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HomeMy WebLinkAbout020-1141-00-000 I• n cn O to, o cn 3~ 2 v z m 2 p o w O CD N O p CD 0 s CL p N0 CD V) b (1 Z Q. : O O rr CD U) 7 fD co = CO C t J ! O (D Q j N C V o r.t CD B- n O f^~ Cr C: CD ClD p 7 p M °aJ O 3 p 7 N co p 0 d 0 v CD D r N N Q C V 0 - W CD 3 CL O O 'a 0 > N O ! L lz co `C ! Cfl co CD w m 2 n r N C N O c «y a N r M -0 _0 0 0 0 0 s * cn -1 N cn a m v 3 v v O ° W in-' CA O i (D O !Y 7 M N D m CL N CD _ Q 0 N z ° z co z y CD o N N 'a cn N O CD w CD _ a 3 7 Z CD -i Cn O D p Z (D N C: _ ~a .O. O Z O 0 d O O 7 _ W C p p CL z a o " z 3 m V z CD A N a La: o - w c (n o a N C N CD a 0 0 Q Z2 C A Q' I ~ 3a DQ ~ y N N Oo I ~ C N O O C N a a K 0 N CD A 69 0 p * ti yV b (D a, C) n Al Parcel 020-1141-00-000 08i28i2006 02:36 PM PAGE 1 OF 1 Alt. Parcel 19.29.19.721 020 - 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 - BONHAGE, JOHN F & SUSAN K JOHN F & SUSAN K BONHAGE 896 AUDUBON CT HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 896 AUDUBON CT SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 1.078 Plat: 2167-MALLACOVE SEC 19 T29N R1 9W MALLACOVE LOT 16 Block/Condo Bldg: LOT 16 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 19-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 01/08/2002 667538 1809/218 WD 10/05/1998 588359 1362/474 QC 07/23/1997 1089/219 WD 07/23/1997 727/544 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 1.078 54,900 192,800 247,700 NO Totals for 2006: General Property 1.078 54,900 192,800 247,700 Woodland 0.000 0 0 Totals for 2005: General Property 1.078 54,900 192,800 247,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 133 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT T„ OWNER L SAN TOWNSHIP "6/ -5SO y SEC./? ADDRESS /`T ST. CROIX COUNTY, WISCONSIN. SUBDIVISIONLOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 VERY-THING WITHIN 100 FEET OF SYSTEM tIto l L' 0 ~ La L~ G t rc I di a e o th Arrow i SCL ~'CiA/~/'~ CTS /.3lFS t'Q tG,+tEiZ BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical reference point: ZO(} Slope at site SEPTIC TANK: Manufacturer: Liquid Capacity: /Ico Number of rings on cover : ~3 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; tota capacity of 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 de ize SEEPAGE PIT SIZE: Number o pits feet diameter feet liquid depth seepage pit in etpipe-elevation bottom of seepage pit elevation feet. SEEPAGE BED SIZE: number of lines wi th, lerzgth.j.'j the dept~~ SEEPAGE TRENCH: width length PERCOLATION RATE` _AREA REQUIRED- ' PREA AS BUILT "YC INSPECTOR DATED ~ / PLUMBER ON JOB ~,v c- f if r T LICENSE NUMBER 73 20:x' RLPORT OF 1NSPLCTf N - INOIVI OUAL SIwAG4 SySIIM 7-i 5 - ~ tiani 1it if q I,vti rn,r-( Q ti( p 4'(- (/4 TownAii.< 1p -St. Carol x Coun-trl r Section Lut M Subdivka4'on I ANK l L~ 9aP.IoKA Nambeh o cotri ait tmenta I i, Allom: Ulelf /L Bukfd.in. 12$ ako.pv Highwa to n WIN(; CHAMBER nd MY Manu actuh n. 4 , p 6 e M o d e t N u mb e. n 1 h I N G TANK i r , -----atpKb aen oA Compantme.nte 1'„rr,r,En ptAm Sya.tem r r n oe 6 h o m: tot _ C B-ucIding=`~ 12$ aope Highwate,tt (1R1'7ION SITE li,,l Th~hnh Alrom: We -U Boi f(ling 12 o 6 Pope 114 ghwa.te n ` i i,'1'I1ON SIf L DIMENSIONS Wr ,I (It o,S t'nench 6t Requ4 d k" I , viii (it o each ti.ne._ At Depth oA hock befow t4.ee n N i, rn 1, ( ~I n 6 X..i *l e.6 _ D w v i e, o A n. u e u oven -t 4, Y. e. t r i r„ to f ength o6 t e e 6.t Depth uh .tite below gnade.~- -..~4.n ti r,rnve between tines r t;t tope o6 the,neh in. peh 100 At - 1 tof obeonp.tion anea ,6.t Type. o4 Coven: Papeit on eteraw i 1' 1 MI N.ti I ONES s 'J11101(111 G4 av(2 ahaund pi to ---yea- nr, r, 1c diamete.h 6t Depth befow I (.it' abAo ption ak(,,a 6,t 5~~x DATE 198f 1 1 1! DATE 19 b 1,11: JLCTION -,PLB State and County State Permit # 67 u Permit Application County Permit # /1-714 ~ Ql for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. ~j OWNER ,tO,rF PROPERTY n ['p~~,~LMailing Address: ~J B. LOCATION: Al 40 '/4 AF_ '/4, Section If-, T .2N, Rj_~ E (or) W Lot# City /Subdivision Name, nearest road, lake or landmark Blk# Village M414cot16- "-141,4G0'0F 5_0130ll51e9A) Z) A2A11E_ Township 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 y Poured-in-Place Steel Fiberglass Other (specify) New Installation k 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 sq. ft. New X Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: Length 3!!