HomeMy WebLinkAbout032-1047-20-110
+ Form - S T C - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER W111) 6-Pel;1g/J TOWNSHIP / SEC. T N-R~W
r` - .7
ADDRESS / ST. CROIX COUNTY, WISCONSIN
SUBDIVISION LOT LOT SIZE
PLAN VIEW
I
Distances and dimensions to meet requirements of ILHR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
f •
t 406
0
h
\y
1
f
INDICATE NORTH ARROW
y f
64 f B'b
BENCHMARK: Describe the vertical reference point used 7,-0p0
~~Qt ~t L%OZits~
f
Elevation of vertical reference point: Proposed slope at site:
T
SEPTIC TANK: Manufacturer: -ei/fs Liquid Capacity: 1/0~
Number of rings used: Tank manhole cover elevation:
TanK Ilea Elevation: Tank Outlet Elevation:
Number of feet from nearest Road: Front,O Side,O Rear, O / feet
.From nearest property line 'Front 10 Side, Rear, O 'IaLr feet-
Number of 1-_t from: well O Wt , building:
°lude this information of the above plot plan)( 2 reference dimensions to septic tank)
SEE REVERSE SIDE
PUMP CHAMBER
Manufacturer: Liquid Capacity:
pump Model: Pump/Siphon Manufacturer: Pump Size
Elevation of inlet: Bottom of tank elevation: F q-
pump off switch elevation: Gallons per cycle:
Alarm Manufacturer: Alarm Switch Type:
Number of feet from nearest property line: Front, O Side, O Rear, Q Ft.
Number of feet from well:
Number of feet from building:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: Z Trench:
Width: , Length: Number of Lines: Area Built
Fill depth to top of pipe:
Number of feet from nearest property line: Front, O Side , Rear,
Number of feet from well:
Number of feet from building:
(Include distances o plot lan).
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: CrVacity:
Number of rings used: Elevation -f 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:
Inspector:
Dated: Plumber on job: 2
License Number:
3/s4:mj
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING
LABOR & HUMAN RELATIONS DIVISION
~.0. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION
~ c~N 7','l State Plan I.D. Number:
SW'MS2 S' 16WI' 3~1 9W 49 CONVENTIONAL El ALTERATIVE (If assigned)
Town of Somerset
Lot 1-210th Ave ❑ Holding Tank El In-Ground Pressure El Mound
NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DA E:
William Geenen Route 1 Somerset, WI
BENCHMARK (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,
Byron Bird, JR 3318 St. Croix 11063
SEPTIC TANK/HOLDING TANK:
MANUFACTURER: LIQUID CAPACITY: TANK INLEERO 7PR ELEV.: WARNING LABEL LOCKING COVER
PROVIDED: PROVDED:
❑ YES ❑ NO ❑ YES ❑ NO
BEDDING: VENT DIA.: VENT MATT. HIGH WATER NUMBER OF D: O PERTY WELL: B UILDING: VENT TO FRESH
FEET FROM NE: AIR INLET:
❑ YES ❑ NO ❑ YES ❑ NO NEAREST
DOSING CHAMBER:
MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER
PROVIDED PROVIDED:
❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH
(DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET:
PUMP ON AND OFF ❑ YES ❑ NO NEAREST 00-
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:
WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID
BED/TRENCH TRENCHES: MATERIAL: PIT DEPTH:
DIMENSIONS t. 3j ~ - 1
GRAVEL DEPTH 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 TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS;
❑ YES ❑ NO El YES ❑ NO
DEPTH OVER TRENCH/BED DEPTH 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:
ELEV.: ELEV.: DIA.: ELEV.: PIP
ELEVATION AND ES: DIA.:
DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO
INFORMATION APPROVED PLANS
❑ YES ❑ NO A~f ❑ YES ❑ NO
PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING:
COMMENTS: 1 FEET FROM LINE:
❑ YES ❑ NO ❑ YES ❑ NO NEAREST
I~
7
1 Retain in county file for audit.
Sketch System on J
Reverse Side. SIGNATURE: TITLE:
ZONING ADMINISTRATOR
SBD-6710 (R. 06/88)
Thomas C. Nelson
Ea7F0:1LHR SANITARY PERMIT APPLICATION COUNTY
In accord with ILHR 83.05, Wis. Adm. Code G/^O
STATE SANITARY ERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than L ~ F& 30
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
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER PROPERTY LOCATION
eme/-t •XPt S T-3,/, N, R E (o
PROPERTY OWNER'S MAILING ADDRESS LOT # / BLOCK #
CITY, STATE _ ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
II. TYPE OF BUILDING: (Check one) ❑ State Owned VILLAGE : NEAREST ROAD
El Public X1 or 2 Fam. Dwelling- # of bedrooms A 4g)XN OF:_
TAX NU ' ER(
III. BUILDING USE: (if building type is public, check T11 that apply)
1 ❑ Apt/Condo UUU ~~~JJJ
20 Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repa;rs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 80 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)
IKA
~!I, New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.0 Repair of an
A) 1. 4
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
eet b/Z-g'"?Feet
VII. TANK CAPACITY Site
INFORMATION in allons Total # of Prefab. Fiber- Expp.
New istin Gallons Tanks Manufacturer's Name oncrete Con- Steel glass Plastic App
Tanks Tanks structed -7- F] F-1 I El
Se tic Tank or Holdin Tank 4+_4 F-1 jj- F1 I El Fj
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' Name (Print): Plumber' Signature: (No Stamps) MP/MPRSW No.: Business Phone Number:
-A 5-
.9 Plum s dress (S r et, ity, Stale, ip Code).
A0 A
e
IX. UN DEPAR MENT USE ONLY
❑ Disapproved nitary P rmit Fso (Includes Groundwater Date Issued Issu' g gent Signature (No Stamps)
Approved ❑ Owner Given Initial S rcharge Fee)
Advers Dee in tin
. CONDITIONS OF APPROVAL/REASONS FOR SAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety 8 Buildings Division, Owner, Plumber
INSTRUCTIONS X
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 property maintained. The septic tank(s) must be pumped by a licensed
pumper whenever necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the
State of Wisconsin, Safety & Buildings Division, 608-266-3815.
To be complete and accurate this sanitary permit application must include:
1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of
where the system is to be installed.
II. Type of building being-served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is Public, check all appropriate boxes that apply.
IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or
repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested in ##1-7.
VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of
tanks and manufactuner'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/gepartment 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)
4
• 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
Location of property gk) 1/4 X1/9, Section T_,1 N-R W
Township
Mailing address /O C)-
Address of site
Subdivision name 1
Lot number
Previous owner of property
Total size of parcel
Date parcel was created
Are all corners and lot lines identifiable? es No
Is this property being developed for resale (spec house)? Yes No
Volume 6 2'06 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 Hap, the Certified Survey
Map shall also be required.
PROPERTY OWNER CERTIFICATION
I(We) certify that all statements on this form are true to the best of my (our)
knowledge; that I (we) am (are) the owner(s) of the property described in
this information form, by virtue of a warranty deed recorded in the Office of
the County Register of Deeds as Document No. '35 C'l )-;;L ; 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 Deeds, as Document No.
Signature of Owner Signature of Co-Owner (If Applicable)
i
Date of Signature Date of Signature
DOCUMENT NO. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA I'
STATE BAR OF WISCONSIN FORM 2 -1982
v
w
" T
y 6711PAGE 51
STE75, OPF~C~
ST. Cnix CO., WISE
Joanne A. Seibel, a single woman Recd fc~I acarcl this 13th
-
. day of Sept A.D. 19_§4
at 1:25 P
conveys and warrants to William T. Geenen and Martha A.
jl _
Geenen- husband.. ani..~i f.e---aa.. Q~.~lt tenant-_.............. t.@ww of o..a.
RETURN TO
the following described real estate in S.t_.C=ix.................. County,
State of Wisconsin:
Tax Parcel No-
The West 678.5 feet of the Southwest Quarter of the Southeast Quarter
(SWa of SEa), Section Sixteen (16), Township Thirty-one (31) North,
Range Nineteen (19) West, intending to include that certain Certified
Survey Map filed August 20, 1979, recorded in Volume "3", page 845,
as Document No. 359214.
