HomeMy WebLinkAbout010-1018-90-000
os; f c o
C A
c
~ i # m 1
n m 0 N vOi z N ~ 3 00 °
N 3 0 e " w x- N is ° i--i
Z CA
:03, p
(D W N W = (D d m O
N u Oo
a
N `
O0o O II h 7 Q' ~p 0 111
w Ui C CD n F O p O
3 O N 7 0
3 C)
0 N C j ""y lV
v to D a
ID
m N m Q
W
(D rn
3 a
cD `may
O O N
(D 00 co 0 (n
W 0 0 O C !1
.r ~
0 !V
Z O O O 3 r.
o m
o c v 0
F In fn vi a o
o y m v
C
II O
N tY
1 M cn
< y o (ly
7' N
co
z N
o
O D D a O
0 ~ co !V •
CD D
c
~ vy
OZ j N
p 2 m
v A z o
0
m g o
CL
0 3
o z
rn
3 . g g
y
(D
A
O0 (n Q
Wp 3 a
3 4 < p
O T
N N
3 Z 3
o a
O=r m
c
N
(D ~
N
mm
O N
(D 0
"ZI
N 0
O
o ti ~
O O
S a
33
N
0
ZS o
g cn a
~ A
w
(D O Q Opp
to O m o
o g ti N
00 0. b
i
~ AS BUILT SANITARY SYSTEM REPORT
OWNER r'rf
ADDRESS ~l TOWNSHIP ! SEC .
A - r S T. CROI X C i TY W I S C ON~S "T` )N R r/G, W
S UB DI VI S T ON Z N .
LOT LOT SIZE
Distances h dimensions to meet requirementsWof H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
d - a •
+
t, r7
r - 1 .J 7
i
i• J
I di a e pth~ Arrow
SEPTIC TANK(S) _ ^~=i•t"
MF'GR. CONCRETE STEEL
NO o rings on cover Depth
PUMPING CHAMBER SIZE PUMP MFGR.
GALLONS Per~Cycle ~EL NO.
TRENCHES NO. of wicTt-1`
BED NO. of lines length area
width length area
NUMBER OF SEEPAaEpP TSo top o pipe
AGGREGATE Our_si e iameer total pit area
PERK RATE - - RE REQUIRED AREAx L C -U
AS B
Disclaimer: The inspection of this system by St. Croix County does not imply
complete compliance with State Administrative Codes. There are other areas tha•
it is not possible to inspect at this point of construction. St. Croix County
assumes no liability for system operation. However, if failure is noted the
County will make every effort to determine cause of failure.
GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYTEM.
INSPECTOR
DATED/ PLUMBER ON JOB
,,,~,t
-)Z Ui LICENSE N tIr1B E R `3
/ Sz
I:l l'OI~I (11 IN.`;I'I1'1IiIN IN UIV 1011AI_ NI WAG[ NYNIIh4
N<<Ylt lt,Itl I'I 'Imp ( 4;t;L3
- UIa~vIhll"~ r)
~ tl(,,,Yl S40 NII(Iltoif I u ( 0
Nubdl vY ti-t url
Cl IC IANK - - -
C yu f' UVth Nil llllr
<''r rurnp~u'i (111o it
Cs
Ii+I r ('d i Yl,l
11 < 11Ia1 ( c I,l
1'INt; cI(A~d1;I I~
r tlu('PUv14 I'um1_) Muit U (a c litil(,~r
_ Mi)tlel' Nurnf)()>r
I)1 NO I r~Nf
C I~ I~ i , VI 1 N YYI O c
1
• f l u Irll.,~cz n l rn c~ yr f b
C Ae(1~lYYl t t
I/ k it
it t tl1t w o
;`;l)I~'I'I I1)N ':t 11
!iid Icit crl
.
~htUYY P in
('rn ~ IUPYt'
1!-t cl11wt~~tc?I
(iN0k1PIIUN SII1 1)1Al INNIONN
Wed(it ( t~<<~P,ch
c'ytlcI[(I d it hu
Icklif ell n ( 1, cIf f ifc r
Uer) tII nA /1u h Oe('Uw t-i.('p rII
_ U l' r., l 11 a ti l (i c u v r It i` c X 11
1nluP I'Cvl(I tIt a 4,tyll. -
- - li-t DI~I~tGI ~~h t.Xe b ctuw gnude ~vl
U h l~avIrc 1) c Iwcvvt e YI0 tit p~~ u ( tl~~.vlcII rI. pC, It I00 fj t
I (rt 1' tl I, a 't 1) U it (i fI t' (I
"t lif v old Cuvt>)'c: PttC)c~t u~t 3-t~luw
I l UIM1Nti10WN
Nuill ) t•h u~ 1~)i-lh
C~it q v c l' a_'u, u kt d p.~ t,% yea vI U
O l l (!t i d t• d i (to c it
- - 0•t 1)cv(It hvYow (rl(o ~i
I i~ dill' It I) 1U~l1.rl (UYl ~(1(('E( -
{t
A /i 1' ~ 1 I l 1 ~1 l' ( I
/,I C
IU)V1 D
I I I C I l 1) 0A 11
- - 19
h
I A';ON I OI: I.I _II ('/]ON !
