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HomeMy WebLinkAbout012-2002-60-000 0(1) 01 -.0 'o d co1 V n co m d ^ m O v m oA o 0 3 o --4 m w 0) o ° CO ? w 3 rn (D w tN i„i oo n. Z ° 3 -0 ° CD p W CD v. v N O ^ N a= O m 10 o' W \ 1 --o S O 7 CD C 7! ° O1 O c m 1 to p D° !r 3 c 3 o w c1) ~ D a ur C -i m ca m a v CL CD 0 3 O W CD O A~ N o co z co OcOD to cCA 0 ) r c (D 1-d M T 'D ""0 (D FJ- o oof ry~~1 rt r v c N w O• H. " F--I N (D co) s N f o 0 v, m CD U) 3 W y H CL N u, ° ymo" 0 4-- I o a _0 trJ CD C o ? cn X 'a CD (O 00 F-' C N (DD I a N Oo uj 1~ n 3 c1) -4 CO) c1 V Ul Z CD < oo H H !z :3 i Azo In o w a O G ° a z ~r1 L, b Fn V ~ ~ I '0 3 a ~ y o t~ ° z F'• w ro 0 CL a C-4 W K W o o ~i 3 c w FJ. o 'o p 0 Nm O t I ~ I ~ ti 0 O O~ I o o °o CD aro e ce 69 0 C oAo 3 Form- STC-104 AS BUILT SANITARY SYSTEM REPORT OWNER -Ta YY1e~ $ _e m HIP r s_- _h -1 -,SEC. T dN-R 7 W _ -A ~9~ L- Y\ rk ADDRESS Q OY 1.31 ti, ST. CROIX COUNTY, WISCONSIN SUBDIVISION ~(~1(`C\ S Uic~dL~c~.QT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of ILHR 83 LI~,3 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM i i9 ~ `K 5a 33~ i INDICATE NO TH ARROW So. Lai BENCHMARK: Describe the vertical reference point used I OSt i ActclePkoro_'~'~J Elevation of vertical reference point: -1 -D, © Proposed slope at site: _ SEPTIC TANK: Manufacturer: Pot.•kr5 Iynp&Liquid Capacity: Number of rings used: Tank manhole cover elevation: 9-k -T Tank Inlet Elevation: 97 7 Tank Outlet Elevation: i Number of feet from nearest Road: Front,~SideoRear, Q ~Q5 feet - '.From nearest ,property line Front 10 Side 10Rear,0 4ly feet Number of feet from: well _Af A , building: /9 (Include this information of the bove plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE w • 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: IQ Length: Number of Lines: Area Built: Fill depth to top of pipe: Number of feet from nearest property line: Front, Q Side, O Rear, 017t. _ Number of feet from well: Number of feet from building: a (Include distances on plot plan). SEEPAGE PIT 4 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: Plumber on job: Dated: License Number: S 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 Ox CONVENTIONAL ❑ALTERNATIVE FS-1.7 Plan lD Number: El Holding Tank [:1 In-Ground Pressure ❑ Mound Iltassignedi NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: James: Kaemmerlin Route 2, Box 131A, New Richmond BENCH MARK (Perfnanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV. NW-1, NE,;,, Section 4, T30N-R17W, Erin Prairie Name of Plumber: IMP/MPRSVV No 1C.unty Sanitary Permit Number: Calvin Powers, Jr. 1563 St. Croix 69620 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. JTANK OUTLET ELEV.. WARNING LABEL LOCKING COVER PROVIDED. PROVIDED: j BEDDING: VENTDIA. VENT MA TL HIGH WATER k ae ! EYES ONO EYES ENO ALARM NUMBER OF ROAD PROPERTY WELL. BUILDING VENT TO FRESH FEET FROM /h LINE ` AIR INLET. EYES O EYES NO NEAREST DOSING C AMBER: MANUFACTURER. BEDDING. LIOUIDCAPACITV JPIMP MODEL PUMP: SIPHON MANUTACTIIREH WARNING LABEL JLOCKING COVER PROVIDED. PROVIDED: EYES ENO EYES ENO DYES ENO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PH OPEH7v WELL JBUILDING F RESH (DIFFERENCE BETWEEN FEET FROM NE IVENTTO AIR INLET PUMP ON AND OFF) EYES ENO NEAREST-~ SOIL ABSORPTION SYSTEM. Check thesoil moistureat thedepth of plowing ]0IAMFTEH IMATIHIA1 