Loading...
HomeMy WebLinkAbout038-1064-20-101 (2) O o 4 O y c7 C O cD 'D > > (D 3 c r m ° Sv v N o c0 v m j w Sr O O N tD ►r7 N 0 f- Q Q 411 N O l^l N N C co co O A O 1 N N C2 O N N N ~ ~J N Z p C CD N ((DD n (D 0 O D y O N O O _ O O .'T. U) N O O 3 7 N 0 0 C t0 O CD N a Q N CD ~ N N W O C C O _ 3 C1 3 0 < O N (D (D 0,) rj 0- ~ Z CD (O c0 (D 0 r- (n CD -4 -4 :E cn 0 c < z ~-2 Q tv ~ ~ can can to ~ ° D a- v O O - o (n O0 N ~ N "O A ~ CD aN J w CD co w A w lv D co z O o (1 7 (n -b AI. (D (D O N N (D (p _ C (D CD (D _ 3 3 -i V1 (D (6 O O A Z CD N O s ~ .-r O p z O Cl C 7 C ((D j T CL z 3 a 70 o " z 3 j z _ A N 3(v°00Ooo Oo0 D co 3 0_ m°Q~N v (D (D-00 n(D ~O N CD ° :nx-Oiv ? :0 a0 c C) m' - - m 3 O~~ Z a m o_ (D (C (D * N ° CL =r-O O 3 (D O ~ (D O N (D ~ ~ N (D n -O N N (D S N * l CL n N O' cO N ^ wE5~ O N O c ~ ( m (D ' ^ p O N ~ ~ 0 0 U N n O O0_,O Sv ~US N 7 N N(D QO O" K O N X N Q ^I d o A v O N N ° 7 O CD W (D CD o N (mo N 0- CD QD o n, s cn a c< o mo,~D E 0 0 0 0 ] N y O O 3 O U) O CD :E; o b N O COD Q N ^ A 60 0 " p O ~ p b C) (D 0 a- n O 3 m n r~ C7 r/,1 3 = m v H' v m a c v CD 3 - su 0 2 0~ 2 N Z N) N O (n rn w ~C 0) U) 0 CD a o o c m rn ° 0- CD a a N CD o r•~S► . Ei C/) 0) N CD W W W C/Chi w O ^ N a 3 N N N °o N CD cCD = 1 Q c (D p D 3 o m o o p o m C o o (ll (n D CD P. N N G N N CD N 3 CA ° CD 3 C 3 a0 z o y CD L rn N (D Ar ca io Z n r v, CD ccoo coo f o o O O O cD v v v o . (D w 3 m w N co a z z co z O v O D a ~ o : !r • N c /y CCDD N N N V Q c m CD w CL CL 3 Z ? m -1 N O O A ? n N c J .'0 y CL ? Z O A * GJ m a 3 z °o z m C 3 w y z G N N N j~ Cll d N 0 CD 0 aNO OA, N s O :1 N CL X Q~(N_ •p r„ Vl .L CD N -n Cp Q N 3 CCDD ,63 N C 7 cn CD O Cn C O is g mp CD *-0 3 m o ° o o ~ 0 N CD 730°3°'~o~i o O N CCooLty o CD ON y -v a A (n0 BCD CD ~3 nx v n~ 5D cn ~~O =r Z2. . N p CL Z O S CD (D CD 0 co N N OD V o N 0) 5 O O CL Co y' O O 0 W (D ~Q O C O ~ r o0 ° O y O ` + ~l o Cj) O 3 O'U 0 i C d (b 0 CD v at v DJ CD ^ 1 3 O cn z z O O O o C (A`~ • cn C cO n o N ~y Y A , c l Q 3 N CL 0 n D -O N v S (D j O a c 3 O o m m O 1 Q O 0 - 'co ~I p~ N v N 3 d W 7 O y (B ~ O O O Z y m cn Z D F- m _!y m m n D d ° ~•i m W (n c CL - A ? d N 3 o 0 00 (D Ca j 1 fN) O CD 0 r- Cl) O 0 0 Z O co 0 01 a O O CC -u -u -9 "NA, Ut o ~ m ~ ~ ~ ~ N ! G G7 N a~ N N f/! O o v N -u 0 0 O n o O0 < @ a N O 0 7 i-3 w 'o CD (OQ (D N (D N C N 3 N N 'D CD 00 Q 00 C N Zco Z O D (D O I ~ ~ a 3 N• CD CD m -OO i m ) c (D w d a 3 Z t -4 to z (D o v, c A z O m n C) 0 c Z -I rn 03 v m CD CD z CL ::t 0 3 a O r. Z cfl 3 ~ Z (D o ~ D Q O0 T N C CL O N y V A I `C I ~ Z ti N N O O A O O 6q O 0C Parcel 038-1064-30-300 11/27/2006 10:24 AM PAGE 1 OF 1 Alt. Parcel 16.31.18.277E 038 - TOWN OF STAR PRAIRIE Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 07/13/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - DIRKES, STEVE J & SABINA L STEVE J & SABINA L DIRKES 1067 220TH AVE NEW RICHMOND