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Parcel 020-1133-20-000 12/13/2005 07:43 AM
PAGE 1 OF 1
Alt. Parcel 18.29.19.644 020 - 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
SCOTT K & SUSAN M ANDERSON O -ANDERSON, SCOTT K & SUSAN M
931 WILLOW RIDGE RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description ' 931 WILLOW RIDGE RD
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 1.950 Plat: 2624-WILLOW RIDGE 2ND ADD
SEC 18 T29N R19W WILLOW RIDGE 2ND ADD. Block/Condo Bldg: LOT 35
LOT 35 INCLUDES PCL 645A
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
18-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
06/17/1998 581168 1332/410 WD
07/23/1997 829/534
2005 SUMMARY Bill Fair Market Value: Assessed with:
92517 427,300
Valuations: Last Changed: 10/25/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.950 88,600 347,200 435,800 NO 05
Totals for 2005:
General Property 1.950 88,600 347,200 435,800
Woodland 0.000 0 0
Totals for 2004:
General Property 1.950 46,000 293,400 339,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 305
Specials:
User Special Code Category Amount
018-RECYCLING SPECIAL ASSESSMENT 27.00
Special Assessments Special Charges Delinquent Charges
Total 27.00 0.00 0.00
Parcel 020-1133-30-000 12/13/2005 07:43 AM
PAGE 1 OF 1
Alt. Parcel 18.29.19.645A 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): 0 = Current Owner, C = Current Co-Owner
SCOTT K & SUSAN M ANDERSON O - ANDERSON, SCOTT K & SUSAN M
931 WILLOW RIDGE RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 0.000 Plat: 2624-WILLOW RIDGE 2ND ADD
SEC 18 T29N RI 9W WILLOW RIDGE 2ND ADD. Block/Condo Bldg: LOT 36
PT LOT 36 LYG SLY OF A LN BG SW COR LOT
36 N 79 DEG E 386.93' TO RD THERE Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
TERMIN. ASSESS WITH P644 18-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
06/17/1998 581168 1332/410 WD
07/23/1997 829/534
2005 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 08/19/1993
Description Class Acres Land Improve Total State Reason
Totals for 2005:
General Property 0.000 0 0 0
Woodland 0.000 0 0
Totals for 2004:
General Property 0.000 0 0 0
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
t
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP... JIUA -SEC . /PTZ?N-R/W
ADDRESS sd t, iA),,; ST. CROIX COUNTY, WISCONSIN.
SUBDIVISION 1yii,u1 _ _e LOT 3 S LOT SIZE > 4C1 e
PLAN VIEW
Distances and dimensions to meet requirements of H63
- OW--EVEE_YTHING WITHIN 100 FEET OF SYSTEM
V,z
f
e -
I
M
- i
5 1
y
I di a e oath Arrow I
SC L~: 7r l ~ ,
BENCHMARK: (Permanent reference Point) Describe: ldf~ F'~er~a °1 /VE carae~r
o ~ tai
Elevation of vertical reference point: /GOB Slope at site: ~}►°Jo
SEPTIC TANK: Manufacturer: W FrrQcgLs*~ d, Liquid Capacity: J666 qa~,
Number of rings on cover _ Tank manhole cover elevation: f "r
Tank Inlet Elevation: qer Tank Outlet Elevation:
PUMP CHAMBER
Manufacturer: /V 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
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: um er o pits feet diameter
feet liquid dept seepage pit in e p pe-elevation
bottom of seepage pit elevation feet. ,
SEEPAGE BED SIZE: number of lines 37i th~! le"gth,618 the depth Ve'v'
SEEPAGE TRENCH: width length
PERCOLATION RATE ,j 0A ,V A REQUIRED (REA AS BUILT
DATED _,Z7! PLUMBER ON 'JOB via r ur
LICENSE NUMBER 2t2 _
t
i
r
V
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP SEC. 1EVIN-R19W
ADDRESS ST. CROIX COUNTY, WISCONSIN.
SUBDIVISION ,.Q~~ 4/9& LOT LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of H63
EVERYTHING WITHIN 100 FEET OF SYSTEM
h
I d i a e o th A ro
S L:
w
BENCHMARK: (Permanent reference Point) Describe:pot
D
Elevation of vertical reference point: /D0 ~ Slope at site: SEPTIC TANK: Manufacturer: s _ Liquid Capacity:- 16 D 0
_
Number of rings on cover Tansmanhole cover elevation: 94
Tank Inlet Elevation: y-~ -Tank Outlet Elevation:
PUMP CHAMBER
Manufacturer: Number of gallons
Number of gal. pump set or a cycle gallons, total capacity of-
distribution lines gallon: sizes 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: - ~Nuin er o pits eet-Iar~ter
feet liquid depth seepage pit in et pipe-elevation
bottom of seepage pit f. evation feet.
SEEPAGE BED SIZE: number of lines---j--widthlerrgthS8 rile depthY_
SEEPAGE TRENCH: width length _
PERCOLATION RATE 0 - /D EA REQUIRED /O P -AREA AS BUILT Q
INSPECTOR
DATED I la G /Ov-~ PLUMBER ON JOB zzr-
LICENSE NUMBER
RLPORT OF INSPECTION - INDIVIDUAL SIwAGE SVSTIM
San<tafl rl I'r~rrni t~CO
State Sept CC-;
~AMI Town eh St. Cqo i x Cuun it
Sec .t~-~.~on 4 Lot # Subdivision Gc~a~1 ~r
~ ~rt t < r• _~.lf_.~~--- .
