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Home My WebLink About042-1017-30-000 o m f c d o rD CD m CD -0 CD n x~ c (DfD m (D cr l 1 w 3 z z o ww W OJ A C ty~~' N O to O CO j N N c 1 N j C1 ~ ~ N CO d 7 ~ ~ ~ C 7 O = (b N (D y N v "l' N O' 0 ~ O O p W CD m (nD j W O k O 7 N C) p N a N CD o n D a o m n CD a C (n W 0 ~ coffin O a N O CS co CD o r- cn co to (n O C O W l'h U) LTJ rt y~ Z N o o o M ~I • (D y,/ 0 y r~ o = D ~O ll~ll (D (D N A_ (D 0 rt F'i rt x Q' 7c 3 0 m as ;d m -0 Qo CD D H o H N O 0 W W C) h m V O d ? N ~ a 00 a a N N N (D 0. D CD CrJ ~ lam; d ~ O ~ d n o ~n !r • i (D (n r (D to lV I 1 c m N. F- CD CD Vo 'ti P J W C1 N 0. W O 0 O A z CD n A z 7 O 0 rj H :n (D N Z z ~ v ~O f M ((D CD z a z H I 0 3 O id 3 ].a" ~i 00 00 v N z CD '3' (D x N. F'• t7 p i> Ia CD Cn p o = z a CD z' s v (v 0 0 ~n a b c., CD ~ o 0 0 o C .Parcel 042-1017-30-000 06/17/2005 04:54 PM PAGE 1 OF 1 Alt. Parcel 07.29.18.102B 042 - TOWN OF WARREN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner " BEND, HAROLD P & BARBARA HAROLD P & BARBARA BEND 931 107TH AVE ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ` 931 107TH AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 20.000 Plat: N/A-NOT AVAILABLE SEC 7 T29N R18W COM NW COR SEC 7, TH S 0 Block/Condo Bldg: DEG W 660.3 FT TO POB; TH N 88 DEG E TO E LN NW NW; TH S ON W LN TO SE COR NW Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) NW; TH S ON W LN TO SE COR NW NW; TH S 07-29N-18W 89 DEG W TO SW COR; TH N 0 DEG E 660.29FT TO POB (MD 895/303) Notes: Parcel History: Date Doc # Vol/Page Type 2005 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/20/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 10.000 65,000 232,100 297,100 NO ENTERED BEFORE'05 CLO W8 10.000 30,000 0 30,000 NO Totals for 2005: General Property 10.000 65,000 232,100 297,100 Woodland 10.000 30,000 30,000 Totals for 2004: General Property 10.000 65,000 232,100 297,100 Woodland 10.000 30,000 30,000 Lottery Credit: Claim Count: 1 Certification Date: Batch 110 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 042-1016-95-000 06/17/2005 04:54 PM PAGE 1 OF 1 Alt. Parcel 07.29.18.101 C 042 - TOWN OF WARREN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner * BEND, HAROLD P & BARBARA R HAROLD P & BARBARA R BEND 931 107TH AVE ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 931 107TH AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 5.000 Plat: N/A-NOT AVAILABLE SEC 7 T29N R18W PT OF NE NW COM NW COR Block/Condo Bldg: SEC 7; TH N 88 DEG E 1643.7 FT TO POB; S 0 DEG W 665.35 FT; TH S 88 DEG W TO W LN Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) NE NW; NLY ON W LN TO NW COR TH N 88 DEG 07-29N-18W E TO POB (MD 890/151) Notes: Parcel History: Date Doc # Vol/Page Type 10/05/2000 631192 1548/411 QC 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/11/2003 Description Class Acres Land Improve Total State Reason ENTERED BEFORE'05 CLO W8 5.000 15,000 0 15,000 NO Totals for 2005: General Property 0.000 0 0 0 Woodland 5.000 15,000 15,000 Totals for 2004: General Property 0.000 0 0 0 Woodland 5.000 15,000 15,000 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 SYSTLM KL:PURT r , UWNLK ac 1~ j i~ dW ADDRESS ST. CROIX COUNTY, WISCONSIN. SUBDIVISION LOT _ - LOT S 1"LE PLAN VIEW Distances and diMansions to a1eeL requirellieflts of H63 THING WITHIN 100 FE'ET OF SYSTEM , - i i - - - - - I di a de No th Arrow ! sc , It__ I - BENCHMARK: (Permanent reference Point) Dedcrrbe:~- Elevation of vertica~,,,reference at 61Le: SEPTIC TANK: Manufacturer: c__. Liquid C;apaaiLy / hvz