This deed is executed solely for the purpose of fulfilling that certain
land contract between the parties hereof, dated September 29, 1980,
recorded October 3, 1980, in Volume "61811, page 390, as Document No.
366799.
This ___-.l S homestead property.
(is) (is not)
Exception to warranties :
`4
Dated this _ day of A-t . - 1~ 19.8......
4-
(SEAL)
ZJoanne A. Seibel
------(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF 'MINNESOTA
ss.
•
•------•--•----•------•-•-•-•-......County.
authenticated this day of 19 Personally came before me this day of
19-8-4_- the above named
Jo nne A. Seibel
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not-
authorized by $ 706.06, Wis. Stats.) to me known to be the person who executed the
7foing instrument a knowledge the same.
THIS INSTRUMENT WAS DRAFTED BY /
Reinstra, Van Dyk & Needham, S.C.
--to r---- neys--- ---------at •
At~
Law-•
New--- R3ch>: Gnd,---Wis-eon6in----•5401-7 X127 Notary Public - ------County, MN !
(Signatures may be authenticated or acknowledged. Both My Commission is perma~n~nt.(If not, state expiration i
i are not necessary.) date: AAAMa19._0._.)
I
CA ROLE . T}..ir)AM ER
*Names of persons signing in any capacity should be typed or printed below their signatur NOTARY PUBLIC-MINNESOTA
i. RAMSPYCOUNTY
Goihl!►~ExPk± Apr..29~19SJ;. _ t
STATE BAR OF WISCONSIISV VVVV IrO. 3OOZ
H.C.Millarcempryl~If1 FORM No. 2 - 1982
' _ MIti,VYN. WI,sM,I• l~i0ffi~!!
1
s FILED
AUG 2 51989►
5 JAMES O'CONNELL 12
Register of Deeds
450922 SL Croix Co., Wt
CERTIFIED SURVEY MAP N
Located in part of the SWa of the SE4 of Section 16, T31N, R19W,
Town of Somerset, St. Croix County, Wisconsin; including all of
Lot 1 of Certified Survey Map in Volume 3, Page 845.
Unplatted Lands
North line of the SWj of the SEi of Section 16 0
N8902614411W 678.731 s
N
O N
N y
CID
-0 41
Lo c co
^ ~ w
M ` 0
L W co
(n M
LOT 2 L. s Co
i ~t 1 4J W
ao o
00 I 0) Q- C-
oo I'D I C O N
~O .--1 •N W Sq. Ft. Including R/W ^ ,1 c
16.85 Acres o d I M
I -1
723,244 Sq. Ft. Excluding R/W I tO1
16.60 Acres - r+
~O - 00 01
w I O eb
'O 1 C
C I •C) goy. O M ..a I
I M N M SCALE IN FEET
17 a >.i 0 100 200 300
1 O - O) O I
Q. M N M L 1
Cn ° °D, Shed o
C) C
d° I o v 1
4J N z
19, N8903814711W ~ i
OWNER
° 41 I
348.671 vi
William Geenen
1-0 R.R. 1, Box 100A
N House Somerset, WI 54025
3 LOT 1 I
0
Lot 1 ° rn ! rn
o Certified Survey Map a Area Including R/W °o U
rn 174,292 Sq. Ft. o
Vol. 3, Pg. 845 Z, 4.00 Acres j'
U-,
o _ Area Excluding R/W
Z 3674'7ACres. Ft. o
M --S89038147°E 2' 678.671-- M
330.001 348.671
210th 330.00' 348.671 M AVENUE 1 2 1
,01 A
10 P, S8903814711E 678.671 M S8903814711E
South line of the SE} of Section 16
Sj Corner of SE Corner of
Section 16 Unplatted Lands Section 16
LEGEND
IS County Section Monument Found ALLEN
NY GE•
• 111 Iron Pipe Found IT
b
0 111 x 2411 Iron Pipe Set, weighing
1.68 lbs. per linear foot. r WIS. APPROVED
w----x- Existing Fenceline<Nd SURD e~ey AUG 17 1989
88 s0~4 ST, CROIX COUNTY
C0WWW4S1ltF PARKS P1AWW,-
ANO zomNG CG1'LSNfrT a
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STC - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER ~,/~v,~.
