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Parcel #: 032-2017-20-300 11/22i2oos 11:18 AM
PAGE 7 OF 1
Alt.Parcel#: 5.30.19.534E 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-VAN SOMEREN, MICHAEL W&KAREN M
MICHAEL W&KAREN M VAN SOMEREN
549 180TH AVE
SOMERSET WI 54025
Districts: SC=School SP=Special Property Address(es): *=Primary
Type Dist# Description *549 180TH AVE
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 4.077 Plat: N/A-NOT AVAILABLE
SEC 5 T30N R19W&SEC 34 T31 R19W SW SE Block/Condo Bldg:
&SE SW LOT 2 CSM 6/1749
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
05-30N-19W
Notes: Parcel History:
Date Doc# Vol/Page Type
07/23/1997 859/229
07/23/1997 762/312
2006 SUMMARY Bill#: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/24/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 4.077 53,300 120,800 174,100 NO
Totals for 2006:
General Property 4.077 53,300 120,800 174,1000
Woodland 0.000 0
Totals for 2005:
General Property 4.077 53,300 120,800 174,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch#: 122
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
MAR 20
MAP OF SURVEY I, h W.Granberg,Registered Wisconsin Land
Si CR01EC OUNTYS eyor,hereby certify that I have surveyed and marked
FOR SU'RVEYO RECORD th property as shown hereon. And that this is an accurate
MIKE&KAREN VANSOMEREN representation to scale of the property surveyed
��gC O NSA
Survey of the West line of Lot 2 of ~�
Certified Survey Map filed in Vol. 6, JOSEPH W.
* GRANB
Page 1749. RICHMON
Wi
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i y'r�qo.r«na CL"I WO MAna+ Property add=c 549180th SUeet
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Bearings referenced to the East line of p d.1tQ60 31'
Lot 2 of Certified Survey Map filed in NN t06''e
p .w ISOM
Volume 6,Page 1749. Assumed to bear
(and recorded as)SO 17'52"E.
r roe pw w+N+v1.e8c.
Irn R wl
Lor 10►
CERTFED SURVEY MAP
VOLUME 4 PAGE 1020.
LOT 1 of
CERTFED SURVEY MAP 01
VOLUME 8,PAGE 1740. LOT Z Of
CERTIFIED SURVEY MAP
VOLUME 6, PAGE 1749.
(260.18'M)-indic"rrleastrred distances between
a Mno found nmunw.
N
Scale 1" = 120'
M1 ''r°"po.r.na
k 0o.16 250.00
g 78'
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DESCRIPTION:
NOTE: no new lots have been cheated. The
The West line of Lot 2 of that Certified Survey Map filed purpose of this survey was to mark the West line
in Volume 6,Page 1749 as Document No.419492 of the of Lot 2 and to find/replace the NW corner of
St. Croix County Register of Deeds. Said map being Lot 2.
located in the NE1/4 of the NE1/4 of Section 5,T30N,
R19W,and the SW 1/4 of the SE1/4 and the SE1/4 of the
SWIA of Section 34,T3 IN,R19W,Town of Somerset,
St.Croix County,Wisconsin.
