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Form - S T C - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER C O 11 t?2 TOWNSHIP ~~Q ~"J!~J?ST SEC. _ T 30 N-R_W
ADDRESS f ~U Tw A U/r' ST. CROIX COUNTY, WISCONSIN
SUBDIVISION LOT LOT SIZE ~ACff-G-5
PLAN VIEW
Distances and dimensions to meet requirements of I•IHR, 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
y0as
4! Er"LL
53~
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poo
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18 x b"3
SEEP ACE AED
INDICATE NORTH ARROW
BENCHMARK: Describe the vertical reference point used 3 %eE'L
Elevation of vertical reference point: zdo,0 Proposed slope at site: .
SEPTIC TANK: Manufacturer: WAFaoF~S Liquid Capacity: /Q~(g
Number of rings used: Aoff-E Tank manhole cover elevation:
`S ~Z7
Tank Inlet Elevation: 113..1 Tank Outlet Elevation: 1.3. 5?
Number of feet from nearest Road: Front,O Side, Rear, 0 feet
t
.From nearest property line Front, 0Side, 0Rear, ~ feet
~ r
Number of feet from: well , building: 30
(Include this information of the above plot plan)( 2 reference dimensions to 'septic tank)
SEE REVERSE SIDE
I
PUMP CHAMBER
I
Ma cturer: Liquid Capacity:
Pump Model: Pump/Siphon Manufacturer: Pump Size
Elevation of inlet: Bottom of tank elevat n:
Pump off switch elevation: Gallons cycle:
Alarm Manufacturer: Switch Type:
Number of feet from nearest prope line: Front, Side, O Rear, 0 Ft.
Number eet from well:
Numb of feet from building:
(Inclu distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: x Trench:
Width: 1 S Length: Y Number of Lines: Area Built: ~ y
Fill depth to top of pipe: AoeAAG,gF
Number of feet from nearest property line: Front, O Side, ® Rear,O Ft. GQ
Number of feet from well: Z9
Number of feet from building: 1 70 -
y-(Include distances on plot plan).
PAGE PIT
r
Size: Number of pits: Diameter:
Liquid depth. Botto of seepage pit elevatio .
Area Built:
Has either a drop box O or istribution box O be used on any of the above soil
absorbtion sytems? (Check one).
HOLDING TANK
Manufacturer: Capacity:
Number of rings used: Elevation o bottom of tank:
Elevation of inlet:
Number of feet fr nearest property line: Front, Side, O Rear, 0Ft.
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
arm Manufacturer:
qq Inspector:
Dated: Plumber on job:
License Number: I ~
I \
3/84:mj
f-T-V ~ U7
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING
LABOR & HUMAN RELATIONS DIVISION
P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION
ISQ~,.1 1 5geC.5 T30-R19 State Plan I.D. Number:
jjw~~nn►►+y CONVENTIONAL ❑ ALTERATIVE (It assigned)
A Town of Somerset Lot
180th St . Ho ding Tank El In-Ground Pressure El Mound
NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE:
Conrad Rivard 318 Hw d5&64, Somerset WI 5402 9.~8 d
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAREF. PT. ELEV.: CST REF. PT. ELEV.:
Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number:
Donavin Schmitt 3205 St. 'x 135509
SEPTIC TANK/ VI I d• o~ lE Cc w_r = 116,30' z • S
MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OU WARNING LABEL LOCKING COVE
PROVIDED: PROVIDED:
t2 ~ / 1 13. 20 /13. 5~ YES ❑ NO ❑ YES NO '
BEDDING: yam F DIA.: *&4 M,ATL.: HIGH WATER NUMBER OF ROAD: PROPERTY I' I WELL: BUILDING: VENT TO FRESH
C.cJ •v / ALARM: FEET FROM LINE: ` AIR INLET:
❑ YES NO $Z ❑ YES ❑ NO NEAREST - `~3 I~
MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
❑ YES NO ❑ YES ❑ NO
GALL CYCLE: PUMP AND CONTROL AL: NUMBER OF PROPERTY WELL:. BUILDING: VENT TO FRESH
(DIFFERENCE BETWEEN LINE: AIR INLET:
PUMP ON AND OFF ❑ YES ❑ NO NEAREST -Zi
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING:
or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN
the soil is dry enough to continue.)
