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HomeMy WebLinkAbout032-2028-80-150 ,i Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix and Building Division INSPECTION REPORT Sanitary Permit No: 499255 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: Rocky Rentals LLC I Somerset, Town of 032 - 2028 -80 -150 CST BM Elev: Insp. BM Elev: I BM Description: n Section/Town /Range /Map No: / 60 OV 1 CST 07.30.19.576A30 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV. Septic ' e. � Benchmark ti 75 7 Dy �S t Bosing f- Alt. BM Y/ �°r✓ '1 g� F'a.r.� �� C oJaA 3 4 z Bldg. Sewer S. �7 Z K rk C r7 5 Z5 Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet '17 T 3Z TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet �. 73 *1_7 O Z Septic Dt BQtern r 1 lQ . 7$ Dosing ) /6D Header /Man. /Se' Z,y 3 ' �f. l5 Aeration 5LV Dist. Pipe fit\ /b. Otc � � Holding Bot. System /I. Z2 13.53 PUMP /SIPHON INFORMATION Final Grade Y.2 Manufacturer Ge S� J Ca 3 too . y Model Numb i ) 7, 15 c? - 7 TDH Lift Friction Loss System He TDH Ft Forcemain th Dist. to Well SOIL ABSORPTION SYSTEM / Vl\ BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS .j re ", SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION Ty Of System CHAMBER OR YP Y r �, o , 3 y /$e oj� UNIT Model Number. J Co,n u C r a DISTRIBUTION SYSTEM Sc l on /6h C�t4,• s' �� �� G 4 �^-( �/� Header /Manifold $ I Distribution x Hole Size x Hole Spacing Vent to Air Intak Pipe(s) s a� F, Length 3�' S Dia Length Dia \ Spacing ` ` - 77e c,L a.A 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 6 L 12- Bed/Trench Edges Topsoil .,-Yes No Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 314 Old Scout Camp Rod Somerset, WI 54025 (SW 1/4 SW 1/4 7 T30N R19W Lot 1 Parcel No: 07.30.19.576A30 Ffo rm4- a� GaJt,�. Z GoJ 1.) Alt BM Description = � 2.) Bldg sewer length = 5 3 - amount of cover Plan revision Required? ; Yes i o Use other side for additional information. , L to _1 — _' -- _ 4 Insepctor's gnature Cert . No. SBD -6710 (R.3/97) Safety and Buildings Division County 201 W. Washington Ave., F.O. Box 7162 isconsin Madison, WI 53707 — 7162 Sanitary Permit Num er (to be filled in by Co.) De artment of Commerce (608)266 -3151 � ZSS Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you pr&vide / 3 3 �, 7 (p U maybe used for secondary purposes Privacy Law, s15.04(I xm )M Project Address (if dillll M than mailing address) I. Applies ' for a-P] M P P ' V 3 / 1 IX �jt-du f Property Owner's Name j / Parcel # Lot # Block # O V 0 ,� 200 v Property er's ing Address d Property Location ST. CROIX COUNTY City, State ne umber '�-- `/4��/,, Section E II. T appl e of Building T 1� N; R E 7 Type g (check all that ❑ 1 or 2 Family Dwelling — Number of Bedrooms hem Name CSM Number Public /Commercial — Describe Use r — / ✓o Z Z - �t; ❑ State Owned Describe Use Ll &4 r&J (�-1 r�J,{ (,� `Y „ Q � ❑City ❑ Village.�Township of III. Type of Permit: (Check only one bog online A. Complete line B if applicable) A. ❑ New System .Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B• ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit �7 and a Before Expiration Plumber Owner IV. Type of POWTS System: Check all that a pply) X Non — Pressurized In- 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 F" Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter hin Ch r Drip Line ❑ Gravel - less ipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) , Design Soil Application / Rate(gpdsf) I Dispersal Area Proposed (sf ) System Elevation r VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel I Fiber Plastic Gallons Gallons of Units / // Concrete Constructed Glass Now I Tanks Talcs Existin (�/ /6 PL SZ Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement I, the undersigned, apsume responsibility for installation of the POWTS shown on the attached plans. Plumbe 's ame Print) Plumbe 's S' ✓� MP/MPRS Number Business Phone Number Plum er's ddress (Street, Cityjlate, Zip ode VIII. un /De artment Use Onl Approved Disapp Sanitary Perm Fee (includes Groundwater Date ued Issui gent Sign (No ps) i en Reason ­ for Surcharge Fee IX. Conditions of ApprovaUReasons for Disapproval SYSTEM OWNER: 1. Septic tank, effluent fitter and dispersal cell must all be SMIOes / maintained as per management plan provided by plumber. Z. AN sstback requirements must be maintained as per applcable code / ordWown. Attach complete plans (to the County only),for the system on paper not leas than 81/2 x 11 inches in size SBD -6398 (R. 01/03) eke ksr C .4P i !3f `� + i. 7 � f r + I j I 1 _ z COPY fir 4 inC j ( I j.3 i3i,,3 3 I , L e /�10��?5F✓� I I f Wisconsin Department of Commerce EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Ws. Adm. Code County Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Revie by Date Personal information you provide may be used for secondary u rivacy Law, s. 15.04 (1j (m)). Properly Owner 0 %: j Property Location Govt. Lot 1/� 1/ S 7 T N R /(ori Property Owner' Mailing Addres Lot # Blo Subd J�lame or CSM# � NOV o 3 200 /,! City Ste p Code (W� ❑ City ❑ Village J$f own Nearest Road ST. CA 7J- ❑ New Construction Use: ❑ Residential J Number of bedrooms Code derived design flow rate GPD (� Replacement Public or commercial - Describe: Parent material Flood Plain elevation if applicable ft. General comments and recommendations: rU re " v? © Boring # ❑ Boring �] pit Ground surface elev. �9, l ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fh in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Efr#1 *Eff#2 11 Boring # El Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDN in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "Eff#2 -- i l4 * gent #1 = BOD > 30 220 mg /L and TSS >30:5 150 gIL * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST le ig CST Number Address Date Evaluation Conducted Telephone Number - M t r Property Owner Parcel ID # Page of F-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application 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 F Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application 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 F-1 Boring # ❑ Boring G ❑ Pit round fae elev. Depth t limiting ft i surface . epo mng acor n. Soil Application 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 * Effluent #1 = BOD > 30:5 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = 800 < 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. san-M0 rx.o7100> Aps e • r— Safety and Buildings 4003 N KINNEY COULEE RD commerce.wi.gov LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 isco www.commerce.wi.gov /sb/ www.wisconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secret October 30, 2006 CUST ID No. 224263 AT77V: POWTS Inspector KIM A O CONNELL ZONING OFFICE K.O. CONSTRUCTION ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA Wl 54020 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/30/2008 Identification Numbers Transaction ID No. 1336768 SITE: Site ID No. 105 Rivard Stone Please refer to both identification numbers, 318 State Hwy 35 & 64 above, in all correspond nce with the agency. Village of Somerset, 54025 St Croix County; Fire Dept ID: 5503 FOR: Description: In- ground Non - pressurized / Commercial (Retail) / Chambers Object Type: POWTS Component Manual Regulated Object ID No.: 1104338 Maintenance required; Replacement system; 489 GPD Flow rate; 94 in Soil minimum depth to limiting factor from original grade; System: In- ground POWTS Component Manual, SBD- 10705 -P (N.01 /01); Commercial System, Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, CO 2 P stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders'" °I • This system is to be constructed and located in accordance with the enclosed approved plans and with the SLE component manuals listed above. • The leaching chambers must be installed in accordance with the manufacturer's printed instructions, the plan approval and Comm 83, Wis. Adm. Code system sizing criteria. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence. • The plumbing for this project discharges to a private sewage system. The approval covers only domestic /sanitary wastes directed into this system. The Department of Natural Resources must be contacted regarding the treatment and disposal of all industrial wastes. Garage floor drains are not domestic waste. • State and federal regulations prohibit the discharge of hazardous wastes to a private sewage system. Accidental discharge of any hazardous substance to a private sewage system must be reported to the Department of Natural Resources or the Wisconsin Division of Emergency Government. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c KIM A O CONNELL Page 2 10/30/2006 • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department which may include local inspectors Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation /operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 10 1. nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 ( D Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday charlie.bratz@wisconsin.gov cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 C9 o W > = aq 06 a: of 5 L A 64/!.'ejr 1 1 14,1 OF iEy INGS y LSPONOENCE ZkZ le 3 9 s. 7 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page — ,:fof (� FILE INFORMATION SYSTEM SPECIFICATIONS Owner i Septic Tank Capacity _ g DNA Permit # Septic Tank Manufacturer — ,- S ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms 14 NA Effluent Filter Model ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity a l 151 NA Estimated flow (average) g al/day Pump Tank Manufacturer JS NA Design flow (peak), (Estimated x 1.5) al /da Pump Manufacturer 0 NA Soil Application Rate , al /da /ft2 Pump Model J15 NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit JR NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L - ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L fid in- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L NA ❑ At -Grade ❑ Mound Fecal Cotiform (geometric mean) 510" cfu /100m1 ❑ Drip - Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank ❑ month(s) s) At least once every: ear(s) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y3) of tank volume ❑ NA inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA _. ? ,D' years) Clean effluent filter At least once every: ❑ month(s) ❑ NA td year(s) Inspect pump, pump controls &alarm At least once every: ❑ month(s) NA ❑ year(s) Flush laterals and pressure test At )ease once every: 13 month(s) M NA ❑ year(s) Other: At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) j • Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cellis) in one large dose, overloading the collie) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the um tank removed b a Se tae Servicing Operator prior to restoring P P Y p g 9 P P i power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products, pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect . at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the j infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < < WARNING > > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT I ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER/ c POWTS MAINTAINER Name Name Phone ,J Phone S EPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name 1 Phone Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, 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 not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road.. Please print all information Reviewed by Date Persona( information you provide may be used for secondary purposes (Privacy law, a. 15.04 (1) (m)). Property Owner Property Location Govt. Lot 1/ 1145 1/4 S 7 T N RorIV, Property Owner' Mailing Address Lot # I Blo Subd (Name or Cam / �. City State Zip Code Phone Number F1 City ❑ Village awn Nearest Road ❑ New Construction Use: ❑ Residential / Number of bedrooms Code derived design flow rate GPD 0 Replacement Public or commercial - Describe: f ' -- Parent material Flood Plain elevation if applicable AX ft. General comments � and recommendations* eA Tom' f,/��cfil A'C' 44E rs (' Boring # n � Boring {zSi Pit Ground surface elev. 9 ft. Depth to limiting factor y, in. Soil Application 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 �. n Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor _ in. Soil Application 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 elmj * uent #1 = BOD > 30 < 220 mg/L and TSS >30 a 150 g/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST le ) ig CST Number Address Date Evaluation Conducted Telephone Number - - - �� � � 1 �,"' ���� i � / � L �_ (� � j/� f';N r i , � y� i � i 5��:�x n { ,�, �Y � j _ _-� '�� :��- � , � l ';- i �` ( �. � � ` ���� c L �� f I /' w �. / / I( � �� �� / /�J1 ��1 4 ji1 C Su'� /)• / G6`G/K"1 - �� /�.� � l � 1 // r _ . .- i �- -- - STATE BAR OF WISCONSIN FORM 3- 1998 A 3 9 3 g 6 QUIT CLAIM DEED KATHLEEN H. WALSH REGISTER OF DEEDS Document Number ST. CROIX CO., WI _ - - - =_= _�--- -- - - -- ------= _ ------ == - -- - -- RECEIVED FOR RECORD This Deed made between Lowell P. and Virginia L. Rivard, husband and wife as survivorship 11/22/2006 02:40PM marital property, f AUIT CLAIM DEED Grantor, EXEMPT # 8 and — _ P, ocky Rentals, LLC, f REC FEE : 11.00 TRANS FEE: COPY FEE: Grantee. GC FEE: i PAGES: 1 Grantor quit claims to Grantee the following described real estate in St. Croix —_ County, State of Wisconsin'. Hecording Area ' I Name and Fetum Address Lot 1 and Outlot 1 of Certified Survey Map Stephen J. Dunlap recorded in volume 21, Page 5192, being a DUNLAP LAW OFFICES part of the Southwest Quarter of the Southwest 600 Third Street Quarter of Section 7, Township 30 North, P.O. Box 129 Range 19 West of the Fourth Principal Meridian, Hudson, Wisconsin 54016 Town of Somerset, St. Croix County, Wisconsin. D - 2o2 - 8o - i30 C 3 32 - za - a Parcel Identification Number (PIN) This _ �G no#' homestead property. I� (is) (is not) i � iI f iI I � 1 i t Together with ail appurtenant rights, title and interests. Dated this 2 0 th day of November 2006 I II i i SEAL —(SEAL) LOWELL P. RIVARD (SEAL) - , (SEAL) VIRGI IA L. RIVARD - AUTHENTICATION ACKNOWLEDGMENT Signature(s) --- -- State of i��9�95�1 4 . ARIZONA lI ss. 122 �� r 9/�FT County. authenticated this day of _ __ -_ Personally came before me this _ `� O day of A"p V 2006 , the above named `( Lowell P and Virginia TITLE: MEMBER STATE BAR OF WISCONSIN �� ARt/ to II (If not, LjAF4j`'0#44j00LJNjWbe the person S who executed the foregoing authorized by X706.06, Wis. Stats.) MY pdm fJWckn ledge the same. 1 lNuglu THIS INSTRUMENT WAS DRAFTED BY STEPHEN J. DUNL.AP � f Notary Public, State i7��� Hudson Wisconsin My commission is permanent. (If not. state expiration date: Signatures may be authenticated or acknowledged. Both are not ecessary) Names of persons signing in any capacity must be typed or printed below their ignat 1 STATE BAR OF WISCONSIN Wisconsin Legal Stank Cc_ In.. UIW(01IAIM DEED FORM No- 3 - 1998 Milwaukee. Wis. �I 6 2 3 1 3 5 VOL 21 PAGE 5192 KAWILEEiI K. REGISTER OF DEEDS ST. CROIX CO., VI RECEIVED FOR RECORD 04/18/2006 11:30AK CERTIFIED SURVEY MAP N0 yrF,1,Fo ;R 6Y 11AP A parcel of land located in the Southwest Quarter of the Southwest Quor=9- egt3on , Township 30 North, Range 19 West of the Fourth Principal Meridian, Town of Somerset, St. Croix County, Wisconsin. . , I NOR7H uNE OF OUILOT /. ST. ORUX CO. LER7IFIED 527RVEY Iy7 1 - -NEST uNE OF LOT A ST. CRUX CO. CERTIFIED SURWY MAP F 3 MAP RECORDED AN N.Y. 12. PC. J48. DOC. NO. SB2 472- - - RECORDED IN VOL 72. PC. 3462, DOC: NO. 562472 y o, NW CORNER Or OUTLOT 1. ST. CRUX CO. �^ O / ^ -r) 3 � ;; ' C£RAFTED SURVEY MAP RECORDED /N - o I' 7, - - 204 SQUARE FEET OU TL O T 1 -r .- - - , ,, , n VOL. 12, PC J462. DOC. NO. 582472• - , /' � o, l , � J ` gH N *zr�E � ,' (S '37 =.' ���` ' r. -r -r, 1 n n 1T� 40 .3 7" ` V�j/ ( SOQ'' L4�t� -_LZ3L /8, ps` =E 66•p0 3 S7I ; -NW CORNEA O 1 0 D 6 '1 - F LOT 1 ST. CRUX x S89 29'3 p E Z90.8 CERAF7ED SURVEY MAP REDO POED W VOL. 4, PC. 956, DOC. NO 364885 C �J; : zn 93 4 -I �� ( : '. -- S89 48'04"'E 264.95 - - - -- --' _ 5 y I � LIJi ► rte, I OwLORNC ;` ''- ��; Li j I ' NOQ7N LINE OF LOT 1, ST. CROIX CO crRAFT£O SURVEY MM RECORDED 11v 1 $ cy 1 I r � VOL. 4. PC. 956. DOC Na 364885- j - � n ♦ ` I CIA I N£ CORNER U" LOT 7, Sr. CROIX CO. L' n; CFJ£D SURVEY MAP RECORDED 1N \ i, - 1 k l I ERO Nx. 4. PC 956. DOC NO. J64&U- -' � N m J -�I .