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Parcel 040-1115-20-000 06/26/2006 10:25 AM
PAGE 1 OF 1
Alt. Parcel 30.28.19.472F 040 - TOWN OF TROY
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 - PFLEIDERER, JOHN R & MARGO E
JOHN R & MARGO E PFLEIDERER
17719 MEADOW RIDGE
MINNETONKA MN 55345
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 4893 SCH D OF RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 5.690 Plat: N/A-NOT AVAILABLE
SEC 30 T28N R19W N/K/A LOT 1 CSM 8/2289 Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
30-28N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 721/251
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/21/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.690 74,200 14,200 88,400 NO
Totals for 2006:
General Property 5.690 74,200 14,200 88,400
Woodland 0.000 0 0
Totals for 2005:
General Property 5.690 74,200 14,200 88,400
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
V
4G3906
CERTIFIED SURVEY MAP
LOCATED IN PART OF THE NEB OF THE SW} AND PART OF THE NWJ OF THE SW~, ALL IN SECTION 30, T28N, R19W,
TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN.
NOTE: This Certified Survey Map represents an existing parcel described in volume 721, page 251.
No new lots are being created, therefore, town and county approvals are not neccessary.
OWNER LEGEND
John Pfleiderer f9 County section corner monument, aluminum cap in concrete
280 Cove Road
Hudson, Wi. 54016 nt o 111 x 241' iron pipe weighing 1.65 LBS/linear foot set.
~ existing fenceline
FILED 2
• 1" iron pipe found
NOV 0 61990O-
JAMES O'CONNELL 3
Register of Deeds
SL GW CO., WI Q
NOTE: This survey does not agree with the survey shown on Certified Survey Map volume 5, page 1247,
however, the deeds between the two adjoining properties do agree.
~ 1 1~- 3 I
N890 58'05"E 1183.41' _I EAST 9_WEST 1/4 LINE
1163.41 t 3969.84' Y V
W I/4 CORNER 1 EI/4 CORNER
SECTION 30-1.28-19 ^ ar. SECTION 30
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n 5.41 ACRES EXCLUDING ROAD N o i3 0 0 co
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VOLUME] 8 PAGE 2289
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this instrument was drafted by Douglas Zahler job no. 90-68
/L/ ~2 S~ LC b / fla 7 ba r br: r
REPORT OF INSPECTION - INDIVIDUAL SWAGE SYSTEM
S ani tail y P e n rn.i-.( ~
Statz. Se.pxtic_
NAME w A, ,
Towv</5htip S Cnotix County
F %0!7 L o c a vi --A(-So . c=tn. o vrl,.~L o t # S ub di v,L6 1 o n-
SEPTIC TANK
S,Lze ga~~.oPI'S Nu.rriben- o~j sampan mevr~b~_- -
Dt.h.taviee {nom: Well- ~utiLd-t.v~ 120 Nape
ff,~ghwaterc
PUMPING CHAMBER
size gaQ_(ovL' - Pump Mavlu~ue.turcen Model Nurnbe.n
HOLDING TANK
S17C, gaQ2ovlb Numbetc oo Compahxmerz-t5
Pumpe.n AEa.n.m Sy6Tem
o h eov~e
aki ee nom: wet t BUitG(,c.ng 12
H'i.ghwa,te4
ABSORPTION SITE
Be.d Tnericit
D~!tav~c~('coal: LVe,~T Bui('.d,iur 12, IlighwaEen
ABSORPTION SITE DIMENSIONS
W, dth of tnevi.ebi Ot Re.gtki,rced aree.a_ --(~r
Levig,th o() each fEu.e. ~t Depth o{ n.och bekaw tti~e Zvi
N u m b e n o o T e b O c-p t h. 00 n o c h. o v c. rr. t4 , , ~e e
To true Ungth o A e i.vi-eb 6t Depth 06 tite below grcade I.v(
0~,I tavree betweevj f,.vje.a -ft Slope a0 ;trce.wch, pe,n 100 ~T
To,tak ab,5orcpttior area ()t Type of Coven: Papers o~- htnaw
PIT DIMENSIONS
Numbers o Glcave-~' anound tiT~ e~ v~o() p . p 9
T~
0at6ide- d4am(t c ().t Depth bek-ow <vl-e C' t - - ~t ~
ToTat ab6otc_ttiovj ctrce.a t
Area nc(((t c.d _ {t
iNSPECIEU BY TITLE
APPROVED DATE 198
REJECTED "DATE 19 8-
i
REASON fOR REJECTION
- -
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State and County State PerTy1h #
PLB 67 f. Permit Application County Permit
County
for Private Domestic Sewage Systems
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
B. LOCATION:'/a Section T. R E (or) Lot# City
' Subdivision Name, nearest road, lake or landmark Blk# Village
Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family l 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 Poured-in-Place Steel Fiberglass Other (specify)
New Installation < Replacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Percolation Ratet 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 WidthZ f " Depth z Tile depth (top) -No. of Lines -
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land 2 c ' 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 Ceryied Soil Tester,
NAME . e-L,, C.S.T. # nd other information
obtained from (owner/builder).
