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Home My WebLink About040-1204-70-000 0(n d r~ c c p `+1 d *0 -0C) (D 3 (D I O N 'p A7 -0 ' O Xt C ~ O1 tD 3 A~ O ^S U) 4 m p O Q7 7 p `C • co =r 3 0 (D O N S K WN _ 0" C.. !D Z C) N w IV N r~► C :3 (D 7 p O O O (D 0) 41 'C9 O p 0 O W Q A c C:) 7 O O 7 y (n O O. C S2o (n D a m (a m a y ElF 3 W 3 a co o j O 10 L~z C CD N lz :z (CD (O CO N W W (D N O c v s a' Z 0 0 0 o n o n C t~i~ ai vii CD m v ° C, v < O v c N D 3 N N DWoC CD a = N !V N • O, CD CD (n N N C D (D C CD W (D C. a 3 E z (D - I (n O = O A Z CD u' C A n p A Z O N O_ C) 7 O 7 Z W N un (D M (D w z o 4, O z o M 3 CD w ~ o d °o a (o o- v o a m 0 N C Sll ~ 7 ~ O A C9 b X W ~ ~ Y CD Q (D I o- i I ti 0 i o I A 0 b O CD 0q A A 69 O a O a O Oa. h, Parcel 040-1204-70-000 12/14/2005 09:49 AM PAGE 1 OF 1 Alt. Parcel 25.28.20.953 040 - TOWN OF TROY 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 - LINEHAN, KATHLEEN J KATHLEEN J LINEHAN 176 DELANDER DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 176 DELANDER DR SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 2.735 Plat: 2332-PLAINVIEW ACRES SEC 25 T28N R20W 2.735A PLAINVIEW ACRES Block/Condo Bldg: LOT 07 LOT 7 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 25-28N-20W Notes: Parcel History: Date Doc # Vol/Page Type 02/16/2001 638746 1588/232 TI 2005 SUMMARY Bill Fair Market Value: Assessed with: 103638 307,200 Valuations: Last Changed: 07/22/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.730 55,700 240,000 295,700 NO Totals for 2005: General Property 2.730 55,700 240,000 295,700 Woodland 0.000 0 0 Totals for 2004: General Property 2.730 55,700 240,000 295,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 104 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT OWNE:R`~_ TOWNSHIP-- _SE:CII-}EJ 91 r „ ADDRESS / t c E .,ST. CROIX COUNTY, W rr' _ ail -2~ SUBDIVISIO 4L pEFiF.E 1 PLAN VIEW Distances and dimensions to meet requirements of H63 E OL~L EVERYTHING WITHIN 100 FEET OF SYSTEM _ a f 0 44 r . { s' - ! 1 l,. } 44* ti I 1_7 i X diEa e orth~Atr_nw r SC LE f BENCHMARK: (Permanent reference Point) Describe: 4-el 4 Elevation of vertical reference point: Slope at. site: r I" SEPTIC TANK: Manufacturer: le-- z.e~v,-' Liquid Capacity: - - - Number of rings on cover > Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: r PUMP CHAMBER Manufacturer: Number of gallons Number of gal. pump set or a cyc gallons; r c tall rapac- ty j Of distribution lines gallon: sire o pump J head., gallon per minute horsepower;__+ ;ran rlaTric= >f pump and model number ; Type of warning device a- HOLDING TANK: Manufacturer Number of gallons - Elevation of maniloie cover _ Type of warning device SEEPAGE PIT SIZE: um er o pits ----TeE~t d a.meter feet liquid dept seepage pit inlet pipe-elevation bottom of seepage -r elev"*-ion feet. _ SEEPAGE BED SIZE: number of lines wi th_ / length -_tile deptr,, SEEPAGE; 'FRENCH: width leng tli PERCOLATION RATE v.f j, r AREA REQUIRED__ z ARF AS RUII.T INSPECTOR DATED - PLUMBER ON JOj3 ~ off ' LICENSE NUMBEltY_ 9 RE PORT 01 INSPECTION - INDIV IVU AI_ SMAGI SVS II M ti a vi i to I I/ I' c ,(m SIaISe NAMI Towv15(ISt. Cifo4x Cuuvil11 Iocat~orl ~-SectioYtZ Lo -t # Sub v16 ion SEPTIC TANK Stize gaelone Numbers. oA eompantments DtS,tanee- nom: we"zk 6u4" d.e".n9----- 12°0 5 Pope. Highwa,te4 1111AIVING CHAMBER gaeea,vi5 1' m Mana (~acltu~ era Model' Numbe-ri ~ - Ifol DIN(' TANK i gaffan5 N mbeh Cum antmeri t.5 I' m r, e'1 k a r S~ A t e m -r - - - - - - - 7 j D r tea vi c is o m°....:~W~.