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Form - S T C - 104
AS BUILT SANITARY SYSTEM REPORT
AL,
OWj&R / ~3 F TOWNSHIP) I SEC. TNR
ADDRESS ST. CROIX COUNTY, WISCONSIN
z~~•~E 1~~ Via/ 7
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of I1HR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
w~
zoo HE.9di.1 r 3/
~`.~vs SBA!
33 ss 41? `
v~ moo.. NDICATE NORTH ARROW
BENCHMARK: Describe the vertical reference point used "
Elevation of vertical reference point: Proposed slope at site:
SEPTIC TANK: Manufacturer:'. Liquid Capacity: Zwo
Number of rings used:_ Tank manhole cover elevation:
Tank Inlet Elevation: Tank Outlet Elevation: 9`5'd,e
Number of feet from nearest Road: Front,O Side, Rear, O feet
From nearest property line Front. OSitiie,~Rear,O ~,3t3 feet
>;.¢fTumber of feet from: well, building:
`(I'~Icl,ude this information of the above plot plan)( 2 reference dimensions to septic tank)
CCA DVXTVDCV CTnF
R
PUMP CHAMBER '
Manufacturer: Liquid Capacity:
Pump Model: Pump/Siphon Manufacturer: Pump Size
Elevation of inlet: Bottom of tank elevation:
Pump off switch elevation: Gallons per cycle:
Alarm Manufacturer: Alarm Switch Type:
Number of feet from nearest property line: Front, O Side, O Rear, Ft.
Number of feet from well:
Number of feet from building:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: V Trench:
r ~
Width: .1e=2 Len$th: SZ2 Number of Lines: Area Built /
Fill depth to top of pipe:
Number of feet from nearest property line: Front, O Side, (2) Rear,0 It
~
Number of feet from well:-
Number Number of feet from building: -moo ~C
(Include distances on plot plan).
SEEPAGE PIT
Size: Number of pits: Diameter:
Liquid depth: Bottom of seepage pit elevation:
Area Built:
Has either a drop box O or distribution box O been used on any of the above soil
absorbtion sytems? (Check one).
HOLDING TANK
Manufacturer: Capacity:
Number of rings used: Elevation of bottom of tank:
Elevation of inlet:
Number of feet from nearest property line: Front, O Side, O Rear, Ft.
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
r
Inspector•
Dated - Plumber on job:
License Number:
3/84:mj
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7.969 BUREAU OF PLUMBING
MADISON, WI 53707 ~~XX
[1CONVENTIONAL ❑ALTERNATIVE State Plan l.D Numher.
IIt -.q.erl)
❑ Holding Tank ❑ In-Ground Pressure ❑ Mound
NAME OF PERMIT HOLDER JADDRESS OF PERMIT HOLDER. INSPECTION DATE
1, Irle Rt. 1, Star Prairie, WI 54026
BENCH MARK (Permanent reference pounl DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CS
NE NE, Section 7, T31N-R17W, Town of Stanton
Nam, of Plumber. JMPIMPRSW No.. County Sanitary Permit Numher
Cal Powers, Jr. 1563 St. Croix 83820
SEPTIC TANK/HOLDING TANK: '
MANUFACTURER. LtOUIO CAPACITY TANK INLET ELEV TANK OUTLET ELEV WARNING LABEL LOCKING COVEH
C ` PR VIDED PROVIDED
/p/ aL YES ❑NO ❑YES '[-]NO
BEDDING. VENT DIA. VENT MATL HIGH WATER NUMBER OF ROAD: PROPERTY WELL BUILDING VENT TO FRESH
/l ALARM FEET FROM ? /1 LINE y.. c ~~IAIH IN I
YES ❑NO ❑YES ❑NO NEAREST V) /VL o~/( c% IV(TJ
fill.
