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HomeMy WebLinkAbout032-1042-30-175 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 552325 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Tennis, William J. Somerset, Town of 032-1042-30-175 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: G 15.31.19.209630 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. rIVY Benchmark 6 1 ~~a Septic F'7 4A / ` J~f ~r 'l d 1a Alt. BM (7 1.75/6z. g 5 Aeration Bldg. Sewer I. 7z /60 (09 Holding St/Ht Inlet !L q St/Ht Outlet . q c~g . TANK SETBACK INFORMATION / TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Dt Bottom Septic 70 / 74 Dosing /V Header/Man. Aeration Dist. Pipe • 415 OL. -15 5. 7 Holding Bot. System 7.o5 9.85 5 PUMP/SIPHON INFORMATION Final Grade Manufacturer Demand St Cover GPM Mo umber T Lift Friction Loss System Head TDH t Force mai lb__~ Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width 11-engity No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Liquid Depth DIMENSIONS 3 V~ 7L Z , ____1 , SETBACK SYSTEM TO ij P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR J /JA- A~ UNIT Model umber; TZAV (System: r 7L 79' ar< $ 2, DISTRIBUTION SYSTEM S ~ 4010 /5 /'F Lei. Header/Manifold Distribution x Hole Size x Hole Spacirq,,,,... Vent to Air Intake / Pipe(s) Length_i:_ Dia 11-engthDia___N!~!, Spacing 44 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over / Depth Over xx Depth of reeded/Sodded xx Mulch d Bed/Trench Center y~ Bed/Trench Edges` Topso Yes E No No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 2194 59th Street SOMERSET WI 54025 (NE 1/4 NE 1/4 15 T31N R19W) NA Lot 3 Parcel No: 15.31.19.2091330 ref ~ ~oJate. 1.) Alt BM Description = 1 2.) Bldg sewer length = 's 9 - amount of cover = 1.,6+- /s4- 61> al C> 12, J Plan revision Required? R Yes No L I 12] - Use other side for additional information. Date Insepctor' Signa Cert. No. SBD-6710 (R.3197) commerce.wi.gov Safety and Building _ County 201 W. Washington Ave.; 1 .,62 'tir Madison, WI 53707- 16 S Sanitary Permit Number (to be filled in by Co.) Depa eM "7 Sanita3 mit pplication State Transaction Number In accordance with s. mm. 83 y i3 ° Ee, sub ission of this form to the appropriate governmental f V unit is required pri or o obtait nlg as sari Not Application forms for state-owned POWTS are Project Address (if different than mailing address) submitted to the D ent C(e(~IjV* o ation you provide may be used for secondary purpo in accordant with th R ts. -y- I. Application Inf nl 1nt All Information ~C c / l Property Owner's Nam Parcel # t ~ r~3 a - ~~ya 3©- Property 6 3 Owner's Mailing Address Property Location r2®~ 1~r 7 t 5- Govt. Lot City, State Zip Code Phone Number y, y4 Section ,(-Sa / circle one) ~J !O T3/ N; R E or W H. Type of Buil ing (check all that apply) Lot # I or 2 Family Dwelli g -Number of Bedrooms - 3 Subdivision Name ~ 1 l Block # (1 V -5)_,_~ -7 .-7 ❑ Public/ ommercial -Describe Use / ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of Town of III. Type of Permit: ( eck only one box on line A. Complete line B if applicable) A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ PPermit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS S stem/Com onent/Device: Check all that apply) ANon-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-G de ❑ Mound > 24 in.. of suitable soil El Mound < 24 in. of suitable soil El Holding Tank El Other Dispersal Component (explain) 4. afi,&eatment Device (explain) V. Dispersal/Treat ent Area Information: ' VU(c? ✓W`~ e S - op Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required Of) Dispersal Area