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Parcel 038-1164-90-000 12/28/2005 01:56 PM
PAGE 1 OF 1
Alt. Parcel 30.31.18.783 038 - 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 - DICKINSON, DANIEL D & LAURA
DANIEL D & LAURA DICKINSON
1925 RIVER VIEW LA
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 1925 RIVER VIEW LN
SC 5432 SCH D OF SOMERSET
SP 1700 WITC
Legal Description: Acres: 1.707 Plat: 0227-CRESTVIEW ADD
SEC 30 T31 N R1 8W LOT 19 OF CRESTVIEW Block/Condo Bldg: LOT 19
ADD.
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
30-31N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
02/18/2004 754582 2512/69 QC
1078/579 QC
860/632
669/105
2005 SUMMARY Bill Fair Market Value: Assessed with:
120024 201,700
Valuations: Last Changed: 10/13/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.707 30,000 168,200 198,200 NO
Totals for 2005:
General Property 1.707 30,000 168,200 198,2000
Woodland 0.000 0
Totals for 2004:
General Property 1.707 30,000 168,200 198,2000
Woodland 0.000 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
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, y 1=r t' TOWNSHIP- TjN-R_W
ADDRESS ST. CROIX COUNTY, WISCONSIN.
/ ' ' S FS J! I l N SUBDIVISION LOT /~LOT SIZE _
PLAN VIEW
Distances and dimensions to meet requirements of H63
SHOW EVERYTHING WITHIN 100 FEE OF SYSTEM
i
f ~
\ I
1 ~
II
144
t 9
I H±
I di at N ffhr BENCHMARK: ( erman-nt reference Point) Describe
f j
Elevation of vertical reference point: --Slope at site -
SEPTIC TANK: Manufacturer4~ Liquid Capacity:
Number of rings on cover Tank manhole cover elevation:
Tank 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 ;brand name of pump
and model number
Type of warning device _ _
HOLDING TANK: Manufacturer- _ Number of gallons_
Elevation of manhole cover
Type 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 TRENCF:: width - ,
PERCOLATION RATE e n g t
t. AREA REQUIRED AREA AS BUILT INSPECTOR
DATED J~ PLUMBER LICENSE ONUMBEB~~-~i
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P ..O. BOX 7969 BUREAU OF PLUMBING
MADISOPr, WI 53707
EN ~ CONVENTIONAL ❑ALTERNATIVE State Plan l.D.Number:
(If assigned)
❑ Holding Tank ❑ In-Ground Pressure ❑ Mound
NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER: INSPECTION DATE.
Ch.antea Seaman Box 19A, Somerset, W1 /p_
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. Town REF. PT. ELEV.: CST REF. PT. ELEV..
SW SF, Sec. 30, T31N-R18W, Lot 19, Cne~stview,Stan Pnai,'Lie
Neme of Plumber. JMPIMPRSW No. County Sanitary Permit Number:
Cat Powet6 1563 St. Croix 43644
SEPTIC TANK/HOLDING TANK:
MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. JTANIO ,LET ELEV.. WARNING LABEL LOCKING COVER
.~Y^ / PROVIDED PROVIDED
L✓j.l / DYES ❑NO DYES ❑NO
BEDDING. VENT CIA VENT MATL. HIGH WATER NUMB R OF ! ROAD: PROPERTY JWBUILDING: VENT TO FRESH
/ C,( ALARM FEET FROM LINE / AIR INLE;-
DYES NO ❑Y p NEAREST (C'G?' 1-33~C L
DOSING CHAMBER:
MANUFACTURER MEGS LIQUID CAPACITY PROVID ROVIDED❑NO I.X ❑NO DYES ❑NO
GALLONS PER CYCLE: PD )AP DCONTRO~ OPERATIONAL 1 NUMGE~ R PROPER ELL BUILDING VENT TO FRESH
(DIFFERENCE BETWEEN , ,FEEFR M LE ET
PUMP ON AND OFF) i` I ❑ 6 ❑NO ly RE
SOIL ABSORPTION SYSTEM. Check the so il m0istuy6aythe pth of plowing r FORCE DI ETER MATERIA An1D MARKING
or excavation. (If soil can be rolled into a wire cohStr Jcti shall cease until MAIN E r
the soil is dry enough to continue.)
