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HomeMy WebLinkAbout022-1031-50-000 p 0 3 N C d _ R 3 M a c w nl. W (D m 3 3 3 F w z 2 F Z o cD r 7 o o v O o a• Q 7 d O SD N 7 N N ICI SD ~O :z 77 2~ O ~ N CO :3 0 C 1 N°o CD CD m m v 6' o O -4 Cj' a' 3 a i o °o l~ 7 N O O Q li w 0 z D M a CD (D O En G _0 3 W 0 3 o se ~ 1z; 0 D « ° N) CD V C t~ z cfl cfl o 0 r to o o CD N a ~z 0 0 0 C) ° \1 c N N ' n y N tll dcr v v v W n v O c m y v N CD d_ - Z z N c c D a m O ~ o. C/) • N CCD (D C O N (D W (o c- a E z Z m ~ Z o m n 0 I a. U) ~ j W to CL 3 3 cn N g g ? m O CD .°-o- m n N CD ° ED o - Z3 c ao W J Z Q "O O o (D O N N N O 7 N N N ~ A i 7 O O A 7 O :3 C) ~ CL v ~ O W N N O I N O O p~ ~ A j ro N DO N o O o O ti O C Parcel 022-1031-50-000 10/03/2006 02:06 PM PAGE 1 OF 1 Alt. Parcel 11.28.18.171 022 - TOWN OF KINNICKINNIC 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 - R&M PROPERTIES OF HUDSON R&M PROPERTIES OF HUDSON C - LLC LLC 1109 CRESTVIEW DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH I Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 11 T28N RI 8W SW SW Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 11-28N-18W Notes: Parcel History: Date Doc # Vol/Page Type 09/16/2003 740194 2411/175 TD 02/02/1998 572170 1292/309 WD 2006 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 08/10/2005 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 35.000 4,400 0 4,400 NO UNDEVELOPED G5 2.000 200 0 200 NO OTHER G7 3.000 40,000 226,500 266,500 NO Totals for 2006: General Property 40.000 44,600 226,500 271,100 Woodland 0.000 0 0 Totals for 2005: General Property 40.000 44,600 226,500 271,100 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 Wisconsin Department of Health and Social Serviess Plb„ #37 3/70 Division of Health - ` SEPTIC TANK PERMIT APPLI ATI ZC~ TYPE or USE BLACK INK ( 3 20 A. OWNER OF PROPERTY Nacre Address (Street, City, Zip Coda) 1z -7 2. Z C z-7 x B. LOCATION OF PROPERTY WIT-RE SYSieLM WILL BE CONSTRUCTED, ALTERED, OR EXTENDED COUNTY Check One: i CITY VILLAGE LEGAL DESCRIPTION \114 A/ Y TOWNSHIP 7 C. IS LOCAL PER!-1IT REQUIRED FOR THIS WORK? YES NO PERMIT NU'.BER D. SEPTIC TANK CAPACITY J-3 r Gallons NEW INSTALLATION REPLACL''SNT ADDITION MATERIAT.:: Prefab Concrete l Poured in Place Steel Other NUMBER OF TA?"KS TO BE INSTALLZD: ( t i E, TYPE OF OCCUPANCY Cheek One: One or Two Family Residence Comercial Industrial Other Specify) Number of Persons to be Accommodated 'Number of Bedrooms F. APPLIANCES, ETC: Food Waste Grinder YES it NO Automatic Clothes Washer YES NO DishNasher YES NO Automatic Potato Peeler YES NO Other (Specify) G. MiASTER ?I-';nER MAKING INSTALLATION Name: Address: z!^ License Nu:.;beri Sigratura of Applicant: MP RSW Address: H.~ Lo be o+rpieted by Issuing Agent) Date of Application C 7 ✓ Fee Paid Permit Issued (date) /,-7 Permit Number Agent (Name) t? % Jai- r ; J Fort Town, Village, City, County, ktc. (Specify) Note: The application cannot be considered for filing until all of the above questions are answered and the fee paid. Agents will for,,ard application, the fee of $1.QU for each septic tanx and the third copy of the permit (canary) to the Division of Health. Checks and money orders should be wade payable to the Division of Health. Do not write in space below - FOR DEPARTMENT USE ONLY r I. DATE RECEIVED j - 7 0 ACCEPTED BY RETURNED (Initials) (Date) See Copres.) FEE RECEIVED ✓ VALID. No. rl -7 PERMIT NO. ? 7 (Yes or No REVIEWED BY APPROVED DATE (Initials) Yes or No T COMPLETE OTHER SIDE ~ l a n SEPTIC TANK PERMIT NO. / t R E P O R T O N S O I L P E R C O L A T I O N T E S T A N D S O I L B O R I N G S TO DIYISI7N OF HEALTH - PLU-WING SECTIN P.O.Box 309, hi; isoa, Wis. 53701 Pursus+nt to H 62.20, Wis. Administrative Code P L R C 0 L A T I 0 N T E S T Test Depth Character of Soil Flours Water Test Time DDro Water Level Inches utes Number Inches Thiekn ess in Inohos Since Hole in Hole Interval Second to Next to Las t To Fall 1st Wetted Ovcrn iKht in Minute=s Last Osiioi!bast period Period Ona, Inch Example P - 0 3611 Top Soil 1011c' Clay 2611 25 Yes or No 30 112 112 1/2 CO L~ RECORD DATA FROM MDiI1-RM OF 3 TEST HOLES Compute size of absorption area in accord with H 62.20 Wis. Administrativa Coda, S O I L B O R I N G S- Miniaua 3611 Belem Proposed Absorption Svztzn Boring Total Depth De th to Ground Water De th to Bedrock Number Inches Observed Estimated Cb3erve3 Esti:ated Character of Soil with Thio:ness in Inches Example B - 0 7210 72" Black. Top Soil 1211i_ Clay 1$11S Sand 1811; Gravel 2411 JI 7r rs S s RE:' Ir DATA FROM MINLNUTh 07 3 BORE HOLES YPE OF OCCUPANCY: RESIDENCE: Ntziber of BadrQ ms 1 OTH R: (Specify) Number of Persons POOD WASTE GR D4DERs Yes No K Distmashaej Yes No Automatic Clothes Washers Yes 11No EFFLUENT DISPOSAL SYSTEM: NEW EXTENSION ADDITION REPLA--,,LIT / r Tile Size No.Lin. Feet - i,60 Trench Width Depth Number of Lines Seepage Beds Length 1C i Width .36 Depth ; 30 l Tile Size 7 No. Lines Seepage Pitt Inside Diameter Liquid Depth I, the undersigned, hereby certify that the percolation tests reported on this form were made by me or under my super- vision in accord with the procadares and method specified in Chapter H 52.20 (13), Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. NAME /l 4" 8• C 1/ b 1, TITLE Type or Print REGISTRATION J~N0O.' j~ or MASTER PLUMBER LICENSE N0. ~ ~~f 9 ADDRESS DATE/ SIGNATURE L .w 'KINNICKINNIC SEEPAGE 29 T 28 N:-IR. IR. 18 W I_ Fi d Mer/on crh f T: er/na.17 Geo e E. 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Advertising - Office Supplies CLOTHING - FOOTWEAR - FURNITURE North Main Street WHOLESALE AND RETAIL I PHONE: 425-2484 River Falls, Wisconsin MOB/LE HOMES RIVER FALLS "The Panel People" RADIO SHACK WISCONSIN 54022 - 425-2563 PHONE: 235-0466 - MENOMONIE, WISCONSIN