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Home My WebLink About038-1009-30-000 y Q O c M -0 0 O c m 10 CD ^ (D \ 1 i U) v O N O OW ti O N Oo (n N n • co 0 m R, 3 o m CL Z ° ( O r_ ID C-D -7 co Cl N N to L co \ 1 O 0 7 (~D n A O O Cil C: CD j O O (D n.r O N C) C o J m O ~ a z D ° C7 W 3 p o o = c Q c n O m Z 0 0 0 ~y (n w w n O C N K Z O O O ry~~• 0 U) cn CA CD o N C O p 2 w m CD cn n y -0 p ! Q, N v O N 3 O z Q N N 0 O O a o' Ely =3 :3 h~ • A v l~J 0 77 O C w m n ~ O D p Z co .a 9 A a O O W W "0 0 O (D (D CL Z O w Cw y ~ < (D W N v =r N O N ? QD 3 Oc -'(n Q C (D N O G a O W N Oo O mo , Z3 -n N - 3 CD~30_ o a n : O C O- O O VOi O 6 O6 O. 0 i ' O i 7 O CO N 7 N C O N ~ O N 2L CD N O CD N t 2- D Sll 3 N N CD a C CD ~ 41 a N a (<D A O 0 CD ~0 V EA p O 00 i b ti e Parcel 038-1009-30-000 09/26/2006 04:22 PM PAGE 1 OF 1 Alt. Parcel 2.31.18.24J 038 - TOWN OF STAR PRAIRIE 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 J F & E (LE) % KM,MA,BJ CLOUTIER O - CLOUTIER, J F & E (LE) % KM,MA,BJ 1220 CTY RD H NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * - Primary Type Dist # Description * 1220 CTY RD H SC 3962 NEW RICHMOND SP 1700 WITC SP 8055 CEDAR LAKE/N R I , Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE SEC 2 T31 N R1 8W PT GL 3 (PARCEL A-2) COM Block/Condo Bldg: 889.67 FT N & 929.26 FT E OF SW COR GI-3: TH N 17 DEG W 75.5' TO LAKE TH N 53 DEG Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) E ALG MEANDER N 100', TH S 20 DEG E 02-31N-18W 108.39 FT TH S 72 DEG W 100 FT TO POB Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1013/417 WD 07/23/1997 418/219 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/12/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 105,000 65,900 170,900 NO Totals for 2006: General Property 0.000 105,000 65,900 170,900 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 105,000 65,900 170,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 215 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 038-1009-20-000 09/26/2006 04:23 PM PAGE 1 OF 1 Alt. Parcel 2.31.18.241 038 - TOWN OF STAR PRAIRIE 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 BRIAN J CLOUTIER O - CLOUTIER, BRIAN J 2763 30TH AVE OSCEOLA WI 54020 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 1218 CTY RD H SC 3962 NEW RICHMOND SP 1700 WITC I Z~ SP 8055 CEDAR LAKE/N R Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE SEC 2 T31 N R1 8W PT GL 3 (PARCEL A) COM Block/Condo Bldg: SW COR, N 729.48', E 777.91' TH N 52 DEG E 108.5' TO POB: N 17 DEG W 149.3' TO Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) LK, N 74 DEG E 90.36', TH S 17 DEG E 02-31N-18W 75.5 FT S 16 DEG W 61.6 FT S 52 DEG W 59.2 FT TO POB TO POB Notes: Parcel History: Date Doc # Vol/Page Type 10/07/2002 693011 2002/63 WD 08/12/1998 584859 1347/553 WD 07/23/1997 414/473 2006 SUMMARY Bill M Fair M 11 arket Value: Assessed with: Use Value Assessment Valuations: Last Changed: 10/05/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 0 46,400 46,400 NO AGRICULTURAL G4 0.000 83,000 0 83,000 NO Totals for 2006: General Property 0.000 83,000 46,400 129,400 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 83,000 46,400 129,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Total Special Assessments Special Charges Delinquent Charges 0.00 0.00 0.00 o m c 0 o m a 1 C H• Nr^r 1 1 I 3 0 0 o o N p ° j n o Ii U) N °w °C• CD -4 w CL Z Z ID c m -4 0 o C ^ C'n M CD SD W C CD n L O 3 0 o N~ d l= N O C (DD - L v w c D ~p 2 C7 . m c~ ~ N a `.C c 3 c°o c°D a J CD a Z 0 r- co ~ N CC) co 3 ~ v z 0 0 0 o "NA, p y N n N m m Q. N O N d ? 