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032-1027-70-000 (2)
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)], Permit Holder's Name: JAMES & ANNETTE JOHNSTON City Village Township TOWN OF SOMERSET CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic t� S.e D On Aeration Holding TANK SETBACK INFORMATION ``__ * r1 M V C c A Ih i .AL TANK TO P/L WELL BLLTG. Vent fc fir Intake ROAD Septic, n 1� Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Numher H Li7 Friction Loss I Sy tem He d JTDH Ft Fo e in Length Dia. Dist. t.) Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches DIMENSIONS SETBACK SYSTEM TO P/L W BLDG WELL INFORMATION Typ z Of System: I R v1♦t or101� DISTRIBUTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 651266 State Plan ID No: Parcel Tax No: 032-1027-70-000 Section/Town/Range/Map No: 10.31.19.131 B STATION BS HI FS ELEV. Benchmark .BMkik6f�•32� IDO•bI Bldg. Sewer ps• I I SUHt Inlet sUHt outlet � � Q,J• 3� t Inl , A A DBtto V U V H ader/Man. iv\ .7 .Q g3.9G Dist. Pipe Bot. System e '693-0611-f-6 Final Grade Q/ •93 l� �9fCover ?L 3, qgy53 ] 5 +y& -AAk " t PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth LAKE/STREAM LEACHING Mwwfb cY re CHAMBER OR ✓ UNIT mb : 2. ado Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake i i:� Pipe(s) , I LengthI Dia Length Dia cing SOIL COVER x Pressure Svstems Only xx Mound Or At -Grade Svstems Only Depth Over Depth Over xx Depth of xXg ded xx Mulched Bed/Trench Center Bed/Trench EdC �s _ Tops ❑Yes ❑ No I ❑Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Location: 2280 CTY RD I 1.) Alt BM Description 2.) Bldg sewer length - amount of cover =�1g'` Inspection #1: —(gyp wctl on lot at inffkCWM Inspection #2: 1;k.j Plan revision Required? ❑ Yes lk No g&qo Use other side for additional information. l SBD-6710 (R.3/97) Date n p or's Signature Cert. No. County SAN-2023-183 RECEIVED St. Croix Industry Services Division 08/22/2023 1400 E Washington Ave Sanitary Permit Number (to be filled in by Co.) S PS Paid via Ascent P.O. Box 7162 Madison, W1 53707-7162 #31236 (0 Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2). Wis. Adm. Code, submission of this form to the appropriate governmental unit I i is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1)(ml, Stats. I. Application Information - Please Print All Information 2 27 CrY P.6 7. Property Owner's Name % T Parcel ItAlbui ?OCIM& Annette Johnston 00 E '0032-1027-70-00-0 6240. S AJ &* GUMEMMMMM-6 374s&g;TT 6 Property Owner"s Mailing Address Property Location 4870 Gallup Road Govt. Lot City, State Zip Code Phone Number SE 1/41 NE 1/4,- Section 10 (circle one) Reno,, NV 89511 T31 N R19Eorr 11. Type of Building (check all that apply) V Lot # 1 or 2 Family Dwelling - Number of Bedrooms 2 Subdivision Name NIA ❑ Public/Commercial - Describe Use Block # City of State Owned - Describe Use El Village of CSM Number (3 2 ^ 72(o .9' ` � g��� �, Town of Somerset i�c�CDO & 111. Type of Permit: (Check only one box on line A. Complete line B if applicable) 1 El Replacement System F Other Modification to Existing System (explain) A. New System Tre atment/Hol ding Tank Replacement Only B. Revision Change of El Permit Transfer to New Permit Renewal ❑Permit Rev's' List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. h2e of POWT5=Sgstem/Component/Device: (Check all that apply) (rff Non -Pressurized In -Group El Pressurized In -Ground El At -Grade El Mound > 24 in. of suitable soil El Mound < 24 in. of suitable soil LJ Holding Tank In G90ther Dispersal Component (explain) F-1 Pretreatment Device (explain) V. Dispersalff reatment Area Information: (2 120 6a F10L,1J Design Flow (apd) Design Soil Application Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 600 Rate(gpdsf) 1200 1200 93.0' 0.5 V1. Tank Info Capacity in Pa Gallons -�` .n ' ° Total # of 4- Gallons Units Manufacturer New Tanks Existing Tanks ci U in V� Septic or Holding Tank 1250 1250 1 Wieser Concrete ❑ I Dosing Chamber I I - I ❑I N'11. Responsibility Statement- 1, the undersigned, assume responsibility, for installation of the POWTS shown on the attached plans. Plumber's Name (Print) PI r ' S ature MP/MPRS Number Business Phone Number John Schmitt 223760 715-760-0486 Plumber's Address (Street, City, State, Zip Code) 586 Valley View Trail, Somerset, WI 54025 V111. Coun t l epartment Use Only my k0l Approved Permit Fee DMF Iss Issuing Agent Signature g==;iPeason for $ �3�� 2023 IX. Conditions o pprova el"SoMi fOr DiStilpff Q� SYSTEM OWNER: (� 1. Septic tank, effluent filter and dispersal call q) must be serviced I maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code / ordinances. Attach to complete plans for the system and submit to the County only on paper not le%s than 8 1 •12 N I I inches in size SBD-6398 (R03/14) 1.1 SYSTEM PLOT PLAN Johnston 4 Bedroom Septic System Project Address: County Road I BM1 Symbol: AL BM Elevation: 100.03' BM Description: Top of 2" PVC pipe BM2 Symbol:A BM Elevation: 103.55' BM Description: Top of 2" PVC pipe Slope Gradient of Tested Area: (6%) Well Symbol (if applicable) Notes: See Plat Map for Complete Lot Proposed WLP 1 250-MR Septic tank w/ Polylok 525 effluent filter Bi F 4 6%, Slope B3 Garage B2 T2 T� 99, 97' Proposed Well o r-- roposed Bedroom House 101, Ti Proposed 3'x12O'EZ Flow Trench El,= 93,0' T2 Proposed 3'x120' EZ Flow Trench El,* 93.0' Design Flow: 600 GPD Attach design flow calculations for commercial plans: Pipe Materials / ASTM Standard Tables 384.30-3 & 384-30-5 4" SC 40 PVC