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HomeMy WebLinkAbout032-2148-20-000 Wisconsin Department of Commerce. PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 420358 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: City Village X Township Parcel Tax No: Sargent, Anthony Somerset Township 032 - 2148 - 20-000 CST BM Elev: Insp. BM Elev: BM Descri on: Z 06 106 ' �/ Zrh TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark may,,, S 07. Dosing / —16 u AI M ' i' Aeration Bldg. a er Holding St/Ht Inlet 7 / & . TANK SETBACK INFORMATION SUHt Outlet 9 •U 06• S TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet M 6 - T Septic �_ 1 ��� Dt Bottom ' Dosing ' '/ Header /Man. Aeration y Dist. Pipe —b1 1 / Z ' �17,2`� L 12.7-4 Holding _ -. Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover s J O y d Mode,(Nu ber TDH Lift Fricti�cn­Loss System Head TDH Ft Forcemain f ength Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 ' tog SETBACK SYSTEM TO P/L S BLDG WELL LAKE/STREAM EA ING Mai fact rejL _ ` �/� INFORMATION CHAMBER OR 1T1�'l 0' �T� Type Of System: f / / /� UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution I x Hole Size x Hole Spacing Vent t Air Intake P, l� ' Il Pipe(s) Length Dia Length Dia Spacing / �'7v SOIL cc-- COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only elf Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center I Bed/Trench Edges Topsoil ] Yes [] No ❑ Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 1,oj-71 U Inspection #2: Location: 2120 54th Street Somerset, WI 54025 (S 1/4 SW 1/4 15 T31 R1 9W) Oak Haven Lot 22 too Parcel No: 15.31.19.1293 1.) Alt BM Description = 2.) Bldg sewer length - amount of cover =� s Plan revision Required? ; Yes W No 1 Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor' Signature Cert. No. -- Stifety and Buildings Divisiun County 7 7;, !V 201 W, Washington Ave., P.O. Box 7162 ' I Vv isconsin Madison, Wl 53707 - 7162 Site De artment of Commerce Sanituy Permit Number Sanitary Permit Application v 3-5 g � ' In accord with Comas 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revuton ma be used for seco ses Privacy Law s15, 1 m state Plan i.D. Numbet_ L Application informatlon - Please Print All Information - E�� Parcel Number -40 0 Property wtkr's Name �� / g 4 2 property Location Property Owner' ailing Address 2002 _ ST G+J '4 ' S T N • R Lip Ccx1e Pty UNT y Lot Number Block N ber City, Sate G OFF CE Subdivision Name CTT'r fOPublic/Conuncrcial of Building (check all that apply) 'h � S� Dory Family Dwelling - Number of Bedrooms „ —__ ❑Village - Describe Use ❑Townshi C Nearest Road ❑ State Owned M. Type of Permit; (Check only one box on line A (numbering scheme for Internal use). Complete line B if applicable) A ' I J9 New 2 ❑ Replacement System 3 ❑ Replacement of 6 C3 Addition to For Count? use S sum Tank Or Exis S stem Date Issued Permit Number ' B. ❑ Check if Sanitary P ermit Previous! Y Issued IV. Type of permit: (Check all that apply) (numbering scheme is for Internal us f� 44XNon - Pressurized in-Ground 210 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wedusd 22 ❑pressurized [n- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 5 10 -Drip Line i 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other _ V. D rsaUTreatment Area Information; Percolation Rate System E ovation Final Gndc Design Flow (go) Dispersal Area Dispersal Area Soil Application Elevation Required Proposed Itate(Gals. /Days /Sq.Ft,) (Min./Inch) Capacity in Total Nuniber Manufacturer Prefa Site Steel Fiber Plastic V . Tank Info Concre led Glass Gallons Gallons of Tanks New Bxistuq Tanks I Tanks Septic or Holding Tank S z2o 0 . Dosing Chamber VII. Res risibility Statement- I, the undereigned assume respoasibaity for Installation or the POWTS shown on the attached lass. Plum is utte (Pritu) Plum c i7Sc MP /MPRS Number Business Phone Number — Plumber's Address (Street, City, State, Zip e) s f ZL L VIII. County /De artment Use OnlY Signature (No Stumps) Sanitary Permit Fee (includes Groundwater Dan Issued Issuing Ag 8 ture Approved ❑ Disapproved Surcharge ) - ❑ Owner Given Initial AdverseS� t1� Z _ Dete rmination IX. Conditions of Appro al /Reasons for Disapproval / -� &yam t f ----- the Attaeh compicte piss (to County only) for the eystem 0.0 Papa a k tu 9 2 a 11 laebes to du S Pc u K' `S ( vet cC�v. ctt" --,.� `� n__0 2�� o r SBD -6398 (R 05!01) �,,..,.� {—� _- ta.�' � t,� s `�S I - �09 ✓ AVI 5 �!a (o J ��/t�l'OFN oS•O+v.E SI,, l.�S:E� r �� f�c�x- ✓�sCi+� �o� mf'��%'!�C' �'�� - eU�Go si°�.e �J,S! 6v /,r�rs /�'a0�•�/ �t "4e / l 0 l n � OPOVRSKO 1 d ! �a \._!