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HomeMy WebLinkAbout020-1119-90-000 o o g -0 0 p 0 CD vm v ~ v m 3 v \ 1 O n U Z O N c v ON C • v 3 o cn Q N o O a z CD 0 N V) CD `'3 C O 1 0 A O W CD W cn (Jl f\ \1 N O O O O O-0 N 7 7c * m 0 ? 7 O r 3 O N W O Q N ~ W Q d w n D 0° o m cn CD X- 0 D N r_ (D 0 0 O C) C) 0 m Cl O W O C O Co N CD 0 r- U) U (D (o O N C v v v U, m "WA. o CD m' to cn to G' c o m ° d '-yo W a) y T< N W O< n N z N ° zz 00 z c( Do O CL o • o C CD m m i) N (D a) C O N C (D N w a a (D (D --I cn O p A Z n n C N O_ 7 O M C V Q z 3 a N o z C A W X -I D W o Q1 a D aa) 7 -n d -O a) C ~ N z o. (n . o O cn m S fn O O O O O O (O ti al CD C ~y CD 5 N A N ~ O x N O O _ O ~n ~ A O ~ A O t~ ;r Efl 0 W o b o a ► 1 Parcel 020-1119-90-000 05/20/2005 05:03 PM PAGE 1 OF 1 Alt. Parcel 17.29.19.516 020 - TOWN OF HUDSON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner MALICK, CLARENCE W & LINDA CLARENCE W & LINDA MALICK 413 BROOKWOOD DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 413 BROOKWOOD DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.640 Plat: 2553-TROUT BROOK WOODS ADDITION SEC 17 & 18 T29N R1 9W TROUT BROOK WOODS Block/Condo Bldg: LOT 13 ADDITION LOT 13 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 17-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 2005 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/26/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.640 35,300 148,100 183,400 NO Totals for 2005: General Property 1.640 35,300 148,100 183,400 Woodland 0.000 0 0 Totals for 2004: General Property 1.640 35,300 148,100 183,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 113 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT iER W , TOWNSHIPJ41LD EC. _ TZLI _N, R_~T1 0. ADDRESS ; 16,l f , ST. CROIs COUNTY, WISCONSIN. _ DIVISION 4r , LOT LOT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ' , 6 t3 FEZ,- --t-A 7T i I ! ' I ( - i 9 - _ - - - - - I Indicate No-'th Arrow a { - r - S CAI.E 1PTIC TANK(S)-`L_ MFGR.LkI i C-: S c- CONCRETE X_ STEEL NO. of rings on cover Depth _ DRY WELL (INCHES NO. of width length area j no. of lines~-2T width length , area depth to top of pipe uREGATE t)j JA S la 1) oink 'Q, K RATE ! AREA REQUIRED / AREA AS BUILT iSclaimer: The inspection of this system by St. Croix County does not imply complete o-pliance with State Administrative Codes. There are other areas that it is not possible ~inspect at this point of construction. St. Croix County assumes no liability for Stem operation. However, if failure is noted the County will make every effort to t~ermine cause of failure. TEASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. `INSPECTOR DATED PLU 1BER ON JOB t.~ ALL,t. ~ LICENSE M BER s ~ (7, IVIX x i z - RFPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM Sanitany Pewit State Spti~e w_. i own.6hip A'st. Cno-ix Coulty NAME _ r Locat.ca~,v ~ 'n . _ ri ti~~ Sec.. x SEPTIC TANK 'L' Size gattona. Numbers oti Compaxtment,6--_ Distance Foom: WeZZ it. 12% oA gxeatex stope _It Bu.i.ed.ing -tit. WetZands_ tit. fl.ighwatex tit. DISPOSAL SYSTEM, Distance Pxom: Wee .12% ox gwatex VopeV it. Bu.i?-ding tit. Wettands Ft. H ighwatex- tit. FIELD DIMENSIONS: Width of txench--tit. Depth of mock be.eow tite__--in. Length o5 each .e ne.