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HomeMy WebLinkAbout006-1082-10-000 0 N O 3 v n l~ C7 ~1 3 ~ ~ m v sv v v 0 O 0 0 O W N 0 Un g :r r 3 o c cn :E o j r., r5/1 c CO W O En fA N L O W N C 1 N N C) c m = m 0 ~ o cn o O 3 0 3 N CP o p W N !V m Pi v_O fn C W a p t~ cn =r -u 0 CA O - N 3 O A (D p 0o N i O O (D 0 r- (n N W co* (p 0 C v v v 3 rT tr, O O O o o Q a 3 cn cn cn o ~D o O O 0 o o DO (D < v J D N D W o O O Q- (D m Nr ~r a m ( m m N IY~ (D N v C (D Cl) @ a- 3 5- (D co s -i fn O ? ? CO C > N O A z O n O O Z j W N (D z CL o A 0 Cn m N z ~ ~ (D zt ~ A W o -o m aD N p7 3 O _O- C (D 7 O N Q 7 3 T S fD N C o a 3 y o o m 3 O (D Q N fD CD En o "00 o 3c~ov v ~ m o a ;I. N N S i OCo C=D Cn 0 N _ CZ O C9 < O ti (D 0 O 0 =3 'o A 'C yQ Cn O Cw~ (A O ti a O ro O fD CD i ti • AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP a SEC- T-~-LN, R-LLW P.O. ADDRESS ST. CROIX LINTY, WISCONSIN. SUBDIVISION LOT LOT SIZE I ffe-3 3 Z~OA S-r PLAN VIEW ~~/S~ ~C. ~ S'• / Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM t i SEPTIC TANK(S) MFGRt^~<, /CONCRETE STEE . NO. of rings on cover -~TDepth rr DRY WELL TRENCHES NO. of width length area BED no. of lines width len th area depth to top of pipe , AGGREGATE , C~ 1~-~ ✓>i ✓r<< x PERK RATE AREA REQUIRED AREA AS BUILT • f~/;I, ' Disclaimer: The inspection of this system by St. Croix County does no's imply complete compliance with State Administrative Codes. There are other areas that it is not possible to inspect at this point of construction. St. Croix County assumes no liability for system operation. However, if failure is noted the County will make every effort to determine cause of failure. GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. INSPECTOR I DATED PLUMBER ON JOB_ f j <-SIX LICENSE NUMBER / n N 0 n N O 3 m o = r1 ° <D CD ° m m a m A~ • ~3 33 3 3 l 1 O 0 N N O 0) N O 0 O CD N O A W p i CT O h• =r_ o c ° = 3 o m CD w Cn f 0 C; lrrry^lll l O\ ? Q= Z fl. N CD J d Z d N Co (D ! 1 N S O co Cn N C (D (D co 7 N I ~ m 00 O - ET CO CD W N N C_ O O N N SD N ` 1 ° O U) C07 ~ N rr CD O o n : CD 0 O N O O O O 0 0 ! ' C CD (D f) W, i O co O .O+ 3 ° co 3 O W O l\ 'a Fa Lyl ra N N CA co C7t ° O N G ° O cn [ D A a C) J cn Z D A CD Cfl N 0 N d CD CL] 0 N C- CD pp CD W CD CD C C N i? O O N 3 A m N 3 O co W J L 20 N N C i Z8 8 O (D !i N N --4 -4 a N (b (b a (0q 0 C 00 00 O O O A 11 O O O A M 0 0 vi co w cn cn w! m `i ~7 cr CD N v CD - y N (D O N 9 rr lD O Cp 0 0 C N 0 3 7 7 (D CD U) o Z Z _ z z z o o D o D O 0 0 ° c • w O O N C:) CD CD O N 0 o p w x CD 01 = C ((D C O O - ~1 CD CD N c _0 C M CD - CL] O 0 ~ (D - O CD CD N 7 N > > N CL p Z 0 (n o m c Z O Q A I C~C W Ln CDC CD CD 0 < O. O. " Z 3 a r: 0 0 0 0 ' Z CA 3 Z Z1 (D A W 0 N 7' C7 N~ o -1 D -0 00 cn O D 3 _O m n c woCD o n m CD 0 :3 (O F CD A O N Q C 3 cn T . T CO N y j C °4 r v ' n m N C N `G II1 C CQ _ o < N p 0 O w o Q -0 a 0 0_ 77 o m (n - U) 50 CD M CD (n ° v \l Cno mm 3° cc o = CD - :D co CL =r 7 CD N ° co CD r- cn J 7 o N N co CL =r CD J CD o CU CT 7 C C) CD J p _ N =r g CD C- o ET 'o :3 CC 77 <n o - x 0 I 0 A b CD la En O En O N 0 b ° b (D O 0. OO 0p_ ti 11RPOP,T OF ITISPECTIO'_1- -1741MIDUAL SE!JAGL DISPOSAL SYSTEM Sanitary Permit State Septic 7a,5" IS TOt1I1STiIP 'V St. eroix County SEPTIC Size gallons. `umber of Compartments ! Distance From: 'Jell , ft, 12% or greater slope ft. Building _ ft. Wetlands 1 ft lLighwater LLP ft. DISPOSAL SYSL.:J Tile Field or Seepage Pit(s) Distance From: Tlell ft. 12% or greater slope ft Building ft. Wetlands Z2 FIELD ~ r~lighwater ft. Total length of lines ft. !Number of lines- Length of each line ft. Distance between lines ft. Width of the trench -ft. Total absorption area sq, ft. Depth of rock below the .