HomeMy WebLinkAbout030-2012-90-000
0 cn O I~ v n r~
d `~1
c
v m ~ o n
3 ~ O
Q d o m U) O o cVr cwn C4 °C
m S O 9 :E O 7
O
w O '
C' Z d` N 7 N 1, CD
M CD (D
CD a
p co cf) N S A
n
< o
a~D m N m a C) W o K
o
1 o 3 y A 7 p w Ch y^ C7 o .y
m CD m ° a
N W
3 C1 ° a o
o m
i j Ln a
C CD -
CD 00 0VD N o c
z O O O o•
O W c z
v B cn N cn t o D
v
CY v °
N n
M ro y c
CL
cn
m = (D
N
N ~ ~ N
O (D co
Z
N
zco z c
v (D O
I ~ o a ~ I,
o m m CD
h•
N
CD v N
CD N'
c CD CD
w Q
z CCD Ili -1 ti
O = O la Z Chi
N c s
n A z O
m CL
L N ~ w
W m w fT
o _ °
Z
0 3 a ~
o cn
3 CD
N Z
(D A
D
a
Q
a' -
:3 T
m C
z o
O
CD
N
t
Q
t
I ti
A
N
O
O
I a
A
O
N b
EA 0 ti
a
O (D
Parcel 030-2012-90-000 03/24/2006 10:36 AM
PAGE 1 OF 1
Alt. Parcel 35.30.19.403B 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 - BROWN, DAVID R & KATHLEEN
DAVID R & KATHLEEN BROWN
784 CTY RD E
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 784 CTY RD E
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 3.170 Plat: N/A-NOT AVAILABLE
SEC 35 T30N R1 9W PT OF SW SE & SE SE LOT Block/Condo Bldg:
1 OF CSM 5/1286 EXC P 403C
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
35-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 710/201
07/23/1997 707/632
07/23/1997 684/221
2005 SUMMARY Bill Fair Market Value: Assessed with:
84197 222,000
Valuations: Last Changed: 07/09/2004
Description Class Acres Land Improve Total State Reason
OTHER G7 3.170 59,600 142,300 201,900 NO
Totals for 2005:
General Property 3.170 59,600 142,300 201,9000
Woodland 0.000 0
Totals for 2004:
General Property 3.170 59,600 142,300 201,9000
Woodland 0.000 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 314
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
00
Total 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT
ER TOWNSHIP o c SEC. 35 T2
N, R J 1 W
,0. ADDRESS _ ~f ;Z ST. CROIX COUNTY, WISCONSIN.
3DIVISI0N LOT LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
y.
I =s
:'TIC TANK(S) I MFGR. CONCRETE STEEL
NO. of rings on cover Depth DRY WELL
'NCHES NO. of width length area
no. of lines width Y- length; area '
depth to top of pipe
3REGATE
-a RATE AREA REQUIRED AREA AS BUILT
.claimer: The inspection of this system by St. Croix County does not imply complete
?liance 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
Lem 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 JOBS' 4. 4
LICENSE NUMBER '
SIsI~l S}~0., r S`
~RFPOP,T OF INSPECTION-- I:1DZJZI)IIAL ,11GE llli~I. ~~.TFI1
• Sanitary Permit ~
State Septic
.,Al 1E T&WNSHIP
s t. Croix County
t
SEPTIC TA' .717
:size gallons. 'umber of Comoartments
Distance From: Well ft. 12% or greater slope it.
r Buildingft. Wetlands ft
Highwater ft.
DISPOSAL SYSTL:1 Tile Field or Seepage Pit(s)
Distance From: Dell ft. 12% or greater slope ft
Building ft. Wetlands f
FIP,Ln_ 1 1 Klighwater ft.
Total ~~n)gth of lines //7 ft, !lumber of lines Length of
each line ft. Distance between lines ft. Width of the
trench (.~ft. Total absorption area sq. ft. Dept:
of rock bcloxq tile in. Depth of rock over the Z in. Cover
over. rock , ,4,/ Depth of tile below grade in. Slope of
trench in ner 100 ft. Depth to Bedrock ft. Depth to
ground water £t.
PITS
Number of pits 0 s'(1), eter ft. Depth below inlet
ft. Gravel a-ro c3~~ it. y
7
es no. Total absorption area
sq. ft.
.Square feet of seepage trench bottom area required
%Fquare feet of see e--Ty- ~ar a required
/ r
r
Inspected' y.
- ~ Title
Approved ~ l r~- . Date L C
!7
Rejected Date ' s / 197
EIS 11 8
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, Section /N, R/_;~E=(or) W, Township or Municipality
Lot No. , Block No. County
Subdivision Name
Owner's Name: ~L
Mailing Address: -
TYPE OF OCCUPANCY: Residence No. of Bedrooms Other -
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACE T - `f
DATES OBSERVATIONS MADE: SOIL BORINGS - 7 PERCOLATION TESTS
SOIL MAP SHEET SOI L 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
P 14
-Z /f
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
I
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
i
it 7~-i•~ 1 it
IIIIIII 7 Z Z
LL
'IAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
dicate on the plan the location and square feet of suitable areas. Indicate numt~er of squar:a fee±. c;fi absc,r tion area
1rleded for building type and occupancy. : AT/ e Indicate scale
distances. Give horizontal and vertical reference points. Indicate slope.
a-4 ~ .
41 7
a ,
Ji-
3
IL-J
I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures
LAdd methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct
e best of my knowledge and belief.
7 J
e (print) Certificatibn No.
ressA-i C e of installer if known
CST Signature
PLB67 State and County State Permit # r
( Permit Application County Permit f ell
for Private Domestic Sewage Systems County
*DENOTES STAVE •APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.U. #
A. OWNER OF PROPERTY Mailing Address:
B. LOCATION: -S'r' % ~ 1-7 '/4, Section 3f, T 7 ~ N, R-J~7 E (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township
C. TYPE OF CUPANCY: Commercial *Industrial *Other (specify) *Variance
Single fa ily J~ Duplex No. of Bedrooms No. of Persons_
D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES NO # of Bathrooms
Automatic Washer -ZYES NO Other (specify) _
E. SEPTIC TANK CAPACITY Total gallons No. of tanks
*Holding tank capacity_ M-0417 Total gallons No. of tanks
'view Installation Addition Replacement _ Prefab Concrete
'Poured in Place Steel Other (specify)
{ .-FFLU T DISPOSAL SYSTEM: Percolation Rate 1) 2) 3) Total Absorb Area sq. ft.
New j Addition Replacement *Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length _~4_Width Depth Tile Depth No. of Lines_
Seepage Pit: Inside diameter Liquid Depth Tile Size
Percent slope of land Q Z Distance from critical slope
1, 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,
NAME NA j/" ~6rL C.S.T. # ~ cl and other information
obtained from (owner/builder).
Phone
Plumber's Signature MP/MPRSW# Q _
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
N_
1 7AZ
s
I
Do Not Write in Space B R DEPARTMENT USE ONLY ate of Application Fees . Praj'd: State /C 1Y Count ~ ~ 4pate
mit Issued/R A ate) Issuing Agent Name %J
Date Recd
tion Yes No Valid#
ty (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
(pink copy) 4. plumber (can:,,.r,nv)