ROUTE/BOX NUMBER /LET fh~zp®x~- FIRE NO. S
CITY/STATE ~~P,c~~~// SZ6C)~ ZIP
PROPERTY LOCATION: S Le 1/4 S 2F1/4, Section T_oj_N, R_Z9-W,
Town of ~ , 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.
S I GNED-e,-
DATE
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
LABOR AND TESTS (1151 P.O. BOX 7969
HUMAN RELATIONS PERCOLATION \ / MADISON, WI 53707
(H63.09(1) & Chapter 145.045)
LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME:
SW 1/4SE1/ 16 /T31 N/RL9)&or)W n/a n/a n/a Snmprq COUNTY: OWNER'S :k)WAME: MAILIN ADDRESS:
St. Croi Wm. Geenen IR.R.#l, Somerset, Wi. 54025
USE DATES OBSERVATIONS MADE sZ-
NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE TONS: A ON T TS: )IN I~@(esidence 3 n/a New ❑Replace 8-8-89 8-8-89
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN_ -GROUND-PRESSURE: S STEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional)
❑U 0 S ❑U ❑ S ou ❑ S [21 conventional
If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the
under s.H63.09(5)(b), indicate: n /a I Floodplain, indicate Floodplain elevation: n / a
decimal' PROFILE DESCRIPTIONS page 10 PMC
BORING TOTAL DEPTH T GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH ELEVATION OBSERVED EST. HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B-1 7.84 103.62 none >7.84 .42bl.1. 2.25bn.s.1. 4.00bn.c.s. 1.17bn.c s
981
B_2 7.50 102.82 none >7.50 .83bl.1. 1.00bn.s.l. 3.00bn.c.s. 2.67 bn. .
B-3 6.50 101.82 none >6.50 2.50bn.s.1. 4.00bn.c.s..&gr.
B-4 7.34 100.56 none >7.34 .50bl.1. 2.42bn.s.1. 4.42bn.l.s.
B-5 6.67 98.15 none >6.67 .75bl.1. 2.00bn.s.l. 3.92bn.l.s.
B-6 6.84 97.64 none 1>6.84 .42bl.l. 2.17bn.s.1. 4.25bn.l.s.
decimal' PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER AFTERSWELLING INTERVAL-MIN. PERIOD 1 PER D 2 P PER INCH
P_ 1 none 3
P_ Z- UU none 3 6 6 6 <3
P-3 3.00 none 3 6 6 6 <3
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 98.82
t r
I
4.1
I ! ~ ~ i I 'i I ' ; !
- I
T
t QO ~
19
_ I
-4 i
1 I i i
Lr-
I, 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 8-17-89
ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional):
988 N. Shore Dr., New Richmond, Wi. 54017 2298 15-246-6200
CST SIGN URE: /7
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 02/82) - OVER -
PLOT PLAN
PROJECT_ &i L,
ADDRESS
!j 1 /4 .,1~1/4/S~/ /T N/R W TOWN .c, COUNTY
';MR'S Byron Bird r. 8 D E 420, 70'
BEDROOM CLASS PERC CONVENTIONA SIN-G OUND PRESSURE
CONVENTI NAL LIFT MOU~HOLDI G TANK
SEPTIC TANK SIZE LIFT TANK SIZE
DOSE TANK SIZE HOLDING TANK SIZE
ABSORPTION AREA PERC RATE -zo-
BED SIZE ~ 116 Benchmark V.R.P. Assume Elevation 100'
Location of Benchmark
* H.R.P. ~o•-.s nez ap A=-1~
0 Borehole Q Well Scale = Feet
O Perc Hole System Elevation
Uent
12" .
