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N C O > o t, m o Y: O L_ E a) U N O L y �•3 c N O E 3 S' N N d >i L of to E 0 N "O C • 7 'n > O C Q w m C O a) -O O a) 'O ( n • U a; .atn 3 0 0 Nv a a) c a m N 0 3 in to ((aa to N N W o , A U E`�)3> Q) om ' -0 • o L a) o �' a) 0 E -0 o E a —v)�� 0� '� E c:? v_• m— o Z U) 0 0) a) ° c c° y m �� c U) -' c O C o v a) � E ca (D �a LL L) , V0oU wm40E.S CL (D c c ai m Q . �n 0 73 •0 0 U. L- O r- 01 °� v E cu m > M R N rn Y c I Z y N H a m I o z t v in (D E O O U N O 2 o 0 0 •� L U N N 0 ON H Z Z Z o` N Lo R E N — a o Q U o` o D a 9 a w Q o to cn to �I o a = ' m 0 0 d *� a g = (V N N N U -0 o °o o �y Q z N N 'O O N N i� O Ck O 00 N ^ r _ O E .E O O N f� m a c 'a (n o ¢ z U) _ C c w c 0 } o0 3 0 0 ° 0 t m rn o 0 0 m o a o o U) d 0 _� 6 6 �G+ O O L N N — I N f f6 N O m \ O o N N E a - 0 N r N M 0 a N a) c a) C a) �a 7 > C L O N U) U v Z N Y z e L ( n €a # a C a • a d .v N c E "1 A U a m O N U I L Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 St. Croix VAIN-Vicons Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266 - 3151 �� y State Plan I.D. Number ®5 State Sanitary Permit Application Trans Id. 167 /1 Z6 In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, sI5.04(1)(m) Project Address (if different than mailing address) L Application Information - Please Print All Information �j (��y►,SLL i Property Owner's Name _ Parcel # Lot # 10 Block # Scott & Jennifer Chapman Property Owner's Mailing Address V Property Location , 283 Arbor Hills Drive ( .76,9 City, State Zip Code Phone Number NE ' /<, SE' / <, Section 24 Houlton , WI 54082 715/549 -5949 T 30 N; R__ w II. Type of Building (check all that apply) � X 1 or 2 Family Dwelling - Number of Bedrooms Three v S r ,1 Ik Subdivision Name CSM Number Public /Commercial - Describe Use I' Arbor Hills ❑ State Owned - Describe Use ❑City_ []Village XTownship of St. Joseph (W) III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System Re Replacement System Q p y ❑ Treatment/Holding Tank Replacement Only Other Modification to Existing System Change of List Previous Permit Number and Date Issued Plumber B. El Permit Renewal 11 Permit Revision El Permit Transfer to New Before Expiration Owner J 7 sue" 1 /3 IV. Type of POWTS System: Check all that apply) -e-' Non - Pressurized In- Ground X Mound > 24 in. of suitable soil _ _Mound < 24 in. of suitable soil At -Grade ❑ Single Pass Sand Filter 0 Z. ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Ar a Proposed (s0 System Elevation 450 ,p 0.2 450 bed 2250 Basel 490 be 2261 basel 98.25' dispersal VI. Tank Info ap ity in Total Number Manufacturer Prefab site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 1000 1000 1 Wieser Concrete X Aerobic Treatment Unit Dosing Chamber 600 600 1 combo X VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Mike Rogers MP 225094 715/235 -1132 Plumber's Address (Street, City, State, Zip Code) E4457 Highway 12, Menomonie, WI 54751 VI . Coun /De artment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued lAuing Agen Si e o Stamps) Surcharge Fee)) ❑ Owner Given Reason for Denial �� IX. Conditions of Approval/Reasons for Disapproval _ / _ D Attach c plete pla (to the County only for the system on paper not less than 81/2 x 11 inches in size 4 7J�� _VJ) rc fc� it,s` e� C C`dI e ale 10' �� ,� SITE PLAN NE,SE,24,30N/R20W St. Joseph (W) township St. Croix county LEGEND I BM: 94.77' top of existing septic tank manhole cover � X pits o grade c/o clean -out contour No Comm 83 problems Scale 1" — 40' except where indicated Lo{ 10 System Elev. 98.25' / on contour 97.5' CXISYI n 3C�drN� � _ � PP\ Y •� •� ' 1 ry � F � 1 ��r � 1 4r r' ' L project: CHAPMAN page 4 of 9 Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 St. Croix N vilsiconsin Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266 -3151 / 0 State Plan I.D. Number State Sanitary Permit Application Trans Id. /6 e, � Z � Z/ In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, s15.04(1)(m) Project Address (if different than mailing address) I. Application Information - Please Print All Information Property Owner's Name _ Parcel # Lot # 10 Block # Scott & Jennifer Chapman _ Z _ U Property Owner's Mailing Address Property Location 283 Arbor Hills Drive ( City, State Zip Code Phone Number NE 1 4, SETA, Section 24 Houlton , WI 54082 715/549 -5949 T 30 N; R 20 w II. Type of Building (check all that apply) X 1 or 2 Family Dwelling - Number of Bedrooms Three Subdivision Name CSM Number Public /Commercial - Describe Use r Arbor Hills ❑ State Owned - Describe Use ❑City_ ❑Village XTownship of St. Joseph (V) III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. _ New System C1 Replacement System P Y ❑ Treatment/Holding Tank Replacement Only Other Modification to Existing System Change of List Prey ious Permit Number and Date Issued Plumber B. El Permit Renewal El Permit Revision El Permit Transfer to New � n� Before Expiration Owner S � 3 y IV. Type of POWTS System: Check all that apply) Q" Non - Pressurized In- Ground X Mound > 24 in. of suitable soil _ _Mound < 24 in. of suitable soil At -Grade ❑ Single Pass Sand Filter 2062 ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Ar a Proposed (sf) System Elevation 450 /, d 2 , 0.2 450 be250 basel 490 bed 2261 basel 98.25' dispersal VI. Tank Info Iffap4ity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 1000 1000 1 Wieser Concrete X Aerobic Treatment Unit Dosing Chamber 600 600 1 combo X VII. Responsibility Statement- I, the undersigned, assume responsibility for installat of the POWTS shown on th e attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Mike Rogers - MP 225094 715/235 -1132 Plumber's Address (Street, City, State, Zip Code) E4457 Highway 12, Menomonie, WI 54751 VI . County /De artment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agen Sig lreTStamps) Surchazge Fee) t El Owner Given Reason for Denial G'L 1 / '7 0 (�C7tn.� IX. Conditions of Approval/Reasons for Disapproval c� 0t�� `} Attach c plet e pia s (to the County only for the system on paper not less than SR2 x 11 inches in size '� t �- Ca�i.,c -e�t.� I SITE PLAN NE,SE,24,30N/R20W St. Joseph (V) township St. Croix county LEGEND 1 BM: 94.77' top of existing septic tank manhole cover � X pits o grade c/o clean -out contour \; No Comm 83 problems Scale 1" — 40' except where indicated Lod I O � System Elev. 98.25' on contour 97.5' / SMIft.ii Ti, w o L A ,�� project: CHAPMAN page 4 of 9 Safety and Buildings commerce.wi. OV 141 NW BARSTOW ST FL 4TH g WAUKESHA WI 53188 -3789 Contact Through Relay It www. commerce.wi.gov /sb/ www.wisconsin.gov epartment of Commerce Jim Doyle, Governor Richard J. Leinenkugel, Secretary August 05, 2009 CUST ID No. 224580 ATTN: POWTS Inspector LORETTA LARRABEE ZONING OFFICE L AN L PERC TESTING ST CROIX COUNTY SPIA N2089 CTY RD Y 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/05/2011 Identification Numbers Transaction ID No. 1692264 SITE: Site ID No. 750181 Scott Chapman Please refer to both identification numbers, 283 Arbor Hills Dr above, in all correspondence with the agency. Town of Saint Joseph, 54082 St Croix County NE1/4, SE1 /4, S24, T30N, R20W FOR: Description: Mound, 3 bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1235510 Maintenance required; Replacement system; 450 GPD Flow rate; 14 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 /01); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD - 10691 -P (N.01 101) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- ' 10706 -P (N.01 /01). In the event this soil absorption system or any of its component parts malfunctions so as to create a l MaA? d, the'" property owner must follow the contingency plan as described in the approved plans. In additio t e d�r : ^1/ or comply with the operation, maintenance and monitoring duties as described in section VIII o c ent manual. A copy of this information must be given to the owner upon completion of the pr tDF �S� qRT All holding/treatment tanks are to comply with Comm. 84.25(7)(a). Sic� Maintenance information must be given to the owner of the tank explaining that periodic cie f the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval con itions. A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. LORETTA LARRABEE Page 2 8/5/2009 ` Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Julia Lewis - Osborne POWTS Reviewer 2, Integrated Services WiSMART code: 7633 (262) 397 -6005, Fax: (608) 283 -7481 julia.lewis@wisconsin.gov Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings Division of the Wisconsin Department of Commerce. "Construction business" means a trade that installs, alters or repairs any building element, component, material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to 87, or the public swimming pools and water attractions code, ch. Comm 90. The term does not include the delivery of building supplies or materials, or the manufacture of a building product not on the building site. For further information, go to our website: www.commerce.wi.gov/SB/SB-BuildingContractorProuarn.html