HomeMy WebLinkAbout030-2002-40-110
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'Parcel 03 -2002-40-110 03/23/2005 03:45 PM
IOAY~A PAGE 1 OF 1
Alt. Parcel 0.19.362G-10 030 - TOWN OF SAINT JOSEPH
Current X 33. ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): Current Owner
WERNER, TIMOTHY,& DARCY NELSON
TIMOTHY,& DARCY NELSON WERNER
509 CTY RD E
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 509 CTY RD E
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 3.390 Plat: N/A-NOT AVAILABLE
S T 2 Block/Condo Bldg:
C.S.M. 8/2135 3.39 ACRES
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
33-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1187/436 WD
07/23/1997 849/01
2004 SUMMARY Bill Fair Market Value: Assessed with:
5678 188,500
Valuations: Last Changed: 07/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.390 80,300 105,100 185,400 NO
Totals for 2004:
General Property 3.390 80,300 105,100 185,400
Woodland 0.000 0 0
Totals for 2003:
General Property 3.390 47,100 79,500 126,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 107
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT 036 YL
OWNER f' - TOWNSHIP S(~ ~SE . 3 Z ~N , R W
ADDRESS ST. CROIX COUNTY WIS
SUBDIVISION 1e, 1141 L. 570cl T ! ~p
LOT LOT SIZE
,
PLAN VIEW 03 vn Fld13- \Y, - IS
Distances & dimensions to meet requirements of H62.20 i0 t189
r
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM RECFIVEfJ
90i Mrs-
OF 1CE
I di, atte ozthl Arrow
SAL : r
C
SEPTIC TANK(S) ~MFGR. C~' < i CONCRETE X STEEL
N0. of rings on cover Depth
PUMPING CHAMBER SIZE PUMP MFGR. MODEL NO.
GALLONS Per Cycle
TRENCHES NO. of
widthi length area
BED NO. of lines 773 width /F length 34~; r area 47
depth to top o pipe
NUMBER OF SEEPAGE PITS outside diameter total pit area
AGGREGATE Lt,) K c)C t
PERK RATE AREA REQUIRED AREA AS BUILT ,y
Disclaimer: The inspection of this system by St. Croix County does not imply
complete compliance 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 system operation. However, if failure is noted the
County will make every effort to determine cause of failure.
GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYTEM.
INSPECTOR
DATED PLUMBER ON JOB
LICENSE NUMBER I/
4r
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AS BUILT SANITARY SYSTEM REPORT
OWNER r - °
ADDRESS_-~ < TOWNSHIP 'N F SEC. Z, T_ ja R W
ST. CROIX C UNTY WISCONSIN.
SUBDIVISION oN -~'r ~ ~ ~ f ,G1i,~ ~ ,
LOT LOT SIZE
Distances & dimensions to meet requirementsWof H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
i
I di a e o~thj Arrow
t~ r~1t1~ /C
LX
r'-1 n+ r rm n n t v r c+a se- t;uNt;KE'I E STEEL
N0* of rings on rcover Depth
PUMPING CHAMBER SITE PUMP MFGR.
~t4ODEL NO.
GALLONS Per Cycle
TRENCHES NO. of wi Cam- length area
BED NO. of lines width length area rA 3
__.dept~to top o pipe Met NUMBER OF SEE AGE PITS Outside er total pit area
AGGREGATE , fi F'b 1 ~/j K-o c_9C
P E RK RATE AREA-REQUIRED
GI _5 AREA AS BUILT 630
Disclaimer: The inspection of this system by St. Croix County does not imply
complote comp_l,ianc-e wi:_th S,tate:-Administrative Codes. There are other areas thn
not possible to in'spect'at"this point of construction. St. Croix County
assumes no liability for system operation. However, if failure is noted the
County wj,,L!make°,eVery'effort` to determine cause of failure.
GREASES" AND OILS SHOULD NOT BE DISPOSED "THROUGH THIS
INSPE
DATED
-a -
PLUMBER ON JOB
LICENSE NUMBER
Z REPORT OF INSPECT1;iN INDIVIDUAL SEWAGE SYSTEM
San.i-tany Penm.it
• State Septic
` S.~. Ctcoix County
NAME Township
t. 4 - -
Loca.t.ioK Section
SEPTIC TANK
SizeZ4,cPP 7 gattons. Numbers o6 Compartments /
ViAtance F,%om: Wett So f 12% ot gtceatetc 4tope it
Buitd.ing /G it. Wettand.b `'p ~ •
Highwaten a it.
DISPOSAL SYSTEM
D.Latance Ftcom: Wett it. 12% on greaten .6tope it.
Buitd.ing..T(o it. Wettands Ft.
• Highwatetc t.
FIELD DIMENSIONS:
Width o j ttcen ch it. Depth o6 tco ck b etow t ite Gi in.
J5 Length o6 each tine.21 it. Depth o6 tcock oven Cite -2- .in.
Numbers , o 6 tines Depth o6 .t.ite b etow gtcadez_6 in.
Totat teng.th of tines 6t. Stope o6 .trench in pen 100 it.
Distance between tines G 6t. Depth to bedtcock
Totat abzotcbt.ion aAeaG'.3o jt2 Depth to gtcoundwatetc it.
Requited atcea t2 Type of Covets: Papetc tc Sttc
•,f it
PIT DIMENSIONS:
Numbek ob pits )cavet atcound pits yes no
Outside d.iam tc Depth b etow .inlet it.
2
Taza.C abs a t.io atcea_St A
Axea %equited it2 rn
INS PECTE TITLE APPROVED , DATE /2 19RO . ~~REJECTED DATE 197 .
\
01
EH 115
WISCONSIN DEPARTMENT OF H6AC i H AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309 `
MADISON, WISCONSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TES/TS
LOCATION: r"? '/4, Section .-~~T_71~N, R Y &(or)~ownship or Municipality
Lot No. Block No. V34 / 6 a,(--- County 5 z" x
O / S/~ / / Subdivision Name
Owner's Name: 1 A l el C4 A / -
Mailing Address: ~ 2 r5 S-/i! `t, ri"Cris' :~~lU~
TYPE OF OCCUPANCY: Residence X_ No. of Bedrooms 3 Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT -
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS
SOIL MAP SHEET ' SOIL TYPE
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-
P- ' 2, Lliv,,
-to
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- /`i~IY*G 7j
B- T 7lt~sr ~I~i,t1(i s;V, je/e-.• s• S/ ~U`~~ r SL ~ r' ~~CI}siC S~
l sr k.C c'_ 1 ~
B-
L _ , o ~s /3:.~ s
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and squarejeet of suitable areas. Indi nu mel of square feet of absorption area
needed for building type and occupancy. « ' r)re~4 Indic to scale
or distances. Give horizontal and vertical reference po) ts. I pate lope. -t- firl"Ilk'f'"'
ii
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I, the undersigned, hereby certify that the soil tests reported on this form were made by me n accord wIt 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) "Ll. 5; r ,.c- Certification No.
t. 5 G1!
Address _t
Name of installer if known
CST Signature. -
MjPY A -LOCAL AUTHORITY
PLB State and County State Permit #
67 County Permit #X -2
u Permit Application
County
for Private Domestic Sewage Systems
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
B. LOCATION: t 14 Y4, Section, T ~(Z N, R E (or) Lot# --L-City
J-Y--
Subdivision Name, nearest road, lake or landm rk Blk# Village
Township
C. TYPE OF OCCUPANCY: *Commercial 'I, dustr al 'Other (specify) *Variance
Single family Duplex No. of Bedrooms No. of Persons -211
D. SEPTIC TANK CAPACITY -Total gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete- Poured-in-Place Steel Fiberglass Othei (specify;
New Installation Replacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify)
E. EFFLUE T DISPOSAL SYSTEM: Percolation Rate Total Absorb Area r" sq. ft.
NewReplacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top No. of Trenches
Seepage Bed: -V -Length f fNidth/-Depth- :.Tile depth (top') No. of Lines
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.S.T. # !y/ and other information
obtained from (owner/builder).
Plumber's Signature MP/MPRSW# Phone #
Plumber's Address .l c
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.
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Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application ; Fees Paid: State County Date %
Permit Issued/R,eiee" (date) Issuing Agent Name y~ ' }
Inspection Yeses' 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