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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
� fety and Building Division
INSPECTION REPORT Sanitary Permit No: 487949 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:
Kro mann, Kurt Somerset, Town of 032 - 1010 -20 -000
CST BM Elev: b Insp. BM Elev: BM Desc ` Section/Town/Range/Map No:
b'm ` 04.31.19.61 B
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Sept / 2-0V 3r7 3r- Z OS• zo"-b
Alt. BM
Aem on Bldg. Sewer
Holding St/Ht Inlet
TANK SETBACK INFORMATION st/ 0
TANK TO P/L WELL BLDG. Vent to Air Int ake ROAD t Inlet
Septic i[s Dt- Betterw- $ �-v / p 7
.---- ! !�
Header an. J, 0
Aeration Dist. Pipe
41 ' �3 9.5-7
Holding Bot. System V X4,3, 9 u �'
Final Grad �
PUMP /SIPHON INFORMATION `j
Manufacturer Demand St Co ver Gc
GPM 2 t S �Os I
Model Number
TDH Lift Friction s ead JTDH Ft
Forcemain gth Dia. Dist. to Well
SOIL ABSORPTION SYSTEM k 3
BED/TRENCH Width LIP I INo.OfTrenches PIT DIMEN ONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS
SETBACK SYSTEM TO P/L BLD WEL LAKE /STREA LEACHING anufacturer:
INFORMATION CHAMBER OR
Type Of System: / 5 / UN Model Number:
D IBUTIO SYSTEM
eade anifold Distribution ) x Hole Size x Hole Spacing Vent to Air In faker 3
! Pipe(s) /� y I
Length Dia Length Dia `P Spacing I I 6Q/L
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulche tYes h,
Bed/Trench Center Bed/Trench Edges Topsoil
0 Yes No � No
COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1:_ I Inspection #2:
Location: 2330 50th Street Somerset, WI 54025 (NE 1/4 SE 1/4 4 T31 N R1 9W) metes & bounds Lot Parcel No: 04.31.19.61B
1.) Alt BM Description = _T_0 f q� /t AJ
2.) Bldg sewer length=
- amount of cover = J
Plan revision Required? E Yes No 0
Use other side for additional information.
Date Insepctor's ignature Ceh. No.
SBD -6710 (R.3/97)
Safety and Buildings Division County
2 W. shi Ave., P.O. Box 7162 ✓' !'
Con sin iso 53707 -7162 Sanitary Permit Num er (to be filed' by Co.)
Mi
(608)266
Department of Commerce
Sanitary Permit-Application a PI I.D. Num bef
In accord with Comm 83.21, Wis. Adm. Code, personal information y u provi .e. ,j
may be used for secondary purposes Privacy Law, sI5.04(1 X ) ject A dress (if different an mailing address)
1. Application Information - Please Print All Information r. CROIX COU ry cSC�/Y>rL2+
ZONING
Property Owner's Name Lot N Block N
-- (, - f./ r u -Id -a0
Property Owner's Mailing Address Property Location
T H ) J Section q
City, State Zip Code Phone Number
)NEW 5 F / J ' � `1 L V 7P � % � ` � T _ N; R L E oQV
II. Type of Building (check all that apply)
L ✓ t Subdivision Nameum r
1111 or 2 Family Dw ^fling - Number of Bedrooms
❑ Public/Commercial - Describe Use �/,✓
❑ State Owned - Describe Use ❑City_ ❑Village Prownship of S Oj le�S r_'
III. Type of Permit: (Check onl ne box on line A. Complete line B if applicable)
A ' ❑ New System It Replacement System Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System
List Previous Permit Number and Date Issued
B. ❑ Permit Renewal 11 PermU evtswn ❑ Change of ❑ Permit Transfer to New ,L ,/
Before Expiration Plumber Owner 6--
IV. Type of POWTS System- Check all that a l S�
19 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 Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑
Recirculating Synthetic Media Filter thing C ber ❑ Drip Line ❑ Gravel -less Pipe ❑ r jeX lain)
V. Dispersal/Treatment Area Information: l U l U
Design Flow (gpd) Design Soil Application Rate( Ca gpdst) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System E /
�j � V
If
VI. Tank Info pacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Holding Tank
Aerobic Treatment Unit
Dosing Chamber Y
t3_ ZZI
VII. Responsibility Statement I , the undersigned, assume responsibility for installs ' f the POW FS shown on the attached plans.
