Loading...
HomeMy WebLinkAbout032-2138-90-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safe and Building Division Safety 9 INSPECTION REPORT Sanitary Permit No: 453340 0 GENERAL INFORMATION (ATTACH 1 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: Bodlovick, Michael Somerset Township 032 - 2138 -90 -000 CST BM Elev: Insp BM Elev: BM Description: Section/Town /Range /Map No: /D 0 O 1 1(k). d 1 14.30.19.1226 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. GB 47 Septic v/ 3 r A,0 1 Benchmark Dosing Al B M Aeration Bldg. S Holding SUHt Inlet TANK SETBACK INFORMATION SUHtOutlet TANK TO /L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic , Dt Botto� Dosing O , ' / r Heade an. Aeration Dist. Pipe , d s q� Holding Bot. System / - o� y 3.�5 97, S" Final Grade P UMP /SIPHON INFORMATION S Manufacturer De St Cover G PM 3, Model Number /� L I I TDH Lift / Frictiop Los S TD i Ft • C1 s / cJ ` q l Forcemain Lencth� / I Dia. 2 y Dist.t Well Z. �� / SOIL ABSORPTION SYSTEM BED/TRENCH Width Length / No. Of Tr �chPs , PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LA EK /STREAM HING Manufacturer: INFORMATION CHAM oo Typ% fdf y Syste � / UNIT Model Number: DISTRIRUT19N SYSTEM / Header anifold I , Distribution _ 2 x ole Size x Hole Spacing3NoE], �7tir In ke Length Dia Length Dia Spacing -V/ SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded ched Bed/Trench Center Bed/Trench Edges Topsoil 0 Yes as', Yes � No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: (� /l / Inspection #2:10/ 2 , 1 16 ` Location: 1590 72nd Street New Richmond, WI 54017 (NW 1/4 NW 1/4 14 T30 R19W) Rockamora�tes Lot 15 Parcel No: 14.30.1%1226 (� 1.) Alt BM Description = sj- Cave — 2.) Bldg sewer length amount of cover = G 7 C' Y - Plan revision Required? (:,; Yes U'No U I Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signa re Cert. No. ` Safety and Buildings Division County COns'I 201 W. Washington Ave., P.O. Box 7082 ^ Madison, WI 53707 — 7082 Sanitary Permit Number (to be filled in by Co.) De artment of Commerce (608) 261 -6546 Sanitary Permit Ap - - -- - - -, State PI LD.Number In accord with Comm 83.2 1. Wis. Adm. Code, pers ra�l info rlJv maybe used for secondary purposes Privac sl5.04(Ixm) Project Address (if different than mailing address) I. Application Information - Please Pn All Informatio 7v?X0 S � . Property Owner's Na e� „ Parcel # Lot # /,S Block # C _ r2 - Z AI , (J _ / Property Owner's Mailing Address Property Location ✓ 0/ _ T� • /2Z (o City, State / , Section �y Zip Code Phone Number �� circle one) II. Type of Building (check all that apply) A 0 9 T�' D N; RJE or W 1 or 2 Family Dwelling - Number of Bedrooms 3 � v Subdivision Name CSM Number ❑ Public/Commercial - Describe Use ( / x is ex ae rn4n yt� floe- a ❑ State Owned - Describe Use q', p l r ❑City_ ❑Village IlTownship of j cA f_-T III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A ' New System �em _ ❑Replacement System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: Check all that a I ❑ Non - Pressurized In - Ground ® 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 Lie ❑ G avel -less Pipe El Other (explain) _ V. Dispersal/Treatment Area Information t A &� Design Flow (gpd) Design Soi A lr at ate( ds Dispersal Area Required (s() D I Area Prop ed (sQ System Elevation v Sa ' `� "' sa o7's VI. Tank Info Capacity in Total Number anufacturer Pr ab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank t Aerobic Treatment Unit p J i Dosing Clamber 8 t7�© oo VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) mb is Signature MP S Nu Business Phone Number ,s� Plumber's Address (Street, City, State, Zip Code) �� ,rte — VII oun /De artme t Use Onl Approved ❑ Disapproved Sanitary Permit Fee (' eludes Groundwa er Date Issued Issuin ge t Sign turc amps) Surchazge Fee) � 2 ❑ Owner Given Reason for Denial i 1 C� 2 IX. Conditions of Approval/Reasons for Disappr al c 3 t�I TEM O �3, 5"?j (µUfi1 ` 1 eptic tank, effluent filter an /' / 1 dispersal cell must all be serviced / maintained � � � MA/V as per management plan provided by plumber. 2. All setback requirements must be maintained / as era licable code /ordinances. AO � 4 Attach compktc plans (to my only) fort t m paper not less than $112 z 1 l�ac�� n size SBD -6398 (R. 08/02 , 72�Gi > Zo {�oc►c�mo2A _ Es ?A�TE LoT /VoR'� ►� �RoPr�2ry Li rvF_ /s liv. l ,t to I 8 _ e gm _ 6M ToP 0171' L 0_x .9�.0 o J}LT. 8 M 7' P o F Z L s _ - PE i CouTOOk /NE FL. _ _97.06 - -- S Co, QC _ - -6q0 . _ lz ._ z . 3 BE02oam NO U s'E -- Lv,sit 2�gEL A - /DO _:_ w��c. $ ourµ o E r y LiNr_ - Jor►'rE� ET }W S`�DaS mE ,eSET �/Oa S - - - -- _r . — _ - - -- - -�- �- - - — - - - _ _ _- - - Q S lP�S Safety and Buildings commerce.wi. OV 4003 N KINNEY COULEE RD g LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i sco n s i n www.commerce.state.wi.us /sb www.wisconsin.gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary June 02, 2004 CUST ID No.223760 ATTN.• POWTS Inspector JOHN F SCHMITT ZONING OFFICE SCHMITT & SONS EXCAVATING ST CROIX COUNTY SPIA 586 VALLEY VIEW TRAIL 1101 CARMICHAEL RD SOMERSET WI 54025 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/02/2006 Identification Numbers Transaction ID No. 1004968 SITE: Site ID No. 684343 Mike Bodlovick/Roland Belisle Please refer to both identification numbers, 72nd Street above, in all correspondence with the agency. Town of Somerset St Croix County NWIA, NW1 /4, S14, T30N, R19W Lot: 15, Subdivision: Rockamora Estates FOR: Description: Proposed Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 961200 Maintenance required; 450 GPD Flow rate; 25 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.0 1 /0 1), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 /01); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. 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 approved plans, and the "Mound Component Manual for POWTS - Version 2.0" SBD- 10691- P(N.O1 /01). The pressure network is to be constructed in accordance with publication SBD- 10706- P(NO1 /01) "Pressure Distribution Component Manual for POWTS - Version 2.0 ". • 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. • 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. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • Comm 83.22(7) - 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. P:O WT�. Co ndiii ®n lly JOHN F SCHMITT Page 2 6/2/04 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) - 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. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • 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. 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 $ 175.00 Fee Received $ 175.00 Gerard M. Swim Balance Due $ 0.00 POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm jswim @commerce.state.wi.us WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 SCHMITT & SONS EXCAVATING S86 Valley View Trail Somerset, Wd S402S 7IS- 549 -6651 I MOUNT) SYSTEM Em'. f4ht6 80Y) I� �OLAA)JO &cZ154 Address: - 7/ Z /0 riy d yr �p nt e2 Legal. • A) 14) /Y A) w /-/ s / z1 7 o Aj k /9 fif, Township County: S7. C2 D/ K ROC 1r A P10e,q / - 0 7- /,.S- ontent Page I Plot Plan Page 2 System Cross Section Page 3 Pipe Lateral Layout Page 4 Dosing Chamber Page 5 Pump Curve Page 6 Management Plan Attachment I Soil Evaluation Report Attachment 2 m 6 p 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) By: MPRSW _ (:2 7 v Date. =a2 IV o y M V RECEIVED DIVISIO F SAFETY AND BUILDINGS MAY 2 7 200 SA FETY � BL�GS D SEE GOR PONDENGE /� D P A(. Lor - NoRtE� �ROPCe�y LiwF !� 1. Jcr'ge" C Ba A gm _ w B#1 ToP 0w 2 p uC ` A / ,Et = Ioo.c�o 83 - - al,D X 9 .U� e W. BM TvP or: Z" PVL _ MOUN4_ el. - CvA) TOak Li NE L. =_ 97.06' . gds C�/�:C P• C _ __ _ _ - -• -- _ PRo (taQO_ �'RL S.T.. _ .3 gEDeoam _ - - -Hvus4E l,u � 71t 2ggcL A -/00 Q(Zp G05ED w�lc. 5owrm 0 - ry L, /V RoL4Na scE_ K 1�lP�5 a�� Page Cf ! t Straw, Marsh Hoy, Or Synthetic Covering ASTMC33 Distribution Pipe Medium Sand K a � t� � 6 Tops �:: __,.�•: F SYS ELEV. �,, { E 0 %Sl X7.0 Bed Of 2 Force Main Plowed Aggregate Layer (6" Below PiPe) D 0.9a Ft. E ►+ Ft Cross Section Of A Mound System Using F Q Ft A Bed For The Absorption Area G 0.5 Ft, A Ft. H I. Ft. Signed; B Ft. K g A aha� •, a37 0 Ft. B license umber: Date: S'oZ s 6 Ft. I Ft. Alternate Position ° Z // of w a 1 • Ft. - xe-�� Force Main ._ L Ob��av ripr - ' i!6 To 1110 9 Frrom of Bed K - I � A - _ _ __ _ _ -- - ----�� Farce Main �.... -------------- - - — _„_ -.._. W ._ { �. �'DistribvfiOn Bed Of Pipe Aggregate obeeryation Pipe Permanent laiarkers 11S To 1/10 9 From End of Bed p ion View 01 Mound Using A Bed For The Absorption Area Page 3 of 6 X85 BQx Turn -up wlih Cleanout �_---► Plug or Ban Vaive Distribui•io n lateral PVC Foroe Main .5 PVC Manifold X —�— X X/2 Distribution Lateral Layout P 36.25 S 3 Ft X 30 I nchPt Hole Diameter 3 /16 Inch S L41 Lateral - signed. Inch(t Manifold 1'� , lnche: License ber: 223760 2_ Inche: Force Main " -at - t� of hole Date s /Pipe 15 Date* D Invert Elevation of Late rals,y8• d r/ . P AC.0 4 r�>< 6 • PUMP CHhMBf R CR0�5 SCET 0►J AtJO SPECrFrCATro�%S man VCWT CAP APPROVED VE KIAlG 4 vEWT PJPC WCATkER