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Home My WebLink About040-1019-60-000 a 0 fA O I 3 -u n r m d 4r f "0 O CJ CD CD (D m co 3 A: O cn --1 1: z o v n o 0 }~~l CAD 3 O N OJ ONO O ~ lA\ N 0. ro Z N O 0 O O O O O (D O co cn N O O 7 W m O a Z3 C CD CD CD ) -9 h O c(D' co O L O U1 C O 3 o r* !~i 7 N O C !i N N d y m j v cn C D m 4 ca N W a O c 3 0- C) 0 (D O N ? L W CO CC Lri 0 r- (n O CEO co = N !V .r Q U) 00 • o Z z a 3 0 w w U, o D C v v v 41 o Q .D CD ~p N O W ~ m q m v o~ ~ ty N fD N CL z N z co z DO aO m O o' E N N CD a) a4 (C 1. C CD N J N d 7 ' z m Cp ~ -i lA O ~ p Z ID Z o' v a A O com ~ co (D M CL z ' ? Z7 °o cn 3 m U z Cr D Q O_ C O ~ T 4J C z 4 CD N A, 4 N O O a ' I A O A O O ft O cfl O O a O C Isk O L ti ~z Parcel 040-1019-30-000 09/15/2006 07:53 AM PAGE 1 OF 1 Alt. Parcel 04.28.19.63G 040 - TOWN OF TROY 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 - NELSON, GREGORY R & JUDY L GREGORY R & JUDY L NELSON 517 OLD HWY 35 S HUDSON WI 54016 Districts: SC = School SP = Special Prop Address(es): Primary Type Dist # Description * 5 OLD HWY 35 S CL c c L ci L sC-. 7 SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 5.000 Plat: N/A-NOT AVAILABLE SEC 4 T28N R1 9W 5 AC IN SW SE BEG 761.4 lock/Condo Bldg: FT N OF SE COR SW SE; N 190 FT; W 1177.4 FT TO ELY R/W HWY 35 SLY ALG HWY TO PT W Tra (s): (Sec-Twn-Rng 40 1/4 160 1/4) OF POB; TH E 1122.7 FT TO POB AS IN VOL 04-281-19W 596/471 Notes: s/s Parcel History: Date Doc # Vol/Page Type 2006 SUMMARY'- - !-4) Bill.#: Fair Market Value: Assessed with: Valuations: ? v 3 ;j Last Changed: 07/15/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 71,500 182,800 254,300 NO Totals for 2006: General Property 5.000 71,500 182,800 254,300 Woodland 0.000 0 0 Totals for 2005: General Property 5.000 71,500 182,800 254,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 121 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 040-1019-60-000 07/18/2006 08:04 AM PAGE 1 OF 1 Alt. Parcel 04.28.19.63J 040 - TOWN OF TROY 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 - MCSORLEY, BERNARD B & ALICE M BERNARD B & ALICE M MCSORLEY 519 OLDHWY35S HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 519 OLD HWY 35 S SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 3.000 Plat: N/A-NOT AVAILABLE SEC 4 T28N R19W 3 AC IN SW SE LOT 2 OF Block/Condo Bldg: CSM IN VOL III PAGE 812 ORD EXC TRI> PARCEL IN NE COR DESC IN VOL 599 P 166 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) ORD 04-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1075/09 WD 07/23/1997 1012/74 SD 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/15/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 60,500 197,000 257,500 NO Totals for 2006: General Property 3.000 60,500 197,000 257,500 Woodland 0.000 0 0 Totals for 2005: General Property 3.000 60,500 197,000 257,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 136 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUIL SP..ITARY SYS'Ti7X REPORT d ✓n ".x TO 1''SIiTP R-LW A DRESS ST. CROIX CGU*~' l; iSCO."iS1N . ~ >iVISION LOT/ LOT SI E PLAN VIEW Distances b dimensions to meet requirements of H62.20 SHOtd r','?RYTIiIiIG WITIIIN 100 17ET OF SYSTEM fi: ii rr i I i w l I y 5 I Ire, t Indic t-e Eor ttl -grow SCALE: "IC TANk(S)MfFGR. t CONCRETE STEEL 0. or rings on c DRY WELL ':CHES NO. of _ width ten tthh area no. of lines__ _ widtI~ lengtiz~ areal depth to top of p .EGATE T a" R":'TE " AREA REQUIRED AREA AS BUILT cial.n,er: The inspection cf this system by St. Croix County does not imilv,co~plete )fiance with State Administrati•-c Cocks. There are ostler areas that it I" "n~?t possible inspect at this point of con::trt._tion. St. Croix County assilmes no liability for -ern operation. However, if failure i:; noted the County will makle every efi:ort to rrnine cause of failure. ASF.S AND OILS SHOULD NOT BE DIS"OSED TI:?":OUGH THIS SYSTEM'!. ie >x e-, fl; .14 .,~jr DATED ~ , ~ , ~ - 111J';DFR ON JOB_ L...Li.it.).. SII..ti-IuI.R ._.