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' Parcel 030-1087-30-000 03/23/2006 09:34 AM
PAGE 1 OF 1
Alt. Parcel 30.30.19.3141 030 - TOWN OF SAINT JOSEPH
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
SCOTT R MCCONAUGHEY O - MCCONAUGHEY, SCOTT R
1373 BROWNS LA
HOULTON WI 54082
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 1373 BROWNS LN
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 5.000 Plat: N/A-NOT AVAILABLE
SEC 30 T30N R1 9W S 1/2 NW 1/4 LOT 1 OF Block/Condo Bldg:
CSM 1/272
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
30-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 540/521
2005 SUMMARY Bill Fair Market Value: Assessed with:
83897 255,900
Valuations: Last Changed: 07/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.000 99,900 132,800 232,700 NO
Totals for 2005:
General Property 5.000 99,900 132,800 232,700
Woodland 0.000 0 0
Totals for 2004:
General Property 5.000 99,900 132,800 232,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 223
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT
,ER TOWNSHIP 4c, EC. T ?r N, R_ W
ADDRESS , ST. CROIX COUNTY, WISC(3IQSIN.
)DIVISION LOT LOT SIZE
4-
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
'i
J -
'TIC TANK(S) MFGR. CONCRETE STEEL
NO. of rings on cover ` Depth DRY WELL
'.`ACHES NO. of width length area
no. of lines' - width len th
depth to top of p g , =1 area
ZEGATE
ti RATE f AREA REQUIRED 4, AREA AS BUILT
claimer: The inspection of this system by St. Croix County does not imply complete
?liance 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
Lem 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.
INSPECTOR
DATED PLUMBER ON JOB
LICENSE NUMBER
z
RET=ORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
SanitaAy Penmit-
State Septic
NAME Township St. Ctoix County
Location % o Section T_N, R I W
SEPTIC TANK
Size gattons. NumbeA o4 CompaAtment6
Di6tance FAOm: wett 120 oA gtLeateA 6tope it
Building it. wettands it.
H.LghwateA it.
DISPOSAL SYSTEM
Distance FAOm: WeU it. 120 oA gAeatvL 6tope it.
Building it. wettands Ft.
HighwateA it.
FIELD DIMENSIONS:
Wid°th ob tAench it. Depth of rock below tite in.
Length of each tine it. Depth of Aock oveA tiZe in.
NumbeA o6 tinez Depth o6 tite below gAade in.
TotaZ .length of Una it. Stope o6 ttench in peA 100 it.
Di.s lance between Zines it. Depth to b ed&o ck it.
Tota.e abso&btion aAea 6t2 Depth to g&oundwateA it.
Requited area it2
PIT DIMENSIONS:
NumbeA ob pits GAavet around pitz yeas no
Outside diameteA it. Depth below inZet it.
2
Totat ab6oAbtion vLea 6t z
A
AAea Aequi&ed it2 rn
INSPECTED BY TITLE
APPROVED ,DATE 197
REJECTED ,DATE 197
~d /
State and County State Permit #
PLB67 ,
O ~ ~ Permit Application County Permi
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: S 14 ,N /4, Section T N, R E (or) W Lot# -/-,City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township
a TY --PE OF - - - ----*-Other--- - - -
C OCCU~PA/NCY : *Commercial Indust-rial (specify) *Variance
Single family Duplex No. of Bedrooms No. of Persons
D. TYPE OF APPLIAN Dishwasher YES NO Food Waste Grinder ESNO # of Bathrooms-~-Z-
Automatic Washer YES NO Other (specify)
SEPTIC TANK CAPACITY ' -'L Total gallons No. of tanks
'Holding tank capacity Total gallons No. of tanks-
Jew Installation Addition Replacement- Prefab Concrete
Poured in Place Steel Other (specify)
C-FFLUEN~ DISPOSAL SYSTEM: Percolation Rate 1) 2) 3) Total Absorb Area ~sq. ft.
A,ew-4iL/ Addition Replacement *Fill System
Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches _
`seepage Bed: Length. Width Depth --7 -e- Tile Depth No. of Lines
Seepage Pit: Inside diameter Liquid Depth Tile Size 44
Percent slope of land 6( *,d~ :2,e Distance from critical slope the undersigned, do hereby certify that the information I have reported is in accord
with Section H62.20,
'A: isconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared
bV the Certified `Soil Tester,
NIA M E C.S.T. # other information
obtained from (owner/builder).
s'lumber's Si nature ,
g P/MPRSW# Phone
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
C
a
ea -
Do Not Write in Spac Below FOR DEPARTMENT USE// ONLY C C?
Date of Application Fees Paid: State Count Date /c9
i.
Permit Issued/ (date) - /7 Issuing Agent Name &
Inspection Yes No Valid# Date Recd
1. county (whitAcopy) 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
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 TES/TS .,1
LOCATION: ~I_L- Section_>C~, T k_-N, R/_!j&(or)I~ownship or Municipality
Lot No. _1_ Block No. (r~Ci(i A6. County
Subdivision Name
Owner's Name: rt .i / ' tflJ~%
Mailing Address:
TYPE OF OCCUPANCY: Residence No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS 7 ~'~?rJ PERCOLATION TESTS 7~
SOIL MAP SHEET a <
SO I L TYPE ~7 t~ Sii7`' •Lc~,lz+~
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
• i'~
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- ~C. ~•~ti .7C~~ v rr , L B- "Irv *-&r- ~
42- lq& 4-64o 22 Y,
B_ .3 gi r A ext i (~.•'1`~ / 7" SA't 6 , 93 ...5-f -6-r ,
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. 4',~ GTS Lc `"r /!jre/ si Indicate scale
or distances. Give horizontal and vertical reference Ints. ica ee slope. ~,y w C fl /17
i
1/0 1 A_
- - J'_ Al
tog
-T t :11 1
1 ;w 1 131
1 ! 7
I
j
t I 1jj~ y y E i f { i ~ ~ ~ 1 1
I, the undersigned, hereby certify that the soil tests reported on this form were made by mein 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 belie .
Name (print) Certification No.
Address L'
Name of installer if known
COPY A -LOCAL AUTHORITY CST Signature