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Parcel 008-1050-50-000 02/21/2006 10:52 AM
PAGE 1 OF 1
Alt. Parcel 17.28.16.2586 008 - TOWN OF EAU GALLE
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
GLORIA J CHAPIN O - CHAPIN, GLORIA J
337 220TH ST
BALDWIN WI 54002
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 337 220TH ST
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 21.500 Plat: N/A-NOT AVAILABLE
SEC 17 T28N RI 6W NW SW S 21 AC & W 2 RDS Block/Condo Bldg:
NE SW
Tract(s): (Sec-Twn-Rng 40 1 /4 160 1/4)
17-28N-16W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1227/045 WD
07/23/1997 1227/037 QC
07/23/1997 801/46
2005 SUMMARY Bill Fair Market Value: Assessed with:
138614 Use Value Assessment
Valuations: Last Changed: 08/04/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 22,500 105,100 127,600 NO
AGRICULTURAL G4 1.000 100 0 100 NO
UNDEVELOPED G5 7.500 3,400 0 3,400 NO
AGRICULTURAL FOREST G5M 11.000 6,200 0 6,200 NO
Totals for 2005:
General Property 21.500 32,200 105,100 137,300
Woodland 0.000 0 0
Totals for 2004:
General Property 21.500 38,700 96,500 135,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 513
Specials:
User Special Code Category Amount
010-GARBAGE SPECIAL ASSESSMENT 138.00
Special Assessments Special Charges Delinquent Charges
Total 138.00 0.00 0.00
AS' BUILT SANITARY SY STE `t. REPORT
01tiTPdER Pe -fie C r9 ~ TOj,INSIiIP SEC. 1_ Tle N, R /6_1r~
P.O. ADDRESS ~}~c~c~, a ST. CROIX COUNTY, 14ISCONSIN
-SUBDIVISION LOT LOT SIZE
FLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHTNG V7ITHIN 100FEET OF SYSMI
\ 7
,
` lo'ISeAwaee,v I AP7KS .
6 A.)
i , 9 F~6►ri iv t i e ieAle ke OF ~Ous.e
~ t~~s t Y~ ,~,ufe,2 - a F ~ uy.as+ c-
e, o-o u~ / S~io f < < A v
fie'"-~
~ok
SEPTIC- TANK.(S)/62oo YFGR. Weeks ~Qe~ CONCRETE ~ STEEL
NO o rings on cover Depth 41 DRY- V3I:LL o00•,9I
TRENCHES No. of width length area
BED no. of lines wi_EE /;C length 9s ' _ area //~D
dept to top of pipe, " r
AGGREGATE
PEM RATE A.hL;A REQUIRED AREA. AS BUILT_Z010
llISCIA.TMER: The inspection of this system by St, Croi.v County does not imply
complete compliance with State Administrative Codes_ There are oCher areas
that it is not possible to inspect at this point of cons tr.ucti.on: St. Croi.:-_
"
Co1
Cr'.!SC ^L 47
!
Yie t_ed t-1-0 (,o,":`1 7 r11_1 71~1..C ,1
GREASES AND OILS SHOULD (D'~ DE DISt'USE1) Tf'POUGi' THSYS
IFSPECTOR
DATED 7- 7~ , R ;N' TO
,-7AGE DISPOSiU, SYSTEii
YT
V Sanitary Permit
1 t Suite ~sel)t1C
x
t . Cro" County
C Tt~.'?T:
gallon;,.umber of Compartment:,
oi^t-ance From: WeII ~ 7 ft. 12% or greater slope ft.
Building ft. Wetlands ft
'igl~~,~~ter ft.
DISPOSAL SYSTE.1Ti.le Field or Seepage Pit(s)
=ist«nce From: hell ft. 12% or greater slope ft
"uildin~- -ter-=--ft. Wetlands f.:
FIELD i:ighwater ft.
Total length of lines L _ft. Number of lines Length of
each line
2 0 ft. Distance between lines ft. Width of toile
trench„ ft. Total absorption are ~f sq. ft. Dept':
of rock below file in. Dp-pth of rock over tile ,Z.. in. Cover
. over .rock, ~ Depth of tile below grade in. Slope of
rench in ner 100 ft. Depth to Bedrock ft. Depth to
1 5ground water ft.
PITS
'Number of pits Outside diameter ft. Depth below inlet
ft. Gravel around pit: `yes no. Total absorption area
_JG~ 1 J s q. f t.
Square feet of seepage trench bottom area required
%Cquare feet of seepage nit area required
Inspected by: Title':
Approved Date 197.
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
IT, ON SOIL BORINGS AND PERCOLATION TESTS
LOCATION: Section IT, T~-N, R/~O 6 (or) W, Township or Municipality
Lot No. , Block No. County
i A s ubdivision Name
Owner's Name: ly, ,
Mailing Address: ~H L. r ( r S
TYPE OF OCCUPANCY: Residence X No. of Bedrooms 772'a esOther
EFFLUENT DISPOSAL SYSTEM: NEW -1< ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS 6 - 2 1 - 77 PERCOLATION TESTS - .2
SOIL MAP SHEET Jim SOIL TYPE X14 T p~~ ~OArh 4~
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
l..i p
P 57
P- A/0 p
v SOIL BORING TESTS r
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
2-q U
B- 01
/(f 1,
S r' T k p C~
B- /
f~ i P~ rr
PLAN VIEW (Locate perco lat io n tests,so i I bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of suitable 9reas. Indicate number of square feet of absorption area
needed for building type and occupancy. 4/195, 143 Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope.
r
Ci q4
t N
L
10
a
C ~ 3
160
G
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) / V RC ft Certification No. - S ly
Address A / 10 ( ~ -
Name of installer if known e f .f a L
CST Signature " -
State and County State Permit #
P-LB67 Permit Application County Permit #
for Private Domestic Sewage Systems County,x (~"1'~~'✓
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
iS
r~~c~car~S Sm"r ~3a1c~u=► A)
B. LOCATION: ltL '/o t. Y4, Section T N, R & (or) W Lot# City -
Subdivision Name, nearest road, lake or landmark Blk# Village _
Township f:-~4 L?_~&LlG
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms e:,E' No. of Persons v
D. TYPE OF APPLIANCES: Dishwasher X YES NO Food Waste Grinder YES NO # of Bathrooms--Q-"
Automatic Washer A -YES NO Other (specify)
E SEPTIC TANK CAPACITY /000 Total gallons No. of tanks O
*Holding tank capacity_ Total gallons No. of tanks
New Installation 14" Addition Replacement Prefab Concrete x
'Poured in Place Steel Other (specify)
F EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) _O_ 2),,2 3) -2-51-Total Absorb Area / sq. ft.
Addition Replacement 'Fill System
New
Seepage Trench: No. Lin. Feet _ Width Depth Tile Depth No. of Trenches
1 1005 -
-JV-Depth f~ Tile Depth No. of Lines 7; c G
Seepage Bed: Length (Width
Seepage Pit: Inside diameter Liquid Depth Tile Size Q
Percent slope of land 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 Certifie Soil Tester,.
NAME f ;2~', ~gl C.S.T. # and other information
obtained from 44) A; e' Ae- (owner/builder).
~~~7~_
Plumber's Signatu MP/MPRSW#Phone # 6
12
Plumber's Address K •~L T
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
P1 96`11 7 L--/
.vou6c 500- ~~om 1Q,00d
b~611 50-, 1;~Oln 1~5101i(f
Well A-Po 't 6m;/7
o
/ ~ Tdh,k
dry ve wa ~ °4 a ~ , l
Do Not Write in Space B low FOR DEPARTMENT USE ONLY _
Date of Application 7 Fes Paid: State/C Count Date J
Permit Issued/Rejected (late), Issuing Agent Name e-j
l
Inspection Yes No Valid# Date Recd
pty (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
to (pink copy) 4. plumber (canary copy)