90 ° 0- < -I O 7 d d N - W Q N r z z co z O o Dam o~ er CD ~ I CD CD N COD w m a a ~ s C v a A G 7 Q W N CD 0 o z a o' 3 °~r o 00 z y co (D D 7' °c a N O_ CD 0 v C O N R O G c CD 9 -0 N J CD I ~ 3 21 I N m t m- o CD A O N CD D0 O~ 69 O w C) „ Q c m b o a REPORT OF INSPECTION - INDIVIDUAL SEWA(;E SYSTVM - { Sari Lary Perini t a 3 ~ State Sept i NAME - -CIO *r"'?~_ 1' O W N S H 1- P t. C r o i x C m t i n t y 1,0(1 410N ',V& 5ec t iont # - ~ L o Subdtvt5ton - SEP'T'IC TANK Size' ga-L1ons Number of comp rtments Distance From: Well Bu '1di ~12% 1o1)e Highwater PUMP I Nt, CHAMBER Size- _ ga I l_ons 1?6 m1) m/anurac curer Mocll NI 1) r IIOLI)1_NC 'T'ANK. Size gallons Number of Compartments Pumper Aiarm Sys ~em Uistarnce f- roin: Well. Building"- 12% slope Highwater ABSORP'T'ION SITE Bed 'T'rench I)i stance from; We I Bu_i Lding_- 1 2% slope 11i ghwate r ABSORP'T' ION SIT-EI DIMENSIONS Width of trench f t Required area 1 t Length of each line - ft Depth of rock below the in. Number of .1 Ines Depth of rock over ti_le in 'T'otal Ierigth of lines ft Depth of tile below grade in. Distance between Lines- ft~l, Slope of trench in. per 100 it 'T'otal absortption area - - - ft 1~ Type of Cover; PIT 1)I.MENSIONS Number of pits--- Crav#~ l around pit yc s Outside diameter ft Depth below inlet Ft Total absorption area it Area required- %f t - r B APPROVED DATE 1 98/ REJECTED DATI," 198 REASON FOR REJECTION DEPARTMENT OF APPLICATION SAFETY & BUILDINGS INDUSTRY, FOR SANITARY DIVISION LABOR AND PERMIT P.O. BOX 7969 HUMAN RELATIONS (PL13 67) MADISON, WI 53707 Attach plans for the system on paper not less than 8'/z x 11 inches in size. Include a plot plan that is dimensioned or drawn to scale. Horizontal and. vertical elevation reference points must be shown. All appropriate separating distances and physical characteristics as specified in chapter H-63, Wis. Adm. Code, must be shown. An index page or each page must be signed, sealed and dated by the designer. If designed by a Master Plumber, the date, signature and license number must be shown. The owners copy or a legible reproduction of the soil test report must be included. Property Owner: [Maililng Address: Property Location: City, Village or Township: County: '/4 k'/4S 1 ,T N/R (or) W 4, ~Z Lot Number: Blk No.` Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number: (If sin d) TYPE OF BUILDING Number of ❑ Public* ❑ Variance* ❑ Other (specify)* Bedrooms: 1 or 2 Family *State Approval Required. TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY HOLDING TANK CAPACITY 2rc, LIFT PUMP TANK/SIPHON CHAMBER MANUFACTURER: 11 EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inchl: PROPOSED (Square feet): ❑ New ❑ Replacement ❑ Experimental ❑ Seepage Bed ❑ Seepage Pit Alternative (specify) ;nL.vc. Z4 Seepage Trench Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): Private ❑ Joint ❑Public I, the undersigned, hereby assume responsibility for installation o private sewage system shown on the attached plans. Name of Plumber: Signatur MP/MPRSW No.: Phone Number: , 0 Z4Y J.