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HomeMy WebLinkAbout016-1035-90-050 a c to o c cn O w c C7 3 > ; 3 0 3 c►~ A~ • CD O F CD 'a M 7! v c (D ID ID ID ID Cl) (D g Z S m z ° .A O Z 2 v, z a w O G rn° ~C • C) O N N O N CS O N N O O' CD 3 n O c -N 1 :3 C CD W O n 0 (D O (D WO HI W n(D (D EL :z 3 N (D n N ° O M 1 C C CD 07 N C 0, N Q. 7 3 a N N - N O O 7 CD CN, 0 (D (D O O cn c o CD CD D O D O CL n O _ 0 VI j D 0 O O O N C L .Ni O O y^ y !V CD CL (D (n Z D a N u? Z D (p Q N (D (D O (D d O (D O N a co co C d C 3 O O CL = O (D O °D rn O oo rn V ° m rn ° j j s I s z Z D cD co D n C4 CD ° to o C) < cf) 0 < co J o 0 co o~ ~ a -0 M M (D O O f l O O O z o z o 0 o I 0 -N CL o- 0 0 3 cn cn cn n a 3 cn cn cn n m c v v v W e v v g 0 o W (D (D N :3 fu 'a :5 7 cn N 2 3 N (D O (D O I 7 iZ O co Ca 3 W I Z N D Z N o D D o O CD :p 0 0 u _0 a) -0 N • O q(0 CD n m - ~ ~ vi x N c CD CD N. c CD CL W m m n 3 E 3 Z CD CD -A cn C: z 0- 0 ca -0 A O rn co a O. CD C) Z 0 3 00 3 3 3 Z cn N 9 D a w w cu ca (n C CD CT) CL CD :E 0 D 3 ° CO a 3 0-0 O= T F d CD N N -n N - C ~ ~ N C 7 -6. p 7 N N- 3 ~(o oz a m 3 o a 0 N n a m CD m - 3 m a) a) n~° CD CD _ o 7 w CD n o d N A n N- 7 a < O C a = N v zm i m N CD o ~3 fi n o s (D M Oµ O H O A o N N PC (D O N _ N (D N N O N N m CD a M A O O b (D CD 11% A A as O o) O NA O O * ya O L O 0- iv y i 1 Z REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM SanitvLy Pe unit- State S ep;.c _ NAME Township St. Ctco.ix County Location% of Section T N,R W SEPTIC TANK Size gattonz. Numbers o6 Compatctmentz Distance Fkom: Wett it. 120 m gtceatvL 6tope it Bu.itd,ing it. wet.2ands it. Highwate,t - it. DISPOSAL SYSTEM D.iz tance Fnom: Wett it. 12% m gneatetc s tope 4t. Building it. wet.iands Ft. Highwatetc 4t. FIELD DIMENSIONS: width o4 ttcench 4t. Depth o6 tco ck b etow tiZe in. Length of each tine it. Depth o4 tcock oven tite in. NumbeA o4 tines Depth o4 tite below grade in. Totat .length o6 tine6 6t. Stope o4 ttcench in pen 100 it. Diz lance between tinez it. Depth to b edno ch. it. Totat absotcbt,ion area jt2 Depth to gnoundwatetc it. Requi,,Led a&ea it2 PIT DIMENSIONS: NumbeA of pitz Gnavet akound pitz yes no Outside d.iametek it. Depth below intet it. 2 Totat abzotcbtion aAea it z A A&ea tcequitced it2 rn INSPECTED BY TITLE APPROVED DATE 197. REJECTED , DATE 197. i I P L B 6 7 State and County State Permit # ; s Permit Application County Permit for Private Domestic Sewage Systems County -J *DENOTES STATE APPROVAL REQUIRED rJ Date Approval Received from State if Required - State Plan I.D. # A. OWNER OF P PERT, Mailing Address: B. 'LOCATION: Section T N, Rt~~ E (or) Lot# City _ Subdivision Name, nearest road, lake or landmark Blk# Village Township C. TYPE OF OCCUPANCY: *Commerc-al *Industrial *Other (specify) Variance Single family Duplex No. of Bedrooms No. of Persons D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES I- NO # of Bathrooms-- Automatic Washer YES NO Other (specify) E. SEPTIC TANK CAPACITY Total gallons No. of tanks *Holding tank capacity 1.7'6 1? Total gallons No. of tanks New Installation Addition Replacement Prefab Concrete *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) 3) Total Absorb Area sq. ft. New _ Addition Replacement *Fill System Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Length Width Depth Tile Depth No. of Lines Seepage Pit: Inside diameter Liquid Depth Tile Size Percent slope of land Distance from critical slope - - - - I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Certified Soil Tester, NAME C.S.T. # ~ and other information obtained from S : (owner/builder). Plumber's Signature MP/MPRSW# Cel Phone # Plumber's Address PLAN VIEW: Provide sketch below of system (include