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..`'Parcel 032-2004-90-000 01/26/2007 05:15 PM
PAGE 1 OF 1
Alt. Parcel M 1.30.19.480A 032 - TOWN OF SOMERSET
Current X', ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - FREY, GREGORY A&CHRISTA PERRIN
GREGORY A&CHRISTA PERRIN FREY
1760 85TH ST
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1760 85TH ST
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 33.580 Plat: N/A-NOT AVAILABLE
SEC 1 T30N R1 9W PT SE NW EXC PARCEL 480B Block/Condo Bldg:
AND EXC PT TO LOT 2 OF CSM 8/2140
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
01-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
09/18/2006 834656 EZ-1
07/23/1997 -938/540
07/23/1997 8
07/23/1997 more
2006 SUMMARY Bill M Fair Market Value: Assesse with:
145845 390,800
Valuations: Last Changed: 07/14/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.000 48,000 187,200 235,200 NO
UNDEVELOPED G5 30.580 61,200 0 61,200 NO
Totals for 2006:
General Property 33.580 109,200 187,200 296,400
Woodland 0.000 0 0
Totals for 2005:
General Property 33.580 109,200 187,200 296,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 306
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
o FLED
AUG 171989~-
C JAMES O'CONNELL
Register of Ueau
45069 ~ ~ st c~ co., w,
r
3 CERTIFIED SURVEY MAP y_ a?
Located in part of the SEo of the NWa and in part of the NE4
of the NWa, all in Section 1, T30N, R19W, Town of Somerset,
00 St. Croix County, Wisconsin.
W CD
I O
s ~
C- L
N OWNER
r- 4) -0 NJ Corner of
Stanley Hale Section 1
0 -0 6757 Lamar Avenue S. 1" Iron Pipe
v r Cottage Grove, MN 55016
ai
u rn
c m
y 3
y 't Ln
Unplatted Lands N
L 0 - It m
- - oo O
N bj N O
L u O
a <n N82005,09 ,W V) a
CA o 514.581 527.60` 66'
L n> c•> u I I
N c O
)79 --A 13.021 w + I c' i • 1
N I .7 -W I N I G. I
LOT 1 W M J1
o
N 135,098 Sq. Ft. Including R/W co co
co NO 411 O I
I °O 3.10 Acres 0 N
v
I ° p N N N v I
oC 132,078 Sq. Ft. Excluding R/W z
-j I 3.03 Acres 14.201 ~-I
508.551 w i v
North Line of the SE} N8905612211E 522.751
of the NW} of Section 1 (Recorded as N8900411311E)
Lot 1
O N I
•J fl NI
W I~ Certified Survey Map
O v v 1 I
0
N I Ln O I N I L I I
Lr)
tZl ~N Vol. 6, Pg. 1530 N O N O, O O I N I a I
cl rn
~I O1 a ~1 'vffI •I
...iw. I c J N-.
(Recorded as S8900411311W) co I 1
170.661 S8905612211W 352.09' w!j
336.441 Ln
15.65'-
coI
o
0 N
O 1
O 1
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O L
O I a
LOT 2 .0
M rol c1 rn
M I N I N
SCALE IN FEET - 0 148,922 Sq. Ft. Including R/W _ J' N
a - 3.42 Acres u>
0 100 200 300 N m 130,680 Sq. Ft. Excluding R/W
~,~U6dCax3;1$y~' co
3.00 Acres
F,1 t+ O LI SCI tDI
14., 4n CD LO I
pp O Col C-
LE C14 C) >
• f( M I G11
=~4G71y I S89c3113511E 336.431 1 _°r i v I ~-1 y
661 PRIVATE ROADWAY EASEM m ~i ~I a
HUDSON, 0 ~ 1 1
WIS. co
uMr• r+•
a
1
V fY,
SUR U-
01et A ~P Unplatted Lands
I
L..1 W
14-
N
LEGEND yN
45 $ZV 1 E1) p -a
Section.Corner Found M o =
C)
y t '7 !n~ z =
111 Iron Pipe Found " L
S} Corner of
0 111 x 2411 Iron Pipe Set, weighing Section 1
1.68 lbs. per linear foot. County Section Monument
L
H
Vol. 8 Page 2140
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER
ADDRESS
SUBDIVISION / CSM# LOT #
SECTION~T 1 N-R W, Town of
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
&4A
dy,
e 4,
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK: '11_11
ALTERNATE BM:
SEPTIC TANK PUMP CHAMBER / HOLDING TANK INFORMATION l
Manufacturer: Liquid Capacity: /
Setback from: Well Z, i / House Other
Pump: ManufacturerL ~,lS Model#L~=D(/~ Size
Float seperation Gallons/cycle:
Alarm Location
II
i
;SOIL ABSORPTION SYSTEM
Width: Length J~-Number of trenches
Distance & Direction to nearest prop. line:
Setback from: well: < House_ Other
ELEVATIONS
Building Sewer ST Inlet ST outlet
PC inlet PC bottom Pump Off
Header/Manifold Bottom of system
Existing Grade Final grade
DATE OF INSTALLATION:
PLUMBER ON JOB: LICENSE NUMBER:
~J
INSPECTOR: ~A4' c~
3/93:jt
I~1i `i~rl wmartran Relations ions 1.30.
