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Parcel 002-1032-40-000 07/13/2005 02:10 PM
PAGE 1 OF 2
Alt. Parcel 15.29.16.225B 002 - TOWN OF BALDWIN
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
* CAMPBELL, LEROY D JR
LEROY D JR CAMPBELL
927 240TH ST
BALDWIN WI 54002
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 927 240TH ST
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 2.000 Plat: N/A-NOT AVAILABLE
SEC 15 T29N R16W PAR IN NW OF SW 10 RDS Block/Condo Bldg:
X 32 RDS ON S LN E OF HWY TOWN BALDWIN
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
15-29N-16W
I
Notes: Parcel History:
Date Doc # Vol/Page Type
12/07/2001 664479 1784/445 WD
07/23/1997 1114/265 QC
07/23/1997 847/612
07/23/1997 754/511
more...
2005 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 11/02/1999
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 9,000 60,700 69,700 NO
Totals for 2005:
General Property 2.000 9,000 60,700 69,700
Woodland 0.000 0 0
Totals for 2004:
General Property 2.000 9,000 60,700 69,700
Woodland 0.000 0 0
I
I
Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 555
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
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Parcel 002-1032-40-000 03/31/2005 04:11 PM
PAGE 1 OF 1
Alt. Parcel 15.29.16.225B 002 - TOWN OF BALDWIN
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
* CAMPBELL, LEROY D JR
LEROY D JR CAMPBELL
927 240TH ST
BALDWIN WI 54002
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description " 927 240TH ST
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 2.000 Plat: N/A-NOT AVAILABLE ( r
SEC 15 T29N R16W PAR IN NW OF SW 10 RDS Block/Condo Bldg: I U
X 32 RDS ON S LN E OF HWY TOWN BALDWIN
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
15-29N-16W
Notes: Parcel History:
Date Doc # Vol/Page Type
12/07/2001 664479 1784/445 WD
07/23/1997 1114/265 QC
07/23/1997 8471612
07/23/1997 754/511 vwe' `
more...
2004 SUMMARY Bill Fair Market Value: Assessed with:
42217 103,700
Valuations: Last Changed: 11/02/1999
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 9,000 60,700 69,700 NO
Totals for 2004:
General Property 2.000 9,000 60,700 69,700
Woodland 0.000 0 0
Totals for 2003:
General Property 2.000 9,000 60,700 69,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 555
Specials:
User Special Code Category Amount
010-GARBAGE SPECIAL ASSESSMENT 45.00
Special Assessments Special Charges Delinquent Charges
Total 45.00 0.00 0.00
• AS BUILT SANITARY SYSTEM REPORT
T
NLI) ER - A t S IV , TOWNSHIP h~~i .SEC. ` T r N, R_ W A, 7,- J2AZVLz, - ,O. ADDRESS ; ST. CROIX COUNTY, WISCONSIN.
.z 444 '3DIVIS0N LOT LOT SIZE :;%/i (id (I
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM i' 14 /
r.
'j Li l
t• VV
l
?TIC TANK(S)J-14'( " MFGR. .'1-N, C, CONCRETE STEEL,,.,{' r f /
NO. of rings on cover ~ "Depth DRY WELL
TENCHES NO. of width length area y
no. of lines width length area
depth to top of pipe
'jREGATE
-a RATE AREA REQUIRED AREA AS BUILT
°,claimer: The inspection of this system by St. Croix County does not imply complete
.,pliance with State Administrative Codes. There are other areas that it is not possible
inspect at this point of construction. St. Croix County assumes no liability for
stem operation. However, if failure is noted the County will make every effort to
termine cause of failure.
:'ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
"INSPECTOR /~7 t ` c, X f >
• r
DATED LUMBER ON JOB ' oou
LICENSE NUMBER
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM {
San.ita)Ly Pvzmtit /
State Septic NAME . i ownship S$. Cn.o.ix County
Location ! Section
SEPTIC TANK
S iz gattons. Numbers o6 Compantments
Di,,6tanee Fnom: Wet 120 on gneateh ztope - St
Bu.i td.ing 6Z. Wettand/s - ~ .
