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HomeMy WebLinkAbout032-2117-30-000 � 1 ST. CROIX COUNTY ZONING DEPARTMENT ` + AS BUILT SANITARY REPORT X! Owner Property Address F ` "`7 City /State r Legal Description: > N.v Lot Block Subdivision/CSM # t /4 &--- t /4, Sec. , Z, TAN -RAW, Town of PIN# SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFOR�A: Tank manufacturer 1t, Size ST/PC Setback from: House --711 Well PAL x- manufacturer 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: ,�'�o Width_ Length >�i- Number of Trenches Setback from: House Well P/L Z' Vent to fresh air intake r. ELEVATIONS Description ion of benchmark 74o � - Elevation ,ice 6 Description of alternate benchmark Elevation 1or�• r ST/HT Inlet ST Outlet Building Sewer ,/ o �, s� PC Inlet 1� �.-��' PC Bottom Header/Manifold 2 7G Top of ST/PC Manhole Cover Distribution Lines h Bottom of System () g -;l Z e () ( ) Final Grade Z () ( ) Date of installation /I / � Pe it num per State plan number Plumber's sign ure / License number 1 3 Date Inspector Complete plot plan • R s t 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. I PLAN VIEW r ^ _ a is INDICATE NORTH ARROW Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count yl 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)). 344514 Permit Holder's Name: ❑ City ❑ Village ❑ of: State Plan ID No.: M & G Inc. Town of Somerset —~ CST BM Elev.: Insp. BM Ele v.: BM De.scription: Parcel Tax No.: l M ,a S 032-2117-30-000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic S 2 Benchmark "� (�� Ov. Dosing Alt. BM 2- v Aeration Bldg. Sewer o ? , ?, O Holding St /Ht Inlet � OF 0 7 - 8 TANK SETBACK INFORMATION St/ Ht Outlet 4 1 38 Mss . TANK TO P/ L WELL BLDG. A I to ntake ROAD Septic > /its' > a () r NA D Dosing �V A Header /Man. 17'90 q Aeration NA Dist. Pipe ' O2 q5't 6 7 Holding Bot. System q6� PUMP / SIPHON INFORMATION Final Grade lZ•30 Manufacturer emand St cover Model Number GPM TDH Lift Fr` n tem TDH Ft ForcemaiATLer gth Dia. Dist. To SOIL ABSORPTION SYSTEM BED Width / Lengt No. Of T enches PIT No. Of is Insi a. Liclut epth IMEN I N 2 DIMENSION SYSTEM TO P / L BLDG I WELL LAKE / STREAM LEACHI Manufacturer: SETBACK CH BER INFORMATION Type O r ► odel Number: System: �-( l 1 IUD — UNIT DISTRIBUTION SYSTEM Header / Manifold V Distribution Pipe(s)� r � x Hole Size x Hole Spacing Vent To Air Int a e LengtKpe,__ Dia. Length - 4 - Z Dia. Spacing -6-L I I --L /O'D, D SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over TBed th Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed / Trench Center /Trench Edges Topsoil ❑ Yes ❑ No []Yes ❑ No COMMENTS: (Include code discrepancies, p ersons resent, etc.) /l Q z p p P Inspection #1: /s/ g Inspection #2: — --f-- 2,* Locatio : 2168 59th eet, $orpex t, WI (NW1 /4, NEIA, Section 15 T31N -R19W) - 15,31.19.1073 3 0 23 p r . >f Y Plan revision required? ❑ Yes No Use other side for additional information. 03 oZ 0 ( �, SBD -6710 (R.3/97) Date Inspector's Signature Cert. No Safety and Buildings Division SANITARY PERMIT APPLICATION 201 W. Washington Avenue Visconsin In 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 8 112 x 11 inches in size. - S Z • See reverse side for instructions for completing this application State Sanitary Permit Number Personal information you provide may be used for secondary purposes ❑ Check it revisio spllication [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATION Property Owner Namq Property Location 1 , 1 /4, S T /, N, R y (or� Property Owners Mailing y ress of Number Block Number City, s to S Zip Code Phone Number Subdivision Name or CSM Nu er b o ytl b �• I II. T PE F B IL ING: (check one) ❑ State Owned ❑ ❑ Vil a Its ge Nearest Road El Public 1 or 2 Family Dwelling - No. of bedrooms Town OF s 111 BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) . 