PROD► C"'ryANr♦OL [ GOVCR .tu>\?GTION bOX ,JINUUv4 NK ► 1t46 6 ►I I AIK ruTAKE (,RADC I M IAIW. COUDUIT — � tD \`� PROVIDE I '� INLE AiRT<<:•;T $CAL. I 1 {( I I I I ± A ,JalaT APPROVC0 jowl/ A I I (I w /C. PIPE W /C,Z. PI ►I; I II ALARM ExTE111G 3' CKTCNDtNr► 3' I I ONTO i0LI0 boll ONTO W610 to' L- 21 gal /inch I ► I i ON � I I p I LLCV. y f T PUMP r. on O I CONCRETE bLOCII 1 3,. APPAI R16CK >EXI'f P>LRMITTEG CUJLy IF TAldtl MAAJUiACTURC'.R HAS SUCH ArPKOVAL. w SEPTIC 5PEGIFICAT10t�IS T A� M�►uut<�cru»c�: W ek • s _ C • P • I.tU^bER OF DOLCti: PLR DAB T"K LIZE : 800 CGAL.LOWS 005E VOLUME -7 om / p D LA MAuurAtruRGa - : S ptronics Tankmate 1 NCLUDIWL. s ^cK O / 7 GALLON! MODCL LWUPAbtK: TM -1 CAPACITIES: A■IAICHE3OR �3• yWiL04Jb swITGM YSP97 _ Mercury D - 2 IuCwEc Oa 43 . 52 �� LE �� pump MA#IUFAC-TUR[R: � Zoeller C p Iuc HCfi OR • Dy GALLOUt , WU)A %tk' 2 D - 1=--- IMr.WES 01 o{ 61 41 OALLOw SWITCH TWP[; _ Mechanical WQTE: PUMP AND N-hKM ARC TO OC Z %L MtIJIMIlM DISC►�ARGE RAY G M 1N5TA:LEG 06J 5EPhRATC CIRCUITS VERTICAL OIFFER,E1JLE OCTWCCIJ PUMP O ,D15TRIbUTIOW PIPC.. 10.0 FEET + MIIJJM%uM WETWORK SUPPI.y PK . . . . . . . 3.25 F FEET OF FORCE MAIM X J•O�'`I F yo►EFKIC'rION FACY04 - y FEES' Y , TOTAL DyIJAMJL KCAD = X56 FEI:T . in (1,ITERIJAL OIMLW6%06 Of TAWK: LENGGI'M ;WIDTH ; 3`7 L.IQuIo DEPTH ._. in . r �lti1.IE D: LICCUSE uUMB 223760 DhTE, 2/9/2 • �Atc c s � � TOTAL CYNAM'C rFAD/CAPACITY HEAD CAPACITY CURVE PER M,'NUTE EFFLUENT AND DEWATERINC W MODEL 152/153 w w MODEL 152 153 UJ 50 Feet Meters Col. Liters Cal. Liters 153 5 1.5 69 261 77 291 12 40 152 10 3.1 61 231 70 265 0 15 4.6 53 201 61 231 a i 20 6.1 44 167 52 197 30 8 25 7.6 34 129 42 159 0 30 9.1 23 87 33 125 Q �20 35 10.7 - -- -- 22 85 jl�' 11 42 4 Lock Velve: 38.0 Ft. (11.6m) 44.0 Ft. (13.4m) 1 014508 0 20 40 60 80 100 GALLONS 1 I LITERS 0 80 160 240 320 1/4 3 27/32a 5/8 FLOW PER MINUTE 1 3 27/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS a� Timed dosing panels available. o e • Electrical alternators, for duplex systems, are available and supplied with a 3 27 /32 an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik -Box available for outdoor installations. See FM1420. • Over 130 °F. (54 °C.) special quotation required. 1521153 Series 12 1/8 1521153 MODELS Control Selection Model Volts-Ph Mode Amps Sim lex Duplex 5 1 /8 N152 115 1 Non 8.5 1 2 or 3 BN 152 1 115 1 Auto 8.5 Included 2 or 3 s czosa E152 1 230 1 Non 4.3 1 2 or 3 I BE1521 230 1 Auto 4.3 Included 2 or 3 N153 , 115 1 Non 10.5 1 2 or 3 BN1531 115 1 Auto 10.5 Included 2or3 SELECTION GUIDE E153 1 230 1 Non 5.3 1 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level float BE153 230 1 Auto 5.3 Included 2 or 3 switch. Refer to FM0477. v CAUTION 2. See FM0712 for correct model of Electrical Alternator E -Pak. All installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10.0225 used as a control activator specif dup lex 3 e lectrician. All electrical and safe code s ho u ld I in cluding h P ( ) lice e e safety s s ou d be fo 1 eluding the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). or (4) float System. 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 ® N O O �' Louisville, KY 40256 -0347 Manufacturers of. . L SHlP T0: 3649 Cane Run Road Louisville, KY 40211-1951 VAL /TY P UMPB S NCE 1g. http: / /www.zoeller.com AR ) 10 (502) 7 FAX (502) 173624 PUMP © Copyright 2001 Zoeller Co. All rights reserved. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 6 of ([p I FILE INFORMATION SYSTEM SPECIFICATIONS T Owner !K , D v i C Septic Tank Capacity 1 000 ga l ❑ NA Permit X / Q C/ Septic Tank Manufacturer WQQk P ❑ NA DESIGN PARAMETERS J Effluent Filter Manufacturer Z a 1 e 1 ❑ NA Number of Bedrooms 3 ❑ NA Effluent Filter Model A -100 ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity 800 gal ❑ NA Estimated flow (average) 300 gal/day Pump Tank Manufacturer ❑ NA wpek Design flow (peak), (Estimated x 1.5) 4 50 gal/day Pump Manufacturer ZO e l l e r ❑ NA Soil Application Rate al /da /ft2 Pump Model 192 ❑ NA Standard Influent/Effluent Quality Monthly average' Pretreatment Unit ■ NA ats, I G) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD,) 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD,) 530 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L 3NA ❑ At -Grade ■ Mound Fecal Coliform (geometric mean) S10' c u /100ml / - ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y, in dia. ❑ N.A Other: ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA 'Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE Service Event Service Frequency ❑ month(s) (Maximum 3 years) ❑ NA. Inspect condition of tank(s) At least once every: 3 q year(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y,) of tank volume ❑ NA, ❑ month(s) (Maximum 3 years) ❑ NA, Inspect dispersal cell(s) At least once every: 3 M year(s) ❑ month(s) Clean effluent filter At least once every: , M year ❑ month(s) -� �' ❑ NA Inspect pump, pump controls & alarm At least once every: 1 ■ year(s) ❑ month(s) ❑ NA' I Flush laterals and pressure test At least once every: 1 M year(s) ❑ month(s) C3 NA;� Ocher: At least once every: ❑ year(s) 'f Other: ❑ NA MAINTENANCE INSTRUCTIONS individual carrying one of the following licenses or certifications Inspections of tanks and dispersal cells shall be made by an : Inspector; POWTS Maintainer; hardware, Septag Servicing Operator. :Tank Master Plumber; Master Plumber Restricted Sewer; POWTS n hardware inspections must include a visual inspection of the tank(s) to identify any missing or broke, identify any cracks or leaks', measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground suorf� n The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any p * j of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requiresthl immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y,) or more of the tank volume, the entirc contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter. NR 1,Y3 Wisconsin Administrative Code. i All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatme units, and any servicing at intervals erformed b a certified POWTS Maintainer. s shall be Y months, P •of 512 m , •.:, authori ' a co mpletion of any service even A service report shall be provided to the local regulatory a u ity 10 da of co m within Y Page -7 of - START UP AND OPERATION For new construction, prior to use of the POWTS check treatment.tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or. must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. he si e a not ben valuate to 'dentify a itab replace nt rea. Up a�enrfea ��a soil �d site alua m t b perfor o loca a s 'able repl eme area. f no r place holding�tarrct' may b mstalle s a last resort to replac the failed PO Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must co rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name John Schmitt Name Owners choice Phone 549-6651 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name owners choice Name St. Croix Cty. Zoning Phone Phone 715 386 -4680 This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHEp CERTIFI'CATION FORM 1Q/iz� L t 12i - 1 OwnerBuyer 111 CR E z- 90,04 o � �� f: �l Mailing Address U4416F2 S> Property Address f'5:k 29 ilea r - (Verification required from Planning Department for new construction) City/State &Nd5U 46L Parcel Identification Number 032-9 hl 90 000 LEGAL DESCRIPTION v 7i& Property Location ` /,, Sec. TQ_N- R Town of �'�n��s,�rj' 4 Subdivision / A &,a /t A ,Lot # �, i D c r _ Certified Survey Map # , Volume , Page # 1 - Pa ge # Y 73 # (� 3 / , Volume g Spec house ❑ yes 6 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, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal 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 septiclsystem has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 daw(0 three- veapexpiragi n date. / /S/ o SIGNAMIKE OFAPPL1CXNT DATE OWNER CERTIFICATION I (we) certify)Lhat all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the,pmperty describeo above; by virtue of a warranty deed recorded in Register of Deeds Office. - T SIGNAVJ�M OF AP LICANT DATE ,p Formation that is mis represented may result in the sanitary permit being revoked by the Zoning Department. « « « « «« ss Include frith 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 1238 WisconsinDeparb�ntofCommerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt Attach complete site plan on paper not less than 8'% x 11 inches in sae. Plan must County I limited St Croix include, ude, but not ded to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all information. Reviewed By Date Personal information you provide may be used for secondary purposes (PNxy Law, s. 15.04 (1) (m)). Pro Owner Property Property Locat ion Bodlovick, Mike, Belisle, Roland Govt. Lot NW 1/4 NW 19 S 14 T 30 NR 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 719 210th Ave. 15 Rockamora Estates City State Zip Code Phone Number ( City �j Village e Town Nearest Road Somerset WI 54025 715 - 247 - 3746 Somerset I 72Nd St. 16 New Construction Use: ✓e Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD =j Replacement �J Public or commercial - Describe: Parent material Glacial TIII Flood plain elevation, if applicable na General comments and recommendations: Area is suitable for a mound system. System elevation is 98.00' based off contour line established at 97.06'. Limiting factor is at 25 ". Slope is 6 %. 