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HomeMy WebLinkAbout032-2176-10-000 Parcel #: 032 - 2176 -10 -000 05/09/2005 10:58 AM PAGE 1 OF 1 Alt. Parcel #: 30.19,1495 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date FN t rical Date Map # Sales Area Application # Permit # Permit Type 01/28/2004 00 0 Tax Address: Owner(s): = Current Owner * TI MAGNUSON ENT INC TI MAGNUSON ENT INC COPAR DEVELOPMENT LLC COPAR DEVELOPMENT LLC 15211 113TH ST N STILLWATER MN 55082 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1628 83RD ST SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 3.000 Plat: 09 /99- LAKESIDE ESTATES 1/22 032/04 SEC 12 T30N R1 9W PT NW SW & SW SW Block/Condo Bldg: LOT 10 LAKESIDE ESTATES'04 LOT 10 (3.00AC) � Tract(s): (Sec- Twn -Rng 401/4 1601/4) 12- 30N -19W NW SW Notes: Parcel History: Date Doc # Vol /Page Type 01/28/2004 752813 9/99 PLAT 08/22/2003 736985 2385/383 WD 09/27/2002 692047 1991/540 QC 09/27/2002 692045 1991/537 QC 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 02/23/2005 Description Class Acres Land Improve Total State Reason Totals for 2005: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 I Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 463453 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)j. Permit Holder's Name: City Village X Township Parcel Tax No: Co ar Development, Inc. Somerset, Town of 032 - 2176 -10 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Ran /Map No: 13M ( 1/ ~ 12,3Q.19.1495 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic .- /2_5b Benchmark ri L Gd �CJ lJ Alt. BM i UA-1 4 -05 /63 , Aeration Bldg. Sewer q Holding St/Ht Inlet .96 73,36 St/Ht Outlet q cf�q TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 7Z 1 5Z 23 ! 3 Dt Bottom Dosing Header /Man. /3tv 93•�S Aeration Dist. Pipe 13 - to Abs 13.77 4 Holding Bot. System ' PUMP /SIPHON INFORMATION Final Grade - Manufacturer De St Cover A Model Number i , 2 C a 7 � TDH Li Friction Loss System Head TDH Ft I p Forcemain th DI Dist. to Well SOIL ABSORPTION SYSTEM BEDlTRENCH Width Length No. Of Trenches PIT PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS Z Z 1 `e SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: —�,�, (�' / INFORMATION CHAMBER OR 1 Type Of System: 0 S / / � /pz j UNIT Model Number: Q J C o ^ ue. n (p j DISTRIBUTION SYSTEM Z3 Z�Z Header /Manifold J/ Distribution x Hole Size I x Hole Spacing Vent o Air I ta L J - ke , L L Pipe(s) Dia Spacing e c 1 Leng t h_ Dia L SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only g Depth Over Deth Over xx Depth o\ xx Seeded /Sodded xx Mulched Bed/Trench Center ,�► ' Z� jBed Edges Topsoil o es No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1628 83rd Street Somerset, WI 54025 (NW 1/4 SW 1/4 1 T30N R1 9W) Lakeside Estates Lot 10 Parcel No: 12.30.19.1495 1.) Alt BM Description = ` ' t '� — " 0 �— G a y � +— �..p ,� 6Y` 2.) Bldg sewer length = Z3 f A - amount of cover = / ` ` '� ter moo,, Plan revision Required? Yes o ¢ �� Use other side for additional