Mound System Maintenance and Operation Specifications Service Provider's Name: Rogers Plumbing, INC. Phone: 715/235 -1132 POWTS Regulator's Name: St. Croix County Zoning Phone: 715/386 -4680 System Flow and Load Parameters Design Flow — Peak 450gpd Maximum Influent Particles Size 1 /8in Estimated Flow — Average 300gpd Maximum BOD5 220mg/L Septic tank Capacity 1000gals Maximum TSS 150mg/L Soil absorption component Size 490bed Maximum FOG 30mg/L Type of Wastewater Domestic Maximum Fecal Coliform >IOE4 cfu/100mL Service FrequencX Septic and Pump Tank -- - - - - -- Inspect and/or service once every 3 years Effluent Filter------------- - - - - -- Should inspect and clean at least once every 3 years Pump and Controls ----- - - - - -- -Test once every 3 years Alarm---------------------- - - - - -- Should test monthly Pressure System --------- - - - - -- Laterals should be flushed and pressure tested every 1.5years Mound -------------------- - - - - -- Inspect for ponding and seepage once every 3 years Other---------------------- - - - - -- Initially filter should be checked yearly to determine service schedule Miscellaneous Construction and Materials Standards 1. Observation pipes, 4 "min. dia. are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap and secured with water closet or 3/8" dia. bar as shown in mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(I), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration 6. Lateral Turn-up to finish at grade or above, enclosed in a 6 -8" diameter lawn sprinkler valve box or similar product. (lateral turn -up consists of a long sweep 90 or two 45degree bends same diameter as lateral) 7. Lateral Turn -up on end of distribution laterals after the last orifice. project: CHAPMAN page 8 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code. And shall maintained in accordance with component manuals and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manholes risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8" in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s.281.48, Stats. The contents. of the septic tank shall be disposed of in accordance with NR 113, Wis Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slip off the filer when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personal shall advise the owner of when the next service needs to be done to maintain less than maximum scum and sludge accumulation in the tank. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings maybe made around the mound's perimeter and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations dictate that the mound be heavily mulched as protection from freezing. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral and it is recommended that each lateral be flushed at least once every 18months. When a pressure test is performed is should be compared to the initial test when the system was installed to determine if orifice clogging has occurred, if clogging has occurred orifice cleaning is required to maintain equal distribution within the cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner and any levels above 6" considered impending failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or components shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank or its components become defective the defective components(s) shall be immediately repaired or replaced with a component of same or equal performance. If the mound fails to accept wastewater or discharges wastewater to the ground surface, it will be repaired or replaced. Increasing basal area if toe leakage or by removing biologically clogged absorption and dispersal media and related piping and replacing components as deemed necessary to bring the system into proper operating condition. See page 8 of this plan for the name and telephone number of your local POWTS regulator and service provider. project: CHAPMAN page 9 of 9 a Wisconsin I apartment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 515122 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: Chapman, Scott & Jennifer I St. Joseph, Town of 030 - 2090 -60 -000 CST BM Elev: Insp. BM Elev: BM Description: SectionFrown /Range /Map No: 24.30.20.760 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER �,��� CAPACITY STATION BS HI FS ELEV. i Septic Benchmark 4 �J �• ti Beewt -- Alt. BM G•, r-� - Ste` w� ; .� Aeration Bldg. Sewer .� Holding St/Ht Inlet TANK SETBACK I NFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom G c 0� I Dosing k Header /Man. 17 /Q3.77 Aeration Dist. Pipe S. 1 - 7 q �b Holding Bot. System C . Q 1 y Final Grade 7 U I PUMP /SIPHON INFORMATION 1 4.1 - 7 Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOI ABSORPTION SYSTEM BED /TRENCH Width Length / No. Of Tre hes PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS �& Z� "I—, 1-- ---, ---1 SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR 5 Type Of System: I 5 , 1A- UNIT Model Number: 5� �J DISTRIBUTION SYSTEM Header /Manifold Distribution / / I x Hole Size x Hole Spacing V n to Air Intake / pipe(s) C -7 S 1 h Lengt Dia Length S�p Dia �� J Spacing G . SOIL COVER x Pressu Systems Only xx Mound Or At - Grade Systems Only i f G Depth Over Depth Over xx Depth of xx Seeded /Sodded o ulched Bed /Trench Center Bed/Trench Edges Topsoil Yes [l No [ Yes u No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: 6$ / 3 / / 200 4 33 Inspection #2: / / Location: 283 Arbor Hills Drive Houlton, WI 54082 (SW 1/4 SW 1/4 24 T30N R1 9W) Arbor Hills Lo nab t - 10 Parcel No: 24.30.20.760 � � 1.) Alt BM Description = � 11 `` -- 2.) Bldg sewer length = t I �� 4AIL 44,, e- - amount of cover = Plan revision Required? Yes ❑ No Use other side for additional nformation. Date Insepctor's Signature Cart. No. SBD -6710 (R.3/97) Safety and Buildings Division County ington Ave., P.O. Box 7162 St. Croix Isconsin n, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266 - 3151 . — / -� State Plan I.D. Number State Sanitary Permit Application Trans Id. j j_ 4 In accord with Comm 83.21, Wis. Adm. Code, personal information you provide / 6 `� 2 may be used for secondary purposes Privacy Law, sI5.04(1)(m) Project Address (if different than mailing address) I. Application Information - Please Print All Information yts2i c Property Owner's Name _ I W Parcel # Lot # 10 Block # Scott & Jennifer Cha man - - - U Property Owner's Mailing Address " 2009 Property Location 283 Arbor Hills Drive Lt1 City, State J * CbUx COUNTY I Phone Number N E , /., SE Section 24 C 7 e, HOulton , Wl P ft �ZONING OF IC '� r l 5/549 -5949 T 30 N; R 20 W II. Type of Building (check all that apply) X I or 2 Family Dwelling - Number of Bedrooms Three C) �N41 Subdivision Name CSM Number Arbor Hills Public /Commercial - Describe Use �' i ❑ State Owned - Describe Use ❑City_ ❑Village XTownship of St. Joseph (W) III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System R Replacement System ❑ Treatment/Holding Tank Replacement Only �` Other Modification to Existing System Change of List sous Permit Number and Date Issued B. 11 Permit Renewal 11 Permit Revision plumber 11 Permit Transfer to New Zo�� �- / IS Before Expiration Owner , S - r Ll � r IV. Type of POWTS System: Check all that apply) { e Non - Pressurized In- Ground X Mound > 24 in. of suitable soil _Mound < 24 in. of suitable soil At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 450 /, C 0.2 450 bed 2250 base] 490 bed 2261 basel 98.25' dispersal VI. Tank Info ap ity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 1000 1000 1 Wieser Concrete X Aerobic Treatment Unit Dosing Chamber 600 600 1 Combo X VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Mike Rogers MP 225094 715/235 -1132 Plumber's Address (Street, City, State, Zip Code) E4457 Highway 12, Menomonie, W1 54751 VI . Coun /De artment Use Onl Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agen Si o- Stamps) Approved 11 Disapproved gi)ature Surcharge Fee) � 11 Owner Given Reason for Denial s z, , o D r G ullcl �- IX. Conditions of Approval/Reasons for Disapproval n X : , k Jk CC-% 1Lc.y LL'c �kF L2z C 4C'�t._lc f'- 1� 671G�c- c'�t�� Attach co plete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size L c3' cif L1 "�.5tifZC��. SITE PLAN NE,SE,24,30N/R20W St. Joseph (W) township St. Croix county LEGEND 1 BM: 94.77' top of existing septic tank manhole cover X pits c grade c/o clean -out contour ` 1 No Comm 83 problems I Scale 1" — 40' except where indicated a . �t �a O System Elev. 98.25' / I on contour 97.5' IV �r� ` 4aJt4 ni - r j T RCCOPY r / project: CHAPMAN page 4 of 9 Safety and Buildings 141 NW BARSTOW ST FL 4TH commerce.wi.gov WAUKESHA WI 53188 -3789 Contact Through Relay i sco n s i n www commer isco go Wsb/ Department of Commerce www.wisconsin.gov Jim Doyle, Governor Richard J. Leinenkugel, Secretary August 05, 2009 CUST ID No. 224580 ATTN: POWTS Inspector LORETTA LARRABEE ZONING OFFICE L AN L PERC TESTING ST CROIX COUNTY SPIA N2089 CTY RD Y 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/05/2011 Identification Numbers