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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 O - DUNN, RANDI & FELICIA RANDI & FELICIA DUNN 1748 CTY RD Z HAMMOND WI 54015 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 5.000 Plat: 3438-CSM 12/3438 SEC 4 T28N R1 7W PT SW SW FORMERLY LOT 4 Block/Condo Bldg: LOT 6 CSM 11/3090 NKA LOT 6 CSM 12/3438 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 04-28N-17W Notes: Parcel History: Date Doc # Vol/Page Type 02/02/2000 617795 1487/576 WD 06/01/1998 580106 1327/626 WD 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 04/08/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 42,600 147,800 190,400 NO Totals for 2006: General Property 5.000 42,600 147,800 190,400 Woodland 0.000 0 0 Totals for 2005: General Property 5.000 42,600 147,800 190,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 157 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 I 'MPORTANT ME FOFZ SSAGE DATE / TIME - J-Js P. M. M N4. OF PHONE ❑ FAX AREA C pE NUMB q MOBILE EXTENSION AREA CODE NUME3 FR TELEPHONED TIME To CALL CAME TO SEE YOU PLEASE CALL WANTS TO SEE YOU WILL CALL AGAIN RETURNED YOUR CALL RUSH M SPECIAL ATTENTION MESSAGE SIGNED FORM 3002P LITHO IN U.S.A. NELSON PLUMBING-' PLUMBING & SEPTIC SYSTEMS *******i 122 E. Summit Avenue err Ellsworth, WI. 54011 (715) 273-4444 0 (715) 273-4446 ( ~ LS r +Lf 2c~C~" DATE: ? - TO: - ~ / - FROM: - Number , c4 ` IF CO 7 PLEASE CONTJ NAME: TELEP NELSON PLUMSINGo-4 PLUMBING & SEPTIC SYSTEMS 122 E. 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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 O - DUNN, RANDI & FELICIA RANDI & FELICIA DUNN 1748 CTY RD Z HAMMOND WI 54015 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 5.000 Plat: 3438-CSM 12/3438 SEC 4 T28N R1 7W PT SW SW FORMERLY LOT 4 Block/Condo Bldg: LOT 6 CSM 11/3090 NKA LOT 6 CSM 12/3438 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 04-28N-17W Notes: Parcel History: Date Doc # Vol/Page Type 02/02/2000 617795 1487/576 WD 06/01/1998 580106 1327/626 WD 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 04/08/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 42,600 147,800 190,400 NO Totals for 2006: General Property 5.000 42,600 147,800 190,400 Woodland 0.000 0 0 Totals for 2005: General Property 5.000 42,600 147,800 190,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 157 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 PLEASANT VALLEY- RUSH RIVER T2$ N7R,17 W 19 F e Q~de ✓ • Cb v • c~ • SEE II PAGE 3/ Kr.Eh f ~ y¢ tl Q y\ o~ a a • L:/oaon f se f• 1 I Da. tee. » y Y~, \ a C ^J y ~ y ^I -a o x wa e Char/ene aCi 9 Pvew G~.r~ 2 r °9e a . h'a~>~so./ \ \ A C v Ctll ~ y C T v " ~ C a/ _s R m ©a/d .n ~ s ~¢rro Lo°c,E • M ,n.ttdo t tl I Qh/ t .396 e yep 9e / .i7 9i 0 b 4\i b y l` W ~5 "'N McLou h/. ~ W d' ~ ~ b J ~ /d . ~ ~ p 0 Faxm~ ~°is ~ /z v',ows 6.~ -9 ~ ~ ~l ~ ~'v d Q'Q ~ Thon ,son /40.36 CTahn 4. ~ \ p .2a/P /s La/cain~ qC Q 0 ~ O/san /rB >s 99~ Cai'/ J Mec~~tf a ~ az.s Fossma ~ 0, 94 Ba. 19 ~ AS /39_ s7 h ~ //e.- Qr> l tl 1 ~Dac dd 73.64 b ~ f Lei res \ ~ 3s d a • 0 h /tee%r>buch Y~ v Thompson a C Cv 0 e tl Ai f'ea6odY \x 7B Z4 zso y,0 ~C'tlC F/a~ Jarne~ E • /z/ we ~ C~ v ~9y o ~ L / Cvv,~~ ~sb. 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RUSH RIVER TWP. 2812 MALL DRIVE OFFICE 717 MAIN STREET EAU CLAIRE, WISCONSIN ST MENOMONIE, WISCONSIN AABY °J FEDERAL SAVINGS Business: 273-4945 113 True Value - AND LOAN ASSOCIATION Residence: 273-4155 REALTOR' - Hardware - Car: 792-2732 DAR-RAY Realty© 344% 19 EAST GRAND AVENUE Raymond Huppert Authorized PAINTS EAU CLAIRE, WISCONSIN Dealers 207 NORTH BRIDGE STREET 372 WEST MAIN STREET 332 West Main Street 698-2377 CHIPPEWA FALLS, WISCONSIN ELLSWORTH, WISCONSIN Ellsworth, Wisconsin 54011 Woodville • REPORT 01 INSPECTION - INDIVIDUAL SELVAGE SYSTEM S a vi ti. ,t a it i P e !r rn,i_ t Sate Septtic i" 1! Q /Q TownsUp A/. V S.t. Cif u i x Coun ty 5L( - -Scc,t.i.on Lot N Subdivi.eion I'[ IC TANK Si Ze_~___ _ gal_lon,5 Numbeh. o6 compaAtme-nxA tanc(, (nom: G1elQ_- 8u~.~ding_ 120 Elope H~ghwa.ten . 