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Home My WebLink About002-1046-95-000 o r 0 O r 3 m O y F O 1 v [ m ? N 3 CO C/) CO N O !r rn ° o o C CC) CD CID m o m CO Na + d .n N c m tai 7 ~ A N IQ W ! O CO C C) M CID c.n W 7 o O O 3 0 o o f3/-1 N (D ° M N n > a w o c m a fn Im N 2 C ° N C S a ri co CD CD Co v n r fn y co w s <n o c 0 d "WA z O O O o~ <-r, z ' a N fn to °o g D c O O N CD O < (D d - (D !V y 07 N ~ _ UNl cn 7 z N ° z co z 0 n. ^ Q 7 D `D ° CD Ch Ch y m N' O (D W 0- a 7 z m -i to ~n .p Z Q A z 7 O ~ C z NJ co O M G CNO o. z 0 3 A_ 3 y z < (D W (p O O Ir O 7 G U) m = ^J C w S c =r 0) O < 7 O. N fD iC CD N y ~ QO fp (D p A 3 a y S ~ m C- N Z 0o a ~c a r~ ti O o i ~rj' b Oo I< Op ,K ~ to C b °o IC Parcel 002-1046-95-000 02/15/2005 03:20 PM PAGE 1 OF 1 Alt. Parcel 20.29.16.297C4 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): * = Current Owner * SIEGERSMA, BRUCE & PENELOPE BRUCE & PENELOPE SIEGERSMA 843 220TH ST BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 843 220TH ST SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 2.390 Plat: N/A-NOT AVAILABLE SEC 20 T29N R16W IN NW SW LOT 4 CSM VOL Block/Condo Bldg: 3 PG 825 ORD TOWN BALDWIN Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 2004 SUMMARY Bill Fair Market Value: Assessed with: 42356 158,400 Valuations: Last Changed: 11/02/1999 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.390 9,500 97,000 106,500 NO Totals for 2004: General Property 2.390 9,500 97,000 106,500 Woodland 0.000 0 0 Totals for 2003: General Property 2.390 9,500 97,000 106,500 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 Parcel 002-1046-70-000 02/15/2005 03:20 PM PAGE 1 OF 1 Alt. Parcel 20.29.16.297C1 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): Current Owner " SIEGERSMA, BRUCE & PENELOPE BRUCE & PENELOPE SIEGERSMA 843 220TH ST BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 2.160 Plat: N/A-NOT AVAILABLE SEC 20 T29N R16W IN NW SW LOT 1 CSM VOL Block/Condo Bldg: 3/825 ORD TOWN BALDWIN Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 705/328 07/23/1997 691/536 2004 SUMMARY Bill Fair Market Value: Assessed with: 42353 13,700 Valuations: Last Changed: 11/02/1999 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.160 9,200 0 9,200 NO Totals for 2004: General Property 2.160 9,200 0 9,200 Woodland 0.000 0 0 Totals for 2003: General Property 2.160 9,200 0 9,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04117/2001 Batch PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 002-1046-80-000 02/15/2005 03:19 PM PAGE 1 OF 1 Alt. Parcel 20.29.16.297C2 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): Current Owner " SIEGERSMA, BRUCE & PENELOPE BRUCE & PENELOPE SIEGERSMA 843 220TH ST BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 2.390 Plat: N/A-NOT AVAILABLE SEC 20 T29N R1 6W IN NW SW LOT 2 CSM VOL Block/Condo Bldg: 3/825 ORD TOWN BALDWIN Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 705/328 07/23/1997 691/536 2004 SUMMARY Bill M Fair Market Value: Assessed with: 42354 14,100 Valuations: Last Changed: 11/02/1999 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.390 9,500 0 9,500 NO Totals for 2004: General Property 2.390 9,500 0 9,500 Woodland 0.000 0 0 Totals for 2003: General Property 2.390 9,500 0 9,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT OR "7ER P Jr.-" ;q TOWN SHIP SEC. z Tl? N, R W --,3. ADDRESS: ST. CROIX COUNTY, WISCONSIN. 3DIVISION , LOT LOT SIZE 3o<_ rt's . Bo 1 l~ hJU.a~ OV\ LoT PLAN VIEW Distances S dimensions to meet requirements of H62.20 ~S Yin SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM / z -Vert e~ 4 131 r _ ti pp - - 'v TIC TANK(S).':?. J MFGR. _CONCRETEY STEEL NO. of rings on cover ~ Depth f;" DRY WELL ..NCHES NO. of width length area no. of lines Z!` width x~ - length s'_; ` area r~llO'~" ¢ jZ5 ~6 "r 'y" depth to top of pipe 4AW 3REGATE .-:K RATE AREA REQUIRED T-1.5 4~ _ AREA AS BUILT x541 --claimer: The inspection of this system by St. Croix County does not imply complete ;pliance with State Administrative Codes. There are other areas that it is not possible inspect at this point of construction. St. Croix County assumes no liability for -tem operation. However, if failure is noted the County will make every effort to ._ermine cause of failure. _=ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. 'INSPECTOR _ DATED PL[JMBcR ON JOB LICENSE N IBER r ,y yCyL i RfiPOP,T OF I11SprCT10'_1--INDI (DUAL SE1,4A(-,E DISPOSAL SYSTEM Sanitary Permit .,fey • • r State Septic MIE T01• NSHIP • t. CroiCounty S)RPTIC TA' ?I ze /DD IQ gallons. `lumber of Compartments Distance From: We 11 70 ~ ft. 12% or greater slope fi. • Building' ;'_q ft. Wetlands ft I~ighwater ft. DISPOSAL SYSTE:-1_Tile Field or ° Seepage Pit(s) Distance From: hell /06) ft. 12%.or greater slope* ft Building; ~5 ft, Wetlands f:. FIELD 'Highwater - ft. Total length of lines Z,37) ft. Number of linesLength of each line ft. Distance between lines ft. Width of the trench ft. Total absorrti.on area sq. ft. Dept-: of rock below tile 1_2 in. Dp-pth of rock over the .Z in. Cover nver.rock,6'_14AA Depth of the below grade S2ope of trench Z in ner 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: _A_yes no. Total absorption area sq. ft. Square feet of seepage trench bottom area required Uquare feet of s epap.e nit area required ~9 9 Inspected by. / Title': Approved l~~~fl Date 197,F. Rejected Date .197-. EIR 1' 15 i 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 LOCATION: ~W'/4~/4, Section 49-'0 , T6VN, R/66 (or) W, Township or Muai-_ J+t+/ ~A~cfwi~d Lot No. , Block No. County rsf Ci0QO 1 K u division Name Owner's Name: Mailing Address: r sJ t S i~~_0 TYPE OF OCCUPANCY: Residence No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT. DATES OBSERVATIONS MADE: SOIL BORINGS 9 " P - 78 rPERCOLATION TESTS / 9 SOIL MAP SHEET SOIL TYPE 5i9,-J 7//A 0 5, 1- 7 - C.j PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN i P- / 6 0 la,V+'',t g-~ a R~~,~ y a+,1 o 30 A. k v;Z /✓r P_ if t AV /V0 P-9 C5 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) 07Z o P or 4 eA. AY 9N y rn p rr B Z y .r J ~r M , Q if ry ri 'T D O f3 7~1" ) 4 ~rr 16 4 q 7;1 /91 el It C B-~ 7a /6' v r~ ~e PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the locationand square fee of um leiareas. Indicatepumber of square feet of absorption area needed for building type and occupancy. "WF 6 0 a Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. I ti. a. a.,__.. .___1, -t . . e _ I I A.1 1~i -4 - ' 1 ' f ~ I "i ' I I ~ 3 t V ff t t a -r -T - _ z t -t Fr t r ._A _ a i I i ~ t i i - T r .7r (L t e P i~ t E 19 3 { 4 1 ; NO + { N 1 t 3 OF 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. ✓~°~~7~ r/O'°~' Certification No. Name (print) Address I R~ d r:v/rJ t~/ Name of installer if known Y e OLgf 4- CST Signature >:PY A - LOCAL AUTHORITY I State and County State Permit # PLB ~7 Permit Application County Permit # for Private Domestic Sewage Systems County S!'f. "ea/ *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER O PROPERTY Mailing Address: ARV e y J~1 ~~C. l~c ,•,~,g 1119 r►) M e A✓ C.tJ ~'t B. LOCATION: 1VW '/4 SW Section Aa, Tal_ N, R 6 (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township 191- co "i C. TYPE OF OCCUPANCY: Commercial *Industrial *Other (specify) *Variance Single family Duplex No. of Bedrooms No. of Persons D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste GrinderYES-)~-NO # of Bathrooms Automatic Washer X YES NO Other (specify) E. SEPTIC TANK CAPACITY 10049 Total gallons No. of tanks olyle- *Holding tank capacity Total gallons No. of tanks New Installation x Addition Replacement _ Prefab Concrete *Poured in Place Steel Other (specify) _ F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) / 3) A0 Total Absorb Area sq. ft. New_ Addition Replacement .Fill System Seepage Trench: o Li Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Ler Width /,;I ' Depth _ CEy if Tile Depth,454 ff No. of Lines -777~7'6,,-t/ Seepage Pit: Inside diameter " Liquid Depth Tile Size Percent slope of land °7. 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, t` NAME IE'y e e -,,4- d~ C.S.T. # c75-~`~T and other information obtained from W N E (owner/builder), q d Plumber's Signature MP/MPRSW# sue--Phone #v,7C- 1,370 Plumber's Address tat / " S PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). L F, n sD~ « It 0 3 lgo R ~ , , -off ~ e- d t~ 0 n P, pRop. 40 301 e in Space Below OR DEPARTMENT USE ONLY -lication Fees Paid: State 'Q, DC~ County Date (date)Issuing Agent Name Valid# Date Recd itttt~~"e--copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 :opy) 4. plumber (canary copy) Revised Date 6/1/76