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Parcel 008-2003-40-000 12/11/2006 04:36 PM
PAGE 1 OF 1
Alt. Parcel 12.28.16.556 008 - TOWN OF EAU GALLE
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 - TORGERSON, RICHARD L & SALLY L
RICHARD L & SALLY L TORGERSON
2611 SANDPIPER LA
WOODVILLE WI 54028
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 2611 SANDPIPER LA
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 8.000 Plat: 0199-COUNTRY ESTATES II
SEC 12 T28N R16W PLAT OF COUNTRY ESTATES Block/Condo Bldg: LOT 04
11 LOT 4
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
12-28N-16W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 746/586
2006 SUMMARY Bill Fair Market Value: Assessed with:
171600 Use Value Assessment
Valuations: Last Changed: 05/13/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.000 27,000 240,200 267,200 NO
AGRICULTURAL G4 5.000 600 0 600 NO
Totals for 2006:
General Property 8.000 27,600 240,200 267,800
Woodland 0.000 0 0
Totals for 2005:
General Property 8.000 27,600 240,200 267,800
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 212
Specials:
User Special Code Category Amount
010-GARBAGE SPECIAL ASSESSMENT 192.00
Special Assessments Special Charges Delinquent Charges
Total 192.00 0.00 0.00
i
NOTE: PRINTS MADE FROM THIS, MAY NOT AGREE WITH THE RECORDED DOCUMENT
II rl.x A.. 696S . .
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Off 'IM COUNTRY ESTATES II
LOCATED IN THE SW. 1/4 OF THE N.W. IM OF LOOtriON lNETW
SECTION It, TOWN Y/ MONTH. RANGE 16 WEST,
COUNTY OF ST. CROIX, STATE OF WISCONSIN
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• AS BUILT SANITARY SYSTEM REPORT
L"P. ~ rr l yt c~;&" S , TOWNSHIP u ,
SEC. 12_ T2 LN, R_LLW ~
ADDRESS LUo ocrl'y / G 1 a~ ~i' r• , ST. CROIX COUNTY, WISCONSIN.
DIVISION LOT y LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
1 1 . / ' . t r y.,,
dL_
r' 4z .
TIC TANK(S) J q MFGR. CONCRETEi~( STEEL
NO. of rings on cover 3 Depth DRY WELL
'.NCHES NO. of width length /p o area o o
no. of lines width length area
depth to top of pipe -*r6 '
REGATE
RATE' AREA REQUIRED AREA AS BUILT loZ C7 U
ciaimer: The inspection of this system by St. Croix County does not imply complete %
_)liance 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
tem 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.
<,jrti
-'INSPECTOR
DATED PLUMBER- ON JOB :1 .4 ,
LICENSE NUMBER S"/ 1P Z/
REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM
Sanitany Pehrnc-t~„3 ~
State Septic ~QA.,
M1 - Town,5hip S Cno~-x Counts/
cat~on~(~ Se-ct4on_Lo.t N Subdivi,5ion
I.PTIC TANK
S.i ze.~~p o gal~onb Numb en o6 eornpantmente
b-tanee. Horn: WC) e- a L✓ Buittlin 12% H.tghwaten
'uMPING CHAMBER
S.i ze gaEtonh mp anu6aetuaen Made-k Nurnbe~r
)LDIN G TANK
Size gaZTon,5 Numb n A Compa~Ltments
Pumpeh_ A n. tem
~6tance ()morn: weU ButiXd4_vtg_ 12,. -eopc
H i,ghwaten
L;SORPTION SI-f -
Bed T 1L e Vl C 1'L
5tanee 6nom: weU-_ Buittling~ 7 r29, hkope
Highwaten
!,SORPTION SITE DIMENSIONS
lUidth of tneneh_ At Requ.in_ed anea ~t
Lvnyih of each fine. '417V At Depth oA tock boeow
Nurnbvrr oA E~-vreb Depth o Hoch oveh t.1I P 47-
l., taX kength 0A f.i.ne5 360 At Depth oA 44'.U. bvIow drradv
U<~,tavicv between eine's Cl ft Skap(2 u~ to-eneh cn. peh 100 Iir
ah,ea ZZ Q Type o6 Cove_L: P a p v n oh -t1law
I DIMENSIONS
Nurnheh ()A p-i.te - - G
ve Q around pAtA ---yep 1
ollo,
ou,o (dv d,i ame to-a _ Depth be-euw 4-n~ct
i
lotal abhonption a)Lea %
An.va ~~equ,ined At
NSPECIED T ITLE
P K O U l U DATE - - - -2 ~ - 19 b
( 1l~CIED DATE 19R
MASON FOR REJECTION
REPORT ON INSPECTION OF SANITARY PERMIT # 9 .
