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HomeMy WebLinkAbout181-4119-00-100 h ~ O 6 0 6-� c c 0. 0 0 ts c 00 N m O Qa coy N M O O m J C U p C � any C. Z 0 cc L 'mm — E 7 O L y Its a°'O� I 'O> V) N o , y m of Z3 o y C N O O m 3 C C d d y O C y L ow > > y 0) E O w y E w 3 O O m w O C 0) 'O Z C O O L O Z m C io w my 3 d C 157 ° LL LL o �0) ; O 'y m° C L :� a r c m O O C - a ' U L - v >> v a. 3 M N M d d' z o Z N d N N 00 N H Z a m a m m v n I I m o Z c c ci V 7 O O d Z o 91 c o c L to H c c Cl) 3 I v �_ I v Y �� I � N O N > > 'QO y t '� 0 y x a t1Nn' a C y . C •� C O L U% O L , y O O n0) Q Z fn Z Z E Z N E m r° d E .. d . o W 3 a in a ��., 3�s c N I v c c o`m $' a a a a E EI E z >° i§ 3 3 3 a° I� 3 3 3 a U •N ! yaaa �aaa a) ° C N O U) J U to ° o LO � Z rn t N Z M O O M CD O O — Q N f0 .- = O O •_ O O O a LO m a w N a m a v d Q Z in m J ti d Q Z in C N Se y y O L V I� C f C O O p Q p N C y C C V 0 y c V ° ' L N d 2€ v y Q 01 O • • d 7 m C .m. 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CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 11/30/2007 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - BLUE JAY PROPERTIES LLC BLUE JAY PROPERTIES LLC 1353 AWATUKEE TRL HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 5432 SOMERSET SP 1700 WITC SP 0035 TID # 4 VIL SOMERSET Legal Description: Acres: 6.000 Plat: 5476 -CSM 23 -5476 181 -2007 SEC 25 T31N R19W PT S1/2 NE SW; ANNEXED Block/Condo Bldg: LOT 01 864956 (07) NKA CSM 23 -5476 LOT 1 (6.00AC) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 25-31N-19W NW SW Notes: Parcel History: Date Doc # Vol /Page Type 12/14/2007 865655 EZ -U 11/30/2007 864956 ANNEX 11/14/2007 864139 23/5476 CSM 02/06/2004 753670 2505/367 WD more... 2009 SUMMARY Bill #: Fair Market Value: Assessed with: 41416 145,000 Valuations: Last Changed: 08/21/2009 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 42,000 67,700 109,700 NO 01 UNDEVELOPED G5 3.000 42,000 0 42,000 NO 06 Totals for 2009: General Property 6.000 84,000 67,700 151,700 Woodland 0.000 0 0 Totals for 2008: General Property 6.000 84,000 0 84,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Chaes Total 0.00 0.00 TOO N 141D p ° En p M ! > m o c c ;0 4i I o I o I O O N O m O G.L S O m N Mom Uu� J c N J o r C S C Q tl O N O O � 'I y I a �, •y I aZ0 mEc m m I h N y 0 a) m O L c N c w 2 Mn 1 ;5 m� rT m O p w> 3 N N (n ar E a; 1 O N N {- O 7 m O C N> Z �0 3 0 Z m o0� a> 7 N CL C LL O O) N V C C LL O 'C 7 a- E 2L•rnc Q aa) mm n Q a. 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W � o N > o .w w IL im z = co) J J W N Z Z O - J 0 z O CO) DC to a Q z .. O cr- 0 LLJ W ULI o_ _ CIO W F— O W O� • W O LL J U— W ., -J Z Z a m to O a Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. CroiX Safety and Building Division INSPECTION REPORT Sanitary Permit No: 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Stout, Richard I Somerset Township 032 - 1069 -80 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 25.31.19.345B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet S Ou TANK SETBACK INFORMATION 'I TANK TO P/L WELL BLDG. Vent to Air Intake ROAD t Inlet Septic Dt Bo Dosing Header /Man. Aeration Dist. Pipe Holding Final Gr PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number. DISTRIBUTION SYSTEM Header /Manifold 113istribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes [id No Fri] Yes [N No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1945 St. Hwy 35 Somerset, WI 54025 (N1 /2 SW1 /4 25 T31N R19W) 40 acres Lot Parcel No: 25.31.19.345B 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Fol Yes N No Use other side for additional information. Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division County a 20, . Washington Av . Box 7162 S� ` � , ad "7) Vin, WI S 1 anitary Permit Number (to be filled in by Co.) Department of Commerce( CCE y 22 Sanitary Permit App I stat Ian I.D. Number In accord with Comm 63.21, Wis. Adm. Code, personal infortmtio you provide 00 may be used for secondary purposes Privacy Law, s15.04( )(m) 8 ',` ('j , y ��� Proj t Addres (if different than mailin address) 1. Application Information - Please Print All Information 97 5 Property Owner's Na me /� Parcel N � � of 5��� lock p �o �1� �.s• o? x 2d Property Owner's M ailing Address Property Locati n 1Af 616? 3V 2 �J %o� s 3V rte,' < _ � J City, State Zip C Phone Number �/ �/ II (circ e) f . Type of Building (check all that apply) T� N; R1 .LE tO% !Zi or 2 Family Dwelling - Number of BedroomF �s� y . Subdivision Name CSM Number ❑ Public /Commercial - Describe Use _ 11� / 20 4 El State Owned - Describe Use _ j� ( Z / 7 ❑City_Gvillage �Vxownship of III. T So.r �yS ype of Permit: (Check only one b x on line A. Comp ete line If i applicable) New System Replacement System V Treatment Holding Tank Replacement Only U Other Modification to Existing System li. Permit Renewal ❑ Permit Revision ❑ Change of Permit Transfer to New List Previous Permit Number and Date Issued� Before Expiration Plumber Owner Lj� U 3 I I S t (Che all that a /� 3�� on - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil U Mound < 24 in of suitable soil ❑ At- Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Bolding Tani: U Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter Jdheach" in r D p Line ❑ Gr- el -1 (gpds ess Pipe 1 5LOth er (exp V. Dispersal/Treatment Area Information: 2 S ale Design Flow (gpd) Design Soil Application Ra Dispersal Area Required (st) Dispersal Area Pro Po sed f) S in Elevation t Ira ,5 ity VI. Tank Info Capac in Total Number Manufacturer I Prefab Site Ste,] Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank `� ! e✓ Y Aerobic Treatment Unit � Dosing Chamber VII. Responsibility Statement 1, the undersi assmne responsibility to r 11 io n o the POWTS shown on the attached p lans. Plumber's Na me (Print) Plumber's Si gnaturo �1GiP1MPRS Number Business Phone Number • 0 � �'�� 7_ lS3�G ,�'l21 Plumber's Addre ss (Street, City, State, Zip Code) } III. Count /De artment Use Onl Approved ❑Disapproved Sanitary Permit Fee includes Groundwater Date Issued Is m�A�gi�e_5n._gmatj, ire ( ps) Surcharge Fee) / j!V _ ❑Owner Given Reason for Denial I IX. Conditions of Approval /Reasons for Disapproval 4 STEM OWNER: <���L ep lc tank, - elTrMnt filter and r� pxr/o dispersal cell must all be s ervi ce d p prov b ! y plu mbe her. idey plur as per management plan as per applicable code /ordinances. — 1Q-0 -� Attach Complete plans (to the County only) for the system on paper not les<sfian 81, x 11 sin size SBD -6398 (R. 01/03) /? ,`C�•r va� S�7�ou � �l� ,fLr��a�rc e / ,l/l�� s��'� 5'.2 S f.� / � f� So in �y.� aJ 'v d • M 4 � V pA k— a � k � �n d� �J 1 �� �Da go qj. �eY Ge f e- �A Parcel #: 032 - 1069 -80 -000 06/03/2005 07:51 AM PAGE 1OF1 Alt. Parcel M 25.31.19.345B 032 - TOWN OF SOMERSET Current X, CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): ' = Current Owner " BLUE JAY PROPERTIES LLC BLUE JAY PROPERTIES LLC 1353 AWATUKEE TR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1945 HWY 35 SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 20.000 Plat: N/A -NOT AVAILABLE SEC 25 T31 N R19W 20A S1/2 NW SW Block/Condo Bldg: Tract(s): (Sec- Twn -Rng 401/4 1601/4) 25 -31 N-1 9W Notes: Parcel History: Date Doc # Vol /Page Type 02/06/2004 753670 2505/367 WD 02/06/2003 708457 2132/369 WD 02/06/2003 708456 2132/368 WD 02/05/2001 638044 1583/388 LC more 2005 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/24/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 48,000 67,600 115,600 NO AGRICULTURAL G4 1.000 100 0 100 NO ENTERED BEFORE 2005 OI W7 16.000 64,000 0 64,000 NO Totals for 2005: General Property 4.000 48,100 67,600 115,700 Woodland 16.000 64,000 64,000 Totals for 2004: General Property 4.000 48,100 67,600 115,700 Woodland 16.000 64,000 64,000 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 210 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel #: 032 - 1069 -50 -000 06/03/2005 07:50 AM PAGE 1 OF 1 Alt. Parcel #: 25.31.19.344B 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): ` = Current Owner ' BLUE JAY PROPERTIES LLC BLUE JAY PROPERTIES LLC 1353 AWATUKEE TR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 20.000 Plat: N/A -NOT AVAILABLE SEC 25 T31N R19W 20A S1/2 NE SW Block/Condo Bldg: Tract(s): (Sec- Twn -Rng 401/4 1601/4) 25 -31 N-1 9W Notes: Parcel History: Date Doc # Vol /Page Type 02/06/2004 753670 2505/367 WD 02/06/2003 708457 2132/369 WD 02/06/2003 708456 2132/368 WD 02/05/2001 638044 1583/388 LC more 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/24/2003 Description Class Acres Land Improve Total State Reason ENTERED BEFORE 2005 OI W7 20.000 80,000 0 80,000 NO Totals for 2005: General Property 0.000 0 0 0 Woodland 20.000 80,000 80,000 Totals for 2004: General Property 0.000 0 0 0 Woodland 20.000 80,000 80,000 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 U 2505P 367 j 753670 13 STATE BAR OF WISCONSIN FORM 2 - 1998 KATHLEEN H. NALSH WARRANTY DEED REGISTER OF DEEDS i ST. CROIX CO., MI Document Number RECEIVED FOR RECORD This Deed, made between 02/06/2004 11:15AN RT _HARD n SIMTIT and .TAN .T P- s Tnffm, WARRANTY DEED husband — c1nCl_ wife, EXEMPT N Grantor, REC FEE: 13.08 �! and BLUIP JA 1 DROPERTIES, LLC, a Wisconsin j TRANS FEE: Ij T,i mi tpd T. abi l i ty Company, I4 COPY EE Grantee. y PAGES: 2 j Grantor, for a valuable consideration, conveys and warrants to Grantee the following j described real estate in St. Croix County. State of Wisconsin: I a3cor li i veaa Lot 22, First Addition to Sommers Landing Name and Return Address in the Village of North Hudson, St. Croix Richard O. Stout County, Wisconsin; '{ 6 , 1353 WI 5 Awatukee Tr. and 'I Hudson i� � i Lots 12 and 13, Plat of Pinewood in the il_�_ City of Hudson, St. Croix County, Wisconsin; - -- = =_ - ° --= --- -- 161- 2010 -20 -000 it and P ntf S 1/2 of N 1/2 of SW 1/4 of Section 25, This homestead A j Township 31 North, Range 19 West, St. Croix property. j 3 (is) (is not) ji 1 -1 County, Wisconsin; it and b l 5 S}, rua it Part of the NW 1/4 of NW 1/4 of Section 34 and Part of the NE 1/4 j of NE 1/4 of Section 33, all in Township 29 North, Range 18 West, jl St. Croix County, Wisconsin, described as follows: Lot 1 of II ii Certified Survey Map filed December 18, 1989, in Vol.8, Page 2179, II Doc. No. 454291 except part to County Concrete Corporation in Vol. 1094, Page 522, Doc. No. 521212. i j u Exceptions to warranties: esements, restrictions, rights -of -way and covenants it of record. ii I, 4 �I Dated this day of February 2004 'I t J \� J► (SEAL) �s'i/�.� �� (SEAL) �. Richard O. Stout Janet P. Stout it j, (SEAL) (SEAL) I' I . it '. AUTHENTICATION ACKNOWLEDGMENT �! i jl Signature (s) State of Wisconsin, I� sa. � St. Croix County. authenticated this day of Personally came before me this e7 G day of F hr ,ary ? 