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HomeMy WebLinkAbout022-1053-20-110 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 538881 0 GENERAL INFORMATION 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: Bettendorf, John D. Kinnickinnic, Town of 022-1053-20-110 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 19.28.18.290A10 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark O / 100 ~6D d Dosi r Alt. BM -Pb l 49le- ✓ _a y-~ Aeration Bld ewer Holding St/Ht Inlet ~jGH ct / St/Ht Outlet Eli/ 6 I Z12 to TANK SETBACK INFORMATION RXCD Z-j - TANK TO P/L WELD BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing ; Header/Man. 4,/A Aeration Dist. Pipe ky, Holding Bo t. h I n0? D 20. PUMP/SIPHON INFORMATION Final Grade ( r. Manufacturer Demand St Cover GPM ~0 ZS~ ~itfn a-67 Model Number t TDH Lift Friction Loss System Head TDH Ft Si n d 53'1 Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM jZfl - \'L - 2CD~- - /oDs BED/TRENCH Width Length No. Of Trenches PIT DIMEN ONS No. Of Pits Inside Dia.'L Liquid Depth DIMENSIONS Manufacturer: SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM L CHI ~kd INFORMATION CHAM OR Type Of System: IT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size Ix Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil E Yes 0 No Lj Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:-U-/ Inspection #2: Location: 285 & 287 Cty,Rd SS River Falls, WI 54022 (NW 1/4 NE 1/4 19 T28N R1 8W) NA Lot 1 Parcel No: 19.28.18.290A10 1.) Alt BM Description n = 'r a'-o k lt'-' p` , f 2.) Bldg sewer length =x 17!~ f C~~~ I Uwl" -amount of cover= Plan revision Required? 0 Yes 5P40 Use other side for additional information. SBD-6710 (R.3/97) Date lnsepct is Signature Cert. No. a o Cl aQ o ° o d o 0 I M c ~ o •c c Y V E- C- N O I C N N w E q 3 3° V E N N N 7 ~k d 1.0 Cc y U Z 3 a) N O O 0 0 O N a0 C C V O O C O. a Y I- C N -O O a N zO a c N` 0 0 0 N E° 0 0 y c O .U-0) 0 (N a V~uM~ C ~m~OO > E f > aNiU a~ pO (a 0 C .0 O C C O O Q j O. O c N co c Z ~.o z m•y 0 2~ ~ LL c d N C IL c (u m N N. V O O C C O Q d a~ a Q O Q fp fOq 7 0 .'y--' .L-N M CL C M y 00 y EZ y c N O~D W U O E 7 N a 0 Z I 4j O Os _ O N £ 0 0. w £ U N N ccoo> d N E d m `NN°' 1 O N> G. m° N d m > .c H Z m N N V y I, om 4) LQ' N E a 3 o Z a c mur°~ >QE 'E 2-0 U v ° ° a) V 7 m ° N fA Fz- e- N ° w c vi C c° m rn . - tl) N r > C E a~OE 'o E c>0 p N r r~cN 1 C 'a 2 Vl d O 0) M 7 N U V7 a) E CL a) N N N m N E c- 'i o N a c o~om ~ L 00a)a.- ° O v,mty, U) a O UU0. O Z cn Z Q 4 Z N N C\l (N N 10 t0 y co CL a) 7 H W c6 H d ° Nova` a m ~+coa` ~ N m 0 LL o 0 o a w ; 3 3 3 a 2 • a a a a af a a (a U) 9 Y a to J CD 0 U O Z Q' OOi OOi Z w N _ _ U O - Z 0 U N N - ``G N p p CO O Q co nN •O O ~ N 04 . a E N N > M .6 Co C C,6 M N c d Q n U) 00 O d Q> U) !0 N a N N a) ° 0 O a~ a) m ~j O O 3 C U) r O f~yq G Iv O~° f~ O ° U O O a1 7 N <O N ►O :L'i N O U : M O C C M N N co U d O O O E a CL CL V M N C to c ,t y E E C N N N 42 a0 'y -O C •7 (D C O O C M c6 1 C) N E ~ 0o y (D a Ono y a~ H H c n a) N 00 00 ' o Y m m o z a Z m o Z N-2- U) O v v1 d M a E `m CL +(m+ ° v r d c m m c rw a~ r A L)(L otn V ~0 aici ififtla. commerce.wi.gov Safety and Buildings Division County " 201 W. Was ' cons f)di in, WI Sanitaryarmit Number (to be filled in by Co.) 4. 1 Department of Commerce` Sanitary Permit App~ic tiolov Q State TransactionNytnbe In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this f to the appropriate v ental / I A unit is required prior to obtaining a sanitary permit. Note: Application f foGtaferoject Address (if different than mailing address) submitted to the Department of Commerce. Personal information you pr i ING &WP purposes in accordance with the Privacy Law, s. 15.04 I m , Stats.n O 1. Application Information - Please Print All Information Property Owner's Name Parcel # 0 ~ f p22 -/0s3-2x -/16 Property Owner's Mailing Address Prope S _ Govt. Lot 6~ cOU #4 / 12tx)4i: O31 City, State Zip Code Phone Number %4 Y, Section G22 7/5"~ ZS' ~~il ircleone) T N; R10Eor4o H. Type of Building (check all that apply) Lot # K1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name 11100r# ❑ Public/Commercial -Describe Use i 236-7 ~f 1j ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of i2~ &Town of JNX;ix LL. III. Type of Permit: (Check only one box on line A. C lete line B if applicable) t!~ 4' El New System El Replacement System IT eatment/H ding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal El Permit Revision El Change of Plumber El Permit T ansfer to New List Previous Permit N ber and Date Issued Before Expiration Owner (/N,DuJ 1 7Y IV. Type of POWTS System/Component/Device: Check all that apply) JKNon-Pressurized In-Gr d ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil Moir < 24 in. of Suitable soil ❑ Holding Tank Other Dispersal Component (explain) STl 0P_ ~tment D xpl in V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (so Dispersal Area Proposed (sf) System Elevation VI. Tank Info Capacity in Total # of Manufacturer S Gallons Gallons Units U B ti New Tanks Existing Tanks FOY l.~: ~ /"i /K o p ^ c"o y v7 w C7 a a U0 :N4 Septic or Holding Tank it ~~A~►~g I~e- 0- Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plu s Signa a MP/MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) v2e!~ Ca 91) SS VI oun epartment Use Only Approved ❑ Disapproved Permit Fee Date Issued ssuing A ent ' afore $25- CD II ❑ canner Given Reason for Denial D U@I1i flltef anj for Disapproval , e L tr/ dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained,' C 9jC~S~7 as erapplicable code/ordinances. 17 Attach to complete plans for the system and sub T' to the CC' yon paper not less an 8 : 11 inches in size 77 1f~G ad- SB -6398 ( /09 L X r7 z o O 0 d w~ a I- LU ca 3 m o c ° w N 00 O Z Oo 8$a av e ° ~ LL a z» w Q O r v x o t ~ (Y) z LO -go -21 0 V .4 rLo= CAI 'L Z th p v c m A m a ~ c~~ a ~ c€ Q O Z W O o ° ~ ~ rn m m R m ~~a c c H ~m =4 - Z a. rL- or.8~ »cL.> aomCw CL Q W ~ m cl)~ ~k.0 Z W W 0 p H ~ 3 a. Z O > O Z J W Cv w w > Z w _ co) ~ m `a z z di Q ~co o J W w I-= Z Q o z J o z oo = © - LL cl) w v ~ ~ Q Q Q p Liu C Z _ w I- N y 1 446 ui a a Z O O N w w L. ui O Woo ~ w w ~Z O w and ❑ Z a - c j0WZ = >A O (L I- ~Q Z roa -se'pl -74^4 k. c ..N~l~' _ o ► QeffeHd64 _____ags ro (2b ss Rood-p11 wax - Al Iw SIP to l I ~ a 2v I I ~ ~ ~2z ~ Jf V) ~ I 6 ' flp /000 r4 Wei 1-4 ~;Z'g A I ~ '~,p0~ ~ ~ 22 ! i 3 p 1~ y i I#V g3/-?Sy Aou 810/1 0 n, a iY yL( y. - X N o c~ia _y N;N ~Im C~ G NIy ~n G!O v y t~ N 7 ~ U C G U y t0 Elo N_ L V x Ig O U;O ~pIC 08/24/05 