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HomeMy WebLinkAbout026-1052-60-000 c~(n0 0(1)0 ~-V0 t: o m f o d f = o 3 Co z 2: 167 O N 0 C, O O N o' O N N y' N j O (D i n 3 O_ O O W O O r 1 Ul W co _ O W O N Co 1:3 7 co a) C (D O U 3 N r~ O_ N "S N N t' ~ v O O lC O (D (O^. co O W 'O L cyl (D (D O z V) c- 0 (A u) = O N fA = O _ Ci a:. d (D (D N v! (p C- N z r (D a N N I (D (D {U O. O m 0 C) 0 m N , r 0 0 N 0 --j O O Z r- U) (n 0 C (D rt 07 Z1 d H 1 9 E !r • OW OS OPU 0 c -1 a~ N N N a (D E7 'a 0 0 CD Qo '0 ol cD (D (j, _ N O o D) N A O Cf _ _ N 7 _ v N 3 75 (D G z z m z z m z D N O y (D O ' a c O a c IO T ~ . o' I (D N CD T a `*a n fl _ (D is m (D CD O' ru O" _ -i Cl) w }V A _z cD C1 U O ~U c c z O O G- C/) ~ o W m W (D z 0 3 0 a ~a 0 rT O Cn co 3 ~n (D z w(D NCD A ? O O O. ,43o r-0 rn='Oa (o o r C, o -n (o m -n o noc) m o v c V who z Q a z 'o. CD v O =3 o p c d N O v Oi -I (no N in A O W O 7 J O O N O C O. 0 CD - -CoD 7 0 (D O O (D N (D Cn (D O ~ 7 O (n (D (D O ' ti O A n O_ 7 Cn -O O O a~ O N O (D O (D 3 O O • (D O N N O v = v (O fl C ; n O O N (D n ~ = O ~ O (D ~ N V O. Q IO cD io o o O o iO 00 ~C p ~icL r Wisconsin Department of Health and Social Services Plb. #67 370 Division of Health SEPTIC TANK PERMIT APPLICATION TYPE or USE BLACK INK V v S U d hyA a / ! !~J'Y~k1 A. 0i[NER OF PROPERTY Gt (f/ Name Address (Street, City, Zip Code) r mac' f B. LOCATION OF PROPERTY WHERE SYSTEM WILL BE CONSTRUCTED ALTERED OR EXTENDED COUNTY -1 C - Cheek Ones /1 O / Z CITY VILLAGE LEGAL DESCRIPTIONTV 6' L_- TOWNSHIP .S?'r /J r S C. IS LOCAL PERMIT REQUIRED FOR THIS WORK? YES NO PERMIT NUMBER D. SEPTIC TANK CAPACITY 1 L7 Gallons NEW INSTALLATION C-'REPLACEMENT ADDITION MATERIALS: Prefab Concrete Poured in Place Steel Other NUMBER OF TANKS TO BE INSTALLED: E. TYPE OF OCCUPANCY -Cheek One: One or Two Family Residence Z---Commercial Industrial Other (Specify) L Number of Persons to be Accommodated Z Number of Bedrooms F. APPLIANCES, ETC: Food Waste Grinder YES Z----NO Automatic Clothes Washer 1---YLS NO Dishhasher YES ~iNO Automatic Potato Peeler YES < _NO- - Other (Specify) G. MASTER PLUMBER MAKING INSTALLATION Name: Lc . y~c~. rJ 2 e-~~ //~-/L LC.`L Z!-~ t~C License Number: Address= MP Signature of Applicant: MP RSW /6, r Address: % l LL! H. (To be Completed by Issuing Agent) Date of Application 7 / Fee Paid / Permit Issued date Permit Number Agent (Name) Z I ; _ r ltJ L~ Pori yyI ~i L s` Town,~Village, City,-Courrt3, etc. (Specify) Note: The application cannot be considered for filing until all of the above q-::stions are answered and the