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Parcel 032-1012-50-000 01/08/2007 08:24 AM
PAGE 1 OF 1
Alt. Parcel 5.31.19.72A 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 - SVANOE, EDWARD A & JORUNN
EDWARD A & JORUNN SVANOE
357 POLK/ST CROIX RD
OSCEOLA WI 54020
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 4165 OSCEOLA
SP 1700 WITC
Legal Description: Acres: 30.000 Plat: N/A-NOT AVAILABLE
SEC 5 T31N R1 9W SE NW EXC SE OF SE OF Block/Condo Bldg:
THE NW1/4 EZ-UT-1486/140
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
05-31N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
09/22/1997 565667 1265/223 WD
07/30/1997 1254/408 TI
07/23/1997 756/461
2006 SUMMARY Bill Fair Market Value: Assessed with:
145022 Use Value Assessment
Valuations: Last Changed: 08/09/2005
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 10.000 400 0 400 NO
AGRICULTURAL FOREST G5M 20.000 40,000 0 40,000 NO
Totals for 2006:
General Property 30.000 40,400 0 40,400
Woodland 0.000 0 0
Totals for 2005:
General Property 30.000 40,400 0 40,400
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
F AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP {{y ~•..,,~SEc. N, RJW
ADDRESS ST. CROIXX COUNTY WISCONSIN.
SUBDIVISION LOT LOT SIZE
Distances & dimensions to meet r_equirementsWof H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
_194 x
- r
a
Tr-di, a 4e oath Arrvw
S 0k
SEPTIC TANK(S) J MFGR. CONCRETEi -STEEL
NO, o rings on cover Depth
PUMPING CHAMFER SIZE PUMP MFGR. -MODEL NO.
GALLONS Per Cycle
TRENCHES NO. of width length area
BED NO. of lines width length area
dept to top o pipe
NUMBER OF SEEPAGE PITS Outside- diameter total pit area
AGGREGATE
'`-~(l~'~„
PERK RATE AREA
REQUIRED
&2,j4n AREA AS BUILT
Disclaimer: The inspection of this system by St. Croix C6vnty does not imply
complete compliance with State Administrative Codes. There are other areas tha
it is not possible to inspect at this point of construction. St. Croix County
assumes no liability for system operation. However, if failure is noted the
County will make every effort to determine cause, of failure.
GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH HIS SYTEM.
INSPECTOR
DATED1- PLUMBER ON JO$
LICENSE NUMBER 1Sl
KEPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM
S a vi i .t an. y 'P e n m.i. t
N !o_~
State. Septic--/-
AME A e- Towne hip _St. Crcoix County
Location jAE,-,Sect<ian Lot Subdi vieian
SEPTIC TANK aovj) 07t-
Size
T gatto ns Numb en o6 co mpalctment,6
Dietance 6tom: Wett Buitding 1.20 6tope
Highwate.A E
PUMPING CHAMBER
Size ga.E one ".Pump Manujjactunen 'lMode. Numbers
HOLDING TANK
Size gaUone Numbe.fc as CompaAtment.6
Pumpelc _ AZatc.m Syetem
Dtietance. (jnom: Wett ~~611 Buitding~ ~11% .6tope_
Highwateic
ABSORPTION SITE
Bed I Tneneh
Dietance hnom: Wetf Building 1.2% .6 tope
High.wateic
ABSORPTION SITE D"IMENS"IONS
I 1.
Width o6 tneneh ht Regwf.Aed anea ✓
Length o 6 each Zine. .6t Depth o6 Aack betow ;tite
I o
cy Numbers. o6 i-nee`_ Depth o6 rock oven ,tile n
7
I;,Tata2 tengxh a6 -etinee 6t Depth a4 tite below grade" ? in
I~,D/i/etanee between fine,5 6t Stope o$ t&eneh c-77' ,n. pefc 100 1i,t
Totat abeonption a~eea __~jt Type oA Coven: /Par~en .dznaw "
V I T DIMENSIONS
Numb eq. o 6 pi to - Gnave.Q, an.ound pi t,6 _y e,6 n.a
Outeide dia.meteA 6t Depth. below inlet $t
Tatat abeanpti~m anea._ 6t
Area Aequtined 5t t
INSPECTED BY'CZTITLE-
C
APPROVED 14 /13 ~ DATE 19 8
r 7ECTED "DATE 19 8
I
FOR REJECTION
i
REPORT ON INSPECTION OF SANITARY PERMIT # 13 (-c/,)
(1) Name and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection
Time of Inspection
Name,, ress, icense NO. o ns a ing Plumber
(3 )INSTALLATION CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber
❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System
BEN ermanent re erence Point) Describe:
Elevation of vertical reference point: Slope at site:
(5)MATERIAL AND DEPTH OF SEWER:
(6)SEPTIC TANK: Manufacturer: Liquid Capacity:
Tank Inlet Elevation: Tank Outlet Elev:
# ft to lot or property line: # ft to well:
M DOSING TANK: Manufacturer: # of gallons:
# of gallon pump set for a cycle gallons; total capactiy of distribution
lines gallon; size of pump head; gallon per minute ;
horsepower ; brand name of pump and model number
Is the warning device installed? ❑ YES ❑ NO Wired? ❑ YES ❑ NO
8 HOLDING TANK: Manufacturer o gallons
construction ; depth to the cover ft; If septic tank is
being used are baffles removed? ❑ YES ❑ NO; ft from residence;
ft from well; ft from property line. Type of warning device
Is the warning device installed? ❑ YES ❑ NO; Wired? ❑ YES ❑ NO;
Locking device on cover? ❑ YES ❑ NO; Diameter of vent and material ;
Distance from building to vent
(9) SEEPAGE PIT SIZE: # of pits; ft diameter; ft liquid depth;
ft to residence; ft to well; ft to property line;
ft to ordinary high water mark of lake or stream; ft to edge of slopes
greater than seepage pit inlet pipe-elevation ft; bottom of
seepage pit elevation ft.
