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HomeMy WebLinkAbout032-1012-40-010 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 556346 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)J. Permit Holder's Name: city Village X Township Parcel Tax No: Schultz, Lance & Lisa Somerset, Town of 032-1012-40-100 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: o5-r 05.31.19.71F10 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER ° S CAPACITY STATION BS HI FS ELEV. Septic Benchmark e ~'t g Alt. BM c>la ~6 -5,05 KI G~ 0166, 112-61 Aeration Bldg. Sewer 3 • Z /p ei y7 Holding \ St/Ht Inlet IX . !oZ 1(B /pg 3s TANK SETBACK INFORMATION St/Ht Outlet Al. TANK TO jWP14 WELL BLDG. Vent to AIr Intake ROAD Dt Inlet Septic / 1 f Dt Bottom Dosing Header/Man. 5Z Aeration Dist. Pipe 6'5Z. 7, Sb ~a s , r Holding Bot. System /GS • 9'4i Final Grade /6--5-1 /d/ e 71S PUMP/SIPHON INFORMATION 4,7o 6 7. S/ Manufacturer Demand St Cover s~ GPM Q`C6 112 Model Numb„o- TDH Friction Loss System Heaq"- " TDR' Ft ForcemairT , ength i Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 3 - - 0z,,~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer INFORMATION CHAMBER OR L o~ 1~dL UNIT Model Number: Type Of System: 33 Z6( , g k4 DISTRIBUTION SYSTEM e5f- '/5 /0 7 j Header/Manifold f/ Distribution x Hole Size x Hole Spacing Vent to Air Intake A Pipe(s) @ 1Eeds- Fi.ncy 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 -3 g Bed/Trench Edges Topsoil Yes 0 No Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 2361 Delong Rd. SOMERSET, WI 54025 (SW 1/4 NW 1/4 5 T31N R1 9W) NA Lot 1 Parcel No: 05.31.19.71F10 1.) Alt BM Description = 41/ 2.) Bldg sewer length = ~ZZ A~LJ r4ts"ItdL ~4~i+Mewr' !S r e``~ 1 - amount of cover = / tJ ~t3 GOJtl t 4..'/ 5 Go~u a 0(:: 9%L Plan revision Required? ® Yes No t Use other side for additional information._- _ Date TInsepcto,r7S'y110%WAC Cert. No. SBD-6710 (R.3/97) So;/ evaAr'16'on/o, 6 E?56/T ~rao(e a le~x3 6'vh XxX L~,GLv~ 5~~.sc ~ cJ~ / es.n fla•R 24~ s8~z, Se 5' - /d f li.t e / o(v/ 4C0 ~ ~ T. o{~~rr1s~S # fit. 4~JZ,r ~ cc~/. 8.38 we- P~a~os~ ` 3 bC.dreon, PrcpoOsui QcSid~ loc,;~ 0(0,/ ~f~1D•D~ 1 ~ Promised 1~cLt~ afs.P..3t~bc.t4•.~ w/JEb/y liA~ PL eficlu.,,v& iC -b omt/xt. ct. Vo,041 e. ~ ~ B60 f.Aein~ow~eFS.T. a i 06.85 ' Mir loc 107 64' ),$K ~~~Qss 80~ i cy%~ol ,4ssccnce/elaµ =/c~J.GY3 o°x IL octd El~da~ ~s - R~9.: Topo{/~"Rd.~. p,~: ,oo.m' (SST.9o Promsscd 6pp of`4 cld~,&ao: C~n+L~✓t5'~nc.~: ~ 3.L- yZ"f.~(.wy~~ /05! a~ ~ (89zo~ /owe fie rc~.= (3.z - setae/u-~Kd /o ' (b 0 Q~ County Safety and Buildings Division St. Croix 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) pa' Madison, WI 53707-7162 5 5(~ ~ '~~t~sstotyry~ Sanitary Permit Application ` StateTransac~tio(nNumber In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appro 'ate tal unit /v is required prior to obtaining a sanitary permit. Note: Application forms for state-owned PO S itted to Project Addres (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide u fo econdary purposes ;titaccordance with the Privacy Law, s. 15.04(1 m , Slats. 3(, ( DeLong Road 1. A cation Information - Please Print All Information Property Owner's Name Parcel # S Lance Schultz 032-1012-40-000 Property Owner's Mailing Address ZON/N F) 128 Laker Drive OPP, Govt. Lot / / City, State Zip Code Phone Number _SW NW section (circle one) Shell Lake, WI 54871 (715) 891-6296 T 31 N; R 19 E or W II. T pe of Building (check all that apply) Lot # 1 or 2 Family Dwelling - Number of Bedrooms 3 Subdivision Name A r t'~ tZ 1 e ~li►•tl~,~C ~.Q~' stock # Na ❑ Public/Commercial -D Adcrij Is 0 ' Na ❑ City of ❑ State Owned - Describe Use CSM Number 96 0 0 ! & ❑ vinaao<f Vol. 25, Pg. 58622 Town of Somerset III. Type of Permit: (Check only one box on line A. Complete line B if applicable) 11 Replacement System El Treatment/Holding Iolding Tank Replacement Only Other Modification to Existing System (explain) F. Xew ystem List Previous Permit Number and Date Issued B• ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner IV. T e of POWTS System/Component/Device: Check all that a 1 Non-Pressurized In-Ground ❑ Pressurized In-Ground At-Grade El Mound ? 