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Parcel I 030-2054-40-000 05/02/2005 05:1R0 PM
PAGE 1 OF 1
Alt. Parcel 27.30.20.536B 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
SQUIRE, DAVID J & JENNIFER
DAVID J & JENNIFER SQUIRE
40 PETERSON ST
HOULTON WI 54082
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ` 40 PETERSON ST
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 0.0 0 Plat: 2111-HOULTON
j SEC 27 T30N R20W S 104 FT OF E 130 FT OF Block/Condo Bldg: 3 LOT 3
LOT 3 BLK 3 VIL HOULTON
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
27-30N-20W
Notes: Parcel History: cIrl 4?41-j
Date Doc # Vol/Page Type
06/03/2000 625703 1523/236 W
07/23/1997 1086/375 TI
07/23/1997 1079/583 TI
more...
2004 SUMMARY Bill Fair Market Value: Assessed with:
6169 221,800
Valuations: Last Changed: 07/09/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.000 50,000 168,200 218,200 NO
Totals for 2004:
General Property 0.000 50,000 168,200 218,200
Woodland 0.000 0 0
Totals for 2003:
General Property 0.000 23,000 150,400 173,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
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REPORT OF INSPECTION J C/
INDIVIDUAL Si-WAGE SYSTEM ~6
Savt~ taii.y Penrni,t
S .t a "t e. Sep "I: i ca V4.9-?
NAME Town6hip St. Cno i x County
L(,cati o Secti,oo -rLot ubdtiv.L,loor
(avi
SEPTIC TANK
S -Eze ~ gaZCovr.5 Numbetc o(jj eornpatctmen-t/5
`D-t~tanee On.om: weft Fug e, di 12% 6tape -
H,tGh ~ n
PUMPING CHAMFER
d 1 ' f~
S,i,ze gaf tcykls. hump Mari u~aetut,(, Model Numbest
HOLDING TANK
Size. gaetans Numben~ c~~j Campan.tme.n t5
Pumpers I` Aka n Sy6tecm
;t
Dti6xanee nom: DIe_~' 12o
ff i,ghR)a to n
A13 S0RP-TION SI E
V
Fed Tneneh
D~,S anee nom: (V c, FutiO- di ng Ito 6fope"
U~ghwa~eh
AFSORPTION SITE DIMENSIONS
Width o o Otc,vich Re.c ui,ne,d an-ea-___!~ t
Length a each. t_i.ne,C_f Depth oA 1cacFz bel-ow te e_---
Numbers- o(j P"tiu.e,5 _ _ Depth of haeh oven ~~e--- --~H
To-ta.C tuigth o o -t-tine.l~_ {t Depth o o title. below q.ltadc V1
D-cb tane_e, be. wee,n t,i.ne~ Ct ~t Seope o(1 Vn-eYlch tin. 100 ()t
To,taQ ab6onpt4'on ahea -Ot Type. oo Coven: n_ arc Naha
n -r -r f,TA4VVQ7(IA1C
Numbe.n o{ ttave~ anoun.d pi"-t,5_ ye6 _nn
Depth Side, d~.ameten. 2 ep.th bekow i-ntc-t f t
' _
r'
Totat ab6o4p_-t.ton altea =t
INSPECTED TITLE /r
APPROVED _ DATE 1981
REJECTED "DATE 19n
REASON FOR REJECTION
I
' ♦ ,y-Ti/-~e~~ ~F V V ~r~4 ~9 ~i, Y `~..yl ~1 flL iti i- Y[ 'r
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DEP'ARTM'ENT OF APPLICATION SAFETY & BUILDINGS
INDUSTRY, FOR SANITARY DIVISION
LABOR AND PERMIT P.O. BOX 7969
HUMAN RELATIONS (PL13 67) MADISON, WI 53707
Attach plans for the system on paper not less than 8% 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: Mailing Address:
Property Location: City, Village or Township: County:
