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Home My WebLink About038-1163-70-000 n cn p K v 0 CJ r~ v1 o m c m o CD m n 3 (D CD m m v m l ~ 3 # 3 ~ o rt 3 -,J _ ~ C ~ H 0D C 007 cn w O ^ \ (D r) CL 0 FD' b 0 , COD o A7 rt a) F.i• rt V 3 3 N IW = O 0 rt a A W W ~ N W CL H Z 3 a Z i C) r H fD (1 UJ £ [OA co co CD n r- cn OD 00 (n en O G rt O P 3 v w ~ z 0 0 0 N (D cn -0 -4 a ~ ~ m ~ cn cn cn m Z I o. O D N CD ID H y ID fD 00 f-" of 0O 00 cn N r 3 m Q W~ y r\ K oZ : 00 tD zco z v - D m o y o 0 CL :3 a) 0 F), CD CD C W b cn Z) -0a N (D N q C Fi tr1 c AD C m n co Q- Z N - I Vl rt N• W 0 A Z_ CD (D 0 F-, a A Z E OO W A , G Z 3 :-r m (n - H z CD p w ~ Q o - Z3 z a 0 CD N p' A. H IZ, 3- Z • A z N tv O qz, A i O ~ Op W O N 0 0 w 6 a Parcel 038-1163-70-000 12/28/2005 11:40 AM PAGE 1 OF 1 Alt. Parcel 30.31.18.771 038 - 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 Owner, C = Current Co-Owner O - HARSTAD, ERIC D & LYNN A ERIC D & LYNN A HARSTAD 1932 RIVER VIEW LA SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 1932 RIVER VIEW LN SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 4.572 Plat: 0227-CRESTVIEW ADD SEC 30 T31N R1 8W LOT 7 OF CRESTVIEW ADD. Block/Condo Bldg: LOT 07 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 30-31N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 761/200 07/23/1997 715/259 07/23/1997 661/246 2005 SUMMARY Bill Fair Market Value: Assessed with: 120012 187,200 Valuations: Last Changed: 10/13/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.572 44,900 139,100 184,000 NO Totals for 2005: General Property 4.572 44,900 139,100 184,000 Woodland 0.000 0 0 Totals for 2004: General Property 4.572 44,900 139,100 184,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 306 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIPO~~i P SEC. T~/N-R/~W ADDRESS CLCm, ST. CROIX COUNTY, WISCONSIN. 9=:4~z,;)ILOT SUBDIVISION LOT SIZE PLAN VIEW Distaoces and dimensions to meet requirements of H63 W- EVERYTHING WITHIN 100 FEET OF SYSTEM 3` IT 00, 0, LoF o 10, I di ate or,tn A rc7}~ , SCALt; : i' BENCHMARK: (Permanent reference Point) Describe: OwAilI~V`C.91' Elevation of vertical reference point: Slope at site: SEPTIC TANK: Manufacturer: 9f,''A'S (w►C%: r"r~ Liquid Capacity: Number of rings on cover : Tank manhole cover elevation: s Sa Tank Inlet Elevation: d__3 Tank Outlet Elevation: /n z.-or PUMP CHAMBER Manufacturer: Number of gallons Number of ga . pump set or a cycle gallons; total capacity o distribut' n lines gallon: size of pump head; gallon r minute horsepower brand name of pump and m el number Ty of warning device - HOLDING TANK: anufacturer Number of gallons Elevat' of manhole cover Typ 'of warning device SEEPAGE PIT; E: um er o pits feet diameter feet uid depth seepage pit inlet pipe-elevation bot m of seepage pit elevation feet. ; SEEPAGE BED SIZE: number of lines 3 width' length C-3 the depth --'o SEEPAGF,~ENCH: width length AREA AS BUILT PERCOLATION RATE_ -,Ow' AREA REQUIRED ~1 S INSPECTOR 19 DATED PLUMBER ON JOB LICENSE NUMBER- _ ~ -DEP9RT"MENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7,369 ' BUREAU OF PLUMBING MADISON, WI '53707 C CONVENTIONAL ❑ ALTERNATIVE State Plan I.D. Number. (If aetigned) ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: DDRESS OF PERMIT HOLDER: INSPECTION DATE: MI SuttvL A 14436 - 56St.Count, Stittwaten BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELE V. SG!% SE%, Section 30, T31N-R18G1, Stan. Ptcaihtie Town6hip Name of Plumber: P PRSW No.: County: Sanitary Permit Number: GvLy L. Steet 3254 St. Cnaix 34794 SEPTIC TANK/HOLDING TANK: ! a 7,3 MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKINGCOVER PROVIDED: PROVIDED: UJ W"_'o F i j ' [DYES ❑NO DYES QNO BEDDING: VENT DIA.: VENT MATS.: gL.ARMAT R NUMBER OF ROAD: PROPERTY WELL. BUILDING: VENT TO FRESH FEET FROM LINE LAIR INLET. DYES NO JDYES :NO NEAREST / DOSING CHAMBER: MANUFACTURER: BEDDING: LIOUID CAPACITY PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: DYES ❑NO DYES ❑NO DYES ❑NO GALLONS PER CYCLE: PUMP AND CONTROL OPERATIONAL NUMBER OF PROPERTY WELL BUILDING. JVENTTOFRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) DYES ❑NO NEAREST or AMETER MATERIAL AND MARKING SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH [I 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. LE NGTH J NO. OF DISTR. PIPE SPACING OV PIT INSIDE DIA *PI TS LIQUID BED/TRENCH J TRENCHES MATERIAL:. DEPTH DIMENSIONS ) 1 ' GRAVEL DEPTH FILL DEPTH IJISTR PIPE DISTR. PIPE ISTR. PIP MATERIAL NO. DISTR. NUMBER OF PROPERTY WELL. BUILDING. /ENT TO FRESH BELOW PIPES ABOVE COV R ELEV. INLET