Loading...
HomeMy WebLinkAbout032-1045-80-000 c O 3 c d ~1 ge --o o v i g• 3 • 10 co 00 n s o m uNO o w chi ' o o °w 3 a ° , c°°n 3 CD CD C Z o ro N rn o M m = c CD oo =r 7 co cn O 1l CD 91 N Dl N CD -i O O1 CD C- 0 O 3 O 7 7 O r N N m! ° O O CD N 01 (n D (D cfl (D N a A (D N W _0 (D 3 O - f0`D (O\D C O K) CD U) L F~ z co to n r cn C') m En :d I En ° m 0) (D N° cc o w o > 3 3 (D pd W. (n T M 'a 'j (D w z O O O tv rt m x o r-3 < Z rt G N No D O F. W *z m ia v W F-' 00 H " ::3 0 N t OM N (fl z 000 C-4 = 3 cn j H o O _y y (WD O 0) O a F-i 0 (D N N N. m .0 tr . r * m v `i ~ O _ N l F' j' w m d -4 U) (D z p Z (D O W1 0 CL A O 0 Z g ` W O a~ 0. m C 1 rh F a z a z (D FJ CD (D c3 h{ o K In (n (D i O w rr L I ~ rn v a I 0 o a 0 m N d A n 4 W N O A 0 N (=D O Q O O b b 0 CD v, I o a O N G t C -1 d I c 7 !(D 7 <D n a , A~ -0 ! a # .c* (D T I Dt N n ID 3 rr " v cn 3 2 v z o ao cn I z 2 v, z W o o- °w `C O• 3 E' 3 0 c o M 0) n o CD m j o 0-4 co CL z a m y 0 0 1 (D n o m CD~ CD 0) CD a m m a N I CCD n a o m° ho °o c m' CD C- CD rn m a o o !i 3 7 N 7 N 1 0 fll C ' I ~ C CD i. ~ r~ Ril Sj l~V CD (a CD U) CL 0 U) Vl m =r 7 W .0, 1 CD C 3 O m co =r O rt A m (D m I cn . 0 r- CO) Ul ° c o rn rn cn o CD 3 3 I 3 Z 0 0 0 0 0 0 A m y v v CD v v o o I o ~ m ~ eD N o I - m y~ '0 00 7 3 01 o 3 d N N ~ I a 7 z W z ' z w z o 0 D n CD 0 p D° 7 0 Er I M, ' CD CD CD m Cn t~l CD w CID w c rM N CD I N CD CL CL W CD !D a 3 7 3 7 Z (D C6 (D (6 -I fn 0 0. I 0. A C 0) to ~ CD m < a3 I c.3 ~z a A o " I o " z y z z I w g I wCD ~ i CL a I m m coop n o -n vrn° n 3 3 v c m' m c 3 o cr N 7 7 CD z a 0 0 o 0 CL w y i `-N o rr CD N y cn C to E; CD CD m =r CL cD ty o 'a (D G) ~ ?=r0 Cf) o 0 =r CD 0 G) I '=r _ S Z CD m CD 0O m 00 kj 3 co rn ° a, CO 14 o o b, m I ti 49 o ° I o ° e o ` o o I o s. ' Parcel 032-1045-80-000 11/1612006 11:55 AM PAGE 1 OF 1 Alt. Parcel 16.31.19.229C 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - SCHACHTNER, JANET E JANET E SCHACHTNER 2191 40TH ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description 2191 40TH ST SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 3.020 Plat: N/A-NOT AVAILABLE SEC 16 T31 N R19W 3.02A IN NW NW LOT 1 Block/Condo Bldg: CSM VOL 3/821 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 16-31 N-1 9W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 760/432 07/23/1997 752/164 07/23/1997 f211644 ~ 1 p 2006 SUMMARY Bill Fair Market Value: Assessed with, 0 Valuations: Last Changed: 07/05/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.020 48,100 105,400 153,500 NO Totals for 2006: General Property 3.020 48,100 105,400 153,500 Woodland 0.000 0 0 Totals for 2005: General Property 3.020 48,100 99,700 147,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 502 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 PARTHSOMERSET T•31 N-R.19W 51 PO K COUNTY Il QP' IL g oftanwood F ia9% :e a /a is f 6 ay P. L.eo} r .4 6F% r ✓m ry T/ac O • L. Cj¢i/ ® O~ Land Co. M MacJ£en ado /zR Ioc/`on B/9,f•5 O .13~ t1 S Anson ~ a 72 ~ • .uz fpYc~i76 ~xm:/ 7' f3o fc °N •~B ~14 ~(S E ~ry 77 Fo 0 ~r' tl CS z 5 /yau('/ca W. CYG.n 2 <7L/%us d Edward i~ 0 po /y479 Ma//h /zo• ustsgvs chic t*.oq t~ E Mh~n' 6e n l on3 o io sMn~.4 /SO VOV~h¢ron 40 /EO Ha~o/d•J ~+C lV FPB /57s Z1 6~' z n 'rswc'rs Coch a.~e _ chacht~B.