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Parcel 016-1012-70-000 02/27/2006 04:09 PM
PAGE 1 OF 1
Alt. Parcel 6.30.15.97 016 - TOWN OF GLENWOOD
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
O - CROES, KEVIN R & ROXANNE J
KEVIN R & ROXANNE J CROES
1748 280TH ST
EMERALD WI 54013
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 1748 280TH ST
SC 2198 GLENWOOD CITY
SP 1700 WITC
Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE
SEC 6 T60N R15W GOV LOT 7 40ACRES Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
06-30N-15W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1203/597 WD
07/23/1997 1203/595 WD
07/23/1997 865/576
07/23/1997 827/244
2005 SUMMARY Bill Fair Market Value: Assessed with:
89084 Use Value Assessment
Last Changed: 10/06/2003
Valuations:
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 37.000 5,900 0 5,900 NO
UNDEVELOPED G5 1.000 100 0 100 NO
OTHER G7 2.000 9,000 130,500 139,500 NO
Totals for 2005:
General Property 40.000 15,000 130,500 145,500
Woodland 0.000 0 0
Totals for 2004:
General Property 40.000 15,000 130,500 145,500
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 204
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
0.00 0.00
Total 0.00
AS BUILT SANITARY SYSTEM REPORT
OWNER LA~ Re TOWNSHIP C.L."Dcv~ SEC. TLN, R/5W
P.0. ADD SS L ~~c-rl ST. CROIX COUNTY, WISCONSIN
L.v r
SUBDIVISION , LOT LOT SIZE 114 cfzc
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100FEET OF SYSTEM
z
331 -rte C"If r. FRom .27
eF SC e6Rivew , $0 'TVK /000) C: 1-
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SEPTIC-TANK(S) / MFGR. CONCRETE X STEEL
N07 oY rings on cover Depth DRY WELL
TRENCHES No. of width length area _
BED no. o-f lines Width -i g' length°gn ° area .11-40
dept to top of pipe
AGGREGATE t
PERK RATE Ca AREA REQUIRED AREA AS BUILT A 6 0
` DISCLAIMER: The inspection of this system by St, Croix County does not imply
j complete compliance with State Administrative Codes. There are other areas
that it is not possible to inspect at this point of construction. St. Croix
County assumes no liability for system operation. Ho r, if failure is
noted the County will make every effort to determine cause of failure.
GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH"" THIS -3"'S
INSPECTOR
y
DATED %L 2 - 7 PLUMBER ON JOB J "
-
LICENSE # 43
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
San.i,taAy PeAm.it-A
State Septic
NAMETown/shi p S CAOix County
Location.%~% 0 ~4 Sectionk- T N,R W
SEPTIC TANK
Size ,`C-Za gattonts. Number o6 CompaAtment/s
D.i,6tance FAOm: WeU C~ it. 12% oA gAeateA 6tope it
Buitd.ing W etZand~s - ~ .
HighwateA ~ .
DISPOSAL SYSTEM
D.i6tance FAOm: WeU y 120 oA gneateA /slope it.
g it. CUettands Ft.
Buitd.in
H.ighwateA it.
FIELD DIMENSIONS:
Width o6 tAench 2-1 it. Depth o6 Aoch below tiZe 12- .in.
Length o6 each tine '7'L it. Depth oi Aoch oveA tite in.
NumbeA o6 tinez Depth of ,t.ite below gtcade 30 in.
Totat .length o4 Zines(r it. Sto pe o6 tAench in peA 100 it.
D.i/s Lance between Zina it. Depth to b edto ch ~ .
Totat ab6otc.bti..on atc.ea /,J/26t2 Depth to gAoundwateA ~ .
RequiAed atcea it2
PIT DIMENSIONS:
NumbeA ob pits AaveZ aAound pits yep no
Outside d,iameten. Ate Depth below intet it.
2
Totat abzoAbti.on. 6t z
A
AAea A e q Aed it2 rn
INSPECTED BY TITLE
APPROVED rk~ DATE Z ®Z 19 7,~).
REJECTED DATE 197
Y12,
1
2 .
8
_EH' 115
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309
r MADISON, WISCONSIN 53701
O REPORT ON SOIL BORINGS AND PERCOLATION TTS
c~
LOCATION: uw-F- ~-'/4, Section 1 , 4_N, R 15(t (or) W, Township or M"r tipu it'y ~/V U26
VF-
Lot No. , Block No. County c~T~, GRa i
~ ter` Subdivision Name
Owner's Name: k l '
Mailing Address: ~e- A./ I'S
TYPE OF OCCUPANCY: Residence _ No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT X
DATES OBSERVATIONS MADE: SOIL BORINGS 5 z3 7, PERCOLATION TESTS 547 '(j 7 W
SOILMAPSHEET SMW 1 OILTYPE ~19A/74/9Sj J ,1L- T /L0Am
a2 / 7~ PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TESTTIME 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
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)
S 1-7
B- 6 r
7-2- r, r ( ~o T r
cc
_
~g
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of suitab e a ebt Indicate number of square feet of absorption area
needed for building type and occupancy. /12 Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope.
ALP Ito'
Ile
4 "A.-
1ZL
l rsr7 s t c e e
t ~
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I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with th rocedures
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 41J i W
Name of installer if known /=F~Ze fee
CST Signature f ) -
CCPY A -LOCAL AUTHOPZJY
State and County State Permit #
PLB67 Permit Application County Perm"
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 Mailing Address: 1
Section T D N, R @ (or) W Lot# City
B. LOCATION: '/4
IV L
Subdivision Name, nearest road, lake or landmark Blk# Village
Township olO4
C TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms No. of Persons 1-77 11
D. TYPE OF APPLIANCES: Dishwasher X YES NO Food Waste Grinder YES X NO # of Bathrooms
Automatic Washer YES NO Other (specify)
E. SEPTIC TANK CAPACITY Total gallons No. of tanks
*Holding tank capacity_ Total gallons No. of tanks
New Installation Addition Replacement _A Prefab Concrete K
*Poured in Place Steel Other (specify)
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) O 2) 3) Total Absorb Area sq. ft.
New Addition _ Replacement _X *Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length ~f Width Depth(Tile Depth t No. of Lines
Seepage Pit: Inside diameter ' Liquid Depth *64J , Tile Size
Percent slope of land < L'r_ 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, L
NAME/ C.S.T. # and other information
obtained from
(owner/builder). C, q
CA j
0 7"3 3
Plumber's Signatu MP/MPRSW# 471 Phone #C p
Plumber's Address 6&,;T,~ r
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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13 0 411
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Do Not Write in Space Below FOR DEPARTMENT USE ONLY / p
Date of Application Fees Paid: State le, G' 0 Count Date
Permit Issued/mod (date) Issuing Agent Name
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) - - F,,
l .