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Parcel 020-1146-00-000 05/16/2005 08:30 AM
PAGE 1 OF 1
Alt. Parcel 17.29.19.769 020 - 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
LUND, ROBERT L & DIANNA K
ROBERT L & DIANNA K LUND
481 MCCUTCHEON RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 481 MCCUTCHEON RD
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 2.240 Plat: 2276-PARK VIEW ESTATES 2ND ADD
SEC 17 T29N R19W PARK VIEW ESTATES 2ND Block/Condo Bldg: LOT 76
ADD LOT 76
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
17-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 713/282
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 2.240 37,300 159,400 196,700 NO
Totals for 2005:
General Property 2.240 37,300 159,400 196,700
Woodland 0.000 0 0
Totals for 2004:
General Property 2.240 37,300 159,400 196,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 126
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
1
COMMERCIAL TESTING LABORATORY, INC.
514 Main Street, P.O. Box 526
Colfax, Wisconsin 54730
715-962-3121
800 - 962 - 5227 C:!::w
FAX - 715 - 962 - 4030 c
.?i.n +..r iu'ii: f tiU Aii 4.;;..
:QURTF filSE UATF RECEIVED: 11/19,
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4.;A1Y77 r 11 ...JC
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` PROFESSIONAL LABORATORY SERVICES SINCE 1952
(d 712
ST. CROIX COUNTY ZONING OFFICE
r , St. Croix County Courthouse
911 4th Street
Hudson, WI 54016
Telephone - (715)386-4680
The St. Croix County Zoning office offers the service of septic
and water inspections to Lending Institutions, Realty Firms, and
private individuals.
Completion pf this form ja essential 5_Q that thg property can be
located.
Please provide the following information, enclose appropriate
fee made payable to St. Croix County Zoning Office, and mail,
along with form to the above address. Testing will be done as
soon as possible after fee and form are received.,
WATER TESTING----------------- -------FEE: $ 35.00
..-C For nitrates and coliform bacteria)
WATER TE§IrING FEE: $185.00
(For VOC'S)
SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00
(Determines if system is properly functioning at time of
inspection) /
PROPERTY OWNERS NAME: 11) (1 rI "-I , (,(k'i('k L
PROP. ADDRESS.- ~ 4 / 5 ~'t C Ci ~t <~Air CITY
Legal Description 1/4 of the 1/4 of Section T N-R
Town of Lot Number Subdivision:
FIRE NUMBER LOCK BOX NUMBER Z)21- - /m
Color of house fi, Realty sign by house? /Vc. If so, list firm:
PLEASE INCLUDE, IF AT ALL POSSIBLE, A HAP,i.e,COPY OF P T BOOR,
WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET.
Testing of residential water requires a sample that is fresh. If
the home is vacant, and has been so for some time, the water line
must be purged by running the water for several hours before the
test can be conducted.
WINTER TESTING: Many times water lines are turned off, or sill
cocks are turned off, making access to the home necessary. If
this is the case, please make proper arrangements with this
office to ensure time when entry may be gained.
Firm or individual requesting services: ';~-4- l o
Telephone Number /r S -_?S(, 1
REPORT TO BE SENT TO: CLOSING DATE: 5 IJ
Signature
AS BUILT SANITARY SYSTEM REPORT
OWNER VIPP TOWNSHIP /,t c 7 a SEC. 7 T26 R 1 W
P.O. ADDRESS-.b r~ 5 w s ST. CROIX COUNTY, WISCONSIN
SUBDIVISION LOT LOT SIZE 3 'C-Z
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100FEET OF SYSTEM
~ r
V/ 4
I ?rri~. ti
z e
SEPTIC-TANK(S) MFGR. ~t/+ CONCRETE STEEL
NO. rings on cover Depth__= DRY WELL
TRENCHES No. of width length area
i
1 BED no. o lines width - length area
dept to top of pipe
AGGREGATE
PERK RATE AREA REQUIRED y AREA AS BUILT -
DISCLAIMER: The inspection of this system by St, Croix 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 THIS SYSTEM.