GRANBERG SURVEYING
1239 C.T.H. "E"
New Richmond, Wl. 54017 1
Phone (715) 246-7529 Fax(715) 246-4598
Job No. 98-004 ^
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CERTIFIED SURVEY MAP App
Located in the NE 1 /4 of the NE 1/4 and in the SE 1/4
of the NE1/4 of Section 5, T30N, R 19W , Town of
Somerset, St. Croix County, Wisconsin OCT 01 1986
Owned by: Lowell Rivard ST. C OiX COUi-M
Rt. 2 COMP.;:HENSIVE PARKS PLANNING
Somerset, WI 54025 ANO ZONING COMMITTEE
NE CORNER
SECTION 5
-I.4T-L
_CER71F1J�P_5_U Rv_E Y MAP
VDL.—4—- EAG-_1029 h o
500.011 00
174.4 4' 47.42 278.15, y m
LEGEND �- --- -
5.57 S88°24 28 W POINT OF
SECTION CORNER MONUMENT BEGINNING
3/4" STEEL REINFORCING BAR FOUND
O I"X 24" ROUND IRON PIPE WEIGHING
1.68 LBS./LIN. FT. SET LOT
277,163 SQUARE FEET OR
6.363 AC. INCLUDING
RIGHT-OF-WAY
253,782 SQUARE FEET OR
y 5.826 AC.EXCLUDING 3
W
RIGHT-OF-WAY
N
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(SCALE IN FEET) I" = 150'
/SOUTH LINE OF E NE-NE
T5 150 300 450' N88022'07°E
ur I 0-
N o24916 ��a /o, -
459 N 9
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69 0•0
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EI/4 CORNER
SECTION
T 30N,R 9W
/ I �
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� �ti�F 1�4 �?�s�`L31� � •
486-1001
Vol. 6 Page 1716
1
Form - S T C - 104
AS BU1:LT SANITARY SYSTEM REPORT
OWNER �/ �,&_,) TOWNSHIP —<Y/ SEC. T _N-R_LW
ADDRESS zz ST. CROIX COUNTY, WISCONSIN
'5'� �aa
SUBDIVISION LOT z LOT SIZE
s6�a-� �d �� ��t
PLAN VIEW �p� Y�" �
Distances and dimensions to me(,;. requirements of I•LHR 83
SHOW EVERYT11ING WITHIN 100 FEET OF SYSTEM
r
i
Y
v
J
�S
�/auST
INDICATE NORTH ARROW
BENCHMARK: Describe the vertical reference point used
Elevation of vertical reference_ point: Proposed slope at site:
SEPTIC TANK: Manufacturer: a � _. iLtq,uid Capacity: � e9�ac/
Number of rings use t Tank manhui_e cover elevation:
Tank Inlet Elevation:---�! � Tank Outlet Elevation:
Number of feet from nearezL Road: Front, Side 0 Rear, 0 feet
From nearest- property line Front,OSide,f'10�"Rear,O /sr�j feet
i
Number of feet from: well _ _, building:
(Include this information of ttic above plot plan)( 2-reference dimensions to septic_tank)
PUMP CHAMBER ~
Manufacturer: Liquid Capacity:
Pump Model: Pump/Siphon Manufacturer: Pump Size
Elevation of inlet: Bottom of tank elevation:
Pump off switch elevation: Gallons per cycle:
Alarm Manufacturer: Alarm Switch Type:
Number of feet from nearest property line: Front, O Side, O Rear,0 Ft.
Number of feet from well:
Number of feet from building:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: Trench:
i
— Width: Length: Number of Lines:,_ Area Built
Fill depth to top of pipe:
Number of feet from nearest property line: Fron , O Side, Rear,0 it _
Number of feet from well: ,U
Number of feet from building:
(Include distances on plot plan).
SEEPAGE PIT
Size: Number of pits: Diameter: 1
Liquid depth: Bottom of seepage pit elevation:
Area Built:
Has either a drop box O or distribution box O been used on any of the above soil
absorbtion sytems? (Check one).
HOLDING TANK
Manufacturer: Capacity:
Number of rings used: Elevation of bottom of tank:
Elevation of inlet:
Number of feet from nearest property line: Front, O Side, O Rear, 0Ft.
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
i�
Inspector:
Dated: - Plumber on job: ��/,��,,/ �►4;Z , �
License Number:
3/84:mj
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS
LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
f P.O.BOX 7969 BUREAU OF PLUMBING
*hDISON WI 53707 state Plan I.D.Number
NE 4�VE 4, Sec. 5 ,T30-R19W ❑CONVENTIONAL ❑ALTERNATIVE St to Plan I.
