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FORM - STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP _C~ Ffd+,~yt
SECTION
ADDRESSLZ. ST. CROIX COUNTY, WISCONSIN
SUBDIVISION (fi LOT4&LOT SIZE
PLAN VIEW '~J~~
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
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INDICATE NORTH ARROW
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BENCHMARK: Elevation and description: .a) AK A4- t-L• loci
Alternate benchmark ~1
SEPTIC TANK:Manufacturer: JU P Liquid Cap. LZ[oO •
G
Rings used: Ma-,thole cover elev: Final grade elev:
-
l~
outlet elev.•
Tank inlet elev.: J' Tank
T~
No. of feet from nearest road:Front Side Rear Ft.
From nearest prop. line:Front4y-- , Side , Rear Ft.
No. of feet from: Well '4: , Building: I Z e
(Include this information in the above plot plan)
(2 reference dimensions to septic tank)
SEE REVERSE SIDE
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PUMP CHAMBER
Manufacturer: Liquid Capaci y:
Pump Model: Pump/S' hon Manufact.: Pump Size
Elevation of inlet: Bottom of tank elevation
Pump on elev.: ump off elev.: Gallons/cycle:
Alarm: Man.: Switch Type: Location
Distance om nearest prop. line: Front, Side_, Rear_Ft.
ce from: Well Building
SOIL ABSORPTION SYSTEM.
Bed: Trench: /Seepage Pit:
Width:,.C_Length :Z 00 10 Number of Lines: L_ Area Built/ann
-ZZ
Exist. Grade Elev. 'S5 Proposed Final Grade Elev. .S'S
Fill depth to top of pipe `O
No. feet from nearest prop. line:Front
Side X , Rear Ft.1,0
No. feet from well: 4_No. feet from building 3 2
HOLDING TANK
Manufacturer: Capacity:
No. of rings used: Elevation of bottom tank:
Elevation of in
No. feet fro nearest prop. line:Front Side Rear Ft.
No. feet rom: Well , building , nearest road
Al Manufacturer:
INSPECTOR:
DATE : D e / 1,e gl PLUMBER ON JOB:
n '
LICENSE NUMBER:
6/90:cj
i
AQ O(OA V1
Wis;onsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
Labor and Human Relations INSPECTION REPORT St. Croix
T Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No.:
GENERAL INFORMATION SW4,SE%,Sec. 2,T31-R18,Co.Rd. H 149137
Permit Holder's Name: ❑ City ❑ Village W Town of: State Plan ID No.:
Richard Hansen Star Prairie
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
31H
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
01
Septic Core, Jr0d2UL~ off} Benchmark 102,79 '16610
J
Dosing--,
Aeration Bldg. Sewer
Holding St/ Inlet B 7,2
TANK SETBACK INFORMATION St/ H Outlet
TANKTO P/L WELL BLDG. Ventto ROAD Ekriet
Air Intake
Septic } GQ1 7-S A NA QLBet em
i
Dosing NA Headers
Aeration NA Dist. Pipe
~ . .Z S,
Holding Bot. System oZ l'~S Sa /
PUMP/ SIPHON INFORMATION Final Grade ~-_!7009 0 '
sy '
Manufacturer Demand
AVI Qr~e PU%r' 3.2~t SU
Model Number GPM
TDH Lift Friction System H Ft
Head
Forcemain Length Dia. Dist. To Well S
SOIL ABSORPTION SYSTEM
BED/TRENCH Width c' I Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSION ~p D
~ LEA
SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM -manufacturer:
er:
Nlll.
r INFORMATION Type O e0y t , ¢ CHAMBER Model
System: Co,)q, tra , D o OR UNIT
DISTRIBUTION SYSTEM
Header/Manifold I Distribution Pipe(s) / x Hole Size x Hole Spacing Vent To Air I/ take
Length --LE Dia. Length C1 7 / Dia. __Y_ Spacing _ZL ~Gv
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over (D xx Depth Of xx Seeded/ Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges a Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
Plan revision required? ❑ Yes ❑ No /
Use other side for additional information.
