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HomeMy WebLinkAbout030-1094-70-000 n fn O g n v ~1 m ° cD v y v 3 v ; i n 2 Z N 2 cn W CD n m w O OD N p~ N W °C (O_ (D W (OD O W W ,O I~ Q d o N N O O •`S cn L. (D N c W o W A Q n n O ~ A O CD a- Q) O -u CD n J O b O r. CT1 7 (%I O A j O Q C co O Q D) t9 O (j) D (D CD C. Q- `G (n m a (D 0 (D W m c e~ N cc ~ o o g v -0 m 'a z O O O 4. o p -1~~ rn o D tv S cn fA cn ~f ° 3 v v v o N N p CD CD v D O (D - co N CD D) N I a N z ZCD Z o O D a o o m D N N+ (D N C N C (D O _ d Cl) D Z C ° o a Z cCDi A Z O m ° C) I o' Z W N W m o C , s Z CL 3 i, x ° » Z 3 y Z C A co N Cn > q o O N CI- 0 O C - C I ~ d O N ' < ~v n 3 ° T < m o (D a a o o v co (=D N CD n o CD o_ o ~ v C (D W O v m W o a, 3 v CD Q ~ cq fl a x A 7 W (O CD CY) N ti _ W n Q 7. N N O CL z w c~ O ti o o bby 6 o n V Parcel 030-1094-70-000 03/23/2005 03:23 PM PAGE 1 OF 1 Alt. Parcel 32.30.19.344D 030 - TOWN OF SAINT JOSEPH Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner HANSEN, DEAN C & BARBARA DEAN C & BARBARA HANSEN 402 S 6TH ST STILLWATER MN 55082 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 448 CTY RD E SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 5.000 Plat: N/A-NOT AVAILABLE SEC 32 T30N R19W NE NW LOT 1 OF CSM Block/Condo Bldg: 2/452 p~ Tract(s): (Sec-Twn-Rng 401/4 1601/4) 32-30N-19W Notes: Parcel History: Date Doc # Vol/Page Type 2004 SUMMARY Bill Fair Market Value: Assessed with: 5583 119,700 Valuations: Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason OTHER G7 5.000 99,900 17,900 117,800 NO QI y Totals for 2004: General Property 5.000 99,900 17,900 117,800 Woodland 0.000 0 0 Totals for 2003: General Property 5.000 58,600 21,400 80,000 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 TOWNSHIP ! SEC. T N, R W .ER 0. ADDRESS. ST. CROIX COUNTY, WISCONSIN. 3DIVISION LOT 2 LOT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 _ SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM -A A 1 _ I I - i--~-1 Indicate North Arrow - ' 1_ t-- - SCALE 1 I i 1 j£P'TIC TANK(S) CONCRETE STEEL NO. of rings on cover Depth DRY WELL RLNCHES NO. of _ width length area no. of lines-_; width length area depth to top of pipe AG?•EGATE - PQV, RATE `AREA REQUIRED' AREA AS BUILT Z'• l ` iiwlaimer: The inspection of this system by St. Croix County does not imply complete :o-pliance 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 ,ystem operation. However, if failure is noted the County will make every effort to 1~termine cause of failure. ,ISASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. `INSPECT'OR DATED PLIRKBER ON JOB ! LICENSE NU:iBER rz REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM San.i.tan y Pehm.i-t ,-~o ' _ • State Septic/„2` 1 S Croix Count . rawnbhip AME T y ~U Locatibm Section SEPTIC TANK Size ! gatton4. Number o6 Compantmentz i D.tb.tance Ftom: We.E.C 12% on greaten scope 6t . ~ • Building it. We.ttand.6 H i.ghwa.ten it. DISPOSAL SYSTEM D.iatance Fnom: Wett 5 12% ok greaten s.2.ope it. Bu.itd.ing . S.t. W ettandz Ft. • N.ighwaten it. FIELD DIMENSIONS: Width o6' thench it. Depth ob nock below t.ite in. Length o6 each tine it. Depth o6 rock oven .t.ite .in. Number o6 tines Depth o6 z.ite below glade .in. Totat teng-th o6 tines it. Stope o4 .trench in pen 100 it. D"' Lance between tined Depth to b edno ck it . Totat abs onbt.ion a,%ea 6x2 Depth to gnoundwaten ~ . Requited area it2 Type of Coven: Papers on Straw PIT DIMENSIONS: Numb en. o6 pits Gnav e.C anoun d p.i.t.5 y e.a no Ou.ta.ide d.iame.ten it. Depth b etow .inZe-t it. 2 Totat abdonbt.ion area it A Area %equ.ined it2 INSPECTED BY 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 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS / LOCATION: 4 , Section 3 y, T3~N, R ~ W(or Wewnship or Municipality S7_' Lot No. , Block No. County Subdivision Name Owner's Name: •//~9•'+ ,~7i~•tef / / / Mailing Address: TYPE OF OCCUPANCY: Residence No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS /vP R OLATION TESTS/~ SOIL MAP SHEET yz SOILTYPE r 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_ Sr P-~ 411 S-e0 X;-,- p~lg ,7/1( y 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_ 1,2 7 ?6 14,14)1-e C- /S- )~5, .7/14 L2 11 S/ S, .4 B- 5 106„ G P6" .t/uC_ >WZ 7" ACS dGr. 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 v /r of square fee of absorption area needed for building type and occupancy. 3 u-~ e,4 Indicate sr le -ta or distances. Give horizontal and vertical reference points. Indicate slope. z i j 4-A - - e ClrQ I / v_J L. 15' r4S 1 ff c'OS_ 'IN I { I k S y} 1t I I i 1 i I . _ f { aa t f( 1 r 4Vf / I t I I i { I f ~I [ - - - - - ` f - ~ ~~-y3 y- ~?lam 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 c Name (print) f'~C tr` l ~Qts Certification No Address Name of installer if known I CST Signatu ~4---- .OPY A -LOCAL AUTHORITY State and County State Permit # - PLB-67 County Pe i # I Permit Application Y 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: B. LOCATION: r '/4 '/4, Section T N, RE (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township i C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) - *Variance Single family Duplex No. of Bedrooms No. of Persons/ P I 1. D. SEPTIC TANK CAPACITY Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete Poured-in-Place Steel Fiberglass Other (specify) New Installation 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. New \ Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: Length Width Depth Tile depth (top) No. of Lines Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land- , L4 Distance from critical slope WATER SUPPLY: Private 5 Joint ❑ Community ❑ Municipal ❑ _ / r - Owners name as listed on EH 115 if other than present owner: 1, 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 ~r if ,`^,f,_~~, C.S.T. # - and other information obtained from caner/builder). Plumber's Signature G, MP/MPRSW# Phone # - 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. { E E i re r Jd Jf: i a SIG 17 AlG i F ~ ~ dP f < ' V i 3 3r i 3 t ✓ t - 1 r - - Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application lQ Fees Paid: State/S_,400 County j~/40© Date 10 a Permit Issued/'Rejee"+ (date)1,-5Z= /1_Z7 Issuing Agent Names Inspection Yes_~__No State Valid# Date Rec'd 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