Loading...
HomeMy WebLinkAbout030-2078-10-000 w n V) Q m n O O N O N n fD ~ ~ 7 CD ' 3 'r CD (D O-i D) -15 3 ~ ~ l 11 3~ o c o cn~0 `~o k. (D O ~ O (D O J N O O N C7 O U7 00 D_ Z d= N O N l-, O ..h N N N C O ry W O ] (D O J OD N A (D (O (n C 3 W Qo l 1\ j 0 0 -p n O 0 '0 Q (p D1 Ul O O (D CD N (D (.077 r N O _ 7 O O 7 N (D > O C N C O •F'S !V m cn D m a ~ O CD a O N O N C) (7 T r') rj C CD O N3 Q O O ~0- O O D1 N) r) 0 C) C, L O A N N (D v -4 W O C to OD OD CD CL vvvo v ti. o ~E -4 --1 - a) CL 77 ° v v = CD =3 N o S N O ° ~ 3 w CD r! ul N A O A D W O ~r o 0 n =3 A lnr+ i~3 =T U) 00.. M • 25 (D Q1 > > CD N (0 _ Qf~ C (D N O (D CL 3 O _ o p Z CD N c , A ,n_.• 0 A Z O Q ~ 7 I U<) Co -v < W W O O. Z 3 a A °o C/) o 3 m y z CD A W x O -0 W N , d OO U7 ' C O (~_D- C 7 (D 3 G_ D j SU ( D W •G CL DJ 3 a"O N C N a~ 3 3 o (D N ~ N ` O W N v O U) OD Q 03 C) 0 G o 0 4 'O 7- O 0 o d v c m j N cD C O (D coO 3 (D to SU 7 O 7 7c3CD O O (D Cn A OD j (D aro ?i CD * 6 m Is v C) CL n N 0-u 0 d F ` C 5 CD ' m v c T d d # d 1 ID 3 - O Z N v W w O "s p~ O p O W O W W `C • 3 01 01 :,:1- m D W C y N O 'O (D C N Cl O O O 7 o 7 < ~ O O CD d 00 O CIl `G O 3 N 7 O p •Ni C N ~O d (V U < D m a w ICD o N 4 o co a a O Gc O ° ow d O N W A ;o O CD O w n f7 r cn N 0 C _ cr T T 00 d 0 "Nd 0 0 7 Cl) E 0 77 o N ti 0 cr D x T p IG C_ N O j O O O' CD CD - d ~ ~ M CD z z - N 0 z w Z h D CD O a p S T O CD. (D N N~ N N C O N C CD CD N C1 Q - ~ z (D o 0 D p Z CCD _ U O p C A Z O * co w CD CD .L Z 0 3 o C/) w m z CD w ~ W~o~OD a- j (D O O N 3 T CL 7 O Z Q 3 0 3Ndo U7 N N CJ N O C-~C U1 W d v 7 77 O i O 7 O A (D 7 C) N d,G N N CD 3 s 4' - S m d 7 O 7 A N N S CD O Q CD O '-n ~ A (D V o z o c~ C) a AS BUILT SANITARY SYSTEM REPORT r. ,,NER 4R_~S TOWNSHI . 0. ' SEC. T N, R W ST. CROIX T 9WISCOsNSIN. _'BDIVISION~r..,,.4 v f LOT / LOT SIZE AP h, PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM . A) J i "•1 7'A pTANK(S)A_ MFGR._~ /4'.L' CONCRETE ~t.c STEEL NO. f,rings on cover '.rNCHES NO. of " Depth_ DRY WELL width length area -D no. of lines width i length_ area depth to top of ' GREGATE Jam" P pipe t ~~C E, „AREA Q UIRED L- r __RK RAT AREA AS BUILT .6 D, sciaimer: 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 em operation. However, if failure is noted the County will make every effort to -mine cause of failure. ES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. `'INSPECTOR I DATED PLUMBER ON JOB LICENSE NUMBE i - . Parcel 030-2078-10-000 03/24/2005 10:30 AM PAGE 1 OF 1 Alt. Parcel 33.30.19.658 030 - 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 * STELTER, JOHN D & ROXANNE L JOHN D & ROXANNE L STELTER 1223 RED OAK RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 1223 RED OAK RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.760 Plat: 2234-OAK KNOLL ADD SEC 33 T30N R19W OAK KNOLL ADD LOT 1 Block/Condo Bldg: LOT 1 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 33-30N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 947/487 07/23/1997 739/213 07/23/1997 707/503 07/23/1997 697/21 2004 SUMMARY Bill Fair Market Value: Assessed with: 6368 192,300 Valuations: Last Changed: 07/09/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.760 66,200 123,000 189,200 NO Totals for 2004: General Property 1.760 66,200 123,000 189,200 Woodland 0.000 0 0 Totals for 2003: General Property 1.760 38,900 98,100 137,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 115 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 t CVI f~ Q M; W b 't co ce w w ` 66 = r \ \ o~ uT O cJ O C ;0 Q; ! tri -C Ct C\j -U OQ rt c ~ ~ n tic c 101 g 0,7 (7 10, ~E A V O Gvo~l 13-9 c` I i N I O CC) C7 C 7\A C> Li LUC) Q __.l I wi r < ob 0 V) 07 I - j rC7 I O? Lij COWERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 800 - 962 - 5227 cz: wi"Ulik 4.u~ CROIX COUP r\rrJx ' ia(4i 4f20JRTHOUBE SON, WI )TIOt ECVI' f .SATE ANALYZED* IME ANALYZED; *COLIFOp1 INTERPRETATION: Bacteriologically F:- Nitrate-Nitrogen, mg/L *NITRATE-N; 4 Above IO ppm exceed; Drinking WAter x 00 C' OF.\NDECFNOEH V" Y G 'V~„ P d~ z ; , I ~,r~;,; tai-'°~~`.a. 6 , •:..f ~ ,o PROFESSIONAL LABORATORY SERVICES SINCE 1952 ST. CROIX COUNTY ZONING OFFICE lot St. Croix County Courthouse l~ ~/D 911 4th Street Hudson, WI 54016 Telephone - (715)386-4680 f he St. Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion -Qf this form ja essential zQ ocated. that the aro erty, can bg Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. WATER TESTING--------------- --FEE: $ 35.00y (For nitrates and coliform bacteria) WATER TESTING FEE: $185.00 (For VOC'S) SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00 (Determines if system is properly functioning at.time of inspection) PROPERTY OWNER'S NAME: PROP. ADDRESS: 1: CJ CITY `i.~: Legal Description 1/4 of the 1/4 of Section T N-R,a Town of.__ Lot Number l Subdivision: FIRE NUMBER O'K BOX UMBER Zo Color of house Realty sign by house=5 If so, list firm: PLEASE INCLUDE, IF AT ALL POSSIBLE, A HAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential wate~ requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual requesting services:-)/ffuti"E Telephone Number REPORT TO BE SENT TO : ~t✓ t CLOSING D A T : Signature _ ' h/#zt `z'ap ir Hy~ x a' ~ Z 9r AX S 234 /91 /N M4P NO' N0 9¢5 7TH 5T 4 i. • `t„ r, ' ° SUB 1 INV 1 CO175~ iO u pot TWA S 0 MUN H!A$OW ZIP AX S 2392 /91 !N MAP N S. 0• No Se. 1{6T11 ST N Y K /N 'l RES MOVACY;OAKACR 1TR.5MNTHtSHS SFORO 1B ASP N LO 784 SUB 2 DN 1 COU 1STCR 8 A S S O 0 MUN CO RD A 351 HUDSON A f 0 Q HWY 005 TO CO(R.EE RD 1ST R ON VALLEY VEW BL M LOT 110%1]0 A~ ASP IN ZIP 5101{ f 712851 DIR 0 HIS FOR 79 00 IN ygl MM- AR 796 SUB 2 DN 1 COU STCA ZO `~I u0 7BR LAME N L0T .35 ACRES S 0 ASP IN SUB 1 DISTRICT; EASY COMMUTE TT7 TWIN Cm TUEN Oi TIE CENTURYNOMEWITH IIARD1V000 FLOORS f 766775 DIR CO RD ACR 35 HS :011 19 00 N DN ` VEW$ Of VALLEY. EA NA71/R I W1OOp. A TO CORN" OF BIpOK YFL ilk WORK. TW BLEU N CHINA HUTCH. ALSO LARGE FOYER TROUT FAT-PI KITCHEN , MAN BOOR LDY VERY WELL KEPT CAPE COD-CENTRAL AIR-DEM-WOVE f 70 m " x!64 ~TWEEN STII - PLUS FOpA1AL DPYY(• KM. 2 CAR GARAGE PRIVACY FENCE. MANY MATURE TREESWNTE PIES R OXOIIAY HK7ME N ~ODFD AA E N OFFICE GRRWGE HOUSE, COLIST 8 AND A BACK. BLACKTOP DRIVE. NEW PAM EXTERIOR. FRONT l1 ;t7: 1EDROpA1 LAII INUVNG ROG AT WELL LGL ON FKE OWNER AGEMTERRY LAPL gNTE. - - REF X - L APR BVATE D O% D PID 020.2361116-00 aat+t 48' ROOf NKI DECK SEAM N AT CONNECT IEfANG.DSP,F/LI - LGL 579 T29N R19W SEC 19 WILLOW RIV 9L ESTATES LOT f2 Y: LOTS OF STDgA 1 18 U 11X1{ AM N .CON LAPROX LAPROX SEW CONNECT PID O AT WELL PF OF SW I /OF NE7 IOi ~1 28 U 10X1{ OT /ELL N7TG i ANT 0 M 117(16 18 U 17X1• LAPflOX LAPROX SEW PRIVATE REFJWG.DWS 0 U 11X9 XT WOO EXF % N LR DR M 16X17 28 U 11X12 FPL LEA Ill NN N LHill FHA VA CON C/D 001 ASM N Lp M 3B 12%20 IB 15X12 FR L APROX 10 FR M 11X12 38 U /GAS MTG AIR C M 0TH L APROX PIN KT S 0 8X11 EXF WOD EXF FHA 00 1NT 11 % " DR M 12X12 28 9X10 LEA FA / GAS MSG 0 N,'a 77X23 18 U It%17 0 2 M 12X17 IB U 10X12 B$M Ps PIN S 600 ASM O 0 3B V 15%1] EXT 16M 18 U 11X70 BET N MBT IN GAR 1,2A 2MC 2MA KT M 70X22 18 CON OD 0 ASL1 N M 6X11 38 U 10X9 FSZ B AGF 0 LD M BSM IF PINS 0 2MC 7All 11X23 U3 'N BEKKUM 115•/25790] B(iF i FSF • SDN SDP 0 BBT N MST IN L 17X11 GAR 2A ;yA REALTY OF W! T - 2.1 SA 2.1 ER AGN ROGER FSZ 12.10 AGF 2300 Ell 0 FSF 58 U 1SX13 88T N MBT N LO 8108 PH 1967.4 HETCHER .15786819{ 2300 SON 000 Spp p F52 [H A)? OFFICE EDBW REALTY Of WI 10.08 PH BB Y - 7.15 SA 3.15 ER AG 0 AGF 0 N TERRY PNWSR(ERRpN BAST SGF i FSF 1920 ,pr s SOP 247-3313 F~ BR 3 BA- 0/0/0 RAMBLER H X702 APT 1]8 7072 OFFICE EDNA REALTY OF WI LO nag PH 88 1]670725 SA 3.15 M 1/D HIM OR SETH iMATION DEEMED RELIABLE BUT NOT GUARANTEED 900 105835 BR- 3 BA• t/1/0 RAMBLER ABCF APT 43S nn t CEIVTIRY 2181DIAIW INFORMATION DEEMED RELIABLE BUT NOT GUARANTE p 9~ ; 8 TI 4 BA- 2/G/0 SPL/EM ACH INFORMATION DEEM ED RELIABLE BUT NOT GU 594,900 R~it1 I 4 BA 11 > r ARANTIJ:O (FORMATION DEEM A. xx - ~y}}pa OUT OF AREA Y0`N- I ; . 1 K S f2 O .Y k Y t t~ta3i-~'L ~'*iF.~rta F '.Gs + OU Ra y~,cg-, x z' ' HO i£s r.t N'~'"°3•d~~, •w xia'`"o"' "'K^ «.a w d.~ AV AX S 2017 /!1 /N MAP ZIP 41872 A S 0 •OFF 011 RIVER VIEW LN W f a, z7r b. 'ari„ fix, r & 1 il1B 1 ON COU 08M ASS S ASP U LAILER101'R MUN SOMERSET 71P 0 AX S 1719 /92 /F MM NO-Off 1065.--'5". ACA ISS WS FOR 19 CLAM AR 706 SUB i DIY A S 0 I HUDSON AX f 29211 /97 /F 1, NO I R IIOX 198 J MIDTOWN RD FOLLOW SIGNS N YBL 19%. LOT 1.60 AC 1 OCl7 OUT $ 8 ASP N ZIP 51016 A S 2908 LAKE ~ TA SOYCEVNLE f )IO1M dfl 75 N TO HRYY C1FFT TO RIVER VEIN HS fOR 19 92 f YBL 1982. LO 786 SUB 2 pry 1 COU STCR p S ZIP 51725 'aRM LGME 150• FROMAGE ON CLAM LAKE LN,LEFT N LOT 786 50 s 0 ASP N MALLAUDI SUB 1 DN 1 COU 'OD FISHING. WONpEgP A - LIL FMILY HOME NESTLED ON A SEAUrFUL 1.iS AC WOODED f ) DIR 194 TO HUDSON Al H$ FOR 19 92 N -1 190. 10 ACRES UTCHEN, LOT. 3 BR RAMBIEp, FAT N NM TO NORTH STTl1RN L 7O SK:N 1 N TO KNAA D ACR BATH INEWI. OVERSIZED 3OX26 GAR. SFORS~ DINAM, 3/4 MAST. TOO RKDIT N 1AM LAKE PBa l LOT 18 THERMOSTATICALLY UPPLEMENTAL WOOD FURNACE/ ME AiMi9HG 2 STORY HOME SUIT BY COPL/ROLLED.SALE CONT.00 OWNERS FN1pIG HO WOODED . ROLLING ACRES. /0X10 E AT WELL REF,NVG,p511$ 'LGL S 3o T 3N R 18W LOT 6 OF CRESTVEW App 32X10 POLE SHED. L APROX SEW PRIVATE PIO 038776360 AT WELL FON LGL ON FIE 't, 1 13X19 FL L AM W M 0TH LAPROX Y/ ' nazlfilTCAVN OFN l APROX SEW PRIVATE PD 130-025 28 1 12X77 LEA BB / ELE MTG 8 LR M 78X17 1B M 11X11 FPL AT CONNECT IAPROX LApgO% REF)ANIGM SE1V COPIECT AT 9 1 11X19 XT 85M NOD EXF CLR ANT A N M 10X11 2B M 12X11 LEA FA /upgp MTG u.~A` _ LR M 19X11 1B 11X12 FFL f Alp N M _ 'SOX L APROX W N PIN SO 2MC N 2MA N FIR 3B M 107(11 E7CT WOO EXF CON COIN 0 % M 10X11 ?B 11X15 HEA FA / GAS MTG 0 CON 07}7 5- 1{X12 30%11 28 iB U 12 R W Ell N to MBT F KT M 17X14 /8 8 PINf 0 2MC 2MA ASM I F FR M 10X11 38 9X11 EM Ml XF CON 000 0 ASM N 18X 157(14 3B U 15X10 HEA FA 14E KT 10%11 18 SZ 210{ AGF 0 GAO 2'Y Of THEIR G101CEJpE1V M 9X11 Ell FA PIN S 0 12X15 XT Mry i1GF i BET N Ml Y L 10X70 9%7 GAR 2A 2MC 11M N U 15X10 BSM W,F /AN 1]0.2100 Y FSF 2706 SDN 1 SDP 775 CAIN N LR HALL STEPS CASH TO Saul 1911{ gEAITY NC. LO.1S PH SA 7.15 DI AGN ►A)RICII{IWSSAN/n62 FSZ 7341 AGF 1711 BGF 0 FSF 13/1 887 -"AIBT- - - 4 2100 APT 