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Parcel 022-1093-80-000 12/28/2005 09:58 AM
PAGE 1 OF 1
Alt. Parcel 32.28.18.P508A 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
GRACE A PAULSON O - PAULSON, GRACE A
1036 CTY RD M
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 1036 CTY RD M
SC 4893 SCH D OF RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
it
Legal Description: Acres: 4.500 Plat: N/A-NOT AVAILABLE
SEC 32 T28N R18W SE SW N OF HWY M Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
32-28N-18W
~I
Notes: Parcel History:
Date Doc # Vol/Page Type
10/21/2004 777670 2680/267 QC
11/19/2002 699072 2052/448 QC
07/23/1997 724/144
2005 SUMMARY Bill Fair Market Value: Assessed with:
143982 254,200
Valuations: Last Changed: 08/11/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 4.500 75,000 182,000 257,000 NO
Totals for 2005:
General Property 4.500 75,000 182,000 257,000
Woodland 0.000 0 0
Totals for 2004:
General Property 4.500 35,000 144,800 179,800
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 308
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT
OWNER - r .~1 6-1 TOWNSHIP SEC . T -N, R W
ADDRESS ST. CROIX COUNTY WISCONSIN.
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
5
a
I
~D
L
I di ,atte ozthj Arrow j !
--t-s I I i
SEPTIC TANK(S) C, MFGR. c_ s r m CONCRETE STEEL
N0. oT rings on cover Depth
PUMPING CHAMBER SIZE PUMP MFGR. MODEL NO.
GALLONS Per Cycle
TRENCHES NO. of wi tF length area
BED NO. of lines - width t T-length area
depth to top of pipe
NUMBER 07 SEEPA E,PITS O tsi e diameter total pit area
AGGREGATE
PERK RATE AREA REQUIRED AREA AS BUILT
Disclaimer: The inspection of this system by St. Croix County does not imply
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. However, if failure is noted the
County will make every effort to determine cause of failure.,
GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYTEM.
INSPECTOR
DATED 'PLUMBER ON JOB
,'LI'CENSE NUMBER
icEPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
San.itan y Penm.it
State Septic
NAME rownbh.ip St.. Cno.ix County
Locat.iox Section
SEPTIC TANK
Size ga.ttone. Numbers oj'Compantment6
ViAtance Fnom: We.t-Z 12% on. greaten AZope it
Buitding it. Wettands bt•
H.ighwaten - it.
DISPOSAL SYSTEM
D.ietanee Fnom: We.t.t 12% on greaten z Zope it.
Bu.i.td.ing 6t. W et.tandz Ft.
H.ighwateA it.
FIELD DIMENSIONS:
Width o6 trench it. Depth o6 rock be.Zow t.i.Ze .in.
Length of each tine it. Depth o6 n.ock oven t.i.Ze .in.
Number-P6 ,Z.ines Depth of t.i.te be.Zow grade .in.
Totatt .Zength o6 tines it. S.to pe o6 trench in pen 100 it.
DiAtanee between .Z.ined__Jt. Depth to bedrock it.
Tota.t abzohbt.ion area 6t2 Depth to gnoundwaten it.
..Requited area it2 Type o6 Coven: Pape:n on Straw
PIT DIMENSIONS:
Numbers o6 p.it.5 Gxave.t around pits ye.a no
Outd.ide d.iameten it. Depth be.Zow •i,n.tet it.
2
Totat abzonbt.ion area it
A
Area %equited it2 rn
INSPECTED BV TITLE J
APPROVED , DATE 197.
REJECTED DATE 197.
I
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masuw+iie'vYi2+-+k.= .Stu.-r.•nsw..s'u.`:..:.•..w•.~..r._:+..._..r.r.........r~ ,•.:..~..:.:..v...o.vumm.:...
EH 115 Rev. 9/78
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION: '/4, Section 7a l T?t N,R i ' Township or--~~y N 1t' 1' I O' \C'
Lot No. - Block No. County _r• lX
Subdivision Name
Owner's/liuyamName: ;P16ULS0N
Mailing Address: Z _N?-6U« PALLS. kJIL 5-_Y0 ZZ
TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW r-- REPLACEMENT ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS PPht2.1 L 2-5 A(. PERCOLATION TESTS typ'l- iL. Z4,
t=1~~J~.~F~ ~If~~2 j R T
SOIL MAP SHEET NAME OF SOIL MAP UNIT
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- 1 Tao) cn ° ```Bn ► ► $ s 1. z Z ti~ -5 1 ~/Y i fib 1 '%b IS
P- e )
P- i3n vwo'A r-1 2 t~,~ Q 71 3`~'! 3'/y 3
P- -3 LA'S. r.. 1a G1 14 4 ~ 'V3 >n S ► ~z
P_
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK
OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES
B- 77 ►.J 1eR `7 -77 ~:Ts - 'V3n S;) 1) ` h `(S I )S &4 S • ! f~ ;
B- "th ~-S8° 3 S 5 )0; S-
B- Z nS V"cc_ )Lir -7 r L. 3'13nSI 11 sal /6° r3 Y;dy
B- "f` n i° 1S " Ll• ) S ru:ni 5I raw5 1"1 ; ~n )S Z
B- LTS.6; tan ! W3 tif3'~8.,s; s i~ y :slSt
B- 16 • "V3 r, !S Z
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas.
ka
Indicate number of square feet of absorption area needed for building type and occupancy 150 1 ° ~e Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope. .4!S ~A _Rl~b
134 161 8.3u~,=t? -776 J?nL 1S.S'.4-8gOC°` Sit,vSi11al,fS,Ics; yj?rSJ,A.; IN jSi
1a a I ~5 a~Lrl,Ib lah1S, ► ; kaesl,~~►J-1 t>his,+1; d4 13,i8
B6 `l`am tti 'z ~S '
~3°•tL ~,;i► r,~ tt,`'t3h) ~'t`tlns,"T5 8: 'ftf~, 3;`tsj,2i;1$y~5 15
►~+a<T Ht C2 t
1~Y1 %.0 (3Plz. V" P t:- / %L-Ao a
NO.~,t• b' i
8~'" $~.~~~Z-~~•~ 31/'~~ lug
Wt Ta14 9_11. Z rth~ Pcet~p I
@S - Q,S.o, $6- g7.D $ R5 fF4fit / Pi 100 ~kl
r
t s._
8y f T N
RT S-CLOP.'sUb&- 3S t of t~ / gy D2 / L oc
ZGrc~►K //v / NW ~2, of SE-Sw
~ \ p3 /
NOTE-. l kNs-TQ11..1.
c
Co1~b5E"D c,,
SdLDC~.I..oG. ® pfpp.
~j TvR 1~ SCLAUE la-_ - yo S~ y sw V
1, the undersigend, hereby certify that the i re d his form were made by me in accord with the procedures and methods
specified in the Wisconsin Administrative Co tF data recorded and location of test holes are correct to the best of my
knowledge and belief.
t~V
Name (print) OR -1 ~)OR L f GC=~.f ~i--I~ Certification No.
Addresses T L L. Kt t,:7N, l~~l• SS~~/>
Name of installer if known
Copy A -Local Authority
i
p 5~
PLB67 State and County State Permit #
Permit Application County Per BY:
l 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:
Poi G sL4 efe t& F//
S k.)
B. LOCATION: L YQ L Y<, Section , Tgj~'N, R-~T E (or) IL" Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village „
Township, `(1 M IC
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family X Duplex No. of Bedrooms No. of Persons
D. TYPE OF APPLIANCES: Dishwasher YES_ NO Food Waste Grinder YES NO # of Bathrooms
Automatic Washer YES NO Other (specify)
SEPTIC TANK CAPACITY~Cet Total gallons No. of tanks
'Holding tank capacity Total gallons No. of tanks
'iew Installation Addition _ Replacement _ Prefab Concrete
'Poured in Place Steel Other (specify)
FFLUENT DISPOSAL SYSTEM: Percolation Rate 1) J?: 2) 3) r/ Total Absorb Area sq. ft.
"9ew1,-*' Addition _ Replacement *Fill System
Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length 3 Width 14W "r Dept l' Tile Depth i~3 " No. of Lines 3_
Seepage Pit: Inside diameter Liquid Depth Tile Size
Percent slope of land Distance from critical slope
the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
isconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared
I:)y the Certifi d Soil Tester, 1
N1AME Ll e Ir" C.S.T. # and other information
obtained from Is L't., I. ts 6 (owner/builder).
lumber's Signature P/MPRSW# J'`' 3 Phone # S/~$ - ~1C
Plumber's Address 1G C- r
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
w~ G
41
.Yi
Z ~
pro
a
Cale
Do Not Write in Space Below OR DEPARTMENT USE ONLY _
Date of Application - to - Fees Paid: State C Coun Date ~C
Permit Issued/Rejae (date) ~l _Issuing Agent Name
Inspection Yes-No Valid# Date Recd _
1. county (wh ite' 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