qj'/a S ~ 7 ~T % N11120-C- ) W c. t r'
Lot Number: 1BIkNo.: Subdivision Name: earest Ro , Lake or La dmark: State Plan I.D. Number:
(If assigned)
r o O di H TYPE OF BUILDING , t
Number of
❑ ublic* ❑ Variance* ❑ Other (specify)* Bedrooms:
V, 1 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 / l
HOLDING TANK CAPACITY
LIFT PUMP TANK/SIPHON CHAMBER
MANUFACTURER: P.~ c s _ Z s CJ v C
EFFLUENT DISPOSAL SYSTEM
PERCOLATION RATE ABSORPTION AREA
(Minutes per inch): PROPOSED (Square feet): ❑ New Replacement ❑ Experimental Seepage Bed ❑ Seepage Pit
7 616- ❑ Alternative (specify) ❑ Seepage Trench
Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner):
Private ❑ Joint ❑ Public --S tAwzf
I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
Name of Plumber: Si natu : MR/MPRSW No.: Phone Number:
e_r Z_ (~s►S~KAS
Plumber's d ress: Name of Designer:
CS $L}c t- L s i`-
COUNTY/DEPARTMENT USE ONLY
Signatu of Issuing Agent: F;ee.:, Date: _ Sanitary Nerrnit ,Vumr,er:
APPROVED ~j
~ ~3 ~r~ ❑ DISAPPROVED L~
eason for Disapproval:
I Alternate course(s) of Action Available:
►
Ch-ange of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to in-
stailation. 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)
fC(
I N
- LDIN
INDUSTRY, OF' FID
REPORT ON SOIL BORINGS AND
NDUS~tY, SION
LABOR
W} 07
HUMAN REDLATIONS PERCOLATION TESTS (115) ~O. B 969
+t N ~f
LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK. NO.: S ~VISIONA/ G l`f
L : ~!!//l/yy N
-5t, `'/4~t,~/a 7 /T N/Rc~c W F A2 ,J
COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS:
1
USE DATES OBSERVATIONS : I S
NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: ON TESTS:
LJ Residence ❑ New QReplace
RATING: S= Site suitable for system U= Site unsuitable for system / J
CONVENTIONAL: MOUND: IN-GROUND PSYSTEM-1 RESS N-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional)
S ou ❑S ❑u ❑S ❑u ❑S ❑u ❑S ❑U
uncle, Percolation Tests are NOT required DESIGN RATE: SYSTEM EL
If any portion of the lot is in the
s.H63.09(5)(6), 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- 715 6)9 to' 9,0,1
B-
B-
B- V
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-
P-
P_
PLFL L l~
P_
P-
AN 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
11~
-ell
r
/coo : N
'
.
cam-- Zo' _-_;1*1
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,
NAME (print): TESTS WERE COMPLETED ON:
ADDRESS: N~ ~1 CERTIFICATION NUMBER: PHONE NUMBER o(ptional):
CST SIGNATURE: 0
j\
DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th-age-Soil Tester.
DILHR-SBD-6395 IN. 03/61)
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Wisconsin Department of Health and Social Services
Plb;. f6x , Division of Health
PERMIT APPLICATION
- for
- ~ PRIVATE DCYIESTIC SEWAGE SYSTEMS
A. 04NER OF PROPE -iY TYPE OR USE BL.4CX I:i4K
Name Address (Street, City, Zip Code)
