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Parcel 030-2073-60-000 12/05/2006 11:34 AM
PAGE 1 OF 1
Alt. Parcel 36.30.20.625D 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): O = Current Owner, C = Current Co-Owner
O - GAST, ROBERT J
ROBERT J GAST
279 122ND AVE
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description ' 279 122ND AVE
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 3.019 Plat: N/A-NOT AVAILABLE
SEC 36 T30N R20W SE SE LOT 2 OF CSM Block/Condo Bldg:
2/555
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
36-30N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1118/152 WD
2006 SUMMARY Bill M Fair Market Value: Assessed with:
170101 380,200
Valuations: Last Changed: 07/09/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.020 91,600 238,300 329,900 NO
Totals for 2006:
General Property 3.020 91,600 238,300 329,900
Woodland 0.000 0 0
Totals for 2005:
General Property 3.020 91,600 238,300 329,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 211
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 L ( ~ I 1 TOWNSHIP`-p P,~(`~ - SEC 36 TAN-PeO W
ADDRESS ST. CROIX COUNTY, WISCONSIN.
A-)
r.
i~GJ LOT LOT SIZE
SUBDIVISION
PLAN VIEW
Distances and dimensions to meet requirements of H63
())W-EVERYTHING WITHIN 100 FEET OF SYSTEM
FTTI
i
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r 1
4^
0
I di a e o th Arrow I
S(
S~ Ef L /~drf ►E SC r j,'v
BENCHMARK,: (Permanent reference Point) Describe:,,tI_ .v5 jic.j~c I;A~E-.
s------~,
I- U y~ r r as r atr Pz ST
Elevation of vertical reference point:/L%? Slope at site: ~S
SEPTIC TANK: Manufacturer: Liquid Capacity : f
Number of rings on cover : Z Tank manhole cover elevation:
Tank Inlet Elevation: Tank Outlet Elevation:
PUMP CHAMBER
Manufacturer: Number of gallons
Number of gal. pump set or a cycle gallons; total capacity o
distribution lines gallon:. size oT pump head;
gallon per minute horsepower ran name of pump
and model number ;
Type of warning device
HOLDING TANK: Manufacturer Number of gallons
Elevation of manhole cover
Type of warning device
SEEPAGE PIT SIZE: um er o pits eet i.ameter
feet liquid dept seepage pit in -et pipe-elevation
bottom of seepage pit elevation feet.
SEEPAGE BED SIZE: number of lines_ wily lerrgthtile depth
SEEPAGE TRENCH: width len th
PERCOLATION RATE -AREA REQUIRED-It, AREA AS BUILT
INSPECTOR
DATED PLUMBER ON JOB ~zc
LICENSE NUMBER f/
REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM
Sanitary Penm,it 133
State Septic alp .
NAME Town1sh.ip St. Cno.ix County
Location,S<E SS P SectioR,3,4 Lot # Subd ti's ton
SEPTIC TANK
Size ga2tonts Numbetc. o6 eompantment/
Di6tanee 6nom: wets Building 12% s tope
H,ighwatvL
PUMPING CHAMBER
Size g tt n,),- Pump Manuaetunen Mo de t Numb etc
HOLDING TANK
Size gatfon,51' Numbe o6 Compantment,5
Pumper Atatc h System
i
D4:6tance {yA.om,: we t,Buitd,ing 12% scope.
H.ighwaten
ABSORPTION SITE
Be.d Ttce nch
D4"6tanee (,A.om: We.u_ Buitding_ r2 o /5fope_ -
fftighwaten
ABSORPTION SITE DIMENSIONS
Q1.i4th o/, thoneh. Req(ci.nEd area ~t
Length of each tine 6t Depth o6 rock betow t-ite H,
Number o(j ~ine/5_ Depth o6 rock oven tile. - tics
Totat te.ngth oA tine/5 5t Depth o6 ti e below gtcade j ~n
Di6tance between fi.ne.5 6t Shope o6 tneneh in. pen 100 ft `t.
