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HomeMy WebLinkAbout042-1000-10-000 C O CD v c(o c H` N o o N O fll N O m W CD N CL Z d c: N (D L, co :3 C) CD CD a 7 O N 7 p co C,O ~ fp 7 N O n O n w 3 ! lil o 00 O c n O U> z D m ~a • co a D W Cl. `C W 0 -0 (D O o C) m C CD z r. w o CD CD cD CD ! 0 r- CO 00 N N o o O f0 O c 3 a O O O a Ili ~y,N~ Q r3c . . . N _0 0 m N t9 ~ O V N Z N z 07 z Q s -0 O D a j m Cl) m CD (n e►1 CD w N C m m w @ d a 3 ~ z m A z C0 C ~ ~ a A Z = I o• 7 Z -I m (D m co 0 z 3 A o z m 00 00 N Lo Q O v C o a CD m I y ~ A A I ' A O b N O O V A h N I N Q'AO a 0 ti a C)O i b ti Parcel 042-1000-10-000 01/09/2007 11:47 AM PAGE 1 OF 1 Alt. Parcel 01.29.18.01 042 - TOWN OF WARREN 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 KEN GAR INC O - KEN GAR INC 1491 CTY RD E NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 1491 CTY RD E SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 36.000 Plat: N/A-NOT AVAILABLE SEC 1 T29N R18W FRL NE NE EXC NSP R/W Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 01-29N-18W NE NE Notes: Parcel History: Date Doc # Vol/Page Type 128511 149/519 WD 2006 SUMMARY Bill Fair Market Value: Assessed with: 148883 Use Value Assessment Valuations: Last Changed: 07/11/2003 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 29.000 2,900 0 2,900 NO UNDEVELOPED G5 2.000 200 0 200 NO OTHER G7 5.000 24,000 312,300 336,300 NO Totals for 2006: General Property 36.000 27,100 312,300 339,400 Woodland 0.000 0 0 Totals for 2005: General Property 36.000 27,100 312,300 339,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 2 Certification Date: Batch 136 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 15.00 Special Assessments Special Charges Delinquent Charges Total 15.00 0.00 0.00 • : AS BUILT SANITARY SYSTEM REPORT OWNER f TOWNSHIP J. SEC. G / J ADDRES. ~ I' ~ N, R W ST. CROIX C UNTY WISCONSIN. SUBDIVIS_ N LOT LOT SIZE PLAN VIEW Distances dimensions to meet requirements of H62.20 SNOW EVERYTHING WITHIN 100 FEET OF SYSTEM , i i" 1,~A r _ r. e I d_i a e oath Arrow SCALL ( i lit SEPTIC TANK(S) MFGR. 4. CONCRETE STEEL NO. o: rings on cover Depth ' PUMPING CHAMBER SIZE PUMP MFGR. ~ M NO. GALLONS Per Cycle TRENCHES NO. of -width R length area BED NO. of lines width length 'i area depthi~to op OT pipe NUMBER OF SEEPAGE`, ,PITS Outsi e diameter total pit area AGGREGATE " PERK RATE RE REQUIRED / AREA AS BUILT Disclaimer: The inspection of this system by St. Croix C6,unty does not imply complete compliance with. State _Admtni_strati~~ -.rnnAmrt -There are other areas thn L1_ Ls no t._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 S SYTEM. INSPECTOR DATED //i ~j (/J PLUMBER ON JOB LICENSE NUMBER j z' j,< ; ~k 1 , REPORT OF INSPECTION,- INDIVIDUAL SEWAGE SYSTEM Sani tarry Pehmit State S e p -tie Q_ NAME ' Townsh.Lp,~~~~'r~}o~ ~ St. CAaix County Luca,tion . _Section / Lot # Subdivizion SEPTIC TANK Size /D n Q ga.L2o n6 Numb eA o j eompan.tment, P,(',s tanee i4om: Wet..e Ald)Vt Building 3 1.2% stope Highwa.teA PUMPING CHAMBER Size. gaUon4 -Pump M ae u eh. Mode.L Numbeh MOLDING TANK Size ga.e.eonb Numbeh o6 Com•p A-tment16 PumpoL AZa.4 S em 0i,5 tanee 6 Lom: Wett Bu.iZd ng 12% .6tope_ Highwa,teA ABSORPTION SITE Bed TAe.neh -tanee 6ALom: Wett Building 12% 4.eope lfighwate.A ABSORPTION SITE DIMENSIONS W 4 dth o A tkeneh ! Z it Req ui4ed area 1 S ~ t L v ng,th o6 each line- A it Depth o6 to ck b e.eow .tite~. ~ n. Numbeh oA Tines Z- Depth o4 Aoch oven -tile 2- in T u tuk 1en•q,th o6 eine.6 it Depth o6 tite below gn.ude Z~ <.n V,(A takic-c between tineb it Stope o6 zAeneh in. pen 100 it i o t u, (,cbo U1Ltj t~.on aAea i.t Type aA CoveAs ape, an. a.tAaw i 1'i_f__" DIMENSIONS j Numbeh. o6 pits GAave.e anou d pyep nu - - Ou.t~~.de