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HomeMy WebLinkAbout032-1070-90-000 n N O 3 v n d o y c m o Lon m ((D (D W # A Cn s z N z V N- (n tO O • CD d 3 ~ CO N j N CD Z O N N O r~,r~~ < 0 CD !b C N O C) D) O Cn 3 d o CL m CD Cn -4 CD Olt D y r- a) ° ' CD D (D 8 I' y CD ~ a o O N W S 3 n CD CD D ~I CO -4 < N O N 6 ID C. co U) O N CO CO ((D N O C co co N 3 Q .N-. v -0 • z O O O O ~y D cn cn c cn n o o N D a. N (D M O (Ni, o ZI ID d N j d 7 z z co z o O D a j Cl) h m m CD • CD cn CD CD N 11 C (D CD (D w ~ d d C O O A ` O .h d O. 7 Cl) ~ N co - M w U1 (D (D a o Z o z CD w ~ b CL CD. o' - D T N ~ o a (D I A I' a z N 0 0 a I ~ c b G'Q O I C) * U 6 CD a} CD d "i Parcel 032-1070-90-000 04/25/2006 10:40 AM PAGE 1 OF 1 Alt. Parcel 25.31.19.346H 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): O = Current Owner, C = Current Co-Owner O - BOUMEESTER, TODD M TODD M BOUMEESTER 736 190TH AVE SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 736 190TH AVE SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 5.000 Plat: N/A-NOT AVAILABLE SEC 25 T31N R1 9W 5A IN SE SW LOT 2 CSM Block/Condo Bldg: VOL 2/591 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 25-31N-19W Notes: Parcel History: Date Doc # Vol/Page Type 11/02/2004 778779 2688/156 WD 08/05/2004 770820 2632/198 SD 10/30/2000 632670 1554/551 WD 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/24/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 58,000 111,000 169,000 NO Totals for 2006: General Property 5.000 58,000 111,000 169,000 Woodland 0.000 0 0 Totals for 2005: General Property 5.000 58,000 111,000 169,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 304 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT tER TOWNSHIP,~Llj, T SEC. T , N, R ~9 {+I AINDRES ST. CROIX COUNTY, WISC NO SIN. :DIVISION LOT LOT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM i 40 _2t v, ' i 'TIC TANK(S) MFGR.ZL.)( CONCRETE-)(/STEEL NO. of rings on cover Depth DRY WELL INCHES NO. of width length area ~ no. of lines width length area __JS! depth to top of pipe RATE- fy``,-~- AREA REQUIREII AREA AS BUILT claimer: The inspection of this system by St. Croix County does not imply complete i 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 tem 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 = 0f PLUMBER ON JOB (j LICENSE NUMBER z - r REPORT OF INSPECTION-INDIVIDUAL SEWAGE SYSTEM i Sani.tarsy Persrnit- State S ep,ti c NAME Township St. Crso.ix County Location % o6 Section T_N,R W SEPTIC TANK Size - gatton6. Numbers o4 Comparstments Distance Frsom: WeZZ it. 12% m grseaters stope it Buitdi.ng it. Wettand~s ~ . Hi.ghwaters it. DISPOSAL SYSTEM Distance Frsom: WeU it. 12% ors grseaters ~stope Bui.tdi.ng it. W ettandz Ft. Hi,ghwatetc FIELD DIMENSIONS: Width o6 trsench ' it. Depth o6 toch betow Cite in. Length o6 each tine it. Depth o6 koch oven ti.te in. Numbers o6 Zi.ne.5 Depth o6 tiZe below grsade in. Totat .length o6 Zi.nu it. Stope o6 trseneh in pers 100 it. Distance between Zi.nes it. Depth to bedrsoch it. Totat absorsbti.on arsea 6t2 Depth to grsoundwatete it. Requi.rsed atcea i 2 PIT DIMENSIONS: Numbers o j pits Grsavet around pits yes no Outside diameters it. Depth below i.ntet it. 2 Totat abz orsbti.on area 6t A Arsea rsequi.rsed it2 INSPECTED BY TITLE APPROVED ,DATE 197. REJECTED DATE 197` • 4 State and County State Permit # 7tj PLB67 Permit Application County Permit for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER F PROPERTY Mailing Address: 01 4B.0 ATION: '/4 yW Section y T__?I N, RA-1 E (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township sp~/'Sr° < C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family Duplex No. of Bedrooms No. of Persons D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES NO # of Bathrooms Automatic Washer YES NO ther (specify) E. SEPTIC TANK CAPACITY 00r) Total gallons No. of tanks _ *Holding tank capacity Total gallons No. of tanks - '!ew Installation ~ Addition Replacement- Prefab Concrete 'Poured in Place Steel Other (specify) .FFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 1_5_ 2)_3) 46Total Absorb Area sq. ft. ~vv - X Addition Replacement *Fill System Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches Lt Bed. Length Width Depth d Tile Depth 2 No. of Lines Seepage Pit: Inside diameter Liquid Depth Tile Size Percent slope of land Distance from critical slope the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, isconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared '?y the Certified Soil Tester, ` AME © C.S. # -5-~ and other information ;;htained from owner builder). _ ?umber's Signature MP/ RS Phone #~f 3 5 Plumber's Address 222 PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). i L It r 3 L CI. ta0' ,~2 K r / 0 t Do Not Write in Spa a Below FOR DEPARTMENT USE ONLY p Date of Application Fees Paid: State _h i 0~'County Date Permit Issued/Rejected datel Issuing Agent Name Inspection Yes_ No Valid# Date Recd 1. county (white copy) 3. 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 EFL 4 15 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 ~r cREPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: Section , T31N, R e?*(or) W, Township or Municipality Lot No. , Block No Q J~ C%_,j- ~ ' County C1 Subdivision Name Owner's Name: IVa.~\dLs. CY ,n c. y 3 ? ~ Mailing Address: s TYPE OF OCCUPANCY: Residence No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS & PERCOLATION TESTS SOIL MAP SHEET SOIL TYPE PERCOLATION TESTS TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IARACTERN INCHES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN TqW A, NO A) 6 -30 P-3 A36 30 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) 7-4 4 V0 B- s i, 96 s~ s _1a 5, ~ _a6 - s. 94, 6 a .t5. -.;?o 4 4, PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable ar,A~aas. Indicate number of square feet of absorption area needed for building type and occupancy. ! 2S" Y-Y Kt-,:!;, Indicate scale T or distances. Give horizontal and vertical reference points. Indi ate slope. f e , , , +V-vc - - _ - j w y I , f I I f 4, { / I I , y I w ( i t ~ ~ I Q '7 v( I ~ i }R s I I i v t , -7 F 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) (f) p V11 1:~ ' Certification No.~ Address 0 r Name of installer if known CST Signature COPY A -LOCAL AUTHOTRd