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Home My WebLink About018-1064-10-000 n cn O K T n o f c 0 n 3 m m -0 ~ (D m ro /ate m Q -1 2 m N O D S N o i ,l►t • W o c f o v ~U 5~/1 3 J o y 3 v J p O i~ Co ry O o f C N O N N Q A ^S R O Ti 7 c (D N O 0 c fil p o w ~ N o ~ N d o a r (p< m p_ c 0 0 < c° (D co 0 `0 a n N c_ (n O C N O O '9 ~ ~ 3 ~ lAI• z O O O o !V E' -4 ~ a a i fn fA fA O v v _ o D m m m 3 m - m o tV d u' ( 73 m a a z Z W Z O D N o a O o c o h+• CD (D (D N ~ C CG N " N y C (D (D w Q Q 7 4~, CD ~ z 0 co Q 3 (n ~ N W < co fl z 3 A ~ 0 Y C J N z P w D a - D m c c 'z_ a CC t a v z ti 0 0 v C w O a o rn o a Parcel 018-1064-10-000 03/15/2007 01:10 PAGE 1 OF 1 F 1 Alt. Parcel 28.29.17.432 018 - TOWN OF HAMMOND 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 - ALINE, GENE E & AUDREY J TRST GENE E & AUDREY J TRST ALINE 1708 CTY RD J HAMMOND WI 54015 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description " 1708 CTY RD J SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 28 T29N R1 7W SW SW INC PT OL 2 CSM Block/Condo Bldg: 13/3621 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 28-29N-17W SW SW Notes: Parcel History: Date Doc # Vol/Page Type 03/20/2006 820983 AFF 07/02/2002 683242 1921/44 QC 07/02/2002 683241 1921/042 QC 07/23/1997 458/266 2007 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/06/2006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 36.000 3,200 0 3,200 NO OTHER G7 4.000 19,200 151,700 170,900 NO Totals for 2007: General Property 40.000 22,400 151,700 174,100 Woodland 0.000 0 0 Totals for 2006: General Property 40.000 22,400 151,700 174,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 12/04/1998 Batch 568 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 018-1064-00-050 03/15/2007 01:07 PM PAGE 1 OF 1 Alt. Parcel 28.29.17.431A 018 - TOWN OF HAMMOND 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 - AUNE, GENE E & AUDREY J TRST GENE E & AUDREY J TRST AUNE 1708 CTY RD J HAMMOND WI 54015 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 37.210 Plat: N/A-NOT AVAILABLE SEC 28 T29N R1 7W PT NW SW INC PT OL 2 & Block/Condo Bldg: EXC OUTLOT 1 CSM 13/3621 (0.490AC) FKA 018-1064-00 (431) & EXC PT TO CSM Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 15/4184 28-29N-17W NW SW Notes: Parcel History: Date Doc # Vol/Page Type 03/20/2006 820984 AFF 07/02/2002 683242 1921/44 QC 07/02/2002 683241 1921/042 QC 07/23/1997 458/266 2007 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/14/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 27.700 2,900 0 2,900 NO UNDEVELOPED G5 9.510 8,400 0 8,400 NO Totals for 2007: General Property 37.210 11,300 0 11,300 Woodland 0.000 0 0 Totals for 2006: General Property 37.210 11,300 0 11,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 12104/1998 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 > OWNER TOWNSHIP I,~;~„ % SEC. ~ T'o N, R/~ J ADDRESS cd g ST. CROIX COUNTY WISCONSIN. SUBDIVISION , LOT LOT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM FF I di ate o-rthl Arrow I ' SCAL to it Iitf s SEPTIC TANK (S) MFGR. U e 1 S t r CONCRETE_ X STEEL N0. o rings on cover Depth ' PUMPING CHAMBER SIZE PUMP MFGR. -MODEL NO. GALLONS Per Cycle TRENCHES NO. of width length area BED NO. of lines width length .'5, area dept to top o pipe NUMBER OF SEEPAGE P TS outside diameter total pit area AGGREGATE (I )r' S 12 e PERK RATE 0-16) AREA REQUIRED AREA AS BUILT 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 TH INSP'_FX ~ DATED PLUMBER ON JOB LICENSE NUMBER ~a3j REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM San.i,tany Penrn.it A/ State Sep,ticIF-4-7- TAME Towns hi St. C1Lot' x County uca ion .S((~ _Sec-tiondr Lot # Subdivti4tion 'EPTIC TANK SizeZ 000 gaetons Number. oA eompan.tmen-t4 ')ia,tanee Anom: Wett~ 6 740" BuiZd.ing__ mope _ Highwa,ten ;'LIMPING CHAMBER Sizegat mp Manu~ac'tun.e)L Modet Nurnben IOLDING TANK Size ~g a e t o n, Ya r,.6t m p a A..tm e n.,t~s Pumpen_-- li,6tanee {nom: WeU.. ding _ 12% st.ope Hl6hwaten ,6SORPTION SITE Bed TnLe.neh s -tancnom: We.t.E j~ Building f2% skope- llighwa.tteeii' 8SORPTION SITE DIMENSIONS W,(' d,th a tnench U - 6 t R e. q ui r e d an, e a 4~-/-__Y 6. I_eng -th oh each U ne._~` ~,t Depth oA n.ock below t~Ee /a ~.vi Nurnben, oA Ttine~ Depth o A Hach. oven t'(' oC cn To,ak e..ength o6 -Une6 90 bt Depth 0A tiPe bet ow ynade V Co <n D.