HomeMy WebLinkAbout032-2089-95-000
n N O 9
°c o
3 cp
o m (D -0 a~
(D m
(D 3 = ~ ~ ` 1
] - < w
7T .
a Q
U 2 n w rn c n °W C "ft.
o v m p ° N r
(D O (D A O N N ".7
n Z a n O
E-- CU 7' (n co ( N N G O C'
O
N Cp
O
° (D (D C O ~ Y,
° S1: O
W O a = O
c O
v 7 N 3 C
~ N
d
D
CO Q s "C
D ID C a o
O N ~
cm ° D
O ' N h~h11r
m co n r fn
W W W
N N O C
o, a
C ~
f o o o l
z o O o l
r
o ~E' ~z aQ
F cn cn cn rn ° 0;l
o ~ m m N y m
n y m
m = O
w
Cl)
45.
_N 7 9 d o N
(D 3
n = (D m
m
N
Z -
_ Z
~I
y (D m o ~
CD (D
c
N _ ~1
O a, N
O N
(D
W (D n
7
o O _ Z n_
N C ~ ~
= p Z O
CL
D C/)
w Ui
(D (D
Q z
0 3 ~ ~
3 z
Z
O A 71
W
n
a ~
Q
~ T
N C
Z Q
O
~U
v
A
~v
w
N
O
O
^1
c ` N
N
(D
(D
N
O a
O t
O
v
0
Parcel 032-2089-95-000 03/23/2007 12:20
PAGE 1 OF 1
F 1
Alt. Parcel 15.31.19.887 032 - TOWN OF SOMERSET
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 - KRATOCHVIL, JUDITH R
JUDITH R KRATOCHVIL
538 UPPER 216TH AVE
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): = Primary
Type Dist # Description ' 538 UP 216TH AVE
SC 4165 OSCEOLA
SP 1700 WITC
Legal Description: Acres: 3.540 Plat: 2224-NORTHERN OAKS ESTATES
LOT 10 NORTHERN OAKS ESTATES TOWN Block/Condo Bldg: LOT 10
SOMERSET
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
15-31 N-1 9W
Notes: Parcel History:
Date Doc # Vol/Page Type
08/15/2006 832247 DEED
08/15/2006 832246 TI
08/07/1981 372635 633/544 WD
2007 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/24/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.540 50,700 142,800 193,500 NO
Totals for 2007:
General Property 3.540 50,700 142,800 193,500
Woodland 0.000 0 0
Totals for 2006:
General Property 3.540 50,700 142,800 193,500
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 118
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
\ e 1
AS BUILT SANITARY SYSTEM REPORT
i
OWNER Yft Cc ,f~ TOWNSHIP F;rT SEC. T N-R W
t
ADDRESS ST. CROIX COUNTY, WISCONSIN.
.4
- -
SUI3DIVISION LOT LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of H63
HOW-EVERYTHING WITHIN 100 FEET OF SYSTEM
jk-
i
i
- I di a otth~Arrow
S C LF
H.E:NCHMARK: (Permanent reference Point:) Describe:
Elevation of vertical reference point: Slope at site: ~
;I?P't'IC TANK: Manufacturer: Liquid Capacity:y-
Number. of rings on cover Tank manhole cover elevatiofi: ys
Tank Inlet Elevation:Z` Tank Outlet Elevation: j;'S
PUMP CHAMBER
Manufacturer: _ Number of gallons
4umlier of gal. pump se- ter a cyc~- - _ gallons; to tem-capacity of--
dLstribution lines gallon: size o pump__ _ head;
gall-on per minute- horsepower _ - bran name of pump
and model number ;
Type of warning device
HOLDING TANK: Manufacturer Number of gallons- _
Elevation of manhole cover- _
Type of warning device
SEEPA(F: PIT SIZE: - er o- pits e t iameter -
feet liquid dei pth seepage pit: inlet-pipe-elevation_
bottom of seepage pit elevation feet.
r
S1,: PAGI? BED SIZE: number of 1_ines wi th ~ let%th ~ the depth-.--
` F1, PAGE TRENCH: widi.h - --lengt_ii
1'EIZCOLATION RATE/ y/~2 -AREA REQUIRED &~,"---AREA AS BUILT
_
INSPECTOR ~
1)A`'I:I) PLUMBER ON JOB -
LICENSE NUMBER----,/'
RLPORT OF INSPLCTION - INDIVIOUAL SLWAUL SVS-ILM
Sttn4 taut! I'e~trn.c t
f%yj~~///►//'/A/U //'/A State S e e r .t k c
~~~.,i~ / v' _ `j T, r r O r t l t✓ _ G,5 l; ~l. u t i l u U Yt 1 i
S l,(/ Section CTLLot N Subdivi,64-oIn
1NK
yuY('uYtb Nurnbot o corn raic.tmentb -
I ~t o rn : LU ek..Y_~~ l 2 o b 1' o p e
H19hwa; -t
IIAM6 R
_yaU 0 Yt4 Pump Manu 6ae.tuaen Mo d e t Nurnb e k
IANK
ga.Uunb Numbers oA Compan,tmeYt-tb
A.Lalim Sq,5 te.m
we 4 1 6utixd,i-n 1 2 4 Eupe. .