Plumber's Name (Print) PI 's Signature M P umber Business Phone Number
_ 1 ; 1 '24
<z
Plumber's Address (Street, City, State, Zip e)
VIII. Co /De artmen se Onl
Sanitary Permit Fee (inclu es Groundwat�L Date Issued lss ng Agent Sig �ture o Sta pproved 11 Disapproved Sur har a Fee o l
c
g ) �� -- ld�� 0
❑ Owner Given Reason for Denial
1X. Conditions of Approval /Reasons for Disapproval 7
T EM_ tN R: �
Septic tank, effluent filter and
C�►'YY�? �i C u' -�-��
dispersal cell must all be serviced /maintained
as per mans ement Ian provided by p l u mber.
9 p
2. setback requirements mus a matnfalne� —
as per applicable codelordinances. !�'I
Attach complete plans (t the Counp only) for the system on r not less than 81/2 ill inches in size
aye.
SBD -6398 (R. 01/03)
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1399
Wisconsin Department of Commerce S EVALUATION REPORT Page 1 of 3
Division of Safety and Buildings in accordance w ++ 1� Tom Schmitt
Attach complete site plan on paper not less than 8%: x size. PI�rt m(; F- I VF� m ounty
include, but not limited to: vertical and horizontal reference point M), direction and
St. Croix
percent slope, scale or dimemsions, north arrow, and location a distan nearest road. arcel L D.
a3Z
Please print all information. r 74�ved By Date
Personal information you provide may be used for secondary purposes rivacy Cdr. . ��1),(60 , °1 � TV
Property Owner iEtt�
Krogmann, Kurt Govt. Lot NE 19 SE 19 S 4 T 31 N R 19 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
2330 50th St.
City State Zip Code Phone Number ..j City �j Village id Town Nearest Road
Somerset I WI 1 540251 Somerset I 50Th St.
. ] New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement Jj Public or commercial - Describe:
Parent material Outivash Flood plain elevation, if applicable na
General comments
and recommendations: Area is suitable for a conventional system with a 0.5 gpd/sqft rating. Possible system elevation for
replacement area is 94.5'. Slope is 4 %.
Boring # jj Boring
16 Pit Ground Surface elev. 99.92 ft. th to limiting factor 108 in.
Dep g Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz
`Eff#1 `Eff#2
1 0 -17 1Oyr3/3 none sil 1mpl mfr gw 1vf .4 .6
2 17 -28 1Oyr4/4 none sit 2msbk mfr gw - .6 .8
3 28-44 1Oyr4/4 none sicl 2msbk mfr gw - A .6
4 4453 7.5yr4/4 none ft 1 msbk mvfr cw -- .5 1.0
5 53 -75 10yr5/6 none Is 1 msbk mvfr cs .7 1.6
6 75 -87 7.5yr5/6 none gds 1 msbk mvfr cs -- .7 1.6
7 87 -100 7.5yr4/4 I none I Ifs 1 1 msbk mvfr - .5 1.0
a le Boring # Boring
Pit Ground Surface elev. 100.50 ft. Depth to limiting factor 110+ in. Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft'
`Eff#1 'Eff#2
1 0 -23 1Oyr3/2 none sil 2fsbk mfr cs 2vf .6 .8
2 23 -32 1Oyr4/4 none sil 2fsbk mfr gw 1vf .6 .8
3 32-46 10yr416 none sil 3msbk mfr gw 1vf .6 .8
4 46 -60 10yr5/6 none fs Osg ml gw - .5 1.0
5 60 -82 1Oyr6/4 none s Osg ml cs - .7 1.6
6 82 -93 7.5yr5/4 none sl 2fsbk mfr cs -- .6 1.0
7 93 -110 1Oyr6/4 I none I fs Osg 1 ml I - ----- .5 1 1.0
` Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD < 30 mg/L and TSS <30 mg/L
CST Name (Please Print) Signature: CST Number