24 in. o s sabl jvlound < 4 in. of le s9it ❑ Holding Tank ❑ Other Dispersal Component (ex lain lL f~1 V. Dispersal/Treat ent Area Informatio • Pol Lok PL-525 effluent filter, 45 Infiltrator Plus" standard chambers & 6end s J 02J Design Flow (gpd) Design Soil Application Rate gp f) tspe ea equire (s Dispersal Area Proposed (s ys em levation 450 Gpd 0.50 Gpd/Sq. Ft. 900.00 sq. ft. 930.60 Sq. Ft. 102.0', 104.0' & 106.0' VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units z7 New Tanks Existing Tanks d c y a U iw C7 P, Septic or Holding Tank © 6 __I ow- 1,000 1 Wieser Concrete X Dosing chamber VII. Responsibility Statement- I, the u dersigned, ass a responsibility for ins! on f the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' Signature MP/MPRS Number Business Phone Number James K. Thompson MPRS 30021 715 248-7767 Plumber's Address (Street, City, State, Zip Code 340 Paulson Lake Lane, Osceola, WI 54020 VIII Coun /De artment Use Only Approved 11 Disapproved Per~mit Fee Date § sued suing Agent e _Sitn ID/ ❑ Owner Given Reason for Denial $ L/ 7 s' 28 Z IX PCK roval/Reasons for Disapproval V I lu_ /U02AJ- 1 Septic tank, effluent filter and go-a WR~L/~ CS M (J dispersal cell must all be serviced / maintained as per management plan provided by plumber 2. All setback requirements must be maintained as per appliGable e ttac to Uep ft p ans for the system and submit to the Comoy only on paper not less than 81/2 x 11 inches in size SBD-6398 (R. 11/11) Conventional POWTS Index & Tilte Sheet Project Name: Schultz 3 bedroom Replacement Conventional POWTS Owners Name: Lance & Lisa Schultz Owner's adress: 1258 Laker Dr., Shell Lake, WI 54871 Site address: XXX Delong Road Project Location: Subdivision: Lot 1, CSM Vol. 25, Pg. 5862 Legal Description: SWIA NWv4, Sec. 5, T.3 IN., R. 19W., Town of Somerset, St. Croix Co., WI. Parcel ID 032-101240-000 Page 1 Index and Title Sheet Page 2 Site Plan Page 3 Dispersal Cell Sizing Calcualtions Page 4 System Cross Section Page 5 System Management Plan Page 6 Filter Specifications Page 7 Septic Tank Cross Section Page 8 Parcel map Page 9 Septic Tank Maintenance Agreement Page 10 Deed Attachments: Soil Evaluaiton Report Mater lumber Restri ted Service: James K. Thompson, Dep't. of Comm. Credential #30021 Signature: Date: Page 1 of 10 Design pursuant to In-Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01101) 0 50;/ eva/44,16a 7/4 f A El,!56rV ~rac(2 >t (e~b'vy, xxx 4~~;~, ~ esr,~ daR zs sBez, , , 0G/ 4(o /4x/. ft 032 -..CAL -vo- /dt !in e. /06/4(o, (aenq 8.38 a ere- Proposed J~~ ~ 3b~dfw.~ Prcposcd ~cS~d wall / / I1D.0 -S2s- '/"zc4. voAat. io8 60' Z ~ „OQinf[G,.vE of S.T, y, ob.8s Gam'`'/ r/ a i~ 7'Jp 441' /47 &a, / y, s~1►. s/o R~ c. ~Pc . 8 p /i SS cta/lL✓ 2 /ul.• = /G~'I. C?~ 14 Eleda~ ~nS: Too vtA~',Q P0.;a: A-cµ~s~.or 6010 of ~da~a~: ..S/1J' ~0•~ ~l uPP~~~ ~ (86'=yz"belcul~,rl~~od•o'(ago) G,,,.~,~~n~: (3Z- Yz "jJ~ yrd~ /05! ~ ~ (8YZ•0~ /owv' fi'crcl.: (3,t - NOybc/u~~ /o ~ • ~ (fs'~ I Po. 2-0r, SCHULTZ DISPERSAL CELL SIZING CALCULATIONS 1. (3 bedrooms)(100 gallons estimated flow)(1.5 design factor) = 450.00 Qpd design flow 2. Infiltrative capacity of native soil = 0.5 gpd/sq. ft. 3. Absorption area required: 900.00 sq. ft. 4. Absorption area as proposed: 1,230.60 sq. ft. (45 chambers total) Infiltrator "Quick 4 Plus" = 20.00 sq.ft. EISA per chamber, Infiltrator "Quick 4 Plus" end cap = 5.10 sq.f, EISA 900.00 sq. ft. - (6 endcaps)(5.10) = 869.40 sq. ft./20.00sq.ft. EISA = 43.47 chambers required Number of trenches: 3 @ 15 chambers per trench (45 chambers total) Trench width: 2.83' Trench length: 63.00' Trench spacing: 7.00' on center Total system area w/ 6' trench spacing: 17.00'x 63.00' Pg. 3 of 10 Soil Absorption System Cross Section /UG.O y ~ ~ft / 0~0 /o9S' ft 4" Schedule 40 103. U Final Grade PVC Vent Pipe /060 With Vent Cap 07.0 ft Leaching - ► l oZ • O Chamber Zell- deft ystS em Elevation ~ U ft t.0 ft ,z. ft Soil Absorption System Plan View ft -2.63 ft { d0 ft Leaching Trench 1 Chambers t 11111101-1 r 11111 IIIH 11" 11111111111111111111101111111 11\ 4" Dia. Trench 2 Header Vent Or Observation Pipe C I Trench 3 Leaching Chamber Specifications l j Manufacturer And Model =0~Q-5/-dw~G~l~c.s EISA Rating X20.0 sq ft per chamber Soil Application Rate y. S gpd/sq ft gpd Design Flow C7•5- Soil Application Rate AO •y EISA Chambers 3 rows of /,S chambers each. , Page `1 of Conventional Septic System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General The conventional septic system shall be operated in accordance with SPS 382-384 Wis. Adm. Code, and shall be maintained in accordance with component manual SBD-10705-P (N.01/01). All local and/or state rules pertaining to system maintenance and maintenance reporting shall be complied with. Septic Tank Septic tank servicing mechanics comply with SPS 383.54(1)(e). Septic tank to be located within 150' of service pad, with bottom of tank to be 15' below service pad elevation. The operating condition of the septic tank and outlet filter shall be assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in the tank exceed 1 /3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If the contents of the tank are not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge accumulation in the tank. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated. Septic tank manholes risers, access risers, and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8 inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with Comm83.33 Wis. Adm. Code when the tank is no longer used as a POWTS component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Soil Absorption Cell Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for vegetative maintenance) over the system is to be avoided. Soil compaction may hinder aeration of the infiltrative surface within and above the system and will promote frost penetration during cold weather months. Cold weather installations (October-March) dictate that the system be heavily mulched for frost protection. Influent quality into the system may not exceed 220mg/L BOD5, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for the installation. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring. Contineencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. Excessive ponding within the dispersal cell will be eliminated by installing a new soil absorption cell to bring the system into proper operating condition. Questions on the operation or maintenance of the system should be directed to the installing plumber, Jim Thompson at (715) 248-7767 or the St Croix County Zoning Department at (715) 386-4680. Pg. 5 of 10 • • y Filters PL-525 EFFLUENT FILTER ( ONI ME ` Cl Polylok, Inc is pleased to add its new commercial filter to its existing line of quality effluent filters. The PL-525 is rated for over 10,000 GPD Alarm (gallons per day) making it one of accessibility Accepts PVC the largest commercial filters in its extension handle class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the new Polylok PL-525 has an automatic shut off ball installed 525 linear feet with every filter. When the filter is of 1/16" .z removed for cleaning, the ball will filtration slots Rated for over float up and temporarily shut off 10,000 GPD the system so the effluent won't leave the tank. No other filter on the market can make that claim! Accepts 4° & 6° SCHD. 40 Pipe PL-525 Maintenance: The PL-525 Effluent Filter should operate efficiently for several years i under normal conditions before requiring cleaning. It is recom- mended 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 Gas deflector done by a certified septic tank Automatic shut-off pumper or installer. ball when filter 1. Locate the outlet of the U.S. Patent No# 6,015,488 is removed septic tank. 5,871,640 2. Remove tank cover and pump tank if necessary. PL 525 Installation: 1. Locate the outlet of the 3. Do not use plumbing when septic tank. filter is removed. Ideal for residential and com- 2. Remove the tank cover and 4. Pull PL-525 out of the housing. mercial waste flows up to pump tank if necessary. 