1 Boring # ==1 Borin 17 Pit Ground Surface elev. 97.56 ft. Depth to limiting factor 26 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft *Eff#1 *Eff#2 1 0 -10 10yr3/4 none sl 2msbk mfr as 2m, 2f .6 1.0 2 10 -26 Y 7.5yr4/4 none sicl 2fsbk mfr gw if 4 .6 3 - 7.5yr4/4 o2 dp y T5/8 /2 sl 2msbk mfr gw .6 .8 4 34-60 7.5yr4/6 o2 dp y T6 /6 fsl 1 msbk mfr — .2 .6 a Boring # Boring Pit Ground Surface elev. 97.56 ft. Depth to limiting factor 25 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft *Eff#1 *Eff#2 1 - 0-7 10yr32 none sil 2fsbk mfr as 2m, 2f .6 .8 i 2 7 - 7.5yr4/3 none sicl 2fsbk mfr gw 2f 4 .6 3 25-41 7.5yr4/4 c2d yr6 8 /I 7.5 /8 sl 1 msbk mfr gw .4 .7 4 41 -72 7.5yr5/4 c2 /8/2 Is 1msbk mvfr — — .4 .6 - 41 -72" has bands of Ivfs 7.5yr6/3 0sg .4 .6 Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS <,30 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 1595 72nd St., New Richmond, Wl 54017 5/17/04 715- 247 -2941 Property Owner Bodlovick, Mike, Belisle, Roland Parcel ID # Page 2 of 3 3 ] F Boring # Boring f/ Pit Ground Surface elev. 94.96 ft. Depth to limiting factor 27 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QP *Eff#1 *Eff#2 1 0 -17 10yr3/3 none sil 2mgr mfr as 2f .6 .8 2 17 -27 1Oyr4/4 none sil 2fsbk mfr gw .6 .8 3 27-44 1Oyr5/6 c 10yr06/66 /2 fsl 2msbk mfr gw .4 .8 4 44-61 1 Oyr5 /4 c2d 10yr6 /1 fsl 1 msbk mfi — — .2 .6 1 5/6 41 -72" has bands of Ivfs 7.5yr6/3 Osg .4 .6 F-1 Boring # Boring LJ Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 F-1 Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD *Eff#1 *Eff#2 * Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an altemate format, please contact the department at 608 -266 -3151 or TTY 608 - 264 -8777. Page 3 of 3 Conducted by- Conducted For: Schmitt Soil and Site Evaluations Name: Mace Bodlovick, Roland Belisle Thomas J. Schmitt, CST 227429 Address: 719 210th Ave. 1595- 72nd St. C' State I City, ,Zip' Somerset, WI. 54025 New Richmond., WI. 54017 Phone: 715- 247 -2941 Subd.Name: Rockamora Estates Lot No.: 15 / Legal Description: NW 1/4 NW1/4 S 14 T 30N R 19 W Township of Somerset Bench Mark El. 100.00' Top of 2" pvc pipe Alternate Bench Mark EL 96.5E Top of 2" vc , P P P� Slope= 6% Contour Line EL 97.06' Scale 1 " = 40" 37 /0 4o+ 91' 9 i 62, a q�f Co►�70 _ _ ' ' 1238 Wisoonsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 'Division of Safely and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt Attach complete site plan on paper not less than 8%: x 11 inches in size. Plan must County St. Crobr include, lot not limited to: vertical and horizontal reference point (BM), directio percent slope, scale or dimensions, north arrow, and location and distance t Parcel I.D. ,�L - -C 'f 3 � L p V G606 Please print all information, iewed Date Personal information you provide may be used for second 2 Q� Property Owner n Bodlovick, Mike, Belisle, Roland NW 1/4 NW 1/4 S 14 T 30 N R 19 W Property Owner s Mailing Address �� i ® 2 0 d ck # Subd. Name or CSM# 719 210th Ave. Rockamora Estates City State Zip Cpde ,Ph pg ,t"lpilr City Village A Town Nearest Road Somerset i WI 1 54025' NIII3 ML4 74 Somerset 72Nd St Mf New Construction Use: 16 Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD I Replacement Public or commercial - Describe: Parent material Glacial Till Flood plain elevation, if applicable na General comments and recommendations: Area is suitable for a mound system. System elevation is 98.00' based off contour line established at 97.06'. Limiting factor is at 25 ". Slope is 6 %. Boring # Boring Im Pit Ground Surface elev. 97.56 ft. Depth to limiting factor 26 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF *Eff ll *Eff#2 1 0 10y►3/4 none sl 2msbk mfr as 2m, 2f .6 1.0 2 10-26 7.5yr4/4 none sicl 2fsbk mfr gW if 4 .6 3 26 - 7.5yr4/4 02 2 sl 2msbk mfr gW — .6 .8 4 34-60 7.5yr4/6 02101 6/6/1 fsl 1 msbk mfr — .2 .6 Boring # Lj Boring am Pit Ground Surface elev. 97.56 ft. Depth to limiting factor 25 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF *Eff#1 'Eff#2 1 0-7 10yr3/2 none sit 2fsbk mfr as 2m, 2f .6 .8 2 7 -25 7.5yr4/3 none sic! 2fsbk mfr gW 2f .4 .6 3 25-41 7.5yr4/4 0 5.5 /g 1 s! 1 msbk mfr gW — .4 .7 4 41 -72 7.5yr5/4 c2 /8 /2 is 1msbk mvfr — .4 .6 41 -77' has bands of Ivfs 7.5r613 Osg .4 .6 ' Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS <,0 mg/L CST Narm (Please Print) Signature: CST Number Thomas J. Schmitt ��-v - -... 