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Home My WebLink About182-1003-50-000 A I I G 2 3 135 Pyyl b 60 _ 4 {a.a"."1 ye ~ a. ~ a.Y NAME OF BUSINESS S~ ~ f LOCATION street or highway ~ ter- or township county' OWNER Mailing address4_A; /7j~j ARCHITECT OR ENGINEER Address PLUMBEP/2J /,11• < Address 1. Check appropriate building usage(s) and fill in the information requested opposite each usage listed: Existing building _ New building Addition if addition to existing building attach detailed memo for each. Restaurant or dining room . . . . Seating capacity (10 sq.ft./person) _ Motel ( ) Hotel ( ) Cottages Number of units: R;~e~ular FIousokoopi 2 persons/unit 4 personas/unit - TOTAL NUMBER OF UNITS Bar or cocktail lounge . . . . . Seating capacity (10 cq.ft./person) Nuraing or rotirem€aait home . Number of beds Mobile home part . . . . . Number of units - dependLxnt nondeapondcxit Servioo station . . . Zr=bor of es?ro zsorved (daily) Sohool . . Nuseber of olaasrooms Meal-, served Yoe- No Showors provided Yeses No Faotow or offico building lhm-bor of persons (total all sitifts) Residonoe llwzbor of bcdrocza _ P` Other - sspccify Vecelz-1 ~.~1~' / !t t.~'aaaoi* 2. Indicate whatlier or not the folloraing faoilities are connocted: Food waste grinder . . . Yes No ~ Aishtashor . . . . . . . Yes 'No Automatio olothcs washer Yes Nom S. Fill in the appropriate infors atiou for th;a ffollo:ring as indicatods Septio frank oaa.paoity planned Norstal septic tom; capacity roquirod J=--t 5Vp inoroano for IWO or J~l /s Total septic te:a~'_-c eapaoity required Percolation test rogults - ATTPs;',FI_PrlP.COGAi1011 HE, I'I-OF1t SI-r Soopago tronoh bottom area planned width depth linear foot SoopmSe pit planned outside diameter depth bolos inlet depth Seepage trench bo`.4;c j are-% requirad width , linear foot Seops-go pit roquirod _ - - ~ outside divz2oter depth bolo: i.-alet Signature of person completing form: STATE BOARD OF HEALTH, PLUMBING DIVISION P. 0. Box 309, Madison, Wisconsin 53701 Address: rr f Approved: Date Date - --SEP 0 419k- (~r THIS APPROVAL IS BASE.' 0 Ir G CODE REQUIREM nl' ri.'; uJES PI03 EXEI PT THE Ir;STALLAi wN IY, VIL. tAGE, TOV1tSliIP O;i Cu;,.f; 6LATW1i3 OR P&Pt,1IT REQUIP,Er„Liif.~. ~r'FC3T OF INSIP CTICN---INDIVIDWiL PHDIA dY T_ .,'TN '_ivT consists of -Septic tank. Other (Describe) _PTIC TANK : Distance from: ` ell ,Sb ft. Lot Line ft : Building h ft. High watermark ft. 1215 or greater slope ft. etland ft. Cistern ft, No compartments/_. Liriuid capacity gal. EFFLUENT DISC-04L SYSTi,T., consists of Tile field. Zr` eepage pit(s). Tile Field:Distance from: Tell 100 ft. Building~ft. Lot line ft. Cistern ft. High watermark of water course ft. Slope 12/ or greeter ft. ' etland ft. Total length of the lines ft. Number of lines Length of each line ft. Distance between lines ft. ,-idth of trench in. Total effective absorption area of trench. 'r.ottom /0D sq. ft. Depth of filter material below tile in. Depth of filter material over tile in. Cover over filter material Depth of the below finished Bade in. dope of trench bottom in. per 100 ft. P,;--nth to bedrock ft. Depth tc ground water ft. Seepage 7its:Distance from: 7Fell ft. Puilding ft. Lot line ft. Cistern ft. High watermark of water course ft. `elope 12 or greater ft, etland ft. Number of °its Outside diameter ft. D pth below inlet ft. Lining material _ Gravel around pit: Yes. No, Total i'oscrption area sq. ft. Square feet of seepage trench bottom area required Square feet of seepage pit area required Pre-construction Inspection Date of Inspection , 19 Inspected by: Title: Construction Insnecti.on Date ,19_ Date ,19 Date ,1 -M. / Anprove(i . Date ,19 G A, ~ Rejected Date ,19 ~,XHIBIT NO. 5 - 10,00 , I~_ County, Town of Gt.~2c v Sanitary Permit Anplication No._2 7 Owner Sanitary Permit Ile, ,roperty .address Land use Permit No. Street or Highway Septic Tank Permit 7 . ~,subdivision Jw -r LO-r- J k~ Parcel 182-1003-50-000 03/19/2007 02:18 PAGE 10F 1 Alt. Parcel 311801-44-50-03-03-000 182 - VILLAGE 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 - SCHWAN, GERALD D & SANDRA A GERALD D & SANDRA A SCHWAN PO BOX 67 STAR PRAIRIE WI 54026 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 308 MAIN ST (L SC 3962 NEW RICHMOND nt' fj4OLA ' SP 1700 WITC Legal Description: ' Acres: 0.000 Plat: N/A-NOT AVAILABLE LOT 3 BLK C ORIG PLAT VIL STAR PRAIRIE Block/Condo Bldg: FKA PARCEL 22 INC PARCEL 182-1003-30 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 01-31N-18W r, 7 Notes: U Parcel History: Date Doc # Vol/Page Type 01/22/2001 637171 1577/429 WD 07/23/1997 8031219 07/23/1997 06/2 2007 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/08/2003 Description Class Acres Land Improve Total State Reason COMMERCIAL G2 0.000 30,000 78,600 108,600 NO Totals for 2007: General Property 0.000 30,000 78,600 108,600 Woodland 0.000 0 0 Totals for 2006: General Property 0.000 30,000 78,600 108,600 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 Lll~-37y Parcel 182-1003-60-000 03/19/2007 02:34 PM PAGE 1 OF 1 Alt. Parcel 311801-44-50-03-04-010 182 - VILLAGE 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 - SOS INVESTMENT LLC SOS INVESTMENT LLC 312 MAIN ST STAR PRAIRIE WI 54026 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 312 MAIN ST SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE S 60' OF W 130' OF LOT 4 BLK C ORIG PLAT Block/Condo Bldg: VIL STAR PRAIRIE FKA PARCEL 23A Tract(s): (Sec-Twn-Rng 401/4 1601/4) 01-31N-18W Notes: Parcel History: Date Doc # Vol/Page Type 04/04/2006 822095 AMLC 03/04/2005 788837 2759/315 LC 03/04/2005 2759/315 LC 07/23/1997 1130/24 WD more... 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/08/2003 Description Class Acres Land Improve Total State Reason COMMERCIAL G2 0.000 15,000 130,300 145,300 NO Totals for 2007: General Property 0.000 15,000 130,300 145,300 Woodland 0.000 0 0 Totals for 2006: General Property 0.000 15,000 130,300 145,300 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