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Parcel 040-1020-20-000 07/21/2006 11:44 AM
PAGE 1 OF 1
Alt. Parcel 04.28.19.64F 040 - TOWN OF TROY
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 - STABERG, BRUCE A & PAULINE
BRUCE A & PAULINE STABERG
521 MARSON DR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 521 MARSON DR
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 3.390 Plat: N/A-NOT AVAILABLE
SEC 4 T28N R1 9W 3.39 AC IN SE SE LOT 2 Block/Condo Bldg:
OF CSM IN VOL I PAGE 140 ORD
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
04-28N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
2006 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/15/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.300 63,000 211,100 274,100 NO
Totals for 2006:
General Property 3.300 63,000 211,100 274,100
Woodland 0.000 0 0
Totals for 2005: II
General Property 3.300 63,000 211,100 274,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 120
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
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_ AS B U I L T S A N I T A R Y R E P O R T
OTtJA'ER: , Township r , Sec. ?h. N, R W
P.O. ADDRESS: wi_sconsin
Z7 17 r
of , Lot size
Subdivision
PLAN =1 t
Distances & dimensions to meet requirements of Sec. R,'_62.20
1
i I
S
f
y
• /b
Septic tank(s), Mfgr. ; r?o rings _T Dept to cover
6
Dry well size Type of Aggregate-` Covered with
Depth of seepage system-3 r 4 Vent caps in place > t 1_-, number used
DISCIAII. R: The inspection of this system by Pierce County does not imply complete
co,r)liance with State Administrative Codes. There are other areas that it is impossible
to inspect at this point of construction. Pierce County assures no liability for system
operation.
_ PLUMBER ON JOB :
DATED: _ ~ LICETISE R:TUT•23EIi: _
C....J
. .
}ZFPCJT 0i IlISPI;CT10I--]:_1iJ1V1llI1AL SE ~r11 ,lACi; I;1~~1.SPOr ~iV. S YS TEii
Sanitary Permit ~2
State Septic ,7..,z /
t +Ai iE 1~2 TOWNSHIP v~
t . C Ol;; Caun ty
SR.PTIC TA',!I
Size ~;all.ons. 'cumber of Compartaents
Distance Front: 1 Je1 1 t ft. 12% or greater slope - f t.
Building ft. Wetlands - f
Iiighwater ft.
DISPOSAL -SYSTL:1 Tile Field or Seepage Pit(s)
Distance From: Well ft. 12% or greater slope`-.-- ft
Builcing ft. Wetlands f
FIELD Hiphwater ft.
Total length of lines 1 ft, !lumber of lines > Length of
each line i, ft. Distance between lines ft, Width of the
trench y `j_ft. Total absorption area 7_30 sq, ft. Depth
of rock bclow tile / --in. Dp-pth of rock over the L ,in. Cover
rver.rock, Depth of the below grade J G in. Sloe of
trench in per 100 ft. Depth to Bedrock ft. Depth to
ground water ft.
PITS
'lumber of nits Outoide di" ter ft. Depth below inlet
ft. Gravel around t: es no. Total absorption area
sq, ft.
Square feet of seepage trench bottom area required
.square feet of seepage,nit--areae quired
e
Inspected Title'7!q7, App197
roved Date
Rejected Date 197
t'`d{SCON-SIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
'i H, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309
C11SON, WISCONSIN 53701
REP084 1€:AL BORINGS AND PERCOLATION TESTS
£
DC/0 ION: Tom„ N, R.~.-- E (or) W;.Township or Municipality-__-_
.ot No. Block No.-__, _ _ County . i=-''
auLrit_ssion Name s y
s:^.ner's Name:
;iailing Address:
YPE OF OCCUPANCY: Residence No. of Bedrooms Other
FFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
-
-_.m-_.__.__.:.-.-.:. ---_-------.-PERCOLA T ION TESTS
:SATES OBSERVATIONS MADE: SOIL BORING;S---.-----.-----------,------PERCOLATION
' Yt. TYPE
PERCOLATION TESTS
t 1 ccYtttT HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INC riES RAE
CHARACJ ER OF SOfl_
- TH
eliM' IN( iE5~
ICKNESS IN (INCHES - SI cT WET ED O ELUT MINUTES PERIOD 1 PERIOD 2 PERIOD 31N INrii
_._1 _
r
k
,f r!
~ 111
5
l $l$, ..__e.._._.._..___.._._.._--.._...-._._ 1 f ~ ~ t • ri 3 C ~l ~rI r y.
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARAC'1`E9 OF SOIL WI fH THICKNESS, III .,I L:; i
t1lJNtf3ER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
.ya+ .._...,.ww..4.sw4~.n..w...,... .+a+wa.r~.^..•.....,....w..:r°.,.,....W .?aw ' t
l ~ .
,
PLAN VIEW (Locate percolationtests,soil bole holes and suitable soil areas.)
indicate on the plan the location and square feet of suitable areas Indicat number of square feet of absorptlc:n arl
needed for building type and occupancy. Indioate scat
or distances. Give reference point. Indicate slope. i..
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the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures
"od methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes. are corre-i
.
to the best of my knowledge and belief
Narne (print) L; - - - S?gnature
Certification No,
Name of installer it known
Copy A Fropert; Ovvr., s
i '
PLB67 State and County State Permit # 2-2- `
4 Permit Application County Per 't #
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:
6. LOCATION: 5L" Section _~pl, T_;7Z N, R-!~f E (or) W Lot# -City
Subdivision Name, nearest road, lake or landmark Blk# Village
.
Township Jr c~
PE OF O U ANC *Commercias -Industrial -Other (specify) -Variance
Single family _ Duplex No. of Bedrooms 3 No. of Persons
TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YESNC _,f 3athr
Automatic Washer YES NO Other (specify)
SEPTIC TANK CAPACITY l a 0 eI Total gallons No. of tanks
Holding tank capacity Total gallons No. of tanks
iew Installation Addition Replacement P
'Poured in Place----- Steel Other (specify)
-FFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 5_ 2) 3) Total Absorb Area s
,,ew,X Addition Replacement *Fill System
eepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches
eepage Bed: Length -7-0--width e g Depth ~ Tile Depth No. of Lines
,eepage Pit: Inside diameter Liquid Depth Tile Size Al ?ercent slope of land ff' ~~r Distance from critical slope 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 I &~r r a j d C.S.T. # 6 /1l and other information
obtained from C'V r (owner/builder).
Plumber's Signature MP/MPRSW# C-f C Phone # 173-
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
XitO
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m
Do Not Write in Space Below FOR DEPARTMENT USE ONLY
Date of Application 17Y Fees Paid- State 0,00 Count Date O
Permit Issued/Red (6atef --51 Issuing Agent Name
Inspection Yes X- No Valid# Date Recd
1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
7 cfrjtp (nink rp^ 1 ni ,rn ira lard nv!
Revised Date 6/1 /76
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