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HomeMy WebLinkAbout032-1049-80-000 0 N 0 K -v 0 w O o 3 try m m 'Cl a Z v c 3 w m ' K 0 2 n N co 0 o . In O w ~ v~ C O S _ A A cii N Ir. C\ cD ° A C O N O A O 1 N ~O N W rOn ~ O N O ^'S N C O u J A CO O I-r O O" I(U O -I O ° ° o is ° 3 D o a rn i~3 w F _ ro j y O O IA N ~ O ~ Al C (a < D CD a ° N U Q A C C ° S O O l a N ~1~~y N ao o N o a o T * * * * 3 mm. ° cn cn cn ° Qf~ m T o o U1 CD A m l~► ° sx t~ C m f(D cn Cr N N O N O O I~ ~ N z W z D a(D 0 Z . o (n CD m N o \ N -1 0 N _ ~ N C (D O W m O (D t6 O O p Z M 7 A z O n O Ic:~ o_ O c co -V m w CD `D ; z 3 P o - O 0 N z (D A W w a D _0 = , q Fn- ox N D C=) _ W g T G C O N z 7 fl' (D ° O O SQ ~ o O C 0 2 m (D v S W W O ? a Q a =r < o o c o O w o m o a a` a a o ° L(D Parcel 032-1049-80-000 03/23/2007 12:28 PAGE 10F 1 Alt. Parcel 17.31.19.249A 032 - TOWN OF SOMERSET ST. CROIX COUNTY, WISCONSIN Current X 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 - MURRAY, ALBA M ALBA M MURRAY 2130 40TH ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description 2130 40TH ST SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 34.000 Plat: N/A-NOT AVAILABLE SEC 17 T31 N R1 9W NE SE EXC P249B AS DESC Block/Condo Bldg: 825/262 & EXC PT TO CSM 8/2107 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 17-31 N-1 9W Notes: Parcel History: Date Doc # Vol/Page Type 07/31/2001 652586 1691/25 Ti 07/23/1997 612/336 435266 805/219 2007 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 08/09/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 60,000 133,700 193,700 NO AGRICULTURAL G4 11.500 400 0 400 NO UNDEVELOPED G5 1.000 100 0 100 NO AGRICULTURAL FOREST G5M 18.500 37,000 0 37,000 NO Totals for 2007: General Property 34.000 97,500 133,700 231,200 Woodland 0.000 0 0 Totals for 2006: General Property 34.000 97,500 133,700 231,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 120 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 y AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP SEC. Tj_N-R./9w ADDRESS 'r'~~~s ~C ST. CROIX COUNTY, WISCONSIN. SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 y,LFVEI_THING WITHIN 100 FEET OF SYSTEM ItIM, I I di a e oath Arrow I I SC LE: BENCHMARK: (Permanent reference Point) Describe: PO F4,:4' 4/'! z~ %Ga 000 Elevation of vertical reference point: o-'On Slope at site: (Cj SEPTIC TANK: Manufacturer: ell . iquid Capacity: " Number of rings on cover a nK manhole cover elevation' Tank Inlet Elevation: Tank Outlet Elevation: PUMP CHAMBER Manufacturer: Number of gallons Number of gal. pump set or a cycle gallons; total capacity o distribution lines gallon: size o pump head; gallon per minute horsepower bran name of pump and model number r Type of warning device HOLDING TANK: Manufacturer Number of gallons Elevation of manhole cover Type of warning device SEEPAGE PIT SIZE: um er o pits eet iameter feet liquid dept seepage pit inlet pipe-elevation bottom of seepage pit elevation feet. SEEPAGE BED SIZE: number of lines ~i th > lerggth' the dept SEEPAGE TRENCH: width lengtl PERCOLATION RATE f - A REQUIRED REA UILT INSPECTOR K. DATED1 PLUMBER N JOB LICENSE NUMBER 1""3 r I ~ • REPORT OF INSPECTION - INDIVIDUAL SLWAGL SVSItM Sanktahy Pehm.i..t- 7 State Septtie. A M E Tow n.6 h.ip tf~l~Di St. CnoiX County ocat.ion Secl -onaLo.t k Subdi v4-'e4' on - IPTIC TANK Size gattond Numbers o6 eompaatmenta (,s tance Anam: WetY BuiLd~ng 1 12% 6tope _ Highwaten LIMPING CHAMBER Size ptton4 _ ,Pump" Man actunen Mudet Numbers OLDING-TANK , Size. gattona. Numbek o6- g.om•pa4tment.6Pum e n p - ~ xa/t m Syc tem ietanee 64om: Wett Bu.itding 12$ aYape___ H.ighwatea IiSORPTI'ON SITE / Bed Tnh i (.stance 64om: Wett ' Building r2% exope H-ighwaten IiSORPT1ON SITE DIMENSIONS Width o6 tneneh 6t Req u,(ned area l t 6t % Length oA each tine----`-`, At Depth o6 hack below t-:xe_ <(Y_... n Numbers 06 t ine,6 Depth o A hack oven t, to Total f ength u6 tinee At Depth o6 .tiTe be tow ynade D.ieLance between ti.nee j At Stope u6 thench~ -_cn. pen 100 At a 1 u, u aLa o&1r CA.uYL a2eu At Type 06 Coven Pape. 0n e t a`w I ' It D I MCNS l ONS Numbers u6 PA, t,6 Gnavel an.ound p4'te yee___ Ylu Out,64 d~ diame,te4 it Depth b etow 4.ntet At Total abeonpt.ion area it Anea nequi led At NSPECTE _~?t TITLE I'PROVED~ DATE Z _ / 1981 I JLCTEU DATE 1911 IASON FOR REJECTION State and County State Permit # PL867 Permit Application County Permt,#T County for Private Domestic Sewage Systems *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # Mailing Address: A. OWNER OF PROPERTY S-1 - /LJ 7 B. LOCATION: - / ./4, Section L Z, T_ N, R'W 5., or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# r Village Township C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family _X Duplex No. of Bedrooms 3 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) i - E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area--C- sq. ft. New. Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (t'op) No. of Trenches Seepage Bed: -X_ Length ~_Width a d, 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 X 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 CerUfi d Soils /ester, NAME ~.1 C.S.T. # and other information obtained from 0"'ADZ (owner/builder). Plumber's Signature MP MPRSW# Phone Plumber's Address, JL'T / 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. i - t ' 4 ' _ a 7 a . , e a e ~ r ve t 1 t t _e t Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY _ Date of Application / " %-,k Fees Paid: State /4/,d2) County pZ) Date Permit Issued/R,je ed (date) Issuing Agent Names ~it~!4CiF/ i,I~.J Inspection Yes No State Valid# Date Recd 1. county (whhiitt~eTc_opy) 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 /78 115 Rev. 9/78 REPORT 07 =0- N to" .,S AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION:I~~'/4, ` Section i ` T~N,R_ _Lk (orl~~ Townships r-Mur►iripatity Lot No.`--- , Block No. County ubdivision Name Owner's/Buyers Name:_-t AA c~Yr Q r r o_\ Mailing Address: TYPE OF OCCUPANCY: Residence X No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS SOIL MAP SHEET c~ NAME OF SOIL MAP UNIT 14 Y 0-3 PERCOLATION TESTS TEST HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES NUM- DEPTH CHARACTER OF SOIL RATE SINCE HOLE HOLE AFTER INTERVAL BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN P- I' 10, 5 3% 3 YL/ 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- =r I, 13/~3 5 44 y _ z~ i o, Ir a, au) 3- '7 1.3 /01 3 1 PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the locationjand 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. ~O(E= r~Q4l° 17 ScS.(. 1 ` i-to G /1, ~'~p w t/~, Cyy ~ N 13~ t ~ .ra t , G E ~ ~1 ! I - 5 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) A ~ Aj v Certitication No. Address t-7 0 c;4 ('f o f<j C~ ~o a~ o f S y cs l Name of installer if known CST' Signature ~~~='~,j•- Copy A -Local Authority SGl3116CES rts" ip'gr r" unrc3 ti _OCAT4OP1 _-.Lr (or) ViVt Tovi a, . _ 6 d r$ Lot E! -Ck O. a,uclav{s.o~r~e TYPE Or- OCCUPANCY: Of ec-Iro» m,_.~~-_ , E E.9 q~nTs-Y ~°57 Er.~.~ - OT 1-1 - Er{= ~.~:"cy~' ®~SP~s~: 5~~~~-~{.~r:~, ~a EI^J ~rc~1~.c ~rp~E w - ~ -_~r-~~aya_T ~f~r R , »n c~.~~T DATES :EC~3/l~ m 10,71S MADE: ML N1AMlE0 7-SOILrJAPU 6'9rir PEMMIL-ATMN TESTS - CF Pi n~ EF)T TVN9E 020? tr) V.ATCR i-f a F! 1- TCST IL r p~ OVA C 7,,, _ ~FOIL r - 1M a [ C3~, 19 pr~l NUM pN PMU a C3 Psi s_r V11 T , c I d P ytl 3 21 BSI NA 11 5 1~_r,01r1ING arStS C i 1ArlAc, En c.= °c?%! t°11T i 1 t Fac' , 3 c,OLI, TEST AL E EPnilUCP'6H 6®CariflS9N~7VJAVCftPR1cfi ~S n !Iv'.C,L=v ~ ~m N IV, c R 1 .1123 cE: .11111:0 ~ES a mIATED I Hr-HES IF 001SIZ .n M pg _ s A PLtlir' V12',J (L ecalc test,, s911 r_cre hones and s{1{t :k,Ae sots area") Indic-Ite on The pinn the fens of Cr}r : a a ,,.a „k cr G+ ®'~ryuara G' a" ~G; ta'iio a area m cdcd for hquiHing 1:vp a and occurp3ncv r-r• ° K ..fSlY V:~.J t~GYac.