004 the above named I Ri_hard O- Rtout and Janet Roger D. S R nt�t :. TITLE: MEMBER STATE B a oPWWiUblic to I (If not, tat�/lf IA /:,._ me known to be the person s who executed the foregoing Ij i Of instrument and a d e the same. authorized by §706.06, Wis. Stats.) 8 ; j THIS INSTRUMENT WAS DRAFTED BY Janet P. Stout i t 1353 Awatukee Tr. Hudson, WI 54016 Notary Public, State of Wisconsin M commiss is permanent. (If not, state expiration date: 11 (Signatures may be authenticated or acknowledged. Both are not i��KJ�/� necessary.) I l ' Names of persons signing in any capacity must he typed w printed below their signature. STATE BAR OF WISCONSIN Wisconsin Legal Bunk Co.. Inc. WARRANTY DEED FORM No. 2 - 1998 Milwaukee, Wis. 0 3 d 0 d [o� eo � eo •o � • -Z M� v' #� r. -0 v' o o w o K) o w �� 3 �p fD O C 3 Z4 p n C• ° N W A C CO co ° n co ' o cn o O a W CO a A W o C 00. cn cnzv cn D N a = co I n. � rn O w 4 w N cn � z O O 0 3 0 O co CD CA C I 000 °~ �• 0 E g p4 =r co CO) N o 3 cr T v v 0 0 CD M d 9 ( SI � 7 3 rr N D D 0 O I OS � N • m m y O C C N CL N �_ � -4 fn CL 3 I .. Z t CD CD co z C w cd co I N C4 CD I � . CC � CD CL CD CD -N3 ° —vS a a d 0° m m o M x. o' — $ in 3 0a v c � o CD > Occ z a N' mv O.O CD Ln c -, 9 N N N O N 7 Q O y AO N � OS - 0 Z C 4) A ('p O n M N ^' O M p = N C j A CD �N cn C -'a A , W p a < cn rn C O A (D �— O _ tv N N U1 5- A V N b A 69 O N CD N O L V Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 ®�$�� Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) De art me I ht of Commerce ( 266-315 30-0 Sanitary Permit Application V,1 State Plan I. D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, s15.04(i)(m) P roject Address (if different than ma_ il_ ing ad dress) I. Application Information - Please Print All Informatio �� V D 1 1 /1 : Property Owner's Na me /V� J UN # 32,_ /O(p F & 6 rV Property Owner's ailing Address G t> 4 l �'; ��'1R !�' °s'� `� f - ) 'A,Section �2 5 — � City, State ST Zip Code Phone Number i �� N; R / 7 (ct gnu) U. Type of Building (check all apply) �s�%h � : + ^ Subdivision Name CSM Number C1 1 or 2 Family Dwelling - Number of B moms ❑ Public /Commercial - Describe Use C ❑State Owned - Describe Use S G (N Z +j Z 4 - J 3 ❑City_ ❑Villagy Townstsip of spy 5' E III. Type of Permit: (Check lin . Complete line B if applic le) A. New System Replacement System reatment/Holding Tank lacement Only ❑ Oth edification to E i in B. ❑ Permit Renewal ❑ Permit Revision El Chang of ❑ ermit Transfer to New List ev' u tuber and Before Expiration Plumber er N. Type of POWTS System: (Check all that appl - W Non - Pressurized In- Ground [I Mound > 24 in, of suitable soil A M < 24 in. of suitable soil C] At-Grade Single Pass Sand Filter El Constructed V�etland El Pressurized In- Ground ED Holding T 11 Peat 'iter ❑ Aerobic Treatment Unit 11 Recirculating Sand Filter 11 Recirculating Synthetic Media Filter ❑ Leaching Chamber Drip Line ❑ vel -less Pipe ❑ Other (xplain) V. rsal/Treatment Area Information: hcx�►�.,� ase Design Flow (gpd) Design Soil Application Rate(gpdsf) ispersal Area Re ' ed (sf) I Nspersal Area Propos d (sf) ystem Elevation VI. Tank Info Capacity in Total Aumber Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New g Tanks Tanks Tanks Septic or Holding Tank X Aerobic Treatment Unit Dosing Chamber L i VII.'Responsibility Statement 1,46 undersigned, assume responsibility for ingallation of the POWTS shown on the ttached plans. Plumber's Na me (Print) Plumber's Si gnature / P PRS Number BusNiess Phone N umber `�C l l Plumber's Addre as (Street, C' , State, Zip