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Parcel 038-1074-60-000 09/20/2006 11:14 AM
PAGE 1 OF 1
Alt. Parcel M 17.31.18.308C 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 - SAALBORN, JOHN & KRISANN
JOHN & KRISANN SAALBORN
100 SARAH LA # 7
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 994 210TH AVE
SC 5432 SOMERSET /
SP 1700 WITC~
Legal Description: Acres: 8.010 Plat: 3551-CSM 13/3551
SEC 17 T31 N R1 8W SE SE BEING LOT 4 CSM Block/Condo Bldg: LOT 4
13/3551
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
17-31N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
05/10/2005 794612 2800/402 WD
05/10/2005 794611 2800/400 QC
07/23/1997 1141/141 _ TI
07/23/1997 556/139' WD
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/13/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 8.010 62,100 75,000 137,100 NO
Totals for 2006:
General Property 8.010 62,100 75,000 137,100
Woodland 0.000 0 0
Totals for 2005:
General Property 8.010 62,100 75,000 137,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 502
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT
`:DER • '
- •.'----z=t-- , TOWNSHIP SEC. r~. T...__L_N, R W
0._ADD rS$~., ST. CROIX COUNTY, WISCONSIN.
'3DIVISION , LOT --1 LOT SIZE
• ~3f -J6 7
PLAN VIEW
-Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
TIC TANK(S) MFGR. CONCRETE ` STEEL
NO. of rings on cover - Depth ! DRY WELL
'NCHES NO. of width length area
} no. of lines width length area
depth to top of pipe
,REGATE
RATE ~ ; , , • u:,
AREA REQUIRED AREA AS BUILT
:claimer: The inspection of this sy^tem by St. Croix County does not imply complete
.pliance with State Administrative Codes. There are other areas that it is not possible j
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' PLUMBER ON JOB ~
.1
LICENSE NUMBER -
d
' R
REPOPU OF IJISPECTION--17MVIDUAL SE MGE DISPOSAL SYSTEM
Sanitary Permit
r State Septic
T&WNSHIP
St.7Croix County
SERPTIC TA'.7 171
Oize gallons, `umber of Compartments
Distance From: Well P
ft. 12% or greater slope ft.
S
Building ft. Wetlands f
Ilighwater ft.
DISPOSAL SYSTL:4 Tile Field or Seepage Pit(s)
Distance From: Well ft. 12% or greater slope ft
Building ft. Wetlands f
FIELD 'Highwater ft.
Total length of lines ft. Number 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
fiver . rock,, Depth of tile below grade in. Slope of
trench _.in ner 100 ft. Depth to Bedrock ft. Depth to
Around water ft.
PITS
Number of bits 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
`"quays feet of seepage nit area required .
Inspected by Title:
Approved Date 197 ,
Rejected Date 197.
State of Wisconsin \ DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH
MAIL ADDRESS: P. O. BOX 309
Aug"t 17, 1'978 MADISON, WISCONSIN 53701
Il IN REPLY PLEASE REFER T0:
SECTION OF PLUMBING
AND FIRE PROTECTION SYSTEMS
Pow era Cement ProAucts
Plan Id on No.
III 3 Um 249
Sww Rie nd, VT 5017 f C' wtX y
>
Dear Sir:
Re : Rov 11. Mott >lsai3stsnea ;
Holding Tank
SF 1/4, 8F. 1/4, :mac. 170 T31HO 314g Sown of a. V1 - St. Croix Ge+tnE7►
This is to acknowledge receipt of your plans and specifications for the above-
indicated project. When referring to this plan in the future, it will be absolutely
necessary to utilize the plan identification number assigned to the project. The
spaces below indicate if proper fees have been submitted or if more information is
required. Providing plan review is not completed within thirty (30) days, a permit
to start construction may be issued if requested. See Section H 62.25, Wisconsin
Administrative Code, for limitations in reference to permits to start construction.
Preliminary plan review for determination of fees does not hold the department
liable in the event additional fees may be required upon complete plan review.
Preliminary review indicates the plan review
Fee required is $
Fee received is $ 't• A, ~ Plan accepted for review.
Fee is being returned because of TJ Overpayment ' Underpayment.
Providing one of the two catagories above is checked, please remit correct
total fee in one payment. Indicate plan identification number on remittance.
U No fee has been remitted. Plans submitted with no fees will be held in
abeyance until remittance is received. Indicate plan identification
number on remittance.
Additional information required. See attached Plb. 100. The permit to
start construction will not be issued until 30 days after requested
information is received and accepted.
Q Plans being returned. See attached Plb. 100.
Sincerely,
sores A. Sarg
Chief
JAS:fjs
y
September 19, 1978
Powers Cement Products
Route 3, Box 249
New Richmond WI 54017
a Plan Identification No. 78-04090
Gentlemen:
Re: Holding tank - 2,000 gallons
Roy H. Mott - Residence
SE 1/4, SE 1/4, Section 17, T31N, R18W
Town of Saar Prairie, St. Croix County, Wisconsin
Examination of plumbing plans and specifications for the above-mentioned
project has been completed.
In accord with Chapter 145, Wisconsin Statutes, and Chapter H 62, Wisconsin
Administrative Code, the plumbing plans and specifications are approved
contingent upon compliance with the stipulations Indicated on the plans and
the following code section. Please review your code for the requirements
of the code section noted.
1. Our review of the holding tank plan has not been evaluated for
structural stability, only for compliance to design requirements of
Chapter H 62 of the Wisconsin Administrative Code.
2. The holding tank shall be maintained and the contents disposed of as
required under Section H 62.20 (7), Wisconsin Administrative Code.
3. H 62.20 (9)(b) 3. Holding tanks - High water alarm.
4. The architect, professional engineer, registered designer, owner or
plumbing contractor shall keep at the construction site one set of plans
bearing the stamp of approval of the department.
5. In the event installation of the plumbing improvements or system has
not commenced within two years from this date, this approval shall become
void and new application shall be made for approval of these plans before
• . work may commence.
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.fir°.a:.~. ~ i F°t~;a::+.d 2~',~ ~ $`if z`•"'?;~,
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ri;~3t °a°ts.,~i s`"1~r ~^f`T•7.. i as~3~ J?VXiu #,~~Z i # ~ ~ ;a ?t~.~,
X114 4164 14Y Ar ttk?`y"w+.i n r oni r ll 4 13; .`f...
lapel ';:`„?o I .w3~.. h1~k.~~ k fiz nw "r
b VOM l'•,;e'
'1 •t ""si5W ra top ~nr! =r" ~VO N. 1,3 3.1 i%;•t
q! '.a.Y~a.S ri i 10..... i/ y{. •"w i.., Muss `€l .i:•'4,l
L in ti. •,rti: L wi'? •;,c'zl A so 7316106 AT
001120? I 7S,r l is pol
e .
"1'3sK 03"1500 FA 47 Qtx yr,;-, ~:t.. .4 a,
<"9Ct °l,t,:,'zz'~:-'{„,a#S,'.~' ~'?$~°#°.~..'~•';•'v. sq`~3_t;7#', sf,.~cC'A~z'i='r ar..!':?:#i,"i~Yk, .:.zoo)
.1007 •jaqw, oil 16 ~ fuvo "k IA m,rst Q b?ffi y}:~~f
*a`d'"`-
[t Mw s
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r ~ A.~`~.', t eb ~•'W. CA+~'~~ ~ <wl v;f: ~.ty~f.`MS X,
NOT
p
v A,
` Powers Cement Products
Page 2
Se&)teniber 19, 1977
In granting this approval, the Division of Health does not hold itself
liable for any defects in plans or specifications, plan omissions,
examination oversight, construction or any damage that may result in
or after installation and reserves the right to order changes or additions
should conditions arise making this necessary.
This approval is based on Chapter H 62, Wisconsin Administrative Code,
requirements. It shall be necessary to obtain and fulfill the permit
requirements of the city, village, township or county in which this
installation is to be constructed. Failure to obtain local permits will
automatically void this acceptance.
By order of Robert Durkin, Administrator, Division of Health.
Sincerely,
James A. 5arc,s,
Chief
JAS:PEP:bah
Lnclosures
cc: Mr. Dennis Sorenson, OWS - District 5 - La Crosse
Mr. Harold C. Barber, Zoning Administrator, St. Croix County
Mr. Roy H. Hott
~L
September 16, 1 978
+~'~w~rs ter~er~E: ~'rODU~.Cs
Koute 3, Box 249
w M chtiond, WI Flan Identification No. 78_04"R."9
Gentlemen:
Re: Holding tank - 2,000 gallons
Gerald Exley -Residence
NL 1/4, SW 1/4, Section 1, T31w, R1bW
Town of Star Prairie, Wisconsin
St. Croix County
Examination of plumbing plans and specifications for the above-mentioned
project has been completed.
In accord with Chapter 145, Wisconsin Statutes, and Chapter H 62, Wisconsin
Administrative Code, the plumbing plans and specifications are approved
contingent upon compliance with the stipulations indicated on the plans and
the following code section. Please review your code for the requirements
of the coda section noted.
1. Our review of the holding tank plan has not been evaluated for
structural stability, only for compliance to design requirements of
Chapter H 62 of the Wisconsin Administrative Code.
2. The holding tank shall be maintained and the contents dispose; of as
required under Section ti 62.20 (7), Wisconsin Administrative Code.
J. h G2.20 (5) (b) 3. Hol6ing tanks - High water alarm.
4. The architect, professional engineer, registered deslVner, owner or
plumbing contractor shall keep at the construction site one set of plans
bearing the stamp of approval of the department.
1
Powers Cement Products
Page Z
September 18, 1978
5. In the event installation of the plumbing improvements or system has
not commenced within two years from this date, this approval shall become
void and new application shall be made for approval of these plans before
work may commence.
In granting this approval, the Division of Health does not hold itself
liable for any defects in plans or specifications, plan omissions,
examination oversight, construction or any damage that may result in
or after installation and reserves the right to order changes or additions
should conditions arise making this necessary.
This approval is based on Chapter H 62, Wisconsin Administrative Code,
requirements. It shall be necessary to obtain and fulfill the permit
requirements of the city, village, township or county in which this
installation is to be constructed. Failure to obtain local permits will
automatically void this acceptance.
by order of Robert Durkin, Administrator, Division of Health.
Sincerely,
James A. Sargent
Chief
JAS: PLP:rmm
Enclosures
cc: Mr. Dennis Sorenson, OWS - Ulstrict La Crosse
y Mr. Harold C. barber, St. Croix County Zoning Administrator
Mr. Gerald Exley
State of Wisconsin \ DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH
MAIL ADDRESS: P. O. BOX 309
MADISON, WISCONSIN 63701
3 tJ ~y „a} ♦ ~ IN REPLY PLEASE REFER TO:
SECTION OF PLUMBING
AND FIRE PROTECTION SYSTEMS
Plan Identification No.
p,,, A All 7
Dear Sir:
Re: >
# it inn;
This is to acknowledge receipt of your plans and specifications for the above-
indicated project. When referring to this plan in the future, it will be absolutely
necessary to utilize the plan identification number assigned to the-project . The
spaces below indicate if proper fees have been submitted or if more information is
required. Providing plan review is not completed within thirty (30) days, a permit
to start construction may be issued if requested. See Section H 62.25, Wisconsin
Administrative Code, for limitations in reference to permits to start construction.
Preliminary plan review for determination of fees does not hold the department
liable in the event additional fees may be required upon complete plan review.
Preliminary review indicates the plan review
Fee required is $ f
f
Fee received is $ L_..a
Fee is being returned because of II Overpayment Q underpayment
Providing one of the two catagories above is checked, please remit correcL
total fee in one payment. Indicate plan identification number on remittance.
