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Parcel 032-1012-95-000 09/12/2005 04:11 PM
PAGE 1 OF 2
Alt. Parcel 5.31.19.74C 032 - TOWN OF SOMERSET
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
MARY K THOMAS O - THOMAS, MARY K
2337 DELONG RD
OSCEOLA WI 54020
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 4165 SCH D OF OSCEOLA
SP 1700 WITC
Legal Description: Acres: 10.000 Plat: N/A-NOT AVAILABLE
SEC 5 T31 N R1 9W PT NW SW COM NW COR S 5 Block/Condo Bldg:
DEG W 1165.52' N 88 DEG E 1335.07'S 4
DEG W 1287.63'S 691.8870 POB; TH S 1 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
DEG W 595.78'S 88 DEG W 825'N 1 DEG E 05-31N-19W
683.47'S 87 DEG E 87.8'; N 5 DEG W
71.6'N 3 DEG E 5.55'; S 54 DEG E
more...
Notes: Parcel History:
Date Doc # Vol/Page Type
10/04/2004 775965 2668/36 EZ-U
02/26/2004 755199 2516/393 TI
05/25/1977 340289 554/449 WD
2005 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/22/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 10.000 83,000 206,900 289,900 NO
Totals for 2005:
General Property 10.000 83,000 206,900 289,900
Woodland 0.000 0 0
Totals for 2004:
General Property 10.000 83,000 206,900 289,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 216
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 032-1012-95-000 09/12/2005 04:11 PM
PAGE 2OF2
Legal Description: cont.
262.63'; TH N 88 DEG E 526. 78 FT TO POB
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--400,00
..a. _ 35x3 00~
r AS BUILT SANITARY SYSTEM REPORT
`',TER
0. ADDRESS , TOWNSHIP j~/rj SEC.
ST. CROIX COUNTY, WISCONSIN. ' R W
sC
3DIVISI0-
LOT___(, LOT SIZE
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
~lJ E'L L.
. ~Quse
• j (fop .
0 0 ~
?TIC TANK(S)Ij ~D~JD MFGR. _
NO. of rings on cover CONCRETE-~-- STEEL
INCHES NO. of /~L= Depth DRY WELL
width length area
3 no. of lines width
ZL_ length, area
dePtto top of
X RATE /REQUIRED ~ z Pr-.,
A REQUIRED AREA AS BUILT
-laimer: 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
aspect at this point of construction. St. Croix County assumes no liability for
u operation. However, if failure is noted the County will make every effort to
ine cause of failure.
AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. '
'-INSPECTOR
)ATED f
- PLUMBER ON JOB
LICENSE NUMBER_
s
RE, 0RT OF ITTSPECTION--INDIVIDUAL SELJAGE DISPOSAL SYSTEM
Sanitary Perri it State Septic TOWNSHIP Z
t. Croix County
v r PTIC TP.77K'
Size gallons. 'hunber of Compartments
Distance From: Tlell ft. 12% or greater slope f~.
r Building ft. Wetlands ft
Highwater ft.
DISPOSAL SYSTM-1 Tile Field or Seepage Pit(s)
Distance From: Well ft. l2°l0 or greater slope ft
Building; ft. Wetlands f
FIELD i;iahwater ft.
Total length of lines ft. Number of lines Length of
each line _ ft. Distance between lines ft. Width of the
trench ft. Total absorption area sq. ft. Dept::
of rock below tile in. Depth of rock over tile in. Cover
over.rock, Depth of tile below grade ill. S1opa of
trench in per 100 ft. Depth to Bedrock ft. Depth to
around water ft.
PITS
Number of nits Outside diameter ft. Depth below inlet
£t. Gravel around pit: yes i no. Total absorption area
_____sq. ft.
Square feet of seepage trench bottom area required
`:quays feet of seepage pit area required
Inspected by: Title:
Approved Date 197`
Rejected Date 197.
