HomeMy WebLinkAbout030-1075-10-050
I
0 3 00
a o
d
M cu
C p
~ ~ m c
m
a)
Zo oa
v
a x Ch
Eo 2U
N
O (6
N M
.O
- 2-0
O C c
~O p co
N y
O N f6
v Z
CD
o
M mm
LL
O 0 L
a)
N a N U
E Q w
U
N V
a
> r ql
O Z EO
Z m m
° w a m
Cl) N F- Z
O Z
N
(D Z v c
v> F- r O N
E
U N
~y]^ N N
O N
N O
N p
N O O O
•
N
d R N O
' O w O
O
N Z [0 Z O
Z Z o
N C)
_ M>
(A
N
U i N d -
A F- EL cn
'N _v (L a a
a
t- r-
►i v) J U 'o rn rn
t I` N
r`i rn cfl (D C) 0
N O - N
p O O j
:3 q) Lo
_ 0 v m
CL)
CD d ¢ > o
O ~
F- N N
'o 3: c N C i
O O Q CD O L E O
F-
o co o aui an) c coi a 00 0 0
~ N L ~ N c6 y ~ 'O N N N
O LO 6~ 1 c [0
L: -0 z
0 17 0) 2 :3
a
M I-- U N O N f6 p coo
C) z O t
V y
a
'k a D
• O y u m y c
E c c
t Q a O in U
6
:DER a,l/~ A i TL , TOWNSHIP SEC. T N, R W
. ADDRESS, „ ST. CP.OIX COUNTY, WISCONSIN. T
c~l'lc'/~ clr
'13DIVISION LOT LOT SIZE
PLAN VIEW
-Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
i
r t
~ARA6e
i
-TIC TANK(S) MFGR, 7 '_S CONCRETE STEEL
NO. of rings on cover Depth DRY WELL
INCHES NO. of_ width length area
no. of lines- width /.f' length. area
depth to top of pipe '
,RELATE
-a RATE AREA REQUIRED AREA AS BUILT
.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.
]ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
INSPECTOR
DATED PLUMBER ON JOB
LICENSE NUMBER P;~~
REPORT OF ITISPECTIO11--1NDIJIDUAL SE?•IAGE DISPOSiV, SYSTEi"S
Sanitary Permit
• • State Septic
• a T&VINSHIP
t. Croix county
SEPTIC TA'IR
Size _ r gallons. `Dumber of Compartments
Distance From: Well _ft. 12% or greater slope ft.
Building` ft. Wetlands f:
11ighwater ft.
DISPOSAL SYSTE:1 Tile Field or Seepage Pit(s)
Distance From: 11ell __j~()ft. 12% or greater slope ft
Building ft. Wetlands f
FIELD 1-11ighwater ft.
Total length of lines r ft. !dumber of lines Length of
each line 'q ft. Distance between lines ft. Width of the
trench ~ft. Total absorption area sq, ft. Depth
.of rock below file in. Dp-pth of rock over tile in. Cover
aver rock,,--, Depth of tile below grade -in. Slope of
trench in ner 100 ft. Depth to Bedrock ft. Depth to
Around water £t.
PITS '
Number of wits Outside diameter ft. Depth below inlet
ft. Gravel around pit: dyes no. Total absorption area
sq. ft.
.Square feet of seepage trench bottom area required
:Squars feet of seepage nit area required '
Inspected hy:~ y Title. -
Approved Date 197 CC.
Rejected Date 197.
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
LOCATION: / '/4, '/4, Section 27, T,3('-)N, R/? lk)(or)~Township or Municipality-
Lot No. , Block No. County
Subdivision Name
Owner's Name: &I-el-
Mailing Address: .o .2- Box o 6,0 _5 , 4 A i TYPE OF OCCUPANCY: Residence No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGSPERCOLATION TESTS
SOIL MAP SHEET ~27!Oey //mil 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
I~
_3 e
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 Vet'. &``,4
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square et of suitable areas. Indicat num erf square feet of absorption area
needed for building type and occupancy. e ~c y- Fps - ` 4 Indicate scale
or distances. Give horizontal and vertical refere c-posy icate slope.
..I 4 -t-- i
{
1 ~ I i t i ~ ' , { i I
I
I II t I t y f
_ _
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 andAelief
Name (print) JJ//~ Certification No.
_ r ~`/c'ar . Cyr S` rJ
Address
Name of installer if known
CST Signature
t'0, Y A - LOCAL AUTHOR!`-
State and County State Permit # /
Permit Application County Per it #
PLB67
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:
Ad /~7,z 4..1, S , S I-)
B. LOCATION: l - /4 OLf~ Section, T N, R~ F' (or) U ot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township 'V
C. TYPE OF OCCUPANCY: *Commerdal *Industrial *Other (specify) *Variance
Single family t Duplex No. of Bedrooms No. of Persons
D. TYPE OF APPLIANCES: Dishwasher _X_ YES NO Food Waste Grinder YES X-NO # of Bathrooms-/-
Automatic Washer _-_YES NO Other (specify)
E. SEPTIC TANK CAPACITY a 0 C-y Total gallons No. of tanks
"Holding tank capacity Total gallons No. of tanks
New Installation Addition Replacement_ X, Prefab Concrete x
'Poured in Place Steel Other (specify)
FFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2)-L3) _LTotal Absorb Area sq. ft.
"vew Addition _ Replacement *Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of_ Trenches _
rte" No. of Lines 3
Seepage Bed: Length r ` Width 1 ' DepthTile Depth
Seepage Pit: Inside diIme Liquid Depth Tile Size" 01 Percent slope of land cy ~`cy= Distance from critical slope
_ rkt "3 Y4s ~ ~
the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
'.'visconsin Administrative Code, an that I have sized the effluent disposal system from the EH-115 prepared
by 1 Y4 the C ified Soil T^,ster(.
i~AME I, t' 1c C.S.T. #and other information
obtained from owner
"!umber's Signature _ MP/MPRSW# Phone #714 " -39,-9&Z3
Plumber's Address ti
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
11'r 0- C-7\ A
Do Not Write in Space Below FOR DEPARTMENT USE ONLY
Date of Application Fees Pai : State County ir' Date
-2~
Permit Issued/Rd (date) -Issuing Agent Name
Inspection Yes No Valid# Date .Rec'd _
1. county (whit copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) 4. plumber (canary copy)
Parcel 030-1075-10-050 03/24/2005 04:23 PM
PAGE 1 OF 1
Alt. Parcel 27.30.19.260A 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): * = Current Owner
SCHOTTLER, JOHN T & GEORGINE M
JOHN T & GEORGINE M SCHOTTLER
1374 CTY RD I
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 1375 CTY RD I
SC 5432 SCH D OF SOMERSET
SP 1700 WITC
Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE
SEC 27 T30N R19W NE NE EXC PT TO HWY Block/Condo Bldg:
(0.130AC)
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
27-30N-19W NE NE
Notes: Parcel History:
Date Doc # Vol/Page Type
03/27/2003 714766 2184/614 WD
07/23/1997 431/16
2004 SUMMARY Bill Fair Market Value: Assessed with:
5370 Use Value Assessment
Valuations: Last Changed: 07/08/2004
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 33.230 5,100 0 5,100 NO
UNDEVELOPED G5 1.640 200 0 200 NO
OTHER G7 5.000 34,900 92,700 127,600 NO
Totals for 2004:
General Property 39.870 40,200 92,700 132,900
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