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Parcel 018-1060-70-100 01/13/2006 10:18 AM
PAGE 1 OF 1
Alt. Parcel 26.29.17.412B 018 - TOWN OF HAMMOND
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 - KEN-RICH FARMS INC, % KENNETH PETERSON
% KENNETH PETERSON KEN-RICH FARMS INC
1958 CTY RD J
BALDWIN WI 54002
Districts: SC = School SP = Special Property Address(es): = Primary
Type Dist # Description " 1958 CTY RD J
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 1.000 Plat: N/A-NOT AVAILABLE
SEC 26 T29N R1 7W 1AC SW SE COM SE COR E Block/Condo Bldg:
200'N 217.8'W 200'S 217.8'-POB
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
26-29N-17W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1110/341 QC
07/23/1997 862/323
07/23/1997 677/154
07/23/1997 456/461
2005 SUMMARY Bill Fair Market Value: Assessed with:
90592 144,200
Valuations: Last Changed: 10/22/2001
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.000 10,000 109,200 119,200 NO
Totals for 2005:
General Property 1.000 10,000 109,200 119,200
Woodland 0.000 0 0
Totals for 2004:
General Property 1.000 10,000 109,200 119,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 149
Specials:
User Special Code Category Amount
010-GARBAGE SPECIAL ASSESSMENT 60.00
Special Assessments Special Charges Delinquent Charges
Total 60.00 0.00 0.00
Parcel 018-1060-70-000 01/13/2006 10:18 AM
PAGE 1 OF 1
Alt. Parcel 26.29.17.412A 018 - TOWN OF HAMMOND
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 - KEN-RICH FARMS INC
KEN-RICH FARMS INC
1958 CTY RD J
BALDWIN WI 54002
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 1958 CTY RD J
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 39.000 Plat: N/A-NOT AVAILABLE
SEC 26 T29N R1 7W 39 AC SW SE EXC P412B Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
26-29N-17W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 677/154
2005 SUMMARY Bill Fair Market Value: Assessed with:
90591 Use Value Assessment
Valuations: Last Changed: 08/24/2005
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 35.000 3,700 0 3,700 NO
OTHER G7 4.000 19,000 179,000 198,000 NO
Totals for 2005: ~
General Property 39.000 22,700 179,000 201,700
Woodland 0.000 0 0
Totals for 2004:
General Property 39.000 22,700 173,300 196,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 149
Specials:
User Special Code Category Amount
010-GARBAGE SPECIAL ASSESSMENT 60.00
Special Assessments Special Charges Delinquent Charges
Total 60.00 0.00 0.00
I;
AS BUILT SANITARY SYSTEM REPORT
OWNER c= ems' `'r t r TOWNSHIP lei y ,SEC. T . ~ V N, R/ 7 W
P.O. ADDRESS j.~ ST. CROIX COUNTY, WISCONSIN.
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
n ro e.
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
V E-N ~f
0
35 "Cea eR a J: f1)AeJ l~al~
'e-q e o F D2Ai a t
o ~ieL~L
tg Iy -/o G1 e.~ foie. °F m, (-{ale
- ~ause
e
~d -
a o S~p~e ~
iU f fi `
SEPTIC TANK (S) MFGR. CONCRETE'S STEEL
NO. of rings on cover Depth DRY WELL
TRENCHES NO. of width length area 'y/ 6
BED no. of lines widths length LQ ' area
depth to top of pipe So,
AGGREGATE r f
PERK RATE f AREA REQUIRED AREA AS BUILT
Disciaimer: 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 ? s PLUMBER ON JOB._,c rL tz,
a LICENSE NUMBER - E-
a
i
t
z
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
Sanitaay PeAmit-71'.
i' State S eptic i" : f
NAME Town1s hip St. CALoix County
Locatiodi, o6.L%, Section ~ T N,R/'
SEPTIC TANK
Size gattoms. Numbers o6 CompaAtment/s
Distance FAOm: Wett 12% oA gneateA 4tope 6t
Bu,itd.ing 6t. wettand/s 6t.
