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HomeMy WebLinkAbout030-1094-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. C roix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 488171 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m) Permit Holder's Name: City Village X Township Parcel Tax No: Sundquist, Thomas & Kathleen I St. Joseph, Town of 030 - 1094 -20 -000 CST BM Elev: Insp. BM Elev: BM Description: / ,� Section/Town /Range /Map No: to • fl o . l e S T yvtct�tf'1 WV 32.30.19.3438 TANK INFORMATION V ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic p Benchmark , 50D v U Alt. BM Aeration �w PLSzS Bldg. Sewer / 1 Holding St/Ht IN ,.j ) _ 2 _ b , o� 957 V f TANK SETBACK INFORMATION St/Ht Outlet — 2 b' ZI 9� r TANK TO P/L WELL )BLDG. Vent to Air lot a ROAD Dt Inlet ptic ! 2 Dt Bottom so y s� K �/ f ' lW i �_ Header /Man. ( 3Z V �ts;69' Aeration Dist. Pipe q S S✓ •�fo Holding Bot. System r PUMP /SIPHON INFORMATION Final Grade 6(4 0-Ir Manufacturer Demand St Cover p i GPM Z•`t I 9�•�Z Model Nu bar � ; Lf•9Z 09 TDH Lift Fricti oss System Head TDH Ft Forcemain Dia. Dist. to Well SOIL ABSORPTION SYSTEM 1':T DI RE CH Width Length / Jo. Of ranches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth S 3 68 e z SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Man ti INFORMATION CHAMBER OR Type Of System: I ! UNIT J I p D y'm Model Num 1 1 DISTRIBUTION SYSTEM Header /Manifold q Distribution x Hole Size x Hole Spacing Vent to Air Intake Pi (s) - s r Lengttt'_� Di Lang Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ® Yes ® No [m Yes A No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1:�/ ' Inspection #2: Location: 479 Old E East Hudson, WI 54016 (SE 1/4 NE 1/4 32 T30N R19W) NA Lot Parcel No: 32.30.19.343B 1.) Alt BM Description 2.) Bldg sewer length amount of cover Plan revision Required? ® Yes K No FA4 U se other side for additional information. _ _ / ' SBD -6710 (R.3/97) Date Insepctor's Signature Cart. No. Safety and Buildings Division County 201 W. Washin1ty AV ., P.O. Box 7162 St. Croix r �s ionsiin Madison, WI 5 7 62 _ Sanitary Permit Number (to be filled in by Co.) Department of Commerce (6 0 017/ Sanitary Permit Applica ion"----, a Plan I.D. Number In accord with Comm 83.21, Wis. Aden Code, personal inform tionyoMA 8 L q 0 6 jeer Address (if different than mailing address) maybe used for secondary purposes Privacy Law, s15. 4(lxm) — r L Application Information — Please Print All Information ST. CROIX COUNT r 79 Old Hwy E ✓ Property Owner's Name arnel #: Pending Lot # Block # 030- 1094 -20 -000, Na Na Thomas & Kathleen Sundquist 10 Property Owner's Mailing Address Property Location 479 Old Hwy E SE ' /,, 9B 1 /,, Section 32. City, State Zip Code Phone Number R T 30 N; 19 W (1,3413 Hudson, WI 54016 (715) 549 -6804 K Type of Building (check all that apply) r 1 X 1 or 2 Family Dwelling - Number of Bedrooms 3 Gx� bf, nq Subdivision Name CSM Number O.MR -. ❑ Pumic/Connnercial - Describe Use /� Na — existing 3 acre parcel ❑ State owned - Describe Use Z A r 34"' �J 15 [ .� 17 'I" 1 - 7 G t.!'S ❑City ❑ Village XTownship of St. JoseUh III. Type of Permit: (Check only one boa on line A. Complete line B if applicable) A. ❑ New S X Replacement S System ep yseem ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of PORTS stem: Check all that a 1 X Non - Pressurized hi -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating synthetic Media Filter ❑ Leaching chamber ❑ Drip Line ❑ Gravemess Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Two trenches @ 3' X 68', thirty four ( total - 17 per trench "Quick 4" Infiltrator Chambers at 19.1 ft. /chamber + 2 r. end caps = 661.00 sq. ft