,;I PT IC TANK
S<ze gaffons Numbe_n o6 eompantments
Bu~2dcnq / ~i
Ur 12% 3 cope _NJ
H.Eghwa,ten
PUMPING CHAMBER
S < i e gaUons _ Pump Manu{~aetunen Mudek Number
1101_VING TANK
Si ze ga Tone Numbers oh CompantmevnT~
Pumpers. _ Atanm Sy6te.m
01i,5 tanee Anom: WeT F-_ LiuikdAing_ - - 12`0' n e o p e H4,9hwaten_
ABSORPTION XSITE C
Bed Ti ench
- Spe
DiAtance- {nam: Glee.?,___-~`(~ 8 u4 f di n g t 2 ° l o ;7
Highwaten_
A-BSORPTION SITE DIMENSIONS
- - - -
wldth aA tneneh At Requined anea ~Qo2 S~ ~t
Length o6 each tine_ .f..-j~_--fx Depth oA n.oefz below tifv ~y,
Numbeh oA Depth 0A noeh r,veq t('eC in
Totaf eeng-th oA 4"ne.6 1 J _ijit Depth o{ tiXe beeow rlnadc, n
100 ~r
0 c-5tamee between f-c.ne.,s 41 , -_6t Stope r,(~ tnencG, _ {n.
: -F " ~1 t h a rat-
t rI C o v c n
f << < ab5 >>r ~J:~ urt a -tc ~T TNL '
PI-1 DIMENSIONS
Numbers o6 pi-ts Ghave(' ano und p<tA ye! nn
t Depth bePow meet
OuT~i.de d.%ameten--- ~DeY -
Totne abaonp,tion anea
I
Anea ~,equ4ied _ -A ~
INSPECTED BY__ - TITLE
19 h
~ _
APPROVED DATE / 0
- - -
REJECTED DATE 1916
RI ASON FOR Rf: JECTI0N
I
r
APPLICATION
PEPAR.TMENT OF SAFETY & BUILDINGS
INDUS-rRY,, FOR SANITARY DIVISION
LJj3013 AND PERMIT P.O. BOX 7969
HUMAN RELATIONS (PLB 67) MADISON, WI 53707
Attach plans for the system on paper not less than 8'/s 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.
ailing Owner: MAddress:
s r G o
Property Location: ` wnshi County:
S t/4 Sly' S % T N R -E-f er) W c_;. o
Lot Number: Blk No.: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number:
/I , 4l , ` j; A (lf assigned)
TYPE OF BUILDING ( J1_
Number of
❑ Public* ❑ Variance* ❑ Other (specify)* Bedrooms-
1 or 2 Family *State Approval Required.
~0 TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER
GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify)
SEPTIC TANK CAPACITY
HOLDING TANK CAPACITY f NMI
LIFT PUMP TANK/SIPHON CHAMBER
MANUFACTURER: "L S.
1
EFFLUENT DISPOSAL SYSTEM
PERCOLATION RATE ABSORPTION AREA
(Minutes per inch): PROPOSED (Square feet: V New ❑ Replacement ❑ Experimental Seepage Bed ❑ Seepage Pit
7 F1 Alternative (specify) ❑ Seepage Trench
,'S- t o
Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner):
Private ❑ Joint ❑ Public S'
I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
Name Plumber: Signat e: } *iP PRSW No.: Phone Number:
} /yam/
Plumber's dr ss: Name of Designer:
COUNTY/ DEPARTMENT USE ONLY
Signat a of Issuing Fee: Date: ~J APPROVED Sanitary Permit Number:
o/ 1 ❑ DISAPPROVED L?A
e on for Disapproval: c 76 0
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.
DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber
DIL HR-SBD-6398 (N.03/81)
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 N_/y `OOH ~ ~ J
LOCATION Section/F T~?&R (or)(11i2rownship or Municipality
Lot No. , Block No 6e- -I T
u dive ion Name County ro
Owner's/Buyers Name: ~tLd a~ ~r e -1 `
Mailing Address: S- al: X 4 -L ZVuZed'
~S O
TYPE OF OCCUPANCY: Residence X No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW X REPLACEMENT ALTERNATE SYSTEM , OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS 4( '00 . PERCOLATION TESTS p/0- ?J ~o
SOIL MAP SHEET ~_~NAME OF SOIL MAP UNIT ~X .402- ytCA 1' 6T
PERCOLATION TESTS
1 TE3T 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 / See &P-r- 4 r, U J •
P- ,e AL-1A //Z-- 4/0 3 6 ,o ~s
P---3 y~<< a ore A7(4- / v Arlo -3 6 6
P-
P-
P-
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
TEXTURE, MOTTLING AND DEPTH TO BEDROCK
NUMBER INCHES OBSERVED ESTIMATED HIGHEST / IF OBSERVED IN INCHES //JJ
B- _3 %611 Wk 14 "5,1 xc)
B- Y6 4' eke 7`~ 6`' y it y" 'g AeS t y S
B- " e, f V 7 f ~6 "s O" Aft Al 4-3 S/7
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the Ian the location and square feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancy O a, Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope. / /4e grate
•vo -SC-0-le - 4), A, ee,+"s,~ 4S Z,c6 tl ihi¢ l D /I^f,~~,~ ~-A
.3 2y WTI / W &e_
~.f' la~rc 5 W u Io ~ ~.c`lut~s
g Z-- rX -160, s- ? a G►~
E
4 .n_ )a
0
1C 3 N
517 1, ~f~,f,,,6-e
o
s
Pte-
eid
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, t 111 ~E
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) 1~7^rA/ Certification No.-
Address G es d
Name of installer if known
e
Copy A- Local Authority CST Signature- ~ ►t~-
I=f A ,
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