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Form- S T C - 10
AS BUILT SANITARY SYSTEM REPORT
OWNER Q0Q_11',*i d AAA-EW.,a TOWNSHIP SEC. T N-R * W
ADDRESS] ST. CROIX COUNTY, WISCONSIN
SUBDIVISION QPAN&-_,4 40(}111~,,r4 LOT LOT SIZE _R e
PLAN VIEW
Distances and dimensions to meet requirements of ILH,R 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
r
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L
v Y
Z
Ica ~
Ak.;.
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INDICATEINORTH ARROW
f
f
BENCHMARK: Describe the vertical reference point used I"% Z" Vic/,, FD STAler, 1Qr~-
Elevation of vertical reference point: lm oo Proposed slope at site: d
SEPTIC TANK: Manufacturer: Liquid Capacity: ~~-it'l ~+au G+.1
Number of rings used: s? Tank manhole cover elevation:
Tank Inlet Elevation: 3.94 Tank Outlet Elevation: ~ 3.5,93
Number of feet from nearest Road: Front 10 Side,0 Rear, O j:.'i feet
.From nearest property line Front,O Side,O Rear, feet
Number of feet from: well Nit building: 351
(Include this information of the above plot plan)( 2 reference dimensions to septic tank)
SEE REVERSE SIDE
a
~K
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: X Trench:
Width: 12~-O Leng I th: -19%-U'Number of Lines: Z- Area Built• q4b
Fill depth to top of pipe: ~v L,"
Number of feet from nearest property line: Front, O Side, O Rear,0 Ft .zz)6`-d'
Number of feet from well: A114
Number of feet from building: 71k_ 0
(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, O Ft.
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
T
Inspector:
Dated: Plumber on job: License Number:
L
3/84:mj
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
LABOR & HUMAN RELATIONS
P.O. BOX 7969 PRIVATE SEWAGE SYSTEMS
DIVISION
MADISON, WI 53707 BUREAU OF PLUMBING
' MCONVENTIONAL El ALTERNATIVE State Plan I.D.Numbe,:
❑ Holding Tank ❑ In-Ground Pressure ❑ Mound (It assigned)
NAME OF PERMIT HOLDER. T DDRESS OF PERMIT HOLDER:
INSPECTION DATE:
Adrian Golledge Box 307, River Falls, WI 54022 I'Q r -k-5
BENCH MARK (Permanem reference point) DESCRIBE IF DIFFERENT FROM PLAN. G
j X77
REF. PT. ELEV.: CST REF. PT. ELEV
SE/NE of the NE of Section 25, T28N-R20W, Town of Troy, Plainview Acr s
Na- o! Plumber -
MP/MPRSW No.. County Sanitary Permit Number
Paul R. Cudd 2739 St. Croix 69690
SEPTIC TANK/HOLDING TANK:
MANUFACTURER.
LIQUID CAPACITY. TANK INLET ELEV/. TANK OUTLET ELEV. WARNING LABEL LOCKING COVER
PROVIDED. PROVIDED.
t t DYES LINO DYES LINO
BEDDING I
VENT DI VENT MATL JHIGH WATE NUMBER OF ROAD: PROPER V WELL. BUILDING: VENT FRESH
f t, ALARM
FEET FROM LAIR I T~J
YES LINO ! DYES LINO NEAREST I
DOSING CHAMBER:
MANUFACTURER BEDDING. LIOUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER
WARNING LABEL LOCKING COVER
PROVIDED. PROVIDED:
YES LINO DYES LINO OYES LINO
GALLONS PER CYCLE: PUMP AND CONTROLS OP ERATIONAL NUMBER OF PFIOPER TY WELL BUILDING VENT TO FRESII
(DIFFERENCE BETWEEN FEET FROM `INE AIR"LET'
PUMP ON AND OFF) DYES L] NO NEAREST 10
Lj
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing TI, A IF E MATERIAL AND MARKING
or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE
the soil is dry enough to continue.) MAIN
CONVENTIONAL SYSTEM:
BED/TRENCH WIDTH LENGTH NO OF P
DISTR PIPE SPACING COVFHA-L NSIDE IT SITS L JO UI D
/ TRENCF.S ` fjSp,.YE`R I PIT .
DIMENSIONS
DEPTH
GRAVE I DEPTH FILL DEPTH DISTR. P PE DISTR PIPE DISTR. PIPE MATERIAL. N TH PROPERTY WELL . BUILDING. VENT TO FRE
FIP~, V COVER EIE INLET ELE~i END PI S NUMBER OF
FEET FROM LINE AIR LET
H LOw P ABO / y/~. 4 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-
YES LINO meets the criteria for medium sand. TIONS MEASURED.
