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Parcel 024-1036-20-000 10/16/2006 03:42 PM
PAGE 1 OF 1
Alt. Parcel 30.28.17.231C 024 TOWN OF PLEASANT VALLEY
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
DANIEL E & LINDA E WALTH O - WALTH, DANIEL E & LINDA E
1515 18TH AVE
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 1515 18TH AVE
SC 4893 RIVER FALLS 2 ~3
SP 0100 CHIP VALLEY VOTECH
L
~ ley
Legal Description: Acres: 17.000 Plat: N/A-NOT AVAILABLE
SEC 30 T28N R17W PT OF SW NW LOT 2 CSM Block/Condo Bldg:
5/1213, TOWNSHIP PLEASANT VALLEY.
Tract(s): (Sec-Twn-R:ng 401/4 1601/4)
30-28N-17W
Notes: Parcel History:
Date Doc # Vol/Page Type
02/21/2006 818925 EZ-U
07/23/1997 1096/570 QC
07/23/1997 1096/568 TI
07/23/1997 697/538
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 05/21/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 8.000 75,000 264,700 339,700 NO
PRODUCTIVE FORST LANDS G6 9.000 21,600 0 21,600 NO
Totals for 2006:
General Property 17.000 96,600 264,700 361,300
Woodland 0.000 0 0
Totals for 2005:
General Property 17.000 96,600 264,700 361,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 137
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
J
CMTIFTED `)URV1`,Y MAP
JOHN MAULS
NW COR. SEC.30,T2P,N, fart of tha ;:Totithwe-nt 1/)a of th(:~ Nnrthwost. 1/)l n ;oct,ir)n
R17 W, (COUNTY SURVEYORS
MONUMENT) Tnvrn-hip ,;,o Nlor l h, F nnp-r) 1'j 'sir"a t,, Town Of P1, .1" gilt,
Va_}.1ey, , St. Cr0 ix (,ounty, W~i_,,;connin.
r Inrli.ca t~ 1" 1_ron pipr, (mind
N o lr) icai/ .S 1" x 21r" iron pi.po wc~ighi_nj? 1 .13 _i_n,
VARIABLE WIDTH TOWN ROAD ft,.
' 73,61 UNPLATTED LANDS N LINE SW I/4 NW I/4
• 9' 51 E 1025'.0
692,09' ~ ~~rs r r rn 333.0h
300 _ 661 .84' W- 33030 __u oil
N 89° 36 14 W 1025.14 N
~ e9 , i a~' d
oa
z j w
o I I E~ r
~ M
1 M .
(p I Ar, ~ 0
1 f"~
°N° ( I 45S 89° 36 14 E 361 .48
Oo l I W \ ,~2 G z
- It 0 269 2~ 2 QI
\ N 60
UI P~ M W
O N F
o - LOT 1 21.805 ACRES LOT 2 17.000 ACRES
INS 740,507 SQ.FT_ aI
9 4 9, 821 SQ. F T. 1-
N J
M v I NET _ 19.730 ACRES NET 16, 490 ACRES
~ 859,449 SQ.FT, 718, 283 SOFT. z
OI ° I~
w o co
d IMO LOT i NOT TO BE USED AS A BUILDABLEiN -
z d LOT AT THIS TIME rn
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33.00
w
i/ 713.30' 643.00' z
N 89° 14' 53"W 1389.30'
1/4 COR.SEC. 30, 0 100 200 300 _ 400 500 600 w
26 N, R17W, E/W 1/4 LINE
-OUNTY
URVEYOR'S UNPLATTED LANDS
AONUMENT)
ALL BEARINGS REF. TO THE WEST LINE
OF THE N WI/4 OF SEC.30, T28N, RI7W,
ASSUMED NOO°03'32"E
THIS INSTRUMENT DRAFTED BY LAURENCE W. MURPHY `
SCALE 1" 200'
" JAW" L.