~~_ S~_~ Plumber'; P)ddress: Name of Designer: COUNTY/ DEPARTMENT USE ONLY Signa re of Issuing Agent ' Fee: Date: Sanitary Permit Number: f APPROVED t~~ ❑ DISAPPROVED f Reason for Disapproval: Alternate course(s) of Action Available: Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to in- stallation. Failure to comply will void the sanitary permit. DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber DILHR-SBD-639$ (N,03/81) DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS 'INDUSTRY, C DIVISION H NAND ' P.O. BOX 76 HUMAN RELATIONS PERCOLATION TESTS (115) MADISON WI 53707 LOCATION: SECTION: r) W] , E,, ZN / 7R/~S ~f TOWNSHIP/MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: COUNTY: OWNER'S BUYER'S NAME: AILIN ADDRESS: USE / DATES OBSERVATIONS MADE NO. BEDRMS.: COMMER~lAL DESCRIPTION: R R TONS: ER LA ON TESTS: (or) W QResidence ❑New Replace RATING: S= Site suitable for system U= Site unsuitable for system r `Da CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOL I G TAN E£t3MM 'NDED SYSTEM: (optional) ❑s ❑u ❑S ❑u ❑s ❑u ❑s ❑u latO _ _ Z-1 4 f-f If Percolation Tests are NOT required DESIGN RATE: SYSTEM EL V. If any portion of the lot is in the under s.H63.09(5) (b), indicate: ~Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL ELEVATION D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 7L, / - sl_lzaz B- l ) 7 4 B- B- B- B 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- P- P- PP P- P- PLAN VIEW: Show locations of percolation tests, soil borings and thR rl;t,ens,ons of ar a zontal and vertical elevation reference of land slop. SYSTEM ELEVATION roc yf " y/ ,r f. 1 1 ,(.ems , 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wisconsin Admimistrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief, #FIAME (print): TESTS WERE COMPLETED ON: ADDRE CERTIFICATION NUMBER: PHONE NUMBBER optional): CST SIGNATURE: ' f-!>. DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. DILHR-SBD-6395 (N. 03/81) --S 4c ~c a r 44 ~8 i 1 I L~/CD i i i Jk RECEIVED 1981 P.K i~'r ~ ~ i v Ys b L~Y'...~ - D ,ate fIEPAR;NiFF, O.= r a~' .4'•i rSi9~%~~-(~~~,z.cre~~~i~ R sew `'mow r, SEE- C;GPFif'.S=';:Pi~IL1~,4?1 ~~1f~ 00 Q cr) ~u~,gt ~lN o~<~s u ac w lYcw 1t /Gr~n~o~1K1 G~~-~ ~ ~ 1414 8- -8® 00 I ~JfpOCn, 5 Clip ~ODOg l //c/o%ws az "y+ t ~`ts7 s.. w i-I. T~!:~4r v rtment of Industry, Labor & Human Relations of `17 tO Division of Safety & Bldgs. State Ot Wisconsin 00 W. J%' Cp,` 4 reau of Plumbing Platting & Fire Protection C~~ P.O. Box7969 Madison WI. 53707 O 1► 0@`~ Tel. 608-266-3815 INALL CORRESPONDENCE REFER TO PLAN IDENTIFICATION NO. NAME OF PROJECT TYPE OF APPROVAL STREET AND NO. CITY OR TOWN COUNTY STATE ZIP OWNER Gentlemen: Examination of plumbing plans and specifications for the above-mentioned project has been completed. In accord with Chapter 145, Wisconsin Statutes and Wisconsin Administrative Code, the plumbing