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Parcel 27.29.18.419B 042 - TOWN OF WARREN 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 - MILLER, WAYNE S & KATHRYN A WAYNE S & KATHRYN A MILLER 1237 CTY RD TT ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 1237 CTY RD TT SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 1.190 Plat: N/A-NOT AVAILABLE SEC 27 T29N R1 8W 1.190A NE NW LOT 1 OF Block/Condo Bldg: CSM V 4/1125 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 27-29N-18W Notes: Parcel History: Date Doc # Vol/Page Type 11/01/2001 660745 1751/391 WD 12/11/1995 537374 1153/178 LC 2006 SUMMARY Bill Fair Market Value: Assessed with: 149633 202,900 Valuations: Last Changed: 10/22/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.190 27,500 120,500 148,000 NO Totals for 2006: General Property 1.190 27,500 120,500 148,000 Woodland 0.000 0 0 Totals for 2005: General Property 1.190 27,500 120,500 148,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 316 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 A:; IM I I,T ~;AN I TAKY SYSTEM KEPOIRT I'OWN,;II I P tL),-Ll,h4~7 `;I:C27 'I-:%~N-RAW y !;T. (:I\,U I X CMINTY, W I `;(;ONS M ~;I IKI) I V I K MN I.O'I' ; I zk PLAN VIEW Uislai -us and dimensions to kee•t requirements of H61 SHOW E YTHIN(; WI'THEN 100 P'LI'T OF SYSTEM S ct . ii ~ i h~ A r raw 1 C I, ISKNCHMARK : (Permanent - reference Point-) Describe: W:levrit i"H "F vertical reference point: •~6+~'~""~'".S[ope at site: - r SEPTIC 'T'ANK Manuf~ac t carer: c,. rt- is ecl& Ate, I, i (uid Mac i t y : /ZYXY (wj N1 nui°e'i oI r i n~;a orr Cove r • ta 01M=_ TaU 'm i I QJe cover- eIeva.t lore . a J. Tank InIel Elevation: y,3 rtk Out-let I-AevatJ_on: < PIfMP CIIAMKI-:R M:niu i nc t rrro r : Number- of gallons c•riha( It:y oT _ ,4u,rl)(,r °)i. ga I . pump Brif- f car a cycle, gaI Ions; 1001- disf ribul_ion I ine8 gallon: tii.e or pump head; gallon per minute horsepower brand bake of pump <ancl model nuruber Type of warm i n):; do v se HOEDINC '.TANK: Manufacturer Number of gallons Elevation "f manhole cover Type of warning device ANN PIT SIZE: ~ Number A pits Feet diatnt~t_er feet IQu.i_d dl.pth seepage pit inlet pi_pe-elevation hot Iok ~paAe plt elevation feet. :i'A(;I': I VD A Q nunrl,er of lines _~3 wi (If 1) j s~ f let,gt i 1 e depth yq? ~ eng th - - '1'11.1?NCH : w! (i l h _ ` I- {'t? I:COI.A'I' L ON RA']'}? J .-1-7u. 2 71AT RT?(~I17RT D , ' ATZFA A R11T - - ` _ 01 INSP1 UA'I'I:I) LICENSE NUMBKR 3' REPORT Of INSPECTION - INDIVIDUAL SEWAGE SySIIM Sanitary Pe Imc State Sep ticcl_ c~2 e , VAMI _Tawnbh4.p St. Cno i x Cc un-tiI I r r a ti un Sec cov>;~Lot n Subdivcb c an S! PTIC TANK Si ze gaUOn,5 Numbe.A, o6 eompaAtmenta~_ G f?istance Welt- - _ Bu4tding~,~ _12% AYone-- Hi.ghwateA PUMPING CHAMBER Si ze ga.E.Eon4 _ Pump Manu~jaetuAen Mode.Y Numbo- HOLDING TANK Si ze gaffons Numbers o6 CompaAtments Pumpers AF-aAm Sy/5te.m DTAtanee 61i.om: We.t Bu~Yding-___ 12o Akape Highwaten ABSORPTION SITE Bed Tkeench Oi.Atance figom: Glee 8uitd.i.ng.