HomeMy WebLinkAbout020-1082-70-000������
(k
1
% ki
c
M ■
E
?
£ ( ( I
-4 / �
C CO K)
03
= —
I
£ £ c
:3 :3 CD
c
K)
« P
-
■
<
e c 2
o Q}'
%
R /
§ ;
\ % a)
� I
§ k
8 8 ƒ ;
E
#�
f
=
§ N \
C - 4
Z
E
@ v >
■ % w
m
R }i
e {
/ g
D
/ $ \
$ $ ƒ.
§ Z
® ƒ
m .
/
§ § E.
2 E c
I
f
II
■ � �
�
2
k
CL
0 0 0 0 3
§
\
§ § 3 7 !
2
B
§
£
\m
0
/
k
-0
®
�
}
z
/
°
�
/
m
\ §
-
�
(
T {
k
CA
/
/
/
\
2 z
!
\
CL
z $
:
z §
2 7
\ 2
;
z co
§
m
�
§
k \. E
�
§E (
c
d
� �
Q[ [
c�,�
$8 ƒ`
m
CD
— §§
26
a —,
@
3 7§
W
\/k
k
%§§
)
CD
2 £
§
}�
K
ƒ
�
<
t
\
�
�
Parcel #: 020 - 1082 -70 -000
05/31/2005 03:23 PM
PAGE 1 OF 1
Alt. Parcel #: 29.29.19.332E 020 - TOWN OF HUDSON
Current X' ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address:
Owner(s): * = Current Owner
0
* TINGBLAD, TODD N, & C A CANINO
TODD N, & C A CANING TINGBLAD
Valuations
767 CARMICHAEL RD
HUDSON WI 54016
Last Changed: 10/29/2001
Districts: SC = School SP = Special
Property Address(es): " = Primary
Type Dist # Description
767 CARMICHAEL RD
SC 2611 SCH D OF HUDSON
RESIDENTIAL G1
SP 1700 WITC
27,900
Legal Description: Acres: 1.070
Plat: N/A -NOT AVAILABLE
SEC 29 T29N R1 9W SW NW COM 1570 FT S OF
Block/Condo Bldg:
NW COR SEC 29 TH E 290'S 1 98' W 290' TH
Tract(s): (Sec- Twn -Rng 0 1/4 1601/4)
N 198' TO POB & EXC P332J
General Property
29- 29N -19W Vs�fn
27,900
Y 1-11v, �
Notes:
Parcel History:
0.000
Date Doc # Vol /Page Type
07/23/1997 899/336
Totals for 2004:
07/23/1997 718/
07/23/1997 654/45 45
7M1r% CI IMMARV Bill M Fair
Market Value: Assessed with:
,lad
2
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
0
Valuations
Last Changed: 10/29/2001
Description Class
Acres
Land
Improve
Total State Reason
RESIDENTIAL G1
1.070
27,900
149,300
177,200 NO
Totals for 2005:
General Property
1.070
27,900
149,300
177,200
Woodland
0.000
0
0
Totals for 2004:
General Property
1.070
27,900
149,300
177,200
Woodland
0.000
0
0
Lottery Credit Claim Count:
1 Certification Date:
Batch #: 305
Specials:
User Special Code
Category
Amount
,lad
2
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Wisconsin Department of Commerce
Safety and Building Divis on
PRIVATE SEWAGE SYSTEM
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Parsnnal information you orovide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
'ermit Holder's Name: City Village x Township
Tin blad, Todd I Hudson Townshi
'ST BM Elev: I Insp. BM Elev: BM Des 'ption: r Q
t o .v � - td Sr t •�
rAmc Iwt= nRMATInN ELEVA DATA
County: St. Croix
Sanitary Permit No: 27
State Plan ID No_
Parcel Tax No:
020 - 1082 -70 -000
TYPE
MANUFACTURER
CAPACITY
Septic
Vent to Air Intake
ROAD
Dosing
> 35 '
> 50 '
Aeration
Alt. BM
Len Dia Spacing
Holding
TANK SETBACK INFORMATION
TANK TO I
P/L
WELL
BLDG.
