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HomeMy WebLinkAbout040-1069-40-000 Jiscc*p in Departrr�ant of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 514883 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: Hanson, Douglas I Troy, Town of 040 - 1069 -40 -000 CST BM Elev: Insp. BM Elev: BM Des pti Section/Town /Range /Map No: /� •0 0 ti 17.28.19.264C TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. j 61 1 j Septic /� Benchmark S� I, // Dosing � � Alt. BM 310) Q i !e Holditon rain . . -� f Idg. Sewe�Lg0 g 5 t Inle X. o 71 St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L W El L BLDG. Vent t it Intake ROAD Dt Inlet Septic ' 1 Mo Dt Bottom Dosi ,w� Header /Man. Aeration L Dist. Pipe �� 3��� i IL Holding Bot. System / , , ' S al Final Grade PUMP /SIPHON INFO MATZO � (r�� - -Od Manufacturer 6 Demand St Cover GPM � 3 Model Number O r d 3 TDH J L4, 3 � Friction V System Head TDH Ft 0 '! m-32- crr� Forcemain Length Dia. r� Dist. to Well SOIL ABSORPTION SYSTEM - =- 7 BED/TRENCH Width Length No. Of Trenc es PIT DIMENS ONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 1 19` 1// SETBACK SYSTEM TO P/L BLD 11 WELL LAKE /STREAM EACHIN w Ma ur r: INFORMATION CHAMBER Typ f System: .� > OD I ` / Model Number: ?� DISTRIBUTION SYSTEM Header Manifold Distribution t /�, , ( x Hole Spacing Vent Air Intak f Length W Dia Length Dia SpaciA 3 VC SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only xx Depth Over Depth Over xx Depth of xx Seeded /Sodded Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes L] No E] Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 6 4o, Z 0 / Inspection #2: / / Location: 449 E. Cove Rd. (nka Meadow Ridge Trail) Hudson,, WI 54016 (NE 1/4 SW 11/4 17 T28 9 ) eadow Rid Parcel No: 17.28.19.264C 1.) Alt BM Description = � Z � 3 t(J /D s V , 2.) Bldg sewer length - 7 _ /� 3. 3 b / g - amount of cover = 7b Q u �, s 1 U Plan revision Required? � Yes o T fS in ature Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Cert. N . I T ) .; �.3 n. -, " , m -i.:. .: { •aia�:Sp * a� x:33, :, „�.f:.; Cot? merce.W1.90V Safety and Buildin ivision County / /°,Q r at 201 W. Washington A .O. Box 7162 J �' L %, /,X i co'n i n Madison, WI 53 —7 Sanitary Permit (to filled in by Co.) Llepa� of Cotnmrc:e d fJ O C/ Sanitary Permit Application State Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropria ovemtf*Ml unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned WTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information y ary u rposes in accordance with the Privacy Law, s. 15.04(1 )(m), Stats. <_1_a17Lf_ I. Application Information — Please Print All Information Prtp Owner's Name Parcel # 00 LI &O, AH SOA MAY 3 0 2008 (' /d - -yU 4dG P pe Owner's Wiling Ad ess Property Location / \ 9 Te r.� ST. CROIX COUNTY f Zt'O�C J i Govt. Lot ` y, City, State Zip Code y, S �2 t /4, Section ) ti u 001 (/�V Sl^ y!1 � l T G� () N , R / (circlE oreW 11. Type of Building (check all that apply) Lot # Pd me I or 2 Family Dwelling — Number of Bedrooms (� Subdivision Na Block # Cl Public /Commercial — Describe Use V. 3 h, ❑ City of ❑ State Owned — Describe Use CSM umber ❑ Village of ®Town of III. Type of Permit: (Check onl e b n line A. Complete line B if applicable) v A. ❑ New System y Replacement System Treatment/Holding Tank Replacement Only Othe r Modification to Existing System (explain) ad / B. ❑Pennit Renewal ❑Permit Revision ❑Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner 7A -7 9' IV. Type of POWTS System/Component/Device: (Check all that app 1 ) ;.Non- Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ound < 2J in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) lat fz 11 V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dis a roposed (sf) ystem Elevatio G o t� �'SdQ �5.�3. 99os s ZI b cQ os Vl. Tank Info Capacity in Total # of anufacturer N Gallons Gallons Units e 9 B V New Tanks Existing Tanks to / �d `^� N tc.! \!2 w tg in y rn i C7 a Septic or Holding Tank f f�1t Dosing Chamber / !i V11. Responsibility Statement -- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. PI 's Name (Print) Plumb gnature MP/ ber Business Phone Number I r Il'g Plumber's Address (Street, City, State Zip Code) V � - 7? o4. A Avg , oz� VIII ount /De artment Use Onl Approved ❑ Disapproved Pennit Fee � Date Issued Iss s 09 Agent Sjghatur ❑ Owner Given Reason for Denial IX. Conditions of Approval /Reasons for Disapproval , 3 I s w/la f� , .s •7 y - 9 k.) J9 Qys Aght 3 3 Onc' � � 5 Attach to complete plans for the system and submit to the County ofi# on 7 p s 11 inches in size Septic tank, effluent filter and dispersal cell must all be