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HomeMy WebLinkAbout020-1121-10-000 c cn0 I3-0 o C7 r~ I c ~ 3 ~ 3 r°. `~1 CD o o # c v ~ m m ~ 3 ~ Q DJ O d N O W A N C J N • Zr c N O = a IV I•y 00 L, O O n p n m z y a h 1 U7 (D 3 O W :3 O N d = NO 47 to W CJ7 :3 (D C> CD 0) 3 f%1 W O c 0 p (n D m a p (D ~p (D co Q. O rn W a ~D M. 3 o CD CD Cn _ !Q o m m ~ c c co cJO o ~ N j 0 0 0 .d.• z Occ CC O CC O ~ I 0 0 n ` 'p C C A N -I =h c c -1 O cn V v a v 0 0 o p m <o m W N g d v O ty C A fD ~ O !V H 77 N ~ y 3 N CL a z to z W zQy D C O ° N o' ~ (n h • 7 l m N CD S N c CD m W m' ° E- 3 o ~ p Z --1 cn z (DD o z 0 a oo~ mN)~ M CD C z A O In ~ ~ ao I N Z (D ~ A W D v a ~ a N r. j T N C a Z a O O 3 NCD m T Az- ~ 0 n 'a CL CL y ti N O O a A 0 A N dQ ~ m e» O w O ~ b O L ti Parcel 020-1121-10-000 08/11/2006 04:19 PM PAGE 1 OF 1 Alt. Parcel 17.29.19.528 020 - 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): O = Current Owner, C = Current Co-Owner ELISABETH A CARSON O - LARSON, ELISABETH A 366 BROOKWOOD DR HUDSON WI 54016 Districts: SC = School = SP Special Property Address(es): Primary Type Dist # Description ` 366 BROOKWOOD DR SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 2.210 Plat: 2553-TROUT BROOK WOODS ADDITION SEC 17 & 18 T29N R1 9W TROUT BROOK WOODS Block/Condo Bldg: LOT 25 ADDITION LOT 25 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 17-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 853/108 696992 2033/624 QC 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.210 70,100 259,200 329,300 NO Totals for 2006: General Property 2.210 70,100 259,200 329,300 Woodland 0.000 0 0 Totals for 2005: General Property 2.210 70,100 259,200 329,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 119 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 y Y tl R N LT Spun Ar%j. SYS'T'EM REPORT r. Ar: E ~ t lX' ~ 1tj~ SHIP sic. TALI$ CROI`X COUNTY KSCQNS117 d~ 's 0Ir OT LOT SIZE t s PLAN VIEW 3~ ee 6 a a iane' to aaeet requireme s of H62.20 ,r ky fi " h M' HOW tYT U1rNG WITHIN 100 FEET OF SYSTEM it t r < ~ ~ es r ~ 1 ~ 4 ~ a rte t v, ' ur~ P I 1 f I 1.a ~i ~^'A tfi drug s ~ t ~ ~ { x fir I 3~ ~ v a~ d r y t t~y t t ti 1/( ~ M K t y d ,T` tt`t h t k t r'x~ j va31 r t{ cf r '/1 ,T'1s1~"`Y'~` S/ i ~..i~~• b s e i s k r~ t~ e r+ G r~ ~ D t 7~1 t~ r r~ ~ t k 1 ~ J r, r ~i r~ x t a x , CONCR TESTXgL WE URA WELL D tb . t~°t~►$~` ale `J 4 ,W1►.+L'_'i~ 1}w rf t ~.•Y a'~M~ 2,; 2 k~.ti r^1wR*.rN~Y{M, yy ;y, r A"o A 'AS BM a „ut W C1~ imeX: i ate t pg Ch~.e .eyahez,'by St. Croix County does not haply complete ince w ' t ':~taC+ , A+ iaireti~re Codes. There are other areas that it is not possible . ect 8C` 01 po nt pf Cooe~;r4ct on. St. Croix County assumes no liability for to oea~efi+q~y ~aeyer~:'if falure ie noted the County will make every effort to e tns of a t f lusre_ ;S 1Ql BE DXSPOSED T UGR` THIS SYSTEM. ,E ANO v Q31 t ~f r~~'i...~ i ' "INSPECTOR i w z yid `r 1LUMETi ON JOB a~ ' L'IC SE NUMBER ~t;" a z REP'.;RT.OF INSPECTION INDIVIDUAL SEWAGE SYSTEM SanitaF; y Pe-`cmit;" State. Sept~C~ i NAMF i ownshiyi C"Lo ix County Location S e, c.t.i o n SEPTIC TANK Size gallons. Numbeh of CompaAtments DKtance f=rom: Tete 6t. 12% on gneateA slope it Bu.itd.ing Q. Wet.lands 6t• H ighwateA 6.t. yISPOSAL SYSTE;',{ 0 Distance En, m: WetZ 6t. .12% on gneate'i lope It. Bu.i.ld-ing 6 t. WetZands _ Ft. 1 N.ighcvateA 6t. I FIELD DIMENSIONS: Width of trench it. Depth o6 no ck below t,ite in. Length of each tine it. Depth_ 06 Aoch oven Me min. Numben Q Zines Depth of ti°.e below grade-- in. Total length of tines It. Syope of trench. in per 100 It. Distance bet,vee.n tines 6t. Depth to bedroeh.