WI 5401 istricts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE PT SEC 16 T31N R18W NW NE W1/2 F W Block/Condo Bldg: EXC P277B AND EXC W -RU EX ~T T N NE) 13/3654 & EXC CSM 18-4785 f/ Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 6 16-31N-18W NW NE , 14 Notes Parcel History: Date Doc # Vol/Page Type 08/05/2004 770798 2632/126 WD 07/13/2004 768698 18/4785 CSM 03/22/1999 599879 1412/483 WD ~a 07/23/1997 918/234 more... 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/05/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 25,000 208,600 233,600 NO UNDEVELOPED G5 14.250 35,600 0 j 35,600 NO Totals for 2006: General Property 15.250 60,600 208,600 269,200 Woodland 0.000 0 0 Totals for 2005: General Property 15.250 60,600 208,600 269,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 10/21/2005 Batch 05-40 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 038-1064-40-100 11/27/2006 10:24 AM PAGE 1 OF 1 Alt. Parcel 16.31.18.278B 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 O - DIRKES, STEVE J & SABINA L STEVE J & SABINA L DIRKES 1067 220TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE SEC 16 T31N R18W PT SW NE W1/2 SW NE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 16-31N-18W Notes: Parcel History: Date Doc # Vol/Page Type 08/05/2004 770798 2632/126 WD 03/22/1999 599879 1412/483 WD 07/23/1997 918/234 07/23/1997 832/548 more... 2006 SUMMARY Bill Fair Market Value: Assessed-With: 0 Valuations: Last Changed: 10/05/2005 Description Class Acres Land Improve Total State Reason UNDEVELOPED G5 20.000 50,000 0 50,000 NO Totals for 2006: General Property 20.000 50,000 0 50,000 Woodland 0.000 0 0 Totals for 2005: General Property 20.000 50,000 0 50,000 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 n to O 3 v 0 r~ o c m o C7 Lo1 ~ cD 3 (D o m ~ Z v c (D 13 *k - 3 I In Z aN, N G) 8 OW C) a) o a a a m coo rv W o CD oj CD 1 CD ON it 6 N 0 'O -4 CD CD R O CD fD _ CD O D 3 O 7 N F O O 0 :3 O N C OV rti. ~1 O (V N W m u) ~ D Cp N CD 'a m W a O c ° =r 3 D 0 CD CD N co co Z n r cn cn cVO CCDD m l/1 o c i 0 3 tai. z o O O o m e O tin tinaa o D 0 m 3 cr v v o ' G) CD U; 00 FD v o Z m r N C3D VII W Q z N z cu z 0 o D n v a CD O CD N CD N N c N CD W CD O_ Z CD 1 N O p Z CD - Z O v a i' O 00 -0 a z 0 3 O r: z Oo 3 m N N N CU CD N n CD NO a N 0 d O N a O N d n S f0"1 N N (ll D O T CD Q (n3 CCD 0 3 fll c N 3 ~°Q.~?c o a F mam 3 N 7 s OS CD 3 oo3 v m a ~O m N CD a C.0 (OW CD 0 (n cn 0 CD C m o ~m CD C') Nm ~ 3 C~ N X. '0 O S CD o C1 0. N N ID N C N co V O O o FZ m O N a 7 :3- V m ~ A i o. cc to O ~O O 73 CD bQ N W f,9 O as O * o °o (D n t/) O K m n o C7 c o c °1 (D m r. ~ .c3 ~ n1. CD c ^ CD # \ 1 3 ~ O U) m N O O j '0 C) C) O) C4 7' `C c 0-0 (D CD (D C~ :3 (D (D 0 i R). co O N CD 0) 7 N N 'A ►5 1 CL X, FD- N O CO p 7 (D V O C ~ C COD CO j ro < -1 D o OO O 3 0 3 (A go o O N c W O p C CD w w cn -G D a (D CD U) 0) U) a 7 W o 3 N 3 O C O w c) O L N lot t3 0 6 -4 0 00 -4 O) 1 ~ N N) 0 COO (CD O O y !1 c lr c O O O ~r o 0 C - z (D 3 0 cn (A fn CD w cD c CD O O N c D N ro .d. O OC N 7 3 7 7 7 ro a a N N z r! 2 Z -I Z cn O D O A O ? 