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Parcel 022-1012-20-000 12/07/2005 08:18 AM
PAGE 1 OF 2
Alt. Parcel M 5.28.18.72E 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
STACY HOEHN O - HOEHN, STACY
1048 CTY RD N
ROBERTS WI 54023
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 1048 CTY RD N
SC 2422 ST CROIX CENTRAL
SP 1700 WITC
Legal Description: Acres: 5.000 Plat: N/A-NOT AVAILABLE
SEC 5 T28N R18W 3A PART OF NE NW & SE NW Block/Condo Bldg:
LOT 1 CSM 4/1128 ALSO COM N1/4 COR SEC
5;TH S 1239.71';TH W 630' POB;TH S Tract(s): (Sec-Tvm-Rng 40 1/4 160 1/4)
381';TH S 70 DEG E 146.22'; TH S 05-28N-18W
74.43';TH N 70 DEG W 411.25';TH N 11 DEG
E 236.85';TH N 55 DEG E 243.82' POB
Notes: Parcel History:
Date Doc # Vol/Page Type
04/15/2004 759E78 2549/008 WD
12/29/2000 636C 09 1571/01 TI
10/13/2000 631728 1550/435 TI
10/29/1998 590201 1371/28 WD
more...
2005 SUMMARY Bill Fair Market Value: Assessed with:
87929 188,000
Valuations: Last Changed: 08/10/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.000 60,000 130,100 190,100 NO
Totals for 2005:
General Property 5.000 60,000 130,100 190,100
Woodland 0.000 0 0
Totals for 2004:
General Property 5.000 40,000 105,700 145,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: 10/19/2003 Batch 05-37
Specials:
User Special Code Categor/ Amount
Special Assessments Speciz l Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 022-1012-20-000 12/07/2005 08:18 AM
PAGE 2 OF 2
Parcel History: cont.
07/23/1997 2001/240 QC
07/23/1997 1165/560 DJ
07/23/1997 1077/447 WD
07/23/1997 827/108
242972 320/301 AD
I
Q01 CERTIFIED SURVEY MAP
ATE 1) IN NF1A4-NW 1/49SE 1/4-NW 1/4 SEC. 5,r2RN,RIBW,TOWN OFKINNICKINNIC,STCROIX CNTY
;3 ! ~ I r •'1 ~ t
_L p I1 Y'1,}l l l r ] WE'~;F°r'' Y , T'F E i ! r'1 land
V ('lt11 (!(,)m1,l i_rance wi.tb t,Y)e; prov'i-ai-or)-- or 23(1.311 . of' t1le, vJi_scotl: -rl 'jI,al,_I!
t~ 11 l~rid S t;.• r• o ix I_; o l l r (t ;3 1.1 1, d iv i i_ o r t (!r r1I_ )-I ~l nc:( 8 n c I.h~ 1a:rovi-~i.c,r~a of C y r ' i
~i r'wc~I,~ on of P(I rt, `1'i.,himerrrlan owrler of ;.-)9i_d 1ari1) and 3ai_d land, 7a.ve ; t cv,ayed, (ii -vi ~k,'d, and !ua1,1,r>d :ail-I.i
1"11'rn_-] ()I' lall(i, t,IIr~L n~'
la', <.cwv,~(.,t,1y represents all e:xl,eri_or, l'ot.trl'.lari and nl t.tic~
arid purveyed; and tha!, t;t)iS I.an(-a i-s 1_ocat.e~d. i.n r,1-2 w 01' !.n(, CJWfw Arid t,l)~ I`iL,w
ile PJVJ4 of Section 5, `l'VN, Rt1P1)W, Towrl of P;i-rtni_<tl<~rtni-c, S!..(,roi_.x '~oru~11,~,, Wi;;(_;(-rl.,
(SmnencLrigr at the i`J4 corner of ~'o(,'Jor) ra.rl., :r Sect,i_on Line 1.239.71'; t,l~ rw West 3',r).")? 1--: 1,01,111 Of
Thence, SOlath 5j2.12' t0 a polnt, oIi I- 111111; Ill-I il, IN, 7(_)a
7t00lIW alonL; Said centerline l;~).~~(Ji; rt(•„ ~ Y~I,?1 7/L. ;r y r.}~,,n~,f, 1y7;Par;710;1tra1
46.2121 y tbt:tncm North. 3f~*1_.0011~1r'rIC:E' 1~,a ,1. ~?fl.~)rl+ !,1~,~ 1)(Arlt 01
Contain3 3.00 Acres sut)jec(, I.() over
1)ortion thereof'.