- ~ ,c 3~ ~ ~ l C Ja s Fe/'n rR L /o. 0 • V 3 b w ~za oa0 ~ .75 ono ~i~a t . o a.'b zoo O'C /eo N 3tl ~00~ la~ e 1-4 ` 3 7 40 Cha /e 6 0 / RD. LF L£ RUN F Fred C`tl p Mi a Bo 3~ O i°' cYil: H C ~0~ w~.V /lrogma., ~ ~ v w~l\6ehra /Ben 74 1. 0-9 cook h.vo~ w~ hC tl v n y v n tl y 0 l et¢/ LAL" SIDE • sz ~S.p g p o C v l O Car/ L •ptlo C \ \w, - ~ O~C~ Coh Weschcke \ b Ci 0 rz° J y o B° Bo i b, SS \ na/ E p tl l v a rrQ~~,ra a s°~of y tl a ~ql,Nn zoo ' ai//ayeon C O o>~ o S • _ So • ~ ~ \ ~ ® 'In /NE L ~ Wi/fled 0 .C3on~n~~ 4 Four h ,6a f~sY-~i• C ,C\ h~ w Fiad O J C P/ourd e • .Pa/ h ~2 rho d ljai// z 0/711 h Q h C7c 0 l H n3 Kay an /4o P { E/a neon t Mis a/oo/s ka L•"nei% ~o ~ _:::::'W.'/m¢fFi-ed.Y P/ou de Se/mew ~ Quinn y9.aB /i6 zoos p C fo tl 0 'MALL go • vchachtne/- i6O M%d e i6o p W R E L a COOk W N L S /6 o RO. E-/LIRA AW KLL - /o.1- AIOI O onna R c. 4 pTohn s Lo~c- U S. F/. e~ . ~ -k 27acwin C WiYd Tan ~y h'Qnne/' ai ~e C l /sue µ.%ma f F ed 1/ { G/o/va a tl 0 •n 40 m 7o a/}e 4~ o L A' cSChaChtnBC' JQCyue/.nz 17odye . . MA4L__ h Ed aix2Eo U 0 9 ~t~. ~ s .ai9 X56/sv~ /s4 \v ...t .u,4`YFipiers: ~k~y FJnn y ~ Q \r /sa W/LOW O 05 . F.tL. HfD. e'ca/ _.rJ. j M RoBf IF/ C. 74 Z o Edrnun Waif Q/t i~se~uX C Toh f IJoci O /er M4/ H."; C y.o Leona C /yQn~ec LuedtRB Tana `e// G7/X 9 E i7/beet p 7'R %xz' , 60 p/ y v e/f b l h l 4o V 79 1. q : //o mns>ir Q.Qq ohn 40 2 A C 0 Thar Rob t os. s Cook v f!a o/d 6 7 /6 0 .Pii'ha!d 0 W\ 2 as e/ Mai aana y/~. rqo-/z f Gudr/ a j ~tl b : son to// eibe/ .n°o:lsn Z Cacufe/ • b F h Ci ma/.~ v q.o 1 I i 40 .¢0 40 • 40 71- S 11j ® • Bo N/LL • D. 4 ~ _ . o O o c a Jeo. • a ~cha2t c. \ d\ a W L NO 3 ~U ,lobe t Dona/d Qe main t? W C,~4 tl eautu W v ~~"OJ BI '3 R Marsha// f .Penee~ 69 Q C V L F 60 ~f 6X a si ' 1 a}}o f/ % l hx N /6 o Cac / No/mon .r U ❑ S'ye~Q t cSi/h¢ ,(O~~e9 c/! • /bo = BO fBo nB ;J 0 ~L s ss 3 ' YO N GRio W. T RTLE • d pp•• • / • ~7/ 4s • '6: t¢sts Honk 0 9~ WiY/earn • uc~% tK R P° cn°~0 o v /3ai//a Bon Schad v AzO i3o35J• \ Ca fad \I .V 2 ` JS~ 7SS /SS M Bn Ao ` KBpDS ~y z. Loc a.ne rte z7 u`•h ~ a a e` a d /.6 is/c rza P £ > @ , GasPai-.3 x i s Bcma:n ~JF .3TZ3 CLIFF • 3 • Q ti E CarnPeaTURTL 65 .£M.2a io u • airL p O V H 4o W ° \ ,fl VIEW q) fE /een N C Dei/¢ ~/en.Br/is/e R~-~an iaa~- ~ ~'o E'a ! V~~ G n 0 h Nso a @ t'~ en• /os-Q Hansen se/ i%7 ` l 0 t~ 0C ~SF f a vc ELQOna,d 8o Lb N ~tl C/ate _ Ea/-/ L. f E/. abeth .7¢sn.Ee O lieor• e T x Pgw ~PP / 9 / • ~V 4% - Pennock 74.x4 ¢e Newmnn s9 Fe/:r 7 ccf Do aih e of 4q/en v tl eme Linda Gi,ja Tam - J~ v/ . z2 7.7,5- Wi brae .:e J Ccce/ lam y °O~ Law- F /ed¢ h' Cons°nt 'N. u d qa 40 .z7n c.iQmH¢ii- JH' 40 V z /.so • 'N1cDeiino} 4O /os LBOna d Fianci~.Ti IGN a R/OGE • DA. Ile[ I!r9N1 /s s F 8o g0 aite ~ o a ~ so.9. son n¢ {~/~'o w~ f Toyce ~ V z en C N ~ 4o ErJi% 4"9 • ~r= 7.i z MoBo n N 1 go ~ C ~ .Pob X ~ a pVe on 6 Louis c a_1- ~ua~e LN W tl~ ° ~ ~s/Gn ae tl y •0 (i1- e'.~ L .O efiy Oe°.t .ce- Le,.,_,;i-e Q% L W0 et¢/ tl\~ o® N r• Laa so ¢ fesn8 MacfcU o Q.¢ l.~ q U l 0 . ~tl 1r// s SJ P 52.82 B.. 4 at\ tltl~ }3e/~s/e G ~Tohn E .~1~ 9s Le 'ni l'+. 0 /zo 'y V V Y2nc. ~b s 40 °Ch tl 2 A491d)•IYAti111_J1~~1/ N 11 ) ~ ~ d ~ ,Q/°rn ppuffs/; U 3S + /9 e \vc~~ W z Ric - i6 .s ar,~e o0C ya 9° som E'.~ C661. vN siw.A.L KQ c~ GNo/combC~oa~ rra C r. cTS'.'