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Parcel 038-1053-10-000 11/22/2006 04:51
PAGE 1 OF 1
F 1
Alt. Parcel 12.31.18.226C 038 - TOWN OF STAR PRAIRIE
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
E ERIC BOHL O - BOHL, E ERIC
1513 2 T AVE
NEW H \ SE✓~Si✓ ~C v
NEW RICHMOND WI 54017 f)
Districts: SC = School SP = Special Property-ddress(gs): Primary
/
Type Dist # Description ` 1513 220TH AVE h
C`
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 2.880 Plat: N/A-NOT AVAILABLE
SEC 12 T31N R1 8W 3A SE SE BEING LOT 1 Block/Condo Bldg:
CSM 3/751 EXC PT/HWY PROJ 8936-06-21
Tract(s): (Sec-Twn-Rng 40 1 /4 160 1/4)
12-31N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1175/317 WD
07/23/1997 879/366
07/23/1997 692/318
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/13/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.880 36,400 132,600 169,000 NO
Totals for 2006:
General Property 2.880 36,400 132,600 169,000
Woodland 0.000 0 0
Totals for 2005:
General Property 2.880 36,400 132,600 169,000
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
• AS BUILT SAPTARY SYSTEM REPORT
;LR_, TOWNSHIP
/SEC. T I Pd, E :7
'D. ADDRESS ST. CROIX COUNTY, WISCONSIN. _
DIVISION a LOT LOT SIZE
PLAN VIEV
.Distances & dimensions to meet requirements of 1162.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
t
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!SCALE:
TIC TAN,(S)_ MFGR. CO;ICRETE_ STEEL
NO. of rings on cover Depths DRY WELL
NCHES NO. of width _l length_. area
no. of lines width_LL__ length-
area
depth to top of pipe ;
'MEGA E
RATE AREA EQUIRED_L ~ AREA AS BUILT t;
'.iarier: The inspection of this systeam by St. Croix County does not imply complete
%lia_nce with State Administrative Codes. °T'n e are other areas that it is not possible
inspect at this point of constriction- SL. Croi.; County assumes no .1.iability for
zem operation. Ho;aever, if _`ail.ure is noted the Coin.'-';- will mace every effort to
_,rmine cause of failure.
ES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
.
'-INSPECTOR
DATED / PLIRKBER ON JOB i,
LICENSE NUILB .R
1 '
RFPOP,T Or I11SPECTIO?1--I MV1DUAL SE?•1AGE DISPOSAL SYSTE11
Sanitary Permit
t. State Septic JOI 1E T0MqS H I P '
,...L.t..,. d_ ,.....c, t. Croix County
Si.T'TIC Tt?'?1:
i2e gallons • `cumber of Compartments ,
Distance From: We 11 , f / ft. 12% or greater slope Aft
Building ft. Wetlands ft
Ilighwater ft.
DISPOSAL SYSJ=.Cl _ Ti e Field or Seepage Pit(s)
Distance From: well R} ft. 12% or greater slope - ft
Building ft. Wetlands f:.
FIELD ilighwater ft.
Total length of lines --4-ft. Number of lines ' Length of
each line 4, ft. Distance between lines ft. Width of the
trench i t. Total absorption area Z' sq. ft. Depth
of rock below the I in. Dp-pth of rock over tile in. Cover
aver.rock., Depth of tile below grade in. Slope of
trench - in ner 100 ft. Depth to Bedrock ft. Depth to
P,round water ft.
PITS
t '
Number of pits Opts c:e~ diameter ft. Depth below inlet
ft. Gravel around pit`: eyes no. .Total absorption area
sq. ft.
Square feet of seepage trench bottom area required
Uquare feet of seepage nit area required -
Inspected bey : Title':.
-
Approved Date 1977
,
Rejected Date
197.
