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HomeMy WebLinkAbout032-1036-90-100 0 ` ° 2 ��•{J � � Ln $ % q 6 s ■ 2 5 � � 0 ( 2 2 \ 0 ° § 7 $ § / \ >\ 22% \§ § , _ = E / o I / \ \ \ \ � / k § » g § g § 0 $ g C § a 2 @ ¥ ƒ 2 E 2 - ° / � ` 0 & / _ o o g Q o _ : § 2 � ® w e � @ @ C , $ c o § o CO) � co w / fT � cr Z 2 2\ o o o� �- . § ] 0 f c (n U) � %' > \ \ \ 2 \ k / \ j 2 R 2 2 9 E : ¥ & CD : @ 0 0 \ R / m • CD k N C a § § \ } ! 2 _ o m c ■ _ . / E z ) ■ T 2 E § z c FF 2 7 2 £_ k % : k ]/k \CD /cn % $(/ 2 � =o ° CD I CL a. _@ m � \7 � � w 2/ rl 0) k c / fE � � 2 I � � o 00 CD § \ : � Parcel #: 032 - 1036 -90 -100 01/24/2006 08:18 AM PAGE 1 OF 1 Alt. Parcel #: 13.31.19.182C 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): O = Current Owner, C = Current Co -Owner O - BENSON, RICHARD W RICHARD W BENSON C - SATTLER PATTI L SATTLER PATTI L 2175 HWY 35 SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): ; = Primary Type Dist # Description " 2175 HWY 35 SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 14.220 Plat: 3585 -CSM 13/3585 SEC 13 T31 R1 9W SW NW BEING LOT 2 CSM Block/Condo Bldg: LOT 2 13/3585 EZ -UT- 1411/587 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 13 -31 N-1 9W Notes: Parcel History: Date Doc # Vol /Page Type 04/25/2002 677221 1878/266 WD 08/22/2001 654442 1703/544 TI 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 76877 267,900 Valuations: Last Changed: 07/1212004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 48,000 145,100 193,100 NO UNDEVELOPED G5 11.220 22,500 0 22,500 NO Totals for 2005: General Property 14.220 70,500 145,100 215,600 Woodland 0.000 0 0 Totals for 2004: General Property 14.220 70,500 145,100 215,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 505 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner Property Address Q ?,Is' s' 3 ST CROIX City/State -` com e �s c 1` !.�` '- ,- C MNTY (W Legal Description: Lot Block Subdivision/CSM # fa4e 3s'B'sJ `� "`✓ 54 V ' /a ' /4, Sec. 13 , T- N -R /�& Town of S' ,*i -t rs- PIN # 3Z SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION Tank manufacturer ALOA Siz r�S�/PO / Setback from: House Y2 - Well P/L � � P I Pum manufacturer Mo7el 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: Width Lepgtlr� Number of Trenches Setback from: House Well P/L Vent to fresh air intake ELEVATIONS Description of benchmark /wC © 4 Elevation 1 0 4 Description of alternate benchmark • / 9Mo Elevation Lo2o-�9 Building Sewer �$� 3S� �/HT Inlet 9 j Z ST Outlet � 7 ��� PC Inlet —� PC Bottom Header/Manifold 7.0 Top of ST/PC Manhole Cover Distribution Lines () C16 Bottom of System ( ) �!L ' ( ) ( ) Final Grade ( ) g ( ) ( ) Date of installation -: 43 M Permit number 3Z Y7 3 State plan number Plumber's signature 0 -0 . License number , 7l Date /3/ S 9 Inspector 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. PLAN VIEW f� INDICATE NORTH ARROW Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count8T . CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) SanitarlNr7iSV.: Personal information you provice may be used for secondary purposes [Privacy L s.15.04 (1) (m)). Permit Holder's Name: 1 96ft RSYj�e ❑ Town of: State Plan ID No.: BENSON, RICHARD CST BM Elev.: s Insp. BM Elev.: BM Description: Parcel � r2o.:1036— — 00 lD i L ' U L I o� 1 TANK INFORMATION ELEVATION DATA A9900004 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Sept' - B rk q. Dosing ' f Aeration Bldg. Sewer S qf.3 Holding S Inlet (o -d 7e, %y TANK SETBACK INFORMATION S Outlet G - ¢S TANK TO P/ L WELL BLDG. -jov 'nt t0 Airintake ROAD Dt Inlet Septic -4 IN �� r NA Dt Bottom Dosing Header / Man. 7 -ZZ q . O RI Aera ion NA Dist. Pipe 32 0 Holding Bot. System $47 (o .