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HomeMy WebLinkAbout040-1058-95-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety an�o Buil,9 Divisirrp Sanitary Permit No: A INSPECTION REPORT 399493 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: Goggins, Michael I Troy Township 040- 1058 -95 -000 CST BM Elev: Insp. BM Elev: IBM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 64) � 80D 11Cb • $.3 08 -V 20 , a Dosing � t L) Alt. BM Aeration Bldg. Sewer ��i Holding St/Ht Inlet CA cm. St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD ° Dt Inlet i Septic Z Dt B n /o�.1fZ� 12. 9s•a Dosing �< <t Lt Header /Ma Aeration Dist. Pipe Holding Bot. System t e k Final Grade PUMP /SIPHON INFORMATION Manufacturer I Demax St Cover �[ �,� 7 '0 � 'q g� Model Number $ ! ' rl , I(qj.25 \ti �e b DH Lift Friction Loss System Head TDH _ Ft ASk t IV s. 'ks 2- q o p!. S` Forcemain Length �. Dia. � Dist. to Well Q ��(3o�az .Z Icy l,� 100,0 D SOIL ABSORPTION SYSTEM Qfift1WENCtL idth ILengt ` No. Of TrenchesL'l �(� PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIM S 3 v�r`� � ( 1�` 4 - SETBACK SYSTEM TO P/L IBLDG IWELL LAKE/STREAM LEACHING Manufacturg� INFORMATION CHAMBER OR 1l �Q" Type Of S stem: UNIT Model Number: It t DISTRIBUTION SYSTEM AP Header /Manifold Distribution Size x Hole Spacing Vent to Air Intake Pip 7 ry� L Length Dia Spacing 7 � SOIL COVER x Pressure Systems Only xx Mound O r At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes [W No rz� Yes No ? 2 COMMENTS. (inclu G Its- crepencies WI 54016 (SW 1/4 NE 1/415 T28N t , persons present, etc.) Inspection #1. Inspectio Location: 678 Glover Road n #2: � �? � � Hudson, i - � arcel No: 5 .1 6G 1.) Alt BM Description = S (: t'�o1►F�, lol'� = ��, � 3 L � ^ . 4 4 10 'ST 2.) Bldg sewer length = , � leb •°$ 041 ) i12 ) �,Z� $.22 11 .03" f co ver amount o co - D y � (.7) '�-uMw`u� ��� -• � � �• �'"°� 0 , Plan revision Required? � uired . No � S Use other side for additi n ation. o_ ° Z9 °Z SBD -6710 (R.3197) r l / d ate V epctor's Sign u / y 0° 1 06 Q (D N 4 0 — 0 I Vl � fA C Q C O C a Ui 0 .5 tm LO CD o fir- c o s y ° o =o c r- C m O G1 N O O m 0 O N M �° N 5m ��N Q� CL HHN i d�a� c o�v ��a� c c p.d m 3 O c s 3 0 L o> o a > m 0? .o o m s— o E c sf-oc ° c�tF 3r pa) g v v3' y cl o a !n A y d N 0 7 m m ( C m N d 9 w C N N O. O O G � m N C Q O O G� C o 0 c m E� c I o v' c � m Ecn 9 F iGsO. m 3 p o �Y �� @ 3 p 0 1 U) CL 0 o D m o m m I m ocO Eo �m m o I o j d CL y - w o �•� Ns 0. :6 c z c >cSin ~ ccm c Z c > N ~ cra�i U. c =covm ��°a ti c Dcovmma p 0 O O N N N N c 3 U y a > �i d= 6 o oDcoca 06 c o d oco av, o sN33Lcncm a� o sw�m cm d F- 0 o �' o o rin 3 E d F-!L� 02 o o y 3 cc € E �O c m m m m cnCN am 2 I am I E o o z a w a�i z v >? Q c 'o o a o rn co 0) z ~ c d . c c a N p N M N 5 N N (D c .. C 1 N V7 fr a m { N N CK C { N 2 �_ r E E � �_ L_ g c O m cc CL U) 1 U O z m z z m z N _ _ _ z I �i • .. dl — .. d — N m N m O. M 0 Y D ca c a D 0 a E 0 0 0 a h w Z LO fn t v s c w rN t N =3 s v N� J §�33 a= 13333 a= Z I •�► R c CL v CL v Iv o o z o o °o N} m N m N N o N N z � N r= o c E O =3 0 0 o m c 0 O m z c 0. N a 2 4: O d d z co o p m d o cn m O H (A I� N H I co N C 'a N N C E O L O m o l U c o m [L ° V O O y O Vl M �O Vr C N C ao F- 1 rn y a�i Y °"' c r. 00 6 O 0 LO 1- c7 c z 5 z D M O z= Y � Ul O y = 1 � M�•a � da I €a I a L: a • e� c o d d w c 0 m c o A 3 3 '0 1 3 o' �1 A 0 at 0A0 0U)0 U 2896P 637 8 State Bar of Wisconsin Form 3 -2003 KATHLEEN H. WALSH QUIT CLAIM DEED REGISTER OF DEEDS ST. CROI CO., WI Document Number Document Name RECEIVED FOR RECORD 89/27/2885 12:48PM THIS DEED, made between Todd J. Soloman and Charlene Soloman QUIT CLAIM DEED EflE1QT # REC FEE: 13.08 TRANS FEE: 19.58 ( "Grantor," whether one or more), and Catherine Goggins COPY FEE: CC FEE: PAGES: 2 ( "Grantee," whether one or more). Grantor quit claim to Grantee the following descn' bed real estate, together with the rents, profits, fixV a-es and other appurtermt mberests, in St. Croix Recording Area County, State of WiScOnSin ("Property") (ifmoae space is nee(1ed, please attach addenlftn): Name and Return Address The purpose of this Quit Claim Deed is to transfer, release and /or extinguish to Heywood, Carl & Anderson, S.C. Grantees any and all right, claim, title or access Grantees have in the following 816 Dominion Dr., Suite 100 described property, whether it be in the form