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C ~in~ ~'o F-D~L m 3 0 ~ d u0i a~ y= o~ ~ o a~ a~ E .7 Y J ~ T j n T O. -p O T m a y C C N~ y 4) N y O C l6 O O C~ 7 } ~ (6 N tp .C ~ p 0 > > c Y Vl U d' ~ a ~ ~ U O avi ~ ~ O ~ 'O 4 O O. ~ C '~ T ~ H C O ~ ti 0 a •'= i O- 0 0 Q O a1w T ~ o ~ ~ d ° L C 'p i !0 p Y ~~ C p U C X~ a C ~ y ~ O ~ ~ ~ .~ ~ _ ~ Gi `O 'O w> ~ y O ~ ~ i U O w0,, ~ a. y y -O w 'O O ~C N 01 1- 7 C O !>'0 w 0 y N V O C O y 3+' a 7 o c~~ ~ E ~ fl-s d ~ 7 .~ !~ cypp 'O C C ~ lp ... O ~ U V O tl1 Cl f6 L C r Y '0~"' ~ ~ 0 N L~ w 0 C a 0 0~ L ~-- O O O 0 0 ` i. N V T O y l6 0 ~ y U N 0 a~4ladc a` 0UC ~ o° mow. ~ i~ 0 U N y c O >+ N`= 0 -p O N 0 f0 U~ y 0 m t0 10 G~ V ~"' Y O) O N C O O" O f6 0 -.. 0 O C y >i f6 !~ V a R >~ > ~ y C O y m -00 y L a i O O O O) L 0 0 c6 0 C U O~ d a 0 L y L U .L..y V y~~moE 3 a`1~°3 •3 cN ~ 0~ .Q a T ys U1 c~ y N 0 N y a L~ E o. v~ a 0 ~ > 0 0 ate. ,.-0. ~ ~. y C N 0 O. ' O. R y -p O` O1 w e 'CS 401 ~ p ~ O. w e O j 0 ~O c 'C ~~ C Q C 0 ~~ O C O p U d N O p N~ w~ V T t0 ~ y ~ f6 U 0 N O) t6 i N U C ~ y C p1 y 401 O N y c~ 0 X 3~ 0 ~> t0 •-~ dl 0 7 0 3 N C > C O 0 L O t o .C ~ p- :~ > ° o~ H 3 F ° F- o a1 y V y !0 (6 ~~ a~ c a o a1 Q m U o O p y= ea R 41 N ~- Taw E 3 mL __ y N ~, 3~ D1 a ~ N a 3 ~ 3 N .0.. r > ~'OL y _T U - O .Q (6 0 Q T ~a~ 0 N y .L...T~ Q C it ~ L (6 6 `~ c 0 a .. V) O (6 •- U ~ O ~ O O C ~' m ~ ~ ~ T O ~ 41 ~ l0 y O Q y C R 0 y ~ 3 0 .c o > FL- ~ 0 LLI y N ~ :: U r 'C ~ l~6 .~-~ ld y Ta 16 3 a 16 o T y a. o U~;u y T f6 0 O p1 U - .r a N c c m N 0 3 ~ L T ~ t0 ~ N _ a c .tom ' '~ v_ I- m o (n '~ y ~ U O 0 N ~ 3 ~ O 0 w w .~ ~ ~ 7 ~ O 6 U O y O 0 O) ~ m y 3 0 ~ N y ~- r ~x: N O +L,., ~ O E O O o N N 0 L T Q C~ .L-~ C ~v•o-'N Q~aR ~~° y p_'~ 0 0 ~ ~ C ~ £ f0w vw o N:°. Oj, 7 O C ~ 01 41 y ~ ~ °'m °~ o•~ ° ~ o' 0 y L d~ a ~ y N ~ 0 O 0 L /6 ~ O L '"' C N - 4) ++ 7 f6 T 0 (6 O cY°Q' a1m3 ~~ (6 C w 0 Q~ ~ a ~0-' Y~°cs 1°~-° m3 c rn - v ... y ~ac~~ omQ ~ U~ O. O~ C 3 Y 401 ~ 0 a y C N C C .C l6 N .V N C E O` ~0 C (Tp o.io ~ a rn~ :°. E 0 >` y 0 C U r 0 0 C r~ C L .L-. ~~ O U _y C N w C J ~ O)\ ~ C Y ~ ~ N f6 ~ "O 'c ~ N ~ fC6 0 0 ~ ~ 40-- Q M ~ L o O j fl.~ V C r O. ~ Y 0~ N C N ~ U L Q. N> N U~ L a 0 Y ~ J ~ a .L-~ ~ N ~ Q N (6 L' ~ O l6 ~ 0 w U ~~ a Y W~~ y y o, R y a1 ~ Yp .+ N 0 a C 3 0. O O O >N O 3 d ~ V O 0 0 ~> Q4) ~.~ TT S a O C7 _ - VViscensin Department of Commerce PRIVATE SEWAGE SYSTEM Safey and Fuilding Division ~ t, INSPECTION REPORT ~~NERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)j. ermit Holder's Name: City Village X Township Mikla, John Hammond, Town of ST BM Elev: insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic / Dosing ~ r7 !~ Aeration ^„ ~ ~ /'`' W Molding U TANK SETBACK INFORMATION TANK TO ~/ ` N WELL BLDG. Vent to Air Intake ~ ROAD Septic / l > ~t~ ~ ~ 3~ osing \ ~ i ~.o Aeration Holding (PU M PI$IPi-f6id-tiQFORMATION Ma acturer -~ Demand G~ C~~.1 GPM Model Number ~' 3~~ TDH Lift Friction Loss System Head TDH Ft - 2.G , S~ iY•S Forcemain Lengt Dia. ,/J, Dist. to well /l 2 SOIL ABSORPTION SYSTEM j BEDITRENCH Width ~ Length ~ DIMENSIONS n S SETBACK SYSTEM TO ~/ INFORMATION Type Of Sy~em: , o. Of Trenches / P/L BLDG WELL DISTRIBU ION SYSTEM Head anifold Distribution !7 Pipe(s) Length_ J Dia ~ Length SOIL COVER C ELEVATION DATA county: -•- St. Croix Sanitary Permit No: 506313 0 Staie Plan ID No: Parcel Tax No: 018-1060-10-000 Section/Town/Range/Map No: 26.29.17.409 B STATION BS HI FS ELEV. Benchmark !f ~ /o ,/ iod .v Alt. BM Bld . Se er S t Inlet ~ 3<f ~, g7 jz. 23 .SMHt Outlet Dt Inlet SCI-( ~ o /1. mil/ • ~o tBOttO ~.Sr ~~"~ Header/Man. / i f / P~~l ;,,~ _ /~ / GJfI, jj ' Bo :System ~Qo ~(d ~, / ~ ~ ~ 2 . yZ Final Grade --J 6 -~ar.~- 7 8S" 9 G- z~ t Cove ~ i ~~ ~. ~ y ~ .L ,~ ~ ~ PIT DIMENSIONS INo. Of Pits LAKE/STREAM i Inside Dia. (Liquid Depth OR ~ tYI ~~ Model Number: ~ ~ x Hole e x Hole Spacing ' 3 ' ~/ 3 "v 2~ ,~ Dia_ Spacing rassura SvctPms Only YY Mnund Or At-Grade Systems Only Depth Over Depth Over / xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center p Bed/Trench Edges 3 . D 3 Topsoil r~ Yes L~ No ~ Yes ^ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ /~ / (~~ ~ Inspection #2: / / Location: 1940 Cty. Rd. J Baldwin, WI 54002 (SE 1/4 SW 1/4 26T2~9jN~R/17W) metes & bounds!'L,otn ~,~~-` ~, /Parcel No: 26.29.17.409 B 1.) Alt BM Description = ~""- - ~ ~'~'"`""' < </ ~ ~~ f~'~°~ 2.) Bldg sewer length = Z 2, ~ ~' ~ `~~~ `~ ~~s~ -amount of cover = ~ ~/ r ~~ __ _ _ , ,, .,' Plan revision Required i Yes ,__, No [~ , / ,~--~ j ` 1. //, ~ _ (p~,~~~ / __ Use other side for additional information. / `r _ Lam' ~'•' ~ ~~ _ .L(.~~~•~-- .- SBD-6710 (R.3/97) Date Insepctor's Si ature Cert. No. ak ~ Vent to Air Intake / ~ /iic r~ n ~ f I }-•~'' f ~' (Y O .~Il'K~ ~ / ~D ~d./I//O,eai'/%J//~ ~ /W /Irv ~r iVii ~!y'1.Gzn .lttaeA Is eompkYe gt:xxs ~r the systea aed sob»xit to tl~ Cauaty say ow t»per cot tea thaa S r2 z 11 i i ' '.A...S~.i _ a +. f SBD-6398 (R- O1i07) Valid three OU09 :,` I l ~"'~_~ Cvillmercetilfi.goV Safety attd Bul7dings Division County,..; 1 ' ^ 201 W. Washington Ave., P.O. Box 7162 .~~ , / d ~ sC~ ~~ ~.~"~ Madison, WI 53? 7162 Satti~ry Permit Number (to be filled in by Co-) Departtttertt of Cotrutterce 3 Sanitary Permdt Applicatio State Transaction NumbeJr~ ~ in aoaordarxce wilfi S. Comm. g3.21(2b Wis. Adm. Cade, srrinniuion of this Corm to the fR/YI.CY ` 7 ~ S~ tnrit is required prior to obtaining a sanitary petntit Note: Application fours for WTS Projxt Address (if different tlranmailitxgaddress) submittal to the Departnwrxt of Commerce. Persoml infomxation you provide may be used for in aceordaaxce with the Pri Law, s. I5. i m Stars.. ' ~ ~ ~ ~ l ~ ~ .:.a..