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Parcel 030-1074-10-000 03/02/2005 04:37 PM
PAGE 1 OF 1
Alt. Parcel 26.30.19.257A2 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
" MCGLADE, JAMES P & CHERYL L
JAMES P & CHERYL L MCGLADE
1320 BASS LAKE RD
HUDSON WI 54016
Districts: SC -School SP =Special Property Address(es): -Primary
Type Dist # Description * 1320 BASS LAKE RD
SC 2611 SCH D OF HUDSON
SP 8040 BASS LAKE REHAB DIST
SP 1700 WITC
Legal Description: Acres: 4.230 Plat: N/A-NOT AVAILABLE
SEC 26 T30N R19W GL 8 LOT 2 OF CSM 3/759 Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
26-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 900/564
07/23/1997 899/60
2004 SUMMARY Bill Fair Market Value: Assessed with:
5358 245,100
Valuations: Last Changed: 07/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 4.230 153,900 87,200 241,100 NO
Totals for 2004:
General Property 4.230 153,900 87,200 241,100
Woodland 0.000 0 0
Totals for 2003:
General Property 4.230 94,700 77,400 172,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 304
Specials:
User Special Code Category Amount
040-OTHER ASSM'T SPECIAL ASSESSMENT 484.46
Special Assessments Special Charges Delinquent Charges
Total 484.46 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP SEC C, TyN-R,-W
ADDRESS ST. CROIX COUNTY, WISCONSIN.
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of H63 G l
_ SHOW _-EVERYTHING WITHIN 100 FEET OF SYSTEM
4,11
I di a e o th Arrow
1 -
SCL~i C I 1
1-7
BENCHMARK: (Permanent reference Point) Describe:
Elevation of vertical reference point: le7e9 -&e Slope at site: -
SEPTIC TANK: Manufacturer: Zle~' Liquid Capacity: 10,0'0
Number of rings on cover : r~!'",V-' Tans-manhole cover elevation:
Tank Inlet Elevation: Tank Outlet Elevation:
PUMP CHAMBtR
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
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 eft -pipe-elevation
bottom of seepage pit (y evation feet.
SEEPAGE BED SIZE: number of lines 3 width leyigthji 9 tile depth
SEEPAGE TRENCH: width length
PERCOLATION RATE .,_5''-. ~5--- ~ AREA REQU D REA BUILT
INSPECTOR
DATED PLUMBER ON JOB
LICENSE NUMBER .x~ 7
13,j
1 1E./
r
UPO RT OT INSPCC-T TON - INDIV IVU AI SIWAGL SYSTEM
Sani tafl II 1'c1(mi
/S e.a tc S ~p.r < c
NAM[ 1~ - ToWmAh ip St., C/i(!t x Crain (rf
I rcation~~' --Scc liavt La.t SLlbdlivi-Aion
St I'IIC TANK
S<ze gafe,onA Numbers oA compan.tme.n-tA
1) tanec A~rom: Wvf f 8u.i_fd.i ng 12 o heope_
If,i.ghwa ten
PUMPING CHAMBER
S~_zc. gae('on~, Pump Manu~dctulie~( Modee NumbvA
HOL.DTNG TANK
Si <<pa4'('un.t Numbs-i oA Compantmen'th
P(l mr)v h Aecf~im Sql tcm
Di.ti tavi ec Ait om: We Cfl " 6 u.tied4' nq 12`~ ti Dupe
N( 0 If W (f r 0 h
ABSORPTION SITE.
Bed TIt eneh
Vi Atance 'ium: (vvfe Buding o tPope
114 gI1(4) atc if
l2
ABSORPTION SITE DIMLNSIONti
Width o f tfrench 6t Requ.c.ned anea
Length n( each erne -C! 6t Depth oA nocF be('aw tii v 112- in
Numhcrr o0 ('.inch Depth o6 dock 0Veh .t'il'e Z ski
Totaf evvigth a( e-inch 6t Depth o6 fife below gnade rn
yP
(6 t a n c( b e tW e e VI (Vl 1 f~ „ °rr~nnr
- 7 1 oA v l( 5 7,h P h c h """7M r"~I`~°I o o
CotaP aOs('hlvtiun aff(Ia 7 ~t Te/pe (16 Coved: Papcn uh !,t1lfa~i~a~~
PIT DIMENSIONS
Numbcit o(~ pitA C' ave' rnoft.nd Y(I
Outside diamcto?I D pth beeow i.nee-t r
Fr
To tae absoriptirrvi a!Iv ( t
Anea ~icquiricd ~
I NS PECTC TITLE
A1-PR0VCD DATE
RC _ICC-f ED DATE
R( ASON IOR RI JI CT ION
R State and County State Permit # PLB 67
v Permit Application County Perm, #
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: _St % _54:1/ Section , TIN, R j E (or) Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial `Other (specify) *Variance
Single family 2( 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 X _ Poured-in-Place Steel Fiberglass Other (specify)
New Installation Replacement 'X
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify)
E. EFFLUENT DISPOSAL SYSTEE~,,M: Percolation Rate_., ~ y STotal 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: -Length ,6 idth46 Depth -Tile depth (top)~141f' No. of Lines .3
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land o Distance from critical slope
WATER SUPPLY: Private X 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 % - C.S.T. # J.5_- and other information
obtained from 'L;' = e "A LifaL /V (owner/builder).
Plumber's Signature MP/ RSW# Phone # 7f. 5y~ 3
Plumber's Address ,it il'-IAZW J e ZZ/
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, 4 G-C7 Date
Permit Issued/Re}eeted (date) '7- le' S/ Issuing Agent Name
Inspection Yes No State Valid# Date Recd
1. -qty (white copy) 3. --ner (green ^-nv) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
k copy) Rev -
EH 115 Rev. 9/78
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
v t WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES Z\ P.O. BOX 309, MADISON, WISCONSIN 53701
i
LOCATIONS-7E Ya~~/a, Sectior:~& ,T-iQN,R~?& (or 1Township or Municipality
Lot No. , Block No. County t •i /yC j~9 ✓
Subdivision Name V
Owner's/Buyers Name: Q A"
Mailing Address: OS - 7.
TYPE OF OCCUPANCY: Residence X No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT X ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS f=ey PERCOLATION TESTS 27-t0/
SOIL MAP SHEET- NAME OF SOIL MAP UNIT
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 AFTE INTERVAL MIN;IN
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P / See- Y 3 • S-
~p b
P_ 1. -See- Aare_ A0 14/0
P-
P-
P-
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
" ,Z - 7 6 t, tl ~f ~l 5 ! " ~C (oY st:. S
B- /
76 A4 e
B- "ist~ 7 tr !J tr tr ~jsr f
B- t~/ tl ti 11 tr J ~r /l i►J
B-
B-
B-
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the Ian the location 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.
We?1,4ae M 4.-4 f~r e1 e~9_3 17 ,Rc,'ev-
s2o - -1010 w es t o P~~
cam;-~ ~~-f1/~ o,•~.,~ ~ ~/~sp a a a _ =
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193 F_Z t We'll
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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.
t~
Name (print) 1 I -R"34 A4J Certification No. -
Address tS 1
Name of installer if known
Copy A -Local Authority CST Signature
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