fee paid, Agents will forward application, the fee of $1.00 fcr each septic taws and the third copy of the permit (canary) to the Division of Health. Checks and money orders should be made payable to the Division of Health. Do not write in space below - FOR DEPARTMENT USE ONLY I. DATE RECEIVED _ ACCEPTED BY RETURNED / (Initials) (Date) See C:.: r 4. ) FEE RECEIVED VALID. No. PERMIT NO. es or No) REVIEWED BY APPROVED _ DATE (Initials) Yes or No COMPLETE OTIMR SIDE SEPTIC TANK PERMIT NO. R= P O R T O N S O I L P S R C 0 L A T I 0 N T L S T AND SOIL BORINGS TO DIVISION OF HEALTH - PU MING SECTI611 P.O.Box 309, Madison, Wis. 53701 P.trsusnt to H 62.20, Wis. Administrative Code P= R C 0 L A T I 0 N T T S T Test Depth Character of Soil Hours Water Test Time Drop in Water Level Inches utes Number Inches Thickness in Inches Since Hole in Hole Interval Second to Next to Last To Fall lst Wetted Overnight i in Minutes Last Period Last Period Period Ee<Inch Example P - 0 36" To Soil 10" Cla 2611 25 Yes or No 30 1/2 1/2 1/2 60 2 -3 ov 5' J j 1 S- RECORD DATA FROM MINIMUM OF 3 TEST HOLES Compute size of absorption area in accord with H 62.20 Wis. Administrative Code. S O I L B O R I N G S- Minimum 36" Below reposed Abso tion System Boring Total Depth De th to Ground Water Depth to Bedrock Number Inches Observed Estimated Observed Estimated Character of Soil with Thickness in Inches Example B - 0 7272" Buck To Soil 12" C1 18111 Sand 1811• Gravel 241' . a G shy ~r ~~1 s~ RECORD DATA FROM MINIMUM OF 3 BORE HOLES YPE OF OCCUPANCYs RESIDENCES Number of Bedrooms OTHER: (Specify) Number of Persons POOD WASTE GRINDER: Yes No t/ Dishwashers Yes No Automatic Clothes Washer: Yes L- No EFFLUENT DISPOSAL SYSTEM: NEE! Z---tXTENSION ADDITION REPLACEMENT Tile Site No.Lin.Feet Trench Width Depth Number of Lines Seepage Bed: Length Width Depth Tile Size I No. Lines Seepage Pits Inside Diameter Liquid Depth i I, the undersigned, hereby certify that the percolation tests reported or this form were made by me or under my nuper- vision in accord with the procedures and method specified in Chapter H 62.20 (13), Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. NAME 'f1j TITLE 61 7~ yz F y Type or Print REGISTRATION N0. 