-� CS "r 1 `� N J I L J p,FZE r J r w� '� .. , oe 6-3 z 6J 3 102 I �► ; 'tea % ) fl I VAC.t7E0 fiC04i".GMP; ROAD--Z' �+ J1 bl a SETBACK LINE-, n � - RlG7iT -lY -WAY LINE OLD SCOUT , � a4'MP -' � ROAD N8 " 657.36 �Q 1� ' nea ia;y • SE CORNER OF THE SW 714, ' 66 FOOT PACE JI UME I OF WAY PER , SEC 7. T. JO M. R. 19 W--- ' C.SM. NXUME 1? J4412 -' �. 50V 7H VAE OF SEC 7, T. JO N., R. 19 w. - - -'' - - RICNT -OF -WAY uNf PER NTOOT Bearings are based on St. Croix County Coordinate Grid (NAD 83)• RXWT - OF- WAY MAP PRO.ECT (N8946'10 "E) Denotes "record" bearing LEGEND (38.81) Denotes record" distance O FOUND CAST IRON MONUMENT • FOUND IRON MONUMENT GENERAL ZONING NOTICE STATEMENT FOUND WISCONSIN D. 0. T. ALUMINUM "The parcels shown on this map are subject DISC RIGHT —OF —WAY MONUMENT to State, County, and Town laws, ru and 0 FOUND NAIL IN PAVEMENT regulations. (i.e. Wetlands, minimum lot size, O DENOTES 1"x 24" LONG IRON access to parcels, etc.) Before purchasing or N RE —BAR WEIGHING 1.68 LBS/ FT. developing any parcel, contact St. Croix WITH R.L.S. CAP 7 ¢' S -2287 County Planning and Zoning and the town for 0 100 200 advice. " OWNER SCALE IN FEET: 1" = 100' MIKE RIVARD EGAN, FIELD, 84 NOWAK, INC. 318 HIGHWAY 35165 U "SURVEYORS SINCE 1872" HOUL TON, WI 54082 741 5 WAYZATA BLVD, MINNEAPOLIS. MINNESOTA 55426 PHONE: (952) 546 -6837 FAX: (952) 546-6839 1 ,$HEET 1 OF 2 Fl FAD WEB: EFNSURV & NO M r ,� COPYRIGHT O 2006 By ECAN, ELD At NOWAK. INC. Vol 21 Page 5192 ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the se i t nk presently serving the , � 9,} 2 „) .x- E ee ud e ocated at: _ --a _ ;, Section —� T _,_ N, R _L,9_ W, Town of y r�cf . Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced: Did flow back occur from absorption system? Yes ! _X No (If no, skip next line) Approximate volume or length of time: gallons minutes Capacity: Construction: Prefab Concrete Steel Other Manufacturer: (If known) : l t /, /-36 Age of Tank (If known) • ��s�nl��° S fleAJ (Signature) (Name) Please print (Title) (License Number) Date Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR 83, Wis. Adm. Code (except for inspection pening over outlet baffle). t n� Name Signatu MP /MPRS J� 3 0 10 20 40 937.0 EXIS TING BUILDING !e 11) in 4W z C3 d < .1 CL 0.10 If: I PROPOSED BUILDING AM71TION OVERHEAD DOOR LOCITIDN 60' X 702 GRADE TO FLOOR ELE ATION 4320 SF 937.5 in TW 937 z z F�66R .0 ELEVATION 940.0 z d V) C o. z Z 0 . TW 939 5; z o 0 3 < in BW Ln 0 - cn T -,%3 TW 939 DETENTION BAST IN z 936 Bv 9 w w NWL W 93 W 20 > O HWL = 936,! It LF 18 RC PIPE ir .,c o TTOM AREA 1370 '%F Q. 0 - 0 OUTLET CO T40L to IF STRUCTURE i (SEE DETAI QRIP RAP 9i3 ; OF BERM ELll = 93J SIF rE i° R ' >P END RI P R 9 OF PIPE I P A E STING Raw 0 A SEED. 12 AREAS - ERTILIZE ALL W EA Ind zw CLASS 1 TYPE t. > z E- z CA. A * 7 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER A, L 2 ADDRESS ?Z9 SUBDIVISION / CSM# LOT SECTION w Z N -R ,/ W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 7 19' s / _ . sr — �s INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. F BENCHMARK: ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: li.>r_es Liquid Capacity: Setback from: Well House 1 Other Pump: Manufacturer Model# Size Float seperation Gallons /cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: Length Number of trenches Distance & Direction to nearest prop. line: Setback from: well: 2&2,.b_ House L' Other ELEVATIONS Building Sewer ST Inlet. 97C/ ST outlet PC inlet PC bottom Pump Off Header /Manifold Bottom of system _9 Existing Grade Final grade DATE OF INSTALLATION: - PLUMBER ON JOB: , LICENSE NUMBER: INSPECTOR: 3/93:jt L N�'�S t f*�t#etY.7.30.19W PMVA►TET4EVM16sESYSTEM county: LLa orand Human Relations Safety ag,d'Buildings Division INSPECTION REPORT (ATTACH TO PERMIT) Sanitar rmit GENERAL INFORMATION Permit Holder's Name: ❑ City ❑ Village ❑ Town of: State PI X Insp. BM Elev.: BM Descriptio Parcel Tax No.: TANK INFORMATION ELEVATION DATA A- 9400114 $ 2� TYPE MANUFACTURER CAPACITY STATION BS HI FS ELE . Septic ,2 C , r f car Ovv ,cam✓ Benchmark Dosin '/ i Aeration Bldg. Sewer 7 3/ 97 77 D Holdi St/ Inlet y 7 1 . TANK SETBACK INFORMATION St/ Outlet ,6z� ZO TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic ��� j�j' �� NA Dt Bottom Dosing NA Header- Aeration Dist. Pipe x'71 Holding_ _. Bot. System 9.418 PUMP/ SIPHON INFORMATION Final Grade Man urer Demand p s , � �j Zo 99, 9a 0 Model Number GPM TDH Lift Friction TDH Ft Forcemain Dia. Dist. Toweu3 /,/ SOIL ABSORPTION SYSTEM BED/TRENCH width _ i Length i f Trenches P o. Of Pits Inside Dia. epth DIMENSIONS S No. O DIMENSION anufacturer: SYSTEM TO P/ L BLDG WELL LAKE /STREAM LEACH S ETBACK MBER INFORMATION Type O n Mod Number: System: �✓�n ��, S/ 5/� OR UNIT DISTRIBUTION SYSTEM Header /Manifold �/}- Distribution Pipe(s) ' x Size x Hole Spacing Vent T Length Dia.' 1 �" Length _-�= Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade S Only Depth Over i/ , Depth Over , rs xx Depth Of -... xx Seeded/Sodded xx Mulched Se�Trench Center -3�f .B�YTrench Edges � - 3 Topsoil ❑Yes ❑ No ❑Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Somerset.7.30.19W, SW, SW, Lot A - n ;tc..± c� I . •a ya... c-` r fit'`'`' -C O Plan revision required? ❑ Yes L� -J'ryo Use other side for additional information. A =Z SBD- 6710 (R 05/91) Date Inspector's Signatur Cert. No. ( — fir — SANITARY PERMIT APPLICATION ' u O&HO In accord with ILHR 83.05, Wis. Adm. Code COUNTY STAT ANITARY PERMIT # — Attach complete plans (to the county copy only) for the system, on paper not less than C heck 0 99 1 8% x 11 inches in size. 1:1 ck if revision to previous application —See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER I. APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION. PROPERTY WNER PROPERTY LOCATION % '/4,S Tye ,N,R 9 g(Or PROPERTY OWNE MAILING ADDRESS LOT # BLOCK # CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER II. TYPE OF BUILDING: (Check one) ❑ State Owned VILLLLAGE NEAREST ROAD ® Public El or 2 Fam. Dwelling -# of bedrooms — A Ax NU ( Ill. BUILDING USE: (If building type is public, check all that apply) 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility /Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 JZ Merchandise: Sales /Repairs 11 ❑ Restaurant/Bar /Dining 4 ❑ Church /School 8 ❑ Mobile Home Park 12 ❑ Service Station /Car Wash 5 ❑ Hotel /Motel 9 ❑ Office /Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1.� New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit # — Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12, Seepage Trench 22 El In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gal /d y /sq. ft.) (Min . /inch) ELEVATION Feet Feet VII. TANK CAPACITY Site INFORMATION in allons Total # of Manufacturer' Con- Steel Prefab. Fiber- Exper. New istin Gallons Tanks s Name oncret glass App App Tanks Tanks structed Sep tic Tank or Holdina Tank 18,51n Q Lift Pump Tank/Siphon Chamber 11 �� El I L1 n F _ EL VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installs on of the onsite sewage system shown on the attached plans. P 's Name (Print): Plumb is gn re: (No ps MP /MPRSW No.: Business Phone Number: / �� 9/ PILIm be 's ddr Street, City, Sta e, Zip Co7 / / .E 1JT IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitajy Permit Fee (includes Groundwater Date issued tQB i g Agent Signature (No Stan) Approved ❑Owner Given Initial Surcharge Fee) / A Determination X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD -6398 (formerly Plb -67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS ; 1. A sanitary permit is valid for two (2) years. 2. .Your sanitary permit may be renewed before the expiration date, and a' the, time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authori'y 4. Changes in ownership or plumber requires a Sanitary Permit Transfer /Fern+ wal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly rn-� +taiF;ed. The ser tic tanks; rr .;t be purr ped -by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your vocal code aoministrator-or the - State of Wisconsin, Safety & Buildings Division, 608 - 266 -3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description +d parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete ## of bedrooms 4 1 or 2 Family Dwelling. III. Building use. if building type is Public, check all appropriate boxes that appl; . IV. Type of permit. Check only one in line A..Comptete line B if permit is for tangy replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1 -7. VII. Tank information. Fill in the capacity of every new and /or existing tank, list t e total gallons, numbEir of tanks and manufacturer's name.. Indicate prefab or site constructed and tank material. Corplete for all septic, pump /siphon and holding tanks for this system. Check experimental pproval only if tanks received experimental product approval from DILHR. VIN. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County /Department Use Only. X. County /Department Use Only. Complete plans and specifications not smaller than 8'% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with comple °e dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers, wel' water mains /water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption aystems; replacement system areas; and the location of the building served; B) horizontal and vertical cle 'ion reference points-, C) complete specifications for pumps and controls; dose volume; elevation dAerences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section c': the soil absorption system if .required by the bounty; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number c regulated practices which'can effect groundwater. The monies collected through these surcharges are used for monitor;ng gro , aV Ver, ground - water contamination investigations and establishment of standards. SBD -6398 (R.11/88) SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations April 19, 1994 2226 Rose Street La Crosse WI 54603 KO CONSTRUCTION RR 1 BOX 105 STAR PRAIRIE WI 54026 RE: PLAN S94 -40180 FEE RECEIVED: 110.00 RIVARD, MIKE SW,SW,7,30,19W TOWN OF SOMERSET COUNTY OF ST CROIX NON- PRESSURIZED IN- GROUND SYSTEM The Department has reviewed the above - referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters ILHR 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter ILHR 82 or in chapters ILHR 50 -64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sincerely, Prardm Plan Reviewer Section of Private Sewage (608) 785 -9348 3470R/ 1 SBD -6423 (R. 01/81) WisF Department of Industry PRIVATE SEWAGE SYSTEM Safety and Buildings Division Labor and FKiman Relations REVIEW APPLICATION Bureau of Building Water Systems Hayward Office La Crosse Office Madison Office Shawano Office Waukesha Office 209 W 1 st Street 2226 Rose Street 201 E. Washington Ave. 1053A E. Green Bay Street 401 Pilot Court, Suite C Rt 8, Box 8072 LaCrosse, WI 54603 P.O. Box 7969 P.O. Box 434 Waukesha, WI 53188 Hayward, WI 54843 Phone (608) 785 -9334 Madison, WI 53707 Shawano, WI 54166 Phone (414) 548 -8606 Phone (715) 634 -4804 Fax (608) 785 -9330 Phone (608) 267 -5119 Phone (715) 524 -3626 Fax (414) 548 -8614 Fax(715)634 -5150 Fax(608)267 -0592 Fax(715)524 -3633 INSTRUCTIONS: To save time, schedule your review with one of the offices listed above prior to submittal. Fill in all applicable data and submit this form together with fees and plans/information. Your submittal must be received at least one working day prior to the appointment at the office where your review was scheduled. Please call any of the listed offices if you need help filling out the form or have questions on what information to submit. PLEASE PRINT VERY CLEARLY. A s a mple of a completed form is on the reverse side for your referent /1 ® a I Q4 1. APPOINTMENT INFORMATION - if you have scheduled an appointment, fill in the information requested below to save time: Appoint ent Date Revie er Name Plan Identification Number -._ 2. PROJECT INFORMATION If this review is a revision or extension to your existing plan identification number, provide that number here: Project Name J . City E] Village ® Town Of: County Project Location GOVT. LOT 1/4_S" � 1/4,S T N R or QL / 3. APPLICATION FO 4. FEE COMPUTATIONS FEE SUBMITTED System Type (check one): System Type t (include new and existing tanks) Up To 1,500 gallon septic tank .................. $110.00 ........ A At -Grade 1,501 - 2,500 allon se tictank $120.00 ........ H Holding Tank 2,501 - 5,000 gallon septic tank $160.00 ........ M Mound 5,001 - 9,000 gallon septic tank .................. $200.00 ........ N ® Non - Pressurized In- Ground (conventional) 9,001 - 15,000 gallon septic tank ............ . ..... $ 300.00 ........ P Pressurized In- Ground Over 15,000 gallon septic tank .................. $ 500.00 ........ O Other: Up To 1,000 gallon dose chamber ............... $ 70.00 ........ 1,001 - 2,000 gallon dose chamber ............... $ 80.00 ........ Building Type (check one): 2,001 - 4,000 gallon dose chamber $100.00 ........ 4,001 - 8,000 gallon dose chamber ........... I ... $120.00 ....... . D E] Dwelling, 1 or 2 Family 8,001 - 12,000 gallon dose chamber ............... $140.00 ....... . P IM Public Building Over 12,000 gallon dose chamber ............... $160.00 . , ..... . S rD State -Owned Building U To 5,000 gallon holding tank $ 60.00 5,001 - 10,000 gallon holding tank $100.00 ....... . Code Derived Daily Flow gpd Over 10,000 gallon holding tank ................ $150.00 ....... . E] Check If Replacing Existing System Experimental System (additional one time fee) .... $300.00 ........ Revisions To Approved Plan 2 .................... $ 60.00 ........ Petition For Variance: Setback .................. $100.00 ........ -w Site Evaluation ......... , .. $225.00 ....... . Petition For Variance Plumbing $225.00 ........ Revision .................. $ 75.00 ........ Groundwater monitoring FiXEIVE D Groundwater Monitoring - Per Site ............... $ 60.00 ........ (other than a proposed subdivision) Q Site Evaluation in Lieu of t Groundwater MonitorinAPR 1 e Site Evaluation in Lieu of Groundwater Monitoring $ 60.00 ........ ' at BM. DW Subtotal: ......... � ao Priority Review: Enter same amount as Subtotal: ........ / %/J MAKE ALL CHECKS PAYABLE TO: SAFETY AND BUILDINGS DIVISION Total Fee: ...... Alg2 _ 5. SUBMITTING PARTY INFORMATION Telephone No. (include area code & extension) Com ny Nam 7COnt#tPer on , ( ) _ No. & treet Address Or P.O. Box City, To n or Vil age, State, Zip Code Aerobic or prepackaged treatment system fees are calculated based on equivalent size septic tanks and dose chambers. 2 Revision fees are not applicable to temporary holding tanks or extensions to existing approvals. NOTE: Fees are pursuant to Wis. Adm. Code, Chapter ILHR 2, and are subject to change annually. SBD -6748 (R. 03/93) OVER — �� Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page L of LAbw and Human Relations division of § afety & Buildings in accord with ILHR 83.05, Wis. Adm. Code r � ! " Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but i not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or / f�-.A C, ��� dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION REVIJrWDBY ?;6, 8 TE PROPERTY WNER: PROPERTY LOCATION ' GOVT. LOT 1/4 " '' q,g; l ' ; ,N R(or� PROPERTY OWNS ':S MA I G ADDRESS LOT # BLOC # I SUBD. ,ABM CITY STATE ZIP CODE PHONE NUMBER ❑CITY VILLAGE ®TOWN ROAD New Construction Use [ ] Residential / Number of bedrooms [ ] Addition to existing building [ j Replacement ()(J Public or commercial describe Code derived daily flow _1�T gpd Recommended design loading rate _ bed, gpd /ft gpd /ft Absorption area require 76 bed, ft 2 --ja2j� - trench, ft Maximum design loading rate .f bed, gpd /ft gpd/ft Recommended infiltration surface elevation(s) / ft (as referred to site plan benchmark) Additional design / site considerations Parent material _ Flood plain elevation, if applicable A11A ft F table for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT GRADE SYSTEM IN FILL HOLDING TANK suitable fors stem CIS ❑U ®S ❑U ®S ❑U OS ❑U CIS MU [IS ®U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft in. Munsell Qu. Sz. Co t. Color Texture Gr. Sz. Sh. Consistence Baar>dary Roots Bed Trench Ground - elev. ft. Depth to _ limiting factor Remarks: Boring # .:;:: >i 'Z Ground r elev. ft. Depth to limiting factor > 9/ Remarks: CST Name: - Please Print Phone: Address: Signature: Date: CST Number: PROPERTY OWNER SOIL DESCRIPTION REPORT Pagt of- PARCEL I.D. # ti Depth Dominant Color Mottles Texture Structure Consistence Y Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Ground - elev. 9 ft. - Depth to limiting factor 949_ Remarks: 1! Boring # Ground - 5 elev. ft. Depth to limiting factor Remarks: Boring # ,.5..... - k - Ground elev. f _ Depth to limiting factor > 9� Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(R.05/92) l i -5WY sic y T�o�t/r�i9<r/ o1s1B Csrd�o a�yy F x --r � 1 a Ise 4 I� ii DOCUMENT NO. !STATE BAR OF WISCONSIN FORM 1-19821 THIS SPACE RESERVED FOR RECORDING DATA JI �) ..... WARRANTY DEED 505600 VOL 1034PAGE 425 r: CIS74:2'r Roderick W. Rivard . ,. 0 - ' 1 ' T This Deed made between ................ ...... ........ •---------- -•-• -- - --.._ �C C fta Reco� ii a single m -� .......... SEP 16 1993 ..............•••... ---• - ---- --------- - - -----•-•---------------•• --- I.......................• --. rantor A f and- .- .Mi- ch.?e1 --- L.,..- Rivard - -- and-- Deborah__K_. Rivard, ' •- (�%"_ Qn hu- sba�d -. -and_- wife- , ... as_- survivorship '1 ........pr.ap e x - Y-------------------------------------------------------------------------------------- -- ----- -- -----•-•--. ------------------------------------------- Grantee, Witnesseth That the said Grantor, for a valuable consideration - -..._ St C rO1X RETURN TO conveys to Grantee the following described real estate in ._. ___...� ........................ County, State of Wisconsin: —+ Tax Parcel No: ................................... Lot 1 of the Certified Survey Map recorded in Volume "4" of Certified Survey Maps on Page 956 as Document No. 364885, being a part of the Southwest �I 1/4 of the Southwest 1/4 of Section 7, Township 30 North, Range 19 West. I �+ i� This ---- ].S --- IIat.......... homestead property. i (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; j And ..... Gr -- ---- __ -- ------------ -- --- ----- ------ - -• - --- .... ...... �i warrants that the title is good, indefeasible in fee simple - - and free and clear of encumb except I I municipal zoning ordinances and easements of record and will warrant and defend the same. ' lI +.h Se tember 93 -.. i D ated is ....•. -` ....- - ---------- -------------------- day of •-- ............... P..--- - --.............- .........- 19. I I ---(SEAL) .......................................... ......................... (SEAL) ' l;ode.ri.ck ... W....Riurd ................. • .--- - - -• -- ------- -•-- -- ---•---- -- --(SEAL) -•-- --- •- -•-- ----- ------ ----------------------------------------- (SEAL) j ----•------------••------------------ -- --- ---- -- ------ •----- -- - - -- ' •... ------••--••---••--------- ---........................._ f� AUTHENTICATION ACHNOWLEDGMENT l Signature(s) ........................ STATE OF WISCONSIN ss. SSA xO�J�........... .County. authenticated this ........ day of ..................... ...... 19.____. Personally came before me this �- 3th._____day of September 13th g93 th above named •-------------------------------•---------------- ....--- •--- ••- - - - - -- Roderick W. Rivar .......... ................................. ......................... ...... .............. ................................... ......._........___._...._._.._ TITLE: MEMBER STATE BAR OF WISCONSIN (If not . ........................ .................................... ... ••- ------ -- -- -- - -- authorized by $ 706.06, Wis. Stats.) State of Wisconsin to me known to be the person ._._........ who -- executed the Notary public THIS INSTRUMENT WAS DRAFTED BY Z P EDEM ON foregoing instrument and acknowledge the same. Lalr7� BAKKE NORMAN S . C . -- - -- • • •... • ----------- - - - - -- ------ • - - - -- - - - - -- -- -- New Richmond -- WI 54017 --- ------- --- ------ - ----- - - - - -- ........... ....................... ota_y Public t •... ".1-- County, 'Wis. (Signatures may be authenticated or acknowledged. Both My Commissi is permanent. (Tf not, state expiration are not necessary.) r date: 1 t ---- - -- - ------ 19....) •Names of persons signing in ary capacity should be typed or printed below their signatures. I WARRANTY DEED STATE BAR OF WISCONSIN Wisronsin I.eeal Blank Co. Inc. FORM No. 1 -1982 MRIIaukee, Wit. 4 sin P-Olt'd Department of Industry SOIL AND SITE EVALUATION REPORT Page—/ of . > a nd - ��-m Ftelations g Dry ion of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code CL COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but 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. d 3Z d a' i �•� 0� v APPLICANT INFORMATION — PLEA E PRINT A INFORMATION VIEWE DATE 7 - 7— � PROPERTY 0 NER: LOCATION ' GOVT. LOT 4 1/4,S T r 7 AR]� or PROPERTY OWNER' MAILING ADDRESS LOT # BLO # SUBD. NAME 0 CSM # CITY, STATE ZIP CODE PHONE VIE-) NUMBER ❑CITY VILLAGE R TOWN NE EST R AD i New Construction Use( ] Residential/ Number of bedrooms [ ] Addition to existing building j ] Replacement Public or commercial describe Code derived daily flow fi?G gpd Recommended design loading rate bed, gpd /ft gpd /ft Absorption area required Z5 bed, ft , �X,5 -- trench, ft Maximum design loading rate bed, gpd /ft _trench, gpd/ft Recommended infiltration surface elevation(s) 5y5 ft (as referred to site plan benchmark) Additional design / site considerations Parent material ,'i. ��F.?AMLt_ Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem �I S ❑ U j� S ❑ U 1�I S ❑ U ®S ❑ U ❑ S ®U ❑ S IOU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourtdary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Ground _ � ele !1 ft. Depth to limiting fa cto Remarks: Boring # Ground elev. ft. - Depth to limiting factor T_, Remarks: CST Name:—Please Print ' Phone: 74 91 A ddress: 1 Signature: ate: CST Number: l E PROPERTY OWNER SOIL DESCRIPTION REPORT , Pap b r,. PARCEL I.D. # Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench u -M 4{ \tiff} :.}}}•: 'v�:�:.v... nvtii � Ground elev. Depth to limiting factor > �q Remarks: Boring # ti: • Ground elev. _ 2Z ft. Depth to limiting fact Remarks: Boring # ef ry'. J �^ Ground elev. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor i Remarks: SBD- 8330(8.05/92) 7 Y�v��°i9w f A , 81.jlzl/ ,/ 60 'All I 7 4z 7 0 1 a //iJ,o�✓,sai X .5Ca4uy' C r 96 ~eol � , A L .r 582472 � FILED We 4b zoo MD JUI 0 7 1998 �,r3 KpTHLEENH.WALSH OjaZ C2 0.w Io OL y pegtster of Deeds 11 8 CE EY MAP Z CD LOCATED IN PA SW1 14 OF THE SW1 14, 4J o z SECTION 7, T30N, R19W, TOWN OF SOMERSET, ME N W m ST. CROIX COUNTY, WISCONSIN. o o� z LOTS 2 & 3 SHALL BE ACCESSED SCALE IN FEE a T 1" = 200' c3�o U. FROM 160TH AVE. AT SUCH TIME Z 3 N W ACCESS IS RESTRICTED FROM S.T.H. Of "35" & "64" DUE TO REALIGNMENT. NOTE A 100 0 100 200 300 L,w w m F_ m k OUTLOT 1 IS CREATED 3/4" REBAR FOUND u- 0 N47'05'30 "E, 0.48' w 0t- a FOR THE PURPOSE OF o- o INGRESS AND EGRESS FROM COMPUTED POSITION. �i a zO Li FOR LOT 3 AND IS TO UNPLATTED LANDS I q. _ :3 j BE RETAINED BY PLATTER ---------------- - - - - -- � Z N NORTH LINE OF THE SW1 /4 OF THE SW1 /4 + �I W o Q N 9'07'22 "W 756.77' _ i m U) 23765' 523.12 EXISTING q FENCELINE r'4 E-4 O .481SO. h ) OWNER � M S �,� (0 LOWELL RIVARD qI Di �I BOX 318 1 00 HWY 35 & 64 3 I SOMERSET, WI 54025'�i 3 co - w Ln LLJ I v co p 0/ 98 Erg Z z �, O O (n a BUT �- BUILDINGS 0 / �• :.dw 9 *4691 V o w ^ F -7 GARAGE y y r.. •!ii S O f I ®WELL 66.00 a HOUSE ® �\ �r ro+n SEPTIC ri OU TLOT 1 / 0.801 A j ' ' CONC. PAD 34,880 SO. FT. q I S89'46 10,E 0 1 0.743 AC. EXC. RW �I 264'9 \ N 32,354 SQ. FT. i N r (S89'43'3 E) l LOT 2 ►J _ �� r S�bB (lNW L0 p R o 4.044 AC. INC RW rn� LOT _) > 176.154 S0. FT. x� 0 cr, W I a0 CC'1- C °�, J !� 3.853 AC. EXC R \W d� ` // S M d M N — — cO 167,851 SQ. FT. t\' LINE DATA © Cri cV cw cV N89'50'30 "E '�i •` =PG. 956 p 66.01' N co - Z"- - - - - -- - SW COR. �i M II�` S1 COR SEC. 7 B l A N89'5'0'30 "E ry / Lji I SEC. 7 S89'1 5'42 w CENTERLINE _ 19L90 589'15'42 "E 290.86' ' L' 89'1 300. 89 '15'42"E 1617.59 S89'1 5'42"E 172.77' / 66.00 160TH A VE. ` SOUT LINE OF T E SW1/4 LEGEND SMALL _TRACTS ALUMINUM COUNTY SECTION CORNER MONUMENT FOUND / �S 1" IRON PIPE FOUND 1" X 24" IRON PIPE SET WEIGHING 1.68 LBS. PER LINEAR FOOT hi . . . . 100 ROADWAY SETBACK LINE Vil M 3/4" REBAR FOUND (89 "E) PREVIOUSLY RECORDED DATA NUMBER RADIUS CENTRAL ANGLE CHORD BEARING CHORD LENGTH ARC LENGTH TANGENT TANGENT C1 5804. 03'10'21" N26'21'33.5 "E 3 321.40 N24'46 "E N27'56'44 "EI Vol. !2 Pa-,e 3482 r Parcel #: 032 - 2028 -90 -050 02/23/2005 08:06 AM PAGE 1 O 1 Alt. Parcel #: 7.30.19.576B -10 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * ROCKY RENTALS LLC ROCKY RENTALS LLC 1474 23RD ST HOULTON WI 54082 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1474 23RD ST SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 2.900 Plat: N/A -NOT AVAILABLE SEC 7 T30N R19W 3.012A IN SW SW LOT 1 Block/Condo Bldg: ESM VOL 4/956 EXC PT TO HWY PROJ AS DISC 19 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 07- 30N -19W Notes: Parcel History: Date Doc # Vol /Page Type 9/28/2004 775521 2664/355 QC 685944 1940/57 WD rl 1425 2004 SUMMARY Bill #: Fair Market Value: Asse sed � 10812 105,700 Valuations, Last Changed: 07/14/2004 Description Class Acres Land Improve Total State Reason COMMERCIAL G2 2.900 58,000 31,600 89,600 NO Totals for 2004: General Property 2.900 58,000 31,600 89,600 Woodland 0.000 0 0 Totals for 2003: General Property 2.900 58,000 0 58,000 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 #: 032 - 2028 -90 -100 02123/2005 08:12 AM PAGE 1 OF 1 Alt. Parcel #: 7.30.19.576C -10 032 - TOWN OF SOMERSET Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * ROCKY RENTALS LLC ROCKY RENTALS LLC 1474 23RD ST HOULTON WI 54082 Districts: SC = School SP = Special Property Address(es): ` = Primary Type Dist # Description SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 3.290 Plat: 0700 -CSM 12/3482 SEC 7 T30N R19W PT SW SW FRL BEING LOT 2 Block/Condo Bldg: LOT 2 CSM 12/3482 (4.044AC) EXC PT TO HWY Tract(s): (Sec- Twn -Rng 401/4 1601/4) 07- 30N -19W SW SW Notes: Parcel History: Date Doc # Vol /Page Type 09/28/2004 775523 2664/357 QC 08/04/2004 770658 2631/01 QC 11/04/2002 696948 2033/435 EZ 04/13/1999 601189 1418/321 LC more 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 10813 135,500 Valuations: Last Changed: 08/02/2004 Description Class Acres Land Improve Total State Reason COMMERCIAL G2 3.290 61,400 53,500 114,900 NO Totals for 2004: General Property 3.290 61,400 53,500 114,900 Woodland 0.000 0 0 Totals for 2003: General Property 4.044 70,300 53,500 123,800 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 #: 032 - 2028 -90 -300 02/23/2005 08:04 AM PAGE 1 OF 1 Alt. Parcel #: 7.30.19.576E 032 - TOWN OF SOMERSET Current r X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * LOWELL &VIRGINIA RIVARD RIVARD, LOWELL & VIRGINIA 314 HWY 35/64 HOULTON WI 54082 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 0. 01 Plat: 0700 -CSM 12/3482 SEC 7 T30N R19W SW FRL BEING OUTLOT 1 Block/Condo Bldg: LOT 01-1 CSM 12/3482 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 07- 30N -19W Notes: Parcel History: Date Doc # Vol /Page Type 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 10815 15,100 Valuations: Last Changed 07/23/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.801 12,800 0 12,800 NO Totals for 2004: General Property 0.801 12,800 0 12,800 Woodland 0.000 0 0 Totals for 2003: General Property 0.801 12,800 0 12,800 Woodland 0.000 0 0 I 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 i LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SOMERSET COMPUTER NUMBER 032- 2028 -80 -000 Parcel Number 7.30.19.576A OWNER NAME: First LOWELL & VIRGINIA Last RIVARD PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment SECTION 7 TOWN 30N RANGE 19W 1 /4160 '/.40 Line Description Line Description TOTAL ACREAGE 19.040 PLAT LOT BLK 01 SEC 7 T30N RI 9W SW SW FRL 15 02 03 EXC CSM 12/3482 17 04 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 1 4 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, 1 History, F10 -Exit i i i LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SOMERSET COMPUTER NUMBER 032 - 2028 -90 -250 Parcel Number 7.30.19.576D -10 OWNER NAME: First LOWELL & VIRGINIA Last RIVARD PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment 314 HWY 35/64 SECTION 7 TOWN 30N RANGE 19W %160 Y<40 Line Description Line Description TOTAL ACREAGE 13.780 PLAT CSM 12/3482 LOT3 BLK 01 SEC 7 T30N R1 9W SW SW FRL 15 02 BEING LOT 3 CSM 12/3482 16 03 EXC TO HWY PROJ 1559 -08 -21 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit 'w nods anvo , • sanou ud w ASS ^ v T M non •:4%iS d� 0 T NO • SIMIdS 1 8 000 ci w s � a ,� is A W # P !' q q, s, � ( e �ll o F 9 G $ w UMW � Rivard - � � 11 W �► 7 tw.ea ss n. 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' 1 0 - Hall eql Pew e ivivaa � o � • Ivt s ' ° 3g 76 B a 9L c ST Edward 1 7 t Wag Nae N t g Hopkins a P S i same a v 8 u�ootu q 3 Annette a ' 7C 3 ° " 88M ►ohnson G n n ,� t ermain .. - 6 W oac - r g tcsr s s a 0 � to x /3 8 2 C cj ... _ $ r In ia so $ s u ' N mlg SZOVS NISNOJSIM '13S213W0S y Suzanne LSL X08 m 67m ST ° a ° 57-, N K—da Harold !^ LQ N M S , Rivard so c Steven '^ N 0 (' Plourde Ta tow o M tv r F of A J .' sw T • O ' IV < DaWd 8 ail �. a < is TO y 3110 m brie m 24 & paaMd �"^ N CL GS John $ G R _ my 7'Itell Borden 1 ES " mulo! Dean fan1Z �t ' H— . p ^ KadkMm �CdtCca $ M eobe 88 Z 86 ! HILCREST L I DR N M q Fact a� Elaine 3 Rr a r.nnr Boardman so E pg • Frank 83rd ST I�6 �.. � a 5" 8 S Boardman N t: �* * 85th S + q T D _ 3 r w t � T .o < G m 86 Q r<i twaae a E S q m 0./ •a r s :0 Bury 7 C f e t- Boardman 3 V �- Limirarl� mao 5 P 009 89th ST 009i st 3Jdd GN01gH:)jV OOti 1!!1i �3 zit •mod �S (saausiopun) ?8: MMM ► - H-oF_Z iVza Sv 13S113WOS i Wisconsin Department Rel g ons Industry Hu Labor and Human n Rel SOIL AND SITE EVALUATION REPORT P ,L Of ..3 Divisian of Safety 8 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 not limited to vertical and horizontal reference point (BM), direction and % of slo a sca a or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearelrt'.d L APPLICANT INFORMATION – PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY 0 NER: PROPERTY LOCATION GOVT. LOT 114 < 1 /4,S 7 T ,NR J((orW PROPERTY OWNER 1 MAILING ADDRESS LOT # I BLO # SUBD. NAME 0 CSM # 7 ` CITY, STATE ZIP CODE PHONE NUMBER OCITY VILLAGE ®FOWN J !N77EST ROAD _ liz ) _) New Construction Use [ ] Residential / Number of bedrooms [ j Addition to existing building (j Replacement b4 Public or commercial d Code derived daily flow /aL gpd Recommended design loading rate . , bed, gpd/ft _, trench, gpd/ft Absorption area required - ?SJ1 bed, ft �, 5 -- trench, ft Maximum design loading rate __,.� bed, gpd/ft gpd /ft Recommended infiltration surface elevation(s) _ S _' : c ft (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable It S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem 0 S ❑ U fo S ❑ U l� S ❑ U ®S ❑ U ❑ S ®U ❑ S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Ground elev. ft. Depth to limiting f actor > y G Remarks: Boring # L`R\ Ground elev. a �'y 9 ft. Depth to limiting factor >- k Remarks: CST Name:—Please Print ' Phone: Address: Signature: � ate: CST Number: PROPERTY OWNER SOIL DESCRIPTION REPORT Page'-0 of PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Roots GPDlft � in. Munsell tDu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench '4 a. I � I Ground — elev Depth to limiting facto > y9 Remarks: Boring # Ground elev. _ c ft. Depth to limiting fact Remarks: Boring # Ground elev. ft. Depth to limiting factor > y� Remarks: Boring # Ground elev. tt. i Depth to limiting factor i Remarks: SBD- 8330(8.05/92) : ys - - ,� , .sc,r4r ,o s , 7 T r S ,9 4 4 0 1 -C? 0 rev�eWV ot; .j,{:f . �t - . /ODD , m _. i .,dude d' .n.p {. t i le SeptfC�iILJ Q{ i : Wis. . submit Admin- ,�,� ;,1r i �x � i';a: �i''i �, and spa _ i .3?8 ,Qsfr'_: that p iiin3 "Fpr®vai is red �isred - I , b i I Z G I 0 _ si . v pGE SYSTEM pRi \JA'E SE BXaD 1L . fie, 44 -t �i , . Y J 7&6r0� , ,. r ' 1 _ ,_-S 94 18 0 -. S /.Z /,vG' > > " . S i a f I cc � J� �•�.E: J OS'S. S��ou. J ' . P Ive i 8 40 OF 401.(��3 freee All 1011111• And OOkuvellon Pipe - C.- Approviod lhel Cef`; M f 1 ftQ1 ra Aeore y flnel Crede ' a � ' 20• 4 2 Above Plpp 4' Cesl If"" H ,; To flnol Orede Pill "Pips ,r i M Moen Her Or Synihankc Co.011nu t r : "� x iV t �' y y 0 ref �Plp jereeole 01e1r10rlloo Pipe ..� o o TeeE`1�I ` ! e ►* Algealsle 8eeesls Pipe ° pe/laeled 1 ° '- Co • A! onew 0 $441 ru o�cD F'I�e.l r,,�at 9o,�/ �<<�� SOIL FILL DISTRIBUTIOI.I PIPE APPROVED S4)JP ETIC COVET 2 " 'MAURI^t• OR V OF STRAW OF 1� 6GRE6A1 E. --�r ''- OR MARSH HAj f:OFl; a'/z AGGRCGATE •P � \�'�,G;l. ELEV• 0F r. F EET 4 d DISTitIfWT10W PIPE TO DE AT LEAST 1WCHES BELOW ORIGIIJAL GRADE AAIU AT LEAST t0 INCHES BUT 1.10 MORE THAW 42 INCHES BELOW FINAL GRADE MAXlMUti OEPrVi OF EXCAVATIotj nom oKI wu 69AK WILL 5 E _ INCHES Puli m PEP r'►i O EXCAVATION rA01A QR,IGINgf` 6RApf- WILL eC INCHC S r s1r,►JCO: � - � LIGCWSC DUMBER: r r ,C DATE STC -105 SEPTIC TANK MAINTENANCE AGREEMENT A n St. Croix County OWNER/BUYER MAILING ADDRESS P( 7 Y PROPERTY ADDRESS _ 31 (location of septic system) Please obtain from the Planning Dept. CITY /STATE _ SGpi -e .-s p7`- 4 � T- PROPERTY LOCATION 5 4i 1/4, 4 1/4, Section --I- T 3 0 N-R TOWN OF S,, A 0,- r e l , ST. CROIX COUNTY, WI SUBDIVISION A l A LOT NUMBER ,I CERTIFIED SURVEY MAP., _,VOLUME 7 PAGE �, LOT NUMBER L 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 licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: DATE: ' St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 i I i STC -100 . This appl ication form is to be completed in full and signed by the owlner(st) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner /contractor,(spec Douse), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property Mic,J,,e/ Location of propert 1/4 SCE 1/4, Section' _�, T -R Township _ S'-, Hailing address Add ress of site _l�- „l�,,v 3 1 Subdivision name Lot no. / Other homes on property? No Previous Previous owner of property _ 4 Total size of parcel _ 3 acv s Date parcel was created Are all corners and lot lines identifiable? ___[___ No Is this property being developed for (spec house)? Yes )� No Volume and Page Number as recorded. with the Register of Deeds. ---------------------------------------------------------------------- T14CLUDE WITH THIS APPLICATION T11E FOLLOWING: A IYARIUUITY DLED which includes a DOCUHEHT NURBER, VOLUME AND PAGE. 1(U1tUI R & THE SEAL OF THE R EGISTGit OF DEEDS. In addition, a certified survey, if available ;would be helpful, so as to avoid delays of the reviewing process. If the deed description referencos3 to a certified survey Map, the certified survey Hap shall also be required. PROPERTY OWNER CERTIFICATION I(%�O) certify that all statements on this form are true to the best of ny (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document , and that I ( oorn the proposed site for the sewage. disposal system or (we) obtained an easement, to run the above' described property, for the construction of said system, and the same has been duly recorded in the office of County Register of deeds as Document No. Signature of aql cant .' Co -appl cant i . Date of Signature Date of Signature �,I AA 0 - 980 --k-tr Q�nz rn 36488a CERTIFIED SURVEY MAP A c) ri .1 J.jr,:j lo(- in the OV thc' S L:!� - i 7, T of S cmv t ( . , 1 , 03 , Lx Cc)wlty, 1 being Cur-thev L ol. luv;s 1 SW 1,7 1 th lint ci j , l thr- iWi•- c as-w-w -6 boa. t e (A C, 1)0111; Q Sb9�'43' 3UT 20" 9 5 t 1 - S 'C; 4i` i.Ll' Lhi.- South 11110 Of S 1 -d Nf39' along said line 300-50' t th poilit of be-inni.rig. pax-cul. cont;Aji-21 3-C12 ac and is SUbjecl, Uo 1.11-1 C)vt-!• the c por•tian thei S&ia parce-1 aa.so subjw(.-T, :,nd rc—t-cicticA*11, (.11 I -, tj j jUNe SL1: hr•adley J. Canz-cci:ly, Wisconsin [, Sm C�, s 'I tx . u ,,,. rc,,pl.,�sent:,ition of rid maj p(-d ti; Etbovu. desci•ibed property; t),:.it su N -It L E L I r - V .: !y (.., I ; tt 2 (*U1.1%- compiied with Lhthe' P) Land 1.iria that I huv,� he extl--rior bowid.t.:� Of tl V t wid the - -) _� Of tl;Q WiSconsin StUtI.O.U.', Ll,,2 Tc;wn of arv L. (, Couj-.-ty Subdivision Ordin to thc- t-1-st p knuw ono-ki t.r, rid Lng, rid belief. This map is hi.reby apprived by the '20vill E'Oax•d of thr! Town ot' J1 "'Vfj-" 1 7 co z rn c) x N Z LA I, Bmiile�j J C ana, cAy fit -n APP ROY t C U Z m ci V11S. 0 ci- s 89 ° 4 3'30) "E - - - -- X40 M 1`11� so. mc 'i c cc6;&yZ(LA rn N P1 SCALE IN FEET z U) affimmma 5 ul F-6mmau- ISIN III-J!1 0 0 0 IOU 200 Sod n 5.1112 ACRES I'D THE 4 rQ SECTION 1-114E 0 Vl 2.729 ACRES TO THE LEGEND R W L I 1 1/4 CORNER M COUNTY SECTION CORNER MONUMENT 0 3/4 "X 2 4 " ST EEL REINFORCING BAR N N WEIGItING 1.502 LBS./LtI4.FT. SET. to C NOTE.* LXi';I CD AN ESCROW OF 3 100 MUST BE PAID U) ou i:. I NG In rr' L) TO TIIE TOWN OF SOMERSET SHOULD 1 . A . A .., U) A RESIDENTIAL BUILDING EVER N BE BUILT ON THIS PROPERTY. 4b - R/ vi LINE CD 4b q , `41,1 c9046'55'W 297.21' TOWN. ,,SOUTH LINE OF SWI/4 69 356.11G' 179022' SW CORNER POINT i.-,F $ 1/4 009 1 NER SECTION 7, T 3UN, F(I SW -7 r- �(I D N 5824 m► r(j U 7 1998 JUL ' 8 199$ � :EN H.µlA gister of Deeds 11 s CE EY MAP Z LOCATED IN PA fI SW> 14 OF THE SW114, w ° z SECTION 7, T30N, R99W, TOWN OF SOMERSET, N�Nw g ST. CROIX COUNTY, WISCONSIN. 0 w o - Lr) z LOTS 2 & 3 SHALL BE ACCESSED SCALE IN FEET 1" = 200' ��ao FROM 160TH AVE. AT. SUCH TIME z A o ACCESS IS RESTRICTED FROM S.T.H. bjNW m "35" & "64" DUE TO REALIGNMENT. NOTE 100 0 100 200 300 w = a L� w W F m OUTLOT 1 IS CREATED 3/4" REBAR FOUND LL 0 Li C) a FOR THE PURPOSE OF N47'05'30 "E, 0.48' Q� T - INGRESS AND EGRESS FROM COMPUTED POSITION. C/]i ¢ Z0 FOR LOT 3 AND IS TO UNPLATTED __LANDS qI z = Ln j BE RETAINED BY PLATTER 0 0 Ln NORTH LINE OF THE SW1 /4 OF THE SWi /4 + a w O a Z N '22 "W 756.77' ( � m �„, 233.65' 523,12 EXISTING fa FENCELINE W 3 �I cn �� OWNER LOT 3 N a 13.923 AC. p LOWELL RIVARD q Q1 606,481 SO. FT. �I BOX 318 00 HWY 35 & 64 SOMERSET, WI 54025 `� w I ' Sri Do q O o 4 i iv Cr ;r p Z w � i O O OUT n a BUILDINGS W "89'46'10 "W rL� GARAG � 5 ®WELL F HOUSE 66.00 0 ® E cD SEPTIC 3d (D ® OUTLOT 1`' / l 0.801 AC. S89'46'10 "E o CONC. PAD 34,880 S0. FT. (, I ' 0.743 AC. EXC. RW 264.9 32,354 SO. FT. �i .N (589'43'30'E) LOT 2 U) � , a� 00 iO4 O N t CND NW U) a o W 4.044 AC. INC RW cy) q l I Q1w a LOT _ / Ao N 176.154 50. FT. `t 'd W r n _ C S, - c0 167,851 SOC' T, / 00 LINE DATA © ELI N No VOL.__- �� f X �(l? �,<v + C Ji v N89'50'30 "E ai o �? PG__956 A� 2 �� 66.01' 1 N 00 Z -% 0') W. 01,10 o' Dt SW COR. ,� r n S1 /4 COR SEC. 7 B A 1\189'5. '30 'E ry Gj� I SEC. 7 5 89'15'42' E rn 4, CENTERL E _ 19 0 S89'15'42' E 290.86' w 89'1 �_F_ 3oo. 589'15 42 E ^ 1617.59' — � S89'15'42 E 172.77% 66.00 ' 160TH AVE SOUT LINE OF T E SW1/4 LEGEND SMALL _TRACTS / ALUMINUM COUNTY SECTION CORNER MONUMENT FOUND 0 1" IRON PIPE FOUND 1" X 24" IRON PIPE SET WEIGHING 1.68 LBS. PER LINEAR FOOT E4 ' • . • • 100 ROADWAY SETBACK LINE V ■ 3/4" REBAR FOUND ill mu (89'43'30 "E) PREVIOUSLY RECORDED DATA an wo NUMBER RADIUS CENTRAL ANGLE CHORD BEARING CHORD LENGTH ARC LENGTH TANGENT TANGENT C1 5804.58 03'10'21" N26'21'33.5 "E 321.36 321.40 N24'46'23 "E N27'56'44 "E Vol. 12 Paqe 3482 AU UJ.L.aV UU 1�JrYVUl:.IJI ;1i11 r , 996 0 aUR M61U'NO81 ONINNIS38 10 1NIOd 'L NOUD3S ( 83 N800 b/ I S 83N800 MS I -- - - - - - - - - - - - - - - - - - -- - - - - - - - - - ,zzoeLl X 1 0 5'00£ M „Zb 1 5 lo68 N M_ ,98'95£ 3 „Zb 91 S '� b /IMs d0 3Nn Hinos ,129'01 M ad02�� NMO1 M ��to - - -- -- - - - - - ---- S Oo660 i ° f o �`o 3NII M, tl9 ° � CD � m P M �kl83dO?Jd SIHl NO i 38 t0 N 83A3 0Wows - IVI1N301S38 V ( ` 1, ', •:: .. , 1 , •.: u. _ �_ - ---� o 13SN3WOS d0 NMOl 3H1 Ol W o Mio - uns 0) OIVd 38 ISM 0019 d0 MO83S3 NV Lo _z ✓t� ONIISIX3 0? :31ON a lD (M `f z w 3 '13S 'ld'N17 /'S81 209'1 9NIH013M lzr N �.p `_ e � ( V 1 a aV8 �JNIO»OdN13a '1331S „bZ X „b /£ Q N 1N3wnNOW 83NHOO NOLMS ,tlNno3 3N1 M/8 W 83N80Ob /IM 3Hl O1 S3aoV 6ZL'Z to ON303 -1 p 3N1 N01133S (V 3H1 01 S380V ZIO'£ d' QOE ,OOZ 001 0 O I Z 1� ,001 = „1 1334 NI 3-IV0S z 1 W W ns1mgw0D r :lw t aNW �a es.�sS: WT?n. . 3 in X 0 4 , • °'r ' �'`.. 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P P T � TeuoTSSa,�o.zd .�uz ,Tc gsag aug og aaueuTp.zO uoTsTnTpgnS �gunoO xTOaO • gS 'ug Pue `aaueuTPJo uOTSTATpgnS gasaauxoS jo uMol aug `sagngegs uTSUOaSTM aug jo �� 9�z za4deu0 jo ,3uOTSTAoid aug ugTM paTTduzoO �TTn3 aaeu I geug pue �pa�anzns pueT aug �o saTJepunoq aoTaagxa aug ,To uoTgeguasaada,z goa.zxoo pue anag e sT geTd cans geug ',�gaadoxd pagT.zosap anoge aug paddeuz pug: �.