Plumber's Signature /MP#~ Phone -"may ~f
Plumber's Address - //~s/r~n T Cs
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 /J
Date of Application Y_ A Fees . Paid: State County Date ~fJ
Permit Issued/ (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
EH 115 Rev. 9178
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION: Section T_N,R_E (or) W:Township or Municipality `
Lot No. , Block No. County
_ Subdivision Name
Owner's/Buyers Name:
Mailing Address:
TYPE OF OCCUPANCY: Residence 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 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 I PERIOD 2 PERIOD 3
P-
P_
P_ P-
P- -
P_
SOIL BORING TESTS
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-
B-
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 Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope.
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I, 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
7owledge and belief.
;print) Certification No.
ess
1<s Of installer if known
ay A -Local Authority CST, signature
REPORT ON INSPECTION OF SANITARY PERMIT # 2t~_z
(1) ame and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection
Time of Inspection
Name, ress, icense NO. o ns a ing plumber
(3 )INSTALLATION CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber
❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System
(4)BENCHMARK: (Permanent reference Point) Describe:
Elevation of vertical reference point: Slope at site:
(5)MATERIAL AND DEPTH OF SEWER:
(6)SEPTIC TANK: Manufacturer: Liquid Capacity:
Tank Inlet Elevation: Tank Outlet Elev:
# ft to lot or property line: # ft to well:
(7)DOSING TANK: Manufacturer: # of gallons:
# of gallon pump set for a cycle gallons; total capactiy of distribution
lines gallon; size of pump head; gallon per minute ;
horsepower ; brand name of pump and model number
Is the warning device installed? ❑ YES ❑ NO Wired? ❑ YES ❑ NO
8 HOLDING TANK: Manufacturer o gallons
construction ; depth to the cover ft; If septic tank is
being used are baffles removed? ❑ YES ❑ NO; ft from residence;
ft from well; ft from property line. Type of warning device
Is the warning device installed? ❑ YES ❑ NO; Wired? ❑ YES ❑ NO;
Locking device on cover? ❑ YES ❑ NO; Diameter of vent and material ;
Distance from building to vent
(9) SEEPAGE PIT SIZE: # of pits; ft diameter; ft liquid depth;
ft to residence; ft to well; ft to property line;
ft to ordinary high water mark of lake or stream; ft to edge of slopes
greater than seepage pit inlet pipe-elevation ft; bottom of
seepage pit elevation ft.
(10) SEEPAGE BED SIZE: ft width; ft length; tile depth.;
lineal feet tile; ft to residence; ft to well; ft to lot or
property line; ft to ordinary high water mark of lake or stream; ft to edge
of slopes greater than 20% falling away toward lakes, water courses or drainage ditches
Elevation of tank discharge line entering bed ft.
11 SEEPAGE TRENCH: Total length of seepage trench ft; width ft;
tile depth ft; ft to well; ft to ordinary high water mark of
lake or stream; ft to edge of slopes greater than 20% falling away toward lakes,
water courses or drainage ditches; elevation of tank discharge line entering seepage
trench ft.
(12) Has system been installed in area indicated on EH 115? ❑ YES ❑ NO
(13) Has system been installed in floodway? ❑ YES ❑ NO Floodplain? ❑ YES ❑ NO
DILHR-SBD-6095 N.05/80
Signature of Inspector:
s,
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