pipe ASTM- D2665 4" SCH 3034 PVC pipe ASTM-D3034 Property Line BM2 Jaunty Road I BM1 0 ct 13 a a I Orchard fence riveway N Scale: 110 = 60' 0 60 90 120 152 0 C 0 CONVENTIONAL COMPONENT DESIGN kesidential Application INDEX AND TITLE PAGE Project Name: Johnston 4 Bedroom Septic System Owners Name: Martin & Annette Johnston Owner's Address 4870 Gallup Road Reno , NV 89511 Legal Description: SE 1/4, NE1/41 S10, T31N, R19W Township Somerset County: St. Croix Subdivision Name: N/A Lot Number: 2 Block Number Parcel I.D. Number 032-1027-70-000 Plan Transaction No. Page 1 Index and title Page 2 Plot Plan Page 3 Septic Tank Specifications Page 4 Effluent Filter Information Page 5 System Sizing & Cross Section Page 6 EZ Flow Information Page 7 Management and contingency plan Page 8 Sanitary System Ownership/Address Form Page 9 Warranty Deed Page 10 CSM or Plat Attachment 1 Soil Evaluation Report Designer: John Schmitt Licnese Number: MPRS 223760 Date: 8/22/2023 Phone Number: 715-760-0486 Signature: In -Ground Soil Absorption Component Manual Version 2.1 May 2022 Page 1 1.1 SYSTEM PLOT PLAN Johnston 4 Bedroom Septic System Project Address: County Road I BM1 Symbol: AL BM Elevation: 100.03' BM Description: Top of 2" PVC pipe BM2 Symbol:A BM Elevation: 103.55' BM Description: Top of 2" PVC pipe Slope Gradient of Tested Area: (6%) Well Symbol (if applicable) Notes: See Plat Map for Complete Lot Proposed WLP 1 250-MR Septic tank w/ Polylok 525 effluent filter Bi F 4 6%, Slope B3 Garage B2 T2 T� 99, 97' Proposed Well o roposed Bedroom House 101, Ti Proposed 3'x12O'EZ Flow Trench El,= 93,0' T2 Proposed 3'x120' EZ Flow Trench El,* 93.0' Design Flow: 600 GPD Attach design flow calculations for commercial plans: Pipe Materials / ASTM Standard Tables 384.30-3 & 384-30-5 4" SC 40 PVC pipe ASTM- D2665 4" SCH 3034 PVC pipe ASTM-D3034 Property Line BM2 Jaunty Road I BM1 0 ct 13 a a I Orchard fence riveway N Scale: 110 = 60' 0 60 90 120 152 0 C 0 10 1-01 13 4" CAST —A —SEAL 4" CAST —A— SEAL OUTLET < WLP1250—MR TANK SPECIFICATIONS DIMENSIONS: WALL: 2 1/2" BOTTOM: 3" COVER: 5 MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 52 1/2" LENGTH: 10'-0 1/4" WIDTH: 7 P-0" BELOW INLET: 41" LIQUID LEVEL: 36" WEIGHT: BOTTOM 4,945 LBS. COVER 3,865 LBS. INLET AND OUTLET: 4" CAST— A —SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 34.81 GAL/IN HOLDING TANK: OUTLET HOLE PLUGGED ACTUAL CAPACITY: 1,323 GALLONS LOADING DESIGN: 8"-0" UNSATURATED SOIL TANK CAN BE USED AS: SEPTIC / HOLDING / PUMP OR SIPHON COVER- MIX DESIGN #8 (NO FIBER) TANK: MIX DESIGN #10 (STRUCTURAL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WESER CONCRETE REVIEWED BY REVIEW DATE d Z 0 CL J= a_ LLI W SHEET NO. Of �wl 0 to a m TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS Inc. Innovations in Precast, Drainage Zabel' & Wastewater Products A Division of Polylok Inc, PL-525 Effluent Filter PL-525 Filter The PL-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL-172, the Polylok PL-525 has an automatic shut-off ball installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shut off the system so the effluent won't leave the tank. Features: • Rated for 10,000 GPD (gallons per day). • 525 linear feet of 1/16" filtration. • Accepts 4" and 6" SCHD 40 pipe. • Built in gas deflector. • Automatic shut-off ball when filter is removed. • Alarm accessibility. • Accepts PVC extension handle. PL-525 Installation: Ideal for residential and commercial waste flows up to 10,000 gallons per day (GPD). 1. Locate the outlet of the septic tank. 2. Remove the tank cover and pump tank if necessary. 3. Glue the filter housing to the 4" or 6" outlet pipe. If the filter is not centered under the access opening use a Polylok Extend & Lok or piece of pipe to center f I I ter. 4. Insert the PL-525 filter into its housing. 5. Replace and secure the septic tank cover. PL-525 Maintenance: The PL-525 Effluent Filters will operate efficiently for several years under normal conditions before requiring cleaning. It is recommended that the filter be cleaned every time the tank is pumped., or at least every three years. If the installed filter contains an optional alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be done by a certified septic tank pumper or installer. 1. Locate the outlet of the septic tank. 2. Remove tank cover and pump tank if necessary. 3. Do not use plumbing when filter is removed. 4. Pull PL-525 cartridge out of the housing. 5. Hose off filter over the septic tank. Make sure all solids fall back into septic tank. 6. Insert the filter cartridge back into the housing making sure the filter is property aligned and completely hiserted. 7. Replace and secure septic tank cover. 061" Filtration Slots Alarm Switch L10,000 GPD (Optional) Accepts I" PVC Extension Handle Accepts 4" & 6" => SCHD 40 pipe il Outdoor SmarffilterCw Alarm Polylok, Zabel & Best filters accept the SmartFilterS switch and alarm. Rated for 10,000 GPD 525 Linear Ft. of 1/ 16" Filtration Slots o ifi Certed t NSFIANS1 !fie Standard SI nard 46 Gas Deflector : Automatic Shut -Off Ball Extend & LokT-`4 Easily installs into existing tanks. Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 Toll Free: 877.765.9565 Fax: 203.284.8514 www.polylok.coni Page 4 IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with EZ1203HP Bundles 3-ft Trench (down -sizing credit) Geotextile min. 12" (typical) Cover SOIL COVER 12" min. trench depth J_ (typical) System Elevation (typical) TYPICAL TRENCH PLAN VIEW Septic Tank(s) Manufacturer: Wiser Concrete Septic Tank(s) Volume(s): 1250 gal I g a I gal gal Effluent Filter Manufacturer: Polvlok Effluent Filter Model #: 525 TYPICAL TRENCH CROSS SECTION VIEW (No Scale) Provide minimum 3 ft separation between trenches. (Show location of inlet / outlet pipe connection on plan view.) 4110 r1kUM1=1 VC2CV" ViPU shall beinstalled (No Scale) at junction between two units. Perforated Lateral Observation Pipe --• - (typical) (typical) B 120 ft (typical) INSTALL PER TRENCH: 12 1 0-ft bundles @ 50 ff EISA/unit = 600 ft` + 0 5-ft bundles (@_ 25 ff EISA/unit = 0 ft2 OBSERVATION PIPE DETAIL (No Scale) Screw -Type or -N-- Finished Grade Slip Cap (loose) (mulched & seeded) 4"0 PVC Pipe Topsoil Cover (min. 1 foot) Top of pipe to terminate at or above finished grade .%Joel (4) 1/4"-1/2" X 6" Slots @ 9*0 apart Anchoring Device Infiltration 10 ft A = 3.0 ft (typical) EZ1203H Bundle (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturers instructions. osed PropEISA per trench = 600 ft2 1200 ft2 Required Infiltration Area x 2 trenches = Proposed Total EISA = 1200 ft2 L RESET m 0J Surface Distribution Method: branched manifold Installation Instructions for AAA Zfl, ��flow ���� Wisconsin in ����m OWTM bv IN by INFILTRATOR ~~^~^^~~~~~^~~^~^~~^^^~^~^^^^^~~^~^^~~^~^~^~~~^^~^^^~^~^~~~^~~~^~^~~~^^^~^^~~~~^^~^^~~~^~~~ Wisconsin Department of Commerce. Safety and Buildings 5. The Absorption area (SF)necessary for agiven site shall Division. has reviewed the specifications and/or plans for this be sized based on maximumdailysewage flow (GPD) and product and determined it to be in compliance with the Permeability for the site. If certain criteria is met, the Comm 82 through 84. Wisconsin Admin. Code. and Chapters BBAsbjng can be used in Wisconsin, resulting in o4O96 145 and 160, Wisconsin Statutes. All sites must meet the Site smeller dnainfield. & Soil Conditions & Locations & Isolation distances as noted in � local regulations. 6. Place EZflow bundle(s) in the EZflmw configuration ap- proved by system design permit specified for the particu- The approved products are 1203H (3-12" bundles with pipe in |ar site. The top or center -most bundles containing pipe center bundle \n5'or1O'lengths) and 12O3HP(3-12"bundles are joined end to end with an internal pipe coupler. Any with pipe in each bundle in 5' or 10' lengths. additional aggregate only bundles that may be required, ~ should be butted against the other aggregate -only bun - A single pipe bundle contains a four inch perforated pipe sur- d|es and do not require any type of connection. rounded by EPS aggregate and is held together with poly- � ehtylene netting.AsinB|eoggregatobundlmoonbainsaggnagate 7- The top ofeach BEOcylinder contains afilter fabric pre - only and isheld together with polyethylene netting. manufactured in between the netting and aggregate. The ~ fabric is inserted to prevent soil intrusion. The installer Materials and Equipment Needed shall make sure the the BEOispositiionedupward and is ~ EZf|owBund1ms in contact with the fabric contained in the adjacent oy|in- = EZflmmGeotexti|eFabho der before beckfiUing. ° EZfowInternal Pipe Couplers � � Pipe for Header and Inlet B. The EZOovv Doainfie|d Systems should be installed in a ° Bockhoe/Excoxsdor level trench in all directions (both across and along the � trench bottom) and should follow the contour ofthe ground Installation Instructions surface elevation (uniform depth), with all continuous The instructions for installation of EZflmw products are given adjoining 10-foot cylindrical bundles placed end to end. below. This product must be installed in accordance with state with central bundle distribution pipe interconnected, rules defined in chapters Comm 82 through 84. Wisconsin Ad- without any darns' stepdovvns orother water stops. ministratiwyCode, and Chapters 145and 16O,VVisconsin Stat-� utes. as well as the local health department's current design utes, 9. The trench top shall be graded such that water will not manual. pond. BackfiU should be seeded or sodded immediately � after completion to reduce erosion. 1. After the local health department has determined sizing, configuration, and layout for the EZ�owv systems, stake� 1O. �Z �ow EPS bundles are flexible and can fit in curved or mark with paint the location of trenches and lines. Be trenches as may be necessary to avoid tnmes, bou\dero, or careful to set correct tank, invert pipe. header line or dio- other obstacles. tribution box and trench bottom elevations before instal- lation of pipe bundles. 11.EPS aggregate is lighter than water, therefore, it might ~ be expected that natural buoyancy forces would tend to 2. Remove plastic EZf1ovv shipping bags prior to placing cause EZflovv assemblies to float out of ground when bundles \nthe trenoh(es).Remove any plastic bags inthe ^ punding occurs. Field experience has shown, however, trench before system is covered. ^ that this is not a problem when systems have a minimum � of6" of soil cover as recommended by manufacturer. 3. This product must have gootexti|e fabric that meets /e- � quinsments of s. Comm 84.80 (B) (B), Wis. Adm. Code, � installed directly on top of the product and extending � 1203H_GEO down along the sides ofthe product toapoint stleast six ~ inches from the bottom of product. � --------- Gaote�i|e ^ V7VVVBarrier Material vvvvvvv -'v " M, v V 7 Vv " 4. When installed in atnench. the trench should be dug to iVVV awidth cf88inches. This not only saves labor inexcava- 12V v Q v V V I tion, but also provides better load -bearing capacity after backfiUing is complete. _ ~ ^^^~^~^~^^~^~~^^~~~~^^~~~~~^^^^^~~^~~~^~~^~~^~~~^^~^~~~~~~^~~^~~~~~^~~^`~~^~~~^~~~^~^~~~~ 9 a I Wel MA In -ground Gravity Management Plan T IT, ro Z-6— V_h, I r LEN, 11 a The owner of this in -ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operati. ng LimiL.