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Home My WebLink About002-1048-40-000 n (n O v n r_ o to o v1 d v m m O 0 ~G _l~1 • 0 Z ° W 0 0 E3 oo 0 I y v p ° c a to N rLl A O C 2'- Z CL z o) O W 7 j li 7 G 1 N_ d= o) Cb a) 0 co .Z7 O WO C) O ~ :0 n N W O W O O I 3 NN) it o 0 0. a m ~ co w cn < D a ° O N C :7 N CD cm < c _ 1 SD r. o o I 3 O W ~ o j m a m -j cJO n 0 cn N O c ~ co co 0o 0O o0. z G G G z co ~ Z - p - -I -'1 -I OfV ' - 3 en fA fn v, a C, v o 0 O ffl N N < " d v N f9 = 1 a I Z N z --I z c D O o 5 ~ s ti N ~ o 77 Z A Z CD O n D A z 0 O I r1i Cl) N O co _0 m co CD (D :~t C z 3 a o cn m N ~ CD 4, W p~ O (D a m a o - Z) ~ z a (D I ~ I 1 A I I a t I ~ t I ~ ' o 0 a a 0 lv I o b A w (D ~ V to O ~ 0 (D O i ti Parcel 002-1048-40-000 02/14/2006 02:21 PM PAGE 1 OF 1 Alt. Parcel 20.29.16.303 002 - 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 - JENSEN, JOAN L JOAN LJENSEN 2290 80TH AVE BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 2290 80TH AVE SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 20 T29N R16W SE SE TOWN BALDWIN Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 10/19/2001 659573 1741/518 TI 07/23/1997 776/455 02/27/1991 466781 894/20 QC 2005 SUMMARY Bill Fair Market Value: Assessed with: 87002 Use Value Assessment Valuations: Last Changed: 05/18/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 9,000 78,200 87,200 NO AGRICULTURAL G4 24.000 2,700 0 2,700 NO UNDEVELOPED G5 6.000 1,800 0 1,800 NO AGRICULTURAL FOREST G5M 8.000 3,200 0 3,200 NO Totals for 2005: General Property 40.000 16,700 78,200 94,900 Woodland 0.000 0 0 Totals for 2004: General Property 40.000 19,900 78,200 98,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 510 Specials: User Special Code Category Amount 010-GARBAGE SPECIAL ASSESSMENT 45.00 Special Assessments Special Charges Delinquent Charges Total 45.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP y r SEC.<~" T N, RXl W P.O. ADD MS ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100FEET OF SYSTEM tire,, 47 35 /~In,E,IF ~ 11C/JSf.' U~ f j SEPTIC- TANK(S)1,- r, MFGR. c.- CONCRETE,~-_ STEEL No. rings on cover / Depth DRY WELL TRENCHES No. of width length area _ BED no. of lines width ~ len t:h 3 g area deptE to top of pipe .5v AGGREGATE , PERK RATE AREA REQUIRED 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 THIS SYSTEM. INSPECTOR DATED PLUMBER ON JOB - LICENSE # r. . S ,T . RFPOP~T •'Jr~'l:t1SI'_r,C'lI0?I--I:IDIJI:llI1AL ~I:,•InGE llISPMV, S YST Fii Sanitary Permit State Septic' .A!-1E L~ t 1)C ~ ~~.~(.~%~Z T01•I11SHIP St. Croix County Ss.°TIC TA'11' Size gallons. 'umber of Compartments Distance From: We 11 ft. 12% or greater slope ii. Building ft. Wetlands ft I1ighwater ft. DISPOSAL SYST:1 Tile Field or Seepage Pit(s) Distance From: Dell ft. 12% or greater slope ft Building ft. Wetlands f FIELD iiighwater ft. Total length of lines ft, dumber of lines Length of each line ft. Distance between lines ft. Width of the trench '.