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HomeMy WebLinkAbout006-1039-60-000 . n U) O 3-0 n 0 N E c w 0 fo c 3 m o CD T d l"D A CD 3 I A~ C 1\ l o0 0 `C • obi o m vN o w a v ° w~ 3 0~ ro ~D w ~ o w i--~ j Q W Z d (N O j 0 M ^ D W N m N D o • D' m ~o m C 0 1 A ' ! 00 (J1 A7 3 N ° ea 7 N Cl O C N lV Co C D r a j CD ~p N N Q W CL O O D O o m L O CD AMIA CD cD CD m n ti N co 3 c o O O O f~A f~A N A O D rl n a o D o m e v v v o o C a p CD = CD N cl -u 0 0) N Z Z co Z c D o o v O ~ g m m ID N (►1 p V) D O N C (D (D W N a D 3 7 Z CD co I N o A Z CD U c 7 _ N a ? z ~ O pp m w aD CL ~t Z 3 a 0 0 Z 3 m N (D A Z W F o m 5-3 ° o F,0 a _ O Q c j d ( r ` O7 Q D N D" O' CD _3 T f0 N C S 3 .D (D 00CDOnc~ 0 4 0 3 o CD 7 N 0-0 QR N fD C j N p 'n'". do N M S y O (D S = (n D tC -6 0 p- * fc W 7 O N Q (D a. 3 N S 7 ^ :3 CD C m m < p T x' A 0 0- (D - 0. N O (a -0 CD m N cn S -0 -1 S _ (D CD CD S 0 N p' N co M, CD = 0 Q O OD C 0 CA) a 0 7C h O b w (D A O O O vY~ yN 0 (D o ` Parcel 006-1039-60-000 11/21/2006 02:46 PM PAGE 1 OF 1 Alt. Parcel 18.31.16.265B 006 - TOWN OF CYLON 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 - BAUKOL, ALLEN C & SUZANNE M ALLEN C & SUZANNE M BAUKOL 2082 215TH AVE DEER PARK WI 54007 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description 2082 215TH AVE SC 0119 AMERY SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 4.620 Plat: N/A-NOT AVAILABLE SEC 18 T31N R16W 4.62A IN SE NE LOT 1 Block/Condo Bldg: CSM VOL 2/372 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 18-31N-16W Notes: Parcel History: Date Doc # Vol/Page Type 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/06/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.620 25,000 233,000 258,000 NO Totals for 2006: General Property 4.620 25,000 233,000 258,000 Woodland 0.000 0 0 Totals for 2005: General Property 4.620 25,000 221,500 246,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 512 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT PLAN OF SANITARY SYSTEM COUNTY SEPTIC TANK PEMIT # V~lj J{"- f -C(F t r I / mow . _ _ZIP 0wNER_ f-l l- - - - - _ -ADDRESS LOCATION OF SYSTEPI: -%,,~y of Section J_Townji~_N, RANGE .Z { W Gov. Lot # , Lot # Subdivision PLAN VIEW Distances & Dimensions to meet Requirements of H62.20(l)(d)(2) SHOW EVERYTHING WITHIN 100 FEET OF SYSTEPt - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ho fi -t S is (-i • v b ry h -4-• y O w~ s f r ~ J 4 ----------------r.-A - - SEPTIC TANK: Concretej.,,:~, Steel P2fgr. Depth to manhole _ SOIL ABSORPTION SYSTEM: Drywell Depth Inside Dia. Depth Below Inlet TRENCHES, No. of Width Length Area Depth to Pipe BED, No. of Lines__~( Width.2.)LLength i Area Depth to Pipe S~ AGGREGATE, r~ Inches Area Required AREA AS BUilt~~ _ DISCLAIMER: The inspection of this system by Polk County does not imply complete compliance with State Administrative Codes. There are other areas that it is not possible to inspect at this point of construction. Polk County assumes no liabil- ity for system operation. However, if failure is noted, the county will make every effort to determine cause of failure. GREASES AND OILS SHOULD NOT BE DIS- POSED OF THROUGH TH ST TIM PLUMBER ON JOB_ _LICENSE INSPECTOR` z DATED- J Y~ T L REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM S a n.it a,,L y P e h.ri,i,t State S e ptic- NAME Imo-uk"-k i'owns h i p _T S j. Cao.ix County Location --c Section SEPTIC TANK Size gatton6. Numben of Compan.tmentz Diztance How Wetk_..- 120 on gne.a,ten Kope~ It 1sui.r'.dc,r7a_ c:~_jt. Wettandz_ ~ . 