REPORT ON INSPECTION OF SANITARY PERMIT #
(1) Name and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection
~ZLl1~ LF lU Lcu? ~t(G'G' X11 t(
Time of Inspection
ame, ress, ice a o." o ns a Ind Plumber
(3)INSTALLATION CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber
❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System
BEN Permanent reference Point) Describe:
Elevation of vertical reference point: Slope at site:
(5)MATERIAL AND DEPTH OF SEWER:
(6)SEPTIC TANK: Manufacturer: Liquid Capacity:
Tank Inlet Elevation: Tank Outlet Elev:
# ft to lot or property line: # ft to well:
(7)DOSING TANK: Manufacturer: # of gallons:
# of gallon pump set for a cycle gallons; total capactiy of distribution
lines gallon; size of pump head; gallon per minute ;
horsepower ; brand name of pump and model number
Is the warning device installed? ❑ YES ❑ NO Wired? ❑YES ❑ NO
8 HOLDING TANK: Manufacturer o gallons
construction ; depth to the cover ft; If septic tank is
being used are baffles removed? ❑ YES ❑ NO; ft from residence;
ft from well; ft from property line. Type of warning device
Is the warning device installed? ❑ YES ❑ NO; Wired? ❑ YES ❑ NO;
Locking device on cover? []YES ❑ NO; Diameter of vent and material ;
Distance from building to vent
(9) SEEPAGE PIT SIZE: # of pits; ft diameter; ft liquid depth;
ft to residence; ft to well; ft to property line;
ft to ordinary high water mark of lake or stream; ft to edge of slopes
greater than seepage pit inlet pipe-elevation ft; bottom of
seepage pit elevation ft.
(10) SEEPAGE BED SIZE: ft width; ft length; tile depth;
lineal feet tile; ft to residence; ft to well; ft to lot or
property line; ft to ordinary high water mark of lake or stream; ft to edge
of slopes greater than 20% falling away toward lakes, water courses or drainage ditches
Elevation of tank discharge line entering bed ft.
11 SEEPAGE TRENCH: Total length of seepage trench ft; width ft;
tile depth ft; ft to well; ft to ordinary high water mark of
lake or stream; ft to edge of slopes greater than 20% falling away toward lakes,
water courses or drainage ditches; elevation of tank discharge line entering seepage
trench ft.
(12) Has system been installed in area indicated on EH 115? ❑ YES ❑ NO
(13) Has system been installed in floodway? ❑ YES ❑ NO Floodplain? ❑ YES ❑ NO
DILHR-SBD-6095`N.05/80
Signature of Inspector:
PLB'-67 State and County State Permit # g7
~j Permit Application County Permit #
for Private Domestic Sewage Systems County
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
B. LOCATION: ! % Section T , R ~ (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township lr~rrc;}gyp
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family 4- Duplex No. of Bedrooms f-2 No. of Persons_ -
SEPTIC TANK CAPACITY Total gallons No. of tanks
HOLDING TANK CAPACITY aa-y7) Total gallons No. of tanks Prefab concrete Poured-in-Place Steel. Fiberglass Other (specify
New InstallationReplacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area sq. ft-
New Replacement- Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: Length- Width Depth Tile depth (top) No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land Distance from critical slope
WATER SUPPLY: Private ❑ Joint 9 Community ❑ Municipal ❑
Owners name as listed on EH 115 if other than present owner:
1, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared
by the Cer~fied Soil TessA
NAME }h1 //~-Jx--1 C.S.T. # i and other information
obtained from at") (owner/builder).
Plumber's Signature MP/MPRSW# IS 1, j Phone Yt% S/ ,Y5 `
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca-
tion shall be included on the sketch- Indicate or dimension location of all wells on the property or neighbors
property. If well has not been drilled please indicate.
t
i
i
s
a- rte-«. eas a ,a ~ ma. n
2
j
' i
x
~ E
E ~
s
E
i
Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application 1Q -,-'~,;2-PL) Fees Paid: State 4".0 County c>z Dat_
Permit Issued/Rejected (date) Issuing Agent Name
Inspection Yes_,A_No State Valid# Date Recd
1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) 4. plumber (canary copy)
Revised Date 7/1/78
1111-
E H 115 flev. 9/78
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION , '/4„Q _Section T, N,R& (or) W,Township or Municipality AaAtlZ o
Lot No. , Block No. County ~ (iAoh Y
Subdivision Name
Owner's/Buyers Name:
Mailing Address:
TYPE OF OCCUPANCY: Residence- No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS ' "7" 80 PERCOLATION TESTS AeLA4!