D
SOIL COVER. TEXTURE PERMANENT MARK ERS. JOBSEH VAT ION WELLS
DYES LINO DYES LINO
DEPTH OVER TRENCH RED DEPTH OVER TRENCH; BED DEPTH OF TOPSOIL SODDED ___fS CENTER EDGES MULCHED
DYES LINO DYES LINO DYES NO
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.NO. DISTR. EISTR IPE
EL EVATION AND ELEVELEVDIA ELEVPIPES DISTRIBUTION
HOLE SIZE HOLE SPACING DRILLED CORRECTLY
INFORMATION COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
PLANS
DYES LINO _DYES LINO
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF ~PH OPE RTY WELL
BUILDING:
FEET FROM LINE:
DYES LINO DYES LINO NEAREST----)P.L
Sketch System on Retain in county file for audit.
Reverse Side.
SIGNAT RE. f TITLE -
DILHR SBD 6710 (R. 01/82) A I 7 r ~ 1
Fi
E7, wlsconsln APPLICATION FOR SANITARY PERMIT
DILHR r-t. IrO1X COUNTY
~PLB 67) UNIFORM SANITARY PERMIT #
InOUSTRV, LR LRBOR 6 HURIRn RELRTIOnS
lcc'e.v C
-Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'/2x 11 inches in size.
-See reverse side for instructions for completing this application. PLEASE PRINT
PROPERTY OWNER MAILING ADDRESS
Adrian Colled€=;e Sox 307, giver Falls, ;:1 54022
PROPERTY LOCATION
1/4; 1/4, S 2 , T28, N, R 5 j) W TOWN OF: ` vj
LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER
Plainview ,~Cres jelander_ ')rive
TYPE OF BUILDING OR USE SERVED
1 or 2 Family Number of Bedrooms. F-1/Public ecify): 6L ~O ~0~
THIS PERMIT IS FOR A:
[XI New System ❑ Tank Replacement ❑ Repair
El Replacement Soil Absorption System ❑ Revision ❑ Privy
❑ Alternate System ❑ Reconnection ❑ Petition for Modification
IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK.
KI 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 ~ 000
Lift Pump Tank/Siphon Chamber
Holding Tank capacity
Manufacturer: s Yoy `"ete Pr0)ducts
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):
Class 2 9/x,5 98
® Private ❑ Joint ❑ Public
I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
Name of Plumber (Print): e: MP/MPRSW No.: Phone Number:
Paul R . Cued / ,t ? 83.12739 V15)425-2_049
Plumber's Address: Name of Designer:
Rt 5, pox 9,,, river a.= : 5 r02? art fegerer (576)
COUNTY/ DEPARTMENT USE ONLY
Signature of Issuing Agent: Fee: Date: ❑ Disapproved
r
ll Owner Given Initial
"e 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.
0 a' YD r .;b
OCL-Iti.on of Pro err_y s
Tawnahip
`x
r3 3! (11.1x1 a3 r k '
PreAPiuu® Owner of Prn~a~ rt-y-
~ii C'LL.
Drate parcel Vaa,
Y/I , J
Are a].1 co-a_sieru i.~~a!lti1.. t>1 - rbo
i r c~xf,
• err:tk1E.d urvey rI
r
. lla4.d
• Land CO!'L fact, or
OthU-I !areal Uocullfi rft: which describus the pt PROPERTY OWNER CERTIFICATION
(be'~e),C,Artiiy that all Statements 011 tl'0% fuii'f a;ij true to the best of rnv (ourj
krs W-Iudqu; that I NVO) am (are) the owner(s) rut tha property descritae(.f in 'tF)i ,
?rrforrr+ation torm, by virtue of a warranty duHd raacorded in the Office of , e
bounty 1400istur of Douds as Doculner)t No..._'± and than I (vvu)
re an, IV owrr the proposed site for the sewage afisposal system (or I (we) Nava
of rained an oaasamunt, to run with th,,a above des.vibed prop arty, for the
construction of said raovem, and the earn" has hijen duly rocorded In the Off cd
of the County R09ister of Daaads, als Document No. _
Sft:iNN7 E GF Cii{JWNE~1 I!F NPPLIC A;L kr_. -
-Z L• 4 J,
DAM SIGNED
DATE SIGN D
_
S l: 105
TA' 1K MAIN' 't?,td,~ NCE AGRE.EME NT
t)W 1? 1, ~I1Jti'L -
'r
fE
x OI~t E/B0R NUMBER_ N
F i r e u an 1, e r f!
