HomeMy WebLinkAbout030-2002-50-000
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K COMMERCIAL TESTING LABORATORY, INC.
514 Main Street, P.O. Box 526
Colfax, Wisconsin 54730
715-962-3121
800 - 962 - 5227 cz: v OC
Chub, u3UNI Y' REP(3 :T DA'T'E' 4J18/9'i
COURTHOUSE r ,T n p„rr- j . ,
11SON. WI
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ATERPRETATION. Bacteric
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PROFESSIONAL LABORATORY SERVICES SINCE 1952
ST. CROIX COUNTY ZONING OFFICE
911 4th Street
Hudson WI 54016
1
Telephone - (715)386-4680
The St. Croix Co. Zoning Office offers the service of septic and
water inspection to Lending Institution, Realty Firms, and
private individuals.
COMPLETION OF THIS FORM IS ESSENTIAL SO THAT THE PROPERTY CAN BE
LOCATED.
Please provide the following information, enclose appropriate fee
made payable to ST. CROIX CO. ZONING, and mail, along with form
to the above address. Testing will be done as soon as possible
after fee and form are received.
WATER TESTING--------------- FEE:$ 25.00 V
(For nitrates and coliform bacteria)
WATER TESTING FEE:$175.00
(VOC'S)
SEPTIC SYSTEM INSPECTION FEE:$ 25.00
PROPERTY OWNERS NAME:
PROPERTY OWNERS ADDRESS : z S-t CITY: Legal Des ption Y 1/4, 1/4, Sec. 3, T 3( N-R_ W,
Town of Lot No. , Su division
FIRE NO. 1Z LOCK BOX NO.
Color of house Realty sign? Firm:
PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP, i.e., COPY OF PLAT
BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET.
Testing of residential water requires a sample that is fresh. If
the home is vacant, and has been so for some time, the water line
must be purged by running the water for several hours before the
test can be conducted.
WINTER TESTING: Many times water lines are turned off, or sill
cocks are turned off, making access to the home necessary. If
this is the case, please make proper arrangements with this
office to ensure time when entry may be gained.
Firm or individual requesting services:`
Telephone No.
REPORT TO BE S NT ,TO : ~1~ 6-111U) y C X 1
CLOSING DATE
r~
Signature:
PIC,
ST. CROIX COUNTY ZONING OFFICE
911 4th Street
Hudson, WI 54016
i~t✓` Telephone - (715)386-4680
The St. Croix Co. Zoning Office offers the service of septic and
water inspection to Lending Institution, Realty Firms, and
private individuals.
COMPLETION OF THIS FORM IS ESSENTIAL SO THAT THE PROPERTY CAN BE
LOCATED.
Please provide the following information, enclose appropriate fee
made payable to ST. CROIX CO. ZONING, and mail, along with form
to the above address. Testing will be done as soon as possible
after fee and form are received.
WATER TESTING FEE:$ 25.00
(For nitrates and coliform bacteria)
WATER TESTING FEE:$175.00
(VOC'S)
SEPTIC SYSTEM INSPECTION FEE:$ 25.00
PROPERTY OWNERS NAME :
PROPERTY OWNERS ADDRESS: /-11~ CITY: Legal Description c LJ1/4, Sec. =j TAN-R W,
own of , Lot No. , Subdivision
FIRE NO. ~ r~ LOCK BC X NO.
' Color of house tl ealty sign? Firm:
PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP, i.e., COPY OF PLAT
BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET.
Testing of residential water requires a sample that is fresh. If
the home is vacant, and has been so for some time, the water line
must be purged by running the water for several hours before the
test can be conducted.
WINTER TESTING: Many times water lines are turned off, or sill
cocks are turned off, making access to the home necessary. If
this is the case, please make proper arrangements with this
office to ensure time when entry may be gained.
Firm or individual, re uesting services:
Telephone No. < < rj
REPO T O BE SENT O : CLOSING DATE--/-,
Signature~-
• S N LAND SURVEYING*
HUDSON , WISCONSIN 54016
( 715) 386- 2007
NAME MidAmerica Bank
ADDRF SS 600 Second St.
Hudson, Wi. 54016
DES'RI~ 101, Part of the SW 1/4 of NW 1/4 & Part of NW 1/4 of SW 1/4 of
Section 33, T30N, R19W, Lot 2 of C.S.M. Vol. 1, Page 96
A91-418
Rose
N PLAT DRAWING
This is not a complete Lana Survey
Easement to St. Croix County Electric, Vol. 256, Page 544
629 368
East 702.54'
668.96
36,
/ garage 26,
451
300 shed / 11 / 40
deck -o°
house N
I~° l 251
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ST. CROIX COUNTY
~r,FJ WISCONSIN
~ yr
x~ rdk° ZONING OFFICE
ST. CROIX COUNTY COURTHOUSE
911 FOURTH STREET • HUDSON, WI 54016
(715) 386-4680
April 23, 1991
Judith Keiser
MidAmerica Bank
600 2nd St.
Hudson, WI 54016
Dear Ms. Keiser:
An inspection of the septic system on the property
of Thomas & Lisa Rose, located at 1253 52nd St., Hudson, WI was
conducted on April 23, 1991.
At the time of inspection, the sanitary system appeared to be
functioning properly. The inspection of this sewage disposal
system was based upon a surface inspection of said system, and
did not involve any excavating or chemical analysis.
Accordingly, there is the possibility of hidden defects in the
system not discoverable by this inspection. This does not in
any way warrant or guarantee the continued proper functioning or
operation of this system. It is recommended that the system
should be pumped once every three years. Therefore, the
prolonged life of this system may be dependent upon proper
maintenance of the system.
i erely,
Ma j '
Jenkins
Assistant Zoning Administrator
cj
Parcel 030-2002-50-000 03/24/2005 08:38 AM
PAGE 1 OF 1
Alt. Parcel 33.30.19.362H 030 - TOWN OF SAINT JOSEPH
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
THOMAS F & LISA A ROSE * ROSE, THOMAS F & LISA A
1253 52ND ST
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1253 52ND ST
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 5.003 Plat: N/A-NOT AVAILABLE
SEC 33 T30N R19W LOT 2 OF CSM 1/96 BEING Block/Condo Bldg:
INSWNW&NWSW
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
33-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 901/577
2004 SUMMARY Bill Fair Market Value: Assessed with:
5679 228,700
Valuations: Last Changed: 07/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.010 99,900 125,100 225,000 NO
Totals for 2004:
General Property 5.010 99,900 125,100 225,000
Woodland 0.000 0 0
Totals for 2003:
General Property 5.010 58,600 98,000 156,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 309
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
of eiir/ v
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SEE PAGE 27
O/9GBRocF o/d/7a/o,oub/slnc iPev./97y
►perative
rmers
r charges
er, cheese, powder,
:s store
BIRCH PARK WILLOW RIVER
SKI AREA INN
'<';l;::;'+„i::;+.;i;i},'y;;f:•.y,•:':2i:<•:''Si;:a2:;:;::'y;!f;:>;yz<:._
` Open 9:30 a.m. - 10.00 p.m. Burkhardt, Wisconsin
Dail V Mile Northeast of
State Park
5 - 263-1145 Area Phones: Old Time
Twin Cities - No Toll
439-3723 Country Tavern
On-Off Sale Liquor
Wisconsin
715 - 549-6777 386-2201
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AS BUILT SANITARY SYSTEM REPORT
OWNER `pal TOWNSHIP SEC. T3-R
L
ADDRESS ` ` (A~ s
ST. CROIX COUNTY, WISCONSIN.
SUBDIVISION'
x ~ e y ~-v r .%LOT LOT SIZE s5l'~Y r X `f D•C ~ Fy
PLAN VIEW
Distances and dimensions to meet requirements of H63
[nL -THING WITHIN 100 FEET OF SYSTEM
t, CL
c
40-
I di .a e o th Arrow
SC LE:- I i
BENCHMARK: (Permanent reference Point) Describe:
Elevation of vertical reference point: 'O c Slope at site:
SEPTIC TANK: Manufacturer:
Liquid Capacity:
l~
Dumber of rings on cover r~ Tan manhole cover elevation:lr.)3--6 1
Tank Inlet Elevation: Tank Outlet Elevation:
PUMP CHAMBER
Manufacturer: d ! Number of gallons
Number of gal. pump set or a cyc e gallons; total-
capacity
distribution lines gallon: sized 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: uNumber o pits feet diameter
feet liquid depth - seepage pit in eet pipe-elevation
bottom of seepage pit e eve ation feet.
SEEPAGE BED SIZE: number of lines wi th I2_' le-rggth_S4 tile depth3S"
SEEPAGE TRENCH: width tv length
PERCOLATION RATE REQUIRED « RE S BUILT
INSPECTOR Ne s .
DATED PLUMBER ON JOB_
LICENSE NUMBER 3 z , 2
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REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM
Savnl tan.y Penm~-t
State Septic
NAME -Lown,5 114, P ~ St. Ctca-F_x County
Location Sec,I-Eon33 Lot # o2o Su6div,t~i.on~ -
SEPTIC TANK
Size ---gafl. ons Numbeh- oo eompatLtmenti5
Di6tance 4Aom: Wee 6uitd.tn.g ~tJ 120 afope
Highwate'r
PUMPING CHAMBER i
Size _ga.Uonb _ Pump. Manu{aetune.& Model Numbe"n.