5. Hose off filter over the septic 10,000 Gallons Per Day (GPD). 3. Glue the filter housing to the tank. Make sure all solids fall 4' or 6 outlet pipe. If the filter is not centered under the back into septic tank. access opening use a Polylok 6. Insert the filter cartridge back Extend & Lok or piece of pipe into the housing making sure to center filter. the filter is properly aligned and 4. Insert the PL-525 filter into completely inserted. its housing. 7. Replace septic tank cover. 5. Replace the septic tank cover. i D z x N D A m 61 86" D z c D 42" n c z r ~ m m N 0 0 m I / m rUP 41" / 4. 1 O 4" CAS x D I 0 3" 36" 4" I D < ' < I o Fri r N N D A D UP 38" rte- 0 r \m / . 4" CAS N N J Z7 T I m CC m v m v, o -o O O v D C XD~ Z p 39" r p D Z D N mi m r- W D O r mD (n m 1 m 71 Z7A r 00 m~ x~ 0 2 D z c) m -10 N z~ A D O C m m m m0 A 0 o v __4 -1 rm~r =fin ao~N D n Or Z DO Z D 0 ~D r~•1-m m m O OD- z K ND 0 0CO 0 O~Z D =Z pr0~Z D r0 2r*i ~rZ C r-4 Fri nm xx vz 0 crri --i 2 cnp in 0 X020 SF) Z 0_4 mm ~m rm4Z n MOO MNOO :71 c ~Nrn r -1D NN \ o N mzOD m~= 0 z 0- 2(C71 z DO.. (n z -r n I c F) rmc= o ~ 0r = w-' ~ SO iN ZZ 0rn >0m D mq DD,-m-.~ ~r ~O~ ~m rO-n. M C:) :4h r- 0 00 _pL n J N N N O O~ 0 C7 v a Z 0000 ZD O (/)rn> I m r~N~~Onr Zn o v a N G7 _ C= W N p_ D r > co = s p O o 0 NZ C 0 m I O °C o v D 0 O Z G) o mom NW ~ A~~-0 N n< a 0 -'m D D m0 p .Z7 v~+ r m T1 0- D CO CZ) \ =rZ r~ Win z o o O H cm -0 c Z Dip co =D p o m< ~ 4 Dv O D D A0'0 00~ ~ON1 p o D V) r r4 r r ~m :vn z Z z o j (n m CD p 0 A D v 0 X C ;u v Z o N Or*, r m r- O m < 3 Z > A DH 0 ~1 m in m 0 \ m WLP1000-MR MIERER COIICRETE DRAWN BY: SME SREV. 1/4"=l'-O" PRE-POUR: zI SEPTIC MANUAL W3716 US HWY 10 MAIDEN ROCK, WI 54750 DATE: JANUARY 2012 DATE:. POST-POUR: \ ° REVISED JAN. 2012 800-325-8456 FILE: YU1000-MR 0. 7cr-/a i 8 0 7 9 4 3 9 Tx:4059815 State Bar of Wisconsin Form 1-2003 961991 WARRANTY DEED BETH PABST REGISTER OF DEEDS Document Number Document Name ST. CROIX CO., WI 08/20/2012 11:16 AM EXEMPT#: NA THIS DEED, made between Jerry Patrick O'Dair, a single person REC FEE: 30.00 ("Grantor," whether one or more), TRANS FEE: 132.00 and Lance M. Schultz and Lisa L. Schultz. husband and wife, as joint tenants PAGES: 2 ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is Recording Area needed, please attach addendum): Name and Return Address a Premier Title Insurance Agency, Inc. SEE ATTACHED LEGAL DESCRIPTION 7300 Metro Boulevard, #300 Edina, MN 55439 File #30088 032-1012-4 azcel Identification Number (PIN) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: All easements, restrictions and reservations of record, if any Dated August X 2012 (SEAL) (SEAL) *Jerry/ Patn O'Datr U (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT . Signature(s) STATE OF 4V;&G9*KN 1' t` nneV0AC-- ) 1 ) ss. authenticated on ~~S hl h$~~c'^_ COUNTY ) Personally came before me on August 1 2012 • the above-named Jerry Patrick ODair, a signle person TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) nstrum and kno deed the same. THIS INSTRUMENT DRAFTED BY: Premier Title Insurance Agency, Inc. 7300 Metro Blvd., #300. Edina, MN 55439 An, Public, State of Wiscon t i Notary Public My Commission (is permanent) (e „ ncnnPCOta ) (Signatures may be authenticated or acknowledged. Both are not necessary M commission Ex ices Januar 31, 2015 NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTiFEED. WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 1-2003 ' Type name below signatures. 1 of 2 nn P I1;~►11~~111~~11~l~~I~il ~~il `6-0 6 7 3 2 E 7x:4049236 960096 BETH PABST REGISTER OF DEEDS o zo > = ST. CROIX CO., WI RECEIVED FOR RECORD o o m So5°53'15"W (SO5°36-40-M 07/17/2012 2:44 PM y ~ ~ > m 1258.333 S05°53'15-W N Z o'~' ~i195.42-' EXEMPT 61 y , p O Z O WEST LINE OF THE FRACTIONAL /y1V1/4 J~ REC FEE: 30.00 p ? 