1/5d i[
10 gol SBD-6710 (R 05/91) Date Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
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SANITARY PERMIT APPLICATION
70ILHR In accord with ILHR 83.05, Wis. Adm. Code COUNTY
S t .Croix
AR PERMi
-Attach complete plans (to the county copy only) for the system, on paper not less than STATE / if SANITARY
To revious application
8!z x 11 Inches in size. 1:1 C15eck p -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER PROPERTY LOCATION
Richard Hansen .619 % -8E S1&2 T 31, N, R 18 V(or) W
PROPERTY OWNER'S MAILING ADDRESS LOT # n / a BLOCK # n / a
1245 Co. Rd. #H
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
New Richmond, Wi. 54017 175 248-35!2 n/a
II. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD
❑ State Owned VILLAGE : Star Prarie Co. Rd. #H
❑ Public 141 or 2 Fam. Dwelling- # of bedrooms 4 PARCEL T NU B ( )
III. BUILDING USE: (If building type is public, check all that apply) 30 -(366
1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
40 Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. ❑ New 2. H Replacement 3. ❑ Replacement of 4.E] Reconnection of 5.E] Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 ❑ Mound 300 Specify Type 41 ❑ Holding Tank
12 61 Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
14 ❑ System-in-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE
REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
600 1000 1000 .60 class 2 95.90 Feet 100.0 Feet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Se tic Tank or Holdin Tank x 1200 1 - Weeks C . P .
Lift Pump Tank/Si hon Chamber
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plumber's Si ure: (No S s) MPRSW No.: Business Phone Number:
Gary L. Steel 3254 715 246-6200
Plumber's Address (Street, City, State, Zip Code)
1554 200th. Ave. New Richmond, Wi. 54017
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Lianitary Permit Fee (Includes Groundwater ate Issued Issuin Agent Signatur tamps)
Surcharge Fee)
Approved ❑ Owner Given Initial L,~
Adverse Det rmin tion `
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary, permit may be renewed before the expiration date, and at the time of renewal any new
criteria in the Wisconsin Administrative Code will be applicable.
3. All revisions to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be
submitted to the county prior to installation.
5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed
pumper whenever necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the
State of Wisconsin, Safety & Buildings Division, 608-266-3815.
To be complete and accurate this sanitary permit application must include:
1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of
where the system is to be installed.
II. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is Public, check all appropriate boxes that apply.
IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or
repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested in ##1-7.
VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of
tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all
septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received
experimental product approval from DILHR.
VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g.
MP, etc.), address and phone number. Plumber must sign application form.
IX. County/Department Use Only.
X. County/Department Use Only.
Complete plans and specifications not smaller than 13'% x 11 inches must be submitted to the county. The
plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of
holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service;
streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system
areas; and the location of the building served; B) horizontal and vertical elevation reference points;
C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump
performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if
required by the county; E) soil test data on a 115 form; and F) all sizing information.
GROUNDWATER SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of
regulated practices which can effect groundwater.
The monies collected through these surcharges are used for monitoring groundwater, ground-
water contamination investigations and establishment of standards.
SBD-6398 (R.11/88)
APPLICATION FOR SANITARY PERMIT
STC - 100
This application form is to be completed in full and signed by the owner(s) of
the property being developed. Any inadequacies will only result in delays of
the permit issuance. Should this development be intended for resale by
owner/contractor,(spec house), then a second form should be retained and
completed when the property is sold and submitted to this office with the
appropriate deed recording.
Owner of property L► ~(7l~aue ~IY~P Lee RA~\Sez'
Location of property 1/4 _ /9, Section T o N-R_L%_W
Township _ l ' fl M('yg'
Mailing address ao s T y
Address of site a Qkc Y1 (ANA LZ_ i Sri 0
Subdivision name
Lot number
Previous owner of property 1^(11.1 t SC')!
Total size of parcel ~IQC~~ S
Date parcel was created CD/~S~ U y
Are all corners and lot lines identifiable? Yes No
Is this property being developed for resale (spec house)? Yes Ve-"*,No
Volume 043 and Page Number _4~ as recorded with the Register of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER, and
the SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if
available, would be helpful so as to avoid delays of the reviewing process. If
the deed description references to a Certified Survey Map, the Certified Survey
Map shall also be required.
