HomeMy WebLinkAbout040-1179-30-000
n v, p v 0 r~
C7 `rl
o o
y f c ~ ~
(D m
v
a a (D
n
3
U) ~O N O 00 Cf) j O A?
117 3 CO I''. , < N
S _ ~~11
O H•1
fl Z o N -I 1
~ C
0) p O ~ n
C7 V
N O m m
CD- 7 O fll W O
CD M
c 0 CD CD
3 N O r•
7 to ~ O Q
to ~ Q
LI CD 0
cn A m a o
CD CQ N W G CD
r
(D cu
0 C) =3
4 m CD
°
3 c
O o =
i rn co c
a
N
O 0 OD 03
7 f/1 O C
CD
v"0 vA
n
Z o o o
cn C/)
C) cl m ¢ I3
m n
_ m m o
w m a x ~r
CD, 0 !mil
`
N D
CD
W N 03 z
ZWO
0 o
D C1 =1
v
o CD CD •
O
-O N
(D (D N'
c CD (D
w Cp
7 _
a- 3
z CD -A C/)
:3 M
O O A 0
N C ;o
p z O
C) CL G1
0
~ ~
W m
CL Z
O Z N
3
Z
CD P
W ~
CCDD o n>
3 c a
a v: a
0 -.1 Z a
o
~o m
c C1
X o a
w
O a) A
CD Q N
CL
(n b
m
CD m
00 z
O_ N
U) S O cz~
(D ::3 ~n
CD A V
Efl 0 ti N
O
O CD
O C1 '
Parcel 040-1179-30-000 12/14/2005 11:23 AM
PAGE 1 OF 1
Alt. Parcel 13/24.28.20.710 040 - TOWN OF TROY
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
C W SHIRLEY O- SHIRLEY, C W
237 COVE LA
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 241 COVE LA
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 3.600 Plat: 2491-ST CROIX COVE 2ND & 3RD
SECS 13 & 24 T28N R20W LOT 53 ST CROIX Block/Condo Bldg: LOT 53
COVE SUB # 3
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 614/542
2005 SUMMARY Bill Fair Market Value: Assessed with:
103420 450,400
Last Changed: 07/21/2004
Valuations:
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.600 85,000 348,500 433,500 NO
Totals for 2005:
General Property 3.600 85,000 348,500 433,500
Woodland 0.000 0 0
Totals for 2004:
General Property 3.600 85,000 348,500 433,500
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 143
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT
'ak:___ TOWNSHIP S SEC. `7 Tjj N, R W
A DRES ST. CROIfi COUP Y, 47ISCONSIN.
VISIO i 1 LOT__AiLO'I' SIZE
PLAN VIEW
Distances & dimensions to meet requirements of 1162,20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
,TIC TANK(S) MFCR. 4,- _CONCRETE J--STEEL
NO. of rings on cover - Depth_ DRY WELL
NCHES NO. of width length_ area
no. of lines J- width length area_ :1
r depth to top of pipe
,.LEGATE Le c
RATES. l
AREA REQUIREDl ; AREA AS BUILT
~ciaimer: The inspection of this system by St. Croix County does not imply complete
_)liance with State Administrative Codes. There are other areas that it is not possible
inspect at this point of construction. St. Croix County assumes no Liability for
Lem operation. However, if failure is noted the County will make every ef=fort to
ermine cause of failure.
ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
'INSPECTOR!'?(
DATED PLUMBER ON JOB
LICENSE. NUN]l3laR
~~r - ~ ~ .t.
~
~
~
~ ~ ~ ~ ~,l~
s
~ J ~-L~
f ~ , . e a ' ~ t',
a'
;.r
.
:.y', .
r ~ M
_ ~I'I
~ Y. a
i.
3
z
• REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
San..tarry Penm.i.t CAS/
` S#aA e SPp.tiC2 1-1
NAME
own4hip_ r' S~. C'noix County
Loca.t.toKS~~ &L/N(Oec.t.ion
SEPTIC TANK
Size ga.t.ton4. Number o6 Compa4tmen.t4 `
D.i.4.tance Fhom: We,t.t 6.t. 12$ o t ghea.teh 4.tope 6.t
Buitding_6at. Wet.tandb bz.
DISPOSAL SYSTEM Highwaxen - 6.t,
D.ia.tance Fnom: WeL.t 6.t. 12% ox gheaten 4.tope 6.t.
Ba i.tding 6t. W e.t.tanda Ft.
H.Lghwaateh 6 t,
FIELD DIMENSIONS:
Width o6, tn.ench 6.t. Depth o6 rock be.tow. -t.t.te .in.
Length o6 each tine 6.t. Depth o6 hock over. -t.i.te .in.
Numbeh.06 ,t.inea Depth o6 .tite be.tow grade in,
Toata.t .teng.th o6 •tine4 6.t. S.tope o6 .trench .in- pen 100 6.t.
D.c.4.tance between .t.inea_4 t, Depth .to ' b edno ck 6 t.
To tat abaonbtion anew 6.t2 Depth to groundwater 6t.
.Requited area t2 Type o6 Coven: Pape-x oh S.tnaw
PIT DIMENSIONS:
Numb eh o6 pit-4 Ghave.t abound p.i.ta yea no
Ou.t4.ide dt.ame.teA 6.t, pep.th be,tow in.te.t 6.t.
