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Parcel 030-2079-30-000 03/24/2005 10:39 AM
PAGE 1 OF 1
Alt. Parcel 33.30.19.670 030 - 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
DALE G & DELORES BYBOTH BYBOTH, DALE G & DELORES
1206 RED OAK RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 1206 RED OAK RD
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 5.260 Plat: 2234-OAK KNOLL ADD
SEC 33 T30N R1 9W OAK KNOLL ADD LOT 13 Block/Condo Bldg: LOT 13
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:
6380 201,800
Valuations: Last Changed: 07/12/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.260 101,000 97,500 198,500 NO
Totals for 2004:
General Property 5.260 101,000 97,500 198,500
Woodland 0.000 0 0
Totals for 2003:
General Property 5.260 59,400 79,900 139,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 307
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
• AS BUILT SANITARY SYSTEM REPORT
0. ADDREGSSe y TOWNSHI aI SEC. T- N, R
ST. CROIX OUN'Y, WISCONSIN.
.T3DIVISION _ LOT LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
i
y
?TIC TANK(S)MFGR. CONCRETE k STEEL
NO. of rings on cover Depth DRY WELL
WENCHES NO. of width length- area
no. of lines width/.Z_ length Z area
depth to top of-pip
e '
>'^,REGATE
C RATE AREA REQUIRED AREA AS BUILT
,claimer: The inspection of this system by St. Croix County does not imply complete ;
mpliance 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
stem operation. However, if failure is noted the County will make every effort to
termine cause of failure.
.'.ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
"INSPECTOR
DATED PLUMBER ON JOB d Z c , L ,
LICENSE NUMBER J~ 3 G
REPORT Or, INSPECTION--INDIVIDUAL SE;,IACE DISPOSAI, SYS TE1.1
r1 Sanitary Permit_r~! L
r State ~e is
T&MISHIP
-Co ty
MEPTI C TA'?T:
Size gallons. -umber of Compartments
Distance From: WeII ft. 12% or greater slope xt.
Building' ft. Wetlands f
Righwater ft.
DISPOSAL SYSTL.:1 Tile Field or Seepage Pit(s)
Distance From: i I ell 12%.or greater slope ft
Building; ft. Wetlands f:.
FIELD iiighwater ft.
Total length of lines ft. Number of lines Length of
each line ft. Distance between lines ft. Width of the
trench ''.Yft, Total absorption area sq. ft. Depth
of rock below tile in. Dp-pth of rock over tile in. Cover
,over.rock,, Depth of the below grade in. Slope of
trench in per 100 ft. Depth to Bedrock ft. Depth to
ground water £t.
PITS
Number 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
Square feet of seepage nit area required -
Inspected by: Title:
Approved Date 197
Rejected Date 197.
EH 1.15
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, Section T,3-9N, R/ &(or)(Qhownship or Municipality 451, ~vs_ 4 _
Lot No. Blo k No. 0,0 ~ County
Subdivision Name
Owner's Name: ,x/16'-~tl L. /
Mailing Address: .23:2 C? A/~ ~V1, ~A6 , 702 1Y Q. :Sfe. ®/4L-~.'~.w. -570.7
TYPE OF OCCUPANCY: Residence X No. of Bedrooms =3 Other
EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS-Y ~c PERCOLATION TESTS
r~+.~l~/Cl~'r~7~~ AuSct!-~ C~vw:~l'f
SOILMAPSHEET eft ~_t/ 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 MIN/IN
SER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P ~v /W/0
~s.-
I cot
P_ 3
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)
-40 1; 0 r` 1r~
f+
PLAN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.;
Indicate on the plan the location and square f et of suitable areas. Indicate nums /E of sy feet -J,?bso- _ien area
needed for building type and occupancy. • ~UL~'~~ 5..•`~i r~~ -Indic to scale
or distances. Give horizontal and vertical referenc int In is a slope.
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y F,96-'
1, 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) `s Certification No.