Code) VIII. Count /De ent Use Onl Approved ❑ Disapproved Sanitary Permit Pee (includes Groundwater Date Issued Iss n gent Signature o Stamps) Surcharge Fee) 1 22S�_ Z� El Owner Given Reason for Denial IX. Conditions of Approval/Reasons for Disapproval Attach complete platy (to the County only) for the kystein on paper not less thdA 8112 x 11 Inches in size SBD -6398 (R. 01/03) 7 d� 4 � �C 0 L �t u k U J� �tr �b l Asa yef'�;� loa led r "Ajv )JeY e- 'pa z9c� - —e 1059 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings Tom Schmitt in accorda omm 85, Wis. Adm. Code i s ze: ita` "� County Attach complete site plan on paper not less �tht;% 11 �t� on distance t ronc eih. rh-must St. Croix include, but not limited to: vertical and horiz etice point (BM); direcfio d percent slope, scale or dimemsions, no d toad. Parcel I.D. � � 032 1069 - - 000 Please pfin a 'for ,� a ewed By Date Personal information you provide may be s secon� ur es Pri J , s.15,Q" (1 (m)). � Z3 C� Property Owner Prope Location Parent, John & Kathleen �� Govt. Vot na NW 1/4 SW 1A S 25 T 31 N R 19 W Property Owner's Mailing Address C?' ��G Lut Block # Subd. Name or CSM# 1945 State Hwy 35 L� na 40 Acre Parcel City State Zip Co kgidn @l)lumbe{ 1 City Village jid Town Nearest Road Somerset WI 54025 x-348$ ' Somerset State Hwy 35 New Construction Use: to Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD 16 Replacement A Public or commercial - Describe: Parent material Pitted glacial drift Flood plain elevation, if applicable na General comments and recommendations: Area suitable for conventional system with a 0.4 gpd /sgft rating. Possible system elevation 93.65'. M id Boring # A Boring Pit Ground Surface elev. 97.15 ft. Depth to limiting factor >95 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. " Eff#1 *Eff#2 1 0 -7 10yr3/3 none sl 2mgr mvfr gw 2m .5 .9 2 7 -23 10yr4/4 none sl 2fsbk mvfr gw 1f .5 .9 3 23 -44 7.5yr4/4 none sl 2msbk mfr gw - - - - -- .5 .9 4 44 -95 5yr4/4 none sl 1 msbk mfr - - -- - - - - -- .4 .6 y3 (RS' Boring # j Boring id Pit Ground Surface elev. 97.83 ft. Depth to limiting factor > i Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 *Eff#2 1 0 -7 10yr3/3 none sl 2mgr mvfr cw 2m .5 .9 2 7 -14 10yr4/4 none scl 2fsbk mfr gw 1f .4 .6 3 14 -21 7.5yr4/4 none grsl 2msbk mfr gw - - - - -- .5 .9 4 21 -35 5yr4/4 none sl 2msbk mfr gw - - - - -- .5 .9 5 35 -96 5yr4/4 none sl 1 msbk mfr - - -- - - - - -- .4 .6 Effluent #1 = BOD? 30 < 220 mg /L and TSS >30 < 150 mg� /L Effluent #2 = BOD < mg /L and TSS < 30 mg /L CST Name (Please Print) Signature . � CST Number Thomas J. Schmitt 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valley View Trail, Somerset, WI 54025 5/10/01 715 -549 -6651 Prbperty Owner Parent, John & Kathleen Parcel ID # 032 - 1069 -80 -000 Page 2 of 3 Boring # A Boring je Pit Ground Surface elev. 96.19 ft. Depth to limiting factor >94 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -8 10yr3/3 none I 2mgr mfr gw 2m .5 .8 2 8 -25 10yr4/4 none sicl 2msbk mfr gw 1f .4 .6 3 25 -32 7.5yr4/4 none sl 2msbk mfr gw - - - - -- .5 _ .9 4 32 -62 5yr4/4 none sl 1 msbk mfr gw - - - - -- .4 .6 5 62 -94 5yr4/4 none sil 3msbk mfr - - -- - - - - -- .5 .8 (e!o ❑ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # :; Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Effluent #1 = BOD 5 > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD <30 mg/L and TSS <30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or —A —t—;i l ;n — olrPrnotP fn—t „1—P —tant the dp—t —f of AOR_1AA -11 G1 — TTV AOR_')fA_R'7'7'7 3 J 3 t-p o a f+ EL Im /Owl I si t 2 6 Id r 33 , rl, I �� qqO i x �3 � p ('d.