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HomeMy WebLinkAbout032-1034-95-000 o 01 o > > o 3 CD o -0 M c n v (D v (D cn CD 3 M o m • Cl) Z 2 (J~ Z O p O N IN S~ O N ~ O N~ j p,y W (D a N CD p O j `►Y l^l O. CD CD O_ N O N' OW "h 1 O\ N 7 (D N j A "'S N O- J CpJ1 o 00 (D N CD n N O n O C:L C) fl1 C N O !r f0 m z D a s 00 W w c ro c s i O N N S 3 0 R lot L ~ ~ N O O O Z li N ,0„ Q CD 3 !V ~ 0 0 0 • Z 0 0 0 55' o 0 D ~i 3 < z ry,~ C) J N cn cn ° v m ~vva CD cQ Z J P. W ~1 IN 3 O Z o ZCDo O nD s m c+r • CD N CD i O N fl_ W N CL 3 N z CD O N O ~ ~ ~ n Q A j N O m N CL i z 3 a G U) p m cD 3 N ~ CD W N O O5-v o N D 3 O N O Q j 0- U) CD 'm o :0, -n 1 0 OS S N C O 3 cD30N= o a p5 Cnm -0 W CD ~ N o:o-o°- a CL 0 n m a v o o'•~ N e v m m 3 a m 3 N V n m o ma N NO Z t a CD O O T). Q N 0 3 -0 CD a v ~ ~ Parcel 032-1034-95-000 09/21/2006 12:26 PM PAGE 1 OF 1 Alt. Parcel 12.31.19.172C 032 - TOWN OF SOMERSET 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 - GERMAIN, DOUG C DOUG C GERMAIN 2248 80TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 2248 80TH ST SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 2.000 Plat: N/A-NOT AVAILABLE SEC 12 T31N R1 9W NE SE LOT 1 CSM 1/230 Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 12-31 N-1 9W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 907/390 07/23/1997 855/446 07/23/1997 841/363 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/23/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 32,000 71,100 103,100 NO Totals for 2006: General Property 2.000 32,000 71,100 103,100 Woodland 0.000 0 0 Totals for 2005: General Property 2.000 32,000 71,100 103,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 143 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Departaent of Health and Social Services Plc,. #67 3/70 Division of Health SEPTIC TANK PERMIT APPLICATION TYPE or USE BLACK INK CJ , i J ~G. A. OWNER OF PROPERTY Name Address (Street, City, Zip Code) 22~ ~ f~ d B• LOCATION OF PROPERTY WHERE SYSTEM WILL BE CONSTRUCTED, ALTERED OR EXTE`MU COUNTY L Check One: CITY VILLAGE LEGAL DESCRIPTIFN -'7 TOWNSHIP..-.~ C. IS LOCAL PM1IT REQUIRED FOR THIS WORK? YES . no ~ fz PERMIT NUMB ERi D. SEPTIC TANK CAPACITY / ' Gallons NEW INSTALLATION REPLtcimbf ADDITION 1 MATERIALS: Prefab Concrete ,,~r Poured in Place Steel Other j NUMBER OF TANKS ?0 BE INSTALLED: / E. TYPE OF OCCUPANCY Check One: One or Two Family Residence Commercial Industrial Other (Specify) Number of Persons to be Accommodated Number of Bedrooms y F. APPLIANCES, ETC: Food Waste Grinder YES NO Automatic Clothes Washer YES NO Dishwasher YES NO Automatic Potato Peeler YLS-57 NO Other (Specify) G. MASTER PLUMBER MAKING,TNSTALLATION Hams; 7: Address= License Number: Signature of Applicant: MP RSW iS> ~ 7 / j Address: H. (TO be Completed by Issuing Agent) Date of Application Fee Paid z Permit Issued (date) Permit Number 7 Agent (Name) For: _ Town, Village, City, County, etc. (Specify) Note; The application cannot be ;onsidered fc r firing until all of the above questions are answered and the fee paid. Agents will forwa-rd application, the fee of $1.00 for each septlo taruc and the third copy of the permit (canary; to the Division of Health. Checks and noney orders should be made payable to the Division of Health. Do not write in space below - FOR DEPARTMENT USE ONLY I. DATE RECEIVED ACCEPTED BY RETURNED (Initials) (Date) See Corres. FEE RECEIVED VALID. No. PERMIT NO. r~ ~es or No REVIEWED BY APPROVED DATE (Initials) Yes or No COMPLETE OTHER SIDE I SEPTIC TANK PERMIT NO. %R X P O R T O N S O I L P Z R C 0 L A T I 0 N T Z S T A N D S O I L B 0 R I N G S TO Q DIVISION OF HEALTH - PLUMBING SECTI6X P.O.Box 309, Madison, Wis. 53701 Pursuant to H 62.20, Wis. Administrative Code P X R C 0 L A T I 0 N T Z S T Teat Depth Character of Soil Hours Water Test :lu+a Drop in Water Level Inches utes Number Inohes Thi*kn ess in Inches Since Hole in Hole Interval Second to Next to Last To Fall 1st Wetted Overni ht in Minutes List Period Last Period Period ~a< Inch Example P - 0 36" To Soil 10'. Cla 26't 25 Yes or