CONVENTIONAL SYSTEM:
BED/TRENCH WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID
TRENCHES: AL:
DIMENSIONS
GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR IPE AT RIAL: NO. ISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH
BELOW PIPE S: ABOVE COVER: ELEV. INLET, E V EN ' / q" ry. jJO , PIPES: FEET FROM LINE: ` e A,IIRR INLET:
-avu 6. _ N 1f~ 3
-30 14? W _-V )aq MOUND SYSTEM:
Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM
slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW
❑ YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED.
SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS;
❑ YES ❑ NO ❑ YES ❑ NO
DEPTH OVER TRENCH/BE DEPTH OVER TRENCH/BED DEPT TOPSOIL: SODDED: SEEDED: M JYES HED:
CENTER: EGES:
E:1 YES ❑ NO ❑ YES ❑ NO ❑ NO
PRESSUR ED DISTRIBUTION SYSTEM:
WIDTH: LENGTH: NO. OF LATERAL SPACING: GRAVE TH BELOW PIPE: FILL DEPTH VE COVER:
BED/TR CH TRENCHES:
DIME IONS
MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING:
ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.:
ELEVATION AND
DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO
INFORMATION APPROVED PLANS
❑ YES ❑ NO ❑ YES ❑ NO
PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING:
COMMENTS: FEET FROM LINE:
❑ YES ❑ NO ❑ YES ❑ NO
NEAREST- ---n in county file for audit.
Reverse Side. SIGNATU E: TITLE:
SBD-6710 (R. 06/88)
R SANITARY PERMIT APPLICATION
=Eagal I~
In accord with ILHR 83.05, Wis. Adm. Code couN
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than
814 x 11 inches in size. ❑ c Vision to eviousapplication
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER PROPERTY LOCATION
COMRAO &C/,440 '/a y S 6' T30 , N, R E (or
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
8 . sLC tYX. CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
6 a
II. TYPE OF BUILDING: Check one CITY NEAREST ROAD
~~QQ'~~ ( ) State Owned ❑
[R 4QWN VILLAGE : O _ 7,y ?
❑ Public LLB 1 or 2 Fam. Dwelling-# of bedrooms PARCEL TAX UMBER filuri
111. BUILDING USE: (If building type is public, check all that apply) 032 v O
1 El 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. Z New 2.E] Replacement 3. ❑ Replacement of 4.E1 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 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
REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
.S 5 , 5.6 Feet 9 9 Feet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New lExisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Holdin Tank OD
Lift Pump Tank/Si hon Chamber
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plumb ' ignature: (No Stamps) M PRSW N Business Phone Number:
i r 9-! es-
Plumber's Address (Street, City, State, Zip Codey
G = Saris S& f` S
IX. C LINTY/DEPAR ENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater a e ssue Issuing Ag nt Signatu No Stam
Surcharge Fee)
Approved ❑ Owner Given Initial / aS.-
Adverse Determination
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
I
SBD-6398 (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 sanitary 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 6399) to be
submitted to the county prior to installation.
5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed
pumper whenever necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the
State of Wisconsin, Safety & 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.
111. 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 115 form; 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.
SBD-6398 (R.11/88)
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' APPLICATION FOR SANITARY PERMIT
ETC - 100
This application form is to be completed in full and signed by the owner(s) of
the property being developed. Any inadequacies will only result in delays of
the permit issuance. Should this development be intended for resale by
owner/contractor,(spec house), then a second form should be retained and
completed when the property is sold and submitted to this office with the
appropriate deed recording.
Owner of property two
Location of property lffZ-- 1/4 A'Z- 1/4, Section S , T~ D~N-R, W
Township
Mailing address -74 ell
5o.~ce~Sef ~1.
