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HomeMy WebLinkAbout032-1060-30-000 4 0 ~ °o o p e°y I ap v ° ~ I h o I N N y RR L (0 C N X y S o ~ ~ Y V C N w w y y C_ C Z C ? C U. O m N N 3 '0 00 y O a ~2w I I 3 v v (D z H rn w E Z = o z w a m N H Z 0 c O z z :!t c u T o y - a+ Z c o v)F~ ~ z I c E -a N w CL ~ ~ c I d 0 O O Z m Z z N OI O d N N ~v ~ £ V _ N H d c C N C O LO 0 d -Q C N Z c> > 0 U) U) U) 1 ~I O z 0 a a a E (n m ~ U ~ rn rn ~ I ti > rn Q Q o o `I Loo 3 N O co LO ml a U-) C N Q } U) m 00 d O ~V O y ocC O 0 O U N 3: ,r- E to M y V a 0 M O C O T i M _ Y C ) N V N r- oi CF W O I f0 ~ N Q73 O C" cl) E Y N C t O N U) N O z c: (n 0 ~ _ - II V Ct tC ~ d ~ t n L: a te • a m .2 m rT~~ y C 3 3 R A U a 0 v) U r L s i 4 b• . STC - 10 4` AS BUILT SANITARY SYSTEM REPORT c• OWNER ADDRESS SUBDIVISION CSM# LOT SECTION T-3Z_N-R1 W, Town ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYS EM 3 nCi3w~ i INDICATE NORTH ARROW Provide setback and elevation information on rev rse of this form. Provide 2 dimensions to center of septic tank manhole cover. s ~ 7 BENCHMARK: ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: Z~)S Liquid Capacity:/ Setback from: Well ~Q House_ Other Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: 2 Length Number of trenches Distance & Direction to nearest prop. line: Setback from: well:_ Housef Other ELEVATIONS Building Sewer ST Inlet, ST outlet 10,7j,2 PC inlet PC bottom Pump Off Header/Manifold Bottom of system 91 Existing Grade) Final grade 99'-5-- DATE OF INSTALLATION: ' - PLUMBER ON JOB: LICENSE NUMBER: 275-9 INSPECTOR: ea 3/93:jt Wisconsin Department of industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildirfgs Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Permit Holder's Name: ❑ City ❑ Village Town of: State Plan o.: GERMAIN, MICHELLE 1i SOMERSET CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic r~ h Benchmark Dosing Aeration Bldg. Sewer S_35" 98. y~ Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet q g g 3_11 Vent TANKTO P/L WELL BLDG. A irito ntake ROAD Dt Inlet ir Septic f'-d5 ' p' /b' 'd S, NA Dt Bottom Dosing NA Header / Man. s 97, 0 Aeration NA Dist. Pipe 9 • l~(„ ' r Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade 3 9 ' Manufacturer Demand ~Y✓; qc/ "1 5- Model Number GPM TDH Lift Lricti System TDH Ft Forcemain h/ I Dia. Fi Dist. To Well 7 r SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION `>3 DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING manufacturer: SETBACK CHAMBER INFORMATION Type O Model Number: System: --G-uP a.' d G '?S tiles OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center 3p Bed /Trench Edges Topsoil . C] Yes [I No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: SOMERSET.23.31.19W, NE, NE, LOT 3, HWY 35 ~a Jz/j Plan revision required? ❑ Yes ["No Use other side for additional information. ~U Uq 7~, SBD-6710 (R 05/91) Date I Spe&4s Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH f SANITARY PERMIT NUMBER: Who 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 81/2 x 11 inches in size. 'Is • See reverse side for instructions for completing this application State sanitar ermit Number OT?'- The information you provide may be used by other government agency programs ❑ Check if revision to previous application IPrivacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION PropertOwner ame Property location r AIX 1/4 1/4, L2 ? T , N, R E/O Pr pertO,_ 's Mailin A dress of Number Block Numb r it tate Zip Code Phone Number Subdivision Name or CSM Number ( ) II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ cite Nearest oad ❑ VII age ❑ Public 1 or 2 Family Dwelling - No. of bedrooms 11 Town OF otild III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church / School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel / Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box online B, if applicable) % A) 1. bf'New 2. E] Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. E] Repair of an SystemSystem 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 JA 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 Req q. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min .%lrnch) Elevation / Feet eet VII. TANK a in galloaclt ns Total # of Prefab. Site Fiber- Ex per- INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Existin strutted T ks Tanks Septic Tank or Holding Tank ❑ E Lift Pump Tank /Siphon Chamber ❑ ~ E] ❑ 1 1:1 VIII. RESPONSIBILITY STATEMENT I, the ndersigned ssume responsibility for i )aI Iat o he o site sewage system shown on the attached plans. Plu ~be Na Lar in Plumb gnat amps) MP/MPRSW No.: Business Phone Number: I :p ~ I umber" Address (S et, City e, Zi Code): r i IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved S itary Permit Fee (Includes Groundwater ate Issue Is ing Agent Signature (No Stamps) Approved ❑ Owner Given Initial 9 40 Surcharge Fee) r Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: U K.1/ SBD-6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To; Safety & Ruildings Divi.ion, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 1 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. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit-,Check only one online A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be suhn :tied *o the co lnty. The plans must in( hide the follovvmcf : A) plot plan, drawn to scale or with co plete ct+ nens!or s, for ai c: „f oding tank(s), septic its) or _r - t-nenttanks ; building sewers, wells, Ovate: nn, ii~si, ester se Tire, st,., 7c lakes; pump or siphon ,!cs, distribu~;(,)•i koxes; sal af~_orpl:on systems; repla(:emen >/,rr r7i ,-seas; anL_ the loc,!iof o the building served; ''1t~riZC tvl IC:i veiilcal elev< _)n reference points, C) complete Spec! hcatlons or purrps ant Jntr015; dose volume, elevation differences; friction loss; pump performance curve; pump model and pump r,; nuf ;urrer; D; cross section of _ v-: soil absorption systen7 if required by the county, E) soil test data on a 115 form; art::: F) _311 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. ~~s' ~a~~' Wyk ',~,Y,~~~i s~~r ~~~i✓, R°~'r,J t~ ~ - IN S A~el its ~r r ~ p ~D -All t4 3 Yfisoonsin'j)epartmant of Industry, SOIL AND SITE EVALUATION REPORT Page J of Labor and Human RBlations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY J Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but 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. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE Al PROPE OWNPROPERTY LOCATION GOVT. LOT - 114 1/4, T N,R e(or A) 21, PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # S BD. NAME OR CSM # 3 CI STATE / 21P CODE PHONE NUMBER ❑CITY ❑VILLAGE 7OWN NEARS T ROAD Pd New Construction Use [;A Residential / Number of bedrooms ~ Addition to existing building ) Replacement [ ) Public or commercial describe Code derived daily flow -ZTe,, gpd Recommended design loading rate _bed, gpd/ft2._Ztrench, gpd/ft2 ,-bed, 9Pdlft2_trench, 9Pd/112 Absorption area required ` bed, ft2 ~S trench, ft2 Maximum design loading rate -7 Recommended infiltration surface elevation(s) _ ft (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U=Unsuitable fors stem ®S ❑U ®S ❑U IMS ❑U 0S ❑U ❑S 21 U ❑S OU 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 - 3 Liz, Ground 3 elev. Depth to limiting factor Remarks: Boring # / g - J S 1~ 21V Al~ ~7,5- 9e C 1 Ground / + elev. L 1h 5e 'llel - - ft. Depth to limiting factor Remarks: CST Name:-Please Pri Phone: - 2S 44114. Address: Signature: Date: CST Num or: - ? . n- zj~L' L PROPERTY OWNER ~ SOIL DESCRIPTION REPORT Page j2- of PARCEL I.D.