HomeMy WebLinkAbout036-1009-40-000
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Parcel 036-1009-40-000 06/30/2006 11:54 AM
PAGE 1 OF 1
Alt. Parcel 4.31.17.56B 036 - TOWN OF STANTON
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
JESSE A & LYNETTE C WAIDELICH O - WAIDELICH, JESSE A & LYNETTE C
2358 CTY RD CC
STAR PRAIRIE WI 54026
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 2358 CTY RD CC
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 5.000 Plat: N/A-NOT AVAILABLE
SEC 4 T31 N R1 7W 05A E 330' OF S 1/2 OF Block/Condo Bldg:
SE NW
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
04-31N-17W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 915/475
07/23/1997 915/26
07/23/1997 444/424
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 05/05/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.000 25,000 80,900 105,900 NO
Totals for 2006:
General Property 5.000 25,000 80,900 105,900
Woodland 0.000 0 0
Totals for 2005:
General Property 5.000 25,000 80,900 105,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 123
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
-tER TOWNSHIP , SEC. T N, R / W
3. ADuRESS ST. CROIX COUNTY, WISCONSIN.
•3DIVISION LOT LOT SIZE
PLAN VIEW
-Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
TIC TANK(S)_ MFGR. CONCRETE- STEEL
NO. of rings on cover Depth DRY WELL
'NCHES NO. of width- length area
no, of lines > width ' length area
..depth to top of pipe '
=GATE ~ J
:a RATE / AREA REQUIRED AREA AS BUILT
:claimer: The inspection of this system by St. Croix County does not imply complete
.pl.iance 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
-tens 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
DA ED s PLUMBER ON JOB ~
LICENSE NUMBER ,
RFPOI%T OF II1SPrCTI0:I--I M1V1llUAL SE',IA(,E DISPOSAL, SY'STEN
SAIhitary Permit
State Septic -
.A2IE _ T611I1SHIP I
t. Croix County
S,.PTIC T)V T1-
r•
.~.~ze - gallons. `lumber of Compartments
Distance From: Well ft. 12% or greater slope £t.
Building' ft. Wetlands f.
Highwater ft.
DISPOSAL SYSTl.il Tile Field or Seepage Pit(s)
Distance From: Well ft. 12% or greater slope ft
Building; ft. Wetlands f„
FIELD i'liphwater ft.
Total length of lines ft. !Number of lines Length of
each line ft. Distance between lines ft. Width of the
trench -ft. Total absorption area so. ft. Depth
.of rock below tile in. Dp-pth of rock over the in. Cover
over . rock" Depth of tile below grade in, Slope of
trench in per 100 ft. Depth to Bedrock ft. Depth to
ground water ft.
PITS
?dumber of pits Outside diameter ft. Depth below inlet
ft. Gravel around pit: ,_yes no. Total absorption area
--sq. ft.
Square feet of seepage trench bottom area
required
Oquare feet of seepage nit area required
Inspected by: Title:
Approved Date 197
Rejected Date 197.
EH 115
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309
MADISON, WISCONSIN 53701
G REPORT ON SOIL BORINGS AND PERCOLATION TESTS
LOCATION:~%'/4, &W, Section T3ZN, R L710(or) W, Township or Municipality a7
Lot No. Block No. County
Subdivision Name '
Owner's Name:
Mailing Address:
TYPE OF OCCUPANCY: Residence No. of Bedrooms_ Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGSA 3PERCOLATION TESTS /_/6
SOIL MAP SHEET SOIL TYPE 1 5.1
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- j 41 P
Sae r►1 s 43c) V, i N o S S .S S /
P- It
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- r ?4 7 9," - 5 - z~ ~o- 9L s
B- -z
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square fee f suita le areas. Indicate number of square feet of absorption area
needed for building type and occupancy. Indicate scale
or distances. Give horizontal and vertical reference oints. Indicate slope.
i
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~N,
9 I ~ i ¢ ~ t ! ~ I I I 1 I
I I , ( I I
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SS f
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I
1
I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord ith 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 knowle a and belief. 19 - Ld-d"111 i . Name (print) Certification No.
Address
Name of installer if known
".?PY A -LOCAL AUTHORITY CST Signature
PLB67 State and County State Permit #
Permit Application County Per
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: t~Y4, Section T N, R _ R! (or) W 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 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 Total gallons No. of tanks
*Holding tank capacity Total gallons No. of tanks
New Installation Addition Replacement Prefab Concrete
*Poured in Place I Steel Other (specify)
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) _ 2) /~1 3) TTTotal Absorb Area sq. ft.
New Addition Replacement *Fill System
Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length Width Depth Tile Depth No. of Lines
Seepage Pit: Inside diameter Liquid Depth Tile Size
Percent slope of land 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 C C.S.T. # / and other information
obtained from (owner?builder).
Plumber's Signature MP/MPRSW# Phone #.,y'i:
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
v F
H62.20, including well). p9 / f Y
r t-
V
I
1
_ I
r
Do Not Write in Space Below FOR DEPARTMENT LPI ONLY
Date of Application ees Pai6 State C ~d~ Date r
Permit Issued7d (-date) - ~)_Issuing Agent Name
Inspection Yesi-No Valid# Date Recd
1. county (whi a copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) n r!,:mH nr r,r ,,.,1