9 C ca, z z COPY FEE: 3.00 c cr3 I m PAGES: 2 m~ mOm z -I f7 r. G 2O m ~0 © z z m Z rn cn BEARINGS ARE REFERENCED TO THE m m6 O O p w m n m WEST LINE OF THE FRACTIONAL NW1/4 OF m z C S rn 0 r- 0 n SECTION 5 BEARING S05°53'15"W (ST. I Ox = n O O Z :j Q CROIX COUNTY COORDINATE SYSTEM). N o (yT- O Qn (n Q (7 T p I > (n z m ` + ~7 : Z 22 3: ED m =m z / z cnm i Z w cn w a ° z Z "O ~Dw. 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N I n T O - z z z z z z z z z A O -Z o 00 0' N o- N N a c~J cm ~ 0 3; i cn z p a Lfl cJ w C g C' T d o RJ Ln W w v C (S r,3 Dm°O < ul o OZ 0 0 0 o O o 0 0~ O X m ° I DI WEST LINE OF THE SW1/4 OF THE NW1/4 I o m 04°33'28"W 438.36' of2 UNPLATTEp L/~NDS (S4°1 7'40"W 450.00') x SHEET 1 OF 2 SHEETS 1 g etc /0 Vol 25 Page 5862 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/ yj3P e e Se Mailing Address Property Address 2 3 (Q j (~e~Oh9 ~045~' (Verification required m Planning & Zoning Department for new construction.) City/State ~70 Yn.e t,-s_a~ Parcel Identification Number 3z- /D/,2- -5/6 ^C& IN LEGAL DESCRIPTION Property Location 5 cJ '/4 , k1 U) '/4 , Sec. T 3 N R 19 W, Town of Subdivision Plat: 44, t/Uh eeCO e d bXVe- /OPhV4 , Lot Certified Survey Map # Volume ;S , Page # ~G 2 Warranty Deed # 9 ( (before 2007)Volume Page # Spec house Oyes E3~rr~~ Lot lines identifiable li~ es i;i 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. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County 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 bedrooms 3 S TU OF APPLI ANT ) 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) 9 off'/O 2300 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 2 Division of Safety and Buildings in accordance with ComrrAAVis. Adm. Code A.C.E. Soil & Site Evaluations County Attach complete site plan on paper not less than 8% x 11 inches in size. Pla m' St. Croix include, but not limited to: vertical and horizontal reference point (BM), directi an percent slope, scale or dimensions, north arrow, and location and distance to a d. Parcel I.D. T 032- 12-40-000 Please print all information Review d By Dat Personal information you provide may be used for secondary purpos y Law, s. 15.04 (m y Z, Property Owner A Prope Location 'ty Lance & Lisa Schultz i~ A. Lot SW 1/4 NW 1/4 S 5 T 31 NR 19 W Property Owner's Mailing Address `•'i~ ?a of # Block # Subd. Name or CSM# 128 Laker Drive * I~ 1 CSM Vol. 25, Pg. 5862 City State Zip Code Phone N r J City J Village i Town Nearest Road Shell Lake ( WI 54871 (715) 891- 6 Somerset 2310 ( DeLong Road U11610 I New Construction Use: W1 Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD _f Replacement Public or commercial - Describe: ~Q~ r d S - Parent material Glacial till over Glacial outwash Flo plain elevation, if applicable Na General comments and recommendations: Site suitable for conventional POWTS dispersal cell with 0.5 gpd/sq.ft./day loading rate. Step trench installations across hillside at 30" - 42' below existing grade. Boring # -I Boring ✓0 Pit Ground Surface elev. 101.75 ft. Depth to limiting factor >147" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 -Eff#2 1 0-5 1Oyr3/3 none sil 2fgr ds cw 2fmc 0.6 0.8 2 5-38 1Oyr4/4 none sil 2fsbk ds gw 3fm,2c 0.6 0.8 3 38-50 7.5yr3/4 none sil 2msbk ds cw 2fm,1c 0.6 0.8 4 50-67 1Oyr4/4 none sl 2msbk dsh ci 1vf,f 0.6 1.0 5 67-102 7.5yr4/4 none sl 2msbk mfi ci - 0.6 1.0 6 102-120 7.5yr4/6 none Is Osg dl cw - 0.7 1.6 7 120-147 1Oyr6/4 none s Osg dl - - 0.7 1.6 Boring # J Boring e Pit Ground Surface elev. 111.38 ft. Depth to limiting factor >153" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 -Eff#2 1 0-3 1Oyr3/3 none sil 2fgr ds cw 2fmc 0.6 0.8 2 3-21 1Oyr4/3 none sil 2fsbk ds cw 3fm,2c 0.6 0.8 3 21-40 7.5yr4/4 none sl 2msbk dh cw 2fm,lc 0.6 1.0 4 40-79 1Oyr5/4 none sil 2msbk cis cw 1vf,f 0.6 0.8 5 79-134 7.5yr4/4 none sl 2msbk dh ci - 0.6 1.0 6 134-140 7.5yr4/6 none Is Osg dl cw - 0.7 1.6 7 140-153 1Oyr6/4 none s Osg cil - - 0.7 1.6 Effluent #1 = BODS> 30 < 220 mg/L an TSS >30 < I JO mg/L - Effluent #2 = BODS <30 mg/L and TSS < 30 mg/L CST Name (Please Print) natur . CST Number James K. Thompson 5---~_ 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020 9/18/2012 715-248-7767 Property Owner Lance & Lisa Schultz Parcel ID # 