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032-2054-50-300
°o 0o m o o 0 0 3 6 o t. cV 0 cn u9 O c» f» h m > ° C o c o w m CL > w °' > a) o :3 ao0 ., aoo� c-w 0 o D �w c� `" c O m!- v 010(D c 34 .Z c a) C Y 3 cc C ° _ m N06 -°o—to m'y'cdf o N( C O d EIaO)N C 62 E N N wo3 or-' :5.2 03 CY) rn c o, c D•�cO 'v EU) (D 0) a oU °� Co oU Ei ° @ 0- ° ° a)- 0 a�r ai - O CL 0.a Z c:Ei y + f6 Z C:E N N C O N C 0-0 C 7 N N N O 2 C O 0 d 0 '—°- • LL O O O (O'O c0 E O Z p'O f6 E E �avm a v EE - '4* m a Q H �� vmo3 ¢ I-° c°>� vmo3 I M 3 Z y E rn N . 00 Z ,n H � a m I O 2 C OC o U) N m 2 a m U) 1- •- E c N O O N � •^) (n L L o 0 z m z N m OI N 0 - d N N a CD H "� y o `o 0 0 0. .0 CL a E ° ° Q 0 fn co fn o a CL CL Z M d N N d N N •� Loaaa N _ 4 0 O N T 0) rn ° o fn J U 00 co z z LO P_ am Z Z ° rn (n `n co m °o °o °o � � d °o °o °o Q N 0 0 N N N _ O O N N N E 2i M co � m � � a. � � m w c c d iD M 'a to N Q m .°-� r w N Q w O 'p 4f Q �' Z 0 N Q } fn Z fn N C O O YO! �V! R C) N C cc � O O N O _ C O'O O N O N Cd O M N U O c O N O C:,a N LO O O O a N O O N N r P� - f` l0 N V� tp N l6 O V O N N C N N O C 7 N M C O C N N C7 O Y O (,0 M C O O O C M N C Z Z C -Op T c0 .- Z Z C U C N O ` C N O H M O r 0 ° o o a>i o o N o o a>i o ° cCi • ' Cl) cq H o z �' F- H Y Z cn Z '� F- F- Y Z to 0 � v E L a a ` (L r`�l E c c ST CROIX COUNTY PLANNING &. ZONING April 24, 2006 KYLE & TAMMY SCHROEDER 150363 RD STREET SOMERSET, WI 54025 RE: House addition/remodel, Town of Somerset, St. Croix County Code A Parcel #: 032-2054-50-300 Parcel ID: 15.30.19.703D dministra tt r 715-3864680 Dear Mr. And Mrs. Schroeder: Land Information& Planning You have requested the Zoning Office to review your remodeling/addition project for 715-386-4674 compliance with the state sanitary code (COMM 83). When remodeling or adding onto a dwelling you are required to examine whether or not the construction involves Real Pro arty 77 an increase of wastewater. 715- 46 R cling I have reviewed your construction/addition plans that were submitted to this office. 5-386-4675 The net result of this project will be one additional bedroom to the structure. The septic system was designed and installed based on wastewater flow for three bedrooms. This project will increase the total number of bedrooms to four. In such cases the septic system can be sized based on occupancy of the residence. Only six people will be allowed to reside in this structure unless the septic system (POWTS) is modified to accommodate the increase in wastewater load. An Occupancy Affidavit is required to notify any future owner of the septic system sizing and occupancy restrictions. This affidavit must be recorded at the St. Croix County Register of Deeds office. This affidavit has been recorded as document number: 823430. As long as occupancy of the structure remains at six people or less, this system will comply with Comm code chapter 83 sizing requirements. Gary Zappa, MPRS, installed the POWTS on April 28, 1989. As a reminder, to prolong the life of the system, remember to have the septic tank pumped once every three years or when the tank becomes 1/3 full of sludge and scum. Other efforts to prolong the life of the system could be as simple as fixing or replacing plumbing fixtures with water conserving fixtures, reducing shower time, .washing dishes when the dish washer is full, avoid using a garbage disposal, using a wash machine with a suds saver feature, etc. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. If this system should be found to be failing at any time in the future, the system will be ordered to be replaced according to current code requirements and all appropriate permits will be required. ST.CROIX COUNTY GOVERNMENT CENTER 1 101 CARMICHAEL ROAD,HUDSON, W1 54016 7153864686 FAx PZPCO.SA/NT-CRO(X.W1.US W W W.C O.SA I NT-C ROIX.W I.US The addition/remodel shall comply with all applicable setback standards. Please contact the town of Somerset to obtain a building permit. hould you have any questions, please contact this office. I incerel , evin Grabau oning Specialist ,/Cc: file ST.CRO/X COUNTY GOVERNMENT CENTER 1 101 CARMICHAEL ROAD,HUDSON, W/ 54016 71X3864686 FAX PZCQ CO.SAINT-CROIX.WI.US W W W.CO.SAI NT-C ROIX.W I.US /r f=3a343Pj KATHLEEN H. WAL31i Document Number Document TWO REGISTER OF DEEDS ST. CROIK Co., WI St. Croix County RECEIVED FOR RECORD 04/24/2006 09:SSA[t Occupancy Affidavit AFFIDAVIT ehtii�i # REC FEE: 11.00 Name-( ner)Typed or printed TRANS FEE: COPY FEE: being duly swam,states,under oath,that. CC FEE: 11A ULS: 1 1. He/she is the owner/part owner of the folio ng arcel of land located in St. Croix County,Wisconsin,recorded in Volume_��Page�_Document Number St.Croix County Register of Deeds Office: Recording Area A parcel of land located in the S E '/.of the 5"J-V4 of Section 5 �Na'me and Return Address T O N—R:�W,Town of SB++�&t2 S&,r ,St.Croix i�m County,Wisconsin,being duly described as follows(include lot no.and ISD3Jlo S� subdivision/CSM or detailed legal description): tot / 0- e5l�7 