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Parcel 030-2060-70-000 04/07/2005 09:25 AM
PAGE 1 OF 1
Alt. Parcel 27.30.20.584 030 - 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
HENNE, GRACE E
GRACE E HENNE
1397 MAIN ST
HOULTON WI 54082
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 1397 MAIN ST
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 0.500 Plat: 2111-HOULTON
SEC 27 T30N R20W LOT 30 BLK 7 VIL Block/Condo Bldg: 7 LOT 30
HOULTON
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
27-30N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
2004 SUMMARY Bill M Fair Market Value: Assessed with:
6214 139,000
Valuations: Last Changed: 07/09/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.500 50,000 86,700 136,700 NO
Totals for 2004:
General Property 0.500 50,000 86,700 136,700
Woodland 0.000 0 0
Totals for 2003:
General Property 0.500 23,000 73,900 96,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 114
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
1
du /Tb rte- Sw
S a N L SURVEYING a
HUOSM ,W# Ii 54016 '
(?15) M-9007
irrrwr ftili r Huma,
1t. i Box 62 i1 ter Minn. 5,%&
1 79, 1,92,3, 81k. 7 Houlton
'i
0 IAA' N 89229'-22" W
330'
3 0' 4
90
LOT 31 a9 LOT I Y'
1
.r 330' 33s
1w LOT 30 LOT 2
® x R. SPIKE 330
LOT 29 io
3 0 LOT 3
LOT 28 to
to
LOT i 1t
ry
S7. CROIX COUNTY '
SURVEYOR'S RECORD
$Me of Wi in
0 iIROW STAKES Afad
of 3T. CROIX 1 as. SCALE OF MAP - I INCH 100 Feet I~ III STABLES FOUND 1
_ ~l l..L Nt n1Y IIAG N registered Wisconsin Lentz lBdrrveYar'do bereft certitp
.BUL~ 22 19 1 surveyed the above descrC d and mapped according property to.
00 sBf 01 ewcords and that the oc Wrap is o s wfft* dimensioned represento4is to scale of this bounderies ftet p;
d $s surd i nts lie wholly within the b m4eryt linsar and that no eneroac Winq
too said sarve , ~x
LEN C.
*own By x
4 1 1 ) i F d;
'TON
w+ q
A Itl_I 1 1.'I' :;AN I TARY :;Y,`,Tl:M I?FTO1~'I'
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liENt_;I ARK : (Pe smarten t r-e terence Pohl(-) Des' c r i tae ;.s - /~~=G~
I lev.►t ion of vertical re:ferenc:e/Imfr►t pu irt_
;F:P'I'IC: TANK: Manc.tftact carer 1,i(Icafcl (:itpt►ci t v
Ncunher of r f ia};s on cover- Tanl< ' manltol_e cover c: l eva t i ml
Titnk Iralet Flevat Lott: funk Out let Flevat iim
PIIMP CIIAMBEIR
M,anu f <~t.~ t rrri r ` Numbet- of gi l I
IJt.tnbei- of gal . l)un►p Set -tur- <a I•YCIe ga11ot►:;, I W;IT c•.11,,ic i I v or
elit;trA1.)ut,i() n Li_nc:s };gal Ion: sizt., o purnp lie<icl
};it l oil pier minute taot-scpowt~u !grand nartie o1 bump
i.tncl mocicA number
Type of' war_ t t.nl; Levi cep
IIOL.I) I NC 'PANIC: Mamtf ac t_ trrer Number gal ga I low;
F:l ev<a t scan of manhole cover
I'ypc of warning.; device
PIT Sl.ZE,: N~ rnlrcr of Alts Teet cTiantt t f-'r
of seepa}~c1 plat--eevatt on'e~~epa~;e p:i t: inlet plLae-~~ Levrat tui►
fect, bottom ~L ~t
f ee t_ il~:l;l'ACt~: ISI~:Lt Sf-l, L:: nurufaer of I i ncti wi di I, leI,p;th
' K1: I' l1( E TRENCII wi 1t. It ~ 1e.ngt1I
ltt'UI.A'1' 10 N RA'Hh: Afil?A RT 61 1TR1?D
LNSPl..C'I'UR
I~A'I'1:1► - PI,IIMBI.;R ON JOTS
1. l Cl?N 'F NtIMM,K
REPORT OIL CNSPECTION - INDIVIDUAL SEWAGE SYSTEM
s
Sanitary Permit ~a
State Septic 7
NAME
TOWNSHIP St. Croix County
Owe
I.OCA'f lON_ _ SectionAlLot # ~3 subdivision
SEPTIC TANK
Size - gallons Number of compartments
Distance from: Well- Building T. 12% slope _
Highwater
I'UMPTNC CtLAMBER
Stze_ _ gallons Pump Manufacturer Model Nmnlwi
n
HOLDINC 'T'ANK /
Size gallons Numb) of fompartm nt~
Pumper A arm S~ st m
Distance from: Well. ~ uild'ng_ 12% slope
Highwater
ABSORPTION SITE
Bed french
Distance from: Well Building 12% slope
H i g h w a t e r
ABSORPTION SITE DIMENSIONS
Width of trench ft Required area it
- - t= - _
Length of each line- ft Depth of rock below tile
Number of lines Depth of rock over tile. 1 in
Totat length of lines : ft Depth of tile below grade
Distance between lines tr ft Slope of trench in. per TOO It.
