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Parcel 022-1036-70-000 03/27/2006 03:01 PM
PAGE 1 OF 1
Alt. Parcel 13.28.18.204A 022 - TOWN OF KINNICKINNIC
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 - BARSNESS, ROBERT A & JANICE M
ROBERT A & JANICE M BARSNESS
329 SHERWOOD FOREST RD
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 329 SHERWOOD FORST
SC 4893 SCH D OF RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 20.000 Plat: N/A-NOT AVAILABLE
SEC 13 T28N R1 8W 20.01A N1/2 SE SW Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
13-28N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 573/508
2005 SUMMARY Bill Fair Market Value: Assessed with:
143336 312,500
Valuations: Last Changed: 08/10/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.000 80,000 170,500 250,500 NO
UNDEVELOPED G5 7.000 17,500 0 17,500 NO
PRODUCTIVE FORST LANDS G6 8.000 48,000 0 48,000 NO
Totals for 2005:
General Property 20.000 145,500 170,500 316,000
Woodland 0.000 0 0
Totals for 2004:
General Property 20.000 67,000 117,500 184,500
Woodland 0.000 0 0
Lottery Credit:
Claim Count: 1 Certification Date: Batch 314
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
• AS BUILT SANITARY SYSTEM REPORT
DR J
TOWNSHIP _ S
i`7 W
EC. TAN, R
A_ ~il
ADDRESS ST. CROIX COUN- ,,1WISCONSIN.
DIVISION LOT LOT SIZE .
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
a
TIC TANK(S)/ % MFGR._ CONCRETE STEEL
NO. of rings on cover Depth DRY WELL
'NCHES NO. of width length area
no. of lines j width j length area i
depth to top of pipe f r '
:LEGATE
RATE IE!~._T_ AREA REQUIRED AREA AS BUILT ~J f j
.ciaimer: 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-j,'
inspect at this point of construction. St. Croix County assumes no liability for
Lem operation. However, if failure is noted the County will make every effort to
.ermine cail.se of failure.
;ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
"INSPECTOR -
DATED PLUIMER" ON JOB
LICENSE NUMBER
.
• i
77- ,
REPORT OF II ISPECTI011--17M1V1D1JAL SE107AGE DISPOS V, SYSTEM
Sanitary Permit
r State Septic
„A! 1E i TOWNSHIP
t. Croix County
SEPTIC TA'?l:
Size gallons, `umber of Compartments
Distance From: We 11 ft. 12% or greater slope ft.
Building` ft. Wetlands f,
Highwater ft.
DISPOSAL SYS4TF:1 Tile Field or Seepage Pit(s)
Distance From: Well ft. 12% or greater slope ft
Building; ft. Wetlands f,.
FIELD i;ighwater ft.
Total length of lines 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 the in. Dp-pth of rock over tile in. Cover
aver rock,, Depth of tile below grade in. Slope of
trench in ner 100 ft. Depth to Bedrock ft. Depth to
ground water ft.
PITS
'umber of pits Outside diameter ft. Depth below inlet
ft. Gravel around pit: `yes no. Total absorption area
sq. ft.
Square feet of seepage trench bottom area required
:%quarQ feet of seepage nit area required .
Inspected by: Title:.
Approved Date 197
Rejected Date 197.
40
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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, //4, Section f T'N, R E-f~W, Township or Munidpaftty 1t' i` k//1- it, ' e
Lot No. , Block No. County
Subdivision Name
Owner's Name:
Mailing Address: f l i f l I i `xl ! `
TYPE OF OCCUPANCY: Residence _ No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW.1A ADDITION REPLACEMENT/
DATES OBSERVATIONS MADE: SOIL BORINGS Z., 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
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
1
P_ Xy_ 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)
B 3c - n !
ti H
3
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yf !7 it
B -
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of suitable areas. I dicate number of square feet of absorption area
r 4 lYX11 9 Indicate scale
needed for building type and occupancy. 7"
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.
Name (print) l1}1` r Certification No. -
Address I t_
Name of installer if known
~ CST Signatl~re
f`~c AUTHORITY
B-67 State and County State Permit #
PL Ai;
Permit Application County Pe
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:
B. LOCATION: /4 v+ '/4, Section T N, R E6f) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Townshipi~rn rC K iN -l•
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
-
Single family Duplex No. of Bedrooms r~ No. of Persons l'
7-1
D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES NO # of Bathrooms-
Automatic Washer X- YES NO Other (specify)
E. :-)EPTIC TANK CAPACITY i l3 t -r Total gallons No. of tanks c
*Holding tank capacity Total gallons No. of tanks _
'ew Installation Addition Replacement Prefab Concrete
'Poured in Place Steel Other (specify) _
'FFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) ! 3) Total Absorb Area sq. ft.
NewX Addition Replacement _*Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length 5, __Width /S! _ Depth Tile Depth > No. of Lines z
Seepage Pit: Inside diameter Liquid Depth Tile Size _
Percent slope of land C" 4:, ` Distance from critical slope i'
1, 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 J /u(_ C.S.T. # li- and other information
obtained from (owner/b).
Plumber's Signature 4', Phone Vp/MPRS~ #
Plumber's Address 4~ v ~ 4-7
i
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 Below FOR DEPARTMENT USE ONLY
ff/ Date -
Date of ApplicationFees Paid: State County
Permit Issued/Rs~ted date) Issuing Agent Name CZ Le
Inspection Yes No Valid# Date Rec'd _
1. county (whi a copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) 4. plumber (canary copy)
WISCONSIN DEPT ur HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
7t," P.O. BOX 309
MADISON, WISCONSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
LOCAI: Section , TN, R E (or) W, Township or Municipality -
Lot No. , Block No. County -
Subdivision Name
Owner's Name:
Mailing Address:
TYPE OF OCCUPANCY: Residence No. of Bedrooms Other -
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT -
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS -
SOIL MAP SHEET SOI L 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
P-
P-
P-
J
SOIL BORING TESTS
TEST J!TAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
B-
B-
B-
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the locationand square feet of suitable areas. Indicate number of square feet of absorption area
needed for building type and occupancy. _ 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.
Name (print) Certification No.
Address
Name of installer if known
CST Signature
CORY C -PROPERTY OWNER