of fee ownership or easement. P.O. Box 125 or Hudson, WI 54016 See Attached for legal description. Pr 040 - 1059 -60 -000 Parcel Identification Number (PIN) This is not homestead property. (is not) Dated September 27 „2005 (SEAL) (SEAL) * Todd J. Soloman (SEAL) (SEAL) * Charlene Soloman AUTHENTICATION ACKNOWLEDGMENT Signature(s) Todd J. Soloman and Charlene Soloman STATE OF WISCONSIN ) )SS. authenticated on ST. CROIX COUNTY) Personally came before me on September 27, 2005 * the above -named Todd J. Soloman and Charlene Soloman TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be 1hopUfths who executed the foregoing authorized by Wis, Stat. § 706.06) nt and ac t6ne. 1A 1,dj f THIS INSTRUMENT DRAFTED BY: * anla N. Laiso • Ryan C. Carl, Heywood, Carl & Anderson, S.C. Notary Public, State'pf *` = P.O. Box 125, Hudson, WI 54016 M commission ' e 11/02/2008 (Signatures may be authenticated or acknowledged. Both arFgot y NOTE: THIS IS A STANDARD FORM. ANY MODIFICATION TO THIS FORM Slft,D Cp1RLY IDENTIFIED. QUIT CLAIM DEED STATE BAR OF WISCONSIN '"I1110441 FORM NO. 3-2003 "Type name below signatures. 0 State Bar of Wisconsin 2003 INFO-PRO- Leo Forma - (a00)655-2021 • ofoprotorms.00m U 2896P 638 Legal Description Part of the Southeast Quarter of the Northeast Quarter (SE 114 of NE 114) of Section Fifteen (15), Township Twenty -eight (28) North, Range Nineteen (19) West, described as follows: Commencing at the East Quarter corner of Section 15, Township 28 North, Range 19 West, Town of Troy; thence South 89 degrees 17 minutes West in the center of the Town Road as presently laid out for 1158.40 feet; thence North 0 degrees 43 minutes East for 257 feet; thence South 89 degrees 17 minutes West for 102.6 feet to the place of beginning of the following described parcel which extends for 3 feet on each side of said description; thence North 0 degrees 14 minutes East for 238.3 feet; thence North 79 degrees 32 minutes East for 104.7 feet; thence North 0 degrees 36 minutes East for 151.0 feet to well and cistern measuring 25 feet by 20 feet which is also included in this parcel. St. Croix County, Wisconsin. • Sanitary Permit Application Safety & B uildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. Nvisc®nsin See reverse side for instructions for completing this application PO Box 7302 Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x I 1 inches in size. County Stag Sanitary Permit Number ❑ Check i u ipn to previous application State Plan I. D. Number 5 A I. Application Information - Please Print all Information Location: Property Owner Name Property Location _ Gt w l ^,, L P&4, I / '' [ �'! Z d- Al � S tj T N RI � G[ I- f �O u hf 1/4 ,Z� *-�o ) W P roperty Owner's Mailing Address' 7 Lot Number Block Number r P -Ge Ge ' ,° nS o /U Gtl �'h I/ $T C49ax pO' City, State Zip / Code one NuQQVRTY Subdivision Name or CSM Number C") ne l 0 N `l"� c G Y ` II. Type of Building: (check one) ❑ City ❑ 1 or 2 Family Dwelling -No. of Bedrooms: ❑ Village � Town of ❑ Public /Commercial (describe use):_ ❑ State - Owned 7'1 X Nearest Road Parcel Tax Number(s) U q 0 _I 0 S fi,_ys O D III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) / L z 10 A) 1. ❑ New 2. 2LReplacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System B) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) IRNon- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: S o s 1. Design Flow (gpd) 2. Dispersal Area 1 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation y ' 1 00 / VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass tp - 44 ✓lj�ki. -ed New Existing crete structed Cdr , t«.kt 14,V,,k Tanks Tanks Septs( 1 -- ► !goo, w eSer c a ❑ ❑ ❑ ❑ I"?,) Vy P 11 0 0 — I I o o ( [ t ® ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (print) Plumber's Signature (no stamps): MP/MPRS No. Business Phone Number P,Veeti Hui ?861( .�� W,4V 2;U O? 3 ?t5- 273 -6 ?Co Plumber's Address (Street, City, State, Zip Code) Wit g o 0SN 63 Retd v4' L-t 5�Y003 IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Ag nt Signature (No stamps) ,C Approved ❑ Owner Given Initial Adverse Surcharge Fee) Determination lZZS, X. Conditions of Approval /Reasons for Disapproval: 1. Effluent filter to be installed: Aik maintained per manufacturer's recommendations. 