CONVENTIONAL SYSTEM:
WIDTH
LENGTH NO. OF DISTR. PIPE SPACING COVER INSIDE DIA =PITS LIQUID
I WI
BED/TRENCH TRENCHES AI: PIT
DIMENSIONS ]
GRAVEL DEPTH FILL H GIST PIPF DISTR. PIPE DISTR. PIPE ATERIAL: NO. DI NUMBER OF PROPERTY WELL BUILDING. VENT TO FRESH
BELOW PII;ES/ ABt7ovER E(Ev I. T E PIPEs FEET FROM , LINP'1 / AIR INLET.
G / NEAREST-► CY
MOUND SYSTEM:
Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGR KHO
FSYSTEM
and furrows thrown upslope: mound systems to make certain that it ON REVERSES E W
ELEVA-
meets the criteria for medium sand. T'IONS ME R
DYES ❑NO /
SOIL COVER TEXTURE PER, ANEN7MA IR S 08 RVATION WELLS
❑YO DYES ❑NO
IDEITH OVER TRENCHBED DEPTH OVER TRENCHBED DEPTH OF TOPSOIL SODD~b j' SEE MULCHED.
CENTER EDGES.
DYES; '❑NO Y ❑NO DYES ❑NO
PRESSURIZED DISTRIBUTION SYSTEM:
WIDTH. LENGTH NO. OF LATERAL SPACING GRAVEL DEP BELOW PIP FILL DEPTH ABOVE COVER.
BED/TRENCH TRENCHES
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR:PIPE MANIFOLD ATERIAL NO. DISTR. DIST PIPE DISTRIBUTION PIPE MATERIAL & MARKING
ELEVATION AND ELEV_ ELEV.. DIA.. ELEV.. PIPES DISTRIBUTION
INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY ER MATERIAL PLANS CAL LIFT CORRESPONDS TO APPROVED
ZY ❑NO C DYES ❑NO
COMMENTS: PERMANENT MARKS OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING:
2 FEET FROM LINE
~ ❑ YES ❑ NO ❑ YES ❑ NO ~ NEAREST
t
Sketch System on in county file for audit.
Reverse Side.
SIGN TITLE.
D I L H R S B D 6710 (R. 01/82)
wisconsin APPLICATION FOR SANITARY PERMIT
'Z D 1 L H R (PLB 67) UNIF~OR~M f SANITARY COUNTY
SANI ARY PERMIT #
U
DEPRFTTT1EnT OF I
In DIJSTQY, LABOR 6 HUTRn RELRTIOns 31, 6, / -
-Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'/2x 11 inches in size.
-See reverse side for instructions for completing this application. PLEASE PRINT
PROPERTY OWNER MAILING ADDRESS
C
PROPERTY _G'AZT~ ION 6-I-TY:
V F6 LAGE: '
1/4 1/4, S , T<<N, R E (or~W, TOWN OF:
LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE R LANDMARK STATE g A i.D. NUMBER
/ U 1.
1
/U Al'
TYPE OF BUILDING OR USE SERVED
inn'] 1 or 2 Family Number of Bedrooms. m'il' ❑ Public (Specify):
THIS PERMIT IS FOR A:
FZ 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.
X 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 !_;l
Lift Pump Tank/Siphon Chamber
Holding Tank capacity
Manufacturer: fJ s
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):
❑ Joint ❑ Public
Private
I, the undersigned, hereby assume responsibility for installation of th private sewage system shown on the attached plans.
Name of Plumber (Pri Signa MP/MPRSW No.: Phone Number.
bur's Address Name of Designer /
Plum
COUNTY/ DEPARTMENT USE ONLY
Signature of Issuing Agent: Fe@ Date: ❑ Disapproved
fit' 7 ❑ Owner Given Initial
1k 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.
I'u xw - `i I' c l UU
Owner of Property-
Location of Property Z07~ '-a> Sectiolk 1?Ci N R
Township
Mailing; Address _OF
Subdivision Name
Lot Number
Previous Owner of Property,
_7~~~~' -
Total Size of Parcel ~ /I(YFS
Date Parcel Was Created_
Are all corners identifiable?_ Yes_ No
Include with this_41))L-Cat ion one of the followin :
.Certified Survey Map
. Deed
.Land Contract, or
.Other L;ebal Document which describes the prollcrty
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.'A'/ 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 duly recorded in the Office
of the County Register of Deeds, as Document No.
