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HomeMy WebLinkAbout040-1298-30-100 . _ . . 0 0 5 s w 0 7 o sr . o $ ; ■ . k T n 2_ g \ 7 2 / o $ 2 - a ; o - \ i \ § § . 2 \ § / } % $ § 8 2 ; ° 0 § C.0 Q . � e ra f > § / / \¥ fx -a ; m G : 2 0 \ 2 G » o a a CD CL \/ \/2q m E 8 8 £ . \ M ; A E CO) CL z m o o o '0 & E � / g § CO) (A ca k ƒ ƒ \ \ \ \ \ -4 �. [ § § $ A D ƒ , f D % ° > t0 \ g a $ � % =r 7� �- cn } \ / \ \ z m a @ % , o , ■ . § ■ \ $ R g CD § c o F \ 0 / z «8 I[[ ƒ�¢0R : / \CDg)(D Cl- k § ri g ¥2��$E a`§7CLs23 °a c ; w\e�G\G9 % ']GAE G \[ f r c, CD @m -_�` » EC f f a = :akE C, t / /, $/ y @ � } / /�& �� \ E# $q § /K =o mP 2 CLfp ct $ SlCD §& kli . a /7$ �\ \ E �\ � § § o . . i 2 � Parcel #: 040 - 1298 -30 -100 09/28/2005 03:20 PM PAGE 1 OF 1 Alt. Parcel #: 09.28.19.1721A 040 - TOWN OF TROY Current Fk 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 MICHAEL A & CATHERINE A DOCKENDORF O - DOCKENDORF, MICHAEL A & CATHERINE A 402 GLEN RIDGE RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 402 GLEN RIDGE RD SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 2.002 Plat: 4460 -CSM 17 -4460 FKA PT GLOVER GLEN SEC 9 T28N R19W PT SW SE SEC 16 T28N Block/Condo Bldg: LOT 13 R19W PT NW NE LOT 3 GLOVER GLEN (2.002AC) NKA CSM 17 -4460 LOT 13 Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) (2.002AC) 09- 28N -19W SW SE Notes: Parcel History: Date Doc # Vol /Page Type 10/13/2003 743458 2434/282 WD 04/04/2003 716073 2196/109 WD 04/04/2003 716070 2196/103 WD 02112/2003 709370 17/4460 CSM mo ... 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/06/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.002 83,000 336,600 419,600 NO Totals for 2005: General Property 2.002 83,000 336,600 419,600 Woodland 0.000 0 0 Totals for 2004: General Property 2.002 83,000 0 83,000 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 f • 71 259a7tZi MAY 14 200 VOL 17 PAGE 4460 d , KATHLM R. REGISTER OF DEEDS ST CRQ;X 1010U „FY ST. CROIX CO. MI SIJRVEYGit'S ! FORD RECEIVED FOR f2ECORD 02/12/2003 03:30PH CERTIFIED SURVEY _ MAP C FEE: 13.00 COPY FEE: LOCATED IN THE SW 1/4 OF THE SE 1/4 OF SECTION 9 AND THE PAGES: 2 NW 1/4 OF THE NE 1/4 OF SECTION 16, ALL IN T28N, R19W, TOWN OF TROY, ST. CRO I X COUNTY, WISCONSIN, BEING ALL OF LOTS 1 , 2 , 3 , OUTL OT 1 AND 7 OF THE PLAT OF GLOVER GLEN. A ?J oe I I fXX1,S W. 6¢' W D pI 1 YES L N D LOT 1 - B Pl�AI �GL.OYt�N I a' ° p I o l -- - - - - -I �''° °6 - N , 204.�9 .� SCALE IN FEET I - LOT 14* I N� ( SEE NOT # 3, PAGE 2)' 0 75 150 300 cy 3 49 A F. — I S 8 0' o \ rh 0 �I LOT 2 s UI � .0 , I \` _ 77.7 27 'Wo E � LQ S \ 0 2 N Wrn. w i� 2. 0,096 S.F. APPRO 298 ACIIIS ,8j9'1�•'E W — — — — — — — — — — — zwmZo 1 ;� ri 0 /M S XG 1/ATE �' �° �� 50 °31' 37„ W i� o / ��, ORAII 'LLD w o H aO10 So LOCA T/ON mw Z ° o w 9043 p E �� a Z co Z 139. 0 : SEPT/C �`� F < m � \ / — c o eN L ��/ TANK G 4 mNNO \ z o� 50' Z LOT 12 3.106 ACRES W LL / S 5 ° 07” W 135,300 S.F. 0 0 9. 5' N. /N 42 °45' 00" / ` ° SE CORNER 9L• 21.00' r^ j SECTION 9 SECTION C ORNER \ AV. o 11 da T28N, R 19W T28N, R19W sj .1 � �"` N 89 E 2645.84' • 8j ' g ,6 j 24 �w / 7 W SOUTH LINE OF THE 'S�, / RES i . SE 1 /4 OF SECTION 9 x / C LOT 13 �� , / S° s \ 2002 AC S EX1SIl��Shf�gE - o B/y�YAr \,� o s`�9✓ / x S.F. 3 POINT OF ,IHE P�dTS� GLQl�B BEN \� nL-A � � BEGINNING � LEGEND ��� \s9� ?�9 1r 4v UNN I E C T I ON F CORNER MOUNUMENT, lA NUM � F OUND. 2 3/8" IRON PIPE. FOUND. \ L�� 1 1/4" UNLESS OTHERWISE NOTED) -- O /!� // IRON PIPE, FOUND. — '.j O 1 5/ I NEAR FOOT, PIPE . WEIGHING LOT 3 \ ` �< J�/ 04 PLA T OF / BUILDING SETBACK LINE, 25' GLOVER STA T ON UNLESS OTHERWISE SHCMAV. , 4& - X• - - X EXISTING FENCE. EXISTING 12' WIDE UTILITY EASEMENT *NOTE: ALL IRON PIPE ( FOUND AS RECORDED ON THE PLAT OF GLOVER GLEN. OR AS OUT SET) ARE DIMENSIONED DE DIAMETER.