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HomeMy WebLinkAbout032-1040-50-000 0 D ~ " t7 D) o v f m ' 0 3 ^ q CD a M \1 3 _ O w i-3-z 0 n S . O N W p~j O A W . m 0 3 rn o°o m 3 N ~~ll tD Z ICS :f) U1 =3 O - ^^S l/~\ W to T~ O 1 N Cl O CD C) O -U n 7 CD cn • O O i (D 0) O CO D A7 01 0 N C j O CJ d (r N ju D CD N CL _ !D C CD , cl) N I O 1 o a, 3 CD (D co rr cr ~s z O O O A g cCi) Cl) lfcn o_ w D CD O _0 0 N (D N w n C M N < I N j fD N Z co Z D O a I? ( h • CD CD N ~i 7 N N C L N O w - a c iv co CD ~~s O A Z Z CD O CL Z C O U) ~ W - m w A a z 0 3 A M N .r z < C Z CD A Cl) C iD C) N C T 0 i? a CD , n O n ~ A 7 ` O X O N N O O CL U A ,ug n O I' y C) ~ ~l Parcel 032-1040-50-000 04/08/2005 12:19 PM PAGE 1 OF 1 Alt. Parcel M 14.31.19.199F 032 - TOWN OF SOMERSET 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 ANNEMARIE C PIPER - PIPER, ANNEMARIE C BUBASH TIM A BUBASH TIM A 636 215TH AVE SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 636 215TH AVE SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 7.650 Plat: N/A-NOT AVAILABLE SEC 14 T31N R1 9W 7.65A IN SE NW LOT 13 Block/Condo Bldg: CSM VOL 1/113 & REPLATTED AS LOT 13 CSM VOL 3/712 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 14-31N-19W Notes: Parcel History: Date Doc # Vol/Page Type 04/03/2002 675342 1866/455 WD 12/21/1999 615826 1479/322 WD 09/22/1999 610802 1458/206 QC 2004 SUMMARY Bill Fair Market Value: Assessed with: 10015 245,800 Valuations: Last Changed: 07/23/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 7.650 71,200 137,200 208,400 NO Totals for 2004: General Property 7.650 71,200 137,200 208,400 Woodland 0.000 0 0 Totals for 2003: General Property 7.650 71,200 137,200 208,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 122 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 f) AS BUILT St'OiITARY SYSTEM REPORT ' , T0~7NSHIP SEC. T~ j_N, R~W ADDREtS~ ST. CROIX- COU.I > TY, WISCONSIN. 0, , a > - ;DIVISION - i LOT ' / LOT SIZE Distances b dimensions to meet Lrequirements of H62.20 SHOW EVERYTHItiG WITHIN 100 FEET OF SYSTE'~ l ( I { I --,dam- t i ; ! I ! --r--;---~--1--- , i it i I ' I i ! ~ I , I I ~ ~ ! I j t j ( I I 1 j .'TIC TAIr'K(S)~~ MFGR. ~ ~ - ' I i * r, N0. Of ri"-- _COiiC2ETE~ STEEL Scale Nan ow ~e on cove Depth DRY F1ELI:_ .,u:iES NO. of`, width length area no. of lines width length area^ depth, to top or pipe ~ . .EGATEr c~ 1, L RATE AREA REQUIRED AREA AS BUILT ;claimer: The inspection of this system by St. Croix County does not imply complete .1oliance with State Administrative Codes. There are other areas that it is not oss' inspect at this point of construction. St. Croix County assumes no liability for able =em operation. However, if failure is noted the County will make every effort to " 'rmire cause of failure. LASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. '-INSPECTO DATED7 E/ . PLU;iBER ON JOB /4 . LICENSE NUMBS ~ ~ ~ ~ ' z REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM SanitvLy PeAmit->>~ State Septic/.),,- y, NAME Townzhip St. CALoix County Location.` ~ ojk, Section//'TijNJ P,/ 1 SEPTIC TANK Size gattonz. Numbers o6 Compantmentz Distance FAOm: Wett 120 oA gneateA ztopeit Building 6t. We.ttands DISPOSAL SYSTEM HighwateA D Distance From: Wett 6•t. 12% of gnea,teA 6tope ~°O it. BuiZding_,,RaZit. wet.Lands Ft. r. HighwateA ~ . FIELD DIMENSIONS: width o6 tAench 2 it. Depth of Aock below tite--'/-~in. Length o6 each tinee74 it. Depth of Aock oveA tite Z in. NumbeA o6 tines Z- Depth o4 tiZe below gAade-3-2-- in. Totat .length ob tines GJ L it. Stope ob tAench in pet 100 it. Distance between tines it. Depth to bedAOCfz Totat abso tbtion aAea ` 6t2 Depth to gtoundwatet - ~ . Requited aAea it2 .~L.---- PIT DIMENSIONS: NumbeA o' pits GAavet around pits yes no Outside diameteA t Depth betow inlet it. 2 Totat absoAbtion e it z A AAea Aequit 6t2 rn INSPECTED BY ITLE A PPRD V ED DATE v 197 ~j . REJECTS DATE 197 I( I If ~f t 4! k! S E i ~F 4 EH A 15 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES ,4N r DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: Ai-%, Section/ , V~ N, R s,(or) W, Township or Municipality-;, _ Lot No. , Block No. County Su " 'vision Name Owner's Name: Mailing Address: I~ k l Il ~d'1.},`x~✓~ c~c (S TYPE OF OCCUPANCY: Residence No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW g ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS 75_ PERCOLATION TESTS _47 / ` •2 C~ Sam/ SOIL MAP SHEET SOILTYPE PERCOLATION TES S TENT 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 t C 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- I L P_ J 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) 7 6- U 1,5 s, 10-36, S,14 36-- 94 s, s / It, s, l 2W s c , -lo S s 3L0 ys -/o 16-34 fps 6- ;7 r T S. s Q - / 61 PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the locationand square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy. Indicate scale or distances. Give horizontal and vertical refere ce poi ts. Indicate slope.' I i 4-14 _ ' I I t a 1 - ! , I N wm - ~ y I f I I / .1 _ _ - - 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) I L~~ ►{5 Certification No. Address er- it ~ Name of installer if known CST Signature ~ Y A - LOCAL AUTHORITY State and County State Permit # \ L PLB67 Permit Application County Per t # 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. LOT CATION: Section /!~l, T_ N, Rj,? E (or) ON Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township 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- YES NO # of Bathrooms Automatic Washer YES NO Other (specify) E. SEPTIC TANK CAPACITY /a2a Total gallons No. of tanks *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►-_3) --,,Z-Total Absorb Area 6 sq. ft. New4 Addition Replacement *Fill System Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches _ Seepage Bed: Length Width Depth-IS"I Tile Depth 3,4 No. of Lines Seepage Pit: Inside diameter Liquid Depth Tile Size _ Percent slope of land 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 ode, and that I have sized the effluent disposal system from the EH-115 prepared by the Ce d Soil ~est , NAME C.S.T. # _5 and other information obtained from (owner/builder). Plumber's Signature i MP/MPRSW# Phone Plumber's Address a PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). Hsi ' 44C &j Do Not Write in Space/ elo_ F PR DEPARTMENT USE ONLY Date of Application l ( ' ~ Fees Paid: State Coun y Date Permit Issued/fk1eeted (date) Issuing Agent Name Inspection Yes__~_No Valid# Date Recd ~Z county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 kh, ate (pink copy) 4. plumber (canary copy) Revised Date 6/1 /76