( 3 PUMP/ SIPHON INFORMATION Final Grade V `I° 5.9 D zoo - Manufacturer emand Model er GPM TDH L Friction stem TDH Ft Forcemainj Length Did. Dist. To Well SOIL ABSORPTION SYSTEM ,AM TggaM_ E I N Width / Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid D DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHIN a acturer: SETBACK INFORMATION Type O CHAMB er: Syste l�tk -I'(� jQ �j ---- -- OR UNIT DISTRIBUTION SYSTEM Header / Marr old „ Distribution Pipe(s) f ,. x Hole Size J x Hole Spacing Vent To Air Intake Length IaL Dia. Length _?_�o Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over p ver odded xx Mulched Bed /Trench Center B �EEI]Yes ❑ No ed /Trench Edges []Yes ❑ No COMMENTS: (Inclu a co a iscrepancie s present, etc.) CATION: SOMERSET 13.31.1 .182A ,NW 2175 HIGHWAY 35 �LOT 32&1 k / Tr►S� I�►'I -tc e. — I`Ga/ i S win • t qj a 9 r 92- 6f 4-f W ►� (,val �. ovt tdt llril ' �( c,0 ��', r. r.� %F' ;^ � 9-,W Plan revision required? 7Yes 14�7 Use other side for additional information. all S SBD -6710 (R.3/97) Date Inspectors Signature 1C ^A Safety nd Buildings Division t^��ia.rin SANITARY PERMIT APPLICATION Bure of Building Water System: 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less Courtty than 8 112 x 11 inches in size. CAooe • See reverse side for instructions for completing this application state sanitary Permi Number The information you provide may be used by other government agency programs heck i revision to pr vi s cation (Privacy Law, s. 15.04 (1) (m)l. tate Plan I.D. Number I. APPLICATION INFORMATION- PLEASE PRINT ALL INFORMATION Property O ner am Propert Location $tt/ 1 /4 J�� t /4,S 1,3 T 2 1 , N, R 11 E (or)o Property Owner's Mailin Address Lot Number Block Number Cit , Sta rip Code Phone Number Subdivision Name or CSM Number 11. TYPE OF B ILDING: (check one) ❑ State Owned Cit Nearest Road Village Public 1 or2Family Dwelling - No. of bedrooms i Town oFso �w aj III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo /� d 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel / Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1.o New 2. ❑ Replacement 3. E] Replacement of 4 E] Reconnection of 5. ❑ Repair of an ____,_System ________System ______________Tank Only______________ Existing System ____ ____ ---- Existi System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11M Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure J$ 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill 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.) Pr osed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) a Elgevation ysa Y /G. 13 Feet f Feet Cap acit y VII. TANK in Ca allo Total # of r Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existin strutted Tanks Tanks ptic Tan r Holding Tank ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ 1 ❑ I ❑ I ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the att ached plans. Plumber's Name: (Print) P is Signature: ( amps) MP/ o.: Business Phone Number: 'h I) r ,' e (l y his -.2b C'6 3 7 Plu , er's Address (Street, ity.State, Zip Codell IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issui g A i ature (No Stamps) Appro Surcharge Fee) ^ /� pp []Owner Given I nitial ` Adverse Determination ja hto X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (R. 05194) 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 -3815. 