* THIS INSTRUMENT DRAFTED BY JEROD A. FINK PAGE 1 OF 2 Vo1.17 Page 4460 / f vas' o�v w/ SYo�6 Wisconsin Department of Commerce SOIL EVALUATION REPORT livlsion of Safely and Buildings Page / of in accordance with Comm 85, Wis. Adm. Code Allach ronlplele site plan on paper riot less Ihan 8 1/2 x 11 Inches In size. Plan must County S ?' G D include, bill 1101 limited lo: vertical and horizontal reference point (BM), direction and 1 � percent slope. scale or dimensions, north arrow. and location and di ~ie-n real road. Parcel I.D. O t> Please prl all ►n ormikrCE`VED Revl wed by Dale Personal information you provide may be used for sec dary purposes (Privacy Properly Owner f 'e MAY rope Location I ����� � �• � vl. L 1 ��j 1/4 1/4 S T � N R q ( W Properly Owner's V Addre g OFFI Block # Subd. Name or CSM# / ?0& G� /l/ �,v D /P . ZONING City State Zip Code Phone Number �1vo� - �/ syO / � � 3 n/ •s �� [ ❑ Village JA Town Nearest Road O y r 't . r7 6:100E,e ��- ❑ New Construction Use:,4 Residential / Number of bedrooms Code derived design flow rate cc GPD F1 Replacement ❑ Public or commercial - Describe: Parent material p O(>et ,$ 0 General comments Flood Plain elevation If applicable N n and recommendations: TES . - A F- p i ?"jf,B 1,C— coNU�Nr�a,�� sys7Z-FlY — -r4 3 IP�CD/yMF.v9�D : /,� sf.l-l� !ii' C �i /- ,�3✓ o Di vt'� Boring # 0 Boring aS 0 0 FS • Zd 7. -'1 M M a: J_ Pil Ground surface elev. f( Depth Io limiting factor In. fforizon bepth bo Soil Application Rate minanl Color Redox Description Texture Structure Consistence Boundary Roots GPD/W ie In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I 'Effoll #E"12 a -& 10 Y1 3 /3 — sL 2 4 sh C,5' f . s 3 514 ez 4— 2 9 . ' 5 7_5ye -.: J 51 • o /o s/ -s• D, �,e 2 i • Z r r • Boring # [j Boring III 111 pit Ground surface elev. �y a g, Depth to limiting factor /49 00 In. Soil Application Rale I forizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD 111 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0#1 'Eff#2 • /o R — y � �S i0# 3 / fS & A-U'09? c ! . Y • G q �S • 2 9 — 11M v ie e / r� . y .4 29 •Y 7•S 'Q y ,> Y. 6 d c �• Z :0 44. b g3.6 Lf Effluent # 1 = ROD > 30 < 220 mg/L and TSS >30 _< 150 mg/L •Effluent 02 =BOD < 30 m !1 and and TSS < 30 mglL CST Name (Please Prtnt) Signalure RoRt~(zT' 2� /d�f'iGr!i CST Number ZZCt3 ?S' Address Dale Evaluation Conducted Telephone Number SS 0� N�iL �D S y01 i A A zo Property Owner T r ^ Parcel ID N 4 0 yp . y� %✓`- ov p age z of [3oring p ❑Boring /Q o . O pit Ground surface rface elev. ft. Depth to limiting factor / Y In. [ !Soil Application Rate f lorizon Ueplh Dominanl Color Redox Description Texture Structure Consistence Boundary Roots WON In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff!!1 'Effg2 0 7 /0Y/ 2 / L ! f S�,e� �� w i t . y Z • rs iD j f YZI i �si1.� �►�, fop -4 WLQQ s. ns s • F. 016 r ❑ Boring ff ❑ Boring ❑ -pit Ground surface elev. fl. Depth to limiting factor In. Soil Application Rate Hvrizon Depth Dominant Color Redox Description Texture Struclure Consistence Boundary Roots GPD14' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Elfl11 •Eff#2 r r Boring Al ❑ Boring ❑ pit Ground surface etev. fl. Depth to Nmtting factor In. Soil Application Role A I lorizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD 111 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Eft!! `EIf#2 ` Effluent ft 1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = 13013 < 30 mg/L and TSS < 30 mg/L r The Department of Commerce is an equal opportunity service provider 4nd 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. Spb.Rtto (R R/fM)) i 0 0 LA LN LM (}J w A � x Lb co y - r of LA TTEO LAAV w f " NORTH LI OF THE N (R-Sr . to ' OF T 1/4 OF THE SE 1/4 Ab'0 SE 1/4 J" � MAW i RAILROAD SPIKE N EAST 3a © SIDE OF 1 TREE � BENCH HARK. RMV027I • RAILROAD SPIKE N SOUTH 3a I SO. SUE OF 18" OAK TREE . • QEV TW 114".07 (NA � OUTLOT 1 9 I I 4.229 ACRES 2.780 ACRES 00 " 164.226 &F. 121011 SF, i I hl COT 1 I ( 2011164�S f. I � � r PON A � � / o � AREA. ' / � • ��� `�� �� I ;.. ELEvAT10Ii•BBB.O / `_._..._ i s 1.001 ACHES 2MI ACRES ` .�` , 87.166 Sf. NI 87 .00 S.F. '60' j , 10 I ''�- 7 I g 7C 2331 A cor z CRES j J c ( 1,a2a� S.F. 1 , II , j_ �I f / I , cs 2031 ACRES 686494 S.F. ry`A r � Pc 4 \ \ 134,4,9 &F. / ' �. \. 