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038-1095-80-000
n w O -0 n O m c w o tD 3 > > n r+ 0 'fl 3 m # 1 (ID 3 3 O ? Z 0 Z ° N ff) w° y O N 0 O O) N 00 0 C 1 CD H Jam, a co m o T O h J 7 m W r CC) CO QO 1 N C1 = a- a N O Cp w ' ID C) 01 c (D N ID C7 T W O_ O N O O ro (A O O~1 N j C !r N O U N N O v us Z D A P. m cn o (n 9 c m W CD c;r 3 O o o CD ~co z' cQ 0 0 0 ~ ~r z O O O ~ " o N N y o' D v m Q v v v o O (n A W CJ1 N (D E; < 3 N V 7 CD E CD N pD z N zcnz D CD a v O CDo o. z h • ~ N N N O N CD co D a E- 3 E Z j N Z CD O rn Oc ;u M Q A Z 47 0 S s j w W C. O+ N Z 3 cn °o 3 w y z, w CL Cn A -0o CD N m o: cn COD m c 'O - 3 v o a Vm N y N I ~ CD Q N ~ "O CL C17 ' ~ o- I S N _ a ~ N c o O ' a O O O csa O N O O O O ~ 0 V C Wisconsin Department of Health and Social Services Flb. #67. 10/68 Division of Health PERMIT APPLICATION for PRIVATE DU%1ESTIC SEWAGE SYSTEMS d A. OWNER OF PRO?ERTY TYPE OR USE BLACK INK Name Address (Street, City, Zip Code) 1 County B. LOCATION OF PROPERTY WH:'RE SYSTEM WILL BE CONSTRUCTED, ALTERED_OR EXTE^1D D Cheek Oise: CITY VILL4GE AL DESCRIPTIONs vu x ~owta~Hl~ ~ ~ ~ ~ i.,,/ C. IS LOCAL PEF?1IT REQUIRED FOR THIS hDRK? YES NO I PER~IT NLTIDE?, D. SEPTIC TANK CAPACITY f•- Gallons NEW INSTALLATION - REPLACEMFYT ADDITION MATERIALS: Prefab Concrete/y\ Poured in Place Steel Other NUMBER OF TANKS TO BE INSTALLED: 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, ETCs Food Waste Grinder YES NO Automatic Clothes Washer YES NO Dishwasher YES NO Automatic Potato Peeler YES NO Other (Specify) G. EFFLUENT DISPOSAL SYSTEM NEW EXTENSION ADDITION REPLACEMENT Tile Size No.Lin.Feet Trench Width Depth Number of Lines Seepage Bed: Length Width Depth Tile Size No. Lines Seepage Pits Inside diameter Liquid Depth .y r; 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 Minutes Number Inches Thickness in Inches Since Hole in Hole Interval Second to i Next to Last Po Fall 1st Wetted Overni~h~ t in Minutes Last Period Last Peri Period Jne Inch Example P- 0 3611 To Soil 10" Cla 26" 25 es or no 30 1/2 1/2 1/2 60 c~u J •tC"i. RECORD DATA FROM MINIMUM OF 3 TEST HOLES n I ompute size of ab I rption area in sword with H 62.20 Wis. Administrative Code. S O I L B O R I N G S- Minimum 36" Below Proposed Absorption System _j oring Total Depth Depth to Ground Water Dapth to 3edrook umber Inches Observed Estimated I Observed Estimated Character of Soil with Thickness in Inches j xample - 0 7211 72" Black To Soil 12"• Cla 18"• Sand 18"• Gravel 2411 RECORD DATA FROM MINIMUM OF 3 BORE HOLES 4 COMPLETE GrHER SIDE r 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 correct to the best of my knowledge and belief. NAME y'1 P-_ TITLE F~ J l J ) J (Type or print) REGISTRATION NO. or MASTER PLUP3 ER LICENSE No. ADDRESS Al~ Wet- v, DATE f / > SIGNATU~E MASTER PLUTIE3ER MAKING APPLICATION MP Signatures License Number: MP RSW 1 ' j ? (To b Completed by Issuing Agent) Date of Application Fee Paid 7 Permit Issued (da ) Permit Number Agent (name) i• ! ~J." / For Town, Village, City, County, etc. (Specify) Notes The application cannot be considered for filing until all of the above questions are an,-vered and the fee paid. Agents will forsard 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. y Do not write in space below - FOA DEPAFG11ENT USE ONLY DATE RECEIVED ACCEPTED BY RETURNED ✓ (Initials) nn / / (Date) See Corres,~ FEE RECEIVED VALID. NO. C~ 3 17` PERMIT NO. (Yes or No) REVIEWED BY APPROVED DATE (Initials) (Yes or No) COMMENTS : Parcel 038-1095-80-000 09/11/2006 05:03 PM PAGE 1 OF 1 Alt. Parcel 23.31.18.400B 038 - TOWN OF STAR PRAIRIE 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 - JACOBSON, GREG & KATHERINE GREG & KATHERINE JACOBSON 1242 200TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 1242 200TH ST SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 5.000 Plat: N/A-NOT AVAILABLE SEC 23 T31N R1 8W 5A IN SE SW LOT 1 CSM Block/Condo Bldg: 2/398 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 23-31N-18W Notes: Parcel History: Date Doc # Vol/Page Type 04/14/1998 577207 1315/34 WD 07/23/1997 1178/185 WD 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/14/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 46,000 175,800 221,800 NO Totals for 2006: General Property 5.000 46,000 175,800 221,800 Woodland 0.000 0 0 Totals for 2005: General Property 5.000 46,000 175,800 221,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 217 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 V -N I r COMMERCIAL TESTING LABORATORY, INC. `514 Nfiein Street, P.O. Box 526 Colfax, Wisconsin 54730 & ~4,j 715-962-3121 800 - 962 - 5227 !i'lVlx ti.Sr'`!ll\l.! ryt_I "~h i stu..i i4'i'oiill CROIX COUNTY REPORT DATE! 1/31/92 t tTHOIlSE DATE RECEIVED4 1/30/92 1oSONt WI 54416 N'. THOMAS C. NFI-60 7 ~W4Ert, Thama-_ the, Muzisun ,!CATIONS 1242-200th AVe.. New Richmond OLLECTORS M+ Jenie i ns =JE COLLECTED** 1-29-92 MME COLLECTED! 3200pm 'JURCE OF SAMPLE' Kitchen fa=uce+ -,TE ANALYZED S 1-30- ,ME ANALYZED*# 2200pn= .-LIFORMS 0 n 'ITERPRETATION: Bacter: 10 Pfi,r. lbove 10 i v, L.iform Bacteria/100 mt ~~ate-Nitrogen. mg/L REC~ ' vED 00 FEB 0 3 199.2 ST CRax COUNTY 4i C' ZONINGOFFICE 9 h LAB TECHNICIAN: Pam Gane 5 O P o PROFESSIONAL LABORATORY SERVICES SINCE 1952 a ' ~r ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse 911 4th Street Hudson, WI 54016 Telephone - (715)386-4680 The St. Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion of this form is essential so that the property can be located. Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. WATER TESTING----------------------------FEE: $ 25.00 xxx (For nitrates and coliform bacteria) WATER TESTING FEE: $127.00 (For VOC'S) SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00 xxx (Determines if system is properly functioning at time of inspection) Property owner's name Thomas E. and Sheila M. Munson Property owner's address 1242 - 200th Avenue, New Richmond, WI 54017 Legal Description SE 1/4 