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Home My WebLink About022-1041-30-000 ocn0 lcvo C7 r~ `r1 o m f c' 3 co D m ii m y y v n c M CD CD 3 3 ~ I ~ Q U) v o v N p ao N O ( m (.n ° `C • co CD 3 (D co cn cn 0) j 00 N CL tD Z CL N 77 : O ~.y O O W O (D CD 00 t o CD y N N] N \ 1 NO - A ? CD ~ 0 , CD CD 0) 3 fD O C7 O 3 tlC W f o O L, U) 00 01 A O (n D 6 F' a • D CD N N O CD CD W ' 3 3 o (a CD C O CD F~ L CD ((Di CO CO ;o a can 0 r (n C v v v CD "WA• =zr Chi 0 rr3- m c, v cn Q° o o N n C2 _ - N Z zcnz D (D 0 0 v O o o CD m • N ~ N CD C N CD W (D a 3 ~ z CD fn O = O A Z CO'1 N X n A Z O o~ a 0 W m v' C Z 3 -P, ;D O : z 3 m rn ~ C0 P N p~ N d y CD N C1 D C1 CD C C1 C1 < C7 c:t 3 q G N X O 0 T a) ~ N07 C Z a Cp _.O O O CD > CD N y~ (n * 0 ,0 N X O CD CD 0) t0 O d 21 _OID m C CD d N X, 0 A 07 0 N Cr N :3 6- CD O X a O 7 w 0 A Efl O ti H yO O CD O L Parcel 022-1041-20-000 01/03/2007 04:12 PM PAGE 1 OF 1 Alt. Parcel 15.28.18.2256 022 - TOWN OF KINNICKINNIC 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 - JAWORSKI, DALE A & RHONDA L DALE A & RHONDA L JAWORSKI 382 OLD CEMETERY RD RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 382 OLD CEMETERY RD SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 2.000 Plat: N/A-NOT AVAILABLE SEC 15 T28N R18W 2A IN N1/2 NE1/4 COM Block/Condo Bldg: 1082.6'S OF NE COR S 87 DEG W 818.32'N 53 DEG W 410.96'N 340' TO POB N 264'W Tract(s): (Sec-Twrl-R66 40 1/4 160 330'S 264' TH E 330' TO POB 15-28N-18W ins ~ Gam= ~ ~ °r~-cam, Notes: _ Parcel History: d4-1 Date Doc # Yol! e 07/23/1997 V JAI' c r 4 Y~ 14 Ile 2006 SUMMARY Bill Fair Market Value: Assessed with: 178944 201,600 Valuations: Last Changed: 08/10/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 40,000 146,100 186,100 NO Totals for 2006: General Property 2.000 40,000 146,100 186,100 Woodland 0.000 0 0 Totals for 2005: General Property 2.000 40,000 146,100 186,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 306 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 022-1041-30-000 01/03/2007 04:12 PM PAGE 1 OF 1 Alt. Parcel M 15.28.18.225C 022 - TOWN OF KINNICKINNIC 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 - LARRABEE, KENT A & BARBARA KENT A & BARBARA LARRABEE 380 OLD CEMETERY RD RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 380 OLD CEMETERY RD SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 1.530 Plat: N/A-NOT AVAILABLE SEC 15 T28N R18W 1.53A IN NE NE COM Block/Condo Bldg: 1082.6'S OF NE COR S 87 DEG W 818.32' TO POB N 324.93'W 330'S 80'S 53 DEG E Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 410.95' TO POB 15-28N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 507/42 2006 SUMMARY Bill M Fair Market Value: Assessed with: 178945 288,300 Valuations: Last Changed: 08/10/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.530 30,000 236,100 266,100 NO Totals for 2006: General Property 1.530 30,000 236,100 266,100 Woodland 0.000 0 0 Totals for 2005: General Property 1.530 30,000 236,100 266,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 124 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT OWNER „ TOWNSHIP ;X tea. ;X _:~---_EC . / T 1eN, R / ,~W T. CROIX COUNTY WISCONSIN. SUBDIVISION LOT LOT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM c M . h t i' `L j µ ti, A I di ate orthl Arrow S CALF : yam' SEPTIC TANK(S) MFGR. &NCRETE STEEL NO. of rings on cover Depth PUMPING CHAMBER SIZE PUMP MFGR. MODEL NO. GALLONS Per Cycle TRENCHES NO. of width length area BED NO. of lines width length area dep tai -to top oT pipe NUMBER OF SEEP GE PITS Outsi e diameter total pit area AGGREGATE PK RATE AREA REQUIRED AREA AS BUILT C Disclaimer: 