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Parcel 040-1059-60-000 01i04i2007 03:46
PAGE 1 OF 1
F 1
Alt. Parcel 15.28.19.227E 040 - TOWN OF TROY
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
12/29/2005 00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
BOBBI J DIXON CO - STANLEY, JOEL A
JOEL A STANLEY
676 GLOVER RD
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 676 GLOVER RD
SC 4893 RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 0.953 Plat: N/A-NOT AVAILABLE
SEC 15 T28N R1 9W PT SE NE W 161.6 FT OF Block/Condo Bldg:
S 257 FT ALSO STRIP 6 FT WIDE EXTENDING
NLY TO A WELL AS DESCRIBED IN VOL 434 P Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
66 INCLUDES P226E 15-28N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
10/05/2005 808529 2902/587 WD
06/07/2001 647672 1655/504 WD
07/23/1997 860/110
07/23/1997 580/467
more...
2006 SUMMARY Bill Fair Market Value: Assessed with:
158182 185,200
Valuations: Last Changed: 12/29/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.480 45,000 123,900 168,900 NO
Totals for 2006:
General Property 1.480 45,000 123,900 168,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 124
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
COMMERCIAL TESTING LABORATORY, INC.
514 Main Street, P.O. Box 526
Colfax, Wisconsin 54730
715-962-3121
800 - 962 - 5227
CROIX COUNTY REPORT IATE:
,'iion i~.:avacic
ATIOhF Rt. 5t Box
i-ECTOR:
St: Croix Dl::: ,
'.?URCE OF SAMPLE: K i tche
_ 1FORI4. 0 /100
'RPRETAT ION'. I: c t er i t _
16 PPtf,
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o PROFESSIONAL LABORATORY SERVICES SINCE 1952
ST. CROIX COUNTY ZONING OFFICE
St. Croix County Courthouse
911 4th Street
~ Hudson, WI 54016 G
Telephone - (715)386-4680
The St. Croix County Zoning Office offers the service of septic
and water inspections to Lending Institutions, Realty Firms, and
private individuals.
Completion of this form is essential so that the property can be
located.
Please provide the following information, enclose appropriate
fee made payable to St. Croix County Zoning Office, and mail,
along with form to the above address. Testing will be done as
soon as possible after fee and form are received.
WATER TESTING----------------------------FEE: $ 25.00
(For nitrates and coliform bacteria)
WATER TESTING FEE: $127.00
(For VOC'S)
SEPTIC SYSTEM INSPECTION FEE: C$25.00 )
(Determines if system is properly functioning--a-t--'time of
inspection)
Property owner's name c,c,L
Property owner's address ~'~\>x
Legal Description 1/4 of the 1/4 of Section , T N-R
Town of Lot Number Subdivision Name
FIRE NUMBER LOCK BOX NUMBER "f,
Color of house Realty sign by house?~~ If so, list firm:
PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT OOK,
WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET.
Testing of residential water requires a sample that is fresh. If
the home is vacant, and has been so for some time, the water line
must be purged by running the water for several hours before the
test can be conducted.
WINTER TESTING: Many times water lines are turned off, or sill
cocks are turned off, making access to the home necessary. If
this is the case, please make proper arrangements with this
office to ensure time when entry may be gained. ~~ti
,
Firm or individual requesting services: kc5 Q'r w
Telephone Number
REPORT TO BE SENT T0:
,3~
Closing date - 1S q d
Signature
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YOU DON'T HAVE
TO BE AN INDIAN Western Wisconsin's Leader
GUIDE TO TRACK YOUR ~
EVERYDAY Edina Edina Realty, Inc.
NEEDS FOR Realty
PRODUCTS
SERVICES. HUDSON: SOMERSET:
700 Second Street 350 Main
(715) 386-8236 (715) 247-3661
YOU'LL FIND THEM FAST IN THE MLS
CLASSIFIED BUSINESS DIRECTORY Or (612) 436-7072
ST. CROIX COUNTY
g WISCONSIN
z r~'zM
ZONING OFFICE
- xc ST. CROIX COUNTY COURTHOUSE
911 FOURTH STREET • HUDSON, WI 54016
(715) 386-4680
November 29, 1989
Don Sukowaty
126 Zed St.
Hudson, WI 54016
Dear Ms. Johnson:
An on site investigation of the septic system on the property of
Don Kokvacic, Rt.5, Box 52, Hudson, Wisconsin was conducted on
November 28, 1.989.
At the time of the inspection, the sanitary system appeared to be
functioning properly for the existing use. The inspection of
this sewage disposal system was based upon a surface inspection
of said system and did not involve any excavating or chemical
analysis. Accordingly, there is the possibility of hidden
defects in the system not discoverable by this inspection. This
does not in any way warrant or guarantee the continued proper
functioning or operation of this system. It is recommended that
the system should be pumped once every three years. Therefore,
the prolonged life of this system is totally dependent upon
proper maintenance of this system.
Should you have any questions regarding this subject, please feel
free to contact this office.
Sincerely,
Mary ',Jenkins C
Asst. Zoning Administrator
TCN:cj
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AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP r SEC.,L4 ~J
ADDRESS ST. CROIX COUNTY, WISCONSIN.
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SUBDIVISION LOTLOT SIZE _
PLAN VIEW
Distances and dimensions to meet requirements of H63
OW EyFaYTHILq WITHIN 100 FEET OF SYSTEM
T
III
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a I di a e o thi Arrow
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BEi4CHMARK: (Permanent reference Point) Describe:
hleVdLion of vertical reference point: Slope at site
_ -
SE,PTIC TANK: Manufacturer: Liquid CaPacitY :_2?