�U �1�.y i-� r: JO �►n �/�"� � / ar�.wt �fGei,.�i�+9 6 y j �as J . �� � % /9 Os 2541.A e y CS T as f .Sotir e.•s � GJ�; �(J s` IYWJ SLJl SoX 7 r� l4 C �r S` S 46 s / V.Z 0 A&W i SEP TIC: TANK & POMP C HAMHFR CR ;5S SECTION AND SPFCTF'ICp� 4" CI VENT PIPE 12" MIN. ABOVE GRADE 9 ,JUNCTION SOX APPROVED ? 2 5' FROM DOOR, WINDOW OR WITH CONDUIT MANHOLE COVER FRESH AIR INTAKE W/ PADLOCK & FINISHED GRADE --- WARNING LABEL 4" Cl RISER _.} MIN. 6" MAX. 18" IN. INLET ' GAS- i ` WATER TIGHT SEALS - 77 TIGHT ► �APPROVEO A ` SEAL ' JOINTS WITH ALM APPROVED PIPE iPPROVED B 0,, 3' ONTO 'IPE 3' 7 { , SOLID SOIL )NTO SOLID ''"" ;OIL PUMP OFF ELEV . FT. OFF P ERMITTED ONLY RISER EXIT D P IF TANK MANUFACTURER HAS APPROVAL 3" APPROVED BEDDING UNDER TANK CONCRETE PAD — SPECIFICATIONS — SEPTIC f DOSE TANK MANUFACTURER: LrJ�V NUMBER DOSES PER DAY: TANK SIZES SEPTIC , /U_ 0 GAL, DOSE VOLUME INCLUDING DOSE_ 5�_.., GAL• FLflWBACK: GAL. ALARM MANUFACTURER: Aeur�,v -1 CAPACITIES: A = al 99 INCHES = 3 G AL. MODEL NUMBER: ,cv - B z 2 INCHES = 2 GAL SWITCH TYPE: PUMP MANUFACTURER: yak /�ls C = 35 INCHES = l4', Z GAL. MODEL NUMBER: D = �� INCHES = GAL. SWITCH TYPE: REQUIRED DISCHARGE RATE 3 GPM PUMP & ALARM WIRING AS PER ILHR 16.23' WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE . . '/? FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . . . FEET + X9'6 FEET FORCEMAIN X L6j/ FT /1G0 FT. FRICTION FACTOR . FEET TOTAL DYNAMIC HEAD = z7 ,FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ; WIDTH DIAMETER LIQUID DVTIT SIGNED: / LICENSE NUMBER: 2� 1/88 Submersible Effluent Pump 3871 EPO4 EP05 a►PPUU'fl N + Fasteners: 300 series * Fully submerged In hid a U*; Nting; cast iron ' sheaf. = 8nd ne OR for for et!tident hard transfer, � fo#la�vinp ' UP* of running efRc lot strengti'� am durab ility. u ; +� city wldtout damage to heat transfer. 3 WN"r W. Ti*tmaplas- componants, tic cover with integral handle Homes Available for "Mom scud Farms manual open tloa. Antomatic and fic awt�h attadtrr�ent Haw duly sump • EPO4 Single phase: 0.4 HP, m ea ls locUtde MaaMfril�l points. • �'ater transfer 115 or 2� V, 60 F1t,1550 float 8wttob aaritntiied and • fow�ir Cable: Severe duly �� RPM, built in overload with prewt ad the bdoatr. rated oil and water resistant automatic reset I Baftp per and lower e EM Single phase: 0.5 HP, h d�ty ba bearing S1 i;UlGATtOl1S ,�„_,. 115 V, 60 HZ 1550 RPM, lFEATOUS hem dq.ion. Pump: D" bulft In overload with r EM Impeliv; The s Sobs handling c apability: automatic reset. plastic Semi -open design ABBOY US1'iIYS ak° M$Arnum. 4 Poreac' cord: 10 foot with pump out vanes for r--- ,, - . lrePacltiea: up to 55 GPM. standard two, 16/3 SJTO mechanical seal prateetlon. �%. Naooiaiicn Total heads: up to 24 feet, with time prong ground!ng rovetf • Oisaharge OW: 'I 'le 1 T- plug. Optional N foot Pl , Thermo, c rnctesed design ognfd r (CSR t i model numbers Mechanical seal: carbon- Ion*, 164 SJTW with impr A and In 4 F" or "AC.) m ere aru:e :m• rota /ceramic4tatlonary, throe p rong grounding plug s} BUNX -fi slastomers, ,standard on EP05), a cui desi provides T superior stre ��ii�F �t>�) cor�inuaus ngth and 140 180 Werrni C4+T0&lOn rti6 106. Faslann: 300 Mies NEWS FEET ----- - SWOON eteei. 