HomeMy WebLinkAbout161-1049-70-000
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Parcel 161-1049-70-000 03/27/2006 08:38 AM
PAGE 1 OF 1
Alt. Parcel 13.29.20.508A 161 - VILLAGE OF NORTH 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 - YUSCHAK, GREGORY
GREGORY YUSCHAK
1004 RIVERSIDE DR N
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 1004 RIVERSIDE DR N
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 0.000 Plat: 0055-VIL OF N H ASSESSORS PLAT
E 100' OL 68 VIL NH EXC N 980' Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
13-29N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 948/175
2005 SUMMARY Bill Fair Market Value: Assessed with:
108235 264,500
Valuations: Last Changed: 07/28/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.000 165,760 93,100 258,860 NO
Totals for 2005:
General Property 0.000 165,760 93,100 258,860
Woodland 0.000 0 0
Totals for 2004:
General Property 0.000 103,600 72,700 176,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 133
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
• AS BUILT. SANITARY SYSTEM REPORT
''NER Leant' , P I l,te_SEC . T`y N. Rt ! W
.0. ADDRWS 'f t y \j; , ST. CROIX COUNTY, ISCONSIN.
"BDIVISION , LOT LOT SIZE
PLAN VIEW
"Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
• F
.'l
PTIC TANK(S) •:~'fii MFGR. CONCRETE/~_ STEEL -q
NO. of rings on cover Depth DRY WELL
ENCHES NO. of width length area
D no. of lines width - length area
depth to top of pipe
:CREGATE J
icK RATFC" I AREA REQUIRED ~ y AREA AS BUILT
54-
3ciaimer: The inspection of this system by St. Croix County does not imply complete
.npliance with State Administrative Codes. There are other areas that it is not possible i
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.
:BASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
INSPECTOR
DATED 76 PLUMBER ON JOB :a a
LICENSE NUMBER
' i
A
REPOP,T OF IIISPECTION--EMIJIDUAL SLT,IA(-,E DISPOSAL SYSTEII
Sanitary Permit
r State Septic
JJ` 1E T&WNSHIP
• to Croix County
SEPTIC TATS;
.,~ze gallons. `umber of- Compartments /
Distance From: We 11 ft. 12% or greater slope f1.
Building ft. Wetlands
Iiighwater ft.
DISPOSAL SYSTL:1
Tile Field or Seepage Pit(s)
Distance From: i7ell )-C, ' 12% or greater slope ft
Building; J"Wetlands 7'
.
- f
FIELD Kighwater.) ft.
Total length of lines -ft. Number of lines Length of
each line ft. Distance between lines ft. Width of the
trench -ft. Total absorption area sq. ft. Depth
of rock below tile Dp-pt, of rock over tile in. Cover
over . rock,, ../bepth o, tile below grade in. Slope of
trench in per 100 ft. Depth t;o Bedrock -ft. Depth to
ground water ft.
PITS
71
Number of pits S. 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
:square feet of seepage nit area required '
Inspected I;y: Title
Approved Date 197
Rejected Date -197-.
EH 1.15 (11-74)
' 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: '/4, Section TN, R _ E (or) W, Township or Municipality
Lot No. , Block No. County
Subdivision Name
Owner's Name:
Mailing Address:
TYPE OF OCCUPANCY: Residence No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS
SOIL MAP SHEET SOIL TYPE
PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
INTERVAL
NUM- INCHES THICKNESS IN INCHES SINCE O AFTER
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
P-
P-
P-
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-
B-
B-
PLAN VIEW (Locate percolationtests;soil bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of suitable. areas. Indicate number of square feet of absorption area
needed for building type and occupancy. Indicate scale
or distances. Give reference point. Indicate slope.
tN
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) Signature
grtification No.
ne of installer if known
- Local Authority
State and County State Permit #
PL867 Permit Application County Pert----~-
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:
C. i RIS i ®Ptf X12. i4` -des tv~~s,l~~ Op-k V€ Yo . #uDso"U is
B. LOCATION: N E '/4 A100 Section 2 T;2? N, R.20 Woo W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village XUDSQn(
eweesloE lP+7-lvc-- /1)0 M,41-LA L 149&wnship
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) 'Variance
Single family Duplex No. of Bedrooms No. of Persons L
D. TYPE OF APPLIANCES: Dishwasher K__ YES NO Food Waste Grinder YES NO # of Bathrooms-/-
Automatic Washer _~YES NO Other (specify)
E. SEPTIC TANK CAPACITY -Total gallons No. of tanks
*Holding tank capacity Total gallons No. of tanks
New Installation Addition Replacement A Prefab Concrete_x_
'Poured in Place Steel Other (specify)
EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) & 3) Total Absorb Area sq.
New Addition Replacement _*Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length Width Depth Tile Depth No. of Lines
n ~
.4 Seepage Pit: Inside diameter _ Liquid Depth Tile Size _
Percent slope of land APCI=TZ d reA t~1A((4 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
')y the j rtified Soil Tester,
NAME j JQ-mfrs ~USc C.S.T. # 6 S SZPand other information
obtained from (owner/b k
;'lumber's Signature MP/MPRSW#Phone #~f'~' A23
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
Yvr4~i.
y 5 ~fTs
~J
Do No Write in Space. Below F R DEPARTMENT USE ONLY O G~
Date of Application Fees Paid: State/~~ County Date
Permit Issued/ (date) - Issuing Agent Name
Inspection Yes No Valid# Date ec'd
1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) 4. plumber (canary copy)