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Parcel 020-1082-50-000 01/04/2007 11:39 AM
PAGE 1 OF 1
Alt. Parcel 29.29.19.332C 020 - TOWN OF HUDSON
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 - WESTCONSIN CREDIT UNION, ATTN: MIKE SCHMITZ
ATTN: MIKE SCHMITZ WESTCONSIN CREDIT UNION
PO BOX 160
MENOMONIE WI 54751
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 402 DEER HAVEN DR
SC 2611 HUDSON
SP 1700 WITC /xid /
Legal Description: Acres: 0.980 Plat: N/A-NOT AVAILABLE
SEC 29 T29N R19W SW NW N 298+T OF S 273 Block/Condo Bldg:
FT OF W 208 FT EXC PARCE ~332J
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
29-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
01/07/2002 667487 1899/29 WD
07/23/1997 718/511
07/23/1997 447/175
2006 SUMMARY Bill Fair Market Value: Assess
161690 51,500
Valuations: Last Changed: 10/25/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.980 45,100 4,000 49,100 NO
Totals for 2006:
General Property 0.980 45,100 4,000 49,100
Woodland 0.000 0 0
Totals for 2005:
General Property 0.980 45,100 4,000 49,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch 124
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Wisoonsin Department of Health and Social Services
Pih. #67 10/69 Division of Health
PERMIT APPLICATION ZO~ ck
for 16 LIAR
PRIVATE DOMESTIC SEWAGE SYSTEMS
332C 1`G ll~u~ ~~V~l e~
A. OWNER OF PROPERTY TYPE OR USE BLACK INK J (r/
Name Address (Street,, City, Zip Code)
j
D
County
B. LOCATION OF PROPERTY WFEtir. SYSTEM WILL BE CONSTRUCTED, ALTERED OR EXTENDED
Check One:
CITY VILLAGE LEGAL DESCRIPTION
1 ~S%
- TOWNSHIP C
C. IS LOCAL PERMIT REQUIRED FOR THIS WORK? / _ YES NO / PEFVIT NLMEk
D. SEPTIC 'LANK CAPACITY Gallons NEW INSTALLATION REPLACEMENT ADDITION
MATERIALS: Prefab Concrete ~ Poured in Place Steel Other
NU 123ER OF TANKS TO BE INSTALLED: Ir Lf
E. TYPE OF OCCUPANCY
Check One: One or Two Family Residence Commercial Industrial Other
(Specify)
Number of Persons to be Accommodated Number of Bedrooms ?
F. APPLIANCES, ETC& Food Waste Grinder YES r~ NO Automatic Clothes Washer X YES NO
Dishwasher YES_ NO Automatic Potato Peeler YES NO
Other (Specify)
G. EFFLMNT DISPOSAL SYSTEM NEW EXTENSION ADDITION REPLACEMENT
Tile Size r~ No.Lin.Feet Trench Width Depth Number of Lines
Seepage Bed= Length Width Depth Tile Size No. Lines
Seepage Pitt Inside diameter _;Zr Liquid Depth , 'i
P E R C O L A T I O N T E S T
Test Depth Character of Soil Hours Water Test Time Drop in Water Level Inches iinutes~
Number Inchesi Thickness in Inches Since Hole in Hole Intarval Second to Next to Last To Fail
13t Wetted Overni ht in Minutes Last Period Last Period Period One Inch
'Exa.mple _
P- 0 36" To Soil 10" Clay 2611 25 es or no 1 30 1/2 1/2 1 2 60
RECORD DATA FROM MI'i1rJM OF 3 TEST HOLES
I
Compute size of absorption area in accord with H 62.20 Wis. Administrative Code.
S O I L B 0 R I N G S- Minimum 36" Below Proposed Absorption System Boring Total Depth Depth It.o Ground Water Depth to Bedrock
i
(umber Inches Observed Estimated Observed Estimated Character of Soil with Thickness in Inches
xample
- 0 7211 7211 + Black To Soil 1211• Cla 18'x• Sand 1811, Gravel 2411 r
t
RECORD DATA FROM MINIMUM OF 3 BORE HOLES
COMPLETE OTHER SIDE
I, the undersigned, hereby certify that the percolation tests reported on this form were made by me
or under by supervision in accord with the procedures and method specified in Chapter H 62.20 (3),
Wisconsin Administrative Code, and that the data recorded and location of test holes are oorrect to
the best of my knowledge and belief.
NAME ("/J ' ) A,
TITLE
(Typo or print)
REGISTRATION NO. or MASTER PLUMBER LICENSE No. /
ADDRESS
DATE SIGNATURE' ~t. 1.~-~ l t.
MASTER PL-11,3-WR MAKING APPP CATION
Signatures License Numbers
MP RSW
(To be Completed by Issuing Agent)
Date of Application 317/ Z l) Fee Paid $ 1"l L C~
Permit Issued (date) Permit Number
Agent (name) _ ~f ~j~1 i' z * 1 For:. +54// 0")
rT -
Town, Village, City, County, etc.
(Specify)
Notes The application cannot be considered for filing until all of the above questions are answered
and the fee paid. Agents will forward application, the fee of $10.00 and Copy (b) of the
Permit (yellow copy) to the Division of Health. Checks and money orders should be made
payable to the Division of Health.
Do not write in space below - FOR DEPARTMENT USE ONLY
DATE RECEIVED ACCEPTED BY RETURNED
(Initials) i (Date) see Corr_es./_
FEE RECEIVED VALID. NO. PERMIT NO.
(Yes or No)
REVIEWED BY APPROVED DATE
(Initials) (Yes or No).
COMMENTS:
PAGE 39 T29 N.-R20-19 W 257
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y Parcel 020-1083-00-000 01/04/2007 11:44 AM
PAGE 1 OF 1
Alt. Parcel 29.29.19.332H 020 - TOWN OF HUDSON
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owners : O = Current Owner, C = Current Co-Owner
O - SCHWAB, DANIEL D & ANNETTE
DANIEL D & ANNETTE SCHWAB
423 DEER HAVEN DR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 423 DEER HAVEN DR
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 5.790 Plat: N/A-NOT AVAILABLE
SEC 29 T29N R19W SW NW LOT 2 OF CERT Block/Condo Bldg:
SURVEY MAP IN VOL I PAGE 299 ORD
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
29-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 7591541-
07/23/1997 ~ 3/~!
2006 SUMMARY Bill Fair Market Value: Assessed with: V/u yed-
161695 278,100 vvt, ` 5~ 7a
Valuations: Last Changed: 10/25/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.790 91,700 173,400 265,100 NO
Totals for 2006:
General Property 5.790 91,700 173,400 265,100
Woodland 0.000 0 0
Totals for 2005:
General Property 5.790 91,700 173,400 265,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 211
Specials:
User Special Code Category Amount
018-RECYCLING SPECIAL ASSESSMENT 27.00
Special Assessments Special Charges Delinquent Charges
Total 27.00 0.00 0.00