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 1595 72nd St., New Richmond, WI 54017 5/17/04 715- 247 -2941 0 property owner Bodlovick, Mike, Belisle, Roland Parcel ID # Page 2 of 3 a Boring # Bering sm Pit Ground Surface elev. 94.96 ft. Depth to limiting factor 27 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 1 0 -17 10yr3/3 none sil 2mgr mfr as 2f .6 .8 2 17 -27 10yr4/4 none sil 2fsbk mfr gw .6 .8 3 27-44 1 c2d10yr6/2 �� 10yr6/6 fsl 2msbk mfr gw .4 .8 4 44-61 10yr5/4 02 6/1 %1 1 msbk mfi — — .2 .6 41 - 72" has bands of Ivfs 7.5yr6/3 Osg .4 .6 F-1 Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 F Boring # "'I Boring P „� it Ground Surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 * Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD <30 mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608- 264 -8777. Page 3 of 3 Conducted by: Conducted For: Schmitt Soil and Site Evaluations Name: Mike Bodlovick, Roland Belisle Thomas J. Schmitt, CST 227429 Address: 719 210th Ave. 1595 72nd St. City, State, Zip: Somerset, WI. 54025 New Richmond, WI. 54017 Phone: 715 -247 -2941 Subd.Name: Rockamora Estates Lot No.: 15 Legal Description: NW 1/4 NWi /4 S 14 T 30N R 19 W Township of Somerset Bench Mark El. 100.00' Top of 2" pvc pipe Alternate Bench Mark EL 96.5E Top of 2" pvc pipe Slope= 6% Contour Line EL 97.06' Scale I"= 40" ��' 3 �" 37' �D oaf �.2 ` f I M r SZ) I qy / Cahro 1/V6 <. �? 06 C; g� VI p� /1 / °A' '' •/ 1 It I Il W, 086 y LO f � � �,�� t� ! � � i �� 3.•06 A � TS7-gZ2LI SO. FT. .3.6.3 ACRES,> � � I 4,85 -� $ � • U W ti v 5 -1�F ,)°° c c � •• � ��;�• M'lN %� FIN. FLDOR EL•EV. OF 492. W 'I L Bi 282,3¢' �m 298 04' �•' •a 'Jo c �j 20' 2F�Al..,•,GE,'EASEMENT. V) D �/ @ c c O �"' Nla1J Fll�t F OR E(�EV � 4� g o a c n � ' / ^ LIMITS OF DRAINAOF !EASFMEN?. A . --� LOT 15 i� 154.31' N 133, 080 SO. FT. j 3 06 ACRES + - -- Q I •f A �. V f1 FL cc MIN. FIN. ON. FIN. R Lo 500, 81 00 1 i v � B 3 LOT f4 _ i • ,C ® — -- — fib, 003 SfJ FT. ACRES �- - N : 3.9.3 ' � L.Or 10 151,00.3 Soh Fr -1 N �. r J. 47 ACRES s 'dviscons;n Depeftent of Commerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm-83.05, Wis. Adm. Code Tom schmirt Attach complete site plan on paper not less than 9% x 11 I Plan must County include, but not limited to: vertical and horizontal refer ppi BSA' I •on and St. Croix percent slope, scale or dimemsions, north arrow; a aorrrtd distn a to earest road. Parcel LD.# �. ; Part of 032 - 2049 -70 -0 APPLICANT INFORMATION - Pleas , it ally &on. ", Reviewe BY Date perso information you provide may be used for sec# d k lt moses rr Property Owner .. "' Proprr±ly_ ooation Rivard, Harold And Belisle, Roland LGovt Lot na NW 1/4 NW 114 S 14 T 30 N,R 19 W Property Owner's Mailing Address• Lot"#" J Block # Subd. Name or CSM# ;>OUNT 812150th Ave � � �F�.r .. 1� na Rockamora e Road i e Town Nearest nel�krrrber Village Code. t - City State Zip Pho 4Y ❑ New Richmond WI 54017 715- 246 =529;1 \ Somerset 160Th Ave ® New Construction Residential / Number o edrooms 3 ❑Addition to existing building Use:. ❑ Replacement Public or commercial describe Code Derived daily flow •450 gpd Recommended design loading rate • bed, gpd/ft' .5 trench, gpolft' Absorption area required '.37 . 5 bed, ft' 375 trench, ft= Maximum design loading rate •4 bed, gpolft' .5 trench, gpolft= Recommended infiltration surface elevation(s) 95.40 1 ft (as referred to site plan bemhmark) Additional design I site considerations System Elevation based on Contour Line established at Elevation 94.40' Parent material Pitted Glacial Drift Flood plain elevation, if applicable na ft L U Suitable for system Conventional Mound kund r -Ground Pressure AT -Grade System in Fill II Hold'arg Tac = Unsuitable for system ❑ S ®U ® S ❑ U ❑ S ®U ❑ S ®U ❑ S ®U ❑ S ® U S= Suitable DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft' g Horizon Depth Munsell Cu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistenc Boundary Roots Bed Trench 1 0 -8 10yr3 /2 none 1 2msbk mfr cs 2m 5 i 6 >' 2 8 -27 10yr4/4 none 1 2msbk mfr cs if 5 6 Ground 3 27 - 57 5yr4/4 m3p'0y 6 sil lfsbk mfr - - -- - 2 3 elev - - - -- 95.10 ft Depth to fmibng factor 27• Remarks: `k 1 0-6 10yr3 /2 none sil 2mgr mfr cs 2m .5 .6 At :Ci! 2 6 -16 10yr4/4 none 1 2mgr mfr gw if .5 i .6 Ground 3 16 -32 7.5yr4/4 none sl Om mfi cs - --- -- .3 .4 elev . 