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HomeMy WebLinkAbout020-1036-50-000 n to p 9 '0 0 r_ CD a- v `~1 03 2 Z co = ; V/ CD = o n cn -1 z p co Z a a, ~C v ~ N ° lD 3 Ul N rn° m z N C?` O W CD F N O- 7 O 7 CJ7 :3 0 O-. W o O c C O D O 3 7 N O ~ ►S R C Q ~ cn ~ D o- (D cn N C N N u a rn N \ (D ° ° _ i ! Q C d CD (O CO N n j Or C N r?, M ~vv- G cr. z 0 0 0 o' N N N o N D u v 0 0 p O (CD fD y A~1 CD O !r CD 61 N N Z C N A 4 N CL a zco Z o CD 0 0 D a ~ CD N N CD D) C -0 (o C CD N W D O_ n 3 7 Z cD 1 to O ~ O A Z n c A z O N a 3 W W < co CL Z z 3 0 z cD Z ( A w Q T N a T CL 23 O X v C cn O Z CD Q Q O O (D O- N 0) rn~ y U1 a ° ~ O A ~ O ~ a (D p t p A f0 ~ N O N ~ N O O A c N O O EA 0 pp O CD b O a O Parcel 020-1036-50-000 02/22/2005 12:55 PM PAGE 1 OF 1 Alt. Parcel 18.29.19.157A2 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): Current Owner TAMMY JO CAMERON " CAMERON, TAMMY JO 369 CASPERSON DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 369 CASPERSON DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.380 Plat: N/A-NOT AVAILABLE SEC 18 T29N R19W NW NE LOT 2 C.S.M. VOL Block/Condo Bldg: 4/1047 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 18-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/15/1998 582985 1340/192 QC 07/23/1997 777/607 2004 SUMMARY Bill M Fair Market Value: Assessed with: 47875 189,100 Valuations: Last Changed: 06/06/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.380 38,100 108,200 146,300 NO Totals for 2004: General Property 2.380 38,100 108,200 146,300 Woodland 0.000 0 0 Totals for 2003: General Property 2.380 38,100 108,200 146,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 130 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 001-WATER SPECIAL ASSESSMENT 0.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP SEC./ e TAN-R& W ADDRESS v cl ~,'z ~Q/~ S ST. CROIX COUNTY, WISCONSIN. SUBDIVISION LOT ;7- LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 TnLEVEYTHING WITHIN 100 FEET OF SYSTEM Ti I I di a e v th Arrow I" L C SC BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical reference point: 3A / / c a Slope at site: SEPTIC TANK: Manufacturer: e ~L,~ 5 Liquid Capacity: l ~rz'z? Number of rings on cover : 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 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 diameter feet liquid dept seepage pit in epipe-elevation bottom of seepage pit elevation feet. SEEPAGE BED SIZE: number of lines 3 width / length_;~S: the depth Tv _3E SEEPAGE TRENCH: width length PERCOLATION RATE AREA REQUIRED AREA AS BUILT ~a INSPECTOR , DATED PLUMBER ON JOB LICENSE NUMBER a i ` RI PORT 01 1NtiVICIION IN01VIDI.IA1. SIwAGI. SytiIIM State Seplic AM/ Tow nAh,i. p St. C h „ , x ( ' I I I , t S -0 t4.anA Lut- a_ ---Subdli.v-i5 i nn I VVIC IANK gaYYortb Numbers p corn ►ai►tmen.t~1 ;f tr,PI c c A ~,urn: G►eYY - Butfdinq n - 120 efopv Ht ghwa te.n 'IMVIW; CIIAMBI R gat f(o) YL1 p Manu 4ac.tuh.e.n Mu de Y Nurnb v,,, ~I DING LANK gaffongT Nuntben, o6 Compan.tment~5 r Pu mpe n ye te.m tonce hnum.: Weft Buy Qding l2 o e Qope H4# wa.tea ',WWPTION SITE Bvd Trench ~ Lance Oom: Weft Buitding- > 1 r2% exope H4.ghwate+r `~OKI'TION SITE DIMENSIONS ' W itth n~ tne.,nch 6,t. ReGu.i hed area 1-entIt1, oA each 14ne Deptd? 