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Parcel 040-1194-95-000 11/03/2004 10:53 AM
PAGE 1 OF 1
Alt. Parcel M 4.28.19.881 040 - TOWN OF TROY
Current K ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
00 0
Tax Address: Owner(s): * = Current Owner
DUFFY, JAMES M
JAMES M DUFFY
583 OAK DR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ` 583 OAK DR
SC 2611 SCH D OF HUDSON j
SP 1700 W ITC
go q
Legal Description: Acres: 1.570 Plat: 2080-HIGH RIDGE COURT
SEC 4 T28N R19W 1.57A HIGH RIDGE COURT Block/Condo Bldg: LOT 10
LOT 10
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
04-28N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
02/17/2003 709959 2144/23 WD
898/253
827/393
714/336
2004 SUMMARY Bill Fair Market Value: Assessed with:
222,700
Valuations: Last Changed: 07/21/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.500 68,000 172,400 240,400 NO
Totals for 2004:
General Property 1.500 68,000 172,400 240,400
Woodland 0.000 0 0
Totals for 2003:
General Property 1.500 55,000 159,300 214,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 313
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 040-1194-95-000 07/18/2006 10:16 AM
PAGE 1 OF 1
Alt. Parcel M 4.28.19.881 040 - TOWN OF TROY
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 - DUFFY, JAMES M
JAMES M DUFFY
583 OAK DR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 583 OAK DR
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 1.570 Plat: 2080-HIGH RIDGE COURT
SEC 4 T28N R19W 1.57A HIGH RIDGE COURT Block/Condo Bldg: LOT 10
LOT 10
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
04-28N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
02/17/2003 709959 2144/23 WD
898/253
827/393
714/336
2006 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/21/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.500 68,000 172,400 240,400 NO
Totals for 2006:
General Property 1.500 68,000 172,400 240,400
Woodland 0.000 0 0
Totals for 2005:
General Property 1.500 68,000 172,400 240,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 313
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
S77 AS BUILT SANITARY SYSTEM REPORT
r ! ` w/z•%'"~ ` TKI tS~iLP SAC.,. T N a _W
~ ST. CR4iX COt71r1 , WY3CONSIN.
'17 A
,`BDVSION LOTLOT SIZE
PLAN VIEW
,Distances b, a imet% ons to.meet requirements of H62.20
a cif
SHOW RVERXTHING WITHIN 00 FEET OF SYSTEM
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4xt7+"' i it ' t } a a r4 .
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'a r i.~ tar ~k i
tii 4
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,a111' CiA, . CONCRETE STEEL
x k a rings. on cover Depth, DRY WELL
} * Nit,. :of width 'leg _ area
dep t " 4f Pi it
ul AREA AS BUSLT
"Asm- -m /If c~ ~m r; + h e inn of this system by,st. Croix County does not imply complete
,,,P, iAn a with State AOxipistrative Codes. There are other areas that it is not possible
Inspect At;, this point o construction. St. Croix County assumes no liability for
z tea oipera40-n. However, if failure is noted the County will make every effort to
t tna cause of fsiiu,,Ve
RND P;L SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
ar a NSPECTOR
PLUMBER ON JO
G'
LICENSE NUMBER -~S
r
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REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
San.itatcy Penin.i-t
• State Sept-ic o
NAME (ownah.ip S~. Ctco.ix County
L o c a ti o kt_K Section SEPTIC TANK -1W /v-R~ / CU
S.ize`0 (9 0 gatton.S. Numbet o6 Compattmen-t5 _
D.ustanee Ftcom: WeZ it. 12% ot gtceatetc zZope ~...6t
Bu.itd.ing ,6t. Wetf'ands ~ •
H.ighwatetc it.
DISPOSAL SYSTEM .
D.i tanee FAom: Wett 120 ot gtceatetc ~sZope it.
Bu.itd,ing~it. WetZands Ft.
H.ighwatetc it.
FIELD DIMENSIONS:
Width o6 ttceneh 1 it. Depth ob n.oeh below tite A-
Length o4 each Zine it. Depth ob tock oven. t.ite in.
Numbetc of tins Depth of ,t,ite beZow gtcade tin.
Totat 2eng,th o6 2.inesglit. Stope o6 tneneh Z~ in pen. 100 it.
Distance between .i.ine~s_ Depth to bedn.ock _
Total. abtsonbtion atcea_jr A~ /`~titi2 Depth to gtcoundwatetc - --jt.