2.004 ACRES \ 67,2114 S.F. \� `\\cam \:\ LOT 1 10 7 ,� / I /;� 1 l ob S wool _ 1507.66' \ , ' �/ S 1/ CORDER ' Jrr ' N 89"W 24" E 264W SECTION 9 �\ di \ ' © I ' ` (+S el?'6Jrasr c ?6/sJl'I s T26K RIOW \ , { ,/2•,002 ACRES WMINWI co T• ♦ 87,220 SF. IRON PIPE �I U\RA LAND . �. \� 1 1/2" . x 3.66 //LINEA PIK SET AT ALL BENCH h1 �y/ / / I _ WILDING SE 1 1 TOP OF 1 i/4" RON PPE • . i OTIERWISf ! - ¢E\f N� AT�40Y7 j i ®EXISTING Yl - ------ - - StN ?J _ -;� _ •• - - S 43' 330.5 6" W - k - - - - EXISTIN0 n f Jp \ — ' PROPOSED 17 1 5 I 4 �/ \ �`' J PREVIOUSLY 1 rf nvrp cre r&w Safety and T n Cou ` m m 201 W. Washingve; P.H.8dz�162 y , ( l� �scons�n Madison, 3707 - 7162 Sani ry Permit Number (to be filled in by Co.) Department of Commerce (60-311 ,: %iii ? 6 c� Sanitary rmit A licati n State Ian I.D. Number I'3' PP IROlx couNr In accord with Comm 83.21, Wis. Adm. Code, personal informatio you PY0o kCNG OFFICE may be used for secondary purposes Privacy Law, s15.04( ro*ect Address (if different than mailing address) I. Application Information - Please Print All Information Property Owner's Name Parcel # pC C f # Block 62. , :�� Property Owner's Mailing Address ' f Property Loca�t (s v' � - � /., / ' JC: V4. Section City, State Zip Code Phone Number t / . circle N 4 i " ! T C. N; R Eo II. Type of Building (check all that apply) A l or 2 Family Dwelling - Number of Bedrooms Subdivision Name I CSM umb ❑Public/Commercial - DescribeUse To 7 Q 7- 78 � ❑ State Owned - Describe Use ❑City _ ❑Village Township of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) — 0 A. kNew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal �^ ennit Revision List Previous Permit Number and Date Issued �.J" ❑Change of El Transfer to New Before Expiration Ilk Plumber Owner c,/3 �J /_ Q _ 6 IV. Type of POWTS System: Check all that appl tkNon - Pressurized In- Ground 11 Mound > 24 in. of suitable soil El Mound < 24 in. of suitable soil ❑ At -Grade El Single Pass Sand Filter El Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter Leaching Chamber Dri Line Gravel -less P'pe ❑ plain) V. Dis ersaL/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (st) Dispe al Ar roposed (sf) System Elevatiop CCU 10 S 7 O VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New I Existing Tanks Tanks Septic or Holding Tank O 0 Do Aerobic Treatment Unit Dosing Clamber G® -� c VII. Responsibility Statement- 1, the undersigned, assume responsibility for i tallation of the POWTS shown on the attached plans. Plu r' a e rint Plumbe ' gnatur MPRS Number Business Phone Number /' as a3.s �.� - ad ocl 6? Plumber's Address (Street, City, Slat Zi Code VIII. ount /De artment Use Onl pproved ❑ Disapproved Sanitary Permit Fee (includes GroundwateiF Date Issued I Is mg Age Signs a (No ps) Surcharge Fee) '0 ❑ Owner Given Reason for Denial ALP IX. Conditions of Approval /Reasons for Disapproval Attach complete plans (to the County only) for the system on paper not less than 81/2 sit inches in size SBD -6398 (R. 01/03) COMBINATION SEPTIC/DOSE CHAMBER TANK & PUMP SPECIFICATIONS PER COMM 84.25 CODE CHANGES 2/1/2004 Access Opening, not top of cover, Access Opening, not top of cover, must adend to a point no greater must eidend at least than 6" below Finished Grade 4" Above Finished cede . v /A r, Cover with W&A114 Y E L � l — 3:4*lkie– Locking Device �� b� 84y a (typical Finished Grade jZ .M /N'//7t dm 5EVdE"1L Min. 23" 3 FT >41 .� Access Opening j*M5 LA's Min. 23" Access Opening Ouha Effluent Filter j w/� ���c JrL;60 Union ,eoYEA PI R6 3 Pr Inlet Baffle C Pump 3 ",Sand ar raw- f bedd e ) 79 und4e uj i;Gh ~46 2.. /ocuer Shat, Pd Two Compartment Septic/PumpTank ( -/ z g h-A on oSide SPECIFICATIONS TANK MFR: U DOSES PER DAY: TANK SIZE: SEPTIC 19, GAL. DOSE VOLUME: ,�>? GAL. DOSE Uc GAL. (INCLUDES FLOWBACK & <20% OF DWF) ALARM MFR: k CAPACITIES: A = R /3( NCHES = L. MODEL # D11 Ll Switch type: _ B = 2_ INCHES= - GAL. PUMP MFR: C = '�, INCHES = t902 MODEL #: SWITCH TYPE: D = 5 INCHES = GAL. REQUIRED DISCHARGE RATE _ GPM PUMP & ALARM WIRING PER COMM 83.43(8)(e) VERTICAL DIFFERENCE BETWEEN PUMP OFF & DISTRIBUTION PIPE (LIFT) _� ✓ FT. MINIMUM NETWORK SUPPLY PRESSURE (DISTAL & NETWORK PRESSURE) = + FT. /-5 FT. OF FORCEMAIN x c 4 FT. /100 FT. FRICTION FACTOR ...... = + I// FT. TOTAL DYNAMIC HEAD (TDH) _ , (O FT. INTERNAL TANK DIMENSIONS: LENGTH ; WIDTH ; LIQUID DEPTH MP/MPRS SIGNATURE: LICENSE NUMBER: p� 02 D 3S E(5 ]GOULDS PUMPS Submersible Effluent