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Parcel 040-1040-20-000 06/01/2007 04:03 PM
PAGE 1OF1
Alt. Parcel 09.28.19.136B 040 - TOWN OF TROY
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 - ROBIDOU, TRACY R
TRACY R ROBIDOU
430 N GLOVER RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 430 N GLOVER RD
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 3.070 Plat: N/A-NOT AVAILABLE
SEC 9 T28N R19W PT N1/2 SW 1/4 BEG INT S Block/Condo Bldg:
LN N1/2 SW1/4 WITH CL TN RD TH W 605'; N
548.4'; E 215' TO CL TN RD; S 35 DEG E Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
ON CL 679' TO POB EXC PT TO PARCEL DESC 09-28N-19W
992/18
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 841 /172
07/23/1997 746/467
02/03/1993 494633 992/18 LC
2007 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 08/23/2006
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.070 37,900 194,200 232,100 NO
Totals for 2007:
General Property 3.070 37,900 194,200 232,100
Woodland 0.000 0 0
Totals for 2006:
General Property 3.070 37,900 194,200 232,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 310
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 040-1041-20-000 06/01/2007 04:04 PM
PAGE 1 OF 1
Alt. Parcel 09.28.19.137E 040 - TOWN OF TROY
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 - ROBIDOU, TRACY R
TRACY R ROBIDOU
430 N GLOVER RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 430 N GLOVER RD
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 2.000 Plat: N/A-NOT AVAILABLE
SEC 9 T28N R19W 2 AC IN NW SW COM INT S Block/Condo Bldg:
LN N 1/2 SW 1/4 WITH CL TN RD; S 89 DEG
W 605 FT TO POB: CONT 261.69 FT, N Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
255.45 FT TH N 89 DEG E 100.69 FT' N 09-28N-19W
125.91 FT; TH N 89 DEG E 161 FT S 381.36
FT TO POB
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 841/172
07/23/1997 746/467
2007 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/19/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 20,000 8,800 28,800 NO
Totals for 2007:
General Property 2.000 20,000 8,800 28,800
Woodland 0.000 0 0
Totals for 2006:
General Property 2.000 20,000 8,800 28,800
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch 308
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 040-1041-40-000 06/01/2007 03:10 PM
PAGE I OF 1
Alt. Parcel 09.28.19.138 040 - TOWN OF TROY
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 - TOWN OF TROY, %TOWN CLERK
%TOWN CLERK TOWN OF TROY
654 GLOVER RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE
SEC 9 T28N R1 9W 40 AC SW SW Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 40 1 /4 160 1/4)
09-28N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
2007 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/23/1995
Description Class Acres Land Improve Total State Reason
OTHER X4 40.000 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
1
Wisconsin Depart...-it of Health and !Social Services
Plb. #67 3/70 Division of Health
SEPTIC TANK PERMIT APPLICATION '✓~V q7 11-?
~j~
TYPE or CSE BLACK INK
A. OWNFR OF PROPERTY -
Name Address (Street, City, Zip Code)
B. LC%IATION C? PROPERTY WH€d. SYSi WILL nr CC :RUCTED■ ALTERED OR EXTENDED COUNTY eq
Check Ones
CITY VILLAGE LEGAL DESCRIPTION
TOWNSHIP
All-
C. IS LOCAL PERPiIT ',EQUIRFI FOR THIS WORK? YES NO PERMIT NUMBER
D. SEPTIC TANK CAPACITY Gallons NEW INSTALLATION ~t REPLACEMENT ADDITION
Prefab Concrete Poured in Place _ Steel Other
OF TANKS TO BE INSTALUDiz C~...~
E. TY OF 0CJ PAATCY Y
Cr;^;=k Oncs One or Two Family Residence 1 Commercial _ Industrial other
~ Specify
Number of P--rsons to be Accommodated Z71 Number of Bedrooms
F. APPLIANCES, ETC: Foc- Vaste Grinder YES Y NO Autonxtie C;,,',thes Washer YES NO .
Dic:,Tastier YES NO Auto:r.atic P. tato Peeler YE:SNO
Oth-., (Specify)
G. MASTER PL'-ER tfAKING INSTALLATION
Name: (-f ! f Address= Lioena !a-z,' r t
MP
r
Signature; of Applioant s MP RSW
If. (To be Completed by IssuiNj Agent)
Date of Application Ll Fee Paid
Permit Issued (date) Permit Number
Agent (Name)/ Fors
'21-~
Town, Village, City, Ga~rrty; etc.