__1 1 z "REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM San.i,taAy PeAmit1 ' State Sep-t,ic_ ~l " k.. Z - - - NAME St. Ctoix County Location i Section . SEPTIC TANK Size ~ 7 ` v gattonz. Number aj Compatc.tment.3 I Diztanee Ftcom: We~~ 120 otc gtceatek zl-ope it Bu.itd.ing it. WetZand~s N i.ghwaten i DISPOSAL SYSTEM ' ~ . D.iatanee Fnom: WeU i' it. 12 a en gtceatetc z t o p e Bu.iZding ~ 6t. W etZand~s Ft. N.ighwatetc it. FIELD DIMENSIONS: Width o6 ttcench 1 it. Depth 06 tco ck b eZow t ite in. Lengtih aj each Zine it. Depth of tcock oven Cite in. Numbete o6 tine/s Depth o6 .tile below gtcade ,in. Total' .length o j tines > it. Sto pe o6 tneneh in pets 100 it. Distance between Una it. Depth to bedtcoek it. Total" absonbt.ion aAea ; r jt2 Depth to gtcoundwaten 6t. Requited area it 21 Type o6 Coven: Papet on Straw " PIT DIMENSIONS: Numbetc o6 pits G&avet around p.itz yeas no Out,S.ide diametetc it. Depth below in-et it. 2 Totat. ablsonbt.ion atcea it Z A A&ea Aequitced ~flt2 rn INSPECTED BY TITLE APPROVED ,DATE 197_ t REJECTED DATE 197 Cl/ EH 115 (11-74) ,pc 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 TN, R _ E (or) W, Township or Municipality Lot No. , Block No. County Subdivision Name Owner's Name: Mailing Address: TYPE OF OCCUPANCY: Residence No. of Bedrooms - 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- P- 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- B- B- PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the locationand square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy. Indicate scale or distances. Give reference point. Indicate slope. tN 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) Signature Certification No. Name of installer if known Copy C ° Local Authority PLB67 State and County State Permit # I Permit Application County Pert, # ~e for Private Domestic Sewage Systems Count l ; *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: ~~N akR lJ M ~ S~'~ -Y T. 1 '3S S f u C, S"') B. LOCATION: V1( '/4 Section , T Z8 N, R W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village C v 5;7 '1 Township ~d C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family 1< Duplex No. of Bedrooms S No. of Persons D. TYPE OF APPLIANCES: Dishwasher X YES NO Food Waste Grinder /'-YES NO # of Bathrooms Automatic Washer YES NO Other (specify) E. SEPTIC TANK CAPACITY i rl V Total gallons No. of tanks _ *Holding tank capacity Total gallons No. of tanks New Installation X-Add ition Replacement- Prefab Concrete X *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) _3_ 2)_X~__ 3) __q_Total Absorb Area /~.sq. ft., NewX Addition Replacement .Fill System /C),;LS n Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Length &D 'Width J' Depth :V Tile Depth 6 " No. of Lines -3 Seepage Pit: Inside diameter Liquid Depth Tile Size Percent slope of land 651 /*r /A we-~ iewly Distance from critical slope 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 T ster NAME ~yQ MSS (~:%S.GI C.S.T. #and other information obtained from (owner/builder). Plumber's Signatur Est- MP/MPRSW# 0 (6 Phone #k>~~W- / y