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Parcel 032-1032-30-050 12/12/2006 08:51 AM
PAGE 1 OF 1
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Alt. Parcel { 11.31.19.154A 032 - TOWN OF SOMERSET
Current ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
07/01/2004 02/23/2006 00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
RICHARD L PLOURDE O - PLOURDE, RICHARD L
PO BOX 290
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 33.680 Plat: N/A-NOT AVAILABLE
SEC 11 T31 N R1 9W SW SW 40A EXC PT TO Block/Condo Bldg:
HIDDEN HILLS'04
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
11-31N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
12/20/2005 814601 2946/197 QC
12/31/2003 750406 2483/200 EZ-U
09/03/2003 738643 2398/532 EZ-1
1209/341 TD
more...
2006 SUMMARY Bill M Fair Market Value: Assessed with:
145205 Use Value Assessment
Valuations: Last Changed: 07/05/2006
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.000 48,000 105,300 153,300 NO
AGRICULTURAL G4 9.000 1,100 0 1,100 NO
UNDEVELOPED G5 8.680 15,500 0 15,500 NO
AGRICULTURAL FOREST G51M 13.000 26,000 0 26,000 NO
Totals for 2006:
General Property 33.680 90,600 105,300 195,900
Woodland 0.000 0 0
Totals for 2005:
General Property 0.000 0 0 0
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
Parcel 032-1032-40-000 12/12/2006 08:48 AM
PAGE 1 OF 1
Alt. Parcel 11.31.19.155 032 - 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
RICHARD L PLOURDE O - PLOURDE, RICHARD L
PO BOX 290
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 624 220TH AVE
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE
SEC 11 T31 N RI 9W 40A SE SW Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
11-31N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
12/20/2005 814601 2946/197 QC
07/08/2002 683616 1923/299 EZ
07/23/1997 1209/341 TD
07/23/1997 1171/355 FJ
more...
2006 SUMMARY Bill Fair Market Value: Assessed with:
145206 211,000
Valuations: Last Changed: 07/05/2006
Description Class Acres Land Improve Total State Reason
PRODUCTIVE FORST LANDS G6 40.000 160,000 0 160,000 NO
Totals for 2006:
General Property 40.000 160,000 0 160,000
Woodland 0.000 0 0
Totals for 2005:
General Property 40.000 196,000 95,700 291,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 139
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT
OWNER J,?4jjOhl' L'Aenr- TOWNSHIP SEC . _tj_ZjLN-R dW
ADDRESS ST. CROIX COUNTY, WISCONSIN.
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SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of H63
-VIMTHING WITHIN 100 FEET OF SYSTEM
I di a e No th Arrow
SC LE-.---
BENCHMARK: (Permanent reference Point) Describe:
Elevation of vertical reference point: Slope at site:
SEPTIC TANK: Manufacturer:; p Liquid Capacity: ~hG~p
Number of rings on cover manhole cover elevat on-rj,
Tank Inlet Elevation: Tank Outlet Elevation:
PUMP CHAMBPR
Manufacturer: Number of gallons
yc e gallons; total capacity o
Number of gal. pump set or a cycle-
distribution lines gallon: size of pump head;
gallon per minute horsepower ran name of pump
and model number ;
Type of warning device
HOLDING TANK: Manufacturer Number of gallons
Elevation of manhole cover
Type of warning device
SEEPAGE PIT SIZE: -Number o pits eet iameter
feet liquid depth seepage pit inlet pipe-elevation
bottom of seepage pit elevation feet.
SEEPAGE BED SIZE: number of lines widt length the depth
SEEPAGE TRENCH: w dth _ length ,
PERCOLATION RATE 3~) AREA E U END E BUILT
INSPECTOR
DATED / PLUMBER ON JOB i
- LICENSE NUMBER 5% 3
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REPORT O1 INSPI-CTION - INDIVIDUAL StWAGL SySTLM
Savrt (arrrl PC!t,r,t
to SPC)t(
NA,4I -
z~qM
WT o w n's 4,p St. CAo4 x Countrl
I 11on S Sw Secx4,on~Lo-t _ Sabdi vi,54'on.
