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Parcel 022-1059-90-000 10/16/2006 12:36 PM
PAGE 1 OF 1
Alt. Parcel 21.28.18.P325B 022 - TOWN OF KINNICKINNIC
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 - TOMLINSON, ELLEN R
ELLEN R TOMLINSON
284 HWY 65
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description 284 HWY 65
SC 4893 RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 6.390 Plat: N/A-NOT AVAILABLE
SEC 21 T28N R18W W PRT NE NW EXC TRI> Block/Condo Bldg:
PARCEL AS DESC IN VOL 490/272 ASSM'T INC
022-1060-10 Tract(s): (Sec-Twn-Rng 401/4 1601/4)
21-28N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 885/88-
07/23/1997 844/605
2006 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 08/10/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 6.390 80,000 131,500 211,500 NO
Totals for 2006:
General Property 6.390 80,000 131,500 211,500
Woodland 0.000 0 0
Totals for 2005:
General Property 6.390 80,000 131,500 211,500
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 145
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 022-1060-10-000 10/16/2006 12:36 PM
PAGE 1 OF 1
Alt. Parcel 21.28.18.P325D 022 - TOWN OF KINNICKINNIC
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 - TOMLINSON, ELLEN R
ELLEN R TOMLINSON
284 HWY 65
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 4893 RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE
SEC 21 T28N R1 8W COM NW COR NENW TH E Block/Condo Bldg:
442', TH SWLY AT DEFL> 97DEG TO RT
374.2', TH NWLY TO PT 300'E OF NW COR Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
TH E 142' TO POB ASSESSED W/022-1059-90 21-28N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 885/88-
07/23/1997 844/605
2006 SUMMARY Bill Fair Market Value: Assessed with:
0 022-1059-90-000
Valuations: Last Changed:
Description Class Acres Land Improve Total State Reason
Totals for 2006:
General Property 0.000 0 0 0
Woodland 0.000 0 0
Totals for 2005:
General Property 0.000 0 0 0
Woodland 0.000 0 0
I
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
• i
AS BUILT SANITARY SYSTEM REPORT
;rR Li~'tJ f TOWNSHIP
ADDRESS , ST. CROIX COUNTY, TM'N, R
WISCONSIN. VISION
_DI LOT LOT SIZE '
• O 22- Id 9~-0610
PLAN VIEW
-Distances & dimensions to meet requirements of H62.20
S1iOT~T EVERYTHING WITHIN 100 FEET OF SYSTPM
1-----1-1-t--1-
i~► ~ I I j l
• ! i J ; i j i ! I t I ~ ~ ~ ~ ; i
1 4
74_
I I I
i
i
! II ! ; 1
7 TIC TANK (S) ~ MFGR. Indicate Nanth AvLow
0I)
C011CRETE L--STE`EL Scate
of rings on cover DeptDRY WELL
.:INCHES NO. of - width length area
no. of lines width length area
depth to top of pipe
;.ELATE \
K RATE AREA REQUIRLD AREA AS BUILT
;claimer: The inspection of this system by St. Croix County does not imply complete
_ialiance 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
t-em operation. However, if failure is noted the County will make every effort to
.--ormine cause of failure.
:BASES A1NT OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
'-INSPECTOR
DATED P11 U1MER ON J
LICENSE NU2• ER
J X23 W~`s~~
~~3
~ ~ 3~
~(-l,~ .(off
J,
r~rac by
z !
REP
ORT OP INSPLCTION_INDIVIDUAL SEWAGE SYSTEM Sanitary PeAm.i C
WY4
QC- State SPpx.ic, r/
1
NAME 7._ C ownship St. Cno.ix County
Location t ~ /,Sect.ion _
i
SEPTIC TANK ~f 'IVE
U
Size gattons. Numbers o6 Compantmentts
Distance FAom: wett 12% on gAeateA 6tope it
Bu.itd.ing bt. WetZands it.
K.ighwaten it.
DISPOSAL SYSTEM
D.i.6tanee FAom: Wett it. 120 on greaten stope 6t.
Bu.i.2_ding it. W ett and.6 Ft.
H ighwateA it.
FIELD DIMENSIONS:
width o4 ,tAench it. Depth o4 Aock below t.ite .in.
Length of each tine it. Depth o6 Aock oveA t.ite in.
NumbeA o6 tineA Depth o6 t.iZe below grade .in.
Totat length ob Zine~s it. Stope o6 trench in pen 100 it.
D.us Lance between Una it. Depth to b edno cfz it.
Totat ab~s onb,tion anew 6t2 Depth to gte.oundwaten it.
Requined area it 2 Type oi Coven: Papen on Straw
PIT DIMENSIONS:
Number ob pits Gnavet aAound pits yeas no
Out-side d.iameteA it. Depth below .intet it.
2
TotaZ ab,s oAbt.ion area it
A
AAea Aeq uiAed it2
INSPECTED BV TITLE
APPROVED , DATE 197.
REJECTED , DATE 197_
t..
State and County State Permit #
PLB67"
~ - Permit Application County Per
Idle
for Private Domestic Sewage Systems County
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNNJERI OFPRJOPE TY , Mailing Address-
011
/ f ( / P-,Oe~4
4
B. LOCATION: '/4 Section TN, R E (or) W Lot# ---City_
Subdivision Name, nearest road, lake or landmark Blk# Village
Township
C. TYPE OF OCC
NCY: *Commercial *Industrial *Other (specify) *Variance
P --7
Single family Duplex No. of Bedrooms :2 No. of Persons
D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES NO # of Bathrooms--
Automatic Washer YES NO Other (specify)
SEPTIC TANK CAPACITY _lon O Total gallons No. of tanks
"Holding tank capacity Total gallons No. of tanks
New Installation Addition Replacement l~ Prefab Concrete
Poured in Place Steel Other (specify)
FFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) 3) Total Absorb Area sq. ft.
'`Sew- Addition (Replacement *Fill System
Seepage Trench: N . Lin eta Width Depth Tile Depth No. of Trenches _
Seepage Bed- Deng h idth Depth Tile Depth No. of Lines
Seepage Pi I diameter Liquid Depth Tile Size
Percen s e of land Distance from critical slope
the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
'.'visconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared
~jy the Certified Soil Tester,
1';?AME C.S.T. # and other information
obtained from (owner/builder).
;'lumber's Signature PAS/MPRSW# 2 Phone
Plumber's Address y
PLAN VIEW: Provide sketch belo of system (include direction of slope and all distances in accord with
H62.20, including well).
N
I~
Q
i
r
1
Do Not Write in Space Below FOR DEPARTMENT USE ONLY
-
Date of Application , Fees Paid: State ,1'5774,C' County--) / Date °9 _
Permit Issued/R eEl (date) Issuing Agent Nartr~ '
LInspection Yeses No Valid# Date Recd
unty (white' copy) 3, owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
to (pink copy) 4. plumber (canary copy)
L Revised Date 6/1 /76