032-1012-40-000 Page 2 of 2 F3 ] Boring # -I Boring J Pit Ground Surface elev. 101.16 ft. Depth to limiting factor > 142" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-3 1Oyr3/3 none sil 2fgr ds cw 2fmc 0.6 0.8 2 3-19 1Oyr4/3 none sil 2fsbk ds cw 3fm,2c 0.6 0.8 3 19-45 7.5yr4/4 none sl 2msbk dh cw 2fm,1 c 0.6 1.0 4 40-79 1Oyr5/4 none sil 2msbk ds cw, 1vf,f 0.6 0.8 5 45-90 7.5yr4/4 none sl 2msbk dh ci - 0.6 1.0 6 90-102 7.5yr4/6 none Is Osg dl cw - 0.7 1.6 7 102-142 1Oyr6/4 none s Osg dl - - 0.7 T1.6 F-1 Boring # - Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # I Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 s.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 (807/00) A.C.E. Soil & Site Evaluations ♦ ErO~5 6l fe bin-, Scu%: / oo es.n Z3 s86z, ~ p swyyrAc SST il. eaw ben 8.38 ae.res i ~ 3 6 ul{err. ~o P~oposcd ~tSid \ wa.cl cocav~bn /r~~ ~ / / IID•D 'Erg ~ C~iF/Ktn~' ~•/~/Q.-~ or•.aE'/~. 'i~N3t~. Sr0 /p~ 60 ~ i~eir~ (~GCUE aF S.T, s Z ,y, i o6.8S oel / / n l! 8 D gg a~ ~ /g~ / , ys sal.. ~o P.~ ,a'Pc 8 0 14 ss K.nc~✓z /mow = /cam ~aQd bl ~ E/cdaf; aY/S c~.,oou- = (3a'= y,~ "be%+•v~rd) ion. a~ (~!(o) /pw v ~i e.scl.: (3,z - Sb~bz/u ~ m z' (fs °1 1 Pe oes !l i!I{Il11lIl~INIl~I~N N~11 8-0' 0 x64049236 8 960096 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI z RECEIVED FOR RECORD co a m ~ Sos°53'15"W (S05°36'40"IA) 07/17/2012 2:44 PM O o c') m 1258.33 L~ S05°53'15"W EXEMPT t#: m O m O O WEST LINE OF THE F95.42' m D o z o ~CTIONAL NW1/q REC FEE: 30.00 z cn z COPY FEE: 3.00 ~v m Iz C8- PAGES: 2 ;13 m Nm O~ 09 Z x m C. BEARINGS ARE REFERENCED TO THE r z m N WEST LINE OF THE FRACTIONAL NW114 OF 'I m co ~ Z C C C A r = n SECTION 5 BEARING 505°53'15W (ST. e) o Qc m n w CROIX COUNTY COORDINATE SYSTEM). I~ v O Z D m 55~~ C> m c ^ m m7i"~ ' c: G) Mi < ~O z r- cn m ~dNn / s / 0 0 m H ~ ~ o 5i z m 0 -n x L7 X37 o= N A N 1-2 - L3 m m L A -n m Om A Z 'n Op m ~ 72.12 rI~ x c i 1T1 Z AN N74 48 84.14___~'r VS I z ~~i 9 _ 42"E_ONO°44'42'E p x *@$loNN z Ta'~ og°~F ~~tJ N x y O v _ ~ N x z 0 0 m ~ I D a° 1 0 m O '11 IS) m, v= m 00 z m -n P p O m -4 mm --4 FR , m o m r O z m m T T v z O :mlo 4h m m o T zo m 5 Co g o C ~ y w rn m D = I C tam w_ Z O 1 A o m O a CA) R N r r r r r r r r r z C) A ~a0 Q ~n iC O .amVmcnaWru~-3 z X td ~IQ Cil I i~ m bDU z z z z z z z z z r- N x I Z o o CD a w r-l I J I rn 3 a N rV CAj Ul a s cn I I~ .0 V a LI 0" a 0~ a n O I Q m W W C!3 R7 C W T .P ru C4 L2 UI Ul UI C11 UI rU rU aD W _ Z ~ I I £ £ £ £ £ £ f''I f'"I fTl I Q V V C), U1 N V Ln d II W 00 v° 0 o A D J j Z N p rmi T O T O Z Z Z Z Z Z Z Z_ Z :U CT a IU W o o m C 00 -4 p pj o N o C.fl N N a W (7 zo O a o A -P U 3 '0 W C.1 ~ a CJ 0~ o N C~ W a W ~I d 'pr, 0 0 0 99 ° o m UI t7 ~ ~ m ~ ~ £ £ £ ~ £ r•i d mniZ a x O v D WEST LINE OF THE SW m 114 OF THE NW1/4 j 04033'28"W 438.36' UNPLATTED (S4°1 7'40"W 450.00') SHEET 1 OF 2 SHEETS i of 2 Vol 25 Page 5862 y g 1 I 'I~IU s Fill f I ~ nl~"IIi~ u1J1111~ I i III n v ui tul l t ~Il,~i , l' it, sg _ g t, iII'IIII I f 111 m i I 111 ~ 'i 1' I ~a III il~lll l` I 11 n li ~ a ~ r i'I rrFr w~~1111V1 4 ~ 77- ~ a ~ I 1~ 1 Iii r ~ "I, I' u z', a V5 w LLLU IM I I r o q N < R , = ~g O E ti T Er OD P O ~•o € Sa 8WA wo s tU) CD § a 0 3; x . 3? i P a Q cam s~ b~ M 2 1® L g ¢ a - FEIT7 E I _ 2 I s ~ ~ ~ a e I ~ gg 14____..y, JAI I , I - I , I , I , i ! 05 C) X Er Oo Y O 10 FI F? 04 - 3 1 >I 3 3 i y i Y~ 1 iii ~ Yea IIL.. x I~~ Y E tl 3 iiF- li m iii-- ii ii ii iiL_ _ o o _.t} £ g iii_,. Y tl g 1 I I I 1 I I~ ~ R 1 I F~ ! ` S y ~ I I I I t l ti' I ® ei I 5 ~ Y I I E ~ I I I I I 1 1 1 1 ~ 1 I I 1 I I I Da z~ x p x'11. -fill if I Z a d a~ z r SK 2 1 i m w 11~; W m m R 30 I i ~ 6 R 4 m A N m i mP g sit ZO m O t 4 sl Parcel 032-1012-40-000 08/06/2012 02:49 PM PAGE 1 OF 1 Alt. Parcel M 05.31.19.71 F 032 - TOWN OF SOMERSET Current ❑X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner 0 - O'DAIR, JERRY PATRICK JERRY PATRICK O'DAIR C - BAIRD JACQUELINE A BAIRD JACQUELINE A 6636 BABCOCK TR E INVER GROVE HTGS MN 55077 Districts: SC = School SP = Special Property Address(es): Primary Ty SC 4165 SCH pe Dist # Description 1 IST OF OSCEOLA - , . 