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Parcel 030-2082-30-000 04/07/2005 11:08 AM
PAGE 1 OF 1
Alt. Parcel 25.30.20.700 030 - TOWN OF SAINT JOSEPH
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): Current Owner
OHRBOM, DAVID T
DAVID T OHRBOM
1390 WOODLAND CT
HOULTON WI 54082
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 1390 WOODLAND CT
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 2.100 Plat: 2644-WOODLAND HILLS
SEC 25 T30N R20W WOODLAND HILLS LOT 23 Block/Condo Bldg: LOT 23
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
25-30N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 833/133
2004 SUMMARY Bill Fair Market Value: Assessed with:
6410 186,800
Valuations: Last Changed: 07/12/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.100 73,900 109,900 183,800 NO
Totals for 2004:
General Property 2.100 73,900 109,900 183,800
Woodland 0.000 0 0
Totals for 2003:
General Property 2.100 42,200 94,400 136,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 504
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT
' TOWNSHIP.~
- 1 SEC. T,~~I-RmW
OWNER/1,I'~'~~
ADDRESS ST. CROIX COUNTY, WISCONSIN.
Z /I J/4
SUBDIVISION ✓/-_a LOT; LOT SIZE_-
/
PLAN VIEW
Distances and dimensions to meet requirements of H63 r,
SHOW ERYTHING WITHIN 100 FEET OF SYST s' r c►
IF,
1
I.T
r
IT
w is ' ,fit l ~
rj,
77 1
~Dr
-1 Ly l
I di a e 140 th Arrow
BENCHMARK: Permanent reference Point) Describe:
Elevation of vertical reference point: Slope at site: (S
SEPTIC TANK: Manufacturer: Liquid Capacity:
Number of rings on cover Tan manhole cover elevation:-?
Tank Inlet Elevation: Tank Outlet Elevation:
PUMP CHAMBER
Manufacturer: Number of gallons
Nuriber 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 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 e.en feet.
SEEPAGE BED SIZE: number cf lines 3 wi th length
SEEPAGE TRENCH: width _ length
PERCOLATION RATE REQUIRED RE S BUILT
INSPECTOR
DATED PLUMBER ON JOB
_
LICENSE NUMBER
_ RfPOR-1 Of INSP(CT1ON - INDIVIDUAL S(WAGf SYSTEM
San i tait rl Peif rn.< 1
Slat S c p t i NAM I~/.~E! oexi /_`li ownbh,ih-~~, _St. Crtot x .('r rrrr
I icrr fi70 vr - Sect<av Lot Snbd,(-v.LA t ovr
'.I I'7IC TANK
S<<c (JafeonA Number oA compartmen-%tA
(I<Atance {rrum: Wcee,~ ' Bu~edinq 12~ Aeope
l'
Lligi rater
PUMPING C11AM6ER
S.i ze ga fcyl6 Pump Manu~aetureh Mode.Number
HOLDING TANK
e rlael'o vr5 Number of ComparttmentA
•
Pumper Alctrrrr Sr1A-tem
OiAtance (Iit otri: (ueP(' - Bu(~d'vey 12Aeope
Hlghwa tear
ABSORPTION SITt-
Bed Tlreneh
04Atance. {arum: (V 6(1 fd.Ivi q12°s Mope
f!-i gti(4) to r
ABSORPTION SITE DIMENSIONS
Width c,( tfrepeh - -h-t Requirred artea
Length c( each erne 5(= _ - f Depth oA rLock be -e.ow tli_Pe_ !w
Number of ('tvreA Depth o4 Aac.h avert ti.Pe tvr
Totae een,qth of e.Ip,A 6-t Depth a6 -twee beeow grade ivr
04At ance between eivleA (,t S,eape 0A 0te.neh dn. parr 100 hf
To tae ahAar.p'ti an arrc ct ' ~t ypt of Caver: rrt,n yr A t~raur
PIT DIMENSIONS
Nurrncc rr pI to - G1aI, around ni-tA r/nA
Ou-tAI de dt am c:{cIt
--6 t v Ih be-k.aw <.nert
Totae abAOrptian altea
/ M
A!rca ~rcroi'rerl ~t
INCPC CT 14 T171 f
('PROVL D OAT[
Rf 1( CT( D VA71 GN
WI A S ON 1 0 I; R (!ICI ION
- ~
i-o'°
State and County State Permit #
PJLB 67 f w Permit Application County Per t#
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: --A("4V'/4 Section jky, T-JON, R_ W,' E (or) Lot# 275 City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township -21~-T-
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms No. of Persons,'
D. SEPTIC TANK CAPACITY &/)IV Total gallons No. of tanks
HOLDING TANK CAPACITY otal gallons No. of tanks
r Prefab concrete Poured-in-PlaSe-- el Fiberglass Other (specify)
New Installation R placement
Lift Pump Tank or Siphon Chamber refab concrete Poured-in-PlaceOther (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Percolation RateJ,% otal Absorb Area sq. ft.
New Replacement X Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: XLength „ Width le Depth Tile depth (top) No. of Lines 3
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land 6!~Tp Distance from critical slope
WATER SUPPLY: Private IX 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,
NAME f wd//S e &,--sT]WAE5/1ft eex C.S.T. # and other information
obtained from (owner Ider). _
Plumber's Signature M MPRSW#) ~.2c_5 Phone #,/3
Plumber's Address z
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.
t
,
,
i
, t
Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application e~n Da i
Fees Paid: State Co
_
u
Permit Issued/Rejected (date) --Issuing Agent Name: '
Inspection YesNo State Valid# Date Recd
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
E H 115 Rev. 9/78 Se 6 . S ` e e:
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION: 14)'/4,_'/4, Section , Imo/ N,~40*(or)( Township or Municipality -!;~4 J~xzooo
Lot No.2.3-, Block No. ~C7Qd /d~~ County
ub ivision ame
Owner's/Buyers Name: d Q
Mailing Address: d C AMINEW -6
TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW -REPLACEMENT- k ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS jMADE: SOIL BORINGS C/x " IV PERCOLATION TESTS
SOIL MAP SHEET NAME OF SOIL MAP UNIT 440 19
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 MIN; IN
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 RIOD 3
P -
P-
,r~ F
P-
P_
P- ;v
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- 00
B-
B-
B-
B-
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the n the location and square feet of suitable areas.
r
Indicate number of square feet of absorption area needed for building type and occupancy 4 1 I cate scale or distances.
Give horizontal and vertical reference points. Indicate slope. 9yS~' ~~c y.~A.-C~-
Derco(Akc,w Test f'N A & fare- fil-o/e, Br
a r.~ \
At.
01
88 E.
~
S~ a-
~ N
(eve l i'AA S~p~- e F_.(.= 92s'
t3 8
Aot-4,4~, y /o-e4 (tom y 24 Sl% E9s 9~ p ® 3 19"
fez sy, s~~-~~1 / ~ aM i8:
w ~ y'r. ~l~ Or-A~~ ~1R4s- L a ~ ~cf~rl~ f3.
S, C /,311- C01A,1Q.P-
I, the undersigend, hereby certify that the soil tests reported on this for 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) c P~.S 4 ~f~ Certification No. -S3 L
Address / v > Jk
.Name of installer if known _
Copy A -Local Authority CST Signatur
w._., . v ( k'c(;cti'q c '17r VL /',A ►
WISCONSIN DEPARI MENT 1 )I HEALTH AND SOCIAL SERVICES T rZAk- Tt IL II=C)tz- ?A='
DIVISION OF HEALTH, BUIII AU OF ENVIRONMENTAL HEALTH ►'F'4-1c rq7 c S
• ^ . , P-(?- BOX 309
MADISON. WISCONSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
II tlv /YWr , N his,, Section .5 , T:~f61V R40.jt*;A) W Township S.E~i~i~----------
N. ' Moi l< No. /J I County f - 61;
f
_ r/ ubdivlsion N;cl,,e
I ,III II•AI\WY Residence No. of Bedrooms
Other
r I' r,Al ',1' I I M NI W ADDI IION REPLACEMENT
li. ,l HVA 11t1N:, MADISOIL_ BORINGS fl7e PFRCOLATION TESTS
I L,, ;I",III I I /Z 3 C`1-r> P'--K- SOIL TYPE 1Nnr'i //ate su ~'1 l c.<
~1~ New F-'t~,~~I'L wt~1r _ N @w ti30oK..
