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Parcel 016-1006-40-000 08i28/2006 10:16 AM
PAGE 1 OF 1
Alt. Parcel 3.30.15.54B 016 - TOWN OF GLENWOOD
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 - NEWCOMBE, DOROTHY O TRUST
DOROTHY O TRUST NEWCOMBE C - C/O NEWCOMBE PETER
C/O NEWCOMBE PETER
3086 170TH ST
GLENWOOD CITY WI 54013
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 3086 170TH ST
SC 2198 GLENWOOD CITY
SP 1700 WITC
Legal Description: Acres: 1.200 Plat: N/A-NOT AVAILABLE
SEC 3 T30N R1 5W 1.2A IN SE SE W 200' OF Block/Condo Bldg:
E 832.9'OF S 371'OF SE SE
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
03-30N-15W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 36
07/23/1997 460/20
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/06/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.200 9,000 106,400 115,400 NO
Totals for 2006:
General Property 1.200 9,000 106,400 115,400
Woodland 0.000 0 0
Totals for 2005:
General Property 1.200 9,000 106,400 115,400
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 016-1006-30-000 08/28/2006 10:16 AM
PAGE 1 OF 1
Alt. Parcel 3.30.15.54A 016 - TOWN OF GLENWOOD
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
DOROTHY O TR ET AL C/O NEWCOMBE O - NEWCOMBE, DOROTHY O TR ET AL C/O
GWEN C MONROE GWEN
MONROE
3086 170TH ST
GLENWOOD CITY WI 54013
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description
SC 2198 GLENWOOD CITY
SP 1700 WITC
Legal Description: Acres: 38.880 Plat: N/A-NOT AVAILABLE
SEC 3 T30N R1 5W 38.80A SE SE EXC W 200' Block/Condo Bldg:
OF E 832.9'OF S 371'
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
03-30N-15W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 834/50
07/23/1997 770/536
2006 SUMMARY Bill Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 07/26/2006
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 12.000 1,200 0 1,200 NO
AGRICULTURAL FOREST G5M 26.880 23,500 0 23,500 NO
Totals for 2006:
General Property 38.880 24,700 0 24,700
Woodland 0.000 0 0
Totals for 2005:
General Property 38.880 24,900 0 24,900
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
WD {Cob- 2 0 c Lvy 5~- ~
Pi x,1069 of H 1 e.nF Scci
z^1 Servic
l 8 7= 6 Division of health
PERMIT APPLTCATION
/ for
6( oC7! AND 13 PRIJ',`P
O'P
Ac?+resS (C, ee,., City, Zip Code)
r
B. LCX'!.'i'IUN
k. -0
WI - 1n,t f~7} A'T t D C.R
CITY VILLA LE'~AL
TOWNSHIP
C. IS LOCAL PEre`iiT FZ;aUIR:":D FOR 'PHIS WJ;CC? ~ YES NO PE~:I'P NU ':d R j
1). SEPTIC `i'A.,;C i~
i CAPE CI`rC NEW INSTALLATI )IN REPLAM,._N ,~y A )DITI;N w
Md,TZRIA-f S: Prefa. crate _
) Co:. Pour'-1 in Place Str,el
- Other
OF TANKS TO F Ld5
_y
E. TYP; OF OCCUPANCY
Check One: One or TWO Fau:ily Residence - Com:reroial Indir.strial Other
I
P.u eryof Perso is to be tic d
c --t d hu.,, zr of B us cc,,
F. A> i.,IANiCE;S, ETC: Food Waste Grinder YES
NO A_ztc.^ ti(, Clo;.:~es WaG`ier YE5 NO
Dis:_nasher --YES NO Automatic Potato Peeler YES NO f
Other (Specify)
G. Err"LUE i' DISPOSAL SYS-t'E ;G EXTE'•SION ADDITION REPLA.C- :ENT
Tile Sizes
No.Lin.Fee- enc:1 Width Depth N,,!,-,:bp,- of
Seepage Bed: Lent: _ Width Depth Tile Size No. Lines
Sear%-oe Pit: Insides died eter .e._.~L iquid
P E R C O L A T I O N T E S T
Test D n h -i.__ Cha : ester o > TT Hoar +
4f cr Tes+
t Time Dro4 ill Wa ;r Lev ?^Inc iF . t
Number Znon i This n ss in L., I S '^le W - in i
1, in -I
in Hole Interval Second-to Next to L°s` Po ra11.
in Minut•e3
Exa.npla~ Iasi Period I Last Pu
_rio•' Period '?:7e I cn
P- 0 36'' Too Sri? 1O" Clav 261v
?LL__ yes or no 30 112 1 2 1 2 (~6
C
I. - -
'A
k 0 D D 1 ~.a, i;I.iI~_~N 0~• 3 -.'s, HOLES
Compute -size of absorption ar.!.. in eccord with H 62.20 His, p.cninistr~tive Cods. T,
S O I L B O R I N G_S ..gym 36" B-31 M, Pr o,) std Absor?tian Sisters
orin~ Total Depth DE2 -z to
umber In
xa mpl cha.s Cbaerv-d E ted I (7be vd Es -t4d C
e haracter of Soil with Thickness in Inches
0 7211 7211
y
Black Ton Soil- 1211; C1av 18'1 Sari ir,'. G a ?
K:
y
RECORD DATA FROM MINIMUM OF 3 BOR; HOLL'S
Ip the 'und,orsii;ried, hereby certify that the perLol, tion tests reported on this fora, wary cr: ,-o by roe
or und<;r by si_uv~rvisioai in aocord. wit}; -,ha procedures and rne',;hud specified in C"tinpter Ei 62.20 ( 3),
Wisconsin ! F-.,d that ;ne cake, rocorde' un:? o
a te u ai ccrrec o
1c.. tio_. f t Ic e t,
the beast of r,y knv ,1,.!;, 1 f
1
NAB, TITLE
(1'yp; or Pr ot)
REOISTFc',TIO`I NO. cr tt;STEER PLUl'-DER ~1CEPd°.. No.
[LATE ~ SiGN TJia
M^.~ E P!,:.._ _R ML,', APPLICATIOrI
Ho
Si', "Ir'.a p
f y MP RSW
(To be Co.-npleted by IssuinL A.;-nt)
Date of Applic%tic:n Fee Paid $ ~
Parmi, Issued (data),- Permit Plumber
Agent (nar;e) For.
To+,,n, Village, City, County, etc_
(Spac.ify)
Note; Ths application oarinot be con^i~•sre.d for filing until all of tho above questiorz are an,r.'or.,d
and th fee paid. Agef:ts will fonvard application, the fee of .10,00 end Copy (b) of the
Permit (yellw-, copy) to the Division of Health, Checks and rn: ,r:ey orders should be rrade
payable to the Division of health.
Do not write in spa.ca below e FOR DEPA ;.'Z-1E T USE ONLY
wDATE R~'CEI,ru.`~_.~l.r..._/~^ ^ ACCEPTED BY RETUP,cED'_
1 (Initials) (Date) (Sea Corres,
FEE fZ CEIV'+'D VALID. NO. PEF~. IIT NO.
(Yes or NO)
R-VIi-,+tED DY APPROVED _ DATE
(initials) (Yes or No) _
C0?: T
i