HomeMy WebLinkAbout016-1077-95-000
o y p -0 n d r~
o m f c O co ~+1
c
3 CD
_0 i CD
n O N vi O N N O'
O' C N (D O W I•y
° m z D_ Co U) N
co O 0) O W= m °o v O
N Q = NO O N p - cn O 1
-U D h ~ W Cr O
1 0 M N O CCDD 0 O
O ►^r+
vi N CD
p
O m A ~I
N C (n fl
(D CD (n CL C: i
a n W
O CD X
CL
(0 CD
n r N
CD 4 -4 (n (D CD Cn
Z
O _
Uri t~/J f~/1 O D
a v o v Wo
O N CCD
C -s fL D
p~ Cl) - O (D
~
~ _ y W co
N CD O
z N
z z ~ z
D ;
v o h ~
O S 7 N .
O (D U) N
CD (D M.
70 N
O N CD
d
W (CD
I a ~ ~
z o z-4 cn
m
o ~ I A
v a R
o.
Z --j co
* o (.n
W
c 3 z
'o _
O (n Cn
y M
z
O A
W
Cn
CD N d
3 CL
C'). CD
CD o
6 Cn O T
C N C
C Q z O
03. o
m
CL m
0 N ~
~ C
O
O N
O
O ~ QN C tp
- 7 !
C~ O
C T
O
W = N
O
O
a
A
O b
CD a
CO
cn O N
O N a
O 0- v .1
Parcel 016-1077-95-000 08/30/2006 05:22
PAGE 1 OF 1
F 1
Alt. Parcel 35.30.15.535B 016 - TOWN OF GLENWOOD
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
JEROME & HELEN MAES O - MAES, JEROME & HELEN
1241 RUSTIC RD R4
GLENWOOD CITY WI 54013
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 1241 RUSTIC RD R4
SC 2198 GLENWOOD CITY
SP 1700 WITC
Legal Description: Acres: 1.500 Plat: N/A-NOT AVAILABLE
SEC 35 T30N R15W 1.47A IN NW SE LOT 1 OF Block/Condo Bldg:
CERT SURVEY MAP IN VOL III PAGE 840
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
35-30N-15W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 603/568
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/06/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.500 9,000 125,200 134,200 NO
Totals for 2006:
General Property 1.500 9,000 125,200 134,200
Woodland 0.000 0 0
Totals for 2005:
General Property 1.500 9,000 125,200 134,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 209
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Nunn 'numu migo
Date Septic Tank Petm-i t Sank taty PeAmi t #
'-4 Section Township Nonth; Range West; Township
Subdi.v.vs.ion Btock Lot Appnox-ima-te Size i
OWNER Ma.uing Ad&Lus
PLUMBER Addnezz - L.ice.we #
C.S.T. Addte s License #
S .V S T E M
o~ Wings F Depth 1 ; Septic Tank (s) gattons; Penc n.ate
o t- tr teeti Dty-wet, . egzgate ktea as
Area Requited - Tank Manu6aetuneJr. T~
Bed # o6 Zi.ne/s ; width ; Length ; Area Depth to top of pipe
Tnenehes # o6 ; width ; Length ; Anea Depth to -top o6 pipe
AS BUILT PLAN So.ct as obseAved
,I
-1 Al
DISCLAIMER: The .inspection of thus system by Dunn County does not -imply comp.iete compti,ance w-itri
State Adm7-n4'A tca t%ve Coda. There ate o,then. aAeos that it iA not possib.ie to inspect at .tdus
point o6 eon~stAuct.ion. Dunk County assumes no EiabZ,ity bon strs-tem openati.on. However, .iJ ~jcu~utt
.ivy noted, the county wiU make an e j 'tt to de te.nmi.ne -thze cause o6 6aiiwte. GREASES AND OILS
SHOULD NOT BE DISPOSED THROUGH THIS SVSTE,f.
Inspected by on Time
Ptumben cetct-i'ie,6 tanks awe zat s6actony (ptumbe/t on job).
ADDITIONAL COMMENTS ON BACK SIDE!
i
ean auo o4. JOIJd •peJinbaJ si eat leuol..lppe ou lanssl
Ja~;a J p9JJ9jsueJ4. sl 4lwJad slyY1 ;I •aa4 jeuol~lppe ue /red pue +luuad-
AJe4.lueS ay4. 4o Adoo Mau a uie4.go 4.snw JauMo Mau ay+ `JanaMOy `algejo~sueJ.~ si +.luuad sly. •_4
• l eMauaJ opedw i Am suo l 4.e l h6aJ pa6uego -I eMauaJ }o owl 4. 4.e
4.oa4 p u l suo l4.e l n6aJ uo paseq aq 111m poi Jed J eaA auo eJ-.Xa ey.. Job ~ lwjad s l y.l. 4o l eMauaa •3
•polJad JeeA om..