(Specify)
Note: The application owr:;ot be ccnaidored for filing until all of the above questions are answered and the
fee paid. Agents w5511 for,~ard appticaticr, the fee of $1.00 for "ch septic tarot and the third copy
of the permit (oarart•) to the Division Health. Checks and money orders should be made payable to
tha Division of Health.
Do not Trite in space below - Ff;R DEPARTMt:NT USE ONLI'
I. DATE RECF I`1t" ACCEPTED BY RETURN:.`; _
(Initials) (Date) See Corres.)
Ffl RECEIVED VALID. No. 5~3 PERMIT NO. 7 C, l q-7
_77as or NoT-
FtFYIEk-: t BY APPROVED DATE
(Ia''°",ls) s Yes or No
COMPLETE OTHER SIDE
` SEPTIC Tkt?K PERMIT NO.
R E P O R T O N S O I L P L 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
DIYIS104 OF HEALTH - PLU`7AI_'?Cr SfXTIN
P.O.Box 309, Madison, Wis. 53701 B
Pursu&nt to H 62.20, Wis. Administrative Code
"'!Y 14
P Z R C O L A T 1 0 N T E S T
Test Depi CharocSta~ of Soil Hours Water Test Time Drop in Wa cr' Ledel Ph ,,h-; Kiztutes
Number Inohss Thio`-i,,., in Inches Sinco Hole in Hole Interval Second to ;xt to" Last To Fall
lst Vetted Overnight in Minutes Last Period Last Period Period ais< Inch
Example .
P - 0 3," 7o2 Soil 10", Clay ?6" 25 Yes or No 30 1/2 1/2 1/2 60
F RECORD DATA FROM MINLMUM T--, T HOLES
Computs size- of absorption area In accord wiLli H 62.20 Wis. A&.d'.ni*trative Code.
_ S 0 I L B 0 1 I N G S F "`nimum 36" !`elow Proposed Ahs=tion Syr'-
Baring Tot. ;Di.a Depth -yo Gro+cr-i ,star o to + ook
N vnber Inch f w, 'od Xstir.atc,t c .+,.-ved mated _ ! ar ter of Soil th Thiekne _ in Ina?.,s
B - 2" 72" Black To Soil 12-; 18r'i'snd 1810: G; _(el 2411
L:'=RD DATA FROM MIND,Or -;ORZ HOLES
PE OF OCCUPANC'is Zel
RESIDENCES Number of Bedrooms OTHv`;s (Specify) Number of Person-4
D WASTE GRINDERS Yes No DishSrashars Yea No Y AutoSaatic Clothes Washers Yes No
EFFLUENT DISPt':;AL SYSTEM: NEW EXTENSION ADDITION REPLACEMENT
Tile Size No.Lin.FH~.f, Trench Width Depth Number r, Lines
Seepage Bad: Length Width Depth Tile Size No. Lines
Seepage Pits Inside Di4tr•:.:,r ? 'liquid Depth w
Is the undo, i-nad, hereby certi that the percolation tests reported on this ford were made by me or undt- my super-
vision in accord aith the proc6d-r.•as and method specified in Clv pter H 62.20 (13), Wisconsin Adxinistrativ- Codp, and
that the data reoorded and location of test holes are correct to the best of my knowledge and belief.
NAB 1 • ) T11 M.£ j /o
Type or Print
REGISTRATION NO. or MASTER PLUMBER L CENST too. h 20
ADDRESS
DATE _ 4/ ~ SIGNATURE