HomeMy WebLinkAbout032-1054-10-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division , f ,
1 ' INSPECTION REPORT Sanitary Permit No:
488119 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:
Moe, Jason & Elizabeth I Somerset, Town of 032 - 1054 -10-0
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
21.31.19.269A40
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
Dosing Alt. BM
Aeration Bldg. Sewer
7 37d mg St/ Ht Inlet
St/H Outlet
TANK SETBACK INFORMATION
TANK TO PIL WELL BLDG. v ent to Air Intake ROAD Dt In
s ept ic Dt B ottom
osing Header/Man.
era Ion D ist . Pipe
o Ing Got. system
Ina ra e
PUMP /SIPHON INFORMATION
m anufacturer Demancl bt Uover
GPM
model um er
i nc ion oss system mea
l- , o rcemain I Lengin
SOIL ABSURPTION %%
DIMENSIONS
INFORMATION CHAMBER OR
UNIT IVIVEIM N Of I MO. JA
Pipe(s)
Length Dia Length Dia Spacing
X Pressure Systems Only xx Mound Or At -Grade Systems Only rj I n Depth of Motu te
- T
Bed/Trench Center f
h Edges Topsoil Yes I j No Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2:
Location: 481 210th Avenue Somerset, WI 54025 (NW 114 NE 1/4 21 T31 R19W) NA Lot 4 Parcel No: 21.31.19.269A40
1.) Alt BM Description =
2.) Bldg sewer length =
- amount of cover =
Plan revision Required? n Yes �� No
Use other side for additional information.
SBD -6710 (R.3197)
Safety and Buildings Division copy
N visc6nsin ! 201 W. Washington Ave., P.O. Box 7162 St. Croix
Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.)
Department of Commerce (608) 266- 1 `q
�
Sanitary Permit Applicati-0 CZ,V ate Plan I.D. Number 1
In accord with Comm 83.21, Wis. Adrr Code, personal information y provi0e. Project dress (if different than mailing address)
may be used for secondary purposes Privacy Law, s 15.04(1 ) A /� /r55
L Application Information - Please Print All rm 'on 481 10 Ave.
Sr CR
Property Owner's Name UU Parol #: Block #
03 1054 -10 -000 lot 4 Na
Jason & Elizabeth Moe 0
Property Owner's Mailing Address Property Location
707 Grandview Drive NW li,, NE '/4, Section 21
City, State Zip Code Phone Number
T 31 N; R 19 W
Hudson, WI 54016 (715) 377 -0119
IL Type of Building (check all that apply) 6% ua s �6 �- 'A � ��
Subdivision Name C5M Number
❑Xl or 2 Family Dwelling - Number of Bedrooms 4
❑ Public/Commercial - Describe Use 5 .ti AA—,\— R o [- CSM Vol. 17, P . 4522
❑ State Owned - Describe Us( 6:i V ❑City_ ❑Village ❑XTownship of Somerset
III. Type of Permit: (Check only one box online A. Complete line B if applicable)
A. ❑X New System ❑ Replacement System ❑ TreatmendHolding Tank Replacement Only ❑ Other Modification to Existing System
--------------
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Perrot Number and Date Issued
Before Expiration Plumber Owner
IV. Type of POWTS stem: Check all t hat a 1
❑ XNon - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ single Pass Sand Filter
❑ Constructed Weiland Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Fitter
❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain)
V. Dispersal/Treatment Area Information: Forty six (46) "Quick 4" Chambers at 19.1 sq. ft. EISA/chamber + 2 pair end caps @ 11.6 sq.ft EISA-
890.20 sq. ft. EISA -
Design Flow (gpd) Design Soil Application Rate(gpdst), Dispersal Area Required (st) Dispersal Area Proposed (s0 System Elevation
600 gpd 0.7 gpd sq. ft. 1 857.15 sq ft ✓ 890.20 sq ft EISA / 91.00' /
l i VL Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Holding Tank 1,250 - 1,250 1 Wieser ConcreteWLP1250 -MR X
Aerobic Treatment Unit
Dosing Chamber
VII. Responsibility State ent I, the de , assume res or urstallaHon of the POWTS shown on the attached plans.
Plumber's Name (Print) N Plum s Signs MP/MPRS Number Business Phone Number
James K. Thompson -- MPRS #30021 (715) 248 -7767
Plumber's Address (Street, City, ip Code)
340 Paulson Lake Lane, Osceola, WI 54020
our /De artment Use Onl
ved El Sanitary Permit Fee (includes Date Issu Issum Si o
Groundwater Surcharge Fee)
❑ r
Owner ven R Denial O� - 7 6
UC Conditions of pproval/Rensons for Disapproval
SYSTEM OWNER:
1. Septic tank, effluent filter and
dispersal cell must all be.serva;es I makltainsd
as per management plan provided by plumber.
