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Parcel 026-1014-60-000 12/12/2005 05:17 PM
PAGE 1 OF 1
Alt. Parcel 4.30.18.50E 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): O = Current Owner, C = Current Co-Owner
O - JOACHIM, LARRY R & DIANNE K
LARRY R & DIANNE K JOACHIM
1141 173RD AVE
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): = Primary
Type Dist # Description 1141 173RD AVE
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 1.860 Plat: N/A-NOT AVAILABLE
SEC 4 T30N R18W 1.86A SE SW LOT 2 OF CSM Block/Condo Bldg:
5/1306
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
01-30N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 953/253
07/23/1997 920/36
07/23/1997 741/521
2005 SUMMARY Bill M Fair Market Value: Assessed with:
95397 223,300
Valuations: Last Changed: 06/19/2002
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.860 38,700 152,800 191,500 NO
Totals for 2005:
General Property 1.860 38,700 152,800 191,500
Woodland 0.000 0 0
Totals for 2004:
General Property 1.860 38,700 152,800 191,500
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 223
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
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Parcel 026-1014-60-000 10/26/2009 11:17 AM
PAGE 1 OF 1
Alt. Parcel 04.30.18.50E 026 - TOWN OF RICHMOND
Current 'X1 ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
LARRY R & DIANNE K JOACHIM O - JOACHIM, LARRY R & DIANNE K
1141 173RD AVE
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 1141 173RD AVE
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 1.860 Plat: N/A-NOT AVAILABLE
SEC 4 T30N R18W 1.86A SE SW LOT 2 OF CSM Block/Condo Bldg:
5/1306
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
01-30N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 953/253
07/23/1997 920/36
07/23/1997 741/521
2009 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 09/09/2008
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.860 47,900 174,700 222,600 NO
Totals for 2009:
General Property 1.860 47,900 174,700 222,600
Woodland 0.000 0 0
Totals for 2008:
General Property 1.860 47,900 174,700 222,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 223
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 026-1014-60-000 12/28i2005 10:47 AM
PAGE 10F1
Alt. Parcel 4.30.18.50E 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): O = Current Owner, C = Current Co-Owner
O - JOACHIM, LARRY R & DIANNE K
LARRY R & DIANNE K JOACHIM
1141 173RD AVE
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ` 1141 173RD AVE
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 1.860 Plat: N/A-NOT AVAILABLE
SEC 4 T30N R1 8W 1.86A SE SW LOT 2 OF CSM Block/Condo Bldg:
5/1306
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
01-30N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 953/253
07/23/1997 920/36
07/23/1997 741/521
2005 SUMMARY Bill Fair Market Value: Assessed with:
95397 223,300
Valuations: Last Changed: 06/19/2002
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.860 38,700 152,800 191,500 NO
Totals for 2005:
General Property 1.860 38,700 152,800 191,500
Woodland 0.000 0 0
Totals for 2004:
General Property 1.860 38,700 152,800 191,500
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 223
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
y AS BUILT SANITARY SYSTEM REPORT
OWNER _ TOWNSHIP SEC. '1'IN -Rj W
ADDRESS ST. CROIX COUNTY, WISCONSIN.
SUBDIVISION LOT LOT SIG,E _
h PLAN VIEW
Distances and diiiicnsions to meet requirements of H63
SHOW EVERYTHING WITHIN 900 FE'T F SYSTEM
~S
~ i
G ;
N 11J,
y
Indic at N r h rrc w
7
IL
BENCHMARK: (Permanent reference Point) Describe : ✓l!~ io ~~„~G~ ~iT~/
Elevation of vertical referen e point. Slope at site:
SEPTIC TANK: Manufacturer: Liquid Capacity: A
Number of rings on cover Tank manhole cover elevatio ,e
'l'ank Inlet Elevation: Tank Outlet Elevation:. /
PUMP CHAMBER
Manufacturer: Number of gallons _
Number of gal. pump set for a cycle ----gallons; Total capacity of
distribution lines gallon: size of pump-- head;
gallon per minute - horsepower
and model. number _
Type of warning device
HOLDING TANK: Manufacturer---- umber ul bailuu_Elevation of manhole cove;
'T'ype of warning device
SEEPAGE PIT SIZE; Number of pits - feet diameter
feet liquid depth` _ seepage pit inlet pipe-elevation
bottom of seepage pit elevation feet.