Labboor Labor and Ha 19. AR& MA1ffYiYSTEM County: Safety®n4Buildings Division INSPECTION REPORT (;T. CROIX
fCI&ERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-:
180291
P -Ider's Name: ❑ City ❑ Village [Town of: State Plan ID No.:
r" P V. r. I SOMERSET
lev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
loo ~ /Do, Z~Niv C a -A a/~¢,. a~ 032-2004-80-000
TANK INFORMATION ELEVATION DATA A92003721()
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark S
Dosing
Aeration Bldg. Sewer
Holding St/ Ht Inlet 9q.o
TANK SETBACK INFORMATION St/ Ht Outlet
vent
ir Ito ntake ROAD Dt Inlet /cl ?6 ~S
TANK TO P/ L WELL BLDG. A
Septic o. NA Dt Bottom / y y6 j q f3
Dosing y r 76' r ' > f r NA Header / Man.
Aeration NA Dist. Pipe a-7 9 IOI, L
Holding Bot. System ws-
PUMP / SIPHON INFORMATION Final Grade jG /od
Demand -7, d
Manufacturer
Model Number GPM
TDH Lift 4 Friction Syestem~ s TDH I,i,) Ft
' Loss
Forcemain Length'/0d' Dia. Hey Dist.Towell'
SOIL ABSORPTION SYSTEM
BED/TRENCH width , Length, No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS / DIMENSIONS
LEACHING Manufacturer:
SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM
INFORMATION TypeO ~y~ CHAMBER model Number:
System: X o OR UNIT
DISTRIBUTION SYSTEM
Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length Dia Length 30 Dia. Spacing rjl r j0 " >30
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over a Depth Over 0 xx Depth Of xx Seeded/ Sodded xx Mulched
Bed /Trench Center J~ Bed/Tv~hEdges ~a Oy Topsoil fpa ( Yes ❑ No es ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: SOMERSET 1.30.19.479C,SE,NW,85TH /6G•SS
Plan revision required? ❑ Yes ❑ No "
Use other side for additional information. / .W, 1 6 k
SBD-6710 (R 05/91) Date Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
f
I
3.5,y
ivo.
`1 0
r r
v
1 •
•
D~LHR SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code COUNTY
STATE SANITARY PERMIT
-Attach complete plans (to the county copy only) for the system, on paper not less than ❑ / O4 q
8% x 11 inches in size. Chec f revision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. 5 94 9
PROPERTY OWNER PROPERTY LOCATION
_5 t/4 %4, S T Q , N, R (or
PROP TY OWNER'S MAILING ADDRESS LOT # BLOCK #
CITY, STATE
1 13 ZIP CODE PHONE NUMBER SUBDIVISION NAME OR 7M NUMBER
II. TYPE OF BUILDING: (Check one) 1-1 State Owned ❑ VILLAGE NEARS ROAD
❑ Public ®1 or 2 Fam. Dwelling- # of bedrooms-5 PARCEL TAX NUMBER(s)
III. BUILDING USE: (If building type is public, check all that apply)
1 ❑ Apt/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 in line A. Check line B if applicable)
A) 1. 0 New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 0 Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
14 ❑ System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE
REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./' ch) ELEVATION
~SO 3 7~ ..S / i Feet ' u Feet
VII. TANK CAPACITY Site
in alions Total of Prefab. Fiber- Exper.
INFORMATION New Existing Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks strutted _M__ -17 F1 I El "
Septic Tank or Holdin Tank
Lift Pump Tank/Si hon Chamber R" zy f) I
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installa 'on of the onsite sewage system shown on the attached plans.
71umb/es Nam (Print): 1 Plumbe 's S' net e: ) MP/MPRSW No.: Musess one Number:
1-24
umbe 's Addre S t, City, State, Zi Code):
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater a e Issued Issui gent Signature tamps)
Surcharge Fee)
pproved ❑ Owner Given Initial AL
Adverse Determination ~ _,,~ky
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
BD-M8 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS
1. A, sanitary permit is valid for two (2) years. ,
2. Your sahitarj permit may be renewed before the expiration date, and at the time of renewal any new
criteria in the Wisconsin Administrative Code will be applicable.
3. All revisions to this permit must be approved by the permit issuing authority.
4. -Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6'399) 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 & 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 in line A. Complete line B if permit is for tank replacement, reconnection, or
repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested in ##1-7.
VII. Tank information. Fill in the capacity of every new and/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% x 11 inches must be submitted to the county. The
plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of
holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service;
streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system
areas; and the location of the building served; B) horizontal and vertical elevation reference points;
C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump
performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system. if
required by The county; E) soil test data on a 11.5form; and F) all sizing information. . .
GROUNDWATER-SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of
regulated practices which can effect groundwater.
The monies collected through these surcharges are used for monitoring groundwater, ground-
-water contamination investigations and establishment of standards.
i 9
l ,l+ h1 ♦ \ ~ ~1. ai ♦ 'e
SBD-6398 (R.11/88)
pig
WORKSHEET - i`iOUNU SYSTEM DESIGN S92,.40729
PROBLEM:
- ~~rP...~...._.,.~..•
Design a mound system fora ____2zz
The site characteristics are:
Depth to groundwater or bedrock in.
1
Landslope
Percolation rate i,,ii, n. n.
Distance from dose chamber to distribution systex ~,Gg_ ►t•
Elevation difference between Dump and distribution s,vstern ft.
Step 1. WASTEWATER LOAD dal
Y
• S :,gip 2. SIZE-THE ABSORPTION AREA
A) Area required
B) Bed or trench length (B) _ ft.
C) Bed or trench width (A) a ft.
r` 'D) Trench spacing (C)
r 2
Wastewater load .24 cial/ft /day B
Step 3. MC°UND HEIGVT
A) Fill depth (0) ft•
B) Fill depth (E) - D + slope (Ay~p) ft.
C) Bed or trench depth (F) _ ft•
D) Cap and topsoil depth (G) =r® ft.
E) Cap an top oil depth (H) = AUG 14 1W2 - ft.
54 -,2 of Ip-
i
Step 4. MOIJND LF_NGTH
1
A) End slope (K) _ CD + E/ + F + H x 3 ft.
~7'
B) Total mound length (L) = B + 2(K) n ~3o.Zft•
Step 5. ! u-jND WIDTH
i' Al) Upslope correction factor
A2) Upslope width (J) (D + F + G)(3)(factor) = ZL3 - ft.
C06 -fo :2e, 3
B1) Downslope correction factor
B2) Downslope width (I) _ (E + F + G)(3)(factor ft.
C) Total mc+und width (W) for bed = J + A + I Ft•~s'3~-r
C2; Total mound width (W) for trenches =
J + + (no. trenches -1)(c) + A + I = ft.
Step 6. BASAL AREA
A) Infiltrative capacity of natural soil „ gal./ft2/day
B) Basal area required = wastewater flow
naturr,l soil infiltra -ive capacity = sq. ft.
C1) Basal area available for bed for sloping sites •Bx (A+I) _ -ft.
C2) Bas are avail le for trench for sloping sites =
t.
B W-- J+A1,sq. f
C3) Basal area available for trench or bed for !COel
.
-9it = B x W = 't sq. t
License, :u
,fir gt .3 .9f Lo
I Step 7. DISTRIBUTION SYSTEM
7A) SIZE DISTRIBUTION SYSTEM
1) Hole size = in.