DOSING CHAMBER:
MANUFACTURER JBEDDING ILIQUID CAPACITY PUM1IV MODEL PUMP. SIPHON MANUF AC TIIHEH WARNING LABEL LOCKING COVER
PROVIDED PROVIDED
❑YES ❑NO OYES ONO ❑YES F
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PHOPF HTY 11111-LL JBIJILOING (VENT TO FRESH
(DIFFERENCE BETWEEN FEET FROM uNE AIR INLET
PUMP ON AND OFF) ❑YES ❑NO INEAREST-0
SOIL ABSORPTION SYSTEM. Check thesoil moistureat thedepth of plowing FORCE LENGTH IDIAN11 IF 1+ INIATI HIAI ANO MAHKING
or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN
the soil is dry enough to continue.)
CONVENTIONAL SYSTEM:
WIDTH LENGTH NO. OF UISIR PIPE SPACING COVER INS( Of UTA =Pits LIUOIU
BED/TRENCH THENC.~g HAL' PIT uFPI"
IMENSIONS / a ~F
D VENT TO FHf ti)1
(VHAVEL DEPi11 FILL DEPTH 11UISTR PIPE DISTR. PIPE MATERIAL STH TNEAREST-------*-- UMBER OF PHOPEHiV WELL HUILDING
HF LOW PIPES ABOVE CO"'. f1L)' EET F ROM AD AIR tNLET
7, 1 ~(J-~ ~/01/e,s oti
11.2,
MOUND SYSTEM: _
Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM
and furrows thrown upslope: mound systems to make certain that it . ON REVERSE SIDE. SHOW ELEVA-
meets the criteria for medium sand. TIONS MEASURED.
❑YES ❑NO _
SOIL COVER TFxTOF1E JPIHMANINIMARKIHS I'list 11 VA111NW1II
_ ❑YES ~JNO _ DYES _ LINO
OF PTH OVFH THE NCH HEO IDI P 111 OVI 11 THE NCH BE 1) =TOPSOIL JSODI)t 1) IsEE llf U Ml1I (:Hf U
CENTER EDGES
❑YES ❑NO ❑YES ❑Np ❑YES C_]NO
PRESSURIZED DISTRIBUTION SYSTEM: _
WIDTH LENGTH NO. OF LATE HAL SPACING TIHAVEL OE P111 III IOW PIPI F IL L DEPTH AHOVf (;OV! H
BED/TRENCH TRENCHES
DIMENSIONS
MANIFOLD PUMP MANIFOL I) DISTR PIPE MANIFOLD MATERIAL NO 1)IS1H DISTH PIPE OItiI HIl4111 It )N PIPI M11A11 HIA1 K AIAHKINI'
ELEVATION AND ELEV ELEV. UTA ELEV. PIPES UTA.
DISTRIBUTION
INFORMATION HOLE SIZE HOLE SPACING LIiILLEO (:OIIHF C71 V COVER MALE HIAL VEI+II('.AI I II i (;f)HHE SPIN DS IG APPRI)V! U
❑YES ❑NO PL nNS
_ ❑YES ❑NO
COMMENTS: PERMANENT MARKERS: OBS ERVATION WELLS. NUMBER OF PROPERTY WELL BUILDING
FEET FROM LINE
❑YES ❑NO ❑YES ❑NO NEAREST
Sketch System on Ret county file for audit.
Reverse Side. 11
SI U E TITLE
DILHR SBD 6710 (R. 01/82)
t -
I
SANITARY PERMIT APPLICATION COUNTY
. D~LHA In accord with ILHR 83.05, Wis. Adm. Code #
-STATE SANITARY PERMIT
d
-Attach complete plans (to the county copy only) for the system, on paper not less than STATE PLAN I.D. NUMBER
81/:2'x 11 inches in size.
-See reverse side for instructions for completing this application. PETITION
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑ YES ❑ NO
PROPERTY OWNER PROPERTY LOCATION
'/a, S 7 , N, R E (or)Ct
FPROE TY OWNER 'S MAILING ADDRESS LOT NU BLOCK UMBER SUBDIVIS N NAME
Alh A10
AT ZIP CODE FPO NE NUMBER NEAREST ROAD, L KE OR LANDMARK
~ - VILLAGE
4.1L e2/ 41~
TOWN OF7,, A'0/
11. TYPE OF BUILDING OR USE SERVED: Q~~ - IQL~`<-UD It] Number of Bedrooms if 1 or 2 Family OR Public (Specify):
III. PURPOSE OF APPLICATION: (Check only one in #1. Check # 2,3 or 4, if applicable)
1. a. ❑ New b. 2 Replacement c. ❑ Replacement of d. ❑ Reconnection of e. ❑ Repair of an
System System Septic Tank Only an Existing System Existing System
2. ❑ A Sanitary Permit was previously issued. Permit Date Issued
3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements.