I T Y S `I` E
" OPERIFY LOCATIc r
~ ' 1£, , Section I N k ~ tv
Tow,rn of 7 St. Croix County,
Sut,t4ivis.ian r
sot number
Improper use and maintenance f your sc-ptic. ~y.rtt-m could resul, i.n
its premature failure to handle wa.st..:es.,
Proper maintenance r_ox2.._
:Mats of pumping out the septic t2.nI-, every three years or sooner,
I
if needed, by a 1 _ eensed s-eI'tic t a n k i?um 1e r. What:: you put into
the sy s t: e m can a _
ffect the funcr. 01~ of the sepf-ic
us a trt,.it-
.aaent stage in the waste disposal.. system.
St. Croix County residents may be eirp;3t~'t."' t.+ rere
r i' a g r'a a1 t.. t) I-
a ma x1.mum of 60% of the cost; of tepl.ac,>ment of a Failing system,
which was in operation prior to Ja.r,ly 1, 1-975, ~t. Croix
County
accepted this program :tat AUu) Ilst -.)f _L980„ with the requirement that:
owners of all rew s sterns agY.- E!e to k..eep their s stems properly
maintained. -
I rFe property owner a ,
I,rees to .,uLa;Ttit to St. Croix Cc>Lint;w ,i:),3irag ..i
cert1.fication form, : ignud by the owner and by a m~.ster plumber,
Journeyman plumber, restricted plumber or a licensed pumper veri--
fyin) that (1) the ern-site wastewater disposal system is in proper
opeMat:.t.r•jg ccanditi.on and (2.) after inspection and pumping (if nec-
essary), the :peptic: 'tank. i-s less than 1/3 full of sludge and scum.
Certification Form will be sent approximately 30 days prior to
three year expiration.
11WE; the undersigned, have read the above requirements and agree J
to maintain the private sewage disposal -;yst(.!►n in accordance with
the standards set forth, herein., as et by the Wisconsin Depart-
ment of Natural Resources. Certification form muat be completed
and re,_urned to the `=t. Croix County Zuaing Offi.ce within 30 days E
of the three year expiration date.,
SIGNED
D A 1 E
I
St. Croix County Zoning .)fficc
P.O, Box 98
Hammond, WI 5401`i
715-796-2239 or 715-425-8363
Sign, date and rct urn to above rld,T E s
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SAFETY & PI-III .P,iNGS
°EI',r-TrnErr OF EPORT ON SOIL BORINGS AND
LAB°R AN°~~~~ PERCOLATION TESTS DIVISION
11(115) P.O. BOX 7969
HUMAN RELATIONSu MADISON, WI 53707
1111.... (H63.09(1) & Chapter 145.045)
LOCATION: SECTION: NSHUNICIPALI_ LOT NO. BLK. NO.: SUBDIVISION NAME:
/ > s /T? NCR ~E (~r, W _ _ r~~ - 1 t~
COUNTY: OWNER' /BUYER'S AME: MAILING ADDRESS:
s Tom' ? 4 \ F~ }J U LL' c X30 X 3 O 1 U i~"f t .t.S t vJ / Y J Z
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS
Residence 'QNew ❑Re lace
l d-8--85
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: iN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional)
❑U--CAS❑ M $❑UuOSzU ❑$_~U L - - i
DESIGN RATE - -
If Percolation Tests are NOT require d any portion of the tested area is in the
under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: + v '
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER -ItQ CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH,
NUMBER DEPTH fbs. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV ON BACK.)
B- } ❑.5' ~ r }-''r_tBhSi! ~ }\.O'BfiGv-S~'1•-l`~r 6v-CS1 3.7' gnmer.'S
B- ? ~•6' 9S•7 ` > Z•a'Sh L- ;14 - S' S
B 3 3 9b.g' > s.W r,
8
(zr
~B 5 9,~' 9~ 1vo>JE 7 9. 3' 1•~' en 6rL ~
i
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1_ -PERIOD 2 PERIOD 3 PER INCH
P- Pi a P3
P-
P- i - C3-
P- 7-
P1 - C36.6 7 6. P1 9(z3, k/ 11
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. 11J1T1R1r, - 9~ y1
SYSTEM ELEVATION
LE t'oST S oC4T'H OF '9-~. - - ; - - S :N c.^ .+'~2 mot= `T? J. 7~y- N
97 ar S. !5
ol= Gov ova
4 SS---
.v ~ ; .9 • r' co n fib ~ i
I C~
C l g S •
f o t~ ,v u Ro. I
1" x " wp, S r..~ L tq
BIN ~h - _ 5
E? 1 srrEJ
G ~Er-inow.