7 O 0 D O CD J J • 7 CD y CD ro l vy C CD CD w (O a CL 3 CD 7 z ? (o -1 to O p Z (D s 0 n 7 A z o w a a o' 7 W CD j CL z 0 ~ G r; z O H m z CD w ~ (n v 0 S a O< CD A a C (a p T7 ro v O ` N w -0 n 7 -n o 2 ro (D w c p O N Z a :3 0- En = CD M 0- CD m O , N O V l a3 5° zz :E CD CD Zz Z. -4 n< a w ro Cc (n M o CD n CD e 3 CD j~ (D 0 O. 7 roa C? 3 c ~c z ccn cn v ~ ~ N O co m W a A CD A A O (D 6q A < A o (D ° a. mill IN, NIP I'l . RAIRIE T 31 N._ R.1 8 55 L POLKw CUNTY • • C C -DOnGt/d _Dou9/as l y % 8 /ro-. ; L ehman L~s1-e'r d ` e/~u//i 79 /~'c2 f/i s Trrs W a Haney ies e /liQ r~ W Q 32.82 CTS v 63 h ^ \ l Larson 69 63 CEDAR L. 1 e~ : /ZO.86 JCS zo2 z6/ /z C wC o, l `C HH ~ov~ ` CsE .ems Lc/ec,% d~ ~ Cv` ~ Y~ a fitly eadd~ . N o ~ tl oo~ ~ 4 yh ~tl tSi9u ~Q' . 160 Qm c/ar o N a 2 A~ a b y h..~ /`9u//e17 b al Cf~C 4~i C Cf l Mb~, • N d ~o6 ei-f • i ICJ 0 W UJJ \aJao.~"''~a0 'CCO ~OH ou/se ~btl~,~~'iPosettQ . r l~J tlF~ v~~ ~nCVt• If • ~ ~0 oe~ tl GYi/son • y v \ :~jryp~l TA c o~.so w ~ ~o C l0~ /.zm `y~ x 0 b io ck ~ Ct~ ° sco ara/ L<.cc% Norman o .(o'~ .r T n ,P r. /4 ¢o cSu// van TC l~ n s1a Ha ~e c/ d 'ttr/ - W 79 //mer' 70 HUN Lorraine 9 Fred ii ¢ h o Normar7 • Ne115 o7 • mo y Larsor/ p)fS~L oa C Q.r/. • Co t N v i~ H e 7 C f F Cora v, yyV fMue /725 OLD M/LL • ~ J ~ a T ~a y ~S'ias Bo Y ~~tl L_ zo Fe r7 • ~'L o .Aei P eas- ¢ ene::,:: 9 eehU E~fia/ ner Ian Ina /6z.9/ zz6.7e _ 0 0 o/f/a9e~ f1¢/varsan /6o CC 40 ~ ~ Q rah/- 0 4Ci eta/ v?-ien sr~. • ane d 0 117 , F C Prao e 40 sor/ <36s K. r~ • eas Q • ber9.6 CQr/S n 0 /i- i% 7 - - ai crs_ . ~ 40 .i r C G r~ ~ 9 cTQmes • eo on •.-rer ~ a sore, o f,3 0 - SQUAW L \ hy.`~ Ilk' W/LO /F a o° clo/ Aso Bo ox e d ' tl /2o z2 C ry~ F/a E Pa9, f•J efor G✓7/a d f ' r'_9an oa~ _ iVe/77e th f Paf- -O „AC • 40 40 ' Q' 80 i:~p /tndC r-s on ` Dav/d w i:? 3 0 Normo~ o~~ • ~ V h N o li eor9e //,1 wAM \ P[2 U/Q Cg B Y HORES f Jo ee YO F/an- • h:/ ~'Mar.on ie.52 - sug 'y MaiTte ar/ Eas f,3ruce .Bi~/rho/ Ntl J ~ n ~ .s '`O Yon ~ iPu th • 3 34 • " home ~ . JER qo h Ne/.S°17 /sz /60 Inc. ' 0 0i, S¢ • y 40 ` 78 .E'obarl- ~l'0 Q O eor /%/to.>~~ t ~s 2obert has. f anler tl p0 imp er O at Tohnso (7as- , § Jane • G✓¢/ter $ etux ~N GOPy£ 60 r7 Pe 9rmi/7 cton /oo G.i¢ vss. R. ~1 ~i-/un X35 arson Bo C 0 Dosede/ ~/-Qe/r7er- /rich h ~/d rons- N 79 /~0 40 20 on "~lp ~!frL Q. Davi f 00 ec.F- Ne/s EfM Rw T /v •~y ~ Cfir/s%7ne ~ ` • • ~//r ' Der~ni5 u/ov~ 7o RM .4a6Q. t\ /o.~ •d i-jreyn ,o~~ f/a X0/7 ?~'f Q fh~f%Ce Fornee yC Esthe/- L/ p e p ~O (J ~ ' e'.E_ ¢p 1- • ~ ~ P E~ori /os o9 Or'Tor/ Q' ~X' 0 0 ~obai-t f/arr: / f` '¢O • B u r a~~ s• Z Q 2 OY% u? LarsoJi s~/und j • C Sfra d F y• Q G Mary f v 9i/ h`\ ~w W 3 60 6O9B • sHan T¢/rn ye YI 0 h'eT,- • ~.9/ica `l 0{ tU I h enwa OH N N SB R`-' G% a y E >,e sow . F 0 L/rbQn J: .Pob f cT ~ N s-H KN- 70 'v11~ Q no • 60 ~Q~~ Ql ~ h ~ei'ma.