plans and specifications are approved contingent upon com- pliance with the stipulations indicated on the plans. Please review your code for the requirements of each code section noted. The architect, professional engineer, registered designer, owner or plumbing contractor shall keep at the construction site one set of plans hearing the stamp of approval of the department. In the event installation of the plumbing improvements or system has not commenced within two years from this date, this approval shall become void and new application shall be made for approval of these plans before work may commence. In granting this approval, the Division of Safety and Buildings does not hold itself liable for any defects in plans or specifications, plan omissions, examination and reserves the right to order changes or additions should conditions arise making this necessary. This approval is based on Wisconsin Administrative Code requirements. It shall be necessary to obtain and fulfill the permit require- ments of the city, village, township or county in which this installation is to be constructed. Failure to obtain local permits will auto- matically void this acceptance. Sincerely, James Sargent-Bureau Director PLANS REVIEWED BY: - LATE: v cc: DPS-OWS Owner DI LHR Local PI Plumber H & R (2) County Mfg. Rep. Bur. of Heai[h Fac. & Services DILHR SBD-6099 (N. 06/80) Rec-& Env. Services Plb 100a 12/78 Detach And Return Upper State of Wisconsin DIV TCTI I OON N OF HEALTH Portion Of This Form With - SEEC - OF PLUMBING AND FIRE PROTECTION SYSTEMS Any Return Correspondence MAIL ADDRESS: P.O. BOX 309 MADISON, WISCONSIN 53701 608-266-3815 DATE: PROJECT: 2 PLAN ID. # DETACH HERE PROJECT NAME PLAN ID. # This is to acknowledge receipt of your plans and specifications for the above-indicated project. Preliminary review indicates the plan review fee required is $ ❑ Plan accepted for review. Fee received is $ Fee is being returned because of ❑ Overpayment ❑ Underpayment. Providing one of the two catagories above is checked, remit correct fee in one payment. ❑ No fee has been remitted. Plans submitted with no fees will be held in abeyance. ❑ Plans being returned. ❑ Additional information required. SEE BELOW. 1. Plan Submission ❑ Additional information shall be submitted in triplicate unless specifically noted. ❑ Plans not clear, legible or permanent. ❑ All information submitted shall be signed, sealed or stamped in accord with Section H 62.25(2)(a) Wisconsin Administrative Code. ❑ Affidavit enclosed. II. Alternate sewage Disposal Systems (Mound Systems) ❑ PLB 108 (Application for use of an alternate system). ❑ County onsite required (1 copy). ❑ Design calculations for pressurized distribution ❑ Cross section of mound. ❑ Pipe lateral layout. ❑ Plan view of alternate. III. Private Sewage Disposal Systems ❑ Ground slope with 2' contours in entire area of soil absorption system extending 25' on all sides. ❑ Elevation of permanent reference point (benchmark). ❑ Location of area suitable for replacement system - provide soil test data. ❑ Plot plan showing lot size and all lateral distances from sewage disposal system or holding tank to bldgs, lot