# n►.rii .t Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tw& 1 El e Ground 3 : - elev. ;yj4j ,7 22,,1, ft. - ` Depth to limiting factor Remarks: Boring # 1 E Ground elev. G S ~ ft. f Depth to limiting factor Remarks: Boring # Al 14 # Ground elev. eX A/ -14 s Depth to limiting factor 9l_ Remarks: Boring # f t Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) A1.491 s,~'c~ iqi✓ ~,vo~'r•~~r~ SO/~rlc'-S.c~ ~V~ .5"7!/x5 X .p~ 1~'•aO,,{%„~ /r'~,~,n- ea~/'.S~`xc/~.~- ~1/ado `~~,s, s i i s FILED do 17 AUG 2 9 1995 ► KATHLEEN H. WALSH Register of Deeds j j SL Croix Co, M 53314'7 CERTIFIED SURVEY MAP Located in part of the NEJ of the NE$, Section 23, T31N, R19W, Town of Somerset, St. Croix County, Wisconsin, including Lot 2 of Certified Survey Map recorded in Volume 5, Page 1355 at the St. Croix County Register of Deeds Office. OWNERS Walter Germain Mike Germain P.O. Box 68 N Somerset, WI 54025 no m CO w a ~o o ? NE Corner N ,n Section 23 3 N N 0-0 co N z - o 1 m CD N CA 0 C) 0- OT I 9 o N (A lY C. 6z. lb9, f 0o co o - - - o VOL. 5, PG. 1355 = ? m - - - l0 75' 8°49'03"E 380.5 om, 22'= , 96.84' Ct T17. 266.Of,' CD AREA * o LOT #3 I ` F 5r Icn ~L x 4.01 Acres Inc. R/W I` z ° °p O1o z I-1 I~ 174,487 Sq. Ft. it °p o op° 'ccoo No I-u o • 3.00 Acres Exc. R/W p LOT ' 3 130,704 Sq. Ft. tO- Jul ICI ~ I t11 I f co s I h~ x o 0 LOT #4 I Cj m x. w I C-) N• o x_ C r trj C) 3.96 Acres Inc. R/W ZE N o fD 172,735 Sq. Ft. I t° a W CD s o C O a d 3.00 Acres Exc. R/W N88°49'03"W 376.80' ~ e a 0 130,724 Sq. Ft. I2'_ + + c 0 C 283.69 93.11 Iy co m Ct 0 _n -0 o d 1< r- I I L c a- ID ~ ICO c -0 :3 N I` N I L7 N n m° ccoi b rN.> 'r y IL7 0 r ? y~,,a~ROMEO `2 ~ N N O AP _ L O T 4 • 0~1 t0 7 AUG 2 4_'95; W O C co CD Sr, CROIX COUNTY loo' Ils' N _n 7 Comprehensive Plans C a Zoning and 10'i5283.68 89.37 Parks Committeo N88°5'28"W 373.05' South line of the not recorded NE> of the NE>4 If o , c A within 30 days of OT % ~ ' (-T1'4Yta { tJt~ approval date p, - loProval shall be S. M. o y Sk~i -A & void VC)L. /0, FIG. 295 FiutJ:.~.t'j~ Section e23 k~P '~Ys1.400$ SCALE IN FEET 1" = 100' 100 50 0 100 200 300 This instrument drafted by Ed Flanum Job No. 95-69 VOL. 11 PAGE 2984 STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER MAILING ADDRESS PROPERTY ADDRESS (location of septic syste ) Please obtain from the Planning ept. CITY/STATE PROPERTY LOCATION N 1/4, E-1/4, Section a3T 31_N-R_ 8.-W TOWN OF Sric~ S~\ ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP`B VOLUME , PAGE, 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. UWe, 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 expiration date. 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 A-W Location of property 1/4 t4-,. 1/4, Section, T_N-R_10 Township ~pn.~tS Mailing address Address of site Subdivision name Lot no. 3 Other homes on property? Yes--"/ No Previous owner of property a'~ Total size of property 3-t wZIx" Total size of parcel 3? a " q5 Date parcel was created 9 2- .1 Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house) ? _ Yes No Volume ~IZZ and Page Number,22Z 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 office of the County Register of Deeds as Document No. 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. t i nature of Applicant Co-Applicant -ag-CN~~ Date of Sionaturp Plato cif Sionatiirp •330®C]~ State Bar of Wisconsin Form 2 - 1982 5 J WARRANTY DEED per'- 1137PacE29'7 VOL DOCUMENT NO. ~ " Rbed for F.o..: . Fred A. Meyers, a single person, AUG 2 8 1995 42 10:00 A.;.; , conveys and warrants to Michael J. Germain and Michelle M. Germain, husband and wife, /OOOPd THIS SPACE RESEERVEDD FF.O,R, RECORDING DATA NAME AND RETURN ADDRESS `%•o~K[~ /hCCl1~( the following described real estate in St. Croix g S a O County, State of Wisconsin: SaWt& •d-mot 10Z S-Cloa l (Parcel Identification Number) Part of NEl/4 of NE1/4 of Section 23-31-19 described as follows: Lot 2 of Certified Survey Map filed October 11, 1983, in Vol. "5", page 1355. This is not homestead property. IBC (is noo, Exception to warranties: Easements, restrictions and rights-of-way of record, if any. k, Dated this 7 day of August , I9 95 (SEAL)~• (SEAL) = Fred A. Meyprc (SEAL) (SEAL) a , AUTHENTICATION ACKNOWLEDGMENT Signature(s) Fred A. Meyers STATE OF WISCONSIN County. authenticated this day of gust , 19_25 Personally came before me this day of 140A 13AAA- , 19_ the above named • Kristin Ogland TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by §706.06, Wis. Slats.) to me known to be the person who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY Kristina Ogland Attorney at law Notary Public County, Wis. (Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If not, state expiration date. necessary.) 19 *Names of persons signing in any capacity should be typed or printed bet heir signatures. DEED t==OF WISCONSIN Wisconsin Legal Blank Co.. Inc. FORM Na, 2 -19U Milwaukee. AMLM .76-'W*n*..' XTN"i~ -Irw'.'- bkK 17'a, V .Sr FAX ST. CROIX COUNTY ZONING OFFICE 1101 Carmichael Road Hudson, WI 54016 (715) 386-4680 DATE: 5- q A TO: Fax Number: 7 to Name: Ml FROM: Fax Number: 386-4686 Name: Number of Pages Including Cover Sheet IF COMPLETE AND LEGIBLE INFORMATION IS NOT RECEIVED, PLEASE CONTACT: NAME: TELEPHONE NUMBER: ~lf~v `f(& ST. CROIX COUNTY WISCONSIN q'l ZONING OFFICE n p N n p p p p p ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road I.N dlv Hudson, WI 54016-7710 - (715) 386-4680 June 5, 1998 Remax Team 1 Realty Attn: Mike Germain 103 Main Somerset, WI 54025 RE: Septic Inspection for Michelle Germain located at 2094 Highway 35, Lot 3, Town of Somerset, St. Croix County, Wisconsin Dear Mr. Germain: A septic inspection of the above referenced property was conducted on October 9, 1995. This property is located in the NE'V4 of the NEY4 of Section 23, T31 N-R1 9W, Lot 3, 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. incerely, Mary J. Jenkins Assistant Zoning Administrator /sm Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page J of Labor and Human Relations Elivision of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but ~5/- ~~a' Z 71 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. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PRO PE OWN PROPERTY LOCATION ZIA GOVT. LOT 1/4 1/4,S T N,R PE ,e(or~ lf~*f 1j) PR PERTY OWNER' :S MAILING ADDRESS LOT # BLOCK # SUBD. NAME ORS 02 CITY STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE OWN NEA T ROAD s-- ( ) .'4 /T New Construction Use Residential / Number of bedrooms [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow :~/S~ gpd Recommended design loading rate bed, gpd/ft2__Z -trench, gpd/ft2 Absorption area required bed, ft2 ;.1-'S trench, ft2 Maximum design loading rate _.,~bed, gpd/ft2_,_g_trench, gpd/ft2 Recommended infiltration surface elevation(s) 9f ft (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U=Unsuitable fors stem ®S ❑U ®S ❑U MS ❑U 0S ❑U ❑S 21U ❑S OU SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring # Horizon in. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. Bed Tre & Ground 3 •3 S' 'X0 .1116 zy 14L elev. /1t• 3~ _ s _ - Depth to limiting factor Remarks: Boring # , Al /0 3 - d s' ~ s Ground elev. lot 1h 5e I/ /If g ft. j Depth to Mr. -OW limiting iWID factor > 99 10 Remarks: T CST Name:-Please Print,, Phone: A :C -1 "1 S Address: el/ b Signature: Date: or: Is - 9,5, /JPROPERTY OWNER SOIL DESCRIPTION REPORT Page,2- of PARCEL I.D. # r N f Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounclary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench •%4\4};y Ground 'UZ elev. Depth to limiting factor L Remarks: Boring # J Ado, Is Ground / elev. G~ Ss / AIZ 27,1, ft. Depth to limiting factor 7~l Remarks: Boring # 1 a"j Ground elev. z /wn ft. _ Depth to limiting factor 79l Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) X r r ~J i i i i at r CERTIFIED SURVEY MAP Located in part of the NEJ of the NEJ, section 23, T31N, R19W, Town