-~nK 46s r P • 1 44 a4 zo 00 /NE R• R• .00 a< © L/ Q4 tCcoix un QA! Wis i9m9 iQacKforrL MvioPub/s, Inc.,iQev./s7S S££ PAGE 53 BANK OF KASTENS SOMERSET L ANDRY SALES & SERVICE L ANDSCOPING New Richmond, Wisconsin Save With Us - Help Barn & Feedlot Build Your Community Black Dirt • Crushed Gravel - Driveways Equipment MEMBER FDIC Landscaping - Fill - Blaektopping Patz-Merrill Phone: 247-3348 247-3480 or 247-3791- Rochester Silos Somerset, Wisconsin SOMERSET Phone: 246-5181 - RfiPORT OF IT]SPECTIO?1--INDIVIDUAL SEINAGE DXSPOSAI, SYSTEM Sanitary Porn, it /J r ; State Septic TOI•114SHIP t. C Ix ounty SRPTIC TA111% ' L Size gallons . `umber of Compartments , Distance From: hell ft. 12% or greater slope ft. Building* ft. Wetlands f. Iiighwater ft. DISPOSAL SYSTE:2 ile Field or Seepage Pit(s) Distance From: Well ft. 12%.or greater slope* ft Building ft. Wetlands FIELD rlighwater ft Total length of lines ft. Number of lines Length of each line _ ft. Distance between lines ft. Width of the trench ~ft. Total absorption area sq, ft. Depth of rock below the in. Dp-pth of rock over tile in. Cover _ Dver.rock,, Depth of tide below grade in. Slope of trench in per 100 £t. Depth to Bedrock ft. Depth to ground water £t. PITS . Number of pits Outside diameter ft. Depth below inlet -ft . Gravel around pit: `yes no. . Total absorption area sq. ft. .Square feet of seepage trench bottom area required :square feet of seepage nit area required, r Inspected by: Title':. Approved Date 197 Rejected - Date 197. State and County State Permit 67 PLB ~5~' Permit Application County Perm' for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF _PROPERTY Mailing Address: G 'r -LL,J Gs,ee', ~ r ~ aox /A B. LOCATION: w. '/4 , to., '/4, Section T N, R_LL (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township So rti o r5 cT C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) Variance Single family 7C Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY 4,600 Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete- X Poured-in-Place Steel Fiberglass Other (specify) New Installation Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area -I:L sq. ft. New Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: X Length- 3 Width / DepthT° 'U~ Tile depth (top)- ''MA= o. of Lines- Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits- Percent slope of land i e-. Distance from critical slope WATER SUPPLY: Private (A Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Certified Soil Tester, NAME P44 el n f~ N r" r/c% 5, e, f, C.S.T. # 2,- and other information obtained from V,' (awoor./builder). Plumber's Signature _ C', c j . MP/*Pf m# Za : Phone #Q'W -3 Plumber's Address _Q -"5 i e?2 = 3 cC F>« L cq f;tlci~ 3'Yv,a C PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. F7 /o- o ®i .U.... F° Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMEN USE ONLY Date of Application t _ 7 Fees Paid: State 6) o t Dat C Permit Issued/ d (date) -,Z- 7 I Issuing Agent Name 9 Inspection Yes No State Valid# Date Recd 1. county (whit copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 7/1/78 .115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH - P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: Section &L, Td-IN, R! 7+Elor W~, ownship or Municipality 4SFT'JY! 4;_A S"C J" Lot No. , Block No. County Z k Owner's Name: & 914 6,d /Subdivision Name Mailing Address: 6_//17 2 S'ce, o 4/ TYPE OF OCCUPANCY: Residence- No. of Bedrooms -3 Other EFFLUENT DISPOSAL SYSTEM: NEW ADDI ION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS 3, A5-~ PERCOLATION TESTS 3 SOIL MAP SHEET 3 FF 9 SOIL TYPE 11-57 PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL RATE BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN P- A~ O- T f 115 C C.) 7- S ~0 A / P-3 5- C9 -79AIJ5- - 7, /0 7/4r, SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) U L 2~ 'I s 7fr U .