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HomeMy WebLinkAbout018-1067-00-100 0 N O K-0 0 1, 0 C o 3 v m m 3 s 0 I;IZ 2 N ,n 2 W° ih ° A N _ p~ O v,' 3 ` (D 3 0 (D N A CD 91 cz z a p 0 3 0 j~ N W (Oh N O J~ C ° m a ^t 11 ~o NCD O ° 3 W, 3 y ° m O ~ o N m '7< CD ((DD 0 a a Q G ° co J N p C O co s ~Vr .~1.- "WA • z 0 0 0 A (D p w0o D i~ C") 0 3 N N N - 'a = i~ ~ m N A m d v m tr 2 m - m ca P.l (D N O 3 ~ N Q 3 co Z co Z D u o R a T Cl) W t"*1 • i ~ (D 'ter C % N ~t J ro 0 c ~J .0 CC Q N O ro CD z 3 ° z (D (Q -i rn N ° J p A Z K ~Ci ~ •P Z O O O CZ N) W Co -u N) < ° cc z a ° G J~C N C ro "O A W p~ n ro D N n D 3 c c n ro A 0 CL 3 3 = Qavro, Q - ~ (D (D m m 3 ro E o o m F o n CD- C7 0 C, ~C-n nn c IU - u o 3 (D m 3 = ID o m m•<~ 3 z (D - N < (D ° y N_ (D O N N ro N~ n r m ° CD m 2 3 3 m 3 m v 3 -0 n a J o 0 0 v v p N A O IC Z, ~(D oq lo w o v Parcel 018-1067-00-100 03/15/2007 01:49 PM PAGE 1 OF 1 Alt. Parcel 30.29.17.457B 018 - TOWN OF HAMMOND 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 - SAUER, THOMAS & CHRISTINE COBB- THOMAS & CHRISTINE COBB- SAUER 1515 CTY RD TT ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ` 1486 CTY RD TT SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 1.740 Plat: 3829-CSM 14/3829 SEC 30 T29N R17W PT NW NW FRL BEING CSM Block/Condo Bldg: LOT 1 14/3829 LOT 1 1.740AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 30-29N-17W NW NW Notes: Parcel History: Date Doc # Vol/Page Type 09/01/2000 629220 1539/446 WD 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 05/13/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.740 20,800 88,800 109,600 NO Totals for 2007: General Property 1.740 20,800 88,800 109,600 Woodland 0.000 0 0 Totals for 2006: General Property 1.740 20,800 88,800 109,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 09/26/2005 Batch 05-16 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 1 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP LM EC_ T. N R/ 7W ADDRESS ST. CROIX COUNTY WISCONSIN. SUBDIVISION , LOT LOT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM A 0' 4 I' T- I 5 7~. • 1 ' o.A di, at e ~ofthj-Ar-,roow aS i AL T = SEPTIC TANK(S) f MFGR.~ Cam. P,,,,,,. CONCRETE STEEL NO:o rings on cover f Depth PUMPING CHAMBER SIZE PUMP MFGR. MODEL NO. GALLONS Per Cycle TRENCHES NO. of wi t length area BED NO, of lines 3 width! length area 9.14- dept two -top of pipe NUMBER OF SEEPAYE PITS outside diameter total pit area AGGREGATE PERK RATE l ~)_S,AREA REQUIRED !2J AREA AS BUILT y 7 Disclaimer: The inspection of this system by St. 1Ctoix 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. St. Croix County assumes no liability 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 DISPOSED THROUGH T YTEN[ INSPECr - DATED 7 'tl PLUMBER ON JOB LICENSE NUMBER ` • AS BUILT SANITARY SYSTEM REPORT WNER , TOWNSHIP SEC. T No -R , W 0. ADDRESS , ST. CROIX COUNTY, WISCONSIN. T '3DIVISION , LOT LOT SIZE ' • PLAN VIEW -Distances b dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM - j i 4 I A 1 ~i i i I Indicate Northi, Arrow SCALE : tPTIC TANK(S) MFGR. CONCRETE STEEL NO. of rings on cover Depth DRY WELL ANCHES NO. of width length area no. of lines width length area depth to top of pipe aGREGATE ;W, RATE AREA REQUIRED AREA AS BUILT lisclaimer: The inspection of this system by St. Croix County does not imply complete .0pliance with State Administrative Codes. There are other areas that it is not possible to inspect at this point of construction. St. Croix County assumes no liability for j5tem operation. However, if failure is noted the County will make every effort to ,itermine cause of failure. .LEASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. `INSPECTOR DATED PLUIMBER ON JOB LICENSE NUMBER 4 RtPORT OF INSPECTIur! INDIVIDUAL SEWAGE SYSTEM San.itarcy Petm,it State NAME i ownah.i.p ST. Cto.ix County Location Section - SEPTIC TANK Size 'r gaEEonz. Numb en v6 Compattmentz i D.vstanee FAOm: WeU bt. 120 oA gteatet stope it Bu.itd,ing it. wettands _ ~t• H.ighwatet it. DISPOSAL SYSTEM . Distance FAOm: WeU > it. 120 of gteatet 4tope it. Bu.iZd-ing it. Wettands Ft. • H.ighwatet it. FIELD DIMENSIONS: Width o6 ttench it. Depth v6 toek betow t,i.Ee .in. Length o5 each tine it. Depth o6 rock over t.iZe ,in. NumbeA o6 Zine.5 Depth of t.ite below gtade tin. Tota.2 °ength o6 Zine/s it. Slope v6 tteneh in pet 100 it. Distance between Zine.