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HomeMy WebLinkAbout040-1201-30-000 nC/) O g m n d 1 O O C ' -0 * C a) 'CD n ~ 'Y A7 t o y O N 0 O J~ a O m O • CD 3 O (D (D O O_ W 0-0 _t n z n N (.n N C-D O W: co 0 C) n NO O- m O u S 7 N W ,-u 0 :3 C CD O n N O ,p, O o O 3 N n O v~ N m CD CO D F' CD L2 O N a n N W C: (D 0 3 `L °,c b O Q j O 1~14V i Z CD CO -4 Cn CO CO O n 0 C C (n O O d 0 r 2 3 ai l~n fin a O a CD V O O y n a. X I (D lD (D A CD 9 V1 (O .•~~7 to 23 E (D O CL CY) N to CD z z o z D z 0 a !r o !r • N (CD N N 0 CC c CD N LO (u Q a 3 z (D --I (n O O O p Z n u ;u n A Z O CL 0 Z rn ao v m iv CD M 00 C Z p A Z1J O r. M 3 m C<° N z < (D A A ~ T7 D g m n - ~ T ~ = O C z a O (D m N N N ~ A Oc A C 3 w N ~ N O O a A W O_ /Q b O A ~ Cg N O * C) L ti Parcel 040-1201-30-000 01/13/2006 03:32 PM PAGE 1 OF 1 Alt. Parcel 6.28.19.924 040 - 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 MELVIN J & LOUISE C HERMANSEN O - HERMANSEN, MELVIN J & LOUISE C 540 NORDIC LA HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 540 NORDIC LA SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.020 Plat: 2204-NORDIC HEIGHTS ADD SEC 6 T28N R19W 2.02A LOT 3 NORDIC Block/Condo Bldg: LOT 03 HEIGHTS ADD Tract(s): (Sec-Twn-Rng 401/4 1601/4) 06-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 717/14 2005 SUMMARY Bill Fair Market Value: Assessed with: 103609 297,700 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.020 55,700 230,800 286,500 NO Totals for 2005: General Property 2.020 55,700 230,800 286,500 Woodland 0.000 0 0 Totals for 2004: General Property 2.020 55,700 230,800 286,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 208 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT R `r~~ , TOWNSHIP SEC. T,) ~ N, R 1 ; W ADDRESS ST. CROIX COU ISCONSIN. DIVISION 9V -t~ u~LOT .:3 LOT SIZE PLAN VIEW -Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Ir i v ¢ I G i `•J ii I I 1 +4 ~ I i F +_7(z Ef I Indicate North; Arrow j r j ! S CALF IC TANK (S) ,'___1 MFGR. l~ r 5 e r'S CONCRETE t STEEL NQ. of rings on cover i Depth !y DRY WELL CHES NO. of width length area no. of lines -3 width i 3' length y area depth to top of pipe ' LEGATE ti RATE _/~~ti / AREA REQUIRED, AREA AS BUILT~j iaimer: The inspection of this system by St. Croix County does not imply complete liance with State Administrative Codes. There are other areas that it is not possible 'nspect at this point of construction. St. Croix County assumes no liability for tem operation. However, if failure is noted the County will make every effort to rmine cause of failure. SES ANTD OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. `INSPECTOR DATED PLUMBER ON JOB LICENSE NUMBER p ; ~f T z REPORT OF INSPECTION INDIVIDUAL SELVAGE SYSTEM Sanitary Penm.i.t~-::~'/Y` State Sep.tic1'1 57-1 NAME ~ Township ~f St. Croix County f L o c at.i o A S e c.t.i o n _ SEPTIC TANK Size ~,,Z`)V gattonz. Numbers o6 CompaAtmen.ts Vidtance Prom: Wett j it. 12% on gneateA 4tope --6t Bu.i.-ding _ S it. Wetlands 6t. H ighwateA it. DISPOSAL SYSTEM . Diz tance F,%om: Wett 12% on gneateA stope it. Buitding~it. We.t.Lands Pt. • H ighwateA it. I - - FIELD DIMENSIONS: Width o6 thench it. Depth of rock below .tite~ in. i Length os each tine it. Depth o6 %ock oven -t.ite ~ in. i NumbeA a6 tines Depth of t.ite below gnade~_.in. TotaQ teng.th o6 tines it. Stope o5 tnench in pen 100 it. ~ D.cz once between dines e,jt. Depth to bedrock ~a To#at abz onbt.ion anea~jt2 Depth to gnoundwaten~it. 2 Type o Coven Pa en a Straw Requited area T-~ it ~ PIT DIMENSIONS: j Number o6 pits GAavet around pits yes no Outside d.iame.ten it. Depth below .intet it. 2 Toxat abzonbtion area it Z Area nequiAed_ i 2 rn II ~ INSPECTED BYE' TITLE rte. APPROVED ,DATE 197. REJECTED DATE 197 01 EH 11 549ev. 