Transaction ID No. 1692264 SITE: Site ID No. 750181 Scott Chapman Please refer to both identification numbers, 283 Arbor Hills Dr above, in all correspondence with the agency. Town of Saint Joseph, 54082 St Croix County NEIA, SE1 /4, S24, T30N, R20W FOR: Description: Mound, 3 bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1235510 Maintenance required; Replacement system; 450 GPD Flow rate; 14 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, S13D- 10706 -P (N.01 /O1); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD - 10691 -P (N.01 /01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD - 10706-P (N.01 /01). In the event this soil absorption system or any of its component parts malfunctions so as to create a t4t]04 d the property owner must follow the contingency plan as described in the approved plans. In additio a d��c>�y 4K comply with the operation, maintenance and monitoring duties as described in section VIII o c ent manual. A copy of this information must be given to the owner upon completion of the prft4F All holding/treatment tanks are to comply with Comm. 84.25(7)(a). �DFM S i c � c Maintenance information must be given to the owner of the tank explaining that periodic cie f the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval con itions. A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. i LORETTA LARRABEE Page 2 8/5/2009 Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/instal lation /operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Julia Lewis - Osborne POWTS Reviewer 2, Integrated Services WiSMART code: 7633 (262) 397 -6005, Fax: (608) 283 -7481 julia.lewis@wisconsin.gov Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings Division of the Wisconsin Department of Commerce. "Construction business " means a trade that installs, alters or repairs any building element, component, material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to 87, or the public swimming pools and water attractions code, ch. Comm 90. The term does not include the delivery of building supplies or materials, or the manufacture o a building product not on the building g PP f f SP g site. For further information, go to our website: www. commerce. wi. gov/ SB/ SB- BuildinaContractorProgram.htm] Private On -Site Wastewater Treatment System (POWTS) Mound and Pressure Distribution Component Design Replacement Residential application Index and Title Sheet RECEIVED JUL 2 3 2009 Project Name: CHAPMAN SAFETY & BUILDINGS Owner: Scott Chapman 283 Arbor Hills Dr. Houlton, WI 54082 Location: above address Legal Description: NE,SE,24,30,N/R20W Township /County: St. Joseph (y townLhip, St. Croix county Contents: Page 1: index and title Page 2: general information & lateral diagram Page 3: mound drawings Page 4: site plan Page 5: construction details Page 6: tank section Page 7: pump information Page 8: management plan Page 9: contingency plan Attachment: soil test to state plan State approval S94 -40087 Designer's name and license no.: Loretta Larrabee license# 18AM , Address: N2089 Cty Rd. Y k ••.,,� Menomonie, WI 54751 Phone: 715/664 - 8184 = : a - Cell: 715/505 -1628 ; 0 E -mail Ian 1perctesting a,wwt.net Designer's Signature: , vac Date: July 15, 2009 Al . I the undersigned submitted these plans under my authority ¢l y �r Mound component manual for POWTS Version 2.0 SBD- 10691 -P (N.01 /01), and Pressure Distribution coAy$ O manual — Version 2.0 SBD - 10706 -P (N.01/01) e � /gyp F SA N CS page 1 of 9 io GENERAL INFORMATION Replacement Site Three bedroom home, 450gal DWF end fed system w/2 laterals 4% slope system area dispersal cell design loading rate 1.0 0.2 soil application rate linear rate 3.52 27" limiting soil factor orifice sq /ft.11.49 Existing 1000/600 Wieser tank with Sim -tech filter effluent quality #I LATERAL LAYOUT DIAGRAM (not to scale) End Fed System Two Cells — Identical Laterals Number of laterals 1 per cell, two cells orifice dia. 3 /16in. (0.188) Lateral dia. 1 %2 orifice spacing (X) 36in. (3 Lateral length (P) 63.0 ft. orifices per lateral 22 Lateral spacing (S) 3ft. lateral discharge rate 14.52gpm Forcemain dia. 2.0 in total system rate 29.04gpm O * *see page 9 of 9 Mis. Construction for turn -up detail turn -up end on laterals at manifold for access of lateral at both ends for servicing ,_Valve box Pressure lug finish grade P first orifice next to fitting X 1.92' (23 Orifices located on bottom of lateral Last orifice next to fitting Force main 2" dia. project: CHAPMAN page 2 of 9 PLAN VIEW OF MOUND (not to scale) J = 7.57' D = 0.75' (9 ") K= 9.5' required bed 450sq.ft A = 3.83' E= 1.67' (20 ") B= 64.0' proposed bed 490sq.ft. I = 12.67' F = 0.83' (10 ") L= 83.0' required basel area 2250 sq.ft. Sp = 15.0' G = 0.50' ( 6 ") proposed Basel area 2261 sq.ft. W = 42.9' H = 1.00' (12 ") observation pipe @ 10.6ft. Observation � 0 5 di F- N L I I� H I L Mound Cross Section View (not to scale) Finished grade elev.100.08' t Lateral invert elev. 98.75' � /2 Dispersal cellelev. 98.25' / / /// - - - -- dispersal cell + 2 ' ispersal cell - - - - - -- ---- lateral S P lateral -- - -- --- - -- aggregate bed 6" aggregate be - -- - -- - - - -- ----- - -- -- - -- - -- -- - -� -- - - -- - -- - -- - - -- - - -- -- IE- tilled layer tilled layer contour 4% site slope elev.97.5 ' Numeral Key 1 topsoil cap 2 subsoil cap 1.5 ft. min. 3 ASTM C33 sand 4" min.dia. observation pipe 4 synthetic cover over cell with 1 /4 " slots, 6" min. height 5 aggregate I closet flange -p. O.Sft. min. infiltrative surface project: CHAPMAN page 3 of 9 SITE PLAN NE,SE,24,30N/R20W St. Joseph (W) township St. Croix county LEGEND 1 BM: 94.77' top ol'existino septic tank manhole corer X pits a grade c/o clean -out contour 1 No Comm 83 problems Scale 1" — 40' except where indicated r ig Z, �1 System Elev. 98.25' I on contour 97.5' P / Q► IVI'l J j s L project: CHAPMAN page 4 of 9 Construction Details 1.) Top soil to be removed from top area of mound system and north end of mound (existing K). 2.) Remove the cell's contaminated rock and lateral. Dispose of properly. 3.) Remove sealed sand of the cells, (side wall and bottom) with track back hoe. 4.) Extend north side (K) of mound to lengthen cells to 64'. Additional length of mound to be form on the north side of system. 5.) Fill void areas with clean ASTM C33 mound sand. 6.) Shape top area of mound, form (cut) cell beds to system elevations. 7.) Construct cells, lateral and completion of mound per code and component manuals. Please note new lateral dia. and orifice dia. and spacing. 8.) Equipment to be tract equipment, with limited traffic on system area. 9.) Effluent pump needs to be pulled, verify make and model. Reset floats to new measurements. Field investigation, Leroy Jansky (Waste Water Specialist), Ryan (St. Croix Zoning), it was determine that the mound sand surrounding the rock cells was sealed. Extending beyond the sealed area, clean sand. project: CHAPMAN page 5 of 9 COMBINATION SEPTIC TANK / PUMP CHAMBER - (No Scale) Approved Locking Manhole Cover aoproved Cap, With Warning Label Attached Warning Label Weatherproof Approved _ Junction Box Vent Cap —� le`k� 12 Minimum Final Grade -� 4" Minimum 78" Minimum Quick Disconnect 1/4" Weep Baffle- , Hole Approved Joint E Extending 3' Alar + Onto Solid Soil g On Approved Joint W/4 Srl4p e `l 0 2. [1EV. C Extending 3' Off 6' Onto Solid So - D Conc. Block 3" of Bedding Under tank— 1k H.o_t¢: Peep_ and Alarm Are On, sgparateCsrc�i 20 e 7 c , 90.0 -- 7, R - CX�S�•h� d� 0 0 — . 7 Tank Manufacturer: C l� 8'• a •�- too, -� G _ Tank Size-Septic/Pump: oo© o Gal 1 ons 6 Alarm Manufacturer: s 3 tec �, y Model Number: _ sk Capacities: A 19 inches or3/ 9. Yq Gallons Switch Type: m ex C- wry + B z i nches or 33.5 2 Gallons Pump Manufacturer: + C ' S i nches or 83, go Gal Ions Model Number: q $ + D / d i nches° uT / 6 7.6o Gallons . Minimum Discharge Kate: 30 Total ... _ . = ,3( i nches or 603.,E Gal 1 ons Vertical Difference Between Pump Off and Distribution Pipe: 1 1.35 Feet wX 1 . - 7(� Minimum Required Supply Pressyyre:. �a,5 .IC !� : .............. _ . � 3�5 ceet 66 Feet of Force Main x 1'v Q Friction Factor/lOO Feet: + I,Z �� Z Inch Diameter Force Main SaTM -tcJ V:�tc,- - _ _, + - o , s o Total .Dynamic Head: _ . _= I ( .3 $ Feet project: CHAPMAN page 6 of 9 w TOTAL DYNAMIC HEAD /FLOW LL PUMP PERFORMANCE CURVE PER MINUTE MODEL 98 EFFLUENT AND DEWATERING 3 7I6 6114 25 MODEL 98 45/6 Feet Meters Gal. Liters °¢ g 20 5 1.5 72 273 37re ui 10 3.0 61 231 �? 15 4.6 45 170 < 15 20 7.1 25 95 4 0 4— Shutoff Head: 23 ft.