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Parcel 15.30.18.227C 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 GEORGE W KTSANES O - KTSANES, GEORGE W 1923 60TH AVE BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 1548 HWY 65 SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 0.000 Plat: 0927-CSM 04/0927 SEC 15 T30N R1 8W 7.11A IN NE SE LOT 1 OF Block/Condo Bldg: LOT 1 CSM VOL 4/927 EXC CSM 13/3769 (RD) ASSESSED BY DEPT OF REV-MFG Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 15-30N-18W NE SE Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1238/407 WD 07/23/1997 852/550 2006 SUMMARY Bill Fair Market Value: Assessed with: 176946 193,400 Valuations: Last Changed: 10/18/2006 Description Class Acres Land Improve Total State Reason MANUFACTURING G3 7.110 36,600 114,200 150,800 YES Totals for 2006: General Property 7.110 36,600 114,200 150,800 Woodland 0.000 0 0 Totals for 2005: General Property 7.110 38,400 124,700 163,100 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 NER rs TOWNSHIP r r ADDRESS a - r NQ ST. CROIX COUNTY, WISCONSIN. fj~~~ _ 3DIVISION LOT LOT SIZE " t_`561 Vj (~C PLAN VIEW o & 7,3 -Vo-~ J S~ Distances & dimensions to meet requirements of H62.20 6,3b kj, t7 u SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM C'SI~ _-TTC TAN:C(S) /w' MFGR. !,a/, c , ' CONCRETE STEEL NO. of rings on cover Depth DRY WELL INCHES NO. of~ _ width length area t no. of lines width length area depth to top of pipe REGATE :;K RATE AREA REQUIRED t / AREA AS BUILT sciaimer: 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 item operation. However, if failure is noted the County will make every effort to -ermine cause of failure. -JASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SY EM. "INSPECTOR A 114 A >1' DATED PLUMBER ON JOB LICENSE NUMBER z .p►REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM Sanitary Pen nit State SPp.tic.Z AM E,,,~ Township / r.. ~ S~C. CTo ix County i Locat.ioit 1, Section j - SEPTIC TANK / i Size U' ga.e..2on4. Numb en ob Compan.tmen.tb < I Distance Fnom: Wet ~ it. 12% on greaten 4.Zope -'fit i Bu,itd.ing it. Wettand.6 HighwaZen DISPOSAL SYSTEM Distance Fnom: Wet it. 12% on greaten 4.2ope Bu.i td.ing it. Wettand.6 Ft. H ighwaten 6 . FIELD DIMENSIONS: w.iRh ob trench it. Depth o6 rock below t.ite :E~-.in. Length os each tine~2 it. Depth o6 rock oven .t.ite .in. Numb en o6 Zineb Depth of .t,ite below grade .in. Toxat. teng,tn o6 tines .406t. Slope o j ,trench ~ in pen 100 it. ~alwq I 4 Distance becueen Zineb c~ Depth to bednoch_~,~_~• J Jt2 Depth to gtoundwaten~it. Tata.i abb onbt.ion an.eaZ 2 Type o Coven: a en o Straw ' Requited area ~t PIT DIMENSIONS: Numbers of pit4 Gnavet around pitz yes no Outside d.iame-ten it. Depth below .inZe.t it. 2 z Toza., bzonbxion area it A Area requited St2 . INSPECTED B _.,/tITLE APPROVED DATE 19t REJECTED DATE 197. 01 a = is State and County State Permit # / PL 67 Permit Application County Per 't # -o u ~ for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. ZWNER OF PROPERTY Mailing Address: B. LOCATIONr1C /4 S '/4, Section LE, T - N, R E (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY 6 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 Lin al Ft. Width Depth Tile depth (top) No. of Trench s Seepage Bed: _Length -5 dth:24-Depth 3Z Tile depth (top)----2!~Z- No. of Lines 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: 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 Certif I°d Soil Tester, NAME C.S.T. # Ir/ and other information obtained rom (,LC (owner/builder). Plumber's Si natur g e~ MP/MPRSW# Phone #tr!v~-9 - -T~ ~ Plumber's Address ,f'- ~Le 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 : i~ i m.... f f 1 m a ~ti..m ~ q. . a i-. .....a ..a »~~~.:.-m mom, j . = m- a a , , 3 i [ i " ~ I : - Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application Fees Paid: State County. `Date - Permit Issued/R (date) - ^1.,~ Issuing Agent Name ,C i _lq -rtion Yes XNo State Valid# Date Recd (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 (pink copy) 4. plumber (canary copy) Revised Date 7/1/78 EH-115 'WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 I~ REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: 1VL'/4, Section , TWN, R a Mor) W, Township or Municipality K16HMON P Lot No. , Block No. County Owner' `JT LKDIX ~F~OWN 5_40I PMENT Subdivision Name s Name: ~p Mailing Address: ~1~W KI(1NMONL24 W1 r--24PI~7 TYPE OF OCCUPANCY: Residence No. of Bedrooms Other ~4cKM J5dUl~ fMf!