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-SYTEM. INSPECTOR DATED PLUMBER ON JOB LICENSE NUMBER ?iSflZZf1AI SSNSOIZ 30f NO MImlhl aayda ummasxz, *MSJS sIHI H9noxHl QSSOaSIQ Sg 1011 (FMOHS SzIO G& TV •ainTTe3 3o asneo auTua:a oz 110jja XJaAa axem TTTM Aluno0 agj pajou si ainTTe3 3T `xanaM.og •uoTleiado maIS aOJ XITTTgeTT ou samnssa ~junoo xTojo -IS •uoTIjon2asuoo 3o juTod sTgl ju -4aadsuT aTgTssod IOU ST IT Ieq-3 sea.ze .zagpo aia ajagl •sapo0 aAT:jsz:jsTuTmpV a:Ie:IS q:1TM aoueTT co• alaTdmoo ATdmT IOU saop Ajunoo xTojD •z$ Aq malsAs sTgi 3o uoTazadsuT aql :aamTej3S% zZing sd vaxv aaxzrnbax dadv 31VH Hleo~~~ adTd go doa oa g3dap eaie qZ?uaT TIPTM saUTT To •OU r- sale q:lsua.T g2pTM 30 'OH SSHON: TISM Dla q:j da(I a@AOO uo s2uTi JO 'ON 'ISSIs ala-aoNoo °xoaw (S)XNVL ona 1 21rivD S - 1 moa.xy !LpaoN a eozptzi i ~I I i rt i r Kals,IS a0 ISSN 001 NIHZIM ONIlUMdaAS MoHS OZ-Z9H 3o sauamazTnbai aaam o4 suoTsuamTp 4 saau2asTQ. MS IA NV`Ia SZIS 10'I I0'I NOISIAICE. HISNOOSIM `XINnOO XIOUD 'IS ` SSS2aQQv M S `N Z ' oas IIHSNMOL ` xa~ic~c luoaau NaISns h2IVIIKVS IZIng Sb REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM Sanktany PeAm-it State Septa \MEYon Town,6hip L St. CAoix County rCtSection Lot Subdivision IPT IC TANK t.V Si ze 1 0 0 0 gattonz Numb eA o6 eompaAtment,5 .stance 4Aom: weft Buitd.ing 1.2% afope Highwaten IMPING CHAMBER Size gat.Ean4 .Pum~ n 6aetuAeA' Model NumbeA 11-DING TANK me-nl Size gattona Numbe 4le PumpeA Ata , a tanee 6Aom: Wett Building 12% .5tope HighwateA SORPTION SITE Bed T e ch _ a tance 6Aom: Weed Buitding t2% tope H.ighwateA "SORPTION SITE DIMENSIONS W.('.dth o6 tAeneh it RequiAed aAea it Length o6 eaAhe it Depth a6 AacFz bekaw ttiPe in Numbers o 6 .~..iDepth o 6 Aoek o ve_A ti le. in Totax Eength 4 6t Depth o4 tiee betow gn.ade in 0.i.stanee bet e.e it Stope o6 tAeneh in. pen 100 it Y I ukul ab6 uApt-i.on -aAeu it Type o6 CoveA: PapeA oA btrcaw I T DIM.ENS`TON`S Numb ea o ptite ~I GAavet aAOUnd pit5_ eyed no Out,stide diameteA C J( 6t Depth betow in-et it Tatat abeoAption anew(, ~t AAea kequ.ined - At 'J S P E C T v~ TITLE PPROVED r DATE > 19 8(l FJECTED DATE 198 I ASON FOR REJECTION_ i REPORT ON INSPECTION OF SANITARY PERMIT # (1) Name and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection Name, Address, License No. o ns a ing Plumber Time of Inspection (3 )INSTALLATION CONSISTS OF: ❑ 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: (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 ❑ N0; 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: LB-67 State and County State Permit #~5 P u w 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: I E N ~ f' L'! r j-7 VJ1= B. LOCATION: jr '/4 N '/4, Section f r Tea N, R /-,S~ E (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township is A,/,A1/V,- 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 04 `v 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 </f q-`"~ Total Absorb Area sq. ft. r, - fr New Replacement Alternate (Specify) 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 7 ` Liquid Depth = No. of Seepage Pits `V Percent slope of land Distance from critical slope 1NATER 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 A'Er~ /ZI < Z C.S.T. # and other information obtained from (owner/builder). Plumber's Signature" - - MP/MPRSW# 6666L-? Phone # 71.5-JPf~> Plumber's Address ~z 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. I ( 4 ~ ~3 g F I _.aP .e., e ~ ..s e ~ ..a... a a.., i..., e ,....e,. e e - P.e.n... ..«.,,,m..c-.._. E . e,,.. ..,e.9.,,,. ~ a. ..«.w,,., n ,..e..... a wP P _ ~ m - ~ e E ~ .,ems... m s s~ y.. ....,n. .e .w~ z.. , ...a. e 3 a .m _e _ ~ s a m . a Wa t r .m, _ - ~ e r. a,.. s--- ° a d..