No fee has been remitted. Plans submitted with no fees will be held in
abeyance until remittance is received. Indicate plan identification
number on remittance.
Additional information required. See attached Plb. 100. The permit to
start construction will not be issued until 30 days after requested
information is received and accepted. _
Q Plans being returned. See attached Plb. 100.
Sincerely, 4 G
-
C4
J 1-71
amen A. Sarg
Chief
JAS:fjs
State of Wisconsin \ DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH
MAIL ADDRESS: P. O. SOX 309
MADISON, WISCONSIN 63701
IN REPLY PLEASE REFER TO:
SECTION OF PLUMBING
AND FIRE PROTECTION SYSTEMS
~RfiA~4Qt}
~;M 1^5 €,E'; ~n~ ~ryu3;cUS Plan Identification No.
f "nx a
Dear Sir:
Re.
)lzli Sr! TaW.
f ~ ?1 T :tee ~,4 rF~» ! Y s T~r'i 1 - Croix CCrinty
This is to acknowledge receipt of your plans and specifications for the above-
indicated project. When referring to this plan in the future, it will be absolutely
necessary to utilize the plan_ identification number assigned to the-project . The
spaces below indicate if proper fees have been submitted or if more information is
required. Providing plan review is not completed within thirty (30) days, a permit
to start construction may be issued if requested. See Section H 62.25, Wisconsin
Administrative Code, for limitations in reference to permits to start construction.
Preliminary plan review for determination of fees does not hold the department
liable in the event additional fees may be required upon complete plan review.
Preliminary review indicates the plan review
Fee required is $ 1.
Fee received is $ II Plan accepted for review.
Fee is being returned because of II Overpayment ® underpayment.
Providing one of the two catagories above is checked, please remit correct
total fee in one pa
No fee has been _
abeyance until remittance is received. Indicate plan identification
number on remittance.
Additional information required. See attached Plb. 100. The permit to
start construction will not be issued until 30 days after requested
information is received and accepted.
< ' , s
Plans being returned. See attached Plb. 100.E
1P
Sincerely,
r,I 4
anes A. Sarg
Chief
JAS:fjs
i
State and County State Permit #4 yo _ 2-~
PLB67 Permit Application County Permit 'z
-~~C-
for Private Domestic Sewage Systems County
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. # ~l
A. OWNER OF PROPERTY Mailing Address:
C -7
B. OCA N: 15 Section T N, ff- Y E (or) W) Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township
C. TYPE OF OCCUPANCY: *C -mmercial *Industrial *Other (specify) *Variance
Single family X, Duplex No. of Bedrooms No. of Persons
D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste GrinderYES NO # of Bathrooms_-_
Automatic Washer YES NO Other (specify)
E. SEPTIC TANK CAPACITY Total gallons No. of tanks
*Holding tank capacity '2onn Total gallons No. of tanks
New Installation X Addition Replacement _ Prefab Concrete
*Poured in Place Steel Other (specify)
F. EFFLUE DISPOSAL SYSTEM: Percolation 3) Total Absor sq, ft.
New Addition Replacement *Fill System
Seepage ench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage ed: Length Width Depth Tile Depth No. of Lines
Seepage it: Inside diameter Liquid Depth Tile Size
Percent lope of land Distance from critical slope
1, the under gned, do hereby certify that the information I have reported is in accord with Section H62.20,
Wisconsin Ad inistrative Code, and that I have sized the effluent disposal system from the EH-115 prepared
by the Certified Soil Te
NAME C - V L,.: (IIIS C.S.T. # -s--s and and other information
obtained from c;'.t< <pwner builder).
Plumber's Signature MP/ PRSW / 1 5 6Phone # L~tL~ S-) SS
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
Ill
fJ)
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CL 1!L0- F
Yr+ A''rt'iF- ' _
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Do Not Write in Spa Below OR DEPARTMENT USE ONLY Q C? `
Date of Application Fees Paid: State Date r '
Permit Issued/ date) ' IssuingAgent---Nam Q
- -
Inspection Yes No Valid# Date Recd -
1. county (wh e 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
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