RECOMMENDED SYSTEM: (optional)61~-f•QFT
s ❑u ~s ❑u s ❑u ❑ s [Nu ❑ s 16W aZ-V;%A.)hL 2 W, s
DESIGN RATE: SYSTEM EL V.
If Percolation Tests are NOT required If any portion of the lot is in the
under s.H63.09(511b1, indicate: Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS
I BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B- > y I? 5 ,*L si'y N, 7 3,1, 1'•~S 5;'4, 7 " Ole, 54
Ae/13,J 1-4.4,1-1 .9N.514 10"L1 (3v,L
B OOd L N G 7
mss.
B-
~7~r` 3 4 1 " ,A) iL~it"L -3Q-6 "~s.'c/ 12"L~! 10
B `J / } 9L M~ X
t~ '0
n,~. h- . 5. 33 a7~, ~c - RAJ
B- No 0 a0. sL 3-;74
A, , ;
B- 70 9(v, SeL w, ~l`sTiveT O~-G' . ~-ro tf z~ fo y
PERCOLATION TESTS G'e "'t ~tv 76 *4d L a. Avg r.~i
f'A la o~P- r~ a'fS
I_ TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
I NUMBER INCHES AFTER SWELLING INTERVAL-MIN. -PERIOD 1 PERIOD 2 PERIOD 3 PER INCH
P- Z t .3
E
P_ /I A) U
P- 2 ~klr Z < 3
P
3 7- z _2
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 huri-
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at ail borings and the direction and perc:,:+t
of land slop. rT f 09 6.3 FT - (3e low V 6- • PE F 'P f 13oT70M or 8*k
SYSTEM ELEVATION
Ry
Iqu019oF 7f t
M~
6
3 ~ P3
`c
. : (3AGebbF P, r_~ / Itl 'VE
5t Tyr t~ ~EIPj1G~9
- WPROVED" ~iaPEf c
;s.rp
Dp1 C O L ~a 5;X 0A1 k ~HHeD ~ N
InspeetarT to a l rokm POOR
liop-
~ ff(,., 13~
FQ
So
DI
7' f/
13~ P~E~ _
I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wiscors ;
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): T STS WERE COMPLETED ON:
Pbbikr 17 IVR-2 -
ADDRESS: 1(!tFITI FICATION NUMBER: PHONE NUMBER optional):
-)A /IlS S 0/ -o~y~2- 31P6
CST SIGNATURE:
DiSTRIBUTiON: Origir:3€-Local Authority, 2nd page Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester.
DILHR-SBD-6395 (N. 03/61)
MAI
~ y
7, 7/
9
1
t3 Al X
v ~1 X '44
A13 '71
60
m
y
, e,~
Fob 3~
3
9 3,
Ak'r
1 ,
1 a
o~
-78
a
7~2~-
1