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Parcel 032-1049-10-000 04/20/2006 04:44 PM
PAGE 1 OF 1
Alt. Parcel 17.31.19.247A 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
DENISE M GUNDERSON O - GUNDERSON, DENISE M
333 RICE LAKE RD
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 333 RICE LAKE RD
SC 5432 SCH D OF SOMERSET
SP 1700 WITC
Legal Description: Acres: 19.000 Plat: N/A-NOT AVAILABLE
SEC 17 T31 N R1 9W 19A E1/2 OF SE NW EXC E Block/Condo Bldg:
100'S OF TN RD (EZ-I-1118/421)
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
17-31 N-1 9W
Notes: Parcel History:
Date Doc # Vol/Page Type
06/26/2002 682720 1917/55 TI
07/23/1997 777/371
07/23/1997 742/429
01/30/1992 478571 932/438 WD
more...
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/14/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.000 86,900 403,200 490,100 NO
UNDEVELOPED G5 5.000 300 0 300 NO
PRODUCTIVE FORST LANDS G6 9.000 36,000 0 36,000 NO
Totals for 2006:
General Property 19.000 123,200 403,200 526,400
Woodland 0.000 0 0
Totals for 2005:
General Property 19.000 123,200 403,200 526,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 130
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 , TOWNSHIP SEC. T N, R W
P.O. ADDRESS ST. CROIX COUNTY, WISCONSIN.
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
r
3
y
SEPTIC TANK(S) MFGR. - CONCRETE STEEL
NO. of rings on cover Depth DRY WELL
TRENCHES NO. of width length area
BED no., of lines width length area
depth to top of pipe
AGGREGATE
PERK RATE AREA REQUIRED 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
DATED PLUMBER ON JOB r
LICENSE NUMBER
F
i}ltjCi
I
z ,
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
San,itany PeAm.it-
State Septic
NAME Township St. CAO.ix County
Location _!-4 o Section T_N, R : , _W
SEPTIC TANK
Size gattons. Numbers o6 CompaAtment~s
D.i.6tance Prom: Wet. 6t. 12% m gtc.eaten stope 6t
Bu.itding bt. Wettand~s 6t.
HighwateA 6t.
DISPOSAL SYSTEM
Distance FAOm: Wett 6z. 12% oA gtceateA stope ~ .
Bu.itd,ing 6t. Wettands Ft.
H.ighwateA bt.
FIELD DIMENSIONS:
Width o6 tAench 6t. Depth o6 tcock below ti e in.
Length of each Zine Ut. Depth o6 Aock oven t.ite in.
Numbe.t o6 tines Depth o4 tite below gAade .in.
Totat .length of Zinez 6t. Stope o6 ,LAench in peA 100 ~ .
D.ustance between Zine~s 4t. Depth to bedtock bt.
Totat ab,soAbtion atcea 6t2 Depth to gtoundwateA 6t.
RequiAed atc.ea 6t2
PIT DIMENSIONS:
NumbeA o6 pits GAaveZ around pitz yes no
Out-side d.iametvL 6t. Depth below inter 6t.
2
Totat ab,5 oAbtion atcea At z
A
AAea AequiAed 6t rn
INSPECTED BY TITLE
APPROVED DATE 197
REJECTED , DATE 197.
State and County State Permit #
PILB67 Permit Application County Permit #
for Private Domestic Sewage Systems County qt- gnu I -
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
OA~
B. LOCATION: S '/4 Al W Section J-L- ' -3,~ N, R1gW0 (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township S
C TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family A Duplex No. of Bedrooms 3 No. of Persons
D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES-ANO # of Bathrooms-4-
Automatic Washer _ _KYES NO Other (specify)
E. SEPTIC TANK CAPACITY/ekeg.-t, Total gallons No. of tanks
*Holding tank capacity_ Total gallons No. of tanks
New Installation Addition Replacement Prefab Concrete
*Poured in Place Steel Other (specify)
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) , Z,2) 3) _L Total Absorb Area ~%S fa sq. ft.
New_A Addition Replacement_ *Fill System
Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length . Width Depth b Tile Depth No. of Lines
Seepage Pit: Inside diameter Liquid Depth Tile Size
Percent slope of land a Distance from critical slope
I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
and that effluent disposal system from the EH-1 15
Wisconsin Administrative Code, a I have sized the prepared
by the Certified oil Tester,
NAME L&J a rs C.S.T. # t5"5 S3 rand other information
obtained from W_ (owner
Plumber's Signature MP PRSW Phone 0
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
5C- i4/2 dec. 7
1
Qr,
417
11~ \ `00
72-1
~ Vo'~- PAST
Do Not Write in Space Below FOR DEPARTMENT USE ONLY
Date of Application Fees Paid: State County Z4 Date 7-16e-78
D -
Permit Issued/Rejected (date) `7-(~-76 _Issuing Agent Name Oo' q h Wc~
Inspection Yes?t,-Colpy) o Valid# Date Recd
1. county (wh 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) 4. plumber (canary copy)
6
Re%ised Date 6/1/76
EH 1 15
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: Q7 /4, Section !7_, T31N, R L` E (orr(Downship or Municipality + y
Lot No. , Block No. Countyi~r`
~Sd~ visiOon me
Owner's Name: ~
Mailing Address: ~ w, sa in 5 -Q--7- I-A-) i S t
TYPE OF OCCUPANCY: Residence - C No. of Bedrooms 3 Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT -.4 DATES OBSERVATIONS MADE: SOIL,BORINGS 2 PERCOLATION TESTS _2°_
SOIL MAP SHEET -/0 SOIL TYPE V ~~~4 ►~i~ ~ /h n~
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- ~ ~1® S S S S fi r.
P- Z 4 ( i
P-3 L, k-I o
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)
; 3d -S6
B_ y-30 5L
6
B - -7 S
B-
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square eet of suita le areas. Indicate number of square feet of absorption area
needed for building type and occupancy. S vW Indicate scale
or distances. Give horizontal and vertical referen a point's. Indicate slope. `t_ rev t
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.^....q _ -3....,._._ , -b----.4.~...,.._ .yam _..,.w- `
I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord wit 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 bel:~2( l
Name (pri C L) r Certification No.
Address K -3 Q w
Name of installer if known
COPY A -LOCAL AUTHORITY CST Signature J