~g f3iv y 7A~ 7 5 PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square fee of suitabl rea . Indicate number of square feet of absorption area needed for building type and occupancy. , or distances. Give horizontal and vertical reference points. icate slope. Indicate scale I ~ 4 i t N m ` 'n i .e [,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best ow edge and belief. Name (pri t) c) NC ~KJq~R f, Ci N SO Certification No. Address 10 1!_D. 2 t Name of installer if known a.~ w• f CST Sign COPY A -LOCAL AUTHORITY atu Form- STC-104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP SEC. 14 _ T ,=2j_N-R1'9 W ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT _ LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I•LHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ~ ~fp Q'01 _ 93- / ~ ,6®,41 k,3 , . J I c ~~3 INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used t Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer:P _es LLiquid Capacity: / Number of rings used:_ Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation:/ Number of feet from nearest Road: Front,O Side, Rear ,"1) feet i From nearest property line Front,O Side,O Rear, feet i Number of feet from: well building: (Include this information of t e above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER • Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear, Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: ~L Trench: Width: Z-2 Length: 0 J Number of Lines: _ Area Built Fill depth to top of pipe: -KO- Number of feet from nearest property line: Front, O Side , Rear,O Ft. Number of feet from well: Number of feet from building: yL/ (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, OFt. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: , is y S Dated: - G Plumber on job: License Number: 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING ' MADISON, WI 63707 XAICONVENTIONAL ❑ALTERNATIVE State Plan 40. Number: Holding Tank ❑ In-Ground Pressure ❑ Mound I It assigned NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER tNSPEC ION DAT 100 Ja*set Sachachtmer R. R. , Somerset, WI 54025 a,'Lyo BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN- R O. PT, EL W.: CST REF. PT. ELE V NW NW, Section 16, T31N-R19W, Town of Somerset Name of Plumber. MP/MPRSW No Cnunfy_ Sanitary Permit Number: Cal Powers 1563 St. Croix 83856 SEPTIC TANK/HOLDING TANK: MANUF ACTOR LIQUID CAPACITY TANK INLET ELEV. TANK OUTLET ELEV. WARNING LABEL LOCKING COVER ~j PR~O-,V}DED: PROVIDED. I /O •~L9 L~IYES ❑NO YES NO BEDDING: 'TENT DL4. VENT MATT HIGH WATER NUMBER OF ROAD: PROPERTY WELL BUILDING. JVENTTOFRESH (L ALARM FEET FROM LINE AIR INLET: ❑YES NO ~I ❑YES NO NEAREST ) / / N S DOSING CHAMBER: MANUFACTURER BEDDING. LI OU ID CAPACI TV JPUMP Mf)OEL [MP, SIPHON MANUF AC T I Iff E If WARNING LABEL LOCKING COVER PROVIDED. PROVIDED ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERAWN _NUMBER OF PHOPEHTY WELL 