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Parcel #: 032 - 2035 -70 -100 04130/2007 02:18 PM
PAGE 1 OF 1
Alt. Parcel #: 09.30.19.612C 032 - TOWN OF SOMERSET
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): 0 = Current Owner, C = Current Co -Owner
O - RAY, MICHAEL S & DEANNE M
MICHAEL S & DEANNE M RAY
1615 57TH ST
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): ' = Primary
Type Dist # Description * 1615 57TH ST
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 4.000 Plat: N/A -NOT AVAILABLE
SEC 9 T30N R19W PT S1/2 SE1 /4 BEING LOT Block/Condo Bldg:
1 CSM 11/3032
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
09- 30N -19W
Notes: Parcel History:
Date Doc # Vol /Page Type
07/23/1997 1172/277 PR
07/23/1997 1172/276 TI
2007 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations: 1- La Changed: 07/23/2003
Description Class Acres Land improve Total State Reason
RESIDENTIAL G1 4.000 53,000 / 62,500 115,500 NO
Totals for 2007:
General Property 4.000 53,000 62,500 115,500
Woodland 0.000 0 0
Totals for 2006:
General Property 4.000 53,000 62,500 115,500
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch #: 502
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County:
Safety and Buildings Division
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)]. 353159
Permit Holder's Name: ❑ City ❑ Village W Town of: State Plan ID No.:
Town of Somerset
CS M Elev.:. Insp. BM Elev.: BM Description: Parcel Tax No.:
032 - 2035 -70 -100
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
Dosi ng Alt. BM
Aeration Bldg. Sewer
Holding St /Ht Inlet
TANK SETBACK INFORMATION St/ Ht Outlet
TANKTO P/L WELL BLDG. Air to
i ntake ROAD Dt Inlet
Air
Septic NA Dt Bottom
Dosing NA Header /Man.
Aeration NA Dist. Pipe
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand St cover
Model Number GPM
TDH Lift Friction System TDH Ft
L oss Forcemain Length Dia. H Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS DIMENSION
SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer:
SETBACK
INFORMATION Type of CHAMBER mod Number:
System: OR UNIT
DISTRIBUTION SYSTEM
Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
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
Bed /Trench Center Bed /Trench Edges Topsoil E] Yes El No E] Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: / / Inspection #2:
Location: 1615 57th Street, Somerset, WI (SW1 /4, SE1 /4, Section 9 T30N -R19W) - 9.30.19.612C
Plan revision required? ❑ Yes ❑ No F�
Use other side for additional information.
SBD -6710 (R.3/97) Date Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
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Safety and Buildings Division .
Vi sconsi n SANITARY PERMIT APPLICATION 2 01 W. Washington Avenue
I n accord with ILHR 83.05 Wis. Adm. Code P O Box 7302
Department of Commerce Madison, WI 53707 -7302
• Attach complete plans (to the county copy only).for the system, on paper not less County
than 81/2 x 11 inches in size.
• See reverse side for instructions for completing this application State s Permit Number.
Personal information you provide may be used for secondary purposes ❑ Check it re� n to pre4ious application
[Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number
I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION oZ Io
Propert O er Nam Property Location
L va 1 /4, S T , N, R& E (ort9
Property Owner's Mail ng Address Lot Number Block Nu m er
City, State Zip Code ( hone ;umber Subdivision ame o CSM N tVer
a/
11. TYPE F B I DING: (check one) ❑ State Owned ❑ City earest Road
❑ Village
Public 1 or 2 Family Dwelling - No. of bedrooms 3 Town O
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) g, $0
1 ❑ Apartment/ Condo
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. ❑ New 2. 1Z Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
------ System ........ System------------- Tank Only______________ Existing System 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 ❑ Seepage Bed 21 Ig Mound fl Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In- Ground Pressure T t 42 ❑ Pit Privy
13 ❑ Seepage Pit 43 ❑ Vault Privy
14 ❑ System -In -Fill" c tl - .D
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
5 _ Feet Feet
Capacit
VII. TANK in Ca allons Total # of Prefab. Site Fiber- Exper.
INFORMATION g Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App
New Existin strutted
Tank Tanks p �
Septic Tank or Holding Tank �1 ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber 9 _ ❑ ❑ ❑ ❑ ❑
VI11. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for in allation of the onsite sewage system shown on the attached plans.