5-,R3<16 - /x) ')�v of 5ix�eZ?,` 032 - 2 05'¢- 570-30V Parcel Identification Number(PIN) A�owner of the abov7e•desaibed property,i adcrto�Medge that the septic system serving this residence is sized for a 3 bedroom home,or a design flow of,�g . The design flow is calculated by assuming 150 gpd for 2 indivitll�s per bedroom. There are currently�oaxlparlts living in this residence: f�otxupaltts are permitted based on the design flow. Therefore the septc system serving thLs residence is code compliant. However,l understand that if there are intentions to exceed the number of permitted occupants,the system will need to be modified to accomodate any increased wastewater flows and/or contaminant bads. I also acknowledge that I will make this information available to any future parties interested in purchasing this property. MM// this day of cob �.; 1 ON , AUTHENTICATION AcKNoWLEDWENT4 5lgnature(s) STATE.OF WISCONSIN audmnitcated this day of St.Croix qty. Personally came before me this /day of O e/o the above named TITLE: MEMBER STATE BAR OF WISCONSIN of not, to me known to be the person(s)who executed the twegoing auttwrized by§706.06.Wis.Slats.) instrument and acknowledge the same. / THIS*ISTRLWENT WAS DRAFTED BY i * yt iL,oAr� 4 L-ddlsh Notary Pudic,Stated Wisconsin (Signatures may be authenticated or acknowledged. Both are not My Commission is permanent. It not,state expiration date: necessary) Date: 1��;,�1�k _ "THIS PARSE IS PART OF THIS LEGAL DOCUMENT—DO NOT REMOVE" 7Ws k0bMNfion nwst be 0oap16fed by submitter and p_ipl fFmKL*". OtherkdwmeNon such as the V&ISp cISIA10 ,168981 desa*tlon,etr~awy be placed on Ws ItVi1 papa of the doc wwg or may be placed on eddlliarnl Pees of ft document.N21L Use of this Omer~adds one papa to your dbcu wit and 5200 to ft mcoridho lice. INlsoonsirr Stetufes.59.517. 1 of 1 Parcel #: 032-2054-50-300 04/27/2006 07:45 AM PAGE 1 OF 1 Alt. Parcel M 15.30.19.703D 032-TOWN OF SOMERSET Current rX] 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 KYLE W&TAMMY E SCHROEDER O-SCHROEDER, KYLE W&TAMMY E 1503 63RD ST SOMERSET WI 54025 Districts: SC=School SP=Special Property Address(es): '=Primary Type Dist# Description 1503 63RD ST SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 5.466 Plat: N/A-NOT AVAILABLE SEC 15 T30N R1 9W SE SW 5.46 ACRES LOT 3 Block/Condo Bldg: CSM 7/1986 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 15-30N-19W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 1152/90 WD 07/23/1997 854/372 07/23/1997 840/17 07/23/1997 825/330 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/23/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.460 60,300 144,700 205,000 NO Totals for 2006: General Property 5.460 60,300 144,700 205,000 Woodland 0.000 0 0 Totals for 2005: General Property 5.460 60,300 144,700 205,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 213 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 �tj 715 - 962 - 3121 800 - 962 - 5227 ST. CROIX ZONING REPORT NO.: 35045/01 PAGE 1 ST. CROIX COUNTY REPORT DATE. 10/17/89 COURTHOUSE DATE RECEIVED; 10/13/89 HUDSON, WI 54016 ATTN: THOMAS C. NELSON :mer)set 703 OWNER: Ron & Lori 3 LOCATION; COLLECTOR: St, Croix Zoning SOURCE OF SAMPLE: Kitchen faucet COLIFORM # /100 ml INTERPRETATION: Bacteriologically SAFE NITRATE-N: 5 ppm Under 10 ppiA is sate for human consumption. *OVERGROWN NON COLIFORM COLIFORM + NITRATE LAB TECHNICIAN! Pam Gane WI Approved Lab No. 19 �.\NDEVENpEMfc v ~ 4AD C Means "LESS THAN" Detectable Level Approved by; ® PROFESSIONAL LABORATORY SERVICES SINCE 1952 '-q(fMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715 - 962 - 3121 800 - 962 - 5227 ST. CROIX ZONING REPORT NO.S 35045/01 PAGE 1 ST. CROIX COUNTY REPORT DATE: 10/17/89 COURTHOUSE DATE RECEIVED; 10/13/89 HUDSON, WI 54016 ATTNS THOMAS C. NELSON OWNERS Ron i4 Lori Thoennes / LOCATIONS 15b3�3ird-8#,,-SomerSet COLLECTORS St. Croix Zoning SOURCE OF SAMPLES Kitchen faucet COLIFORMS * /100 ml INTERPRETATIONS Bacteriologically SAFE NITRATE—NS 5 ppm Under 10 ppm is safe for human consumption. OVERGROWN NON COLIFORM COLIFORM f NITRATE LAB TECHNICIAM Pam Gane WI Approved Lab No. 19 oF.N0E0ENpE�! V ► I SA ( Means "LESS THAN" Detectable Level Approved by' o PROFESSIONAL LABORATORY SERVICES SINCE 1952 T1g 962 4030 COMM. TEST LAB. 10/17/89 16:30 P.01 ,uMMERCIAL TESTING LABORATORY, INC. 514 Main Str"t, P.O. Box 526 Colfax,Wisconsin 54730 715 .962 . 3121 800 -962.5227 ST, CROIX ZONING REPORT N04: 35045/01 PAGE 1 ST. CROIX COUNTY REPORT DATES 10/17/89 COURTHOUSE DATE RECEIVED: 10/13/89 HUDSON# WI 54016 ATTNS THOMAS C. NELSON OWNERS Ron b< Lori Thoennes LOCATIONS 1503 63rd St., Somerset COLLECTORS St. Croix Zoning SOURCE OF SAMPLEI Kitchen faucet COLIFOR10 * /100 mt INTERPRETATIONS Bacteriologically SAFE NITRATE-Nt 5 ppm finder 10 ppm is safe for human consuwtion. *OVERGROWN NON COLIFORM COLIFORM + NITRATE LAB TECHNICIAN: Pam Sane WI Approved Lab Not 19 < Means "LESS THAN" Detectable Level Approved byi PROFESSIONAL LABORATORY SERVICES SINCE 1962 . of ST. CROIX COUNTY ZONING OFFICE St . Croix County Courthouse 911 4th Street Hudson, WI 54016 Telephone - ( 715 ) 386-4680 The St . Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals . Completion of this form is essential so that the property can be located . Please provide the following information, enclose appropriate fee made payable to St . Croix County Zoning Office, and mail, along with form to the above address . Testing will be done as soon as possible after fee and form are received . WATER TESTING----------------------------FEE: $ 25. 00 (For nitrates and coliform bacteria) WATER TESTING FEE: $127 . 00 (For VOC' S ) SEPTIC SYSTEM INSPECTION-----------------FEE: $25. 00 (Determines if system is properly functioning at time of inspection) / Property owner ' s name Al f L or T'40e._'iAcS Property owner ' s address 503 G ?rte S7 - Legal Description 5W 1/4 of the 4-vV 1/4 of Section /S- , Ted N-R,1g W Town of So r7erse f Lot Number Subdivision Name FIRE NUMBER 10-0-P LOCK BOX NUMBER--7---l- "I Color of house c w000( Realty sign by house? c�If so, list firm: Eo`:na IPea/�y PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP, i .e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted . WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained . Firm or individual requesting services : `//^ Telephone Number REPORT TO BE SENT TO: 4anna eea/ly ADD aAoe S�. /i�ltK��oti�� C✓�. .�f�a� A1tN.' 22>% Closing dat Signature ina Realty INC. t Property Info. Sheet ADDRESS_ �•I x,+r I t t✓ h I j PRICE i CfTY/TOWN DISTRICT LOT SIZE/ACRES J =` I I ADDITIONAL SALES HELPS: NOTE: Location Map, Directions and Financing Helps on reverse side. PRICE: 98,900 ## BFDP,0Ck1S: 3 H PAWS: 2 MB I-1 OF [-XI B(3 0 113OLS:Cash ZN:Res ADDRESS: Rt 2 Sixty-Third Street 503 l:l'IY: Somerset ZIP: 54025 CCUNI'Y: St Croix LT SZ: 5+ Acres D151': 06 SCHOOLS/ EL.EM: Somerset MLD: Somerset HIM: Somerset PAIi: LEGAL: Lot 3 CSM Vol 7 Page 1986 STYLE: Split Level. FXI111,10t: Redwood YEAR BUILT: 1989 TA:;FS: f New 1'I;: 19 SQ FT MAIN LEVEL: 1000 1L7rm, FIN 1T: 1250 ROOM DIPtMIONS L W F ML;C LR: M REFRIC: C. WIR: DR: M v ovEll: C. S R: ICI': M v MIK;l:: WILL: Yes FR: L DWSItP: Yes SL111'1C: Yes MB: M DI SP: DFG:: Yes BR2: M WS: PA 1'10: BR3: L A/C: Yes DASMI': Yes w/o BRW: 'CAR: J Car GIX): Yes p F1:PLC: No 1'055 1'!'*M:Immed::p IIFAT: Propane FA An excellent housing value in this 38R home now under construction. Ceramic entry & main bath. Redwood garage doors ./openers. Central Air, vaulted ceilings, all Andersen windows. $2000 flooring allowance. $350 lighting allowance. Est. completion date of Augsut 1, 1989. LISTEP,: Jim Dahlby Fllir 386-7775 LIS;U',: 1111? S/BIC 2• Brkr* Edina Realtv i'r 260 1 MIX.1i 715- 386-8236 612-436-7072 r . ti�yy � � •A •o� pct Jp�� �o w�� :': � \ t 0i n/ r 0 !d 1 0 e r �e .. •, c., vr>y 0 017 ° 711/JAI H L �• �L , ' r i!? ,�,o e1 � 0. x L "i +r.� ••i L7u iron�• 'r.,r•I io rJ `•� jQ rN f err/r}r { Mayy►ES»aid, :; ay r �� 5 , C,i//Rf7rom ob 'n Y F rd ell �r .7oh :�� Ld)��+: L .^ x i:(�.� O y,6werre/r /1 0; ,• ;0`2; a c \V j•� 0 C`o �.a•. < b•??o :a 'e t/intV `fir y - • r 1 ° . rypr�.r7 uT✓ "' ' •aiQ r , b. 1 S7J3 • wpb• .:rcii �� Co r s C•9 b '�1 .Lr G e Eor/L C� rrwn ,••nJ V f t < . e ,• . (fir Cae,.ron • �ei r •�.oid no..n ° M wbhr'ri O i 1 •7 " •1n c�'1=l— �s Srnr.ct o ' /Bw�/ i u F r iN a ►✓iie .Qti 4 iao Pcp �o I �ro .�...'45..:., S, ^ �•r'�' sec '^ � •�a .�d1� ' P iAe r �°n,i dN�. 0 � ,• p Q� o 2 'Sr r O R r rr o -n 1"r so rq A ,( r 4 QDonnn• J�l.�/f- 4�p 40 h^ o C�3' �A 0 g j. • ,.. "a) J ie •d ► \ Q i p P r zz rj tj 0 - A s Q ,j 3n e.u Ud-.S,.• �� i - '} �� TAOma• I �4 1 • �• `{x" e? !L 'n i° qq\� ti • ::�F e`�j Xra�VV, l .tr A,. e o, ° `' � _.... . Lh e�°4 �) 11�� ('013 'S1N3 -3HinO3H NOIldWf1SSV-ions 1Nn ' ' ' '013 'SHV3A ANVW OS NI NOOTIV9 '31VH LS3H31NI H0( V HOf1S'NMOa Honn OS H1IM a/0'' ' EJNIONVNI:I ivnsnNn ANV JNIOHVJ3H 3H3H S31ON 3)IVI ST. CROIX COUNTY r WISCONSIN ZONING OFFICE - , ST.CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON,W154016 (715) 386-4680 October 13 , 1989 Jim Dahlby 700 2ed St. Hudson, WI 54016 a Dear Mr. Dahlby: An on site investigation of the septic system on the property of Ron and Lori Thoennes at 1503 63 St. , Town of Somerset was conducted on October 12 , 1989- At the same time I also obtained a water sample and submitted it to the laboratory for testing. The results of that testing will be sent to you as soon as we recieve them back from the laboratory. At the time of the inspection, the sanitary system appeared to be functioning properly for the existing use. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system is totally dependent upon proper maintenance of this system. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, gal Mary J nk ns Asst. Zoning Administrator TCN:cj 832 — - 50 --3 « � � � 3�� Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER / on r i Y ,�^+� �,,,E, TOWNSHIP Sarh Ed c7 L r SEC. T 0N-R W ADDRESSJ� �r�x / �„ ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of 11HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM per/f pknw r4' D V ER Roo' Te> ,L�iv� �s• �k$r A���e�TY L�iNE 34" . GJ�s'r sy' 41Nr P.POPO:fo V) w[« A,p fo,p o s EA L)R,v6 W A y1 M ��E D✓Ex /So. INDICATE NORTH ARROW /AJO SU4Lr BENCHMARK: Describe the vertical reference point used <oeC?.