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HomeMy WebLinkAbout026-1110-50-000 o o c 00 r1 c d > > 3 3 A~ ice' CD # ^ 3 - \ 1 X N (ND p A ON • 0 W v v vy O :r Cil N OC ro D_ a(D y a l O W lAl N (D 7 W W O ZJ 7 ~o O 0 1 N d= m m y 0 O ~S O 0 Q• 07 (D S N p ~ O 0 c (D CD CD O o A7 D O 7 y ~ O O yr C Cn -4 W !r C1 cn G m N D a t~ (D G y w a C W May O V 3 p ° D CD C) rQ < CL SD CO CO Z (D CC) OD CD y 0 0 I' Co O C !r z O O O o V 7 ci' N a W CCD ~f m r O Q c 77 m (D N ° ZJ < V N 3 m Z) CD N Q 3 ~ z m z co Z (D 0 y (D o Q v O D o a V) -a W (D m .0 (Q N C (D (D W CD CL a 3 E Z (D -i U) O p Z C ~Z1 n O A Z O v ~ O O I 0 Z -i (°D° CD o CL z 1 0 K Z E'O 3 m y (D ? 0 W ~ n C/) NT(D D 3 CD ? Q -o~~m n a: _ S O 7 I "n x m O Z CL O -0 O (D O 3 m (D N _ y O 7 co D C C O ~ y N ! i y (D 3 ~ A (D (D p~ ry ,a A 7 y O A CL y d =1 O 0 O (n y N wQ °o m m v 7 Q A O_ ti O SAO V O O . °w O (D a O C S O i ~ Parcel 026-1110-50-000 01/05/2007 08:52 AM PAGE 1 OF 1 Alt. Parcel 4.30.18.622 026 - TOWN OF RICHMOND 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 - JOHNSON, CRAIG A & SARAH B CRAIG A & SARAH B JOHNSON 1732 174TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 1732 174TH AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 0.000 Plat: 2573-VIEBROCK'S RIVER VALLEY VIEW SEC 4 T30N R18W LOT 23 VIE- BROCK'S Block/Condo Bldg: LOT 23 RIVER VALLEY VIEW ADDITION Tract(s): (Sec-Twn-Rng 401/4 1601/4) 04-30N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1121/195 QC 07/23/1997 998/408 WD 07/23/1997 708/153 07/23/1997 445/265 2006 SUMMARY Bill M Fair Market Value: Assessed with: 177551 218,300 Valuations: Last Changed: 06/20/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 64,400 105,800 170,200 NO Totals for 2006: General Property 0.000 64,400 105,800 170,200 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 64,400 105,800 170,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 108 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 m xp ~ Rt ~ mi°a ~ < ; nF g I~ 4 ~`cp.a N STi e °-mme01 a$~Im'^oS °mOZ~ I A n^ ~z i man f>I 3~~~ur.:y=', o ~ 1 r LL S t' ?I f~ ~ N m Fmk < ` A 1 Im , ~ a a$ no o~n'a$ n•m .'U' I 1 ° =i• ~t i'1 ~ lc~ p o'' D N~$~IO Zm~` -'I 'I~,i 1 z°~~ ! 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CROIX COUNTY WISCONSIN. y r SUBDIVISION , LOT 3 LOT SIZE VA'L L PLAN VIEW ~U Distances & dimensions to meet requirements of H62,20~ SNOW EVERYTHING WITHIN 100 FEET OF SYSTEM I ~ I ~ f . e ' { I di atte oath AAr}-rro_w SCALE SEPTIC TANK(S) CONCRETE—_STEEL NO. of rings on cover Depth 1)tWING CHAMBER SIZE PUMP MFGR. MODEL NO. . GALLONS Iffier Cycle TRENCHES NO. of wi th length area , B1'.D NO. of lines` width length S; area depth to top 07 pipe NUMBER OF SEEPAGE PITS Outsi e diameter total pit area AGGREGATE r~~,) PERK RATE A 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 DATEDPLUMBER ON JOB LICENSE NUMBER ~tC~ R1PO R1 01 1NSPECT10N INDIVIDUAL SEWAGE SYSTLM S avi." t,~h y V( it in-i t State Sept,c.c J A M I Towyl6hip St. Cn04.x County c a t4. u n ~ lY 5 c' ~ n- - Lot Sub d.('. vi/s,i. a n - 1 I'I fC TANK S4 zc©Q ya.ky.on.A Numbeh o6 eurripa~r#rrie.ntA i tancC noiri: WcYk - - 1.3a -4,e(14 n11 .3 12' sfo pe. Htiyhwaten - - IIMI'INC CHAMBER Sl z~ ga.eZonA Purnp ManuAaetulie>t Modek. NurribCIt JLU1N~~ iANY. S.cze gaeeonA Numbest, oA Compahtrne.ntA Purnpcn Atanm SyAtero otance 'I,utit : Ul8ui. d-t.nc _12o s o p e II.< yhwate~r / Ii 0 I: PT 10 N S I T- E G~ J~ U! Q l A 8ed_~~ Tncncir A , inIance- 0.orn: (Vek-k I3u- Q.d.tng r2° XoC~E NtdhwatC- ic I;tiORPIION SITE 01MINSIONS W d141 o tnench # Re q 14 ncd anea _ - rte h - - - - ~1 I_en!1tIt of each Z'(nc J (-t Depth oA 11uc-h be Ow t4fc to Numbeii o f ine6 Depth o A n.och ove -n t (T'c I n fota.f kenU-t{i o 6 Y1.vi cA_ - --6t Depth o6 t'& bekow qht de ViAtapicc between e -LncA ft Seupc oA tnv_nciI Z in. pen 100 ~t fuaa(' it l,Aunp.t'i.On anew---(/p 02~ {t Type obi Cove.~L: f° Papen~n. 5t01 aw It DIMINSIONS Nit mbe it o A p-(t.A - - Gnavc e an.oun.d p~ to _yeA --no Oil tA.ide di.armoton At Depth be.,flow inlet At I t a T abnu'Ipt.(ovi a A v a 6.t Ali ca ti cilai!Icd 6t III C I 1 II 6v T I T L I J VITOVED DATE 1 915 - I II C II D DATE 1 9 'I ASON 1 0R RI JI CI 10N i PLB 67 State and County State Permit Permit Application County Perm t # 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: r B. LOCATION: /1- % Section T N, R Lt 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- Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY ; Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete k Poured-in-Place Steel Fiberglass Other (specify) New Installation Replacement 4 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 Depth Tile depth (top) No. of Trenches Seepage Bed: X. Length Width Depth ' Tile depth (top) No. of Lines J Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land Distance from critical slope WATER SUPPLY: Private Q 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 a C.S.T. # and other information y obtained from _ (owner/builder). Plumber's Signature MP/MPRSW# Phone # - Plumber's Address 4 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. 4 7 r E 4 4 3 } i ~ S e . m . e m p m..k m'e. e ,...a, 4 ~ Sm,-. e e ..m...... ~ ,.e _ 4 7-- l E . , , ~ .,e„„ . ee . , . e s ..,...e. mm. .t m e.~_..... , e . . m._ a - ~ e .,em,»...... . -..~a~ 6 to . ~ m. . „ s . w ws P P .m... v m. a ,.w , . e . .m. T.. „s. tea. , e.-.. . " 3 e i Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application /(1 Fees Paid: State ZS, County °'v D to C~ _ Permit Issued/Rejected (date) Issuing Agent Name Inspection Yes No State Valid# Date Recd 1. county (whit 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 /7` •E H 1 0 Rf2v. 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION: Section T YN,RL,~E (or) W, Township or Municipality Lot No. , Block No. County 'o_4~ Subdivision Name Owner's/Buyers Name: Mailing Address: 1` TYPE OF OCCUPANCY: Residence No. of Bedrooms ",-COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS G PERCOLATION TESTS L SOIL MAP SHEET_ NAME OF SOIL MAP UNIT h -~'1-'~' _ 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 AFTER INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- _ /11, - All- P- - t 3 IV" P_ 71 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 B- > oa B B- B- B- PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan thylocation 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. 17 .'e _72577 '~tJ1f z .rG _ i s E . y J- x i P, E a E - w + - I x _ s F 3 € £ 4 E e 1 pA ~IJ% Leh.: 1 E I E ~ ~ s ~ ~ I w. { 1, 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) f Certification No. _ Address .Name of installer if known I Copy A -Local Authority CST Signature - ~n 17 Iry ~ tSf/hEi✓% CrE/~lt~' ZA c 04 s TO WHOM IT MAY CONCERN: I hereby acknowledge thatI am granted a permit to install a new sewer system - drain field as proposed, it will be installed on what is now Jerry Street, Viebrock's Valley View Addition, Town of Richmond. This property does not belong to me, and I accept full responsibility for any consequences that may arise. I will also provide for it's installation to be the proper distance from the centerline of the street. Signed and Sealed in Presence of 'Ap. Sol James G. Heebink r' Tammy Ha ner Katherine M. Solarz 4-1 State of Wisconsin County of St. Croix Personally came before me, this 26th day of September, 1980, the above named R. F. Solarz and Katherine M. Solarz to me known to be the persons who executed the foregoing instrument and acknowledged the same. r FRAN(,Eg sic) 2SON Notary Public St. Croix County, WI My Commission Expires •J \W REPORT ON INSPECTION OF SANITARY PERMIT # (1) Name and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection me, ess, is a o. o n/ ing plumber Time of Inspection M N Add , 5n F/ (3)INSTALLATION CONSIST OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber ❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System BEN ermanen re erence oin 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: POSING 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 ❑ 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: