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Parcel 192-1054-70-000 03/19/2007 11:29 AM
PAGE 1 OF 1
Alt. Parcel 2.28.16.537 192 - VILLAGE OF WOODVILLE
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
JOHN G SAVERS O - SAVERS, JOHN G
3900 PEBBLEBROOK DR
MINNEAPOLIS MN 55437
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
SP 0003 TID C=TID 3 BALD/WOODVIL
Legal Description: Acres: 11.000 Plat: N/A-NOT AVAILABLE
SEC 2 T28N R1 6W PT SE SE COM 585'W OF Block/Condo Bldg:
SE COR, TH E 500' TO HWY B N 875' TO S
LN 1 94 TH N 66 DEGW 846.12' ALG 194 TH Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
W 79';TH SELY TO POB FORMERLY 02-28N-16W
008-1006-95
Notes: Parcel History:
Date Doc # Vol/Page Type
12/21/2000 635641 1569/123 AX
07/23/1997 1087/599 TI
07/23/1997 491/368
2007 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 08/18/2005
Description Class Acres Land Improve Total State Reason
COMMERCIAL G2 11.000 84,600 2,000 86,600 NO
Totals for 2007:
General Property 11.000 84,600 2,000 86,600
Woodland 0.000 0 0
Totals for 2006:
General Property 11.000 84,600 2,000 86,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 192-1054-60-000 03/19/2007 11:26 AM
PAGE 1 OF 1
Alt. Parcel 2.28.16.536 192 - VILLAGE OF WOODVILLE
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 - MGM PROPERTIES LLP
MGM PROPERTIES LLP
538 CTY RD B
WOODVILLE WI 54028
Districts: SC = School SP = Special Property Address(es): = Primary
Type Dist # Description 538 CTY RD B
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
SP 0003 TID C=TID 3 BALD/WOODVIL
Legal Description: Acres: 14.000 Plat: N/A-NOT AVAILABLE
SEC 2 T28N R16W S1/2 NE1/4 SE1/4 EXC A Block/Condo Bldg:
PARC 290' IN WIDTH ACROSS SE SE & S1/2
NE SE LYING WITHIN LNS THAT ARE 110' Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
DISTANT RADIAL LY & AT RT ANGELS SLY 02-28N-16W
FROM 180'DISTANT RADIALLY & AT RT ANGLES
NLY FROM & BOTH PARA- LLEL TO THE
more...
Notes: Parcel History:
Date Doc # Vol/Page Type
12/21/2000 635641 1569/123 AX
11/06/1998 591095 1375/127 WD
07/23/1997 728/459
07/23/1997 684/515
more...
2007 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 06/29/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 4.000 52,100 87,000 139,100 NO
UNDEVELOPED G5 10.000 5,500 0 5,500 NO
Totals for 2007:
General Property 14.000 57,600 87,000 144,600
Woodland 0.000 0 0
Totals for 2006:
General Property 14.000 57,600 87,000 144,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
J
APPLIC_~TICN FOR SA ITAlY P_; j1IT
f or
INSTIL L _TICN CF . SF.-'TIC T'.NK
(Sec. 144.03, l,dis. Stats.)
C? qVE.t OF °_1OP RTY
N me ~ T~?j 1 address (StreetC*ty, Zip Code)
B. LCC. CN OF PROP.-]~ Y 3 "TIC TANK IS TO B^ IlNSTiILLi.,D ~
Che 1. City Nil addre County
one: 2. Village
3 . Town 7S'6c Ste' Yr~
C. IN°T,'.LIJ ,t Give lic Zns i&beA A'
isconsin Restricted
Licensed Sewer
P11.unb l' Z
) Services
Name, tiddre a1,
D. SPW-- IFICiiTIC`NS OF SEPTIC T.~NK '
Size in gallons: (check one)
1. ` 1,000 Gal. 5. _ 4,000 Gal.
2. _ 1,500 Gal. 6. 5,000 Gal.
3. 2,000 Gal. 7. If over 5,000 gal., give capacity.