of the sw 1/4 of Section 23 , T 31 N-R 18 Town of Cie, Lot Number Subdivision Name FIRE NUMBER 1242 LOCK BOX NUMBER Color of house Realty sign by house? If so, list firm: _ PLEASE CALL THOMAS FOR AN APPOINTMENT AT WORK - TELEPHONE # (715) 246-2872 PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT B OK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual requesting services: Bank of Somerset Telephone Number (715) 247-3348 REPORT TO BE SENT TO: Bank of Somerset, ATTN: Kristen Dixon, P.O. Box 220, Somerset, WI _ 54025 closing date ASAP Signature ST. CROIX COUNTY ,rv WISCONSIN ~r ZONING OFFICE rs rc~k 1,' ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 Jan. 30, 1992 Kristen Dixon Bank of Somerset P.O. Box 220 Somerset, WI 54025 Dear Ms. Dixon: An inspection of the septic system on the property of Thomas and Sheila Munson, located at 1242 200th Ave., Somerset, WI was conducted on Jan. 29, 1992. At the same time a water sample was obtained for testing. The results of that test will be sent to you as soon as we receive them back from the laboratory. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. Si,Bgerely, t Mar--j. 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O~HOce o% i c,o ce /s: fLaL 2 0 \ F c5' oub ~ l ~ s s k/7:Z~oa U~ r9Rghq e~ h /`la'~idon i Ul Rebhan ql~ ~ ~ ;I e7 `940 ~ /Gp t ~ Laws. vim., e14/ o, _ s z 6 q C? m, ee> es SEE P~GE'1✓ X97 SEE .PAGE 43 5/ G°.n cou,r /y, 4 Gv..< BERNARD'S FRIENDS OF 4-H NORTHTOWN FARMERS UNION G.T.A. LINE ELEVATOR 401 South Main - Stillwater, Minnesota 55082 HIGHWAYS 64 & 65 NORTH NEW RICHMOND, WISCONSIN 54017 NATRO-GAS INC. Highway 12 - Baldwin, Wisconsin 54002 PHONE: 246-2236 O COAST-TO-COAST STORE TWIN CITY W10-- si.eaI Baldwin, Wisconsin 54002 PHONE: 439-2905 Parcel 038-1095-95-000 09/11/2006 04:56 PM PAGE 1 OF 1 Alt. Parcel 23.31.18.400D 038 - TOWN OF STAR PRAIRIE 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 - PEPLAU, JEFFRY & MARILYN JEFFRY & MARILYN PEPLAU 1232 200TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description ' 1232 200TH AVE SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 20.050 Plat: N/A-NOT AVAILABLE SEC 23 T31 N R1 8W W 800 FT OF N 853 FT OF Block/Condo Bldg: SE SW AND THAT PT OF SE SW LYING WLY OF W LN LOT 1 OF CSM VOL II PAGE 398 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 23-31 N-1 8W Notes: Parcel History: Date Doc # Vol/Page Type 07/07/1998 582468 1338/39 WD 11/10/1997 568263 1275/641 QC 2006 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 10/05/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 25,000 141,600 166,600 NO AGRICULTURAL G4 7.050 1,100 0 1,100 NO ENTERED BEFORE 2005 OPE W7 12.000 30,000 0 30,000 NO Totals for 2006: General Property 8.050 26,100 141,600 167,700 Woodland 12.000 30,000 30,000 Totals for 2005: General Property 8.050 26,100 141,600 167,700 Woodland 12.000 30,000 30,000 Lottery Credit: Claim Count: 1 Certification Date: Batch 203 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 