Number of rings on cover : Tank luanhole cover elevation Tank Inlet Elevation: Tank UuLIeL ElevaLlun PUMP CHAMBER Manufacturer; - Number of galluiis Y Number of gal. pump set or a cyc~ e bal lut►a ; total of distribution lined bxIlon:~size ur punup - Ikuti , gallon per minute horsepower bratid naule 0I pinup and model number Type of warning ev ce RULDING TANK: Manufacturer, NuuLbe► of ballutib Elevation of mAtnhole cover 'ry e of warning device SEEPAGE PIT SIZE: _ Number - Of JAL 5 Ce e t d iau«C t U1 feet liquid dep seepa6' it Miler piplevaLiOn t e p e~ e bottom of seepaKe-pft Obivarfun _ tees ~ ' SEEPAGE BED SIZE: number of l lnvv ~ wid t h 1en~ thS~(L L 1.. LlCl,Lh 3C SE'EPAGL TRENCH: width__ _ 1 eti Lli PEkLULATION RATE AREA R.EQUIRI;:D AREA AS BUILT LNsill% ;'1(M _ PL.UMMJi i)N 166, ( Ll S DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR &*HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS t) DIVISION P`J. BOX. 7969 BUREAU OF PLUMBING MADISON, WI 53707 k2 CONVENTIONAL ❑ALTERNATIVE Suu PI.. I.D. Numb.n ul ..~lan.al ❑ Holding Tank ❑ in-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: JADDRESS OF PERMIT HOLDER: INSPECTI N DATE: Dr. Afton MN 1367 Stagecoach Harold Rend BENCH MARK IP.--rB o -n- p.-I DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV NW NW, Section 7, T29N-R18W, Warren Township Na- of Plumb., lTiMPRSW No.: lCourBy: So.avy Puma Numbo, Richard Hopkins 1059 St. Croix 34819 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY: TANK INLET ELEV_ TANK OUTLET ELE V.. WARNING LA LOCKING COV R C/ P DED: PROVID / c L 5' • YES ❑NO [:IND b EDDING. VENT DIA. JVENT MATL: HIGH WATER ) NUMBER OF ROAD: - JPROPERTY WELLBUIL[~NGV NT TO FRESH ALARMFEET FROM NE: ! AIR INLET. ~ J ~ ❑YES NO / ' YE O 1NEAREST---J1bj2,, DOSING CHAMBER: MANUFACTURER. BEDDING LIQUID CAP Y P MO (L PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED: PROVID: ❑YES ❑NO ~ ❑YES ❑NO ❑YDEES ❑NO GALLONS PER CYCLE: Pu AN N L OPERATIONAL NUMBER OF PROPERTY WELL BUILDING IVENTTOFRESH (DIFFERENCE BETWEEN I FEET FROM LINE AIR INLET PUMP ON AND OFF) ❑ ES ❑NO NEAREST MATERIAL AND MARKING SOIL ABSORPTION SYSTEM. Check the soil molstu re et the epth of plowing LENGTH olAMt 1111 Or excavation. (If soil can be rolled into a wire, construct; shell cease until FORCE MAIN the soil is dry enough to continue.) 71 CONVENTIONAL SYSTEM:" - WIDTH LENGTH N UISTR. PIPE SPACING INSIDE DIA xpITS LIQUID [BED/TRENCH THENCHfS COVI HtAL: IT DEPTH DIMENSIONS ? W G AV L DEP H FILL DEPTH UISTR 1 E DISTR PIPE IS .PIP MA IAL NO TR NUMBER OF R V WELL BUILDING. V NT TO FRESH BELOW PIPES ABOVE COVER ELEV INLET ELEV.ENU PIPE LINE AIR INLET q n f FEET FROM BL,79 ^v,5 1 M ? NEARE57 MOUND SYSTEM: 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. i ❑YES ❑NO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS ~ ❑YES ❑NO ❑YES LINO iC PTH OVER TR[NCH(BED DEPTH OVER TR N H/ ED DEPTH OF TOPSOIL SODDED SEEDED MULCHED ENTeR EDGES ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH LENGTH NO. OF LATE H AL SP_ACING (1HAVEL DEPTH BELOW PIPE ILL DE T~ H AT OVER BED/TRENCH TRENCHES. DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR PIPE MANIP OLD MA EHtAL NO UISTR UtSTH 1 OISTHIBUI ION PIPE MATEHIAL & MARKING ELEV ELEV DIA ELEV. PIPES DIA. ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DHILLEDCUHHECILY COVEHMATEHIAL VERTICAL LIFT CORRESPONDS TO APPROVED _ L YES QNO ❑YES ❑NO COMMENTS: PERMANENT MARKER OBSERVATION WELLS NUMBER OF PROPERTY WELL: BUILDING FEET FROM LINE DYES LINO DYES NO _ NEAREST-- ff -7 -7 l i I' ~J S ;;ketch System on Retain in county file for audit. 