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Parcel 032-1009-10-100 07/03/2006 05:09
PAGE 1 OF 1
F 1
Alt. Parcel 4.31.19.55C 032 - TOWN OF SOMERSET
Current Xf 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 - LOWE, LAWRENCE T & SALLY B
LAWRENCE T & SALLY B LOWE
2369 40TH ST
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description
SC 4165 SCH D OF OSCEOLA
SP 1700 WITC
Legal Description: Acres: 4.300 Plat: 3481-CSM 12/3481
SEC 4 T31 N R1 9W SW NW BEING LOT 1 CSM Block/Condo Bldg: LOT 1
12/3481
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
04-31N-19W
I
Notes: Parcel History:
Date Doc # Vol/Page Type
08/06/1998 584591 1346/433 QC
04120/1998 577591 1316/436 WD
07/23/1997 506/558
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/22/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 4.300 54,500 86,200 140,700 NO
Totals for 2006:
General Property 4.300 54,500 86,200 140,700
Woodland 0.000 0 0
Totals for 2005:
General Property 4.300 54,500 86,200 140,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 118
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
FORM - STC - 104
AA91- AS BUILT SANITARY SYSTEM REPORT
OWNER_ /i,eg,, tV TOWNSHIP
SECTION__~/ _T _Z~ N-R_J~ W
ADDRESS ST. CROIX COUNTY, WISw IN
23~ t S-1-
fry 3 YD'
SUBDIVISION LOT LOT SIZE
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
40
INDICATE NORTH ARROW
BENCHMARK:Elevation and description:, m,,saEa-
Alternate benchmark
SEPTIC TANK: Manufacturer: Liquid Cap. IzW"
Rings used:LManhole cover elev:LFinal grade elev:
Tank inlet elev.: Tank outlet elev.: S
No. of feet from nearest road:Front , Side , RearLFt.
From nearest prop. line:Front , Side , Rear X Ft.
No. of feet from: Well -;40-'D , Building:
(Include this information in the above plot plan)
(2 reference dimensions to septic tank)
SEE REVERSE SIDE
J
r
i
i
PUMP CHAMBER
Manufacturer: Liquid Capacity:
Pump Model: Pump/Siphon Manufact.: Pump Size
Elevation of inlet: Bottom of tank elevation
Pump on elev.: Pump off elev.: Gallons/cycle:
Alarm: Man.: Switch Type: Location
Distance from nearest prop. line: Front_, Side, Rear-Ft.
Distance from: Well Building
SOIL ABSORPTION SYSTEM
Bed: y Trench: Seepage Pit:
Width: 1,e Length / Number of Lines: Area Built-
Exist. Grade Elev. ~f Proposed Final Grade Elev. /
Fill depth to top of pipe
No. feet from nearest prop. line:Front , Side Rear,,~_Ft.,-:LQ '
No. feet from well: y~A/r No. feet from building
HOLDING TANK
Manufacturer: Capacity:
No. of rings used: Elevation of bottom tank:
Elevation of inlet:
No. feet from nearest prop. line:Front , Side Rear Ft.
No. feet from: Well building , nearest road
Alarm Manufacturer:
INSPECTOR:
DATE: - 7 - PLUMBER ON JOB:
2Z
LICENSE NUMBER:
6/90:cj
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
-Labor and Human Relations INSPECTION REPORT St. Croix
Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No.:
GENERAL INFORMATION SW4,NW4,Sec.4,T31-R19,40th St. 149134
Permit Holder's Name: ❑ City ❑ Village [2 Town of: State Plan ID No.:
Reuben DIartin Somerset
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
53C-54B-55A-56
TANK INFORMATION ELEVA N DATA a0 r/
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Benchmark Y'
Septic s* /C .%ZC~.d /O/.3S % db.OZ>
Dosing-`
Aeration Bldg. Sewer
Holding St/ H-j Inlet i 535
TANK SETBACK INFORMATION St/ Outlet (,'23/ a'
TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic ate' A NA Dt Bottom
sing NA Header IU^-r
Aeration NA Dist. Pipe " j( 41
9
Holding Bot. System y" 3, (al
PUMP/ SIPHON INFORMATION Final Grade
Demand A ~ 97,651'
Model Number GPM
TDH Lift Friction S m TDH Ft
Forcemain Length Dia. Dist. ell
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
f DIMENSIONS 6P S DIMENSIONS
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK
INFORMATION Type Of CHAMBER Model Numer:
System: 3$ >OR UNIT
DISTRIBUTION SYSTEM
Header /4 an+#eld Distribution Pipe(s) „ x Hole Size x Hole Spacing Vent To Air Intake
Length Dia. Length Dia. Spacing _-L-
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 - Bed /Trench Edges ~4 - Topsoil E] Yes ❑ No ❑ Yes E] No
COMMENTS: (Include code discrepancies, persons present, etc.)