✓ piper ),T ASORIA16 Zr Elevation of vertical reference point: /oo ' Proposed slope at site: (o SEPTIC TANK: Manufacturer: LJIESeK Liquid Capacity: 1/000 6 L Number of rings used: o` Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front,O Side, Rear feet , O l�3 From nearest property line Front 10 Side 10 Rear, zz feet Number of feet from: well a' , building: /lo ' (Include this information of the above plot plan)( 2 reference dimensions to septic tank) '� SEE REVERSE SIDE � r 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 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: /07 Length: Sr Number of Lines: Area Built: Pf Fill depth to top of pipe: 3 Number of feet from nearest property line: Front, O Side, &9—ear,0 Ft . r?f Number of feet from well: Number of feet from building: °f (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: 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, O Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job: License Number: &OS JAJ C . 3/84:mj 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 MADISON,WI 53707 30 State Plan I.D.Number: %JZ SWi4j S15, TnN-R19W )pg CONVENTIONAL ❑ ALTERATIVE (If assigned) Town. of Somerset ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound F DER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Ronald N. Thoennes Route 2, Box 318N, Somerset, WI 54025 F-g9 )-J 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: Zappa Bros. Inc. 3300 St. Croix 119431 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED. ❑YES ❑NO ❑YES ❑NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY I WELL: BUILDING: VENT TO FRESH ALARM: FEET FROM LINE: AIR INLET: ❑YES ❑NO I I ❑YES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER: I BEDDING: LIQUID CAPACITY: I PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO ❑YES [1 YES ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF IPROPERTY WELL: BUILDING:I VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF ❑YES ❑NO NEAREST---IIIII SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: I 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: MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL DEPTH I FILL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV.INLET: ELEV.END: PIPES: FEET FROM LINE: AIR INLET: NEAREST-� 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 I TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; YES NO YES NO DEPTH OVER TRENCH/BED ED YES OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL: NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING: ELEVATION AND ELEV.: ELEV: DIA.: ELEV: PIPES: DIA.: DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑YES ❑NO ❑YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF I PROPERTY WELL: BUILDING: FEET FROM LINE: ❑Y_E S ❑NO ❑YES ❑NO NEAREST—* 0, U Sketch System on �\ Retain in county file for audit. Reverse Side. SIGNATURE: TITLE: Zonin SBD-6710(R.06/88) g r DILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05,Wis.Adm.Code CouNTY� %f�y��j(/J-.+/�) ��wMHe1�W111M�v1� d �.l �J / STATE SANITARY PERMIT# —Attach complete plans(to the county copy only)for the system,on paper not less than // 9 yd/ 8%x 11 inches in size. ❑ Check if revision to previous application –See reverse side for instructions for completing this application. STATE PLAN I.D.NUMBER I. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. PROPERTY OWNER P P iUT f LOCATION a,^d IV, T '/a '/a,S T , N, R E(Or PROPERTY OWNER'S MAILING ADDRESS LOT# BLOCK# /� A CITY,STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER o 0,S- El II. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD ❑State Owned O VILLAGE:,_ Em❑ Public 01 or 2 Fam.Dwelling-#of bedrooms� PARCEL jX NU ER ) 111. BUILDING USE: (If building type is public,check all that apply) '7a3 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) 1.9`i11ew 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 0 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 7o, 17 967/ Feet 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 Holding Tank lao F1 F1 Lift Pump Tank/Siphon 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): Plumber's Signature:(No Stamps) 1#W/MPRSW No.: Business Phone Number:n Z�Ao/0 Plumber's Address(Street,City,State,Zip Code): .� IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee(Includes Groundwater ate Issued Issuing Agent Signature(No Stamps) Surcharge Fee) Approved ❑ owner Given Initial �/r r� \, �,. h Adverse De rmination `-I vV -t7 X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: 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: 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. Vlll. 