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HomeMy WebLinkAbout032-2109-20-000 ST. CROIX COUNTY ZONING DE + PART N. - � \� AS BUILT SANITARY REPORT Owner } Property Address City /State �- 11j d r Legal Description: Lot ; ) Block — Subdivision/CSM # t /a & ' /a, Sec., T -RW, Town of „> PIN # /',Y- /0�_o -� SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION loved 6-a - 75_ Tank manufacturer U� Size ST/PC / Setback from: House Z Well PV-,` :— Pump manufacturer 4 Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: Sin Width /_ Length Number of Trenches Setback from: House Well --- P/L f.� Vent to fresh air intake z ,lov ELEVATIONS Description of benchmark _ Elevatio Description of alternate benchmark _ Elevation Building Sewer ST/HT Inlet o 8 � r 7 � ST Outl °` ,� . PC Inlet &s" : / sh 89 ©7 PC Bottom R/, s.V Header/Manifold a 3 Top of ST/PC Manhole Cover, , � Distribution Lines O 7 O ( ) Bottom of System( � O ( ) Final Grade Date of installation P rmit number � State plan number Plumber's signature License number Date r 1 , Inspector d, „ Complete plot plan � NOTICE Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. �st PLAN VIEW Lam: X70 ' INDICATE NORTH ARROW ,r Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 344623 Permit Holder's Name: ❑ City []Village ❑ xoown of: State Plan ID No.: Nosbish Kathleen M. Town of S omerset CST BM Elev.; ( Insp. BM Elev.: BM Description: Parcel Tax No.: I G , 0 ' S(N IA liy wo 032 - 2109 -20 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark '�, 4$ /03•:'8 . Dosing toov Alt. BM �'•Ze Z Bldg. Sewer 11 92,6 L St/ Ht Inlet �(�, If 2 TANK SETBACK INFORMATION St/ Ht Outlet /G •3(, 'f+ TANK TO P/ L WELL BLDG. Air I ntake ROAD Dt Inlet ` $� 75" gy Air � Septic �'. >ice (oz r NA Dt Bottom 22.ut V . - 2 •Beni+ }�� / � t ` — NA Header / Man. q TD 1 71 ( - 39 A& >/ > t t . NA Dist. Pipe Q•S 9# Z f Bot. System 1,0, q Q 3, 38 PUMP/ SIPHON INFORMATION Final Grade ./ �( 00 � Manufacturer Demand A St cove (� 10 . 09 �b Model Number 3 L ' GPM �Z JAI TDH Lift n,,�j�o Friction 0� System TDH o3Ft Head Forcemain Length o� I 1 Dia. Z ~ Dist. To Well '>I IIv �- S ABSORPTION SYSTEM BED #rSINQ Width I Length t f PIT No. Of Pits Inside Dia. Liquid Depth N I N DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type Of CHAMBER t � r _ _ Model Number: System: Pftkv, D �� D �S(� OR UNIT DISTRIBUTION SYSTEM Header/Manifold „` Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Lengt Dia, Dia. Spacing 2GQ SOIL COVER x Pressure Systems Only xx Mbund Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection 1 d/61 /99 Inspection #2: 4-- L aition: 1790 46th Street Somerset, WI (NW1 /4, NE1 /4, Section 5 T30N -R19W) - 5.30.19.1020 zr A4 1 ,J, wj Plan revision required? ❑ Yes No Use other side for additional information. Q3 o Z D ( s Z (� `/, SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. r ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: �. . f e E fi #r s 7 � # l # _ . _ k E } __ < ._ f s a a t i e � < f # 3 1 c 1 } 3 t � # g # } } < y < d � S r a } t i e E 3 v a. 3 .. r. .,.. .° & � a E 5 # t 4 .. .< me l <. < < <_ fl F 9 E F' E a F' E i � M a <w 7 # 3 5 , p a s e f E i � f Safety and Buildings Division N*6 cons i n SANITARY PERM O.N 201 W. Washington Avenue P O Box 7302 Depattment of Commerce In accord with ILHR Is. Adr�l. Code - Madison, WI 53707 -7302 V , :` unt y Attach complete plans to the count co only) fort tem .not les o ( ) s � • p P Y PY Y § -, than 8112 x 11 inches in size. • See reverse side for instructions for completing this a pl itatiAV 9 - ate Sanitary Per it Number 3 6;0 Personal information you provide may be used for seco / ary },��!! at a Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. 4 State Plan I.D. Number I. APPLICATION INFORMATION - PI-M PRI AL T Properyy Owner Name `; 11brt ` "cation O OS 1i4,5 T ,N,R - TorXW Property Owner's Malling,Addre Lot Number Block Number City, State Zip Code Phone Number Subdivision N e or CSM er I S ''� ( ) s . TYPE F BUILD G: (check one) State Owned l o Nearest ad Public 1 or 2 Family Dwelling ❑Vil age - No. of bedrooms Town OF 111. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 E] Apartment/ 9 S• • 1�', I a ?_o 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel / Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV. TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) A) 1 jg New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5, ❑ Repair of an ------ System System Tank Only Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 J� Seepage Bed 21 []Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 1 I 43 ❑ Vault Privy 14 ❑ System -In -Fill X i Z VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /' ch) Elevation e N Feet Feet Capacity VII. TANK in Ca allo s g Total # of Prefab. Site Fiber- Exper- INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existin strutted Tanks Tanks is Tan o — S' ® El 1:1 1:1 1:1 1:1 Lift Pump Tank /Sirhea,ChamLws ® ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for ig6tallation of the onsite sewage system shown on the attached plans. Plumb r' Nam (Pri q Plumb is 'gn �(Al s) MP /MPRSW No.: Business Phone Number: 2 Plu ber's Address Stree , City, Stat , Zip Cod ): IX. C UNTY / DEPARTMENT USE ONLY ❑Disapproved Sanitary Permit Fee (includes Groundwater J ssue tssui A n Si ature (No Stamps) surcharge Fee) pproved []Owner Given Initial Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS ' 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608- 266 -3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II_ Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information_ Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer.; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCI-FARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. 0 y o i � � h \ t \� I J I � / Vi IA 1 - a� PAeE OF PUMP CKtMb[R CROSS SECTION AND SPECIFICATIONS / VEAJT CAP y� VENT PIPE WEATHERPROO _APPROVED LOCKING JU►JCTIOM BOY MA4HOLE COVER WITH ? 25' FROM DOOR, WAKNING LABEL WINDOW OR FRE5H 12 MIU. I AIR IMTAKE GRADE le'MIU. COQDUIT -- _- _- __ -_ -_ -- - - - - - - - - PROVIDE -- IIJLE T � AIRTIGI {T SEAL I � I APPROVED JOIPST A I I A PPROVED JOWTS W/ PIPE I I W/ ' PIPE EXTENDIUG 3' I II ALAR>� EXTEWOIWG .3' O JTO SOLID SOIL B I 11 ONTO SOLID SOIL I I I o►J c i L LEV. FT. PUMP J b OFF 0 COLICRETE CLOCK RISER EXIT PERMITTED OIJLy IF TAUK MAUUFACTURER HAS SUCH APPROVAL 3" APPAOVEb, 6EDCING Uridtr - r/tw7K SEPTIC f SPECIFICATIOAIS DOSE TAUKS MAUUFACTURE:R: � a IJUMBER OF DOSES: PER DAM TAMK SIZE: /6 -/ G / ALL.OAIS DOSE VOLUME ALARM MAUUFACTURER: S ,/ �ec�iu�, � IMCLUDIIJG BACKF GALLONS MODEL QLIM15EK: 1 u� CAPACITIES: A= IAICNES OR oG SWITCH TyPC: ' ' B = INCHES OR GALLONS PUMP MAMUFACTURER: G = IS IUGHES O Rc2kF9_ GALLOU MODEL MUMBER: �.L ��� D - INCHES OR GALLOAIS SWITCH TYPE: ��l �/¢L_�Lt IJOTE7 PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE GPM INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFERE SETWEEU PUMP OFF ALID DISTRIBUTIOU PIPE.. �� FEET 4- , NETWORK SUPPL9 PRESSURE . . . , . . . FCET + FEET OF FORCE MAIN X F/oorT.FRICTIOU FACTOR. _.?�FEET — TOTAL O'3JAMIC HEAD = A�-=- FEET ,D,.'o-.. A4e .9x // WTERMAL DIME.1JS1 ►JC OF TAIUJK: LEWGTH iWIDT14 ;LlQU10 DEPTH �IGrJED:� LICEKISE NUMBER: OAT E: Pumps -ourves Mgniu ncT }SIZE 1 ,4 Solids 70 I 2Q-- wE01N— I I (— I If I ! �o 10 WEOJM i WEOJI -- - - - - � I _ i 0 U 0 10 20 00 50 6J lv W bJ 1w 110 1:y GYM p 10 •� ^ ; Q m'IR CAPACITY �;; .Ctr'.1.. „J. r . , /'ey+ ^f,.1 I •iw', :�• �•.'�.. ,a• r l.�UID:� PUMP INC. MUM fEEr % u D E L 3885 wko$mm ( - 0 0 0 10 90 40 y0 (,0 10 - w .