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HomeMy WebLinkAbout028-1034-90-000 n fA o m m 0 Cy c ° (D f 0 ,g 9 (D m ro o z . :r S11 3 N C O v ro N~ I~ u) (n W CD 7 O ro ro V N 7 OD , ~F T- 03 N O- 3 m O , Cp C) a- C: CD (n 0 0 0 ro 0 7 0 (n co O A~ 3 ! o ° N N co o p O1 oc N O r~7 !V ro U) D cv ro n CD ro N a :D cn 03 O o 20 CD (0 CD C- ro (il 0 OD cn C z O O O ' !fir co o < z O V~~q 0 °Q 3 to cn to N o D v v o O < K N ! A ro ro 3 d ~ N ro N ca. z ° zco z D ro o v ° O h o' l CD CD N CD N !V C= CD CD N C1 n 3 ET I z CD Cp V1 O A z n m c CL A z 0 co m m z 00 0 A Z1 o z N z CD Cl) I D C1 Q o - I n~i c z a o CD N t A O N O O ~ V A N ro m ,rnO 0 v N a : Parcel 028-1034-90-000 01/05/2007 11:48 AM PAGE 1 OF 1 Alt. Parcel M 26.28.17.214B 028 - TOWN OF RUSH RIVER 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 - PIERRE, PETER & SARA PETER & SARA PIERRE 1912 18TH AVE BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 1.150 Plat: N/A-NOT AVAILABLE SEC 26 T28N R17W 1.148A IN NW NW LOT 1 Block/Condo Bldg: OF CERT SUR- VEY MAP IN VOL IV PAGE 969 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 26-28N-17W Notes: Parcel History: Date Doc # Vol/Page Type 10/29/2001 660318 1747/483 WD 07/23/1997 1219/241 QC 07/23/1997 1138/307 WD 07/23/1997 743/584 2006 SUMMARY Bill M Fair Market Value: Assessed with: 166160 165,800 Valuations: Last Changed: 08/30/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.150 21,500 133,100 154,600 NO Totals for 2006: General Property 1.150 21,500 133,100 154,600 Woodland 0.000 0 0 Totals for 2005: General Property 1.150 21,500 133,100 154,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M 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 ] ©;s e r TOWNSHIP ADDRESS SEC. C6• T28 N, R ' W 1-1nmm0igjj )"41 , 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 F r N el c Cy _ V 1 ' I di, ate o~thj Arrow S CAL t 24"ke"' SEPTIC TANK(S) MFGR._ CIINCRETE- ! STEEL NO. o rings on cover Depth PUMPING CHAMBER SIZE PUMP MFGR. -IX " riJD-EL NO. GALLONS Per Cycle TRENCHES NO. of width - length area BED NO. of lines width /2- length ; Ufa' area 2,:~0 depth to top of pipe NUMBER OF SEEPAGE PITS Outsi e diameter total pit area AGGREGATE PERK RATE AREA REQUIRED 9-15-f AREA AS BU-LT 96'af 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 SYT-'. INSPECTOR DATED - f'-JAL? PLUMBER ON JOB /LICENSE NUMBER - , asNaol'I Of No u3fi3maa aazva uozoaasn, ' 'RIITSIS SIHT 110IIoulu Q3SOdSIQ ag TON GIMOHS S'IZO Qtr SHSYaj' •ainTTe3 3o asneo auT=a:p, 03 aIo33a XJaAa ahem TTTM AZunoo agl pazou ST aanTTs3 3T 'laAzmOH -uoTluaado majS~ a03 KITTTgVTT ou samnsse Alunoo xTozo -IS •uoTjonaisuoo 3o iuzod sTg1 Ie ;aadsuT aTgTssod IOU ST IT :jeq-j saaae .zaTpo a.ze azagl -sapoo aAT:jez:lsTU-,wPV DIVIS g-3TM aoueTT&o' a3aldmoo ATdmT 2ou saop Alunoo xioao -IS fq malsis sTgj 30 uatjoadsui aql :aamTelosil izing Sv vnv Qaaifibu yauv ama nt . azVOau~~ adid 3o do3 o1 g3dap Ease 4-32uaT gjPTM sauTj 3o •ou r ease - gi2uaT tPPTM 30 -ON SUOMI. ( 'I'IaM MQ q:lda(I aaAoo uo s2uTi 3o -ON Zaais azauotloo -uo t (S)mm oila) 11 Ds rioaay !tp, OR a .uazplui L-L 3 i a i i i i i _ R ' RaZS,Is do zaaa 001 NIHSIM ONIHTkuaAa MOHs OZIM 30 sauamaJTnbai laam o4 suoTsuamTp 4 saauEIsT{I- MH IA NV`Ia 32IS 1011 ,LO'I NOISIAIQU 'NISNOOSIM `XINnOO XIoda 'Is ` SSHaQQb '0 M 11 IN Z 'Das aIHsmmol ZaOdaa WaISIS kUVIINVS Iging SK • REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM i San.i.tatsy Pe4mit ~y 7 State. Sep-t.iet-A. f/ *7 ~~~►~y__ Townhhip I St. Croix County Location N(k)Sect ond& Lot # Subd-iv-i/5ion SEP-TIC TANK Size ~/Q►-~ gat tons Numbetc. o6 eompatLtment/ Di/stance Atom: We2f xy, A/ CZ/ Buitding / j- 1.2 0 5tope Highwatetc PUMPING CHAMBER Size _ga to P p Manujactutcets Model Numbers HOLDING TANK Size ga tons mb is ompa tment6 Pumpers t rs S 6 em Di6tanee (,nom: Wett u,itd~ng 12% tstope H,ighwateA. ABSORPTION SITE Bed _ Ttseneh - yz D.iAtance /dam: We~f .,Al Bui eding -12% 5 tope H,i.ghwatets ABSORPTION SITE DIMENSIONS Width o{ tn.eneh _6t Requitse.d a4ea ~t Length o o each fine- 7 41 At Depth o6 4o ek below' el.ow tiU i,n Number oA kti4q.e5 2 Depth. obi tcock oven Life 2- in Totae eeng-th o6 tines At Depth o6 tiee betow grade o7~' in Dti6ranee between fine/s li 6t Stope o6 ztsench tin. pen 100 At r Total abtsotsp,tion arced At Type o{ Covets: Pa.pets o 3ttca R PIT DIMENSIONS Numben.QA,.pi t~ Gtsavef atsound pith yeb no Out/side diametetc Depth betow inZe.t At Totat abtsotsption arse'. Area nequ,ined At INSPEC TITLE APPROVED DATE /O/Z 1980 REJECTED DATE 198 REASON FOR REJECTION _ c B kit's Plum6ing and Heating Plumbing - l leating - Electrical Baldwin, 'Asconsin 54002 r 4' 4' 10 ,3 F r CIO i t By r 30~ ? I } I 413) 1310 P4 + ~I t 1 60 104 ~pk ; ` a` ~ ~ i ,fit. pe4 I 17 I _ I E H ' 115 k,, . 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS i ` WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 17 LOCATION: -✓l-A-2'/4,~'/4, Section-,2 6,T N,RJ1&(or) W, Township or Municipality /lyS v r 2 Lot No. , Block No. County ~.Ra /x ~ Subdivision Name Owner's/Buyers Name: oS s K /U. } Mailing Address: OA &70 )'V w~ TYPE OF OCCUPANCY: Residence X No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW _X REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS ~d PERCOLATION TESTS - 6", SOIL MAP SHEETS _ NAME OF SOIL MAP UNIT clew! ~ f PERCOLATION TESTS TEST DEPTH e CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL MIN;IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- / o . 5 , v S , L,,, o if 54 6 11 o / z 2 ao P- (5Z 1,~Ro 7 of A~L '30 /AL P-3 if if rr 0r/ D / oZ0 P- p t n 11 If P- If e/ t l rr O 3 P- d u l/ P Q r V g 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 Q rr 4 B- r' if 4 r/ it tr B- r' 4 If If aA. B- r i m If O rr If q e/ f~ t( B- it +t y If q r, r~ r/ ! . B- u D I/ t~ y !t PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan a locati n and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy `s Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. / 9t 40 k a z b 83 { 6,4 45, - 97/ Bz E t'J E E 3 ~N E r .wm f a' ) E a z a s a ci ail 70-CV AJ 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),-. Certification No. Address L Name of installer if known C)C Copy A - Local Authority CST Signs ur PLB 67 State and County State Permit # ~ 1V el ,f Permit Application County Permit # ,QD 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: Ro S S / t e q ,5d A) '1~5,g ,G c /W / ~J 1 6Ji S B. LOCATION: IVW'/a IVk-) '/4, Section e~ T N, R @ (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township bsj / ✓6i2 C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family _X Duplex No. of Bedrooms 3 No. of Persons D. SEPTIC TANK CAPACITY /OOp Total gallons No. of tanks ©/✓e HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete X Poured-in-Place Steel Fiberglass Other (specify) New Installation X 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 ~TaJ-sq. ft. New X Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenc es Seepage Bed: X Length O 1 Width 1A Depth Tile depth (top)-No. of Lines 44-20 Seepage Pit: Inside diamvve~~ter Liquid Depth No. of Seepage Pits Percent slope of land ! Q Distance from critical slope 1'VATER 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 oil Tester, NAME✓Cee - J )4 pi(sc~T- C.S.T. # and other information obtained from 12 (owner/builder). Plumber's Signature MP/MPRSW# 6j.9-4499 Phone #715`6.911- Plumber's Address r 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 i 5 , i F i Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application ~Fees Paid: State .~y County - ,date ef 'pal - Permit Issued/Rejected (date) P6 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 J