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HomeMy WebLinkAbout012-1056-60-000 eqy 69 ~ ~ N I ~ I N O i I ~ I I I ~ o I I CD 6 Z °c u°. c Eo 3 0 I Q ~ I M a3i I Z E z E z N~z am o I E z g z c E O Cl) N N C N N y N N 2 L ' O Q z m z N z c wQ v i E c "4 0) E - d Y N d °O D O a` .n c E;mrmrm aI0 3 o R eaaa y m J V ,m rn rn O ~i Z ~i Q N N ti~ N S O O = O = v m y c d 'O Qw y Of rn p d } Cl) Q O p! ° to m c H c o E co Q ° ~ L m y p aUi c c v d O n 'C N C C y A N o f0 7 N N C ° m Z :3 v N M C CO ad+ N:N `T E C CD co 0 N W 0 O Z N H rd in RS I it a € a CL m n y E _ L N DEPARTIAENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 ❑CONVENTIONAL ❑ALTERNATIVE (11State Planl.D. Number: assigned) NE 4NE 4f SeC . 26 , T30-R17W ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound Town of Crin Prairie 1 F PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE. Dan Donahoe Rt.2 Baldwin, WI 54002 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELE V. Name of Plumber MP/MPRSW No. County ]San Permit Number: Kim A OConnell 3259 St . Croix 28657 SEPTIC TANK/HOLDING TANK: _ ARNING MANUFACTURER: JOUID CAPACI7 V: TANK INLET ELEV.. TANK OUTLET ELEV.: PROVID DLAB PLOCKING ROVIDED OVER ❑YES LINO ❑YES LINO BEDDING: VENT DIA.: VENT MATL. HIGH WATER NUMBER OF : ROAD: PROPERTY WELL: BUILDING. IVENT TO FRESH ' ALARM. LINE: AIR INLET: FEET FROM ❑YES LINO ❑YES LINO NEAREST DOSING CHAMBER: MANUFACTURER BEDDING: LIOUID CAPACITY JPUMP MODE L. 1PUMP,SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED PROVIDED: ❑YES LINO ❑YES LINO ❑YES LINO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH FEET FROM LINE AIR INLET. (DIFFERENCE BETWEEN PUMP ON AND OFF) ❑YES LINO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BED/TRENCH WIDTH LENGTH NO. OF DISTR. PIPE SPACING COVER J I INSIDE DIA s~PI75 LIOUID MATERIAL' DEPTH. TRENCHES PIT DIMENSIONS BUILDING V NT TO FRESH GRAVEL DEPTH FILL DEPTH j0ISTRPIPF UISTR PIPE DISTR. PIPE MATERIAL NO UISTR. NUMBER OF PROPERTY WELL. AI BELOW PIPES ABOVE COVER ELEV. INLET ELEV. END PIPES FEET FROM LINE. R INLET: NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ❑YES LINO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS ❑YES LINO ❑YES NO DEPTH OVER TRENCH BED DEPTH OVER TRENCHlBED DEPTH OF TOPSOIL SODDED JSEDER MULCHED CENTER EDGES ❑YES LINO ❑YES LINO ❑YES NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH. NO. OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFO LO MATERIAL. NO DISTR ID ISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV.. ELEV. DIA. ELEV.: PIPES DIA.: ELEVATION AND DISTRIBUTION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION PLANS ❑YES NO ❑YES LINO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF LIRNE ERTY WELL: BUILDING. FEET FROM ❑ YES ❑ NO ❑ YES ❑ NO NEAREST I I I i Sketch System on Retain in county file for audit. Reverse Side. TITLE.. SIGNATURE: DILHR SBD 6710 (R. X ll/82) SANITARY PERMIT APPLICATION 7 UILHR In accord with ILHR 83.05, Wis. Adm. Code COUNTY -...,~....~~..a. 0 r STATE SANITARY PERMIT -Attach complete plans (to the county copy only) for the system, on paper not less than (,e,5-7 8% x 11 inches in size. ❑ hg i revisiovious application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PRO RTY OWNE PROPERTY LOCATION '/a '/4, TSp , N, R (or~ PRO WE TY OWNER'S MAILING ADDRESS LOT # BLOCK # CI E ZIP CODE PHONE NUMBER SUBDIVISION AME OR CSM NUMBER ITY LLAGE NEAREST R D~ II. TYPE OF BUILDING: (Check one) El State Owned R VI ❑ Public ~ 1 or 2 Fam. Dwelling- # of bedrooms PAR LTAX NUMBER( 111. BUILDING USE: (If building type is public, check all that apply) 1 ❑ Apt/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: (Check only one in line A. Check line B if applicable) A) 1. ❑ New 2. 0 Replacement 3. ❑ Replacement of 4.E1 Reconnection of 5.0 Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ~ rvi Seepage Bed 21 El Mound 30 El Specify Type 41 ❑ Holding Tank 12 Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 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 REQUIRED sq. ft.) PROPO D„(N. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION s ( Feet Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name oncret Con- Steel glass Plastic App. Tanks Tanks structed Septic Tank or Holdin Tank Lift Pump Tank/Si hon Chamber L] I L] 0 1 L] L] VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installati of the onsite se ge system shown on the attached plans. Plumber' Name rint): I Plumb 's ~*nat : ( to ) MP/MPRSW No.: Business Phone Num er: ?Z Plu b is Address (Street, City, fate, Zip Code es~ 'S I'lle r .sr IX. COUNTYID PARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) Approved ❑ Owner Given Initial / 06 t?j_ Adverse Determination [ ca` X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) 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 the 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 & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. 