~ ! I t•% ' - ` ` ~ i. A lisatioa iaformatioa - Ptea~ Print AO I n '- Propeny Owner's Name ~' Parcel # , ~. ~dh ~ l k/a © - o o- 4- o00 Property1'Owner's Mailing Address Property Lacatton • L J ~j / l: ~ 7 kJ . - 1 g " o C~ l ? . • Govt Lot Ctty. State rp Code N s E /.,, S W v,, Sect~ Z ~D r 1, ' Cl ~~ 6¢ 1N ~ Jr~UD lg~ '" ~5 ~a ot ~ T Z / N; R l~` r II. Type of Btttl7diwg (check all that apply) ` Lot a L~ ~lor2_Farn7yDarelting-~I~rmberofHahnoms_ ~ a , _• ''•,. Subdivision Name © PubliclComrnercial -Describe Use _; ^ City of ~ State Owned -Describe Use ~ CSM Number ^ Village of __ ~ r r ~•, ~. o III. T ppe of Permit: (Check only one box on Imc A^ Compietle lice B if applicable) A- ^ New System Repbttxrrrettt System -------, ^ Tnea>mertUElotd'ing Tant Replacattgtt Only ^ Other Modification to Foisting System (exphtin) B. ^ Permit Renewal ~ Permit Revision ^ Chats of Plumber ^ Permit Transfer to New i.ist Previots Permit N and Issued Before Expiration Owner ~ Z ~ ~~ rv. T of POwTS S em/Co t/Devic~ Check aH that a l Q Non-Pnxsurized b--crowd Pressurised in-Grouud ^ At-Grade ^ Mamd > 2d m. ofsuitabk sox? ~ Mound < 24 in" of srritabk sal ^ Holding Tank ~ Other Dispersal Coxopaxxxt (explairxj Pretrratrttent Device (explain} ~'?O ~S Y. - ersuuflfrestmeat Area tatot-matioa: Design Flow iSPa) [Resign Soil Application ~ Dispersal Area Required (sfj Dispersal Area Praposnd (sf) ystem Elevation 'S~5 O ~ V i. Tank tufo Capttciry in Tata1 g of Manufacturer o Gallons Gallas Units ~ . ~ n ~ Nls Txtia Existing Tspks ,~ ! ~,.. f ' `wLa c S 2 ~ ~ ~ m ~~ Ji <:l:~r3 1 ' ti"'C. p. V q m h is. i7 i% lTxmk r7 /.s l~~ ~" f" al~(~j ~Sf CJin~+ 1CI'D . c/ - 73~ ''` 750 / "c.ea.Qn ~ ~' VII. Respotl>.~~ity Shtemeat- [, the , aesrme for tbe POWIS shown ea the attached picas. Piumba'`s Name (Print) Phaaber• i MP/MPRS Number Bus' Phone Number `''s e ~ ~ ~ 1<e NIP as ~i ~ ~~ a - y/s Pi 's Address (Street, City. State. ?ap Code) ~V 1 ~ AQ Gc ~J i3n a~O ,~te~n ~.-- ~D e. ~-. ~` ~ ~ ~ e ~ ~ ~ t. ~a` l ~'a~X ~ ~.~J ~~t~ VIII. as t ~ Permit Fee Date gets Si ~ urn Denial S QD ~ ~ $ 3/ Q7 Of. Coa ' foi- Disapproval ~ ~ .~ effluent fitter and , "~ -s> ~ , ,:.'~ ,:~ . .. Stlptiatank, 1 . ~S.M+... r --.. ~+ ~- w" `~'~ ~=~~=,' . . dispersal cell must all be services /maintained ~ , _ ~ M,, , K x a - " ` " as p~ managerttertt plan provided by plumber. ' - 2 ~AN ttta'lb.ek ragttiremertts must be maintaited_ `~ , , ,1 f. ' ^ 4 c • ~,' {{ •, i i,U ,~ c ,c ~.~ C l ~ d-. ~Fc c 1 .. , * ,,. 1;. , r 1 > i dirtattCas. _ . . _ .- .. - ,~~~ 4 SE,SW,26,29N/R17W Hammond township SITE PLAN St. Croix county /~ LEGEND ~ " -`J°"`''~ BM 100.0' top seam of ~ ` ~ bottomconcrete corner .block ~~ a~j~~ ~a ~ _ X -pits ` ~~ ~~ 0 -grade el eva~ti ons - ~ ~ contour ^ ` ~ ~ ` No Comm 83 setback problems .,t ~ ~ E-~ flow 1203H 1 ~',~, i w. ` fi b' sand material n r ;/-` ,~ '~ Y„r 1 ~~`~ ,~ ~ t h ~ ~ System to be installed on contour 95-.30' (5ft, each ,-` s~de ~{ ~ ~ ~ ~. O- ~. ~ ~ f conto ~~ Scale 1 - 30' ur) ~~~ ~~~ 0 1 ~ ~~ except where indi ted o °~ ° ~ ~ ~ ~ ~ ~. ~ -~ '' ` ~ S ~ ~ ~ °'' ~ ra ~ , E" -'~ ~---- ~ 6D ' --~ ~r r I~ ~:'~ `~ (~ a 1 5 ~~ ~, n U l~ lry c~ 3 ~'~~o t C - r/ '~' project: MIKLA r ~:~ ~~ / _ ~~ ~ ~., "r r _ G a ~ 1 4° ~ ~ ~ X `9 U ~~ . lJ ~ . V ~~'` ,~ 1jJJ _._ _.. .~` ~ ~y ` 't ~~ ,~"' X r ~ C s~- ~:, J P ~ ti ..f. f . l i I r page6of9 . r ay SE,SW,26,29NJR17W Hammond township St. Croix county ~"' ~.~ a BM 100,0' top seam of - bottomconcrete corner .block X -pits ~~4` ~ ~'~~ ~ 0 -grade e7ev&tions '~~- ~~ contour ~ ~~ ~ No Comm 83 setback problems ` ~ 1- E-~ flow 1203N ~ ~,` i ~ ` ~ sand material ~ ~ ,. '°~ r, System to be installed on ~'` ~ :~o ~, contour 95-.30' (5ft, each s~de ~ ~ ~ ~`~ ~~ Scale 1" - 30' f contou~r~), o ~ ~,,, `~ except where indi ted ° °~~~.:_.__.._. -- ~~O ~ ~~` ~~ _ ' S~ 1~ a'' 3~ '~ .~ 4 I ~r r -=, ~ s P ~ P $ ,,.~ ~ !'L ~~ project: MIKLA ~~ ~~ SITE PLAN S ~~ ~ ~~~ Y'r y t -____ 0 page6of9 _ - - ~ '~ ~' ~'~y"; ' ~ ` commerce.wi.gov ~ ~ ~scons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. co m m e rce. wi . g ov/s b/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary August 07, 2007 CUST ID No. 224580 LORETTA LARRABEE L & L PERC TESTING N2089 CTY RD Y MENOMONIE WI 54751 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIl2ES: 08/07/2009 IdentificationNumbers SITE: Transaction ID No. 1425516 John Mickla Site ID No. 728564 1940 County Road J Please refer to both identification numbers, Village of Hammond above, in all corres ondence with the a enc . St Croix County _ SE1/4, SW1/4, S26, T29N, R17W FOR: _ __. Description: Pressurized In-ground POWTS /Replacement construction /Pretreatment unit Object Type: POWTS Individual Site Design Regulated Object ID No.: 1144986 Maintenance required; Replacement system; 450 GPD Flow rate; 17 in Soil minimum depth to limiting factor from original grade; System: Pressurized In-ground The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system has been reviewed and approved as an Individual Site Design. The system shall be constructed in accordance with the approved plans and ch. Comm. 83, Wis. Adm. Code. • The application for a sanitary permit shall be accompanied with documentation that the master plumber or master plumber-restricted service who is to be responsible for the installation or modification of the POWTS has completed approved training on the proposed POWTS technology or method. • Any maintenance requirements that the pretreatment unit requires at an interval of 12 months or less must be recorded with the deed for the properi~py of the document must be presented to the county before the permit can be issued in accordance with the requirements of Sec. 145.135 and 145.19 Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • A COpy of the ap roved plans, specifications and this Letter shall be on-site during construction and o ep n to inspection by authorized representatives of the Department which may include local ins ectors. R.~.'~"~~.T.S. ~n11 ~l t101? l~~~y ~~ DEPARTMENT OF COMMERCE y • LORETTA LARRABEE Page 2 8/7/2007 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1), Wis. Adm. Code. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the pxoperty owner must follow the contingency plan as described in the approved plans. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence maybe made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS._ - ____ Sincerely, ~~%~~ erard M Swim POWTS Plan Reviewer ,Integrated Services (608)789-7892 ,Mon -Fri, 7:15 am - 4:00 pm j erry. swim@wiscons in. gov Fee Required $ 300.00 Fee Received $ 300.00 Balance Due $ 0.00 WiSMART coder 7633 cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 ,Friday, 7:00 A.M. To 3:30 P.M. .