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. JLENGTH NO OF JUIST11 PIPE SPACIN(I COVER - INSIUL DIA PITS LIQUID j 3 THENCHF,~ VtAT `H+A PIT DEPTH . DIMENSIONS P ,R.., . E_ UEI'Tlt FILL DEPTH DISTH PIPE DISTH PIPE DISTR PIPE MATERIAL NO [dISTH NUMBER OF PHOPE R7V WELL. BUILDING VENT TO FRESH B LOW IPES ABOVE COVER Et E V INLF I ELEV. ENU PIPES LINE,: 9 AIR INLET. , y 7 GJ FEET FROM 1' j 7,~ 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- E YES NO meets the criteria for medium sand. TIONS MEASURED. E SOIL COVER TEXTURE JPIIIMANINT MAHKI I'S OBSERVATION WELLS _ ENO DEPTH OVER TRENCH BED DEPTH OVER TRENCH HEO DEPTH OF TOPSOIL SOD')DF D E YES SEEDED E YES MULCHED E NO CENTER EDGES EYES. ENO EYES ENO EYES ENO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH NO. OF LAT ENAL SPACING (iHA VEL DEPTH HE LOW PIPF FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL NO DISTH JD:STRPIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEVATION AND ELEVELEVCIAELEVPIPES DA.: DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING; CI31LLED CORRECI LV COVER MATERIAL VERTICAL LIFT COHRESPONDSTOAPPROVED PLANS EYES ENO _ EYES ENO COMMENTS: PERMANENT MARKERS. OBS E RVAT ION WE L LS. NUMBER OF PROPERTY WELL: BUILDING: ` LINE EYES ENO EYES ENO F1NEEAET R FROM Sketch System on Retain in county filefor audit. Reverse Side. -_$jGeMA URE. TITLE DILHR SBD 6710 (R. 01/82) w F uJisconsin APPLICATION FOR SANITARY PERMIT J/- elzo~ COUNTY D' L H R (PLB 67) UNIFORM SANITARY PERMIT # OEPRRTTr7EnT OF InOUSTRV, LRBOR 6 HUMRn RELRTIOns 7 -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'/zx 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT P~PERTY.OWNER ~ MAILING A~DDRiE1~S~ w ( on~ a-me-S 4e i, G IRJ CJ/ PROPERTY LOCATION C-f+Y: W~+~t A'G E : Nu 1/4 fJP_ 1/4,S y ,T30,N,RI I(or)W TOWNOF: C1"Ir-alR1p LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR I nPIDAA ou STATE PLAN I.D. NUMBER TYPPEt OF BUILDING OR USE SERVED uzl 1 or 2 Family Number of Bedrooms. ❑ Public (Specify): /v THIS PERMIT IS FOR A: V 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 ❑ 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 O O Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: Cv~ ~~I d 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): Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation oft priva sewage system shown on the attached plans. Name of Plumber (Print): SignatPT/MPRSW No.: Phone Number: Pluumb`e~r's Address: Name of Designer: A J M, G-'/j I✓ COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved h - ~ 0 v ~S ❑ Owner Given Initial Approved 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 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. 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 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 i MIES KgEAiM E RLIW&I Location of Property 1 -k. Section , T ,3o N - R 17 W Township EIC11V PXAiRi*& Mailing Address RT 2 O1( ~3 A ti'ca RI cHAOA;6 wrs~o~rs~~C3 S~o~7.. Subdivision Name 6A R a R 0'0 T'! 