Piumbe , Na : (P b '
Plums b na a s MP/MPRSW No.: Business Phone Number:
l 3 -
Plumber s Address (Street, Cit , State, Zi Code):
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved S nitary Permit Fee (Includes Groundwater ate Issued Issuin Agent Signat a (No Stamps)
Surcharge Fee)
Approved ❑Owner Given Initial
Adverse Determination
X. (; ONDITIONS OF APPROVA / REASONS F DISAPPROVAL:
�►w�aP� .pi`s ., �� C� �. , S3. o?Cz�
rum cz
SBD- 6398 (8.11/97) 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.
Il. 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 6 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 81/2 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 SURCHARGE
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.
Safety and Buildings
* iScons i n 10541 N RANCH ROAD
HAYWARD WI 54843
TDD #: (608) 264 -8777
www.commerce.state.wi.us
Department of Commerce Tommy G. Thompson, Governor
Brenda J. Blanchard, Secretary
September 14, 1999
CUST ID No.224263 ATTN.• POWTS INSPECTOR
ZONING OFFICE
KIM A O'CONNELL ST CROIX COUNTY SPIA
504 3RD AVE 1101 CARMICHAEL RD
OSCEOLA WI 54020 HUDSON WI 54016
RE: CONDITIONAL APPROVAL
APPROVAL EXPIRES: 09/14/2001 Identification Numbers
Transaction ID No. 241246
Site ID No. 179136
SITE: Please refer to both identification numbers,
Site ID: 179136 L above, in all correspondence with theagency.
ST CROIX County, Town of SOMERSET; 1615 57TH ST, SOMERSET 54025
SW1/4, SE1 /4, S9, T30N, R19W
Facility: MIKE RAY 1615 57TH ST, SOMERSET 54025
FOR: MOUND, 450 GPD
Object Type: POWT System Regulated Object ID No.: 486508
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes 1 . 0
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in
chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. 4 .)
9
The following onditions shall be met during construction or installation and prior to occupancy or use: T .
g g p P Y L tE
r .
1. This plan action is subject to designer comments on the plan. siQra c�
2. The orientation of the mound system must be such that the mound's longest dimension is perpendicular
to the direction of maximum slope.
3. The area 25' below the downslope edge of the mound must remain undisturbed.
4. Abandon failing system per COMM 83.03(2).
A copy of the approved plans, specifications and this letter shall be on -site during construction and open to
inspection by authorized representatives of the Department, which may include local inspectors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction /installation/operation.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
Sincerely, DATE RECEIVED 08/11/1999
l /
FEE REQUIRED $ 180.00
--� - Z�U� FEE RECEIVED $ 180.00
PATRICIA L SHANDORF , POWTS ' P "VIE BALANCE DUE $ 0.00
Integrated Services
(715) 634 -7810, FAX: (715) 634-5150, M -F 7:45 AM - 4:30 PM
PSHANDORF @COMMERCE.STATE.WI.US WSMART code: 7633
MOUND SYSTEM DESIGN
(:sidential Application
INDEX AND TITLE SHEET
Project MIKE RAY
Owner MIKE RAY
Address 1615 57TH ST
SOMERSET WI 5.4025
Legal Description SW- SE- SEC9- T30N -R19W
Township SOMERSET County ST CROIX W T S,
Subdivision Name Lot No. ###1# itionally
Parcel ID Number VE
7
OMMERC
D BUI S
Plan Transaction Number
:ESPUNDENCE
Index and title sheet Page 1 ,
Mound calculations Page 2 I l � J
Mound drawings Page 3 /
Pres, dist. calcs, and laterals Page 4
TDH and pump tank drawing Page 5
PUMP CURVES Page 6
PLOT PLAN Page 7
Designer KIM OC ON ELL License Number 224263
Signature c. Phone No. 715 - 755 -3145
Date 8 -2 -99
Notice: Tampering wish this file by unauthorized persons Is prohibited.