serviced / maintained SBD - 6398 (R. 01/07) Valid thru 01/09 as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. �I v fi � G�trx Y J of ly ACRES (1c -oriel- , l� J8 C�a CtVI S p j. j03, ._� t,prle�v � Ho, SIAM `5 S j r v ( x '"`5 jet.; t oo.ad o $ s ,y j rte'" tog p Bl �fMC�. {- rro IK On2r V-1 SM J03 © N40N n+ j4ouSwc. cf 17110 e / c • Q. / l � NOS 'V V c a _ F lev ; g7.SS i Tort, s e,Sld�n �, boo rte'" , OBI F e Ps- CDPer iv�t ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK Th* is to ertify at I have inspected the septic tank presently serving the � S 7r7f hS residence located at: ' /4, lc, '/4, Section _L _ ; Town 9? N, Range /r' W, Town of po , St. Croix County Wisconsin. Upon inspectio , I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of Comm. 84.25, and it (they) appear(s) to be functioning properly. Most recent date of service Did flow back occur from absorption system? Yes No (if no, skip next line.) Approximate volume or length of time: gallons minutes Capacity: a W X — /000 7Y Construction: Prefab Concrete Steel Other Manufacturer (if known): Goa Age of Tank (if known),/L Va'i �S (Licensed Plumber Sign tore) (Print Name) kas � (Title) (License Number) MP/MPRS (Date) Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer v u „ Or Mailing Address 4 j r , Property Address �;4014 f- (Verification required from Planning & Zoning Department for new construction.) City /State 1 V) i Parcel Identification Number U 46 — 1 04. q - 9-a o � o LEGAL DESCRIPTION Property Location N t '/a , �w % , Sec. 17 , T o'2!g N R 1 5 W, Town of 'T U, z, Subdivision Lot # Certified Survey Map # yg7oo� , Volume '3 , Page # L A `-> Warranty Deed # , Volume p? Page # a6 Spec house 0 ye l n?5 Lot lines identifiable 0 yes 0 no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm. $3.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Cettification stating that your septic system has been maintained must be completed and returned to the St.. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the owner(s) of the property described above, by virt of a warranty deed recorded in Register of Deeds Office. N tuber bedrooms - I I I A l 0 t>- t � ? �A � yo SIGNA OF APP ICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08105) rursuant to Comm 83.54, Nis.bdm. Code Sectic Tank 'The septic tank shelf - be maintained by an i the filt certified b service septic teaks enders. 281.48 Statr, Th . outlet � did bed osed of a ac.�irdarrce w h NR' 11.3, Wis. Ada. Code. The operating common of me pntena of the messed at (east septic tank and ensure proper opera, orr<e ever13 ye"s by inspec:ioa The nude! fire. s' .� to lined as necessary to e should not be tamoved URIeSS p rovi$i()n$ are n--.,de to fEteia 506dS in the tank that may slough off er whew removed -%m Is erg -re. 8 the fitter is eGdpped with an ' .. the Stir b s he tan the alarm fs WeSvated pry � OW 8W SePtic tanhc AM have Ss pn alay O tcste surge NOW or an � s a� The the tank. If the contents of the tank � when the vai�une of sloe MW =Un en the tank eras ds U3 the d voGrne of rgnw # O ofwhen the "A ss� b an d time d a b a SW advise ft is L The add6on of biologist o[ a b toss bran malanarrn SM and sludge *=nWa8on in . if such Waducts are used au dl8res t0 � � is geiW* rat required. Ofvts�on, eY shaft be approved far se* tarok use by the Depmbnent of . c -v Puma Tank - :ft PUMP (dosing) tank shalt be inspected at feast once ! Y Proper oP are, tf an eflko�t tfiter is inked rrdtrk eVWY the t 8 shill • � p shag be bs*d b wed and servn;ed as nee�satX • At- cede Cosoonent and Pressure Distribution System o.trees .or s s s o be made around the p e P ante or a owe ' grow on the component. Plantings May imete to err and the component small be seeded and mulched as necessary prevent erosion and to than for vegetative couptenan e)eonothepComponent is Cold weather install- ations require the c omponent to be heavily mulched for frost protection. Influent quality into the at-grade 8 3f1 m8 /b FOG I system may not exceed 220mg /L BODS, 150 ag /L TSS and nfluent flow crap not exceed the maiimvm design flow specified in the permit for this installation. Wend be 6ah sys 1 5 WOWded VA a titW*Q is at the end of each . and a is ead COMPued b b the martial beet Whu I* once sverY 18 tiro 3ML Wbuur a prem" testis p � t be U maw � � w8tdrr 8W c daWaine f or x doggTxg has Or -red and f °awe clearing is i Observation Obsery levels xithin the dispersal cell shall be for effluent pending. as_aa ls ahOUid be reported to the owner and any levels `above `4 Inches considered' pending hydraulic' failure requiring additional, more frequent monitoring in a with-Comm 83.52 (2). General _ ,- hsYStem sha11 be operated in " accordance with Comm 12 -84 ihis.Adm.Code and shall be maintained is accordance with It!s state rnl.es component mamral SBD 10570 - ($.6 199) and:]ocal and per tang to system mainte 10570-P- and maintenance reporting.. No ogre should ever b� en a or Pip faNt since � dangetous gases � �- and be to a On WI.A�dm. Coftwhen VW cMW cum daft Sqft dre tart woe no b hared as oc punp fadc a •. ; • - . 