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Parcel 038-1014-20-000 09/09/2005 08:49 AM
PAGE 7 OF 1
Alt. Parcel 3.31.18.36E 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 - MEALEY, CAROL J
CAROL JMEALEY
2371 W CEDAR LA
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 2371 W CEDAR LA
SC 3962 NEW RICHMOND
SP 1700 WITC
SP 8055 CEDAR LAKE/N R
Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE
SEC 3 T31 N R1 8W PT GL1 COM INT S LN GL1 Block/Condo Bldg:
& HIWATER LK, TH N 50 DEG W ON MEANDER
LN 120 FT, N 57 DEG W 200 FT N 50 DEG W Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
100 FT TO POB: S 39 DEG W 165 FT, N 50 03-31N-18W
DEG W 100'N 39 DEG E 165 SE 100'
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 858/359
07/23/1997 809/204
2005 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/12/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.000 139,500 83,100 222,600 NO
Totals for 2005:
General Property 0.000 139,500 83,100 222,600
Woodland 0.000 0 0
Totals for 2004:
General Property 0.000 139,500 83,100 222,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 124
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
':E'ER : rrlru,; , TOWNSHIP` ~ p SEC. T.~, N R W
0. ADDRESS;,!,. ST. CROIX COL'~vTY, WISCONSIN. ,
'3DIVISION LOT LOT SIZE
PLAN VIEW
-Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
i .
. I
_ lsy-
• T s~ -
Jt ! ~
o
TIC TANK(S) MFGR., CONCRETE ' STEEL
NO. of rings on cover Depth DRY WELL
INCHES NO. of width length area
1 no. of lines width t ^ ' length" area
dept4 to top of pipe
31REGATE
.r~ AREA REQU~
1RED AREA AS BUILT
:V rwJ ,,.ciaimer: The inspection of this system by St. Croix County does not imply complete /
pliance 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
tem operation. However, if failure is noted the County will make every effort to
.ermine cause of failure.
:ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
"INSPECTOR
DATED
r PLUrBER.ON JOB
LICENSE NUHBER
J
REPOP,T OF IJISPECTIO?I--I-4DIJIDIJAL SUMGE DISPOSiV, SYSTEii
Sanitary Permit:
r State Septic
T&I-111SHIP
t. Croix County
SEPTIC TAM"
Si2e gallons. 'lumber of Compartments
Distance Front: rJeII ft. 12% or greater slope
f t.
r Building ` ft. Wetlands ft
gbiwater ft.
DISPOSAL SYSTEJ:1 Tile Field or Seepage Pit(s)
Distance From: hell ft. 12% or greater slope ft.
Buildini.eft. Wetlands f
FIELD Highwater ft.
Total length of lines ft. Number of lines Length of
each line eft. Distance between lines ft. Width of the
'trench -ft. Total absorption area sq. ft. Depth
.of rock below tile in. Dp-pth of rock over the in. Cover
..,over - rock., Depth of the below grade in. SZope of
trench in per 100 ft. Depth to Bedrock ft. Depth to
,ground water ft, y
r
PITS
Number of pits Outside diameter ft. Depth below inlet
ft, Gravel around pit: `_yes no. :Total absorption area
sq. ft.j
.Square feet of seepage trench bottom area required
Uquare feet of seepage nit area required .
Inspected by: Title':-
Approved Date 197
Rejected Date 197.
State and County State Permit #
PLB67 Permit Application County Per .t # -1- Z
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:
_ALQ14~ r, 8_1 I
B. LOCATION: F '/'/4, S tion T N, R/T W (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township
C TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family _ C Duplex No. of Bedrooms _ No. of Persons
D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES NO # of Bathrooms -
Automatic Washer YES _,>~_NO Other (specify)
E. SEPTIC TANK CAPACITY 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: Perc ation Rate 1) _/1-2) Zo 3) Z6 Total Absorb Area 7„ _b " sq. ft.
New Addition Replacement *Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length 6C)r WidthDepth ; _Tile Depth No. of Lines
Seepage Pit: Inside diameter Liquid Depth Tile Size
Percent slope of land rQ 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 Co nd that I have sized the effluent disposal system from the EH-115 prepared
by the Certif d oil Tes r,
NAME iq C.S.T. # -f ` and other information
obtained from (owner/builder). _ A
Plumber's Signature MP/MP SW# - Phone .ry Y6 - 5, c or4 Plumber's Address W 4_4,
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well). / l
s
Do Not Write in Spa Below FOR DEPARTMENT USE ONLY 0 0
Date of Application Fees Paid: State (0 ,0() Co t Da
Permit Issued/Rejected ( ate) C Issuing Agent Name
Inspection Yes No Valid# Date Recd •
1. county (white opy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink c py) 4. plumber (canary copy)
Revised Date 6/1 /76
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 S I L BORINGS AND PERCOLATION TESTS
LOCATION: - L114,Y)A~/,, Section , T.4N, R E (or1n, Township or Municipality
Lot No. , Block No. County 1 C t
bdivision Name
Owner's Name: t,i
Mailing Address:
1 4-
TYPE OF OCCUPANCY: Residence_ No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW- ADDITION REPLACEMENT _
DATES OBSERVATIONS MADE: SOIL BODNGS P ~COLATIONLTESTS I 1
SOIL MAP SHEET ? ' it G ' SOIL TYPE
PERCOLATION TESTS t
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 MIN/IN
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P-_
z. 1 1 z=
P
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)
2- C) C3 3 -fs " 7 2_: L
a- S 7 5 L
S.
U'
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area
needed for building type and occupancy. 7 Z d Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope.
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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. Address j e e Name of installer if known
COPY A -LOCAL AUTHORITY CST Signature
I