0 .1-J Lot Number Previous Owner of Property RR4 bL E / 6IU JAW `1- t>0/VA1.11 S i E P-HE-INS Total Size of Parcel S30 !00 Date Parcel was Created Are all corners and lot lines identifiable? Yes No . ~ No Is this property being developed for resale (spec house) ? Yes volume 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. PROPERTY OWNER CERTIFICATION I (We) eeAti6y that aU 6tatement6 on this 6onm ane tAu.e to the best o6 my (oun) know.Qtedge; that I (we) am (a&e ) the owneh. _(a) o6 the pno petit y deb en ibed in th i b in6onmati,on 6onm, by viA tue o6 a wauanty deed neeonded in the 064ice o6 the County RegiAten o6 Dee6 " Document No. yo37by ; and that I (we) pnea entey own the pno pod ed bite j ox the a ewag a pob a A ya ter" (o& h I (we) have obtained an eabement, to nun with the above deacA bed pnopenty, gthe co nd t.u c ti.o n o6 4 aid 6 ye tem, and the came has been duty neeonded in the 0 6 6ice o6 the County Reg.i aten o6 Dee& , ab Document No. ATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) 4SN-- DATE SIGNED DATE SIGNED H z En . H a ST C- 105 r r a SEPTIC TANK MAINTENANCE AGREEMENT ryi St. Croix County z t7 ' a OWNER/BUYER .JAKES KRE MM E RLiN& ROUTE/BOX NUMBER R.'~ el jOX 13( q Fire Number CITY/STATE NEB C4AI bu%SCo)u I,N ZIP $Y6 1.7 PROPERTY LOCATION: V E Section Al T 34 N, R_ 1'7_W, Town of ERW P1?09ik1 , St. Croix County, Subdivision (G:gRD q~p Lot number 0 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 I/WE, the undersigned, have read the above requirements and agree z to maintain the private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- b 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. ~IGNEDQd-.-C-0 DATE 4! 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. rz, "a f k, 0 r -6 cc -0 .2 LE -6 U= R) L w L 'a 0 C O 0 f_ N c0 Q O p c L- C V O O O V i N O O m b1 ~ L. 4) 7 0) C7 0 0 L. v,L~ 3 c~ 0-0 C73~ y ~~vv w = i tY 2 co -0 0 ~ 0-0 0.0 J "o E cc Ma 4) c 0) _ V N O w 0 Q Z cad c c cc o'er... U yv,~a~ c oyc 0 CL Cc Cc U) E 0 LU 30 300v 2T= U) rn'D L y C C U- 0 0 U) L W o 03t n ~ o mr. o Q F- y rn~ 12 w 0- 4) 4) r co- " Cc Z Q 3~ cc U) c U) cl- 4) Vi 0 cti c 0 `r O ~~0° co`w O O U 7 Q 0 i N y 0 L Cf O O O N L- M Q aa L oao ocr C c y O O 0 c`d c C O 0 3 C L O ~Z C U'0 oE 75 O _y : O C 0 c 0-5 C C C i- ...0. L O ca O 0 = c c M 0- O 'O c 0 y 0 O i (D QD _ C) C 00 tU i U 0 O Q 3 cn-- 3 m a~ c ` ° 0 0 (D *0 C (L 0 0 a ° 0 cm M c E 2E co ~y c w 0 :33 00 i O ao C O 0 0 le 0 0 3 O A U i O EN ai aim ~ F-~ 3 ~ m N cc N J D •.-min -PARTMENT OF a SAFETY & BUILDIN~S \DUS R& D ~~&s`DEPORT ON SOIL BORINGS AND DIVISION AHOR AN JMAN RELATIONS PERCOLATION CC P.O. BOX 7909 TESTS (1lJ) MADISON, WI 53707 (1-163.090) & Chapter 145.045) ' CATION: SE 10 TOWNSHIP/ OT NO.: BLK. O.: SUB IVISION NAME: N1 :11NTY!' O NER'S BUYER'S AME: IL N ADD SS: -3 z NO. BEDRMS.: COMM R PTIQ : DATES 0 SER ATIONS MADE Residence (D1New P or A STS: g New %?ING: S= Site suitable for system U= Site unsuitable for system JVENTIONAL: MOUND: IRZkOUND•PRESSUR : S TS .IN-41NLDING TANK: RE OMMENDED SYSTEM:(optional) ercolation Tests are NOT required I If any portion of the tested area is in the ter s,H63.0915)(bl, indicate: TIGN RATE: V Floodplain, indicate Floodplain elevation: A)14 PROFILE DESCRIPTIONS RING TOTAL P H T GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH wBER DEPTH W* ELEVATION OBSER ED H TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) i 7 i 7 Z161, 04 YD - l y _ ,.A x PERCOLATION TESTS SST DEPTH WATER IN HOLE TEST TIME DROP I WATER LEVEL-INCHES r- 113ER INCHES AFTER SWELLING INTERVAL-MIN. P R - RATE MINI l ES PER INCH A2 U2,j._ ,i r PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- al and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the di action and percent id slope. J V 'STEM