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Parcel 032-1015-50-000 03/20/2007 08:35 AM
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Alt. Parcel 6.31.19.82C 032 - TOWN OF SOMERSET
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 - UNITED STATES OF AMERICA
UNITED STATES OF AMERICA
X
X 00000
Districts: SC = School SP = Special Property Address(es): = Primary
Type Dist # Description
SC 4165 OSCEOLA
SP 1700 WITC
Legal Description: Acres: 3.000 Plat: N/A-NOT AVAILABLE
SEC 6 T31 N R19W S 100' OF N 800' OF GL 2 Block/Condo Bldg:
EXC TN RD
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
06-31N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
2007 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/05/1992
Description Class Acres Land Improve Total State Reason
FEDERAL X1 3.000 0 0 0 NO
Totals for 2007:
General Property 0.000 0 0 0
Woodland 0.000 0 0
Totals for 2006:
General Property 0.000 0 0 0
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
rid
4 N
APPLICATICN FOR SA,fITARY FEiMIT
for
INSTALLATICN OF A `OPTIC T•ii`JK
(`;ec. 144.03, ',,'is. Stats.)
:a. O:N~,R OF PROP'~,RTY
Nsm~ ;~ddre s (Street, City, "Lip Cede)
D. LOC ,.TICN OF PKP TY `,!FREAE S:.PTIC TANK IS TC B INST ",LL'?,D
Check 1. -City Mail address County
one: 2. Village c r vc rf a
3. 4T own A.
C. Give L _cense✓num4r hel,d:
Wisconsin Restricted
Licensed Sewer
Plumber Services, Cr' r
Name Address
D. SP`=FICyTICNS OF V7TIC T~UJY
Size in gallons: (check one)
1. 1,000 Gal. 5. - 4,000 Gal.
2. 1,500 Gal. 6. f. 5,000 Gal.
3. 2,000 Gal. 7. I' over 5,000 dal., Five capacity
4. 3,000 Gal.
Materials: 1. Prefab concrete 2. Poured concrete 3. Steel
TYPE CF OCCUP'~PJCY
1. + Single Family residence 3. Commercial establishment
2._ M 1tiple family residence 4. Industrial establishment
F. APFRCADTAT-~ NLPNB ,3 OF P'litSONS Q--.',,,iVED DAILY
i`
G. PFRCCLATICty TE,S~ IiADE 1.4 Yes 2. No Date
By whom /i ( • l ~,1, /
-T
r
(To be completed by County Clerk)
Date a-plication is filed nd f 'e paid .'1
Permit issued (date) Permit Number,
County Clerk.
Percolation -date ~Kinimum absor?)tion Area in Square Feet per Bedroom
Minutes aeouired Normal !,iith lt~Tith ',lith Both
For !later to Fall Plumbing Garbage Automatic Grinder and
One Inch Fixtures Grinder Washer automatic
-dasher
2 50 X65,; 75 85
3 60 75 85 100
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 - 9o 240 290 325 400
b`~'
NAME S I N E S S V -J 1
LOCAION~`.}L
street or highway city or township county
014N ER Mailing address 1 ^ `1
(lam J~v~~
ARCHITECT OR-ENGINEER ',Address \A,
PLUMBER Address C4~ `
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 mama for each.
Restaurant or dining room . . . . Seating capacity (10 sq.ft./person)
Hots6kco~niap
f : T: t^1 r t U ' 1 ' 1 rc±±a . .J,, her of units: !P '+r
2 persons/unit
4 persons/unit TOTAL NUI,MER OF UNITS
Bar or cocktail lounge . . . . . Seating capacity (10 sq.ft./person)
Nursing or retiremmat horse . . . Number of bods
Mobile hose park . . . . . . . . Number of units - dependent
- nondependent
Service station . . . . . . . . Number of cars served (daily)
School Number of classrooms Meals served Yes- No~ Showers provided Yes_ No
Factory or office buildings . . . Number of persons (total all shifts)
O Residence . . . . . . . . . . . Number of bedrooms
other - specify
2. Indicate whether or not the following facilities are connected: Food waste grinder Yes No
Dishwasher . . . . . . . Yes No
Autosatio clothss washer Yea No
3. Fill in the appropriate information for this follmring as indicated:
Septic taut capacity planned Norrml septic tank capacity .-'v- -:'red 4 `t 'r) 'icl
5014 i^cree.s3 FL'U or AN Total septic .°n,. „apno+ty required
Percolation test results - A'iPA:CH PEFZOLATION TEST_A'SPORT SI[F-Tr
Seepage trench bottom area planned- t,On width-3- , linear feet r 0~ ~ depth ~v 1!
Seepage pit planned , outside die-meter depth below inlet , depth
Seepage trench bottcm aria required , width , linear feet
Seepage pit required , outside dianater , depth below inlet
Signature of person completing form: STATE BOARD OF HEALTH, PLUMBING DIVISION
P. 0. Box 309, Madisa; * consin 5 ~01
Address: J / tl~- ~`I0 I Ap rovet3r--`1~•~`L
_
Date Date JUN 4-1969
THIS APPROVAL IS BASED ON STATE PLU`T.
ING CODE REQUIREMENTS AND DOES ftig
EXEMPT THE INSTALLATION FKCM CITY, VI?-
LAGE, TOWNSHIP OR COT' Y REG'j1-ATICN3
OR PERMIT P,EQU1FE,,!ENTS.