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Parcel 004-1017-50-000 01i11i2007 11:26 AM
PAGE 1 OF 1
Alt. Parcel 8.28.15.117 004 - TOWN OF CADY
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 - SOBOTA, PATRICK J & MARY
PATRICK J & MARY SOBOTA
2845 50TH AVE
WILSON WI 54027
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description ' 2845 50TH AVE
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE
SEC 8 T28N R1 5W 40A NE NW Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
08-28N-15W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1241/078 WD
07/23/1997 856/18
07/23/1997 851/39
07/23/1997 838/341
2006 SUMMARY Bill Fair Market Value: Assessed with:
164401 Use Value Assessment
Valuations: Last Changed: 04/17/2006
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 28,000 179,900 207,900 NO
AGRICULTURAL G4 25.000 4,000 0 4,000 NO
UNDEVELOPED G5 13.000 7,800 0 7,800 NO
Totals for 2006:
General Property 40.000 39,800 179,900 219,700
Woodland 0.000 0 0
Totals for 2005:
General Property 40.000 39,500 179,900 219,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: 04117/2001 Batch 511
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
i ,
AS BUILT SANITARY SYSTEM REPORT
OWNER e~ TOWNSHIP. L SEC 11,-RLW
ADDRESS -COUNTY, WISCONSIN
"
All 44
SUBDIVISION LOT
PLAN VIEW i 4Ir F
Distances and dimensions to meet requirements of H63
Y THING WITHIN 100 FEET OF SY TEM pF~ v x
4=4 1 *T,
5a ,e f, a L
.7 0'
i
I di a e o th Arrow
SC L :
BENCHMARK: (Permanent reference Point; Describe: Elevation of vertical reference point:. 4'C f'` Slope at site
SEPTIC TANK: Manufacturer: K-c> Liquid Capacity: )
Number of rings on cover : / Tank manhole cover elevation:--
Tank Inlet Elevation: Tank Outlet Elevation:
PUMP CHAMBER
Manufacturer: Number of gallons
yc e gallons; "total capacity o
number of gal. pump set or a cycle-
distribution lines gallon:. size of pump head;
gallon per minute horsepower ran 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 o pits feet diameter
feet liquid dept seepage pit in et pipe-elevation
bottom of seepage pit elevation feet.
SEEPAGE BED SIZE: number of lines width length tile depth
SEEPAGE TRENCH: width length
PERCOLATION RATE.. ~ AREA '-REQUIRED ARE AS BUILT
DATED PLUMBER ON JOB -
T---/ LICENSE NUMBER ~-~1 / l
REPORT OF INSPE ON -,INDIVIDUAL SEWAGE SYSTEM
r
•
(YA
Sanitary Permit 4; State Septic/-jrjZ!r
NAME TOWNSHIP St. Croix CouneV
I,OCA'I'TON )y Section Lot fir` Subdivision
SEPTIC TANK ~ i
G ~
Size gallons Number of compartments
Distallct' I rom: WeI I BuiJ-din.g_ 1- 12% slope
Ii fghwater
PUMPING CHAMBER
Size gallons Pump Manufacturer Model Numbil dl"
(TOLD I NC, TANK
Size gallons N,ber f Co artments
Pumper. Ala rng tem
~i stance fromWell Bu -1- 12% slope
HIgfix,
ABSORPTION SITE
Bed .f' Trench
Distance f rom: Well 1.2% slope-
Ili g h w a t e r---=
S
ABSORI"I'fON Sl E DIMENSIONS
Width of trench ft Required area 11•
Z
Length of each line ft Depth of rock below tiile in-
Number. of lines Depth of rock over tile in
Total length of lines / ft Depth of tile below grade in
-
Distance between lines ft Slope of trench in. per 100 it.