•tca Eiid l1Gwt!::. il uG»G~~.tG3 r;c1'+~c>o E4C!~'"'-" Slu3C73., s t i. ~ a kz. • } 1 } ~ I a w i- VI t ; t T. f SS ~ r h,1 C •f-~1' U101 t-,3 tdl tCitS fcpcy-tct' on tlNs form vic7c Palo L-1 C3 in ec A ,J 17 1p t.:3 6Yv C e11 tc3. t ...._J C v:..., C~i~~ t: c`iY Ua C. C'. C_.1C.... LJ t.L 3 L ✓tr.~v.t.. 1'.J rcc nd c. t:,n b•v;!cf! ,3 .1 f ; ~ ° r~ C r' a __a~. P,^.ar:3 LJ 7tiilcatic ~ f N,anno of inst^_99c7 if l':nocjn.- - - ~ - CST Signatira _ " - - - -r - .4 t Y Ix~ y i J Ray. 9178 REPORT ON SOIL BORINGS AND PERCOLATION TESTS R' WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES ; a.'# P.O. BOX 309, MADISON, WISCONSIN 53701 U_J~,-ATIO4:Aa% ` s' Section __~=,T LN,R 1i (or) W)'Township br-Murridr1'aU3y`___e ' •1_t~t 1110, --.Block No: r ; 3 V County u ivision ame Otas:t.r's/Buyers Name: a ` y ze ' i d u- t 4 e It;xiling , address: 4, TYPE OF OCCUPANCY:: Residence No. of Bedrooms.. E EFPLOENT.,DISPOSAL SYSTEM: NEW , f REPLACEMENT ALTERNATE SYSTEM.._. , _.~OTHER DATES OBSERVATIONS MADE: SOIL BORINGS -T PERCOLATION TESTS ` SOIL MAP SHEET NAME OF SOIL MAP UNIT PERCOLATION,TESTS TEST HOURS WATER IN TEST TIME DROP iN v1A7ER LEVEL, INCI{c NUiU!- ~ ' ~ 'CHARACTER OF SOIL T~ ` 14L'S THICKNESS IN INCHES SINCE HOLjf" HOLE AV-Tffl 4 IrRVA`L ' 1~lifN/Ir. ~ BEE INC IST WETTED SWELLING iN MINUI ES PFRIOD I PERIOD 2 PERIOD 3 r - J p f e - ! \ SOIL BORING TEST'S TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH 'r4iCKNl SS, (rLOR, k NUMBER RUCHES TEXTURE, Nio- TLi]NG AND UJEP'rH TO BEDROCK 1 • OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES Ali- I ~MU P 4 I ~f.n t..~'Y.~4 ~ d y ~ 1 B t C y : k. $ i - - A .r._..~..~. 'PLAN VIEW %,gcate percolation tests, soil bore holes and suitable soil areas.) indicate on the plan the locatior anti square feetzsE suitable r~aa"~ !ndicate number of square feet of absorption area needed for building type and occupancy:. Indicate scale of cl:.Aances.` Give horizontal and vertical reference points. Indicate slope. j- J !i jjy{y , t L.....h. _ . i u,. ° • £ w e I'_ 8 E ~-i 4 b I 1a f, l @ 1.4rt .per4,IY / y~ d dr , ; 5 3 1 Y I` ~I gg _ 7 7 tf I ) i q I' .as~z ~ , _ ~,..:..,..,}..w.-.~ ..E~-_. y~....,•.. t-., ~e~La. ~:c-rQ srrr,...~„ ~ >-,~~...v:do:.e..t-. '~ta.i: . ,wr4 aw.vf,n"ir•...nKO..,~te,«„G • - 4 ~.,~.«...4.^..- ..1.=.. I.__..... .w. a-, .~.Z.. ..d_ ~.E _.i ..aT .-r.....t.1..... ..f..~ V t SP' i d4 # I ~ ' { _ fie! J 7 -r, r, rVr a...«,..4.- _.+ys"` b.r a .n.rt+x,+a..,+.+..r,. '.~~e •7"G•"'~ '7 f a, P ~ p l ~ I, 1 y ~ i I•~ lr ~.,r~... y ~~~-t~<..jr'T . 111 y% ` r 1, the undersigend, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and rtetthoCs specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my 71 knowledge and belief. 1 1 Name (print) Address Corti ficatioxs 1q ; G ~ f t i y•r.i •g,.• ~ ~ r), ; ~ .r*~.~..4 .t,,.1 f e x ..•-•--w' Name of installer if known CST Signature L;" Copy C PIr:?pcvty Owner u REPORT ON INSPECTION OF SANITARY PERMIT (1) Name and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection L Time of . O Inspection ,-Name, ress, icense oo instal ng-plumber. 3 INSTALLATION CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber ❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System (4)BENCHMARK: (Permanent reference Point) escri e: 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: M 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 ❑ 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? ❑YE5jNO (13) Has system been installed in floodway? ❑ YES ❑ NO Floodplain? ❑ YES ❑ NO DILHR-SBD-6095 N.05/80 Signature of Inspector: 1`3/ A/, )Pl YA/ Sr . l~~r~c 6"5-10 7 Na~Crf1 Parr Son ~ ~ s ~T .G1cuf f ~ i~/E ~d ~ Q ~~aJ.,.X TO ~4 r