Thomas J. Schmitt 227429
Address Tom Schmitt Date Evaluation Conducted Telephone Number
1595 72nd St., New Richmond, WI 54017 10/14/05 715 - 247 -2941
Property Owner Krogmann, Kurt Parcel ID # Page 2 of 3
F3 ] Boring # Boring
Pit Ground Surface elev. 99.30 ft, Depth to limiting factor 100+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
*Eff#1 *Eff#2
1 0 -12 1Oyr3/2 none Sill 2fsbk mfr as 1vf .6 .8
2 12 -21 10yr4/6 none sicl 2msbk mfr gw 1vf .4 .6
3 21 -31 1 -----
Oyr5/6 none s Osg ml a .7 1.6
4 31 -42 1Oyr5/4 none grs Osg ml cs ---- .7 1.6
5 42 -71 1Oyr5/4 none grsl 2msbk mfr cs — .6 1.0
6 71 -75 1Oyr4/6 none Ifs 1msbk mvfr cs — .5 1.0
7 75 -100 1Oyr6/4 none s Osg ml — --- --- .7 1.6
F—I Boring # Boring
�j Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP
*Eff#1 *Eff#2
— A
F—I 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
*Efr#1 *Eff#2
* Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD -S 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.
Page 3 of 3
Conducted by: Conducted For:
Schmitt Soil Testing Inc. Name: Kurt Krogmann
Thomas J. Schmitt, CST 227429 Address: 2330 50th St.
1595 72nd St. City, State, Zip: Somerset, WI 54025
New Richmond, Wl. 54017
Phone: 715- 247 -2941 Subd.Name:
Lot No..
/0—/Y _O',s` Legal Description: NE1 /4 SE1 /4 S4 T31N R19W
Backhoe pit Township, County: Somerset, St. Croix
Bench Mark EL 100.00' Top of 2" pvc pipe
Alternate Bench Mark EL 99.29' Top of vent cw, existing drain field
Slope= 4%
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I
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF AN EXISTING SEPTIC TANK
This is to certify that I have inspected the septic tank presently serving
the – 6/2 7 - r' ket residence located at: NE
Sec. T �_ N, R _L3 W, Town of St. Croix
County, Wisconsin. 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 Aafr Coo
Did flow back occur from absorption system? Yes No_,�L' (if no, skip next
line.
Approximate volume or length of time: gallons minutes
Capacity: 110 -"-" R -�
Construction: Prefab Concrete Steel Other
Manufacturer (if known):
Age of Tank (if known) :
(Signature) (Name) Please Print
/ 1 llpfi a) 9,;17 /3
(Title) (License Number)
lZ'
(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 opening over
outlet baffle) .
Name , L?UJ� Sign a re
M MPRS / 2 y 3
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer / 1 /.�/P % aon / %A&y
Mailing Address Y0 7 0f s /7• T0MjE 2 s,!C;; T &h
Property Address 0
TH
(Verification required from Planning Department for new construction)
City /State 50 &,j52s,e r Parcel Identification Number 03a2 - /-0/D -,.o
LEGAL DESCRIPTION
Property Location _&�F Y4, :5F'_ V4, Sec. 4, T_[_N -R-L�LW, Town of 6-7 .
I
Subdivision . Lot #
Certified Survey Map # `7 V6 i Nolume . , Page #
Warranty Deed # (a 06 , Volume � � 7 � , Page # �
Spec house ❑ yes H no Lot lines identifiable 6 yes ❑ no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site 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.
I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification f
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.