2. Property is zoned Ag residi tvi l - only one principal dwelling is allowed on this property. The existence of a two family structure is not permitted unless the structu I receded the St. Croix County zoning ordinance. The approval of this sanitary permit does not conclude that zoning compliance exists. 3. Entire chamber must be inF' led in natural soil < 23 inches below grade and there shall be > 12 inches of cover over the system. SBD -6398 (R. 07/00) a RESIDENTIAL APPLICATION CONVENTIONAL SYSTEM 900 GPD INDEX AND TITLE SHEET OWNER MICHAEL GOGGINS %PATRICE GOGGINS ADDRESS 1210 HALPIN AV CINCINNATI OH 45208 LEGAL DESCRIPTION SW 1/4 NE 1/4 S 15 T28 N R 19W TOWNSHIP TROY COUNTY ST CROIX SUBDIVISION NAME LOT NO, PARCEL ID NUMBER INDEX AND TITLE SHEET PAGE 1 CROSS SECTION & PLAN VIEW PAGE 2 J. 3 PLOT PLAN PAGE y TANK CROSS SECTION PAGE S PUMP CURVE CHART PAGE 6 MAINTENCE PLAN PAGE 7 DESIGNER DARRELL HUBBELL LICENSE NUMBER 221073 SIGNATURE PHONE 715 273 -6360 DATE 7/30/01 CONVENTIONAL SYSTEM MANUAL SBD- 10567 -P (R.6/99) Pt A N V I Ew 4 SId c R. Se C WS" hR 2 Uj ? S� T2 TI -�-z Foy CoLO pyp�y tt /� Cs�ar �ww soft s Elul 5 bob" ' d..f o Au nAd� bpi Tim w�i 041 4 yt TaMN t�M•3. Una" bnow C x *kt r. , t t r v c n Ve4 came V o l vme a$ CAci"1 -f s) v" &'f a�' x,w«1`cy (o cu ydr qoQ �,!/ V Skb, 2 Ci y` •.S Gt® 6 �` Gct� a n ha fP t vPc , y o L 16 d o 9 �,g // q Ckd� ' a�vPc✓c ws.rsn l DG 0s g/ ct f- /7• S /v h r -t- r kewcA PLAN V I Ew aNd R���� C tt Secriert 7•s' q 3• -- .--. _ o T . T �f e�.N�r. crrw.ww ��S `• ' ter'.. I� o � s +`' 1r11rM ---r ��� MA�IMaQ� : r li�lrf suit � �Ai�M�� L1r1�r/NMW tJwlNr���Mr qv le 7 1 4 t a� + :� 0 AW v *Mgt Z t job 3ff Ec a � VA — v. � l � � � � �- of - ICU . a � f: 0 N t SEPTIC TANK E PUMP CHAMBER CROSS SECTION AND SPEC IFICATIONS.So-rj 7 v" CI VENT PIPE 12" MIN. ABOVE GRADE E WEATHERPROOF 25' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE. WITH CONDUIT MANHOLE COVER W/ PADLOCK E FINISHED GRADE f ---- -- WARNING LABEL n MIN. H � C • I. Ce6Egiiunoti! 29" IV IN. fifE �'' t8 � MtM• INLET I' WATER TIGHT SEALS GAS- , TIGHT l `vAPPROVED FILTER JOINTS SEAL ; JOINTS WITH APPROVED Z4hGL --�— w ALM APPROVED PIPE PIPE 3' .� ON 3' ONTO ONTO SOLID C SOLID SOIL 501L PUMP OFF ELEV . FT. -}— OFF D 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE TANK MANUFACTURER: Wt'f COyGkrt NUMBER DOSES PER DAY: S TANK SIZES SEPTIC 00 GAL. DOSE VOLUME INCLUDING DOSE GAL- F LOWBAC K: 2 /.Z. L GAL . ALARM MANUFACTURER: roh CAPACITIES: A = 2575 - INCHES =9 CAL. MODEL NUMBER: SLOE TM ! SWITCH TYPE: r►�cr�drl„r, B = � 2 INCHES = CAL - PUMP MANUFACTURER: Zoeller C = 0.5 INCHES = ZJ� AL. MODEL NUMBER: SWITCH TYPE: D = $ INCHES = 200 GAL. REQUIRED DISCHARGE RATE 2fr _ j eim PUMP E ALARM WIRING AS PER ILHR 116.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE . (it !FEET MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . �— 'FEET * 00 FEET FORCEMAIN X 1. FT/ 100 FT. FRICTION FACTOR . !FEET TOTAL DYNAMIC HEAD = FEET INTERNAL DIMENSIONS OF PUMP TANK:' LENGTH; WIDTH DIAMETER 00 9 4L LIQUID :D�'is°t`H SIGNED: INCENSE NUMBER DATE: �: Page goeir wa- 7/8 6 1/4 HEAD CAPACITY CURVE _ 30 MODEL -9e'l' 4 5/8 3 5/8 s 20 o + 0 o to 4 3/16 i 2 0 5 1 1/2 - 11 1/2 W1 T U.S. GALLONS 10 m . !o ao So so 7D so tJ1ERS 0 10 too 240 7 g T0H ao �� F" "ons Me a- Liles s ,a iz to n eenrt, 4 3/16 1 CONSULT FACTORY FOR SPECIAL APPLICATIONS • ElecMW albrreators, for dupbx system are aysaieble and. Varlabb %vsl dW vMtchos are ava bble for aonlra ik Ole suppled with an alarm. and ft" phase systems.. - Madm ioal afternators, for duplex system, are available Double p;Wbei* variable Wel Aoat arr MM ara SMAIMble with or without *term sw)td+es. for vwMft level Wq cyde conbvis. StarlelaM alit lessdNs - WeWd 3s Na. -% N.P, 1 M aa.1 ap.wrrd 2 pox seAleh, nn a,daneel aeNflal 2 Oboe pWjbn * vMbbvtl4e. tsrpd�areoub4o�6.ekvaArealavel, lose" e:errol aabes" foee ndd L Rder b PM04 Modal VWW^ O b 3. Medor" aMe I Al "72 *r 100075 we 115 1 Adu 94 iat1A7 -- 4. 6w V* 0712,baorArdngdddB*oMndAMx%d r. 15 4 S Cw *W see * 10.0215 o d. as a oDI1ti01 aollribr, opeft dovW (3) or (4) on me 1 Am 4.7 1 ar t a — e. Fo1rN � 1�ak J vA dio�► 6mc.lbr�alwtlehtoaww:eatarv�ed•N EM 230 1 Non 4.7 2or2i8 3w465 dnp1*xa**MopaaAb00-0002. 7. 7iao (2) tax !Pak. toti1A11etaaAe oornecyou a aplos. CAUTION Fmsd rw vtsddasr 2odr }eedsetiwAet ataYoO as Vaiik taal rlrioMsl, AN iadeN.. of otelI I pobdhm etselees asd ebb# der/ M deas by a lWlMd aw77 leee FMWAk rlV9wAaLFea W. eo«a.r. t Aa.r»wrcae..r.:reboea , sMwNe . wwwnadwww.