SOIL MAP SHEET 30 W1'2 NAME OF SOIL MAP UNIT
~~rn~.' { r2~
_ PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TESTTIME DROP IN WATER LEVEL, INCHES RATE
NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL MIN1N
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P_
P- `
P-
P-
P-
P-
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK
OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES
B - f
B- l t
r
B- Z1Z
B- A-).rd u 7.
B- c -
B- V '.C
J:Y- 7_J
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancy Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope.
a
3
eat
I 3
f . t
is.lc
~i?►11°~f/~ i
l
e a E
° ! I
R I
s
1, the undersigend, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods
specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my
knowledge and belief.
Name (print) ' Certification No.
Address 1 ~rL eS' D/
Name of installer if known
Copy A -Local Authority CST Signature LI'ti ~ _
AGREE MEINT
617 341
This agreement, made and entered on this day of 19 by °
and between the Township of P.ddress
• a
V-'EEREA. S: In application has been made for a sanitation system on the
t following described property:
r:
ViEEREAS: Septic tank drainage does not meet the minimum standards of-the
ordinance of St. Croix County and state codes. ;
'ViELREAS: The owner agrees to install a holding tank for septic tank purposes
purposes.
NOV, THEREFORE: For and in consideration of the issuance by the Town-
ship of of a permit for the above premises, the parties
do hereby agree and bind themselves as follows:
1. Owner agrees that they will conform to all the rules and regulations
pertaining to a holding tank system. They agree that anytime said
township deems it necessary to pump out said tank, the owners shall
have same pumped out in 24 hours, or township will have said work
doneand charged to owners and place same on their tax bill as a
special charge.
2. The Township reserves the right to assess a bond if they desire to
cover any possible pumping charge in the sum of $
IT IS UNDERSTOOD that this agreement shall be binding on the owners,
their heirs and assigns.
IN V ITNESS WEERLOF, the parties have hereunto set their hands and seals
the day and year first above written.
Township of EGISTER& OFFICE
by CRO ix Co., W
K<*c'd. for r econd thus-_1 th
Developer
or owner day of.---Sept. A.D. 19 80
at~ 2:30 p,
STATE OF V ISCONSIN) >
SS: t.r of D*ed
COUNTY CF _S','. CRM) _
Subscribed apld sciworn to'before me this ' day of 19
r'
c
Notary Fub1jC,'"5t... t,oi.x County
Department of Industry, Labor & Human Relations
State of Division of Safety & Bldgs.
State of Wisconsin Bureau of Plumbing Platting & Fire Protection
=mow ' P.O. Box7969
Madison WI. 53707
Tel. 608-266-3815
INALL CORRESPONDENCE
REFER TO PLAN
+ fC vl~oN(~ r IDENTIFICA TION NO.
4jo (7
NAME OF PROJECT
5k
TYPE OF APPROVAL
STREET AND NO. /
CITY OR TOWN ~ COU~/ STATE ZIP
O NER Qt/ t'14
i
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 bearing 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 Direc i
PLANS REVIEWED BY: DATE:
cc: DPS Owner DILHR
Local PT---- Plumber
H&R(2)
Mfg. Rep. Bur. of Health Fac. & Services
D I L H R SBD-6099 (N. 06/80) Rec. & Env. Services
A
'ESr, ST. CROI X COUNTY
WI S C 0 N S I N
Ia
J ~s~}s Y:...t . ZONING OFFICE 796-2239
Post Ob66.ice Box 227
r' s t_ tt Hammond, WT 54015
O W N E R
P U M P E R
A G R E E M E N T
PLEASE BE ADVTSEa, That 11 it you arse again not.i6 ied, I wilt
/ i r J
conznact with oJ
il.cscons.in, (Pumper), Got the purpose o6 nemov.ing att waste Jnom the
,6an.itany system to be toeated on the pnopenty and Sutu,%e home site
.located in St. Cno.ix County, Wisconsin, Township o6
being in the o6 the 441'; % o6 Sec. ~ T.. 3~'
(On mo ate Gutty d es en.ib ed as 6 ott ows : )
Dazed this day o6 (OWNER)
State o6 Wisconsin)
4.
County o6 St. C,%o.ix )
Pensonnattyappeaned be6one me this day o6 19
the above named to me 'known to be the
pennon who execute the 6onego.ing instrument and ackn,owtedged the same.
Ko-t y Vic, t. no cx ounty, l
Icy Comm. (is penman ) (Expikes) _
I, i,;,;,,~;w1r; r, hene.inbe6one ne6enned to as Pumpers,
join in the above agreement to e extent that I have a contract with
Owner as above stated.
(PUMPER)
T
r
Department of Industry, Labor & Human Relations
of VV, Division of Safety & Bldgs.