(7.Om) J r 10 I ++rzx - +rz evr 009971 2 j I 5 I I 0 I 10 20 30 40 50 60 70 80 121116 j GALLONS I I LITERS 0 80 160 240 1 421/32 FLOW PER MINUTE i SK1102 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and Variable level float switches are available for controlling single supplied with an alarm. and three phase systems. • Mechanical alternators, for duplex systems, are available Double piggyback variable level float switches are available for with or without alarm switches. variable level long cycle controls. • Refer to FM 1922 and FM0806 for temperatures above 130 °F. SELECTION GUIDE 98 Series Control Selection 1. Integral float operated mechanical switch, no external control required. Model Volts -Ph Mode Amps Simplex Duplex 2. For automatic use single piggyback variable level float switch or double M98 115 1 Auto 9.4 1 4 piggyback variable level float switch. Refer to FMO477. N98 115 1 Non 9.4 2 or 3 4 3. See FM1228 for correct model of simplex control panel. D98 230 1 Auto 4.7 1 4 4. See FM0712 for correct model of duplex control panel or FM1663 for a E98 230 1 Non 4.7 2 or 3 4 residential alternator system. CAUTION For information on additional Zoeller products refer to catalog on Piggyback Variable Level Switches, All installation of controls, protection devices and wiring should be done by a qualified FM0477; ElectricalAltemator, FM0486 ;MechanicalAltemator,FM0495 ;Sump/Sewage Basins,FM0487; licensed electrician. All electrical and safety codes should be followed including the Single Phase Simplex Pump Control, FM1596; Alarm Systems, FM0732. most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 Louisville, KY 40256- � ���.•���QQ ®® SHIP T0: 3649 Cane Run n Manufacturers of.. R oad Louisville, KY 40211 -1961 �! (502) 778 - 2731.1(800) 928 -PUMP Qvaurr PuMas � /iNCE /9s�9" http: / /Www.zoeller corn FAX (502) 774 -3624 © Copyright 2004 Zoeller Co. All rights reserved. Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code. And shall maintained in accordance with component manuals and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a um or septic tank since dangerous g ases may be present that could cause death. P pump Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manholes risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8" in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s.281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slip off the filer when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personal shall advise the owner of when the next service needs to be done to maintain less than maximum scum and sludge accumulation in the tank. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings maybe made around the mound's perimeter and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations dictate that the mound be heavily mulched as protection from freezing. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral and it is recommended that each lateral be flushed at least once every 18months. When a pressure test is performed is should be compared to the initial test when the system was installed to determine if orifice clogging has occurred, if clogging has occurred orifice cleaning is required to maintain equal distribution within the cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner and any levels above 6" considered impending failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or components shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank or its components become defective the defective components(s) shall be immediately repaired or replaced with a component of same or equal performance. If the mound fails to accept wastewater or discharges wastewater to the ground surface, it will be repaired or replaced. Increasing basal area if toe leakage or by removing biologically clogged absorption and dispersal media and related piping and replacing components as deemed necessary to bring the system into proper operating condition. See page 8 of this plan for the name and telephone number of your local POWTS regulator and service provider. project: CHAPMAN page 9 of 9 I - 1 Mound System Maintenance and Operation Specifications Service Provider's Name: Rogers Plumbing, INC. Phone: 715/235 -1132 POWTS Regulator's Name: St. Croix County Zoning Phone: 715/386 -4680 System Flow and Load Parameters Design Flow — Peak 450gpd Maximum Influent Particles Size 1 /8in Estimated Flow — Average 300gpd Maximum BOD5 220mg/L Septic tank Capacity 1000gals Maximum TSS 150mg/L Soil absorption component Size 490bed Maximum FOG 30mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100mL Service Frequency Septic and Pump Tank -- - - - - -- Inspect and/or service once every 3 years Effluent Filter------------- - - - - -- Should inspect and clean at least once every 3 years Pump and Controls ----- - - - - -- -Test once every 3 years Alarm---------------------- - - - - -- Should test monthly Pressure System --------- - - - - -- Laterals should be flushed and pressure tested every 1.5years Mound -------------------- - - - - -- Inspect for ponding and seepage once every 3 years Other---------------------- - - - - -- Initially filter should be checked yearly to determine service schedule Miscellaneous Construction and Materials Standards 1. Observation pipes, 4 "min. dia. are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap and secured with water closet or 3/8" dia. bar as shown in mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(1), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration 6. Lateral Turn-up to finish at grade or above, enclosed in a 6 -8" diameter lawn sprinkler valve box or similar product. (lateral turn-up consists of a long sweep 90 or two 45degree bends same diameter as lateral) 7. Lateral Turn-up on end of distribution laterals after the last orifice. project: CHAPMAN page 8 of 9 J&4,.,A 6cA m t' el r SIC -' K 7- YYS 7 Parcel #: 030 - 2090 -60 -000 `7/ S - 7 o p �r!p 07/23/2009 11:29 AM PAGE 1 OF 1 Alt. Parcel M 24.30.20.760 030 - TOWN OF SAINT JOSEPH Current ❑X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - CHAPMAN, SCOTT A & JENNIFER L SCOTT A & JENNIFER L CHAPMAN 283 ARBOR HILLS DR HOULTON WI 54082 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ` 283 ARBOR HILLS DR SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 3.000 Plat: 06- 002 -ARBOR HILLS SEC 24 T30N R20W PT NE SE LOT 10 ARBOR Block/Condo Bldg: LOT 10 HILLS 3AC Tract(s): (Sec- Twn -Rng 401/4 1601/4) 24- 30N -20W Notes: Parcel History: Date Doc # Vol /Page Type 06/04/2002 680759 1903/541 WD 07/23/1997 1073/582 WD 1045/323 LC 2009 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations Last Changed: 07/12/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 72,900 208,400 281,300 NO Totals for 2009: General Property 3.000 72,900 208,400 281,300 Woodland 0.000 0 0 Totals for 2008: General Property 3.000 72,900 208,400 281,300 Woodland 0.000 0 0 Lottery Credit Claim Count: 1 Certification Date: Batch M 135 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 >rn-.r � Q = O n:Ec z a "' O Z 3 m o m OD ;0 —I Q m m O C1� o � �� z 55 � m Z CA m n U) a rn� pD Am z c Z o X - — N _ � r11 o N . O z N O Z c m 0 z z n G) m cn C --� r � � m r v m X � M r, .� Z Q C rn O m -n _ C -� Z F Q m m Z � v � C m< TI -, sm m i» Sas�,S Z z -� �� vii C.� -.41 - Z z s, u U ) 06 936 Cil a� am,Z Z f � Z o w „► a c $ � 0 2 / {� 1 V �� z l •• O g z Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building,division INSPECTION REPORT Sanitary Permit No: 43 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: Chapman, Scott St. Joseph Township 030- 2090 -60 -000 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade 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 IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution 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 IDepth Over xx Depth of r Seeded /Sodded T Mulched Bed/Trench Center Bed/Trench Edges Topsoil I I [� Yes ❑ No ❑Yes [ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 283 Arbor Hills Drive Houlton, WI 54082 (SW 1/4 SW 1/4 24 T30N R19W) Arbor Hills Lot 10 Parcel No: 24.30.20.760 1.) Alt BM Description 2.) Bldg sewer length - amount of cover = 3.) Contour = Plan revision Required? X Yes ❑ No I Use other side for additional information. L=L__ SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. County Sanitary Permit Application ST. CROIX COUNTY WISCONSIN �V In accord with 15.04 St. Croix County Sanitary Ordinance ZONING OFFICE Personal information you provide may be used for secondary purposes ST. CROIX COUNTY GOVERNMENT CENTER [Privacy Law. S. 15.04(1)(m)) 1101 Carmichael Road At Hudson, WI 54016 -7710 7 — - 0 L j S (715)386 - 4680 Fax (715)386 - 4686 Attach complete plans for the system on paper not less than 8 -1/2 x 11 inches in size. County Sanitary Permit # ❑ Check if revision to previous application o0 3 Fon Information - Please Print all Information [ on: ner Name RECEIVED J 1/45 [,J 1/4, Se / / L in, 0 N, / !3 R r ropery wner's Mailing Address JUN 2 1 2002 m / ber Block Number City, State Zip Code Name or CSM Number ��vl i s - rr II Type of Building: (check one) []Village [Town of J? 1 or 2 Family Dwelling - No. of Bedrooms: ❑ Public/Commercial (describe use): ❑ State -owned Nearest Road 11. Type of Permit: (Check only one box on line A. Check box on line 61 applicable) - //' Parcel Tax Number(s) A) 1.