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Parcel 030-2079-95-000 03/24/2005 09:49 AM
PAGE 1 OF 1
Alt. Parcel 33.30.19.677 030 - 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
DAVID R L'ALLIER DALLIER, DAVID R
1226 RED OAK RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 1226 RED OAK RD
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 3.370 Plat: 2234-OAK KNOLL ADD
SEC 33 T30N R19W OAK KNOLL ADD LOT 20 Block/Condo Bldg: LOT 20
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
33-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
03/03/2000 619188 1493/632 WD
07/23/1997 828/388
07/23/1997 759/45
2004 SUMMARY Bill M Fair Market Value: Assessed with:
6387 206,300
Valuations: Last Changed: 07/12/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.370 80,000 123,000 203,000 NO
Totals for 2004:
General Property 3.370 80,000 123,000 203,000
Woodland 0.000 0 0
Totals for 2003:
General Property 3.370 46,800 103,500 150,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
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~L TOWNSHIP SEC.iZ T__~t;N, R~W
P.O. ADDRESS ST. CROIX COUNTY, WISCONSIN.
SUBDIVISION LOT ~X)LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
4
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SEPTIC TANK(S) MFGR. CONCRETE STEEL
NO. of rings on cover Depth DRY WELL
TRENCHES NO. of width length area
BED no. of lines 1- width /-r " length t-- 1-1 1
area,/ '
depth to top of pipe
AGGREGATE
45-
PERK RATE AREA REQUIRED AREA AS BUILT
v-j--
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.
INSPECT i
DATED PLUMBER ON JOB
LICENSE NUMBER
i
' REPCRT OF ITTSPECTIO:J--INDIVIDUAL SEZ,JAGE DISPOSAL SYSTEM
Sanitary Permit
State Septic
TOt•TIISHIP
SE. Croix County
SEPTIC TA.-!T\'
Size gallons. 'lumber of Compartments ,
Distance From: '-Jell ( ft. 12% or greater slope < f 1 ft.
Building _ ft. Wetlands f:
Izighwater ft.
DISPOSAL SYSTE:1 Tile Field or Seepage Pit(s)
Distance From: TTell ft. 12% or greater slope ft
Building; _ j ft. Wetlands
i f:
FIFLn
;:;ighwater IIU ft.
Total Ieng i of lines ft. Number of lines Length of
each line ft. Distance between lines ( ft. Width of the
trench l ft. Total absorption area sq. ft. Depth
of rock below the in. Dp-pth of rock over tile in. Cover
over rock, / Depth of the below grade in. Slope of
trench ~p in per 130 ft. Depth to Bedrock - ft. Depth to 1
ground water fL ft.
P 1TS
Number of nits . Outside diameter ft. Depth below inlet
ft. Gravel around nit: _yes no, :Total absorption area
sq.-ft.
Square feet of seepage trench bottom area required
`square feet of seep-are nit area required -
Inspected by Title: Approved Date 197
Rejected , Date 197 r,
ER-1 15
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
It DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309
• MADISON, WISCONSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TESTS l
LOCATION: Sectiori-a, ~T,-j,C"N01;_7 ,RL P(or) W, Township or Municipality- -
- 0 L% KWS) County )4,
Lot No. ~ Block No.
division Name
JDA14 A--
Owner's Name:
Mailing Address: O
3 IN
TYPE OF OCCUPANCY: Residence k No. of Bedrooms -3 Other
EFFLUENT DISPOSAL SYSTEM: NEW x ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS - 7 PER O ATION TESTS Z -7 7
a
SOIL MAP SHEET SOIL TYPE
V
PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES] RAT',
NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/1N
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
Zli
P-2
'T
L_
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
`DUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
914 y -~7 5:,
6_6 ,
z
_ .~3 ~6 ? G_w G 1N Sc 915
17
17c, 4
,?!_AN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.)
iiicate on the plan the location and square feed of suitable areas. Indicate number of square feet of absorption area
,,Ceded for building type and occupancy. o Indicate scale /
or distances. Give horizontal and vertical reference dints. Indicate slope.
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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 oa_ 7, ` Certification No.
Address Ak_A~ B-t442.'!:C~
Name of installer if known.
d CST Signature
COPY A-LOCAL A 9T,-i:. 2iTY
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Pa
~ ~ ~ ~ State and County State Permit #
Permit Application County Perg it #
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:
L) rL1 t i L_ c G, j i : t' i 1 ! 1 L G• t
B. LOCATION: t. '/4 Section , T 3(' N, R i E (or) W Lot# -City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township
i
C. TYPE OF OCCUPANCY: -Commercial *In ustrial *Other (specify) *Variance
Single family Duplex _No. of Bedrooms No. of Persons Zy
D. TYPE OF APPLIANCES: Dishwasher X YES NO Food Waste Grinder YES.>< NO # of Bathrooms
Automatic Washer }AYES NO Other (specify)
E. SEPTIC TANK CAPACITY C' Total gallons No. of tanks
'Holding tank capacity_ Total gallons No. of tanks
New Installation A -Addition- Replacement Prefab Concrete ,k
'Poured in Place Steel Other (specify)
f EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) y 2),J3) Total Absorb Area r! % sq. ft.
New Addition Replacement *Fill System
Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length Width I 2-`-Depth r.1,' Tile Depth f j No. of Lines 2--
Seepage Pit: Inside diameter Liquid Depth Tile Size `i
Percent slope of land .4 J 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 Certified Soil Teste „
NAME C.S.T. # and other information
obtained from (owner/builder).
Plumber's Signature ( -fit Phone
MP/MPRSW#
? f%-
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
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T\7 t
t
0176
~ 6.
7
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Do Not Write in Spec e~ Below FOR DEPARTMENT USE ONLY
Date of Application l"/cn ? Fees Paid: State U"` Coun ate
Permit Issued/RRiQated (date) Issuing Agent Name
Inspection Yes No 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 copy)