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HomeMy WebLinkAbout040-1128-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 515220 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: Haskins, Gina I Troy, Town of 040 - 1128 -30 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: / /o „Ito IM Z GST 34.2 . 8.536A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER ' CAPACITY STATION BS HI FS ELEV. Septic /rte b� I L 50 Benchmark O' G „/ //OI Dosing I6 � �5 Alt. BM a Aeration Bldg. Sewer / 17 140 . •L7 Holding SUHt Inlet TANK SETBACK INFORMATION St/Ht Outlet /27- 7v 5 7 TANK TO i i L WELL BLDG. Vent to Air Intake ROAD Dt Inlet g A- A- Q 3 Septic 7Z6 f Z y Zv / 7 ZO Dt Bottom q4 1 Dosing Header /Man. /a3 , aL Aeration Dist. Pipe Holding Bot. System /aL • 3 Final Grade PUMP /SIPHON INFORMATION Manufacturer I Demand St Cover /6 Ee Z GPM rtlL..' Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Len th I Dia. Dist. to Well n 9 SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTE TO P/ BLDG IWELL LAKE /STR�i LEACHIN nufactu INFORMATION Type Of S CHAMBER OR Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia SOIL COVER x Pressure Systems my xx d Or At - Gr ystems Only Depth Over Depth Over xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Q Yes Fa No W Yes Q No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 630 Swedish hP sion Road River Falls, WI 54022 (NE 1/4 SW 1/4 34 T28N R1 9W) NA Lot 2 Parcel No: 34.28.18.536A ry c.KL.ola, J 1.) Alt BM Description = 2.) Bldg sewer length - amount of cover o nG � � �✓ aXX, 10 b � J13b . Plan revision Required? 0 Yes �(No Use other side for additional information. Date Insepc s Signatu Cert. No. SBD -6710 (R.3/97) • - F " Tm1a commerce.wi Safety and Buildings Division County 201 W. Washington Ave., P B 71 5 Cln a l X It i S C O n �' Madison, WI 7 Sanitary Permit Number (to be filled in b Department of Commerce 5 1 5 Z Z C) Sanitary Permit Application State Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of t s form Op men 1 unit is required prior to obtaining a sanitary permit. Note: Apphcati form t - e TS a e Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information yo provide may be used for seconda ur oses in accordance with the Privacy Law, s. 15.04 1 (m), Stats. J �jO - A S M I. Application Information - Please Print All Informa a Ip J . l 11 Property Owner's Name Parcel # ''ll rJ ST. CROIX COUNTY © (� -- Property wner's Mailing Address Property Location / 7 �r� /� I `JD Govt. Lot C' , State Section Zip Code one Number , r r f ��� Cd Ph Nb _��/(/f / <, V / t !j ? �0 Z Z o circle one I. Type of Building (check all that apply) 2 oA Lot # T J / T z O N; R - E ❑ 1 or 2 Family Dwelling - Number of Bedrooms v Subdivision Name nC Block # El Public /Commercial - Describe Use f` le El City of ❑State Oyrrted - Describe U CSM Number ❑Village of 5 X I 3 Town of inn III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System y El Replacement System Treatment/ nk Replac ement Only VOther Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner M L IV. Type of POWTS System/Component/Device: Check all that appl ❑ Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pr treatment Device (explain) V. Dispersal/Treatment Area Information: Design F ow (gpdZ Design Soil Application ate(gpdsf) Dispersal Area R uired (sf) Dispersal Area (sf) System Elevation VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units o g _2 New Tanks Existing Tanks o 4 y A w V Ln y V) u C7 a Septic or Holding Tank I -Z- f 5_0 Dosing Chamber 7 U 1 -1) / to�J t VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. PI tier's Name (Print) Plumber's Signature MP /MPRS Number Business Phone Number Z76 "I7 714 = z7 3 Plu er's Address (Street, City, State, Zip Code) _ VII ount /De artment Use Onl Approved ❑ Disapprove Permit Fee Date ssued Issuing A Signature tven Reason for Den' IX. Con rtions of Approval/Reasons for DisaPeroval Y " S E eptic tan�c,�etaefiltk dispersal cell must all be serviced / maintained — k *kfU rtd � as per management plan � provided �� by plumber. � All setback requ'rements, must he maintained as per applicable Co& nl1�5,plans for the system and su n to the County nl n paper not less than 8 1/2x 11 inches ins' hoe j( 1- +ti.