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Parcel 1 2-1028-80-000 06/19/2007 02:39
PAGE 1 OF 1
F 1
Alt. Parcel 311706-31-50-06-01-000 182 - VILLAGE OF STAR PRAIRIE
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 - SWANSON, STEVEN J & BETTY L
STEVEN J & BETTY L SWANSON C - PO BOX 131
PO BOX 131
120 SARATOG AVE
STAR PRAIRIE WI 54026
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 120 SARATOGA AVE
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 1.630 Plat: N/A-NOT AVAILABLE
BILK F & ADJ 33' ABD GROVE ST & ADJ S Block/Condo Bldg:
33' ABD LINCO N AVE NEW SARATOGA SPRINGS
ADD VIL STAR PRAIRIE FKA PARCEL 246 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
06-31N-17W
Notes: Parcel History:
Date Doc # Vol/Page Type
04/02/1998 576278 1311/174 WD
07/23/1997 557/372
2007 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations Last Changed: 09/08/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.630 12,000 149,400 161,400 NO
Totals for 20 7:
General Property 1.630 12,000 149,400 161,400
Woodland 0.000 0 0
Totals for 20 6:
General Property 1.630 12,000 149,400 161,400
Woodland 0.000 0 0
Lottery Cr dit: Claim Count: 1 Certification Date: Batch 215
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
I.OUNSHIY _ SEC. ! + J _
r!1z" t ST. CROIY C UNTY WISCONSIN.
LOT_ I,(,T SIZE
PLAN V.I FW
I nr lTis to meet requirement,, of H62.20
>i!OW EVERYTHING w'TTHIN 100 FEET OF SYSTEM
3
O
i,0
t (0
y
a
3EPTIC TANK(S) MFGR.
CONCRETE ~ STEEL
NO. o rings on coverer F Depth DRY WELL
MENCHES NO. of width length area
3ED no. of lines width length ~Z area
dept to to of pipe
kGGREGATE : A Ieul )C K
?ERK RATE AREA REQUIRED 41,70 AREA AS BUILT
)isciaimer: The ins ection of this system by St. Croix County does not imply complete
:ompliance with State Administrative Codes. There are other areas that it is not possi'[)!>
to inspect at this oint of construction. St. Croix County assumes no liability for
system operation. H wever, if failure is noted the County will make every effort to
letermine cause of failure.
:REASES AND OILS SH ULD NOT BE DISPOSED THROUGH THIS SYSTEM. ,
INSPECTOR
DATED PLUMBER ON JO
LICENSE NUMBER
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
Sanitany PeAmit-
State Septic-,;
NAME
r Township 'St. CAOtix County
1 Location % o~ Section ~TYN,RW
SEPTIC TANK /JOYlA
Size DCr0 gatZons. Number ob CompaAtmenta
D.iatance nom: Wett 80 it. 120 on gneateA atope it
Buitding~it. wettanda b .
H.ighwatvL
DISPOSAL SVS EM
D.ia,tance FAV : Wet d it. 120 on gAeateA zZope ` - it.
3 Buitding sZ it. Wettands Ft.
g HighwatvL vt.
FIELD DIMENSIONS:
W, I ' dth o6 tAen chit. Depth o6 Ao ck b eX ow tit e-/2.-in .
Length o6 each dine ~s it. Depth v4 AocFz oveA ite Z in.
Numbe , v6 tines Depth of tite below gAade~in.
Totat Zeng,th o6 tinez 70 it. Sto pe o b tAench in pet 100 it.
Di/sta ce between tinea_~.6t. Depth to bedALock ~ .
TotaZ ablsmbtion aAea 6t2 Depth to gAoundwateA - ~ .
Requited aAea l~ it2
PIT DIMENSIONS:
N mbeA o6 pits GAavet around pita yea no
O ta,ide diamet t it. Depth below .inter it.
2
T tat abaoAbt'on vtea it
z
A
A ea Aequ,i&e.-d-- bt2 rn
INSPECTED t~V-r]4~~ / TITLE
APPROVED /11 QIN ,?ATE 197
REJECTED DATE 197
I
EH 115
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: _'/o, '/4, Section , TN, R - E (or) W, p or Municipality
1
Lot No. Block No.- Count
, ~ Y - ~
Subdivision Name
Owner's Name: - r'
Mailing Address:
TYPE OF OCCUPANCY: Residence No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW t., ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS 17 PERCOLATION TESTS
So! I_ MAP SI IEET SOI L TYPE
PERCOLATION TESTS
TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES
CHARACTER OF SOIL RATE
UM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL
1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
B E R
P-
i
i _
P-
14 I /
L
ip-
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)
OF',
ti n
6 7.- -.7 717
PLAN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.)
Indicate on the plan the locationand square feet of suitable areas. Indicate number of s 1t ar - fept of abs
needed for building type and occupancy. ( / it r ' r)41.1,ltjbir') _ Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope.
71~li tN
Tf1-1
E
j ! 3
i
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)
~~ly G` 22 i1 1~1 x/ Certification No.
Address P-2 ~tii c lr r,-a .r✓~ / 5 -
4
Name of installer if known.
CST Signature '
"OPY A - LOCAL AUTHOPi-A
State and County State Permit # /
PLB67 Permit Application County Permit #
for Private Domestic Sewage Systems County v
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY}} Mailing Address:.
(V /;h r'
B. LOCATION: '/4 '/4, Section T N, R E (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# 17 Village
61/ Township
C. TYPE OF OCCUPANCY: *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 NO # of Bathrooms
- -74
Automatic Washer --kYES NO Other (specify)
E SEPTIC TANK CAPACITY C; 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),, 2) 3)__5-Total Absorb Area sq. ft.
Newx Addition Replacement *Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length _3~_Width _ Depth Tile Depth No. of Lines
Seepage Pit: Inside diameter Liquid Depth Tile Size wt~
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 H62.20,
Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared
by the Cer ' ieo Soil Tester, i _
NAME C.S.T. # L and other information
obtained from (owner/. -7
Plumber's Signature Q MP/~ J Phone 5-• - U 3 / 6 C~
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well). - /
r.D ~
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EY
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f rT
Zall
4.4
Do Not Write in Spa 7B to F[~R DEPARTMENT USE ONLY 4 O i
Date of Application Fees PaiGd: State/ Con ` Date v---? -
Permit Issued/Ft (date) - -'7 r'-Issuing Agent Nam
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)
CIVIL ENGINEERING • LAND SURVEYING • 8JILDiNG DFSIGN
Eau Claire and River Falls, Wrsesnsen
J+ esa
h
OC'
Q~
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C 0
Ld
N
(`Jl
M ~
M
JVEGERER registered Wisconsin Land Surveyor, do hereby certi`
+UvuST ?y 74 I s„rveyed the above described and mapped property accor
Ullil,,ai records and that the accompanying r!li0`,iS"A vogjEh:tly dimensioned representation to scale of the boundanr
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