~ Service Provider's Name: System in Fill Maintenance and Operation Specifications H & H Plumbing L.L.C. POWTS Regulator's Name: St. Croix County Zoning Office System Flow and Load Parameters Design Flow -Peak 450gpd Estimated Flow -Average 300gpd Septic tank Capacity 975gals Soil absorption component Size 450bed Type of Wastewater Domestic Phone: 715/962-4155 Phone: 715/386-4680 Maximum Influent Particles Size 1/bin Maximum TSS 30mg/L Maximum FOG 30mg/L Service Frequency Septic and Pump Tank --------Inspect and/or service once every 3 years Effluent Filter-------------------Should inspect and clean at least once every 3 years Pump and Controls ------------Test once every 3 years Alarm----------------------------Should test monthly Pressure System ---------------Laterals should be flushed and pressure tested every 1 'la years Drain field----------------------Inspect for ponding and seepage once every 3 years Other----------------------------Initially filter should be checked yearly to determine service schedule Miscellaneous Construction and Materials Standards 1. Observation pipes are of materials conform to Table Comm 84.30-1, have a watertight cap and are secured as shown in the In ground component manual. 2. All pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 3. The disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration 4. Lateral Turn-un to finish at grade or above, enclosed in a 6-8" diameter lawn sprinkler valve box or similar product. (lateral turn-up consists of a long sweep 90 or two 45degree bends same diameter as lateral) 5. Lateral Turn-up on end of distribution laterals after the last orifice. 6. Bottom area of E-Z flow to be hand rake level project: MIKLA page 8 of 9 f ~ ^ f h ~ System Management & Construction Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code. And shall maintained in accordance with it's component manuals and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks aze no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8" in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic -Micro Fast Tank The tanks shall be maintained by an individual certified to service septic tanks under s.281.48, Stats. 'The contents of the septic tank shall be disposed of in accordance with NR 113, Wis Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 yeazs by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slip off the filer when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personal shall advise the owner of when the next service needs to be done to maintain less than maximum scum and sludge accumulation in the tank. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. System in Fill and Pressure Distribution System No trees or shrubs should be planted on the system area. Plantings maybe made around the perimeter and drain field azea shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the system is not recommended since soil compaction may hinder aeration of the surface within the system and snow compaction in the winter will promote frost penetration. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral and it is recommended that each lateral be flushed at least once every 18months. When a pressure test is performed is should be compared to the initial test when the system was installed to determine if orifice clogging has occurred, if clogging has occurred orifice cleaning is required to maintain equal distribution within the cell. Observation pipes within the dispersal cell shall be checked for ei~luent ponding. Ponding levels shall be reported to the owner and any levels above 6" considered impending failure requiring additional, more frequent monitoring. Construction Details Cell to be dug with tooth bucket, to prevent compaction. Cell excavation continuously checked for width and elevation. Bottom area of E-Z flow to be hand rake level, loosen infiltrate surface. Side walls of E-Z flow to be compacted by field personal. Back filling of cell with a track machine. Continency Plan If the tanks or any of its components become defective, the tank or components shall be repaired or replaced to keep the system in proper operating condition. If the system fails to accept wastewater or discharges wastewater to the ground surface, it will be repaired or replace by removing biologically clogged absorption and dispersal media and related piping and replacing components as deemed necessary to bring the system into proper operating condition. See page 8 of this plan far the name and telephone number of your local POWTS regulator and service provider. project: MIKLA page 9 of 9 ~ , , uv~c;~sinDeparuner-tot~omrr~rce ~ SOIL EVALUATION REPORT Division of Safety and Buildings _ in accordance with Comm ~is. m. Code Attach County Than 81/2 x 11 in size. include, twt tat reference point (BM . Parcel LD. percent S< ons, north snow. and location and distan n t ~),~ ~" Please print a!! information. Re Pers«>el r~ ya+ rte mey ae +,sea S~o~,VhC~ ~. +s.oa (~ m»• J,,R Pf Off' °~'~ roperty tACation ,P. '/o Pk a MAY 2 5 2007 vt I.ot S'[ va, Properly Owner's Mailing .Tess # Block # Sut ~9~D ~~ .~ ST. CROIX COUNTY ~ City State Zip Code Phon City ; ^ Vitlage !(J Date • .. cal S~(,~ T ay N R j7 CSM# ~Z~~Z~Yyt~~ - wn Nearest Road 1 LJaidCV1"r~ i lAl1 i -5~/0o d I (`1/~) ~'~- ~s~a 1 / ~s;~l' ~ ~ ~,,~, ,Pd T ^ New Constnrctlon Use: Residential / Number of bedrooms _ 3 Code derived design flow rate _ '~Sa GPD . Replacement Public or commercial -Describe: /V.,S - Parent material -. ,,..en d?tfi( rrr ~fL_ze Flood Plain elevation if apptlcable ~- ,4 • ft General commends = _ and r8commendatiOr:,S' ./DC°~m.,,ro~..~ Cc. m ~1~~~ ~i O~ ~ ~ ~oii~.,~ ~.~ `~~ a0~,~ ,~,g,~c J 4~~U .tl/2 /. J~S~ ~ ~ . L' .m ~a ~ Rpn ~ n ~...t °I~i~,~ i L. Boring# ^. Boring Pit Ground surface elev. g 7 ~ n i?eath ~ NrraBne facxcn ~ ~ ~ ;., Hori¢on Depth Dominant Color Redox Descriptpr- Textun; - Structure Consistence Boundary Roots Soil Apptlptwn Rate GPO/ft2 in. Munsetl Qu. Sz. ConL Color Gr. Sz. Sh. 