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Parcel 012-1035-30-000 02/27/2006 11:12 AM
PAGE 1 OF 1
Alt. Parcel 14.30.17.219B 012 - TOWN OF ERIN PRAIRIE
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
MICHAEL & DAWN MARSHALL O - MARSHALL, MICHAEL & DAWN
1974 CTY RD G
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 1881 140TH AVE
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 1.294 Plat: N/A-NOT AVAILABLE
SEC 14 T30N R1 7W 1.294 AC IN SW SE COM Block/Condo Bldg:
SE COR SEC 14; TH W 1323.9FT TO CL HWY G
& POB: TH W 188 FT; TH N 300 FT; TH E Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
188 FT TH S 300 FT TO POB BEING LOT 1 OF 14-30N-17W
CSM 11 528
Notes: Parcel History:
Date Doc # Vol/Page Type
06/03/2004 764682 2587/500 QC
07/23/1997 1172/66 QC
2005 SUMMARY Bill Fair Market Value: Assessed with:
104832 140,100
Valuations: Last Changed: 11/07/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.294 19,400 125,400 144,800 NO
Totals for 2005:
General Property 1.294 19,400 125,400 144,800
Woodland 0.000 0 0
Totals for 2004:
General Property 1.294 7,300 92,100 99,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
• AS BUILT SANITARY SYSTEM REPORT
c mil, l AI r
::,NER j~ c',!Z1j1/ ~i
TOWNSHIP SEC. T~N, R% J
.0. ADDRESS CROIX COUNTY, WISCONSIN. 'T
'BDIVISION LOT LOT SIZE
~_1 /
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
t,
CV
'PTIC TANK(S) l e i MFGR. 1 AS CONCRETE STEEL
NO. of rings on cover Depth DRY WELL)
'.ENCHES NO. of width - length area-~
"',D no. of lines-,)- width length area ,
deith to top cf pipe 'GREGATE f
:RK RATE
AREA REQUIRZ AREA AS BUILT C
'_sciaimer: The inspection of this system by St. Croix County does not imply complete
`Mpliance 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
stem operation. However, if failure is noted the County will make every effort to
termine cause of failure.
BASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
°INSPECTO&' (per. , .
2
DATED PLUMBER ON JOB '2 z
' LICENSE NUMBER
f
REPORT OF I11SPECTIO_I--1NDI 1DTJAL SE?•IAGE DISPOSAT, SYSTE1.1
Sanitary Permit
1 . r.. State peptic
3 1E
T&UNSHIP
4t.4rolix.-County
SEPTIC TA'?K
Size gallons. `umber of Compartments
Distance From: Ile 11 ft. 12% or greater slope fi.
Building ft. Wetlands f:
Iiighwater ft.
DISPOSAL SYSTL:Q Tile Field or Seepage Pit(s)
Distance From: t7e11 ft. 12% or greater slope ft
Building ft. Wetlands " f:.
FIELD Nighwater ft.
Total length of lines ft. !lumber of lines Length of
each line eft. Distance between lines ft. Width of the
trench ft. Total absorption area sq. ft. Depth
of rock below the in. np-pth of rock over tile in. Cover
over.rock,, Depth of tile below grade in. Slope of
trench ih ner 100 ft. Depth to Bedrock ft. Depth to
ground water ft.
PITS
Number of pits _ .~O-Uts'id-e__d_a_pmeter ft. Depth below inlet
ft. dra 1 around pit: `yes no. Total absorption area
sq. ft.
Square feet of seepage trench bottom area required
Oquare feet of seepage nit area required
III
Inspected by: Title:
Approved
bate
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
sJ7~~EPORT ON SOIL BORINGS AND PERCOLATION TESTS
LOCATION: SectFpn ft T24, R ~E (or W,,,}Township or Municipality.
Lot No. Block NJ ' t County
1 Subdivision Name
Owner's Name: ~L'E►=r~ 1 tit'
Mailing Address: C ? L7.~lC~ w' se,
TYPE OF OCCUPANCY: Residence No. of Bedrooms 5 Other
EFFLUENT DISPOSAL SYSTEM: NEW A ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS 1940,4!w 7,k' PERCOLATION TESTS
SOIL MAP SHEET SOIL TYPE
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
7
P f 1 12 l l z
P- Z s- j'
P-3 D
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)
I3 1^ s E, E' SL /~r
q >J 5- 2- r3 s 516, KeWSL 3 0'
/I rA
41 __S k .,S
PLAN VIEW (Locate percolation tests,soil 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. C1 IVY I--, 1r gym' 3cf~~e~ s Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope.
1b
R w
eI ~
v ~ "ate
I ► ~ Z ~v~ J~ r.
Y ~'µv
I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures W ti, c.
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 jh~i.~%~✓
Name of installer if known
CST Signature
COPY A -LOCAL AUTHORITY
i
l
State and County State Permit #
PLB67 Permit Application County Permit # yam`.
for Private Domestic Sewage Systems County y
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
4L.
AAM;p J,
B. LOCATION: Section / T ?Q N, R [ E (or) & Lot# City
Subdivision Name,rr nearest road, lake or Iandm/ark Blk# Village
Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms No. of Persons
t:;,-
D. TYPE OF APPLIANCES: Dishwasher - YES NO Food Waste Grinder YES NO # of Bathrooms
Automatic Washer /YES NO Other (specify)
E. SEPTIC TANK CAPACITY Z-7 Total gallons No. of tanks
*Holding tank capacity Total gallons No. of tanks
New Installation Addition Replacement- Prefab Concret lo~ *Poured in Place Steel Other (specify)
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1),~O 2) v 3) Total Absorb Area sq. ft.
New Addition Replacement *Fill System
Seepage Trench: No. Lin.s.Feet Width Depth Tile Depth No. of Trenches
Width rDepth Tile Depth_ 4 No. of Lines_
Seepage Bed: Length
too /10 y
Seepage Pit: Inside diameter Liquid Depth Tile Size
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 Certified Soil , Tester, ,
NAME C/,S.T. # f~ and other information
obtained from Akd((owner/builder).
Plumber's Signature MP/MPRSW# 7 Phone # /,7
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
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Do Not Write in Space plow OR DEPARTMENT USE ONLY O
Date of Application Fees Pai State ~Cou t ? -Date
Permit Issued/ (date) .~_Issuing Agent Name Zled 2Z Inspection Yes~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