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Parcel 024-1033-40-100 10/16/2006 03:19 PM
PAGE 1 OF 1
Alt. Parcel 29.28.17.212B 024 - TOWN OF PLEASANT VALLEY
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
JONATHAN L COLBY O - COLBY, JONATHAN L
1683 18TH AVE
HAMMOND WI 54015
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1683 18TH AVE
SC 2422 ST CROIX CENTRAL
SP 1700 WITC
Legal Description: Acres: 19.820 Plat: N/A-NOT AVAILABLE
SEC 29 T28N R17W N1/2 SE NE TOWNSHIP Block/Condo Bldg:
PLEASANT VALLEY NOW KNOWN AS LOT 1 CSM
VOL 6/1677 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
29-28N-17W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1125/477 QC
07/23/1997 1011/527 WD
07/23/1997 746/347
07/23/1997 733/476
2006 SUMMARY Bill Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 04/20/2006
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 26,100 107,900 134,000 NO
AGRICULTURAL G4 16.640 1,900 0 1,900 NO
UNDEVELOPED G5 1.180 200 0 200 NO
Totals for 2006:
General Property 19.820 28,200 107,900 136,100
Woodland 0.000 0 0
Totals for 2005:
General Property 19.820 28,300 107,900 136,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: 09/29/2005 Batch 05-24
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
• AS BUILT SANITARY SYSTEM REPORT.
ER 0}e`y{ L, TOWNSHIP.; C. T N R W
. ADDRESS,
ST. CROIX COUNTY, WISCONSIN.
~t
")DIVISION LOT LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
'
~P
CC44 _/c ~ t; ,
• Y'
TIC TANK (S) MFGR. CONCRETE STEEL
NO. of rings on cover Depth DRY WELL
+CHES NO. of width length area
no. of lines-'`;,, width- length area
depth to top of pipe °
UGATE
.K RATE AREX'RE(jUIRED AREA AS BUILT
iaimer: The inspection of this system by St. Croix County does not imply complete /
)liance 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
tem operation. However, if failure is noted the County will make every effort to
ermine cause of failure.
. SES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. • -7
"INSPECTOR
DATED PLUMBER ON JOB
LICENSE NUMBER- 7 I
i
z' REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
SanitaAy Penm.it
State S e p ti c___
NAME i" o w n.6 h i p -~t. Cn vix County
Y
Loeation S F"" A c- Section O~ J
SEPTIC TANK
Size ga.i.ions. Numbers o6 CompaAtment6 A i
}
E
Distance FAam: Glee ' 12% on gteeateA stvpe At
Bu,itd.ing tit. WetZands ~ .
H.ighwateA 6t.
DISPOSAL SYSTEM
e r
D.idtanee FAom: Wett 12% on gteateA -stope 6t.
Bu.itding tit. Wettandz Ft.
H.ighwateA tit.
FIELD DIMENSIONS:
Width o6 tAeneh tit. Depth o6 Ao ck b etow t.iZe _.in .
Length o6 each tine ' tit. Depth o6 Aock oven t.ite J'. .in.
Numb n o6 t in e/s_ ' Depth o4 t.ite b etow grade. - in.
! Totat Zength o6 Zine/s tit. Slope o6 ttt.eneh =r in per 100 tit.
6t. Depth to bedrock. 6t•
Distance between tines
f Total ab.sotbtion aAea 6t2 Depth to gnaundwateA tit.
Requ.i..Aed aAea Type oti Covet: Paperi oA StAaw
4f - tit2
PIT DIMENSIONS:
Numbers oti pitz GAaveZ around p,itz yes no
a
Outside diamete.A 6t. Depth b etow .inX et
2
Total abzoabtiion aAea 6t A
2 rn
Area AequiAed 6t
4 TITLE
INSPECTED B~l±
APPROVED DATE -
REJECTED ,DATE 197.
State and County State Permit #
PLB 67 Permit Application County Permit #
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:
s J .
B. LOCATION: '/4 Section T_ N, R_ E (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township
C. TYPE OF OCCUPANCY: *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 Total gallons No. of tanks
Prefab concrete X_ 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 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) 4 No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land Distance from critical slope
WATER SUPPLY: Private E 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. # and other information
obtained from (owner/builder).
Plumber's Signature MP/MPRSW# Phone
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.
