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Parcel 030-2061-20-000 02/28/2005 10:17 AM
PAGE 1 OF 1
Alt. Parcel 27.30.20.589 030 - 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
" PRESCOTT, LUCILLE M (LE) ET AL
LUCILLE M (LE) ET AL PRESCOTT
1359 HWY 35
HOULTON WI 54082
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 1359 HWY 35
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 0.420 Plat: 2111-HOULTON
SEC 27 T30N R20W LOT 3 BILK 8 VIL HOULTON Block/Condo Bldg: 8 LOT 3
Tract(s): (Sec-Twn-Rng 40 1 /4 160 1/4)
27-30N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
05/24/2001 646400 1645/592 QC
07/23/1997 960/520
2004 SUMMARY Bill Fair Market Value: Assessed with:
6218 127,700
Valuations: Last Changed: 07/09/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.420 50,000 75,600 125,600 NO
Totals for 2004:
General Property 0.420 50,000 75,600 125,600
Woodland 0.000 0 0
Totals for 2003:
General Property 0.420 23,000 66,100 89,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 305
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 030-2061-30-000 02/28/2006 09:52 AM
PAGE 1 OF 1
Alt. Parcel 27.30.20.590 030 - 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
O - HESSIER, STEVE M
STEVE M HESSIER C - BOUCHER AMBER K
BOUCHER AMBER K
1361 HWY 35
HOULTON WI 54082
f
Districts: SC = School SP = Special Property Address(es): * = Pr'mary
Type Dist # Description * 1361 MAIN ST ~w2
SC 2611 SCH D OF HUDSON
SP 1700 WITC Vy✓
Legal Description: Acres: 0.560 Plat: 2111-HOULTON
SEC 27 T30N R20W LOT 4 BLK 8 VIL HOULTON Block/Condo Bldg: 8 LOT 4
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
27-30N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
11/24/2003 747333 2461/320 WD
06/25/2001 649328 1667/612 QC
05/29/2001 646577 1647/80 QC
07/23/1997 868/515
more...
2005 SUMMARY Bill Fair Market Value: Assessed with:
84615 131,100
Valuations: Last Changed: 07/09/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.560 50,000 69,200 119,200 NO
Totals for 2005:
General Property 0.560 50,000 69,200 119,200
Woodland 0.000 0 0
Totals for 2004:
General Property 0.560 50,000 69,200 119,200
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
Parcel 030-2061-20-000 03/01/2006 08:55 AM
PAGE 1 OF 1
Alt. Parcel 27.30.20.589 030 - 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
O - PRESCOTT, LUCILLE M (LE) ET AL
LUCILLE M (LE) ET AL PRESCOTT
1359 HWY 35
HOULTON WI 54082
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 1359 HWY 35
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 0.420 Plat: 2111-HOULTON
SEC 27 T30N R20W LOT 3 BLK 8 VIL HOULTON Block/Condo Bldg: 8 LOT 3
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
27-30N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
05/24/2001 646400 1645/592 QC
07/23/1997 960/520
2005 SUMMARY Bill Fair Market Value: Assessed with:
84614 138,100
Valuations: Last Changed: 07/09/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.420 50,000 75,600 125,600 NO
Totals for 2005:
General Property 0.420 50,000 75,600 125,600
Woodland 0.000 0 0
Totals for 2004:
General Property 0.420 50,000 75,600 125,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 305
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
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KIVOKT OF INSPLCTIQN /NUIVIUUAI_ SIU)AGL SySllM
S r ~I t ~S V r-•,'
- a-u Towneh ip- Am@ S,t. C~loi x Cu(A n.ti/
~Se.c-tio►q Lot M - SI dt.v-i.4ion
I+' IANK /3S~ 0 3S'
f 61 ~ gaPXonA Numbers o6 cumpah-tmen,te
Oiim. we.Xt'_-- 6 8a4- kd4 ng ) 12% I
Mcghwate.n
IN(, I'IIAMRf R
' ' - Qat't0na...,rIQ ,p Manu6act;uheit ` Modet Number.
