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HomeMy WebLinkAbout030-1096-90-000 0Cn0 g-00 p ~1 O m f = v O (9 CD 0 CO -0 v 3 v A A m 3 ~ ~ ~ c 11 O m O A W N OW i~• (D 0- CL Z n v' 'gyp N ° CD co N d- O Cp O Zi n 7 U7 O O O (D N m O K cri 7 N CC) p O O cn (n O O DJ p ~-(n CD D a G 7 N O 3 ~ O co °y li lot cl c~ r <n CD m -4 -4 m_ d o c co co a 3 rr o v ? z O O O o < w z MQ fR N fA o D V v s O O° O of f(D N rn N CD o = (l O O D) v °f N 3 (D CL CL z N Zco Z01 O CD 0 D O O lV CD (D CD ~ ~ N v = E CD CD (D W CD C1 Q : 7 z -i Cn p :D O A Z n A Z O N d C 7 O W V < O N CL CD Z 0 A Z7 0 . Z to z O A A ~ ° c - o 3 CD c CD m z c N p N ° Neap N p'N CD 0- p i O O N ~ (D C/) 0 - Ca) 7 CA W a W CD - n S N N = - m 2 3 kl C) N ~ (D p O CD Q° - a ~o b v 2 a ~ a,~ o O O a i o a ~ ~ 03/24/2005 07:41 AM Parcel 030-1096-90-000 PAGE 1 OF 1 Alt. Parcel 32.30.19.353E 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): = Current Owner * MESCHIEVITZ, HENRY S & JESSIE HENRY S & JESSIE MESCHIEVITZ 1229 ROLLING HILLS TR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 1229 ROLLING HILLS TR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.540 Plat: N/A-NOT AVAILABLE SEC 32 T30N R19W NW SE LOT 3 OF CSM Block/Condo Bldg: 2/514 & REPLATTED BY CSM 3/636 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 32-30N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 694/08 2004 SUMMARY Bill Fair Market Value: Assessed with: 5625 275,800 Valuations: Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.540 82,100 189,200 271,300 NO Totals for 2004: General Property 3.540 82,100 189,200 271,3000 Woodland 0.000 0 Totals for 2003: General Property 3.540 48,100 146,100 194,2000 Woodland 0.000 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 313 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges 00 Total 0.00 0.00 Parcel 030-1096-90-000 02/25/2005 12:32 PM PAGE 1 OF 1 Alt. Parcel 32.30.19.353E 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): = Current Owner MESCHIEVITZ, HENRY S & JESSIE HENRY S & JESSIE MESCHIEVITZ 1229 ROLLING HILLS TR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 1229 ROLLING HILL TR 1 SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.540 Plat: N/A-NOT AVAILABLE SEC 32 T30N R19W NW SE LOT 3 OF CSM Block/Condo Bldg: 2/514 & REPLATTED BY CSM 3/636 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 32-30N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 694/08 2004 SUMMARY Bill Fair Market Value: Assessed with: 5625 275,800 Valuations: Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.540 82,100 189,200 271,300 NO Totals for 2004: General Property 3.540 82,100 189,200 271,3000 Woodland 0.000 0 Totals for 2003: General Property 3.540 48,100 146,100 194,2000 Woodland 0.000 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 313 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges 0.00 0.00 0.00 Total TOWNSIII16~ ( L SEC~~ _,rL; N, R~W ADDRESS ST. CROIX OUNTY, WISCONSIN. '3DIVISION LOT -13 LOT SIZE 030-10 ~'0 0,f5b PLAN VIEW CS✓~ -3, 3 Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING T,,7ITHIN 100 FEET OF SYSTEM ~-Y TIC TANK(S) MGR. CONCRETE L,-STEEL NO. of rings on cover Depth11 DIZY WELL N HES NO. of width length area nc,. of lines width L len, h area=_ dept tai top of pipe hE:GI TF. Y )ATE AREA REQUIRED o AREA AS BUILT :claimer: The inspection of this system by St. Croix County does not imply complete ; pla.ance with State Administrative Codes. There are other areas that it is not possible j inspect at this point of construction. St. Croix County assumes no liability for .t.em operation. How-over, if failure is noted the County will make every"effort to -ernune cause of failure. _.ASES AN-D OILS SHOULD NO BE DISPOSED THROUGH THIS SYSTEM. ° -'INSPECTOR DATED 6PLUMBER ON _16B LICENSE NUMBER z REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM Sanita,',y Penmit- State Septic _ f NAME ( Township / a St. CtLo.ix County Locatioki % o~ Section T_N,R W SEPTIC TANK Size gattons. Numbers o6 CompaAtmentz Distance FtLom: Wett /O _it. 12% on gtceatetc zZope it Bu.itd.ing_it. W ettands it. H.ighwatetL DISPOSAL SYSTEM D.i6tance Ftc.om: Wett lQQ it. 12% on pLeatetL 6tope it. Bu.itding_ it. Wettandts Ft. H.ighwatetL it. FIELD DIMENSIONS: w.id•th ob ttcench 2 it. Depth o4 tcock below t.i.