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HomeMy WebLinkAbout038-1058-70-000 c f ° m c MAD 3 fT I ~ O ~ w ~ n d o m o o 0-' C4 s 3 o v oo rr CL Z n m y o (3D o cm 2 ~ n _ _ a O rn I A y o >v 3 w (D Oo C y cn < D a M CO - a 3 N W O N (D 3 Get w n 'V PO m N ° co Qcoi z Cl) f°+, Q F Fl td ~t 0 C-- ~ Z O O O Sr V in. W ° -0 •°°p °o v r1~r. 0 cn N Q w ~(D O H O_ CD cr 'a a y m m CD m ~ 3 m ° F-3 4 ° f O D (D (D 0 d j m m Cn I Cl) m m 0. X M N* OIQ a~ H H cn m 0 In O W m m I r- w ° _ Z 43k? 3 ON z CD 00 U) m M ~ (D n n rt W rt o b ° cn E n i a z Ch 3 co Fl- (D C ~ a a co o o` m 3 m' c ao o a 2 N :F 0- CL y I I ~ o C o ~ O ~ V (D N O I p o_ ?D m as o o °a °o a v li j Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ~ - TOWNSHIP SEC. T N-R1~W ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE a Ole PLAN VIEW Distances and dimensions to meet requirements of 11HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM At , io ` wt~L ~ r ;2 ~kse n.. INDICATE NORTH ARROW r 1' BENCHMARK: Describe the vertical reference point used s ~ Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer:)(/)~PA~ ~o,,~,/-&,,.2~iquid Capacity: / Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: C94/n Number of feet from nearest Road: Front 10 Side,0 Rear, 0 rT 26 feet feet From nearest property line Front,WSide10 Rear, O _J' Q-2 Number of feet from: well building: (Include this information of the above plot plan)( 2 reference dimensiE SIDE septic tank) SEE REVERS PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear, 0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width:_ 1-7, Length: Number of Lines: Area Built: Fill depth to top of pipe: 2 Number of feet from nearest property line: Front, O Side, O Rear, Ft Number of feet from well: Number of feet from building: 2 (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: AC 9 Plumber on job: sl License Number: 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOk 7969 BUREAU OF PLUMBING MADISON, WI 53707 CONVENTIONAL ❑ALTERNATIVE Sta"Plan ed'D. Number E(If assi gn) ❑ Holding Tank D In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: _ ADDRESS OF PERMIT HOLDER iON CATS: pp++)) James Kiemersrud Rt. 2, Box 38, New Richmond, W7 ~1 ab - 3!30 BENCH MARK (Permanent reference PdmU GESCRIBF IF DIFFERENT FROM PLAN: REf. PT. ELEV.. CST REF. PL JLFV.: SW SW Section 14, T31N-R18W, Town of Star Prairie Name of Plumber: MP/MPRSW No.. TTsy: $amtary Pemt Numberal Powers 1563 t. Croix 75030 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: (WARNING LABEL LOCKING COVER _ PROVIDED: PROVIDED. YES ENO DYES NO BEDDING: IVENTDIA. VENT MATL_. HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM FEET FROM LW( AIR INLET DYES ODYES ~NO NEAREST DOSING CHAMBER: MANUFACTURER. BEDDING: ILIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER 'WARNING LABEL LOCKING COVER _ PROVIDED: PROVIDED: DYES ENO DYES ENO EYES ENO GALLONS PER CYCLE: PUMP AND CONT 044 PERA ZONAL NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM SINE (AIR INLET PUMP ON AND OFF) DYES ENO NEAREST 30 SOIL ABSORPTION SYSTEM. Check the soilmoistureatthedepthofplowing E',-,IH rITIR MATERIAL AND MARKING or excavation, (If soil can be rolled into a wire, construction shall cease unti=FORCE the soil is dry enough to continue.) CONVENTIONAL SYSTEM: BED/TRENCH WIDTH 111'NGTH INC, OF DISTR PIPE SPACING COVER INSIDE DIA #PITS LIQUID TRENCHES. MATERIAL: :EP T DEPTH: DIMENSIONS ) iw ry GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR PIPE DISTR. PIPE MATERIAL: NO r TR. NUMBER OF PROPERTY WELL, BUILDING VENT TO FRESH BELOW PIPFS: ABOVE COVER 'LE V.INLET ELE END PIPeB`. LIN a / r a FEET FROM AIR INLET: d/ I ) r::. J G NEAREST. ---t► 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- DYES ENO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE PERMANENT MARKERS JOBSERVATION WELLS DYES ENO DYES ENO DEPTH OVER TRENCHBED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED. SEEDED. MULCHED. CENTER. EDGES. DYES ENO DYES ENO DYES ENO PRESSURIZED DISTRIBUTION SYSTEM: BED/,TRENCH WIDTH. LENGTH: NO. OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: JNO. DISTR. [STR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV.. ELEV.: DIA.: ELEV.: PIPES: A.: ELEVATION AND . DISTRIBUTION INFORMATION 'HOLE SIZE HOLE SPACING: DRILLED CORRECTLY. COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS: DYES ENO _ DYES ENO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE: ❑ YES ❑ NO DYES D NO NEAREST Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE TITLE DILHR SBD 6710 (R. 01/82) --'I" isconsin APPLICATION FOR SANITARY PERMIT '~IDILHR (PLB 67) COUNTY ~ DERRRTmEI'1T OF UNIFORM SANITARY PERMIT # PDUSTRV, LRBOR. umRn RELRTIons '75030 -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 81/2x 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER MAILING ADDRESS , PROPERTY LOCATION etTY: LAJ1/43-M/4, S f 4' , T,?