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Parcel 036-1096-20-000 09/19/2006 04:40
PAGE 1 OF 1
F 1
Alt. Parcel 31.31.17.580A 036 - TOWN OF STANTON
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
STEVEN WALLIN O - WALLIN, STEVEN
1897 142ND ST
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 1897 142ND ST
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 0.386 Plat: 03/038-WESTVIEW (1956)
SEC 31 T31N R1 7W PT NW NW LOT 3 & N 22' Block/Condo Bldg: LOT 03
LOT 4 WESTVIEW
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
31-31N-17W NW NW
Notes: Parcel History:
Date Doc # Vol/Page Type
09/21/2005 807045 2893/118 WD
03/03/2004 755729 2520/296 WD
12/19/2001 665684 1794/522 TD
11/07/2000 633171 1557/201 OC
mor
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 05/06/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.386 20,000 116,100 136,100 NO
Totals for 2006:
General Property 0.386 20,000 116,100 136,100
Woodland 0.000 0 0
Totals for 2005:
General Property 0.386 20,000 116,100 136,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 126
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
e \
AS BUILT SANITARY SYSTEM REPORT
OWNER n_ TOWNSHIP pp.Q n SEC-J/ T.~ N-R/
ADDRESS IZ~3 ST. CROIX COUNTY, WISCONSIN.
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of H63
OWL-EVERYTHING, WITHIN 100 FEET OF SYSTEM
FFT
mom"
- - -
1$~ - -
I di a e oath Arrow
SC Lt:
BENCHMARK: (Permanent reference Point) Describe:.Cc L61'."FiyE.
Elevation of vertical reference point: loot Slope at site: Q Z °70
SEPTIC TANK: Manufacturer: Liquid Capacity:
Number of rings on cover Tan manhole cover elevation:
Tank Inlet Elevation: Tank Outlet Elevation:
PUMP CHAMBER
Manufacturer: .j Number of gallons o Q
Number of gal. pump set for a cycle /tee gallons; to a capacity o
distribution lines GS',yc gallon: size o pump head;
gallon per minute horsepower ran name of pump
and model number ;
Type of warning device Q%MW.#,&AmW,,
HOLDING TANK: nufacLurer Number of gallons
Elevati of manhole cover
Type o warning device
SEEPAGE PI IZE: Number o pits feet diameter
feet quid dept seepage pit in et pipe-elevation
bot m of seepage pit elevation feet.
SEEPAGE BED SIZE: number of lines I, wi th i j _lefigth.A Mile depth ZZ
SEEPAGE TRENCH: width length
PERCOLATION RATE _ REA REQUIRED GIS4• R AS BUILT,,
Q I N S P E C T 0 R DATED l . PLUMBER 0 JOB
LICENSE NUMBER
REPORT OF iNSPECTiON - 1:NDIVI:DUAL SEWAGE SYSTEM
Sanitary Permit,40
State Septic NAME~~r TOWNSHIP TQ~- St. Croix County
I,OCATION_~*y I lot*j__ _Section%3 Lot # Subdivision
~I':PTIC TANK
Size gallons Number of compartments / _
Iii stance from: Well. u Building _ 12% slope
Highwater
PUMPING CHAMBER
I
Size gallons Pump Manufacturer Model Number
1101.1)14C 'T'ANK
Size gallons Number of
Pumper Alarm System
)i stance from: Well ( ,r Building- 1.2% slope _
Highwater
n1i SORP`1'10N SITE
Bed Trench
Oi stance from: Well D Building- 12% slope
Highwater
11iSORP'T'ION SITE DIMENSIONS
Width of trench ft Required area 5 ft.
Length of each line- I _ ft Depth of rock below tile__in.
Number of lines Depth of rock over tile _ & _-in.
~r 7
'T'otat length of lines ft Depth of tile below grade-v_9 4___in.
Distance between lines tt ft Slope of trencliz,2- -in. per 100 ft.
Total absortption area. ft Type of Cover:
111T DIMENSIONS
Number of pits Gravel- around pits- yes- no
Otitslde diameter ft Depth below inl-et ft:
Total absorption area - ft
Area required _ ft
INSPECTED BY APPROVED DATE /~l ) 198
R EJECTED DATE
REASON FOR REJECTION
l% !y
p L 67 State and County State Permit #
Permit Application County Pert #
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: &~'/4AyIT Section - ! T 3 1 N, R $ (or) W Lot# --City
Subdivision Name, nearest road, lake or landmark Blk# Village
V_ ! Township
J ~ ~ is
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms -3 No. of Persons
D. SEPTIC TANK CAPACITY 11)67o Total gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete Poured-in-Place Steel Fiberglass Other (specify)
New Installation Replacement
Lift Pump Tank or Siphon Chamber' Total gallons Prefab concrete T/ Poured-in-Place Other (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate -f- 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: v' Length 5 2 Width 2 ' Depth i 1 ' Tile depth (top) Wig'? " No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land-- r^ ' 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 v' C.S.T. # - - and other information
obtained from =,ti, r-, , [owner/builder).
Plumber's Signature MP/MPRSW# Phone #
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.
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Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application Fees Paid: State,,,T- - Count D to
Permit Issued/Rejeefed-{date) Issuing Agent NameK r l ~
Inspection Yeses ) No State Valid# Date Rec'd
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
'DERA-?.,0TMENT OF REPORT ON SOIL BORINGS A. SAFETY & BUILDINGS
INDUSTRY„ DIVISION
LABOR AND PERCOLATION TESTS (.5): P.O. BOX 7969
HUMAN RELATIONS MADISON, WI 53707
LOCATIONSECTION: TOWNS HIP/IbbMCIPALITY: LOT . NO.: SU /%ISION NAME:
4t
i_\/Tc I N/R 17E(or) W I _ \ 5 r .t`.. {I c..
COUNTY: WNER BUYER'S NAME: MAILING ADDRESS:
1'^Z~l X r° .~G fi F _ #t L/
USE DA 08SERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: R TONS: ER LA ION TESTS:
Zpesidence ~ ❑ New Replace i-
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:loptional)
4S ❑U E]!
(~U ❑S ZU ❑S ZU ❑S ElU If Percolation Tests are NOT required DESIGN RATE: SYSTEM EL I If any portion of the lot is in the
under s.H63.09(5)(b), 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. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
/VLap ✓ < ' z j
B'
B-
B-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERT D PER INCH
CC
P- . 7 S' 't jf i <
P-
P-
P-
PLAN VIEW: Show locations of percolation tests, soil boring
zontal and vertical elevation reference points and show their
of land slop.
i
SYSTEM ELEVATION'
011 '~r m ti's
711
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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 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): y% TESTS WERE COMPLETED ON:
4 7
ADDRESS CERTIFICATION NUMBER: PHONE NUMBER optional):
-
CST SIGNATURE:
DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester.
DILHR-SBD-6395 (N. 03/81)
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