❑ Repair 2. ❑ Reconnection 3 Sanitation 030 ✓ ® 6 -Co _000 Permit Number Date Issued State Sanitary Permit was previously issued `^ oZ IV. Type of POWT System: (Check all that apply) ❑ Non - pressurized In- ground' Mound ❑ Sand Filter [I Constructed Wetland 11 Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line 13 At-grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other . Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed (Gals. /day /sq.ft.) (Min.Anch) Elevation / L �v 1"0 1571 \, S' (,..vs VI. Tank Information Capaicty in Gallons otaI # of Manufacturer Prefab Site Con- teel Fiber- Plastic New Existing Gallons Tanks Concrete structed glass Tanks Tanks L l f1Q ❑ ❑ ❑ ❑ - <fiurl Go ❑ ❑ ❑ ❑ II. Responsibility Statement 1, the undersigned, assume responsibility for repair/ reconnencUon /rejuvenationAnstallation of non - plumbing for the POWTS shown on the attached plans. A license is not required for terralift repair or the install 'on of non - plumbing sanitation system. Plumbers Name (print) Plu s atur no stamps): MP /MPRS No. Business Phone Number G � � � 2i✓6� �7 Plumber's Address (Street, City, State, Zip Code) 0 VIII. County Use Only Disapproved Sanitary Permit Fee Date Issued Issuing Agent Signature (No stamps) Approved Owner Given Initial Adverse 9r /� s';' Determination � IX Conditions of Approval /Reasons for Disapproval: 111_7 sue - � 06/12/02 WED 13:35 FAX 715 386 4686 ST CRX CO ZONING 0 002 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER /i�CF d �or» e /// ADDRESS a &V t' qla -zl ar 4j/ ado /G SUBDIVISION / CSM# f1/ jar !b" /�Q �/' _ LOT # -/© SECTION 2- -� T -To N--R -.p W, Town of 'A' i i ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHI G WITHIN 100 FEET OF SYSTEM L L y �r G t k• 0 ° O .i 1 i i - 1 I3 INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. L ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 0 '�t pmain Mailing Address Property Address (Verification required from Planning Department for new construction) City /State , d /?U�'7 Uyi� Parcel Identification Number 0 dd 90 60 LEGAL DESCRIPTION L PAY Pro Location � '/4, � '/4, Sec. �' �T ?i�) N -R W, Town of St. 4 �Sepk Subdivision Lot # 4:�? Certified Survey Map # Volume Page # : SI Warranty Deed # 6 KO ?s , Volume 1q03 . Page # Spec house ❑ yes ❑ no Lot lines identifiable ❑ yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restrictedplumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 of year expiration date. OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of ro ed above, by virtue of a warranty deed recorded in Register of Deeds Office. / i / tHMAtbRE O APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed i ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the 6C - -,:5 �'Y)o on residence located at: Sec. GjI T _,_?C)_ N, R Town of �7°, p y� St . Croix County, Wisconsin. Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced IAVQLs o� Did flow back occur from absorption system? Yes No>�_ (if no, skip next line. Approximate v6lume or length of time: gallons minutes Capacity: .100o,� Construction: Prefab Concrete Steel Other Manufacturer (if known) : w, e.�,Z Age of Tank (if known) : - dl.e -i.r (Signature) (Name) Please 1 (Title) (License Number) (Date) Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank, to the best of my ko ledge, will conform to the requirements of ILHR 83, Wis. Adm. Code 7(exXciTr, r inspection opening over outlet b . Name (�/�2 >_� _ Signature MP /MPRS 5 2 682360 HATHLEEN H. WALSH REGISTER OF DEEDS M ST. CROIX CO., WI Document Number Documentintle RECEIVED FOR RECORD St. Croix County , j 06 -21 -2002 12:30 PH AFFIDAVIT Affidavit of System Rejuven4tion, EXEMPT # ~ ` REC FEE t 11.00 TRANS FEE: COPY FEE: Name - (Owner) Typed or printed CERT COPY FEE: being duly sworn, states, under oath, that: PAGES: 1 L He /she is the owner /part owner of the following parcel of land located in St. Croix County, Wisconsin, recorded in Volume M Page <yl Document Number 4Q O 7 d 9St. Croix County Register of Deeds Office: RecordingArea Name and Return Address A arcel of land located in the '/4 of the '/4 of Section _V_ 0 T N - R � W, Town of ST1 1;5'wP , St. Croix County, Wisconsin, being duly described as follows (include lot no. and subdivision/CSM or detailed legal description): LoT 16 A f bOr O Parcel Identification Number (PIN) As owner of the above described property, 1 acknowledge that the septic system serving this residence (is /is not) undersized by current code standards. I understand that the issuance of a sanitary permit to allow the attempted rejuvenation of the septic system does not imply that the system meets current code sizing requirements, nor does it imply that the proposed procedure will be successful. I also acknowledge that I will make this information available to any future parties interested in pruchasing this property. Dated this 2 day of : `r )O-e- 0 0 AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) )ss. authenitcated this day of St. Croix County. ) 'Ir Personally came before me this day of C i`- the above n ed TITLE: MEMBER STATE BAR OF WISCONSIN (if not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Slats.) instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY No sin (Signatures may be authenticated or admowtedged. Both are not My ne ::1.not, state expiration date: necessary.) Daj THIS PAGE IS PART OF THIS LEGAL DOCUMA �46"W-ROVE"( r . This information must be completed by submitter. document fide. name 8-return a dd s p *IIIY,(if' ' Toed). Other information such as the granting clauses, leagai description, etc. may be placed on this first page of the document 6 y laced on additional pages of the document. Note: Use of this cover page adds one page to vour document and $2.00 to the recordina fee. Wisconsin Statutes. 59.517. f � NC CD �p o 720.00 Ni A F LOT 9 Do V� 3.00 ACRES � �'�> �� 130, 892 SO. 13 : C\ o \ \ S89035'57"yy 432,10' �\ \ 0 +6 _ o !D z 0 w $ � � � N_! m N g r� LOT 4 Im o a 4 O rns CERTIFIIEp S URVEY �; \ 11 SURVEY E , PSG— 2 AP z o �` \ A� O \ \ LOT 10 rr m (Al 3.00 ACRES I.z M 130,724 SO. F7. Z ss •�� uo 'o- p O - 17 �4 NlTo6' r. 2 S'�G Ro 4D 1 -1 1 r00 S03 2324 "W 66.00 I LOT CERTIFIED SURVEY MAP VOLUME 8 � A _PG . -_E 2t84 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER / z4" d ' ron4 Q ADDRESS a b'� & r S�Y� //7 Or SUBDIVISION / CSM# %� /r �` /�� �/ LOT SECTION T N -R a0 W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTH G WITHIN 100 FEET OF SYSTEM 1 c" — 0 0 0I -- D " �, �! INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. f BENCHMARK: ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION i Manufacturer: Liquid Capacity: Setback from: Well House �d �6 Other Pump: Manufacturer Model# 47 Size Float seperation 7,33 Gallons /cycle: 11)3 Alarm Location SOIL ABSORPTION SYSTEM Width: Length :61o11 Number of trenches 2 Distance & Direction to nearest prop. line: Setback from: well: ��� House 579 Other ELEVATIONS Building Sewer ST Inlet ST outlet PC inlet PC bottom Pump Off Header /Manifold Bottom of system ��•� $ Existing Grade Final grade 1'�50.3S1 DATE OF INSTALLATI -� Q /` PLUMBER ON JOB: LICENSE NUMBER: � .�2 21y INSPECTOR• 3/93:jt i Loa � ''s,Ua;,At,to#TQge,; ?h.2 30. WYIA , R , SE*AdG SYSTEM Arbor Hills ounty: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division G,,ENEIrAL INFORMATION — ST- CROIX (ATTACH TO PERMIT) Sanitary Permit No.: Permit Holder's Name: ❑ City ❑ Village R Town of: State Plan ID No.: i . - MTCHAE St- jasaj3h --- — lnsp. BIVI Elev.: BIpescription: Parcel Tax No.: TANK INFORMATION ELEVATION DATA A9400047 VELEV. TYPE MANUFACTURER CAPACITY STATION BS HI FS Septic 4� �� � Benchmark Dosing Aeratio Bldg. Sewer Holding St /A Inlet TANK SETBACK INFORMATION St /fft Outlet TANKTO P/L WELL BLDG. tVentto ROAD Dt Inlet Septic ��� ��5� Dt Bottom Dosing / /( �� NA der-/ Man. , Aeration Dist. Pipe Holding Bot. System PUMP / SWUOff4NFORMATION Final Grade Manufacturer! tD {;� , ( � 7 Model Number 1 9 t GPM TDH Lift (� r Friction �3 5ystem+ TDH 1 4 . ql Ft oss 0 Head Forcemain Length Dia. 0 2 '' Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width / r� Lengt� / No. Oflrenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION 7 ° DIMENSION VZ SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION TypeO ew ! 3 CHAMBER y Model Number: a System: you N �-�. .� 7 � OR UNIT aj DISTRIBUTION SYSTEM Header/ Manifold Distribution Pipe(s) , �r , x Hole Size x Hole Spacing Vent To Air Intake Length r�d Dia_ ° Length _/� Dia. A SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over ,� Depth Over , xx Depth Of ., fj xx Seeded/ Sodded xx Mulched . gelCr -Trench Center /P B�Trench Edges Topsoil G -�� [�, es' ❑ No ❑Yes COMMENTS: (Include code discrepancies, persons present, etc.) �]E3� ON:, Joseph. 