HomeMy WebLinkAbout030-1021-50-000
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Parcel 030-1021-50-000 03/21/2006 09:09 AM
PAGE 1 OF 1
Alt. Parcel 06.29.19.91 C 030 - TOWN OF SAINT JOSEPH
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 - BENSON, DAVID C & JANET
DAVID C & JANET BENSON
1191 MCKINLEY DR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description ' 1191 MCKINLEY DR
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 3.000 Plat: N/A-NOT AVAILABLE
SEC 6 T29N R19W NW NE LOT 2 CSM 2/587 Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
06-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
2005 SUMMARY Bill Fair Market Value: Assessed with:
83277 229,700
Valuations: Last Changed: 07/07/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.000 91,200 117,700 208,900 NO
Totals for 2005:
General Property 3.000 91,200 117,700 208,900
Woodland 0.000 0 0
Totals for 2004:
General Property 3.000 91,200 117,700 208,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 124
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT
40
OWNER , TOWNSHIP SEC. T N, R W
P.O. ADDRESS r i"v ~S ST. CROIX COUNTY, WISCONSIN.
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
.
bird
130
SEPTIC TANK(S) C MFGR. W CONCRETE STEEL
NO. of rings on cover Depth DRY WELL
TRENCHES NO. of width length area
BED no. of lines__ width length area
de th to top of pipe
AGGREGATE W, ep d~ (</L r
PERK RATE Na AREA REQUIRED AREA AS BUILT
Disciaimer: The inspection of this system by St. Croix County does not imply complete
compliance with State Administrative Codes. There are other areas that it is not possible
to inspect at this point of construction. St. Croix County assumes no liability for
system operation. However, if failure is noted the County will make every effort to
determine cause of failure.
GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
INSPECTOR
{ DATED t q 1 ~ PLUMBER ON JOB
LICENSE NUMBER ~A
i
s
' RRPOr,T Or ITISI'ECTIO:1--II-MVIDUAL SET,IAGE DISPOSAI, SYSTEM
. Sanitary Pcrmit`-~
i r State , eptic
Zi,
• 't.'/l County
SEPTIC Th'?T:
:ize gallons. ,umber •o Conoartments
Distance Front: well ~ it
t. 12% or greater slope ft
Building' ~ ft. Wetlands f
Iiighwater ft.
DISPOSAL SYSTE:1 Tile Field or Seepage Pit(s)
Distance From: Well ft. 12% or €reater slope ft
Building S-6 ft. Wetlands f .
FIELD Flighwater ft.
Total length of//lines e 2 ft, dumber of lines Length of
each linef ft. Distance between lines ft. Width of the
trench IA-ft. Total absorption area 72-. sq. ft. Depth
of rock below tile -,/-L-in. Dp-pth of rock over the in. Cover
over .xock,,-~ Depth of tile below grade 0? in. SZope of
trench in ner 100 ft. Depth to Bedrock ft. Depth to
,round water ft.
PITS
1
Number of pits Outsi4 dia r ft. Depth below inlet
ft. Gravel around p'`. I
•,ye no. Total absorption area
sq. ft.
Square feet of seepage trench bottom area required
Square feet of seepa-fie n3' ar a required
l
Inspected b_/y''i"`'"' ! Title':
Approved Date 197
Rejected Date 197.
EH. 11 5 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309
MADISON, WISCONSIN 53701
` EPORT ON SOIL BORINGS AND PERCOLATION TESTS
j%X or unicipality , ~
LOCATION: AW/4, Section N, R N (or) ownshi
Lot No., Block No. `Q a~ County J~4tIX
Su division Name
Owner's Name: t w
Mailing Address: 14i 7 V< rii, 1 C9
TYPE OF OCCUPANCY: Residence _ No. of Bedrooms -3 Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS S _1t_ 7k -
SOILMAPSHEET .26fnTY SOILTYPE 0-2- 5~k//-
` PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
CHAR
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-/ Set z. -ro- ~Vv ;2 IVv l c
P_ ,
P- 3 ~e e oil W6
l 1
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_ ~i~" itt~*r~ `7~~ lad `Y f 3f" SAC, ya<. yam'
_06, 36, 4. 4/12
0<
16 1, F,~' -F 0-0 k -2 71. 5Z 11 "1
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square feet pf suitable areas. _jDdI j?umber of square feet f absorption area
needed for building type and occupancy. lty` Indicate scale
ints indicate slope.
or distances. Give horizontal and vertical ref ncy~
1 ~
1-4
- -
-7 _4
el 4
_
w
~4
f }
e 4"!
1 %4
,
3 5 t ~ ; 1 1 f
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A sk- 'y 0,F~'"~` ~y
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 bell f.
Name (print)` Certification No.~
Address
Name of installer if known L
r 1
CST Signature
COPY A - LOCAL AUTHORITY
State and County State Permit `
PLB67 Permit Application County Permi
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:
V v
1 ~tEScT~i Sao!.
B. LOCATION: LG.j % 4~ Section, T N, RZY& (or) Lot# ~_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 X_ YES NO Food Waste Grinder YES >CNO # of Bathrooms
Automatic Washer AYES __NO Other (specify)
E. SEPTIC TANK CAPACITY 00 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. f
New X Addition _ Replacement- Fill System
Seepage Trench: No. Lin . Feet Width Depth_ Tile Depth No. of Trenches
Seepage Bed: Length `Width ,,e' Depth 1!~'_ Tile Depths " No. of Lines ~3
Seepage Pit: Inside diameter Liquid Depth Tile Size lpl'
Percent slope of land 1 ~ ~ fcs~~~k was-/,`K Distance from critical slope
114*
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 Cer ified Soil Tester,
NAME e` ~,61S4. C.S.T. # C7f-41~ and other information
obtained from owner ~j j~- c~ ~
j Plumber's Signature P/MPRSW# Phone #
~~s !
7 7
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well). Ala
~ t
M
/IV
ae
V • ,
I. • 135 • ~ ~W 5! ~
O 7
Do Not Write in Space Below FOR DEPARTMENT USE ONLY
Date4
Date of Application s /1 Fees P r: State 16"' CC County, .:~2 "J Le
Permit Issued/ (date) -Issuing Agent Name
Inspection Yes No Valid# Date Recd
1. county (wh ea copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) 4. plumber (canary copy)
L