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Home My WebLink About012-1031-50-050 0 (n O R: v C) 0 y c 0 3 (D I (D 0 ID (D C7 O N N O N C 1 (b :O O R. O A W r D E N O (D Q O (D W O CY, O D (D J } O co O p~ O ~ O CD ~w N ~ Cn O ~ ;y C _ O cD (n CC s _ N co O O N 3 0 r- U) co co CD N O O C a_ N CD O O O S 0 y s N z (n W (n 3 D n! D N n o n y o ®r < ° N CD o m 3 Z J z @ z ~ D a o N F+a • r CD 0 CD (D N IO CO N' (D O Q O " Z M O a z n O_ ~ 3 Cn WO N D N z o. 3 a ~ o o Cn N z ~ ~ O A W Q O 00 C O (O (D CD- d 0 a (D a O V: G) e O N O X ~ a cn CD (D N (D ca- CT FT m ^ (D O ~ , v Cp N -O R 'D J C1 lr j~ O ! } 0 3 y Parcel 012-1031-50-050 12/21/2007 08:05 AM PAGE 1 OF 1 Alt. Parcel 12.30.17.183B-05 012 - TOWN OF ERIN PRAIRIE Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 03/24/2006 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - NYBERG, DAVID A & SUSANNA M DAVID A & SUSANNA M NYBERG 1609 200TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description ` 1609 200TH ST SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 5.976 Plat: 4906-CSM 19-4906 SEC 12 T30N R17W 3.1A IN PT SW SW LOT 1 Block/Condo Bldg: LOT 02 CSM 4/935 NKA CSM 19-4906 LOT 2 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 12-30N-17W SW SW Notes: Parcel History: Date Doc # Vol/Page Type 07/12/2004 768518 2614/320 AFF 07/12/2004 768517 2614/318 QC 07/23/1997 1034/589 WD 07/23/1997 927/483 more... 2007 SUMMARY Bill Fair Market Value: Assessed with: 207727 253,400 Valuations: Last Changed: 06/22/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.970 56,800 186,700 243,500 NO Totals for 2007: General Property 5.970 56,800 186,700 243,500 Woodland 0.000 0 0 Totals for 2006: General Property 5.970 56,800 186,700 243,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 07/07/2006 Batch 06-06 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT K R f~ TOWNSHIpt,, 0. ADDRESS ' ~.y x'/.t'it` S,:C._ TN, R-L7W ST. CROIX COUNTY, WISCONSIN. BIVA. ION C'Sj1') S/1-~ LOT~LOT SIZE PLAN VIEW tJQ 5i -Distances b dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM i i I IN I i I I I , I ~ ~ i I I I } -T-t- I Indicate North, Arrota --i ---rte-~ .-T- 1-- -f , I ` -r /i I SCALE. TIC TANKS) MFCR. i CONCRETE STEEL NO. of rings on cover Depth " DRY WELL t NCHES NO. of width length area no. of lines- width /.I- length area _1 7 , depth to top of pipe aGTRECATE ' 3 +RY RATE . y , AREA REQUIRED C ! ; AREA AS BUILT (~.5< 1 iticlaimer: The inspection of this system by St. Croix County does not imply complete ,0pliance with State Administrative Codes. There are other areas that it is not possible ,o inspect at this point of construction. St. Croix County assumes no liability for 4stem operation. However, if failure is noted the County will make every effort to i~ermine cause of failure. I ,TEASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. `INSPECTOR. .r DATED PLUMBER ON JOB LICENSE NUMBER j~ • :J z , REPORT OF INSPECTION INDIVIDUAL SEWAGE SVSTEhl • SanitalLy Peam.i.t X00 ` State SPp.tiQ-PY-- NAME Townahipt~ i S~. Cn.oix County Loca.tio* SW Slab Section SEPTIC TANK Size gatton4. Numb en o 6 Compaumen.ta ° I D.iA Lance Fnom: WetI',4LA iJW it. 12$ on gnea-ten .6tope it 1 utCding-~jE it. We.ttand4 ~ t. Hig hwa.t en___^__ 6.t . DISPOSAL SYSTEM , Di4 tance Fnom: % Wett 6t. 121 on gneatea a 1?.a pe ~.t. ~iw~. ding --i t. We.ttand4 Ft. N~.ghwa~en b.t. FIELD DIMENSIONS: (didth ob' ,tnench__,/ it. Depth ob nock below, -tize,,-'2- in. Length o6 each 4i.ne~it. Depth ob nock oven .tile o2 ///.cnin. Numb ea- 06 ~~.ne4 2 Depth 05 t~.te be.bow 9nade..r ~4// , - To.ta.L 4eng.th o6 tine, it. S.bope o6 ,tnench in pen 100 it. Di4.tance between Zinea .t. Depth ata'bed,%Qak To.tat ab4 oi,b.tion a4ea (i2.. W Depth to g4ouadwa.ten Requied area 'S2 ?ype o6 Coven: Paper K S.tn.aw PIT DIMENSIONS. Numbers ob pit.a Gnave4 mound pity yea no Out ide d~ ame-te pepth bet.ow in4e,t To.tat abaanbt' p4a 2 6 t 2 rh AK ea 4 eq 4' j ,t rn 1NSPbCTED-4Y--- TITL ,.APPROVED DATE 197 REJECTED ,DATE 191 r • I PLB 6.7 State and County State Permit # 026 161 w Permit Application County Permit # for Private Domestic Sewage Systems County ; wki&d *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # ~S A. OWNER OF PROPERTY Mailing Address: 63-5 B. LOCATION: Section, T N, R-,L:Z g (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township 4~1"IAI ~i to?