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 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. SANITARY PERMIT APPLICATION S afety and ui � Bureau of B ui l di n g Water S stem 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 811 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary PPer Number The information you provide may be used by other government agency programs ❑ Check it revision to pre �lous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Propy4y O ner Name Propery Location 1/4 JXW 1/4, S 13 T .3 1 , N, R t E (or)6 Property 0 er's Maili Address Lot Nurnber Block Number b r Citv S Zip Code P one Number Subdivision Name or CSM Number � f g�° (4/Z )) _ 3S8'� I1. YP E OF BUILDING' (check one) ❑ State Owned Its earest Road Village _-- Public 1 or 2 Family Dwelling - No. of bedrooms Town OF -erg III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo JZ' r Ad 3 C 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 gNew 2. ❑ 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 P.Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure l o 42 [] Pit Privy 13 ❑ Seepage Pit o 43 E] Vault Privy 14 ❑ System -In -Fill 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. /inch) Elevation /�0 (.9 (� 97• -� Feet �Vjr 6 Feet capacit VII. TANK in gall Total # of r Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Existin structed Tanks Tanks eptic Tan or Holding Tank / coo ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber V1 ❑ 1 ❑ 1 ❑ 1 ❑ 1 ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plum is Signature: (N mps) M MPRSW o.: Business Phone Number: 7i -.ZL� C 37 Plumber's Address (Stmt, City, State, Zip ode): IX. COUNTY / DEPARTMENT USE ONLY [] Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuin ge t Sign ture (No Stamps) `Approved ❑Owner Given Initial Surcharge Fee) i^ � Adverse Determination I , X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS I. 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 administrator or the State of Wisconsin, Safety and Buildings Division, 608 - 266 -3815. 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. i 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. ! Vt. 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 acid 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. Vlll. 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. � • .A d �� Vii_ I�'p :�� .,.• pio � /Z T ,3 /5 _PvZ 1 boo mo LOD �lZ.o7 ro aSej7 T_. b � /6 - LT . y 3 V - 06 , Prate S�v Nk/ S i3 7 I w 2Zi le T '2- SOmko sq- 1Tkt 1 fGe jy� z2 r� �we�l Ptc r.-Sep 4 e. Wes- /v- _ �( L 1 f ti f Y 7-6 . � �l ctrae/14 "UV 113:4:1 P'AA 715 :I$6 4666 ST C:RX CO ZONIING ®p0. P rtMM Alt lefel/ And 06eerealle" Pipe ( 44**Vnd VeAI Ce; MYdwre, 49 •Nee . -sgafg =U - 42 AINe Pte .... 41' Ceut Itee To Fled Ot0 /• Vent e9Pe wt e� 1N/ OI s , Cp ioq 000 004 pepele OlN P eell��� �— fee • d�Ad�t ep•}• 11104 httrN a4 e• Pipe •e• Oe1r•Il v OwpM�p MolnetMp � bueln O1 t /e }erw . E. c v . � ► - n —ter,,,,, �^,..•'"^ OISTR,'8Ur,01.1 PI /%. !