12 7 1 -11. 11 U'1 'j 1 ❑ Apartment / Condo ©`�`� J ' 7 — 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. ,IFS New 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 ® Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 1P 42 ❑ Pit Privy 13 ❑ Seepage Pit > 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 2 4 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc Rate 6. System Elev. 7. Final Grade q q p (q ) Y q Required (s . ft.) Proposed s . ft. (Gals/day /s . ft.) (Min. nch) Elevation fiY' S 7 Feet Feet Capacity VII. TANK in allo s Total # of Prefab. Site Fiber- INFORMATION g Manufacturers Name Con- Steel Plastic Exper. New Existin Gallons Tanks concrete structed glass App. Tanks Tanks Septic Tank or Holding Tank -- ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ 1 ❑ 1 ❑ 1 ❑ ❑ VIIL RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for in5hIlatiogof the onsite sewage system shown on the attached plans. Plumber' ame (Pr ) n Plumbe sS na r No s) MP /MPRSWNo.: Business Phone Number: f Plumber's A ddres — sitstriiet, Ci ,State, Z' Code): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate ssue Issuing Age ignat re (No Stamps) Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11I97) 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. 111. 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 8112 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. t Ad -s. / /38 �f /.ors 3s ' X � i � A � 0 a Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Bureadof Integrated Services in accordance with Comm 83.09, Wis. 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 l percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # APPLICANT INFORMATION - Please print all information. R viewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). b a q r Property Owner Property Location 7 Govt. Lot ) 114 - 1 14,S T N,R(o+V Property Owner's Mailing Address Lot # Bock Subd. Name or CSM# City Stat Zip Code Phone Number Village Town Nearest Road 2!�' )_Z75 ❑ City ❑ [Z New Construction Use: Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow L�X — gpd Recommended design loading rate _ bed, gpd/ft gpd /ft i Absorption area required _ bed, ft 2 CL_ trench, ft M!!�cimum design loading rate bed, gpd/ft trench, gpd /ft Recommended infiltration surface elevation(s) �7 r ft as referred to site plan benchmark) Additional design /site considerations � Parent material R 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 ❑ U ® S ❑ 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 . � D x Q - -tea ` 1 Ground elev. S ' i Depth to limiting factor } in. ot to Remarks: Boring # s J„ L' y (S C Ground s _ - e ev. A ae- ft. Depth to limiting Li factor >,&0 in. Remarks: CST Name (P ase Pr t) Signature , Telephone No. Addre Date CST Number PROPERTY OWNER /2/� 7"N1,' SOIL DESCRIPTION REPORT Page � of .� PARCEL I.D. # // 7 -�O Boring Horizon Depth Dominant Color Mottles Structure 2 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 3 is Ground r / elev. 5 , Depth to limiting factor Remarks: Boring # i Ground _ elev. Depth to limiting factor Z?Lin. 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 # s d ' Ground s . elev. s z Depth to limiting factor ,.��in. Remarks: Boring # M a Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) .b��:Ja/ �3�s; o � �F T r ' /os� b��e sl ✓/('.Y - .