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'f 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. SBM398(8.11/88) i r " APPLICATION FOR SANITARY PERMIT 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), 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 k I\\ E S Location of property 1/$. W 1/4, Section ��" 3�-19 , T N-R W Township Mailing address IL� ` `� ��� � ��`Yt�v � W( sc lb- q Address of site I2-+ o v-nc'-2,�tj W tsc_ �`1 OZ-S- Subdivision name Lot number Previous owner of property �"1 1 l �'t f" ` VlJ I eEse Total size of parcel ( c2c S Date parcel was created C Are all corners and lot lines identifiable? _ Yes No Is this property being developed for resale (spec house)? Yes _No Volume 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, 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. ---------------------------------------------------------7--------------------- 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 warrant yed recorded in the Office of the County Register of Deeds as Document No. C dg Z-3 qn ; 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 egis of Deeds, �asDo�cument No. ) . Signature of Owner Signature of -Owner (If Applicable) Date of Signature Date of Signature DOCUMENT NO, STATE BAR OF WISCONSIN FORM 1-1982 THIS SPACE RESERVED FOR RECORDING.DATA WARRANTY DEED 442 so 2'a PA[I 13 3 0 REGISTER'S OFFIa This Deed, made between ...................................•..............•...•••• ST. CROIX CO., W1 for Record, ------- G l.en...M__Wles.e......................................... Recd .......................................................... ............................................... ------ `OCT 2 01988 rantor, ------------R-*0 iyal-1-d N------Th-uenyiLs-s9Md---L0-ri---J-.---T-h0-eT1n% and....... husbarid aria wife as""marital"""sur'vivorsiip "" ------------- ----------- ------------------------------------------------------------------------------------ t .............pr.op-e-r.--y......................... .... .... . .. ..................................................................................................I Grantee, V)WHSVI� -Thie t the said Grantor, for a valuable consideration...... ie ----------------------------------------------------------------------------------- conveys to Grantee the following described real estate in St- --Cmix R E= -6 R 14- TO .................................. County, State of Wisconsin: Tax Parcel No: ................................... Part of E! of SWI of Section 15-30-19 described as follows: 2 4 Lot 3 of Certified Survey Map filed June 11 , 1988 in Volume "7" , page 1986. Q ,N4EEEV This ......i-a.-riat........ homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And------ G warrants that the title is good, indefeasible in fee-_simple-_and_free-an-d-clear-of-e-neumbrances.excep.t.••.•.....•••••••......... easements, restrictions and rights-of-way of record, if any. and will warrant and defend the same, Dated this .. n ---_----V__�_ ------------------- day of ....... 'Z'�A ------------------------------------------------ 19 ......... ---------------------------------------------------------------------(SEAL) ------- . p...._..•..---(SEAL) Glen M. Wiese - -------------- .............•..••......•..•••.••..•.•. ------------------------------------------------------------ --------(SEAL). ---.--------------------------------------- ........................(SEAL) ................................... .............................. -------_------------ -------------- ............................. AUTHENTICATION ACKNOWLEDGMENT Signature(s) ------------------------------------------------------------ -STATE OF WISCONSIN -------------------------------------------------------------------------------- Ss. ----a.t_._QrQ_jx-------------County. t\ authenticated this _.._....day of--------------------------- 19....-- Personally came before me .... tr this X_r,)_ __day of -------------------------------------------------------------------------------- Qq pbe-------------------------I 19.aQ--- the above named -------------------------------------------------------------------------------- --- ------------------------------------------------------------------- ...... ---jalgLin i e s e TITLE: MEMBER STATE BAR OF WISCONSIN ------------------------------------------------------- -------------------------------------------------------------------------------- (If not, authorized b -- ------------- --------------------------------------------------------- to me known to be the person ............ who executed the oregoing trume t nd ackn�wledge the same. ..................... THIS INSTRUMENT WAS DRAFTED SY Kristina Ogland Lundeen -- ---------- ------ ---------------------------------------------------------- �). S . nljpr ------------------------------- Alice . Fleischauer ---- --- -- --- -------- ------------------------------- -------------------------------------------------------------------------------- Notary Public ........