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AS BUILT SANITARY SYSTEM REPORT l (�
OWNER Y Y , TOWNSHIP -SEC T 3) N, W
P.O. ADDRESS , /v/C/��T ST. CROIX COUNTY; WISCONSIN
SUBDIVISION , LOT LOT SIZE 1 y 3 3 �� ��i
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM C -(f r / n
/� GtatGL I
\J
SEPTIC TANKS) 1000 MFGR. (.04E L$ CONCRETE STEEL
NO. of rings on cover (", Dept " — DRY WELL
TRENCHES NO. of width length area
BED no. of lines width J1 length__3 area Gyp
depth to top of pipe 34
AGGREGATE �z I %_ CyASW, a
PERK RATE AREA REQUIRED AREA AS BUILT
Disclaimer: The inspection of this system by St. Croix County does not imply complete
compliance with State Administrative Codes. There are other areas that it is not possible
to inspect at this point of construction. St. Croix County assumes no liability for
system operation. However, if failure is noted the County will ,Make every effort to
determine cause of failure.
GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
"INSPECTOR
DATED PLUMBER ON JOB
LICENSE NUMBER �/
RRPORT OF IIISPECTIO11-- I4DIJIDUAL SMACE DISPOSAL SYSTEM
' Snnitary Permit �Z
r State Sep
.,.A:IE T01II1SHIP
•
_41t. Croix County
Size gallons. ` -umber of Compartments
Distance From: We 11 /0 _ft, 12% or greater slope ft
Building ' Jc�-t- --- ft. Wetlands ft
Highwater ft.
DISPOSAL -SYST Tile Field or Seepage Pit(s)
Distance From: We �/ iL- ft. 12% or greater slope ft
Building ft. Wetlands
FIELD Hiphwater ft.
Total length of lines Qft. Number 9 f line Length of
each line J® ft. Distance between lines ,i_ft. Width of the
trench 1, --ft. Total absorption area (- sq. ft. Depth
of rock below the /Z, in, Depth of.rock over tile Z.► in.. Cover
nver.rock Depth of tile below grade
Q g aZ in. Slope of ,
trench : er 100 ft. Depth to Bedrock t. Depth to
.�
ground water t.
PITS
Number of wits 0 ts diameter ft. Depth below inlet
ft. Gravel a n i ` yes no. Total absorption area
s q. f t .
Square feet of se age trench bottom area required 4 A _.
,
:square feet f epa it a reAlired .
Inspected b F A le; .,
Approved A ,: Date 197
Rejected Date 197
EH 115
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309
MADISON, WISCONSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
LOCATION: S_E %, %51//4, Section °, - &[N, R /J X (or) 1��( Township or Municipality r Pnwi"i e,
Lot No. , Block No. County
u division Name
Owner's Name: 15 - j C
Mailing Address: R R #/ , y /4 fd __Sam & set=- -UAi- - T3 0.7u_
TYPE OF OCCUPANCY: Residence No. of Bedrooms "L Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS Al-4177-2x ` —PERCOLATION TESTS -417:2Z7- J
SOIL MAP SHEET �� SOIL TYPE CROC AIWA 7Ti1�laI
PERCOLATION TESTS
TEST DEPTH I SOIL HOURS WATER IN TEST TIME DROP IN WATER.LEVEL, INCHES RATE
CHARACTER SINCE HOLE HOLE AFTER INTERVAL
BE INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN /IN
P . s
48 S ee, 6 oire, Da No 3 <SIV 3
S e e, ore + �/ N o 3 ,�' •
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
B_ I No 7 9rz'j 7' TS, /a ',L S 7 7"-S
.� 96'' Nom 8" TS !o" A S . 71
B _ 9(o j ' Non v 7 16 1, /S" 75, 7 "L-5 ; 76 "S
96" N o n (o N ri 7 a
B _
None , 7 96" I /'' °�S� //` LS j 70d
6 96" Non& - 96N •r •, "s
PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of suitable areas. Indicate number of square of absorption area
needed for building type and occupancy. 4T a ' 4 1 , 1 S ", #n-bib ((,,Xrr_ J Indicate scale
or distances. Give horizontal and vertical refere ice poin s. Indicate slope. Fps SjsterA * R e place, mon+
L Or
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S� r
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I, the undersigned, hereby certify that the soil tests reported on this form were mad by me in accord with the proce ures
and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct
to the best of my knowledge and belief.