State Ot 1SCOIISIII Bureau of Plumbing Platting & Fire Protection
P.O. Box7969
Madison WI. 53707
Tel. 608-266-3815
INALL CORRESPONDENCE
REFER TO PLAN
IDENTIFICATION NO.
NAME OF PROJECT
TYPE OF APPROVAL
STREET AND NO.
CITY OR TOWN COUN //fTATE 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 bearing 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 constryzve"OP_ _ • l o obtain local permits will auto-
matically void this acceptance.
Sincerely, O H 1-1 r-r7
Irv C~
!llff6d
cz~ °
James Sargent-Bureau Director
PLANS REVIEWED BY: DATE:
cc: DPS-OWS Owner DI LHR
Local PI Plumber H & R (2)
County Mfg. Rep. Bur. of Health Fac. & Services
DI LH R SBD-6099 (N. 06/80) Rec. & Env. Services
P!b 1Jk-.2/7fi-
Detach And Return Upper State of Wisconsin
Portion Of T 1 his Form With I OF HEALTH
1111 ~ - SEECTCTIOON N OF PLUMBING
Any Return Correspondence AND FIRE PROTECTION SYSTEMS
MAIL ADDRESS: P.O. BOX 309
MADISON, WISCONSIN 53701
608-266-3815
DATE:
PROJECT:
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.
ll. 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.
111. 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 side slope begin).
❑ Depth and type of fill.
❑ Copy of onsite report by county or district plumbing supervisor.
L Ji Length of time fill has been in place.
~ ~ / f AC3c / v
VJ zx'f /0 SNP G'
i
s
s' 4iC E / 7(1
f
,2c
80-049,0
i
j
v
r
o s
L-OU417 ~.4a
n to O 3-0 n d ~
~p
0 Er 1
3 ~ r- 11 O
3
M ~ m co
w3 z2v-z ° r m°C)
o d v o FD' 3 •°D
0
m a y o m°
rn n (D o ^
d LT1 m a m m a 0)_ Fli
00 CD CD
O
~ ~d PI 3 °
O Fj- ~-t
0 o 5
O CA F-' 0 m
J-h H~ ¢ F- N co n N a s
A~ rt a N IW o o c°o
ri (D H O m O o o N
P, F- ~C C11
a lz .5: ~ o
Z (0 CD s
00 00 0 0 CO CO 0 W li N 0 v
~-d i O N CD
N G 00 N m T T m
In N Z 0 0 O
(D o a n ~
00 a
t_n Q
Q~ n ul N N a °
a-
N3
ICD
:3 CD CD
'a cn
gu 1 CD Cn
I (D
z N Ft g w °
(D w
00 x z
S Ui (D O z z 2 0
D D o
m O D
Lon D 0. CD
z CD -4 cn
p A
O A Z O
O d = z 7
N
~A a W C* L CO
5 CL Z
13
m g
° Z
I -ADO A
N p~
N
=r a) cL CD i
N 3 a
O -
7C .C O'
N SU p= C
3 3 z a
O (D
O
a~
CD s
v <
y D O
C
N N
:3 =r
CL p
-O r
(D N
CD
N
j 7 Q
A
C ~ ' Z
3v o
m (OD N
~ - N
O
O
a\
A
0 w
N dQ li
60 0 N
O
6 (D
y
° a
Parcel 010-1018-90-000 10/02/2006 03:05 PM
PAGE 1 OF 1
Alt. Parcel 8.30.16.110 010 - TOWN OF EMERALD
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
O- KIEKHOFER, S A&M L-FAM TR%SHERMAN J
S A&M L-FAM TR%SHERMAN J KIEKHOFER
1669 220TH ST
EMERALD WI 54013
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 1669 220TH ST
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE
SEC 8 T30N R16W 40A SW NW Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
08-30N-16W
Notes: Parcel History:
Date Doc # Vol/Page Type
01/30/2006 817458 EZ-U
07/23/1997 990/277 QC
2006 SUMMARY Bill Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 10/19/2004
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 37.000 6,200 0 6,200 NO
UNDEVELOPED G5 1.000 100 0 100 NO
OTHER G7 2.000 10,000 128,600 138,600 NO
Totals for 2006:
General Property 40.000 16,300 128,600 144,900
Woodland 0.000 0 0
Totals for 2005:
General Property 40.000 16,300 128,600 144,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 204
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
r
W
EMERALD T.30N-R.16 47
S SEE PAGE 60
SEE PAGE 59
S O C Sp 2us~e// E y o
ti V _Ph f lNebs?ar; et x S
F - b C G/
Hend son !_a /ra>ne p
tom! Z• h h
ti cTar»e.s Coo e.s, v o
D
i /z/~ mh /04- ef~x l1~/LLOVV y~ ZFh zb/ "z
~0 3 2 1 3w 3 2 1 4 3 2 1 4 3 L z Wdy 4 3
t Pate K ~r se/>t> s zes ~ yy z y 3 0
w •f/el,de~.so~ Ke~,~>Etfi ~ p / Ja~¢~ef /~'/e 0-f/7 ?•1 4 s b
>°odue Lor~a/na
~s E e~son v G>/ien sai N y 3y/ R,
4 5 _ re S 7 b nI` ~r . b gz T 8 5 6 7 B 5 y 7 8 y o R
~7o.ras Z79 Q ~ Ke.wh ~ ~ ~ v/
~n 9 i✓ >re t W~ ^ Sh,~ieyy Fr/a. o n
63
Wy /s4e ~ C ~ v v ~ W.itme~ w z7z ~ F ~..E ~Tarncs ~enn.s Q v yi +i~
95 p 40 € iTiinef p Joyce i v
h ~_ff W ~f •Da /ene Tarn 0~ d\~' ~ Denn/s v o~ cNamara Peiecs en ~ h p 0
b 0 ^J 6 iik eMa ~ McNa~>->a ~ C', ~'c 5 7~o~>s tl F/~ /Ph K i.s ~ ~ ~ tl v V
q°-7 g° Bo ~ ~ ~ ~~ds ~ u rzo `yO ~ryis~ teo /60 ~ j oo `w
/70TH 3~.7
~'C h A ~-hem->nan q o,S~/ ic, W hr,. ~s 0 x v U.nce • • 5• AVE
Ca/ <I Ka.
C C - Louae ~"E /2o Koh/e~ Mawm L.
p Nea/fJ May F 7'
-C ~w n G✓o3nia d V b~ C /7e>-vim>n
/7a/by Ke.Eho efer .Ora ~U~ >•9 j w ~ C~ ~ ¢-O r9e Gee J)ebra, J
/98 zoo KahY ti~~ /'Tp a d v~ w a~i~ o • e`/ z47 U/echf JJa~,d
N f~ v CUZn 8 /e/moo eo~>n>e
\ n /6o Rcn D vid f ~ife.ne>-/
~P La/r/a R- h/mss Dennns >~o cremes
~ ~ j ,~a Ct/en Si' 4 Dor/s cSiP: >~t E/a.s won, zs3
b ~ ~ 6o iTot>>w O `0 o etaJ r' Sharon c~cnds 8° 7d s/ 7Y aB t~
_IJO~othy De MaJ' 66 ~i~e 9. A/. •rT¢nes
itiav- /3a3>//e v /SS aji//e /ssb / f>a h/ 1J¢nef 80
rzo y • go /ycNamai
160 r H rw 7164
d /fen y f N /a < mad w s • AVE.
C Kennet v L _ f 5onn.e 'ven
~ 5a i ete/ ~ ,T / e p 41 y, ~ N Maan ~ N CS/e>i7e~f - eLo.,~ acs. SM.vid L-
ea~s 0 et f .J ,3s' s' Anderson,
~ rbo SP ap Cd Loy/e~ma/~ Fanc/s - o er Fie c>,E Ka /afi ef~
>60 f Susan /GO ~ Dann G~ ~~``/B8
~~I u z s9 s K/a ~ Van_
c w~~ U~ Rans ~lNa//a~-~
`'~~0 '9a C ssf//us 97 AV V.
ul T//Orn¢l$ /JQU iCe I E ~4 y n b 0
v WSW /7¢z Gnu
/'/a ai^%/° zro ~,C Duane Hi// 117 MER o,
S 39 ~C 0 wCC l/ar»>e
Gg'~ p P insc uu Q
Ah aoo v ~d 'J /90
0 i/a 42n
O Sys V- Ti nosh
Ae~ o s~ o~ ~jq sva/s5 ua/er>e v
~ G ~ • 9crc, , ~c f
77-7i • >s Ba 5oc/>e
C `C 0 40 ,P tfi M Kegoody y ago /Vo~man C7 p C/ear Vew BLat/bhne
~ 0 ~ rrow ~ F ~ ~ Mary aZ m ~ f)e~es. ~ h
~ ~ tl JMar wren ~ Lo, fc te?'ma/7 ~ ~ ~ d v Larson
~d W _.ao /.-ranee 'Q.chard /si eo C~ Znc -~g ,
n F a. • f L ,.s ~ d too
h ~Cl 3s zv~ e/niscfi David ~JY/ <
~0~ v~~ B° Bo Bo Were/ F adr~ck_ ono/d
„ o vW ~ o EvH- f ~ ~s° ~ <s~ /~/e~ v'~ ~ ?gas e ,eont~
` 5u pW ~h ene >`>'/es J p C/eai Vew qc -e s. l ` ~d~ /45 ~m ~y a_v.
