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HomeMy WebLinkAbout032-1058-60-000 n Cl) p K m n O N C w 0 c c o 3 m CD a w h c o v fD w m p~ 3 fn -1 = 5 n cn N o O w cn 07 T O N N • p (D 3 O CD (D 3 ~ CL Z a rn m o c N CL j w Co w w (D N C O O Ti Lj O O F -I W p !1 O 3 N Q O cn :3 (D 7 UI v N O O C• !'M i> (D w CD Q O W !rr, O_ C D O < o cO cD (D o c h~ 3 n y N EO, EO N (p O C CD O O O O• N _ iO. N O (Ji O C) w a w fD - N w m w y c 3 w O day O co z z co z o D N o v 0 ° ~ r 3 ~ eV h o CD N -a CD w c CD CD w 2) o 3 m _ z cO ~ -i cn G. Fn O A Z C O f? C A CL Z a C O Z -I N co m M N a z Z 3 z m ~ w ~ (1> O C Q n CD ~ p T w - 7 CCD C, fl M. Cn r v n w W N O O p ~ N p (b ~ p Parcel 032-1058-60-000 03/23/2007 12A0 PM PAGE 1 OF 1 Alt. Parcel 22.31.19.289B 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 - WESTPHAL, CHRISTOPHER J CHRISTOPHER J WESTPHAL 543 210TH AVE SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 543 210TH AVE SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 3.000 Plat: N/A-NOT AVAILABLE SEC 22 T31N R19W 3A NE1/4 NW1/4 LOT 1 Block/Condo Bldg: CSM VOL 4/1095 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 22-31N-19W Notes: Parcel History: Date Doc # Vol/Page Type 10/02/2000 630967 1547/350 WD 07/23/1997 946/575 07/23/1997 797/38 07/23/1997 794/66 more... 2007 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/23/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 48,000 98,900 146,900 NO Totals for 2007: General Property 3.000 48,000 98,900 146,900 Woodland 0.000 0 0 Totals for 2006: General Property 3.000 48,000 98,900 146,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 212 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT g OWNI?K ~ ~ 'T'OWNSHTP- S[ C . j~ N-R/r'W AI)1)1ZI'SS ST. CROIX COUNTY, WISCONSIN. SUI~DI_VI:SION LOT LOT SI7. PLAN VIEW Distances and dimensions to meet requirements of H6;? HOW-EVERYTHING WITHIN 100 FEET OF SYS'T'I:f' flrTII k: k r I di a P otth Arrow SC L 1 C= sl t J BENCHMARK: (Permanent reference Point) Describe: k2fj o: Elevation of vertical reference point: Slope at site : SEPTIC TANK: Manufacturer: i«~; Liquid Capacity: Number of rings on cover Tank manhole cover elevation': Tank Inlet Elevation: Tank Outlet Elevation: PUMP CHAMBER Manufacturer: _ Number of gallons Dumber of gal. pump set or a cycl-e- gallons; totem capacity of distribution lines- gallon: size of pump-- head; gallon per minute- horsepower- _ ran name of pump and model number ; 'T'ype of warning device _ HOLDING TANK: Manufacturer _ Number of gallons__ Elevation of manhole cover Type of warning device SEEPAGE PIT SIZE: Number of pits feet iamei:er feet liquid dept seepage pit in et pipe-elevation__ _ bottom of seepage pit elevation feet. SEEPAGE BED SIZE: number of lines wi th 1 ' lels.gth.~, ' rile depth, ~l en.g th SEEI'AGI: TRENCH: wid-h PERCOLATION RATE REA REQUIRED / EtrS BULL _ S PE C'I~9R DA'Z'ED PLUMBER ON JOB LICENSE NUMBER /0..> o REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM Sanitary Permitj~ State Septic %T r AAME_ Y7 4-4 aTOWNSHIP%Q-'~4&9X5?T7 St. Croix County ()CATION IV F. ty Al SectionZ&~Lot Subdivision-n 1-;PTIC TANK Size gallons Number of compartments Istance from: Well LJ Building 12% slope Highwater LIMPING CHAMBER ~P Size gallons Pump /M nufacture~ Model Number r i, 10LDING TANK Size gallons Number of Compartm s Pumper Alard System_ ,t_stance from: Well Builr?ding 12% slope Highwa~er ABSORPTION SITE Bed Trench [stance from: Well C-)(l! Building 1) 12% slope Highwater ABSORPTION 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 linesft Depth of tile below grade-- in. Di-stance between lines- ft Slope of trench--in. per 1.00 ft. Total absortption area ---~s= - ft Type of Cover: ~-2- - P•IT DIMENSIONS Number of pits Ll el around pits yes___ no Outside diameter f Depth below inlet ft Total absorption area Area required I NSPgCTED- TITLE ___i -"ROVED DATE REJECTED 8 REASON FOR REJECTION DEPARTMENT OF APPLICATION SAFETY & BUILDINGS 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% 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: l✓ Property Location: City, Village r Township: County: Alm) '/4S i N/R (or) W - ' 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. 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 ❑ Replacement ❑ Experimental 5Z Seepage Bed ❑ Seepage Pit ' ❑ Alternative (specify) ❑ Seepage Trench Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): Q Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the priv a sew ge system shown on the attached plans. Na a of Plumber: Signature* MP/MPRSW No.: Phone Number: AZ '4 Plum is Address- Nam of Designer: > 1. COUNTY/DEPARTMENT USE ONLY Sig at re of Issuing A n Fee: Date: Sanitary Permit NNi"um er: ,qe 19 ❑ DISA PROVED R ason for Disapproval: Alternate course(s) of Action Available: Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to in- sta!iation. 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) DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION 'LABOR ARID PERCOLATION TESTS (115) MADISOP.O. BOX N WI 53707 HUMAN RELATIONS LOCATION: SECTION: T: LOT NO.: BLK. NO.: SUBDIVISION NAME: - '/4 ; /T, N/Rp (or) W , - w COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: t USE J DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: IPERCOLATIUN-T-E-STS: ,54Residence New ❑Replace RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOL ING TANK: RECOMMEND D SYST' M:(optional) OS ❑U [--is ❑S ❑U ❑S ❑u ❑S ❑U If Percolation Tests are NOT required DESIGN RATE: SYSTEM EL V. > If any portion of the lot is in the ~ NO- under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain ele !~-'n: C DESCRIPTIONS PROFILE BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICK COLD URE, A DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABB 1.ON BA _ s B- tI B-.J v y i~ Q C~ '-j Z "o 'e i fit" ` PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD PER INCH P- ? , r P- 4/, Lc IL P- 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 `J'/ e ct.,,~ L s: ,r,c-' r e , .t-,~S -i' ZiL r _ l "T 11~ Ifs v N 10 C t' e , l~ , 4t r I I, the undersigned, hereby certify that the soil tests reported on this form were made by me in 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 COMPLETED ON: ADDRES CERTIFICATION NUMBER: PHONE NUMBER optional): 3 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) 7-3 J / /ow.U o.lo I 41) ' 44 i y,. y~ L 64 /7r7uSc0 LIIE/ I