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HomeMy WebLinkAbout020-1139-60-000 v c '0 3 I m N O iD 4' c~D o. N 'O h"i (D W C~ = O O O 1 N d p N -1 V "'ti p O Q) t 0 (D 0 CD CD C) 3 _ o s N (D C Ca C/) CD ° C c i m ° CD a - W (D C O O ~j c C 3 O m N ~V c N CD O 0 c e p O O O a Z o CD cr, O N v 3 y m O a w CD (D _0 0 y^ CD ? ((DD (D o 0 0) N D N 3m - O (D a z p' Z m ~ Z Q Z ° O y n o r O N 0 CD D N CD n) M~ cn N. C (D CD (.J O_ Z (D s -1 (n Z fDf1 V~ O ? 0 n t> Z j G y O C N CO (D CCD < O Q Z 0 3 a ~7 O Z (o 3 j N Z CD I N Q O N p7 T N C z o CD O N (D n O ° a 02 I x fi rn N Q CD O O a ~ i~ I b w Parcel 020-1139-60-000 08/28/2006 02:44 PM PAGE 1 OF 1 Alt. Parcel 19.29.19.707 020 - 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 - LEIER, DONALD J DONALD J LEIER 363 AUDUBON LA HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 363 AUDUBON LA SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 1.221 Plat: 2167-MALLACOVE SEC 19 T29N R19W MALLACOVE LOT 2 Block/Condo Bldg: LOT 2 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 19-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 697/455 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.221 58,300 197,500 255,800 NO Totals for 2006: General Property 1.221 58,300 197,500 255,800 Woodland 0.000 0 0 Totals for 2005: General Property 1.221 58,300 197,500 255,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 08122/2005 Batch 05-4 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP 1 ~L 11 SEC. q T~-R W ADDRESS ST. CROIX COUNTY, WISCONSIN. SUBI)LVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 r HQW_EVERYTHING WITHIN 100 FEET OF SYSTEM i i 0 I di a e oath Arrow tt - - I SCALE : ' f Bl?NCHMARK: (Permanent reference Point) Describe: L o r 5 f~/-0 r r F;l.evat.:ion of vertical ref.er.ence point: Slope at site: .,.F['TIC TANK: Manufacturer: L=S___ - Liquid Capacity: ! 2 4 1 Number of rings on cover Tank manhole cover elevation:-4 0 j t Tank Inlet Elevation: o'er r r~ --Tank Outlet -Elevation: I' UMP CHAMBER Manufacturer: Number of gallons Number of gal. pump set for a cyc:le__ _ gallons; total capacity of distribution lines _gallon: size o pump _ -i -head; gallon per minute horsepower brand name of pump and model number _ Type of warning device HOLDING TANK: Manufacturer Number of gallons I:{;_l_e.vation of manhole cover----- Type of- warning device SEEPAGE PIT SIZE: _ -----Number o~-pits fleet diameter feet liquid dept-i--,--- seepage pit in. et pipe-elevation bottom of seepage pit evation feet. SEI:'PAGE BED SIZE: number of lines wic lef~gth the depth SEI?PAGE TRENCH: width length PI RCOI.ATION RATE j AREA REQUIRED j, ~ -AREA AS BUILT INSPECTOR UA'1'ED vC~l~ PLUMBER ON JOB y~L., LICENSE., NUMBER !i ~ t.¢. U L ~ 1 ~ 11 ~ ,;f ~ ~ ~ v fa ~ ~ ~ ~~~f^ 1.3 ~ ~ O ~f~Z~GC' ~j~t( ~ I ~ ~ ~ ~ x ~ ~ ~ ~ G~ ~ t ~ ~ ~ i i V 1 ~ i N ~ i V~ ~--f-1---~ 3 3~ ~l r- ~ ohs ~ _ / ~ .r ~ M Wisconsin Department of Industry, PLE-1 INSPECTION REPORT Labor & Human Relations Safety & Buildings Division Bureau of Plumbing, Platting & Fire Protection Name o remises a e an No. Street City County Sanitary Permit Master Plumber Firm Name dress Journeyman Plumber Address Owner Address iscusse with Signature ( )See Attached. DILHR-SBD-6192(N.09/80) Signature o is Plumbing up. On-Site Waste Specialist ldhite-Inspector Yellow-Local Inspector Pink-Plumber or Responsible Party Green-Owner " REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM Sanitary Permit L State Sept NAME,',______--s - TOWNSHIP_,*D St. Croix County tLot Subdivision ~eA040'd SEPTIC TANK '44eba4dw .41flE Size gallons Number of compartments Distance from: Well A u1-c- Building 12% slope Highwater PUMPING CHAMBER Size gallons Pump Manufacturer Mod(2a Number HOLDING TANK Size- -gallons Number o- •Compartme its Pumper- l rm Syste Distance from: Well- Bu lding ~f 12% slope Highwater~.