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Parcel 020-1072-80-000 10/16/2006 10:16 AM
PAGE 1 OF 1
Alt. Parcel M 26.29.19.2908 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
O - BRADSHAW, REGINALD L
REGINALD L BRADSHAW
728 KINNEY RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 728 KINNEY RD
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 2.001 Plat: N/A-NOT AVAILABLE
SEC 26 T29N R19W NE SE LOT 1 OF CERT Block/Condo Bldg:
SURVEY MAP IN VOL III PAGE 731 ORD
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
26-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 798/374
07/23/1997 727/540
2006 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/25/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.001 75,000 164,200 239,200 NO
Totals for 2006:
General Property 2.001 75,000 164,200 239,200
Woodland 0.000 0 0
Totals for 2005:
General Property 2.001 75,000 164,200 239,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 134
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT
"FR aJL. , 4 , TOI,'NSHIP `
SEC. T21 N,
R t ~ ~1
ADDRESS , ST. CP.OI' COJ.ITY, WISCONSIN. -
civ
DIVISION , LOT__L_LOT SIZE
PLAN VIEW P1 -I y~
Distances b dimensions to meet requirements of H62.20 y
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
i f ! I
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- S I
- --t 1--
- i I I I I , I ~ I I I I T-_T---f,--•1
IC TANK(S) MFGR Indicate NAnnow
C0*3CIRETEK STEEL Sca e
NO. Of rings on cover
-`-""HF..S NO. of width Depth DRY WELL
length area
no. of lines width f~,~ lengthL ~ area f/
depth to top of pipe
::,ELATE 1/~!. vC ,!1' t~~ •r~ ~ _ ,
L !t7/'
RATE f AREA REQUIRILD AREA AS BUILT
'laimer: The inspection of this system by St. Croix County does not imply complete
liance with State Administrative Codes. There are other areas that it is not possib'.e
,.spect at this point of construction. St. Croix County assumes no liability for
m operation. However, if failure is noted the County will make every effort to
'ine cause of failure.
AND OILS SHOt'LD NOT BE DISPOSED THROUGH ':"HIS SYSTLIM.
'-INSPECTOR
DATED PI.L; f 3t ER ON JOB
J,
LICENSE NU TIBER
Z
REPORT O.z INSPECTION-INDIVIDUAL SELVAGE SYSTEM
Sanitary PeAmit
State Septic
NAME iownship _ST. Ctoix County
Location Section
SEPTIC TANK
Size -gaZton6. Numbers o6 CompaA,tmen,t6
Di,6tanee From: LVeZf- 112, it. 12% on greater ztope Zno- /lt
Building ZZ- it. wettands ~ .
HighwateA it.
DISPOSAL SYSTEM ,
Diztanee Enom: Wet Q fit. 120 on greaten /scope av
Buif-ding 7 2-- it. LVettand,5 Ft.
• HighwateA it.
FIELD DIMENSIONS:
Width o6 tAench Q it. Depth o6 rock be.Low tiZe--,- I .in.
Length o6 each tine it. Depth o6 Aock oven tiZe_n.
Numbers o6 .roes .3 Depth of tiZe below grade-0-in.
TotaZ tength o4 Zine6 / Q$ it. Stope o6 ,tnenrh in peA 100 it.
Distance between Una-Le-6t. Depth to b ednc ck .
Tota.L absorbtion area QV 6t2 Depth to gnoundwatVL
Requi.Led area it2 Type o4 Coven: apeA or Straw
PIT DIMENSIONS:
NumbeA o6 pit GAave.2 around pits yes no
Out,side diame e Depth below -i.nZet it.
2
TotaZ abzonbt" a St A
Area Aequkned``~f i2 rn
INSPECTED BY TITLE
197
APPROVED' DATE
4~rrlk If
YA
REJECTED , DATE 197.
2,#
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EH 11 5
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309
MADISON, WISCONSIN 53701
/R-EPORRT ON SOIL BORINGS AND PERCOLATION TESTS
LOCATION: Section T? N, E (oroownship or Municipality /
Lot No. , Block No. T iZOlx
-County
Subdivi ion Name
Owner's Name:
/`1 l s ~
Mailing Address: ) -r" 7 4 L
TYPE OF OCCUPANCY: Residence No. of Bedrooms 73 Other
EFFLUENT DISPOSAL SYSTEM: NEW DX7 ION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS Ne
SOIL MAP SHEET SOIL TYPE
PERCOLATION TESTS
TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
NUM- INCHES THICKNESS IACTERN INCHES SINCE HOLE HOLE AFTER INTERVAL ~ gER/ 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
P-/
K
r
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
N
UMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
B- SL
B- -7 2" it
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and squar eet of suitable areas. Indicate number of squar feet of absorption area
needed for building type and occupancy. r=fl S~ Pr, V~~ Nct( `l S Ttjndicate scale
or distances. Give horizontal and vertical reference points. Indicate slope.
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17
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A F1.
1, 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 kn ledg elief.
Name (print) O~~ b 1Zti t Certification No. = S
Address ex
Name of installer if known
CST Signature ,
bhhh,.OCAL AUTHORITY
PLB 67 ~ State and County State Permit #
a li Permit Application County Per
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: /
E0L>-C-~ Z'3 EP,A s ~f(- Lj/Ti1 /y
B. LOCATION:'/' Section T~ N, R f~ E (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
, / ~ 9~ L
LL 1V/V !rte/j DLy 6.,7"3 6.,7"3 Township )q'P hj
C. TYPE OF OCCUPANCY: `Commercial *Industrial *Other (specify) *Variance
Single family _X Duplex No. of Bedrooms No. of Persons
D. SEPTIC TANK CAPACITY /e)t)(') 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 7 Total Absorb Area e- YT
sq. ft.
New- Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: _Length Width-~-Depth - 34*, Tile depth (top) t'-/ No. of Lines --3
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
T
Percent slope of land `C Distance from critical slope
WATER SUPPLY: Private Q 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 S it Tester,
NAME tLfl~ A ,d- ,6 C.S.T. # & and other information
obtained from t'', /C (owned r).
Plumber's Signature M /MPRSW# 32&,x, Phone # 7jy-~ S y J -C~;,; /
Plumber's Address x
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 DEP~RTMEN; USE ONLY , C"
Date of Application Fees Paid: State ~y~C County Date
Permit Issued/Ra}eswrl (date) Issuing Agent Name 1 t t
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
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