94.53 It 4 32 -51 7.5yr3/4 map 6 y r I 5/3 5/3 sl Om mfi - - -- ----- .3 .4 Depth to frniting factor 32 Remarks: CST Name (Please Privy Signature: �� Telephone No. Thomas J Schmitt 715 -549 -6651 Address Tom Schmitt Date CST Number Raf # 586 Valley View Trail, Somerset, W1 54025 5112/00 227429 1012 PROPERLY OWNER: Rivard, Herold And Belisle, Rota SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL LDJ Part of 032- 2049 -70-0 Tom Schmid Depth Dominant Color Mottles Structure GPD1 Horizon in Munsed Qu. Sz. Cont. Color Texture Gr. Sz. Sh. onsistence Boundary Roots Bed i Trench S: 1 0 -9 10yr3/3 none SR 3fsbk mfr cs 2m .6 2 9 -27 7.5yr4/4 none Sid 3msbk mfr cs - - - - -= .4 .5 Ground Slav 3 27 -48 7.5yr4/6 py 6 sicl lmsbk m& ---- - - - - -- 2 4 9275 R - Depth to limiting factor 27• Remarks: 2S'ti k I Ground elev Depth to I knifing factor Remarks: Ground elev e Depth to Ming factor Remarks: I �x r Ground elev Depth to knifing factor Remarks: it I a i t - -- C a oc.) - -- - — -- a -- -I f,. F3,3 I i I I i I I i i i -- - Le. 9y � ?7 I I I 9 �LO I i i f - w-'� �M^�''i iZ..y - .. _►C.OICt!+ �il� s �e c'G� iy _ f ; •• 3 -- - - — /1 — 1 C $7�rl j y 9 1 ,V w/ Sly "ryolvAl 9 cnJ i i i __ � __ I �' I 1 i r . _. � i i � i I., � � �. j � { I I, : i, � i � I Y ' ',. .. .. I _. ___. - _ I ...._ 1 I _ ' I _ '. I I I �'I I t ' _ � �., I � i t i � �' �, � i I � i � 1 � i I I 1 i �,, i I �i i i I I I i 1 t I I i i � I i i � I I � � �', I � i I i ., ,' f 1 - - -- - - -- I . _.. .__.._ � F } _ .. i _ _ ... i - -- _ - -._. I I I ' i � ' " � .. !_ � ... ..___.. .._ F ._ ._ L .__ _. r - -- _. _ _- � - I -- �- � � � -� I � � I I i �_ i �._ _ _ — � — �- t -- l — -- -- i i i i I — I —�— — — �. � � 1 ��� it i � _... 1�� _ � _. _ __... _ L._ ` 1 � -__ � 1 i , -- �. 1 I I . , I _ _ . , - _ _ � � -- - -__ __, _ I � � � - - r � I � i _ f- I � -- i - � -- ��- � i-- �- i i � 4 _. __ �. _- __ i -- - - -- �. � 'I .. I_. � _ ... ;.. �.._ ; i � i � I ; ! I _ � � - � -- - - - � i _ � I '� i ! _- � -- � -- - I i L f I I — '— � I � i I � i I �— i i— I I— —i - -— i i � _ r r- � t _� __... { - -� - -- -- ;_ �. I i j �. I F__ � � � r - - � �- __ -- - i I I - � r_ �. _ , _ _ , _ _. - -_ F I I I -- - _. ; i ;_ ; _ _ �_ _ I �� I i — t r � � i I L . f i i � I a � i L . _ ,... ,. _ t _ — I � — — -- — — -- � f I i i ;_ — , � i r _ I _ �__ _ .'' I i � I i f ` - F 'r__. '_ _. , I � I I I � i �. i I I I I ,_ { , i- I - -- �' � - -_ � I � _. _ � � _ _ - -- r _ _ _ _ I I I — — —.. I I I �, ; i� i � ' i it � I I _ I _ � - -- -- -- - I I ; � ' i j I - __ , _ i -r f -- i I � � - -- I ', I I I i I __ I I 1 + - �- ! - -- ; ` - � - -- i I i i L. _ ,_. I , -- - � - -�---- F -- i � i i i i I - � �: - � , J 210 Ls l3 - ;rtztsZ3 i STATE BAR OF WISCONSIN FORM 11 - 1982 KATHLEEN H. WALSH LAND CONTRACT REGISTER OF DEEDS Individual and Corporate ST. CROIX CO.. WI (TO BE USED FOR ALL TRANSACTIONS WHERE OVER RECEIVED FOR RECORD 525,000 IS FINANCED AND IN OTHER NON - CONSUMER Document Number ACT TRANSACTIONS) 01/10/2003 09:30A11< EXEMPT # CONTRACT, by and between Harold K. Rivard and Roland J. Belisle _ REC FEE' 13.00 — TRANS FEE: 165.00 �._._— __-------- _ —_ --- COPY FEE: _ CERT COPY FEE: ( "Vendor ", whether one or more) and Michael J. Bodlovick !� PAGES: 2 _ ( "Purchaser ", whether one or more). Vendor sells and agrees to convey to Recording Area Name and Return Address Purchaser, upon the prompt and full performance of this contract by Purchaser, the following property, together with the rents, profits, fixtures and other KRIST!i 1A OGLAND appurtenant interests (all called the "Property"), in St. Croix ATTC ` Y AT L County, State of Wisconsin: HL i t JI 54016 0 32- 2138 -90 - (Parcel lden[ification Number) Lot 15, Rockamora. This is not homestead property. ()6) (is not) Purchaser agrees to purchase the Property and to pay to Vendor at place Vendor directs _ the sutn of $ 55,000,00 in the following manner: at the execution of this Contract; and (b) the balance of $ 50,0 together with interest from date hereof on the balance outstanding from time to time at the rate of 7 % percent per annum until paid in full, as follows: Commencing on the 7th day of February, 2003, and on the 7th day of each and every month thereafter, equal monthly installments of principal and interest in the amount of $500.00. Provided, however, the entire outstanding balance shall be paid in full on or before the__ __ day of (the maturity date). Following any default in payment, interest shall accrue at the rate of o /u per annual 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 after day of closing. (OR) there may be no prepayment of principal without permission of Vendor.