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CR032 - TOWN OIX COUNTOY, WI CONSIN Tax Address: 00 O Application # Permit # Permit Type KURT G FREESE Owner(s): O = Current Owner, C =Current Co-Owner O - FREESE, KURT G 608 155TH AVE SOMERSET WI 54025 Districts: SC= School SP = Special Type Dist # Description Property Address(es): Prima SC 5432 SOMERSET ` 608 155TH AVE ry SP 1700 WITC Legal Description: SEC 15 T30N R19W 3.02A IN SW NW ALOT cres: 3.020 Plat: N/A-NOT AVAILABLE CSM VOL 4/963 Block/Condo Bldg: Tract(s): (Sec-Twn-Rn 15-30N-19W 9 401/4 1601/4) Notes: Parcel History: Date Doc # Date 2003 Vol/Page 722604 2251/293 Type 08/18/1998 585276 1349/296 WD 2006 SUMMARY WD Bill Fair Ma 58,rket800 Value: Valuations: 146286 1 Assessed with: Description Class Last Changed: RESIDENTIAL Acres G1 Land Improve 07/23/2003 3.020 48,100 Total State Reason 72,300 120,400 NO Totals for 2006: General Property Woodland 3.020 48,100 0 72,300 .000 0 120,400 Totals for 2005: 0 General Property Woodland 3.020 48,100 72,300 0.000 0 120,400 Lottery Credit: Claim Count: 0 1 Certification Date: Specials: Batch 115 User Special Code Category Amount Total Special Assessments 0.00 Special Charges Delinquent Charges 0.00 0.00 COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 800 - 962 - 5227 ujk Nu++ t7`Y~ri~l a~,: uvi~ hT DATE: 5/26/92 LIRTHOUSE DA T r XiE~:. a JEt1: 5/21/92 NER: Thomas L.or Ma h.G Av?, r k -'ATIaN. 608 1550 _LECTOR: M. Jenk rE ANALYZED.5-29. '4E ANALYZED.2:00 _TI aRfti 0 PRETAU 4 Bacterio I 4 PPm .,ac,r : i!? c+nt~ rsy-~c?r!:; jl^Q rG4"'llTi+.A~51~pf.~ Gllk} ^ C OF.\NDEPENOpHr ,.L , i a. ^Sii J` ~O o PROFESSIONAL LABORATORY SERVICES SINCE 1952 T. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse U 911 4th Street Hudson, WI 54016 Telephone - (715)386-4680 The St. Croix County Zoning Office offers the service of septic Z' and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion of this form ia essential aQ that tag property can bg located. Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with fors, to the above address. Testing ::x.ll be done as soon as possible after fee and form are received. WATER TESTING FEE: $ 35.00 xxx (For nitrates and coliform bacteria) WATER TESTING FEE: $185.00 (For VOC'S) SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00 xxx (Determines if system is properly functioning at.time of inspection) PROPERTY OWNER'S NAME:- Thomas J. Math and Lori A Math PROP. ADDRESS: 608 - 155th Avenue CITY Somers t 0-~L 4'0-,JL-- Legal Description Sw 1/4 of the Nw 1/4 of Section 15 , T 30 N-R 19 Town of Lot Number Subdivision: FIRE NUMBER 608 LOCK $_QX DER Color of house Realty sign by house? If so, list firm: PLEASE CONTACT LORI MATHYS AT HOME FOR AN APPOINTMENT - (715) 247-5678 PLEASE INCLUDE, IF AT ALL POSSIBLE, A HAP,i.e,COPY OF PLAT BOOR, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential ester requires a sample t',.aa- is fresh. If the home is vacant, and has been so for some time, Vthe water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual requesting services: Bank of Somerset Telephone Number (715) 247-3348 REPORT TO BE SENT TO: Bank