- � 0 � f� '�� J��/�� L,✓/d� 'i+� � ® '/ / .' ° �L' T `�< - .z� �G © / � � j i'�r /e �J,q� 6 rs /�'e) / / Igoe, qs O �II /�OUV� �rh<9GQ pQ�f� ta 1 i jj 1 I Wisasnsin De yartment of Commerce SOIL EVALUATION REPORT Page 1 _ of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. pendin Please print all information. Re iewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Z3 Property Owner Property Location Gerald J. Smith Govt. Lot SE 1/4 SW 1/4 s 15 T 31 N R 19 XNor) w Property Owner's Mailing Address Lot # I Block # I Subd. Name or CSM# 11160 190th. Ave. 22 na Oak Haven City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road Elk River, MN 55330 ( 612 441-8888 Somerset I 210th Ave. (: New Construction Use: ® Residential / Number of bedrooms . 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material ph f wa ch Flood Plain elevation if applicable ' {' ft. General comments and recommendations: i trenches @ el. 96.20', spaced to code 3.50' below grade !,.. T X Boring a Boring # 99.70 90 0 Pit Ground surface elev. ft. Depth to limiting factor a lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 1 0 -8 10 r4/3 none sl 2mgr mvfr gw if .5 .9 7 5 r4 6 none ms osg ml na na .71 1.2 r a Boring # Boring Pit Ground surface elev. 99.90 ft. Depth to limiting factor 90 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 10 r4 3 none sl 2mgr mvfr gw if .5 .9 2 10-2E7.5yr4/4 none is osg mvfr gw na .7 1.2 7 5 r4 none ms osg ml na na .7 1.2 tf4. Y W . ' Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = B0 9 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature V . CST Number Gar L. Steel 02298 Address Date E aluation C6nducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 6 -3 -2001 715 - 246 -6200 I t Property Owner rcra .T Samft Parcel ID # ,o } Page 2 of 3 Boring # ❑ Boring 80 3 ® pit Ground surface elev. 591 ft . Depth to limiting factor - , -- in. Soil Application Rate .Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 1 -8 0yr4 /3 none sl 2mgr mvfr gw if .5 .9 2 -80 5 r4 6 none Ms Ogg M1 gw na 7 1.2 4 3 �Z a Boring # ❑ U Boring pit Ground surface elev. 101 ft. Depth to limiting factor +90 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 I `Eff#2 1 -6 0 r4 3 none sl 2m r mvfr gw if 5 9 2 -16 .5yr4/6 none is osg mvfr gw if .71 1.2 3 16 .5 r4/6 none ms osci ml na na .7 1.2 Boring ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. F] pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fP- in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg /L ` Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R.6/00) I to STEEL'S SOIL SERVICE Gary L. Steel Gerald J. Smith 1554 200th Ave. CSTM2298 New cm SE4SW4 S15 T31N - Richmond, WI 54017 MPRSW -3254 town of Somerset 715 ) 246 -6200 lot #22 -Oak Haven This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. f1 =40' top of 1" pvc pipe @ el. 1 99,01— 1- Alt. BM.= top of 1" pvc pipe @ el. 102._ 10`_ N oP7� l t Gary L. Steel 6 -3 -2001 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Kip _j0( FILE INFORMATION SYSTEM SPECIFICATION Owner Se tic Tank Capacity 0 al a NA Permit It Zp Sep tic Tank Manufacturer o NA Effluent Filter Manufacturer o NA DESIGN PARAMETERS Effluent Filter Model o NA Number of bedrooms o NA Pump Tank Capacity al ANA Number of Commercial Unit A Pump Tank Manufacturer _KNA Estimated flow (average) gal/day Pump Manufacturer .6 NA Design flow (peak), Estimated x 1.5 ) gal/daX Pump Model ANA 1 Soil Application Rate _ tl /d t /It Pretreated Unit Inl'luunt/I?fl1ucnt (duality Momhly Average* t.r Sand /0 - avel filter Diller Fats, Oils & Grease (1`00) <30 ntg /L n Mechanical Aeration t Wethuu) Biochemical Oxygen Demand (BODs) �22U tttg/L o Disinfection o Other: Total Suspended Solids (TSS) <150 m L Manufacturer Pretreated Effluent Quality C3 NA Monthly Average ** Dispersal Cell(s) Id ground (gravity) o In- ground (pressurized) Biochemical Oxygen Demand (BODs) <30 mg /L o At -grade o Mound Total Suspended Solids (TSS) <30 mg /L o Drip-line o Other. Fecal Coliform (geometric mean) <10 cfu /IOOmL Maximum Effluent Particle Size '/v inch diameter + Values typical for domestic (non - commercial) wastewater and septic tank effluent. ++ Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Fre uenc Inspect condition of tank(s) At least once every o months _; ears (Maximum 3 rs) Pump out contents of tanks When combined sludge and scum a uals one third 'h of tank volumL- Inspect dispersal cells At least once every o months 2f Year Maximum 3 rs Clean effluent filter At least once every o months g ycur(s Inspect puni p, pulnp controls & alarm At least once every a months ❑ year(s) NA Flush laterals and pressure test At least once every a months o y ear(s) A Other: At least once every o months o ear(s) KNA Other: At least once every o months o ears A MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator, Tank inspections must include a visual inspection ol' the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface, The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in an an eq uals o ne - thir d '/ v th en g y tank eq a (3) or more of the tank v e nrr contents of the tank shall be removed by a Septttge Servicing Operator and disposed of in accordance with ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatment components, and any other maintenance or monitoring at intervals of 12 months or less shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that my impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tanks(s) removed by a septage servicing operator prior to use. r Owner: Page ,20t'i2 System start up shall not occur when soil conditions are frozen at the infiltrative surface, During power outages pump tanks may fill above normal high water levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls' to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact. The area within 15 feet down slope of any mound or at -grade soft absorption are. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONEMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with ch. Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant re ment system: plac 7 A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed P 8 upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at the time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER 0 POWTS MAINTAINER Name Phone _ Name Phone SEPTAGE SERVICING OPERATOR PUMPER) LOCAL REGULATORY AUTHORITY Name P Name - ' Phone — ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address Q u_ a Lew Property Address 5L A O.P t (LO T 12 cc (Verification required from Planning Department for new constructio City /State �(l f , , b3i T_ Ca Parcel Identification Number LE GAL DESCRIPTION Property Location S� ' / <, 5W ' /a, Sec., T_N -R_A_W, Town of c_� "15 Subdivision �� �l , Lot # ` . Certified Survey Map # , Volume , Page # Warranty Deed # �/0, , Volume ti [�s�- � , Page # Spec house ❑ yes no Lot lines identifiablq yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 ;NA of the three year expirati date. 7 7/ R F APPLICA DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the roperty described above, by virtue of a warranty deed recorded in Register of Deeds Office. VC2� §!)� NATdt,E OF APPLICA T DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed U 1951 P `I90 STATE BAR OF WISCONSIN FORM 2 - 1999 687403 KATHLEEN H. MALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Forest Oaks Condos, Inc. RECEIVED FOR RECORD 08 -19 -2002 9:30 AN WARRANTY DEED Grantor, and Anthony A. Sargent and Jacqueline L. EXEMPT # Sargent, husband and w fe, REC FEE: 11.00 TRANS FEE: 131.70 COPY FEE: CERT COPY FEE: Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area (!F N) Oak Haven, St. Croix County, Wisconsin. Name and Return Address David I Estreen" 304 LOC USt Street Hudson. WI 54016 $ Pt of 032 - 1043 -50 -000 & 032 - 1043 -40 Parcel Identification Number (PIN) This is not homestead property. Q$) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this (�; of August 20 02 Forest s Condos Inc * * Gerald J. Sm resident * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) Forest Oaks Condos, Inc., by Gerald J. Smith, STATE OF WISCONSIN ) President, ) ss. County ) authenticate thi d f August 200 — - Personally came before me this day of the above named * Kristina Ogland TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY * _ Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, WI 54016 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ') * Names of persons signing in any capacity must be typed or printed below their signature. information Professionals company, Fond du lee, wl OW455 - 20 21 WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 - 1999 - — — — 80Z— — — — — — — —,BL ON— — — — U I� 0£ �. Q o '\ • �y0 /. ................I............. ...............1............. .............. ....... .. . .. Vol 3.6r,ZC.toN a L � N O o ^ 7 N II N M N M r cq f" ►� 4 rn a � h J "$ co Q Q i tO N V °, W wi O g g V ,8L'OOZ ,8L'8OZ ,SL'80Z ,06'6 LZ f/l MS -?/,u . ,LZ'999Z M „OS, l LOON ------------------- o SaNb'� 4311`d�dN(1 v 0 0 t o it c � 8 0 W 2 a° o 43 a � W ° :� � y Q i t c S 3 v .• 0 Parcel #: 032 - 2148 -20 -000 06/24/2009 01:23 PM PAGE 1 OF 1 Alt. Parcel #: 15.31.19.1293 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - NILSSEN, JENNIFER V & ANDREW B JENNIFER V & ANDREW B NILSSEN 2120 54TH ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description " 2120 54TH ST SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 3.000 Plat: 08- 063 -OAK HAVEN 032 -01 SEC 15 T31 N R1 9W SE SW LOT 22 OAK HAVEN Block/Condo Bldg: LOT 22 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 15-31N-19W SE SW Notes: Parcel History: Date Doc # Vol /Page Type 07/20/2005 800939 2847/545 WD 05/16/2005 795024 2802/608 SD 03/23/2004 757308 2531/476 QC 03/23/2004 757307 2531/475 QC more 2009 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/03/2008 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 48,000 116,900 164,900 NO Totals for 2009: General Property 3.000 48,000 116,900 164,900 Woodland 0.000 0 0 Totals for 2008: General Property 3.000 48,000 116,900 164,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 11/08/2006 Batch #: 06 -19 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00