of Somerset, St. Croix County, Wisconsin, including Lot 2 of Certified Survey Map recorded in Volume 5, Page 1355 at the St. Croix County Register of Deeds Office. OWNERS Walter Germain Mike Germain P.O. Box 68 N Somerset, WI 54025 wa co fi ? NE Corner N Section 23 B (D N a O -n (D C-t o & S CD N W N (~D W O a z t0 0 3 Rl CD W N .01, n C> h 0- C2 N N tY co m O - - - - C 5' PG. 1355 0_ = - 100' 75' S88°49'03"E 380.531 om, 22': N 283.69' 96.84' Cr i 4 N AREA 18': -0 A-1 LOT #3 IL N r 1(n IC 4.01 Acres Inc. R/W i ~ z r o o z 1-1 I~ 174,487 Sq. Ft. i 1J oo %D 0 00 oo I1 I~ 0 • ® 0 3.00 Acres Exc. R/W r o LOT o o o - I 130,704 Sq. Ft. 1?I w 1° IG~ I-I I h l ~o l J - 1 rh x o a v> ti LOT #4 I Cj m LN88049103"W w I U o x3 t2i 3.96 Acres Inc. R/W AE ;o o Z 172,735 Sq. Ft. F a (1) °a z 3.00 Acres Exc. R/W 376.8R? m a v 'a o 130,724 Sq. Ft. Ir- = o 0 `D C 12'_ 283.69,' 93.11' Zia 0( (D rt 0 D o a C Ir- ID ICj J v D ' 0~ (D N I` l0 N IL7 (D f) v 0 CD N 7C I~~ N l0 N IL7 Y r N r u 7 LOT: 4 N m o o ? W a 0 00 c 100' 116, Ct N -n C 7 d 10'± 283.68' 89.37 N8805.512 811W 373.05' South line of the NE1q of the NEk n o 0 O.^ j no LOT F N Oo C. S. M. 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" 2r r 19 Og xl W o J I I, I _ U- W r In I M ; I-I Z of 3 :c 0 z to Z 0 QLL N JI N _ I I I 1 W0 J (7IW % M ~WQ q (dI j Z IzHi l k" I r14 X LL D F- U rn N v rnI I O ¢ F Lu u, Q I I Z v o S 31 f-. r w 1-1! 7 LA U "cu) to I Z 'ri * J SCALE IN FEET ; i CD rY _ ( tY i uj 11 Lo LA n W H h- iL Iw qLl c; SW CORNER C z C/) OF NW1 /LI OF NE1 /4 ) I L rev W ' 0 75 SOUTH LINE OF THE 'Z I I w irv w N1 /2 OF "1 HE NE1 /4 i° N87 29'59'V 00 ' 272.81 9x.1.19' k! M N 87°29' 59"W 2699.4 ~~y_, , o ~ X 1 0 1 ,YjS' I z U N P L A T T E D L A D- rn~ M in N M cn M CENTER OF E1 /4 CORNER SECTION 23 SECTION 23 T31N, R19VV T31N, 121911' N 87°36' 35"W 2691.21' Drafted by Walter J . Gregory. -OCATION: TOWNSHIP/fdZ3%cb&: LOT NO.: BLK. NO.: SUBDIVISION NAME: NE VVE Y 23 /T31 N/R19 bpr) W Somerset :OUNTY: OW E R S AM : MAI-LIN DDR S: St. Croix ISE DATES OBSERVATIONS MADE NO.6 D CO M RCIAL DESCRIPTION: PROFILE ESTS: Residence 3 n/a New ❑Replace 4-1-88 n/a SATING: Ss Site suitable for system Ua Site unsuitable for system ONVE L: JMOUND: IN-GR UND N-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) ©S ❑U ®S , ~ X3 S DU 0 S )2U ❑ SX011 conventional f Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the nder s.H63.09(5)(b), Indicate: class 2 Floodplaln, indicate Floodplaln elevation: n/a decimal' PROFILE DESCRIPTIONS page lOMCI ORING TOT ELEVATION P H R D ATE ",ES CHARACTER O SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH UMBER DE BSE V D TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 1 1 7.17 104.90 none >7.17 ,75bl.1. .75bn.sil. 1.67bn.s,1. 4.00bn.c.s. 1.2 7.35 103.90 none >7.35 .67bl.1. .50bn.sil. 2.2.5bn.s.l. 3.92bn.c.s. 1.3 7.25 103.20 none >7.25 .75bl.1. .58bn.sil. 2.50bn.s.1. 3.42bn.c.s. 1.4 6:34 101.05 none X6.34 .50bl.1. 2,67bn. s.l. 3.17bn.c.s. I.5 6.51 100.23 none >6.51 .42b!. 1.42bn.s.s?.1..2.00bn.s.l. 2.67bn.c.s. PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP I WATER LEVEL-INCHES RATE MINUTES UMBER INCHES AFTERSWELLING INTERVAL-MIN. PER INCH )T PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- tal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent and slope. (STEM ELEVATION 100.40 W 7"'J"" _ - - - - i - - - - - -All ItN a 023 i e undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and -nethods'specified in the Wisconsin dnistrative Code, and that the date recorded and the location of the tests are correct to the best of my knowledge and belief. AE (print): TESTS WERE COMPLETED ON: .y L. Steel 4-1-88 )RESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): I N. Shore dr., New Richmond, Wi. 54017 22,98 CST SIGNA 'RIBUTION: Original and one copy to Local Authority, Prol )wm, d Soil Tester. IR-SBD-6395 (Ft. 02/82) - OVER -