1-ighwa,ten . DISPOSAL SYSTEM Distance From: We.it~___~ ~ 5~• 12% on gnea-ten stope it. BuiZding We.ttands Ft. tl.ighwaten _ fj.t. FIELD DIMENSIONS: Width of .then ch-~~ Depth o6 .tc.o ck b etow tote .in. Length of each tine -".4 It. Depth of neck oven We in. i o n. }dumber of 'tines _ Depth of -ta v be..iow grade a n To:ta.P.. .ie.ngth, of tines-,; _6t. S.iope 06 tnenchin pen 100 It. Pistance be ween Z nes :t. Depth to bedrock It. TotaZ abzo bti.on aaeaz q2 Depth to gnoundwa. It. Requ..ned akert 6t2 Type o,~ Cove.; Papers n Stnaw PIT DIMENSIONS: Nurr,ben of pitz GnaveZ around pi,tz yep no Outside dtiametien S,,t. Dept Won .inZe,t if. ' 2 Total abz o Abttion/ane4_ t At rn Kea Aequ.i.ned {t2 INSPECTED BY TITLE APPROVED . ,DATE 19 7-11". REJECTED DATE 197_ r PLB67 State and County State Permit # syys Permit Application County Permit # for Private Domestic Sewage Systems County / *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPEL/RTYi Mailing Address: Rrl e4 //-t J B. LOCATION: S j1F Y, /Yc Section T ~r/ N, R V 4gr) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family t~ Duplex No. of Bedrooms No. of Persons D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES i NO # of Bathrooms L_ Automatic Washer AYES NO Other (specify) E. SEPTIC TANK CAPACITY A1 Li Total gallons No. of tanks / *Holding tank capacity Total gallons No. of tanks New Installation Addition Replacement _ Pr *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) J~r 2) .r 3) Total Absorb Area G / s sq. t; New Addition Replacement *Fill System Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Length ~Width aS" Depth Tile DepthG No. of Lines Seepage Pit: Inside diameter Liquid Depth Tile Size -z' Percent slope of land c2% Distance from critical slope 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 (u.'111'4. C x~¢rS~r C.S.T. # SI- „Cj ; ~JZ and other information obtained from ) (ownerAoma1eler). Plumber's Signature r MP/MPRSW# 61'77 Phone #.%-1 Plumber's Address Log" Lcre-r ti- PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). JXafi Tt Sc~/t 1 F . E 64 t cl.tl v ~ r E r - a . ►~90k 10- a Ll."' (70 et ILI YL 50 vi Do Not Write in Space Bel w FOR DEPARTMENT USE ONLY Date of Application ` I Fes Paid: State _Zo_ County ate Permit Issued/Reject (date) Issuing Agent Name _ Inspection Yes No 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 6/1 /76 EH 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 ' MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: S Section T31N, R W, Township @F M l® v~0 n~ C ~a~r 1 Lot No. , Block No. County 'S / L Subdivision Name Owner's Name: A 13 a to k o l Mailing Address: ~ C 1eA I- k 1 C'-.5"Z o ~ TYPE OF OCCUPANCY: Residence No. of Bedrooms 3 Other EFFLUENT DISPOSAL SYSTEM: NEW ko/ 77!> Crg ADDITION REPLACEMENT p DATES OBSERVATIONS MADE: SOIL BORINGS- -5'-- 3 ' 77 PERCOLATION TESTS 1 - SOIL MAP SHEET _ SOI i_ TYPE _C__.ta PERCOLATION TESTS TEST DEPTH HOURS WATER IN . t CHARACTER OF SOIL i NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL N/IN I BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD I MI P- 3 F4'' l;,~ _ o M st ~~-.sue 3 / 3 SOIL BORING TESTS = 0 TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) 3 t v.~~ /a'o " S - 7"SL ago" [ S - 91,Y 11 Zal' 7A 0 '20 41 J/ 6: N© /1'! o Nq PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) indicate on the plan the locationand square feet f, s itable areas. Indicate u r of s uare fyet of absorption area So needed for building type and occupancy. _ S T'% = Indicate scale or distances. Give hori 4~i ~n i~t8ar&e~ tti edicate Ape.' A4, Ay+ 3 I ~ ' ~ + Seep w I E } I h t+ _ t i , ! F 1 f ~ W t , 3 r 3 # i I , I sl i 1 d t t ' I Qr ,~5 r 1 _,...,...~...._i _._..i._ G._ k N~ L,y I I - _ III f( ~ ~ I ~ i I - i mm ~ , I _ 4~r~K t . ._..._t. + _ Jr7LA tip An' I, the undersigned, 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) W t l( A n m L+ GtA j ae I- So V Certification No. 5-S- A a 3 7 Address R r .y aeAjC 1.2_0 Q_ 14L y 7-otil Wisc. ~ y e 0 y Name of installer if known CST Signatur -,x7Y