lines, well, watercourse, etc. ❑ Construction detail of septic, holding or lift pump tank if site constructed or tank manufacturer if precast. ❑ Construction detail and cross-section of soil absorption system. ❑ Soil boring and percolation test on EH 115 completed by certified soil tester (1 copy). ❑ Complete data relative to anticipated use of bldg. ❑ 3 copies of PLB 60 enclosed. ❑ Deed restriction required (1 copy). IV. Holding Tanks ❑ Profile of holding tank. ❑ Holding tank agreement signed by owner and local unit of government (sample enclosed). ❑ Reason for installing holding tank soil test or statement from county (1 copy). V. Lift Pump ❑ Calculations for total lift pump discharge, head and gallons pumped per cycle. ❑ Size, length & depth of force main. ❑ Detail & model of pump or automatic siphons including size, pump curves, drawdown and average flow rate GPM. ❑ Cross section of lift pump tank showing pump(s) or siphon(s). VI. Systems In Fill (Fill must be placed prior to plan submission) ❑ Total area filled (fill to extend 20' beyond edge of trench before :de slope begin). ❑ Depth and type of fill. ❑ Copy of onsite report by county or district plumbing supervisor. ❑ Length of time fill has been in place. N01'I?: 'I'll 1.. (tocnrUQtIt Is t.o be recorded In (lie 7'Yact Index at. tic, o f I lci of the ltclJstcr of Ueechi In the cmint y Indicated below. HOLDING TANK AGREE14ENT This Agreeilrent is made and entered into this 31st day of August 19 81 by and between the Town of- Star Prairie , hereinafter called rt Town " an .john F. Cloutier hereinafter ca _ec-t e "Owner. We hereby acknowledge that application has been made for a building permit on the following described property, to wit: Part of Section 3-31-18, North of. C.T.H. "II" , St. Croix County, Wisconsin or that continued use of the existing premises requires that it holding tank be installed on the property for the purpose of proper containment of sewage. We also acknowledge that said property cannot now be served by a municipal sewer or septic tank -w soil absorption system. Therefore. as an inducement to the County of St. Croix to issue a sanitary permit for the above described premise!;, we Here y agree and bind ourselves as follows. 1. Owner agrees to conform to all applicable requirements of the Plumbing Code relating to holding tanks. Any time the Town or Municipality of Star Prairie through its Plumbing Inspector or Health Offi- cer, eeins t necessary to pump out the subject holding tank, the Owner shall have same pumped out in twenty-four (24) hours, or, `town will have said work done and charge same back to Owner anU p ace sairre on the tax bill as a special charge. The Owner further agrees that the Town or Municipality of Star Prairie Wray enter upon the property des- cribed above at any reasondRe t Irle, tonspect, or pump and haul wastes from the subject holding tank. 2. Owner agrees to pay all charges and costs incurred by the Town or Municipality of Star Prairie for inspection, pumping, hauling or otherwise servicing an nra main ng tie subject holding tank in such a man- ner as to prevent or abate any nuisance or health hazard caused by such holding tank. 