of Somerset, ATTN: Kristen Dixon, P.O. Box 220 110 Spring Street, Somerset, WI 54025 CLOSING DATE: May 29, 1992 .Y ) Signature -r t ST. CROIX COUNTY WISCONSIN t P ZONING OFFICE Irw.;~~+~.s~ t ST. CROIX COUNTY COURTHOUSE T ' T 'L 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 May 21, 1992 Kristen Dixon Bank of Somerset P.O. Box 220, 110 Spring St. Somerset, WI 54025 Dear Ms. Dixon: An inspection of the septic system on the property of Thomas & Lori Mathys, located at 608 - 155th St., Somerset, WI was conducted on May 20, 1992. At the same time a water sample was obtained for testing. The results of that testing will be sent to you as soon as we receive them back from the laboratory. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. Sin erely, Mary„-.,7 J nkY s Assistant Zoning Administrator cj A" IM 1 1,T `-;AN I_TARY `iYS'T kM REPORT J ~ UWI' d l?P TOWN SII I P //r,~- St 7-.S F.' : -7JN-R / W AI)I RI%,';5 CIM I X COUNTY, W I SCONS 1.N . t :;Illil) I V I I1)N L.t)'I' I.O'I' L/. I? P I.AN V T I,"W 11i:;I iIfWc..; JII(I (IintenS i~)t1;; I..o Ill ceI reyili_rr_~allrnt s of 116 t _;a,IIOW KVPJ; YTH MG W11.11 I N 100 OIL' .~Y:I?M t ` ~l9 fog f E i s ~ I } { I S_ st ~P L770 I dI.L- atte 14oiLth Arrnw W-:NCIIMARK (l'c,rnlanenl reference Poiitt) Describe:' 56,) ~ Sfo~P 1~'!t,v.il ion of vert_f_eai reference I)oint /oo' Sl_opc~ at site: _T !;!''I' I C 'I'ANI< ManuEacl urNr: l.l.clu _(f Cal)ac i Ly 61 lunihk.r of rir1~,s on cover Tank 'manhole. Cover c levat lotl I',ink Inlet h:levat't'ank. Outlet Elevati_un: ___C__ !'LIMI' t:IIAMHI~:Il M,lnnl iac.'1_IA rer' Ncnt)ber of era l ion duiiil7cr e)f gal pulnl) set for a cycle Y'a1 1)s; total ca1)ac I-y o Ali tr- i.bution 1fnes )2,a1ton: size or pump bead ) 1 1 on p el- rni rlr.rte horsepower 1)ran(T name of pump nicl niode.l number Type of warntng deV1_ce II()i.I)IN(: 'T'ANK: Manufacturer Numhcr ol_ gal_low; I~: I ('Vat ion of_ mall1w Ie covet !'yl)cr O f warn i ny, (tev i ce PIT IZF, Nt.unl,c r F I>11 s rcet c11ainrt r I(-('( I iclu.id depth 's e1)aY,e 1'i l irrTc 1 1) 1,1)c -c Levat Toff hOI I (n1 of ;e(:jM),C 1)i t e_,eviiI i on f c c t - !!!-:I'A(:!-: 11,1,:1) ; I /.1-:: numl)c r oI- I i no r; w i X11 li / 1 F"r}~, I It I t I , ~1~~1)I li~c ' :;I,:I-TACI% 'ITF:Nt:II : wi (11 h ON RATI-: _5--, S- ARI,.A pryfTlzrv) APEA M ItlliT,'I' INtiI'1,.C"I'OK DEPAfFTMENT`)F INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS Olvlslol P.O. BOX 7969 1 BUREAU OF PLUMB IN MADISC`,N, WI 53707 YCONVENIIONAL ❑ALTERNATIVE State Plan I.D. Number. (If assigned) ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound RMIT HOLDER: INSPECTION DATE. p p NAM - PERMIT HOLDER. ADOR S n n 1.00 ~*i- S~►o~SZ I BENCH MARK (Permanent reference point) CRIBE IF DIF ERENT FROM LA REF. PT. ELEV.: CST REF. PT. ELEV. ce t, - Name of Plumber P/MPRSW Na. County Sanitary Permit Number: / r i (4", _ SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV. WARN NG LABEL LOCKING c E~' P O DG PROVI D YES ❑NO L Y NO BEDDING VENT DIA. VENT MAT L. HIGH WATER NUMBER OF ROAD. PROPER V WELL'. BUILDING: IVAIERNIT O FRESH J I ALARM. FEET FROM LINE / ❑ NLET'. + ❑YES ❑NO NEAREST YES ❑NO DOSING CHAMBER: MANUFACTURER BEDDING LIQUID CAPACI TY PUMP MODEL PUMP, SIPHON MANUFACTURER PWRAROVNIIDNEGD LABEL PLOCKING ROVIDED OVER . ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS oPERAT ONAL NUMBER OF PROPERTY weLL BUILDING JVENTTOFHESH LINE AIR INLET. (DIFFERENCE BETWEEN FEET FROM PUMP ON AND OFF) ❑YES ❑NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing -c,_" I, MF TEH MATERIAL AND MARKING FORCE or excavation. Ilf soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH LENGTH NO-OF DISTR. PIPE SPACIN<I COVER INSIDE DIA -PITS . LIQUID BED/TRENCH _ TRENCHES MATERIAL PIT DEPTH DIMENSIONS GHIl .[PTII f LI DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL. NO -D TH NUMBER OF PROPERTY WELL. BUILDING. VENT TO FRESH FEET FROM uNE AI ff BE LOI% f IF I ti ABOVE COVER ELEV INLF T ELEI/. END PIPES n ~l r NEAREST 4 w1 MOUND SYSTEM: Mound site plowed perpendicular to slope (check the texture of the fill mat ial for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make cer that it ON REVERSE SIDE. SHOW ELEVA- meets the criterior medi sa d. TIONS MEASURED. ❑YES ❑NO SOIL COVER. TEXTURE PERMANENT MARKERS. OBSERVATION WELLS j ❑YES ❑NO ❑YES ❑NO UEPTH OVFH TRENCH BED DEPTH OVER THENCH:BD DEPTH OF TO OIL SOD ED v 4 SEEDED MULCHED CENTER EDGES YES ❑NO ❑YES ENO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: _ 4'rI D TH LENGTH NO. OF LATERAL S ACING. GF]AVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES DIMENSIONS MANIFOLD PUMP MANIFO DISTR IPE MANIFOLD MATERIAL. NO. DISTR DISTR. PIPE DISTHIBUTION PIPE MATERIAL & MARKING ELEV.'. ELEV. DIA. ELEV. PIPES. DIA.'. ELEVATION AND DISTRIBUTION VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION HOI-E SIZE HOLE SPACING DR LED CORRECTLY COVER MATERIAL. PLANS ❑YES ❑NO _ ❑YES ❑NO OPERTV WELL: BUILDING. COMMENTS: PERMANENT MARKERS. OBSERVATION WELLS. NUMBER OF PuNR E FEET FROM ❑ YES ❑ NO ❑YES El I\ NEAREST--fir y - 4.2R A/ 5" Sketch System on Re n,M county file for audit. Reverse Side. ~ TITLE. ff NATURE DILHR SBD 6710 (R. 01/82) - State and County State Permit # PLB. 67 6( w Permit Application County Permit # County • for Private Domestic Sewage Systems *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: r111V /V/ B. LOCATION: % IVUf%, Section ` T N, R_jL W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township S~'e ire, S~' C. TYPE OF OCCUPANCY: `Commercial *Industrial Other (specify) Variance Single family- Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY Z'/!(' Total gallons No. of tanks !f HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete X Poured-in-Place Steel Fiberglass Other (specify) New Installation X 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 sq. ft. New Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: X Length 5 Width L', Depth Tile depth (top) No. of Lines Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land 31~` Distance from critical slope WATER SUPPLY: Private X Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: I, the undersigned, do hereby certify that the info mation 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 Ztf7 h1c, Al A%/✓ S C.S.T. # and other information obtained from C"/Y/ T/f caner/builder). Plumber's Signature M MPRSW L c,:5- Phone # Plumber's Address /i % 2 /7" i., ~"Lr=,/' Sr 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. m, , . a r. ice. - f,.. 