Address r y
Name of installer if known
CST S natu
COPY A - LOCAL AUTHORITY
TRANSFER FORM
PLB 67- T SANITARY PERMIT
State Permit #
Sanitary Per i
County
Sanitary Permit Transfer Date Original Permit Issuance Date
A. Property Location: Section T_% ~ N, R ~1-V (or) W Lot # City
Sub ivision Name__ I Nea est R , Lake or Landmark BLK # Village
CU Township
B. TYPE of Occupanc . Commercial Industrial Other (Specify)
Single Family Duplex No. of Bedrooms Variance
C. SEPTIC TANK CAPACITY Total gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab Concrete Poured-in-place Steel Fiberglass Other(Specify)
New Installation /Y. Replacement
LIFT PUMP TANK/SIPHON CHAMBER Total gallons Prefab Concrete Poured-in-place -Other (Specify)
D. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area sq. ft.
New Replacement Alternate (Specif
Seepage Trench: No. Lineal Ft. Width Depth Tile Depth(top) No. Trenches
Seepage Bed: Length ' - 2 Width L Depth Tile Depth(top)-X~ No. of Lines
Seepage Pit: Inside diarpeter Liquid Depth No. Seepage Pits
Percent slope of land / I -IrDistance from critical slope
E. WATER SUPPLY: Private ❑ Joint ❑ Community ❑ Municipal
Present Sanitary Permit Holder Phone No. - = i- unitary Permit Transfer d To: Phone No. F -
Name try; ; z a 1 c
Name
'N 7~
Address Address ~LL_c ~ L n'~:_~^-Je
a
Zip' Zip
I, the undersigned, do hereby certify that I have reported all revisions to the sanitary permit and that all revisions are in accord with
section H 62.20, Wisconsin Administrative Code and that I have sized the effluent disposal system according to the EH-115 prepared
by the Certified Soil Te ter and/or any-9)lditional soil tests that may have been required.
Plumber's Si nature
g _ - MP/MPRSW # Phone # ` k
Plumber's Address ~1
Information obtained from
(owner or agent)
PLAN VIEW: Provide sketch below of any revisions to original sanitary permit. Include direction of slope and all distances in accord
with H 62.20. Well location shall be included on the sketch. Indicate or dimension location of all wells, on the property or neigh-
bor's pro,ert~y. If v_ell has of been drille
I
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Signature of Issuing Agent ve,Lt,
1. County (Yellow copy) 3. Owner (Pink copy) DIVISION OF HEALTH
2. State (White copy) 4. Plumber (Green !copy) P.O. BOX 309, MADISON WI 5370+
State and County State Permi #
PLB67 v Permit Application County P it C=~
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:
AM, je~d 4) ? A10. SA
B. LOCATION: 51~'/4 59 '/4, Section jj- T,-30 N, RZ (or) (~2Xot# __City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township jX 7bsr~
C. TYPE OF ID C UPANCY: *Commercial *Industrial _*Other (specify) *Variance
Single family Duplex No. of Bedrooms -3 No. of Persons
D. TYPE OF APPLIANCES: Dishwasher _,X_ YES NO Food Waste Grinder YES x NO # of Bathrooms
Automatic Washer _X_YES NO Other (specify)
SEPTIC TANK CAPACITY_,/Qc9_rTotal gallons No. of tanks
'Holding tank capacity Total gallons No. of tanks
? ew Installation Addition Replacement- Prefab Concrete X
'Poured in Place Steel Other (specify)
EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2► ~ 3) Total Absorb Area g sq. ft.
New _X Addition Replacement *Fill System
Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches----
- Seepage Bed: Length _14' Width- Depth t` Tile Depth No. of Lines
Seepage Pit: Inside diameter -Liquid Depth Tile Size
Percent slope of land--*-1_-~e~ ~ t ( C5"4, S Distance from critical slope
~-r•'+ - Ad-( Ir Vic' r ~ ~U the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
"disconsin Administrative Code, and that I have sized the effluent disposal system from the EH 115 prepared
%sy the Certified Soil Te ter, /
lAME iLi-~S' o ~rj4y C.S.T. # and other information
,obtained from owner
s'lumber's Signature MP/MPRSW# - v _o-1 Phone #ff -39E7°36L
Plumber's Address
104
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well). /
I
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We I 04-k
Do Not Write in Spac Belo W R DEPARTMENT U E ONLY OL r/r p
Date of Application , Fees Pai : State C unty Date
Permit IssuedlRoWn-Y ' (date -Issuing Agent Name -A4Z4 4Z
/ri L/
Inspection Yes-No Valid# Date Recd
1. county (w tFYI a copy) 3, owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
I~ 9 ,tats (pink copy) 4. plumber (canary copy)
Revised Date 6/1 /76