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Parcel 30.28.19.470B 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 - ERICKSON, BRADLEY C & COLLEEN A BRADLEY C & COLLEEN A ERICKSON 159 SKYLINE DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 159 SKYLINE DR SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 5.090 Plat: N/A-NOT AVAILABLE SEC 30 T28N R1 9W 5.09 AC W 168 FT OF E Block/Condo Bldg: 1008 FT OF SW NW Tract(s): (Sec-Twn-Rng 401/4 1601/4) 30-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 567491 1272/522 WD 2006 SUMMARY Bill Fair Market Value: Assessed with: 158600 295,100 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 71,500 197,700 269,200 NO Totals for 2006: General Property 5.000 71,500 197,700 269,200 Woodland 0.000 0 0 Totals for 2005: General Property 5.000 71,500 197,700 269,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 313 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 040-1114-95-000 12/22/2006 03:29 PM PAGE 1 OF 1 Alt. Parcel 30.28.19.472D 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 - LINDER, LILLIAN M LILLIAN M LINDER 9255 15TH ST N LAKE ELMO MN 55042 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 340 GLENMONT RD SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH i U L Legal Description: Acres: 5.122 Plat: N/A-NOT AVAILABLE SEC 30 T28N R19W 5.122 AC IN NE SW COM Block/Condo Bldg: SW COR NE SW, TH E 820 FT TO POB: N 857.64 FT, E 260 FT, TH S 858.48 FT, TH Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) W 260 FT TO POB 30-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 05/27/2005 796061 2810/218 WD 09/09/1998 586795 1356/78 WD 07/23/1997 1231/73 LC 2006 SUMMARY Bill M Fair Market Value: Assessed with: 158609 357,500 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 71,500 254,600 326,100 NO Totals for 2006: General Property 5.000 71,500 254,600 326,100 Woodland 0.000 0 0 Totals for 2005: General Property 5.000 71,500 254,600 326,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 • AS BUILT SANITARY SYSTEM REPORT r i Y TOWNSHIP Le_ a SEC. Tj., N, R NER •r r c c ST. CROIX ,0. ADDRESS., OUNTj-; WISCONSIN. _3DIVISION , LOT LOT SIZE _ PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 1 .?TIC TANK(S) MFGR. CONCRETE STEEL NO. of rings on cover Depth -W " DRY WELL ,TENCHES NO. of width length area no. of line width length area , depth to top of pipe . i ?.EGATE ,K RATE AREA REQUIRED AREA AS BUILT dY .;claimer: The inspection of this system by St. Croix County does not imply complete _apliance 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 termine cause of failure. 'EASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. --INSPECTOR DATED a PLUMBER ON JOB- LICENSE NUMBER r REPORT OF ITISPECTIO'.1--INDIVIDUAL SEMCE DISPOSAL SYSTEM Sanitary Porn, it State Septic ' IE L,k Croix County SEPTIC TA .71; Size _ Zc9Zy'Z~ gallons. `umber of Compartments / Distance From: Tle11 ft, 12% or greater slope Building Wetlands f_ Itighwater ,{eft. DISPOSALS VS42 Tile Field or Seepage Pit(s) Distance From: Well _4&~ ft. 12% or greater slope - Building ~ft. Wetlands f . FIELD g Hiphwater _f-t. Total length of lines ft. !lumber of lines Length of each line eft. Distance between lines ft. Width of the trench Total absorption area ?02--: sq. ft. Depth of rock below the Z'2-in. Dp-pth of rock over the 2 - 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 r" ft. PITS Number of pits Out4'e `di~frie er _ ft. Depth below inlet y ft. Gravel around Ai Yes no. .Total absorption area sq. ft. Square feet of seepage trench bottom area required `'.quare feet of seepEq., nit ar a required Inspected by~- Title ' Approved Date 197(6. Rejected Date 197. State and County State Permit # 5~ f PLB67 . Permit Application County Permit - S~ ! J U[ n 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: B. LOCATION: '/4 4 Section T rN, R "E "E (or)W Lot# City _ Subdivision Name, nearest road, lake or landmark Blk# Village Township _ - . M PE OF O _-CCU U - PANCY: *Commerci-al - - - *Industrial Other (specify) *Variance Single family Duplex No. of Bedrooms No. of Persons, 13 D. TYPE OF APPLIANCES: Dishwasher YES i---- NO Food Waste Grinder YES J--' O # of Bathrooms--..:.- Automatic Washer ~ NO Other (specify) E. SEPTIC TANK CAPACITY-/49~Vl Total gallons No. of tanks `Holding tank capacity Total gallons No. of tanks New Installation L/ Addition- Replacement- Prefab Concrete l-~ 'Poured in Place Steel Other (specify) EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) 3) Total Absorb Area sq. ft. ,Nlew_Aof!~~Addition Replacement *Fill System Seepage Trench: No. Lin . Feet _ Width Depth Tile Depth No. of Trenches Seepage Bed: Length,~""Width JtV' Depth !~;4.;q'jTile Depth No. of Lines _ Seepage Pit: Inside diameter Liquid Depth Tile Size .gf C- Percent slope of land _ "y Distance from critical slope the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, !,,'Jisconsin Administrative Code, and that I have sized the effluent disposal syste f ;rr the E_,, 115 prepared by the Certified Soil Tester, _ NAME C.S.T. # ~ - and other information obtained from wner/builder). Plumber 's Signature /MPR # Phone Plumber's Address . PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). 2./4. N , { A7 I Do Not Write in Space Bel w FOR DEPARTMENT USE Q, C~L Y O Date of Application j Fee Paid: State / County Date ✓ _ Permit Issued/Rejected (date) Issuing Agent Name ` ell A Inspection Yes__A_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 coov) 4. plumber (canary copy) Revised Date 6/1 /76 EH 11,5 t. 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: ~SW%, Section , fl_-t"N, R L' &4Ew) W, Township r~_~ Lot No. , Block No. County - - ~ Subdivision Name Owner's Name: Mailing Address: ~c> > ~~y1~>~1 10 j ~~•1 V ~/~L-I-~,Gv) y TYPE OF OCCUPANCY: Residence X No. of Bedrooms 3 Other - EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS SOIL MAP SHEET All SOIL TYPE~`~`-- 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 3,1V ,1y 31,1 Ll ~P- s - 3 3(C= 11 ~ . ~ r- - - 3 3/y 3%y 3/y ~l 61 P-'~ 3 LTA, ;3h s i i.~~;h I~,, ►3h IP yZ L iS,~~ t3~~s~(,z ; F3►, cE - - t/~/~l~ Sly" 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) I_. r ~S C c 12; 52 L PLAN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.) ;dicate on the pan the location andsquare feet of suitable areas. Indicate numbei.ef square feet of absort-•t.inn area „eeded for building type and occupancy. 4-9 r/ES 6 ►C, ~1 Cat=sue Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. ~6 N t76fl 1`~7 1'ti 4- C, ~i l 5 u P1 L 1 t kL DZ,"L~ N Z c~ L S ► 4I i= art lI ~ CY 4 LC nl -b 13 ""T_406 S %3(j701?(- t S'1Ac A7 Nas c~ 1, the undersigned, hereby certify that the soil tests reported on this form were made by Pin ac9" wit" *Wro4' es and methods specified in the Wisconsin Administrative Code, and that the data recorded d loca 4bh holes aI` rrect to the best of my knowledge and belief. ! Name (print) Certification No. Address Name of installer if known _ CST Signature COPY A - I.OCAL At;T !0!'; T Y