~s - it. Depth to bedrock Tota.E ab,sotbt.ion atea jt2 Depth to gAOUndwatV, fit., 2 Requited at e a j t Type vj Covet: Papet ot,Stta PIT DIMENSIONS: Numbet o6 ptt~s G .ave.- around pity yeas no Outside d.iameteA it. -D-epth below .inlet 2 Total dab,6oAbtion area it nz 2 AAea tequkAed- 6t INSPECTS-D BY TITL,.E APPROVED DATE . REJECTED w,. DATE 197. c, y EH 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH z P.O. BOX 309 MADISON, WISCONSIN 53701 ~REPORT ON SOIL BORINGS AND PERCOLATION TES JS LOCATION: ktol L yil-, Section3"0, T~ieN, R L1t(or)QTownship or Municipality *1 aM- Lot No. , Block No. County X ivision Name ~r Owner's Name: 6111-e 606^y Mailing Address: e Q f1 13 TYPE OF OCCUPANCY: Residence X No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT SOIL BORINGS !?-x-"71 PERCOLATION TESTS DATES OBSERVATIONS MADE: SOIL MAP SHEET ~d SOILTYPE X CA 4MerY ~B*/-"L PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME 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 r' e Pia re At& )12-- S_ 6/ l - to P 2 _ee re A /1v S 312- 3 3/ '90 r 4'4 /A 2, 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- ".-le t C~+?.CC EEC 8 ~C l -S/C 6S-r( _5 B Z lam- ? ~S"" S~ Y B- _3 Akwe_ '7 t96 st 5- PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy. 4?/ Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. 6 ~ I X36' I 1 i ~ I ~ m I ~ t F-4-- j I I I ~ I c RS4 '7 t 7 f _/,q _ I I I ) ~ ~ I 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) t J e' Certification No. Address Name of installer if known CST Signature COPY A -LOCAL AUTHORITY PLB67 State and County State Permit # for Private Permit Application County Per # Z' Domestic Sewage Systems County's *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. LOCATION: bt! '/4 /lc.-_ Section c-; , T,2~ N, R/-7 C (or) (W Lot# City Subdivision Name, nearest road, lake or landmark Blk# _ Village Township ' Awoc C. TYPE-0 F OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family X Duplex No. of Bedrooms -3 No. of Persons -3 D. TYPE OF APPLIANCES: Dishwasher X YES NO Food Waste Grinder- YES X NO # of Bathrooms Automatic Washer _X YES NO Other (specify) F. SEPTIC TANK CAPACITY ~~MCC, Total gallons No. of tanks *Holding tank capacity Total gallons No. of tanks New Installation Addition Replacement- X Prefab Concrete X 'Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) -5- 2) / 3) .S'Total Absorb Area ! / -,2L sq. ft. ?Jew- Addition Replacement X_ *Fill System Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Length Width 1.P Depth Tile Depth 7C- No. of Lines -3 Seepage Pit: Inside diameter Liquid Depth Tile Size Percent slope of land `?o s-=L,- )',i „ t, Distance from critical slope V e "q 4,-e"9 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 T,ejster, NAME C.S.T. `/SYl9-and other information obtained from 6; r C, C`r`ll `S (owner Olelerl. Plumber's Signature r~ MP/MPRSW# Phone Plumber's Address PLAN VIEW: Provid- sketch below of system (include direction of slope and all distances in accord with H62.20, including well). 7 / A/O ~G`,Q //,L~t` PS t f •a c C{c ei) 7/ e /Y f ,c/e J Em's G- Res. ne p a l~ s~ ,e, YI- I L~isM~t F/., Do Not Write in Space Below FOR DEPARTMENT USE ONLY Date of Application Fees Paid: State Count - --Date ' Permit Issued/Rojes#ad- (date')A -/l / _Issuing Agent Name l I 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) -