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HomeMy WebLinkAbout036-2000-20-000 c Np aF. -0 0 m o d ~1 1 m 1 ■s o v v~ o 0)i v °w ~C • N O Q H °ro o o a a m CO 5 _ " °o o ^ N Q N N O m N n'4 \ 1 c (OD CD - n `O F 0 Cn A CL o 3 3 N m o C) ~i N N ~ ~ !V v (n z D a .`~r1 `O (D (fl O N G ` V W -0 4- 3 a ~ w V I a' _ Z s ~ m O (O O ,i N O G z 3 ^ v z ooo~ll~Vl1 o m * * * _ (7 'O C tq fA fn 0 N 0 - ~i v ~vv .O. N N p u7i CD t' - CD D O H > N N j a CD a CL a I z O O 7 O ZWo 0 D a :3 tr o CD N co CD w ~ C (D N (D w co a a 3 z -I N 0 :3 p Z fD N C1 D Z O v a o. M j I W v m fD m z 0 3 a M a a z N N g x a N p - (17 T Q 47 C Q z m O CD 3 N A N •r. CD a d O• 7 I 4 ti ti N O O a A • Oq ,6q 0 ~ N O CL rya 4 Parcel 036-2000-20-000 09/11/2006 09:29 AM PAGE 1 OF 1 Alt. Parcel 31.31.17.609 036 - TOWN OF STANTON 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 - JOHNSON, DARREL E & CAROLE A DARREL E & CAROLE A JOHNSON 1819 143RD ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 1819 143RD ST SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 0.530 Plat: 2106-HOOK'S ADD SEC 31 T31 N R1 7W SE SW & NE SW LOT 12 OF Block/Condo Bldg: LOT 12 HOOK'S 2ND ADD 682/454 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 31-31N-17W Notes: Parcel History: Date Doc # Vol/Page Type 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 05/06/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.530 18,000 125,200 143,200 NO Totals for 2006: General Property 0.530 18,000 125,200 143,200 Woodland 0.000 0 0 Totals for 2005: General Property 0.530 18,000 125,200 143,200 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 Wiseonoin Department of Health rLnd Sooicl Services Plb. f,`-t ! 3,7 0 - Division o? Realtti SEPTIC TANK PEP.-1IT APPLICATION TYPE or USE BLACK Ii?T{ A. C-;TN ER Or PROPERTY W=7 Address (Street, City, ZIP Code) LOCATION OF PROPERTY Who:-;E S T•:M WILL B.. CONSTRUCTED ALTERED OR E3CTEivDED COUNTY " Chack One: CITY VILLAGE LEGAL DESCRIPTION TOWNSHIP .l r C. IS LOCAL PERMIT REQUIRED FOR THIS WOPX? YES NO PERMIT N02F.R D. SEPTIC TANK CAPACI'T'Y ~-!•-t Gallons NEW INSTALLATION ---REPLACEMENT ADDITION MATERIALS: Prefab Concrete ! Poured in Place Steel Other NUMBER OF TAN;{S TO BE IN3TALLEDs E. TYPE OF OCCUPANCY Check Ones one or Two Family Residence L ! Commercial Industrial Other (Specify) Number of Persons to be Aoco=odated Number of Bedrooms . F. APPLIANLES, ETC: Food Waste Grinder YES = NO Automatic Clothes Washer L - YES NO Dishnasher YES i - NO Automatio Potato Peeler YES NO - Other (Specify) G. MASTER PLUPBER MKING INSTALLATION Name: fi' Address: / ; J~ arc W N - License Number: HA Signature of Applicants MP R i r Addressi H. (To be Completed by Issuing Agent) Date of Application _ Fee Paid $ Permit Issued (date) ^ Permit Number Agent (Name) Fors 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+~ard application, the fee of $1.00 for each septio tanx and the third oopy 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 I. DATE RECEIVE) ACCEPTED BY RETURNED _ (Initials) (Date) See Corres.) FEE RECEIVED VALID. No. PERMIT NO. Yes or No E REVIEWED BY APPROVED DATE _ (Initials) Yea or No) COMPLETE 07FuR SIDE BUD 30 3 t 4f°{ `f3 SEPTIC TANK PiFSIIi 210. / '7 REPORT 021 SOIL PERCOLATION TEST N D S 0 1 L B O R I N G S ,✓I 46(d L-0~ r 2 f't(/D . 1G~A DZL'ISI..,v 017 HEALTH - PLL~iBLN v SyCTIR:1 t. PA nv P.O.Box 309, Ka.dison, Wis. 55701 ld++° f Furcuant to H 62.20, Wis. Administrativs Code ":Islor ^r { r 'EO 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 Wator Level InnlleS utos Number Ireh3s Thio:mass in Inohes Since Holo in Holo Interval Second to Next to Last To Fall 1st Hatted Ovornisht in Minuto3 Last Period Last Period Period Cne: Inch Example P - 0 36" Top Soil 1011, C Y 61: 25 Yea or No 30 1 2 1 2 lf2 60 61- RECORD DATA FROM MINIMUM Or 3 TEST HOLES Compute size of absorption aroa in accord with H 62.20 Wis. Administrative Code. S O I L B O R I N G S- Minirr'm 36" Baler Prc used Absor tion 5 3tcm Boring Total Depth Depth to Ground Water Depth to Bedroc„ Number Inohas Cbservod atimatod Obaerved Estir-6tod Character of Soil with Thio!mess in Inches Example B - 0 721# 720f Black To Soil 12" Cla 18,E Sand 18'x• Gravel 2411 ~ ~G I RE=RD DATA FROM MINIMUM OF 3 BORE HOL-) TYPE OF OCCUPANCY: / RESIDENCEI Number of B©droor_+s OTHER: (Speoify) Number of Persons D WASTE GRI1NDZRt Yes No Dlstaiashers Yes No Automatic Clothes Washers Yes L---No FFLIJEW DISPOSAL SYSTF.P1: NEW EXTENSION ADDITION REPLACEMENT Tile Size No.Lin.Feet Trench Width Depth Number of Lines Seepage Bed: Length ? Width Depth ? Tile Size No. Lines L Seepage Pits Inside Diameter Liquid Depth I, the undersigned, hereby oerti:j that the pareol.tion tests sported on this for= were made by ma or under my supor- vision in accord with the procedures and method specified in Chapter H 62.20 (13), Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knoxledZ-o and belie:. //.l NAM: /.l / I , / 1 / //r /I , , < TITLr Typo or Print REGISTRATION NO. or MASTER PL'U'MBER LICw'dSE N0. ADDRESS DATE -:I SIGNA'T`URE fu -