WED 08:12 FAX 715 386 4686 11001 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION :FORM Owner/Buycr G~.1! lI y Lie tkn&-rr Mailing Address C a u it /;c a 9 n or p ~ vPrC F~//s i- d ZZ Property Address _5AAz~7-- (Verification required from Planning & Zoning Department for new construction.) City/State /p~1vF/L `g/~ ~ Parcel Identification Number ~"'~d~~--Z0:y/d LEGAI. DESCRIPTION Property Location A /4 , Sec_ I' Z,~ N R, W, Town of k"001- AS Subdivision , Lot # _ CcrtiFed Survey Map # -40, Volume _,.Page # S-ZO ~Volume Warranty Deed # , Page # s - Spec house yes Lot lines identifiable e ilo 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. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance- The property owner agrees to submit to St. Croix County Planning & Zoning Dcpartmcut 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 itlspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. 1/we, 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 Convnerce 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. I/we certify that all statements on th' form are true to the best of my/our knowledge, i/we ant/are the owner(s) of the prope bed,,above, b virtue f a ty deed recorded in Register of Deeds Office. SIGN E OF APPLICANT DATE Any inforniation that is misrepresented may result in the sanitary permit been revoked by the Planning &L,o.nin Zoning Departn2enz,*** Include with this application a recorded warranty deed from the Rr:s_,rister of Deeds Office and a copy of tale certified survey map if reference is made in the warranty deed. (REV. 08/05) s Pep, i i i EXHiBfT Parcel 022-1053-20-000 11/09/2011 AM PAGE E 1 1 OF 1 Alt. Parcel M 19.28.18.290A 022 - TOWN OF KINNICKINNIC Current 1XI ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - BETTENDORF, JOHN JOHN BETTENDORF 285 CTY RD SS RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 285 CTY RD SS SC 4893 SCH DIST RIVER FALLS SP 0100 CHIP VALLEY VOTECH L escription: Acres: 33.113 Plat: N/A-NOT AVAILABLE SEC 19 T28N R18W NW NE EXC P290B &EXC Block/Condo Bldg: CSM 8/2307 EXC CS Tract(s): (Sec-Twn-Rng 401/4 1601/4) 19-28N-18W Notes: Parcel History: Date Doc # Vol/Page Type 2011 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 09/07/2010 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 25.000 4,000 0 4,000 NO AGRICULTURAL FOREST G5M 7.113 18,000 0 18,000 NO OTHER G7 1.000 9,000 30,000 39,000 NO Totals for 2011: General Property 33.113 31,000 30,000 61,000 Woodland 0.000 0 0 Totals for 2010: General Property 33.113 31,000 30,000 61,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch 315 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 022-1053-20-110 11/09/2011 10:06 AM PAGE 1 OF 1 Alt. Parcel M 19.28.18.290A10 022 - TOWN OF KINNICKINNIC Current I-XI 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 - BETTENDORF, JOHN JOHN BETTENDORF 285 CTY RD SS RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 285 CTY RD SS SC 4893 SCH DIST RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 4.820 Plat: 2307-CSM 08-2307 022-90 SEC 19 T28N R18W PT NW NE LOT 1 CSM Block/Condo Bldg: LOT 01 8/2307 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 19-28N-18W NW NE Notes: Parcel History: Date Doc # Vol/Page Type 2011 