~S wZ` . ~ w _ a/sh K Boe~Yy v ~ .>c. /60 ~ ~ ~ ~F u . ~cr ass--
¢o Edo 0 ~Z5 i e/i
/40TH .4,
4
He//e O ¢nn E • • rc~ c%ar F d •AVE. 6nG>
S ° 9 o Denn>s f Jori>es f 60 fK¢th
,37 Ober-
Ma~i ~7ane//
°v a Omann M F7 Ed and f o ° a p v d i Fey 4 J e/%
177 /60 --z _-na ~✓a/ h C v~ ~h u~ yea. mss/ mat ado
/6o U zco .~C /sRS Nod a ~h
17
Nance vPoo e e~ • L>i>d~av H / W O0p :°C R 79zs- Hen y ~tT anne E.
N p sae - '769 /zo w C a y F ones r ~7ayca yw~ Nurfyen Fo/-i'as~`
M .eec>be.> 0 °J Ci o. s •/ber 17anie Ft ar
ar/as Larson V z. C i/>;s • 4 e . Fi rToyM //er q v~ 3 •C 3 q~°~f ~Q n
.a7/ TH,so • - • Bo Nadeau ast
p~ • r/en V m~~ W • Zw~ . AVE qO
Z C d •b e!✓ai/ 0 204 a JaTES w,~ c Nnec-
lC~ C1.C~ ~ ~ w ~ C G'aro/ ~o zo ~ •n9e• ,o
T/7oma s ti ~ v r7o~a /d
~p~~ C p go o p P /o n ~p p s dy ?1l o' r/eyec //0 3u Ts on>Px
°r e~J 6ene s ; o w E Ldwn,
u~o o~ ~h v
v ~ J ~9 ~ 9 ne I N~ W p a /z- Gay ~ Kcnneh5, s //o
A w v d f v s ;t zoo C 9n,/~ e~~,ooa t
v~ T co/i ~so q~ a d. ✓adea~ /go 3
63 0v W>t/am t9z.ya c~iis W~~ ~o `G°o F
~xC f2 th n y zOCv ~va p v° /zo 00 ~q` /e E<r a.H
~v~~ ~ sender/ .Mar>on o / ft.~ ~ ~ v r: ~l' ~ ~ ~ nc 17ona td R rjr->°n S D
C~ f Susan tl y a Ld v~~ p ~ o ~ ~ ~ ~ k F D ~ ,6m Marsane
/GO l 1. o ~ ~ ~ ~ W //u c/< ~>c an,
V o v v Sf~izhc Ma/-,a>/ et.,~ f/uri~a~
6r n
• N DeJon9 vN dan;5 ~ ~ ,e h'~r/ _ t C' / ~ No~,(/,-zs, zoo 760 /6O
DD • t ro cSabot ~ ~ ~ /
~i9es,Po - rd carp b/s, r c SEE PAG • 3,3 DD
cSf Cro>,< Co<.nty,w.s
WOLLACK POLLED
HURTGEN TRUCKING, HEREFORD FARM
Ed & Donna Wollock and Family
01 INC.
- Route 1 - P.O. Box 73
(7 15) 265-4966 Woodville, Wisconsin
(715) 698-2001
4-H Route 1, Box 253
Registered Polled Herefords
a family affair Glenwood City, Wisconsin 54013 Breeding Stock For Sale
Springfield Section 17 NNW,
1
r
ST. CROI X COUNTY
W I S C 0 N S I N
0A~ ZONING OFFICE
796-2239 (HAMMOND)
4258363 (RIVER FALLS)
HAMMOND, WI 54015
QUARTERLY P U M P I N G REP O R T
ST. CROI X COUNTY
NAME; jjtz~~-' RETURN COMPLETED FORM TO:
ADDRESS: ST. CROIX COUNTY ZONING OFFICE. -of xz P. 0. BOX 98
HAMMOND, WI 54015
715-796-2239 or 715-425-8363
TOWNSHIP: PLEASE PROVIDE ION ACCOMPANIED
RECEIPTS FROM YOUR PUMPER:
NAME OF PUMPER:
1G
17
LOCATION OF DISPOSAL SITE: NUMBER OF PERSONS LIVING IN RESIDENCE: f
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.
OWNERS SIGNATURE
mj :12-83
c
O
Nom, Z
~D s ? Z
r CNT O -
r 0
= n d
^Z^ o-
L! J O
V
k
7 ST. CROI X COUNTY
Y ri ;.Eri+~ k1 2 .may .d "'f WI SC O N S I N
5 ~
ZONING OFFICE
_ 'rr~►4' 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
NAME RETURN COMPLETED FORM TO:
ADDRESS ST. CROIX COUNTY ZONING OFFICE
P.O. BOX 98
f?"' , Fl '1~ HAMMOND, WI 54015
715-796-2239 wn 715-425-8363
TOWNSHIP
PLEASE PROVIDE THE FOLLOWING INFORMATION ACCOMPANIED
BY RE =_~.-WN OUR__PUMPER:
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.PUMPED DATE VOL.PUMPED
THIS REPORT MUST BE RETURNED NO LATER THAN OCTOBER 15, 1985.
