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Parcel 032-2077-20-000 04/19/2006 01:26 PM
PAGE 1 OF 1
Alt. Parcel 14.30.20.793D 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
O - SMITH, MARSHAL G
MARSHAL G SMITH
1541 ANDERSEN SC'T CP TRL
HOULTON WI 54082
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 1541 ANDERSEN SCOUT CAMP TRL
SC 5432 SCH D OF SOMERSET
SP 1700 WITC
Legal Description: Acres: 1.770 Plat: N/A-NOT AVAILABLE
SEC 14 T30N R20W 1.77A IN NW SE PARCEL Block/Condo Bldg:
REFERRED TO AS # 9 ON SURVEY & DESC IN
VOL 496 PAGE 404 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
14-30N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
08/13/2004 771652 2637/638 WD
04/27/2004 760749 2557/570 QC
940/398
797/440
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/24/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.770 28,300 129,800 158,100 NO
Totals for 2006:
General Property 1.770 28,300 129,800 158,100
Woodland 0.000 0 0
Totals for 2005:
General Property 1.770 28,300 129,800 158,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 142
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
+ AS BUILT SANITARY SYSTEM REPORT
SEC. T) N, R-~W
JWNER TOWNSHIP` j
P.O. ADDRESS 2 7 ST. CROIX COUNTY, WISCONSIN
SUBDIVISION ' LOTLOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100FEET OF SYSTEM
IZ A i
I lot
° I
SEPTIC-TANK(S) / MFGR. CONCRETE STEEL
NO rings on cover Depth DRY WELL
TRENCHES No. of width length area
BED no. of lines_ width length area
deptT~ to top of pipe
AGGREGATE • - / ' 1 (11 , ~ Ii r (_I
.PERK RATE AREA REQUIRED la ` AREA. AS BUILT
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:?
INSPECTOR
t
DATED, PLUMBER' ON JOB
LICENSE
RE .POP,T OF IPTSP~,CTIO~l--I",4",It~.L ;~'U~,I~Ia ~.:.r.ii
, S " ' L,~i~.~~r )'r;~ S~rS`-"`
Sanitary Permit 25
State Septic 7,
t
T&WNSHIP
St:. Croix County
S^PTIC TA7K'
;ize ~dUp gallons. `lumber of Compartments 1 ,
Distance From: 1-Jell ~ft. 12% or greater slope
Z Building ft. Wetlands ft
L
I '
lRighwater^ft.
DISPOSAL SYSLE'AJ Tile Field or Seepage Pit(s)
Distance From: Well ft. 12% or greater slope ~ft
7 Building ft. Wetlands f:.
FIE,Ln ;Aighwater L/ ft,
Total length of lines !1 ft, Number of lines L_ Length of
each line _ 7 ft. Distance between lines ft. Width of the
Ile,
trench _f 2 f- t. Total absorption area ~ny sq. ft. Depth
of rock below tile in. Dp-pth of rock over tile in. Cover
ever. xock Depth of the below grade , in. Slopes of
trench in per 100 ft, Depth to Bedrock tj~ft, Depth to
1
ground water Alit .
PITS
"lumber of pits ~ )t~sicie diameter ft, Depth below inlet
ft. Gravel a-roti~d pit: ~Ves no. Total absorption area
sq. ft. /
Square feet of seepage trench bottom area required
`square feet of seepage----q- -a required
Inspected ti , Title: Approved Date 197
Rejected Date 197. w'
!L
r
State and County State Permit #
PLB67 Permit Application County Per t# -
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:
B. LOCATION: Al Section f T--W N, RE (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township -5& CY !g
CTYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family L--- Duplex No. of Bedrooms No. of Persons "T
D. TYPE OF APPLIANCES: Dishwasher 6-DES NO Food Waste Grinder YES 4-NO # of Bathrooms
Automatic Washer vYES _NO Other (specify)
SEPTIC TANK CAPACITY_(01~-V Total gallons No. of tanks
Holding tank capacity Total gallons No. of tanks
ew Installation Addition- Replacement- Prefab Concrete
`Poured in Place Steel Other (specify)
FFLUENT _DISPOSAL SYSTEM: Percolation Rate 1) I]t 2) .3) _LTotal Absorb Area ~Y _ sq. ft.
"few Addition _ Replacement *Fill System
`>eepage Trench: No. Lin. Feet Width _ Depth Tile Depth No. of Trenches
eepage Bed: Length Width Depth p
j$. Tile De p
No. of Lines
Seepage Pit: Inside diameter Liquid Depth Tile Size LY
Percent slope of land l `ls Distance from critical slope
the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
''lisconsin Administrative Code, and that I have sized the effluent disposal system from the EH 115 prepared
!:)y the Certified oil Tester,
i`.IAME t7 G~61 p / ~alr S C.S.T. # L J 4 and other information
btained from (owner/builder). S 7
Plumber's Signature p Phone yam-
MP/MPRSW#
Plumber's Address
} PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
I H62.2 including well).
I
lot
Do Not Write in Space Below - FOR DEPARTMENT USE ONLY
Date of Application rC~ 12 /7 7 Fees aid: State O ) County Date 2
Permit Issued/Refeeted (date) _ ssuing 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) Revised Date 6/1/76
EH 11 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309
MADISON, WISCONSIN 53701
A REPORT ON SOIL BORINGS AND PERCOLATION TESTS
LOCATION: ~J/4,501/, Section 4Y-, TWN, RAAe E (or) W, Township or Municipality -50,14
Lot No. , Block No. j ~ t_ /!/.'Y County T l"a►'l.~
7- Subdivision Name
Owner's Name: / j:g , - j,
Te _Sr DD
Mailing Address: ~ S A&t~ ~
TYPE OF OCCUPANCY: Residence No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW
ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS - ,/,O - 22 PERCOLATION TESTS
SOIL MAP SHEET SOI L 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
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
1
P- '
SOIL BORING TESTS
I TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
02 kL_-_15 -3 ff
4a - C -v
72-
7 -3
AN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
irate on the plan the location and square f e of sui able areas. Indicate num of square feet a s n area
eded for building type and occupancy. 1 /53~ ~Ce scale
distances. Give horizontal and vertical reference points. Indicate slope.
Q
t N
1 ~
I
n
L4 -
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) 46 C~ 4i q' yy~ Certification No. l
Address t.
Name of installer if known
CST Signature
COPY A - LOCAL AUTHORITY