[= C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family _ 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 concreted 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-ZiL22- Total Absorb Area sq. ft. New n Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (/tlo~) No. of Trenches Seepage Bed:_ Length Width 7 Depth Tile depth (top) No. of Lines Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land- f Distance from critical slope C~ WATER SUPPLY: Private X 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 Cer ified Soil Tester, NAME r4L Ay rzx J4, C.S.T. # and other information obtained from r (owner/builder). Plumber's Signature MP/MP SW# / Phone #-ZyL~ Plumber's Address _ l 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. f 3 3 E j l1lcl 4 ? C r Y . 1 q ~f s , E E E 4f t Do Not Write in Space Below - FOR COUNTY AND STATE DEPARTMENT USE ONLi Date of Application Fees Paid: State County Date C!~ Permit Issued/Rejected (date) Issuing Agent Name t CL'n Inspection Yes No State Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P. 309 M WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 7/1/78 J EH 1 15 Rev. 9/78 ' REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES 41 P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION:0%4 ' ''/4, Section.y1__~_,T3LN,RJ_Zl1 (or) W, Township or Municipality~Sld 1Jf0/ 464 Lot No. , Block No. County s-;r J~ > Subdivision Name Owner's/Buyers Name:!, l 4t~4> Mailing Address: TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW. REPLACEMENT, ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION fJ TESTS SO SOIL MAP SHEET ~26 NAME OF SOIL MAP UNIT PERCOLATION TESTS 4UM HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES DEPTH CHARACTER SOIL SINCE HOLE HOLE AFTER INTERVAL RATE MIN/IN INCHES THICKNESS IN INCHES PERIOD 1 PERIOD 2 PERIOD 3 1ST WETTED SWELLING IN MINUTES 1 ~ 7 7 P-3 4&Aild i el P- 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- / ? , . B_ B- > . E B- B- B- PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan thelopation and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy 4,1 .Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. E , 3 ,44 td WA ' . x l~i,~,e'~t' f~~i► BAs r~~/ All QYt 9`y N t E 3 r e r , , r 4cri /11~~lr 3 , y a , ~ a. I s a a , l 1, 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) a,4461111 J A0 Certification No._c_- Atd/ Address Name of insta:'er if known ' e_S Copy A -Local Authority CST Signature _ 'OrLB State and County State Permit # q 1/ 0 67 t, Permit Application County Permit # c) - for Private Domestic Sewage Systems County ETC ' 0 r~ x *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. LOCATION: ,SLJ '/4;1~ '/d, Section , T N, R12_y (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# _ Village Township z a C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY f(}01' 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 Total Absorb Area sq. ft. New Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: y_Length idth ~.7• Depth !Tile depth (top)..241 No. of Lines Seepage Pit: Inside di/o~meter Liquid Depth No. of Seepage Pits Percent slope of land- T Z~l Distance from critical slope WATER SUPPLY: Private W 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. # ;Z221 and other information obtained from )ffwl (owner/builder). Plumber's Signature M_P/ PRSW# ~~-3 Phone Plumber's Address Ir- L; _ ,4',~.~r✓o 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. J ~......E _ . . _ ' .t3.~.✓c~.-1~1~ r , + s i me E I. s i E i Do Not Write in Space Below FOR COUN Y AND STATE DEPARTMENT USE ONLY Date of Application s;26 Fees Paid: State County Q~ 47' ate IA6 -&16 Permit Issued/RP#mted - (date) 6 •O~(o LIe Issuing Agent Name 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 state (pink copy) 4. plumber (canary copy) Revised Date 7/1 /78 EL115 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:s W '/4ll~t~ '/4, Section 12, T•2N, R)??Cor) W, Township or Mu "eipali#Y Lot No. , Block No. , - County`' Subdivision Name Owner's Name: Mailing Address: 'Of TYPE OF OCCUPANCY: Residence No. of Bedrooms -3 Other - EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT - DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS Z ?_1 SOIL MAP SHEET SOIL TYPE 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 PERIOD 1 PERIOD 2 PERIOD 3 6ZO ?V0 .:2 A)a Az 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- 7-7/1 4jo IV 7 '2 ~ Jr- .2 54 7 z- PI ' • - i -yG . 7Z Z Q h *-e.G. 1*2 f,-5 " 92" B- Z,7 7 2- PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of uitable areas. Indi to number of squ re eet of absorption area needed for building type and occupancy. 6fsb ~ ? 13Bd " P/e Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. ---Q-- _ - - - _ i i , I ~ ~ ~ I I N ~.4-_ I _ • 1 - E I i F-77 # ~ i C I, the undersigned, hereby certify that the soil tests reported on this form were made by mein 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 kn ledge and belief. Name (print) ifi tion No. Address Name of installer if known CST SignatuC