Proposed (s System Elevati 7 ~y. s-- VI. Tank Info Capacity in Total 4`0f Manufacturer Gallons Gallons Units U 2 L h New Tanks Existing Tanks 0 _ v c y p Gj '7 t7 ~ a U Lo i*. C7 a Septic or Holding Tank Zoo (n (76 O Dosing Chamber VII. Responsibility Statement- I, the undersigned, ass We responsibility for installation of the POWTS own on the attached plans. PI is ame nt) Plumb i tur CM~MPRS Number Business Phone Number i u 3S ?i1=?fib ` 0~1 Plumber' Address (Stree City, State, Zip Code) V VIII. un /De artment Use Only - Agent ignature Permit Fee Date Issued Is pproved ❑ Disapproved Is ZC 1 Z' ❑ Owner Given Reason for Denial 7-'; IX. Conditions of A pproval/Reasons for Disapproval I~ 2 SYSTEM OWNEPK: fV 2 Lz, I'd IiL( _I~/h.G2,//C,Q~='~oI/ 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. ((X~e ' ice, U L'~ r Sf,- f CGt~,:Z _J2, c;h - 2. All setback requirements as per applicable "btb?& &gs for the system and submit to the County only on paper not less than 8 12 x 11 inches in size SBD-6398 (R. 02/09) l Ooo 1.5 i06' 7 yqI33 r ~ a - - y, 5- - i S93 o c CW y 1J f. C Z M ° a7° $ O a L ` C c ° q O ( , a 3»0 a o$ _ `a~a w .8W ~.i cm v x u x E b ~ 40 a L-2 b* I - I (A F4 LO W p» O ~O a ii O E ' O r 1 I Is ti 21 W O F aoa~~ : c ~WNy . m m~ m m or~i oss 1.I. V Z Z r. t , -0 1.- a 0 0 0 Z rio ca > r' Z W W D oN z W J N > 0 W w a F- U) w J giftm .j 43 ~ N Z Z a O _ o -N z o co = w CO a 0 z O 1- Q r O O ui z U) w v w LLI 0 F- z ON w w LL 1~- LL o • I- W0\0 WN>; Z Z-0 W m a CO) - -9 O a0WZ CONVENTIONAL COMPONENT DESIGN Residential Application ING~~~ AND TITLE PAGE Owner's Name: ~.~,f✓1~t1Y~-:~- _ _ _ _ Owner's Address: 6- (013 I"owi isnip: S C3°Y><.p, ~ * t County: S-.uibdivision Name, ijt Nu ?1:41. ~I Parcel ID Number: O 3 -1~ `fa - l 7,5 Page 1 a_ Index and title Page 2 Plot Plan Page 3 System Sizing & Cross-Section Page 4 1° Ater Specs - Pane 5 Maintenance info µr; ation__ . Page 6 Manaaement Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 3 Warranty Deed rage, C~S~ Mf Or I'l@f / Attar,i°nerite;. J:7il Test e ioiuse Pianos t?r gn.er Pl nber: U a-W License, Number: __f s 7 :'late iV7V l'ncr;e }fur ,ber Sig11a tune, D t io t:he In ~siound Soo r },,sorct=,..n Jinr.D`?f:ent Wl. oal for F'OV4TS V(-5 7 11. Pane 1 l ~ "oy a ~U _l .31~ r K-3 1 113-1 cid t r 1 t4* t g. j t9m cross §2gon Final Grade y(o,.5 -r7 f( Leadiing p i r yS-~'- 5 91, sft ~---v - System Elevation ft Soil Absorption System Plan View ft ft 11 11 1 LA ©ei I# Ld 17, r Chambers i {I:EI € 4°Dia. Trench 2 Header Lowhko Chamber Swjc otions Manufacturer And Model EISA Rating _0&) sq ft per chamber Soil Application Rate r ( gpolsq ft 6AY3 gpd Design3Plow Soil Application Rate --70 EISA = Chambers 2 rows of chambers each. 33 x ' r Page of r i C) o s w \7 OU ~H -nm r Q W O x n C _V C Z m m C') C12 4 m m ~t l - - - Z ~ gam-.-_ , ~ 1 t f ~ ~ 11 f ZF~ cr, 444 ~y o I 3 s ~Q oil E AN PF r : I i i Qu1ck4 Staridarci Chamber i - 48 (EFFT7,CTIVE 1 FINOT!+)f I I - - C n rl In tiz ~ I ~ ~ _ I lsi~ ' i i I ' IN 34' SIDE VIEW I f lulfiPort E,,id GDS i fi - -i - 1 34" sff). vlcw FRONT VIEW i :T A•;,,i,°AS7Fi'$G~?~Ff~'4.S'"~`'`'ti.Y~ {QuicM Standard Chamber Nomm' ~et'~Ificatl~ns MultiPnrt isnd'Cap Nominal-Snerificatlans =1 - h _ c ~rx 4sz ~ xi ~IZe(*xLxNiT {1~," n 34 XA6 x12 Invert`Height r i INFII.TRATQR SY$1EM$,.IN--f,-5iTANDAR UM ED-WA B-ANTY ~ a„- a ~urv, en and Unt fo U I tlet~nrin©U Cy innnrulnr IV I r -w ro oy . LII r ar,a,. ~,c,,,q,ri - , , un~,va! eno/~. m la lar cin of iha Unit.c ~ Wes{ r+ ai .il,~_ ,..n u~: JE 'rtF,3e AH1_ ICU V,e1F.N vVAHnHMIk:S Wl, rr hit7F'El;i 1~TF i NJ ' "~PLIEL` `h::hRAhl I[„ OF PAER„HANTA&I ITV ~R FITNESS FJH A PARTICULAR PUHI'OG[. Y ~f .J Environmental Onsite Wastewater SOlutiOns" I ~n e Business Park Hoaci • P.u. box (bb t'Did f-. - 860-577-7000 • FAX 860-15-77-7001 Utz-X21-~t4;1~, J { , IPU Wd( ly 0 F Oly B C U I 1. r 0 :Il,lit.(I ,n BCI'.Ortla,Q' -l.' ii Od-, dll r,[I',. .u,ul I<-lino J n .ni,xs tctd 1, liU i_-Gn;. t f POWTS OWNER'S MANUAL & MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity 6)0 al 13 NA Permit # Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer E3 NA Number of Bedrooms 3 ❑ NA Effluent Filter Model P1, - C-3 NA Number of Public Facility Units NA Pump Tank Capacity - al ❑ NA Estimated flow (average) gal/day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) 1,15 0 gal/day Pump Manufacturer - ❑ NA Soil Application Rate al/da /ft2 Pump Model ❑ NA Standard Influent/Effluent Quality Monthly average" Pretreatment Unit EM A Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODE) 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BODE) 530 mg/L Xin-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 51W cfu/100ml ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size Y. in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA "Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA L7 Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: a ❑ month(s) year(s) (Maximum 3 years) 13 NA r~ ❑ month(s) 1-k 1 ❑ NA Clean effluent filter At least once every: /f JJ year(s) i, Inspect pump, pump controls & alarm At least once every: 'n' ❑ month(s) ❑ NA year(s) Flush laterals and pressure test At least once every: month(s) ❑ NA ❑ year(s) Other: At least once every: ❑ month(s) ❑ NA 13 year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. 11 other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment A units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. l~ START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the P S fails and cannot be repaired the following measures have been, or. must be taken, to provide a code compliant replace ent system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. WPI alua ' o Ong tank b e ai a ft0~li817~ ~Di21~/ ✓ !-'O~vS" l?zclc~o ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name nG^ " 1 E Name U Phone Phone 1S 6 io SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name t M ° 'au 2v~Jt~cJ Phone Phone . , This document was drafted in compliance with chapter Comm 83.22(2)(b)0)(d)&(f) and 83.540), (2) & 3), Wisconsin Administrative Code. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer ° Mailing Address Property Address (9191/ 10s2 (Verification required from Planning & Zoning Department for new construction.) ~ Z " l Z / City/State Parcel Identification Number G ~ ~ LEGAL DESCRIPTION Property Location '/4 Sec. J , T3_1 N R~W, Town of Subdivision Plat: Lot# Certified Survey Map # 3 3 , Volume p2 ( , Page # Z Warranty Deed # O~ (before 2007)Volume a ?36 ,Page # 3 Spec house ❑ yes Kno Lot lines identifiableyyes ❑ no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of be oo s SIG ATURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 09/07) gi~a~z t3 QQ KATHLEEN H. WALSH S 9011 ONSI F~RM 1 -1998 STGICROIX CO. DEEDS WI WARRANTY DEED RECEIVED FOR RECORD Document Number 11/17/2005 08:300 This Deed, made between Mitchell J Knack single Grantor, WARRANTY DEED and William J Tennis, a marr~~t~TCOi1 EXEMPT # Grantee. 