2. AN ss&ack requirements must be maintained
as per gVicawble cads / ordA wim.
Attach complete plans (to the County only) for the system on paper not less than 8112 1 11 inches in size
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Wwonsin DepBrtimttofCWmenoe SOIL EVALUATION RERBn-,,,. p age t of 3
Division of Safely and Buildings in accordance with Comm 85, A.C.E. Soil & Site Evaluaati"
Attach complete site plan on paper W less than 8'h x I I inches in size. Plan m t R E Ci E IM St Croix
include, txd not limited lo. vertical and horizontal reference point (BMQ, direction Parcel I.D.
percent slope, scale or d mernsions, north arrow, and location and distance to t rogdP R 0 032 - 10541
Please print all inforn>adort. AA Reviewed By ,`11
personal irrarrrrafmrr you provide may be used for sewrrdary purposes (Pcivecy Law, s.1 (1) W CROI X rOUNTY
Properly Owner PkWertv Location
Jason & Elizabeth Moe Govt. Lot NE 1/4 N 19 S 21 T 31 NR 19 W
Property Owner's Milling Address lot # Block # I Subd. Name or CSM#
1803 Fairway Dr. 4 CSM Vol. 17, Pg. 4522
City Stake Zip Code Phone Number _j City I Village 0 Town Nearest Road
Hudson I WI 1 54016 1 (715) 377 - 0119 Somerset 210Th Ave.
r
New Ccinstruclion Use: k;I Residential / Number of bedrooms 4 Code derived design now rate 600 GPD
_j Replacement J Public or commercial - Describe:
Parent material Glacial outwash Flood plain elevation, if applicable na
General comments
and reccimmerwalions: Instal conventional POWTS using two trenches with combined E.I.S.A = 857.15 sq. ft at elev. 9 1.00'.
Bortri
❑ -J 1 Bortt� # its/ Pit Ground Surface Bleu. 94.96 It. Depth to limiting factor >104" in. Sod Application Rate
Horizon Depth Dominant Color Redox Description Texhrre Structure Consistence Boundary Roots GPD/fF
in. Mmrsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2
1 0-12 10yr3/3 none s 2fsbk mvfr cs 2fmc 0.6 0.8
2 12 -23 10yr4/4 none sl 2fsbk mvfr gs 1fmc 0.6 1.0
3 r37-50 10yr4/4 none sl 2msbk mvfr gw 1fm 0.6 1.0
4 10yr4/6 none Is 0 sg dl gs 1vf 0.7 1.6
5 50-71 10yr4/6 none s 0 sg dl gs 1vf 0.7 1.6
6 71 -104 10yr5/6 none s 0 sg dl - - 0.7 1.6
q
52
Z9 # g Pit Ground Surface elev, 84.79 ft. Depth to limiting factor >110" in. Sa{ Application Rate
Horizon Depth Dominant Color Redox Description Texhs'e Structure Consistence Boundary Roots GPDM
in. Munsell Qu. Sz, Cont. Color Gr. Sz. Sh. t ff#1 `Eff#2
1 0-18 10yr3/3 none I 2fsbk mvfr cs 2fmc .6 0.8
2 18-32 10yr4/4 none Is 2fsbk mvfr gs 1fmc .7 1.6
3 32-40 10yr4J6 none Is 2msbk mvfr gw 1fm .7 1.6
4 40-52 10yr4/5 none s 0 sg dl gs 1vf 0.7 1.6
5 52 -88 10yr5/6 none s 0 sg dl gs - 0.7 1.6
6 88 -110 10yr6/4 ne s 0 sg dl - - 0.7 1.6
tl
'
Effluent #1 = BOD ? 30 < 220 mg/L TSS >30 < fflumtt #2 = BOD !E mglL and TSS <,0 mg/L wil
CST Name (Please Print) S CST Number
James K Thompson
Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number
6/13/2005 715 248 - 7767
340 Paulson ta Lane Osceola, VIII 54020
ke
P ro p er t y Or Jason & Ebabeth Moe Parcel ID # 032- 1054 -10-0 Page 2 of 3
F 3 Ong # Boring 97.07 ft. Depth to limiting factor >116" in. Rate
Pit Ground Surface elev. APPI
Horizon Depth Dominant color Redox Description Texture Structure Consistence Boundary Roots GPDIfF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - 011#1 *Eff#2
