HomeMy WebLinkAbout032-1046-60-001 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
572863 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:
Morud, Martin & Mary Maureen Somerset, Town of 032-1046-60-000
CST BM Elev: linsp.BM Elev: BM Description: Section/Town/Range/Map No:
L X3 Wt ,
16.31.19.235
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER �µ,.j CAPACITY STATION BS HI FS ELEV.
I
Septic Benchmark 6-J 1D 3• a
e-ISLA 1 •I
n ��
Alt.BM GPi
G•t r 3 'a �a�' °5
Aeration Bldg. Sewer '74 7Z
la.r g •3
Holding St/Ht Inlet
$•l, ?y. 3$
TANK SETBACK INFORMATION St/Ht Outlet •�
TANK TO P/L WELL BLDG. ent Air Intake ROAD Dt Inlet
cq 64,0—. �
Septic .7L 15 LIZ Dt Bottom
Dosing Header/M n.
D� ex %•� ��S 93 .Z
Aeration Dist. Pipe ie r
..r ,EZ fr7o
Holding Bot.'System •'. 7Z
Final Grade ff
PUMP/SIPHON INFORMATION 1,71
�
Manufacturer Demand St Cove
GPM J
Model umber
TDH Lift S on Loss System Head TD Ft
Forcemain Length Dia. Dist.to well
SOIL ABSORPTION PYS TEM
BED/TRENCH Width Length No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth
g
DIMENSIONS b l ��� �_
SETBACK SYSTEM TO P/L JBLDG JWELL LAKE/STREAM LEACHING Manufacturer: G Z c�
INFORMATION Typy Of System: CHAMBER UNIT OR Model Number:G L •.J/
6A,JZ�,eek 160 1 33 �j'�f 7/6d
DISTRIBUTION SYSTEM ue4- �JtA.,, k3 L
Header/Manif Id Distribution x Hole Size x Hole Spacing Ve to Air Intake
� Pipe(s) Ns".
\ �� �e, a /
Length Dia r Length Dia Spacing
SOIL COVER I x Pressure Systems Only xx Mound Or At-Grade Systems Only aM
Depth Over Depth Over xx Dept f xx Seeded/Sodded xx Mulched
„]
Bed/Trench Center J� U7 Bed/Trench Edges ` Topsoil Yes M No Yes ® No
COMMENTS: (Include code discrepencies, persons present,etc.) Inspection#1: / / Inspection#2:
Location: 434 210th Ave Somerset,WI 54025(SE 1/4 SW 1/4 16 T31 N RI 9W) 40 acres Lot Parcel NJ 16.31.19.235
1
1.)Alt BM Description= '� (�6v".—
2.)Bldg sewer length= /L
-amount of cover
Plan revision Required? ❑ Yes ;�Ni) L-.91 Use other side for additional information. --
Date Insepctors Si ature Cent.No.
SBD-6710(R.3/97)
County
Safety and Buildings Division
201 W. Washington Ave., P.O. Box 7162 sanitary Permit Number (to be filled in by CO-)
i ~
0
ps , <j r r't1€ Madisgn,7 Q _J
` - 57 2'3 • ~ State Transaction Number ~
~ary Permit Application
In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit Fem.
is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than g address) -7 L)
the Department of Safety and Professional Servies. Personal information you provide may be used for secondary , j j134 / _jo kv o
ses in accordance with the Privac Law, s. 15.04 1 m , Stars. '(~lY L~ C
1. A lication information - Please Print All Information parcel #
Property Owner's Name / C9 00 0
property Location
Property owner's Mailing Address
2 NQ') y~ ✓r . 47AS % Govt. Lot ,
/ , Zip Code Phone Number .5, y,, J w Section -Z-(0_
City, State n , _ q irole one),
~ 0013 ~~lV JS~~ / Lot # T ` N; R Eor&i
. 4A)z W
H. Type of Building (check all that apply) Subdivision Name
1 or 2 Family Dwelling - Number of Bedrooms - / 4 fG
~k ~ ptYS4_ Block #
❑ public/Commercial - Describe Use ❑ City of
CSM Number ❑ Village of
❑ State Owned - Describe Use ❑ Town of 50.# y e le se r
3 p;- cep w 80,f,, a~ L Fi
III. Type of Permit: (Check only one box on line A. Complete line B if applicable) o
A. New System ❑ Replacement system ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
List previous Permit Number and Date Issued
e of Plumber E] Permit Transfer to New
B. ❑ Permit Renewal ❑ Permit Revision F1 Chang Owner d
Before Expiration Lba
IV. T of POWTS S stem/Com onent/Device: Check all that apply)
Non-pressurized In-Ground El Pressurized In-Ground 11 At-Grade 11 Mound > 24 in. of suitable soil El Mound < 24 in. of suitable soil
❑ Pretreatment Device (explain)
El Holding Tank ❑ Other Dispersal Component (explain)
V. Dis ersaUT "ea ent Area Information: Dispersal Area Required (sf) Dispersal Area Proposed (s system Elevation C/ V
Design Flow (gpd) Design Soil Application Rate( gp f) /zoo ?0 7 0 7e. 0
~p p 0157 /ZOD
Capacity in Total # of Manufacturer
VI. Tank Info ry
U
Gallons Gallons Units a
New Tanks Existing Tanks /i 1 a I Dl" f m 1 44 0 V y ix C7 L~.