7
Sic:;NATUNE OF OwNEN SIGNATURE OF CO-OWNER (IF APPLICABLE)
(JAIL. SIGNED DATE SIGNED
ST. CROIX COUNTY ABSTRACT COMPANY
I'
HUDSON, WISCONSIN
CONTINUATION OF ABSTRACT NO. 374
From the _ 4th day of June _ 1982_ at 8:00 o'clock in the A • M.
of the land described as:
Lot 19, Crestview Addition to the
Town of Star Prairie.
55
Lester H. Martell, Renee Change of Covenant.
Seaman, Charles Seaman, Dated Feb. 19, 203 & 21, 1983•
Burton Gustafson, mark Ack. March 7, 1983.
Sutter and Lori Sutter, Rec. Maly 203 1983,
In "665', page 56, 1#384798.
-to-
-,,Recites:
'
Crestview ~Addition orecorded.
The Public. 4~~1 ~ Kv No. 53',)
n o_ume 646, page 535
on lay 18, 1982 reflects th- 'I",3n changes. This is pursuant to
this agreement signed -by~-`,th lanaowners ~of Crestview Addition: Covenant
kl, sentence 1#2: In/adds pion, there alsa,,m~ y be constructed one addi
tional outbuilding rpot,,, to~exceed .600 squarg 'feed in area, the exterior,
design of which steal bed/ "a-sdma-_gareral~character as the house.
Shall be changed to n ac Lion, ~t. ereels _ l y be constructed one
!dditional outbuild ^g=nbt`~o`exc ed `$LO ,,ouirb'feet in area, the ex-
terior design of which-I-Vha he same general character as the house.
All houses inclusive\ of Lots 13 `to F,18 shall ','r&t u~on Riverview Drive,.
(Signed: "Renee N. Seamaand " ,urton A/^Gustatfson').
001
56
I
Nancy G. Peterson and Paul Warranty Deed.
0. Swenby, each an undivided Con. $1.00 0VC.
one half interest, Dated July 131 1983•
Auth. July 13, 1983.
Rec. July 22, 1983.
In 1166911, page 104, 1#386315•
Lester H. Martell.
Lot 19 Crestview Addition located in SWI of SE!, the N-v;i-, of SE,-,,
and the NEE of SE- , , of Section 30-31-18.
Recites: This is not homestead property. ($1.10 Transfer Fee)..
57
I eter F. Martell., Warranty Deed.
Con. Valuable.
Dated July 21, 1933.
Auth. July 21, 1983.
Charles E. Seaman and Renee Rec"669", July 223 1983• Seaman, husband and wife, In page 105, #38/0-316.
as joint tenants.
Same land as shoran at No. 56.
Recites: This is not homestead
Dronerty. ( -~0 00 Transfer Fee).
ST. CROIX COUNTY ABSTRACT c6MPANY
CONTINUATION OF ABSTRACT
I
w.r~P".,. 'xY~~.,. ;~s-.,~ '"raw ..,sk 4.. psi s, 'K ;.r 1
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, DIVISION
LABOR ACID PERCOLATION TESTS (115) MADISON W 7969
HUMAN RELATIONS
(H63.09(1) & Chapter 145.045)
LOCATION: SECTION: TOWNTSHIP/MUNIQlPALITY: LOT NO.:BLK. O.: SUBDIVISION NAME:
'/a' '/4 /T:N/R "i (orl W
COUNTY: OWNER'S/BUYER'S NAME: MAILIN ADDRESS: I
USE DATES OBSERVATIONS MADE
NO.B91MS.: 1COMMERCIAL,(DESCRIPTION: (PROFILE DESCRIPTIONS: PERCOLATION TESTS:
QResidence New ❑Replace J
J ) 1
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND~ P RE: SYSTEM-IN FILLHOLDINGTANK: RE OMMEDED ~SYSTENJ': (optional)
UU _ S 1:1U os ~ 11 ❑U S U ~S U J/ f
If Percolation Tests are NOT requiredi DESIGN RATE: If any portion of the tested area is in the
under s.H63.09(5)(b), indicate: f Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B- - '
zf/
J
B-
B- l f~;'
.
B
B-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD z PERIOD 3 PER INCH
i
,
P_
P
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 12 r~%U.
AA_
f
I
i 2D
,
a
E
54- J
• n._ - - t -
1 \ 3
r.`
_ E
1 0 .
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-,(print): ) TESTS WERE COMPLETED ON:
SS: / CERTIFICAT ON NUMBER: PHONE NUMBER (optional):
CST,%+6NATURE:
u
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