4r,oh 1) 1,e(7to ti Yc - - - - Numl,eh o(a Y.lnee - Depth o6 noch oveh ti Ye in fotaY Yenrlth uA fine.e 6t Depth „6 tite befow grade ,r, D(ntancv between Y4ne3 ~ Ott S.Yupe „6 tneneh <n. pvn 100 A t I , 4 )1 4 un a~iva - 5 6t Type oA Cuven: Papeh on b thaw 'I I DIM/ NSIONS IV (4 fill) vIf u6 p,4ts Gn.avv around p,( to yer, n„ OutA(de diamete.h 6t Depth beeow 4-nevt 61 Totaf abeonpt.t.on ahea ~t A►aea gvqu<ned_ 6t NSPf('Tt D 8V TITLI 1111KOVI D DATE 19 k " I It CTI D DATE 198 'I AtiON I OK REJECTION i ~ i 5Rev. 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES .may ~~9 P.O. BOX 309, MADISON, WISCONSIN 53701 Ir I- LOCATION '/a,/yE'/a, Section lLT Z9 N,R_dE (or) _W, Town or Municipality Z LCJ ~ f}.Sjv ~SD.tJ S /3 /E// ~D Count ~ C~O rF Lot No. Block No. i~~1U C U S y y` M Owner's/Buyers Name: ~P9N N£ ubdivision ame ~y ~ •~1 Mailing Address: ~ Wy -3S 13OX ~ititi• TYPE OF OCCUPANCY: Residence X No. of Bedrooms 3 COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW V REPLACEMENT -ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE- SOIL BORINGS 4!/' Z /10'/ --PERCOLATION TESTS ,2- SOIL MAP SHEET S^C~ NAME OF SOIL MAP UNIT 01411 If4Pr ~~19 4P64V 5~w/;) acs Svb -57161 7_59 PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE P!UM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- yl ~E y P-_2_ YO l3oee z -D z y~-- P- P_ . 6, „ J~,r 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 B- L S/`" eiP aae_ R0 eS Al ]Ae 94 5Z B- 3 00 1vo,A1_r_ > 8 :,A . lSv. 51-,S- 1'6v. e ud-c S[. S-" Zl ,Cv 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 Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. ~iP9/n~FjELl3 ,{~EL7 TF 9 lea, . _ - - - r; # 2- ; 51~S i' r E c e I r ~G~iUS AlO I TD S5/91Z, SvT K N/ Al-frlfV65~~ If dy QS 45 sor v E - ~N N 1' 3 'O P3 /r~N,MO~i ~7tQ0~bSL~1~ Y~ I- 3 w Q.. , 30 t5 gT4Si S0 'or-If 10_A4 ~ ~ . • y~; ~ TEST ~,PE~t B s i 1 ~-ly Fr G N9'_. 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. ~i Name (print) A14e/ `yel e/I _ Certification No.~f r©L T ~Z- Address RT 3 ~ &A-)50 A,) W~ S 0/4{ - Name of installer if known Copy A -Local Authority CS Zure 11 5Rev. 9/78 ,f REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 y o,cJ LOCATION: Section ~u T 2/ N,R / E (or) W, Township or Municipality yy~~ Lot No. Z Block No. ~l>/~ D1 ~ 0'~ ~U~✓~~Ui Siy.~ County e~A) "~i~ Subdivision-Marne Owner's/Buyers Name: ,Q ~ Mailing Address: _270 e) G!>~f lt, i_ A, r/ TYPE OF OCCUPANCY: Residence -Y No. of Bedrooms 3 COMMERCIAL SS~~L EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT D ALTERNATE SYSTEM OTHERC DATES OBSERVATIONS MADE: S-O7IL BORINGS &Lez z ~~a ~PERCOLATIONN TESTS 4W SOIL MAP SHEET JCS S / NAME OF SOIL MAP UNIT /✓V~ / PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- SINCE HOLE HOLE AFTER INTERVAL BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN;IN P- P- P- 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- SL /T' /,-/N. B- s. [ v~GQ B- N O.