__-_ Total absoAbtion area 6t2 Depth to gnoundwaten 6t. Coven: Paper on Stmaw Requined area 2 Type of t- 6t PIT DIMENSIONS: Number of pits GAave.l around pitz yes no Outside d,c.ameteA -6t. Depth below Wet it. Total. abs onbtion area 6t 2 Area Aequined ~6t2 INSPECTED BY TITLE APPROVED DATE _197 REJECTED DATE 97_- . TRANSFER FORD? 4`1 SANITARY PERMIT State Permit PLB 67-~T # Sanitary Permit County Sanitary Permit Transfer Date j y Original Permit Issuance Date A. Property Location: M6 % '/4, Section T N,R_/9-,E (or Lot # City Subdivisi e, Nearest Road, Lake or Landmark BILK # Village Township B. TYPE of Occupancy: Commercial Industrial _ Other (Specify) Single Family Duplex No. of Bedrooms Variance C. SEPTIC TANK CAPACITY -a,/Q Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab Concrete L- Poured-in-place Steel Fiberglass Other(Specify) New Installation Replacement LIFT PUMP TANK/SIPHON CHAMBER Total gallons Prefab Concrete Poured-in-place -Other (Specify) D. EFFLUENT D OSAL SYSTEM: Percolation Rate ` ~ Total Absorb Area sq. ft. Nev. Replacement Alternate (Specify) Seepage Trench: No.LineaI Ft. Width Depth Tile Depth(top) No. Trenches Seepage Bed: y/Length -4:T: Width j r Depth Tile Depth(top)14 No. of Lines > Seepage Pit: Inside d.ameter L quid Depth No. Seepage Pits Percent slope of land Distance from critical slope E. WATER SUPPLY: ❑ Private ❑ Joint ❑ Community ❑ Municipal Present Sanitary Permit Ide Ph ne No. Sanitary Permit Transferred o: Phone No. Name Name Address 'r Address Zip Zip I, the undersigned, do hereby certify that I have reported all revisions to the sanitary permit and that all revisions are in accord with section H 62.20., Wisconsin Administrative Code and that I have sized the effluent disposal system according to the EH-115 prepared by the Certified Soil s r and/o `any iti t soil teats at may have been required. Plumber's Signature ~ -fv1~rMPRSW # 51 Phon?4, G I j r.- d~ / , tt Plumber's Address Information obtained from (owner or agent) PLAN VIEW: Provide sketch below of any revisions to original sanitary permit. Include direction of slope and all distances in accord with H 62.20. Well location shall be included on the sketch. Indicate or dimension location of all wells, on the property or neigh- bor's rppgrtl If~well has_ of been drif.le _Rl~s~S rlCl.l@ ate f ..m... _ : f _LL l/ I i i 7 1 ! B ~ Signature of Issuing Agent 1. County (Yellow copy) 3. Owner (Pink copy) DIVISION OF HEALTH 2. State (White copy) 4. Plumber (Green!copy) P.O. BOX 309, " • TRANSFER FORM r PLB SANITARY PERMIT 67-T State Permit # Sanitary Permit # County Sanitary Permit Transfer Date Original Permit Issuance Date A. Property Location: '/a, Section T N, R E (or) W Lot # -City Subdivision Name, Nearest Road, Lake or Landmark BLK # Village Township B. TYPE of Occupancy: Commercial Industrial _ Other (Specify) Single Family Duplex No. of Bedrooms Variance C. 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 Replacement LIFT PUMP TANK/SIPHON CHAMBER Total gallons Prefab Concrete Poured-in-place -Other (Specify) D. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 'Total Absorb Area sq. ft. New Replacement Alternate (Specify) Seepage Trench: No.Lineal Ft. Width Depth Tile Depth(top) No. Trenches Seepage Bed: Length Width Depth Tile Depth(top) .No. of Lines Seepage Pit: Inside o ameter Liquid Depth No. Seepage Pits Percent slope of land Distance from critical slope E. WATER SUPPLY: ❑ Private ❑ Joint ❑ Community ❑ Municipal Present Sanitary Permit Holder Phone No. Sanitary Permit Transferred To: Phone No. Name Name Address Address Zip Zip I, the undersigned, do hereby certify that I have reported all revisions to the sanitary permit and that all revisions are in accord with section H 62.20, Wisconsin Administrative Code and that I have sized the effluent disposal system according to the EH-115 prepared by the Certified Soil Tester and/or any additional soil tests that may have been required. Plumber's Signature MP/MPRSW # Phone # - Plumber's Address Information obtained from (owner or agent) PLAN VIEW: Provide sketch below of any revisions to original sanitary permit. Include direction of slope and all distances in accord with H 62.20. Well location shall be included on the sketch. Indicate or dimension location of all wells, on the property or neigh- bor's proper t If well has not been°drillpd plea ind~c9t ° I i e 4-11 e 9 s I I I I i . Signature of Issuing Agent 1. County (Yellow copy) 3. Owner (Pink copy) DIVISION OF HEALTH 2. State (White copy) 4. Plumber (Green copy) P.O. BOX 309, MADISON WI 53701 EH 115 Rev. 