H.ighwatvL U .
DISPOSAL SYSTEM
D.i6 tance FAOm: Weft 6t. 12% oA gneateA 6tope bti.
Bu-itding wettand~s Ft.
H.ighwateA 6t.
FIELD DIMENSIONS:
WiRh o6 tAench 6t. Depth of Aock betow tite .in.
Length o6 each tine 6t. Depth o6 Aock oveA t.ite in.
NumbeA ob ti.-ne/s Depth o6 t.ite below gAade. .in.
Tota...length o j Zine6 4L: 6t. Sto pe o6 trench in pet 100 fit-
Di/stance between tines 6t. Depth to b edtLo ch 6t.
Totat ab~sonbtion aAea 6t2 Depth to gAOUndwateA 6t.
2
RequiAed aAea 6t
PIT DIMENSIONS:
NumbeA o6 pit6 GAavet around pith yes no
Outside d.iametvL 6t. Depth below .inter ~ .
2
Totat abzo)tbti..on aAea 6t A
AAea Aequited b 2
INSPECTED BY. TITLE
APPROVED DATE 19 7.
REJECTED DATE 197`
f
a
EH 115
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309
MADISON, WISCONSIN 53701
r~ REPORT ON SOIL BORINGS AND PERCOLATION TEST
A' C/- -
LOCATION 545/4, Section , TAU, R ~E (or) W, Township or Al~+s►palFty /))"j
Lot No. , Block No. County -
division Name
Owner's Name: r G r►1 j - - - - _
Mailing Address:
TYPE OF OCCUPANCY: Residence No. of Bedrooms kC Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT X r 7~
-y- 9
DATES OBSERVATIONS MADE: SOIL BORINGS-- 7 PERCOLATION TESTS
SOILMAPSHEET SOIL TYPE-__~----r`J~-"---- Gk - -
PERCOLATION TESTS
TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RA-I
CHARACTER OF SOIL SINCE HOLE HOLE AFTER INTERVAL
NUM- INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/?N
BER
P6 It
P -A t(
P-(
L-
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)
or / f oA~► r
113- 7 720',o ft
s 3 7 t/ 7 ~Lo
~ y2 ~ r cl t~
113-
1 61
i
LAN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.
,dicate on the plan the location and square feet of suit~.blerare s. Indicate
_ Inulaie s,
,seeded for building type and occupancy. 94A 00. 4 o
or distances. Give horizontal and vertical reference points. Indicate slope.
a¢
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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) / Certification No.
Address
Name of installer if known
CST Signature
COPY A - LOCAL AU T HOM T Y
PLI367 State and County
r State Permit # ~LPermit Application County Permit
for Private Domestic Sewage Systems County S7`
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. # -
A. OWNER OF PROPERTY Mailing Address:
1~9,' 4 5 --o's 1, C4 C.'-) " "o I Lj.) t
B. LOCATION: ~~'/4 . /4, Section, T N, R (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township Q,P,yt_0, Q
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family X Duplex No. of Bedrooms No. of Persons ~DV t=
D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES XNO # of Bathrooms d/ve-
Automatic Washer _,)_(_YES NO Other (specify)
SEPTIC TANK CAPACITY /D0e~ Total gallons No. of tanks 614 L°•
'Holding tank capacity Total gallons No. of tanks
New Installation Addition Replacement A Prefab Concrete
'Poured in Place Steel Other (specify)
;_FFLUENT DISPOSAL SYSTEM: Percolation Rate 1) A 3).20 Total Absorb Area _ ft.