-__ _ _--St. Depth of n.ock oven ti e__ - .in. Numbet of Ane5 Depth of tiZe Wow gnade_ .in. At& Zength oti linas___ tit. Sto pe of txench~ in pet HO it. DiALance be.tweeF ~,inc-5 tit. Depth to hedxoch._ It. To.ta.e ab!s o Lbt,iokt aAe.a tit2 Depth to gxoundwate n~~ .Requited a.ea - 2 Type of Coven: Papew on Stnaw PIT DIMENSONS: Numbex of pits GAaveZ axouk,.d pit,6_--_yeS no Outside diameters tit. Depth below .intet_ _-tit, Totat ab s onbtion axea it 2 rn Axea xequ.ixed It ~ _ INSPECTED By TITLE APPROVED DATE 197_ REJECTED DATE State and County State Permit # L 13,67 Permit County Application y for Private Domestic Sewage Systems County, LiA2:~4 *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: Ile, 6" Z"/ X111-1 Y B. LOCATION: SEE' Y4~ i~ Y4, Section T2-0 N, RZ~Z_ E (or) W Lot# City Siubdivision Name, nearest road, lake or landmark Blk# Village Township C. HYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family _ Duplex No. of Bedrooms No. of Persons c S D. SEPTIC TANK CAPACITY Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete _ Poured-in-Place Steel Fiberglass Other (specify) New Installation X Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify) E. EFFLUEN DISPOSAL SYSTEM: Percolation Rate -Total Absorb Area 3f~ sq. ft. New Replacement Alternate (Specify) Seepage Trench: No. of ~Lin~e-~al- Ft. ~TWidth Depth Tile depth (top) No. of Trenches Seepage Bed:~Length - 3 idth A> Depth '%C" Tile depth (top) -Z~ -No. of Lines :3 Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land Distance from critical slope WATER SUPPLY: Private X 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 C tified Soil Tester, NAME l 7 I `I` / / C r,~"T C.S.T. # and other mfe,rmation obtained from ' (owe, ner/builder). Plumber's Signature I Phone # MP/MPRSW# 3r?,/, Plumber's Address - - 6 /*',Cc~a S~_ c• 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. x -T®.-..__.-~... E 3 a e i E q . . a~.. a n . - i I i 3 m 1 E E E w 3 `toy z is Write in Spac Below FOR COUNTY AND STATE DEPARTMENT USE 9NLY Application ` Fees Paid: States/.~ County 0 Da - % - sued/Roi.ewrd (date) Issuing Agent Name Yes No State Valid# Date Recd (w to copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 ~ copy) 4, plumber (canary copy) Revised Date 7/1/78 1,15 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH 3 P.O. BOX 309 MADISON, WISCONSIN 53701 ' REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: '/a,s '/4, Section ~7, TzaN, R / E((or) W, Township or Municipality Lot No. /_3B lock No. 7TOIVT V001e`)0-!9A1;5 County 61, Subdivision Name Owner's Name: r Z'001-04W,+ © Mailing Address: ,05-6 //145- /la eTq, 41E',Lj E? ✓L~~~~ TYPE OF OCCUPANCY: Residence No. of Bedrooms 3 Other EFFLUENT DISPOSAL SYSTEM: NEW -ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS .M,+y lg lG7 71 r'A"-/lyPERCOLATION TESTS 1~~ify ~y IVA11 ° I?" SCs e41V F:jC4D - r~ XB ~13f1iPkH~4iPDT- S~4?TiPE c"~-y~ SOIL MAP SHEET SOIL TYPE D~A 17ERAN14'7E-- 51A S>477AF 5/1-7' I-0,4M PERCOLATION TESTS I{~ 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 MIN/IN SC BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 2- y~ 9'QPtAv SI 12 "13.V S/ s/ z AV&/VE 8 13 3 Y57 /a "'Ae A i/ P y 3 y6AI P (J. S. f"'~ h ivoTNEC NONE f' i5"' / s z W N C, o, S. NQNE j 1` 5/ /y„ x6p 0S /vo~vE /U r~ ~5~ r$' S SOIL BORING TESTS pErQG 14IF47E = S' TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) ell NONE g &ry > A. 5:/ 7,S " o. si S-4 C Or, 5 r . B 3 ti'®NE sr/ Z~ i3,v S:% za" Q. S/ 38 C'. or 5, r y N'OWE t Q. Sf w h SS''' C,UN,y.v E S. v . y ,vo/vE > g, Y _UJO 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. fio/P T~E'VG/f--«f~R gfb Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. C/kWOO hwlile t 1 - - I D /O~E'r I- ~r h zxx (all 01 A 3 Tie~v r41~'ERti'~r~ _ P Pik os~~ iN113 x Ar c sT ; W ! j eca F ~4 31 P~ _ s~l- I ,E N I f 4 I ~ i ~ ~ 3 , 3 13 , 1 V s Zoo ) 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) '?oAE 7- Wlb'vl;::~_ Ar Certification No. _46-_5- 0~/OOZ Address /PT'/ f7' UDSoit1 &0"S. 5 Vol Tql t~ `t C , IV'OAO, ~7l~I~.SC~/t~ ,S Name of installer if known CST Signature ua, i