18JILDIN( VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) ❑YES O NEA REST-1111- ~/T SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE _ T f NI,IfI 1111ANIF TE If INIATt HIAL ANJ MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BEd/TRENCH WIDTH. LENG iH NO OF UISiff PIPE SPACINI. COVER INSI()L OIA -PITS LIQUID /7 O TRENC-=1ES / MnT RIALJ PIT DEPTH. DIMENSIONS GRAVEL DEPTH FILL DEPTH UPIPF UISTR PIPE DISTR. PIPE MATERIAL NO UISf LIN PROPERTY WELL LDING VENT TO FRESH BE L~W PIPS ABOV C VER [Ft'S'V' INtfI ELEV NU PIPE NUMBER OF ^ _7 FEET FROM ~fJAIR INLET j Z / Z NEAREST ( 2 BUI u, 30 MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- ❑YES ❑NO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE IN FIMANI11 1MARKEIII O fiVATIONWELLS ❑YES ❑NO ❑YES ❑NO JDEPTH OVER TRENCH BED DEPTH OVFH TRENCH HE 1) UE PT1f OF Tf )F'S()IL SOUOE U SEE OF I) MULCHED CENTER EDGES ❑YES. ❑NO ❑YES ONO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH NO, OF LATERAL SPACWG GRAVEL DEPTH HE LUW PIPF FILL DEPTH ABOVE COVER TRENCHES DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL NO 1)1 T UISTH PIPE UISTR IBUI ION PIPE MATE HIAL & MARKING ELEVATION AND ELEV. ELEV CIA ELEV. PIPES DA DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING UHILLEU COHRECILV ]COVER MATERIAL VERTICAL. LIFT CORRESPONDS TO APPROVED PLANS ❑YES ❑NO ❑YES ❑NO COMMENTS: PERMANE❑NT MARKERS- JOBSERVATION WELLS. NUMB FIND ER OF PROPERTY WELL: BUILDING: - FEET FROM LINE YES NO ❑YES ❑NO NEAREST -7 0 r co 1'~ Sketch System on county file for audit. Reverse Side. SIGNA _ TITLE. DILHR SBD 6710 (R.01/82) e o~L R SANITARY PERMIT APPLICATION UNITY In accord with ILHR 83.05, Wis. Adm. Code ` STATE SANITARY P RMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 9 8/ x 11`inches in size. ` STATE PLAN I.D. NUMBER -See reverse side for instructions for completing this application. 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PETITION PROPERTY OWNER FOR VARIANCE ❑ YES ❑ NO PR9PERTY LOCATION -t n PRO TY OWNER'S MAILING ADDRESS / S T N, R E (or)~ LOT NU BER BLOCK UMBER SUBDIVISIO NAME CITY, STATE ZIP CODE PHONE NUMBER ITY , NEARES ROAD, L OR LANDMARK lo WN S VILLAGE : r II. TYPE OF BUILDING OR USE SERVED: - 43a - ~YS- a ~d Number of Bedrooms if 1 or 2 Family_ OR ❑ Public (Specify): Ill. PURPOSE OF APPLICATION: (Check only one in ##1. Check 2,3 or 4, if applicable) 1. a. ~ New b. ❑ Replacement c. S stem ❑ Replacement of d. El Reconnection of e. E1 Repair of an Y System Septic Tank Onl 2. El A Sanitary Permit was previously issued. Permit # y an Existing System Existing System a Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum req u rements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. 7aa-w SYSTEM: (Check only one in ##1 and only one in ##2) onventional b . ❑ Alternative c~ ❑ Experimental . . ystem- b. ❑ Holding c. ❑ Pit Privy d. ❑ Vault Priv In-Fill Tank y e. E1 Mound I. El IGP V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. X See a e Bed b. ❑ See a e Trench c. ❑ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED (ware Feet): PROPOSED (Square Feet): i VI. TANK CAPACITY Feet A Private ❑ Joint ❑ Public INFORMATION in allons Total of Site New xisting Gallons Tanks Manufacturer's Name Prefab. Fiber- Tanks Tanks Concrete Con- Steel glass Plastic structed App. Se tic Tank or Holdin Tank Lift Purl Tank/Si hon Chamber El 1:1 ❑ VII. RESPONSIBILITY