Town Of Somerset F-1 Holding Tank ❑In-Ground Pressure ❑Mound
61 NAME OF PERMIT MOLDER ADDRESS OF PERMIT HOLDER: INSPECTION DATE
-3._W 3106
Lowell Rivard R - 1 , Somerse-t- WT 94025 It
BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN REF.PT.ELEV.: CST REF.PT.ELEV.
Name of Plumber: \ MP/MPRSW No.. County. Sanitary Permit Number.Powers Ir
SEPTIC TANK/HOLDING TANK:
MANUFACTURER: LIQUID CAPACITY TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL ILOCKING COVER
PROVIDED: PROVIDED �y
�j�CA5 f V (� v ! v / g gjL YES ❑NO ❑YES I�NO
BEDDING: VENT OI A.: VENT MATL HIGH WATER NUMBER OF ROAD: PROPE RTV WELL: BUILDING VENT TO FRESH
ALARM FEET FROM dU ./ u V /� Zf IAIR INLET'
DYES NO : YES NO NEAREST ( �V
DOSING C AMBER:
MANUFACTURER BEDDING. ILIOUID CAPACITY PUMP MODEL IPUMP/SIPHONMA NUFACTURER WARN I NG LABEL LOCKING COVER
PROVIDED. PROVIDED'.
: YES ❑NO D YES ONO I DYES ONO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL JEA AIR JVENTTOFRESH
(DIFFERENCE BETWEEN FEET FROM LINE
PUMP ON AND OFF) ❑YES ONO NEAREST
SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH UI AMETER MATERIAL AND MARKING
or excavation. (If soil can be rolled into a wire,construction shall cease until FORCE
the soil is dry enough to continue.) MAIN
CONVENTIONAL SYSTEM:
WIDTH LENGTH NO.OF DISTR.PIPE SPACING COVER INSIDE DIA .SPITS LIQUID
BED/TRENCH C ` TRENr ,� MAT IAL: PIT DEPTH'
DIMENSIONS ✓ 7 J G GRAVEL DEPTH FILL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL. :NO:D I UMB ER OF PROPERTY WELL BUILDING. V NT TO FRESBELOW PIPES ABOVE CO ER ELEV INLE I EL V END 2- FEET FROM LINE/� ��� AIR INLET
?, NEAREST GS
MOUND SYSTEM:
Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM
and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA-
meets the criteria for medium sand. TIONS MEASURED.
❑YES ❑NO
OIL COVER ITEXTURE PERMANENT MARKERS OBSERVATION WELLS
DYES ❑NO ❑YES ❑NO
DEPTH OVER THE NCR BED DEPTH OVER THENCP_BFO :JH.OF TOPSOIL SODDED SEEDED MULCHED
CENTER EDGES
❑YES ONO ❑YES NO 1-1 YES ❑NO
PRESSURIZED DISTRIBUTION SYSTEM:
WIDTH LENGTH. NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER
r�BEO/TRE.NCHI- TRENCHES'.
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL NO DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING
'
ELEV. ELEV. DIA. ELEV.: PIPES
ELEVATION AND
DISTRIBUTION
INIxORMATION' HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL P`ANSCAI LIFT CORRESPONDS TO APPROVED
❑YES ❑NO
YES ❑NO
COMMENTS: v PERMANENT MA K OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING:
FEET FROM LINE:
❑YES ❑NO ❑YES ❑NO NEAREST
Sketch System on in county file for audit.
Reverse Side.
SIGNATURE: � TITLE.
