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AS BUILT SANITARY SYSTEM REPORT
`:DER' w , TOWNSHIP SEC. f~ T L N, R~W
J. ADDRESS 1(y~~. J,F-/1 Jet; ST. CROIX COUNTY, WISCONSIN.
,DIVISION , LOT LOT SIZE y1 -Lr"d-,
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
/
(AI& ii,i t
iv iv i. 3 I
e t,'t LD'T 7-
4b`
f~ `'j
t y~ t~ SOP
1 Ai Tt' R i L 5; N
'TIC TANK (S) MFGR. a _ 5 - > CONCRETE STEEL
0. of rings on cover Depth /,C ~i DRY WELL
'ETCHES NO. of width length area
no. of lines ; widths length y area Yz 1 }s
deith to top of pipe
_=REGATE A4-;,4 %l _ c - ,
_ K RATE AREA REQUIRED i7 AREA AS BUILT
,claimer: The inspection of this system by St. Croix County does not imply complete
pliance with State Administrative Codes. There are other areas that it is not possible,
inspect at this point of construction. St. Croix County assumes no liability for
tem operation. However, if failure is noted the County will make every effort to
-ermine cause of failure.
_:ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYS
"INSPECTOx
i
DATED PLUMBER ON JOB C/L c' 1 ~47
LICENSE NUMBER
REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM
Sanitary Permit-
State Septic /
NAME TOWNSHIP ` St. Croix Count
LOCATION S d _ --Section Al- Lot rl - Subdivision -00/% -A4rw1
SEPTIC TANK
Size gallons Number of compartments
F y-.-
Distance from: Well 5 Building -A 3 12% slope
Highwater
PUMPING CHAMBER
Size gallons Pu p a uIacturer Mode_i Numbs
HOLDING TANK
Size -gallons Number of Comp' tments
i'
Pumper la ' stem
~ n
Distance from: Well i~ B ild ng 12% slc~pc
Highwatey'
ABSORPTION SITE
Bed Trench
Distance from: Well _10L, - Building ) S - 12% slope
14
Iighwater _ If, .
i~BS-ORP_TION SITEDIMENSIONS Required r e
V G
Width of trench f t ReI L .aL~ f t
Length of each line ft Depth of rock below tile-- G
Number of Lines ~L Depth of rock over the Z in.
Total length of lines f r Depth of ti le be Low grade S4 i
Distance between lines--_-~L ft SI-ope of trench in. per 100 it.
Total absortption area ft Type of Cover
PIT DIMENSIONS
Number of pits--- GraV-e a pits - yens n~
Outside diameter
L {Mpth ,below inlet t t
- - r-- - - .
Total. absorption area / f
Area required t
INS
L 1%
APPROVED DATE L98i----------
REJECTED DATE 198
REASON FOR REJECTION
SEPARTMENT OF APPLICATION
INDUSTRY, FOR SANITARY SAFETY & BUILDINGS
ON
LABOR AND PERMIT P.O. BOX 7969
HUMAN RELATIONS (PLB 67) MADISON, WI 53707
Attach plans for the system on paper not less than 8'/2 x 11 inches in size. Include a plot plan that is dimensioned or drawn to scale. Horizontal
and vertical elevation reference points must be shown. All appropriate separating distances and physical characteristics as specified in chapter
H-63, Wis. Adm. Code, must be shown. An index page or each page must be signed, sealed and dated by the designer. If designed by a Master
Plumber, the date, signature and license number must be shown. The owners copy or a legible reproduction of the soil test report must be
included.
Property Owner: Mailing Address:
,C-.D G - s n~, ale
Pk, SI-5.
roperty Location: City, Village or Township: County:
/V tl %S /T -J N/R /9 E (or -1 - .1 C )/v C, en 5 s Co-rNumber: Blk No.` Subdivision Name: Nearest Road, Lake or Landmark: State
Plan I.D. Number:
1 _ (If assigned)
i
TYPE OF BUILDING
Number of
❑ Public* ❑ Variance* ❑ Other (specify)* Bedrooms:
[R-1 or 2 Family *State Approval Required. j!
TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER
GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specifyi
SEPTIC TANK CAPACITY ®p
HOLDING TANK CAPACITY
LIFT PUMP TANK/SIPHON CHAMBER
MANUFACTURER:
I
EFFLUENT DISPOSAL SYSTEM
PERCOLATION RATE ABSORPTION AREA
(Minutes per inch): PROPOSED (Square feet): 2 New ❑ Replacement ❑ Experimental Seepage Bed ❑ Seepage Pit
❑ Alternative (specify) ❑ Seepage Trench i
of
Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner):
Private ❑ Joint ❑ Public
I, the undersigned, hereby assume responsibility for installation of the private sewage s stem shown on the attached plans.
Name of Plumber: Signature: MPMRPftSW No.: Phone Number:
Plumber's Address: Name of Designer:
t _
COUNTY/ DEPARTMENT USE ONLY
Signature of Issuing Agent: Fee: Date: ❑ APPROVED nitary Permit Number:
❑ DISAPPROVED
Reason for Disapproval: /
Alternate course(s) of Action Available:
J
Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to In-
stallation. Failure to comply will void the sanitary permit.
DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber
DILHR-SBD-6398 (N.03/81)
EH 115
1 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 TEST #
LOCATION:.? G Section _Li TJ/N, R 19~W( Ir) 'L oor) W, Township or a y
Lot No. , Block No. b P County i~-
~ S division Name
Owner's Name: l~ Z~ _,dA
Mailing Address:
TYPE OF OCCUPANCY: Residence _A No. of bedrooms -3 Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS
SOIL MAP SHEET SOILTYPE
PERCOLATION TE TS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN j
P-3 SOIL BORING TESTS 1
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
B_ > 7 9` y , 5' 65 9,4
-I-, `i~ 5, z 6 ~2 Q s~ ~?a s
B_ _3 y c5 1- (r-zc vv.. f
C, T
7 51 a /--9
L"~ L -yys
PLAN VIEW (Locate perco lation tests,soi I bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area
needed for building type and occupancy. Indicate scale
or distances. Give horizontal and vertical reference oints. dicate slope.
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I, t e 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 of my knowledge and belief.
Y
Name (print) Certification No.
- -
Address
Name of installer if known
CST Signature
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Parcel 032-1040-60-000 09/22/2006 10:03 AM
PAGE 1 OF 1
Alt. Parcel 14.31.19.199G 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 - EBERHARDT, EDWARD C
EDWARD C EBERHARDT
635 215TH AVE
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 635 215TH AVE
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 4.200 Plat: N/A-NOT AVAILABLE
SEC 14 T31 N R1 9W 4.2A IN SE NW LOT 14 Block/Condo Bldg:
CSM VOL 1/113 & REPLATTED AS LOT 14 CSM
VOL 3/712 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
14-31N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
11/16/2004 780078 2696/489 WD
12/02/2003 747991 2466/065 PR
12/02/2003 747990 2466/063 TI
07/23/1997 836/338
more...
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/23/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 4.200 54,000 81,100 135,100 NO
Totals for 2006:
General Property 4.200 54,000 81,100 135,100
Woodland 0.000 0 0
Totals for 2005:
General Property 4.200 54,000 81,100 135,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 203
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
I DCON
J ,
NORTH LINE OF SEI/4-NW1/4,SECTION 14 SCALE
200 0 100 200
S 86°54'20"E 272°50'
559.15'
CURVE DATA TABLE
CURVE 1-2 R=85.00'
Central Angle = 96°41'50"
N
N Chord = 515°38'05"W 127.02'
3 Tangent Bearing = 532042'50"E
13 } o '01 12 LOT 13 R=85.00'
4 In Central Angle = 41°00'
6,82 ACRES LO Chord = S43° 29' W 59.54'
LO LOT 14 R=85.00'
M ` Central Angle = 55°41'50"
cli M 3E \1/4 - N W I/4 Chord = S4° 51' 55"F. 79.41'
~t 148°03'20° ASSUMED
BEARING
(Vs 5
? 0 s0/'W 039 0
ao 0s 22~ WESTERLY RIGHT- LEGEND
w to . -O OF-WAY LINE
LL z
o EX ITINk SECTION CORNER T~10NUIviENT
_S_
w C. O TOW N ROAD
Z 14 O - - - - - - O 1" X 24'' IRON PIPE
v~i o 5.02 ACRES ~','EIGHING 1.68#/LINEAL F00'
W 0
3 o,~°' `,,aNee~ off
AN V;!
\o~ _ LFRANCis H.
0 I5 WEST 4.30' NE COR NERS, 41 SECTION 14, T31N, R19 W r ~POINT OF BEGINNING Ui aD SURJ~e`••
00
b o N CENTERLINE STATE
rn CENTER OF SECTION Ig (ND -
'n TRUNK HIGHWAY "35"
00 c N 86° 51"W N 87°31'W
Z T 1337,10' 26 4.25' ; g
SOUTH LINE OF S UTH IN F
SE 1/4 -NW 1/4, SECTION 1 4 NE 1/4, SECTION 14
SURVEYED FOR: Edward Germain, Box 66A, Somerset, Wisconsin 54025
DESCRIPTION: A parcel of land located in the SE1/4 of the NWI/4 of Section 14, T31N, 8191,',
Town o£ Somerset, St. Croix County, Wisconsin described as follows: Commencing at the NE corner
of said Section 14; thence West 4.30'; thence Sl°28'W (assumed hearing) 2645.88' along the center-
line of present State Trunk Highway "35" and the Northerly extension thereof; thence N87°31'W
2674.25' along the South line of the NE1/4 of the said Section 14; thence N86°51'W 1337.10' along
the South line of said SE1/4 of the NW1/4; thence N1°38'40"E 194.90' along the West line of said
SEI/4 of the NW1/4 to the point of beginning; thence N1°38'40"E 1132.13' along said West line of
the SE1/4 of the NW1/4; thence S86°54'20"E SS9.15' along the North line of said SE1/4 of the
NWI/4; thence S5°55'40"W 454.101; thence S26°O1'E 169.52'; thence Southerly 143.45' along the
Westerly right-of-way line of an existing town road on an 85.00' radius curve concave Easterly
whose chord bears S15°38'05"W 127.021; thence S57°17'10"W 694.14' to the point of beginning.
I certify that the above description and map are correct and that I have fully complied 1,;ith
the provisions of Sec. 236.34 of the Wisconsin tatutes.
L 41-
DATE: April 3, 1975. 1
FRANCIS H. OLDEN S-882 Jo No. 7S-434
1.
NOTE: ASSUMED BEARING REFERENCED TO CENTERLINE OF STATE TPLNK IIIGIIWAY "35".
Volume 1 Page 113 3-7/1