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Parcel 026-1014-10-100 05i24~2005 04:14 PM
PAGE 1 OF 1
Alt. Parcel 4.30.18.49F 026 - TOWN OF RICHMOND
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): Current Owner
' BISCHOF, TRAVIS R & SUSAN E
TRAVIS R & SUSAN E BISCHOF
1718 112TH ST
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 1718 112TH ST
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 1.625 Plat: NIA-NOT AVAILABLE
SEC 4 T30N R1 8W SW SW 1.625 ACRES LOT 1 Block/Condo Bldg:
OF CSM 6!1636
Tract(s): (Sec-Twn-Rng 401/4 160114)
04-:;ON-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
07;0112002 683192 19201498 WD
01!26;1998 571751 1290/178 OC
07!213i1997 1150!187 WD
107,123;1997 739!323
2005 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 06!19;2002
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.630 35,600 89,000 124,600 NO
Totals for 2005:
General Property 1.630 35.600 89,000 124,600
Woodland 0.000 0 0
Totals for 2004:
General Property 1,630 35,600 89,000 124,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 217
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
OWNER_ ~a~rL ~I~ o v`c~ 'rowNSHIP__ff cL: t is~'C . ! .1.,zN- ~t1~w
ADDRESS T ST. CRO 1X COUNTY, W I SCUNS 1N -
It 2 ~ Wrd t r ~4~1
SUBDIVISION LOT__ LOT S1LL _ _ -
PLAN VIEW
Distances and dimensions CO meet requirtwejits of Hb3
10V 9-12e IV, VWVT141N(-; W13:HIN IOU "I' OF SYSTEM
_TT
FT i
-
F S
r a
r Q
t
I di a e o th, Arrow I
SCAL
BENCHMARK: (Permanent reference Point) Describe: /'f•w Cn~~c~St~e,~. T,p p,
Elevation of vertical„reference point: t:.416)0 Slope at Site.
SEPTIC TANK: Manufacturer: powe,•~ P,tio_ Liquid Cd},a~iLy: _16~ t
Number of rings on cover z Tank manhole cuver elevaLiun
Tank Inlet Elevation: 10 Tank Dut1LL l:levatiun.
PUMP CHAMBER Manufacturer: _ Number of gallons
Dumber of gal . p -ii set__fdrii cycle
sifballon5 rot a- CaP A: i t y 0 pump_______ Ilt-il I . distribution lines gallon; ze of
nau►c Of t,umN gallon per minute horsepower brand-
and model number
Type of warning aev ce _
HOLDING TANK: Manufacturer _ Number ut gallut►,,
Elevation of manhole cover_
Type of warning device
SEEPAGE PIT SIZE ~ -Nun►bei' of Nits Peer. diafficLer
feet.. liquid d~p_ 8eepa,3e Pit inlet
bottom of eaepa4epit e~avat. ~on _ feet
SEEPAGE BED SIZE: number of linos ~ ~ - wiolt.h _l:di►gth 6.i 1, ~i~:t,i_t► ~a SEEPAGE TRENCH. width le►ib~ cl1 _
PERCOLATION RA'rE 4 3,~I IREA REQUIRED /1~5 _AREA AS _4UT1 T::yZa_S'
I NSI'h:CTOtt
DATED S y PLUMBER ON 1 13
I.iCEN5E NUMIiEK (v
~y
DEPARTMENT OF IvCL STRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS r'