�:.0 /7,o?.S f logeel , le -�a�s i i 7 WlisconstnDepartment of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page 1— of '— Pvreau of"Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code ty Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. R %n -must_ - ur include, but not limited to: vertical and horizontal reference point (BM), d' otiolraand e0 X St. Croix percent slope, scale or dimensions, north arrow, and location and dista 9 . t�fieareot P cel. A,D. # . APPLICANT INFORMATION - Please print all inform h. n �-, t�€�t eviewe by Date Personal information you provide may be used for secondary purposes (Privacy , 9. 15.04 Property Owner Prope�tpU: bftion Richard Stout �'� Goo t��'LPV c c . 1/4 �1`E 1/4,S 1 5 T 31 N,R 1 E (or) Property Owner's Mailing Address tot # - Block# Sybd. Name or CSM# 1353 Awatukee Trail '�6�..,; Shadow Pines City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road Hudson Wi P4016 (715 -P49 -6731 Somerset 160th Street [&New Construction Use: ® Residential / Number of bedrooms 4 Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 600 gpd Recommended design loading rate ' 7 bed, gpd /ft • 8 trench, gpd/ft Absorption area required 858 bed ft 7 5 0 trench, ft 2 Maximum design loading rate • 7 bed, gpd /ft • 8 trench, gpd/ft Recommended infiltration surface elevation(s) See plot plan ft (as referred to site plan benchmark) Additional design /site considerations Parent material EE)C 2 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 E] U ERs El b[ S El [Y S ❑ U ❑ S ®U [Is ki U SOIL DESCRIPTION REPORT Boris # Horizon Depth Dominant Color Mottles Structure GPD /ft Boring Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh Bed ,Trench . Lj ,� mfr c s 1 f . 5 .. 6 1 0 -6 10yr2/1 -- sil 2lf1, -t�K 2 6-25 10yr3/4 -- is I r046r, mfr cs -- .7 .8 Ground 3 25-E 1 10yr4/6 -- ms osg ml cs -- .7 .8 elev. 9 6 -3-0-ft- Depth to limiting factor 81 in. Remarks: Boring # 1 0 -5 1 0 r2 1 -- si1 2 rn mfr cs 1 f .5 .6 2 2 5-83 10 r4/6 -- ms osg ml cs -- .7..8 Ground 9 2 1 0 ft. ; Depth to limiting factor _m in. Remarks: CST Name (Please Print) Signature Telephone No. Address �/ Date �+ �/ CST Number Richard Stout SOIL DESCRIPTION REPORT PROPERTY OWNER _ Page 2 of 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 3 1 0 -4 1 0yr2 /1 sil 2VnAbr, mfr cs 1 f .5 .6 2 4 -29 1 0yr3 /4 ls 1 mA -Ar mfr cs -- .7 8 Ground 3 9 -91 10yr4/6 -- s osg ml cs -- .7 ;.8 elev. 9 4 -e ft. Depth to limiting factor _in. Remarks: Boring # 1 -2 1 0yr2 /1 sil 2 mA-e, r mfr cs if .5 .6 4 g0.0 2 -88 10yr4/6 ins osg ml cs -- .7 ;8 Ground elev. 9 3 -0— ft- Depth to limiting factor _gym. 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 # 1 -2 10 r2/1 sil 2 mQpK mfr cs 1 f .5 '. 6 5 ° 2 -30 10yr4/3 ls 1 „,gee, mfr cs -- .7 .8 3 0 -9 10yr4/6 -- s osg ml cs -- .7 '.8 Ground elev. 95. ft, i Depth to limiting factor gLL in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) 4.0 7j? N r- 8� A4 T A 3, jyL,LY T 8� Q t ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer m6,5" ___ Mailing Address I Property Address (9.9 Cry �sTkF- (Verification required from Planning Department for new construction) __ ��— City /State _�C'9TC� -e �S e i { ._ Parcel Identification Number MQ - 091 / 7 - 3 C� syoas LEGAL DESCRIPTION Property Location V, Sec. � , T �_L — W, Town of So��>2seT Subdivision N ADD N1 - - -- Certified Survey Map # _ , Volume , Page # Warranty Deed # _ �1 — ,Volume 3 , i agc # C7 Spec house 5� yes ❑ no Lot lines identifiable K 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 syster can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. 