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 in 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 in ##1-7. VII. Tank information. Fill in the capacity of every new and/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 81/2 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, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) APPLICATION FOR SANITARY PERMIT STC - 100 his application form is to be completed in.full and signed by the owner(s) of the roperty 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 Location of Property fit, Section T ? N-R W Township /Tvt cling Address C~_\ A c~ S4 ob ~ Address of Site / Subdivision Name Lot Number Previous Owner of Property Total Size of Parcel / O P. d- Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes ✓ No Volume and Page Number ~ as recorded with the Register of Deeds. 2 016-1- INCLUDE WITH THIS APPLICATI THE FOLLOWING: Vl,.7 -60 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 refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION I We) ceJtt 6y that att Atatementa on tW vhm eAe tAue to the best o6 my (om) hnowtedge; that I (we) am (aAe) the owner(s o6 the phopehty desc4i.bed in .thiA •En6olmation 6o4m, by viAtue o6 a wa4Aanty he~ohded in the 066.ice o6 the Co~utty Registeh o6 Deeds ass Document No. ; and that I (We) pheAen.tey Own the phopoeed site 6oh the sewage di~sp01 1eyes em (oh I (we) have obtained an easement, to nun with the above deAenibed p)topehty, 6oh the eonstnuction o6 said A`ste~m, and the same has been duty heeohded .tn the 066tce o6 the County Re9i4teh o6 ab Vocpntent No. ) . SIGNATURE Oh OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED DOCUMENT NO. STATE BAR OF WISCONSIN FORM 3-1982 THIS SPACE RESERVED FOR QUIT CLAIM DEED R RECORDING DATA 446 a its REGISTERS o ST. CROIXCo" VICE a~e s ona iue anc n n Recd for Record u~ nc quit claims to Tl n i i _ Tlnn h.. _ Pamnl a.. T nnna ue C!f APP, 1 C J~OJ W /11:45 A,M f V Reglster of Diulds the following described real estate in State of Wisconsin: ~t rr~i l County, RETURN TO Tax Parcel No: M 2-1- n 5 7-: s Ran e 1 4 and of SE4 of r 4 all in Section ? Tovai ,h i ri -3 7, St, Croix County, cousin FEE ,X &T This is not - (Is) homestead property. (is not) Oat d this 6th ~ day of A ril 19 Daniel B. Donahue (SEAL) (SEAL) Joh Jaynes Donahue Pamela J. Donahue (SEAL) Edna Donahue AUTHENTICATION ACKNOWLEDGMENT Signature(s) 'STATE OF WISCONSIN St. Croix. ss. authenticated this day of County. • 19 Personally came before me this '7t day of A 1 ri 4 19 j-0-the above named j-ples DG r. TITLE:MEMBERSTATE BAR Daniel B. ~p211 -.l lIl n #r.r• OF WISCONSIN la J . (If not, ..Onahue •I~ authorized by § 706.06 Wis. Stalls.) to me kno to be the efsGrl THIS INSTRUMENT WAS DRAFTED BY forego nStfUmeflt a aC nowlhe samexecuted the G Nancy O~sdn4-' fgnatures may be authenticated or acknowledged. Both NlotaryPublic Wit' r^1h- re not necessary.) y Commission is county, Wis. permanent..(If not, state expiration date: JU1 'O 19 Names of persons signing in any capacity should be typed or printed below their signatures. QUITCLAIM DEED SB3 NTF 7776 STATE BAR OF WISCONSIN H z En H a ST C- 105 r a H SEPTIC TANK MAINTENANCE AGREEMENT o S Croix County z ty a OWNER/BUYER ` c ROUTE/BOX NUMBER Fire Number c CITY/STATE ZIP SU a PROPERTY LOCATION: Section(? T'2C N, R / `7 W, ~ n Town of St. Croix County, Subdivision Lot number Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment 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 in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. H o I/WE, the undersigned, have read the above requirements and agree cn to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart- ro ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. S I G N E D DATE } St. Croix County Zoning Office P.O. Box 98- Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. DEPARTKENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, , DIVISION LABOR AN P.O. BOX 76 HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 3707 (H63.090) & Chapter 145.045) LOC TI SECTIOIN:T? /o TOWNSHIP/MUN+E+PA-t : LOT 0.:BLK SUBDIV ION NAME: ,L OU TY: NER'S BUYER'S NAME: MA LING ADDRESS: &2 &W4L2 USE ATES OBSERVATIONS MADE NO. BEDRMS.: COMMER L DESCRIPTION: PROFILE D SCRIPTI NS: PERCOLATION TESTS: Residence ❑ New