4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy.
IV. TYPE OF SYSTEM: (Check only one in #1 and only one in #2)
1. a. Conventional b. ❑ Alternative c. ❑ Experimental
2. a. ❑ System- b. ❑ Holding c. E1 Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP
In-Fill Tank
V. ABSORPTION SYSTEM INFORMATION: (Check one)
1. a. 0 Seepage Bed b. ❑ Seepage Trench c. ❑ Seepage Pit
2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY:
(Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet):
~I Private ❑ Joint ❑ Public
Feet r~
VI. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
O ❑ ❑
Septic Tank or Holding Tank ~ ❑ E1
Lift Pump Tank/Si hon Chamber FOL]
VII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibiltu nstallation of th sewage system shown on the attached plans.
(Print): er' Signa ture: ( o Stamps MP/MPRSW No.: Busness Phone Number:
Plu er's in
_41 ~ P -3 -fI
luis Adress tree, y tate, Zip CName of Designe,.
AM4
i'
VIII. SOIL TEST INFORMATION
Certi ' d So' Tester ( T) Name CST #
C T' D ESS treet, City, tate, Zip Code) Phone Number:
q /Z
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved SarR~itary Permit Fee Groundwater Date Issuing Agent Signature (No Stamps)
~
Approved ❑ Owner Given Initial S charge Fee G~
Adverse Determination v! ff
X. COMMENTS/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber
INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT
APPLICATION
TO THE APPLICANT: e
1. This 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. A new permit may be needed
if there is a change in your building plans, system location, estimated wastewater flow (number of bed-
rooms, etc.), depth of system, or type of system;
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. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed
pumper whenever necessary, usually every 2 to 3 years;
6. If you have questions concerning yo;;r private sewage syste..a, contact your local code administrator or the
State of Wisconsin, Bureau of Plumbing, 608-266-3815.
To be complete and accurate this sanitary permit application must include:
1. Property owner's nanne and mailing address Provide the legal description where the system Is to be
installed;
11. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat
restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling;
Ill. Purpose of application: Check only one in #1. Complete #2 if permit is for tank replacement, reconnection or
repair;
IV, Type of system: check all appropriate boxes depending on system type. Check experimental only if project
is in conjunction with University of Wisconsin;
V. Absorption system information: Provide all information requested in #1-6;
Vi. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed,
number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete
for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if
tanks received experimental product approval from DILHR;
VII. 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. Fill in designer name if
applicable;
VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number.
IX. County/Department Use Only;
X. Comment area for use by county or resaon given when application is disapproved.
Complete plans and specifications not smaller than 8%2 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; dosing or pumping chambers; 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 digerpnces; friction loss; pump
performance curve; pump model and pump manufacturer; D) cross section of soil absorption system if
required by the county; E) soil test data on a 115 form.
r l:r
E
GROUNDWATER SURCHARGE
On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more
commonly known as the groundwater protection law. This change in statutes was the
result of over 2 years of steady negotiation and public debate. The groundwater bill Ground Water -
included the creation of surcharges (fees) for a number of regulated practices which Wiscor*sin's
can effect groundwater. The surcharge took effect on July 1, 1984 All of the water that buried Treasure
is used in your building is returned to the groundwater througb your soil absorption
system or the disposal site,bSed by your holding tank pumper.
The monies collected through these surcharges are credited to the groundwater f:end adminis-
tered by the "department of Natural Resources. These funds are used for nionstoring ground- ~t
water, groundwater contamination in. estigations and esta'olishrnerit of standards. Groundwater, Y
it's worth protecting.
