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Parcel 040-1110-20-000 12/19/2006 12:00 PM
PAGE 1 OF 1
Alt. Parcel 28.28.19.444B 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 - O'MALLEY, ALICE FRANCES-ET AL
ALICE FRANCES-ET AL OWALLEY
602 CTY RD MM
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description 602 CTY RD MM
SC 4893 RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 3.980 Plat: N/A-NOT AVAILABLE
SEC 28 T28N R1 9W 3.98 AC PRT SE SE - S Block/Condo Bldg:
323 FT OF E 537 FT INCLUDES P426B
EZ-UT-1505/137 Tract(s): (Sec-Twn-Rng 401/4 1601/4)
28-28N-19W
I
I
I
Notes: Parcel History:
Date Doc # Vol/Page Type
2006 SUMMARY Bill Fair Market Value: Assessed with:
158558 217,100
Valuations: Last Changed: 07/21/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.800 76,000 122,000 198,000 NO
Totals for 2006:
General Property 5.800 76,000 122,000 198,000
Woodland 0.000 0 0
Totals for 2005:
General Property 5.800 76,000 122,000 198,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 116
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP SEC.`t~-Tr~N, R~ W
P.O. ADDRESS f , ST. CROIX COU';Y, WISCONSIN -
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
ek I
%',L Sri ` J1
SEPTIC TANK (S) MFGR. CONCRETE STEEL
NO. of rings on cover Depth DRY WELL
TRENCHES NO. of width length area _
BED no. of lines _ width length area
depth to top of pipe
AGGREGATE i, ,.L,11
PERK RATE AREA REQUIRED AREA AS BUILT
Disclaimer: The inspection of this system by St. Croix County does not imply complete
compliance 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
system operation. However, if failure is noted the County will make every effort to
determine cause of failure.
GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
INSPECTOR
DATED PLUMBER ON JOB
7---
LICENSE NVITI ER
S -
z -
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
San,itaty Penmit
State S o ptic_ -
NAME lr (I fownsh.ip S j. Qo ix County
Location Section
SEPTIC TANK
Size ga.l.lonz. Numbet of Compattment6
D.iotanee Flom: WeZZ 12% on greaten .lope It
Bu.itd,ing It. Wettank_ It.
H ighwaten It.
DISPOSAL. SYSTEM
D.i.dtanee Flom: weU It. .12% on greaten •s.lope It.
Buitd.ing 4:t. wetlands Ft.
N.ighwatet It.
FIELD DIMENSIONS: Width of trench It. Depth of Aock below t,i.le .in.
Length of each .Line It. Depth of noels oven t.i.le in.
NumbeA on .lines Depth of We below glade _.in.
Totat .length of Zinez It. Slope of trench in pen 100 It.
D.iztanee between Zines t. Depth to bedmock it.
Total absotbt.ion area 4t2 Depth to gnoundwateA It.
Requited area It 2 Type of Covet: Papen on Straw
PIT DIMENSIONS:
Numbet of pits GAave.l around pitz yeas no
Outn ide diameten it. Depth Wow .in.le.t it.
2
Total absorbtion area It A
2
Anea tequ.ited It
!R'
INSPECTED By TITLE
APPROVED , DATE 19 7___
REJECTED , DATE 197.
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 TESTS
LOCATION: SE 3F-'/,, Section 2_S__, T2_8-N, R 1-q E tel:) W, Township or Municipality Troy y r\'
Lot No. , Block No. County
Subdivision Name
Owner's Name: Alice O'Malley
Mailing Address: RR 3 River Falls, WI 54022
TYPE OF OCCUPANCY: Residence No. of Bedrooms 2 Other`
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMEN
DATES OBSERVATIONS MADE: SOIL BORINGS May 15 1979 PERCOLATION TESTS MaY 16, 1979
SOIL MAP SHEET Saint Croix Co. SOIL TYPE Pillot Silt loam
Sheet No. 90
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
P-1 42 14" silts, 19" sil, 9" sand 22 none 10 1 5/8 1 112 1 7/16 7
P-2 36 15" silts, 20" sil, 1" sand 22 no 10 1 3/4 1 5/8 1 5/8 6
P-3 36 17" silts, 18" sil, 1" sand 22 no 10 1 5/8 1 1/2 1 1/4 8
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)
B-1 78 none > 78 14 silts 1911 " - sand
R-2 72 none > 72 1 „ , -,ill ~ 71, Sand
B-3 72 none > 72 " ,nnci
B-4 72 non " "
_S 72 none > 72 14" silts 19" sil 39" sand
B-6 72 none > 72 12" silts 18" sil 42" sand
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 numt er of square feet of absorption area
needed for building type and occupancy. tn J Indicate scale
or distances. Give horizontal and vertical rIndicate slop~P«
$cale f"-i0'
i Perc Tests, _
I r ~`aY
_ _._BOre Hoes
3 4 Elevation
Existing I Ref poiot
i-
_ )~is~n-
Well bedroom home
t
_I - Re£ _.CQrner£.. N
Elevai for 40arage I
-t - _ r
t
1100' i I
! X25 I_
L ¢ 195'1 t i
t i -I E1v. )i_ Sec , 28
-1 1 14lo I
4
C f 1 i I y i }
S t 1701
I ,01
.w
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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.
Name (print) Roger A. Swanson Certification No. 55 606
Address RR 5, Box 124, River Falls, WI 54022
Name of installer if known Calvin Wwg
CST Signature
110I3Y A - LOCAL AUTHORITY
4., ta 14
PLB,67 State and County State Permit #
u. Permit Application County Perm4 #
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:
I'
B. LOCATION: '/a % Section , T , R J1 E (or) Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township
C. TYPE OF OCCUPANCY: "Commercial `Industrial "Other (specify) 'Variance
Single family _x Duplex No. of Bedrooms No. of Persons _
D. SEPTIC TANK CAPACITY 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 -yr------
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-PlaceOther (Specify)
- -
E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area ~q•
New Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: -Length " idth 12 Depth -Tile depth (top)__0_m?_No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land l~ 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. # j.7i~^r®6 and other information
obtained from (owner/builder). j
Plumber's Signature Y" A MP/MPRSW# Yy Cy Phone # 9 yl~/
.010 -!ne ~4 J2
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 e r c c Count / Date - ~Ir
Z Issuing Agent ent Name L ~r1 L '
Permit Issued/ eP date) 9 g
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