Mew Addition Replacement *Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
`:seepage Bed: Length~Width -/y-Width ~ Tile Depth a2~'' No. of Lines
tr ~r q
-
Seepage Pit: Inside diameter _Liquid Depth_ I Tile Size
Percent slope of land Distance from critical slope
the undersigned, do hereby certify that the information I have reported is in accord with Section 1-1622
,Jisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prep::
by the Certified__Seil Tester,
NAME 0 C.S.T. # and other information.
obtained from W N (owner/builder►. ^y ~j
Plumber's Signatu MP/MPRSW# _-~9 Phone #~~T l t3
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
Cl~
co
Ac- A es
~ d
d '
- o o in e+ A L
~1 rc Q `OL,
.Q' DO
t L) 1
Q ~
14.0i
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i
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K V K
Do Not Write in Sp Belo? FOR DEPARTMENT USE ONLY J~
Fees Paid: State 0. Count Date
Date of Application
Permit Issued/Re}eeted (date) Issuing Agent Name
° Valid# Date Recd
Inspection Yes No
1. county (whit opy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) 4. plumber (canary copy)
State and County State Permit #
.B 67 rwr ~f' Permit Application County Permit #
for Private Domestic Sewage Systems County ~f -k'~' x
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
B. LOCATION: ~'6 515 Section , T~N, _L2(re (or) W_ Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village /
Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance 1
Single family Duplex No. of Bedrooms No. of Persons r'~ Kaz'S~/
D. SEPTIC TANK CAPACITY Total gallons No. of tanks C/✓e'-
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete x Poured-in-Place y 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 X Alternate (Specify) 5&- aRe---f', f - 5-e X :3 r ~c !~F'~•
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
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 _-V 7c Distance from critical slope
WATER SUPPLY: Private K 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 e- 7,C C.S.T. # and other information
obtained from n1r? < (owner/builder 7/-5'
y~ ~~7J
Plumber's Signature s MP/MPRSW# ~ VPhone #
Plumber's Address w S
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.
SSA
as .
r
ill PR ~:v ;.j
le s _
{ aP
1 ~
3 F
t
(09
Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY v
"~7 ~S
Date of Application Fees Paid: State, County S! Date
Permit Issued/Rai@4tad (date) 6 ~ id('~O Issuing Agent Name 4 Al -
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
4-INDIVIDUAL SEWAGE SYSTEM Sanitany pen~n~~.~
State Septic
g~. Cnoix Counxy
row n,6 htip-
-
NAM Section oy~~
LacatioAsf~.. S
I g~~. ~•~.y Pal.. SEPTIr, TA m,.~ b
ga~~.ona. Numbcn o6 Companment4~..---
S~.z 12~ on 9,%eaten o'tope _6t
fit.
p,Atance FnQm: Wets Wet~and4
DISPOSAL SYSTEM 12$ on,gneaten d4ope______--~ .
D,t,btance Fnam; We" j Ft.
Wea aa
~u,Ltdi.
High atf"4
FIELD DIMENSIONS o nook. beeow,.t~.~e~ Wi'n' '
.~nench~.-6 t' Depth 6
. OUdth 4 pth o~ nock oven
r
Length a each 44ne
b etoW 9nade in
`e pth 06 . i ~e i
7 m
Numben• o6 tine4 in pen 100 6t.
e o tnench
6 e ' 6.t. =rS..oP 6
Totat 4eri9th o 6.t.
~.ne4 t, Depth ta' b edna ch.
D ,a tanCe between z 6t.
t2 Vepth to g~toundwatcn_._..-
TotaZ ab4o4bt4on a4ea___...--6 2 o~ Coven: Papers on stAaw
Requ.i.ned area
PIT pIMENSIONS~ Gnave~ anound pit.o_,,,_-yea----no
6t.
Numbers 06 pit-4
pepth b elow 4n~e
pLL.ta..de d.ameUn t. 2
a t ~
Totat abdoAbtg t o I f 6 rn
6t2
Anea nequ~ned
TIT1. j~
INSPE ~ G 197.•
ODAU
DATE
REJECTEV