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Parcel 038-1157-70-000 02/10/2006 10:45 AM
PAGE 1 OF 1
Alt. Parcel 22.31.18.737 038 - 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): 0 = Current Owner, C = Current Co-Owner
O - BAUERMEISTER, LARRY & JULIE
LARRY & JULIE BAUERMEISTER
1148 NORTH WOOD ADD'N
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 1148 208TH AVE
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 1.530 Plat: 2230-NORTHWOOD
SEC 22 T31 N R1 8W PLAT OF NORTHWOOD LOT Block/Condo Bldg: LOT 17
17
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
22-31N-18W
I
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 806/607
2005 SUMMARY Bill Fair Market Value: Assessed with:
119985 188,300
Valuations: Last Changed: 10/12/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.530 28,700 156,400 185,100 NO
Totals for 2005:
General Property 1.530 28,700 156,400 185,100
Woodland 0.000 0 0
Totals for 2004:
General Property 1.530 28,700 156,400 185,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 129
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 OWNERS r t{' TOWNSHIP SEC T _N, R W
ST. CROIX COUNTY WISCONSIN.
SUBDIVISION -
LOT LOT SIZE
Distances & dimensions to meet requirementsWof_ H62,20
-...SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
01,
r
i I di a e 140 Arrow
SC, a i
SEPTIC TANK(S) MFGR. ....CONCRETE ` STEEL
N0. of rings on cover Depth
PUMPING CHAMBER SIZE PUMP MFGR. MIL NO.
GALLONS Per Cycle
TRENCHES NO. of width length area
TIED NO. of lines width length area
depth 60 -top o pipe
NUMBER OF SEEPAGE PITS Out_si e iameter total pit area
AGGREGATE
PERK RATE RE REQUIRED 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 tha
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.
Jas
C7
INSPECTd~~~
DATED PLUMBER ON JOB `LICENSE NUMBER
z
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
Sani tarry Pea►ni t /0
` State Se p t.L
NAME 6 rownahip ` g1r- ~)("a; r i C S~° Croix County
Location l.F 81w Section aa
SEPTIC TANK
Size gatjon4. Numbers o6 Compa4.tmen.t4
D44,tance Fnomr WetZ it. 121 on gnea•ten o.tope it
Ouitding i it. We.t.Zand4 6.t.
DISPOSAL SYSTEM % Di4,tanee Fkom: We.Zt 6t° 121 on gnea-ten 4zope 6t.
&u•izaing it. We.ttan44 Ft.
H~.ghwa.ten 6t.
FIELD DIMENSIONS:
Width 06. •trench ~ 6.t. Depth o6 noek below, •tite y- in.
Length o6 each 4ine it. Depth o6 hock oven •ti e in.
Numbers, 06 tine4 Depth o6 -tiZe betow grade--, in,
To.ta.t Zeng.th o6 Zine4 it. Stope o6 .trench J n pen 100 it.
Di4.tance between Zinea 6t. Depth .to'bedn.ock 6t.
To•tat ab4 o4b•tion area j t2 Depth to 94oundwa.tea. 6 t. .
Requtned a4ea 6.t2 Type o6 Coven: Papers -on S.t)Low
PIT DIMENSIONS:
t
Numbers 06 pit4------ _ Gnave-t around pito yea no
OuUide dsame-ten it. pep•th below in.Ze.t~it.
To•ta.Z abaonb.t,.on anea
6t2 ° A
Aua negwined 6.t2 rn
ti
INSPECTED By TITLE
APPROVED , DATE
`S / 1G1.
REJECTED ,DATE 197
Y
~r a .w.fylWe
J
RLB 67 State and County State Permit #
u, Permit Application County Permit # / d
7~ • C'
for Private Domestic Sewage Systems County .^o i X
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
/
B. LOCAT N: /4, Sec UOn T. N, R (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township
IS 46
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family x 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-PlaceOther (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area sq. ft.
Newo-Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: X❑ Length Width AQ / Depth -Tile depth (top) ( No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land Distance from critical slope
WATER SUPPLY: Private X Joint ❑ Community ❑ Municipal ❑
Owners name as listed on EH 115 if other than present owner:
t, 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 ster,
NAME 1")4j j2 ,„J ~ I J C.S.T. # ~ -and other information
obtained from (owner/builder).
Plumber's Signature MP/MPRSW# Phone
Plumber's Address
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.
3 E a W
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3
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J Vol r4 9-01,0
Do Not Write in Space Below ` FOR COUNTY AND STATE DEPARTMENT USE ONLY /
Date of Application 6 "'r~ r fl Fees Paid: State AS • ~ County ~ 10-V Dale 6 _2 "F
Permit Issued/Rejeceed (date) Issuing Agent Name ' -e
Inspection Yes_~o 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
EH 115 Rev. 9/78
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION: Y4/JL' '/a, Sectio1 ,T-~LN,R (or) W, Township or Municipality CC)1~t5` 4 j 4, k
Lot No., Block No. I County) /
Subdivision Name
Owner's/Buyers Name:
Mailing Address: ecmf 4,114
TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT -ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS
SOIL MAP SHEET_ Ji NAME OF SOIL MAP UNIT fu, wb6t hPa:ri!TZr
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 AFTE INTERVAL
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
P-
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- L 1 G -
B- > 7
B_
IS4 L,2
B- > T
B- ) l
B- `
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancy AC .Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope.
P.
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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.
^,:,ame (print)._ I Certification No. S 3
Address
Name of installer if known
CST Signature 'l Z
Copy A -Local Authority