1 SP 1700 WITC YU~ Legal Description: Acres: 8.880 Plat: N/A-NOT AVAILABLE SEC 5 T31 N R1 9W 8.88A SW NW COM NW COR Block/Condo Bldg: SEC 5 TH S ALG SEC LN 1165.52; TH N 88 DEG E 134.35'-POB; TH N 88 DEG E Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 1200.72' TH S 4 DEG W 450' TH S 88 DEG W 05-31N-19W SW NW 821.31'TH N 3 DEG E 50.15'TH N 14 DEG E 112'TH N 0 DEG E 70.30'TH N 32 DEG W more... Notes: Parcel History: Date Doc # Vol/Page Type 08/07/2009 901655 EZ-U 08/01/1997 563291 1255/258 WD 07/22/1997 562701 1252/581 QC 11/03/1986 418908 759/110 LC more... 2012 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/12/2010 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 8.880 48,500 0 48,500 NO Totals for 2012: General Property 8.880 48,500 0 48,500 Woodland 0.000 0 0 Totals for 2011: General Property 8.880 48,500 0 48,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 YaL 125 PIPF 563291 STATE R4:a Of WISCONSIN FORM 1 - 1982 tYARRANITY DL•FD - DOCUMFNTNO - ar. ..1 9 This Deed, made between _ 1]ayid Wward Cent ar, a cingle-, mn pK K,. - - AUG 1 1997 1 i - Grantor, r,:j 2 :30 P. M and Jerry Pat~ig]c O Dair and Ja. r„wline Arm ~yrj, Ag j(nt_tenan_,t&- rM1.yl,t. d ..adal,, yy Grantee. J r } Witnesseth, That the said Grantor, for a valuable cvnsideratirs•t_-- :1 THIS SPACE RESERVED FOR RECORDING DATA conveys to Grantee the following described real estate to St. Croix ' t. County. State of Wisconsin: 1; NAME AND RETURN ADDRESS 1' Heywood & Carl, S.C. A parcel of land located in the S10 of the NW's of. Section 5-31.-19, is Samuel R. Carl Town of Somerset, St. Croix County, Wisconsin, being further described 204 Locust Street. P.O. Box 125 1 as follows: 1i Hudson, FTI 54016 t i Commencing at the Northwest corner of Section S; thence S5°36'401 W along the Section Line 1165.52 feet; thence TV88°19105'IF 134.35 feet ` i to the point of beginning; thence continuing N88°19105"E 1200.72 feet; l li thence S4°17140"W 450.00 feet; thence S88°19'05"If 821.32 feet; thence PARCEL IDENTIFICATION NUM8ER ~j N303712511E 50.15 feet; thence N14°33'00"E 112.00 feet; thence NO°29'00"E I 70.30 feet; thence N32013110'W 30.64 feet; thence N25°55140144 50.77 feet; thence N41042'WN4 70.06 feet; s i thence 1,160°4014014-7 74.45 feet; thence N72004110111-7 157.73 feet to the point of beginning. Subject to i „ road easement over the Idesterly 33 feet thereof. Being 8.883 acres more or less together with a 66 Foot 1 11 road easeTent and subject to the conditions therein stated as recorded in Volume "51711, pages 595-596, Document Number 324721 (No. 28). ~i l~ I ' TRANti FE R This in not homestead property it i (is) (is not) i; 1 Together with all and singular the hereditaments and appurtenances thereunto belonging; ~i And - warrants that the Utie is good. inocieasibic in fee simpie and imc anu coral of r"cumcoi u-v v-pi exceptions to easements. it !1 li li and will warrant and defend the same. ;I ii Dated this.-/ day of - 19-Q7 i l I it w n it (SEAL)(SEAL) IL~ David Fdward Genter ;I i (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT David Edward Center State of Wisconsin, Signature(s) ss. County authenticated this day of 19 97 Personally came before me this day of 19 , the ab,n-c named Samuel R. ri TIT r MEAIBE /STATE BAR OF \VISCONSIN 6 not. atithonzed by §706 06. \\'IS Stats) to me known to be the person who executed the foreg,-,g Instnlmcnt and acknowledge the sank. THIS INSrn,IMFNT WAS DRAFTET) By Iteywood.,5 Hari - _ S.C. _b T~Samuel. R., Cari 204.. Locust Street._ itud5or) r_ X'TC. 54016. _ _ _ N.,tarv Puhbc. Coum)-. %Vis. t Sigi it,.c, n1.IV he .aua+x•1111. .l b; tl or ack111,\al al;-ed N,di are 11'.1 M% conimisml -n IS pormanew Ili not. >lme c).I)Iraiwn dm- It \\'1RRA~1tl'f`tIU ' - ~T•\It :\ht1P ~4'Iti,t)~cl~ `•'1•%''s.