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Parcel 038-1012-70-000 09/09/2005 09:58 AM
PAGE 1 OF 1
Alt. Parcel 3.31.18.33G 038 - TOWN 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 - VIEBROCK, ALAN T
ALAN T VIEBROCK
14242 170TH ST N
MARINE MN 55047
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 2396 CARDINAL DR
SC 3962 NEW RICHMOND
SP 1700 WITC
SP 8055 CEDAR LAKE/N R
Legal Description: Acres: 3.200 Plat: 0308-CSM 04/1154
SEC 3 T31 N R1 8W PT OF GI-1 LOT 1 OF CSM V Block/Condo Bldg: LOT 01
4/1154
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
03-31 N-1 8W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1139/427 QC
2005 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/12/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.200 40,000 181,200 221,200 NO
Totals for 2005:
General Property 3.200 40,000 181,200 221,200
Woodland 0.000 0 0
Totals for 2004:
General Property 3.200 40,000 181,200 221,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
• AS BUILT SANITARY SYSTEM REPORT
,.,rR }'=tom, k y
Z r YrL TOSTNSHIP~ SEC. T N, R W
ADDRESS ST. CROI COU.i.TY, WISCONSIN.
ti.
7;DIVISION , LOT LOT SIZE
PLAN VIEW
Distances b dimensions to meet requirements of H62.20
- - SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
1
' I
' I I I
I ;
i
TIC TANK(S) / MF'GR.~ CONCRETE STEEL I ndticae Na,5th A
Seate z ~r
No rings on cove ,k Dnpth f;`I ~ WELL
"NICHES NO. of - width length area
no. Of lines width L2, length area -f
depth to top of pipe ~y
3:.EGATE
RATE <~o AREA REQUIFED AREA AS BUILT
;claimer: The inspection of this system by St. Croix County does not imply complete
.iDliance with State Administrative Codes. There are other areas that it is not possible
inspect at this point of construction. St. Croix. County assumes no liability for
stem operation. However, if failure is noted the County will make every effort to
ernine cause of failure.
.LASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYS EM.
`INSPECTOR
DATED PLU:tBER ON JOB
~c_-~
LICENSE h^J:II3E~ i~ 6
RFPOP,T OF I11SPrCTION--INDIVIDUAL SETJAGE DISPOSA7, SYSTE11
Sanitary Permit
State Septic OS-
.,A:IE T0WEISHIP C
• A/ k; c~ ~J St. Croix County
J i
SEPTIC TA'11'
..aze gallons. `umber of Compartments
Distance From: 1lell f -
ft. 12% or greater slope mot.
Building 'Z,5- , Wetlands f
Highwater - ft.
DISPOSAL SYSTL.4 Tile Field or Seepage Pit(s)
Distance From: Well ft. 12% or greater slope" ft
Building; ft. Wetlands f,.
FIELD iiighwater ft.
Total length of lines 1~9_ft. Number of lines Length of
each line --C ft. Distance between lines ft. Width of tiie
drench
j~ ~ft. Total absorption area sq. ft. Depth
of rock below tile
in. Depth of rock over tile in. Cove
f ~ r
J nver.rock" Depth of tile below grade in. Slope of
1~ trench in n e r 00 ft. Depth to Bedrock ft. Depth to
-
ground water ft.
PITS
Number of nits 0 side diameter ft. Depth below inlet
ft. Grav -rou d pit: yes no. Total absorption area
sq. ft.
.Square feet of s epage trench bottom area required ,L---.-
wquare feet of seepaEe n ar a required
Inspected Title:.
Approved _ Date. 1972.
Rejected Date 197.
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: A4C_% jh,'_ a, Section _?L, T:,~N, R4' E Township or Municipality 7i`15 ~j~ : rll 1
Lot No. , Block No. _ County Si l=L'~
~ Subdivision Name
Owner's Name: &7t 42 .44k; xp)
n
Mailing Address: Lu1-
TYPE OF OCCUPANCY: Residence No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS 4 ;';i' PERCOLATION TESTS
SOIL MAP SHEET i SOIL TYPE
PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TESTTIME 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
Pr
j
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)
.5 e- 4 y As
.f
__{fir . _ ,l_~°.L•__- _ . . ,c _~.a t ~ ~_-~.,y~,~,~, _ _ ~ -y__-~6_ sue...
7_757se -9
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the locationand square feet ofauitable areas. Indicate number of square feet of absorption area
needed for building type and occupancy. Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope. r '
~ t
) 3 i i
a t f f k X , j i }i. V f
f
--i-
- -4
-
~___L4---
f f
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) e Certification No.--
Address- Name of installer if known
CST Signature f -
. -Y A - LOCAL AUTHORITY
PLB67 State and County State Permit #
Permit Application County Per it # _
for Private Domestic Sewage Systems County T 1
* i
DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
17 141
B. LOCATION: Section T N, Ra E (or) Lot# -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 2 No. of Persons__
TYPE OF APPLIANCES: Dishwasher ~ YES NO Food Waste Grinder YES)( NO # of Bathrooms
Automatic Washer YES NO Other (specify)
SEPTIC TANK CAPACITY ./000 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)
EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) J~) 2) 3) 30 Total Absorb Area sq. ft.
New -k Addition Replacement *Fill System
Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches _
-`eepage Bed: Length W-~Width Depth Tile Depth No. of Lines -
Seepage Pit: Inside diameter Liquid Depth Tile Size
Percent slope of land .4AX Distance from critical slope
the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
t''.'isconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared
)y the Certified Soil Tester, r$'~
;`,iAME C.S.T. # and other information
i-Jbtained from owner builder).
;'lumber's Signature MP/MPRSW# Phone #=S
~3 /911-
Plumber's Address
i PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
I
i
Do Not Write in Space Below FOR DEPARTMENT USE ONLY G, d
Date of Application rQ y-~ Fees Paid: State 10,00 Co Date Q 8
Permit Issued/Rd (date) (a - ( [ _Issuing Agent Name
Inspection YesNo Valid# Date Recd _
1. county , ie copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) 4. plumber (canary copy)