'Etf#1 'Ett#2 ~` ~" a- S .s P 6 -F r - 3/ li, C ~ ~ ~' ~ / ~» t r W oyl. r ~- g ~~ ~ ~9 ~ ~' Gnxurcl surface elev. ~ `~~ Co tt r~,n, rn „~, ~,.~ i 8 .,, tiorizan Depth Domirant Color Redox DescripGar Texture _ Stnu~ure Consistence Boundary Roots Soli Applic~flon Rate GPD/ftz in. MunseB Qu. Sz. Coat Color Gr. Sz. Sh. •Etf#f'1 'Eff#2 /~ , -18 .~ 3/ P e a6k f ~-l b -SY ~~ 7.5Y~ 6~6~.5~ r' ~ / r v -(m 73 3/ ~ -~ --~+- ~-~ lr~ ~0 q ~ ~ alp' ' #1 = BOD, > 30 < 220 ng/t and TSS >30 _ 50 mglt ' Effluent #2 = BOD, < 30 mg/t. and TSS _< 30 mglL CST Name (Please Print) ignature CST Number Ms. Loretta A. ~~ CSTM 2245$0 Address Date Evaluation Concluded Telephone Numb N2089 Cty. Rd. Y, Mentmtonie, WI 54751 p ,/ -" _ ,fin:./ ~7; ~bO~ `T7 S/~F,a_~ti r~ . Page ~~ of ~. c < t> . ,~ ? // Y• Property owner ~.l~1'l~ /~: X~it, ' f~'a~oi31 lD # c9> 8~ 1O to 0 - /D ~ c~ Pane v~~, ~f ~ - 1 Boring # ^ Boring r . ~" ~ Pif Ground surface elev. ,~ ~ Depth to limiting factor ~~~O~ in. Sal Application Rate Horizon Depth Dominant Color Redox Oespiption 'Texture Structure Consistence Boundary Roots ~ GPDJtiz in. Mansell Gtu. Sz. Cont Color Gr. Sz Sh. 'Eff#~ 'Eff#2 - ,3~ . s 3~~ e m bk ~ S ..~. . s ,~ ~ ~, -~ -+- . l~- lrr~ . b f ~ ~ a ,o - ~. ^ Boring # ^ Boring ^ Pit Ground surface.elev. ft . Depth to Umiting factor in. Sal AppNcation Rate HoAZOn t)epth Dominant Color Redox Description Texture Structure Cansistence Boundary Roots GPD/Rz in. Mansell Qu. Sz. Coat Color Gr. Sz. Sh. 'Eff#i 'Eff#2 # ^ ~S ^ ~ Ground surface elev. R Depth b tirnifing factor ~. Sod lion Rate Horizon Depth Dortdnant Color Redauc Descxiptiorr 7exhse Strur~rrne Consistence Boundary Roots Gpp~z hr. Mansell t1rr. Sz. Cont Cobr Gr. Sz. Sh. 'Ett'#1 *Eff#2 ~~. ' Effluent #1 =SODS > 30 < 220 mgll_ and TSS >30 < 150 mgll. ' Ettluent #2 = BODS < 30 trrg/L and TSS < 30 mglL 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 five department at 60&266-3151 or TTY 60&264.8777. . . ssu.~w~.dory c sT ~' f _ Property Owner ~/o~/i~ ~ '/i ~`~Q.. ~ Boring # ^ Boring yam, ~ "/.:^ ` Pit Ground surface elev. ~='''`' Depth to limiting factor \ /'~j gyn ~~ OePth in Dominant Color Redox Description 'Texture ' . Structure Consistence Boundary Root Sal Application Rate ~ . Munseli Qu. Sz. Cont Color Gr. Sz. Sh. s GPO/ft 'EtT#1 'Eff#2 =~ ! 7 s !i o v ,..r ~., .. Ong # ^ Boring __ ^ Pit Ground surface elev. ft.. Oepth to limiting factor in. Ho~on ~Pth Dominant Color Redox Description Texture StrucWre SoU Elppiiration Rate in. MunseU Qu. Sz. Cont Color Cons~stenoe Boundary Roots GPD/R~ Gr. Sz. Sh. 'EtT#1 i 'EtT#2 t Bonng # ^ ~B , ^ Pit Ground surfaoe elev. R Depfh tD limiting factor in. t~ocizon ~~ Dominant Cobr Redox Descxi~ion Texture StrucGme SoU Rate tr-• tJlunseq Qu. Sz. Cont Color ~~ Boundary Rom GPWIt~ Gr. Sz. Sh. 'Eti#1 ~ 'Eff#Z i I ~ ~ ' EfRuent #1 = 80Ds > 30 < ~p ~ and TSS >30 < 150 rngll, ' EtAuent #2 = BOD < ~p s _ ~ and. TSS < 30 mglt. TLe i~pathnent of Commerce is an equal opportunity service provider and employer. If you need assistance W access services or need material in an alternate format, please contact the department at 60&266-31 S 1 or TTY 60g_2ti4-8777. seo.a~w txwoot - . +` ~ Soil and Site Evaluation Report 1 John Mikla N Al ~, I SE SW 26 29N/R17W Hammond. township St. Croix county ~- ~ _._~-~' " r ~' ~~. Loretta Larrabee CSTM 224580 "Y LEGEND 1$M: 100.0' top seam of bottom concrete corner block X -pits • -grade elev. --- contour No Comm 83 setback prob ms Scale 1" - 30 xce where indica d 9 G U GJ d ~ ~i f? E'S ~~~~ ~'~ ~ ~ ~~ ~`~ a ~ j ,~~ K - . \ r* ~ \ ~~ ~ ~ ~ -''"~ ~. ~\~ P~yu ~ (~ ~t _.~ I t ~ i o ` lam' . f ~ h. i I ~ a -'` 1 i ~S' 4~ 9~ ~ ;; j ~° S (~° I r ~i , ~ 1 ~o °~.~ % ~~- _/ F --~ {-- ~ 6n - --~ \~ r 1 {,+ 7 C ~~~ a ~ t-+ L ~~ ~ K Page 3 of 3 s~ ,.~ 0 ~y, K ~ _.. 1 , l~ ~ _ . i ~.... , r P ~~ .s ``~, ~~4 ~~`., --- .~ ~~ ~- - f:~ /~ ~~ ~EIVEC j . ~ ` A?,G - 6 ~ivate On. Site Wastewater Treatment System (POWYS} S stem ><n Fill & Pressure Di tr><bution Com nen De >! y s po t s gn SA~~ ~ i ~ ~U~~DI~'d.~~ Replacement Residential application Index and Title Sheet Project Name: MIKLA Owner: Mr. John Mikla Owner's address: 1940 Cty. Rd. J, Baldwin, WI 54002 above address Street Address: SE,SW,26,29,N/R17W Legal Description Hammond township, St. Croix county TownshiplCounty ParcelId.# 018-1060-10-000 Trans Id # 1425516 Contents: Page 1: Page 2: Page 3: Page 4: Page 5: Page 6: Page 7a-e Page 8: Page 9: Attachment: index and title general information & lateral diagram top & side view drawings dose tank pump information site plan microfast specifications management plan contingency plan soil test to state plan Designer's name and license no: Loretta. Larrabee # 1872-007 Address: N2089 Cty Rd. Y Menomonie, WI 54751 Phone: 715/664-8184 Fax: 715/664-8164 Cell: 715/308-1668 e-mail: lanlnerctesting~lwwt.net Designer's Signature:, a, ```~~111#11/~~~, `~~GQ.t~~l~1,,. I~~ ;~ ~ ~ 3i~: .. _: ~ .:~= .. •;~ .:. * ;. ~' ~~Q~ - i'Sg~p . Date: July 24, 1007 ~~ ~""' I the undersigned submitted these plans under my authority SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81} Dltli5-0t~ {1F 5 Y ANU bliiLU1NGS page 1 of 9 SEE GORRESPO ENCE .ti Replacement site far system In-Fill three bedroom home, 450gats DWF eilluent quality #Z W975/1425 Bi0-500gpd Microfast 0.5 7SOgal Wieser Concrete pump tank soil pit depth @ 63" limitation @ 18-34" required 24" of suitable soil available suitable soil 29" - ?.4" credit of natural soil proposing additional 8" (0.67') approved sand men su ~~ 1 -~~, finish grade ell loft. by 75ft. with pres sand rate LO site area is < 35% gravel orifice 6.0 sq.ft. 450sq.ft. required 450sq.ft. proposing 5132 dia. orifice / 0.54 discharge rate 3.5 pressure in ft. 37 orifices per lateral 1198_ 39.96 gpm total system l-1'ateral icug~.u ~r ~ i au. rifice from end of cell {E} 1.Sft. {18") ~rifice spacing 2ft. ~24"} first 4 orifices up, 5 onfice down, pattern continued the length of lateral last orifice of lateral bottom of lateral GENERAL INFORMATION VIEW OF LATERAL(S) Not to scale project: MII~L~L page 2 of 9 ,~ ~~ Observation i~.valve box TOP VIEW Not to scale ,i n Finish grade elev. 45-3~~ back fill material ~ ~ Z~f ~.... V~i ~ in ~ ~~ ~.\, sar~' fi 11 ~~ ;'~ r~ b ;~ disperal cell elev. ~Z.4'7 cell_ bottom elev. q 1.$O' i ., ~;~ ~ t ZZ-N~ ~. I ~..~ '~ ~Q U~ F H ~~ ~,~ ¢~-~~~g~ ~i1~ invert lateral el ev .~12,~7 ~ ~ ,i ~7A l A Fi %~ project: MIKLA page 3 of 9_ SIDE VIEW Not to scale ~, .` PU!•~P CHA.t~B~R CRt55 5EC`10.J ANG SPECIF It:~~rlU~!5 V1=A.~T CAP 4" Sch 40 vent ~ 15ft good WItJDOW OR FRESH AIR INTAKE 12"MIU. I I I cououlT `-- APPROVED LOC~(~AIC.. MAFJHOIE CaVEF. WEATHERPROOF JUAICTIOIJ BOX GRADE 18"/ \lt~. tA1LET APPROVED JOIAIT A 8 C D v ~~ _ -__ \~~ _ 1 PROVIDE I AIRTIGHT SEAL I I PUM1P-~~y -,~ CONCRETE 6LOCK 4" MI-J. ~i~ V ~I~ I ~ ( APPROVED JOtt<ITS II+ WIC.=. PIPE I ~ ALARM EXTEUDIIJG 3' + I OIJTO SOLID SOIL { b OtJ • i OFF RISER EXIT PERMI1i'EC OfJLy fF TAtJK MAUUFACTURER Has SucH APPROVAL SPECIFI~CAT`IOA3S -~'~'~~'""'~"`~"~~~~ ~~71~~ ~~ ~ ~ ~~ TANK. MANUFACTURER: '75© GALLOWS _ ~O~!o ~v~j= _ ~~_ c~~~S TAfU)( SIZE : ~ ~''7 I Ib ALARM MAISUFACTUR7i.R: ~_ J• ~Ie~o ~ • ~e ~®~ ~" ~-~ S MODEL WUM6ER: ~~ T1 CAPACITIES: A=~{IJCHES OR ~~oy SWITCH TYPE: ~ e ~~ Lt r~/ f3 = ~' IAICHES OR ~" ~GAILOAIS PUMP MANUFACTURER: L91<><le ~g~-~'¢ ~ C= ~~tIJCHES OR ~~~ ~/GALL01J5 MODEL fJUMDER: ~ ~~ ~ '~ D ~ =2_.INCHES ~~ ~J='^=`'pGAll01~15 © 37 ?So..3b SWITCH TJPE' „~`reChc~ri-C0.. fJOTE: PUMP AUD ALARM ARE TO pE MfN1MUM O1SCfiARGE RA7E~GPM INSTALLED 0A1 SEPARATE CIRCUITS -~g yERTItAL DIFFEREI~ICE DET W[CIJ PUMP OFF At~?D DISTR{RUTIWJ PIPE.. ~ ~~ FEET Z ~ 1E7+'I Z~• ~-U I + MIAIiMUM nlETWORK SUPPLY PRESSURTE~,3°~,'~ ~°3, y•~ FEET y`. ~~ ~- _ la`' FEET OF FORCE MAIM X 3'~' FlooiT.FRICTio1J FACTOR:. ~°~~ FEET project; MIKLA W~C.I. PIPE EXTENDitJG 3' piJTO SOLID SOtt j ,t~ , ELEV. ~` ~"FT. - -TOTAL DyfJAMIC HERO = -3~ FEET ~ y. S'y page4of9 i r y ~ 3EH High Head Series I'RCII)UCT C'IIARACTF.RISTIGS ~. .....................»...........alallp slr.aaa Polo AAsoaraao now race ..............70 GpM O 5' 289lP1d o 1.52m Mmami.aMeea__ ................32' ........................9.am Saids trerrdlrp tdla.) ............3/4' »..........»........19mm Upuid Tamp. to ....................tAOF ....................saC CMdwDs .............»...»........i 1/2' HW~(38.imrrd hlouair9 ..............................Epoxy coetedca~t iron Cover ..................................G11eae~Hed nylon V61ute ..................................ABS Mgreler ................................Clo~edvane pcyoerbonese Shaft Seal ............................Cebon/Cererrrc 8aarirgs .» .............»..........Upper: Stntiaed slaere txsMrps Lower. 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CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNElZSHIP CERTIFICATION FORM Mr. John Mikla Mailing Address 1940 Cty . Rd . J , Baldwin , WI 54002 Property Address same a s a b o v e (Verification required from Planning & Zoning Department for new construction.) City/State Baldwin , W I LEGAL DESCRIPTION Property Location S E '/4 ~ S W Subdivision Parcel Identification Number 018-1060..-10-000 '/a, Sec. 26 ,T 29 NR 17 W, Town of Hammond Certified Survey Map # ~ ,Volume -r ,Page # Warranty Deed # ~` ~9 '1 ~ y ~ ,Volume _ ~ 5 5 ~, Page # Spec house X no Lot lines identifiable yes ~oX SYSTEM MAINTENANCE AND OWNER CERTIFICATION Lot # i. 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 Department a certification forth, 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 Wi$consin. 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. Uwe amlare the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. ~ ~. Number of b rooms t h r e e SIGN OF APPLIC (~ ~ DATE ***Any information that is misrepresented ~y result in the sanitary permit being revoked by the Planning & Zoning Deparment. *** 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 warrarny deed. - ' (IZEV. os/os) ~ '' . 07/23/07 YON 13:52 FAd 715 386 4686 r ST CRd CO ZONFNG I~~~~~ I~II~ I~~~I ~~~~~ ~~~~~ ~~~I~ II~~ ~~I~I~ II~~ ~I~~ X 8 5 9 4 0 7 2 859407 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 08/28/2007 08:45AM AGREEMENT E%EMPi t REC FEE: 13.00 PAGES: 2 St. Croix County AEROBIC TREATMENT UNIT (ATUj SERVICING AGREEMENT fate Pfau Transactlon Number John Mikla Name - (Owner) Typed or printed Bang duty anroTn, atetee, under oeds. tit: 1, Hdshe is the ownrr/part owner of the following parcel of located in St. Croix Cotmty, Wisconsin,. riled in Volume page _L Document Number St. Croix County Register of Deeds Office: A par 61 of land located in the S '/. of the $ W '/. of Section T_ 2 ~_ N - R ~_ W, Town of -mod m m o n d , St. Croix County, Wiacronsin, being duly described as follows (include lot no. and tntbdivisiatD/CSM or detailed legal description): AOr..msrN one: O ~ - O ~ ~ O 7 1 ~3 rn ~.~, a.~ S ~e,,l eR w ~ . t,..fr..._ 5 44oZ ~~ -1060-10-000 As m Nrdrouewrt b tits carry b iaue a sarrtary Pit tar a P8WT3 equ4ped wMh ar Aerobic TreMrtrarK UnM on the abow~desaibsd prapsny, vw apnea b do srs toeowinp: 1. Owrwr a0reea b atntant b alt appliurbM regrirorrtsnte d Caren 83. Vyb. Adm. Cade reiatlnp b Aerobic TraMnrwtt UNb IATU) and ttw rmkrterwrce requtrarrrerrts lorthe proposed POVV13 (Wirses QnsiY WatarraW TrWnwd syehrn) eadmdooy. 1} tks oserer tstk b trove ere P~OWT3 arq ATU pnpaly asrvked in raepdrse b areas Nn+sd by 1M yo+rermwaat unit or 1M OepsNnsrri a Comrtwas b pavsra or abate a human haMh hwrd ae desatbsd in s. 2b4.6Y, aeets..1M povsnrnrsrrW unk tram) K+aY en6er span ~ qty aril ssrMas ors tank or caws b have ttte tank b be asrvtosd and drarga ere aeerer q pk~cirrp thr driupa on ets tea bfl a e apacfet aeaeanrant for arr.nt aarvtoss ranched. The alrrgee wd be ae>iaeead r prasrr[bad by:. 88A/OD, 8tte. 2 71w aKar apnea b rralrivkr s contract wMh a kcenad POVtITB mait>tirrsr nor the IYe or the syMam. The POINTS mainakw~r wiw pNlorm polodle YrpsNnw aril ntMniM>•ra a repuirsd try rra rnermM.ttrar and itrs Ospsrb+snt, incbdNrp, but not anrpad 1a tlrs btorrer. eMebbal eanlrals, one H.atmarrt urt opsraear and aMrdps daPYr. Thew Mrpstltorn eve b ba sehrarad every a moretrs for are first two years a opaadan and yearly YraedMr. 