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION:/, '/4,3klY4, Section ' T ~N,R LL E (or) W, Township or Municipality Lot No. Block No. r..f County Subdivision ame Owner's/Buyers Name: A41f• AfX 3 • G'L1.-v7- Ed & Mailing Address: 3r& %'13 ST ~ ?,4 yL A//" 1A, TYPE OF OCCUPANCY: Residence n No. of Bedrooms- COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW x REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATION//S DE: SOIL BORINGS ? 6- 7 PERCOLATION TESTS --e SOIL MAP SHEET (f NAME OF SOIL MAP UNITp Z- 13 PERCOLATION TESTS /_0,4"4t/ TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- e 3 ~,~N 15 6 "e is iv cs z V Ne;w P- P- P- T H SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B- % 7 7_? ,Aq/. SZ 2 f •'/J. 4.1 x _i/ B- 2 area G -72 71,112AI . 2.2'' Ze4' 5 X3 0- mss" B- 3 22 ,'V 0411vz- > 7 /3ti t cif S' 33 " U , e S B- '7 U 5l 22 Q, C S B- 5 ~~fi✓E ~;z J.,AN o,rs, Vii`' a. <s B- 7 ~ G > 7;1- "13,v 10-i^ s° 2 5' 3 0, PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the Ian the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy /5~ 94cD .Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. ~ ~ T _ lVp~Q;T/~ LOTI/.~11~ I~rSP/fNL'~"S .,~i000ICa1~'lL~. _ .m a_ C A/ IPO~T "04a 'r-107 S, yA, 17OS v F Bs goo woo i'oC 13 ' © p F ~ ~N ,410 *4,/00 0 e O E~ /s/,f 7 ;1I~~" 2~ I a P ~ S i _ - Q`l a ~ -7.,..- e _ Mj I~~® r w t . r O MAI I, the undersigend, hereby certify that the soil tests reported on this form were made by me in accord it the procedures; Jthods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are ' biaatr°of my knowledge and belief. I t Name (print) h.,E Certification No. Address /C ✓ ' 3 A., GUM'S.. Name of installer if known Copy A -Local Authority CST Signature State and County State Permit # > r P L B 67 Count Permit, # ek Permit Application y 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: NZ-- '/4, Section, T-L N, R E (or) Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village f?ei..-1 R e'f' a-Township-- C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family ✓ Duplex No. of Bedrooms 3 No. of Persons D. SEPTIC TANK CAPACITY ! G['t• Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete r° Poured-in-Place Steel Fiberglass Other (specify) New Installation r Replacement Lift Pump Tank or Siphon Chamber LC.~Total gallons Prefab concrete Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate/'-;~~ -Total Absorb Area ---4 is sq. ft. New Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: Length- :3 7 Width /1 ' Depth fG Tile depth (top) .Ct No. of Lines Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land C 7, r -i. Distance from critical slope I/e- WATER SUPPLY: Private 0 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 Certified Soil Tester, NAME /f Q,L S t IcHT C.S.T. # j ~'-r X y~S:C• and other information obtained from '~i*►j " - - j (ewRwr builder). Plumber's Signature ,r1 MP/MPRSW# >>~=f_~ -Phone #flx.~ Plumber's Address "P )i. lY /bbl' f/', tJiJjcs - 6c1L 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. E E R. Ar lC.~ tC h L L. ~ - roe 1_ _ -~'r~~ r 7,o p 0 1 3 / sT C,~r = di s% Z~ 7 4v ~ E _ e e C Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Y ,t f' lJ Date Date of Application Fees Paid: State f` Count Permit Issued/Rmjt'e'd (date) Issuing Agent Name Inspection Yes `.No State Valid# Date Ree'd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 state (pink copy) 4. plumber (canary copy) Revised Date 7/1 /78