information. Date Insepctor's Si nature Cert. No. SBD -6710 (R.3/97) O ildings Divisio O S: C 20 ; in � 201 W. W Ave. resin (,, San Permit Number (to be filled in by Co.) • De artment of Commerce 4 s� Sanitary Permit A ppucatl n =., v �' ` S LD. N umber / In accord with Comm 83.2 1, Wis. Adm. Code, personal inf provide N N( V may be used for secondary purpose. Privacy Law, .15.04T(Im) � G ({ N`G �FF1 Add (if diftnt than mailing address) I. AppHicaHon Information - Please Print All Information l �- �S S 3 /� D S ]'` ✓ of dP 9 Property Uwner•s Name ,rs �' • o • o ? S' a C�U�°/p`2 Parcel a Lot # Block # Property Owner's Mailing Address v-e! / City, State� ti T. itJ K/, SltJ • 1 �` Zip Code Phone Number / ti '/ti Section S'5*4966 1 LOT 1 6, 0 , 0 IL X Type of Building (check all that apply) / T N; RE or 2 Family Dwelling - Number ofBedrooms Subdivision Name QgM. •+ ❑ PublicJCommercial- Describe g Use G� E c( , r4 r e- S ❑ State Owned - Describe use D►S'T Ct;Z(,� �,tf f- 3 ❑CSty_❑Vinago0Towidipof III. Type of Permit: (Check only one box on Hine A. complete line B if applicable) A. New System ❑ R ep t System ❑ Trramretit/Hoiding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renew mit Revision Last Previous Permit Number and Date issued D of ❑ Permit Transfer to New Before Expiration Owner IV. of POWTS Check aU that a i on In'Ground Mound > 24 in, of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At Grade ❑ Si Conatruered Wetland 11 ngle Pass Sand Filter ❑ Pressurized ln- Gr°und ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Fiher bing Chamber ❑ V. D ersaUTreatment Area Information:` DP Line Gravel "less Pipe ❑ other Design O (8Pd) Design Sm7 Application Ra f /ten/ *7 4:m Dispersal Required (sfl ispersal pro st) Synem pevaticu r X57 �7/ V g7 f Gailons Gallons of Units I. Tank Info Capacity in Total Number Manufactwnr Prefab Site Steel Fiber /D /. Concrete Coated Plastic New Exirtiog - Glass Talcs Tanks / 5 Septic ar Holding task / Aerobic Treatment Una Doting tanaraber VII. Responsibillity Statement- I, the andersigned, assume ✓ Plumber's Name (Print) bility for iastallatioa of the POWTS shows on the attached plans. Plumber's Signature PRS Number Business Phone Number "IZ . U L [3 I dl-r- RL 2 Zeoo 31 .5 7/S • 7 7 • 3 Plumber's Address (Street, City, State, Zip Code) �U.e . S�/C %vim l/•4/ k�/ SY �� VII our /D rtment Use Onl Approved ❑ Disapp Sanitary Permit Fee (igchKks Groundwater Date ing Agee S Surcharge Fee) '¢�� / ignature ) ❑ Owner Given Reason for Denial ]IX. Conditions of ApDroval/Reaso for Disc p Val SYSTEM OWNER Septic tank, effluent l fllte dispersal cell must all bq seryiged / maintained l� as per management plan provided by plumber. 2. requirements mus e mam alne as per applicable code /ordinances. 3 Athei p (o tae Cwaty only) for the s as sot tas stn : t t taere la/d^a �� SBD -6398 (R. 08/02) I • C S 1' � �` 2 -,..