} w
t y ~i
EH 115
- WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
z P.O. BOX 309
MADISON, WISCONSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
~GiJ)t' Ii-SF
LOCATION. % '/4, Section /v , T,~N, R (or) W, Township or Municipality
Lot dw, Block No. 1 ` rtC~ f~ . f t, r t County / C r f X
ubdivision IV-aMe
Owner's Name: %
~12:2i i, "!L C-
Mailing Address: / S IV / ~L C'
TYPE OF OCCUPANCY: Residence t / No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
7
DATES OBSERVATIONS MADE: SOIL BORINGS 7 - 7 7 PERCOLATION TESTS ~f /
SOi L MAP SHEET SOIL TYPE
PERCOLATION TESTS
PEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
CHARACTER OF SOIL SINCE HOLE HOLE AFTER INTERVAL
`dUM- INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
13
i
i P- Z
-3
Jl~ cSOIL 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 - E-
?LAN VIEW (Locate perco lation tests,soi I bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absor;
naeded for building type and occupancy. f IN, (3~111 Z7 ~4-r^ Indi
or distances. Give horizontal and vertical reference points. Indicate slope.
r.
I S1 - ~
jE
~N
v -
:T 77-
~ i'fi5 ~ F I
1 y ~ t r+ -1~~ s } - ~ ~
1 tF
_TT
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. ~r f
Name (print) --g?1 ✓-A Jt_ ` Certification No.
01
Address '
r
Name of installer if known
. / f
CST Signature 4L-~=
OPY A -LOCAL AUTHORITY -
State Permit #
PLB67 State and County
Permit Application County Permit # _
C-ice--
for Private Domestic Sewage Systems County
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNE OF PROPERTY Mailing Addre
- r . Au L)
B. LOC ION: ~(~'/4 Section T N, R F (or) W Lot# ~~Q -City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance___ Single family Duplex No. of Bedrooms No. of Persons_
D. TYPE OF APPLIANCES: Dishwasher &-4€S NO Food Waste Grinder YES 1--O # of Bathrooms-,?
Automatic Washer L----7-ES NO Other (specify)
E SEPTIC TANK CAPACITY t~2-,:n d Total gallons No. of tanks
*Holding tank capacity _ Total gallons No. of tanks
New Installation's Addition Replacement Prefab Concrete
*Poured in Place Steel Other (specify)
V EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) „5 2) 3) y,5~-Total Absorb Area SZO sq. ft.
New I/ Addition Replacement *Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length Width ~R Depth _ Tile Depth Z~F 'z No. of Lines - ;3_
Seepage Pit: Inside diameter Liquid Depth Tile Size '
Percent slope of land Zh Distance from critical slope
1, 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 Tester,
NAME Ca f., -54-~- E=( C.S.T. # Z- 2 967 and other information
obtained from (owner/builder).
Phone #rw~=16
Plumber's Signature ZCL MP/MPRSW#--f--
Plumber's Address 41 -74,
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
S
5 vo-v As C-7
Do Not Write in Space Below FOR DEPARTMENT USE ONLY
Date of Application y Fees Paid: State /6,,, Co y ate
Permit Issued/ (d te) suing Agent Name ~=J
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) a
--~raiYrrllril~111~11
f
PLB67 State and County State Permit #
Permit Application County Permit #
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:
N, R
B. OCATION: _I/ Section -r T J E (or) W Lot# 5 City _
Subdivision Name, nearest road, lake or landmark Blk# Village
Township
C. TYPE OF OCR PANC -commercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms No. of Persons
D. TYPE OF APPLIANCES: Dishwasher ---YES NO Food Waste Grinder YES ENO # of Bathrooms-
Automatic Washer ---YES NO Other (specify)
E. SEPTIC TANK CAPACITY % Total gallons No. of tanks _
*Holding tank capacity Total gallons No. of tanks
New Installation t,: Addition Replacement- Prefab Concrete
'Poured in Place Steel Other (specify)
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1)- 2) 3) y Total Absorb Area ft.
Newer Addition Replacement *Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length =Width Depth Tile Depth ( 1~ ' No. of Lines
Seepage Pit: Inside diameter Liquid Depth Tile Size
+ -
Percent slope of land Distance from critical slope
I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.2C
Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prep
by the Certified Soil Tester,
NAME f` f C.S.T. # and other informatic
obtained from (owner/builder).
Plumber's Signature MP/MPRSW# ~f/eul 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).
VV,
S-e
13L t=
Do Not Write in S ace Below FOP, DF~~jR T SE NLY
Date of Applicatio l - - ees a at C Mu Da~e
Permit Issued/ d (date) -Issui g Agent Name k-tL
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) Revised Date 6/1/76