4. ` 3,000 Gal. L~rN~
Materials: 1.~ Prefab concrete 2./LPoured concrete 3. Steel
E. TYP°' OF CCCUP MY
1. Single Family residence 3. &Commercial establishment
2. Multiple family residence 4. Industrial establishment
F. APP_ZCXIIJLAT NUMB' OF P--SONS S IW7D DAILY G. P71COL. TICN T"ST M,M 1.~ Yes 2. No Date r. t I
By whom'
(To be completed by County Clerk)
Date annlication is filed and fee ;paid
P rmit issued (date) -Permit Number
County M . - ~ clerk
Percolation Rate Minimum :.bsor tien .rea in Sure Feet der Bedroom
Minutes tzeauired Normal ?rdith 'Jith With Both
For ?rTater to Fall Plumbing Garbage Automatic Grinder and
Cne Inch Fixtures Grinder Masher automatic
'!Iasher
2 50 65 75 85
3 60 75 `'5 100
4 70 85 95 115
5 75 90 105 125
5 - 10 100 120 135 165
10- 15 115 140 160 190
15- 30 150 180 205 250
30- 45 180 215 245 300
45- 60 200 240 275 330
60- 90 240 290 325 400
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State of Wisconsin \ DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH
DISTRICT 7 OFFICE
STATE OFFICE BUILDING
718 WEST CLAIREMONT AVENUE
EAU CLAIRE, WISCONSIN 54701
PHONE (715) 834-2931
.;ro john C. iauers
;t311xater, Minnesota 55082
near ''Ir. Seuersr k{es iestaurant Cocktail 3a.r
1-94 & Co. `fr. E
.4u Gallo Twp., St. Croix County
:.ffluent Disposal iel d
An inspection was made by our district plumbing supervisor Pir
I. nald K* Kirgon, of the above installation on dully 5, l n
accordance with his findings, you are hereby directed to make the
following change to conform with the Wisconsin State Plumbing Coder.
1. H 62.20(2)(a) Install, rock to depth of 12 inches below the
lines due to dirt mixed with gravel in soil below tile.
;a9 suggested on July 5, 19680 bed or trenches should be
lastallod in place of the herring bone or fish gone des-1gn
y<au have 1laiined,
The at,ove correction is 14 be rya-de bej.'o.re / further plumbing, is
installed. Your c:.)operation in making this correction is required
and when it is oampleted, kindly notify the Division of Health,
Astrict 7, 718 W. Clsiremont Avenue, FAu Claire, Wisconsin.
If this department can be of further assistance, feel free to
contact us at any time.
Sincerely,
W. R. Koenig., P.i;. Chief
Section of Plumbing and
Related Services
o ,
r'
Donald X. -irq,)n
District 7 "lwibing ~upezvi.sor
DKK s as
cas ~;entral Office
Harold e~ax ber, -ronirlr; Jl'.A inistrator,
Encl. PLB &C
P l b 60 dam` y
NAME OF BUSINESS 8 'i4u/ j? A At --r- - C s E S J~ o R
50 cap . Ss t1)_j7_7_kK,.R /6 u, ~qp
LOCATION Gr-k B * ' 0", a (r- A L L 5- ~S )d e
street or highway 4it."r- township DIVSo my
MER Me N A( cS . 3 A- u E Mailing address f T ' ST / L L G/ 6 ~Itfd.~
ARCHITECT OR ENGINEER Address
PLUMBER Address
1. Check appropriate building usage(s) and fill in the information requested opposite
each usage listed:
Existing building New building Addition
If addition to existing building attach detailed memo Tor each.
o ~ ~Fd
(~bstaurant eF dining room ~ D ~ . . . .Sating o"Ity (10 sq.ft./person)
O Mal O Hotel O Cottages Number of units: Re ar 11ousekespins
2 persons/unit
4 persons/unit TOTAL NUMBER OF UNITS
O Dar or cocktail lounge . . Seating capacity (10 sq.ft./person) eg i. vT- N a iN. O i/►r /Y 1POd /tf
OWaving or retirssest hose Number of beds
O Mobile home peak . a Number of units - dependent
- nondependent
O Service station Number of oars served (daily)
Sobool . . Number of olaasrooss Neale served Yu_ No^ Showers provided Yes. No..~.