� J ~ �C . /1��,,� l 51 � yo, 4-0 T f71' - r" r 1 I c T J 0 oa o 59, 8p o O #- T °p p X00 ej Z- O T /0 E F 1 i Y5 POWT SYSTEM SHALL INCORPORATE PER COMM. 83.44(2)c A PROPER ZABEL FILTER MODEL # A -100 ` ' ULBRICHT & ASSOCIATES CO. 2812 10th Ave. • Spring Valley, WI 54767 Reg. P se 715- 772 -3442 PROJECT INDEX PLAN ID # DATE 3 - CJ S OWNER 1 5/ 4 f #AV5EiV CO�/rJ2 J S O O . 160C �/ ,y PHONE ADDRESS /D�O / '/� %/1J ST (��l� �•(� ! 'V G-- / l./ S.S O G LEGAL DESCRIPTION GOT 73 0�/0 G�¢if'�'"S /�6 �'s�► -, q� - r s TOWN OF .S & I= T` COUNTY 15r . C P— X CSTM Jc LOCAL AUTHORITY/ SUPERVISION 57'• CP-Ot ft; " C- - f PROJECT DESCRIPTION: N&W 6 S 7 ve- 7 MA) Ulbricht & Associates Private Sewage Consultants 2812 10th Ave. Spring Valley, X1/154767 D s P9•1 INFILTRATOR SIZING WORKSHEET P9.2 SYSTEM PLOT PLAN Pg.3 CROSS SECTION OF SYSTEM, WITH ELEVATIONS. P9 .4 If 11 it If of if P9.5 OWNER MANAGEMENT PLANS & ZABEL FILTER SPECS P9.6 (OPTIONAL) CROSS SECTION AND SPECS FOR DOSING TANK. PG.7 (OPTIONAL) PUMP PERFORMANCE SPECS. plans and Specifications are b Absorption Component based Treatment S Comp ne Manual For °n "In- Ground (Version Private 75_p(N Wastewater 2.0) SBD- 1075- p(NO1 /01.. /1/10, 14-0 r Gititl s 13 , C i; r d s S .�► 17, v / y �� x 1 t� /0/ Ti J �6p �— its 4 o Q 'OZ.� O O 1 T 1 n L 1� Reolzvonzw PIM /60,6 �r 5 Thk��d o v T z- oT . l0 SiP e -< - 7 _-S POWT SYSTEM SHALL t (t INCORPORATE PER COMM. 83.44(2)c A PROPER ZABEL s FILTER MODEL # _ /0O f 30 i T5 OR �r LA � G � IN CL z z 0 -t• `' c b q < g m ro m z t� tl) tA kA e 1 o � �t �r 51f4N4 C. y+ P 5 4PRI 0V I ff _. Irr I 17 O �i�o SS' Sic © Tio� � 7 llv Q0 rT C,VXCIr .ems C4,05 -f AMA eR �AITAEC a,V T/o v _ �1i�v. � 2 Iff AREA; e ll 7&M � OVER: See Reverse Side for Vent/ Observation Pipe Details. oZvWee j y�ap,� s,� // = 70/1 H4VSEA1 / Cp. ,Ptk 3106 /" - S sod Wisconsin Department of Commerce SOIL T page / of 3 Division of Safety and Buildings in m 85, Is_ ' Adm. Code Attach comple site Q CoA $ T• C rZ0 r)! cal plan on paper not less than 81/2 >PI izg. s �Q include, but not limited to: vertical and horizontal reference difr�Q{idn slid P I.D. 3 0 1 •20 4S Q• O percent slope, scale or dimensions, north arrow, and location Isfance4 3 2 O y S' S d 00 O Please print all information. OFFIC Re ' y Date Personal information you provide may be used for secondary purposes ( 1) (m)). EL k Property Owner C3 t9 ( Lid M V y E Property Location 7 • - 1 , M A C=F /V 05o AJ y 0M C- s Govt. Lot ty W 114 5 *1/4 S /Z T 3D N R 141 E (or Property Owners Mailing Address Lot # Block # I Subd. Name or CS&V 1 5 z l) 1 1 3 -r+4 5 i LA K�rStD�-T�TS City State Zip Code Phone Number I] City ❑ Village ® Town Nearest Road ST LLWA(TEX, M'Q X0$2 (t 2) 9 4o '78471 Sa) $3cr (� New Construction Use: ® Residential / Number of bedrooms 3 Code derived design flow rate 'J �� (Q 00 GPD ❑ Replacement ❑ Public or commercial - Describe: -- Parent material o yv�r_ O 10 TWASit Flood Plain elevation if applicable 0,j A ft. General comments and recommendations: AtM..,&_SPt Tested suitta M for a WII4Ond=1 inground system (P.O.W,T.S.) a ! Bori # ❑ Boring ® Pit Ground surface elev. D/ • O / ft. Depth to limiting factor > 9 8 in. Appl ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 l 0 -14 I o Yle 3 / 3 - f .8 2 14 -2'7 1 1 o eR sic a f C, df •a .3 v -?. > a Boring # 0 Boring ® Pit Ground surface elev. Sag ft. Depth to limiting factor q 7 in. Sou! Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GMT in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -�a ► n Yk31 - 11, � .f r M � r C S f 2 10-17 IuYR - SiCI m Sb)t M-F, 0 3 vk •�F )VYR '6/ - SiCI 3C 5bK m-Hi a s Z.vf y at to• a - (�. Al . j(o 1 7 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 _5 150 mg/L Effluent #2 = BOD 1 30 mg/L and TSS 1 30 mg& CST Name (Please Print) Signature CST Number 3 IEN t j if u L Ia. f2tc- # - r ? 599 3 Address V Data Evaluation Conducted Telephone Number 2S1�_ DT't Ave W I MA f / Z CPO I C 7 I ORW GINAL I I /o Property Ow Eb 4 garcel ID # Page _ _ of 3 B (� ❑ O&V U # ❑ Pit Grou surface etev. 9 3. 66 a. Depitrtb facbr > 98 ir Sol R Horizon Depth Dom Color Redox Description Texture Structure Consistence Boundary Roots GPM in. Munsa Qu. Sz. Cont Color C, r. S - Sh. 'EM 'E>fli2 1 0- n YR 3/3 — a r m -Psi S` 4 S 2 '7 -17 10 YR4/4 i C ; S 3 V .?� 3 n -2q IU YR5 /b - s cl 3f-5 W m i a.w 2- V* 4 29- 9 l o YR 6 ls S s m - 1. F -1 ❑ Pit Ground surface etev. R Depth to MOV factor in. Sal Afozabbn Rate Haimn Depth Dw*mtCokx Redox Description Texture Structure CorWsWnce Boundary Roots GPM In. Mured Qu. Sz. Cast. Color Gr. Sz Sh. •EfM •EW F S 0 SorkV ❑ Pit ft Depth factor k Sot Rate Hor mn Depth Datwnant cc&x Redox Deser"on. Texlrre Consistence Boundary Roots " " GPOW irr. Munsel Qu. Sz. Cont. Color . Sz. Sh. •Eff#1 .W F - 1 0 ❑ � s� stair. ft Depth io factor in. � Rate Hor mn Oep1h DondnantColor Redox Texture SkLx* a ConsManoe Boundary Roots GPOOff in. Munsel Qu. Sz Color Gr. Sz. Sh. 'EW1 2 4 • Elltuent #9 = I3OD > 30 < 220 and TSS >W < 150 mgt. • Mient #2 = SCiD _< 30 rrtgR_ and TSS < 30 mg& The Department of Commerce is an I opportunity service provider and employer. If you need assistance to access services or need material in an al fora at, please contact the department at 608- 266 - 3151 or TTY 608-264 -8777. sOD4ue(eAM) L- A= K 6751 D-' C�T - r� s L Ld >� �bP 3 a IERJ c H M ,*P.K BO R 1,4 (r ® = GO N Tc>O iR PvG PI PC 5a2 5 ET 9Y CbT CL- NC). PRc>PERTY LIN 15 , 13 M / 2 = 9 S•5 1 341. 83 ly G) 3• L o '7 9011 g3.66 0 Z3 ► = 101 o I %,6) 2-1572 M l = Ioo-00 Z.S G'R -4DEE SHOT = 1 I" PVC PIPE • 2b' BUILDICJ(i S�WIFR Exm^3er S E'I h3Y A- PPR O yc . A T q.8 S CST P RoPnS�D 4 • B�pROaN► HO NSE' Idl•OJ VJ m 4 9q.) So tr'r+F P RO PV-tZ LI A E Ulbricht & Associates Private Sewage Consultants 2312 10th Ave. Spring Valley, WI 54767 /a% I� v.�GOf1 � �'v j�S � l �i4 ,17� veGOp�,�v T a,/o Tov fl.9.vsE.v S T2�v Cvi�vG �-1 v. SO GG 6 S/ • 3 88 • /Go oc, Wisconsin Department of Commerce SOIL EVALUATION REPORT Page ! of 3 Division of Safety and Buildings In accordance with Comm 85, Attach complete site plan on paper not less than 8 t12 x 11 i es i r �� C � O / x r Include, but not limited to: vertical and horizontal reference int (B ), rection andI.D. SEE percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information l �J i`? .