MUPPI IY
Aw /7-
Vol. 1~ P,IFro j mr r,. Murphy w1.
ryor
,:r ,r c rrj'-- r,r,.>c~ l a.nri .,urv,
tifi r~~l :survey ~1 ~p^ F+
LA Croix Cr7,a7ty,scnngin (1).~~'RT fI'~ON ON RFVi~SE)
Form-STC- 104
• AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP SEC. 0 T,°, N-R W
ADDRESS ST. CROIX COUNTY, WISCONSIN
SUBDIVISION LOT - LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of H 63
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
- -
J/ rve l~
11 ~ s~U~n~ ~oa~ o
{
X" ~ k
~ X
INDICATE NORTH ARROW
s
BENCHMARK: Describe the vertical reference point used --t
eVZ.
Elevation of vertical reference point: Proposed j1slop11"4e at site: -S
SEPTIC TANK: Manufacturer: Liquid Capacity: j
Number of rings used: Tank manho e cover elevation:
Tank Inlet Elevation: Tank Outlet Elevation:
r ,
Number of feet from nearest Road: Front,0 Side,~) Rear, O feet
r
From nearest property line Front,O Side, 01 ear, O feet
Number of feet from: well
building:
(Include this information of the above plot plan)( 2 reference dimensions to septic tank)
SEE REVERSE SIDE
PUMXCER
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: Trench:
Width: % Length: Number of Lines: Area Built:--
Fill depth to top of pipe:
Number of feet from nearest property line: Front, O Side,(~/( Rear, O Ft.Z;7/~
Number of feet from well: Jw
Number of feet from building:
(Include distances on plot plan).
I SEEP PIT
Si e: 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
absorbti n sytems? (Check one).
HOLDI TANK
Man facturer: Capacity:
Number of rings used: Elevation of bottom of tank:
Elevation of inlet:
~ l Rear, O Ft.
Number of feet from nearest property line: Front, O Side,
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm anufacturer:
Inspector*
Dated: /
CZ
Plumber on job: License Number:
3/84:mj
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
'LABOR & H.JMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O~BOX 7969, )01 BUREAU OF PLUMBING
MADISON,WI 53707)
LIA ENYCONVENTIONAL ❑ALTERNATIVE State Plan 1. D. Number.
❑ Holding Tank 1:1 In-Ground Pressure ❑ Mound (If assigned )
1
NAME OF PERMIT HOLDER. / ADDRESS OF PERMIT HOLDER:
INSPECTION DATE.
Dan watth. 979 Davit, Hammond, W1 ~o
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.. CST REF. PT. ELEV.
SW NW, Section. 30, T28N-RIN, Town o~ Pte"ant VaUey
Name of Plumber. MP/MPR SW No.. County. Samtary Permit Number_
David B. Pogen-ty 3289 St. Cn.oix 58870
SEPTIC TANK/HOLDING TANK:
MANUFACTURER LIOUID CAPACITY. JTANK INLET ELEV.: TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED.
BEDDING: VEN JV . HIGH WATER C~ r YES ONO OYES ONO
ALARM NUMBER OF ROAD: PROPERTY IWELL. UILDING. ENT TO FRESH
AIR INLET.
/I FEET FROM LI"a ~J IV
WYES ONO li OYES NO NEARE IB ST ~f
DOSING CHAMBER:
MANUFACTURER J BEDDING. LIQUID CAPACITY PUMP MODEL JPUMPiSIPHON MANUFACTURER WARNING LABEL JLOCKING COVER
PROVIDED. PROVIDED:
OYES ONO OYES LINO OYES ONO
GALLONS PER CYCLE: PUMP ANO CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING I VENT TO FRESH
(DIFFERENCE BETWEEN FEET FROM LINE AIR INLET
PUMP ON AND OFF) EYES ONO NEAREST 310 SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH DIAMETER JMATIRIAI AND MARKING
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:
WIDTH. LNO. OF DISTR. PIPE SP/~CING COVER J INSIDE DIA -PITS LIQUID
BED/TRENCH ) „ THEN / MA HIAL. PIT DEPTH. 161 DIMENSIONS 6 ;/14
f
GRAVEL DEPTH FILL DE TH DISTR PIP DISTR. PIPE DISTR. P E MATERIAL. N TR NUMBER OF PROPERTY WELL. BUILDING. VENT TO FRESH
BELOW PIPES ABOVE COYER E NLET EL V ND. pl LINE
E
AIR INLET
o 9 r-
FEET FROM 17d D
n
NEAREST ► U O(D /
33
MOUND SYSTEM:
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 ONO meets the criteria for medium sand. T IONS MEASURED.