1 0-6 10yr3/3 none I 2fsbk mvfr cs 2fmc 0.6 0.8
2 6-15 10yr4/4 none Ifs 1msbk mvfr gs lfmc 0.5 1.0
3 15-26 7.5yr4/6 none Is 2msbk mvfr 9w 1fm 0.7 1.6
4 26-38 7.5yr4/6 none s 0 sg CH gs 1fm 0.7 1.6
5 388 10yr4/6 none s 0 sg
dl gs 1 vff 0.7 1.6
6 68-116 10yr516 none fs & ms 0 sg CI - - 0.5 1.0
° t 1
F Boring # — Barirg
J Pit Ground Surface eiev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant color Redox Description Texture Stricture Consistence Boundary Roots
in. Mwoell Qu. Sz. Cont. Wor Gr. Sz. Sh. *Eff #1 *Eff#2
a I # Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon 080 Dominant Color Redrnu Description Texture Stricture Consistence Bowndary Roots
in. Murtsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
* Effluent #1 = BOD 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD < 30 mg/L and TSS <30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608- 264 -8777.
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1148
Wiscortsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt
Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information. Reviewed By Date
Personal information you provide may be us 1 J�w .15 (1) (m)).
Property Owner P perty Location
Goodman, David Got. Lot NE 19 NE 1/4 S 21 T 31 N R 19 W
Property Owner's Mailing Address Lot Block # Subd. Name or CSM#
485 210th Ave. COUNTY 4 Proposed CSM
City State Zip ode City Village ✓ Town Nearest Road
Somerset WI 54 15 247 - 4250 Somerset 210Th Ave.
✓ New Construction Use: ✓ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD
Replacement Public or commercial - Describe:
Parent material Outwash Plain e b Flood plain elevation, if applicable na
General comments 0 co Y
and recommendations: Area is suitable for a conventional system with a 07 gpd /sgft rating. Possible system elevation for Area I
is 94.0'. Slope is 7 %. See remarks for bores 3 M for loading rates
Boring # Boring
✓ Pit Ground Surface elev. 97.05 ft. Depth to limiting factor >100 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP5M - -
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 *Eff#2
1 0 -12 1 Oyr4 /4 none Is 1 msbk mvfr cw 2m,2f .7 1.2
2 12 -18 7.5yr4/4 none Is Osg ml gw --- - -- .7 1.2
3 18 -100 10yr5/6 none s Osg ml ---- ----- .7 1.2
F2 ] Boring # Boring
✓ Pit Ground Surface elev. 97.05 ft. Depth to limiting factor > 101 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-5 1 Oyr3 12 none is 1 msbk mvfr cs 2m,2f .7 1.2
2 5 -18 1 Oyr3 /4 none Is 1 csbk mvfr gw 2f .7 1.2
3 18 -68 1Oyr5/4 none s Osg ml gw --- .7 1.2
4 68 -101 10yr5/6 none s Osg ml - - -- --- - .7 1.2
Effluent #1 = BOD 5 > 30 < 220 mg /L and TSS >30 < 150 mg /L " Effluent #2 = BOD S30 mg/L and TSS S30 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 Richmgrtd, Wl 54017 1219/02 715- 247 -2941
/ Property Owner Goodman; David Parcel ID # Page 2 of 3
Boring # Boring
I 'h ✓ Pit Ground Surface elev. 94.30 ft. Depth to limiting factor >100 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-10 10yr3/2 none Is 1 msbk mvfr cs 2m,2f .7 1.2
2 10 -19 10yr4/3 none Is Icsbk mvfr gw 2f .7 1.2
3 19 -50 10yr4/4 none Is 1 msbk mvfr gw 2f .7 1.2
4 50-66 10yr4/6 none is 1 msbk mvfr gw - - - - -- .5 .9
5 66 -100 10yr5/4 none s Osg ml — . 5 .9
Horizon #5 has bands of 7.5yr4/4 Ifs 1msbk mfr changing the loading rate of the horizon to 0.5 gpd /sgft.