SEEPAGE BED SIZE: number of lines- _ width- length tile depth
SEEPAGE TRENCH; wid h e~gth
PERCOLATION RATE AREA REQUIRED AREA AS BUILT
INSPECTOR
DATED - - PLUMBER ON JOB
LICENSE NUMBER / _
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O. 6sJX 7969 BUREAU OF PLUMBING
MADISON, WI 53707
NCONVENTIONAL ❑ALTERNATIVE State PlanLD.Numben
Y (lf assigned)
❑ Holding Tank ❑ In-Ground Pressure ❑ Mound
NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER. INSPECTION DATE.
Bernard Kopp RR# 2, New Richmond, WI
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN REF. PT. ELEV.: CST REF. PT ELEV_
SE SW, Sec. 4, T30N-R18W, Lot 2, Town of Richmond
Name of Plumber. JMPIMPRSW No.. County_ Sanitary Permit Number_
Cal Powers 1563 St. Croix 38518
SEPTIC TANK/HOLDING TANK:
G LABEL LOCKIN COV
MANUFACTURER ILIQUID CAPACITY. JTANK IN T ELEV A OUT ET ELEV.. )KED
PROVI ES ENO ❑
BEDDING: VENT IA.. VENT MATL. HIGH W ER NUMBER OF ROAD. JPROPERTi' WELL BUILDI G. VENTTO ESH W4 ALARM FEET FROM . L n
f!~ / AIR NL
❑ YES NO / NO NEAREST l L L
DOSING CH ER:
MANUFACTURER 7EYES GJLIOUID CAPACITY JPUMP MODEL JPU MPiSI N MANUF RER WARNING LABEL LO1 PROVIDED PENO DYES ENNO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. UM ER OF PROPERTY WELL ILDING I VENT TO FRESH
(DIFFERENCE BETWEEN FEE FROM LINE AIR INLET
PUMP ON AND OFF) DYES NO NEA EST
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGT DIAMETEH MATERIAL AND MARKING
or excavation. (If soil can be rolled into a wire, construction shall cease until OR
the soil is dry enough to continue.) AIN
CONVENTIONAL SYSTEM:
WIDTH. L GTH NO. OF DISTR. PIPE ACING; COV INSIDE DIA.
BED/TRENCH TRENCHES E6~~ PIT DEPTH.
DIMENSIONS j
GRAVEL DEPTH FI I 111PTH 1111TH. PI F DISTR. PIPE DISTR. PI MATERIAL. O. NUMBER OF PROPERTY WELL. BUILDING: VENT TO FRESH
BELOW PI FS AB E COVER E V N IF ELEV. END' PIP LI 7 AIR INL T
FEET FROM L,
5-INEARESr----►
'''U 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-
meets the criteria for medium sand. TIONS MEASURED.
DYES ENO
SOIL COVER TEXTURE PERMANENT MARKERS JOBSERVATION WALLS
DYES ENO EYES ENO
DEPTH OVER TRENCH BED DEPTH OVER TRENCH: BED DEPTH OF TOPSOIL. SODDED SEEDED. MULCHED
CENTER EDGES
EYES ENO OYES ENO DYES ENO
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 MANIFOLD MATERIAL. NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING.
ELEV.. ELEV.. DIA. ELEV.. PIPES DIA..