Iel -~l uI e44- Job ..Iwied sly+ 4o A4.lpl1en ay+ 4.09~4e +ou I I I M suol4.ein6eJ ul sa6ueyo Auy •p
'J
auo Jo4 paMauej aq Aew pue sJea~( oM eal~ leuol~lppe
4o polJad e Job pljen sl 4.lwJad AJe4.lueS s141 •0
•enssl
s+l ~o a.l.ep }o se suol+eln6aJ 6ul4.slxa uo paseq sl H wJOd AJe4-lueS s144. 40 lenoJdde eyl 98
•esJanaJ uo pagiJosep se 'wa+sAs lesodslp pue LuawLeaJ+
s6eM9s ol..sawop 94.enlJd a 40 uol..ei le.-sul Mol le o-. sl 4.lwJed AJe4.1ueS sly4 }o asodJnd aye, •y
310N
=SIN31,11100 IVNOl1{aid
REPORT OF INSPECTION-INDIVIDUAL SEWAGE SYSTEM
Sanli.taAy Pvun i.t
r ~
State Septic NAME iowndh i p St. CALoix County
Location Section S
SEPTIC TANK
Size L -~°r7 gatton4. Numbers o6 Compattment,5
Distance FAOm: Wett 6t. 120 on gAeateA .6Zope 6t
Bu.itd,ing 6t. W ettand~s 6t.
H.ighwateA - 6t.
DISPOSAL SYSTEM
D iztanee FAOm: WeZZ 6t. 12% on gtceatvL ~stope 6t.
Buitd,i..ng 6t. W ettands Ft.
H.ighwateA 6t.
FIELD DIMENSIONS:
Width o6 ttcench 6t. Depth o6 ,Lock betow t-ite-z -Z- in.
2_
Length o6 each tine !L` 6t. Depth o6 Aoc oven tite in.
NumbvL o6 Zines Z Depth o6 t.i.°e betow glade -2 `-`/in.
v
Totat .length o 6 Zine~ . 6t. S.to pe o6 tAe n ch in peA 100 6t.
Distance between Z,ine~s Depth to bedtcoefz 6t,
Totat abzmbt.ion area 6t2 Depth to gtcowndwatel _ 6t.
2
Requited area 6t Type a6 C o vets: a en A St,Law
• p
PIT DIMENSIONS:
NumbeA o6 pit,5 G ve anou;id p.it,5yes_ no
Outside diameteA 6t. lelpth below intet_ 6t.
2
Totat absonbt,i.on area 6t
A
- 2 rn
AAea Aequ-i.Aed~' 6t
INSPECTED BY ✓f TITLE
.
APPROVED DATE L~2`_197
REJECTED -,DATE 197.
ti
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: Section , R tSE (or(OTownship or ll
Lot No. , Block No. County
Subdivision N
Owner's Name:
C
Mailing Address:
'ZA
Z, /E C
TYPE OF OCCUPANCY: Residence t-,/' No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW I- / ADDITION REPLACEMENT
7 ~
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS
AM Zlq
SOIL MAP SHEET SOI L TYPE -
PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TESTTIME DROP IN WATER LEVEL, INCHES RATE
NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
P- ~ 41 3, 'Xy -3 13
P- iIp
Ile,
ZC"
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
B' 14., r2 1'S J 9 s i f S q ? s
20
s r yS s
r, S S
^J
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the locationand square feet of suitable areas. Indicate number of square feet of absorption area
needed for building type and occupancy. Indicate scale
or distances. Give, horizontal and vertical reference points. Indicate slope.
J
{ i I I { I
t '
L4 '
C l
o+ I
I 3 I I E
{ {
I
L -
-
1 f {
I , I ~ I f
i / ~~~J ~M I I 4
'7 ~ '4x7_ ff
_ v .
I, the unde~sig'ned, *4 certify t ' a soil tests reported on this form were made by me in accord the proo
and method`"pecified in'the Wis Administrative Code, and that the data recorded and location o gs holes ar~'correct,
to the best of,n*ryArwwledge ef. ~
Name (print) r i 14 L Certification No. `S
Address 11 " ~/C e I [ 1 F
Name of installer if known f C f I,1117 - 1A, 6r-
COPY A -LOCAL AUTHORITY CST Signature -r=
r
State and County State Permit #
PLB67 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 PR P
' "RTY Mailing Address: l
0 LO TION: ! '/4 ~t '/4, Section TAN, R ^ E (or) Lot#, City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township9
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family IX" Duplex No. of Bedrooms No. of Persons
D. TYPE OF APPLIANCES: Dishwasher YES L-' NO Food Waste Grinder YES NO # of Bathrooms-L-
Automatic Washer DYES NO Other (specify)
E. SEPTIC TANK CAPACITY Total gallons No. of tanks
*Holding tank capacity Total gallons No. of tanks
New Installation Addition Replacement _ Prefab Concrete
*Poured in Place Steel Other (specify)
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 1-2) 2) /,Q 3) Total Absorb Area sq. ft.
