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Parcel 020-1143-90-000 12/0612005 09:12 AM
PAGE 1 OF 1
Alt. Parcel 17.29.19.748 020 - 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 - SCHLEI, DIETMAR, & JUDY WYATT
DIETMAR, & JUDY WYATT SCHLEI
458 MCCUTCHEON LA
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 458 MCCUTCHEON LN
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 2.270 Plat: 2276-PARK VIEW ESTATES 2ND ADD
SEC 17 T29N R19W PARK VIEW ESTATES 2ND Block/Condo Bldg: LOT 55
ADD LOT 55
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
17-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 685/298
2005 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/25/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.270 70,300 239,000 309,300 NO 05
Totals for 2005:
General Property 2.270 70,300 239,000 309,300
Woodland 0.000 0 0
Totals for 2004:
General Property 2.270 37,500 235,000 272,500
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 214
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
- - AS BUILT SANITARY SYSTEM REPORT
0WAR TOWNSHIP SEC. T _N, R W
ADDRESS 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
a
4
t
i
d .w 4
1
I di, ate orthl Arrow
SCAL SEPTIC TANK(S)t? g MFGR. CONCRETE STEEL
NO. oT rings on cover Depth
PUMPING CHAMBER SIZE PUMP MFGR. -M65EL NO.
GALLONS Per Cycle
TRENCHES NO. of widtFi length area
BED NO. of lines width d length area
depth Tt top of pipe
NUMBER OF SEEPAGE PITS outside diameter total pit area
AGGREGATE
PERK RATE 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 THIS SYTEM.
INSPECTOR
DATED PLUMBER ON JOB
LICENSE NUMBER
• AS BUILT SANITARY SYSTEM REPORT
KR , TOITNSHIP ;'EC. T N, R W
0. ADDRESS , ST. CROIX COUNTY, WISCONSIN. T-
.
.BDIVISION , LOT LOT SIZE
PLAN VIEW
-Distances b dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
I
iA 4
I
i
I i
• I
I
1
4
S I
I:rYdicate Nozth Arrow j
i SCALE:
tPTIC TANK(S) MFGR. CONCRETE STEEL
NO. of rings on cover Depth DRY WELL-
;r NCHES NO. of width length area
no. of lines width length area
depth to top of pipe
aGREGATE
,,;W, RATE AREA REQUIRED AREA AS BUILT
kisclaimer: The inspection of this system by St. Croix County does not imply complete
.0pliance with State Administrative Codes. There are other areas that it is not possible
p inspect at this point of construction. St. Croix County assumes no liability for
Stem operation. However, if failure is noted the County will make every effort to
.jtermine cause of failure.
,IE.ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
'INSPECTOR
DATED PLUIMER ON JOB
LICENSE NUIMER
Z -
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
San.ita4y Penm.i.t CMG
State Sep-t.ic..119
NAME - townah.ip St. CALoix County
LocatioA 11+1? n C_ Section I-
US
SEPTIC TANK
S.cze~ ga.2.bona. Numb en o6 Compant"men.ta
DiA Lance F&om: W ett 77
6t. 12% on greaten a Lape_ 6
Buitd.ing 6.t. We.t.banda
DISPOSAL SYSTEM Highwa.ten
D.ia.tance Fnom: Wets 6.t. 12$ on greaten 6tope_ 6t.
Bu.i.Ldin t. We-ttanda Ft.
H.ighwa.ten
FIELD DIMENSIONS:
Width o 6• .then ch_6.t. Depth o6 no ck b et ow, -t.i.e.e Z i n .
Length o6 each tine--A 6.t. Depth o6 rock oven .tile in.
Numb en- 06 Linea Depth o6 .tite be.Cow grade!:.; .in,
1.
]'o#at berg th o6' pine in
-6 4 .6.t. Stope o6 .trench pen 100 6-t.
j D.ia Lance between ' tinea!_L-it, Depth to ' b edno ck
h
Toxat abaoab.t.ion area j/,,/,() 6.t2 Depth to gaoundwa.ten 6.t.
Requited. area . 6x2 Type o6 Coven: P pen' ~n S V L a w
PIT DIMENSIONS:
Numbers o6 p.itz Gnavet around pitz yea no
Ou" ide di'ame.ten. 6.t. Depth below .in.Ee-t
To.tat Oz o kb.t.ion area 6t z
Areaequ.ined 6t2 rn
INSPECTED BBC TITLE 'C,
APPROVED , DATE 19.
REJECTED ,DATE_ 19 7
a
State and County State Permit # ~S
PLB 67 Permit Application County Permit S
• for Private Domestic Sewage Systems County r
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
~G.r~ t l~~
B. LOCATION: AI'LV% Xd_%, Section T_,2:'jN, R E (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township d 5 vi
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family jf Duplex No. of Bedrooms No. of Persons
D. SEPTIC TANK CAPACITY Total gallons No. of tanks
HOLDING TANK CAP, ,CITY Total gallons No. of tanks
Prefab concrete Poured-in-Place Steel Fiberglass Other (specify)
New Installation ~f 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 Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width 4 . Depth Tile depth (top) No. of Trenches
Seepage Bed: Length ,~4- Width 2- Depth (z -z Tile depth (top) - No. of Lines
Seepage Pit: Insi e diameter 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 e I;• i, r ~t /~.r+ G h- ~~k • - C.S.T. # and other information
obtained from j ',i i ! (owner/b i y
2-Phone # Z-
Plumber's Signature yyMP/MPRSW# Al P 5'
Plumber's Address fy ~1
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.
a
3 3
3
E A'r) G ~ u rtlP V _
Do Not Write in Space B ow - FOR COUNTY AND STATE DEPARTMENT USE ONLY Z3 SL
Date
Date of Application S 1 'Fee Paid: State 1 S County
2 Cj A
Permit Issued/R je d (clte) Issuing Agent Name
inspection Yes No State Valid# Date Recd /
1, county hire c py) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pi k copy) 4. plumber (canary copy) Revised Date 7/1/78 f
E H t5 Rev. 9/78
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
< WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701-~~
LOCATION: 9_0__/1/4, /"SectionL7_,T~LN,R/_4L (or ownship or Municipality
Lot No., Block No. t.1'c`< ` S County X Subdivision ame
Owner's/Buyers Name: ~t~•ll /
Mailing Address:
TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS
SOIL MAP SHEET NAME OF SOIL MAP UNIT
PERCOLATION TESTS
TEST HOURS WATER IN mTEST-TIME DROP IN WATER LEVEL, INCHES v T
NUM- DEPTH CHARACTER OF SOIL SINCE HOLE HOLE AFTE INTERVAL RAZE i
BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IPJI
P-
P_
X S'
P-
P-
P-
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
TEXTURE, MOTTLING AND DEPTH TO BEDROCK
NUMBER INCHES OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES
B- 3
B- 7
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 ~ii`stances.
Give horizontal and vertical reference points. Indicate slope.
AIL"
Pews
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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.
rs r ' r~ eCertitication No. S I
Name (print) k1F/1"I' /
Address c e l-e / cc ) S , d t
Name of installer if known -
Copy A -Local Authority CS_ sic: