HomeMy WebLinkAbout032-2000-95-000
n cn p m v n
r~
V
Cc c v 0 r,
o 3
'G 3 6a A /y
3 = ~ L L 1\
3 -
U Z 2 U O
r WO Cn (n m .y„ r l e
~ o o
o v m
Ut D j N
O O _ N
CL`- Q co
O
(D CO O N
O
N IcLL 3 ~ J ? O
rI O O 03 C
rn N In O a
ff00 O O
V) :E 7
C...+ d O
r
O t,,
Z D m Q' ~a
O G G7
W 41
C O O N
Z~l O _
CD
C1 \ \ \
o m rn -I n cn
(.C) (c) O cn 0 O c
~ v v n cam.
z
O - ~ --1 -4 A
c a C: cn co fn
° 3 v v q co
L
7 a Vv
O N U
N N ~ ~ Cn
CL CD 0
3
Z m
N
Z (n Z (Np
D N O
a O a :p !J
O ro w - ~e
n _ ~ a N
N O A_
ib N C Cy,
(D
G D CD-
7
Ca.
z N
iI0 ~ O j ~
P Z O
a ° G') O
m m w
CL Z
A ~
O - cn
O " * O
N Z
C A
O
n N 'y`am.
CD ~ ~
O
N O O
a O ~ T
N C
6 co
O N Z SZ
CD n
n (D
d T U
N O
N
y
C
N ~
N ~
a
N
N V
CD
(D
N
O N
O
"O
N _N
N ~
_ a
S ~
f~ 5` b
0
O y a
O N
O O-
Parcel 032-2000-95-000 03i20i2007 09:16 AM
PAGE 1 OF 1
Alt. Parcel 36.31.19.468E 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 - TOWN OF SOMERSET, %TOWN CLERK
%TOWN CLERK TOWN OF SOMERSET C - TOWN HALL & FIRE HALL
TOWN HALL & FIRE HALL
BOX 248
SOMERSET WI 54025-0248
Districts: SC = School SP = Special Property Address(es): = Primary
Type Dist # Description 748 HWY 35
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 2.900 Plat: N/A-NOT AVAILABLE
SEC 36 T31 N R1 9W PT SE SW COM SE COR SE Block/Condo Bldg:
SW, TH N 219.7 FT TO N LN HWY 64 THE
POB; N 450'W 832.5' TO N LN HWY 64; Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
SELY ALG HWY TO POB 36-31N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
11/24/2004 780800 2701/624 EZ
2007 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/08/1992
Description Class Acres Land Improve Total State Reason
OTHER X4 2.900 0 0 0 NO
Totals for 2007:
General Property 0.000 0 0 0
Woodland 0.000 0 0
Totals for 2006:
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
a 3 z.. .2- 0&- ?!57_ 6 ~
Form Plb 67 ~ ~ 7/ Wisconsin State
/ / 0g6`APPLICATION FOR PERMIT Division of Health
for
PURCHASE OR INSTALLATION OF A SEPTIC TANK
(Sec. 144.03, Wis• Stats•)
A. OWNER OF PROPERTY Type or use BLACK ink.
Name Address Street, City, Zip Code
aB. LOCATION OF PROP~;RTY WHERE SEPTIC TANK IS TO BE INSTALLED
Check 1. _ City Mail address , Counter
one: 2. Village '-v
3• Town
e l
Give license number held:
C. INSTALLER Wisconsin Restricted
Licensed Sewer
Plumber Services
Name Address
f j 3
Lrl..%.e- ,t ~ r Y .i~r.sf ~ d'J ~~t ..~i/ ..j' +.._,•~„a~. 'f "}.._Nf'
D. SPECIFICATIONS OF SEPTIC TANK NEW TANK_ REPLACEMENT
Size in gallons: Check one
1. 500 gal. 4. _ 1,500 gal. 7. 4,000 gal.
2. 750 gal. 5. 2,000 gal. 8. - 5,000 gal
3. 1,000 gal. 6. _ 3,000 gal. 9. mover 5,000 gal. give capacity
Materials: 1. Prefab concrete 2. Poured concrete 3. Steel
E. TYPE OF OCCUPANCY
1. _ Single family residence 3. Commercial establishment 5. Other
2. Multiple family residence 4. ` Industrial establishment
F. APPROXIMATE NUMBER OF PERSONS SERVED DAILY
G. PERCOLATION TEST MADE 1.✓ Yes 2. No Date
By whom ; .~t s`> a f~' '
(To be completed by County Clerk)
rA
r
Date application is filed and fee paid
Permit issued (date) f r' Permit Number
~:4-'
County Clerk
Note: The application cannot be considered/for filifig<'until all of the abb~te questions are
answered and the fee plid. County Clerk will forward application, the fee of $1.00,
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.
RECEIVED
Plb~ Ky 1 3
NAME OF BUSINESS ?Jl f
PLUMBING SECTI o
LOCATION';
street or highway city--or township county
OWNER ` ` r ~7 { Mailing address,'
ARC
16T CT 0R EN~I SEER Address Y • C iii:. _s
PLUM.BER'..~~C~:.f~-'
~1. Check appropriate building usage(s) and fill in the information requested opposite
each usage listed:
Existing building New building / Addition
if addition to existing building attach detailed memo for each.
ov.-.ca u.V a vv.u • • • • :rcuvi:n vwjj+va oy Div .+:j.f v. /ptPv uTi)
O Motel O Hotel O Cottages • Number of units: Rcilar Hoasctkeapinr~
2 persons/unit
4 persona/unit TOTAL NUMBER OF UNITS
Bar or cocktail lounge . . . . . Seating capacity (10 rq.ft./person)
Nursing or retirement home Number of beds
O Mobile home park . . . . . . . . Number of units - dependent
- nondependent
Service station . . . . Nurbor of ears served (daily)
School . Number of claverooma Meals served Yes- NoShowers provided Yesl~ No y
O Factory or office building Number of persons (total all shifts) a=~
( ) Residence • • . • . • • . . . Number of bedrooms
Oother -specify -~.~f, -
2. Indicate whether or not the following facilities are connected: Food waste grinder . . . Yes - No /;-'No
° - Dishwasher . . . . . Yes
Automatic clothes washer Yes No
3. Fill in the approprl te'infoz Lion for the following as indicatod:
Septic tank a3paoity planned - .Norrml
septic tank capacity ' 'r'
required
50% increase for F,G or AN Total septic tank capacity required
Percolation test results - ATTACH PEFFZOLATION TEST RSPORP SHE.XT PA"
Seepage trench bottom area planned , width , linear fact
depth
Seepage pit planned -`2 . outside diameter > - ; depth below inlet depth
-
Seepage trench bottect area required . width , linear feet
Seepage pit required outside diameter , depth below inlet
Signature of person completing form: STATE BOARD Or-HEALTH, PLUMBING DIVISION
P. 0. Box 309, Madison -Wisconsin 5,3701
7
Address: Approved: '
Date Date J i~ 4 P.
ING CODE REQUIREd,INTS AND ~ ; ;,cl
EXEMPT THE INSTALLAI lYN C: (f, 4`IL-
LADE, TOWNSHIP 0,f C011NT'f kE uL; iiUi;S
OR PERCAIT @EQUIRu' ENIS,
Hwy l~
C