HomeMy WebLinkAbout016-1027-40-000
n U) 0 3-u n t7
O
4 m y h
3
o (D v
v d m
3 ~
a Q
U) p Z twD oo N G7 w ° cc ~(y; •
d N O O O N CD W m yr
O M 1
1 0 Q Z n y 00 N :E
v 0 O O C O p v O
CL O N N A '1
N O
O A p ° o
cn f7 W O r
3 - N s o
~ d o
O
.r N Q
=
d
U) D •
~ W a -4 `C
3 n I cn
O -4 -4 a
cD 8 n
cn
CD n r -4 -4 Q
m N cn o c
Co eo m Q
13
z O O O O
_ <,Z
r~ * * aQ
° :3 2. D
= a a
D 3
v cr ~vv0 o
N CD W N C. N
CD (a
.C .di N K A
N CD d C A
< N
z Lrl'
z -~z~ o
D m w
nC)
O
C S h
CD m
p C N
CD m
c m m
w co d
CD
z CD cfl A Z
0 (D
O m
v Q A O
ao m co w
zt z
CL "
3
0 A
O FF Z
H z
w
I
o n
°o a
cn o -
CD z a
CD IF
d ~
a
L, lzi
x C!
o_
CD o
s o
v
N
0
0
A
ti
N
CD Q
N
c» O a
o° CL
Parcel 016-1027-40-000 12/07/2005 11:51 AM
PAGE 1 OF 1
Alt. Parcel 13.30.15.206B 016 - TOWN OF GLENWOOD
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 - CASSELLIUS, RICHARD & RITA
RICHARD & RITA CASSELLIUS
1597 SANDY CREEK RD
GLENWOOD CITY WI 54013
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 1597 SANDY CREEK RD
SC 2198 GLENWOOD CITY
SP 1700 WITC
Legal Description: Acres: 5.680 Plat: N/A-NOT AVAILABLE
SEC 13 T30N R15W 5.68A IN NE NW & NW NE Block/Condo Bldg:
LOT 1 CSM VOL 2/ 464
Tract(s): (Sec-Twn-Rng 40 1 /4 160 1/4)
13-30N-15W
Notes: Parcel History:
Date Doc # Vol/Page Type
.
2005 SUMMARY Bill Fair Market Value: Assessed with.
89229 212,500
Valuations: Last Changed: 10/06/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.680 20,000 159,100 179,100 NO
Totals for 2005:
General Property 5.680 20,000 159,100 179,100
Woodland 0.000 0 0
Totals for 2004:
General Property 5.680 20,000 159,100 179,100
Woodland 0.000 0 0
I
Lottery Credit: Claim Count: 1 Certification Date: Batch 308
Specials:
User Special Code Category Amount
I
I
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
f
• AS BUILT SANITARY SYSTEM REPORT
r. < -
IER TOWNSHIP 1.~ s... SEC. T N, R W
0. ADDRESS , ST. CROIX COUNTY, WISCONSIN.
'5DIVISION LOT LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
:'TIC TANK(S) MFGR._ CONCRETE STEEL
NO. of rings on cover Depth DRY WELL
INCHES NO. of width length ,area
no. of lines.. width length area
depth to top of pipe
?tEGATE
u{ RATE AREA REQUIRED=/'.'11, AREA AS BUILT
claimer: The inspection of this system by St. Croix County does not imply complete
liance 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
gem operation. However, if failure is noted the County will make every effort to
.ermine cause of failure.
_;ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
"INSPECTOR
DATED PLUMBER ON JOB
LICENSE NUMBER
s
z..
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
y ' San.itaty PeAm.it--) l
_ State Septic ,S
NAME Townes hip, j~. z; 4k St. CAOix County
1 j
( Location Sect~.anr~ 7'N,l~~ CU
f
SE TIC TANK
Size/,.> gatton6. NumbeA o6 CompaAtmentz
D i.6Lance FAOm: CV et 12% aA gAeateA 6ta p 6t
Bu.itd.ing 4t. WetZand/s ~ .
HighwateA _ 6t.