OWNERS SIGNATURE - !
a
o
O
~ rn
N da
m a
~ , ~ .a.
~ ~ U
A
~ ® c
~,n
Z rn
p
~ ^ ~ Y m
~ ~ rn
~ ~ ~
n
n ~ ~/f
n O
~ Z v
1 ~ ~
`o N
r ~
~ ~ °
V
a~
# ST. CROI X COUNTY
v4 F ? al r f L!WI SC0 N S I N
ZONING OFFICE
jv,~,~g~~G 796-2239 (HAMMOND)
A. q-P r 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. C R 0 1 X COUNTY
NAME RETURN COMPLETED FORM TO:
ADDRESS ST. CROIX COUNTY ZONING OFFICE
P.O. BOX 98
HAMMOND, WI 54015
TOWNSHIP 715-796-2239 an 715-425-8363
,f
PLEASE PROVIDE THE FOLLOWING INFORMATION ACCOMPANIED
BV RECEIPTS FROM YOUR PUMPER:
NAME OF PUMPER:
LOCATION OF DISPOSAL SITE:
NUMBER OF PERSONS LIVING IN RESIDENCE:
USE: YEAR ROUND SEASONAL (CHECK ONE)
JANUARY FEBRUARY - 6~
-
DATE VOL. PUMPED DATE VOL. PUMPED DATE VOL. PUMPED
THIS REPORT MUST BE RETURNED NO LATER THAN MAY 15, 1985.
OWNERS SIGNATURE
r, E+
v
L
n 3: CA
O
z zz
t
o
V
k
ST. CROI X COUNTY
z 's 'T' WI SC O N S I N
L zj J ZONING OFFICE
796-2239 (HAMMOND)
425-8363 (RIVER FALLS)
HAMMOND, WI 54015
QUARTERLY P U M P I N G REP O R T
ST. CROIX COUNTY
NAME: RETURN COMPLETED FORM TO:
ADDRESS: ST. CROIX COUNTY ZONING OFFICE.
P. 0. BOX 98
HAMMOND, WI 54 015
715-796-2239 or 715-425-8363
TOWNSHIP : ~~YyLPiY~~
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 A- 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.
/ o
OWNERS SIGNATURE
mj:12-83
0
ro
.J O
m o•
~i
~ r U
~ N
N
4
v m
rn
91
= rm- (1 m
'm o
r i Z O
U
J.
_O
V
~ xrr
T. C R 0 1 X COUNTY
2 . t ~ ~ r
3~a W I S C O N S I N
s ,
r) ZONING OFFICE
796-2239 (HAMMOND)
~--r"
r 425-8363 (RIVER FALLS)
HAMMOND, WI 54015
QUARTER LYPUMPING REPORT
ST. CROIX COUNTY
i
NAME; RETURN COMPLETED FORM TO:
A'D'DRESS ( ST. CROIX COUNTY ZONING OFFICE
J P.O. BOX 98
HAMMOND, WI 54015
715-796-2239 on 715-425-8363
TOWNSHIP
yj r
PLEASE PROVIDE THE FOLLOWING INFORMATION ACCOMPANIED
BY RECEIPTS FROM YOUR PUMPER:
i
NAME OF PUMPER:
LOCATION OF DISPOSAL SITE: I lc~~~r~Ic
I
NUMBER OF PERSONS LIVING IN RESIDENCE:
USE:_ YEAR ROUND a SEASONAL (CHECK ONE)
JULY AUGUST SEPTEMBER
DATE VOL.PUMPED DATE VOL.PUMPED DATE VOL.PUMPED
THIS REPORT MUST BE RETURNED NO LATER THAN OCTOBER 15, 1984.
