HomeMy WebLinkAbout038-1157-30-000
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Parcel 038-1157-30-000 02/10/2006 10:44 AM
PAGE 1 OF 1
Alt. Parcel 22.31.18.733 038 - 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 - YORK, MICHELLE L
MICHELLE L YORK
2080 114TH ST
NEW RICHMOND WI 54017
I
Districts: SC = School SP = Special Property Address(es): = Primary
Type Dist # Description * 2080 114TH ST
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 1.330 Plat: 2230-NORTHWOOD
SEC 22 T31 N R1 8W PLAT OF NORTHWOOD LOT Block/Condo Bldg: LOT 13
13
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
22-31 N-1 8W
Notes: Parcel History:
Date Doc # Vol/Page Type
03/09/1999 599075 1409/245 WD
07/23/1997 1195/623 PR
2005 SUMMARY Bill Fair Market Value: Assessed with:
119981 193,200
Valuations: Last Changed: 10/12/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.330 27,300 162,600 189,900 NO
Totals for 2005:
General Property 1.330 27,300 162,600 189,900
Woodland 0.000 0 0
Totals for 2004:
General Property 1.330 27,300 162,600 189,900
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
AS BUILT SANITARY SYSTEM REPORT
~ iER , TOWNSHIP SEC.
07 ADDRESS T N, R W
, ST. CROIX COUNTY, WISCONSIN.
zDIVZSI0:1 LOT 3 LOT SIZE
PLAN VIEW
-Distances b dimensions to meet requirements of H62.20
I
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
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Indicate North; Arrow
SCALE.
tPTIC TANK(S) MFGR. CONCRETE STEEL
NO. of rings on cover Depth DRY WELL
ANCHES NO. of width length area
no. of lines width length area
depth to top of pipe
ASREGATE
'ARK RATE AREA REQUIRED AREA AS BUILT
i+Siziaimer: The inspection of this system by St. Croix County does not imply complete
.o,pliance 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
ystem operation. However, if failure is noted the County will make every effort to
;itermine cause of failure.
,LEASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
`INSPECTOR
DATED PLLfiSBER ON JOB
LICENSE NUMBER
z .
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
San.itany Pexm.it
State S P pt.ic,/lllf)" ' ,
NAME rownahip S CAo i.x Count
Locatiox ~i fl! Section
SEPTIC TANK
I
Size gatt.Eons. Numbers o6 Compan.tmen.ts `
Di4tance Fnom: Wett O 12% on gxeatex 4tope it
Bu.i.Ld.ing rJ St. W ettand4 St.
DISPOSAL SYSTEM Highwatex ~ St.
•
D.i6tance Fnom: Wet St. .12% ox gneatex 4tope St.
Bu.itd.ing St. W ettands Ft.
• H.ighwaten St.
FIELD DIMENSIONS:
Width oj txench 1-2- St. Depth oj xock below t.ite .in.
Length o6 each tine ~ 2- it. Depth o6 nock ovex t.ite 2 .in.
Numbex oS tines .2- Depth oj tite below gnade32- .in.
Totat Length o6 t ineA/~St. Stope o6 tnench in pen 100 St.
D.i4tance between tines fol~ Depth to bednock St.
Totat ab~s onbt.ion anea J, jt2 Depth to gnoundwatex St.
Requited anea St2 Type oj Coven: Paper ox Stxaw
PIT DIMENSIONS:
Num6ex os pigs Gxavet axound p.itz yea no
Outta.ide d.iamete Depth below ,inlet St.
2
Totat abaonbt-`on` anea ' it
A
Area xequ.n.ed / Ste m
r
t
INSPECTED-77 B" TITL
APPROVED DATE 19 7&.
REJECTED DATE 197
01
EH 111 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: L-'/4, _t__%, Section TAN, R J_ V (or) W, Township or Municipality
Lot No. _ ~ , Block No. i County
Subdivision Name
Owner's Name:
Mailing Address: r 6~, irl i $
TYPE OF OCCUPANCY: Residence Y No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW / ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS "Z~Z
SOIL MAPSHEET _ SOIL TYPE 1> ri/ _ JC' =
PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TESTTIME 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
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)
B
I _ -
B-L - - - - y - _ - =L
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of suitable meas. 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. i
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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) J Certification No. 5-
Address
Name of installer if known
CST Signature
COPY A -LOCAL AUTHORITY
State and County State Permit # / 75 PLB 67 u, Permit Application County Perryi~ #
- 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: Section T > N, R E (or) W_ I ot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township /.","d
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms No. of Persons j
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 - i s
q. ft.
New Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: _2~_Length Width Depth Tile depth (top) 2 No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land Distance from critical slope s(
WATER SUPPLY: Private 19 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 Cgrtified Soil Tester,
NAME C.S.T. # 5 5 J and other information
obtained from (owner/builder).
Plumber's Signature Phone # /
Plumber's Address /i. ! . i
PLAN V I EW: 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 fBe owo FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application / _ pa Fees Paid: State`,] 06 County 1,7 4i ,!J Date
Permit Issued/mod' (date) / - - y Issuing Agent Name
Inspection Yes _LNo 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