Pump MODEL 3871 EPO4 & EP0 Series APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower Specifically designed for the grade turbine oil for tic enclosed design for heavy duty ball bearing following uses: lubrication and efficient improved performance. heat transfer. construction. • Effluent systems ■ Casing and Base: Rugged • Homes Available for automatic and thermoplastic design provides AGENCY LISTING • Farms manual operation. Auto- superior strength and corrosion • Heavy duty sump matic models include resistance. f e - h. Canadian Standards Association • Water transfer Mechanical Float _ File # LR38549 t Si • Dewatering ■ Motor Housing: Cast iron assembled and preset at the for efficient heat transfer Goulds Pumps is ISO 9001 Registered, factory. strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic • Solids handling capability: FEATURES cover with integral handle and '14" maximum. ■ EPO4 Impeller: Thermo las- float switch attachment points, • Capacities: up to 60 GPM, tic semi -open design with p 0 Power Cable: Severe duty • Total heads: up to 31 feet, pump out vanes for mechanical rated oil and water,resistant. • Discharge size: 1' 12" NPT. seal protection. • Mechanical seal: carbon - rotary/ceramic - stationary, BUNA -N elastomers. • Temperature: 104 °F (40°C) continuous 140°F (60°C) Intermittent. METERS FEET • Fasteners: 300 series 10 stainless steel. • Capable of running 9 30 dry without damage to —' * 2.5 .—s GPM — . ,. ..._.. _. s ... _. components. FT 25 ° z — Motor: W i • EPO4 Single phase: 0.4 HP, L) 6 20 115 or 230 V, 60 Hz, 1550 RPM, built in overload with } 5 automatic reset. • EP05 Single phase: 0.5 HP, 4 0 ..._..... 115 V or 230V, 60 Hz, 1550 ___..... _...EPOS RPM, built in overload with 3 10 automatic reset. .. 2 ..... EPO4 . .. I ..... . • Power cord: 10 foot 5 standard length, 16/3 1 - —_� SJTW with three prong grounding plug. Optional 20 0 00 so GPM foot length, 16/3 SJTW with 10 z0 30 40 three prong grounding plug (standard on EP05). 0 2 4 6 8 10 12 mllh CAPACITY Goulds Pumps C 2003 Goulds Pumps Effective July, 2003 B3871 <& ITT Industries Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 430196 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 N Cameron Homes, Inc. I Troy Township U CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: 10 6� a 914+ 16.28.19. TANK INFORMATION ELEVATION DATA 0 j jW TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. .fie Septic Benchmark , t Z.; Dosing � Alt. BM • �j Aeration � r/ Bldg. Sewer 0 Y / Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/ WELL 8 G. Vent to Air Intake ROAD Dt Inlet t B ottom //• �� l 33 ' 3 , Dosing V H$adgr /,Man. _ t a A � 3 Aeration ! Dist. ipe 0 Holding Bo S �j Fin G PUMP /SIPHON INFORMATION a .GttQ.d S 3 w/. v Manufacturer U De and St Covef GPM ✓� 1 �-�YS 2 Q Model Number � O "�� Q 3 aAl Z3 GsG TDH Lift Frictip� L s System H a TDH -1 � Ft Forcert7�in/ Len th Dia. I Dis o W II 6.r / d Y SOIL A BSORPTION SYSTEM c( l BED/TRENCH Width 4- Len th ,r No. Of Trenchg, PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREA LEACHING r INFORMATION CHAMBER OR Ty Of System: ` fj , UNIT Model Number: 12 a DISTRIBUTION SYSTEM FLength ader Dia / nif9ld Distribution x Hole Size x Hole Spacing o Air Intake Pipe(s)' t Length Dia �- / ping SOIL COVER e f x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over epth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Centerd n� Bed/Trench Edges Topsoil Yes No ]Yes ! " "' No COMMENTS: (Incl a code discrepencies, persons present, etc.) Inspection #1: / /03 Inspection #2: / 1 Location: 402 Glen Ridge Hudson, WI 54016 (NE 1/4 NE 1/4 16� R19W) NA Lot 13 ' _"�/� f�Parcel No: 16.28.19. 