6-- 5 or MASTER PLUMBER LICENSE NO. ADDRESS 00 DATE J 3G / SIGNATURE ~~Lr~.G' 7 J Z '7 r sr~ ~s l Poo - s 70 3i 21 ~'`r( Parcel 026-1052-60-000 07/11/2007 0834 AM PAGE 1 OF 1 Alt. Parcel 18.30.18.273B 026 - TOWN OF RICHMOND 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 K TIMM O - TIMM, DAVID K 922 150TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description ` 922 150TH AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.050 Plat: N/A-NOT AVAILABLE SEC 18 T30N R18W 1.05A SW SW BEGIN 1106' Block/Condo Bldg: E OF SW COR SW 1/4 TH N 214'E 214'TH S 214' TH W TO POB & AS DESC IN VOL Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 611/169 18-30N-18W Notes: Parcel History: Date Doc # VoILPage Type 07/23/199724 r i 07/23/1997 7 07/23/1997 707/245 t 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/19/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.050 27,900 123,600 151,500 NO Totals for 2007: General Property 1.050 27,900 123,600 151,500 Woodland 0.000 0 0 Totals for 2006: General Property 1.050 27,900 123,600 151,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 316 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 RICHMOND T. 30 N7-R. 13 W 43 SEE PAGE 57 64 SE£ PAGE 55 ltss x HF/ ~ ~ ,pry /s„ K ath :664 6?_ -cd c ol<> N E:W 79 s V A dc.76 5 Cc o ~ -RICH 3 ~ V6 ~ ~ o ' k 5' >e s dND 'lJh/n (irea 0 1 i7 0 .v R 'Cha./ea V~9 0. zy a y 7s8 ra yof /'ade soa v 0 ' 4 ClUd/ffl y75-69 R a ~Q y,f d> - 7 7•> / a P Ica, en ao y c 6k4cK n. o. 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Gay n/ase~ ` Ij Farms v v d DER Ea~f ass ei Fao 2¢0 / qo ~ah~ ~ E/Fi a/ V G lh/„Ei ~jeia/~ e hb ua. ins RUSH OUND •cT¢.ri sW Da//orJ 9 y ~~33 Ji' ~a.~hofei' i2o ems ~ z2o Ted o T o ~Toh 4u ~ - i~o e enEf `sue Pa<d e Co/%ea ~ ~ 'C _ !Ni//ia- n 14o Kohs • 9b - - Ca.s E-c/ d ~ ~ ~ r~ ~ ~/ii//~o:; L 7Rs - _ J ~y~ - Robb ONGKUe- I/e~,~ on f 7i4 /60 ° C CiU~ c h Cit'~ cz..7 /b o `9 c$ta~k 7s6 ' ~Tofi.7 eaa 7 6 Dean v 39 15 3zo c/ l// /beg Ed. 0~_, zs6s 1s7 ase/ Jha /Vob/e ,bas e% / /elk f C -irlo e{a/ ' .360 Ke/%o~ cS'cfiunem a-~ 6$ 6a Sao /sSS ~ /oo -Case 320 Bo `6 • ~ y 9 G Z62, c y ° ~l ~ 0 • Mo~ine C'/rff ,Cias ~p ~l ~ ~0~ Ct ~Tahn F Tfiorrra.s /6 o Case Bo .tea fh f h/o Sued f/a j /d of / l`(j~ h l k 0 Le~e~/- f L//e cfiT y cTeremia/i /'~uOiaU Es~e~ser7 /i~~s /rn.se J 16, /60 117 5?0 s /do 3G37S d- A Tan U uy,/ s ckr ~d Mew / LUN r ND Bo 760 (S/i//am LVi//lams Ge~.,t /.3s 4v r/~rkn zis 760 _ ~ Bo /zo l/an Dy,Fe M G ~na~d, W ~s M cJo.se~h C'a~ s Fi-°n,E 5/~/aC</ 40 /60 / Zss fay ev da DMA 4 w L~~,dy /6o c'u/rte cam/ en 0 79~ 4o ca~ - fse~ •Lav2in 4 _ • ,P.chai-o~ Judith 41 ~S~c /vicc, i4 I'Fu//i Al y o ti~ F` < - Fe~y~soi7 /dab/e B 2B3 p /60 /ZO 3~ N do.8 ZS9-3 ISCZBO ema~) 2-0 - o JO Tfeo. f Toa S 16. Theo J C GS i/nc T 40/o~ 4 wU o /boa S 3 4° o C u /~o vand Q 10 C Sia 9~s 'Duman eTohn F E 80 eu fens \ vRn Dy,(e /orer7 ~~s9 0 d Q p A//en Q p A 9B z6B na /.3a// 60 ~0. 