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HomeMy WebLinkAbout032-2044-20-100 0 c J o / % k 2 k ® ( ƒ 7 ° A E / S 0 k i m i §§ 00 3 2 [ § @ ° $ i CL cr CA c \ ` ■ r \ = E § $ />2 / \ o o -4 0 o 2 K 9 1 70 . � ® � "WiA § § a $ 8 8 z 0 r ch � / 0 0 o \ \- / q 7 (a i 0 ~ > 25' § 7 J k & (D ' \_ \ CA) ::3 / ® k f .. 0 § > 0 \ 9 7 \ / : f I CL � \ � CD / k \ \ $9 o \ \ \ � 2 z a � m " . C ® \ . \ \ � } [ I \ . � k q . � NJ ■ . R � k \ f i ! 2 8� ' � # Parcel #: 032 - 2044 -20 -100 01/27/2005 11:33 AM PAGE 1 OF 1 Alt. Parcel #: 12.30.19.6476 032 - TOWN OF SOMERSET Current k ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner MICHELE M MONTBRIAND * MONTBRIAND, MICHELE M 865 170TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: cress- 3.380 Plat: 0861 -CSM 13/3656 SEC 12 T30N R19W NW NE BEIN LOT 2 CSM Block/Condo Bldg: LOT 2 13/3656 �'-- Tract(s): (Sec- Twn -Rng 401/4 1601/4) 12- 30N -19W Notes: Parcel History: Date Doc # Vol /Page Type 02/20/2002 671535 1839/302 WD 12/21/1999 615830 1479/338 WD 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 10949 201,200 Valuations Last Changed: 07/14/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.380 49,900 120,700 170,600 NO Totals for 2004: General Property 3.380 49,900 120,700 170,600 Woodland 0.000 0 0 Totals for 2003: General Property 3.380 49,900 118,500 168,400 Woodland 0.000 0 0 Lottery Credit Claim Count: 0 Certification Date: 12/04/1998 Batch #: PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 VWsconsin Department of Commerce SOIL AND SITE EVALUATION Division o Qf ,, Safety and Buildings -v . Page of Bureau of integrated Services in accord t+lrl�l is1' ILtR"3.09, Wis. Adm. Code 9 -, Attach complete site plan on paper not less than 81/2 x 1 inc bes`�in must County include, but not limited to: vertical and horizontal refers point in p fj Parcel I.D. f percent slope, scale or dimensions, north arrow, and loc$tlort and Distance to neatest road. , _ . # APPLICANT INFORMATION - Please Tint �! ll info ik," Re ' by Date P / a Personal information you provide maybe used for se xy Pu 4Pmra�d,#hr U �%64 (1) (m)).; � Properly Owner - ; .- proprir�r (� \ 1/4 1/4,S �� T 3 d,N,R E (or (W) �7I w Property owner's Mailing Address "FA # Block# I Subd. Name or CSM# . 0, i c7 5U `f a - City State Zap Code Phone Number ❑ City ❑ Village 19 Town Nearest Road . 5�0� c� /s� 6 a s New Construction Use: Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow � 5d gpd Recommended design loading rate bed, 9P trerK:h, gpd Absorption area required - bed, ft trench /fl , ft Maximum design loading rate bed. 9P french, gpd Recommended infiltration surface elevation(s) r ft (as referred to site plan benchmark) Additional design/site considerations ./ i D �1 Parent material Flood plain elevation, if applicable _� 4 n S = Suitable for system I Conventional Mound In -Ground Pressure I AT -Grade System in Fill Holding Tank U unsuitable for system 1 X S ❑ U I XS ❑ u I Qs ❑ U LZLs ❑ U ❑ S 0 U ❑ S „Z1 U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench e' ate.- a y l l m . Ground 7,81 Al , l A ft. Depth to limiting factor ?Lzain. q7-41 s Z Remarks: Boring # I o � /d of 7-1k 14 1 err+ s Uf e s - Ground IOn. 3.r Depth to { limiting fa r � Remarks: CST Name (Please Print) Sign re Telephone No. Address Date CST Number s C , cam 21 y J SOIL DESCRIPTION REPORT ' PROPERTY OWNER ��L- C/i --p! � r� , , Page of V PARCEL I.D.# Boris # Horizon Depth Dominant Color Mottles Structure 2 Boring in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots 0 Bed ,Trench 0-g Ground Depth to limiting fa or `y 8 n• lao.1, S' S Remarks: Boring # 9 1 A - Ground elev. Ai2-� Depth to limiting facto Tin. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # C S� ,p Ground Depth to limiting factor Remarks: Boling # Ground elev. ft. Depth to limiting factor ' Remarks: SBD -8330 (R. 07/96) I s j Soil Test Plot Plan Project Name W hite Pine Inc. Shaun ZL Address P.O. Box 504 Hudson Wi 54016 CSTM #226900 Lot 2 Subdivision -- - ---- Date 3/28/99 NW 1 /4 1/4S 1 2 T 3 0 N/R 1 9 W Township Somerset Boring ()Well PL Property Line County ST. C ROIX BM or VRP Assume Elevation 100 ft. T op of Survey Pipe System Elevation 104.1 * H R p Same as Benchmark Alt. BM Top of Survey Lath @ 103.4 288' Property ine Alt. B.M. 15 B -5 15' B-4 45' M. 232' Property Line CD Rep A 60' r CD 17% >20% Slope Slope O' -3 � Site Requires a Lift Station 60' Pri A c� B -1 5' B -2 452' Property Line 170th Ave I 2lid g � .,.� � RONALD f. 1:7 ll FILED 10HNSOPI MAY 2 8 1999 ► 1 AMERY KATHLEEN H.WALSH WIS. RepistefoiDeeds S7 CROIX Cgfi'v'TY /' •, Q "' V ®as SL CroixCo..WI SURVEYOR L RI?y_ <,1 E. t o . 981 ���.:*CERTIFIED Y MAP The Northwest Quarter of the Northeast Quarter of Section 12, Township 30 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin. Prepared for and at the request of: NOTE: The parcels shown on this map are subject to State. County and OWNER Township laws, rules and regulations (i.e. wetlands, minimum lot size, access White Pine, Inc. to parcel, etc.). Before purchasing or developing any parcel, contact the St. P.O. [lox 504 Croix County Zoning Office and the appropriate Town Board for advice. Hudson, WI 54016 I Drafted by. Kristi A. Eylandt FND 1" TIE IRON PIPE LOT 1 CERTIFIED SURVEY MAP I I -- -- - - - - -- IS N81'26'53 "W 0.96' VOLUME 9 PAGE 2680 LOT 2 FROM SET 1" IRON PIPE - f ° o 1 33 NORTH UN£ OF THE NW 114 THE NE 114 ENTERLINE I -- 17 0TH AVENUE – - N89'36'35 "E 1 2636. R- ssa•4o'a2•w — 170th Ave. M - - -- ` 14; - - -- _J — - \ -- N89'36 35 E 1318.07 - - - - - -- �. — .. — • • „ 5 66.06_ 451.98 _ 300.03' �� -— — %,452.02p,., >t'w �300.0� — 1318.07 � �... ' / /.` 533.06, ! 1 i 3 i -- N89'36'35 "E 12 5.11' - - ! -22.7.t R.O ! � 170th Ave.- °_ o ;,�� >. -vim UYx✓ o `t 'i ice: I 6 N N \ l ...c ..�.y.. �.- M;n °'� < X'( / �t ° Y. '1••1• 1 1 �� v 1 o o '., eo X"�BLDG SETBAC INE °f �° �� > 1 I 1 V d ,o) O LOT 3 fv n (100' FROM R. .W.) J�C r Y I I I I d o ! c dI ` XN O N X 00 1 • = s ` -- 53.06 - - -- - / 232.26' ,'�, 2 d ♦� '.�'y I l ' " ' ' -- N893635 E 798.32-- . ,. �A19 o Z W I I - 33.00'' • ' `' ?8 ���� LOT 1 1 _ 9.0 f rn v` Y.x✓Y ` 2 Z L N � ,v, ;i S89'36'35 "W �u W %0 I �° 300.03' 0 ao I ^ t �' yv`�. • `. ". '' l CONTIGUOUS BUILDABLE AREA: ! V 144,310 SQ. FT. / 3.31 ACRES '� I cnl I I I Ni Z f I � I tnl hl a I� " W x °° DI dDl IN O ��. °< 'Yv • x :•�f...: r' I I N ♦ W 1 LOT 4 �I i r a � i o g ° TOTAL AREA: 1,290,474 SQ. FT. �� '� i g DI �� I N 29.63 ACRES I Ito o� I I w \n I to Z AREA EXCLUD. R.O.W.: 1,256,251 SQ. FT. W t H Zi Ln I I i 1 3 28.84 ACRES I I W 1� u� f2 NOTE: AREA SOUTH & EAST PCERA�N AY W I y BE AN AREA POSSESSED BY - JOINING LAND OWNERS MAY H c N ° IN RIGHTS. CONSULT ADJOINING L I o S I I °o ( i m F O E R N C� ATTORNEY BEFORE RE Z I I 1 1 i SOUTH LINE OF THE NW 1/4 OF TH 1286.50' TYP. / x _r._ 7-,-7 X — ----- S89'37'57 "W 1319.50'---- - to l I j�� - -- I ,H °I I `33.00' LOT 1 •-� '� ~ ' I �, CERTIFIED SURVEY_ MAP UNPLATTED LANDS � 1 01 viiil al 1 VOLUME 2 PAGE - 33 8 8 ' OLUE 1 3388 ^I - - - - -- - n� CONTIGUOUS AUILDABLE AREAS ! �'✓ r DENOTES CONTIGUOUS BUILDABLE AREA PER TOWN OF SOMERSET ORDINANCE w LOT 1 = 54,276 SQ. FT. / 1.25 AC. CHAPTER 98,R4r ° LOT 2 = 62,999 SQ. FT. / 1.45 AC. - "Now N 100 LOT 3 = 86,021 SQ. FT. / 1.97 AC. I I County Section Corner Monument TOTAL AREA LOT 1: of Record 11 �Z 140,714 SQ. FT. / 3.23 AC. 0 Set 1" x 24" Iron Pipe weighing 1 ' AREA EXC UD. R.O.W.