3. The owner eyrsea b cronblR Yre POlArfS mairlWtrsr kMndfalety upon any maNrr'Uon a the troabtrard tart end b rnMrMah t1+e uNt m a b rat avant a teerren Neahh Maard a daubed ti a. 254.SD. SM1s. 4. TM owrwr reooprrxse that tM ca+rtY, OepertmsM d Conrnera, or POWrS nrkdNner may make parlodic Ytapecgarrs a the wmparrsrrts b compteEa perlorrrrarrce morrtoAnp of ens unR 5. The avnsr a Yr aenr'a aparrt apreN b sport to the dapwtraenl or 0esgrrslsd ~K et are aonrpledon a each irwpeeYOrt, rnaYrwrwrae a aniana evsrrt in a enamor spsclMd by the depar4Nnt or dsgprraMd tpsrtt rritlrn 10 busktsss days lrorrr drs does d , mMnMnwta a pnidny. B. This spraernsnt wi nmah to etled only urdi the Caatty otuoe raPareide for the rogWaaon a POWTS oaAiries thatthe aerobic iresenant trnh m tarpsr aervse bra properly. M addltiar.ltlia a-rnrlwM may bs vrasled by maeu+Gn4 and reoordMtp said asrtlaastlon weh ralsrwroe b tlris proxrrork M awYr enamor rvtridt wNt permit the askiMrroa d tlts osrt111eatlon b bs dMMnrnsd by ralsrertce b the property. 7. This aproameM snaY Ds b4dY>o upon t!r awrar, dw heir d tre owrrar. and aaslpraa d Yra owner. Ttr owner Mao submit bb apnaararrt b fns Rspirder d Dssds, and the agaemerrt shed t» remided M a nrererer Prat wN pennr<era aaYtsrraa a ttw aprarnenl b bs ddsnnbtsd by r.tsrerrca b the property whore the Astable Traatasrrt tM[t is irneelad. John Mikla ~~rn~f~r~Tt bj(er'~a'~e nrs /o~n~ass a L/ . ~.IAJ if 3tlr~ L an L c . `', `.. ~~~ ' , f y. .l • Y~, lug`, ~ r ... _ , ~~' 1 C ' ~ ~ ,, . :~ :ti_: ~: 'TMs PAGE la PART OP TWf -YtiAL DOGMAlNi- DO qGT RENOYE" TMsrnwnn.aanmwcaarrnplsr«rcysuwnasr. ,mt~•r+de~lft-r+ouwdl• on..4namaaar.ach.adr. 'ti+etrp alauae, Iaw+dsauyMiwt, eee. rrny a pfea0 on rA4 rtisr Papa a/tlira dosrnwrt arnrsy ee pASasd m adblYwrM paps d the docrwrrsnt tins asw oo-.-wYe.aMl, erne peps b yandoasnsef end Wlaoonsb 4ROen+Oee. eia17. AUG-30-2007 07:54 FROM:H&H PLUMBING - - - -... y , °f e C715)962-4156 T0: 171538646$6 P.2 pOWTS INSPEC'~ION AGREEMENT The correct operation of the below equipme stem asnd prtevent~thecneed forfcost y repasse This agreement authorizes inspections will help extend the life of the sy da Is ht hours to provide regular access t nsoand rOou1 t ne main enance to help assure the equipment islworkingipfopefly inspectso `~ r- (Service Provider) that in It is hereby agreed by and between Purchaser and consideration of the payments provided forons of the equipment sdescr'sbedr be ow h ServiaeeProv dea will prepare a written representative to perform periodic inspects of the report to the Purchaser. This report will contain recommendations report after each inspection and provide a copy ro riate by the ins actor. P for any operation and maintenance deemed app p This agreement does not assume any resposTa slbe assoc ated~withtanyaecommendat ores madesunsder thi agreement. and does not extend to cover any costs that Y ecial or consequential damages, including but not limited to, In no event shall Service Provider be responsible for any sp loss of time, injury to person or property or incidental economic loss due to equipment failure or for any other reason whatsoever. Service Provider may supply additional services, parts or labor only after authorization by' Purchaser. 5~~~ 1.t 20.x_ and This agreement shall remain in force for a period of 2, years, beginning wsth at least 30 days written will automatically renew each year thereafter for one year unless canceled by either party notice. This agreement may be canceled by we Service Provnder mayl delay o can esl future respectiosns f paymenzted service provsder for the equipment {fisted belo e becomes at least 15 days past due. ~ Service Provider $ ~~ per inspection for four (4) Periodic Inspections: The Purchaser agrees to pay ments are due upon inspection. Any additional inspections for the first two years at six monfhnstal atilon; add t onal pay action each year thereafter. Payment for the srst two years of inspections is due at the time o ~, testing or services required by Purchaser will be billed based on time and ma rial amounts. Date ~uw~ ktN~ i~k4 Signature Phone ~3~s~lts 7/S-~iZMyd.S3` Service Provider ~ State ~s_ ZiPs~"~?;°- le City Cole Address " - ~ o'~ E ,~ Covered Under This A reement Serial No. Install Date Location i ~~ y~ Owner ~~ i~ S stem Owner: Dats: ~( Company Name: .~ y,- ~-k A ~A • SlBnatura: //yy`r/mar 7 t !-N Mt Kr Phone: ~~~ ~ v y -~9Z Print Name: ,~ O C Q~ ~ Fax: Street: f`O csty, State, 21p: RP}L~wh~ . twiS SyaOZ, E-Mall: Ths doaanent piepstatl Dy Petersen Management Co., LLC }% ` PO Box 340, 421 Wheeler Ave., Fredonia, WI 53021-0340 USA VbE LOVE TO SERVE Oui Customers Tel: 888~i55-6864, 262-692-2416 Fax: 800-669-1232, 262-692-2418 E-Mail service~petersen.cc QUAL/TYPRODUCTS S/NCE 1918 DOCUMENT NO. 4 ~ TIiIS INDENTURE, Made by ~„'~. tu7~ert ~. ~uc~~ert. si grantor of ~ t • G r O i x County, G'1'isconsin, hereby conveys and warrants to Jo~~n I~2il~la <~.~~~! l~i~~r~ ~lilcla, husband alld wife I,-. NARRARTY DEED STATE OF WISCONSIN-FORM 9 i TNiS SPAtB AFSI9tVED FOR REWRDDiG DATA t~EG18TERS OFFICE sT. c>~olx co., wts. Recd ft~1' Record this_ nth __ day of September _A.D.19 b9 at_ ~;3Q____ A, M. 4 1 Re~.CeF f ..Ad$ ~~ S RETURR TO of ~ t . (.% r O 1 X County, Wisconsin, for the sum of One <3allar r~rzcl of}Ier valuable considerations the following tract of land in ~ t • ~ r O 1 x County, State of ViTisconsin; ?~ parcel o.f land. comznenc~in~ at a point 5UC= feet ~,(~st anz~ 33 feet Morth of the gout}east earner of tze SOUtheast ~~u~irter of Southwest ruarter. (SE.~ Sw4 of Section af~, Town-sl~~ip 2~ North of )tame 17 1~est, ~n.~l runlli~~n thence west ~5C~ ~''eet, tt~enr,e itiort~~z =~Q feet, tlzellce fast 25O feet, thence Sotltil 2t)O feet to the place of be~rinnin~. IN WITNESS FVIIEREOF, the said grantor day of Se?aternher , A. D., 19 ~9 . has hereunto set ~ ~ S hand and seal this 5 ,~ (SEAL) Ftu.pert i~. Duclsert (SEAL) SIGNED AND SEALED IN PRESENCE OF ., I s a.l~ e 1 t+~~,r (i t~tr~. td. ~arci STATE OF WISCONSIN, 1 .