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HomeMy WebLinkAbout026-1010-10-000 o to O -0 0 C7 r~ °c ~ 3 ID m 'o m (ID v ~ v 3 \ 1 3 I I' ~ O ;~O co O v Nn O N m- - W N • ro 7• 3 O 9 N- N S WO m ICI OD d fD z d~ N p 1 O r~+ M- co D o O CD y <n v n W a = O j = D o- Q O O CO N n C O W ~ J ~ N C O N N W O C _ Cn D m n' N (D N O G m : C U) O. CDw CD O z _ N O m Z7 !~i N CD n r N rn rn ° c tr J J z O O O ~yZ 0 o W D o, N U 'O my a C O C7 v v c 7 j N N DWO O o Z s c... CD CD CD N N O D l C m N. CD ~ W CD Cl. a 3 Z O W A Z m N C ~ ~ n n a A z O p C 3 O Cn ~ W 0o v M W m m _ ° 1 z 3 A x o O r: C/) y Z 00 CD A W D C Q O ~ T I N C z a 5 co m A, , a b 0 ti ' o 0 a A i 0 O O_ hQ Oo m to 0 ti N O M ya O M y O a ti Parcel 026-1010-10-000 04/03/2006 10:10 AM PAGE 1 OF 1 Alt. Parcel 3.30.18.34J 026 - TOWN OF RICHMOND 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 - TJELTA, ARNOLD A & JANET A ARNOLD A & JANET A TJELTA 1718 125TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 1718 125TH ST SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.910 Plat: N/A-NOT AVAILABLE SEC 3 T30N R1 8W 1.919A IN SE SW LOT 3 OF Block/Condo Bldg: CSM IN VOL 2/402 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 03-30N-18W Notes: Parcel History: Date Doc # Vol/Page Type 2005 SUMMARY Bill Fair Market Value: Assessed with: 95352 203,900 Valuations: Last Changed: 04/22/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.910 52,200 122,700 174,900 NO Totals for 2005: General Property 1.910 52,200 122,700 174,900 Woodland 0.000 0 0 Totals for 2004: General Property 1.910 52,200 122,700 174,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 106 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 `N'ER , TOWNSHIP SEC. T N, R W 1. ADDRESS. ST. CROIX COUNTY, WISCONSIN. -3DIVISION LOT LOT SIZE PLAN VIEW -Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM :'TIC TANK(S) MFGR. CONCRETE STEEL NO. of rings on cover Depth DRY WELL INCHES NO. of width length area no. of lines width length area depth to top of pipe ;REGATE .K RATE T AREA REQUIRED AREA AS BUILT claimer: The inspection of this system by St. Croix County does not imply complete j 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 -tern operation. However, if failure is noted the County will make every effort to -ermine cause of failure. :ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. INSPECTOR?~ DATED PLUMBER ON JOB LICENSE MfBER ? PORT Of i'?S'?, i~Pi'10 ?--Itd' 1~ILutJAL S ,.,iE_ xE I4~ S`Y, TEI'~ oanit.?ry Permit °tte "eptic ~c r 7 ~ ~S. TIT H 113 A': F Z ~,3 i l TMINSI X C oiN County k TA`TV AL 5Q =aye gallons. "'umber or Comi~artrments /11 r_ Distance r-'ror ft. 12!0 c _ ur greater slo .,e ft ,1: pYell mo uilding ft. Wetlands - - - fL Ys111~3ater f-. r1S 0;AI. "YSlL. t __,X''?'ile Field or Seepage Pit's? t>` stance Fr(-J,,: T?C'. -J.. 1'. ~C~ mr r_e ate slo7e ft ^u~ldln~° ~2 ft. T,Tetlands f' 1'i-hwater f t . dotal length O lines s t. 1 ' beY O lines Lam t l of ft. Iji-Itil of t 1a trench __IL_ft. Total absorption area ~O Z- - S ii s~ T?t':. CIJ- rock oel ow the in. Depth of rock over the in. Cover over rock T~~~ , - dtitJ L trenc..'1 Pin Per ~LL. De~~Lh to ,>eds.ock ft. J) c_, t- , ft to 7round, water :i t. lumber of nits Out a eter ft. Denth below inlet ft. Gravel around nit: yes 110. Yotal absorption area sq. ft. Square feet of seepage trenca botton area require,] Square feet of se s apes nit ea requires' _ 7 T ' Title:-- _ _nST7ECteG1 by : A)nrovec- Emte 197 G/ 97 '3, ' t a ')ate - - - - JN r - State and County State Permit # Permit Application County Permit # PL867 { for Private Domestic Sewage Systems County f l r > *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: (0/s Z il, 1, B. LOCATION:'/4 Y4, Section T_ N, Rf E (or) W U04 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 D. TYPE OF APPLIANCES: Dishwasher -__4 YES NO Food Waste Grinder YES NO # of Bathrooms~x Automatic Washer -k-YES NO Other (specify) E. SEPTIC TANK CAPACITY Total gallons No. of tanks *Holding tank capacity_ Total gallons No. of tanks New Installation X Ir Addition Replacement _ Prefab Concrete *Poured in Place Steel Other (specify) sq. ft. F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1T;-2) j. 3)_,_Total Absorb Area New Addition Replacement *Fill System Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Length Width kA. Depth Tile Depth No. of Lines _ Seepage Pit: Inside diameter Liquid Depth Tile Size Percent slope of land 1-i Gam! 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 Certi d SQiI Tester NAME .0.: 1 l1 ~ V% C] Wk wis C.S.T. # -sf J~3~ and other information obtained from (owner/builder). Plumber's Signature MP/MPRSW# 11 ~ 3 Phone 0 Plumber's Address PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). 1 6 V r ~ ~ / r Do Not Write in Space Below FOR .,DEPARTMENT U h ONLY - Date of Application Fees Paid: State County Date 6 ` Permit Issued/ ( te) %~ssuing Agent Name i,,' Inspection Yes~No Valid# Date Rec'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) EH 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 TEST LOCATION:,jiY4,'/a, Section., T~1V, R a" (or)NV Township or Municipality i'~i Lot No. , Block No. County In Subdivision Name Owner's Name: ~i ,l 'IJ~J ► 'Z }al Mailing Address ~a 54' L4_4. i ]k TYPE OF OCCUPANCY: Residence No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW [S ADDITION REPLACEMENT DATES OBSERVATIONS MADE:: SOIL BORINGS PERCOLATION TESTS SOIL MAP SHEET I f SOILTYPE IV2L(1>~~"L- 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 BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN 1-3 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) ?Z S?" ,x :26 s/_ Zo 7Z Z 7 7Z C~ 'f O S <a - 7Z rF Ca 7 2 7 4 -Za5L ~2b-7 SAC 6-4, T_ 5, - 2 5 IL -2 Q" -;;'2- + :Z ;2 7~ ~ © k-.2b SL 7L SVr 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. Indicate scale , it or distances. Give horizontal and vertical reference points. Indic a slope. U i I , i i I ~R i i 1 I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the proce lures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes art correct to the best of my knowledge and belie Name (print) it A7 Certification No. -j-~ -3~ Address { Name of installer if known - CST Signature - COPY 17l_Mlllp~?Ty 4