Vent to Air Intake
ROAD
Septic
> 35 '
> 50 '
2 1
Alt. BM
Len Dia Spacing
D
Bldg. Sewer
SETBACK
INFORMATION
SYST TO
St/Ht Inlet
BLDG
LAKE/STREAM
LEACHING
CHAMBER OR
UNIT
St/Ht Outlet
Type Of stem:
'
C 1 1. 6 4 1
Dt Inlet
Model Number:
PUMP /SIPHON INFORMATION
Manufacturer Demand
GPM
Model Nuller
TDH Lift Frict' oss System Head TD Ft
Forcemain gth Dia. Dist. to well
c+nu A ocno TV1A1 QVCTCU
STATION
BS
HI
N
FS
ELEV.
Benchmark
Z. L`�
OF
(Dt•z
Liquid Depth
� a o.o
Alt. BM
Len Dia Spacing
Bldg. Sewer
SETBACK
INFORMATION
SYST TO
St/Ht Inlet
BLDG
LAKE/STREAM
LEACHING
CHAMBER OR
UNIT
St/Ht Outlet
Type Of stem:
'
C 1 1. 6 4 1
Dt Inlet
Model Number:
Dt Bottom
Header /Man.
Dist. Pipe
Bot. System
Final Grade
St Cover
x.
ge. lS
D.W • I ti
t -o
91. ny
p.oat
t t.�}
gor S� 1
BED/TRENCH
Widt
Length
No. Of Trenches
Vent to Air Intake
PIT DIM
Pip Length
idle Dia.
Liquid Depth
DIMENSIONS
Dia
Len Dia Spacing
SETBACK
INFORMATION
SYST TO
P/L
BLDG
LAKE/STREAM
LEACHING
CHAMBER OR
UNIT
Manufacturer:
Type Of stem:
Model Number:
r11nTr]I�I IT1^kl 0V0'rECR I -- /
Header /Manifold .
Distr
x Hole Size
x Hole Spacing
Vent to Air Intake
Bed/Trench Center
Pip Length
Topsoil
Yes [] No
Yes [] No
Dia
Len Dia Spacing
Q^H P•!1 \/ u A..1.. v 11Annnrl (]r Ot.r SVsxams unit/
Depth Over
Depth Over
xx De th of
xx Seeded /Sodded
xx Mulched
Bed/Trench Center
Bedrrrench Edges
Topsoil
Yes [] No
Yes [] No
COMMIENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 0 `i / I U / V 1 Inspection #2: — 7 - /
Location: 767 Carmichael Road Hudson, WI 54016 (NW 1/4 NW 1/4 29 T29N R19W) NA Lot NA Parcel No: 29.29.19.332E
1.) Alt BM Description
2.) Bldg sewer length = 2 f
It
- amount of cover = 1r l O \ � nom- • 4 � � S / �"<<
Plan revision Required? ❑ Yes 'A No
Use other side for additional information. $'i�
Date Insepctors Signature Cert. No.
SBD -6710 (R.3197)
County Sanitary Permit Application
ST . CROIX COUNTY WISCONSIN
In accord with 15.04 St. Croix County Sanitary Ordinance
ZONING OFFICE
Personal Information you provide may be used for secondary purposes
ST. CROIX COUNTY GOVERNMENT CENTER
G
(Privacy Law. S. 15.04(1)(m)j
1101 Carmichael Road
JAO
yy''''
12
Hudson, WI 54016 -7710
(715)3864680 Fax (715)386-4686
Attach complete plans for the sysA aper not less h, x 11 Inches
in size.
