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Parcel 030-2005'5-20-000 03/24/2005 09:30 AM
PAGE 1 OF 1
Alt. Parcel 33.30.19.368B2 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): Current Owner
" RALEIGH, KAREN M
KAREN M RALEIGH
1232 60TH ST
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 1232 60TH ST
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 4.988 Plat: N/A-NOT AVAILABLE
SEC 33 T30N R19W NE SE LOT 2 OF CSM Block/Condo Bldg:
1/210 Tract(s): (Sec-Twn-Rng 401/4 1601/4)
33-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
2004 SUMMARY Bill Fair Market Value: Assessed with:
5709 288,900
Valuations: Last Changed: 07/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 4.990 129,400 154,800 284,200 NO
Totals for 2004:
General Property 4.990 129,400 154,800 284,200
Woodland 0.000 0 0
Totals for 2003:
General Property 4.990 76,000 123,300 199,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 311
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT
+r ,
OWNER e' , TOWNSHIP)-/ ;1 SEC:J ' T N, R L% W
P.O. DRESS C" ST. CROIX COUNTY, WISCONSIN.
d_1 i,L ! 11t:a
SUBDIVISION , LOT LOT SIZE-/;I f
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
SEPTIC TANK(S) MFGR. CONCRETE c STEEL
N0. of rings on cover Depth ,5 " DRY WELL
TRENCHES NO. of width length area
BED no. of lines ::;2- width i_-) r length ; area 1-_--,z 1C
depth to tpp of pipe ,
AGGREGATE v.:~ h c b 3~~~ "
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 SYSTEM.
"INSPECTOR
DATED
PLUMBER ON JOB ' r
T LICENSE NUMBER
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RFPOr.T OF INSPECTION--INDIVIDUAL SEWAGE DISPOSAL SYSTEM
Sanitary Permits
State Septic
'.'.Al IE L
T&INSHIP
t. ix C my
Sr,PTIC TA'?K
Size gallons. 'umber of Compartments
Distance Frorn: dell ^5_Z) ft. x
12% or greater slope ~1.
Building`
-Z ft. Wetlands ft
Highwater ft.
DISPOSAL SYSTL.~1-Tile Field or Seepage Pit(s)
Distance From: ilell
ft. 12% or greater slope ft
Building CK,("o ft. Wetlands
f:
FIELD i'Aiphwater ft . - -
O'n
Total length of lines -71J ft. Number of lines
Length of
each line ~ft. Distance between lines ~ft. Width of the
trench ft. Total absorption area r~sq, ft. Dept::
of rock below (the ~ in. Depth of rock over tile -r_.--- in. Cover
over.rack, .Depth of tile below grade Z D-in. Slop a of
trench in r loo ft. Depth to Bedrock ft. Depth to
around water ft.
PITS
{
Number of pits .POu side iameter ft. Depth below inlet
ft. Gravel a-ro d pit _yes no.. Total absorption area
sq. ft.
Square feet of seepage trench bottom area required S
`square feet of seepa e ni are required
r
Inspected by: Title':
Approved
Date v` 197:
Rejected Date 197
EH Al 5
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 TEST
LOCATION: Section~74 , T3UN, R/-7 (or o nship or Municipality ,
Lot No. . rnZ, Block No. dy.tc F
/ JS bdiv' ion Name County S7r. C°t^.a~ j(
Owner's Name: k A ,
Mailing Address: e?/ y 6t l rJy T&Ve Al. 47,
TYPE OF OCCUPANCY: Residence _o&No. of Bedrooms 3 Other
EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT c~
DATES OBSERVATIONS MADE: SOIL BORINGS_ ^3-72 PERCOLATION TESTS
01L MAP SHEET a~A 7 SOIL TYPE 4u d qt~y.~ :A
PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES g I
NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL RATE
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN!
I I
Se e- A-)
70 7 /1-- 3
3
I_P- 5-,e e- A/o to 312- 3 3
SOIL BORING TESTS
F TEST TOTAL DEPTH I DEPTH TO GROUNDWATER, INCHES
CHARACTER OF SOIL WITH THICKNESS, INCHES
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
71 OL
B- 3 966 ~~'G , 7It`1`'5,
S 2 70 Gh
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square et of s~it~able areas. Indi to rmf~ey0T/sAu
needed ar~ feet o absorption are<
eeded for building type and occupancy. (e 3~ mG li. /L Indicatgg.sca
or distances. Give horizontal and vertical reference points. Indicate slope. /~j"~ 1c0 SAS~`°
u 5~.~• Q Aj{►Q~
s ~ t
77 1
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3
_41
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I, the undersigned, hereby certify that the soil tests reported on this form were made byme in accord withffthe proscedures
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. W,< Zai _ 768 0
Name (print) ,4~ •L3 / a Certification No. Address z
Name of installer if known
CST Signature
4
- State and Count
PIMB6 7 Y State Permit #
Permit Application County Permit
for Private Domestic Sewage Systems County! r
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
19/9, C rRFAN ,t~~r, c%
4ti[ G . f 4e s-
B. LOCATION: A/,_10~ y, S~E y,, Section 3 T-70 N, R b (or) Lot# Z- City
Subdivision Name, "e nearest road, lake or landmark Blk# Village
% Lr~cal Township yr!.,~~_
C TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance _
Single family Duplex No. of Bedrooms No. of Persons L
D. TYPE OF APPLIANCES: Dishwasher YES
X NO Food Waste Grinder YES <NO # of Bathrooms-2-
Automatic Washer YES NO Other (specify)
E. SEPTIC TANK CAPACITY Opp Total
gallons No. of tanks -
*Holding tank capacity Total gallons No. of tanks _
New Installation x Addition- Replacement- Prefab Concrete X
*Poured in Place Steel Other (specify)
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1)__? 2) y~3)Total Absorb Area_ sq. f;
New Addition Replacement *Fill System p,
Seepage Trench: No. Lin. Feet
Width Depth Tile Depth _ No. of Trenches _
Seepage Bed: Length 3E, Width / Depth 11' Tile Depth 346"' No. of Lines
Seepage Pit: Inside diameter Liquid Depth
Tile Size
Percent slope of land is ae-rr Distance from critical slope 3
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 Cer fled Soi! est
NAME Q ' j Q C.S.T. # 99F and other information
obtained from drT own /bar).
Plumber's Signature ,
Phone #
MP/MPRSW#
Plumber's Address ~/jam-~~~
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
e Al
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74,
1 .
ho' e
_47 ,
12 1149 /D.. ch.6)-y
Do Not Write in Space Below - FOR DEPARTMENT USE ONLY
Date of Application J) ~ I- Fees Paid: State J 0 ,00 Cot4Gty(7Qtj,a)C) Dat 7 "
Permit Issued/ - (date) s -Issuing Agent Name . 4
Inspection Yes__ANo 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 cnnvl
Revised Date 6/ 1/76