~ %•~V~ RECEIVEl' `4scotlsinDepartment ofCommew p 3 ?O,? SOIL EVALUATION REPO~~ jj Page of t3ivision of Safety and Buildings by S1 ,,,,in accordance with Comm 85, Wis. Adm. Code l~ t g zot4 y1 v; . County Attach complete site plan on r not less than 8 1/2 x 11 inches in size. Plan must I include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. R 'ewes b Da e P al information ou provide `ay b ndary purposes (Privacy Law, s. 15.04 (1) (m)). lij r L - I L 'Property Owner Q Property Location' e16- fi 1 S~ Lot S(,J 114y /4 S T I N R/ E( W Property Owner's Mailing Addre Lot # Block # Subd. Name or CSM# LI-. r 6 City State, Zip Code Phone Number ❑ City ❑ Village 'Town Nearest oad k5ylf 7 New Construction Use,< Residential / Number of bedrooms Code derived design flow rate ~Jy GPD ❑ Replacement Public or commercial - Describe: Parent material d r ood Plain elevation if applicable ft. General comments and recorrwrtendations: _ /r/_ C~ 'itc System Type System Elevation M Boring # pp~~ Boring JAI pit Ground surface elev.79• -7 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 o- 31 3/_z- f' z y_al /1 44 7~~ Q rS Boring # ❑ Boring ® WPit Ground surface elev. Y~ ~Ift. Depth to limiting factor _JL/J! • Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 I o-3 Z 0 r /3- 7 121Z -1 A Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Pate Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 017~~~ 715-246-4516 -7 Property Owner _ arcel ID # Page of Boring # Boringa ~ Pit Ground surface elev. ft. Depth to limiting factor /7/--in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 10-3 2 7 J r S /V l,~ > > a Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F-1 ❑ Pit Soil ication Rate Horizon I)epth Dominant Color Redox Description- Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BODS > 30 < 220 mg1L and TSS >30 1150 mg/_ ' Effluent #2 = BODS < 30 mg/_ 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. SBO4330 (R.W00) • h o V Property Owner _ arcel ID # Page of ❑ Boring IS] Boring # . Pit Ground surface elev. ft. Depth to limiting factor /V in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 e 10-11" A~ 2 3 Sly- ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ Boring F-1 Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil lication Rate . Horizon ' )epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I i Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mglL ' Effluent #2 = BOD, < 30 ffKA and TSS < 30 mg1L 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 (86/00) Soil Test Plot Plan Project Name Lance and Lisa Schultz Sha rd Address 128 Laker Drive Shell Lake Wi 54871 C #226900 Lot 1 Subdivision Dat P12/12 S W 1/4 N W 1/4S 5 T31 N/R19 W Township Somerset Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1.25" pipe System Elevation 96.7/95.0 *HRpSame as Benchmark Scale is 1" = 40' unless otherwise noted 105' 102' 99' B 30' 30' B-2 0' Shift system this 20% way as much as B.M.* Slope possible 30 B-1 200 No sands found! Delong Road 150' 788' Property Line Parcel 032-1012-40-000 09/27/2012 02:10 PM PAGE 1 OF 1 Alt. Parcel M 05.31.19.71 F 032 - TOWN OF SOMERSET Current 0 ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner JERRY PATRICK O'DAIR 0 - O'DAIR, JERRY PATRICK C - BAIRD JACQUELINE A BAIRD JACQUELINE A 6636 BABCOCK TR E INVER GROVE HTGS MN 55077 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 4165 SCH DIST OF OSCEOLA SP 1700 WITC W ~F Legal Description: Acres: 8.880 Plat: N/A-NOT AVAILABLE SEC 5 T31 N R1 9W 8.88A SW NW COM NW COR Block/Condo Bldg: SEC 5 TH S ALG SEC LN 1165.52; TH N 88 DEG E 134.35'-POB; TH N 88 DEG E Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 1200.72' TH S 4 DEG W 450' TH S 88 DEG W 05-31N-19W SW NW 821.31'TH N 3 DEG E 50.15'TH N 14 DEG E 112'TH N 0 DEG E 70.30'TH N 32 DEG W more... Notes: Parcel History: Date Doc # Vol/Page Type 08/07/2009 901655 EZ-U 08/01/1997 563291 1255/258 WD 07/22/1997 562701 1252/581 QC 11/03/1986 418908 759/110 LC more... 2012 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/12/2010 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 8.880 48,500 0 48,500 NO Totals for 2012: General Property 8.880 48,500 0 48,500 Woodland 0.000 0 0 Totals for 2011: General Property 8.880 48,500 0 48,500 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