direpion of slope and all distances in accord with H62.20, including well). l 71 L e'` 0 ~f S or t L t p \ 4f F 1 J/ : S l Do Not Write in Spa Bel w R DEPARTMENT US-F ON Y < Date of Application f f Fees State I Con Date Permit Issued/ (date) ? _Issuing Agent Name S ) $ 1 Inspection Yes/~No Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 6/1 /76 L r gMG 14 TONING r,- QUA <W 3~cn 1, uox tLa , ~c~l ru r r 4 '41 Flan Identification i r..i. T'J-13316 ing taiik - UUJ aIIons ,rr ibermue1ler - Parsiuerii; 1/4, NU 1/4, Section 7~;~:., .1wn of Glenwood, 7ij0 ..'iI Ur 1'.,,,tUifI j,;"ai,: 6niLA Sipi:Girlcuti%)iis rc;r Liic:: reject has been completed. accord with Chapter 14 , Wisconsin Statutes, and Chapter H 62, ':i;ccrnisin .,,Aia,inistrative Code, the plumbing plans and specifications are approve, L-ontingent upon compliance with the following stii:ulations. t. Our review of the holding; tank plan has not kF._: ? t fur Lructural stability, only for compliance to deli r ir. is U of the 'Wisconsin A6r::iinistrative CUU.. The voiding tank shall be maintained and the contcni:s c;ie:r.•cs.:: Of -y r,:;qulred under Section H 62.20 41sconsin Administrative *.otic. J. The architect, professional engineer, registered designer, owner or Jumbing contractor shall keep at the construction, Liic sit cif plr.ns u-ariny the stamp of approval of the departriiaeriL. =i. In the event installation of the plumbing iri.provu,;ur:ts or system i-s i,ut coiamneed within two years from this date, this approval shall bcc ;.Tie void and new application si,ull tie: nor re work riay cor.irirence. M , sL ~ i t iir. Byron Ulyd Page 2 jrantiny rois approval, th.- Uivision of Health does not hold itself Liable for any defects in plans or specifications, plan omissions, ~xamination oversight, construction or any damage that may result iri or after installation and reserves the right to order chanues or additions should conditions arise making this necessary. Tnis approval is based on Chapter H 62, Wisconsin P,c ministrativa Code, requirements. It shall be necessary to obtain and fulfill the permit requirements of the city, village, township.or county in which this installation is to be constructed. Failure to obtain local pe:rrflts will automatically void this acceptance. by order of Robert Durkin, Administrator, Division of health. i ncere: l y, aes A. Sargent "'AIef ,,'1S : K5 : rmm .--closures uc: Mr. Dennis Sorensen, OWS - i istric:, L_- LA . iiarold barber, St. Croix Lounty ;:oninc: f Ar. Uon 0be rciueile.r rile i ~W ti m a AGREE AIM This agreement, made and e tered on this day of.; 19 by and b,.ptween th Township of,r FddressA V EEREA S: In aiplication has been made for a sanitation system on the following described property: EEREAS: Septic tank drainage does not meet the minimum standards of the ordinance of St. Croix County and state codes. VF.EFFAS: The owner agrees to Install a holding tank for septic tank purposes purposes. NCti TPEREF ORE: For and in consideration of the issuance by the Town- ship of /Z'"t t~ of a permit for the above premises, the parties do hereby agree and bind themselves as follows: 1. Owner agrees that they will conform to all the rules and regulations pertaining to a holding tank system. They agree that anytime said township deems it necessary to pump out said tank, the owners shall have same pumped out in 24 hours, or township .rill have said work doneand charged to owners and place same on their tax bill as a special charge. 