�r�•- .� -�'�. s�o � l � rem SBD -6398 R. 02/09 Valid thru 02/11 / '3 o PL� /G 5 4 y 4 Z b� N O o C — X (Sltj ° S CLi r 't�c 4 � ,v o sun r` A - � , -{far✓ � 5 '' �— ❑ N,� A C O ' - 3 O 1-74 z Z IN ol G O � KI SfiM� 9 N D ,v o SuYL� � Tro.�+ �G � jam✓. �o� �"� ) Cp .tib / -i/o✓ l / / p o i r te' IAA FILET? SEP 2 400271991► 9 D KAIKM H, WAS srr S Croix co, m �0 RVtY '� NIY 2 , avi REtapRp 5644134 CERTIFIED SURVEY MAP JOHN AND JODY O'GRADY Part of the Northeast 1/4 of the Southwest 1/4 of Section 34, Township 28 North, Range 19 West, Town of Troy, St. Croix County, Wisconsin. W 114 COR. SEC. 34, T 28 N, R 19 W, N 114 COR. SEC. 34, T 2BN, R 19 W, 1 COUNTY SURVEYOR'S MON.) !COUNTY SURVEYOR'S MON.) lm� N Q UN TTED LA e h N N 88 • 40' El //4 L /NE !u m 1321, 6P x \ FENCE 330. 93' 735,57' 184.62 9� 386.06' 2626.36 LOT/ LOT 2 QI 6, 287 ACRES 5. 845 ACRES v � a �j 3 Q N ? 273, 833 SO, FT. 254, 6/4 S0. FT. 0 2 q 41 l� 3 6.012 ACRES EXC. ROAD R.O.W. 3.496 ACRES K O 2 Q ? \ 2 261, 870 SO. F7. 239, 418 SO. Fr. I N N ,o Z 2 g Q � 40 ^ y I ~ R O Q ON -Po q % W 414)) M j RI tk y lk 6A tu \ 3 y m v � DR/ VEWAY LU v \mss\ o, % ,a a44RN Q � = 2 , 41 ku FENCE y Dated: May 20, 1997 "Revised this 25th day of �•4y °ss 5 ? a August, 1997." \S+ \e R m SCALE 200' 0 50' /00' 200' 300' 400' 500' \�Q '1 m \s Q \'s o Indicates i" x 24" iron pipe weighing 1.13 lbs. /lin. ft. \O'Y set. --I,- Indicates fence. 1ts 11< Indicates driveway location. I APPROVED A 51 5 ... Owner's Address: ." • AIA M; CO; nn Rna .► - - - -- , Z£££ abed Z l'IOA ;.ftl r z .40 1 J peon out 1pnu ao6anang pus? paaa4siBag 2q ;; -us peaa:ddl N dudanN . M aouaan a; 0 }o s ,'siurii? tsp} t ul J. i vA rV Im b IB `Sllb3 3A1>j _2 nW .M aouaans7 Aq paljsap 4uamna4SUi STgj J AHd A M "' • •_�J HnH'1 lUt L i `� ZZOVS IM `SIIVJ aanig .. 01/20/2010 14:55 FAX 715 273 0444 NELSON- PLUMBING 001/001 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWN ERSHIP CERTIFICATION FORM Owner /Buyer _ WA" Mailing Address d� Property Address (Verification required from Planning & Zoning Department for new construction.) City /State Parcel Identification Number LEGAL DESCRIPTION Property Location Al " ya , 5 V/4, Sec. , T N R W, Town of ao Subdivision Plat: , Lot # . Certified Survey leap # , Volume , Page # Warranty Deed # (before 2007)Volume Page # Spec house F- yes Y Lot lines identifiableFyes i J 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 f4ticdon 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 - 5t. 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 13 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County 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. I /we am/are the owner(s) of the property described above, by virtue of a warranty dead recorded in Register of Deeds Office, Number of bedrooms SIGNATURE OF APPLICANTS) 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. 