'I"own shall notify the Owner of any such cost which steal ~e pt►~T~y` t ie (~yner within thirty (30) days from the date of notice and in 'the event that the Owner does not pay said cost within thirty (30) days, Owner hereby specifically agrees that all of said costs and charges may be placed on the tax roll as a special assessment for the abatement of nuisance. and said tax shall be collected as provided by Wisconsin Statute. F1CCE{VIEC1 `state of W sconsin Departinuot of >try, Labor & Human Fielahons DILHR-SBD-6123 (8.3/81) J jx Bison of Safety & Buildings PLUNIL{WG BUR ,~T,{~y document is a full, true and correct c.~~py A .'I df' fhe onginai on file and of record m 111Y l jl ..r.+ tc office i ~erhhed c Page 2 3. Owner agrees to have a quarterly pureping r(,port submitted to the local government and the county Which will state the Ow►ier's name, location of the property can which the holding tank is located, the pumper's name, the dates, voluw,i,:s pumped and the disposal site. An annual pumping report or the fourth quarter report including a summary of the pumping history of the previous year shall be submitted to the Department of Industry, Labor and Human Relations by the governmental unit responsible, per section 145.01 (15), Wisconsin Statutes. 4. We guarantee that the holding tank contents will be disposed of at a site meeting the requirements of chapter NR 113, Wisconsin Administrative Code. 5. This agreement will remain in affect only until the sanitary permit issuing agent in St. Croix County certifies that the subject pro- perty is served by either a pub c sewer or a septic tank soil absorption system that complies with ch. H 63, Wis. Adm. Code. In addition, this Agree- ment may be cancelled by executing and recording said certification with re- ference to this Agreement, in the Tract Index indicated above. 6, finis agreement shat ue u;.:ainq upon fine indicated governmental unit and the Owner or heirs and assignees and shall run with the deed. WITNESS our hands and seals this 14th day of September , 19_.U. TOWN OR MUNICIPALITY OF STAR PRAIRTF. OWNERS by V-Xn R. e1~ n Johi F.' Cloutier by 7Y _Rut i 7V., ohnison STATE OF WISCONSIN Personally came before me this 14th day of pt~mber. 1981, the above named Vern R, Nei-son, g i _1011n:,c,r and John ,Clouti to me known to be the persons who executed the orego rrg`1nstrument a-nd acknowledged the same. THIS INSTRUMENT dam' RY1' PUBOC '.panya L. Glaser DRAFTFD BY: My coitrni ssion expires: -.4./,10/83 Ruth A. Johnson, Town Clerk 4'ewn 6i RT I, SOX R MERRET. wi 54025 JIM MELVIN 715-247-d783 CUSTOMER'S ORDER NO. DEPT. DATE NAME (9 s C G ADDRESS f -77 SOLD BY CASH C.O.D. CHARGE AC T. MDS,FRETD. PAID OUT DESCRIPTION 1 2 3~ 4 5 6 4 7~\fj 8 .d 10 11 12 13 14 15 16 17 18 RECD BY rtED1FiOrt~l. KEEP THIS SLIP 5H 320 FOR REFERENCE ST. CROI X COUNTY to ~t ~-AR, WI SCO N S I N ms`s _ '~~t cn ZONING OFFICE SEP 019 796-2239 (HAMMOND) 425-8363 (RIVER FALLS) HAMMOND, WI 54015 U A R T E R L Y P U M P I N G R E P O R T ST. CROIX COUNTY NAMEtip' a cot RETURN COMPLETED FORM TO: ADDRESS -s~ -2 s,~P 'a°lL- ST. CROIX COUNTY ZONING OFFICE P.O. BOX 98 . c HAMMOND, WI 54015 _ _ 715-796-2239 on 715-425-8363 TOWNSHIP ( PLEASE PROVIDE THE FOLLOWING INFORMATION ACCOMPANIED BY RECEIPTS FROM_-VOUR__P_UMP-ER: ~ P NAME OF PUMPER: LOCATION OF DISPOSAL SITE: NUMBER OF PERSONS LIVING IN RESIDENCE: USE: YEAR ROUND SEASONAL (CHECK ONE) JULY AUGUST SEPTEMBER DATE VOL.PUMPED DATE VOL.PU,MPED DATE VOL.PUM.PED THIS REPORT MUST BE RETURNED NO LATER THAN OCTOBER 15, 1985. OWNERS SIGNATURE k 1 ST. CROI X COUNTY WISC0NSI N tY<<?