OWNERS SIGNATURE ~ .r
v
o
0
rn
m o~
v
54
~ ~ rn m
rn
n ~ y
Z o
Ol
r
6
CROI X COUNTY
W I S C 0 N S I N
®'4& 0, ZONING OFFICE
IT Or
y
96-2239 (HAMMOND)
`~tii~>•Iwi
258363 RIVER FALLS
HAMMOND, WI 54015
R E P O R T
U A R T E R L Y P U M P I N G
ST. C R 0 1 X COUNTY
NAME ~V ZL! RETURN COMPLETED FORM TO:
ADDRESS ST. CROIX COUNTY ZONING OFFICE
~y P.O. BOX 98
` HAMMOND WI 54015
_ 715-796-2239 on 715-425-8363
TOWNSHIP
PLEASE PROVIDE THE FOLLOWING INFORMATION A0004PANIED
BY RECEIPTS ROM YOUR PUMPER:
NAME OF PUMPER:
LOCATION OF DISPOSAL SITE:
NUMBER OF PERSONS LIVING IN RESIDENCE:
USE: YEAR ROUND SEASONAL (CHECK ONE)
APRIL MAY JUNE
DATE VOL. PUMPED DATE VOL. PUMPED DATE VOL. PUMPED
THIS REPORT MUST BE RETURNED NO LATER THAN JULY 15, 1984
OWNERS SIGNATURE
1LC~r2Ci
vk~
ST. CROI X COUNT_
W I S C O N S I N oz's
ZONING OFFICE qq
796-2239 (HAMMOND)
425-8363 (RIVER FALLS)
Ap< HAMMOND WI 54015
~~%~'1=fit / l
r
LIARTL R L V P U M PI NG RE P- ORT
T. CRO1X COUNTY
NAME ~
- RETURN COMPLETED FORM TO:
ADDRESS ST. CROIX COUNTY ZONING OFFICE:
P.O. BOX 98
HAMMOND, UPI 54015
715-796-2239 oa 715-425--8363
TOWNSHIP e~ i
PLEASE PROVIDE THE FOLLOWING INFORMATION ACCOMPANIED
BY RECEIPTS FROM YOUR PUMPER:
~ r
NAME OF PUMPER:
LOCATION OF DISPOSAL SITE: -
NUMBER OF PERSONS LIVING IN RESIDENCE: USE: YEAR ROUND SEASONAL (CHECK ONE)
JANUARY FEBRUARY MARCH
DATE VOL. PUMPED DATE VOL. PUMPED DATE VOL. PUMPED
THIS REPORT MUST BE REfURNCO NO LATER THAN APRIL 15, 1984.
OWNEI:S SIGNATURE / ~ ~ `
0
Q ro
N
Z
rrp fl
r
o
d
ST. CROI X COUNTY
y5z : ti, ± a,° WI SC O N S I N
ZONING OFFICE
796-2239 (HAMMO
425-8363 (R I V E f S) "0-
It,,;
HAMMOND, WI _ 15o y G~
V V% V0 '-n -
Q U A R T E R L Y P U M P I N G REP O R T Ca
ST. C R O I X C O U N T Y
NAME: RETURN COMPLETED FORM TO:
449 1
ADDRESS: jJ~ - Joe ST. CROIX COUNTY ZONING OFFICE .
P. 0. BOX 98
,"mewQLd~~~ Sao HAMMOND, WI 54015
715-796-2239 or 715-425-8363
m e y..
TOWNSHIP:
i
PLEASE PROVIDE THE FOLLOWING INFORMATION ACCOMPANIED
BY RECEIPTS FROM YOUR PUMPER:
NAME OF PUMPER:
~LOCATION 0,$. DISPOSAL SITE: 1~
C
NUMBER OF PERSONS LIVING IN RESIDENCE:
USE: YEAR ROUND SEASONAL (CHECK ONE)
OCTOBER NOVEMBER DECEMBER
DATE VOL. PUMPED DATE VOL. PUMPED DATE VOL. PUMPED
f cE S
THIS REPORT MUST BE RETURNED NO LATER THAN JANUARY 15, 1984.
OWNERS SIGNATUkE
mj :12-8 3
T
v
c .v
0
} Z
rn
m a
' n 3:: IA
t x 0
V
I
I ~
POWERS
j- 2 1 1/
LIQUID WASTE MANAGEMENT
James K. Thompson
Asst_ Zoning Administrator
'Ot.. Croix Co. Zoning Administrator ,
Ic~ \
:~t. Croix County Courthouse
911 Fourth Street c„r 1,
Hudson, WI 54017
Dear Mr. Thonpson:
Below is the information you requested regarding holding tanks we
currently service.
1. Adada Rental Rental property in Houlton
Box 37 County E on Hwy 35 across from liquor store.
Houlton., WI 54082
Owner: Don Peters Capacity: 3000 w.als
2. Brown, Dan West side of Bass Lake.
129 South 9th 726 143rd Ave.
River Falls, WI 54022 Capacity: 2000 gals
3. C'harland, Flora trailerhouse
22.33 90tH
New Richmond, WI 54017 Capacity: 2000 gals
4. Hartigan, Terrence Bass Lake
1394: Frog Pond Lane
New Richmond, WI 54017 Capacity: 2000 gals
5. Ki.ekhoefer, Sherman trailerhouse
1669 220th St.
Emerald, WI 54012 Capacity: 2000 gals
6. Kingdom Hall Jehovah Witness Hall west of
c/o Michael Faust. New Richmond on Hwy 64.
408 'S'unrise
Somerset. WI 54025 Capacity: 3000 gals
To my knowledge, this is a complete list. If you have any questions
pli_ase feel free t;; -,ontact me.
:sincerely, ~
J
'I"ammy ~'oWer S
manager
(715) 246-5738 550 RILEY AVE.
NEW RICHMOND, WI 54017