4"" B8 Y - 3.1S SA 3.15 SDN 000 130. SOP 306./120 110 SDP 0 887 N OFFICE ED/Y11 REALTY. NC. LOOS PH 7741775 AP7 )79.2620 AGN D. 1090 AGF 1092 HBC%S/& Ell 1092 1 20M BR 3 BA 0/1/0 SPL/EN7 H OFFICE WBCE1VrURy 21 IPDI1AF"ER N L0./7 PH 8B 52667125 SA LS ]5/1M ~PER$IC0715 SN) 0 4TION DEEMED REWLBLE Bl1T NOT GUARANTEED 900 105838 BR- 1 BA-1/0/0 OTHER APT 247 REALTY 1 c0 81 ABCDF 589,900 1 8R- 3 BA• 1/1!0 SPL/ENT sw.u+ s r1r £_INFORMATION DEEMED RELIABLE BUT NOT GUARANTEED 03/15/92 121 DAYS PTS 0- FHA L-595,900 BR- 4 BA-T/0/0 2 SO 8304 OLP- 97,500 S $92,500 NFORILIATIpN DEEMED RE a 1 s +N~ 1 s z a " r% ; s8 nq ~r e i of ~1 ay y ~ ; b 1 y f, n, m R k 21P SWIi t Ax s 4020 /81 /N MAP NO 116/ 90TH STS Y A S 0 NO- 3 2 DIV 1 COU STCR SIT SO MUN SOMERSET TAx f IU2 ~t ,IV Y`:~ ~ ' ASP N ZIP 51025 TWA S 1192 Np. NC 122J RED OAK RD W ACR 138 HS FOR I9of AH 786 SUB 1 DIV 1 CCU MUN ST JOSEPH iWSp AX 5187/ /91 iN L1i3 1C 1 9110711 ST M 1861• N LOT 1277X329 S)C71 B S N ASP N ZIP 51010 A f 1831 •11OBERTS :i WELLESTABU51Ep f 700711 dfl LIWY 61 TO 35NOF ACR .M HLS FORT 00 N VBL 19µ- AR 786 SUB 1 DN 1 COU STCR SB S 1 Lr S+OZJ COAU4I7NTY SOMERSET RT ON 110(90 N LOT WRC{'i ASP N 7M SUB 1 DIV CCU SiCA DIR SPLIT FOYER WITH I. CAR NICEWALK-0VT RAISED RANCH ON SEAUTi A 7773/0 DIR FROM STW BR ACR 2.9 HS FOR 19 92 N VBL 1 ROLLIN :;TRUCTM GOOD WATER TEST. B WOODED LAND W/Pp~p, pKX,BC AREA, LR, OPEN TAKE E 5.5 M8E5 TO RED OAK I2 E OF ACR 70 :S fEE. COUNTRYSIDE VIEW.160 NE OF WBDUPE' LAPq$GpED ULATE. RECNE'TLY DECOMTED-12%30 DECX OVERLOOKS Sy00p® F 7 pF ROOM N~~~ 1t M TO 750TH 57 -EW ESTATES 1ST ADD TOWN OF HW DISTANCE TO CITIES FOR SOMERSET. GOOD COMMUTING - BEGUSE OF SELLERS WORKING HOURS-SHOW BETWEEN QFMOERI DTS OF S7~ 4861 THIS WELL soN I LOT 2 OF CSM Y" MM. ANNALS OK. 11:30 OR 1349.30 WEEKDAYSANYFN/E ON WEERENpSSAIE CANT. 9]4 AND AN AT RNGAWS PG ] VOL TRUE 681 UPON SELLERS ACpUWR1G HOME OF CHOICE 'TOYS" . OLD BARN GIVES You L APROX SEW PRIVATE PID SAME WAT WELL lGL LOT 1 OAK KNOLL ADIX. ACCESS. N 10X11 LA R GOOD FREEWAY N 11X11 R W ANi N M 0TH L APp07( L APROX SEW PRIVATE D - PID 0 AT WELL 1 CSM VOL 7ING'917 SEC 30 T25W S HEA FA / pw MTG 0 M 1{X79 18 M IZXIS FPL LAPROX LAPROX SEW PRIVATE D OX 11X11 XT WOO EXF CLR 00 INT 8 4 % DR M 9X70 ZB M 12X70 HEA fA NR N TRM FHA VA CON SM CI L APItOX AT WELL ASM N Fq l 11X10 38 M 10%9 EXT M) B1 Lfl M 12X16 18 21%11 fFL A1R C M' PRIVATE Ell F RN Si G 000 INT 10.5 % d1 M 13X11 ze M 12X11 MTG CON .CN-~-~, ~IX1S M 8X177 hEA F AIR N GAR 2 2MC 21 KT M 8X10 1B L 127(11 BSM 1YF,OL EXF VA OD0 ASM 0 FR FEA FA / PRO L 