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HomeMy WebLinkAbout020-1124-30-000 n(A O m v n G ~1 o o d c 0, 3 CD -a n a It c ~ v m - CD 1 o 3 v Q cn m z CY) to Z, o o . C) Cy N N W O CO - ~ NO o o m v cn j N) C1 d it N N O= CO j K 1 N ~ 7 W W N (D A O N Q? N SU 3 p W C) CD (t, (D A O Z3 O O N O O N o O N N ~ c N O U) D (D CD (fl (D I a `G 4 m W c Cl. C) o O CD N N = .7~ CD W C lz E m (o Cfl m n r cn ~y m co co a (n O c ev z 0 0 0 K h~ o c W V`, Cl) E O N N w ZT T O 0 m a C ro m N CD m a a CD - 77 (ID (C ;z D 0 m n CD a ~ ~ N z m zQy O D a N 7~ `D O Cn v N 70 ; .0 F4. W CL O O A ? f~Y ~ A Z O v a O c oZ -I ~ co v m CD CD _ C° z 0 3 o cn 3 m C~C N Z - G CD A W D CL o - T OJ C z a O CD cn 4 a, o- fi a I ~ 0 0 a i A ~ w CD j a < ft O fA 0 a O CD L ti O CD 02/15/2006 02:56 P Parcel 020-1124-30-000 PAGE 1 OF 1 Alt. Parcel 07.29.19.560 020 - TOWN OF HUDSON 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 - IRVING, MICHAEL J & JULIA L MICHAEL J & JULIA L IRVING 422 KRATTLEY LA HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 422 KRATTLEY LA SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.450 Plat: 1925-EAGLE RIDGE SEC 07 T29N R19W EAGLE RIDGE LOT 31 Block/Condo Bldg: LOT 31 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 07-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 739/470 07/23/1997 686/296 2005 SUMMARY Bill Fair Market Value: Assessed with: 92431 321,300 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.450 71,700 256,000 327,700 NO 05 Totals for 2005: ~ General Property 2.450 71,700 256,000 327,700 Woodland 0.000 0 0 Totals for 2004: General Property 2.450 42,700 186,400 229,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 101 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 If AS BUILT SANITARY SYSTEM REPORT OWNER ~ TOWNSHIP k, 5 o h SEC-7 T 2 N R/ g W ADDRESS u ST. CROIX COUNTY WISCONSIN. SUBDIVISION f, , LOT- 1 LOT SIZE . PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING_ WITHIN 100 FEET OF SYSTEM 1 1 e TF F %.c F 11 r F I di atte o~thi Arrow ' SCALD : SEPTIC TANK(S) MFGR. kli l5f h CONCRETE STEEL NO. of 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 12- length, area dept - to top o pipe NUMBER OF SEEPAGE PITS Outsi e diameter total pit area AGGREGATE PERK RATE AREA REQUIRED l AREA AS BUILT 0' ,1 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 TkS SYTEM.,,,-" INSPECTOR DATED C 1 f PLUMBER ON JOB LICENSE NUMBER AS BUILT SANITARY SYSTEM REPORT TOWNSHIP SEC. T N R" W 0. ADDRESS , ST. CROIX COUNTY, WISCONSIN. "BDIVISION , LOT LOT SIZE PLAN VIEW -Distances dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM i i k I ~ ~ Iridica e North, ArroW SCALE ((TIC TANK(S) MFGR. CONCRETE STEEL NO. of rings on cover Depth DRY WELL ANCHES NO. of width length area no. of lines width length area depth to top of pipe ~G?ZEGATE ?;P4: RATE AREA REQUIRED AREA AS BUILT l,Sciaimer: The inspection of this system by St. Croix County does not.imply complete ,09liance with State Administrative Codes. There are other areas that it is not possible ,o inspect at this point of construction. St. Croix County assumes no liability for 4Stem operation. However, if failure is noted the County will make every effort to ;etermine cause of failure. ,TEASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYST 1. '-INSPECTOR f^ DATED ('/,PLM1BER ON JOB LICENSE NUMBER z REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM Sanitary Permit Oho( ` State S P p •t•i c,?11~__ 1 NAME len rownah.ip rX<3 S Croix County L o c a.t.i o n Section c SEPTIC TANK V Q S.izeLL - --_ga.t.tona. Number o6 Compar.tmen.tz I D.t,b.tance Fnam: Weft 5 it. 12% on gnea.ten s.to pe ,SZ it Bu.i.td.ing e it. We.t.tanda -6t. DISPOSAL SYSTEM Highwa.ten - -6.t. , D.iz tance Fnom: Wet. 12% on gnea-ten z tope- ---6 t. Bu.i.tding it. We.t.tands_ Ft. H.ighwa.ten it. FIELD DIMENSIONS: Witt o6" .tr.en ch / it. Depth o6 no ck b et ow, t i.te-Z.L-.in . Length o6 each tine it. Depth o6 rock oven .t.ite ~ in. Number.