Sep tic or Holding Tank / ® 7~Q 0 l` olf~- S le
Dosing Chamber J
VII. Responsibili ty Statement- I, the undersigned, assume responsibility for installation of the POWTS sshoowwn on the > ched plans. Phone Number MPRS Nber Bus cgs
Plumber's Name (Print) Plumber' 'gna
Plumber's Address (Street, City, State, Zip Code)
C /V f w^
( 6 / 0 rH ✓C cSo~~tc~1,CJ ~i{JL J J
VIII. Conn /Department Use Only Permit Fee Date Issued Issuing t Signature
Approved asap S q 75. Z
even Reason for 1
IX. Condit941STE040~W*AWteasons for Disapproval 3\
1: Septic tank, effluent filtor and JJ l~CllJ
dispersal cell :must all "rvlces / maintained
as per management plan provided by plumber.
2. All seawe requirements must be'maintained
as PKI applicabt. eD l ordWOUM.
Attach to complete plans for the system and submit to the County only on paper not less than 8 t!2 a 11 inches in size
SBD-6398 (R. 11/11)
PLOT PLAN N
Project Name: Morud 4 Bedroom Septic System
Legal Description: SEII/4, SW114, S16 T31N, R19W P.I.D: 032-1046-60-000
Subdivision Name: NA Lot NA SCALE: 1" = 40'
Township: SOMERSET Parcel Size: 40 Acres Parcel
County: ST. CROIX
System Elevation: T1=89.50' Proposed 80' EZ Flow Trench
Slope: 11% T2=90.10' Proposed 80' EZ Flow Trench
Ak BM1 Elevation: 100.00' To of 2' PVC pipe T3=90.70' Proposed 80' EZ Flow Trench
A BM2 Elevation: 99.48' To of 2' PVC pipe
Backhoe Pits: 4 inch Sch 40 -ASTM D2665
4 inch 3034 - ASTM D3034
TANK SCHEDULE
S1 Proposed 1250 gallon septic tank w/Pol lok 525
S2 Proposed 320 gallon septic tank w/Pol lok 525
NOTE: See page 11 for a complete plot of the parcel.
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CONVENTIONAL COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: Morud 4 Bedroom Septic System
Owners Name: Martin & Mary Maureen Morud
Owner's Address 929 Connor Ave. East
Maplewood, MN 55109
Legal Description: SE1/4, SW1/4, S16, T31N, R19W
Township Somerset
County: St. Croix
Subdivision Name: 40 Acre Parcel
Lot Number: NA Block Number
Parcel I.D. Number 032-1046-60-000
Plan Transaction No.
Page 1 Index and title
Page 2 Plot Plan
Page 3 System Sizing & Cross Section
Page 4 Septic Tank 1 (S1) Specifications
Page 5 Septic Tank 2 (S2) Specifications
Page 6 Filter Information
Page 7&8 Management and contingency plan
Page 9 Septic Tank Maintenance Agreement
Page 10 Warranty Deed
Page 11 CSM or Plat
Attachment Soil Evaluation Report
Designer: John Schmitt Licnese Number: MPRS 223760
Date: 11/18/2014 Phone Number: 715-760-0486
Signature: /~~A ZAZr--~
In- round Soil Absorption Component Manual Version 2.0 SBD-10705-P (N. 01/01)
Page 1 of 11
PLOT PLAN N 71
tem
Project Name: Morud 4 Bedroom Septic Sys
Legal Description: SEIM, SWIM, S16 T31N, R19W P.I.D: 032-1046-60-000
Subdivision Name: NA _ Lot NA SCALE: 1" = 40'
Township: SOMERSET Parcel Size: 40 Acres Parcel
County: ST. CROIX
System Elevation: T1=89.50' Proposed 80' EZ Flow Trench
Slope: 11% T2=90.10' Pro osed 80' EZ Flow Trench
BM1 Elevation: 100.00' To of 2' PVC pipe T3=90.70' Proposed 80' EZ Flow Trench
BM2 Elevation: 99.48' To of 2' PVC pipe
Backhoe Pits: 4 inch Sch 40 -ASTM D2665
4 inch 3034 - ASTM D3034
TANK SCHEDULE
S1 Proposed 1250 gallon septic tank w/Pol lok 525
S2 Proposed 320 gallon septic tank w/Pol lok 525
NOTE: See page 11 for a complete plot of the parcel.
