HomeMy WebLinkAbout022-1074-70-000
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Parcel 022-1074-70-000 03/29/2006 09:19 AM
PAGE 1 OF 1
Alt. Parcel 26.28.18.414B 022 - TOWN OF KINNICKINNIC
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 - KUSILEK, MELVIN B
MELVIN B KUSILEK
131 PONDEROSA RD
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description " 131 PONDEROSA RD
SC 4893 SCH D OF RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 1.290 Plat: N/A-NOT AVAILABLE
SEC 26 T28N R18W 1.29A LOT 1 CSM VOL Block/Condo Bldg:
3/672 ALSO A PARCEL DESC AS COM NE COR
LOT 1 CSM 3/672 POB; TH N 01 DEG E 416'; Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
TH N 88 DEG W = WITH N LN LOT 1 TO N/S 26-28N-18W
1/4 LN SEC 26; TH SLY ON N/S 1/4 LN TO A
POINT ON SD 1/4 LN THAT IS N 88 DEG W OF
more...
Notes: Parcel History:
Date Doc # Vol/Page Type
11/22/1999 614262 1472/604 QC
07/23/1997 1019/361 QC
2005 SUMMARY Bill Fair Market Value: Assessed with:
143768 176,100
Valuations: Last Changed: 08/11/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.290 30,000 148,100 178,100 NO
Totals for 2005:
General Property 1.290 30,000 148,100 178,100
Woodland 0.000 0 0
Totals for 2004:
General Property 1.290 15,000 113,400 128,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 158
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
'_tiER STD N- N , R (e i 'M O AIQ , TO~r1NSHI:t'x/NNICI~AtV/v° SEC. 7 lp T N, R_ ZJL_W
O, ADDRESS ST., CROIX COUNTY, WISCONSIN.
3DIVISION t is r. LOT LOT SIZE
PLAN VIEW
Distances b dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
P01M2/ R,OSA RP
- i
.TIC TANK(S) MFGR. i(M5S ,1-~7: F ~0 N F,-1 'jam CONCRETE Z---STEEL
NO. of rings on cover Depth DRY WELL
INCHES NO. of width length_ area
no. of lines width. length _VL2 area 4)
deoth to top of pipe
REGATE I L~ RIC, ~i
RATE /f~'-• 13- /L AREA REQUIRED ----J--- AREA AS BUILT D
claimer: 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
tem operation. However, if failure is noted the County will make every effort to
ermine cause of failure.
a1SES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
`'ZNSPECTORIZGt%4 4got ~
DATED -I ? PLUMBER ON JOB 49
LICENSE h'UIIBER
r
Z
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
Sanitatcy Permit-,,
State Septic _
NAME Township St. Ctcoix County
• - Lacaion,! % o Secztion w% U•\N, R;~_1~W
SEPTIC TANK '
Size gattons. Number ob Compatctmentz
Di.stance Fhom: Wett 6t. 120 on gxeatetc zZope 6t
Building J t. W e.tZandts .c 5b 6t.
DISPOSAL SYSTEM Highwatetc-506t.
Diztance Ftcom: Wett 6t. 12% on gtceatetc stope 6t.
A Buitding~Jt. Wettands Ft.
H.i..ghwaten <1j, 6t.
FIELD DIMENSIONS:
Z Width of ttcench 1_~t. Depth o6 tcock below Cite/.l in.
5 ~
d Length ob each Xine 6t. Depth o6 dock oven late Z- in.
NumbeA o6 Zine/s _ Depth o6 tite below gkade4&in.
t
l1 Totat .length o6 Zinez k {t. Stope o6 trench in pets 100 6t.
~
Distance between tines"p 6t. Depth to b ednock 6t.
Totat ab~sonbtion aAea ,6t2 Depth to gtcoundwatetc ~ .
~ 2
RequiAed atcea b
PIT DIMENSIONS:
Numbetc o6 pits aver atcound pitz yes no
Outzide diametetc h betow intet 6t.
i 2
Totat ablsotcbt.Lon a a sit . z
Atcea ui&ed t m
a
INSPECT . '0E
01
I ez
APPROVED 19 7 \v
E
REJECTED DATE 197
r~
I ti
I vtot
EH 115 (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: _'/o, Section , T-N, R E (or) W, Township or Municipality
,•Lo"o. Block No. County
Subdivision Name
,Owner's Name:
~MaiIThg /~ddr~,ss y'_
-\TYPE O~ OCCUPANCY:, Residence No. of Bedrooms Other
EFF,-U,ENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS
SOIL MAP SHEET SOI L 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 MI
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 percolation tests soil bore holes and suitable soil areas.)
Indicate on the plan the locationand 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
Certification No.
Name of installer if known
Copy C - Local Authority
PLB67 State and County State Permit #
-
Permit Application County Per A#
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 ress:
B. LOCATION: Section ,2 , T~Zq N, R W Lot# i
Subdivision Name, nearest ro d, I ke or landmark Blk# illage
/ Township k/el/y/~kh'ViY/G
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) `Variance
Single family L--'--Duplex No. of Bedrooms No. of Persons
D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES-_ANO # of Bathrooms-
Automatic Washer YES _&NO Other (specify)
E. SEPTIC TANK CAPACITY /pop Total gallons No. of tanks
*Holding tank capacity Total gallons No. of tanks
New Installation Addition Replacement Prefab Concrete 4-1
'Poured in Place Steel Other (specify)
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) -[f 2)/33) Total Absorb Area sq. ft.
New L~-`Addition _ Replacement *Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length YU Width- Depth Tile Depth No. of Lines
Seepage Pit: Inside diameter Liquid Depth Tile Size
Percent slope of land / Distance from critical slope
1, 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,
NAME OP-1-4-F; C.S.T. # and other information
obtained from (owner/*a+H&+
Plumber's Sig ature P/MPRS /91>✓? q-3s-S Phone -3
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
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Do Not Write in Sp B to R DEPARTMENT Y
Date of Application Fees Paid: State C t Da
Permit Issued/ (date) Issuing Agent Na
Inspection Yes No 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