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Parcel 181-1034-95-000 11/22/2006 11:41 A
PAGE 1 OF 1
Alt. Parcel 35.31.19.152 181 - VILLAGE 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
BARRY T BREAULT O - BREAULT, BARRY T
BOX 88
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description " 300 GARFIELD ST
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 0.000 Plat: 01/69-HARRIMANS ADD
HARRIMANS ADD LOT 11 BLK F VIL SOMERSET Block/Condo Bldg: F LOT 11
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
35-31 N-1 9W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/13/2000 626396 1526/381 TI
07/23/1997 706/404
04/26/1990 457955 869/22 WD
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 09/26/1994
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.000 9,000 0 9,000 NO
Totals for 2006:
General Property 0.000 9,000 0 9,000
Woodland 0.000 0 0
Totals for 2005:
General Property 0.000 9,000 0 9,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
016-CURB&GUTTER SPECIAL ASSESSMENT 480.14
Special Assessments Special Charges Delinquent Charges
Total 480.14 000 0.00
Parcel 181-1034-90-000 11/22/2006 11:41
PAGE 1 OF 1
F 1
A't. Parcel 35.31.19.151 181 -VILLAGE 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
BARRY T BREAULT O - BREAULT, BARRY T
r _
BOX 88
SOMERSET WI 54025
's
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 302 GARFIELD ST
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 0.000 Plat: 01/69-HARRIMANS ADD
HARRIMANS ADD LOT 10 AND EAST 1/2 LOT 9 Block/Condo Bldg: F LOT 10
BLK F HARRIMAN'S ADDITION VIL SOMERSET
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
35-31N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/13/2000 6263,96 1526/381 TI
07/23/1997 867/285
07/23/1997 706/404
04/26/1990 457955 869/22 WD
2006 SUMMARY Bill M Fair Market Value: Assessed with:
Valuations: Last Changed: 10/13/2006
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.000 36,000 167,400 203,400 NO 05
Totals for 2006:
General Property 0.000 36,000 167,400 203,400
Woodland 0.000 0 0
Totals for 2005:
General Property 0.000 36,000 111,300 147,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 524
Specials:
User Special Code Category Amount
016-CURB&GUTTER SPECIAL ASSESSMENT 160.04
I
Special Assessments Special Charges Delinquent Charges
Total 160.04 0.00 0.00
St. Ooi, Cnmily Planning mid Zaeing
Parcel 181-1032-20-000
11/22/2006 11:41 AM
Alt. Parcel 35.31.19.129 PAGE 1 OF 1
Current X 181 - VILLAGE OF SOMERSET
ST.
Creation Date Historical Date Map # Sales Area Application # Permit #
Peerm tOType Y, WISCONSIN
C
00 0
Tax Address:
Owner(s): O = Current Owner, C = Current Co-Owner
FM & FMJ PROPERTIES LLC O - FM & FMJ PROPERTIES LLC
3955 HWY 61
WHITE BEAR LAKE MN 55110
Districts: SC = School SP = Special
Property Address(es): ' =Primary
Type Dist # Description * 244 GARFIELD ST
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 0.00rk/W 01/69-HARRIMANS ADD
HARRIMANS ADD LOT 7 BLK D VIL SOMERSET
Condo Bldg: D LOT 07
(Sec-Twn-Rng 401/4 1601/4)
-19W
Notes:
History:
Doc # Vol/Page T ype
004 772478 2643/003 WD
004 772477 2643/001 WD
004 772466 2642/582 TD
97 840/97 WD
2006 SUMMARY BIII more...
Fair Market Value: Assess ed with:
0
Valuations:
Last Changed: 10/13/2006
Description Class Acres
RESIDENTIAL Land Improve Total State Reason
G1 0.000 30,000 81,600 111,600 NO 05
Totals for 2006:
General Property 0.000 30,000 81,600 111,600
Woodland 0.000 0
0
Totals for 2005:
General Property 0.000 30,000 49,800
Woodland 0.000 0 79,800
0
Lottery Credit: Claim Count: 0
Certification Date: Batch
Specials:
User Special Code
016-CURB&GUTTER Category Amount
071-DELQ WATER SPECIAL ASSESSMENT 160.04
072-DELQ SEWER DELINQUENT CHARGE 89.52
073-DELQ GARBAGE DELINQUENT CHARGE 142.24
DELINQUENT CHARGE 51.63
Total Special Assessmen
160 is Special Charges Delinquent Charges
.04 0.00 283.39
z
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
Sanitary Penm.ix--k
State Septic
nt
NAME. Township St. CZj74~NRV~'N
Location) a Sect. ,
SEP
TIC TANK vi -FKAAJ I
Size Compartments
Distance Ft, ~ 00C~ 'S ^ _~t. 12% on gtceaten zZope
~vw y
_ _ - iS bt. We-ttands b .
