HomeMy WebLinkAbout042-1091-20-000
0 co 0 F. "a 0 C r~
O c d 0
C ? 3
3 m ci v 0
~7 v o # c
(D m C/a
I
(D 3 = ~
~ A~t O m (on o a CO W N N
CD a a CO
_ o Z a :3
5 co n
A
Q C N Cn N 0 CD 1 A
N O O < O CD N O a' 0 C7 7 CD CD CD O
rn C m b
3 0 K) (D
Sn' CD
CL
v v> G
D (D
C~
a N W G D
c C C
3 CL - CD
CD 0
co cD ~ 'I 0 r, CA
CD Co 00
CA O O N dl O C
cn "NA.
N o D
W m G N Z
o v C)
cQ
O N CD .O. N A
d V lei
CD ~
d
3 co
N W
d CL fD N
N
ZO3Z O
O
v D a
CD CD
O N
C
CD c N
c CD CND
W d
Z 1 N
N
Z
Q CD
A
I 0 O ~ C1
c _
O
v CL A
O
7
W
W m N N
CL N Z
Z Z1
O
N Z
CD
W F
I
j 0O D
i 2
O (n = T
N N c
X o CL
N_ CD
N) N
N O
CD CD
CL a
I 1
R7
n
N 4
CD `
A
O
Q
A
N
W
CD N
~ O
I n O
V
A I
O A
CD D'C
ti
cn O V
C) o b
O CL ti
Parcel 042-1091-20-000 01/12/2007 04:37 PM
PAGE 1 OF 1
Alt. Parcel 32.29.18.499E2 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
BOBBY G & MARJORIE L RICCI O - RICCI, BOBBY G & MARJORIE L
1050 65TH AVE
ROBERTS WI 54023
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1050 65TH AVE
SC 2422 ST CROIX CENTRAL
SP 1700 WITC
Legal Description: Acres: 5.000 Plat: N/A-NOT AVAILABLE
SEC 32 T29N R18W 5A IN E1/2 NW LOT 2 CSM Block/Condo Bldg:
VOL 4/932 ORD ALSO TH E 5.15 FT OF LOT 1
CSM VOL 4/932 AS IN 635/569 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
32-29N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 752/40
07/23/1997 731/275
07/23/1997 707/122
2006 SUMMARY Bill M Fair Market Value: Assessed with:
149850 319,500
Valuations: Last Changed: 10/23/2001
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.000 48,500 184,600 233,100 NO
Totals for 2006:
General Property 5.000 48,500 184,600 233,100
Woodland 0.000 0 0
Totals for 2005:
General Property 5.000 48,500 184,600 233,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 310
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 - p / TOWNSHIP SEC. . ~ .-z T ~ N, AT W
ADDRESS ST. CROIX COUNTY WISCONSIN.
SUBDIVISION ~~jj, LOT LOT SIZE
!z L bT 2 - C, rM Llq~PLAN VIEW
Distances & dimensions to meet requirements of H62.20~ /01r 6
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
! i x
-T1 1111
L
I -T
i
t1
i
I di atte 0xthi Arrow-
SCALE
--LLLL
SEPTIC TANK(S) MFGR. CONCRETE STEEL
N0, 67 rings on cover Depth
PUMPING CHAMBER SIZE PUMP MFGR. MODEL NO.
