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Parcel 010-1073-95-000 01/10/2007 05:15 PM
PAGE 1 OF 1
Alt. Parcel 30.30.16.451 010 - TOWN OF EMERALD
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 - SPOO, BRUCE H & NANCY M
BRUCE H & NANCY M SPOO
1336 220TH ST
EMERALD WI 54013
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 1336 220TH ST
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE
SEC 30 T30N R16W 40A NE SE Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
30-30N-16W
Notes: Parcel History:
Date Doc # Vol/Page Type
03/20/1979 355728 591/145 WD
2006 SUMMARY Bill Fair Market Value: Assessed with:
168318 Use Value Assessment
Valuations: Last Changed: 10/20/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 15,000 239,400 254,400 NO
AGRICULTURAL G4 15.000 2,300 0 2,300 NO
UNDEVELOPED G5 1.000 100 0 100 NO
PRODUCTIVE FORST LANDS G6 22.000 59,000 0 59,000 NO
Totals for 2006:
General Property 40.000 76,400 239,400 315,800
Woodland 0.000 0 0
Totals for 2005:
General Property 40.000 76,400 239,400 315,800
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 215
Specials:
User Special Code Category Amount
010-GARBAGE SPECIAL ASSESSMENT 30.00
Special Assessments Special Charges Delinquent Charges
Total 30.00 0.00 0.00
I
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP SEC.2() T ON-RII, W
ST. CROIX COUNTY, WISCONSIN.
ADDRESS
SUBDIVISION LOT IZE rw-s-
PLAN VIE1981
Distances and dimensions to meet requiremen;t-8 of 63
EVERYTHING WITHIN 100 Ft-ET OF SYSTEM
-TF
I di a e 140 Arrow i
BENCHMARK: (Permanent reference Point) Describe : -/e-1" 0~ 0"o
Elevation of vertical reference point: /e~.0"0 Slope at site: S o,~
SEPTIC TANK: Manufacturer: Liquid Capacity: ~-'60
Number of rings on cover 0 Tank manhole cover elevation: 'j
Tank Inlet Elevation: q57' Tank Outlet Elevation:
PUMP CHAMBER
Manufacturer: Number of gallons
Number of gal. pump set or a cyc-le- gallons; total capacity o
distribution lines gallon: size of pump head;
gallon per minute horsepower bran name of pump
and model number
Type of warning device
HOLDING TANK: Manufacturer Number of gallons
Elevation of manhole cover
Type of warning device-
SEEP GE PIT SIZE: Number o pits feet diameter _
feet liquid depth- seepage pit in et pipe-elevation
bottom of seepage pit r. evation feet.
SEEPAGE BED SIZE: number of lines width leiigth ~n'tile depth w
SEEPAGE TRENCH: width length
PERCOLATION RATE a REA REQUIRED 416 REA AS BUILT r~~ '
INSPECTOR
DATED PLUMBER ON JOB
LICENSE NUMBER_____#~c
REPORT OF INS PECTIPN INVIV IOU AI_ Si UTAGC SVS 11 M
Sari ta~;rl I'ern4 1~
Stine Sepa`(.c
Ch - Town6is 4P.- ~St. ciioi x Count
Subdivi6kon
i'l I(' IANK
r 1~ C gaPkanb Number, oA compan-tme.n.t6
i m:
~ Wo v ISu4.Xcl.c n 12$ 4'a,.)e
Hi 9hwate.n
WIN(, ('IIAMHF R
Qatton& _ ,,A&,kmp Manu 4a'c ttu&en Modet.. Numb e.n
1 n I NG TANK
MMombe)L o6 Compan tme n tb
I',r rnlrn ,,A4,anm S yb te.m
(,rk,ce 6Aomi U►e~.2 ButiCd~ng 12$ bX.ope.