038-1095-50-000 09/11/2006 05:09 PM PAGE 1 OF 1 Alt. Parcel 23.31.18.3998 038 - TOWN OF STAR PRAIRIE 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 - PEPLAU, JEFFRY & MARILYN (DREW) JEFFRY & MARILYN (DREW) PEPLAU 1232 200TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: 15.950 Plat: N/A-NOT AVAILABLE SEC 23 T31 N R18W 15.952A I 1/2 SW 1/4 Block/Condo Bldg: LOT 1 OF CSM IN VOL II PAGE 517 Tract(s): (Sec-Twn-Rng 401/4 1601/4) TUUir (S~ 23-31 N-1 8W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 992/635 WD 07/23/1997 568/212 WD 07/23/1997 566/528 LC 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/14/2004 Description Class Acres Land Improve Total State Reason ENTERED BEFORE 2005 OPE W7 15.950 30,400 0 30,400 NO Totals for 2006: General Property 0.000 0 0 0 Woodland 15.950 30,400 30,400 Totals for 2005: General Property 0.000 0 0 0 Woodland 15.950 30,400 30,400 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 jr- 71 . . I STAR PRAIRIE PLAT I T31-N R18W ers, Ltd. 3 POLK COUNTY EMIL. RO.I.X R.CI 1 11:Q0 CARCIINAL 20'Q 1 00 14QA R&N 3 C7~1" Pc a I+IITxllax)t . I 5 10 1 Douglas 14 9q 2 v W Phyllis S'Mxhel& andall & = Rivard SW ° 1 CEDAR Menke Ico TR o174 ou 3a3 j CEDAR Mary Trust a`'3 S 8nd-s.. r~y s Deulling : J 2 LAKE H T 2 PRA. k~ 201 c~. CEDAR IN TO D ❑2 # .u<< J.a DR &M i B tt& Allen Wright tr _ 1 a I Lavaun Seandberg 59 .1 Neumann Trelstad tal Q'~L4 fi N13 NR10 33"' '9 ~7 C1 Rog-r Rodney_ 35 80 t er 21 anat 64 1&e c, dS m f ward t i ' Vincent& > e`eI79 Allen & f Robert & gradle dt 00 2 116 Cynthia Campeau G Anne to Peterson b L v ~'z n vl Wilson 80 M Do een Noak 62 ❑O rJ 1 Adj 71 oa°~v Ou~NS 6 3y J a 38 10 J{kM IS d- 79 8 ~wm um O PPl- - - M.iZ._ 32 2 b g76 - - - RIVER PA 414 $N10 z V St- M a Join & Susan 5 10 Rac e & 20 Alfred & M 1 1 + SL 6 Douglas & o Gail Meeds co =tent All- a- N 7 jl 5CR Katherine ~U AbrOn rack Larson 38 - NEW_ l2 Rivera 60 hamson 38 z uc p a ss g r H ao 4 33 ~E Q m T&C &K G oho Norma CC L u a BB Mary & 82 L, 1D9 }t r Nelsq>1 Q Q Caudy C&J to v I r ^g0R zwickey z n 35 80 z z 10 60 E 1<v to rN S; 1 2 C- c&I L N :1 V16 & Ke n& T&$ 20 Fern &R OLD MILL FJ } ugne& Beverley K 5 S Diane Parnell Munson 20 Daniel Nm & Leon &C T&H d o k' 27 Med David & Mcasner w Daniel 40 1 & D Trust aroi Orr ; 9 w 15 E ET 10 chill 29 Christine N~rman R&C 20 Es[ate Ahl 1 Edin 22 810 g 6 _ 4 3 Green ~~({J Joyce Potting qp GdTY O Y 117 ,tM+,r, & Karen 2 -t - 120 ante P Ma a- lessen Oo C 24 t 20 ~ Bruce ` 1 ate' >E lolkert Duane & (7 g cc Develo 1L 15 dance & J ALLC 46 y, L&L 75 Ethel Kathryn 39 Edin C Emerson 'ss K t 35 M-- J.D,J&D 3 40 C e 3 D& L&n ce to ao chnt< 13 40 40 5 P +T- G R& 7 1 R z 1 2 Z ° 3 3 Janet 1---'~ w, I T Mary 76 R& 4 o Nemeth ' c & J. nn Dubois th 5 ' Norman 77 I3a SO° F 4 4~ & Joyce ° e Scott Bw<lar 'B&J r e; Crisdhsome b Farm v " < ! 