HOLDING TANK
Size gaffon6 Numb e. n. o() Compan-tme.ntb
Pumpe~c Atan.m Sy/5 em
Dli,6 tanee. ()ham: W ef-~' - Butikdtin9---- 1296 6 tope-----
H,c.ghwccteA 0
Z
ABSORPTION SITE 2 on~t G 7<
Bed Tft.e.nch
Di/5,tance am: W
~f{h e - B u~. 2 d-t n g1 2 0 ~E a PC
Htighwate-n
ABSORPTION SITE DIMENSIONS
Width a t each 4,t Re-q uiAed a~cea_ / ( t
Length oo each eivi,e ~ (I Depth oo dock below ti"le x.n
Numbers, oo kin.u Depth. oo tock oven tile, in
Totaf fength o4 Une5 11 -6/ ~jt Depth o() ;tiff be"Q.ow gjeade i_n
Di/stance . between eine,5_ ~ ~t Scope o6 tne.nch tin. p'eh 100 ( t
TataP ab6olLption anea-_ ft Type oo Cove"n.: Papers. o 6 ttcaw "
PIT DIMENSIONS
Numbe-n oo p-tt6 r" Gnav~? -ca",4.-ou'vid pith yeb na
Out,~~.de h bekow kn6et - f C
Totae a-b,5on-pt on arse-a Ott
Ajce_a nequtned
INSPECT TITLE
APPROVED - DATE-- - - 19 8
REJECTED DATE 198
-
REASON FOR REJECTION
J
State and County State Permit #
PLB 6 7
Permit Application County Permit #
-k 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:
B. LOCATION: w '/4 NLO '/4, Section 1'3L, Tjr) N, Rjj_--& ~ W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
C~ ~t it, Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family V Duplex No. of Bedrooms j No. of Persons
D. SEPTIC TANK CAPACITY 4600 Total gallons No. of tanks f
HOLDING TANK CAPACITY 11 T 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 -"~lL~ Total Absorb Area--6.1 r'"»z
sq, ft.
New~Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: LO/_Length !5'-? Width L r r Depth 41F " Tile depth (top) No. of Lines 'i-
Seepage Pit: A/,4 Inside d'ameter Liquid Depth No. of Seepage Pits
Percent slope of land_ Distance from critical slope
WATER SUPPLY: Private Joint ❑ Community ❑ Municipal ❑
Owners name as listed on EH 115 if other than present owner: Cr+6
i4c
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 1t~ k : bC.S.T. # jjS 2327 and other information
obtained from i L__ (a -tvig reP, builder).
Plumber's Signature
MP P SW# Phone #215
Plumber's Address Z
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.
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Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY G
Date of Application c~2 f Fees Paid: State County &-t) D e/
Permit Issued/"ee d (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
L
2. state (pink copy) 4. plumber (canary copy) Revised Date 7/1/78
l I5 Rev. 9/78
9
• REPORT ON SOIL BORINGS AND PERCOLATION TESTS is
~
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
APB 2E~~F'
981 -
LOCATION:- Section > T ?G N,R /L
&+&4 W, Township or Municipality
fl>
Lot No.Block No. - wty' S "V' Lf
r-- ubdls on ame County
Owner's/Buyers Name:
E. oit
Mailing Address: L-%
TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS Z ~ PERCOLATION TESTS LjCt1U1 J / /
SOIL MAP SHEET"ATL / N OF SOIL MAP UNITL _rs1 .rk L J4 - ~ e G,.A!,x
PERCOLATION TESTS /2 -~e'Ir sl e~4,f'~
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 SW LING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P S ti
P- J 3 R q
P-
P- 1-41 t Sol S,
,14 P-
P- Q -A C c Z G c~ C -4
SOIL BORING TESTS L ^ `-C'
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
~i
B- dn
;i
B- 77 ij
A e-t
St C
B T' f 1 ~r fr1 r~ 'rs ~ t
O r
_J
B- r
k All /T W ~ Get- c..
B- ` c t Z c
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the Iodation and square feet of suitable are.
Indicate number of square feet of absorption area needed for building type and occupancy 2 .Indicate scale or distant
Give horizontal and vertical reference points. Indicate slope.
A
c_ 31- Z
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CYC7
4V
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I - 4j, 700
J, ~7 l( 61
-
a
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rJ
710
I, 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) Certification No....f` _ _..~---7 -
Address
Name of installer if known
Copy A -Local Authority CST
REPORT ON INSPECTION OF SANITARY PERMIT # ,f
(1) Name and -Address of Permit Holder Person/Persons at Site (2 )Date of Inspection
Name, r ss, icense o.,,50 ns a ing Plumber Time of Inspection
42) -
Y)INSTALLATI7 CONSIST 0 ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber
❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System
BEN ermanen 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 ❑ NO; Wired? ❑ YES ❑ NO;
Locking device on cover? ❑ YES ❑ N0; 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:
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