` ABSORPTION SITE Bed \ Trench ~J Distance from: Well G Bull ing 12% slo e 41, Highwater ABSORPTION SITE DIMENSIONS; Width of trench t ft Required areal- ft. Length of each line _ C) ft Depth of rock below tile Number of 11-nes Depth of rock over the Total length of lines- _ ft Depth of the below grade in Distance between lines ft Slope of trench in. per 100 it. Total absortptnon area ft Type of Cover PIT DIMENSIONS Number of pits Gravel around pits ye:, no Outside diameter ft. Depth below inlet it Total absorption area 'ft Area required ft ' TITLE APPROVED DATE 198 REJECTED DATE- 198 REASON FOR REJECTION y t F~ ((rI~ ` } t +L I r ~t ot S3 U~c r- v REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM Sanitary Permit State Septic~ZZ-M TOWN -'e ec AME TOWNSHIP St. Croix County OCATION a) Ale- Section Lot # Subdivision EPTIC TANK Size gallons Number of compartments istance from: Yell Building 12% slope Highwater UMPING CHAMBER Size gallons Pump Manufacturer Model Number OLDING TANK Size gallons Number of Compartments Pumper Alarm System )istance from: Well Building 12% slope Highwater BSORPTION SITE Bed Trench istance from: Well Building 12% slope Highwater ,BSORPTION SITE DIMENSIONS Width of trench ft Required area ft. Length of each line ft Depth of rock below tile, in. Number of lines Depth of rock over tile in. Total length of lines ft Depth of tile below grade-- in. Distance between lines ft Slope of trench in. per 100 ft. Total absortption area ft Type of Cover: SIT DIMENSIONS Number of pits Gravel around pits yes___v__no Outside diameter ft Depth below inlet J J _ft Total absorption area ft Area required ft NSPECTED BY TITLE .XPROVED DATE 1.98 EJECTED DATE 19$ t::ASON FOR R.EJECTION A r~ State and County State Permit # w PL13'67 [ 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 D~Ia/G~ eiL- Mailing Address: B. LOCATION: % 1/4, Section , T N, R 14 E (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village it ((:,t V 4/-" Township F ced ° C. " "TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family _L~ Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY Z Q Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete 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 Total Absorb Area `j sq. ft. New Replacement Alternate (Specify) Seepage Trench: No. of Line Ft. Width epth Tile depth (t 0) No. of Trenches Seepage Bed: Length Width ;-Depth ' Tile depth (top) No. of Lines Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land 3 -C 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 Tester, L NAME n K ii i `L r~ i 5 I v A b y f~i'1 C.S.T. # and other information obtained from d+ (owner/bwlder)-- 2 Plumber's Signature OOL) M 6 jt '3.2,--Phone # ;21;7 -3<- J 2 P/MRSW# LEI Plumber's Address w i ~f 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. 3 3 € r a 3 d 3 j c F E s <a e e e ..e w... t t s r f t t Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY n Date of Application Fees Paid: State County Dat Permit Issued/Rejected (date) Issuing Agent Name U Inspection Yes No State Valid# T~ 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 . , 115 Rev.9/78~ E REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES ®py~`~'G P.O. BOX 309, MADISON, WISCONSIN 53707 lt~S`F~ ~,l~' C LOCATION %,46L%, Section147,e~~N,P&V(o Wi~wnshiporMunicipality /a Lot No.07-, Block No. A CO V County s / Ct"O~X L ubdivlsion Name Owner's/Buyers Name: lei. JL Mailing Address: S TYPE OF OCCUPANCY: Residence X No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW X REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS '.9-eI PERCOLATION TESTS SOIL MAP SHEET _577 NAME OF SOIL MAP UNIT ' ice __Aft 16 ;Y11- Af, PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE p UM_ SINCE HOLE HOLE AFTE INTERVAL MIN/IN BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- l .S " SQL 'IA ' 0 3 P A& P_ ft t A.. id ! L~ © 3 ll~ 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 " S B_ 2 Of 11 L 5,4-6p-0 B- /671' B_ c i ! r. rs S . ,ZCl •s rS '1 .~sr rss B- Zo 0 54 .3 S7 B- ~J PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on th Ian rthh location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy kQ A Indicate scalegr distances. rvo- ,Give horizontal and vertical reference point Indicate slope. ASM V.T /0Q' .BI IFI = /0 10 r Y lei. p N Dei91E;w e !d 16,x. = 92' o _ _ __E_ ff ^ 7BP A 0Z Free Pest - 810,W 004-6 Y 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. ✓ l Certification No. Name (print) Incsce, Address t - Name of installer if known - s Copy A -Local Authority CST Signature i ~ ~ ~ v ` J ~ c.. ~~f i r..l ~ ~ ~ 1. ~ ~ c ~ ~~n. ~ - ~ G~ Vic, ~ e •d ~ t ~ , - ~ ~ ~ s ~ ~ c, a lII ~ \ ~ ~ ~ ~ zf _ ~.1'`~ ~ f