-ft. Total absorrti.on area sq. ft-. Dept:: .of rock below the in. Dp-pth of rock over tile in. Cover over .rock,, Depth of tile below grade i.n. S1ope of trench in per 100 ft. Depth to Bedrock ft. Depth to ground water ft. PITS Number of pits Outside diameter ft. Depth below inlet ft. Gravel around pit: ___yes no. Total absorption area sq. ft. Square feet of seepage trench bottom area required vquare feet of seepage nit area required Inspected by: Title: Approved JD ate 197 Rejected Date 197. EH 1 15- WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS r r / f LGCNTION: 34 F'/4, Section T• /-N, R M7 9 (or) W, Township or Municipality County Lot No. , Block o. Subdivision Name Owner's Name: -q G- /L~'a L~ I 7-e "a - Mailing Address: _L62 o r~ TYPE OF OCCUPANCY: Residence No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS SOILMAPSHEET SOIL TYPE y,; Jc, C' i - PERCOLATION TESTS TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE CHARACTER SOIL SINCE HOLE HOLE AFTER INTERVAL NUM- INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN BER P- / P 3b ' 6-.i L[ /d S L ~~t1 ICC 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) ft 7 ,;2 c h/ G f /~iJl Ct b: ; r TJ~~ 5 r ; 3 v vc y G- G f[ - Ir / " es ,,ic B_ t /ofls e ~ ~ G• 5'~,ucly ~,Ja y b S a ~ 7a 11y1' :4 r- C1,vk,vG C-l" b ) Al ;rrJJ o . / uC y r 14, y_ 41 ~d Ae r . B %)1 jJ c% ~lC IN A141 It ~b 'I:1 c.l[? t~.v~~:c,t~~r y~'rdJ500~ ~"!t" ~,dn~cJye/vy-5 B- 71° q t, Al /li&z,,G-~ ~f•;r ./VSn; .I'S~iS'1FiUG y/Cl' /iG ''cSd~✓ 36 7 9 % of ov kAl c" &:A1 8 y s /'357PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of st t able a s. Indicate number of square feet of absorption area needed for building type and occupancy. ` ta/ ~ 1'e-4 Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. - - _ ~ -tom/ -4.,._. -Y T I s I f 1 I t ' 401 f 3 I ~ , I ~ ~ 3i I( t t { ~ i I i i { i t I ) ! µ l .v t~ < oe~4_ I I I I I I i { s~ l i k 1 ~ t y l t S 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 kno `edge nd belief. f / Name (print)~/~ y At F--5: ' Certification No.~~"r ` Address C~J ✓ a%° 1 le-el C✓ Name of installer if known E ` CST Signature y F ' = ' ' PLB67 State and County State Permit # 40 t v Permit Application County Permit # - for Private Domestic Sewage Systems County ~ f *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required _ State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. LOCATION: S /4 /4, Section C3 , T, N, R E (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village _ Township t,J,, C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance _ Single family C Duplex No. of Bedrooms No. of Persons D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste GrinderYESX-NO # of Bathrooms Automatic Washer 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 *Poured in Place Steel Other (specify) EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) 3) Total Absorb Area sq. ft. New Addition Replacement X. *Fill System Seepage Trench: No. Lin . ~ Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Length Width / z Depth a Tile Depth No. of Lines c c? _ All- a Seepage Pit: Inside diameter r Liquid Depth -t` Tile Size 5 Percent slope of land e% 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 Soil Tester, NAME e- ae 4 /7 _C.S.T. # A~~~ 777-_ and other information obtained from CAJ^,' (owner/builder). Plumber's Signatur _ MP/MPRSW# Phone # G G d V J~17S Plumber's Address L+ { w c S PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). LAY ` t 1p, Acf-ae-S L\ 0 01 US il ~r 13 aC ik IzL Do Not Write in Spa ;e Below F R DEPARTMENT USE ONLY Date of Application - 7 - Fees P Aid: State ~Q Qd CoJUnt c~ --~~Date d Permit Issued/R*j@@"d (date) 1 - s -Issuing Agent Nam " Inspection Yes--No -Valid# Date Recd _ 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 ate (pink copy) 4. plumber (canary copy)