� '` by Date Personal Irdonnation you provide may be used for secondary purpoa (Pfiracy Low. a. M04 ( Property Owner 4ty lflcation S /� 61,#bt � JefF) 90,41PDM•9 Govt. Lot 114 114 S Ix T ` N R I V * (or) W P rty Owner's Mailing Address Lot # Block 4 =/A-76- Name or CSM# - 2 - z /Cob w - �4 Vie • /a p "J, - 0 /e P114 7 Coy &W State Zip Code Phone Number ❑ city ❑ Village (aTown Nearest Road RiG"ewe? I W1 15 ( 7/5 2Y6 'S3k Sd.tiE/P.sET /lo 'gue . 0 New Construrfion Use JM Residential 1 Number of bedrooms 3 Code derived design flow rate �',Q . GPD ❑ Replacement ❑ Public or commercial - Describe: _. Parent material S/4�t Y 007' t:l1�t Slk-,- Flood Plain elevation If applicable General comments and recommendations: ♦ p� j� 7T"S _5 i 7, 0 etf 4A� tlz5oT /o v of4 ,a. D. w. T. S _ ,�io�,•fIvSE� Ce //S F/I Borin # � Boring Pit Ground surface elev. Depth t ft. epo limiting facto IV(; in. ioafl0n Rate Horizon Depth Dominant Color Redox Description Texture Studkxe Consistence Boundary Roots GPDNf In. Munsel Qu. Sz Cont Color Gr. Sz Sh. '091 •Ef 92 o •/ /oy/e 3/3 L l fs6e 4m 75e w 3 f• y • 20 /D /g — S1 S6 / 4) /� .2- 3 3 ,o 71e 4154e s . 0 /p Scr' S. . _ Yd eU Y• O Bong > 9� F # Pit Ground surface elev. �' O ft. Depth to limiting factor in. Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPM M. Munsefl Qu. Sz. Cont. Colo Gr. Sz. Sh. *Eff#1 *Eff#2 / a -/o /o Ye 313 G 775,4 3 I S Yle 0 p ' Effluent #1 = BOD > 30 1 220 mg1L and TSS >30 1 1150 mg& ' Effluent #2 = BOD < 30 mg& and TSS < 30 nVL e CST Na R "ease Print 7-11h �/?t/j � Signature Z 2- f 3 S 1 i Address Date Evaluation Conducted Telephone Number Ulbricht & Associates If • ieaj 7IS• 77.7- • k394 Z. 2812 10th Ave. 3 A • Spring Valley, W 1 54767 Y� ° ife S /� f s� �'�-C, // Z " 2 o K o • DAD 5eISE .See. For issuance of ermits and desi nin P 9 9 _ • ozS Contact: Ulbricht & Associates 03 Z �YS • SD Registered private wastewater consultant and plumbers / _ p3 -Z a yf_ yo .oaz 2812 10th Ave. 1.5 sE�• YZ— Spring Valley, WI 54767 715 -772 -3442 4/ s W/N w 3 p,o z 3 z - �� yS • yd • �-Q-o A. U I Property Owner _ Parcel ID # Page of F3] Bdg 0 Bo ""g Pit Ground surface elev. fl. Depth to limiting fador in. 7GPDff Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. f#2 o-12- 10YR31) Z— 51AI fIL / s 4.t I• w If /40 , p , s. D, S ng # p Boring Cr G surface elev. ft. Dep to Crm factor in. ❑Pit ro P � So8 Application Rate Horizon r Depth Dominant Color Redox Description Texture Structure Consistence Bou ry Roots GPDIff In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 - Eft#2 Boring # p Boring ❑ Pit Ground surface elev. ft. Depth to ' factor In. Soil AMka§T Rate Horizon Depth Dominant Color Redox Description. Texture S Consistence Boundary Roots GPDM In. Munsell Qu. Sz. Conn Color Gr. Sj Sh. 'Eff# *E1f#2 E Boring # ° Bodng ❑ Pit Ground surface elev. ft Depth to 9 Soil Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/Pf i In.-- Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. FE tf #1 'Elf#2 it Effluent #1 = BOD, > 30 < 220 nxA TSS >30:s 150 mg1L ' Effluent #2 = BOD, < 30 m%& and TSS <_ 30 mglL 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. seo.uue pe.beoi y I i 30 low' neAf-e , A 1 � _ �'0� �arP G %v�e.S • 2 sE 7 T p i/u, �� f = ys 67 So y� / o a If I S -(P oo. la' oo,d/ @ 80' - � OWNER + s _.. �,. . MAINTEANCE OF SEPTIC SYSTEM POWTS (landowner ) Is maintenance of (landowner) for servicin Ystem. Regular proper operation and s The necessary for the safe healthy inspections and /inspection YsUe owner is required b Y operation of, this maintenance Y code to submit reports all necessary to the controllin ry controlling ,authorities., SPECIFIC CONTACT AGENTS * Governmental authority/ inspectors.* ST - G�4lX cry 20 1,�'A3 ? /s• 3� ' Sal v maintenance installer, - responsible for providing an oper ation/ ance Usersy manual: P ationj 7�S . - 7 ? 3 q4/ * Licensed servarce / inspection agent other than ��/ - G �-�./ ✓ 7�j'�-T /DV i n s t a l l e r Electrician, f pump, electric controls, wiring units: IMPORTANT OWNER MAINTENANCE RE UIREMEN �. Winter TS traffi shall not be g, shove*ing, etc.) across the the cell Permitted, or frost can/will freezing up the system- penetrate winter (a vacaction Discontinuos use into lead to freeze ups. resulting in no water use) the rI • ) can also 2 • Water conservation needs hydrolically overloaded and be exercised! Or system can be designed for a max destroyed. This sv wastewater flow of sjem was OWTS G0 O gals. daily- 3• P a re not designed to _'- d OWTS a l unit accomodate wastes Any introductionrofnY other unnatural sources of a garbage destroy this such waste materials of waste, system. will overload and 9 • If a over P outage occurs, or a in a temporar Pump fails, it may cell Y overload of effluent bein Y result which may adversely Pumped into the. zecommended that a Y impact the cell (leakhge) It is allowing the licensed pumper empty the dosin Consult Pump to return to dosin tank, Your installer immediate) g the Correct amounts. S• Neglect Y for advice. r the ve erosion cove preventi r (the cells tr affic ! ) Can lead to fa' Insulation & REGULARLYIso can destro failu Compaction WATER THE VEGETATIONsYstem. It IS NECESSARYrTOeavy the -QpsteM beneath IS NOT OVER A SYSTEM!! Effluent in y1 �TOVwr sufficient alone to maintain a 6 . Periodic inspections b necessary. I Y the owner, or his a into th pection pipes and g is inspect on the Ports have been e mound i t 0 P io and incorporated n b r Pipes), cleanout asal area (effluent Posted laterals, at each terminals level out:, tip for flushing n the pressurized The filter system g and cleaning the laterals ground cover /manhol Person s �. Only and a locked above should be Y licensed severe safety Performing this Properly qualibl ed fet s f l system's Y risks, k which ' Evi involves treatment Bence of effluent Ives health • cell shall Pondin also be re 9 in the ,����� 9Ularly inspected. ST CROIX COUNTY SEPTIC TANK 1vIAINTBNANCB