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Home My WebLink About034-1084-30-025 c tn p l d c `+1 3 r. o ~A m ID CD 3 3 rr T' o z v- N) C- 0 co N o O 0 O w N toil v O _o w • C:D o Ca D CO 7 rn a z a N w O o (D y N N W N ? a O n W O (D (D CD o o D ro ° 3 fD cn 3 N CD I O O CT N U) l< C = (n c D a N CL ~ (E- cD N W ww 0 C) CD u " m rn O w CD W a' "Imft, D N C)~ y Or C N Z ? lhl~ * * * g III fn fn fA IV - N t7 v v, ? V O CO rl) O_ d a v N _ N O N N 0 3 m A CL N DWO p v O f1 =3 CD N N CD O N CD CD w ~ a Q ~ 7 Z CD -1 y O = O A Z N c ;u A Z O v CL C) o. Z -1 N W -0 m N CO w `D 0 z 3 cn o N CD N A I ~ W p~ to U) > 3 N N CC 3 O N CD N C SU N O a CD N. O a N N n O 7 X, cO A p N _ CD N N I i X q 'Z! i CJ1 CJ A CL tS ~ Od CD O H O O N O O CT O 0 A _D CD DO oho O o I o Parcel 034-1084-30-025 09/15/2006 04:53 PM PAGE 1 OF 1 Alt. Parcel 28.29.15.556A-10 034 - TOWN OF SPRINGFIELD 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 WESTLEY H JOHNSON O - JOHNSON, WESTLEY H 2934 73RD AVE WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 2934 73RD AVE SC 2198 GLENWOOD CITY SP 1700 WITC SP 7059 SPRINGFIELD SAN DIST #1 Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE SEC 28 T29N R15W E 1/2 BILK 9 LOTS 1,2,7, Block/Condo Bldg: & 8 VIL HERSEY ALSO THOSE PTS OF ABANDONED 74TH AVE & INDEPENDENCE ST Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 28-29N-15W Notes: Parcel History: Date Doc # Vol/Page Type 10/15/2003 743686 2435/581 MISC 06/06/2000 624311 1516/517 TI 07/07/1978 349999 577/245 WD 04/25/1974 321474 510/124 WD 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/03/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 4,200 60,000 64,200 NO Totals for 2006: General Property 0.000 4,200 60,000 64,200 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 4,200 60,000 64,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 132 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 034-1085-10-025 09/15/2006 04:27 PM PAGE 1 OF 1 Alt. Parcel 28.29.15.559A-10 034 - TOWN OF SPRINGFIELD 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, WESTLEY & MAXINE WESTLEY & MAXINE JOHNSON 2934 73RD AVE WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description ' 2934 73RD AVE SC 2198 GLENWOOD CITY SP 1700 WITC SP 7059 SPRINGFIELD SAN DIST #1 Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE SEC 28 T29N R15W LOTS 1,2,3, & 4 OF BILK Block/Condo Bldg: 12 VIL HERSEY ALSO PT OF ABANDONED UNION ST & 73RD AVE Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 28-29N-15W Notes: Parcel History: Date Doc # Vol/Page Type 10/15/2003 743686 2435/581 MISC 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/09/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 3,950 14,750 18,700 NO Totals for 2006: General Property 0.000 3,950 14,750 18,700 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 3,950 14,750 18,700 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 I I LJ 'I T7 ~ 1h 7 . G Zm_ obi / / r, f= I I , s -14 66 ~ ~ r ~ ~ Vii: ~ • ~ ~ . 66 C w _ 111 ~ - O ICI 1 ~ ~x ..L~ ~ntc7re.ei+t 1 V .7 r I~j - T j s of - --~z-- i n, o a I i S 4 G ` P ji c \ s ca \ c C ' J i AS BUILT SANITARY SYSTEM REPORT OWNER ~ Lj"' SLC`f -,~CH/Y~("/ , TOWNSHIP ►~i'>,ycFitly SEC. T~ N, R W ADDRESS R T &JiL k-al ST. CROIX COUNTY WISCONSIN. SUBDIVISION l9~°..: LOT LOT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM t~ acv 77- .10 r I }ddipaa~t-e- ozthj Arrow S CA' LE SEPTIC TANK(S) MFGR. t&)t iC,vt>4 &,9L, CONCRETE - -STEEL N0. oT rings on cover Depth 10'" PUMPING CHAMBER SIZE PUMP MFGR. MODEL NO. GALLONS Per Cycle TRENCHES NO. of wiJ- length area BED NO, of lines width j ' length 43-/ area JIL dept to top o pipe '>0j• NUMBER OF SEEPAGE PITS Outside diameter total pit area AGGREGATE PERK RATE` AREA 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 DATED PLUMBER ON JOB 21,M~~ LICENSE NUMBER M Pies ie 410 • AS BUILT SANITARY SYSTEM REPORT TOWNSHIP SEC. T N, R W 0. ADDRESS , ST. CROIX COUNTY, WISCONSIN. • .