`~' t. C r O 1 X County. )} ss Personally came before me, this 5 day of Septemlaer A. D., 19 6 g . the above named ku-pert E. Ruckert sS.n~Fle to me known to be the person ~ who executed the foregoing instrument and acknowledged the s ! ;;' -- ~~~ ~ S~~ rr~ _ !r` _ 'spa. r r~ NOTARY.; , . StEAL .~. This instrument drafted by ~'" tam . w, 4ti~"~.rd , Attorney, N ewtti chmo~r_i`d..`~~i s . Notary Public {SEAL) (SEAL) St. Croix County, Wis. My Commission (Expires) (Is) ~~ e r rlan e n t (3ecttoa 54.51 (i) of tha Wisconsin Statates provideathst all iAp~ is to be r ded shall have pisin~y priated or typowrittea thereon the names of the @rantoro, grantees, witnesses cad aotary), enn 44 WARRANTY DEED-STATE OF WISCONSIN, FORM NO u9'~K ~Q L t Y. C. YlLL6A CC., YILWAUKCr K r CA Z 2 y Z I ~ o w m ~a I a~ m Q m ~ c N Q. ~ ~ N N CD ii ~ d O ~ Z A ~ ~ o ~ ~ ~ ~ c ~ r. i z 0 I I Z ° ~ 'o c ~'~ m ~ o W m ~ ? N 7~t n p) Z ~ O ~ I ~ m O o ~ C W CD n 3 Z m o ~ ~, 0 ~~ I I, I I A a o. 0 v Z 0 m N I O ~ fD O Q I O Q- O ~ O ~ ~ n ~ ~'° K m ~ ~ ~ ~' . ro 'n C ~ ~ ~ ~ d ~ fD ID ~ - ^~ ~ ~ ~ o` '' ~ ~ rn ~ j~ a _ .A ~ L -~ ~ `L ~ W O 7 N ~ 7 O N N ' a - a o ' 0 o C7 ' v rn ,~ O N N Q ` ~ ~ ~ '! C1 r UJ ~ 0 0 ~ ~ a a ~ ~ ~ ~ f. !~ m 0 ~ ~ 7 .. ~ ~ ~ ~ 3 N ~ ~ ', rn ~ v v ~ A ~ N .~ d ~ O ~ N N Q C1 ~~ N c 3 m _ ~ ~ a ~ r- N Z (n Z D ~ ~ 'I ~ ~° I o `~ ~ N ~ _. N N fD a ~ ~_ +' ~ ~ z ~ o ~ ~ ~ a ~ ~ ~ m N rn W a ~ -• ', -' z c 3 ~ A o 3 " ~ ~ ~ N1 Z w fD £ ?, 'I ~_ T C 7 a I «- Parcel #: 0~ $-~ 060-~ 0-000 05/03/2007 11:03 AM 1' PAGE 1 OF 1 Alt. Parcel #: 26.29.17.4096 018 -TOWN OF HAMMOND 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 -MIKLA, JOHN J & MARY C TR JOHN J & MARY C TR MIKLA 1940 CTY RD J BALDWIN WI 54002 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description ` 1940 CTY RD J SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 1.340 Plat: N/A-NOT AVAILABLE SEC 26 T29N R17W 1.34 AC IN SE SW COM Block/Condo Bldg: 500FTW&33FTN F E W 250 O S COR,TH FT, N 200 FT, E 250 FT, TH S 200 FT TO Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) POB 26-29N-17W Notes: Parcel History: Date Doc # Vol/Page Type 06/01 /2006 826544 QC 07/23/1997 455/1 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/22/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.340 23,100 135,100 158,200 NO Totals for 2007: General Property 1.340 23,100 135,100 158,200 Woodland 0.000 0 0 Totals for 2006: General Property 1.340 23,100 135,100 158,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 201 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ~ P~.br ~b7 3/70 ~' lYPE or USE BLACK INK biisoonsin Departstient of Health cad Soeial Ser-ices Division of Heattb ~ SEPTIC TANK PERMIT APPLICATION i ~. l ~ ~0 C~v. I~~ S ~~~ - ./~~ ~-- /~}- O`1.~~ • X09! 1. 011NER OF PROPERTY Name Address (Street, City, Z!p Code) ~, /° -~ ' ~ ~~~~%' B•. DED COUNTY_'~- ~/ LOCATI023 OF AOPERTY WHERE SYSTEM WILL 3E CONSTRUCTED. ALTERED OR EXTEA Check One: S ..I ~/~ •.CITY VILLAGE LEGAL DsSCRIPTION (iCJ TOWNSHIP , / ~ ~ ~': -,- ~• ~ 1 C. IS LOCAL PERPIIT REQUIRED FOR THIS WORK? ~ YES NO 0~~' PERMIT NUMBER D. SEPTIC TANK CAPACITY ~ ~~-'~ Gallons NEW INSTALLATION ~' REPLACEMENT ADDITION MATERIALSs Prefab Goncrete ~ poured in Plats Stew Other NUMBER OF TANKS TO BE 1NSTALLEDs ,r~-'~i_<' ' E. TYPE OF OCCUPANCY ~Cheok One: One or Txo Fami]y Residence / Coeimercial Industrial Other ,~, Speoify) Number of Persons to be Accommode.ted ~~ Number of Bedrooms ~ ~` F. Food Waste Grinder ~ YES N0 Automatio Clothes Washer ~~ YES NO APPLIANCES, ETC: . ' Dishxasher YES ~ N0 Automatio Potato P•elsr YES~~NO Other (Speoify) G. LLATION ING INSTA MASTER PLUMBER MAK / / / 1 Namss L~ r ~=~ I//> /'~/ FZ Addreass (_i1 ~L~;~~<G'~~::%t i l,'!~ ~~i 'Lioenae Numbers ~ RSW i cant: Signature of Appl ~ / ,/ Addreass ,,~i,!r:,: _ ,t1 _~% l ~ r -~C~, H. (To be Completed by Issuing Agent) '`• ._ Fee Paid ~~~ -~:r`, Date of Applicat2or. ~ /..=- /% '7 ~~'~ , Permit Number Permit Issued {date) ~ /~'- -~~?! ~ j~ ~'~ ~~I ~ ; > ' ~ /~ ; ~' ' / ~//~ ~! ~~ ~ ;, , _ :. r„ ; Fort. 7, Agent (Name) ,' ~'= Toxn, 1 lage, Cit;~, County, etc, (Speoify) Notes The applloAtion cannot be considered for filing until all of *.he above questions are ansvrered and th+ tee paid. .Agents xill forward appiieation, the Pee of .S1.0U for each ssptio tarot and the th~.rd oopy of the permit (oanary) to th6 Division of Health, Chsoks and bogey orders should be made payable to the Division of Health. Do not xrite in apace below - FOR DEPARTMENT USE ONLY L ~ ff~~ DATE RECEIYID ~v ACCEPTED BY ~~ RE?URNE'D (Initials) ~ (Date) ~g~Ctior a .) ~ ~~ ~ ~ PERMIT. N0. FEE RECEIYED VALID. No• es or No AEY IZSdED 8Y d~ APPROVED ~~ DATY ~ ~. ~ o ' ~O (Initials) Yes or No t StPTIC TANK PtRMI? N0. .r ~• • ~ R t P 0 R T O N S O I L P t R C O L A ? I O N T t S '! AND SOIL BORINGS TO DIVISION OF HEAL?H - PLI2~IDING SECTI~i P.0.8oxs09, Madison, W1s. 53701 Puragant to H 62.20, Siis. Admiaistrative Cods PtRCOLATION TtST Test Hsyth Character oP Soil Hours Water ?est Time Drop in Water Level Inches utea Number Inches Thiolciess in Inches Since Hole in Hole Interval Second to Next to Last To Fall 1st Wettad Overni in Minutes Last Period Last Period Period Ones Inch Bxampls P - 0 S6" ?o Soil lON Cla 2bn 25 Yes or No 30 1 2 1 2 1 2 60 2 r ~ _ RECORD DATA FROM MINIMiJM OF 3 TEST HOLES Compute size of absorption area in accord xith H 62.20 Wis. Adainistrative Code. SOIL BORINGS - Iiinimum 36'* Helow Pro osed Abso Lion S stem Boring ?otal Depth De th to Ground Water De th to Bedrock Number Inches Observed tstimated Observed Estimated Charaotar of Soil with Thickness in Inches txaaple B ' 0 72" 72" Black To Soil 12" C 18" Sand 18"• Gravel 24" ! , , " ' , ,., ~ -~ ,% ~. RFrCOAD DATA FROM MINIMUM OF 3 BORE HOLES PE OF OCCUPANCYs RESIDtlJCEt Number of Bedrooms zyr OTHERS (Speoifq) Number of Persons D WASTE GRINDER: Yes ~ N~~ Distarashert Yes No ~_ Automatic Clothes Washers Yes ~ No ~~ r FFLUENT DISPOSAL SYSTEM: NEW ~ tXTENSION ADDITION REPLACQIENT ~` 2 Tils__Sise ~ ~~ No. Lin. Feet /(~U~ Trench Width ~~ Depth Jd ~ Number o! Lines eepags Hed: Length Width Depth ?11e Size No. Lines ~_ Seepage Pit= Inside Diameter ~ Liquid Depth ~` I, the uadsrsl3ned, herebq eert+ry that the percolation tests reported 'n this form sere made bq me'or under m. super- ~vislon in accord with the procedures and method specified in Cha ter H 62 20 (13) Wis o i Ad i i tf C p . , c ns a n stra n ve ode, and 'Shat the data recorded and location of test holes are correct to the best of my knowledge and belies. "~ ? , NAME _ ~~ ~~- i ' I ~ / I i~ ~.: 7 TITLE. ~~ ~ ~ . i _-- ~!