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HomeMy WebLinkAbout016-1034-20-000 rC I o ° o ~ O ~ I o ao I 4 o I c e 0 N I N C i m 4 I I C 'tr I Ln O z LL c L ~ o 4 I co z N LO W E .E v z d d ° 17 co a co o I ozv' d cn ~ ~ m z I ~ ~ a O N_ Y U Q O N Q' N C •'V L L_ 2 C C O c O w Z ~ Z O N c N ` E ) E V) (D Q) M C M N d i (U ~ O ° o a -0 Z > H H FN- U O O O z •w > a a a CL U N o W o r- 00 C9 0 ~ O E I c m C a L N N D Lo Q 'Fu O N N O C N A C o U 3 o o E U Q) W CO ~ CD ` N C U d m Q co O i. C m N O N z O • ° co o° v ® m oo m L Iv i,,,, o c5 M z 2 F- cn V = wi € cz E ~ xt a • ca o 6 .2 d a Y `1v E ` c c r a 2 1 O in U r A U Parcel 016-1034-20-000 02/27/2006 04:30 PM PAGE 1 OF 1 Alt. Parcel 15.30.15.251C 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 - MAES, MARK & AUDREY MARK & AUDREY MAES 3052 150TH AVE GLENWOOD CITY WI 54013 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 3072 150TH AVE SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 9.500 Plat: 3446-CSM 03/671 SEC 15 T30N R1 5W 9.5A IN SW SE LOT 1 CSM Block/Condo Bldg: LOT 01 VOL 3/671 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 15-30N-15W SW SE Notes: Parcel History: Date Doc # Vol/Page Type 2005 SUMMARY Bill Fair Market Value: Assessed with: 89292 309,200 Valuations: Last Changed: 10/06/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 12,000 233,600 245,600 NO PRODUCTIVE FORST LANDS G6 7.500 15,000 0 15,000 NO Totals for 2005: General Property 9.500 27,000 233,600 260,600 Woodland 0.000 0 0 Totals for 2004: General Property 9.500 27,000 233,600 260,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 130 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 • AS BUILT SANITARY SYSTEM REPORT :INER TOWNSHIP &E_~•.~d SEC. T N, RAW .O. ADDRESS JR IR , ST. CROIX COUNTY, WISCONSIN. '.'BDIVISION LOT LOT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM JJC~° C~H 4 Se'.I'T/c rr*ar~ Y~ • 'PTIC TANK(S)MFGR. CONCRETE X STEEL NO. of rings on cover , Depth l " DRY WELL ;rNCHES NO. of width 4-1 length_ area D no. of lines width length area 'depth to top of pipe 'x y uy =GREGATE ,tK RATE ;t- i _ AREA REQUIRED AREA AS BUILT C 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. :~`ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. "INSPECTOR , G JC DATED 7rf PLUMBER ON JOB L-tom • ~z fr..~ t, LICENSE NUMBER &P .G7 y w 4 RFPOR%T OF I1ISPECTI0.1--17M1VIllUAL SE?OIAGE DISPOSAI, SYSTE11 Sanitary Permit r State Septic ✓~~~cf ,,l ; y~~ lc( TOWNSHIP t. CroiCounty MEPTIC TA'?K i ze gallons. ':umber of Compartments Distance From: We 11 ft. 12% or greater slope I. Building` ft. Wetlands f. Highwater ft. DISPOSAL SYSTL:1 Tile Field or Seepage Pit(s) Distance From: Well ft. 12%,or greater slope' ft Building; ft. Wetlands f FIELD 11ig hwater ft. Total length of lines ft. !lumber 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. Dp-pth of rock over the in. Cover nver.rock,, Depth of tile below grade in. Slope of trench in per 100 ft. Depth to Bedrock ft. Depth to ground water £t. PITS 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 ;square feet of seepage pit area required Inspected by: Title': Approved .Date 197 Rejected Date 197 6 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 ~ LOCATION: '/4,5~'/4, Section /_i__, T_kN, R L~i tr) W, Township or ly t`* kvo 0 Lot No. , Block No. County _6,7 et?e Subdivision Name Owner's Name: Z~' of Mailing Address: E'C -~y-W/r TYPE OF OCCUPANCY: Residence X No. of Bedrooms - Other EFFLUENT DISPOSAL SYSTEM: NEW Imo -ADDITION ---REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION T S 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 PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN I.J4 - A10 --v P_j 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- iL..-r-3 4 7a i.4 -2 Ale" 70 P 43'1. ix So `1-5,4 B- 7"r10 1P Sji, 419"`57,4 J L 7_,)_ hie > 2~ re p SiL "I 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 numbe of square feet of absorption area needed for building type and occupancy.- Indicate scale or distances. Give horizontal and vertical reference point . I dic a slope. i + ) +15 ;PjA$e_j t I I i IF + ; i `m ONA i a r + I i 3 . + I ; P 3 }L} I I ~ i i s t7t f t $ 5 4i4-~ t i I ' f 2 f i i i ~ I tv /4 0 { 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. 7 Name (print) Certification No. Address 1.1 a 0 j 7~ v 1v Name of installer if known CST Signature .l 00'i~~ ~ ♦ .0 State and County State Permit # as -o PL967 Permit Application County Perm~t -3-1. 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. LOCATIO Section 1 T C N, RW Lot#' City Subdivision Name, nearest road, //lake or landmark Blk# Village Z Township 6-- ~~/1/lv~~ ©d C TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family X _ Duplex No. of Bedrooms No. of Persons D. TYPE OF APPLIANCES: Dishwasher __A_ YES NO Food Waste Grinder- YESNO # of Bathrooms Automatic Washer _X_YES NO Other (specify) E SEPTIC TANK CAPACITY /e-?"7 V Total gallons No. of tanks / 'Holding tank capacity Total gallons No. of tanks New Installation x_ Addition Replacement Prefab Concrete 'Poured in Place Steel Other (specify) F. E=FFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) 2~- 3) -..Total Absorb Area sq. ft. New Addition _ Replacement *Fill System Seepage Trench: No. Lin . Feet ~Width Depth-j,. 111 Tile Depth ;?-;K No. of Trenches 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.- /dO z 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 6:,44 --1- S M / XZ1 C.S.T. # 1 7 Z 8- and other information obtained from a (owner/builder). Plumber's Signature _ MP/MPRSW# Phone #;S ye-7e Plumber's Address PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). 1-eCG 40 loo use /U =tS`X 7~5'f3GNL/fe-S N ~ e,~d A/ Do Not Write in Space BeI FOR DEPARTMENT USE ONLY ~yG Date of Application X- Fees P i : State Count Date Permit Issued/Fxjeritd (date) Issuing Agent Name 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) Revis=