2, The Township reserves the right to assess a bond if they desire to cover any possible pumping charge in the sum of $ IT IS UNDEFtiSTOOD that this agreement shall be binding on the owners, their heirs and assigns. IN V ITNESS WEERLOF, the parties have hereunto set their hands and seals the day and year first above written. Township of ~f Developer or owner r STATE OF V,,ISCONSIN) w S5: COUNTY CF ST, CRCE) r Subscribed and sworn to before me this day of 19. Notar .Public, St. Croix County I! r~IV'E ~"°%d.•e "d.~..+~Jj..°a_..~ y_..._.__6 n~ z 2 r _._~...,i._•____._._._....._..._._ . "``~Tss-r. m~c=~rs4+rv~N .w,...x.~.av+w.mvcaw*c~..„.. n by the ua • ~~sf ,urea _'F_ ~r t,~~ w,.>r 1 q an"ire 'rc -ct'~ . l v15ic?rf ~rr~o Ce ~ h~~Veron~~~.. ;["iCai~'sft.. •~nc+ - _ aC$Ci~r't aIL Section of plumbing of Health, ©eP ~ _eG~ to-_ ~omdltions _ tfre_ ` F`no -es, Cl anSocial ervi ro~a set forth In ...v-- - verification I i I I' . a a EH 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: L~,Section ~.,TiZN, RL5 E (o W,Township or Municipality Z i~%,~~~~~> Lot No. , Block No. County - ~~F ~Subdivision Name Owner's Name: f ` a Mailing Address. l_ TYPE OF OCCUPANCY: Residence No. of Bedrooms ~ Other EFFLUENT DISPOSAL SYSTEM: NEW X A DITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS- IPERCOLATION TESTS r'gy SOIL MAP SHEET SC)I L TYPE I PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TESTTIME DROP IN WATER LEVEL, INCHES RATE NUM- BER INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 A !P- P em F P_ SOIL BORING TESTS ( TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES I NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) s T. ew 7-e c % 7n _ AN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.) dicate on the plan the location and square feet of stable areas) Indicate ~number of square et of absorption area needed for building type and occupancy. ~L15 I.6 /a ,e5t ~Indicate scale ur distances. Give horizontal and vertical reference points. Indicate slope. A j - ~4 ~ l^rl £ ~ ~ - { v I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. Name (print) '11':.' I A cj'V 110 Certification No. Address Name of installer if known ' CST Signature - y COPY A -LOCAL AUTHORITY I State of Wisconsin \ DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH y{ MAIL ADDRESS: P. O. BOX 309 July 124 1978 MADISON, WISCONSIN 53701 IN REPLY PLEASE REFER TO: SECTION OF PLUMBING AND FIRE PROTECTION SYSTEMS GOutu I0 iax 211 Plan Identification No. 73-i,3y,8 Amen,, W1 !5001 Dear Sir: Re : <+ot~ ;areeselwr cuiiare r;o~<tin~ b°atak a:T 1/4o d't3 n of t7,1:[t'~•Y00'r" t,7I :7t. (.,rC1 ~r % t`t13tt~ This is to acknowledge receipt of your plans and specifications for the above- indicated project. When referring to this plan in the future, it will be absolutely necessary to utilize the plan identification number assigned to the project. The spaces below indicate if proper fees have been submitted or if more information is required. Providing plan review is not completed within thirty (30) days, a permit to start construction may be issued if requested. See Section H 62.25, Wisconsin Administrative Code, for limitations in reference to permits to start construction. Preliminary plan review for determination of fees does not hold the department liable in the event additional fees may be required upon complete plan review. Preliminary review indicates the plan review` - Y' Fee required is $ r ! , - , Fee received is $ = II Plan accepted for review. Fee is being returned because of II Overpayment Q underpayment. Providing one of the two catagories above is checked, please remit correct total fee in one payment. Indicate plan identification number on remittai.,--. No fee has been remitted. Plans submitted with no fees will be held in abeyance until remittance is received. Indicate plan identification number on remittance, Additional information required. See attached Plb. 100. The permit to start construction will not be issued until 30 days after requested information is received and accepted. Q Plans being returned. See attached Plb. 100. Sincerely, Z • . z. 77 cr~iucQ~~!