~ ,. ,~ Typa or Print REGISTRATION A10. or MASTER PLUMBER LICENSE NO. / ~~f ~~' -_ ~ ADDRESS ~_" L / ~' ,a.!' ~' ~~ li, ~ j - , DATE w_L.~_•r'lL~~ SIGNAR'URE ~~:~•v ~I'~~~,LE~~G~~ ' - - --- - ' 01/13/2006 10:17 AM Parcel #: 018-1060-~ 0-~00 PAGE 1 OF 1 4. Alt. Parcel #: 26.29.17.409B 018 -TOWN OF HAMMOND 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 CaOwner O -MIKLA, JOHN & MARY JOHN & MA Y MIKLA 1940 CTY RD BALDWIN WI 5 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC " 1940 CTY RD J ~2~~-~ ~ ~ Gff ~ ~, ~ w ~~/ v Description: Acres: 1.340 Plat: N/A-NOT AVAILABLE SEC 26 T29N R17W 1.34 AC IN SE SW COM Block/Condo Bldg: TN F 500FTW&33F O SECOR,THW250 FT, N 200 FT, E 250 FT, TH S 200 FT TO Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) POB 26-29N-17W rs Notes: ~ ~~. ~ f ~ J Parcel History: Date Doc# Voi/Page Type ~~Cl~" Uy 07/23/1997 455/1 9M~ CI IMMARI/ Bill #: Fair Market Value: Assessed with: ---- ---------- --- 90584 191,400 Valuations: Last Changed: 10/22/2001. Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.340 23,100 135,100 158,200 NO Totals for 2005: General Property 1.340 23,100 135,100 158,200 Woodland 0.000 0 0 Totals for 2004: General Property 1.340 23,100 135,100 158,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 201 Specials: User Special Code Category Amount 010-GARBAGE SPECIAL ASSESSMENT 60.00 Special Assessments Special Charges Delinquent Charges Total 60.00 0.00 0.00 - - - Parcel #: 018-1060-00-000 otios~soos 08:18 AM ,~! PAGE 1 OF 7 ~ ;,.. Alt. Parcel #: 26.29.17.409A 018 -TOWN OF HAMMOND ' Current ! 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 STEVEN E & JEAN A PETERSON O -PETERSON, STEVEN E & JEAN A PO BOX 38 HAMMOND WI 54015 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC ~ ~ ~"'~ ~ r ~' C, ~~~ O G Y I~~~ r l~r~~L/1~~1 Legal Description: Acres: 38.660 Plat: N/A-N .T AVAILABLE SEC 26 T29N R17W 38.66 AC SE SW EXC Block/Condo Bldg: 1 .34A SE COR Tract(s): (Sec-Twn-Rng 401/4 1601/4) 26-29N-17W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 869/43 07/23/1997 830/07 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 90583 Use Value Assessment Valuations: Last Changed: 07/14/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 37.910 4,300 0 4,300 NO UNDEVELOPED G5 0.750 50 0 50 NO Totals for 2005: General Property 38.660 4,350 0 4,350 Woodland 0.000 0 0 Totals for 2004: General Property 38.660 4,350 0 4,350 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Special Assessments Total 0.00 Category Amount Special Charges Delinquent Charges 0.00 0.00 ~f~ t ~ ~t • I I I _ ~ m I°o-^ C_ ~ ~ ~ ~ I N n ~ ~ ~ I ~ I o I °' I ~ I 3 L I ~ 1 I I I o I o 7 I N I ~ Z O v I a I ~ I I ~, I a Z ~ o ~ ~ I ~ I I I I I I I I I I I I l I I I I o nz, u o ~ G ro N ~ a y d N ~ ~ CD 1 Q ~ N cn ~ y 7 Q C_ O fD y o _-° C a ~ m m N .x O m m G m °c v a= vi~ m n m ~d,y v ~~• a t~D 7~C" fD y ~ O t9 ~ o d r°,aN~. m ~ ~ <ogo?°cm m y m C y N ao _ - 'O fD O `~G N N ~ N N 3 t0 ~p N rnm m ~ a~ au~'o~vy °'~co ~ ~~ a~ ~ ~.~ cm o ~ fir: ~my~mtn O ~ ~f~D Sy O -Oi.O~ ~ ~ 7 Efl O O £ o:. C1 t/~ Q ~ c o: ~ ~ O ID ~ ~v :! ~ 3 3 =i d w w ~ I ~ ~ o ~ I Q' o- A f1 N C ~ S ~ f0 N d. ~ 01 ~ ~ ~ 7 VI 3 a ~ I v a (~ m `G I, ~ C o a°~o a ~ 3 rn o ~ m ~ ~ i ~ W CJO CEO N ~ ~ ~ a ~. I ~000~1 a vov,Nl °= d ~ <D ID d N 7 •• ~ K1 '~ ( Z O ~ a ~ N cn ~ I o m y I ~ ~ N. (D (D a I ~,,~ ~ a cn I Z c ~ ~ p, ~ ~ a 3 O •'•' 3 I N ~ W ~ 3 I m m C a I I 'I I I O o ~ O C ~ Z ~ ~ N tl7 ~ N 7 ~' CD (~ O. O o N d ~ O m o ~ C °- 3 m m m '~ O m fD C m m L_ X ~ ~ Q cvi~xa ~~yv, r« Qw~m m O p~ f~D o(O 7 O om ~ m o m m ~ ~ O. ~- f7 7~ vv`D CD Z °' o ~~'~ co ~ m ~n~3 o °' F N ~ m m Coco y 7 'p ~ ~ n ~ .n-. fD ~ Q d (D O ~ O 69 Q O O ~ n N Q O y^ ~ !. 3 A <D 1 ~ 3 3 .^. r: X ~ ~ ~ S '11 ~ N N ~ i a C) ', K ', m ~ Q m w c- tD t0 {{~_ O O O' ~' O O O ~ ~~~v, N N N d ~ v v, r°a m ~'. N ,, ~ Gf y 3 °-' ~ .. 7 y m~ o a ~ ~ ~ m ~ m ~' v ~' v CD ~ a <n 0 c 7 d ~ A °' 3 N ~ O pj N m C 7 a 3 ~ G ~ ~ 3 O ~ ~ C ~ ~ ~ _ ~ o v ~ N ~ rn a A O V O W 7 O 0 N O C ~ :' a m A O m n m N A Z n A A ~ ~ j ~ ~ Z A ~ ~ ~ m ~ A d A A7 -.. A'+ O "! '~ ~< ~• O ~`I ~• O ~~yy.,~.,~ • v~ A a A 0 a N ~O a M tra A l0 ~ ti H a °~ - ti ~, Parcel #: 018-1060-70-100 02/06/20PAGE.1 OFn1 ~ .~r, + Alt. Parcel #: 26.29.17.4126 018 -TOWN OF HAMMOND Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Ma ales Are lication # Permit # Permit T e p # S a App yp 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -KEN-RICH FARMS INC, % KENNETH PETERSON KENNETH PETERSON KEN-RICH FARMS INC 1958 CTY RD J BALDWIN WI 54002 Districts: SC =School SP =Special Property Address(es): " =Primary Type Dist # Description " 1958 CTY RD J SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 1.000 Plat: N/A-NOT AVAILABLE SEC 26 T29N R17W 1AC SW SE COM SE CORE Block/Condo Bldg: ' ' ' ' 200 N 217.8 W 200 S 217.8 -POB Tract(s): (Sec-Twn-Rng 401/4 1601/4) 26-29N-17W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1110/341 QC 07/23/1997 862/323 07/23/1997 677/154 07/23/1997 4561461 7nn~ CI InnnneQV Bill #: Fair Market Value: Assessed with: 90592 144,200 Valuations: Last Changed: 10/22/2001 Description .Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 10,000 109,200 119,200 NO Totals for 2005: General Property 1.000 10,000 109,200 119,200 Woodland 0.000 0 0 Totals for 2004: General Property 1.000 10,000 109,200 119,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 149 Specials: User Special Code Category Amount 010-GARBAGE SPECIAL ASSESSMENT 60.00 Special Assessments Special Charges Delinquent Charges Total 60.00 0.00 0.00