H.ighwater it.
DISPOSAL SYSTEM
Distance From: Wett 12% on greaten USX-ope it.
Bu.itd.ing 6t. WetZands Ft.
H.ighwaten it.
FIELD DIMENSIONS:
Width o6 znench it. Depth o6 tco ck b etow t.ite in.
Length ob each tine it. Depth o6 rock oven tite in.
Number o6 tines Depth o6 tite below grade in.
Tota.2 .length o6 tines it. Sto pe o6 trench in pen 100 it.
Distance between tined jt. Depth to b edno ck it.
Totat abs orbt.ion area 6t2 Depth to groundwater it.
2
Required area it
PIT DIMENSIONS:
Number ob pits Gnavet around pits yes no
Outside d,iameten it. Depth below intet it.
2
Totat abdotzbtion atcea 6t z
A
Area tcequ,ired it rn
INSPECTED BY TITLE
APPROVED , DATE -197-. REJcCTED DATE 197.
EH 115
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH t i
P.O. BOX 309
MADISON, WISCONSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TEST ,
LOCATION: Section JJ, T-W ~N, R/if-{or) W, Township or Municipality /
Lot No. , Block No. County .4a r J~C
? Subdivision Name
Owner's Name: I
I Mailing Address: r. U
TYPE OF OCCUPANCY: Residence No. of Bedrooms 490 Other
EFFLUENT DISPOSAL SYSTEM: NEW ADDITION
REPLACEMENT 47-2 3K
DATES OBSERVATIONS MADE: SOIL BORINGS q 7 1- PERCOLATION TESTS
SOIL MAP SHEET 3 SOIL TYPE
PERCOLATION TESTS
TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
NUM- INCHES THICKNESS ICHARACTERN INCHES SINCE HOLE HOLEAFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
~ cc)
P ~~G` l / r rV t7 .l
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_
T.5 a V 5,
i- j s , i~11 Sal -~'t - ~
c
PLAN VIEW (Locate percolation 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
r+
or distances. Give horizontal and vertical reference points. Indicate slope. r C
O- I
I AtIr
, i
I ! € € - i t N
,
,
Y
,
i ii{ t ~ t i t € i f I ~
! M
I, 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 of my knowledge and b ef.
Jas t S Certification No. S S s 3Z
Name (print)
Address
Name of installer if known
~ ~ -
COPY A -LOCAL AUTHORITY CST Signature
r
State and County State Permit # 41
Permit Application County Per #J
PLB67
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: '/4 t Y4, Section , T-~/ N, R-11- 4, (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. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES_~,NNOO # 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 A"
*Poured in Place Steel Other (specify)
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2), 3) Total Absorb AreaG sq. ft.
New_,)( Addition Replacement *Fill System
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length
Width / Depth G` Tile Depth No. of Lines
11
Seepage Pit: Inside diameter Liquid Depth Tile Size `f
Percent slope of land / 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 Co and that I Have sized the effluent disposal system from the EH 115 prepared
by the CeVed Soil Test,
NAME f-• 4.J e. Y' C.S.T. # j S 5f and other information
obtained from (owner/builder).
Plumber's Signature MP/MPRSW# Phone
i
Plumber's Address ~it
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with
H62.20, including well).
i~
l_ 1
Do Not Write in Space Below FOR DEPARTMENT USE ONLY
Date of Application - Fees Paid: State C r Cl, Count Date - C~
Permit Issued/PtaoeteeL (date)` Y _Issuing Agent Name F
Inspection Yes -No J Valid# Date Recd
1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, Wl 53701
2. state (pink copy) 4. plumber (canary copy)
Revised Date 6/1 /76