~/ . ames A. Sarg Chief JAS:fjs i Plb 100a V77 Department of Health & Social Services Division of Health Section of Plumbing and Fire Protection Systems ` 608-266-3815 Re : In reply refer to Plan ID # 2 / • / r The plans indicated above have been given a preliminary review and the following data is either missing or needs clarification. Please submit the additional information as indicated and checked below. Upon receipt of this additional data, plan review will be continued. I. Plan Submission ❑ Additional information shall be submitted in triplicate unless specifically noted. ❑ Plans not clear, legible or permanent. All information submitted shall be signed, sealed or stamped in accord with Section Affidavit enclosed. H 62.25(2)(a) Wisconsin Administrative Code. )aj II. Alternate Sewage Disposal Systems (Mound Systems) ❑ PLB 108 (Application for use of an alternate system). ❑ County onsite required (1 copy). ❑ Cross section of mound. ❑ Pipe lateral layout. ❑ Plan view of alternate. III. Private Sewage Disposal Systems ❑ Ground slope with 2' contours in entire area of soil absorption system extending 25' on all sides. ❑ Elevation of permanent reference point (benchmark). ❑ Location of area suitable for replacement system - provide soil test data. '17 Plot plan showing lot size and all lateral distances from sewage disposal system or holding tank to bldgs, lot lines, well, watercourse, etc. ❑ Construction detail of septic, holding or lift pump tank if site constructed or tank manufacturer if precast. ❑ Construction detail and cross-section of soil absorption system. ❑ Soil boring and percolation test on EH 115 completed by certified soil tester (1 copy). ❑ Complete data relative to anticipated use of bldg. ❑ 3 copies of PLB 60 enclosed. ❑ Deed restriction required 1 copy). IV. Holding Tanks DC Profile of holding tank. c'r&c,_ L]Holding tank agreement signed by4wr and local unit of government (sample enclosed). [Reason for installing holding tank soil test or statement from county (1 copy). V. Lift Punps ❑ Calculations for total lift pump discharge, head and gallons pumped per cycle. !I Size, length & depth of force main. ❑ Detail & model of pump or automatic siphons including size, pump curves, drawdown and average flow rate GPM. ❑ Cross section of lift pump tank showing pump(s) or siphon(s). VI. Water Supply, Distribution & Service ❑ Sizing calculations. ❑ On/off pressure of pump if private water supply or static pressure at source if public supply. ❑ Gallons per minute of pump. and size of pressure tank. ❑ Size of pipe, length of run and materials used. VII. Systems In Fill Fill must be placed prior to plan submission) ❑ Total area filled (fill to extend 20' beyond edge of trench before side slope begin). ❑ Depth and type of fill. ❑ Copy of onsite report by county or district plumbing supervisor. ❑ Length of time fill has been in place. -over- i . SAMPLE DRAWING - NOT TO BE SUBMITTED FOR PLAN SUBMITTAL y Y ' BEf`JCH MARK , ~ / 00' O" ~ti ` SEPTIC LOT LIKIE 1 -AAI K f WELL J 1 I 6 r I ` ~2 9 H' l / / 96' 98' r-- -II r----I-- 7 7-7 Imo ~ ~I li~l i'I i I I ~ / ~ I I I I I I ~I I i t ~ jI Iill III I 1 I ~ ~ I I I► I I I C I I ~ I l / I I i i l l ~ ~ l ! ~ I I ,I Iii ill i ~ i I ~1 ~ DETAIL '~A-A" ~ ZRCPLAC_E%EUT H" VEUT S LOT LIQE AREA -PLOT PLAN - ~oHnJ DoE PRIVATE SEWA&E DISPOSAL SYSTEM M.P.010000 SCALE - I"= '-I O'- O" 5' O"MAX. !o' 0"WK1. O"MAX. MARSH HAY oR UNTREATED E~L04m, PAPER P ER F PIPE EARTH -DETAIL "A-A" MOT TO SCALE ENWOOD T 30 N.