~
c z~
J 15
County
B. LOCATION OF PROPERTY WHEF`E SYSTEM WILL BE CONSTRUCTED, ALTERED OR EXT&NDED J
Check One: I CJL
CITY X VILLAGE LEGAL DESCRIPTIONS
TOWNSHIP
C. IS LOCAL PERMIT REQUIRED FOR THIS WORK? YES NO n_,.;.
I- ADDITION
D. SEPTIC TANK CAPACITY E.' Gallons NEW INSTALLATION ~ REPLACEMENT
MATERIALS: Prefab Concrete poured in place Steel Other
NUMBER OF TANKS TO BE INSTALLED:
E. TYPE OF OCCUPANCY
Check One: One or Two Family Residence Commercial Industrial Other
Specify
Number of Persons to be Accommodated _
F. APeLIANCES, EmC: Food Waste Grinder YES i~ NO Automatic Clothes Washer YES NO
Dishwasher YES x' NO Automatic Potato Peeler YES NO
Other (Specify)
G. EFFLUENT DISPOSAL SYSTEM NEW ~ EXTENSION ADDITION REPLACEMENT
-T-Ile Size No.Lin.Feet Trench Width Depth Number of Lines
Seepage Bed: Length Width Depth Tile Size No. Lines
-7 Seepage Pit: Inside diameter Liquid Depth
P E R C O L A T I O N T E S T
Test Depth Character of Soil Hours Water Test Time Drop in Water Level Inches Minutes
Number Inches Thickness in Inches Since Hole in Hole Interval Second to Next to Last To Fall
1st Wetted Overni ht in Minutes Last Period Last Periold Period One Inch
Exampl e
P- 0 36" To Soil 1011, Clay 26" 25 es or no 30 1/2 1/2 1/2 60
F /S
REC0rM DATA FROM MINIMUM OF 3 TEST HOLES
ompute eize of absorption area in accord with H 62.20 Wis. Administrative Code.
S O I L B O R I N G S- Minimum 36" Below Pro osed Absorption System Boring Total Depth Depth to Ground Water Depth to Bedrock
umber Inches Observed Estimated Observed Estimated Character of Soil with Thickness in Inches
Example
- 0 72" 72" Blaok To Soil 12"• Cla 18"• Sand 18"• Gravel 24"
2
1
RECORD DATA FROM MINIMUM OF 3 BORE HOLES
xCOMPLETE OTHER SIDE
I, the undwrsigned, hereby certify that the percolation tests reported on this fo m were made by me
or under by supervision in accord with the procedures and method specified in Chapter H 62.20 (3),
Wisconsin. Administrative Code, and that the data recorded and location of test holes are correct to
the best of my) knaKledge and.belief.
NAME
( 1
TITLE - s r tier '
Type or Print)
REGISTRATION NO. or MASTER PLUS ER LICENSE No.
ADDRESS
DATE SIGNATURN
MASTER ePLIM ER MAKING APPLICATION /
Signature;/, r License Number:
1 ~ MP RSN
(Too be Completed by Issuing Agent)
Date of Application Fee Paid $
Permit Issued .(date) Permit Number
Agent (name) 1~ RI- For:
f a
/7 J ~~J Town, Village, City, County, etc.
J V, (Specify)
Notes The application cannot be considered for filing until all of the above questions are answered
and the fee paid. Agents will forward application, the fee of $10.00 and Copy (b) of the
Permit (yellow copy) to the Division of Health. Checks and money orders should be made
payable to the Division of Health.
Do not write in space below - FOR DEPARTMENT USE ONLY
DATY RECEIVED
ACCEPTED BY RETURNED
(Initials) (Date) See Corres.T-
FEE RECEIVED VALID. NO.
PER11T NO. Yes or No)
REVIEWED BY APPROVED DATE
(Initials) Yes or No)
COMMENTS:
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Wisconsin Department of Industry, SOIL AND SITE EVALUATION
Labor and Human Relations Page 1 of
Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis.
Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must County .5 7- C 12 O 04-
Include, but not limited to: vertical and horizontal reference point (BM), direction and zo .81oc4 3
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. #
030- 1053 - 1500a
L°T 3 R/,f - 03 0- 1.05 y- 2-01 :24,
INFORMATION Please print all information. Reviewed by Date
Personal information you provide may be used for,secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner I Property Location Jl
fie) DD r M Ai? Y R TO- o rJ Govt. Lot 'SF_ 1/4 /WI/4,S -27 T30 30 N,R Z 0 E (or0
