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HomeMy WebLinkAbout022-1008-95-000 stop 3-0 n C o m c o v 2) m 3 _ ~ l 1 O n p N N j j A N `C :r • 3 10 m O N 2 N rryll CD O_ (D Z C7 CA ~ 7c'. co O 5, F y m° a C,~ o m 0 0 0 0 N c~ co CD (D w C) N f o 0 N_ VI ~ 7 v (n D C fl CD (Q N I d C 0 0 N m a CD o j Z ~~1 N (VO CJO Q O~ _ !V CD CY 0 00CS CO CO ~i• co -p i G < Z C, y N o D n v a- M 0 a w o O m O I CD m m N A - A z !T z N zco z Q w' 0 D a (D 0 CD CD "ftA. y Cn v = O N C (D N W lD a 3 o (D p Z CD 0 a v 0- (Cn ~ A co A < 00 a z a O Z z CD ' A A ~ N N Q F D Q C ~ ~ G O c O N = -n N d a C - - 7 x ~ z a (0 o o a) m CL N CD CL o v 3 N A C> O O m o- - cp CD o CD CD 77 N N O N ~ A 0 O b N (D (D Op fn tG,W O *c CD (D v b O Parcel 022-1008-95-000 08i17r2007 09 57 AM PAGE 1 OF 1 Alt. Parcel 4.28.18.558 022 - TOWN OF KINNICKINNIC 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 - VORWALD,SUSANL SUSAN L VORwAt n 550 FAIRHOME RD ROBERTS WI 54023 )tt~_ Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ` 550 FAIRHOME RD SC 2422 ST CROIX CENTRAL SP 1700 WITC f ~ Legal Description: Acres: 1.268 Plat: N/A-NOT AVAILABLE SEC 4 T28N R18W 1.01A SW NW LOT 1 OF CSM Block/Condo Bldg: VOL 3/647 ALSO A PARCEL DESC AS COM NW COR LOT 1 CSM 3/647 POB; TH N 00 DEG E Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 75'; TH S 89 DEG E 150 FT; TH S 00 DEG W 04-28N-18W 75';THN89DEG W150'ONNLNSID LOT 1 TO POB (.258 AC) Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 962/379 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/10/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.268 25,000 144,000 169,000 NO Totals for 2007: General Property 1.268 25,000 144,000 169,000 Woodland 0.000 0 0 Totals for 2006: General Property 1.268 25,000 144,000 169,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 314 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 022-1008-95-000 10/05/2005 12:06 PM PAGE 1 OF 1 Alt. Parcel 4.28.18.55B 022 - TOWN OF KINNICKINNIC 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 SUSAN L VORWALD O - VORWALD, SUSAN L 1106 CTY RD N ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 1106 CTY RD N SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 1.268 Plat: N/A-NOT AVAILABLE SEC 4 T28N R1 8W 1.01A SW NW LOT 1 OF CSM Block/Condo Bldg: VOL 3/647 ALSO A PARCEL DESC AS COM NW COR LOT 1 CSM 3/647 POB; TH N 00 DEG E Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 75'; TH S 89 DEG E 150 FT; TH S 00 DEG W 04-28N-18W 75;THN89DEG W150'ONNLNSID LOT 1 TO POB (.258 AC) I Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 962/379 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/10/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.268 25,000 144,000 169,000 NO Totals for 2005: General Property 1.268 25,000 144,000 169,000 Woodland 0.000 0 0 Totals for 2004: General Property 1.268 12,500 125,900 138,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 314 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 022-1008-90-000 10/05/2005 12:06 PM PAGE 1 OF 1 Alt. Parcel 4.28.18.55A 022 - TOWN OF KINNICKINNIC 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 - VORWALD, GLORIA F TRUST GLORIA F TRUST VORWALD 1110CTYRDN ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC I I Legal Description: Acres: 37.464 Plat: N/A-NOT AVAILABLE SEC 4 T28N R1 8W SW NW EXC 2.02 AC IN CSM Block/Condo Bldg: 3/647 & EXC PARCELS DESC IN 962/379,380 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 04-28N-18W Notes: Parcel History: Date Doc # Vol/Page Type 09/26/2003 741459 2420/375 SC AF 03/20/2003 713950 2178/89 QC 962/379 959/292 2005 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 06/11/2003 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 37.464 4,100 0 4,100 NO Totals for 2005: General Property 37.464 4,100 0 4,100 Woodland 0.000 0 0 Totals for 2004: General Property 37.464 4,100 0 4,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 • AS BUILT SANITARY SYSTEM REPORT ►►IER TOWNSHIP t~ SEC. T . N, R W 0. ADisRESS ST. CROIX COUNTY, WISCONSIN. .