* 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 less than the armor 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 herefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchasr r for examination except: None. 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 day of closing XXXXX * Cross out one. LAND CONTRACT - Individual and State Bar of Wisconsin Corporate Form No. 11 - 1982 Information Professionals Company,. Fond do Lac, WI 800 -555 -2021 I _— 2 •1 D G '1 7 t t Purchaser promises to pay when due all taxes and assessments levied on the Property or upon Vendor's interest it it and to deliver to Vendor on demand receipts showing such payment. Purchaser shall keep the improvements on tLie Property insured against loss or damage occasioned by fire, ex- tended coverage perils and such other hazards as Vendor may require, without co- insurance, through insurers approved by Vendor, in the sum of $ N/A , 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 ofthe 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 ofthe Property damaged, provided the Vendor deems the restoration or repair 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 and 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, ofthe Property, frec and clear of all liens and encumbrances, except any liens or encumbrances created by the act or default of Purchaser, and except Easements, restrictions and rights-of-way of rec i any. Purchaser agrees that time is ofthe essence and (a) in the event of a default in the paymen of any principal or interest which continues for a period of days following the specified due d or (b) in the event of a default in performance of any other obligation of Purchaser which continues for a period of days following written 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: (i) Vendor may, at his option, terminate this 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 ofthe 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 forfeited as liquidated damages for failure to (ultilt this Contract and as rental for the Property if purchaser fails to redeem); or (ii) Vendor may sue for specific performance of this Contract to compel immediate and full payment ofthe entire outstanding balance, with interest thereon at the rate in effect on the date of default and other amounts due hereunder, 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 costs and expenses 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- curred, 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 ofthe Property, including homestead interest, to collect the rents, issues, and profits of 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 full 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 due under this Contract. Purchaser may make any such payments directly to the Mortgagee if Vendor 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, successors and assigns of Vendor and Purchaser. (If not an owner of the Property the spouse of Vendor for 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 this �i__ of January 2003 ���G ✓ •' SEAL) ( --- �k�J�"e�-•"- _ _ (SEAL ) * Harold K. Rivard * Michael J. Bodlovick� Vendor Purchaser (SEALI (SEAL) * Roland J. Belisle — ___.-- _._�.. .— __- -_,.__ Vendor Purchaser AUTHENTICATION ACKNOWLEDGMENT Signature(s) Harold K. Rivard, Roland J. Belisle and STATE OF WISCONSIN ) Michael J. Bodlovick ) ss. y� COUNTY) authenticated this 'l liay of January 2003 Personally came before me this day of the above named -- -- * Kristina Ogland - - - -- - - - -- -- —. —.. _. — TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing instrument and acknowledge the same. authorized by § 706.06, Wis. Slats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina — Hudson, WI 54016 Notary Public County, Wisconsin " My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not ) necessary.) * Names of persons signing in any capacity should be typed or printed below their signatures. LAND CONTRACT. Individual and Corporate - State Oar of Wisconsin Form No. 11 - 1982 ndonnanon Professionals Company, Fond du Lac, VVI 600- 655 -2021 - �' tO.T �• / / u I tt n 1.x.3, 086 Sa .3.•06 A I Z so. FT. I J 6.3 ACRESr �OSFI�- BER *�E�E 489 -- 41 ti ca. p�Q`J`�' 0� B -3 O r, o ® U 7� FLOOR EL•EV. OF' 492. g�,` 282.4 298 04 20' A9EMENT. RAI..,,GE ; E (�}' _ ,� �r _" 492 v ,"' NlN Fly �OR E4EV I r- r. / i ~ LIMITS OF DRAIN 'EASEMENT i\ 154.31' LOT 15 O I . '• N 1.33, 080 SO. FT. 8 _ 3.06 A ORES C B : I O MIN. FIN. • fCOd�. - MIN. FIN. R 4vr 500' 81 R: I . 0 1,38,551 V A , B 4 1 L07 ice" s - 171, 003 - 3: 93 ACRES' N 02 s- 4 ' r I LOT •.. �� " B 3 151, 00.3 so. Fr•� i 3.47 ACRES g