HomeMy WebLinkAbout018-1065-00-000
ov,o-0 n d
= O
lD y~ <
D ~ `T
ti (D
CD 0.
d ; Vl
3
~ Q
n O N 0 O v N N p o
~ •
: 3 o c co rn~ - 3 N r-
m _ m m cfl
00 ° z a_ y 3 O
o o
O v N W N N Sr Q A "S
C:, cr
O_ O S r O
11 c CD :3 CD (D COD
n CL O W O
3
3 tB 7 O C
,y C w I O "r3' !V
a
m 0)
_ In D cp o
ko CD In N W . s
m ?
c a o o
3 O CC) 6 '
Z) 6
CD F 3 !ri -4 0) co m -4 3 n p
v, ~i
00 W c
z O O O
cn cruel
a n c vii tincan° oo z
v a s fl D O U C
O_' W CD w N N
N co 'o
C C G CD
N
N 3 W
C.
Z Q
N
o D co o
O a ~y
o cn !r .
:3 CD CD N
c(o N
c m m
w m n
CD C6 ::t O p ` W
Z
O p C1
Z O
N d A
i O
~ 10
co ~
CL j z
3 a
3 ~C
N <
N
A
i
D
n
n
O T
N C
z a
O
CD
N
5
A
I.t
a
ti
0
i o
I a
A
0 b
D A N
A V
ff3 0 N
O CD O a
O 0-
Parcel 018-1065-00-000 08/14/2006 09:11 AM
PAGE 1 OF 1
Alt. Parcel 29.29.17.442B 018 -TOWN OF HAMMOND
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 - PETERSON, VINCE E
VINCE E PETERSON
753 160TH ST
HAMMOND WI 54015
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ` 753 160TH ST
SC 2422 ST CROIX CENTRAL
SP 1700 WITC
Legal Description: Acres: 5.350 Plat: 0255-CSM 02/393
SEC 29 T29N R17W PT SW NW LOT 1 CSM Block/Condo Bldg: LOT 01
2/393 5.35AC
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
29-29N-17W SW NW
Notes: Parcel History:
Date Doc # Vol/Page Type
09/17/1999 610514 1457/105 WD
07/23/1997 1096/593 QC
07/23/1997 766/272
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 05/13/2002
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.350 33,900 109,900 143,800 NO
Totals for 2006:
General Property 5.350 33,900 109,900 143,800
Woodland 0.000 0 0
Totals for 2005:
General Property 5.350 33,900 109,900 143,800
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 550
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
_ rns-..eruy..rer:~a~rawrrn
'NTER
TOWNSHIP~~`~ , . , r - .S1E. C. 't) T LJLJN, R
0. ADDRr S W
ST. CROIX COUNTY, WISCONSIN.
•3DIVISION LOT LOT SIZE .
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
4/
i
5
a
'i-TIC TANK(S) MFGR. CONCRETE STEEL
N0. of rings on cover Depth Y r` DRY WELL
'INCHES NO. of width length area
no. of lines width ! length ' . area
depth to top of pipe '
MGATE
{ RATE AREA REQUIRED r AREA AS BUILT
5-
,ciaimer: The inspection of this system by St. Croix County does not imply complete j
:pliance 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
tem 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 JOr3
t
LICENSE NITIMBER . , r fLA
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
San,i,tatcy PeuniZ-
State Septic
A Aft A"404"
NAME Township Mrs St. Ctco.ix County
Locat.ion'. Wzl, o 6AVc 4, Section,&T 1-*, R~7 W
SEPTIC TANK
S.ize~ gattonz. Numbers 06 Compantmentz
Distance F&om: Wett 12% an gteatetc. ztope
Building _6t. W ettand,5
Highwatetc. b .
DISPOSAL SYSTEM
Distance Ftc.om: Wett 04 wt. 120 m gneate& zZope t.
Bu.itding___ 6x. W ettand,5 - Ft.
Highwatetc. 0 bt.
FIELD DIMENSIONS:
Width a6 VLench f_6t. Depth o~ tc.och below tite in.