New✓ Addition Replacement *Fill System
Seepage Trench: No. Lin. Feet 4 Width Depth ~ Tile Depth 1 y No. of Trenches
Seepage Bed: Length Width Depth Tile Depth No. of Lines
Seepage Pit: Inside diameter Liquid Depth Tile Size
Percent slope of land 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 ) ~ p , C.S.T. *5S -CO Sc~) L and other information
obtained from (owner/builder).
Plumber's Signature DI'sa-,Q- , cE MP/MPRSW# CL34 Phone #6~- 3a03
Plumber's Address , E
PLAN VIEW: Provide sketch below of system (include dir tion of slope and all distances in accord with
H62.20, including well). Coe'
r_
3 3
U
3
o ~ E
i
3
i, A.
s
f
Do Not Write in Spwo elow FOR DEPARTMENT USE ONLY
Date of Application ,f 9 % Fees Paid: State /.j Or C t Date 7
Permit Issued/R.e (date) 3, / Issuing Agent Nanl ' L
Inspection Yes__4~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
ST. CROI X C011?i fY
WI S C 0 N S I N
1 41~1
ZONING OFFICE 796-2239
P.O. Box 227
. _ • Wit, Hammond, WI 54015
lu ? 1., 1979
}°ir. Wayne. Lorei:
foute 1, Box 313
Boyceville, WI 54725
Dear Mr. Lorenz:
At your request, I am returning to you the EH 115 of Jerry Maves.
This EH 115 is unacceptable as the Certified Soils Tester, Richard
Lee, failed to supply the following information:
1. Soils Map Sheet Number, 2. Soil Type (name), 3. Soil boring
test character oberservations of boring numbers 1, 2, and 3.
Should you wish to discuss this, please contact this office or the
Soils Tester Program, Division of Health, Madison.
Sincerely,
r
THOMAS C. NELSON
Asst. Zoning Administrator
TCN:
Enclosure
i
s _
. y `
• '°iiSCONSIN DEPA11 TPAE;~ ( 1Ji tt. f9 i I Q"1'.INU 'J~Jvis> Yl Y ~iS
f;U-!;JJH, BUREAU OF ENVIRONMENTAL HEALTH
10.0, BOX 349.
MADIWNI, WISCOtMN 63701
j REPORT ON SOIL fift3►RINIGS AND PERCOLATION TES
l,I0CATI(1Ni: Sectio~ro N, R t5F bt Tav tship or 1d AINW iiiti- y
i
tat Shirk No.____. County
Owner's Name:..
t o
Moiling Address: _
TYPE OF OCCUPANCY: Resinancs -~loe . No. Of Bedrooms_ _ Other J
EFFLUENT DISPOSAL SYSTEM: NEW---.-- ADDITION REt'tAC NT .
DATES OBSERVATIONS MADE: SOIL BORINGS / _-___.._PERCOLATI(* TISTMS
SOIL MAP SHEET _ SOIL Y 9
I"ER :OLATION TIES`" S
TEST EaEP1y1 HOURi WATFS IN TEST TIME DROP IN WATER LEVEL, INCH RATE
CHARACTRA OF SOIL SINCE HOLE HOLE APT tNT(MVAL THICKNESS IN INCHES IST WMEO SWELLING IN MIND I ES PERIOD I PERIOD a PERIOD S IAINIIN
P-r
& 10 '1
SOIL BMING TESTS
~...~s,rr«~.,....~,wes,,+w.}~o t a.«.,-..................~.-:nr~...v,...r.~-.~.
#r+'t 1(7tAC ps'I#Ftr+ rtf iykOU'NillNrkl~*f ttwtti i! Wltti (NICKNES.
r a t if
owwwkw
d!l~r~vsn F~~.'r+4~1t`I"w ialt€l+rr~~''y-
L
72
Pl rtli'ir►" 41~e pwdolletion toftOll 3' ov holn:)tr~al asilodfle *4 ~J
ktOwte an" Plan the towlon and sqs wo feet of suitaltl+e areas. tnilkne number of sQuare feet of abserp tim area
rrswNd for building type and occupancy. Indicate scale
or distsracas, Give horipw" out vertical reterenoa poie ta. k►dicate slope.
- N
_ . _ ? _ w. 4_.
s y - -
l
he undersigned, hereby certify that the soil tests reported on this form were made by me in accord the prID1
methods specified in the Wisconsin Administrative Code, and that the data recorded and location o holes ar Orr P'!
the best of my knowled and belief. ~
~ ~ ft
Arne (print)~j. Certification No.
- _ r -
-nee of Lns tatter if known 6? IL hi 2
_ - -