3everse Side. v S slGyp.Ik1H- f-' 1 LE ALHR SBD 6710 (R. 01/82) DEPAR►('MENT 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 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. Property Owner: Mailing Address: /71 e 0--V C- . , 4 C Property Location: may-}}age-or TownsCou nt ' In'w t/4PN/S 7' N/R (or) W f Lot ANumber: Blk No.: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number: A r (if assigned) TYPE OF BUILDING Number of ❑ Public* ❑ Variance* ❑ Other (specify)* - edrooms: 1 or 2 Family *State Approval Required. TOTAL NUMBER PREFAB POURED-IN NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE STEEL FIBERGLASS INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY_ HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER MANUFACTURER: VV e- d, ° EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA , (Minutes per inch): PROPOSED (Square feet): X New ❑ Replacement E:1 Experimental X Seepage Bed ❑ Seepage Pit ❑ Alternative (specify) A✓4 ❑ Seepage Trench Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): K Private ❑ Joint ❑ Public /I I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber: Sign e: Mf6/MPRSW No.: Phone Number: Plumber's Address: Name of igner: I COUNTY/DEPARTMENT USE ONLY $ign ture of Issui A t: ♦ Lee: Date: gppROVED Sanitarry,Peerrrmit Number: 00~) 0-943 DISAPPROVEDT d' l Reason for sa ."g. 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) -mop Z/ Form - S T C 100 Owner of Property 44,.,-40~ Location of Property z, Sectiun'1' j N RW Township- f Mailing Address r C ~S L C Subdivision Name_ A A Lot Number Previous Owner of Property.. Total Size of Parcel Date Parcel Was Created Are all corners identifiable? f/ Yes No Include with this application one of the following: .Certified Survey Map geed L-i-Land Contract, or .Other Legal Document which describes the property PROPERTY OWNER CERTIFICATION c 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. ->-6 ~'y/ 3 ; 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. SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED i`c6{;ld, .AU CIreSS and 11Lor I'ne, i-uil AouIL-" Mill vvt.. aria ' J L,: Z''t211l of a 'W"UP 0M P. and r- < . :.t. ^otzte 1 1367 Stage Coach i xf it, Soak 1: ,t RicIrlond, rlisconsin 54017 Af t022 , Minnesota S';,1 p1 Is grantor related to grantee? (Blood or Marriage) ❑ Yes R9CNo Name and Address to which tax bills should be sent PART I - PROPERTY TRANSFERRED County of: Check proper box and enter name of municipality Street address of property transferred ❑ city ~garm 4 St. Croix ❑ Village OF: 7 E2~ Town Legal Description (Fill in legal description in space below or attach 2 copies of full legal description from instrument of conveyance) Lot No.------------------------ -----------------------Block No.--------_--------------- Plat Name..-..----------------------- Town------------------------------------ --------------Range--------------------------------Section-------------------------------------Property Parcel Number---------------------------- or metes and bounds description: t PART If - PHYSICAL DESCRIPTION AND INTENDED USE. 1, Kirl~ pf Property 2. Princi al Intended Use 3. Land Area and Type a. # Land Only a. Residential a. Lot Size - Estimated ❑ ❑ New Construction b. ❑ Commercial X ❑ Building Previously. Used c. ❑ Industrial b~- Total Acres - Estimated b. ❑ Residential Units, if any d. ❑ Agricultural 1. _ Tillable Acres ❑ One Family e. ❑ Recreational 2. W.T.L. Acres ❑ 2 thru 7 Units f. ❑ Other (Explain) 3. w. 4.t F.C. Acres ❑ 8 or more Units. c. Feet of Water Frontage ' Estimated ❑ PART III -TRANSFER 1. 