' { r ~ . ~ , ~ <,.~; r?(.. ~ i .w ma=r 246-<40-
/ f
revision required? ❑ Yes UX0_
Plan
Use other side for additional information. ZZ:L
SBD-6710 (R 05/91) Date Inspector's Signatu a Cert. No.
SANITARY PERMIT APPLICATION I/do1a3
713ILHR In accord with ILHR 83.05, Wis. Adm. Code COON i. ~ &,&"`o
veil'`-'C
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than ❑ Y
8% x 11 inches in size. Check if revision to revi s application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE P "T ALL INFORMATION.
PRO ERTY OWNER~8 PROPERTY LOCATION
' kJ '/a S T„3 , N, R (Or~
PROPERTY OWNER'S AIL)NG ADDRESS LOT # BLOCK #
-2- d
CITY, STATE ZIP CO E PHONE NUMBER SUBDIVISION NA E CSM NUMBER
1
.41
.WN
ID CITY I
1D
11. TYPE OF BUILDING: (Check one) ❑ State Owned VILLAGE NEAREST
. UM ( )
❑ Public X 1 or 2 Fam. Dwelling-# of bedrooms --S PARCEL TAX
111. BUILDING USE: (If building type is public, check all that apply) S- lw-
1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
30 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. 154 New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.0 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 M Seepage Bed 21 ❑ 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
REQ IR. ft.) PR=. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
Feet 9, 6' Feet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Hold In Tank O )6~. - El 1 0 F-1 F] F-1 r-1
Lift Pump Tank/Si hon Chamber
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for install tion of the onsite sewage system shown on the attached plans.
Plumber s Name (Print): Plumb is ignatu : (No a ) MP/MPRSW No.: Business Phone Number:
Plumber's Td-dress (Street, City, State, Zip Cod :
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (includes Groundwater Z;": Issuing gent Signature (No s)
Surcharge Fee)
A roved ❑ Owner Given Initial
pp Adverse et rmination
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Pll 67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
• APPLICATION FOR BRNITARY PERMIT
9TC-100
This appllcatlon form Is to bo conplntod In full and reigned by the ovnet(s) of
the property being developed, hny lnadoquacles will only result In delays of
Lhe pttrnlt Isluance. -Should thin development be lntended for tesaII by
owner/contractot,(epec house), then a second form should be retained and
corpIsted vhan the property is sold and submitted to this a f f I c a v I t h the
approptlate deed reeordlnq.
Ovnir of property -
Location of property 114 --1/4~ Bastion T_Z2_j(-R V
Township
Ka IIIng address
IWdtess o[ site
labdivlslon name_ ~1~ •
Lot number 1 t
Ptevlous owner of property '
Total ■1=e of parcel '
e Date parcel was created
Jets all cotnats and lot linos ldentlflable? Yes
Is this prapatty being developed for resale (spec house)?` Yes ?(o
Yolar.a sand page HuMb.szq S-
an recorded wlth the Raglatet of Deeds.
IHCLUD9 WITH THIS APPLICATION Tlla FOLLOWIHCI
A VXARNITr D¢tD which Includes a DOCUHRHT IIUNSRR, VOLUHR KXD PAot 1"ItR, and
the STKL of TIIL RROISTRR OF DRRDS. In addltlon, a certltled survey, it
available, would be halplul so as to avoid delays of the tavlowlnq precise. It
the deed desctlptlon teterencas to a Cattlfled Survey Hip, the Cattlfled Survey
Hap shell also be tequlred.
PROPZRTY OvlltR C
-6RTIFICATIoH
live) certlty that all statements on lhls form are true to the bast of my (out)
k n o v I i d 9 t I that I (we) am (Ste) the owner(s) of the property described In
this In(otmatlon Corm, by virtue of it Warranty
t h e deed recorded In the ot(lca of
county Reglstar of Deeds an Document Ho.
prand th
~ or I Iat I (weI
esently own the proposed alto for the sewage disposal a ates, (
obtalntd an easement, to run with the above described roertyvs) have
conattuctlon of sold nyatem, and the same )time been duly recorded InthefoofIIca r the
of the county Regtst.r of beads, as Document Ho.
signature of Ownet Blgnatuta of co-ovnet (ft Applicable)
DIt te of slgnatuta Date of llgnature
f
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNE BUYER
ADDRESS: FIRE NO:
LOCATION: X1/4, 1/4, SEC. ~T_Z / N-R~W,
TOWN OF: ST. CROIX CO7TY
SUBDIVISION: LOT NO.
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 to
help with the cost of the 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 the St. Croix County
Zoning 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 (2) after inspection and
pumping (if necessary), the septic tank is less than 1/3 full of
sludge and scum. Certification from will be sent approximately
30 days prior to three year expiration.
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 form must be completed and returned to the St.
Croix County Zoning Officer within 30 days of the three year
expiration date.
SIGNED: DATE: St. Croix County Zoning office
911 4th St.