~,~_~ 1 H.',ghwate~c AI;SORI'71ON SITE Eked TrlenCh- D<5tarie~iom: (Ve- e.e - 6u4"~d,(ng 92`a Pupc 5 1l.tighwa-te A6SOKP71ON SITE DIMENSIONS (a1(dth of tLevteh Requ 411 cd an.ea I I "VI(Ith of each t4yie x Ocpth a ~toch beeow t46! ipi Nnrrtbcn a',A- e4'vle-5 w~ Depth Coach ovcn 1-4ec vi f(, ta(' 1'enqt h a.f4,vie5 Death otie_e bceow q iadc Df lavic, betiueQn YlvteA (t SI/ o p c of te_vicki - cvi. rich 100 (yt I,r~ri,, abNo'trv1-iopt a?icu A.1 lifpc (.I(, Covell: Par.)c 1'I 1 1) 1 M I NS IONS i Nrimbch of ,)4,.t5 Ghavcp atlountt ~.ts i(CA Y10 ~r outS.<Je diamcten t Depth be.kow -va(-et f, fotaf ab6o4pt'an anea t i A r' ( e t1 a to-e. t 1N~P1 C I 1 h 6v .TITLE AI~rROV1) DATL I9 fJ/ I~ I I C I 1 U DATL 1 9 n b'I ASON t 0111 RLJE'CTION III ~ 1 ~ \ \ r IV, UA V y State and County State Permit # / PLB 67 a Permit Application County Per it # 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: Section T N, R - O E (or) W Lot# _City Sub CVV is on Name, nearest road, lake or landmark Blk# Village Township C. TY -OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY 104a Total gallons No. of tanks F 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 POSAL SYSTEM: Percolation Rate Total Absorb Area sq. ft. New Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. r~ Width - Depth Tile depth- top) No. of Trenches Seepage Bed: ~"_Length Width -t_L-Depth ~c Tile depth (top) No. of Lines Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land___., Distance from critical slope z WATER SUPPLY: Private ❑ 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 Cer ied Soil Tester, NAME C.S.T. and other information obtained from (owner/builder). Plumber's Signature "lpfp PRSW# Phone ' 1C) 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. i ~ .tee e , r 3 t ' t t F j E i a t , S m . . _ .wm. a a k , € . « ~ a m € , , . ems. a s , , € € 7 Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application Fees Paid: State County Date Permit Issued/Rejected (date) Issuing Agent Name Inspection Yes No State Valid# Date Recd ' county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 5370' Revised Date 7/' State and County State Permit # of ~ Permit Application County Per i # 6ce PLB 6 7 County ` for Private Domestic Sewage Systems *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER PROPERTY ? Mailing Address: B. LOCATION: /4 Z-__%, Section T; N, RgQ~ (or) W Lot City ubdivision Name, nearest road, lake or landmark Blk# Village 01 Township s2A I A011 Z A Z I L-e eL -4 -.e TYPE OF OCCUPANCY: *Commercial *Industri3 *Other (specify) *Variance Single family _ Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY I m Gr Total ,.gallons No. of t ks HOLDING TANK CAPACITY Total gallons No. of to ks Prefab concrete Poured-in-Place Steel Fib rglass Other (specify) New Installation Replace nt Lift Pump Tank or Siphon Chamber Total gallons efab concrete Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total A sorb Area sq. ft. New Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed:- ~~Length