10 Requited atcea 5 it2 Type o6 Coven: (Pape, on Stkaw
PIT DIMENSIONS:
Number o6 pits_, GAaveZ a4ound p~.tt~ yeas no
Outside diame-te~f` S J Depth below inZet it.
2
TotaZ zonbtion area it A
Atcea tcequiAed -it2 m
P
v(~ INSPECTED B ?TLE
APPROVED , DATE D~ 19 7.
REJECTED , DATE 197.
d'I
E1.15 _
16 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 fd.f CZ/
LOCATION: ~ '/4, '/4, Section _~L, Tt` N, R f E (or) W, Township or Municipality
~1 ,tX
Lot No. Block No. , 21~~_1=~-~)~ 1 County
Subdivision Name
Owner's Name: /
Mailing Address: ~~c . \~t~\ , ~~1~ 1~ 1-_!~.•(_~ C a`~~'~G z
TYPE OF OCCUPANCY: Residence x No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS
SOIL MAP SHEET 1 SOIL TYPES
PERCOLATION TESTS _
TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
CHARACTER OF SOIL SINCE HOLE HOLE AFTER INTERVAL
NUM- INCHES THICKNESS IN INCHES MIN/IN
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P-
P_ C-i L t ! t1N \ ►I l-_l"~~~~ i 1 -t ~'0 1- ~i P f C_ C, _ ; '',~~i,
ci, j
P_
SOIL BORING TESTS
r TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES 1
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
B ~ ~1~~-~ L l as ~ a ~ > ~ ~ j ~ ~ V,
f/ ^
►~c,,~, c > 3 L 7s zi,,
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 occupancy. 1`1 r' 4 t- T) Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope.
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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.
Certification No.
Name (print) lc 13 ~1 ` 1~, (Z7C
Address
~t'1A>l Cv1ti a S'c,~..
Name of installer if known
~ r
CST Signature./
- ..e._..........m,.-.....a.....~..,~ rla man
E1 1,15
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES I
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309
MADISON, WISCONSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
LOCATION: '/a, '/a, Section A, T'' N, R 1`l E (or) Q) Town `ship or Municipality ! 1
Lot No. Block No. County .
Subdivision Name
Owner's Name: ~~~f~ ~a
Mailing Address:
TYPE OF OCCUPANCY: Residence No. of Bedrooms 3 Other
EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOILBORINGS /'7,] PERCOLATION TESTS SOILMAPSHEET__~ S0 IL TYPE L*A,!t,sK.wi~'i)v
PERCOLATION TESTS
-
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
vUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
P-t
P
,
P3 90
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)
r
141
l J,
44 1
INK f;. 7
14 7 S,
<< i W ' • el
I car,
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areal)
Indicate on the plan the location and square feet of suitabl areas. Indicate number of square feet of absorption area
needed for building type and occupancy. (,1:~ Indicate scale
or distan s. Give horizontal and vertical reference i ts. Indicate slope.
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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 _knnowledge and belief.
Name (print) ~~"FF ~,O 3! Certification No.
Address • t ' ` /`f3~=+ ,
Name of installer if known
CST Signature '
-COPY A
E - -
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State and County State Permit #
PLB'67 Permit Application County Permit # for Private Domestic Sewage Systems County
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. JWNER OF PROPERTY Mailing Address:
~L
B. ~OCATION:Section T, N, R E (or) W Lot# City
ubdivision Name, nearest road, take or landmark Blk# Village
- Township
~l r
C, TYPE OF OCCUPAN Y-: *C lnercial *Industrial *Other (specify) *Varian (Ye
Single family Duplex No. of Bedrooms No. of Persons
D. SEPTIC TANK CAPACITY 1j0,tC Total gallons No. of tanks
HOLDING TANK CAPACIJ~" Total gallons No. of tanks
Prefab concrete Poured-in-Place Steel Fiberglass Other (specify)
New Installation iPo Replacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify)
E. EFFLUENT DPOSAL SYSTEM: Percolation Rate Total Absorb Area sq. ft.
New , -Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. -Width-?
Tile depth top) No. of Tre hes
Seepage Bed: p~ Length J Width Depth Tile depth (top) 'r No. of Lines
Seepage Pit: Inside diam ter Liquid Depth No. of Seepage Pits
Percent slope of land I r c 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 Certified So Teste ,
NAME f C.S.T. # and other information
obtained from (owner/builder).
Plumber's Signature -F/MP Wf# A Phone ~f t24-1
T'
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 i County Date
Permit Issued/Rejected (date) Issuing Agent Name''. i / , (
Inspection Yes No State Valid# Date Rec'd'
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