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Home My WebLink About032-1060-90-200 W Wisconsin [Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix 'Safety and Building Division ii INSPECTION REPORT Sanitary Permit No: 399644 0 A GENER. 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: Germain, Walter I Somerset Township 032 - 1060 -90 -200 CST BM Elev; Insp. BM Elev: BM Description: �� •,E r %I , { L TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing _ Alt. BM s we Aeration Bldg. Sewer 5J �I s— Holding St/Ht Inlet 7 v TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic G Dt Bottom Dosing Header /Man. Aeration Dist. Pioe t � IL V 1 I V 0 7 Holding Bot. System 9 Fin I Grade PUMP /SIPHON INFORMATION - -4�_ 50 /C y. Manufacturer GP and St r Model Numb �I TDH Lift Loss System Head TD Ft Forcemain ength DI SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L LDG IWELL LAKE/STREAM - tiEACHING Manufacturer. / q p INFORMATION CHAMBER OR Typ#tf �S�y�s /tem: ( / .. /��j UNIT J Model Number: 1 � ti DISTRIBUTION SYSTEM 3C ? Header /Manifold /( Distribution t� ywL� L / x Hole Size x Hole Spacing Vent to Air Intake __ j S> I II ] -f �- �U Length Dia Length Dia Spacing 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 Bedlrrench enter f Bed/Trench Edges Topsoil Do Yes [] No ®Yes ®No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: 1 1 Inspection #2: Location: 2095 60th St Somerset, WI $4025 (NW 1/4 NW 114 23 T31 R1 9W) NA Lot 1 Y %rcel No: 23.31.19.306A20 1.) Alt BM Description 2. Bldg ewer le n g th = .tS i l �� C y Y? r 9 g L 7� �/� Yr� ! i - amount of cover = Plan revision Required? 1 I Yes o Use other side for additional information. SBD 6710 (R.3197) Date Insepctor's Signa re Cert. No. I V k �Z y e s �r 1 - z09.- loCA' S-i Sanitary Permit Application Safety&Buildings Division In accord with Comm 83.21,Wis.Adm. Code 201 W.Washington Ave. V See reverse side for instructions for completing this application PO Box 7302 � �+®�� Personal information you provide may be used for secondary purposes Madison,WI 53707-7302 Department of Commerce (Submit completed form to county if not [Privacy L4w,s. .04(1)(m j s ,(,t i- RC 7/i7 state owned.) Attach complete plans(to the county copy only)for the system,on paper of less than 8-1/2 x 11 inches in size. County t State Sanitary Permit Number ❑Check if revision to previous application State Plan I.D.Number Cro-or .; '?I/ yy I.Application Information-Please Print all Information Location: Property Owner Name /` Property Location t/4�" t 1 � -&-- tAj�( iy01/4 Na/1/4,S.23T3/,N,R/9(or& Prope Owner's Mailing Address Lot Number Block Number pl iau HtO y 3 S' _ l �� City,State Zip Code ' Phone Number Subdivision Name ore umber �TO/vi i2sc=r a/h' .5 'e2- ) ( ?/' ) i- z: .._ dot. ( -- PQ . 9037 H.Type of Building: (check one) �`),� ! ?4 City ll' 1 or 2 Family Dwelling-No.of Bedrooms: 3 1 ok P Gr f f et"-S • , Ii`y(illage // I$'Tijt n of ❑Public/Commercial(describe use):_ ��i�ttG� ^� ��``1�0 i ❑ State-Owned V ®'4__ Orj _4.3 r 2® Nearest oad • $ 1114 Poicel'Tax Numbers .:-. ,....:'\' III.Type of Permit: (Check only one box on line A. Check box on line D 03 2.-/0 D- go-zoo 23.3/./q.3o8A•20 A) 1. gNew 2. ❑Replacement 3. 0 Replacement of 4. 7---.._ ^ y1h•4�,,'. 6. 0 Addition to System System Tank Only 0/W *1 Date . s'�' Existing System B) Permit Number Date Issued 0 A Sanitary Permit was previously issued IV.Type of POWT System: (Check all that apply) Non-pressurized In-ground ❑Mound El Sand Filter 0 Constructed Wetland ❑Pressurized In-ground 0 Holding Tank ❑ Single Pass ❑Drip Line ❑At-grade ❑Aerobic Treatment Unit ❑Recirculating 0 Other: V.Dispersal/Treatment Area Information: L 'Z .,-(%//rala✓ S, ii,,i,.rtley4- 1.Design Flow(gpd) 2.Dispersal Area 3.Dispersal Area 4.Soil Application Percolation Rate 6.System Elevation 7.Final Grade Required Proposed Rate(Gals./day/sq.ft.) (Min./inch) _ . 