%-C EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS 12'x' ~q P,,EIIRCOLATION TESTS I Z-4 - 1 q SOIL MAP SHEET No. ~ co SOIL TYPE \J V 5W~TT 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 BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN P- Z1,21' J I r, -j0 ~r , 8 Nof ~ o I n III I n I D P 1~370 'I SAN N o, I It 10 P-3 to Io SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES (DEPTH TO BEDROCK IF 0 E1[ JR ,E D_ OBSERVED ESTIMATED HIGHEST _ - I' 'rh, hA NP G iz v'E!~ SAN 17 I is ,E 1-2. I' T-~, 11 j2 IF Y" IV, Nic (o Fed„ No ntF_ I~ T,/5. II PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the locationand 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. - I10610 f I I _I - } t I ~ ~ t I ~ ~ ~ i ~ I } I , ~ I y I ~ I I j a I t I f t ? ~ I I ~ {{f 1 I € I-~ I i it N i I -_.-_g _ i t t I t ! I ! ; 1 ! 33? Iro ! j i ! I I q, n i ~i4,5 I I 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. Stephen L. Aabv Certification No. 1406 Name (print) Address BOX 254+ Woodville. Wi Name of installer if known CST Signature €-OPY A -LOCAL AUTHOR' ; i February 21, 1980 Cedar Corporation 604 Wilson Avenue Menomonle, W1 54751 Plan Identification No. 80-00287 Gentlemen: Re; Brown Equipment Sewage Disposal NE 1/4, SE 1/4, section 15, T30N, R18W Town of Richmond, St. Croix County, Wisconsin Examination of plumbing plans and specifications for the above-mentioned project has been completed. in accord with Chapter 145, Wisconsin Statutes, and Chapter H 62, Wisconsin Administrative Code, the plumbing plans and specifications are approved contingent upon compliance with the stipulations indicated on the plans and the following code sections. Please review your code for the requirements of each code section noted. 1. H 62.20 (5)(f). Sizing - public buildings. 2. H 62.20 (5)(9) 2. Trench pipe and headers - width, length S separation. 3. The architect, professional engineer, registered designer, owner or plumbing contractor shall keep at the construction site one set of plans bearing the stamp of approval of the department. 4. In the event Installation of the plumbing improvements or system has not cony enced within two years from this date, this approval shall become void and new application shall be made for approval of these plans before work may commence. e Cedar Corporation Page 2 February 21, 1980 In granting this approval, the Division of Health does not hold itself liable for any defects in plans or specifications, plan omissions, examination oversight, construction or any damage that may result in or after installation and reserves the right to order changes or additions should conditions arise making this necessary. This approval is based on Chapter H 62, Wisconsin Administrative Code, requirements. It shall be necessary to obtain and fulfill the permit requirements of the city, village, township or county in which this installation is to be constructed. Failure to obtain local permits will automatically void this acceptance. Approved/issued By The Department of Health and Social Services Division of Health lay : James A. Sargent, Chief Section of Plumbing and Fire Protection Systems JAS:JQ:bah Enclosures cc: M . Leroy Jansky, OWS - District 6 - Eau Claire . Harold C. Barber, Zoning Administrator, St. Croix County r . r AFFIDAVIT STATE OF WISCONSIN ) )ss ST. CROIX COUNTY ) PATRICK J. BROWN, being first duly sworn on oath, deposes and says: 1. That he is an adult resident of New Richmond, St. Croix County, Wisconsin. 2. That he has purchased property under a land contract, located in the Town of Richmond, St. Croix County, Wisconsin, and described as follows: Part of the North Half of the Southeast Quarter (N2 of SE4), Section Fifteen (15), Township Thirty (_30) North, Range Eighteen (18) West, described as follows: Commencing at the point where the North line of said North Half of Southeast Quarter (N1-2 of SE 4) intersects with the West right-of-way line of State Trunk High- way "65"; thence South along said West right-of- way line of State Trunk Highway "65" a distance of 430 feet; thence West parallel with the North line of said North Half of Southeast Quarter (N1-2 of SE4) a distance of 2076.5 feet; thence North parallel with the West right-of-way line of State Trunk Highway "65" a distance of 430 feet to the North line of said North Half of South- east Quarter (N2 of SE4); thence East along said North line a distance of 2076.5 feet to the Point of Beginning. 3. That this affiant statesthat the building to be constructed on the above described property will not be occupied, or put into use, prior to April 1, 1980. Dated at New Richmond, Wisconsin, this 28th day of February, 1980. Patrick J" rown Subscribed and sworn to before me this 28th day of February, 1980. Tany L. laser, Notary Public St. Croix County, Wisconsin MY Commission Expires 4-10-83. ZL