EISA Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 450 gpd ✓ 0.7 gpd sq. ft. / 642.86sq ft ✓ 661.00 sq ft EISA V 94.25' oK VL Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New T an k s 1 Jak. P 4 5 L5 Tanks Tanks Septic or Holding Tank 750 500 1,250 2 Wieser Concrete X Aerobic Treatment Unit Dosing Chamber VIL Responsibility Sta ment- I, the dersl * a res b or installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' Signature MP/MPRS Number Business Phone Number James K. Thompson MPRS #30021 (715) 248 -7767 Plumber's Address (Street, City, State rp Code) 340 Paulson Lake sceola, WI 54020 VIW CountyADepartment Use Onl Approved I ❑ ved Sanitary Permit Fee (includes Date Issu Issuing ant Si Stamps) 11 Groundwater Surcharge Fee) A t / )Zao er en R 'al "1 DL Conditions of Approval/Reasons for Disapproval ^ SYSTEM OWNER: nk 3, 6ldt Sybw� I Le- a- �oc, o✓�- 1. Septic tank, effluent flker and n- ll dispersal cd must all baservitea / malfbilIM as per management plan provided by plumber. 2. AN sMpadc M**ements must be maintained as par �ppAapit ©ode /ardiflanea. Attach complete plans (to the County only) for the system on paper not less than 81/2 s 11 inches in size . `.pr ... r ... F !1r`.:; {t1• �1Y+.1 2C r ,7•r'.•r':r r t . �, ?'rrNts�9 NtJ�Wi .1,14,08e !,A n • • / � ..Jp;/ Qt/a /ua�fian ,o; t ,. 177 77 79 Y it lra - z�, Sun / 4(79 a/d may. E, U 5� . �Ts4o�, .SE . Croc G, c✓� a propose/ W, - esel '(on"e"' -9,,P Aso • 6-c- I" �k- u�/ /Do / /oK-PLS'2�eFr /ucn CXi36 dry rwc 6 op fo be airO- ►dor+cd s r COoIL • `/" S,-A- VO +'Za XSea CAJ er 0 n 1 cd 3 -- -- - .v ev • �• N t � ara� eoncr Se yZ To be re Cc n n e t ° 4Z two oFST. Ina, /iole Over e l ei`- 63 cam-/ i 1979 Wisconsin Department of Commerce SOIL EVA T Page 1 of 3 Division of Safely and Buildings in accordance with Comm ti5, is. Adm. Code �� A.C.E. Soil & Site Evaluations MPS Attach complete site plan on paper not less than 8'/ x 11 inches in size. Plan mu County -�Y St. CfODC include, but not limited to: vertical and horizontal reference pant (BM), direction an percent slope, scale or dimensions, north arrow, and location and distance to near t road. T L RO r I.D. S � 030 - 1094 -20 -000 Please print all information. Reviewed Date Personal information you provide may be used for secondary purposes (Privacy Law. s. 15.04 (1 ). / O Property Owner Property Location Thomas E. & Kathleen Sundquist Govt. Lot SE 19 NE 114 S 32 T 30 N R 19 W Property Owner's Mailing Address Lot # Block # I Subd. Name or CSW 479 Old Hwy E East Na Na Na City State Zip Code Phone Number I City _J Village 1#1 Town Nearest Road Hudson WI 1 54016 1 (715) 549 -6804 St.Joseph I Olds Hwy E J New Construction Use: tI' Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD 16 Replacement -j Public or commercial - Describe: Parent material Glacial outwash Flood plain elevation, if applicable Na General comments and recommendations: Site suitable for conventional POWTS @ 0.7 gpd/sq.ft. Inst two trenches at 94.25' using 17 "Quick 4" chambers per trench (34 total). Boring # Boring > 108" m in. Soil ✓� Pit Ground Surface elev. 98.98 ft. Depth to limiting factor App lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -30 10yr3/2 & 4/4 none sil/sl fit Na mfr aw 2fmc Na Na 2 30 -36 10yr3/2 none sit lcsbk mfr gs 1fmc 0.4 0.8 3 36-42 10yr4/4 m 1 d 5yr4/6 sicl 1 csbk mfr gw 2fm,1 c 0.2 0.3 4 42-49 10yr4/4 none sl 2msbk mfr cw 2fm,1c 0.6 1.0 5 49 -56 7.5yr4/6 none gr Is 0 sg ml cw if 0.7 1.6 6 56 -108 10yr5/4 none s 0 sg ml - - 0.7 1.6 F : 2.1- 1 Redox. concentrations in H#3 due to compaction of horizon durinp garage construction and placement of fill material. q 2, 1(a 51ta to Bori # Pit Ground Surface elev. 98.93 ft. ? Depth to limiting factor >109 i n. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 10yr32 none sit 2fsbk mvfr cs 2fm,1 c 0.6 0.8 2 9 -19 10yr4/4 none sit 2msbk mfr gs 2fn 0.6 0.8 3 19 -37 10yr5/4 none sl 2fsbk mfr cw 1fm 0.6 1.0 4 37-44 10yr4/6 none gr Is 0 sg ml gw if 0.7 1.6 5 44 -109 10yr4/6 none gr s 0 sg ml - - 0.7 1.6 d * Effluent #1 = BOD 30 < 220 mg/L a 2 kTSS >30 < 150 L #2 = BOD <30 mg/L and TSS <-0 mg/L CST Name (Please Print) Signature: CST Number James K. Thompson "— 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola,-WI 54020 522006 715- 248 -7767 i Property owner Thomas E. & Kathleen Sundquist Parcel ID # 030 - 1094 -20 -000 / Page 2 of 3 $ � Boring # Boring 1 - F 1 �/ 16 Pit Ground Surface elev. 99.75 ft. Depth to limiting factor >113" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 10yr3/2 none sil 2fsbk mvfr cs 72f,1mcO.4 0.8 2 9 -21 10yr4/4 none Sid 2msbk mfr gs 0.6 3 21 -29 7.5yr4/6 none sl 2fsbk mfr cw 2f,1m 0.6 1.0 4 29-42 7.5yr4/6 none gr Is 0 sg ml gw if 0.7 1.6 5 42 -113 10yr4/6 none gr s 0 sg ml - - 0.7 1.6 F-1 Boring # J Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 i F—] Boring # _ Boring Pit Ground Surface elev. ft. Depth to limiting factor in. F Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg/L * Effluent #2 = BOD -s.30 mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. P;e * If 79 Y - 7 -, � , » if - a y Sc- ,/ 79 6/d h4.. E, B 5Eys/ si c. 3;z, -.r, o' 66 • Tse off, SE . Crl:;4 G c)/. a &s r Cods • 0 i 6/ EXiSE: � E,Yisu' r2 .540 -6m e- Z i TO � /'econnec.�<d ti � dZ o - -- eJL40' :Top oFS.T. /11an�ta /e Cdve!' m a 43', . v v i � o rl Scale A fh ~ 1 — P e f7 O LJ i z a it � la e � � � J � C m I � ial■ • Z O is� • � D %16 Z ���• _ ■ ®■ Lip D o d e N ■ D < ■go Z m m ■w��• _ WON UWE � '� � � .� a 3• ■off � a 2 � fT1 r r = a H I A -I U V I � I � j Conventional Septic System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General The conventional septic system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall be maintained in accordance with component manual SBD- 10705 -P (N.01 /01). All local and/or state rules pertaining to system maintenance and maintenance reporting shall be complied with. Septic Tank Septic tank servicing mechanics comply with Comm. 83.54(1)(e). Septic tank to be located within 150' of service pad, with bottom of tank to be :!� 15' below service pad elevation. The operating condition of the septic tank and outlet filter shall be assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If the contents of the tank are not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge accumulation in the tank. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated. Septic tank manholes risers, access risers, and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8 inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Soil Absorption Cell Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for vegetative maintenance) over the system is to be avoided. Soil compaction may hinder aeration of the infiltrative surface within and above the system and will promote frost penetration during cold weather months. Cold weather installations (October- February) dictate that the system be heavily mulched for frost protection. Influent quality into the system may not exceed 220mg/L BODS, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for the installation. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring. Effluent flow shall be alternated between dispersal cells on a two -year schedule by use of a diversion valve. Valve to be switched diverting effluent from dispersal cell currently in use to resting cell on a two -year cycle coinciding with septic tank inspection and maintenance. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. Excessive ponding within the dispersal cell will be eliminated by installing a new soil absorption cell to bring the system into proper operating condition. Questions on the operation or maintenance of the system should be directed to the installing plumber, Jim Thompson at (715) 248 -7767 or the St Croix County Zoning Department at (715) 386 -4680. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Br o.-,a e5 Mailing Address Property Address =Sa- '' // (Verification required from Planning & Zoning Department for new construction.) City /State /�`` -`- G // M, L-' Parcel Identification Number �D LEGAL DESCRIPTION Property Location St- 1 /4 , n E 1 /a , Sec. 3 , T 30 N R W, Town of S£ • SC�� Subdivision a , Lot # A— . Certified Survey Map # Volume fi4 , Page # 16z Warranty Deed # Z/ f'S7z , Volume 22 , Page # Spec house Xs no Lot lines identifiable yes SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. $3.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. knowledge. I/we am/are the own s of the • form are a to the best of m /our owner( s) Uwe certify that all statements on this r true g y my /our described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of ooms 3 I TURE OF A PLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revok by the Planning & Zoning Department. *'* Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) J 2 2 16 P 6 15 7 1 8572 .S l KATHLEEN H. WALSH REGISTER OF DEEDS MORTGAGE ST CROIX CO WI DOCUMENT NUMBER RECEIVED FOR RECORD 04/24/2003 08:20AM NAME & RETURN ADDRESS MORTGAGE EXEMPT t CM01 97148257 Review, Packaging, & Shipping Dept TRANS FEE: 39.00 TRA FEE: First Federal Capital Bank COPY FEE: P 0 Box 1868 CC FEE: La Crosse, WI 54602 -1868 PAGES: 15 PARCEL IDENTIFIER NUMBER 030 - 1094 -20 -000 [Space Above This Lim For Recording Data] DEFINITIONS Words used in multiple sections of this document are defined below and other words are defined in Sections 3, 11, 13, 18, 20 and 21. Certain rules regarding the usage of words used in this document are also provided in Section 16. ` (A) "Security Instrmnent" means this document, which is dated April 7, 2003 , together with all Riders to this document. (B) "Borrower" is Kathleen G Sundquist and Thomas E Sundquist wife and husband Borrower is the mortgagor under this Security Instrument. (C) "Lender" is First Federal Capital Bank Lender is a federally - chartered, federally- insured savings bank organized and existing under the laws of United States of America WISCONSIN - Single Family- Fannie Mee/Freddie Mae UNIFORM INSTRUMENT Form 3050 1/01 ® -6(Wq (0006) Page 1 0115 In I I'llllll III (III nil I�I IIII VMP MORTGAGE FORMS - (SW • CM01B J 22161 617 (P) "Successor in Interest of Borrower" means any party that has taken title to the Property, whether or not that party has assumed Borrower's obligations under the Note and/or this Security Instrument. TRANSFER OF RIGHTS IN THE PROPERTY This Security Instrument secures to Lender: (i) the repayment of the Loan, and all renewals, extensions and modifications of the Note; and (ii) the performance of Borrower's covenants and agreements under this Security Instrument and the Note. For this purpose, Borrower does hereby mortgage, grant and convey to Lender, with power of sale, the following described property located in the County of St Croix [Type of Recording Jurisdiction] [Name of Recording Jurisdiction] Part of the SEi /4 of NE 1/4 of Section 32, Township 30 North, Range 19 West, St. Croix County, Wisconsin described as follows: Beginning at a point where the West line of the SE 1/4 of NE 1/4 of Section 32 -30 -19 and the South Boundary of County Trunk Highway E intersect; thence South along the West line of said SE 1/4 of NE 1/4, 250 feet; thence East at a right angle 500 feet; thence North parallel with said West line to the said highway; thence Wly along the South boundary thereof to the point of beginning. which currently has the address of 479 Old East County Rd E [Street] Hudson [City], Wisconsin 54016 [Zip Code] ( "Property Address "): TOGETHER WITH all the improvements now or hereafter erected on the property, and all easements, appurtenances, and fixtures now or hereafter a part of the property. All replacements and additions shall also be covered by this Security Instrument. All of the foregoing is referred to in this Security Instrument as the " Property. " BORROWER COVENANTS that Borrower is lawfully seised of the estate hereby conveyed and has the right to mortgage, grant and convey the Property and that the Property is unencumbered, except for encumbrances of record. Borrower warrants and will defend generally the title to the Property against all claims and demands, subject to any encumbrances of record. THIS SECURITY INSTRUMENT combines uniform covenants for national use and non - uniform covenants with limited variations by jurisdiction to constitute a uniform security instrument covering real property. UNIFORM COVENANTS. Borrower and Lender covenant and agree as follows: 1. Payment of Principal, Interest, Escrow Items, Prepayment Charges, and Late Charges. Borrower shall pay when due the principal of, and interest on, the debt evidenced by the Note and any prepayment charges and late charges due under the Note. Borrower shall also pay funds for Escrow Items pursuant to Section 3. Payments due under the Note and this Security Instrument shall be made in U.S. currency. However, if any check or other instrument received by Lender as payment under the Note or this Initials: ® 4) 4(Wo (0005) Page 3 of 15 Form 3= 1/01 Parcel #: 030 - 1094- 20-000 05/12/2006 09:46 AM • PAGE 1 OF 1 Alt. Parcel # 32.30.19.343B 030 - TOWN OF SAINT JOSEPH Current , XI 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 0 - SUNDQUIST, THOS E & KATHLEEN THOS E & KATHLEEN SUNDQUIST 479 OLD E EAST HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): • = Primary Type Dist # Description * 479 OLD E EAST SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.000 Plat: N/A -NOT AVAILABLE SEC 32 T30N R19W PT SE NE BEGIN INT W LN Block/Condo Bldg: SE NE & S LN HWY E TH S 250 FT, E 500 FT TH N TO HWY, TH WLY TO POB Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 32- 30N -19W Notes: Parcel History: Date Doc # Vol /Page Type 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 04/26/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 91,200 111,600 202,800 NO Totals for 2006: General Property 3.000 91,200 111,600 202,800 Woodland 0.000 0 0 Totals for 2005: General Property 3.000 91,200 108,000 199,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 110 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ST. CROIX COUNTY ZONING OFFICE I� CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the 1 S .e el7 Gcr' "sz� residence located at: 5� 1 /4, / - /4, Section ,3 Z , To 30 N, Range _ W, Town of SZ' . jo - ' - a 4 , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of Comm. 84.25, and it (they) appear(s) to be functioning properly. Most recent date of service S /O Olp Did flow back occur from absorption system? Yes No (if no, skip next line.) Approximate volume oir length of time: gallons minutes Capaci O� c Construction: Prefab Concrete Steel � Other (' ufacturer if known): �rr Age of 'Tank (if known): LCr� � i icensed Plumber Signature) (Print Name) (Title) (License Number) PRS` (Dat Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) 6rk-