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032-2004-10-100
� \ / \ \ / k E . I 0/ . /f � $ �� $ 0� LO c � - x � ( CL E\ mad � ,c § ) % a - ) ) kj\ 3 � $ ® � / z a m § ) z 2 ) \ ■ _ J ® \ $ 7 7 D { \ C © \ 7 } •� ) A Q) § o z m z a co \% § ƒ 7E % - \ \ 4 § R 2 I CO ) n \ \ k k � � z -W i a E 2 CL U) \ } \ \ p ) j \ 6 2 LO _ ° E « // « _ ' 2 2 ! £ ; _ 2 < m m 52 k ■ & / E to a � ° e ) $ a CL 8 � ` o $ R \ $ m 2 D ) o f \ Lo - \ / \ \ § 0 2 $ k k \ ) k § C E § ' k a § ƒ J a / U) 0 Parcel #: 032-2004-10-100 03/02/2006 03:41 PM PAGE 1 OF 1 Alt. Parcel#: 1.30.19.477D-10 032-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 ERICH J LONG O-LONG, ERICH J 1791 82ND ST NEW RICHMOND WI 54017 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description * 1791 82ND ST SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 4.880 Plat: N/A-NOT AVAILABLE SEC 1 T30N R19W 5A IN N1/2 NW1/4 LOT 3 Block/Condo Bldg: CSM VOL 3/893 EXC PT TO HWY PROJECT 1559-08-22 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 01-30N-19W Notes: Parcel History: Date Doc# Vol/Page Type 06/28/2004 767046 2603/618 WD 11/03/2003 745560 2448/222 SD 08/28/2003 737857 2392/087 SD 10/18/2001 659405 1740/302 WD more 2005 SUMMARY Bill#: Fair Market Value: Assessed with: 77477 255,500 Valuations: Last Changed: 07/24/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.880 57,400 148,200 205,600 NO Totals for 2005: General Property 4.880 57,400 148,200 205,600 Woodland 0.000 0 0 Totals for 2004: General Property 4.880 57,400 148,200 205,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 211 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 V1psscoRsin,Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of - Bureau of Integrated Services in accordance with s. ILHR 83.09,Wis. Adm. Code Attach complete site plan on paper not lWhnd ,x 11 inche's in,size. Plan must County include,but not limited to: vertical and ence point(BMT;,direction and percent slope,scale or dimensions,norcn and distance to ne arest road. parcel I.D.# APPLICANT INFORMATION-`Pl 0e print all information. ! Reviewed by Date Personal information you provide may be us lnuseco es(Rn Law,s.18.04(1)(m)). Prope Owner C i C`.s/p Property Location 'Xj0° J A nu -F",,E // Govt.Lot 1/4 1/4,S T� ,N,R E(ore Property OWnees Mailing Addre v `y r`r Lot# 1 Block Subd.Name or`S # Z '791 572 ' 13 S, City Stag Zip Code Mbna4urril5er ❑ City ❑ Villa a � Nearest Road 1 9 Town N Construction Use: Residential/Number of bedrooms Addition to existing building X ❑ Re lacement Public or commercial-Describe: e derived daily flow-y� gpd Recommended design loading rate ,gpd,*_�Ltrench,9l Absorption area required 1 bed,ft2 � trench,it Maximum design loading rate 1zbed,gpd/ft2trench,gpd/Fl2 Recommended infiltration surface elevations) ft(as referred to site plan benchmark) Additional design/site considerations Parent material Flood plain elevation,if applicable ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system S ❑ U 0 s ❑ u Us ❑ U El ❑ u ❑S au [--Is 2 U SOIL DESCRIPTION REPORT Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench l _ , Ground , elev. Depth to limiting fa min. Remarks: Boring# E3 Ground elev. ft. Depth to limiting factor in. Remarks: CST Name leas Print) . Sign re Telephone No. Address p Date CST Number PROPERTY OWNER SOIL DESCRIPTION REPORT Page `of� PARCEL I.D.# Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 13 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench Ground elev. ft. ' Depth to limiting factor in. Remarks: Boring# Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD/ in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench Boring# Ground elev. ft. Depth to limiting factor in. Remarks: Boring# 3 Ground elev. ft. Depth to limiting factor in. Remarks: SBD-8330 R.07/96 �.