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Parcel 040-1197-30-000 07/18/2006 10:26 AM
+ PAGE 1 OF 1
Alt. Parcel 4.28.19.897 040 - 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 - MCKINTOSH, ROSS & MARGUERITE ANNE
ROSS & MARGUERITE ANNE MCKINTOSH
558 HIGH RIDGE DR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 558 HIGH RIDGE DR
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 2.170 Plat: 2081-HIGH RIDGE COURT 1ST ADD
SEC 4 T28N R19W 2.17A HIGH RIDGE COURT Block/Condo Bldg: LOT 25
1 ST ADD LOT 25
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
04-28N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 728/382
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 2.100 60,500 170,500 231,000 NO
Totals for 2006:
General Property 2.100 60,500 170,500 231,000
Woodland 0.000 0 0
Totals for 2005:
General Property 2.100 60,500 170,500 231,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 220
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT
TOWNSHIP SEC. T-;VN. R W
'AD RE T. CROIX COUN WISCONSIN.
ONVISION LOT LOT SIZE
°r PLAN VIEW
Distances ~ dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
F
3 f
7 r1i
)
k '
1 f
f CONCRETE STEEL
1WORR.
a airings on cover Depth ~ rr DRY WELL
-
,width length area
! ► et it* _ width ! longth~ area
depth to etsp o pie i -4:2 6
AAA REQUIREb AREA AS BUILT
claimer: The inspection of this system by St. Croix County doe', not imply complete
nplitnce 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
item operation. However. if failure is noted the County will make every effort to
' termine cause of failure.
=4325 AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
,-'INSPECTOR
DATED"" z PLUMBER ON JOB
LICENSE NUMBS
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
San.itahy PvLm.it
State S e ptic_
NAME rownah.ip S~. CAO.ix County
Locat.ioA Section
SEPTIC TANK
Size ga.Z.Zonb. NumbeA o6 CompaAtmentz i
Distance FAom: Wett 6t. 12% oA gneateA a.Zope 6t.
Bu.itd.ing 6t. Wettandd 6t.
H.ighwateA - 6t.
DISPOSAL SYSTEM
Distance FAom: WeU 6t. 12% on gneateA s.Zope 6t.
Bu.itd.ing 6t. wettands Ft.
H.ighwateA~6t.
FIELD DIMENSIONS:
Width o6- tAench 6t. Depth o6 Aock below t.i.Ze .in.
Length o6 each .Z.ine 6t. Depth o6 Aock oven t.i.Ze .in.
Numb en o 6 ,Z.in ens Depth o j ti Ze b e.Zow gAade in.
Totat .Zength o6 .Z.ines 6t. S.Zope o6 tAench in pen 100 6t.
Distance between Zinea 6t. Depth to bedrock 6t.
Total abz oAbt.ion aAea 6t2 Depth to g.toundwateA 6t.
Requited aAea 6t2 Type o6 Coven: Pape.n oA StAaw
PIT DIMENSIONS:
NumbeA o6 pits Gxavet around pits yea no
Outside d.iameteA 6t, Depth be.Zow .i.n.Zet 6t.
2
Totat abaonbt,ion aAea 6t A
AAea %equkted 6t2
INSPECTED BY TITLE
APPROVED , DATE 19 7 / .
REJECTED DATE 197.
4
EH 115 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. Section _L,Tr`N,R-4-LE (or)~V
,'fownship or Municipality
Lot No. Block No. County
C-1 ub ivision ame
Owner's/Buyers Name: ~as,` 6-e,,LT.-5r _
Mailing Address:
TYPE OF OCCUPANCY: Residences No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW -4 REPLACEMENT ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS2q PERCOLATION TESTS
SOIL MAP StI~~~
NAME OF SOIL MAP UNIT
PERCOLATION TESTS
TEST HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES
NUM- DEPTH CHARACTER SOIL SINCE HOLE HOLE AFTER INTERVAL RATE
BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN?/IN
1P-Z '315 -5
P-3 (C`
0
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- Q n1 N tZ e L-I "64 5-:L L 'q L _ - L~ S
6
IVOA;,~ 605
B- 9A 1 ".54; 15i L
B- 5-
L.3 i A7
LiJ L f-
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the Ian the location andsquare feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancy LI:Sr_ 4 1` 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) Ctr=/ Certification No. ~
Address C)q di~Y~i~.i G(1// S Y
Name of installer if known
L Copy A -Local Authority CST Signature j _
P 6 7 LB State and County State Permit #
1 Permit Application County Per it # 'f
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:
B. LO ATION: '/a Section 1 T N, R E (or) W Lot# City
Subdivision Name,1 nearest road, lake or landmark Blk# Village y~-
Township
~r~ t
C. TYPE OF OCCUPANC Y. -Commercial *Industrial -Other (specify) -Variance
Single family Duplex No. of Bedrooms No. of Persons
D. SEPTIC TANK CAPACITY r i ! Total gallons No. of tanks
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. -e `2LIT0tal Absorb Area z~ sq. ft.
- Z4 New t 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) - -t No. of Lines -
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land- i r 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 Soil ,Tester,
NAME+ C.S.T. # - and other information
obtained from (owner/builder). _
Plumber's Signature % --~/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 FO.R COUNTY AND STATE DEPARTMENT USE/ONLY _
Date of Application % /Fees Paid: State/ ! C un yi~f. Date
Permit Issuedlfled (date) c' ~~-?ssuing Agent Name
Inspection Ye,~_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