(10) SEEPAGE BED SIZE: ft width; ft length; tile depth.;
li.neal feet tile; ft to residence; ft to well; ft to lot or
property line; ft to ordinary high water mark of lake or stream; ft to edge
of slopes greater than 20% falling away toward lakes, water courses or drainage ditches
Elevation of tank discharge line entering bed ft.
11 SEEPAGE TRENCH: Total length of seepage trench ft; width ft;
tile depth ft; ft to well; ft to ordinary high water mark of
lake or stream; ft to edge of slopes greater than 20% falling away toward lakes,
water courses or drainage ditches; elevation of tank discharge line entering seepage
trench ft.
(12) Has system been installed in area indicated on EH 115? ❑ YES ❑ NO
(13) Has system been installed in floodway? ❑ YES ❑ NO Floodplain? ❑ YES ❑ NO
DILHR-SBD-6095 N.05/80
Signature of Inspector:
EH 1 5 Rev. 9/78
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
• WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION: 1~'/4, = 1/4, Section -j-,T=/ N,R--Lf (or) W~Township or Municipality
Lot No. , Block No. County
Subdivision Name
Owner's/Buyers Name: Z47',I
Mailing Address: t
TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEWREPLACEMENT ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS s PERCOLATION TESTS - - 7
SOIL MAP SHEET _ NAME OF SOIL MAP UNIT <~,ialrl.-;GQ L /T 162211
_ PERCOLATION TESTS
r 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 MIN/IN
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P- - 1
i 1J
-
P-- 4, Ile,
P_
P-
P-
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK
OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES
B- > - S
B- C "
B- > S - K `7
B- - sS s C - `1 -
PLAN VIEW (Locate percolation tests, soil 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 points. Indicate slope.
A _
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1, the undersigend, 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 doles are correct to the best of my
knowledge and belief.
:nt) ' Certification No. - f
1 -4
,ler if known 1, /A
e4:~.
-Local Authority CST Signatur
•
State and County State Permit #
PLB-67 of y Count Permit #
Permit Application Y
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. LOCATION: 4tE /4 Ahl-%, Section _,!J:, T~_ N, R (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township C1~ylCSl~r
C. TYPE OF OCCUPANCY: *Commercial *Industrial 'Other (specify) *Variance
Single family _X Duplex No. of Bedrooms No. of Persons
D. SEPTIC TANK CAPACITY JAC/,0 Total gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete - 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 j~L-sq. ft.
New Replacement Alternate (Specify)
Seepage Trench: No. of Linea] Ft. Width Depth Tile depth (top)-No. of Trenches
Seepage Bed: _X_Length - q~ WidthJ_Depth~Tile depth (top) ,-2 No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land- ~Yy 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 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 TT ter,
NAME a41ur✓1/~_LLr~t'r 4 C.S.T. # X511 4
S-~ and other information
obtained from U~+f' (owner/builder).
Plumber's Signature NIP/MPRS # Phone
Plumber's Address Zuo Z_` a
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 STATE DEPARTMENT USE ONLY
Date of Application ~~-X~i Fees Paid: State, County Date, - ~G)
"-,mit Issued/Rejected (date) `Z Issuing Agent Nam e'
"es _X_No State Valid# Date Recd
(white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
ink copy) 4. plumber (canary copy)
Revised Date 7/1/78
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16 '
ST. CROIX COUNTY ~
WISCONSIN
- - ZONING OFFICE
r M u r ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
- Hudson, WI 540 1 6-771 0
(715) 386-4680
SEPTIC INSPECTION / WATER TEST REQUEST FORM
Please specify desired test(s) & remit appropriate fee with
application. Outside water lines are often turned off during
winter months, making access to the home necessary. Please make
arrangements with this office to insure that entry can be gained.