✓X-- 1 8 " De QN, ear 5'L t'aT ~ s4- 10A.1 B- B- 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 -102 h~-P Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. E&VA7-%QaJ 13A~ lQ~ „f_ i Top of w~sT G© j- c~rof _ j ~fl/31J-e'1 1:3 . i.Po,v gT /3zvF I ~ - 3 F ° =1S"° ~ /our 6~M ,z y 8 ° . e ._e . _ 13 _ /,P 13e /0k.+ /~/l a . Z.- P,4phlA) ;1 g~f 1J i E : _ .o 1 e s t , IE 13 ~ !r°°°~•~ " ~ 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. U Name (print) /O4e7- C14 7- Certification No. /192, Address 4r.3110,PSOA/ CyiS - Name of installer if known Copy A -Local Authority CST Signature ~~2~! ` State and County State Permit # -PLB 67 Permit Application County Permit 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: AW y six q / s~;~/~,~~- ~s B. LOCATION: Nk) /4_&~ Section Tt~f N, R4L E (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village APP1710AI j,U/ G/9.t~E 2i%5-% Township UOS~'~y C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family Duplex No. of Bedrooms -3 No. of Persons D. SEPTIC TANK CAPACITY /0-C-0 Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete _ K 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 z Z Total Absorb Are sq. ft. New X, Replacement Alternate (Specify) Seepage Trench: No. of ineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: Length _Width A? Depth 2~ Tile depth (top)--3,0-No. of Lines -3 Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land ~Po Distance from critical slope WATER SUPPLY: Private X 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 Ah EwT C.S.T. #5 62 9V9Z and other information obtained from (owner/builder). Plumber's Signature i MP/MPRSW# /U S J Phone # 7/5 - YG ~j Plumber's Address ?v. :2e-4- 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. Cis ~XcT~f. yl"ew /M A01ftv1 RiQ f v ge7`ToA1 F... n . (2"rN~wrH~'y ' AQa u~ T1i4h~ ly Vi k G.P.9y~, t e e , ~ . ~ yN~e ova 3 YEuT~~ o LOV~/AhjROGK' D/~S~t°i UAL/ON 11 F P I h 0 C3, 0 C:> 7 13kA.) Ll Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application -~1-6 --Jr _Fees Paid: State County , Dat 7 Permit Issued/Re}eeted (4a4@4 G-, Issuing Agent Name . Inspection Yes 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 L- REPORT ON INSPECTION OF SANITARY PERMIT # (1) Name and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection Time of Inspection game, ress,. 1cense No. o ns a ing Plum~er 3 INSTALLATION CO ,XSISTS OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber ❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System BENCHMARK: (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: M 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 ❑ N0; 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: • DA~U ~M ~~~~y HoM c- , l t}P~i~ /j f~~Ad/5 No7 1o S~,g/~ WOMESI T E TESTING CO. RT-3, O'NEIL ROAD HUDSON, WIS. 54016 1 • ~~,vo TE`S /o c,fT~ous of ,Qo~P~" P~ TS ~QoM Cf~/1,~ W s i ~ ~opo~oSc 1~ I + 6;V 7- S/Pc o,r- 6 14100s-,6- ,y%u /Af dM 1CWOM } p,(>itly ,(f 6~ , I L`/. /3t D 66 T1»,7 2 " I ky piE~OPO,jE y' c/E~!'Au'~ S2 NcMr 4'0yE ~s,, ~ FRoM S ~~vFF LiN~