-A. I Design Flow = boo gpd; BOD5 :5 220 mgL-; TSS:5150 rngL"; FOGS 30 mgL-' Inspection Checklist INSPECT EVERY 3 YEARS • type of use • age of system • nuisance factors (i.e. odors, user complaints, etc.) • mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) • material fatigue (i.e., leaks, breaks, corrosion, etc.) • solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) • neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) • extent of ponding in distribution cell prior to dosing • dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.) • electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.) • distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification) • surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) * Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stats. when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. * Effluent filters shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Local government unit: Schmitt &Sons Excavating, Inc. St. Croix County Community Developernent Phone: 715-386-4680 Local government unit address: 1101 Carmichael Road, Hudson PW,one: 715-760-048tN-, ZIP: 54016 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code, Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384, Wisc. Admin. Code. Contingency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component may be abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned In accordance with SPS 383,33, Wisc. Admin. Code. Page 7 Subdivision Plat: Certified Survey Map # 1168854 Warranty Deed # 1170249 Number of bedrooms New Property Address (Staff Initials) SANITARY SYSTEM File #: S�: ClhC- 'j..X% 'GO. L J N J- Y Office Use Only �` ��==�--�" OWNERSHIP/ADDRESSCreated212027 FORM -1 Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. If you would like to view your issued sanitary permit online, you can do so by using the Property Files Scanned weblink. OWNER/BUYER INFORMATION Owner/Buyer Martin &Annette Johnston Mailing Address 4870 Gallup Road City/State/Zip Reno, NV 89511 Phone Number (required) 715-222-1670 Email Address (required) arpjohnston@gmail.com Parcel Identification Number 032-1027-7g-000 (found on the property tax bill) T 2a2 y aj�9ejyPwvz1- A� pY2—j627-70•-OZb .NEW SYSTEM: LEGAL DESCRIPTION Property Location SE 1/4 ) NE 1/4 Sec. 10 9 T 31 N R 19 W, Town of Somerset , Lot # 2 Volume32 Page 47265 (before 2006)Volume Page # 4 Spec house 0 yes N no Lot lines identifiable M yes 13 no OFFICE USE ONLY 2�7 CAI (Verification of new address required from Community Development Department for new construction.) 2 (Date) This form must be submitted with oil Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form a recorded warranty deed front the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. Community Development Department — Land Use Division 715-386-4680 St. Croix County Government Center cdd@sccwi.gov 1101 Carmichael Road, Hudson, WI 54016 715-245-4250 Fax WWW.SCCW�9_0' Page 8 I WARRANTY DEED Document Number Document Name THIS DEED, made between John V. Plourde, ("Grantor," whether one or more), art� Annette P. Johnston and James M. Johnston, wife and husband as survivorship marital property ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the fixtures, profits, rents, and other appurtenant interests, in Saint Croix County, State of Wisconsin ("Property") (If more space is needed, please attach addendum): Lot 2 of Certified Survey Map filed July 12, 2023 in Vol. 32 of C,S-M., pg. 7265 as Doc. No. 1168854 located in part of the Southeast Quarter of the Northeast Quarter (SEI/4 of the N E/4) of Section 10, Township 31 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin. Dated:C.� % % C� 2� Z'3 _ j r P ou de I r, V AUTHENTICATION Signature(s). John V. Plourde authenticated on TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706-06) THIS INSTRUMENT DRAFTED BY: St. Croix County Abstract & Title Co,, Inc,by Amanda Manske at direction of the Grantor S23-00646. 575 N. Knowles Ave., Ste. B /TI41/1 New Richmond, Wl 54017 *Type name below signatures 1170249 BETH PABST REGISTER OF DEEDS ST. CROIX CO, WI RECEIVED FOR RECORD 08/21/2023 01:26 PM EXEMPT#: REC FEE 30.00 TRANS FEE 195.00 PAGES: I **The above recording information verifies that this document has been electronically recorded & returned to the submitter Recording Area Name and Retum Address: St. Croix County Abstract & Title Co., Inc. 575 N. Knowles Ave., Ste. B New Richmond, Wl 54017 032-1027-70-229_ipart oq__ Parcel Identification Number (PIN) This is not homestead property. 10oolt" III I It j)j4j1.,-jj �?