.~yoas
Address of site
Subdivision name 0,4
Lot number
Previous owner of property ZdW e~/
Total size of parcel I. o S ~c e/-
Date parcel was created
Are all corners and lot lines identifiable? Yes No
Is this property being developed for resale (spec house)? Yes _No
Volume and Page Number /c;C as recorded with the Register of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER, and
the SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if
available, would be helpful so as to avoid delays of the reviewing process. If
the deed description references to a Certified Survey Map, the Certified Survey
Map shall also be required.
PROPERTY OWNER CERTIFICATION
I(We) certify that all statements on this form are true to the best of my (our)
knowledge; that I (we) am (ate) the owner(s) of the property described in
this information form, by virtue of a warranty deed recorded in the Office of
the County Register of Deeds as Document No. ; and that I (We)
presently own the proposed site for the sewage disposal system (or I (we) have
obtained an easement, to run with the above described property, for the
construction of said system, and the same has been duly recorded in the Office
of the County Register of eeds, as Document N
Signature of Owner Sig atu a of Co-Owner (If Applicable)
5~-
Date of Signature Date of Signature
DOCUMENT NO. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA
STATE BAR OF WISCONSIN FORM 2-1982
458716
L 871 PAGE 122 RE ISfiER'
G S OFFICE
ST. CROIX CO., W
Lowe1.1 .-P,._Zi_v-ard.-and__y.i-rgi-ni.a-.L,---Ri-y_and.,---hi-s-.wi-fe-------------- ReC'd for Record
j
- ~ 3A4d P 1J90 M
- - - -
conveys and warrants to - -C-anrad-A._.Rivar_d.-and_dayce._A_..Rivard, r Cary
h-u.sta-nd--a.rl.d.wi-f-e_.as,.mari-ta] . r-o er-t--- '
' ...P p wi-th..r.i-9hts--of
keglsrer of Deeds
s_u.r_v_1-v-or_s-h-i-p--- .
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1! RETURN TO
.I - '
the II ~,I
I the following described real estate in St • Cr01 X County,
State of Wisconsin:
it
Tax Parcel No-
Part of the NE4 of the NE4 of section 5, T30N, R19W, and the SW4 of the
SE4 and the SE4 of the SW4 of Section 34, T31N, R19W, Town of Somerset,
St. Croix County, Wisconsin, described as follows:
Lot 1 of Certified Survey Map filed in the office of the Register of Deeds
for St. Croix County, Wisconsin on November 20, 1986, in Vol. °6°, Page 1749,
as Document Number 449492.
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This
1S_-nOt-------- homestead property..
(is) (is not)
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Exception to warranties :
it
Easements and restrictions of record, if any.
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Dated this 4----------•--------------•--- day of -------------------May. 19.9.0....
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(SEAL)
(SEAL)
Lowell P. Rivard
(SEAL)u ---.(SEAL)
* * -Vi_rgi.ni-a--b- Rivard--. .
ii AUTHENTICATION ACKNOWLEDGMENT
Signature (s) STATE OF WISCONSIN
f
ss.
.6V/--------------County.
authenticated this day of___________________________ 19 ersonally came before me this day of
7 / / C \19.11 the abov named
AL I ~C~tic r a P }_v l ry -C .
1 ~iJ
r _ ~
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not-
authorized by § 706.06, Wis. Stats.)
to me k own to be the pegs 5---------- who executed the
f ego gins rum an hack wledge the same.
THIS INSTRUMENT WAS DRAFTED BY i
William J. Radosevich, Attorney at Law -~c J - -
* corn- an mYr------------------
502 Second St., Hudson, "WI 54016
- - - Notary Public Ir kl~-k ------------------County, Wis.
(Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration
are not necessary.)
date: t-a--- _;)_a
"Names of persons signing in any capacity should be typed or printed below their signatures.
WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Cu. hic.
FORM No. 2- 1982 iUil,cimkcr, Wis.
L
STC - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
n
OWNER/BUYER
ROUTE/BOX NUMBERok FIRE NO.
CITY/STATE ZIP la's
PROPERTY LOCATION: NE 1/4 /4, Section T_10 N, R_4_W,
Town of p/ sefi , St. Croix County,
Subdivision Lot No. 1
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
$3000 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
systems properly maintained.