DISPOSAL SYSTEM Nighwazen 6t.
D.i.6tanee Fnom: Wett S 12% on greaten ztope 6t.
Bu.it.d.ing_ _6t. Wettand/s Ft.
H ighwazen6t.
FIELD DIMENSIONS:
Width oS tinench 6t. Depth o6 `cock be.-ow t.ite in.
Length o6 each tine 6t. Depth o6 cock over t.iZe in.
Numbers o6 tinez Depth o tiZe below gtcade .in.
Totat .length o% 2-inez '6t. Stope o6 trench in pets 100 6t.
Distance between Zines y 6t. Depth to bedrock 6t.
Tota.- absorb'(-,ion area ~t2 Depth to gnoundwaten 6t.
Requited axea 6t2 Type o5 Coven: Pap.en on Straw
PIT DIMENSIONS:
Numbers o6 pits GAavet around pity ae/sno
Outside diameters 6t. Depth below in.?-et-6t.
Tota.- ab.sonbtion area St Z
A
Area aequiyLed 6t2
INSPECTED BY D_44(f T-/T TLE 'J
APPROVED a;1 , DATE 19 7.
r
REJECTED DATE 197.
State and County State Permit # -
PLB,'67 Permit Application County Permit for Private Domestic Sewage Systems County
*DENOTES STATE APPROVAL REQUIRED z'
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY T Mailing Address:
/lSC
B. LOCATION: Section 1 , T;qN, R E (or) _W, Lot# C y
Subdivision Name, nearest road, lake or landmark Blk# Village
Township aiz 2y",
C. TYPE OF OCCU ANCY: '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 ~O c Total gallons No. of tanks
Prefab concrete Poured-in-Place Steel 2_ 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 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 Width Depth Tile depth (top) No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land 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 ~ ililme S 1 er Z / C.S.T. # IS~nd other information
obtained from e R( (owner/builder). 7
l
Plumber's Signature MP/MPRSW# Phone # C ~ 5-3 Z7
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. / /v
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Do Not Write in Space ,Below FOR COUNTY AND ST/ATE DEPARTMENT USE NLY
Date of Application Fees Paid: State County ~t^ Date
Permit Issued 4T (date) I'D Z- / "Issuing Agent Name a Lt ~L- f
Lje
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 1.5
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309 •
' MADISON, WISCONSIN 53701
/ l REPORT ON SOIL BORINGS AND PERCOLATION TESTS
LOCATION: Section, To RE (or) 1Township or Municipality AI~✓~~
Lot No. Block No. County
f1~ r7 S bdivision Name
t°/UIY/~ S I .Y/
Owner's Name:
~ ' A
Mailing Address: ~ G✓!/r1 1;-1s.S&
TYPE OF OCCUPANCY: Residence No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT ,
DATES OBSERVATIONS MADE: SOIL BORINGS
~?F' 14
ERCOLATION TES
;5 1 1 -1'
SOIL MAP SHEET SOIL TYPE 0 ee4`3 h~
PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TESTTIME 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-
P
P
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
_ OAK, •i '1 c 4 cS A)
-34- AeAj~
zex r-,; f_7
f! .er'/t1 S?S4 t.
AeA) PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square feet o pit blg ire sir Indi number of squafll eet of absorption area
needed for building type and occupancy. tl .~ilfflC Indicate scale
or distances. Give rtic r ce points. Indicate slope.
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F_ L& Al l y
I, the undersigned, hereby ce 'fy 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) C l Certification No.
