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Home My WebLink About020-1099-40-050 0 CD A 7 v m co ` 1 ir 3 - ~ O co z 0 0 O W N O O w O C: w or) `C (V • ~Xl m 3 O CD Wp CL (1 N ° 0-0 O CD a) N (o CL z d N A ? O ..M- CD y - CD N CD O W N A O 0 1 p A :3 CD * CD o D b y O w cc CD i h 7 N CD O O O C cn (n O CCD 0 CD D a n CD N N W O. _ 3 0 3 0 o co\o W N c ' ( o c n Q O 3 o O O O Y ~y~• 3 ai ai N A p D 4 3 0 r3 o' CD ° rn p ' a !V ~ ~ y c ~ cn N A N O to N z ° z w z O O D a o' Z h N ~Y CD N N (V MA C CD CCDD V W ~ CZ z CD CL] -1 N O O A Z CD CL A Z U) -i W °o cn 3 I' m ~ I W m CD CL 3 o - T m C o a N x A a I ~ a t ti 0 o a A O b CD d0 N ~o O A y~ OO Q y Parcel 020-1099-40-050 09/18/2006 05:08 PM PAGE 1 OF 1 Alt. Parcel 33.29.19.400A-20 020 - 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 - JORDAN, DWIGHT O DWIGHT O JORDAN 615 OLD HWY 35 S HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 615 OLD HWY 35 S SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 21.990 Plat: 4509-CSM 17-4509 020-03 SEC 33 T29N R19W PT SW SE & NW SE Block/Condo Bldg: LOT 06 (21.99AC) CSM 17-4509 LOT 6 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 33-29N-19W SW SE Notes: Parcel History: Date Doc # Vol/Page Type 05/14/2003 721432 2241/182 QC 05/02/2003 719915 17/4509 CSM 05/02/2003 719914 2228/401 WD 827/536 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason UNDEVELOPED G5 19.990 60,000 0 60,000 NO OTHER G7 2.000 59,000 124,600 183,600 NO Totals for 2006: General Property 21.990 119,000 124,600 243,600 Woodland 0.000 0 0 Totals for 2005: General Property 21.990 119,000 124,600 243,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch 219 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ` Parcel 020-1099-40-050 02/23/2006 12:24 PM PAGE 1 OF 1 Alt. Parcel 33.29.19.400A-20 020 - 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 - JORDAN, DWIGHT O DWIGHT O JORDAfy__----"- 615 OLD HWY 35 S HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): ` = rimary i 1 Type Dist # Description * 615 OLD HWY 35 S J 1 SC 2611 SCH D OF HUDSON j / SP 1700 WITC Legal Description: Acres: 21.990 Plat: 4509-CSM 17-4509 020-03 SEC 33 T29N R1 9W PT SW SE & NW SE Block/Condo Bldg: LOT 06 (21.99AC) CSM 17-4509 LOT 6 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 33-29N-19W SW SE Notes: Parcel History: Date Doc # Vol/Page Type 05/14/2003 721432 2241/182 QC 05/02/2003 719915 17/4509 CSM 05/02/2003 719914 2228/401 WD 827/536 2005 SUMMARY Bill Fair Market Value: Assessed with: 92179 238,800 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason UNDEVELOPED G5 19.990 60,000 0 60,000 NO 05 OTHER G7 2.000 59,000 124,600 183,600 NO 05 Totals for 2005: General Property 21.990 119,000 124,600 243,600 Woodland 0.000 0 0 Totals for 2004: General Property 21.990 70,000 80,800 150,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch 219 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 2 `ry _ AS BUILT SANITARY SYSTEM REPORT OWNERS TOWNSHIP SEC.N-R;yW Y .r t ADDRESS ST. CROIX COUNTY, WISCONSIN. UZvJ 09~ f } rTl G< i J C, l .s (off (mot/ I/ 3 SUBDIVISION LOT LOT /SIZE PLAN VIEW Distances and dimensions~toimeet requirements of H63 HO:t kYTHING WITHIN 100 FEET OF SYSTEM . _ . -7177 s _ r - ~G / 7f r - - - - I 'A f i ~ Y L I'l~ YI ~ - I di a e o th Arrow - / SC L,:- i BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical reference point: Slope at site: /e` G jcrC SEPTIC TANK: Manufacturer: Liquid Capacity: Number of rings on cover' Tank manhole cover elevation: 'L)T Tank Inlet Elevation: Tank Outlet Elevation: PUMP CHAMBER Manufacturer: Number of gallons Number of gal. pump set or a cycle 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 depth seepage pit in e~ t pipe-elevation bottom of seepage pit elevation feet. SEEPAGE BED SIZE: number 6f lines ! width leyigth J.-;~ tile depth Or SEEPAGE TRENCH: width length PERCOLATION RATE REQUIRED 9--BUILT INSPE'L:rt-OR:-__._.