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SOIL ABSORPTION SYSTEM DETAIL / GRAVELLESS LEACHING UNIT
Project Name: Martin & Mary Maureen Morud
Gravelless Leaching Unit Specifications
Manufacturer Model Laying Length EISA Rating
Infiltrator EZ12031-1-5ft 5.0' 25.0
EZ1203H-10ft 10.0' 50.0
System Sizing
Flow Rate 600 gpd
EISA Rating per Foot of EZ Flow ft2 Soil Application Rate 0.5 gpdtft2
600.0 gpd Design Flow = 0.5 Soil Application Rate = F 5 1 EISA = 240.0 Feet of EZ Flow
73 ]trenches 80 feet long each
3 No. of Cells 8 Per Cell
3 ft Cell Width 30 Total No of 1203H
80 ft Cell Length 400 sq ft EISA Per Cell
3 ft Cell Spacing 1200 sq ft Total EISA
Typical Cross Section
Finished Grade 100 ft Observation Pipe with
approved cap or vent
* Soil Backfill
■
36 inch Geotextile Fabric
` >31t
bm > aft. Slotted and Anchored VentlObservation Pipe
12 inch O IN
with Cap
T °
90.70 ft O I / 89.5 ft Infiltrative Surface
>36 inch 90.10 ft/
a-r~r.r~ars.■.sa■■
■r■rr■rrrr■■■r■■■■■■ *Mangano,, n Plumber/Designer Signature:
License MPRS 223760 Date: November 18, 2014
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POLYAkax-Inc.
Innovations in Precast, Drainage Zabei° PL-525 Effluent Filter
& Wastewater Products `i A Division of PWok Inc.
PL-525 Filter
The PL-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has
525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the Polylok PL-525 has an automatic shut-off ball
installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shut off
the system so the effluent wont leave the tank.
Features: 1/16" Filtration Slots
• Rated for 10,000 GPD (gallons per day). Alarm o Switch
• 525 linear feet of 1/16" filtration. 1Q OW GPD (optional)
• Accepts 4" and 6" SCHD 40 e. Cr'~ Accepts 1" PVC
Pip Extension Handle
• Built in gas deflector.
• Automatic shut-off ball when filter is removed.
• Alarm accessibility. Rated for
10,000 GPD
• Accepts PVC extension handle.
PL; 525 Installation:
Ideal for residential and commercial waste flows up to 525 Linear Ft.
10,000 gallons per day (GPD). of 1/16-
Filtration Slots
1. Locate the outlet of the septic tank.
2. Remove the tank cover and pump tank if necessary.
Accepts 4" & 6"
3. Glue the filter housing to the 4" or 6" outlet pipe. If SCHD 40 pipe
the filter is not centered under the access opening use a M
Polylok Extend & Lok or piece of pipe to center filter.
4. Insert the PL-525 filter into its housing.
Certified to
5. Replace and secure the septic tank cover. NSF/ANSI standard 46
PL-525 Maintenance:
The PL-525 Effluent Filters will operate efficiently for
several years under normal conditions before requiring
cleaning. It is recommended that the filter be cleaned
every time the tank is pumped, or at least every three
years. If the installed filter contains an optional alarm,
the owner will be notified by an alarm when the filter
needs servicing. Servicing should be done by a certified Gas Deflector
septic tank pumper or installer. rAut.matic
Shut-off Ball
1. Locate the outlet of the septic tank.
2. Remove tank cover and pump tank if necessary.
3. Do not use plumbing when filter is removed.
4. Pull PL-525 cartridge out of the housing.
5. Hose off filter over the septic tank. Make sure all
solids fall back into septic tank. +
6. Insert the filter cartridge back into the housing making
sure the filter is properly aligned and completely inserted. Outdoor l & Best filters Alarm Extend hallall n~
Polylok, Zabel & Best filt accept Easily installs
7. Replace and secure septic tank cover. the SmartFilter® switch and alarm. into existing tanks.
Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 Toll Free: 877.765.9565 Fax: 203.284.8514 www.polylok.com
-:3ae 6
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page_of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner: Martin & Mary Maureen Morud Tank Manufacturer: Wieser Concrete r NA
Permit # E Septic E: Dose Holding Volume: 1250 gal
DESIGN PARAMETERS Tank Manufacturer: r NA
Number of Bedrooms: 4 r NA E Septic E Dose Holding Volume: 320 al
Number of Public Facility Units: NA Vertical Distance Tank Bottom (s) to Service Pad: ft
Estimated (average) Flow: 400 gal/day Horizontal Distance Tank(s) to Serivice Pad: ft
Design (peak) Flow = estimated x 1.5: 600 al/day Specific servicing mechanics must be provide if vertical is>15 feet or if
In Situ Soil Application Rate: 0.5 gal/da /ft2 horizontal is > 150 feet. Specific instructions to be provided on back.
