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HomeMy WebLinkAbout032-1065-95-110 a) O y o I o I c o I o I N ~ I d I ~ I w I ~ I C ~ I a I Z I c ' `4 I c LL O v Q I ~ ~ M I z E I 0) U) o z m w am N I- Z I O Z a c c o m Z ~ (n a N O O O~'~IJ1 a 3 O. w a (D n O O O N d UO w N I !mil O O O N 0 .~O Z m z Z Z Z C) N I co E N ~ Y CL 'm 0. " Mn -0 c (o N c G d C) E U z m> I H H =3 1 FL O 3: 3: 3. 1 • a a a U) to U rn 0) o o z N ~ N LO r- E o o 5 m N C IL I CN < co c N o c O o ° m a c r c o a E o 0 U') ti o c C N V a °o I r \ M~ N E m N v (0 a? a) c o o t to CQ N a~ a 1- c m E N Cl) 0 t=y~,l N o E m I • ~i O N fn CO N O Z in, Z L) v~ m R L a V C~ ~ y I EL L IL • eis o m `2 m c tt`1wv o (`o = 3 - oo , _1 A L)a.2 0 0) c) Parcel 032-1065-95-110 osios/zoo? 05:19 PM PAGE 1 OF 1 Alt. Parcel 24.31.19.327F 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 - YAVIS, KAREN J KAREN J YAVIS 731 72ND ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 3.000 Plat: 1623-CSM 06/1623 SEC 24 T31N R19W NE1/4 SW1/4 LOT 6 CSM Block/Condo Bldg: LOT 6 VOL 6/1623 ALSO A PARC DESC 1238/483 EZ-UT-1252/16 727/77-78 LC-1048/152 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) WD-1165/575 24-31N-19W NE SW Notes: Parcel History: Date Doc # Vol/Page Type 07/20/2005 800899 2847/248 WD WD 07/23/1997 a /1997 152 LC 07/23 07/23/1997 ' more... 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/23/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 48,000 112,600 160,600 NO Totals for 2007: General Property 3.000 48,000 112,600 160,600 Woodland 0.000 0 0 Totals for 2006: General Property 3.000 48,000 112,600 160,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 515 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS SUBDIVISION / CSM# G'/~b--7 p LOT # SECTION _T -R /9 W, Town of ST. CROIX COUNTY, WI CONSIN PLAN VIEW SHOW EVERY HING WITHIN 100 FEET OF SYSTEM XrE jliPr JF-6 RTH ARROW ~fifieo6'k ~usi2 Provide setback a d elevation information on reverse o this form. Provide 2 dimens ons to center septic tank manh le cover. 9-p coke BENCHMARK: Ali ALTERNATE BM: J/ 67 SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: -z~ Liquid Capacity: Setback from: Well y~ House Other Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: Length Number of trenches Distance & Direction to nearest prop. line: Setback from: well: ~~-House Other ELEVATIONS Building Sewer ST Inlet: 7 ST outlet: 95 PC inlet PC bottom Pump Off Header/Manifold Bottom of system eLo62.,2, Existing Grade Final grade DATE OF INSTALLATION: - > PLUMBER ON JOB: LzIP LICENSE NUMBER: INSPECTOR: wry, 3/93:jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and euman Relations INSPECTION REPORT ST. CROIX Spfety andauildings Division (ATTACH TO PERMIT) Sanitary Permit 0 GENERAL INFORMATION 289330 Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.: BASSETT, DANIEL SOMERSET CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 032-1065-95-110 TANK INFORMATION ELEVATION DATA A9700145 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. i Septic (rt/ 5 ~xC , Benchmark er/ Aeration Bldg. Sewer (o, /,3' Hol St/ F Inlet 6,84 ~7 TANK SETBACK INFORMATION St/fir Outlet 7 /e2' /U S7~ Vent TANK TO P/ L WELL BLDG. AirIto ntake ROAD Dt Inlet Septic _;O NA Dt Bottom Dosing NA Headed , ' D3, 3 ~ Aeration A Dist. Pipe Holding Bot. System '7 PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Jr 5, v~& -2~ Model Number GPM TDH Lift Lricti TDH F ead Forcemain ngth Did. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT o. Of Pits Inside Dia. Liquid Depth LEACHI cturer: DIMENSIONS /a 7 DIMENSIONS SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM Number: INFORMATION Type O Z C BER M System: Cc~, ~,v~ ^ 3s >SS OR UNIT DISTRIBUTION SYSTEM Header /Wam4oW Distribution Pipe(s) ole Size x Hole Spacin Vent To Air Intake Length Dia. Length Zv_~ Dia. _Y/_ Spacing SOIL COVER x Pressure Systems Only xx Mound Or At- de S Only Depth Over Depth Over xx Depth Of xx Seeded / Sodded Bed /Trench Center Bed /Trench Edges Topsoil E] Yes E] No El Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: SOMERSET 22.31.19.327F,NE,SW,7,31 72ND ,STREET LOT 6/ C I? Plan revision required? ❑ Yes a4c) Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: i d•Safety and Buildings Division SANITARY PERMIT APPLICATION Bureau of Building Water systems 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 8112 x 11 inches in size. , • See reverse side for instructions for completing this application State Sanitary Permit Number 3 y y y programs ❑ Check if evislon to previous application The information you provide may be used by other government agency i 30 [Privacy Law, s. 15.04 (1) (m)]_ State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION Proper.W Owner me Property Location 1/4 1/4, S T S1 , N, R ~ (or& Prope y Own is Mailing Lot Number Block Numb 3 Crate Zip Code Phone Number Subdivision Name or C M Number Cry 11. TYPE F BUILDING: (check one) ❑ State Owned ❑Vill it age y Nearest Road ❑ Public 1 or 2 Family Dwelling - No. of bedrooms Town of III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 3rd ~ S ` ~1S~/~ 1 ❑ Apartment/ Condo I <v 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 online B, if applicable) A) 1- g New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5_ ❑ Repair of an ------System --------System Tank Only______________ Existing System ______ExistingSystem 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 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.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min. Inch) Elevation :Z~~ I 9,yo I/V Feet Feet Capacity VI TANK in gallons Total # of Prefab. Site Fiber- Exper. INFORMATION g Tanks Manufacturerrs Name Concrete con- steel Plastic New Existing Gallons strutted glass App Tanks Tanks Septic Tank or Holding Tank ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ~~j ❑ 1:1 El 1:1 E] E] VIII. RESPONSIBILITY STATEMENT I, the )undersigned, assume responsibility for ins lation of the onsite sewage system shown on the attached plans. Plu s Nam rp Plum er's Si ur O- a s) MP/MPRSW No.: Business Phone Number: Mu(nber'!rAcldress ee Ity, State Code): c IX. COUNTY/ hFPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Agent Signature (No Stamps) XApproved C] Owner Given Initial Surcharge Fee) ~QJ Adverse Determination ItT6 L-aV4,7, 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 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: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. IL Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling- III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line 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 rwmber 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 8 112 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. r~ ~ w s/~7S. . 10,1 -,z.L/ODD D'~,/w - goy ` ~ - r f _ _ _ I ~ i i I I~ ~ I ~ - - -r ~ - _ - _ - _ - i I, L. ~ _ ~ -r _ r 1 _ . _ _ _ _ r - . - - I i i ~ ~ ~ ~ ~ i i - ~ ~ - - - _ -.--1- _ - - - - - i i r i r .t r 7 1 ~ I j } r ~ ! I ~ { 1 i i i .1-..--_.. . ~ _ . _J - - ~ i ~ i 1 - _ _ - , - _ _ y-- _ : _____.---1- i I _ _ i - - + wsconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but Polk not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 032-1065--95110 APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION GOVT. LOT NE 1/4 SW 1/4,S 24 T 31 'N' 9 :Ei0r) W Wendell Vighrock PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 6 na csm 6-1623 2702 55th. Ave. CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE SOWN NEAREST ROAD Osceola, WI. 54020 1715 294-3173 Somerset 205th. Ave. [x] New Construction Use [x ] Residential / Number of bedrooms 3 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 4 5 0 gpd Recommended design loading rate ' 5 bed, gpd/ft2 ' 6 trench, gpd/ft2 Absorption area required 900 bed, ft2 7 5 0 trench, ft2 Maximum design loading rate • 5 bed, gpd/ft2 - 6 trench, gpd/ft2 Recommended infiltration surface elevation(s) trenches 10 2 . 