DILHR SBD 6710(R.01/82) (/—
IILHR SANITARY PERMIT APPLICATION COUNTY
In accord with ILHR 83.05,Wis.Adm.Code /
STATE SANITARY PERMIT#
.–Attach complete plans(to the county copy only)for the system,on paper not less than ❑ ,� �8%X 11 inches in size. Check if evision application
—See reverse side for instructions for completing this application. STATE PLAN I.D.NUMBER
I. APPLICANT INFORMATION–PLEASE PRINT ALL INFORMATION.
PROP RTY OW PROPERTY LOCATION
t/4 %4,S T, N, E(or)
PROP RTY OWNER'S FAAILING ADDRESS LOT# BLOCK
/ �,�
CITY,STATE T ZIP CODE PHONE NUMBER SUBDI)PION OR CSM NUMBER
II. TYPE OF BUILDING: (Check one) CITY NEAREST AD
State Owned VILLAGE
❑ Public [4 1 or 2 Fam. Dwelling–#of bedrooms�Z PAR ELTA NUMBE
III. BUILDING USE: (If building type is public,check all that apply)
1 El Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 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. W 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 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 19 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./inc ) ELEVATION
Feet , //Feet
VII. TANK CAPACITY Site
in a alIons Total #of Prefab. Fiber- Exper.
INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed eq
Septic Tank or Holdina Tank ^ B
Lift Pump Tank/Siphon Chamber Lj El El L1 I El I El
Vlll. RESPONSIBILITY STATEMENT
I,the undersigned,assume responsibility for installation of th 'te sewage system shown on the attached plans.
Plum er's ame(P ' t): Plumb�ure: o S ps) MP/MPRSW No.: Business Phone Number:
umbe7r's Address( rest,City,S Zip Code):
J . L
IX. COON /DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee(Includes Groundwater a e ssue Issuing Agent Signature(No Stamps)
Approved ❑ Owner Given Initial surcharge rcee)
Adverse Determination
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398(formerly Pib-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:
I. 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 takes; 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.
SBD4LW(R.11/88)
APPLICATION FOR SANITARY PERMIT
S T C - 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 Owe L.C.- V--t V AP-0
Location of Property , WC, �4 N6 'y„ Section ^, T N - R W
Township "740 r
Mailing Address 1ZQL4-M .
Subdivision Name
Lot Number 1-'6�
Previous Owner of Property
Total Size of Parcel #\ca.4e;S
Date Parcel was Created
Are all corners and lot lines entifiable? No
Is this property being developed for resale (spec house) ? Yes No
VoIt.ime '-1(0 and Page Number 3i Z% as recorded with the Register of Deeds
INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING:
1. Warranty Deed
2. Land Contract
3. Other recordings filed with the Register of Deeds Office
t�i.►'ov4v I rN sin act
In addition, a certifi d 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 the Certified Survey Map shall also be required.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
PROPERTY_OWNER CERTIFICATION
I (We) ce.nti{y that aet 5tateme.nt6 on. ,t_h z KoAm coe •tAue_ to the be,s.t o4 my (ouA)
I;nowYedge.; that I (we.) am (cute) the, owneh (.$ ) of -the plope.Aty de,s"ibed in ti"
in4o�r.maf ion 4oAm, by vi,,rtue o6 a waAAanxy deed AeeoAded in the 064iee o4 ,the
COUvr-ty Re.q_i tte,h 04 Veedx ati Pocumen-t No. 41�0 0G-L
_: ;,and that I (we)
pacAe.ntfy own .the pn.opopsed Site Aoh. the. Aewa e_ poici.V hrAte.m (on I (we) have
obtained an eaAe.Me.nt, to hun. w-itft the above. deA- n ibe.d pupeAty, Aon ,the
c,onAtsr.uc.ti_on o6 ha.id AyAte.m, and tfie same hah be.e.n day texon.de.d in -the 06(lace
()K the. County Re.g.,steA o� Vee,6, ah Document- No.
SIGNATURE OF OWNER SIGNATURE. OF CO-OWNER (IF APPLICABLE)
4q--V2- j
DATP SIGNED DATE SIGNED
�l
•
ANT NO.
om
C?
Richard "'. For^ °°- F�tC2
&.
�o1re �r n�a L. 1
•
Rivard f
u"at wboonsw
4 ..