-R. 15 W SEE PAGE 61 Gzk.: 2 0 i 17 v\ acf Aeb. 5 dae d 0 S Dan e an e 9z /03 f Ei He.m¢ V 1 h ~Q5 9B D w h ~ ,PasE 6 P'tri 4 0 ~ i~ ~ z a s/s s . C Q [ 0 ~ s gp a 3. ,¢o is/ ~ _ ~ ~ O a ."1C N. h~ 5\ xtG' o i 8 K~ ~avrL~✓d/. ~E S - \ 9.-Jf 4 6 63 4 K S 6'h hJ 3. 4. 5 6V~ 3 4 5 •6 PCC(' R°be~~~- P Sch~~ 4Leo ~ 0\ V 0 49 l0\` 0 4 s v I EM 9 D e SO 9 a 7 9 V 6 N~L rc 9 1 io sa¢ 7 9 e e e STA. 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S h~ V`•b f - Jos s ~ Giese 'i ;ro • ~ ~ Q ~ 9 ~j'o f • /r'~ ~ ~y .Pobe " a h a\o n GLEN 0 D Cv~ Oberm..e/%~ P l' Y -Y T/FF - ~..1 pT Y ?~~y ef~x aohF ~C~ jdhC b h m n Ch ~n lP ~o 8 y~ ass r V~F ~We n h v,~ oQh vpar\ <<,~~a~e U ,q 9 > ~ ~ ~ + C ~ ~ ~ ~ F7ride~s ~ v aca CYo~c~ce E ~esf . o a/t b C 7: /70 o Bo h \N % S h iebe Ca se% S~'n~f fines \v C 0 ga ;us Q V ` t,Z~//me Ch~i6fenscn~ 9 d e V ll~ v do 6a u6~/ V ` ~o ~~-3 e~ /'vG:r ~ .s>Yro v_s V ~ 60 ~ 39 Q~• • ~ ~ yG/en wa° ~o i~~~o%' .moo dei ~dw.~r c sE, ryoc w Jui"e - _ vh k GZ7~/~"as 7 -j9 09 ~o F.ebu:9 . pz • ~F` C v~ Cu mss ~T DOWNING ~y f 9 .~e T c l F//~6 o y fioin~ o~ U ,y f~ 6c I._ i~o as. F •Da v. Q' Ma~v~n ~ q v ~ e% 2'~. • f ~aJ/ .Doers v y~ -600 <6 ~ ~ ~ ~ o~• Can- n ~ L%.~fis f3ocfh, C `3 r3o fie/d !No/d iiB Tei9izo fo isB 6S J et x 41 l Fo '~y Ga pC L¢~~enee Ct C F d°o fh 7/ E Qv /~o~ro d Q • ,Po6e~1 36 sf766~e CC`C C Y. Ba izi Q s~~e~ n. 1/e/ cz 4o zbs h °>ili ip oa0~ ~Q /B/ va ~ ~ CCFn Ham. en p rQ 0 d ~~v0 ~9%fv~ - ~ ` ~ Phl V. C -insby Bo ~ ~ e0 r,D ~ 0 S mo -Z7°.~a von ~ ~ Uv l ti. q, D D e `Sao so~J C osb Bo ~`O eio b d v w ~l sTc Rav.i97¢ SEE PAGE 37 GLENWOOD Lundeen LEON LEE'S CITY AUTO CO. Frame & BERENSCHOT DRUG STORE a Body Shop INSURANCE AGENCY Glenwood City, Wisconsin PHONE: 265-4877 GLENWOOD CITY INSURANCE & LOANS Congratulations to GLENWOOD CITY 54013 PHONE: 265-4080 the 4-H Program WISCONSIN GLENWOOD CITY 54013 Wisconsin Department of Health and Socie.l Services Plb. #67 3/70 Division of Health SEPTIC TANK PERI•11T APPLICATION TYPE or USE BLACK INK A. MIER 04 PROPERTY Name Address (Street, City, Zip Code) f ff fj i ;~/?~i.`.y~•1] j)lf/~1%J;:,![-LC c- t-•//1.'~t£'P~~ `--t ~J~~/.J B. LOCATION OF PROPERTY WFKF SYSTEM WILL BE CONSTRUCTED, ALTERS CR EXTENDED COUNTY < Check One: CITY VILLAGE LEGAL DESCRIPTION Y TOWNSHIP X C. IS LOCAL PERI%IT REQUIRED FOR THIS WORK? YES NO PERMIT NUeBER i I D. SEPTIC TANK CAPACITY l~'! Gallons NEW INSTALLATION REPLACEMENT ADDITION i Poured in Place Steel. Other MATERIALS% Prefab Concrete _V NU?MER OF TANKS 70 BE INSTALLED: (-!ri E. TYPE OF OCCUPANCY Cheek One: One or Two Family Residence Commercial Industrial r~ Other ¢ (Specify) Number of Persons to be Accommodated Number of Bedrooms F. APPLIANCES, ETC: Food Waste Grinder YES lI NO Automatic Clothes Washer YES ' NO Dishwasher YES r 1 NO Automatic Potato Peeler YES X NO Other (Specify) G. MASTER PL.M ER MAKING INSTALLATION Name: Address (7, / License Numbert , Signature of Applicant: / MP RSW Address= • ; t` / t/ c _ H. (To be Completed by Issuing Agent) it Date of Application 5' 7 ! 1 Fee Paid $ i Permit Issued (date' Permit Number r Agent (Name) lr i Fors - ' Town, Village, City,~ty, etc. (Specify) Note: The application cannot be considered for filing until all of the above questions are answered and the fee paid. Agents will fon and appiicaticn, the fsc of $1.00 f-.r each septic tar.Ic and the third copy of the permit (canary) to the Division of Health. Checks and :coney orders should be made payable to the Division of Health. Do not wr'.te in space beiaw - FOR DEPARTNENT USE ONLY I C / I. DATE RECEIVED ACCEPTED BY vI L RETURNED (Initials) (Date) See Co res.) FEE RECEIVED VALID. No. PERi`IIT NO. (Yes or No REVIE'VED BY APPROVED DATE ( (Initials) - 7 Y7.