SOIL COVER TEXTURE PERMANENT MARKERS JOBSERVATION WELLS
OYES ONO OYES ONO
DEPTH OVER THENCH'BED DEPTH OVFR TRENCH'BED DEPTH OF TOPSOIL. SODDED SEEDED. MULCHED
CENTER EDGES.
OYES ONO OYES ONO OYES ONO
PRESSURIZED DISTRIBUTION SYSTEM:
WIDTH. LENGTH. NO. OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER.
BED/TRENCH TRENCHES
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR. PIPE JMANIFOLD MATERIAL. NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING
ELEV.. ELEV. DIA.. ELEV. PIPES CIA
ELEVATION AND
DISTRIBUTION
INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
PLANS
EYES ONO DYES ONO
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL. BUILDING:
FEET FROM LINE:
DYES ONO OYES ONO NEAREST
Sketch System on Retain in county file for audit.
Reverse Side.
RE. ITITLE.
S
DILHR SBD 6710 (R. 01/82)
DEPARTMENT OF APPLICATION SAFETY & BUILDINGS
INDUSTRY, FOR SANITARY DIVISION
LABOR AND PERMIT P.O. BOX 7969
HUMAN RELATIONS (PLB 67) MADISON, WI 53707
Attach plans for the system on paper not less than 8'/z x 11 inches in size. Include a plot plan that is dimensioned or drawn to scale. Horizontal
and vertical elevation reference points must be shown. All appropriate separating distances and physical characteristics as specified in chapter
H-63, Wis. Adm. Code, must be shown. An index page or each page must be signed, sealed and dated by the designer. If designed by a Master
Plumber, the date, signature and license number must be shown. A legible reproduction of the soil test report or the owner's copy must be
included.
Pro Owner: Mailing Address:
Property Location: 17 City, Village or Towns County:
t/ ~%S. 0 ~T N/R E (o r
Lot Number: Blk No.: Subdivision Name: Nearest Road, Lake or Landma State Plan I. D. Number:
r"'~~ (If assigned)
TYPE OF BUILDING
Number of
❑ PPublic* El Variance* El Other (specify)* Bedrooms:
0? 1 or 2 Family *State Approval Required.
TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER
GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify)
SEPTIC TANK CAPACITY
HOLDING TANK CAPACITY
LIFT PUMP TANK/SIPHON CHAMBER
MANUFACTURER:
EFFLUENT DISPOSAL SYSTEM
PERCOLATION RATE ABSORPTION AREA
(Minutes per inch): PROPOSED (Square feet): New ❑ Replacement ❑ Experimental Seepage Bed ❑ Seepage Pit
1 ❑ Alternative (specify) ❑ Seepage Trench
Water Su ly: Owner's N as Listed on S it Test Report (If othe than present owner):
rivate El Joint ❑ Public I 'A !e I, the undersigned, hereby assume responsibility for installation of the private se ge system shown on the attached plans.
Uam of Plumber: Si na MP/Mo.: Phone Number:
3=-$
71. 12
jjerjs aAddre Na
COUNTY/DEPARTMENT USE ONLY
Signature of Issuing Agent: Fee: / Date: X APPROVED Sanitary Permit Number:
9/ ~D " ❑ DISAPPROVED 54 9 70
Reason for Disapproval:
Alternate course(s) of Action Available:
Change of ownership, building use or plumber requires a Sanitary Permit Transfer 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, Goldenrod-Plumber
DILHR-SBD-6398 (R.07/81)
APPLICATION FOR SANITARY PERMIT
S T 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/contractgr,("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
Location of Property Section , T ~ N - R 7_ W
Township
Mailing Address
Subdivision Name
Lot Number / y
"Previous Owner of Property
T-Total Size of Parcel C-C" z•~6
• Date Parcel was Created
Are all corners and lot lines identifiable? Yes No
7-Is this property being developed for resale (spec house) ? Yes - No
Volume. and Page Number as recorded with the Register of Deeds
INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING:
1. Warran yv Deed
2. Land Contract
3. Other recordings filed with the Register of Deeds Office
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 the Certified Survey Map shall also be required.
