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HomeMy WebLinkAbout020-1023-50-000 n cn O v O `r1 d d ~1 c ~ 1 I G1 A ~ A 1 I\ 1\ • n v N cn O Cp (0 ((D C A N CD O O O y Uri p N 0.4 c.n 0. a a m O _ O CNp W W 7 CD III (D N O N Q D O O Cn °o C.n ro m a n 2 0 o 7 N V ~ 0 O O d I ~ (n D a = m n ° a ° N c ° W O it - CD o ~ L m oz 2 \r w Q N o c NJ o -9 z o O O ~r• z o _ (jam o-' ~E 4~ CD 0 0 D O rn m h 0 (D :3 ° m v PO CD 6 d N O N ~ 3 r. I n N N a z zco z o CD 0 v p D n O N N N N C M/~ O CD V O O O I W N 0- a 3 z CD --1 cn ° O O p Z CD N c n A z O o. C N A W (D < C.0 a 3 zzT 0 N 00 r: Cl) Op W D _s a (n C_ N N Z) - O z G ~ O W CD O_ rn C O 0 O a CD 0_ Cll 2 C 4; ° 0 I ~ VA m p a A o b m o-AO W cyv O C) m 0 0- Parcel 020-1023-50-000 07/14/2006 05:07 PM PAGE 1OF1 Alt. Parcel 14.29.19.104H 020 - TOWN OF 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 O - SACHSENMAIER, SCOTT A & DEBORAH M SCOTT A & DEBORAH M SACHSENMAIER 766 HOLDEN LA HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 766 HOLDEN LA SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 5.030 Plat: N/A-NOT AVAILABLE SEC 14 T29N R19W PT NW SE COM E 1/4 COR Block/Condo Bldg: TH WILY 2010.32 FT TO POB S620.56'-ELY 353'- NLY 620.49' TH WLY 353 POB Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 14-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 759/534 07/23/1997 733/61 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 05/30/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.030 81,100 162,900 244,000 NO 05 Totals for 2006: General Property 5.030 81,100 162,900 244,000 Woodland 0.000 0 0 Totals for 2005: General Property 5.030 81,100 153,500 234,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 112 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 la { 1983 44' NVV 1/4 cF f> 't 1'l CENTERt INE_ OF PROnSEQ T4-WN____ROAD "470C 51ou ERLY R!GHF -G= W AY `NE nw Pii0P SFD, AS BUILT SANITARY SYSTEM REPORT OWNER, TOWNSHIP SEC. 1-P/jw -ialyl ADDRESS ST. CROIX COUNTY, WISCONSIN. SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 F -V ERYTHING WIT. 100 FEET OF SYSTEM hL_' I di a e No th Arrow sc & BENCHMARK: (Permanent, reference Point) Describe: Elevation of vertical reference point: zhr.,',`' Slope at site: SEPTIC TANK: Manufacturer: ,r Liquid Capacity: jG100, :7A4 Number of rings on cover / Tank cover elevation: Tank Inlet Elevation: Tank Outlet Elevation:--f't" PUMP CHAMBER Manufacturer: Number of gallons Number of gal. pump set or a cyc e gallons; total capacity o distribution lines gallon: size o pump head; gallon per minute horsepower ran 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: Number o pits feet iameter feet liquid depth seepage pit in epipe-elevation bottom of seepage pit elevation feet. SEEPAGE BED SIZE: number of lines n width e ' leiigth, raj file depth SEEPAGE TRENCH: width length PERCOLATION RATEAREA REQUIRED . REA AS BUILT ' INSPECTOR DATED PLUMBER ON JOB LICENSE NUMBER IS' REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM Savtt.-tats-y Pet~m,(. S.ta t e. S e p t 14 c_ ► NAME Township St. C4.0.('-x County Locat,Eon Section Lot # Subdivi64'on SEPTIC TANK Size gaUon6 Nu_mbe_n oo eompaAtments Dl,5tanee (IAOm: Weft Buit(Ung120 6Zope Highwate_n PUMPING CHAMBER Size __gat_eons Pump Manu(jaet(vt.eA Modet NurnbeA HOLDING TANK Size _g a. eons Number o6 CompaAtments Pumpe.A. Atahm Systern Di,5 ante {Aom: Wc,e- Z Buitding 12% h~ope___- Highwa-te.A ABSORPTION SITE tied / ~x ~ti- Tlceneh - Di6ta-nee ()AOm: W e f f_ ,0-y- 6 u i dtin126 Mope Highwa,teA ABSORPTION SITE DIMENSIONS Width o4 t4eneh 6t RequtiAed area Length oo each 4"He j-0 6t Depth oo Aoek be.eow ttiee. J ~ i.n. Numberi oo .t-ti4q.e6 _ Depth oo rock oven t if e. , Totat eeng-th of Pined -6t Depth o6 tile be~-ow grade- 90 i-n Di.,5 anee between fine-6 4 6t S.Eope o6 tAeneh- 2-- in. pet 100 At O Totaf abdoApt.ton aAea ~j,t Type o6 Coven: Paper oA dttaw i PIT DIMENSIONS Gt2~ NumbeA o() pitd GAavet vLoun. p.Etd yed no Outdtide diame"tel- -fit Depth below in.ee_t ( f TotaE abAOApt.ion anew 6;t ~i AA.ea Aequi Led 7 (I t INSPECTED BY TITLE G APPROVED - DATE _ 19-~ REJECTED DATE 1q& I REASON FOR REJECTION E M 115 Rev. 9178 REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION SectionT.,,~'..