ELEVATION AND
DISTRIBUTION
INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
DYES ENO DYES ENO
UMBER OF PROPERTY WELL BUILDING
COMMENTS: PRMAN ENT MARKERS OBSERVATION WELLS ]NEAREST
EET FROM LINE
ES OYES ENO 0-
SL A - CY~
I)Ji
l (J
f~'d~h In CO n a d
Sketch System on
Reverse Side. 'J~-rvr~~
T IfE,
71 SIGNA
lam. I
DILHR SBD 6710 (R. 01/82)
mi'wisconsin APPLICATION FOR SANITARY PERMIT _
®ILHR ~-COUNTY
(PLB 67)
~ - IonEOCURSRTTRmVE,LnRT SoOf R&HUR1Rn O UNIFORM SANITARY PERMIT #
-Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'/zx 11 inches in size..
-See reverse side for ins ructions for completing this application. PLEASE PRINT
PR ERTY OWNER MA ING ADD SS a )
-lnJ G}1; ~C-~ J
PROPERTY UCA I ION CITY:
( VILLA ,GE:
1/4 1/4, S , N, R (or) W wN oF:
LOT NUMBER BLOCK NUMBER SUBDIVI ION NAME NEARES ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER
io O
TYPE OF BUILDING OR USE SERVED
1 or 2 Family Number of Bedrooms: 3 ❑ Public (Specify):
THIS PERMIT IS FOR A:
New System ❑ Tank Replacement ❑ Repair
❑ Replacement Soil Absorption System ❑ Revision ❑ Privy
❑ Alternate System ❑ Reconnection ❑ Petition for Modification
IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK.
Z Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank
System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy
❑ Existing, For Which A Previous Permit Is On File, Permit # issued
An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions.
Total #of Prefab. Site Steel Fiberglass Plastic
Gallons Tanks Concrete Constructed
Septic Tank Capacity
Lift Pump Tank/Siphon Chamber
Holding Tank capacity
Manufacturer:
IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure
Total # of Prefab. Site Steel Fiberglass Plastic
Gallons Tanks Concrete Constructed
Septic Tank Capacity
Lift Pump/Siphon Chamber
Manufacturer:
PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY:
(Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet):
Private ❑ Joint ❑ Public
I, the undersigned, hereby assume responsibility for installation o the rivate sewage system shown on the attached plans.
Na of Plumber (Print'Sign u e MP/MPRSW No.: Phone Number: /
1 G ' ~2 3J
P umber's Address. 7 rNarrpf 14)l 7
COUNTY/ DEPARTMENT USE ONLY
Signatu a of Issuing Agent: Fee: Date: El Disapproved
❑ Owner Given Initial
Approved Adverse Determination
Reason for Disapproval:
Alternate course(s) of Action Available:
DILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber
INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398
To be complete and accurate the permit application must include:
1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in
a city, village or town);
2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant,
etc.);
3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks.
4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of
square feet to be installed;
5. Complete the section on water supply;
6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi-
fication, place your license number in the space provided and sign the permit in the signature block;
7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the
permit;
8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation.
Failure to comply will void the sanitary permit.
9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable.
10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system,
depth of the system, type of system.
11. All revisions to this permit must be approved by the permit issuing authority.
12. A complete plan including a plot plan, drawn to scale or with complete dimensions.
13. Horizontal and vertical elevation reference points that are permanent and clearly shown.
14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s)
to system, building sewer and vent observation pipe(s).
15. The permit issuing agent may require a cross section drawing of the effluent disposal system.
TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems
must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning
your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin.
Vr-
Dorm - S T C 100
Owner of Property
Locatiuu of Property 4
Township ~l
M a i l i n g A c! d r e s6
S u b d i v i s i o n N a ui e
Lot Number-_
Previous Owner of Property_ e `
Total Size of Parcel
Date Parcel Was Created /Uj -
Are all corners identifiabl- Le
Yes N u
[aclude -w_LtII this ahht) <II ton o)ie o1_the 1 oiluw_iI-6
Certified Survey Map
. Deed
.Land Contract, or
Other Legal Document which describes the property
PROPERTY OWNER CERTIFICATION
I (We) certify that all statements on this form are true to the best of my (our)
knowledge; that I (we) am (are) the owner(s) of the property described in this
information form, by virtue of a warranty deed re or n the Office of the
County Register of Deeds as Document No.
presently own the proposed site for the sewage disposal system d(or~I (we) have
obtained an easement, to run with the above described property, for the
construction of said system, and the same has been duly recorded in the Office
of the County Register of Deeds, as Document No.