The property owner agrees to submit to 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 form 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 Department of Natural Resources. Certification
form must be completed and returned to the St.Croix County Zoning Office within
30 days of the three year expiration date.
SIGNED
DATE -50
St. Croix County Zoning Office
St. Croix County Courthouse
911 4th Street
Hudson, WI 54016
(715) 386-4680
Sign, Date, and Return to above address
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, DIVISION
LBOR
P.O. BOX 769
Fill ANREDLATIONS PERCOLATION TESTS (115) MADISON WI 3707
(H63.09(1) & Chapter 145.045)
I.OC;AT ION: SECTION: TOWNS HIP/MtiR X: TOT N .JBLK. NO.: SUBDIVISION NAME:
NE NVE1/ 5 /T30 N/R194(or)W Somerset 17-
n/a n/a _
t.:l?UN f Y: Y- R€ S iUAM N-i G U R S
St.._ Croix Conrad Rivard 1318 Hy. #35&64, Somerset, iii. 54025
USE DATES OBSERVATIONS MADE
RNO. BEDRMS.: COMMERCIAL DESCRIPTION: r TS:
3 n/a New OReplace I 5-10-90 5-11-90
RATING: S- Site suitable for system U- Site unsuitable for system
ONVENT NAL: MOUND: IN-GROUND ESS: S STE - N-FILL OLDING TANK: RECOMMENDED SYSTEM:(optio-ial)
[US ❑U ®S ❑U El S OU ❑S ®U ❑S ®U conventional
If Percolation Tests are NOT required DESIGn JisATE: If any portion of the tested area is in the n/a
under s.H63.09(5)(b), indicate: / I Floodplain, indicate Floodplain elevation:
decimal' PROFILE DESCRIPTIONS page 26 AmD2
BORING TOT _DEPIH T R NDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, "-EXTURE. AND DEPTH
NUMBER DEPT LEVATION OBSERVED ST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.-
13.1 8.67 100,08 none >8.67 1.17b1.1. .75 bn.s.sil. 6.67 bn. d.b.
B2 7.20 98,98 none >7.20 1.42bl.s.1. 1.00bn.s.si1. .75bn.s. .
-
B-3 7.92 98.58 none >7.20 1.42bl.1. 2.17bn.s.sil. 4.33bn.s.l.
B-
B-for alt. ee 115 f 9-16-85 Lovell Rivard o attached
B-
decimal' PERCOLATION TESTS
IFST DEPTH WATER IN HOLE TEST TIME D OP TE L VEL-INCH S RATE MINUTES
NUMBER AFTERSWELLING INTERVAL-MIN. _ PER INCH
P. 1 4.30 none 5 'z
P- _ none 3U 2 t314 3
P. 3.00 none 30 2 12 Z 20
P-
P-
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances.:aicribe what are the horl
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings anti the direction and percent
of land slope.
SYSTEM ELEVATION 95.58 51
i- - ((c %i
7-4
I ! I o' ' r'' ! z a'I T H
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k 14
1, the unrlnrsigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methocra t.pecifled in the Wisconsin
Administrative Code, and that the date recorded and the location of the tests are correct to the best of my knowledge and belief.
NAPAF (Ixirtt TESTS WERE COMPLETED ON:
Gary L. Steel 5-11-90
AI')IjItESS CERTIFICATION NUMBER: PHONE MBER(o tional):
988 N. Shore Dr., New Richmond, Wi_. 54017 2298 7 3X46-629
CST SIGNA
DI STRIBLITION- Original and one copy to Local Authority, Property Owner at, i Snil Tester.
n11.1IR q1111 G195 Ill. 02/R2) OVFR -
L
SOMEONE!
I iv~RiTMENT OF f/ REPORT ON SOIL BORINGS AND SAFETY & B LDINGS
JYJUSTRY, DIVISION
ABOR AND PERCOLATION P.O. BOX 7969
i►MAN RE AT IONS TESTS 0115) MADISON, WI 53707
(1-163.09(?i & Chapter 145.045)
t1l
N,t. IQ ]C
TI N: jTOWNSHW4A4W#WfPAj.ITY: LOT N BLK. : SUBDIVISI N NAME:
- AUeDil/ry ,x1or1 W cStj" fi1~~
U11/VT OWNERWBWY~R A -'MAILING U S :
Z
~ ` _ , ;ice ~ ~
DATES OBSERVATION MADE
T,.rc0 rrfYl~:r1.~ .R Fl rCr - PROFILE OLSCRIPTIONS! II!e-id,) rice
6~
3 New LJRepiace
ATING: S- Site suitable for system U- Site unsuitable for system URE: :j K. V1E(`N1~(('Oi-~T.AI.: MC'UNO: EA IN•.~s M ou DS ISYSTEM-12 L a ~G T~ RECOMMFFN D
SYSTEM:loptional)
Percol•ition Tests are NOT required DESIGN R TE: if any portion of the tested area is in the
;der s.1463.09(5)(b), indicate: Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS ~aZ
-)RING TOTAL ELEVATION DEPTH T GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
_ EST. HI
ER - OBSERVED HES TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
d
33 /(1033 a)~ r 4 #5~9
A)d /9-- J06 kb Al,
•7 /.S. .S. . 84.4,0• S D7: .Z ~A. s
/17
? y ~7(~ ✓3 - Q' L -
LI-Z s
r~ to • ,,.s.,c a ~.s: . l'
L/ %L
3
_ j..r.J/r3FJI PERCOLATION TESTS 1°.oM.~E:.Sis+'> 1 ~,&SS `mom
-'-DEPTH WATER IN HOLE TEST TIME I DROP IN WATER LEVEL-INCHES RATE MINUTES
.;tlVBEA 4NtTES AFTERSWELLING INTERVAL-MIN. P p,' i,' PEII INCH
Or PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the horn
r;al and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and.the direction and percent
land slope.
YSTEM ELEVATION 9'l ark rs
a &4 rIs~-
~ .
62
661
r r. i.. 1 f
- - ; 1 0
ae
Mot,
. ~ Ate a•' .
r
L ,
:he 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
iministrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
iMF print : TESTS WERE COMPLETED ON:
9-/0 85-
4 RESS: CERTIFICATION NUMBER: PHONE NUMBER(optionall:
/ cc) Z p his
CST 1 NA UR : n -0
STRIBUTION: Original and one ecpv to Local Authority, Property Owner and Soil Tester, C7
L.HR-SBD-6395 (R. 02/62) - OVER -
Now-20 1986
n~_ZA,
~1 y
CERTIFIES SURVEY MAP APP eD
LOCATED IN THE NE 1/4 OF THE NE V4 OF SECTION 6. T3ON.RI8W. AND THE
SW 1/4 QF THE SE 1/4 AND THE SE V4 OF THE SWI/4 OF SECTION 34.
T 31 N . R18 W. TOWN Of SOMERSET. ST CROIX COUNTY WISCONSIN N OV 181986
FOR., LOWELL RIVARD
SCOUT CAMP RD,R I
HOULTON. WI ST. CROIX COUNTY
1 c6Ed~!~► C0.1APXtHENSIVE PARKS PIAKP04
t-T c s~T •t"=SV^v --~1 Ar.G ZvNltiv CCJAdiNTTi
SECTION CORNER MONUMENT
0 50 160. 200 400 0 I"X24" ROUND IRON PIPE IWEISMINA
1.66 LBS./LIN. FT. SET
• 1" ROUND IRON PIPE FOUND
!►wps'
EET
007-rZ~6°' STR 13 41!
N ee~ 24 x E Q. NE COR.