3 i 3 3 j w m :g ~ r a , E t - w.w. e...l r.. , e 3 dd°° f ! j k 1 . i - a Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT US ' ONLY Date of Application - ) " k Fees Paid: State oQ County Da Permit Issued/Refes-ted (date) S~ 9,4 Issuing Agent Name Inspection Yes lyc_ No State Valid# Date Recd 1. county (white 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 f1r I { r f C) -3 I'D ,Ic.)4- C) U, ~ o 00 W 3 3. 0 -5 { 3 0.3 _f Z- CD ~I p - Vi A z C) ~ ~ It oo nn e I O rr. C h„ +•t,rt;, . +i'~~ 1 ~ ~i ! i t ~ t ut'Li:w~ , t l~il r,, 1j". C~('~t.l c,Il~ 1 Ifir_W'11 Full" - l r] ! 'r 1 51 1 5Y>' ri tbnl to +rro sfot4t' t-!;r ("'I ( rlin, IoIJ.(1 ) 'c1 1r"o C) r'~ ~Ir v t)Of ~:}1(ilCe n + ~Ct i; r (J(i r >r+trxin]+.;~ .;'r ..r' , r.:,,. , ~ ~i i~ t. ~ , r. ~>v r tic :;<~u-t tr~~r•', trerE~c ct.iol; 4 44 EH 1 15 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 I REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION Section /LS7, T3-N, R,'If (or) W, Township or Municipality. -sn ,,7 e Lot No. J_ Block No. , ~y J Z G r7_4 __T, 4 50 121__- County s C e 1 _ l1 ubdivision Name Owner's Name: 4 r d" yj q 04 _,7 So h Mailing Address: /y/ p h d::7,( NV -1 5 TYPE OF OCCUPANCY: Residence No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW _ _ 4 -ADDITION .REPLACEMENT _ DATES OBSERVATIONS MADE: SOIL BORINGS 8a PERCOLATION TESTS SOIL MAP SHEET SOIL TYPE S~n✓ PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHT3MIN/INj RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD P-1 _t 1 , S- A6, It- 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) B- / 7z D/'P > >-2' 64 - - 7-3; /S SL 413 S _ Z o 7P_ , B_ JL,e > 7.0- - , - B S 72 G "v 7 7~ i I i `L_ ~-3 3L~S PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indi n mber of square f pet o, a r area needed for building type and occupancy. _ / a v Sc~ /i~r scale or distances. Give horizontal and vertical reference points. Indicate s pe. _I z I I f I#V h. - I It I Ilr,i 0I1y co'it it-y W'li 0W .,1.i , i11A~1 Led tin this form were made by ni,. n tlCCUI' III till _ 1 I I~rl hr f\ilflimis!iai,ve Code, and that the data ieairded and Iucai- JJ t ~ ice- - - u y ra;t, . 114 4 i 1 -70 i + t F ! 1 ~ i i s t ~ ~ Y fzh !0o, 17 t: _ JAI 3. ~ t~ 1 . 1 Y i A"A /V e, I 9 ST. CROI X COUNTY Ye a WI SC0 N S I N ZONING OFFICE 796-2239 HAMMOND, WI 54015 ~s May 19, 1982 Tom MathyS 924 Kinnickinnic Street Hudson, W1 54016 Dear Mr. Mathy: We have issued a sanitary permit for your property located in the SW'-4 of the NW-4, Section 15 of Somerset Township. The bench mark that was used for a reference point on the 115 has been removed and must be replaced before they can proceed with the installation of the sewer sytem. You may need to contact your surveyor to replace the south west lot stake. Should you have any questions, please contact our office. Yours truly, L ~ A Thomas C. Nelson Assistant Zoning Administrator sl