4 Boring # Boring
✓ Pit Ground Surface elev. 96.70 ft. Depth to limiting factor >110 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-10 10yr3/2 none Is 1 csbk mvfr cs 2m,2f .7 1.2
2 10 -18 10yr4/3 none Is 1csbk mvfr gw 2f .7 1.2
3 18 -51 10yr4/4 none is 1 csbk mvfr gw - -- .7 1.2
4 51 -60 10yr4/6 none ifs 2msbk mvfr Cw - - - -- . .9
5 60-110 1 r5/6 s ml - - -- - - - - -- .7 1.2
OY none s 0 g
Horizon #3 has bands of 7.5yr4/4 sl 2msbk mfr changing the loading rate of the horizon to 0.5 gpd /sgft. Horizon #5 has bands of 7.5yr4/3 Ifs 1 msbk
mfr changing it's loading rate to 0.5 gpd /sqft.
F-1 Boring # Boring
Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP 2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
i
* Effluent #1 = BOD 30 < 220 mg/L and TSS >30 < 150 mg /L * Effluent #2 = BOO <30 mg/L and TSS <30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
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ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer so+'� `�'�Qb e �� /Yto e.
Mailing Address 2 Z.,-
Property Address 4tX - ►n el
(Verification required from Planning & Zoning Department for new construction.)
City /State Parcel Identification Number 032 /OSS�
LEGAL DESCRIPTION
Property Location &w t /a , rJ t /a , Sec. _ , T 3 / N R /9 W, Town of
Subdivision — Lot #
Certified Survey Map # 72- 3f , Volume /7 Page # � 52�
Warranty Deed # Z2?2 7'7 , Volume ';? 28 Page # (A 3 a
Spec house IP4, no Lot lines identifiable es
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
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. Owner maintenance
responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & 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.
I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin.
Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning &
Zoning Department within 30 days of the three year expiration date.
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.
Nu a of bed s T
SIGNATURE OF APPLICANT(S) DATE
** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * **
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. 08105)
V. 2 .2 97 P 630 727277
STIE 132 a AS9 0NSIN I B 999 KATHLEEN H. WALSH
WARRANTY DEED REGISTER OF DEEDS
Docum Number ST. CROIX CO., WI
RECEIVED FOR RECORD
This Deed, made between David A. Goodman and Rita B.
Goodman, husband and wife, 06125/2003 10:30AM
WARRANTY DEED
EXDPT #
Grantor, and Jason P. Moe and Elizabeth A. Moe, husband and wife, REC FEE: 11.00
TRANS FEE: 191.70
COPY FEE:
CC FEE:
PAGES: 1
Grantee.
Grantor, for a valuable consideration, conveys to Grantee the
following described real estate in St. Croix County,
State of Wisconsin (if more space is needed, please attach addendum):
Recording Area
Part of NE 1/4 of NE1 /4 and part of SE 1/4 ofNE1 /4 of Section 21, Name and Ret pIn Address
Township 31 North, Range 19 West, St. Croix County, Wisconsin, described
as follows: Lot 4 of Certified Survey Map filed May 21, 2003, in Vol. 17,
page 4522, Doc. No. 722387.
Gv s'y6fDa y1 Wd
Together with and subject to a 66 foot access easement as shown on said
Certified Survey Map.
032 - 1054 -10 -000
Parcel Identification Number (PIN)
This is not homestead property.
pJ) (is not)
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any.
Dated this � day of June 2003
D _
* + &4d A. Goodman
y
• + R to B. Goodman
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
) ss.
St. Croix County )
authenticated this day of Personally came before me this 46 day of
June 1 2003 the above named
David A. Goodman and Rita B. Goodman, husband and wife,
s
TITLE: MEMBER STATE BAR OF W SIN ''•.�G -
(If not, i A ��G k wn to be the person(s) who executed the foregoir ;
authorized by § 706.06, W is. Sta .� i 1/ in nt and now the same.