~, N, R 0 (or) W TOWN OF: L T NUMBER BLOCK NUMBER ISUB VI ION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER GO 141 TYPE OF BUILDING OR USE SERVED y 1 or 2 Family Number of Bedrooms: 3 ❑ Public (Specify): 11 THIS PERMIT IS FOR A: Y New System ❑ Tank Replacement ❑ Repair ❑ Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank ❑ System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued - El An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity /po2j Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: c, IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): 2' L / 5 (o / Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation private sewage system shown on the attached plans. Name of Plumber (Print): f S e /MPRSW No.: Phone Number: cl 't -L% C (7 51 y6 -5-/J5- PI ber's Address: Name of Designer: l 5-2011 COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: p e ❑ Disapproved t..~f • ~4qf ~ Approved ❑ Owner Given Initial Adverse Determination Reason for Disapproval: Alternate course(s) of Action Available: DILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber J ~ f INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable. 10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system, depth of the system, type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan, drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin. I APPLICATION FOR SANITARY PERMIT S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resat` 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 A Mto 0 I Location of Property Section T N - R W Township Mailing Address, 4 s-j e Subdivision Name Lot Number Previous Owner of Property Total Size of Parcel p/ s 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 ~ 0 and Page Number as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also be required. I - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION 1 (We) eeAtit'y that aU statements on this ~otm ahe tAue to the best o6 my (ouA) k.nowtedge;. Vat I (we) am (oAe) the owneh(s) o6 the pnopetty de~seni.bed in this in6o4mati.on totm, by vivitue os a wa4Aanty deed %ecoA in the Oj6ice of the County Reg"' 4 etc o ~ Deeds as Document No. IS1 77 d ; and that I (we) I pne,sent.ey owv the p~toposed s.c tc SoA the sewage osaX. system (on I (we) have I obtained an eaaemen:t, to nun w.t.th the above de~scAi.bed pnopeAty, 4oA the co►vstAuction o4 said system, and the same has been duty Leco4ded in the O~bice o6 the Counts Registe.t o~ DeedC, as Document No. ) . GNATURE 01 OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) ,ATE SIGNED DATE SIGNED l H ' CA , H a STC - 105 r r a SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z ty OWNER/ BUYER ROUTE/BOX NUMBER Z,. 17 0 Fire Number .CITY/ STATE N?_- l 1 t ~ Y1/1 dN M S Z IP ~j~yL7/ 7 PROPERTY LOCATION: W S W14, Section, T31 N, R I W, Town of J1 , 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 0 E I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- v 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. j S I G N Elr~)J' i, e, 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. c y x ~ m 3 ~ v (D Ca CD (O n n CD N ~ W:7 w m ,Q O O W w m E 3 -o 0 =-r FD* -0 CD z s cn cn ° ° o N cO I (D V) d N ni ] w 0 m CD a 0) A i PL) -0 CD U) < C-) i Rr r\ CD O CD C O w O (o 0 3 c c C - :3 Cl) o ° ° 3 &0-0 Z=r c .G Q 5 O 7 w 'n (D w L In w CD O O Cl. CD :3 =(D- " 31 oo~T~ D - CD CD cOn cn " o D c CCD 1 ° 0 - C7 O c° cp C =r ~ o _ m a _ °a Nom" O OL Q~ w o f o~ m ~ ~~.0 w cn C N W n ~ W CD w tD m ° = CD m C- CDo 3 -,mm(na D °nn c CD ° = g " c o > M °a w~OS0 (n a CD cn ? M ~ w a c 0 :E CD . CD 0 CL CD =r cn CD (n ° " 5). n S OL (D (D 3: ► ° cn o - - to m C° to 70 a 3 f c n C c0-0 C * fT1 (D a w o O ° _ - na N. o a No ~ccO~C 3 m n cs n c o o m O ? ° O. O 7 O co O C . cn p p' W° a O a CD = C= a r. o t/y c 'p ~3 O°3 Qm 0. CL CL D o D = O. O < t°o CD o O DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN !RELATIONS \ / MADISON, WI 53707 • (1-163.090) & Chapter 145.045) LOCATION: SECTION: p TOWNSHIP/ L IV/O.:IBLK. NO.: SUBOIVISION NAME: 1,7 S w ~~~~4 Jy N/R 181 (or) W S 1(7 N IVV COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: .7• cf o r 5 X~ RI C 0-1 ~ USE DATES OBSERVATIONS MADE INC. BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: PERCOLATION Residence 7 New ❑ Replace Il IV 2-~5- -i5 S~ RATING: S= Site suitable for system U= Site unsuitable for system I Z Tc CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM- N- ILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) ~s au ~s ❑u ; s au os u as ~u If Percolation Tests are NOT requ"r DESIGN RATE: If any portion of the tested area is in the Al / ! P under s.H63.09(5) (b), indicate: Floodplain, indicate Floodplain elevation: i 4 Dew r-r PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER BC-F~fl110d, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) z B-1 95- s w an 5 r B- t' 1 r B- $ 69 h one d' o. - - I,/, 1 /•2. 1W - B- ?4, S h on o- aJ - J I -zl l B- la 2-- 1.96n IS 1. 9 - B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER FNo"'C~S AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD PER INCH P- I . $1 A o n -3 c/ P- 2 1. / P- .I n an e X2 .3 141 1 P-_ 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 X23 Qenj 117r~r!~ __p /_Gb ?1111 3 F ; ~ra^c:~5 T` i D ie I F _ e_ _ 1 2, r Z' 4 F 1 E 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 (print): TESTS WERE COMPLETED ON: PCVC"#*j^Ajr - 13-9, 6 A R SS: 7 CERTIFICATION NUMBER: PHONE NUMBER (optional): 1QUj?A!(1oar,e%c4 U.. 0 / 5_ C IG TURE: RIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. -SBD-6395 (R. 02/82) - OVER - INSTRUCTIONS FOR COMPLETING FORM 115 - SRC - " Tc, corrni- ind --?°urate sail test, your report must include: 2. ly ~i ether this is a re 's' smce or commercial project; 1 commercial use 4, 9m; "IT r? 3L FOR A HOLDING T/AN K ONLY IF ALL T I ONOITIONS; 6. PLE s 1 plot plan, 7. l preferred. A are permanent; } ition test exemp- 10 floocl plai is e box; im I' N WITH THE L LE- -FIF- , TESTERS s sn s r al s * c I sang _ m _ p, rri E !`es 10 it L $ i.. i.« G i f i.. , rn~s Iemes~Q40 bit S''lx.o yy wYy 5 crc, / y T3/A/ R t,~w Qej JI 2c..- I"ZfkSy('~: 615 Z` A Ser-hc_-,rc,nK-- PG1" /00©oy~ 1 rr o r S~t9 /e 0 -LI-c-3-12 rr, P es w r5-63 vo b so,~ ~6r~.~.c~ qr V 5~~ ~ i ~f - n 1 5~ ti i , PAGE OF C, r c~ S S S z . o ,a 13 r 1-3 S y ~jpne-5 k c~mesru~Q froth Air Inlelc And ObcArvollon Pipe W N~<~r an~ t^1^- Approved Vent Cap Minimum 12" Above Sw is YY 5~/ ! Final Grads " 7-3tN, t2~Sw' sr kP12M - 20- 42" Above Pipe _ 4" Cast Iron To Final Grade Vent Pipe Marsh Hay Or Synthetic Covering win 2" Aggregate Over Pipe Distribution -To* Pipe 0 0 0 0 6" Aggregate 0 Perforated Pipe Below Beneath Pip• 0 -Covpling Terminating At Bottom Of System Pu 5~1~~..~ tom SOIL FILL DISTRIBUTIOh.I PIPE APPROVED ~4MTHETIG COVER "'-MAT~RI^I OR 9" OF STRAW Z"OF0\66RIEGA1E MARSH HAS P ~O 1 (o OF AGGREGATE ELEV. OF-i3- FErT-)L DISTRIf3ILITIOM PIPE TO BE AT LEAST . IMCHES BELOW ORIGItJAL. GRADE AfJU AT LEASTr_O IMCHES BUT KIO MORE THAfJ 42 INCHES BELOW FINAL GRADE MMIMUM DEPTH OF EIACAVATiewl FKom Ai&wu 6RAoF- WILL BE IUCHES M141MUM ®rEFT-0 OF EACAVATIOW FRotA'0IKIG1bAL CaRAPE WILL bE INCHES SIGNED: f-a- LICF-USC- AJUMBER: DATE: ~~o Parcel 038-1058-70-000 02107/2007 08:46 AM PAGE 1 OF 1 Alt. Parcel 14.31.18.254 038 - TOWN OF STAR PRAIRIE Current XST. 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 - KLEMESRUD, JAMES H & JOYCE JAMES H & JOYCE KLEMESRUD 1206 CTY RD C NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): • = Primary Type Dist # Description " 1206 CTY RD C SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 39.240 Plat: N/A-NOT AVAILABLE SEC 14 T31 N R1 8W SW SW EXC PT TO HWY Block/Condo Bldg: DESC 993/472 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 14-31 N-1 8W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 993/472 2007 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 06/2712006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 37.240 7,000 0 7,000 NO OTHER G7 2.000 40,000 160,700 200,700 NO Totals for 2007: General Property 39.240 47,000 160,700 207,700 Woodland 0.000 0 0 Totals for 2006: General Property 39.240 47,000 160,700 207,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 124 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00