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Home My WebLink About002-1036-70-000 n cn O K v n ~1 `e.l > > 0 3 r.~ ~ m ~ m •a a% • v 3 m ro /et m L 3 N -,I TI W O 0 Z= w V W (D N O O • O N ~Sn co W Q N N - G O- G G 10 - = CD a L. C) j0 W (D (D W G d1 O N rn `S N N O. =r ~ N N O ? v O J Q N N o O J 3 W o C. N C CO ~ Z D F- a ° =r a' D c o OW j j Q C) ~c w o m_ "%%t r to o -JO --j Co co (n O C '0 0 0 z O O O Y ~yt'`R~Yi, o o ° g y °n) 0 D m iu v v q o !D W G N I(D ; N n .r d ' N (D ly < N R C d co N co f z G z CO z D (D o N 0 O o m • ~o N CD w c (OD (D W a a E z cc ~ cp ~ ? 10 ? n U: + 0 A Z D n O C I G 07 _0 M N 6 O O O CL Z 3 a i O r. U1 O M_ N z (D co D C T ~ CJ C O. I ~ 2 I a I ~ ' o w 0 0 a .C a 0 `D o; EA O o t o ro CD G- Parcel 002-1036-70-000 09i22/2006 11:00 AM PAGE 1 OF 1 Alt. Parcel 16.29.16.247C 002 - TOWN OF BALDWIN 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 - FERN, RICHARD & CLARICE RICHARD & CLARICE FERN 2382 90TH AVE BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description 2382 90TH AVE SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 1.200 Plat: N/A-NOT AVAILABLE SEC 16 T29N R16W IN SE SE LOT 1 CSM VOL Block/Condo Bldg: 3/689 ORD TOWN BALDWIN INCLUDES P247E Tract(s): (Sec-Twn-Rng 401/4 1601/4) 16-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 11/14/2001 662005 1761/537 QC 07/23/1997 1064/172 WD 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/02/1999 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.200 6,600 95,700 102,300 NO Totals for 2006: General Property 1.200 6,600 95,700 102,300 Woodland 0.000 0 0 Totals for 2005: General Property 1.200 6,600 95,700 102,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch M 510 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 002-1036-70-000 07/12/2006 05:18 PM PAGE 1 OF 1 Alt. Parcel 16.29.16.247C 002 - TOWN OF BALDWIN 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 RICHARD & CLARICE FERN O -FERN, RICHARD & CLARICE 2382 90TH AVE BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 2382 90TH AVE SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC ~2,~~~~,~rYlitJ} Legal Description: Acres: 1.200 Plat: N/A-NOT AVAILABLE SEC 16 T29N R16W IN SE SE LOT 1 CSM VOL Block/Condo Bldg: 3/689 ORD TOWN BALDWIN INCLUDES P247E Tract(s): (Sec-Twn-Rng 40 1 /4 160 1/4) 16-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 11/14/2001 662005 1761/537 QC 07/23/1997 1064/172 WD 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/02/1999 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.200 6,600 95,700 102,300 NO Totals for 2006: General Property 1.200 6,600 95,700 102,300 Woodland 0.000 0 0 Totals for 2005: General Property 1.200 6,600 95,700 102,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04117/2001 Batch 510 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 OLO • AS BUILT SANITARY SYSTEM REPORT R ~r_% ~.tc( ry~ , T0JNSHIP SEC._1` N, R~~ W ADDRESS ST. CROIX COUNTY, WISCONSIN. -DIVISION LOT LOT SIZE . • PL kli VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM --r- j - --,--i f I i Y - j i Indicate Narc~~~ TIC TANK(S) IiFGR. t CONCTETE V, STEEL r~ - ~5~- S cat e % is N0. of rings on cover Lcpth~ ~ DRY WELL 'ACHES NO. of width ' engh area _ no. of line- width---L- ?.ength 7~ a, ea~ e~ c as depth to top of pipe 3:;_EGATE / . RATE ~-yS Aim A REQUIRED ~ARIA AS BUILT rx :Claimer: The inspection of this system by St. Croix County does not imply complete .:Diiance with State Administrative Codes. There are other areas that it is not possible inspect at this point of constzuction. St. Croix County Lssumes no liability for tern operation. However, if failure is noted the County will make every effort to %-rmine cause of failure. ,,6ES AI~D, OILS SHOULD N07' BE DISPOSED THROUGH THIS SYSTEM. 'INSPECTOR I)A'~FD PL12,t3ER ON JoB LICENSE N`JIMER z REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM Sanitatcy Pehm.iti- State Septiv'_ NAME Tawn/Shtip St. Ctc.oix County Location'~"% o6 Sectiom-'- V N, R' W SEPTIC TANK Size gatton1s. Numb etc. o6 Compatctment/s Di,s Lance FAOm: W ett 6t. 12% oA gtceateA zZope bit Buitd.Lng 6t. Wettand~s 6t. HighwatvL 6t. DISPOSAL SYSTEM Durance Ftcom: Wett 6t. 12% otc gtceateA ztope 6t. Buitding ? bt. WettandIs Ft. Highwa,teA 6t. FIELD DIMENSIONS: Width o6 t&ench 6t. Depth o{ Aock below Cite ~ gin. Length o6 each tine ~ 6t. Depth o6 tc.ock oven tite in. NumbvL ob Una Depth o6 tite below gtcade. in. Total Zength o6 Zine~s-! fit. Stope o6 ttcench in pert 100 6t. Distance between tines 6t. Depth to b edtco ch. Totat absmbtion area ~t2 Depth to gAoundwateA 6t. RequitLed atcea 6t2 PIT DIMENSIONS: NumbeA o6 pits Gtcavet vLound pitz ye,5 no Outside diameteA 6t. Depth below inter 4t. Totat absOAbtion aAea ~t 2 z A AAea Aequi,7ed 6t2 rn INSPECTED BY TITLE APPROVED ,SATE 197 REJECTED DATE 197- EH 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BO 309 MADISON, WISCONSIN 53701 ~ REPO~RRT ON S I L BORINGS AND PERCOLATION TEST LOCATION: Section //6, TIN, R EE (or) W, Township or M isipality t ^D 24Lot No. , Block No. County Subdivi Owner's Name: , , ,4 9. d / on Name / Mailing Address: Let W If ^D i Lj I'S TYPE OF OCCUPANCY: Residence x_ No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW X ADDITIONn REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS 4~ ~X PE P)COLATION TESTS SOIL MAP SHEET SOI L TYPE PERCOLATION TESTS TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS ICHARACTERN I NCHSOIL SINCE HOLE HOLE AFTER INTERVAL ES, BER .!'t _ P~ 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN P; No J~ o P 3 F' ll It „ 9 if He) ~ r) *L. 31LI 3144 / 1. SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) _/7 17 14 p~ a r A a ,v1~i1.. Lr/ lu 7-M y ;t I St__ ~-3 t r ~ / r r j u If ty a ~ t B- h tr rt it ,t s- tr 0 . ~r PLAN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.) i idicate on the plan the location and square feet of sjuitable yeas. Indicate n,_,r, ' s~u,r t c ' atr« r 1 a -eded for building type and occupancy. ° ~ eA, wau -F-, C-L~- - Indicate scale distances. Give horizontal and vertical reference points. Indicate slope. s i - Q FT I . ; I I, the undersigned, 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. Name (print) ° Certification No. Address L" 1 l-D ' Name of installer if known VC 12C, * - 1C. CST Signature CC COTY A - LOCAL AUTKCJ!l TY State and County State Permit # PLB67 Permit Application County Permit # 1 l' for Private Domestic Sewage Systems County C r *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. LOCATION: Section /v tM N, R e (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family X Duplex No. of Bedrooms No. of Persons D. TYPE OF APPLIANCES: Dishwasher YES X NO Food Waste Grinder YES NO # of Bathrooms Automatic Washer X YES NO Other (specify) E. SEPTIC TANK CAPACITY Total gallons No. of tanks _o-^ ~ *Holding tank capacity Total gallons No. of tanks New Installation -Addition Replacement _ Prefab Concrete ~C *Poured in Place Steel Other (specify) to - F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) 3) 141 Total Absorb Area -sq. ft. New X Addition Replacement *Fill System Seepage Trench: No. Lin . Feet _ Width Depth Tile Depth No. of Trenches Seepage Bed: Length Width AO I Depth !r Tile Depth / No. of Lines / OF Seepage Pit: Inside diameter 7,I Liquid Depth 434" Tile Size Percent slope of land i~> _ Distance from critical slope 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 S it Tester, LL NAME ' e) T _C.S.T. # and other information obtained from e (owner/builder),. Plumber's Signatur MP/MPRSW# Phone # ~d Zef Plumber's Address 4 4L PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). Ann //7 e C) 1 Z7 4:7 4t7 9~r X) ell m - - - o ! a ~ i Do Not Write in Spac el vY~ F PR DEPARTMENT USE ONLY Date of Application Fees Paid: State `e" Coun Date Q 17 Permit Issua- (date) Issuing Agent Name Inspection Yes No Valid# Date Recd 1. county (white` copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, M DISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 6/1 /76 ' TRANSFER FORM PLB 67SANITARY - T PERMIT State Permit # Sanitary Permit # County Sanitary Permit Transfer Date Original Permit Issuance Date A. Property Location: S '/4 Section , T a N, R '*r) W Lot # -City Subdivision Name, Nearest Road, Lake or Landmark BLK # Village Township 4~ B. TYPE of Occupancy:.Commercial Industrial _ Other (Specify) Single Family Duplex No. of Bedrooms Variance C. SEPTIC TANK CAPACITY -Z60V Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab Concrete X Poured-in-place Steel Fiberglass Other(Specify) New Installation Replacement LIFT PUMP TANK/SIPHON CHAMBER Total gallons Prefab Concrete Poured-in-place -Other (Specify) D. EFFLQRT DISPOSAL SYSTEM: Percolation Rate_ 3o- 4-5 Total Absorb Area / sq. ft. New Replacement Alternate (Specify) Seepage Trench: No.Lineal Ft. Width Depth Tile Depth(top) No. Trenches .7 V Seepage Bed: ` LengthWidth Idr Depth 3 Tile Depth(top) No. of Lines 3 Seepage Pit: Inside o ameterLiquid Depth -5 No. Seepage Pits Percent slope of land 0 Distance from critical slope E. WATER SUPPLY: Private ❑ Joint ❑ Community ❑ Municipal Present Sanitary Permit Holder Phone N Sanitary Permit Transferr dTo: Phone N . ti Dr --t Name Name - - r . - Address Address Zip S Zip I, the undersigned, do hereby certify that I have reported all revisions to the sanitary permit and that all revisions are in accord with section H 62.20, Wisconsin Administrative Code and that I have sized the effluent disposal system according to the EH-115 prepared by the Certified Soil Taster and/o an additional soil tests that may have been required. Plumber's Signature MP/MPRSW # Phone #_5125 Plumber's Address- d Information obtained from d w` (owner or agent) PLAN VIEW: Provide sketch below of any revisions to original sanitary permit. Include direction of slope and all distances in accord with H 62.20. Well location shall be included on the sketch Indicate or dimension location of all wells, o pr~ erty orn eigh bor's ro pert y. If well has of beennlled p)~_i"r1,dc T._ e _ € 3 I ~ , . i ~ ~ I i 6 me { 3 ~N d~ E 1 i Signature of Issuing Agent 1. County (Yellow copy) 3. Owner (Pink copy) DIVISION OF HEALTH 2. State (White copy) v. Plumber (Green eop P.O. BOX 309, MADISON W,