___.__..in. Depth of rock over the in. Cover nver.rock, . Depth of tile below grade - _in. Slope of trench in ner 1,00 ft. Depth to Bedrock ft. Depth to ground water ft. Number of pits Outside diameter ft. Depth below inlet ft. Gravel around pit: ____yes no. Total absorption area sq. ft. Square feet of seepage trench bottom area required Oquare feet of see nit area required Inspected y • Title: Approved Date 197. Rejected Date 197 i J State and County State Permit # 61 PLB67 Permit Application County Perm)t # s_- for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: cl, B. LOCATION: S~J Y4 '/4, Section , T N, R y Ir (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township C. TYPE OF OCCUPANCY: *-Commercial *Industrial *Other (specify) * ariance Single family( Duplex No. of Bedrooms j No. of Persons D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES NO # of Bathrooms-- Automatic Washer YES NO Other (specify) E. SEPTIC TANK CAPACITY lz~M Total gallons No. of tanks *Holding tank capacity Total gallons No. of tanks ` New Installation Addition Replacement- Prefab Concrete x *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1 U 2). U 3) Total Absorb Area sq. ft. Newer` Addition Replacement *Fill System Seepa Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Length Width / _ Depth ;'w Tile Depth No. of Lines Seepage Pit: Inside diameter Liquid Depth Tile Size y ~r Percent slope of land Distance from critical slope I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Co nd that I have sized the effluent disposal system from the EH-115 prepared by the Ce i d oil Test r NAME v ' t C.S.T. # s S and other information obtained from ?rv~ (owner/builder). C' Plumber's Signature MP/MPRSW# Phone #2y6-3 Plumber's Address PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). J _ Z1~1 ~c _ .Z F6 1r . ~ r Do Not Write In Space Below tt1 FOR DEPARTMENT USE ONLY / Date of Application-- O Fees Paid: State hip A'_+ C _ C un ~I - 66 th Date Permit Issued/Rojeeted (date) ~2~~ -Issuing Agent Name-~f"-L~ Inspection Yesx No Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 6/1 /76 EH 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TES~Sd LOCATION _'/a,ISE'' '/c, Section ; T_. _ N, R _ f>(or) W, Township or Municipality Lot No. , Block No. County Subdivision Name Owner's Name: - u. - Mailing Address: o__5 TYPE OF OCCUPANCY: Residence No. of Bedrooms '3 Other EFFLUENT DISPOSAL SYSTEM: NEW N ADDITION REPLACEMENT -~4 7 DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS SOIL MAP SHEET SOIL. TYPE PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE 'JUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN 3ER I-- SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) f CS.. fl'~Z 14 ~fl~ SL 3 6 1 -3 s J- - T S -,zy 4- ~ y -~6 SC 17 s T r z 6 AA. 1~t 6 _V -_3d J PLAN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of squar feet of absorption area needed for building type and occupancy. /l~SI Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope.- I w ~ i ~ I I f I ` I I ~N { ~ f I I I, the un ersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and meth ds specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief i Name (print) 0 /L Certification No. Address A Y 3 Name of installer if known L CST Signature COPY A -LOCAL AUTHORITY _ ' ~ 1959 1956 • 1948 1946 • I m m d- ^ N ~ N • N • ~ L N N N N m 189 1 • 1875 1873 • 18 h Ave. 00 • 1853 35 184th Ave. 1840 - 0 N .2466 468 - to - - - 1I f1 t„ N 1788 . Parcel 006-1082-10-000 05/09/2011 12:10 PM PAGE 1 OF 1 Alt. Parcel 35.31.16.545 006 - TOWN OF CYLON Current X' ST. CROIX COUNTY. WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner 0 - HENDERSON, LATON N & RANAE J LATON N & RANAE J HENDERSON C - ERICKSON, SAMUEL C SAMUEL C ERICKSON 1790 220TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description ' 1853 240TH ST SC 3962 SCH DIST NEW RICHMOND 11 U l~-~ SP 8020 UPPER WILLOW REHAB DIST ILCl'~t~--j SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 35 T31 N R1 6W 40A NW SW Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 35-31 N-16W Notes: Parcel History: Date Doc # Vol/Page Type 03/03/1998 574222 1302/044 WD 07/23/1997 1191 /160 WD 07/23/1997 863/304 LC 07/23/1997 7481436 2011 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 06/10/2010 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 15,000 24,900) 39,900 NO AGRICULTURAL G4 38.000 7,800 0 7,800 NO UNDEVELOPED G5 1.000 100 0 100 NO Totals for 2011: General Property 40.000 22,900 24,900 47,800 Woodland 0.000 0 0 Totals for 2010: General Property 40.000 22,900 24,900 47,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0 00 ~o c fA ON iO~ ^ ° 0.o r . : `""*i.: .,,,'.•q"~`s ,~..._.,»h a .gym;. " rr rte. ° 41 @. v.....,.. IN 9!1100 0 .$5... x. MOP. yr CD ~m HICGZ a1 n Y CD (D D u) - 0 0 g ' l~,rh `v 75 -1 (n N N APOO CD r„ F e,~ q a~;. xt (f_I "y. Fm a~ cn ° . ~ a "1 4, `F ~`rs u z D.n 1 w` kuOR"~3 a v " JW" p~F't k~ ^ Z ei1 v+a;t. `Er a ^^uk w, . Parcel 006-1081-80-000 02/17/2006 01:27 PM PAGE 1 OF 1 Alt. Parcel 35.31.16.542B 006 - TOWN OF CYLON 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 - HENDERSON, LATON N & RANAE J LATON N & RANAE J HENDERSON C - ERICKSON SAMUEL C ERICKSON SAMUEL C 1790 220TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property-Address(es): Primary Type Dist # Description 3 240TH ST SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 2.060 lat: N/A-NOT AVAILABLE SEC 35 T31 N R1 6W PT OF SW1/4 NW1/4 COMlock/Condo Bldg: NW COR OF SW1/4 OF NW1/4 TH S ALG CEN LN - TOWN RD, 561' TO POB; TH E 495' TH S Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 1815TH W 495' TO CEN LN TN RD TH NLY 35-31 N-1 6W TO POB Notes: Parcel History: Date Doc # Vol/Page Type 03/03/1998 574222 1302/044 WD 07/23/1997 1191/160 WD 07/23/1997 863/304 LC 07/23/1997 748/436 more... 2005 SUMMARY Bill Fair Market Value: Assessed with: 685 242,800 Valuations: Last Changed: 09/09/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.060 15,000 196,500 211,500 NO Totals for 2005: General Property 2.060 15,000 196,500 211,500 Woodland 0.000 0 0 Totals for 2004: General Property 2.060 15,000 196,500 211,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch M PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00