❑ Water (VOC's) $185.00 s ❑ Septic $50.00
@~Water (Nitrate & Bacteria) 45.00e ❑ Nitrate & Bacteria
r Water (Lead Concentration) 21.00 ~ retest $15.00
Owner: 5 Q l2 e- r SA erz- Requested by: O W yl£ Vt
Address: 0110 5 4 C&o ;,r R eQ Address:
05c eo[A 11U11 ZIPIS'490 ZIP
Telephone W: (ZS- ;L 9 y - 3 O a'l Telephone W: ( )
Property adres(F,ire W & Street) : .S'all1e,
Location: Sec. 57 , T_31_N, R_ f 9 W, Town of LY G
Realty firm: Lock Box Combo: Closing Date:
IC, 1'2-
r SSW TO BE COMPLETED BY PROPERTY OWNER
'*PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORMS
Water sample tap location:
Is the dwelling currently occupied? Yes ❑ No
If vacant, date last occupied:
Age of septic system:
Septic tank last pumped by: Date:
Previous Owner's Name(s):
Have any of the following been observed?
❑Y ❑N Slow drainage from house.
❑Y ❑N Sewage Back-up into dwelling.
❑Y ❑N Sewage discharge to ground surface or road ditch.
❑Y ❑N Foul odors.
Other comments relative to system operation:
I certify that the above information is complete and true to the
best of my knowledge.
OWNERS SIGNATURE: ATE:
1/94
OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION
IN
TO BE COMPLETED BY INSPECTION AGENCY
System design &/or permit on file? []Yes ❑No
Soil series per SCS Soil Survey: sheet #
Type of soil absorption system: []Below grd ❑At-Grd []Mound
Approx. size 'X []Gravity []Dose []Pressurized
[]Bed []Trench []pry-, Well
[]Holding Tarikl: ❑outfall pipe
OBSERVED DEFICIENCIES []Other []Unknown
Septic tank
Setbacks: []House []Well []Prop. line []Other
Dose tank
Setbacks: []House []Well []Prop. line []Other
[]Locking cover []Warning label []Pump/Floats
[]Alarm []Elec. wiring
Soil Absorption System
Setbacks: []House []Well []Prop. line []Other
❑Ponding: 4 []Discharge:
General comments:
INSPECTORS SKETCH OF SYSTEM LOCATION
N
Inspector
Title
r~ ST. CROIX COUNTY
WISCONSIN
" ZONING OFFICE
b p II II p N 4 11 ■ M~.~6 ST. CROIX COUNTY GOVERNMENT CENTER
4 1101 Carmichael Road
- - Hudson, WI 540 1 6-771 0
(715) 386-4680
September 29, 1997
Shirlee Fisher
357 Polk/St. Croix Road
Osceola, WI 54020
RE: Water Test Results for Shirlee Fisher
located at 357 Polk/St. Croix Road, Osceola,
Wisconsin, St. Croix County
Dear Ms. Fisher:
Enclosed is the original water test results from Commercial Testing
Laboratory for a water inspection that was taken at the above
referenced property.
If you have any questions regarding this, please call our office at
(715) 386-4680.
n rely,
ame s k . ThomPsofa
Assistant Zoning Administrator
Enclosure
sm
COMMERCIAL TESTING LABORATORY, INC.
514 Main Street, P.O. Box 526
Colfax, Wisconsin 54730
715-962-3121
I 800-962-5227
f FAX - 715-962-4030
i.. fiiU Lin. u t 1bJJ7
•'li•a.L It t. l i ..:l i' . 6, : ; r'I•PIRT r;A71 Q /2-
1 CARMICF{AEL ROAD
t9ON, WI
4ER: Sh i r lee F i si
NATIONS 357 Polk
-,LECTORS Jim Thom
E COLLECTF'n'
^E COLLECT
-9RCE OF Sk
'E ANALYZED24-18
.
,,E ANALYZED' 2200
;..IFORM, WCC S 0 ; ~ vv
=ERPRETATION2 Bac" j,
3e
,ve ii; µFm exceeas tht-
nking Water Standar
!5''1
PROFESSIONAL LABORATORY SERVICES SINCE 1952
COMMERCIAL TESTING LABORATORY, INC.
514 Main Street, P.O. Box 526
Colfax, Wisconsin 54730
715-962-3121
800-962-5227
FAX - 715-962-4030
C;kUlX w,WN t Z+.iN1146 UFFICL KEFlkl NO, 4675WO'I PAGE
CROIX CTY GOV.CTR REPORT 1lATE: 9/26/97
1101 CARMICHAEL ROAD DATE RECEIVEW 9/19/97
HUDSON, WI 54016
ATTN« THOMAS C. NELSON
I
WI DNR LAB CERTIF4617013980
W5331 Method MDULOO Date
ahirlee Fisher Code Analyzed
Kitchen 9-17
- -
Leads ug/L 2 200.9 1/3 9-18-97
I
The maximum contaminant level (MCL) for lead in drinking
water systems is 15 ug/L.
The maximum contaminant level (MCL) for copper in drinking
water systems is 1300 ug/L,
V
k_
i
s
ti
PROFESSIONAL LABORATORY SERVICES SINCE 1952