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HomeMy WebLinkAbout032-2095-20-100 Fan : St. Croix Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT ry Permit No: 579026 (ATTACH TO PERMIT) Plan ID No: GENERAL INFORMATION Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Parcel Tax No: Permit Holder's Name: City Village X Township 032-2095-20-100 Miller, Core & Orlean Somerset, Town of ection/Town/Range/Map No: D L Insp. BM Elev: ~BM CST BM Elev: escription: v0 Oo ~T y 614 6 /yi e (~04 23.31.19.926A30_ TANK INFORMATION ELEVATION DATA HI FS ELEV. TYPE MANUFACTURER CAPACITY STATION r Septic ` ( Benchmark Alt. BM Dosing Aeration Bldg. Sewer S P los. fl Holding St/Ht Inlet 7.37 oN-3y St/HtOutlet 77t [D`/.00 TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet o. Septic Dt Bottom I I 7L~ W Dosing Header/Man. 71 Dist. Pipe Aeration Holding Bot. System Final Grade ~ toc~~6 PUMP/SIPHON INFORMATION Manufact er De d St Cover Zq GPM 107,117 Model Number TDH Lift Fricti System Head TDH Ft Forcemain ngth Dia. to Well SOIL ABSORPTION SYSTEM Inside Dia. Liquid Depth PIT DIMENSIONS No. O:9R BEDITRENCH Width Length ~ No. Of Trenches DIMENSIONS t Z W N SETBACK SYSTEM TO P/L BLDG ELL LAKE/STREAM LEAManufacturer: CHAM~ INFORMATION Ty pe Of System: UModel Number:Q `9 it 1, JAIVKAIT01111#1- DISTRIBUTION SYSTEM S FtN Hole Spacing nt to Air Intake Header/Manif9jd Distribution X Hole Size x N Pipe(s) Length Dia_ Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Mulched Depth Over xx Seeded/Sodded Depth Over xx Depth of Bed/Trench Center `f' Nl Bed/Trench Edges 17 It • Topsoil Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: j Inspection #2: Parcel No: 23.31.1'9.926A30 Location: 622 200th Ave Somerset, WI 54025 (SW 1/4 SW 1/4 23 y31 N RI 9W) Serenity Lot 4 ~~OpQS~ `o30 1.) Alt BM Description = ~ S N0~ I~ 9U--r ?L~~ i 2.) Bldg sewer length = p - amount of cover = ~Z•7 1 Na -46 Plan revision Required? R Yes Fr~.No c~ Fg Date ICert. No. Use other side for additional information. SBD-6710 (R.3/97) v~r County IX COUNTY Industry Services Division ITY DEVELOP 1400 E Wash on a Sanitary Permit Number (to be filled in by Co.) P.O. Bo 2 7yo S F 3 Madison, WI 53707- 5~9az ~O~'ss,oxP F SIT C~'•~~^~ I jr.Nlt Permit Application State Transacts nNumber In "ON SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit r(]' is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary Project purposes in accordance with the Privacy Law, s. 15.04(1 (m , Slats. 1. Application Information - Please Print All Informatin Property Owner's Name ' Parcel # Property Owner's Mailing Address Property Location / 26 222 Govt. Lot City, S to Zip Code Phone Number SNf '/4sW '/4, Section (circle o T 31 N R ~p E or(V~~' II. Type of Building (check all that apply) Lot # / I or 2 Family Dwelling - Number of Bedrooms Subdivision Name ❑ Public/Commercial - Describe Use Block # o 0,5~0_ 16 V1, - ❑ City of ❑ State Owned - Describe Use ❑ Village of n CSM Number Z 0_64- w ZL r LZ { 0 Town of r III. T pe of Permit: (Check my one box on line A. Complete line B if applicable) A. New System ❑ Replacemett System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit tiNumber and Date Issued u~ Before Expiration Plumber Owner 4d ` C IV. Type of POWTS S stem/Com onent/Device: (Check all that apply) Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil C Holding Tank Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersal/Treatment ea Information: Design Flow (gpd) Design Soil Application Dispersal Area Required (sf) Dispersal Area Propo d (sf) System Elevation Rate(gpdst) q5-1 /4~_ < VI. an Info Capacity in [EEI Gallons Total # of Manufacturer w Gallons Units ~ c a . New Tanks Existing Tanks 5 a U Septic or Holdig Tank [ ❑ ❑ ❑ Dosing Chamber ❑ ❑ ❑ ❑ ❑ VII. Respo sibility Statement- I, the undersigned, assume respans' . tty for installation of the POWTS shown on the attached plans. Plumbe ame rin~Plumber' tur MP/MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) / VIII. (:ounty/Department se Only Approved PoVtsappmed Permit Fee Dat Issue Issuin gent Signature rven Reason for Denial $ IX. Condi8 ffirEF easons for Disapproval 3~ ~Q<<i.