HomeMy WebLinkAbout040-1178-90-000
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Parcel 040-1178-90-000 12/14/2005 10:39 AM
PAGE 1 OF 1
Alt. Parcel 13/24.28.20.706 040 - 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
KATHLEEN D LAUERER O - LAUERER, KATHLEEN D
248 COVE LA
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 248 COVE LA
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 2.100 Plat: 2491-ST CROIX COVE 2ND & 3RD
SECS 13 & 24 T28N R20W LOT 49 ST CROIX Block/Condo Bldg: LOT 49
COVE SUB # 3
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 576/322
2005 SUMMARY Bill Fair Market Value: Assessed with:
103416 261,700
Valuations: Last Changed: 07/21/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.100 85,000 166,900 251,900 NO
Totals for 2005:
General Property 2.100 85,000 166,900 251,900
Woodland 0.000 0 0
Totals for 2004:
General Property 2.100 85,000 166,900 251,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 112
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
Sanitany Penm.it°'`/
State Sept~,c
NAME Township ~Wt/ St. Cno.ix County
Locatio's % 06 Section;fT_V,RZO W
SEPTIC TANK
Size gattons. Number o6 Comparstmentz
Distance Frsom: WeU 120 ors greaten sZope`- 6t
Bu.itd.in9 6t, Wettands _ 6t.
H.ighwaters 6t.
DISPOSAL SYSTEM
Distance Frsom: WeU 12% on greaten zZope 6 •
Bu.itding 6t- Wettandls Ft.
H,ighwaten .-R.6t.
FIELD DIMENSIONS:
Width o6 trench 6t. Depth o6 tock below tiZe i~ .in.
Length o6 each tine 6z. Depth o6 rock oven tiZe in.
Numbers o6 Zine~5 Depth o6 tite below grade tin
Total .Length o6 Zinez 6t. SZope o6 tneneh in pen 100 6t.
D.is Lance between Una 6t. Depth to b edno ck 6x•
Totat ab6orsbtion area 6t2 Depth to grsoundwateA 6t•
2
Requi.Led area 6t
PIT DIMENSIONS:
Numbers o6 pits Gnaviz around pits yeas no
Outzide d lame ers 6t. , De,'th b etow intet 6t•
2
Tota.L abzonbtion area 6t z
A
Area rsequined 6t2 rn
INSPECTED BV TITLE
i
APPROVED ,DATE 197.
REJECTED , DATE 197.
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EH-1,15
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: Section 't , TMN, R Z-6" E (or) W, Township or Municipality
Apt) A
Lot No. Block No. Cc L County S j
rr Subdivision Name
Owner's Name: l ~iCC'~C'S 'U~ i b ET C--i=`P '
Mailing Address: Al-yL>/
TYPE OF OCCUPANCY: Residence No. of Bedrooms 3 Other -
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT -
DATES OBSERVATIONS MADE: SOIL BORINGS /T, fy ✓`f~ 17S PERCOLATION TESTS
SOIL MAP SHEET SOIL TYPE I`f~ - -
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 PEfOD PERIOD 2 PERIOD 3
L7 (_o
/3. 4"e-
G. L
36
REFER 13E[ ' uk_:
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
NUMBER IN?CHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) cc T '33
C S _
S c: (U S 1 C.
B- Ts 51
d .
PLAN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area
needed for building type and occupancy. - re"k;, /I is 1=7 Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope.
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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.
, ~ /fi ti
i< <
Name (print) Certification No.
Address lit ti`'C Sal 745~S % /A.%C - .4_1 6: / S~7C", (c
Name of installer if known
CST Signature
State and County State Permit # 7J/7- 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 OF PROPERTY Mailing Address:
N
B. LOCATION: /4 '/4, Section T 9N, R20 E (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
/y Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family X 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)
L. SEPTIC TANK CAPACITY I eO 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)
FFLUE DISPOSAL SYSTEM: Percolation Rate 1) _;7- 2) L3) Total Absorb Area -sq.
New,(Z Addition Replacement *Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length Width Zk Depth Tile Depth 41( ;Z- No. of Lines
Seepage Pit: Inside diameter Liquid Depth Tile Size 41 _
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,
`Jisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared
by the Certified Soil Tester c f
'NAME ~0 C.S.T. # ~ G 7►,✓ Z d other information
obtained from (owner/builder)./
;'lumber's Signature MP/MPRSW# Phone #
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
41e, J,
101
L d
Do Not Write in Space Below FOR DEPARTMENT E ONLY
r t ees aid: State Count o Date t
Date of Application Y
Permit Issued/Rejected (date) Issuing Agent Name
Inspection YesNo Valid# Date Recd
1. county (whit copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) 4. plumber (canary copy)
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