DISPOSAL SYSTEM
Di4tance FAam: Wett , S-3 6t. 12% an gAeateA stope 11- 6t.
Bu.itding 6t. Wettands Ft.
H.ighwateA 6t.
FIELD DIMENSIONS:
Width o6 tAench 6t. Depth o6 Aock below tite in.
Length o6 each tine 6t. Depth o~ Aock oveA tite in.
NumbeA o6 Zines Depth o4 tiZe below gAade .in.
Total Length o6 Zines 6t. Stope o6 ttench in pet 100 6t.
Distance between Zinez 6t. Depth to bedrock
Totat ablsotbtion aAea % 6t2 Depth to gtoundwateA 6t.
Requited area 6t2
PIT DIMENSIONS:
NumbeA of pits GAavet around pits yes no
Outzide d,iameteA fit. Depth below •intet 6t.
Total ab6oAbtion aiea bt2. A
AAea Aegcri%ed 6t2 rn
i INSPECTED BY TI TL E 1
! APPROVED , `)ATE 19 7
REJECTED DATE 197. f
'r
k
C
I~
I •
'f( le
f
I pp~
i
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 SS31L BORINGS AND PERCOLATION TEST
LOCATION '/4, '/4, Section T'i N, R E (or) W, Township or Municipality_._:~
U✓ e
Lot No. , Block ~1Q County _C~
Subdivision Name
Owner's Name:
Mailing Address: 0
TYPE OF OCCUPANCY: Residence i. No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
DATES OBSERVATIONS MADE:// SOIL BORINGS RCO,L-ATION TESTS __44 ~"7 s
SOIL MAP SHEET SOIL TYPE
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 INTERVAL
BER 1ST WETTED SWELLING IN MINUTES rRPERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
P-
C
P ~ r aI ~ 41 z~
e/
P 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)
B/
l > 3 S
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square feed Qf suitable areas. Indi to number of square feet of absorption area
needed for building type and occupancy. 4Indicate scale
f.; u
or distances. Give horizontal and vertical reference points. Indicate slope.
+
+
+
, Lil,
i fdl +
~ { i I t I I +
I
+
a '
o~ col S" '
- -
_ ___1-__.__
[ l_ I ~y I l---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) I, C Certification No. Address IS c~-I" o y P I (~ae<1_+ -
Name of installer if known OEV:
CST Signature ,",Y A LOCAL AUTHORITY
State and County State Permit #
PLB67 Permit Application County Per it #
for Private Domestic Sewage Systems County c'
i
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
c. Gu ;co 1
B. LbcATION.J Y4, Section, N, R/ V, E (or) W Lot# City
Subdivision Na nearest road, lake or landmark Blk# Village
Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms 3 -No. of Persons
D. TYPE OF APPLIANCES: Dishwasher YES - NO Food Waste Grinder YES_-,--PJO # of Bathrooms
Automatic Washer t, YES NO Other (specify)
E. SEPTIC TANK CAPACITY c o c9 Total gallons No. of tanks i
*Holding tank capacity Total gallons No. of tanks
New Installation L- Addition- Replacement- Prefab Concrete
*Poured in Place Steel Other (specify) _
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) 3) Total Absorb Area 42f5.' sq. ft.
New_-,L Addition Replacement *Fill System
Seepage Trench: No. Lin. Feet Width S` Depth Tile Depth r~ No. of Trenches _L-
Seepage Bed: Length Width Depth Tile Depth No. of Lines
Seepage Pit: Inside diameter Liquid Depth Tile Size
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 Code, and that I have sized the effluent disposal system from the EH-115 prepared
by the Certified Soil Tester,
NAME C.S.T. # `j S LT c~ S~d other information
obtained from (owner/builder).
Plumber's Signature MP/MPRSW# Phone #Cy~
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 L-
41
I
A
Q
1
.
s
,
Do Not Write in Space Below FOR DEPARTMENT USE ONLY
Date of Application Fees Paid: Stateh, G = ou ty --_z ,1 G Date
Permit Issued/Rojeeted (date) -Issuing Agent Nam j , - C ~~z
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)
- Revised Date 6/1 /76