` Jq~ ZONING OFFICE -1111, v? 1~► ~r _rmli_ Ali e, IeN~7 796-2239 (HAMMOND) 425-8363 (RIVER FALLS) °W HAMMOND, WI 54015 F Q U A R T E R L Y P U M P I N G R E P O R T i7 ST. CROIX COUNTY NAME; /I y'L RETURN COMPLETED FORM TO: ADDRESS/ S ~ ~ d7t/1 4~ ST. CROIX COUNTY ZONING OFFICE, r P. 0. BOX 98 HAMMOND, WI 54015 715-796-2239 or 715-425-8363 TOWNSHIP: PLEASE PROVIDE THE FOLLOWING IN _F RMATION ACCOMPANIED BY RECEIPTS FROM YOUR PUMPER., NAME OF PUMPER: Al t LOCATION OF DISPOSAL SITE: A/I NUMBER OF PERSONS LIVING IN RESIDENCE: i USE: YEAR ROUND SEASONAL (CHECK ONE) OCTOBER NOVEMBER DECEMBER DATE VOL. PUMPED DATE VOL. PUMPED DATE VOL. PUMPED THIS REPORT MUST BE RETURNED NO LATER THAN JANUARY 31, 1986. r' OWNERS SIGNATURE mj:12-83 LITTLE JOHNNIES INC. DATE Trucking & Excavating f - Route 2 NUMBER NEW RICHMOND, WISCONSIN 54017 Phone 248-3735 248-3393 TERMS: (GJ~_ PLEASE DETACH AND RETURN WITH YOUR REMITTANCE DATE CHARGES AND CREDITS BALANCE: BALANCE FORWARD I ~ d PAY LAST AMOUNT LITTLE JOHNNIES INC. ~ IN THIS COLUMN Sri ST. CROI X COUNTY W l SC O N S I N y tin 4 t v~ ZONING OFFICE 796-2239 (HAMMOND) 425-8363 (RIVER FALLS) I HAMMOND, WI 54015 Q U A R T E R L Y P U M P I N G R E P 0 R T ST. CROIX COUNTY NAME RETURN COMPLETED FORM TO: ADDRESS % j %_o f ST. CROIX COUNTY ZONING OFFICE P.O. BOX 98 HAMMOND, WI 54015 715-796-2239 an 715-425-8363 TOWNSHIP 1 v 1 - PLEASE PROVIDE THE FOLLOWING INFORMATION ACCOMPANIED BY RECEIPTS FROM YOUR PUMPER: NAME OF PUMPER: LOCATION OF DISPOSAL SITE: NUMBER OF PERSONS LIVING IN RESIDENCE: USE: YEAR ROUND SEASONAL k (CHECK ONE) APRIL MAY JUNE DATE VOL. PUMPED DATE VOL. PUMPED -DATE VOL. PUMPED THIS REPORT MUST BE RETURNED NO LATER THAN JULY 30, 1985 OWNERS SIGNATURE LITTLE JJHNNIES INC. Trucking & Excavation Route 2 %1--W RICHMOND, WI 54017 ,715) 248 3735 U 1 ("A 1- F-:' ~<C;ER iii 0. SG LL) BY ilAi E SOLD TO 79 ADDRESS MDSE. SOLD MDSE. RET'D RECD ON MISC'L PAID OUT CASH CHARGE CASH CHARGE ACCT.-NOTE I I I I I I I I I v~ i I ~ i I CITY. I PART NO. ARTICLES PRICE AMOUNT J _LLF I I I I RECEIVED BY i TOTAL A All claims and returned goods ' 2161 Aan~ , MUST be accompanied by this bill. You k -j` ST. CROI X COUNTY W I SC 0 N S I N ZONING OFFICE - _ 9 10. C 796-2239 (HAMMOND) 425-8363 (RIVER FALLS) ®~FS ,1 HAMMOND, WI 54015 ,r Q U A R T E R L YP U M P I N G R E P O R T ST. CROIX COUNTY NAME RETURN COMPLETED FORM TO: ADDRESS ST. CROIX COUNTY ZONING OFFICE P.O. BOX 98 HAMMOND, WI 54015 715-796-2239 otc 715-425-8363 TOWNSHIP PLEASE PROVIDE THE FOLLOWING INFORMATION ACCOMPANIED BY RECEIPTS FROM YOUR PUMPER: NAME OF PUMPER: f LOCATION OF DISPOSAL SITE: NUMBER OF PERSONS LIVING IN RESIDE - - - USE: YEAR ROUND SEASONAL (CHECK ONE) JANUARY FEBRUARY MARCH DATE VOL. PUMPED DATE VOL. PUMPED DATE VOL. PUMPED