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HomeMy WebLinkAbout261-1213-50-000 m `s1 Cc 0 m 3 - ~ 3 - O 0 Z S m CS -11 o n rn rn 1 ~''r • O N ~2 N _ m a PO ° t C, z co N CD (D CD CD c ° 7_ Z7 O ylyi/ D_ Q O n z D m a a O O cn ty n C C C n O7 O C~ O ° -4 O n O r- U) c N N cr Z 0 C0 0 CD ~ lrl~ly ° 0 < (zD < N z - ~ In fn fn ~ ° D {~J[rf (D v v o - v (D (D (o < ° rn ~ d a N (D < O_ r _ 3 C Z Z m z t O CT, D m O O O o V m _ p ro CD !~i CD • CD cn ((D N N Z ~ N. C (D (D W Q 10 Y..~ Z CD O O (ir O ~ Z n P Z O Z -i (a 00 'o m ° C z 3 ~ o o Z N m z (D A O O J N (n N D W O < O { C O G O O O O v N T C Q> (D O O (D ~Z Q p O C 0--o v O (D (D O e`-- C r v -0 o (D (n O N CD F Q J F ID O ~ V N ' Q O N (D ti N (D -v Q (D (D N C ~ 00. < ? N v D p ti O AO7 3 O a C O N O O CD C (D JG O O CD 0 o CL Parcel 261-1213-50-000 03/21/2007 08:33 AM PAGE 1 OF 1 Alt. Parcel 261 - CITY OF NEW RICHMOND 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 - DOYLE REAL ESTATE LLC DOYLE REAL ESTATE LLC 560 DEERE DR NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 560 DEERE DR SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC SP 0030 TID #8 NEW RICHMOND Legal Description: Acres: 0.000 Plat: 1957-FARM & HOME STORE SEC 36 T31 N R1 8W COM ON S LN RD 411.75FT Block/Condo Bldg: W & 250.35FT S OF NE COR;S 450 FT; W 382 FT; N 16 DEG E 316 FT TO S LN RD; N 63 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) DEG E ALG S LN 326 FT TO POB 2.83A ALSO 36-31N-18W NE NE TH W 382 FT OF LOT 2 CSM 1/61 Notes: Parcel History: Date Doc # Vol/Page Type 06/30/2000 625667 1523/140 WD 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 05/17/2002 Description Class Acres Land Improve Total State Reason COMMERCIAL G2 0.000 563,000 1,071,000 1,634,000 NO Totals for 2007: General Property 0.000 563,000 1,071,000 1,634,000 Woodland 0.000 0 0 Totals for 2006: General Property 0.000 563,000 1,071,000 1,634,000 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 ~ t I ►o ,L-• _ , u ff{ 1 s ~ w This a sic. € AProval is __a,. code re based on state +~t the installation from d does Fleming 9 a ship or county pef'm City.. illa8o,towexempt requirement,. mit AP P I DATE ' NOV 7 19 PLUh181VG SECTION ~yL WIS. LEPT. OF HEALTH $ ,~'~7AG SE f I r RVICES A ` ~0 THIS APPROVAL SHALL RE VOID IF NOT INSTALLED WITHIN TWO YEAR; FROM THE DATE OF APPROVAL THIS APPROVAL WITHOUT THE NTRIi7LL BE VOID IF • DIVISION OF 1, W EALTIj RIT EN APPROVAL OF TAE D a J rive- ; F t °r Plb X67 7/71 Wisconsin Department of Health and Social Servion Division of Health SEPTIC TANK PERMIT APPLICATION C~~/L¢dL TYPE OR USE BLACK INK - PLEASE PRINT A. OWNER OF PROPERTY Name Address (Street, City, Zip Code) B. LOCATION OF PROPERTY WHERE SYST WILL BE CONSTRUCTED ALTERED OR EXTENDED COUNTY Check Ones 1-2 '4"' „/e 1ja-1 CITY VILLAGE LEGAL DESCRIPTION TOWNSHIP (Block, Lot, Sec.) C. IS LOCAL PERMIT REQUIRED FOR THIS WORK? YES No PERMIT NUMBER D. SEPTIC TANK CAPACITY " GALLONS NEW INSTALLATION 4a. REPLACEMENT ADDITION MATERIALS: PREFAB CONCRETE POURED IN PLACE STEEL OTHER NUMBER OF TANKS TO BE INSTALLED:`' E.. TYPE OF OCCUPANCY Check Ones One or Two Family Residence Commercial _ Industrial Other (Specify) Number of persons to be Accommodated: Number of Bedrooms F. APPLICANCES, ETC: Food Waste Grinder YES _ NO Automatic Clother Washer YES NO DishKasher YES NO Automatic Potato Peeler YES NO OTHER (specify) YES NO G. MASTER PLUMBER MAKING INSTALLATION Name: f Address s_ SIGNATURE OF APPLICANT: License Numbers MP ADDRESS: MP RSW H. (TO BE COMPLETED BY ISSUING AGENT) D Date of Application Fees Paid 2 Permit Number Permit Issued (date) / Agent (name)Fors taw-, village, city, , e specify) NOTES The Application cannot be considered for filing until all of the above questions are answered and the fee paid. Agents will forward application, the fee of $1.00 for each septic tank and the third copy of the permit (canary) to the Division of Health. Checks and money orders should be made payable to the Division of Health. COMPLETE OTHER SIDE NAME: COUNTYs SEPTIC TANK PERMIT NUMBERt f.L REPORT ON SOIL PEJWOLATION TEST ~T- AND SOIL BORINGS TO DIVISION OF HEALTH - PLUMBING SECTION P.O.BOX 309, Madison, Wis. 53701 Pursuant to H 62.20, Wis. Administravive Code P E R C O L A T I O N T E S T TEST DEPTH CHARACTER OF SOIL HOURS WATER TEST TIME DROP IN WATER LEVEL INCHES MINUTES NUMBER INCHES THICKNESS IN INCHES SINCE HOLE IN HOLE INTERVAL SECOND TO EXT TO LAST TO FALL 1st WETTED OVERNIGHT IN MINUTES LAST PERIOD LAST PERIOD PERIOD ONE INCH EXAMPLE P - 0 3611 TOP SOIL 10111 C 26" 25 YES OR NO 30 60 ,f lI ' RECORD DATA FROM M~NII`AJM OF 3 TEST HOLES COMPUTE SIZE OF ABSORPTION AREA IN ACCORD WITH H 62.20 WIS., ADMINISTRATION CODE. S O I L B 0 R I N G S- MINIMUM 36" BELOW PROPOSED ABSORPTION SYSTEM BORING TOTAL DEPTH DEPTH TO GROUND WATER DEPTH TO BEDROCK NUMBER INCHES OBSERVED ESTIMATED OBSERVED ESTIMATED CHARACTER OF SOIL WITH THICKNESS IN INCHES EXAMPLE B - 0 7211 BLACK 0 SOIL " CLAY 8" n MAVEL " f, k 2 3 x RECORD DATA FROM TYPE OF OCCUPANCY: LL- RESIDENCE: NUMBER OF BEDROOMS OTHERS (SPECIFY) t NUMER OF PERSONS FOOD WASTE GRINDER: YES N4x` DISHWASHER: YES NOX _ AUTOMATIC CLOTHES WASHER: YES NO EFFLUENT DISPOSAL SYSTEMS NEW EXTENSION ADDITION, REPLACEMENT TILE SIZE NO. LINN.` FEET TRENCH WIDTH DEPTH NUMBER OF LINES SEEPAGE BED: LENGTH/ WIDTH DEPTH TILE SIZN~' r ' NO. LINES SEEPAGE PITS INSIDE DIAMETER LIQUID DEPTH Is the undersigned, hereby certify that the percolation tests reported on this form were made by me or under any super- vision i naccord with the procedures and method specified in Chapter H 62.20 (3 Wisconsin Administrative Code, and that thud dta rZ), rded and roca!on of test holes are correct to the best of my 2niowledge and belief. TITLE C..•L v' NAME ! e TYPE or PRINT) a a REGISTRAT~Ij~2~1 NO. + f OR MASTER,?JUMBER LICENSE NO; ADDRESS DATE t' SIGNATURE•.r rC,r~"..J DO NOT WRITE IN SPACE BELOW - FOR DEPARTMEUS ONLY DATE RECEIVED ACCEPTED BY RETURNED FEE RECEIVED VALID NO. PERMIT NO. REVIEWED BY APPROVED DATE INITIALS YES OR NO PIb.+ # 60 w k3/70 PROJECT DETAIL DATA SHEET NAME OF BUSINESS LOCATION street or highway city or township county LEGAL DESCRIPTION OWNER Mailing address ZIP ARCHITECT OR ENGINEER Address _ Z I P PLUMBER Address ZIP T.-'Check'appropriate building Ltsage(s) and fill in the information requested opposite each usage listed.: Existing building New building Addition If addition to existing building attach detailed memo for each. ( ) Drive in restaurant Car spaces ( ) Restaurant Seating capacity (10 sq. ft./person) ( ) Dining hall Per meal served Toilet waste Yes No ( ) Motel ( ) Hotel ( ) Cottages Number of units: 2 persons/unit 4 persons/unit _ TOTAL NUMBER OF UNITS ( ) Churches Number of persons y_ Kitchen Yes No ( ) Bar or cocktail lounge Seating capacity (10 sq. ft./person) ( ) Nursing or rest home Number of beds ( ) Mobile home-park Number of units - dependent (camper trailer) _ - nondependent (mobile home) _ ~ (*'Retail store Number of employees Number of customers T10 sq. ft./person) ( ) Service station Number of cars served (daily) ( ) School Number of classrooms Meals served Yes No Showers provided Yes No ( ) Factory or office building Number of persons (total all shif_ts ( ) Apartments Number of bedrooms ( ) Other Specify 2. Indicate whether or not the following facilities are connected: Food waste grinder Yes _Y_ es Dishwasher Yes _ No Automatic clothes washer Yes No Automatic potato peeler Yes Other . . . (Specify) r~ No 3. Fill in the appropriate information for the following as indicated: Septic tank capacity planned s Percolation test results - ATTACH PERCOLATION TEST AND SOIL BORINGS REPORT SHEET COMPLETE OTHER SIDE Seepage trench bottom area planned width Y linear feet ! *Or dep 9(6 - Seepage bed area planned width linear feet & depth Seepage pit planned outside diameter depth below inlet depth 4. See approved plan for specifications and details. Signature of person completing form: STATE DIVISION OF HEALTH, PL RING SECTION P. 0. Madison, Wis o in 53701 Approv - Address.:; Date. NOV 7 1972 r. /;ZIP THIS APPROVAL IS BASED ON STATE PLUMBING CODE REQUIREMENTS AND DOES NOT EXEMPT THE Date: INSTALLATION FROM CITY, VILLAGE, TOWNSHIP OR COUNTY REGULATIONS OR PERMIT REQUIRE- MENTS AND SHALL BE VOID IF REVISED WITHOUT THE WRITTEN APPROVAL OF THE DIVISION OF HEALTH. THIS APPROVNOT ALL AL SHALL BE DEPARTMENTAL USE ONLY "'C)MINST HE ED WITHIN TWOI YEARS DATE Of APPROVAL