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Parcel 032-2037-60-000 08/14/2006 12:16 PM
PAGE 1 OF 1
Alt. Parcel 10.30.19.617C 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): 0 = Current Owner, C = Current Co-Owner
O - HAMMOND, THOMAS R & CHARLENE A
THOMAS R & CHARLENE A HAMMOND
697 68TH ST
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 697 68TH ST
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 5.000 Plat: N/A-NOT AVAILABLE
SEC 10 T30N RI 9W 5.08A IN SE NE COM E1/4 Block/Condo Bldg:
COR TH W 120' TO POB, TH W 494', TH N 9
DEG E 480.37' ELY ALG CURVE CON CAVE NLY Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
50.9', ELY 369.5'S 510.45' TO POB 10-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 779106
07/23/1997 586146
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/23/2003
Description Class Acres Land Improve 'Total State Reason
RESIDENTIAL G1 5.000 58,000 128,200 186,200 NO
Totals for 2006:
General Property 5.000 58,000 128,200 186,200
Woodland 0.000 0 0
Totals for 2005:
General Property 5.000 58,000 128,200 186,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 209
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
..er V a V 1 Y: Y'Y 1lL.C l7I\1
f '
! .
' ERADD :ESS , , TOWNSHIP, -Sw ' SEC. Vic, T` Td, R W
, ST. CROIX COUNTY, WISCONSIN.
DIVISION LOT LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
.
- f _
- I
TIC TANK(S) _ MFGR,_ , CONCRETE STEEL
NO. of rings on cover ; De th T
'~~CHES NO. of width DRY WELL
length area
no. of lines Z width lengtho area '
RELATE depth to top of pipe
"a RATE-- AREA REQUIRED C,kj AREA AS BUILT do7
:Claimer: The ir_>pection of this system by St. Croix County does not imply complete i
_pliance with State Administrative Codes. There are other areas that it is not possible j
inspect at this point of construction. St. Croix County assumes no liability for
tem operation. However, if failure is noted the County will make every effort to /
-Ermine cause of failure.
:'SES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. ,
"INSPECTOR
DATED" PLUMBER ON JOB
LICENSE NUMER ~
z
REPORT OF INSPFCTIUN_INDIVIDUAL SEWAGE SYSTEM
SanitarLy PeAm,it ?
State Septic
NAME Towns hip- St. Ctoix County
Loca Lavi o6/%Sectian T N,R W
SEPTIC TANK
Size gattons. NumbeA o6 CompaA,tmentz
r
D.iz tance FAOm: Wett 12% oA gnea,teA Ztope 6t
Bu,itding r it. Wettand~s it.
H.LghwateA - it.
DISPOSAL SYSTEM
Distance FAom: Wett ' 12$ oA gnea et Ztope i .
Bu-itding 6Z. Wettands F;~o
Highwa,teA it.
FIELD DIMENSIONS:
Width o4 tAench it. Depth o4 Aock below tite in.
Length of each tine it. Depth o4 Aock oveA Cite -n.
NumbeA o6 Una Depth o i ,t.i.Ee b etow grade f =icy:
Totat .length o6 t ine/s ; it. Sto pe o6 ttench in pen 100 it.
D.i,sLance between Una f it. Depth to b edAO ck it.
Totat ablsoAbtion aAea jt2 Depth to gtoundwateA it.
RequiAed aAea 2
PIT DIMENSIONS:
NumbeA a6 pits GAavet around p,itz yes no
Outz.ide diameteA it. Depth betow inte-t it.
Totat abzoAbtion atc.ea ~ 2, z
AAea tequited ~ 2
m
INSPECTED BY TITLE
APPROVED ,DATE 197
REJECTED DATE 197
tA -Al
L B
y
PLB67 State and County State Permit #
Permit Application County Permit
for Private Domestic Sewage Systems County J
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
t&v .07 72 e-
ZE
-
B. LOCATION: Y4 _&p y%, Section T e N, R E (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
- Township S~sr~ q
- -
C. TYPE OF OCCUPANCY: 'Commercial _ 'Industrial 'Other (specify) 'Variance
Single family Duplex No. of Bedrooms ~j No. of Persons_ _
D. TYPE OF APPLIANCES: Dishwasher 1/DES NO Food Waste Grinder YES 4---NO # of Bathrooms-
Automatic Washer y'YES NO Other (specify)
F SEPTIC TANK CAPACITY Total gallons No. of tanks *Holding tank capacity Total gallons No. of tanks
New Installation - Addition Replacement Prefab Concrete ::f "
'Poured in Place _Steel Other (specify)
EFFLUENT DISPOSAL SYSTEM: Percolation Rate ~3)-~=Total Absorb Area +t~ sc;. fr.
New L,-` Addition _ Replacement *Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length -50!-Width / ` Depth f Tile Depth No. of Lines '2-
Seepage Pit: Inside diameter Liquid Depth Tile Size V
Percent slope of land Distance from critical slope
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 Certi ied Soil Tester,
NAME i C.S.T. # f y 3 - - and other information
obtained from (owner/builder).
Plumber's Signature Phone
Plumber's Address MP/ PRSW# .,C 5
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
P 0 d
Do Not Write in Space Below - FOR DEPARTMENT USE ONLY
Date of ApplicatioW Fees Paid: State d , County J` Date
Permit Issued/mod (date) J-/y - Q _Issuing Agent Name C`- L~xfz~ly(
Inspection Yes__,X No Valid# Date Recd
1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2 ;t,,- (nink t-onv) 4 nlumh,r lr:; -
Revised Date 6/1 /76
EH 11.5
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 TESTS
LOCATION:,'/4, Section T-3-A, R 17E (or) W, Township or Municipality ~La -,7 e- e 2
Lot No. , Block No. County
Subdivision Name
Owner's Name: .1 t3
Mailing Address: 0 /'55'tic 2 3.f Es < !t ..Ire
TYPE OF OCCUPANCY: Residence No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
DATES OBSERVATIONS MADE SOIL BORINGS S PERCOLATION TEST - G --~s'
SOIL MAPSt-(EET--- SOILTYPE f ,~a~c
PERCOLATION TESTS
! TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
j 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-1 3
p- I
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES i
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
N
7-
I
41? 17.21
'3 `r --j
k L S~,., _ f
l
Al" e
3-
PLAN VIEW (Locate perco lat ion tests,so i I bore holes and suitable soil areas.)
1,idicate on the plan the location and square feet of suitable areas. Indp ate numb of square feet of absorption a
i;ceded for building type and occupancy. s . e
r distances. Give horizontal and vertical reference poi V . Indicate slope.
3 € ,
mm
I ( ~
I
_ } N
- -
- IV
i d
I
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) Certification No.
7
Address
Name of installer if known
CST Signature
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