�NNDA 4f kP 114 0 'A 0 fJ ti $ OA, ACKNOWLEDGMENT STATE OF WISCONSIN COUNTY OF ST. CROIX 4- '0' Personally came before me this )?day of August, 2023 the above named John V. Plourde, to me known to be L IL I K the person v*d ex cuted tRe foregoing instrument and acknowledge the same. 9 Pudic, St. C ff_�'n`ske,N_otary P i ty, isconsin My Commission is permanent: (If not, state expiration date: 03/1112024) (Signatures may be authenticated or acknowledged. Both are not necessary-) St. Croix COUnty 1170249 Page 1 of 1 Page 9 CERTIFIED SURVEY MAP LOCATED IN PART OF THE SE1/4 OF THE NE1/4 AND IN PART OF THE SW1/4 OF THE NE1/4 OF SECTION 101 T31 N I R1 9W, TOWN OF SOMERSET, ST. CROIX COUNTY, NSCONSI N; BEING LOT 2 OF CERTIFIED SURVEY MAP RECORDED IN VOLUME 12, PAGE 3296, DOCUMENT NUMBER 551970 AT THE ST. CROIX COUNTY REGISTER OF DEEDS OFFICE. SURVEYOR PREPARED FOR: MICHAEL J , ERICKSON JOSEPH PLOURDE FOUR SEASONS LAND SURVEYING, LLC 2280 C.T.H. "I" 848 WILLOW RIVER DRIVE SOMERSET, WI 54025 HUDSON, WI W1 6 SURVEYOR'S CERTIFICATE 1, Michael J. Erickson, Professional Wisconsin Land Surveyor, hereby certify that by the direction of Joseph Plourde, I have surveyed, mapped and described the parcel of land which is represented by this Certified Survey Map; that the exterior boundary of the parcel of land surveyed and mapped is described as follows - A parcel of land located in part of the SE1/4 of the NE1/4 and in part of the SW1 /4 of the NE1/4 of Section 10, T31 N, Ri 9W, Town of Somerset, St. Croix County, Wisconsin; being lot 2 of Certified Survey Map recorded in Volume 12, Page 3296, Document Number 561970 at the St. Croix County Register of Deeds Office; described as follows: Commencing at the El /4 Corner of said Section 10; thence N00'36'06"E, along the east line of the NE1/4 of said Section, 814.55 feet to the north line of lot I of Certified Survey Map recorded in Volume 12, Page 3296, Document Number 561970 at the St. Croix County Register of Deeds office, being the point of beginning; thence N88'50'23"W, along said north line and the north line of lot 3 of said Certified Survey Map, 1143.25 feet to the northeasterly line of said lot 3; thence N45004'33"W, along said northeasterly line, 405.45 feet to the east line of said lot 3; thence N00"36'06"E, along said east line, 229.83 feet to the north line of the S1/2 of the NE1/4 of said Section; thence S88"50'48"E, along said north line, 1433.33 feet to said east line of the NE1/4; thence S00036'06'W, along said east line, 510.45 feet to the point of beginning. Described parcel contains 15.86 acres (690,817 Sq. Ft.). Parcel is subject to County Road "I" right-of-way and all other easements, restrictions, and covenants of record. 1, also certify that this Certified Survey Map is a correct representation to scale of the exterior boundary surveyed and described; that I have fully complied with the current provisions of Chapter 236.34 of the Wisconsin Statutes, the Land Subdivision Ordinance of the County of St. Croix and the Subdivision Ordinance of the Town of Somerset, in surveying and mapping same. Michael rickson, P,L.S, 2592 Date SGONs';' e0es"'06" 4 WOWL J " % Asup-mcowid 'JUL 12 2023 save 0 St. Croix County Community Development SU COUNTY TREASURER'S CERTIFICATE STATE OF WISCONSIN)SS COUNTY OF ST, CROIX) 1, Denise Anderson, being the duly elected, qualified and acting Treasurer of St. Croix County, do hereby certify that the records in my office show no unredeemed tax sales and no unpaid taxes or special assessments as of -�,Tu (1, is-Q,@ 60-8 affecting the land included in this Certified Survey Map, %J kj' C3 ORO Denise Anderson, Date County Treasurer Each parcel shown on this map (plot) Is subject to State, County and Townohlp Iowa, rulas and regulations (I,o,, wetlands, minimum lot size, access to parcel, etc;,), 13efore purchagIng or developing any parcel contact the St. Croix County Zoning Office and the Town -of Somerset. SHEET 2 OF 2 SHEETS 3a - 7ato15 qt (rn;v r^i int%, 1 1 AQPC;A Pana, I of C4�LsElevation ve. ,� - =ee �� HOD yea 0 H ear Elevation 2 1 ht . 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Y■Cn T iDM a ,t r'1r %ck;r% W ,1r■.r+s# #la. wY.. ^lna'4 i►7 "i � than,"': 33in�@ C[&E•+c,�F ild€n�'t@ :-=`pC'F rvlti.giT+# 9Nu .YrPC 01 ?9ar J i~I 31 @unrlu*all ,r.xsyn© Ic„ it � � _ ,AfY+.p .k�a-,[ a -a ,w6.s ■ ,Fr 5 O�a — _ Yis m■4mr II U,, ,p H7,2d 3 /) IiR„ i K-+=n■4a fn. 91.aalf:fnv' ..� _ F Z - 7 ,i' {,] t1 .:•1 I .8+1 • r r . 'Yfaww- lra. 1E..71�i lafi 01 !�� •� 1 Fr u•.#,n wliYars >trub'� av+c'rI■ r�sn � I# WQU�� � urn Fri u�i-rl*Wm 1 1/�1�1�� �' �r�si@o.+r ■ni rvr 7RTtEr� WV .M .f4 Vh?TT 9.•MI■ IT I ^M MV HINB'7 ayQT • IWW>. a • �• r a: ry s e s ram_ ,g_a0::: . a .e 1F s r. o a+ l3 � �.SL.tdx r acip Ir -xi II lk - _---- - - - - -- II - 11 i w.. ,.a I, 7v ,n .4•d ., a-r ... I Yl 1 I GI N i + " ■ IiMra.-.rWJ v 1 11 M - 6 - MIrr" • ! e•.I • .6I' t 1 , Yr• + y . - .t mad " . al.• r + •9• L s•: a k L _ _ f%%1Wld -] phIwR H 11 � Fi k �i1�Jl + P I MOW* 1 r pl7 • 0� � 1# 1 .IK � .r: • .w a @� I� M b v ' �',E 'f-lu-,E t 8- 6 9•.Z Y� i Al {] - - - - - - - - - - - - L n a II d — 1s,.r _ —'F T tl r,c • .cr,rl lAl z , i 11 W I � i8aq _ ti +ir r ,f+.t 'o r x•µ.+ . t,t;: ti a.+ .F Ro,+ .. O—S a-arl r .. -- no,+ k N+ 'Ca � ravr+.,1� ri.�ckcv c.ur•.cr� :.aufc� a.,:-a,� 21x-.r✓! a,vs-.may a.oc+.c a:x,ir.�� ,�57 cq-.9 Lip V � s dg' Irot a _ .. _........-.--- P6� ?•,9 i .Q € jk U I --------- ---- --------- 1'11/11y911'�71i1►#?fi J'W '[ --''__ s p 11*Orn jj! MOAN 4 wl If131@IN7Y s R ■'.clyed I v,a _tin eca� ai vhl ..a rlfisr+3MhR•r si Rr, ktT- ,Y OO 1- ,i +iM I •op coils s a arr+-r■ri ■.� Tpi 1ai Imo. >.a Miif�67 ftr+CFOC7'1 IF -MGM x .nv.-T" w•-"b.= aui . a,. I -m fl..cl. t.�rr.,aad �arlCirr c4t•Yd�4.1 1 r,.g I19"`3 „4•,9 MY it .1aY'.IpfW.b+ T'Iam r0 r't 19 y:: rZ 4N1T':K2 CFi�rY�r.�17>!