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HomeMy WebLinkAbout032-1007-10-100 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 569599 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). Permit Holder's Name: City Village X Township Parcel Tax No: Haase, William &O al Michael Somerset, Town of 032-1007-10-100 CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No: 106,0 e d 'r �" 03.31.19.43A10 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark /0 , "00 d Dosing n /— �-�' Alt.flA. r76 Or_ Aeration Bldg. ewer >6 ' fzwolrn 5 8' 5 5 .7 Holding S Ht Inlet Z q, �o TANK SETBACK INFORMATION St/Ht Outlet O T3 y TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 74 36-39 Septic 'S 1 r 1 DtBottom / Dosing �-yl ,ST eader/Man. Aeration Dist.Pipe INIV4704 V d Holding GryAt`�C Bot.System PUMP/SIPHON INFORMATION Final Grade 83 9 � Manufacturer Demand St Cover GPM l 3 .Z f�• Model Number �r TDH Lift 1FriZtt6n Loss System Head TDH Ft I I Forcemain Length Dia. Dist.to Well SOIL ABSORPTION SYSTEM B DIMENSIONS Width Length No.Of Trenches IT DI S No.Of Pits Inside Dia. Liquid Depth DIMENSIONS CI '7 SETBACK SYSTEM TO D P/L p LDGG•� W LL LAKE/STREAM EACHING Manufacturer: INFORMATION (�H A MBER OR f , ' f P UNIT Model Number: DIST BUTION SYSTEM ash eader ni old Distribution 1� ,, J r+Q��•Q x Hole Size Ix Hole Spacing Vent Air Intake �� E Pipe(s) _1 A4, `"'""77//- ,L p�� _ d r fp G'01 Length Dia Length Dia Spacing I �_ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center �'l.� Bed/Trench Edges Topsoil Yes Efl No I N] Yes No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: —7 /' / 1q. Inspection#2: Location: 2325 50th Street SOMERSET,WI '54002,5(SW 1/4 SW 1/4 3 T31 R1 9W) NA Lot 1 / Parcel No: 03.31.19.43A10 54 1.)Alt BM Description= "'�rG� «I' .,A f� (� Stls ii'j.I q� 2.)Bldg sewer length= Y7 1/ I / a -amount of cover= 3 + r� � /_ •'_ G �� — —— — — -- {-- — ---- — Yes Plan revision Required? No - Use other side for additional information. 1 -� I SBD-6710(R.3/97) Date Insepctor's ure Cert.No. z °l, 1 F �I\ V p Grp Iv NJ D � 3 tiffs 3 A � � N h t o � 9 i a h i only L A,0 °k. Safety and Buildings Division Q g f �V 201 W.Washington Ave., P.O. Box 7162 Sanitary Permit Number(to be filled in by Co.) �, 07-7162 �u 1 N �1 J �6FfSBiOtyPtij� State Transaction_Number Sj.��cyy� ermit Application /•V/ /� In accordance wR 'ZSj• (2),Wis.Adm.Code,submission of this form to the appropriate governmental unit /� is required pri r to obtaining a sanitary permit. Note:Application forms for state-owned POWTS are submitted to Project Address if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law,s. 15.04(1)(m),Stats. I. Application Information—Please Print All.Infortnation Q� P cel# yY10 Y Prop Owner's Name P n� sF roperty Loc n�= 032-/oa�,p- / 3 �o , roperry Owner Address 's Mailing T ( J 1 D E�,iy✓7 d A., .J Govt.Lot City,State Zip Code Phone Number Stiy '/o,S1ilJ '/d, Section 7 / ZD circle one) DS 00 C �0` r� � T�_N; R f7 EorW II.T pe of Building(check all that apply) Lot# Subdivision Name ! n or 2 Family Dwelling—Number of Bedrooms Q k n n I l kt,V- z Block# ❑Public/Commercial— esc ibe Use ❑City of CSM Number r / r ❑Village of ❑State Owned—Describe Use Ga 0) LL 19'Town of kTO/y" rAcy � �Jr' U ZZ III.Type,ofP it: (Check only one box on line A. Complete line B if applicable) A. New System ❑Replacement