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. , / 3 / - SIG ATURE . F APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on ibis form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) o the property described above, by virtue of a \N arranty deed recorded in Register of Deeds Office. &X'�4 L — / t o - 3 /9 9 SIGNA OF ' PPLICANT 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 06'02/99 WED 14:54 FAX 715 388 4687 REGISTER OF DEEDS STATE BAR OF WISCONSIN FORM I - 1982 is vo • a:2_ 1 C KATHLEEN H. WASH DEED REGISTER OF DEEDS ST. CROIX CO., WI DOCUMENT No. YN4431FACE . .. ....... RECEIVED FOR RECORD This Deed, made between RICHARD 0. STOUT and 06-Q-1999 3:15 N JANET P. STOUT, husband and wife,_, VXMTY DEED y I CERI Wr COPY FEE: COPY FEE: and M & TRANSFER FEE: 133-80 RECORDING FEE: 10.00 PAGES: I -f oun iftv-five Dollars jl;L40usand hundred f S t THIS SpAce rieSERVIED FOR RECORD! DATA conveys to G ran t ee the following & tae scribed real cs in Croix ... . .... ..... ....... . . .... ......... . NAME ANO RETURN ADDRESS County, State of Wisconsin: 10k -<�4ouJ li L 16, plat of Shadow Pines, Town of Somerset;', 1< e -,-- T St. Croix County, Wisconsin. PARCEL 7DE NUMBER it G-3-2-4042 M 4 8­ This i n homentead property. t15; (u noti TO&CILher with all and singular the hereditamcnts and appurtenances thereunto belonging; And Richard 0. Stout and Janet F. Stout warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions, rights-of-way and c ovenants of record, if any, and w ill warrant and defend the same. li Dated this, 2nd day o f june 99 Richard 0. Stout (SEAL) Pt P. Stout (SEAL) (5EAL) AUTHENTICATION ACKNOWLEDGMENT State of Wisconsin, St. Croix personally came before. me this 2n day of authenticated this.,— day of--, 19_.._ June 19 99 the above named Richard 0. S to u t d - Ti - Eet P. Stout TITLE: MEMBER STATE BAR Of WISCONSIN (If not — authorized by 9706.06, Wis. Stat-0 LOnIC - ;1 — be lil — PCT$OA whki executed the foregoing irlarument and acknowlcdfv the same. THIS INSTRUMENT WAS L)RAFTED BY Janet Pi Stout Tr Hudson, Wi. 5 4016 Cary Public, County, Wis. (Signatures may be authenticated or acknowledged. Both are MA My commission is P ermanent. t, state cxpiratio I ncCe%-sary.) ... .... .. ....... .. . ... .... . .... ..... ... . • Nsrne* ofum'soks signing in any e3P30ty shnvld by typed or printed haluA t1wir signiltkirkn. Wisconsin Legol 91;aAk Co., Y1C. - sTME BAR OF WISCUNSIN m1waukes, Wis. form No, I ., 1982 WARRANTY DILED t � -t' �l ,.r � I. l03'!'•P )GWr 0v 1111Y 4w•Y11uttX Jf 11 t - `.s p.� v.. l i i E�`��P @ 7 `i, r ! t � � Y- �.)sl�Lr��,7. X i � � •4 ? i � . .' \ 1 ,: .� o 6G ! �-� - �" � ` _ -• i t ( 'YE < �—'i D 3 �' 1 � �' ` � . - 'y•�`' \ .) .�a :�\ >f�. \ 1_.�"^ \ rnNaerr .m . •. 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CROIX COUNTY GOVERNMENT CENTER " " ■" 1101 Carmichael Road Hudson, WI 54016 -7710 _ (715) 386 -4680 November 30, 1999 REMAX Team 1 Realty Attn: Mike Germain 103 Main Street Somerset, WI 54025 RE: Septic Inspection for M & G Inc., located at 2168 59 Street, Lot 16 of Shadow Pines, Town of Somerset, St. Croix County, Wisconsin Dear Mr. Germain: A septic inspection of the above referenced property was conducted on November 5, 1999. This property is located in the NW' /4 of the NE' /4 of Section 15, T31 N -R1 9W, Lot 16 of Shadow Pines, Town of Somerset, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a four (4) bedroom home. If you have any questions regarding this, please contact our office at (715) 386 -4680. Sincerely, &V- 6ya 4'u- Kevin Grabau Zoning Technician sm