ELEV. END PIPES FEET FROM LINE: AIR INLET L~ 7...2 NEAREST MOUND SYSTEM: 5 a S • 4-5 Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM 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 ❑NO SOIL COVER TEXTURE PERMANENT MARKERS: OBSERVATION WELLS DYES ❑NO DYES ❑NO DEPTH OVER TRENCH!BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER. EDGES DYES ❑ND DYES ❑NO DYES ❑NO 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 DISTH UIST H. I DISTRIBUTION PIPE MATERIAL & MARKING ELEV. ELEV.. DIA ELEV. PIPES DIA.: ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED COHHE Cl t Y COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED DYES ONO DYES ❑NO UMBER OF PROPERTY WELL. BUILDING. COMMENTS: PERMANENTMARKERS: OBSERVATION WELLS: JNEAREST EET FROM LINE OYES LINO DYES ❑NO _ ~►1.4 z ~~s~~ S,~ 5 I o S.-2 J / t G,3v rJ Sketch system On Retain in county file for audit. Reverse Side. SIGNATURE TITLE DILHR SBD 6710 (R. 01/82) DEPARTMENT OF APPLICATION SAFETY & BUILDINGS INDUSTRY, FOR SANITARY DIVISION LABOR AND PERMIT P.O. BOX 7969 HUMAN RELATIONS (PL13 67) MADISON, WI 53707 Attach plans for the system on paper not less than 81/2 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. Property Owner: Mailing Address: Property Location: City, Village o Townshi County: WI '/a 5& '/4S J O/T 3 / N/R /,°q (or) W qtr r P- I ~5-l• , i> Lot Number: Blk No:: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number: / A-". a,d 41 c, (If assigned) TYPE OF BUILDING Number of ❑ Public* ❑ Variance* ❑ Other (specify)* Bedrooms: ® 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 /OOCU / !rte HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER MANUFACTURER: S --4,-- EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): New ❑ Replacement ❑ Experimental ~X Seepage Bed ❑ Seepage Pit 'y ❑ Alternative (specify) ❑ Seepage Trench Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name Plumber: Signature: M PRSW o.: Phone Number: Plumber's Address: n Name of Designer: ~13 A) Z~5 l mrN- COUNTY/DEPARTMENT USE ONLY Signat ssuing Ag Fee: Date QQ Sanitary Permit Number: %PPROVED V ❑ DISA PROVED 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) Form - S T C 100 Owner of Property Location of Property- ~Vl Section_ N R/N W Township Mailing Address Subdivision Name Lot Number Previous Owner of Property Total Size of Parcel Date Parcel Was Created Are all corners identifiable? Yes No Include with this application one of the following: .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 recorded in the Office of the County Register of Deeds as Document No., = ; and that I (we) presently own the proposed site for the sewage disposal system (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 du y r corded in the Office of the County Register of Deeds, as Document No. ' SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) ~ I r r DATE SIGNED DATE SIGNED DEPARTMENT OF R PORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY,. DIVISION LABOR;AND . ,PERCOLATION TESTS (115) MADISOP.O. BOX 76 N WI 53707 HUMAN RELATIONS 1 LOCATION: SECTION: TOWNSHIP/MbW+etf`AtITY: LOT NO.:BLK O.: SUBDIVISION NAME: ~4~: 1/a /T--)N/R) # (or)W COUNTY: OWNER'S/BU YER'S NAME:~yf~r~i M ILIN ADDRESS: LA.) USE DATES OBSERVATIONS MADE NO. BEDRNIS.: COMMERCIAL DESCRIPTION: ROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence i / New ❑Replace i~ - - ) ~ a. RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: S YSTEM-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM: (optional) r7i ~s❑u sow, s❑u as u as u 1 )XI !4~ 4J If Percolation Tests are NOT required DESIG RATE: SYSTE EL V. If any portion of the lot is in the under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, OBSERVED EST. HIGH-EST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) ' 7 - s B i I ~i pp PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES 1 NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIO t PERIOD2 PERT D PER INCH ) -7 P- i ~j c' 3 P-, 4& A14E 3 L-, ' = P- - P_ P_ -P.- 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 ocation cr, ,he p;o-, plan. Show the sUrface elevation at all borings and the direction and percent of land slop. SYSTEM ELEVATION' I e. r c_. i 1, 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. NAM ,(print): TESTS WERE COMPLETED ON: Jam, 12,AJ ; . a c~? - eQ- 9a IAD RE, S: ) CERTIFICATION NUMBER: PHONE NUMBER optional): CST S . A RE: DISTRIBUTION: Original-Local Authoroy, 2nd page Eweau of Plumbing, 3rd page-Propertk; Owner, a*.h page-Soil Tester. DI LHR-SB D-6395 IN. 03/81) 11 74 % tl i Nnu.5G Ilk- -7,0 , 000 h S~ P4,e_ ` xp / no