14 Calpaibhl of nnlning T ' wifluw,d S a to as E < < t —�- � a mp• • Solids handling capability: f 7 VO maximum. T � + caw m up to 60 GPM. TOW heads: up to 31 to. • e 20 icai seal: n• /aerasrrbratatlonary, � � 15 ; ,. fiutCm8r8• � - i --- -- T tie: 3 10 I cro =41nuous 140 (sm irr mut x I 1 0 0 so 0 0 e 19 12 m orn CAPACY ', , a low aw a PWAM ins. Bhative May. ►giiB POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pa of FILE•1NFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity g a l ❑ NA Permit # jp0� 3 Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer 7- 6 G ❑ NA Number of Bedrooms 3 ❑ NA Effluent Filter Model ffd 0 NA Number of Public Facility Units ❑ NA Pump Tank Capacity al ❑ NA Estimated flow (average) LSD a l /da Pump Tank Manufacturer Z1 ,• s ew ❑ NA Design flow (peak), (Estimated x 1.5) ,25 g ai/day Pump Manufacturer ❑ NA Soil Application Rate 4 0 /ft� Pump Model j ❑ NA Standard Influent/Effluent Duality Monthly average* Pretreatment Unit 0 NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand IBOD 5220 mg /L ANA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L Odn- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L X NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510• cfu /1 OOml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Oar ❑ NA Other: ❑ NA Other. ❑ NA 'Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tanks) At least once every: 3 rr�(s) s) ( Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one - third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: 3 months) (Maximum 3 years) ❑ NA aar(s) Clean effluent filter At least once every: 3 ❑ month(s) ❑ NA ear(s) Inspect pump, pump controls & alarm At least once every: El month(s) 13 NA ❑ earls) Flush laterals and pressure test At least once every: ❑ month(s) ❑ NA ❑ yeads) Other: At least once every: CI month ❑ NA Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer, Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cells) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cellW. If high concentrations are detected liave the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal collie) in one large dose, overloading the cell($) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain isump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is property and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or, must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result In the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The $rte 044 site e tank ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < < WARNING > > SEPTIC. PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name 9Q91/41e4 Name Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Phone Phone This document was drafted In compliance with chapter Comm 83.2212)(b)(11)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. V 2 13 2 P 3 6 9 - 7 4bati.s • `` M STATE BAR OF WISCONSIN FORM 2 - 1999 XATHLEEH H. WALSH '! WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX CO., MI This Deed, made between John W. Parent and Kathleen A. RECEIVED FOR RECORD Parent, h usband and wife, 02/06/2003 08:30AN EXEMPT # Grantor, and Richard O. Stout and Janet P. Stout, husband and wife, REG FEE: 11.00 TRANS FEE: 1080.00 -- COPY FEE: CERT COPY FEE: PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area S 1/2 of N 1/2 of SW 1/4 of Section 25, Township 31 North, Range 19 West, Name and Return Address St. Croix County, Wisconsin. I � L C 032 - 1069 -50 -000 & 032- 1069 -80 -000 Parcel Identification Number (PIN) This is homestead property. (is)�Q Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this -2�1 y7)— day of February 2003 W , * * Parent rdltL * * Kath en A. Parent AUTHENTICATION ACKNOWLEDGMENT Signature(s) John W. Parent and Kathleen A. Parent, husband STATE OF WISCONSIN ) and wife, ) ss. A County ) auth tic _day of February 2003 Personally came before me this day of the above