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Parcel 038-1046-10-000 01/09/2007 04:14 PM
PAGE 1 OF 1
Alt. Parcel 11.31.18.197A2 038 - TOWN OF STAR PRAIRIE
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
%TAMMY L ABRAMSON O - DENNO, JOANN M
JOANN M DENNO
1289 CTY RD H
STAR PRAIRIE WI 54026
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1289 CTY RD H
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 9.330 Plat: N/A-NOT AVAILABLE
SEC 11 T31 N R18W 9.33 AC IN SE NE LOT 2 Block/Condo Bldg:
OF CSM III PAGE 649
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
11-31N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
09/14/2006 834492 TI
04/21/1983 384084 663/184 WD
2006 SUMMARY Bill Fair Market Value: Assessed with:
174954 244,600
Valuations: Last Changed: 10/13/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 9.330 66,700 149,500 216,200 NO
Totals for 2006:
General Property 9.330 66,700 149,500 216,200
Woodland 0.000 0 0
Totals for 2005:
General Property 9.330 66,700 149,500 216,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 135
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 TOWNSHIP•`~;~t~ f 2ix'~a SEC. J ! T N, R / W
ADDRESS ST. CROIX COUNTY WISCONSIN.
K<~, alley:-,~ 1 1
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
11 j
1
I di, ate ozthj Arrow j
SCALi : L
SEPTIC TANK(S) MFGR. CONCRETE STEEL
NO. o7 rings on cover I Xpth
PUMPING CHAMBER SIZE PUMP MFGR. MODEL NO.
GALLONS Per Cycle
TRENCHES NO. of width lengl►-.h area
BED NO. of lines width- length ,S:) ` area r
depth to top of pipe '
NUMBER OF SEEPAGE PITS Outsi e iameter total pit area
AGGREGATE
PERK RATE AREA REQUIRED AREA AS BUILT
Disclaimer: The inspection of this sys em by St. Croix County does not imply
complete compliance with State Administilative Codes. There are other areas that
it is not possible to inspect at this point of cgpnstruction. St. Croix County
assumes no liability for system operation. However, if failure is noted the
County will make every effort to determine cause ailure.
GREASES AND OILS SHOULD NOT BE DISPOSED THROUG IS SYT
INSPE
DATED J P MBER ON JOB ~
LICENSE NUMBER
,i
Z .
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
Sani tany Pen►n.i Z99
• State Septic:2/My
NAME /'a~ eg=2 Townah.i A6,00. - Ale Z.A'4j
S C40 ix County
Loca.tiog Sect4on _
SEPTIC TANK
Size gatton4. Numbers 06 Compa4tmen.t4
D,iA tance Fnam; Wet ► 6 t, 121 on gnea.ten a,topei it
Bu4td4ng_-~`) it. We-t4and4 ~ .
DISPOSAL SYSTEM Htighwa•tenit.
D.ia.tance Fnom: We~~ 1 Z$ on'qua.ten a.Eope
Hu4td~.ng E' 6 t. W e.ttand4 Ft.
H4ghwa.te4
6.
FIELD DIMENSIONS:
04dth 06' atnench 4.t, Depth 06 nock betow, •t.i.te_Z
Length o6 each 4.44e it. Depth 06 nock oven -tile "X
in.
Numb en-o6 "nea z_- Depth o6 .t.ite be.Eow gn.ade
To.ta4 teng.th 06 tine- 4. it. Sto pe o6 .tnench 4n- pen 100 it.
D.i4tance between Z4ne4 it, Depth -to "bedn.ock 6t.
To.tat aba o4b-t4on aua 6~Z 4,t2 Depth to g4oundwa.te4 it.
,
Requ44ed a4ea ~.t2 Type o6 Coven: ap+e~ % St&aw
w
PIT DIMENSIONS:
Number ob pi.ta ave4 mound Pi .ta Ue4 no
Ou.t44de d~ame-ten 6.t. depth be-tow 4n4e-t it.
To•ta4 ab4 onb.t~lo 4e e. 642 • z
Z ~
Area aega'44e - -6.t rn
INSPECTED
B _
TITLE
APPRO j DATE, 191 A;)
REJECTED ,FATE Jy7 ,
~EH 115
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 V-, T---'/-N, R/±-V (or) W, Township or Municipality ~h
Lot No. , Block No. County L-lAc
Subdivision Name
Owner's Name:
Mailing Address:? -l%-~ -
TYPE OF OCCUPANCY: Residence _ No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW _ADDITION REPLACEMENT
DATES OBSERVATIONS MADE:/ SOIL BORINGS , . Z PERCOLATION TESTS SOIL MAP SHEET / SOI L TYPE
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
P- r r / 'j 3
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)
> . t o 7-S 21
? , - .s -
PLAN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of suitable areisl Indicate number of square feet of absorption area
needed for building type and occupancy. t Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope.
i
- i
J 41'
I I N
-
I , l I ~ ~ i ~ I I I ' ! I !
- ~ 1 I ~ I It I I 3 EEEE 111
[ -h
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.
Name (print) L Certification No. S
Address 4c
Name of installer if known
CST Signature
COPY A -LOCAL AUTHORITY
J`?
~ ~ State and County State Permit #
PLB
' Permit Application County Perpn.it
J
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:
J ~
B. LOCATION: Section 1L; T N, R j (or) 1~L Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township~S2-& 4 4ja~tZ'
C. TYPE OF OCCU~P/ANCY: *Commercial *Industrial *Other (specify) *Variance
Single family 2( Duplex No. of Bedrooms _ No. of Persons
D. SEPTIC TANK CAPACITY /00-e)
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-PlaceOther (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Percolation Rates 44 Total Absorb Area sq. ft.
New Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (to ) No. of Trenches
Seepage Bed:-,Length ~0_WidthDepth ~Tile depth (top)No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land -1 ;2 Distance from critical slope
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 T ter,
NAME C.S.T. # and other information
obtained from doj) (owner/builder).
Plumber's Signature MP/MPRSW# / 2 -3 Phone
Plumber's F.ddress
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
Date of Application X•-L2 S/ O d Fees Paid: State/,S-..A-T- Co t D
Permit Issued/Rzfeeed (date) Issuing Agent Nam
Inspection YesX V__ 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