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Home My WebLink About026-1113-30-000 1 n cn p m -0 n I f Ln ~ y ~ c O 1 7 = 741 M 7! 3 d CD 1 3 F ~ O O O O ti W O N O O N O w N • s C N CD S w ICI CD CL a O. ro CD d CD y V 3 3 0 ►~S' lAl fJ O. CD N :3 Q O w 1 w O C:) CD (D 3 C co L, CD n 0) O A 'O A7 n O r~ O 7 f0 C=D O O C Q D1 a sv u~ Z D a CD a O N a W -4 C - - ~ O ~ CD ° y l~ L < o m m n c c O O CD N 'T P z 0 0 0 0 o. w t'vo O y 0 d v n 0) O - z 4~- Ch IV 7 3 D a. _ - V a Z a: Z co z 0 m O D a j !r • o. CD CD CD N N CD a) N O CD N w n Q 3 7 Z CD Z CD O = ~ A Z CD N CL A Z O 7 cn -I Ca (D CD W CD wo CL z 3 o cn 00 N CD CD w ~ N N N S N n O N Q n x _O• C P Z O S w = CD N Cn - O T O O; P O - 7 CD CL A 7 Q S Q Z O c r O• N j IN ~ ~ O O CD O C d ' c03~QO y nC CD-a dO CD Q cr N.0 y CD N O0 CD O co CD 7 O S~ 7Z-N ~ VO ((DD .O=r-. 7 N (~D D' c o (a CD - CD ° 3 o n n e` CD O aaco 3 ) O . N N • 3 CD n 3 7 CD =r CD O CD cz) N C N CD n ~ A 0 I CD < ft A O ti b c as 00 ti 1 PM Parcel 026-1113-30-000 10/11/2006 04:08 PAGE 1 OF 1 F 1 Alt. Parcel 3.30.18.648 026 - TOWN OF RICHMOND 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 - RIGGLE, DAVID M & PAMELA E DAVID M & PAMELA E RIGGLE 1221 172ND AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1221 172ND AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.040 Plat: 2021-GREEN ACRES ADD SEC 3 T30N R18W LOT 13 GREEN ACRES ADD Block/Condo Bldg: LOT 13 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 03-30N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1040/112 QC 07/23/1997 1035/575 TI 07/23/1997 1018/354 QC 07/23/1997 971/569 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/20/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.040 27,500 93,100 120,600 NO Totals for 2006: General Property 1.040 27,500 93,100 120,600 Woodland 0.000 0 0 Totals for 2005: General Property 1.040 27,500 93,100 120,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 217 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 026-1113-40-000 10/12/2006 08:49 AM PAGE 1 OF 1 Alt. Parcel 3.30.18.649 026 - TOWN OF RICHMOND 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 - NIEDERER, DIANE M DIANE M NIEDERER 1225 172ND AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 1225 172ND AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.040 Plat: 2021-GREEN ACRES ADD SEC 3 T30N R1 8W LOT 14 GREEN ACRES ADD Block/Condo Bldg: LOT 14 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 03-30N-18W Notes: Parcel History: Date Doc # Vol/Page Type 08/14/1997 1257/637 QC 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/20/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.040 27,500 95,600 123,100 NO Totals for 2006: General Property 1.040 27,500 95,600 123,100 Woodland 0.000 0 0 Totals for 2005: General Property 1.040 27,500 95,600 123,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 206 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisoeasin Department of Health and SOcial Services Plb. #67 3/70 Division of Health SEPTIC TANK PFRMIT APPLICATION TYPE or USE BLACK INK A. OWNER OF PROPERTY Name , Address (Street, City, Zip Code) B. LOCATION OF PROPERTY WHERE: SYSTEM WILL BE CONSTRUCTED, ALTERED OR EXTENDED COUNTY Chack One: CITY VILLAGE LEGAL DESCRIPTION