~.4 6WLink, effluent Me 00 Mspersal cell must gll be SBrvka / = 00404 as per martagtememt plan provided by' plumber 4-eetb,lck requifpnenE mustl?gittaiittain . 3; A Attach to complete plans for the system and submit to the County only on paper not less than 8 1n x I1 inches in size G G - _ n - ors - _ _ _ _ - If hl--- IIL _ l c2cl CONVENTIONAL COMPONENT DESIGN Residential application INDEX AND TITLE PAGE '•kG:?v.,v,:~~S•Y,.L i$iiitik`.ilh~:-:4~ Project L;_. Y •.:v:.C"n1'+Y'i', ':Y~k...• -ti"'--?':}'4YYi5: 'f•, .ry J•w: ?~C •'`~'::c "'\'+'a` apid s.'"~.+'•'~~• tY'.v^.. ,~<:-i..: r<-~. v r,+~bt`2k`~~`-+'~ Nam Owner's S-,:'~'•:`~-:+~~M sv:.~'~Y`•'a~",'N^`•ef~c~~?~:'~~*~:;<:e?~C<?~3;c~~•f'•~,'''',` "tit •'%.S%"`-?+;~., "Et" Name. 'mat- '-nv'•i.,..'`.-'" ?•yy`5a t Y.h vY 'a\'+_.'i•,\_'uy .~,..,.v}y~ j. ::s:`-r., Owner's :\~Q,r,~~..'• ,.••t:.~~•.-. '4hi-:•:a?~-- oy''~cy~sv-"Si:v:i:•}hr~Eaa.~?'P-•~'` /~.1= ;'[yj Address: r r r 'i• 1~a Y~~ ) '3Fv~{kh Yti nJF:- ::f,• :~~•,'+G.:~r: ¢:.~-rk~: /i~/~Y.f..~•~ : ' .9 01111-1-1-1 111 WIN ^e: ♦Y .~,<~}:}-^.a:•: aY'tit'S::'~'-,<:ti=?=;A'Y8'ke=aziy-:8-s:,c-'+,'•'_, ? lF~ 1~ff'' ~ y - l\ '<'ii<~:k`,'..2' 4 tD'}•`.y+~t f.$£' 'Y- j's~"v----Eft Legal Description: ~S > Lot # Subdivision: . l Town: County: Parcel ID# ~~--~=--~o -(:~r ~ f License *--,-2a Designer/Plumber: Date: Signature: Comments inocianorl nnrc//ani fin tho In_f'rnnnrl Cni) Ahcnrntinn rmmnnnPnt Manual fnr PnvvTS verrion 7-0 - D I - I , I - I I ' , j I I I I Y I _ I I 7,1 I ' 7b I I I , I : - J I I a sa bsor~on Ib` @In ,Dww won e~tii. e-a.+~ 1 ! eft Grade 4° Sdwdvle4O PVC Vent Pipe / , _r ft wm Veal Cgp ~--r Leaching Chamber systern Elevation t. a t,~nrnition Sysi+~ a Plan VI"" -ft Trench ~ Leaca',ing Vent Or Observaetion Flpe Chambers ft Trench 2 Header Leachi C-haertber Saectfo~ts Manufacturer And Model IJOEfflon Rate g`_ sq it per Chamber Soil APP EISA Rafin - Chambers J Sol App~on Rate _ EISA = Ap- gpd Design Flow 2 rows of chambers each. Page 3 of 1 ' ' S O y~ TER PL-625 FIL _~S INSTALLAAMON INS UCflON-S Opel" r :.;q.. : ,.•s 's~1~ Y .:Y%- : f,,r~ sv~,~ rz : Sr' - t Y' y k . ~5 n00, . F b Sx! 'i. ' {:f~''-yam _ £ ~ ~ '~`~e 0-:5-R-1- -M Step 3. 'the h on Step ~i: Win: . t of the septic, tank {A} Before ft (A) Glue the {A} Locate of fftr housing on to ~ outW page- a" pipe- (B) Remove tank cover and pump tank Malca sure that #0 housing i the necessat3'- is sotheir can be housing, is and removed front the tactic fat' coGWftjdgS rny Inserted to the housing. tn~rttenance and ice. s a•*a~3reaF'^'*6om°'s8P'~ n~ r r t ~ mm`oirnrmrs MAINTENANCE INS €LctIaNS Tgi mill ,yy rt~f xf ¢ art r" ~ Xc-` 'tJ' 8~-3 rf3: a~'•.' 'M _ { ups? s i r `•~u..£.. 2 t.."""'rte- '•'..'~-'ice ; +y.~rC.r , .3 y ` ...,.s se.-~~ ""4'L ~i •"'+7,Y . ~a•" L i~ ~s`1L. H' s~^'y".'~ ; fG ~~5- _ a~,y. ' Step 1: . y~tanlL ( Remove tank cover and pump (A) Youth if necessmy bib the the ~V ' g sere Lata ft Outlet of the F - me aw Is if aWed Pug #I r out of Me houektg. ~ © a tip m s s x~ (8) and compw*in sepwulk . (B) Reese 9epft t3nk Wler -R 513 surest r 1171 of POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page SYSTEM SPECIFICATIONS FILE INFORMATION ❑ NA Septic Tank Capacity 9a1 Owner - O NA Septic Tank Manufacturer Permit # ❑ NA Effluent Filter Manufacturer DESIGN PARAMETERS ❑ NA Effluent Filter Model ( ❑ NA Number of Bedrooms gal NA 1NA Pump Tank Capacity Number of Public Facility Units ,IfiNA Uday Pump Tank Manufacturer Estimated flow (average) a NA Pump Manufacturer Design flow (peak), (Estimated x 1.5) al/day NP, al/day/ftz Pump Model E¢ NA Soil Application Rate Pretreatment Unit Oil & Greasy <30 Monthly mg/L average* ❑ Sand/Gravel Filter ❑ Peat Filter Standard Influent/Effluent Fats, Oil & Grease (FOG) <220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BOSS) :5:- 150 mg/L ❑ Disinfection ❑ Other: Total Suspended Solids (TSS) ❑ NA Monthly average Dispersal Cell(s) Pretreated Effluent Quality In-Ground (gravity) ❑ (n-Ground {pressurized) Biochemical Oxygen Demand (BODS) p mg/L ❑ Mound 530 mg/L jd NA ❑ At Grade Total Suspended Solids (TSS) 104 c#u/1©0m1 _ ❑ Drip-Line ❑ Other: Fecal Coliform (geometric mean) c - Other: Dri ❑ NA Maximum Effluent Particle Size ya in die. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE Service Frequency Service Event ❑ month(s) (Maximum 3 years) ❑ NA Inspect condition of tank(s) At least once every: W ear(s) When combined sludge and scum equals one-third of tank volume ❑ NA Pump out contents of tank(s) ❑ month(s) {Maximurn 3 years) ❑ NA At least once every: 0 year{s} Inspect dispersal call(s) [5 month(s) ❑ NA At least once every: K year{s} Clean effluent filter ❑ month(s) 9 NA alarm At least once every: El year(s) Inspect pump, pump controls & d month(s) NA Flush laterals and pressure test At least once every: ❑ year{s} ❑ month{s) Other: At least once every: ❑ year(s) ,0 NA ❑ NA Other: MAINTENANCE INSTRUCTIONS an individual carrying one of the following licenses OPcertifica Tank • POWTS Maintainer; Septage Servicing Inspections of tanks and dispersal cells shall be made by ancracks r. leaks, Master Plumber; Master Plumber Restricted Sewer, POWTS Inspector; missing ken har inspections include a visual um and toocheck~fa any back up oropond ng of effluiden ent on the ground surface. for measure the volume combined 9 pip any The dispersal cell(s) shall visually pen to check the effluent levels in the efflent on the ground surface may nd cate a failing c ndiition and requ es he of effluent on the ground surface. Thepond9 of immediate notification of the local regulatory authority. one-third (Y nk volume, more of the the When the combined accumulation of sludge and scum tank equals and disposed)ofrin accordance awith chapter idRe113, contents of the tank shalt be removed by a Septage Servicing Operator Wisconsin Administrative Code. feels, pretreatment imited rvicing to the ilters All other services, includ' inn but nos sof 512 months eshall be pertolrmedfby a cert~ed QOWTS Ma~•intan~erCOmpo units, and any servicing service event. A service report shall be provided to the local regulatory authority within 10 days of completion of any GMW (4101) Page /I of START UP AND OPERATION For new construction, prior to use of the PO damage the dispersal cells) If high concentrations are detected have the contents that may impede the treatment process and/ 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. exces sursface waste Later will of discharge During power outages pump tanks may fill above normalhighwater the levels. cell(s) and When may power is result in the restored the backup or discharged to the dispersal cellist to one large doss, overloading controls to tank opera ing therpump rvicing effluent. To avoid this situation have the contents of the Plumber or POWTSPMai tainertodasby a sist Sept power to the effluent pump or contact a restore normal levels within the pump tank. soil llls. o n aredriv a e or park over, or otherwise disturb or compact, the area Do not drive or park vehicles over tanks and dispersal within 15 feet down slope of any mound or at-grad l disinfectants; the may eduction or elimination of the following from the w~ecotto~~ bs;tdegreaserse d perform tat foss and diapers prolong the mrife edications; oil• at; R POWTS: antibiotics; baby wipes: cigarette butts; condoms; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides. meat scraps; m painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out o serviceomm 83the ollowingsin steps shalllt6e to en to insure that the system is property and safely abandoned in compliance with chapter seated. • All piping to tanks and pits shall be disconnected and the abandoned pipe openings • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. all tanks and