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Parcel 032-2033-80-000 11/20/2006 03:05 PM
PAGE 1 OF 1
Alt. Parcel 9.30.19.600B 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
O - BAKKEN, PETER F & BONNIE
PETER F & BONNIE BAKKEN
PO BOX 205
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 577 170TH AVE
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 26.900 Plat: N/A-NOT AVAILABLE
SEC 9 T30N R19W 26.9A IN S1/2 NE1/4 COM Block/Condo Bldg:
E1/4 COR; TH S 89 DEG W 910.23' TO POB;
S 89 DEG W 1075.6'N ODEG W 1299.07'N Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
89 DEG E 730.52'S 15DEG E 1342.62' POB 09-30N-19W
ASSESSED WITH P601C
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 598/105
2006 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/05/2006
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.900 30,400 132,000 162,400 NO
ENTERED BEFORE'05 CLOSE W8 25.000 100,000 0 100,000 NO
Totals for 2006:
General Property 1.900 30,400 132,000 162,400
Woodland 25.000 100,000 100,000
Totals for 2005:
General Property 1.900 30,400 126,700 157,100
Woodland 25.000 100,000 100,000
Lottery Credit: Claim Count: 1 Certification Date: Batch 102
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
s
1
• AS BUILT SANITARY SYSTEM REPORT
;rR T0;•TfJSHIP, SEC._~ T, _N, R
ADDRESS t , ST. CROIX COUNTY, LJISCONSIN.
.JcunPll'S~~i ~ ~
_iDIVISION LOT LOT SIZE
PLAN VI E4
Distances b dimensions to meet requirements of H62.20
SHOW EV^'RYTHING WITHIN 100 FEET OF SYSTEM
- 1
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I
i { I ~ 1 ~ I i ! I i
1
t F ~ ~ ! i I ~ 1 ~ ! ! O" I I i j !
- I ~ ~i 1 i i ! i ~ ~ ! 1 !
Indicate Nmth Anaow
'TIC TIANK(S);MGR. /s- CONCRETE A' STEEL Scate
NO. of rings on cover Depth DRY WELL
:CHES NO. of - width length_ area
no. Of lines ~y width / ) ' length- jd7 area depth to top of pipe j;
-):.EGATE 1i~ K,~ ac~c~
ROTE AREA REQUIRED
~'y- AREA AS BUILT
;claimer: The inspection of this system by St. Croix County does not imply complete
_rDliance 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
item operation. iiokever, if failure is noted the County will make every effort to
.'__•2rm,ine cause of failure.
:::41SES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYST
'-INSPECTOR
DATED -
PLU;•iBER ON JOB
LICENSE NafBER .~~C
z -
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
San.i-tany Penm.i,t/-)
State Septic--,
NAME r i own.dh.ip _ST. Ctoix County
Locati.oA / Sec,t.ion
SEPTIC TANK
l I
Size 60 gattonz. Numb en o6 Compattimen.tz I
Di,6tance Enom: WeU N3 it. 12% on gneateh zZopeit
Buitd.ing _6t. We.ttandh ~Q 6 •
Highwatetla_-16t.
DISPOSAL SYSTEM .
Distance Ftom: Wet12% on gteatet tope i✓ it.
Bu.i.Lding it. Wettands ~ Ft.
i
• H.ighwatenZo_6t.
FIELD DIMENSIONS:
w.td•zh o6 trench it. Depth o6 tock below t.ite--/-~in.
Length o6 each tine it. Depth o6 tock over Cite Z-- gin.
Number o6 tines pZ, Depth o6 t.ite below gnadej ~ in.
Totat .length o6 tines it. Stope o6 ,ttench 2 in pen 100 it.
Distance between tines (f it. Depth to b edno ck
Toad absotbion areal Depth to gnoundwaen-,L -6
•
Requited area 6t2 Type o6 Coven: Paper of Sttaw
PIT DIMENSIONS:
Numbet o6 p.it GnaveZ around p.itz yeas no
3
Outside d lame Depth b eZow inZet it.
2
Toat absonbt n/area 6 A
Ate tequtite 6t2 rn
INSPECTED BY Xn A PAPA V •`-'l.~
APPROVED ,DATE 1979.
REJECTED DATE 197_~~
E 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
LOCATION--;ila 4,,41J_2Ya, Section_ JJ' N,R~Lv (or) W, Township or Municipality ~-16 Lot No. , Block No. County __s.~% ~
y~ Subdivision Name
Owner's/Buyers Name:
Mailing Address: 1 %rr De-C-A°T
TYPE OF OCCUPANCY: Residence- No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEWREPLACEMENT ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS
SOIL MAP SHEET =2_ 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 AFTER INTERVAL RATE
BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
P_ ) e i 5
P- / &d X 3
D_
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- 914
B-
B- }
C
B- ` E _61
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the IoGation and square feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancy? 5!S.~ Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope.
.
. ~ F
E
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4
N
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i E F
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Pm_ Y,_
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) Ae, Certification No.
Address
.Name of installer if known - y
Copy A -Local Authority ` CST Signature
i
B State and County State Permit #
PL v[. 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:
-
R -S
B. LOCATION: -,S Section T.', N, R_ff If (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 K Duplex No. of Bedrooms r 5' No. of Persons 1K
D. SEPTIC TANK CAPACITY /04V Total gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete Poured-in-Place Steel Fiberglass Other (specify)
New Installation 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.
NewKReplacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (t op) No. of Trenches
Seepage Bed:- X Length Width U * Depth 31f~ Tile depth (top), No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land G l Distance from critical slope
WATER SUPPLY: Private 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 Te er,
NAME C.S.T. # and other information
obtained from (owner/builder).
Plumber's Signature cf MP/MPRSW# Phone
Plumber's Address d,
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 County - Date I !
Permit Issued/Reacted (date) - Issuing Agent Name
Inspection Yes I 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