Standard Domestic Influent/Effluent Monthly average Effluent Filter Manufacturer: POLYLOK NA
Fats, Oils & Grease (FOG) 530 mg/L Effluent Filter Model: 525
Biochemical Oxygen Demand (BOD5) 5220mg/L NA Pump Manufacturer: NA
Total Suspended Solids (TSS) 5150mg/L Pump Model:
High Strength Influent/Effluent Monthly average Petreatment Unit
Fats, Oils & Grease (FOG) 530 mg/L Manufacturer:
Biochemical Oxygen Demand (BOD5) 5220mg/L rV NA r mechanical Aeration I Peat Filter NA
Total Suspended Solids (TSS) 5150mg/L r Disinfection r Wetland
Petreated Effluent Monthly average r Sand/Gravel Filter r Other:
Biochemical Oxygen Demand (BOD5) 530mg/L Soil Absorption System
Total Suspended Solids (TSS) 530mg/L JVNA fK In-Ground (gravity) In-Ground (pressure) NA
Fecal Coliform (geometric mean) 5104cfu/100m1 At-Grade r Mound
Maximum Effluent Particle Size: Ye in dia. N r Drip-Line Other:
Other: r7 Other: NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
When combined with sludge and scum equals one-third ('/3) of tank volume
Pump out contents of tank(s) When the high water alarm is activated
month(s)
Inspect condition of tank(s) At least once eve : 3 la year(s) (Maximum 3 ears r NA
month(s)
Inspect dispersal cell(s At least once eve : 3 rpl year(s) (Maximum 3 ears) r NA
r month(s)
Clean effluent filter At least once eve : 1.5 rr year(s) IF NA
month(s)
Inspect pump, pump controls & alarm At least once eve : fr' year(s) F-0 NA
month(s)
Flush laterals and pressure test At least once every: year(s) R' NA
month(s)
Other: At least once every: year(s) r NA
Other: Maintenance is the same for both tanks
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 Insepector; POWTS Maintainer; Septage Servicing Operator (pumper). Tank
inspections must include a visual inspeciton 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 a check for any back up or ponding of effluent on 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 indicated a failing condition and requires the immediate
notification of the local regulatory authority.
When the combined accumualtion of sludge and scum in any treatment tank equals one-third 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
Admininistrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, petreatment units,
and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 30 days of completion of any service event.
(Rev.2/05)
ae 7
START UP AND OPERATION Page of
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other
chemicals or sediment that may impede the treatment process and/or damage the soil 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 extended 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 and may overload them resulting 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 wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain
(sump pump) discharge; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products;
pesticides; sanitary 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:
• All piping to tanks, pits and other soil absorption systems shall be disconnected and the abandoned pipe openings sealed.
• 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 the opportunity to obtain a sanitary permit for
a code compliant replacement system:
ly, 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 by required
setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will 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 the time of their
permit issuance.
❑ A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be
rehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort.
❑ 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 biomat at the infiltrative
surface. Reconstructions of such systems must comply with the rules in effect at that time.
WARNING: TREATMENT TANKS AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES AND LACK SUFFICIENT
OXYGEN TO SUPPORT LIFE. NEVER ENTER A TREATMENT TANK OR HOLDING TANK UNDER ANY
CIRCUMSTANCE. DEATH MAY RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK IS VERY DIFFICULT.
ADDITIONAL INFORMATION:
POWTS INSTALLER POWTS MAINTAINER
Name: John Schmitt Name: John Schmitt
Phone: 715-760-0486 Phone: 715-760-0486
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name: Owners Choice Name: St. Croix County Zoning
Phone: Phone: 715-386-4680
This document is intended to meet minimum requirements of Ch. Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.
Use of this document does not guarantee the performance of the POWTS.
(Rev. 2/05)
8 2 7 2 7 6 8
Tx:4223426
Document Number Document Title 1005353
St. Croix County BETH PABST
REGISTER OF DEEDS
Accessory Structure Affidavit ST. CROIX CO., WI
RECEIVED FOR RECORD
12/12/2014 10:37 AM
Martin C. & Mary Maureen Morud EXEMPT
Name - (Owner) Typed or printed REC FEE: 30.00
being duly sworn , states, under oath, that: PAGES: 1
He/she is the legal owner of the following parcel of land located in St.
Croix County, Wisconsin, recorded in Volume Page _ Document
Number 983115 St. Croix County Register of Deeds Office, Recording Area
being duly described as follows (include lot no. and subdivision/CSM or Name and Return Address .
Morud
detailed legal description): Marvin
5301 Edina ina Industrial Blvd lit
- ~'40 Acre parcel; S£i/4, SW 1/4, Section 16, Town 31N. Range 19W Minneapolis; MN'55439 -
Parcel Identification Number (PIN)..
032-1046-60-000.
I
As owner of the above described property, I acknowledge that the Private Onsite Wastewater Treatment System
(POWTS) services both an existing principal dwelling and an accessory building on this lot and is sized for a (_4_)
bedroom home, or a design flow of 600 gpd. This accessory building may not be used as a second residence on this
parcel I also acknowledge that I will disclose this information and stipulation to any future parties interested in
purchasing this property.
Dated this day of
x ~
Maw r A I A
Y1 M D YY"
AUTHEN T N ACKNOWLEDGMENT
Signature(s) STA'rE OF WISCONSIN )
)SS.
St. Croix County. ) 1+"t r
P
A authenticated this day of I t
ersonally came before me this day.of~ I the above named
to me known to be
TITLE: MEMBER STATE BAR OF WISCONSIN the person(s) %vho executed the foregoingyinstritment and acknowledge the
(If not, same. , ~a`
,
authorized by § 706.06, Wis. Stats.) E
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(Signatures may be authenticated or acknowledged. Both are not My com ission is pe tanent,~lf note stt ie!i'i i B-on date:
necessan%) Date:
I St. Croix County 1005353 Page 1 of 1
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ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer Martin & Maureen Morud
Mailing Address 0111 o h 0 r _ wi,o mpj__5_~~
Property Address 4 4 210th Ave..+
i.
(Verification required from Planning & Zoning Department for new construction.)
