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Parcel 161-1094-80-000 10/03/2006 09:39 AM
PAGE 1 OF 1
Alt. Parcel M 13.29.20.751 161 - 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
JOSEPH H & JANET COTHERN O - COTHERN, JOSEPH H & JANET
243 STATION CIR N
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 243 STATION CIR N
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 0.000 Plat: 04/38-ST CROIX STATION 1977
ST CROIX STATION LOT 27 VIL NH Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
13-29N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 06/22/2006
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.000 112,000 260,900 372,900 NO 02
Totals for 2006:
General Property 0.000 112,000 260,900 372,900
Woodland 0.000 0 0
Totals for 2005:
General Property 0.000 112,000 238,000 350,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 114
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
• AS BUILT SANITARY SYSTEM REPORT
";ER , TOWNSHIP SEC. T N, R W
. ADDRESS , ST. CROIX COUNTY, WISCONSIN.
==DIVISION LOT LOT SIZE .
PLAN VIEW
-Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
1 ~
AC'
.'TIC TANK(S) MFGR. CONCRETE { STEEL
NO. of rings on cover Depth DRY WELL
!':ivCHES NO. of width length area
3 no. of lines width
length
are
a
1
depth to top of pipe
REGATE
,:K RATE AREA REQUIRED AREA AS BUILT
-claimer: The inspection of this system by St. Croix County does not imply complete
zliance 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
..tem operation. However, if failure is noted the County will make every of rt to
:_ermine cause of failure.
_..ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
'INSPECT
DATED _ PLUMBER JOB
LICENSE NUMBER
I
FF
RFPOP,T OF IllSPECTIO_l--171DIJIDUAL SE,,]AGE DISPOSAI. SYSTM
Sanitary Perm c
. - r
State Septic/
eptic/
.,1E T0I•1NSHIP
St. Crop: County
Sx.?'T L TAM-
Size gallons. `lumber of Compartments .
Distance From: Well ft. 12% or greater slope
Building` ft. Wetlands ft
ILighwater ft.
DISPOSAL SYS T;.:1 Tile Field or Seepage Pit (s)
Distance From: Well ft. 12% or greater slope ft
Building; ft. Wetlands f:.
FIELD Klighwater 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. Dept:
of rock below tile in. Dp-pth of rock over the in. Cover
aver. roclc,, Depth of tile below grade in. Slope of
trench in ner 100 ft. Depth to Bedrock ft. Depth to
Around water ft.
PITS .
Number 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
Square feet of seepage nit area required -
Inspected by: Title':
Approved Date 197
Rejected Date 197.
,ER 115
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
- t P.O. BOX - 09
MADISON, WISC NSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
LOCATION:._-+ Section ~'.4-, -E&N, R-,7--E,(or) Township or Municipality
Lot No. 2_~, Block No. S 5~ ~ County
TT61 Subdivision Name
Owner's Name: E: y~A /
Mailing Address:
6? u
6, 1, < ~Xr •~c+.~ z /Z_
TYPE OF OCCUPANCY: Residence No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION --REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS SSA- c -2 F -PERCOLATION TESTS 3 `2
SOIL MAP SHEET
SOIL TYPE S 7!3 /'~t~- ~i-d' A t
PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TESTTIME 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_ /
5cklf 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)
S- S _ r - co h
B_ 3 ?6 > Fe, ao-r-5, 76 CL
'k A,
vldc'_ 7 `~E' tiZJ 'yS (o
Ce 4,
> 2o -1 2
PLAN VIEW (Locate percolation tests,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. ,Z-uc; sc: iQs-Pip fi -In i c a t e scale
or distances. Give horizontal and vertical reference poin s. Ind' to sl pe. S
i
i_
C _ w
I i ( I
I ~
! I Y~ - , , I
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) 3 7~O v, - Certification No.=
Address / Z6 ~ ~ ✓ _ ~,r
Name of installer if known
CST Signature
State and Co l/ State Permit #
•
PIm B 6 7 Permit ApplicI ' 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: //4, Section --2. T N, R 0> (or) ot# ',Z 7 City
Subdivision Name, nearest road, lake or landmark Blk# Village _
/ Township
C TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family x.,- Duplex No. of Bedrooms _3 No. of Persons -3
D. TYPE OF APPLIANCES: Dishwasher __.&_YES NO Food Waste Grinder YESIX NO # of Bath rooms;%Z__
Automatic Washer AYES NO Other (specify)
E. SEPTIC TANK CAPACITY Total gallons No. of tanks /
*Holding tank capacity Total gallons No. of tanks
New Installation X Addition _ Replacement _ Prefab Concrete X
*Poured in Place Steel Other (specify)
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) ° --2►~t_3) 5 Total Absorb Area_ . ft.
~S
Newer Addition Replacement *Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length Width / 11 Depth Tile Depth 26 ' No. of Lines
Seepage Pit: Inside diameter Liquid Depth Tile Size 91
Percent slope of land Says t4 .iv' SXs , q Distance from critical slope
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 Ce ified Soil est
NAME YZA; /sr C.S.T. # and other information
obtained from S ! (ceder). 386-hZ
Plumber's Signature MP/MPRSW#~-3 Phone #_713
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well). /
h
• a 1
.J
oil
f7~ / L fell? F,c.
Do Not Write in Space Below FOR DEPARTMENT USE ONLY 7
L/ 12C, ~ql Fees Paid State Count Date - i
Date of Application
Permit Issued/R4ieetcd (date) - Issuing Agent Nam
Inspection YesNo Valid# Date Recd _
1. county (w 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 6/1/76