08/05) I I I (I III I I ' V II�III (�tll (I�fI ��I�I'IIII �t�it �'i� �I�III �l�l III State Bar of Wisconsin Form 1 -2003 * 9 1 0 5 4 0 1 WARRANTY DEED 9 1 0540 BETH PABST Document Number Document Name REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD THIS DEED, made between Lyda B. Haskins, a single woman 01/20/2010 10:25AM WARRANTY DEED EXEMPT 11 8 REC FEE: 11.00 ( "Grantor," whether one or more), and Gina M. Haskins , a single perso TRANS FEE: 114.00 PAGES: 1 ( "Grantee," whether one or more). Grantor for a valuable consideration, conveys to Grantee the following described real Recording Area estate, together with the rents, profits, fixtures and other appurtenant interests, in Name and Return Address Q 1 f - A O & p St. Croix County, State of Wisconsin ( "Property") (if more space is I L needed, please attach addendum): G i n a 0 1 , tf as t� i h S LOT TWO (2) OF CERTIFIED SURVEY MAP IN VOLUME TWELVE (12) OF Stuekt5h I i S5)m f aIZA CERTIFIED SURVEY MAPS, PAGE 3332, AS DOCUMENT NUMBER 564434, FILED IN ST. CROIX COUNTY REGISTER OF DEEDS OFFICE ON AUGUST T 27,1997, BEING LOCATED IN THE NORTHEAST QUARTER OF THE SOUTHWEST QUARTER (NE 1/4 OF SW 1/4) OF SECTION THIRTY FOUR 040 - 1128 -30 -000 (34), TOWNSHIP TWENTY EIGHT (28) NORTH, RANGE NINETEEN (19) Parcel Identification Number (PIN) WEST, TOWN OF TROY. Subject to Swedish Mission Road right of way. This is t wfhome C property. (is) (Unal) Grantor warrants that the title to the Property is good, indefeasible, in fee simple and free and clear of encumbrances except: easements, restrictions, and rights of way of record, if any. Dated / Ll :5116 (SEAL) (SEAL) * * rydaWflisidris (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF ) ss. authenticated on COUNTY) Personally came before me on * the above -named Lyda B. Haskins TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.0 VARLEM A. LARSON instnim t d kno led d the same. Notary Public / THIS INSTRUMENT DRAFTED BY: State of Wisconsin Joseph D. Boles - Attorney at Law Notary Public, State of W I River Falls, WI 54022 -0138 My commission (islerttlarient) (expires: �g ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATION TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED 02003 STATE BAR OF WISCONSIN FORM NO. 1-2003 *Type name below signatures. INFO - PRO"' Legal Forms • (800)655 -2021 • infoprofams.com I 0 c 0 0 e § g . : R ■ k - T'�� / % !f It $ % ( J } ) A 0 , e N) A i E) k \ M / \} . k K d §D- $) % k\ 7 § 0 w 2 Co Co n $ § 2 ° 2 ' ° (i o 8 E � ■ 2 « E ƒ % m ƒ i a 2 2 0 % e «� § § ® $ § CO / 8 S' 2 E c o w 0 ■ 0 0 0 �j � ƒ 2 % : < \ - ca ■ ■ � % > Oro - .0 o v ) G 0 E C , w \ ' Ln w � ) 8'8 � CD � =g 2 > > 0 � § � § 0 n g 2 m 8§S Oro � � ƒ 7 + § $ � Q. ■ § § � CL 2 � 0 � ; q � % -0 mn -0 o > E & ( 0 pr\ � § o, -,& 0 , 0 ,.2 a E k / \f // % 2®E &IE � \ § afG� 2 it a ;/E r 3 $ 14- /\ /� 2. E %man q ;a]» �G;� Q -4 2 . �§ Err 7 . . 0 G A ƒC �a � o � ' � ■ � r 'Parcel #: 040 - 1128 -30 -000 01/21/2010 08:18 AM PAGE 1 OF 1 Alt. Parcel M 34.28.19.536A 040 - TOWN OF TROY Current 0 ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner 0 - HASKINS, LYDA B LYDA B HASKINS 624 SWEDISH MISSION RD RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist# Description 630 SWEDISH MISSION RD SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 5.845 Plat: 3332 -CSM 12 -3332 040 -97 SEC 34 T28N R19W PT NE SW BEING LOT 2 Block/Condo Bldg: LOT 2 CSM 12/3332 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 34- 28N -19W Notes: Parcel History: Date Doc # Vol /Page Type 08/27/2008 880630 WD 07/10/1995 531044 1129/507 WD 2009 SUMMARY Bill #: Fair Market Value: Assessed with: 33392 Use Value Assessment Valuations: Last Changed: 11/09/2009 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 60,000 107,800 167,800 NO 10 AGRICULTURAL G4 3.845 200 0 200 NO 10 Totals for 2009: General Property 5.845 60,200 107,800 168,000 Woodland 0.000 0 0 Totals for 2008: General Property 5.845 76,000 145,100 221,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 141 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS l SUBDIVISION / CSM ?