18X11 3B M 12X70 GAR 887 Y MBT N GAp 7,D PINS 0 2MC 2MA E%T KT M 10X9 18 SVOD EXF CON OO 0 Al 8' M8R 38 2 6x16 XT MHil /V/ PRO SZ 0 AGF ISO BSM F,L HN BGF 0 iSF 2000 EST N 2MC N 7MA i 0X27 19 8%8 BSM P OF 88 TY Of W1 WI f 0 1]Y6•7.2 3.15 SA 3.15 ER SDN 000 SOP 0 FSZ i0 MST AN ~ 91(11 ~ LO 5109 PH AGN KATHY SMITH 715.3B68g02 GF 1050 BGF 1056 FSF 15M SDN SOP 0 88T GAR F L Y MST N APT 1367.! OFFICE EDNA REALTY OF WI BB Y - 2./ SA 2,/ 1;p AGN DIANNE IDp NARK /3672K FSZ 4 AGF 0 BGF 0 FSF tdp SDP 0 7200 M AGF EST 108109 PH QS. 072 APT 1367072 OFFICE EDNA REALTY NC. LO N77 PHB8174>?pp SA 29 9 _100ER HETp~R71S FSZ 346B196 INFORMATION DEEMED RELIABLE BUT NOT GUARANTEED ttM L176YA REALTY OF Sp L08109 PH I APT , n 4: N r ST. CROIX COUNTY 4 t 77 WISCONSIN kt f L~~ L~j ZONING OFFICE rte= X'~ ST. CROIX COUNTY COURTHOUSE `t 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 Apr. 15, 1992 Diane Hark Edina Realty 200 E. Chestnut Stillwater, MN 55082 Dear Ms. Hark: An inspection of the septic system on the property of Joseph and Marry Junker, located at 1223 Red Oak Rd., Hudson, WI was conducted on Apr. 13, 1992. At the same time a water sample was obtained for testing. The results of that testing will be sent to you as soon as we receive them from the laboratory. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. SinVerely, f, 7 1 i 7 Maly--,j J nk ' s Assistant Zoning Administrator cj TRANSFER FORM PLB 67-T SANITARY PERMIT / State Permit # r • Sanitary Per it # 6,S, County Sanitary Permit Transfer Date) C1 ; 7i Original Permit Issuance Date A. Property Location: %-S:4 Section :E~'_, TAO N,R --/~Erfe4W Lot #City Subdivision Name, (C l.,t✓~~1 Nearest Road, Lake or Landmark BLK # Village Township=.(_ B. TYPE of Occupancy: Commercial Industrial _ Other (Specify) Single Family V, Duplex No. of Bedrooms Variance C. SEPTIC TANK CAPACITY Total gallons No. of tanks HOLDING TANK CAPACITY _ Total gallons No. of tanks Prefab Concrete Poured-in-place Steel Fiberglass Other(Specify) New Installation- Replacement LIFT PUMP TANK/SIPHON CHAMBER-&~Total gallons Prefab Concrete Poured-in-place Other(Specify) D. EFFLUENT DISPOSAL SYSTEM: Percolation Rate /C- 7 ,mss Total Absorb Area ~ /!7 sq. ft. New ✓ Replacement Alternate (Specify) Seepage Trench: No.Lineal Ft. Width - Depth - Tile Depth(top) - No. Trenches Seepage Bed: S, Length ' Width f~o ---Depth c-- Tile Depth(top) '2> No. of Lines Seepage Pit: Inside o~ameter Liquid Depth No. Seepage Pits s Percent slope of land t P Ott Distance from critical slope- E. WATER SUPPLY: Private ❑ Joint ❑ Community ❑ Municipal Present Sanitary Permit Holder Phone No. Sanitary Permit Transferred To: Phone No. 3 Name TZ~ ice, L<ki-riOt j, Name. E1 ~4,14 L. ~T Address 7' mot'SfY: 64), , Address J- i) 1,4,< - C ~ Zip v~ ] 1, the undersigned, do hereby certify that I have reported all revisions to the sanitary permit and that all revisions are in accord with section H 62.20, Wisconsin Administrative Code and that I have sized the effluent disposal system according to the EH-115 prepared by the Certified Soil Tester and/or any additional soil tests that may have been required. Plumber's Signature C~Z y s~GO i- MP/MPRSW # Phone #11P Plumber's Address- Information obtained from (owner or agent) PLAN VIEW: Provide sketch below of any revisions to original sanitary permit. Include direction of slope and all distances in accord with H 62-20. Well location shall be included on the sketch. Indicate or dimension location of all wells, on the property or neigh- bor's ro r . If well has of been drille ) a I 1 4 + 2 s~ Signature of Issuing Agents 1. County (Yellow copy) 3. Owner (Pink copy) DIVISION OF HEALTH 2. State (White copy) 4. Plumber (rreee'c P.O. BOX 309, MADISON WI 53701 z REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM Sanitaky Petcm c State S - - Townsh Lp NAME - ' St. C~Loix County Lacatian' ; a~ ;f.!-4, Section- T~N,R/%(U SEPTIC TANK size gattonls. Number o6 CompatLtments Distance Ftcom: Wett 4t. 12% m gtc.ea.tetc .Lope 6,t Bu.i.Lding fit. W et.Lands 4t, H.ighwateA _6,t. DISPOSAL SYSTEM Distance Fnom: Wett 6t. 12% m gAeaten stope 6t. Bu.i.Ld-ing 6t. W ettands Fz. HighwateA 6t. FIELD DIMENSIONS: Width o~ ttcench 6t. Depth o~ /toch below t,ite .in. Length ab each tine t. Depth og Hack oven tite in. Numbers o6 tine/s Depth o6 tite be.Low grade in. Totat Length of Zines 6t. Stope of ttcench l.n pen 700 6t. Di,s Lance between tines 6,t. Depth to b edtco ck 6t. Totat ab,5onbtion aAea jjt2 Depth to gtcoundwa,ten 6t. RequiAed area 4t2 PIT DIMENSIONS: Numbers o6 pits /Gtavet atcound pits ye/s no Out/side d-iametvL {jt. Depth be.Low intet ~ . Tota.L ab,sonbtion area 6t2, z Area tequitced 4t2 rn INSPECTED BY TITLE APPROVED , ')ATE _19 7_ REJECTED DATE 197 ir i i t 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: 54~4'/a, Jl Section _ j, T_N, RL!!