• a minimum of 1.13 pounds per foot. SOUTH 114 CORNER 130,813 SQ. FT. / 3.00 AC. O Found linear fo o Iron Pipe • / SEC. 12 -30 -19 � (ALUM. CO. MON.) TOTAL AREA LOT 2: R= Recorded As 4} 147,389 SO. FT. / 3.38 AC. JOB #99006 AREA EXCLUD. R.O.W.: 250 I 25a N� I Prepared by: 132,473 SO. FT. / 3.04 AC. A & E TOTAL AREA LOT 3: GRAPHIC SCALE SCALE IN FEET: 1 inch = 250 feet LAND SURVEYING & CIVIL ENGINEERING 158 ,498 SQ. FT./ 3.64 AC. Phone No. (715) 246 -4319 AREA EXCLUD. R.O.W.: BEARINGS ARE REFERENCED TO THE NORTH -SOUTH 11 109 East Third Street, P.O. Box 325 131,665 SQ. FT. / 3.02 AC. LINE OF SECTION 12, TOWNSHIP 30 N., RANGE 19 W. New Richmond, WI 54017 WHICH IS ASSUMED TO BEAR NOO'28'20 "E. � Sheet 1 of 2 Vol. 13 Page 3656 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 404918 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)(in)]. Permit Holder's Name: City Village X Township Parcel Tax No Montbriand, Michele Somerset Township 032 - 2044 -20 -100 CST BM Elev: ( Ins . BM Elev: BM Description: (� • �� Q r �— L �.o 1 M. a -[; TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmar Dosing IV Alt. BM Aeration Bldg. Sewer Holding SUHt Inlet TANK SETBACK INFORMATION St/Ht Outlet `F-3 (o 0o • 4 ' TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Z �v • �� Dt Bottom 30 Dosing Header /Man. Aeration Dist. Pipe se ee Holding Bot. System Final Grade ` PUMP /SIPHON INFORMATION Manufacturer Demand St Cover O�fps p �• OS GPM Model Nu ber r &>kI� S. $9 q� 9a TDH Lift NN Fric' oss System Head DH Ft D 2 �,T`"r 8•�6, rk Forcemain U6 ngth Dist. to Well SOIL SORPTION ISYSTEM 3 ITRENC PIT Width f No. Of Trenches DIMENSIONS No. Of Pits Inside Dia Liquid Depth DIME IONS � SETBACK SYST EM TO P/L JBLDG IWELL LAKE /STREAM LEA CHING Manufact ( C INFORMATION CHAMBER OR `} • )� Type Of System: I /) UNIT r J 10 2 M el Number DISTRIBUTION SYS EM sd. P/L Header /Manifold ,,D S istribution r. Hole Size x Hole Spacing Vent to Air Intake Iry9'f�� Fp e(s) Length Dia en Dia S 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 Bed/Trench Edges Topsoil Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1 0(o � Inspection #2:. Location: 865 170th Ave Unknown (NW 1/4 NE 1/4 12 T30N R19W) NA Lot 2 / arcel No: 12.30.19.6478 1.) Alt BM Description = sT te..er , 2.) Bldg sewer length= 3 a # 9�r•�f , x=,,,40 •�+. 4• Z Sr � .,(S— ~_ .1.4 � � - amount of cover = ? �� .` "" �FZ 9 � c is r ,o = 9 S•(► S Plan revision Required? a, 1 Yes 1/ No Use other side for additional Information. Date Insepctor's Signature Cert. No SBD -6710 (R.3/97) Safety and Buildings Division Cou y' . CROIX 201 W. Washington Ave., P.O. Box 7162 i scons�n Madison, WI 53707 — 7162 Sj� � l Department of Commerce �O?� Sanitary Permit Number Sanitary Permit App licat In accord with Comm 83.21, Wis. Adm. Code, personal inf tiag o you provide - ❑ Check if Revision may be used for second ses Privacy 1 La , s State plan I.D. Number I. Application Information — Please Print All Information (O_ m ECEIVLQ ' Parcel Number Property owner's Name FF R 1 2002 032204420100 MICHELE MONTBRIAND G0UWTY 1, Property Location Property Owner's Mailing Address a, ZC"#4G0FF1OE 647 3849 WESTON AVENUE NW 9 NE u • S 12 T 30 N R 1 Zip Code Phone Number \ Lot Number Block Number City, State �, 2 -- WOODBURY MN 55125 651 /5 2 , 741 Subdivision Name CSM Number 60391 H. Type of Building (check all that apply) ✓ Cary Q;1 or 2 Family Dwelling - Number of Bedrooms 3 ❑village ❑ Public /Commercial - Describe Use ®Township SOMERSET (9 ) ❑ State