HomeMy WebLinkAbout026-1022-70-000
0 N o E-0 0 d
0 d f a, O to
CD CD y
v71 clD
0
N c.. Z1 0 0
3 7 S wo 9) r~ ~Yl
(O d z d` N N o
N = N W= 0 = C) N O
0 2)
N 0. O D) y 10 = n CO v n
0 CD
a
= S 3 o
CD -
o °1 `
{ D C c o
(n W a wO
(D r_
3 a
~ ~ °rn o
(D nNi w "%*A
D
CD -.4 - n o c
CO OD Z c
z 0 0 0 •
Z ooo~ c.
0 -0 .
v * * * ' w z
rye
CD ~ o
O
p V) (D CD W N
01 'O ty
CL 3 v
z ca z 0
D a
~r
O
o CD
N N
(DD
(D 4
C CD CD
w m
z D ID
N
O = O A Z p
n = A z O
v n G
C/) w rn
03 -0 W CD m o
CL " z
O ~ . X
U) O
0
H z
CD
a
w
n
v c
" a a
N
o
III
yn
I
O
O
N
a
i A
0 ti
O_
N
7q O
N
EA 0 O
O a
O
AS BUILT SANITARY SYSTEM REPORT
JER - , TOWNSHI ~'.r,,_ SEC. T_x` N, R_ _W
.0. ADDR SS ST. CROIX COUNTY WISCONSIN.
3DIVISION G3~ '•/G Z-2-770 '
LOT LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOtd EVERYTHING WITHIN 100 FEET OF SYSTEM
'TIC TANK(S)MFGR CONCRETE STEEL
NO. of rings on cover Depth DRY WELL
'NCHES NO. of width length area
no. of lines 7 _ width' _ length 4 area
depth to top of pipe
REGATE ' L hc_
.a RATE AREA REQUIRED ' AREA AS BUILT
claimer: The inspection of this system by St. Croix County does not imply complete /
?liance 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.
'ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. `j.
"INSPECTOR
DATED PLUMBER ON JOB
LICENSE NUMBER f,
z
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
Sanity y Petcm,it_~2e//
State Sept.i_c Zj >
f
NAME Town,5hip S Cnaix County
Cl)
Location Sec,tionLT) N,R
SEPTIC TANK
Size - - gatton6. Numbers. o6 Compatctment,5
Distance F&om: Wett 6t. 120 m g&eateA 6tope 6t
Bu.itding 6t. Wet.2and~s 6t.
DISPOSAL SYSTEM Highwatetc 6t.
D.i6tance Ftcom: WeU 6t. 120 otc greaten ztope 6t.
Building 6t. W et.Land,5 Ft.
H.ighwaten bt.
FIELD DIMENSIONS:
Width ob ttcench 6t. Depth o6 tcock below tite .in.
Length o6 each lane 6t. Depth o6 tcock oven t.ite in.
Numbetc ob ti.ne/s Depth o6 tite below grade .in.
Totat .length o6 Zinu 6t. Stope o6 ttcench in pen 100 b.t.
Di/stance between Una fit. Depth to b edno ck bt.
Totat absonbt,ion atc.ea . ~t2 Depth to gtcoundwatetc 6t.
2
Requited area 6t
PIT DIMENSIONS:
Numbek of pits Gtr_avet atcound p.it6 yell no
Out6 i.de d,iametetc. bt. Depth betow .intet 6t.
r
2
Totat abzotcbtion atcea z
r
j Atcea tcequited 6t2 3Z
1
INSPECTED BY TITLE
APPROVED ,')ATE 197
V
REJECTED ,DATE 197.
J
I Li
tl
i ,
i
w
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 TESTS
i
LOCATION: '/4, Section 4 , T _'N, R'' E (or) W,`Township or 3/ L
Lot No. Bloc No. i'" County <
Subdivision Nam
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 / 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
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
P
P- L
P-3 ~A- t
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)
A
f
f .1 L I$ t-
L 74
I~
/ - Y► S '2 c r E ~C
PLAN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of suita le areas. Indicate number of square feet of absorption area
needed for building type and occupancy. r ' 4;: Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope.
, t f i I
_4 ~
11 I N
!
` I i I
c
j7 I ~ it y i
Ii I ~ .n i i t I
i i
t j _ W
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) Certification No. 5 3
r~ I .
Address
Name of installer if known
CST Signature
COPY A -LOCAL AUTHOR MI
• ~ ~ ~ State and County State Permit #
Permit Application 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:
4' 17 D' P
B. LOCATION: % Section T t`N, R
L~_ E (or CW Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township r'
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms ; No. of Persons
D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YESk_NO # of Bathrooms-/-
Automatic Washer -.YES NO Other (specify)
E. SEPTIC TANK CAPACITY f C' ( 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 Area--(,/ sq. ft.
New Addition Replacement .Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches _
Seepage Bed: Length ' Width1 Depth '12.. z.. "'Tile Depth Ift, No. of Lines 2
Seepage Pit: Inside diameter Liquid Depth Tile Size t/
Percent slope of land mot' 41 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 Teste~1
NAME ; , r ( C.S.T. # and other information
obtained from r _ owner/builder).
atur MR# ( Phone #l, `l~~ - I 1
Plumber's Sign
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 n c- c 1.. 1
Do~ Not Write in Space Below FOR DEPARTMENT USE ONLY
Date of Application Fees Paid: State ~lC' C0 Count 0Dat 3-
r
Permit Issued/8g sted (date) -"~-7,~ -Issuing Agent Name % L
Inspection Yes No Valid# Date Recd
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)
Revised Date 6/1 /76
ArcIMS Viewer Pare I of 1
926
v
4
0 A,
1$7.9$ 93.44
b.
436.$
F 2$1.4 436 $ i~
H, (Y 41
LOT2 ' T3 10
LUT1 . =4
v
81C 82B
N 81B
CSM VOL 2 PG 697 ~
2$1.4
~ 435r`'„r...
~i
x
I
http://72.21.230.178/website/LRPortal/ARCIMS/MapFrame.asp?PIN= 3/31/2006
Parcel 026-1022-70-000 10/25/2006 11:44 AM
PAGE 1 OF 1
Alt. Parcel 6.30.18.82B 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
STEVEN D & SUSAN J RUDD O - RUDD, STEVEN D & SUSAN J
930 170TH AVE
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description ` 930 170TH AVE
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 2.500 Plat: N/A-NOT AVAILABLE
SEC 6 T30N R18W 2.5A IN SE SW LOT 3 CSM Block/Condo Bldg:
VOL 2/597
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
06-30N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 06/19/2002
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.500 42,800 100,800 143,600 NO
Totals for 2006:
General Property 2.500 42,800 100,800 143,600
Woodland 0.000 0 0
Totals for 2005:
General Property 2.500 42,800 100,800 143,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 207
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00