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Parcel 040-1183-20-000 09/11/2006 09:57 AM
PAGE 1 OF 1
Alt. Parcel 36.28.19.743 040 - 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 - AMMANN, DUANE & KIMBERLY
DUANE & KIMBERLY AMMANN
65 OAK RIDGE DR
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 65 OAKRIDGE DR
SC 4893 RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 0.425 Plat: 03/58-DANATE PARK
SEC 36 T28N R19W LOT 27 DANATE PARK Block/Condo Bldg: LOT 27
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
36-28N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
02/23/1998 573558 1298/576 WD
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/21/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.425 44,000 182,700 226,700 NO
Totals for 2006:
General Property 0.425 44,000 182,700 226,700
Woodland 0.000 0 0
Totals for 2005:
General Property 0.425 44,000 182,700 226,700
Woodland 0.000 0 0
I
Lottery Credit: Claim Count: 1 Certification Date: Batch 302
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
REPORT OF ITISPECTION--174DIJIDUAL SE',TA(',E DISPOSAL SYSTEN
Sanitary Permit
J State Septic '.'A.IE TOWNSHIP .
• t. Croix Couli tj
MEPTIC TA711;
Size gallons. 'umber of Compartments ,
Distance From: We 11 ft. 12% or greater slope fi.
Building ft. Wetlands f*_
Highwater ft.
DISPOSAL-SYSTE:l Tile Field or Seepage Pit(s)
Distance From: Tlell ft. 12% or greater slope, ft
Building ft. Wetlands f:
FIELD 1:1 ighwater ft.
Total length of lines ft. !lumber o` 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
aver. rock, Depth of the below grade in. Slope of
trench in ner 100 ft. Depth to Bedrock ft. Depth to
ground water ft.
PITS
Number of pits 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
`'.quare feet of seepage nit area required '
Inspected by: Title:
Approved Date 197.
Rejected Date 197.
EH 115
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
c P.O. BOX 309
MADISON, WISCONSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
LOCATION: :5f_'/4,AJ/4, Section , T N, R _R E (or) W, Township or Municipality 77A&
~'~dv'r✓
Lot No. j, Block No. County r
Subdivision Name
Owner's Name:
Mailing Address: ~(C) T~ Iy !1
iLe-55
TYPE OF OCCUPANCY: Residence - No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
I
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS SOIL MAP SHEET SOI L 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 PEfR)IOD 2 PEA/Rr/~IOD 3 MIN/IN
~c yp /0
qt :2% q
P -:2
-3
I A SOIL BORING TESTS
TEST -TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
I
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
i
13-
~ z.
•
AN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
:.plicate on the plan the location and square feet of suitable are s. Indicate number of square feet of absorption area
needed for building type and occupancy. :~sr•f Indicate scale
or distances. Give horizontal and vertical reference point I icate slope.
s
X FtiSIAJ
It f o n
I
I
- -
70 :ft4
1 C
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 b ief.
Name (print) Certification No.~
Address
Name of installer if known L`
CST Signature
COPY A - LOCAL AUTHORITY
C`
State Permit # -
PLB67 State and County
~ Permit Application County Perm ~
for Private Domestic Sewage Systems CountyL
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. # -
A. OWNER OF PROPERTY Maili ddress:
B. LOCATION: 1/4 '/4, Section T. N, R E (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township
C. TYPE OF OCCUPAN---:--*C-om-me-rc- i-a *Industrial 'Other (specify) *Variance
Single family Duplex No. of Bedrooms No. of Persons
D. TYPE OF APPLIANCES: Dishwasher YES ~O Food Waste Grinder-YES A`NO # of Bathrooms
Automatic Washer i/q-ES NO Other (specify)
E SEPTIC TANK CAPACITY 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)
FLUENT DISPOSAL SY Percolation Rate 1) V 2) 3) Total Absorb Area sq.
i`„e:w Addition Re a en *Fill ystem
Seepage Trench: No. Lin Feet T° Width Depth Tile D/pe h No. of Trenches
Seepage Bed: LengthWidth Depth Tile Depth No. of Lines_
Seepage Pit: Inside diameter- Liquid Depth Tile Size
Percent slope of land, Distance from critical slope
the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
^?isconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared
)y the Certified oil er,
~.+AME C.S.T. # and other information
obtained from wner/builder).
Plumber's Signature P/ PRSW# Phone 0;5--
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
i
L
l
C . ,
. f
Do Not Write in Sp a ~B low,- FOR DEPARTMENT,/USE ONLY
Date of Applicatio Fees Paid: StaC6 Co y=~~' ~~ate - 1571
Permit Issued/Reieeted"~( ate) ' -Issuing Agent Name
Inspection Yes No Valid# Date Recd
1. county ( hi a copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) 4. plumber (canary copy)
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RIVER FALLS River Falls
MEDICAL Dental RIVER FALLS REALTY CO., INC.
CLINIC, LTD. Associates, Ltd. DENNIS R. SCHULTZ
Stephen Schwalbach, D.D.S. REALTOR .
425-6701 Robert W. Hasel, D.D.S.
David A. Page, D.D.S. 113 Phone: 775 - 425-9707
650 South Main Strctgr REALTOR-- 113
River Falls, Wisconsin River Falls, wisconsiA- REALTOR 54022 220 SOUTH MAIN STREET
425--67 67 5 32 RIVER FALLS, WISCONSIN 54022