PTIC TANK
'e ms gaUon~s Numbers o6 compait tme.ntb
U(.5 tance {Aom: WeU_ Buifd.tng-% 120 5f'ape. - -
Highwa.ten
PUMPING CHAMBER
Size _ g ie~ n~5/ P u m p M a n u ric.tuAeit Mode.Numb v. it
IIOI.DING TANK
S (•'c j(Aee0nA NumbeA o(I CornpaA tmen tb
I' a u, I c, ,r C' A rn S cl 6 to. rn
1) avrce i(om....,-,W-e,Qe,2 .dui-iding----- 1,2s Xope
n
Highwa,te.A
A6SOKPTIO-N SITE
Bed_ Ttcench
I?< tr,r<c (prom: LU(2 B(44,zd"cng 12A f o p v
11 u11wa to ti
AI;~;OI~I'I ION SITE DIMENSIONS
w(,lth o( -tneneh _6t Requ,tced a 4 c a
~ (t
L 'JI.,1 lr oA each 114n 6;t Depth oA icoch beeow t"1ke.
Nt,rnl,err o{ e vte"s - Depth ~ Auch oveic tek'e 1n
lotaP een.g,th OA fineh Depth oh .tiXe beeow littade
1) tance between 4n(-"A ~
t S X u p c o6 h a is e yr c h gy n. I> r A 100 A
Tu"taP et 63aApt-ion ctA.e.a ~ k- ().t Type of Caveir-: Pa_peA~oti AtA,r(u `
PH DIMENSIONS
V
NumbeA of pi tb. GA.avefl (,rAtrt.nrl ltc~% no
' I
OutAlde d<ame-teA t Depth be-kow 4'.neot (t
ro tue absoit p-t4(in aif9"'a
Area Aequi.ree.d ~.t
TITLE C
ROV1 D DATE V x
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1:1 1I C I I 'D DATE 19
h
I'I ASON I OR RI JI (T 10 N
State and County State Permit #
S67PLf Permit Application County Permit #
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for Private Domestic Sewage Systems County
*rcNOTES STATE APPROVAL REQUIRED
Jate Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
B. LOCATION: '/a, Section T,--- N, R (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# _ Village
Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family _ Duplex No. of Bedrooms No. of Persons
D. SEPTIC TANK CAPACITY Total gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete- k 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 5~- L -sq. ft.
New x_Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed:_ -Length 4 .2, Width 4 Depth Tile depth (top) a No. of Lines -
Seepage Pit: Inside diameter. Liquid Depth No. of Seepage Pits
Percent slope of land- •z-.) Distance from critical slope
WATER SUPPLY: Private M 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 Certiified Soil Tester,
NAME ' C.S.T. # i • ( and other information
obtained from (owner/builder).
Plumber's Signature MP/ PRSW# ~i Phone # a / i`
Plumber's Address > - '
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.
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Do Not Write in Space Below - FOR COUNTY AND STA E DEPARTMENT USE ONLY,
Date of Application ZY Fees Paid: State , dL-,j County Da
Permit Issued/f eireted (date) c,,, -,7341 Issuing Agent Name
Inspection 'Yes 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
Z
•REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
San.itaAy Permit 3
State Septic
NAME ( wnsh.i St. Cno.ix County
Locat.ioKsC ~(,cJ Section
SEPTIC TANK
s
Size gaUonz. Number o6 Compatctmentz
Distance From: WetZ 12% on greaten 4tope it
Bu.itd.ing it. Wettands 6t.
Highwaten it.
DISPOSAL SYSTEM
Distance Fnom: Wet-e it. .12% on gteaten zZope it.
Bu.itding it. Wetlands Ft.
H.ighwaten it.
FIELD DIMENSIONS:
Width o6 trench it. Depth o6 rock below tiZe .in.
Length o6 each tine it. Depth o6 rock oven t.ite .in.
Numbers o6 tines Depth o4 t.ite below grade in.
Total .length ob tines it. Slope o6 tneneh in pen 100 it.