8 =84 risers and covm *OM be bzed brwater d ar s"blad b ahtr be sealed the 0 110 G be by an bddng device b 6r di ersball Ift « �� b 1 eabpitlo a ia<ttt orcdrppoo� _ - eor�6oct, begone deice ilia ode or emauponetd sal be rapdtad ar rapf3xd to keep f'he �d �ledwi�pbeummesdur�eu�eihede6�5vsmaapo�ab fdp.bcod>wvracoaopor "Ofi n same aregaatpubra , 3f the at- jade co`mponent-tails - _ .. _._. the to accept: l aatevster: Or" — bye s''Eo ttrmmad surface, it my be necess dis�srae wastewater to **PUee tbt �poseate AMI a lts to iasesll she aerobic prs- traataat unit or tiomsl site sat so s o Ima'J need to be done: and meed to be prepared and approved tions by the Department of Commerce,- J . Safety and mtildin$e'Division. . Ques .about the - _..._� operation or naiateaaace of this system shonid be directed_ �t ,. the Coaaty Ao� - g Office at - t 2'? �5.. b 7 l t'R ,s'. The D1 2he apse"` installer at "115 — Ll2S— 9.4 SR teak ra4aufaetarar at &O�-'s2.S- The effluent filter manufacturer at 4 - - - - TI". �A • • • A y , + Zn v� s 5z C-b \: Lj t rye i if cl i , v ■ � i_i � � :i Lj r ifs_ 0 1 i � s � i v-ti t ►i in a, - e � � to - A � �l .�+.�- 1 '• '- _ .�.y 't Z7 L• t - f it 4 f �',. -- o, 's • t P.., • ' 3 Q. AJ I I - j Cl 'v' f - "• - -_ ` °•� ty t • — V t ;' , t . _ - t 9 e - L►. � R ms's `! ..! •�I � �; r �'R A li e%L 1 \] :� - ^ j ;_? i ni v - lAi d \ l 1F _ > D IF Y [ F t o! [ L.r Q. - i fi is P :y C1 12 Pa 5c"o,'. C CA I,11o, Scale) .Approved Locking Manhole Covers w J - h W d rn i n a d 7r 4 rwke Weatherproof \ Approved" Q_/ vant r. GX - . — .•--°.., , ll I r —fir � _� ( I �/ ; : � ] I .I ,� I I t 1� ,~ ( / 91 1 -4 1 1 Quick,. I L i i 1 � as..ay „ rP' - ,iiwa%%f+ce.+r-�avv4 - r Baffle Hole I � A On T + -APPROVED O f f 6 JOINTS WITH Ar rrw w r1r. 3 ONTO SOLID SOIL j j Con:. 3" of Be-dding Under Tank Number of Doses � Per Day gal Ppr n;-V14 r7 f , ,_0 7r- d Total Dose Volume .......... a 7 Tank ManufacLurer: , r#_0 Tank Size-Septic/Pump: /7_� - Gallons Model Number: Capacities: A �j inches or 4 Switch Type: P r + B , Ll;- w inches or ? 'A'Ions ;Ld -nrhpC nr Model Number; 3,5'71 C w ti + p inches or Gallons Minimum Discharge Rate: Total w inches inches o r- �Sl Gallons ' vertical Difference Between Pump Oft and Ui_q e ribution P 4157 " c _ +e_� Minimum ReqUi red Supply Pressure: C 6 of Forcce Munin X 1-2 77F-4-fon F Inch Diameter Force Main Total Dynamic Head: ... /7. Ifeet rnT-Oflids Tank' DIMEflSIOTIS: kj I U Lij L I t4U I U LJPP7.11_a i �- - - MW ^ �RnA k '14 �r 0U APPLICATiONS ° Fasteners. 300 - series W gully t In high i i /WLUr nuu'a iii4- W 11 Uii Specifically designed for the • stainless steel. grade turbine oil for for efficient heat transfer, Capable of running lubrication and efficient strength, and i IM ..! durabiliit ..} nry wannut riamnna to ilea: i; ansfer_ � ILA r 7►. ,..... Es tlIJeOt rj�yy7iLf11J _ _ - 'J - i InHNJr VUVGI. oJ Available for auto A Homes components. va automatic and tic cover with integral handle Ho Motor: atic a d and float switch attachment _ = r-YIf4 Sinai nnaaa_ li_4 ' _P . rfoinis. = Heavy duty sulilp m0 visa i[i&[1t 4 I�Arn�ni�ai 115 or 230 V, 60.Hz,155u • Water transfer Float Switch assembled and ■ Power Cable: Severe duty RPM, built in overload with • Dewatering pros at tt,e faotnw_ rated oil and water resistant. tlTrlr !!' rPCO? - r' y G«„. LPt1J .Si +Ia14 phase: 0 F 3 HP, >i �2�wwr.c- I Innar.pnii irnuar C �a�a.as. n"yar. vYf+v, aw,u aY+r is, S i ngle se: heavy duty ball bearing SPECIRCATIM 115 V, 60 Hz, 1550 RPM, FEATU e..a...a. eon, htiilt in nwarinsrl w4h co nstructi o n. P ump: E Yul,a ua YvY„vuu .riva � E-00.1-4 n9rrylY- ......+.:.. ..p • Solids handling capability: autuuiauc reset. plastic S em i-o pen design V4" maAmum:. • Power cord: 10 foot ' with pump out vanes for AGENCY LISTING • Cap acities: 1 n fin SS (� i1R standard lenptth,lti/3 SJTO merhonirol cool nmt ,,, � , } 1., nn !w . .�,..- .P.... ._. , ,aiwaauaaaarw caw a vairvil !'_flAil!e]tl im! : 7 vini w .sin- ,an in 7A AF + cairn ri gee Wrong nrrn�nninn ti. 1 otaI heau0- Up IV LT i'4i t- > ir i �'' • Discharge size* Vir NPT. plug. Optional 20 foot impeller Thermo - (CSA listed model numbers • Mechanical.seal: carbon- length,1 W SJTW with Plastic enclosed design for ..