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HomeMy WebLinkAbout042-1004-80-050 n - Q ! 3 n r► c c d O 7 O f1 3 A. Q A C 3 n m O w uNi o ~ v W° ~C • 3 o CD y awo m N D CL :z z a cD m o c7 fry - TJ cN`n m y N m N 9 0 M CD C) w b b H 0 0 7 N O O o V C 0 14 o to C D a ' I N (W a o U G n o S A 3 O a N (D Ln Z ? on Z ` !Z z !Z CD O W :Z7 N .Or. r CD cn c _ lv H >l) CD z 0 f E (A (A ~ Io m N - m a- T v v o 0 I \ o 7 N CD W Ln 1 N ~..i < = CD W IV Q IV CL K O d~ W Q S z Z co Z O CD 0 0O D CL =3 CD ID C7 cS (o rn \ cc~~ (DD N N to M. CD _ W z CD > -I Cl) 5 O A Z p N O 0 c A z ~ m o- 'i ~ o w Z w co T m CL 3 „ z p A .Z~1 O FF Z N Z 00 CD w F ' I p. CL D m n 3 v c Z 'a 0 CD ~ N a N M. 0 o S :3 a A ~ N a N O O V i I A O O N CD aQ A En O . C) s a. k Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ° TOWNSHIP SEC. T.,?9 N-RhEW ADDRESS ST. CROIX COUNTY, WISCONSIN 1 SUBDIVISION /(J LOT } LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of ILHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 1 I i, ~S • J } of , /XmU INDICATE NORTH ARROW i% r BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: Proposed slope at site: D~'• ~ SEPTIC TANK: Manufacturer: quid Capacity: Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation -1-- Tank Outlet Elevation: _ /_,tJS Number of feet from nearest Road: Front,O Side,w Rear, O ~"Q f feet T From nearest property line Front,0 Side,0 Rear, feet Number of feet from: well t} building: (Include this information of themeabove-plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE h 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, Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: Lenith: Number of Lines: Area Built: ~j Fill depth to top of pipe: , Number of feet from nearest property line: Front, O Side, Rear,O'Ft. Number of feet from well: Number of feet from building: -r (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: Inspector: Dated: Plumber on job: La1" °c License Number: 3/84:mj DEPARTMENT O•' F INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON,-WI 53707 ❑CONVENTIONAL ❑ALTERNATIVE State Plan L)D. Number. ❑ Holding Tank 1:1 In-Ground Pressure El Mound (If assigned NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER: INSPECT N DATE'. Bnyan Hawfziv6 R. R. 1, New Richmond, DUI 54017 _,~,I7z _ BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV.. NFU NW, Section 3, T29N-R18W, Town aj WaIzAen, Lat#3,Wm Hopkiu Sub. Name of Plumber: MP/MPRSW No.. County Sanitary Permit Number. Cat Paweu 1563 St. C/l oix 58938 SEPTIC TANK/HOLDING TANK: MANUFACTURER'. LIQUID CAPACITY. TANK INLET ELEV TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER P I- 1 I V q, 1 ' 0 PROVIDED'. PROVIDED'. V YES ❑NO ❑YES NO BEDDING: VENT CIA.'. VENT MATL. HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING'. VENT TO FRESH . ALARM. IFEET FROM LIN 1 LAIR INLET ❑YES O ❑YES NO NEAREST DOSING CHAMBER: MANUFACTURER. BEDDING'. LIQUID CAPACITY PUMP MODEL JPUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING I VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) ❑YES ❑NO NEAREST SOIL ABSORPTION SYSTEM. Check thesoil moistureat thedepth ofplowing LFN(,TH DIAMETER 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 DISTR PIPE SPACING COVER INSIDE DIA PITS LIQUID TRENCHES MA ERIAL PIT DEPTH. DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR PIPE DISTR. PIPE MATERIAL: NO. STR NUMBER OF PRNO~PEERRTY WELL 1 BUILDING: VENT TO FRESH BELOwPIPES ABOVE COVER ELEV INLFr ELEV D PIPES FEET FROM LG/ AIR INLET 11 NEAREST--s 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 NO meets the criteria for medium sand. TIONS MEASURED. ❑ SOIL COVER TEXTURE PERMANENT MARKERS JOBSERVATION WELLS DEPTH OVER TRENC HBED DEPTH OVER TR ENC HEED [TIFTA_~ OF TOPSOISODDED ❑YES SEED ❑ ED NO ❑YES IMULCHE ❑ NO D. CENTER EDGES ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. ING ELEVATION AND DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV.. ELEV.. DIA. ELEV. PIPES DIA.: DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS ❑YES ❑NO ❑YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL'. BUILDING: FEET FROM LINE: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST Sketch System on ai in county file for audit. Reverse Side. _ rIGNATUJ;,E--' TITLE. l DILHR SBD 6710 (R. 01/82) wisconsin APPLICATION FOR SANITARY PERMIT i~1 D I TO~ LHR OUNTY (PLB 67) mEnUNIFORM SANITARY PERMIT # m In OUSTRV, LPROR 6 HUTPn RELRTIOns 5 (V i -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 P ERTY OWNER MAI{ ING ADDRESS,- 1 U~;CL-KIJ15 _21 PROPERTY LOCATION G+T\-: -H 1f -G, E : IL,-)1/4 V/4, S TJ_`~ N, R ( (or) W TOWN OF: LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD„ LAKE OR LANDMARK ST T~/PLAN I.D. NUMBER TYPE OF BUILDING OR USE SERVED 6.ZM 1 or 2 Family Number of Bedrooms: Public (Specify: 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. X 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 Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer. Ct --t JC'' 'L 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): PROPQSED (Square Feet): l (c~ / Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation b>f e private sewage system shown on the attached plans. Name of Plumber (Prim: S 0ayure:.i INFP/MPRSW No.: Phone Number: i / i Pluc7r's Address: Name of Designer: / '_d r COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: Disapproved ~r old,&' k A roved ❑ Owner Given Initial U pp 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 t 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 L L Location of Property Section , Ti N - R W Township Mailing Address Subdivision Name y Lot Number ' Previous Owner of Property ti~ l j P1 Total Size of Parcel cf, Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) 7 Yes No 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. PROPERTV OWNER CERTIFICATION I (We) eenti..6 y that att b.tatement6 on .th.i b 4o4m ah.e tAue to the but o4 my (ould knowledge; that I (we) am (ah.e) the ownen(6) o6 the pnopehty ducA bed in .thi.6 in6onmati,on 4oAm, by vi tue o6 a wav.anty died "neeon in the 066ice o6 the County Reg4.6,teA of Deed6 ab Document No.~~ ' --3 and that I (we) p4e6en.tey own the ptopobed 6.ite 6oh the e~wage pod -bybtem (on I (we) have obtained an ea6ement, to hu.n with the above debcl4i.bed pnopenty, 6oh the constAucti.on o6 6aid 6y6.tem, and the Game hab been duty necon.ded in the 066tce of the County Regizteh o6 Deed6, a6 Document No. SIG TURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) A Feb L2. ?85 DATE SIGNED DATE SIGNED H a S T C'- 105 r a H SEPTIC TANK MAINTENANCE AGREEMENT H 0 St. Croix County z t7 a OWN E R / RUALER t7 ROUTE/BOX NUMBER Fire Number CITY/STATE F i, 1--,,-''•~!~' C--. I ZIP ~ / 7 PROPERTY LOCATION:l,/ / Section_ T N, R W, I Town of I,< St . Croix County, Subdivision r Lot number I 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 i 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. 0 E I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart- Iv 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. Jy S I G N E D ((uL (.DATE ~9 J 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. L DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AN-D PERCOLATION TESTS (115) MADISOP.O. BOX N WI 7969 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/ PAY: LOT NO.: BLK. NO.: SUBDIVISION NAME: Al 41 '/a'it~/a 3 /T)7 N/R (or) W ~,yh COUNTY: vr"e'rNER'S)BUYER'S AME: MAILING ADDRESS: 5rC/oi s USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPPT-IONS: PERCOLATION TESTS: IXResidence 3 d XNew ❑Replace 5/ /~}J /00 7-/~ RATING: S= Site suitable for system U= Site unsuitable for system l CONVENTIONAL: OUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) ,®.S ❑US ~S []U ❑ S ~,U ❑ S U Ce h v e n 7~o ti c?/ !3 If Percolation Tests are NOT required DESIGN RATE: IV A If any portion of the tested area is in the under s.H63.09(5)(b), indicate: C Y4e'.5 Floodplain, indicate Floodplain elevation: AIA S PROFI RESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER- S CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTHA, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) /,Q &4'ye J; / .511 Xl~ B-~ 1/ D -3 o Ane .o f75"/.