PROPERTY OWNER CERTIFICATION
I(We) certify that all statements on this form are true to the best of my (our)
knowledge; that I (we) am (are) the owner(s) of the property described in
this information form, by virtue of a warranty deed recorded in the Office of
the County Register of Deeds as Document No. Q4LZR ; and that I (We)
presently own the proposed site for the sewa a disposal system (or I (we) have
obtained an easement, to run with the above described property, for the
construction of said system, and the same has been duly recorded in the Office
of the County Register of Deeds, as Document No.
Signature of Owner Signature of Co-Owner (If Applicable)
1 kMWLy11'__ /9/
Dat 0 f S' nature Date of Signature
J. t
} A 5w yr r
4k P
2, n ~ ~ ,il'" ~ • 1, ~ :SI
pro rs -p. a l .and..Mi £s,,-
Ilt t .
- --M-- *Sir No pe area). t
~its~ie~ r and weds to er r I~uleelAane, wpm t►91i pzeirrpt and hu per.
rIR Ws'audstaet A>;jl p~Pti~Te tOpber trkb the '
"~,G•.,'° r vi; sic - t .F i^i
AN"
F 3h0 Sout'Aw0Sta 4 oaf the Southeast ` 1/4
,P.'Totuhi:S'North, Range. -18 ,M1est
aiollo>wss ~iirauencia 980 `;feet' Tats
: . }
1Paced No.
h bf: the~~5tiu~tbwest ~.cQrner Hof said :Southwest.
f =the .Southeast hence South 170.8 ~e# „7•thence 'ast 35- feeti,' more-~-or less to
Arline ; of,, highlray,~,"thence., Northwesterly on
nterline 344~~feet, thence Southwesterly E,.
ert+
t more
or
le~s"3to_the,Place of beginning..
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Pripet Y'aad to' r tl► ,de New Richmond, Wisconsin
..........................d..a....
4..a 4 t 1 t .71,
' 'of tbi. Co~traet;:
tosemr wW" intereet from....te
ootatandbw hoar ti • to time at the ' rate of .10 S t,,._ MN:ws: . per cent, per annum'
k
~^plty~tents~of~S462 00 coaunencingrJuly 15, 1989.,
t
s;a- S , Yr 7E, w,:A++r ~v t
. the ettit~t' e°O dint ' eltall be paid in full on or before the.......... 15th......
'ls.94:...( th. IMM~Ipdga daa)• da''pt 1 ,
to pay moatWy "premiums amounts sufficient to pay reasonably Antic{. t
1 ► oD~l uwlim* fire and roodred insurance premiums when due. To the extent received by Vendor, k k
a'
Paymeaft *6 itbeee. obligations when due. such amounts received by the vendor for payment of f
,its and i0su"A e UM be deposited Into an "crow fund or trustee account, but shall not bear interest '
Nlwrwbs sr,a hvd by hw k -
~'yl~d~lTttst job" on the unpaid balance at the rate s
• ' ' specified and rhea to principal. Any
m ,
yr,be Prepack wkbout.prrusium.or fee upon principal at any time,aW............................. X
~IiI~dGX~li)hlil6)6D(d@7foWa6d'n1E.X
Of aW PC4"YOMA, thin Contract shall not be treated as in default with respect to pa3mmat so Ions
+ y bailaoes of Prlelpai, and interest (and in such case accruing interest from month to month shall be treated {
`I~Id' Trrbtelpd) U Iess than the amount that said indebtedness would have been had the months
at lf;st goei0~d above; provided that monthl Y Payments been
~t"e suadeatna Y payments shall be continued in the event of credit of any proceeds
tbn, the 00161140111441 being thereafter excluded herefrom. ;
' r+ltMest Matra th Pm4h bt satfWAed with th title as pen by the title-evidence su it to baser
t b intan~tatisa a m * $ : a g a t i o n s to i r s t ~ i n n e s o t a avings ~'a nc a n c~Te
e, Bank of New Richmond which are of record and which I'scr Stllr r
shall pay in full prior.to the maturity date of the contract.
