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Parcel 026-1034-70-100 01/05/2007 09:32 AM
PAGE 1 OF 1
Alt. Parcel 11.30.18.155A-10 026 - TOWN OF RICHMOND
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 - DCCI INVESTMENTS LLC
DCCI INVESTMENTS LLC
1505 HWY 65 PO BOX 445
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 1627 140TH ST
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 17.050 Plat: 3684-CSM 13/3684
SEC 11 T30N R18W PT SE NE BEING LOT 2 Block/Condo Bldg: LOT 2
CSM 13/3684 17.050AC EZ-U-1216/433
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
11-30N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
03/04/2003 712055 2161/504 WD
07/23/1997 1076/606 WD
07/23/1997 1076/600 PR
07/23/1997 574/298
2006 SUMMARY Bill Fair Market Value: Assessed with:
176844 Use Value Assessment
Valuations: Last Changed: 06/22/2006
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 17.030 2,400 0 2,400 NO 10
Totals for 2006:
General Property 17.030 2,400 0 2,400
Woodland 0.000 0 0
Totals for 2005:
General Property 17.050 2,400 0 2,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: 12/04/1998 Batch PRGRM
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 012-1018-90-050 01/05/2007 09:31 AM
PAGE 1 OF 1
Alt. Parcel 07.30.17.93B-05 012 - TOWN OF ERIN PRAIRIE
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
10/15/2004 00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - NASER, DAVID L & ARDELL F
DAVID L & ARDELL F NASER
1659 140TH ST
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE
SEC 07 T30N R17W PT NE NE COM N LN NE Block/Condo Bldg:
1/4 NE 1/4 WHERE THE WILLOW RIVER
INTERSECTS SD N LN; TH W TO POINT WHERE Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
CTH GG INTERSECTS; TH SELY ALG N R/O/W 07-30N-17W NE NE
CTH GG TO POINT WHERE SAME INTERSECTS E
LN NE 1/4; TH N TO WILLOW RIVER TH NWLY
more...
Notes: Parcel History:
Date Doc # Vol/Page Type
08/09/2004 771164 2634/504 QC
08/09/2004 771163 2634/502 QC
07/23/1997 1076/600 PR
07/23/1997 848/132 WD
more...
2006 SUMMARY Bill Fair Market Value: Assessed with:
155703 Use Value Assessment
Valuations: Last Changed: 11/30/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.380 51,000 300,700 351,700 NO
AGRICULTURAL G4 3.200 600 0 600 NO
Totals for 2006:
General Property 6.580 51,600 300,700 352,300
Woodland 0.000 0 0
Totals for 2005:
General Property 6.580 51,600 300,700 352,300
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
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP _
yI SEC. T- N, R j
ADDRIsSS~ _ ST. CR01_X COUNTY WISCONSIN N.
SUBDIVISION - LOT LOT SIZE`t
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOk' EVF,RYTHING WITHIN 100 FT.ET OF SYSTEM
r
44-
I I I I ~ ' I
i i I I
In~dilcat'e North Arrow -
A~ _ - - I
1 I I ' i 7 SCALE:
SEPTIC TANK(S) ~~MFGR. _ / CONCRETE STEEL
NO. of rings on cover j Depth
PUMPING CHAMBER SIZE PUMP MFGR_ MODLL NO.
GALLONS -Per-Cycle
TRENCHES NO. of -width length area
BED NO. of lines width length area .,2~ y'
depth to~top of pipe X
NUMBER OF SEIPAGE PITS Outside diameter total pit area
AGGREGATE II)v..c_ y
PI?RK RATE AREA REQUIRED AREA AS BUILT
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
GREASES AND OILS SHOULD NOT BE DISPOSED T ROU SYTEM~
~CTOR_ G -
DATED PLUMBER ON JOB 7
LICENSE NUMBER
Z
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
San.i.tany Penm.i-t 4"71
` State S e p.t.i c qs 7
NAME V o'fl e Townehip_W_,`n j1 vy)6 yld S CToix County
Lacatioa IVE% N Section r~
SEPTIC TANK
Size -gattona. Numbe4 o6 Compan.tmen.tz I
r~
DiA tance Fnom: Weft (o~j 6.t. 12% on gnea-ten z tope 6.t
Buitd.ing _6,t. W et.Eanda 6 t.