/ DIVISION
P,O. BqA 7969 BUREAU OF PLUMBING
rv1AbISON, WI 5;707 t
]CONVENTIONAL _ ALTERNATIVE $rJI::PhnlnNumhrr
111 Jss,gnrrl
I Holding Tank In-Ground Pressure L_ Mound
NAME I;F PFFMiT )t l 7ADLIPUiSQF -E RAAR MCLDER ( IN$PECTICV L )ATE
RE CP MARK rv~,men~r; •e'v.nn[c Inll CESf.R IRE IF Inl r r r., N I F ROb, VLaN REF. PT. ELEV CST REF. PT ELE4'
~ r •
N ~ ,.I PI, •rtw [MP , h,PRS'N N+: S-,,.,,, Perm., Ndmb.,
I'
f- ~ - oloz
S_EPTIC TANK/HOLDING TANK:
r,, r. r:IUF ACi~IPElt ILIOUID CAP1f.IT,, lr•1 Y: r. L' ELF: i'ANI, 011 - 1t'ARN NCi LA4iF F-
~ 4'-tr1J'LiFD P;VILIEJ
H_ooING vEVTnla vFVrr,rAn IML,4 /A_c YES FINO ~YE NO
NUMBER F IFGA C' )'F. ER ti ESL r ILL WI, E,n cIRt YFI
YES L_.NO (FEET EST- I----
L IYES i NO NEAREST--- 4
DOSING CHAMBER:
d=GJi I•IG li :.P.^,i.l l' v.➢, '611 SIi4L F'.1,, _J: a•..t.'.r:I.l: u4F+ WAPNI J:, Lti3EL. JL;)('K~IQG COVEP
F,VDED
YES LINO YES NO L-1 YES 1N0
LA ONS PER CYCLE FL,mv.;vDC:)NTPOLSOPERnT"~N°'L NUMBER OF ;T, 1", 71 111A, nrl . r,r roFZ_sR
ERENCE BETWCCN FEET FROM AIR INLET
ON`AND OE F; YES _ NO
(NEAREST I
SOIL ABSORPTION SYSTEM. Check the so l lnolsture at the depth of plowing
FOR
~;I xcavann I I` soI! cap he rolled into a'r;ire, construction shall cease until ~.E
J `
I~ sc II Is -_n:-Lqh to contirue.,I MAII I '
CONVENTIONAL SYSTEM:
ILI'. T, WI
BED/TRENCH ,xi PIT a:lu, Lnrnl
DIMENSIONS
CISTP PIKE 1ArEFI ^ I NUMBER OF PROFLnT IVE'.. FLLII rM, VFNT l 1 FFF<_-T
:yTtl' ~7• vI>F FEET FROM N 0 n LSD 4IR 'I-FT
V 1 IJ l
l l ( - V Si' ----L - - NEAREST--I
MOUND SYSTEM - r~
r-N'uuttd site plov4red oerp ncf cular to slnpr check The texture of the `ill material for I PROVIDE A DIAGRAM OFSYSTEM
and furrows thrown unslope: mnund systems to make certain that it ON REVERSE SIDE. SHOW ELEVA-
meets the criteria `or medir m sand. TIONS MEASURED.
NO
NO
n:I Fn•a .I n.i r: : L; •n
SOIL COVER .-NO EYES I- NO
DES NO EYES I- NO
.I 41 .'!I', TRF I- II ,ill
I I'• t I
l I YFS LINO OYES LNO :YES NO
(PRESSURIZED DISTRIBUTION SYSTEM:
•t , T'1 Il
BED/TRENCH . A-FF'AI yPAI N4. r,IIA"; i_ L UL "14 l1LL":"/ 41 1 41~_L 7EPTP A4OVE i
EOFNCPES
l
DIMENSIONS IrF
PUMP hrnr.IF::10 DsTR PIPF h1r1NIFOLC YAT -.RIAL Nn -1 71 F CISTF PI-'E i ;T^•IBU- CIr, PIPE M,', I I'+I:.1
I l F',: L _LV J A FI F': PIPES CIA
ELEVATION AND
DISTRIBUTION
INFORMATION = -'E -L1, a•'A': 1:c IL° I VA-FFIAI 'TICAL LIFT cnRRESPONC's r.:
PL V$
F_'NO - - - YES -INO
COrVtME N1 S: 4RM4NENT 1IAFKFP$ O BSERVATION WELLS NUMBER OF iPROPFF+.-Y ['6FIl RIIII IANI
FEET FROM NI
IYES I-'NO _:YES r'NC? NEAREST---io- J
Sketch System on Heta:r in r_,onnty file for aL.dit.