24o e~~ick• /60 av: o• . • O o • y,8. 5 177e5 Q ~ v ~ Ncko/as o ° w u Fed s C /Ue a.d lo O/zche \ /e man 0 v /6 o ao r\ C S~a /e 6 o w~ 3 yv.E e,P~rh Q C ~ /3~u/ ~ ,~iHBO 760 z4a e/u/ sy 76/ /yay ~a~~ef~ zoo 3/ 34 f Jan, Ram Ge.-~it f .17a ..d l a yi . Pat ✓Qn Dyne may L7do 0/7 ~y Kene ~7'6- ~.C Adayne F/oyd £ Jhn f Jf 7 9 f/errnaase~ \ 0 Bicwn ° - /.3eff C \ 49G ~~d Ken o ° ~ ~ ~ N /✓asea W cress7e y W 0 f~ico~ ,Pcz a. Du// /6 0 ~ o ~0 /60 ' ~ p ~ /20 • ~ •~n/ia w /`7iGFe%saa ~ mil' ti /zo 4oy • T REE LK,S. 160 AA AA ~2_ b/s., I c SEE PAGE 29 Sf. Ci .u C~ Ws~ ' y- i NEW RICHMOND BERNARD'S VETERINARY CLINIC SUPER SERVICE, INC. 1231 N. KNOWLES AVE. 355 SOUTH KNOWLES AVENUE PHONE: 246-4875 NEW RICHMOND, WISCONSIN 54017 DR. A. R. CARNES PHONE: 246-2236 DR. R. N. LANZ TWIN CITY ci~~t~st:}a DR. G. F. JONES PHONE: 439-2905 F777 mg _ n cn O n cn O 0 C `~1 o i f o m c° o m m m m s~ c v m v m w m 7r Cn ~ 2 W W\ z= c p TJ p hY O p1 c O O N cn N n W N CO c S W CD- 0- FD cO 3 Cl) D- z a O S CD CL N O , O W W O W (D @ D 7 Co N C N N O u, ) m D_ jv 't N N O (J; EL J O .d O O D CD (OD D i0 N O~ W O Q CO C71 Y .7-. O. ~E O 7 to ~ 7 N ` O O N (A N N O ° M N d m e•, N O vO a G O O a a N \}1J O C _O C S p o O W~ N H A W N S o N < rn 4 l p -,J -4 0 cn i . J CO rN D CD CD z O C ((D CO z o o o 0 0 0 3 ti Q C~~ A O r 0 0 J O O N p~ ~T T. 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Parcel M 18.30.18.273B 026 - TOWN OF RICHMOND 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 K TIMM O - TIMM, DAVID K 922 150TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 922 150TH AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: / 1.050 Plat: N/A-NOT AVAILABLE SEC 18 T30N R18W 1.05A SW SW BEGIN 1106' \ Block/Condo Bldg: E OF SW COR SW 1/4 TH N 214'E 214'TH S 214' TH W TO POB & AS DESC IN VOL Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 611/169 18-30N-18W Notes: Parcel History: Date Doc # , Vol/Pa e Type 07/23/1997 07/23/1997 708/309 07/23/1997 707/245 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 f'rdy Valuations: Last Changed: 06/19/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.050 27,900 123,600 151,500 NO Totals for 2006: General Property 1.050 27,900 123,600 151,500 Woodland 0.000 0 0 Totals for 2005: General Property 1.050 27,900 123,600 151,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 316 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 I . RICHMOND. T 30 N.-R. 18 W SEE PAGE 55 • 64 I SEE PAGE 57 vam f / f~cs e G'¢>h 1`; ~ yF ybf,v ~ C ~'+~''1 v° ~ 7 /,n K ' 9ndc~-- cr¢~cf,ow a r , <.