Number of rings on cover : Tan manhole cover elevation: G3 i!
Tank Inlet Elevation: ' Tank Outlet Elevation: _
y`
PUMP CHAMBER
Manufacturer: Number of gallons _
Number of gal. pump set or a cycle gallons; tota capacity o~
distribution lines gallon: size o pump head,
gallon per minute horsepower _ ran name of Pump
and model number ;
Type of warning device
--T-
gllons_-
HOLDING TANK: Manufacturer Number of a
Elevation of manhole cover
Type of warning device
iameter
SEEPAGE PIT SIZE: um er (5-f -pits eet i
et
feet liquid depth seepage pit ink- PiPe-elevation
bottom of seepage pit elevation feet. ,
SEEPAGE BED SIZE: number of lines wi th lerigthtile depth
SEEPAGE TRENCH: width length _
PERCOLA ION RATA REQUIRED, REA AS BUILT - •
d
INSPECTOR
DATED C PLUMBER ON JOB
LICENSE NUMBER
RI PORT- 01 iN,~l'I_CT ION - INVIVi OUAL MWAGt SySII_M
S a v( 4 l-a it (I I' c'I ill t ( /
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N A,% I I 6-1WA t,- L o w vt 6 It i S t. C !I u 4 x C v u vl I I
I ~I t l (rl - sec -tion Lo-
ti I V1 IC I AN K
Sd 7C ya Cone Numbe/t oA comC)an mV-n~A
Vi AxavlcV f lom: plo.U- % Bul(.1'd4,w 12 s s eohe
Highwa
PUMPING CHAMBER
Si zc - _gat f(IyiA Pump Manu~yac.tu~ie~~ Mode(' Numbv.lt
HOLVING TANK
ga eovtA Numbetc o(I ComhaAtmcntA
!'llmpc ~I A(:ati m Sif6tVrn
V t n t a vl c c ( ~t o mti...,.,,.w~L,. 12 0 .'A X o V-
H,I_ghwate
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Ar,.ti0RI'1I0N SITE
Ii('I IrIV VicPI
V< t'lit cc 0itom: G'JV.PY BIIiZdi vng 12`l, Afoi.)V
ll,i ,qIt wa-te a
Ahti0K1'II0N SITL DIMENSIONS
w( (I th o ( tnVnch RVyu,I hod area ( t
Il-olItit oh eac_It C'.i.vtV t DVp -th o ~tocFZ bVeow t'ieV <v(
Nurllbcti (1~_ f'4'n a 0vptIt (I it och ove~I tiev tvl
f(f(II' tevtgth o~ f.tn.vs 6t Depth u6 t4Je bVYow gti ado
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U(ti t(IYl('V 1) (1 tW0C0 f.i n V A (~t titnC)ln ( tfl Vr(ch Ivl. I'l' , 100 !i I
I (r11 abSlhr.)(4oVI a~Ica Ilt ILIC~I' oI1 CUVV1I' Val_rv i! i aU'
r'. I OI MINIONS
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I u t(I a1) AOApt-f.on a ~IVU -tAAVa nequirr.ed ft
1 N.~ I ' I CTL By TI T L I
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State and County State Permit # I,
PLB 67 "i
Permit Application County Permi
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:
B. LOCATION: Section Z-5, T.;VfN, RZ~Z E (or) ,_%4L Lot# City
Subdivision Name, lnearest road, lake or landmark Blk# Village
Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms No. of Persons
D. SEPTIC TANK CAPACITY /GUf~ Total gallons No. of tanks l
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete Poured-in-Place Steel Fiberglass Other (specify)
New Installation Replacement
Lift Pump Tank or Siphon Chamber Total gallons fab concrete Poured-in-Place Other (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area sq. ft.
New Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: y- Length" Width Z,5'-' Depth , Tile depth (top)e No. of Lines 73
Seepage Pit: Insid diameter Liquid Depth No. of Seepage Pits
Percent slope of land .raDistance 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 Cer ified Soil Tester,
NAME ,c C.S.T. #~7 and other information
obtained from (owner/builder).
Plumber's Signatur _ AAR/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.
3 E ,
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Do Not Write in Space Below 6- FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application 'O/ Fees Paid: State , 6t< Co nt ®-6 Date
Permit Issued/.Rejected (date) Issuing Agent Name
Inspection Yes No State Valid# Date Ree'd
1. county (whit 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
•C`iEPAT~MENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY- DIVISION
LABOR AND PERCOLATION TESTS (11 P.O. BOX 7969
HUMAN RELATIONS MADISON, WI 53707
3707
LOCATION: SECTION: NSHIP/MUNICIPALITY: ILO Np..: DIVI NAME:
r
1/a 1/a /T.: -N/R E (.47
COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: -
USE D ,tS OBSERVATIONS, E
NO. BEDRMS.: COMMERCIAL DESCRIPTION: D T,L : ER LA ION TESTS:
❑Residence - ❑New 'EReplace
-
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional)
S ❑u ❑ s ❑u ❑ s ❑u ❑ s ❑u ❑ s ❑u -
If Percolation Tests are NOT required DESIGN RATE: SYSTEM 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 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.)
13-
B-
B .
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 PERIOD2 PERIOD PER INCH
P__
P_
P_
P.-..
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 location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slop.
SYSTEM ELEVATION
.W.._ t~-~ ..rte--~'Y~
00.r V.
t N
t
I, 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.
NAME (print): TESTS WERE COMPLETED ON:
ADDRESS: CERTIFICATION NUMBER: PHONE NujVlBE`R_ optional):
CST SIGNATURE:
DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester.
DILHR-SBD-6395 (N. 03/81)
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