Totak ab6onption area 6t Type oA Coven: Paper on atnaw
PIT DIMENSIONS
Numb en o) pits ~Gnavet around pith _yes _no
Outside diametet t Depth. below .inlet {t
Total abh onpt4ion are ~t
Area nequ,ined 6t
INSPECTED BY TITLE
APPROVED DATE ;r 19 8~
REJECTED DATE 19 8
REASON FOR REJECTION
i
REPORT ON INSPECTION OF SANITARY PERMIT #
(1) Name and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection
~
Name-, ress, icens o. OT ns a ing Plumber Time of Inspection
L L. ~ /
3 INSTA f ONS STS OF: E] Septic Tank ❑ Seepage Trench ❑ Dosing Chamber
❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System
BEN ermanent reference oint 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:
M 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 ❑ N0; 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:
z:xe,.4 v4r,, v f f• S'/a~A~ fif✓'o~/ E,} S 7- S11~E
State and County State Permit #
PLB 67 6
*r Permit Application County Permit #
f • f
for Private Domestic Sewage ~ Systems Count
`DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
66e& 30C11rZ49- di 0 46' "IlCe4 f ',I. 5-Y,11a,4721f A'-,,
B. LOCATION: Section T_.?(- N, R .20 E (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
yv ~~~f39/l~~sfC~~✓ C / (v~/ Township 571, J-os~Af71-
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family X Duplex No. of Bedrooms -3 No. of Persons 2-
D. SEPTIC TANK CAPACITY 1600 Total gallons No. of tanks /
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete X 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 AreaS~ sq. ft.
New X Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: A Length %Q11
Width .2-!l . Depth %f # _Tile depth (top) -12-0 No. of Lines
~y
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits _
Percent slope of land /a Distance from critical slope 5 10 '
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 Certified Soil Tester,
NAME 4b,62l" 41he/C~,~ % C.S.T. # ~S Y~Z`7r~2 and other information I
obtained from lo'd L (owner/builder). / J1
Plumber's Signature r = 1> MP MPRSW# /6, o1V Phone # 7/y 0
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.
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Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY
'late of Application Fees Paid: State--1~0--j County 4-7-, 0-0 Date '1',-;2
Issued/Re
4eeted-(date) 7 fU Issuing Agent Name 41
f
s 4 No State Valid# Date Recd
ihite copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
ik copy) 4. Plumber (canary copy)
Revised Date 7/1/78
ER 11 J Rev. 9/78
- REPORT ON SOIL BORINGS AND PERCOLATION TESTS
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATIOON: '/4, S,`e/~ction J& ,T~N,R ~E (or)(@Township or Municipality
Lot No.7L` Block No. fT1 &yZ"4V'IS 5-016'd' - 36yv County s/~ 6eo/T
~~L. 1iU G~E Subdivision Name
Owner's/Buyers Name:
Mailing Address: /Rfig ✓57(.) . G~EELL`1 5Y- 57eilljOW7E.(' ~/✓(/N. cS$~0~~
TYPE OF OCCUPANCY: Residence X No. of Bedrooms -3 COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW ^A REPLACEMENT ALTERNATE SYSTEM OTHER G
DATES OBSERVATIONS MADE• OIL BORINGS 2-3Ad • PERCOLATION TESTS Ze 7fn
SOIL MAP SHEET JCS f NAME OF SOIL MAP UNIT 0 -I/V fi,-!~o
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- "'13A) Loj--f Z7</.3~. S' - O - i(o 3 3 /Coo
P-
P- z A., 40+V R "Zi' 4); s, z " z -0- y O y16 3 /60
P-
P-3 "4 A, L4AM 3o° 4AI S; - o -
3 o
4461 m 5 1-0
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- / 7.2- cvF7 t%ss S5- L0,04 13 „Lf ajji~ / 33-0 B- .V 7 Z J"15, V. L . N. S"•f to "
.72- iyo-
B-
B- Aa-,1V 51.
B- Z IVOVE- 2 72-- 6", . Gv, y " Z;,-d . .2.2, " ~'vQ-i3✓ Sc/ 3 S1
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 A07-SU%TPU 119W Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope. 0,14,41.VFE4Q- / AY4f)0/°/&/ 7e0ly sXokl
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I, 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.
t:iarrae iprintl Certification No. 7
A.Jdress .,R-r.~NEiL 01S me of installer if known-
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