Address 7,0 L 11W, C,
Name of installer if known
CST Signature _ rl -
C101PY A -LOCAL AUTHORITY
AGREE ME T,1
This agreement, made and entered on this ;►~th day of Auspat 192~gL, by
and between the Township of F~alelwin F ddress , Sjdirin,
# a.crsr, n
V EEREAS: f n application has been made for a sanitation system on the
following described property: Sao# 15 T29:'tl RI Poroel in A: of SW
10 rds x 32 rda ort In E= of 'ivy*
V I EREAS: Septic tank drainage does not meet the minimum standards of the
ordinance of St. Croix County and state codes.
V~hEREAS: The owner agrees to install a holding tank for septic tank purposes
purposes.
NCV, TEEREF (DRE: For and in consideration of the issuance by the Town-
ship of of a permit for the above premises, the parties
Ge9st,'~~i aka,?,
do hereby agree and bind themselves as follows:
1. Owner agrees that they will conform to all the rules and regulations
pertaining to a holding tank system. They agree that anytime said
township deems it necessary to pump out said tank, the owners shall
have same pumped out in 24 hours, or township will have said work
doneand charged to owners and place same on their tax bill as a
special charge.
2. The Township reserves the right to assess a bond if they desire to
cover any possible pumping charge in the sum of .
IT IS UNDERSTOOD that this agreement shall be binding on the owners,
their heirs and assigns.
IN V ITNLSS WEERLOF, the parties have hereunto set their hands and seals
the day and year first above written.
Township of~ .1-?ta t i
by ,
Developer`
or owner
~EIVEp
STATE OF VJS CONSIN) AUG
r
F1.UMB1N~
COUNTY CF ST. CRUS) SS: SEC1-10nr
Subscribed and sworn to before me this day of fl- _ ;,j 19tlia
Notary Public, St, Croix County
f ,off.
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RECEIVED
AUG271979
PLUMBING SECTIOPJ
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7 9 U 4 0 5 _
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i°:r. Byron Ui rd
i .,;u to 1, box 226
p ry, W1 >4GU1
Plan luentification No. 1"-04558
Dear itr. Bird:
Rea: holding tank 2,UUU gallons
Dennis Preston - Residence
wW 1/4, Sri 1/4, Section 15, R106W
Town of Baldwin, Wisconsin
St. Croix County
Examination of plumbing plans and specifications for the above-mentioned
project has been completed.
In accord with Chapter 145, Wisconsin Statutes, and Chapter H 62, Wisconsin
Administrative Code, the plumbing plans and specifications are approved
contingent upon compliance with the following stipulations.
1. Our review of the holding tank plan has not been evaluated for
structural stability, only for compliance to uesiyn requirements of
Chapter H 62 of the Wisconsin Administrative Code.
i
The holding Lank shall " maintained and the contents disposed of as
re;quire;d under Section H 0'2.2U Wisconsin Administrative Coda.
,s. The architect, professional engineer, registered designer, owner or
plumbing contractor shall keep at the construction site one set of plans
bearing the stamp of approval of the department.
4. In the event Installation of the plumbing improvements or system has
►iut conui iencewd within two years f row this date, this approval shall become
%Q ij and new application shall be made for approval of these plans before
Y.urk may commence.
kr. 6yron bird
Page 2
i, X,:I, ilq this approval, the division of health does not hold itself
ij4A i'or any defects in plans or specifications, plan omissions,
~..."~acni nat i on oversight, construction or any damage that may result in
or after installation and reserves the right to order changes or additions
should conditions arise making this necessary.
iiis approval is teased on Chapter H 62, Wisconsin Administrative Code,
requirements. It shall be necessary to obtain and fulfill the permit
requirements of the city, village, township or county in which this
i,lstaliation is to be ,constructed. '-=allure to obtain local permits will
u:atomatically void this acceptance;.
cy order of Hoilert Durkin, t43mini`•Lrz:rr)r, :`ivi%iorr ^f
Sincerely,
4titCi
JAS. r':e:riro
r
Enclosures
cc: qtr Oennis Sorenson, UWS - District La Crosse,
Xr• Harold C. Barber, St. Croix County Zoning Administrator
I