~ ~~.~Q. Coo, 0 ¢ /9 Dona/d 8o CS 'C 6 ~ ~ f3 p fi~s/o /unCL/ ~ ~ ~ z 9 E/rne ~ f\ w / who p u rR D y\ /26 to I~•v 7. 7s 0 TfE~ ~~hjtl • H12/117 rim • • Ql ~ ~ p ~ / ~ Vl 0 ~ Bo ~ y. . /GO Ne% .eaP E /`7ary 'e/de C Lo 7 b(T eToh~ J c. /`7o¢/)FOn Mo o.- S o • h 1' Q hf da L " ~s P /.3emd i2o6 er-f • ChQ /e rr pafior 'u, ~ tce/ Bo 9 Maxthe Mrs. Pau/ E/.rear Yo/Eerr o ys> o n ✓CoQLE /zo e C19 £ Po6E t u 1 190 /.30..37 P ec,Ee f/s~/ur7d 2 lJ F~~ /¢/son • Lu • 40 80 2.j7 d • 7d S /c 60 gerQ Ice 6. - Lu£B/RO OR. ~-os- Morce//a b_ tl ^ Ke~y~"h -y .f3ac.Ees /K/emesru yarPe \ ~ cToe `~ar~co/s T/'iomas, _ d Thomas - M.c 20 /20 ¢o ~.OyO`~ ,3u~owL67G ofai Ees FA Qo zs~.9/ ° ~d 6S ~ i//~ ~ P f amo p~~- J 200 /oo 203 isats o evil C° w u S at8s 4o r~~ ~i ~ N i l''9K ~ ober ARRY• RO. ~/d 2S ~ l ~ 3 Nc c $~Co. ~ ~ h t~-Otl 'O~a Jo- ~ ~s/o /y ° ~ 0 0 ~4 oh - ARRY o0 tl-l p~ gO ~o eo CC W\ v~ \ 0 c.ames La ✓oi~nQ NZ{ RO. 4~~ 260 q.o 8c, /ZO • h tiN ~AAF/E Q crane o fca.n- 'L. .Pay £ /yr, gO 4° ~ r rv b oar ~a 9 Q cSf 64 e// L ~ayna n ue 0 /6o Ci o/x \ • e/<x ~0 /s6 % o d `n f ary J /lea/th Ge ~/e. 'VI, n.' m~ 0 ber Ne y Y, 0 ~io• • o 4T _ e 2 N va 4 0 (i s. uA~ Q /oo R OOLARO o h rt v & ltiay ~e INE R l n Parcel 038-1064-20-000 11/27/2006 10:31 AM PAGE 1 OF 1 Alt. Parcel M 16.31.18.277A 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 O - SPRINGER, DAVID M DAVID M SPRINGER 1073 220TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 1073 220TH AVE SC 5432 SOMERSET - SP 1700 WITC Legal Description: Acres: 16.470 Plat: N/A-NOT AVAILABLE SEC 16 T31N R18W E1/2 NW NE EXC CSM Block/Condo Bldg: 8/2384 (3.53AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) a CJ 16-31N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/13/2006 829586 QC 07/23/1997 897/224 07/23/1997 832/548 07/23/1997 806/582 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/13/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 37,000 173,000 210,000 NO UNDEVELOPED G5 13.470 33,700 0 33,700 NO V 'Totals for 2006: General Property 16.470 70,700 173,000 243,700 Woodland 0.000 0 0 Totals for 2005: General Property 16.470 70,700 173,000 243,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 135 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 038-1064-20-100 11/27/2006 10:32 AM PAGE 1 OF 1 Alt. Parcel 16.31.18.277A10 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 DAVID M SPRINGER O - SPRINGER, DAVID M 1073 220TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 1073 220TH AVE SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 3.530 Plat: N/A-NOT AVAILABLE SEC 16 T31 N R1 8W PT NW NE BEING LOT 1 Block/Condo Bldg: CSM 8/2384 3.53ACRES Tract(s): (Sec-Twn-Rng 401/4 1601/4) 16-31 N-1 8W Notes: Parcel History: Date Doc # Vol/Page Type 07/13/2006 829586 QC 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 3.530 39,700 22,000 61,700 NO Totals for 2006: General Property 3.530 39,700 22,000 61,700 Woodland 0.000 0 0 Totals for 2005: General Property 3.530 39,700 22,000 61,700 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 Parcel 038-1064-40-000 11/27/2006 10:34 AM PAGE 1 OF 1 Alt. Parcel 16.31.18.278A 0313 - 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 DAVID M SPRINGER O - SPRINGER, DAVID M 1073 220TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 20.000 Plat: N/A-NOT AVAILABLE SEC 16 T31N R18W SW NE E1/2 SW NE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 16-31N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/13/2006 829586 QC 07/23/1997 897/224 07/23/1997 832/548 07/23/1997 806/582 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/13/2004 Description Class Acres Land Improve Total State Reason UNDEVELOPED G5 20.000 50,000 0 50,000 NO Totals for 2006: General Property 20.000 50,000 0 50,000 Woodland 0.000 0 0 Totals for 2005: General Property 20.000 50,000 0 50,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: E atch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 • AS BUILT SANITARY SYSTEM REPORT 4E R 7 1. jD CC~~~ , TOSJNSHI i SEC. 16, _ Tr3/ N, R~W _ ,12 ADDRESS , ST. CROIX COUNTY, WISCONSIN. :DIVISION , LOT LOT SIZE • PLAN VIEW Distances S dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM - --T - - - j ~ i i I 1 54z i i ; i Indicate North;Arrow I ~ S CALF a--j-----~I I 'TIC TANK(S) i MFGR.- CONCRETE TEE NO. of rings on cover Depth DRY WELL -NCHES NO. of width length area no. of lines width j-~j; length area 1&,L-s - depth to to o pipe Sl EGATE ,~1`1 RATE AREA REQUIRED AREA AS BUILT ;Claimer: The inspection of this system by St. Croix County does not imply complete -,aliance 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 -,iem operation. However, if failure is noted the County will make every effort to rmine cause of failure. BASES ANT OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. `'INSPECTOR DATED•~~I_~: C~ 7 1 PLULIBER ON JOB LICENSE NUMBER b~ z _ w REPORT OF INSPECTj;iN INDIVIDUAL SEWAGE SVSTEt1 San.i.tany Penmi t State Septic NAME - ` Township St. Cno.ix County Locat.iom Section SEPTIC TANK Size gattonb. Numbers of CompaA.tmen.t.6 Distance FAOm: Wett 12% on gneaten scope it Buwitd.ing it. Wettanda N.ighwaten it. DISPOSAL SYSTEM Distance Fnom: We.tt k ~rnr 7 .12% on gneaten stope it. Buitd.in9 it. We.ttands Ft. ~ • H ighwaten it. FIELD DIMENSIONS: Widxh og .tnench it. Depth o6 nock below tite in. Length o6 each tine it. Depth o6 nock oven .t.iZe ~ .in. NumbeA o6 Zines Depth o6 tite beZoc,r grade in. Totat Zeng,th o6 Zinez ;2 it. Sto pe o6 ,trench in pen 100 6.t. Distance between Zineh it. Depth to bed nocFz_ ~ - Tatat abbonbion area ~t2 Depth to gnoundwaen