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Parcel 012-1022-30-110 09/06/2006 05:07 PM
PAGE 1OF1
Alt. Parcel 08.30.17.119A-10 012 - TOWN OF ERIN 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
DAVID J & SANDRA M BEEBE O - BEEBE, DAVID J & SANDRA M
1622 160TH AVE
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 1622 160TH AVE
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 3.320 Plat: N/A-NOT AVAILABLE
SEC 8 T30N R1 7W PT SW SW E 280' OF LOT 2 Block/Condo Bldg:
CSM 4/1133 ALSO PARCEL DESC AS BEG SE
COR LOT 2 CSM 4/1133; TH S 89 DEG E Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
230'; TH N PARALLEL WITH W LN SW1/4 08-30N-17W
300.98'; TH N 89 DEG W 510'; TH S
PARRALLEL WITH W LN SW1/4 65' MOIL TO
more...
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 960/154
07/23/1997 895/534
07/23/1997 877/216
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 11/21/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.320 46,200 169,700 215,900 NO
Totals for 2006:
General Property 3.320 46,200 169,700 215,900
Woodland 0.000 0 0
Totals for 2005:
General Property 3.320 46,200 169,700 215,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 221
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Wisoorsin Depart:aeat of Health anal SQoiul Services
Plb. k67 370 Division of Health
SEPTIC TANK PERMIT APPLICA'T'ION
TYPE or USE BLACK INK
A. OWNER OF PROPERTY tit>
Name Y\t.'" Address (Street, Ci~y, Zip Code)
"L ' r~ ~i L r s ~~L Lam, / ~i P. LOCATION OF PROPERTY W:En SYSTEM WILL BE CONSTRUCTED, ALTERED OR EXTENDED COUNTY
Check One: /
CITY VILLAGE LEGAL L'ESCRIPTION
TOWNSHIP r~`~ ~lr \ l
J
C. IS LOCAL PERMIT REQUIRIED FOR THIS WORK? YES NO / J / PERMIT NUMBE.1
D. SEPTIC TA14K CAPACITY Gallons NEW INSTALIA TIOH REPLACf~ENT ADDITION
MATERIALS: Prefab Concrete L Poured in Place Steel Other
NUMBER OF TANKS TO BE :NSTALLF.D: /
r
E. TYPE OF OCCUPANCY
Check One: One or Two Family Residence Commercial Industrial Other
Specify)
Number of Persons to be Accommodated ~:3 Number of Bedrooms
F. APPLIANCES, ETC: Food Waste Grinder YES NO Automatic Clothes Washer NO
Dish ashen YES NO Automatic Pota:o Peeler YE'S NO
Other (Specify)
G. M4STLR P IFR 24AKING INSTAL
i
Name: Address: License N~--bar:
Signature of Applicant; HF RSd
Add"zs:
H. ~(To be CC feted by Issui:o Agent)
Date of Application %•x~~ / / 7
Fee Paid
Permit Issued (dwte - 1,r, /tz" 7 Permit Number
Agent (Name) Far:
Town, Village, City, County, etc.
(Specify)
Note: The application cannot be considered for filing until all of the above questions are answered and the
fee paid. Agents will forward application, the fee of 41.00 for each septic taruc and the third copy
of the permit (canary) to the Division of Health. Cheeks and !Honey orders should be made payable to
the Division of Health.
Do not write in space below - FOR DEPARTMEi+r USE ONLY
1. DATE RECEIVED I (-3 - 0 ACCEPTED BY R1-17UR`tED
(Initials) (Date) See Corres.)
FEE RECEIVED VALID. No. I1,1 ~'I PERMIT NO. J
es or Nor-
REVIEWED BY APPROVED DATE
(Initials) Yes or No
COMPLETE OTHER SIDE
SEPTIC TANK PERMIT NO.
R Z P 0 R T O N S O I L P Y R C 0 L A T I 0 N T E S T
A H D S O I L B 0 R I N G S
TO
DIVISION! OF HJ+LTH - PLLMBI?K, SSCTI,-*
F.O.ox 309, Madison, Wis. 53701
Pur-4uant to iI 62.20, Wis. Ad-dnistrativa Code
P 9 R C 0 L A T I 0 N T E S T
Teat Dep~th~Charaetcr of Soil Hours Hater Tes. Ti,~+s Drop I- Water Lcvel lnoheS nut's
Number Ini'l2"'_.'Y~ess in Inohas Since Hole in Hole IntesVal Second -;o Next ttoo best To F-'11
1st Hatted Overni ht in Minutes Lest Period Last Period!Per.od @r& Inch
Example
P - 0 3611 7op Soil. 10" „Ci?- 2611 25 Yes or No 30 1 2 1%2 1/2 60
RECORD DATA FROM MDir-;UM OF 3 TEST ECr.,re
Compute size of absorption area in accord with H 62.20 Wis. Administrative Code.
S 0 I L B O R I N G S- M_tntrctm 3611 Belcw reposed Absorption System
Boring Total Lepth Depth to Groundwater De th to Bedroe',
Number Inohos ~Cbserved Seti.^ated Observed Estir-ated Character of Soil with Thio!rne`.+S in Inohs5
&mapls
B - 721' 7201 Black Top Soil 12"; Ciay 1811; Sand 1811: Grave? 24211
RECORD DATA FROM MI`iL`WNI OF s B•)=.j HOL S I
i
1 YPE OF OCCUPANCY4
RESIDENCE: Ntaaber of Bedrocas O'THERs (Specify) ( Number of Persons
FOOD 'BASTE GRINDER: Yes N(, X Distnrasher: Yes No Auta atic Clothes Waahar: Yes L No
FFUILNT DISPOSAL SYSTVis NE74 EXTENSION ADDITION REPLiCLMIENT
Tile Size ' No.Lin.Feet~ Trench Width Depth 17 Number of Lines,
Seepage Beds Length Width Depth Tile Size No. Lines
/ Seepage Pit: Inside Diametep Liquid Depth `
I, the undersigned, hereby eerti!y that the percolation tests reported rn this form were made by me or under M, super-
vision in accord with th"rocedures and method specified in Chapter H 62.20 (13), Wisconsin Ad-ministrative Code, and
that the data recorded and location of test holes are correct to the best of my knowledge and belief.
i
NAME TITLE
Type or Print
REGISTRATION NO. or MASTER PLUMBER LICr'TiS.Ea NO.
ADDRESS I'•'i r - )
DATE SIGNATURE