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Parcel 032-2090-80-000 11/20/2006 03:37 PM
PAGE 1 OF 1
Alt. Parcel 15.31.19.895 032 - 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 - TAUBENBERGER, PETER P
PETER P TAUBENBERGER
7 BENT TREE COURT
ST PAUL MN 55127
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 513 217TH AVE
SC 4165 OSCEOLA
SP 1700 WITC
Legal Description: Acres: 2.731 Plat: 2224-NORTHERN OAKS ESTATES
LOT 18 NORTHERN OAKS ESTATES TOWN Block/Condo Bldg: LOT 18
SOMERSET
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
15-31N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 860/92
07/23/1997 736/328
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/24/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.731 43,700 0 43,700 NO
Totals for 2006:
General Property 2.731 43,700 0 43,700
Woodland 0.000 0 0
Totals for 2005:
General Property 2.731 43,700 0 43,700
Woodland 0.000 0 0
Lottery Credit:
Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
San.i.tany Penm.it 1i6
' State Sep-tic_z1~-
AME 6'4 Tawns h ip Cno.ix County
Location Section _
SEPTIC TANK
S.ize/ gattons. Number o6 Compan.tmen.ts ~
Distance Fnom: Wett 12% on greaten Atope it
Bu.itd.ing 6z. Wettands ~ •
H.ighwazen a it.
DISPOSAL SYSTEM
Distance Fhom: Wett 12% on greaten 4tope 6.t.
Bu.itd.ing 6.t. Wettands Ft.
• H.ighwaten it.
FIELD DIMENSIONS:
Width oS thench it. Depth o6 noek below Cite .in.
Length of each tine it. Depth o6 rock oven -tile .in.
Number ob Zines Depth o6 t.iZe below grade .in.
Totat teng.th o6 Q.ines 6t. Sto pe o6 trench in pet 100 it.
Distance between Zines {t. Depth to bedrock
Totat absonbtion anew 6t2 Depth to gnoundwaten ~ •
2
..Requited area it Type o6 Coven: Pa et on Straw
PIT DIMENSIONS:
Number o6 p.itz Gnavet around pits yes no
OuU ide d.iame.ten it. Depth below .intet it.
2
7otat absonbtion area it zz
Area Aequkned it2 rn
INSPECTED BY TITLE
rS
APPROVED ,DATE 197.
REJECTED DATE 197.
01
cr
EN 115
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309
MADISON, WISCONSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
LOCATION:C ,/~j LiMI/4, Section L-9, T3A, R/110or) W, Township or Municipality
Lot No. , Block No. S 4.=N ~ County
S ivision Name
Owner's Name: Oc"c9 az Scu-,,!4Cs
c
Mailing Address:
TYPE OF OCCUPANCY: Residence- No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS
SOIL MAPSHEET_ SOIL TYPE P (R L ~41ti1j
PERCOLATION TESTS
7M- PTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
CHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN
1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P_ foa .2
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_ f ;
2 7 - - L-. -ft-
B B- s ~b ? S, Sc -94 s SC - 1e
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) /
Indicate on the plan the location and square feet f 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 poi ts. Indicate slope.
! I I
JA KAA
t
F
s
a I ~ I a
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 Wisc nsin Administrative Code, and that the data recorded and location of test holes are correct
to the best of my knowledge an bell
Name (print) pp J t ~ ✓5 Certification No. 53_3 Z
Address
Name of installer if known"
CST Signature
. f
Via. Qa
PLB 67 State and County State Permit #
y( Permit Application County Permit #
for Private Domestic Sewage Systems Coun
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
B. LOCATIO : lam: '/4 '/4, Section lam, T73~_ N, R/? ill) (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
~,rQ Township
C. TYPE OF OCCUPANCY: , *Commercial *Industrial `Other (specify) *Variance
Single family _A Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY 42:fjO 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-Place Other (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate s Total Absorb Area -sq. ft.
New Y Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: BALD 1'9 Length 70 Width LZ DepthY 9 P Tile depth (top) %;2!!~-No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land /tea 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 Cer fled Soil Teter,
NAME 0 .4 d.A.-•. C.S.T. # and other information
obtained from (owner/builder). '~77
Plumber's Signature MP/MPRSW# 156 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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IN,
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Do Not Write in Space Below FOR COUNTY AND STATE P6PARTMENT USE OULY
Date of Application Fees Paid: State/_ Co n
- Date
'
Permit Issued/Rejected (date) Issuing Agent Name d
T-
Inspection Ye,/>~_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