~- 9, B- 3 X83 /3/.s~/ .O is 7/ r- B No c 7 7.0 BS ►G7 i31.3 ~ 2,3 3 B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER IPie AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH P- P- r^° 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. SYSTEM ELEVATION 105.1, 13N- l A/ w_c 4 Y11J'' lid 30 17 = _do /'tm 5 O _ o • p~ o ; TeoT N , , , - - I , I, the undersigned, hereby certify that the soil tes 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: Ri C-1 7-/7- R'3 ADDRE CERTI ICATION NUMBER: PHONE NUMBER (optional): ~ ) CST zziev, TRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DIS DILHR-SBD-6395 (R. 02/82) - OVER - T be. c €r pW and accwaz s: M (100410 logy 7"he use section rriugt clearly indic,-. G€. lit-f-l~~r tl* i~ a residence )t" t:,on-I€€'e"G al project; E bid I;X3r;MJ€M ti£3mb of W'<,}t)m y f, n .(dal a Qnmd, 5.. ;<<:.q .,e the, sun sly.! rj 3 ink, Eioxm. #'i SITE ISM FABLE R. t..'s, HOLDING TAN ONLY 1 ALL ~ OTHER .r t ~ r ; 1~~ ; ~ JL,.L. ~~dIt.3.~ r~1,-.. ~::D ; , ..a 1E_ tx 0la h )9 i L.Y``iC C, , 3 L WE we We ax,..=.v:"'€ s lath NN wii „r,£}i_.W C?f.`:LIi,=<:it €s an =06nuthe plot rdan; r' ;/e:. _ 0, LECABl..E .77,:..i,:ans .:.g:.<, ,t €a!,es' €i3s,aing Yom- hocaLo La cr ing to staff is Csr?efca!wdA H. a s"we Ne£'sC'b s .:'r-P1wk and `a ,a_€ poin a, clearly ale pemiarlent; 9. Co - e aH app € p e boxes as t Ows, rlwlit n .aA ?'aat od plsaiu { ala, t: >i ;Ql m" t£3s, exE'nlf _ a Or A w . Ao .I..,-_ku (s3..di a P.;t'€::, € 1min H uabonj elms {I E. Il#CJW, Oka; l~ A !n n a';}{.wqKan box; i ~ ►Li! 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CD = cD CA w aaaa,. 0-o C -•f ,ys~ 0 c 5i. -4 0-0 7 cco w C m -im C CD - to 0 7 o a S = 0 O c 0 V spot a~~ 03 0°3 0 0-w v \CTy w a < o R - CD # CD co O 0 i r PAGE OF ~ru S S Sr r'cri I u 1, o ia 13 4r e o- Froth Air Inl4116 ^And 0bgsirvallon Pipe i...} Approved Vent Cap Minimum 12" Above Final Grade 20- 42" Above Pipe _ 4" Cost Iron To Final Grade Vent Pipe wash Hay of SymMllc Covering win 2" Aggregots Over Pip• Distribution Pipe - 0 0 0 0 0 - Tee - 6" Aggregate Beneath Pipe ° Perloraled Pipe Below, o '-Coupling Terminating A! Bollom Of System Pru~oSe Ptn,,-I (gro.cl< SOIL FILL DISTRIBUTIOI•.1 PIPE APPROVED S41lT-HETIC COVER ZwOFgGGRGATE -~~-MATERII~t OR. 9'' OF STRAW OR MARSU HAy OF%2 2_x/2 AGGREGATE o08° ELEV.OFZQ FEF-T liN rr DISTRIFSUTIIDM PIPE TO BE AT LEAST ' IUCHES BELOW ORIGIIJAL GRADE AQIU AT LEASTZO IIJCHES BUT KIO MORE THAI) 'i2 WCHES BELOW FIUAL I-RADE MAXIMUM ®EpTH OF F-XcAVATi(D0 FX0M ORIGINAL 6KADF- WILL BC I U C H E 5 /Alf"UM ®EP" of EXCAVATIOM fRoM olk1(IMAL_ GRAPE WILL.. M- c~ INCHES LIGEUSE AJUMBER: DATE: r3 JJ~ > > o J~ I ~ ~ ro ~ ' I rte. n CU ~ © ~ O O -p ro rt y n -3 KJ rt O rOf, 1L O O CL N x N f"• rn ~ C), n, ~n ro o rt. ro robes. ~Qj Nn N ~p n rt N Sll 1 t ro N N ro w o po c _ o 03 c~ x ~ n ~ ~ ~ rt C C F. W ro ri n rt. Lo + N w a 0 N O N N eD CD (D n ro rt ro N zr N a a ro b c t H G i to 1 n"~ N~ F r ro ra N C~ r i Cl C rt T y a ro tv-~ 1 CL Cu F Y ro N p~ W N 'D r rt n Ql m ti N ro ~ CL w N ~ ~ I ` \ C rt \ J /LJ~ ' R L • 1 I 1 Ptt CrJ l i . r r Eft-) U y, 36 j Parcel 042-1004-80-050 01/26/2007 09:48 AM PAGE 1 OF 1 Alt. Parcel 03.29.18.38B-10 042 - TOWN OF WARREN 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 ERIN D MCKENNA O - MCKENNA, ERIN D 1177 120TH ST ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 1177 120TH ST SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 1.200 Plat: 1330-CSM 05/1330 SEC 3 T29N R1 8W PT NW NW LOT 1 CSM Block/Condo Bldg: LOT 1 5/1330 & EXC PT DESC IN QC 1894/330 & INC PT DESC IN QC 1894/326 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 03-29N-18W NW NW Notes: Parcel History: Date Doc # Vol/Page Type 06/04/2002 680807 1904/144 WD 05/20/2002 679516 1894/330 QC 05/20/2002 679514 1894/326 QC 07/23/1997 1210/525 WD more... 2006 SUMMARY Bill M Fair Market Value: Assessed with: 148935 202,300 Valuations: Last Changed: 07/11/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.200 27,600 120,000 147,600 NO Totals for 2006: General Property 1.200 27,600 120,000 147,600 Woodland 0.000 0 0 Totals for 2005: General Property 1.200 27,600 120,000 147,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 15.00 Special Assessments Special Charges Delinquent Charges Total 15.00 0.00 0.00