THIS REPORT MUST BE RETURNED NO LATER THAN MAY 15, 1985. OWNERS SIGNATURE ST. CROI X COUNTY WI SC O N S I N r e%r ZONING OFFICE ~f~^ lt~h/ 796-2239 (HAMMOND) `act' 425-8363 (RIVER FALLS) HAMMOND, WI 54015 Q U A R T E R L Y P U M P I N G R E P O R T ST. CROIX COUNTY NAME RETURN COMPLETED FORM T0: ADDRESS./ J ST. CROIX COUNTY ZONING OFFICE P. 0. BOX 98 / +C/T HAMMOND, WI 54015 / S 7 715-796-2239 or 715-425-8363 TOWNSHIP : PLEASE PROVIDE THE FOLLOWING INFORMATION ACCOMPANIED BY RECEIPTS FROM YOUR PUM ER: NAME OF PUMPER: ' LOCATION OF DISPOSAL SITE: NUMBER OF PERSONS LIVING IN RESIDE CE: , USE: YEAR ROUND SEASONAL (CHECK ONE) OCTOBER NOVEMBER DECEMBER DATE VOL. PUMPED DATE VOL. PUMPED DATE VOL. PUMPED THIS REPORT MUST BE RETURNED NO LATER THAN JANUARY 31, 1985. OWNERS SIGNATURE mj : 12-83 ST. C R O I X C O U N T Y 71r W I S C 0 N S I N it. Ilk ZONING OFFICE 796-2239 (HAMMOND) 425-8363 (RIVER FALLS) HAMMOND, WI 54015 2 U A R T E R L V P U M P I N G R E P O R T S. CROIX COUNTY NAME J6 J{ F ~~tom(' (C RETURN COMPLETED FORM TO: ADDRESS s o % /9 iP~ ST. CROIX COUNTY ZONING OFFICE P.O. BOX 98 HAMMOND, WI 54015 715-796--2239 on 715-425-8363 TOWNSI-11 P S fi ;'/Pay' r C- PLEASE PROVIDE THE FOLLOWING INFORMATION ACCOMPANIED BY RECEIPTS FROM YOUR PUMPER: NAME OF PUMPER: LOCATION OF DISPOSAL SITE: NUMBER OF PERSONS LIVING IN RESIDENCE: USE: YEAR ROUND SEASONAL Z----(CHECK ONE) JANUARY FEBRUARY MARCH DATE VOL. PUMPED DATE VOL. PUMPED DATE VOL. PUMPED THIS REPORT MUST BE R TURNED NO LATER THAN APRIL 15, 1984. OWNERS SIGNATURE L r ST. CROI X COUNTY WI SC0 N S I N Var y ' ZONING OFFICE 1p f► ®,e~► - 796-2239 (HAMMOND) - rep' 425-8363 (RIVER FALLS) HAMMOND, W 1 54015 Q lI A R T E R L V P U M P I N G R E P O R T ST. CROIX COUNTY NAME RETURN COMPLETED FORM TO: AVPR -SS lot ST. CROIX COUNTY ZONING OFFICE P.U. BOX 98 HAMMOND, GPI 54015 715-796-2239 w 715-425-8363 TOWNSHI P PLEASE PROVIDE THE FOLLOWING INFORMATION ACCOMPANIED BV RECEIPTS FROM YOUR PUMPER: NAME OF PUMPER: C ~ \ ~r C i es c LOCATION OF DISPOSAL SITE: NUMBER OF PERSONS LIVING IN RESIDENCE: IA G ccc ~rc~G~ USE: YEAI: ROUND qFA-go&JAL (CHECK ONI JANUARY FEBRUARY MARCH DATE VOL. PUMPED DATE VOL. PUMPED DATE VOL. PUMPED THIS REPORT MUST BE RETURNED NO LATER THAN APRIL 15, 1984. )DINERS SIGNATURE i ST. CROI X COUNTY fx~, 6>= ~~9 WI SC O N S I N ZONING OFFICE Y~I~ 11 ~t r- .4 Ipai "9 y6 8A 796-2239 (HAMMOND) y, ` /!!c 4258363 (RIVER FALLS) HAMMOND, WI 54015 0 U A R T E R L V P U M P I N G R E P O R T T. CR01X COUNTY S NAME om`- RETURN COMPLETED FORM TO: l AITDRES- .~2 7 S o ` 5 7-.-f of ST. CROIX COUNTY ZONING OFFICE {P.O. BOX 98 orJ~LW( HAMMOND, GPI 54015 715-796-2239 on 715-425-8363 TO(UNSfII P PLEASE PROVIDE THE FOLLOWING INFORMATION ACCOMPANIED BY RECEIPTS FROM YOUR PUMPER: NAME OF PUMPER: Q "o rU C( T z /W/' LOCATION OF DISPOSAL SITE: , 41 c -('Z:# I? NUMBER OF PERSONS LIVING IN RESIDENCE: 1 USE: - - J YEAR ROUND SEASONAL (CHECK ONE) JULY AUGUST SEPTEMBER DATE VOL.PUMPED DATL VOL.PUMPED DATE VOL.PUMPED Y' THIS REPORT MUST BE RETURNED NO LATER THAN OCTOBER 15, 1984. oWNERS SIGNATURE r, v OFES POSTI p ~ Vi ~ n v n United States ` Postal Service f zz, f (~•'✓-r'f'Q LPL. y~L..:~L-~ r J G~