Lot L�� Survey p fjled p s of e s of St: T�+c�.1►;a l .Y
T38N R191f Torn of S t= :�•-
of 1 and 2 Certified. S ► f1 Reg�sr.- `; Desds►o ;
wtty,;:1Ef°:an 1�a.
located i n t SI*Coaf the :5 d'"ft < ;
� 73T xa�Rtt,Y+
the WU x or'°Se�C�} �''•' �,., �� ��-:�' ',,ts ",�,,
t
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1
✓ 'ro �� �� 7 ��.�' My ���` try' M
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90
RIVER VALLEY ABSTRACT & TITLE, INC.
220 LOCUST STREET
HUDSON, WISCONSIN 5401.6
CONTINUATION OF ABSTRACT NO. 11 .469
From the 28th day of July , 19-8 6 at 1 : 3 0 o'clock in the P M.
of the land described as:
All that part of NE; of Section 5-30-19 lying Nly of
S .T .H . "35" EXCEPT parcels as shown in the Caption
at No. 81 .
91
Certified Survey Map
In Vol . "6" , Page 1716 , Doc . No . 417657
( See Following Page)
92=< ;
Certified Survey Map
In Vol . "6" , Page 1749 , Doc . No. 419492
( See Following Page)
y`
93
Richard T . Forrest , ti Warranty Deed .
Dated. D4c . 5 , 1986 .
-to- Ack . Doc . 5 , 1986 . l
1 Rec . Dec . 5 , 1986 .
Lowell P . Rivard and{` Virginia , In "762" , page 312 , 11420052 .
L . Rivard .
j Lot 1 , Certified Survey Map filed in the office of the Regist r
of Deeds of St . Croix County , Wisconsin October 1 , 1986 in Vol . "6" , Page
1716 as Doc . No . 417657 (No . 91 ) located in the NE4 of NE4 and in the SE4
a
�ecti on 5 , T30N , R19W , Town of Somerset , St . Croix County ,
Wisconsin . so- Lot 1 and 2 , Certified Survey Map filed in the office
of rhp Register of Dee s o t . roix County , Wisconsin November, ,
in--Vol "6'-Tease 1249 aS Doc . No . 4194 o . e E4 of
NE4 of Sec . 5 , T30N , R19W and the SW4 of SE4 and the SE-14 of SW-14 of Sec .
34 , T31N , R19W Town of Somerset , St . Croix County , Wisconsin .
Recites : This is not homestead property .
(Fee #3 Exempt) .
RIVER VALLEY ABSTRACT & TITLE, INC.
r-.
SEPTIC "'ANK MAINTENANCE AGREEMENT
p
St . Croix County
0
Y
OWNER/BUYER LA:j1n(Gt.>v vp-4� r
ROUTE/BOY NUMBER ��� '
Fire Number
CITY/STATE 47C*Aea.&c T ZIP 54'0 LS
P70PERTY LOCATION • , , Section j T 3� N , R )f
W,
/ �� I
Town of 1iAAem' St. . Croix County ,
I
Subdivision . wtnAtcy Lot number_.
t
Improper use 9nd maintenance of your septic system could result in
its premature failure to handle wastes . Proper maintenance con-
sists 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 treat-
ment stage in the waste disposal system.
St . Croix County residents may be eligible to receive a grant for j
a maximum of 60Z 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 veri-
fying that (1) the on-site wastewater disposal system is in proper
operating condition and (2) after inspection and pumping ( if nec-
essary) , 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. .�
0
I/WE , the undersigned , have read the above requirements and agree Cn
to maintain the private sewage disposal system in accordance with
the standards set forth, herein , as set by the Wisconsin Depart- v
ment 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 . i
S ICNE. �
DATE
i
St . Croix County 7.onin,ti Office
3ox
lam. rnond W 54015
7 '_ 5- 2 a
S ;rn , (I o an r ve l(!cireSS
RTM OF
RY, REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS
• ,t`.iS'rt G DIVISION
`• UMA AND PERCOLATION TESTS (115) MADISON WI 969
'HUMAN RELATIONS
(H63.090)&Chapter 145.045)
LOCATION: E TOWNSHIP/MUNICIPALITY: OT NO.: LK NO.: SUBDIVISION NAME:
NE 1/4NEI/4 �%T 30 N/R191d,,)W Somerset 1 j n/ n/a
COUNTY: AM : M A R SS:
. Croix Mike VanSomere R.R.�� lot #2 S erset Wi. 54025
USE DATES OBSERVATIONS MADE
MS : COM AL E PTION: I R I 0 S S-
Residence 3 n/a New ❑Replace
8-7-89 8-8-89
RATING:S-Site suitable for system U-Site unsuitable for system
WEN L: MOUND: IN-GROUND- R UR :S S EM-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM:(optional)
�S ❑U OS ❑U ®S ❑u ❑S.[ ❑S�]x (J conventional
If Percolation Tests are NOT required DESIGN RATE: I If an
under Percolation eats a,indicate: n/a y Portion is the tested area is v the
Floodplain,indicate Floodplain elevation: n/a
decimal' PROFILE DESCRIPTIONS page 26 AMD2
BORING TOTAL LEVATION P H TO R UNDWATER-INCHES CHARACTER O SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH
NUMBER DEPTH I BSERVED tb I.HWHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.)
B- 1 6.75 100.11 none >6.75 1.00bl.l. .83bn.sil. 4.92bn.s.1.
B- 2 7.08 100.03 none >7.08 .75bl.1. 1.08bn.sil. 5.25bn.s.1.
B- 3 6.59 99.26 none >6.59 .67bl.1. 1.42bn.sil. 4.50bn.s.1, ,
B- 4 6.58 96.81 none >6.58
.92bl.1. .83bn.sil. 4.83bn.s.1.
B- 5 6.75 97.36 none >6.75 1 .58b 1.1. 1.42bn.sil. 4.75bn.s.1.
B-
decimal' PERCOLATION TESTS
EST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-IN HES RATE MINUTES
NUMBER I)GOW AFTERSWELLING INTERVAL-MIN. p PER INCH
P- none z z
P-2 3.50 none -- - 30 2- - 13/4, 13/_4 - - - 1
P- none a 'a
P-.
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 and the direction and percent
of land slope.
SYSTEM ELEVATION 96.53 -�r
01 1
a -
E 65 ,t -
_
77
Y
T 1 - AN
I -t-
t I i
e 3 i 31 ..__
Ile
l........._.
1,the 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 print : TESTS WERE COMPLETED ON:
Gary L. Steel 8-8-89
ADDRESS:
ARichmond Wl. 54017 CERTIFICATION NUMBER: PHONE NUMBER optional):
988 N. Shore dr., New
2 9 7,15-246-6200
CST SIGN E:
DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester.
