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HomeMy WebLinkAbout106-2034-50-000 0 to y O m v 0 o d `r1 f c m o 3 T ID 2. 2_ v v ! c m y # 1 3 3 A: a~i n=i m o cn o am° G OR 8 `C • rn m o m CD cn 00 N -S~ N 0- ~ d C) CD ~ O r.y a ~W o a Woo 0 (D (D 0 o CL o o ? !i 3 y v o N N a a O w to < D M a CD N a N co 3 ° rn w O ~ S _ CD i I ~ _ I co co 4 -4 O co (n C Cp a 3 Q ~ 0 0 0 ? K t~il• z 0 0 < !mil o = 9 w z 0 ~E 3 tin tin ai a 9 D - ~I v Q V O O° o O N @ CD (D o f/I N v (D d m - ~ co M N CD 1 CD C1 7 N Z N z co z 0 o d O D a o @ N• N N (D N C C CD CD W CD C1 FL 3 7 z (D Cp N I O = 4 . A ? C~1 C') A C 7 p Z N rn W v a CD 00 Z O 3 i7 p r! C/) m 3 m z CD A I - v ti a CL v Cy :3 CD O C O O v O a N J N X COI)CDQ 1 CD N ° N 1 O O 0- O j A O CL CD 1•~ Dn b ell °o< C.C 1 N O CCD CD M O cn C' A O o0 CD 7q Oo O Efl 0 ti p 6 (D as 6 O CL y Parcel 106-2034-50-000 12/02/2005 02:12 PM PAGE 1 OF 1-- Alt. Parcel 06.28.16.949 106 - VILLAGE OF BALDWIN Current X CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # rmit Type _ f 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - CELLOTTI, MARK T & KATHIE A MARK T & KATHIE A CELLOTTI 2245 205TH AVE DEER PARK WI 54007 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 2121 55TH AVE SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC legal Be~crlp ' Acres: (_~4.030 at: 2012-CSM 07/2012 SEC 6 T28N R1 6W 14. 30 AC THAT PART LOT lock/Condo Bldg: 3 CSM 4/1123 NKA L 3 CSM 7/2012 17-95 (90A) EZ-U-1262-500 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 06-28N-16W Notes: Parcel History: Date Doc # Vol/Page Type 06/05/2000 624175 1516/115 WD 07/23/1997 1090/632 TI 07/23/1997 654/620 535/608 ANNEX 2005 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/02/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 30,000 170,400 200,400 NO UNDEVELOPED G5 12.030 13,200 0 13,200 NO Totals for 2005: General Property 14.030 43,200 170,400 213,600 Woodland 0.000 0 0 Totals for 2004: General Property 14.030 43,200 170,400 213,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch 103 Specials: User Special Code Category Amount I Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 008-1017-95-000 12/02/2005 02:28 PM ° PAGE 1 OF 1 Alt. Parcel 6.28.16.90A 008 - TOWN OF EAU GALLE 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 - BENGTSON, ANNEXED ANNEXED BENGTSON Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 14.030 Plat: N/A-NOT AVAILABLE SEC 6 T28N R1 6W 14.030 AC THAT PART OF Block/Condo Bldg: LOT 3 CSM 4/1123 NOW KNOWN AS LOT 3 CSM 7/2012 AX-535608 NKA 106-2034-50 (949) Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) (EZ-U-1113/028) 06-28N-16W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1090/632 TI 07/23/1997 654/620 O 2005 SUMMARY Bill Fair Market Value: Assessed with: Valuations: Last Changed: 01/10/1996 Description Class Acres Land Improve Total State Reason Totals for 2005: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2004: 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 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP( SEC. t~ T N, R /~C= W P.O. ADDRESS ST. CROIX COUNTY, WISCONSIN. SUBDIVISION_ LOT LOT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM tai t 1 k SEPTIC TANK(S)_ MFGR.'c CONCRETE, STEEL NO. of rings on cover Depth DRY WELL TRENCHES NO. of width length area ~r BED no. of lines - width / length area J-7 depth to top of pipe /11 AGGREGATE PERK RATE AREA REQUIRED AREA AS BUILT C -'S rJ Disciaimer: The inspection of this system by St. Croix County does not 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 wil make every effort to determine cause of failure. GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTE . 'INSPECTOR C l' I P . ' l j . z DATED PLUMBER ON JOB S T 7j •.7 1` LICENSE NUMBER i f~ -`S x REPORT OF ITISPI;CTIO_i--Ii~DIVIDIJAL SE JAGE DISPOSiV, SYSTEii Sanitary Permit State Septic T01•1I1SHIP-c~4~ St. Croix County S^nTIC TA'?I; Sze 1Cc~'~ gallons. `umber of Compartments Distance From: T•Je11 ft, 12% or greater slope Building ft. Wetlands ft Highwater =ft. DISPOSAL SYSTL:1 __)~_Tile Field or Seepage Pit(s) Distance From: Well 12% or greater slope ft Building L"L, ft. Wetlands f.. FIELD i;ighwater ft. Total length of lines Oft. Number of lines_ Length of / Z each line ft. Distance between lines 4- ft. Width of the trench Total absorption area sq. ft. Deptt: - of rock below the ` Z,-in. Dp-pth of rock over the in. Cover aver. rock r Depth of tile below grade -in. 51opa of t trench 2-in er 100 ft. Depth to Bedrock ---"ft. Depth to Around water ---fit. PITS Number of vits but id diameter ft. Depth below inlet £t. Grave -r und/,, `yes no. .Total absorption area sq. ft. Square feet of see age trench bottom area required_ `:quarQ feet of s epa >e ni ,,,Ate~aequired c_. Inspected by r Title • Approved Date ` I97 Rejected , Date 197 1 EH 1,15 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES ,DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 laREPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION:'/4t,2.4_", Section , T-~ N, R/Z E-_(or) W, Township o-r_~aJity ~ i, t /C Lot No. Block No. Subdiv' ion Name County ° ~-1--1 X Owner's Name: C ` Mailing Address: TYPE OF OCCUPANCY: Residence No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT PERCOLATION TESTS y " 7 -y f DATES OBSERVATIONS MA E: SOIL BORINGS _ 7 to SOIL MAP SHEET SOIL TYPE ~ w t'h PERCOLATIO TESTS r TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN xZ_ /Z_ 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) R_ 72 7,7 7 7,; 3'el 5j A -3f 13 77 -7 12- 3 ~ L/ 5 " S _ 72,1 7 ~Z - 3 ','/S4 S/,4 72" 7 7Z'15-1 ",,-X . PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area Indicate scale needed for building type and occupancy. or distances. Give horizontal and vertical reference points. Indicate slope. - 04 i I k° a. I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods 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. Name (print) Certification No. ~ Address ~~>11-u /21L ZL"~ Name of installer if known CST Signature COPY A LOCAL AC i O::1 s Y State and County State Permit # PLB67 Permit Application County Permit 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: ~ z7 B. LOCATION: Y4 '/4, Section T_2y N, R/&--E-(or) W Lot# City Subdivision Name,4W t_5~arest road, lake or landmark Blk# Village Township ~7 - TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance C. Single family Duplex No. of Bedrooms No. of Persons D. TYPE OF APPLIANCES: Dishwasher -'YES NO Food Waste Grinder YES d- I O # of Bathrooms lz Automatic Washer -YES NO Other (specify) E. SEPTIC TANK CAPACITY Total gallons No. of tanks *Holding tank capacity Total gallons No. of tanks New Installation z-----Addition Replacement _ Prefab Concrete *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1)0? 2) /,,5- 3) :_~_Total Absorb Area _sq. ft. New Addition Replacement *Fill System Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Length 5 `f Width 1Z / Depth_ 3 " Tile Depth Z y~ „ No. of Lines _ 7 Seepage Pit: Inside diameter Liquid Depth Tile Size Percent slope of land e7 - G `J 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 Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Certifie Soil Tester, I- 11 C.S.T. # e2 7W and other information NAME obtained from /I (owner/builder). c~ Phone #v~yr Plumber's Signature MP/MPRSW# 19 Plumber's Address Ltol Lt.~.~ Aly PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). 2- 1 :VN 4L, } ) tcole_ Do Not Write in Space Below FOR DEPARTMENT USE ONLY Date of Application rr~ f Fees PZd: State Coun jy Date Permit Issued/Rajectr$ (date) Issuing Agent Name z~'~X raft (?L'K-- - Inspection Yes 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)