System [I Treatment/Holding Tank Replacement Only El Other Modification to Existing System(explain) B. ❑Permit Renewal ❑Permit Revision ❑Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV.Type of POWTS System/Component/Device: Check all that apply) won-Pressurized In-Ground 11 Pressurized In-Ground [I At-Grade El Mound? i i f I ' I CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: ��c� a,St, Owner's Name: Owner's Address: _ 13 D 6 d N ` Os� 0 a Legal Description: -w Sic 3 X1 � Township: ry n r t,S i< County: S� ' L A-o Subdivision Name: Lot Number. ' 0 J C CS AA_ Z 0/&d 7, 2,- Parcel ID Number: ?j' Z 1.0,22-10— (V U Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing &Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 S or Plat__ Attachments: oil Test House Plans Designer/Plumber: u E ��uw K ; ti s License Number: Z 2-Z 8 7 9 1 -S3 Date: b -/1, -I Phone Number �1 8 Signature j Designed pursua�Ihe In-Ground Soil Absorptions component Manual for PowTS Version 2.0 SBD-10705-P(N.01101). Page 1 n � _ Z G O NJ '! (A u �1 4 0 N � a d Q Q tN G slk 4 wY� w G Soil Absorption System Cross Section 9Y. 3 ft Final Grade 4"Schedule 40 PVC Vent Pipe 9 3. 3 91.ft With Vent Cap Leaching —D 9Z 3 _ /• 3 Chamber ft ` �- System Elevation 3 ft S ft Soil Absorption System Plan View g8 ft 3 ft 1111110 7 j ft Leaching Trench 1 Vent Or Observation Pipe Chambers IIIIIIIIIIIIIIIAMM 4"Dia. Trench 2 Header Leaching Chamber Specifications Manufacturer And Model IA L K `! J EISA Rating Zo •0 sq ft.per chamber Soil Application Rate gpd/sq ft C.tl o gpd Design Flow= • -7 Soil Application Rate _ Z 0 .0 EISA= y Chambers 2 rows of Z Z chambers each. Page of Eal Ud v — M IV. 5 FIE �j WON E.1 "limp L2 Li Ln rr.. L) 7 mi rl D ----------- 7-5 5 Ld ci a rp ---P-5 Z. e w d ci 91-0-0®R IT 6 dd M f: 0 '——e ej O > U LZ c To ri I _ g- v CD ci -b4 ci f I tl u C7 r- ci CJ fj v LO N rl- O ti 00 N 4 r-- � N ti N -�p z OO--- ------------------ 00 cti o w L O cc � NLO 3 i LL L g O C: LL o LU LL o 0 o W o O j LL ro L LL p w F- w w QLO 3 Q O V o �—M z � W " � � N W N 3 Ucn�Y a C m va�C7 p N O LO LL o N LL o (.0 D Cl) W T s� N N ° w Z O m N O M O LL 0 V- 00 o cn U� Z a o a LL U z5 O CL 33 ,O > Lu a o U J O a M ' O ITJ � 1= C7 � � S �, ao N N—T N O p O w O O � w C-,j � w hW W W Y p Z i Cl)2 a�J� O U-i ti W Z 2� z O vZo Q <t Q � START UP AND OPERATION Page 2—of - For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipe's; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sad itary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • Alf i in to tanks and` its shall be disconnected and tl e-abandoned--i e o eninesealed _ -- pP g P PP P � 9 =-° - • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon b� required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area wiP, result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. El. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the b)omat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name a W J��`A, Name Phone 7 J _ Y9 I _ 8 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name a 0— Name Sf eti d".X Zd N• �` Phone Phone 715- - 3f'(. - Y e8o This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f)and 83.54(1), (2) &(3),Wisconsin Administrative Code. I' POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 1 of F RMATION SYSTEM SPECIFICATIONS Owner �'x� a3-S 1 �l' Cpl (CQ Septic Tank Capacity Z SO gal ❑ NA ermit# Septic Tank Manufacturer cJ "5 ct „" ❑ NA Effluent Filter Manufacturer /3�,3' ❑ NA DESIGN PARAMETERS Number of Bedrooms ❑ NA Effluent Filter Model F/Q ❑ NA Number of Public Facility Units $NA Pump Tank Capacity gal Estimated flow (average) O U gal/day Pump Tank ManufacturerA Design flow (peak), (Estimated x 1.5) gal/day Pump Manufacturer p Soil Application Rate + '7 gal/day/ft2 Pump Model Standard Influent/Effluent Quality Monthly average* Pretreatment Unit J2 NA Fats, Oil & Grease (FOG) <30 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODS) <_220 mg/L _4�r']TA ❑ Mechanical Aeration ❑Wetland Total Suspended Solids (TSS) <_150 mg/L ❑ Disinfection ❑ Other- r_1 Pretreated Effluent Quality ___ _ Monthly average Disp-ersal Cell(S) _ — — _- Biochemical Oxygen Demand (BODS) <_30 mg/L �'(n-Ground (gravity) i ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L _e(`NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) <_10'cfu/100ml ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size Ys in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA 'AINTENANCE SCHEDULE Service Event I Service Frequency ❑ month(s) (Maximum 3 years) ❑ NA Inspect condition of tank(s) At least once every: .p-years) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA ❑ month(s) (Maximum 3 years) ❑ NA Inspect dispersal cell(s) At least once every: /, I .p-year(s) ❑ month(s) ❑ NA Clean effluent filter At least once every: 1 . ! -EE�year(s) ❑ month(s) NA Inspect pump, pump controls & alarm At least once every: ❑ year(s) ❑ month(s) I:k'NA Flush laterals and pressure test At least once every: ❑ year(s) ❑ month(s) ❑ NA Other: At least once every: ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of:02 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW(4/01) Feb-06-2014 03:45 PM St. Croix County Plan/Zoning 715-386-4686 2/11 ST.CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer t• Q S S UlNesgy, / o 4l ]V�81l111$Address C55 13 0 f ,�rr�,�o,%1-1 03 e G a I�, Property Address Z> S 7 . � (Verification required from Planning&Zoning Department for new construction City/State `d,,,, r � Parcel Identification Number 0 3 Z ' 0Q —/0- LEGAL DESCRIPTION Property Location5"' 1/4,LW t/4, Sec.—j-,T Y l N IZ_Z.2_9Town of Subdivision Plat' _---- _ ,Lot# Certified Survey Map# ! ` / ! ,Volume 2( ,Page# 00 22. Warranty Deed# 9S (0 (before 2007)Volume ,Page# Spec house 0 yesk no Lot lines ident1fablexyes 0 no SYSTEM MA.=NANCE AND OWNER CERTIFICATION 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 lionised pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in§Gomm.83.52(I)and in Chapter 12-St.Croix County Sanitary Ordinance. The property owner agrees to subrdit to St.Croix County Planning&Zoning Department a oertificadon 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/or(2)after inspection and pumping(if necessary),the septic tank is leas than 1/3 full of sludge. I/we,the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the .standards set forth,herein,as set by the Department of Commeroe and the Department of Natural Resources,State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St.Croix County Planning& Zoning Department within 30 days of the three year mxplration date, I/we certify that all statements on this form are true to the best of my/our knowledge. I/we mn/are the owner(s)of the property described above,by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms 4 �J �lLIA SIGNATURE OF APPLICANT(S) DATE ***Any ittibrmadon that is misrepresented may result in the sanitary permit being revoked by the Planning&Zoning Department.*** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if rd armed is made in the warranty deed. WOW Property Owner! '" ✓d 3 Parcel ID# Page ;t- of `3 M Boring# ❑ Boring�] pit Ground surface elev. / � 3 ft. Depth to limiting factor X88 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 * 02 a i -71 102'Z si — i- 3 ' A- 74-10 Jd yti v�y U- o s a Boring# ❑ Boring v { ® Pit Ground surface elev.-93 ft. Depth to limiting factor V in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Donsistence Boundary Roots GPD/ft 2 in. Munsell`, Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 ff#2 Z ' y I Boring Os ❑ Boring# Ground surface elev. ft. Depth to limiting factor in. 1:1 pit =Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *1 ff#1 02 *Effluent#1 =BOD 5>30<220 mg/L and TSS>30 <150 mg/L *Effluent#2=BOD 5<30 mg/L and TSS <30 mg/L The Dept.of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,contact the department at 608-266-3151 or TTY through Relay. M4330(RI 1/11) RECEIVED PA I ^ r Wis.Dept.of Safety and ProfessiorT9YSC4A 2014 SOIL EVALUATION REPORT Page / of 3 Division of Safety and Building k. CROI &rae with SPS 385,Wis. Adm. Code 30MMUNITY DEVELOP M��T Couniy S etiu 'X Attach complete site plan on paper not less than 8 112X 19 inches in size.Plan must include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. percent slope,scale or dimensions,north arrow,and location and distance to nearest road. - Please print all information. R ewed by Date f� Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). t �� Property Owner v LA--;/1�Gi ,,,,,, / �,.SS Property Location Govt.Lot SW 1/4 J'W 1/4 S N R / 9 E( Property Owner's Mailing Address Lot# Block# Subd.Na or CSM# City State Zip Code Phone Number ❑City ❑Village 03Town Nearest Road Osc � Gv, sYo�6 (7/S) 33�j'- 79z`3/ T ew Construction Use:❑ Residential/Number of bedrooms "7 Code derived design flow rate 6 O O GPD ceme7it- ❑ Public or commercial-Describe: / Parent material � � 1'c ( Z Flood Plain elevation if applicable ft. General comments and recommendations: 5 � �—�NC -Ab / 97 3 F-/! Boring# Boring � 3 8s Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 1.01 02 y/V s s 2z .3 �/ ti I Fil- Boring# Boring p 1f g Pit Ground surface elev. / ft. Depth to limiting factor U 9 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 01 ff#2 /d d U ,c.ss — S ,r✓ nom+✓ ' (,�, ! 7 ! L 6 f D JA y"N 3� J 2, Effluent#1 =BOD >30<220 mg/L and TSS>30 <150 mg/L "Effluent#2=BOD <30 mg/L and TSS <30 mg/L CST N e Please Print) Signature CST Number Q[� r'� tN �-� ZZ-7-0 Address Date Evaluation Conducted Telephone Number v - SBD-8330(RI 1/11) � u � � � � 0 6 U Cl w 0 0 �,,, w I IIII �II II��I I I II�I�IIII II IIIIIII State Bar of Wisconsin Form 1-2003 8 0 4 9 7 8 5 Tx:4036774 WARRANTY DEED 951126 Document Number Document Name BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI 02/21/2012 1:21 PM THIS DEED,made between Donna M.Summerfield EXEMPT#• NA ("Grantor,"whether one or more), REC FEE: 30.00 and William W. Haase and Opal H. Haase, husband and wife as survivorship TRANS FEE: 390.00 