24.30.20W, N E , ��� SE, Lot 10,A bor Hills I Ro C/ 7, i x Plan revision re 'r ed? [ Ye(s �'I0 Use other side for additional information. l a SBD -6710 (R 05/91) Date Inspector's Signa re Cert No. f ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: i a 2 e-rt I z r d I = D - L SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COU sif STATE SA PERMIT # Attach complete plans (to the county copy only) for the system, on paper not less than 8% x 11 inches in size. ❑ Check if revision to previous application —See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER I. APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION /j/L Y4 _Tf Y4, S ,2 g T 3t3, N, R V (o W PROPERTY OWNE 'S MAILING / A gD R € SS LOT # BLOCK # 7 xJ�,bo Vii`/ CITY, STATE, ZIP CODE PHONE NUMBER SUBDIVIS ON NAME OR CSM NUMBER lzr 11. TYPE OF BUILDING Check one) CITY NEAREST ROAD ( State Owned VILLAGE // ❑ Public g-* of bedrooms 3 L AX R() r 1� r 5 • p>` ❑ 1 or 2 Fam. Dwellin III. BUILDING USE: (If building type is public, check all that apply) © -3o 1 ❑ Apt/Condo 0 2 ❑ Assembly Hall 6 ❑ Medical Facility /Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales /Repairs 11 ❑ Restaurant/Bar /Dining 4 ❑ Church /School 8 ❑ Mobile Home Park 12 ❑ Service Station /Car Wash 5 ❑ Hotel /Motel 9 ❑ Office /Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. 1Z New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit # _ Dat Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 El Seepage Bed 21 N Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals /day /sq. ft.) (Min. /inch) ELEVATION 11 D r 70' 70,65 Feet X • 0 � Feet VII. TANK CAPACITY Site in as llons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name oncrete Con- Steel glass Plastic App Tanks Tanks strutted Septic Tank or Holding Tank I' Lift Pump Tank/Siphon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumb ' Name (Print): Plumber's Signature: (No S ps) MP /M Business Phone Number: Plumber's ddress (Street, City State, Zip Code): IX. COUNTY /DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes G roundwater ate sue Issuing Agent S na a (No ps) Approved ❑ Owner Given Initial Adverse Determination � 1 � r o X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD -6398 (formerly Plb -67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and w the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3- All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer /Renewal Form (S3D 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608 -266 -3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete ## of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1 -7. VII. Tank information. Fill in the capacity of every new and /or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County /Department Use Only. X. County /Department Use Only. Complete plans and specifications not smaller than 8'f x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains /water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD -6398 (R.11/88) Wisoorwin Department of Industry SOIL AND SITE EVALUATION REPORT Page of '.tabor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code ` COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but riot limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROP RTY OWNER: PROPERTY LOCATION 0 - GOVT. LOT - 1/4 1/4,S TAG N,R - , E (or)f PROPERTY OWNED �p AILIN ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # CITY STATE \ ZIP CODE PHONE NUMBER ❑CITY ❑VILLAG OTOWN NEAREST ROAD (S) 3y - NJ New Construction Use [xJ Residential / Number of bedrooms [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow Ali gpd Recommended design loading rate ed, gpd /ft trench, gpd /ft Absorption area required bed, ft trench ft Maximum design loading rate gy bed, gpd /ft _ _ trench, gpd/ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations Parent material ' Flood plain elevation, if applicable al ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRE 7RE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ❑S ®U ®S ❑U [Is OU EIS GJU ❑S 123U ❑S OU SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench sy � Ground ele . s�>� Depth to limiting factor Remarks: Boring # O ��L Ground elev. ft. Depth to limiting fa Remarks: CST Name: — Please Print Phone: Address: i Signature: j J / a CST Number: PROPERTY OWNER SOIL DESCRIPTION REPORT Page, - PARCEL I.D. # Consistence Bour>dary Roots Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench — f. c �yX � Ground elev. aft. Depth to limiting factor Remarks: Boring # 4t }; .1.........:44:.. Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Ss.fe R Boring # e. g eJ fir:.. % ::: )Zi Y br:.aa_ Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) PROPERTYOWNER' � fZ��j1�� SOIL DESCRIPTION REPORT Page�Sf _ MiCEL I.D. i ' Boring # Horizon Depth Dominant Color Mottles Texture Structure Consisterice Bouffiry Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tmnch 13 :�d , 7 1 1 4 , �yx � Ground , eley. ft Depth to limiting factor Remarks: Boring # 13 Ground ew. ft. Depth to inriting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor R Boring # fl Ground elev.� ft. �r Depth to limiting factor Remarks: SBD- 8330(R.05/92) �/�• — t - I I I I I ita ' 1 I 1 .. ' -I �._. I _ —... i :- _ j 1 1 I I I I �-.✓ 1 I A ' - r r + I I i I I I I 1 T -4 r -. I I I , L d 1 I e I i i L� + i L mOs>�t1 —y , i - - i ( {-1- r I I I + 1 i i 1 I i1 j I I � I f 1 i i I I i I i j Imo I ! i I , i 1 ,. , ., _, i ,_ _ _- �� _ __ _ I ', -- __ _ _ . i -� - - _ __ _._ :. ,. _ - i - ---- , -- - - -Y -- - __ r - Q S 4008'7 Michael O'Connell - Mound 594 -40087 Location: Lot 10, Arbor Hills NE 1/4, SE 1/4, Sec. 24, T 30 N, R 20W Town: St. Joseph County: St. Croix Date: March 11, 1994 Owner: Michael O'Connell Address: 1383 Woodland Court Holton, WI 54082 Plumber: Roger L. Timm _ Signature: License # MPRS 3224 Attachments: 6748 -Plan Approval Application 115 County On -site letter page 1: cover 2: calculations 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve RECEIVED MAR 10 1994 page 1 of 7 SAFETY a BLMS. ow. System Calculations S94-40087 One family residence bedrooms Loading rate ' gallons /sq ft per day Depth to ground water ��� in Depth to bedrock 1 � G o in Cross slope it % Force main length 44 ft of Z in Manifold /header length ��'� ft of Z in Drainback ° '�� gallons Lateral length 71 @ ft of "14, in Lateral elevation • � ft (bottom of pipe) Lateral hole size 1 14 in @ 60.0 in ( S•O ft) spacing to holes /lateral, Z ° holes total Lateral volume �' } �' gallons Total lateral discharge rate Z 2 ' ¢ gpm @ ft head Elevation difference ft Friction loss O -N ft @ Z � gpm Total dynamic head ft Pump /si)�hon S gpm @ ft of head Manufacturer ° `'�l�' , Model # C Dose volume gallons Lift /si'vCaon tank �"��- ��-t•�*u , G� gallons Septic tank gallons Measurement pump on & off in Height alarm from tank bottom in Reserve capacity gallons calcs page Z of �' i :� - 40087 r 0 x M s M l �{ J "o s �� ✓ a f J . 44 1� � a .p 1 Gi • 1 M / V N 0 �' �- •` o -� , so AL w i -t J O ✓ 0 t PRIVATE SEWAGE SkS ;EM a i ° �'®nd it ionirl d • EL IO J + µ � o Pi J Arr .5 , DEFY. Of, INDUSTRY, LABOR & N REL ATIONS BUILDINGS .� DIVIS OF SAFETY q t D SEE C RE PONDENCE v+ • n I r � 1 N p a _ Z 4L VA% S94 0087 I.r' \ mo yb.z 4z .q C s�rS c o nalti OF 11403ST RI 1 pg ®R � p 6�1 SEE 6 94-40087 -3 c oll AP 0� N. Ct I rIVII +(, t. 4 • k �G O 0 I -L A 5 �E ► �o.ti � ( ti.1 r x ' �L s � .. a \ 1r 6 « �.. o•� »: v., � . � Oi. w. � .�. l� ....�. �,.., XA, : v... .a �. y► . puc �..,e o C,c.�.,.�l:o......ltt �� l,.tto».. ,,.�1� •4•a«�.� np TO+ra �, Mr riM •� � T • P �1 C � ♦ � µ :.� Pws ^ 40 �.... ti * r l J w d o tg•g� 1 1 , 1 • ��L+. Lal o �a.i w. •YN �uRe�... ,:.�1.� .CJ S• � 1 �� Cb iv� q�fYrT 1 0 �.. `a.t " k . ( Zv ' t►o�at )C`IAN `^1�,,.1e. : -os.4 s e� � 087 z X02 X i M AIN , WEATHERPROOF JU NCTION IACKImG GOVER hoc 1C3T\ C /E QUIC1C DWC.ON*11GTl1 4" C.T. IN%Pecnw0"641%G — _T :.I. Pigs. 3� r T 0 ND1STuRBED SO IL— L 24" Z.D. VENT 13 � fMANLIOLE _ m MIN. /A" r r QpPaovCD A PR, \jATE SEWAGE SYSTE .si(ZT W*jr muddy . ALLY �O PIP .L. Plm Q 2" ON _ umcula m :NriEC.TtONS �- n I 't - "' GRpuaao 3 q & "WAAR REtAT10NS OF INDUSTRY, LAB AND BUN.QtNGS OsF OF SAF FuMP SEE ESPONDENGE COAltRa I Z �L.FV. J� 3 B�oCK �S SEPTIC E SPEGIFI'CATIOIJS DOSE TAWKS MAWU IWLI FACTURER: MBER OF DOSES: 4 PER DAy TAWK SIZE: I lv_ - L ' O '' GALLOWS DOSE VOLUME ALARM MAAIUFACTURER: S INCLUDIWG BACKFLOW: GALLONS / 3¢6.42. MODEL 1JUMBER: �"� N ` CAPACITIES: A= � � WCAES OR ���'` GALLONS SWITCH TYPE. ` A= 2- 0.(o7 g- - � IMCHES OR ' GA�LLOUS PUMP MAWUFACTURER: �' L ..7+3,3` C== _�_WCHES OR ti GALLONS 105.6 MODEL WUMBER: D = 1O IMCHES OR GALLONS SWITCH TYPE: �' 'D ` MOTE: PUMP AMD ALARM ARE TO BE MIWIMUM DISCHARGE RATE { GPM INSTALLED O!\1 SEPARATE CIRCUITS I I . VERTICAL DIFFERE BETWEEW PUMP OFF A1JO OISTRIBUTIOW PIPE.. FEET 4 MIAIIMUM ►JE:TWORK SUPPLY PRESSURE 2 . 