� three nronn nrounriing nl= i —, n........... rotary /ceiilMin -5u!u1 u! a;, r a Y r ...... ,. a... end in "F" or "AC ".) a.... aUNA N eiastomers. (standard on EP051. ■ Casing and Case: mugged • Temperature: thermoplastic design provides ?i!ao= irfirvl3i rnminiir3il superiorstronath and 140 °F (C(rC) intermittent. 1,011031011 IUSISUHICU. • F 300 series ram FM stainless st '• n ' I - i l i - !.- .�_,_._ _t ... = Capable of ru nning l l dry without damage to 9 3 0 components. l l ! I ; • Solids handling capability: o 7 %" maximum. a ---� - —r W ' UavaGILIBS.- UU LU OV Uf _ j I ''� ! i V v L LV!. 1 i.. I - ._ -L • I offal heads: up to 31 feet Discharge size: 1W NPT. rv11+r"nn!��I 5I !l nnn�n � rotaryideram iG-bouo nary, 4 _ BUNG N elastomers. c • Ternneratu!re, N R to I r ! ! 1M i oC /Anorl rnntinitrn!le I I 1 Y 1 I i i wryer. , Y 140 °F (60PC) intermittent I N! — � 10 20 . 30 40 50 GPM v 0 2 4 s a 10 12 nwm CAPIICrrV C� 1995 Goulds Pumps, Inc. Effective May, 1995 B3871 4 Wisconsin Department of Commerce SOIL EVA TION REPORT Page of 3 Division of Safety and Buildings in accordance with Comm 85, Wi . d ode counn 77 Ck D fk Attach complete site plan on paper not less than 8 1n mu include, but not limited to: vertical and horizontal re ence reel I.D. c percent slope, scale or dimensions, north arrow, an location and i ad. U O ! Y a — (0 (0 v Please print all info ad � Y �} 1 Re ' wed D Personal information you provide may be used for second ry purpodf (Pri�4a L.0 &04 (1) )). nl� — 1 t Property Owner ` 1 ST. CROIX CO Property catioon d G t l atA s O ZONING 0 ,j NT (_ fI. jjo vt Lot �) F 1/4 S & S 1 7 T 0 N R I` E (o W Property er's Mailing Address ^ o F V R . Block # Subd. Name or CSM# 4 1'-/ 9 Me w r i d Tr a - �� 1 q IT � i k �- City State Zip de Phone Number ity ❑ Village own Nearest Road 4USOv U)T (61D) 4 // - 031 ra El New Construction Use: 9 gesidential / Number of bedrooms _ _ Code derived design flow rate 6 0 GPD eplacement ❑ Public or commercial - Describe: Parent material Plain elevation if applicable �r ft• General comments and recommendations: 3 Boring �oring # o'-Plt Ground surface elev. /Pq. ft. Depth to limiting factor >70 in. Soil 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 *Eff #2 1 6 - 9 �y t— C �4►- t (- f ►' ClJ It * >C5 c5 s L F ' J o Boring # ❑ Boring Pit Ground surface elev. J� ft. Depth to limiting factor 2 7 ) in. Soil A lication 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 t mp - 5 1 L ,_ L 3 * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 _< 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L CST Name (Please Print) r \ Signat CST Number Address t Date Eva tion Conducted Telephone Number ,1 / 4_ �'7 7 70A ,4uc, 5ph (�� ( t S � - 9 7/5` 770 —3 _,7 8 r Property Owner V o g, d Parcel JD* �Q IO �+9 — �l b — �C ° Page f Boring # ❑ L Bo /- / _/ g Pit Ground surface elev. S ft. Depth to limiting factor �n Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cord. Color Gr. Sz. Sh. *Eff#1 *Eff#2 as U S5 o I-- -- SCt s c,-,) t u C u 3 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. 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 F Boring Boring # Ground surface elev. ft. Depth to limiting factor in. El Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDMf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 I * 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.07 /00) Pk f P 3 04 3 H OUSt � iR� J J dI�CLL �' S V ! Fiev.97.SS" Of � y i � GaV �� e✓ �,M. � co.nd B� I ms s ✓' p B 1 F««� Prn - ��t 0 0 E n G O w : r d O 3 M CD d �* •• m z = m z v O O. a o m o < a o m ° �. N a m n O o N (D CO 3 N O (D O O N a 0 N d 3 IV O CA C CD O A O n O m O 3 Q O _ _ O O 3 (n O m m d cn C O a I � C. ^ O O CD z vh�yyi ° w CO CD N o 'tr 0 0 0 m �y h� _ l• N Ca ' y y N (D O N ( _ R c Q (D N .(D N d W O N C a 7 .. a m O N N (D o N DWO O N O a � \r 00 - CD y rn � = + • CD CD ° ( N m C D CD _ �f c a CD -• -1 to (D O A Z Chi O. N C _ Q 7 p z O r n G1 o .. o o W T m N co CL z o fD A o N O ' U m (O 3 N z ( A T D W � a. O d a � 7 ° N O O 3 < (D N O T N (D °' O v C °'. z a o d - 7 O (D O N C K W 0 O d y CD S c ° � v y (D = n O A dam N (� d CD (D N ° O N O O o 3 a A 0 w • b 3 O b (i9 O O CD 0 CL H 79398 2 7 9 6 P 0 2 6 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI STATE BAR OF WISCONSIN FORM 2- 2000 RECEIVED FOR RECORD Document Number WARRANTY DEED 05/04/2005 09: 30AN WARRANTY DEED THIS DEED, made between Scott A. Deetz and Julie E. Dean, EXDPT # husband and wife, Grantor, and Douglas W. Hanson, a single person, REC FEE: 11.00 Grantee. TRANS FEE: 672.00 Grantor, for a valuable