H~y6twaten
A. (IN 171
Di e.Yich
tri: (UeXk I `l Buc L.di.ny J t2% bXope
IIc yhwu-(eti
III U I MI NS I ONS
t
„ lnench 6 Recqu,t vd ane-a
- l f-
each x4Yte At Dv.p-th oA "Loch bofow tie,, Vv. p t h 04 n U e h o o e tt t.( t, 1 Yt
41
Depth t'fe bvfow yttacle < ( _'r~
1,IweeYt fj neb At S~ope o A t 11,vYtcPt c rt . It 100 At
.tl.~rltrlt( UYI ahea _ 6 # Type (rA Coven.: Pape it o~( ~ i 1iltt!
!i t't th (0 tarel' itnuund pt tb.._ t!t"ttI;'Irrtt,toIt (tt Depth bveow c.YLfvt (~1
T ✓r ~ t
I;v l T1 T'I_L '
DATL f'1 n
J l t
UATI
'f 11 ('I 1ON
PLB 67 State and County State Permit #
Ilk Permit Application County Permit #
for Private Domestic Sewage Systems County v
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
B. LOCATION:lyl Wjd2 /4, Section Tom;/ N, R (or) ~L Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township
C. TYPE OF OCCUPANCY: "Commercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms No. of Persons_
D. SEPTIC TANK CAPACITY/nom 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 l ~ sq. ft.
NewkReplacement Alternate (Specify
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (to,) No. of Trenches
Seepage Bed: Length _Width_Depth Tile depth (top) No. of Lines
Seepage Pit: Inside diarr~e~ -Liquid Depth No. of Seepage Pits
Percent slope of land_ Distance from critical slope
WATER SUPPLY: Private Joint ❑ Community ❑ Municipal 1:1
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 Cert ied Soil Tester,
NAME r/`,_A/ C.S.T. # and other information
obtained from
J ~ (owner/builder).
Plumber's Signature P/MPRSW# Phone # -
Plumber's Address - ,
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.
and . _ . E.,
e
4.se. .
E
n . • _ r
i
E
Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY /
Date of Application Fees id: State County ate - /
Permit Issued/Rejected (date) _12-Issuing Agent Name
Inspection 'Yes No State Valid# Date Recd
1. county (w 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
'INQUST~, '
LABOR AND P.O. BOX 7969
HUMAN RELATIONS PERCOLATION TESTS `115 MADISON, DIVISION
WI 53707
3707
LOCATION: SECTION: TTCTSHIP W /MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME:
41.
COUNTY: OWNER'S BUYER'S,NA E: MAILINGAD RESS:
61~1--, Y, ~ ;L.. -.4 - t~ J
USE DATES OBSERVATIONS MADE
NO. 7717777 ION: R E STS:
QResidence ®New ❑Replace 6- Z 7 cN2
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND PRESSURE: SYSTEM-IN-FILCH LDING TANK: RE p(i
s❑u ❑s❑u ❑s❑u ❑s❑u ❑s❑u
If PercL tion Tests are NOT required DESIGN RATE: SYSTEM EL V. If any portion of the lot is in the
under 63.09(5)(b), indicate: Floodplain, indicate Floodplain elev 4~
PROFILE DESCRIPTIONS 0~~ /G 1 r-
BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNES OR, T TUBE, EPTH
NUMBER DEPTH IN. OBSERVED EST. HIGH-EST TO BEDROCK IF OBSERVED (SEE ABBRV. CK.)
>SZ
B- ;
ci •r
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PER D 1 PERIOD 2 PER 15D PER INCH
P
P- M: 4C ° J ? ?
P-
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 borings and the direction and percent
of land slop.
SYSTEM ELEVATION
e 0/4
xl~ x ell - ~.K
)
n
A
r
I
I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord vCith 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 COMPLETED ON:
K. ~E ! . ZA 'a
ADDRESS:, CERTIFICATION NUMBER: PHON NUMBER optional):
CST SIGNATURE:
DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester.
an'rl 03/81)
r JA2,,< /,5 T.3/~✓ 2r19'-4'
~nr
r00
Hs+us~ Abli
f~.
r
c~ II o
K
ti l -o y
~G
~r
I ~
~o