1.) Alt BM Description 2.) Bldg sewer length = 1 / /_ 1 `� / ,( - amount of cover = �T ��QL�I,� f� / �J� -� � �/ °, mot S� • 6tj � f�{,f�yy,� Plan revision Required? Yes r ' No Use other side for additional information. I . _ Date Insepctor's Signature Cart. No. 4D -6710 (R.3/97) Safety and Buildings Division Coun ` 201 W. Washington Ave., P.O. Box 7082 i sconsin Madison, WI 53707 - 7082 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 261 -6546 /(IV • . on State Pan I.D. Number Sanitary rmit Appl r3' PP In accord with Comm 83.2 1, Wis. Adm. Code, personal information you provi may be used for secondary purposes Privacy Law, sl5.04(1 xm) 4D Pro' t Address (if different than mailing address) I. Application Information - Please Print All Information r A P " C ::�" e o Property Owner's Name tarcel # Lot # Bloc # Property Owner's Mailing Address Property Location l Y., N F-- ��., Section City, State t Zip Code Phone Num "`1SCr ,�,_ 6 00 circle one) II. Type of Building (check all that apply) .K P,z, 5 ,�; T N; RE or W tr 1 or 2 Family Dwelling — Number of Bedrooms Subdivision Name ❑ Public/Commercial — Describe Use 7 — t ❑State Owned — Describe Use �C ❑City_❑VillageI? of III. Md Type of Permit: (Check only one box on line omplete line B if applicable) tA a a A ' p System ' ys ❑Replacement System ❑ Treatment/Flolding Tank Replacement Only ❑Other oifica n to Existing System B • ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: Check all that a 1 K Non — Pressurized In -Ground ❑ Mound > 24 in. of suitable soil ound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Disp ersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) 1 System Elevati VI. Tank Info Capacity in Total Number Manufacturer Prefab Sit Steel riber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank ^� Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for ins Ration of the POWTS shown on the attached plans. PI a (P . t) Plum s Si ature PRS Number Business Phone Number U 3 s ?is- - � Plumber's Address (Street, City, State, Z)Code) Aj VIII. County /De artment Use O l if Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing ge ignature (No S Ps) ` ' Surcharge Fee) ❑ Owner Given Reason for Denial 01 DA D IX. Conditions of Approval/Reasons for Disapproval i C "� Owl ` /�►Q ��� -�-�^� / 1tM/� 1 �.Jt f l • , Attack complete plans (to the County only) for the system on paper not ins than 81/2 x l I Inches In size SBD -6398 (R. 08/02) o � S70 so laso ,r1 le • r D � � � 00 � Sys -I� ,ate 83af-q�.z• (6 % N / ) 9st 75 Ta =9s �c 870 so ..�..� 7 Faso i i lal,a7 Il a jr T� 13-3 r a ys ee ffvPt w/ sYoi6 lMsconsin Department of Commerce SOIL EVALUATION REPORT rlvision of Safety and Buildings Page / of In accordance with Comm 85, Wis. Adm. Code Attach cornplele site plan on paper riot less Ilian 8 1/2 x t i iriclres in size. Plan must County S r G D Include, but not limited to: vertical and horizontal reference point (BM), direction and 7 � percent slope, scale or dimensions, north arrow, and Iocalio 1 nearest road. Parcel I. O I , /O�l� Dora P lease print all info ` t ` ' p tit, e wed by Dale Personal Information you provide may be used for secon � 'purposes law, s. t o (m)). Properly Owner v D p Te/e�/ / �/� i j am' 1 �., �'� Prope lion A ' � , rL /lo z 8 G .) Lot # ock # Su Vt. L l:" �j 1/4 1/4 S T N R 7 jr (or) W Property Owner's Mailing Address R` �' $ bd. Name or CSM# /90� �•'l /.�,v D.P . /ate City State Zip Code Pho a ber 11uD��� �/ s � D / � � y` !' Cily' [] Village ,® Town Nearest Road 11 _�' S ❑ New Construction Use: ,4 Residential / Numb4 of bedrooms ._ Code derived design flow rate _ CO 075 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material /pis o 4 y Y dV f�i4 Flood Plain elevation if applicable N n. General comments � ` and recommendations: T6,5 T A P Svi y'r¢ �p�Q �,� /N� ,pov v c ?A,'P 4 4 srs PI . 3 �'�fv�lMev9� /N Jt,44 41 C Gi �-�/ ,tai o Di ,�;�'vS� ? ?/P�2r•�Gr S . 0 Boring # ❑ Boring C7 ' Pit Ground surface elev. / fl. Depth to limiting factor �• / in. Soil Application Rate Horizon A A Redox Description Texture Structure Consistence Boundary Roots GP Qu. Sz. Cont. Color Gr. Sz. Sh. Eff #1 Eff#2 3 0 • ioy� ce 5 2 1 - A41 fe 4 ?-s i 7 AO PIP Z Born ❑ Boring Boring P] H Pit Ground surface elev. � � ((, Depth to limiting faclo� /O in. \ SdLAodicaiion Rorie Property Owner f K s parcel ION 0 io ' ��� / f� Page Z of 3 Boring # ❑ Boring 100 .2,Z D �- Pit Ground surface elev. fl. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPOW In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eft #1 'Eff#2 Z • rs is 3 IS # 7 •-SY/� SQL /f S/fi� n�t->c�' ctS Z 3 HE ,` t .ICY ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. tl. Depth to limiting factor In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots WON In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Elf #1 'Et742 r r Boring # U Boring ❑ pit Ground surface elev. #. Depth to limiting factor in. Soil Application Rate ; S Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fl' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Effluent #t = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L Effluent 02 = BOD < 30 mg1L and TSS < 30 mg/L r llre Department of Commerce is an equal opportunity service provider qnd employer. If you need assistance to access services or need.material in an alternate format, please contact the department at 668-266-3151 or TTY 608- 264 -8777. snn -e»o rrt R M„ r - - 9�P�9U.� v�Piv� v IA c i Y � I POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of 2 FILE INFORMATION SYSTEM SPECIFICATIONS Owner �, Septic Tank Capacity 5 -6) gal ❑ NA Permit # C� Septic Tank Manufacturer * ❑ NA IF DESIGN PARAMETERS ! Effluent Filter Manufacturer z , ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity a l P13IA Estimated flow (average) bQ g al/day Pump Tank Manufacturer 15IA Design flow (peak), (Estimated x 1.5) 1 ,cp 4LOO gal/day Pump Manufacturer P NA Soil Application Rate V gal/day/ft' Pump Model A Standard Influent /Effluent Quality Monthly average* Pretreatment Unit "A Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L ,)1 in- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At- Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA "Values typical for domestic wastewater and septic tank effluent. Other' ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank ❑ month(s) (Maximum 3 years) ❑ NA t9 s) At least once every: y ear(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y3) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA Vyear Clean effluent filter At least once every: ❑ mo l [3 NA � ❑ month(s) 4XNA Inspect pump, pump controls & alarm At least once every: ❑ year(s) ❑ month(s) c A Flush laterals and pressure test At least once every: ❑ year(s) Other ❑ month(s) A At least once every: ❑ year(s) Other. 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 of 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 any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and dispoped of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, 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. Page 2 of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(a) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the 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 soil absorption area. 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. ABANDONMENT 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 chapter 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 replacement system: 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 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. tfl�' D T alua ' a o i e ai a �R01 - 118 Tim �� /�/�1�✓ CoNS77Zt1GTI.� ❑ 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 that time. < < WARNING > > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES 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 POWTS MAINTAINER Name Name Phone ' Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name S . C k ( Cj 20t4jI Phone Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)Id) &(f) and 83.5411), (2) & (3), Wisconsin Administrative Code. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICC FORM C,4 -vim. 0 Owe -r/Buy '::s ..�....,,. Mai ng Ac d a Prol :tty A . W (Verific ttion required from Planning Department for new cons(ruction) - --- . Cit) State _ .J '�' Parcel Identification Numb IO-C �R L! AL2 Ef a,1; I P , �Crw• (° '3 ' —°�` `� cam• Prol ;try L :ica`: on Sec., T ZY N - R--LY — W, Town of Sub ivisiot I Lot #– 13 ? 9 70 1 �y Cel< stied . v ri ey Map f -.