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HomeMy WebLinkAbout040-1071-80-000 'o CD Q c u) o N p °va y h to c a a ° c h ~ a V O U N c y N O (0 ! c N N I N N N Z n O i c L f15 p) LL c cp d O CL Co w N (D a o c 'O N Q N 3 r) N Z w' E rn z o v Z ! D 00 cu C14 a co U o z v' : d Z a ° c cn 0) C E _0 N N N d w •N rn a m n p 0 a) w Z O Z N N ~ I FO T O d :3 0 «s a a N o o (L co a~ es es F- F- F- m 3: 3: R. EL N •iw o o a a N o 0 o U) J U rn rn o 2 Z aU') w v LL rn I po 0 0 0 = Q N N N N C) 7 O = N r N n c n- O <r O co L N O N c d Q Z tq Q O 3 r O O Vyl C 0 v Q o w o ° m o o 00 O U O C O a 0 0 o a o c O a s ~ 0 0 0 0 0 N U (n (6 E -O N N N N N r, p p c C CD N c Q) Lo I- O t- 4.i p~ F- O N 1,5 -0 Lo N p N d Lo r- I--i N T C N 0+ 3 O O O • O H O Z N 2 Z (n v ~ E c1 N m 0- = it O. L a • C~ a m E c m y c ~V '9 c r/► O -M 3 3 O ~1 A U a E 0 <n U Parcel 040-1071-80-000 05/25/2007 08:52 AM PAGE 1 OF 1 Alt. Parcel 18.28.19.274E 040 - TOWN OF TROY 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 - BEEBE, JOHN W & LORIE L JOHN W & LORIE L BEEBE 355 CTY RD F HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 355 CTY RD F SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 1.500 Plat: N/A-NOT AVAILABLE SEC 18 T28N R19W 1.5A IN SW NE COM SW Block/Condo Bldg: COR NE1/4, TH E 1175 FT, TH N 591 FT, W 225 FT TO POB: TH W 385 FT, S 170 FT, E Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 385 FT, TH N 170 FT TO POB 18-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 11/06/2000 633077 1556/546 PR 02/16/1999 597860 1403/637 TI 07/23/1997 483/151 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/20/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.500 48,400 186,400 234,800 NO Totals for 2007: General Property 1.500 48,400 186,400 234,800 Woodland 0.000 0 0 Totals for 2006: General Property 1.500 48,400 186,400 234,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 217 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 Sorvices : +'=a•,67 3/70 Division of Health • SEPTIC TANK PERMIT APPLICATION V/~~?~/_--_1 • I~.tt, V WD l TYPE or USE BLACK INK A. OWNER OF PROPERTY Name Address (Street, City, Zip Code) B. LOCATION OF PROPERTY WI :RE SYST£c'I WILL BE CONSTRUCTED ALTERED OR EXTENDED COUNTY Lf Check Ore: CT_TY Vir-I- E LEGAL DESCRIPTION TOWNSHIP 1 / i : 4 C` ~t c S C. IS LOCAL PERMIT REQUIRED FOR THIS WOP ? YES NO PERMIT NUMBER D. SEPTIC TANK CAPACITY tz Gallons NEW INSTALLATION ; REPLACEMENT ADDITION *IATERIALS: Prefab Concrete a, poured in PI~ce Steel Othei NUMBER OF TAh;{S TO BE I `iSTALLED: E. TYPE OF OCCUPANCY Cheek One: One or Two Family Residence Commercial Industrial Other Specify) Number of Persons to ba Accommodated Number of Bedrooms F. APPLIANCES, ETC: Food `Waste Grinder YES NO Automatic Clothes Washer YES NO Dishwisher j YES NO Automatic Potato Peeler YES- NO Other (specify) G. MASTER PLUI"-ZR MAKLING INSTALLATION Name: 1 f!~ Address:~=Z~~~y~f ("License Number: 1 t Signature of Applicant: f_ c r r Y MP RSW A" Address: (To be Completed by Issuing Agent) - / ? ~7 , # d Date of Application _ - / Fee Paid Permit Issued (dates)/ Permit Number Agent (Name) Fors _:<-1 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 $1.00 fir each septic tanx and the third copy of the permit (canary) to the Division of Health. Checks and money 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 f (Initials) (Date) See C-.•~ra(s.t FEE RECEIVED VAI,~TD. No. PERMIT NO. Q'--) es or Na REVIEWE0 BY APPROVED DATE (Initials) Yes or No COMPLETE OTHER SIDE SEPTIC TANK PERMIT NO. R I P 0 R T O N S O I L P S R C 0 L A T I 0 N ? E S T A N D 5 0 I L B O R I N G S TO DIVISICN 0° HEALTH - PLU-011 ~ SECTION P.O.Box 309, ra.dison, Wis. 53701 Pursusnt to H 62.20, Wis. Administrative Code P B R C 0 L A T I 0 N T I S T Test Depth Charaoter of Soil Hours Hater Tes-; Time Drop `.n rater Level Inches I~nutes 1 Number I Inohe3Thiokno33 in Inohas Since Hole in Holo Interval Second to Next to Last To 4n_. lst Wetted Over'% ht in tt',tute3 Last Period Last Period Period ~'-3~ Inch E~ x^pie P - 0 3611 ?o Soil 10" C1a 26~" 25 Yes or No 30 1 2 1/2, 112 ' 60 ~L t1.a:3 ~~1j' <i /t L j i.J L- RECORD DATA FROM MINR~R[M OF 3 TEST HOLES Compute size of absorption area in accord with H.62.20 Wis. Administrative Coda. I S O I L B 0 R I N G S- Miilmam 36'f Below Prooosed Absorption 5 st.'m ~ Boring Total Depth Depth to Ground Water 02 2" to Bedrock N Leber Inchaa Inserved E3-tir tad Oose:^ied Estimated Character of Soil with Thioinness in Inches Example - A - 0 72" 72" Black Top Soil 12''; Clay 1811; Sand 1811• a a) 94 14 ~Oit. ~y~ y 4 n , J L' Shce' RECORD DATA FROM MI'YP,IUM O? 3 BORE HC-1-Z3 YPE OF OCCUPANcyt RESIDENCE: Number of Bedrooms OTHER; (Specify) Number of Parsons < D WASTE GRLNDERt Yes No Dlshnashers Yes No Automatia Clothe.t Washer: Yes No FFLUENT DISPOSAL SYSTEM: NEW EXTENSION ADDITION RF3L1C-1-'-N' Tile Size No.Lin.Feet Trench Width Depth Number of Lines Seepage Bed: Length Width Depth Tile Size No. Linea Seepage Pits Inside Diameter / Liquid Depth I, the =darsigned, hereby eert._y that the percolation tests reported zn this fora were ride by me or under n1,• super- vision in accord with the procedures and method specified in Chapter H 62.20 (13), Wisoonsin Administrative Coda, and that the data-recordad and location of test holbs are oorr_et to the best of my knowledge and belief. y - NAME TITLE - Type or Print ! 1 f`~' 0 / t REGISTRATION NO. or MASTER PLJMBER LICF?IS£ NO. ADDRESS DATE ~~'J- A Lam/ SIGNATURE A -