~e(or)( Township or Municipality' Lot No. Block No. Ace/ County 4bdlvision Name Owner's Name: Gig A)/Aj r rCt LAd Mailing Address: A e xj 5 44&4& z:- TYPE OF OCCUPANCY: Residence No. of Bedrooms -3 Other EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS __PERCO~LATIION TESTS SOIL MAP SHEET SOIL TYPE it v Ifi J d ' y r e4_0 , - PERCOLATION TESTS _;WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE 1 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- z P_ 2,1 SOIL BORING TESTS TEST TOTAL DEPTH r DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) L. wv~ I_ lp - .2 4, S ~-G 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 nu ber of square feet of absorption area needed for building type and occupancy. 12 0.0 ~,4? Fc' - Indicate sca e or distances. Give horizontal and vertical refer nce ints .,Indicate slope. Alf o t I f ~ ~ I I ~ l ~i I 133 j~ 3 E- - _ .sy?- ci(ayc- 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) 6z'6 y , r Certification No.~S`~`= /S3 N Address /l/ Name of installer if known CST Signatu DPY A - LOCI" State and County State Permit # ` PLB67 - Permit Application County Per it for Private Domestic Sewage Systems County • (-_t4 *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. LOCATION: '/4 Section - T%f", N, R ,tlj/ E - (or) W Lot# 4" City_ Subdivision Name, nearest road, lake or landmark Blk# - Village Township r~ C. TYPE OF OCCUPANCY: -Commercial -Industrial Other (specify) -*Variance-___ Single family y~ Duplex No. of Bedrooms _ No. of Persons D. TYPE OF APPLIANCES: Dishwasher YES X NO Food Waste Grinder YES' NO # of Bathrooms Automatic Washer YES NO Other (specify) - SEPTIC TANK CAPACITY - - ~00 _Total gallons No. of tanks 'Holding tank capacity Total gallons No. of tanks New Installation Addition Replacement Prei,!,j £;en:rete i _ `Poured in Place Steel Other (specify) FFLUENT 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: LengthWidth / Depth "Tile ~ - - Depth- No. of Lines ~j Seepage Pit: Inside diameter Liquid Depth Tile Size ercent slope of land Distance from critical slope he undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, ,1,1isconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared ~)y the Certified Soil Tester, : AM E l i- &-y C.S.T. # ` C 5--~J Xj and other information oiztained from (owner/bui4de-0. (`!umber's Signature z MP/MPRSW#,- Phone # ~d(- - Plumber's Address 'L L PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). 7t 4, I ~ - 13 I ! ~tiG v _ "(ri_ I Do Not Write in Spac Belo -FOR DEPARTMENT U E ONLY Date of Application Fees P id: State ¢ - ~ to Coun C" ~1 Date Permit Issued/.Beisa ed (date) Issuing Agent Name Inspection Yes No Valid# Date Recd 1. county (w ite copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 7 :ta.. (ninl~ rn n✓~ V,I y..i l., r -,.opY) Revised Date 6/1 /76