<_e tavnce be.twe.en einea_ At Skope o trench i.n . pc) 11 I U 0 t ab~ulcptcukt aneu {~I Tyne oA Coven.: Pa1~~en. cn t If DIMENSIONS- Numbers oA p.i.,t5_ GnaveZ around pli..tls ---e's nu Outside d.i.ame,ten bt Depth below .i.nUt ~x To t a l a b s o 4 p,t,i,o n. a 4 ea ~ t Area q-equi4ed At NS PE ✓/6 TITLE PPROVED DATE 19 8- 't JECTED DATE 19 'IASON FOR REJECTION . - State and County State Permit # PL8 67 ( Permit Application County Permit # 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: 11 C o~:G1, t !e t" d 4-1 " ~ B. LOCATION: cv 'Y, Section 2_a:, T.3 N, R /7 E (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 IL Duplex No. of Bedrooms 3 -No. of Persons D. SEPTIC TANK CAPACITY-/ C&i'0 Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete - A 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 A Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed:_ -Length 3 Width Z Depth- YL' Tile depth (top) y=? No. of Lines Seepage Pit: Inside diameter -Liquid Depth No. of Seepage Pits Percent slope of land- Distance from critical slope f G!' f 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 Certifie Soil Teste NAME y- I C.S.T. # and other information obtained from (owner/builder). Plumber's Signature 1wt,~,_ WAf, MP/MPRSW# art 3 f Phone # Yys~ Plumber's Address > l '44,e,5-, 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. s i i - f ) E t , Do Not Write in Space elow FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application / G Fees Paid: State &c) County , P/. O-e Date /z Ike) Permit Issued/RejeCLed' (date) Issuing Agent Name ~E C Inspection Yes 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 EH 115 Rev. 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS J l WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES I~ P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION:S %'S'to Section 1 ,T2L44 N,RZP-E (orCkj Township or Municipality j a i~ Lot No. , Block No. County mss/: ol~~ Subdivision Name Owner's%Buyers Name: CC,', C '4 Ij 11 1 Mailing Address: ~Izt, o ono el f sy TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT~ALTERNATE SYSTEM -OTHER DATES OBSERVATIONS MADE: SOIQL BORINGS- ( 4 PERCOLATION TESTS ~f SOIL MAP SHEET NAME OF SOIL MAP UNIT_ PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TESTTIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL MIN;IN BER t' ,~yf 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- " ®l' l /Y C 06 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- f)` f/ ` 9 , jam S l/ „1 `aG / /NC J J° j' q B- ~e B- B- B- PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the loc tion 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. i ~ ~la a~ ~ f I I I w V3 Ice,, 3 . E AEU { E N F 41 r- ' ~!~J r R ! \ O~/._ tea p F D CL t-t x 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. Name (print) U/"w 3 /1 4-)a ri Q- Certification No. J~ Address 'C'0 9 I ' / ' Name of installer if known Copy A -Local Authority CST Signature a-~ c/ REPORT ON INSPECTION OF SANITARY PERMIT # 270'1 (1) Name and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection Time of Inspection ame, ress, icense No. o ns a ing plumber (3 )INSTALLATION CONSISTS F:r ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber ❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System (4)BENCHMARK: (Permanent reference Point) escri e: 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: M 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 ❑ NO; ft from residence; ft from well; ft from property line. Type of warning device Is the warning device installed? ❑ YES ❑NO; 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: I~ 0 -vit ~ r r V~ foe&