___" DATED -'PLUMBER ON JOB LICENSE NUMBER 101"30-,-100 REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM X~0 Sanitary Permit ~ State Septic 'AME ' zGW7- VQ 11 TOWNSHIP St. Croix County .OCATION -Section.?.? Lot # Subdivision EPTIC TANK Size gallons Number of compartments ,istance from: Well Building 12% slope Highwater v L L' 'LIMPING CHAMBER ( 4 Size gallons Pump Manu"ficturer Model Number !OLDING TANK Size gallons Number of Vmp tments Pumper A ari- system )istance from: Well Building 12% slope Highwater ,BSORPTION SITE Bed fem. Trench )istance from: Well Building 12% slope-_..__ Highwater "L ,BSORPTION SITE DIMENSIONS `j Width of trench ~,L7 ft Requirred~ 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--?0 in. Distance between lines ft Slope of trench in. per 100 ft. Total absortp tion area ft Type of Cover • 'IT DIMENSIONS j Number of pits Gravel around pits yes no 1 Outside diameter % ft Depth below inlet ft f Total absorption area J ft Area required ft I NSPEe ~ TITLE APPROVED 7DATE Z19 8_/ :EJECTED DATE 198_ C~ KEASON FOR REJECTION _I DEPAR?MENT OF lawn" APPLICATION SAFETY & BUILDI GS INDUSTRY, FOR SANITARY DIVISION LABOR AND PERMIT P.O. BOX 7969 HUMAN RELATIONS (PLB 67) MADISON, WI 53707 Attach plans for the system on paper not less than 8'/2 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. Property Owner: _ Mailing Address: Property Location: City, Village or TOWnshlp County- 1/4 ;P t/aS /T . s} N/R 1`Z (or iell~_ Z Lot Number: Blk No.: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number: (if assigned) TYPE OF BUILDING Number of ❑ Public* ❑ Variance* ❑ Other (specify)* Bedrooms: 1 or 2 Family *State Approval Required. 11 TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER MANUFACTURER: EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): ❑ New K Replacement ❑ Experimental Seepage Bed ❑ Seepage Pit J ❑ Alternative (specify) ❑ Seepage Trench Water Supply: ( U Owner's Name as Listed on Soil Test Report (If other than present owner): PK Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name o#-Plumber: SigriatuF&_ MP/MPRSW No.: Phone Number: Plumber' Ad r ss: me of Designer: Na COUNTY/ DEPARTMENT USE ONLY Signature Issuing Agent: Fee: Date: Sanitary P rmit Number: ❑ APPROVED ❑ DISAPPROVED ; Re on or Disapproval: Alternate course(s) of Action Available: L 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 DILHR-SBD-6398 (N,03/81) EH 115 Rev. 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS 6 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 ~ ;OHS _j co LOCATIO / /a, Section- or Waownshi or Municipality C Lot No. , Block No. County ub vision Name Owner's/Buyers Name: I_ 4.Aj -A Mailing Address: Ax 3 TYPE OF OCCUPANCY: Residence X No. of Bedrooms --3 COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT~ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS f___ d ~ -PERCOLATION TESTS 9-7-001 SOIL MAP SHEET NAME OF SOIL MAP UNIT sDX /7L[riQi 71~ PERCOLATION TESTS c A~ A TEST DEPTH CHARACTER- OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN"IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- / " aSe~ i d .3 3 3-f IV / P_ it ~ee- O re- ~ L a ..7 J / P- 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 f .7y B- h r. . r C y C. e A// ~ 10 "S B- B- B- PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the Ian the loc tio4and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy ell 4 P4 Indicate scale or distances. Give horizontal and vertical reference ~ifp ts. Indica a slope. 40.4 po! W101 SSA e - Pj~44~-er XS T,~~' e`.1''TGd 8.,c. ToP do x;.#~ x o-,, d yt/jaw Awl- eel ~ r 1.4 IS 01 \ Q ~+ZSIbk+.ere L N marts 70, ryslae^ _7a 4, h 11GM"' 3 ~ `s I ~ ~ f i pes't' ~ cs. c 2 _ m-I- 4---j----- 1, the undersigend, hereby certi at 4te 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) V%s Certification No._~! Address 1 Name of installer if known Copy A -Local Authority CST Sig .r ~ Y V i r i f s J r + ' I y' I v Ae-