Factory or office building Number of persons (total all shifts)
!ti ) Residence • • • • • • • • • • • Number of bedrooms
other - specify
2. Indicate whether or not the following facilities are oonneoted: Food wte grinder . Yes No
Dishwasher . . . . . YesNom!
Automatic clothes washer Yes
3. Fill in the appropriate information for the following am indioatedt
Septie tank eapaelty planned O D Normal septic tank capacity required
W$ increase for M or W Total septic tank capacity required 1543 4 _
Percolation test results - ATTACH PIFICOLATION TEST RCPORT SAM
Seepage sr«wdr bottom ara planned .s q O r width ~i linear feet a depth
Seepage pit planned outside diameter depth below inlet depth
Seepmgs trench bottom area required 711' width linear feet j9'
_ Seepage pit required outside dieseter depth below inlet
I . r .
Signature of person completing form: STATE BOARD OF HEALTH, PLUMBING DIVISION Y>
P. 0. Box 309, Madison, Wisconsin 53701
Address: Approved: _4004 CA
e
Date Date 7,
~E a rS t G N p D ct -C-7 7,0 6 A A/ C~ 1 K .31- ' 4- P"L i} K S, 2"C N d A
s'-/ z - G 7 /f RRP 6 v ~t- L , cc: Donald Kinyon, DPS, District 08.
Plb 60
NAME OF BUSINESS S `
LOCATI Oid
street or tiight,J y -city ti r - toemship county
01MER ;j 5'1 r r - ~ Meiling address
ARCSITL'M OR ENGINEER Address
PLUt~EL Address
1. Ch eck. nppropriate building usage(,q) and fill. in the inforwation requested opposite
each usage listed:
Existing building - New building_ - _ Addition
If addition to e; istin- building attach detailed metro for Each.
CA' Res-Vurant •oz dining •Ova S iii
Motel ( ) Fiotol ( ) cotta•.4°ea . t'taAonr of units. IL"I'I.ar Hc~areslca ink
2 pc:: sons/unit
4 persona/unit TOTAL OF UNITS
B~.!- or coc'.;Wai.l lowise . . . . . Scatin; oa,pacity (10 tq.ft./porson) t, .
( ) Kuralxg or reti.rci.i:.zt he -_Q Huubor of beds
( ) Mobile hoao park . . . . . . . . Humbor of w-1-its - dopsndcnt w ~ ~a
- nondop3ndcnt
( ) Soirvi.oe ctw- lon . . . . . . . . 131= or of oa a cscd vod (lily) School . h`u-::aer of al^v rvc,; s ~ M aM sowed Ye:- HoShotorrs providod
Yes-- L'o
( ) Factory or office buildln;, . . . Nu ..')ov of pcrjons (total all shifts)
Rosidcnoo . . . . . . . . . . . hunbor of b"Iroc_.is ~
Qthnr - vpocify
2. Indicate r;hathor or not tha follo".ir.g facilities aro oonnooted: Food t.asto &^indor . . . Yes Die
Dish;ra rhei. . . . . Yes~~~ p How
hatorua'io olothos waehor Yes He
3. Fill in tho appropriate inQOr tie ~ for th:) folluaing as indioatod:
Septio 3«l. esi ; . avY r, ! c t ! ^ 1:0-' ial 130 tic t." % req
5Gw inor a3o for r-F4G or till Total sopti.c tan', oapaoity rcquircd
Peroolation tort roaulta - AiPAOH FL.wOL_MtYO'1 TEST V',fORT ST"";I
seep-go bottom Brea plea?nod ~ t4width . ®.t lino-ar feet depth
Seepruo pit pl,~'-YMod outsido dizanster m depth bolo, inlet , dopth
a
Sow traah bo v::a a
p:g3 _ rc~u_.rad ~ ri.dth lint.^_r feet
seopa--e pit rzquirad cutrido din--aster , dopth b-1lva inlet .
Signature of person cn _:pleting form: SPATE BOARD OF HEALTH, PLUt-MING DIVISI014
P. 0. Boy: 309, Madison, Wisconsin 53701
Atacireon
Date Date
i7j r