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HomeMy WebLinkAbout020-1121-00-000 (2) o Co O ER a0o ~ I a a o ° I N ti y z° C LL C T ~ V I Q 3 Co V N z CO 0 LL L z `m w a co z o I o z v v w d z ~ ~ ~ o to F- O z c E a ch N I ~ p_ 4J N O O O o a) Q z co z N ~ Z > m E N 0 ` R 0 co CL ii - m O N y ` O a 2 't L > fn fn Cl) a .v ~ C,4 > d N O c 0 0 0 z •N 0 a a LL ~w1 a ►i a g _ co o N V) fA J U p rn rn O ~ o ° o ' Q 3 m i0 O E 0 0 0 IL I m v m ~ o~ (D co ~i O O E y q E O O C F O N O fn N-2 C U CL c)) it F' (!l (9 ON 1=6 e-- V y~ N ci C O m N o O yr Z =3 (D 0 N ~ m ~ o c cu o cn v ~ E d L: a • C~ a d .V d d = rr'I~ra E c ~1 0 A a o N U Parcel 020-1121-00-000 03/15/2006 03:54 PM PAGE 1 OF 1 Alt. Parcel 17.29.19.527 020 - 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 - COUNTRY HOUSE INC COUNTRY HOUSE INC 374 BROOKWOOD DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 374 BROOKWOOD DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.700 Plat: 2553-TROUT BROOK WOODS ADDITION SEC 17 & 18 T29N R1 9W TROUT BROOK WOODS Block/Condo Bldg: LOT 24 ADDITION LOT 24 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 17-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 05/29/2001 646695 1648/11 WD 07/23/1997 767/521 2005 SUMMARY Bill Fair Market Value: Assessed with: 92397 280,600 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.700 79,800 206,400 286,200 NO 05 Totals for 2005: General Property 2.700 79,800 206,400 286,200 Woodland 0.000 0 0 Totals for 2004: General Property 2.700 44,200 201,400 245,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch 312 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 AS BUILT SANITARY SYSTEM REPORT OWAR TOWNSHIP r"I y e~ S c,ni SEC. ! T,'"/ N, R / W P.O. ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVIS ON 1 i ~p lA~ bt~P~S LOT_Zt~-LOT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM j i i \j j r ALLO I-' -'et SEPTIC TANK(S)MFGR. uy C_- j , CONCRETE }C STEEL NO. of rings on cover Depth DRY WELL TRENCHES NO. of width length area BED no. of lines_~3 width__j~ length~W area depth to top of pipe AGGREGATE ( l j 'IL ti jcoC k PERK RATE -,Z AREA REQUIRED le ) j AREA AS BUILT Disclaimer: The inspection of this system by St. Croix County does not imply complete compliance with State Administrative Codes. There are other areas that it is not possible to inspect at this point of construction. St. Croix County assumes no liability for system operation. However, if failure is noted the County will make every effort to determine cause of failure. GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. INSPECTOR DATED PLUMBER ON JOB LICENSE NUMBER f i,- r REPORT OF IT1SPECTIO11--INDIVIDUAL SEMAGE DISPOSAL SYSTEM Sanitary Permit .a State Septic 1 • y TOWNSHIP t. Croi" -County SEPTIC TA?T~ Size ! gallons. "lumber of Compartments Distance From: Tlell ft. 12% or greater slope Building ft. Wetlands ft Ilighwater 'r c ft. DISPOSAL SYSTEI-I Tile Field or Seepage Pit(s) Distance From: TTell ft. 12% or greater slope IJ ft Building ft. Wetlands f: FIELD 'I,ighwater 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. Dept: of rock below the in. Depth of rock over tile in. Cover over rock, Depth of tile below grade in. Slope of s trench in ner 100 ft. Depth to Bedrock pig ft. Depth to 'ground water , ft. STS "lumber 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 c, `square feet of seepage pit area required Inspected_b,. Title: p Approved , Date 197 Rejected , Date 197.~ J i r_ 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 TES S LOCATION:Section/,f.- T-29N, RWor)owns ip or Municipality--- Lot No. &'-"f, Bloc No. oK Subdivision Name County ~ Owner's Name: !1 Mailing Address: TYPE OF OCCUPANCY: Residence No. of Bedrooms -3 Other EFFLUENT DISPOSAL SYSTEM: NEW A ADDITION REPLACEMENT 7 DATES OBSERVATIONS MADE: SOIL BORINGS ~70_~o 77 PERCOLATION TESTS i r SOIL MAP SHEET SOI L TYPE IZS _7_-7e ±-~ef~_C --V PERCOLATION TESTS HOURS WATER IN TEST TIME 1DROP IN WATER LEVEL, INCHES TEST DEPTH RATE CHARACTER OF SOIL SINCE HOLE HOLE AFTER INTERVAL IVUM- INCHES THICKNESS IN INCHES MIN/IN DER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 e e IC> co I Y2- 112- 2- P- 02 O © aC °L- P f BZ O'er- ,e ¢ o 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) 916, I Owl IG S o" A101a 7YE 3`~~-s a Nib v" CGS N20-d - ,GS A lam e- >,C/ M, 17" t4 PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable area§. In sate u perf~f sqt, e ? yet of absorpi ion 'D needed for building type and occupancy. C)P041 •y~ ~r Ind ate cafe or distances. Give horizontal and vertical reference points. In ate a ~ $ E l n i i tN I~ gp71 i 701 ~igi•s` y 3 & S I, the undersigned, hereby certify that the soil tests reported on this form were made by me iii 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 an belie . Name (print) Aexw Al.'s At Z Certification No. Address e- 4e4: S, O Name of installer if known Z1 3 CST Signature _OPY A - LOCAL AUTHORITY 0 G PLB67 State and County 1✓t State Permit # t # - Permit Application County Per 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: ae-% SC Section , T.2-qN, R/ _jp (or) Lot# vZ City Subdivision Name, nearest road, lake or landmark Blk# Village Township /ALL SC7.~/ C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family X Duplex No. of Bedrooms No. of Persons D. TYPE OF APPLIANCES: Dishwasher )e YES _ NO Food Waste Grinder YES_,V'NO # of Bathrooms Automatic Washer _X_YES NO Other (specify) E. SEPTIC TANK CAPACITY 000 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) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) _ 2) S- 3) y~Total Absorb Area l5 sq. ft. New Addition Replacement *Fill System Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Length' Width -1 lift Depth it Tile Depth " No. of Lines -3 Seepage Pit: Inside diameter Liquid Depth Tile Size Y~ Percent slope of land - OY'1-4 Distance from critical slope SO !41tS ~ X ;'44 #'A nFSYSte. 1, 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 C tified Soil ter _ NAME V/.4fZ,V ~9, - 'll~r'3 C.S.T. # and other information - 3X obtained from @ !G arSc-t owner/builder). Plumber's Sig ure MP/MPRSW 16e Phone # 376 Z S 0 Plumber's Address - PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). ~Or t s• gad ~ _ ~y4 + ft7 t~✓~ $'X7 ` P~~ wu~~ --~.`e Res:-~~•~~~ _ 31,5 V Do Not Write in Sp Ve ellFOR DEPARTMENT U6SE ONLY 67 Date of Application Fees Paid: State/ ,66 Count Date / Permit Issued/Red te) Issuing Agent Name a 4,1 inspection Yes /IN0 Valid# Date Recd 1, county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISO-N,'Wi 53701 2. state (pink copy) 4. plumber (canary copy) r Revised Date 6/1 /76