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HomeMy WebLinkAbout020-1068-30-000 n v, O K v n con v fD m m 3 a p z 2 O A S N o 1 h• O m v: O? Q A O O- (D O_ 's - O O W c (W O ? CO 05 n N ~ ~ N U: 7 ~ fV ~ "S 0 O WO J p C O (D r O C" O ~ 1-Os O O O ( 7 N O T3 _ to w C N D !V C7 ( W Z D ID F- m '~A D 0 O. Co W v O C N C) C) W co co N N C.0 C.0 0- o 0 0 a 0 0 0 0 y y N - ~4 v q O _ (D M (D y N T). '0 cn CT CD (D C N O O ~M (D n Imo" = N zco z p D m o Q 0 (D (D (D N N C (D (D C 7 2 CD a p .`P Z CD O_ C) z N co - N A (D N O O. Z O "r cn O 3 m z (D p W O 2 O R: O 2 a O N - TI - N C N a 'O i0 O' (D ~U v O N ~ O X C W CT v (D Z CL h S a tv O O d O In i y Parcel 020-1068-30-000 03/16/2007 12:50 PAGE 1 OF 1 F 1 Alt. Parcel 24.29.19.259C 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 - DANIELSON, THOMAS E & DIANE L (TR) THOMAS E & DIANE L (TR) DANIELSON 872 BADLANDS RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 872 BADLANDS RD SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 3.740 Plat: N/A-NOT AVAILABLE SEC 24 T29N R19W PT NW SE COM SW COR TH Block/Condo Bldg: E 126.25 FT TO CL TN RD N67DEG E 1033.15 FT TO POB; TH N 285.76 FT E 175 FT S Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 212.59 FT TO CL RD S67DEG W 189.87' TO 24-29N-19W POB- ALSO PCL OF 2.74 ACRES N 1/2 OF SE1/4 LYG ADJ TO ABOVE PCL AS DESC VOL more... Notes: Parcel History: Date Doc # Vol/Page Type 01/09/2007 842190 QC 07/23/1997 2001/590 WD 07/23/1997 589/247 WD 07/23/1997 464/233 WD 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.740 92,000 177,400 269,400 NO Totals for 2007: General Property 3.740 92,000 177,400 269,400 Woodland 0.000 0 0 Totals for 2006: General Property 3.740 92,000 177,400 269,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 110 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Health and Social Services Plb.~`67 Division of Health PEFtaT APPLICATION U ! for .-t 2 PRIVATE DCr1ESTIC SEWAGE SYSTF2 S A. OWNER OF PROPEkiY TYPF OR USE BLACK INK Name Address (Street, City, Zip Code) County B. LOCATION OF' PROPERTY WHERE SYSTEM WILL BE CONSTRUCTED, ALTERED OR EXTENDED Check One: - CITY VILLAGE LEGAL DESCRIPTIONS L SL S%~ C/ c ' TOWNSHIP lie) C. IS LOCAL PEFNIT REQUIRED FOR THIS kORK? YES NO = D. SEPTIC TANK CAPACITY Gallons NEW INSTALLATION REPLACEMENT ADDITION MATERIALS; Prefab Concrete Poured irk Place Steel Other NU23ER OF TANKS TO BE INSTALLED: / E. TYPE OF OCCUPANCY " Check One; One or Two Family Residence Commercial Industrial Other Specify Number of Persons to be Accommodated 3-z F. APPLIANCES, ETCt Food Waste Grinder YES NO Automatic Clothes Washer L.-- YES NO Dishwasher YES NO Automatic Potato Peeler YES NO Other (Specify) G. EFFLUENT DISPOSAL SYSTEM NEW EXTENSION ADDITION REPLACEMENT Tile Size No.Lin.Feet Trench Width Depth Number of Lines rJ l Seepage Bed= Length Width Depth Tile Size No. Lines Seepage Pitt Inside diameter Liquid Depth 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 Next to Last Tn Fall lst Wetted Overnight in Minutes Last Period Last Peri Period ,,,e Inch _ Example P- 0 36" To Soil 1011, Clay 2611 25 es or no 30 112 1/2 1/2 60 f` , C RECOFO DATA FROM MINIMUM OF 3 TEST HOL ES Compute size of absorption area in accord with H 62.20 Wis. Administrative Code. S O I L B 0 R I N G S- Minimum 3611 Balo°v Pro used Absorption System oring Total Depth Depth to Ground Water Depth to Bedrock ^I lumber Inches Observed Estimated Observed Estimated Character of Soil with Thickness in Inches I! xample - 072" 72" Black Top Soil 12"; Clay 18"; Sand 18"; Gravel 2411 t. iC •,/i f i'- iRECORD DATA FROM'MINIKUM OF 3 BORE HOLES COMPLETE O'PHER SIDE I, the undersi&med, hereby certify that the percolation tests reported on this form were made by me or under by supervision in accord with the procedures and method specified in Chapter H 62.20 (3), Wisconsin Administrative Codo, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. NAME Z~ TITLE 'r:' Type or Print) / REGISTRATION NO. or MASTER PLUMBER LICENSE No. ADDRESS 7- DATE / 71? SIGNATUF3 MASTER PLUMBER MAKING APPLICATION Signatures -Ile License Number: MP RSW (To be 7~, plated by Issuing Agent) Date of Application ~ 7 Feo Paid ; 1 Permit Issued (date)/7 Permit Number 12r Agent (name) Fore 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 forward application, the fee of $10.00 and Copy (b) of the Permit (yellow copy) to the Division of Health. Checks and money orders should be made payable to the Division of Health. Do not writs in space below -I FOR DEPARTMENT USE ONLY DATE RECEIVED l 3I d ACCEPTED BY RETURNED (Initials) (Date; -7see Corras. FEE RECEIVED _ VALID. NO. PERMIT NO. Yas or No) REVIEWED BY APPROVED DATE (Initials) Yes or No) COMMENTS: