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Parcel 006-1001-10-000 02/17/2006 09:04 AM
PAGE 1 OF 1
Alt. Parcel 1.31.16.10B 006 - TOWN OF CYLON
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
LOUIS J & LINDA L MAYER O - MAYER, LOUIS J & LINDA L
2349 250TH ST
DEER PARK WI 54007
I
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 2349 250TH ST
SC 1127 CLEAR LAKE
SP 1700 WITC
Legal Description: Acres: 5.194 Plat: N/A-NOT AVAILABLE
SEC 1 T31N R1 6W 1.194A IN NW SW LOT 1 Block/Condo Bldg:
CSM VOL 3/678 ALSO 3.237 ACRES AS IN VOL
623 PAGE 13 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
01-31 N-16W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 727/534
2005 SUMMARY Bill Fair Market Value: Assessed with:
12 219,200
Valuations: Last Changed: 09/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.194 30,000 161,000 191,000 NO
Totals for 2005:
General Property 5.194 30,000 161,000 191,000
Woodland 0.000 0 0
Totals for 2004:
General Property 5.194 30,000 161,000 191,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 512
Specials:
User Special Code Category Amount
073-DELQ GARBAGE DELINQUENT CHARGE 150.00
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 150.00
vER ~t n Jf'td J ,,.),143j A.. +C
TOj ( i
ADDRE3rS , NSHIP/' - SECT_ N, R W
'0 , 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
. • I ~\R
31
-TIC TANK(S) MFGR. CONCRETE STEEL
NO. of rings on cover Depth DRY WELL
NCHES NO. of width length area
' no. of lines width7 ler_gthy'?
area
depth to top of pipe
,REGATE / _
.dK RATE AREA REQUIRED ~ AREA AS BUILT
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 rr 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.
'INSPECT
DATEDD PLU'MBER' ON JOB~t~r:
LICENSE NUMBER
NLMBER
fe 7__
•
RFPO11T OF I?1SPECTION--INDIVIDUAL SE,14AGE DISPOSAL SYSTE14
Sanitary Permi4;
r State Septic
T61•1I1S H I P `ter
SF. Croi•" County
SI.DTIC TA'?71
s i ze gallons.umber of Compartments
Distance From: 'dell ; i
ft, 12% or
greater slope
Building ft. Wetlands f
lii.gtiwater ft.
DISPOSAL SYSTL.:1
a Tile Field or Seepage Pit(s)
7Z -
Distance From.. hell ft. 12%.or greater slone',.2 "'fft
Building ft. _
Wetlands f
FIELD iai.ghwater ft.
Total length of lines ~c ft. Number of lines Length of
each line ft.. Distance between lines ft. Width of the
trench ft. Total absorption area sq, ft. Depth
of rock below tile in. Dp-pth of rock over the ? in. Cover
over. xock,, v 1CL- Depth of the below grade in, Slope of
trench i -per 100 ft. Depth to Bedrock- ft. Depth to
ground water ft.
PITS
Number of pits Outside is tc~ ft. Depth below inlet
ft. Gravel around pit: es no. .Total absorption area
-sq. ft.
Square feet of see ~Ie tren h bottom area required
vquare feet of s epaf>.e p a ea required
Inspected 1>Y v' Title
i
Approved Date 197
, A-T 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: ry0'/46jl`'/<, Section TAN, R A,5ztM) Township or Municipality C e 4c&
Lot No. 4TT~, Block No. ` C£A S4 1.t~v~~' NM y~r ASS%9 D ounty S~ C1QOlX
Subdivision Name
L
Owner's Name:
Mailing Address: 49t#I ,:~)2K~j
TYPE OF OCCUPANCY: Residence - L~ No. of Bedrooms 1-3 Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS Tug - -3.5 `7k PERCOLATION TESTS
SOIL MAP SHEET SOIL TYPE g16 0,&Y e_~~~~-
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 MIN/IN
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P-
;L 15
P- A40 5 2, lg,
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)
O "I Y_& ~ U `i 4 + s' ~1.d N
/C(~P SAW
-
15 NC ff ry ~i tr IY2P -r S '.b
Ct+K
PLAN VIEW (Locate percolation tests,soiI bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of suitable areas Indicate number of square feet of absorption area
needed for building type and occupancy. lolS i I~W4i.A_ Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope.
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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. y
Name (print)u~ Certification No.
Address I 1 cs
Name of installer if known
CST Signature L'~~`
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: Section i TJtN, R _/F W, Township or Municipality CVL,,,,)
Lot No. /-cr- Block No. Cog; S 1A)Z t?-EY ~Nar Y>r7 13&1944U) County ST S
Subdivision Name
Owner's Name: G.AuC
Mailing Address: f V%'P
TYPE OF OCCUPANCY: Residence No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW V' ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS J~A " PERCOLATION TESTS
14er 40
SOIL MAP SHEET F(- '7SOIL TYPE
PERCOLATION TESTS
TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LE INCHES RATE
CHARACTER OF SOIL SINCE HOLE HOLE AFTER INTERVAL
NUM- INCHES THICKNESS IN INCHES
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD '3 /IN
P-
Sg /Q f17f 1~ C6 F c> LS
P rr
P_
SOIL BORING TESTS,scg 11444*0
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
O tr /VQ G~ ~C ! r)9 .t~ /~7 6.e fc J'/KE L CC'
Nd
517 r "B 6 L41,4&& 12 cr S p
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square f pet ofuitable areas. Indicate number of square feet of absorption area
needed for building type and occupancy. / r Indicate scale / 4 6 or distances. Give horizontal and vertical reference points. Indicate slope. A16 SC-4
f. 0, 3r- ,4jC<5 t g
t
4-130 ' 4 i i t I I l t { ' ) 4- W, - f
l
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I E r11 f I t l T'. Xjt
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i
H I
7- ft -
KK-
4--
-t---- __.__~t, - - r _
I I 1 ii + .
3 a f l y i ~ i I l 1 I ! E $ 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) AV c T), ` Certification No. -7
Address et gI BAL- ,4
Name of installer if known
CST Signature
COPY A► - LOCAL AUTHM-F4
PLB67 State and County State Permit # -
Permit Application County Permit
for Private Domestic Sewage Systems County
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY MailincL_ Address:
~ .e Y' r K m. yr (,t~ `J2 bb
B. LOCATION: AILL1'/ (Section , T_V N, Rj~& 40 (or) W Lot# City_
Subdivision Name, nearest road, lake or landmark Blk# Village
r 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 NO Food Waste Grinder YES NO # of Bathrooms_?
Automatic Washer A-YES NO Other (specify)
E. SEPTIC TANK CAPACITY Zmn Total gallons No. of tanks
*Holding tank capacity Total gallons No. of tanks
New Installation Addition Replacement _ Prefab Concrete X
*Poured in Place Steel Other (specify)
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) 3) Total Absorb Area 6X4sq. ft.
Newt/ Addition _ Replacement .Fill System
Seep e Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches
r
Seepage Bed: Length_Width Depth z Tile Depth No. of Lines
Seepage Pit: Inside diameter Liquid Depth Tile Size
Percent slope of land 9 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 Certi .Soil Tester, I Du NAME - C.S.T. # 07 and other information
obtained from (owner/builder).
Plumber's Signature P/MPRSW# _ 5 Phone
Plumber's Address ~11
I
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
y
L
i
Do Not Write in pace elow F DEPARTMENT USE ONLY t'°
Date of Application - C - Fees Paid State % u Date
Permit Issued(date) - ~-Issuing Agent Name
Inspection Yes X-No Valid# Date Recd
1. county white coPY 3. owner (green coPY DIVISION OF HEALTH P.O. BOX 309- MADISON WI 53701
2. state (pink copy) 4, plumber (canary copy)
Revised Date 6/1 /76