Name (print) Do h n * IS P 0_ Il OIDh j5ef,n Certification No. 55 — 16gq
Address
Name of installer if known a
CST Si a u
COPY A — LOCAL AUTHORITY
PLB67 • ' State and County State Permit
Permit Application County Per #
n for Private Domestic Sewage Systems County
* DENOTES SATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
Ri hcL rd T M o cu. wo R* ( SS So m e rse°i, W i is . 64 CW,
B. LOCATION: S. E. % $, 0j, %, Section ;M, T 3 N, R_" ).5, (or) ® Lot# City _
Subdivision Name, nearest road, lake or landmark Blk# Village
Township 6e
C. TYPE OF OCCUPANCY: Commercial *Industrial *Other (specify) * Variance
Single family X Duplex No. of Bedrooms I-T No. of Person
D. TYPE OF APPLIANCES: Dishwasher _X NO Food Waste Grinder YES NO # of Bathrooms—/—
Automatic Washer RYES NO Other (specify)
E. SEPTIC TANK CAPACITY /000 Total gallons No. of tanks /
*Holding tank capacity Total gallons No. of tanks
New Installation Addition Replacement _ Prefab Concrete X
*Poured in Place Steel Other (specify)
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) .Z 2) „ 3) , &_ Total Absorb Area sq. ft.
New_X Addition Replacement *Fill System /PCgV.,j red
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length 36' Width Ig'_ Depth q gv Tile Depth 1 " No. of Lines &_
Seepage Pit: Inside diameter Liquid Depth Tile Size
Percent slope of land ,5 f Z—ZV a& h easfer (y Distance from critical slope —^
i n s vsfem area,
I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH -115 prepared
by the Certified Soil Teper,
NAME 1"' C.S.T. # ,5S /599 and other information
obtained from owne /h —&hua ".
Plumber's Signature Mgyy*- �7� Phone
Plumber's Address
PLAN VIEW: Provide sketch bel of system (include direction of slope and all distances in accord with
H62.20, including well).
No Scale, _
!ll l /lo ll // oi�J' A 4 A1,
P ierce/
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Do Not Write in Space elow FOR DEPARTMENT USE ONLY 0 0
Date of Application �Vj k� �_� Fee P 'd: State /0, C 0 C un y (1; . D e
Permit Issued /mod- date) _Issuing Agent Name C
Inspection Yes No Valid# Date Recd
1. - county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) 4. plumber (canary copy)
Revised Date 6
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Parcel #: 038 - 1119 -20 -300 02/09/2006 11:04 AM
PAGE 7 OF 2
Alt. Parcel #: 29.31.18.491 B -30 038 - TOWN OF STAR PRAIRIE
Current X 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
LIMITED PARTNERSHIP STAR PRAIRIE O - STAR PRAIRIE, LIMITED PARTNERSHIP
1912C RALEIGH RD
NEW RICHMOND WI 54017
Districts: SC = School SP = Special roperty Addr ss(es): * = Primary
Type Dist # Description " 93RD ST
SC 5432 SCH D OF SOMERSET
SP 1700 WITC
Legal Description: Acres: 18.100 Plat: N/A -NOT AVAILABLE
SEC 29 T31 N R1 8W PT NE SW BEING LOT 2 OF Block/Condo Bldg:
CSM 9/2402 ALSO PT OF LOT 1 COM S1/4 COR
SEC 29;TH N 00 DEG W 1310.70';TH S 89 Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4)
DEG W 1315.33';TH N 00 DEG W 963.54 ;TH 29- 31N -18W
N 89 DEG E 269.33 FT POB;TH N 00 DEG W
12';TH N 89 DEG E 76.48';TH S 00 DE G E
more...
Notes: Parcel History:
Date Doc # Vol /Page Type
08/08/2001 653262 1695/524 WD
07/23/1997 1012/60 WD
2005 SUMMARY Bill #: Fair Market Value: Assessed with:
119672 145,200
Valuations: Last Changed: 10/15/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 18.100 112,600 30,100 142,700 NO
Totals for 2005:
General Property 18.100 112,600 30,100 142,700
Woodland 0.000 0 0
Totals for 2004:
General Property 18.100 112,600 30,100 142,700
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
CF
/MMMVV/ LIA� oe FILED
&A*tl g SEP 2 01991► 11
! ,�W !� l ez ,MMES O CONNELL
4'73'751L � ad aw �l o"U,:. A960 � ,tR. a*cooewi
a 41 j o- t0
CERTIFIED SURVEY MAP
Located in part of the NEh of the SWh of Section 29, T31N, R18W,
Town of Star Prairie, St. Croix County, Wisconsin.
LEGEND OWNERS
t9 Aluminum County Section Monument Found Richard E Ramona Moulton
N .e 0 x 24 Iron Pipe Set, weighing 1.68 lbs. 1947 93RD Street .
z a per linear foot. Somerset, WI 54025
«
v Roadway Setback Lina NJ Corner of
.0
++ o�
o V Marsh Area Section 29
u u
APPROVED
r
- o -1 n , SEP 20 1991
UINPLATTEv :a�SO� sr,criauccounrnr
° '" 0 PRC�IBVS►1� PARKg
�o
N86 17"E 819.17 nrGC
e w ( 791.09'
28.06,E Septic Vent LOT I
House 5422 Acres Including R/W ' q t'
227 406 S . F o
' `� �- N
N Sheds 5.05 Acres Exc:ludin9 R/W
220,038 Sq. Ft. * N
S89 617.71 e
l
�
28 T88.8T1
* Shed
� V O
dD y-
O
� 01 j - 100 QS Septic Vent � C_]�{ a "' N
CD
°- X1 1 ,° • r : �J c
eq _.11 o
Y LE . r1 Wi e
LLJ
m H-I p 3
I-- I � LOT 2
;. - Jt
° M o. o ~ I 18.10 Acres Including R/W �, �; o 0
,q L'L I e 'd' :r 1O • " W 1 788 549 S . Ft. `O, fO `r �I
W I e q so of e
15.52 Acres Excluding R/W o o �I
x 719,572 Sq. Ft.
0
192ND AVENUE -
• .�J
Ln
S89 °19 784 ,
498.87
= S89016127"W-816 . 461 S8901612711W
South line of the NEJ of the S�
UNPLTTE LET 1 UNPLATTED -
- -- -----E' I - -- — I -- - - - - -- —
40 LANDS C.S.M. IN VOL.7 PG. 2011 LANDS o
SCALE IN FEET
1110000101 VOLUME 9 PAGE 2402 S} Corner of
Section 29
0 100 200 400 ..
I
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety avid wilding Division
INSPECTION REPORT Sanitary Permit No:
29
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:
Star Prairie Limited P rtnership I Star Prairie Township 038 - 1119 -20 -200
CST BM Elev: Insp. BM Elev: 7 escription:
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
Dosing Alt. BM
Aeration Bldg. Sewer
Holding St/Ht Inlet
St/Ht Outlet
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic Dt Bottom
Dosing Header /Man.
Aeration Dist. Pipe
Holding Bot. System
PUMP /SIPHON INFORMATION Final Grade
Manufacturer Demand St Cover
GPM
Model Number
TDH Lift Friction Loss System Head TDH Ft
Forcemain Length Dia. Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer.
INFORMATION T Of S ystem: CHAMBER OR
Type Y UNIT Model Number.
DISTRIBUTION SYSTEM
Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake
Pipe(s)
Length Dia Length Dia Spacing :J
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade System Only
Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ® No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / /
Location: 1937 93rd Street Somerset, WI 54025 (NE 1/4 SW 1/4 29 T31 N R1 8W) NA Lot 2 Parcel No: 29.31.18.491 B20
1.) Alt BM Description =
2.) Bldg sewer length =
- amount of cover =
Plan revision Required? ❑ Yes ❑ No
Use other side for additional information.
Date Insepctor's Signature Cart. No.
SBD -6710 (R.3/97)
- ,t O
County Sanitary Permit Application ST. CROIX COUNTY WISCONSIN
In accord with 15.04 St. Croix County Sanitary Ordinance ZONING OFFICE
Personal information you provide may be used for secondary purposes ST. CROIX COUNTY GOVERNMENT CENTER
[Privacy Law. S. 15.04(1)(m)] 1101 Carmichael Road
Hudson, WI 54016 -7710
(715)386 -4680 Fax (715)386-4686
Attach complete plans for the system on paper not less than 8 -1/2 x 11 inches in size.
County Sanitary Permit # ❑ Check if revittoprevious application
GZ
1. Application Information - Please Print all Information Location:
Property Owner Name
11 1/4, Sec
S T N, R E (or)
Property Owner's Mailing Address Lot Number Block Number
/4
City, tate Zip Code Pho o "berp c C n � Subdivision Name or CSM
ZYt1Z
! s`
1
1 T pe of Building: (check one) I fixity ❑ Village 33T own of
C,
1 or 2 Family Dwelling - No. of Bedrooms: `' C► ` O r
❑ Public/Commercial (describe use): > >
❑ State -owned 'r Nearest Road
II. Type of Permit: (Check only one box on line A. Check box on line B if applicablq) :` y i 1 S
Parcel Tax Numb
A) 1 1.0 Repair 2. Reconnection ❑Non - plumbing ❑Rejuvenation Z v
Sanitation
Permit Number Date Issued
B)
❑ State Sanitary Permit was previously issued
IV. Type of POWT System: (Check all that apply)
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
. Dispersal/Treatment Area Information:
1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade
Required Proposed (Gals.idayisq.ft.) (Min./inch) Elevation
I. Tank Information Capaicty in Gallons Total # of Manufacturer Pr fab Site Con- Steel Fiber- Plastic
New Existing Gallons Tanks Concrete structed glass
Tanks Tanks
p - ❑ ❑ ❑ ❑
II. Responsibility Statement
I, the undersigned, assume responsibility for repair/ reconnenction /rejuvenationrinstallation of non - plumbing for the POWTS shown on the attached plans. I
license is pot required for terralift repair or the installation non - plumbing s nitation system.
Plum s Na t Plumber ign re s s Z MP /MPRS No. Business Phone Number
Plumbe s Address (Str��City, ate, Zi
6
VIII. County Use Only
Disapproved Sanitary Permit Fee Date Issued Issuing Agent Signature (No stamps)
Approved Owner Given Initial Adverse _ c ) 1
Determination O�J r® 2
IX. Conditions of Approval /Reasons for Disapproval:
1. Property is zoned Ag- residential — only one principal dwelling is allowed on this property.
2. The existing structure is being modified to become the principal structure on the property. The proposed modifications must meet applicable
building codes and result in a structure >720 sq. ft. (one - level) or >1000 sq. ft. (multi - level).
3. The septic system is sized for a 2 bdrm residence. A violation of the state administrative codes would be created if any modifications are made
to the structure that increase the # of bdrms /design wastewater flow.
P h�ec% /iau. nti at��vrs a /93 �. lVp ` Iq 7� e-'s><
'p�
PAY
1-2
s 4
' .� Cif ��
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page _- L-- of�
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County �..�.
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must
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 used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Q
rn_
Property Owner Property Location
.S Govt. Lot &I 1/4 *) 1/4 !29 T� N R E (or
Property Owner's Mailing Address Lot # ock Subd. Name o ga MA� -
City Sta Zip Code Phone Number ❑City ❑Village Town Nearest oad
el G x°�
❑ New Construction Use: ❑ Residential / Number of bedrooms Code derived design flow rate GPD
❑ Replacement / ❑ Public or commercial - Describe : G,
Parent material ct�L�sr/ Flood Plain elevations pllcable . ft.
General comments
and recommendations:
t
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 GPD /ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
3
- ✓
i
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 GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I 'Eff#2
Effluent #1 = BOD > 30 < 220 mg /Land TSS >30 _< 150 mg /L *Effluent #2 = BOD < 30 mg /Land TSS < 30 mg /L
CST Name (Please Print) Signature CST Number
Address Date Evaluation Conducted Telephone Number
SBD -8330 (1107/00)
Page Parcel ID # Pa of
Property Owner 9
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 GPD /ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
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 GPD /ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
F - 1 F1 Boring
Boring # Ground surface elev. ft. Depth to limiting factor in.
❑ Pit 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 *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.
SBD -8330 (R.07 /00)
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PHONE N0. 715 247 38880 DE C. 20 2000 06:13PM P1
ST CROIX COUNTY . .
SEPTIC TANK MAMMNANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer S'f'0.r �c'aisi Livvti�"2C� F441 5; U /J . C/o 6-02bdAf �a�QtItS7'
Mailing Address 1 q �- 9 00/1 S fi �� D t C �I W10✓t (� r V if 1 S �" 0 7
Properly Address (�� qIf d 5
(Verification required from Planning Department for new construction)
City /State So wtE5Q 1- , Z Parcel Identification Number
LEGAL DESCRWnOD1
Property Location N %4, SW %., Sec. 2 q . T 3 i N N -R ij' ! W, Town of S-ar Am r 1'e .
Subdivision Lot # _ -
zy�z
Certified Survey Map # 7 .3 7 `�, f , Volume ,-e�_. _....,page
Warranty Deed # .T� Z , Volume 10 2 . Page # 0
Spec house 0 yes 14 no Lot lines identifiable M yes 0 no
STEM lVi iNTENANCE
Improper use and araintenancoof 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 aft'ect the function of the septic tank as a treatment stage in the waste disposal system.
M properly owner agues to submit to St. Cram Zoning Department a cerUG"Um fa • signed by the owner and by a
muster plumber, jorrincYmBAPlujober, w4ttietcdplumber or a Roma pumper vcd*iug that (1) the ou -site wastewat¢tdispoaal system
and/or (2) after inspocticn sad Pumping (If amessaiy), &c septic tack is less than 113 W of zlodge-
is in ptnpCr aper:mr8 condition
LNM the undersigned have read the above requirements au4 agree to mawtam tba private sewage disp*W qmm w A the ctsndagds
ad forth, herein. as sat by the ba bet n maient of Commerce be co a lle and returned f urnned to the St. Croix County Zoning a� 30
s"ng tbat your $eptic sys has beentained mP
days of the three year expiration date.
're � S - far f -6 ('1,te ctzd f &nqr .;ti (,;a
DATE
go F IIC`,ANT
OWNER CMIU ICA�P= lwowledge. 1(we) am ("a) tike owna(S) of
I (we) certify that all statements on this fora are i Re of Deeds Office.. _
the property descri'bcd above, by virtue of a warranty deed g
a Tre of d �eVP+rQf / - 11-1 vy�r �;�� DATE
APPLICANT
SIGNATURE « « « « +«
od may result in the sanitary permit being revokodby thV Zoning DeparbDOL
«.. «.. p infoanuitioa that is mis- represent .
deed from the gegiater of Deeds office
•• Leelude with this sgppieatiun: co py of waffan the certified survey urap if refereneo is made in the wa=lLnty deed
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_ 0[/20!0 TL[F_12* 23 7_15_ 247 3300 1 002
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POWERS LIQUID WASTE MANAGEMENT, INC
346 GREATON RD
NEW RICHMOND, WI 54017
(715 )246 - 5738
FAX (715)246 -7762
December 21, 2600
I
Garden Lofquis�
1926 90th St
New Richmond, �1 54017
Dear Gordon:
Following is a (report regarding the current condition of the septic
system at 1935193rd St, New Richmond, W3 54017:
Pumping date: November 18,1998
Gallons piUmped: 1000
Statement regarding the condition of the system,
prior to ppumping:
thelwater level in the septic tank was normal.
the solid levels in the septic tank were normal.
thebaffles were in place.
thel,septic tank structure was O.K. (no signs of leakage)
-nex recommended pumping date - November 2001
Inspection date: December 20, 2000
-dra cif field pipe had 0 waiter in it
-no signs of leeching in drainfield area.
-dues to present conditions, the septic could not be
located for pumping.
i
s er Hoppe .`fi'ox5 {�o� _54 "W A r�9num4
Certit�ed Sept Hauler
License #80559;
aMtd - i S r vt �1lcJ� r
0 Jej -A] ee 0014, e q Pm
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Parcel #: 038 - 1119 -20 -300 03/31/2005 12:00 PM
PAGE 1 OF 1
Alt. Parcel #: 29.31.18.491B -30 038 - TOWN OF STAR PRAIRIE
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
*
LIMITED PARTNERSHIP STAR PRAIRIE STAR PRAIRIE, LIMITED PARTNERSHIP
1912C RALEIGH RD
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): • = Primary
Type Dist # Description ' 93RD ST
SC 5432 SCH D OF SOMERSET
SP 1700 WITC
Legal Description: Acres: 18.100 Plat: N/A -NOT AVAILABLE
g p
SEC 29 T31 N R1 8W PT NE SW BEING LOT 2 OF Block/Condo Bldg:
CSM 9/2402 ALSO PT OF LOT 1 COM S1/4 COR
SEC 29;TH N 00 DEG W 1310.70 ;TH S 89 Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4)
DEG W 1315.33 ;TH N 00 DEG W 963.54';TH 29- 31N -18W
N 89 DEG E 269.33 FT POB;TH N 00 DEG W
12';TH N 89 DEG E 76.48';TH S 00 DE G E
more
Notes: Parcel History:
Date Doc # Vol /Page Type
08/08/2001 653262 1695/524 WD
07/23/1997 1012/60 WD
2004 SUMMARY Bill M Fair Market Value: Assessed with:
30620 136,700
Valuations: Last Changed: 10/15/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 18.100 112,600 30,100 142,700 NO
Totals for 2004:
General Property 18.100 112,600 30,100 142,700
Woodland 0.000 0 0
Totals for 2003:
General Property 18.100 44,600 22,300 66,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch #:
Specials:
User Special Code Category Amount
p 9 rY
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02
REAL ESTATE TOWN F R PRAIRIE
O STA E
COMPUTER NUMBER 038 - 1119 -20 -300 Parcel Number 29.31.18.491 B -30
OWNER NAME: First LIMIT HIP Last STAPRAIRIE
PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment
2, 93RD ST
SECTION 29 TOWN 31N RANGE 18W'/4160 '/440
Line Description Line Description
TOTAL ACREAGE 18.100 PLAT LOT BLK
01 SEC 29 T31 N R18W PT NE SW 15
02 BEING L OI-2 LOT-2 OF CSM 9/2402 16
03 �O PT OF LOT 1 c'n_n� S1 /�l 1
04 COR SEC 29;TH N 00 DEG W 18
05 1 HS89 DEG W 19
06 1315.33';TH N 00 DEG W 20
07 963.54';TH N 89 DEG E 269.33 21
08 FT POB;TH N 00 DEG W 12';TH 22
09 N 89 DEG E 76.48';TH S 00 DE 23
10 G E 12';TH S 89 DEG W 76.48' 24
11 POB 25
12 26
13 27
14 28
F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit
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111f,20 20 6
Dy>cu N O. WAPt ANTY DEED THIS SPACE REBERYEo FOR RECORDING DATA
STATE BAR OF WISCONSIN FORM 2-1982
499 AGE
P_�.__. REGISTER'S OFFICE
Ri .chard..Maul.tnn..a /.k /.a..Ri. chard..T .....Moul.tan..and..Ramana..... ST. CROIX CO., WI
Recd for Record
, Mau l. tnn ..a /.k /.a..Ramona..M....Moul. ton ,...husband..and..wife.........
....... ........................... . .......................................... :.. MAY 2 7 1993 •.
............................................ ........................... .... .. .............................................. 11:45 �
conyu and warrants to — Star - ai. r. ise.. Li .mi.ted..Par.tnershi-n;........ M
at
I
........ ...— .......
. .. ....................
�Z 7 y • • .. • . Par Register of Deeds
..... . ..................
................................................................ ...............................
............................................... .................................
I
f or ... ..... .. .... c .. o .. n .. s .. id ..... e ... r .. .... .. .. .................. . .......... .. _..................... .... RETURN TO
. �a. 1. ua. .. ... . . ........................ ...............................
... .... .... .................. .............. ................. . .....I......................... .
the following described real estate in St... .C1r0 .1X ...................County, --
State of Wisconsin:
Tax Parcel No: ..............................
Part of NEn of SWJ, Section 29, Township 31.North, Ranqe 18 West, St. Croix
County, Wisconsin described as follows: Lot 2 o f Certified Survey Map filed
September 20, 1991, in Vol. _ "9" of CSMs, page 2402 Doc. No. 473751.
li
Subject to public road riqhts- of -w a,y along the southerly and westerly sides
of said Lot 2 as shown on said Certified Survey Map thereof.
I Together with and subject to easements, flowage rights, restrictions and
covenants of record, if any.
{ $ J
{ FE .
I
This .. is- not ............. homestead property.
(is not)
Exception to warranties:
Dated this ._ _r C / e l day of ........:! .... r ; ............. ...................................
, I9..9. ..
... .......
(SEAL) .................... ....... ................(SEAL)
Richard Moulton a /k /a T. Moulton
_ ............................. .........
.... ..... ............ I............................. (SEAL) - -.. ,2�lQ'IU�... " "'7...................... (SEAL)
. .. ... ....... ............. I.................... # . Ramona.. MQu.1 ton.. a/. k /a.. Ramona . M.,.. Mou l ton
AUTHENTICATION
ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN
ss.
St. Croix .County.
.... ............................... ..yyam�
authenticated this ........ day of ..... ...................... 19...... Personally came before me this ..O..Y........day of
l!f..y� .................. 19..43.. the above named
��//
•---• .......................................... ...............................
• .............•-•--......--•-----•-•-....... ..............--- •••......•• - -- Ri.ohard..Moul. ton.. /.a R %�hard..T....MQU.1.tQn
l TITLE: MEMBER STATE BAR OP WISCONSIN a nd..RamQna._ MAUI. tQn .. /k Ja,- RamQna,•M.•., ton
I (If not . ................... ............... -.................
..._.._ ...._........_._....._.........---............... ...............................
{ authorized by § 706.06, Wis. Stats.) to me known to be the person .... S...... who executed the
ROGER �E� it instrum I t and acknowledge the some.
THIS INSTRUMENT WAS DRAFTED BY
NOTARY PUBLIC
...
Wi_l J. Gilbert, Attorne
p'�'' T4 <01 WISCON5 ; .......
��i.l�... �1 ........ ................... ...........
Sec
206 Second St. , Hudson, WI 54016 Notary Pub lic .........Srt,...Croix _
06 nd S . ....................... ...... . County, Wis.
(Signatures may be authenticated or acknowledged. Both My Commission is permanent (It not, state expiration
acre not necessary.) date. /
I
I 'Nunes of persons signing in any euimcity shu ild be typod or ln•inLud below their signatures.
� r
Aluminum County Section Monument found Richard�9 Ramona Moulton
�' �„ 0 1" x 24 Iron Pipe Set, weighing 1,68 lbs. 1947 93 0 Street
N per linear foot.
Sonersek, NI 54025
Roadway Setback Line Ni Corner of
N * Marsh Area
Section 29
AtOPROVED
WW
Y M
G Y
SEA' 2 t1 f99t
s j UNVLa ^ v_ S7, C;flt�Lv. Cc�U
Y ,.. a ��`t7MV/x9HE1}rS VE Pt Refs P{/{NN71ViC
„ 6 18' 17 "E 819.17 nti »mF
C ^ 791.09' "
28.0 �Ru�AW
t ,.
8 —Septic Ve
pn
� � LOT �RQ�'�RT'`/ s
.� [�Rouae 5.22 Acres Including R/Y <<i +he
'27,406 Sq. Ft. N; 1r1
'RTh +S es't�� t `~ Sheds 5.05 Acres Excluding R% 1 j 9{7
bv;0 "�► II 220,039 Sy. Ft.
w4 wsw�� bl� S89OL3 Zq"W 817,71' e
{p - 1"i'nd 9EC�at 788.87' /
,' clfi EfiaKEt •••aw� '� * J
~ !!
"SPLP Shed y
A ��,►st' set -leaek � L �
-f o i00 !a . Fnece ,
pShed Septic Vent � (l�1
C 1 _] s �o j ='; ems) + ,o •°*
ILI Ctl 1b l (1 Y c -31
Dui ` W L0; s
s �
LOT 2 �Z
ML w e o, °o N-' 1 18.10 Acres Including R/W ;�, 0 1
�` LEI a `r 1O z 1111 788,549 Sq. it. i° O Z
0 c_ I •r 1 01 o. 40
- a O 10 �{ 16.52 Acres Excluding R/W C N
Z t ji 719,572 Sq. Ft.
ry 1 i
Mt o
!92ND AVENUE Q� 4
—
589 °!9'02 "k 784 49e.671
S$9o16' 27 "W Se9 2 w
1 South line of the NE of the SM} 1
{ 31
UN
o
LANIDS t�.J_iIvl iN VOL. 7 PG. 2-0 LAND S g
SCALE IN FEET f
VOLUME 9 PACE 2402 � S1 Corner of
a loo 200 400 Section 29
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$00' 00££ LbZ 5T -, -- -- 0/00 0
�j L k�'� 67�ZI $ii.L 10/0Z/70
_02 /2 /01TUE_ 12_28 FAX 715 247 3300 2003
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ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
p Y A p■p■ Nit No ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
-=_ Hudson, WI 54016-7710
_ (715) 386-4680
March 8, 1994
Ms. Jill Everson
MidAmerica Bank
600 Second Street
Hudson, Wisconsin 54016
RE: Water Inspection for Todd Boumeester
Address: 1037 93rd Street, Somerset, Wisconsin
Dear Ms. Everson:
Enclosed is the original test results from Commercial Testing
Laboratory, Inc. for water inspection of the above property. If
you have any questions with regard to said report, please let me
know.
n rely,
lames K. Thompson
Assistant Zoning Administrator
mz
Enclosure
COMMERCIAL TESTING LABORATORY, INC.
