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Parcel 036-1096-50-000 07/21/2006 12:30 PM
PAGE 1 OF 1
Alt. Parcel 31.31.17.583.584A 036 - TOWN OF STANTON
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 - OLSON, DENISE M
DENISE M OLSON
1891 142ND ST
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ` 1891 142ND ST
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 0.413 Plat: 03/038-WESTVIEW (1956)
SEC 31 T31 N R1 7W PT NW NW LOT 7 & N 22' Block/Condo Bldg: LOT 08
OF LOT 8 WESTVIEW
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
31-31N-17W NW NW
Notes: Parcel History:
Date Doc # Vol/Page Type
10/05/1998 588380 1362/521 QC
07/23/1997 953/540
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 06/03/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.413 20,000 143,500 163,500 NO
Totals for 2006:
General Property 0.413 20,000 143,500 163,500
Woodland 0.000 0 0
Totals for 2005:
General Property 0.413 20,000 143,500 163,500
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_-"U I LT_-LAP! Oi=_"AN I TA,: Y "Y"TEi
d ✓
SEPTIC T1Wl" PE-__'d-,IT r`- r c- e2,
0tvner's Name Addressr C i tyr ;eater Z i p
LOCATION
I_OCAT I ON OF S YSTEI'.: Section r T r
Gov. Lot r Lot 7-,' SuDdivision_ - - - - -
PLA N -V I E`.l
Disk-lances & Dimensions to meet i,eq,_, i rements o•I 7'32, 2.O(I) (d;
5'90'.! EVE?YTiIING "!ITI-1IN 100 FEET OF SYSTE;:
-se 44,C
Al-
Yz ,64 I
~i.
J'L' ,~''i0c lit g~
µt:41.
E
SENT IC TAN": Concrete- S Gee 1, Dep:::i to nanho 9 e.
,,.f.S
SO 1 L A~S0?PT 101`1 SYSTEi Dryt-!e 1 1 ~De;3th Inside D i a„
~eptl; e l of-1 I n l eta
T~ENC;'.ES, No. o- 'i d-c;-i LenCth Area Dep- to Pipe
t i C1"Lal Len~1 l rea Depth to I ~e_
Ho. av' Lines
P,GGiZEG'ATE nches %krea :'ecru i red l/ ]`E I LT~
1 SC L% I i..E~ : The I nspeC' ! On o this sys-"em '~y Po I : Coun'cy does not
1 r:. :3 1 y complete comp 1 I ance l•1 i %:l .itate %1dC.l I n 1 ` ~ I Ve Codes. There
are ocher areas that it is not possi Ie to inspect at -this ;point
o' Construct I on n 'jo I Coun-iy a,seui,ies- no I i a" I I i ty or sys-'-en
operat I on. However, i-4' ra I lure is noted, "che county t! I l l na.:e
every e". ort to determine cause o-, a i ! urea G.,Er.Oc~ (°,i1D O I LS
S1 OLD 1JOT E D I/S)-OJED 7F T:O'_';CTI {S SYSTEi.;➢ m t
PLI;f E? ON J zap- ~~z~s - - - - L ICE1i1) ~
REPORT OF INSPECTION - INDIVIDUAL SELVAGE SYSTEM
San.i,tars.y Penmit_~oZ
State Sep-tic~
NAME Township' St. Cno.ix. County
LoCat,ian &)A_Secction,V_Lo.t Subdivi.5ion
`SEPTIC TANK
e-144-0 ga.Ekonb Numbeh o6 eompan.tments
ULs tance 6nom,y We.E.E~~r _ Building ?J--12% .6tope
H.ighwa-ten
PUMPING CHAMBER
Size ~a.L.Lonk .Pump Manu6ae-tunen Mode.E NumbeA
iIOLDTNG TANK
Size gaeeon,6 Numbers o6 Compah.tment,6
Pumpers. Atatm System
04,5,tanee 64om: Wett Building 120 .5tope
H.ighwa.ten
ABSORPTION SITE
Bed L~~ Theneh
D.«6 tanee' ~aam: Wett Bu.itding M e.Eope
Highwa-te.n
ABSORPTION SITE DIMENSIONS
LV id.th o6 •tneneh 6,t Requited area J ~,t
Length u6 each lone 6 Depth o6 Hack beEaw ti~e..:
Numbers- o6 k,in e.5 °Z ~ Depth o6 Hoek oven .t.i.E e. in
To tat Eeng th o tinee 9 t Depth o6 tide below grade c.n
04,6tance between t.ine,6 ~y 6t S.Eope o6 tnench_ in. pen- 100 6t
t )Lu,(, abo u&p,t.ion area q _6,t. Type o6 Coven: Papers rs. 6 trs.aw
1
PTT DIMENSIONS'
Numbers o6 p.i,te Gnavet around pits yeas no
Outs de diame.tek 6t -Depth betow in.Ee.t _ 6,t
To-tat absonpt " n area 6-t
Area nequine 6t