5 FEET U + FEET OF FORCE MAIW X %,A F /oo yT,FRICTIOW FACTOR.. C�, S FEET TOTAL 0y3WAMIC HEAD = 14' 3 FEET • _. I et-4 )UTERAIAL DIMEWSIOWC OF TAWK: LEIJGTH ' ;WIDTH }g ;LIQUID DEPTH S DI Uj HEM W 2 115 - CA PACITY 34 110 - 32 105 -- - CURVE 30 ,95 _ 85 -- 28 - 90 } _ 28 85 EFFLUENT - 2a so i MODEL and Q 75 MODEL 189 DEWATERING = 2 70 165 - - 0 65 j Q > 18 60 _ 55 16 50 MODEL 163 MODEL 14 - - - -_ - 188 12 + 40- i ± i 35 10- MODEL MODEL 30-- - -- - 137, 1391 t - - 185 SEWAGE and 6 25 t DEWATERING 6 +20 J } -- M ODEL 15 - - -I. MODE L, 161 4 97 "�4 - - - -- - a u 2 MOD L W W 5 53. Lau LL 57, 0 4t- GAL 10 20 30 40 50 601 70 60 t 90 100 110 24 _ -- LITERS 0 80 160 240 320 400 75 22 FLOW PER MINUTE 70 6-5 I G 1s 60_ - MODEL — - - Q 295 W 55 - S 16 50 -- - I ABLE DISTRIBUTING CO,, INC. Q 14 a5 M MODEL Z i" — 144 W. WASHINGTON ST. 0 12 40_ _._ _ . - - -___ __ +_ P.O. BOX 1367 Q 35 MODEL WAUSAU, WISCONSIN $4481 MODEL - -- I F- 10 293 - - - 715 • 841 -2256 0 30 H 284 j 1 e -} 25 MODEL 6 20 - 282 a 15 - __ - - - - - - _. -- - -- _• __ - 10 MODEL - - zflzzz,-R Oi 2 5 267,268 0 3280 Old Millers Lane GALLONS 10 20 30 40 50 60 70 80 90 100 110 120 '130 140 150 160 170 180 190 P.O. Box 16347 Louisville, Kentucky 40216 `- LITERS 0 80 160 240 320 400 480 560 640 720 (502) 778-2731 FLOW PER MINUTE J S ' _ 4'o g System Calculations ! one family residence � bedrooms ncoing rate gal J.onsJyq ft per day Depth to ground water *"-4,1 in Depth to bedrock in Cross slope �- Force main length ft of �' in Manifold /header length ft of in Drainback gallons Lateral length 2 % @ 4� ft of 1 '4- in Lateral. elevation _ 9' _ ft (bottom of pipe) Lateral hole size in @ �m•a in ft) spacing to holes /lateral, t ' O holes total Lateral volume 40+6 gallons i Total lateral discharge rate gpm ft head Elevation difference ''' ft i Friction lose O ' S ft - 9Pm • 'dotal dynamic head ft Pump /s4hon 4% . gpm @ ft of head Manufacturer , Model # Dose volume It gallons Lift /silOon tank �`��-"' °'' e "�" °4 "'' 6 01 0 gallons Septic tank , i gallons Measurement pump on & off in Height alarm from tank bottom �S'�Z in Reserve capacitor gallons 7. of caics p age s °,4 .4 c LOCKI14G3 C ER (Soot 1r/�v�iu iNG .0 ©v�cK p�aGtwysCY -�ti �'' C.'�. tr2er'4trit�+(Q44�tttlG •--- •+-.,� d^ iZp NOgI 'TUROED V ENT ' t38taw MAN LIOLE Ci► MIN* x "r zo, 4 APPM= c.s. Pip 6simT..bblw'6 � BAF L SS AI. ' 00+16 .1. iPi 4 _..... ON WADWMJM S tw PUMP �� w D b" ` X44. JROCle 5>`PTI G DOSE W rut a,. TAW MAIJUFACTURER: i`IUMBEfi OF DOSES: TAWK SIZC:....� � I ' 0 ' GALLOWS DOSE VOLUME ' LARK ALARK MALILWACTUPICR: 1� �`• INCLUDINI:i 6ACKfwOW% WALLONS ekoccL. Mum6ER: 1 a'� w CAPACITIES: A= L � GALLOU4 I1JCIdCS OR r...,...�.. sW17'CH 'YJPES 1 r 4 "'"` .Ata B =.. IUC11E5 01t ME '3AL&.0W5 PUMP MAAlUFAGTURCR: � << w C a }.'SE W4HES oR ,. GALLOWS MODEL MUMDER: -4 - �.... D a r..6 INC14ES OR — � Id UALl SWITCH TVPC2 "ter"''""' C7L MOTE: PUMP AMD ALAk ARE TO 0& MIMIMUM DISCHARGE= RATE -LI G M INSTALLED OW SEPARATE CIRCUITS VERTICAL. DIFFEKS DETWa~SU PUMP OFF AMO QISTRII,UTIOW PIPE.. Il "3 FEET }- MIU ALIM. Mr-TWORK SUPPL9 PRESSURE . . 2-5 - FLET ♦ FEET OF FOR MAIN X F {on it. FKICTIOU FACTOR O ._. � � FEET TOTAL. OyWAMIC. HEAD = t � � FELT iI YCKMAL DIMEUStOWS& OF TAWK. L£1�IC+'T'H 1 ;WIDTH ,LIQUID ME"M 3�—•� STC -105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER A6 d Z C . MAILING ADDRESS °� 3 1 6j 11- PROPERTY ADDRESS pZ c� l9rj� ��� pr�yP (location of septic system) Please obtain from the Planning Dept. CITY /STATE - 3� �✓s' PROPERTY LOCATION /VL 1/4, 1/4, Section a y , T 30 N_R ° W TOWN OF J �, . ST. CROIX COUNTY, WI SUBDIVISION D-fr.41r LOT NUMBER ill CERTIFIEDSURVEY MAP . VOLUME , PAGE , LOT NUMBER Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost . of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: ,. LD DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 1 r S T C. - 100 This application form is to be . completed in full and the owners) of the signed by wlll only 'result � n delaystof the ny' inadequacies development be intended for resale by owner/c n a hoord this house), thenta second form should' retained and completedCwhen the property' is sold and submitted to this appropriate deed re6ording. office with the ----------------------------------------------------------- - - - -- Owner of property /V., Location of' property AIC l�4 Section T �.� - R o?c. Township '�, -" W . Mailing address r Address of site Subdivision name / -Z, Lot no. • fp Other homes on property? es .1r —yes Previous owner of property �6r B Total size of parcel Date Parcel-was created 'Are all corners and lot lines identifiable? _ Yes No Is this property being developed for P (Spec house) ?____Xes >C.Nv volume and page Number „ 3 -2 of Deeds. =- as recorded with the Register INCLUDE WITH THIS'APPLICATION THE FOLLOWING: - - A WARRANTY DEED which .includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER & THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description .references to a Certified Survey Map, the Certified Survey Map - shall also be required. PROPERTY OWNER CERTIFICATION I(we) certify that all statements on this form are true to the } best of my (our) knowledge that I (we) m the property described in this infrmation form tb a virtues) of warranty deed recorded i the office of the County 'of Deeds as Document No. Register _l).l (�� own the �.-- , and that I (we) presently Proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described rt, for the construction ,of said system, and the •same has been duly recorded. in the office of County Register of deeds as Document No. ` v c', signature of applicant Co applicant Date of Signature bate of Signature. MEN 1 OOGwUMENT N0. j STATE BAIT 11 -1988 TNia srwcE acsEavao mR aECOROIN6 DATA LAND CONTRACT Individual and Corporate I (TO BE USED FOR ALL TRANSACTIONS WHERE OVER I S26,000 IS FINANCED AND IN OTHER NON - CONSUMER ACT T REGI Q FF IG E Contract by and between .... E. IEN ROBERT O�BR and F- C CO-, W .. .......... E .. .. .. . .........----- ._____ :--- . - - - MARIANNE REPP O'BRIEN. husband and wife a s ..• survivors - _ - hip - Ret'�1 for Record _.- ------ _ ---- -- ----- -- --- ------- - ----- _ - ----- --•-` - -- - -- marital pro--- perty____ ___________ "Vendor". N O V 0 Whether one or more) and-- MX�H�lFJr..F_.__!?'.�Q1 1F.�+1< - i3ASl _,IIJLII TTE_.... N 11-55 A, M — F..O'CONNELL- husband__and__wife - ._as_ survivorship---- ----- -- -- -- - -- ----- -- - ------ - - marital property________ . ( "Purchaser", Whether one or more). Vendor sells and agrees to convey to Purchaser, upon the prompt and full per- formance of this contract by Purchaser, the following property, together With the rents, profits, interests / and other appurtenant interest (all called the "Property"), ill . ................... aJ. A.. 3lX ............................_. County, State of Wisconsin: RETURN TO v 30 - 208 io Tax Parcel No .... ............................... Lot 10, Arbor Hills in the Town of St..Joseph. TOGETHER with an easement for Ingress and egress over all that part of the Southwest Quarter of the Southwest Quarter of Section 19 -30 -19 lying northly and westerly of County Trunk Highway "V ". and an easement for ingress and egress over 0ut2ot 1 as shown on the Plat of Arbor Hills, recorded as Document Number 499560. This :........ is not_ homestead property. (is) (is not) Purchaser agrees to purchase the Property and to pay, to Vendor at _ 274 Arbor_ Hills Dr . WT the sum of ;Z,Sl1[QwQQ ----------- --- --- in the following manner: (a) ;.1.Z,Q4 Q -- ----- -- - -- - -- at the execution of this Contract; and (b) the balance of $5.9.0.0,920 _ ----- - -- - -- together with interest from date hereof on the balance outstanding from time to time at the rate of- ......... a..5........................... per cent peg annum until paid in full, as follows: The entire balance shall be payable in full, with interest in one balloon payment on or before one year from the date of this Land Contract. Plo vided, however, the entire outstanding balance shall be paid in full on or before the..._. 29th day of - __October ____ ___ _________ 19__ 94 _ (the maturity date). Following any default in paymenk interest shall accrue at the rate of.JL5.... % per annum on the entire amount in default (which shall include, Without limitation, delinquent interest and, upon acceleration or maturity. the entire principal balance). — Purchaser, unless excused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonably antici- pated annual taxes, special assessments, fire and required insurance premiums when due. To the extent received by Vendor, Vendor agrees to apply payments to these obligations when due. Such amounts received by the Vendor for payment of taxes, assessments and insurance Will be deposited into an escrow fund or trustee account, but shall not bear interest unless otherwise required by law. Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any amount may be prepaid without premium or fee upon principal at any time.a M=.x bodwrAx liltrsr>gc�eamac3ma�ticOSficloaA In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated as unpaid principal) is leas than the amount that said indebtedness would have been had the monthly payments been made as first specified above; provided that monthly payments shall be continued in the event of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded her -from. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: NO EXCEPTIONS. Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall be retained by Vendor until the full purchase price is paid. Purchaser shall be entitled to take possession of the Property on- ...October- 29.