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Parcel 038-1086-20-000 12/06/2006 05:14 PM
PAGE 1 OF 1
Alt. Parcel 21.31.18.357B 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
O - FRANKO, SUSAN M
SUSAN M FRANKO
1087 CTY RD C
EW RICHMOND WI 54017 J
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1085 CTY RD C
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 0.630 Plat: N/A-NOT AVAILABLE
SEC 21 T31 N R1 8W PT NE NE LOT 2 OF CSM Block/Condo Bldg:
5/1274
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
21-31N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
06/09/1998 580702 1330/406 WD
07/23/1997 1092/228 WD
07/23/1997 90894449 ~ 7 TI
07/23/1997 668/58
2006 SUMMARY Bill Fair Market Value: Asse with:
175370 121,600
Valuations: Last Changed: 2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.630 37,800 69,700 107,500 NOnn C
Y~
Totals for 2006:
General Property 0.630 37,800 69,700 107,500 rn
Woodland 0.000 0 0 L~~1111 CS
Totals for 2005: ~Y
General Property 0.630 37,800 69,700 107,500
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 123
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 c4 SEC.__TN, RLW
ADDRESS ST. CROIX COUNTY WISCONSIN.
SUBDIVIS ON LOT LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
.y
- _ 7
~ L rL.
1 Y.3
, L
-i A
3 i .
k +
I rd! ate orthjArrow~~
_J -I ITT I I- SCALE: I!~- II I ~I}~
SEPTIC TANK(S) ~_MFGR. J i CONCRETE_ STEEL
N0. of rings on cover Depth -
PUMPING CHAMBER SIZE PUMP MFGR. MODEL NO.
GALLONS Per Cycle
TRENCHES NO. of wi ttF length area ;
BED NO. of lines
width length area ~ depth to top of pipe ! " -
NUMBER OF SEEPAGE PITS outside diameter total pit area
AGGREGATE
PERK RATE AREA REQUIRED zi'/(AREA AS BUILT,./,),,'
Disclaimer: The inspection of this system by St. Croix: County does not imply
complete compliance with State Administrative Codes. There are other areas that
it is not possible to inspect at this point of construction. St. Croix County
assumes no liability for system operation. However, if failure is noted the
County will make every effort to determine cause of failure.
GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYTEM.
INSPECTOR
DATED / PLUMBER ON JOB
LICENSE NUMBER „r:
Z
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
Sanitan.y Permit (0 el
State S Q p.t.i c
NAME _V Opr r I awnah Lp CJAQ ~'r~S. - Croix County
Locatiox.NE&JE7 Section
SEPTIC TANK
Size, ga.ttona. Numbers o6 Compan.tmen.ta
Di4 tance Fnom: Wett 6.t. 12% on gnea.ten a.to pe 6#
Bu.itd.ing 6.t. We.ttanda_ 6t.
DISPOSAL SYSTEM Highwa•ten ~ 6t.
D.ia.tance Fnom: Wett bat. 12% on greaten aQope 6.t.
Bu.itd.ing 6.t. W e.ttandaFt.
H.ighwa.ten 6.t.
FIELD DIMENSIONS:
Witt o6* •tnench 6x. Depth o6 nock below, •t.ite .in.
Length o6 each tine 6z. Depth o6 %oak oven .t.ite .in.
Numbers o6 tinea Depth o6 -t.ite below gaade .in.,
To.tat. teng-th o6 tine.6.t. Sto pe o6 .trench in pen 100 6.t.
DiA tance between tinea_______Jt. Depth .to ' b edno ch 6.t.
Totat abaonb•t.ion area 6#2 Depth to gnoundwa.ten 6t.
Requited area 6.t2 Type o6 Coven: Paper on S.tnaw
PIT DIMENSIONS:
Numbers o6 p.i.ta Gnavet around p.i-ta yea no
Ou.ta.ide d:iametea 6.t. Depth bet.ow .intet 6.t.
To.ta.t abaoab.t.ian area 6t2.
A
Area %equi;&ed 6.t2 M
INSPECTED BY TITLE p
APPROVED,DATE 197--.
REJECTED DATE 197
Z
I
~ State and County State Permit # !
PLB 6 a6 w 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:
j
i C i ,+t d& A~ X Zq~a
B. LO TION:
All '/4, Section , T - N, R (or) \~t_ Lot# City _af
Subdivision Name, nearest road, lake or landmark Blk# Village
Township
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 Total Absorb Area ' sq. ft.
New Replacement- Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth L(top), No. of Trenches
Seepage Bed:)(- Length -3.Width J-;2 ' Depth 56Tile depth (top, No. of Lines r
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land- 9 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 Certjfied Soil T~1ter,
NAME ~i'(~EC.S.T. # and other information
obtained from (owner/builder).
Plumber's Signature MP/MPRS Phone
] r i ';r
Plumber's Address 41 A
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.
t
lakv
1 V
Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application lM" Fees Paid: State County , Date `
Permit Issued/Rejected (date) - t ~ 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
2. state (pink copy) 4. plumber (canary copy) Revised Date 7/1/78
FE H, 115 Rev_ 9178
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
- WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATIOSectiortiN,Ril (or) W, Township or Municipality
Lot No. , Block No l a~Er
County
Subdivision Name
Owner's%Buyers Name:
Mailing Address: 3
TYPE OF OCCUPANCY: Residence-, No. of Bedrooms c:V COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS ' Y-- &I PERCOLATION TESTS
SOIL MAP SHEET NAME OF SOIL MAP UNIT &M6$6 /L S4A- _
PERCOLATION TESTS
TEST HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES
NUM- DEPTH CHARACTER OF SOIL SINCE HOLE HOLE AFTER INTERVAL RATE
MIN/IN
BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P-
1 S
P-
P-
P_
P_
SOIL I/
P_
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-
E^
B- _ 0_1 91,
B-
B_
B-
B-
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the pla~njth~pcation 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.
1_7 SOA,
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69; WAA
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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.
Name tprint) ~~,u,~+~ ~a !a~'S Jx Certification No.
Address
Name of installer if known
Copy A -Local Authority CST Signature