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HomeMy WebLinkAbout010-1021-90-000 y O N O h ti O V ~ I n O I O N O C I I rn i (U I O I 'O z i O 7 R LL O Q 3 N ~ O Z CD WI'. E O Z 9 rn U) a m c 0 O Z ~t lA F- ~ N Z c ~ -a ch N O O 0 c (6 N N • N O C n IV (n L O a ' ~ R O O d Q w Z m z N 0 m O cu N a R E cu N y ` C O O d a a Z M H H I- ~ o ct d 0 0 0 Z LO 0. a. CL aE 3 O U) .a O O U) J U rn rn m i:z E N Y o w O O L ) CD C a ~ y O Q1 (D CD -6 N O R Q (n 0 G1 M N N 0 O O N N C 8 m c ~2 O E Cl) rO C O O C R-2 C V Q' w N (D N :3 04 C) C, N o rn Z -0 o) cD - o in co o • ]A~)1 O O W co om Z° 2 H (n O ~ r 4-; E v v~ ~o a xt EL a E 2 r A 0 a m O in v Parcel 010-1021-90-000 01/08/2007 11:34 AM PAGE 1 OF 1 Alt. Parcel 9.30.16.1356 010 - TOWN OF EMERALD 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 - BAZILLE, JOHN M JR & MARK A JOHN M JR & MARK A BAZILLE 1623 220TH ST EMERALD WI 54013 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 1623 220TH ST SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 0.670 Plat: N/A-NOT AVAILABLE SEC 9 T30N R16W.67A IN SE SE COM SE COR Block/Condo Bldg: SEC 9 AT INT CEN LN OF TN RIDS, TH W 648' TO POB; TH N 137', W 214'S 13T E 214' Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) TO POB 09-30N-16W Notes: Parcel History: Date Doc # Vol/Page Type 02/02/1999 596924 1400/385 QC 337821 548/364 QC 2006 SUMMARY Bill Fair Market Value: Assessed with: 167849 43,800 Valuations: Last Changed: 10/19/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.670 5,000 33,600 38,600 NO Totals for 2006: General Property 0.670 5,000 33,600 38,600 Woodland 0.000 0 0 Totals for 2005: General Property 0.670 5,000 33,600 38,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount 010-GARBAGE SPECIAL ASSESSMENT 30.00 Special Assessments Special Charges Delinquent Charges Total 30.00 0.00 0.00 r : SEC. F,')~_ M g,}.f t~ Uj L ST. CROIY COUNTY, WISCONSIN LOT LOT SIZE - ,.AN VT' requ, FV R."THTNG WITHIN 100 FEET OF SYSTEM ti s cn, (S7, `b I j, i 1 D ce,.~,l ~C7d~,~ 'rIC TANK(S)MFGR. (LJ~JC 5 ~~~r_ PQr?• CONCRETE STEEL NO. of rings on cover Depth DRY WELL „ -`ICHES NO. of width length area no. of lines width length area- depth to t~ of pipe 77 REGATE ~ 5 2 1/: 2 1f 6 C., RATE -Ito_M/~).AREA REQUIRED- AREA AS BUILT ,>claimer: The inspection of this system by St. Croix County does not imply complete -: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 ,<tem operation. However, if failure is noted the County will make every effort to ?:ermine cause of failure. ;uFA FS AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. °INSPECTOR - _ ` ~ /y DATED ""i ( PLUMBER ON JOB LICENSE NUMBER C~ 10 3 C) RLPORT O1 INSPECTION - INOIVIDUAL SEWAGE SYSTEM Sava. taty Pr nmi t A .1 Sf:atC Se_p~ti NAME Yit TnutvtSGcti~ G/ - 'a?r S t . rr a x C o a vr. l y L<,cat ec-tiow- Lot # Subdivision SEPTIC TANK Si ze - _ y a f f o n 6 Numben- oA CorrrY~alc~rnevr,,tb Drntayrce Atom: Well Buildiyr4--- 12o bkope---~ H,Lghwa ten PUMPING CHAMBER r S1ze yaffonj u at p Janu.Aae.tumt Made_k Numbe.n HOLDING TANK Size_ _gafkavr5 NumbeA oA Compantmevr Diatavree. AAom: WrI Uu~.k.d~ny 12'a 3Tane Highwatco AISORPTION SITE 6od- Z To e N c;,t ot'Atavrce Atom: WVfI- C~ Bu~:i_dlvrri 12o A op~Hzyhwaleit WORPTION SITE DIMENSIONS Width o6 R e g a-I n e d a tt e a A t Length oA each ~c-vre fa Depth aA &ock below ti Q___/ T- err Numben o e.~ - Depth 06 AM ove4 Total length oA tines A:t Vep-th oA .tif_e. below yradv rv, Distance between fines 6t scope 06 pet 100 At Total ab6oAp.tion area 6t Type- oA covet: Pape& on 60_aw PTT "DIMENSIONS Numben. oAi pits - _ - Goave.f. aAouvrd pi.a5 r eb vru - - Outside dx-ame-tVA - 6-t Depth below tivr('e~t ( f Total abAo4p:rt onaI ea- - A) t Anea acquin.e.d 5t _ TITLE INSPECTED BY - - - APPROVED DATE 19 h Rt JECTE'D DATE /98 REASON FOR RE JECTION o EPORT ON INSPECTION OF SANITARY PERMIT # (1) Name an Address of Permit Holder Person/Persons at Site (2 )Date of Inspection Name, Address, icense No. o ns a ing Plumber Time of Inspection (3 )INSTALLATION CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber ❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical reference