1(/ - , X, Elevation VII.Tank Capacity in Total #of Manufacturer Prefab Site I Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks Tfi1 ❑ ❑ 0 0 Sepr, 1069 /o'ov / 1,4, mars ❑ ❑ ❑ ❑ ❑ VIII.Responsibility Statement I,the undersigned,assume responsibility for installation of the POWTS shown on he attached plans. Plumber's Name(print) Plu .er.Signature(no stamps): C-MP/MPRS i 3 Business Phone Number aA1310,/v &#ki rr t ...�:; (S � i 71/ 7f -5 yQ i4S7 Plumber's Address( treet, ity,Mate,Zip Code) �5- 1` C)y L L -7y uo,.=ua Tn 5/v! _.s T IP. :f 9ZO IX.County/Departme Use Only El Disapproved Sanitary Permit Fee(Includes Groundwater Date Issued Issuing Agent Signature(No stamps) Approved ❑Owner Given Initial Adverse Surcharge Fee) Determination zZ-C, 00 ('Zlz.-1 I U çZ " CK X.Conditions of Approval/Reasons for Disapproval: J 1. Effluent filter to be installed and maintained per manufacturer's recommendations. 2. Chamber louver shall be installed in soils with a soil application rate of.7. 3. System shall be installed 35-68 inches below uniform contour line to ensure proper location within soil profile. SBD-6398(R.07/00) ' 1025 .. SOIL EVALUATION REPORT Page 1 of 3 Wisconsin Department of Commerce Tom Schmitt Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must 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. part of:032- 1060 -95 -00 - Please print all information. Re 'wed Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Germain, Walter &Debra Govt. Lot NW 1/4 NW 1/4 S 23 T 31 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2100 State Hwy 35 1 CSM Pending City State Zip Code Phone Number City Village ✓ Town Nearest Road Somerset I WI 1 54025 715 - 247 -5972 Somerset 1 60Th St. ✓ New Construction Use: ✓ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material Outwash Plain Flood plain elevation, if applicable na General comments and recommendations: Area suitable for a conventional system with a .7 gpd /sgft rating. possible system elevation for Area 1 Is 98.1'. ��'�t "ii✓ 'i N�71- L.Lrt'rfc Boring # Boring > 100 ication Rate C go Pit --" Ground Surface elev. 101.10 ft. Depth to limiting factor in. Soil Application Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 -12 1Oyr3 13 none si 2mgr mvfr CIS 2f 5 9 2 12 -22 1Oyr4/4 none sl 2msbk mvfr gw 1f 5 9 3 22 -33 7.5yr4/4 none Is 1 msbk mvfr gw --- 7 1.2 ml — .7 1.2 4 33 -100 10yr5/4 none ms Osg -� _ -- ' ,i1 G U [7j] Boring # ; . Boring > 101 in. Soil Application Rate V Pit Ground Surface elev. 101.90 ft. Depth to limiting factor pp Horizon Depth Dominant Color Redox Description Texture Structure h Consistence Boundary Roots *Eff#1 PD/ft *Eff#2 in. Munsell Qu. Sz. Cont Color 1 0-16 1Oyr3/3 none sl 2mgr mvfr cs 2f 5 .9 2 16-28 10yr4/4 none sl 2msbk mvfr gw 1f .5 .9 3 28 -38 7.5yr4/4 none Is 1 msbk mvfr gw _ - -- .7 1.2 4 38 -101 10yr516 none ms Osg 1.2 ml - - -- - - - - -- 7 * Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >30 < 150 mg /L * Effluent #2 = BOD <30 mg /L and TSS <30 mg /L S' nature: � , CST Number CST Name (Please Print) 227429 Thomas J. Schmitt Date Evaluation Conducted Telephone Number Address Tom Schmitt 11/22/00 715 - 549 - 6651 586 Valley View Trail, Somerset, WI 54025 r G Walter &Debra Parcel ID #-0 of:032- 1060 -95- 001 -002 Page 2 of 3 