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HomeMy WebLinkAbout038-1030-10-000 C7 cn O 3 -0 n y `r n n' A V ~CD A m J ^ 3 o A r (A o c [n g z 2 v 0 T y o m c O cNO j ac r cu 7 n 0 ~ n A W (C d 9 W t7 ~ ~ ~ O .y 1ni a 3 y co cf - 1 ° o - m m R n O Vr N ~ p p N ~ A :3 ~l y ~ O •v a o v_: z D (D m C. O :n om T ~ p c CD Cl G o w w z n Z c~ cD (D o c o r ~r- (n tir =r os v v v 3 O O O o ti n' £ 3 N fn N ~ n Ct O O O J CJ 'N6 AO 90 tit a _ [D Q N V1 V ,yw~ a z cn z ~ (D c y O D (n "am • c N N G~ CD a' Q I1 7 Z cc cI -4 W C' _ ? A z M A z 7 Z -4 J m ' m 1 o z 0 3 ~ ~ o Cl) 3 m mC N z A Cl) T' 1 L1 -7 T m C z 3a m r v r' 3 p i O L` 2 ti r, ` tJ J 7 C) J Parcel 038-1030-10-000 12!04!2006 12:-4 PNI PAGE 1 OF 1 Alt. Parcel T31.18.139C 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 O•.vner, C = Carent Cc-Umler O - LICHT, RICHARD R & CAROL J TR RICHARD R & CAROL J TR LICHT 2224 90TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Prirnary Type Dist # Description ' 2224 90TH ST SC 3962 NEW RICHN10ND SP 1700 WITC Legal Description: Acres: 15.600 Plat: N!A-NOT AVAILABLE SEC 7 T31N R18W S V2 NE SE EXC N 290 FT Block/Condo Bldg: OF E 660 FT Tract(s): (Sec-Twn-Rng 401!4 160114) 07-31 N-1 8W I Notes: Parcel History: Date Doc # Vol/Page Type 07!07;2006 829150 WD 07!23;1997 462!519 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10i13!2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 35.500 224,900 260,400 NO UNDEVELOPED G5 13.600 34,000 0 34,000 NO Totals for 2006: General Property 15.600 69,500 224,900 294.400 Woodland 0.000 0 0 Totals for 2005: General Property 15.600 69,500 224,900 294,400 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 Wisoonsin Depetirtmeat-or Health and Soolal Services • Plb., e67 3/70 Division of Health SEPTIC TANK PERMIT APPLICATION ; -41 TYPE or USE BLACK INK 2 2 2,y ~ ( S T. A. CIWNE.R CF PROPTRTY Name 4 1 Address (Street, City, Zip code) B• LOCATiCN OF PzOPERTY i;~ ftI SYS-,r-K ;{_LL RE CCNS'IP.I."CTF.D ALTF.RFC OR F,XTEN'DED COUNTY Check One: CITY VILLAGE LEGAL DESCRIP ICN X TO*W.SHiP i C. IS LOCAL PFRN:T RF.CUIRED FOR THIS WORK? YES NO PETi~iIT NJi6ER D. SEPTIC TA.'rK CAPACITY l _ Gallons NEW INSTALLATION REPLACEMLhi ADDITION MA ZRIALS: Prefab Concrete ?oured in Place Steel Other HUMBER OF TANKS TO BE INSTALLED: / E. TYPE OF OCCUPANCY Cheek One: One or Two Family Residence Commercial Industrial other 1' _2 Specify) Number of Persons to be Accommodated Nuanber of Bedrooms ~ F. APPLIANCES, ETC: Food 'waste Grinder YES X NO Autorwttio Clothes Washer / YhS NO + Dishwasher YES X NO Autocatio Potato Peeler YLS/_ NO Other (Specify) G. N.:STIR PLUP3ER IIAKING INSTALLATION Name: Address: „mot 1 l\:, v F , car License Number: Signature or Applicant: e r, Address: H.. {To be CocpleLed by Issuing Agent} n n Date of Application J L) Fee Paid = .L • ~ Permit Issued (date) pemit Humber Agent (Name) f t7l _ For: ~ h✓""~ Town, Village, City,, County, etc. ,Specify) ;:aCe: The a.,pllc~ icn cannot cc considered for filing until all of the a'love questions are answered and the fee paid. Aaent9 will fcr &rd appsicati.-n, the fee of $1.C:; or each septic twvc and the third copy of .he permit (ca::ary) to the Divisicr. or Health. Checks and money orders should be W-de payable to tre Division of Health. Do not wri.e in space below - FGR DF.?ARTM!NT USE ONLY I ~ I I. DATE RECEIVED ~Z, ACCEPTED BY RETURNED (initials) (Date) See Corri FEE RECEIVED ~ VALID. No. PEPk;IT NO. lYes No R£YIE'WED BY APPRCVEG DATE 'S 1 (Initials) Yes or No} COMPLyTE OT TR SIDE ♦ ' SEPTIC MIX PERMIT NO. ~ r , y r R L P 0 R T O N S O I L P I R C 0 L A T 1 0 N T E S T A N D S 0 I L B 0 R I N G S TO DIVISION OF HULTH - PLU'',BING SRCTI0%( P.O.Box 309, Mrdison, Wis. 53701 Purauarit to F( 62.20, dim. Ad::Anistrativ9 Code P L R C 0 L A T I 0 N T T S T Test Depth Criss: wo or oP Soil Hours Water Too. Time DroRin Water Level Inones inutos Number Inohes Thickness in Inches I Since Hole in Hole Ints:^ral Second t~ ;lext to Last To Fall 1st Wetted OvenAgInt in Hin~rtos Last °er:od List Period Period aih Inch Example P - 0 3G11 To Soil 10" Clay 26" 25 Yes Cr No 30 1 2 1/2 1 2 60 RECORD DATA FROM MINXJM OF 3 TEST HOLFS Compute size of absorption area in aocord with H 52.20 Wis. Adainistrative Code- S O I L B O R I N G S- Minimum 36" Below Pra osed Abso tion S stan Boring ?ot.1 Depth Depth to Ground a- er Depth to Bedrock Number Inches Cb3erved Lsti-stod Observed Estla,ated Character of Soil with Thiokness in Irohos Yxample B - 0 72" 72" Black To Soil 12" Clay 1B" Sand 1811, Gravel 24" RF=RD DATA FFO`i MINL':U.i OF 3 BORE Hol-rS I YPE OF OCCUPANCY: RESIDENCE: Number of Bedrooma i OTHER: (Specify) Number of Persons ) POOD WASTE GRINDER: Yes No Dishwsshor: Tes No tutomatie Clothes Washer: Yes k No EFFLUENT DISPOSAL SYSMM: NEW ? EXTENSION ADDITION REPLA_M11UNT Tile Size a No.Lin,Foet ` n C Trenoh Width Depth Number of Lines , Seepage Bed: Length Width _ Depth Tile Size No. Lines - Seepage Pits Inside Disnater Liquid Depth I, the undersigned, hareby certify that the peroolation tests reported on this fors wore wade by oe or under my super- vision in a,oord with the proce,ires and method cpeoiPied Ln Chap.er H 2.20 (13), Wisoonsin Adainistrative Ccc..a, and that the data reoorded a_nd loco ion of test i:oie3 are oorrect to the bait of cry knowLeduo and belief. NAMF, ! - - - - TITLE (Type or Prin- REGISTRATION NO. / or' MASTER ?Ljv3cR LICMSE NO. DA-F. - / ~l SIr,NA'R.1R%