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Home My WebLink About022-1058-30-000 0 con 3 CD (D '0 o c CD m ^ CD ~ ~ ~ y \ 1 O CL z n N v 1 0 w e= 0 0 3 j ~ N 7 UT - CD W W O W N) O O O = N) " 0 O D 3 0 o 3 N O O N N C _ ~1 (D O (V C1 (D C D a CD Cn N m a o 3 a ((D a (D p o ` w al Z CD Co N O O N o c 'T cr ~ 0 0 0 rr o < 3 B < r3 . C)7 fA fA N O CD m v o v o o m ° E. v -a Q T 1 l a- _ (C 41 A N ' N z z O Zou z D a v o m CD N -O N Z (D co C .0 (a c m N W m n 3 0 p Z Cl) ( D O 0 A 0 CL C.) R O M N O W M m 00 z 41 0 3 0 cn 3 m N z (D A Cl) o a + a o - = C N N C X Z CL O O (D (D o m N O w, ~ b ~ S m Z ~ N V N O i O A = dC A to O °w C) N O L ti Parcel 022-1058-30-000 12/27/2005 05:05 PM PAGE I OF 1 Alt. Parcel 20.28.18.320A 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 - HILL, JAMES R & DONNA JAMES R & DONNA HILL 216 LIBERTY RD RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 216 S LIBERTY RD SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 30.120 Plat: N/A-NOT AVAILABLE SEC 20 T28N R18W SE SE 463 PAGE 81 EXC Block/Condo Bldg: LOT 1 (4.88A) & LOT 2 (5A) OF CSM VOL 4/1064 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-28N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 631/133 2005 SUMMARY Bill Fair Market Value: Assessed with: 143578 Use Value Assessment Valuations: Last Changed: 08/10/2005 Description Class Acres Land Improve \ Total State Reason RESIDENTIAL G1 3.000 50,000 198,500 248,500 NO AGRICULTURAL G4 11.120 1,200 1,200 NO UNDEVELOPED G5 16.000 40,000 0 40,000 NO Totals for 2005: General Property 30.120 91,200 198,500 289,700 Woodland 0.000 0 0 Totals for 2004: General Property 30.120 42,200 143,300 185,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 204 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 • AS BUILT SANITARY SYSTEM REPORT dER r t , TOWNSHIP n (C SEC.,10 T 09N. R W j. ADDRESS , ST. CROIX OUNTY, WISCONSIN. ':DIVISION LOT LOT SIZE PLAN VIEW (~LZ,l~S ~7j(~~Q,lL7 -Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM jI r- 'TIC TANK(S) MFGR. CONCRETE STEEL NO. of rings on cover Depth DRY WELL 'NCHES NO. of width length area no. of lines width length area 1.:1 depth to top of pipe REGATE ;K RATE AREA REQUIRED. AREA AS BUILT 'Claimer: The inspection of this system by St. Croix County does not imply complete pliance 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 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 ' i LICENSE NUMBER ,I REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM Sanitary Permit State Septic NAME Town.Ship St. C&oix County,' Luca ionSection,~O Lot ~ Subdivi,6ion SEPTIC TANK Size yo o gattond Number o6 eompantmen" Dietanee 6nom: W e I t Building Lp 1,2% 6.Lope Highwate,t ZGXj PUMPING CHAMBER Size Pump Manu 6actunen Mo det Numb en HOLDING TANK t Size gait nb Na4e4,:> ~ Com.pantmen-ts Pumpet,a. A rtn n' ya tem 14.6 tanee {nom: eL~ Building 120 ~stope______~ _ Highwaten ABSORPTION SITE Bed_ 70 Tkench r~ 3('/s tanee 4&om: We_ZX O Buitding~ 12o atape._ Highwaten-.,p tog, ABSORPTION SITE DIMENSIONS c Width o6 tnenehu~/g 6t Req uX red anea S f Length o4 each tine l? -,6t Depth o6 kock below tite _X.n Numbers o6 roes Depth a6 Lock oven tile. ~Z... i.n TotaX Length ob Zwnea6t Depth ob tiZe betow ghade 3 n. Di4tance between tine.e 5t Slope ob ttench in. pen 100 At y 104-u.,abl~,u)Lpt.4.un anea T2 6t Type o6 Coven: Papers a C,6tnaw PIT DIMENSIONS Numbe.n o6 pits ,Gnavet around pits yeno ryr Outs de diameters Depth below XnXet At h Totat abbo4-ption Aea 6t A&ea ,tequi4ed ~ INSPECTED V TLE A 116 O V E D, OWN DATE 19 8 _0 I REJECTED DATE 198 REASON FOR REJECTION -1 REPORT ON INSPECTION OF SANITARY PERMIT # (1) ame and A ss~Qf Permit Holder Person/Persons at Site (2 )Date of Inspection Time of Inspection Name, ress, cense NO. OT installing Plumber s e,,,LJL i, , P 3 INSTALLATION CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber ❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System BEN 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: (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: L~„w PLB 67 State and County State Permit # 07~ y/ f Permit Application County Permit # 7Z 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: B. LOCATION: mod= Section t!C , T 2,q N, R C (or) +Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township jjrry~~iyyr~ C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family oe"" 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 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: Length 57,5 Width_ /L Depth 1 2 Tile depth (top) /f 'JO No. of Lines 3 Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land Distance from critical slope WATER SUPPLY: Private [ Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: 'k" 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 Spit T""e,sst~ter, NAME 4-!) k., A-11' refzz-~ 1 C.S.T. # 1.''7 Z;'Sri and other information obtained from (owner/builder). Plumber's Signature P/ Phone #V..;? 7 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. E E L r E Itbss~5~ r ~ t i € N a. a 4 14 G ~ r ' /De~S•7 ~t ~ i w. 5G A 1 J4 3' f Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application Fees Paid: State, 3S County Dat ~-/5 Permit Issued/Rejected (date) 9 - / 5 Issuing Agent Name Inspection Yes 4 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 Ilk- B 1 B21 ti `x'1,3 E!u 4 ,'L5 Rev. 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS y WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION Section O jT~EIN,R L E (or W Township r Municipality F= Lot No. , Block No. County Subdivision Name Owner's/Buyers Name: Mailing Address: TYPE OF OCCUPANCY: Residence ✓ No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS c-- ° SOIL MAP SHEET NAME OF SOIL MAP UNIT PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RAT NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- Z c- e---) 7-11 c_') 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- r B- Zr- "A B- B- ~C~ / / oh U B- CJ S~ SAO / 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. S'- ..~-~-1''~- F r4 2 scZ / i~'.~Q>C G~ C~ O L`s mac-- ~j _4 . p E TN /.il tea., f' ,r ' s 3 i E E i i . % it ~ I F ~ _ ~ a s I 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) Certification No.~ - Address --fZ 1 Name of installer if known Copy A -Local Authority CST I ignature 115Rev. 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS ` WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION L" /4, Section=- - T' 'N,R_E (or~W ownship r Municipality County Lot No. , Block No. r 2 Subdivision Name .C Owner's/Buyers Name: Mailing Address: TYPE OF OCCUPANCY: Residence No. of Bedrooms --s COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS - &-y PERCOLATION TESTS SOIL MAP SHEET NAME OF SOIL MAP UNIT PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- SINCE HOLE HOLE AFTE INTERVAL MIN/IN BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- P- P- 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- B- B- B- 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. M _ (D C , N GC/ ~Y G~ s &14 _7 $ I 300 \ a i I e - 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. N :,,,m- Certification No. S-~5=.c Address fc i ~t~x i t- 1a~ L ~r Name of installer if known r Copy A -Local Authority CST jgnature -