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Parcel 018-1074-10-000 05/03/2007 11:12 AM
PAGE 1 OF 1
Alt. Parcel 34.29.17.517 018 - TOWN OF HAMMOND
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 - OLSON, LEROY A
LERO A OLSON
1875 TY RD J
BALD IN WI 54002
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 1875 CTY RD J
SC 2422 ST CROIX CENTRAL
SP 1700 WITC
Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE
SEC 3 T29N R1 7W NW NE EXC PT TO PARCEL Block/Condo Bldg:
DESC N 992/272 455/295
Tract(s): (Sec-Twn-Rng 40 1 /4 160 1/4)
34-29N-17W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1038/283 WD
07/23/1997 992/272 LC
07/23/1997 741/249
07/23/1997 455/295
2007 SUMMARY Bill Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 08/24/2005
Description Class Acres Land Improve Total State Reason
RESID NTIAL G1 2.000 28,800 201,000 229,800 NO
AGRIC LTURAL G4 18.500 2,400 0 2,400 NO
UNDEVELOPED G5 0.500 50 0 50 NO
AGRIC LTURAL FOREST G5M 19.000 19,000 0 19,000 NO
Total for 2007:
General Property 40.000 50,250 201,000 251,250
Woodland 0.000 0 0
Total for 2006:
General Property 40.000 50,250 201,000 251,250
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 202
Specials:
User S ecial Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
• Wisconsin Department of Health and Sooial Serviocn
Plb# k67 /70 Division of Health
SEPTIC TANK. PERMIT APPLICATION 16-7 Y-1 0
TY'E o USE BLACK INK /F -7 C~ /01 - "51--7
A. WIe OF PROPERTY
Address (Street, City, Zip Code)
B, LOCATION OF PROPERTY Wh-RI SYST M WILL BE CONSTRUCTED, ALTERED OR EXTENDED COUNTY
Chack One: ~m
CITY VILLEGE LEGAL DESCRIPTION
TOWNSHIP
C. IS LOCAL PERMIT REQUIRED FOP, THIS WORK? YES NO PERMIT NUMBER
D. SEPTIC TANK CAPACITY Gallons NEW INSTALLATION ' REPLACEMENT ADDITION
IiATERIALS: Prefab Conerei.e ti• Poured in Place Steel Other
NUZMB R OF TALKS TO BE I'69'ALLED:
E. TYPE OF OCCUPANCY
Cheek One: One or Two F~.mily Residence Commercial Industrial Other
_ (Specify)
Number of Persons to be ncconmodated l Number of Bedrooms _
F. APPLIANCES, ETC: Food Wa.tcte Grinder YES - NO Automatic Clot, es Washer , YES-_ NO
Disrwasher YES NO Automatio Potato Peeler YES, NO
Other (Specify)
G. MASTER PLUMBER HAKING 'NSTALLATION
Address: Name: - ^ " License Number:
HA
Signature of Applicant: - MP RSW
Address:
g. (To be Completed by Issuing Agent) .
Data of Applica.ti)n Fee Paid j
Permit Issued (dace) ' 7 7 D Permit Numbers
Agent (Name)
Town, Village, City, County, etc.
(Specify)
Note: The application cannot us considered for filing until all of the above ;^estions are answered and the
fee paid. Agents xil' for-A.ard application, the fee of $1.00 "or each septic tanK and the third oopy
of the permit (canary) to the Division of Health. Checks and money orders should be aa.de payable to
the Division of Health.
Do not write in space below -1 FOR DEPARTYENT USE ONLY
I. DATE RECEIVED ACCEPTED BY N\y RETURNED
(Initials) (Date) See i rres.)
FEE RECEIVED VALID. No. PERMIT NO.
Yes orNo
REVIEWED BY APPROVED DATE
(Initials) Yea or No
COMPLETE OTHER SIDE
• SEPTIC TANK PERMIT NO.
R Y P 0 R T O N S 0 1 L P Y R C 0 L A T I 0 N T E S T
A N D S O I L B 0 R I N G S
TO
DIVISION OF HEALTH - PLUIBIHG SDCTI&N
P.O.Box 309, Madison, Wis. 53701
Pursuant to 11 62.20, Wis. Administrativi) Code
P K R C 0 L A T I 0 N T E S T
Test Depth Character of Soil Hou°s Water Test Time DroRjn Water Level Inches izsutos
Number Inches Thioknoss in Inches Sineo Hole in Hole lutcrval Second to Next to Last To Fall
lst Vatted Ovornight in r.inutes Last Period 1,nst Period Period Ono Inch.
Example
P - 0 3611 lop Soil 1018, C1E. 2619 25 Yon or No 30 1 2 1L2 1 2 60
RECORD DATA FROIA MI.NLNIUM OF 3 T --ST HOLES
Compute size of absorption area in aocord with H 62.20 Wis. Adninistrative Codo.
S 0_I L B O R I N G S- Minimum 3611 Belaw Proposed A.bso tion S stem
Boring Total Depth Depth to Ground Water Da th to Bodrock
Number Inohos Gbserved Natimatod Obrserved Estic~,ted Character of Soil with Thiolmoss in I:ashes
Example
B - 0 7211 7211 Black To Soil 12"•, lay 18111 Sand 1811 Gravel 2411
RECORD DATA FROM MIN11MU111 OF 3 BORE HOLES
YPE OF OCCUPANCY:
RESIDENCE: N"-ber of Bedroans OTHER: (Specify) Number of Persons
FOOD WASTE GRINDFIi: Yes No DishNashor: Yes No X futomatic Clothes Washers Yes No
FFUJENT DISPOSAL SYST"n.l•L: NEW d~. EXTENSION ADDITION REPLAC&I1E?7T
Tile Size r ~ No.Lin.Feet Trench Width Depth Number of Lines
Seepage Bed: Length _ Width _ Depth _ Tile Size No. Lines
Sezpade Pit: Insido Diamoter Liquid Depth
I, the undersigned, hereby oertify that the poreoiation tests roportnd on this form were made by me or under my super-
vision Li accord with the procedures and method specified in Chapter H 02.20 (13), Wisoonsin Adwinistmtivs Cone, and
that the data recorded and location of test holes are correct to the best of my knowledge and belief.
NAME TITLE
Type or Print
REGISTRATION NO. or MASTER PLUMBER LIC_4SE 140.
ADDRESS
DATE % r SIGNATURE - i
I r'\ IVI IVI v i v v I. c v I v rt. 1 1 vv-
45 I /
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FA RMERS
Proudly Serves You And Offers These Services
FERTILIZER: BULK AND BAGGED - TRUCK OR TRACTOR SPREAD
BULK FEED - GRINDING - MIXING
i CHEMICALS - CUSTOM WEED SPRAYING - COMPLETE LINE OF
HOMIX FEEDS - SEED CLEANING & TREATING
GARDEN TRACTORS - SNO TRAVELERS - CAMPING EQUIP.
PHONE: 684-3371 BALDWIN, WISCONSIN