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Parcel 020-1128-10-000 12/05/2005 02:52 PM
PAGE 1 OF 1
Alt. Parcel 17.29.19.596 020 - TOWN OF HUDSON
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sale Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - NOSER, JOHN T & KRISTI J
JOHN T & KRISTI J NOSER
476 PARK LA
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 476 PARK LA
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 1.380 Plat: 2274-PARK VIEW ESTATES 1ST ADD
SEC 17 T29N R19W PARK VIEW ESTATES 1ST Block/Condo Bldg: LOT 15
ADD. LOT 15
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
17-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 686/285
2005 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/25/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.380 62,100 141,400 203,500 NO 05
Totals for 2005:
General Property 1.380 62,100 141,400 203,500
Woodland 0.000 0 0
Totals for 2004:
General Property 1.380 31,900 129,200 161,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 206
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
COMMERCIAL TESTING LABORATORY, INC.
514 Main Street, P.O. Box 526
Colfax, Wisconsin 54730
715-962-3121
800 - 962 - 5227 C3:w
FAX-715-962-4030
•aa~~t~~ ~~yy~.~~lT~~ryry: ~~r~~. ta..twk i i ~•.p i U:F
'.VVI~ I f OUS ^ve- ~r{•.6"i', 1CPi, i i.
• !DSM. WT
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OF.\NDEGENDf~r, - ~ W
D
"LE S" T!-AN" Pe-fec ,.,h le t_eve t Apa wed ti? . r?.i'
PROFESSIONAL LABORATORY SERVICES SINCE 1952
t. ST. CROIX COUNTY ZONING OFFICE
St. Croix County Courthouse
911 4th Street
Hudson, WI 54016
Telephone - (715)386-4680
The St. Croix County Zoning Office offers the service of septic
and water inspections to Lending Institutions, Realty Firms, and
private individuals.
Completion of this form ,fie essential -?_Q that thg property can be
located.
Please provide the following information, enclose appropriate
fee made payable to St. Croix County Zoning Office, and mail,
along with form to the above address. Testing will be done as
soon as possible after fee and form are received..
WATER TESTING------------- --FEE: $ 35.00
(For nitrates and coliform bacteria)
WATER TESTING FEE: $185.00
(For VOC'S)
SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00
(Determines if system is properly functioning at time of
inspection) _
PROPERTY OWNER'S NAME:- 17 J o G~~, I , f~~ ; 11PROP. ADDRESS: cyr1 L CITY ~i1w~~saz
Legal Description 1/4 of the , 1/ of Section ! 7 , T Z_V N-R 2Town of Lot Number tit 5Subdivisi.on
FIRE NUMBER 4-7l LOCK BOX NUMBER -2- b _6,!~6 /6
Color of house i , Realty sign by house?. If so, list firm:
PLEASE INCLUDE, IF AT ALL POSSIBLE, A HAP,i.e,COPY OF PLAT BOOR,
WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET.
Testing of residential water requires a sample that is fresh. If
the home is vacant, and has been so for some time, the water line
must be purged by running the water for several hours before the
test can be conducted.
WINTER TESTING: Many times water lines are turned off, or sill
cocks are turned off, making access to the home necessary. If
this is the case, please make proper arrangements with this
office to ensure time when entry may be gained.
Firm or individual requesting services:
Telephone Number
REPORT TO BE SENT TO: z4g o
CLOSING DATE:---/("-
signature
/ AS BUILT SANITARY SYSTEM REPORT
'TER TOWNSHIP .-t SEC. 17 T N, R W
O. ADLt..;S C ST. CROIX COUNTY, WISCONSIN.
BDIVISION , !LOTIL_LOT SIZE
PLAN VIEW
Distances S dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
I f Y
r
:'TIC TANK(S) Q MFGR. CONCRETE A-' STEEL
NO. of rings on cover Depth DRY WELL
NCHES NO. of width length area
D no. of lines-__ width f r length ,5' area
dept to top of pope
-YREGATE ± ; . Zr~ `
x'.K RATES _ AREA REQUIRED ~~3~ AREA AS BUILT
sciaimer: The inspection of this system by St. Croix County does not imply complete
ipliance 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.
j "INSPECTOR
DATED PLUMBER ON JOB
LICENSE NUMBER Li/
ce
REPORT OF ITISPECTIO'_I--INDIVIDUAL SE JAGE DISPOSIJ, SYSTEJ.J
Sanitary hermit O
Stare Septic ~;7 V -7
T&I-INS H I P 'Gov
t, roix County
SEPTIC TA'?I:
Size 10 0 F;allons. "lumber of Compartments
Distance 'From: 11ell ft. 12% or greater slope~~V.
r Building-
ft. Wetlands' f
Nighe. titer ft.