- o6 tines Depth o6 .t.i.te be.tow grade, .in: To.ta•t ,teng•th o6 tines it. Sto pe o6 .trench .in pen 100 it. Distance between tines- ' it. Depth .ta"bedrock ~ it. To.ta.t abs or.b,t.ian area' ~:)'y6 t2 Depth to gnoundwate& it. Requ.ined area ' it2 Type of Cover: Papers or Straw PIT DIMENSIONS: Number o6.. pits Gravel around pits yes no Ou" ide diameter it. Depth b e.tow .in.te-t it. . 2 To.ta.t aba orb.tion area it 2 Area /nequir.ed i t2 M INS P E C T E D BY TI TL E APPROVEDDATE - 19 REJECTED ,DATE 197. PLE3. 68 DEPARTMENT Of if '0`LTI-I AND SOCIAL. SI:-RVICES l'?ivlaNall ~~t 19<lalth r q ~ FEE • $10.00 O w)x a1l1 No. 21~ 5 2 (I Permit per Tank) Mhdistan, Wlsconsha 63101 T Date Issued 1 Tank Size-L.,- -gal. STATE SEPTIC TANK Y'EBMFY Private Res. This porlllit is for purchase of septic tank only wul doe9 (WhIL ~a..l>rnpt+rlV ilwnair (I Inl )-I inla keclnUrlr not oxeiript installation from state or lucaal approval (Mali l-ulvlsloil of I1"aml Public and/or permits. (t:anary)-Issulny Aaenl Owner's Name Owner's Address Location (Legal Description) of Properly Where Tank Will be Installyd \ 'oullty t Plumbers Name I icenu No. Address Signature of Person Obtaining Permit Address if Othei Than Owner Address of Issuing Agent (Town, Village City) P.O. D©Y 227 Title: signalure. ZONING ADMINISTRATOR . L ~o -t2 PLB.67 . State and County State Permit # u Permit Application County Permit # ~H for Private Domestic Sewage Systems County ~'rrzz *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: S --,~;L /,A A ( ((1►r on G4 B. LOCATION: '/4, Section T2A N, R E (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township )44-4S01 /l L ci C. TYPE OF OCCUPAN . *Commercial *Industrial *Other (specify) *Variance Single family Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY -t Dad Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete C Poured-in-Place Steel Fiberglass Other (specify) New Installation LI Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-PlaceOther (Specify) E. EFFLUENT~DISPOSAL SYSTEM: Percolation Rate- 7 Total Absorb Areal sq. ft. New Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (to) No. of Tre c es Seepage Bed: Length h Width~Depth Tile depth (top)_ No. of Lines Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land_ 1 171 Distance from critical slope 3 5 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 C tified Soil Tes er, 4 (and , enitlf nP~ C.S.T. # y 4 7 (and other information obtained from c ' Ar (owner/ uil Plumber's Signature MP/MPRSW# A/d ~f 3L Phone #,.247- j .Z J 3 Plumber's Address w/ i of rr y 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. E , 4 E f 2 5 w_ .v e . . p c . s v -1 w 2.~ S`2 E / To W. w o~ ous~ ti IZ`'lr /a r,P o' f 4 r_~► _L t _el - - a - E Do Not Write in Space B ow FOR COUNTY AND STATE DEPARTMENT USE O LY C Date of Application Fee Paid: State 1,5 County Da J .3 _5110V P Permit Issued/R jected (clte) 57-W80 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 1 I TRANSFER FORM SANITARY PERMIT PLB S7-T State Permit # Sanitary Permit # County Sanitary Permit Transfer Date Original Permit Issuance Date A. Property Location: /q 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 DISPOSAL SYSTEM: Percolation Rate Total Absorb Area sq. ft. New Replacement Alternate (Specify) Seepage Trench: No.Lineal Ft. Width Depth Tile Depth(top) No. Trenches Seepage Bed: Length Width Depth Tile Depth(top) -No. of Lines 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 Sanitary 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 Tester and/or any additional soil tests that may have been required. Plumber's Signature MP/MPRSW # Phone # - Plumber's Address Information obtained from (owner or agent) PLAN VIEW: Provide sketch below of any revisions to original sanitary permit. Include direction of slope and all distances in accord with H 62.20. Well location shall be included on the sketch. Indicate or dimension location of all wells, on the property or neigh- bor's _ro ert . If well has not been, ~lrille l olea _ _ m m~ ~ ff ( I I W r , ~ I I I i Signature of Issuing Agent 1. County (Yellow cop 3. Owner (Pink copy) / DIVISION OF HEALTH 2. State (White cop 4. Plumber (Green jcopy) P.O. BOX 309, MADISON WI 53701