To#a.C abaonb.t.Lon area 6t2,
Area nequi.n.ed 6at2 m
INSPECTED BV TITLE `
'S
APPROVEDOVATE
197
REJECTED DATE 197 ,
9mi-E YE=S i Al •>A i._T1= 2-,vh-_l S i `f'GT
EH 115 Rev. 9/78 Y A_S 'J~•~r` ;z~ ~ L 0 SL-
--REPORT ON SOIL BORINGS AND PERCOLATION TESTS "3v y
WISCON'SIN_ DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
VRZ
LOCATION~Va '/a ~
V4 a, Section ,T_N,R_62tos.) W, Township
Lot No. , Block No. ~i dZ0/)(. vE County 6► ~I -
ubbdiT visio Name
Owner's/Buyers Name: C412414-10 t- 2.L tT '
_~7 le
wrJ
Mailing Address: Z /Z Z _ !7 iN l ~a ~`y
TYPE OF OCCUPANCY: Residence No. of BedroomsCOMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM / OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS -PERCOLATION TESTS ~IU
SOIL MAP SHEET NAME OF SOIL MAP UNIT rt-r4/NFi-~ c1 T~
PERCOLATION TESTS
TEST DEPTH 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- ~ 6c) -E - D I k2- 4 E 3 (I~v 1'~ro 3
P-Z. +r +r n I Wit!✓~ 3
P- 3~ rr r /E 3 3
P_ 5- Z4 r~ r• 1r /r 1 - 3
P-(v (off
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- ~ 10 L - 7 p Z 8L 'T, Zf, 131 S►,_ a+, S+r_ Il' rr $ 6P e-- 7
B- G
Nei, if = 2. 8L T5, 1A 61 Sri, 'i 51c_ Z' A;% :5 C:afL 'v
B- `SL lam` /S~ p' SAC 7., 1VeQA1E B- A/' >B 4 n 5 L 5 Sif&
B- ~b'¢ tcs Sri S` S G2
S 46S :Z
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.
1140 irt+ g-11V I..: L-cT ~f:.
~~Lt i IZc:7~ 7Z~
,'v19~'~C o r Cu
F~VSi IIVC~ C.1Zr~t~NO ' ~c.cNS ,
a~ 98,E
7.Z
13 (v too, E;-- R3F_NQ+ rAAIarL t
V1 SrP1K
i
v13 `
Qf ~Gt rb+NA+_ +s ro o r=
Z
_ e . vxrsr~~~~,~,;
_ SY 13 - ( C-i9-
ac t~E 'E'sc`-
a
o QE ccr~ o~/ L-_ - i-(c~Lk~
I, the undersigend, hereby certify that the soil tests reported on this form were made by me in accord with the rocedures and methods
specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correc to the :nest of my
knowledge and belief. /
Name (print)_I ' •-s C-'t'~ ertification No. a -
(/J., .
Address Cyc_Ec~ is d/)
.Name of installer if known-
Copy A -Local Authority CST Signature _ _.v_
Rev. 9/78
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701 I r0
~ 41 v
LOCATION :)AL'/4,N /4' < t<- C
, Section=~.,T C N,R=EAeH W, Township or f ?
-17
Lot No. Block No.'T'• C /2,r \.C r~ «✓L= County i C /x
Subdivision Name
Owner's/Buyers Name: / C-7 ? tl i i~c L Y
Mailing Address: _ 4-l:_' 2 d 7%-,
TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT -ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGSe4le,(, PERCOLATION TESTS ' 7/F" `
SOIL MAP SHEET <<' NAME OF SOIL MAP UNIT ` ~Ff.fr
PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME 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-7 r/4
P_~, 514- If'
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-
B-
B-
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.
f
3
g-7 IoJ.~ U
E
~N
' CC),
F
I~ a
iz
2-LLB
- F
7c
I, the undersigend, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and met ds
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.
~7 - Certification No. ~ -
Name (print)
Address S
Name of installer if known _
CST Signature_
Copy A -Local Authority - ~
PLB, 6 7 State and County State Permit # ` 71
f Permit Application County Permit # lyq
for Private Domestic Sewage Systems County-S4, d
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. QWNER OF PROPERTY. cling Address:
B. LOCATI S tion , T' N,r (or) W Lot#` City
7, Z7
Subdivi'on Name, arest road, lake or landmark Blk# Village
j Township
C. TYPE OF OC UPANC Co mercial *Industrial *Other (specify) *Variance
Single family _2 Duplex No. of Bedrooms No. of Persons
D. SEPTIC TANK CAPACITY o:~ -Total gallons No. of tanks
HOLDING TANK CAPAC~Y Total gallons No. of tanks
Prefab concrete f/ Poured-in-Place Steel Fiberglass Other (specify)
New Installation p/ Replacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-PlaceOther (Specify)
E. EFFLUENT D POSAL 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 Tre ches
Seepage Bed: Length Width ~ Dept c ~~Tile depth (top) l'~r No. of Lines
Seepage Pit: Inside iameter 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 Certifi Soil Tester, R
NAME C.S.T. # and other information
obtained from (owner/builder). _
Plumber's Si atur Phone JIV
/MPRS~f11#:
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.
;92
,
e
r
~ E
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) j - tfC~ Issuing Agent Name G ~^~~p~G~ "Li! f- J
Inspection Yes_ZNo 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