PROPERTY OWNER CERTIFICATION
I (we) een.t-<6y that a.i atatemen-te on thia Ao~un ate true to the bat oA my (out)
k.nowtedge; that I am (ano I rnl,610 ( (h I o4 the pnopeA-tcj deanibed in -tW
injo4mat%on Jo4m, by vi tu.e o6. a waAAan:ty deed ,ecnn~cd in the 066ice of the
County Regiz te4 o j Deeds as Document No. and that I (we)
pnaent.by oan the p4opo4ed site ~m the sewage pos ~ys.tem (on I (we) have
obtained an easement, to n.un with the above deaeAbed pnope&ty, bon the
eonattuat%or, 06 said system, and the same has been duty aecoaded in the 06jice
o6 the County Peg"teA o6 Deeds, as Document No.
SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE)
DATE SIGNED DATE SIGNED
H
a
ST C- 105 r
r
a
SEPTIC TANK MAINTENANCE AGREEMENT
0
St. Croix County z
d
a
OWNER/BUYER
ROUTE/BOX NUMBER Fire Number I
I
CITY / S T A T E Z I P
PROPERTY LOCATION,Ci 4, ~CJI,ti Section
~c. T N , R~ W,
I
Town of i-~e 4 St. Croix County,
Subdivision Lot number
I
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. ti
0
E
I/WE, the undersigned, have read the above requirements and agree
to maintain the private sewage disposal system in accordance with x
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.;.,
4
SIGNED
_
i
DATE
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.
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INDUSTRY, TENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRVIRY, DIVISION
HUMAN 7969
'LUMAN,R ELA?IONS \ / PERCOLATION TESTS (115) P.O.MADISON, WI BOX 53707
3707
LO ATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME:
-5 3a /To,? N/R/j E (o
COUNTY: OWNER'S BUYER'S NAME: MAILING EWS:
S
USE 4 ` r l J
NO. BEDRMS.: 7COMMERCIAL DESCRIPTION: DATES OBSERVATIONS MADE
'Residence 3 New [E] Replace PROFILE R ONS: ER OLAION TESTS:
F7-30 7"'3/
RATING: S= Site suitable for system U= Site unsuitable for system
CON TI:Ir AL: MEI S IN-GR~OUOUNDPRESS~IRE: SYSTEM-IN_FILLHpLpING T :RECOMMENDED SYSTEM: (optional)
UU SS RD I
S RU S r-{-2/ui 9 EIS
p
Fun ercolation Tests are NOT required d RATE: SYSTEM EL V.
[Floodplain, any portion of the lot is in the
er s.H63.09(51(b), indicate: v,* indicate Floodplain elevation:
N
PROFILE DESCRIPTIONS /
BORING TOTAL K !A lqL L
NUMBER DEPTH IN, ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICK ESS, COLOR, TEXTURE, AND DEPTH
OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
BB -
S- 41 AvIf ZZ
3 "'aw Is GI " AZ /:P h r
B- 97
"7'1
w ~
B -
Z_ oft, E/ Q Ll/f •rh~drr
B- Al
L ?w
y~~r /fin S 6 fit /3h
B-
PERCOLATION TESTS
TEST R IN
TIM NUM ER IDNCHES AFTER SWELOLING INTERVA MIN. DROP IN WATER LEVEL-INCHES
RATE MINUTES
PERI D 1 PERIOD 2 PERIOD 3 PER INCH
P_
P- Z S'O
P_ 3 s
PLAN VIEW: 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 slop.
SYSTEM ELEVATION 9 y
_ yon
reei
s; ~ rte!
' D ~ot'v~p
17
01
.
36 '
nom'
1410 0
37, w/tiaE SMkc Ht~+' r
ar! ~m ,3m / " ~ p 6on~P~~k
i, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wisconsin
Admimistrative 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:
ADDRESS: V/ V _L_?_ ole 24 f p d x
l CERTIFICATION NUMBER: PHONE NUMBER option~all):
f •~~r O X le.1 CST SIGN 3 RE: 7 5~ 7 J
DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester.
DILHR-SBD-6395 (N. 03/81)
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