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Parcel 038-1012-60-000 09/13/2005 09:31 AM
PAGE 1 OF 1
Alt. Parcel 3.31.18.33F 038 - TOWN OF STAR PRAIRIE
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 - PITZEN, EUGENE I & JOY ANN
EUGENE I & JOY ANN PITZEN
2393 CARDINAL DR
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 2393 CARDINAL DR
SC 3962 NEW RICHMOND
SP 1700
WITC
SP 8055 CEDAR LAKE/N R
Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE
SEC 3 T31 N R1 8W PT GL1 COM 1973.95 FT E Block/Condo Bldg:
& 353.84 FT S OF NW COR, TH S 86 DEG E
210.02 FT TO LAKE, N 14 DEG E 40', N 29 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
DEG E 60', N 86 DEG W 233.19'S 26 DEG W 03-31 N-1 8W
38.73' SLY 57.76' TO POB
Notes: Parcel History:
Date Doc # Vol/Page, Type
2005 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/12/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.000 152,800 129,500 ) 282,300 NO
Totals for 2005:
General Property 0.000 152,800 129,500 282,300
Woodland 0.000 0 0
Totals for 2004:
General Property 0.000 152,800 129,500 282,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 214
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
13 1. 17'- N 8 9° 32'E
2.402> j~ /
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AS BUILT SANITARY SYSTEM REPORT
OWNER! ✓ ~ r TOWNSHIP 1 j.r>l.~SEC. T~N, R1 h W ;zJ'
P.U. ADDRESS / ST. CROIX COUNTY, WISCONSIN.
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
r
i '
SEPTIC TANK(S) zz: MFG:2. CONCRETE STEEL
c. k
NO. of rings on cover Depth DRY WELL_ ~
T'RraN(,-FI S NO. of ( width cL • length area SC' i'
BED no. of lines width - length area
depth to top of pipe l Gam'
AGGREGATE
PERK RATE AREA REQUIRED - AREA AS BUILT F~
Disclaimer: The inspection of this system by St. Croix County does not imply complete
compliance with State Administrative Codes. There are other areas that it is not possible
to inspect at this point of construction: St. Croix County assumes no liability for
system operation. However, if failure is noted the County will make every effort to
determine cause of failure.
GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
f 'INSPECTOR
DATED PLUMBER ON JOB ' .
LICENSE NUMBER
t
i
REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM ! G
Sanitary Permit
State Septic
AMEJ1/~~~!//~ TOWNSHIP!,~St. Croix County
oCATION~ Sect:ion,,.~-Lot # Subdivision
EPTIC TANK
Size gallons Number of
istance from: Well Building _ 12% slope--- _ _
Highwater
'UMPING CHAMBER
Size gallons Pump Manufacturer Model Number
OLDING TANK
Size gallons Number of Compartments
Pumper Alarm System
Distance from: Well Building 12% slope
Highwater
BSORPTION SITE
Bed Trench
)istance from: Well Building 12% slope
Highwater
,BSORPTION SITE DIMENSIONS
Width of trench ft Required area ft.
Length of each line ft Depth of rock below tile- -in.
Number of limes Depth of rock. over tile in.
.Total length of lines ft Depth of tile below grade-- ____in.
Distance between lines ft Slope of trench in. per 100 ft.
Total absortption area_ ft Type of Cover:-
'IT DIMENSIONS
Number of pits Gravel around pits yes_____ no
Outside diameter _ ft Depth below inlet _-ft
Total absorption area__ ft
Area required f't?>
N S.T-E-C U T I T L E - -
,PPROVED DATE 1.98
E J E C T E ll DATE - 1-98
h:ASON FOR REJECTION Q~
State and County State Permit # ~w
PLB67 u Permit Application County Per #
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 f t Mailing Address:
B. LOCATION: F6 /4 /V!t> Section T N, R / E (or W Lo/t# [City _
Subdivision Name, nearest road, lake or landmark Blk# K Wage
Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family t/ Duplex No. of Bedrooms No. of Persons
D. TYPE OF APPLIANCES: Dishwasher YES L----NO Food Waste Grinder YES Z--Nf5-- # of Bathrooms -~7-.
Automatic Washer YES 'L--'--NO Other (specify)
E. SEPTIC TANK CAPACITY ~-pZ- Total gallons No. of tanks
*Holding tank capacity Total gallons No. of tanks
New Installation Addition Replacement_ Prefab Concrete
*Poured in Place Steel L/ Other (specify)
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) _'2_- 2) ,S 3) Total Absorb Area ? 7 5 sq. ft.
New Addition Replacement *Fill System
Seepage Trench: No. Lin. Feet • Width 5 ` Depth 3 Tile Depth ;PL e No. of Trenches
Seepage Bed: Length Width Depth Tile Depth No. of Lines
Seepage Pit: Inside diameter Liquid Depth Tile Size
Percent slope of land /P ily Distance from critical slope
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 Certifed Soil Tester,
NAME e. J y < d 141 C.S.T. # /Y) '3 and other information
obtained from (owner/builder).
Plumber's Signature "'Lzy MP/MPRSW# Jy S Phone yL S~/1j
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
Do Not Write in Space Below FOR DEPARTMENT USE ONLY ~
Date of Application qA) 6el Fees Paid: State/~, 6U<J Co my D
Permit Issued/Rejected (date) Issuing Agent Name oo "I
Inspection Yes_ No 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 6/1 /76 ~
DEPARTMENT OF REPORT ON SOIL BORINGS AND INDUSTRY, (0~ ~ S10N
LABOR AND PERCOLATION TESTS (115) 7969
HUMAN RELATIONS 53707
LOCATION: SECTION: JTPALITY: LOT NO.:BLK. N0. BDIVI
I/16 eZ
/T3N/Rl~' I(or) W ~~F yc 8~
COYNTY: t OWNER'S BUYER'S NAME: MAILING ADDRESS:
USE DATES OBSERVATIO E r S,if
NO. BEDRMS.: COMMERCIAL DESCRIPTION: R ON A ION TE TS:
R ence ❑ New Replace ' 7, ;'7 _ el
RATING: S= Site suitable for system U= Site unsuitable for system -3 /f /77 e ~ ".4, OUN CQNVE STI❑U . M❑ S. ❑U IN G❑ S P❑u RE: SYS~T~/❑~LHO❑LDING TANK: RECOM
NDED SYSTEM: (optional)
If Percolation Tests are NOT required T ESIGN RATE: SYSTEM EL V.
~ ~ ~ If any portion of the lot is in the
under s.H63.09(5)(b), indicate: r ~fi 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. HIGH-EST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
r
B- _SfiWx-
B-
B-
B-
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- 2, 3 3 Z'
P_ / 3 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.
SYSTEM ELEVATION
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YM S- r -
d
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Co ,P -e+_ 0V
1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the pro edures methods speci ied 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:
/C X a t^r I
AD RES CERTIFICATION NUMBER: PHONE NUMBER optional):
-7
CS SXUR
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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