� LOT �--- SECTION _ T Town of A F ST. CROIX COUNTY, WISCONSIN v U� -PI&N._VIEW W EVERYTHING WITHIN 100 FEET OF SYSTEM o � o ti a , I P INDICATP.Nno, H ARR�W Provide setback and elevation info ' ton on rev . erse of this form. Provide 2 dimensions to center of septic tank manhole cover. ' pENCI�fARR: l ^) J ✓y` 1 L 1 = L fi , ',tl A l i ^ / j' l ,, ALTERNATE :SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: f } cam G - `^ tu5 e a .�v, ti• �- `Liquid capacity:_ Setback from: Wel House Other Pump: Manufacturer 1 rL ct,*.4.7&, ti y ., „ , �c-a► odel f Size r Float seperation ` ;/� .�- �`� '`Gallons /cycle: 9 y 4 - Alarm Location c , c<_,_�.- ► , <_. � -_ SOIL ABSORPTION SYSTEM 1 Width: - D / Len th c " g /� ., Number of trenches L – .S bC A Distance & Direction to nearest prop. line: Setback from: well: House Other c t ELEVATIONS Building Sewer 6 ' ST Inlet: ` ST outlet' _ 6 � PC inlet , 3 0 PC bottom Pump Off S .W Header /Manifold / b 3 ' 0 Bottom of system /(ji 7 -o)� Existing Grade Final grade DATE OF INSTALLATION: PLUMBER ON JOB: 4 LICENSE NUMBER: 4� INSPECTOR: 3/93:jt I f r . Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety Buildings Division Count,. CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitar Personal inf you provice may be used for secondary purposes [Privacy L%V, s.15.04 (1)(m)]. O PgrgUti , N jabY f3,Li6 Village [I Town of: State Plan ID No.: CST BM Elev.://J, /� ' Insp. BM Elev.: BM Description: Parcel —000 TANK INFORMATION ELEVATION DATA A970 230 7 5� �T TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing r, Aeration Bldg. Sewer Holdi St /Inlet TANK SETBACK INFORMATION St/ Outlet i.3/ TANK TO P/ L WELL BLDG. A ir ir i to ROAD Di Inlet Antake 7, IT- Septic a 30 " / 7� NA Dt Bottom � /�/ Dosing NA r /Man. Aeration A Dist. Pipe J,. "� w Hol Bot. System PUMP / SIPHON INFORMATION Final Grade Manufacturer r Demand e } Model Number GPM TDH Lift - ", Friction System TDH /I, ?� Ft Head Forcemain Length / Dia. a Dist. To wen y�50' SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS /"~ IM E N I N SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHIN urer: SETBACK CRAM INFORMATION ype O �� rr 75 /a P '' }� OR IT Moe Number: System: DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length ?! Dia. Spacing �� g SOIL COVER - x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded / Sad xx Mulched Bed /Trench Center 1g" Bed/ Trench Edges )0 ! Topsoil (p 4,. @y�es _ []No M ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: TROY 34,.2$.19.536A,NE,SW 630 SWEDISH MISSION 7 10 7a Plan revision required? ❑ Yes Ef No Use other side for additional information. 7 n If' SBD -6710 (R.3/97) Date ; Irnpector's Signature Cert. No. I t ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: I J . p 6 i f I r Safety and Buildings Division ��■■_r■r■ SANITARY PERMIT APPLICATION Bureau of Building Water Systems 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. nL - Cr© 1 • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide may be used by other government agency programs ❑Check if revision to C pr vio s application lPrivacy Law, s. 15.04 (1) (m) }. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION Property Owner Name Property Location 6 1/4 V4, S 3 T ;yL r N, R 1 ! E (or Property Owner's Ma fling Address Lot Numberpsysw 9 l Block Number -sue d s� ,s��N1 7 City, ate Zip Code Phone Number Subdivision Name or CSM Number !'U ,al- 7, 7 A 0J7_ 7 S )* 5:r sq II. TYPE OF BUILDING: (check one) ❑ State Owned it Nearest Road Public 1 or 2 Famil Dwelling - No. of bedrooms 0 vll� n of d Sc���is �s icv'Y 111 BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 4- _ 3 U 1 ❑ Apartment/ Condo 2 ❑ Assembly Hall 6. ❑ Medical Facility / Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales / Repairs 11 ❑ Restaurant / Bar / Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Chet only