Reverse Side.
. TIF
TI
DILIIR SeD ?IO Is . el a?I ; L1 -
CAA kAll,
I
1
DEPARTNiENT OF L, APPLICATION SAFETY & BUILDINGS
INDUSTRY,, FOR SANITARY DIVISION
LABOR 4iND PERMIT P.O. BOX 7969
HUMAN RELATIONS (PL13 67) MADISON, WI 53707
Attach plans for the system on paper not less than 8312 x 11 inches in size. InCIuJe a plot plan that is dimensioned or drawn to scale. Horizontal
and vertical elevation reference points must be shown. All appropriate separati-ig distances and physical characteristics as specified in chapter
H-63, Wis. Adm. Code, must be shown. An index page or each page must be s gned, sealed and dated by the designer. If designed by a Master
Plumber, the date, signature and license number must be shown. The owners ropy or a legible reproduction of the soil test report must be
included.
Propert Owner: Mailing Ad ess:
r - 71'
Property Location: City, illar or Town;hip: County:
ti '/4 'oS /T ? N/R If (or) W _
Lot Number,: Blk NO.: Su division'Name: Nearest I3oad, tyke or Landmark: State Plan I.D. Number:
,4 ` I K I If assigned)
TYPE BUILDI
Number of
[3 Public" 1:1 Variance' ❑ Other {specify}* Bedrooms:
1 or 2 Family *State Approval Required.
TOTAL NUMBER PREFAB POUREit-IN STEEL FIBERGLASS NEW REPLACE- OTHER
GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify)
SEPTIC TANK CAPACITY f
HOLDING TANK CAPACITY
LIFT PUMP TANK/SIPHON CHAMBER
MANUFACTURER:
n
EFFLUENT DISPOSAL SYSTEM
PERCOLATION RATE ABSORPTION AREA
(Minutes per inch!: PROPOSED (Square feet): 2 New ❑ Replacement ❑ Experimental Seepage Bed C Seepage Pit
1 ❑ Alternative (specify) ❑ Seepage Trench
Water Supply Owner's Name as 'sted on Soil Test Report If other than present owner
Private ❑ Joint C Public
I, the undersigned, hereby assume responsibility for installation of the private st wage system shown on the attached plans.
Narryj of Plumber: Signature: MP/MPRSW No.: Phone Number:
P umb is Address' Name Designer:
- y - J , % ) S
4
COUNTY/DEPARTMENT USE ONLY
Sig ature of Issuing Agent: Fee: Date:] APPROVED Sanitary Permit Number:
_:J ❑ DISAPPROVED
Reason for Disapproval:
Alternate course(s) of Action Available:
Change of ownership, building use or plumber requires a Sanitary Permit Tr nsfer Form (67-T) to be submitted to the county prior to in-
stallation. Failure to comply will void the sanitary permit.
DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Gold3nrod-Plumber
DILHR-SBD-6398 (N.03/81)
DEPARTMENT OF REPORT ON SOIL BORINGS AND SALFTY & BUILDINGS
INDUSTRY; DIVISION
H HUMA HUMAN RELATIONS PERCOLATION TESTS (115) MADISON, WI 53707
(H63.09(1) & Chapter 145.045)
LOCATION: SECTION: TOWN HlPrly"UNICIP[Y LOT NO. BLK.NO.' SUBDIVISION NAME:
R, Pori YY I~~Lt - ti Y /T-1C NI
UUINT//Y O NE 'S!BUYER'S NAME: MAILING ADDRESS:
USE DATES OBSERVATIONS DE
~v NO. BEDRN4S, C MM R AL DESCRIPTION: IPHOFILF Df-SCHIPTIONS: 1PERCOLATION TESTS:
-7Residence ®Ne,.v ❑R,•place
RATING: S= Site suitable for system U= Site unsuitable for system CO~ 7NV -N STIT . MEIS EU IN-G[I S Pa 'URE: SY~STEM-IN-FILL Ht IN:; PJK:IRECOtv~AqEr EDU SYS]
ptiona r -
ul Percolation Tests are NOT eyuired DESIGN RAT If any portion of the tested area is in the de r s.1463.09(5)(h), indicate: Floods lain, indicate Floodplain
elevation:
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-1NCHES CHARACTER OF SOIL WITH THICKNFSS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED __-EST. HIGH sT TO
BEDROC< IF OBSERVED iSEE ABBRV. ON BACK.)