3 -101 . a (as referred to site plan benchmark) Additional design /site considerations alt. area= trenches @ 100.77 & 99.90 Parent material p i t g l a c i a l drift Flood plain elevation, if applicable n a ft I S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ®S ❑ U ®S ❑ U ® S El U g7 S E] U El S ❑ U ❑ S :E111 SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends 1 2.mc;hk mfr gw 9f 91 .6 1 -13 1 2 13-36 7.5 r4 4 none sicl- 2msbk Mfr -C[W if .4~ .5 Ground 3 6 - 51 7. 5 r elev. 102.9t. 4 L1-84 7. Depth to limiting factor +84" Remarks: Boring # 1 - 2'~`'` 2 7-45 7.5 r4 4 none sicl 2msbk mfr w if .4 .5 Ground 3 5-55 7. 5 r4 6 none is os mvfr w na . T .81 1~1e3v; t 4 5-84 7.5 r4 6 none Cos os ml na na .7 .8 Depth to limiting factor +84 Remarks: coy- [Address: Name:--Please Print Gary L. Steel Phone: 715-246)-6200 1554 200th. v New R"ch n WI 54017 ture: Date: 4-11-96 CST 8 PROPERTYOWNER Wendell Viebrock SOIL DESCRIPTION REPORT Page 2 of r 3! PARCEL I.D.# 032-1065-95 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bound 3y Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0-16 1 2 16-3 10 r4 4 none scl 2ms rnfr aw if .5 Ground 3 38-8 7.5 r5 4 none fs os mvf elev. 104.6ft. Depth to limiting factor +82" I Remarks: Boring # 1 0-13 10 r4 4 none 2msbk mfr Qw 2-F1 2 13-32 7.5 r4 4 none sicl 2msbk mfr Qw lf~ .4 i.5 Ground 3 32-47 7.5 r4 6 none elev. 105.81t. 4 47-88 7.5 r4 6 none ;.8 ' Depth to limiting factor +88" Remarks: Boring # 1 0-11 10 r3 3 none 1 2msbk m1 w 2f .5 .6 -34 3 34-84 7.5 r5 4 none Ground a .7 8 elev. 105 . Rt. Depth to limiting factor +84" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05192) STEEL'S SOIL SERVICE Gary L. Steel Wendell viebrock 1554 200th Ave. CSTM2298 NE4SW4 S24-T31N-R19W New Richmond, WI 54017 MPRSW 3254 town of Somerset (715) 246-6200 lot #6-csm 6-1623 N 1"=40' BM.= top of NW lot stake @ el. 100' Alt. BM.= top of pvc pipe @ el. 100..60' ti. 2 LII` 12' 2 3 cce~ a Ak 1 C~ i x K g.~ Gary L. Steel 4-11-97 - N 2';29'44-E-: i X27.19 0 0 r'M 1 6016 3Q FT N 1rt, e' i 00'99 +h R a: M«Vb.6Z Z S } o i I b8'26z \ ~ ~ m 33 i _ m o " . a a z Pi r..N r Co L G ~ z Y, m KPI wW t o m F m v ~ L~, 1s Im f r: m-1v yd W ~gN3~~D ~~j ~98s c6ir w p4'~ CERTIFIED SURVEY MAP• LOCATED IN THE NE1/4 OF THE SW1/4 OF SECTION 24, T31N, R19W, TOWN 0 SOMERSET, ST. CROIX COUNTY, WISCONSIN. OWNER AND SUBDIVIDER WILLIAM E. ON R. R. 1 SOMERSET, WISCONSIN 54025 z w T m w rn a! to p UNPLATTED LANDS N> mm / ~m~ zo W 0 ~ ~D / z S 2° 29 44 6\ 2 W ° / 0 O 292.84 _ m \ 4 rn z / w0 \ / O~ (D N) I 0 ( c I .i m .n m Q O w w = I ~ ~O is o o z , c z m m -c I lz N 1~ cn rn D m o m I IT jr co N m OD Lai G) I Ir .gyp ID Om O ~ ~ I ID I-I a, -n N N_ N 0 I I-1 I-1 0 - O = O I I--I Im o 0 O D I I Im to w I lo s 2° 24' 40"W ID m = c z i Irn 423.57 I ID Iz 0 = m rn lo * I rn 0° / > m z,,~// jN m z rn / c) m i i 0~2 oro ) i % % APPROVED mm ~z 61 JAN 0P, 16 ='m _ om £Z9T a$vd 9 'TOA M„OZ,S£,L8N M„8Z,62,6ZN SL'19T M„bZ1L£o8SN ,S8 '89T ,L91 „ZS,SS,LS V-2 M„L0,6to69N M„OZ,SEoL8N LT'Z8 M„£T,Zbo8LN ,OS'Z8 199Z ,2To9t1,LT Z-T SINUNVI axoHO ONIEVElff H19Nd'I Sf1IGV'd dZJNV ffAidno QNZ .LST GUGH0 'ItTUAHO 'QNnOd `ddId NOUI aT • '.LOOd gVaNI'I/.