Plumber's Address c C." t v / t04-1 VIEW: Provide sketch below of system (include direction of slope and all distances in accord with -4 IZI H62.20, including well). NOr~~a~ r EL, IoCo:< %/A ice i y ' '4 1 1 • r~zi I N 40W + All 4®r Sc,(*- $ t Arne Do Not Write in SpAce Below - FOR DEPARTMENT USE ONLY 0 C' Date of Application - -7~ Fees id;., State C , O O Cou y Date s Permit Issued/Rsjected (date) Issuing Agent Nam % LJ Inspection Yes , No 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. rh-h TRANSFER FORM PLB67- T SANITARY PERMIT State Permit # Sanitary Permit # County Sanitary Permit Transfer Date Original Permit Issuance Date - -5- g) ffl `r -/y 2 A. Property Location: Section T N,R~,E (or) W Lot # City Subdivision Name, Nearest Road, Lake or Landmark BLK # Village Township B. TYPE of Occupancy:.Commercial Industrial Other (Specify) Single Family- Duplex No. of Bedrooms Variance C. 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/SIPHON CHAMBER Total gallons Prefab Concrete Poured-in-place Other(Specify) D. EFFLUENT D OSAL SYSTEM: Percolation Rate Total Absorb Area/AZ ly sq. ft. New Replacement Alternate (Specify) Seepage Trench: ~No.Lineal Ft. Width 01 Depth Tile Depth(top) f No. Trenches .0 Pr_ .I Seepage Bed: kfLength Width 02,41- Depth 1~4,03 he Tile Depth(top)44 .No. of lines '5 _ Seepage Pit: -Inside diameter Liquid Depth No. Seepage Pits Percent slope of land ~ Distance from critical slope E. WATER SUPPLY: ❑ Private ❑ Joint ❑ Community ❑ Municipal Present Sa ' ry Permit Holder Phone No. Sanitary Permit Transferred To: Phone No. Name Name Address Address Zip Zip I, the undersigned, do hereby certify that I have reported all revisions to the sanitary permit and that all revisions are in accord with section H 62.20., Wisconsin Administrative Code and that I have sized the effluent disposal system according to the EH-115 prepared by the Certified Soil T er d/or an dditi I soi sts that m have been required. ~r Plumber's Signature /MPRSW # Phone~~jy~y`- / Plumber's Address Information obtained from (owner or agent) PLAN VIEW: Provide sketch below of any revisions to original sanitary permit. Incl irection of slope and all distances in accord with H 62.20. Well location shall be included on the sketch. Indicate or dimension I cation of all wells, on the property or neigh- bor's r ert . If well has~gt b illep~ ind. _F 02_ i ~ i ~ i 77 F 9 S 9 t r. FT L&g,ature of Issuing Agent nty (Yellowcopy) 3. Owner (Pink copy) DIVISION OF HEALTH e RA!hite P.O. BOX 309, MADISON WI 53707 Plp. lv WISCONSIN DEPARTMENT OF HEALTH & SOCIAL SERVICES Division of Health Section of Plumbing & Fire Protection Systems ON-SITE WASTE DISPOSAL INSPECTION REPORT Name of Premises Street City County Master Plumber Address Owner Address ❑ County Permits ❑ Appropriate State Permits Type of Building: ❑ Public ❑ Single Family or Duplex CHECK APPROPRIATE BOX FOR VIOLATION TYPE OF TREATMENT SYSTEM ❑ Building Sewer ❑ Conventional Soil Absorption System ❑ Septic Tank ❑ Conventional System-in-fill ❑ Holding Tank ❑ Alternate Mound System ❑ Seepage Bed ❑ Holding Tank ❑ Seepage Trench ❑ Seepage Pit ❑ Experimental System BRIEF, FACTUAL COMMENTS AND SKETCH- , E , 7777 7-7 I i E r t r , , ( , i , t E E E I 3 i p El I E r ' d i 1 i 3 t i 3 tl i ate. d , r , i , M a v r i , F f 3 - 'a N.. } .....E _ - - - - r , E ~ 3 0SEE ATTACHED DISCUSSED WITH PLUMBER ( ) Yes ( ) No SIGNATURE (Voluntary) DATE OF INSPECTION Signature of Inspector N ',','hite - Inspector Yellow - Local Inspector Pink - Plumber or Responsibi=e Party