ELEVATION 1311 rOA~ 06 /r zw_ T N I % '1e undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specifi d in the is nistrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. rnsrn f` A~ ( rin r` TESTS WERE COMPLETED ON.. - CER IFICAT WhrNUMBER: PHONE NUMBE131o7itiona ) CST S N URE: t. K I::1N: r)ilinol:n.i,,,,. y,, r,, Lac;rl /1riliirlV l'Oevncr ,m.7 Soil ?e:;lar. r PAGE OF Z aox 31 A Oe- - Dwt-s- ,11 Crc)SS Szc~►ur~ p~ ~'1 i~ri-) 1 ~ 0-1 Yy NE -zQc- Lt T 3 N K (9 cU r n t0*c'tpt 9- Fresh Alf Inlnls And Observation Pipe Approved Vent Cop Minimum 12` Above Final Grade 20- 42° Above Pipe _ 4° Cost Iron To Final Grade Vent Pipe Mash Hoy Or Synthetic Covering win 2° Aggregate Over Pipe Distribution Pipe 0 0 0 0 -Tee 6v Aggregate o Beneat Pips Perforated pipe Bdor h o -Coupling Terminating At Bottom Of System -01 ~ Prp~olel~ t"tnkl grt:.~l< ~ ~L~tJ°• T t art ~ SOIL FILL pISTK18UTlOt'.I PIPE APPROVED S4WJ-HETIC COVER ° MA7~RI^~ OR 9" OF STRAW Z"OFOroREGAll E MARSH HA`j to' 0 F2il2 AGGREGATE DIS-Ri5UT10" PIPE TU BE AT LEAST INCHES BELOW ORIGIAJAL GRADE AQ1) AT LEASTZO INCHES BUT 1.10 MORE THAlJ HZ INCHES BELOW FILIAL GRADE y MAXIMUM ®r~Pt►i OF EXcAVATIm►.D F014 o0F014 bKIGINAI. WoR w!LL BE i1JCHEs PUI41MUM MET" of EXCAVATIOW FROM 011~1411MAL GR49E WILL BE 3 4 INCHES SIGHED: aLL& LIC E►U SE AJUMBE R: r S6_ s f DATE'- ~,jQrne.S KQe- rnrr,c~(I 2 Q ax ! New. W • A) uj N 0-1 .oe<- y r3 0 N 911 w S-cfT] ic- Ln - oc,P l oo c fl sGtT (C ode / i J ~enc, rna.nK` l7a~~,n PsTt>n Qac.K dTJ i Nbf ~L ,00, 0 Ca/v,v, Pc,-4f. v Lo i L, me r Air r ta' ~9q.q 1 ' - 39 3~' - a3 ` 3 i jy9 f i 09/15/2006 08:46 AM Parcel 012-2001-10-000 PAGE 1 OF 1 Alt. Parcel M 04.30.17.565C 012 - TOWN OF ERIN PRAIRIE Current XI 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 - KAEMMERLING, JAMES H & JUDITH K JAMES H & JUDITH K KAEMMERLING 1784 178TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1784 178TH ST SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 0.560 Plat: N/A-NOT AVAILABLE SEC 04 T30N R1 7W PT BLK 73 LOTS 21 THRU Block/Condo Bldg: 26 VIL OF JEWETT ASSESSED WITH P570A Tract(s): (Sec-Twn-Rng 401/4 1601/4) 04-30N-17W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 717/55 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/07/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.010 15,200 244,300 259,500 NO Totals for 2006: General Property 1.010 15,200 244,300 259,500 Woodland 0.000 0 0 Totals for 2005: General Property 1.010 15,200 244,300 259,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 131 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 012-2002-60-000 09/15/2006 08:46 AM PAGE 10F1 Alt. Parcel 04.30.17.570A 012 - TOWN OF ERIN PRAIRIE Current XI 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 - KAEMMERLING, JAMES H & JUDITH K JAMES H & JUDITH K KAEMMERLING 1784 178TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 0.450 Plat: N/A-NOT AVAILABLE SEC 04 T30N R1 7W LOTS 1 & 2 EXC E 64.1 Block/Condo Bldg: FT ALSO LOTS 37 & 38 BLK 78 VIL OF JEWETT MILLS ASSESS WITH P565C Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 04-30N-17W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 717/55 i 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 012-2001-10-000 Valuations: Last Changed: 09/28/1993 Description Class Acres Land Improve Total State Reason Totals for 2006: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00