�IO�Gf Cr=f�,�w,� /�.��y /l�G+.��-s;mac � - T.30i✓-�/�G J 7%l 9,2 i0� m 8a/-97 �s o l Jk a� 0.71 I l Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER r �f j eat u2 c/ TOWNSHIP el^ /"SEC. T�N-R. W ADDRESS G X�� ST. CROIX COUNTY, WISCONSIN SUBDIVISION `-'� LOT LOT SIZE PLAN VIEW ')'34'2CV4J to 7..Distances and dimensions to meet requirements of I•I.HR 83 77�(o SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM st so ,� I�y 4st � 8 9 RECENEO MAY 1 0 1988 L ST CFiOIk COUWY_ ZONINGOFFICE � w\ INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: Proposed slope at site: 02 SEPTIC TANK: Manufacturer: c e 7(_-,_Liquid Capacity: l � Number of rings used: �U�` Tank manhole cover elevation: ��. '35 Tank Inlet Elevation: Tank Outlet Elevation: 47 4 /© Number of feet from nearest Road: Front,O Side, Rear, O 5c9z� feet From nearest property line : Front,0 Side 10 Rear,O ]c> feet Number of feet from: well t, building: 112 Q," (Include 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: 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: Width: Length: Number of Lines: Area Built: Fill depth to top of pipe: r,2Q X � _ Number of feet from nearest property line: Front, Side, O Rear,O pt . 'Lz—_— Number of feet from well: /Gf D Number of feet from building: © (Include distances .on plgt plan). SEEPAGE PIT f 5 9 � Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: , Has either a drop box O O or distribution box 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: - —x/45 Dated: � y Plumber on fob: License Number: 3/84:mj I . ORM N0.98SA FILED ST CROIX COUNTY -jXgWO-CONNELL OD SIJRVEYOR'S RECORD 1 %gMw of Deeds S% Croix Cow,y, V CERTIFIED SURVEY MAP r s NA/2 — NW 1/4 - SEC. 1, T 30N , R19W -i on . /+ z — o OaarC0 Z � ALt�[rt C. -� -4:Z C' 3 tD rn NYHAGEN _ -� •— ° =aro —ix 5-140T "'arIDMO ca 0 HUDSON, _ -w •c Wis. �04 . , � . _> a �_ :r y .r- -i D •r z m �`"� n a a "�' Z r' "o ww ° n r ai r lop m REVISED NOV. 30�1979 .° m`' cl,yCO '4 r —� 3 40 A09� \ Y 00 69 �L A*,, O _4 6 c) W my y4 M 0 'o ch Doti 22 . oL7-,00-006 tip` cr r ig 60 ' 3 0 9� 0 N b 4 �4 M .121 ° (n z 0 z W 1 I +0 O 110 - I-1 p r cn r N 3Fc ac nj` ;1 N O m M O O p 0� t0 0 0 T 40.. O -4 D W �.� n "' A O N = z CERTIFICATE OF THE TORN OF SOMERSET oa?g, ° ° A A I, do hereby certify that this Ss, Certified Survey Map has been /o• ''90 approved by the Town of Somerset a °at 11 6, loo' this day of , 1979 z 6° r ,VO, z .Z : D % W 0) •v co too' Town Clerk of Somerset o 0 10 xn I 0I I APPROVED OD , Z O p W DEC 3 _o in Ln -i O • 0 ST. CROIX COUNTY 0 N ? ( I COMPREHENSIVE PARKS PLANNING AND ZONING COMMITTEE r O N c m x c M D iN O -� cn z -I Z ON z r O Wm - rn 0 APPROVAL OF THIS MINOR SUBDIVISION c z Z ? z o N m 9 � � D z o DOES NOT MEAN APF;,OVAL - ° o �+ � _ z BUILD, SITE OR SEPTIC SY�T� FOB z m z m m C m z m co' REFER TO H62.20, o g 9 � g 0D D m W rn i VOL. 3 PAGE 893 z v `�" cn m z CERTIFIED SURVEY MAPS o D Z n ALL BEARINGS REFER0O g TO THE NORTH LINE OF ST. CROIX COUNTY, WI. M THE NW 1/4 OF SEC. 1 3 0 (ASSUMED TO BE N v N 89440'-32"W } ` DEPAfiTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7969 BUREAU OF PLUMBING MApISON1 WI 53707 slate Plan I.D.Number. NE4,M, S1,T30N-R19W WtONVENTIONAL ❑ALTERNATIVE Stafe assigned) I. Town of Somerset ❑Holding Tank ❑In-Ground Pressure ❑Mound Lot 3 NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: <' Fred Cheaney Box 66, Somerset, WI 54025 BENCH MARK(Permanent reference po—I DESCRIBE IF DIFFERENT FROM PLAN. REF.PT.ELEV.: 1CSTRE1.PT.ELEV.. Name of Plumber: MP/MPRSW No.: County: Sanitary Pe-1 Number: Byron Bird Jr. i3318 St. Croix 106104 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.. PROVIDEOLAB L PR IOCVKIIDNG E D C OVE OYES ❑NO EYES ❑NO BEDDING. VENT DIA.. VENT MAT L.. HIGH WATER NUMBER OF ROAD: PROPERTY WELL. BUILDING. VENT TO FRESH ALARM FEET FROM LINE AIR INLET DYES ONO OYES ONO NEAREST DOSING CHAMBER: MANUFACTURER BEDDING LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER AC TIIRER WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO [—]YES ONO OYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERAT ZONAL. NUMBER OF PROPERTY WELL BUILDING AER NLOT HE SH (DIFFERENCE BETWEEN FEET FROM LINE PUMP ON AND OFF) DYES ❑NO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH DIAMETER 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 A -PITS LIQUIBED/TRENCH TRENCHE S MATERIAL: jLI DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH UISTH PIPE DISTR.PIPE DISTR.PIPE MATERIAL. NO.DISTR. ROPERTY WELL BUILDING VENT TO FRESH BELOW PIPES ABOVE COVER ELEV.INLET ELEV.END. PIPES INE AIR INLET MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. OYES ONO SOIL COVER ITEXTURE PERMANENT MARKERS OBSERVATION WELLS ❑YES ❑NO OYES 1:1 NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED D SODDED SEEDED MULCHED CENTER EDGES ❑YES ❑NO OYES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH LENGTH NO.OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE JMANIIOLD MATERIAL NO DISTR DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING ELEV.. ELEV.. DIA.. ELEV.. PIPES DIA.'. ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS ❑YES ONO El YES ONO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS. NUMBER OF PROPERTY WELL. BUILDING. FEET FROM LINE DYES [_1 NO DYES ONO NEAREST Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE. TITLE DILHR SBD 6710(R.01/82) Zoning Administrator t �'�R SANITARY PERMIT APPLICATION %STF NTY _ In accord with ILHR 83.05,Wis.Adm.Code GY'� • SANITARY PERMIT# -Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 8%x 11 inches in size. -See reverse side for instructions for completing this application. PETITION �R I. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. FOR VARIANCE ]YES L NO PROPERTY O NER I PROPERTY LO AT r ec! �t G —'/4 a, S T , N, R E(or PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLO K NUMBER SUBDIVISI N NAME CITY,STATE., ZIP CODE PHONE NUMBER 0 CITY EARES ROAD, KE OR LANDMARK VILL AGE : } Q II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family. OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in#1. Check#2,3 or 4,if applicable) 1. a. Ak New b.❑ Replacement c. ❑ Replacement of d.❑ Reconnection of e.❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit# Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to-County-Copy. IV. TYPE OF SYSTEM: (Check only one in#1 and only one in#2) 1. a. conventional b. El Alternative C. 1:1 Experimental 2. a. ❑System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. 9 Seepage Bed b. ❑seepage Trench c. ❑ seepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): �1-111 -Feet Private ❑Joint ❑ Public VI. TANK CAPACITY Site in ga ons Total #of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank 00 e ❑El _X+_Lift Pump Tank/Siphon Chamber ❑ ❑ ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name(Print): Plumber's Si nature:(No Stamps) MP/MPRSW No.: Business Phone Number: i �3r �� ZU� �l r�o h �1v,1 r Plum ddress(Street,City,State,Z' Code): Name D�signer: eo .e Z VIII. SOIL TEST INFORMATION Certified Soil T ter(CST)Name �C CST# CST's ADDRESS(St et,City,State,Zip Code) , Phone Number: ,,Q A t� r`�� 3" O �i2 o Q IX. COUNTY/DEPARTMENT USE ONLY ��(( ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) Il�Approved ❑ Owner Given Initial ��) ��ll S charge Fee Q�( Adverse Determination `" W ��' ���v" X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO THE APPLICANT: 1. This 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. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 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. Private sewage systems must be properly maintained. The septic.tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 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 where the system is to be installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in ##1. Complete##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. 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. Fill in designer name if applicable; Vlll. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8'h 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; dosing or pumping chambers; 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. ----------------------------------------------------------------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater bill Ground Ester— included the creation of surcharges (fees) for a number of regulated practices which Wiscor>,►f1`S can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reaSure is used in your building is returned to the groundwater through your soil absorption o system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- f water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398(R.03/86) 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 Ere C�, Location of property , 1/9 &W .-1/4, Section , T_QN-R-_W Township soC�A .P"ur —,7i— Mailing address Ebb (9(0 .�n�l et- 1, Cl' , t 63ur6 2, Address of site Subdivision name e Lot number Previous owner of property J--S lu.lP iii 7 ALP_-, --' At IPU S'e,Lkq.e;cv- Total size of parcel Date parcel was created Z Z 7 3 Are all corners and lot ident' Yes No Is this property being developed for resale (spec house)? Yes No Volume and Page Number 9 - as recorded with the Register of Deeds. ------------------------------------------------------------------------------- INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER, and the SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. ------------------------------------------------------------------------------- PROPERTY OWNER CERTIFICATION I (We) certify that all statements on this form are true to the best of my (our) knowledge; that I (we) am (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 ; 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) /,,,-� d �-(� Y Date of Signature Date of Signature DOCUMENT NO. STATE BAR OF WISCONSIN FORM 2-1982 THIS SPACE RESERVED FOR RECORDING DATA WARRANTY DEED 424807 1, ML 776PAGt REGISTERS OFFICE Allen E. Siekmeier, an- undivided one-half interest, ST. CROIX CO., WIS.. and Stanley V. Hale and Mary Hale, husband and wife, as joint tenants, an undivided one-half nterest Redd. i' Rewrd M23rd y Olt„�April A.D. 1987 conveys and warrants to Western Development . a partnership 8:30 M. — RETURN TO the following described real estate in St. Croix County, State of Wisconsin: Tax Parcel No: Part of the Nil of the NWT of Section 1-30-19 described as follows: Lot 3, Certified Survey Map filed December 3, 1979, in Volume "3", Certified Survey Maps, page 893, as Document 4361545. $0 i I This is not homestead property. (is) (is not) Exception to Warranties: Easements of record Dated this 9th day of April A 19 87 -�f �?