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Parcel 040-1015-95-000 07/18/2006 10:54 AM
PAGE 1 OF 1
Alt. Parcel 04.28.19.60E 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
DAISY L LAIDIG O - LAIDIG, DAISY L
509 BAUER RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 509 BAUER RD
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 3.420 Plat: N/A-NOT AVAILABLE
SEC 4 T28N R19W PARCEL IN SE SW AS DESC Block/Condo Bldg:
IN VOL 488 P 623 ORD
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
L12~- IX ~)-7 1 X 04-28N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 928/504
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: j r Last Changed: 07/15/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.400 63,500 I 185,700 249,200 NO
Totals for 2006:
General Property 3.400 63,500 185,700 249,200
Woodland 0.000 0 0
Totals for 2005:
General Property 3.400 63,500 185,700 249,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 127
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
':DER. ' of 4L ,,I, TOWNSHIP - SEC.T._.; N, R W
:3. ADBRESS-f ST. CROIX COUfi;TY, WISCONSIN.
"-DIVISION LOT I~ LOT SIZE ~ P w~ z s s~ ~~z
LAN VIEW l~o
"Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET Or SYSTEM
.r
X _
"TIC TANR(S)_ _ MFGR.y~~ STEEL
CONCRETE
NO. of rings on cover Depth ' DRY WELL _
-NCHES NO, of width length area
J no. of lines width , length. area-.,-, ~/,4
depth to top of pipe
~R.EGATE
RATE AREA REQUIFED__,~-= s.'S -4/ AREA AS BUILT
-claimer: 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 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. /
INSPECT.OR
DATED PLU2SBER ON JOB. d
LICENSE NU',fBER i x" j
II
S C~~~
/vl.~. s~~3 -1d~
i
i
M REPORT OF IT1SPrCTIO'.l--T-I"IJIDUAL SItJAGL UISPOSAl, SYS''Eti
Sanitary Per -iit
State Septic
,Al
TOWNSHIP
Croix ounty
SP.PTIC TA'?K
Size gallons. "umber of Compartments
Distance From: Tlell ft. 12% or greater slope fi.
Building i_ ft. Wetlands f
1lighwater _ ft.
DISPOSAL SYSTLITile Field or Seepage Pit(s)
Distance From: T7ell ft. 12% or greater slope ft
Building ft. Wetlands
FIELD ~~ighwater ft. _f
Total length of lines ft. dumber of lines Length of
each line _p' ft. Distance between lines ft. Width of the
trench 'ft. Total absorption area 1 sq. ft. Depth
of rock below the in. np-pth of rock over the in. Cover
over .rock
Depth of the below grade in. Slope of
trench in per 100 ft. Depth to Bedrock ft. Depth to
ground water ft.
PITS
"number of pits Outside ;diametr ft. Depth below inlet
_ft. Gravel around pit~y_.,'_yes no. Total absorption area
sq. ft.
Square feet of seepage trench bottom area required -
Square feet of seepage nit area required
Inspected by: Title:
Approved Date 197
Rejected Date 197
EH 11 5
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309
MADISON, WISCONSIN 53701
~y~ REPORT ON SOIL BORINGS AND PERCOLATION TESTS
LOCATION /yca, Section' , Tom, R t~ L (or) W, Township or Municipality
Lot No. Block No. County
~J Sub iv;$ion Name
Owner's Name: ~L~ Q
Mailing Address: `
TYPE OF OCCUPANCY: Residence No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS_ f. ~G r d PERCOLATION TESTS
SOI L MAP SHEET SOIL TYPE
PERCOLATION TESTS
i 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
IP-
57
- - -1 - -
SOIL BORING TESTS
. C.'' TAI- FP I E ' ; s 1 TO vRNJdV ~ H , INCHES CHAR AC?ER OF 601L WITH THICKNESS, INCHES
I NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
19
AN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
iicate on the plan the location and square feet of suitable area . In icat number o rare eet o r tI ea
r~~eded for building type and occupancy.
r distances. Give horizontal and vertical reference points. n icate slope.
I i I I !
_ .
t N
i 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 knowledge and belief.
rG/)AI /7 p Certification No. 3)
Name (print) hi' l
Address &0 S
Name of installer if known
CST!
ignature
COPY A - LOCAL AUTHORITY
PLB67 State and County State Permit #
Permit Application County Permt # _379
for Private Domestic Sewage Systems County • tc~-t:c~G
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
B. LOCATION:', Y,, Section R (or) W Lot# t -City
Subdivision Name, nearest rod, 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 '2 -
Q- TYPE OF APPLIANCES: 'Dishwasher 4--Y-E S NO Food Waste Grinder YES t'_ kC' # of Bathrooms--;_`
Automatic Washer ES NO Other (specify)
SEPTIC TANK CAPACITY
` Total gallons No. of tanks Q-~..k._~
"Holding tank capacity / Total gallons No. of tanks
New Installation t~ Addition Replacement Prefab Concrete
'Poured in Place Steel Other (specify)
FFLU. ENZ. DISPOSAL SYSTEM: Percolation Rate 1) ~2)_~___g7 3) -1-S,-Total Absorb Area
"yew Addition Replacement *Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenc'
seepage Bed: Length S Width / Depth Tile Depth/ No. of Lines -
Seepage Pit: Inside diameter Liquid Depth Tile Size l/ Percent slope of lane - 12 ~ Distance from critical slope
file undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
v', isconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared
~
by the CX64`1 ledoil T ter,
it,=AME C.S.T. # and other information
obtained from u (owner/builder).
P' umber's Signature Phone #
Z~y MP/MPRSW# 'lA
Plumber's Address ,
4 '1
PLAN VIEW. Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
Do Not Write in Space Below - FOR DEPARTMENT USE ONLY
Date of Application 17 Fees Paid: State/C DO Count Ci Date
Permit Issued/ gj@Md (date) 1y1 Issuing Agent Name
Inspection Yes--k_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 cony) ? nlumher Icanarv rn-A
Revised Date 6/1 /76