STATEMENT ❑ ❑ ❑ ❑ I, the undersigned, assume responsibility for installation of the rivate wage system shown on the attached plans. Plumber's Name (Print): Plum is Signature: o St S) ' MP/MPRSW No.: Business Phone Number: Plumb is Address treet, Cit late, Zip Code): Name of Desi9rSer: VIII. SOIL TEST INFORMATION Certified Sgil Tester CST) Name t CST # CST' DDRESS ( reef, City, tate, ip Code) SS er: _ Phone NumbIle IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater Approved ❑ Owner Given Initial !a S,charge Fee ate Issuing Agent Signature (No Stamps) Adverse Determination X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Pill (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT ' APPLICATION I - TO THE APPLICANT: 1. This sanitary permit is valid for two (2) years; 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable; 3. All revisions to this permit must be approved by the permit issuing authority. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation; 5. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a license pumper whenever -necessary,•usually every 2 to 3 years; 6. If you have questions concerning your private sewage yster~,, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 608-266-3815. To be complete and accurate this sanitary permit application must include. I. Property owner's name and mailing address. Provide the legal description where the system is to be installed; Il. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 34 sea restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in #1. Complete #2 if permit is for tank replacement, reconnection or repair; Check experimental only if project IV. Type of system: check all appropriate boxes depending on system type. is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in #1-6; the gallons to b installed, total Vi. Tank information: Fill in the capacity name. every Ind Indicate prefab or s e construct d and tank materriall.. Complete number of tanks and manufacturer's royal only if for all septic, lift/siphon chamber and holding tanks for this system. Check experimental app Y tanks received experimental product approval from DILHR; Tomb Fill inh adesigner ppropriate prefx (e.g. VII. Responsibility statement: Installing plumber is to fill in name, license MP, etc.), address and phone number. Plumber must sign application applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; application is disapproved. X. Comment area for use by county or resaon given when app he drawn to complete dimensionsh location of Complete plans and specification Anotsmaanrah n to scale service; plans must include the following ) plot plan, holding tank(s), septic tank(s) r or r treatment st distribution boxes; soil absorptionrsystlems;replacement streams and lakes; dosi ng or chambe elevation refe points; system areas; and the location for pumps and dose volume televation d ffelrences; frictionrloss; pump performance specifications p Ps and performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system r required by the county; E) soil test data on a 115 form. GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection faw. This change in statutes was the Grou result of over 2 years of steady nP9oAsa~°~ for } a number debate. The p acdtiees whbiich Wiscor~in~sr included the creation: of surcharge (fees) effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried ~reas.Are is used in your building is returned tc the groundwater through your soil absorption system or the disposal site used by your holding tank pumper. YI e .