fit? ! I 82 ~
T
I, the undersigned, hereby certify that the soil tests reported on thig form were made by me in accord with the procedures and methods specified in the F onsin
Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NOME (pin t): - - -
-~--~5 ~ ]TESTS WERE l v,'.1PLETED VON: S
(DRESS I r C~U:.t ER: H`NE L4 7 5,-
S Rr J,j;,ll
`I J
I Y NATURE= ~
01
10 1 _ :a' u r-operty 0.~ner and Sol'
v
^r
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, DIVISION
LABOR AND P.O. BOX 76
HUMAN RELATIONS
PERCOLATION TESTS (115) MADISON, WI 53707
(H63.09(1) & Chapter 145.045)
LOCATION: SECTION: WNSHIP MUNICIPALITY: LOT NO.: BLK. NO.:SUBDIVISION NAME:
E (or) yy_
COUNTY: OWNER'S(BUYER'S AME: MAILING ADDRESS:
USE DATES OBSERVATIONS MADE
i NO. BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: PERCOLATION TESTS:
Residence New ❑ Replace 4
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional)
U
1:1 S
If Percolation Tests are NOT required DESIGN RATE: If an
any portion of the tested area is in the ^V i
under s.H63.09(5)1b1, indicate: b~K L Floodplain, indicate Floodplain elevation: 1
PROFILE DESCRIPTIONS
BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INS CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH I~t OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
1 ` ` ".i ; 1 Uti1 vL- S,-1 rl'st; J~J' `S 3.~ r 6%~ 1h1 C} --a
r
lz~
v • 1 . ~3n Gr L 9
B- S el
B- \_..1
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATE EL-IN RATE MINUTES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERT I TYD 3 PER INCH
P- r
/'y
P-
P- \
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. 'y, I
SYSTEM ELEVATION
5T S
or r~ %w C.,yl-w ~rNC SEA,. t~ti:
IS1
►J T LOT t JAJ L!'S IFMO- So `til.
1•~R.p ~ Z3M 1 r. ~ JNS`tYcL,L. Ft 4~~. v~ yov+~ (oU~~-R:
All!
. T- . ,
_ ,
INT C41`~ N C 5
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I, the undersigned, hereby certify that the soil tests reported on thig 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 ofthe tests are correct to the best of my knowledge and belief.
NAME (print): TESTS WERE COMPLETED ON:
ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional):
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CST SIGNATURE.
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
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By the granting or approving of the above plan, or upon the event of a subsequent
E~ermit being issued,L Croix County and the St.CroixCounty Zoning Administrator, dog's
not assume or hold itself liable for any defects in plans or specifications, pla
omission, examination oversight, construction, or any damage that may result in rr
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Parcel 040-1160-10-000 10/20/2006 11:32 AM
PAGE 1 OF 1
Alt. Parcel 25.28.20.624A-10 040 - TOWN OF TROY
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
PANU K & JENNIFER M ZOLLER O - ZOLLER, PANU K & JENNIFER M
168 DELANDER DR
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 168 DELANDER DR
SC 4893 RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 11.670 Plat: N/A-NOT AVAILABLE
SEC 25 T28N R20W PT SE NE BEING LOT 3 Block/Condo Bldg:
CSM 11/3212 11.67 AC
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
25-28N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
02/20/2004 754757 2513/265 EZ-1
07/19/1999 607069 1442/631 WD
07/23/1997 1122/279 QC
07/23/1997 715/379
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 09/06/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 11.670 102,700 234,200 336,900 NO
Totals for 2006:
General Property 11.670 102,700 234,200 336,900
Woodland 0.000 0 0
Totals for 2005:
General Property 11.670 102,700 234,200 336,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 138
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 040-1160-10-000 10/20/2006 11:27 AM
PAGE 1 OF 1
Alt. Parcel 25.28.20.624A-10 040 - TOWN OF TROY
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
PANU K & JENNIFER M ZOLLER O - ZOLLER, PANU K & JENNIFER M
168 DELANDER DR
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 168 DELANDER DR
SC 4893 RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 11.670 Plat: N/A-NOT AVAILABLE
SEC 25 T28N R20W PT SE NE BEING LOT 3 Block/Condo Bldg:
CSM 11/3212 11.67 AC
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
25-28N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
02/20/2004 754757 2513/265 EZ-1
07/19/1999 607069 1442/631 WD
07/23/1997 1122/279 QC
07/23/1997 715/379
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 09/06/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 11.670 102,700 234,200 336,900 NO
Totals for 2006:
General Property 11.670 102,700 234,200 336,900
Woodland 0.000 0 0
Totals for 2005:
General Property 11.670 102,700 234,200 336,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 138
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00