consideration, conveys and warrants to Grantee COPY FEE: the following described real estate in St. Croix County, State of Wisconsin: CC FEE: PAGES: 1 Part of the NE ' / 4 of SW '/a of Section 17, Township 28 North, Range 19 West, St. Croix County, Wisconsin, described as follows: Lot 2 of Certified Survey Map filed June 26, 1978, in Vol. 3, page 625, Doc. No. 349702. Recording Area Name and Return Address: Edina Realty Title, Inc. 400S.2 nd St. — Suite 115 Exceptions to warranties: Hudson, WI 54016 Easements, restrictions and rights -of -way of record, if any. 464541 U 040 - 1069 -40 -000 Parcel Identification Number (PIN) This is homestead property. Dated this 2nd day of May, 2005. * Scott A. De J lie E. D * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) _ _„ r ;QSCOW r STATE OF WISSCONSIN T ) authenticated this 2nd day of May, 2005 NO r$1 Personally came before me this May 2, 2005 the above named Scott A. Deetz and Julie E. Dean, husband and wife to * me known to be the person(s) who executed the foregoing TITLE: MEMBER STATE BAR OF WISCONSIN instrument and acknowledged the same. (If not, authorized by § 706.06, Wis. Slats.) ---moo THIS INSTRUMENT WAS DRAFTED BY *Cheri Brown Notary Public, State of Wisconsin Peterson, Fram & Bergman — Steven H. Bruns My commission is permanent. (If not, state expiration date: 50 East Fifth Street, St. Paul, MN 55101 3/11/2007 ) (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 WARRANTY DEED STATE BAR OF WISCONSIN FORM No.2 -2000 '1• ♦ it FILED wH 26 1978 a A": 0 GowfarLL bView a D.*'h 340702 �. 0` � "" v s a CERTIFIED SURVEY MAP DESCRIPTION A parcel of land located in the NE 1/4 of the SW 1/4 of Section 17, T 28 N, R 19 W, Town of Troy, St. Croix County, Wisconsin, described as follows: Commencing at the W 1/4 of Section 17; thence N 88 40' 11" E (assumed bearing referenced to the North -South 1/4 Section line, bearing assumed North) 2061.10' along the East -West 1/4 Section line; thence South 33 .01' to the point of beginning; thence continuing South 327 -00 thence N 88 40' 11" E 580.00 thence North 360.00' along the North -South 1/4 Section line; thence S 88 40' 11" W 16.73 along the East -West 1/4 Section line; thence Southwesterly 100.77' along the Southerly right -of -way line of Cove Road North on a 148.00' radius curve concave Northwesterly whose chord bears S 69 09' 52" W 98.83'; thence S 88 40' 11' W 470.87' along said right -of -way line to the point of beginning. I, James E. Rusch, registered Wisconsin land surveyor, do hereby certify that 1 have surveyed and mapped the above described property; that such plat is a true and correct representation of the exterior boundaries of the land surveyed; and that I have fully complied with the pro- visions of Chapter 236.34 of the Wisconsin Statutes and the Subdivision Ordinance of St. Croix County to the best of my professional knowledge, understanding and belief. r ,._e. a t..�c..•R� James E. Rusch June 7, 1978 N 1/4 Wisconsin Land rveyor CORNER Stevens Engineers, Inc. 1409 Coulee Road Hudson, Wisconsin 54016 1 ! W 1/4 CORNER m SECTION 17 , T 2 8N R19 W _ar wo UNPLATTEO LANG � 2os1.IO' — — — — — NORTH — COVE ROAD Y v X1673' / - ' , - r Be -4V 11"W o S 88 46 It W " 470.8T' _ T �j SOUHERLY 9� 290.00 176.04' to o w RIGHT �9 • C 180.1 I' �� 4.83' POINT OF F9•• O BEGINNING o N m \ \8p S 'n ( Z N EAS -MEN i A-- E SS EXIS -rING GR AVEL \ . i HOUSE DRIVEWAY OR \_01 \\ o of cD f ° E o zl z 10 1 _j. .2 r a o 2.18 ACRES ! + 2 2.19 ACRES = w F� "+ EXISTING PROPOSED 917E o v ai BARN FOUNDATIO9 FOR NEW HOUSE _ d a. F w z 71 O f J N � NE-SW Z 9 �i g ° P FIR �; 0 290.00' 0' N 88 40' II" E 580.00' C3 J UN X of OF z F — - J W z qpp NPLATTED LAND c,Jo ROVA� U Of THIS ST, CROiX C .•v- Ty Z DOES MINOR SUS C�OMPRE ENSINGPCOMM1f NAR4G LLj ww ,F 8UlLD N MEAN APP;�OVglV1$T� AND w REFER TQ Hb 02 SEPTIC yY T FOR CORNER _ z awa SCALE. (1" = 100' ) m = w ►-. m 100' O {00' 200' Volume 3 Page 625 THIS INSTRUMENT WAS DRAFTED BY SCOTT B. LOHMAN 0 CA 0 / 0 0 r � 0 '0 7! CD T CD 9 Cl) z m z -4 a 0 0) 0 CF) K) 0) G) 0) -< K) \ 2 $ CD 00 — CA CD CO CD CD W 0) CL X3 CD CD 0 C � CD co o CL 6 rn c 0 Cl) CD Cn CL U) ca CD C c CL CD CL 3 a CD CD z 0) 0 -4 -4 00 00 "we 0 0 0 U3 CD CA CO) CO) T3 CD :3 CD =r 0 0 . N) Ln to CL z Z M Z > M 0 :F CY) CD "me CD CD w 13 CD N CD CL 3 CD 0 z 0 0 z m 00 Z CL o Cn M to z CD Z > 0) CD 0 CL :E 2� 1 0 3 Z M Q) "n CD CD 0 -0 Q) r_ 5 o = i Z M 0 co lo CD -4 CD co \ 0 CD 0 CL 0) (n K 0' 0 z o Sv 0 :E D = 2 0 0 < @ =r CD 0 CL cn U) CD CD k-4 Er 3 CL 0 m CD < _o Parcel #: 040 - 1069 -40 -000 09/21/2006 11:07 AM PAGE 1 OF 1 Alt. Parcel #: 17.28.19.264C 040 - TOWN OF TROY Current , X