SIGNATURE OF A1 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.
t
SIGNATURE OF APPLICANT DATE
Any information that is fibs - represented maX 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 #
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pa of 2
FILE°INFORMATION SYSTEM SPECIFICATIONS
Owner Septic Tank Capacity al O NA
a
Permit if Septic Tank Manufacturer t
S ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA
Number of Public Facility Units ® NA Pump Tank Capacity a l JO NA
Estimated flow (average) gal/day Pump Tank Manufacturer 0 NA
Design flow (peak), (Estimated x 1.5) ;,el g al/day Pump Manufacturer 51 NA
Sail Application Rate `j al /da /ft: Pump Model ® NA
Standard Influent /Effluent Quality Monthly average' Pretreatment Unit E 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 Cellls) ❑ NA
Biochemical Oxygen Demand (BOD.) 530 mg /L M In- Ground (gravity) ❑ In - Ground (pressurized)
Total Suspended Solids (TSS) 530 mg /L L4 NA ❑ At -Grade ❑ Mound
Fecal Coliform (geometric mean) S 10` emqooml ❑ Drip -Line ❑ Other:
Maximum Effluent Particle Size a in di ❑ ] Other: ❑ NA
Other: ❑ Other: ❑ NA
'Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA !
MAINTENANCE SCHEDULE
Service Event Service Frequency
j Inspect condition of tank(s) At least once every: ® Qa� { s (s) (Maximum 3 years) ❑ NA
Pump out contents of tank(s) When combined sludge and scum equals one -third (Y,) of tank volume ❑ NA
-
Inspect dispersal cell(s) At least once `every: "' ® year(s) ❑ month(s) (Maximum 3 years) ❑ NA
Clean effluent filter least once eve ® 0 ye mo ar(s) I ❑ NA
Inspect pump, pump controls & alarm At least once every: ❑ month(s) eB NA ;
❑ year(s)
Ftush laterals and ressure test At least once eve ❑ month(s) ®NA
P every:
❑ years)
v ❑ month(s.. .. , p NA I ,
Other. At least once a ery: ):.
❑ year(s)
i Other• s
❑NAB x
MAINTENANCE INSTRUCTIONS rYl !
Inspections'of , tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications o x
Master_ Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator Tank r1
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 urface. The ponding of effluent on the ground surface may indicate a faiUng condition and requires .the F r
immediate n'oUfication of the local regulatory authority. _ [
When the combined accumulation of ,sludge and scum in an tank a uals one third (Y) or mor of the tank volume,Y.the,entir� i
any a :: • x -
contents of,,the tank shall be removed :by a Septage Servicing Operator and disposed of in ac ordance with chapter
Wi dmlrnstraUve Code ' x f t ;�
z,t ��t�; -: "mac r zCE sx;. t 3.
All other services, °:including but not limited to the servicing of effluent filters, mechanical or pressurized componentsupretreatrrient
'� ...t . ,.avtE;isa, 1 t
nits, and any servicing at intervals of 512 months, shalt be performed b yy iner Y
., r . •` .,r.':..'st .' ..
A'servlcereport shall be provided to the local regulatory authority wtthin 10 days of;compleUon of any service event, =�*r
)� ' r bw s �'i
✓� _ --,��,._ R;� kl 3, \.;`, i S .3 � �c.� -,� 4 � '/.. ��y.
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� � :: �� 1 �� J; ."' � { +, i n r .\ s �v _t ��'�. �£ ;�g s . �t, .'s,� k �� •-.t „' ' x }' s. � � ,�'! :
Page of y
STARTUP AND _OPERATION
Fdr 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 an 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 cell(s) in one large dose, overloading the cell(s) and may'result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
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.
I
• 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. i
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 j
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 l
evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank
maybe 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 r
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
ENTER ASEPTIC, 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
�x t
POWTS INSTALLER . POWTS MAINTAINER - x a
Name t' Nane 7t A f t
Phone , Phone 5
r s .t'� ?.Y
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULAT ORY AUTHOR ITY
*Name
tt
i
Phone
5 ,.� - a
.; s..t.•: r ._.' S. .i ,.,. n <j,; - alr4 r, r.,r- x,.rf ••, f.:,, t rr� 'x ++` w + a��f4;,4�Lea
This oc ument was drafted in compliance with chapter Comm 83 22(2)jb)(1)(d) &(f) and 83'54(1), (2i &:(3) Wisconsin AdministraUVe Code t Y �
�, s "T , t }r} 6 _ y b °c. f:. # r ( r r a. +.,.'3 P �`^Y:.�#�.F,'�5�'�` �� - � �" Cr e � � '4:ti ,y '( � s k. t r �+ Fad .+N+�rYy�,,'c�3Kt
... 'Y z ..
f �
U 1 9 7 2 P 3 `f 1 689803
KATHLEEN H. NALSH
' STATE BAR OF WISCONSIN FORM 2 - 1998 REGISTER OF DEEDS
ST. CROIX CO., NI
This Deed, made between Carole J. Schwan, a single person, Grantor, RECEIVED FOR RECORD
and Kurt G. Krogmann and Toshimi I. Krogmann, husband and wife, as 09 -10 -2002 8:30 All
survivorship marital property, Grantee. WARRANTY DEED
Grantor for a valuable consideration, conveys and warrants to Grantee EXEMPT ii 17
the following Wisconsin (The • described real estate in St. Croix County, State of Wisc
b REC FEES 11.00
i
"Property "): TRANS FEE:
COPY FEE:
A part of the Northeast 1/4 of the Southeast 1/4 of Section 4, Township 31 North, CERT COPY FEE:
Range 19 West, described as follows: COMMENCING at the Southeast corner of PAGES: 1
said Northeast 1/4 of Southeast 1/4; thence North along the East line of said forty
a distance of 450 feet; thence West 300 feet; thence South 450 feet to the South
line of said forty; thence East a distance of 300 feet to the point of beginning;
Recording Area
subject to easements and restrictions of record. Name and Return Address
_
032- 101 -20
Parcel Identification Number (PIN)
This is not homestead property.
This conveyance is given in Satisfaction of that certain Land Contract dated May 1, 1996 and recorded May 3, 1996 in
Vol. 1176, page 37 as Document Number 543127.
Exceptions to warranties: Subject to all easements, restrictions and covenants of record, and any lien created by act or
omission of Grantee.
'?
Dated this I — day of August, 2002.
'Carole J. Scb
� s
AUTI IENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
e
)Ss.
�( CrDf County )
authenticated this _____ day of , 2002.
Personally came before me this Z- /d
ay of
2002 the above named — �Y4t.L
TITLE: MEMBER STATE I3AR OF WISCONSIN to me known
(Knot, to be the persons) who executed the foregoing instrument and
authorized by § 706.06, Wis. Stats.) acknowledge the same.
THIS INS'T'RUMENT WAS DRAFTED BY
Ronald L. Siler (JJ aruj—v,
VAN DYK, O'BOYLE & SILER, S.C.
Post Office Box 118 Notary Public, State oft nrisiana =5 ion is permanent.