•.___ .......... 1933... *Cross Out One. LAND CONTRACT — Individual and STATE BAR OF WISCONSIN Wisconsin Loral Blank Ca Inc. Corporate FORM No. 11 — 1982 j ' Milwaukee. Wis. - VOL 1045PAGE 32 Purchaser promises to pay when due all taxes and ar- essmen.s levied on the Property or upon Vendor's interest in Ii and to deliver to Vendor on demand receipts showing such payment. Purchaser shall keop the improvements on the Property insured against loas or damage occasioned by Are, ex- -tended coverage perils and such other hazards as Vendor may require, without co-insurance, through insurers approved by Vendor, in the sum of _ vacant_ but Vendor shall not require coverage in an amount more than the balance owed under this Contract. Purchaser shall pay the insurance premiums when due. The policies shall contain the standard clause in favor of the Vendor's interest and, unless Vendor otherwise agrees in writing, the original of all policies covering the Property shall be deposited with Vendor. Purchaser shall promptly give notice of loss to insurance companies and Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall be applied to restoration or repair of the Property damaged, provided the Vendor deems the restoration or "pair to be economically feasible. Purchaser covenants not to commit waste nor allow waste to be committed on the Property, to keep the Property In good tenantable condition and repair to keep the Property free from liens superior to the lien of this Contract, and to comply with all laws, ordinances anW regulations affecting the Property, Vendor agrees that in case the purchase price with Interest and other moneys shall be fully paid and all conditions shall be fully performed at the times and in the manner above specified, Vendor will on demand, execute and deliver to the Purchaser, a Warranty Deed, in fee simple, of the Property, free and clear of all liens and encumbrances, except any liens or encumbrances croated by the act or default of Purchaser, and except :.................. ................._...._...... ..– .... .................... .....• -•---------.....--..._.......----•--•--•------.....__...... ........- •----......_..-- °..... .....–_..................-- ----- ---------- ------ -- -----•••-•-----•-•--- --•- --- -------- -- ......_ _._– ....----- •–•---------------------••-----....---...--•---.....---....---•-•°---.•....._..----•-.....---.._....-•---....----------------------- - °- -----.._--......- ....... .._ Purchaser agrees that time is of the essence and (a) in the event of a default in the payment of any principal or interest wbich continues for a period of .3Q..._ days following the specified due date or (b) in the event of a default in performance of any other obligation of Purchaser which continues for a period of ... 30 -_. days following ritten notice thereof by Vendor (delivered personally or mailed by certified mail), then the entire outstanding balance under this contract shall become immediately due and payable in full, at Vendor's option and without notice (which Purchaser hereby waives), and Vendor shall also have the following rights and remedies (subject to any limitations provided by law) in _ addition to those provided by law or in equity: (f) Vendor may, at his option, terminate tbis Contract and Purchaser's rights, title and interest in the Property and recover the Property back through strict foreclosure with any equity of redemption to be conditioned upon Purchaser's full payment of the entire outstanding balance, with interest thereon from the date of default at the rate in effect on such date and other amounts due hereunder (in which event all amounts previously paid by Purchaser shall be forefeited as liquidated damages for failure to fulfill this Contract and as rental for the Property if purchaser fail& to redeem); or (ii) Vendor may sue for specific performance of this Contract to compel immediate and full payment of the entire outstanding balance, with interest thereon at the rate in effect on the date of I default and other amounts due hercatider, in which event the Property shall be auctioned at judicial sale and Purchaser shall be liable for any deficiency; or (iii) Vendor may sue at law for the entire unpaid purchase price or any portion thereof; or (iv) Vendor may declare this Contract at an end and remove this Contract as a cloud on title in a quiet -title action if the equitable interest of Purchaser is insignificant; and (v) Vendor may have Purchaser ejected from possession of the Property and have a receiver appointed to collect any rents, issues or profits during the pendency of any action under (i), (ii) or (iv) above. Notwithstanding any oral or written statements or actions of Vendor, an election of any of the foregoing remedies shall only be binding upon Vendor if and when pursued in litigation and all coats and expenses I F including reasonable attorneys fees of Vendor incurred to enforce:any remedy hereunder (whether abated or not) to the extent not prohibited by law and expenses of title evidence shall be added to principal and paid by Purchaser, as in- cured, and shall be included in any judgment. Upon the commencement or during the pendency of any action of foreclosure of this Contract, Purchaser consents to the appointment of a receiver of the Property, ,"eroding homestead interest, to collect the rents, issues, and proses bf the Property during the pendency of such action, and such rents, issues, and profits when so collected shall be held and applied as the court shall direct. Purchaser shall not transfer, sell or convey any legal or equitable interest in the Property (by assignment of any of Purchaser's rights under this Contract or by option, long -term lease or in any other way) without the prior written consent of Vendor unless either the outstanding balance payable under this Contract is first paid in fall or the interest conveyed Is a pledge or assignment of Purchaser's interest under this Contract solely as security for an indebtedness of Purchaser. In the event of any such transfer, sale or conveyance without Vendor's written consent, the entire outstanding balance payable under this Contract shall become immediately due and payable in full, at Vendor's option without notice. Vendor shall make all payments when due under any mortgage outstanding against the Property on the date of this Contract (except for any mortgage granted by Purchaser) or under any note secured thereby, provided Purchaser makes timely payment of the amounts then d :e under this Contract. Purchaser may make any such payments directly to the Mortgagee if Vender fails to do so and all payments so made by Purchaser shall be considered payments made on this Contract. Vendor may waive any default without waiving any other subsequent or prior default of Purchaser. All terms of this Contract shall be binding upon and inure to the benefits of the heirs, legal representatives, successor& and assigns of Vendor and Purchaser. (If not an owner of the Property the sliouse of Vendor of r a valuable consideration joins herein to release homestead rights in the subject Property and agrees to join in the execution of the deed to be made in fulfillment hereof.) Dated t 29th October 19 ...9.. ....._... -- -• ............... day of . .(SEAL) ..... – ...... (( EAL) . _ _ .... i ' •-- ROBERT._E. O' BHIEN ............................ MICHAEL E. O'CONNELL --•--•- --- - -• --- - -- - ------ _!f�-� EAL) e MAR_ IANNE-- REPP__ lHIM...-- •-- • .. .......... . .. r.... .JULIETTE.. AUTHENTICATION ACHNOWLBDGMBNT 4 ia. Signature(s) ------•-•- ----------- -- -- -•--- ------- ----- -- - ----- STATE OF WISCONSIN 0 ss. y •------ -------------------------------- st..._CJCOi _.. A _ ----------- -- -Coun ty authenticated this ........ day of .......................... 19 -. - --- Personally cant; before me this -- .9tlt ---- day of 3 October ------- , 19..93._ the above named --- - - - - -- •---------- R_ �xiem _�d_Ma�rianne_Regg._Q�Hrien ' ..........................•------.....-----.. .----- .......--- •-- •----- - - - - -- Michagl -_ :..Q'._Comoel ].. atnd: til iette_F..._...._ TITLE: MEMBER STATE BAR OF WISCONSIN O'Connell ' – _r ------ ----- (If not . ............................................ - ---...... - ........... authorized by 4 706.06, Wis. Stats.) to Cmenown o be the pe n A_.- _.._.._ executed the fe ument an now ge same. .j THIS INSTRUMENT WAS DRAFTED eY - K ...... .... ............. &. tts xneY .�4.rXY..Q._Jande-en._... - - - - -- ANN E OQST - MIIDGE, PORTER 6 LUNllEEN, S.C. ' =-- • = - - - -= 110._Second_Sts�et,.•Iittdson ._UL_.5AaL6. Notary Public . � .. .... County, Wis. (Signatures may be authenticated or acknowledged. Both My Cc fission permanent. (If not, state expir on are not necessary.) date :�. - ..... _ _______ __ ____ 19..> 01 Wames of persons sianinE in any capacity should be typed or dntal below their arknuturee. LAND CONTRACT — Individual and Corporate — Stab Bar of Wisconsin, Forms No. 11. -1982