Length a6 each tine ~ 2..
6t. Depth o6 tcock oven tite .in.
Numbe.k o6 tines -3 Depth o6 t.i.2e below gtcade2 jn.
Totat .Length o4 t inez 4t. SZo pe o6 ttc.ench in pert 100 6t.
Distance between tinez 6t. Depth to bednock - 6t.
Totat ab.6mbtion atcea~6t2 Depth to gtcoundwatetc 6t.
Requtitced atcea ~ 6t 2
PIT DIMENSIONS:
Numbetc o6 pitz Gtcavet atcound pitz yes no
Outside d,iamete, Depth b e.-ow .intet 6t.
J 2
Totat abs o,,-Lb an ne 6t z
A
Atcea tcequitced 6t2 rn
INSPECTS ~TITLS
1
APPROVED °V ,DATE ~s 197Af. r`
REJECTED DATE 197
r~
8 v
I
e
1
EH 15
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:.j~ Section, T Nll R~ _0EE (or) WW, Township or Muunicii7pality (f -')'1 174 f tx
Lot No. Block No- 3 13 abw t I County f; 41 tF y
- Subdivision Name
Owner's Name: L~ >
Mailing Address: j9{ iIhC~L ,7e c----9
TYPE OF OCCUPANCY: Residence' No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATIO TESTS
SOI L MAP SHEET SO I L TYPE
PERCOLATION TESTS
TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
NUM- INCHES THICKNESS IERN INCHES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 7 PERIOD 2 PERIOD 3 MIN/IN
P- 1 7J
61e c-4 "Ar _1
1 P-3 3L ~7Z1 3
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 _5_
R 4_
PLAN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of suitable reas. Indicate num Kerf square feet of absorfigi are,,
needed for building type and occupancy. e, .2 4 _ a `Indicate ale
o~.rtarrC~.i e izontal and vertical r Indicate slope.
f ! I_ iW ! r j fN
i
~ I I I JI _ _ _
_ _I ~
_
I ( ( I i i
.e ,hereby certify ~at ~the soil tests reported on this form were made by me in accord with the procedures
I, the undersigA
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) ~A G I 4 ~at~ t ~h , Certification No.
Address Ale Z_, / 11 r c~ y v i
Name of installer if known -
CST Signature
COPY A -LOCAL AUTHORITY
PLB67 State and County State Permit # -7-:47
v Permit Application County Permit # _ 7~
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: Section T ` N, R E (or) W Lot# City
A
Subdivision Name, nearest road, lake or landmark Blk# Village
Town shi `,44.u-r,
C. TYPE OF OCCUPANCY: 'Commercial *Industrial 'Other (specify) *Variance
Single family Duplex No. of Bedrooms No. of Persons
D. TYPE OF APPLIANCES: Dishwasher YES L---'NO Food Waste Grinder YES k- NO # of Bathrooms
Automatic Washer YES O Other (specify)
E. SEPTIC TANK CAPACITY _ 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)
_FFLUENTj61SPOSAL SYSTEM: Percolation Rate 1) 2) ~3) Total Absorb Area sq. ft.
"Jew Addition Replacement 'Fill S stem
Seepage Trench: No. Lip . Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length j Width' Depth Tile Depth No. of Lines y
o.
Seepage Pit: Inside diameter Liquid Depth Tile Size _
Percent slope of land Distance from critical slope
the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
';"visconsin Administrative Code, and that I have sized the effluent disposal system f; rrn the Ei? 1';5 prepared
by the Certifie oil T , er,
NAME C.S.T. # and other information
obtained from (owner/builder). y~ _
Phone
;'`lumber
's Signature
P/MPRSW# Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
i H62.20, including well).
I
- i
f
3
{
# I L
Do Not Write in Space Belo FOR DEPARTMENT SE ONLY
Date of Appli ation Fees P id: State C County Date 10 79
0-
Permit Issued/Rejected (date) to ssuing Agent Name o 1
Inspection Yesx- 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 cony` -!ember (canary copy)
Date 6/1