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HomeMy WebLinkAbout020-1137-40-000 0~n0 3-0 n o c d o m o y A 2) ~ v .a ~ c CD m to (D O n ti O Z O O C C CO N `G • a -4 CL 0-0 (D = Q z }n~ ~n V O p j O C O (D O O 7 O W Cl zt CD v 5 O (Oj 7 cn p O cn C N v O 4 T co 7 N N 0 O N m CD cn D m fl ti N a < v ~ a o o C O co cn m o = pC_ 4 (D En 0 cn o C N J co y 00 co =3 3 s' s z o O O a O O N 0 N y - ~t 3. v v O O N (D O M H a N < O - a z zD co 0z O M O 2 b CD m ti• !1 D N N !v O ~ C O N C (D O W d a 3 7 z CD ..t "-I cp O :3 p p Z Q cZ1 7 ? z O N a 7 J Z N co W ' m z o Z N co 0 co z C A W (D O jc1 O Xk N T V - O C z a ((DD CD :ti ~ U N N O O W X A Q) C A a cv n N c p N O A O 6Aj N O 0 O z y~ O a r y Parcel 020-1137-40-000 05/23/2005 11:06 AM PAGE 1 OF 1 Alt. Parcel 29.29.19.685 020 - 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): Current Owner STEPHEN M & WENDY J HAMEL HAMEL, STEPHEN M & WENDY J 782 GHERTY LN HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 782 GHERTY LN SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.873 Plat: 1979-GHERTY'S ADD SEC 29 T29N R19W GHERTY'S ADD LOT 2 BLK Block/Condo Bldg: 1 LOT 2 1 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 29-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/06/2004 767768 2609/423 WD 04/14/2000 621177 1502/311 WD 07/23/1997 665/286 2005 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/26/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.873 34,400 123,300 157,700 NO Totals for 2005: General Property 2.873 34,400 123,300 157,700 Woodland 0.000 0 0 Totals for 2004: General Property 2.873 34,400 123,300 157,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 127 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 i AS BUILT SANITARY SYSTEM REPORT .0. ADDRESS 5 jp 7/1 , TOWNSHIP 'I SEC. T_2 _ R_ W , ST. CROIX COUNTY, WISCONSIN. ~Ock Cob "'BDIVISION LOT led OT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM s~ - - r- t jl TIC TANK(S) LC' MFGR. /1L CONCRETE STEEL NO. of rings on cover De p `NCHES NO. of width p DRY WELL length area no. of lines' width i' len th gr3,1 area v.,r depth to top of pipe] ,~REGATE K RATE AREA REQUIRED AREA AS BUILT sciaimer: The inspection of this system by St. Croix County does not imply complete 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 item operation. However, if failure is noted the County will make every effort to .ermine cause of failure. 3ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. 'INSPEMk`` ~ DiiTED PLUMBER ON JOB LICENSE NUMBER s~~ )nnitary Perr: ~ state Septic 7 c To, '171MITr ;ize gallons. u.nber rdf C&L7I7~,~IiL licI'L 'el.l ft. 12% or greater slope yuil_ding ' f*-4 ighwater Tile Fie:_. 0,: Tlell ft. 12% or greater slo-pe Ta'.tJ_ ft. Wetlands _ . 4 " .wl 1.. L ft. "Total length of lines ft. Number of lines Length of line ft. Distance between lines ft. Width of the Ch ft. Total absorption area sq. ft. Depth of rock below the in. Dp-pth of rock over the in. Covei over-rock, Depth of tile below grade in. Slope of trench in per 100 ft. Depth to Bedrock _ft. Depth to -round water ft. Number of pits Outside diameter ft. Depth below inlet :Lw Gravel around, pit: _yes no. Total absorption area q. ft. Oquare feet of seepage trench bottom area required ;guars feet of seepage nit area required " -ispected by : Title': Approved Date 197`. Rejected Date 197_,,. • 21 Yj! APPROVED # "AU G' 1 X73 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES EH 1 DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH • P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS _jCATION: Section, T,01\1, R/9 )/W, Township tv Lot No. Block No.A, YI 41.) 13 i7-1County r L,_'rtx Subdivision Name Owner's Name: K-~y t~U r 7 4:F_1__ f Mailing Address: `2 / Z / r? Af f~vySC,) r TYPE OF OCCUPANCY: Residence X No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT t DATES OBSERVATIONS MADE: SOIL BORINGSPERCOLATION TESTS Ll SOIL MAP SHEET tl If r- I SOIL TYPE PERCOLATION TESTS TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE CHARACTER OF SOIL SINCE HOLE HOLE AFTER INTERVAL NUM- INCHES THICKNESS IN INCHES MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 et C l/ JI Ir rl / / - l- P- ) 4(' 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- / 9C' /~Lt7~. L `J c's7)! / f; j ~✓rv ~a4~ [Co j6 iGr/~~ $~c B _ .'~~CXv PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicat~ number of square feet of absorption area needed for building type and occupancy. k`T t=i_ -i;x'e-A r/ / s/ %i / I=sc=/? Indicate scale or distances. Give horizontal and vertical reference points. Indicate slop . I I AIL . F }~~1 - - i - - - f a -II I _ I ( ! h N f Ali v1L k- C~ 1-4 I f i ~1 I 1 € I t t , 3 i ` - € € Il~ ~ ( I I { - ~ ~-_1 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. _2 Name (print) Am Z= Vl, tr Certification No -C - Address 1`41 I rft c=L `~i I V c=~' fi t c 5 I L/ i> ~~f E~ Z z Name of installer if known CST Signature COPY A State and County State Permit # ° 6 - 7 Permit Application County Permit - . ~!r 6 r 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: / A I) CA, -S /V-1 i` ! L B. LOCATION: /N >e '/4 /Y Section T = N, RZl~- Fr~sr) W Lot# 2- City Subdivision Name, nearest road, lake or landmark Blk# Village Township C TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance_. Single family__. Duplex No. of Bedrooms No. of Persons F) TYPE OF APPLIANCES: Dishwasher X YES NO Food Waste Grinder-YES NO # of Bathrooms- Automatic Washer X YES NO Other (specify) ;SEPTIC TANK CAPACITY I41P 6c~ Total gallons No. of tanks 'Holding tank capacity Total gallons No. of tanks 1 iew Installation Addition- Replacement- Prefab Conc;etf Poured in Place Steel Other (specify) FFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) -13) 1 Total Absorb Area !a1 sq. ft. ~ew_)(_ Addition Replacement *Fill System _ ;creepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches _ eepage Bed: Length y Width / Dept"""! . Depth 4Z No. of Lines ~ _4t1 Seepage Pit: Inside diameter Liquid Depth Y Tile Size ~Rercent slope of land Ov7- 1(0?0 Distance from critical slope--ZIF - the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, '!%Iisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Certified Soil Tester, NAME joqMt~-> r= C.S.T. # and other information obtained from (owner/builder). ::tuber's Signature MP/MPRSW# Phone I'fi.mber's Address I'LAN VIEW: Provide sketch below of system (include direction of pe and all distances in accord with H62.20, including well). i GC-A Le ley Haase Do Not Write in Space Below FOR DEPARTMENT USE ONLY Date of Application , _dat Fees Paid: State / Count Da ) ' ~-S Nam ` Permit IssuedlBr~}eeted _Issuing Agent e - Valid# at Recd Inspection Yes_ No 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 5 2. state (pink copy) 4. plumber (canary copy)