Property Owner E Boring 103.90 ft. St Depth to limiting factor > 145 _ in. Soil Application Rate Boring # ✓ Pit Ground Surface elev. -- R ' Texture Structure Consistence Boundary E *�1 2 *Eff# Dominant Color Redox Description Gr. Sz. Sh. Horizon Depth Munsell Qu. Sz. Cont. Cola . g in. sl 2mgr rrrvfr cs 1 0-12 2m .5 none 10yr3/3 ,7 1.2 Is 1 msbk mvfr gw 1 m 2 12 -27 7.5yr4/4 none ms 0 ml - - -- .7 �, 1.2 3 2 145 10yr5/6 none _�__' Boring dug and evaluated to a depth of 145" because system was t be installed below` al elevation. Done on 5/8/02. Boring ft Depth to limiting factor _ in. Soil Application Rate Boring # Pit Ground Surface elev. - - - - -- R � PD Z El Structure Consistence Boundary *Eff#1 *Eff#2 Horizon Depth Dominant Color Redox Description Texture Gr. Sz. Sh. in. Munsell Qu. Sz. Cont. Color Boring ft Depth to limiting factor in. Soil Application Rate ❑ Boring # Pit Ground Surface elev. - -- ' ROts P 2 Structure Consistence Boundary *Eff#1 *Eff#2 Horizon Depth Dominant Color Redox Description Texture Gr. Sz. Sh. i in. Munsell Qu. Sz. Cont Color * Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >30 < 150 mg /L " Effluent #2 = BOD < 30 mg /Land TSS <_30 mglL PP ort . unk rnrtor+ tl,P iar�,*,••P ^t �+ rng- , )"_21 G 1 — TTV �nR_7tiA_R'r' The Department of Commerce is an equal o ppunity sery ice provider and employer. If you need assistance to access services or nP A Z- 09.5 Sf Sanitary Permit Application Safety &Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 ®4 .9e®nsrn Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce [P ivac L s. .04(1)(m ] (Submit completed form to county if not ' w state owned.) Attach complete plans (to the county copy only) for the system, on paper riot less than 8 -1/2 x 11 inches in size. County State Sanitary Permit Number ❑ Check if revision to previous application State Plan I. D. Number Y I. Application Information - Please Print all Information Location: Property Owner Name Property Location / 1/4 1/4, S T ,N, R (or Prope fir's Mailing Address Lot Number Block Number 149 AW Y 3 S City, State Zip Code Phone Number Subdivision Name or SM umber II. Type of Building: (c eck one) �aw5 :>Q city g 1 or 2 Family Dwelling -No. of Bedrooms: c k Q Lr Q C T .11 of ❑ Public /Commercial (describe use):_ �� ❑ State -Owned e o i Nebrest oad 60 7* S� - P po ~, ax Number(s III. Type of Permit: (Check only one box on line A. Check box on line tea lica a3 2- - 90- aao Zs.3 /. /q. ;o tp A) 1. RNew 2. ❑ Replacement 3. ❑ Replacement of 4. , f: " 6. ❑ Addition to System System Tank Only / a j y Existing System B) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) 0 Non- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: Z 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. Syste Elevation► 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) �y i � / y )� Elevation 1 13 Q 325 7 . 6 ✓ 2� Crud frl� D VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks jo ❑ ❑ ❑ ❑ PLO OD ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume respo nsibility for installation of the POWTS shown 22 plans. Plumber's Name (print) Plu er Signature (no stamps): P/MPRS No. Business Phone Number Plumber's Address (Sfreet, City, State, Zip Code) 94 IMLLCF�4 Ulgtio LW 01,6z;-7 t- IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) IFApproved ❑ Owner Given Initial Adverse Surcharge Fee) Determination L L X. Conditions of Approval /Reasons for Disapproval: 1. Effluent filter to be installed and maintained per manufacturer's recommendations. 2. Chamber louver shall be installed in soils with a soil application rate of .7. 