Owned ' Nearest Road ( 2 ) 3 ��� ZS - r 39 �iS 170TH AVENUE III. Type of Permit: (Check only one bAn e A (numbering scheme for internal use). Complete line B if applicable) For County use A =stem System 3 ❑ Replacement of 6 El Addition to Tank Onl B. usly Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply) (numbering scheme is for internal use) t lore 44 11 Non - Pressurized In- Ground 21❑ Mound 47 ❑ Sand Filter 50 ❑ Constructed Welland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. Dispersal/Treat ent Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade 97.25 Elevation Required Proposed Rate(Gals. /Days /Sq.Ft.) (Min./Inch) 450 643 643 .4 / � 9 99.75 � N/A 95.65 98.95 —98.15 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks I 'ranks Septic or Holding Tank 1 - 1000 1 WIESER CONCRETE X Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plant. Plumber's Name (Print) s Signawre MP/MPRS Number Business Phone Number PI ' BENNIE HELGESON 220292. 715/772 -3278 Plumber's Address (Street, City, State, Zip Code) W1229 770TH AVENUE, SPRING VALLEY, WI 54767 VIII. Coun /De artment Use Only Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Approved ❑ Disapproved Surcharge Fee) ❑ Owner Given Initial Adverse. z2 5 f�.2S2ao Determination lJf. Conditions of ApproY gasons for Disap�prov -k Art s s ►1e� We em on not lea than SW =11 huhee in she Attach complete (to the Comte only) for system Pa1K+o 1 GXX. $ y s SBD -b398 (R. 05101) , 83 r } c 1 y 0 ?Tcn. o a- -- 1 \ r. rl l � r L � k J� ilk 0 S F� s a l N d v -3 � d y© � T UN r L IV 0 o•G v 3- C , r / 3 Wisconsin. Department of Commerce SOIL EVALUATIO N REPORT Pag of Division of Safety and Buildings in accordanh Comm e r ' County - 51 "' c'/P Attach complete site plan on paper not less than 8 1/2 1 $ i s' ;' ZO? must , mu include, but not limited to: vertical and horizontal ref tBMr r t l6n d Parcel I.D. percent slope, scale or dimensions, north arrow, d on andistance f eatit road. f R viewed by Date Please print all i o,K " atio ( , % , t Personal information you provide may be used for s #ry purposes (Privacy Law4, a. f5.04 L) ( )). •O WuZ Property Owner � F � n t s rr , IP- perty LA lion / v l i C elm �- l O� T p i' IG , -' ' Govt. I.ot j�f. 1/4 E_ 1/4 S T3p N R 1 9 4400 W Property Owner's Mailing Address " {' g F �of #' r # Subd. Name or CSM# City State Zip Code Phone , u er . (� ❑ Village 21own Nearest Road woo bc..arr /70�1i v� New Construction Use: Residential /Number of bedrooms _ Code derived design flow rate ��d GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material r�(v C/� :Z// Flood Plain elevation if applicable 194 General comments f_YJ�i$TO/� '�$� G! 1 1, 93 and recommendations: USE ". ff �Gtj �Ar� j/U y3 /7, % 4 = 3J GhawLbt�� Sys -4e.., / - %v= 17. 0 96- YS'— K L/(f L) 99, 7 s - Boring # Boring ' Pit Ground surface elev. _ � 1-.S ft. Depth to limiting factor '7.;? in. Soil Applicato n 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 LO 0 vti ki c v ' to 3 0 �s #' S `' 4 6 ❑ Boring # Boring 0- Ground surface elev. ft. Depth to limiting factor > 8 in. Soil Ilcation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 `01142 � ' ,8c b y ( T) l:Z.7- =47-� ' Effluent #1 = BOD > 30 220 mg/L and TSS >30 150 mg/L ' Effluent #2 = BOD _< 30 mg& and TSS < 30 mg/L CST Name (Please Print) CST Number Si re 2�aa fY e� Address Date Evaluation Conducted Telephone Number /- �"- o� 7 77� 3a7d� PropertyOwner /�.,.LIPIr Parcel ID# Page of Boring # ❑ Boring 3 Uf it Ground surface elev. �C = ft. Depth to limiting factor > 7y Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fE in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 �4 Ak M V aL) u �r i u .3 O J'c— C LJ o b F�l Boring # E) Boring _ ©p Ground surface elev. � � ft. Depth to limiting factor Y" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 - Eff#2 , L (A) . - 36 1 c v 3 0 '12 C L s � t,� , v S f 3 i' ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate F 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 < 220 mg/L and TSS >30:5 150 mg/L ` Effluent #2 = BOD < 30 mg/L and TSS 5 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. SBD -8330 (R.6=) a M r� CD m� M� q .