HomeMy WebLinkAbout161-1094-10-000
i
0 O 3 n d r1
O fD _ 1
`D co fD o A7
C a gt " l^\
-0 1 d CD 1
1
O
R 7 O O c O O N m N ICI `A\
N c a Q N N N O <
7 0 o p O
A 7 CO CO
Q SU am m cn n J
0 CD CL 0
C. CD CD
3 ! c~ O
3 ~n Q 2 o O
C N c
o y co cn o.
N D C P. N O
(D c N N a U) 1 7
a V
W
7 _
- o'
CL °rn
7
cn O ? o C) ~1
CD co co -
m n 0 N
-4 -4 cn
N (D ((0 z O c N
m C
Z 0 0 0 0 Z•
I o 7 Z1
v ~ NOS Qnz
n 7 fR N N
v v
o v -
7 Of O O X ~y
'm -Oi rn (mil
a 3 o
N CD
Z I N
z03z O
O D a 7
Cl) (n
CD N N
N v~
c N
w a
n 3
z (D ~ N
A Z fD
0 7 _
W j ~ n
n 7 A z O
v my
a.
7
W -0 cNO w
c. 3 z
a
O r: N
O OO
N z <
CD
D
0 O_
(O a
N
T
4l C
3 z
a
o_ o
Q: m
v
N
A
n
O
o-
t
O
W
N
O
O
a
A
~ b
O
(D
7 bQ N
ft
E» O o
O
C) i
Parcel 161-1094-10-000 10/03/2006 09:39 AM
PAGE 1 OF 1
Alt. Parcel 13.29.20.744 161 - 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
O - BONGIOVANNI, MICHAEL G
MICHAEL G BONGIOVANNI C - FARROW YVETTE R
FARROW YVETTE R
252 STATION CIR N
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 252 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 20 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
06/29/1999 605840 1437/595 WD
03/23/1998 575613 1308/159 TI
07/23/1997 907/155
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 0.000 112,000 259,300 371,300 NO
Totals for 2006:
General Property 0.000 112,000 259,300 371,300
Woodland 0.000 0 0
Totals for 2005:
General Property 0.000 112,000 259,300 371,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 521
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
• AS BUILT SANITARY SYSTEM REPORT
.
f`uy li~~~ n SEC._ %
T .2 N, R kl
; ' - ~,,r` • -
ADDRESS ST. CROIX COU.iTY, WISCONSIN.
DIVISION .S l7dr r+- , LOT LOT SIZE
PLAN VIEW
-Distances b dimensions to meet requirements of H62.20
SHOW EVrRYTHING WITHIN 100 FEET OF SYS'T'EM
- -
O w~ I I ' ~ I FT,
-33
i - ' _ - '
1
J I-f ; - v - t I I - -
I 1 I i 0~ I f
' I
\_3 le 11
f4
i Indicate Nottti Attt ow
"TIC TAhK(S)_/,? MFGR. Scale ar i~
_~--~-~•~r CONCRETE STEEL
NO. ot-rings on cover j Depth ~C" DRY WELL
.:_NCHES NO. of - width length area Jed
-j no. of lines _3 width ' length qt,; area
depth to top of pipe
a:.EGATE
RATE ClG,Ss / AREA REQUIRED 7i AREA AS BUILT
;eiaimer: The inspection of this system by St. Croix County does not imply complete
;,•Dliance 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
."•~rmir.e cause.of failure.
-:ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
'`INSPECTOR
DATED PLTIMER ON JOB
LICENSE NUMBER /1] 3 CJ
Z
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
San.i.taAy PeAmit/
State Septic
NAME 4f awns hip S. . CAoix County
Location z~ .`aGc~ Section l _
-_4
SEPTIC TANK j
Size ' gattons. Number o6 CompaAtments ~
I
D.is.tance From: Wett 6t. 12% on gtcea,tetc ztope ~,t t
Buitd.ing 6t. We.ttands _ ~ .
If i.ghwatetc - 6t.
DISPOSAL. SYSTEM -
Distance Ftcom: wept 6z, 12% oA gtceatvL 3tope 6t.
Bu.itding _6.t. W ettandls_ Ft.
q i,ghwatetc 6t.
FIELD DIMENSIONS:
Width on tt~ench 6.t. Depth o6 tock below kite .in.
Length o6 each tine 6t. Depth o6 tcoch oven t,ite in.