PL8 6 7 w State and County State Permit # 00/5
a Permit Application County Per it #
r for Private Domestic Sewage Systems County
*DENOTES STATE APPROVAL REQUIRED Ze
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
B.___-LQ_CAnQN_- ,:jC'/i _ 54 Section , T N, R (or) W Lot# City
Subdivision Name, nearest road, _-Lake or landmark Blk# Village
Jx~~~-C f ~ Townshi
T P OF OCCUPANCY: *Commercial 'Ind stria) 'Other (specify) 'Variance
le family Duplex No. of B 'ooms No. of Persons
D. SEPTIC TANK CAPACITY Q-4 , Total gallons No. of tanks I/
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 Total Absorb Area sq. ft.
New Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: Length Width Depth 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 ❑ 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 Certifie Soil Tester,
NAME C.S.T. and other information
obtained from' (owner/builder).
Plumber's Signature 26 MP/MPRSW# Phone #p~`- ~~J
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.
I
/L Z 4-1
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E
Do Not Write in Space Belo~w/ FOR COUNTY AND STATE DEPARTMEN USE ONLY
Date of Application Fees Paid: State/O.0 6' Coyrn Date
Permit Issued//R (date) y Issuing Agent Nam
Inspection Yes No State Valid# Date Recd
1. county (w ite 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
r- -
P1b•. 60 Ir~
3/70 PROJECT DETAIL DATA SHEET( 97fs,.:r
i.
NAME OF BUSINESS l
4 1
LOCATION _ F r
street or highway city or township county
LEGAL DESCRIPTION
OWNER Mailing address
ZIP
ARCHITECT OR ENGINEER Address
ZIP
PLUMBER Address
ZIP
1. Check appropriate building usage(s) and fill in the information requested opposite
each usage listed:
Existing building New building OX Addition
If addition to existing building attach detailed memo for each.
( ) Drive in restaurant Car spaces
( ) Restaurant Seating capacity (10 sq. ft./person)
( ) Dining hall Per meal served Toilet waste Yes No
( ) Motel ( ) Hotel ( ) Cottages Number of units: 2 persons/unit
4 persons/unit TOTAL NUMBER OF UNITS
( ) Churches Number of persons Kitchen Yes No
( ) Bar or cocktail lounge Seating capacity (10 sq. ft./person)
( ) Nursing or rest home Number of beds
( ) Mobile home park Number of units - dependent (camper trailer) _
- nondependent (mobile home) _
( ) Retail store Number of employees
Number of customers T10 s_q. ft./person)
( ) Service station Number of cars served (daily) _
( ) School Number of classrooms Meals served Yes
No
Showers provided Yes No
( ) Factory or office building Number of persons (total all shif_tsT-
( ) Apartments Number of bedrooms
( A,.)' Other Specify
2. Indicate whether or not the following facilities are connected:
Food waste grinder Yes No Dishwasher Yes _ No
Automatic clothes washer Yes No Automatic potato peeler Yes
Other . . . (Specify) No -,r~-
3. Fill in the appropriate information for the following as indicated:
Septic tank capacity planned
Percolation test results - ATTACH PERCOLATION TEST AND SOIL BORINGS REPORT SHEET
COMPLETE OTHER SIDE
Seepage trench bottom area planned width
linear feet 4 depth
Seepage bed area planned N" width
linear feet depth
Seepage pit planned outside diameter
depth below inlet depth
4. See approved plan for specifications and details.
Signature of person completing form: STATE DIVISION OF HEALTH, PLUMBING SECTION
P. 0. Box 309, Madison, Wisconsin 53701
1
C'& Approved:
Address: U Date:
ZIP THIS APPROVAL IS BASED ON STATE PLUMBING
CODE REQUIREMENTS AND DOES NOT EXEMPT THE
Date: INSTALLATION FROM CITY, VILLAGE, TOWNSHIP
OR COUNTY PERMIT REQUIREMENTS AND SHALL BE
VOID IF REVISED WITHOUT THE WRITTEN APPROVAL
OF THE DIVISION OF HEALTH.