County Sanitary Permit # ❑ C revisi�l s a on
002' '
1. Application Information - Please Print all Information
SEP
Location:
Property Owner Name 1. 4UU
ST (
/V &) 1 /4 ,Vf) 1/4, Sec 2
/�
N 6-- J I A OdUWV �R
l W
T N, R (or)
Property Owner's Mailing Address
��
Lot Number
Block Number
767 C'Wlll li G ,f E`L /�f� s
Py � __ '`�
J4
City, State
Zip Code
Phone Numer
Subdivision Name or CSM Number
1 'o.J 5'101*
40/.
74.5 U6•3V/
T pe of Building: (check one)
amity [I Village Town of
1 or 2 Family Dwelling - No. of Bedrooms:
[ 11 Public/Commercial (describe use):
Nearest Road
�/p�l�G
❑ State -owned
. Type of Permit: (Check only one box on line A. Check box on line B if applicable)
Parcel Tax Number(s)
1.XRepair 2.0 Reconnection 3. ❑Non - plumbing 4. ❑Rejuvenation
� /O(�Z. '7Q .m—�
d /
A)
Sanitation
Permit Number
B)
Date Issued
❑ State Sancta Permit was previously Issued
1 q
iV. Type of POWT System: (Check all that apply)
V Non- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Welland
❑ Pressurized In -ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line
❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other
V. Dispersal/Treatment Area Information:
1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade
Required Proposed (GalsJday /sq.ft.) (Min./inch) Elevation
11_5L19 , V/+ Iv /,.f . - 7 1-- •s° 73.3
VI. Tank information
Capaicty in Gallons
Total
# of
Manufacturer
Prefab
Site Con-
Steel
Fiber-
Plastic
Gallons
Tanks
?
Concrete
structed
glass
New
Existing
Tanks
Tanks
2• /p !a
o50
OS
l
-
❑
❑
❑
❑
Z
Z
❑
❑
❑
❑
VII. Responsibility Statement
I, the undersigned, assume responsibility for repair/ reconnenction/rejuvenation/installation of non - plumbing for the POWTS shown on the attached plans. A
license is not required for terralift repair or the Installation of non - plumbing sanitation system.
Plumber's Name (print)
Rot101T' 21 ?
Plum Signature mps):
MP/MPRS No.
1 S
Business Phone Number
1 7/S'-3 d'G • �'�s
r
^ ^• i / ,,���� (�/ J'' s /1a
Plumbers Address iStreet, City, State, Zi��)
�
Vlll. County Use Only
Disapproved
Sanitary Permit Fee
Date Issued
I g Agent Sign lure (No stamps)
(� Approved
Owner Given Initial Adverse
CIV
r
Determination
'Z •
�d. �� l
�•l1'�M
IX. Conditions of Approval /Reasons fo Disapproval: L 1 n
�"..
t-E-- s -rte YS P
1 Nisconsin Npartment of Commerce SOIL EVALUATION REPORT
)!vision of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
❑ New Construction Use: (� Residential / Number of bedrooms
Code derived des(gn flow rate I.� �
❑ Replacement
❑ GPD
Public or commercial - Describe:
Parent material �a j` D gl -
General comments O ,1� 4f&22 Y Flood Plain elevation If applicable
and recommendations:
Z
Page of
County 4/eo f
Par I I.D. O ZO •10J2, • 70' em
viewed by Date
` 0
1/4 N)1/ S 2 / T Z N R I/
Subd. Name or CSM#
svoU � "P0 C
f7 [r State Zip Code Phone Number
t "P 0A) 715 El City ❑ Village 4 Town Nearest Road
Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must
Include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information.
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner
Property Loca�tio
'roperty Owner's Mailing Address Govt. Lot /VN/
EA Boring # 11 Boring 3 O
Pit Ground surface elev. — ft.
Horizon D
iX� 5 q W&- D.p
SDiI
a Boring # El Boring
❑ Pit Ground surface elev. ff
rj:!tTC inant Color Redox Description
Munsell Qu. Sz. C ont. Color
Depth to limiting factor in.
Soil Application Re
Texture Structure Consistence Boundary Roots GPD /ft
Gr. Sz. Sh. • Eff#1 I 'Eff#2
Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L
CST Name (Please Print)
Ro1 W, *ICI�t� Signatur
Private Sewage Consultants
655 O'Neil Rd.
Hudson, Wis. 54016
Depth to limiting factor in.
on T
epth
Dominant Color
Redox Descripl!
Boundary o
In.
Munsell
Qu. Sz. Cont. C
l
•�a
IOM /3
-
1d. irJ.*
ice. is �..
EA Boring # 11 Boring 3 O
Pit Ground surface elev. — ft.
Horizon D
iX� 5 q W&- D.p
SDiI
a Boring # El Boring
❑ Pit Ground surface elev. ff
rj:!tTC inant Color Redox Description
Munsell Qu. Sz. C ont. Color
Depth to limiting factor in.
Soil Application Re
Texture Structure Consistence Boundary Roots GPD /ft
Gr. Sz. Sh. • Eff#1 I 'Eff#2
Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L
CST Name (Please Print)
Ro1 W, *ICI�t� Signatur
Private Sewage Consultants
655 O'Neil Rd.
Hudson, Wis. 54016
Depth to limiting factor in.
on T
Texture S
Structure C
Consistence B
Boundary o
oots a
aorl Application Rate
Effluent #2 = BOD. < 30 mg/L and TSS < 30 mg/L
CST Number
2 Z� 3 7 S
Date Evaluation Co uclec
Y4. 3D • �, 00
- 71 5 - • 30 AS
I f^ ?Ti' I AGLlil . 1,l>M
be
�o9s
�, 0 '
MID
0 0
cp
V•
0
p
V
v
J
V w V
V.1
� J^
��o
� J^
��o
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT •.�.-
AND r
OWNERS IIiP CERTIFICATION FORM
Owner /Buyer
S I rut Mailing Address
v
Property Address
City /Stale
Parcel Identification Number O LO - 70 ovv
LEGAL DESCRIPTION
Property Location N W '/4, N ' /,, Sec. �' f , T N -R W, Town of
Subdivision
Certified Survey Map #
Let #
Volume , Page #
Watrnnty Deed # q 5o , Volume - ,Page # 3 3 6
Spec house U yes '�_110
Lot lines identifiable 19-yes O no
SYSTEM MAINTENANC
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance
consists of pumping out the septic lank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.
1 /we, the undersigned have read the above regnirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30
days of the tivee year expit 'o date.
/ //0/0
sl NATURE r. YKICANT DATE
OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) Am (are) the owner(s) of
the pt ope described ab e„ y virtue of a warranty deed recorded in Register of Deeds Office.
10NA'TURE 71PPLICANT DATE
* * * *'* Any information that is rrtis- represented may result in the sanitary permit being revoked by the Zoning Department.
- 7 (4 7 / c �14 c /� P , - # I/ PS::
(Verification required from Planning Department for new construction)
** include 10111 this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
T. S SPACE RESERVED FOR RECORD.NG DATA
R E G , t. ; W I - 0 F F i C E
ST. CROIX C10.
Russell D.... Link and Debra _J. Lin- k,. -.- Rec"d for Riq
husband .an wife as joint tipnant.s ... .. ......
APR 2 2 1991
of 11 :40 A. M
.. ........ .... .....
con-.e�s and %v:irrant., to Todd N.... Tingb-lad.-and ----- - Cyr' C
Christine A. Ca.nirw, - h.ushand and.. wife.l. ......... ... R eg l lter Of Deeds
as ... s q r. v i v o r sh, i p marital prQperty ... ......... .. .. .......
.. ......... ..... .
.. . ......... . RE TO
the fn1lowing described real estate in . .... 5 t Q _r Q.i X .............. County,
State of Wisconsin:
Tax Parcel No: - --------------------- -- - - - ---
See attached descriptioi—
M 7%
i s
This homestead property.
(is) (is not)
Exception to warranties:
Subject to easements, reservations and restrictions of record.
Dated this ------- ------- day of -,- -- April 19. 9 1 1 .
. ...... 11 --- .. .. I.. - .(SEAL)
- - - -- ------------ --- -- --
- ----- ------- I --------- ...... (SEAL)
AUTHENTICATION
Signature(s) ------- ----------------------------------------------------
.- •----- -•---- •- °--•--- -•• --- -•- ---------- ---------- ------------------
authenticated this _______ of -------------
. .... ......
.................................. ------------------ ---
QTA
.......•... . ...•.....•...••..•...• ............. - ----- 0...
TITLE: MEMBER STATE BAR OF l W4SCONSI*
i. ;N 1 .
(If not * tea
authorized by § 706.06, Wis. Stkts.)
THIS INSTRUMENT WAS DRAFTED BY
STEPHEN J. DUNLAP
........................................ -------
Wisconsin
---------- ------ ............... ..•
(SEAL)
RUSSELL D_ __ L ' I - NK
---- - -(SEAL)
DEBRA J. LINK,
ACKNOWLEDGMENT
STATE OF WISCO-
85'
St. Croix
- -------------------------- County.
Personally came before me this --- /.. of
---- ----- •- - - • - - --.. 19Q1_.- the above named
n ...........
-------------- -----_--------- --------------------------
-----------------------------------------------------------------------------
------------------------ --------------- _----------- ........
4 me known to be the person --S ....... Wio executed the
p-f.regoing instrument and acknowledge the same.
... .... ....... --------
-,.- — ------------- ------------------------
Not. + ubl .... .. _ St. Croix
q ------ -------- -------------- County, Wis.
f of not Cf.to pynir.finn
. y
vr 899 rA:137
Part of the SW 1/4 of NW 1/4 of Section 29, Township 29 North, Range 19 West
described as followc: Commencing at the centerline of the Town Road on the
West line of said Section 29, 1570 feet South of the NW corner of said
Section 29; thence East 290 feet; thence South 198 feet; thence West 290 feet
to the centerline of the Town Road; thence North on said centerline 198 feet
to the place of beginning. St. Croix County, Wisconsin. Excepting therefrom
the following described parcels: Beginning at the W 1/4 corner of said
Section 29; thence S89 50.01 feet along the South line of the NE 1/4
of Section 30; thence N00 0 02 1 01 11 W 118.46 feet; thence N18 0 44 1 40 11 E 52.81 feet;
thence N00 0 02 1 01 11 W 273.55 feet; thence S84 0 57 1 05 11 W 12.05 feet; thence
N00 ° 02'01 "W 327.50 feet; thence N3 0 50 1 52 11 W 150.33 feet; thence N2 0 19 1 39 "W
374.75 feet; thence N00 ° 02 1 01 "W 275.55 feet; thence N2 0 43 1 14 11 W 105.62 feet;
thence N00''02 11 W 93.48 feet; thence NO2 0 49 1 44 11 E 100.13 feet; thence
N00 0 02 1 01 11 W 640.58 feet; thence N45 ° 26 1 21 "W 103.48 feet* thence N84 0 22 1 44 "W
206.81 feet; thence N00 ° 50 1 41 "W 33.00 feet; thence N89 "E 350.00 feet
along the North line of said NE 1/4 of Section 30 and the centerline of
C.T.H. "UU" to the NW corner of said Section 29; thence N89 0 09 1 19 11 E 175.00
feet along said centerline of C.T.H. "UU "; VIence S00 )0 "E 33.00 feet;
thence S79 0 13 1 38 11 W 144.99 feet; thence S00 ° 02 1 01 11 E :282.76 feet; thence
S6 0 57 9 14 11 E 182.59 feet; thence S00 0 02'01 "E 450.00 feet; thence S89 0 57 1 59 "W
10.00 feet; thence S00 ° 02 1 01 "E 394.42 feet; thence N89 0 38 1 49 "E 5.00 feet;
thence S00 0 02 1 01 11 E 273.00 feet; thence S89 0 38 1 49 11 W 50.00 feet to said W 1/4
corner of Section 29 and the point of beginning.