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Home My WebLink About032-2109-60-000 Wisconsin Department of Commerce y Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count St. Croix INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary t o: Personal information you provice may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: ❑ City ❑ Village ❑ T6Wn of: State Plan ID No.: Seaton, Steve Somerset Township r� CST BM Elev. - - ' Insp. BM Elev.: BM Description: Parcel Tax No.: GO r) s _ C`ST �dk 1 032- 2109 -60 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM �,e� 02 •sS Aeration Bldg. Sewer Holding St /Ht Inlet �p� X 16 Si TANK SETBACK INFORMATION St/ Ht Outlet F. z} 6.3� TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic ys,� 3 z' NA Dt Bottom -- r Dosing NA Header / Man. g,8 qS Aeration NA 94 t__ i Holding _ 1 = Bot. System PUMP / SIPHON INFORMATION Final Grade _ t JA E M facturer emand St cover _ Mode{ Num GPM TDH Lift L Ion System TDH Ft Forc In Length Dia. Dist. To SOIL ABSORPTION SYSTEM L� s k _ BED/TRENCH width Length No. renches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION 3 1i2 •S� a DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING Manufact _ �-, S di&.r..,.�,cQ�¢✓ INFORMATION Type CHAMBER M e Numb System: Z ( " I0 OR UNIT DISTRIBUTION SYSTEM Header / Mar Distribution Pi x Hole Size x Hole Spacing Vent To Air Intake r Length !!� Dia. Length Dia. Spacing 7 Liv SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over FBed h Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Tren ch Edges Topsoil ❑Yes ❑ No E] Yes E] No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: (I /29 Inspection #2: Location: 1758 46th Street Somer et, WI 5 O25 (NE 1/4 NE 1/4 6 T30N R19W) - 0530191024 Cedar Valley Estates -Lot 6 1.) Alt BM Description= - 1n�5 5�o� 2.) Bldg sewer length = 32, d' - amount of cover Plan revision required? ❑ Yes TO No ( z Use other side for additional infor ation. 12- 1S 2 SBD -6710 (R.3197) Date Inspector's Signature Cert. No. •� Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT P age I Of Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but St. Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 032-2017-30 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Mike Lundberg GOVT. LOT NW 1!4 NE 1v4,S5 T 30 N,R 19 for) W PROPERTY OWNERS MAILING ADDRESS LOT ff BLOCK # SUED. NAME OR CSM # ti CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE MOWN AREST ROAD t . -D x. MN. 5A0g2 (612) 436 -6172 Somerset 7 180th. Ave. Pc] New Construction Use [ A Residential /Number of bedrooms 3 ( ) Addition to existing building L I Replacement [ I Public or oommercial describe Code derived daily flow 450 gpd Recommended design loading rate .4 bed, gpd/ft .5 trench, gpd/ft Absorption area required 375 bed, ft 375 trench, ft Maximum design loading rate • 4 , bed, gpd/ft _ trench, gpd/ft Recommended infiltration surface elevation(s) 108.40 ^ ft (as referred to site plan benchmark) Additional design / site considerations _ system el . based on contour line of Ei _ l n7.40 Parent material pitted glacial drift Flood plain elevation, if applicable na ft S - Suitable for system CONVENTIONAL MOUND IN•GROLIND PR£SIURE I AT -GRADE SYSTEM IN FELL I HOLDING TANK U Unsuitable for sy stem OS EI U IRS ❑ U I 0S O u [IS p U O S C#u ❑ S F U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Botxffiry Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Sec Ttendh - .6 �Iaw 2 14 -33 10 r4 4 none sici 2msbk mfr gw if .4 .5 Ground 3 33 -60 5 r4 4 c2 7:i5 r4 6 scl icsbk mfi na na np .2 elev. 1 08.0 ft. Depth to limiting factor 33' Remarks: Boring # i? {N 1 0 -12 10yr3 3 none sii 2msbk mfr aw 2f .5 .6 2 i 2 12 -32 10 r4 4 none sil 2msbk mfr aw 1f .5 .6 .., Ground 3 32 -65 7.5 r4 4 