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Parcel 020-1013-80-100 03/07/2006 02:47
PAGE 1 OF 1
F 1
Alt. Parcel 11.29.19.59A-10 020 - TOWN OF HUDSON
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 - RIVARD, CONRAD A
CONRAD A RIVARD C - ALBRECHT VELDA R
ALBRECHT VELDA R
1014 TANNEY LN
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 1014 TANNEY LN
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 2.000 Plat: 4098-CSM 15/4098 020/01
SEC 11 T29N R19W PT SW SE BEING CSM Block/Condo Bldg: LOT 01
15/4098 LOT 1 2.OOAC
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
11-29N-19W SW SE
Notes: Parcel History:
Date Doc # Vol/Page Type
07/05/2001 650227 1674/153 WD
09/28/2000 630707 1546/169 WD
2005 SUMMARY Bill Fair Market Value: Assessed with:
91445 249,600
Valuations: Last Changed: 10/25/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 75,000 179,600 254,600 NO 05
Totals for 2005:
General Property 2.000 75,000 179,600 254,600
Woodland 0.000 0 0
Totals for 2004:
General Property 2.000 44,000 138,800 182,800
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: 1012512005 Batch 05-41
Specials:
User Special Code Category Amount
018-RECYCLING SPECIAL ASSESSMENT 27.00
Special Assessments Special Charges Delinquent Charges
Total 27.00 0.00 0.00
j
, T
„ R~:i"JP,T OF INSPECTION- -I:IDIJIllUAL r .,I;,•)AGE llISPOSAI, S~.+r
~TEii
Sanitary Permit
r State Septic
•,.Ai1E TOWNSHIP
t. Croak County
.117
S%DTIC T)V.
Size ~ gallons.lumber of Compartments
Distance From: Well ft. 12% or greater slope f1.
Building` ft. Wetlands ft
ILighwater ft.
DISPOSAL SYSTIMI Tile Field or Seepage Pit(s)
Distance From: Well ft. 12% or greater slope ft
Building; ft. Wetlands f
FIELD 111lighwater ft.
Total length of lines ft. Number of lines : Length of
each line eft, Distance between lines ft. Width of the
trench -ft. Total absorption area sq. ft. Depth
of rock below theDp-pth of rock over the - in. Cover
aver.rock, Depth of tile below grade 'in. Slope of
trench win ner 100 ft. Depth to Bedrock ft. Depth to
ground water ft.
PITS
Number of pits Outside Aiameter ft. Depth below inlet
ft. Gravel around pit: yes no. Total absorption area
sq. ft.
Square feet of seepage trench bottom area required
Oquars feet of seepage nit area required .
Inspected by: 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
LOCATION: w J-1-, T••*N, R/9$? (or) RI X1/1ir~d~c", Y
S /a, ~/a, Section ownship or Municipality, ,
d
Count_
Lot No. , Block No. a Y ,-<t
u division Name
Owner's Name: '
Mailing Address: SeA 3,1.S- a C
' i
TYPE OF OCCUPANCY: Residence No. of Bedrooms - Other
EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS o~0 -.2q- -PERCOLATION TESTS
IAI
SOILMAPSHEET FF- ~ SOIL TYPE C
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 MIN/IN
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P ~ L~r -57 ee Aire 411U 12-- IV. e - /
~.I& C> kre G~ & Ale
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- Alaa a, F46 sv-
WCAtJe ? y /.7" S,[ )yr` S,~!r SY" S
B- j~ ^10f4C~_ 8`rs f/f/" Ste,
PLAN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.)
Indicate on the plan the locationand square feet of suitable areas. Indicate nu b f~f s are fe t of absorption area
needed for building type and occupancy. ~/S 0' 2. Sc~u ~r ndicate ca le
or distances. Give horizontal and vertical reference poin s ,nd s pe.~.S
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_4 I
s
P. Joe A,.t
a
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104 /.00/
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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) y/ Certification No.
Address ` f
Name of installer if known
CST Signature - . e-
PY A -LOCAL AUTHORITY
State and County State Permit # 767
PLB6.7, Permit Application County Permit,# _ .
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:
Ooy. .31s-
B. LOCATION: S '/4 Section /0~- T!? N, R/9- e (or) (ZD Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
f~ rf~c/
~ iE Township
C. TYPE O O CUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms No. of Persons
D. TYPE OF APPLIANCES: Dishwasher X YES NO Food Waste Grinder YES A NO # of Bathrooms
Automatic Washer AYES NO Other (specify)
E. SEPTIC TANK CAPACITY a,00 Total gallons No. of tanks f
*Holding tank capacity Total gallons No. of tanks
New Installation h Addition Replacement Prefab Concrete X
*Poured in Place Steel Other (specify)
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) _L 2) / 3) /Total Absorb Area sq. ft. f
New X Addition Replacement *Fill System g~Q t=i L~
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length -JIt Width J _f Depth "t Tile Depth 46" No. of Lines
„
Seepage Pit: Inside diameter Liquid Depth Tile Size y
Percent slope of land 12P" wt-.A Distance from critical slope .30
Z-t o9ntm o c 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 Cerr Tied Soil est
NAME l/~,Etc~s~rid~}~td~ras~ C.S.T. # and other information
obtained from owne H~rilder).
-141 Plumber's Signature .~2y' MP/MPRSW# : /Z/ ~ Phone #71f~ -3A6
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
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Do Not Write in Space Below FOR DEPARTMENT USE ONLY
Date of Application ' $ Fees P State ® C 0 County Date
Permit Issued/Rajas~ed date) Issuing Agent Name 2
Inspection Yes No Valid# Date Recd v
1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
state (pink copy) 4. plumber (canary copy)
= Revised Date 6/./76