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Parcel 030-1093-50-000 03/23/2005 04:28 PM
PAGE 1 OF 1
Alt. Parcel 32.30.19.341 C2 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): = Current Owner
" FOGELBERG, BRUCE & KAREN
BRUCE & KAREN FOGELBERG
474 CTY RD E
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description ` 474 CTY RD E
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 5.230 Plat: N/A-NOT AVAILABLE
SEC 32 T30N R19W NW NE LOT 2 OF CSM Block/Condo Bldg:
4/1012
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
32-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/19/2001 651644 1684/01 WD
07/23/1997 631/263
2004 SUMMARY Bill Fair Market Value: Assessed with:
5563 318,300
Valuations: Last Changed: 07/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.230 131,100 182,000 313,100 NO
Totals for 2004:
General Property 5.230 131,100 182,000 313,100
Woodland 0.000 0 0
Totals for 2003:
General Property 5.230 76,800 147,900 224,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 140
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
• AS BUILT SANITARY SYSTEM REPORT
W'iER G ~f l , TOWNSHIP C , SEC. T N, R .
G. ADDRESS U
• ST. CROIX COUNTY, WISCON IN.
c%r4r i_ i G
'LDIVISION , LOT LOT SIZE
•
PLAN VIEW
-Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
II i ( ! I i !
-
_T
-
,
1 i - - a I
I
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d+~
ljilt
- - i I
Indieate lozth' Arrow
-
- r _
!SCALE:
TIC TANK(S) s MFGR. t 1E; r2 C C( Mg - CRU CONCRETE STEEL
NO. of rings on cover Depth DRY WELL
'I NCHES NO. of _ width length area
no. of lines widthlength r_ area
depth to top of pipe
•
,ar:EGATE j U Ac, vo ,
i=; .'1°E Z AREA REQUIF.ED~ AREA AS BUILT
hwlaimer: The inspection of this system by St. Croix County does not imply complete
:G;.pliance with State Administrative Codes. There are other areas that it is not possible
t,i.nspect at this point of construction. St. Croix County assumes no liability for
IStem operation. However, if failure is noted the County will make ever effort to
(;~ermnine cause of failure.
.LEASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYST
~INSPE
DATED jq PLL', iB ON JOB
LI NSE NUIMER ~q /
;f
Z '
REPORT OF T'4SFa,~,CTION_INDIVIDUAL SE(VAG'E SYSTEM
Sanitatsy Pe,,unit
( State Septic_2~'
/-St. Croix Count
NAME___~ ~ (owns hip y
Locatioa Section
SEPTIC TANK
Size ~ - ~ gaZZonz . Number o6 Compatstmen-tz i
Distance Ftsam: WeZZ ;'A12% an g&e.atets zZope yit
BuiZding t. WetZands
Highwatets it.
DISPOSAL SYSTEM
Distance F)som: WeZZ -1 12% on gtseatetc zZope
BuiZding it. WetZands Ft.
Highwatets it.
FIELD DIMENSIONS: j
Width o6 trench - it. Depth o6 tsock)'b 'd'w tite in.
Length o j each tine it. Depth o6 tock ovvL t,ite i_- in.
Numb eh o6 tin eta Depth o4 tiZe b eZow gtsade C Ln .
g t. SZope o ~tseneh in pets 100 it.
TotaZ Zen th o Ztines
Distance between tines r',• it. Depth to b edtso ck ~ t.
To:LaZ absonbtion area jt2 Depth to gnoundwatets ~ .
Requitced area 6 t 2 Type o6 Covets: Pa p etc oa SVLaw
PIT DIMENSIONS:
Numbers of p~ts GtsaveZ atsound pit.6 yeas no
Outside diam etc. it. Depth beZaw inZet it.
~//j 2
TotaZ ab.3okElt .on atsea it
A
A&ea tsequi. Led 2 rn
INSPECTED , TITLE -
APPRO_D.._ -,DATE ' ? 197
_
REJECTED DATE 197.
