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Parcel 038-1155-30-000 11/30/2006 04:57
PAGE 1 OF 1
F 1
Alt. Parcel 13.31.18.717 038 - 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 - WARNER, NATHAN G
NATHAN G WARNER C - MCCANCE RACHEL R
MCCANCE RACHEL R
2193 132ND ST
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description ' 2193 132ND ST
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 1.306 Plat: 2348-PRAIRIE RICH ADD
SEC 13 T31N R1 8W 1.306AC PRAIRIE RICH Block/Condo Bldg: LOT 13
ADD LOT 13 A 1/15TH INT IN OL 1 HAS BEEN
ADDED TO THIS PARCEL 677/136 887/381 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
13-31N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
08/05/1998 584444 1346/40 WD
07/23/1997 887/381
07/23/1997 677/136
1223/422 QC
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/05/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.306 27,900 157,000 184,900 NO
Totals for 2006:
General Property 1.306 27,900 157,000 184,900
Woodland 0.000 0 0
Totals for 2005:
General Property 1.306 27,900 157,000 184,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 118
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT
TOWNSHIP S/_./)rO?i21:,
OWNER r: C.- T 3i N _W
P.O. ADDRESS 1 F_Lti t 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
Nc~vc ~~j/,4s.L,
SEPTIC TANK(S)MFGR. o -(--,,r,4; CONCRETE STEEL
NO. of rings on cover Depth DRY WELL
TRENCHES NO. of width length area
BED no. of lines 2 width-,,) length 2-' area
depth to top of pipe 2-
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 5
LICENSE NUMBER
t
RRPOI;T OF II1SPECTIO'_1--I7IDIJIDUAL SEWAGE DISPOSAI, SYSTE14
S.rtnitary Permit
State Septic
T&INSHIP
• t. Croix County
SPEPTIC TAM"
Size gallons. 'umber of Compartments
Distance From: T-le 11 ft. 12% or greater slope ft.
Building ft. Wetlands ft
ILighwater ft.
DISPOSAL•SYSTL:1 Tile Field or Seepage Pit(s)
Distance From: Uell ft. 12% or greater slope ft
Building -ft. Wetlands f~
FIELD i;ig;hwater ft.
Total length of lines ft. !lumber of lines Length of
each line ft. Distance between lines ft. Width of the
trench -ft. Total absorption area sq. ft. Depth
of rock below the in. Dp-pth of rock over tile in. Cover
over . rock, Depth of tile below grade in. Slope of
trench in per 100 ft. Depth to Bedrock ft. Depth to
ground water ft.
PITS
Number of pits Outside diameter ft. Depth below inlet
ft. Gravel around pit: __yes no. Total absorption area
sq. ft.
Square feet of seepage trench bottom area required
Sfquars feet of seepage nit area required
Inspected by: Title:
r
Approved , .Date 197.
Rejected Date 197.
L. e
EH T15
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: )W/4, 19-W/a, Section 13,T=3/N, R M E (or ownship or Municipality ~--'J i rf
Lot No. Blo o. County C)lC
Subdivision Name
Owner's Name: _
Mailing Address:.
TYPE OF OCCUPANCY: Residence_ No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION~/ REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS-x_21 ` 2d~ PERCOLATION TESTS -3-2--
SOIL MAP SHEET 3 SO ILTYPE e?y (2 b! K A
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
17
P3 36
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)
1 CZ S~ 1
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square eet of suitable areas. Indicate number of square feet of absorption area
needed for building type and occupancy./ Indicae scale(
or distances. Give horizontal and vertical reference poi ts. Indicate slope.4
I ~
~_i E
i
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 owledge and ief.
d y
Name (print) / 11 JA J- 1 04 I Certification No. SS >
Address
Name of installer if known
CST Signature
COPY A - LOCAL AUTHORITY
State and County State Permit #
P-LB67 Permit Application County Per i
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:
L it %
A94~ af~ CA-~ P AI (-j
B. LOCATION: Ins Section f , T ' N, R E (or) & Lot# City _
Subdivision Name, nearest road, lake or landmark Blk# Village
y~ Township
C. TYPE OF OCCUPANCYCommercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms No. of Persons L
D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES NO # of Bathrooms
Automatic Washer YES NO Ather (specify)
E. SEPTIC TANK CAPACITY / UQU 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)_2_3) _?__Total Absorb Area l sq. ft.
New Addition Replacement .Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length Si r Width 1 Z/ Depth 4e 0 "Tile Depth ~ 9 No. of Lines 7_
Seepage Pit: Inside diameter Liquid Depth Tile Size
Percent slope of land Distance from critical slope
1, 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 Certified Soil Tester,
NAME C * L I n 0 Qj p S C.S.T. # 5-5 -3,/ and other information
obtained from CPL-d 0,-1 (owner/builder).
Plumber's Signature MP/MPRSW# Phone # -S-43
Plumber's Address 3 y-A., + ce-4 n l~iS c
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
Do Not W ite in Space Below OR DEPARTMENT USE ONLY l
Date of Application Fees Paid: State C'! County Oc i' Date 2- 76-
Permit Issued/Roject2Z1 (date) Issuing 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