Property Owner's Melling Address Lot # Block# Subd. Name or CSM#
3 S i s rltre ,~wy 3 S /k.
City State ZIP Code Phone Number / p Nearest Road
l f b v LToA✓ (7/,5 ) S y q. &I B ❑ ity o L Vill ge ❑ Town $1**72F S7- '
r❑; New Construction Use: [residential / Number of bedrooms Addition to existing building
[9 rteplacement ❑ Public or commercial - Describe:
Code derived dally flow 30-D gpd Recommended design loading rate S bed, gpd/ft2 trench, gpd/ft2
Absorption area required 250 bed, n2 250 trench, ft 2 Maximum design loading rate S bed, gpd/fit trench, gpd/ft2
Recommended infiltration surface elevation(s) S~ r 3 ft (as referred to site plan benchmark)
Additional design/site considerations T JE~:-5 I w ~d
Parent material J~N! AM ~~St_PP-_ Y Flood plain elevation, if applicable N n
S = Suitable for system Conventional ;~pd In-Ground Pressure AT-Grade System In Fill Holding Tank
U = Unsuitable for system El S L~J U s L1 U ❑ S D-6 ❑ S 10u ❑ S El _ ❑ S U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2
Texture Consistence Boundary Roots
In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
/ o-& lt9YR313 - Ls /fTk 4,%06e (;2S' if .5
2 ~s /oY~ yl3 - ~S /fsl4v~,e s it s ; .
Ground 3 •1 /0ywy Ls
elev. -
fl /0 ft. Y,10 411
sc /fS e 4*1 7e.e c~ - o • 5
a 60
S 3 y 10,V -75~ 14e !Y/ 51C. 2fSh~ >ci~ - .S
Depth to l
limiting /0 Y U~.sL ( .3 q
?j factur
d
in. Y/C AkAtQ 17- S ! v
5 S • Remarks: Si¢7"UMM 17 33 tr 7'2 0~P~1 yuG~472
Boring # R 313 Z-5- 1-,-"5 e /~U-F/Q 2~ . S
/,qM 7/5 ZS Ile- -5
Ground 119YX U/"SL ~T /m fl a S .5 j
elev.
n -60 /d / C2eQ ors S~L T
~ 510le /YNTI .2- 3
S YX Y/y -
Depth to
limiting
factor
;4---in. Remarks: U i _547-4(,e4-7'~ ' ~T Yy ~OU`
CST Name (Please Print) Signature Telephone No. j
Address Date CST Number
Ulbricht 8 Associates
Private Sewage Consultants
65s O'Neil Rd.
Hudson, Wis. 54016
D
0
SOIL DESCRIPTION REPORT 2
PROPERTY OWNER Page of
PARCELI.D.9 03o • 20S- - i.S'da o govt 03o - Z 6S Lo o o C-)
Boring # Horizon Depth Dominant Color Mottles Structure 2
Texture Consistence Boundary Roots QCD/ft
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trend
Ground 3 3 ioYle LS 1,.e elev. t'-f}a
Dept, to "01
limiting ylp
y~7
factor - - f -
S~s•'S •
Remarks: Ue,~X S,17-kej7-EP 3 y"- 70
Boring #
Ground
elev. - - -
fl.
Depth to -
limiting
factor
in.
Remarks:
Horizon Depth Dominant Color Mottles Structure GPD/ft`'
Texture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Tren
Boring #
Ground
elev. - - -
it.
Depth to
limiting
factor
in.
- Remarks:
Boring #
Ground _
elev.
fl. '
Depth to
limiting
fa ;tor
in.
Remarks:
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Parcel 030-2054-30-000 10/10/2008 05:07 PM
PAGE 1 OF 1
Alt. Parcel 27.30.20.536A 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): O = Current Owner, C = Current Co-Owner
-ILI
O - AUBUT, PATRICIA L & SHELDON T \ I
PATRICIA L & SHELDON T AUBUT `jv"71
38 PETERSON ST
HOULTON WI 54082 tnk
Districts: SC = School SP = Special Property Address(es): = Pro ary„
Type Dist # Description 38 PETERSON ST lY~
SC 2611 HUDSON 11 Vi y-
SP 1700 WITC'
' 44
ILI"
Legal Description: Acres: 0.000 Plat: 02-022-HOULTON
SEC 27 T30N R20W S 104 FT OF W 130 FT OF Block/Condo Bldg: 3 LOT 3
LOT 3 BLK 3 VIL HOULTON
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
27-30N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/01/2003 728305 2297/271 WD
12/08/2000 634950 1565/592 TI
07/23/1997 1144/629 EZ
12/07/1995 537265 1152/532 WD
2008 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/09/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.000 50,000 114,300 164,300 NO
Totals for 2008:
General Property 0.000 50,000 114,300 164,300
Woodland 0.000 0 0
Totals for 2007:
General Property 0.000 50,000 114,300 164,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 213
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00