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HomeMy WebLinkAbout012-1060-10-000 o 0 m o C r1 C ~ (9 3 ~ o y ty O v 1-m O O = w N I~ @ p l0 N N p_ ` 00 N 3 Z c- :3 3 O O .y F W~ v. v o O ^ CD co p co 0 O D c N = COi v I m o A~ U) 0 3 0 O 0 N O N j lV C O d D a o N N W O 00 C 0- O O 3 0 c~ I N N ~1 A co CO L C j j N co (o 0 r- (n CCD 6 D D O W O~ C to < L1 O A !Y Cn CD Z a v v v o D v v v ~ _ !r m y _ CD cv N z N O_ z z o D CD O v p > O o' l m !r • ( m CO ~f -0 N M CD w (C fl. Q 3 m z cD -4 cn O .p Z O I O O l0 Z7 .n. n C A Z O I o I cn w N) 00 -0 m o CD , 7t z c 3 ~ ~a p ' (n 3 m N Z (D A N ~ I ~ i n O - T fl C Z O • p • fb N yy O A o- t I a a I ~ cv I ~ I N 0 0 a A 0 O O A v O 5a a Efl d O C a O O O i V Parcel 012-1060-10-000 02/27/2006 10:01 AM PAGE 1 OF 1 Alt. Parcel 27.30.17.416 012 - TOWN OF ERIN PRAIRIE 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 THOMAS M & CAROL KAMM O - KAMM, THOMAS M & CAROL 1896 130TH AVE BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 1896 130TH AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 27 T30N R1 7W 40 AC SE SE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 27-30N-17W Notes: Parcel History: Date Doc # Vol/Page Type 2005 SUMMARY Bill Fair Market Value: Assessed with: 105086 Use Value Assessment Valuations: Last Changed: 11/07/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 30,000 158,900 188,900 NO AGRICULTURAL G4 36.000 6,700 0 6,700 NO UNDEVELOPED G5 2.000 200 0 200 NO Totals for 2005: General Property 40.000 36,900 158,900 195,800 Woodland 0.000 0 0 Totals for 2004: General Property 40.000 12,200 105,400 117,600 Woodland 0.000 0 0 I I Lottery Credit: Claim Count: 1 Certification Date: Batch 130 Specials: User Special Code Category Amount it Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 • AS BUILT SANITARY SYSTEM REPORT R /lle~s_ , TOWNSHIP] F~~N PV ~SEC.,~_ T 1-C' N, RW a 0. ADDRESS A /j~ ; /1l j~• i , ST. CROIX COUNTY, WISCONSIN. . _'BDIVISION , LOT LOT SIZE PLAN VIEW Distances 5 dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM r. /moo J e1vaN M® l~ o4l~f 4 "PTIC TANK(S) MFGR. S CONCRETE STEEL NO. of rings on cover C-; Depth DRY WELL NCHES NO. of width,V' length ©p ' . area ~d J _:D no. of lines width length area depth to top of pipe "RELATE JRK RATE 3 p AREA REQUIRED AREA AS BUILT _sciaimer: The inspection of this system by St. Croix County does not imply complete mpliance with State Administrative Codes. There are other areas that it is not possible inspect at this point of construction. St. Croix County assumes no liability for 'stem operation. However, if failure is noted the County will make every effort to termine cause of failure. ,EASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. °I CTOR DATED_ PLUMBER ON JOB L: LICENSE NUMBER (,1 RFPOP,T OF IJISPECTIO.1--INDIVIDUAL SI:OMGE DISPOSiV, SYS TEi.1 Sanitary Permit ' r State Septic 7A1 r TOWNSHIP St. Croix County SEPTIC TA71 Size _ j/,~-c gallons. `lumber of Compartments Distance From: ?,Jell ,9 ft. 12% or greater slope I(/ ,.1. Building' ft. Wetlands Highwater ft. DISPOSAL SYS7:1 Tile Field or Seepage Pit(s) Distance From: ilelle' ft, 12% or greater slope'~ft Building - ft. 7 _ Wetlands- . f FIELD i:i.ghwater /11/+ft. Total length of lines o ft, Number of lines___Iz_. Length of each line Z&V ft. Distance between lines ft. Width of the trench .-J-'. ft. Total absorption area sq. ft. Dept:: of rock belt}ti. tile in. Dp-pth of rock over tile in. Cover tfver . xoclc,, e Depth of tile below grade in. Slopo of trench in Per UY) ft. Depth to Bedrock r - t. Depth to Around water '4L~t. PITS ?lumber of pits Outside diameter ft. Depth below inlet £t. Gravel around pit: -___-yes no. Total absorption area sq, ft. Square feet of seepage trench bottom area required Square feet of s fired Inspected ~ ; y: Title. Approved Date 197 Rejected Date 197. 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 7, R,~~) W, Township LOCATION ' __-/4, Sectior_ N, R Lot No. , Block No. County -~~Q) ~ Subdivision Name Owner's Name: 4,# ! 1 /Z!-'l Mailing Address: TYPE OF OCCUPANCY: Residence X No. of Bedrooms Other 02 EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS .5 -/4" 70' SOIL MAP SHEET SOIL TYPE PERCOLATION ESTS TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE CHARACTER OF SOIL I NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 Ne 2o L~ 1.14 I IP- 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) B- rr Tt3 /fir / ir~ L ~C3 J,S"~ 7 : B- uL~ fir re L,J -7 e. : 7-4 PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the locationand square feet of suitable areas. Indicate n mbar of square feet of absorption area needed for building type and occupancy. Indicate scale or distances. Give horizontal and vertical reference points dic a slope. i ) E i f L -J I z I I_ ~ I I f , i I E7 E 1 I / 1 I __<L _T_ I E 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. 1 t✓ L r Certification No. JAG s~ Name (print) Address ' Name of installer if known CST Signature COPY A -LOCAL AUTI-ORITY State and County State Permit # / PLB67 Permit Application County Permit Z/ 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: i '/4 ,5:E5_'/4, Section j,7_, T N, R a 4006) W Lot# ---City_ Subdivision Name, nearest road, lake or landmark Blk# (2A,5'& 4A& I? Village TownshipjEQ//S/ A/'jk,46 C TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family X Duplex No. of Bedrooms e2 No. of Persons .2- D. TYPE OF APPLIANCES: Dishwasher _X__ YES NO Food Waste Grincler-)(- YES NO # of Bathrooms Automatic Washer _)(_YES NO Other (specify) E. SEPTIC TANK CAPACITY 16,0p Total gallons No. of tanks _ *Holding tank capacity Total gallons No. of tanks New Installation X Addition Replacement- Prefab Concrete- X *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1)2. 2) :7-C 3) ~Total Absorb Area .4100 sq. ft. New Addition Replacement *Fill Sysfem 0 e, Width Jr Depth Tile Depth 0~7- No. of Trenches Seepagee rench: No. Lin. Feet Seepage Bed: Length Width Depth Tile Depth No. of Lines Seepage Pit: Inside diameter Liquid Depth Tile Size 40 Percent slope of landO - 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 Certified Soil Tester, f NAME (5-,+1- e- C.S.T. # and other information obtained from rlzto M A, (owner/builder). Plumber's Signature - f MP/MPRSW# .5 Phone #AOC Plumber's Address R 1 Cr-LC~! /y A,,g 1 d G 7`T 4,j PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). i~ r~N l~~,G, S ePr , ff4A tiI ~C Do Not Write in Space Below fOR DEPARTMENT U$E ONLY MY Date of Application Fees, Paid: State p " Count , '%U Date es Permit Issued/ (d te) /Issuing Agent Name Inspection Yes7No 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) i