B- ~2
B_ IV A
t 51, 5 Y2 ~2, Z
PERCOLATION TESTS
TEST DEPI H WAI ER IN HOLE TEST TIME DROP IN .HATER LEVEL-INCHES RATF PPINU I ES i NUMBER INCHFS AF I eR SWELLING
INTERVAL-MIN- PEatOot P on PERign 3 PER INCH
77
P n !`f W s j''r,~' PG' y yl - ~3 7
D_
i 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-
;on:al and vertical elevation reference points and show their location on the plot plan. Siow the surface elevation at all borings and the direction and percent of land slope.
SYSTEM ELEVATION . Tt, ¢ r• y~
> 3~-T--- ;
~-rte ~ t ---//47 rb ~ 1~d
3
I
I, _he undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and meth-ds seacif ed in the Wisrn
Administrative Code, and that the data recorded and the location of the tests are correct to th best of my knowledge and be,irt.
N :\N11E fpr' t): - -TESTS WERE COMPLET=E, DP•J
_di~'~rr ADDRESS: _ CERTIFICATION NUMRFR: JPHONE NUMBER(uptional)
'21r 06
T /~TUHE~
:RIBUTION: Original and one copy to Local Authority, Prow)i,y Owner a
T be a rnmolete and ac
, . Ca)inpleta !egai descripli,
The use section .oast cleMAXIMUM -umber of b htiu rr, u
his a i or replaceme.nt systen;; -nplete the suitabi';ty ratirq boxes.. A SITE IS SUIT:
HER SYSTEl~9S Alit RULED OUT BASED ON SUIt Ci)NUII ICJ','
:HSE use the abhviw> itions shown here ivr %tili!~y profi,e d2,cripti
,Kr_ A LEGIBLE dia!.ram acculaNdY loca`incl your test Iccaliors. U
mate ;h~~r Ine'y~ =re. ust (l i` desired;
. :UIC y-w b! nchn-iaric P.nd VEI'ICal ul:'Vallu:'' Ie{e-1ce {)ninl ar0 clearly shown, and are permnnr-
:Ie al: iwpi opriatp boxes as to dates, names, adtJre>se,, flood plain data, percolation t
al?pro tit late; ')`Ol Tlat!on !.Buell as flood plafll• O'.'VatiunI djps not apply, p°ac.v N.A. to the, applrprta,
fl:rnl a!,d of.jc^ Yl,ur c.:rrent address and yowl CC' ti`
=r' , ;?i}~c CI!<tt'.')!1'2? frC;~. t1rf'rI. %al. 1.
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Parcel 026-1014-10-000 05i13~20C5 09 39 AN4
PAGE 1 OF 1
Alt. Parcel 4.30.18.49D 026 - TOWN OF RICHN10ND
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): ' - Current Owner
JOHN D & MARY A SMASAL ANDERSON i R ANDERSON, JOHN D & MARY A SMASAL
1710 112TH ST
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 1710 112TH ST
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 2.540 Plat: N/A-NOT AVAILABLE
SEC 4 T30N R1 8W LOT 1 CSM V 4i1028 Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
04-30N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
0763!1997 984!249 - WD ; -
07673!1997 _ 984!248 CIC
l 07/23,1997 - 735!52
2004 SUMMARY Bill Fair Market Value: Assessed with:
19634 1921,500
Valuations: Last Changed: 06;19/2002
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.540 42,800 131,900 174.700 NO
Totals for 2004:
General Property 2.540 42,800 131,900 174,700
Woodland 0.000 0 0
Totals for 2003:
General Property 2.540 42,00 131,900 174,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 210
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00