1
THIS INSTRUMENT WAS D D13
Attorney Kristina O gland Qr�'••...,,�., Notary Public, State of Wisconsin
Hudson, WI 54016 My Commission is permanent. (if not, state expiration date:
(Signatures may be authenticated or acknowledged. Both are not necessary.) 9MRJr , d OD S )
• Names of persons signing in any capacity must be typed or printed below their signature. Informadon P rofessionals c ompany, Fond du Lac. va
STATE BAR OF WISCONSIN 900
WARRANTY DEED FORM No. 2 - 1999
Conventional Septic System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
General
The conventional septic system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall be maintained
in accordance with component manual SBD- 10705 -P (N.01 /01). All local and/or state rules pertaining to system
maintenance and maintenance reporting shall be complied with.
Septic Tank
Septic tank servicing mechanics comply with Comm. 83.54(1)(e). Septic tank to be located within 150' of service pad, with
bottom of tank to be <_ 15' below service pad elevation. The operating condition of the septic tank and outlet filter shall be
assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in
the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR
1 l 3, Wis, Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. if the contents of the tank are
not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be
needed to maintain less than 1/3 scum and sludge accumulation in the tank. The outlet filter shall be cleaned as necessary to
ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank
that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be
serviced if the alarm is activated. Septic tank manholes risers, access risers, and covers should be inspected for water
tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of
service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater
than 8 inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank.
No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank
abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS
component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If
such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings
Division.
Soil Absorption Cell
Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should
be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for
vegetative maintenance) over the system is to be avoided. Soil compaction may hinder aeration of the infiltrative surface
within and above the system and will promote frost penetration during cold weather months. Cold weather installations
(October- February) dictate that the system be heavily mulched for frost protection.
Influent quality into the system may not exceed 220mg/L BODS, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not
exceed maximum design flow specified in the permit for the installation.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the
owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring.
Effluent flow shall be alternated between dispersal cells on a two -year schedule by use of a diversion valve. Valve to be
switched diverting effluent from dispersal cell currently in use to resting cell on a two -year cycle coinciding with septic tank
inspection and maintenance.
Contingency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the
system in proper operating condition. Excessive ponding within the dispersal cell will be eliminated by installing a new soil
absorption cell to bring the system into proper operating condition.
Questions on the operation or maintenance of the system should be directed to the installing plumber, Jim Thompson at (715)
248 -7767 or the St Croix County Zoning Department at (715) 386 -4680.
Parcel #: 032 - 1054 -10 -100 04/07/2006 02:39 PM
. I . I • PAGE 1 OF 1
Alt. Parcel #: 21.31.19.269A -40 032 - TOWN OF SOMERSET
Current LX_j ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner
O - MOE, JASON P & ELIZABETH A
JASON P & ELIZABETH A MOE
1803 FAIRWAY DR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): ' = Primary
Type Dist # Description ' 481 210TH AVE
SC 5432 SCH D OF SOMERSET
SP 1700 WITC
Legal Description: Acres: 5.000 Plat: 4522 -CSM 17 -4522 032 -03
SEC 21 T31 R1 9W PT NE NE & PT SE NE CSM Block/Condo Bldg: LOT 04
17 -4522 LOT 4 (5 AC)
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
21- 31N -19W NE NE
Notes: Parcel History:
Date Doc # Vol /Page Type
10/21/2003 744426 2441/64 AFF
06/25/2003 727277 2287/630 WD
05/21/2003 722387 17/4522 CSM
2006 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/14/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.000 58,000 0 58,000 NO
Totals for 2006:
General Property 5.000 58,000 0 58,000
Woodland 0.000 0 0
Totals for 2005:
General Property 5.000 58,000 0 58,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch #: 209
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
I
NIZ 19 e y5'22_
/!l .) adz — /Q�y -�� - oLs� ���� -1 t � ,fie f /
722387
032_ - /LSD/ /v - DSC0 .2 2 -
VOL '17 PAGE 4522
2&119 �v�� REGIS EGIS OF DEEDS
D Z ~ lv /0 - /De e - ( 10 /0 7 ST. CROIX CO., KI
RECEIVED 3 RECORD
CERTIFIED SURVEY MAP
05/21/2003 02:50P1t
LOCATED IN PART OF THE NE1 /4 OF THE NE1 /4 AND IN PART OF CERTIFIED SURVEY MAP
REP FEE: 13.00
THE SE 1/4 OF THE NE, A OF SECTION 21, T3 IN, R19W, TOWN OF
COPY PEE: 3.00
SOMERSET, ST. CROIX COUNTY, WISCONSIN. PAGES: 2
I
dO4 9 C?o�oGu�t a OG� N89 °37'58 "W 2604.58'
ION Oo` o[t o �[r w o
MQdo 9 _PC�o 9`?o M
_ - 2 O T H "EN U r _ NORTH LINE OF T T HE NE 1/4 p m
4 302.29' - N89 °37'58" 1A/ 651.18' — — _ �651_11'� w
N. 1/4 COR
m 238.9 ' 41 NE COR. � Z z
SEC. 21 O 23T: ?- . 66.02 �— X23' }! O SEC. 21 w w m
O I I O
O
ch °3T58 "E o v�i 651.22 411.25 $ c) qgI w w0
M nn I
a7 M 589 w .I V I w
+1 w
al
CDa �z�
W .1. ..... ...: ..... w� ....................... z�. .............. �i Z
XX 1 Q
~ W(O ° i z N
0
�I
O
LOT 2 of a
' SURVEYOR:
z 4.020 ACRES CV SHED WELL DOUGLAS J. ZAHLER
_ 175,132 SO. FT, iNC r: ® ° j S & N LAND SURVEYING, INC.