point: Slope at site: (5)MATERIAL AND DEPTH OF SEWER: (6)SEPTIC TANK: Manufacturer: Liquid Capacity: Tank Inlet Elevation: Tank Outlet Elev: # ft to lot or property line: # ft to well: (7)DOSING TANK: Manufacturer: # of gallons: # of gallon pump set for a cycle gallons; total capactiy of distribution lines gallon; size of pump head; gallon per minute ; horsepower ; brand name of pump and model number Is the warning device installed? ❑ YES ❑ NO Wired? ❑ YES ❑ NO 8 HOLDING TANK: Manufacturer o gallons construction ; depth to the cover ft; If septic tank is being used are baffles removed? ❑ YES ❑ N0; ft from residence; ft from well; ft from property line. Type of warning device Is the warning device installed? ❑ YES ❑ N0; Wired? ❑ YES ❑ NO; Locking device on cover? ❑ YES ❑ NO; Diameter of vent and material Distance from building to vent (9) SEEPAGE PIT SIZE: # of pits; ft diameter; ft liquid depth; ft to residence; ft to well; ft to property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than seepage pit inlet pipe-elevation ft; bottom of seepage pit elevation ft. (10) SEEPAGE BED SIZE: ft width; ft length; tile depth; lineal feet tile; ft to residence; ft to well; ft to lot or property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches Elevation of tank discharge line entering bed ft. 11 SEEPAGE TRENCH: Total length of seepage trench ft; width ft; tile depth ft; ft to well; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches; elevation of tank discharge line entering seepage trench ft. (12) Has system been installed in area indicated on EH 115? ❑ YES [:]NO (13) Has system been installed in floodway? ❑ YES ❑ NO Floodplain? ❑ YES ❑ NO DILHR-SBD-6095 N.05/80 Signature of Inspector: EH -115 Rev. 9178 REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION:26- '/4,_:L'/4, Section_ Z T ~_N,RfL &(or) W, Township or m"icipality Lot No. , Block No. County Subdivision ame Owner's/Bt►ym Name: I H i Mailing Address: C, ,►rl L6 y(o ~a , u(j i TYPE OF OCCUPANCY: Residence L--- No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS_ /b" ryf~9J PERCOLATION TESTS ~~EX te"~., J AS' SOIL MAP SHEET r~' + , NAME OF SOIL MAP UNITA2!.~ ~1 1~ 'V PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL MINTIN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- i ~•~r cw 1~ /1)0 5 fJ / C P_ 3 P- - P- P- SOIL BORING TESTS 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 " 1 B- a- B- PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. e -t I h 3 # I S 12' i ~N a 4; a ~g I, 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. L r Name (print) Certific tion No. Z Address VLF ,.f-, i+, , Name of installer if known 4.1 i' " Copy A- Local Authority CST Signatur. PLB 6 7 State and County State Permit # o 13 3 Permit Application County Permit # (50 x 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: 6 ATz 1/6- ~6,7 B. LOCATION: Section T~N, R/A 1, (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township C. TYPE OF OCCUPANCY: *Commercial *Industrial 'Other (specify) *Variance Single family_ Duplex No. of Bedrooms No. of Persons_ D. SEPTIC TANK CAPACITY 1000 Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete _ X Poured-in-Place Steel Fiberglass Other (specify) New Installation 1, 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. X Replacement Alternate (Specify) Seepage Trench: -No. of Lineal~Ft. Width Depth- -Tile depth (top) No. of Trenches Seepage Bed: Length 4-4' Width _Depth7'Tile depth (top)--15V--No. of Lines Seepage Pit: Inside dia eter 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-~19i`C 6,/ / - C.S.T. # •2 a and other information obtained from 0, '42 ;-77 (owner/b- 7 Plumber 's Signature MPS Phone Plumber's Address 7-,44 X 1'0, 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. N 0 / LJ e ~ 140 `mss ft- 7~v L i 3 Ja© 'At 1A, n) ~L A-D Do Not Write in Space elo FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application 17 $O Fee Paid: State 735 County "I Date -7/17/80 Permit Issued/Reje ted (date) 171130 Issuing Agent Name Inspection Yes No State Valid# Date Recd 1. county (w to 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