named * Kristina Ogland T1TL : MEMBER STATE BAR OF WISCONSIN - -- (If not, to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, WI 54016 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) , •) * Names of persons signing in any capacity must be typed or printed below their signature. Information Proresslonais company, Fond du Lac. wi STATE BAR OF WISCONSIN 800.655 -2021 WARRANTY nEEn FORM No. 2- 1999 i LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SOMERSET COMPUTER NUMBER 032 - 1069 -80 -000 Parcel Number 25.31.19.3458 OWNER NAME: First RICHARD O & JANET P Last STOUT PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment 1945 HWY 35 SECTION 25 TOWN 31N RANGE 19W %160 '/440 Line Description Line Description TOTAL ACREAGE 20.000 PLAT LOT BLK 01 S EC_25 T31 NB1.9W 20A S1/2 NW 1 02 SW 16 03 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SOMERSET COMPUTER NUMBER 032 - 1069 -50 -000 Parcel Number 25.31.19.344B OWNER NAME: First RICHARD O & JANET P Last STOUT PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment SECTION 25 TOWN 31N RANGE 19W '/4160 '/440 Line Description Line Description TOTAL ACREAGE 20.000 PLAT LOT BLK 01 SEC 25 T31 N R19W 20A S1/2 NE 15 02 SW 16 03 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SOMERSET COMPUTER NUMBER 032 - 1069 -80 -000 Parcel Number 25.31.19.345B OWNER NAME: First RICHARD O & JANET P Last STOUT PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment 1945 HWY 35 SECTION 25 TOWN 31N RANGE 19W %160 '/.40 Line Description Line Description PARCEL VOLUME & PAGE HISTORY TYPE VOLUME PAGE DOC# NOTES lo-.WD 2132/ 369 708457 PARENT JOHN & KATHLEEN TO STOUT RICHARD & JANET ..WD 2132/ 368 708456 MCDERMOTT MILDRED TO PARENT JOHN & KATHLEEN ..LC 1583/ 388 638044 MCDERMOTT TO PARENT ..TI 1583/ 382 638043 TERMINATING JAMES INT .. 435/419 0 Use Arrow Keys to Select, F7 -ROD, F10 -Exit 7 Farms Inc u Gerald & 45 ro pq (( actin 1u 35 i 2 ° Iennifer IA 167 M C Laventure '� p ti o O o W &M 20 William V oo p ,L a m 0 Gnu ' lac Zoo H Y tl' tl U C 5 7 1 P 37 154 , M Kn4- � 232nd a ° M 24 & Trust N e o &L Not AVE t ' Cro Mary 117 11 t� "� 10 Mi- &Susan 2 v AVE 3 40 . 21 a Tralser r " f f V Z WK t JR Ol $. s TS H 3 I § 2 C 41 14 C & M AVE itNebroc � r Mu4aret 1 Taiser Family � eye v 40 xhachme, 4o r Trust 79 10 35 b r11 3 3 C 1 L e 1 14 12 E: S Donald twan& X h sX r „ 45 h „ a C i - Martin 4! 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Jo key RV n 4 44 & uma _ 40 8 4i 14 V 8 uwnn 4 !! r a s S ams 20 a �o na Louis & ` 16 " g L r G aw 3 a tr * T is L rmain E 279 per_ z 14 U Belisle h _ ro &�unda . " 00 tg AVE pq t Dennis & o ■ o er 11 ° _ , Dawn • 40e l o 8 ewm 47 " TM 8 Neumann 91 m 1 aot,nt M o v o o> A �.... s e st I A gg S m Pine Cliff a cas Elizabeth I ` Partnership 1. M N Neumann , s 40 40 9 37 B� & a James 159 2 T 6 N 111 39 x ]9 _— cloacae m _ »Harr Landry Edward 1 w John \ M L�. 40 P Sampair Parent ZWickey 80 g aB saa sac Vic a LI1 99 D e anc 10 • s s R Elaine & Lawson Donald odor & Lisa ` x _24 N _ 51 g n 17 17 _ Trust 101 Gx y 149 � u 49 >ti' � 2 - 40 Gaz _ ° ry o Louise " �, Tbomas "' m . N DM 0� " 3 °�' 1r ■.: . _ i a c I a O LgtD 3 Z o 2 L &K s s ■ 40 Belisle 80 ° m 3 A 11 ,Samuel �,� R I� " " n R m' o� 10 iBUtih Mont- sle 65' ua P U z C b d '41st s Ftr 183rd JKRC <1P1. ►. ST ,0 8 HD AvE I LC , o w M lames& s JOaePb Somerset et 115 tr f 4 50 DM Vargo 33 - 4! 180th AVE SOMERSET'S' PAGE 62 180th AVE Team 1 Realty David Bracht & Jack Harrison ge 712 Rivard Street, Suite 100 Somerset, Wisconsin 54025 lul Office: (715) 247 -5900 Toll Free: (888) 223 -3283 Fax: (715) 247 -4880 __