• U LL s J (-�- / �� -Y r od V J� � U rU � S i Y CL � o N 0 'v y/ i c Le I / L L P I 7 � Lt rrYJ[v �. e— 1/1 vl t Q r Sc (L Se-' C- ov. �f E /cam _ — 3' --A / oLlo J-lhes I I POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pape i ot�_ FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity ooD g al O NA 2. O Permit # Septic Tank Manufacturer dIESER CONCRETE 13 NA DESIGN PARAMETERS Effluent Filter Manufacturer 7A gg L O NA Number of Bedrooms 3 ❑ NA Effluent Filter Model A -100 12P46" 0 NA Number of Commercial Units ❑ NA Pump Tank Capacity al M NA Estimated flow (average) O O gal/day Pump Tank Manufacturer WIESER CONGgETE ® NA Design flow (peak), (Estimated x 1.5) ,5 " 0 gal/day . Pump Manufacturer GOULDS PUMPS INP NA Soil Application Rate y aUda /ftz Pump Model O NA Month e' Pretreatment Unit NA Influent/Effluent Quality y avers g ❑ Sand/C�ravel Filter ❑Peat Filter Fats, Oil &Grease (FOG) 530 mg /L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BOD 5220 mg/L ❑ Disinfection ❑ Other. Total Suspended Solids (TSS) 5150 m /L Manufacturer Pretreated Effluent Quality ❑ NA Monthly average" Dispersal Cell(s) Biochemical Oxygen Demand (BOD 530 mg /L gin-ground (gravity) ❑ In -ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ At -grade Mound Fecal Coliform (geometric mean) 510 cfu/100mi ❑ Drip-line ❑ Other Maximum Effluent Particle Size Y Inch diameter Values typical for domestic (non - commercial) wastewater and septic tank effluent •+ Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every 2 ❑ months Qyear(s) (Maximum 3 ym.) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume Inspect dispersal cell(s) At least once every 2 ❑ months 13 year(s) (Maximum 3 yrs.) Clean effluent filter At least once every 1 ❑ months . Cjyear(s) Inspect pump, pump controls & alarm At least once every 1 ❑ months Clyear(s) 01 NA Flush laterals and pressure test At least once every 3 ❑ months [lyear(s) ® NA Other. At least once every ❑ months ❑ year(s) ❑ NA other. At least once every ❑ months ❑ year(s) ❑ 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(sr 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 (Y) 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 ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreattment components, and any other maintenance or monitoring at intervals of 12 months or less 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 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. /l� /"l Ic�e%L / looLf�r1l1�0/ Page 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 cell(s) in one. large dose,*ovedoading the cell(s) and may result in the contents of the um tank removed b a this situation have the co Y backup or surface discharge of effluent To avoid P P Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Malntalner 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 We of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; 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. DON ABAN MM ENT 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 ch. 