2) Hole spacing in.
i
3) Distribution pipe length a2- i-r'•fr
4) Distribution pipe diameter a_ in.
5) Spacing between distribution pipes in.
6) Distance from sidewall to distributeion pipe - ~ in.
7B) DISTRIBUTION PIPE DISCHARGE RATE ft.
1) Number of holes per pipe
2) Flow per pipe _ GPM
i7C) SIZE MANIFOLD
1) Manifold is central/ end
2) Manifold length a ft.
3) Number of distribution lines
=
4) Manifold diameter in. I
7D) SIZE FORCE MAIN
i
1) Minimum dosing rate ~(L GPM
2) Force main diameter .i..._ in.
j
3) Friction loss •gj~a = 1. ft.
7E) TOTAL, DYNAMIC HEAD
1) Vertical lift o ft•
2) Friction loss = ft.
3) System head 2.5 ft. ft.
i
ft.
4) Total dynamic head =
s LICBrC;C
:i
i
7F) PUMP SELECTION
1) Pump selected will discharge GPM at ZS- ft.
total dynamic head.
2) Pump model and manufacturer
7G) DOSE VOLUME }
1) 10 times v i volume distribution lines gal./cycle
2) Daily was ewater v ~ume 4 doses/24 hrs. _ gal./cycle
3) Minimum dose volume = Z,A gal./cycle
7H) DOSE CHAMBER
1) Minimum capacity required = 5-z,7 7S'~ya~ _ gal.
Licunso "U:
Date:
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Pags_.~ Of-,1=
Straw, Marsh Hay, Or
Synthetic Covering Distribution Pipe
Medium Sand
H ~ G
Topsoil F
3 E D
it Slope Force Main Plowed Layer
Bed of V- s"
Aggregate
Cross Section of a Mound System Using
A Bed For The Absorption Area D Ft.
EFt.
F R3 Ft.
AFt. G 0 Ft.
B Ft. HFt.
Signed: Kam, Ft.
Olga-
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License f : -`7 J 7 3 Ft.
Date: w ~Y 51
ON IT P~ p'l
~ fi,, ~ t• air ~ t~
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P".
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Alternate Position of
Force Main
I
_J Observation Pipe
A i Forc Main
W
Distribution Pipe of"-2~"
Bed
S= uts~~, Aggregate
Observation
I Pipe Permanent Marker
Plan View of Mound Using a Bed For the Absorpiion'Arsa
TEM.
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Perforated ae~ Detail
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An 9*411 40ced
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PVC Force Mo1w _
PVC
Modfotd Pica
Alternate Position of
Dispip Ilion force Main
Lost Mob Snould Be ,
""I TO W Cap
Eid cop Distribution Pipe Layout P ?,0 Ft.
R
Sr
X '20 Inches
y )S' Inches
Signed: Hole Diameter Inch
Isla 9z
Lateral Inch(es)
License Number: Manifold 0 42 -Inches
Date:Force Malin " Inches
# of- holes/pipe„
Invert Elevation of Laterals, fq,~Ft.
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PAGE OF..L~_
7;. PUMP CHAMBER CROS5 SECTION AND SPECIFICATIOMS
VENT CAP Lk0 1 0
H"C.I. VENT PIPE
WEATHER PROOF APPROVED LOCKING
JUMCTIOIJ BOX MAWHOLE COVER
25', FR¢M DOOR.
WIWDOW OR FRESH 126MIN.
AIR INTAKE
GRADE.
- ) Y MIN.
B' MI IJ.
CONDUIT L--
IB'/rIN.~
INLET `PR VIDE
` HT SEAL
A/CI P E'JOIUT ..:.A ,~~5~~ APPROED
PE011JTS
W/C.I
W , ON5 ~ rll I
EXTENDIN III ALARM EXTEWOIN6 3'
(s 3 f,.
ONTO SOLID. SOIL' B t ' v-1, 4 ~5~ I I I ONTO SOLID: SOIL
~tF PUMP -~J
OFF
CONCRETE BLOC+t
RISER EXIT PERMITTED OIJL4 IF TANK MANUFACTURER HAS. SUCH APPROVAL
SPEC.IFICATIOUS
.
