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Parcel 040-1155-90-000 01105/2007 12:01
PAGE 1 OF 1
F 1
Alt. Parcel M 24.28.20.611 H 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 - SETZER, STEVEN C & GENA
STEVEN C & GENA SETZER
254 COVE RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 254 COVE RD
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 1.500 Plat: N/A-NOT AVAILABLE
SEC 24 T28N R20W PRT G L 2 COM W LN SEC Block/Condo Bldg:
24646.3 FT N OF W 1/4 COR, N 89 DEG E
445 FT TO POB: N 5 DEG W 454.84'S 76 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
DEG E 84.35 FT, S 55 DEG E 50 FT, SLY 24-28N-20W
410.11 FT, W 150 FT
Notes: Parcel History:
Date Doc # Vol/Page Type
05/19/2004 763122 2576/069 PR
07/23/1997 1186/29, QC
2006 SUMMARY Bill M Fair Market Value: Assessed with:
158920 336,100
Valuations: Last Changed: 07/21/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.500 221,400 85,200 306,600 NO
Totals for 2006:
General Property 1.500 221,400 85,200 306,600
Woodland 0.000 0 0
Totals for 2005:
General Property 1.500 221,400 85,200 306,600
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
Parcel 040-1155-30-000 01/05/2007 12:00 PM
PAGE 1 OF 1
Alt. Parcel M 24.28.20.611 B 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 - SETZER, STEVEN C & GENA
STEVEN C & GENA SETZER
254 COVE RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 254 COVE RD
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 0.300 Plat: N/A-NOT AVAILABLE
SEC 24 T28N R20W PT G L 2 COM AT PT 75' Block/Condo Bldg:
WLY OF NW COR LOT 29 OF ST CROIX COVE
SBDVSN, WLY ON MEANDER LINE 60', TH SLY Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
149.7', TH ELY 9 FT TH SELY 60' TH ELY 24-28N-20W
16' TH NLY 187.4' TO POB
Notes: Parcel History:
Date Doc # Vol/Page Type
05/19/2004 763122 2576/069 PR
07/23/1997 1186/29, QC
2006 SUMMARY Bill Fair Market Value: Assessed with:
158914 361,700
Valuations: Last Changed: 07/21/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.300 242,900 87,000 329,900 NO
Totals for 2006:
General Property 0.300 242,900 87,000 329,900
Woodland 0.000 0 0
Totals for 2005:
General Property 0.300 242,900 87,000 329,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch M
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 040-1179-70-000 5(i J 01/05/2007 11:57 AM
PAGE 1OF1
Alt. Parcel 13/24.28.20.7136 040 - TOWN OF TROY
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 5
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - SETZER, RETIRED
RETIRED SETZER
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 1.000 Plat: N/A-NOT AVAILABLE
SECS 13 & 24 T28N R20W WEST 66 FT OF LOT Block/Condo Bldg:
56 ST CROIX COVE SUB # 3 ASS'D W/ CSM
7/2015 ROADWAY Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
Notes: Parcel History:
Date Doc # Vol/Page Type
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/25/1995
Description Class Acres Land Improve Total State Reason
Totals for 2006:
General Property 0.000 0 0 0
Woodland 0.000 0 0
Totals for 2005:
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
Parcel 040-1156-90-000 01/05/2007 11:59 AM
PAGE 1 OF 1
Alt. Parcel 24.28.20.614A 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 - SETZER, STEVEN C ET AL
STEVEN C ET AL SETZER
254 COVE RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description
SC 4893 RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 3.560 Plat: N/A-NOT AVAILABLE
SEC 24 T28N R20W N 1/2 SW 3.56AC LOT 5 Block/Condo Bldg:
CSM 7/2015
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
24-28N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/09/1999 606533 1440/481 WD
07/23/1997 1176/522 QC
2006 SUMMARY Bill M Fair Market Value: Assessed with:
158929 126,400
Valuations: Last Changed: 07/21/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.560 115,300 0 115,300 NO
Totals for 2006:
General Property 3.560 115,300 0 115,300
Woodland 0.000 0 0
Totals for 2005:
General Property 3.560 115,300 0 115,300
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
P]`b. #67 10/69 Wisconsin Department of Health and Social ~[Serv~ic_e-s
+ Division of Health ZS 1
PERMIT APPLICATION "
'
for
PRIVATE DU"ESTIC SEWAGE SYSTEMS D 2, X3 Y -7 Vv ( J~
A. OWNER OF PROPERTY TYPE OR USE BLACK INK
Name Address (Street, City, Zip Code)
S1 -G/4, i Y,
County
B. LOCATION OF PROPERTY WE9:RE SYSTEM WILL BE CONSTRUCTED, ALTERED OR EXTENDED
Check One: i
CITY VILLAGE LEGAL DESCRIPTION:
TOWNSHIP -t '
r
C. IS LOCAL PERMIT. REQUIRED FOR THIS FORK? YES NO 7
PERMIT NUMBER
D. SEPTIC TANK CAPACITY Gallons NEW INSTALLATION-X REPLACEMENT ADDITION
MATERIALS: Prefab Concrete Poured in Place Steel Other
NUt,23ER OF TANKS TO BE INSTALLED: I
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 NO Automatic Clothes Washer YES_ NO
Dishwasher YES _ NO Automatic Potato Peeler YES_ NO
Other (Specify)
G. EFFLUENT DISPOSAL SYSTEM NEW -46 EXTENSION ADDITION REPLACEMENT
Tile Size No.Lin.Feet Trench Width Depth Number of Lines
Seepage Beds Length Width Depth Tile Size No. Lines
Seepage Pitt Inside diameter if-Liquid Depth:
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 +.n Inches Since Hole in Hole Interval Second to i Next to Last To Fall
Example 1st Wetted QYerni~ht Ln Minutes Last Period Last Period Period ?ne Inch
P- 0 36" To Soil 10" Clay 2611 25 es or no 1 30 1 /2 1/2 1/2 60
JI/
rt,',~ c ti i1 Al j- A-L
RECORD DATA FRaM MINIMUM OF 3 TEST HOLES
I
Compute size of absorption area in accord with H 62.20 Wis. Administrative Code.
S 0 I L B 0 R I N G S- Minim= 36" Balow Proposed Absorption System
oring Total Depth Depth to Ground Water Docth to Bedrock
umber Inches Cbserved Estimated Observed Esti ated Character of Soil with Thickness in Inches
xa,Tple
0 72" 72" Black To Soil 12"• Clav 18"• Sand 1811• Gravel 2411
4-1, c'
1~ ~ ~ it
RECORD DATA FROM MINIMUM OF 3 BORE' HOLES
COMPLETE OTHER SIDE
P
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 t - s ~~75 TITLE
(Type o print)
REGISTRATION NO. or MASTER PL113 ER LICENSE No.
ADDRESS 1-- 2 ~~rv U r (A) CIS
DATE f q `I (1 SIGNATUt~
MASTER PL;UIT3ER MAKING APPLI,'A'TI0N
/ MP
Signatures License Number:
MP RSW E'• l
(To be Completed by Issuing Agent)
Date of Application Fee Paid $
Permit Issued (date)-17 Permit Number
L
Agent (name) For:
Town, Village, City; County, etc.
(Specify)
Note: The application cannot be considered for filing until all of the above questions are answered
and the fee paid. Agents will for^xard 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 70 ACCEPTED BY RETJRNED
(Initials) (Date) See Corres,
FEE RECEIVED VALID. NO. i PERt"I1T NO.
(Yes or No)
REVIEXED BY APPRO'JED DATE
(Initials) (Yes or No)
CONu'L`1TS;