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/07/2010 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.820 80,000 176,400 256,400 NO Totals for 2011: General Property 4.820 80,000 176,400 256,400 Woodland 0.000 0 0 Totals for 2010: General Property 4.820 80,000 176,400 256,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 553 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 022-1053-60-100 11/09/2011 10:08 AM PAGE 1 OF 1 Alt. Parcel 19.28.18.292B-10 022 - TOWN OF KINNICKINNIC Current ❑ 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 - BETTENDORF, JOHN D & CANDACE R JOHN D & CANDACE R BETTENDORF 285 CTY RD SS RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 285 CTY RD SS SC 4893 SCH DIST RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 20.000 Plat: N/A-NOT AVAILABLE SEC 19 T28N R18W 20A SE NE BEG INT E LN Block/Condo Bldg: SEC 19 & N R/W HWY 65, TH N 780'W 1166.3' SLY ALG FENCE 787.8' TO N R/W E Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) ALG R/W 1063' TO POB & S 33' OF E 1063' 19-28N-18W SE NE EXC PT TO CSM 15/4200 Notes: Parcel History: Date Doc # Vol/Page Type 09/17/2001 656702 1719/385 EZ 07/23/1997 993/635 07/23/1997 902/69 07/23/1997 884/614 more... 2011 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 09/07/2010 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 20.000 3,200 0 3,200 NO Totals for 2011: General Property 20.000 3,200 0 3,200 Woodland 0.000 0 0 Totals for 2010: General Property 20.000 3,200 0 3,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch 143 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 L"MIEit€i - STAVE LAR C - "SC0M~UK-:FCW-% t ° q IWAAB•AN TT OIL' c_~_.~'~~-~.-~t_, _ ~:r. t~ _ •..'r.!.tJ -,-~s sr ac[ .;x Yg..eo coR Ftteoff~e c.,.rx v i vim s C?'L~ .rY^sY-e_n "a:1 t q.r { _1 1 1; L-.'.,_. 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ACKNOW! EDGMENT . Se~:.ata!cs a cltrneicaLr r[ ;a - day of STATE OF WISCONSIN - - . c? s5 I'ersena tt came Sefore me, th day of tpri_-1 L9 7-, above nsmed Staf11C { -11TLE - NtEMBER STATE PAR OF WISC0,-4SIN Ac1So i and lla-el Nelsen , b•1I anc: 3 a- - - - - - :,u?Y^o :[C~: cr _ 701646- lens- stat3'--) _k (Jailed 65- : C [ C.,. D- FE"at t , At {!'77-tli a t. l._it•: - ;.ci ir:e known to be the person. who rxeculad the fore-, - - going in,trument and acknowledged ;he same. r vc r r .:i 1 s, "s Ji .cet i .;-1 ? may he ,.cut°.- .>r Q.krtnwtedged Both ~•f'_- `~i: r=s__S"iar4 .I Not Jry~lrJt°C.,.__ _ County, Wis. My-Comrnisstor. -t-rr.anenl (if nut,'-st;,te Pxpiration cia' - - 19 1 .'-ar.~s r! p :G3~enq e~.any cep-,..rv -ssa. E. r. vn^-'1.c:r urn tori. 6~lyr• LFeYr :~p;;a.~ c-.. `p A/a'J AN'7'~ E. F!) PAT'. F1 AP 0 f. >rr_._ NSIN.. F..3;tu VO r- - n y O 3- o d -1 o f c tD 1 ',I m D1 tD cn z o W x O l~l NT 7 N 3 d 3 3 C co c0 d. e0-' --1 N y co 7 n 00 =r =r CD 0 -4 M O O O O OO W -N+ G1 ? 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N (D (D 3 0 n O- -03 , p 0 0) (D n N fD O\ O.N 7.-4 O 00 7 7 U co 0 0) S N p tN D y 2 f7 u! = p ! 3 <D 3 O m 3 c ~o A N p ~ ~ Z3 D r O CD CY U > w r CD :3 o ~ O ro o < 2 0 I <0 0 O ~ O O O i r aa~~ JAMES nY,, 3 4f s2(;2 SG9Coix focads CERTIFIED SURVEY MAP JOHN BETTENDORF Part of the Northwest 1/4 of the Northeast 1/4 of Section 19, Township "?8 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin. OWNER'S ADDRESS: 285 C.T.H. "SS" River Falls, WI 54022 N 114 COR. SEC. /9, r28N, 3 R/ew,/couNrr 00 o VNPLATTED LANDS SURVEYOR'S MON.) o F6 S89.56'03"E 350.