IIto IIt ,i __N 114 CDR SEC 5,
1 ~ 8d l,0"",\s I I '~Irl Y~l -C hA y I T 2 C. 8 S.NM. FOUND)
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ARTHUP I. •
WEGERER
5-163 = r 1,}~ur_
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WIS. J ver a W-1
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- NOTE_ HEARINGS
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REFERENCED TO
1 THE N--S OUARTF_R
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ASSUMED BEARING
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CENTER OF SECS,
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( ,c3) -T28N,R18W
5000' ~ O' SU 100' 00 (I LP FOUND)
cS ~
-iC. rr~ n~ 0 -SET I"X24"IHON PIPFWEIGHING
13 f_BS PEN I-INEA(- FOOT
• _ (HON PI PE FOUN 1)
HI 1 1 6 T Ff I S I N I I-~ I I M i N I I ~l-i -"I r r I i i
AS BUILT SANITARY SYSTEM REPORT
OWNER l) TOWNSHIP SEC.
ADDRESS !I/ ST. CROIX COUNTY, WISCONSIN.
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of H63
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
1
- I cli_ a e o~,' h~Arrow
BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical reference point:/a,)~`-,A' Slope at site:
SEPTIC TANK: Manufacturer: -A Liquid Capacity:
f 7--~
Number of rings on cover Jank manhole cover elevation:
Tank Inlet Elevation: Tank Outlet Elevation: 1 1
PUMP CHAMBER
Manufacturer: Number of gallons _
Number of gal. pump set or a cycle ~ gallons; total capacity o-----
distribution lines gallon: size of pump head;
gallon per minute horsepower ran name of primp
and model number ;
Type of warning device
HOLDING TANK: Manufacturer Number of gallons____
Elevation of manhole cover
Type of warning device
SEEPAGE PIT SIZE: um er o pits feet diameter
feet liquid depth seepage pit in et pipe-elevation
bottom of seepage pit elevation feet.
SEEPAGE BED SIZE: number of lines r width j length- ; the depth
SEEPAGE TRENCH: idth length
PERCOLATION RATE ,.1 AREA REQUIRED RE AS BUILT
- tom- _A
INSPECTOR ry% i1
DATED- / f PLUMBER ON -J B 4) u, ,
LICENSE NUMBER__-_)__"6y
. KI VORT OF INS IL CTION INVIVIVUAL. SI-wAGL SVSILM -"2
Sand tai((/ V('111114 I
State SepT,(.c 140s eo
_Ly1t7lC1%~r~~'C _
~AE _~w~ S e c xti u vt Lot N S u b di v i,6 4'o n
- yaxkovtb Nurnbe.it o6 eornpanamen"ta
'Iofit : wezk 6u-xdiny ~ 12% atope
Nighwa.te4 -t
i1,1Mt.il R
_ yaxtona Pump Manu6ae.tune4 Mode.t Numbel(.
IANK
yaefon6 Number oh Compantmente
A.eahrn Sips tem .
lUeeLia~.Xd.i.ny 12s akopv
ff4 yhwa1e.11
,~~N `,I 11
T It e n c h
Bukeding J 12% elope-----
N.tyhwa.ten
,N 1It. DIMENSIONS
r o taench_ At Re.cluc red ane.a._
rv~ „A each Zine. 6t Depth oA hock befow t4.ee
1i o6 4.ICfte.e t" Dooth ilk boob n~inh -tl ran '21 .
i'c r((Ith o6 Une.,6 6t, Depth o6* -t-%k.e- below (4liade
I)ctwvvvi x4Y1v6 6t Skope o6 tLeneh -2 61. 1)('11 100 At
I,,,o,(I,t.tun at(va._...L~~_6x Type oA ct,ven-: Pape(
(1 j').( t6 G'&akw e ant nd p{ is IINJ
4 (6tl tv I 6-t Ovpth bvk.ow cft fv t
i I~1,~ll~ t ((,YI i(hN U 6 ('i i' r 11 ( 1 _.r._ 6 x
( 1) fS y A: T J T 1- L
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IF
DEPARTMENT OF APPLICATION SAFETY & BUILDINGS
FOR SANITARY DIVISION
INDUSTRY, '
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.
Property Owner: Mailin Address:
/r
Property Location: City, illage or Township: County:
'/4 '/4S /T _2.f? N/R (or) W
4Z
Lot Number: Blk No.: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number:
(If assigned)
TYPE OF BUILDING
Number of
❑ Public* ❑ Variance* ❑ Other (specify)* Bedrooms:
1 or 2 Family *State Approval Required.
TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER
GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify)
SEPTIC TANK CAPACITY
HOLDING TANK CAPACITY
LIFT PUMP TANK/SIPHON CHAMBER
3P 2
MANUFACTURER:
EFFLUENT DISPOSAL SYSTEM
PERCOLATION RATE ABSORPTION AREA
(Minutes per inch): PROPOSED (Square feet): New ❑ Replacement ❑ Experimental Seepage Bed ❑ Seepage Pit
❑ Alternative (specify) ❑ Seepage Trench
/6 %a
Water Supply: 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.
Name of Plumber: Signature: MP/MPRSW No.: Phone Number:
Plu er s Addr s: Name of Designer:
2E.1) _JZ
COUNTY/DEPARTMENT USE ONLY
Sign toe of Issuing Agent Fee: Date: APPROVED Sanitary Permit Number:
Q DISAPPROVED
ea on for 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-
sta lation. 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)
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
4DUSTRY, . DIVISION BOX HUMAN REDLATIONS PERCOLATION TESTS (11J) MADISON WI 53707
LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.: BILK. NO.: SUBDIVISION NAME:
1/ /4 /T N/R; J(or) W
COUNTY: OWNER'S BUYER'S NAME: AI LING ADDRESS:
t - ~
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: ROFILE DESCRIPTIONS: 1PERCOLATION TESTS:
Residence New Replace 7
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDI(cN~G TANK: RECOMMENDED SYSTEM: (optional)
~v OU
El S EIS EIU ❑S ❑U
If Percolation Tests are NOT required DESIGN RATE: SYSTEM EL 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
B - u L 5
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD t PERIOD 2 PERIOD 3 PER INCH
P-
P-
P- lr
P-
P-
P-
PLAN 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 f _31 w
,_t,/1'C:.if. //~I~i,:Tc ' h'rtC ~n..,%1r,/.. f~C; ✓L -4.i ,
,
.r ,
~ /C~~~ e~~.'r1.CE• . -gin'
. a«
I '
E
1. • wE.u
C^ i 4a
t
I, the undersigned, hereby certify that the soil tests reported on this form were made by me i accord with t -pfocBdures 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 knowled a and belief.
NAM print): l TESTS WERE COMPLETED ON:
ADDRF~SS: CERTIFICATION NUMBER: PHONE NUMBER optional):
CST GNATUREy
t
DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page Soil Tester.
I LHR-SB D-6395 (N. 03/81)
~~`e7~l.5 L✓.~ / /1 iNN/Cry'/.~///c:. ~v
j
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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, DIVISION
LABOR AND' PERCOLATION TESTS (115) MADISON W 7969
HUMAN RELATIONS
LOCATION: SECTION. TOWNSHIP/MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME:
'r= '/4/ i /T 'N/k' > ior) W , )-I) 4_ E. ` ; J--
COUNTY: OWNER'S BUYER'S NAME: _ MAILING ADDRESS:
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: 1~1 PROFILE DESCRIPTIONS: 1PERCOLATION TESTS:
Residence a New ❑Replace I
RATING: S= Site suitable for system U= Site unsuitable for system
CONVECCNTIONIA'L: MOUNCD: IN-GROUND-PRESSURE:SYSTEA`M-IN-FILLHOLDIINGTANIK:RECOMMENDED SYSTEM: (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. IGH_EST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B- G~JJ~~" J f J
B-
B-
B-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH
P- e-7
7 L=
P-
P-
P-
P-
P-
PLAN 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 9 . J
6
f--- 7r _
e
f
/W
n I /
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.
NAM print): TESTS WERE COMPLETED ON:
AD FS CERTIFICATION NUMBER: PHONE NUMBER optional):
CSTAGNATU E:
7)
DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester.
DI LHR-SB D-6395 IN. 03/81)
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