HomeMy WebLinkAbout008-1049-50-000
0
0 E; (n0 F. -0 0 d
CD ~ O
, CD v
v m (
O
z= N ~l CC W O
O N 0 O W W C N ~l 0 `C
C N W a N
1
cri
(D O N co
E C)
WN
L N CJ1
CD CD 0) C:) CD
Q 7 W O O
O
N o o O
N C
fv
n D D a s
A
0 W ~
Z
O CO
W m
o 'per O C !1
00
O O O
m-: * * *o z
<(A N (n N D
73 3
u v v v
O D (("D M y'
3 1
J (D
N ~ 1
S
N (D
N
D co O 0
O o 7 !r
rn ~ m ; NcO+•
O N
N
CD N C~
-C (a N
C (D
CD ~
CD a~ p Z N
:3 A z O
Q C
V
W (D co
a z
0
o " Z rn
m
rn
z
CD A
W
CD
Q) Q
N CC
O ~ ~ G
O O
_ O T
N OI C
C z Q
O O O
n
c N ~
(D a
~a
N _ fp
ff7 `C
(D Z7
SZ ~
a
~ z
o a
CD
~ N
c N
0
o
~ a
o_
(A
OAq A
~ W
cfl O ~ ~n
° a
O m
O
Parcel 008-1049-50-000 02/22/2006 09:09 AM
PAGE 1 OF 1
Alt. Parcel 17.28.16.250B 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 - LEE, RICKEY R & DONNA M
RICKEY R & DONNA M LEE
2378 20TH AVE
BALDWIN WI 54002
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 20.000 Plat: N/A-NOT AVAILABLE
SEC 17 T28N R16W 20A N1/2 NW NE Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
17-28N-16W
Notes: Parcel History:
Date Doc # Vol/Page Type
02/02/2005 786463 2741/615 OC
07/23/1997 609/624
2005 SUMMARY Bill Fair Market Value: Assessed with:
138602 1,400
Valuations: Last Changed: 10/09/2000
Description Class Acres Land Improve Total State Reason
PRODUCTIVE FORST LANDS G6 1.000 1,000 0 1,000 NO
ENTERED BEFORE'05 CLOSE W8 19.000 29,200 0 29,200 NO
Totals for 2005:
General Property 1.000 1,000 0 1,000
Woodland 19.000 29,200 29,200
Totals for 2004:
General Property 1.000 1,000 0 1,000
Woodland 19.000 29,200 29,200
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
Z -
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
SanitaAy Pe lunit
State Septic-
NAME i own~ship _St. CALoix County
Location Section
SEPTIC TANK
Size gattons. Number of CompaAtments
Distance Ftom: Wett it. 120 on gAeateA 6tope it
Buitding it. Wettand~s ~ .
HighwateA it.
DISPOSAL SYSTEM
Di.6tance FAom: WeU it. 120 oA gneateA 6tope ~ .
Buitding it. Wettands Ft.
HighwateA it.
FIELD DIMENSIONS:
Width of tAench it. Depth o6 Aock below tite in.
Length of each tine it. Depth o6 tock oveA tite in.
NumbeA o6 Zine~s Depth o4 tite below gAade in.
Totat Zength of tines it. Stope o6 tAench in peA 100 it.
Di.s Lance between ZineZ jt. Depth to b edAO ch.
Totat absotbtion area jt2 Depth to gAOUndwateA
RequiAed aAea it2 Type oA Covet: PapeA oA Straw
PIT DIMENSIONS:
NumbeA o6 pit6 GAavet around pits yeas no
Outside diameteA it. Depth below inlet it.
2
Totat abzoAbtion aAea it z
A
AAea AequiAed ~t2 `m
4
INSPECTED BY TITLE
APPROVED , DATE 197 REJECTED , DATE 197.
56
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 TESTS
1 `iL
~ t 1 ' i
LOCATION: :v vv /4, 'v /4, Section i 7, TN, R k'E (erg, Township ar-lV~t+R+e+F~al+t~ 4- 11
Lot No. , Block No. County r r I r, -
i' Subdivision Name
Owner's Name: \_JI t`i+ y~ 1 L i rl P l '
Mailing Address: L J
TYPE OF OCCUPANCY: Residence No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS , 144
SOIL MAP SHEET SOIL TYPE «~d/I I\,'I
PERCOLATION TESTS _
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 IN MIN/IN
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
( 4 > c z tx=, r Icy _Sri it I A/C /V't
he, I
z j
F-,
1. 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)
P
B- y / r
rf I I F It x- > fi r
t i
PLAN VIEW (Locate perco lation tests,soi I 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
needed for building type and occupancy. : r-,-- FJji'. . )4- r Indicate scale
or distances. Give horizontal and vertical re erence points. Indicate slope. i
I
i
t
I I _ k
1 77 V i
r ( u ;
*r e f lI- ~ f ~ i
{ i fF I { I 1
' ~ l i l ll l~ I i
1y i
1> i ~ i i { 1 I f I I I I
i I I f i
_ y s ' i f 1
1-1 _31, G
JZ°{ f C1~ I I'r; ~'1 t~y~
i i I l { s f i I I ~ - -
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) 1>'I Certification No.
Address /C
Name of installer if known
T p CST Signature ' . " ,
State and County State Permit #
PLB-67 Permit Application County Per j # -~-k -
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:
B. LOCATION: 1/4 L Y4, Section i T N, R I( E (o&7-W- -City_
Subdivision Name, nearest road, lake or landmark Blk# Village
Township c`. do Ct h)c T
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family k Duplex No. of Bedrooms' No. of Persons 41
D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste GrinderYES-&NO # of Bathrooms,,.,
Automatic Washer AYES NO Other (specify)
E. SEPTIC TANK CAPACITY /Z'M Total gallons No. of tanks
*Holding tank capacity Total gallons No. of tanks
New Installation Addition Replacement _ Prefab Concrete
*Poured in Place Steel Other (specify)
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) $ 2) 1'7- 3) 27Total Absorb Area sq. ft.
New Addition Replacement .Fill System 5?vs-,E'e-eye
Seepage Trench: No. Lin . Feet Width _ Depth Tile Depth No. of Trenches-
Seepage Bed: Length j _Width ~ Depth IF~9' Tile Depth +R 4* No. of Lines _I
ft
Seepage Pit: Inside diameter Liquid Depth Tile Size q
Percent slope of land 10 Pc Distance from critical slope a
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 Certified Soil Tester,
NAME . - ri-.i~:•~.~ C.S.T. # r ° !5%,V and other information
obtained om C~ tcrrrv (owner/builder).
Plumber's Signature MP/MPRSW# 3 Phone 9~ 3GI3
Plumber's Address 1•
PLAN VIEW: Provide sketch below of stem (i clude direction of slope and all distances in accord with
H62.20, including well).
°
IN 01
Alf%
O 6 C
Do Not Write in Space Below FOR DEPARTMENT USE ONLY Ci
Date of Application=-~Y Fees Paid: State ~~7unty Date
J
Permit Issued/ReOcTed~(date) _Issuing Agent Name
Inspection Yes__4No 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
t