HomeMy WebLinkAbout020-1063-00-000
0 0 m-0 0 d
0 N c d 0
0
m a xt c
m 0) v U o -4 CD W c CO
N) CD
N) ~
cn m a
o rr
v CD N j n m
A Cp iv W o v N)
O Q (a O 1
O
N N Q = ~ O O
7 N C1 O O
N C ~ O !r
d N
cn D CD fl- N
:D CE CD T Q N
I N I (D
C ~ C CO Ul
_
C1 _ ~
CD CO CO N 0 r- U)
CD Cto co -14 co O C
~
co
C1
v w w a) !r
O O O o a ry~~i
IT m < w Z
Ncncno o D
13 s T 0 a w o
O M CD N
~
GN ~ ~ A d _ '0 ~ Q
Q
N O S d. (N
A
O 7 4
N
Zco Zc o
D CD O A
C)
v IG
•
o m CD
N Z
N
CD w c
CC N
C CD CD
W D C1
{1 7
z Z CD
~ = O ? Z n
n A Z O
m n G7• O
J cn
I W
C
W CD (C
CL , , z:
3 a zi
00 Cn
N
Z
CD
W ~
N D z
0
'o c.
~ o 0
c
N -
F N Z O.
O ~ O
Cll CD
N cn
7
XN-.
CYI N
A
CD
CS CL
CL Z
CD R
CD
3
a
C)
0
N
N N
~ o
0
CD
CD a
it
c
o
G N
cfl
ti o
o b
oa
CD 3
Parcel 020-1063-00-000 04/22/2005 03:15 PM
PAGE 1 OF 1
Alt. Parcel M 23.29.19.240C 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
* VOLOVSEK, JEFF & REBECCA
JEFF & REBECCA VOLOVSEK
724 BADLANDS RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 724 BADLANDS RD
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 9.470 Plat: N/A-NOT AVAILABLE
SEC 23 T29N R19W SW SW LOT 3 CERT SURVEY Block/Condo Bldg:
MAP IN VOL II PAGE 347 ORD EXC PT TO
TOWN HUDSON FOR ROAD PURPOSE (DESC Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
888/353.053AC) 23-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
11/05/2003 745854 2450/475 TD
10/30/1998 590318 1371/440 QC
2004 SUMMARY Bill Fair Market Value: Assessed with:
48131 233,100
Valuations: Last Changed: 05/06/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 9.947 73,900 106,400 180,300 NO
Totals for 2004:
General Property 9.947 73,900 106,400 180,300
Woodland 0.000 0 0
Totals for 2003:
General Property 9.947 73,900 106,400 180,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 316
Specials:
User Special Code Category Amount
018-RECYCLING SPECIAL ASSESSMENT 27.00
001-WATER SPECIAL ASSESSMENT 0.00
Special Assessments Special Charges Delinquent Charges
Total 27.00 0.00 0.00
• AS BUILT SANITARY SYSTEM REPORT
:DER 6 s '
TOWNSHIP SEC. T ~ N, R W
r,J. ADD ESS ST. CROIX COUNTY, WISCONSIN.
-3DIVISION LOT__~ LOT SIZE`S t'/~
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
•
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
i A
I
• ~ i ~ ~ ~ f ~ Y i I ~ I i ~ i -I
44- H
-4-
- ! ~ ~ I I I I i i I
a-- - - - I i - - - i j
;Indicate North Arrow
---Y r-
iSCALE
4TIC TAh'K(S)MFGR.CONCRETE ` STEEL
NO. of rings on cover Depth DRY WELL
~LNCIIES NO. of _ width length area
no. of lines width length area_ r~
depth to top of pipe-__,,X
WGREGATE L^~' f "I t~ t t
RATE_- AREA REQUIRED G, 7 AREA AS BUILT 2_
,Fiaimer: The inspection of this system by St. Croix County does not imply complete
o2,pliance with State Administrative Codes. There are other areas that it is not possible
o 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
e~ermine cause of failure.
t-ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM
~
? /f
'-INSPECTOR-
DATED PLUMBER ON JOB
LICENSE NUMBER
s o (n 0 K-0 0
3 a7 O
C V r1
O O ci m y W
T O N O 1
CD I
U S Z 6n W 2 W CD
!7 H•
N O (n -4 =r C _
A_ (O O O CL N A O a N Ol O
O- d (lD o n O O
m A O N
N N 4 IV
00 CD m 5. (D 3 Ao CD
O a 0 00 7 O O T
7 f/1 n ~ O O
o CD > a N
D m a N
A N N Q N
A O
N c O O
O O
3 cn
N
ID -
0 C:
O i
O
(D O O (7 r ~•1
O c N
O A cn
CVO (J N
a
CC)
"Nd
O O O !`liy
A ° a
N -D m w Z
C) F), 4." ~E < N o v N
O O (D (D N n ON
W O + v a 2
N (D (D a (p N
G y N Cl)
C1 OCC V
z (D <
Z W Z cn O
D n o N
O
rn Nr •
7) m (D
N N
`D a)
O (D
C (D (D
76 n
W
-
a 3
z (D
° A 2 t9
A Z O
N n C 7
rl)
C* N W
CD A C O
Q Z
0 ~ ? Z11
0 C/)
y Z
O A
Cl)
(D
(D 7 Q
-0- EF n
A O
O T
v ~
7
N OJ- C
~ m z O.
O O
O cn
N U
X .N-.
(D
(T CL
(D
N
3
t
p R
O c
(O O
~ N b
N
O
(D O
~ V
(D O
O by Oo
to O
V
O (D e
O n ~ v
Parcel 020-1063-00-000 01/25/2005 03:58 PM
PAGE 1 OF 1
Alt. Parcel 23.29.19.240C 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
VOLOVSEK, JEFF & REBECCA
JEFF & REBECCA VOLOVSEK
724 BADLANDS RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Add s es): * = Primary
Type Dist # Description * 724 BAD NDS RD
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 9.470 Plat: N/A-N LE
SEC 23 T29N R1 9W SW SW LOT 3 CERT SURVEY Block/Condo Bldg:
MAP IN VOL II PAGE 347 ORD EXC PT TO
TOWN HUDSON FOR ROAD PURPOSE (DESC Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
888/353.053AC) 23-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
11/05/2003 745854 2450/475 TD
10/30/1998 590318 1371/440 QC
2004 SUMMARY Bill Fair Market Value: Assessed with:
48131 233,100
Valuations: Last Changed: 06/06/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 9.947 73,900 106,400 180,300 NO
Totals for 2004:
General Property 9.947 73,900 106,400 180,300
Woodland 0.000 0 0
Totals for 2003:
General Property 9.947 73,900 106,400 180,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 316
Specials:
User Special Code Category Amount
018-RECYCLING SPECIAL ASSESSMENT 27.00
001-WATER SPECIAL ASSESSMENT 0.00
Special Assessments Special Charges Delinquent Charges
Total 27.00 0.00 0.00
z
REPORT OF INSPrCTION_INDIVIDUAL SEWAGE SYSTEM
Sanitary Permit
State Septie,`7
NAME own.ahi.~~ _St. Croix County
r
Locat.ion,,.~ ection
SEPTIC TANK
Size t C'O _ gatton4. Numb en o6 Compartments
Di.6tanee From: Wett it. 12% on greaten zZope
Bu-itd.ing fit. Wettand~s
H.ighwater it.
DISPOSAL SYSTEM
D.iztanee From: Wett it. 120 or greater 4Zope•?,.5-6t.
Bu.i.Ld.ing it. wettands Ft.
H.ighwater - it.
FIELD DIMENSIONS: _
Width oS trench it. Depth o6 rock below t.ite Zcn.
i
Length o6 each tine 6t. Depth og rock aver tite Z,.in.
Number o6 Z in ens Depth o6 t-ite b et.ow grade
Total dength a iines J~IJ it. S tope a trench Z" n per 100 it.
Distance between Una (p it. Depth to bedrock t.
' vroundwateAt it.
Tota.~ ab~sorbtion area~_it2 Depth to
Pa er
- Requited area it 2 Type o6 Cove or S tr aw
p
PIT DIMENSIONS:
Number o6 pits GAaveZ around p.itz yeas no
Outside diameter 61t. Depth below -inlet it.
2
ZAA ab,sorbt.i..on area it
requ~.red St2 INSPECTE TITLE(
APPROVED , DATE 19 779-.
REJECTED DATE 197,
f`
N
EH 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 , T y N, R ff E (or) W, Township or Municipality
Lot No. Block No. LG CG~.~.~3i Sys e/C / • f ~ C7'etS County
A01114 , , 13 ~ k Subdivision Name
Owner's Name: ~
Mailing Address: TYPE OF OCCUPANCY: Residence X No. of Bedrooms 3 Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLAC MENT
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS/>v"'7 P09 YyA #71
JaX~ _ -
SO] L MAP SHEET SOIL TYPE 1501'(10144
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 MIN/IN
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 NCd
0 7 2 0,
RN. Si 51 vo r
17 P-&
A
" . 0. 5 Ye.
y
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)
71 /VL> •vE 7.2, OR. 5.
B-- y 7z 72 13 Or. 51 Al, 4.- j1.; p si ~ / G•
B 114 iG~Q~vE r ? "i3.v s1 /d" or 51 w rod ,1 v 4_u
r: 72 AIP.VE 72- 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 ~-.0 tk`
needed for building type and occupancy. Indicate scale -nk ;k
or distances. Give horizontal and vertical reference points. Indicate slope.'