SBD-6398 (R.03/86)
APPLICATION FOR SANITARY PERMIT
ST C- 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 ~~r.eo~o re ~t ✓
Location of Property N E 'Z AlEff-_141 Section 7 , T N-R 7 W
Township S A_ k,
Mailing Address Q~ c~„ LLB 7
~~c ~ ~r fit. ~ ✓ r ~ C~> ~ S .5~~0 ~ C~
Address of Site S C
Subdivision Name
Lot Number
Previous Owner of Property N Y ~ y 2-r I-e- _
Total Size of Parcel
Date Parcel was Created
Are all corners and lot lines identifiable? Yes No
Is this property being developed for resale (spec house) ? Yes No
Volume 732 and Page Number -444_ 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 refer-
ences to a Certified Survey Map, the Certified Survey Map shall also be required.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
PROPERTY OWNER CERTIFICATION
I (We) cehti6y that att statements on th.iz bonm ane true to the best ob my (oun)
knowledge; that I (we) am (cute) the owner (,s) o6 the pnopWy dens cA bed in thtis
inbonmati.on bonm, by viAtue ob a way anty deed neconded in the Obbice ob the
County Reg.usten o6 Deed6 as Document No. V ; and that I (We) ptuentZy
own the pnopo~sed site bon the .sewage dizpozaZ SyAtem (on I (we) have obtained an
easement, to nun with the above de~scA bed pnopehty, bon the construction ob said
system, and the same has been duty seconded in the Obb-i.ce ob the County Register ob
Deeds, as Document No.
SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE)
DATE SIGNED DATE SIGNED
H
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9
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ST C- 105 a
H
SEPTIC TANK MAINTENANCE AGREEMENT o
St. Croix County z
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9
H
OWNER/BUYS /
ROUTE/BOX NUMBER X tl'2 7 Fire Number ® y-yo
.CITY/STATE S ` kA ~rd ✓ i~ • S ZIP
PROPERTY LOCATION: 1, 1, Section , T N, R W,
Town of St. Croix County,
Subdivision Lot number won~•
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,
if needed, by a licensed septic tank pumper. 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. 00
z
I/WE, the undersigned, have read the above requirements and agree
to maintain the private sewage disposal system in accordance with H
the standards set forth, herein, as set by the Wisconsin Depart- 'u
ment of Natural Resources. Certification form must be completed
and returned to the St. Croix County Zoning Office within 30 days
of the three year expiration date.
SIGNED
DATE rI/oZ 5~~~
St. Croix County Zoning Office
P .O. Box '98f
Hammond, WI 54015
715-796-2239 or 715-425-8363
Sign, date and return to above address.
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, DIVISION
LABOR ANC G P.O. BOX 7969
HUMAN RELATIONS PERCOLATION TESTS (115) MADISON, WI 53707
(H63.09(1) & Chapter 145.045)
j.OCATION: SECTION: TOWNSHIP/MU`Nt8+AALITY: OT NO.:BLK. O.: SUBDIVI ION NAME:
1/ /T'~, N/R/ Al
for
ICOUNTY: OWNER'S BUYER'S NAME:. AILING A DRESS:
i
USE DATES OBSERVATIONS MADE
NO.BEDRMS.: COMMERCI L DESCRIPTION: (PROFILE DESCRIPTIONS: PER OLATION TESTS:
M®Residence ❑New Replace 7
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK: RECD MENDED SYSTEM: (optional)
LOS ❑U 1ZS ❑u S DU EIS (Ou 0 S Mu .
If Percolation Tests are NOT require, DESIGN RATE: If any portion of the tested area is in the
under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: AIZ
PROFILE DESCRIPTIONS
r
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH t81, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B-
B-
B-
B-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER 4Al;b AFTERSWELLING INTERVAL-MIN. PERIOD -1 PER O 2 P R O PER NCH
P-A10AIE ./4Q 19 __9 P y1Z 111)
_AZ,2~ /109 P-
P-_
P_
PLOT PLAN: Show locations of percolation tes soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation referenW2 s an show their locatiof on t e plot plan. Shoyv~~z~surface elevation at all borings and the direction and percent
of land slope. /30 /O' q,
SYSTEM ELEVATION J``
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I, the undersigned, hereby certify that the soil tests reported on b~t ere made by me in accord with the procedures and methods specified in the Wisconsin
Administrative Code, and that the data recorded and the location re correct to the best of my knowledge and belief.