none sci icsbk mfr n .3 1 08. Qt. MIN I Depth to limiting ; , 4I (j 19 factor + Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715 246 - 6200 Address: 1554 200th. Ave: New Richmo d W 44017 Signature: Date: 5 -2497 CST Number: m02298 PROPERTY OWNER eke Lundberg SOIL DESCRIPTION REPORT page 2 el 3 PARCEL I.D. # ,• Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundwy Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tmnch ,L3 2 11 -27 10 r4 4 none sici 2msbk m Ground 3 27 -54 7.5 r4/4 119M sci lcsbk M fK aw ifl .2 .31 elev. 1 Em• 4 54 -64 7.5 4 4 wet 81 lcsbk mfr na na Depth to limiting factor 54 1 Remarks: Boring # wx �v..•.tfi.. yy.. Ground elev. ft. Depth to limiting factor Remarks: Boring # -st Ground elev. ft. Depth to limiting factor Remarks: Boring # .v Ground elev. ft. Depth to limiting factor I STEEL'S SOIL SERVICE Gary L. Steel g Mike Lundberg 1554 200th Ave. CSTM2298 Somers New Richmond, WI 54017 MPRSW 3254 town of S canerset �dnoi s {715} 246 -6200 lot #6 -Cedar Valley Estates 1 "=40' BM.= top of SE lot stake @ el. 100 Alt. BM.= 1k" pvc pipe C el. 104.00 Z ur G 3 , AO ° 2 r � M or lob, 6f 2 A� Gary L. Steel 5 -24 -97 Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 lVisconsin Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not state owned.) Attach complete plans (to the county copy only) f e j er not less than 8 -1/2 x 11 inches in size. County State Sanitary Permit Number c tq re,Y� s application State Plan I. D. Number 340 32-2- I. Application Information - Please Print all Informati gik;-/ Location: Property Owner Name Property Location - 1 Q! T e p 1/4 AIZ 1/4, S 2 T ,N, 5 (or Property Owner's Mailing A dress S7 �':R(ilx i,_ Lot Number Block umber , City, State Zip Code r. / ,T one Number Subdivision Name or CSM Number II. Type of Building: (check one) ❑ City A 1 or 2 Family Dwelling -No. of Bedrooms: ❑ Village ❑Public /Commercial (describe use):_ P1 Town of ❑ State -Owned f Nearest Road 60 ? � X t 2 , $U r �re tnc i�q CC S Parcel T Number(s) ` III. Type of Permit: Check only one bo x on line A. Check box on line B if applicable) 5. 1 t o 2-4 A) 1. i4 New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System B) Permit Number Date Issued , ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) ONon- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch Elevation VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks _ _ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ VIII. Responsibility a ement I, the updersigne assume r esponsibility for installs n of the POWTS shown on the attached plans. Plumber's ame (print) Plumbe 's Sig �r (n slam MP /MPRS No. Business Phone Number r � I tuber' Address (Street, City, State, Zip C de IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) Approved ❑ Owner Given Initial Adverse S%Oarge Fee) Determination -1 P 0 - a'D w -R - ZAD X. Conditions of Approval /Reasons for Disapproval: - AA sC&c-4 " Ste. ' a,.s e,&,c0c0Qb. (��o..a,.9.,� — w.,l.ir,,, sQ� ..o��!P.�,a... -� � � p.� s r�e.c��,,.►.a� , `� IZM - f .� tu)o SBD -6398 (R. 07/00) e.A) ` 1,1 S 35 - a 3 X — .n - �� Xmel �,, Ok ��ew - z�Inqe % �� A ,c3 363 ; �-- - ms's ;� z- Se;.9 ��- �-`�s � w, �. •� i 5� G � �, s = L� 9 �- .. Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page I of 3 Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Emta! By 17r:s+:gu Attach complete site plan on paper riot less than 8% x t i inches n size. Plan must County include, but not limited to. vertical and horizontal refererwe point (13M), direction and percent slope, scale or €hmernsso north arrow, and location and distance to nearest road. _ $t. Croi��c ns, Parry l.D.# APPLICANT INFORMATION - Please print all information. Personal Worrraion you WmWe may be used #or seoo wbn pxpoeft fRwacy Low. s. 15.04 (1) (m)). v By Data Property owner Property Location Lunberg TYWc Govt. Lot N E 114 NE 1/4 S 6 1 30 NR 19 11 Property Owners Mating Addmess Lot # 1 l # ; Subd. Name or C•SW 2040 Oriole Ave. N 6 ' Cedar Valley Estates City State Zip Code PhoneNumber 1 city U Village Z 1 own Nearest Road Stillwater fviN 55082 Somerset. 19071 Av 1 New Construction : � Residential / Number of badrexum 3 1 Addition to existing budding Replacement n Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate 3 bed, gpdiw .4 trench, gpdAl Absorption area required 1500 bed, f1 1125 french, W Maximum design loading rate . bed, gpdifiiz .4 tr ench, gpdfiF Recommended infiltration surface elevalion(s) 93.5 & 96 It (as referred to site plan bent hmar Additional design / site consideration Parent material Mess Over Glacial Outwash Flood plain elevation, if applicable It S for sy�^tem � Conventional f Mound i In-Ground Pr re � AT-c i System In Fig a Holding Tank U= Unsuitable for system MS ❑ U I M s❑ U I ® S❑ U I M S❑ U I EIS M U I 1:1 S M U SOIL DESCRIPTION REPORT De th Dominant Color Mottles Structure GPD11F , Rfulnfl# Horizon I p 1 A /11nt all I 11 C� nn4 T I Texture I !`� z, Qh IConsistenc o Boundary I Roots ; _ 111. YIIWII tY. VL. CV IW WM VI. VL. VII. BW re it 1 I 0-6 I 1Ovr3/2 ( - ( sit I 2msbk I mfr I Sw I 2f I .5 .6 n nn �, r___.1 tr r •t I n,__ _t_t_ c_ i t L t c L I V -GL 1 /.JYIY /V d - i Jil I L!(lAVll { 11U.1 ( VW I LL Ground 3 1 22-49 ( 7.5yr3/4 i - I A � Om i mvfi I cw I - I .3 .4 3 elev 96.96 tt 4 i 4940 i 7.5yr414 i - i 1s l 2msbk i mfr i cw i _ i _7 .8 . Depth to 5 ! 60 -94 1 7.Syr3./4 i - I sl I Om I mvfi i _ i _ i _3 _4 .3 f -------- 1 k I B 1 A A >94 I I � I I I I I I Renrr;�r�5: ti -9 1i)yr3i1 - I sit Zmsbk mir I gw i zt s e I ,g 2 1 9 -19 ( 7 5vr4 /6 I _ I cil I 2mshk I mfr I cw I if I 5 6 . S' (jml irvl I env 3 I 19-48 I l.Syr3 %4 I - I rd 1 L I mfr 1 CW I - 1 .5 .6 i 1 I 1 1 1 1 R 1 99.26 fl 4 1 48 -92 I 7.5yr4/4 - I sl I Om 1 mvfi I - I - I .3 ? .4 , J Depth to L limiting i ; s i i I factw i >92 Remarks: CST Nan (Please Print) Signature: Telephone No. Thomm C. Nei-on 715 -246 -2454 Address Emir tat By Design Date CST (dumber Ref # 1432 120th Strect Neu Richnio sd,1, ] 54017 06102, 227387 293 LROPERTY OWNER: Lm h6ke SOIL DESCRIPTION REPORT I Page 2 of 3 PARCEL l.D.# Er.v*MMMw i• Dasi I D?pM I Dorninanit Cokw i Modies 1 AN i Horizon � � Boundary Roots I in. Munsefl Qu. Sz. Cont Color Texture Gr. SL Sh. on 1 I I Bad : Trench 3 I L V-10 LVY13/'Z. ;w I 2i L I j U 2 i 10-26 i 1 Ovr4/6 sfl i 2msbk i n* I cw i I f i .5 .6 Ground elev 3 i 26-90 i 7.5yr3/4 sl i Om mvfi .3 .4 99.06 ft Dep to I factor RemWs Ground elev Depth to limiting tacka Remarks: Ground &V Depth to limiting factor Ground elev L"ffi to limiting factor Remarks: 03/26,/1999 14:42 7152462601 TOM NELSON PAGE 02/02 w w C10 91" L L�- I � o To off` �?t.t LiL V tv 00 �' °Q�' Wi sconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page i of --3- Labor and Human Relations DiyWon of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. C roix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE v -9- PROPERTY OWNER: PROPERTY LOCATION Mike Lundbercf GOVT. LOT NW 1/4 NE 1/4,S 5 T 30 N,R 19 )E{or) W PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK # I SUBD. NAME OR CSM # 2040 Orinle Ave N. 6 C edar CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE NFOWN NEAREST ROAD t Ll . y�t_a X082 (612) 436 -6172 Somerset 180th. Ave. [xj New Construction Use [ x] Residential / Number of bedrooms 3 [ ] Addition to existing building (] Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate .4 bed, gpd /ft .5 trench, gpd /ft Absorption area required 375 bed, ft 375 trench, ft Maximum design loading rate _,gy bed, gpd /ft gpd /ft Recommended infiltration surface elevation(s) 108.4 ft (as referred to site plan benchmark) Additional design/ site considerations system el based on contour line of F.I. 107-40 Parent material pitted glacial drift Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem I ❑ S ] U 12 S ❑ U [IS ®U ❑ S Cam] U [Is UU ❑ S 0 U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # rHorizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Bax>dary Roots Bed Trench _ f 2f .5 .6 , 14 -33 10 r4/4 none sicl 2msbk mfr gw if .4 .5 Ground 3 33- 5 r4 4 c2 7 5 r4/6 scl lcsbk mf i na na np . 