City/State Somerset, Wl Parcel Identification Number 032-1046-60-000
LEGAL DESCRIPTION
Property Location SE '/4 SW '/4 ,Sec. 16 , T 31 N R 19 W, Town of Somerset
Subdivision Plat: NA 40 Acre Parcel
Lot # NA
Certified Survey Map # Volume Page #
Warranty Deed # (before 2007)Volume Page #
Spec house❑yesUo Lot lines identifiable E)yes[-]no
SYSTEM MAINTENANCE 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 licensed 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 §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department 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/or (2) after inspection and pumping (if necessary), the septic tank is
less than 1/3 full of sludge.
Uwe, 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 Safety And Professional Services 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 expiration date.
Ihve certify that all statements o this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the
property described above, by virtue of warranty deed recorded in Register of Deeds Office.
Number of bedrooms 4
2
/ JE7"
SIGNATURE OF APPLICANT(S) -DA
***Any information 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
reference is made in the warranty deed.
(REV. 04/12)
Parcel 032-1046-60-000 12/15/2014 08:51 AM
PAGE 1 OF 1
Alt. Parcel M 16.31.19.235 032 - TOWN OF SOMERSET
Current [X1 ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
MARTIN C & MARY MAUREEN MORUD O - MORUD, MARTIN C & MARY MAUREEN
5115 45TH AVE S
MINNEAPOLIS MN 55417
Property Address(es): Primary
Districts: SC = School SP = Special
Type Dist # Description
SC 5432 SCH DIST OF SOMERSET
SP 1700 WITC Notes:
Legal Description: Acres: 40.000
SEC 16 T31 N R1 9W 40A SE SW
Parcel History:
Date Doc # Vol/Page Type
06/27/2014 997872 EZ-U
07/29/2013 983115 WD
07/16/2009 900246 WD
11/01/2004 778553 2686/276 LC
Plat: * = Primary Tract: (S-T-R 40% 1601/, GL) Block/Condo Bldg:
* N/A-NOT AVAILABLE 16-31N-19W SE SW
2014 SUMMARY Bill Fair Market Value: Assessed with:
282742 Use Value Assessment
Valuations: Last Changed: 04/07/2011
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 14.000 1,800 0 1,800 NO
UNDEVELOPED G5 1.000 100 0 100 NO
AGRICULTURAL FOREST G5M 25.000 50,000 0 50,000 NO
Totals for 2014:
General Property 40.000 51,900 0 51,900
Woodland 0.000 0 0
Totals for 2013:
General Property 40.000 51,900 0 51,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch M
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
-,~Ya. tktJt
t
Department of SOIL EVALUATION REPORT #1703
Safety and in wi 85, Wis. Adm. Code Page 1 of 5
= Professional Services )CIF Schmitt Soil Testing, Inc.
Attach complete site plan on paper not less than 8% x 11 -In n must County
include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.
032-1046-60-000
Please print afl information.
Personal information you provide may be used for secd evlew B Date
rrdaa purposes (Privacy Law, s. 15.04 (1) (m)). / Z / -7
Property Owner Property Location
Morud, Martin C & Mary Maureen J),> Govt. Lot SE1/4, SW1/4, S16, T31N, R19W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
5115 45th Ave. S NA NA 40 Acre Parcel
City State Zip Code 01616 ber
City Village ❑ Town Nearest Road
Minneapolis MN 55417 9651)587-6341 Somerset 210Th Ave.
ew Constructio Use: Residential/ Number of bedrooms 4 Code derived design flow rote 600 GPD
❑ Replacement ❑ Public or commercial - Describe: 2YK ~ ACA~~ 0yx P
Parent material Outwash (PmC Plainfield loamy sand) Flood plain elevation, if applicable NA ft.
General comments area is suitable for a conventional system with a 0.5 gpd/sgft rate. Possible system elevation for Area 1 is (T189.5'), (T2 90.1), &
and recommendations: (T2 901). Slope of area is 9%. /
t'r
❑ Boring
❑ Boring #
Pit Ground surface elev. 92.70 ft. Depth to limiting factor 76 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f!e
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#t *Eff#2
1 0-18 10yr3/3 none sl 2fsbk mfr Cs 2vf 0.6 1.0
2 18-29 10yr3/4 none Ifs lcsbk mvfr gw lvf 0.5 1.0
3 29-42 7.5yr5/6 non girls OSg ml Cs 2vf 0.7 1.6
4 42-76 10yr6/4 none s Osg ml Cs 0.7 1.6
5 76-96 5yr4/4 map 7.5yr6/8 sl Om mfi - 0.2 0.6
10yr6/1
a
D t
2] Boring # Boring
Pit Ground surface elev. 96.70 ft. Depth to limiting factor 81 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GPDtft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-13 10yr3/3 none sl 2fsbk mvfr Cs 2vf 0.6 1.0
2 13-26 7.5yr5/6 none grs Osg ml gw lvf 0.7 1.6
3 26-81 10yr5/6 non fS Osg ml Cs 0.5 1.0
4 81-90 5yr4/4 7m2d.5yr6/2 r6/2 /6 sl Om mfi 0.2 0.6
' Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BODS < 30 mg/L and TSS S.30 mg/L
CST Name (Please Print) Signature: CST Number
Thomas J. Schmitt 227429
Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number
1595 72nd Street New Richmond, WI 54017 11/15/2013 715-760-1978
SBD-8330 (R.07J00)
Property Owner Morud, Martin C & Mary Maureen Parcel ID # 032-1046-60-000 Page 2 of 5
a Boring
Boring # Pit Ground surface elev. 92.45 ft. Depth to limiting factor 45 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#t -Eff#2
1 0-17 10yr3/3 none sl 2fsbk mvfr gw 2vf 0.6 1.0
2 17-29 10yr4/4 none sl 2msbk mvfr gw 2vf 0.6 1.0
3 29-45 10yr5/6 non s Osg ml as ivf 0.7 1.6
4 45-76 5yr4/4 m2d 7.5yr6/8 sl Om mfi 0.2 0.6
7.5yr6/2
7-
4] Boring # F] Boring
Pit Ground surface elev. 93.40 ft. Depth to limiting factor 86 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft=
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 -Eff#2
1 0-16 10yr3/3 none sl 2fsbk mvfr gw 2vf 0.6 1.0
2 16-26 10yr4/4 none sl 2msbk mvfr cs ivf 0.6 1.0
3 26-34 7.5yr5/6 non s Osg MI Cs 0.7 1.6
4 34-45 7.5yr5/4 none vgrcos Osg ml cs 0.7 1.6
5 45-61 10yr5/4 none cos Osg ml a 0.7 1.6
6 61-86 10yr6/4 none fs Osg ml a 0.5 1.0
7 86-96 5yr4/4 m2d 7.5yr6/8 I sl Om
7.5yr6/2 fi 0.2 0.6
Boring
F--5]Boring # Pit d
Ground surface elev. 0.70 ft. Depth t imi ng factor 65 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 -Eff#2
1 0-13 10yr3/3 none sl 2fsbk mvfr as 2vf 0.6 1.0
2 13-19 7.5yr5/6 none grcos Osg ml as ivf 0.7 1.6
3 19-65 10yr5/6 non fs Osg ml as 0.5 1.0
4 65-84 5yr4/4 c2d 7.5yr6/6 sl Om mfi 0.2 0.6
7.5yr6/2
- Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 <150 mg/L - Effluent #2 = BOD5 < 30 mg/L and TSS <30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD-8330 (R.07/00) Sch Ott Sall Tes ft, Inc
Property Owner Morud, Martin C & Mary Maureen Parcel ID # 032-1046-60-000
Page 3 of 5
F6' Boring # Boring
Z Pit Ground surface elev. 94.00 ft. Depth to limiting factor 69 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-14 10yr3/3 none si 2mgr mvfr as 2vf 0.6 1.0
2 14-36 10yr4/4 none sl 2msbk mvfr gw 1vf 0.6 1.0
3 36-48 7.5yr4/4 none fs1 lmsbk mfr Cs 0.2 0.6
4 48-69 Syr4/4 none cos Osg MI Cs 0.7 1.6
5 69-90 10yr4/6 c2d 5.56(6/6 fsl icsbk mfr 0.2 0.6
F7] ❑ Boring
Boring # k Pit
Ground surface elev. 93.40 ft. Depth to limiting factor 100+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#t *Eff#2
1 0-15 10yr3/3 none sl 2fsbk mvfr as 2vf 0.6 1.0
2 15-29 10yr4/6 none si 2fsbk mvfr gw ivf 0.6 1.0
3 29-40 10yr5/6 none is Osg MI Cs 0.7 1.6
4 40-52 10yr5/4 none s Osg M1 Cs 0.7 1.6
5 52-100 10yr6/4 none fs Osg ml 0.5 1.0
1
d
F-81 Boring # F] Boring
Pit Ground surface elev. 92.10 ft. Depth to limiting factor 96+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#t *Eff#2
1 0-14 10yr3/3 none sl 2fsbk mvfr Cs 2vf 0.6 1.0
2 14-38 10yr4/4 none sl 2msbk mvfr Cs 1vf 0.6 1.0
3 38-50 10yr5/6 non Cos Osg MI Cs 0.7 1.6
4 50-96 10yr6/4 none fs/sl icsbk mfr 0.4 0.7
50-96" has 2" bands of 7.5yr4/4 sl lmsbk mfr, Changes rate of horizon to 0.4gpd/sgft.
* Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 <_150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS <30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD-8330 (R.07/00)
samWa son resdng, rnc.
~
, ~ ~ \
k;:.
~ ~
_
Page ,4 of 5
C6nducted-b . .
pr- , Co®ducteilFor:
Schmitt Soil_Testing, lnc Name ur~cv~C.&_Mary_ManreenMorud
Thomas J Schmitt, CST 227429 Address: 5115 45th Ave. S.
- 1585 72nd St
-
City; State; Zip: Minneapott§1VI1Y354T"f
Ne !MchmGndr.W_L540'L7
Phone: 715-7p-1978
PID: 032-1046-60-000
S~gnature _
- Lot No.: NA 40 Acre Parcel
- - ~ X13 !
c~~ce .~1 J !-®gal~escriptien sE114 s~v-ua-s1G ~'3}#-R~11VV
■ Backhoe Pit Township, County: Somerset, St Croix County
f3enCh l~iark 1 Bi. 100.00' Top of 2' PVC pipe.
- l3enGh-Mafk~ €1. &4g"-Tep of 2" ~aFG pipe.- _
Slope= I%
Scale 1" 40' - _ f~ - - -
Q o p6/2 r(r
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` Z SOIL EVALUATION REPORT #1629
iscon
Department of Co in accordance with Comm 85, Wis. Adm. Code Page 1 of 5
Division of Safety and uil gs Schmitt Soil Testing, Inc.
Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.
Part of. 032-1046-60-000
Please print all information. Re4iewe Date
Personal information you provide ma u s (Pri cy Law, s. 15.04 (1) (m)). ~ 411 t -7 / D
Property Owner Property Location
Hillquist, Kirk Govt. Lot SE1/4, SW1/4, S16, 31N, R19W
Property Owner's Mailing Address J U Q Lot # Block # Subd. N ame
CSM#
Nol
11150 121 st St. N. 1 CS Pending 29.61 Acres) pG w
City St teP & Z r ❑ City 1:1 Village ❑ Town Nearest Road
Stillwater Somerset 210Th Ave. A7,
❑ New Construction Use: ❑ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material Outwash over till Flood plain elevation, if applicable na ft.
General comments
and recommendations: Area is suitable for a mound system. System elevation is 100.04' based off contour line established at
99.20'. Slope of area is 12%. Depth to limiting factor is 26".
F 1-1 Boring # Boring
❑ Pit Ground surface elev. 99.70 ft. Depth to limiting factor 26 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistent Boundary Roots GPD/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2
1 0-12 10yr3/3 none sil 2fsbk mfr Cs 2f,2vf .6 .8
2 12-26 10yr5/3 none sil 2msbk mfr gw 2vf .6 .8
3 26-38 10yr4/4 c 1d 10yr6/6 sicl 2msbk mfr gw 1vf .4 .6
4 38-48 10yr5/4 c1d 10yr6/6 sl lmsbk mfr w 4 7
10yr6/2 9
5 48-92 10yr5/4 c2d 7.55/6/6 7.55/5/2 grfsl lcsbk mvfr .2 .6
Boring # ❑ Boring
❑ Pit Ground surface elev. 99.60 ft. Depth to limiting factor 37 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GPD/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 •Eff#2
1 0-10 10yr3/3 none sl 2fsbk mfr gw 2f,2vf .6 1.0
2 10-20 10yr4/4 none sl imsbk mfr gw 2vf .4 .7
3 20-37 10yr4/3 none vgrsl lmsbk mfr Cs .4 .7
4 37-69 10yr5/6 cif 10yr6/6 rlcos lcsbk mfr Cs 6
g
10yr6/2 2
5 69-96 5yr4/4 c2d 7.5yr6/6 sl Om mfi 2 6
7.5yr5/2
37-69" has 2" bands of 10yr4/4 fsl imsbk changes rate of horizon to 0.2gpd/sgft.
Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS <30 mg/L and TSS <_30 mg/L
CST Name (Please Print) Signature: CST Number
Thomas J. Schmitt , 227429
Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number
1595 72nd Street New Richmond, WI 54017 6/4/2010 715-247-2941
SBD-8330 (R 07/00)
S
Property Owner Hillquist, Kirk Parcel ID # Part of: 032-1046-60-000 Page 2 of 5
F3 ] Boring # ❑ Boring
M Pit Ground surface elev. 95.70 ft. Depth to limiting factor 30 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 0-8 10yr3/3 none I 2fsbk mfr cs 2f,2vf .6 .8
2 8-23 10yr3/4 none sicl 2fsbk mfr gw 2vf .4 .6
3 23-30 10yr4/4 none sl imsbk mfr gw lvf .4 .7
4 30-38 10yr4/4 c2d 7.5yr6/6 sl lmsbk mfr w 4 7
7.5yr6/2 g
5 38-84 10yr5/4 7 cif 5 2 7v r5/2 6 grlcos icsbk mfr .2 .5
.
38-84" has 2" bands of 10yr3/4 fsl Om changes rate of horizon to 0.2gpd/sgft.
Boring # Boring
Pit Ground surface elev. 97.49 ft. Depth to limiting factor 28 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 0-16 10yr3/4 none sl 2fsbk mfr cs 2f,2vf .6 1.0
2 16-28 10yr4/4 none I 2msbk mfr gw 2vf .6 .8
3 28-38 7.5yr4/6 c1d 7.5r6yr6/6 sicl 2msbk mfr gw lvf .4 .6
7.5y 2
4 38-59 7.5yr5/6 c2d 7.5yr6/6 fsl 2msbk mfr a 4 8
7.5y r6/2
5 59-84 7.5yr5/4 c2d 10yr6/6 Icos lcsbk mfr 7 1.6
10 r5/2
a Boring # ❑ Boring.
Pit Ground surface elev. 98.29 ft. Depth to limiting factor 29 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 0-14 10yr3/4 none sil 2fsbk mfr a 2f,2vf .6 .8
2 14- 10yr5/3 none A 2msbk mfr gw 2vf .6 .8
3 29-42 10yr4/4 c2d 10yr6/6 10yi-6/2 sl imsbk mfr gw lvf .4 .7
4 42-56 10yr5/4 m2d 7.5yr6/6 rlcos lcsbk mfr CS
g
7.5yr6/2 7 1.6
5 56-84 10yr5/6 cif 10yr6/6 Ifs icsbk mvfr cs 5 1.0
10yr5 2
6 84-115 5yr4/4 c2d 7.5yr6/6 s1 Om mfr 7.5yr6/2 .2 .6
* Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 <150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD-5330 (R07/00) Schmitt Soil Testing, Inc.
Property Owner Hillguist, Kirk Parcel ID # Part of: 032-1046-60-000 Page 3 of 5
❑ Boring # Boring
❑ Pit Ground surface elev. 106.66 ft. Depth to limiting factor 27 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2
1 0-7 10yr3/4 none I 2fsbk mfr gw 2f,2vf .6 .8
2 7-27 10yr4/3 none sl 2msbk mfr gw 2vf .6 1.0
3 27-37 10yr4/4 c2d2/6 sl 2msbk mfr gw 21vf .6 1.0
4 37-50 1r5/4 c2d 7.5yr6/6 -----0y 7 5yr6/2 grlcos Osg mfr cs .7 1.6
5 50-58 7.5 r4 4 m2d 7.5yr6/6
y / 7.5 r6 2 sl imsbk mfr a .4 .7
6 58-76 5yr4/4 c2d 7.5yr6/6 sl Om mfi .2
7.5yr6/2 6
❑ Boring # Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2
❑ Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2
" Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 <150 mg/L " Effluent #2 = BODS < 30 mg/L and TSS - 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD-8330 (R.07/00) Sdnldtt Soil TesUty, IM.
Page 4 of 5
Conducted by: Conducted For:
Schmitt Soil Testing Inc. Name: Kirk Hillquist
Thomas J. Schmitt, CST 227429 Address: 11150 121st St. N.
1595 72nd St. City, State, Zip: Stillwater, MN 55082
New Richmond, WI. 54017
Phone: 715-247-29 Subd.Name: NA
41
sisn 4 Lot No.: 1
Date / O/O Legal Description: SE1/4 SW1/4 S16 T31N R19W
■ Backhoe pit Township, County: Somerset, St. Croix County
A Bench Mark 1 El. 100.00' Top of 2" PVC pipe
D Bench Mark 2 EI.82.43' top of SE lot corner iron pipe rd -
Slope= 11% Contour Line Length 92' Contour Line El. 99.20'
LIZ
Scale 1 40' 7w
9
-31
93
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CERTIFIED SURVEY MAP
LOCATED IN PART OF THESE 114 OF THE SW 114 OFSECT/ON 16, T31N, R19W,
TOWNOFSOMERSET, ST. CRO/X COUNTY, WISCONSIN. y
m
PREPARED FOR: SURVEYOR: 2 0
K/RKH/LLOU/ST DOUGZAHLER O $ Z
11150 121ST ST. N. S & N LAND SURVEYING, INC. k
STILL WATER, MN55082 2920ENLOESTREET p y
SUITE 101 C O
HUDSON, W154016 y a 2
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EACH PARCEL SHOWN ON THIS MAP IS LEGEND SCALE IN FEET 1"=200'
SUBJECT TO STATE, COUNTYAND O T 2
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REGULATIONS FOUNDALUM/NUM COUNTY
1/.E., WETL ANDS, SECT/ON CORNER MONUMENT any 200 100 0 200
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CONTACT THE ST. CRO/X COUNTY DIAMETER IRON PIPE p
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55y1 VOLUME 1115, PAGE 342 5114 CORNER
SECTION 16
brn~- I `
N89°30'52W 847.72
o D rn _NQ°SS'51"W _ _ N189-ii) 52-W 332.64'
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Mlt~pLQ 7r6D LANDS
TH1S1NSTRUMENTDR4F7E0BY. DOUGZAHLER JOBNO. 6446-002 DATE orV3110 SHEET 1 OF 2
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Parcel 032-1046-60-000 05/06/2013 02:29 PM
PAGE 1 OF 1
Alt. Parcel M 16.31.19.235 032 - TOWN OF SOMERSET
Current Ik ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
00 0
Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner
KIRK L & TRACEY A HILLQUIST O - HILLQUIST, KIRK L & TRACEY A
11150 121 ST ST N
STILLWATER MN 55082
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 5432 SCH DIST OF SOMERSET
SP 1700 WITC
Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE
SEC 16 T31 N R1 9W 40A SE SW Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
16-31N-19W SE SW
Notes: Parcel History:
Date Doc # Vol/Page Type
07/16/2009 900246 WD
11/01/2004 778553 2686/276 LC
2013 SUMMARY Bill M Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 04/07/2011
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 14.000 1,800 0 1,800 NO
UNDEVELOPED G5 1.000 100 0 100 NO
AGRICULTURAL FOREST G5M 25.000 50,000 0 50,000 NO
Totals for 2013:
General Properly 40.000 51,900 0 51,900
Woodland 0.000 0 0
Totals for 2012:
General Property 40.000 51,900 0 51,900
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