I 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 DOUGLAS W HANSON O - HANSON, DOUGLAS W 449 MEADOWRIDGE TR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ' 449 E COVE RD SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 2.400 Plat: N/A -NOT AVAILABLE SEC 17 T28N R19W 2.40 AC IN NE SW E 290 Block/Condo Bldg: FT OF N 360 FT OF NE SW BEING LOT 2 CSM 3/625 (MINERAL DEED 889/638) Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 17- 28N -19W Notes: Parcel History: Date Doc # Vol /Page Type 05/04/2005 793980 2796/026 WD 07/08/1998 582569 1338/369 WD 07/23/1997 1102/376 WD 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/20/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.400 55,000 132,000 187,000 NO Totals for 2006: General Property 2.400 55,000 132,000 187,000 Woodland 0.000 0 0 Totals for 2005: General Property 2.400 55,000 132,000 187,000 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 r ' ia ti J8 L Ammer of ft44 3 4 0 7 0 2 °t v sRV co EYOR'S R EMP CERTIFIED SURVEY MAP DESCRIPTION A parcel of land located in the NE 1/4 of the SW 1/ of Section 17, T 28 N, R 19 W, Town of Troy, St. Croix County, Wisconsin, described as follows: Commencing at the W 1/4 of Section 17; thence N 88 40' 11" E (assumed bearing referenced to the North -South 1/4 Section line, bearing assumed North) 2061.10' along the East -West 1/4 Section line; thence South 33.01' to the point of beginning; thence continuing South 327.00'; thence N 88 40' 11' E 580.00'; thence North 360.00' along the North - South 1/4 Section line; thence S 88 40' 11" W 16.73' along the East -West 1/4 Section line; thence Southwesterly 100.77' along the Southerly right -of -way line of Cove Road North on a 148.00' radius curve concave Northwesterly whose chord bears S 69 09' 52" W 98.83'; thence S 88 40' 11' W 470.87' along said right -of -way line to the point of beginning. I, James E. Rusch, registered Wisconsin land surveyor, do hereby certify that I have surveyed and mapped the above described property; that such plat is a true and correct representation of the exterior boundaries of the land surveyed; and that I have fully complied with the pro- visions of Chapter 236.34 of the Wisconsin Statutes and the Subdivision Ordinance of St. Croix County to the best of my professional knowledge, understanding and belief. James E . Rusch June 7, 97 ����� l � 1 8 % v t olNPt! N Wisconsin Land rveyor - ,r C ' 0 M ,� ��O CORNER Stevens Engineers, Inc. 1409 Coulee Road Hudson Wisconsin 54016 a r W 1/4 CORNER "` SECTION 17 ;i f 7�i �' �z T 28 N, R i9 W Liver falls, r / o w U t UNPLATTED LAND ( ..• �p�� 16.73 — — — Z�____TH COVE ,.. ' . NORTH ROAD 206110 ' S' 8 ° 40' " 580,00 S 88 40'11" W '" 470.87' / �0) IV N O / co �j SOUTHERLY 910 290.00 176.0.4' / m RIGHT-OF - WAY /9' b N 180'11' �� 4.8 i :° POINT OF 99.E O 'd: BEGINNING o N oo 000 6 MEND / M N-T3 0 APS / GE SS EXI ST ING PC i HOUSE GRAVEL DRIVE OR DoE �� ZI cD F ° O I ZI t0® M JI QI r(D � -t -h a r q 2.18 ACRES � 2.19 ACRES WI EXISTING PROPOSED SITE c a a� = BARN FOUNDATIO FOR NEW HOUSE x a� —�� W zl EL ZI OI p Z OI _ - o NE — SW = . 9,0� w a 290.00' f �R00/00' g9. N N 88 40' 11" E 580.00' ow �. F- _j u zz APpROVgt OF UNPLM92 LAND ST. CROIX CCU TY _ 1 Z P DOES TNIs MINOR CoMpREt1eN PARKS p J V[ NG LU W NOT MEAN SU BDIV /$� J1ND ZONING COMM"a wu�� _ BUILDING $tTr: pa SEPTI FOB S 1/4 Ov LL WIZ REFER TQ H62.1a TI C SY;;T R CORNER I Z z z �►. Fr aw l SCALE (I 100') _ ^ w III = - m I ' 0 100' 200' Volume 3 Page 625 '� CURVE DATA TABLE Curve No. Lot No. ` Radius Length Chord Chord Bearing Central Angle Tang Bearing .,. 1 Easement 62 68.67 N 39 22' 26" E 67 15' 08" S 73 W 2 Easement 67 19.81' N 81 30' E 17 N 73 E 3 Easement 133' 39 '32' N 81 30' E 17 N 73 E 4 Easement 128' 159.20' N 34 32' 53" E 76 54' 14" S 73° W 5 2 148' 98.83' N 69 09' 52" E 39 00' 38" S 88 40' 11" W i 5 Easement 148' 62.95' N 76 23' 28" E 240 33' 26 { • f LP,GEND -' County Section Corner Monument - Berntsen Cap Found ���N 1" Iron Pipe Found as Ties for Section Corner O �,���GjG�/S� -k -Fence v � • 1" x 24" Iron pipe weighing 1.68--lb-s./lineal ft. set + JAMES E. RUSCH Owner and Subdivi S 1376 der' David Day l� Route 3 River Falls, s 'l ®R Wis. r ✓ '�� North Cove Road � O • Hudson, Wisconsin 4016 • N wE� ♦ i 5 ���� a sua 'V '� This map is hereby app d by the Town - Board. ` / 5 Date , Town of Troy f I i i Y, c, • AS BUILT SANITARY SYSTEM REPORT `NER J j b A cl , TOWNSHIP l SEC.. ' TJ ?N, R�W 0. ADDRESS , ST. CROIX COUN Y, WISCONSIN. *DIVISION , LOT_,21 LOT SIZE CJ M PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM !y 7 NL tit _�eV i c T" " fL- ?TIC TANK(S) MFGR. Q) C; l (/Q S CONCRETE STEEL NO. of rings on cover Depth DRY WELL - NCHES NO. of width length area J no. of lines . width lengt are depth to top of pipe 3REGATE N !