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HomeMy WebLinkAbout030-1093-40-000 0 ~0 O 9 d o p ~1 3. n r* (o m o m • CD o c (D d rr O n O cr O ]~/1 N) W CD 3 o Co O O m o W° ..r CD O(D O - .7 Q z n to ~I 7 N O ..y O ^ D z N ~o (D w N Q O O 7' co O > O ~ ~ O 0 CD N J 7 O O N N N O ".7 y CD N n 0 ~A d `G CD ul 0. C CD F~ N y ? w m C) m { (o a (o N n r U) N co co 0 o c r. a v 0 0 0 V'• Iz O O O a cv IT 0 D v v v O O ICS (D CD N a 0 m ID O (D w hJ ] _ O z zD W Q O o a CD En cn ~ c N (D (D co n O t1 J Z N Z CD a A z O J C o N W CD < G , z 3 a o z m N z C A W O N T ~ Lm C O O IZ O III ~s 0 v o a X W A m n Q (D N d N O O to A O ~ En O N .a 0 ° 3 Parcel 030-1093-40-000 03/21/2005 10:41 PAGE 1 OF 1 F 1 Alt. Parcel 32.30.19.341C-1 030 - TOWN OF SAINT JOSEPH Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner FOGELBERG, BRUCE A BRUCE A FOGELBERG 472 CTY RD E HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 472 CTY RD E SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.400 Plat: N/A-NOT AVAILABLE SEC 32 T30N R19W NW NE LOT 1 OF CSM Block/Condo Bldg: 4/1012 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 32-30N-19W Notes: Parcel History: Date Doc # Vol/Page Type 12/20/1999 615780 1479/220 WD 07/23/1997 909/622 07/23/1997 728/578 2004 SUMMARY Bill Fair Market Value: Assessed with: 5562 191,700 Valuations: Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.400 98,900 89,700 188,600 NO Totals for 2004: General Property 3.400 98,900 89,700 188,600 Woodland 0.000 0 0 Totals for 2003: General Property 3.400 58,100 71,100 129,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT AXiER TOWNSHIP - SEC. T N, R W O. ADDRESS ST. CROIX COUNTY, WISCONSIN. .'3DIVISION , LOT LOT SIZE • PLAN VIEW -Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM f t --j lj ~ I F i y I• f i i = f Indicate North; Arrota (SCAL$ . j-C-r--- tPTIC TANK(S) MFGR. CONCRETE STEEL NO. of rings on cover / Depth DRY WELL `.tl:NCHES NO. of width length area no. of lines width length area • depth to top of pipe aSREGATE RATE; AREA REQUIRED AREA AS BUILT lisclaimer: The inspection of this system by St. Croix County does not imply complete .%:-pliance 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 IStem operation. However, if failure is noted the County will make every effort to :itermine cause of failure. ,TEASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. j `INSPECTOR DATED PLUMBER ON JOB LICENSE NUMBER - z REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM San.i•taay Penm.i-t 080 ` State Sep.t.ice? NAME &a 1 ^ ~P,`Tawn4h.ip s"f, J aSeT_5~. Cn.oix county Laea.tio►~r Section SEPTIC TANK Size &e ga.t.tona. Number o6 Compan..tmen-t4 DiA tanee Fn.om: WeZt 6.t. 12% on gnea.te,% a.topez-I 6t Bu.i.td.ing 6.t. We.t.tand4 6.t. H•ighwa.ten. 6t. DISPOSAL SYSTEM D.i4-tanee F,%om: Wet.t 6.t. 12% oa gn.ea.ten 4.tope , 6-t. Bui.tding ti 6.t. We.t.tand4 Ft. H.ig hw a.t en. 6t. FIELD DIMENSIONS: width o6 thench 6.t. Depth o6 noeft be.tow..t.ite / in. Length o6 each tine 6.t. Depth o6 n.och oven. .t.i.te ~ in. Numbers. 06 Zine4 Depth o6 -t.i.te be.tow gn.a e gin: Tota.t •teng.th o6 Zine4 6t, S.tope o6 t Leneh - in pen 100 6.t. Di,6tance between tine. 6__(- 6-t. Depth .to'bed)Lock 6z. To#a.t ab4 onb.tion area ~4 6.t2 Depth to gn.oundwa,tea 6.t. Re4 - 2 ui,%ed an.ea > 6 , Type o6 Coven:. Papen Q,% S.tn.aw PIT DIMENSIONS: Numbers. o6 pitta GnaveQ an.ound p.i.t4 yea no Ou•ta.ide d:iamet:aP-a& Depth below .in.te.t 6.t. To.ta.t ab4 on.b ,Z/ea_6t2 , Anea %equ. 6.t2 rn INSPECT By= TITLE I° A ROVED , DATE 197. REJECTED DATE 197 S aw a«.+.+.«w.w'~Yii'Y➢wanlYxYnr., ..,--.._saew... E I P•' 115- 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 , Section-$' Rf fe{ 1 W, Township ztr-MF y JT S 2 Lot No. , Block No. P-14V Yi= y County ST G2~~ix Subdivision ame Owner's/ yers Name: L)e(L i d Mailing Address: C' f TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW _REP ACE ENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS SOIL MAP SHEET NAME OF SOIL MAP UNIT ©A)AMii A PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS rWALTER N TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM INCHES THICKNESS IN INCHES SINCE HOLE E INTERVAL MIN/IN BER 1ST WETTED G IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- t Ste j=- fi% Ce = am i- E YL I I P- - r i ;3 P- 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 B- I 86 M6AZ L5 15 ,309 Pik- Dn LS B- Z ~r!