13,
T~ a d.Mat tr N I
Z'T
;o ' ! w
-
I
oil
i> ✓ ~l !
I 1 y - - - - -
7 6
-V~E _ I
r - r -T
! I 1. •g
f I i ~ (}y(lJ
s~ 1
-4.n
i.'.._
f ` i f
, aeI EST'
FT
6#' 's
ion✓r ~i r
V
\ - I Ali
v -.-mss. -
I, the upder5igned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures .PD
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 knowteoge and belief.
Name,(print) G Certification No. 's
Address
Name of installer if. } own a/~ ~ ~t 0 NO. 1 224 OV
CST Siqn2tijrp
EH 115
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
y J DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309
MADISON, WISCONSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
LOCATION: N/, 1~ ,~y /f(,fiso~c:'L S
/4, Section , TAN, R E (or) W, Township or Municipality
Lot No. Block No. zo r C®Av 5/ G/C y ? /f - County 5'1- eieol:Y
Q~ Subdivision Name
Owner's Name: /C
Mailing Address: eleehr ~ 14-11"o- r
TYPE OF OCCUPANCY: Residence No. of Bedrooms 3 Other
EFFLUENT DISPOSAL SYSTEM: NEW x ADDITION REPLACEMENT y
DATES OBSERVATIONS MADE:: /SOIL BORINGS I'MY 3A 1-~' f PERCOLATION TESTS d 'V' X
SOIL MAP SHEET SOIL TYPE
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 MIN/IN
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD/2 PERIOD 3
P- 21 V
Z" ,e -5,& ~-m~,
~
J 7
P_
1-1-11Al PE;y44e'14v&T1_ IV 7-1-J
7-0 11 ?,OA -2, ~ -TN-,o
P-3T36 /-A 1,TA1
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)
S>j-- Nd~o~ o 10"Cn~ln/ si'! 13 11 L//'ti S'; y," 0-s.
'72 6.
3 ?0 ~vo~E > c~ U"r3N 3l r~ " AlIv 5 o, S w
' z LS> Z - M -h: 5;/ o0,4 3Io /
z 1110 C- 7 51,L " Ll`•/',~ y 7y'' C.U.S. f"
72 4/0, _4- 7 7.2. ,R f/ /Jr C• si S G. O- S. w c i
PLAN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of sui$abLe areas. Indicate numbWr of square feet of absorption area
needed for building type and occupancy. Naj SuorAA/E FM 0,0011,yifELL) DJ - Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope. So11 su di~'y ~1'~'~PC
-
D/
:5y~r-
4 0/` 16
1 I ; I ! I
-4-- If
i
l t t f
i ; ~ -
I
V-
I J f k '/~J~,y /V
S P,
3! ~ I ~ 1 I ~ 3 t I i ; 1 I f _f f ~ I I y
5
-
I ~ i l I
1:'
I, the undersigned, hereby certify that the soil test rted op tis fo' ,W~~re made by me in accord with the procedures
and methods specified in the Wisconsin Administ of e Cod~y~rfd"Ehe' recorded and location of test holes are correct
to the best of my knowledge and belief. r
'77 1010
Name (print) "-h~~ ' f ,Ce ification No.
Address
f .t.
Name of installer if known
CST Signature.,
r q
` o/
State and County State Permit # jq
• P L -6 7
w Permit Application County Per #
for Private Domestic Sewage Systems County L
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
1<1144~1 7 7&-9Z Pliy~~ 91A;'4)..
B. LOCATI N: Si,rLl i<jSection, T N, R f E (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township H UAC>S. 0
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms No. of Persons_ _
D. SEPTIC TANK CAPACITY J060 Total gallons No. of tanks /
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete _ X 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. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area 60 sq. ft.
New. *X. Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft.-Width Depth Tile depth (to) No. of Trenches
Seepage Bed: -~_Length 2~~ Width jr1 • Depth i~ Tile depth (top) - No. of Lines *3
Seepage Pit: Inside diameter Liquid Depth, No. of Seepage Pits
Percent slope of land Distance from critical slope
',HATER SUPPLY: Private 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 Certifie Soil Tester,
)t, 0
_
NAME
~ 1 L 13k t C IN- C.S.T. #.51!; and other information
obtained from 1Cf (o~_nner/builder).
Plumber's Signature MP MPRSW# _,L Phone #394 -2_t?56
Plumber's Address ~i t., 0 3, r ,;~i - c- Q t
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
}
m
1 f~ ,
1
Pro pU V
,
E
M
E -
E t
Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application l Fees Paid: State /o, eo unt e-`2 O Date 'f5 oZ/
~
Permit Issued/RsjeCF€ed (date) / Issuing Agent Name E
Inspection Yes No State 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 7/1 /78