NAMF~ (print): TESTS WERE COMPLETED ON:
f _
A S: CERTIFICATION NUMBER: PHONE NUM ER(optional):
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CST N T
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 02/82) - OVER -
Ab
INSTRUCTIONS FOR COMPLETING FORM 115 - 91313 - 6395 /
a complete and accurate; soil test, your report must include:
f: r ` ~'R le,Ral descr` °ion:
2. T ua -section 3(i . ly indicate whether this is a r commercial project,
1 nui bedroor Pr commercial use plane
t s~
5a. Lon A SITE IS SUITABLE FOR P F"NG TAIL K ONLY I ALL
C T_ F BASEL C \1 SOIL CONDI;
i rare iu profile desci' c 1 e plot plan; .
rattily for y r test locations is p eferrecl. A
l = point are clear rrr rit;
. C E: dresses, flood plaid ;
1C. i' ech as flood pl r, iva c' riot apply, place Cei.A. )ox;
tirr,irr,=ogre, ~ ''r'ation nUr-
I list AIL TEST« :JITI-l THE
1 -T'
ML r-I TIONS FOR CERTIFIF' TESTERS
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• PAGE OF
A
CroSS See~Ion o~ f~ ~en Sys~en-~
ca~rr J/
Fresh Air Inlets And Observation Pipe
( Approved Vant cop
Minimum 12" Above Final Gred*
C/ 4
i
20- 42" Above Pipe _ 4" Cost Iron
To Final Grade Vent Pipe
tdersh Nay Or Synthetic Covering
Mln. 2" Aggregate
Over Plpe
Distribution Tee ~
pipe 0 0 0 0 0
6" Aggregate o J: Pipe Below
Beneath Pipe
Coupling Terminating At
Bottom Of system
i
ProPose~ ~ln~~ ``9rAc< , j.
SOIL FILL
DISTRIBUT101~..1 PIPE
APPROVED S4NTHETIC COVER
` PIATF.RIAt- OR 9" OF STRAW
QM OFI►6GRE6VE OR MARSH NAY
1o' OF %Z -2.1/Z AGGREGATE
r-LEV.OFA 7, FEET_..,
DISTRIB+JTIOAI PIPE TO BE AT LEAST INCHES BELOW ORIGIUAL GRADE
AQLJ AT LEASTM INCHES BUT AIO MORE THAN H2 FICHES BELOW FINAL GRADE
MAXIMUM MPTH OF EXCAVAT100 FROM OKIO AL 6RAoF. WILL BE ~ INCHES
PUNIMUM ®F-f rh of EXCAVATImN FROM 01RIGINAL C394PE WILL BE INCHES
' i
SIGAJED: ~
LIGEM SE
AJUMBER: ✓
DATE: 1 e~
02/06/2007 05:05 PM
Parcel 036-1014-20-000 PAGE 1 OF 1
Alt. Parcel 7.31.17.90 036 - TOWN OF STANTON
ST. CROIX COUNTY, WISCONSIN
Current ' X
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 - IRLE, THEODORE A & SUE K
THEODORE A & SUE K IRLE
1475 CTY RD H
STAR PRAIRIE WI 54026
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1475 CTY RD H
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE
SEC 7 T31 N R1 7W 40A NW NE Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 40 1 /4 160 1/4)
07-31 N-1 7W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 739/367
2007 SUMMARY Bill M Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 05/26/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 15,000 139,900 154,900 NO
AGRICULTURAL G4 31.000 4,800 0 4,800 NO
UNDEVELOPED G5 7.000 3,500 0 3,500 NO
Totals for 2007:
General Property 40.000 23,300 139,900 163,2000
Woodland 0.000 0
Totals for 2006:
General Property 40.000 23,300 139,900 163,2000
Woodland 0.000 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 125
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
00
Total 0.00 0.00