2FSale 2. ❑ Gift 3. ❑ Exchange 4. ❑ Deed in satisfaction of L.C. dated 5. Other Explain 0, -4 Here j. PART IV - COMPUTATION OF FEE 1. Total value of REAL ESTATE transferred (purchase price, etc.) $ 22,000 00 2. Ownership interest transferred 2~1 Full ❑ Other (Explain) 22.00 3. Fee 4.~jnyo,I your opinion w s this ale or tragsfer m e at fair market value? ❑ Yes ❑ No A No opinion (If no or no opinion, Explain Cst~Z!L( P5_' 1.9 fry u1 1ACe"t3*?ect 27e,91~or OY rcznu a tats cT.Praj -_!%r Here) I (We) declare under pena!ty of law, that this return (including any accompanying schedule) has been examined by me (us) and to the best of my (our) knowledge and belief it is true, correct and complete. . Sign Signature of Grantee oI; Agent Date Here Document No. Vol.r(Reel) Page (Image) Date Recordg.d Date and Kind of ~pFvgy~ '`~l;(. C',Z.c x'77 ~'/2~/ ~Q ;a5'z"aT1t~1 71211 ~'6 LEAVE I THIS Parcel Number County Code District Code AREA 19 19 BLANK A E3 C D E F 1 Office 2 Field 3 Use 4 Reject I Ratio Consideration i Y T PE-566 ' .School District# ' PROPERTY OWNERS COPY DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTWY, c DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX N W1 53969 HUMAN' RELATIONS (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: YAJ 1/ah'4/4 J /T,;2-/ N/IX`3 I (or) W r e. 11V i1~ A 7 ~r COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: ST L111-d' Z i-3 6 sip 5 USE DATE OBSERVATIONS MA DE L i y3 NO. BEDRMS.: COMMERCIAL ESCRIPTION: PROFILE DESCRIPTIONS: 1PERCOLATION TESTS: Residence A/A XNew ❑Replace CONVENTI❑U . MM'NS. E:]V IN-GROUND-PRESSURE: RATING: S= Site suitable for system U= Site unsuitta'bble for system EIESSURE: SYSTEM-I LH OL C_ -r DI NG TANK nRECOMzlMENDEe,DhSYSTEM:~ID ptiZ ;KS J If Percolation Tests are NOT re uir d DESIGN RATE: q / If any portion of the tested area is in the under s.H63.09(5)(b), indicate: elqS5 '7 Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL/ DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH##, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- J,G g,/ B- ?0 4, AOL B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH Pi ,..7 10 .3 „3 P- P--37 -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 4.~r 7 -M ~3~ y J cry M lev go~~ K S c; 5- f r fraQ E I . 3 - r r ~ E r 3 , I 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): b TESTS WERE COMPLETED ON: 1 ADDRE S: CERTIFICATION NUMBER: PHONE NUMBER (optional): CST NATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) -OVER To be a curopliqo am! an: -t; ~r .etc"r. d'SiI LSD i,1 -t; t 060 t itv . _ &"v , x SITE IS 501 1 CM HER SYRFEMS ARE RUED ONT MED ON SOIL C(AMMIUM' _ . _..L,t_ i, 3 _s s h a c f A 0; ng 1W . c firs. MAKE ,T F j n '.bm.. , t, . W Y }umf 1120= . a y jt Coto r [Yarn raj. . W Vain ,ch al 'w".. of .v Cis` W len I,:t,,., at, ..:i= "art sht t, , i p£;,inan< , app We k .a ss in (it?tC.e, t inn `..;C<'.. u. , al p €1 do, psi u, a-M, so n- 14 i c. rF..s„ i A-i as MW Ann, W t.i.?,on) rows wk Edt3, ly, rho; it A o W-r 0?`4?llAme Pic Son- W) Low, `S s` .pis' i a. Can rif3 S3,',f cam' F 3lirat; Wow, Spa,' W „ , Pow Mal Bldg t t F e s - , ltd ety _ COV 1_.. NOV Coy Lnw,-~ it r R C 'w-n rite t 140 4 3f 1, 'tE~p f Clay Sir2t". My r j, a'Y f, C,F ,fir°i lowiv, S i so~l s, tour-k i$11h" kv .,I in tieemi€,, ,ax r} n c 1 W cis nc or the Ea pa mu, a quest 'i S,.,.v -.e.1 of s et aCx 7.t'St the E pnin- w E myna , . i, ?t?`?No vi of [,t,"ii5. tM 'Lfve Om 9th wd WW- -i-0 K- s>. w _ .Z r , or .wl € r f,- P P o . v, t i i; tt F 'err f~~ ,~~ti~ ..Gives ~L