New Richmond, WI 54017 (If not, state expiratiO te: _ ) ki
(Signatures may be authenticated or acknowledged. Both are not t J ��� S i
necessary.) JANEEN BENDY
Notary Public —State of Wisconsin
`Names of persons signing in any capacity should be typed or printed below their signatures
WARRANTY DF.F.D STATE aAR OF WISCONSIN
FORM Nw 2 -19"
INFORMATION PROFESSIONALS COMPANY FOND OU LAC. WI 90""2021
Par #: 032- 1010 -20 -000 01/31/2005 08:33 AM
PAGE 1 OF 1
Alt. Par 4.31.19.616 032 - 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
" KROGMANN, KURT G & TOSHIMI I
& TO ROGMANN
2330 50TH ST
ERSET WI 54
Districts: SC = School SP = Special Property Address(es): # = Primary
Type Dist # Description
SC 4165 SCH D OF OSCEOLA - �v ,, S �
SP 1700 WITC 2
Legal Description: Acres: 3.100 Plat: N/A -NOT AVAILABLE
SEC 4 T31 N R19W 3. OA NE SE S O' OF E ,✓ Block/Condo Bldg:
300' OF NE SE ('
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
04 -31 N-1 9W
4
Notes: Parcel History: X40
Doc # Vol /Page ype
09/10/2002 6 72/341 WD
117
07/23/1997 1080/590 TI
2004 SUMMARY Bill #: Fair Market Value: Assessed with:
9739 181,700
Valuations Last Changed: 07/22/2003
Description Class Acres Land prove Total State Reason
RESIDENTIAL G1 3.100 48,500 105,600 154,100 NO
Totals for 2004:
General Property 3.100 48,500 105,600 154,100
Woodland 0.000 0 0
Totals for 2003:
General Property 3.100 48,500 105,600 154,100
Woodland 0.000 0 0
Lottery Credit Claim Count: 1 Certification Date: Batch #: 104
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
ST. CROIX COUNTY
W ISC 2
ZC?NI 1
N M N ti N N it r rR•� ST. CROIX COU VER t T C
1101 ichael Qy} `' � � �
Huds aD I W16- 7710
(7 4 386 -4680 '
SEPTIC INSPECTION / WATER TEST REQUES
Pppp-
P
J t s .
Please specify desired test(s) & remit appropria fee ' h
application. Outside water lines are often turned o cd ring
winter months, making access to the home necessary. Please make
arrangements with this office to insure that entry can be gained.
0 Water (VOC's) $185.00 S tic 50.
P $ 00
0 Water (Nitrate & Bacteria) 45.00 0 Nitrate & Bacteria
retest $15.00 °
Owner. J ' t2) L Requested by: \_
ddress•' YJ Address: d13. e yh - fl\
• Z I P
Tel phone E CI �
� - Telephone N°: I: to It,,,, '
Property address (Fire If & Str et) � J�
Location • - Sec . T R W, Town of
Realty firm: �f Lock Box Combo: Closing Date:
�.31.��1.tPit3
i
TO BE COMPLETED BY PROPERTY OWNER
*PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM*
Water sample tap location:
Is the dwelling currently occupied? 0 Yes El No k ;
If vacant, date last occupied:
Age of septic system:_ Wil _
Septic tank last pumped by: IVA Date:
Previous Owner's Name(s):
Have any of the following been observed?
❑Y "NN Slow drainage from house.
OY NN Sewage Back -up into dwelling.
OY 'ON Sewage discharge to ground surface or road ditch.
OY "5N Foul odors.
er comments relative to system operation:
tify that the above information is complete and true to the
f my knowledge. ..
OWNERS SIGNATURE: L - � - DATE: J Z��J ° /�
q
� o
s
;0 6, �Q
��� `OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION
% p ,� t wo e
,d
f' C6 s f w
n ED BY I NSPECTION AG
fi le OY
• es ONO ENCY
survey. -
o`o vim' motio system Sheet #
�o G X OBelo grd _ - ----__
d �� ..�'� _ _ __Ft; = OGravity p oserd OMOUnd
1��
� 0G,y � ` c
oa DEFICIENCIES OBed OTrench ODr Oressurized
o,� O c OHolding Tank Y Well
- enk O HOldi Ooutfall Pipe
a 10 , ,� - etbacks: OHouse OUnknown
' °s�o�� ;,• .,�• �� --, �.� tank -- _,_..,_ OWell
Setbacks- . Prop , line
•- -----
CIHOUSe r
Mocking ---_ OWell ----_ Oothe
g cover — OPrO
Soil Ala OE .- OWarning label p� lines_ OOther
Ab w irin g p /Flo
SOr cks - on S stem irin -- -_____ OPum ats
Setba; OHOUS -- -- --•--
O Ponding: --___ OWell
•�� c`c; General comments: ODischarge� OOther
soa,4�,®
0 . � % It �
fig$," M INSPECTORS SRETC
�< Hof Sy S T LOCATION
I nspector
Title —
ST. CROIX COUNTY
WISCONSIN
- ZONING OFFICE
r r x n n u r n r ■...� ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
- Hudson, WI 54016 -7710
(715) 386 -4680
February 7, 1996
Carole Schwan
#2010 Highway 35 North
Somerset, WI 54025
RE: septic Inspection /Water Test Request Form
Dear Carole:
Per your request, please find enclosed the Septic
Inspection /Water Test Request Form. Return the completed form
along with the appropriate fee(s) to our office. We will process
your request promptly upon receipt. If you have any questions or
if we can be of further assistance, please give our office a call.