PTIC AND
E TANKS MANUFACTURER: WMBER OF DOSES: 7 PER DAB
TAIJK':,ITE GA LOAJS DOSE VOLUME:GALLOAIS
ALARM . MANUFACTURER: ~:..s CAPACITIES. A-.NICHES OR s",..,y' C
GALL'OA15
"MODEL IJUMBER: - T B=- -INCHES Olt GALLONS
SWITCH TYPE: / C= INCHES OR ,Ts
ALLOWS
PUMP MANUFACTLIKE R: D= ,-INCHES OR GALLOWS
MODEL NUMBER. -~1 1 NOTE: PUMP AND ALARM ARE TO BE
bWIICH. TYPE' INSTALLED OW SEPARATE CIRCUITS
PUMP DISCHARGE RATE ~Q GPM A f' .~S'0Ws0
VERTICAL. DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE... FEET
+ MINIMUM NETWORK SUPPLY PRESSURE 2.5 FEET
FEET OF FORCE MAIN X _19L2 _L FEET-b1"
s0o FLFRlCT10N FACTOR.. ~
TOTAL DyAIAMIC. HEAD FEET
ii.t-"
Al
IMTERNAL DIME STOWS OF TANK: LEAICsTH ;WIDTH ; LIQUID DEPTH
SIGNED: /
LICEIJSE AJUMBER: gal ! DATE:
<~-=[4-~C
T,9G,C /D .P' M
Performance i
. ,~acEffluent
curves Pumps
METERS FEET /l7PA'Sr,J 3v7S 9
- 90 MODEL 3885
25 80 SIZE 3/4" Solids
WE15H
70
I 20 WE10
H
Q
60
H
- WE07H
15
WE05H
40
10 30 WE03M
WE03L N. N
20
5
10
0 0
0 10 20 30 40 50 60 7 80 90 100 110 120 GPM
w r~1u.L 0 10 20 30m3/h
CAPACITY
[QGOULDS PUMPS, INC.
SEPECA FALLS PEW Ym 13148
METERS FEET
120 MODEL 3885
35 110 WE15HH SIZE 3/4n Solids
30 100
90
25 80
70
X 20
a
60
0
50 WE05HH
15
i
40
10 30
20
5
10
0 0
0 10 20 30 40 50 60 70 80 90 100 110 120 GPM
1 I
0 10 20 30 ml/h
CAPACITY
01985 Goulds Pumps, Inc. Effective July, 1985
C3885
W-tront,n Decii-tr"►rl of Indultry, !IiUll Utbt.liilr' I IVrr rtLt vii, r
labor and human Rtlationt jCr
(Attach Soil Profile Location Map • To Scale - On A Separate, Signed Sheet) ra+orton, :.4 51: c'
Page
cisrura
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CICv =
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Elev a I SA) Al 14
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Elev s
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Other $It# Features:
Syslcm Elevation - r. • Iv"+t"'• ete rgne TeteohoneNO. Sr •
CST Names (PeW) City Stale
Zip
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S T C - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER
~3ra /C~f~el~sT PE ~E'/h!
ADDRESS FIRE NUMBER
CITY/STATE ZIP_r
PROPERTY LOCATION : ~l/4 ,,6L1/4 , SECTION T,.f22_N-R_/_~_"W
TOWN OF St. Croix County,
SUBDIVISION , 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 a licensed septic tank pumper. What
you put into the system can affect the function of the septic tank
as a treatment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant
for a maximum of 60% of the cost of replacement of a failing
system, which was in operation prior to July 1, 1978. St. Croix
County accepted this program in August of 1980, with the
requirement that owners of all new systems agree to keep their
system properly maintained.
The property owner agrees to submit to St. Croix Zoning a
certification 'form, signed by the owner and by a mater plumber,
journeyman plumber, .restricted plumber or a licensed pumper
verifying that (1), the on-site wastewater disposal system is in
proper operating condition and (2) after inspection and pumping (if
necessary), the septic tank is less than 1/3 full of sludge and
scum.
I/We, the undersigned have read the above requirements and
agree to maintain the private sewage disposal system in accordance
with the standards set forth, herein, as set by the Wisconsin DNR.
Certification stating that your septic has been maintained must be
completed and returned to the St. Croix Co. Zoning Officer within
30 days of the three year expirations date.
SIGNED:.[ ~,/G!_ Z~
DATE :
St. Croix co. Zoning Office
911 4th St.