INSPECTED BY K TITLE
APPROVED DATE 19 0
REJECTED DATE 19 8
REASON FOR REJECTION
REPORT ON INSPECTION OF SANITARY PERMIT
(1) Name and A dress of Permit Holder Person/Persons at Site (2 )Date of Inspection
`Z & _3 ~ Cry
ame, ress, icens o. o ins a ing Plumber Time of Inspection
e 'e3
(3 )INSTALLATION CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber
❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System
BENCHMARK: (Permanent reference Point) 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:
(7)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 ❑ N0; ft from residence;
ft from well; ft from property line. Type of warning device
Is the warning device installed? ❑ YES ❑ N0; Wired? ❑ YES ❑ N0;
Locking device on cover? ❑ YES ❑ NO; 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:
PRPMRev. 9/78
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION:A&L_'/4,AL '/4, Section~_ ~,T _31_N,Ral/ (or) W, Township or Municipality
Lot No. , Block No. County ~ST~S~_1j✓
Subdivision Name
Owner's/Buyers Name:
Mailing Address: i"I
TYPE OF OCCUPANCY: Residence-,e -No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMEN ALTERNATE SYSTEM r~ OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS - PERCOLATION TEST
SOIL MAP SHEET 1C~ NAME OF SOIL MAP UNIT. r-l t
PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES
RATE
NUM- SINCE HOLE HOLE AFTER INTERVAL
MIN/IN
BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P- _
1 ~ 11L JZ) I Y6
P- t` C ,s 9
~ ! 1
P- tt I.f ~Jbl Al C 10
P-
P-
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- I
-
B-
> 4
B-
B-
B-
B-
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the ~q tion and square feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancy 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) 1 Certification No.
Address 4J 4
Name of installer if known
Copy A -Local Authority CST Signatur 4
State Permit #
FB 6 7 State and County
Permit Application County Permit #
for Private Domestic Sewage Systems County 7-1
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
B. LOCATION: f' Section N, R J (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township 1tg/j-~7T z/
C. TYPE OF OCCUPANCY: *Commercial *Industrial `Other (specify) *Variance
Single family- Duplex No. of Bedrooms No. of Persons
D. SEPTIC TANK CAPACITY Yf9a) 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 ~k
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 Rep lacement -
A Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (t p~-No. of Trenches
Seepage Bed: Length _Width Depth r~ Tile depth (top) r z No. of Lines ~T
Seepage Pit: Inside diamet Liquid Depth No. of Seepage Pits
Percent slope of land- 4 Distance from critical slope
VATER 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 Cer .jfied Soil Te r,
NAM E ~U 0441 Mi." C.S.T. # and other information
obtained from 6a),fA (owner/builder). l
Plumber's Signature MP/MPRSW# Phone
#:24
Plumber's Address ~ ) t 12, ~-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.
F
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Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ON4Y
Date of Application 'PC) Fees Paid: State L' County - ,D D to e7
Permit Issued/Rejected (date) el--' -Issuing Agent Name 3Z Ldo .
Inspection Yes _K_ 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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