PERCOLATION T S'TS
.I I UI I III CHAHAC TER OF SOIL I HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RA I'
M NCI W!, THICKNESS IN INCHES • SINC.I- HOLE HOt C AF IER INTERVAL -
.
rll 11 iST WFI I ED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/Ir
? t I fir. 2 {{c~~ ~r+ r~1 Z 4 AleNl= 3v / 96,
j i/~ .1 1 r z 4- /l(lan/ 3o f iL l i` l ~g Z z
SOIL BORING TESTS
I , I nl M PI-14 DFP1 H i t) 6HOUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
INC HF. ; OBSERVED LSTIMA I ED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
t' i, A~C'/b'l. >~1c, IS~L 'fi=t ~~~i }}Gr2 J
f, /\(OrV[° 7fo 511 3A S.S F=,A-
6 /C
13v 14 L 4
,•,c'
I I AN VIEW (Lo c, tci perco ationtests,soll bore holes and s`uitabletso li areas.
I rnhl.,lle I,n the plan the locatlunand square feet of sudable areas Indicate number of square feet of absorption area
i n -Ied lot bcnldnut type and occupancy. 14 ►e(I 1R-90Indicate scale
dr,lances Give horilont_al and vertical reference point,.;. Indicate Slope. Z 7-Sv Ste- F7. Su cTi?14 Lam'
i I ..0/~~3 yb
I
( f~11y1 f7Fx~S6n/e L
ICIVP
O /
/ /
f i 1
k - I - - , -
_ I
I ;
~✓s/
t ~ ~ ~ -
I I ~ I ~P ~ u
Iw Imilt-l"nlned, henll,y (,I-lll(y Thal the soil tests leported on this torn) were made by me in accord with the procedures
Ih,)&, '•Jwl flied In Iht, Wl,,con,,m AdnunlsRallve Code, and that- the data recorded and location of test holes are correct
III III my hnowlndy:,wd belle(.
~V S<_ Certification No. ~5= Gr- r_
F/V
CS I Slynalurr - - ~ ► r~ t-0`~ _
IOCAI AUTHORITY -
•
M
7 '
'A r't-
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• AS BUILT SANITARY SYSTEM REPORT
kX'41 ER TOWNSHIP 5 SEC.) S T_~Q N, R Z O W
0. ADDRESSi24 ► c- ,/,iu j ST. CROIX COUNTY, WISCONSIN. .
- i?DIVISION ~~c„_,~< tiy < < LOT L ~ LOT SIZE
PLAN VIEW
Distances b dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
- -_T
-r- _
5,
fL-
i
~I
i 0 i
Iri sate North; Arrota
e ! j I ! ! S CALL C^) r-
j
i
II~PTIC TANK, (S)/ fC~r~O~MFGR. t K CONCRETE X'~ STEEL'
NO. of rings on cover / Deptli Q DRY WELL
iLNCHES NO. of _ width length _~Q area
no. of lines 4- wi.dth length area
/depth to top of pipe
~GREGATE
)r~ RATE ' AREA REQUIRED IF -
AREA AS BUILT
,_1 _
isclaimer: The inspection of this system by St. Croix County does not imply complete
oipliance with State Administrative Codes. There are other areas that it is not possible
o inspect at this point of construction. St. Croix County assumes no liability for
Stem operation. However, if failure is noted the County will make every effort to
ermine cause of failure.
EASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
'-INSPECTOR
DATED PLUIMER ON JOB
LICENSE NU11BER ~ f'~~<~,,
z
"PEPORT OF INSPECTION-INDIVIDUAL SEWAGE SYSTEM
ji Sanitary Permit A
• State Sep.tic.?
NAME Z(L L.` _Township St. C'toix County
LacatiaA/c~c~ Section 2-~
SEPTIC TANK
E
Size gattons. Number o6 Compartments j
Distance Fnam: We.-.2 it. 12% an greaten 6tope it
Buitd.ing 26 it. Wettands ~ •
H~.ghwaten it.
DISPOSAL S~'STcM
Di.6tance From: Glee it. 12% on gteaten s.2ope. fit.
BuiZding_. _jt. Wettands Ft.
Highwate)L it.
FIELD VTMENSIONS:
Width o6 tneneh it. Depth o6 hock below tite in.
Length o4 each -Eine it. Depth o6 rock oven tite in.
Nurib en o' tines Depth o4 tite_ b etow g,t ade in.
Totat length o' Zines it. Stope o6 trench in pv, 100 fit.
Di., .stance between tines_ 6t. Depth to b edto ck it.
Totat abs oAbt~ on area St2 Depth to g.noundwaten!t.
Requined area it - u l Type o6 Coveh: Papen o St•uw
PIT DIMENSIONS:
Numbers o6 pits Gnavet around pits yes_~!^0
Outside diameters 6t. Depth betow intet_ 5t.
2
Total absotbtion area it
2 rn
Area nequ~,ned ~t
TNSP CTED BY TITLE
APPROVED , DATE 197.
REJECTED , DATE 197.
O 0
5 ~
g
fi
State and County State Permit #
PL9y4 [ y Permit Application County Per
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: /L`_,C % % Section T )a N, R or) W Lot# LLCity
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 3 No. of Person
D. SEPTIC TANK CAPACITY AC'C` Total gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete 1k 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)
Se°na°° Tr°^^"' SCE No. of Lineal Ft. Width Depth__,Z~Tile depth (top)-i- 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 19 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 Certifie Soil Tester,
NAME C.S.T. #and other information
obtained from (owner/builder)..
Plumber's Signature MPRSW# Phone
I~IA J,
Plumber's Address z
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.
`L
Lk~'rE 4, L.
A,L f%p
.
r
A.
_
3
•
Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application Fees Paid: State,/, 71 Fount ="f' f Date
Permit IssuedlBa}eettd r (date) /i Issuing Agent Nam
Inspection Yes X 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
EN. ~ ~ 5 r:> P ~ I G,47~ s ~ r-
DIZIC=/A,/4-1.._ 61 VE/u tc
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES Cviv'TR4C TGcL- irGrr_ f'~11
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH 14-Pfg (C,i4 i c c •-f 5 .
P.O. BOX 309
MADISON, WISCONSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TESTS J
LOCATION: [/4, A tai, Section 4 T3~1, R ) W, Township ✓~/S~~ ~y
Lot No. Block No. WOO D`tNp 141 ~ 1~s County `~/x
Subdivision Name
Owner's Name: AnE~ P_ I Cr & 4;7- --~R ,
Mailing Address: 5 Z5~ LcMQN rAo -A:p7-_7 YUD54A/ V~~ 1 54-C.3
TYPE OF OCCUPANCY: Residence K No. of Bedrooms 3 Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS /7~
SOIL MAP SHEET Z-/•Z3 00:~ I'--0PK SOIL TYPE 5A VT7 A'= ~ ?_>O°_X, -
41 NEW gc;,~K_ A melzY - N i w 13eG~
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 MIN/IN
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P-Z 3 Z S~ ENCIP-P t{olT>+74 Z4 Al Ng 31 l 1 iv 9
2,3]
P_ Z* X/4,
SOIL BORING TESTS
F TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
roc 71 7r iL 38; 53 L~/L,3o; sir. iL /0; 50
B_ ,
t
A/C NE > e ,L, 38; S;5 m 30 ' 5i ~ UiZ /z,
~ a /tic /V,7_ > u 5.L~ 38 ; 5, S tG K, 3"~ Sri ►9-~
B !L.
g~ /Yc% J=- iL SIL 3S• 313' S,L " G,c- rZ.
B- S 8* NAN7- /4
~U NoNi= SQL, 38 S, SC~Rj 38 ; S~ 9'
U ~~lDn/y-.~ >Cr SQL 3b 5t5 `~2j 3~' r7
LAN VIEW (Locate percolationtests'soil bore holes and s~uitabldsoil areas. /
Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area
needed for building type and occupancy. 9457 5D' p7 z. i R-ac, Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope. ZZS~ 5 ` FT.
i
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l3 ! .04 i i i - - -
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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)~MI~ " V SC-1} Certification No. ~5 -s GU
Address G 4 t 404Za_4--ST V --4--~ ~i(~~ 574-02-7-
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CST Signatures-..__-
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