__! Volume ,Page # Wa ranty 1) o tl # . Volume Page # s Zo._, Spe house b ;yes' Lot lines identifiable ( yes O no hmpr n;. µ:.i , use and ma: atenanceof your septic system could result in its premature failure to handle wastes. P roper . + atuance cons ,ts of pt;kr l: i )gout de s :ptic tank every three years or sooner, if needed by a licensed pumper. Whit you pat into ;1 system can text the f ar::tion of the septic tank as a treatment stage in the waste disposal System. The in ra;: tarty owner .tgroos to submit to St. Croix Zoning Department a certification form, signed by the owne - : nd by a m rplumb in . ; + aumeyman plumber. restricted plumber or a licensed pumper verif�+iag that (h) the on -site wsstewater disp :: a t system ass is in +roper o {x � * Ong condition and/or (2) after inspection and humping (if necessary), the septic tank is less than 1/3 full : i sludge. Uwe the und; :r:::ii; t►ed have re, rd the above requirements and agree to maintain the private sewage disposal system with th ; sadards set f :w, hen it, sr set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. G s ifrcatioa state ;that you - r: :ptic systeQ. has been maintained must be completed and returned to the St. Croix County Zonal; Off c+ ithin " da sf the di 4: year expirat n date. 1 I SIGI AT'fJRI : (J,;; APPLICAI R DATE I (w ;) c,: rtify that alt. statements on this form are true to the beat of my (our) knowledge. l (we) am (are) the s: rer(s) of VC; a . , i.be ve, by a of a warranty deed recorded in Register of Deeds OtI`ice. 11463 ATUP + >F APPLICAI lT BATE • * *' '* Any r.' : rmation ft is mis- represented may result in the sanitary permit being revoked by the Zoning Dcpertmr. " « "« " h elude v -st li :Isis applies lion: a stamped warranty deed from the Register of Deeds offmce a copy of the c4nitied survey reap if reference is made in the warranty deed `1 2 19 6 P 109 � 7 1 6073 STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., MI This Deed, made between Gregory W. Walsh, A single perso RECEIVED FOR RECORD �. -- - -- 04/04/2003 04:20PM WARRANTY DEED Grantor, and Cameron Homes, Inc., a Minnesota Corporation EXEMPT # REC FEE: 13.00 COPY TRANS 249.00 { CC FEE: Grantee. PAGES: 2 Grantor, for a valuable consideration, conveys to Grantee the 8 following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area See Attached Exhibit " A ". N�AZ§EZ �f9 Y BANK, NA 1301 ul a Rd PO Box ��� Hud 'o , WI 54016 3'1� Sl;1r RITPrTf..�1ED Parcel Identification Number (PIN) '['his is not homestead property. 1)4) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this 10th day of Marc , 2003 + + Gregory W. Walsh AUTHENTICATION ACKNOWLEDGMENT Signaturc(s) STATE OF WISCONSIN ) ) ss. St. Croix County ) authenticated this day of Personally calve before me this 10th day of March , 2003 the above named Gregory W. Walsh, TITLE: MEMBER STATE BAR OF WISCONSIN to me known to a the rson(s) ho c4 . Qr o�ng (if not' instLffAt a gcd sagti.� . ; authorized by § 706.06, Wis. Stats.) 1. THIS INSTRUMENT WAS DRAFTED BY + M.L. Breitenstein •s _ Attorney Kristin& Ogland Notary Public, State of Wisconsin WI 54016 C � Hudson, My Commission is permanent (1i't$it; late cxorktibn (Signatures may be authenticated or acknowledged. Both are not necessary.) 2/22 / 22 /04 , �� + Names of persons signing in any capacity must be typed or printed below their signature. Information Prof es;i6fWl� �a � .p��P eu Lac, W ess zoz WARRANTY DEED STAT BAR WISCO NSIN FORM No. 2 - 1999 }J 2196P .11p Lot 13 of Certified S filed February 12, 2003 in Volume 17 of Certified Survey Maps, page 4460, as Document N . 709370, located in the SW K of the SE '/4 of Section 9 and the NW '/ of the NE '/, of Section 16, all in W, ROW, Town of Troy, St. Croix County, Wisconsin, being all of Lots 1, 2, 3 and 7 of the Plat of Glover Glen. Infotmationai Notes: The real estate property ID or plat and Parcel Numbers are 040-1064-90-000 040- 1043 -50 -000 040 -1043- 30-001 040- 1042 -95 -000 040 - 1064 -80 -000 040 - 106495 -000 Property Address: XIXX Hudson, Wiscon4in. ' 709370 VOL 17 PAGE 4460 KATR= R. V IEUff - -- REGISTER OF DEEDS RECEIVEDD FOR "RECORD 02/12/2003 03:30PM CERTIFIED SURVEY MAP COPYFFEE: 13. LOCATED IN THE SW 1/4 OF THE SE 1/4 OF SECTION AN H PAGES: 2 NW 1/4 OF THE NE 1/4 OF SECTION 16, ALL IN T28N, R19W, TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN, BEING ALL OF LOTS 1,2,3, OUTLOT 1 AND 7 OF THE PLAT OF GLOVER GLEN. — m I , , II X S W LOT 1 \ / � // �►' d ,5•�, 9 ° " -�� - SCALE IN FEET - I 21i LOT 10 ' a � (SEE NOTE /3, o H PAGE 2) 0 75 150 300 1 �I 2.358 ACRES ^` 102,749 S.F. S �1 _ ., E - - ♦�� I I� \� — 7°p -W s � 77 a ♦ F'L 8b{�N - - - - -- II 1 �� — °L- W �'� 23 8 ACRES 8 - E I- W APPROXPA4TE ri N 100,096 S.F. ,� S' DRAAFELD �N 50.31' 37" W Sp �.. �i� LOCOIrOV �� fN j8 � �fln E � / '�• ,; of z ;t m 139. � : S DI= l i p l TAAK N 4 �! b!