1)1NG ('11 AM131 R Si Ze gaflonh Pump Manu6ac-tuhen Model Nurnbe-~r IDING TANK )izc gal.f'on,5 Numbers oA Corn.pahtrnent5 A. ahm Sy t te.m Lance 6&om, WeU. Bu.i.Cding _ 12 0 6tope_______ . Nighwa-teh. ,,ORPTION SITE k;c'd Thench ti to nce {nom: LUe,el Bu,ild,in.g---- r2~ elope- Highwa.te n 'SORPTION SITE DIMENSIONS width o{ tnene.h_ t Requ~n.ed anea (~t I eoij th (16 each_ k..i n.e._-_ -At Depth oA kock below -tile <n Depth oA hock oveh ti (e ~.n Iota, eengfih o6 l.i.ne.e _6,t Depth o6 t,il.e below gnade -n DiAtance be,twee,n. Uviee 6t Sfope 0A .tneeneh l-n. pen 100 t o l u 1 l L J 1L J ((UYt arse a rrt _ {t Type oA Cove-n: Papers ah a 01 MA) I UIMINSIONS Gnavel anound pi.tb Yee nu oli to i de di ame tchl 6t Depth be.tow t nl-e t 6 t IottzP ab5onp,ti-on anea_ _6t Area ~~equined 6.t ;/,I CTED by TITLE PROVED "DATE 198 It CTID DATt 198 1ti0N IoR RE_IECTION EH 115 v Rev. 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS ' WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES- BOX 309, MADISON, WISCONSIN 53707 P.O. LOCATION:. l' ''/a,71'/%, Section Te!N RZE or Townshi or Munici alit ` l ~ p p Y Lot No. , Block No. County 0 I 'A ' b ivision ame Owner's/Buyers Name: lh6mq d S'!4 Mailing Address: C' TYPE OF OCCUPANCY: Residence _No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEWXREPLACEMENT -ALTERNATE SYSTEM q OTHER DATES OBSERVATIONS MADE: SOIL BORINGS 6.11. PERCOLATION TESTS &,y- / SOIL MAP SHEET-_NAME OF SOIL MAP UNIT C~ PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN BER 1STWETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 r P_ s, . P- P- P- SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, MOTTLING AND DEPTH TO BEDROCK NUMBER INCHES OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES 13- B- 113- tic PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location asquare feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy ,Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. 9,v10C, ` GY 4e, F5.A14 46 i 4_ 4 /a re--. F1e &.aa d s t,~,ke 41 ~i ~v o r°t ^ t clC.s rv S 4 96m c. d be toI,:eA at -nor o) , N , n e M ~ i I { { ; E 9.._ 8t... 3 ¢ S I, the undersigend, hereby certify that the soil tests reported on thil"O were fade bye a ~dCco'r' with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location f test holes are correct to the best of my knowledge and b elief. 4-1-1 e_1 7 `7 Name (print) Certification No.._ Address O t .Name of installer if known Copy A CST Signature -Local Authority -,did State and County State Permit #L PLB 67 ( Permit Application County Permit # D for Private Domestic Sewage Systems County j *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: 61 J hq B. LOCATION: '/4 Tkti '/4, Section __L, T,r N, RZ E (or) 1V Lot# City Subdivision Name, nearest road, lake or landmark Blk# ry Village Township 6-5 i+lT GL?/'r C. TYPE OF OCCUPANCY: 'Commercial *Industrial *Other (specify) *Variance Single family X Duplex No. of Bedrooms No. of Persons 3 D. SEPTIC TANK CAPACITY GG~= Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete - Z Poured-in-Place Steel Fiberglass Other (specify) New Installation k Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate- ~ Total Absorb Area , S sq. ft. New A Replacement Alternate (Specify) Seepage Trench: No. of Lin-~egIl Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed:---X-Length WidthZ e-'_Depth l2 Ji Tile depth (top)~_No. of Lines -:3 Seepage Pit: Inside dia5eter Liquid Depth No. of Seepage Pits Percent slope of land-r_% Distance from critical slope C' WATER SUPPLY: Private ❑ Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Certified Soil Test C.,* NAME A C.S.T. # VIC' and other information obtained from (owner/builder). y Plumber's Signature MP/MPRSW# 3r~..~~J Phone Plumber's Address 47 PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. f ~ I 3 r , s { r j i E a 1 c F ~ I Do Not Write in Space B ow - FOR COUNTY AND STATE DEPARTMENT USE ONLY G Date of Application a l.2 j ees aid: State County ~te, Pe rmit Issued/ e' ted (date) l Issuing Agent ame ' Inspection Y No State Valid# Date Recd 1. county white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state X ink copy) 4. plumber (canary copy) Revised Date 7/1/78 -rho mgs Pqyis t ~q ~Il N Free Div n f' . -S•cale ~~=~v~` Li 11 U~- Drilled ~~~~4 nz 000 ~ a St'~Y ~C