(1) Name and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection
Time of Inspection
ame, Address, License o. o ns a Ong Plumber
3 INST CATION CONSIST" F: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber
❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System
(4)BENCHMARK: (Permanent reference oint Describe:
Elevation of vertical reference point: Slope at site:
(5)MATERIAL AND DEPTH OF SEWER:
(6)SEPTIC TANK: Manufacturer: Liquid Capacity:
Tank Inlet Elevation: Tank Outlet Elev:
# ft to lot or property line: # ft to well:
(7)DOSING TANK: Manufacturer: # of gallons:
# of gallon pump set for a cycle gallons; total capactiy of distribution
lines gallon; size of pump head; gallon per minute ;
horsepower ; brand name of pump and model number
Is the warning device installed? ❑ YES ❑ NO Wired? ❑ YES ❑ NO
;
8 HOLDING TANK: Manufacturer o gallons
construction depth to the cover ft; If septic tank is
being used are baffles removed? ❑ YES ❑ NO; ft from residence;
ft from well; ft from property line. Type of warning device
Is the warning device installed? ❑ YES ❑ NO; Wired? ❑ YES ❑ NO;
Locking device on cover? ❑ YES ❑ NO; Diameter of vent and material ;
Distance from building to vent
(9) SEEPAGE PIT SIZE: # of pits; ft diameter; ft liquid depth;
ft to residence; ft to well; ft to property line;
ft to ordinary high water mark of lake or stream; ft to edge of slopes
greater than seepage pit inlet pipe-elevation ft; bottom of
seepage pit elevation ft.
(10) SEEPAGE BED SIZE: ft width; ft length; tile depth;
lineal feet tile; ft to residence; ft to well; ft to lot or
property line; ft to ordinary high water mark of lake or stream; ft to edge
of slopes greater than 20% falling away toward lakes, water courses or drainage ditches
Elevation of tank discharge line entering bed ft.
11 SEEPAGE TRENCH: Total length of seepage trench ft; width ft;
tile depth ft; ft to well; ft to ordinary high water mark of
lake or stream; ft to edge of slopes greater than 20% falling away toward lakes,
water courses or drainage ditches; elevation of tank discharge line entering seepage
trench ft.
(12) Has system been installed in area indicated on EH 115? ❑YES ❑ NO
(1.3) Has system been installed in floodway? ❑ YES ❑ NO Floodplain? ❑ YES ❑ NO
DILHR-SBD-6095 N.05/80,
Signature of Inspector:
r
State and County State Permit #f
PLB 67
of 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. OWNER OF PROPERTY Mailing Address:
Ronald Anderson RR 1 Baldwin, Wi
B. LOCATION: SW '/4 NW '/4, Section 12, T? N, R 1 E (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Country &tates, Lot 4 Township Eau Galle
C. TYPE OF OCCUPANCY: *Commercial "Industrial *Other (specify) *Variance
Single family X Duplex No. of Bedrooms 4 No. of Persons
D. SEPTIC TANK CAPACITY 1250 Total gallons No. of tanks 1
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete X Poured-in-Place Steel Fiberglass Other (specify)
New Installation X Replacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify)
E, EFFLUENT DISPOSAL SYSTEM: Percolation Rate '10 Min Total Absorb Area 1200 sq. ft.
New X Replacement Alternate (Specify)
Seepage Trench: X No. of Lineal Ft. 300 Width 6" Depth Tile depth (top) No. of Trenches -3
Seepage Bed: Length Width Depth Tile depth (top) No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land Distance from critical slope None
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 Stephen L. Aaby C.S.T. # 1406 and other information
obtained from Owner (owner/builder).
2r7
Plumber's Signature Stephen L. Aaby z~je "P/MPRSW# 5184 Phone # 696
Plumber's Address Box 254, Woodvill . Wi r~
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.
t
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Do Not Write in Space elow FOR COUNTY AND STATE DEPARTMENT USE ONLY
U
Date of Application Fees Paid: State /y e,-o County . &6) DZ±~~
rmit Issued/ftm` cmd date) D IY4 Issuing Agent Name ~h- P
Pe
Inspection Yes No State Valid# Date Recd
A-
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
EH 1,15
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: SW NW '/4, Section 12 , T28N, R 16E (or)(W) Township or Municipality Eau Ga112
Lot No. 4 Block No. Country Estates County St. Croix
Ronald Anderson Subdivision Name
Owner's Name:
Mailing Address: RA 1, Baldwin, Wi.
TYPE OF OCCUPANCY: Residence x No. of Bedrooms 4 Other
EFFLUENT DISPOSAL SYSTEM: NEW- x ADDITION REPLACEMENT
June 7, 1979 PERCOLATION TESTS 9 June 1979
DATES OBSERVATIONS MADE: SOIL BORINGS
SOIL MAP SHEET 79 SOI L TYPE SAC 2 Santiago
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 MIN/IN
BER 1ST WETTED SWELLING IN MINUTES rIPERIOD 2 PERIOD 3
P- 1 30 6" T.S. 240 Silt Loam 24 No 30 1" 1" 30
P- 2 30 6" T..S. 24" Silt Loam 24 No 30 1}" 1j" 1J" 20
P 3 30 6" T.S. 24" Silt Loam 24 No 30 l" l" 1" 30
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)
1 74" None 26o Silt 42" Sandy Loam " T.S.
B-
2 76" 84" 6" T.S. 24" Silt 46" Sandy Loam
3 78" " T.S. 24" Silt Loam 48" Sandy Loam
B 4 76" None 84" 6" T.S. 24" Silt Loam 48" Sandy Loam
6" T.S. 22" Silt Loam 44" Sandy Loam
B 6 76e None 84" 6'r T.S. 24" Silt Loam 46" Sandy Loam
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 absorption area
needed for building type and occupancy. 1200 Sq Ft. (T eriches) Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope.
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1, 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) Stephen L. Aaby Certification No. 1406
Address Box 254, Woodville, Wi
Name of installer if known iaa'by Plwnbing, Heating ~c eCt.
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