one box on line A. Check box on line B, if applicable) A) 1. ❑ New 2 [ teplacement 3 ❑ Replacement of 4 ❑ Reconnection of 5_ ❑ Repair of an _____System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressun d Distribution Experimental Other 11 ❑ Seepage Bed 21 Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade 7,57e Ce Required (sq. ft Proposed ( q. ft. (Gals/day /sq. ft.) (Min. /inch) :3 co < Elevations, 4: � . J �� Feet 10Y - 0 S Feet VII. TANK in Cap cl alio s Total # of Prefab. Site Fiber- Plastic Exper INFORMATION Galleons Tanks Manufacturers Name Concrete Con- Steel glass App. Tanks Tanks New Existin strutted Septic Tank or Holding Tank pf 5"0 Lift Pump Tank /Siphon Chamber n G) VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plu er's Name: (Print) Plumber's Signature: (No St ps} M P Business Phone Number: /1��=! l: F / 3 �- s s -7y7-3 � Plumber's Add Ass (Street, City, State, Zip Code): IX. COUNTY / DEPARTMENT USE ONL ❑ Disapproved Sant ry Permit Fee (lndudesGroundwater ate Issued' Issuing Age Sig ture (No S p Approved [:]Owner Given Initial y " -7 Surcharge Pee) Adverse a'--- Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: I SBD -6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS ' 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608 - 266 -3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection; or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. r SAFETY & BUILDINGS DIVISION . 201 E. Washington Avenue P.O. Box 7969 isconsi Madison, Wisconsin 53707 Department of Commerce Tommy G. Thompson, Governor William J. McCoshen, Secretary May 22, 1997 201 East Washington Avenue Y g P. 0. Box 7969 Madison WI 53707 ULBRICHT & ASSOCIATES ROBERT ULBRICHT 655 O'NEILL ROAD HUDSON WI 54016 RE: PLAN S97 -01225 FEE RECEIVED: 180.00 0 GRADY, JOHN / JODY NW,SE,34,28,19W TOWN OF TROY COUNTY OF ST CROIX MOUND SYSTEM The Department has reviewed the above - referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters Comm 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter Comm 82 or in chapters ILHR 50 -64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shail notify the appropriate inspector when inspections can be made. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the number listed below. Please refer to the 1 n number sh above. Si e y, _ Peter E. Page Plan Reviewer o Section of Private Sewage (608) 266 -2889 3082R/ 1 I SBD5524 (R.07/96) S97` 01225 ULBRICHT & ASSOCIATES CO. 655 O'Neil Road • Hudson, Wl 54016 Reg. Designers of Engineering Systems 715- 386 -8185 Private Sewage Consultants RECEIVED PROJECT INDEX MAY 21 1997 SAFETY 8 BLOGS. DIV. DILHR Plan I.D. S9 7 -01225 Data May 23, 1997 Owner John & Jody O'Grady Phone 715- 425 -0259 Address 630 Swedish Mission Rd. River Falls, Wis. 54022 Legal Description 11 acre site. Tax Parcel # 040- 1128 -30 ' -- NW 1/4, SE 1/4, Sect. 34, T28N, R19W Town of Troy County St. Croix C.S.T. Robert Ulbricht CSTM 2482 Installer Local Authority/ Supervision St. Croix County Zoning Dept. PROJECT DESCRIPTION An existing home with 5 bedrooms has a failing drywell type system. Estimated daily wasteflow: 750 gals. Soils in the replacement area are permiable (.4/.5 GPD /FT 2 ) but seasonally saturated at 32 ". A long mound type system using 12" sand fill is proposed. Note, all non - compliant existing treatment tanks shall be properly abandoned per code. k , enutonu�u�� �. 10 S N 1S Sj�!% 5 = `C : ROBERT W. O ! ULBnicHT GO HUDSON. WI . , s �. d ....._....