#89'T ONIHOIdM `JaS `ddId NOUI ,VZX„T o 'ZNakMNOW 2idNUOD NOI,LOdS .k.LNn00 CMD R'l ,~~~11{111111, SZOVS NISNOOSIM `laSUaWOS i ONOSNVAIS ~ i nONO*,p T # "d ' 2i 1o N Nd77Idg 'd WITTIM. UUCI IAIGUS GNV UaNMO • w Q ZZOtiS ut sTM. nuTuTud aanTd % aaaS T M' M £ T T Mg746%, ~1~ •00 BUTaGQUTBUg.uap20 S9ST-S8 'oN qof ZSVT-S uosuuMS ',L saiuuf S86T `TT (Tnf :ajuQ 'GOUVUTpao BUTUOZ AjunoO.xioa0 -IS aqa jo qV•S uoTjoaS puu saInivIS UUTSUOOSTM age. Jo V2'9£Z UOTI:)aS ;o s.UO'TSTnoad aqZ gjTM paTTdwoo ATTn; aAVq I juqz pup joaaaoo aau.d-eut puu UOTIdtaOSap. anoqu auk. Iui{I A;Tzaao I •ssaT ao aa0w saaOu L00'£ 2u?aq `ssaT aO aaoui `Iaag aaunbs 996`0£T SUTvIuOO Taoaud stgZ •2UTUUTBaq ;o 2UTod,agj ol ,SL'T9T M „17Z,L£o8SN sauaq paogo asogm ATaa4saMujnoS aAUOUOO aAano sntpua ,L91 V Uo auTI STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER 06C17;'_' /m, cc tiJj' MAILING ADDRESS ~7d'd //B U 7 S~0 77 PROPERTY ADDRESS (location of septic system) Please obtain from the Planning Dept. CITY/STATE PROPERTY LOCATION 1/4, 1/4, Section , T 35 N-R_jj_W TOWN OF ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER ~U CERTIFIED SURVEY MAP Y0 8 , VOLUME L , PAGF/, LOT NUMBER 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 licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year ex i SIGNED: DATE: _ St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. owner of property Q 01;&/ Location of property /1/,-' 1/4 1/4, Section, T .33 N-R_/9 W Township oN'rcr'.S ~f Mailing address /,?go S') "q J1 'd A" 7 Address of site 7 Subdivision name Lot no. _ Other homes on property? Yes No Previous owner of property / Total size of property loo 2 Total size of parcel .3, Ov Date parcel was created /-02- 36 Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes No Volume 6 and Page Number ~.3 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in_ the ffice of the County Register of Deeds as Document No. S / and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of the County Register of Deeds as Document No. vr~gl44-- 'A natu f plicant Co-Applicant S_ 6'°- ~'7 Date of Signature Date of Signature VOL 2 P CE B a ~vC'` y X59318 STATE BAR OF WISCONSIN FORM 1 - 1982 WARRANTY DEED DOCUMENT NO. REuISTE'I'S C^ ICE 1 ST. CROIX CO., WI This Deed, made between Dennis M. Neumann and 'Dawn J. WdlaMoog Neumann, husband and wife as survivorship marital property MAY, 14 1997 Grantor, f 9:30 AM and Daniel W. Bassett and Monica A. Bassett, husband and l~~k wife as survivorship marital property fWgister of D"da Grantee, Witnesseth, That the said Grantor, for a valuable consideration of one do l la j and other good and valuable considerations conveys to Grantee the following described real estate in St. Croix THIS SPACE RESERVED FOR RECORDING DATA ~j County, State of Wisconsin: A parcel of land located in the North- NAME AND RETURN ADDRESS ` east Quarter of the Southwest Quarter (NE4 of SWt-), of ~ V G 6 r 0 c- Section 24, T31N, R19W, described as follows: Commencin W e a 2 at the West Quarter Corner of said Section 24; thence ~ 7 A V South 87°57' 05" East, along the North line of the 'SC_ e o G- j'✓ O Southwest Quarter (SW4) of said Section 24, 1745.94 feet; thence South 02°24'40" West, 423.57 feet to the North line of Lot 6 of Certified Survey Map recorded in VOlume 6, page 1623; thence North 87°35'20" West, 032-1065-0-80 & 031-1065-95-110 along said North line 178.02 feet to the beginning PARCEL IDENTIFICATION NUMBER of a curve concave to the North, said curve having a radius of 266.00 feet, a central angle of 17°46'13" and whose chord bears North 78°42'13" West, 82.17 feet; thence Westerly along said curve 82.50 feet to the end of said curve; thence North 87°30'16" West, along said North line, 36.55 feet to the Northwest corner of said Lot 6; thence South 02°29'44" West, along the West line of said Lot 6, 66.00 feet to the point of beginning; thence continuing South 02°2944" West, along said West line, 226.84 feet to the Southwest corner of said Lot 6; thence North 88°16'08" West, 26.50 feet; thence North 02°29'44" EAst, 227.19 feet; thence South 87°30'16" East, 