2 elev. 1 08.0 ft. Depth to limiting factor 33 Remarks: Boring # 1 0 - 10yr3/3 none sil 2msbk mfr aw 2f .5 .6 •S 2 12 -32 10yr4 /4 none sil 2msbk mfr aw if .5 .6 Ground 3 32 -65 7.5 r4/4 none scl lcsbk mfr na na .2 .3 � elev. 1 . qt. Depth to limiting factor +65 Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Ave. Richmond, _ WX 44017 Signature: Date: 5 -24 =97 CST Number: m02298 PROPERTY OWNER Mike Lundbera SOIL DESCRIPTION REPORT Page 2 '� of 3 f PARCEL I.D. # Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends 3 s 2 11 -27 10 r4 4 none sicl 2msbk mfr aw if .4 .5 .`f Ground 3 27 -54 7.5 r4/4 none scl lcsbk mfr Crw if .2 .3 •� elev. 106.00. 4 54 -64 7.5 r4/4 wet sl lcsbk mfr na na .4� .5 • `� Depth to limiting factor 54 " Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # ................. Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to , limiting factor Remarks: i SBD- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. ' CSTM2298 Mike Lundberg 4 NE 4 S5- T30 -R19w New Richmond, WI 54017 MPRSW 3254 town of Somerset (715) 246 -6200 lot #6 -Cedar Valley Estates " =40' �= p of SE lot stake C el. 100' Alt. B = 12" pvc pipe C el. 104.00' -2 10 E s� 3 , 4L m t ob' 2 pM Gary L. Steel 5 -24 -97 Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component. Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567 -P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number 3 4 932-2- Number of Bedrooms Design Flow - Peak (gpd) �aa Estimated Flow - Average (gpd) ov Septic Tank Capacity (gal) 6 0 Soil Absorption Component Size (ft Type of Wastewater Domestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septi and outlet filter shall be assessed at least once every 3 years by inspection. Th N utlet felt s hall be cleaned as necessary to ensur ro pper operation. The filter cartridge 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 Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole 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 one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 *' Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep- rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. 3 ST CROIX COUNTY SEPTIC 'TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer �L U� y R �e Mailing Address 1q70 70 Property Address (Verification required from Planning Department for new construction) City /State it ) Parcel Identification Number I �29 —I,� o LE GAI, DESCRIPTION Property Location ,a %4, t�f_ '/4, Sec. � T ,2P N -R_J W, Town of Subdivision �F�i �� F� , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # V81; kl� , Volume Page # Spec house ❑ yes [ rto Lot lines identifiable) yes ❑ no SYSTEM MAINTENANCE 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. The property owner agrees to submit to St, Croix 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 an(1/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 Zoning Office within 30 days of the three year expiration te. ,,��>> �V v SiGNAT OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge, I (we) am (are) the owner(s) of the property described above, by , n ue o - a warranty deed recorded in Register of Deeds Office. � 2l a& 0:0 SIIN, TU OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. ** Include with this application: a stamped v{ deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed vo .1536fut 404 628587 Warranty Deed REGIST O WELSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD This Deed, made between GEORGE HERIOT Grantor(s) 08"22-2000 10:40 AM and WARRANTY DEED EXEMPT M STEVEN D. SEATON AND MICHELLE R SEATON, CERT COPY FEE: HUSBAND AND WIFE Grantee(s), COPY FEE: TRANSFER FEE: 134.70 RECO(DINO FEE: 10.00 WITNESSETH, That the said Grantor(s), for a valuable PAGES: 1 consideration conveys to Grantees) the following described THIS SPACE RESERVED FOR RECORDING DATA real estate in ST CROIX County, State of Wisconsin: NAME AND RETURN ADDRESS Lot 6, Cedar Valley Estates in the Town of Somerset, five- St. Croix County, Wisconsin 032 - 2109 -60 -000 PARCEL IDENTIFICATION NUMBER This is homestead property . Together with all and singular the hereditaments and appurtenances thereunto belonging; And above named grantors warrant that the title is good, indefeasible in fee simple and free and clear of encumbrances except any easements, restrictions and reservations of record, municipal and zoning ordinances, and will warrant and defend same. Dated; �� .2000 (SEAL) (SEAL) Ge6rge Heriot (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(,) authenticated: April 9, 1999 State or Wluonsin, ) SS. 5T CROIX Courtly. ) Personally came before me on �/ 2000 the above TITLE: MEMBER ST;{°°a+r��,,6� WIS IN_ named George Heriot to b mown the peraon(s) who executed the forego en �d aclmo edged the same. (type or print) THIS INSTRUMENT WAS DRAFTED BY: otary Public, ST CROI County, Wisconsin. KRISTTNA OGLAND My commission is permanent. (If not, state expiration date HUDSON, WISCONSIN ft Warranty Deed This Deed, made between GEORGE HERIOT Grantor(s) and STEVEN D. SEATON AND MICHELLE R. SEATON, HUSBAND AND WIFE Grantee(s), WITNESSETH, That the said Grantor(s), for a valuable consideration conveys to Grantee(s) the following described THIS SPACE RESERVED FOR RECORDING DATA real estate in ST CROIX County, State of Wisconsin: NAME AND RETURN ADDRESS Lot 6, Cedar Valle Estates in the Town of Somerset, y St. Croix County, Wisconsin 032 - 2109 -60 -000 PARCEL IDENTIFICATION NUMBER • This is homestead property. Together with all and singular the hereditaments and appurtenances thereunto belonging; And above named grantors warrant that the title is good, indefeasible in fee simple and free and clear of encumbrances except any easements, restrictions and reservations of record, municipal and zoning ordinances, and will warrant and defend same. Dated: , 2000 (SEAL) (SEAL) Ge6rge Heriot (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) authenticated: April 9, 1999 State of Wisconsin, ) \ C\ ) SS. ST CROIX County. ) 2 TITLE: MEMBER ST S $ Personalty came before me on '0 /2000 the above r ; named George Herlot to own the person(s) who executed U ' ` 't- the forego' en d ackno edged the same. THIS INSTRUMENT WAS DRAFTED BY: o scon OGLAND tary Public, ST CROI. County, Wisi (type or print) n. HUDSO N, , WISCONS IN My commission is permanent. (If not, state expiration date:: HUDSON, i S88 0 24'14 "W 429.00' LIS tK W Y ( 874.5) m p 1 1 a J� � 1 � `�-- -L4 —.� O 3.44 ACRES 8 149,782 SO. FT, \� W s N \ 'E 3,33 ACRES � m EXC. R/ W 1 44,945 S0, FT. Z O }n fn F" U u U- A O N 8 W ? — J � 4 ►_- 6 6' O W n 3.20 ACRES-G5- /— GI - ri 139,293 SO FT / \ z I �ry C� �O (`80.4) H3 ' r� L �� .J .T_ H4 3.00 AC, EXC. R/W d �ro .) `• 130,758 SO. FT. ^ 3.52 ACRES 0 ✓\ \ �// =` 0 0 1 53, la' SG. F r. C, ✓ n• / / H6 \ l( 879.1) N88••28 "E p\� N 60.82' � 49 TEMPORARY - \ X3 3 ,, (TO CUL-DE-SAC EASEM ENT \ \ 8E REMOVED UPON EXTENSION 2 ?� ` OF ROADWAY) 3e� 99 51 2 •eF/ — 3 i V � SCALE IN FEET 100' MA TCH, 0 100 200 300