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Parcel 038-1108-80-000 11/30/2006 02:31 PM
PAGE 1 OF 1
Alt. Parcel 27.31.18.456D 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 - MOUNTAIN, G EGORY J & CAROL
GREGORY J & CAROL MOUNTAIN
1991 115TH ST
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address es): Primary
Type Dist # Description * 1991 115TH ST
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 4.885 Plat: N/A-NOT AVAILABLE
SEC 27 T31N R1 8W 5A IN NE NW LOT 3 OF Block/Condo Bld :
CSM 3/708 EXC PT TO TOWN RD DESC 979/415
Tract(s): (Sec Twn-Rng 40 1/4 160 1/4)
> 27-31N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 979/415
07/23/1997 689/292
-3
2006 SUMMARY Bill M Fair Market Value: Assessed-with:
0
Valuations: Last Changed: 10/14/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 4.885 46,500 123,800 170,300 NO
Totals for 2006:
General Property 4.885 46,500 123,800 170,300
Woodland 0.000 0 0
Totals for 2005:
General Property 4.885 46,500 123,800 170,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 130
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
T
• AS BUILT SANITARY SYSTE11 REPORT
''.ZER C4, Sj2 , TOWNSHIP SEC. T_21 N, R1W
0. ADDRESS X ST. CROIX COUNTY, WISCONSIN.
"3DIVISION LOT LOT SIZE
PLAN VIEW
-Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
.,2?' (.1
~c
1
-:'TIC TANK(S) STEEL
_ M. FGR. CONCRETE
NO. of rings on cover -I Depth DRY WELL
3NCHES NO. of width length area
no. of lines width ' length area
dept to top of pipe j
vREGATE
:K RATE AREA REQUIRED AREA AS BUILT sciaimer: 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
item operation. However, if failure is noted the County will make every effort to
--ermine cause of failure.
BASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
-'INSPECTOR
DATED - - PLUMBER ON JOB
LICENSE NU:IBER ) S
RFPOP,T OF IIISPECTI N--174DIVIDUAL SE?,IAGE DISPOSAL $ YSTEM
Sanitary Permit
State Septic /
.,IE T0T•II1SHIP
St. Croi;; County
MR.PTIC TA'TI
ze gallons. `umber of Compartment:
Distance From: WeII ft. 12% or greater slope ft.
Building' ft. Wetlands f~
11ighwater ft.
DISPOSAL SYST I Tile Field or Seepage Pit(s)
Distance From: Well ft. 12%,or greater slope ft
Building; ft. Wetlands ~ f_
FIELD '111ighwater 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 tile 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
. ~J
Number of pits Outside diameter ft. Depth below inlet
ft. Gravel around pit: _yes no. Total absorption area
sq. ft.
. C_
Square feet of seepage trench bottom area required
W:quare feet of seepage nit area required
Inspected by: Title: .
Approved Date 197.
Rejected Date 197.
i
`
1 115
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: L_,%, Section , TqN, R E (or)& Township or Municipality tit r /_7 Y K, t:
Lot No. , Bloc No. Subdivision Name County S~• C Ilo j X
'
Owner's Name: C
Mailing Address: < l-
TYPE OF OCCUPANCY: Residence No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW- ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS 2"/ "Z " PERCOLATION TESTS
SOIL MAP SHEET SOIL TYPE 14 L
PERCOLATION TESTS
F EST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
UM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN '.7 _Y3
P-
P_ 5V
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)
Y - S L •Z Y S
- j - Z"- S, L -x ' S ~
}
t ~ 2S~ S L- 2 S
r 2 13 7-15
PLAN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of suit le areas. Indicate number of square feet of absorption area
needed for building type and occupancy. i - Indicate scale
or distances. Give horizontal and vertical reference 4oints. Indicate slope. c. ~c t
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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.
y" Certification No. -
Name (print)
Address y c < c [ v
Name of installer if known &A~
CST Signature
COPY A -LOCAL AUTHORITY
A
r
I •
State Permit #
State and County - 5
A~~w
Permit Application County Perm'
PLB67
for Private Domestic Sewage Systems -ourµy%
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Ad ess:
B. LOCATION: 1'/4 17 Gti. Section T N, R E (or)^ W Lot# City
Subdivision ame, % ~nearest road, lake or landmark Blk# Village
Township
C. TYPE O OCCUPANCY: *Commercial *In stria) "Other (specify) *Variance_
Single family Duplex No. of Bedrooms 3 No. of Persons _L
D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES NO # of Bathrooms .
Automatic Washer RYES NO Other (specify)
E. SEPTIC TANK CAPACITY I C Cr 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) CIO 2) 1-lc 3) j L1-Total Absorb Area_ I _ sq. ft.
New -k Addition Replacement *Fill System
Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length Width [ "2,' Depth 4 6' ~ _ Tile Depth It No. of Lines
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, nd that I have sized the effluent disposal system from the EH-115 prepared
by the C tified Soil Tester
NAME ~l r 7 l ; C.S. and other information
obtained from nlbuilder).
Plumber's Signature MP RSW Phone #~-,16.
Plumber's Address 3
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
R
~ I
Do Not Write in Space Below FOR DEPARTMENT USE ONLY
Date of Application J Fees Pai State Q 0 Co n y Date 1(e -
Permit Issued/ •ee - (date) 0 /,V-I~Issuing Agent Nam .
Inspection YesX _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)
g; vised Date 6/1/76