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Parcel 032-2041-95-000 01/08/2007 12:27 PM
PAGE 1 OF 1
Alt. Parcel 11.30.19.636G 032 - TOWN OF SOMERSET
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 - DELANEY, WILLIAM J & VIRGINIA ANN
WILLIAM J & VIRGINIA ANN DELANEY
715 68TH ST
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description " 715 68TH ST
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 10.600 Plat: N/A-NOT AVAILABLE
SEC 11 T30N R1 9W PT W1/2 NW 1/4 COM W1/4 Block/Condo Bldg:
COR, TH N 88 DEG E ON S LN 1314.41' TH N
ON E LN W1/4 NW1/4 859.63'- POB TH N Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
378.01' TO R/W TH N 66 DEG W 920.7' TH S 11-30N-19W
461. 47' TH S 36DEG E 144.35' TH S 16
DEG W 188.12' TH N 89 DEG E 807.08' TO
more...
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 832/4135
07/23/1997 647/14.7
2006 SUMMARY Bill Fair Market Value: Assessed with:
146190 351,300
Valuations: Last Changed: 07/23/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 10.600 86,000 180,400 266,400 NO
Totals for 2006:
General Property 10.600 86,000 180,400 266,400
Woodland 0.000 0 0
Totals for 2005:
General Property 10.600 86,000 180,400 266,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 217
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
• AS BUILT SANITARY SYSTEM REPORT
a . ER jl:x-Va' TO~dNSHIPSEC. T N, R / C/ W
ADD ,ES ST
0. , . CROIX COUNTY WISCONSIN.
:BDIVISION LOT LOT SIZE
PLAN VIEW
-Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
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Iridi~cate North; Arrow 11
S CALF :
TIC TAh'K(S)MFGR.~~s'~'S CONCRETE STEEL
NO. of rings on cover Depth DRY WELL
INCHES NO. of width length area ;
no. of lines b width length_,:S:~ area r~J 1,
depth~tF/ top of pipe
~C~?tEGATE j ~L CEt~ s i~ Jas
'~1C RATEk„ .JAREA REQUIRED G 5 AREA AS BUILT~,
Wsclaimer: The inspection of this system by St. Croix County does not imply complete
.0pliance with State Administrative Codes. There are other areas that it is not possible
,Q inspect at this point of construction. St. Croix County assumes no liability for
jstem operation. However, if failure is noted the County will make every effort to
,etermine cause of failure.
.TEASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
`INSPECTOR
AATE13 - _ PLUMBER ON JOB J 1,, 1' ,1 }
LICENSE NUMBER S^G
Z
REP007- OF INSPECTION-INDIVIDUAL SEWAGE SYSTEM
San.itaAy Penm.i.L
• State Septic
NAME rownahip St. Cnoix County
L o c a.t.i o x 'a e ct.i o n
SEPTIC TANK 4
Size.,' gatton4. Numben o6 Compantmentb j
Diztance Fnom: Wett 6t. 12$ on gneateA btope 6t
Bu.i.Ld.ing 6.t. Wettandb 6t•
H.ighwateA - 6t.
DISPOSAL SYSTEM .
Distance Fnom: We.C.E 6t. 12% on grceaten .s.Zope 6 •
Bu.i.Ld.ing 6.t. Wettandz Ft.
• H.ighwaten 6t.
FIELD DIMENSIONS:
Width o6 ttench 6t. Depth o6 Aock below t.ite .in.
Length o6 each tine 6t. Depth o6 Aock oven .tile in.
NumbeA, o6 tines Depth o6 t.ite below grade .in.
Tota., .Eength o6 tined 6z. Sto pe o6 txench in pen 100 6z.
Distance between tines 6z. Depth to bedAock 6~•
Totat absoAbtion area 6t2 Depth to gnoundwateA 6t•
Requited area 6t2 Type o6 Covet: Pape.n ox Straw
PIT DIMENSIONS:
Numben o6 pits GAavet around pits yea no
Outside d.iameteA 6t. Depth below .inlet 6t.
2
Totat abzoAbt,ion area 6t A
Area Aequkted 6t2 rn
INSPECTED BY TITLE
APPROVED , DATE 197
REJECTED DATE 197
EH 1 .1-5 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: ' Section ~ lT-y N, R E (oryW, Township or Municipality
Lot No., Block No. County
Subdivision Name
Owner's Name: ''•~i~Mailing Address: L~`j 09tco~'
TYPE OF OCCUPANCY: Residence < No. of Bedrooms - Other -
EFFLUENT DISPOSAL SYSTEM: NEW ` ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOI L BORI NGS PERCOLATION TESTS - ll WZ 1-?
SO] L MAP SHEET I s SOIL TYPE fft
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
114
P-
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)
; ,
- 41
PLAN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.)
Indicate on the plan the location and square feq-of suitable areas. Indicate number of squa-e.feQtpf a sorption area
needed for building type and occupancy. _ r--' - 'J7 c to scale
7 or distances. Give horizontal and vertical reference oints. Indicate slope. '
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, 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) of/= l Certification No.
Address ~6
Name of installer if known j
CST Signature
i COPY A -LOCAL AUTHOF~ `
State and County State Permit #
PLR 67-
Permit Application County Per #3
`-e 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:
B. LOCATION: YQ Section TL_ 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 IN 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 concrete Poured-in-Place Steel Fiberglass Other (specify)
New Installation i 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 X, Replacement 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. n Joint ❑ Community ❑ Municipal ,0
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 2 i C.S.T. # /and other information
obtained from _ (owner/builder)
Plumber's Signature MP/MPRSW# - Phone
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 US~ENLY _
Date of Application S Fees Paid: State __lS C unty T~ Date S 5~` 3
Permit Issued/&e*@teef- (date) Issuing Agent Name
Inspection Yes No State Valid# Date Recd
1. county (wh to 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