marital property PAGES: 1 ("Grantee,"whether one or more). Grantor, for a valuable consideration,conveys to Grantee the following described real Recording Area estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin("Property")(if more space is needed,please attach Name and Return Address addendum): + The SWIA of SWIA of Sec.3-T31N-R19W,St.Croix County,Wisconsin. AISTINA OGLAND ESTREEN & OGLAND 304 Locust uason, vl 24 032-1007-10-000 Granter warrants that the title to the Property is good,indefeasible in fee simple and free parcel Identification Number(PIN) and clear of encumbrances except:easements,restrictions and reservations, if any,of This is not homestead property. record. (is)(is not) Dated SEAL l I (SEAL) * * Donna M.Summe field (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) Donna M.Summerrield authenticated on STATE OF ) / — )ss. COUNTY ) * Kristina OF-land TITLE: MEMBER STA E BAR OF WISCONSIN Personally came before me on , (if not, the above-named authorized by Wis.Stat. § 706.06) to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: Kristina Ogland, Estreen&Oeland 304 Locust Street,Hudson,WI 54016 Notary Public,State of My Commission(is permanent)(expires: ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ©2003 STATE BAR OF WISCONSIN FORM NO.1-2003 *Type name below signatures. INFO-PRO—Legal Forms 800-655-2021 www.infoproforms.com 1 of 1 i 996911 BETH PABST REGISTER OF DEEDS CERTIFIED SURVEY MAP ST. CROIX CEIVED FOR RECORD RE ECOCO RD LOCATED IN THE SW/4 OF THE SWY4 OF SECTION 3,T31N,R19W,TOWN OF 06/06/2014 3:19 PM SOMERSET,ST.CROIX COUNTY,WISCONSIN EXEMPT #: REC FEE: 30.00 COPY FEE: 3.00 PAGES: 2 W/4 CORNER, SECTION 3 (SURVEY MARKER NAIL GENERAL NOTICE STATEMENT CO FOUND AT POSITION) EACH PARCEL SHOWN ON THIS MAP IS SUBJECT TO STATE,COUNTY AND TOWNSHIP LAWS,RULES AND REGULATIONS(I.E.,WETLANDS, 000 MINIMUM LOT SIZE,ACCESS TO PARCEL,ETC.)BEFORE PURCHASING `- OR DEVELOPING ANY PARCEL CONTACT THE ST.CROIX COUNTY iw ZONING OFFICE AND THE APPROPRIATE TOWN BOARD FOR ADVICE. (0 C UNRA�EL�MEN I�N oz zI N l inrn x I �N S89 039'56"E 516.17' 328.78' 148.14' l 39.25' 476.92' I w I I �0 x M 1 I �: 3 ; N LOT I ® N co coD l op N = l W � .mod 199,945 SQUARE FEET(4.59 ACRES) h- i INCLUDING RIGHT-OF-WAY �O ,� w uJ h © W O l �� ao 181,336 SQUARE FEET(4.16 ACRES) lrj � is w N l LO EXCLUDING RIGHT-OF-WAY ` (V z l pp (') per,' w w co —a to Io I o MZLQ Z�u LL I a kz Q, Co V o° l I WFU LLj ONZ x o0o N I l I U l Z1-0 w ix I i w j U LL Q H 1 33' 33- 1 35.55' Z Fx D N l 251.96' y�'5,c Nsiy m°Z I l N89 039'56"W 287.51' 1 JOSE H ~~ l I : GRAN ER ED S-2. 5 co = NEW RICE�4^, ' CID DGtlyPRARED NDS � wl SURV 7�j, IN )jA INOTE. LOT MAY BE SUBJECT TO (V FUTURE SPECIAL ASSESSMENTS LEGEND p FOR ANY UPGRADES AND SECTION CORNER MONUMENT Z IMPROVEMENTS TO THE ROAD (AS NOTED) IB 0.75"X 18"IRON REBAR WEIGHING SW CORNER,SECTION 3 1.502 LBS/LINEAR FOOT SET SCALE IN FEET (SURVEY MARKER NAIL FOUND AT POSITION) 0' 50' 100' t" = 100, LAND SURVEYOR: PREPARED FOR: - S SOLUTIONS JOSEPH GRANBERG WILLIAM & OPAL HAASE DRAFTED BY: JWG 1235 CTY RD. E 324 230TH AVENUE JOB NO. 100-227 SHEET G4NBERGSONNEN4�G NEW RICHMOND, WI 54017 SOMERSET, WI 54025 DATE: 04/30/14 1 OF 2 r 4�1 F++S a`A1S19M&CP°k r. age I OT 2 Vol 26 Page 6022 I see on 6/6/2014 there was a certified survey map located in the SW N of the SW%of Section 3,T31N, R19W, Town of Somerset, St. Croix County, Wisconsin.The map was surveyed by Granberg with owner name of William & Opal Haase. This map has one lot labeled "Lot 1". The recording information for the map is document number 996911, recorded 6/6/2014 as Certified Survey Map volume 26 page 6022. Your plumber can get a copy of this map from our office for$3. Beth Pabst, cp-nm 11'12 )_;l ;'" Vice 11res dent 1Leplster of Z)eeds I1 C)1 CG7Y1r4lC�'l.aP.