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HomeMy WebLinkAbout030-2121-10-000 n(A O 3 v n d _1 O v c O c 2. ~t C v 3 I m 3 3 r. 0 o m N o p I 1~~1 (SD 3. 3 o(D N co N) m o 0 0 O. Z a 03 _ N O p W m j a m N N cn p (O R m-0 ° m(D a w o 0 ao m C W O O O J ~ O n~+ 3 N W :3 O C N N O o y CD N CD E: - (n < D A a m e~ CD Ul N W < m b 3 n co co (D N ~ N r- cn w O C z OC OC OC p. o N G G G° 00 (n (n cn ID _o m a O O O (n N N O ~ D] ~ n , N ~ G f9 N (D v z N p z z D (D O O4 C) O 4 ' O m !r • N N C (D (D W d a 3 3 CD --I cn z O O O A Z n N c s O A z v a O a. Cl) W * o ° a z 3 $ U) B M N (D A W pj O (D D 3 C1 (D a o - ~ T N C z G 0 N I a, I ~ A y A I n N N O I O A ~ W CD 0 O EA O p O b ° C O ~ ' ti Parcel 030-2121-10-000 03/22/2006 02:29 PM PAGE 1 OF 1 Alt. Parcel 30.30.19.983 030 - TOWN OF SAINT JOSEPH ST. CROIX COUNTY, WISCONSIN Current X 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 - BEER, HAROLD G & FLORENCE E HAROLD G & FLORENCE E BEER C - CARLSON, GARY & ELIZABETH TR ET AL C - PARKS, CLAYTON E III & DENISE M 378 OLD E WEST C - THEISEN, ALLEN V & KOREEN B HOULTON WI 54082 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 378 OLD E WEST SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.036 Plat: 2433-SANCTUARY,THE 01 SEC 30 T30N R1 9W PRT SW SE LOT 1 THE Block/Condo Bldg: LOT 1 SANCTUARY Tract(s): (Sec-Twn-Rng 40 1 /4 160 1/4) 30-30N-19W NW SE Notes: Parcel History: Date Doc # Vol/Page Type 12/27/2001 666579 1802/48 QC 12/27/2001 666578 1802/47 QC 2005 SUMMARY Bill Fair Market Value: Assessed with: 85051 222,900 Valuations: Last Changed: 07/12/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.036 92,000 110,700 202,700 NO Totals for 2005: General Property 3.036 92,000 110,700 202,7000 Woodland 0.000 0 Totals for 2004: General Property 3.036 92,000 110,700 202,7000 Woodland 0.000 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 126 Specials: User Special Code Category Amount Special Assessments Special Charges 00 Delinquent Charges 00 Total 0.00 • AS BUILT SANITARY SYSTEM REPORT ` 1NER k, I ✓ / TOWNSHIP. SEC. TN, R 1'7 W .0. AD RESS , 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 r AJ~ u 'TIC TANK(S) MFGR. j KJ ij~ CONCRETE__' f_ STEEL NO. of rings on cover Depth DRY WELL 'ENCHES NO. of width length area _ D no. of lines A width _l length__;Q ~ area ,,_--:Z6, depth to top of pipe 3REGATE1 > -K RATE I'~ AREA REQUIRED AREA AS BUILT <.-claimer: The inspection of this system by St. Croix County does not imply complete :npliance 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 Stem operation. However, if failure is noted the County will make every effort to ::ermine cause of failure. EASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.. "I TOR f' 1 DATED PLUMBER ON JOB '111t Al LICENSE NUMBER f REPORT OF ITTSPECTIO_'*'--III!-IJIDIJAL SEWAGE DISPOSAL SYSTEM Sanitary Permit St e Septic 11EG TOI°TTJSHIP 4 z• 14- t. Cr'ix County r, -7TH SP T ._IC TAC Size gallons. 'lumber of Compartments ' -4. Distance From: ',,?ell .•1-'~ fit. 12% or greater slope 'Building ft .6t1 ands I ighwater ft. DISPOSAL SYSTEb4 Tile Field or Seepage Pit(s) Distance From: Well ft. 12% or greater slope ft r ` ~t:. - Builc;ing t. Wetlands f; FIFL) Hirhwater ft. Total length of lines ft. dumber of lines. Length of each line ft. Distance between lines ft. Width of the trench _ft. Total absorption area--sq. ft. Depth of rock below tile in. Depth of rock over tile in. Cover over rock ~Depth of tile below grade in. Slope of trench in ner 100 ft. Depth to Bedrock ft. Depth to ground water ft. PITS Number of nits Outside,/,liam er ft. Depth below inlet ft. Gravel around pt:s no. Total absorption area sq, ft. Square feet of seepage trench bottom area required "quare feet of seep Fe nit,. ea required Inspected by: Title: - / Approved Date L197 . Rejected Date 197. i State and County State Permit # r PLB67 Permit Application County Perm # 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: /7- _ B. LOCATION: S~L1 '/o Y4, Section ~3(5, T::~01\1, R 0 (or) _Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township USt C. TYPE OF OCCUPANCY: *Commercial _ *Industrial 'Other (specify) *Variance Single family_ Duplex No. of Bedrooms 3 No. of Persons D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YESNO # of Bathrooms-- Automatic Washer YES NO Other (specify) E. SEPTIC TANK CAPACITY /000 Total gallons No. of tanks C,~14 S *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) _yp 3) 9 Total Absorb Area 1.260 sq. f'~t~~ / .11 New Addition Replacement *Fill System Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of -illrenches Seepage Bed: Length 7©, Width /F/ Depth " Tile Depth 7-1/" No. of Lines Seepage Pit: Inside diameter Liquid Depth Tile Size Percent slope of land f/- yD / Distance from critical slope .,.So' X11 co r- 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 Soi~~ey,~l ` NAME et la tdiS--_ C.S.T. and other information obtained from ~r , 2e (owner/1r). Plumber's Signa re P PRSW# l Phone Plumber's Addres PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H6220, including well). % 3 2-c> ADU ,q~`>tbKa~ pr~~cu f~`~ no,; ~ h U W C' c~f o F ow~`G,~ivf} ~ ~ J° r 4 4 Foot U 0 JL J \ ~2r X / \ rid f 7-0 ¢ Q v o o a` o A-,0,W F,'e /j ~0i,0 ;AI-e-,4 s e L pe,0~~ S w`T s~ c GAw9Gp c-' si("'(r 0.67 /,Se o h' >f Do Not Write in Space Below - FOR DEPARTMENT USE ONLY Date of Application 2/3 /7 7 Fees Paid: State C unt ' ate Permit Issued (date Issuing Agent Name Inspection YeTtecopy) Valid# Date Recd 1. county (w3. 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 EH 115 (11-74) 1 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, VVISCONSIN 53701 REPORT ON SOILJ30WINGS AND PERCOLATION TESTS OCATION: '/4, '/4, Section , TN, R E (or) W, Township or Municipality of No. , Block No. County _ Subdivision Name iwner's Name: ti lailing Address: YPE OF OCCUPANCY: Residence No. of Bedrooms Other FFLUENT DISPOSAL SYSTEM: NEW -ADDITION REPLACEMENT ATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS DIL MAP SHEET SOIL TYPE PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE VUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN 3ER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MI SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES VUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) I- 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 or distances. Give reference point. Indicate slope. t N 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 oy C - Local Authority f D rri 3 ti t n 7 7 r y /9 rv o m ` w~ ~ fro f~. C C , ` j • BO 9 W sf o r l P 80 ~ ~j~ \ p~ ~ Edwa.-d 4 \ f) r /chore/ L. 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