■o.e 8kprtPlgleBl�dwPY�nPCpMIa1 ,fM1�A1�nSyMl�ftlO/J2. weMlNsWnsl6tebfeeeds plEC) aa/ 1MOarp6onslsM�sadINe11A 11et�3 • f • RESERVE POWERED DESIGN For unusual eonclMons a reserve safety fader is enginsered Mb the design of V4QV Zoeper pump. .� �b � TeL PA. i01f 1a3i7 , ` Lawn IM KY 402144W � � arrTir: 31MCaasAlwRoaO raldl�ll lf1'402r1•f001 2LwffAmwAar WON .rra .ae J AW11 r Pag : SYSTEli.MANAGEMENT e � og Management and maintenance of this system is critical to its proper operation and longevity. The system owner must be provided with a complete set of plans including the management section. GENERAL Proper functioning of any type of on -site waste disposal system is dependent on the amount of water entering the system and the qualit? of the water. The lower the volume of water and the lower the level of contaminants, the more efficient and longer lasting. the system will be. Typical system components include a septic tank settle out and break down solids, an effluent filter at the septic tank outlet to filter out small particles, a pump tank with an- effluent pump and controls and an absorption cell to dispose of the water in a manner which will protect the groundwater and public health. RECOMMENDATIONS 1. Install water saving devices when and where possible. 2. Repair any water leaks as soon as possible. 3. Do not pour greases, oils, chemicals such as paint or paint thinners into the system. 4. If you have a garbage disposal, use it sparingly. 5. Do not dispose of any paper products other than tissue into the system. 6. Try to avoid excessive flows of water in short periods of time. Spreading clothes washing throughout the week is recommended. MAINTENANCE I. The septic tank should be inspected by a licensed pumper ever7 three years or less and pumped if necessary to remove solids and scum. 2. The effluent filter must be cleaned periodically to remove any accumulated particles. It should be washed back into the septic at 6 month intervals or as per the manufacturer's recommendation. 3. Periodic inspections at the observation pipes should be made by the owner to determine if any ponding is taking place in the absorption cell. Also check for any seepage to the ground surface. If consistent ponding or seepage is noted, a licensed plumber should be contacted. 4. This sytem.contains an alarm which must be installed on a separate circuit from the pump. If the alarm activates, minimize water use and contact a licensed plumber immediately. CONTINGENCIES Monitoring of the volume and effluent quality may become necessar7 if problems develop. Monitoring must be done as the requirements of COMM 83.54(2). Pumping and disposal of wastewater by a licensed pumper may be necessary while analysis and repairs are made. I. Failed mound systems may require removal and disposal of the existing sand fill and replacing it with new sand or installing an aerobic pre- treatment unit to reduce or eliminate any clogging mat that may be present. 2. In- ground soil absorption systems or at -grade systems may require the installation of an aerobic pre- treatment unit or replacement of the system. Additional site and-soil evaluations may need to be done and additional plans may need to be.prepared and approved by the Safety and Buildings Division of the Department of Commerce. yviammire Depewanwd of cenwmm SOIL EVALUATION REPORT P.ae er Z DlvYlerr of aefely erta pttlloMpe in aaaoreann Wth cow 4& ims. Aden, Coda am* ST CR,p► � mean aemptaes. rte pion 041 aep.r nm Isss loan a 14 1 11 Inches In also. Ph" nam IreeitrAs, but noe 1lmfted to; veRlod and horRanMI m%rann Print (11M. d1redlan rand Fie I.D. percent slope, mWe or dlmmolorts, here+ avow, end location end distance m neens road. 040- l0SB - RS -000 Planter Pdfit all /nronnelldn. RwAmwad by Deft PNMMal Inleenatlerr Ma rxe'ads ffm as used IN awwwwy pwpeees ("Now Law 0.16.04 11) Ge P ownef MIC,1r1AVt 4 MA04 126MC MS rtyt,,ovtlen Ppmpu Gtx aW 6 W 114NE t N 8 15 T 2.4 N R 19 IbM W PR*wly owneft MAamm Address La 0 Elloair M 8ubd. Nsrne r Q" eteto C ❑ Wage own Neeroat Road rAlt:, - t I 1 bH 1 462oRti I GLUM RA• Q Now Cansbudlw UseJa Realdaedal / Number of bedrooms .. _ 6 Code derived dulom Now rote 'Ro _ GPO ❑ ReploOnWI ❑ PuWA or commercial - Da&~. Peferw malarial nLrM%*a Flood Pleln sievellon If applicable Ali' R. t3elwsi com" 0 and feaornrnendaNa►a; ya- 6RDI.LND I:ANV�At'I1o�1�1L TR�NdMFS � 1�.S14N 8y M Pr4Sr L� .J °ori" # � P Ground curfew slev. t+. Depth to llmieng fame' L52 _ In. sow tarn Rero Mw1 on Depth Dominant Colo Redos Dwcdpdon Texture Sbuoun Canelatence Boundary Roofs 9P M. Munsell Ow, Sz, cone. Color fir. sz. 8h. •sffp7 'Ef1A! 1 0-10 14,1R. 1.Z'✓ Z - io a a/ — r 1. Z ✓ 2 � y - Vt. 0 - t~ 9 . 