I NG IANK
9attO A6 '-fi a{0bex ah Campantmevlte
~rniir At-altm Sye.te.m
Wett Building_______ 12% '6tope
Ntighwate&~ -
Cl'l ION SITE
'''I T/rnwnh
A I FYI. welt bu~~d~nc 12`~ ekope
114* ghwa..teit
I ION 1;111 DIMENSIONS
101 of trench At Requ4 red area
oIl1 o6 each tine.__. / o Depth
At o A 400k b e k ow t.i k e < n
MI' ,I oA X~#ee Depth uA n-oc.h oven t~Xe ~
YI
f'eYlgth 06 Linee 1L
At Depth o6 ti e below gnade_/ e n
%
, tooce between tinee ~ At Stolle oA .tne.nch ~ in. peh 100 At
, 4 r,r" ,l,eon.p-t.ion aKea
6 Type aA Coven Pape.& a ex aw
~z t
I'IMINti1ON w
11161-1 (14 p4t46 no
r, 'lc iliameten ~t Depth below At
•
111-~oit pt,i.o anew- ht
t t'rr((i,IfQ~ t
II II l;V TITLE DATE C,~ 199
11 1 DATE 19 K
N I IIR I.'1 JECTI-0N
PLB 67 State and County State Permit # f
County Permit #
[ Permit Application c
for Private Domestic Sewage Systems County 2C&Ci!/
r
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. WNER OF PRO R Mailing Add ss:
B. LOCATION: '/4 l: Section , T N, R;ga E (or) W Lot# City
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_ No. of Persons
D. SEPTIC TANK CAPACITY _~_Total gallons No. of tanks /
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete f~ Poured-in-Place Steel Fiberglass Other (specify)
New Installation Replacement 41`- /
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete ` Poured-in-Place Other (Specify)
E. EFFLUENT DISPOSAL SYSTEM: 5LQOI tton Rate Total Absorb Area sq. ft.
New Replacement li_ Alternate (Specify)
Seepage Trench: No. of ineal Ft. WidthDepth Tile depth (top)I No. of Trenches
Seepage Bed: Length -
Width Depth Tile depth (top) No. of Lines
Seepage Pit: Inside, iame r Liquid Depth No. of Seepage Pits
Percent slope of land 47 !X42 Distance from critical slope
WATER SUPPLY: Private ❑ 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 it Tester,
NAME C.S.T. # `J and other information
obtained from , (owner/builder).
Plumber's Signature W/MPRSW# Phone C.~ 9
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 '
3
t
E
E
i
.tee _ e r. P _e .
3
ems.. _ e. . s"e .m:. t _ ,e s ....e.
Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application Fees Paid: State County Date
Permit Issued/Rejected (date) - -i/ Issuing Agent Name
Inspection 'Yes No 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
EH,. b15 Rev. 9178
' REPORT ON SOIL BORINGS AND PERCOLATION TESTS
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
' ,fig
'/4, Section T_N R_E
LOCATION: /4, --~eo W, Township or Municipe ity
Lot No. Block No. County
Subdivision Name s_ ~~~C
Owner's%s Name:
Mailing Address:
TYPE OF OCCUPANCY: Residence >r No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ✓ ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS ? - ' PERCOLATION TESTS
SOIL MAP SHEET NAME OF SOIL MAP UNIT
PERCOLATION TESTS
TEST DEPTH e 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- > r i • / cam.
P-
P-
P_
P_
P_
IL BORING TESTS
SO
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 C~~7 L J l~ l/
B-
B-
B-
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil 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 ) i 71':7) ry Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope. ; ' x \
tj 1S'ls a'
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1, 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.
Name (print) Certification No.
Address
~l
Name of installer if known-_
Copy A - Local Authority CST Signature_