" lass'
/4 C OR. WOG'47"E 3: I _ - - - ol'- SEC. ~
SE
btE 27. SEC. 34
O~ NORTH LINE 0 THE NE V4
a s_ LOT 2
W
= n p 177,586 So. FT. in
LOT 1 4.077 ACRES q q-p
o~
~ vi 176,396 SQ. FT. Y-% INCLUDING RIGHT-OF-
w a 4.090 ACRES N WAY - 1°
i INCLUDING RIGHT-OF- ~ in
ki 167,814 S O- FT. ~p
w WAY y 3.e5$ ACHES n _ a~K
m = wl 163,380 So. FL a EXCLUDING RIGHT- = i N
I'_ ( M 3.7968 ACRES IN OF-WAY h a O IJ1
'EXCLUDING RIGHT-OF- w o i-
j WAY 4
m J =
R1 W
260.
620.1 4
28 •0 4-q6"1t' 0 w ~ J
E 1/4 CORNER
UNSL~ITT[,Q~}AttOt SECTION 5
CURVE. DATA TABLE
(:carve Lot Radius Central Are Chord Chord Tangent
No. No. Angle Length Length Bearing, _ Bearing
i 300.00' 19040138" 103.03' 102.52' N67040110!IE N7703012911E
L 2 333.00' 19056142" 115.92' 115.33' N6704811211E N77046133"E
3 - 500.001 34004122" 297.34' 292.98' N74052102'IE
1 500.00' 15047100" 137.74' 137.30' N 65043121 IS
2 500.00' 18017122" 159.60' 158.931 N8204513211E
4 - 467.00' 3400412211 277.72' 273.64' N74052102/'E
1 467.00' 14055'44" 121.68' 121.34' N65017'43"E
2 467`.00' 19008138" 156.041 155.31' N$2019154"E
Vol. 6 Page 1749
486-1001
DESCRIPTION
A parcel of land located in the NE1/4 of the NE1/4 of Section 5, T30N,R19W
and the SW I /4 of the SE 1 /4. and the SE 1 /4 of the SW 1/4 of Section 34, T31N, R 19W.
Town of Somerset, St. Croix r,"o;,rity, Wisconsin, describ;2d as follgws:
Commenceing at the NE corner of said Section 5; thence S88124°29"W(bearings
referenced to the East line of the NE1/4 of said Section 5, assumed bearing
Sio17'52"E) 500.01' to the point of beginning; thence S1017'52"E 546.21'; thence
S7801Z10811W 520.001; thence N9047'21"W 571.521; thence Northeasterly 103.03'
along the arc of a 300.00' radius curve concave to the Northwest whose chord
bears N67040'10"E 102.521; thence N57049'51"E 94.711; thence Northeasterly
297.34' P Long the arc of a. 500.001.. radius curve c.nnr_-ave; to the Southeast whose
chord bears N7405210211E 292.981; thence S8800594' 134.431; thence 51017152"E
72.73' to the point of beginning, containing 353986 square feet (8.126 acres), more
or less, and being subject to Town Road right-of-way as shown, and all other
easements, restrictions and covenants of record.
1. James E. Rusch registered Wisconsin Land Surveyor,. do hereby certify that I
have surveyed and ,mapped the above described property; that such plat is a true
and correct representation of the exterior boundaries of the land surveyed; and
that I have fully complied with the provisions of tection 236.34 of the Wisconsin
Statutes, the St. Croix County Subdivision Ordinance, and the Town of Somerset
Subdivision Ordinance to the best of my professional knowledge, understanding
and belief.
♦~t{{tttltiry~~~
OIVS.~~~ii
0 ~CJG
pow"
James F.. Rusc AME.ri IE.~t~ ~r
Pl roff~ssional Land Surveyor RUSCH
'
Rusch Surveying, Inc. : S-1316
407 Second Street Sir Mob. O
Hudson, WI 54016 ,rZ ti+
ZA'
August 20, 1986 ;0UR
This mar) is hereby approved by the Town Board, of the Town of Somerset.