K
E 1
.L ,y,•S~S'"5>tt lt,~'6r1• ~.Af' y 07. ; ~``Ne,+hf)
~5 ~Ma to PaY tI►e e0d4f,future title evidence. If title evidence is in the form of an abstract, it shall 37
lssd b' Vendor until` the full purchase price is paid
Pute►aMr,shall'beentiuWto take Possession of the Property on- 1une.•..... •1$
¢ .Out Oak, 19,
H aCllNSON.?w: Wfu•- fn" L-Wet Btrek I
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f?((1>t/t )1~lwrukrr. Wu
ST C- 105 r
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SEPTIC TANK MAINTENANCE AGREEMENT o
St. Croix County z
v
9
OWNER/BUYER 1 C(rd Le
ROUTE/BOX NUMBER,*v4t.2 &x Fire Number
CITY/STATE New R)eh1*_)Ad it) ZIP 5-yo/2
PROPERTY LOCATION:SW ~4, Section, 'r_31_N, Rjj_W, I
Town of 0XI St. Croix Cou ty,
Subdivision 1.0 t number
Improper use and maintenance of your septic system could result in
its premature failure to handle wastes. Proper maintenance con-
sists of pumping out the septic tank every three years or sooner, i
if needed, by a licensed septic tank um qr. What you put into
the system can affect the function of the septic tank as a treat-
ment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant for
a maximum of 60% of the cost of replacement of a failing system,
which was in operation prior to July 1, 1978. St. Croix County
accepted this-program in August of 1980, with the requirement that
owners of all new systems agree to keep their systems properly
maintained.
The property owner agrees to submit to St. Croix County Zoning a
certification form, signed by the owner and by a master plumber,
journeyman plumber, restricted plumber or a licensed pumper veri-
fying that (1) the on-site wastewater disposal system is in proper
operating condition and (2) after inspection and pumping (if nec-
essary), the septic 'tank is less than 1/3 full of sludge and scum.
Certification form will be sent approximately 30 days prior to
three year expiration.
0
E
I/WE, the undersigned, have read the above requirements and agree
to maintain the private sewage disposal system in accordance with x
H
the standards set forth, herein, as set by the Wisconsin Depart w
ment of Natural Resources. Certification form must be completed
and returned to the. St. Croix County Zoning Office within 30 clays
of the three year expiration date.
S I C N E
DATE O/~a II
St. Croix County Zoning Office
P.O. Box 98
Hammond, WI 54015
715-796-2239 or 715-425-8363
Sign, date and return to above address.
DEPARTAIIENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
'INDUSTRY, DIVISION
P.O. BOX 76
LABOR AND PERCOLATION TESTS (115) MADISON WI 53707
HUMAN RELATIONS
(ILHR 83.090) & Chapter 145)
LOCATION: SECTION: TOWNSHIP ITY: LOT NO.:BLK. NO.: SUBDIVISION NAME:
%Z/T31 N/R184 (or) w Star Prarie n/a n/a n/a
COUNTY: OWNER'S ~y1(}INAME: MAILING ADDRESS:
Richard Hansen 1245 Co. Rd. #H, New Richmond, Wi. 54017
St. Croix
DATES OBSERVATIONS MADE
USE ESCR IPT IONS:PER QQ LA IONTESTS:
NO. BEDRMS.: COMMERCIAL DESCRIPTION PROFI LE D
: I 6-26-91 n/a
Residence LI n/a ❑New t eplace
RATING: S= Site suitable for system U= Site unsuitable for system
ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:loptional)
®S E] U Cl S OU ~ OU El S ®u El S ®U conventional
If Percolation Tests are NOT required ]DM GN RATE: I If any portion of the tested area is in the na/
under s. ILHR 83.0915)1b1, indicate: Class 2 Floodplain indicate Floodplain elevation:
decimal' PROFILE DESCRIPTIONS page 4 BrC2
BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH I LEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B-1 7.50 100.40 none >7.50 .83bl.1. 1.67bn.sil. 2.00bn.s.l. 3.00bn.c.s.&gr.
B-2 7.34 99.30 none >7.34 .75bl.1. 1.42bn.s.l. 1.25bn.l.s. 3.92bn.c.s.
B-3 7.25 99.55 none >7.25 .58bl.1. 1.17bn.sil. 2.00bn.s.l. 3.50bn.c.s.
B-
B-
B-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATER INCH ES
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERI D1 PERIOD2 PERIOD
P-
P-
P- see desi rate
P-
P-
P-
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope.