d.i,ame~teA it Depth bed' w Ze.t ~A.t Fo-ta.e ab.6onp,tion aAea it AAea AequiAed INSPECTED B~-t TLE APPROVED,,- DATE 198 REJECTED DATE 198 REASON FOR REJECTION REPORT ON INSPECTION OF SANITARY PERMIT # (1) Nape and Ad ress of Permit Holder Person/Persons at Site (2 )Date of Inspection t/ Sge", 7 ame, re s, icense NO. o install ing Plumber Time of Inspection (3 )INSTALLATION CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber ❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System BENCHMARK: (Permanent reference Point) Describe: 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: (7)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; li.neal 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? ❑ YES ❑ NO (13) Has system been installed in floodway? ❑ YES ❑ NO Floodplain? ❑ YES ❑ NO DILHR-SBD-6095 N.05/80 Signature of Inspector: State and County State Permit # 11 / PLB 67 C Permit Application County Permit # ~o 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: ell fiw -"Z Ali,, .B. LOCATION: '/4 JV,~'/4, Section _LL, T N, R y'f (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 _Y 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 et~ Total Absorb Area a, sq. ft. NewXReplacement Alternate (Specify) Seepage Trench: No. of in zal Ft. Width ~Pepth Tile depth (ya No. of Tren es Seepage Bed: Y_Length Width Depth Tile depth (top)f No. of Lines Seepage Pit: Inside d ~,ia eter Liquid Depth No. of Seepage Pits Percent slope of land-_ f✓ 2 Distance from critical slope -'VATER SUPPLY: Private X Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: 1, 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 Cer fied Soil A2 ter, f NAME 44 Lr44S J7F~ C.S.T. # , L 31 and other information obtained from (9u(owner/builder). Plumber's Signature MP/M;P.RSW# 1c~~ J Phone #o- Plumber's Address )Iy ~_r ? , s ~/~'1 i 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. A . a= _...~mo a _ _ _ i I e 7 E { z s ~ f ...m„ t _ _ _ s e e _ 3 7 !rv i 7 ~1 e { 3 ' a { E f ...-~6,- . „a: a ~ P. a . . . e 3 Do Not Write in Space Below - FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application 9-/© -16 Fees Paid: State Cout~~', 0 t; D to - /L - Permit Issued/Rejected (date) -/0 Issuing Agent Name _W ~ D Inspection Yes X 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 EH 115 Rev. 9/78 R - REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION: 6L 114,)L'/4, Section 1 N,RaIf (or) W, Township or Municipality i/,A z' '9A/ Lot No. , Block No. County ubdiv ion -Name Owner's/Buyers Name: ° 9 Mailing Address: L TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT -ALTERNATE SYSTEM OTHER 4qQ DATES OBSERVATIONS MADE: SOIL BORjjINGS_T PERCOLATION TESTS ' / SOIL MAP SHEET 5't NAME OF SOIL MAP UNIT rul,---4j ,S.~r cttrrl PERCOLATION TESTS 4UM DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE SINCE HOLE HOLE AFTE INTERVAL MIN/IN INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 ck /0 "N I - I P- r i P - P- P- SOIL BORING TESTS T'ST 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 INC B- 7- )~s B-- a/ 794 -j6 5.4,16 11-3 - 94 S B- B- > Ri <-.1 4o -9 J- 6,40 B- ? c" > > PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the loc tyon and square feet of suitable areas. Indicate number of square feet of absorption area needed for building tvpe and occupancy .Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. f~r'e. X kkd* et , i)oS fit, !o J /GL? `aC4~.c F ~ 5v ~f N NA E A,Ayrw \,C4 91? 44 E 44 97 ~ F = a g" t e j i ` s e e c ' 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. ~5i" t`3l i Address Name of insta:"er if known C Local Authority CST Signaturel J34 - ~ j~A~iP~it/ ~C~irr~;~a i-~' • ~~'iJ~'p,~ A9 / / ~ ~ c~ ~ ~ O~ ~i x J' ~1 • c4e F,f,~ i 1 / \1~ i i