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. IR 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 blomat at the 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 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 POWTS MAINTAINER Name Name Phone 715/772 -3278 -Phone 1 715/273 -5811 SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY Name JOHNSON SANITATION Agency ST. CROIX COUNTY ZONING OFFICE Phone 715/273 -5811 Phone 715/386 -4680 This document was drafted by the staffs of the Green Lake, Marquette and Waushara County Zoning and Sanitation agencies. This document meets,. • the minimum requirements of ch. Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. Use of this document does not guarantee the performance of the POWTS. GMy(ypt) f ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 1 it h ell< �1)1.4 / iu �r Mailing Address A wc" 4 tit" w6odh-r- Property Address 170 Ave. )biner' (Verification required from Planning Department for new construction) City /State J o r,-, e `� L.�,�' Parcel Identification Number o -3a 2 o 4 f `e�2 Q -! e LEGAL DESCRIPTION Property Location 10 ' /a, i E '/4, Sec. 0 , T �30 N -R_L�_W, Town of � Subdivision , Lot # v'l Certified Survey Map # Volume �2_ �, Page # _ FS3°t P. o 3 b Z C. I ar an Deed ' 3S ,Volume Page tt ( p 9 Spec house ❑ yes eno Lot lines identifiable Dyes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. have ad the above requirements and agree to maintain the Uwe the undersigned h re private sewage disposal system with the standards P g 9 g set forth, herein, ass et b y the De Department of Natural Resources, State of Wisconsin. Certification D e p artment of Commerce and the De P stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. ow SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. .7l O Z/ SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. *• * * *• ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed 66 3 6 v 1 796 P ..569 REGISTER " DEEDS ST. CROIX , WI RECEIVED F RECORD STATE BAR OF WISCONS FORM ;: - 4 7 9:30 AM Docurmni r w YARRANTY DEED EXEMPT II CERT COPY FEE: CORY FEE: 'RANSFER FEE• 144.00 RECORDING FEE: 11.00 RAGES: 1 / Record n$ Area Name and Return Address 7NE RIVER U14K BOSC AVE EGL4. wl 54020 Parcel Identification No. 32 2044 20 100 This Deed, made between JAMES P THOMMES AND TARA L THOMMES AS HUSBAND AND � C WIFE GrantorW, convey and warrant to MICHELE M MONTBRIANII A SINGLE PERSON, as Grantee(s), theJ (O following described real estate in ST CROIX COUNTY County, State of Wisconsin: Lot Two of Certified Survey Map filed May 28 1999, in volume I , Pa a 356 Document Number 60 39 located in the Northwest Quarter of the Northeast Quarter of Sec ' wnship 30 North ange 19 West, Town of Somerset, St. Croix County, Wisconsin Exceptions to warranties: 1 r � � Dared: O CTOBER 26TH. 2001 JA64EIP. SO S � T_ARA L. THOMMES �r e-S - ACKNOWLEDGEMENT w STATE OF ) or )ss. COUNTY OF . Crr71 ) OB 26TH 2001 the above named JAM P. OMME and Personally came before me on - _ TARA L THOMMES HUSBAND AND WIFE . to me (mown to be the person(s) who executed the foregoin 7 ent and acknowledge the same. 1. c Notarial Stamp or Seal Notary Public - ► ({� C ( This instrument was drafted by: sp nQlr / Attorney's Title of Stillwater d 1335 Northwestern Ave. Stillwater, MN 55082 'y.,, ��1 ��'o.