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Parcel 032-1045-70-000 01/09/2007 11:23 AM
PAGE 1 OF 1
Alt. Parcel 16.31.19.229B 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 - WACHTER, DAVID A & PATRICIA A
DAVID A & PATRICIA A WACHTER
BOX 249
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 3.000 Plat: N/A-NOT AVAILABLE
SEC 16 T31N R19W 3.OOA IN NW NW COM 310' Block/Condo Bldg:
N OF SW COR, TH N 360', E 360', TH S
360'W 360' TO POB BEING LOT 1 CSM VOL Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
1/281 (EZ-U-1108/044 16-31N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
2006 SUMMARY Bill Fair Market Value: Assessed with:
145326 63,600
Valuations: Last Changed: 07/23/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.000 48,000 200 48,200 NO
Totals for 2006:
General Property 3.000 48,000 200 48,200
Woodland 0.000 0 0
Totals for 2005:
General Property 3.000 48,000 200 48,200
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
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
San.i-tax y Pen.m.it 0's State Septic- cz'q .g
NAME rownehipe~Me(Sey S~. Croix County
Loca.t.iox a'/ sec•t.ion
SEPTIC TANK
Size gattona. Number o6 Compax.tmen.tz I
DiA tance Fnom: We.LQ 6t. 12$ on gxeaatex etope 6-t
Su.i.Ld.ing 6.t. We•ttandb 6 .
N.ighwa.tex it.
DISPOSAL SYSTEM
D.ia.tance Fxom: Wett it. 12% on gxeatex 4tope it.
Bu.i.Ld.ing it. We.ttandb Ft.
N.ighwaatex 6.t.
FIELD DIMENSIONS:
Width o6" .txen ch it. Depth o6 no ck b et ow..tite in.
Length os each tine it. Depth o6 hock oven •t.ite .in.
Number o6 Zinea Depth o6 .t.i.te below grade .in.,
To.ta.P. .Length o6 tinea 6z. Stope o6 .trench in pen 100 it.
Di,4 Lance between tinea`6-t. Depth to A b edxo ck 6 t.
To.tat abb oxbt.ion area 6t2 Depth to gxoundwa.tex it.
Requ.ixed ahea 6,t2 Type o6 Cove)L: Papers ox Straw
DIMENSIONS:
Num1ber o6 p.itz Gxavet around p.i.ta yeo no
Ou.tb.ide d~ame.tex it. Depth below .inte-t it.
To#at abaoxb.t.ion area 6.t2. z
Area kequ.ixed 6.t2 M
r
INSPECTED By TITLE
APPROVED DATE 197
REJECTED DATE 197
I
State Permit # -f y1~3 l
PkB 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:
i
B. LOCATION: L. '144AI '/a, Section T.:,L N, R±L q (or) W Lot# , City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township &~r `.r
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 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 > r~~ Total Absorb Area L sq. ft.
NewKReplacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: X Length Width Z-* Depth L " Tile depth (top) > No. of Lines_
Seepage Pit: Inside diam/~ter Liquid Depth No. of Seepage Pits
Percent slope of land y, Distance from critical slope-
WATER SUPPLY: Private X 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 Cert fled Soil Tester,
NAME ~_r C.S.T. # 6 and other information
obtained from (owner/builder).
Plumber's Signature P/MPRSW# Phone # f ~d 3?
Plumber's Addresses f /2
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.
4 J 14 i24 1
&AC~ ~ 4 34 J(
.26
O
e.
~ O
5
1
E
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m_
:
Do Not Write in Space Be ow FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application Fees Paid: State /.3 d 9 County Date rC~
Permit Issued/Rejected (d te) 07 Issuing Agent Name
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
state (pink copy) 4. plumber (canary copy)
Revised Date 7/1 /78
J
EH X115 Rev. 9/78
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
r WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION:k,. 'I.,A '/4, Section N,Rry, (or) W, Township or Municipality 1~>~% 'tom
Lot No. , Block No. ubdivlslon Name County
Owner'sBuyers Name: f,~ ' Fes! ~1 ,f A C
` C
Mailing Address: 4~c ~TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS A c ( PERCOLATION TESTS ti ~ •
SOIL MAP SHEET NAME OF SOIL MAP UNIT /r A2 a---
PERCOLATION TESTS
TEST HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES
DEPTH CHARACTER OF SOIL RATt_ I
NUM INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/I\!I
1
P- i > f1 t
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` . _
_
i
1
B- e s C,
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan they location and square feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancy L /S_ Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope.
L /S yt
l.7 i7 f~
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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.
Blame (print) C Certification No.
Address
Name of installer if known
Copy A - Local Authority CST Signature '