Hudson, WI 54016
STC-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), thenia 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 _ 4 f/
Location of, property ,j 1/4 /AN&,'_1/4 , section Tf,~) N-R_Z,~'W
Township
Mailing address ~f
Address of site
Subdivision name ,dZ~ Lot no.
Other homes on property? yes No
Previous owner of property k7_
Total size of parcel
Date parcel-was created
'Are all corners and lot lines identifiable? Yes No
Is this property being developed for (spec house)? Yes 'V-,No
volume- 979 and Page Number 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 & 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 the office of the County Register of
Deeds as Document No.j ► 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 County Register of deeds as Document
No.
Signature of applicant Co-applicant
1
Date of Signature Date of Signature
4
r Hale husband and ..=f
a a t as Wan undivided
w ion E. Siekmaier 11
as. to air
wnveys and Warrants to - r t~►..~►. TtX-a ej.Cbcl.aCa.Q.Peccio . t
F
n b•rUrq to sip.
r ,M11..v~;r~ detcrtbeJ teal e+tate ip St...-Croix Cutalty,
Of 'v` UMUSin f s , 1
Tax Pared Nr.....;.r.
> attached 1"*1 Gp'iption
aL + ms's t, ~F.t' u~ - r~
901'
3.j NUEt y ~3 } iyz
and rivhts-of way.
tiai6ordi'-, if ariy.
7~~ r VV
P *v 7 Aar
talc
T 5 OVAL); -Coll
Allen SielFmeier
4 {
ACRNOWLSDi' KXNT ;
-a s ~ a: a` • tp~y~t ~i~!~('tt!'Iltt,~'"'~t~ t 't ~sR~..
E ~1. I S~~?Vr A;4✓. u[ -tf!I }wx ~1 ~:t::i',.r - .1'~x~aa11 e.ite.l six tr.:+ `
1 woN a
A ~ Iu "kpeur tq br the- grr*Dn t.tl tlceectte
~yys,yy~y '
nuzl at
i r k ~y~, t1 °Ir,th ~t l y; t04
~n r j., 3 E_ to
x
~1
++haw! .twrd blsr lt+~3~33"tE-75•#1 #~lt; 4't~
Way ;line 963`. 7a feet td'th! -sly Right-e(-way `1los vt' 8tit -4k I
thence M89'5-7'24"l♦ slang "'td Sly Right-o[ litae,iA• [e!t
slap "Ad Nlttljt-Est-Mny tithe 50.0 1*0i; -thlOC ` ` # Aw.
20
_S8>t" ~ V) aiowxl m,0d Ri~trt-ant-itor Dina 499: i3, ett~ thsn E
r6coctted S$7' 4,'2A fait to •034ce of be4tttrting• `
EXCBR tlttC. i'ft
pm* that. - Y ib ~c
!d' -35810V
t).
• AJAO ; MCWTp16 Tv"ZIM l1 (tea t, 2t': lld? of 'trti Carta
ied.
i. 1919. in ail..,
' Rcx, Let t of t L a ! Is. ` i~# t v. ' t
40 ,
P+tNt lt,'R, ' >sn
RCS hlt'tts !r
t99r- iA 1103. " 2140 tat 2 of t1Mili1~ Sul,
~~Xo 3h
ptrg! ~ti+i, t►s il'oetmetNt 'lllo. 6Sl t9s (Ib. t~+i):
Y )tea
tl
K
s
ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
ST. CROIX COUNTY COURTHOUSE
911 FOURTH STREET • HUDSON, WI 54016
(715) 386-4680
Aug. 11, 1992
Division of Safety and Building
Bureau of Plumbing
P.O. Box 7969
Madison, WI 53707
To whom it may concern:
An onsite soil investigation of the Greg Frey property, located in
the SE1/4 of the NW1/4, Sec.l, T30N, R19W, Town of Somerset, St.
Croix County, WI., has been conducted with the assistance of Kim
O'Connel, CST# 2344.
This onsite revealed suitable soil for onsite sewage disposal to a
depth of 32" while meeting the requirments of the A + 4" rule. This
site should be suitable for new construction using a mound septic
system having 12" of sand fill.
Should you have any questions, please feel free to contact this
office.
Sinc rely,
awes K. Thompson
Assistant Zoning Administrator
cc: file