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Parcel 040-1186-30-000 09/23/2005 04:53 PM
PAGE 1 OF 1
Alt. Parcel 36.28.19.778 040 - 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 - WILLIAMS, CHARLES W & JUDY
CHARLES W & JUDY WILLIAMS
94 W WOODRIDGE DR
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 94 W WOODRIDGE DR
SC 4893 SCH D OF RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 0.459 Plat: 2237-OAK RIDGE ACRES
SEC 36 T28N R1 9W LOT 25 OAK RIDGE ACRES Block/Condo Bldg: LOT 25
INCLUDES P565D
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
36-28N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
2005 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/21/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.507 44,500 236,100 280,600 NO
Totals for 2005:
General Property 0.507 44,500 236,100 280,600
Woodland 0.000 0 0
Totals for 2004:
General Property 0.507 44,500 236,100 280,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 120
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
• AS BUILT SANITARY SYSTEM REPORT
*,TN ER r C
TOWNSHIP - SEC T,;25N, R~W
.0. ADDRESS CROIX COUNT, WISCONSIN.
3DIVISION~ - LOT LOT SIZE
L-~
PLAN VIEW
Distances 6 dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
.3l h
/V J,5~ Cr ~ 4 ~ y
1! 1 r 1t 0 it I'O
?TIC TANK(S) MFGR. CONCRETE STEEL
140. of rings on cover Depth.--<7 DRY WELL
_ENCHES NO. of width length area
D no. of lines_ width f'r length_ ' area _y
depth to top of pipe
~GREGATE
,RK RATE AREA REQUIRED ' AREA AS BUILT ~L
claimer: The inspection of this system by St. Croix County does not imply complete
^pliance 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
"ermine cause of failure.
-ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
"INSPECTOR 'may
DATED PLUMBER ON JOB C'
LICENSE NUMBER ~r lr✓ r~'
z ,
REPORT OF IN,SI;ECTION INDIVIDUAL SEWAGE SYSTEM
Sanity Ay PQ.Amit
` State S e p.tic-J
NAME 1c` r, r"uwn~ship St. Croix County
L o c a.tx. o n%~ S e. 01'i e n
SEPTIC TANK
Si, ze_ ! gattuns, Numb eA u CompaA menxs
Distance FAom: Wett_ _6 t. 121, on gAeateA stope - ~,t
Buitding fit. Wettands - .
Highwate&
DISPOSAL SYSTEM
Distance FAom:Wett_ 12 a oA gAeateA scope - 6t.
Eu.i.td.ing 4t. We.ttands Ft.
Highwatey~ ~t.
FIELD D711,,!ENSIONS:
Width o{ .t,tench at, Depth o6 tooth below Cite ' Z_ in,
Le;tigtih c each taNe^r n Depth c4 tuck oven bite .in.
NumbeA e6 J_'ine Dc.p.th o6 t i Z e betoto gtcade tin.
To.tat teneth . i
T' t~.nes It. Stcpc oi, ;tAench _-Ln pert 100 6.t.
Des lance betiwe.en 2 rtesi ;)t. Depth to bedAoeh
n
Tu tat abts orb tiun a/~e Depth to gACUndwa eA f 7 't.
2
Regcciaed ajHLea It Type u CoveA: PapeA.oA St.Caw
~t '
PIT DIMENSIONS:
N(+_mbeA o~ p,i,ts A G)Lav?eZ atound pits ye/s no
OutA-ide diame_te.t ° tit. Dep.th;'betgw inter 6t.
2~
Total abzoAbtion a.tea, „6t
AAea nequ.i;Aed 6t2 rrt
INSPECTED Sy TITLE
APPROVED DATE 19 7 = / .
REJECTED DATE 197
cam,
PH 115
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309 !Z~}
MADISON, WISCONSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
•'~!'/o,'/a, Section ~
LOCATION:
, TZ!."N, R 19 E (or W ownship r Municipality- 7 AF
2S 0,4 !G /P / County
Lot No. Block No.
Subdivision ame
Owner's Name:
Mailing Address: v G l/ - y
TYPE OF OCCUPANCY: Residence Np. of Bedrooms 3 Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS 7
SOIL MAP SHEET 9 SOIL TYPE /::70/e7-
TESTS
PERCOLATION
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
i
0'9-" 4G, /e /T'T Y S '¢9' 1
P- / ~ C) /6 S /~6
P- O 7s;/ P- 3 &Er (oo M 4:rb s i w o 3O ¢ ~ s
, ~ vim( /✓i / v .C7 S i 6 /-s T Q E
00 ~C-t~sS
SOIL BORING TESTS
S~e~i U v , W/J / y/
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
/ . , i7 /.r E 7'7 / ~c /TT v S. O q:
B-
E.
g
4/
gY- A.,, e.) li/ tV
r~-S 9 f j'
B- .vE ia r " 6,Q
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the locationand square feet of suitable areas. Indicate number of square feet of abserP.T;, n aru'l
needed for building type and occupancy. «~A4*,fzQ u (mss ~c(~15 F. Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope.
~I ' I Icot~. ;,moo I
~t. 4 12.3 )2
_ fa _ N
ds-
~ 1 i 1 ^ /3..1~ • /
or_
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) E f'"G-t!E ,Vl c-, ' Certification No. 5-"-
Address Z~ln ae .3" 7 / . ✓ r",~ ~i
Name of installer if known ✓
COPY A -LOCAL AUTHORITY _ _ -
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IC
State and County State Permit #
PLB67. Permit Application County Pe
~
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 Mang Address:
B. LOCATION: bL.'%, Section T °r ''N, R Jq E (or) W Lot# ` City v
Subdivision Name, nearest road, lake or landmark Blk# Village
Township
_ _
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms No. of Persons
D. TYPE OF APPLIANCES: Dishwasher YES :.~O Food Waste Grinder YE'-
Automatic Washer YES NO Other (specify)
E. SEPTIC TANK CAPACITY %Total gallons No. of tanks
'Holding tank capacity Total gallons No. of tanks
New Installation Addition Replacement Prefab Concrete
'Poured in Place -Steel Other (specify)
4. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) - 3) - Total Absorb Area sq. ft.
New__L--Addition Replacement *FIIIII System
Seepage Trench: No. Feet _ Width s, Depth Tile Depth No. of Trenches _
Seepage Bed: Length . Width Dept Tile Depth No. of Lines -Ye Seepage Pit: Inside diameter Liquid Depth Tile Size -7`
Percent slope of land 7z Distance from critical slope
I, the undersigned, do hereby certify that the information 1 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 Certifgd Soil Tester,
NAME C.S.T. # and other information
obtained om Towner/builder).
Plumber's Si nature % Phone #
9 MPRSW#
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
C?
Ott C~'
/s X /Z
Do Not Write in Space Below FOR DEPARTMENT USE ONLY
Date of Application Fees Paid: State /C oun Dat 'or
Permit Issued/Rejealad (date) _Issuing Agent Name ' s
Inspection YesX1-1N o Valid# Date Recd _
1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
1) 1`"7'-1inn„) 4. plumber (canary copy)
Revised Date 6/1 /76
7 7
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