SIGNATUNE OF OWNEq _ _
SIGNA'rUHE OF C WNLN (IF gPPLICAdLE)
4,37
DATE SIGNED
DATE SIGNED
I,c -,cvfiz /V,
DEPART E(, F REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS
INd~USTR, Y • DIVISION
LABOR'AND PERCOLATION TESTS (115) P.O. BOX 7969
HUMAN RELATIONS MADISON, WI 53707
(H63.09(1) & Chapter 145.045)
LOCATION: SECTION: TOWN HIP/MLAICIPALITY: LN
.:BLK.,NO.: SUBDIVISION NAME:
1/ /T~> N/RiR (or)W f,
COUNTY: OWN R' /BUYER'S ME: MAILING ADDRESS: /
'
USE -
DATER OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: ~j [PROFILE DESCRIPTIONS: PERCOLATION TESTS:
Residence New ❑Replace
RATING: S= Site suitable for system U= Site unsuitable for system 7
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK: RECOMMENDEDSYSTEM: (optional)
os ❑u s ❑u os ❑u as au os ou ^f
ElfPjercolation Tests re NOT required DESIGN RATEt If an
CI y portion of the tested area is in the
63.09(5)(bl, indicate: Q Floodplain, indicate Floodplain elevation:
>/1; ti~lA
PROFILE DESCRIPTIONS
BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
_s
B-
7 0
B-j/
S
PERCOLATION TESTS /~tiG+(~iJ S7
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERI D 1 PERIO 2 PERIOD 3 PER INCH
P_ / -
i j
P_ :I
s' 41114)!-- / 3
P-
P-
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
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.
SYSTEM ELEVATION
/t/*jCCrha
44ic"l Iml- ,aat11 ~;cr /~sr ~/QD o ~ ~m F
r E '
A I
m r-- -
.
i
1✓
•eJ~~ =1 7 m
3
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.
NAME (pr nt):
TESTS WERE COMPLETED ON:
ADD ESS: CERTIFICATION NUMBER: PHONE NUMBER (optional):
CST N/TUR
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
D!LHR-SBD-6395 (R. 02/82) -OVER
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6EARIN01 ARE REFERENCED ALONG
THE •OUTH LINE OF THE SW 1/4 OF
SECTION 4-30-18, ASSUMED TO BEAR r
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VOLUME PAGE
CERTIFIED SURVEY MAP$
v CD ST. CROIX COUNTY. W 1,
SURVEYORS CERTIFICATE
I, Allen C. Nyhagen, a registered hand Surveyor, herab,y certify that by
the direction of Gerald Harvieux, I have surveyed, described and mapped
the land parcel which is represented by this Certified Survey Map; -
that the exterior boundary of the land parcel surveyed and mapped is
described as follows:
A part of the BE 1/4 of the SW 1/4 of Section 4, T 30 N, R 18 W, Town of
Richmond, St. Croix County, Wisconsin, further described as follows:
Commencing at the S 1/4 corner of said Section 4; thence N 890-321-35" W 1
along the South line of the SW 1/4, 416.03 feet; thence N 000-51'-00" W,
820.71 feet to the point of beginning of this description; thence continuing
N 000-51'-00" W, 406.76 feet; thence N 840-43'-00" W along the southerly
R/W line of a Town Road, 450.00 feet; thence S 000-511-00" E, 406.76 feet;
thence S 84°-43'-00" E, 450.00,feet to the point of beginning.
That this Certified Survey Map is a correct representation of the exterior
boundary surveyed and described;
that I have fully complied with the current provisions of Chapter
236.34 Wisconsin Revised Statutes, in surveying and mapping same;
'xASCONS
T
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v m CERTIFIED SURVEY MAP$
ST. CROIX COUNTY. WI,