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Parcel 032-1002-40-000 10/23/2006 11:53 AM
PAGE 1 OF 1
Alt. Parcel 1.31.19.16B 032 - TOWN OF SOMERSET
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
RUSSELL R & LORALEI MILLER O - MILLER, RUSSELL R & LORALEI
782 CTY RD H
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 782 CTY RD H
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 20.010 Plat: N/A-NOT AVAILABLE
SEC 1 T31N R19W 20.01A SE SE LOT 1 CSM Block/Condo Bldg:
VOL 3/777
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
01-31 N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 730/558
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/12/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.000 48,000 105,300 153,300 NO
UNDEVELOPED G5 7.000 14,000 0 14,000 NO
PRODUCTIVE FORST LANDS G6 10.010 40,000 0 40,000 NO
Totals for 2006:
General Property 20.010 102,000 105,300 207,300
Woodland 0.000 0 0
Totals for 2005:
General Property 20.010 102,000 105,300 207,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 217
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT
' , TOZ?NSHIPSEC. TN, R~W 14,
ADDRESS , ST. CROIX COUNTY, WISCONS N.
DIVISION LOT LOT SIZE
PLAN VIEW C' jy
Distances 6
dimensions to meet
. requirements of H62.20
_
SHOW EVERYTHING WITHIN 100 FEET OF SYSTPM
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i i i ~ ! I I I I I
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Indicate Noh-th. AAAow
,'TIC TANK(S)_ _ MFGR. COi.CRETE X' STEEL Scale
,,NO. of rings on cover Depth DRY [,ELI:
_ACHES NO. of _ width length area
no. of lines s~ width length area- Z2V~
depths to top of pipe
3..EGATE
RATE AREA REQUIRED ` AREA AS BUILT Z2
-L_ -
:claimer: The inspection of this system by St. Croix County does; not imply complete
,:oliance 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
`gym operation. However, if failure is noted the County will male every effort to
cause.of failure.
OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
`'INSPECTOR
`J PLU11BER ON JOB L°~.~t 1: ~1 Jfowl6. r' _ t
LICENSE NUIE3ER
'REPORT OF INSPECTION-INDIVIDUAL SEWAGE SYSTEM
San.itany Penm.it _
State Septic
a
NAME ! i ownship St. Cnoix County
r
Locat.ioK Section
SEPTIC TANK -
S.ize r' gaaons. Numb en o6 Compartments I
Duttanee From: GleZ2 12% oa greaten s.iope _ it
Building it. wetZands _ ~ .
H.ighwaten = it.
DISPOSAL SYSTEM
D.idtanee Fnom: Wetf- 120 on greaten sZope_
Bu.iZd.ing it. wetZand.s_ Ft.
H.igh-waten it.
FIELD DIMENSIONS:
Width o6 trench it. Depth ob rock below tiZe .in.
Length o6 each .i.ine / it. Depth o6 rock oven t.ite in.
Numb en o6 dines Depth of tiZe below grade /,e/in.
Total .length o6 tine, s/ it. S-f.o pe o i trLeneh -in pen 100 it.
Distance between .Lines it. Depth to bedrock
Tota.L abs onbt.ion area it2 Depth to gnoundwaten. it.
. Requ,iaed area ~t Type of Coven: ('Papek on Straw
PTT DIMENSIONS:
Numbers o6 pats Gnavet around pi.t-s___yes no
Outside diamete V I•j t. Depth b etow .inlet it.
2
Total abs o,&ti~ ~it A
Area nequ cne t2
`r'
INSPECTED BY TITLE
APPROVED+ , DATE l 4 71.
147_
REJEC D DATE
r-
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A
EH 1'15 Rev. 9/78
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION: ~~'/a,.~r Section T?/ N,R1j1j (or) W, Township or Municipality SC% %,-`2n
Lot No. , Block No. syt~ i'-~--= County (ii'C-'C x
Subdivision Name
Owner's/Buyers Name: :
Mailing Address:
TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS L- Zf PERCOLATION TESTS W-AC2 - 72
SOIL MAP SHEETw NAME OF SOIL MAP UNIT,
PERCOLATION TESTS
TEST HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES
NUM- DEPTH CHARACTER OF SOIL SINCE HOLE HOLE AFTE INTERVAL RAT"E
BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
a_~ 7
P- Ah",A) if
P-
P_
P_
P_
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
TEXTURE, MOTTLING AND DEPTH TO BEDROCK
NUMBER INCHES OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES
B-
.&,.4-
13- f `2
B- 3 7
B_ _
B-
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.
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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; Certitication No. Sl <S
Address s
i lme of installer if known
CST A -Local Authority
,
w~ 40
v State and County State Permit #
PLB-67f„ Permit Application County Per it # -
for Private Domestic Sewage Systems County r
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
B. L CATION:L-'/a SteSection T N, R If (or) Lot# City
i
Subdivisipn Name, nearest road, lake or landmark Blk# Village
Township 4e"k"ZA:-t,- j
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 _0~(_ 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 otal Absorb Area sq. ft.
New- Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: -y _Length _r~' Width_- 42 Depth 42" 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 Y1 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 ,~r C.S.T. # and other information
obtained from (owner/builder).
Plumber's Signature MP/MPRSW# ~I-3 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 - r~ + Fees Paid: State County Date
- ~ r
Permit Issued/Rd (date) Issuing Agent Name 04
No State Valid# Date Recd
Inspection Yes
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