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Parcel 038-1064-95-000 11/21/2006 10:23 AM
PAGE 1 OF 1
Alt. Parcel 16.31.18.281 B 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 - LITTLEFIELD, RICHARD A
RICHARD A LITTLEFIELD C - SPIEGEL LINDA M
SPIEGEL LINDA M
1047 220TH AVE
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1047 220TH AVE
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 5.000 Plat: N/A-NOT AVAILABLE
SEC 16 T31 N R18W 5A IN NE NW LOT 1 OF Block/Condo Bldg:
CSM IN VOL III PAGE 855
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
16-31N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
03/29/2004 757989 2536/463 WD
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 5.000 47,000 151,300 198,300 NO
Totals for 2006:
General Property 5.000 47,000 151,300 198,300
Woodland 0.000 0 0
Totals for 2005:
General Property 5.000 47,000 151,300 198,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 126
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 038-1039-60-050 11/21/2006 10:20 AM
PAGE 10F1
Alt. Parcel 9.31.18.169A 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 - GREEN, DAVID L & CHRISTINE J
DAVID L & CHRISTINE J GREEN
1040 220TH AVE
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address( Primary
Type Dist # Description * 1040 220TH A
SC 3962 NEW RICHMOND ( G
SP 1700 WITC AK
2 3
Legal Description: Acres: 40.000 Plat: N/A- T AVAILABLE
SEC 9 T31 N R1 8W PT NE SW & SE SW; THE Block/Condo BI
EAST 1/2 OF NE SW & THE EAST 1/2 OF SE
SW Tract(s): (Sec-Twn-Rng
09-31N-18W SW
Notes: Parcel History:
Date Doc # Vol/Page Type
09/13/2004 774183 2654/628 EZ
06/25/2003 727331 2288/312 WD
07/23/1997 772/251
2006 SUMMARY Bill Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 10/05/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 32,000 212,500 244,500 NO
AGRICULTURAL G4 22.000 3,400 0 3,400 NO
UNDEVELOPED G5 6.000 15,000 0 15,000 NO
AGRICULTURAL FOREST G5M 10.000 25,000 0 25,000 NO
Totals for 2006:
General Property 40.000 75,400 212,500 287,900
Woodland 0.000 0 0
Totals for 2005:
General Property 40.000 75,400 212,500 287,900
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
Sanitahy Pe.Amit
State Septic_
NAME fownsh St. Cko ix County
Location Section /IV
SEPTIC TANK,
Size gaZZons. NumbeA o6 Compantments
Distance FAOm: WeU 120 oA peateA Kope +St
Bu.i"td.ing St. WeMands t,
Higluvate:`c - 6 t.
DISPOSAL SYSTEM -
DUtance FAO : WeZZ it. .12% o.t gAeatem scope
Bu.iZd.i.ng 4t. wettands- - Ft,
i
H ghwateA _._--6t.
FIELD DIMENSTONS:
Width o4 toe zrEt Depth Q kock betow ti e_ _-in.
Length Q ,.cia X-Ene _.-.__,Jt. Depth o6 sock oven Me in.
NumbeA o Depth of tite be.Low glade .in.
Totat .Length o Zines~_ 6t. SLope Q tAench - in pe_A 100 it.
Vi6tance between Mes fit. Depth to bednoctz__-_,
7 otc abs a 7.c+.t:tion aAea jt2 Depth to C,~coundcUate'~_---.._"~.
->;~eq~iiked at ea ! J2 Type of Coven: Pape, ox Maw
PIT DINENS1:MS:
Numbe.tc o') pit's _ GAaveZ around pits yes no
Outside diameteA ~t. Depth below .inlet it.
Total absoAbt.ion area it A
2
Kea &equived It
INSPECTED BY TITLE
APPROVED , DATE 197-.-.
REJECTED --,DATE-. 197_
` 1
State and County State Permit # ~~Cf
PLB67. Permit Application County Pe it
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 New Address:
A 4 1
B. LOCATION: Ala) 1/4 &Z' '/4, Section f T -3L N, R / ,~-{er►• W Lot# " City
Subdivision Name, nearest road, lake or landmark Blk# Village _
Township .3Y-,,r
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) - *Variance
Single family ✓ Duplex No. of Bedrooms - No. of Persons
D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES-~JNO # of Bathrooms- L
Automatic Washer J/YES NO Other (specify)
E. SEPTIC TANK CAPACITY 168) Total gallons No. of tanks j
*Holding tank capacity - Total gallons No. of tanks -
New Installation ✓ Addition- Replacement- Prefab Concrete
*Poured in Place Steel Other (specify)
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) ' 2)~C 3) Aff Total Absorb Area sq. ft
New ✓ Addition - Replacement - *Fill System
Seepage Trench: No. Lin. Feet Width Depth - Tile Depth - No. of Trenches
Seepage Bed: Length -S Width !2, Depth -)40 Tile Depth e_F? No. of Lines Z
~r
Seepage Pit: Inside diameter Liquid Depth Tile Size
Percent slope of land7-63 Distance from critical slope > ZO
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 C.S.T. # 5.31 and other information
obtained from
4Qwnef/builcler).
Plumber's Signature MP/MPRSW# Phone
Plumber's Address - z 1, - 11 PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well). Z2-0f -
y1
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• ~ ell = ' j _ _
Al
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Do Not Write in Space Below FOR DEPARTMENT USE ONLY
Date of Application Fees Paid: State/5. pD punt Date
Permit Issued/ft te-d (date) CO, lee Issuing Agent Name
Inspection Yes~No 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 6/1 /76
. 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:,'/4'/4, Section ,Es"-,T=~ N,R E (or W, TO or Munici
Lot pality
Lot No.Block No f~ County { ? I
ivision ame
Owner's/Buyers Name:
1
Mailing Address: ✓1~, ,v
TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL uG
ZONIN
EFFLUENT DISPOSAL SYSTEM: NEW _REPLACEMENT ALTERNATE S M ORA OTME
DATES OBSERVATIONS MADE: SOIL BORINGS C - 7 7 !Z PERCOLATION TES
SO ,L I= AP S! IEE' NAME OF SOIL MAP UNIT
PERCOLATION TESTS
HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES
DEPTH CHARACTER OF SOIL RATE
NUM- SINCE HOLE HOLE AFTE INTERVAL
MIN/IN
BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P- - 9 -I
as '36 ~V/
P- a
IP-
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-
B- S.4 _-2 4 L
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the I4gcation and square feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancy GIs 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) CXN 'r • Certitication No.
Address Y~ 4
Name of installer if known
Copy A -Local Authority CST Sigr xairE ~'w