--. rNo COHPI.F.TF: OIRER SIDE SEPTIC TANK PERMIT NO, R E P O R T O N S O I L P E R C O L A T I O N T E S T A N D S O I L B 0 R I N G S TO DIVISION OF HEALTH - PLLMING S=Ti6di ' P.O.Box 309, Madison, Wis. 53701 Pursuant to H 62.20, Wis. Adninistrativo Code P S R C 0 L A T I 0 N T T S T Test Depth Charaoter of Soil }fours Water Teat Time Drop in Water Level Inches mutes N=bor Inches Thia,mess in Inches Since Hole in Hole Interval Second to No?ct to Last To Fall 1st Wetted Ovornicht -in Minutes Last Period Last Period Period Onor Inch Example P - 0 3611 To Soil 1011 CJ.7 2611 25 Yes or He 30 1 2 1 2 1 2 60 l%r./I RECORD DATA FROM MINETUM OF 3 TEST HOLES Compute size of absorption area in accord with H 62.20 Wis. ACainistrative Code. S O I L B O R I N G S- Miniim 3611 Below Proposed Absorption System Boring Total Depth Depth to Ground Water Depth to Bodrocl: Number Inohas Observed Estimated Observed Estic>.ted Character of Soil with Thiokness in Inehss Exaaplo B - 0 7211 7211 Black To Soil 12' Cla 011 Sand 18'1• Gravel 2411 RECORD DATA FROM MINIMUM OF 3 BORE HOLF'a YPE OF OCCUPANCY: RESIDENCE: Number of Bedrooms OTHRRI (Speoify) Number of Persons ~l PDOD WASTE GRINDER: Yes - No sy DisImasher: Yes No _ Automatic Clothes Washer: Yes X No FFLUENT DISPOSAL SYSTEM: NEW /1 EXTENSION ADDITION REPLACEMENT 1 1 ' ' Tile Size No.Lin.Feet /f--- Trench Width h C• . Depth Number of Lines Seepage Bed: Length Width Depth Tile Size No. Lines Seepage Pit: Inside Diameter 'I ° Liquid Depth ' - I, the undersigned, hereby eert''y that the percolation tests reported a this form were made by me or under m; super- vision in accord with the procedures and method specified in Chapter H 62.20 (13), Wisconsin Adainistrative Code, and that the data recorded and location of test holes are correct to the best of my knowled e and belisf. NXM !l}~f TITLE Type or Print) c ftEOSTRATION NO. or MASTER PWMi3ER LICENSE NO. ADDRESS 4 ( 1 0 DATE SIGNATURE II . I, o y 0 m o ` (D v ^ 3 - n O N (D O O N Q m• N 7 n 0 CCD l w m > W O F.y n 5 n~ y ~ o CD co :3 CD C) Cn Cn ::t CD n 7 3 N d N CO N CD CD O q C CD j --I O O O cn D o CL o (n 3 fA :3 O O En =3 a CD n u> Z D (D • N CD 0 CL -0 W C: (D 3 n 0 w lot CD U CL S o D n o c 0 0 < (n Q (D "WA Z O O O F o O cn En En C) o v l 3 v v v ~ 4 ~Q 0 co CD - 0 'a N m A N m O z w co n co 3 ` o (.n z (n Z 0 D CD o m • U :9 En m F c m w n n 3 _ O W C: i d A C I O z --I W 'D C WO m o. z 0 3 A o Iz (D CD (D n m D CD _ c rk)c g z ? N CD ~ O7 o~CD < =r 0 0) N O CD CD C F n Go 0- =3 O j. O \~Q Q N N Y J C)2~ V U) p O O J CD w O • CD ryq O t» O ~ v O ~ ti Parcel 016-1035-90-050 08/28/2006 08:36 AM PAGE 1 OF 1 Alt. Parcel 16.30.15.259B-10 016 - TOWN OF GLENWOOD 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 - OBERMUELLER, DONALD J & STAR M DONALD J & STAR M OBERMUELLER 2931 160TH AVE GLENWOOD CITY WI 54013 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE _SEC_1&T3QN-R 1/4 BEING W1/2 OF Block/Condo Bldg: E 1/2 OF NW 1/4 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 16-30N-15W NW Notes: Parcel History: Date Doc # Vol/Page Type 08/07/2000 627769 1532/578 WD 08/07/2000 627768 1532/577 WD 08/07/2000 627766 1532/575 WD 08/07/2000 627765 1532/574 WD more... 2006 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/26/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 12,000 134,200 146,200 NO AGRICULTURAL G4 38.000 3,100 0 3,100 NO Totals for 2006: General Property 40.000 15,100 134,200 149,300 Woodland 0.000 0 0 Totals for 2005: General Property 40.000 15,800 134,200 150,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 523 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 GLENWOOD / T. 30 N:-R.15 W 49 SEE PA S E O 1eorH I DUNN LO UNTY Y L.