pits shall be excavated and removed or their covers removed and the void space filled with • After pumping, 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 aceme rep of a replacement system: for the loc absorption A suitable replacement area has been evaluated om disturbance a d compaction and shoo d (not berinfringed upon by area will system. The replacement area should be protected and required setbacks from existing and proposed aatntuo stab's a suitable replac'lemure ent sea. R placemlent syst ms must result in the need for a new soil and site evaiuio comply with the rules in effect at that time. advances in POWTS last resort to replace the fatted POWTS limitations. Barring ❑ A suitable replacement area is not be installed as available due to setback and/or soil the site technology a a holding g tank may Upon failure of no replacement area is a affable a h 'Iding tank ❑ The site has not been evaluated to ide nreplacement lrsees. area. evaluation must be performed to locate asuitable may be installed as a last resort to replace the failed POWTS. cted remo ❑ Mound and at-grade soil absorption systs may be recon comp y with in place ill wing at that limf the biomat at the the rules effect infiltrative surface. Reconstructions of such Y < <WARNING> > EN. DO NOT SEPTIC. PUMP AND OTHER TREATMENT TANKS MAY C UN~NAi11lY C RCU~MSZANC~ Dl ~~-~H MAY ~SUL~GRESCUE O A ENTER A SEPTIC, PUMP OR OTHER TREATMENT A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS ~ POWTS MAINTAINER POWTS INSTA! Name Name Phone Phone ~S n - LOCAL REGULATORY AUTHORITY SEPTAGE SERVICING OPERATOR (PUMPER) Name ^ Name Phone Phone This document was drafted in compliance with chapter Comm 83.2212)(b)(0)W&(f) and 83.5401, (2) & (3), Wisconsin Administrative Code. I ST. ct o COUNT SEPTIC T.AN~ lv A NrIENANCE AGRI EIMENT AN-D OWNERSOF CERTIFICATION FORM Qwner~Bu er , i a address Property Address (Verification, reared from Planning & Zoning Department for new construction ) S Parcel Identification Number i CitS't rate i } j LEGAL DE,oc RIP'f`IO f F1< Sec.. N R W, Town of r Property Locations. 1 l:' f4 Subdivision Plat: 1r' M:a , Lot # f r Volume ` Page c ertified Survey Map # ; (before 2007)Volume , Page T Warranty Deed # Spec house C yes .0 no Lot lines identifiable, yes o no Ci ANTD OiNTER CER`l CATION Improper use and maintenance of Your septic system could result in its premature faik re 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. 38352(]) 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 lumber, restricted plumber or a licensed pumper verifying that (1) the on-site was er and d a master plumber, journeyman p condition and/or (2) after inspection and pumping (if necessary), the septic tank is wastewater disposal system is in proper operating less than 113 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 ofNatural Resources, State of Wisconsin_ Certification staring that your septic system has been maintained must be completed and returned to the St. Croix County Planning cgs Zoning Department within 30 days of the three year expiration date. Ii-Ale certzf; that all statements on this form are true to the best of my/our knowledge. L'we am/are the owner(s) of the propem. described above; by virtue of a deed recorded in Register of Deeds Office. Number of bedrooms i SIG'~iATLRE OF APPLIG_ANT(S) DATE i -.Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Departmeat. * Include with this appficatian a recorded viwraory deed f rom the Register of Deeds Office and a copy of the certif ied store} map if reference is made in the warranty deed (REV. 04n2) r ~ a Wisconsin Department of Commerce S REPORT Page of Division of Safety and Buildings in acco nce with Co'b' A County Attach complete site plan on paper not less th S 1/2 rf4,~;i0ches in'siie: PI must !p 3 ~s o~ include, but not limited to: vertical and hodzo I reference p int (BPI), direction and Parcel 1.01. percent slope, scale or dimensions, north a w, anriloGaltlon and distagce to nearest road. `r'~ Revi Date r, Please print all i 4; j _ ' i Law, a.15.04 1 m . Personal information you provide may be used for secondary pu (Rn,edy O t Property er Property Location ~Z(!f} 30 011 Property Owner's Mailing Address f~ Zip Cde Phone Number Road GNmrownNporast Rl" GPD New Construction Use:f ~ Residential /Number of bedrooms- Code derived design flow rate ❑ Replacement ❑ Public or commercial - Describe: Parent material 1'7'-k2't6tz Flood Plain elev n if applicable tt General comments J AI am- and recommendations: 1:51- 1/44 1-- v Boring Boring # 1~I I~ Pit Ground surface elev. ~7 ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *E GPD Eft#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ~ R W Boring # Boring Pit Ground surface elev. „[jft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 .c S * vent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mgA- * uent #2 = BOD < 30 mg/L and TSS < 30 mg/L FAd]dres ag Ie Pri t Signature CST Number v' Telephone Number Date Eva nation Conducted e , r Property Owner Parcel ID # page of 0 Boring # r❑ Boring ~y Pit Ground surface elev., Depth to limiting factor:/ in. Soil licetion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Efl#2 9 4 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence BoundaryRoots GPD1f- in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Etf#1 *Eff#2 4M ❑ 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 GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODO > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD, < 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 (R07100) P"" OmarRHO ~ of 12 9otin8 S 6roa~dwhoee~v, OepIA b Caesitlrg taelor-yin OR Rate Htttisen Dep1h Cantu Redex DtipGm Tahre 8mtxsn C+msietstroo seumdety Rom QPW in. Min" Ou. SL Carts. Cofer Or. 8a. Sh. 'Eflit 'EASt Y ~ J 9 y At~ ' ~ BOrhip t {.J ~ d Pd Q"wd suttees elsr. R. Oepth to Ikr ft (,;W Nt HOMM Cep1h DoxiroM Cotor Redex OaseripSOtt Tttr~tns 13ffttahtse t ernietsnoi! BowxNay Roots t3PL>flr in. ttWrtses am. ex. Cont. Cola or. 8L Sh. 'EICPt 'EiM2 r Cl Cl Pft Grotrra t trisooalev. fl 060% to l M ft bow iA wor4rat+ MwM our"" Cob Redex Dttstn~lion Ta*m &a"n Cor4W&m faotstdery Raole in. Muttselt tau. Sr. Cat Color Gr Sx 'El~t "F.l~T tillptertt S4 Bt?O, > 80 S ?$0 mgll snd T516 » w 750 mgA ' E11Nrant 42 = 8170 5 50 ngA. And Ts8 190 mplL The D'Oertsment of CoCnttteree is m tgtati OWftL%1lty retviae provider aad employer. If you rued 4ni"MM to W Ms services or steed mater iR On sltaDke th mss, P congas the depa, at 6042663151 or TTY 608.264-9777. . „ ..nrr~ ; win.. `~'_aa• - .r..... n , nn• ;xn r ~ ~ w'",mow„~Vi ••4• ~ ~ ~ .°O~• n.•. • ~ : . • _ , , - , • _ : ~ ;-,/f/.ago , - •.w ~•...f...ax+.JC•~ ~J,~~~,r l e~ ~''~G:~/,.fem. ,~rc~.c • ~ , . 871 p 404 Z5 Ile ,:Z4~5 Z- Parcel,#: 032-2095-20-100 03/28i2008 04:35 PM PAGE 10F1 Alt. Parcel 23.31.19.926A-30 032 - TOWN OF SOMERSET ST. CROIX COUNTY, WISCONSIN Current X Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 04/25/2005 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - CSC DEVELOPMENT INC CSC DEVELOPMENT INC PO BOX 268 SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ` 622 200TH AVE SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 5.162 Plat: 4973-CSM 19-4973 032-05 SEC 23 T31 N R1 9W PT SW SW LOT 2 PLAT OF Block/Condo Bldg: LOT 04 SERENITY EXC AS DESC 1337/584 BEING CSM 19-4973 LOT 4 (5.162 AC) Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 23-31N-19W Notes: Parcel History: Date Doc # Vol/Page Type 03/30/2006 821796 WD 08/23/2005 804286 2873/310 QC 07/14/2005 800252 2842/572 WD 04/25/2005 793156 19/4973 CSM more... 2008 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/05/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.160 58,800 0 58,800 NO Totals for 2008: General Property 5.160 58,800 0 58,8000 Woodland 0.000 0 Totals for 2007: General Property 5.160 58,800 0 58,800 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