DISPOSAL -SYSTL•:1 X Tile Field or Seepage Pit(s)
Distance From: well ft. 12% or greater slope ~t
Building, ft. Wetlands
f
IVA)
FI 11~D i~ighwater-ft.
Total lengt o lines ft. Number of lines 2... Length of
each line 41 ft. Distance between lines i~ft. Width of the
trench / ,Aft. Total absorption area dA . sq. ft. Depth
of rock bclow tile in. Dp-pth of rock over tile Z..,, in. Cover
nver.rock, Depth of file below grade in- Slope of
trench in ner 100 ft. Depth to Bedrock ft. Depth to
around water ~ft.
PITS
~,Number of pits Outside d' er ft. Depth below inlet
ft. Gravel around pit
_ e no. Total absorption area
sq. ft.
.Square feet of seepage trench bottom area required
Oquare feet of pay it
re required
Inspected"r''
Title:.
Approved Date 197.
Rejected Date 197
' i
EH 1.15
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
` P.O. BOX 309
MADISON, WISCONSIN 53701
C REPORT ON SOIL BORINGS AND PERCOLATION TESTS
IC)l
LOCATION: A j '/a, NY)'/4, Section -L, N, R E (or) e Township - or Municipality►UQ~DA)
Lot No. , Block No. Eg C ' G ~ w~s5 County ~CPC) I x
Subdivision Name
Owner's Name: N - l
Mailing Address: ~_Ot '1 A R f~~ LAKc ~~~d ~ ~"f 3
TYPE OF OCCUPANCY: Residence No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW AD ITIIOON REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS
SOILMAPSHEET! 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
P-1 s8 EE
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)
_ s t, is
fi
& ` OWu L ~ l,hC~
q0
0,' F
l i t
Y, bras L n
i t • f O~( r.
J.
PLAN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of uitable area . Indicate number of square feet of absorption area
Indicate scale
needed for building type and occupancy. L~% S AQ RELI
or distances. Give horizontal and vertical reference points( icate slope.
r LI 'S ;
y
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4~4 ~1 I 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) Certification No.
Address ti ~"l ~ M1+~ i 1 T2~ItJ V'C A C_L's Lv'' `s
Name of installer if known . 4 ' rr
i
CST Signature
r0PY A - LOCAL AI IHOlIIJY
kV - 7~0q-.03'11 'I
State and County State Permit # PLB67 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:
pt- -
B. LO TION: Section /~7, I , Re~7 E (or) Lot# /_,`V~City
u ivision Name, nearest kroalake or landmark Blk# Village
Township
C. TYPE OF OCCU'PA/NCY: *Commercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms No. of Persons
D. TYPE OF APPLIANCES- Dishwasher f~S'ES NO Food Waste GrinderYES O # of Bathrooms
Automatic Washer ]l YES . Other (specify)
E. SEPTIC TANK CAPACITY_Jte(, Total gallons No. of tanks- _
*Holding tank capacity Total gallons No. of tanks
New Installation Addition Replacement- Prefab Concrete o__~_
*Poured in Place Steel Other (spec y)
F. EFFLUE DISPOSAL SYSTEM: Percolation Rate 1 ) --Total Absorb Area=~ sq. ft.
NewAddition Replacement- *Fill System
Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length %l1 -Width Depth L ~ ile Depths /r No. of Lines
Seepage Pit: Inside diameter Liquid Depth Tile Size_ 1i_
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,
+isconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared
T ster>
y the Certif S7
i`AME t - ~►s C.S.T. # c`! Vand other information
obtained fro (owner/builder). 4? 17
MP/MPRSW#-~-Phone
umber's S nature fit. .
Plumber's Address
PLAN VIEW: Provide sketch below A /system (include direction of slope and all distances in accord with
H62.20, including well).
~r
i ~
i
locr
"Iti~F I J~ 4-A
Do Not Write in Space Below FOR DEPARTMENT USE ONLY
Date of Application 7~ ~ Fees Pai Staty, , , ' Count _5~' "-Date
Permit Issue d/Reteeted (date) ~ Issuing Agent Name ~C~~
Inspection Yes No Valid# Date Recd
1. county ( ite 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 C,
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