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HomeMy WebLinkAbout006-1072-80-002 o en O 3 T n d r_ O d F' C 11 O fD C r+ 7 0 E3 7 CD (D C1 O '6 (D N A 3 ` \1 I a~ Cl) 2 2<: rn n w O • O W N w N O N (n .C N O (D O j 000 0 ~ cD C O O O A d 2 d a O N _ O l^l N C fu CO CO N = 00 Q) N -0 0 A 7 j O ~O O O O 6 CD N (D 3 N N (D `z O o K 7 N Op N N 0 CD (D T U} Z D 0 a m o N a 00 0 ~ W O ° o CD cD cD Z7 0 r cn V V y Cn v, (n 0 C or W Z O "WA O O O Q CD C y N N o D T N O A O O (D (D y' O O D V cD N to O M CD Ul D N o O O -ADO !~I • CD N -0 _ (n Z C N (D m a 3 ~ (D -I cn a O A Z m A Z O a ~ F Cl) ~ w W v * N CL z O A o z rn N z g 0-0 O D n o n 3 n m c _ 2 N m a :3 T (D n -O N C ~ o ° 0 z 0 O a (DO O ' m ((Dn - -o m 'S I CD m'~~ o ° CD ID n~ o m 6 M. w (D O N p N C D p' (D N n O o- (D n l (D (D 3 3 N CD N N C S O O O 3 ti • I b CN (D ~ N Efl O ti b CL ti a REPORT OF IN PECTION--INT)TVIDUAL SEVTAGE-DT_SPOSAL SYSTEM PRIMARY TREATMENT consists of Septic Tank: Other (Describe) S7P IC TAUT- Distance from: Well OV ft. , Lot line ft. , Rudd'g £t. HiPhc-,later hark - ft. 127, or greater slope r_ft. , ,-''e*E and ft. , Cistern ft. , No. compartments Liquid capacity / _Waal. EFFLUEITT DISPOSAL SYSTEM consists of Tile field eepage i5 F 10- Seepage Pit or Tile Field: Distance from: jdellA~' t. BtiilTing 2,57f_ t . Lot Line ft. Cistern ft. Highwater Mark of water course __ft. Slope 12% or greater._-- ft. wetland Total length of A,,I'ola e Ines ft. -Tvmber of lines Length of each line Dist etween lines ft. Width of trench il _feive absorption area of trench bottom Depth of filter to ial be 7 the in. Depth of filter material over t' Cover over filter material Depth of tale b, o in*sh grade in. Slope of t_-rer~ch bottom. i'. er 10, ft. Depth. of R~Tdxock _ft. Depth to ground water ft. Number of Pits Outside diameter ft. Depth below inlet ft. Lining raterial Gravel around pit: yes. No. Total absorption area sq. ft. Square feet of seepa,e trench bottom area required Square feet of seep ge pit area requ&rt-pd 6 Inspected by: Title: r Approved Date , 1976 -77 Rejected Date , 197. County, Town of Owner )'eJll~ _ - A Sanitary Permi do. Prope - y Address Septic Tank Permit No. ~ Subdivision State and County State Permit Jr J PIS 5 Permit Application County Permyit~# for P, iyat_ Domestic Sewage Systems County ,jENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: eel s B. LOCATION: SatJ /4 /✓4~ Y4, Section 3 T3 N, R16 j* (M W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township CYLUW/ C. TYPE OF OCCUPANCY: *Commercial X *Industrial *Other (specify) *Variance Single family Duplex No. of Bedrooms No. of Persons --Z D. TYPE OF APPLIANCES: Dishwasher YES X NO Food Waste Grinder YES- NO # of Bathrooms Automatic Washer YES x NO Other (specify) E. SEPTIC TANK CAPACITY /ppU Total gallons No. of tanks / *Holding tank capacity Total gallons No. of tanks New Installation X Addition Replacement _ Prefab Concrete X *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) 3) Total Absorb Area sq. ft. New Addition Replacement *Fill System Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches _ Seepage Bed: Length Width Depth Tile Depth No. of Lines 2- Seepage Pit: Inside diameter 7 Liquid Depth S Tile Size Percent slope of land 3 °/a A,, E, Distance from critical slope 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 iC©er-~ EC~itJ7"an~ C.S.T. # 1357-6 and other information obtained from ,S/ (owner/builder). Plumber's Signat a- Mp/ # Phone #71S -3,~ PLAN VIEW: Provide sketch elo of system (include direction of slope and all distances in accord with H62.20, including well). (A/ 0 S-CA L l`= i DIVE - _F - - ~ s~i~s4cE( _ e o t3 f~~~- 1 Al W y / _ Ir ,~-4, o6 E 8vP I r 3 CPO f2S1' t i a (~'c~prasc=~ s y s r& M t-.4L(O)1 s'C197'1G j 3 k Z Qd C-- }CLOAJ ~r ~4G-E PI 3 7,9 i = A C l!'CS 3 ( l; P ec P. L r Al E Do Not Write in Space Below FOR DEPARTMENT USE ONLY Date of Application ae) /c7T Fees Paid: State County Date Permit Issued/fhejecxed (da e) ,&~3 5 _Issuing Agent Name A Inspection Yes3No 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 3/1/75 j~•~fy` State of Wisconsin DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH • May 28, 1975 MAIL ADDRESS: P. O. DOx 309 MADISON. WISCONSIN 53701 IN REPLY PLEASE REFER TO: SECTION OF PLUMBING AND FIRE PROTECTION SYSTEMS Evenson Plumbing 419 2nd Street Hudson, WI 54016 Dear Sir: Re: Form Plb. 67 for Henry Weeks We are returning the Plb. 67 application for private domestic sewage systems to you. Form Plb. 67 applications must be submitted to the county in which the installation will be made, and a septic tank permit issued, before being sent in to the Plumbing Section. The counties will submit the forms along with the septic tank permits directly to this office. Form Plb. 67's are no longer required for plan review, nor should a plumber or soil tester submit them directly to this office. Please submit these forms to the counties. Thank you If you have any questions regarding these forms, please feel free to contact this office. Sincerely, .lames A. Sargent Chief Donald K. Kinyon Plan Approvals JAS:DKK:rr enclosure 4 S "ISMUTION S `z,r)n :1 f, iI?C' 10n r.:h e 7t. Cy o1:1i 'C)L1nt-v 3 oar(J tab 3. i.s11eci ilit., I`;tll;tf'I V~ 'iII71:Laq' 't1TI L~1~?' s~11C: Parks r;C)I?Lr'-L tt3t'. I t).lk~_1 AI' petition, !iol d pu-,b . e "1karin~n F121d rC't1l'7 ".'C •11Cl;ti'.a.ii .':..I+_'.. L, t:tZ.:': !.oi1Ti~ ' Board for action and 6Y f7.ER,E , t.-e.. 1~r 1~. T~~~r:iiensi~ve Planning - am! -,`~t T,. Y.. ~ 'r has ~ ' ~ ~ Parks n fullfil.:led its duties on r_11 : _,etiti.on o:-`. jeekS. rj-,- rMr~ ter,; ' rt. ! Si~r b •t'~L~ r NOW 7':1 S..l.D thrt T`ar i,oni.n2 and T.-larks ConIYittee xeeoimiends riP)prov i ~wr.' ttw- rezoneme n,". to :.industrial frovi agriculture of the follo,,NJ-n~: ,.and: Cormuenci.ng at the 11orti•lwest corner of Sectti,on 32; thence Soutz-i. along the West 'A. Me of said Section a distax c!,' o l- 2 391.72 ' to tl:e point of beginning; thence S 36'58 , , O-3 .44 r t.. y • l n , 716 . c> r' to .14 the Northerly line of tt'ie Minneapolis, St. Paul, and Seal t St. Marie Railroad; thence N 87'10' W along said ?',.Ior. therly line 510.19' to the West line of Section 32; thence North along said Section line 71:3.95' to the. point of beyinrinF. Contains 3.510; aert-:~3. CArA--) ~i.f& BE IT FURTHER R5!,'SCL%1 D that the St. 1~rr) . ~ + t:?.1~tt.' . x;oa t.'-ie said recommendations as presented and tale action for the, adoption of same:. DATED 1975. €1 ...ul, BES'.C.~ 4 1 T, f" 1, L Parcel 006-1072-80-002 11/15/2010 11:23 AM PAGE 1 OF 1 Alt. Parcel 32.31.16.495C 006 - TOWN OF CYLON Current XST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - NAGY, GARY J & ALICE I GARY J & ALICE I NAGY 1851 HWY 63 NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 1851 HWY 63 SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 8.515 Plat: N/A-NOT AVAILABLE SEC 32 T31 N R16W PT NW SW AS DESC IN Block/Condo Bldg: 827/116 N/K/A PT LOT 1 CSM 912451 INCLUDES P492G Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 32-31N-16W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 922/550 07/23/1997 827/116 2010 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/07/2007 Description Class Acres Land Improve Total State Reason COMMERCIAL G2 8.515 112,000 305,000 417,000 NO Totals for 2010: General Property 8.515 112,000 305,000 417,000 Woodland 0.000 0 0 Totals for 2009: General Property 8.515 112,000 305,000 417,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 006-1072-30-100 11/15/2010 11:23 AM PAGE 1 OF 1 Alt. Parcel 32.31.16.492G 006 - TOWN OF CYLON Current XI ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner GARY J & ALICE I NAGY O - NAGY, GARY J & ALICE I 1851 HWY 63 NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE SEC 32 T31 N R16W PT SW NW DESC AS BEING Block/Condo Bldg: PT OF LOT 1 CSM 9/2451 ASSESSED WITH P495C Tract(s): (Sec-Twn-Rng 401/4 1601/4) 32-31N-16W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 922/550 07/23/1997 827/116 2010 SUMMARY Bill Fair Market Value: Assessed with: 0 006-1072-80-002 Valuations: Last Changed: Description Class Acres Land Improve Total State Reason Totals for 2010: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2009: General Property 0.000 0 0 0 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