- E»m fir el` ~ P~Z' A.P/28 'n s f a5r STA•//¢ AVE 1 6facl sB4 s 7 > > L/T SHY Henke • 00 •l~arr>er- Fa.>cis M oaf Suck d UaA, ,z ,3 Y ~✓Tna~- <9t 9 aar-f a/ce/¢P /a/ence sae.-sor F Q Mrzr zz7 Lo99he • Cl? /q ~ sar> ~ k Lechne/ • iTQCke/En ~ M.➢rh -<7erzn c,... /70TH •/-ao /°9 "ado /9/ 98. zB z~s 49 F3o<>tfi z7G / 7 • • • ay, •AVE. /r F2ob~t h Dam B ua- n Ham/a.> Fi-ar,/- Tames £Mar_y O Cf /rfch ~s.Ee c% /sz 'P 80 .o%f s g" • warner- Sch J,Snson g° ¢o d e~ oa ~F e~ t~ C h Moe a`✓ .>d cS/a~sb tl~~s~sa ~ C o ~ Ta'id~ ~a ~na~s .Pow/ ~ . ~9 zoo rs • /60 LG aroma 1'Why e/da /GO k✓a- 7 • C A zoo .y°d 5 • Ro~s~s / J h or, ~~l >r _OO~a/d c ~o y n E (TrzmeS 4 d 0 K e 9o a a~~_. 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W Fa~c.s Lei'y^l • ZX /'4 • E//.5o.~y h ,Sc,s~ 7e C GF._-ar,~ J-3 .'.ienrls 9nde soy 0 t~ ` G J 7 7B `Y c7✓ ro • h 40 6 Robe.-T L,a vei i~ • p tl n ~ v c f ~ ~./a c,7 60 • ~ T°se~/i /Z ~J d ^ C ~5'fa~dae~t fa/ 7 ecT /ewe ~ /2 ~ ~ G p p ~ ~ 3 1>r~zx/e~ Q 19 G 7oc U~ ~~b0 ~lbcif~~F~a ~~~.rass x a3e.c- ~o~ 'Q UW rzo • ~$1 r /at,s <l bof°fi• ry,> G✓a nc £ ~ ~ ~ h lwa/d ` ~ to H Avg F °/yam ~ r>f/~ A~ c r~.y~ ~~a~ ~rz~~~ • O. fog p 0 htv n.x/ f ~7hic%y - r- aoc /r9 -'o rCPVn y sf moo V~p ~oUner~- J ,~ar~ V T 6 _ Tam Scfi>'oeder' yo 9o W~ 4v ^l r • c'Sou• No a yU 2r2 i S 3 • ~ s ~ s8 r. ~ dK ~ /s C,~ ~ Y Wtr C ~ 1 ,C= ber ~ ~ ~ k Fa ci vdh 0 ~3a'~ TI~FfP ~~ee /B o r ah ~pC ~IJE .ham h ova V.y '50 c berms.°f //e. g p 0 C e VC tl~P n ~ v 'V '0 50 v C ~ Theresa CSC o w U v J S p q% ~ o n Sto,.~>n oU. F v c /a E 7 26 no U E. .>es1 • Shred- BLU ~ _L~arryf Jalres ~ ~3 ~ 0 0 6cfrrab a~ Leon ~ e ~ [ F /!a S Chrst rx~~ c s - U do "P,F e s _ R. Thaye a> rw • sH~ d@ v o ~ rr „df rz° .zo h ° oo a /so°fs/ C~ p "tltl@ pIJ~ do _ leroyl Ha3e/ »r GLE OD CIT 61 ~J ~ 4° ao M~ ¢0 9~ s FJ/- - N `'A 4n 6u~/eyh/ orH ar~~ P ~d 9 t• co c y ood R, w a f c vo~r.P t Ka. ~n • ~ ~ va / -~oyS, -vo~afd 4~y / Gars Dora/o •f Korid Kcndrr o sR. M E. z F Ju/ ~ f9 e ~ ~R ~r a> v~ 7/S S e/are BO 7B sz ° iebu • J AVE. N I I m B2 AV J ffi J H e Thom so.~ a P a 0 • `1 stun - ~ Curfi booth o s H .oa r° l 0 Fl/6°.-1 s ~o s s ~ n -C C s ~ Th ~scn 240 U v Irc°r> e cone b tl a a r/ar vr~ f ao R s r9 He%.~ 7z b K /3a • ah/ an- o ~'ti y J7orv s - F /JB 3 ° aid c 3 tly~ ra.yaz f hti Asa 9 ~ ~ .F3 0th '/n+a.Ft 36 ~C tl Cur1{'sG cT 13 r3c tf ~ belt r. 71 96h 'e fay, ar> Bo fh 5 Y y• s v nna y h D C • ntl?,: x4CiFp UcU r iya~ Cr°s6Y az6 x C Mrf-o.>~ rzo ~Ct~ l~~ ~2v Bo -J / B 19373 /~95 Elz'~,,, Qf o ~ ~ ~ r/a/1>n sore ~ U//°m ~~Z ~•p 128 ~¢dn1 c. Told- r V'. ~ ~ ~ w • ~O /0/7~ ~ ~ [c..,,_si he, k~zi_ {Y o ao g° 779B77'cefa rd OD Maw 6/.7 c SEE PAGE 37 RD- Q5}Cro._ C ds c~r/ty rnr.L GLENWOOD CITY CO-OP SERVICES Gl GLENWOOD CITY WISCON enwood City SIN 54013- y EX-PRO i Ford Phone: 265-4224 FARM SUPPLY Mill: 265-4827 ! Fertilizer Plant: 265-7212 Custom Blended Protein Sales & Service Computer Balanced Rations Phone: (715) 265-4877 GAS * FUEL OILS ,t LUBE OILS * TIRES Custom Extruded Soybeans 4 Glenwood City, Wisconsin LP GAS ACCESSORIES SEED * AG CHEMICALS ON 770 - GLENWOOD OTY 54013 FERTILIZER * ANIMAL HEALTH * FEED, BAG & BULK 265-4239 Parcel 016-1035-60-000 08/28/2006 08:49 AM PAGE 1 OF 1 Alt. Parcel 16.30.15.257A1 016 - TOWN OF GLENWOOD 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 - OBERMUELLER, RETIRED RETIRED OBERMUELLER Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description ' 2931 160TH AVE SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 12.860 Plat: N/A-NOT AVAILABLE SEC 16 T30N R1 5W 12.86 AC NE NW BEGIN Block/Condo Bldg: 1500' OF NW COR SEC 16 TH F 70D'Tl~\ 00'; TH N$00' TO POB