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HomeMy WebLinkAbout161-1093-10-000 0 cn 0 3-u 0 d `r1 ~ c c D co Fj* CD "a v 3 w 1 co o o N o w- U C w rn `C • 0) -0 C) m CD a CD 0 cD cn (Np lAl . Om CL Z (D N W CD N 1 m C- 7 (D I O O(0 0 IV CL O 3 N < Z v w !y CD =3 5' (D o O C) C CD CD N 3 a• rn o N (n = o p N N CL O !V y CD U) CD N a a v = N CD n 3 a rn rn ` F W N Z Z l _ !S`~f O 00 CO a N ~i CO 00 N 0 C (V Q Z O O O !t`iil 3 ~ 3~'3= v v v a~' ~ O C~ y O 7 LI -O X (D Z m N CD 7 N L z C/) zco Z 0 o D C CL :3 p o s p' ::T N 7 h • N m C v cn (n c m m y w Q a 3 5 z (D ~ cn O O_ p Z_ M N CL A (Z 7 O S M N W d ' Z o~ A Z o N z N O d 003 (O d O v a 7 T ~ - 7 fll C ~n z a FD. O O m 3~ (n ~ N ~ O O O O N A W ja X N ~o fi ~ n A O. CD ~ b 0 N O O ~ a A O O b O 69 0 ti b O ya Parcel 161-1093-10-000 01/09/2006 10:45 AM PAGE 1 OF 1 Alt. Parcel 13.29.20.735 161 - VILLAGE OF NORTH 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 TODD B WALKER O - WALKER, TODD B 206 STATION CIR N HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 206 STATION CIR N SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 0.000 Plat: 04/38-ST CROIX STATION 1977 ST CROIX STATION LOT 11 VIL NH Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 13-29N-20W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1172/319 WD 2005 SUMMARY Bill Fair Market Value: Assessed with: 108568 626,600 I Valuations: Last Changed: 05/20/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 120,000 493,100 613,100 NO Totals for 2005: General Property 0.000 120,000 493,100 613,100 Woodland 0.000 0 0 Totals for 2004: General Property 0.000 75,000 316,100 391,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 133 ~ Specials: User Special Code Category Amount I Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 J AS BUILT SANITARY SYSTEM REPORT OWNER T Q) 10 P IL I-LW TOWNSHIP SEC. /J T2yN-R bW V 'd ADDRESS 41 1Z ST. CROIX COUNTY, WISCONSIN. SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 SHOWLEVERYTHING WITHIN 100 FEET OF SYSTEM = c ! j' fix a 14 I diva a oath Arrow SC BENCHMARK: (Permanent reference Point) Describe: pow o~ %~~P~~"''°✓~`'~ Elevation of vertical reference point: i y cl) Slope at site: SEPTIC TANK: Manufacturer: e3(_1/, Liquid Capacity: /,.fir 0 &,c Number of rings on cover : C~, Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: PUMP CHAMBER Manufacturer: Number of gallons Number of gal. pump set or a cyc e gallons; total capacity o distribution lines gallon: size of pump head; gallon per minute horsepower bran name of pump and model number Type of warning device HOLDING TANK: Manufacturer Number of gallons Elevation of manhole cover Type of warning device SEEPAGE PIT SIZE:. Nun' Ii o pits eet iameter feet liquid dept seepage pit in et pipe-elevation bottom of seepage pit elevation feet. SEEPAGE BED SIZE: number ?f lines width ~b length s', 'the depth.,`6 - SEEPAGE TRENCH: width length PERCOLATION RATE. C /mss j _ AREA REQUIRED j"gib REA AS BUILT F? INSPECTOR DATED PLUMBER ON JOB LICENSE NUMBER -7 1 3 • RI PONT O1 1NNU CIION IN UIV IOUAI_ NI WAG[ SYN II M tiani tang/ I' Mi t Stot,' Septic 1440-r9d NA~41 Y I ownsIt 4 p St. Crcoi x County v I rat~0n ~ecti.avi_L..Z Lut _ Subdivision A 1'I I C TANK Si e t 1 - a fan6 Number cr carn~antrne.v►te r - PiAtance finorn: Well Building 120 slope ~ H.i ghwa to n PUMPING CHAMBER Si ,e g a f F 0 n 6 Pump ManuA&We4 Model Numbers m)IVING FANK a gaQPon6 Numbers- ufi Compahtrnen s I'll m.reit Afa.Am System Ut5tanee fihom: A1eII'_.____- Bu,i-ldt12% ekape- Hi g6awaten ANNO►:1'-1ION SITE lia'f Tievic6a Ur n tavice fin-om: Wvfk Building, ---~---T?