DEPARTMENTAL USE ONLY
'._~1~~,
upon by the Section
ctn6 reported Bureau
Pt"_ction ~~sterns,
' tt'.^.}7 gilt l'Sr n fYlS;c;1 of 1~2Lxi~h,
i i!'1trC7;4: tt! 11 xih, U
clnd Soda! Services-
~lgttf!e it o Hwc
,
ChieT
& fire Protection
j ~'>ec7i =r+ of f'1urn'oing 4De t of
" the Division of l4ealth,
j A,,p?R0VED by ert to conditions
k
Health and n in he SOcjcjj
IetFerrvic approval.
set fora `
1
Verification
1
{t4l ~
~f
+rq. "4artin 13ohl
t;'e 1. Box 700 Plan Identification No. 79-00151
~WI 54025
s t i emeen :
lartin & Bohi Veterinary
cage Disposal
1/4, SC 1/4, Section 12, T31N, ft18W
of Star Prairie, Wisconsin
"4. Croix County
i,-,ation of plumbing plans and specifications for the above-mentioned
ject has been completed.
In accord with Chapter 145, Wisconsin Statutes, and Chapter ii 62, Wisconsin
f-."iinistrative Code, the plumbing plans and specifications are approved
contingent upon compliance with the stipulations indicated on the plans and
the following code: sections. Please review your code for the requirements
of each code section noted.
1.. H 62.20 (5) (g) 2. Trench pipes and headers. Width, length and separation.
h. The architect, professional engineer, registered designer, owner or
Plumbing contractor shall keep at the construction site one set of plans
bearing the stamp of approval of the department.
3. In the event installation of the plumbing Improvements or system has
not corweenced within two years from this date, this approval shall become
void and new application shall be node for approval of these plans before
work may commence.
,r
r
Qrs. Martin s Bohl
Pane 2
January 19, 1973
in granting this approval, the Division of Health does not gold itself
liable for any defects In plans or specifications, plan omisrsions.
examination oversight, construction or any damagc± that may result In
or after installation and reserves the right to order changes or additions
should conditions ,rhea making this necessary.
This approval is based on Chapter H 62, Wisconsin Administrative Coda,
requirements. It shall be necessary to obtain and fulfill the permit
requirernsrnts of the city, village, township or county in which this
installation is to be constructed. Failure to obtain local permits will
automatically void this acceptance.
By ordar of Robert Durkin, ,Administrator, Division of Health.
5incerr~ 1y,
James A. Sargent
Grief
JAS: PESO: skk
em;
.
cc: Y. Dennis Sorensen, District 5, La Crosse
04r. Harold C. Barber, Zoning Administrator
Mr. Calvin Powers
4 s. s;
.
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State of Wisconsin \ DEPARTMENT OF HEALTH AND SOCIAL SERVICES
4 DIVISION OF HEALTH
MAIL ADORES S: P. 0. SOX 309
MADISON, WISCONSIN 53701
IN REPLY PLEASE REFER T0:
SECTION OF PLUMBING
AND FIRE PROTECTION SYSTEMS
~z t Plan Identification No. 7
Dear Sir:
Re:
Lis T'>Yf"i =,ai§ S;.ll` ;"rA.lrf«.', - `.•i,• r"Ox ~Io,3n1y This is to acknowledge receipt of your plans and specifications for the above-
indicated project. When referring to this plan in the future, it will be absolutely
necessary to utilize the plan identification number assigned to the project. The
spaces below indicate if proper fees have been submitted or if more information is
required. Providing plan review is not completed within thirty (30) days, a permit
to start construction may be issued if requested. See Section H 62.25, Wisconsin
Administrative Code, for limitations in reference to permits to start construction.
Preliminary plan review for determination of fees does not hold the Department
liable in the event additional fees may be required upon complete plan review.
Preliminary review indicates the plan review
Fee required is
Fee received is $ Plan accepted for review.
Fee is being returned because of ❑ Overpayment ❑ Underpayment.
Providing one of the two catagories above is checked, please remit correct
total fee in one payment. Indicate plan identification number on remittance.
❑ No fee has been remitted. Plan submitted with no fees will be held in
abeyance until remittance is received. Indicate plan identification
number on remittance.
❑ Additional information required. See attached Plb. 100.
❑ Affidavit sent.
❑ Plans being returned. See attached Plb. 100.
Sincerely,
C'!' '-Llri'' -Ga
,;James A.
Chief
JAS:lds