//' W LOT AREAS 2 M 4.822 ACRES I 323.40' J J 210,068 SO.Fr. ?6 7/' 4. 449 ACRES EXC. ROAD LO/ Z R. O. • I W. ~ Cl /93, 8 8/7 S0. Fr. y v N~ 4.~ Y "1v N y W y o Indicates 1„ x 24" Q N d °o pl cn iron pipe weighing ZI I h • I°°--`~ b o 1.13 lbs./tin. ft. R 3 N WFOUNDAr/ON STEEL W JI ^ set. y ; I bl OBU/LO UNDER CONS'. v 14 C4 41 ~I N m IQ h 2 vl ~I 2~ o v STEEL BU/LD. h QI W L1 ~n J k m N 41 ,I b'~ ZI J DWELL/N(, h 27. 47' ? I 322.64' SCALE 200' . '0 50' 100' )50'200'250' 300' 400' 600' N 89• 03 "W 3500C/I 5-,~~1 L ~ %uNPLA l'TED LANDS h ^ a S 114 COR. SEC. /9, r28 N, R /8 If', Description: /COUNTY SURVEYOR'S MON.) That certain parcel of land located in the Northwest 1/4 of the Northeast 1/4 of Section 19, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin, more fully described as follows; Commencing at the North 114 corner of said Section 19, thence S 01a2314111E (assumed bearing on the North/South 1/4 line of said Section 19) a distance of 76.02' to the POINT OF BEGINNING, of the parcel to be herein described; thence S 89056'03"E 350.111; thence S 010713141"E 600.201; thence N 89056'03"W 350.111; thence N 01023'41"W 600.20' on the North/South 1/4 line of said Section 19, to the POINT OF BEGINNING, containing 4.822 acres, being subject to easement over Westerly portions of saicr`parcel for C.T.H. "SS" R.O.W. purposes, as shown on this map and also being subject to easements of record. Dated: December 1, 1990 Revised: December 28, 1990 C' ~\5 /v State of Wisconsin) County of Pierce) 'LA EN dP M z. W RPHY cc w I, Laurence W. Murphy, Registered Land Surveyor, do hereby 713 aC: that by direction of the Owner, John Bettendorf, I have RIVER FALLS, surveyed and divided the lands shown hereon in accordance r t~..''•.. W~SC. Q,' 11109/2011 AM AGE 1 OF1 022 -TOWN OF KINNICKINNIC ST. CROIX COUNTY, WISCONSIN Parcel # 022-1053-20-120 # of Units 19.28.18.290A-20 Application # Permit # Permit Type Alt. Parcel # Sales Area Current Map C .Current Co-owner p =Current Owner, Creation Date Historical Date 00 0 Owner(s): JOHN E O - BETTENDORF, Tax Address: ,10HN E BETTENDORF 283 CTY RD SS • . Primary RIVER FALLS WI 54022 Property Address(es): SC =School SP =Special • 283 CTY RD SS Districts: Dist # Description Type DIST FALLS SC 4893 CHIP VAL EIY VOTECH SP 0100 2.067 Plat: NIA-NOT AVAILABLE Acres: BlocklCondo Bldg: Legal Description: Sec-Twn-Rng 40 114 160 114) SEC 19 T28N R1 8W PT NW NE BEING LOT 2 Tract (s): CSM 1113176 2.067 AC 19_28N-18W Parcel History: # Vol/Page Type WD Date Doc 1208153 Notes: 07/2311997 Bill O Assessed with: Fair Value: Market 0910712010 2011 SUMMARY Last Changed: Land Improve Total State Reason Valuations: Acres 4Land 158,000 198,000 NO Description Class G1 2.067 RESIDENTIAL ) ,000 198 40,000 158,000 Totals for 2011: 2.067 ) General Property 0.000 Woodland 158,000 198,000) O~ 2.067 40,000) Totals for 2010: General Property 0.000 Woodland 554 Batch t~ 1 Certification Date: Count: Lottery Credit: Claim Amount Q Category Specials: User Special Code 0 Special Charges Delinquent Charge! 0.00 Special Assessm O 0 Total if n "It recorded '