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Parcel 010-1086-60-100 01/08/2007 11:53 AM
PAGE 1 OF 1
Alt. Parcel 35.30.16.523B 010 - TOWN OF EMERALD
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 - THAO, UE & CHIANG YANG
UE & CHIANG YANG THAO
2518 CTY RD DD
GLENWOOD CITY WI 54013
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 2518 CTY RD DD
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 20.000 Plat: 3748-CSM 13/3748
SEC 35 T30N R16W PT SW SW & SE SW BEING Block/Condo Bldg: LOT 1
CSM 13/3748 LOT 1 20.OOAC
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
35-30N-16W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/30/2001 652484 1690/198 WD
07/23/1997 1024/166 WD
07/23/1997 1009/467 WD
07/23/1997 1001/391 SD
more...
2006 SUMMARY Bill Fair Market Value: Assessed with:
168431 Use Value Assessment
Valuations: Last Changed: 10/19/2004
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 14.000 2,100 0 2,100 NO
OTHER G7 4.000 15,000 122,700 137,700 NO
Totals for 2006:
General Property 18.000 17,100 122,700 139,800
Woodland 0.000 0 0
Totals for 2005:
General Property 18.000 17,100 122,700 139,800
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 568
Specials:
User Special Code Category Amount
010-GARBAGE SPECIAL ASSESSMENT 30.00
Special Assessments Special Charges Delinquent Charges
Total 30.00 0.00 0.00
• AS BUILT SANITARY SYSTEM REPORT
rR f'~,,-~,~~= TOWNSHIP SEC. T 3<aN, R~ W
J. ADDR SS r , ST. CROIX COUNTY, WISCONSIN.
'DIVISION LOT LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
U,E N j ~ Rte.. s _ : ~ ! , ~ e`
o~
"TIC TANK(S) MFGR. CONCRETE
'Z_ STEEL
NO. of rings on cover Depth DRY WELL
NCHES NO. of width length area
no. of lines width length_.. area,
depth to top of pipe
_'_ZEGATE
RATE AREA REQUIRED AREA AS BUILT
claimer: The inspection of this system by St. Croix County does not imply complete /
Dliance 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
Lem 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
DATED PLUMBER ON JOB
LICENSE NUMBER
r
f
1
REPORT OF INSPECTION - 1AinIll-f-MIA I ors. A,lv
San.itvi Penmi. - G
State Se.p,t,4 c.
AML Z:2~LTown.6hip fQz z'/ St. Coo x County
cation_ ,'(,J Sectiun~Lo.t N Subdivia4.on
'PTIC- TANK
S.i z o t G C ga.L Lo na Numb et o j co mpaA tmen-ta /
(.5 tanee (AOrn: [UexX Cam' Bu4tding--lG-' 12% mope
Highwate4
'(IMPING CHAMBER
Si z e g;, gatzo- n4 _ Pump Manu 6ae.tuu.A Mu det NumbeA
c)LDING TANK
S.i ze galtona NumbeA u C"ompa4tment,6
Pumpet_ Atatm dye em
iatanee Atom: we.bt sup d.i.ng 12% atupe
Highwatet
tiSORPTION SITE
Bed Trench
stance Atom: Wet.E Building t2$ a Eope
Highwa.tet
IiSORPTION SITE DIMENSIONS
W-4 dth o A tteneh - - At Req u.i red area _ i At
Length uA each tine -Z At Depth oA tuck bet.ow tkxe tom, .i.n
Numbeh oA t.i*le.6 Depth uA toeh oven hike - Z cn
Tuta,e Length uA t•inea At Depth uA tixe betow grade in
Dta.tance between tines At Stope uA -tAench~, `tiYl. pen 100 At
1u4(,( Ub60)Lljt~.un area / At Type oA Covet: Pape.n u ""a.ttaw If DIMENSIONS
Numbers o6 pito ~Aave,t, a uund p4~ xa yea nu
Ou.ta•ide d•i.ametet ,t LDP~-p,,~,G, b xow CnEet_ At
Tu-tat abaotp.t.Eon area At
Area n.equi4ed At
NSPECTED-..`. 1y TITLE
''PROVED DATE 2 ,f u'7( 19 k_
' JECTEDDATE 198
'tASON FOR REJECTION
PLB 6 7 *State and County State Permit # ~-3
Permit Application County Permit #
- "I I
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:
Eugene Hopkins RR 1, Cameron, Wisconsin
B. LOCATION: SW /4 .S,i /4, Section , T'J0 N, R 16 E (or) (W) Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village hnerald
Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family X Duplex No. of Bedrooms j No. of Persons 4
D- SEPTIC TANK CAPACITY 1000 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 Replacement X
Lift Pump Tank or Siphon Chamber 600 Total gallons Prefab concrete X Poured-in-Place Other (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate j- Total Absorb Area Ili sq. ft.