_ o APope Hi ghwa-ten ANg0R1'TION SITE DTMLNSIONSS [Uidth 06 tneneh 6t Required area Length ofi each trine ----fit Depth ofi hock below We an Nnrnben ufi; kines _ Depth ufi loch, oven f.utaP feng-th o6 Lines n fit Depth o6 ti e befow grade in 0 tanee between li,neb ~ At hope ofi tn.eneh in. pen 100 (yl folaat aabAoAption araea- fit Type oA Coven: Papers ~t~aaau Pit UIM(NSIONS C Nurnbon 06 pits Gnavvf anoun-d r<tA a es nir Ou tAiA diarne,ten fit Depth below ,i.nfe t ( ( Iotat aknn.ption ane.a --l---6t Area nequined - At i N4 P l cT[ D by TI rLL ~ AVVNOVI U DATL 19 N TATL 19 1% W1 ASON I OR REJECTION Q -PLIB 67 State and County State Permit # e / e . Permit Application County Permit # for Private Domestic Sewage Systems County r *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if R quired State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. LOCATION:'/,_jj V .7j Se lion J,~k, T N, R,26 k (or) `W Lot# City .37 Subdivision Name, ne rest road, lake or landmark Blk# Village L 7Jg,~-~ C?n 1A, Township C. TYPE /OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family X_ Duplex No. of Bedrooms 7 No. of Persons D. SEPTIC TANK CAPACITY IAOf) Total gallons No. of tanks f HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concreted Poured-in-Pla e Steel Fiberglass Other (specify) New Installation X Replac ment Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Perc lation Rate Total Absorb Area sq. ft. New--Replacement Alternate (Specify) Seepage Trench: No, of Lin al F . Width Depth Tile depth (toy) No. of Trenches Seepage Bed: Length Width /a Depth- J6 depth (top)~No. of Lines ~ Seepage Pit: Inside diameter. Liquid Depth No. of Seepage Pits Percent slope of land - 6 Distance from critical slope WATER SUPPLY: Private ® Joint ❑ 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 Te ter, NAME 70 C.S.T. # 5 - c3 2 Z and other information obtained from - (owner/builder). Plumber's Signature MP/MP SV1(# Phone # 3X -Y L, Plumber's Address ! 5 . 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. 41. E F _ r E , a 3 m a m r _a.. ..,,..e E.,....... P. .m a P. .nom e.» 2 Do Not Write in Space Below - FOR COU TY AND STATE DEPARTMENT USE ONLY Date of Application (Q-" Fees aid: State Count Date to Permit Issued/fjejeemel (date) Issuing Agent Name Inspection YesYNo State Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 `te (pink copy) 4. plumber (canary copy) Revised Date 7/1/78 EH 115 Rev. 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS , WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES • P.O. BOX 309, MADISON, WISCONSIN 53701 V LOCATION: S~ 1/4,s '/4, Section / T_N,R ~E (or) W, Township or Municipality Lot No.~Block No. ,377' ~~O/X STigTI~N County Owner's/Buyers Name: Subdivision Name C~~ Mailing Address: -~7~ Z ddW - ?C~~ ~Ly~ayv( , 5 5- y-5// TYPE OF OCCUPANCY: Residence -k No. of Bedrooms 3 COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENCT~p ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: IL BORINGS PERCOLATION TESTS Oc/, SOIL MAP SHEET -7eJ NAME OF SOIL MAP UNIT PERCOLATION TESTS TEST HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES NUM- DEPTH CHARACTER OF SOIL SINCE HOLE HOLE AFTER INTERVAL RATE BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN P- f . ~S 2o`'G~ . ~S /o" of 2- P_ P-,j GS S/ Z,1.13,~J. h4.5 IU&~ 2- . Z P- 7777- P- . 54,1b SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B- F /VLF ~E > 7",6,# ZS) 2-1,2140. a S"6 N IM CS ajAZ.L 4u/ Z P c c)~ > U. 4S 3 'W -4N. h-4• S 1 O,P• . S' w e B- ~2_ IV OAt C a- 7,4w, 1-5 L7"✓~AY. S 8'r . D/P. Sa,~ w [d-C-- B- Z NQN 7 z 2z OA' -:5-4 AZ) B- Sz y 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 615- -3 Indicate scale or distances. Give horizontal and vertical reference points, Indicate slope. /TtD~dDMf - 04 2vf0_ _ 1~p~a,%, ,r . ~,QC Si7`ES _ . X10 1-44A).97sEr iEv~~~d, g~- a I, a. ~M a F ~ 41j 3A4 2,11 13 f E 5 ~3 = 3Y `x.10 ,3 IN4 3 13 0 _ /j y 1 PL 135, N r P; PRO, • s 8o rfi r _ r a£.+ST SCE' l i r/16,02. a, 11a7l IIM = 6X0 C_ A) 74~!P /3o X fT r 467 1 S© 40 ZO,14 1, the undersigend, 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 my knowledge and belief.`` Name (print) Grp 7e'1hf4c1,7 - Certification No. 5'd Zy~~ Address k Name of installer if known r ate ° e C~% CST S•r Copy A -Local Authority I ~l ~ L f Z) r ~,b i I Y \ o I f rA . ~~i T k r~ i