Numbe,'c o6 tine/s Depth o6 ti.ite. below gtcade. .in.
Totat tengt-h o4 tines- LL_6t. Stope o6 .tt~eneh- -_.in peA 100 6t.
Distance between Zinet 6t. Depth to bed>toeh. -.6t.
Totat ab,6okbtiori a%~e 3A- Depth to g%z-oundwatetc
Requined area 6t2 Type o6 Coven: Papn. of SttLax
PIT DIMENSIONS:
Number o6 pits Gnavet ati.ound pits yeas na
Outz ide d.i.ameten 6t. Depth b etoto -into L 6 .
2
Totat ab6onbtion vLea 6ti A
Area nequined _6,t2
INSPECTED BV TITLE =
APPROVED ,DATE 1 ;
REJECTED , DATE 191___
,i
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~',S 'Q,.Iw'/4, Section 12-, T5~N, R~~ (or)G/Township or Municipality AW_S6/_1
Lot No. ~2, Bl/o^ck..No. , 5;7`, Crdi>C :5)1•4;Vl* -County
-S`` `rd!
l~f r ~d SuC`n Name
Owner's Name:
Mailing Address: l <'k~ 4,C), IS, 516~2 2-
TYPE OF OCCUPANCY: Residence X No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW X, 'ADDITION REPLACEMENT c'
DATES OBSERVATIONS cM./ADE SOIL BORINGS 7-,,6-- 2 /PEERC9/LATIO/N TESTS 7--906- ~ 7
SOIL MAP SHFET_____ 1 ~ _ -COIL TYPE r ~ h`~kJ,bAr d. ~"A~-ty s/. L
-
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- %S11 _<ee Are
P t
P__ Ace
1 IVr ,2 /y 0212 2z
A-1,41
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
j NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
ii X11 « , L f~ tr , ~s/ 7 <~J~/~~ CC ~C ` ~1~
B- itiu~ 7(G r l9 ~Of ~~~~~j ~~~r S'J/ ~i`•
=3- 9,W1
> q~ir ~p ~<7`S< l~~t. Bl/t yiJ SDI
6..ffYa°° B.~ QCs, y°. y
'?_.AN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of suitable areas. Indicate num se <; e*, r t ahr ,Orl.r oo r =a
needed for building type and occupancy. 8,2 d At. _e Indi ate scale 11
or distances. Give horizontal and vertical reference points. Indicate slope. `C:A4
g
At-
f I
-.4 LA cn
1
l -
I
E
i0
I o
T__
3
c E s I
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) v~fj~, ' &4j Certification No.
Address W+_ S
Name of installer if known' A~ 'Ad 2L
CST Signatu`
,COPY A - LOCAL AUTHORITY
PLB 67 State and County State Permit #
Permit Application County Perm
' 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:
-G 6 s _c w Gies e 1&4,t ellrcle
B. LOCATION: ection 1,;t , Ta9 N, R ` G (or) Lot# 20 City
Subdivision Name, nearest road, lake or landmark Blk# Village n%, 14., d s-c-,,L
'TI. Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family _ . Duplex No. of Bedrooms No. of Persons
D. SEPTIC TANK CAPACITY /XoL, 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 A( Replacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-PlaceOther (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area- - sq. ft.~~~~ 4(~,
New-Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches -
Seepage Seepage Bed: A Length1/4 _Width Id' Depth V ?4" Tile depth (top) 3.2 0No. of Lines
Seepage Pit: -Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land / T C&.Sfe, 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 Certified Soil Te er,
NAME 1AZA U's C.S.T. # and other information
obtained from Ltiu 1/ey; (owner/builder).
7 :W
Plumber's Signature t,, MP/MPRSW# /Phone l-J~ `J I
Plumber's Address Y+ l 0 rd r~ 4(.` Yl 4u I Is C
yG~ h
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.
We,~ Kr~ft1e C, role 41 Li ej I to sep f,i
.
33
•
i
~~m3
, a
3yy~ Hour
4- dA
t
-41
h
iJQ)s f K•rAoky
CI~de
Do Not Write in Sp7e Below FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application ( ' - % `r Fees Paid: State Co my : ~ C 2 Date
Permit Issued/
RejecMI (date) r ;7~7 Issuing Agent Name --c ' CCU
Inspection Yes _X 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
l