+'� �6v�ta NR7IQ3C3 9Nl�6 Zfirm g-,w� Ot ktp Department of #2249 SOIL EVALUATION REPORT 8 Safety and in accordance with Comm 85, Wis. Adm. Code Page ---- 1 ---- of - 5 8 - Professional Services 41 ___Schmitt Soil Testing, Inc. Attach complete site plan on paper not less than 8'/2x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and 1 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 0* 032-1027-70-000 Please print all information. --_Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Plourde, John Govt. Lot S1/4, NE1/4, 510, T31N, R19W Property Owner's Mailing Address Lot # Block # Subd- Name or CSM# 2280 Cty Rd 1 2 CSM Pending approval city State Zip Code Phone Number F city F Village Town Nearest Road Somerset WI 1 54025 1 715-247-2709 1 Somerset Cty Rd I I- --- - I New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: Parent material Outwash (Onamia.Series) ____NA f Flood plain elevation, if applicablet. General comments Area is suitable for a conventional system with a 0.5 gpd/sqft rate. Possible system elevation for Area 1 is 93.0'. Slope of area is and recommendations: 6%, Boring # Boring Pit Ground surface elev. -----98.-50 — ft. Depth to limiting factor 110+ in. JSoil Application Ratel Horizon Depth in. Dominant Color Munsell Redox Description Chu. Sz. Cont. Color Texture Structure Gr. Sz, Sh. Consistenc Boundary Roots GPD/ft 2 *Eff#1 *Eff#2 1 0-11 10yr3/3 none sl 2mgr mvfr as 2vf 0.6 1.0 2 11-20 20-4 10yr4/4 7.5yr5/6 none none sl 2msbk mfr gw 1Vf 0.6 1.0 1.0 3 fS Osg ml as ------ 0.5 4 47-110 10yr6/4 none s Osg ml ---- ------ 0.7 1.6 Boring # E] Boring �711 Pit Ground surface elev. 98-90 --- ft. Depth to limiting factor 110+ in, ISoil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. ConsistenceI 7 Boundary j Roots GPD/ft 2 *Eff#1 *Eff#2 1 0-11 I 10yr3/3 none sl 2mgr mvfr as 2vf 0.6 1.0 2 3 11-18 -24 7.5yr4/6 7.5yr4/4 none none grscl grsl 2msbk 2msbk mfr mfr gw gw lvf 1Vf 0.4 0.6 0.6 1.0 4 24-46 10yr6/4 none grcos Osg M1 as ------ 0.7 1.6 5 46-110 10yr6/4 none fs Osg ml ---- ------ 0.5 1.0 g3-o I -A * Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 <- 150 mg/L * Effluent #2 = BOLDS s30 mg/L and TSS < 30 mg/L '.'.ST Name (Please Print) Signature.- CST Number Thomas J. Schmitt 227429 kddress Schmitt Soil Testing, Inc. X/10" Date Evaluation Conducted Telephone Number 1595 72nd St. New Richmond, WI 54017 4/13/2023 715-760-1978 SBD-8330 (R.07/00) Property Owner Plourde, John F Boring 3 Boring # i i Pit Parcel ID # 032-1027-70-000 Ground surface elev. 96-55 ft. Depth to limiting factor 105+ in. Page 2 of 5 ISoil Application Ratel Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. ConsistenceBoundary Roots GPD/ft2 *Eff#1 *Eff#2 1 0-11 10yr3/3 none sl 2mgr 1 mvfr as 2vf 0.6 1.0 2 11-17 10yr4/4 none scl 2msbk rnfr gw 1Vf 0.4 0.6 3 17-22 10yr4/6 none sl 2msbk rnfr as 1Vf 0.6 1.0 4 22 10yr5/6 none grs Osg MI Cs ------ 0.7 1.6 5 48-105 10yr6/4 none s Osg MI ---- ------ 0.7 1.6 93C) 42.E .� Boring Boring # I I pit Ground surface elev. Depth to limiting factor in, ISoil Application Ratel Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. iConsistence,l Boundary Roots GPD/YF *Eff#1 *Eff#2 Boring # F Boring ft. Depth to limiting factor I 1 7] pit Ground surface elev. in. ISoll Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture 1 Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft2 *Eff#1 *Eff#2 * Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) Schmitt Soil Testing, Inc. Conducted for: o John V Plourde 2280 Cty Rd I Somerset, WI 54025 Lot 2 Part of: PID 032-1027-70-000 SE1/4 NE114 S10 T31N R19W Town of Somerset 0 oo95' 0 Mov 569.031 Conducted by: Thomas J. Schmitt CST 2 4/29 4-13-2023 BM 1 100.00'Top of 2" PVC Pipe BM 2 103.55"Top of 2" PVC Pipe BM 009 7' • • ago BI 6% • SLOPE B3 04 < < 157' LLI Ld d X < 110, B2 51' 97' 991 0 101, 351 1 9914 - LOT 2 BM 2 �A (490'+ SEE PAGE 4 of 5 FOR FULL VIEW OF LOT RM b ICTY RD I St Croix County, W1 Legend Lakes and Rivers Rivers and Streams Dam Internutten- Parmmal Interstates US Highway-, State Highways County Highways Local Roads Rustic Roads Ramps Road Right of Way Aborkdormc Ra*cLad PM -aft Rood ReWood Rood VaceWd ROW Railroads lit = 60' N 0 20 40 60ft DISCUAMER: This map is not guaranteed to tie accurate, correct, current, or complete and conclusions drawn are the responsibility of the I Ir-or ffA � * v{` 41Z St Croix County, WI Legend Sections Ty, _ Lakes and Revers .' Rivers and Sr..reams DOM _' �� `y �� "' Intermttten' RerrrniEd Interstates US Highway State Highways County Highways Local Roads Rustic Roads •4. ',." Ramps Road Right of Way zt, Abondo-w Po*uad Private Rom . ` * Raikoad _ Road �,< 'f Vacates! RliW t Railroads M[ LAKE. V.v N i '. it oil i' o goo 200 300ft tl f DISCLAIMER- This reap is not guaranteed to tie accurate, correct. current, or complete and conclu ions drawn are the responsibility of the user. Y dl i gl23 9- 7 AM Lo i o CERTIFIED SURVEY MAPI Lo 4) LOCATED IN PART OF THE SE1/4 OF THE NE1 f 4 AND IN PART OF THE SW1/4 OF THE NE1/4 OF cm m SECTION 10, T31 N, R19W, TOWN OF SOMERSET, ST. CROIX COUNTY, WISCONSIN; BEING LOT 0. i 2 OF CERTIFIED SURVEY MAP RECORDED IN VOLUME 12, PAGE 3296, DOCUMENT NUMBER I 561970 AT THE ST. CROIX COUNTY REGISTER OF DEEDS OFFICE. SURVEYOR MICHAEL J. ERICKSON N D SURVEYING LLC FOUR SEASONS LAN � 8LLOV1l 48 WI RIVER DRIVE HUDSON. WI 54016 , 4 PREPARED FOR. JOSEPH PLOURI]E 2280 C T. H.11 SOMERSET, W 54025 LOTS -C.S.M. V. 10, P. 2878, DOC. #526122 UNPL4 7TED LANDS S8805&48"E 1433.W W I Bo ra cm M 6 c+ HOUSE 1{i cm LOT 1 DRIVEWAY �50'25'E S88 602.03 569,03' Loll\` LOT 2 r t7a+ 3.46 ACRES INC. R/W 150,500 SO. FT. 3.27 ACRES EXC, R/W 142,250 A SO. FT BEARINGS ARE REFERENCED TO THE z EAST LINE OF THE NE1/4 OF SECTION 10, 602.03 BEARING SW 36, W 569.03 (ST. CROIX COUNTY COORDINATE SYSTEM). N8805025°W 1143.W THIS INSTRUMENT DRAFTED BY MICHAEL ERICKSON LOT 3 LOT 1 JOB NO: 23-52 DWG: CSM C. S.M. V. 12, P. 3296, DOC. #561970 C.S.M. V. 12, P. 3296, DOC. #561970 --- - DRAFTEQ; X/X/23 FIELD: XX/X)V23 IN I I rrT^^ Q ti V� to J� 33.00' � to � ci �� Uf 33-W �I U, SHEET 1 OF 2 SHEETS INFORMATION MAP CERTIFIED SURVEY MAP LOCATED IN PART OF THE SE1/4 OF THE NE1/4 AND IN PART OF THE SW1/4 OF THE NE1/4 OF NE CORNER SECTION 10, T31 N, R19W, TOWN OF SOMERSET, ST. CROIX COUNTY, WISCONSIN; BEING LOT (SURVEY MARsECMAR E KER FD) 2 OF CERTIFIED SURVEY MAP RECORDED IN VOLUME 12, PAGE 3296, DOCUMENT NUMBER 561970 AT THE ST. CROIX COUNTY REGISTER OF DEEDS OFFICE. LEGEND N 0 ST CROIX COUNTY SECTION CORNER SURVEYOR ANY LAND BELOW THE ORDINARY HIGH POSITIONED FROM COUNTY MICHAEL J. ERlCKSON WATER MARK OF A LAKE OR A COORDINATES, POSITION VERIFIED S FOUR SEASONS LAND SURVEYING LLC NAVIGABLE STREAM IS SUBJECT TO WITH MONUMENT AS NOTED OR TIES THE PUBLIC TRUST IN NAVIGABLE OF RECORD c M 848 WILLOW RIVER DRIVE WATERS THAT IS ESTABLISHED UNDER f HUDSON, WI 54016 ARTICLE IX, SECTION 1, OF THE STATE ❑ 3,!4' X 18 IRON REBAR SET WEIGHING I 1.50 LBS. PER LINEAR FOOT PREPARED FOR: CONSTITUTION co co JOSEPH PLOURDE LOT 5 - C.S.M. V. 10, P. 2878, DOC. #526122 1 5!`16 O.D IRON PIPE FOUND o 2280 C.T.H ' I - - - - - - - - - cc I SOMERSET, WI W25 NORTH LINE OF THE S1/2 OF THE NE1 4 OF SECTION 10 SOIL TEST I UNPLATTED LANDS (R-S88°51 31 'E 1433 GO) S88050'48"E 1433.33' FIR ---- - 1 5/f6" O.D. IRON PIPE F WELLLu N 1 W 0.62' 1400.33' __3 00O' 0 NER VENT ®E (R-1400 00) �® F CBA Ow�HOUSE GARAGE__ZLL12 - 20 PERCENT SLOPES tom > I � oCID o \� / _ DRIVEWAY w o -� � ts� Z I 4 20 - 25 PERCENT SLOPES V Z / N o o Lo� \� b' `O cf u7 �n O 3 E 6 - \ \ __S88 50 202.03' AND 25 D SLOPES\cr\� 31 _ (' O ' � 33 co �'' I I � GO et _ t[) \© �So /r 6 ACRES LOT 2 0_ 0' \\sue fO�i� 346ACRES INC R/W coo DUI VS. � I • 150.500 SO FT Q� I g g D17, I Ln ��' � \ 11 A 3.27 ACRES EXC Rti'V o � I � � it � BEARINGS ARE REFERENCED TO THE J sQ � 10 142.250 SO FT o �� M EAST LINE OF THE NE1/4 OF SECTION 10. PROPOSED � � BEARING S00036'06'VV (R-333.00') 54f 22' 602.03' DRIVEWAY (ST CROIX COUNTY COORDINATE SYSTEM) - - -333 1 _- - ¢ - - r - _ _ __ _ _669-per- - __ - _.._ �. - _ 3.00 I � (VERTICAL DATUM NAVD 88) T N88050'23"W 1143.25' (R-SOp. 00< I OBI LOT 3 (R-N88 51 31'W 1143 00) L_T 1 N 00°36�06= E V THIS INSTRUMENT DRAFTED BY MICHAEL ERICKSON - - I O_ 814 55 JOB NO. 23-52 DWG CSM C.S.M. V. 12, P. 3296, DOC. #561970 SCALE IN FEET 1" = 150' V. 12, P. 3296, DOC. #561970 C.S.M.E1/4 CORNER DRAFTED. 4/29/23 FIELD 4/22/23 - - - - - _ - - - - -- - - - - -- - - - - SECTION 1OT; I 0 150 300 SHEET 1 OF 2 SHEETS (SURVEY MARKER FD)� b N I EXISTING DRIVEWAY Va . 1A ► #2249 Department of L 'EVALUATION Are, t]RT Safety and in accordance with Comm 85, Wis.. Code Page 1 of 5 Prohmionaf Services Schmt t Soil Testing, Inc. County . Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must St. Croy Include, but not limited to: vedka# and horizontal reference point 13M), direction an r+ara+d. Parcel 1.D. end distance to percent slope, scale or dtmensbrs, north arrow, and kxon 432-1027-704)00 Pt"se print ell ►nformedon. Revkwied By Date PersonW irtbmwtw you provide may be umo for seovrwW purposes (Pdvwy Low, s. 16.04 (1) (m)). Property Owner Property Location Plourde, John GovL Lod SE114, NE1 /4, S 1 O, T31 N, R19W Property Ow ees Mailing Address Lot # Skxk # Subd. Name or CS!# 2280 Cty Rd 1 2 1 CSM Pending Approval City State Zip Code Phone Number Ej City Village [] Town Nearest Road Somerset WI 154025 _ 715w-247-2709 Somerset C Rd I }y use: ; : Residential 1 Number of bedrooms 4 Code derived design flow rate GPD New Construction [� Replacement Public or commercial - Describe: lParent material Oub"Sh Ona--Mia des Flood plain ekvadon, it aWscabte General comments Area is suitable for a convatona l system with a 0.5 gpd/sgft rate. amble system 4vagon for Area 1 is 93.(Y. Sloe of area Is and recommendatlons/ Boring Boring # Ph Ground surface elev. 98.50 ft. Horizon Depth Dominant Color Redox Description Twduie in. Munsell Qu. Sz. Cont. Color 1 0-11 10yr3/3 none si 2 11-20 10yr4/4 none S1 3 20-47 7.5yr5/6 none fS 4 147-1101 10Vr6/4 I none s Depth to limiting factor Structure Consistence Gr. Sz. Sh.. 110+ In. Boundary Roots Sail Appl%atlon Rate GPD1W *M1 'ems 2mgr mvfr as 2vf 0.6 1.0 2rnsbk mfr gw 1vf 0.6 1.0 059 M1 as ------ 0.5 1.0 Osg . m1 0.7 1.6 Boring 2 Boring # Q Pct Ground surface elev. 98.90 ft. Depth to limiting f or Horizon Depth Dominant Color Redox De pdon Texture Structure C�onsiste� In. Munsell Qu. Sz. C,onL Color Gr. Sz.. Sh. 1 0-11 10yr3/3 none s1 2mgr mvfr 2 1 f -18 7.5yr416 none grad 2msbk mfr 3 18-24 7.5yr4/4 none grsl 2msbk mfr 4 24-46 10yr6/4 none 9rcos OS9 ml 5 46-114 14yr6/4 none fs Osg ml Effluent 01 Q SOD s' 30 220 rn91L and TSS ?30 c 150 mg& CST Name (ftm Print) Signature.. Thomas J. Schmitt Address Schmid Sail Testing, Inc. 1595 72nd St Now Rkohmostd, W154017 110+ in. Roots Soil Application Rate GPD1ft Boundary •Ef 1 T02 as 2vf 0.6 1.0 gw 1Vf 0.4 0.6 gw ivf 0.6 1.0 as 0.7 1.6 -.-.- ----.-- 0.5 1.0 Effluent 02 w BOO 1.30 rnglt. and TSS < 30 rrrg►'t.. CST Number 227429 4CW0 Evalustlon CandueW ToMphons Neffftr 4/13l= 71 &71976 page 2 of . 