No 30 F12 2 12 60 RECORD DATA FROM MINIMUM OF 3 TEST HOLES 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- Minimum 36" Below Proposed Absorption System Boring Total Depth Depth to Ground Water De th to Hedrock Number Inohes Observed Estimated Observed Estimatid L Character of Soil with Thioitn"s in Inches T Example B - 0 7272n 1191aek To Seil 121' C i8' ~Sah 1811•' ravel 24" A. RECORD DATA FROM ~t}- Bon HOLES PE OF OCCUPANCY: RESIDENCE: Number of Bedrooms OTHERS (Speoify) / Number of Verson POOD WASTE GRINDLR: Yes No \ Dishwasher: Yes No Automatic Clothes Washers Yes No i EFFLUENT DISPOSAL SYSTEM: NEW _ EXTENSION ADDITION J,WLACEiENT 1 Tile Size No.Lin.Feet Trench Width Depth Number of Lined Seepage- V014, Length dth-;, f _ Depth il Size No. Lines Seepage Pit: side Diame er Liquid Dep_~...- i• I, the undersigned, hereby certi y that the peroolation tests reported '.?n this fora were made by me or under m, super- vision in accord with the procedures and method specified in Chapter H 62.20 (13), Wisooasin Administrative Code, and that the data recorded and 1~~ation of testholes are correct to the bee o? /49oh dge and belief. I NAME TITLE - Type or Print REGISTATION NO. ~ ~ ~ or MASTER PLUMBER LICENSE NO. ADDRESS DATE SIGNATURE C ! 1 o O 0 v m v CD f ~y m 3 _ t Cr z = C O N ICJ! O 'A phi N A O~ - (D D CL 177~ _ O (D N W CO O W (D A a. N ~ O O Q ~D v O O U) O N O Cr) cn 7 O 7 N G. O PL N N ~ O N Nml i.0 CI N Z D (D a - t O a O P A ` p co co j _O O i(p O o co (D CD Ca r cn 0 o z cn ° (D I-A ~ ~ tae O O O o -1 -i < Z `r+a (D 0 L m v O 0 CD- cn ~ m v cD CD c o n cD v CD a ~ ew G_ a) g, N 7 ~ 9L O W (D O 3 J z m z D D ° -0 10 O N w -0 7 N. N (D _ Q CD- if O Z n 'p Z O Z -I co v m (D (D z O - Cn O m N ~ (D A W {u O (D O EF "O O N 'D p~ n (D -O Wy O N (D T "t m - go N N O O T N j m (D 0 ~ cJ o ~ ~ o wi m (D -0O N (ND Cr' io-°-a -0 ° - N ° N 0 0 ° m,G o _ Z3 - = N c~ ~cnw °G* m v _ ° m fl' G N _ N Z 3 ? -1N00 Et (D (D (o v (D ~ ~ v ';p r^4 L O O t p `'~~r'r^ ST. CRdIX COUNTY ZONING OFFICE; St. Croix County Courthouse's fro.` grC ,"~~9 911 4th Street it Cp Hudson, WI 54016 S O Telephone - ( 715) 386-4680 : + "~•x Croix County Zoning Office offers the servkde P ptic and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion of this form is essential so that the property can be located. Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. WATER TESTING----------------------------FEE: $ 25.00 (For nitrates and coliform bacteria) WATER TESTING FEE: $175.00 (For VOC'S) SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00 (Determines if system is properly functioning at time of inspection) Property owner's name T)".. Property owner's address 4 Legal De~ription 1/4 of the 1/4 of Section , T N-R Town of .Lot Number Subdivision Name FIRE NUMBER LACK BOX NUMB z 3e Color of house Realty sign by house? If so, list firm: PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual requesting services: Telephone Number REPORT TO BE SENT TO: Closing date Signature t C fi y. t~j A;4 6tC f sn. f j /L' t(.,, ~MERCIAL TESTING LABORATORY, INC. 514 ,Wain Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 CICAw 600 - 962 - 5227 5T. CROIX ZONING REPORT NO.. 35720/01 PAGE ST. CROIX COUNTY REPORT BATE; 11/03/89 COURTHOUSE BATE RECEIVER. 10/31/39 HUDSON, WI 54016 ATTN: THOMAS C. NELSON iWNIEt..: nar i Karen Traynor. LOCAT10N~ Rtfi 2, New Richmond COLLECTOR: St. Croix Zoning SOURCE OF SAMPLE: Outside faucet COLIFOFMI 1601100 mL. INTERPRETATION: Bar-terioiog:iCaiiY UNSAFE NITRATE-N; 2 ppm Under 10 ppm i safe for humnr, consumption. COLIFORM + NITRATE LAB TECHNICIAN! Dam Gane WI Approved Lab No. 19 OF.\HD ~FHpEH r ;L 9m O O vi y i A 6+ ® i Means "LESS 1H44 Dete~iable~ ave iippri?V2CL by'. © PROFESSIONAL LABORATORY SERVICES SINCE 1952 . t i - -OMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 Cl LA&, 800 - 962 - 5227 U tt~~r.i DrTF 1Ir a o'i ,7URTi10USE N. Wl CATION: Rt. 2, Box 159A r :a LECTOR: St. Croix Zonin her, f s. "Jo ,r• TERF'RETATIONi Bacteri,,:.'. PPq! I Of.\NDE7ENOfH V l 7m O PROFESSIONAL LABORATORY SERVICES SINCE 1952