►�1NtOVEp sYII�'j� +Et GC►YC�I ✓'ter OR a" OF STIMW Olt JJARSM 14A`! p � CA a trOP %t�n AG4rlCGATC '�.. DbST'RIrIUl',OAI PI11 To SC AT LEAS', ING++CO OCLOW ORI( GplADC A411s AT L'GASTLO 111 8tlT LIp M*Kt TMAN 42 Iu(.1fES BELOW F,gIAL bRApC MAxIMW CAPrH ar cX , tAVN'r+oN F1ooM ORI&WAL 6KAor, WILL ac �,c1+e rV140MYPS WrVi of LVxCAV,ATION MOM CA 141 MAL, 6,R40t WILL Sr. 1 :WCHES L c C u S C AI U M O E R : irsr� –LS L 04 C : I Wiscoribin Department of Commerce SOIL AND SITE EVALUATION 9ivisiai of Safety and Buildings Page l of Bureau of Integrated Services in accor , ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/ ches in W e. Plan must County include, but not limited to: vertical and horizontal r ereXe point( a lion and S , percent slope, scale or dimensions, north arrow, a *, nearest road. T C ° t ation arr r2 Parcel I. D. # CD APPLICANT INFORMATION - Please all it for fiatio;.9,9'8 Reviewed by Date Personal information you provide may be used for second ryurposes (Pr ftPK,'t. 15.04 (1) (m))' Property waer O FFICE . Property Location o C - 'IC<d �{�SC�/Z Govt. S �" 1/4 iY�/1 /4,S T 3 j ,N,R / E (or)�b Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# City tate Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road ST I - htn I .s°s -128 1 c biz 9-- cas-�y �t : — 3 New Construction Use: & Residential / Number of bedrooms Addition to existing building ❑ Replacement �� ❑ Public or commercial - Describe: p Code derived daily flow ft gpd Recommended design loading rate r 7 bed, gpd /fi � p 0 - trench, gpd /ft Absorption area required (Cq3 bed, ft S o _ trench r ft 2 Maximum design loading rate 1 7 bed, gpd /fi 0 trench, gpd /ft Recommended infiltration surface elevation(s) / 7- ft (as referred to site plan benchmark) Additional design /site considerations Parent material 0 ' - W 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 El U ❑ S '7u El S E'U ❑ S ® U ❑ S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench Z -3 " s y/L Ground el v. /e ft. Depth to limiting or L Tin. LM Remarks: Boring # / 010 S /WS& SL Ground elev / / Depth to limiting factor 7 !�Lin. Remarks: CST Name (Please Print) Signature Telephone No. ve Address ?C, Date CST Number 2 ? Z y0 s7 hi-e. _S $ -.2v -W' 2z/q7 SOIL DESCRIPTION REPORT PROPERTY OWNER _& "I Page Z- of "S PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0,0 Ground 33 -1bp . jV S A L / > 0 elev Depth to limiting ' factor �� in. Remarks: 2 Boring # .......................... z y - 3q ........................... .......................... 3 y -9 ( ?,MS-/ 6 5 Ground elev. C " , 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 # l 0 .5 YR3�� SL• GSI�(' ~ :,�Y -). S yk 3/y 3 9 , r R . 5 A Ground elev Depth to limiting �•� }motor 73 in. Remarks: Boring # .......................... Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) / 7 fur �(t� Si� Tai /S /07"Z. �R /02, L T Z1 -4 J 7 70 I h=i aT � 1 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address a Property Address —;Z (Verification required from Planning Department for new construction) City/State S/A Q rSJk Parcel Identification Number IeS C I LEGAL DESCRIPTION Property Location SW ' /s, l�� V,, Sec. /3 • T / N -R1_W, Town of -Sow-e S� Subdivision Lot # 2- - Certified Survey Map # ���q , Volume Ud Page # s�� . T- Warranty Deed # y� 2 3 g , Volume Ft/ , Page # 2 '� S Spec house ❑ yes,)�fno Lot lines identifiable �q 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 disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, 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 the three year expiration date. /J / e SI NAT OF APPLIC DATE OWNER CERTIFICATION I -( 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, b virtue of a warranty deed recorded in Register of Deeds Office. SIGNATU 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 - atiaM...._.