HomeMy WebLinkAbout020-1264-60-000 ry o 03 6e,
N y
N
N 0
w
� I
n
o I
N
� I
o I
� I
� 0 (
v I
N
� Z C
C
LL C
O
Cl)
w z
o
rn a m
N H Z
O
cc
O Z C
O
z
H r
c � -o I
v
2 M
N N O
C N N
y N
Q N z m z
N >
cc °
Z
rn a ,��,
!. O
C I N O
y i
w A o G {S 0 a of
p O S
N _
a �
O
X000 Z
a c a a a
IL (n
3 o U)
CO CO Z
Q Q - 0
co 00
> 0 0 m
a
ayi
o H H
O Q N C
r.a O N p
r\Q N N C C V d. CN
v C CO m ~ N C N N C O CO
C,
N O 0) y Z Z . v
O V) N
A C N
FBI N 'p N +. O - L
CO E E
O N 2 •N- O Z O FO- Fp- 'E' (A
CL d 2 d a
e ,
_1 A ciao !, 0U)i0
i
l=1 � ST. CROIX COUNTY ZONING OFFICE
911 4th Street
Hudson, WI 54016
Telephone - (715)386-4680
The St. Croix Co. Zoning Office offers the service of septic and
water inspection to Lending Institution, Realty Firms , and
private individuals.
COMPLETION OF THIS FORM IS ESSENTIAL SO THAT THE PROPERTY CAN BE
LOCATED. .
Please provide the following information, enclose appropriate fee
made payable to ST. CROIX CO. ZONING, and mail, along with form
to the above address. Testing will be done as soon as possible
after fee and form are received.
WATER TESTING--------------------------------FEE:$ 25.00_
For nitrates and coliform bacteria)
�+
S SYSTEM INSPECTION---------------------FEE:$ 25.00
PROPERTY OWNERS NAME: 5.N.Q Dr-&
SIZ
PROPERTY OWNERS ADDRESS:c ouw- ti' v to W CITY: jky )$o,kj
Legal Description OLJ 1/4, p_1/4, Sec.Zg_, T Z` N-R-L,3-W,
Town of Lot No. Z-_,Subdivision
F-,v2k- �
FIRE NO. $l L. LOCK BOX NO. `
Color of house C*_&(p,,r Realty sign? Firm:
PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP, i.e. , COPY OF PLAT
j., BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET.
Testing of residential water requires a sample that is fresh. If
the home is vacant, and has been so for some time, the water line
must be purged by running the water for several hours before the
test can be conducted.
WINTER TESTING: Many times water lines are turned off, or sill
cocks are turned off, making access to the home necessary. If
this is the case, please make proper arrangements with this
office to ensure time when entry may be gained.
Firm or individual requesting services:
Telephone No. 3$ko -44a-t Q,, L-) Z-g-z4,-3z.L1
REPORT TO BE SENT TO: d.,r ,.s ca� � �. � a C�C1v'e,TI
CLOSING DATE:
Signature•
qOMMERCIAL TESTING LABORATORY, INC.
514 Main Street, P.O. Box 526
Colfax, Wisconsin 54730
715 -962 - 3121
800 - 962 - 5227
ST. CROIX ZONING REPORT NO.: 09445/01 PAGE 1
ST. CROIX COWTY REPORT DATE: 8/16/91
COLRTHOUSE DATE RECEIVED: 8/14/91
HUDSON, WI 54016
ATTN: THOMAS C. NELSON
OWNER. Robert � Sandr encer
LOCATIONS 512 Country View Rd., Hudson
' i
COLLECTOR! M. Jenkins
SOURCE OF SAMPLE' Outside faucet
S.
COLIFORMS 0 /100 ml
INTERPRETATION'# BacteriologicaLLy SAFE
NITRATE-NS 2 ppm
Above 10 ppm exceeds the recommended PubLic
Drinking Water Standard.
Coliform Bacteria/100 mL
Nitrate-Nitrogen, mg/L
LAB TECHNICIANS Pam Gane
WI Approved Lab No. 19
i
r
.
V
< Means "LESS THAN" Detectable Level Approved by:
® PROFESSIONAL LABORATORY SERVICES SINCE 1952