HomeMy WebLinkAbout020-1004-40-000
N O n r1
m
CD # 1
o M 1: 0
0 o ° a c of N) 1
m
O
c- ro N d (D =3 N O CD p j I\j
o
:3 (D CO :3
co °
o
N d N t/i cf) p W A
°o CD N. N n ~T o
C: =1 O
cn 3 a o o
3 N < o O
N N W
(D N
0 (n Z D (D .0.- °
GD cn O a
~ W m
m
O r
0 0 ~ ~ A
L J j N O
z
o ° m m n r N
2 fn O c
rT 0,
a v
rT
Z O O O r !mil
a c 3 GQ
o CD -0 m F S N ~yy
ID _a 0
° 0 N
m o
N N C
G1
rl) Q - a
Q a N N
Z
y N o O
a" O 0 T
o. m m !r
N
T N
D F
C F4* Ql~
Cl)
(D
d ~ 7
Z (D <n
O O A Z CD
n A Z O
v a O
0
Z
m N
w v °
CL N z
R C/)
o
z i>
(D
W
CL
o s Q
~v
r-
v c
m Z 7a
o
=3 (D
O to
c_
0
m
(7 ~
N A
(p
w
W
CD
O
ON
A
q
0 A
N UAgb ti
f W
O ti
O a-
ti
Parcel 020-1004-40-000 07/10/2006 05:31 PM
PAGE 1 OF 1
Alt. Parcel 07.29.19.8C 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): O = Current Owner, C = Current Co-Owner
O - JENSEN, LAVERNE,MICHAEL & PAMELA
LAVERNE,MICHAEL & PAMELA JENSEN
326 KRATTLEY LA
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 326 KRATTLEY LA
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 5.040 Plat: N/A-NOT AVAILABLE
SEC 07 T29N R19W PT SE SW E 299.54' OF W Block/Condo Bldg:
1837.79' OF SW 1/4 LYING NLY OF TN RD
EXC N 1532' Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
07-29N-19W SE SW
Notes: Parcel History:
7 Z 3Y Date Doc # Vol/Page Type
I / 02/21/2006 818927 ^ EZ-U
07/23/1997 730/24
07/23/1997 9
07/23/1997 516/373
2006 SUMMARY Bi I air Market v sse ~I7/
0
Valuations: U~ e~ C Last Changed: 05/30/2006
Description Class Wcres Land Improve Total State Reason
RESIDENTIAL G1 5.040 87,200 194,000 281,200 NO 05
Totals for 2006:
General Property 5.040 87,200 194,000 281,200
Woodland 0.000 0 0
Totals for 2005:
General Property 5.040 87,200 190,900 278,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 103
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Wisoonsi.n Dcp%rtmont of ::calth _nd Social Services
Plb. #67 3/70 Division of Health
SEPTIC TANK PER14IT APPLICATION
TYPE or USE BLACK INK
A. OWNER OF PROP-PTY
Na^~e Address (Street, City, Zip Coda)
Be LOCATION OF PROPERTY WHE:RV- SYST11 WILL BE CONSTRUCTED ALTERED OR EXTENDED COUNTY
Check One:
CITY VILLAGE LEGAL DESCRIPTION S r f l' _VV
X TOWNSHIP :S' , Cc` C Z"N
C'` "lOd~~JI 76WNii0r j~C It I
C. IS LOCAL PERMIT REQUIRED FOR THIS WORK? r YES NO PERMIT NUMBER
D. SEPTIC TANK CAPACITY Gallons NEW INSTALLATION _ i REPLACEMENT ADDITION
MATERIALS: Prefab Concrete x Poured in Place Steel Other
NUMBER OF TANKS TO BE INSTALLED: f r I -
E. TYPE OF OCCUPANCY
Cheek Ones one or Two Family Residence 7C Commercial Industrial other
Specify)
Number of Persons to be Accommodated-- 11. Number of Bedrooms r>
F. APPLIANCES, ETC: Food Waste Grinder YES NO Automatic Clothes Washer YES NO
Dishnasher x YES NO Automatio Potato Peeler YES NO
Other (Specify)
G. MASTER PLUMBER KA3KING INSTALLATION
Name: 1 iC r Address: / / i; z ~I!r. License Numbers
'~O lrl L1~~ MP
Signature of Applicants KP RSW
Addressi ,l l 1j
H. (To be Completed by Issuing Agent)
Date of Application - Fee Paid $
Permit Issued (data) Permit Number
Agent (Name) / i Fors •c
i' Town, Village, City, County,' etc.