�an.zns anew I gegg �jTgjao -Rgaaau op pue7 UTSUODSTM pa.zagsTS,9a `,�epeueO •r @TVeja `I •p.zcaaa JO SU0Tg3TJgSa.z pue sguawasea og goaCgns OsTe TaO,aed pTeS ' joaaaug uoTgzcd �TzaugnOS aug ,zano I�eM- JO -gVTJ peo.z UM04 DUTgSTxa ue cg gaaCgns ST pue SaaOe 8TO'9 SUTeguOO Tao.zed preS -2uTuuT 09q jo guTod aug og ,OS'00� auTT pies OU01e M „z+7,STo6gm aouaug ` Pies o auzT ugno S aug 0 , T+ • 99� a„LO 10+ o � S aouaug ` , 56' +9z a „0� , �+ aouaug , 69' zy+� TMS PTes JO auzT gsaM aug ugTM TaTTeaed'H „ST ,F,7 0 0M aauaug t2UTUUTS@q jo .q. od aug og , 9�•9S� TMS Pies JO aUTT ggnOg aqg SuoTe (S „ST,3+00M JO DUTJeaq paumsse `L ucTgoaS Jo TMS aug JO auTT -saM aug og paoua.zaja.a s2utzeaq) g,,E�,5T aauaug !uoTgoas pies do zaujoD Ms aug ge DuTauawwoO :SMOTTOJ se pagTaDsap .zaggxnj BuTaq �UTSUOOSTM `RgunOS xTOJO •gS `gas.zaulos 3o uMos `M6Ta `mom ,i `L uotgoas `TMS aug 3o TMS aug uT pageOOT pueT Io T@3jed V dVA k3An jns a3 Id Ii�130 ' ate 085 ,��� �' ode o� ''��d0 M z ID a� CD W I CD S m N c n w CO N 3 W N N d m � K ' 3 L tdr CD Q CD O r�-F a 0 w 3' N � co m o v, 1 C40 c O co co N I 7 m cc) W p D° O o i 0 o 3 r d d m Co ID I -� n Z D a v? D a a D ° O0 � u`D, M 4 a CL z 0 0 O o o rt m co n n r to O N 0) 0) �' A A O O 0 C5 y N N o C) 1 5 3 !% f�q N 3 I o D M M 0. '0 0 C 3 n 0 C CD O z N N N N �., 7 CD tD W N r CD 7 A W_ M I A �• CD w Cp lV 3 3 m - co cn ! N 0 N O O N O O O D ' O D CD CD O o a D T Z, l� cn N w CA U) y ID rn m CD C) N N w _. 3 a CD W CD a s z N O to O A n q �. d A 3 O cn -� W M W o C p Z o 0 3 a o " o cn U) H Z CD CD a o o CD a 3 CD CO CO o CL a 3 3 a O = 7 3 = v c s0. v c o a o y o a !I CD N CD N : N a CD y I O I I bpi O < O n d a CD ^. CD ' 0 li O A X 0 O 0 N O tj CD CD A En O o 0 CD CL O CD i RECEIVED +U 1 p 8231 3S jut a o VOL 21 PAGE 5192 KATRLM H. REGISTER OF DEEDS ST. CRbIX COUNTY RECEIVED RECORD SURVEYOR'S RECORD 64/18/2006 11: 36AM CERTIFIED SURVEY MAP N ib FI E D MAP A parcel of /and located In the Southwest Quarter of the Southwest Township 30 North, Range 19 West of the Fourth Principal Meridian, Town of Somerset, St. Croix County, Wsconsin. i 1 MWIN LA1E Or OLn OT 7. ST. CROIX Ca CERWXV St/RVrl LAJ 1 \3 1 , YAP RECORDED OV WL M PC. J482 DOG NO. 382472- - - � ^! � " -ME L me or Lor ,A Sr. CRaX CO- CER13FAM SL*Wr YAP O I i RECORDED M VOL f2. PG J"A DOG, NO 362472 N C1ERW1ED "VEY YAP RECORDED AN -- y1 ,° S r - OUTLOT 1 IE VOL. /2. PG -7482, DOG Na 5e2472- , t/ » , ,f tp I ; 1,204 SQUARE FEET r \ ; fNGb *?'r . "'01 � 42'3 A A I/-% 4O .J7"�r - � i � � '� •r DO q.0 37 W 80-6 c_ `� �' 1 �",' ^ `S 1- '1 rfj6. 00 a co nAxR S897 = 9'30 "E 290.86 ` - _ " - CRR � REECOR D N ' VOL. 4, Pa 936. DOG Na 364M5 9 ,, t cj o -.t'1 " C S8948'04"E 264.95-- - E , _ 1 L'J I Cor "I LAME Or Lor 7, sr. OROIX oa E7PVFJEO SU4VE'Y YAP RECCMED AV ^ 1 ►• \ ZS �( 1 K r I t- M.. 4. PG 936, 0 Na JBI663- ' I i Ll t l t ti 1 l 1 AE aa Cr LOT 1. 12WE o � { LIJI GLRAF7ED SUPYtI' YAP R ECC14aED AN WL. �. PG 936, DOG Na J64885- -' t f J o . ` w � ,rJ P: , I e el CJ ='� • ' , PRE J w v a eA s t a vz ti" I! Z t J L 1 OZ , I I 1- ► a yA . �•(Eiy4E60'/7 . .. QpADgym..` .J j SETBACK LINE- 1 r '�'• Q . - 4&W7 -Q- -WAY LAV£ OLIN SCOUT Cfl P' I RO�1� 657.36 66 FOOT AY6Nr or WAY PIER -, 1 SE CORNER of 7NE Sw I /s. GS.AL VfLL(AIIF /2 PACE 3482 - - / SEG 7, T. JO N., R. ID SOU77l LAYS a'' SEG 7, r. JO N.. R. 76 W - -' - - R/oNT- or-WAY LAME PER WDOT Bearings are based on St. Croix County Coordinate Grid (NAD 83). RWHI -Or -WAY YAPPRaE (N89 46'10 E) Denotes record" bearing LEGEND (38.81) Denotes record" distance O FOUND CAST IRON MONUMENT • FOUND IRON MONUMEN T GENERAL ZONING NOTICE STATEMENT FOUND WISCONSIN D.O. T. ALUMINUM "The parcels shown on this map are subject DISC RIGHT —OF —WAY MONUMENT to State, County, and Town laws, rules and o FOUND NAIL IN PAVEMENT regulations. (l e. Wetlands, minimum lot size, O DENOTES 1 z 24" LONG IRON d%*J access to parcels, etc.) Before purchasing or N RE —BAR WEIGHING 1.68 LBS/ FT. developing any parce% W/TH R.L.S. CAP contact St. Croix # S - 2287 1 County Planning and Zoning and the town for I 100 200 advice. " OWNER SCALE IN FEET: 1" — 100' O MIKE RIVARD EGAN, FIELD, & NOWAK, INC. 318 l TON, 1 4082 "SURVEYORS SINCE 1872" HOUC TON, WI 54082 � IF 741 5 W AYZATA BLVD, MINNEAPOLIS. MINNESOTA 55426 PHONE: (952) 546 -6837 FAX: (952) 546.6839 1 . SHEET I OF 2 N WEB: EFNSURVEY.COM dump COPYRIGHT O 2000 By ECAN, FIELD a NOWAK. ING Vol 21 Page 5192 I Parcel #: 032 - 2028 -90 -100 02114/2007 12:07 PM PAGE 1 OF 1 Alt. Parcel #: 7.30.19.576C -10 032 - TOWN OF SOMERSET 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 - ROCKY RENTALS LLC ROCKY RENTALS LLC 1474 23RD ST HOULTON WI 54082 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 3.290 Plat: 3482 -CSM 12/3482 SEC 7 T30N R19W PT SW SW FRL BEING LOT 2 Block/Condo Bldg: LOT 2 CSM 12/3482 (4.044AC) EXC PT TO HWY Tract(s): (Sec- Twn -Rng 401!4 1601/4) 07- 30N -19W SW SW Notes: Parcel History: Date Doc # Vol /Page Type 09/28/2004 775523 2664/357 QC 08/04/2004 770658 2631/01 QC 11/04/2002 696948 2033/435 EZ 04/13/1999 601189 1418/321 LC more 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/09/2005 Description Class Acres Land Improve Total State Reason COMMERCIAL G2 3.290 61,400 88,400 149,800 NO Totals for 2007: General Property 3.290 61,400 88,400 149,800 Woodland 0.000 0 0 Totals for 2006: General Property 3.290 61,400 88,400 149,800 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 f Parcel #: 032 - 2028 -90 -050 02/14/2007 12:07 PM PA 1 O F 1 Alt. Parcel #: 7.30.19.5766 -10 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 04/18/2006 00 6 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - ROCKY RENTALS LLC, RETIRED RETIRED ROCKY RENTALS LLC Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 2.900 Plat: N/A -NOT AVAILABLE SEC 7 T30N R19W 3.012A IN SW SW LOT 1 Block/Condo Bldg: CSM VOL 4/956 EXC PT TO HWY PROJ AS DESC 1940/578 CSM 21 -5192 TAKES ALL Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 07- 30N -19W Notes: Parcel History: Date Doc # Vol/Page Type 09/28/2004 775521 2664/355 QC 08/0512002 685944 1940/578 WD 07/23/1997 1034/425 WD 2007 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/12/2006 Description Class Acres Land Improve Total State Reason Totals for 2007: General Property 0.000 0 0 0 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 September 5, 2007 File Ref: SE0126 Michael Rivard Vice President, Rivard Stone, Inc. 318 Highway 35/64 Houlton, WI 54082 Re: St. Croix County Special Exception Reconsideration Parcel #s: 12.30.20.759 and 12.30.20.765, Town of Somerset Dear Mr. Rivard: The St. Croix County Board of Adjustment (Board) has considered your request to reconsider its July 26, 2007 decision regarding the special exception permit renewal for the Kraemer Company and Rivard Stone. At the meeting on August 23, 2007, the Board approved your request for reconsideration and has scheduled a subsequent hearing at its next meeting on September 27, 2007. Please submit to the Planning and Zoning Department 11 copies of any new written evidence that you wish to include with the staff report for the Board's consideration no later than Monday, September 17, 2007. Please feel free to contact me with any questions or concerns. Sincerely, Jennifer Shillcox Land Use Specialist/ Zoning Administrator Cc: Deborah Rivard, President, Rivard Stone, Inc. Lowell and Virginia Rivard, Lowell and Virginia Rivard Family Trust Benny Stenner, Kraemer Company, LLC Clerk, Town of Somerset Steve Olson, St. Croix County Land and Water Conservation Department Greg Timmerman, St. Croix County Corporation Counsel Jim Devlin, Wisconsin Department of Natural Resources March 5, 2004 Rivard Stone Attn: Mike Rivard 318 STH 35/64 Houlton, WI 54082 Subject: Saw Shop Addition Sec. 7 T30N R1 9W Town of Somerset Dear Mr. Rivard: This letter is to serve as approval for the construction project (saw shop expansion) and sign location as submitted on January 22, 2004 and March 4, 2004. After reviewing your request, the Zoning Office does not deem this as a major change from the original Board of Adjustment approval dated 9- 22 -99. Therefore, the project may continue as submitted. You are responsible to contact the Town of Somerset to obtain the necessary building permits for the project. If you have questions relating to this matter, please do not hesitate to call. You can reach me at the number above, Monday — Friday, 8:00 a.m. — 5:00 p.m. Sincerely, Rod Eslinger Zoning Specialist Cc: Jeri Koester, Town Clerk file