New Replacement X Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: X Length A Width SJO Depth 0 ° Tile depth (top) 18 No. of Lines 5
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land 6 Distance from critical slope iJone
WATER SUPPLY: Private It 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. Aab_y C.S.T. # 1401 and other information
obtained from Owner (owner/builder).
Plumber's Signature MP/MPRSW# 5184 Phone # 698 - 2407
Plumber's Address Box 2154. Woodvilie W onsin
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.
s
Please refer to attached drawings.
i
E
{
Do Not Write in Space B plow FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application / --;i/ E~ Fees Paid: State V, er-C County Date /I z/ pn
Permit Issued/Reye" d (date) Issuing Agent Name --e-4 ~ 2le-,elu
Inspection Yesk_No State Valid# Date Recd
-ounty (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
b(pink copy) 4. Plumber (canary copy)
Revised Date 7/1/78
$
EH. 115
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES /~C
-
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH r. A, AF 11 Y
P.O. BOX 309 v r ~Fa ' o
MADISON, WISCONSIN 53701 49, 19 "
REPORT ON SOIL BORINGS AND PERCOLATION TESTS A, 6 ,
LOCATION: '/4, Sou '/4, section J3, _t101\1, R16 E (or)6,}fownship or Municipality Emerald
Lot No. , Block No. County St. Oroix
Owner's Name: &gene Hopkins Subdivision Name
Mailing Address: M 1, Cameron, Wisconsin
TYPE OF OCCUPANCY: Residence x No. of Bedrooms j Other
EFFLUENT DISPOSAL SYSTEM: NEW- ADDITION REPLACEMENT X
DATES OBSERVATIONS MADE: SOIL BORINGS 11/10/du PERCOLATION TESTS 11/10/60
SOIL MAP SHEET_ SOIL TYPE FNBFreeon
PERCOLATION TESTS
TEST DEPTH ;THIC RACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
NUM- INCHES KNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
P-1 42 b» TSilt Loam 10" Sandy
Loam Non 0 0
P 2 36 6" T.S. 10" Silt Loam 16" Sand None j0 1" IN 30
P- 3 36 6" T.S. 5" Silt Loam 25" Sandy 4 None jo 1» 1" 30
Loam I
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 84 None 60 T.S. 16" Silt Loam 30" Sandy Loam 42" Sand
B-2 64 None 6" T.S. 104 Silt Loam 16" Sandy Loam 52" Sand
B j 84" None 6" T.S. 5" Silt Loam 28" Sandy Loam 45" Sand
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. 1125 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.
Name (print) Stephen L. Aaby _ Certification No._ 1406
Address Woodville. Wi
Name of installer if known Aaby Plumbing, Heating & Elect. Inc"
CST Signature
G%'
REPORT ON INSPECTION OF SANITARY PERMIT # 931
M Name and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection
v, L
Time of Inspection
Nam V, es License o. o ns a ing Plumber
3 IN ALLATION CONSIST 0 : ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber
❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System
BENCHMARK: (Permanent reference Point) Describe:
Elevation of vertical reference point: Slope at site: I
(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:
M 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 ❑ N0; Wired? ❑ YES ❑ NO;
Locking device on cover? ❑ YES ❑ N0; 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;
li.neal 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
(13) Has system been installed in floodway? ❑ YES ❑ NO Floodplain? ❑ YES ❑ NO
DILHR-SBD-6095 N.05/80
Signature of Inspector:
LIN pi
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