w RIGHT OF WAY CV Lu I i 2920 ENLOE STREET
O: w HOUSE �p OU 1 HUDSON, W1 54016
O M N 3.839 ACRES T r c � ( O� (D I
r C�: 167,229 S0. FT EX r, iLl u�5 i r n /A �� I
z O a0 RIGHT OF WAY Y O ( W C� . U/ o f
( t,,) m w ; zo ti SEPTIC (0 ° PREPARED FOR:
u: o?:
1 co v 0
u v N' DAVID GOODMAN
Q Q "1 � LOT 1 ° i 485 210TH AVE.
p 6.494 ACRES !� I
to 1 I SOMERSET, WI.
' O 282,874 SO. FT. INC. °
a BU AREA 66' 1 RIGHT OF WAY AND U
a ' 3.$t ACRES : INC. EASEMENT p
I
° r 5.167 ACRES O [
O 225,076 SO. FT. IX, Op
RIGHT OF WAY AND N d
m o EX. EASEMENT w CR r S89 0 21'21 "E CR v;1 652.06' r- a s ►- w
w w 392.02' - -- o z o g F= 0 OO i W 260.04 L1 1 326.00' r ¢ i
' O O w tc ° T
O 154.:4y. f05.57 f33 43 i92 57' M:: x z O
m 293:5 �I (�: 359:01 �u ac - a
{ '- L7 L8 r O o a
O CONTIGUOUS: 3 O 2 LU w
O BUILDABLE AR CONTIGUOUS O c i z z 9 o Z
(�/ i Z 0.9 ± .ACRES O a : BUILDABLE AREA (A r u-
ai. 2 7+ ACRES p 0 p rn •- O
¢ 0 C Z
}� �j�g p�+ O
a US
CONTAINS 1 + ACRES ST CROfX COUNTY ° i W Om D r O w
0 i NET BUILDABLE PJannrrii} Zanlnq alid Park$ Gpmmi, ..e a i LL U v a
M '
LO �, MAY 1 2003 �;
�
0 0
Z co tD it n recarped within 30 clay c�'
t ' ' ✓" ai U.I appr I dale dpprav shat Q .
�p �p nttfl end void
LOT 3 N '
5.001 ACRES 20 V�
01
217,833 s0. Fr. LOT
4.950 ACRES 5.000 ACRES ° NOTE: ALL LOTS HAVE ACCESS
215,640 SO. FT. EX. 217,815 SO. FT. i AVAILABLE WITH OUT
EASEMENT
�' DISTURBING 20% SLOPES.
4.950 ACRES '
215,652 SO. FT. EX.
EASEMENT
SOUTH LINE OF THE NE 1/4 O'
OF THE NE 1/4 o
w
NORTH LINE N89 °21'21 - M 652.89'
OF THE SE 1 / 4 SCALE IN FEET 1 " = 150'
OF THE NE I/4 �O4 -- --- ul�° 0� �
V @L . _� 2 � 0� U �/
_ P �� 150 0 150
THIS INSTRUMENT DRAFTED BY: WES ANDERSON v�� 7 9 SHEET 1 OF 2 SHEETS
JOB NO. 6221-01 DATE: 11/20/2002 REVISED: 1/27/03
Vol. 17 Paqe 4522