~ _ Width 2 y Depth NA(a Tile depth (top)-40 No. of Lines Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits , Percent slope of land .3 970 Distance from critical slope O iE /oe 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 A196 { ,p J- A7- C.S.T. # and other information obtained from (owner/builder). ry Plumber's Signature , l~Gc~ i~-1 G•~ MP/MPRSW# ZL151 Phone #71 Plumber's Address2 L C~ti% 8C' i16.5-0 j CDl S 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. ~'N o A4 44-5-5 14A . R Aq X-C 00 Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY _ Date of Application Fees Paid: State t/, 1-0 County ate Permit Issued/Re~ected (date) - 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 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, c DIVISION P.O. BOX 76 LABOR AND PERCOLATION TESTS (115) MADISO N WI 53707 HUMAN RELATIONS LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.: BILK. NO.: SUBDIVISION NAME: kW 1/Wi/ /9 /T 1y N/Rf9 E (or►W vDSo.-v - Cdv~` COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: j AE oL.Sit~ S7~• ~~'C/x J ~ USE DATE ERV TI M E NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROF/t ONS: ER L ION TESTS: Residence 7New ❑Replace i RATING: S= Site suitable for system U= Site unsuitable for system A re CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: ISYSTEM-IN-FILLHOLDING TANK: RECOMME VIYST E M:(optionalI as ou as ❑u as ou 0s ©u as au 19-WA If Percolation Tests are NOT required DESIGN RATE: SYSTEM EL I If any portion of the lot is in the under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) j/ "GV , it 13,A) /P P4 2- Ae B- -3 F2_ Zj: a-to . 0-7 .3 B' g ) 1 / / Zr " r./ e B- dd+~ PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 -PERIOD PER INCH P_ 32 P_ /(✓d1/y1 > P- P- PLAN VIEW: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all orings and the direction and percent of land slop. A3'E'P )3p j;ra-1 /o 'LtE- ~(p f Pk0pa5ep ~ lu 0 13E/Ow ae -4T ( 1* SYSTEM ELEVATION ,1 ? T ( i ~ ~ tit ~ r ac 5i 1,! . !tl fi✓ ~i ~9 i r , i I , . _ .e P '!~14 V4 " /40v"4`6, I r~ ~ Y~~ jr B , 1 lir /0 s,QAI~. a ,Ez'p °76 /'V R I/i4 SSG ~ ~ G i, the undersigned, hereby certify that the soil tests reported on this form were made by mein accord with the procedures methods specified in the Wisconsin Admimistrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (Print) : TESTS WERE )x1ty l fgl ON: ADDRESS: 1 Sctii ~J/~ UC/ CERTIFICATION NUMBER: PHONE NUMBER optional): 33--0 7- y~2-- CST SIGNATURE- DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. DiLHR-SBD-6395 (N. 03!81) " ~N.> ''PLB 67 PL,gtiV'I'E W PET-EI° MOL5E~,J HA 2. a qg l r r I ~ 0 f l 5G~ f ~ I _ I f' ~k CAP) Q i M - /o Li.,E- 130 TTQ V-A 13e /0 Lu TRANSFER FORM PLR SANITARY PERMIT 67-T State Permit # Sanitary Per it # County Sanitary Permit Transfer Date Original Permit Issuance Date A. Property Location: Section T-2-Y N,R /9 E (or) 1o1 Lot # 3 city Subdivision Name, / J' A4-A. fFCDC1~= Nearest Road, Lake or Landmark BILK # Village ~r~//,~.~ Township jm,2 ~ B. TYPE of Occupancy: Commercial Industrial Other (Specify) Single Family X, Duplex No. of Bedrooms 4?e Variance C. SEPTIC TANK CAPACITY -19 00 Total gallons No. of tanks Q HOLDING TANK CAPACITY Total gallons No. of tanks Prefab Concrete Poured-in-place Steel Fiberglass Other(Specify) New Installation' Replacement LIFT PUMP TANK/SIPHON CHAMBER Total gallons Prefab Concrete Poured-in-place -Other (Specify) D. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area sq. ft. New Replacement Alternate (Specify) Seepage Trench: No.Lineal Ft. Width Depth Tile Depth(top) No. Trenches Seepage Bed: _Length 3s7 Width 'Y Depth 3 Tile Depth(top) ^1' 41f"/e,.No. of Lines Seepage Pit: -inside ,,diameter Liquid Depth No. Seepage Pits Percent slope of land 1-% Distance from critical slope E. WATER SUPPLY: Private ❑Joint ❑Community ❑ Municipal Present Sanitary Permit Holder Phone No. Sanitary Permit Transferred To: Phone No. Name 4y&/ Sew Name Address /62. I&I1-25er'1/ f0f, Address Zi pZip I, the undersigned, do hereby certify that I have reported all revisions to the sanitary permit and that all revisions are in accord with section H 62.20., Wisconsin Administrative Code and that I have sized the effluent 0(sposal system according to the EH-115 prepared by the Certified Soil Tes er and/or any additionalsoil tes that may have been required. Plumber's Signature sJ.~ MP/MPRSW # Phone Plumber's Address_ 7 A Information obtained from o45,~Fz owne r agent) PLAN VIEW: Provide sketch below of any revisions to original sanitary permit. Include direction of slope and all distances in accord with H 62.20. Well location shall be included on the sketch. Indicate or dimension location of all wells, on the property or neigh- bor'se ro erty If well~has dot been ~dr{II d _u ease, t.~ 9 d I i s t I E { i E i 9 Signature of Issuing Agent 1. County (Yellow copy) 3. Owner (Pink copy) DIVISION OF HEALTH 2. State (White copy) 4. Plumber (Green copy) P.O. BOX 309, MADISON WI 53 O.