-ez-~~in. Length o6 each UnLA8& 6t. Depth of kock oven tite 2_ in. Number of Zinens Depth o6 tite below gtcade~/___A in. Totat .length o6 tine6 it. Stope of ttcench in pets 100 it. Distance between tinez C/ t. Depth to bedtcock Totat ablsonbtion vLea 6t2 Depth to gtLoundwateA ~ • Requited atcea it 2 PIT DIMENSIONS: NumbeA o6 pits ~ Gtavet atcound pits yets no Outzide diametetc" Depth below .intet ~ • 2 Totat abis otLb o_.`.., tce it z 2 rn Atcea tcequtitLed it INSPECTED BY TITLE APPROVED t ,DATE f 197 ~ t REJECTED DATE 197. N a Eli 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: A-&., _5_6%, Section J;,, T_ R Z7E (or) W, Township or Municipality County ~ ~ t Y Lot No. , Block No. - Su d'vision Name Owner's Name: Mailing Address: TYPE OF OCCUPANCY: Residence C~ No. of Bedrooms y Other EFFLUENT DISPOSAL SYSTEM: NEW 1/_ ADDITION REPLACEMENT - DATES OBSERVATIONS MADE: SOIL BORINGS P RCOLATION TESTS ' SOI L TYPE O , SOIL MAP SHEET PERCOLATION TESTS HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE TEST DEPTH CHARACTER OF SOIL SINCE HOLE HOLE AFTER INTERVAL NUM- INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN BER _ 5 ? (s, P_ 17 P -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) B B c 7 1"C s " 1 B -4 G 72- ~_c 77 /1 r3 5 h~ I PLAN VIEW (Locate perco lat i o n tests,so i I bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable rea indicate number o uare feet of absorp ea cale needed for building type and occupancy. --Z or distances. Give horizontal and vertical reference points. Indicate slope. ) f I i I a F _ - - I - N t I I 4-4 w i ---r.---T_ _ ji 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 10. Address- --r 41 'k- A In J. Name of installer if known CST Signature LA ~THORITY %t B67 State and County State Permit # County Permit Permit Application i aim 1 J11 k L - 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: B. LOCATION: GL/ '/gS Y4, Section T N, R E (or) W Lot# City Subdivision Name, nearest road, lake or landmark Village S Township. * A C. TYPE OF OCCUPANCY: 'Commercial 'Industrial 'Other (specify) *Variance _ Single family k'-~ Duplex No. of Bedrooms Z-J No. of Persons 3 D. TYPE OF APPLIANCES: Dishwasher t- --YES NO Food Waste Grinder YES L P40 # of Bathrooms-? Automatic Washer 1---YES NO Other (specify) E. SEPTIC TANK CAPACITY 19-- o-V Total gallons No. of tanks *Holding tank capacity Total gallons No. of tanks New Installation t/ -Addition Replacement _ Prefab Concrete 'Poured in Place Steel Other (specify) - F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) / 5, 2)_,_ 3) Total Absorb Area sq• ft. New 1/ Addition Replacement *Fill System Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches _ Seepage Bed: Length 7P_Width Depth Tile Depth 2 No. of Lines 1- Seepage Pit: Inside diameter Liquid Depth Tile Size y Percent slope of land 7% 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 Tester, [ NAMEi C.S.T. # and other information obtained from owne builder). Plumber's Signature Gtr MP/MPRSW# /-y phone Plumber's Address 12,1 PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). 3-01 f _ i e_ e r. Do Not Write in Space Below FOR DEPARTMENT USE ONLY Date of Application Fees Paid: State County Date Permit Issued/Re}ee4ed (date) -Issuing Agent Name'~ Valid# Date Recd Inspection Yes ~ No 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumbe _