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HomeMy WebLinkAbout161-1094-70-000 a C) h o 0 v H Oq O a o C ti 1 O N O ti h Oq .r. Q C h y a~ 0 3 c6 O Q 3 Cl) a~ z iii O E CN 0 v a z r d a~i M Z 0 z O Z ~ c N Z d' ' c c E ` _ O N O N N ►la N a 0 ~ z z m z N C lot _E ~ E fn (D N U N L X a y 2 O N U o 0 a a~ L_ _ E (0 (n cn cn k- F- d 2 (V~.~Q In N `n ~ 3: RI 3. a a a • w C a N o N " ~ PI- r u~ J U S rn rn ) m N _ oo 76 0 i w ~ iZ: Q N N U O O .3 'O O C m N C d O C O 'O m N N N O 'C d7 Q (n is y ~j O 2 ~ N C C, V- L IV O N O E O O O V U W Z r a> c v if °o 0 0 - N N N W N O C m = N m (C O of m N z+ a ~M N c6 M w0^' 7 C L 0 w y LO z Lh E d V ~ ~ ~ y E EL L: a. +cl+ v 'c c E „ ~~ww y c 44 0 a O v~ U "'1 A Parcel 161-1094-70-000 10/03/2006 09:40 AM PAGE 1 OF 1 Alt. Parcel 13.29.20.750 161 - VILLAGE OF NORTH 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 DAVID W LANG O -LANG, DAVID W 253 STATION CIR N HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 253 STATION CIR N SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 0.000 Plat: 04/38-ST CROIX STATION 1977 ST CROIX STATION LOT 26 VIL NH Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 13-29N-20W Notes: Parcel History: Date Doc # Vol/Page Type 02/16/2005 787626 2751/144 QC 02/16/2005 787625 2751/143 PR 07/23/1997 932/574 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 05/20/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 112,000 218,000 330,000 NO Totals for 2006: General Property 0.000 112,000 218,000 330,000 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 112,000 218,000 330,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 111 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 - i " AS BUILT SA.'NITARY SYSTEM REPOP.T /d r7 .76-L 7R ' 41 S~t-IP?f~~ EC. TT N S 7 , R o2C~ W ADDRES SCONSIN. ST. CROIX CGJ.ITY, It DIVISION t r y i f sec LOT _LOT SIZE PLAN VIEW Distances dimensions to meet requirements of H62.20 IVFII J~ JUL. 7 -;';`79 SHOW EVERYTHING W11"EIN 1100 FEET OF ~STE?T 11t?'' S 1 ! I ~I I ,y ..~-j j ~ I ~ I -t- I 1 ' i ~ 3rC /)Pj lop j _TT_ i I TIC TANK(S) /~6~cJ aMFGR. Indcae Nanh Anna_w 5 eV S ~1C i ~?Jt _CO.ICRETE X STEEL NO. f rings on cover 2 D ep th si D Sca?o_ -~RY WELL :INCHES NO. of width length area no. of lines width lengthy_ area depth to top of pipe aye/ ,7-ELATE RATE <~2 AREA REQUIPED AREA AS BUILT 1c)D,?47' ;claimer: The inspection of this system by St. Croix County does not imply complete .'oiiance 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 -ermine cause of failure. .:.ASES AND OILS SHOULD NOT BE DISPOSED THROUGH '.HIS SYSTEM. `INSPECTOR DATED PLL^tBER ON JOB st P~✓ ~L~~ cw LICENSE NUtflER~~S _3 'ZEPORT OF INSPECTION INDIVIDUAL SELVAGE SYSTEM San.itaAy PeAm.i-t =Y State Septic-; - NAME____'_ iownsh.ip _St. CAO.ix County f Location - Section f F f SEPTIC TANK ' Si zegat.Conz. Numb en a4 CvmpaAmenz _ j Distance FAOm: W e.CC it. 12% on gtceaten 4tope it BuiCdif2g - it. wettand~5_ ~ . H.ighwateA it. DISPOSAL SYSTEM Distance FAOm: WeU ~ it. 120 on gAeateA .slope it. Bu.itd,ing it. W et.Cands Ft. H.ighwatet- it. FIELD DIMENSIONS: Width o f trench it. Depth o6 Aoek below tiZe -(.n. i Length o j each tine Z it, Depth o6 hock oven ti.E'e tn. NumbvL o6 X-ines Depth o6 tite below gAade '(in. Totat length o% tines fY it. Stope of tteneh in pet 100 it. Distance between .C.i.na it. Depth to bedrock ~ti. To.ta.C absotcbtion aAea/),-'(,' it2 Depth to gtoundwatet_ 6 - 2 Requited Type os Covet: Papn, oA .StAaw ~ it aAea s PIT DIMENSIONS: NumbeA o6 pitz GAave.C around p.i s yes no Outside diameFonea it Depth below inter it. - 11) 2 Totat abzoAb it t2 rn u "~e~d'"' s AAea Ae4,. INSPECTED By,,Z-/Y~ TITLE f 6-; APPROVED. DATE 19 REJECTED DATE 197. 