~N,Rl.X V (or) W Township or Municipality Al Lot Nd. , Block No. County ft u iv Ion Name Owner's/Buyers~Na/me: K~'1 Mailing AddrLe f~ , - TYPE OF OCCUPANCY: Residence No. of Bedro ms CO MERCIAL EFFLUENT DISPOSAL SYSTEM: NEW _REPLACE MEN ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS Z" , ,2 PERCOLATION TESTS SOIL MAP SHEET , Zld' ? NAME OF SOIL MAP UNIT , 1' &V;ZZJ, PERCOLATION TESTS TEST DEPTH v~- CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MINIIN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 S _ c- P- A16 AJr P- i (1 11 P- P- P- 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- B- s B- - 13- -2 B_ f ! ) / PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the I~cption and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. I A ' s~7t-AlcJ* //ifdt{ s:aT/ .UT7,.k E I ~ a I f , U S1` 4- 4 } ( a ~N I Y I ~ i F r ~ f ' - . . m.. _ a 9... .r.a. _3...._. ..#F~F..(t'. Y E i 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) - Certification No.-:S: Address 2, 4) Name of installer if known Copy A - Local Authority CST Signature ti State and County State Permit # v PLB 67 w Permit Application County Permi # 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: cu, B. LOCATION: Section TJ~/ N, R_a (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township ~Lj C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family ~X Duplex No. of Bedrooms No. of Persons D. 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 X Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate -4, Total Absorb Area L / sq. ft. New Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: _X_Length 1 ` Width Z .1 Depth_ 2 Tile depth (top) - No. of Lines Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land Distance from critical slope WATER SUPPLY: Private Q 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 Tester, NAME t - L A 1!t, C.S.T. # and other information obtained from , , t (owner/builder). Plumber's Signature Mp/MPRSW# Phone I% Plumber's Address-4 A . d~ 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. E I i P { E { rl.. ~ m, v ems. rs A ma m a. .s. ~ e e-,.... ..d~i_ e e. . i € E P x mm. a, m e..~,..... _ , m.P.n .,„e e ;-,..m. i...< e _ ~ . ...e „ « .«,~n..~...~.. f e. t k t ~ Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY r Date of Application Fees Paid: State .1 (y, &'o Co my Ole.) Date Permit Issued/Roortarl (date) y .20 -F1 Issuing Agent Name Inspection YesNo 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 REPORT ON INSPECTION OF SANITARY PERMIT # I (1) Name and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection Time of Inspection Name, Address, License No. o ns a Ong plumber (3 )INSTALLATION CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber ❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System BEN Permanent reference Point) Describe: Elevation of vertical reference point: Slope at site: (5)MATERIAL AND DEPTH OF SEWER: (6)SEPTIC TANK: Manufacturer: Liquid Capacity: Tank Inlet Elevation: Tank Outlet Elev: # ft to lot or property line: # ft to well: (7)DOSING TANK: Manufacturer: # of gallons: # of gallon pump set for a cycle gallons; total capactiy of distribution lines gallon; size of pump head; gallon per minute ; horsepower ; brand name of pump and model number Is the warning device installed? ❑ YES ❑ NO Wired? ❑ YES ❑ NO 8 HOLDING TANK: Manufacturer o gallons construction ; depth to the cover ft; If septic tank is being used are baffles removed? ❑ YES ❑ NO; ft from residence; ft from well; ft from property line. Type of warning device Is the warning device installed? ❑ YES ❑ NO; Wired? ❑ YES ❑ NO; Locking device on cover? ❑ YES ❑ NO; Diameter of vent and material ; Distance from building to vent (9) SEEPAGE PIT SIZE: # of pits; ft diameter; ft liquid depth; ft to residence; ft to well; ft to property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than seepage pit inlet pipe-elevation ft; bottom of seepage pit elevation ft. (10) SEEPAGE BED SIZE: ft width; ft length; tile depth; lineal feet tile; ft to residence; ft to well; ft to lot or property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches Elevation of tank discharge line entering bed ft. 11 SEEPAGE TRENCH: Total length of seepage trench ft; width ft; tile depth ft; ft to well; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches; elevation of tank discharge line entering seepage trench ft. (12) Has system been installed in area indicated on EH 115? ❑ YES ❑ NO (13) Has system been installed in floodway? ❑ YES ❑ NO Floodplain? ❑ YES ❑ NO DILHR-SBD-6095 N.05/80 Signature of Inspector: . 1 L ~hcfi✓mv t" T~iW% A-' ,~'ao',c.•,prs 111' rt,~~> ~ ti~.sE~.✓ i /00" 00 .01 4C W i I~ i I i . 10