Distance between .lines jt. Depth to b edno ck _6t.
Total ab.s onbt,ion akea 4t2 Depth to gnoundwaten it.
_ RequitLed area it2 Type o4 Coven: Paper on Straw
PIT DIMENSIONS:
Numbers o6 pits Gnavet around pits yes no
Outside d.iameten it. Depth below inlet it.
2
Total ab,s o kbtion area it z
A
Area requited it2 rn
r
INSPECTED BY TITLE
APPROVED DATE 197
REJECTED DATE 197
EH 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 "Y
LOCATION: __'/4, Section , TN, R _JI11IV(or) W, Township or Municipality '
Lot No. , Block No. County
ubdivision Name
Owner's Name: ~ , ] - b
Mailing Address: - -7 ? F =
i
TYPE OF OCCUPANCY: Residence No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS # Z' PERCOLATION TESTS r !
SOIL. MAP SHEET SOIL TYPE
PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DRG rf{
NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN;
P-j
t
I
.
lp-
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)
Z
-i
,c f 4 t C' / G <
I i_AN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)
i. dicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area
seeded for building type and occupancy. _ f ` Indicate scale
or distances. Give horizontal and vertical reference point . Indicate slope.
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I, the undersigned, hereby certify that the soil tests repCgod oji this form .w re made by me in accord with the procedures
and methods specified in the Wisconsin Adminlstratr~e Code, apcd'tbat the I to recorded and location of test holes are correct
to the best of my knowledge ano4elief.
Name (print) -y Certification No.
Address
Name of installer if known
CST Signature
4~
COPY A - LOC,'J, J 10. 1,it'Y
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State and County State Permit # P L26 7y Permit Application County Permit #
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:
B. LOCATfON: '/'/4, Section / T~ N, RI (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# - Village
Township sc+m~ y y C~ T
C TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family X Duplex No. of Bedrooms No. of Persons L
D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste GrinderYES__4NO # of Bathrooms
Automatic Washer YES NO Other (specify)
E. SEPTIC TANK CAPACITY Total gallons No. of tanks
*Holding tank capacity Total gallons No. of tanks
New Installation Addition Replacement _ Prefab Concrete
*Poured in Place Steel Other (specify)
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) Y 2) 3C' 3) 40 Total Absorb Area ~'I:SLt sq. ft.
New A Addition Replacement *Fill System
Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length 6 Width Depth Tile Depth J~ No. of Lines 2
i
Seepage Pit: Inside diameter Liquid Depth Tile Size
Percent slope of land M- 7~ Distance from critical slope
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 Certifie Soil Tester,
NAME , / Lj I_ P, [_+wQ r C.S.T. # .5,5 -S>'/ and other information
obtained from (owner/builder).
Plumber's Signature ftL%/MPR # ~---Phone 4~2yG
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
A
t
Do Not Write in S page B ow FOR DEPARTMENT USE ONLY
Date of Application: - G Fees Paid: State l'; ( Coun - Date
(date Issuing Agent Na e ,
Permit Issued
IUWV 2i
Inspection Yes o 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 6/1 /76
Parcel 032-1032-30-100 05/25/2007 05:05 PM
PAGE 1 OF 1
Alt. Parcel 11.31.19.154B 032 - TOWN OF SOMERSET
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
02/23/2006 00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - CHRISTIANSEN, SANDRA J
SANDRA J CHRISTIANSEN
624 220TH AVE
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): = Primary
Type Dist # Description ' 624 220TH AVE
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 6.430 Plat: 5159-CSM 20-5159 032-06
SEC 11 T31 N R1 9W PT SW SW CSM 20-5159 Block/Condo Bldg: LOT 01
LOT 1 (6.43 AC)
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
11-31N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
04/09/2007 848021 EZ-U
03/08/2006 820288 WD
02/23/2006 819152 20/5159 CSM
12/20/2005 814601 2946/197 QC
more...
2007 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 06/05/2006
Description Class Acres Land Improve Total State Reason
Totals for 2007:
General Property 0.000 0 0 0
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