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Parcel 022-1078-40-000 10/16/2006 12:18 PM
PAGE 1 OF 1
Alt. Parcel 27.28.18.432B 022 - TOWN OF KINNICKINNIC
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 - BEDNAROWSKI, THOMAS R & MARY F
THOMAS R & MARY F BEDNAROWSKI
123 CTY RD JJ
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 123 CTY RD JJ
SC 4893 RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 10.100 Plat: N/A-NOT AVAILABLE
SEC 27 T28N R18W 10.1A IN S 1/2 SE 1/4 Block/Condo Bldg:
CSM VOL 1/206 572/252
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
27-28N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1128/456 QC
07/23/1997 1019/317 WD
07/23/1997 1019/315 AF
07/18/1997 1252/229 WD
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 08/11/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 10.100 100,000 273,100 373,100 NO
Totals for 2006:
General Property 10.100 100,000 273,100 373,100
Woodland 0.000 0 0
Totals for 2005:
General Property 10.100 100,000 273,100 373,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 220
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
A9-30 771
a, y
~~jj' L11
ST. CROIX COUNTY
SURVEYOR'S RECORD
Certified Survey Map
Part of the SW 1/4 of the SE 1/4 & the SE 1/4 of the SE 1/4 of Section 27,
Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County,-Wisconsin
y I George Hanson
5 89° 18'35'"YY 1320.00 589°/8'35"w
N oo° q-/" 25 YY ~
> 506°12"00"YY
40 10.1 Acras 330. DO"
O
r ,
E 1355. 80' o
N
~ o m
Eo,s+ lines. Sz,. 27
Sou+hanst corner
Scale: 111 = 3001 Sa.c. 275 T28N, R ISYY
o Indicates 241, long iron pipe stake weighing 1.13 #/ft.
Description:
That certain parcel of land or tract of real estate located in the SW 1/4 of the
SE 1/4 and the SE 1/4 of the SE 1/4 of Section 27, Township 28 North, Range 18
West, Town of Kinnikkinnic, St. Croix County, Wisconsin, more fully described as
follows: Commencing at the southwast corner of said Section 27, thence go
N 000 001 0011 E (assumed bearing) along the east line of said Section 27 a distance
of 1320.60 feet; thence S 890 181 35" W a distance of 234.17 feet to the Point of
Beginning of the parcel to be herein described; thence continue S 890 181 35" W
a distance of 1320.00 feet to the easterly right of way of C.T.H. 11JJ"; thence
S 060 121 00" W along said right of way a distance of 332.40 feet; thence
N 890 181 351t E a distance of 1355.80 feet; thence N 000 411 25" W a distance of
330.00 feet to the Point of Beginning, tha above described parcel containing 14.1
acres, more or less.
State of Wisconsin)
County of Pierce )
I, James L. Murphy, Registered Land Surveyor, do hereby certify that by direction
of the Owner, George Hanson, I have surveyed and divided the lands as shown hereon
and that the map and description shown hereon are a true and correct representation
and description of the lands as &ivided; and that I have complied with all the
provisions of Chapter 236.34 of the Wisconsin Statutes and the St. Croix County
Sub-dividion Ordinance in surveying, dividing, mappi
11 IIlFnd describing said lands.
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Dated: 7 November 1975 0~`~~
J!
MSS L
=J~a~fies9
eg rEte ec Lar~~z~yox
Vol. 1 Page 206 l RIVER FALLS,
Certified Survey Maps Wisc.
St. Croix County, Wisconsin ..fib... COX)
,3 uunlluullu
3071 /1
APPROVED
1 2 ST. Crpa,;-,,(
COMPREHF;.~61VE- Pte;" 5 PLANNING
AND Z0N.NG : C,,,oN IT'TEE w
~ plc 221975 12-17-75 ~
b o' W-
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'Aroma' of too&
a cow come"
6' *100-b vol=e 1 Page 206 oe
8 ►
C~, 6 AS BUILT SANITARY SYSTEM REPORT
VER
J . A REST , TOWNSHIP EC . J T j fN, R• W
ST. CROIX COUNTY, W SCONSIN.
'BDIVISION LOT LOT SIZE
PLAN VIEW
Distances b dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN '100 FEET OF SYSTEM
r ~ r
'TIC TANK(S) MFGR. CONCRETE t--'"STEEL
rings on cover Depth DRY WELL
INCHES NO. of width 1 gth area
no. of lines-- width len th~ area
depth to top°of pip
;REGAT t"
U( RAT AREA REQUIRED AREA AS BUILT r1
.;claimer: The inspection of this system by St. Croix County does not imply complete
.pliance with State Administrative Codes. There are other areas that it is not possible
inspect at this point of construction. St. Croix County assumes no liability for
=tern operation. However, if failure is noted the County will make every effort to
'ermine cause of failure.
-ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
"INSPECTOR _ 4 ZI-1,
DATED PLUMBER ON JOB
r
LICENSE NUMBS
z
• WSPORT OF INSPECT70N_INDIVIDUAL SEWAGE SYSTEM i
` Sanitary PeAm.i-t
State Sep,t,ic'
NAME ' r iownAhc St. Cnoix County
p
Location Section
' i
SEPTIC TANK
Size Q,:a^ gaZton4. Number o6 CompaA.tmentz 4 I,
Distance FAOm: WeZi 120 on greateA 4tope 6t
Bu.itding 6t. WetZands 6t•
H.ighwateA 6t.
DISPOSAL SYSTEM
D.iztance FAOm: wet.t . 6t. .12% on greateA 4tope 6t.
Bu.iZd.ing_ 6z. wettand-s Ft.
Highwatier 6z.
FIELD DIMENSIONS:
WiRh o6 ttench~6t. Depth o6 Aoch be.2ow tiZe .in.
w
1'14 Length o6 each tine 6t. Depth a6 Hoch aveA ti2e in.
Numbers o6 Zines Depth o6 tite be.iow grade 'in.
Tota.2 length o6 Zinn' 6t. Stope o6 tAench_ in per 100 6t.
Distance between tines 6t. Depth to bedrock 6t.
To.tat absorbtion ariea 6t2 Depth to gtoundwateA 6t.
RequiAed area 6 2 Type o6 Cover:Papek..,''oA Stkaw
A.
PIT DTMENS70NS:
NumbeA o6 pits GAaveZ around pitz yes no
Out,side d.iameteA 6t,i "Depth be.iow .in.iet_ 6t.
2
Totat abzorbt.i..on atea 6t A
AAea keq ui red 6 2 m
INSPECTED BY" TITLE
APPROVED DATE 197+1
* y
_
REJECTED P DATE 197
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-EH 116(11-74)
! WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
• ' P.O. BOX 309
MADISON, WISCONSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
LOCATION: '/4, '/4, Section , TN, R E (or) W, Township or Municipality
Lot No. , Block No. County
Subdivision Name
Owner's Name:
Mailing Address:
TYPE OF OCCUPANCY: Residence No. of Bedrooms _ Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION •tREPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS
SOIL MAP SHEET SOI L TYPE
PERC(MOM ON TESTS
TEST DEPTH CHARACTER OF SOIL S WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
NUM- INCHES THICKNESS IN INCHES SINCE OLE HOLE AFTER INTERVAL
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
P-
P-
P-
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
B-
B-
I I
B-
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the locationand square feet of suitable areas. Indicate number of square feet of absorption area
needed for building type and occupancy. Indicate scale
or distances. Give reference point. Indicate slope.
3
s
i
N
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 location of test holes are correct
to the best of my knowledge and belief.
Name (print) Signature
Certification No.
Name of installer if known
Copy : ~a;
PL-B-67 : State and County State Permit # / G
# fC
Permit Application County Pe" )t
for Private Domestic Sewage Systems County.
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
4efl
B. LOCATION YQ„5 e,-a , Sectio T N, R E (or) W # City
Subdivision me, nearest road, lake or landmark Blk# Village
Township ~y
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms No. of Persons 4e I
D. SEPTIC TANK CAPACITY Total gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete Poured-in-Place Steel Fiberglass Other (specify)
New InstallationReplacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify)
E. EFFLUENT~BISPOSAL SYSTEM: Percolation Rate Total Absorb Area sq. ft.
Nev Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: i~_l ength- J Width Depth Tile depth (top) ` 'No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land 42 ee Distance from critical slope
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 Certi d Soil Tester, } :3 ^210
NAME Z24f -J, W , C.S.T. # and other information
obtained ffQ,_ature (owner/builder).
Plumber's I .WP/MPRSW# Phone
Plumber's Address
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.
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Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application} C, Fees Paid: State C C ; Cod y,.;) _f_ [ r. Date J .3
Permit Issued/Red- (date) Issuing Agent Nam ct_ L E v
Inspection Yes No State Valid# Date Recd
1. county (whi e copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) 4. Plumber (canary copy) Revised Date 7/1/78