AGREEMENT AND OWNERSHIP CERTIFICATION FORM 0wner0sym IbA-1 ��4�rr -y • �op� D� -����� Mailing Address Property Address (Verification required from Planning Department for new construction) City /State S,6A4& 2S& Parcel Identification Number ? ys 3 S/S so • oo a LEGAL DESCRIPTION / 3�. � I '1(0 — — o 6 b Property Location /�� %s, ` %s, Sec. j Z , T 3 d N R / W, To of SO�'s'� 7 Subdivision k & - S Lot # Cerhf' red Survey Map # , Volume . Page # Warranty Deed # 7 Volume 2 L� S� Page # / Spec house Dyes ❑ no Lot lines identifiableAyes ❑ no SYSTEM MAINTLNANCE Impropwuse and maintenanceof 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 masWphnrber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, 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 a ear expiration date. X SIGNA71ILR OVAPPLI&NT 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 virtue of a warranty deed recorded in Register of Deeds Office. e SI C DATE * * * * *• Any information that is mid represented may result in the sanitary permit being revoked by the Zoning Department. ** Include with this application a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed G-TNAL ' V N59 -7 -1+ 7 4a 0 1. _ STATE &R 41 4ISC&S& F"2 KATHLEEN K. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX CO., WI RECEIVED FOR RECORD This Deed, made between Elaine G• §2Kdmau a side > Grantor, 11/19/2003 01: 20PH and QM Selo e-id- M& WARRANTY DEED Gramm. EXIT Grantor, for a valuable consideration, conveys and warrants to Grantee REC FEE: 13.00 the following described real estate in a_Croix _ County, State of TRAITS FEE: 1725.80 Wisconsin (if more space is needed, please attach addendum): COPY FEE -t See Attacked Exhibit "A" CC FEE: PAGES: 2 Reootding Area Name VM SUM 200 1900 SILVER LAKE ROAD MEW BRI O 66118 Ma NO- 32-204546t28 , 0* 32-0454%M Parcel Iderificum Number (PIN) This is uaR homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rAghwd way of record, N airy. Dated this � day of November _ ' Ela G. Boardman AUTHENTIMION ACKNOWLEDGMENT SignatuWs) Elaine G. Boardman, a sho! person _ STATE OF / � i n - • _ ) ) ss. -- - - -- -- - - - - -- - R. County ) authenticated this 1_y of No vembe r —.200— Personally came before me this _ ` day of o.tc.•b _ . u:3 the above named e Kra Odd --- - - - - -- - -- - - - - -- - TITLE: MFM ER STATE BAR OF WISCONSIN (If not, _ to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY • Attorney Krisstitm Oglm d _i ------- -_.___ 1gf�iRY MOUNTAIN Hudson, W I 54016 — _ - Notary Public, State of TARY - - NO ysuc - MINNESOTA __.. —.._ _ My Commission is permanent ,'&E'BR�iey' Zone , (Signatures may be authenticated or acknowledged. Bah are not necessaty.) • Names of persons signing m any capacity must be typed or printed below their sigma m. Intormaaon Professionals Co— Faad du Lac. W1 FrATS BAR or WISCONSIN 800. 