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HomeMy WebLinkAbout038-1074-40-000 , J O CO) 0 "a $ n c d r_ c M m o \/1 T d ^ 3 ~ \ 1 0 2 z o 00 0 m m c a Cl) o" 90 °C • ao N o m io cco o s°D CL z a y rn v N W > > G7. go A 7 O N N .i fD W A i~~„ ` 11 ° -0 n O N O fD O O O Q O , (D 0 00 o w N 3 ° o D o ^ CD 0 G (D I-d t1i c~ o m ; o rt ° p CD m y N a s ao F'• ro o m 0 F'. I N 3 a o o o tt P p 00 a =r (n j (D H H CL H 0o tai I W o 00~~ c~rtn 00 F- i C 0) 0) CO 3° Q tv (D ON I 1 v m-0 O w N• t-n z H w i N vi vii m `i O O N 90 t2i z-~ o M d ~ r c~ - a y N 00 ON rr z © y co 3~r H H C/] o. ° N M ",a ° rW m m ti N • 'a (n z O I t=] m w N d c ° m t-h ! V w a rt En ~ m a 3 5 co rt n z ? C rn ° w t rt z m w rb ` C a A z 0 N 1 CL ~ z (D o 3 o " Cl) M j y z C I a D a) Q v a ~ 3 m o z a CD o m I a I s • fi I y A ti ti N O 0 ON ~ A j b V CD 6Q A ~ O ~ V O ti 04/04/2008 08:01 AM Parcel 038-1074-40-025 PAGE 1 OF 1 Alt. Parcel 17.31.18.308A-10 038 - TOWN OF STAR PRAIRIE ST. CROIX COUNTY, WISCONSIN Current X Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 03/19/2007 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - CRICHTON, TENNEY R & REBECCA P TENNEY R & REBECCA P CRICHTON 2118 100TH ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 2118 100TH ST SC 5432 SOMERSET SP 1700 WITC j Legal Description: Acres: 17.580 Plat: 5374-CSM 22-5374 038-07 SEC 17 T31 N R1 8W PT SE SE CSM 22-5374 Block/Condo Bldg: LOT 01 LOT 1 Tract(s): (Sec-Twn-Rng 40 1 /4 160 1/4) 17-31N-18W Notes: Parcel History: Date Doc # Vol/Page Type 03/19/2007 846729 22/5374 CSM 07/23/1997 1157/250 QC 07/23/1997 1069/554 WD 07/23/1997 698/598 2008 SUMMARY Bill Fair Market Value: Assessed with: 0 Last Changed: 03/30/2007 Valuations: Description Class Acres Land Improve Total State Reason Totals for 2008: 0 0 General Property 0.000 0 0 Woodland 0.000 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 038-1074-40-000 07/09/2007 08:58 AM PAGE 1 OF 1 Alt. Parcel 17.31.18.308A 038 - TOWN OF STAR PRAIRIE Current ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 03/19/2007 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner TENNEY R & REBECCA P CRICHTON O - CRICHTON, TENNEY R & REBECCA P 2118 100TH ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 2118 100TH ST SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 20.000 Plat: N/A-NOT AVAILABLE SEC 17 T31N R1 8W N 1/2 SE SE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 17-31N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1157/250 QC 07/23/1997 1069/554 WD 07/23/1997 698/598 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/13/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 20.000 75,000 160,100 235,100 NO Totals for 2007: General Property 20.000 75,000 160,100 235,100 Woodland 0.000 0 0 Totals for 2006: General Property 20.000 75,000 160,100 235,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 125 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 f T Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER 1. TOWNSHIP ` SEC. 1 _ T 3N-R l~ W ADDRESS ST. CROIX COUNTY, WISCONSIN ~ 1 C lr/ SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I•LHR, 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM L~ 7 k~l 1r .1 INDICATE NORTH ARROW A BENCHMARK: Describe the vertical reference point used f` s " Elevation of vertical reference point: Proposed slope at site: [9.0 SEPTIC TANK: Manufacturer: S Liquid Capacity: Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation:/ 0 / Tank Outlet Elevation: -T- Number of feet from nearest Road: Front, Side,Q Rear, O~ d feet From nearest property line Front ,uide10 Rear, O feet Number of feet from: well Qt building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: *PyxtCp/Siphon Manufacturer: Pump Size Elevation of inlet: r-°'~r Bottom of tank elevation: Pump off switch levation: Gallons per cycle: Alarm Manu cturer: Alarm Switch Type: Number,. f feet from nearest property line: Front, O Side, O Rear Ft. 0 Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: J Length: .J 0 Number of Lines: Area Built; r/ Fill depth to top of pipe: Number of feet from nearest property line: Front, Side, O Rear,O Bt.S Number of feet from well: A" 44 f Number of feet from building: (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: T Capacity: Number of rin s used: Elevation of bottom of tank: Elevation o inlet: Number of'feet from nearest property line: Front, O Side, O Rear, O Ft.~ Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: -1 Q Inspector: a.-'6'4 Dated:' Plumber on job: License Number: C.SCO 3c:~ 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. 60X`1969 BUREAU OF PLUMBING MADISON, WI 53707 R.CONVENTIONAL ❑ALTERNATIVE State Plan 1. D. Number n, a„I9ned1 ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Tenn Crichton 17 E Road, Circle Pines, MN 55014 - ' BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN REF. PT. ELEV.' CST RIFE PT. ELEV.. SE SE Section 17, T31N-R18W, Town of Star Prairie Name o, Plumber: JMPIMPRSW No. County Sanitary Permit Number: Gar Steel 3254 St. Croix 83786 SEPTIC TANK/HOLDING TANK: 1?7 w. It] MANUFACTURER. LIQUID CAPACITY- K INLET ELEV.. JTANK OUTLET ELEV.. WARNING LABEL JLOCKING COVER PROVIDED: PROVIDED. ' i L9 2 YES ONO OYES ONO BEDDING'. VENT DIA.- VENT MATt JHIGH WATER NUMBER OF ROAD: PROPERTY WELL. BUILDING. VENT TO FRESH ALARM FEET FROM f LINE. ' 74 LAIR INLET: YES ONO DYES ONO NEAREST v 1.470 17 ZIU DOSING CHAMBER: MANUFACTURER BEDDING- LIQUID CAPACITY PUMP MODE I. PEIMP; SIPH ON MANUFAC111EiEH WARNING LABEL LOCKING COVER PROVIDED. PROVIDED. DYES ONO OYES ONO DYES ONO GALLONS PER CYCLE: PUMPAND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING I(DIFFERENCE BETWEEN FEET FROM LINe AIR INLET PUMP ON AND OFF) DYES ONO NEAREST SOIL ABSORPTION SYSTEM. Check thesoil moisture at the depth of plowing ' " .,.AMETEK 111ATIHIAL AND MAHKIN13 or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BED/TRENCH WIDTH Q LENGTHS NO OF 1111TI PIPE SPACIN❑ COVER P NSIDE DIA =1I75 LIQUID ✓y THE NCEi F,p, MAwfAL' IT DEPTH: DIMENSIONS r,H•1 ;'EL DEPTIi FILL DEPTH DISTK PIPE UISTR PIPE DISTR. PIPE MATERIAL 7MF OPROPERTY WELL. BUILDING. VENT TO FRESH BELOW PIP ABOVE OVER El EV. NILE f ELEV. END LINE. AIR INLET: M (I I n - s C MOUND SYSTEM: en , Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- OYES O meets the criteria for medium sand. TIONS MEASURED. NO SOIL COVER TEXTURE III RMANENI MAHKEHS OBS EHVATION WELLS DYES ONO OYES ONO DEPTH OVER TRENCH BED DEPTH OVER TRENCH BED DEPTH OF TOPSOIL 1"'OD'O JEFUFD MULCHED CENTER EDGES YES ONO OYES ONO OYES ONO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH TR EONCH ES LATERAL SPACING IGHAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MNO DISTH DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEVATION AND ELEV.'. ELEV. DIA ELEV. PIPES DIA: DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED COHHECI LY r7MATIHIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS DYES ONO OYES ONO COMMENTS: PERMANENT MARKERS: JOBSERVATION WELLS: NUMBER OF 'PROPERTY WELL: BUILDING: FEET FROM LINE. OYES ONO EYES ONO NEAREST Sketch System on Retain in county file for audit. Reverse Side. SI N TU TITLE. DILHR SBD 6710 (R. 01/82) 70ILHR SANITARY PERMIT APPLICATION Co- ln accord with ILHR 83.05, Wis. Adm. Code . ~ 6 STATE E SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than STATE PLAN I.D. NUMBER 8% x 11 inches in size. -See reverse side for instructions for completing this application. [FOR TITION 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. VARIANCE ❑ YES ❑ NO PROP RTY OWNER PROPERTY LOCATION -r e !1 n 56- '/a SC '/4, S 17 T3), N, R 8)L(or) W PROPERTY OWNE 'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVIS~I/Q'N AME CITY NEARES VO/ADT* AK OR LANDMARK 71 CITY, ST TE ZIP CODE PHONE NUMBER V ~n + 6 VILLAGE : AYIG 11. TYPE OF BUILDING OR USE SERVED: ' OFS-ld7 c `410-60(~ Number of Bedrooms if 1 or 2 Family OR ❑ Public (Specify): III. PURPOSE OF APPLICATION: (Check only one in P. Check # 2,3 or 4, if applicable) 1. a. t4 New b. ❑ 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.t9conventional b. ❑ Alternative C. ❑ Experimental 2. a. ❑ System- b. ❑ Holding c. ❑ Pit Privy d. ❑ Vault Privy e. E] Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. ❑ seepage Bed b. See a e Trench c. ❑ seepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM LEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet) : /a/ V f 'Q 00 05 Feet RPrivate ❑Joint ❑ Public 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 Septic Tank or Holding Tank G`~D s ❑ ❑ ❑ ❑ Lift Pump Tank/Si hon Chamber ❑ ❑ ❑ ❑ ❑ VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plu ber's Name (Print): Plumb gnature: (N to s) -MPFMPRSW No. Business Phone Number: .Q W 4DO Plu er's dress (Street, City, State ip Name of Designer: I'V VII . SOIL TEST INFORMATION Certified Tester (CST) Name CST # tc-t-3 Pry- S-/s IF CS' RE S (Str et, City, State, Zip Code) Phone Number: M~`dl`L 71-5 6e IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater Date Issuing Agent Signature (No Stamps) Approved ❑ Owner Given Initial rc rge Fee Adverse Determination 47 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: 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 mus 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 yoeir privat sewage system, 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 name and mailing address. Provide the legal description where the system is tc be installed; ll. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartmen,, 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. Fifl in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address,.,~nd 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'/z 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 differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross sectican of the soil absorption system if required by the county; E) soil test data on a 115 form. 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 ever 2 years of steady negotiation and public debate. The groundwater bill Groundv~ ator ` included the creation of surcharges (fees) for a number of regulated practices whichtiscort;n's can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried treas.-re is used in your building is returned tc the groundwater through your soil absorption system or the disposal site used by your holding tank pumper. ~ The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6396 (R.03/W 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 Ole ~C Location of Prop rty ' o Section , T 3f N-R W Township r~i~~ Mailing Address 1 ~oX 24 Address of Site =~yle Subdivision Name Lot Number Previous Owner of Property LDl~I/ ~Gtt ~~'t Total Size of Parcel fifes Date Parcel was Created \ 197 Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes 4K No Volume and Page Number 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) cma6y that all dtatement,6 on this jonm ane true to the be.6t ob my (ouA) knowledge; that I (we) am (are) the owner(,s) of the pnopenty deacAibed in this inbonmati.on Jonm, by viAtue o6 a waxt.anty deed neconded in the 046ice ob the County Regi6ta o6 Deed as Document No. 397JOO ; and that I (We) pees entty own the plh opoe ed z to jot the sewage di-6 poz at sy.6t (on I (we) have obtained an ea6ement, to nun with the above desehibed pnopenty, jon the construction o6 said .6ystem, and the same ha6 been duty recorded in the 04jice o6 the County Regi6teA o6 Deed6, as Document No. 1. T ~ r SIGNAT/ /OF~OLWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) 04;1 24 DATE SIGNED DATE SIGNED a b z Eun) a r ST C- 105 r a A H SEPTIC TANK MAINTENANCE AGREEMENT z St. Croix County . d a H OWNER/BUYER lG,/~N~~~~ `CAN ROUTE/BOX NUMBER 4aX .277 (5: Fire Number CITY/STATE Z I P ~sE Section / T_L--N , R~~W . PROPERTY LOCATION: 44 14, Town of Se*y 5 St. Croix County, Subdivision Lot number I use and maintenance of your septic system could result in I Improper its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, What you put into if needed, by a licensed septic tank pumper. 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 sludgelandtsscum. Certification form will be sent approximately 30 days p y three year expiration. ° 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- 110 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 -0( 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. REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS DEPARTMENT OF DIVISION INDUSTRY, 1 1 P.O. BOX 7969 LABOR AND PERCOLATION TESTS (115) MADISON, WI 53707 HUMAN RELATIONS (H63.090) & Chapter 145.045) N NAME: O L~NO.:BLK„NO': SUBA].