�ROad 'l(Tidson, 117 54o16 715-38(- 650 innv.co.saint-croix,iv Luslrod beth.pabst@co.saint-croix.wi.us ST. CRO I uNTY r,tir<rrr:5'rrt From: Brooke Haase [mailto:BHaaseCd)krechexteriors.com] Sent: Monday, June 16, 2014 11:57 AM To: Beth Pabst Subject: RE: Lot in Somerset Township Hi Beth— I am just curious if you would be able to let me know where we stand with our lot. I believe that the information has been delivered to the Register of Deeds on the 9th but wondering when it might be recorded. Any information that you could provide would be greatly appreciated. Or if I should contact someone else please let me know. Thank you, Brooke -----Original Message----- From: Beth Pabst [mailto:Beth.Pabst(&co.saint-croix.wi.us] Sent: Tuesday, May 27, 2014 12:54 PM To: Brooke Haase Subject: RE: Lot in Somerset Township My records will not acknowledge the "new" lot number or the creation of the lot until all approvals have been received and the final survey map is recorded by Joe. I am not sure whether your plumber will be able to pull his permits with the underlying lot information. Alex should be able to tell you that information since permits would be issued by his department. Good luck with your new lot. Beth Pabst, ch:�i IZglister of 'Deeds rror Cazr ichcie(Road 2 Pam Quinn From: William Blake Sent: Wednesday,June 18, 2014 9:18 AM To: Beth Pabst Cc: Britta Kelly; Cary Oehlke; Ryan Yarrington; Pam Quinn Subject: RE: Lot in Somerset Township As it comes through, it'll get assi C2325 DSt' 540 25 I'll forward it to him soon. From: Beth Pabst Sent: Wednesday, June 18, 2014 8:23 AM To: William Blake Cc: 'Brooke Haase' Subject: RE: Lot in Somerset Township Brooke, By way of this email I am forwarding your request for an address to Bill Blake in the County Community Development Department. He should be able to assist you. Bill, Can you see if the CSM mentioned below has an address yet and if not can you let Brooke know what the time frame may be to get an address?Thanks. Beth Pabst, cp-m IVRD-A 3"" Vice President Register of Deeds nol CarmichaeCRoad :JIzufson, AVI54o16 15-386-465o iy,i1i1y.co.sai,nt-croix.tilfi.us/rod beth.pabst@co.saint-croix.wi.us ST. C» N'1"Y; From: Brooke Haase [mailto:BHaase(a)krechexteriors.com] Sent: Wednesday, June 18, 2014 8:07 AM To: Beth Pabst Subject: RE: Lot in Somerset Township One last question, do you know who would provide the address for the property? -----Original Message----- From: Beth Pabst [mailto:Beth.Pabst @ co.saint-croix.wi.us] Sent: Monday, June 16, 2014 12:05 PM To: Brooke Haase Subject: RE: Lot in Somerset Township Hudson, 14'I54oi6 715-386-4650 ,i,il ,i i,.co.sa.int-croix.i,yi.uslroG� beth.pabst@)co.saint-croix.wi.us Sr. R iii x'�ITY From: Brooke Haase [ma i Ito:BHaase@krechexteriors.com] Sent: Tuesday, May 27, 2014 12:44 PM To: Beth Pabst Subject: Lot in Somerset Township Hi Beth— My name is Brooke Haase and my husband and I are going to be building a new home in Somerset Township. We are in the process of getting everything started and a lot is being created with the help of Joe Granberg. Our plumber is wondering what the lot/block might be for the property so that he could pull a sanitary permit. The lot has been approved by the planning commission and is going to the Town Board next Wednesday June 4, 2014 and Alex Blackburn said that Brian Halling is working on this at the county level. Is this something that you might have some information on or could you point me in the right direction? Thank you, Brooke Haase I I 3 Pam Quinn From: Pam Quinn Sent: Wednesday, May 28, 2014 11:45 AM To: 'Brooke Haase' Subject: RE: LD0505 Haase certified survey map Hi again, Brooke, Just a heads up,we do not yet have Jacque Hawkins'original soil report for the proposed lot and will not issue a sanitary permit unless the original report is submitted for review to go along with a sanitary application. A Copy was submitted to go along with the CSM paperwork, but not the original paperwork. Pam Quinn, Land Use. Specialist (POAV9'5) St. Croix County Community Development Dept. 1101 Carmich.aet Road Ifudson, WI 54x16 715-386-4680 pam.yuinngco.saint-croix.wi.us From: Brooke Haase rmailto:BHaase(a)krechexteriors.com] Sent: Tuesday, May 27, 2014 1:06 PM To: Pam Quinn Subject: LD0505 Haase certified survey map Hi Pam— I received your name from Alex Blackburn since he is on vacation. Just a quick question about a sanitary permit that we need to have pulled for a lot that is being created in Somerset Township. The plumber is asking if there is any lot/ block information yet that he can use to apply for the permit. It has been approved by the planning commission and goes to the Town Board next Wednesday. I know that Alex said that Brian Halling was working on it at the county level. Is this something that we will need to wait for until after next weeks meeting? Approximately how long does it take for the sanitary permit to be approved once it is submitted? Thank you for your assistance. Brooke Haase 1 Parcel 032-1007-10-000 06i18i2014 01:44 PM PAGE 1 OF 1 Alt. Pa el#: 03.31.19.43 032-TOWN OF SOMERSET Current ST. CROIX COUNTY,WISCONSIN Creation Date a Map# Sales Area Application# Permit# Permit Type #of Units 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner 0-HAASE,WILLIAM W&OPAL H WILLIAM W&OPAL H HAASE 324 230TH AVE SOMERSET WI 54025 Property Address(es): *=Primary Districts: SC=School SP=Special Type Dist# Description SC 4165 SCH DIST OF OSCEOLA SP 1700 WITC Notes: Legal Description: Acres: 40.000 SEC 3 T31 N RI 9W 40A SW SW (EZ-U-1146/508) Parcel History: Date Doc# Vol/Page Type 02/21/2012 951126 WD 10/11/2007 862110 SC AFF 09/05/2007 859930 WD 10/03/2003 742445 2427/519 SAD more Plat: *=Primary Tract: (S-T-R 40%160%) Block/Condo Bldg: *N/A-NOT AVAILABLE 03-31N-19W SW SW 2014 SUMMARY Bill#: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 04/17/2013 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 32.000 4,200 0 4,200 NO UNDEVELOPED G5 5.000 6,200 0 6,200 NO AGRICULTURAL FOREST G5M 3.000 6,000 0 6,000 NO Totals for 2014: General Property 40.000 16,400 0 16,400 Woodland 0.000 0 0 Totals for 2013: General Property 40.000 16,400 0 16,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch#: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00