5 Soil Application Rate GPDW *Eff#1 *EfN2 0.6 1-0 0.4 0.6 0.6 1,0 0.7 1.6 0.7 1.6 property Owner MoUrde, John Parcel ID # 032-1027-70-000 F-11 P^rgnA Boring # L -- j Pit Ground surface elv e. 96-55 ft. Depth to limft*ng factor 105+ In. Horizon Depth Dominant Color Redox DescrOtion Texture Structure Consistimce Boundary Roots In. Munsell Qu. SL Cont. Color Gr. S z. Sh. MWMMMN� I U-11 LUYr.1/j none S1 2rngr MVfr as 2Vr' 2 11-17 10yr4/4 none sci 2Msbk mfr 9W 1Vf 3 17-22 10yr4/6 none sl 2msbk rnfr as 1Vf 4 22-48 10yr5/6 none grs 059 MI CS 5 148-105 Joyr6/4 none S Osg M1 UBoring BoringBo I I El Pft Ground surface etev, % Depth to limiting factor In. Boring # Boring ft. Depth to limiting factor In. Pit Ground surface elev. Soil Application Rate Horizon I Depth I Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell I Qu. Sz. Cont. Color I I Gr. Sz,. Sh.- - i I le =Ef IM L"Em * Effluent 01 = SODS > 30 -S 220 mg/L and TSS :oW <0 50 mg& * Effluent 02 = SOD6,j 30 mg1. and TWC30 MO& The Deparment of Commerce is an equal opportunity service provider and employer. If you need "sisWce to amss arvices or need material in an alternate format, please contact the department at 608-266-3 151 or TTY 608-264-8777, "Ma so To", tric, 98D-83" OL071M L St Croix County, WI Legend Lakes and P vers R.-.-ers anl Strtt,'ims !E Prft�r�'I Intersitates US Highway.; Swe HpOw;e/s, county Kgh-vays Ramps Rcad Right cif Way ill = 60t 0 20 40 60ft DISCLA IMER This map is i cA gunfiWeed tz; L-e accwale. correct. currert or comViele and (:cndu-;tons dr3.vn arty the i e%pop-siblity of tht- r 1)69.03 f* 569-0311 It St Croix County, WI Legend Sect-ons Lakes and R vers Rivers and Streams Interstales US Highway; State Highways County Highways Local Roads RLIst,c Road�- Ra,,r,,-s Road Right of Way Railroads 0 100 200 30011 DISCLAIMER Thi5 nvap is not guarant-eed to bu acculalt, correct. urrent. or compts-ole and A joichi irons draAn are the responsiblity of tit user. CERTIFIED SURVEY MAP LOCATED IN PART OF THE SE1/4 OF THE NE114 AND IN PART OF THE SW1/4 OF THE NE1/4 OF NE CORNER SECTIONUiV 10 � a SECTION 101 T31 N, Ill 9W. TOWN OF SOMERSET, ST. CROIX COUNTY, WISCONSIN; BEING LOT (SURVEY MARKER FD) c a a SURVEYOR 2 OF CERTIFIED SURVEY MAP RECORDED IN VOLUME 12, PAGE 3296, DOCUMENT NUMBER I- W - W Ln W N in co MICHAE _ J. ERICKSON 561970 AT THE ST. CROIX COUNTY REGISTER OF DEEDS OFFICE. LEGEND LA � o v W oa > "� �+ FOUR SEASONS LAND SURVEYING, LLC r ai p ce o �„� N lu W 84$ WILLOW RIVER DRIVE ���LLI i i��t ANY LAND BELOW THE ORDINARY HIGH ST. CROIX COUNTY SECTION CORNER � cc m W N .0 W i9 HUDSON, WI 54016 col ��� WATER MARK OF A LAKE OR A POSITIONED FROM COUNTY MD It o ®� a Lu U. d ��' ...�, � +. NAVIGABLE STREAM IS SUBJECT TO COORDINATES. POSITION VERIFIED � =" '�' u W a ��� ram" �: THE PUBLIC TRUST IN NAVIGABLE WITH MCNUMENT AS NOTED OR TIES LL y W PREPARED FOR, .. �► : ELJ WATERS THAT IS ESTABLISHED UNDER OF RECORD ' JOSEPH PLOURDE � i it W o~ w 2280 C.T.H. "1" � � � ARTICLE IX, SECTION 1, OF THE STATE 3 � W u ; S- CONSTITUTION. p 3/4" X 18" IRON REBAR SET WEIGHING SOMERSET, WI 54025 . o p bu �, ► �l 1.50 LBS. PER LINEAR FOOT � � ' LOT 5 - C.S.M.^V. 10, P. 2878, DOC. #526122 9 1 5/16" O.D. IRON PIPE FOUND 8 NORTH LINE OF THE S1/2 OF THE NE1/4 OF SECTION 10 UNPLA TTED LANDS /4b/z3 (R-5881151'31 "E 1433.001) 588°50'48"E 1433.33' &2 100.47' 1299.86' (R-1300.34') oc (R-99.6fi'1 1 5/16" 0,D. IRON PIPE FOUND WELL 33,4Q" Z SEPTIC 1400.33' 2 I N45009'51'W 0.62' Q in V FROM 40 CORNER VENT � (R-1400.0G) U- G IT ? �? = HOUSE GARAGE �fL N89`23'S4'VY z 8 to 75 SETDACK FROM THE F 46 SHARED c c 1 11 `' ORDINARY HIGH WATER MARK �- 66.W �- C to to �1I J DRIVEWAY EASEMENT ---�� 0 W . u ORDINARY HIGH y -- �- WATER MARK=868.5' co c I? > LOT 1 ! o �. WATER ELEVATION 4122/23 = 867.5CD 12.40 ACRES INC. R/W v� 00, TI-.IS MAP CONTAINS AREAS THAT ARE 540,317 5Q. to C 5fi9.03 in SUBJECT TO THE SHORELAND 12.2i C S88°50'23"E 602.03' �- fo (KY co C ACRES EXC. RIW t cc; \� �,> OVERLAY ZONING D,STRCT; ts- - ° ADDITIONAL RESTRICTIONS APPLY, 531,722 SO• FT. ® LOT 2 o � °� � � � cs` CONTACT THE COMMUNITY EnC\f3.4fi ACRES INC. RJW to `� c ��'L�'• DEVELOPMENT DEPARTMENT FOR w 150,500 SO. FT. w o ca r o � 0 e FURTHER INFORMATION. is o (R-1110.001 3.27 ACRES EXC. R/W BEARINGS ARE REFERENCED TO THE .� j � 1110.25' 142.250 SO FT. Z 0 � � � tr EAST LINE OF T HE NE1 /4 OF SECTION 10, a BEARING S00°36'06"W. (R-333.00') 541,22' 602.03' `"- a (ST. CROIX COUNTY COORDINATE SYSTEM). 333 14� 208.08' 569.03' 33.00' `� � �' T (VERTICAL DATUM NAVD 88) 1 0! (V N88°50'23"W 1143.25' (A-S00 35 ��, I LOT 3 (R-N88051'31 "W 1143.0G) N 00 t r THIS INSTRUMENT DRAFTED BY MICHAEL ERICKSON �. LOT 1 _. 14.55' U JOB NO: 23-52 DWG: CSM C.S.M. V. 12, P. 3296, DOC. #561970 SCALE IN FEET 1" = 150' , P. 32�lj, DOD. �56i97t� E1/4 CORNER C.S.M. .N1. 1/ c DRAFTED: 4/29/23 FIELD: 4/22/23 _ _ _ r _--�.—..._�—�---.�-� SECTION IDT I L 0 150 300 SHEET 1 OF 2 SHEETS (SURVEY MARKER Fd) u CKorx COUNTY OWNER ` Coo ME`�C- �Oa-&)SIOtJ - -- ----------- PLUIVIBERTDRn` C,,r,tMl—rT LIC.# 20'0L3>7(00 .................. TOWN ud""' F S'OO"DV\1\6e!!16T sr-ju Nq 1M. AND/ xx LIU No. bs �zb� at06 Y%140 CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a specified period. (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. (f) The sanitary permit is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314 Note: 1f you wish to renew the permit, or transfer ownership of _ _ the permit, please contact the county authority. if 1792 VAN! L TI aw . .. ........ .. . ........ ....... ........ ..................... . . ............ . .. N�+Ob . . . '... ....... ......... ........................... ... . .. .. ... .. . . .... . . . . . . . ........ SBD-06499 (RI 1/20)