V 1 1 1 5 Rev. 9/78
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
WISCOP;~+IN DEPARTMENT OF HEALTH AND SOCIAL SERVICES r
'O P.O. BOX 309, MADISON, WISCONSIN 53701 FCE1VC!J
1919
1' awl :L 7 Sry ~l LOCATION:'/4, Section IL,TN,R ' E (or) W, Township or Municipality
Lot No. ,Block No. County ~t aPrJ4x
Subdivision Name \
'r Owner's/Buyers Name: At'EL
gAddress: 6!41A Y4i%4 71a~ /4/cpseVIL; 6 ,cols . S yo/ c-
Mailin
TYPE OF OCCUPANCY: Residence-No. of Bedrooms - COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS IV14,T di PERCOLATION TESTS I 2 i
SOIL MAP SHEET NAME OF SOIL MAP UNIT ®N y- 62WIAL:4 - A~N'l~ G
PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
NUM- SINCE HOLE HOLE AFTE INTERVAL
MIN/IN
BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P- / .3 ~ 6" At Sv "get/. 5 w r ~ `'o.5. /1 "`u lk .f/&,~ f- 3
P- 2 3 "Pt & 15, 5 w p /s,„O,S I,,eq/gyp ~VtW r
P- 3 3 Z~`'a~BN 2r• . S Yoi, -2,2-
P- `
P-
P-
SOIL BORING TESTS
TEST TOTAL 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 ~G ti~~ ~c> l3~ / U " D~ 111ED, S 3'" r Or. 5 N
B- Z > vlo 1 ' "~N 5 Z6" C3,ae, h/r=p. S . S3 L' Gh. S , r .
B- 3 72 ,~r o, vE 7 7,2- 33 15 3 Y" or. A_-14. S,
B- ,Vv E' -7 7L B,v 15,
B- .5 2_ ? 7 4 7 ,Pt; 6v. A by hires S,. 0.4nca S.
PLAN V IEW (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 yes mEtic 1# Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope.
i
VA NC 'TO 504Hof
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5Y5iEM 5iTE #45 9-10t, Sa, 5/94'5 N
33
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1, 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).~G Certitication No._~
Address k~f V
Name of installer if known `qM j&a o~L) 4691S'
Copy A -Local Authority CST Signature
State and County State Permit #
PLB*67 County Per i#
Permit Application 1
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: 0 5V Z, A vD A) eei CS
B. LOCATION: /jLj4~/_% Section , T Z6 N, R E (or) RW Lot# _C4
Subdivision Name, nearest road, lake or landmark Blk# Village
C7"_ V /C r Township 3o jfrll
C. TYPE OF OCCUPANCY: `Commercial/ -4 "Industrial `Other (specify) "Variance
Single family X Duplex No. of Bedrooms _ No. of Persons c
D. SEPTIC TANK CAPACITY Total gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete ~i Poured-in-Place Steel Fiberglass Other (specify)
New Installation X Replacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-PlaceOther (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area sq. ft.
New V_< Replacement Alternate (Specify)
Seepage Trench: No. of neat Ft. Width De th Tile depth (to No. of Tren es
Seepage Bed:
X_Length ~ Width~Dept Tile depth (top )_No. of Lines
Seepage Pit: Inside,_jiameter Liquid Depth No. of Seepage Pits
Percent slope of land-r~ Distance from critical slope
WATER SUPPLY: Private J< 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 Cer fled Soil Tester,
NAME C.S.T. #,j and other information
obtained from 1 (owner/builder).
Plumber's Signature MP/MPRSW .~y~-Phone #A?6 L'~ C)
Z2 fZ
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 <<C?C C un y L1 Date
Permit Issued7e) d (date) / Issuing Agent Name G
Inspection Yeo State Valid# Date Recd
1. county (wpy3. 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