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Parcel 004-1078-30-000 02/16/2006 09:45 AM
PAGE 1 OF 1
Alt. Parcel 32.28.15.509A 004 - TOWN OF CADY
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
JAMES A & ANNE M HELMER O - HELMER, JAMES A & ANNE M
2880 PIERCE/ST CROIX RD
SPRING VALLEY WI 54767
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 2880 PIERCE/ST CROI RD
SC 5586 SPRING VALLEY
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 38.000 Plat: N/A-NOT AVAILABLE
SEC 32 T28N R1 5W 38A SE SW EXC CERT Block/Condo Bldg:
SURVEY MAP IN VOL 3/695 ORD ASM'T INC
004-1078-40 EZ-UT-1505/89 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
32-28N-15W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 969/199
2005 SUMMARY Bill Fair Market Value: Assessed with:
106930 224,200
Valuations: Last Changed: 09/07/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.000 29,900 115,800 145,700 NO
UNDEVELOPED G5 6.000 3,800 0 3,800 NO
PRODUCTIVE FORST LANDS G6 29.000 87,000 0 87,000 NO
Totals for 2005:
General Property 40.000 120,700 115,800 236,500
Woodland 0.000 0 0
Totals for 2004:
General Property 40.000 35,700 56,200 91,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 511
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
• vaV~a.(( (Wi VL~1
'NER
0. ADDRESS TOWNSHIP
SEC.'"" : T -N., R W
ST. CROIX COUNTY, WISCONSIN.
'3DIVISION LOT LOT SIZE
PLAN VIEW
-Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
:'TIC TANK(S) MFGR. CONCRETE STEEL
NO. of rings on cover Depth_ DRY WELL
-NCHES NO. of width length area
no. of lines width length_ area
depth to top of pipe `
REGATE
.a RATE AREA REQUIRED AREA AS BUILT
,claimer: The inspection of this system by St. Croix County does not imply completa
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 x "
DATED . PLUMBER ON JOE
LICENSE NUMBER.
REPORT OF 111SPECTION--1NDIJIDUAL SI;?JAGE DISPOSAL, SYSTEii
Sanitary Permit
r.. State Septic
~ T&I-INSHIP
' t. CZOl;; COU21t _f
S7.PTIC TAMI
size gallons. "4umber of Compartments
Distance From: Well _f t. ~
12% or greater slope 4iv -ft
Building' ft, Wetlands ft
Ilighwater ft.
DISPOSAL SYS77L:4 Tile Field or Seepage Pit(s)
Distance From: Well '_.r.
ft. 12% or greater slope ~ ft
Building ft. Wetlands
FIELD Higl-lwater ft.
Total length of lines f ft, Number of lines -4° Length of
each line: ft. Distance between lines ft. Width of the
trench ~ft. Total absorption area sq, ft. Dept::
of rock below file, in. Depth of rock over the in. Cover
rr
,over.rock,, Depth of tile below grade in. Slope of
trench in ner 100 ft. Depth to Bedrock
• r. ft. Depth to
ground water ft.
PITS
Number of pits Outside diameter ft. Depth below inlet
ft. Gravel around pit: eyes no. Total absorption area
sq. ft.
.Square feet of seepage trench bottom area required`
:square feet of seepage pit.atea vequired
Inspected by Title
y ✓
Approved
Date. - 197,1
Rejected Date
197 •
EH 115
_ 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: ' - '/4, '111/4, Section Z , T?_ N, R I5' E-490 W, Township or-Ku Q 1~
Lot No. , Block No. J I hl? I X
County
Subdivision Name
Owner's Name: L_A c is t
Mailing Address: LA I,_
TYPE OF OCCUPANCY: Residence e~ No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT /
DATES OBSERVATIONS MADE: SOIL BORINGS/ PERCOLATION TESTS C-/F, /7f--
SOILMAPSHEET____~ SOIL TYPE F~l.• 1 if\F~c~
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
P- T"73 5AI:
P--F,,
C- C
SOIL BORING TESTS OFFICE r%w
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF S H NCHES
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BE )
B 1 : ti..
-7 q-
- 7 '7 ►s-n s i Z l' n G' j /
7 E, r it ' 13h S ~ 3 ' SZ 3h 1 Z Z ; Ct jn C? ~ Z. ~
B_
y -7 Z- Li 7 7 Z ~y, K (t 1 1 c e l L lZL-'~ Z
B S ' LI 7 : y s ,
O 11 /l ~'fi Z> '
.1/ k, ,-,k ~ 1 r ij i I S1 ~ .1 4, Cf ~ Z-3 !
~ ` C;
~b ~ 16 ~Y
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of suitible areas. Indicate number of square feet of absorption area
needed for building type and occupancy. J ~ J, , ' _r12L A,,r-HC C Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope.
u` C<<~N{2 ~vN_ ~ ill I_ l4`~ ;
+
V~-A Lots, C,
- - - -
f
2~
t N
TI,
3. i C, T
! I
I 4 f i
_J
_a
_ _
llj _ r
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 ~dLj _ S~lol)
Name of installer if known
CST Signature ~ C ' ~ • ~~b ` ~ ~
4 `OPY A LOCAL AUTHORITY
State and County State Permit # /
• R6 7
Permit Application County
for Private Domestic Sewage Systems Count
y-~
*DENOTES STATE APPROVAL REQUIRED j
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
(WIL M, PC
C0 Allk
E3. LOCATION: 4PS E''/4 ~L '/4, Section T~ N, R
r) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township +
c O OCCUPANCN: *CumR161iC,ai indusU-ial _ *Other (specify) *Variance
Single family Duplex No. of Bedrooms No. of Persons
TYPE OF APPLIANCES- Dishwasher YES O Food Waste Grinder YES N^ of Bath <
Automatic Washer !/YES NO Other (specify)
SEPTIC TANK CAPACITY /I Total gallons No. of tanks
Holding tank capacity Total gallons No. of tanks
Jew Installation Addition Replacement _ Prefab Concrete
Poured in Place Steel Other (specify)
FFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) 3) o al Absorb Area scI
Jew f/ Addition Replacement *Fill System
Seepage Trench: No. Lin. Feet Width 6- Depth le Depth No. of Trenches 3_
:seepage Bed: Length Width Depth Tile Depth No. of Lines
eepage Pit: Inside diameter Liquid Depth Tile Size
"ercent slope of land Distance from critical slope
~e
}'.e undersigned, do hereby certify that the information I have reported is in accord with Section H62 20.
1lsconsin Administrative Code, and that I have sized the effluent disposal
by the Certi iedoi! Tester,
NAME C.S.T. -
obtained from (owner/builder). _
Plumber's Signature MP/MPRSW# U '7 Phone may`-
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
I
H62.20, including well).
Jai „ ~ 3i•~ _
113 171~
MIA,
Do Not Write in Space Below F DEPARTMENT USE ONLY
Date of Application - Fees Paid: State C'6 County's ate i c~
Permit IssuedLEM;kwied (date) -Issuing Agent Name
Inspection YesNo Valid# Date Recd
1. county (whit copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) 4. plumber (canary copy)
i Revised Date 6/1 /76