�Le�+•�- •- (SEAL) Z�-`'�7 ' G�c �� (SEAL) • Allen E. Siekmeier -Stanley V. Hale (SEAL) 2�"12'1_�'f_ (SEAL) -Mary Hale AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN SS. St. Croix County. authenticated this day of , 19 Personally came before me this 5T1I day of April 119 87 theabovenamed Stanley V. Hale and Mary Hale, Allen E. Siekmeier TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to a he persons A�whho ecuted the authorized by§706.06,Wis.State.) foreg I an THIS INSTRUMENT WAS DRAFTED BY ACORN REALTY, INC. 245 Main Street Dennis Fleischauer Somerset, WI 54025 Notary Public St. Croix County,Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date: September 30 19 90 'Names of persons signing In any capacity should be typed or printed below their signatures. NTF 2280 WARRANTY DEED STATE BAR OF WISCONSIN Nelco Forms,P.O.Box 10208,Green Bay,WI 54307-0208 Form No.2—1982 STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER UYERr2-rrJl ROUTE/BOX NUMBER S©tc FIRE NO..! CITY/STATE —S^,,A gus- ir=� (.tl� . ZIP PROPERTY LOCATION: /YC 1/41/4, Section j , TN, R�W, Town of 0%A. ,EST S 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 '- DATE St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 (715) 796-2239 dr (715) 425-8363 Sign, Date, and Return to above address '�DQS TR Y, T , OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS ' Ol1S DIVISION BORAN9 PERCOLATION TESTS (115) P.O. BOX 7967 ;i.JM.AN RELATIONS MADISON,WI 53707 (11-163.090)&Chapter 145.045) .00ATI N: E ION: TOWNSHIP Y: LOT NO.:BLK.NO.: SUBDIVISION NAME: INE '/vw1/ 1 /T3o N/P.9 E(" W 'OUNTV: OWNER'S AME: MIA I ADDR S: St. Croix Fred Cheane Bdx 66 Somerset Wi. 54025 DATES OBSERVATIONS MADE NO.BEDR : COMMERCIAL DESCRIPTION: TESTS: �gResidence 3 n/a 30New ❑Replace L4-, 87 ATING:S-Site suitable for system U-Site unsuitable for system ONVENTI N L: MOUND: IN-GROUN T -N-FILL OLDING TANK:RECOMMENDED SYSTEM:(optional) S ❑U I ®S ❑U Z]S ❑U ❑S RI U I ❑S 9U I 5x100' trench f Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the .finder s.H63.09(5)(b),indicate: n/a Floodplain,indicate Floodplain elevation: n/a PROFILE DESCRIPTIONS slap 27 COD2 decimal F ��- iORING TOTAL DEPT H TO GROUIS DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH VU7,1BER DEPTH)M. ELEVATION BSERV TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) B- 1 6.50 105.22. none >6.50 .67bl.s.l. 1.33 bn.1.s. 4.50bn.s.&gr., 8- 2 6.74 105.12 none >6.74 .83bl.s.1. 1.58bn.l.s. 4.33 bn.c.s.&gr. B- 3 6.50 103.61 none >6.50 .58111.s.1. .92 bn.s.l. 5.00bn.c.s.&gr. 3-4 6.58 102.49 none >6.58 .83bl.s.1. 1.42bn.l.s. 4.33 bn.c.s.&gr. t3- 5 6.17 101.60 none >6.11 .70b:i.s.i. .42bn.sii. .942ba.l.s. 4.33bn.c.s.&gr. 8- decimal' PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER )GOEfEX AFTERSWELLING INTERVAL-MIN. PER INCH P- 1 3.50 none 3 6 6 6 <3 P. 2 3.60 none 3 6 6 < P. 3 3.50 none 3 P.. LOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori• )ntal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent land slope. )YSTEM ELEVATION 101.72 _ 7_1 AEI. Fri OS.2 .. I -- i -- S Z 0 - - --- - 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 ,dn,inistrative 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 4-7-87 DDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): 988 N. Shore Dr. New Richmobnd Wi. 54017 2298 1745-Z46-6200 CST SIGN )ISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. )ILHR-SBD-6395 (R.02/82) OVER — a PLOT PLAN PROJECT _ADDRESS ��- �•- 1/4//,o 1/4/S / lT3U /y W TOWN�m er5e OUNTY � MPRS Byron Bird Jr. 3318 DATE -� —$� BEDROOM CLASS PERC / CONVENTIONALZN-G ND PRESSURE CONVENTI NAL LIFT MOUND HO DING TANK SEPTIC TANK SIZE LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE , ABSORPTION AREA 474 PERC RATE —BED SIZE S'- b Benchmark V.R.P. Assume Elevation 100' Location of Benchmark ► -e AV * H.R.P. O Borehole Q Well Scale = Feet O Perc Hole vA, - System Elevation /0 /. 