GALLONS Per Cycle
TRENCHES NO. of wi tai length area
BED NO. of lines -z__ width ~T . length 1 areal . x
depth to top o pipe4
NUMBER OF SEEPAGE PISS Outside iameter total pit area
Y '
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
LICENSE NUMBER
1\11_I'ORT of INSPECTION INDIVIDUAL SLWAGE SYSTLM
Sa~~ -tzn y PE nrni:I-
St ate Sept'4.c
lAMI Towrt6It 4,p J St. CAO-i.x Cuuvity
uC a_ttiorl Sec-tioYl 01.4uT SubdIt' v4,5 i.on
1PIIC TANK
S.i.zc fhZ~'~I gaet on.6 NambeA o6 cump(vLtmenrta
,I ariec 6Piorn: wc.YP- (~o I3u~edi.ng 12a eupe
11ighwaten
HM III NG CHAM6t 1
u X .e a vi rl, r m i u c-t u ~c e n ,.M o del
x N u m b e n
g
LUI Nt~ i ANh
i zc cz.ekone NuIn be /u Curnpantfit e.rrt4
_9 - - _
i
r
uIII pe>t man t terr
r
s
6u.tYd,t.n.,y. Ito akope
I1T(I lr.wat e-A
01.1 1' 1 10 N I T1
Ii cd 3-n T)'Lerl -ch
~.h tart ce "10 m; (Velk - I3u~td-ing_ r2o hTupe_--
IfL.ghwa-teA
]ON SITk DIMENSIONS
w < <l t It o 01 e n c h R e. q u ,i.ne. d a A e. a
- - - - - 6 .t
l (Iki,I t1( u ( each trine De-pth o6 n.oA bekow ti. ~z. -ri
NiimbeIt P:irle. Depth o6 AoC_h oven .t.i_fc_ i.n
lotoe ecn.oth. u6 i'iye6 At Oe-p-th 06 t-L~.e. below gnadc. Z tin
DiAtaviec be.twe.e- n e-i.rtc.A 6 t Shope oo tnene6~ c.n. pe.h 100 A
lu-taf abnul(.pt.,ion area {T Type of Cove.A: ape oil. b-tAccw
1 I DIMINSIOIN
Numb e ~i o o ` `ave f anound pit/5 y(2.e no
0utn -~1c d-4' arneteA_ _.1 ~6 Depth be-fow 'Cneet _ ----6t
I l rz t A)AI O>>h.tt.ow anea
Anco it r(;ui ~Icd At
III C I 1 U TITLt
I'I'W V 1 D DATE 19
I Il C111) DATE 198
i
f A`;ON I OI\' I:l JI CI ION
REPORT ON INSPECTION OF SANITARY PERMIT # ?(//f
(1) Name and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection
Time of Inspection
ame, Aaaress, License NO. ns a ing Plumber
(3 )INSTALLATION CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber
❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System
BENCHMARK: ermanent 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 ❑ N0; 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 # x/
PLB 67 a I
,l 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 PROPE TY Mailing Address:
B. LOCATION:-'/, Section T-~?oy N, R-/~g 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 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 t---- Fiberglass Other (specify)
New Installation L--- 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: L- Length 6- Z " Width / 1 ' Depth Tile depth (top)-- e q " 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 /-v~j 4rjy7 C.S.T. # -2~~ 4, e,' and other information
obtained from (owner/builder).
Plumber's Signature MP/MPRSW# D Phone
Plumber's Address
r 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.
~ I l
1
~i
1
i
E
wm _ . n.
Do Not Write in Space Below - FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application Fees Paid: State T CSC County i, Date /
Permit Issued/Rrejeete& (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 7/1/78
t
EH 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:,'/4,1Vkj~/,, Section T 1N,RAE (or) ownshi or Municipality V.\ b" ~1<1
Lot No- , Block No. County
Sub ivlslon ame
Owner's/Buyers Name: VC P I
Mailing Address:
TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW--REPLACEMENT ALTERNATE SYSTEM Q`HER
DATES OBSERVATIONS MADE: SOIL BORINGS- e b L~1 ytS PERCOLATION TESTS
MAP SHEET NAME OF SOIL MAP UNIT lv L7-
SOIL PERCOLATION TESTS
TEST
DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES
NUM- INCHES THICKNESS SINCE HOLE HOLE AFTE INTERVAL RATE
BER IN INCHES MIN/IN
1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P_ f 1
P- 41 7y
P- /
P_ 4~
P- C n_ Z
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
NUMBER INCHES OBSERVED ESTIMATED HIGHEST TEXTURE, MOTTLING AND DEPTH TO BEDROCK
IF OBSERVED IN INCHES
B- ` IN ?a "Cis ' 1-2 jr G r
B- ft
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 n*01JI ,Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope.
. i1c
.E
.
ti_3
VIC, E_
E -
N
E
t
d < all
g~
FeKce
T rD n6,SCA 64~e m
t.
th Gq t4, j~~
1
F; ; x'14
°
Vel
IDt'Aih 87, P.
U
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) I n Certification NO.
•
Address jti hin
.Name of installer if known /-x j
l ' y
Copy A -Local Authority CST Signature " l / )
12..E x i
C` Y
l~
~ c c
57 -11
1