13. Grantor, for a valuable consideration conveys to Grantee the followingRfRANSEFEE: 1310000 described real estate in St Croix County State of COPY FEE: Wisconsin (the "Property"): GC FEE: PAGES: 2 Recordin Area Name and Return Address RETURN TO: Burnet Title 7550 France Ave. S. First Floor Edina. NIN 55435 ATTN: Poct Closing Central 032 1042 30 100 Parcel Identification Number (PIN) This is homestead property. (is) (is not) See Exhibit A attached hereto Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Properties good, indefeasible in simple fee and free and clear of encumbrances except r Dated this day of 2005. 1 (SEAL) (SEAL) Mitchell J. Knack (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT State of Mlnesota, Signature(s) ) ss. Anoka County I authenticated this _ day of N da of Personally came before me this y 2005 the above named r di, Knack single to me known to be the person who executed the foregoing instrument and acknowledge the same. TITLE: MEMBER STATE BAR OF WISCONSIN (If not, m. ~nrLfN authorized by §706.06, Wis. Slats) t THIS INSTRUMENT WAS DRAFTED BY Nota blic, State of Minnesota Coldwell Banker Burnet My commission is permanent. (If not, state expiration date: 1301 Coulee Road Hudson, W l 54016 I ) 5-35275 j, (Signatures may be authenticated or acknowledged. NOTARY PUBLIC • MINNESOTA ' Lly Comm. EW- JM 01. 2010 Both are not necessary.) ' Names of 22rsons signing in an ca acit must be ed or rinted below their signature. STATE BAR OF WISCONSIN Wisconsin WARRANTY DEED FORM No. 1 -1998 \ _ f130 F 03 1 EXHIBIT "A" Legal Description File No. 5.35275 Located in Part of the NEof NE'/. and part of NW % of NE'/. all in Section 15, Township 31 North, Range 19 West, St. Croix County, Wisconsin described as follows; Lot 1 of Certified Survey Map filed September 29,1994 in Vol. 10, Page 2823, Doc. No. 521879 except part to Richard 0. Stout and Janet P. Stout, husband and wife in Vol. 1350, Page 17, Doc. No. 585420. Also, a Part of the NW'/. of the NE'/. of Section 15, Township 31 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin, described as follows: Beginning at the north Quarter corner of said Section 15; thence on an assumed bearing along the North line of the NE'/, of said Section 15 S89°23'33"E a distance of 330.03 feet to the Northwest corner of Lot 1 of a Certified Survey Map. Doc. No. 521879 as recorded in Vol. 10, Page 2823 in the Register of Deeds Office in said County; thence along the West line of said Lot 1 S00°10'51 "E a distance of 663.42 feet (recorded as S00048'59"E a distance of 663.50 feet) to the Southwest corner of said Lot 1; thence on the extension Westerly of the South line of said Lot 1, N89°24'21"W a distance of 330.03 feet to the West line of the NE'/, of said Section 15; thence along last said West line N00°10'51"W a distance of 663.50 feet to the point of beginning. l~ 3 635312 VOL21 PAGE 5277 KAT9= H. YWL-Sff- REGISTER OF DEEDS ~ ~ p ST. CROIX CO.L MI SOUTH V4 _ NORTH 114 RECEIVED FOR KECORD COR. SEC. 15 R=663.50' COR. SEC. 15 I 09125/2006 02:36PM ~r4661.63' NO0'00'38°W 663.65' I CERTIFIED SURVEY HAP v Y NORTH-SOUTH 1/4 LINE 630.64' a O y T ; n o m W REC FEE: 13.00 0 oo I. omo m '°c' M. o lam COPY FEE: 3.00 z~? a~c^NO: mvmlq IF-4 PAGES: 2 IP A$~ ?bm"'O• mtmn0 3pz I~ Om2 DO-Z: il (O I-I1 NNm { •Nmm. Im d ~ 1> TA' Z I I~ Id g A A x BEARINGS ARE REFERENCED I m TO THE NORTH LINE OF THE NE114 OF SECTION 15, lI33'33I I ASSUMED TO BEARS89°1700"E e, (ST.CROIX COUNTY COORDINATE SYSTEM) •m rn•o • Nom' I I C i• ~ m n = l ZI ® 1. O m ~ L m' - l ml f O v -0 m 0 0 m 0 .9 ~c I MI 0 O 'D 0 z m $ m m O O m 0 0 fTl IF e~O~ 1 z z~ z Z I~ nn~ninuAminM `P CA I I o 0 D m o 0 0 Z D p z 0 Ip O $mI I G7 O D =y > ? 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N*j.cnns♦ in accord n om 85, Wis. Adm. Code County Department of Comme ~U N 0 2 Z006 St. Croix Division of Safety and B ildin Ian m . 