•' < vo 1839wE302 6'7 2 5r35 itir "�'i HL'�EN H. WALSH REGISTER OF DEEDS J. CR CO., dI STATE BAR OF WISCONSIN FORM 2 -1999 u =nt Nuffibcr WARRANTY DEED = CEIVED FOR RECORD 8:00 AN WARRARY DEED EXEMPT 0 3 CERT COPY FEE: 2.UPY 'EC 2.00 TRANSFER FEE: ECikDiSiii FEE: i1.00 WAGES: 1 Recalling Ana Name and Regan Address 1\Lp Ewa so , \..) - I;- SVO1Se tit 34o 6 Parcel Idendrrcation No. 32 2044 20 100 This Deed, made between JAMES P. THOMMES AND TARA L. THOMMES, AS HUSBAND AND WIFE Grantee(s), convey and warrant to MICHELE M. MONTBRIAND, A SINGLE PERSON, as Grantee(s), the following described real estate in ST CR= COUNTY County, State of Wisconsin: Lot Two (2) of Certified Survey Map filed May 28' in volume 13, Page 3656, as Document Number 603981, located in the Northwest Quarter of the Northeast Quarter of Section 12, Township 30 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin Exceptions to warranties: Dated: OCTOBER 26TH 2001 S P. T110 ME TARA L. THOMMES This deed is being re- recorded to correct ACKNOWLEDGEMENT the legal description. J� I. I'1Sco P Sb9 STATE OF WISCONSIN ) )ss. COUNTY OF ST. CROIX ) Personally came before me on OCTOBER 26TH. 2001 , the above named JM P. THOMMES and TARA L. THOMMES . HUSBAND AND WIFE. to me known to be the persons) who executed the foregoing nstrument and acknowledge the same. 'ate • ,t �t.c�/ Notary Public Notarial Stamp or Seal DIANE M. BARRON Notary Public This instrument was drafted by: State of Wisconsin Attorney's Title of Stillwater 1835 Northwestern Ave. Stillwater, MN 55082 CERTIFIED SURVEY M The Northwest Quarter of the Northeast Quarter of Section 12, Township 30 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin. SURVEYOR'S CERTIFICATE T, Ronald F. ,Tolrrrson, a Registered Wisconsin hand Surveyor, hereby rPt-1:i.fy t by I.he. clirer.tion of White Pine, Tnc., I have surveyed, d i.vi.dP and matt, # : -8 the Northwest: Quarter of the Northeast Quarter of fiect.ion 12, Tc,wrashih 30 North, Range 19 West, Town of Somerset, St. Croix f'c Wisronsi.n, desr.ri.bed as follows: Beginning at: 1:hc- Nor•Lh Quar t - pr Corner of said Section 12; thence, on an asgunli- 1 hearing along the north line of the Northwest Quarter of the Nort Qrrart:er of said Section 12, North 89 degrees 36 minutes 35 seconds East- a distance of 1318.07 feet to the east line of the Northwest Quar. l-.er of the Northeast Quarter of said Section 1.2; thence, along last said east line, South 00 degrees 24 minutes 35 seconds WPst. a d i s tance of 131.7.56 feet, to the south Line of the Northwest: Qtrarl of the Northeast. Quarter of said Section 12; then(-P, Along 1 ast said south line and in part along the north line of Lot 1 c,f a ( ' 01 •1 - .i f ied Survey Map recorded in Volume 1.2 page 3388 in the Regi.st or needs Office in said County, South 89 degrees 37 minutes 57 seconds West a distance of 131.9.50 feet to the northwest corner (if said T,( .1 this also being the west line of the Northwest QuarVor of t.hP N orthe ast Quarter of said Section 1.2; thence, along last said wosl l ine, North 00 d egrees 28 minutes 20 seconds East a d i -;l :arloo - I :' 17. (lfi fF -.L 1'" I h P C)o:i.nt; of :. beginning. Containing 1,737,075 �;�I,c,a „ fc�r.l (39.88 acres) S ubjt (It, to L•h right: -of -way for 135 (1) SI. reF t (A '.t'( Road) along the westerly line, and 170th Avenue (a Town Road) :along the northerly line of the above described parcel. Staldect t:ra a ll PagPmPnt.s, r.Pst.ri.c:tion and covenants of record. I also cert.i fy that this Certif_.i.ed Survey Map is a correct repreSent.al:. , n Lo sc -ale of the exterior boundaries surveyed and described; tla:al T have coral >.lied with the provisions of Chapter 236.34 of. the Wi.sr..ons i n Statutes and the Subdivision Ordinanc -e of the County Of St. Croix and the Town of Somerset in surveying and mapping the same. Ronald F. ,T - Itisorr Rey. No. 11.86 Date A & F Telephone (715) 246 - 4319 Land Surveying & Civil Engineering P. O. Rox 32gi New Richmc,nd, Wi 54017 gC O N S� ti RONALD F. �} M JOHNSON s —aaee AMERY. r WiS. • Su a jlr-- CnMX g $ T ►-a = Brim C = mr Sheet 2 of 2 �` �. o , �► ilepister of Deeds Q •' ®:S St cfoixCo.,wt ..