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HomeMy WebLinkAbout022-1029-70-000 0 cn 0 K 9 n C: 0 f 3 J 3 m F m v `D m 3 - _ J r o tp*yr~. p 110 _ J O a O N O N W O O N C l J J O O art' ° O O c. (D a ( x ° 1 O _ N C (D O 97 O i0 `t 1 a co O N- co O .r co oo L 3 y A ~ O _ !is r..J N N fV O ~ C ~cG O m a ~ ~ O IT r N ~I J `G r. A°"Mn GR% v J p. (D -4 ~ O C7 Or ~R co Co 0 0 0 Cn ;-r. cn z ST in in in C ~ N v v w i~ m rD. m 3 (D o iz A zz m o N a C l +Me • N° v CD (D CD a~ rn D v N ° III o (D w N' (D (D a Cfl A z m in o ~j n_ O A z O co -0 No ° CL z o - i> 7J o " Cn ~ 3 m N Z (D p W ~ N In IT N CO N ~f2. CD O r- 7 J O D err. O J a D (D CD Cn D Co CD 3 N Q c N O 3 0 O Q J D O (n ~ J C n o' (D 3 a O N ~ fU N < N < jp (D 10 y O 14 O f=- - - n. O mv0 Cy r_ c "0 3 v1 CD v v o sk ~ 1 f11 N A o j n O m a, o N go 5 O° `C CD (D ~5- 00 O_ iD z CL d+ 7 L-, O ~'h CD 0 O. 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CROIX COUNTY, WISCONSIN • Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner O - R&M PROPERTIES OF HUDSON R&M PROPERTIES OF HUDSON C - LLC LLC 1109 CRESTVIEW DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description SC 4893 SCH D OF RIVER FALLS o / I SP 0100 CHIP VALLEY VOTECH '7 zz- abu, V Legal Description: Acres: 20.500 Plat: N/A-NOT AVAILABLE SEC 10 T28N R1 8W 20.50A N 676.5' OF W Block/Condo Bldg: 1320' OF N1/2 SE1/4 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 10-28N-18W Notes: Parcel History: Date Doc # Vol/Page Type 09/16/2003 740194 2411/175 TD 02/02/1998 572170 1292/309 WD 2005 SUMMARY Bill Fair Market Value: Assessed with: 143264 Use Value Assessment Valuations: Last Changed: 08/10/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 60,000 206,500 266,500 NO AGRICULTURAL G4 2.000 300 0 300 NO AGRICULTURAL FOREST G5M 15.500 38,700 0 38,700 NO Totals for 2005: General Property 20.500 99,000 206,500 305,500 Woodland 0.000 0 0 Totals for 2004: General Property 20.500 69,000 150,400 219,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 RE'ORT OF INSPECTION-INDIVIDUAL SEWAGE SYSTEM ~3~(J San-itatcy Penm z- State Septic NAME : J Township St. Cno.ix County Locat.ionlll, 'A o4__>~%, Section G`T.;L'"N,RZ W SEPTIC TANK Size gattonz. Number o6 Compattmentz D.ustance Ftcom: WeZZ 12% on gteaten stope it Bu.itding it. wetZand, it. ~ DISPOSAL SYSTEM Highwaten- it. Distance Ftcom: WeZZ 12% m greaten zZope 6t. Building it. Wettands Ft. H.ighwaten it. FIELD DIMENSIONS: Width o4 trench it. Depth o6 rock below t.ite .in. Length o6 each tine it. Depth o6 Aock oven t.iZe in. Numbers, ob Z-ines Depth o6 t.ite below grade .,in. Totat .length o4 Z ine~s it. Stope o j ttcench in pen 100 it. Distance between Zines jt. Depth to bedtc.ock it. Totat abaotcbtion atcea 6t2 Depth to gtcoundwaten ~ . Requited area it2 PIT DIMENSIONS: Numbers o6 pitz GAaveZ around p,itz yes no Outside diameters it. Depth be.Low .inZet_ it. 2 Total abzotcbtion area it z A Atcea &equ.itced it INSPECTED BY TITLE t~ APPROVED DATE 197. DATE 197 Grp State and County State Permit # J C PLB67 Permit Application County Per y. for Private Domestic Sewage Systems Count *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. L CATION: AV) Section , TA N, R_/rE (or) ~V Lot# City _ Subdivision Name, nearest road, lake or landmark Blk# Village Township f--& rte,',-~ 'air C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family Duplex No. of Bedrooms J No. of Persons D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YESXNO # of Bathrooms 2 Automatic Washer {YES NO her (specify) E. SEPTIC TANK CAPACITY 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) 3) -Total Absorb Areasq. ft. New Addition Replacement *Fill System I~ Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Length ,Width 4F Depth Tile Depth_--2 No. of Lines - Seepage Pit: Inside diameter Liquid Depth Tile Size 471 Percent slope of land 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 Certified Soil Tester, p NAME C.S.T. # and other information obtained from (owner/builder). Plumber's Signature MP/MPRSW# Y C Phone #~7? { Plumber's Address - 1'- f"~ r' C- PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). /r x s s~- Do Not Write in Spac Below ~F~R DEPARTMENT U 5E ONLY 17 /L Fees Pai : State ( County ate Date of Application Permit Issued /R (date) Issuing Agent Name 7~- Inspection Yes No Valid# Date Re 1. county (w t copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, 3701 2. state (pink copy) 4. plumber (canary copy) Revised Date 6/1 /76 KH 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 TESTS LOCATIONy S~'/4, Section I , TffN, RZf E (or)(!Oownship or Municipality (r y'~ c't U,ri, c Lot No. , Block No. County CYc~ l dd 4--- Subdivision Name Owner's Name: Mailing Address: A~7,' TYPE OF OCCUPANCY: Residence No. of Bedrooms 3 Other EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS 47 ZZ Z 7 JPERCQLATION TESTS UU/7 SOIL MAP SHEET I ! f 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 MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P_ 3 57 16 cs Sn--.acv ~.O r.`L P-3 3 G G ?ff~~ S o N C, 3 o rr L Q-r a ! ! 1 rv / 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- PLAN VIEW (Locate percolation tests,soi I 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 horizontal and vertical reference points. Indicate slope. f r s I i---~ l I - aF. _ : i CZ ell { f I i , I - `j- I N - - d - - - d- 4 I -t_ _ I ~ t7 ~ I i I I R l ; I t k X ii i , i , ! I I i ~ I ' I ` c 1 { t I = _ I yy - yIt {1 (/7{ ~ 11 i L__ Al _L 4_-_ I i ; I i I I { t 3 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) m Srh - bYLo_6( y Certification No. 5 S - S7d Address A /r T'G L SW ri.i_ rGt Name of installer if known' CST Signature `OPY A -LOCAL AUTHORITY