TYPAR COVERING
2
. ~
"
12" 30 4 61 O 3- 3- (D 3'
1 6* Sewer Rock
12' 18'
A
o ` -
~0 I r
r ~ 1
1~0 SG
30
/60
T7f:
41-
~ I
f` o a N
t~ 4 Fuse ~ n 1 I
. 0► ~ .mss
x
w ~t I
c, Rw
U , o I , I
00
xl T
_ t
s r s qI~
V Pam f LAO GG"Y~IT a / 31 ~
F~f
1
10
w !c
N ~
i ~
a
I -y II ''r I I
I
I
013 'I lu
SL06S IM Xlosiawos
5~~ ato Zoos
ZZ6SL6Z uauQQE)aa~. wm
,G`~u ~-!vJ
Parcel 032-1047-20-000 02/12/2007 12:14 PM
PAGE 1 OF 1
Alt. Parcel 16.31.19.2388 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
GERALD & JUDY BICHA O - BICHA, GERALD & JUDY
452 210TH AVE
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 17.630 Plat: 2144-CSM 08/2144
SEC 16 T31 N R1 9W SW SE BEING LOT 2 CSM Block/Condo Bldg: LOT 2
8/2144 ALSO THE W 67.83' OF LOT 1 CSM
8/2144 Tract(s): (Sec-Twn-Rng 401/4 1601/4)
16-31N-19W SW SE
Notes: Parcel History:
Date Doc # Vol/Page Type
08/03/2006 831309 WD
11/05/1997 568048 1275/76 QC
07/23/1997 857/66
07/23/1997 696/354
2007 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/23/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.000 48,000 155,800 203,800 NO
PRODUCTIVE FORST LANDS G6 14.630 58,500 0 58,500 NO
Totals for 2007:
General Property 17.630 106,500 155,800 262,300
Woodland 0.000 0 0
Totals for 2006:
General Property 17.630 106,500 155,800 262,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 515
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Co
s FILED
AUG251989►
Cj JAMES O'CONNELL 12
Register of Deeds
t., 0922 St. Croix Co., Wl
CERTIFIED SURVEY MAP
1 Located in part of the SW,- of the SE4 of Section 16, T31N, R19W,
QI Town of Somerset, St. Croix County, Wisconsin; including all of
~..J Lot 1 of Certified Survey Map in Volume 3, Page 845.
Unplatted Lands
North line of the SW} of the SEA of Section 16 0
N8902614411W 678.731 c e
= N
O N
N "
L t0
41 1
O C
" y O
N
O D 41
U W
If, C (n
n al W
M L 4- _
N O f~
L. W CO
f/) M
a) O
LOT 2 s 00
fV)
I N
co
tD co I Q1 4- L
cp l0 1 C O A
L a) ~
734,134 Sq. Ft. Including R/W ° ~I d
I~ • I O C
16.85 Acres co a; M 41
i
723,244 Sq. Ft. Excluding R/W
_ 16.60 Acres o1
- t` co 7 1
w I ~ ° O
oI ° n cI
C I ,r, M I
4, M C,4
~ 01 SCALE IN FEET
U ti
N i~ 3 > I 0 100 200 300
I ~O (M - a, a) I
•--1 I ~ M N ~ L I -a i
LO Shed o V) a~° o
ro C:) W
~ N z 1
4 is' N8903814711W i OWNER
41
1 ° 348.671 C
William Geenen
.:i R.R. 1, Box 100A
ouseCQ o 411 Somerset, WI 54025
3 o LOT 1
0 of 1 °a, %R/((g eo Area Including Q
Certifie Survey Maps3
174,292 Sq. FtLO
Vol. 3 Pg. 845 4.00 Acres
~ I
o _ Area Excluding R/W
o Z o 162 ,786 Sq. Ft. o
--S 903814711E 3.W Acres h
330.0 1 348.671
210th 330.001 348.671 AVENUE 1926,011
S8903814711E 678.671 S8903814711E
L- South line of the SEi of Section 16
~Sj Corner of SE Corner of
Section 16 Unplatted Lands Section 16
LEGEND
1vg r.~6„y
® County Section Monument Found e ALLEI4
NY GE ,
0 111 Iron Pipe Found
0 111 x 2411 Iron Pipe Set, weighing co j p ~
1.68 lbs. per linear foot. r~
WIS 'fib t ~J
. b;k'~ o'r ;
w--F- Existing Fenceline
d UG 1 1,, S
R
f;
~
CROIX ~c;t:lvl'Y
f. '1 1a~S}isiJ v*-- P Ri:SPi;kj,`4if
AND 7( N:NC: CC{v:i.f{l'Ef
This instrument drafted by Fran Bleskacek Proj. No. 79-3g-189
Volume PAGE 2144