-3DIVISION LOT LOT SIZE PLAN VIEW -Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM AT 4 Gf I i ~ !7 -1- ! it diltate North! Arrow -4LP --1 -T i SCALE . r, - t?TIC TANK(S) MFGR. CONCRETE STEEL N0. of rings on cover Depth DR WELL ANCHES NO. of width length area j no. of lines r width length area depth to top of pipe ~SREGATE . RATE AREA REQUIRED AREA AS BUILT e lisclaimer: The inspection of this system by St. Croix County does not imply complete .o4►pliance 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 13tem operation. However, if failure is noted the County will make every effort to aterriine cause of failure. AEASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. ''INSPECTOR DATED • PLUMBER ON JOB c 17LICENSE NUMBER , r' Z REPORT OF INSPECTION-INDIVIDUAL SEWAGE SYSTEM San.itatsy Petsm.itt 3 State S c p,ticz,l r e NAME i ownship S Cna Lx County Location Section SEPTIC TANK Size gattons. Numbers o6 Compats.tments j I Distance Ftsam: WeZX- it. 12% on gtseatets s.iope it Bu.iXd.ing it. WetZands H.ig hwatets it. DISPOSAL SYSTEM Distance F&om: Wett it. .12% ots gnea,ten s.2ope it. Bu.itding it. Wettands Ft. H.ighwateA it. FIELD DIMENSIONS: Width o6 ttsenc.h it. Depth o6 nock below t.iZe .in. Length o6 each tine_ it. Depth os Aock oven Cite ~ .in. Numbetc oa tines Depth a6 tite below gtsade .in. Totat .length o6 tines 6z. Shape a6 tench in pets 100 it. Distance between tines it. Depth to bedrock- it. Totat absotsbtion atsea 6t2 Depth to gtsoundwaten it. 2 .Requited atsea it Type oi Covets: Pa et/ ots Straw f~ PIT DIMENSIONS: Numbet ob pits Gtsavet atsound pits yes no Outside diametet it. Depth betow .inlet it. 2 Totat absotsbtion atsea it . A 2 rn Atsea ,tequ.i"t<ed it ` INSPECTED BV TITLE APPROVED DATE 197 REJECTED DATE 197. EH 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 r MADISON, WISCONSIN 53701 1' REPOQRT O OIL BORINGS AND PERCOLATION T T~ LOCATION-750 '/4, W/4, Section _T, ~UN, R1 E (or W1 Township or Municipality (NN tGK ( 0 V ~ C Lot No. , Block No. County l Ix. ubd vision ame Owner's Name: L. Mailing Address: TYPE OF OCCUPANCY: Residence No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT C~ DATES OBSERVATIONS MADE: t SOIL iBORINGS PERCOLATION TESTSn 3 l 7 SOIL MAP SHEET 2~Sk--_14 I I_ _ SOILTYPE_A~j S7 81 I f'~l~v PERCOLATION TESTS 1_W ~E10 S(o~3 TEST DEPTH I 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 MI P- l ~t~'' I/E17 LF, o k) C;x P K f/ I if 6 L0 Nbk~_- P? '7 A 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) B- vZ Q iA 11 0 um "my, / 6011 p '1 1 Cat= s jl c~ c S L B- 7011 1 011 1(an SC,L) S tt ~I.. bN E ~I L PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square f et of i able areas. d' ten r of square f t of absorption area needed for building type and occupancy. I Indicate scale or distances. Give horizontal and vertical reference poi s. Indicate slope. _ I CTt , - I I i I € i 7 r 7- _7 _~ot 1 ! -71 N c 1118 _ ' ! - - - ti r C~ - I_ CT U -ID-4---- (('I L - ~ . - r_. 011 r. - I ~ P j f t 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 mw ledge and belief. Name (pri AR y Certification No.~7 - 08c) 5 -4 T4 J Address Sc / Name of installer if known A+ COPY A -LOCAL AUTHORITY CST Signature L State and County State Permit # PLB 6 7. 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: J ~SFI w Y C P- W Aq x_ , / J~✓~ a F,- / cj ' S B. LOCATION: r /W Section T N, R . & (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township illy/c-lk-i/V C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) `Variance Single family _x Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY 1000 Total gallons No. of tanks (?/)iP- HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete `Poured-in-Place Steel Fiberglass Other (specify) New Installation Ix 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 sq. ft. /462 A' New X Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. OW Width )M Depth Tile depth (top)-QW No. of Trenches Seepage Bed: X_Length ?.S Width 42 Depth -56 Tile depth (top)--=2-1- 0 No. of Lines o Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land 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 Tester, NAME C-Ve- Qe f .f oL f C.S.T. # S,5"- S'lY and other information obtained from (owner/builder}. Plumber's Signature MP/MPRSW# Phone # 7 Plumber's Address 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. 1 ' q D~ p ~iNC' 1 -1 doo, p Q 8-Z s _ t , 0-3 F~13-4 e.5 l CA , PROAJ e ~~©o MCI+ .711D ~JvA>1~11 TRK o r Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE NLY Date of ApplicationC-/`/- ~7~/ Fees Paid: State 1 ' Count <<% Date L/ Permit Issued/Ati7e d (date) Issuing Agent Named L-~ ~f- ~ Inspection YesZNo 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