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HomeMy WebLinkAbout042-1067-30-000 n y O I' 3-0 n d O O r1 d f C fp c 3 3 A. 3 O (D o O 'o A7 i~ I 3 ~ -4 co N) 0 CD 7 3 p C ~p 'P CD N N 0.0 CL A z n N N O ~.y C O O :3 O W N O w W N O O O 0 --4 d O n 7 O (D F c O o N N n ~ O W O ~ • G O k N B - O ~d co a w w U> < W D (D n m C a (n W CL o o V 3 O Q =r CD m n r- co CD N m a o 0 cr ~r z O O O N l~rl o ~ a -•D GQ n N N N v s 3 v v _v t o p < ~ ' (D fD W O W 7 (D i S7 'C GNJ = D fD (p CD 9 N N fD OD n z zca z o v D O O CL O o' m m CD N • N N CD CC 0) Si l C (D CD w (D CL n 3 Z CD cn O 7 P, Z n N C O A Z ~ n 0 3 o. W ~ CD 3 z 0 cn z (D w ~ I D CL CL o' - n=i -n i z a O CD N A ~ A ~ I R R N N O O V O CD tiq O ~ O E» O . ti O (D 6 Parcel 042-1067-30-000 01/02/2007 11:36 AM PAGE 1 OF 1 Alt. Parcel 24.29.18.3766 042 - TOWN OF WARREN 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 - BRUESEWITZ, MYRON C & KATHRYN MYRON C & KATHRYN BRUESEWITZ 839 140TH ST ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 839 140TH ST SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 1.970 Plat: N/A-NOT AVAILABLE SEC 24 T29N R18W 1.97A IN NW SW LOT 1 Block/Condo Bldg: CSM VOL 3/687 ORD Tract(s): (Sec-Twn-Rng 401/4 1601/4) 24-29N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 582/422 2006 SUMMARY Bill Fair Market Value: Assessed with: 149550 328,400 Valuations: Last Changed: 11/20/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.970 37,100 202,500 239,600 NO Totals for 2006: General Property 1.970 37,100 202,500 239,600 Woodland 0.000 0 0 Totals for 2005: General Property 1.970 37,100 202,500 239,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 130 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 15.00 Special Assessments Special Charges Delinquent Charges Total 15.00 0.00 0.00 AS BUILT SANTTARV CVQ-rrM ovvno•r , TOWNSHIP SEC. T N~ R W ADD~1_.>_ ST. CROIX COUNTY, WISCONS N. l` '"VISION LOT LOT SIZE PLAN VIEW S 3 ~jSf °'~l 2 ( Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ej lit 4.4 Ile d ~ d C TANK d , °F'GR. s"`~ • CONCRETE STEEL x N0 rings on cover De th DRY WELL,' :S3F,S NO, of r~ widths length ' . area ~.o. of lines width length L area _ depth to top of pipe -GATE RATE AREA REQUIRED AREA AS BUILT aimer: The inspection of this system by St. Croix County does not imply complete / Lance with State Administrative Codes. There are other areas that it is not possible / spect at this point of construction. St. Croix County assumes no liability for m operation. However, if failure is noted the County will make every effort to Ana cause of failure. ES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEK. 'INSPECTOR " ' DATER, _ PLUMBER ON JOBS LICENSE NUMBER f RFPOI;T OF IIISPECTION--IidDIJIDUAL S):MGE DISPOSAI, SYSTEM Sanitary Permit r State Septic 1.W1 1E TOIINSHIP • t. Croix County SE ?'TIC TA7111 Size gallons, 'lumber of Compartments Distance From: Well ft, 12% or greater slope ft. Building' ft. Wetlands f gliwater ft. DISPOSAL SYST2,i1 Tile Field or Seepage Pit(s) Distance From: Well ft. 12% or greater slope ft Building; ft. Wetlands f;. FIELD rllighwater ft. Total length of lines ft. Number of lines Length of each line eft. Distance between lines ft. Width of the trench `ft. Total absorption area sq, ft. Depth of rock below tile in. Dp-pth of rock over tile in. Cover ...aver. rock,, . Depth of tile below grade in. Slopo of trench in ner 100 ft. Depth to Bedrock ft. Depth to Bround water ft, PITS ' Number 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 %Jquare feet of seepap.e nit area required Inspected by: Title: Approved Date 197. Rejected Date 197 tH 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH y P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: Section may, TAN, R/eZ(or) 4aownship or Municipality &UA- Lot No. , Block No. County ~--C ~eVdivision Name Owner's Name: /`4 e Mailing Address: /Q /'i ®f~~Y 1 C""' .3 TYPE OF OCCUPANCY: Residence No. of Bedrooms -3 Other EFFLUENT DISPOSAL SYSTEM: NEW A ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS S__ PERCOLATION TESTS SOIL MAP SHEET h- C _ SOIL TYPE 7// t.-le GT PERCOLATION TESTS r TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES CHARACTER OF SOIL RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN P_ X2- 3 j/ / P P!_3 y: S yr ~ -IL X2, p S 3 .L 3~i 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) c, C's.` .00, 4 B _ ~il ~e S 1.4 36- _32 " 4-14'k 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 nuf,bfj of square feet of absorption area needed for building type and occupancy. ~-02, sk•~/hi/f' ► Indicate scale or distances. Give horizontal and vertical V Oren p its. Indicate slope. S~rfA" I v ` I i s {L t I , I f 77 E~ r I n) 1 QI os 4eSra N 's (JV~~• I~ 13 ~j~ ~ ~ ~ 3 I~ I ~ I , ~ B~~ I I I I I z [ f i i ~ I I i I I• ~ { i ' I t/Q~~ y ~ I I 3 ~ i f 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. Certification No. S Ll~ Name (print) Z" e C- 'e Address -46C¢r f c' s Name of installer if known COPY A -LOCAL AUTHORITY CST Signature PLB67 State and County State Permit Permit Application County Permi # " 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: Section 4y, T,2~N, R/ j (or) (~F2Lot# -_-City Subdivision Name, nearest road, lake or landmark Blk# Village Township (,ClwPrew C. TYPE OF OCCUPANCY: 'Commercial 'Industrial 'Other (specify) 'Variance Single family Duplex _No. of Bedrooms 3 No. of Persons D. TYPE OF APPLIANCES: Dishwasher X YES NO Food Waste Grinder YES }ENO # of Bathrooms--- Automatic Washer X YES NO Other (specify) SEPTIC TANK CAPACITY V C-l Total gallons No. of tanks _ `Holding tank capacity Total gallons No. of tanks New Installation X -Addition- Replacement- Prefab Concrete `Poured in Place Steel Other (specify) FFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) _2_ 3) 2- Total Absorb Area _5e;?2 sq. ft. / Pdew ~ Addition _ Replacement .Fill System _ q'~(riwxwii i.,~.~ Seepage Trench: No. Lin. Feet _ Width Depth Tile Depth No. of Trenches seepage Bed: Length Width Depth Tile Depth 3' No. of Lines Seepage Pit: Inside diameter Liquid Depth _ Tile Size" Percent slope of land 0 ± Se"7.4 tj-'s 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 Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Certified Soil Tester NAME L E j 4 a C.S.T. # and other information obtained from (owner/builder)Plumber'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). V'/1`-k0 ,J LL 3~''v p'~ 14Y/u Do Not Write in Space Below FOR DEPARTMENT USE ONLY Date of Application 7 l Fees Pafid State Cn C~ County L`~ Date Permit Issued/RA d- (date) S Issuing Agent Name & ✓Inspection Yes No Valid# Date Recd 1. county (whi 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