�. �� P9.1 PLOT PLAN VIEWS 4 S n iGTA a Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS Pg.3 PIPE LATERAL LAYOUT Pg.4 DOSING CHAMBER CROSS SECTION Pg•5 PUMP PERFORMANCE SPECS This design for installation is based entirei o landscape conditions (slopes etc, y n measurements, elevations, The accuracy of hiss ) and soil suitability provided b y CSTM of the CST". Pecs, as reported, shall remain the sole res ponsibility I Any use of this POWTS design by any licensed plumber, or any related unlicensed parties or persons (excavaters, laborers) shall not be construed as an assumption of responsibility by the designer for the workmanship, construction, placement, substitution or selection of any components not specified, or ' any assumptions by the plumber that any unspecified components are state approved or proper, or the effects of p oor judgement if working under adverse damaging weather conditions soils) by any such parties or (wet /frozen ti persons, p .5 RM. -,# /= aw 'e4c &l..e P i Ts Z6v 149 — to /01 it SAN p /o� . 3G ' ' • PER PLUMBING PRODUCT APPROVAL o; GD CODES, ALL ABOVE- GROUND PVC PIPING (FROM TANKS & SYSTEM AREAS) • , 13 MUST BE SCH.40 PVC MEETING ASTM 3 #/ D1785 OR D2865 STANDARDS, TN OI S L Willi iN111e a !e 011h �. Id • !3y 5 4-4 2 t'P fob o T' 3 0 q �iF yv 5 1 ALL NON - CONFORMING / /�' � TREATMENT TANKS SHALL 1 6r BE ABANDONED PROPERLY O ovre.� FOR ILHR 83.03(2). io ✓r �� • �\ FR3 IvE SEpr�G f1OP�eo • 10'2L_'0 o ' tit �a tv57'�P N1-- 0r A Pp ?7-r , f v T Cp • Fi��IFD ?�►' ,o S. 2 'X35 P' f t` S'� S� CRo5S S EC TIdAJ 0 Mou wi 'r ti (3ED (0Ev of % r'o 1 ` Agglet:SATF 'Di StRit3uT�o,V rl�i P ► P 11.1 �- sysreM of T °P s o r L e le- rioa , 00I FORM TOE •tr , H t-I E T SAmD • 1 /II //� L Plowr� Top Sot uN � FdR►ti 10 70 510PE FOR � 1= 1f= VATY0 l»DER T3� /o/ 36 1, C? FT. -- ELEV 5 W VERr O F y IATERA( 102. Q(i F . gy FT. 1-0P o f G 1.0 Fr. 103. H ( 5 F • T o p 0� IATERAIS PLAN VI OF MOU "D ~ Lei rtt 13E D rORM MA A - - - - -• I (3 /;Z S F r I 2 K � Fr C, 1 7 w g k -�� a f r F >— w z w 3 o o 0 Fr B e v o f To I i" PVC- <Appep A 9lPelATE 09SP- R VATI o,v pipes PERMA,.)EAuT M Ae VERS 'P Ai�- �h l ow ���� �✓ RE (QuiRED BASAL. RReh _ SOIL, 1010T12/ CAPAciTy PRO?OSEV BASM AReA = B x (A + :1 C s�, F T �P/A(F IA r Rio% Perforated Pipe Detoll 71/, 6A Fe V11 tvl t- VA C U 7 I'o 0 End View ) Peorforoled End Ca p VC Pipe Ng Holes Located On Bollom, Are Equally Spored X PVC Force Main � d Distribution Pipe Lost Hole Should Be Newt To End Cop End Cop Distribution Pipe Layout P (00 Ft. i X yf Inches Y Inches 1 Hole Diameter Inch Lateral /�- Inch(es) Manifold Inches Force Main " 2 Inches # o'f holes /pipe1(,o Ci g Invert Elevation of Laterals 10*'* Ft. - D 1 ' 5 TRi13UT'10&1 3) 5GFJA RvE RATE FO R e b{ L, A T eR AL I P A,, r OTf I z -7 1 - 7 -1 — • � TO TA L_ - DiS - TRiBL)T - 104 VIGCHARG E RArE FOR Me Two R K .�2. M i ►J 2 A4 I 'N f'M U ljEA D Wiscorlsln Department of Industry SOIL AND SITE EVALUATION J 2 Labor and Human Relations Page / of Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must County 57 .- Include, but not limited to: vertical and horizontal reference point (BM), direction and /L percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # print dyD"' // 2. APPLICANT INFORMATION -Pleas p all Information Reviewed by Date Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ' Property Owner 1 Property Location )I 4F S 40 n q aO t'f k) J o ©y �'�""W Y Govt. Lot 1/4 1 /4,S 3 y T Zd •,N,R E (o CJW Property Owner' Mailing Address Lot # Block# Subd. Name or CSM# 6 5w erP&// A// S,Sso,v 1 - City State Zip Code Phone Number Nearest Road R! Ei2 �` /s Cv / . syo u ( 71Y )112s 'DLS ❑ City la a ffTown SsVEp /S 1 fl srJ ❑ New Construction Use: esidential / Number of bedrooms Addition to existing building [replacement ❑ Public or commercial - Describe: Code derived daily flow Y ., gpd Recommended design loading rate bed, gpd/tt trench, gpd/ft Absorption area required �i� bed, ft2 G Z S trench, ft mum desig loading rate bed, gpd/fl trench, gpd/e Recommended Infiltration surface elevation(s) -she - Z • 3G ft (as referred to site plan benchmark) Additionaldesign/siteconnsfd w ns Si'-TE .SU /'T/f'/3 /6 N AX /ydlU•uj' $�� /S7'��J . Parent material s C/ To Ad 1 G av 'k' l Flood plain elevation, if applicable i S Suitable for system Conventional Moou In-Ground Pressure AT-Grade _ � System InFill Holding Tank U = Unsuitable for system ❑ S gru L'J s 11 U El L� U 11 S Ly'U [1 S B U ❑ S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft slow In. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed ,Trench / - /2 /D y/e 3/ 3 SL 5Te /w Vim' "? f S Z 2 -L /o /t 3 - SL 1fSbk .►-Fie es l f . 5 • G. Ground 3 2- 2- 34 /ow es - 2: • $ elev. /Ol • 16A . /oy S/ S Depth to limiting factor n. Remarks: Boring # / 0-6 /O 313 5L /7 - 4k /*1/4! 'ZS � y •S 2 2 `! /o Ye 3/ 3 SL / f P1 lwv-F2 G /f . y ; Ground 6 / % 0 J X_ C .5, - 7. S YR ego- *& 5G �f R Ufi at 5 — � i- pBP�iLt �i /Y /o yp ,S /(r - f Z 1-f o fif l � ✓ � f ,yn &C Depth to limiting factor S'T I�i4T/!- 45 16 4N l7 sZ 6ew�Ap � In. Remarks: CST Name (Please Print) Signature Telephone No. �' o,O z r- � ' ,' 715 3Z • 9 Address Date CST Number ZY l� C5 7"/�FZy i Private Sewage Consultants 655 O'Neil Rd. Hudson, Wis. 54016 RECD® ` O RIGINAL PR 3 s1 1997 r <� °\' a S k PROPERTY OWNER JO HA-) SOIL DESCRIPTION REPORT Page of 3 'Z PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Structure 2 In. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed ,Trench 3. 0 -1 /o VR 3 5L, /- fsl�,� Vii' s /� . �t' • 5" Ground 3 � i�, /Y+��G S • -� O elev. 10 3• -3Lft S�DEZV , Depth to limiting factor Y 4 -- In. 53S� Remarks: Boring # 2 • / /o I/ -Ti L She a j a 7 5 7 y le df CS — • ?:•�3 Ground s 3 Z l 51 elev. �j c 7. 34o--ft- S l oyjf S B 0 / w� a- — • 7:- d Depth to " /D VA S/ n o tS SCL / f S /+-t 7 /' rC • Z - 3 limiting - 7 / d G 3 P " S V Me, 5Z- / �S� / 1 � � . � ' , S factor _ 32 Remarks: ,�o %�S 5,+ GGA- cT �Z7 It 7 .� a —' - 7 s 7 � Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots P In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # O- /O /OYle 312 Z. S �iv�+ /hq (/ 0s M s o fl c w y S KLAQ /o /' c 3 e SQL z s /*on (t� Ground t( IZ 5l /0 F. 'ft. Depth to limiting factor In. Remarks: d,4e,/4l J O%G 4141 Boring # Ground elev. Depth to limiting factor In. Remarks: S13DW -8330 (R. 08/95) P osx 3 r o 3/y " PST of Iv _ /00. SCALE / 30 Z!N iF��f'M 2--� . fte /G s - �n 5 vy�S r� /�lou�crJ) 3 S ys r, 45' /eV w , 54AJO 36 yo' 13 3 !35 TTOM SiD�,v6- -/0- i Ry A ?Pko K . 1 0 2- , 0 ' o �- ' f ` of A , 2.0 pifsp N • - mow Li,v.0 5 6444 ,e /-eve S� jE h` 3/7 �� s.I'io� STC -105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ,�l n To cl 'k /, a d MAILING ADDRESS �� u,f �i S X /o < <aA/ IPA' PROPERTY ADDRESS �� /YI f= (location of septic system) Please / obtain from the Planning Dept. CITY /STATE S/ U F F �tz //—s & r -g PROPERTY LOCATION 1/4, _}- ' 1/4, Section - 3 T '..�- N -R TOWN OF � �,1� ST. CROIX COUNTY, WI SUBDIVISION /�� �f LOT NUMBER CERTIFIED SURVEY MAP , VOLUME , PAGE , LOT NUMBER 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 licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program n August of 1980 with the requirement that owners of all news stems a to P P� g q Y � keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date.. SIGNED: DATE: `7 St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 sTc - 100 144K Odd- 1I z8 -30 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner /contractor, (spec house) , then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. ---------------------------------------------------------- Owner of property .j A A/ f �q V ` d S j Location of property l /4 1/4, Section y ,T � I N -R�� Township 14Ek4SW M ., . address g ICJ Address of site �u Subdivision name Lot no. Other homes on property? Yes k Previous owner