�:tt---QXM14BAPG11"Awis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If Wallyfttiftpiration are not necessary.) --------_ 6-11- State cf ft rdate: ...... ............... - A .... •Names of persons signing in any capacity should be typed or printed below their signatures. WARRANTY DEED STATE BAR OF WISCONSIN ragm ri, i—ineq Wiscnnsfn Legal Blank Co. Inc. STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER 6CNAt'I(,S ROUTE/BOX NUMBER Z— �"� �J I�, FIRE NO. S CITY/STATE SUIML^(LSC T W tSc- ZIP PROPERTY LOCATION: E 1/% 1/4, Section T N, R W, Town of J O ►^^L�2SC "� , St. Croix County, 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 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° Y \. DATE TE 3 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 INDUSTRY,. REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY,. DIVISION LABOR AND, PERCOLATION TESTS (115) MADISON WI 969 HUMAN RELATIONS (H63.090) &Chapter 145.045) LOCATION: SECTIOn/R r W TOWNSHIP MUNICIPALITY: LOT N .:BLK.N .. SUBDIVISION NAME: SE �/4SW�/4 /5 I9 E (o n SOMERSET FUTURE C.S.M. COUNTY: WNER' ER'S NAME: MAILING ADDRESS: S7. CRO/X GLEN W/ESE R3 RIVER FALLS W/ 54022 USE DATES OBSERVATIONS MADE NO.BEDRMS,: COMMERCIA ESCRIPTION: (PROFILEDESCRI TIONS: PERCOLATION TESTS: ©Residence 3 ®New ❑Replace It 6 _ / 7 - e5 7- IS - 85 RATING:S=Site suitable for system U=Site unsuitable for system CONVENTIONAL: MQUND:�� IN-GROUNDP�ORE: SYSTEM-I®ILLHOaLDING TANK:RECOMMENDED SYSTEM:(optional) INS UU ®S ®S U S U S ®U CONVENTIONAL If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b),indicate: CL ASS / L Floodplain,indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B_ 1 6.6' 98. 4 ' NONE 7 6.6 Bn / /0. 7'1 Bn s/ / /,O'1 Bn /s ( 4.99 B- 2 6.8' 97,1 ' // y 6.B' an s/ / /.B'1 B Is f 5.09 3 B- T.6 98.9 T. 6' an / / /.3 '1 Bn s/ /2.7'1 an Is / 3, 6`I B_ 4 6.9' 99"9' 1/ 7 6.9 Ba //1.09 Bit s1 /1,3'1 an Is /4.6'l B- 5 7. 8' 100.4' /l 7.8' Bn s/ /1.9'1 an Is f 5.9 '1 S- SOIL MAP SHEET 34 PERCOLATION TESTS CHETEK ONAM/A COMP, TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERT D2 P R PER INCH P_ 1 3.3' /0 31181, 3 314" 3 112" 3 p- 2 2,0' 0 /0 4 e` 3 3/4 3 9//6" 3 P_ 3 3.8' E /0 4 112 " 4 //8" 4 114" 2 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. I N I T I A L 95.1 ' SYSTEM ELEVATION REPLACEMENT 96.73' FE CE ON AP�OX�AI RT L NE SW 14 SW/ 4 SEC G /5 E r € (( I d € I SIJITA'BL AR CA � 23o o. kr.. 3 -- I W r ' -�-- 4-- .�� �! _ r � - -�---- -�--- --x-_----�- N IAL UT,TR ESQ 2 TOl}�N OA . 3 PL C MEivr I i _ tN I SC L E 1/112 30 RA/ R AD. SP/K£_ fi T P / O P/ E jRO�/ P PES BURIED I FOP r _ } _ L_...... L ABA K � I �__.. ( SEC. 15 (8) PE C OL I / I,the undersigned, hereby certify that the soil tests reported on this wer, rt� Pfaccgr ith the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and the location of th t are tot est;,fff y knowledge and belief. NAME(print): /`y � TESTS WERE COMPLETED ON: L AURENCE W.MORPH Y i 7 - /8 -85 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): R/ BOX 36A RIVER FALLS, W/ 54022 55 - 2445 425- 9032 CST S1 NATURE: 1 DISTRIBUTION:Original and one copy to Local Authority,Property Owne ^1 Soil Tester. DILHR-SBD-6395 (R.02/82) IL- INSTRUCTIONS FOR COMPLETING FORM 115- SBD - 5355 To be a complete and accurate soil test,your report must include: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A separate sheet may be used if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown,and are permanent; 9. Complete all appropriate boxes as to dates, names,addresses, flood plain data, percolation test exemp- tion,if appropriate; 10. If the information (such as flood plain,elevation)does not apply, place N.A. in the appropriate box; 11. Sign the form and place your current address and your certification number; 12. Make legible copies and distribute as required, ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbois st - Stone (over 10") BR _ Bedrock cob Cobble (3- 10") SS -- Sandstone gr - Gravel (under 3") LS - Limestone *s - Sand HGW High Groundwater cs Coarse Sand Perc Percolation Rate med s - Medium Sand W - Well fs Fine Sand Bldg - Building Is - Lo arny Sand > - Greater Than sl - Sandy Loam < - Less Than *1 - Loam Bn - Brown *sil - Silt Loarn BI Black si - Silt Gy - Gray *cl - Clay Loarn Y - Yellow scl - Sandy Clay Loam R - Red sicl - Silty Clay Loam mot - Mottles sc - Sandy Clay wl with sic - Silty Clay fff - few, Pine,faint *c - Clay cc -- common,coarse pt -- Peat mm - Many, medium m - Muck d - distinct p - prominent HWL - High water level, Six general soil textures surface water for liquid waste disposal BM - Bench Mark VRP - Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary permit must be obtained and posted prior to the start of any construction. AMATA PhoAf2?Y LzwF r /SEC f—D� n0 ST >-7 Dr�/ pp �oPosEo l�/FLL� l JEST Pfto)orjzTY Z-rNlr 70/ fi S-S .TL o p- /W q r oo 6AIZA 6E SEyI.vFi� I� ZOi �9� oO /000 CAL SEP7ZC TANK �ON�5CT ' -/fAFL&,&vT L ",E , V&rr rTAC$ S —I /\Divro L Y> ��YOfivNf.S L .a, pa3A�w tf.>'.1'T/F�iyi k— — ovF/t 900 ro EAST � /OWE./ Off' J OI-n r1zsFT PRO/t/tTY Lzdvt �S 0 QQy S7: Ci2USJC CauriT Y A:PE ELE✓, = /00, 00' .Tvu7/J %o/0jorZTY L3'rvE _ NU 2CALE FRESH AIR 1MLETi AMO OR-SER'i'ATION PIPE 1 :{° td'- , ! iRk-_Fy f =N' FIFE. Fir-JAL GrADE LICENSE- -Z700 t Mlrilhdllatvl f'° d GGRE=af.TE DATE- OYER PIPE — i s CaISTRIB RTION' PIPE 1 -'Q IL TESTIN( BY: E � _�a�.!_�r.✓c.E- �c�?nom' _ ELE`v.b.MN BEC? �" AGGREGATE-TE—{ 1 � i °..- R���TT+,�I:d1 i'"•1"1-'i LJrkflL ! � a •=" . 1i)G:r FIIG ocLri IT-ST IS �=�C� S 41� ' 7; COUPLING. TERMINATING f. AT BOT TON1 yaF°_r'.3TD- A • X ' �3�_ •2o S'y_sco P7B 3N ,7s, C. o 4.68-244 CERT IF IED SU R Located in the SE1 /4 of the SW 1/4 ��� ��� Of Somerset, St. Croix Count of Section 15, T3 ON,R 19W , Town y, Wisconsin. APPROX. q• OF ABANDONED RAILROAD BEI Surveyed for: Larry Johannsen 66 5725 Hilltop Ave. Panama City Beach I I Fl. 32408 p wo Nl rn I HARVEY ° 1 G. JI m I JOHNSON S-1899 1 aI HUDSON 1 Wl 1 F�-•.1 N�I I I I L ��I� WNrIMS wI' � < LEGEND I a W I I ��, Section C orner 1 a �I ' I W'I (330.00') Previously usly I I UN PLATTED LANDS_ information II � 66 SCALE IN FEET 1" - 200' 1 S 89- 14'53 -E 655.07 ' o' S0' 100' 200' 400' W I1� FILED ` � Z APR 15 1991► 2 w JAMES _I V) - Register St.Croix Co.,WI 01 to LOT 1 Cn JI 1p 878, 601 Sq. Ft. ~ M 20- 170 AC . N ° 0 N 3 ID mo IP 2 000 W C� / Z O v 0 a p o 3 -�I N cn�.al NI 1 °a ' I �► 1 � v WI v ►.1 o M C) 0 Z Z W �I I M I W` a : 1 1 W J � N 'i _ ZI W V) I I z° DI _ Z pW U, H <Z °i W Q1 Q1 J 1 0 0I, �W La t-: WETLAND WETLAND Q SW COR. °I N WI �I ��I SEC. 15 ;,al yi ' SOUTH /LINE OF THE SW I/\` S I/4 COR. _8. IW '`�/ SEC. 15 ..n "'� 1968.08_ �I 1 ` T30N. R 19 ----��-- .- N 90°00'00" W 656.001. DRQFTED BY: JWG UNPLQTTED LANDS VOLUME 8 PAGE 2346 491 -1854 DEPARTMENT OF REPORT ON SOIL BORIN SAFETY& BUILDINGS INDUSTFrY, DIVISION AND PERCOLATION TESTS P.O. BOX 7969 HUMAN RELATIONS MADISON,WI 53707 (ILHR 83.09(1)& Chapter 145) LOCATION: SECTION: OWNSHIP UNICIPALITY: 0r NO.: SUBDIVISION NAME: se- !/sw !/ �s /T30 N/R)9 E _ _ COUNTY: �3UL-(LR MAILING ADDRESS: 78 53 ST C ItX )M tit►.t�'I-E Ge;Rl�tfl>JN 1� fl3v SS I Z S USE DATES OBSERVATIONS MADE NO.BEDRMS : COMMER IAL DESCRIPTION: I PERCOLATION ESTS: Residence '3 - R ^ New ❑Replace Il Ll— y-9l RATING:S=Site suitable for system U=Site unsuitable for system ONVENTIONAL: MOUND: IN-GROUND PRESSURE: SYSTEM-IN-FILL OLDING TANK:RECOMMENDED SYSTEM:(optional) NS au ®Sou OS ou 2S D ❑S 0U el � l�P 8� If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)(b),indicate: C�-PCS $ ` Floodplain,indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL ELEVATION PTH TO ROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, OBSERVED EST.RrTH—EST— TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) \ S9 48.x, IVIyJtw > 89 ©=6; loyR -L/Z, 1S ; 6 1 89 %b-1 B- 2 SC ZLZ is '�- » �'tio-f9 3/. 1s; rz YA Mj S 86 47, 4 o-`7, to-1 t-,Lz/ 1 Rsib is ; 30— 8I[. B- L) _ 0)3.9 �` _ 76 - a-(' Ibl-m Z/Z )S 6- t7 1q`iR 3/6 IT ; 1-) - 716 ? 93 0 -7 , lQi fTZ Z,/Z )s '7-y0 16yR 3/` MS S • yo- 93 1�4R fir/_ v>7e S coY _. q"1 • Z S I D-b 1b-t P, Z! Z. I S W-ttZ L//6 S Gh PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD3 PER PER INCH P- P- P- 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. Z�I\G( 3 y �1�1 7OZ'r `S SYSTEM ELEVATION s pf�Gt Z OF Z 0 Th I 1 , 3 E i r a t 7 3 E , 7,- a r 11hd1' b iII'I se- 1C I,the undersigned, hereby certify that the soil tests reported o R+tS orm w9517made.,V me i a1� d with the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and the locatio f tests are rre he b t my knowledge and belief.EGERER SOUL UV __r O nU� �'CP NAME print i AND -. 1> Cp ,� p ESTS WERE COMPLETED ON: (` p vinp ADDRESS: �. C? C0 CERTIFICATION NUMBER: PHONE NUMBER(optional): 112.10, BOX74 421 N. MAIN 8T. \' h' c ST 0 0o S7 6 CIS-Ll2S-o/6 S CST SI NAT RE: RIVER FILLS, WI 54022 :Lr �' 1�•L 715-42"165 DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. L DILHR-SBD-6395(R. 10/83) -OVER - 6� dI- INSTRUCT FOR COMPLETING FORM 115- SBD -6395 t To be a complete and acwrate soil test,your report must include: 1. Complete legal des¢�iption; 2. The use sect.ign_ntUst clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations.Drawing scale is prefered.A separate sheet may be used if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown,and are permanent; 9. Complete all apropriate boxes as to dates,names,addresses,flood plain data,percolation test exemption,if appropriate; 10. If the information (such as flood plain,elevation)does not apply,place N.A.in the appropriate box; 11. Sign the form and place your current address and yur certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st — Stone (over 10") BR — Bedrock cob — Cobble (3 - 10") SS — Standstone gr — Gravel (under 3") LS — Limestone 's — Sand HGW — High Groundwater cs — Coarse Sand Perc — Precolation Rate med s — Medium Sand W — Well is — Fine Sand Bldg — Building Is— Loamy Sand > — Greater Than 'sI — Loamy Sand � — Less Than 'I — Loam Bn — Brown 'sil — Silt Loam BI — Black si — Slit Gy — Gray cl — Clay Loam Y — Yellow scl — Sandy Clay Loam R — Red sicl — Silty Clay Loam mot — Mottles sc — Sandy Clay w/ — with sic — Silty Clay fff — few, fine, faint 'c — Clay cc — common, coarse pt — Peat mm — Many, Medium m — Muck d — distinct p — prominent HWL — High water level, surface water Six general soil textures BM — Bench Mark for liquid waste disposal VRP — Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request verification of this soil test in the field prior to permit issuance.A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit.The sanitary permit must be obtained and posted prior to the start of any construction. 