Date Town Clerk
Vol. 6 Page 1749
• Parcel 032-2017-20-200 11/22/2006 11:18 AM
PAGE IOF 1
Alt. Parcel M 5.30.19.534D 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 - HOBBS, MATTHEW L & NICOLE R
MATTHEW L & NICOLE R HOBBS
547 180TH AVE
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 547 180TH AVE
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 4.050 Plat: N/A-NOT AVAILABLE
SEC 5 T30N RI 9W & SEC 34 T31 R1 9W SW SE Block/Condo Bldg:
& SE SW LOT 1 CSM 6/1749
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
05-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
08/15/2003 735777 2365/532 WD
06/17/2003 726226 2279/10 QC
03/01/2000 619005 1493/01 ?,,WD
04/26/1999 601940 1421/371 WD
more...
2006 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/14/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 4.050 53,200 106,300 159,500 NO
Totals for 2006:
General Property 4.050 53,200 106,300 159,500
Woodland 0.000 0 0
Totals for 2005:
General Property 4.050 53,200 106,300 159,500
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
N `
O N O O
N N 0 E°9 b°4 0 °Efi °
a. O O
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= to = to
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r\O J N C N C N C f=6 C
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40. 7 0 (7 O C O O .O. V* (D
0) °yo Q N w CD O'a c m C 'a c
00 N Ln N 00 O =3 to N O N O O V7 (0 O N O
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FILED fo
NOW201980
Imm a wxA
Aww« a D..* i
$'w%q" Ana
SURVEY MAP APP D
CERTIFIED
LOCATED IN THE NE 1/4 OF THE NE V4 OF SECTION 5, T30N.R19W. AND THE
31 N4.R14F THE SEI/4 AND THE 8WNTOWN OF SOMERSET ST CRO X COUNTY WISCONSIN 34 NOV 1 8 1986
FOR: LOWELL RIVARD
SCOUT CAMP RD/R I
HOULTON. WI $Y, CROIX COUNTY
LEGEND CO:NP.tEHENSIVE PARKS PUN14ING
(SCALE IN FEET) 1"a 2 0'~ AND ZONING COWAITTEE
YSECTION CORNER MONUMENT
p' Sp' tpp• 200 400 0 1"X24" ROUNO IRON PIPE WEIGHING
1.68 L98./LIN. FT. SET
I" ROUND IRON PIPE FOUND
urrVi~~ STREET
NE COR.
N 68024' 2 , . t36. '47"E SEC
N 1/4COR. •2118.87'1ME••••' \`P~. _ ~,•r' 8800 39.1,-,.-..• 01'- . lS
3E 56~110~ S ICOR. Nse 02 ` T 100
~27 SEC. 34
0 9b q
H LINE 0 THE NE V4
AIL I ~ rr
LOT 2 5
w A n 177,588 S0. FT.
LOT 4.077 ACRES m o
F- 176,398 S0. FT. INCLUDING RIGHT-OF-
N b^ ly
`C 4.050 ACRES a WAY -
= y INCLUDING RIGHT-OF- 167,914 S0.FT.
WAY Z ,R It 3.855 ACRES r ~
w pl 165 380 S0. FT. b = • \
a' EXCLUDING RIGHT-
317866 ACRES a
b, OF-WAY h } a 'p
O;EXCLUDING RIGHT-OF- a 0 i-
z w WAY r W o
,y W I GD O h 0 O
x H1 aft z W 2 O
C r =
J
ILI
O a~c O r.
46 d -
w 6.10.0O
~I E 1/4 CORNER
UNPL~I TT[D„} AIID~ SECTION 5
CURVE DATA TABLE
urve. Lot Radius Central Arc Chard Chord Tangent t
No. No. Angle Length Length Bearing Bearing
300.00' 19040'38" 103.03' 102.52' N67040'1011E N77o30'29" E
L 2 333.00' 19056142" 115.92' 115.33' N67048' 12"E N77046'33".E O
3 - 500.00' 34004'22" 297.34' 292.98' N74052'02"E t
1 500.00, 15047'00" 137.74' 137.30' N 65043'21 "E
2 500.00' 18017'22" 159.60' 158.93' N82045'32!'E
4 - 467.00' 34004'22" 277.721 273.64' N74052102"E
1 467.00' 14055'44" 121.68' 121.34' N65017'4311E
2 467.00' 19008'38" 156.041 155.31' N820 19'54"E
Vol. 6 Page 1749
4 66-1001 '