32-1 0 pa r not less than 8'/z x 11 in nt (aM) di n and parcel I.D. 2-30 +W_ / Attach complete site plan n , rafg rice st road. part of include, but not limited to: ttice ~andd Ibbcat, and distance to n Dat to nsions, north arrow, percent slope, scale or Rev' BY cd o (P Please print all nT0_M Privacy Law, S. `15.04 0) (m))- Personal information you Provide may be used for secondary Purposes ( property Location NE1i NE1/4 S15, T31 N, R19W Property owner Govt. Lot ~ Block # Subd. Name or CSM#J Lot Tennis, William Address CSM Rea+n9 Property owner's Mailing Nearest Roa 7 6693 Goodview Court S. City ❑ Viuage Town 59Th St. State Zip Code Phone Number Somerset city 651-402-9000 GPD e Grove MN 55016 600 cottage Code derived design flow rate New Construction use: N Residential 1 Number of bedrooms NA ft. Replacement ❑ Public or commercial -Describe: Flood plain elevation, if applicable Parent material Outwash Sand /sgft rating. Possible system elevation for Area General comments trench y to Slope 40ia;re~a is 11 and recommendations: Area his Suitable for a i h trench 95.5 (low tre nal s system with 1 is ( g 98+ in. Soil Application Rate Boring 100.16 ft. Depth to limiting factor Roots GPD/ft2 ED L Boring # Pit Ground surface elev. Structure Consisten Boundary *Effff#1 •Eff#2 Dominant Color Redox Description Texture Gr. Sz. Sh. 1.0 Horizon Depth Munsell Qu. Sz. Cont. Color mfr as 2vf 6 in. sl 2msbk 1 0-9 10yr3/3 none 1vf ,6 1.0 sl 2msbk mfr 9W r5/3 none .7 1.6 2 9-18 1W imsbk mvfr 9w none Is 7 1.6 3 18-36 10yr4/6 ml 10yr5/6 none s Osg 36-98 5 in. Soil Application Rate Boring 98.51 ft. Depth to limiting factor 9_ 5+_-_- GPDIft' 2] Boring # Z Pit Ground surface elev *Eff#1 Eff#2 * Redox Description Texture Structure Consisten Boundary Roots Depth Dominant Color Gr. Sz. Sh. 6 1.0 Horizon Munsell Qu. Sz. Cont. Color mfr as 2Vf in. sl 2msbk 1.0 1 0-5 10yr3/3 none mfr 9w ivf .6 sl 2msbk 1.6 10yr4/3 none .7 2 5-16 Osg ml none s ,7 1.6 3 16-36 10yr5/6 s Osg ml 10yr6/4 none 4 36-95 < * Effluent #2 = BO D5 <_30 mg/L and TSS _30 mg/L 30 < 220 mg/L and TSS >30 < 150 mg/L CST Number * Effluent #1 = BOD 5 227429 Signature: CST Name (Please Print) Telephone Number Thomas J. Schmitt Date Evaluation Conducted 715-247-2941 Inc. 5/26/2006 SBD-8330 (8.07/00) Address Schmitt Soil Testing, I 5,4017 1595 72nd Street New Richmond,' Parcel 032-1042-30-175 04/10/2012 09:47 AM PAGE 1 OF 1 Alt. Parcel M 15.31.19.2098-30 032 - TOWN OF SOMERSET Current ❑ ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 09/25/2006 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - TENNIS, WILLIAM J WILLIAM J TENNIS 6693 GOODVIEW CT S COTTAGE GROVE MN 55016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 2194 59TH ST SC 5432 SCH DIST OF SOMERSET SP 1700 WITC Legal Description: Acres: 3.700 Plat: 5277-CSM 21-5277 032-2006 SEC 15 T31 N R1 9W PT NW NE & PT NE NE PT Block/Condo Bldg: LOT 03 LOT 1 OF CSM 10/2823 (30.61 ACRES) NKA CSM 21-5277 LOT 3 (3.7 AC) Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 15-31N-19W Notes: Parcel History: Date Doc # Vol/Page Type 09/25/2006 835312 21/5277 CSM 11/17/2005 812292 2930/33 WD 11/17/2005 812291 2930/31 WD 11/17/2005 812290 2930/29 QC more... 2012 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 10/12/2010 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 3.700 500 0 500 NO Totals for 2012: General Property 3.700 500 0 500 Woodland 0.000 0 0 Totals for 2011: General Property 3.700 500 0 500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 la lU 1 a e 7;lna7 NaMOI •9-~rl ,NA I ^u I~ II 1 I,y/ # p ~1 II II ~1 II II II_cz=.d ~ ii II II II tel. 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