�° J� 50, /LOT 12 3.106 ACRES NLL - S 7" W 135,300 S.F. �/ %9 r" 9� f ♦ \ IN 42.45' 00" `& ° SE CORNER \��. ♦ 21.00 �^ SECTION 9 SEC C ORNER \ till y `& / T28N, R19W r � T2 19W �� v V1 R �• 8N, s _ � 5 9 . y6�� j 2 N 89 24" E 2645.84' 0 . 8 , iw SOUT 4 OF SECTION 9 y S� L 1 /� • 5 S �� \ 01 s° 'a x \214 SF. S � s/ POINT OF �Iva"mr- L_ \ �~ BEGINNING . LEGEND �Zo � ,_, �s� � / / � '� 9M' / COUNTY SECTION CORNER MOUNUMENT, ALUMINUM CAP, FOUND. P/ • 2 318" IIRON PIPE, FWND. 4,� 1 1/41' (UNLESS OTHERWISE NOTED) — — — I p 1 5/8" x 24" IRON PIPE WEIGHING L OT 3 2.27 / /LINEAR FOOT, SET. PLA1 \ / _BUILDING SETBACK LINE, 25 SLQVEISrATIQw\ UNLESS OTHERWISE SHOW. �\ -K Of — EXISTING FENCE. EXISTING 12' WIDE UTILITY EASEMENT *NOTE: ALL IRON PIPE (FOUND AS RECORDED ON THE PLAT OF GLOVER GLEN. OR SET) ARE DIMENSIONED AS OUTSIDE DIAMETER.* THIS INSTRUMENT DRAFTED BY JEROD A. FINK PAGE 1 OF 2 Vo1.17 Page 4460 I n■ o 3� o c k . � E @ r T ! $ - 7 k ion / M ƒ/ E S 2 ® 2 k e a e - CD E a ! « B \ . § / / 7 ( % / \ § co ] ) c CL m { a d § ■ to k / m ■ e CD / §® % # co i § Q . = S 8 ƒ lot CD @ a ® CL / d Q § k � CL 2 ° M I ^ M . 3 / 3 0' - c < § \ �� _ £ c (A ■ ca 0 o 0 g 7 ` 0) ƒ 2 � ; \ » 7 § % 0 Z / 2 k / \ . �$- ƒ �§ o / k CL \ J & 7 _ ■ F t= % k�m / ƒ k k { { 0 .. m co c \ k CL A \ } ƒ 7 0 e� /m&f ± § §aim(\ § rJ&EI� -n acSCD § CD CL z CL . g &0 CD CD CD k . k \k< 2 ] /J)C \ CD t § mCn g_ CL Ca ( m 0 .00 » \D ƒ :3 &aCA � q /§m CD x 5 Er 2 aCD \ 0 e < \ $o �tA t §i �2 . : � Parcel #: 040 - 1298 -30 -100 09/12/2005 03:41 PM PAGE 1 OF 1 Alt. Parcel #: 09.28.19.1721A 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 MICHAEL A & CATHERINE A DOCKENDORF 0 - DOCKENDORF, MICHAEL A & CATHERINE A 6168 LAURENE AVE LINO LAKES MN 55014 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description " 402 GLEN RIDGE RD SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 2.002 Plat: 1639 -CSM 17 -4460 FKA PT GLOVER GLEN SEC 9 T28N R19W PT SW SE SEC 16 T28N Block/Condo Bldg: LOT 13 R19W PT NW NE LOT 3 GLOVER GLEN (2.002AC) NKA CSM 17 -4460 LOT 13 Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) (2.002AC) 09- 28N -19W SW SE Notes: Parcel History: Date Doc # Vol /Page Type 10/13/2003 743458 2434/282 WD 04/04/2003 716073 2196/109 WD 04/04/2003 716070 2196/103 WD 02/12/2003 709370 17/4460 OW 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/06/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.002 83,000 336,600 419,600 NO Totals for 2005: General Property 2.002 83,000 336,600 419,600 Woodland 0.000 0 0 Totals for 2004: General Property 2.002 83,000 0 83,000 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 o■o ■ -0 tv Z \ 7 c ■ -0 Z ° ^ 0 n e ° - , = o w , : » I E 3 # e e ) \\ - <» E 9 a' m§ o ® K � k § } § \ \ � \ 2 2 § � ƒ 3 > F E / E e > \ \ G E j CL § § � f § § n r CO) � W ° i $ & % �- z o o o ? & E E § § \ / } -4 c i § CD l< 7 , t E I @ z .. E e z ( # m o i \ \ E � )CL § g § m ° J k D -§ ( [ / } j \ B a 0 7 z o R 2 \ W i C a co CL 2 \ m � § i ! e § 3 � © a . £ { k 0 a � as / § =3 (D CD § \IMCD - CS 9 /eo§io CL m ° gym @= @ % ;£E E$ =aa )30 =0 \ i%Rp » iv CD Er a.m$ °E W CD § ® =o5. 0 CL 2 §� %C / C 2 0 \ � o � CD A LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF TROY COMPUTER NUMBER 040 - 1298 -30 -100 Parcel Number 09.28.19.1721A OWNER NAME: First MICHAEL A& CATHERINE A Last DOCKENDORF PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment 397 N GLOVER RD OR SECTION 9 TOWN 28N RANGE 19W %160 SE 1 /440 SW Line Description Line Description TOTAL ACREAGE 2.002 PLAT CSM 17 -4460 FKA PT GLOVER GLEN LOT 13 BILK 01 SEC 9 T28N R19W P SW SE 15 02 SEC 16 T28N R19W PT NW NE 16 05 LOT 3 GLOVER .002AC) 17 04 OR 400 GLEN RIDGE RD NKA 18- 05 M 17 -4460 LOT 13 19 06 . 2AC) 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit I