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Parcel 008-1037-95-000 06/16/2009 09:42 AM
PAGE 1 OF 1
Alt. Parcel 13.28.16.191 B 008 - TOWN OF EAU GALLE
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
0 - STONE, FRANCIS E & ROXANN M
FRANCIS E & ROXANN M STONE
365 CTY RD B
WOODVILLE WI 54028
Districts: SC = School SP = Special Property Address(es): = Primary
Type Dist # Description ' 365 CTY RD B
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 17.000 Plat: N/A-NOT AVAILABLE
SEC 13 T28N R16W 17A SW NW LOT 1 CSM Block/Condo Bldg:
4/1193 (EZ-U-1107/574)
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
13-28N-16W
Notes: Parcel History:
Date Doc # Vol/Page Type
01/06/2005 784349 2727/093 FENCE
07/23/1997 982/527 PR
07/23/1997 442/1 8
07/23/1997 /143
2009 SUMMARY Bill Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 10/07/2008
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 29,700 145,400 175,100 NO
AGRICULTURAL G4 9.000 1,600 0 1,600 NO
UNDEVELOPED G5 6.000 6,900 0 6,900 NO
Totals for 2009:
General Property 17.000 38,200 145,400 183,600
Woodland 0.000 0 0
Totals for 2008:
General Property 17.000 38,200 145,400 183,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 513
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
r
AS BUILT SANITARY SYSTEM REPORT'
I
OWNER TOWNSHIP -1 W
S E C T ~r
ADDRESS
•rE COUNTY, WISCONSIN %
I
SUBDIVISION LOT OT SI7 1
PLAN VIEW
Distances and dimensions to meet requirements of H63
SHO Y HING WITHIN 100 FEET OF SYST ~C'
+ I
1 ~
i -
I
I - -
rrow
I di: !a e or`tTi
- - -
SCALE--. -
BENCHMARK: (Permanent reference Point) Describe: `
Elevation of vertical reference point: Slope at site:
SEPTIC TANK: Manufacturer:
- c-,-t fl~_ Liquid Capacity:'
apacity : /c~~_
Number of rings on cover 5 Tank manhole cover elevation:
Tank Inlet Elevation: "s Tank Outlet Elevation:
PUMP CHAMBER
Manufacturer: Number of gallons
Number of gal. pump set or a cyc e gallons; total capacity o
distribution lines gallon:. size o pump head;
gallon per minute horsepower ran name of pump
f and model number ;
Type of warning device
HOLDING TANK: Manufacturer Number of gallons
Elevation of manhole cover
li Type of warning device
SEEPAGE PIT SIZE: Number o- pits feet i.ameter
feet liquid dept seepage pit inlet pipe-elevation
bottom of seepage pit elevation feet.
SEEPAGE BED SIZE: number of lines ZI/ wi thi lerigth~tile depth__~s6
SEEPAGE TRENCH: width length
PERCOLATION RATE y/•- AREA REQUIRED AREA AS BUILT _
DATED PLUMBER ON JOB s~
'I LICENSE NUMBER s -
REPORT 0F I NSPECT ION - I NDIV I DUAL SEWAGE SYSTH'M n
Sanitary Permit
Stage Septic /
AME TOWNSHIP St. Croix County
)CATION S ction~ Lot Subdivision--_ of/' `
F:11 1'IC TANK
Size gallons Number of compartments
istance from: Well. -5,-, Building 12% s.
H i g h w a t e r UMPINC CHAMBER
Size gallons Pump iufacturer Model Number
OLDING TANK
Size gallons Nu er of Ccipar meat
Pumper Al, rm S stem
istance from: Wel u i I d i g 127, slope
H' water
BSORPTION SITE
Bed Trench G, v.t
i.stance from: We 11 liuiIdi.n}; s.lope -
Ilighwater
h SORP I' I ON S 1_'l'L D IMI NS I ONS
Width of trench ft Itequired area ft. i
Length of each tine ~ft Depth of rock below the in.
Number of lines C Depth of rock over ti-1_e G~ n
Total length of lines ft. De)cIt of the below grade Z / in.
- -
Distance between fines ft Slope uf_ trench in. per 100 1-t
Total absortptiLon area lA~ It Type of Cover:
DIMENSIONS
Number of pits ravel around pits---------yes no
Outside diameter eptIt below iit ]_et ft
i
Total absorption ea It
Area redui_r ft
NS ED BY LE
PPROVED DAII!. 198
EJECTED DATE 198
I-,ASON FOR REJECTION
DE'PARTM'ENT OF APPLICATION SAFETY & BUILDINGS
INDUSTRY, FOR SANITARY DIVISION
LABOR AND PERMIT P.O. BOX 7969
HUMAN RELATIONS (PLB 67) MADISON, WI 53707
Attach plans for the system on paper not less than 8'/2 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. The owners copy or a legible reproduction of the soil test report must be
included.
Prope ty Owner: Mailing Address:
Proper y L 65t City, Village or ownst~ip: County:
SZONLf'/a Q ~T'A N/R )(a °-E-4or) W 'Lla Gam. S?" 1C
Lot N~mber: Blk No.: Subdivis on Name: Nearest Road; State Plan I.D. Number:
C Y~ r (If assigned)
TYPE OF BUILDING I
Number of
❑ PP Mjc* 1:1 Variance* ❑ Other (specify)* Bedrooms:
L 101r 2 Family *State Approval Required. 2
TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER
GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify)
SEPTIC TANK CAPACITY t} ✓
HOLDING TANK CAPACITY
LIFT PUMP TANK/SIPHON CHAMBER
MANUFACTURER: Y 1
EFFLUENT DISPOSAL SYSTEM
PERCOLATION RATE ABSORPTION AREA
(Minutes per inch): PROPOSED (Square feet): I~ New ❑ Replacement ❑ Experimental Seepage Bed ❑ Seepage Pit
;`60 ❑ Alternative (specify) ❑ Seepage Trench
Water Su ply: E' Owner's Name as Listed on Soil Test Report (If other than present owner):
Private ❑ Joint ❑ Public
I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
/ MP/MPRSW No.: Phone Number:
Name of Plumber: Sig re:
'~~i r Ct~ s c> fj.J-Y--
Plum er's ddress: ~ Name o Designer:
COUNTY/DEPARTMENT USE ONLY
Sanitary Permit N er:
Signature I ing Age t: Fee: Date: APPROVED r
~'L/"`L I w ~ ❑ DISAPPROVED Z9 C~ Ze~
Rea n or Disapproval:
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-
staiiation. Failure to comply will void the sanitary permit.
DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber
DILHR-SBD-6398 (N.03/81)
EH 1,15
• - WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES RECEIVED
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH co APR 161981 I`
P.O. BOX 309 ZONING
MADISON, WISCONSIN 53701 OFFICE
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
LOCATION: Section A~, T 2dN, R 16E (or)(W)ownship or Municipality &U Galle
Lot No. , Block No. County St. Croix
Subdivision Name
Owner's Name: Virgil Helgeson
Mailing Address: Rh 1, Woodville, Wi
TYPE OF OCCUPANCY: Residence x No. of Bedrooms 3 Other
EFFLUENT DISPOSAL SYSTEM: NEW x ADDITION REPLACEM
DATES OBSERVATIONS MADE: SOIL BORINGS 9-10 April 1981 PERCOLATION TEST 11 April 1981
SOIL MAP SHEET 87 SOIL TYPE JSB Jewett
PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
P- 1 36" 10" T.S. 18" Clay Loam tea Sand 2 No 10 1" In In 10
P- 2 54" 6" T.S. 140 Clay 32" Gravel 2 No 10 1" 1" 1" 10
P- 3 50" 12" T.S. 18" Clay Loam 20" Sandy 2 No 10 10
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)
1 84" None No 0" T.S. 18" Clay Loam 20" Sand J6" Gravel
B-
2 84 None No " T.S. 14" Clay Loam 60" Gravel
B- 84" None No 4" T,S. 16" Coarse Gravel 54" Gravel
84 None ivo 12" T.S. 18" Clay Loam 54" Sandy Gravel
B- 5 84" None No 2" T.S. 18" Clay Laom 20" Sand 34" Gravel
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. 945, Sq. Ft. Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope.
s
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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) Stephen L. Aaby Certification No. 1404
Address Woodville Wi
Name of installer if known
CST Signature
IYO
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HELGESC xv TRUCKING. INc
Spring Vallev, Wise rjSin
' FORM NO. 985-A L/
F
Stock No. 26273
T I F ED SURVEY MAP
1/4-NW 11SF_C. 13,T28N,R16W TOWN OF EAU
GAL OIX COUNTY, WISCONSIN.
AWNED BY: VIRGIL HELGESON, RT I BOX 284, WOODVILLE, W1.
I, Arthur L. Wegerer, registered land surveyor, hereby certify: That
in full compliance with the provisions of Chapter 236.34 of the Wisconsin
Statutes and the provisions of the St.CeDtic-;cCounnyySubdivision Ordinance
and under the direction of Virgil Helgeson, owner of said land, I have
surveyed, divided, and mapped said parcel of land, that such plat correctly
represents all exterior boundaries and the subdivision of the land surveyed;
and that this land is located in the SW4 of the NWT of Section 13, T28N,
R16W, Town of Eau Gallo, St. Croix County, Wisconsin, to-wit:
Commencin at the W4 Corner of section 13; thence North along the West
line of the NW of said Section 653.77' to the point of beginning;
Thence continuing North along said line 665.301 to the NW corner of
the SW~, of the NW4; thence S87"24135"E along the North line of said forty
1107.601; thence south 670.431; thence N87°17157"W 1107.701 to the point of
beginning.
Contains 17.00 Acres subject to C.T.H. "B1t right-of-way over the
westerly portion as shown.
CC, 0 NS/
Dated this f`3 day of L. ly•.• . , _6
ARTHUR L. Arthur L. Wege` er S-9
G WE~FRER • Kazel, Wegerer and Assoc.,In
N W COR. SEC. 13, µ 5 953 fiver Falls, WI
S ELLSVVORTH W
(314 "RO0 FOUND). WIS.
SUR
UNPLATTED L A,N,D' 11111%O=SET I"X24"IRON PIPE WEIGHING
w I 1.13 L BS PER Li (VEAL FOOT.
p =EXISTING FENCE. ~
v NORTH LINE SW I/4-NW 1/4
S87024'35"F_ 1107.60 5'
_ C
4L.II6 1064.94
I~w Z7 ~No
A v (J) -i m
i ~ b W
rn~
0. 00'
o0 0'0_
LOT 1 0zrn
ry I - z~m
17.00 ACRES
( 740, 625.9 SO. FT) I , m
00 IW 73 9, 189.3 To P.o.w rn z a n
n~ V) U
0, O C~ i' m
n y
O
n 4-%
50 >
~50'
W Z - -i
NO°i5'17°W m
~
Vc - 86.94'
~y 4 7115
1060.55
N87°l7';>7"W 1107 7 ' -
UNPLATTED LANDS SCALE 200'
J 0 00 2 00~ '100
82 30
W 114 COR. SEC. 13, V0 1. `
T2-8N, RI6W_ (C.S.M. FOUND) ) ~
THIS INSTRUMENT DRII~-+F_D BY » ~