` TOWNSHIP LOCATION: SECTION: ff,„,~`''//ll . /T31 N/R or) W L lc~l CO NT Y: OW R'S vv= + NAME: MAI INC ADDRESS: ''I : 1 11 f f © DATES OBSERVATIONS M DE E DESCRIPTIONS:PER OLATION TESTS: USE PROFIL NO. BEDRMS : COMMERCIAL DESCRIPTION: Replace b R ~lew - esidence RATING: S= Site suitable for system U= Site unsuitable for system rNVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) $ ❑U S DU S ❑U ❑ S U❑ S U 4 DESIGN RATE: If any portion of the tested area is in the aT If Percolation Tests are NOT required SS T Y under s.1-1633.09(55)(b), indicate: Z / Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS LG QZ Si q'1 OLOR, BORING TOTAL ELEVATION DEPTH GROUND ESTEHIG ESTS TO BEDROCK IF OBS RV D (SEE. ON BACK jEXTURE, AND DEPT NUMBER N, OBSER RVED. B- D l J)0 fie. ~r~•S•1.,, (}l1 ,l,,.S. 6n. oS J4 o1c. B- B- 1 S B- PE.RCOLATION TESTS TEST I NUMBER INCH DEPTH ES AFTER WATER N SWELL HO IN LE G INTERVAL-MIN. TEST TIME PERIOD 1 P- DROP 777M P- P- P-. LP_ 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 ELEVATION SYSTEM E i I E ! i E ~ U E 3 I i t 3 e i E N t _ r ._w x'00 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. TESTS WERE COMPLETED ON: '1;41 NAM4R: I - CS 7, / - a - 8v ~j L _ - CERTIFICATION NUMBER: PHONE NUMBER (optional): ADD© Q 0, 9 MeW ~ z ~ CST SIG E: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - INSTRUCTIONS FOR CC ` LETING F 1'115 - SBD - 5395 cornple~ -ate soil test, . port must ir3cl__: e. 1. i 2. plicate whether this is a r lc;nce csi ~.al project; r commercial u! A -F T )NLY IF ALL r _ < p- 1rJ 71 Dx, i r E, Z f d ' b~pp B _ E: G' : y B , N 1 REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS DIVISION DEPARTMENT OF ' INDUSTRY, P.O. BOX 7969 LABOR AND PERCOLATION TESTS (115) MADISON, WI 53707 HUMAN RELATIONS (H63.090) & Chapter 145.045) LO ATI , SE N: TOWNSHIP Y: OT : .NO.: SUBDIVISIO AMEi ~E 1/4-5- SG 4 /TN/~} (or) W COU TY. R' AME: MAI D R SS: fq -4 DATES OBSERVATIONS M DE USE R A ESTS: i Np.BEDRMS : OMM L CR TION: New Replace i I$esidence RAY!NG: S- Site suitable for system U9 Site unsuitable for system MOUND: M-IN-FILL 'CEDING TANK: RECOMMEN ED SYSTEM:(optional) CONVENT O AL S ❑U DU IN-GRJOUN S Du El S U MS~u If•Percolation Tests are NOT required DESIGN RATE: If any portion.of the tested area is in the ;,nder s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS ,0 'BORING OTAL P H T R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKN SS, COLOR, TEXTURE, AND DEPTH NUMBER DEP;W-M. ELEVATION OBSERVED f ST. HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 1137oB 5s Gs„ S 6a 13- .2 as oo o Cv 43-- 1 13 (~r PERCOLATION. TESTS !/n TEST DEPTH DROP IN WATER LEVEL-INCHES RATE MINUTES , WATER IN HOLE TEST TIME AFTER SWELLING INTERVAL PERINCH NUMBER JUCW" -MIN. p I D 1 P 3 r~- I P_ 7- z~ 3 P_ 17~ P P ?LOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- contal 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 /0 2- I S _ I - _ , 1 , _ - . - - - r-- - r, I 4 ~ Vi z b e al Ile. ~ l i ' i I t 1, 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. TESTS WERE COMPLETED ON: NAME (print C CERTIFICATION NUMBER: PHONE NUMBER(optiohal): !ADDR S: r Z Z 7/J' ~ ~L7~G9 CST SIGN T E: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - S ~ ,1y /o1-71 000 loo o<, Parcel 038-1074-40-000 05/11/2006 07:42 AM PAGE 1 OF 1 Alt. Parcel 17.31.18.308A 038 - TOWN OF STAR PRAIRIE Current k 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 TENNEY R & REBECCA P CRICHTON O - CRICHTON, TENNEY R & REBECCA P 2118 100TH ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 2118 100TH ST SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 20.000 Plat: N/A-NOT AVAILABLE SEC 17 T31N R1 8W N 1/2 SE SE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 17-31N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1157/250 QC 07/23/1997 1069/554 WD 07/23/1997 698/598 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/13/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 20.000 75,000 160,100 235,100 NO Totals for 2006: General Property 20.000 75,000 160,100 235,100 Woodland 0.000 0 0 Totals for 2005: General Property 20.000 75,000 160,100 235,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 125 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00