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Parcel 030-2079-90-000 03/24/2005 10:06 AM
PAGE 1 OF 1
Alt. Parcel 33.30.19.676 030 - 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
KATH, CHRISTOPHER A
CHRISTOPHER A KATH
568 WHITE OAK LA
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ` 568 WHITE OAK LN
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 4.000 Plat: 2234-OAK KNOLL ADD
SEC 33 T30N R1 9W OAK KNOLL ADD LOT 19 Block/Condo Bldg: LOT 19
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
33-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/03/2001 650069 1672/611 QC
01/27/1999 596574 1399/86 QC
07/23/1997 913/303
07/23/1997 747/387
2004 SUMMARY Bill Fair Market Value: Assessed with:
6386 241,900
Valuations: Last Changed: 07/12/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 4.000 110,400 127,600 238,000 NO
Totals for 2004:
General Property 4.000 110,400 127,600 238,000
Woodland 0.000 0 0
Totals for 2003:
General Property 4.000 64,800 95,300 160,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 138
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
11 LANDS
39°12 42 E 1125-88'
183.59'
369.44 300.04
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• AS BUILT SANITARY SYSTEM REPORT
T.TER TOWNSHIP SEC. T N, R W
.0. ADDkESS , ST. CROIX COUNTY, WISCONSIN.
UBDIVISION LOT_LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
I
_
?TIC TANK(S) MFGR. CONCRETE STEEL
NO. of rings on cover Depth DRY WELL
-.ENCHES NO. of width length area
,J no. of lines width length area
depth to top of pipe
'f~REGATE ,
RATE AREA REQUIRED AREA AS BUILT
'.sciaimer: The inspection of this system by St. Croix County does not imply complete
pliance 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.
BASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
"INSPEC
DATED PLUMBER ON JOB
LICENSE NUMBER
' i \il L~~.i ' i ...Jd..,.111, li i,ii 'i'. _-t+~..
Sanitary Pernit
r State Septic
7
DTIC: TA"
)ize ~ gallons . 'umber c;;. ;c, pay ~i 1Lns
Distance From: Well 6 > ft. 12% or gre i._
r Building 'l C~gt ft, Wet1, ILigtiwater f t
DISPOSAL SYSTL:1 Tile Fie'_
Distance From: 11eli ft. 12% or greater slope i t.
Builcin` j ft. Wetlands f:
I:LD :;ighwa r - ft.
otal lentth, of lines
17 ft. Number of lines Z-. Length o "
ache line ft. Distance between lines _ft. Width of
rend; Total. absorption area L sq. ft. Dep~':
f 'roc bel.t~Y~r the in. Dp-pth of rock over tile `2- in. Cove:-, . xc?r.. . Depth of file below grade - in. Slop- f
rench in ner 1~1r) r-t . T)?-)I-h e) tb t;.
,round water f
ITS
t Y3?; of V i t l Outs , y. 1 '
Grave., f un p t : ~~es zoo. 'T'otal absorption area
q. ft,
square feet of rxFf?Y-a~, Lea yu 1:ed
quare feet of eparr. a n ` - e rewired -
ected- Title:
1
prov Date 7_Cj
?ie-te<" p~, 197
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
FH 115 N I
a P.O. BOX 309
MADISON, WISCONSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
LOCATION: ~/4, 1'/4, Section, Tell, R r) W, Township eri ►wir~°,!~tv !
L L County
Lot No., Block No.Nt~ L.
Subdivision Name
Owner's Name: Ke_frri 4f/4~ M PaL-_L_(-
Mailing Address: 1345 t&_ .5/na Dally P'i /Q_c ~A_,-,_ ii i✓ / //~1/~(~ 5
TYPE OF OCCUPANCY: Residence No. of Bedrooms -S Other
EFFLUENT DISPOSAL SYSTEM: NEW x ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS &/2'Z/-76 PERCOLATION TESTS 7
SOIL MAP SHEET 3SA^ ZFF^ /f~j SOIL TYPE _5L~XKJ4A 4N 504 r6'~'I P~ ~ X
k..
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
P_ 7,
P- 3 4-0 4
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)
; 9 y9 !5 i3' L 23 l d
4° - y 9~ S~~ iS`• L Z --Cw ~ ~
B_
as 1~. c> S t. Z G~.t S
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of4uitable areas. ndicate number of square feet of absorption area
needed for building type and occupa. ~`~S FT " 7XC 4,14 Indicate scale
ncv. RRI13-6 FO el or distances. Give horizo tal and vertical reference points. Indicate slope.
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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) JAM Es t " QU Certification No.
Addressin/ CP 4-~ 0,4 2-
Name of installer if known K?iv~-~-~
CST Signature
COPY A LOCAL AUTHORITY
i
• r f
State and County State Permit #
PLR67 Permit Application County Perm = C/-11&
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:
Ka r4 C,4 M ri>-B e-L- L 13 4- I c tj 5 .reT)Rj ue-APr-
3 el N, R/9- &-4e+4- W Lot# TCity
B. LOCATION: ff '/4 '/4, Section, T-
Subdivision Name, nearest road, lake or landmark Blk# Village
y " 45 Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family OK Duplex No. of Bedrooms -No. of Persons '7
D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES-X" NO # of Bathrooms
Automatic Washer?(- YES NO Other (specify)
E_ ;SEPTIC TANK CAPACITY Qc U Total gallons No. of tanks I
'Holding tank capacity Total gallons No. of tanks
';ew Installation -Addition Replacement Prefab Concrete
'Poured in Place -Steel Other (specify)
FFL NT DISPOSAL SYSTEM: Percolation Rate 1) 2) 7 3) ~ -Total Absorb Area sq. ft.
P.<ew01 Addition Replacement *Fill System _
Seepage Trench: No. Lin. Feet Width --Depth Tile Depth No. f Trenches
1A Z-
Seepage Bed: Length Width 1Z c Depth _1"D Z.Tile Depth No. of Lines
Seepage Pit: Inside diameter Liquid Depth Tile Size
Percent slope of land 46% $ b Distance from critical slope
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 ;C rtified Soil Tester
NAME t=, C.S.T. # and other information
obtained from (owner/builder).
Plumber's Signature MP/MPRSW# . J~/-," 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).
t{ov~,c
4bt
T 2
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1PV N- i Tom' 0 A-i~-
Do Not Write in Space B ow F RR DEPARTMENT USE ONLY C t~ `
Date of Application Fees P id: State/'42r0 d C y ~ Date
Permit Issued/Ra oe4ed (d te) / Issuing Agent Name
Inspection Yes-4,No Valid# Date Recd
1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
state (pink dopy) 4. plumber (ca- -