�Q 110 1w GPM Z'0 0 10 a0 m'M CAPAC17 r • 1 WO OwW� Pvmp�. Ina. Ebb~ �' 1 W0 Wisconsfn Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page _'L of -� Bureau of Integrated Services in accordance with Comm 83.09, WI Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and �' �` percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # APPLICANT INFORMATION - Please print all information. a iewej by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). f l Pro pe Owner Property Location Govt. Lot 1/4 1/4,S T 0 ,N,R E (or Y� Property Owner's Mailing Address Lot # I Bloc # Sub . or CSM# s city State Zip Code Phone Number Nearest Road ❑City El Village ® Town S ( ) New Construction Use: Residential / Number of bedrooms 4 � Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow ,qD� gpd Recommended design loading rate S` bed, gpdfiF trench, gpd/ft Absorption area required Z&O _ bed, ft 41 trench, ft Maximum design loading rate bed, gpd /ft gpd /ft Recommended infiltration surface elevation(s) 7 ft (as referred to site plan benchmark) Additional design /site c Sider ions Parent material ,p.�/Oi ;,�,(J�;F� Flood plain elevation, if applicable ft I TU — T — Unsuitable Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank for system [A S ❑ U © S ❑ U fZ S ❑ U © S ❑ U ❑ S ® U ❑ S 0 U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft Texture Gr. Sz. Sh. Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Bed , Trench u l Ground _ elev. I w ' Depth to limiting factor >2fin. Remarks: Boring # S' Ground elev. e ft. 'x•' 9,58 Depth to limiting factor din. Remarks: CST Name (Plea a Print) Signature ` _Telephone No. Address / Date CST Number I SOIL DESCRIPTION REPORT PROPERTY OWNER - �n'��� SR�s Page of PARCEL I.D.# Boris # Horizon Depth Dominant Color Mottles Structure 2 Boring in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed .Trench �? 6 Ground elev. Depth to limiting factor Remarks: Boring # 3 ..........:::.. s� n ,^ Ground - _ elev. Aa Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /f12 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # s Ground ,/ 8 — elev. ft. Depth to limiting factor > Remarks: Boring # S Ground elev. Depth to limiting factor �,-IZEin. Remarks: SBD -8330 (R.9/98) e h � �i V Y I M O a Nb a4 j Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations ,Division of Safety & Buildings in accord with ILHR 83.05, 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 St rrnix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Mike Lu ndber g GOVT. LOT NW 1/4 NE 1/4,S5 T 30 N,R 19 X (or) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # I SUBD. NAME OR CSM # CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE EFOWN NEAREST ROAD (612)436 -6172 1 Somerset I 180th. ave. [K] New Construction Use [ X] Residential/ Number of bedrooms 3 [ J Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate .4 bed, gpd /ft .5 trench, gpd /ft Absorption area required 375 bed, ft 375 trench, ft Maximum design loading rate .4 bed, gpd /ft .5 trench, gpd /ft Recommended infiltration surface elevation(s) 109.60 ft (as referred to site plan benchmark) Additional design/ site considerations system el based on ocntour line of el 108.60 Parent material pi t g1 ac-i al drift. Flood plain elevation, if applicabl ft L S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ❑S ®U ERS ❑U El ®U El ®U ❑S ®U EIS ®U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in. Munsell Q Sz. Co C olor Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench Ground 3 29— elev. 1 -6 ft. 4 — Depth to I limiting factor 33 " Remarks: Boring # 1 0 -14 10 r3 3 none 1 2msbk mfr cry 2f .5 .6 <'2 2 14 -24 10 r4 4 none sic 2 sb mfr .4 .5 Ground 3 —72 elev. 1 04.9 ft. Depth to limiting factor +72" Remarks: CST Name : -- Please Print Gary L. Steel Phone: 715 -246 -6200 Address: 1554 200th. New Richmond, WI 54017 Signature: Date: 5 -23 -97 CST Number: m02298 I PROPERTYOWNER Mike L,LtndK -y — SOIL DESCRIPTION REPORT Page 2 �of PARCEL I.D. 0 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench 2 13 -23 10 r4 4 none sici 2msbk mfr if .4 .5 Ground bk mfr aw if, .2 .3 elev. 1 04.7 ft. 4 41 7 c 5yr5 sic-1 m na na J nn: - 9. Depth to limiting factor 41 " Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Mike Lundberg New Richmond WI 54017 MPRSW 3254 NWINE4 S5- T30N -R19W ' 715 246 -6200 town of Somerset lot #2 -Cedar Valley Estates W 0, �� N ---� -- 0 1 " =40' BM.= nail in Aspen tree C 1. 100' Al.t BM.= top of wooden pos @ el. 101.30' nw ,1 7 S/dY9 � 1 Zo 510P �� 4 j t v ) +0 zo 3 © . Gary L. Steel 5 -23 -97 CSI 09 ST CROIX COUNTY �q a SEPTIC TANK MAINTENANCE AGREEMENT �k�` �G AND OWNERSHIP CERTIFICATION FORM Owner/Buyer bMe,6 �t Mailing Address ia_ SSla(a Property Address (Verification required from Planning Department for new construction) City /State !�=QAf)2 :k 14 (M arcel Identification Number (' lG LE GAL DESCRIPTION Property Location /4 p �y ' '/4, Sec. 5 , T_-JQN -R 1 0 1 W, Town of Subdivision , Lot # c. J' Certified Survey Map # , Volume , Page # Warranty Deed # /n�s�n , Volume , Page # Spec house Byes ❑ no L,ot lines identifiable X yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance _consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposaI system is in proper operating condition and/or (2) Oiler 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 Zoning Office within 30 days of the three year expiration date. NATURE OF APPLICANT` DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by vi tic of a warranty deed recorded in Register of' Deeds Office. NATURE 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 I I I DOCUMENT NO. II I I I � STATE BAR OF WISCONSIN FORM 3 -- 1982�� 6QS�56 11 QUIT CLAIM DEED KATHLEEN H. WALSH REGISTER OF DEEDS I a 711' r"" � ST. CROIX CO., WI RECEIVED FOR RECORD I Robert J . Grea 1 i sh 08 -09 -1999 9 :30 AM ; I I .._.._....--•-----------------•---------......---------••----•----••-------•---••--- .....----------- •-- •- •- • - - - -- � QUIT CLAIM DEED ----------------------•-------------------------- •- - - - - -- EXEMPT # ` ------------ - - - - -- -------- CERT COPY FEE: I I.athleen ht. Nosblsh quit - claims to ---•------••-----•--------------------•--------- .......--------- ..._.... - - -- COPY FEE: _ TRANSFER FEE: 86.10 - ........................................ RECORDING FEE: 10.00 f PADS: 1 ...................-•----•---••-----•--------••--------------•------•----._......-- -••------ •-•- •-.....-- •- - -_... j the following described real estate in ............. St. Cro __,____ County, — State of Wisconsin: :� RETURl To Lot c, Cedar Valley Estates in the Town of Somerset IDAViL : TREEN•.,, -" f HUDSON, WI 54016 Tax Parcel No: • .032- 2109 -20 -000 i I I 1 t l This ....... S, not,,,_,,,,_ homestead property. OL4q (is5not) Dated this ................ Stbl .............. ..... .... day of .................... Au gmt..................................... 19 .. ....... (SEAL) .................. (SEAL) i<Q J J. Grea ........(SEAL) ................................................... ................ (SEAL) ................................... ............................... a _................-----............. ............................... AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ss. { .........................................•-------------- .....-- •-- ....._........ _- 5t.... aix .................. County. authenticated this ........ day of ...................... ...., 19 ------ Personall came before me this .... 5 ..... day of �i�lgll $t.- • ------- • ----- ...... 1959.... the above named --------------------------------------------------------------- ----------------- Robert J. Grea 1 i sh I� `----•-----------------------•-----•--------------- •- ••---- •----- •- .._..._.__.. ---------------------------_-•---_------------------------------------------•--- TITLE: MEMBER STATE BAR OF WISCONSIN ___________________•----._._.... .._..-------------------------- (If not- ---------------•--•----•---- -- ---- ---- -•-••---------- - - - --- authorized by § 706.06, Wis. Stats.) > to a own to be the person ......_.___. who executed the for goi instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY j+ At torne Lar Olson - •- •..... - -• • ......................... ••........_...---- •- ......... '! . .............................. - bavid J, Estreen j ROS eville, i1 Notary Public ............ St. CroiX County, Wis. y fi My Commission is permanent. (If not, state expiration II (Signatures ma be authenticated or acknowled Both are not necessary.) I date: -------------------------------------------------------- , 19--- ...... ) I I *Names of persons sipnin¢ in any capacity should be typed or printed below their sicnatures. .J yi►tcmll�r - -- - - - - -- STATF. BAR of WISCONSIN Stock No._ 130 Ole F 'Iil� r ^ ✓�L 1N ! 10 N 3.50 ACRES j 102,255 SO FT 1 1 37 Vag. X33,. 27!+ 1 e t i , a t t � t 1 N S88 "W 429.00 KI Lfi Ll E2 \G r 3,4a ACRES 3.35 ACRES 148,782 30. FT. 140,793 Sq. M 3.33 ACRES EXC, R/W 144,945 $0. Ff, p to "Q-4 N88 ° 26'54 "E 363.00 of N ti N850 44'24'"W 489.9 jn 4` N -� 5 _ ee• w 3.20 A RE9 % Gt • S! 139, s� FT / 3 ' N 3.34 ACRES yr 1680.43 / y �� 144,590 50. fT. IL 0 \ 3.00 AL. E%C. Now �a 3.52 r ACRES �. 130,758 90. FT. 153,124 90, F T , 8 D ° W l (878.1) r N 60.82 —Ys AC EASEMENT 2 8 s 3CTEN$ION Or ROADWAY) ei, 10 'd ov%Ape 9;L 'ON udd Wd 9:�:e0 Ifil E8- ^Z - Nff v; eor in Departmentof Indus", SOIL AND SITE EVALUATION REPORT Page I of 3 w Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code •�� OUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (B8 fi, direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 032-2017-30 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Mike Lundberg GOVT. LOT NW 1/4 NE 1/05 T 30 ,N,R 19 7E (or) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # CITY, STATE ZIP CODE PHONE NUMBER CITY []VILLAGE ®TOWN N AR ROAD (612)436 -6172 Somerset 180th. ave. {K] New Construction Use I R / Number of bedrooms 3 ( ] Addition to existing building I ] Replacement I ) Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate .4 bed, gpd/ft .5 trench, gpd1ft Absorption area required 375 bed, ft 375 trench, 9 Maximum design loading rate .4 bed, gpolft .5 trench, gpdm Recommended infiltration surface elevation(s) 109.60 ft (as referred to site plan benchmark) Additional design / site considerations system el. based on ocntour line of el, 108,60 Parent material t4-ad gl ar-; t drift. Flood plain elevation, if applicab It S - Suitable for s ys tem CONVENTIONAL I MOUND 1N- GROUND PRESSURE AT- GRADE SYSTEM IN FILL I HOLDING TANK U - Unsuitable fors stem 1 ❑ S 2) U CR ❑ u ❑ S ®U 1 ❑ S ®u ❑ S ®U ❑ S 0 SOIL DESCRIPTION REPORT Boring # Horizon depth Dominant Color Modes Texture Structure Consistence Botxld3y Roots GPD /ft in. Munsell Clu. Sz. Cont Color Gr. Sz. Sh. Bed TMrtdl G elev. l ft. Depth to limiting factor - 11 Remarks: Boring # 1 —14 10 r3 3 none 1 2msbk mfr 2f .5 .6 �:....::.� � 2 14 -24 10 r4 4 sicl 2 Ground 1 04.9 ft. CE tj Depth to 99 t� limitin f acto r , +72 couta nE Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. v New Richm nd WI 5 17 Signature: Date: CST Number: m02298 r 5 -23 -97 • PRDPERTY OWNER _ mike Lundbary — SOIL DESCRIPTION REPORT Page 2 of - PARCEL i.D. # Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon Texture Cor>srsbenoe Baxriary Roo in. Mansell tau. Sz. Cont. Color Gr. Sz. Sh. Bed Trench ..: 0 - 1 3 14 none 2 – r4 4 e sicl 2msbk mfr if .4 .5 Ground r aw I if .2 .3 elev. 1 Depth to knifing factor —41" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # rJ 1 11 - Ground elev. Depth ft. b limiting factor L I I-T Remarks: Boring # Ground elev. t to limiting fir — I 1 -1 1 - r F I ---- I - Li gamark�• I r r STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Mike Lundberg New Richmond, WI 54017 MPRSW 3254 NWkNEk S5 T30N -R19W (715) 246 -6200 town of Somerset lot #2 -Cedar Valley Estates N 1 "=40' EM.= nail in Aspen tree @ 1. 100' Al.t BI.= top of wooden pos C el. 101.30' IV %k IV v^ /Z- s1 m � ' �yrt .� M0 u-N D ) 4-rLb 09 i� 17- A0vj t .51 dP 44 1 a}I—Q r 20 Gary L. Steel 5 -23 -97 l