3 4 Marite .o M&K z ° Pr.P<ree. zetah AeTES J&D 108 m ° = a M s " Counter L4 IC ` 13 ,a Inc 156 r ;c I T11 I B N y 9 Yi M , _ 1 _ .R J I 1 12' w&C ° Robert Matthew ,b`J4wwun I Wallrich &c<n i R@p 1 Ml0 b N N t & Pats Chnrt.phe~ S t 4t rr'~ ? Estates 1 Th m W 6 y Le* Ann t ) es & EvrJrttl>,~ 114 ° o Larson s e tm,a , J yr< Harlan Inc 75 40 00 lain Patric Joseph .)&x h aE Price 3 1^'10 m0 5 Trust 90 1~ Klem<emd Vehis J&L 25 Alice & , Rivard T&R 20 J&D 20 z 60 m DdVl ° 100 I 15 5 , , W 65 Crichton Aronson g ^ 3 Cooks 135 Tarma&J 38 erso[I 4 4 E T&T 2 CJ SZ& E&M 20 R&L 1 2 C& x9 1 b 79 4 B 9 it 2 2 2 " 1 14 D 9 t;'~ 3 Q r Dupre "to RM 8 LA 9 3 43 2 U it J V » Q. i~ z z&I 4 21 Nit Margaret s 3 210th VE ith z 3 3 B c<or st 17 Alice H<m<nwar Hem<.wa} rL]Ce Wayne O F o m o N ,a° o o &yroone ' 9 1 (Talmage M 39 39 Emerson IR.a ger & &Gene v " 9 .a c O Brot:i<r 3 a R : 1 wt 39 39 Neumann Thomas z a ~Ed2 a~~a° o"xu 55 1p Jones s9 z 1 & 1 G&c 4 z ED s t IA &J 12 R'il -E Rob Pa m1 ge 79 20 9 CC 80 st G N is T. J. P & F iz 4 s7 z - ar & t o As lurid r & ce ~-3-s 1 Tal age E 20 Steven & Ge n< rmain 1, 4C1C N r 12 RA C Z6 6 G z 40 Glaser Cristy Olson 1 i ~ I z 4 3 Y. Wickenhauser )onna ~ df~ Pai w @ 1 1 z 1 1 tOSe Ralph &L 20 oger & 142 Matthy de 1 ,A.ur~e F <m I 1 Im & Ma nrnY 1 c an z f Mary ry Ji Phillip h nman A&s KR.s ~ma<b 'r Mondor l s s is ~oP B TC 29 e Roselle S[ewart & Anna T ust 9' { 5 T&7 1 t ]9 sue en Curtin :2 LLC 30 G 5 \B b Bonestroo 40 " „ , ° 2 ` 3 ~ 3 n $ & Anderlik \ JH 14 RTS New 80 e 0 1 1D6 2 \ °'tia 2 le: a D s i4 v & Assoc Richmond 2 - KC ot`~~ ' 157 4 N m LLC 80 2 96 K 3 Ki z n 4 4 4 3 4- _ r 1 7 KM 9 6. -79 Gary _ iri<& ° 200th AV & Bon ie 34 1 4 - D&K A 9 D.riz 4 Lehner 4 4 4 Steven Lakeside/ 49 ounce B@D ~t R&D H 8 a_ Gerald & &A 34 " 4 4 4 2 & Christy , Genevieve foods c RB L5 7 a" 2 4 4 ✓ Marcella o . 7 wickent aL~er Francois 62 &D TlBackes th.nr 3 760 213 M s Riche d & 1, Hill H , A us Douglas G aghty Moulton m 1 Pe : ~:TTUSt 221 Tam. & Janet 1 100 ' H@Je sh,iitls Olson 1 RS :S s6 BR. t&D 195th AVE ` 9 IZ«y" {',S^ 0 0- 1 40 39 Gerald & ] 2 / L~~ 3 B&T ry Genevieve Danie Reb l 0.<becca w ity Of Francois Carson ecca B aIeon <BE m ° RF~ id the z ° B 10 Case Haitinan w ,8 y 15 2 Pe wsnm.na Y 3s D& 34 .a o o v, z z a 4, I z z z m o m 2 j eze 411 80 lvt 3 BM 3 4 2 192nd AVE St Croix Helene w& ~ert 10 e 3 Victor h 1 T 1 U o County Houle Rs 1 r.<pper )&L zz m Myers III q 01 W 15 0 3 m 40 u) 80 1 Farm 120 72 x 1 z z 7 -k5 Br ■ own 103 - - - - ' - - - - - N m - - - James & ` Stix I County Of ob- Carolyn co -t<r Co Health St Croix roert o par c~» Craig I& Win, Center 120 z L 41 ■ - 40 39 c<ss 40 Scott o Sherman NR Glenn ' Newby 115 3 KK © o Michael 1 & Jean Archery & Mary 80 Flandrick i Boucher CI .b Inc owbyLI 40 185 z 201Ralph & 157 JG Ma[}' CSiL 16 S&) D&P N 2 4 13 ( M 1 I ~(it RR -clor 13 D&LO 13 Lakeside ' 120 Needham R 'M ]6 K 2_s K.- Foods Mark && Michael & Inc 127 He~'nan Kathie 6 R& & Carol D&$ s . zl Kathleen RC Friday 3 k J - CD Duis n Cell Otti Cody 2 a Canning a - z 13 15 * tw 30 53 108 3 Corp n . r 2 i 49 3 Straub 11 1 1 2 2 38 1 L&TZ 34 ......d 64 180th AVE