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Parcel 042-1026-30-000 01/09/2007 03:13 PM
PAGE 1 OF 1
Alt. Parcel 10.29.18.145C 042 - TOWN OF WARREN
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 - TURBEVILLE, PAUL & JEANETTE A
PAUL & JEANETTE A TURBEVILLE
1281 110TH AVE
ROBERTS WI 54023
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 1281 110TH AVE
SC 2422 ST CROIX CENTRAL
SP 1700 WITC
Legal Description: Acres: 5.000 Plat: N/A-NOT AVAILABLE
SEC 10 T29N R18W 5 A N 726 FT OF W 300 Block/Condo Bldg:
FT OF E 1018 FT OF NE NE
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
10-29N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
03/20/2002 674022 1857/229 LC
07/23/1997 549/617
2006 SUMMARY Bill M Fair Market Value: Assessed with:
149158 214,100
Valuations: Last Changed: 10/22/2001
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.000 48,500 107,700 156,200 NO
Totals for 2006:
General Property 5.000 48,500 107,700 156,200
Woodland 0.000 0 0
Totals for 2005:
General Property 5.000 48,500 107,700 156,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 215
Specials:
User Special Code Category Amount
018-RECYCLING SPECIAL ASSESSMENT 15.00
Special Assessments Special Charges Delinquent Charges
Total 15.00 0.00 0.00
REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM
Sani~any Pehm~t 3
State Septic
NAME Township Y.(/ijof_ St. C,,Loix County
Location Section /6 Lot # Subdivision
SEPTIC TANK
Size gafton,6 Numbeh o(j eompahtments
i
Distance {nom: WeU Buitd.ing ) 12% stope
H,ighwaten
PUMPING CHAMBER
Size gatfon4_ Pump Manu6actunen Model NumbeA.
HOLDING TANK
size ~ j _gafon5 Numbe.n o6 CvmpahLtments
Pumpen~ _ Atan.m System
Di,, anee ()nom: WeU Bu,itding 120 stope
Highwaten
ABSORPTION SITE
Bed Trench.
0.i_6tanee (1nom: Weff_ 1,5 y y Bui. ding 920 stope
H ighwa,tc-A
ABSORPTION SITE DIMENSIONS
Width o o the nch
6t Requ.i.h.ed area- At
Length o o each tine
J?Ij -6t Depth 06 naeFz befaw ttite.~in
Numbers oo ftine,5 Depth 06 nook oven tile. in
Tq ta. length. o6 Unes6t Depth o6 tiU below grade .S Q in
' i6tanee between ttnes ~ 6t Shope, oA trench in. pen 100 6t l
T ,taQ" abs onption area 6Z T
ype 06 Coven: Paper v .5thaw
-'PIT DIMENSIONS
Numbe.h oo pits Gnave2 around pits ye's no
Out/side d,iameten- Depth b etow .intet 6t
Tota,L abson.pt,ion area 6t
Area ncqu~ned 6t
INSPECTED BY-TITLE
APPROVED A DATE S 198
REJECTED DATE 198
REASON FOR REJECTION
f REPORT' OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM
Sani~ any Penrriit ..3
State Se-pt.i.cA - - -
'AM Aa& Township St. Ckoix Countt
cation Alf- _Sec'tion/d Lot # Subdivi.6ion
:1PTIC TANK
S4 ze___~ gattone Numbers o6 eompaAtmen-th
4 tance 44om: WeX-X BuiXdin
9 G..A 12% sk a a e
Highwa.te.A
'HMPING CHAMBER
Sc-ze_ gaX.2on6 -Pump Manu6ac-tun.eA Modet NumbeA
O1.DING TANK
~ S.i z e.
gatton,5 NumbeA o6 CompaAtmen-t,5
PumpeA AZaAm Sy,6tem
cn tance. 64om: We.E.E Building 12% slope
Highwa.te,t
BSORPTION SITE
Bed TAeneh
'catance 64om: WeXX` !'5 Building 12% stope
Highwa,teA
iiSORP7ION SITE DIMENSIONS
Width o (j tAeneh C~) 6,t. RequiA-ed area 6t
Lenuth o6 each one ~ ~ 6t Depth o6 Aock betow tite-ZX --in
Numbers o6 X4_-4'Lea_ Depth o6 Aoek oveA tiXe. in
f o taX Un -th. o X.i,ne.
9 6 ____Z0 6 `___6t Depth an ttiXe beXaw gAade in
,flc:ntance between tine's 6t SXope o6 .tAeneh in. pe.A 100 6.t
l u to e abs oAp -t.c.on area 6.t Type o6 Coven: PapeA o a ttaw
'I1 DIMENSIONS
Numbers o A pi t% GAaveX. a&ound pits ye,5 no
Ou.t.6ide d.i.ameten.6-t Depth beXow inte-t 6,t
TotaX abeoAp.tion aAea 6-t
AAea Ae-qutiAed _ 6t
NSPECTED BY Ly , TITLE APPROVED _ DATE 198
EJECTED DATE 198
'(ASON FOR REJECTION
y AS BUILT SANITARY SYSTEM REPORT
. t
OWNER TOWNSHIP( 3f~; SEC. IL=TN, R I W
ADDRESS ST. CROIX COUNTY WISCONSIN.
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
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' I di ate ozthj Arrow
SCAL t
SEPTIC TANK (S) f q MFGR. CONCRETE L / STEEL
NO.---'of rings on cover Depth
PUMPING CHAMBER SIZE PUMP MFGR. MODEL NO.
GALLONS Per Cycle
TRENCHES NO. of wig- length area
BED NO. of lines width length ~ area
dept to top o pipe
NUMBER OF SEEPAGE PITS outside diameter total pit area
AGGREGATE
PERK RATE ~~f,~ AREA REQUIRED 1_ / 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 iiIS SYTEM.
INSPECTOR
411"
DATED PLUMBER ON JOB .~~•1.~ r c 'L _
LICENSE NUMBER r
• AS BUILT SANITARY SYSTEM REPORT
T014NSHIP SEC. T N R
0. ADDRESS , ST. CROIX COUNTY, WISCONSIN.
-3DIVISION LOT 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 j
I S CALF : I
.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
).W, RATE AREA REQUIRED AREA AS BUILT
1ISCiaimer: The inspection of this system by St. Croix County does not imply complete
.0p liance with State Administrative Codes. There are other areas that it is not possible
10 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
.jterrdne cause of failure.
,,EASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
'-INSPECTOR
DATED PLU:tBER ON JOB
LICENSE NUMBER
v.
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0
State and County State Permit #
PLB-67 Permit App
for Private Domestic lication County Permit #
Sewage Systems County
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
yc, 16 l 1) ( f V"~ )/r h / X, E. E , I,, t," ~f
B. LOCATION: f✓! '/4 N/' '/4, Section ie , Tv-,_ N, R A E (or) (_W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township is
C. TYPE OF OCCUPANCY: *Commercial "Industrial *Other (specify) *Variance
Single family X_ Duplex No. of Bedrooms j' No. of Persons ;v
D. SEPTIC TANK CAPACITY / CC Total gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete ?C 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 X Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: Length 54' Width b Depth- 24 Tile depth (top) 2c No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land C c `/r 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 Tester, ?
NAME All C.S.T. # .575-- C- -ZAj and other information
obtained from ovyner builder).
Plumber's Signature Phone #
MP/MPR W#' 7l~
Plumber's Address ScZL" ~T. l//~.✓ ~ S` C/
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 ,p''-~6 Fees Paid: State~.CZ County e L~~ Dat - Gl
Permit Issued/Rejected (date) Issuing Agent Name
Inspection Yes_A/ 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
REPORT ON INSPECTION OF SANITARY PERMIT
(1) Name and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection
~ / - ~
Time of Inspection
ame, ress, icense NO. o ns a ing Plumber
3 I STALLATION CONSISTS OF: Septic Tank ❑ Seepage Trench ❑ Dosing Chamber
❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank Fill System
BEN Permanent reference Point) Describe: 4A-04.4
Elevation of vertical reference point: Slope at site:-, Yt,
(5)MATERIAL AND DEPTH OF SEWER:
(6)SEPTIC TANK: Manufacturer: Liquid Capacity: Z, ca
Tank Inlet Elevation: ' Tank Outlet El ev :
# ft to lot or property line: # ft to well:
POSING 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 ❑ NO; 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 QED SIZE: ft width; ~ ft length; -tile depth;
_1 i.neal fee ti 1 e; ~.Z j ft to res i dence; .eft to wel 1 ; l 0 ft to lot or
property line; ) ft to ordinary high water mark of lake or stream; I ft to edge
of slopes greater than 20% falling away toward lakes, water courses or drainage ditches
Elevation of tank discharge line entering bed ILI 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 PIMO Floodplain? ❑ YES 0 NO
DILHR-SBD-6095 N.05/80 l
Signature of Inspector:~~ /
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PFHPPP1--l~ Rev. 9/78
t a . „ w REPORT ON SOIL BORINGS AND PERCOLATION TESTS
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION: Section T / 114/ In
~N,R _E (or) W, Township or Municipality ' 1
Lot No. , Block No. County S// e-~eolx
~4 Subdivision Name
Owner's%Buyers Name:
Mailing Address:
TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW REP'L~ACEMENT ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE SOIL BORINGS 3~ PERCOLATION TESTS
SOIL MAP SHEETS J NAME OF SOIL MAP UNIT
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 MIN; IN
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
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1-3& 6 "jdm-G S/Z- "~~l,u- S;/
P- yL ? 2 "DAP Z 3 Oo f 3_
P- 3 5r~ 1.
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- /R R
B- _jrAV
B- P ENE > 12A, • C/' 0 QtL 3 "L
B_ OJ~E_
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan theel cation 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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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.` `
/ poh,6:xr Certification No.-33 0.2- 5`f Z-
Nacre (print)
Address Le/-3 612~11,)N
Name of installer if known
CST Signature
Copy A - Local Authority