of property gL /#; Total size of property Total size of parcel Date parcel was created Are all corners and lot lines ident fiable? Yes No Is this property being developed for (spec house) ? Yes __Z,- Volume -1 / - A� and Page Number s-a'7 as recorded with the Register of Deeds. ----------------------------------------------------------- INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. _ . ,S73/0 and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of the County Register of Deeds as Document No. CI Si tu App ican Co- Applicant Date of Sigrfatfire Date of Siqnature A W V W . 'r s s. . _' - +tin �r , 7� Blatc Bar (vi Wisconsin Form 2 — 1982 I 531044 WARRANTY DEED DOCUMENT NO. val..1129W., 507 -_ -' - -- — — - ` Wei nr.a�.,r- J flrK'Glw'r.�._ ' 1 _Theodore C. Pedersen and Mildred F. Pedersen, l j rb� a`n dsis sster, as �n n s, ena A f LL 10 M 9:45 A...i ' conveys and warrants to J ohn F. Q y � G ra and .IodT E. •"'""��'�- �- ! - O'Grady, husband and wife. as survivo � I . �rital__p�ggC�Y __.. .. •_ —_ . . I - -- .. ✓ t!i SWACe mese Foil RECOA DATA —... __......_.. ... 111-416 MGM A -URV ACORES$ fbONa anal Bank of River Falls the (allowing described reai estate in St. Croce_ — __ •_ P.O. Box 166 s County. Slate of Wisconsin: FAmw Falls, Wisconsin 54022 f ' (Pmae Beatification Number) 1i All that part of Northeast Quarter of Southwest 4=rter (BEi /4 of SW1 /4) of Section Thirty -four (34), Township Twenty -eight (28) !forth, Range Nineteen {� (19) West, lying Northerly of the Hignway excerpt the Fast 586 feet thereof. i I � I I I . i This �_� s homestead property. i ; (is) Exception to Warranties: Easements, restrictions and rights af of record, if any. I Dated this _ day of - — �� .19. l (SEAL) (S L) • _ T heodore C- Pedersen I I • t; - ----- (SEAL) — ~... ersen _. (SEAL) i _ ld rted F_ Pedersen _ 'l AUTHENTICATION ACKNOWLEDGMENT Signatures) _ -. _ Theodore C. Ped ersen. STATE OF WISi[oet IN i l �ldrec�� Pedersen sa- � - County. autbentica t / his� 'lL_ dny o! Jam' , 19 95 llemplas emote before me this _..• day of 19_ the above named II . Kristin land I TITLE: MEMBER STATE BAR OF WISCONSIN 1� (If not. authorized by 97116.06. Wis. Slats.) to me hmm an)tile tae person "o executed the II foregoing innummew nand acknowicd8e the same. THIS INSTRUMENT WAS OnAFTEo ev ` Kri stin O gland_ Att orney a L Laur - -- Notars Rrliac _ County. Wis. (Signatures may be authenticated or acknowltdged. Bah are ON I eottaalaitaiip� s permanent. (!! ntx state esoiration date: necessary.) Valle,• .l,k...nw 4tning in any tarAtn .annld tv q,cJ av prim•! twt...r twe, - VOWret 1� WA RRANTI, nF.rq %TATF. DAR OF WISCONW VASCO rrl+l.ayal flank Co.. Inc. FORM No. _ — ND2 Mewauaaa. Me -. A.t'JW: :c 1 U203 •fAS.rr. S— ­U% Parcel #: 040 - 1128 -30 -000 03/29/2006 07:55 AM PAGE 1 OF 1 Alt. Parcel #: 34.28.19.536A 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 JOHN F & JODY E O'GRADY O - O'GRADY, JOHN F & JODY E 630 SWEDISH MISSION RD RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): ` = Primary Type Dist # Description " 630 SWEDISH MISSIO RD SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 5.845 Plat: 3332 -CSM 12/3332 SEC 34 T28N R19W PT NE SW BEING LOT 2 Block/Condo Bldg: LOT 2 CSM 12/3332 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 34- 28N -19W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 11291507 WD 2005 SUMMARY Bill M Fair Market Value: Assessed with: 103051 229,700 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.845 76,000 145,100 221,100 NO Totals for 2005: General Property 5.845 76,000 145,100 221,100 Woodland 0.000 0 0 Totals for 2004: General Property 5.845 76,000 145,100 221,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 141 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 1