~o es :ois „tec through these -:arch arg~s r -e credited to the groundwater fund adminis- tom terei. by he Department of Natural f ~fsource t ~n ht~n~~ establ slime t of standalydsi. gro ndwater, _.Y :eater, groundwater contamination r 0a it's worth protecting. ,BD-6398 (R.03/86) i a APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor,("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - • I Owner of Property Location of Property • V _'y4 14, Section T N - R W Township Mailing Address _ Subdivision Name A de± Lot Number Previous Owner of Property SO-JZA: " ~ Total Size of Parcel Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume gazl and Page Number as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (We) ceAtiby that all 6tatement6 on .th.i6 bonm ahe tAue to the best ob my (oun) knowledge; that I (we) am ( ane ) the owneA (6 ) o6 the pnopen ty deb cAibed in thi6 ,i.nbonmation bonm, by vi tue ob a waAAanty deed neconded in the Obbice ob the County Reg-idteA ob Deeds as Document No. 7w a 90 ; and that I (we) pne sentty own the pnopo6ed .6 to bon the 6ewage di.6po-a -aystem (on I (we) have obtained an ea.6emenat, to nun with the above deacA bed pnopenty, bon the cons-tAuction ob 6aid 6y6tem, and the Game has been duty neconded in the Obbice ob the County Regist ob eed6, al., Document No. 1. -tx SI NATURE 0 OWN SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNE DATE SIGNED H z W a ST C- 105 r • a H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z t7 a l H ,JE OWNER/BUYER ROUTE/BOX NUMBER Fire Number Z IP _114A/2 C ITY/STATE ..4 PROPERTY LOCATION: _~4, Section le T21 ___N, RT_W, Town of St. Croix County, Subdivision Lot number. Improper use and maintenance of your septic system could result in I its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to H three year expiration. o E z I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with H the standards set forth, herein, as set by the Wisconsin Depart- 'd ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office withi 30 days of the three year expiration date. SICNE DATE St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. =Mom TDEPAJ3MENt OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INNDUS DUSTRY,, DIVISION LABOR AN P.O. BOX 76 HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 (1-163.090) & Chapter 145.045) LOCATION: SECTION: 4 TOWNSHIP/MUNICIPALITY: LOT NO.:BL V_yO:1SUB D V SION NAME: ut /a t ~ IT31 NIR19 E cp tkJi / COUNTY: OWNER'S/BUYER 'S NAME: IMPLIN ADDRESS: ,`3c ct t ./1h 1 i! C ,51c_rD_iy_Jane:r__ E Q7r USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: X New DESCRIPTIONS: PERCOLATION TESTS: Residence `New ❑Replace 1PROFILE RATING: S= Site suitable for system U= Site unsuitable for system 0 CMp Z\Is. Q~ IN-GROUS qD-PE1RESSOU RE: SYSTEM- N-FILLHOLDINGTANK: R~ poM✓CNDEDOYST M: ptional) If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: 5 Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS 7 FIT BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH FN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABB RV. ON BACK,.) B- s' i r u~ .Y , 27 f 971 r s B- > 6 .3 -/~7pG' as