5 6A. r 4 - Wt d�P N p Wn a ❑ jolt Ground suAeee oiev, fl. Depth to flrnitft, fads __ M. Sall AMoallorl Rau Horizon Depth Dominant Radon DesarlpW Teutum atruehre Carlsidence Boundary Roofs WO In, Munsell ou. Gz, Cann Color Or, 9z. 5h, 'EtlMt 'ENff2 AL L 1 ;fIM�aM #t BOp a 30 w Zoo nryL end TSS >30 1 t10 rr>dIL m &fflluuW #2 ■MOD l� < 3e nglL end Tss S 30 mp CST Name "M t3lpne Q NOC.�(J(l/�� �. N �� H s i� Addraas Dole Evralustien Cortduded TaNplrarre Number W1175 1,9e"Ave, 'Rtt1E L S wI 5Motz IO�Z4 -01 '7t5 1416 -1-175 �. S 16 T N 02 PJAIL MWO OF TKQy St tR01 tO1[eii\L - ova Nju AM NO COMM M 9-VACK MOUMA5 WELL ? cc, i P90PERI'4 ADOOSS : wit a /.eV Ht 'PLO- 4� 1 1 � A r� Z 1 1D Z � EV MIM d', .0 ILDL SEC.1 5 d or ZL49 PAZ-, 00- CA Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85 Wis. Adm. Code County sT Cko\ 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. Nib- ot56 (j5' 60 Please print all information by Dale Pemonel irtlormation you provide maybe used for secondary purposes {Privacy Law, B. 15.04 (1) (m)), Property0wrler t) T T2tCE 60QGW5 Property location M IctAAE - L tr� 60'6rotN.S _900_L•ot • r 1/4 114 S 15 T 2% N R 19 ><W Property Ownees Mailing Address Lot # Block # Subd. Name or CSM# 1- H At t ij AvE- - City State zip Code Phone Number ❑ City ❑ Village Zown Nearest Road � =ruC{►�r\1!+'� OH 452t7� ( ) — �� �..tv�.RY.r�, ❑ New Constrvdion Use Residential /Number of bedrooms.--. Code derived design flow yefe � _____ _ .___ GPD Replacement ❑ Public or commercial - Describe: Parent material _ (A1A). --S Flood Plain elevation if app'dbls` i01 , __.._ _ - R• General commerrtS and recommendations: SN)- t "s20tlaD CoI��6►�ftON�tL �CZ>rNCt�ES i - -, ? E] Boring Boring q Pit Ground surface elev. �i. W ff. Depth to limiting factor FE ' �$ Ins r , I s App lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIT in_ Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eft#1 `E(f#2 LS � nmhK MJ .t^ -M . a r 2✓ I 2 -/ Z r n -_ abjK "7 ( 2 _ 1 2'} 0 .t2 rnSb 1Pt �'' S - 4'f p, Z7 t( 2y 3(p W y — Is \ M sbi t1)�r° OL s \u�-•C D 7 i. 2✓ 15 �► ro�.� ass iv�--F D.'7 !, 4 10" .H 1 .5 1 1 m5bK I l w& I Cf, 0. 7 5� -t,s rov �5vi�l y si IMSbK rJr� Boring Al C] Boring {03 �$ U 19 Pit Ground surface elev. ft. Depth to limiting factor S in. Soil Applicafti Rate Horizon Depth Dominant Color Redox Descriptlon Texture Structure Consistence Boundary Roots GPD /tF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I 'Eff#1 'Eff#2 \ 6 -14 jow IS I rr\5b rr \4Y- a-b Ak a� I it 3 41— 104 W 8 O m l C! -c Ti - tr i A -1, 4 wi /t q It Ts OAN MI — o. (ii s w�afc�. � inn Effluent #1 = BOD > 30 < 220 mglL and TSS >30 1150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 3 mgA_ _ CST Name (Please Print) I lure CST Number Address e Date Evaluation Conducted Telephone Number -7T5 VJ"7" 69 *\A -. �oVEK FALLS stir W2Z Property Owner Parcel ID # 0 0 — Page Z _ of , Boring y t he g _ SoII Ikation Rate Boring Pit Ground surface elev. �1 ft. Depth to IlmfUng tailor �— In. Horizon Depth Dominant Color Redox Description Texture Stivcture Consistence Boundary Roots •Eft#1 *Eff#2 in. Munsell Qu, Sz. Cont. Collor Gr. Sz. Sh. r I I 0 - 1D 10`1 42- �3 ti r 2. 10 - IoV2"'j3 r 1 S S K s CS iC-co O, rM s G15 Jf m m Boring p Boring �( pi Ground surface elev. __ ft, limiti . Depth to ng factor In. _�__ SOp lM,atiort Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots -Eff$$1 'Eif#2 In. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. L D\ 'C PtS rrO COtJV E1J T t o lJ L� S [] Boring ❑ Boring a pit Ground surface elev. _ ft. Depth to limiting tailor - in. Soil ration Rale GPD/PP Horizon Depth Dominant Color Redox Description Texture r. Sz ure Gonsistence Boundary Roots Gr. Sz Sh. 6 0#1 1 °Eff#2 in, Munsell Qu. Sz. Cont, Color ° Effluent #1 = BOD > 30 <_ 220 mg1L and TSS >30.5 150 mglL ' Effluent #2 = BOD 5 30 mg/L and TSS 5 30 mglL The Department of Commerce is an equal opportunity service provider and employer. if you need assistance to access services or need material in an altemate format, please contact the department at 608 - 266 - 3151 or TTY 608 264 - 8777. ssoa�uo ts.arou� PAGE 3 D�,� t;Ot'�tz1Y OWN�tz; Ga G��as, M icw{e L l,t;GENn, f � 1 410 1 CeL LOC - MD IPJ -TOE' [3M° - IL N 1 A (ME T W 51P- C. 1,5 TZS� 5T 3 �T. [' e z- NAI u e y ou Io .zq -5OL PRING W/ PA CM NO COMM 83 5ET ACK p120[ EM5 Weu. ? 