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION: A/ '/4;-~11' ''/4, Section 6- , N,R&Iq (or* Township or Municipality Lot No. Block No. AllOr W r c //4-, ` ~S County S C a bdivisjon Name v Jb Owner's/Buyers Name: Mailing Address: A ~ /114, Z- TYPE OF OCCUPANCY: Residence X No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW, X REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS SOIL MAP SHEET 3 NAME OF SOIL MAP UNIT f3X CnZ i ` cflr~`r-•SHIT/c' c [/~~'x 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 AFTE INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- SCI ( L P- ,0 C' '7(I / f Y /LC4~ (G f 5 (C` P- P_ P_ P_ BORING TESTS SOIL TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B- -3 y B- y B- c• ••~S /Y''`APP 7B- n d1cL 7 J to t- r5 " J c C' > . S PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the_pIan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy 's ` Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. C 3 C. usr~ + 1 V _ L A, r/f 1+ N 141 i ~ ~ _ ~ F~ =y7' _ ~ t✓ ~f ) C / V~41 -41 E Fl. =lcc~• 1, the undersigend, 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) t / S Lli'- /t~ Ic S Certitication No.S Address //,1/+ ~f4i1.eJ GIP c 4 !A G~ `~S, Z c~'Cd Name of installer if known i Copy A - Local Authority CST Signature State and County State Permit # PLR67 Permit Application County Permi 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: AJ46- % ,.fit Y4, Section T 3-a N, R (or) 0 Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township Ti'D C. TYPE OF OCCUPANCY: *Ce5imercial *Industrial *Other (specify) *Variance Single family X Duplex No. of Bedrooms No. of Persons ly, D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste GrinderYES XNO # of Bathrooms Automatic Washer X YES NO Other (specify) E. SEPTIC TANK CAPACITY /,AQZ2 Total gallons No. of tanks *Holding tank capacity Total gallons No. of tanks New Installation X Addition _ Replacement Prefab Concrete *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) ~ 2) S, 3) Total Absorb Area sq. ft. New x Addition Replacement *Fill System 6~Lo 0 're urwd Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Length J4 to' Width Depth , Tile Depth - No. of Lines ri Seepage Pit: Inside diameter Liquid Depth Tile Size -91 Percent slope of land y o 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 Tester, NAME Eden n e Chr~ /t rseAC.S.T. # and other information obtained from f'i4 I-e S C ~LZ d, (owner/buil Plumber's Si9nature< 'smss Phone (s MP/MPRSW# i\1('-l'~ (oC. Plumber's Address 1 f\'i<±L: ST r u,^, Ilk-CL- : f~ ~s- ` Lt r" s d PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). fu's/ ~-emu-/C ~S ~Cc,~'tc~P~ ns cl~c~ci ~rC.~ CI L* W F OF 2P, w well 1-o Tap Sep ✓t/r~~~ _ Lk A-0 34 ;Igo 5 eJj b 13 E Do Not Write in Spa a Below FOR DEPARTMENT USE ONLY Date of Application Fees Paid: State / Q Q Date ~l - 7 Permit Issued (date) ~S -~Issuing Agent C. I 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. plumber (canary copy) Revised Date 6/1 /76