Sincerely,
goo
Thomas C. Nelson
Zoning Administrator
St. Croix County Zoning Office
db
Enclosure
QA I
p �n
ST. CROIX COUNTY
.�� WISCONSIN
ZONING OFFICE
a N r r ■ Nounb ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
Hudson, WI 54016 -7710
(715) 386 -4680
May 21, 1996
Carole J. Schwan
2010 S. T. H. 11 35" N.
Somerset, W 54025
Dear Carole:
On May 20, 1996, an inspection of the septic system on the property
located at 2330 50th Avenue, Somerset, Wisconsin, was done.
It was indicated on the application that the residence has been
unoccupied since 1980. Therefore, should the system be failing, it
most likely would not be evident at this time.
The inspection done on May 20 was based on a surface inspection of
the system, and did not involve any excavating or chemical
analysis. Accordingly, there is the possibility of hidden defects
in the system not discoverable by this inspection. This does not
in any way warrant or guarantee the continued proper functioning or
operation of this system. It is recommended that the system be
pumped once every three years. Therefore, the prolonged life of
this system may be dependent upon proper maintenance of the system.
Should you have any questions, please contact me.
Sincerely,
Mary J. Jenkins
Assistant Zoning Administrator
cc: File
� 4
't
Wisconsin Department of Industry SOIL AND SITE EVALUATION l j Page _1_ of -a—
Labor and �uman Relations
Divis ron_af alety & Buildings
1 id
in accord with ILHR 83.05, Wis. A ame
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan m lude, but tu
not limited to vertical and horizontal reference point BM , direction and % of sloe a or 11 ''; ° 'T i
Po ( ) P 4t., , �., 1010
dimensioned, north arrow, and location and distance to nearest road. r`
APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION 00UN VIEWE DATE
Z'O N!'tir. FEGL
PROPERTY OWNER: PROPER W m
Carole J. Schwan GOVT. LOT �i341i 31 N,R lg ¢or) W
PROPERTY OWNERS MAILING ADDRESS LOT # BI-01 # A E OR CSM #
2010 Hy. #35 ° 4'in 64 -ate na na na
CITY, STATE ZIP COD PHONE NUMBER [ EIVILLAGE MOWN NEAREST ROAD
Somerset, WI. 54025 (715) 247 -5283 Somerset 50th. sT.
[ ] New Construction Use [x ] Residential/ Number of bedrooms 3 ] Addition to existing building
i bd Replacement [ ] Public or commercial describe ?
Code derived daily flow 450 gpd Recommended esign loading rate .7 bed, gpd /ft trench, gpd/ft
Absorption area required 643 bed, ft 563 trench, ft Maximum design loading rate .7 bed, gpd /ft .8 trench, gpd/ft
Recommended infiltration surface elevation(s) 87.35 ft (as referred to site plan benchmark)
Additional design / site considerations na
Parent material outwash Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK
U= Unsuitable for stem ®S ❑U ®S ❑U ®S ❑U [3S ❑U [ S ❑U CIS EJU
SOIL DESCRIPTION REPORT
R
Depth Dominant Color Mottles Structure
GPD ft Z
Boring # Horizon Texture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed
1 -16 10yr2 /2 none 1 2msbk mfr gw 2f .5 6
_ fr 1f .2 3
s m
I
2 6 34 Oyr4 /4 none s' 1 if bk gw
Ground 3 4 -80 7.5yr4/4 none is Osg mvfr na na
.7 .8
elev.