Dulloerate muditicafioii vnll result m disciplinary a(.1 ion under s. 146.1 U, Wis. Stats.
Personal information you provide may be used for secondary purposes (Privacy Law. s.15.04 (1)(m)].
SBD- 10462 -E (R. 05/96) Page 1 of
- MOUND SYSTEM DESIGN
;residential Application
INDEX AND TITLE SHEET
Project MIKE RAY
Owner MIKE RAY
Address 1615 57TH ST
SOMERSET WI 54025
Legal Description SW- SE- SEC9- T30N -R19W
Township SOMERSET County ST CROIX
Subdivision Name Lot No. ####
Parcel ID Number
Plan Transaction Number
Index and title sheet Page 1
Mound calculations Page 2
Mound drawings Page 3
Pres. dist. caics. and laterals Page 4
TDH and pump tank drawing Page 5
PUMP CURVES Page 6
PLOT PLAN Page 7
Designer KIM OCONNELL License Number 224263
Signature Phone No. 715 - 755 -3145
Date 8 -2 -99
Notice: Tampering with this file by unauthorized persons Is prohibited.
Deliberate modification will result in disciplinary action under s. 146.10, Wis. Stats.
Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)].
3BD- 104W -E (R.05M) Page 1 of 7
MOUND SYSTEM DESIGN
Complete red boxes as necessary. 1000 gpd maximum design flow.
I -pou nds Metric
Residential or commercial? R (r or c) (y or n) C � Replacement system?
Creviced bedrock site? n (y or n)
Slope 7 %
Wastewater flow rate 450 gpd 1703 Lpd
Depth to limiting factor 25 in 63.5 cm
In situ soil infiltration rate 0.5 gpd/ft 20.4 Lpd /m
Contour line elevation 97.0 ft 29.57 m
Use standard fill depths? x OR Design depth? L� Jin C�cm
Place X in box to use standard depths (24 and A +4 inclusive) OR specify design fill depth.
Center or end manifold e� or e) Hole diameter 0.25 11 n 0'M 0. 168, 0.188, 0.210, 0.25,
0.28!1, or 0.313 irxh or#y.
Lateral spacing : 3 00 ft use 0lateral spacing for trenches.
_ Estimated hole space 4.00 : ft Na a final calculation.
Number of laterals 2 Pump tank elevation 88.3 : ft Outside bottom of tank.
Fo - emain length 30.0 :ft Forcemain diameter = 2.0 =in 1 "5, 2 ,3 or 4 inch only.
2.067 in Actual I. D.
1M =0.125 1/4=0.250
SYSTEM SOLUTIONS Inch-pounds Metric 5M =0.156 W32 = 0.281
Estimated daily flow 1 450 Igpd 1703 I Lpd 3/16=0.188 5/16=0.313
7x32 = 0.219
Absorption cell
Design load rate & area 1.2 "gpd/fe 375.0 ft 34.84 m
Linear loading rate (LLR) 7.14 gpd/ft 88.5 Lpd/m
Design width (A) 6.00 A 1.83 m
Cell length (B) 63.0 ft 19.20 m
Depth of cell (F) 9.5 Jin 24.1 cm
Sand filter
Upslope fill depth (D) 12.0 in 30.5 cm
Downslope fill depth (E) 17.0 in 43.2 cm
Basal area required (gpd /infiltration rate) 900.0 ft 83.61 m
Supporting components
Topsoil depth 6.0 in 15.2 cm
Subsoil depth at center 12.0 in 30.5 cm
Subsoil depth at cell wall 6.0 in 15.2 cm
End slope toe length (K) 10.50 ft 3.20 m
Up slope toe length (J) 6.90 ft 2.10 m
Down slope toe length (1) 12.20 ft 3.72 m
Total mound length (L) 84.00 ft 25.60 m
Total mound width (W) 25.10 ft 7.65 m
Project: MIKE RAY
Transaction Number: Page 2 of 7
MOUND PLAN VIEW
observation pipes (typical)
J
25.1 Ift A A = 6.00 ft 1.83 m
7.65 m B = 63.0 ft 19.20 m
VV B J = 6.90 ft 2.10 m
I K 1= 12.20 ft 3.72 m
K = 10.50 ft Mg m
Ice L _ 84.00 ft
25.60 m typ, obs. pipe
(anchored securely)
I = down slope dimension = absorption cell (AxB)
J = up slope dimension = plowed area (LxVV)
K = end slope dimension 1W 6' (152 mm)
T
MOUND CROSS SECTION
subsoil cap D = 12.0 in 30.5 cm
lateral topsoil H E = 17.0 in 43.2 cm
invert 98.55 ft _ F = 9.5 in 24.1 cm
elev. 30.02 m - JF G = 12.0 in 30.5 cm
D ASTM C33 E H = 18.0 in Z. 71 cm
Sand Fill
Sys. 98.00 ft y
elev. r 29.871 m 97.00 ft contour
29.57 m elev. 7 %
slope
D = upslope fill depth plowed layer
E = downslope fill depth Note: Absorption cell media will consist
F = absorption cell depth of aggregate and pipe with laterals
G = subsoil + topsoil depth at cell wall centered across AxB media. The cell
H = subsoil + topsoil depth at cell center media is covered with g eotextile fabric.
Designer notes:
i -
Project: MIKE RAY
Transaction Number: Page 3 of 7
PRESSURE DISTRIBUTION CALCULATIONS
Absorption cell Inch-pounds Metric
Width (A) 6 ft 1.83 m
Length (B) 63.0 I ft 1 19.2 1 m
Lateral specifications
Number laterals 2
Holes/lateral 16 holes
Lateral length (P) 60.00 ft 18.29 m
Hole diameter 0.250 in 6.35 mm
Lat. dis. rate 18.64 gpm 1.18 Us
Sys. dis. rate 37.28 gpm 2.35 Us
Hole spacing (X) 48 in 121.9 cm
Lateral diameter Pipe diameter Design optio_ choice
Designer must 1 in (25 mm) _ Place X in red
"X" one choice 1 114 in (32 mm) box of chosen
from the options 1 12 in (40 mm) x X diameter.
provided. 2 in (50 mm) x
3 in (75 mm) X
Manifold diameter Pipe diameter Design options D�enchoice
Designer must 1 in (25 mm)
'X" one choice 1 1/4 in (32 mm) Place X in red
from the options 1 12 in (40 mm) x box of chosen
provided. 2 in (50 mm) x X diameter
3 in (75 mm) x
4 in (100 mm) x
Distribution system contains: 2 Lateral(s)
LATERAL DIAGRAM - END CONNECTION
Place correct lateral diagram by clicking In one of the drawings at right and dragging the diagram Into this area.
L aterals centered over the A tx 13 dimension Last hole drilled next to end cap en Q , oaP
P
All laterals are identical lE X — >I Holes drilled on the bottom of the lateral S
equally spaced
•
Force main connection via tee or cross to manifold at any point. Laterals b force main of PVC Soh 40
e -permanent end marker (per COMM Table 84.30 -5)
Inch-pounds Metric
Lateral length (P) 60.00 ft 18.29 m
- Lateral spacing (S) 3.00 ft 0.91 m
Hole spacing (X) 48 in 121.9 cm
Manifold length 3.00 ft 0.91 m
Hole diameter 0.250 in 6.4 mm
Lateral diameter 1.50 in 40 mm
Forcemain diameter 2.00 in 50 I mm
�?rpject: MIKE RAY
� �nsaction Number: Page 4 of 7
TDH and Pump Tank Drawing
Total Dynamic Head
Operational head 2.50 ft 0.76 m
Vertical lift 9.30 ft 2.83 m Are laterals the highest point in the
Friction loss 0.70 ft 0.21 m system? Yes 'W here.
Total dynamic head 12.50 t 3.8 m If no, what is the highest elevation
Dose Volume downstream of pump?�
Dose is > 10 times lateral volume Forcemain drain
Lateral void volume 12.7 gal 48.1 L back to tank? (x" one)
Minimum dose 127.0 gal 480.7 L x Yes
Drain back 1 5.2 gal 19.7 L No
Dose volume 132.2 gal 500.4 L
Typical Pump Chamber Layout
In combination with state approved treatment tank. Tank construction as per Comm 83.20(3) WAC.
approved manhole cover with
wither proof warning label and locking device
grade levels) junction box `—"� rade levels
disconnect g
aIts
mate
4" vent pipe electric as per NEC 300 and E — outlet
Comm 16.28 WAC location 18" (46 cm) min.
wall of pump �" approved
chamber or outlet joint
combination tank
A Provide 1/4' weep hole or anti -
alarm on 1 siphon device as necessary
pump on B
Grade levels
pump 89.2 ft C - pump tank manhole = 4' (10 cm)
off el ev. 27.2 m minimum above finished grade
D -vent =12' (30.5 cm) minimum
above finished grade
88.3 ft Pump tank elevation
3 " (75 mm) of bedding under tank 26.9 m bottom of tank
Tank manufacturer WEEKS
Pump tank capacity 19.04 gal /in
Pump tank volume 800 gal
Pump manufacturer GOULDS Inches Gallons
Pump model number WE0311 L o A 25.1 477.4
B 2 38.1
Alarm manufacturer S.J.ELECTRO INC C 6.9 132.2
Alarm model number H.W. 101 i5 D 8 152.3
Project: MIKE RAY
Transaction Number: Page 5 of 1
curves P umps
y
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Solids
WE 1 SH
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I
Wisconsin Department of Commerce SOIL AND SITE EVALUATION
Division of Safety and Buildings Page 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. R iewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property ner Property Location
Govt. Lot 1/4 1 /4,S T N,R 1�Y
r _
Property Owner's Wifirrg Address Lot # Bloc Subd. Name or CSM#
AW S
City Stat Zip Code Phone Number Nearest Road
/ ❑ City ❑ Village Z Town
❑ New Construction Use: ® Residential / Number of bedrooms Addition to existing building
Replacement ❑ Public or commercial - Describe:
Code derived daily flo gpd Recommended design loading rate ,. S� bed, gpd/ft gpd/ft
Absorption area required -. bed, ft ft2 Maximum design loading rate , S� bed, gpd /ft trench, gpd/ft
Recommended infiltration surface elevation(s) ,gfi�G ft (as referred to site plan benchmark)
Additional design /site considerations
Parent material Flood plain elevation, if applicable ft
S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank
U = unsuitable for system ❑ S U ®S ❑ U ❑ S [0 U I ❑ S N U ❑ S ® u ❑ S f K u
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft
in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots
M.. Bed Trench
k
/
- / 6 2 4
Ground - !/ ,
elev. S' A61 W1
Depth to
limiting
factor
) Z in.
Remarks:
Boring # </
2.
Ground
elev.
Depth to
limiting
factor
,,5 in. Re arks:
CST Name. (P ase Print) ti Signature / Telephone No.
Address Date CST Number
SOIL DESCRIPTION REPORT
PROPERTY OWNER Page —!;�2 of
PARCEL I.D.#
Boris # Horizon Depth Dominant Color Mottles Structure 2
9 Texture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
Ground 3 s/� 9
elev.
s 3 y _
Depth to
limiting
factor
Remarks:
Boring #
.....mss...,.....'
Ground
elev.
ft. ,
Depth to
limiting
factor
in.
Remarks:
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
Boring # ;
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft. '
Depth to
limiting
factor
in ' Remarks:
SBD -8330 (R.9/98)
NL� /' /�'1� � � ✓ °� B��il'k:�/ /g,S� ' ��0�:. 29 �
o f
Gtc�li0�p14� 1 44 9 X —
3
0 ) WRII
i
Mj
s•r CROIX COU
SEPTIC TANK MAINTENANCE AGRI.I All-,N 1'
AND
OWNERSHIP CERTIFICATION FOIZNl
Owner/Buyer I C �C-�P
Mailing Address 16 7 `7
Property Address C5 6 wl C)
(Verification required from Planning Department for new col 1
City /State 5;2J eyyeA t w l Parcel Identification Number
LEGAL DESCRIPTION
Property Location _ '/< /4 Sec. "I'_ d N -IZ W, To I1 0
Subdivision _ • _, Lot #
Certified Survey Map # s 7�d'� , Volurne � Page d
Warranty Deed # s`�/s� Volume Page. It
Spec house ❑ yes 2 Lot lines identifiable f (1 ycs ❑ nu
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could rc,ult in its prcru.r,L,I, Ia,lulc to handle wa,tcs. I 'rUPCr nlalntCnailCC
consists of pumping out the septic tank every three years or sooner if needed by a h,cnscd pumprr. What you put into the system
can affect the fimetion of the septic tank as a treatment stage in the waste disposal sy,trru.
The property owner agrees to submit to St. Croix Zoning Department a cctufication funn, signed by the owner and by a
rnasterplumber, journeyman plumber, restrictedplumberora Ircen,edpumper vvflfyant dia((I) the ,,te waste water disposalsystcul
is in proper operating condition and (2) after inspection and pumping (lf necessary), the scpuc tank is less than 1/3 full of sludge.
I/we, the undersigned have read the above requirements and agree to maintain the dh,posal system with the standards
set forth, herein, as set by the Department of Commerce and the Dcpaltiucnt of' N atul.d Kc:,om,:cs, Jt:rtc of W rsconsin. Certification
stating that your septic system has been maintained must be compIctcd and returned r,� tl,. ;l ro,.. c'ounty Zonnlg Ofii.,e within 30
day.: of the three y expiration date.
SIGNATURE OF APPL CANT DATE
OWNER CERTIFICATION
I (we) certify that all statements on thl, foiin are Uue to the best of my (,'U kii,,'A I, 1i, c i ("c) arrr (.,:c) ti:,: owner(s) of
the property described,afjpve, by virtue of a warranty deed recorded in Register of I terlf, O Ilk r
4A
SIGNATURE OF APL ANT DA FE'
••• *•• Any information that is ribs represen(ed may result in the sanitary PClutrt l,eui,,' ,c� oked f,) llrc Zoning Department. •• * *••
•• Include.with this application: a stamped warranty deed from the Register of Decd" office
a copy of the certified survey map if refctcuce r.. rn.id,' a 111, �narranly deed
Bai ll %k n >m f-"rlll � 1982
PV R-,O\%I REPRESUNTX I I% F'S DFF D
J E, N
Beverly A. '_,11 APR
16 n i
Frank Hopkins
Michae S. Ray
and DeAnne 1. Ray, husband and wife as survivorship
- property
A III St. Croix
:
l't Th T;oPe1"%'*1 Z L
jlart of SE 1/4 of SE 1/4 and Part of SW 1/ 01 SE
t/4, I i i9
Al in Section 9, Township 30 North, Range
i, St. Croix County, Wisconsin described as "),rt of 032-2035-80 and part of
of - lows: Lot I of Certified Survey Map filed
Oecember ;'8, 1995 in Vol. "'W', Page 3032,
Document No. 537882.
