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Parcel 020-1026-60-000 08/11/2006 05:03 PM
PAGE 1 OF 1
Alt. Parcel 15.29.19.114A 020 - TOWN OF HUDSON
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 - BAER, BEVERLY J
BEVERLY J BAER
1515 N INNSBRUCK DR
FRIDLEY MN 55432
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 2611 HUDSON
SP 1700 WITC „ S- 14
Legal Description: Acres: 39.560 Plat: N/A-NOT AVAILABLE
SEC 15 T29N R19W SE NW EXC PARCEL TO CO. Block/Condo Bldg:
FOR ROAD AS DESC IN VOL 734/467
Tract(s): (Sec-Twn-Rng 40 1 /4 160 1/4)
15-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
03/06/2006 819867 EZ
07/23/1997 900/551
07/23/1997 734/467
2006 SUMMARY Bill Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 10/25/2005
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 36.590 5,300 0 5,300 NO
NO
0 100
UNDEVELOPED G5 0.970 100 Qn
OTHER G7 2.000 53,600 230,400 NO
&
Totals for 2006:
General Property 39.560 59,000 176,800 235,800
Woodland 0.000 0 0
Totals for 2005:
General Property 39.560 59,000 176,800 235,800
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
SEE PAGE
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i~
DICK KENALL •
Broker oN~ner GILBERT E GINS We Keep the Spots
KENALL REAL ESTATE SALES & SERVICE Debme CQeaKim
1511 Coulee Road Boat Docks • Chain Saws CWU •
Lawn & Garden Equipment
Hudson, Wisconsin 54016 Wood Stoves •
Office (715) 386-3700 Jim Gilbert, Owner When You Care Enough To Send
208 Locust Street Your Very Best
Hudson, Wisconsin 54016 "Hudson's On Location Dry
ERA' REAL ESTATE (715) 386-2233 or Cleaner For 38 Years"
Eac•, office ;noeP2ncki)!':, -fled and opted (612) 436-6781 Josk Bm.ern(eind
ta -
AS BUILT SANITARY SYSTEM REPORT
OWNER ~ TOWNSHIP ~ ~ SEC./,-5 1,19N, R/W
- - ADDREST, CRO_ C UNTY WISCONSIN.
SUBDIVISION LOT- LOT SIZE
Distances & dimensions to meet requirementsWof H62,20
SNOW EVERYTHING WITHIN 100 FEET OF SYSTEM
t'I d_i a e oath Arrow I
SCAL, : r I
SEPTIC TANK(S) MFGR.
CONCRETE STEEL
NO . o . rings` on cover Depth
PUMPING CHAMBER SIZE PUMP MFGR. r-MODEL NO.
GALLONS Per Cycle _
TRENCHES NO. of width length area
RED NO. of lines r width Z,.2 lengthl area
dept to top o pipe'( G,
NUMBER OF SEEPAGE PITS Outside ameter to
-
AGGREGATE -
PERK RATE RE REQUIRED AREA AS BUILT
Disclaimer: The inspection of this system by St. Ctbix County does not imply
complete compliance with State Administrative Codes. There are other areas tha
it is not possible to inspect at this point of construction. St. Croix County
assumes no liability for system operation. Howe /eo if failure is noted the
County will. make every effort to determine causf fail ure.
GREASE'S AND OILS SHOULD NOT BE DISPOSED THROUGH S TEM. J
INSPECTOR(~J;,~
DATED PLUMBER ON JOB `
LICENSE NUMBER- ~,r c3
j11 C
171~, V
/ , TOWNSHIPIC. 015t 0 c
0. RESS 1 ti i , ST. CROIX COUNTY, WISCONSIN. -7- -7`-
'3DIVISION
LOT LOT SIZE
PLAN VIEW
-Distances b dimensions to meet requirements of H62.20>
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
V41 Ali, zz. Ti{
w J 1~ok~ .
410 ley /
,ter`
l r
TIC TANK(S) Z : MFGR.'l .-5 CONCRETE STEEL
NO. of rings on cover--,` _ Depth DRY WELL
-NCHES NO. of width length area RECFIVF[J
no. of lines - width _ IenPfh area 980
depth to top of pip r
e hNING
GATE OFFICE
'.K RATE J AREA REQUIRED $ /G, AREA-AS BUILT rC
.,claimer: The inspection of this system by St. Croix County does not imply comp L ;
Reliance with State Administrative Codes. There are other areas that it is not possible j
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.
- 'INSPECTOR,
DATED PLUMBER ON JOB AZ -
LICENSE NUMBER
. a. -1~.e .
REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM
SanitaAy Petcmit
State Septic
NAME
Town,5hip2o. St. Ctcoix County
/ Z_Clxlz AZ4) - I r
Locatio Section,4f Lot # Subdivision
SEPTIC TANK
Size/ -L-4- (1. gattons Numbetc o6 eompattments
Di6tanee A,t om: WeZt Building 1.2% s tope
Highwateh
PUMPING CHAMBER
Size gaftgns _ Pump ManuAactune.tc. Modef Numbetc
HOLDING TANK
Size ga tons Numbet oA Compattment6
Pumpeh Atanm Sy/stem
Di,stanee {nom: Weft Buitding 120 6 tope
Highwatetc
ABSORPTION SITE
Bed-/2A,,) Tnench
Di6tance {tcom: Wete Building 120 scope
H.LghwateA
ABSORPTION SITE DIMENSIONS
Width o4 ttceneh At Requited area At
Length o6 each Stine. At Depth o{ kock below Cite in
Numbetc oo imes Depth o6 tcock ovetc ti e tin
,,~LTotaf_ Length oA fines At Depth o6 -tile below gtcade i n
l
~yi6tanee between Unes 6t Slope o6 theneh ~lkn. peh 100 At
j t' Total ab,5otcption atce_a At Type o6 Covet: Papers o s ttc.aw Fr'
PIT DIMENSIONS
Numb etc. o A pits Gkave.E aAound pith ye's _no
Outside diameters At Depth beEow intet
Total absorption a4ea At
Area nequ' e jj
INSPECTED BY t~~! TITLE
APPROVED A/ DATE C~ 19 8
REJECTED DATE 198
REASON FOR REJECTION
REPORT ON INSPECTION OF SANITARY PERMIT #s
(1) Name and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection
me, re s, icens No. o installing plumber Time of Inspection
3 I STALLATION CONSISTS OF: Septic Tank ❑ Seepage Trench ❑ Dosing Chamber
❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System
BEN ermanent reference Point) escri e:
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
(13) Has system been installed in floodway? ❑ YES ❑ NO Floodplain? ❑ YES ❑ NO
DILHR-SBD-6095 N.05/80
Signature of Inspector:
PLB State and County State Permit #
67 permit Application County Permi
/
d
-zZ
for Private Domestic Sewage Systems County
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROP Y Mailing Address:
IV Ao, 4r.., 15
B LOCATIO 1 la '/4 R h/ /a, Section , N, R_4 E (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township L- XX U~ljo
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 concrete Poured-in-Place Steel Fiberglass Other (specify)
New Installatio Replacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate ~d Total Absorb Area -sq. ft.
NewReplacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. -Width ~Depth Tile depth (toy No. of Trenches
See
page Bed: -Length Width! _Depth- Tile depth (top) No. of Lines-
Seepage Pit: Inside diamee r Liquid Depth No. of Seepage Pits
Percent slope of land- 'Y - Distance from critical slope LamAt P
WATER SUPPLY: Private U 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 Certitie Soil Tester, ^yZZ
NAME
1/ 1,41 /1
/ C.S.T. # and other information
obtained from i{. w/')
- (owner/builder)
Plumber's Signa re MP/MPRSW# Z Phone # Z,3
Plumber's Address
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.
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Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application Fees Paid: State`' 5-, County ate
Permit Issued/R-,- ~ (date)- PC) Issuing Agent Name
Inspection Yes No State Valid# Date Recd
1. (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
gate (pink copy) 4. plumber (canary copy)
Revised Date 7/1/78
E K 115 Rev. 9/78
` - REPORT ON SOIL BORINGS AND PERCOLATION TESTS
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION. '/4, Section 1,T-"v 4
/_5 ,T~N,R E (or ,~fownship or Municipality/ C o),,-
Lot No. , Block No. County
yy ybdiyisio Name
Owner's/Buyers Name: c°PPc/ kA
Mailing Address: G0
TYPE OF OCCUPANCY: Residence X No. of Bedrooms c>-? COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW, REPLAC ,MENT -ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS d PERCOLATION TESTS
SOIL MAP SHEET' r~ x b NAME OF SOIL MAP UNIT -ICIZA At,
_ PERCOLATION TESTS
TEST HOURS WATER IN TEST TIME
DEPTH CHARACTER OF SOIL DROP IN WATER LEVEL, INCHES RATE
NUM INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/Ifd
P- l 9 ITS 7 7 I
P-2- ca 3 ' 3 ' W
P- r
.7 Z 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- 7X Al
2L
B- t 2 q ? 2~ ( ii
L.
B- C° Z ; l 7 ~i
B- 74 7 Ts . L
B- v 7 S t- ,2G.' S -
113-
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the ioryj_nd square feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancy y r`U~1,4 Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope.
Tc,;,AALle ~1t_
304 e Alk
0A,izi ' 1t' aKwclZ (;,-f 0~
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70 Ail i4i~e~
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64 le,
I, the undersigend, hereby certify that the soil tests reported on this for were made by me in accord with the procedures and methods
specified in the Wisconsin Administrative Code, and that the data record and location of test holes are correct to the best of my
knowledge and belief. .Q
Name (print)- - P UI'A2 Certification No.
I
Address
Name of installer if known
Copy A -Local Authority CST Signature
L
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FORM 17-3509
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