1 KDPU" NoOvvss : 6 C�l oV EK Qa. $ I ti 1 ti N JS� jo� 3 a Y 1 Y 6 3 $184 !'Z+COT fl►�E y J� Gt- 46-K f PL 1s 51CUP C5t MdAU Z2-LA N c PATE: 05- 1 5 -01 ST C ROVE COUNTY S> C TANK MADIrZNANM A AND OWN EMV C MTMCATtON FORM /�1 `C h e C /Yt a ;l o-, S wing A&IMM / 2 t 0 !� a ��'n Avg°.. _ e ,'h C. T�' op praW Addrm G ? g �'Lo tZ� �i.'c ►' Fzt t �S w r , S�Ga22 w• w �■�e ■w.r lNwl0C*dM ... (,I,-1 PsrW IdeWficafim Numb& ©go — IOSV - sus pmp�y Lo=dM SW V4 !��.. Y., Sec. , T1 W RI�Lw, Town of r° ' S abdkWian cetMed Suva WLMP d Voh=e . - Pw # IJ! 1N-- —. Deed N �01 � �1 � V,0hM „■ � 75 # S7746-1 1 316 v yo Spec bom D yes Qua Lot &a ideodfabb O'yoe ❑ no �mpco petuueaodoeofnr�apti�sacaa�idini�t ll otp wpft *ago septic unit CM7 am rM a tooam it nsededby a Roeaaad gmrner. VI.W 7m iO W tip " om saw tha fMdM of the septic tads m a t:atmant ssipe in do vu" d w"d now= 'Are p"atr aws r av — W a*@* b St. Csat ?A ft Dapu mog a m fmM by dw *uw sad by a masterplssbe�) oomaeymas plumber. reaenatadpi�aaaberaraiica .redpmpee*ad 6 system is ptopar apacatieg oosdidm gmNo M after WVoc(an sad pomp*g Cif Y)•'W 2PPdC task is lm &m U3 felt of aiodge. gg U t fire mb, as ed Id a b try y g m the above Comma= ad dw Depsrtmaataf Remww% � Of Wiaoaoeife. � i�, b that poor septic syMn is been maiataioed most be oomepWM and =mud 0 fire St. Crok Coeioly Zamiop OMM wdl�da 30 dada a!' dreee dL �lA DATB i art am at+a tlra awam{s) of i (SO am* that an atatammats as fin tam an un to do my (aft) la�oiri 4l& ( ) ( ) dre pt�oparty abawre. bx vhme of a wunaty &od eeooalubd ' of Deeds Ofoe. DLM ANY iafaao�ioa � is - n >� b� nv�o8nd by 6a Zaaiog - """ loch s VAth tide appUau ISM a sbmped •mcmats deed & to Ragbw of Deeds a ice 0 copy Of 60 oee68adamrnsy man d W&rra Mil mane ft ft �7deee . , � .. • G'o GG hs Fa �,, c y T <� sfi � i a— �Se ac�Hr! as 7 all f 226 C i 0 2�6 e , a y � SE / F I�2 226 A pot 1148/347 22 6 LOFT A 0 226 \ lk 17saa 227 N 226E 12 . 226 227 - 1106 --- L45 i r l S• la • �`3 1 2 � co County Sanitary Permit Application ST. CROIX COUNTY WISCONSIN In accord with 15.04 St. Croix County Sanitary Ordinance ZONING OFFICE Personal information you provide may be used for secondary purposes ST. CROIX COUNTY GOVERNMENT CENTER [Privacy Law. S. 15.04(1)(m)) 1101 Carmichael Road 1 ADP fL��S : ( (g C LOV6A Ip Hudson, WI 54016 -7710 (715)386 -4680 Fax (715 )386 -4686 Attach complete plans for the system on paper not less than -1/2 x 11 inches in size. Coun oQ tary Permit # ❑ Check if revision to previous application 1. Application Information - Please Print all Information Location: JJIF Property Owner Name �j (1.f �r1 n 1 /4 N E' 1/4. Sec Ste' \L L t VMl 60G � T 2$ N. � R E(or)� Property Owners Mailing Address Lot Number Block Number 210 4ALPIN A0)6 � City, State Zip Code Phone Numer Subdivisionme CSM Number C NC /NNf}T1 O N �{'SZD$ t /A1(r� P A - (Z(-&L— U;* V 1 Type of Building: (ch ck one) ' ❑ Village own of R 1 or 2 Family Dwelling - No. of Bedrooms: ❑ Public/Commercial (describe use): D ❑ State-owned NT ` Road R D 11. Type of Permit: (Check only one box on line A. Check box on line B if applicable) � Parc el Tax Num r(s) \% A) 1.8 2Repair . ❑ Rejuvenation Sanitation 105 B) Permit Number ate Issued OL State Sanitary Permit was previous ' sued 39 °� p�2s . Type of POWT System: (Check all that ap C9 Non - pressurized In- ground ❑ Mound C d Filter �❑ cted Wetland ❑ Pressurized In - ground Holding Tank n ass ❑ p Line 0 At -grade erobic Treatm /Unit rculating Other V . Dispersal/Treatment Area Information: s p D I ZrA M - 0 1. Design Flow (gpd) 2. Dispers*Area 3. Dispers j oil Application t . Percolation Rate ystem Elevati Final G de R uired l 1900 t,� e eq Propose als. /day /sq.ft.) (' (Min.r ) v , . �'j Elevati Tank Information Capaicty in Gallons Total of [N,Manufacturer refab to Steel f - P 'c New Existing Gallons anks ate struct 6 gla Tanks Tanks SG�2 c. r ❑ ❑ ❑ w t�� � ❑ ❑ N. Responsibility Statement 1, the undersigned, assume responsibility for r ir/ reconnenction /rejuvenationCnstalla of non-plumb' for the POWTS shown ed plans. A license is not required for teralift repair or nstallation of non - plumbing sanitation syst Plumbers Name (print) Plu s S ignatur 9� 6) /MPRS No. usiness one Nu Me �W 2-10 f3 Pkimbees Address (Street, City, Stat ip Code) Af O USA A 3 St✓LzeNV i L L b-) r ./ 4., 11. County Use Only proved Sanitary Permit Fee ed Issui nt Sig mps) Approved en Initial Advers Petermination 5� ' LY 1 9 IX. Conditions Approval/ 1: .