7f 3° `� TYPAR COVERING 2" 12" 3- 4 6' Q 3' 1 6" Sewer Rock 12' A ,"000z 0 J_ i q • 0 ST. CROIX COUNTY WISCONSIN 1. .� ZONING OFFICE 796-2239 (HAMMOND) ? 425-8383 (RIVER FALLS) HAMMOND, WI 54015 October 13, 1987 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 7— �.. Dear Sir: J Z-1 An on site investigation for the Vern Voght property located in the NW 1/4 of the SW 1/4 of Section 14, T30N-R20W, Town of Somerset, St. Croix County, revealed suitable soils at a depth of 4.7 feet, below which seasonable high ground water was noted. This site'should be suitable for a mound system. Should you have any questions, please feel free to contact this office. Sincerely, won tu 0. Thomas C. Nelson Zoning Administrator TCN:rmc DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (H63.0911) & Chapter 145.045) LOCATION:,. SECTION:T p .�TOWNSS IP/ TY: LOT NO.:BLK. BDIVISION NAM 1 '1J '/ /t /T' N/h (or COUNTY: OWN R'S BUYER'S NAME: MAILI G ADDRESS: �. USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMER I L DESCRIPTION: PROFILEDESCRIPTIONS: PERCOTATION TESTS: Residence RINew ❑Replace T. i� i RATING:S=Site suitable for system U=Site unsuitable for system[ZU ON�VENTIOIyAL: M®ND:❑� IN-GROUND-P®UR : SST M-I®ILLHO�LDING TANK:RECOMMENDED SYSTEM:(optional) If Percolation Tests are NOT require DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: 41 -v PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DEPTH144 ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- , Y B- B- B- B' PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER I W&df AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIO 2 PER PERICkD 3 PER INCH P- 20 S 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 of Ian. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION ,/ 1 l . t j WA I � : pp I + : p e OCT 1987 wial y 51 . , , i f I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with t rocedures 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 rin : / TESTS WERE COMPLETED ON: 42—, � r. ADDRESS: C RTIFICATION NUMBER: PHONE NUMBER(optional): IV C�.P�IGN T E: DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) —OVER — FORM N0.98SA �. nLE c3 7 ST., OIX COUNTY 4URVEYOR'S RFCORD CERTIFIED SURVEY MAP r s N•1/2 . - NW 1/4 SEC. 1 , T 30N , R 19W orb 00-9 Y% Z :j n � ► -0 s cp „ ALLEN C. _ _ NYHAGEN = m{ID m x S4407 v HUDSON, �. 0 = N •C jN� St1R`I� • z �o ww\� � v� rm" :v in I r ' 0 w n r" • . �n v a s9 y w c � �/O8 '71 (D •-1 s� "rFq REVISED NOV. 30,1979 .° �y ' S/h�oq�� 0 34o T� o � ti,` N Q 3s g 4,9° ` 6 o.C' rn „1.2-,00-006 ` Y to 00 0 C.7 1 o o' mC4 �y M 0 •0 ••/ N z m zo I 8v �� OD O 110 i 1-4 100' 14 n 0 0 = z N y y 4 N! N i z 1 I OD M m Ln 340��:4s9 e2 o O a a! L0 0 °„ o •� 0 -i * * �- Z Ca a a) g w ' �3 0 ? O N i CERTIFICATE OF THE TOWN OF SOTERSET 00?4' N o o I, do hereby certify that this S�!�o- '>s0 Certified Survey Map has been approved by the Town of Somerset : C as, II too' this day of , 1979. ;r : v °, >' z a r `te w m Z D ODD" 0 I I ' 100' Town Clerk of Somerset o . 10 APPROVED I � z O p m w W � DEC 3 19 0 o N " V O • 00 N `_ ST. CROIX COUNTY COMPREHENSIVE PARKS PLANNING n O � AND ZONING COMMITTEE r z C m X C Rl D O -� to z r o APPROVAL OF THIS MINOR SUBDIVISION M 3 0 Z z _ o O ° zz0 DOES NOT MEAN APF;;GVAL � _ z BUI!DING SITE OR SEPTIC SYoTE/y14 FOB z z 0 � O M �. c m .� z m � REFER TO H62,20, `0 w�. W a m mm - Z (A z VOL. 3 PAGE 893 z v -+ � v, m CERTIFIED SURVEY MAPS O D r -I N ALL BEARINGS REFERSOD z TO THE NORTH LINE OF ST. CROIX COUNTY, WI. v 8 THE NW 1/4 OF SEC. I co km (ASSUMED TO BE N N 89440'-32"W )