TOWNSHIP C. IS LOCAL PERMIT REQUIRED FOR THIS WORK? YES NO PERN,IT NU118E-1 D. SEPTIC TANK CAPACITY > Gallons NEW INSTALLATION A REPLACEMENT ADDITION MATERIALS: Prefab Concrete ! Poured in Place Steel Other NUMBER OF TANS TO BE INSTALLED: O E. TYPE OF OCCUPANCY / Cheek Ons: one or Two Faz i1y Residence / Commercial Industrial Other Specify) Number of Persona to be Aecocradated Number of Bedrooms F. APPLIANCES, ETC: Food Waste Grinder YES V NO Automatic Clothes Washer YcS NO Dishrasha: YES NO Automatic Poteto Peeler YES- N0 Other (Specify) G. MASTER PLLl`;3ER TCL':G INST1+DkATtON ~ ~ Name:Addressi r~ License number: j Signature of Applicant: MP RSW !If Address:~~ H. I /(To be C pieted by Issui.V Agent) Date of Application ~C 7 Fee Paid Permit Issued (dal) A," '2 7~~~~j J Permit Number Agent (Name) fJ ~~,;,r,l J. / Fors~~---/A"hl'li 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 foma.-d application, the fee of 41.00 for each seotie taatc and the third copy of the permit (canary) to the Division of Health. Checks and money orders should be made payable to the Division of Health. I Do not write in space below - FOR DEPARTMENT US's ONLY 1. DATE RECEIVED t _ - ALCEPTED BY RETURNS (Initials) (Date) See Correa,) FEE RECEIVED VALID. No. ( (2- PERMIT NO. es or No) REVIEWED BY APPROVED DATE (Initials) Yes or No COMPLETE OTHER SIDE C a SEPTIC TANK PERMIT NO. y r 1 ~ b R E P O R T O N S O I L P T R C 0 L A? I O N T E S T A N D S 0 1 L B O R I N G S TO DIVISION 0? HEALTH - PL1tWI2G SBCTI6N P.O.Bnx 309, b,adison, Wis, x,4701 Pursuant to H 62.20, Wis. Administrative Code P E R C O L A T I O N T E S T Test Depth Character of Soil Hulirs Water Teat T1.-. Dro in Water rnQyss .utos k•-asber Inohes Thickness in Inohes Since Hole in Hole Interval Second to Next to Last To Fall 1st Wetted Overnight in Minutes Last Period Lsst Period Period To Fall Inch example F 0 361, To Soil 10" Cla 261, 25 Yes or No 30 1 2 1/2 112 60 RECORD D'TA FRC` ML*d.r.,iJM OF 3 TEST HOLES Compute size of absorption area in accord with H 62.20 Wis. Administrative Coda. S O I L B O R I N G S- iiiai=um 3611 Balc:a' Prc osed Abso tton S at . Borire Total Depth Depth to Ground Na:sr Depth to Bedroc,% Number Inohe-s Observed Satiated Observed Estir,.sO:ed. , C)^-rscter of Soil with Thio2mess in L eha3 Yxs.Mple B - 0 72'r 72n Blac% Too Soll 12"; C!-? r l811, Sand 161;. e'u RE -C-RD DA A FROM MI1~:'^4 OF 3 BORE HOLT-• YPE OF OCCUPANCY: ~ RESIDY-NCEs Number of Bedrooms , OrIYLRs (Speoify) Nuxbsr of Parsons ~C D WASTE GRINDER: Yea No Dishwashers Yes No-Autorsatic Clothes Washers Yes No EFFLUENT DISPOSAL SYSTEM: NEW EXTENSION ADDITION REPLLC I'IE" Tile Size" No.Lin.Feet Trenoh Width Depth Number of Lines Seepage Beds Length ?C Width A Depth 5 Tile Size No. Lines ~t Seepage Pits Inside Diameter Liquid Depth Is the undersignsd, hereby oart_.y t:st the percolation tests reported in this form we.-* made by me or under Mj super- vision in accord with the proced, sand method speoified in Chapter H 62.20 (13), Wisoonsin Administrative Code, and that the to reaor3ed and location test holes are correct to the best of ~lY knowledge and belief. j ' NAME ~r U' J L, v' TITLE Type or Print REGISTRATION NO. r1 or MASTER PLUMBER LICm.''~!. SE NO. ADDRESS '1 i i DATE SIGNATURE