J Requited area sr it2 Type o6 Covet::-' Pape.n qA Straw PIT DIMENSIONS: Numbers o6 p.itz GAavet around pit.6 yea no Out-6.ide d.iameten it. Depth b et ow .int e.t it. 2 Totat ab4o4btion area it A AAea AequkAed gt2 1 ~ INSPECTED BV' _TITLE~t (1 APPROVED , DATE , .,19 T-:'~ , REJECTED DATE 197 r EH•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 TEST/S~ LOCATION: i L '/4/Q-Z'/4, Section TYJ-N, R JZ S (or) W, Township or patity~-~~ Lot No. , Block No. County ~-+,P E Z Subdivision Name Owner's Name: T O X j (2) Mailing Address: ~Z 0 Ls117 a'y~~a, U)i _ TYPE OF OCCUPANCY: Residence ` No. of Bedrooms Z Other EFFLUENT DISPOSAL SYSTEM: NEW c_ ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS 10-1'2- 77V PERCOLATION TESTS 16 - / `7 - 7 Z SOIL MAP SHEET SOIL TYPE J~A1C~2 4YYy k _v ro m 096A PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN 0 4 j2 o-ns7 10 4;~ /VO n? ~a o~~~i 1 P-3 3b• 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) 2 ` 7 72 17-w f5- 72- 72- -7 7Z'. p u -65 - 72 q 7Z Z 11-5, PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indi to number of square feet Qf absorption area needed for building type and occupancy. l'7 "T 4"' (/30o a"4,04 I i2j& ) Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. t + (c ' _ tN + 1E -0- + + + I I ( ~ ~ ~ a , r ~ I i i ( I i t-- -6----- - - - fi------ . ' t I I I I i 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 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) ~p -Y, V C ficat' n No. Z Address ~a Name of installer if known COPY A -LOCAL AUTHORI i CST Signature i State and County State Permit # PLB, 67 Permit Application County Permit # for Private Domestic Sewage Systems County & -n *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: APP" B. LOCATION: /Y, IL, '/4, Section T,:JL N, R ~i E (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 / Duplex No. of Bedrooms No. of Persons _ D. SEPTIC TANK CAPACITY Total gallons No. of tanks r HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete Poured-in-Place Steel L Fiberglass Other (specify) New Installation ~j 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 s~z %L Distance from critical slope WATER SUPPLY: Private ❑ Joint M 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 l i y L_ S r c_ C.S.T. # sZ , J and other information obtained from (owner/builder). Plumber's Signature , , r. L<z- In 1, MP/MPRSW# Phone #---2 z Plumber's Address / - L/ L i, 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. ff E t E t ~ ~ 4 c F E 1 3 ry e.... m ._..q t.a...a m 4n.a w- .......d, ~e ._e.., s. e,... 3 3 . .,em, .y e e~.w s. m e ~<..e ...e a .m . vs. a a. M._. _m». fi a E 3 r Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application / 7/ Fees Paid: State/c,"',/ ^ Y, C Date Permit Issued/R ed (date) fT' - Issuing Agent Name Inspection Yes _~_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