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HomeMy WebLinkAbout040-1040-70-000 o CD a gc U) 'S O m o p 00 0 COD A ~C • N CD CD v CD CO N".3~ N_ n z n N O N F O `A\ c CT CD O O O (D (D cn A C 1 N CL O 7 = W p O CD 0 7 W O O 3 n O 3 N CD CD O C N W < D z Cn 2 z C m cfl CD a 'i (P co CD G) a 3 a°° `n \o c < V CD N) C) < co co a CD -4 -4 (n 0 c c o CL ~ I m 0 iv lV • z O O O Y Z 0 CD 0 o aQ =1 C: v 3 . Q v v v CD m o m m CT o 7 d N OC N C 2) d~l I a = 7 m Z co z O CD 0 D O n Z (D m c CD m N (D N C CD CD W CD n ' n 3 7 Z O p Z o (DD N Z o iv n a O I o Z N O oov m00 m (D CL t z 'o a ~ O C/) 3 Z D CL Q o m_ c z a O N 1 A, I Ar d I Q• ~ N ' O O H A 0 p CD A < 0 CN to O A b O CL ti Parcel 040-1040-70-000 12/14/2005 04:10 PM PAGE 1 OF 1 Alt. Parcel M 09.28.19.136G 040 - TOWN OF TROY 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 - DONELSON, BRUCE & BETTY BRUCE & BETTY DONELSON 437 N GLOVER RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 437 N GLOVER RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 6.090 Plat: N/A-NOT AVAILABLE SEC 9 T28N R1 9W 6.09 AC IN NE SW COM SE Block/Condo Bldg: COR, TH W 165 FT, N 786.2 FT TO POB: W 1188.94 FT,N 35DEG W 258 FT, TH E 1339 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) FT, S 210 FT TO POB 09-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 2005 SUMMARY Bill Fair Market Value: Assessed with: 102328 292,700 Valuations: Last Changed: 07/19/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 6.000 75,000 206,700 281,700 NO Totals for 2005: General Property 6.000 75,000 206,700 281,700 Woodland 0.000 0 0 Totals for 2004: General Property 6.000 75,000 206,700 281,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 308 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 pop, AS BUILT SANITARY SYSTEM REPORT NER o r. 't s TOWNSHIP SEC. T N, R W .O: tDDRESS , 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 i i TIC TANK(S) MFGR. CONCRETE STEEL NO. of rings on cover Depth DRY WELL :.dCHES NO. of width length area D no. of lines width length area " depth to top of pipe :'rREGATE ::K RATE AREA REQUIRED AREA AS BUILT °ciaimer: 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 stem operation. However, if failure is noted the County will make every effort to termine cause of failure. '-'ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. • INS DATED PLUMBER"ON JOB LICENSE NUMBER ` i RRPOP,T Or ITISPECTION--1. DIJIDUAL SOJAGE DISPOSAL Si'STE11 Sanitary Permit State Septic 7A` 1E 1111 Ad A A-4 j,& TOt• NSHIP • St. Croix ounty S'JRPTIC TA'?l: Mc, 5 Sale __Zr CO gallons. 'umber of Compartments , Distance From: Well ft. 12% or greater slope ~'c~ Building ft. Wetlands Highwater~- `-ft. DISPOSAL SYSTL:1 Tile Field or Seepage Pit(s) Distance From: Well ft. 12% or greater slope ft Building ft. Wetlands T` f;. FIELD 11 iFhwater ft, Total length of lines / ft. Number of lines 3 Length of each line -4-•--f t. Distance between lines L ft. Width of the trench/ -ft. Total absorption area ~sq. ft. Depth of rock below the ~Z in. Dp-pth of rock over the ~ in. Cover over.. rock -A- Depth of the below grade :3 in. Slope of trench in ner 100 ft. Depth to Bedrock ft. Depth to ground water ft. PITS Number of pits Ou. de , is ~e---ft. Depth below inlet ft. Gravel around p't: Tyes no. :Total absorption area sq. ft. -Square feet of seepage trench bottom area required %Square feet of seepafe nit ar quired Inspected Title': Approvedf ! l` ,..Date - f 197L~. Rejected , Date 197 c` ~ s . t,,~ 4(o 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 L0CATION:Alf--% '/4, Section , -;;MN, R/C f VorCVyjlownship or Municipality T/' C%0' Lot No. , Block No. County c.5Z OyPo e `X ,t~1) Subdivision Name Owner's Name: N ru /_T / Mailing Address: X4 14VAI, LL_)"ej 61-yo/4 TYPE OF OCCUPANCY: Residence No. of Bedrooms !Y Other EFFLUENT DISPOSAL SYSTEM: NEW x ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS 2~ PERCOLATION TESTS y ' ~S> SOIL MAP SHEET IF~- 1.21 SOIL TYPE 6'!K - PERCOLATION TESTS TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IACTERN INCHES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN IP_ X77- r P- .2 ~P.- ° SOIL BORING TESTS F TEST TOI AL DEPTH ;)LP, H TO .ROUNDVVA` ER ?-ACHES CHARACTER OF SOIL WITH HICKNESS, INCHES 1 NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) L, Aelew C', 7-5 6 54 49 rr p 9.6-01 6-5.4 3- I I_AN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Jicate on the plan the location and square feet of suitable areas. Indicat um er ,square feet of absorption are ceded for building type and occupancy. g!, d r- -r• 1 CA Indicate scale or distances. Give horizontal and vertical reference vols. I yca lope. I L /.~vn cSk~ e4 4__- +LO I I i 1 0 117' w I 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) Certification No. Address Name of installer if known CST Signature COPY A - LOCAL AUTHORITY L B67. State and County State Permit # 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 OF PROPERTY Mailing Address: f' E1 t` F c7 Ae E" ~ B. LOCATION: Vii '/n L / Section T04 N, R oi (or) (%~ot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township ':r;t0 c. TYPE OF OCCUPANCY: __4_m _ercial *Industrial 'other-- (specify) *Variance Single family Duplex No. of Bedrooms No. of Persons 0. TYPE OF APPLIANCES: Dishwasher X YES NO Food Waste GrinderYES X NO # of Bathrooms Automatic Washer JXYES NO Other (specify) SEPTIC TANK CAPACITY Total gallons No. of tanks 'Holding tank capacity Total gallons No. of tanks w Installation X Addition Replacement Prefab Concrete Poured in Place Steel Other (specify) FFLUENT DISPOSAL SYSTEM: Percolation Rate 1) r 2). S-3) . Total Absorb Area .L sq. ft. :w X Addition Replacement *Fill System ::)=:epage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches /do " Depth "Tile Depth __3fp if -3 No. of Lines D: epage Bed: Length S4:1 Width .=epage Pit: Inside diameter Liquid Depth Tile Size y« Percent slope of land to Ve, ~q 'll Distance from critical slope - r r -1.g the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, lisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared )y the Cert' ied Soil Te er, _ 'AME -~.S.T. #S- and other information oibtained from _ own Flumber's Signature MP/MPRSW# Phone Plumber's Address G. =f y PLAN VIEW: Provide sketch hplo% system (include direction of slope and all distances in accord with H62.20, including well). i i 1n I'2©~ / rG/~:3-c'~ j}~~: ~~aei' A'~/.1'~'Nc•d~ is f kk \ E' 97 OAS Do Not Write in SpaFdate) low F R DEPARTMENT USE ONLY G7 Date of Application Fees P d: StateCo DatePermit Issued/ Issuing Agent Name A 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) t