� SYSTEM OWNER: ' 3) t s /\.GBU.KQ_ N" � 1 Septic tank, effluent filter and t`S r _ M dispersal cell must all be serviced / maintain - t °'� as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. d.�l t� d . t -_ � � 1� /~ l V �., _ '� y ..�! 4 �'` � �� .e � ... �,,,.s t. ' J" �. �' 4� ' � �., �' ,' 1 i t a ,�P �. t �� .. "i • � � . � � }. d , �� � •,,,�+, l , ; , , '� R �� � w � �" 'w <.� . ., r T Pe F V o/ e v Cl s age°` v �t 0 L l i fm = �, a s s K � 3 #� a 3 Et t o3. �L 97ct� FL Gr lea I ow red 13 ash a F= 6 0 yt 'h s a 0 C-4 226 C i N o fi f6 C C4 I - e W � f i 127` 1148/347 ��WK�' • OD G oU .� H N e s .00 1 ot.Sr , ` gox "226 �► 226 �- 12 226 D 227 1106 ~!— Safety and Buildings Division County �7 201 W. Washington Ave., P.O. Box 7162 S7 C � 6 1 VVisconsin Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled ill by Co.) Department Of Commerce (608) 266-3151 - 3 j / Sanitary Permit Application State Plan I. Number Comm n accord with Con 83.21, Wis. Adm. Code, personal information you provide AA may be used for secondary purposes Privacy La Project Address (if different titan mailing address) FIX asn ED 1. Application Information - Please Print All Information / / - / et f 1-, - e e �o'O r yt f (o l G zo� led Property Owner's Na me reel a Lot N Block # �t'Chri eL VY o Property Owner's M ailing A ICE roperty Location 7Z0N1MG0 City, State r� Zip Code Phone Number 'A. %,Section /S one C t`'l G h � r t e V � f N; It (c l a ) II. Type of Building (check all that ap — 1 or 2 Family Dwelling - Nwnber of Bed roa nts� ____� ----- _ -- , A- - - - -- »Itdivision Name CSM Number ❑ Publictcolun rcial - Describe Use Lj State Owl - Describe Use I__ICity � � I. (Village 'ownship of - Y_ III. Type of Permit: (Check only one box on tine A. plete line B if appli e) A. CI New System ❑ R System Y Pl y C) T reanne Holding Tank R laceutent Only � Other Modification to Existing System B. El Permit Renewal ❑Permit Revision , I. I Change of �: unit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber net 31 1 7 f IV. T ype of POWTS System: (Ch eck all that ap ply) )<Non - Pressurized In- Ground 1] Mound > 24 in. of suitable so" L� Mound < 24 it of suitable soil LI At -Grade I.1 Single Pass Sand Filter t_I Constructed �Ye[lancl I_� Pressurized In Growtel (� HOW 'rank U Peat Fitter ( erobic Treatment Unit t.I Recirculating Sand Filter L I Recirculating Synthetic Media Filter El Cha ] G Pi in U Drip Line L ravel -iess I I Other (explain) V. Dis rsal/7 reatnuent Area Information: _ _ __ - Design Flow (gpd) Design Soil Application Rate(gpe4s Dispersal Area Required {sf) Dispersal Area - olwsrcl (sQ System Elevation yea .S (00 1l bob qq — rOt VI. 'Cartk Info Capacity in T Number Manufacturer Prefab Site Stecl Fiber Plastic Gallons G as of Units Concrete C o eructed Glass New aisrittg Tanks < Septic or Holding Tank V / , ,j-t_0[�ew Aerobic Treatntcta Unit t J M J iriTe '\ Dosing Clunnber E. V11. Responsibility State ;t he uudersigned, assume responsibility for installation o the PO WTS shown on the attached p Plumber's Na tree (Print) I'1 a is Si gttatu MP /MPRS Number Business Phone Number rk�� al� 21 — � 63 G•6 Plumber's Addre ss (Street, City, State, Zip Code) I �l �t o t fwY_�3?_ dQnv i e w S- vo3 VIII. Count /De rtment Use Ord L_I Approved ❑ Disapproved ry Permit Fee (includes Groundwater Date Issued Issuing Agent Signature tamps) Surcharge Fee) _ El Owner Given a for Denial 1X. Conditions of A / us for Disapproval r �� VIA- f Atktch cwnplete plaits (to the County only) for the system on paper not less than 81/2 x 11 Inches in A ze j SBD -639$ (R. O1 /O XS 7eN/1 Q�it t f j (,�� Lc'h t? f ''n° j' 7'�ryllC __.___rn_ S- YSy`�'- -- _ Jul 18 05 03:35p HUBBELL EXCAVATING INC p.1 l F ,.EPTC. SYSTEMS Darrell Hubbell - Owner r ax r L ) h9 C 0 r e174 pe-r r 7 leev +" "S O� N6490 U.S. Hwy 63 • Beldenville Wl M03 Shop Phone: 71S- 273 -6360 • Fax: 71S- 273 -6365 • Cell: 71S- 307 -1630 Serving Pierce Sr St. Croix Counties Jul 18 05 03:35p HUBBELL EXCAVATING INC p.2 a _ i,�i i , i >.:vl, jii: -a: :�". +: •,, ilil:; 111 %'�' .