514 Main Street, P.O. Box 526
Colfax, Wisconsin 54730
715 962 - 3121
800 - 962 - 5227
FAX - 715 - 962 - 4030
k
ST. CROIX COUNTY ZONING OFFICE REPORT NO.: 58153/01. PAGE 1
r ST.CROIX CTY GOV.CTR REPORT T1ATE! 3/04/94
1101 CARMICHAEL ROAD DATE RECEIVED: 3/03/94
HUDSON; WI 54016
ATTN: THOMAS C. NELSON
OWNER: Todd Boumeester
LOCATIOW 1937 93rd St., Somerset
COLLECTOR: Jim Thompson
DATE COLLECTED: 3-02-94
TIME COLLECTED! 2:15pm
SWE OF SAMPLE: Kitchen faucet
DATE ANALYZED:3-03-94
TIME ANALYZED22S00pm
COL.IFORM,MFCC e 0 .1100 m l
INTERPRETATION. BacterioLogicatly SAFE
NITRATE-NT 3 ppm
Above 10 ppm exceeds the recommended Public
Drinking mater Standard.
Conform Bacteria/100 m!
Nitrate-Nitrogen, mg/L
(P M`L1
LAB TECHNICIAN: Pam Ganre
DF.INDEVFNOE�I. ..,,1'
�D WI Approved Lab No. 19
S Means "LESS THAN" Detectable Level Approved by'.
® PROFESSIONAL LABORATORY SERVICES SINCE 1952
VK �-
'' � ST. CROIX COUNTY
p WISCONSIN
ZONING OFFICE
"�""""■ Mr.�i ST. CROIX COUNTY GOVERNMENT CENTER
��„• _ 1101 Carmichael Road
.•n ---= - — Hudson, WI 54016-7710
(715) 386-4680
SEPTIC INSPECTION / WATER TEST REQUEST FORM
Please specify desired test(s) & remit appropriate fee Y%i.th
application. Outside water lines are often turned off during
ter months, making access to the home necessary. Please make
ngements with this office to insure that entry can be gained.
, 6�
❑ Water (VOC's) $185. 00 ❑ Septic $50. 00
'J d ;' Water (Nitrate & Bacteria) 45. 00 ❑ Nitrate & Bacteria
II ��� retest $15. 00
Owner:- rule e S Requested by: IJ i c r1 60v/11
Address: 1197 - 3r-01 Address: 0 -
somej—' -f "L1 ZIP S46b)5 SOr1 wZ ZIP 5-lbA.
Telephone N°: ( ) -74 30x3 Telephone N°: (`T i 5 )
Property address (Fire NO & Street) : I q -3 -7 - ei- 3 r4 S�
Location: NE ; , 5 ice; , Sec. , T N, R ` W, Town of q
Realty firm: Lock Box Combo: Closing Date: 3---,,,)
PTp 4 03`6' -i i 19-2-(0 100
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? ❑ Yes ❑ No
If vacant, date last occupied:
Age of septic system:
Septic tank last pumped by: p -- `
Previous Owner's Name(s) : *
,r.
Have any of the following been observed?
❑Y ON Slow drainage from house.
❑Y ON Sewage Back-up into dwelling.
❑Y ❑N Sewage discharge to ground surface or road_ ,d1itch.
❑Y ON Foul odors.
Other comments relative to system operation:
I certify that the above information is complete and true to the
best of my knowledge.
OWNERS SIGNATURE: DATE:
1/94
OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION
1N
TO BE COMPLETED BY INSPECTION AGENCY
System design &/or permit on file? ❑Yes ONO
Soil series per SCS Soil Survey: sheet #
Type of soil absorption system: ❑Below grd ❑At-Grd ❑Mound
Approx. size ' X ❑Gravity ❑Dose ❑Pressurized
�.
Ft. 2 ❑Bed ❑Trench ❑Dry Well
❑Holding Tank ❑Outfall pipe
OBSERVED DEFICIENCIES ❑Other ❑Unknown
Septic tank
Setbacks: ❑House ❑Well ❑Prop. line ❑Other
Dose tank
Setbacks: ❑House ❑Well ❑Prop. line ❑Other
❑Locking cover ❑Warning label ❑Pump/Floats
❑Alarm ❑Elec. wiring
Soil Absorption System
Setbacks: ❑House ❑Well ❑Prop. line ❑Other
❑Ponding: ❑Discharge:
General comments:
INSPECTORS SKETCH OF SYSTEM LOCATION
N
Inspector
Title