-3DIVISION LOT LOT SIZE • PLAN VIEW -Distances b dimensions to meet requirements of H62.20 SHOUT EVERYTHING WITHIN 100 FEET OF SYSTEM i i! I kw_ 1 i a I I J 00) i I } } I ! } Zridicate North, Arrow i i - SCALD . ~ f tPTIC TAN-K(S) MFGR. CONCRETE_ STEEL NO-of rings on cover Depth DRY WELL TENCHES NO. of width length area no. of lines width length area depth to top of pipe a&REGATE ~ ' , ?'RE: RATE AREA REQUIRED AREA AS BUILT iiSClaimer: The inspection of this system by St. Croix County does not imply complete .copliance with State Administrative Codes. There are other areas that it is not possible ,o 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 ;jtermine cause of failure. ,rEASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. `INSPECTOR DATED PLU:SBER ON JOB LICENSE NUMBER Z . REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM San.i.taty Petm.i.t State S P p.t.i" ~ NAMFC Tawndhi Cnoix Count N ( R 1 Location Section SEPTIC -TANK 2~ x Size gatbond. Numb et CampaKtmentd I Pidtance Fnom: Well S 12$ on gtea.tet dtope S.t Building Wettand.6 Highwa.tet - ~ . DISPOSAL SYSTEM Di4 Lance Fnom: Well 12$ an gteatet d.bope 6.t. Building /L it. Wetbandd - Ft. H. ghwa.tea 6t- FIELD DIMENSIONS: (Vid.th o6' -ttench, r% it. Depth o6 tack 6etow, tile .in. Length of each line it. Depth o6 tack ovet tile in. Humbet, o6 Zi,ned Depth o6 tile below grade Tota.L' teng.th o j tine. 6' % it. Slope o6 _ .ttench in pet 100 it. Piz Lance between- Zined~ .t. Depth .to'b.ednocii ~ . Total abd otbtaon anea rf. `i t2 Depth to gtoundwa.tet Requited area 6,t2 Type. o6 Covet: , Papet of -S.tAaw PIT DIMENSIONS: Numb e4 of-, pi-td~7 GAave4 around pi.td yed no Ou.ta`.ide diametek it. Depth b etow inlet it. 1 'Total abd otb.t:io anea 6t2 , z Area 4equ.i4ed2 rn 71 __6 INSPECTED BY-~"`' T17'LE APPROVED-. / C. C" ,DATE 19 7CL REJECTED ,DATE 197 wmyewpo,.vsy a«.+erav.«s,rru.mwr.++w»twx+~MmMtw ...,w.h+.w.+4di,..v._.,«...,....., I r~ PLB 6 7 State and County State Permit # 40 k Permit Application County Permit # for Private Domestic Sewage Systems Countyt *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. LOCATION:1 t Y4 Y4, Section 't , TN, R i E (or) 1N Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township 3 l'/)7/N( / ,/%i i C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family Duplex No. of Bedrooms 7 No. of Persons D. SEPTIC TANK CAPACITY ! f 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 X Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify) f E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate t~ Total Absorb Area sq. ft. New Replacement \ Alternate (Specify) Seepage Trench: No. of Lineal Ft. ~i~ Width Depth Tile depth (top) No. of Trenches Seepage Bed: A Length Width -la Depth Tile depth (top) T No. of Lines 2 Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land- y ) ( r z-`/ Distance from critical slope WATER SUPPLY: Private N 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 ly, l; AK /)i/l i11-Z,SZAD C.S.T. # 5 and other information obtained from /Y /V .,y _ (owner/builder). _ Plumber's Signature MP/MPRSW# Phone #I(. Plumber's Address r 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. 164 T 1 C z IMF 4A 7, is TINt- 177 E , 73 ~occ c Al. ~ ~c, IAn~ t G A5T j li«iY j~l Y~~ -Aff by/Sr i. :t4 )IM SATE 1VfA1 s -tZ Do Not Write in Spac B w OR COUNTY AND STATE FARTMENT US~pW Date of Application Fees Paid: State/ ~f County 7 Date Permit Issued/Rejected (date) Issuing Agent Name, o State Valid# Date Recd opy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 Y) 4, plumber (canary copy) Revised Date 7/1/78 FEW 115.Rtov. 9/78 • REPORT ON SOIL BORINGS AND PERCOLATION TESTS ~ WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 i'' r LOCATION( ✓1 1%~f Section ,T=,N,RLZE (or)~W, Township or Municipality ~ Lot No. , Block No. R f l County S /7 L X-30/h Subdivision Name Owner's/Buyers Name: t /byS( /y Mailing Address: ~7 TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENTZALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS 114A PERCOLATION TESTS 1141141Y SOIL MAP SHEET NAME OF SOIL MAP UNIT - PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL., INCHES RATE NUM- SINCE HOLE BOLE AFTE INTERVAL MIN/IN BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 Ne A) P- NC.. 1Z V o P_ 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~ L:CAM C5 7& 5/ )NP C -S,9 IVa 74 B_ W i. (7, e- B- Cf_~ Vii' ,p= 7 sz- w PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the Ian the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy ~4~• R_- *Z-P&Dindicate scale or distances. Give horizontal and vertical reference points. Indicate slope. ~/3~ a 1 rv~ € ~9 i lw.a. 1 € 4 i r I F° t ~ ! w~ I t~ ',w.....m ,ems.... ~ } w..,. . 9 ~ E i E V r 3 r F I € E .e A lbo E u _ ,w.--- _ i E 7 I I~ 0 / O F1 p E A~I7 s s `f B i Y IL _ i < e _j J g F p S ~ # k a a e ` S z e s 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) LL L E Certification No.- Address. 12-P L .S _ ame of insta er if-known H[ L) ZM I TLL SLAD% l CST Signature~~- opy A - Local Authority