DILHR-SBD-6395 (R.02/82.) —OVER—
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t ..yam/�gHit3 PAGE OF
CrUSS S0-c � 1Url p � A & 1-3 JyJen-)
n/ Frelh Al( 1111016 And Ob6oryollon Pipe
L�J'�—� Approrid vent Cop
Mlrllmum 12"ADO.e
Fln°I Grade
20-•2"Above Plpp _4"Cost Iron
To Final Grade Venl Pipe
Nor en
By Or SymMlk Coverina
in 2"Aggregole
O.er Pipe
Olelrlbutlon
Pipe o 0 a -- Tee s
b"Aggregate
B.nula Pipe ° Perlorobd Pipe betor
o Coupllno Terminating At
Balloon Or System
��cJ•.7 Iorl ����/ /
SOIL FILL
DISTRIBUTIOKI PIPE
APPROVED S414TNETIC COVER
~'/"1ATf-R1/Nt. OR I" OF STRAW
2"OF AGGREGATE -� ' OR MARSH HAy
1=LEV. OF EE �• � fe�OFlt AGGREGATE �P
1
DIS-rRI5UTI0W PIPE TU BE AT LEAST,!,.2� INCHES BELOW ORIGINAL GRADE
A,QU AT LEAST ZO INCHES BUT 1.10 MORE THAN 42 IAICMES BELOW FINAL GRADE
MAXIMUM DaPTH OF EXCAVATIOO FK011 OKlt,*JAL 6KADF. WILL BE �� INCHES
nti)MUM ®r-PrH OF FAM/ATION f-KO/A. OlkIGIagL CRAVE WILL BE INCHES
i
I
51GIJCO:
LIGEAISC
DATE :
Ila_. — ---
FILED
NoV:20�98�
CONIC
wvwor of 0064 ,
9.43 . 4 0wx
CERTIFIED SURVEY MAP APP P T�
.p
LOCATED IN THE NE V4 OF THE NE V4 OF SECTION 5,T30N,R19W, AND THE
SW 31 N4,R19 WN TOWN OF SOMERSET ST CRO X COUNTY W WISCONSIN 34, NOV 181986
FORE LOWELL RIVARD
SCOUT CAMP RD,R I
HOULTON,WI ST. CROIX COUNTY
LEGEND COMPxLHENSIVE PARKS PLANMNG
(SCALE IN FEE_ T) t"=®� SECTION CORNER MONUMENT AND ZONING COMMITTEE 1�—•�, �
0 60' 100` ZOO` 400 0 1"X24" ROUND IRON PIPE WEIGHING
1.69 LOS./LIIN.FT. SET
I" ROUND IRON PIPE FOUND
STREET
a _ 134.4s' CE NE COR.
" 136. SEC. 5
ee°24'21_
N 1/4 COR. N •2119.87 E ._.b�r�. _ y, �� 69° '47"E 30.1 - 00.01'.
-SE b fit - S 1%{4 C Mae*24'29"E
1. - 27 SEC.34
i/ m s o
�,' e�b1°� H LINE 0 THE NE V4
)^ E�
s� '
�� LOT 2
elfW z
=o n 177,588 S0. FT. a
LOT 7 4.077 ACRES
in
0 INCLUDING RIGHT-OF-
I,- 176,398 So. FT. 4 w
o a 4.050 ACRES a'' WAY -
_ INCLUDING RIGHT-OF- 167,914 90.FT. ,Np
ww s WAY ; 3.955 ACRES h ~
L w pt ;: 165,380 S0.FT. 1h EXCLUDING RIGHT-
wH �1 a 3.7966 ACRES p, Of-WAY 0
'EXCLUDING RIGHT-OF-,r p 1-
z ' r WAY °r z W o F
(q4(�dKK w 01 v a o a O c y,
W J F)
` p) O F-
Z u �
260 01
w 620.00 j
26 .0 S.TOo12�0 I
q E I/4 CORNER
UNPLATTES„„Lntlue SECTION 5
CURVE DATA TABLE
C,urvc. Lot Radius Central Arc Chord Chord 'Tangent �
No. No. Angle Length Length Hearing Bearing
- 300.00' 19040138" 103.03' 102.52' N6704011011E N77030129"E
2 2 333.00' 19056142" 115.92' 115. 33' N67048' 12"E N77046133"E
3 500.00' 34004122" 297.34' 292.98' N74 052102"E t
1 500.00' 15047'00" 137.74' 137.30' N65043121"E
2 500.00' 18017'22" 159.60' 158.93' N82045132"E
4 467.001 34004122" 277.72' 273.64' N74052'02"E
1 467.00' 14055144" 121 .68' 121 .34' N65017143"E L
2 467.00' 19008138" 1.56.041 155 .31' N8201915411E
UM
Vol. 6 Page 1749
486-1001 '