Replace t 9 _ fT-~f RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYST M:(optional) ~s❑u ®s❑u ®s❑u os®u ❑sC7u~~ If Percolation Tests are NOT require DESIGN TE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS S S BORING OTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH W ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- B" 7 B- B-2 i / PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER PieH`cS AFTERSWELLING INTERVAL-MIN. PERIODA4 PERIOD PERIODA PER INCH P- 3,11 To 4 P- P-- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION i 40 ~ i i 414 lye. r~ TN Ile 34 F + 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 the location of the tests are correct to the best of my knowledge and belief. NAME (p ' t): TESTS WERE COMPLETED ON: 7/111 !1 17 AD J CERTIFIC TTIQN UMBER: PHONE NUMBER (optional): CS IG ATU DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - INSTRUCTIONS FOR COMPLETING FORM 115 - SBCD - 6395 To be a complete and accurate soil test, your report roust include: 1. Comp legal description; 2. Tl• =ction most clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to seals= is preferred. A separate sheet may be used if desired; S. Make sure your be and vertical elevation reference point are clearly shown, and are permanent; 9. Complete all appropriate boxes as to dates, names, addresses, flood plain data, percolation test exemp- tion, if appropriate; 10, If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; 11. Sign the form and place your current address and your certification number; 12, Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL A -TY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone (over 10") BR - Bedrock cob - Cobble (3 - 10") SS - Sandstone gr - Gravel (under 3") LS - Limestone *s - Sand HGW - High Groundwater cs Coarse Sand Perc - Percolation Rate rued s - Medium Sand W - Well fs Fine Sand Bldg - Building Is - Loamy Sand > - Greater Than "sl Sandy Loam < - Less Than *1 - Loam Bn - Brown *sil - Silt Loam BI - Black si - Silt Gy - Gray *cl - Clay Loam Y Yellow scl- Sandy Clay Loam R - Red sicl - Silty Clay Loam mot - Mottles sc Sandy Clay wl - with sic - Silty Clay fff few, fine int x.c Clay cc comma pt - Peat rnrn - Many, n m m - Muck d - distinct p - prominr; HWL - High w1, * Six general soil textures Sur;., u for liquid waste disposal BM - Bench M VRP - Vertical Reference Point rVNERe est report it g a he county or Department may request ion of this s it c rior : A complet of plans for the private se_ sysiern and a perr applica n must be sr the approl sal ~ local authority in order to )ermit. -File sanitary permit must lie obtained and posted prior 1,r start of any construction. ' r A-I rr~~ w~11 r ~o•C f~o31 i r f PAGE OF C,rUSS 1 0-0-(L Jr, p~ A Vr1-3 J, Sfc'_0-) x 7Y,,d.~ / Fiv►h Ali Ihialb And Obearvallon pipe 11 Approvbd Vent Cap Minimum 12" Abova Final Grad* 20- ♦2" Above Plpla _ 4" Coal Iron To Final Grada Vent Pipe MaM Hay Or hook CqV41I;nV Owin 2" Aparepole t9gle Olelrlbullon pipe 0 0 0 - Tea 6" ala Beipe o Perforated PipeBelovr o '-Coepllna Twmlaollna At Bollom Of Syalem P~p~o~e D ~1~a-I 11~rac~< ~L.~cJ..T l on ~ gv,a SOIL FILL DISTRIBUTIOVI PIPE APPROVED 94kt NETIC COVER r. .r ° '14ATF-RI41- OR q" OF STRAW 2"OFAGGREGAlE OR MAKSH HAy OF -21/a AGGREGATE ELEV. OF FELT. DISTRIBUTIOAI PIPE TU BE AT LEAST INCHES BELOW ORIGIMAL GRADE A►JU AT LEASTLO INCHES BUT MO MORE THAI) 42 M10JES BELOW FINAL GRADE M x1muM ©Epni OF EXCAVAT100 FKoM 0KI&WAL 6KAor- WILL BE _ IMC14ES MIKIMUM ®EPrt+ of ACAVATIOM F-KOM 0~10WAL CRADF- WILL. BE ~ INCHES C i I SIGiJED: ,7z ~ I LICEAISE AJUMBER: DATE: 110 - Parcel 012-1056-60-000 02/08/2007 04:11 PM PAGE 1 OF 1 012 - TOWN OF ERIN PRAIRIE Alt. Parcel 26.30.17.397-1 B 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 O - DONAHUE, DANIEL B & PAMELA J DANIEL B & PAMELA J DONAHUE 1979 140TH AVE BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1979 140TH AVE SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 1.500 Plat: N/A-NOT AVAILABLE SEC 26 T30N R17W 1.5 AC IN NE NE W 234 Block/Condo Bldg: FT OF N 280 FT Tract(s): (Sec-Twn-Rng 401/4 1601/4) 26-30N-17W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 511/513 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/07/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.500 22,500 197,900 220,400 NO Totals for 2007: General Property 1.500 22,500 197,900 220,4000 Woodland 0.000 0 Totals for 2006: General Property 1.500 22,500 197,900 220,4000 Woodland 0.000 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 129 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges 00 Total 0.00 0.00