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Parcel 022-1041-90-000 03/27/2006 03:20 PM
PAGE 1 OF 1
Alt. Parcel 15.28.18.227D 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 - PARNELL, RICHARD A & JANET
RICHARD A & JANET PARNELL
368 OLD CEMETERY RD
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): k = Primary
Type Dist # Description ' 368 OLD CEMETERY RD
SC 4893 SCH D OF RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 2.100 Plat: N/A-NOT AVAILABLE
SEC 15 T28N R18W 2.1A IN SW NE LOT 2 CSM Block/Condo Bldg:
VOL 2/370
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
15-28N-18W
I
Notes: Parcel History:
Date Doc # Vol/Page Type
2005 SUMMARY Bill Fair Market Value: Assessed with:
143388 205,300
Valuations: Last Changed: 08/10/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.100 40,000 167,600 207,600 NO
Totals for 2005:
General Property 2.100 40,000 167,600 207,600
Woodland 0.000 0 0
Totals for 2004:
General Property 2.100 20,000 130,400 150,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 141
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
• AS BUILT SANITARY SYSTEM REPORT
,Ell` J;•., 7 h~ TOWNSHIP ~EC.,_ T -W
3. ADDRESS '0 R .2 , ST. CROIX COUNTY, WISCONSIN. ib :',DIVISION LOT LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ant
TIC TA:d:: 4S; rim MF^vB. ` CONCRETE i . STEEL
NO. of rings on cover Depth I DRY WELL
'NCHES NO. of width length area
no. of lines - width length L- area ~ . _
depth to top of pipe
REGATE '"7-RATE AREA REQUIRED .',15''* AREA AS BUILT >
claimer: The inspection of this system by St. Croix County does not imply complete %
;)fiance 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 ~
_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.
fr
. ~ INSPECTOR
C
'DATED ~ PLUMBER ON JOB
LICENSE NUMBER r S''} y
i
U ' X11
RF-10RT 0r, ITTSPHCTIO?1--INDIVIDUAL SE;Vtr,EISPOSi SYS'rF:r~
l
'L PO Sanitary Permit
0r State Septic
1E T&WNSHIP
• t. Croix County
SEPTIC TA7?1:
. Size gallons., `lumber of Compartments
Distance From: 'dell ft. 12% or greater slope A.
2~ Building Z ft. Wetlands f:
YSPCOSA Highwater ft.
SYST:1 Tile Field or Seepage Pit(s)
Distance From: deli ft. 12% or greater slope ft
Building ft.
2? - ~ Wet-lands f
FIELD Z Highwater ft.
Total length of lines ft. Number of lines Length of
each line ft. Distance between lines _ft. Width of the
trench _L~,`ft. Total absorption area //3t sq. ft. Depth
of rock below tile in. Dp-pth of rock over tile in. Cover
_ over.rock,, Depth of tile below grade :L-1. siope of
trench in per 1,00 ft. Depth to Bedrock ft. Depth to
ground water ft.
PITS
~4umber of pits Out 'e cl~ eter ft. Depth below inlet
ft. Gravel around ~i ; ! s no. Total absorption area
sq. ft.
Square feet of seepage trench bottom area required
:square feet of seepage.-rkt -are required '
Inspected h
y • `~='iz' Title':.
Approved-" Date 197i6.
Rejected Date 197.
H 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
_ P
LOCATION:, Plt~/4, Section l , T N, R& f-{t5r) Township or Municipality 4L, ~ ~ • r ' -
-b
Lot No. Block No. - - {p } County
en Subdivision Name _ s
Owner's Name: %t ~111 N. fa
` t ia~ s ;~tt 1 Mailing Address: TYPE OF OCCUPANCY: Residence y No. of Bedrooms Other -
EFFLUENT DISPOSAL SYSTEM: NEW Ar/ /ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS- PERCOLATION TESTS
'01 L MAP SFiEET -..r.- SOIL TYPE
PERCOLATION TESTS
-T------...
DROP IN WATER LEVEL, INCHES RATE
f . HOURS WATER IN TEST TIME
EST DEPTH CHARACTER OF SOIL I NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN
8ER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 r
AM
17f I
11-10 r-I
1 1 ! 1
I P- 7 ~T I~R,« fy fr f %
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
NUMBER INCHES OBSERVED ESTIMATE' HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
7' ei /IV
= / 1
iB-
i
ir)dicate on the plan the locationand square feet of suitable areas. Indicate number of square feet of absorption area
:ceded for building type and occupancy.
Indicate scale
c; distances. Give horizontal and vertical reference points. Indicate slope.
d > J _
%
# ~ i
jl%
I r
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 Certification No.5
Address
Name of installer if known
CST Signature
COPY A - LOCAL AUTHORITY f - ! 1,
PLB67, State and County State Permit # Permit Application County Permi
i
for Private Domestic Sewage Systems County -117
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
T)C,14,4jFj_-) t~i91~i1'.E,( /0 -3.2 5v A7,11 Me v~=R 0~ ~ 3 z
B. LOCATION: 5 '/4, Section Zj_ TU N, R W Lot# City
Subdivision Name, nearest road, lake or landmark Village
.E/YJ/ft~itiZ /,t711r7% r Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family ✓ Duplex No. of Bedrooms No. of Persons
D. TYPE OF APPLIANCEES- Dishwasher YES NO Food Waste Grinder YES ✓NO # of Bathrooms-_
Automatic Washer ✓ YES NO Other (specify)
E. SEPTIC TANK CAPACITY /®dPC' Total gallons No. of tanks _-L-
*Holding tank capacity Total gallons No. of tanks
New Installation A-- Addition _ Replacement _ Prefab Concrete
*Poured in Place Steel Other (specify) _
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1)AV 2)00,33) Total Absorb Area sq. ft.
New Addition Replacement .Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length _7y_Width /Z Depth Tile Depth ° No. of Lines
Seepage Pit: Inside diameter iquid Depth Tile Size
Percent slope of land p :!50 Distance from critical slope Ali,,
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 S 'I Teste
NAME C.S.T. # and other information
obtained from P (owner/ft4+dLtr).
Plumber's Signature MP Phone -"3zsZ
Plumber's Address 0-4
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
f
iN~
I
Do Not Write in Space Below FOR DEPARTMENT USE ONLY _
Date of Application ~e? Fees Paid: Paid: State 000ount CJ Date
Permit Issued/Rojeeted (date) 02 / _Issuing Agent Name e- trCy ~ - i8,0-7L rInspection 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