1yoTE; Tlie �T �x'1 MrRp Z PRNP'C— Ty LJUE OF q8.6 cw spItzL T?f[S ?�J I�C2E t'. c� q,_ Nz'" RBo� Gra( IWuo r- I�'z WEST s)DE of I I I I I � � 10 1 \ q4 1 I �S 1n I L Q-b r 1 I \ I AS l I l 1 9� �L�C�S1�1u G �-�►'tUv�� Z°lo $ \ 1 I $7 a 7 _ I� 9a I WE?s r OF SITE. aA KR - °. I WEGERER SOIL. TESTING ON DESIGN SERVICE NIS P1$wE P,O, BOX 74 421 N. MAIN ST. lFJ v1� SIDE` pF FOVER FALLS. W154022 Z 01= Z 715-423-0165 T4M E N T OF REPORT ON SOIL BORINGS AND N°S MODS TRY, IN,�t35 IVISION LABOR AND PERCOLATION TESTS (115 ° BOX 7969 HUMAN RELATIONS \ � MADISON,WI 53707 (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: OWNSHIP UNICIPALITY: LOT NO.:BLK NO.: SUBDIVISION NAME: �/ is /T30 N/R)9 E (o _ — COUNTY: k�ER MAILING ADDRESS: 7853 1�)/•)���t� [ZLj/�D ST X -7)1-1 $ ►_�QeTTg GemkrIoN I I Mlv SS)2.s USE DATES OBSERVATIONS MADE [Fe IND.BEDRMS.: C DESCRIPTION: TS: Residence '3 IJ . R - LRNew ❑Replace �— L/_9 /V A. RATING:S=Site suitable for system U=Site unsuitable for system CONVENTIONAL: MOUND: D PRESSU RE: SYSTEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTEM:(optional) lZ S ❑U ®$ ❑U JIN-GROUN LAS OU .®S DU ❑S OU i 'x 1GP If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)(b),indicate: y�- � ` Floodplain, indicate Floodplain elevation: )v' PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED HE T TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) \ a 9 '89 C-b'; loyR Z-/-L \S ; 6" 89" �D LI/6 M"s S B- Z 8(. 9g-I ? 8C_ Q-'l" 1\Z,-Ivzlh IS ' � - 17 ,a10�-1L� 3lio \S � yCN-1-1z V/6 Yn.0� 5 B- 3 _ Q(o �`�. � q ? $b S B- _y -�6 �3.q 'I ? 7� a-� tU`zR ZlZ iS • 6 - \-) B- rr ? 9' 3 O - -7 LO`1R 7,/Z )S ' -J- L1O 16 Y 3A. M'S S ' 4 0- 9 3 6 6 g_Z qS, $ 7 8Z a-6, coY ZlZ lS 6 -iZ l u 1Y P� 3J6 m S -- B-.'T �, �` 7 S 0-6 l b-i Z I/ 1 IS b- j 1 W-1,lZ Y/( S a' 6 h PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH P- P P- -- P- P- LP_ 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. 1��GE:- LIZ T" ` S SYSTEM ELEVATION f n eta 713,1 S _...._ J2 s , 1 1 `R .?\�.. ,�,T _ _ _,TNT, S ITli 3 CAL .'fN \. � 1 o1' Y . nr � :o_��. v,u�� � tt �t� . tN __ , >`Ut'w i�l �''Jl �LP x-•01 k-1 .VIT )G TH 3F __:. _ ,.� .__� G S J 4.S . �3,OT4T i 3F 71" L �`? S 1 L -Q �'1 �v ) `?( ass*>+ . _oT'I7 ''. t srrE- �J Lj - Sic_ 15 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)7 AND TESTS WERE COMPLETED ON: DESIGN SERVICE ADDRESS CERTIFICATION NUMBER: IPHONE NUMBER(optional): P�Or BOX 74 421 N. MAIN 9T. CST 30o S-) L Wl S RIPER FALLS; Wt 54022 CST SI NAT, RE: f. � 715-425-0465 cc�� °ll- ll DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. l DILHR-SBD-6395 (R. 10/83) —OVER — h s � �L y6 g8.6' oxi SPIVLL pF.oP. t2.`(�j LI1UE t� �z" FTSo� G2tlU�t� Tit/S Zv l�c(z� t� ��� r-`L- 'VQ WEST R)WE of IS z op' -.rely S 1`T� , y �1� I i I I T, 1 S4sT7EM EL F . 9�1.y I , �� ►.�fl L , X r \ Iftyl \ q6 C �x�s`n�G coy.►-���� 2020 $'7\a 7 I� 9� I_ I (�F SITS.VECERE R SOIL TESTING 1�►-� HRH i �� 2 AND . tou.o' o�, Split: DESIGN SERVICE P.O. BOX 74 421 N. MAIN 8T. t t� Sow SIZE t,F RIVER FALLS; Wt 54022 6 pc' PL,-,z '> 1'�� 715-425-0165 ArcIMS Viewer Page 1 of 1 CSM 18-4659 m�.r) IAT1 702A•20 ?03 A 0 R CSM VOL 8 PG 2346 dd R LOT2 R ?03 c TN 30MERSET mass 702A•30 OT3 L 7703 0 R i i i maa. a' mo TN ST JOSEPH, 22 x ! 1856. W http://72.21.230.178/website/LRPortal/ARCIMS/MapFrame.asp?PIN= 4/21/2006 Parcel M 032-2054-50-300 04/21/2006 04:43 PM PAGE 1 OF 1 • Alt. Parcel#: Y15.30.19.703D 032-TOWN OF SOMERSET Current [Xj 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 KYLE W&TAMMY E SCHROEDER O-SCHROEDER, KYLE W&TAMMY E 1503 63RD ST SOMERSET WI 54025 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description * 1503 63RD ST SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 5.466 Plat: N/A-NOT AVAILABLE SEC 15 T30N R1 9W SE SW 5.46 ACRES LOT 3 Block/Condo Bldg: CSM 7/1986 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 15-30N-19W Notes: Parcel History: ,/�Q CG • �• Date Doc# V Type J 8 07/23/1997 /90 WD 07/23/1997 854/3 07/23/1997 840/17 07/23/1997 825/330 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/23/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.460 60,300 144,700 205,000 NO Totals for 2006: General Property 5.460 60,300 144,700 205,000 Woodland 0.000 0 0 Totals for 2005: General Property 5.460 60,300 144,700 205,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 213 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00