NKA Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 016-1035-90-050 16-30N-15W NE NW Notes: Parcel History: Date Doc # Vol/Page Type 08/07/2000 627767 1532/576 WD 07/23/1997 902/511 07/23/1997 568/207 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 016-1035-90-050 Valuations: Last Changed: 05/18/2001 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 105 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 016-1035-50-050 08/28/2006 08:53 AM PAGE 10F1 Alt. Parcel 16.30.15.257A-20 016 - TOWN OF GLENWOOD 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 - OBERMUELLER, RICHARD JR & LORI RICHARD JR & L RMUELLER 2973 297TH ST - VI-- GLEfA10ITY WI 54013 Distr SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC I L~ i Legal Description: Acres 40.000 Plat: N/A-NOT AVAILABLE SEC 16 T30N R15W PT NW 1/4 BEING E 1/2 Block/Condo Bldg: OF E 1/2 OF NW 1/4 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 16-30N-15W NE NW Notes: Parcel History: Date Doc # Vol/Page Type 08/07/2000 627768 1532/577 WD 08/07/2000 627766 1532/575 WD 08/07/2000 627765 1532/574 WD 08/07/2000 627764 1532/572 LC more... 2006 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/26/2006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 40.000 3,600 0 3,600 NO Totals for 2006: General Property 40.000 3,600 0 3,600 Woodland 0.000 0 0 Totals for 2005: General Property 40.000 4,400 0 4,400 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 08:49 AM Parcel 016-1035-70-000 08/28/2006 PAGE 1 OF 1 Alt. Parcel 16.30.15.258 016 - TOWN OF GLENWOOD 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 - OBERMUELLER, RETIRED RETIRED OBERMUELLER Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 16 T30 R15W NW NW NKA PT CSM 14/3983 Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 16-30N-15W NW NW Notes: Parcel History: Date Doc # Vol/Page Type 07/30/2001 652343 1689/233 WD 07/30/2001 652342 1689/232 WD 08/07/2000 627764 1532/572 LC 07/23/1997 902/512 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/13/2000 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 016-1035-80-000 08/28/2006 08:48 AM PAGE 1 OF 1 Alt. Parcel 16.30.15.259 016 - TOWN OF GLENWOOD 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 - OBERMUELLER, RETIRED RETIRED OBERMUELLER Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 16 T30N R1 5W SW NW NKA PT CSM Block/Condo Bldg: 14/3983 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 16-30N-15W SW NW Notes: Parcel History: Date Doc # Vol/Page Type 11/08/2000 633273 1557/530 WD 11/08/2000 633272 1557/529 WD 11/08/2000 633271 1557/528 WD 11/08/2000 633270 1557/527 WD more... 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/13/2000 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 016-1035-20-000 08/28/2006 08:49 AM PAGE 1 OF 1 Alt. Parcel 16.30.15.254 016 - TOWN OF GLENWOOD 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 - OBERMUELLER, RICHARD JR & LORI RICHARD JR & LORI OBERMUELLER 2973 297TH ST GLENWOOD CITY WI 54013 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 16 T30N RI 5W NW NE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 16-30N-15W Notes: Parcel History: Date Doc # Vol/Page Type 08/07/2000 627768 1532/577 WD 08/07/2000 627766 1532/575 WD 08/07/2000 627765 1532/574 WD 08/07/2000 627764 1532/572 LC more... 2006 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/26/2006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 37.000 4,600 0 4,600 NO UNDEVELOPED G5 1.000 100 0 100 NO AGRICULTURAL FOREST G5M 2.000 1,800 0 1,800 NO Totals for 2006: General Property 40.000 6,500 0 6,500 Woodland 0.000 0 0 Totals for 2005: General Property 40.000 7,400 0 7,400 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