~.,zrl: s Fl 3 65 75. N E W 64 41 s g ~2 s I%r-y M J 7 ~P Charm/ea /sg F1- R I C H O N D. F/h/ v ea n s./ T fS E T ll iJ E U d /h C%ym er- E f f'e d~ ..song r J R. _7--.69 7s71 z° 21 ' oX / o L h / 1sP / Leo 7n = s z S~ P L l / I7~n I ~H F /0~e n, F a P W ~~t~~K !Na/s/i dFt -~a 7aa oPn om..e~yC vA sora 40 3 4n a ao i ~?rn A~ t /f3 z /7 see C GG v 79.7z U w CQ /-ss //i el " T rohn .-r _s h a C QJ 1 A ~7 9/ T ru e 4, • - - u F -eye/ha / 6 s F Ap RJA~ /9 80 xr s 4 V F 760 ~ v v 0' V ER •M P sDor G.Ezz . Gay n/ase.- ~ _ yes W:7 /74s EarFy ass e, ago IV zoo / yo / 2 kv Z7a/!0n 9/ibo E6he/ v v ~Pe:°. C ekh fe. 2or ers zso led I d sfs Inc s/y N dram ~~3a q/be ~o RUSH OUND Kabs n7 Case d tl~ M ~ Phi//.mss 0 erno /i4 /60 y v .i 6/ • 5 Nc Px~./.hA da 0. _ Mari ~ O~ l U a C O D 4o c ~e main ~ierr~ a. ~ ~ y Vi y. f// TohO V' p ~f. V /6a ~ ~9 JS/ork berf GZs.<So~ne • ~ - 8. C o ~ gO ® p~ i 6 •Joh.7 can o~ .3,-0 /ber d 6 .7~eu ~r_, v 390, C/,ff ~ Ed r zsB.s ~ ~ ,base/ • o/ Z ho /Vo6/e A" FJ/ ea/ 360 Maw _Sc✓iu~em n '65' ga Ni//ia Der- c F /sss D /¢o ~ ~ - c3zo \ Casr_ 3s o Bo 9 G G ~~ff ,C3 a.s C ~o .pa Tfiama.~ • Ca Pe Bo ~Tohn f of / EU C y k 0 Tohn F /60 //o wl"z f xro/d ~ v N ~ ~ ~ L//ech~ Leer/y Jr Kath, g eSue ue ~r .36375 / • \ d /Bp 237 e emio /`7lir'iaU ES~erser7 -/iris /en.se /60 160 / 16, -d_ mJ _ • Bo s cke /0~ a0 Z7 1ei f L UN ND Bo /mss - 9a rk; W GVi//iarr7s 17s /60 Bar,/ 1 36 Ila Fe rnard, W.s y DMA 1ss far c-, C'or ~s Fz E • ra Mory ~osePF /zo Lur~dy /Go C'a//csr/ ~M Bo 40 /60 c~/L La v~rr~ Ln~o/ • 40 40 n" - zd,3 ~ /6o Fza ~ ~ N F ~ _ Fe~9crsoi7 Nob/e ,B eo. 8 ` 3~ ~3 zs9.3 s~=eo e na , a 30 Tfieo_ f'~ Jo r/ S iGo h 0 ° ri/ieo. C1une o h ~r S e . J C o w O C V C ward c C S as Yss 'Dif/m ¢r/ cToh.~ F 4 8o V\ Van D ,Fe f 3 A 4/e be s f Lo e~ 0 a o C 3 U 0 98 z86 H na 3x / P r /s9 760 240 < C ° cE e~ o ° v 40 o Fwd Y /6o ao er C3iyichc f/e~marr ~ ~ Ne.Eo/as v C~ v~e ancL Wn E. e.P ~h d 1.5,11 vrr, .fie/%~ .sr., ha.,/ef • ,Qio wry, 3 /lo /60 1;~n/aa75 31 eo 5 Z4a a S9 ,6/ ~Qy ~QZaa saw, R G'err;! F W J o ox,,,d 40 Via/ ✓0n Dy,E e may /-7o'o/p/7 v ~V Kew e Ka.fh. • , • 9 f/er r7 V yp, y F/o d E f hn f QCi manse Wa ne fir? 496 .Paavld Du// /6o v 3 4J ° own K /lvxaei- cTess7a /3e/ff A H/CO.E ~ AA ~y a T REE LK~S. ~~0 /60 ~ ~ .fkr<,oow /%cke/ n ~ ti /Lo /66 J ©/97 R d MaP P 6/s, Snc SEE 'PAGE 29 AA NEW RICHMOND BERNARD'S VETERINARY CLINIC SUPER SERVICE, INC. 1231 N. KNOWLES AVE. 355 SOUTH KNOWLES AVENUE PHONE: 246-4875 NEW RICHMOND, WISCONSIN 54017 DR. A. R. CARNES PHONE: 246-2236 DR. R. N. LANZ TWIN CITY DR. G. F. JONES clml;m R PHONE: 439-2905