1. / f EH 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES 4 DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: N~'4, 04-4Z., Section a, T-2-1N, R -OE (or) A, Township or Municipality P11, C6E a~ ~Ok~ UDSOAJ Lot No. 2_6 , Block No. S74- C/f0/A :574, low County ✓ e~eol x ~.O 01-i U t FLE R Subdivision Name Owner's Name: J Mailing Address: 290l7 Rc eloUD t Soud4 l3u1?415u111,,s- 1-r1',yv • 5533-7 TYPE OF OCCUPANCY: Residence X No. of Bedrooms I/ Other EFFLUENT DISPOSAL SYSTEM: NEW x ADDITION REPLACEMENT 8477 PERCOLATION TESTS MARCH 3U / 7 DATES OBSERVATIONS MADE: SOIL BORINGS 1414RC# ~2/ SOIL MAP SHEET SCS SOIL TYPE JJ/ /Ir 5 - Hu~OWD L-5' 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 BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN P_ o b~r x 0 P- 1390 WA) AIEP. 2-0 0 15, I S A9 iv ' `2 -'k, Coto 1_0 P-3 3/ 13 ,QowA) AIFP / a C 0 1 c In .9-0 0 64A) D j"C 6) b 140 Ica 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) 2 7 L o ? 7~, ;10" SAJ, /s 7V " R v lite~e, S zy" t/i $nv Tj~ S. > ZO &VN S 0 /3u• n14, 5. 2-2 " E//' 13A) ,1i $ . B- 3 14 1 0 > '71 2 `'/~M %S with cob. 3 L" 9,vAr S E/-l3iv f• sr I'll s L o J- 57 "13,v S 3 o It N. NISA s E/ -sv. S_ ?Z o > 7a 2C`"/3N /S 30" 449N. MEO. E/ w F 5: PLAN VIEW (Locate percolation tests,soi I 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. 1000 J50K 'TX16A1C `f' T 12- 6 FG-V At=-n~ Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. 4 ` /41 i s 3- ~ 3 w' S _!_.1VV { pa e S~ T Ekc SIT j i s i s i ! I i I ~ I I t _ t I ! - - - g 4- - - 47 I I I N O ~Dp HA Rl I IL I X Ia $~Q Re_ r- _ - z 7~ IT P - ro - w - - y i 1111 t L. L! ~V i t I s ,2 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) Rohe er ZI/h~ / Certification No. ✓ / " Address X r, l ~~Q)i 5 Name of installer if known CST Signature L~~ 5 ' PL B• ~ ~ - State and County State Permit # -v Permit Application County Permit 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: ~v~+e l,~~J K r~,~~- ley1e Grc-I~ TC) 10 14 14 )LO (or) ®Lot# 594, City B. LOCATION: Nei '/4 VJ Section _L-Z, Tomj- N, R Subdivision Name, nearest road, lake or landmark Blk# Village ap NV. S Township C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) Variance Single family A_ Duplex No. of Bedrooms -No. of Persons D. SEPTIC TANK CAPACITY ~~SCSL~ Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete- Poured-in-Place Steel Fiberglass Other (specify) New Installation >C Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate C-Tc.SS~Total Absorb Area b , sq. ft. 9y5a re,r&-e.Z New X Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. -Width- Depth Tile depth (top) No. of Trenches Seepage Bed: Length fVidth Depth Tile depth (top) ~~No. of Lines Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land 4-eSS" f17c2 rt lrti Jys ~~n aeec- Distance from critical slope WATER 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 Cert d Soil Tester, / NAME 12t.,/- a f C.S.T. # 3el and other information obtained from fr t~ (owner/builder). J 1 f t I MP/ RSW# Phone #5,K, Plumber's Signatur P7 n -k r1r\ Plumber's Address `40I 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. f z , m. m. . . / AV i 00, well E ~ , Cen der zilC~ GI Cv f JI11ra,0 /Ely Do Not Write in Spac Beell~ow FOR COUNTY AND STATE DEPARTMENT USE O PLY / p ~'l CJ Date of Application ~i Fees Paid: State&) I el 0 C un at Permit Issued/ (date) - - Issuing Agent Name Inspection Yes No State Valid# Date Recd 1. county (whi e 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 - J