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Parcel 030-1018-40-000 09/05/2006 09:11 AM
PAGE 1 OF 1
Alt. Parcel 05.29.19.77B 030 - TOWN OF SAINT JOSEPH
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
DELORES FOSTER O - FOSTER, DELORES
494 RIVER RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 494 RIVER RD
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 20.020 Plat: N/A-NOT AVAILABLE
SEC 5 T29N R19W SE NE LOT 1 CSM 3/802 Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
05-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 685/313
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 09/07/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.020 25,500 142,200 167,700 NO
PRODUCTIVE FORST LANDS G6 17.000 155,400 0 155,400 NO
Totals for 2006:
General Property 20.020 180,900 142,200 323,100
Woodland 0.000 0 0
Totals for 2005:
General Property 20.020 180,900 142,200 323,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 209
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
I
i
.1
• AS BUILT SANITARY SYSTEM REPORT
,
P. - T-.'LN R
N, R W
°RADDRESS TONINSHI SEC. `
ST. CROIX COUNTY, WISCONSIN.
,DIVISION LOT LOT SIZE
PLAN VIEW
-Distances & dimensions to meet requirements of H62.20
Sf?Ot,* E~cRYTHING WITHIN 100 FEET OF SYSTEM
I
Lam. ! f - t
I
I I I I ,
J L-.t
;'TIC TANK(S)MFCR. i Indicate Wo ltth ~ArLnLow
..A, CONCRETE ~ STEEL S ca ° e
N0. o~ rings on cover = Depth DRY ?icLL
IT 1CHES NO. of - width le-gin t`~ area
no. of lines 21' width length
~ area
depth to top of pipe
S UGATE
f.. h, / t. iAXEA P.~.QUIF.ED ~i. AREA AS BUILT
;claimer: The inspection of this system by St. Croix County doer not imply complete
.oiiance 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
,_orrnine cause of failure.
LASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
`'INSPECTOR
DATED PLU'•iBER ON JOB j
, c1 :
LICENSE NU 1BE R f , j
• Y
REPORT OF ITISP?_,CTION--l",MVIDUAL SIai,)AGL DISPOSAL SYSTFII
Sanitary Permit
r State Septic;
.TAI 1E
f TOWNSHIP
I
St. Cr0 ; County
S1.°TIC TA'?Y
SA2e gallons. 'lumber of Compartments
Distance From: rJell ft. 12% or greater slope t fi.
Building ft. Wetlands f,
I'Lighwater ft.
DISPOSAL SYSTL:1 Tile Field or Seepage Pit(s)
Distance From: Well ft. 12% or greater slope ft
Building ft. Wetlands f
FIELD ;;ighwater ft.
Total length of lines ft. Number of lines Length of
each line eft, Distance between lines ft. Width of the
trench _.._ft. Total absorption area sq. ft. Depth
of rock below tile in. Dp-pth of rock over tile in. Cover
-,over. rock,, Depth of tile below grade in. Slope of
trench in per 100 ft. Depth to Bedrock ft. Depth to
ground water ft.
PITS
Number of pits Outside diameter ft. Depth below inlet
ft. Gravel around pint: `yes no. Total absorption area
sq. ft.
.Square feet of seepage trench bottom area required
`square feet of seepa.e nit area required
Inspected by `L Title': .
Approved Date 197
Rejected Date 197.
EH 115
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309
MADISON, WISCONSIN 53701
SPORT ON SOIL BORINGS AND PERCOLATION TESTS
LOCATION:'/4, N_%, Section I T -2-5N, R 0 E (or V1f, Township or Municipality _5T
Lot No. , Block No. County C
Q Subdivision Name
Owner's Name: ,Q~. J ~S i✓~
Mailing Address: S
TYPE OF OCCUPANCY: Residence No. of Bedrooms s'l Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT J
DATES OBSERVATIONS MADE: SOIL BORINGS Z 'Z Z 1~~ PERC ILIlOJTETSJ
SOIL MAP SHEET SOIL TYPE 42 1 ,
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
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
~f
P-Z 36 L l
P-3 141~
( 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)
0 _5
r,E - Z 5 l C
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square~eet of suitable areas. Indicat number of square feet of absorption area
needed for building type and occupancy. `r ~SIndicate scale
or distances. Give horizontal and vertical reference points. In icate slope. Q0
7 p f f f If I$I I
t7ttt7 1 t~' i f t
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if fft y ~ ~
i 1 3 ttt ( {li ii t
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r _ _ _
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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 b i C
(print C A-)'' Certification No.
CrcJ
installer if known
't
~ CST Signature
# 6
- State and County State Permit f /
PL1367 Permit Application County Permits -
• 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: I
ac Is W
B. L CATION:515- '/Y4, Section, T,~Z71\1, R_&(F(or) Lot# City
Subdivision Name, nearest road, lake or landmark Blk#_ Village J
Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family A Duplex No. of Bedrooms No. of Persons I
D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES-41\10 # of Bathrooms-!Z-
Automatic Washer _YES NO Other (specify)
E. SEPTIC TANK CAPACITY a.90 Total gallons No. of tanks _
*Holding tank capacity Total gallons No. of tanks
New Installation Addition _ Replacement _ Prefab Concrete
*Poured in Place Steel Other (specify)
F. EFFLUENy DISPOSAL SYSTEM: Percolation Rate 1) 4 2, 2) , 23) Total Absorb Area O sq. ft.
Newt/ Addition Replacement *Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length (2 / Width Depth- Tile Depth ~ No. of Lines Z_
Seepage Pit: Inside diameter Liquid Depth Tile Size
Percent slope of landS~ Distance from critical slope
I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
Wisconsin Administrative C e, and that I have sized the effluent disposal system from the EH-115 prepared
by the Certd Soil Tes r
NAME . G CL V- C.S.T. # SS - Sal and other information
obtained from (owner/builder).
Plumber's Signature btv~-•~ MP/M,PRSW# S 4 3 Phone #p7~- S~3-s
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
or
f r'Y
1ST
ve- Y\
Do Not Write in Spa a Below FOR DEPARTMENT USE ONLY
/j 6
-
' oy y D 6
Date of Application _ -i Feels Paid: State P r"`C
!
Issued/RM (date) Issuing Agent Name ! al l- )iL-4
Yes No Valid# Date Recd
(whi copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
ink copy) 4. plumber (canary copy) Revis