/ ef �, a =:K RATE C AREA REQUIRED ! �' AREA AS BUILT .:claimer: The inspection of this system by St. Croix County does not imply complete pliance with State Administrative Codes. There are other areas that it is not possible/ inspect at this point of construction. St. Croix County assumes no liability for .tem operation. However, if failure is noted the County will make every effort to ermine cause of failure. 'ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. ~ INSPECTOR win / � ~ � � J � PLUMBER ON JOB I LICENSE NUMBER `� it - . t •. •_ REPORT Or I IaDIJIDUAL SEWAGE DISPOSAL SYSTEM Sanitary Permit f� r State Septic TOWNSHIP • �" t. Croi;;7County SEP . , �1:. TIC T1� . •1. S ize gallons. `Humber of Compartments �. Distance From: !-jell ft. 12% or greater slope ft s Building ' ft. Wetlands f : Iiighwater ft. DISPOSAL SYSTE: Tile Field or Seepage Pit(s) Distance From: Well ft. 12% or greater slope" ft Building; ft. Wetlands f T . FIT:Ln ighwater — ft. Total length of lines ft. Humber of lines Length of each line eft. Distance between lines a ft. Width of ' te trench eft. Total absorption area s q \ ft. Depth of rock below file in. Depth of rock over tile in.. Cover - over. rock,, Depth of tide below grade fin. Slope of trench in per 100 ft. Depth to Bedrock ft. Depth to p.,round water £t. PITS _ :lumber of pits Outside diameter ft. Depth below inlet ft. Gravel around pit: _yes no. "Total absorption area sq. ft. ,Square feet of seepage trench bottom area required Cquars feet of seepage nit area required Inspected by: Title': Approved , -Date 197 . Rejected Date 197. EH 115 . WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES : DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: 6!- r-2-Y' /a, Section LZ—, TZ1, R �9 E Township or-M" ie� r Lot No. , Block No. —, County 7 ; � Subdivision Name Owner's Name: I %/ yi D D 4X Mailing Address: 6 5 TYPE OF OCCUPANCY: Residence No, of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW Z ADDITION REPLACEMENT / DATES OBSERVATIONS MADE: SOIL BORINGS �i ¢l l' PERCOLATION TESTS SOILMAPSHEET 1�J/4" /1/ " `�' SOILTYPE PERCOLATION TESTS TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE CHARACTER OF SOIL NUM— INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN /IN BER // 1ST / WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P— L3C / l/�rf! r !'� Xv/LC fs 1 4 P - 2 3 r f (r it SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) ¢ ' w B (.�" c:c� r! j��r'c:• �> t , L + / ! -mat C.,�t �'; / � C-T,t, �c,�' L_> � "1 K CS� PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. IndicajA number of square feet of absorption area needed for building type and occupancy. ��'- i -IKG - - _1r= Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. 14 Mc 0 9 A 3 !o . cz C L c i �< < – N 44 [. I V 1 , FT i i Ll A I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. !__>, Name (print) �il'N�r.� t. �```� :�-, Certification No. Address '! ;� ` ` 1 'i i t;< f -� c Name of installer if known 1 1� "1" � % - v - v CST Signature COPY A —LOCAL AUTHORITY i PLB-6-7 State and County State Permit Permit Application County Permit for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY f Mailing Address: D A B. LOCATION: V '/4, Section , T - N, R W Lot# City _ Subdivision Name, nearest road, lake or landmark Blk# Village i Township 7" y C. TYPE OF OCCUPANCY: * Commercial *Industrial *Other (specify) * Variance Single family X-- Duplex No. of Bedrooms No. of Persons Z- D. TYPE OF APPLIANCES: Dishwasher YES ")<,— NO Food Waste Grinder _ YES X, NO # of Bathrooms -Q2,-' Automatic Washer YES NO Other (specify) E. SEPTIC TANK CITY , o0o Total gallons No. of tanks olding tank capaci y Total gallons No. of tanks ( New Installation `� Addition Replacement _ Prefab Concrete X in -Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) & 2) 9 3) 9 Total Absorb Area sq. ft. New Addition Replacement *Fill System Seepage Trench: No. Lin Feet Width Depth Tile Depth No. of Trenches _ / 0 Seepage Bed: Length �� Width I Depth 4 42 Tile Depth � No. of Lines - .3 J � Seepage Pit: Inside diameter Liquid Depth Tile Size ( Percent slope of land Distance from critical slope I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH -115 prepared by the rtified Soil Tester, C NAME C" - , Cd- ",C- C.S.T. # __ - r �"� and other information obtained from aq /V T H ©N TA (omierfbai+ der)- Plumber's Signature MP/MPRSVy# Phone Plumber's Address — :2 '2- - 2- Py 0 vo ! PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). Ccv �o IJ VR, Pe s Wet1 F, HOUS b N _ 305 .... T�►�c� S� 0 ntn'(,p hori se- (D"iIC TIAw k. Cad �„ Do Not Write in Space Below FOR DEPARTMENT USE ONLY Z Date of Application Fees Paid: State �� Cunt . ---? Date Permit Issued /RqF (date) - Issuing Agent Name L Inspection Yes — IN o Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 6 WEST PART TROY T28N:-R.20-19W 13 SEE PAGE 25 ' Gce pats dwa. -d µ'�i+yer 72.64 era/ C. .C3affy 1 • 9nd/ew M.'mb¢ah .O�e /s1nd1- • A KE Ma ez; /c o '9' bo.7s em/ /se. r6 sr CRO /X a ° 9 is °" A w //10 " V. /Bi /z En /oe, UX Zc3 • Bo.67 7- et yMCA • lTa rxs£ • > ry 0� Marva /es G• FF c� � h Q.a .1 6 3.45 W • Vr • /94 _ • 'Pue R. Eizc.F • ; ,zd - E /afar/ • .BCyer \' ,Z 76 Bo /�rf GIC�iSG/) tu � U�U x+01 • ® 672 0 �0 1 +•moo _ �Tac,E Na a y � O�1N cS / ., n E dman c5a /marz ,� .sir zo 9 1 4 4 /°on . J ,. e7 1.57 y �� • z a � . ci ts. ni OYL' 5+*AI:C Mo /den - Z acJ ° h tb RRCTS • haugr .: �:. .�a 29.23 • T F 47 9:i.....G. •:' .Pith. .Puemrne% eSch6e /a y Thomas J ............... /c94z .Po63E tMy a • qq LL/ e{je /G_ 2744 No f/ z W 40 ao � 214.7 q /Uewton • K : !lnC7w4 • .� ". • /'✓e'6Gr /B° r.r Y /aY /zo e cc 76 73 Ile dd�w:v °�vY� � may:: � ry b3 h ?�: T �.� .�„.�oa '4: ,.. q Mr•s: (,"ed s /oc% tl � a 0 Q En. , xt Eixs� as: /zr 0 C K afa/ .79 Clar . C 0 k o �• 43 �� y 0 n� V m%rusf: Margin p l 4 S.. f'6- • �� p er �rzoho s K� 1 ��rU o� z •i „Q(S�0 /SB.67 cazo 93 ll JJ • • N i 4 /ds /B7 F/ff'o /ter � -C Leo /ic 9 CiB. y.�c �Ea �- Knabue f i/oae 9 :2 Enz1- �� sts, LhL. C /ase. tt: C j B o f•Fi /en NO. /L re 76 /si. 6 v 0 •• 3985 �a fn� p 456.5 In /sy /P3 iToh J N .Tarns T ($5C 5 � . / hwmme ; J tl V �i q e�ozi 4o F: T7'ust V Mo Tier S. . L • R O. Bo K.t. // 949 c.Ffor MaP Pub /,r lnc., Re /979 PIERCE COUNTY R. 20 W - I 4-- R. /9 n & a SALES AMERICAN FAMILY UNION STATE - Arctic Cat & Yamaha - WEBSTER, INC. Cycles & Snowmobiles W/V l v,4ff BusiNESS HEALTH L /FE John H. Jacobson -Owner STEVE MOORS AGENCY P.O. so 84 732 North Knowles Amery, Wisconsin 54001 New Richmond 425 -8989 715 - 268 -7117 246 -2488 704 North Main Street Insurance Of A11 Kinds River. Falls, Wisconsin 54022 • Parcel #: 040 - 1069 -20 -100 09/21/2006 11:05 AM PAGE 1 OF 1 Alt. Parcel #: 17.28.19.264A -10 040 - TOWN OF TROY Current I_X_ ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner GREGORY J & RACHEL L TSCHUMPER O - TSCHUMPER, GREGORY J & RACHEL L ' 441 E COVE RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): • = Primary Type Dist # Description ` 441 E COVE RD SC 4893 RIVER FALLS n SP 0100 CHIP VALLEY VOTECH �✓ Legal Description: Acres: 2.760 Plat: N/A -NOT AVAILABLE SEC 17 T28N R19W 2.40A IN NE SW W 290 FT Block/Condo Bldg: OF E 580 FT OF N 360 FT OF NE SW BEING LOT 1 OF CSM 3/625 ALSO TRI> STRIP ADJ W Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) LN AS DESC IN 588/417 (MINERAL DEED 17- 28N -19W 889/640) ALSO COM W1/4 COR SEC 17;TH N 88 DEG E 2016.95'POB;TH S 00 DEG more Notes: Parcel History: Date Doc # Vol /Page Type 11/10/2000 633357 15581160 ac 07/23/1997 1132/597 WD 07/23/1997 761/313 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations Last Changed: 07/20/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.760 66,000 171,700 237,700 NO Totals for 2006: General Property 2.760 66,000 171,700 237,700 Woodland 0.000 0 0 Totals for 2005: General Property 2.760 66,000 171,700 237,700 Woodland 0.000 0 0 Lottery Credit Claim Count: 0 Certification Date: Batch #: 216 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 `Parcel #: 040 - 1069 -30 -200 09/21/2006 10:57 AM PAGE 1 OF 1 Alt. Parcel #: 17.28.19.264B -20 040 - TOWN OF TROY Current 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 KEITH S WERNER 0 - ESZKA D ANEH S RESZKA DIANE 433 E COVE RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 433 E COVE RD SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH � �Wl Legal Description: Acres: 13.346 Plat: 3970 -CSM 14/3970 SEC 17 T28N R1 9W NE SW BEING LOT 1 CSM Block/Condo Bldg: LOT 1 14/3970 Tract(s): (Sec- Twn -Rng 401/4 160 114) 17- 28N -19W NE SW Notes: Parcel History: Date Doc # Vol /Page Tuna 06/07/2002 681219 1906/628 WD 07/23/1997 1183/2 883/01 07/23/1997 883/01 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations Last Changed: 07120/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 13.346 110,000 209,600 319,600 NO Totals for 2006: General Property 13.346 110,000 209,600 319,600 Woodland 0.000 0 0 Totals for 2005: General Property 13.346 110,000 209,600 319,600 Woodland 0.000 0 0 Lottery Credit Claim Count: 0 Certification Date: Batch #: 131 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00