Total. absortptiLon area ft Type of Cover:
PIT DIMENSIONS
Nuin ber of pits Gravel- around pits yes nr
r
Outside diameter t i Deyj--h below inlet f t
Total absorption area--
Area required ft
I NSPECTED Yr 1 ITLE
APPROVED°~ DATE 198
REJECTED DATE, 1_98
REASON FOR REJECTION
State and County State Permit # / ~"_D d
PLB 67 a; Permit Application County Permit # O~~G
' for Private Domestic Sewage Systems County (11"i 4L ~oz
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
B. LOCATION: /V ✓Section T R ` E (or) W Lot# .;41 City
Subdivision Name, nearest road, lake or landmark Blk# Village
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) * ariance
Single family Duplex No. of Bedrooms 5 No. of Persons
D. SEPTIC TANK CAPACITY Total gallons No. of tanks
HOLDING TANK CAPACI Y Total gallons No. of tanks
Prefab concrete L/ Poured-in-Place Steel Fiberglass Other (specify)
New Installation Replacement
Lift Pump Tank or Siphon Chamber Total gallon refab concrete Poured-in-Place ther (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Perc tion Rate Total Absorb Area sq. ft.
New Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: Length idth~' _Depth Tile depth (top) ~No. of Lines
Seepage Pit: Inside di meter-~-~-Liquid Depth No. of Seepage Pits
Percent slope of land---X- Distance from critical slope
WATER SUPPLY: Private Joint ❑ Community ❑ Municipal ❑
Owners name as listed on EH 115 if other than present owner:
1, 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 it Test
NAME C.S.T. # and other information
obtained from owner/builder).
Plumber's Signature MP/MPRSW# Phone f
Plumber's Address
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.
E
e
r 3
e
-F T'
3 E ~ ?
t
E
E
E
f
Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT SE ONLY
Date of Application -,,j~ Fees Paid: State /V oz Co nt Date - -
Permit Issued/ eK"eed (date) Issuing Agent Name
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
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
•,1NDU~RY, DIVISION
'ABO~R AND PERCOLATION TESTS (115) MADISOP.O. BOX N WI 539069
HUMAN RELATIONS
LOCATION: SECTION: T9W4&I4P/MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME:
Nw %/Nr__1/ z,--VT3o N/R Z0't<ar) W 1~0 k-_3 L_ r 30 -7 LAHE of Na(j L-mt,,
COUNTY: OWNER'S B4*&RFF-NAME: MAILING ADDRESS:
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: El New ER Replace DESCRIPTIONS: JPERCOLATION TESTS:
Residence, E~RReplace I l D t ZC~ C
RATING: S= Site suitable for system U= Site unsuitable for system
r ONNjV~'ENTIINAL: MOUND: IN-GROUND PRESSURE:SYSTEM-IN-FILL HOLDING TANK:RECOMMENDEDSYSTEM: (optional)
VSJs ❑u ❑S ❑u ❑S ❑u ❑S ❑u ❑s ❑u j8 'x 3S' -C3G-1~)
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: L-,)Ss g S 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- 1 l03 l bb 3 - > I b ~k `bh s ~ t S, /6 ; h S g- G)-
B- Z 1~3 ti~~$ - to8 l~ , 89
B- 3 1 OD lwg - > eon
13- S~ ~oS 100- - los t~ECEIVE SZ
13-
J
ZONING
OfE
B-
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 PER INCH
P-
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. So,LS ~vj2Lct}r?;; `~T S~
SYSTEM ELEVATION 9 5 BoT of -1;1~b Chrt/krm/,u H x.cr 14Z"GDS GUEM 71PE/AiC
t-QTL. E'X.fk>T. LoaLI._ 15 LOO- o G`dt,Crz
- 4Qrt , .?_,~5' N_ pF bey t`4 or
r
J.P fi L1AtaL. a
I •i SL~> I'm"a %_G RR-EA
I'
_....ro. ~ctS"O N 1 ~l2~ r SST _L~P C1 C
LiI yl "il'cU1R. g~2`fW~-L..
oLiSE I m LA C ft KE7C H
~ L3Q
X "s
I
S c ~t ~.~~1._30 'Sec. -e_-)
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.
NAME (print): TESTS WERE COMPLETED ON:
ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER optional):
CST SIGNATURE: J
DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester.
D I L H R -S B D-6395 (N. 03/81)
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