- 111 , :f•. t , 1 li %., - -� I� b'� !1!:I ir:l •. .i 11., '•IL• il.,r i!: •,1 �: .1. ,1 ....y,... Singfe seal De sign '� It ' I,,. i • •,.I V . {. 111'( 'td /) q S d tNK i j 1 i I S fli �._. 1_ j I I " TO h 1 , d id 11 /"'11 %► Clu •,,'1G 1 �1 A I - �alrt� j:a- Standard all nindels - 20 Ir. cord - 1'. H.P. iGI1100EL5 14t61M00FJS 1 � � Control Scicetion � LMings j �. ■,: . i 1 Double 5W 1 Vohs - Phf Mode Mips ! Simple. - Duplex i CSA UL I - i k1161 iI15 1t Nub 15.5 I w Id8 i Y N. Will N41(il :115 1 Nun IS'i 2x267 i ., or J All Y Y^' 016I - 1 2.10 II Auto l 75 .: for l98 I Y .2M 1 NMI I LS 2or29'1 ` 1x596 Y Y 3 i 6151 Edlo1 i I HIM ..- '200.211}! 11 MAt I RR ` _ 1911 .i Y N - .. `. RR 3-546 I full i W1G1 1121x)•288 111 Mtn - 1 Y N �b � ^f.: ..•__.._I_. JIGI ' J•1lfil .2002M :1' Mxl I 6,1 49f, i 394n1591i Y Y I - Fln1 F4167 1130 1! Nlxl 52 49d J941NSAft Y Y I r - � -- 1 , 1 I 1.... I 1/I - 1 , I/:' r0l • C,161 r'A IGI ' 16 '460 311 NMI I :.!I 496 38'1 A 5911 I Y Y ( 11 1;;' fall V.11) I 1 r ,�•1 Stoddard all models .2011. cord - S, H.P. .. • �.� s j 16JM0 416 mookS; Control SekcHon - Listings o �SiogkSeal DoubkSnll Wil% - Ph: 111.& 1 Amtts Simplex Duploa , CSA , UL 61163 its 1I Aldo i . 158 i IIrr IAA Y Y ! N IG:1 N41Gt 1115 I i 150 i 2or2A7 3((599 Y•" Y 1)11;3 . -- i 7jD 1 Auto 75 I w1 91 I Y Y i I9 E761 EM63 1270 li Msl i 1.5 2or 2A7 3dr5AIi 1 Y i Y i r r l 1163 -- i 201I.70fl t I Auto 1 9 0 t Y I N; ' 111113 i '9163 ;2110.208 1� 14x1 US 267 j 3x596 V N u1 i G ,�. 1 •U + 11163 J4 ICU 1200.208 31 We 6.0 i _ 4A6 3A'I or 5RIi Y 1 Y F103 l..'. (• 163 ! 7110 . - 3. kin I 411 466 394,w588 .. .. Y Y f f ' G161 'cAiw !4fi0 3j Nal 2.9 4Ati -1 394m566 i Y 51-mndatlnll models -2U 11. cord -1 H.P. 115MODELS �lltr5fA00Li5� Coldrol SeteuSion Listings Singk S& uawo Sett I Volts - Phi Nndo i Amps Simplex 011piox CSA UL j PIGS - 1 241 .. I i Mtsl ._ 102 1 oe 1 A R .. .. \' Y E 1 F 1156 113(1 1' r" I 102 2,297 3d5Ab .I Y i Y I < •J Illli• # 200-208 _ 1 I Aw j 12.6 I A 8 _ Y N Ila 14165 2011.201 11 Ain 12.0 � . .. 267 ) 3m5AH � ,Y N JI65 I 'J'11GS Z10 7 il, T f .!i 1 49 6 a&4or i :110 Y Y i i .�. r F 115 F4 his 1 230 :1 �! I ' , , _ � N .Non 7,4 4 R G 3 9 4 nr 5 S 0 I Y Y _ , , 6165 1' 64165 1 41x1 3 Non 3.7 1 4 A 6 :13 4 or f, &• Y Y I T r ! ' HA185 j ' DAdlfati j 57!• 71 Nil 3U 4a(i :1& N N 4 - _ / D ,��� M, Fa'aato Pala 7. Four (4) hole J -Pak• junction box, for walortghl torlrtrlclitln for ^ u. rwa +a uM,wrb,ala »ae'ofnrll,lalM. hartWiml � sim lee ration 1U -0W2. P H. Two (2) hole J•Pak, For W: lerlight connection or Splice, 10.OW3. 1 A CAUTION . _. _...._... . I F,r klbmrinn,ul alldAional Za.4kr prlxhu:> r rrlcr In al>.4My it Plg?rybach Vatrable Lrvtd FrrcY Ah in�ix8atinnnlcmHrol „prwrctionik vicnS alW wifiNg sholAAlMdonclwngllnlifirdlicrn ^.rA awu,:lie”. FMU47l. f_ac4iud Ahranaler, FTiWIIU; fvkxhalacal Allrrr'ald, fMU4g5; Alrmu I'.vck:l eirchieivt. All elechicalarid%ilruy ealen should heliellowWinckidin9Or.Irtosl lrcrntNalhtnal F6107:12: ros1 Slm4rl.4,:eclgr Da•An:,- FM611T Lleclric Lode INEC) mid live occuparionai Salery and itailrh AIt (I)SHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. Parcel #: 040 - 1058 -95 -000 06/29/2005 05:00 PM PAGE 1 OF 1 Alt. Parcel #: 15.28.19.226G 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): = Current Owner " GOGGINS, MICHAEL J & MARY MICHAEL J & MARY GOGGINS PKWY SE PKWY SE 1083 WOODRUFF PLANTATION MARIETTA GA 30067 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description " 678 GLOVER RD SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 1.790 Plat: N/A -NOT AVAILABLE SEC 15 T28N R19W PT SW NE COM 233 FT N Block/Condo Bldg: OF SE COR SW NE TH W 179.22', TH N 35 DEG W 144.4 FT, TH N 41 DEG E TO E LN SW Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) NE, TH S TO POB INCLUDES P227H 15- 28N -19W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 875/115 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/19/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.340 63,500 170,300 233,800 NO Totals for 2005: General Property 3.340 63,500 170,300 233,800 Woodland 0.000 0 0 Totals for 2004: General Property 3.340 63,500 170,300 233,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 0 ca 3 0 d �1 m ci V ro J Q 7 7 n N CO O. 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