� T d J ��� {
all "! the c ,t, t t c ,n,I jnICTC11 11) ! V�'-PV t h e p Rcpt -c !
lat ,la.. I April
u i !SF - -AI I
Beverly A. Hal
At'l u El, f 1(
Be A. Hall s r %Tf- OF \k IS( t)VIIN
Beverly
10 h Arril 1,) 96 Per,omtlk came bet-7c f1l" 1.1% of
! he ah, cd
• Hendrik W. Van Jyk
I I II j- \IF \Iiij R st \1I it \R 01 'A IM ()NSI\
II nll.
in,mirn,'11 .111d 1 ldo' the 111I1
REINSTRA VAN DYK, S.C.
201 South Knowles Avenue
N Richmond, Wisconsin 54017
Both I I','[
53'78�3�'
CERTIFIED SURVEY MAP
Located in Part of the Southeast Quarter of the Southeast Quarter and part of FILED
the Southwest Quarter of the Southeast Quarter all in Section 9, Township 30 DEC 2 8 199 ►
North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin. Z KATHLEEN H.WALSH
Prepared for and at the request of Owner : Frank Hopkins Estate ReMsterof Deeds y
Michael and Deanne Ray SL CroixCo.,WI
1615 57th Street
Somerset, WI 54025 ` O
UNPLATTED LANDS ti
Drafted by: James M. Brault
NORTH LINE OF THE SW 1/4 OF THE SE 1/4
- -S 88'14'50" E 341.28'- -
/
x7x---
FEN X _
X-_ X
X I \
�
O f/S FENCE 1 3 �, C U o
3 v
N i ,tom 0 X 1 d p 0.0 DOUGLAS J. t ^ "�' \ v ° 'o
Q� ! co ZAH� R Z N o ((n o y U
JI ` 2, 1 in W v
I oU
� p l �, l c 0
I o° '9�, k S 89'52'07 "E \ W o N
I
a��� Y � , ,,7.W8' W
zi LOT 1 Cn W Cn
3 N
::::::.;•:. (n ° E . L
I AREA @'.n.'RN...... o F= � v 4 174, 240 sq. ft. o J .6 i -
W X 4.00 acres I ! 1 3 E ° o. o
3
00 >'
O r'n >. o
IU SEPTIC AREA WELL O 4 W N � p
•- - O) h (n Z v 3
co Z CRIB
r� ;.. N I IX rn
HOUSE N Q W
N I L J � N ;7 J! O o y S F
o X BIN oN a i c> E; o a)
Z I CRIB / �i O Z °? > a
� .0 . y t
! X SN�D :: W o
I
\�
'21.16' o 0, o `a
N 8814'50" W 3 o rnv
to 3: CC
FENCE W W y L
\ - -- 191.85' - -- - i oN M a
` - L 341 28' / o 4) co o
N 88'14'50" W - -- T a w
o
-
ALL QUARTER QUARTER LINES 1 33' 33' I I I iii
WERE ESTABLISHED PER STATE '' ~pI UNPLATTED LANDS / I o 3 u c
STATUTE 59.62. / I Z ON
V)
�I Ln /
I o ^ /
66= R.O.W. I
— �I W - -- 1315.91' - -- � �_ 1315.91' - -
_- S 88'43'35" E 1 6� ►-i_ AYE. 2631.81' - - --
SOUTH 1/4 CORNER SEC. 9 SOUTHEAST CORNER SEC. 9
SOUTH LINE OF THE SE 1/4 SEC. 9
GRAPHIC SCALE LEGEND
o 25 eo 100 150 200 County Section Corner Monument
of Record. Found Aluminum Monument
( IN FEET) • Set 1" x 24" Iron Pipe weighing
1 inch = 100 ft. a minimum of 1.13 pounds per
A & E LAND SURVEYING NO ZTH linear foot.
PHONE # 246 -4319 — x— Denotes Fence
P.O. BOX 325
NEW RICHMOND, WI 54017 BEARINGS ARE REFERENCED TO THE SOUTH LINE OF THE
JOB NO. 14895 SE 1/4 OF SECTION 9 TOWNSHIP 30 N., RANGE 19 W.
WHICH IS ASSUMED TO BEAR S 88'43'35 "E
Sheet 1 of 2
VOLUME 11 PAGE 3032