---- t2% eYope_-- HighwateA _ ABSORPTION SITE DIMENSIONS Width o6 tneneh ~t Re.qu-iA.ed aAea - _ t Length o6 each Zone 6t Depth oA nock be-Yow t4Xe in NumbeA oA De.p-th oA Aoch oveA tike in -e beXow gAade ivr TotaP length oA Unu__ At Depth of ttf Di,stanee between f-ine.,s 6t SYope o6 tAeneh _ _in. t>cn 100 6f I c a b 5 oApttovt aAe(A _ 6t Type 0A CO VC A: Pape-A oA A0caw PIT DIMENSIONS ,I NumbeA o6 pits _ GAavel' aAouvnd . ? t h b e Y ow 4n Y e t--------___ Outs.i-de d-i ame_te.n At D eC Totak absoArtion aAea _--tit j Anea Aequtne.d--------------- t! INSPECTED BY TITLE APPROVED DATE 198 IIh RE Jf CTED DATL IZFASON FOR REJECTION State and County State Permit PLB 67 a Permit Application County Permi # , 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: ~T, /'nl~~o~iT~U1r~ B. LOCATION: Al i~5 '/4 IYA,' Section :L2-2, TjR:.f N, RS E (or) Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township c:Lla C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family Duplex No. of Bedrooms No. of Persons_ D. SEPTIC TANK CAPACITY led-'L? Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete- _A-""' 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 Rate ~~-'Y✓L-~-~^ Total Absorb Area sq. ft. New~Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width pth Tile depth (top) No. of Trenches Seepage Bed: Length -SLIC-Width. Depth Tile depth (top) 2- No. Lines 3 Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land %D 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 Soil Tester, _ NAME C.S.T. # Viand other information obtained from wn /builder). _ Plumber's Signature MP/MPRSW# 3 ~4' .,`I' Phone I-C ` Plumber's Address- 9 /~i~-L,,~i•2``- J/ '.S' 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 f s k s o 3 E , t f 6P w .b _ . ,m..- -Jr e e- . E i k l f ~ ~ 1 , m~ _ . , s.._. y d n..e..a.... _ _ - 3 E , Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application - -_Fees Paid: State County Date I - - Z_ L Permit Issued/fCT-e-d (date) Issuing Agent Name fl~~ M/d 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 7PDr-VU/1 '7`0 MY a, 1e,1V1L s~rc TES F OF 1-?- , A,c-:P,4 RTM ENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, V DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX N WI 7969 HUMAN RELATIONS LOCATION:N SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: wF '/a .2 -7 /T #N/Rd E (or) W /71,~T o -7/y IFCA6 ~Pjt? CO NTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: S C ko/ X ~6'A y .~7 j' / 113o X lf, ' ~'o d ~,eTS ~iS USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: 1PERCOLATION TESTS: Residence 3 New ❑Replace I 9_ r (✓j_-"C> SCS` Se4TTiPF w~ RATING: S= Site suitable for system U= Site unsuitable for system N A? CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: ISYSTEM-1 N-FI LLIHOLDING TANK: RECOMMENDED SYSTEM: (optional) S ❑U ❑ S ❑x U ©S ❑U ❑ S 2U ❑ S ZU ~'ac~vE.vT~o•(~rl L e-ce9- 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: 6 I` 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.) 72- T h~ -7 ~2_~ B-~ P3 . 