Total absortptiion area tt 't'ype of Cover:
PIT DIMENSIONS
Number of pits (;rave] around pits--- ---yes 11
Outside- diameter ft Depth below inlet ft
Total- absorption a a ft
Area required
INSPEC TED .-B-
APPROVED DA'I'S 198
REJECTED llA'I'E 198
REASON FOR REJECTION
• ,Ra L
State and County State Permit #
PLB 67 v Permit Application County Permit # 'fi:Z
~
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:
i
B. LOCATION: Section T ' 4 N, R /t '6-{or) W Lot# City
Subdivision Name, nearest 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 ! . Total gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete f Poured-in-Place Steel Fiberglass Other (specify)
New Installation Replacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab 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. --r Width ` Depth -E ~ / Tile depth (top) No. of Trenches "
Seepage Bed: Length Width Depth Tile depth (top) No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land Distance from critical slope
WATER SUPPLY: Private F~Koint ❑ 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 Certified Soil Tester,:
and other information
NAME bc ,,t t; C.S.T. # 3 t9~t 5/
obtained from (owner/builder).
Plumber's Signature z>_. > - Phone # - 7
MP/MPRSW#
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 Fees Paid: State County Date (J - -
Permit Issued/Re'ected (date) O ~L k1 Issuing Agent Name
Inspection YesNo State Valid# Date Recd
1. county (white 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
SAt8~ ILDINGN
DEPARTMENT OF REPORT ON SOIL BORINGS AND SI O
t'N DU~T'R Y, N
LABOR'AND C ~ P O. 69
-HUMAN RELATIONS PERCOLATION TESTS (115) e M FD~N, 9
't 7
LOCATION- SECTION: N/R j r) TOWNS~HIR/MUNICIPALITY: LOT NO.: BLK. NO.: SUB . SION
YER'S°: ME: MAILIN ADDRESS: < j
CO NTY: OWNER'S Bkl y /
-ts 'S
USE DATES OBSERVATIONS
NO. BEDRMS.: COMMERCIAL DESCRIPTION: ~ R TONS: jr:
~tkT ESTS: nce ❑New L~~Replace RATING: S= Site suitable for system U= Site unsuitable for system
coo Ap +ti n .t 451,44 1.2 -_1
CONVEfVTIO❑NAL: MOUND: EU IN-GROUND-PRESSURE: Sa EM-IN- U L Ha ~G❑U • RECOMMENDED S STEM:(optional)
If Percolation Tests are NOT required DESIGN RATE: SYSTEM EL V.
I 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.)
B , 'Z.(~t ~%'y r •-7 [ r'.~ %~j ~~Jr.+ -1,n+ ~Y f>~}= C"~.~~~ Y I~%31 ~l
r' L// t > / . J;/ ~S )'ll 3"
77- f oc,A C'c;vt C"` /`tic c9 uJ</ rY /
B- - /
PERCOLATION' ESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PER OD PER INCH
P- !
P- .2
r1-
r-
PLAN VIEW: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate sc a or distances. Describe what are the hori-
zontal and vertical elevation reference points and show on tMe plot urface elevatio at all borings and the direction and percent
of land slop.
SYSTEM ELEVATION ,t`<a
5 c.
E
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f, C
1
431/1 Ov.•
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-
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65
1
i, the undersigned, hereby certify that the soil tests !r orted 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 NUMBER 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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{ r ST. CROI X COUNTY
W I SC 0 N S I N
ZONING OFFICE 796-2239
' HAMMOND, WI 54015
September 14, 1981
Bennie Helgeson
R. R. 1
Spring Valley, WI 54767
Dear Bennie:
I am returning the 115's for both Richard Rasmussen,
located in Cady township and for Robert Richardson,
also located in Cady township, for the following
reasons:
1. Soils Map Page number is missing.
2. Map unit name is missing.
3. System elevation should be in relation to bench
mark (not listed as inches below grade)
4. Depth of percolation hole does not correspond
to location.
Please correct these problems and return the per-
colation tests to us.
If you have any questions, please feel free to
contact us.
.Yo u r s u 13~-T__~
Thoma's C. Nelson
sl
Enclosures: Percolation tests
(Rasmussen and Richardson)