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Parcel 038-1119-70-050 12/04/2006 02:26 PM
PAGE 1 OF 1
Alt. Parcel M 29.31.18.4948-10 038 - 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 - WINKEL, DAVID W & ANDREA
DAVID W & ANDREA WINKEL
941 192ND AVE
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 941 192ND AVE
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 1.020 Plat: 0888-CSM 03/0888
SEC 29 T31 N R1 8W PT SE SW LOT 1 OF CSM Block/Condo Bldg: LOT 1
3/888 (2.020AC) EXC AS DESC 1555/109
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
29-31N-18W SE SW
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 603/502
2006 SUMMARY Bill Fair Market Value: Assessed with:
175709 151,300
Valuations: Last Changed: 10/15/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.020 25,100 108,600 133,700 NO
Totals for 2006:
General Property 1.020 25,100 108,600 133,700
Woodland 0.000 0 0
Totals for 2005:
General Property 1.020 25,100 108,600 133,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 223
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
• AS BUILT SANITARY SYSTEM REPORT
►'iER TOWNSHIP_`
r r/r ,<SEC. t TAN, R i W
0. ADDRESS ST. CROIX COUNTY, WISCONSIN.
.-BDIVISION LOT LOT SIZE
PLAN VIEW
-Distances b dimensions to meet requirements of 1162.20
SH041-EVERYTHING WITHIN 100 FEET OF SYSTEM
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Indicate North Arrow j
j SCALE . - -
tPTIC TANK(S)__Z_ MFGR. CONCRETE STEEL
NO. of rings on cover / Depth DRY WELL
ANCHES NO. of width- length -
area
-i no. of lines width length area
aCREGATE depth to top of pipe
,
RATE / AREA REQUIP.ED AREA AS BUILT
iisclaimer: The inspection of this system by St. Croix County does not imply complete
'Opliance with State Administrative Codes. There are other areas that it is not possible
to inspect at this point of construction. St. Croix County assumes no liability for
istem operation. However, if failure is noted the County will make every effort to
.j~ermine cause of failure.
,{EASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
'-INSFECTO,,.
DATED PLMIBER ON JOB
LICENSE NUMBER
z REP(,RT OF INSPECTION-INDIVIDUAL SEWAGE SYSTEM
San.itany Pvuti it
State Sept.tier'
NAME iownehip_St. Croix County
Locat.ioo Section
SEPTIC; TANK
Size gatton6. Number o6 Compantment6
Di.6tanee Fnom: WeZZ it. 120 on greaten 6tope it
Bu.itd,ing_ it. Wettands
H,%ghwaterc it.
DISPOSAL SYSTEM
D.idtanee Fnom: Wett - 120 on greaten 6tope it.
Buitd.ing it. W ettands Ft.
H i,ghwaten 6t.
FIELD DIMENSIONS:
Wid=th o6 trench Z it. Depth o6 no ck b etow ti°.e in.
Length o6 each tine it. Depth o6 rock oven tite 2.. .in.
Numb en o i .-in ens ~2 Depth o6 tite b etow grade 2, in.
Totat .length o4 tine6 it. Stope o6 trench - in pen 100 it.
Distance between Zinez t. Depth to bedrock. 6t•
Totat ab,6o4btion anea~_it2 Depth to gnoundwaten it.
.Requited area it 2 Type oA Coven: Papen on Sttaw
PIT DIMENSIONS:
Number o6 pits Gnavet around pitzs yeas no
Outside d,iameten fit. ro Depth betow ,ia et it.
2
Totat ab~sonbt.ion area it z
A
2
Area nequ.ined it IR'
, e!
INSPECTED BY. T T'T LIE
APPROVED DATE 19 7
REJECTED , DATE 197.
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L I 15 R w. 9178" -
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
ti
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION. '/a, Section ~,T, N,R_4.e_E (or) V!(, Township or Municipality
Lot No. , Block No. County ,
Subdivision Name
Owner's/Buyers Name:
Mailing Address: ,Z
Y
TYPE OF OCCUPANCY: Residence- No. of Bedrooms ~ COMMERCIAL E~6-
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYS ER
DATES OBSERVATIONS MADE: SOIL BORINGS A• '1:~'' 1`~y~ PERCOLATION TESTS
SOIL MAP SHEET `
NAME OF SOIL MAP UNIT LL7,~,nd ~.z -mIX,
PERCOLATION TESTS
TEST DEPTH CHARACTER ~ OF ` SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
TEST
II INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P- /
Ak.Aj 's,
P_
P-
P-
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
TEXTURE, MOTTLING AND DEPTH TO BEDROCK
NUMBER INCHES OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES
B-
fy
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancyIndicate 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) Certification No.~
Address
Name of installer if known
Copy A -Local Authority CST Signature __r 1 7 24,
Y State and County State Permit # Permit PLR-67 Application Y ~
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:
~ /1 j f /k /
B. LOCATION. -.5, Z '/4 - '/4, Section TIZ N, R J L F (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
n Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial Other (specify) *Variance
Single family Duplex No. of Bedrooms g No. of Persons
D. SEPTIC TANK CAPACITY Total gallons No. of tanks A
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete d 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 x;~yt_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:- l Length s - Width /`2 Depth ~ Tile depth (top) - .y No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land 9::L Distance from critical slope
WATER SUPPLY: Private X 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 Ceftified Soil Tester,
NAME C.S.T. #and other information
obtained from (owner/builder).
Plumber's Si nature _
g _ MP/MPRSW# ~ ~ 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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Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application ~ Fees Paid: State (o Co n (~Tl Date - r C
Permit Issued/l (date) Issuing Agent Name A-t
Inspection Yes No State Valid# Date Recd
1. county (w it 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