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Parcel 23--)3(38-02-000 08/28/2006 03:38 PM
PAGE 1 OF 1
Alt. Parcel 236 - CITY OF HUDSON
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Hip to, cal Date Map # Sales Area Application # Permit # Permit Type
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - WENDELL, CHRISTOPHER J & NANCY A
CHRISTOPHER J N;' NCY A WENDELL
866 STRAWBERI" 7F;
HUDSON "VI 51C
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # C -r7 t;-n * 866 STRAWBERRY DR
SC 2611 H S( N
SP 1700 V
Legal Des--riptic Acres: 2.298 Plat: N/A-NOT AVAILABLE
L 0 C STRF "JBG L'2 C&M 12/3512 Block/Condo Bldg: N/A 12
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
19-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
2006 SUMMi Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 03/24/2006
f escripticrn Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.298 150,000 364,100 514,100 NO
T, '-iIs f~ r
r: I Property 2.298 150,000 364,100 514,100
'Joodland 0.000 0 0
utals f r 2J0`:
I Property 2.298 150,000 364,100 514,100
Woodland 0.000 0 0
Lottery Crec' Claim Count: 1 Certification Date: Batch
U , Special Co. Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
.mod ,
• AS BUILT SANITARY SYSTEM REPORT
a
GER tl L _41i_ , TOWNSHIP ~ Strvl. SEC. T -)LN, R it
ADDRESS , ST. CROIX COUNTY, WISCONSIN.
-UDIVISIOAI f~ w rry z , LOT LOT SIZE
PLAN VIEW
-Distances S dimensions to meet requirements of H52.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
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*'i ate North', Arrota
SCALE
TIC TANK(S) MFGR. L- r Se r 's CONCRETE STEEL
N rings on cover LL) Depth DRY WELL
NCHES NO. of width length area
no. of lines width /9 length's area
depth to top of pipe 4 1
1ZEGATE / I/
RATE Clai j AREA REQUIRED L/~ AREA AS BUILT 6,`/`
claimer: 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
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.
SES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
`INSPECTOR
DATED YU PLU;MER ON JOB
LICENSE NUMBER 3,9,~L/
-
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REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM
S ani ta4 y P c`.Amit
State S e p .t.i c
1h11 Township _St. CAoix County
u t i uvi S Se.c.t.i.onl-9-Lo.t # ~Subdiv.L.eion
I'1IC TANK
gattonos Numbers o6 eompan.tmen,ts
ti three 6nom: Wett Building" 1.20 6tope
Highwa.teA v a~
Aill
~ti1P1NG CHAMBER
ti r C gatton,5.._ Pump Manu6ac,tu&e4 Model Numb e /L
I UlN0 TANK
_ gattonb Numbers o6 Compattmen-ta
I'll rtipcic.._.._ Atahm Sy-6tem
tare(, 6Aom: pelt Bu-itding 12% e.Eope_
tlighwa.teA
r,l,'ORI'TION SITE
he d Trench
(once 6n.om: Glee Buitding t2% 6tope
HighwaxeA
,,:OPPTION SITE DIMENSIONS
.r d 0t o tAe n ch ~y--
I~ 6 6t Requ.i.Aed area a 6z
Ic pinjt6c o6 each Zine 6x Depth o6 Aock beeow -tile
Nisrnlr(-t l16 ti- ens Depth 06 Aock oven. .tide tin
lo taP fen
gth 06 tines 6t Depth o6 tite below grade in
Oin tance between fine-6 6.t ST.ope o6 tAench in. pen. 100 At
y
l o ta.Y ab.5onp,tion aAea 6 t Type o6 Coven: PapeA oA A-taaw,
^
1 I UIMI NSIONS
N o rnb c l 04 pi t,5 GAavet. around- pi t5 yeb no
vatA<.de d-i.ame-teA 6.t Depth below inl'e.t 6-t
l o.tae absoAp,ti,on area 6-t.
A n. e a 4C q u.i. A Cl. d 6t
I
v Ill C I L 0 liY TITLE .
`
~I'►IOVfD DATE 19 8'
II rT► D DATE 198
A':oN FOR REJECTION
REPORT ON INSPECTION OF SANITARY PERMIT # r"
(1) Name and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection
Time of Inspection
ame, ress, License o. o ns a Ong Plumber
(3 )INSTALLATION CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber
❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System
(4)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 ❑ NO; ft from residence;
ft from well; ft from property line. Type of warning device
Is the warning device installed? ❑ YES ❑ NO; Wired? ❑ YES ❑ N0;
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 TREN H: 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:
B- 67 State and County State Permit it l
Permit Application County Permit ~y.
- 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:
+ Ile Ir
y C, r
B. LOCATION: /4, Section T N, R (or) Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township r~ta Sei.2
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family -*K Duplex No. of BedroomsNo. of Persons
D. SEPTIC TANK CAPACITY %DOf) Total gallons No. of tanks J
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete X' 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 s Total Absorb Area ~J sq. ft.
New N" Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: X Length A c / Width/ 9' " Depth Tile depth (top) ~No. of Lines - ~
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land Distance from critical slope
WATER SUPPLY: Private Sd 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 Q rMes e C.S.T. # and other information
obtained from K'c11 (owner/builder).
Plumber's Signature M /MPRSW# Phone
Plumber's Address 3/rte Ne-C!i S/ Miu~ i, o"I's -~I(
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.
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Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application . Fees Paid: State County Date
Permit Issued/Rejected (date) Issuing Agent Name
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
r
E H IO 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: N IN 1)0 Section \9 T Z? N,R_\~i,E (or) w Township or Municipality ~tQ c\
Lot No., Block No. County S L,~~ ` X
Subdivision Name
Owner's/Buyers Name: ~\i C_4~z.
Mailing Address: L',3QW wQ 6S0 t,~ tif,\-tz
TYPE OF OCCUPANCY: Residence y No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS S wr r PERCOLATION TESTS
SOIL MAP SHEET `J1 NAME OF SOIL MAP UNIT + ICL 5C.A.'L,
PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS EWATERIN TESTTIME DROP IN WATER LEVEL, INCHES RATE
NUM INCHES THICKNESS IN INCHES SINCE HOLE AFTE INTERVAL MIN/IN
BER 1ST WETTED LING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P- o P L .J C7AIC
P_ \A Vk
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
(0
B- 14 A m-6.
B- '60 No vhcd z
4 b[~
8m;
B- 3 1 90 No N C 7 G 'i srr 5, 5 A eye Vi 6r n; lag,!g - rtl02mz ! 46
B- Zr -7 N 8 N 7 Sc 5 2 . L re-1 S' (zft \7. e d" d 7 L_ A B- S Z NoN~' > r~ 3v. L a 5 = 23` rr, L SrS,
7_9
B- Z L r S --7' iR - E ,R 7,,,,6K R 37
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.
Soc ; ]♦inr ,/V r. vF 1 S~i'f L G l = 11-01
72,00 +ZhVV 13E2P_T 'Or-'P Al
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I` 14 Pr,~ptRN LINE
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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.
Name (print) -S C \A Certification No. 'S!5 " 5'S4'9
Address 11V SSG k L
Name of installer if known-
14-09 (ai u L a E P_6 44c) C> 5o d
Copy A -Local Authority CST Signature
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