(Specify)
Note: The application cannot be considered for filing until all of the above questions are answered and the
fee paid. Agents will for-ward application, the fee of $1.00 for each septic tanx and the third copy
of the permit (canary) to the Division of Health. Checks and m.;ney orders should be cade parable to
the Division of Health.
Do not write in space below - FOR DEPARTMEII: USE ONLY
1. DATE RECEIVED ACCEPTED BY RETURNED
i (Initials) (Date) See Correa.)
FEE RECEIVED VALID. No. PERIIIT NO.
Yes or No
REVIEWED BY APPROVED DATE
(Initials) i Yes or No
COMPLETE XiLR SIDE
t
S~r'TIC TA~ax ~NRiiI'r N0. ~ -
R E P O R T O N S O I L P Fi R C O L A T I O N T E S T
A N D S 0 1 L B O R I N G S
TO -c- t~ yJ.0
DIVISICI OF HEALTH - PLUKKIr,, SECTI~3
P.O.Box 309, tiuiison, Wis. 53701 fYI: , ' ~Y ~
_ J1
Purvu^nt to H 62.20, Wis. Ad=inistrative Coos
6.
EA.
P E R C O L A T I O N T E S T
Test Depth Charactor of Soil Hours Water Test Time Drop in Water Level Inches mutes
Uxw.ber Inohso Thie moss in Ir.ohos Sineo Holo in Holo Interval Second to Next to Last To Fall
1st Watted Oyota i¢he in Mtnutol IAst nortod Last Period Period Czc: Inch
Exaaeplo
P - 0 3611 To Soil 1011 C1 a, 2611 25 Yes or No 30 1 2 1/2 1 2 60
/A
._'l -lam ''li9 "l A,/ •?/X~rru 1~. ~iC -J f`~lrY lS ,~c ;"i ~J `~1~ C
vy2 'e
RECORD DATA FROM MINRM11 OF 3 TEST F.OL S
Compute size of absorption area in accord with H 62.20 Wis. Administrative Code.
S O I L B O R I N G S- Minim ,m 3611 Belo:r Proposed Absorption System
BorirtS Total Dopth Do th to Grc«.nd Hater Do th to B droc':
Number Inohos Caservod Estir-%tod Observed Estiz~:ated Character of Soil with Thio'mess in Inches
E~~plo
B - 0 7210 7211 ! Black To Soil 1211: Clay 011: Sand 1811; Gravel 2411
f)` l Il ii 1i~~:- )l/ T, .l' ~ i t -I,~~ / ~~V --~~"~ii'c L- _ % rl
R=RD DATA FROM MINIMI.U 0: 3 BORCZ HOLE'
YPE OF OCCUPANCYt
RESID-'?ICEt Number of Bedroc-no OTHERt (Speoify) Number of Persons
A
FOOD WASTE GRI]NDERt Yes No Y Dishwasher: Yes No ~a Autoryatic Clothos Washer: Yes No
FFUMNT DISPOSAL SYSM: YEW Y EXTENSION ADDITION REPLACI-AIENT
Tile Size No.Lin.Feet Trenoh Width Depth Number of Lines
Seepage Bod: Length Width Depth Tile Size No. Lines
Seepage Pits Inside Diameter Liquid Dapth
I, the undersigned, hereby certify that the peroolation tests roported on this form were wade by me or under my super-
vision in accord with the procedures and method speoified in Chapter H 62.20 (13), Wisoonsin Aatdniatrative Code, and
that tho data recorded and location of test holes are correct to the best of my knowledge and belief.
N.SM£ TITLE
(Typo or Print
I REGISTRATION NO. or MASTER PLUMBER LIC. ISS 110. c-
ADDRESS
DATE l / ; SIGNATURE j \ - - -