�•R����•� ERTIFIED Y MAP The Northwest Quarter of the Northeast Quarter of Section 12, Township 30 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin. Prepared for and at the request of: NOTE: The parcels shown on this map are subject to State, County and OWNER: Township laws, rules and regulations (i.e. wetlands, minimum lot size, access White Pine, Inc. to parcel, etc.). Before purchasing or developing any parcel, contact the St. P.O. [lox 504 Croix County Zoning Office and the appropriate Town Board for advice. Hudson, WI 54016 I I Drafted by. Kristi A. Eylandt FNO i" TIE IRON PIPE COT 1 CERTIFIED SURV MAP_ IS N81'26'53 "W 0.96' VOLUME 9 PAGE 2680 FROM SET 1" IRON PIPE ( -- LOT 2 I b 1 33 1 - NORM LINE OF 7H£ NW 11 I THE NE 1/ 4 ENTERLINE ° -- - �3 - -- 17 0TH A V E N_U E R- see•4o'3z•w 170th Ave. I M _ - N8936'35`E J 2636.14_ _ _ _ _ - --- — — - N89'36 35 E 1318.07 - - - - - -- T 566.06 5, 30003 'i _ 451.98' _ �._.. —.. i \ _ ` S89'36'35� W- �. 533.06/ , / 7 �/i .452.02 < �l Y 1318.07 Z _ - - 300.07 W .R: ---0 "'. / 3 -% N8936'35 "E 1285.11' x' - �/ ` / .O. W. 170th Ave. o,_��_ o ► �, y : � ; i - ?2.7f to N w j I O n 1 LOT 3 ,' k'M • r.:x DG SE 'BACK iNE ' io r'Kx . •I• I t °� V I co N i.;�lvr Y l4cXX, ° N N \ :(100' FROM R.O.W.) 'iCM f i i,i j I a N J j I �� ;' - - -- 566.06'x.:;. «Sc;y F r �Z ✓f � n 3 �� 0 0 533.06'- o . ° Q I - -- - 232.16 ; LOT 2 n `• ! j? K I W \- \` r ` `t'� ` ' - - -- -- i y vS: `� AX j 798.32' -- -'� 4, 4 17$ Q Z° W 1 9 $ a i I 1 r 1 I �►Y Q LOT 1 t ►� X, ' \,, w a' ON I� t ` �� r S89'36'35 "W f �u � ' yv ' x`�. 300.03' f 1 1 r..., . y ,; , ., . CONTIGUOUS BUILDABLE AREA: I� N ! •� < 144,310 SO. FT. / 3.31 ACRES x j (ni I z ° I M ~ %i ' VY i I qI hI ro M !'.+'� y,. �, % 7 ; 3 of 14 o f 1 I,: r LOT 4 I r a 0 'I g TOTAL AREA: 1,290,474 SQ. FT. - $ a. I MI 0.I 2 C I I I r w 29.63 ACRES DI N ' I I I 00 j AREA EXCLUD- R Ci W - 1,256 SQ. FT, 28.84 ACRES I I W 100' ° a W ' NOTE: AREA SOUTH do EAST OF FENCE MAY � v BE AN AREA POSSESSED BY OTHERS. AD- I I ' o JOINING LAND OWNERS MAY HAVE CERTAIN I 1 S RIGHTS. CONSULT ADJOINING LAND OWNERS ► j M OR AN g i I FENCE. ATTORNEY BEFORE REMOVING SAID i i 1 1 I I I / l SOUTH LINE OF 7HE NW 114 OF 77.1E NE 114 1286.50' FENCE, TYP. _ x L_x _.._.._ P - -- ----- S89'37'57 "W 1319.50' - - - -- -- NI �JT7 33.00' LOT 1 I 4 i �f NI .1 1 CERTI SURV MAP_ I UNPLATTED LANDS VOLUME 12 PAGE - 3388 m I > I •FI i CONTIGUOUC BUI >• V DENOTES CONTIGUOUS BUILDABLE AREA LOT 1 54,276 S F Q. F T. A" 1.25 RSA25 AC. y PER TOWN OF SOMERSET ORDINANCE / CHAPTER 98w4o N LOT 2 - 62,999 SQ. FT. / 1.45 AC. I (IN LOT 3 - 86,021 SO. FT. / 1.97 AC. ��12: I ji�- County Section Corner Monument z TOTAL AREA I OT 1: of Record I 140,714 SQ. FT. / 3.23 AC. • Set 1" x 24" Iron Pipe weighing AREA X .I un PO . a minimum of 1.13 pounds per SOU7H 114 CORNER 130,813 SQ. FT. / 3.00 AC, linear foot. \ 1 SEC. 12 - 30 - 19 O Found 1" Iron Pipe �1 (ALUM. CO. MON.) TOTAL AREA LOT 2: R= Recorded As { 1 147,389 SO. FT. / 3.38 AC. JOB J99006 AREA X .I Un R 0 W e 250 a 250 NO Prepared by: 132,473 SO. FT. / 3.04 AC. A & E TOTAL AREA LOT 3. GRAPHIC SCALE LAND SURVEYING do CIVIL ENGINEERING 158 SCALE IN FEET: 1 Inch = 250 feet Phone No. 715 246 -4319 498 SQ. FT./ 3.64 AC. AREA EXCI ►1n_ R_n_w_. BEARINGS ARE REFERENCED TO THE NORTH -SOUTH 1/4 109 East Third Street, P.O. Box 325 - - i LINE OF SECTION 12, TOWNSHIP 30 N., RANGE 19 W. New Richmond, WI 54017 131,665 SQ. FT. / 3.02 AC. WHICH IS ASSUMED TO BEAR N00'28'20 "E. Sheet 1 of 2 Vol. 13 Page 3656