655 -1021 WARRANTY MMD MMM MO. x - t9" RI G U. 2459 P 218 EXHIBIT "A" A parcel of land located in patt of the SW 1/4 of the SW 1/4, part of the NW 1/4 of the SW 114, par of the SW 114 of the NW 1/4 and part ofthe SE 1/4 of the NW 1/4 of Section 12, Township 30 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin; being Part of l,ot 23 of the Plot of North Bass lake list m; described as follows: Beginning at the W 1/4 corner of said Section 12; thence North 88° $7 1 " E. along the Fast -West 114 line of said Section, 599.05 feet to the NW corner of Lot 1 of Certified Survey Map recorded in Volume 15, page 4186 at the St. Croix County Regisbor of DoWs Office; thence South 00 9 20' 08" E, along dio West line of said Lot, 660.05 foot to the SW corner ofsald Lot; thence North 88 57' 3 P L, along the South line of said 14 660.OS feet to the SR corner of aid Lot; thence North 00° 20' 08" W, along the rssw line of said Lot, 677.53 feet to the Southerly line of 165'" Avenue and a point on curve of 1383.00 foot radius ourve, concave Northerly, whose central anglo measures 17 3T', whose cord bears Smith 82° 2 P 10.5" B and manures 115.71 foct; thence Hasterly along said Southerly lino and the aro of said curve, 116.16 feet to the East-West 1/4 line of said Section; thence South 88° $7' 31" W. along said Ud -West 114 fine, 48.59 fact to the East line of the West 1/2 of the SW 1/4-, thence South 00 20' 08" F, along said East line. 2654.23 feet to the South lino of tho SW 1/4 ofsald Section; thence South 89 14' 08" W, along said South line. 223.78 feat to the SE corner of Lot t of Certified Survoy Map recorded in Volume 16, Page 4345 at said office; thence North 00 45' 52" W, along the East line of said lot 1, 385.13 feet to the NB corner of said Lot; thence South 89 34' 47" W, along the North line of said Lot 1, 372.54 foot to the NW corner of said Lot: thence South 00 °45" S2" E, along the West lino of said lot, 387.37 feet to said South line of the SW 1/4; thence South 89 08" W, along said South line, 437.60 fear, thence North 00° 45' 52" W, 165.47 feet; thence North 35° 13' 13" W, 101.43 feet; thence North 58 51' 18" W. 219.64 feet; thence North 02° 36' 46" W. 315.02 fact; thence South 87 23' 14" W. 28.05 feet to the West line of sold SW 114; thence ]North 00 0 27' 04" W, along said West line,1968.67 feet to the Point of Beginning. i ii+ 0� _ 8EWL 3.W.LZ.00S 6 i tl1 p � N m W fQ nm al Nor nl O ,Do Lt F 3g l S1 �I� 2%g � I I� I LOT y SEE SHEET S EAST 11NE OF THE SE1 /40F SECTION 11 T04'. 144390' 620.88 327.3I' Z 258.72 : EJ 304.34' 259.92 D 33 j N M 1 .4 atn FOFyVq m ODI= i �m on cFn I r � sl $ A EB mm co Ln v • • ! $mr gib r Z N o N 06 (J • aso $ co O M a "� $f O r n O rr�� o M 4 P O9 - > O i d mO 0 Igo fn Fn ti M 22 Fn / 502 `�SOG'2�'OB`E�5350 ft !� ® -10 E FAA? Ct, V / —� ! (IN � • ®V ♦ ��/ �S t ~— � 1g 00°20'OB'E6TL ° a 500 650.03' V I ! o ti _ p % v o0 _..) o � N D m m v v • \ ® $o r \\ �% \ 2 O V ® \ \ \ pl 'a Sn1 •° ul s Im18 ic g`� ° _ �IpI� I a mrla I d ` a >o l I 8wr Rolm >12 I I � I' " I 5jl $ I I NOO *2O'O8'W 164.98 4M 17 _ W 88 EASEMENT FOR MIdiESS & _ 1 - W EGRESS REC/ VOL 1708, M 145 232.48 287.98 728. ,.�� EAST UNEOFTHEW112OFTH ESWI /4SEC. 12 - _ .