Nighwaatek
ION SITE
lire - /
Tnovp1, /
s
~ , ~(nurnr welt ~c fd4"Yl 120 6Xupe
lI i ~IG,c£fa to h
ci'l I ON ti l I I O I MCNS IONS
I tne.neh ~t Regui red area
I P,,r(6s o~ each t.i-ne.-- 6't Depth oA Koch below t.iXe - - <
N,rrril,c'n [r~ f'4d1ee_ T Depth aA hock oven. ti. v
A
i,, tae E'eng.th a6 Linee C
J 2 6t Depth oA -tite be~ ow gnade_-
Din Lance between tinee ~Xope o6 trench gin. pen 100 h
r o to Y ab6 onp.tion area
Type, oA Coven.: Pa)A ah. etn.aw
I I 1 Ml W ti l 0 ly~S. " ~~~9
vf,rr,llv~r rite GAooo e anaund p,:.tb Yee n
t ~ •.Ic d('ame•ten_ At Depth 1)eeow .<n-('et
i r,rI, abaanp.tion ahea h.t
A t c a ncquin.e.d 6t
,j :I 'I I'II.1Z_'1iV TT TL f
c ,r
VAT[ x
/ / - -
DATt/ !s
A ON I 1ZI. 11 CTION
L B 6 7 State and County State Permit #
u Permit Application County Permit #
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 Addres
B. LOCATION: IVE Section C30 , T O N, R LL 0 (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township ~./YJL°RAGc~
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family )C Duplex No. of Bedrooms No. of Persons
D. SEPTIC TANK CAPACITY A50 0 Total gallons No. of tanks 0A1e
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete X 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.~ r Z~
New X Replacement Alternate (Specify)
Seepage Trench: No. of ineal Ft. Wicith Depth Tile depth (top) No. of Trenches
Seepage Bed: X Length- V6 40/4 depth (top)No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land.. 5' nDistance 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 Certified Soil Tester
,
f / ~oLdf- C.S.T. # -5- 5~4Y and other information
obtained from nJe- (owner/builder).
Plumber's Signature MP/MPRSW# MP ~`r-0 Phone #775-65'41--3573
Plumber's Address r .4A- ~
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.
ti- C-
3
.
E ,
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t 3 i
Do Not Write in Space Below OR COUNTY AND STATE DEPARTMENT E ONLY
Date of Application Fees cP id: State/-,/" oun y Date
Permit Issued/R 'e ted (date) ~ O/ Issuing Agent Na
Inspection Yes No 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
bb,
EH 15 Rev. 9/78
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES <
P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATIO ~Y'/4, Sectiond0__,TC&2 N,R/612 (or) W, Township or MmTtc~_l--MC ~
Lot No. ,'Bl'ock No. County 57~- RO/ s"~ Gr
Subdivision Name
Owner's/Buyers Name: v G C~ ff yy ~r~
Mailing Address: r>c~SO sv S
TYPE OF OCCUPANCY: Residence No. of Bedrooms OMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW X REPLACEMENT -ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE:: SOIL BORINGS /1! ?Z PERCOLATION TESTS!!' Z9 - OF
SOIL MAP SHEETS 7` 6} ----NAME OF SOIL MAP UNIT P rK e OAl
PERCOLATION TESTS
TEST HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES
NUM- DEPTH CHARACTER OF SOIL SINCE HOLE HOLE AFTER INTERVAL RATE
MIN/IN
INCHES THICKNESS IN INCHESsd~, 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
BER
P- No 30
P- a ti rn A S o O O
P-3 3 11 D ~l 11 i/ o S L
AV-
P- it
9 (I 9 r o~ J/ O a yo
P- el It a;L O a 3 19
P- 3,6 16, a 5 \/v 3a % X16
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK
OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES
B- 3 '71 } it /r C~rp B- Y" a2 1> /I cl; /t C!/
B- Jr
B-
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan ieJloc ition and square feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancy Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope.
t '
0 9 15
13.0e.
o I dec~,3C~ N
t~ spa d.~
30 P-5-
0 141 oI _
83 P.2
1 - ~
pR0posed
P- 0S C 67, 4. C-Ase-y
a ( T p
of l 70 of Gus!/ ,
Ps7ClS'r/nl - CvBL L I/ - ~j /
b
I, the undersigend, 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) " e_ R e- -A I"3O Certification No.
Address 4L ~3P Cwt ,e S
Name of installer if known- U'~'~ cif
Copy A -Local Authority CST Signat
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