SYSTEM ELEVATION 95.90
nova r vL
IN
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 the location of the tests are correct to the best of my knowledge and belief.
PLETED ON:
NAME (print): --77;7
Gary L. Steel ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional):
159 200th, Ave.. New Richmond, Wi. 54017 2298 715-246-6200
CST SIGN RE:
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 10/83) - OVER
STEEL'S SOIL SERVICE
Gary L. Steel 988 N. Shore Drive
C.S.T. 2298 New Richmond, WI 54017
MPRSW-3254 Richard Hansen (715) 246-6200
SnTl y Sa-T31N-R18W
Star Prarie, toimship
p of ~0'
160
x~N42 ®8, iO
4r07 tln~ 111°° ~~(2
~~.[W' La I ~
Q
31 L'i
/00"
V
b ~ c ev
fie P(a 7 z 9 P
Gary L. Steel
8-12-91
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, n DIVISION
G 1 P.O. BOX 7969
LABOR
UMAN RE AND LATIONS PERCOLATION TESTS (115) MADISON, WI 53707
(I LHR 83.09(1) & Chapter 145)
LOCATION: SECTIO wTOWNSHIP ITY: LOT NO.:BLK. NO.: SUBDIVISION NAME:
NW t/4 NE 1Q 117)T31 N/R184(or) W Star Prarie n/a n/a n/a
COUNTY: WN S/ NAME: ]MAILING ADDRESS:
St. Croix "Richard Hansen 1245 Co. Rd. #H, New Richmond, Wi. 54017
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: PER pQ~ATION TESTS:
I Residence 4 n/a ❑New ,Replace 6-26-91 n/a
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional)
®S ❑U ~S ❑ll EaS ❑U ❑ S ®U ❑ S ®U conventional
If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the
na/
under s. I LHR 83.09(5)(b), indicate: Class 2 I Floodplain, indicate Floodplain elevation:
decimal' PROFILE DESCRIPTIONS page 4 BrC2
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH I LEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.(
B-1 7.50 100.40 none >7.50 .83bl.1. 1.67bn.sil. 2.00bn.s.l. 3.00bn.c.s.&gr.
B-2 7.34 99.30 none >7.34 .75bl.1. 1.42bn.s.l. 1.25bn.l.s. 3.92bn.c.s.
B-3 7.25 99.55 none >7.25 .58bl.1. 1.17bn.sil. 2.00bn.s.l. 3.50bn.c.s.
B- 9
B-
B-
PERCOLATION TESTS
G
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES TE UT
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PE 9 DER INCH
r f
P-
P-
P- desi rate
P-
P-
P-
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope.
SYSTEM ELEVATION 95.90
3
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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 the location of the tests are correct to the best of my knowledge and belief.
NAME (print): TESTS WERE COMPLETED ON:
Gary L. Steel 6-26-91
ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional):
1554 200th, Ave., New Richmond, Wi. 54017 2298 1715.-246-6200
CST SIGN RE:
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 10/83) -OVER -
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. Parcel 038-1011-30-000 06/22/2007 08:58 AM
PAGE 1 OF 1
Alt. Parcel 2.31.18.31 H 038 - TOWN OF STAR PRAIRIE
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 - HANSON, JEFFREY F & CARMEN L
JEFFREY F & CARMEN L HANSON
1245 CTY RD H J
NEW RICHMOND WI 54017 GJ~2 f &U
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 1245 CTY RD H
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 1.414 Plat: N/A-NOT AVAILABLE
SEC 2 T31 N R1 8W PT SW SE COM 980 FT N OF Block/Condo Bldg:
SW COR, TH S 170.8 FT, E 359 FT TO CEN
LN OF HWY, NWLY ON HWY 344 FT, TH SWLY Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
188 FT TO POB 02-31N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
05/09/2005 794487 2799/335 WD
07/23/1997 1004/49 WD
07/23/1997 843/418
07/23/1997 691/452 more...
2007 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/12/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.414 27,900 134,000 161,900 NO
Totals for 2007:
General Property 1.414 27,900 134,000 161,900
Woodland 0.000 0 0
Totals for 2006:
General Property 1.414 27,900 134,000 161,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 218
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
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