}c 7 £G LS L , B- ONE 8 i LS T-5 ` 3r, I- ° O (55& 9 B- S, B G ~tJc >8~y~ Bi L 5 5~, L S t3 2 C B- & At y /a la l f~ 38'' 3,1 L !3i L N J 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. LE 1h•aID I e b~c o r= E w S r/'06 Al Q Teo/✓ i J e,ENC.H 1VWK 83-3 1.3 E E N 3 Z" E w 6e F , I, the undersigend, hereby certify that the soil tests repor is 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. Nar-s (urint) f4 Certification No. S~ - Address ~ EE A Ac,0-so !Name of installer if known CST Signatur , Copy A - Local Authority r PLB State and County State Permit # Permit Application County Permit # sd v 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: !e v L 6/0 1)_5 C, el 00 B. LOCATION: / Y4 '/4, Section _32_, T_30 N, R.Ly E (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village CGC, hlTli h~ it Township 14S C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family X Duplex No. of Bedrooms ':77) No. of Persons D. SEPTIC TANK CAPACITY 1000 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 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: Length _Width. Le! Depth Tile depth (top) No. of Lines Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land- 6t !1 O 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 Test , r NAME _,5' 04 IE- U C 14 C.S.T. # -SS and other information obtained from G [ (o, caner/build Plumber's Signature MP/MPRSW# l f Phone #3 96 'Ys Plumber's Address O / o , 42 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. 3 i m {r~v's V 112 jTW Kr g y 7e coo GOL SEPTIC tlL..' /t~fa,ao ~ /C . ~ , 3 r 1 ne _ w_ P F Do Not Write in pace Below FOR COUNTY AND STATE DEPARTMENT USE ONLY C~ Date of Application - Fees Paid: State/-5-. County C di Date (C 0 G Permit Issued/#t*e4-&4 (date) c (f ~ Issuing Agent Name T- •T,- e- -2✓ Inspection YesX_No State Valid# Date Ree'd unty (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 to (pink copy) 4. plumber (canary copy) Revised Date 7/1/78 LB 67 State and County State Permit # P Permit Application County Permit # 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: A B. LOCATION: Alz-, '/4 :ys= Section T'7c' N, R E (or) ((V1; 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 31 No. of Persons D. 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 or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate - Total Absorb Area-4/sq. ft. New X _Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: Length 34-Width ~(•5 Depth Tile depth (top) r'' No. of Lines Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land f 7 ~ Distance from critical slope WATER SUPPLY: Private ❑ Joint 0 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 Ll ,NiYfs T[',.~%//C.C'.SC._.~i/ S. T. # •_i 5% and other information obtained from r ? owner/builder Plumber's Signature Phone MP/MPRSW# Plumber's Address 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. jyi~ N i Cusp Poe ~ ~ `)ITCG/ C~ fj ro ` if t fi ?Gi~i~~ L. t .1C l } , L , E lL PA -74 j i1 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 Rec'd 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 PLB 6 7 State and County State Permit # Permit Application County Permit # 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: B. LOCATION: '/4 Section T_ N, R_ 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 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 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: Length Width 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 ❑ 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 C.S.T. # and other information obtained from (owner/builder). Plumber's Signature MP/MPRSW# Phone # Plumber's Address 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. € t ? ; E € t 1 = ~ m r 7 , e , E ~ m3 r ~ r r ° ~ I a e 1 E ~ I d ( ~ i 3 e f , , , t_ . _ v~ s t r i 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 7/1/7- State and County State Permit # ^P 67 u w Permit Application County Permit # 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: B. LOCATION: /4 Section T_ N, R_ 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 Poured-in-Place Steel Fiberglass Other (specify) New Installation Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-PlaceOther (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: Length Width 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 ❑ 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 C.S.T. # and other information obtained from (owner/builder). Plumber's Signature MP/MPRSW# Phone # Plumber's Address 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. ( , Yt j' t , f , ~ # 3 m P t t i ~ , } t f 7 , $ I , . a e. ~ .w _ m,. r ~ .,....s _ w„e _ s _ M... e 4 .....m. ...,,e E e e m _ e _ 71 - I 7 , f 3 ~ f r , r 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 state (pink copy) 4. Plumber (canary copy) Revised Date 7