5~f ? d C. B- (P 120 7/J? PERCOLATION TESTS r TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER L CJNCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PE-PTO D PER INCH P- P- o,@i So />oR o - - 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 locatio`n/ on the plot plan. Show the surface elevation at all borings and the direction and percent of land slop. Q/e f r Cl l~E~~~A~ ~E~ L`~(JC~ /~Q/~~ /00 fr, SYSTEM ELEVATION U o-Ah. waep5 - i3o TToM of /3Z"D 0,.1A ,&Q eX4 cTL Y % L L o~CErS e&F .4iw 5 "4C RI 77,e SV_i,-2_ 44- M rva "tC }.v E~~'Q~ o A,, o'ens'. /,v )tZPO F, C04 F1 OA) 5012_72~_.57L5T l'E -5 /f 74e- T, ,q v S/ I . /foe r3,O O j f~~ S f/v cv,c> Ott , 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: ,PohG9 T /bk'/c r -D c . &-d- I ~ d' / ADDRESS: CERTIFICATION NUMBER: PHON NUMBER optional): O:vi'~ ~cPyf~si~.,v lvi~ =a zyfL 36 / CST GNATUR : DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. DILHR-SBD-6395 (N. 03/81) J DEPARTMENT OF REPORT ON SOIL BORIN D SAFETY & BUILDINGS INDUSTRY, DIVISION P.O. BOX 76 LABOR AND PERCOLATION TESTS, MADISO N WI 53707 HUMAN RELATIONS J LOCATION: SECTION: - TOWNSHIP/MUNICIPALITY: VULL OT NO.. E, 0: BDIV~ ION NAME: !V~ / z? /T2YN/R/J0E(or)Wc/AR~P~v COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS:// USE DA IONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE D TONS: PERCOLATION TESTS: ~Residence 7 New ❑Replace I RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) WS ❑u DS au o S ou [:]S ®u DS EZu If Percolation Tests Tes51t(s ab)re NOT required DESIGN RAT JSYSTEM EL V. j~ j I If any portion of the lot is in the under s.H, indicate: ~.J Floodplain, indicate Floodplain elevation: fAk/_<4 F /D~¢y yyy S .`j ,/ROFILEDESCRIRTIONS ED BORING TOTAL ELEVATION D Ti LIC T OUNDWATER-INCHES CHARACKCTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, O RVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) /00 s~1,AV. / L/•,'a.L LS•'ee-Ll•RJ, L; S"f 1wr`~ ~ a life, ? B 00 q0. / Fr B Z 72 Y71 Fr. % 7 Z . G7Payti - e'7 L1 "L!'13v . 5 L , 27'" B S/ k 72. Afi.- AV C C~- f. /,GHQ SL . J*.4 s _ .S'•,0,0 ,D B- 72- 9-4 7 B- 0 o e -2 . B- 6 4,40 '~.IPF)~~:L 0 19 1,4'.'.-V s-,-: PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD PER INCH P- ER 09 U o i l y O P o >e_sr E fitl IAI t A i /i' ,P,9 £ P f-1 1,f A;D q o P_ . Idi k01 &e- c/1~o r~oa A7` aR IRA 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. of A_-'v SAAB/ L/'r- E:Y4C7"e j. lqrlo w SYSTEM ELEVATION oR F ~/Ev,,~EF Pr=~v~ ' r R6rro.., of /3t/~ E~Ev = X75 tr'. CROS s • n G. `~c vXC~ r • =13AG~C'NoE /~Dlt ~i%S E $~a 2 . A~y co eivER 4, x'0 _ Ff~vct~ /dSi' 36 63 fly • • vier. AV. Pr yQAnE Ar 13.!~r Of ~ Z 3g' o ~o t N f L " " s.Pos S 1/4//OA) 13L ~PEFE2'F.,~CE P% ;5 v2oP°~~ p T£ST fjQE,q. 13 /uUttrovs fJ/fd~E"~ E" EAR' . r_ y~ fA~EA Iv ,eel-#rmv 70 741s 1348 ,uIUST 41r 40 rt f,Po~, riesr° `ocE ~Ro os,r1~ u~El/ 1144E11`- 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: 0, a-el A'00 15a /-j ADDRESS: J CERTIFICATION NUMBER: PHONE NUMBER optional): iL Rd - v .sd-v 4~Z)/S D/ 33-:-0 CST SIGNATU DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. DILHR-SBD-6395 (N. 03/81) 7, 1 -;2d t-i R F f i i 1 I