9
Depth to
limiting
factor
+80"
Remarks:
Boring # 1 -10 10yr2 /2 none sl 2mgr mvfr gw 2f .5 .6
<w i« 2 0 -29 10yr4 /4 none sl 2mgr mvfr gw if .5 .6
U
3 9 -38 7.5yr4/6 none is Osg mvfr gw na .7 .8
Ground -
elev. 4 8 -84 7.5yr4/6 none co s Osg ml na na .7 .8
90. ft.
Depth to
limiting G� S
factor
+84
Remarks:
CST Name: Please Print Gary L. Steel Phone: 715- 246 -6200
Address: 1554 20 h. Ave. New Riclimond, WT. 54017
Signature: Date: CST Number:
5 -8 -96 cstm 02298
PROPERTYOWNER Carole J. Schwan SOIL DESCRIPTION REPORT Page _ of —
PARCEL LD. # 032 - 1010 -20 4
AW
t
Depth Dominant Color Mottles Texture Structure Consistence Roots GPD ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed JfWrxh
h 1 0 -15 10yr3 /3 none 1 2msbk mfr gw 2f .5 .6
1' 3
M�t: >:::r: 2 15 -20 7.5yr4/4 none 2mgr mvfr gw if .5 .6
Ground 3 20 -84 7.5yr4/6 none co E Osg ml na na .7 .8
elev.
90 ft,
Depth to b
limiting
factor l0
+84 IF
Remarks:
Boring # 1 1 0-6 10yr2 /2 none 1 2msbk mfr gw 2f .5 i.6
2 - r4 4 none sl 2m r mvfr if .5 .6
6 25 10 Y / g �
3 1 25-80 7.5yr4/6 none S Osg ml na na .7 i .8
Ground
elev.
89. ft.
Depth to
limiting
factor
+80"
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
k:
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD- 8330(R.05/92)
STEEL'S SOIL SERVICE
Gary L. Steel 1554 200th Ave.
CSTM229$ Carole J. Schwan
SE4SE4 S4 T31N - R19W New Richmond, WI 54017
MPRSW 3254 town of Star Prarie (715) 246 -6200
BM.= bottom bolt power line cover C el. 100'
� 6 )0
r
Is
h�
>� M
f `
la `
i
f
�0
QQ�
Gary L. Steel
5 -8 -96
Parcel 32- 1010 -50 -000 01/31/2005 08:34 AM
PAGE 1 OF 1
Alt. Parc #: 4.31.19.64 032 - TOWN OF SOMERSET
Current ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): * = Current Owner
* HAASE, WILLIAM W & OPAL H
WILLIAM W & OPAL H HAASE
324 230TH AVE
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description
SC 4165 SCH D OF OSCEOLA
SP 1700 WITC
egal Description: cres: 40.000 Plat: N/A -NOT AVAILABLE
SEC 4 T31 N R1 9W 40A SE SE Block/Condo Bldg:
(EZ -U- 1146/509)
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
04-31N-19W
Notes: Parcel History:
Date Doc # Vol /Page Type
07/2311997 1212/431 WD
0
07/23/1997 1212/429 WD
2004 SUMMARY Bill #: Fair Market Value: Assessed with:
9742 Use Value Assessm nt
Valuations: Last Changed: 07/22/2003
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 38.000 5,500 0 5,500 NO
UNDEVELOPED G5 2.000 200 0 200 NO
Totals for 2004:
General Property 40.000 5,700 0 5,700
Woodland 0.000 0 0
Totals for 2003:
General Property 40.000 5,700 0 5,700 7
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