Width Depth ~r Tile depth (top) No. of Lines Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits e Percent slope of land Distance from critical slope WATER SUPPLY: Private ❑ Joint ❑ Community ❑ Muni R al ❑ Owners name as listed on EH 115 if other than present owner: I, the undersigned, do hereby certify that the information 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 C.S.T. # and other information obtained from (owner/builder). Plumber's Signature +A1yWMP # G Phone __Y7 7 -3 Plumber's Address PLAN VIEW: Provide sketch below of sys em (include directior\,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 rilled please indicate. i E . € 3 d ~a- row 3 € W` 4 - 3 t 1 t i I 3 t i ' a E F S c L Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY f Date of Application 7 -,!Fl Fees Paid: State County Date Permit Issued/ (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 D r'RTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS DIVISION INDUSTRY, P.O. BOX 7969 LABOR-AND PERCOLATION TESTS (115) MADISON W1553707 s~ HUMAN RELATIONS w^ TOWNSHIP/MUNICIPALITY: O N .:BLK. NO.' ~U~q'VISION NAME: « s LOCATION'. N;. AM / COUNTY; WNER 5 Bt1 R'S N)kmt: MA L1 1`4U AUU i DATES OBSERVATIONS MADE ~ ` U$E I N: DESCR7 NO. 0 L ,flesidence New ❑Replace tx} RATING: S= Site suitable for system U- Site unsuitable for `system ENDED SYSTEM: (optional) InS EJU [ IN Gr 0U oS~ L rNt'ElU RECOMM w I NV STC1U . „i DESIGN RATE: if Percolation Tests are NOT required If any portion of the lot is in the j under s.H63.09(5)1b), indicates. Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS RlfuL3 H N T R-I H S CHARAC ER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH pgER 1(~ EL:LVATI I.. TO BEDROCK IF OBSERVED (SEE ABBRV ON SACK.) ~l ~d ..cf'',... ,E,.,. _ `.«._.wR..C'~.w~R..«+d ..ra ,:......t,.*.«... .....~n......._ I L7 ~d'.. ~.R.!" (,,,•,i ~ `exam '~.w-.«L..,»_. m ~ .,.,.e.,..".,. 'w~ M,..:«ivi.......n.,...:~:..-...,u.F.,......,.,...,....,.-»-.....-..».»<._....,...., f `+...''tJ - '".r."'"'✓ f~'' ~L,.~ , .t..,..a».-.,.mow .:Iko,......._. . , ' & PERCOLATION TESTS q t DEPTH WATER IN HOLE TEST TiM DRO WATER L N ES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PER190.1 PEA PER INCH - p , . • E ~ / e''~` .ac:....+i... a;:..'7 ""mow:,, .w"-••• - P^ PLAN Vt*WY; Show locations of percolation testa, 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 directMq gild percem r".G..,J , ,s+•. ~C, Gr a of land slop. SYSTEM ELEVATION I e.... i. ,y F I ( F.Rw"^°"r ` , i f... E•• N,, 17 r r'. . r s 444 < I •i- r°'' ' r i 3 t4 Z- 1• -e=......._,. ; .~..r.:......r.#. wr,-......r...w....~-r+++ .....•`.w- "".""w' ; ~_i r+.n.,ww~er~^'r"~s.~^~'. fir" 1 f - w i NS _ ~__4 . .....j. _ _.v.. . j i y~ 1, 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 Wiscons Admimistrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. 1 NAPE print : TESTS WERE COMPLETED N: ..x:~'►~ t<~ ,ate--'~„-.,,&~~ ,+1°~,r'». . . AD ES CPTW1CATLQN LVt1 B F~"A~fi NUMB (optional) S TUBE ! DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. DILHR-SBD-6395 (N. 03/81) U \ J ~ I J 1 1 lZt4A y V ' ^'3 R \`T 1 V t l ~ ~ _ ~ ~ ~ ~ ~ ~ , ~ r ~ ~ ~ w ~~f~~ ti P• V R ~ ~ t \ " -i`~i4 e ~ ~ . c X11 ~ ~ tO' r u ~ \ ~a } INI