26.50 feet to the point of beginning; AND Lot 6 of Certified Survey Map recorded in Volume 6, page 1623, Document No. 408894, being.located in the Northeast Quarter of the Southwest j Quarter (NE4 of SW4) of Section 24, T31N, R19W; This is not homestead property. (is) (is not) TRA~SFER Together with all and singular the hereditaments and appurtenances thereunto belonging; And grantor warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and reservations of record and will warrant and defend a same. ay 19 97 Dated this day of 01 (SEAL) , (SEAL) Dennis M. Neumann (SEAL) t-x~ Il P~t~/YYVR/1'U~ (SEAL) Dawn J. Neumann j' AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, ss. POLK County. 1 A„e ~-15 riav of ~ P86 004 CERTIFIED SURVEY MAP LOCATED IN THE NE1/4 OF THE SW1/4 OF SECTION 24, T31N, R19W, TOWN 0 SOMERSET, ST. CROIX COUNTY, WISCONSIN. OWNER AND SUBDIVIDER WILLIAM E. ON R. R. 1 SOMERSET, WISCONSIN 5402S z CD W o -o rn w UNPLATTED LANDS mm mm w0N -zjD Z -i A S 2° 29 44 W o 0 O ;o Z 292.84' / - N m \ 0 / m N z / a0 0 \ / O \ 1 \ 1 0 0 c: -I O m 0 0 z m i Ic is m 4 --1 OD I Iz Ic rn z I~ N m D m y o I Iv jr- co N m O W G) ZZ I Ir D (n CD . m O = I N ID h u -n N -0 I I~ 0 = m 0D ~ D I Im Iv 0 0 I Io S 2° 24' 40"W jr- m = 0 z I Ir_ 423.57 ID / m I D Iz I = / m I 0 m i lz IN In N / z 0 to I v m z ''ZIv) / G / .0 ro % APPROVED rn OZ JAN 02 IPR36 j --4 rN~l o m 4 z Wisebnsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page _ of ` Labor and Human Relations 0 Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code C I el^ Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but N.- ZILOX not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or EL dimensioned, north arrow, and location and distance to nearest road. n APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION IEW D ST CR:h, PROPERTY OWNER: PROPERTY LOCATION (or f GOVT. LOTAIE 1/4,"51,_j PROPER OWNER': ING AD ESS LOT # ffL~OCK # SUBD. NAM . ''i 11 - ' 4th C , STATE ZYTCODE PHONE NUMBER ) VILLAGE, ®f OWN NEAREST RO New Construction Use [ Residential / Number of bedrooms [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe c/ Code derived daily flow X22 gpd Recommended design loading rate ~ 2 bed, gpd/ft2. trench, gpd/ft2 Absorption area required bed, ft~7 trench, ft2 Maximum design loading rate bed, 9Pd/ft2trench, 9pd/ft2 Recommended infiltration surface elevation(s)Pc f s "m 'V &n .'g ©ft (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable It S ILL HOLDING TANK = Suitable for system C ENTIONAL MO D IN UND PRESSURE A RADE SYSTEM IN U= Unsuitable fors stem S❑ U S❑ U jgr )Fl AO [I U So U ❑ S U El S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench Ground 3 - 1~~4 5-, ,5;r Al 1W NIA "61 l e tvft. Depth to limiting face q3 - Remarks: Remarks: Boring # n / X44 r O-S Ground OV. ft. Depth to limiting factor f 3 Remarks: CST Name: Please Print f Phone: l Address: Signature- D e: CST Number: r '7 0) PROPERTY OWNER ,fi990/'' 6e1WZ?/,`SOIL DESCRIPTION REPORT Page _o€ PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourxby Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench Ground 3 , g 9 Jev ft. Depth to limiting factor ~44 •0 Remarks: Boring # Ground el v. _ ft. Depth to limiting Remarks: Boring # A, 3/-L h. w All Ground / ' " 7 ft. / n-v Depth to limiting Remarks: Boring # 'M Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) Soil Test Plot Plan Project Name Lennon Germain Byrpi~Bird Jr. Address 2005 Hwy 35 Somerset Wi 54025 TM #3479 Lot Subdivision Date 6/2/96 NE 1/4 SW 1/4S24 T 31 N/R 19 W Township N. Somerset Boring O Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Fence Post Orange Ribbon System Elevation 93.4/93.0 *HRpSame as Benchmark 72nd St 225' B-2 30' B-5 1 , 30' ep A o 3% B 3 Slope c~ 03 Pri A Bedroom 30' House 30' 40' M.g* B-1 30' B-4