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Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application Fees Paid: State L County- Date
Parmit Issued/ (date) Issuing Agent Name
Inspection Yes '1\ 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
E M 115 Rev. 9/78
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
SE 1/4 NESection 9 J2 -N.R1Z W. Township or Municipality Pleasant Valley
NE
LGCATION: County St. Croix
Owner's/Buyers Name: Lowell Stoppelmore Subdivision Name
Mailing Address: RR 1, Hammond, 111 54015
TYPE OF OCCUPANCY: Residence X No. of Bedrooms 2 COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW X REPLACEMENT ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS_ July 7 , 1979 PERCOLATION TESTS .T„73r I R I lg7q
SOIL MAP SHEET #93 Saint Croix Co. NAME OF SOIL MAP UNIT Santiago Silt Loam
PERCOLATION TESTS
TEST DEPTH CHARACTER SOIL ESfNCE RS WATE R IN TESTTIME DROP IN WATER LEVEL, INCHES RATE
NHOLE HOLEAFTE INTERVAL
BINCHES THICKNESS IN I NCHES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
TTED SWELLING INMINUTES
P- 1 31 12" sil TS 8" sil 11" red 1 112 1 5/8 1 1/8 27
P- 2 31 13" Sil TS 6" sil 12" red s ,-l 22 no 30 1 1/8 1 1 .30
P- 3 30 11" sil TS, 7" sil, 12" red s el 22 no 30 1 13/16 3/4 40
P-
P- I
P_
SOIL BORING TESTS
TEST 'OTAL 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-1 67 none > 67 12" sil TS 8" sil 47"
6-2 67 none 67 13" sil TS, 6" sil 48" red brn scl Till
B-3 66 none 7 66 11" sil TS 7" sil 48" red b
B-4 67 none > 67 13" sil TS 8" sil 46" red brn scl Till
B-5 67 none 7 67 12" sil TS 8" sil 47" red brn scl Till
B- 6 66 none > 66 12" s i l TS 8" si l 46"
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan tf location and square feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancy 600 ft trench ,Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope. 750 ft bed
Town Road
E
bore holes 1
fperc tests
E
elevation reference -
Scale 1" = 40' '
Owner has 20 acres for
building site Existing old
house will be
e
removed
E
E -
o /A 3 ',I,0 l4_'-.Elevation Elevation
I
m 2% slope 4 A'A 95' reference
w
i,ZM Proposed point 100'
2 bedroom ' elev. existing
431- home well
:'ection 29
' L
1 J
Some holes dug to 7 $ 8 fee4r did indicate water but keeping
the system shallow at 30-32" will provide a good adequate disposal system.
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
knowledge and belief.
Name (print) Roger A. Swanson Certitication No... 55-606
Address RR 5, Box 124, River Falls W1 54022
Name of installer if known linknown
Copy A -Local Authority CST Signature,4
i
EH 115
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
- DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309
r
` MADISON, WISCONSIN 53701
one REPORT ON SOIL BORINGS AND PERCOLATION
p), `
LOCATION: /V(AJ~/4, Section o(7, T, R/,7*(or) W, Township or Municipality S~y /v~ yl Cy
Lot No. , Block No. Ln T County ~~0 1
ub K15 ion, fame
Owner's Name: L._ Ld _S L 7V f)r it
Mailing Address: 7 0 L7 ~tiAlll
TYPE OF OCCUPANCY: Residence No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW _ ADDITION REPLACEMENT
DATES OBSERVATIO09. MADE: SOIL BORINGS P PERCOLATION TESTS
SOIL MAP SHEET S TYIJ.
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 RIOD 2 PERIOD 3
P 5E a
PIE
P-CIlr
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)
B- T7 _1~
o " G/ T on"K C 6 7 om,,Iva
B-
io/ `TL f~
6 C) y /0
L 5, B- r7 dj y . 1-4 6 -T 's 0/ /
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.
A 1
t {y I , } ! I
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If{{{ E IY 1
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E j ~ t ~ I ~ j ~ i I ( I I
___1_____
i -
I + i I I I ; ~
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I, the undersigned, 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 knowledge and belief.
Name (print) y~ ~M Il /YV /1/f% ITT j t" T Certification No. ss- I _
Address
Name of installer if known
a C ~ ~ y y CST Signature
_4~~Z
Laglah, 7