- M p._ L'2state ot Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY of Application - C~ Fees Paid: Stag County Date t Issued/Rejected (date) Issuing Agent Name IL2 < tion Yes 4_N0 State Valid# Date Recd unty (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 (pink copy) 4. plumber (canary copy) Rev-- , r 'w\ 1 rte. 4 G m J w ~ I V I . In r 1~ ~T n 1 , t I n I rl O nr z ~f rn v~ to o ~ r F T RI C m ~ ~ zl Zt- z m 1~ m LA ~ C C i.n In a x E I It 15' Rev. 9/78 /,4 6' 2- j~ • REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION: '/4, Section /2 T N,R/ E (or) W, Township or Municipality hr',,Vy' C'i( /,V y, ~ Lot No. , Block No. County 2 p De L ub ivision Name Owner's/Buyers Name: '4~B~oA ,~vT L11 149e_C_ Mailing Address:T .2° TYPE OF OCCUPANCY: Residence No. of Bedrooms Z' COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT-ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS ~S L~ri _ /yip SOIL MAP SHEETGC~ NAME OF SOIL MAP UNIT PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE ^'UM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- T/ NOT 5; LD P- OX 9-VC E P-/ " oA)E F 5c P- 2-- a4 1 o /ED 50 / L . ;PSER ~~Af S ~E/o O P- /~,P~S P- No T , i4ll _ G S 7Aez;c1 0- E P_ j-, k>eclo 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- MOVE > /,5 tSV ~L 2j .,Z 6A/. SL Z0„ oiP SL 23 C5 L;i+ES~a ~ B- B- /I/dAOE c/ A/ l- / "L~ elv. 5i/ 32" af..S1_ m,° / catiMO~ B- / rfi,Cr Ve, A-JOTS ls~SL w LrMtS CIE /l°. AW '72 B- ~Gwe 10011E 41 SA,vD . B- 3 V .Nd>vE 4 - y0 " /CJ' /~aJ. SL 3~"6cL •w;A ~aM~,au pr S~i~c7~ PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy : ~ Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. 5eEA46,6 oof 014--le ?,_e ~ i ~ t i ley f~r E E ffOk'Z, II~P% 70, ~ ; • = ~r4tkk~%v~ FX~Fry I ~If •W " E g (3 _ - 3 1 I, the undersigend, hereby certify that the soil tests reported on this form were made by me in accord with the proce dures 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. ~j (print)" Certification No. it Name -3 yupNo14/ 401S• Address /f it66- /i 1✓i//F EX ~rfUf~Ti f4G Q 6 c~PTS Zvi f -Name of installer if known C Copy A -Local Authority EH. 115 -Rev. 9/78 Piz yE z o~ ~ "7~Cf REPORT ON SOIL BORINGS AND PERCOLATION TESTS / f WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION: '/4, /V4. Section N,R/3' E (or) W, Township or Municipality Lot No. , Block No. County Sf' A 0/ V Owner's%Buyers Name: L~},fVA Subdivision Name L A Mailing Address: (4- , 9 Z Pjyg e TYPE OF OCCUPANCY: Residence X No. of Bedrooms Z COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW -REPLACEMENT X ALTERNATE SYSTEM -OTHER DATES OBSERVATIONS MADE: SOIL BORINGS WO PERCOLATION TESTS P-2-r44 SOIL MAP SHEET ~C- NAME OF SOIL MAP UNIT NI C k;- -l _ 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 I PERIOD 2 PERIOD 3 P- 72. /Zv1'/'C.t/- To P- P- 2- 1.2 JX,0141ft- 'to 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 yS ~J E OBSERVED ESTIMATED HIGHEST ~ a IF OBSERVED IN INCHES r1 !/O a 7 J z B J coo ;,-iv - o£ Di` 'wW . !14 6 2 B- aZ S . Z w /oc7sc 7rS. B- NOV 4 W EI?4 1_3.3' „ " /?,v . ,SL 2 „ 0, 0. SL /S0-4 A w 61 V . SG B- G/e. (OW ail T. Ae0 /Y 31, ..S- 4-, 4i_4Ej''1t'E B- A/0 N,6- t Wfg~, 10" 5i:/- Cp1,,44 v OiP'/~v N B- /Qn S._~~ SAT w Gi.yC v PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. Ste- ~~6E7 SE~7 M~ - ZS = I 1EI1,4 Tid Q~ t = 2 3 r.N " 13~ lae /4, " Ian y aM Q N r b e m. NQ T 4 r)Af/i2 0 (l_ aer t~_ n i Per e 4.1 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. - Z " Name (print) /Q LIT Certification No.~-~ ' .)7d _r Address Xr. -3 (J A~ i~) S f_LY .Name of installer if known Gr441,2*4 CSTSignatu Copy A -Local Authority re- R-I c~