B-V elf B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER IAC"" AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIO 2 PERIO PER INCH P- P'-'2 3 3 %S 7 P- i 7 rp - PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATIONS s ( x ~ ~ X13` .3 ~ -r / i x x 1 E 1 __J - ` ZIP) 3c) tN - 1 i r x , t` ox E ~ a x x La'r STA-Kr. I, the undersigned, hereby certify t t the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the to recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print: TESTS WERE COMPLETED ON: ec) k e6; AD RESS: CERTIFICATION NUMBE PHONI,' UMBER(optional' I v d Iri S S CST 3N URE: I DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. L ILHR-SBD-6395 (R, 02/82) - OVER - INSTRUCTIONS FOR .7 PLETINC Fib! 11 - D - 6395 0 To be a complete and accurate soil to . , rort must include: 1, Corers' legal description; 2. TI- ~ n must clearly i iris is a residence or corn ercial project; 3. Ml I u of bedrooms cial use planned; 4, Is rent system; 5. rating boxes 'E 11; SUITABL i G TANK ONLY IF ALL JLED OL ) ON SOI _ - . rg profit s od completing the plot plan; 7, i., test I(. ving to scale is preferred. A cd are permanent; test exernp- 14. s,+ ily, )ropriate box; 11. _ son 12. FILED WITH THE LC A' ' ITHIN; _ k) M "'EVIATI DNS FOR EIS SOIL TESTERS a *si * si fff cc Pt mrn rs - cf - P Ti :r ILL X w f 7 - f~/fXJ ~1G',riL' Tq,JiS' • ~/~/QX~~c ~t f 'S'O ..SGA 13l go I,c 9z~i J , x--- - ' .ern r `/Y f4 49 1 -Cv PAGE OF C.roSS See}Ion o~ r1.~eO Sys~et~ ~ Fresh Air Iniels And Observation Pipe ( Approved Vent Cop Minimum 12" Above Final Grade t 4" Cast Iron 20- 42" Above Pipe To Final Grade Vent Pips Marsh Hay Or Synthetic Covering Min. 2" Aggrsgals Over pips - clot, lbutlon - Tea Pipe 0 0 0 0 0 i B Aggregat e a Perforated Pips Belau Beneath Pipe Coupling Terminating At Bottom of System j 7 ProPoSeD Ina' 9rtiA{ ~~~v•.~ ton / t i \\•c`y\\~\, SOIL FILL DISTRIBUT1OI.J PIPE APPROVED S49PETIC COVER OF1~6GR~GATE-~~ c c ATfRII~I Op, 9"OF STRAW OR f jARSN HAy 4o' 0 FJ2-P- AGGREGATE Z., ELEV. OFD FEET DIS-rR113~~TIOM PIPE TU BE AT LEAST ~j(~ INCHES BELOW ORIGIMAL GRADE AUE) AT LEAST20 INCHES BUT 1.10 MORE THAN H2- ILICNES BELOW FINAL GRADE MAXIMUM ®F-QTH OF EXCwATiewi Mm M&vvu Win- WILL BE ~ INCHES MKIMUM 9Ef r" OF EXCAVATION FROM OIKt(IbgL GR49E WILL BE ~?-X INCHES I i i SIGNEO: 1 t LICENSE AJUMBER: ~C DATE: Parcel 032-1045-80-000 10/23/2006 12:14 PM PAGE 1 OF 1 Alt. Parcel 16.31.19.229C 032 - TOWN OF SOMERSET Current XST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner JANET E SCHACHTNER O - SCHACHTNER, JANET E 2191 40TH ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 2191 40TH ST SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 3.020 Plat: N/A-NOT AVAILABLE SEC 16 T31N R1 9W 3.02A IN NW NW LOT 1 Block/Condo Bldg: CSM VOL 3/821 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 16-31 N-1 9W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 760/432 07/23/1997 752/164 07/23/1997 752/163 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/05/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.020 48,100 105,400 153,500 NO Totals for 2006: General Property 3.020 48,100 105,400 153,500 Woodland 0.000 0 0 Totals for 2005: General Property 3.020 48,100 99,700 147,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 502 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00