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Parcel 030-2078-40-000 03/21/2005 11:44 AM
PAGE 1 OF 1
Alt. Parcel 33.30.19.661 030 - TOWN OF SAINT JOSEPH
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): = Current Owner
LUNDGREN, MARNA L & ELDON E
MARNA L & ELDON E LUNDGREN
576 BURR OAK LA
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ` 576 BURR OAK LN
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 1.480 Plat: 2233-OAK KNOLL
SEC 33 T30N R1 9W OAK KNOLL ADD LOT 4 Block/Condo Bldg: LOT 4
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
33-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
04/03/2003 715811 2193/538 QC
1226/67 QC
1025/340 WD
1025/339 WD
more...
2004 SUMMARY Bill M Fair Market Value: Assessed with:
6371 266,200
Valuations: Last Changed: 07/09/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.480 59,500 202,400 261,900 NO
Totals for 2004:
General Property 1.480 59,500 202,400 261,900
Woodland 0.000 0 0
Totals for 2003:
General Property 1.480 34,800 163,100 197,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 115
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
• AS BUILT SANITARY SYSTEM REPORT
WJER TOWNSHIP • SEC. T_~ ; N, R~W
0. ADDRESS -4) ST. CROIX COUNTY, WISCONSIN.
C T,CL~ ",e;rZe' J)VAy
.•3DIVISION C,4 e i'A&AL LOT4LOT SIZE
PLAN VIEW
-Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
i I
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.3 ' -
t
Indicate North; Arrotq j
'SCALE :
a
tPTIC TANK(S)MFGR. CONCRETE STEEL
NO. of rings on cover j Depth DRY WELL
"ENCHES NO. of width length area
no. of lines width /j' length area '
dep h to top of pipe
aGREGATE ✓ toris:cAic~ ,2'
RATE AREA REQUIRED AREA AS BUILT
lisclaimer: The inspection of this system by St. Croix County does not imply complete
.o;pliance with State Administrative Codes. There are other areas that it is not possible
o inspect at this point of construction. St. Croix County assumes no liability for
13tem operation. However, if failure is noted the County will make every effort to
;i~ermi.ne cause of failure.
.,EASES &ND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
'-INSPECTOR--- .
;7- f
DATED PLUIMER ON JOB 'A AJ
LICENSF NUMBER~~(~
r ~
Z
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
Sanitary Penm.i t
• State Sep-tic~.
NAME' rownship i S$, Cnoix County
- f`
Section
Location
SEPTIC TANK
Size gattonb. Numbers o6 Compartments j
DiAtance Fnom: Wett it. 12% on greaten slope jt
Bu.itd.ing it. Wettands ~ •
Highwaten it. R
DISPOSAL SYSTEM
D.iatance Fnom: Wett it. .12% on greaten slope ~ .
Bu.itd.ing St. Wettands Ft.
• H.ighwaten it.
FIELD DIMENSIONS: Width o j' then ch it. Depth o6 no ck b etow t.ite in.
Length of each tine it. Depth o6 rock oven t.ite .in.
Number of .Lines Depth of t.ite below grade .in.
Totat .length o6 .Lines it. Slope of ttcench in pen 100 it.
D.iatance between .Lines 5t. Depth to bedrock it.
Total abz ohbt.ion atcea jt2 Depth to gnoundwaten it.
Requ.ined atcea it2 Type of Coven: Papex on Straw
PIT DIMENSIONS:
Number o6 pits Gnavet around pits yes no
Outz ide d.iameten it. Depth below inlet it.
2
Totat abzonb.t.ion area it Z
Area %equited it2 m
INSPECTED BY TITLE s
197_
APPROVED DATE
REJECTED DATE 197
h
.abam~.c,.niia3.w.,......y:......e.s,...a..,::,.....,..e,.. .:._...w. i+..,,JaC'-.a,a......e.:.:....... _
EH 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 Section ,T_]LN,R_/.~LE (or) W, Township or M ipaUty
Lot No. , Block No. County
Subdivision Name
Owner's/Buyers Name:
Mailing Address: ~r6k L''
TYPE OF OCCUPANCY: Residence No. of Bedrooms , COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS - C PERCOLATION TESTS - -3
SOIL MAP SHEET NAME OF SOIL MAP UNIT 1"B 4 x;/,,a
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 AFTE INTERVAL
MIN/IN
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P- I
ILA 44"
P_ t
P-
!E 11
P-
P-
P-
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
TEXTURE, MOTTLING AND DEPTH TO BEDROCK
NUMBER INCHES OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES
B- - c < r'
B- 3-
B-
B-
B-
B-
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the I~gation and square feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancy l /5 Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope.
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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)_. 14 Certification No.
Address
--r n
Name of installer if known_l~/ i1L ' J
Copy A -Local Authority CST Signature -
EH -15
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309 J/
MADISON, WISCONSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TESTS ~0*14 ' 'T'y
LOCATION: '/4, '/4, Section 'T '"'N, R ✓ E•-{er) W, Township or Municipality JE S
a
Lot No. Block No. County
~j Subdivision Name
Owner's Name: / 16
iL 1` ~1
Mailing Address:
TYPE OF OCCUPANCY: Residence No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS_ s_- •r`~s=^a=[ F PERCOLATION TESTS 4' I-AW
OiLMAPSHEET SOIL TYPE F• .T °cc tib rt" cl•~~tv
PERCOLATION TESTS
HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES
1"EST DEPTH RATE
CHARACTER OF SOIL
I :SUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN
j BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
i_
P-
na. ,cam
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) I
ltit `7 r \,zi i~
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. C., / "J Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope.
ILA
V'
Err
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. -11) - C 12
Name (print) 7~W'e1 Certification No. G
Address"
Name of installer if known
CST Signature. C Y A
State Permit #
PLB 6 7 State and County
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:
///A/
B. LOCATION: r, /4 Section T ,r N, R (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 Total gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concreted Poured-in-Place Steel Fiberglass Other (specify)
New Installation -X 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.
NewReplacement 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 Liquid Depth No. of Seepage Pits
Percent slope of land.. Distance from critical slope
WATER SUPPLY: Private Ul Joint ❑ Community ❑ Municipal ❑
Owners name as listed on EH 115 if other than present owner: (~p /r2- 9 / 7j
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 Te ) ster,
f
NAME / '~`u /ZZ C.S.T. # and other information
obtained from (owner/builder).
Plumber's Signature MP/MPRSW# / Phone -
Plumber's Address / r
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 - Fee, Paid: State/5 , G7 County 7l e- 6',' Date G ~G
Permit Issued/ - (date) Issuing Agent Name i,1
Inspection YesX.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
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