INSPECTOR
DATED PLUMBER ON JOB
LICENSE
Z'
`REPORT OF INSPLCTION_INVIVIDUAL SEWAGE SYSTEM
' San.itaAy Penm.i-t X60
State Sep,tic
- .-S C. vix County
NAME - ~ -t z Lc-C i owns h i.p
Location S C L ~!'Sec..t~ on_ % _
SEPTIC; TANK
Size gaUons. Numb en v Compa ttmen,ts i
Diz tanee Kom: Wett ~ t. 12% on gneaten stope It.
Bu.i.td.i.ng It. WetZands _ It.
H ighwa-ten - It.
DISPOSAL SYSTEM
D.iUance Kom: WeQ.i' fit. 1 2 ~ on gnea.ten s Zope_ It.
Bui ding W e.-t.iands Ft.
N,i ghwa.ten 6.t.
FIELD DIMENSIONS:
Width Q .tnench 4t. Depth v6 lock betow .tile in.
Length os each tine It. Depth ors loch oven ti e ,in.
Numben Q Zines Depth o j We Wow glade in.
Totat .length o6 i?.ines_ 6f. Stope o~,j tinench_ in pen 100 It.
Distance between Un.es It. Depth to bedAock It.
Total, absonbtion anew_ It Depth to gnoundwa.ten 0 .
Requited anea _ I 2 Type cj Coven: Papen on SUaw
PIT DIMENSIONS:
Numbers o6 pits GAaveT anound pits yes no
Outside diameten it. Depth be.iow .inZe.tIt.
2
TotaZ absonbtion anea It
A
AAea nequ.i.Aed It2 rn
INSPECTED By TITLE 1
APPROVED DATE 197
REJECTED DATE_ 197`
`,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
LOCATIONS Section ,TAN,R&lff (or p or Municipality
Lot No.- Z6- Block No. /q~ J~ /✓y E'~rJ=Se'3 County
Subdivision Name
Owner's/Buyers Name:
L
may- - /
Mailing Address: 6a, ,
TYPE OF OCCUPANCY: Residence X No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW A REPLACEMENT ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS 1~,-,20 - C/ PERCOLATION TESTS
SOIL MAP SHEET S7T NAME OF SOIL MAP UNIT 14~9 Z3 J64-16944
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 AFTE INTERVAL
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
P- I 0011 Sc'C re Z- /ACV -3
P-
P-
P-
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- % 6 w /close F " ,CS 3" al S'
B- c 7 / ` .CS 6 a/s
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on theplan the location and square feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancy 6 e C)C)A, Indicate scale or distances.
.
Give horizontal and vertical reference points. Indicate slope.
i
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I, the undersigend, 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) Certification No. -
Address Ale,
Name of installer if known
.i
Copy A -Local Authority CST Signatur
L v
1-~,
'f ~ ~ { ~ J~ yl`'~. • - i'~.;a evil ' =3~~' 1 L
~ LL
_ Y
~ ~ s ~ h , ~ FAY
t
State and County State Permit # .
Permit Application County P~rit
PLB 6 7
for Private Domestic Sewage Systems County f
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
5-,;,z m A i ((f,- 1-1 u J'7 u A L41i S
B. LOCATION: Section / , T21 N, R E (or) W Lot# 76 City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township Aeil So,l
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms No. of Persons
D. SEPTIC TANK CAPACITY / 066 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 or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate y Total Absorb Area sq. ft.
New (Replacement Alternate (Specify)
Seepage Trench: No. of~~Lineal~~Ft. Width Depth Tile deptfj,l j~ No. of Trenches
Seepage Bed: ~Length.~~~~ _Width ~_Depth Tile depth (top) j No. of Lines
Seepage Pit: Inside di meter Liquid Depth No. of Seepage Pits
Percent slope of land "7o Distance from critical slope
WATER SUPPLY: Private Fi~ 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 Test r, j l
NAME OilglJ / ( /rS Y!A C.S.T. # 6~"`~Ind other information
obtained from qt A, ?h (owner/hiiil
Plumber's Signature ! cfs P/MPRSW# A4 " 7 IL 7 L Phone #2--f 7- '3 2 j
Plumber's Address ,j r rJ = '
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.
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Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application - Fees Paid: State County Date
Permit Issued/Reed (date) Issuing Agent Name
Inspection Yes_._No State Valid# Date Rec'd
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 7/1/78