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Parcel 042-1067-50-000 01i02i2007 10:57 AM
PAGE 1 OF 1
Alt. Parcel 24.29.18.377B 042 - TOWN OF WARREN
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 - HANSEN, MAX A JR & NANCY L
MAX A JR & NANCY L HANSEN
1406 CTY RD TT
ROBERTS WI 54023
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1406 CTY RD TT
SC 2422 ST CROIX CENTRAL
SP 1700 WITC
Legal Description: Acres: 2.330 Plat: N/A-NOT AVAILABLE
SEC 24 T29N R18W IN SW SW S 350' OF W Block/Condo Bldg:
290' OF SW SW (THIS INCLUDES LOT 1 CSM
3/717) Tract(s): (Sec-Twn-Rng 401/4 1601/4)
24-29N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1129/136 WD
07/23/1997 895/339
2006 SUMMARY Bill Fair Market Value: Assessed with:
149552 278,200
Valuations: Last Changed: 10/22/2001
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.330 39,100 163,900 203,000 NO
Totals for 2006:
General Property 2.330 39,100 163,900 203,000
Woodland 0.000 0 0
Totals for 2005:
General Property 2.330 39,100 163,900 203,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 212
Specials:
User Special Code Category Amount
018-RECYCLING SPECIAL ASSESSMENT 15.00
Special Assessments Special Charges Delinquent Charges
Total 15.00 0.00 0.00
AC RTTTT T Ce~TT'r'~ev cvea•cu^~^^
SEC. T=_ _N, R
'R r , TOWNSHIP
RESS ST. CROIX COUNTY, WISCONSIN.
VISION LOT LOT SIZE
PLAN VIEW
Distances S dimensions to vnect requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
C_.
V -
:C TANK(S)T 4NFGR. r x ~ _CONCRETE STEEL
NO. o` , rings on cover 4_ ! a° Depth_ DRY WELL
:HES NO. of ~4 width ' ength area
to. of lines width length area
,
depth to top of pipe
:GATE ,
RATE AREA REQUIRED AREA' AS BUILT l._
aimer: The inspection of this system by St. Croix County does not imply complete %
iance with State Administrative Codes. There are other areas that it is not possible
spect at this point of construction. St. Croix County assumes no liability for
m operation. However, if failure is noted the County will make every effort to
mine cause of failure.
ES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
'INSPECTOR L
DATED PLUMBER ON JOB •
LICENSE NUMBER
z r
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
~Sanitatc y Petcmitr~-- f State Septi-Le7~ ~'Jf
NAME 7ownt~hip S Ctcoix County
Locatiov~% . 14 aSection ~fT,'N,R~rW
SEPTIC TANK
Size { gatton1s. Numbetc o6 Compatc,tment~s
Distance Ftcom: Wett ~j it. 12% otc gtceateA 5tope 6t
Building it. Wet.2and,5
Highwaxen it.
DISPOSAL SYSTEM
Diztanee Ftcom: Wett 120 otc gtceatetc 6tope 6t.
Building it. W ettandts Ft.
Highwatetc b .
FIELD DIMENSIONS:
Width o6 trench it. Depth o6 rock below tite in.
Length o6 each tine it. Depth o4 kock ovetc tite in.
Numbetc o6 tines Depth o6 tite below gtcade in.
Totat .length ob Zine~ it. Stope o6 ttceneh in pets 100 it.
Distance between Zi..ne/s it. Depth to bedtcock it.
Total ab~sotLbtion atcea 6t2 Depth to gtcoundwatet it.
2
Requited atea it
6
PIT DIMENSIONS:
NumbeA o6 pit/5 Gtavet around pits yets no
Out.6ide diametetc it. Depth below intet it.
Totat abz otc.btion atcea it2 . z
A
C Atcea tcequitred 6t2 rn
INSPECTED BY TITLE
j APPROVED DATE 19 7
REJECTED ,DATE 197
i
EH 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:-2!1` Section-'___T_, ~nN, R/_XIV(or) Iaownship or Municipality
Lot No. , Block No. County
//a~ ubdiv' io ame
Owner's Name: M2N es
`tYT Gl
Mailing Address: mow. s
TYPE OF OCCUPANCY: Residence No. of Bedrooms J Other
EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS tf ~2 Jy
`:OI L MAP SHEET ~t f' : ~j - 17r --c jf SCI L TYPE - -_57- c' s-•-
PERCOLATION TESTS
r r ST 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 N/INI
PER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MI
P 2 >(-c C, 4/ Alc -3 20
I-
P
3 A~%_ 2
AAA k, 3c'
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)
r
7-15
I_J ` (G rr•DIC 4 C r - 5 ' CD-Ale V ft✓~ r -
13-
SL,
[r l ,r /KJ✓~~'- ~ri/r f~st~~ i.~ ea cti f. 1. ~tO~i, ~'a J✓A~~F r'L
2;2 ACS, 7
12 kl;:~, /a - 5A 0Z C 45
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of suitable areas. Indi to n m of s uare feet f absorption are-,
YW S_ needed for building type and occupancy. "4, ~f2 A, Indicate scale
or distances. Give horizontal and vertical reference in aiInd' ate slope. 5'j 4l,_ 10
i
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 an belief.
i
Name (print) Q ! 4' Certification No.
Address ~c,Name of installer if known
CST Signature •
:OPY A -LOCAL AUTHORITY
State and County State Permit
P ~ Permit Application
County Per,
i
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:
-AM es~ 00
B. LOCATION: jam'/, li~! y, Section A T i N, R43 (or) W Lot# City _
Subdivision Name, nearest road, lake or landmark Blk#- Village
Township
C. TYPE OF OCCUPANCY: "Commercial *Industrial *Other (specify) *Variance
Single family X.Duplex No. of Bedrooms 3 No. of Persons
D. TYPE OF APPLIANCES: Dishwasher )C YES NO Food Waste Grinder YES_A NO # of Bath!ooms-/
Automatic Washer __X_YES NO Other (specify)
E SEPTIC TANK CAPACITY/COO Total gallons No. of tanks _
'Holding tank capacity_ Total gallons No. of tanks
New Installation Y -Addition Replacement- Prefab Concrete 1e
'Poured in Place -Steel Other (specify)
FFLUENT DISPOSAL SYSTEM: Percolation Rate 1)['G* 2),73) Total Absorb Area sq. ft.
New-9- _ Addition Replacement *Fill System yv,-d ±~i{'4cvti~
Seepage Trench: No. Lin. Feet _ Width Depth Tile Depth No. of Trenches
Seepage Bed: Length !C-Width Depth 'r Tile Depth A/"-No. of Lines 3
Seepage Pit: Inside diam ter L'quid Depth Tile Size
Percent slope of land c? C (a~ ly/ Distance from critical slope
I, 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 Cer ified Soil ster
NAME At., ~ sao, C.S.T. # and other information
obtained from LAG) C-,- -
Plumber's Signature MP/MPRSW# Phone #7rJ a~~ awiGa'
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
J~a l _
EF~~v~3-Tiutii ,v
\
Ix 11
~ . cre to Ae Ha.stud i`xv `
I33-- "
C
t. C-110
e
13 3` iii
Top, 0,C j~W.-c-
i
Do Not Write in Space elow F R DEPARTMENT USE ONLY
Date of Application - Fees Paid: State/oa County ;2~ Date
Permit Issued/R (date) -Issuing Agent Name
Inspection Yes No Valid# Date ec'd
1. county (whi a copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
!mber (canary copy)
Revised Date 6/1/76