3. System shall be installed 35 - 68 inches below uniform contour line to ensure proper location within soil profile. SBD -6398 (R. 07/00) 1 f t I T , — — 1 LLD I f t I 103.-A, I i i i f l : 44 �4 - ray � i✓ � �. 4s !d 1 , So rlT L0r x, � I ' d ti LS I , -•-} -� f T ; 9 1 , : - -- — - — — i i�(;,f7fr Ar 10 q- T -a -.. - - - - - -- - - -- — -- - -��- -s cwt.. -- ' - -- f-- r------ ---- -- - - - -- - t _ � _ T r i : i 1 + woo U I 11 - /too F � �3`X s IN1�iG T/��'yE'S , { - - - - - -" - -- - fol i ; I � k r r I f { r i E , 1 , I f . t T i , , fi ! I t i i t ! r I F { j 0 yyy , I t f I 111 I I , } a , I fi I I , f � E t j 1025 J VVisconsin 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 percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. Please print al rfotltrati± part of:032- 1060 -95 -001, -002 en. Revi ed B Date Personal information you provide may Law, s. 15.04 (1) (m)). Z L Property Owner Property Location Germain, Walter & Debra ±: �', U �; Govt. Lot NW 1/4 NW19 S 23 T 31 N R 19 W Property Owner's Mailing Address 1 Lot # Block # Subd. Name or CSM# 2100 State Hwy 35 r u 1 CSM Pending City State ZipCdde PhpW:Humber ' .._..j _j City J Village J Town Nearest Road Somerset 'WI 54025 -;::� - 5 / Somerset 60Th St. LOJ New Construction Use: V Residential / Numgeraftaed{ooms 3 Code derived design flow rate 450 GPD Replacement J Public or commercial scribe: Parent material Outwash Plain Flood plain elevation, if applicable na General comments and recommendations: Area suitable for a conventional system with a .7 gpd /sgft rating. possible system elevation for Area I is Boring # I Boring ✓J Pit Ground Surface elev. 101.10 ft. Depth to limiting factor >100 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eft#2 1 0 -12 10yr3/3 none sl 2mgr mvfr cs 2f .5 ✓ 9 ✓ 2 12 -22 10yr4/4 none sl 2msbk mvfr gw 1 f .5 .9 ./ 3 Z?- 7.5yr4/4 none Is 1 msbk mvfr gw - - -r .7 ✓ 1.2 ✓ 4 33 -100 10yr5/4 none ms Osg ml - - -- - - - - -- .7 ✓ 1.2 ✓ 3/o Boring # I Boring ✓l Pit Ground Surface elev. 101.90 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 I *Eff#2 1 0 -16 10yr3/3 none sl 2mgr mvfr cs 2f .5 ✓ .9 ✓ 2 16 -28 10yr4/4 none sl 2msbk mvfr gw 1 f .5 .9 3 2 - 8 7.5yr4/4 none Is 1 msbk mvfr gw - - - - -- .7 i 1.2 4 38 -101 10yr5 /6 none ms Osg ml - - -- - - - - -- .7 -- 1.2 i * Effluent #1 = BOD? 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD <30 mg/L and TSS < 30 mg /L II � CST Name (Please Print) Signature: CST Number Thomas J. Schmitt 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valley View Trail, Somerset, WI 54025 11/22/00 715 -549 -6651 Property Owner Germain, Walter & Debra Parcel ID # part of:032- 1060 -95- 001, -002 Page 2 of 3 0 [ Boring # Boring ✓I Pit Ground Surface elev. 103.90 ft. Depth to limiting factor >104 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *EfF#1 *Eff#2 1 0 -12 10yr3/3 none sl 2mgr mvfr cs 2m .5 ✓ .9 2 12 -27 7.5yr4/4 none Is 1 msbk mvfr gw 1 m .7 1.2 3 27 -104 10yr5/6 none ms Osg mvfr - - -- - - - - -- .7 ' 1.2' F—I Boring # I 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 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # J 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 QP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD 5 > 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 —A w,orAr;ol ; , a„ oltP.Y,atP f .,,,mot -1.O tort the .i- -t.,,A.,t .r An8 -14A -Z 1 ;I — TTV fnQ -7tA -8777 I l I I i . �i I I I i I I i R ill :c s x - - -- -- __ ajb4 �e llr.� CST lqj of ! ! i I 1 I ! , � � , I � ' l '. �. "� , I ... -. _ _.. ,.... _ _ ; .. - I .. - ._ � -. _ _. - -_ .._.._ i � i -I I , I I I , .. - -_ � I .. i_. _.._,. -_ ._ i �. .. -- - - r - - - -.. - - - -- - -- , f , L f I � � � 1 1 i I i i , L.. I I i �. ' - --� I I .� � - , i � � � i i , r _ '�. i I � , � _ � ,. - . i -- _� � j. j.. _ �.� � I � � - I I � I I a � � I I i ', � -_i - � _ _ I I � _ _ � ,__ �.__. _.i - -�_ �_._ } _ , - - -4 � - r - i - - -I- - - - -- -- I ', i � I i I I , + ,; I I ' -. _ � - - - _ � I j � i , , I � I �, i j I ,, I� _ � I,_ .._._ I_ f r i___, � L -- 4 - � � - F_ _ _ I i - -- I I I ; �._. I I i i I � y � 11 �_... :._- l . -_. _ _ ___. � __ I I I 1 i `r I_�� i r - - I - +- -, I-- I i -i-- f ' I � L l � } I f F i � � � � � I � I � i t � i �._ � -i �- -- - -;— �_ � I -- 1- - -� _ � _ —� __ � -� i - - -� � � -- � -- 1_ { -_ �_- - -- I i I I I I I I -- -- { I I I - - _ I �. __ -- - r i _ I _. t - I - _ i - � - f - -- - ,, { f I t I.._ _. '�_ ' I I I � � � � � � i I 1 __ _ , -__ �_ _ � - � �- I r - I � � _ � ,— � I I � i I I I I , I I i I h � -- � , i � - I - .' -- I _ � I i I I I � i i _ ._.._ �__- _.. ._ ___.. � _ �.._ ___ ;_ �._- -_ _. �- _ j.. _. �. _. _ __ -r_. -- -. I - f - - --- t.... —_y- -- � I � I I 4 �_ I I i � _ , � i, i '. � __._— �. t I I- a I -. �-__ � �___ _. � i._..._- I� �;. __ _i_ _. _... I __ _ L _ _ _ 1-.- _ _ �� .�. � l � __.__ i _ __ _ __ _ l i .. _. 1_._ __ , I - I �. �_ � } . ,. . � � _ ,� � I � - - _ - _ � I - I { I �` I 1 - - ' i , I I � I - - � _ _ __ I - i_. i ', i � t I I _ �_ _ -_ I � I � L �. I I I I I I II , 1 I _ __ t i I i I �` � � � ' � _ i � _ • 4 • _ - -- I i ;.- I i � I :, ... _ � _., . }:.._. .may. - -- y.- ,r... -j-.. it. -.._. -� +._.._ - I 1 __'}. !. �._ �, - I- _ -_. ' y � I f � I � I I 1 �, �, � � '. _._ .. -_. __.__ t —, -_.. ,. -_ - �.._. j � ._ _.. L _ _ t __. _.. i _ _.... I � � }- __ L _ '� � _ t f I i � ,. � � � � . �.. L � i ! - ___ — _.. �— II I I I -- 1 i ' I I i r t_._...- -. _ __. .... I .- _._ � _. __ i. t.. _.. _. t _.. j... _. ___ � - � ._._ — __. __.. i I " L ' I I ' � � � ( � ' r � i - � _, - -, I I � _ -- - , i ' _ I. ' �� I , � I � ' ' _ "_- I I I ;._ _ , ._ _ . � I _ _ i I _ - __ i ; _ - _ ;_ � i - ' �__ � - -' - _; _- ', I � i _ I -, _ . - __ - -� ST CIZ01X COUNTY ' E AGREEMENT SI.1 71C, I ANK MAINTENANC AND OWNERS141P CERTIFICATION FORM t � �Q , Owner/Buyer U Vf\ i NC. 1C��>J�rc`c Mailing Address 'I a- R.t u p No STR_ 5 u itt r-_� 100 60 y'"I S� - Property Address A (Verification required from Plannin�� Department for new construction) � 5t'� Parcel Identification Numberf Y . LE GAL DESCRIPTION Property Location `/4, Sec. ,2� T N- R_Jj _W, Town of .SOMfV ji7 Sub,.. Certified Survey Map # (off y� 7�' , Volume _ s , Page # _ V03 Warranty Deed # (,,3,3 Volume /J Page fl, B� Spec house J9 yes ❑ no Lot lines identifiable N yes ❑ no SYSTEM MAINTENANCE Improper use and maintenanceof your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the syste - 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. 1/wc, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. JkL2 1- SIGNA OF APPLICANT DATE; OWNF,R CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) ant (are) the owner(s) of the property described above, by virtue of a , arranty deed recorded in Register of Deeds Office. 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 III vn11557ppGt 85 �Y STATE BAR OF WISCONSIN FORM 2 - 1999 EsS312� KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Kimberly K. Alexander, a single person RECEIVED FOR RECORD 11-06 -2000 10:00 AM WARRANTY DEED Grantor, and Walter Germain and Debra Germain, husband and wife EXEMPT II CERT COPY FEE: COPY FEE: TRANSFER FEE: 381.00 RECORDING FEE: 12.00 Grantee. PAGES: 2 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 See Attached Exhibit A Name and Return Address KRISTINA OGLAND ATTORNEY AT LAW P.O. BOX 359 HUDSON, W1 54016 032 - 1080 -95 -001 & 032- 1080 -95 -002 Parcel Identification Number (PIN) This is homestead property, Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. (is) N3i01) Dated this c ;�� day of October 2000 + — + Kimberly K. Alexander + + AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. County ) authenticated th __dav � �� day of —f ttt3tL Personally came before me this NOTARY PUBLIC October , 2000 the above named WISUUNZON Kimbe K. Alexander, a single person ■ TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY + Attorney Kristina Ogland Notary Public, State of �Wisnsin Hudson, WI 54016 My Commission is permaQent. ([f n t, state e xpiratJ'S�n date: (Signatures may be authenticated or acknowledged. Both are not necessary.) _ j�� / 0? '; .) * Names or persons signing in any capacity must be typed or printed below their signature. information Professionals Company, Fond du Lac. wi SPATE BAR OF WISCONSIN soo455-2021 WARRANTY PEED FORM No. 2.1999 � • BODGE ': _ _ ...._,�.- �.,......._....�.._.. __....__._ ��._...__. S-2-184 �. Cl.r.;R LAKE, - _. - - - �1 WI 4, 0 SURVEY ERTIFIED SURVEY MAP Located In part of the Northwest Quarter of the Northwest Quarter of Section 23, Township 31 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin. Prepared for and at the request of: D.O.T N0. Walte LOT _ 3 55 - -35- 3200 -2001 Walter and Debra Germain 2100 State Trunk Highway "35' 133•I I CERTIF SURVEY _SURV_E_Y_ _M_A_P I Somerset, 0 54025 I VOLUME_3 PAGE_746 Drafted by. Ty R. Dodge —J ! L- ---------- - ----I 210 +- SQ�0 - E U_NPLATTED_ LANDS •co - — — „ — — — NOR7N UN£ • OF 7H£ NW 1, 4 t4� 1 i N88'53 , 47 E 443.96 - - -4-- 410.96 NOR7NWEST CORNER r I 3 _4� 33.00' SEC77ON 23 -31 -19 I �\ (FOUND ALUM /NUM COUNTY MONUMENT) T 1 T) I .. .......... I o �- M TOTAL AREA: Q CAUTION: I m 1'0 LOT P)F 141,764 SO. FT. HIGHWAY RESTRICTION M M 3.25 ACRES PROHIBIT PROVEMENTS I (� AREA EXC. R -o -W: !n R SEES I CRA +n w l 130,854 SQ. FT. ST. CROIX COUNTY lannin I In = z 1 3.00 ACRES [ p C Pg zon' ^� nnrt verkC f;nmmitt". — T ' "' 7 0 1 LOT 2 r �:_ B 2 8 2001 I I U) p i TOTAL AREA: 88'45'06 E 15.04' e1® 1 142,200 SO. FT. _ 382.04' 001 3.26 ACRES It not recor 'ea witnin 30 day I ��3.00' z I AREA EXC. R -O -W: approval to approval sh l e I Q I II and void I N (n o 3.00ACRES FT. 3 IU u 0 i LOT 3 I 2 11 Io I ° a V) I I I (D in I ;n 0 F U J I TOTAL AREA: o NQ ZI I j I N N I LOT 2 "' cLj 139,214 SQ. FT. iu c"n a �+ ;� z 1 3.20 ACRES ° o J I v, I I ;,� Q I AREA EXC. R —O —W: C o� pl W I 1 A in in 131,558 SQ. FT. in ° a) „ col F- i j N I Q O 3.02 ACRES N V > l-I tiOl IN p Z O O QI Z 13 O p Z r!)Z 0 0 C JI ( bit Z - (1 ° Z i I N i N88'45'06 "E 415.04' N88 45'06 "E °; B Z E :D I Q I I 382.04' 185.02 °E 6o -X 1567.06' c o m z I r�33.00' 88'45'06 E / 600. 6' o B c 3 w 3 I I ++ /�� M 1. °� ��, ; I o jN LOT 3 N C - 0 pC 0 1 ° f y +, a o o I I N N o C.B.A w C7 _O '� W M M O in d; zQ I W N I N� •- 0 y 0 J of I LO _va . I �33� P r c° 3 Z � I ��' ;. 3. 0' 567.06' y °c .' �Sn o c •o , -9 o X o_ N i �o `, r S88'45'06 0 W .I 600.06' X: C-4 ••• 33 UNPLATTED LANDS OF OWNER o = 0 o 0 0 "' °z I - E xrsnNG D&W I ------ d to ~ ------------ o ��- --- - - - --1 o c 0 0 II wpm I t I33I I O' I NOTE: EXISTING - U) m c' r c w z ° I P C i � WAY.�l11-,LOT -2 M o ° v .- w O o I I �i I TO BE MOVES? WR"M 15 TO PROVI N = I= w o I ,`�, I 200' .SEPARA7I! 1�.. QRIVEWAY ON a o w w w LOT 3 AND UNPLAM $$' STRIP X � Q N in I I Q �.P% I TO SOUTH FE :L � v z t„ I 'st11 0 0 o E a X 0 I � County Section Corner Monument z 1.2 .. U $ N m z - kA SWG DRIPEWAY of Record • Set 1" x 24 Iron Pipe weighing 1.13 pounds per linear foot. 3 JOB # A00115 I O Found 1" Iron Pipe Prepared by. I in Proposed Driveway Locations A & E \ ' o • • • • • • • • Building Setback Line (100' from R.O.W.) LAND SURVEYING & CIVIL ENGINEERING z (100' For Possible Future Town Road) Phone No. (715) 2464319 !TEST 114 CORNER 109 East Third Street, P.O: Box 325 SEC710N 23 -31 -19 New Richmond, WI 54017 (FOUND BRASS CAP Sheet 1 of 3 COUNTY MONUMENT) •_ . .__.ate .: ,_ ,..,._ l ER,SE`T' (N) �" ® T.3 III® - R.19W. W E S ®IV9'!CI /farXxrvlrX' 1 / .Tr fl.,rr.l. MN SXlnl Polk Count Polk - St Croix Rd Polk - St Croix Rd in 1 "r m A° 1" 9 5 `� L 3 Dej 9 232nd, r Av 4 y 35 230th Av o 2 230th Av H 1. Ferry Landing Rd Ln •� 2. 216th Av � .� Lakeside � U as a 3. 36th St Rd Lake 10 "� 1 12 � q, 'qtr L Av 00 0 221 st 220th Av 0 N Av m CD <a�e 3 2 215th 7 Rd 16 15 214th Av 14 AV 13 L F 210th Av 210th Av a 0 a� 207th Av � P c 0 o 21 205th Av OA V A vlc v r 2 nd St Falls rL�� a ye b� g �� 200th Av N Appte QIs ° g 28 27 26 25 a 300 Q 4 v 192nd Av d° 191st Av P S 190th Av N s N O� cz OD 3 34 184th Av a �� i � Y 0 180th Av C &NW RR ` 64 35 64 aoo 50o See Page 59 goo aoo V LANDRY - o 11 LANDSCAPING L &Z wefflm M TAU 0 5`mo C o., v , Inc. Black Dirt • Crushed Gravel c BOX 157 Driveways • Landscaping SOMERSET, WISCONSIN 54025 (715' 247 -3480 (715) 247 -3376 SOMERSET, WISCONSIN 57 t rAo 0 6 AMO RF/,/{ K team 1 realty P.O. Box 68.103 Main St., Somerset, WI 54025 Direct: (715) 247 -4449 Office: (715) 247 -5900 Fax (715) 247 -3622 LOT 3 133 I CERTIFIED SURVEY _MA_P 1 $399900 ! I 1 VOLUME 3 PAGE 746 I ' I---- ----- - - - - -J 21D7H — J S0 ;'05'�3"E UNPLATTED LANDS 2.00 - --- ----- ------ o _ — .._,..,,,.._... t4�F11(!1� i N88'53 47 E 415.06 T — — — NORTH UNE OF Nk NW '04 - - — '��33.00': 382.06' tl(1 NORTHWEST CORNER I 33'� \ Lot 160 St. SECTION 23 -31 -19 (FOU T COUNTY MONU MENT) Somerset, WI I Q �" o LOT SR 1 ... ... -� C.B.A M z1 in ol Ci N I I 0� TH N88'45'06 "E 415.04' w (n� 382.04' W z 1 I I- I J I LOT 1 {� In I N ® N w TOTAL AREA; 141,987 SQ. FT. Q Q 3.26 ACRES 0 i W W1 1 `° i I 'n <o AREA EXC. R –O –W; Q i i 1 3 M I 3 LOT 2� z 130,680 SQ. FT. I o �I 3.00 ACRES Q 2 I •- IN a FI N I ��(�pi3 oz IZ P I N 4.15.04' N88'45'06 "E 382.04' 185.02' /567.06' 3 Acre Lot North of Somerset Surveyed and perks conventional. Suitable for a walkout lower level home. Easy covenants. Back lot line is marked with pine trees. Feel free to drive in along the N. to E. lot line, using the old town road. Taxes to be determined. Contact Mike, Jo or Stacy for more information. Directions' N.�on Hwy 35, West (left) on 200 Ave., North (right) on 60 St., property on the East side of road. Legal Description: Schools: Somerset Lot 1 CSM Sec. 23 T31N R19W PID #: Taxes: To be determined i Mike Germain Jo Hinz Stacy Swanson Carol Germain Broker -Owner Licensed Assistant Licensed Assistant Team Coordinator mgermain @realtor.com 1 2t johinz @pressenter.com stacyswanson @pressenter.com Equal H www.mikegermain.com ® MESH Page of MANAGEMENT PLAN 'this Private O nsite Wastewater Treatment System (POW'I'S) has been desimed and is to be installed and maintained in acoordingto Comm 83, Wis. Admin. Code, the in- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems (SBD- 10567 -P; June It, 1999), I 'I Iris ( 1W 'I N hart IN - 4'11 4I4'h11.;114'41 140 it( 4 41111111414h1t4 11 11611"11111[111 41m1t 114na ul gallons of domestic wastewater -per day. The quality of influent discharged into the POWTS treatment or disposal component shall be equal to or less than all of the following: a monthly average of 30 mg/L fats, oil and grease a monthly average of 220 mg/L BOD 5 a monthly average of 159 mg/L TSS. Wastewater shall not be discharged to the POWTS in quantities or qualities that exceed A these limits or that result in exceeding the enforcement standards and preventative action limits specified in ch. NR 140 Tables 1 & 2 at a point of standards application, except as provided in Comm 83.03 (4)m Wis. Admin. Code. 2. The owner of this POWTS is responsible for system operation and maintenance. The following maintenance shall occur within three (3) years of the date of installation and at least once every three years thereafter: 1. The septic tank shall be pumped be a certified septage servicing operator, licensed under s2.81.48, Wis. Stats, unless inspection by a licensed master plumber or other person authorized to make such inspection, finds less than (1/3) of the tank volume occupied be sludge and scum. More frequent pumping may be necessary to prevent solids from exceeding one -third (1/3) if the volume of the tank.. Wastes shall be disposed of by the pumper in accordance with ch. NR 113 Wis. Admin. Code. At each pumping the pumper must visually inspect the condition of the tank, baffles, rizers, and manhole cover and verify that any required locks are present. 2. The soil absorption component(s) shall be visually inspected by a licensed master plumber, certified septage servicing operator or POWTS inspector. Inspection shall check for evidence of discharge of sewage to the ground surface and for ponding of effluent in the distribution cell. 3. The tank filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. The filter cartridge shall not be removed unless provisions are made to retain solids in the tank. Cleaning of the filter at more frequent intervals may be necessary. 4. Any pump, alarm or related electrical connections shall be visually checked for defects and tested to confirm that they are operating properly. 5. Reports for all system maintenance shall be submitted to St. Croix County Zoning in accordance with Comm 83.55, Wis. Admin. Code. 3. Defects or malfunctions identified during maintenance described in item #2 above shall be repaired in conformance with Conan 83, Wis. Admin. Code. 4. Anytime a failure or malfunction occurs, it shall be reported to the owner of this POWTS. Repair or connection of such failure or malfunction shall comply with Comm 83, Wis. Admin. Code. 5. No one should enter a septic or other treatment tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within these tanks may contain lethal gases and rescue of a person from the interior of the tank may be difficult or impossible. 6. No product for chemical or physical restoration or chemical or physical procedures for POWTS may be used unless approved by the Department of Commerce in accordance with Comm 84, Wis. Admin. Code. 7. In the event that this POWTS or a component of this POWTS fails and cannot be repaired, the following contingency plan is proposed: The failing component shall be replaced, This may require a new soil evaluation to determine where a new soil absorption c component can be. 8. If this POWTS is replaced, or its use is discontinued, it shall be abandoned in accordance with Comm 83.33, Wis. Admiu.. Code. 9. Name and number of local health agency St Croix Co ' - - - 1 10. Name of service contractor in case of failure or malfunction:-Shm & Sons Excavating 715 -549 -6651