__ __. ----- -r -• -- -- RIt�'d�fo ��Record _p and wife conveys and warrants to _ __RL 8 r W e n s o (� q_ j � M_ al! 11 :00 AM - -- - Be n sga.. __b_LL ..._... Y ,.V_0.Y'. hj —Ma ri t a j,_. p rn pe r at....__ Ropistet' of Deere A &TU A N TO Century 21 the M Cou nt owing described real estate in _... ._ SS, r q i _ Somerset, W i . • y, State of Wisconsin; —�-- --- --�- -- ---- Tax Parcel ,--- __ -_ -- The North 1,035 feet of the West 842 feet of the Southwest Quarter of the Northwest Quarter of Section 13, Township 31 North, Range 19 west. f� This _? 5_ n _ homestead prop", (is) (is not) Exception to warranties: recroder easements and rights of way. Da ted this. .. 14 th _dayof.- _•---- w._.._._ —_ .._ _ _ . _.__.19 .__. - -- . _ �r -- -- - — (SEAL) - - -- _. ___. _. (SEAL) '�.._ - - -- A Y _. �.�...1 Julianne M. Jol l�! J;EALt AUTHENTICATION ACKNOWLEDGEMENT Signaturo(sj _.__..�__ .....•_,___ ___...__. . _ STATE OF WISCONSIN ss, County. Personally came before me this . Y _ 41.11 day of authenticated ihls _ _._ day of . ,, --_.__ 1 9 _ - S e D t Q m b e r _____._ 1 g g_Q _. h above n err M Ea ry J J o l = 1_y__ a n d--- • .- - - - - -_ _. uI TtlLt_. MEfytBER STATiw BAi2 OF WISCONSIN -' .�, ►°, »" ` _.. __ -- - - -_. ____.., _.. -• - -- (If d Q known M be rsor. who execiotcd the authorized by $ 706.06, Wis. Stats.) k. A fn instr ent t 1 a g 4 ac w cd a e s THIS INSTRUMENT WAS DRAFTS 9 John D . t4 a 7 s h Public �unty WIS. (Signatures may be authenticated or acknow!e d. r omrni9aivn is pe �li ! ?l anent (If not, state g w" are not necassary.) , AS Ott of r.evzns signing in any capt;ily fholAd bD "Id Of ()!i ntact below then AP WN � �0 �U CERTIFIED SURVEY MAP LOCATED IN PART OF THE SW 1/4 OF THE NW 1/4 OF SECTION 13, T31 N, R 19 W, TOWN OF SOMERSET, ST. CROIX COUNTY, WISCONSIN. SCALE IN FEET V = 200' NW COR. SEC. 13 200 0 200 400 W UNPLATTED LANDS o o PROPOSED 66' WIDE z a c) JOINT DRIVE q, cu NORTH LINE OF THE w i o co EXISTING SW1 /4 OF THE NW1 /4 + N w w z MELD DRIVE ON S89 °06'45 "E 842.07' ° Wo 0 q ; I 70. 01 w °o w W z z Dc E� I w ( + w 3 ELI I u o� : w j w = a SAIL :TESTS 70' 70 .......::::::::::: w ........... C3 ........... ........... N (U .: Z f - - - - -- U7 N — lli In ZWVI W; I I� �... ate¢ O. 03 c ♦ Li ^ O I q • SOIL TESTS p N °Q 3 Q; uj M d co o In GL' C`') 00 5 <Z) LOT 2 0 o w w I � O W ° S89 °06'45 "E 515.01' w W 70.01 CD 445.00' ON 4: O N -4--- x� SEPTIC VENT p ° 3 �' O tn NO N I O .— x __ X x X O J W W. O 4J N 4J 1~ Z HOUSE 1'+/- ,- �; �, co (EXISTING DRIVE 00 tom. �� cd •r 47 I - w o N! 3 m > ELI I �; u� (Ln ® 3 Q,1 O U) fo =• OD o! LOT > a O 3 Ln j co co o -4 S4 1 c'1 GARAGE CD .. b �4 4-) x LD W I~ O 4 F- I Ei —1 44 0 Ei ¢ ± 000.1 ra 772.06' 2 h A �4 u1 a , z 1 7 0.01 445.00' 327,06' I� 140' N89 °06'45 "W 842.07' co °N W W + SOUTH LINE OF THE NORTH 1035' o lO oll � ^ OF THE SW1 /4 OF THE NW1 /4 OWNER H o p I DICK BENSON PROOSED C. S. M. o W o - ----------------- - ----------- �, 165 GR STONE AVE. N, IN c:) I LEGEND ST, PAUL, MN 55128 Z 3� ALUMINUM COUNTY SECTION CORNER J MONUMENT FOUND W W1/4 CDR. • 1' IRON PIPE FOUND w EC. LOT AREAS 13 O 1' X 24' IRON PIPE SET WEIGHING >- 1.68 LBS. PER LINEAR FOOT LOT 1 w — x x — EXISTING FENCELINE 5,788 ACRES 252,108 SO. FT. 100' ROADWAY SETBACK LINE 5.001 ACRES EXC. RW ry MASONRY NAIL FOUND 217,837 SO. FT. w 0 WELL LOT 2 14.220 ACRES a ® SEPTIC 619,433 SO. FT. z 2 ACRES +/- OF NET BUILDABLE AREA 13.343 ACRES EXC. RW .� V) PER TOWN OF SOMERSET ORDINANCE 581,244 SQ. FT. ....... ... ..... 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