Hudson, WI 54016
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
IN.CJUSTRY; 1 C DIVISION
L BOR P.O. BOX 76
HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707
(H63.090) & Chapter 145.045)
LOCATION: SECTI N: p ~f TO VIP/MUN G;PA-I=tTY OT N BLK. SUBD
~1 I V ION NAME:
1 JT3/ N/fl L (or 1H ~S r1
COUNTY: OW NE ' B Y oZ;S N MAILING ADDRESS: la~
S
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMER AL DESCRIPTIO PROFILE DESCRIPTIONS: PERCOLATION TESTS:
®Residence N: [ZNew ❑Replace
Lam, -
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUNccD: IN-GROUND-PRESSURE: S STEcM-IN-FILLHOLDIING TANK: RECOMMENDED YSTEM/loptional)
If Percolation Tests are NOT require DESIG RATE: If any portion of the tested area is in the
under s.H63.09(5) (b), indicate: S Floodplain, indicate Floodplain elevation:
t A114
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED EST. I HEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
> -
B- 7 ~s
B-,3 q11) 9A --i'Ma5z sy- S e
B- 9,-7 ql. 'Z 41,QAZ6
5 s~crs~
gel, Z - Z2 'oB-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERT 2 PER PER INCH
P- - J
P- 8 3
P-_
P_
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings nd the direction and percent
of land slope. ,
SYSTEM ELE"TION
3
I
7 LA
_4
0
s I I ( R
N
t
--f _ _../4
I, f~fe undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin
Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NAME TESTS WERE COMPLETED ON:
AD S CERTIFICATION UMBER: PHONE NUMBER (optional):
3 /,~Ore
CS IGN U l
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
D I LH R-SB D-6395 (R. 02/82) - OVER -
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582319 ST. CROIX COUNTY
SURVEYOR'S RECORD
CERTIFIED SURVEY MAP
Located in part of the Southwest Quarter of the Fractional Northwest Quarter of Section 4, Township 31 North,
Range 19 West, Town of Somerset, St. Croix County, Wisconsin.
Prepared for and at the request of:
OWNER: NOTE: THIS IS A FARM LAND CONSOLIDATION
Reuben C. Martin
2371 40th Street
Somerset, WI 54025 -NORTHWEST CORNER
Drafted by. Kristi A. E&ndt SEC 4-31-19 a h
i (AL UM. CO. MON.) •
I i jp
0 o~ ~~'~2199a .
RTHegEisEteNr H• SN t}
~ J
of 0eeW1
2 I to
Q) jq
o Y v
I Z I i I UNPLATMC LANDS OF OWNER ` YRH
W ~ 'I a y
N l b \ S86'19'58"E 750'00'
p W 1 g
01 1
z1 ~I N I 00°1~`33.00' iiSHD>!: 717.00'
w
of Cn oI W I--I N I C-41 ® W CENTERLINE DRIVEWAY t,
0 LL
2
QI 1? 071 D I W WI 3 Q ry OI
a. I t" C" En
° . "
o I g~/ 3
Z a o
O133.00' ! ES
O i I I in
0
717.00' o Q
Cn -J
~J 1i I N86'19'58"W 750.00' a.
I to I ~I
' aot wIpW
UNPLATTED LANDS OF OWNER
i w
RONALD F.
o JOHNSON
~ : ~ 6--1 196
AMERY,o
t\~~ I Z WEST 114 CORNER Wls'/vi a'0
SEC. 4-.T I -19 C
; 'y"'P 0
(f-ND R.R. SRIKE)
0 SU R `i E' +6~,,
Mte •pM
TOTAL AREA: NOTE: THE PARCEL SHOWN ON THIS MAP IS SUBJECT
187,500 SQ. FT. / 4.30 ACRES TO STATE, COUNTY AND TOWNSHIP LAWS, RULES AND
REGULATIONS (I.E. WETLANDS, MINIMUM LOT SIZE, ACCESS
AREA EXCLUDING R.O.W.: TO PARCEL, ETC.). BEFORE PURCHASING OR DEVELOPING
179,250 SQ. FT. / 4.12 ACRES ANY PARCEL, CONTACT THE ST. CROIX COUNTY ZONING
OFFICE AND THE APPROPRIATE TOWN BOARD FOR ADVICE.
LEGEND:
County Section Corner Monument
of Record 4t
• Set 1" x 24" Iron Pipe weighing
a minimum of 1.13 pounds per r
linear foot.
• • • • • • . • Building Setback Line (100' from R.O.W.)
0 Septic Vent
Iso o 'SO NO TH
JOB #98065 (R14)
Prepared by. '
A & E GRAPHIC SCALE
LAND SURVEYING do CIVIL ENGINEERING SCALE IN FEET: 1 inch = 150 feet
Phone No. (715) 246-4319 BEARINGS ARE REFERENCED TO THE WEST LINE OF THE
109 East Third Street, P.O. Box 325 FRACTIONAL NW 1/4 OF SECTION 4, TOWNSHIP 31 N.,
New Richmond, WI 54017 RANGE 19 W. WHICH IS ASSUMED TO BEAR N03'40'02"E.
Sheet 1 of 2
Vol. 12 Paqe 3481