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Parcel 030-2001-70-000 03/21/2005 11:00 AM
PAGE 1 OF 1
Alt. Parcel 33.30.19.361 L 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
* NELSON, STEVEN J
STEVEN J NELSON
524 CTY RD E
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description ' 524 CTY RD E
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 5.500 Plat: N/A-NOT AVAILABLE
SEC 33 T30N R19W PT W 1/2 NW 1/4 AS DESC Block/Condo Bldg:
IN 540/390 ASSESSED WITH P3621
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
33-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
03/03/2003 711969 2160/614 WD
540/390
2004 SUMMARY Bill Fair Market Value: Assessed with:
5671 211,200
Valuations: Last Changed: 07/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.500 102,100 105,700 207,800 NO
Totals for 2004:
General Property 5.500 102,100 105,700 207,800
Woodland 0.000 0 0
Totals for 2003:
General Property 5.500 65,000 92,900 157,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 107
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 030-2002-60-000 03/21/2005 11:01 AM
PAGE 1 OF 1
Alt. Parcel 33.30.19.3621 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
* NELSON, STEVEN J
STEVEN J NELSON
524 CTY RD E
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE
SEC 33 T30N R19W W 1/2 NW 1/4 COM SE COR Block/Condo Bldg:
NW NW; TH N 521.2 FT; W 243.9 FT; S
523.7 FT TO S LN NW NW; TH S 10DEG W Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
436.5 FT TO CL HWY; S 78DEG E 237.6 FT N 33-30N-19W
10DEG E 487 FT -POB ASSESSED WITH P361 L
Notes: Parcel History:
Date Doc # Vol/Page Type
03/03/2003 711969 2160/614 WD
2004 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed:
Description Class Acres Land Improve Total State Reason
Totals for 2004:
General Property 0.000 0 0 0
Woodland 0.000 0 0
Totals for 2003:
General Property 0.000 0 0 0
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
WiER TOWNSHIP _SEC. T N, R W
0• ADD 5 , ST. CROIX COUNTY, WISCONSIN.
LDIVISION -LOT LOT SIZE
PLAN VIEW
-'z'n
Distances b dimensions to meet requirements of H62.20 ,
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
I i I ~ t ! i ~ ~ I
_4 1
I
Indicate Noi`th{ Arrow
I I ! ~ ~ ~ ~ ; S CALF
PTIC TANK (S) _ MFGR. CONCRETE STEEL
NO. of rings on cover Depth DRY WELL
t NCHES NO. of width length area
no. of lines width length area'.
depth to top of pipe _:'Tr '
. CREGATE - ~•~-dam %4t ~•rf
RATE AREA REQUIRED AREA AS BUILT
kwlaimer: The inspection of this system by St. Croix County does not imply complete
:oi,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
ii ermine cause of failure.
sEASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
'-INSPECTOR
DATED s'~7 s r f PLU: f 3ER ON JOB
LICENSE NUMBER_ JLZ~ 5--
Z REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
40 ~2
1 Sanitary Permit
-State Septic
NAME (ownahip ? ' r S$. Cnoix County
Location Section
SEPTIC TANK
Size gattonz. Numbers ob Compantmentz j
DZ6 t.ance FAOm: Wett 12% on greaten zZope it
S t.
Buitd.ing it. WetZand.6
Highwaten it.
DISPOSAL SYSTEM
Distance Fnom: WeU it. 12% an greaten ztope it.
Buitd.ing _ 6z. Wettands Ft.
• H.ighwaten it.
FIELD DIMENSIONS:
Width a trench it. Depth o6 rock betow tite .in.
Length o6 each tine it. Depth o6 rock oven tite .in.
Number o6 tines Depth o6 tite be.iow grade .in.
Tota.2 .length o6 t inez bt. S.Lope o6 trench in pen 100 it.
Distance between Una 6t. Depth to b edna ck it.
Total. abaonbtion area 6t2 Depth to gnoundwaten it.
-Requited area it 2 Type oi Coven: Papen on S thaw
PIT DIMENSIONS:
Number of pits GAave.- around p.itz ye.5 no
Outside d.iameteA it. Depth below ,inlet it.
2
Totat abz onbt.ion area it A
A&ea tequiAed it2 r"
INSPECTED BY TITLE
APPROVED ,DATE 197.
REJECTED DATE 197
r,
Pte.,
f
EIS-115.
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
• DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309
' MADISON, WISCONSIN 53701
~REPO~~R"T ON SOIL BORINGS AND PERCOLATION TES/TS ~J
LOCATION: Section-13, T3AN, R,~Y 19(or ownship or Municipality T 5
Lot No. , Block No. _ County
/ Subdivision Name
Owner's Name: ' G" igw([ /
Mailing Address: . 2~3G five, - /-/Lt
TYPE OF OCCUPANCY: Residence X No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
- 2
DATES OBSERVATIONS MADE: SOIL BORINGS 3"" l PERCOLATION TES S 2- 7 y
SOIL MAP SHEET SOIL TYPE -S/1 ~f -g-1
PERCOLATION TESTS
TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
NUM- INCHES THICKNESS ICHARACTERN INCHES SINCE HOLE HOLE AFTER INTERVAL
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD ]3 MIN/IN
P-
Se, 2 / 1,21
P-) 112-
-4/1 Se e- e pAye~ ;7
P e A*re-
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- ~ ef mac- ,/6 " " fs, 3 Z s~~.S,1
Y 7,I is ,,I / S „ 6-.
6 ry/sr -3 7
PLCA:~N VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square eet f suitable areas. Indicate mber of square feet of absorption area
needed for building type and occupancy.yT$~,`~"
~-~~t n`' Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope. Sri o.. i4e e"~/ fT~. .'r
k,: ri~ 4~4-
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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.
~S = if `l i
Name (print) Certification No. -
Address
Name of installer if known
€:;:DPY A -LOCAL AUTHORITY CST Signat P L
L _
a
I
State and County State Permit #
PLB 67 ~ N Permit Application County Per` t #
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:
e) _
~rl'~%F~~ ~.~►II%~Lh~l.~ ~ilf .LOt 'y:.
B. LOCA ION: i / , ~ '%1LL~ _1C I
/4, Sections T N, RJ E (or) (D 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 -;7-
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 x Replacement
- Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 4~-- 4/STl Absorb Areas sq. ft.
NewXReplacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: -k_Length -Width 4j? Depth-2/,?- Tile depth (top) 3C No. of Lines j
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land i 2 - c Distance from critical slope
WATER SUPPLY: Private IX 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 O&E(x& f S r1pfs~/jC.S.T. # and other information
obtained from ( ner builder). 2
Plumber's Signature MP/MPRSW# c 3~)0 ~ Phone # 70~i`
L
Plumber's Address 40.
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 ST TE DEPARTMENT IS
E QI
Date of Application Fee Paid: State AC, O n C u t Da
te
Permit Issue (date) ) 7y Issuing Agent Name LL6
Inspection Yes 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