DISPOSAL SYSTEM flighwa.ten ~ 6.t,
D.iztance From: Wet JGgjl~ 6#, 12% on gnea.ten 4Qope 6.t.
Bu.itd.ing 6.t. W e.t.Eanda Ft.
N.ighwaten 6.t.
FIELD DIMENSIONS:
Width o6 -tn.ench~6.t. Depth o6 rock be.eow, .t.ite~.in.
Length o6 each tine 6t. Depth o6 rock oven •t.ite 2-- in.
Numbers o6 tine.6 Z Depth o6 .tile below gnadely in:
To.tat .Ceng.th o6 Z.ined 6z. Stope o6 .trench in pe'. 100 6.t.
DiAtance between Z.ineb if% -t. Depth .to-bedaock 6.t.
To.ta.b abe onb.tion anea i 6.t2 Depth to gnoundwa.ten6.t.
Requited anea 6,t2 Type o6 Coven: Pape on. Straw
PIT DIMENSIONS:
Numbers o6 p.i.te Ghavef- around p.i-ta yea no
F
Out,6 ide d.iame-ten Depth below .in.be-t 6.t.
To#at abbonb.t,i.on 6.t2, z
2
Area %equiAZ-d-..._x.._,.._. 6.t n,
INSPECTED TITL
APPR, D DATE 19 7c'-(--' "IS
REJECTED DATE 191
_A
EH.115
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: '/4, &C114, Section & T3A, R LgE (or) W, Township or Municipality r d~ ~ ~ ~T
Lot No. Block No. County
Subdivision Name
Owner's Name: ~
Mailing Address:
TYPE OF OCCUPANCY: Residence t~ No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS
SOIL MAP SHEET SOILTYPE
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
P- 3
P 2- 34
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- p
7-Y- 15
/ n
l -s l ~ ~ 5
B- 4-.r5
B- j
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the locationand square feet of suitable area . Indica 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.
I
{
~ I I r I I
I i
~ : I s I i a
s
I i
- I - - I --1 _
I, 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) G l~ Certification No.
Address l~
Name of installer if known
CST Signature
COPY A - LOCAL AUTHORITY - J
State and County State Permit #
PLB,67 Permit Application County Permit #
a ~
. for Private Domestic Sewage Systems County S ~~-1---
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
B. LO ATION: % Section T 317N, R E (or) W Lot# -City_
Subdivision N e, e nearest road, lake or landmark Blk# Village
Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family L---buplex No. of Bedrooms 3 No. of Persons
D. TYPE OF APPLIANCES Dishwasher _-YES NO Food Waste Grinder YES L-40 # of Bathrooms-?--
Automatic Washer i/ ESYES NO Other (specify)
E. SEPTIC TANK CAPACITY /zIL-t~ Total gallons No. of tanks
*Holding tank capacity Total gallons No. of tanks
New Installation Addition Replacement Prefab Concrete
*Poured in Place Steel Other (specify)
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 1.5 2) < <; 3) Total Absorb Area6 /-5 sq. ft.
New Addition Replacement ~*Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches _
Seepage Bed: Length.sa Width IA' Depth Tile Depth a „ No. of Lines I' /I
Seepage Pit: Inside diameter Liquid Depth Tile Size y
Percent slope of land x; ~O Distance from critical slope
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 Certifie Soil ~Tester, n'
NAME / G 11 9' ! J C.S.T. # and other information
obtained from (owner/builder). 117 Plumber's Signature MP/MPRSW# /d 5Phone
Plumber's Address v s
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
Do Not Write in Space elow - FOR DEPARTMENT USE ONLY
Date of Application c~6 Fees Paid: State County Date U
Permit Issued/Rejected (date) _Issuing Agent Name
Inspection Yes)~_No 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!