HomeMy WebLinkAbout032-1080-80-000 COMMERCIAL TESTING LABORATORY, INC.
14 Main Street, P.O. Box 526
Colfax, Wisconsin 54730
715- 962 -3121
800 - 962 - 5227
F
i
ST. CROIX ZONING REPORT NO.S 03642/01 RAGE i
ST. CROIX COUNTY RF..PORT DATEt 4/10/91
COURTHOUSE DATE RECEIVEDS 4/09/91
HUDSON, WI 54016
ATTNS THOMAS C. NELSON
I
2 -- 146— p` 0 — OZ
2. - 31 �9. 3`�fF
OWNERS Paul 6 Dorthy Rivard ,
LOCATIONS 1960 -42nd St., Somerset
COLLECTORS M. Jenkins
SOURCE OF SAMPLES Outside faucet
COLIFORMS 0 /100 mt
INTERPRETATIONS Bacteriologically SAFE
NITRATE -NS { 1 ppm
Above 10 ppm exceeds the recommended Public
Drinking Water Standard.
Coliform bacteria /100 ml
Nitrate - Nitrogen, mg/L
LAB TECHNICIANS Pam Gane
WI Approved Lab No. 19
O \NDEDENb
2� �s
O A
V D
g A { Means "LESS THAW" Detectable Level Approved by'
�� PROFESSIONAL LABORATORY SERVICES SINCE 1952
S t — c; q —q
C!'�
ST. CROIX COUNTY ZONING OFFICE
St. Croix County Courthouse
911 4th Street
Hudson, WI 54016
Telephone - (715)386 -4680
the St. Croix County Zoning Office offers the service of septic
ind water inspections to Lending Institutions, Realty Firms, and
private individuals.
:ompletion of this form is essential so that the property can be
.ocated.
•lease provide the following information, enclose appropriate
.ee made payable to St. Croix County Zoning Office, and mail,
ilong with form to the above address. Testing will be done as
Noon as possible after fee and form are received.
'DATER TESTING - - - - -- -FEE: $ 25.00 XXX
(For nitrates and coliform bacteria)
WATER TESTING FEE: $127.00
(For VOC'S)
, ;EPTIC SYSTEM INSPECTION---------- - - - - -- -FEE: $25.00 XXX
(Determines if system is properly functioning at time of
inspection)
Property owner's name Paul L. & Dorothy A Rivard
Property owner's address 1960 - 42nd Street, Somerset, roll 5402
Legal Description 1/4 of the 1/4 of Section _ 2R , T - _ N -R
"own of Somerset Lot Number Subdivision Name
FIRE NUMBER 1960 LOCK BOX NUMBER
Color of house Realty sign by house? If so, list.firm:
Aim
WRIVARD AT THE ST. CROIX COUNTY TREA,i'r l
PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT BOOK,
WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET.
"esting of residential water requires a sample that is fresh. If
.he home is vacant, and has been so for some time, the water line
must be purged by running the water for several hours before the
:est can be conducted.
(INTER TESTING: Many times water lines are turned off, or sill
-ocks are turned off, making access to the home necessary. If
:his is the case, please make proper arrangements with this
)ffice to ensure time when entry may be gained.
'irm or individual requesting services: Bank of Somerset
"elephone Number (715) 247 -3348
,:EPORT TO BE SENT TO: Arlene P. Reardon. Bank of Somerget,_P.O
Box 220 Somerset WT 9402
, .losing date PL R ASE RUSH
:ignature
'^ � "
ST. CROIX COUNTY
WISCONSIN
r �} ZONING OFFICE
ST. CROIX COUNTY COURTHOUSE
911 FOURTH STREET • HUDSON, W154016
I
(715) 386 -4680
April 8, 1991
Arlene Reardon
Bank of Somerset
P.O. Box 220
Somerset, WI 54025
Dear Ms. Reardon:
An inspection of the septic system on the property
of Paul & Dorothy Rivard located at 1960 42nd St., Somerset, WI
was conducted on April 8, 1991. At the same time a water sample
was obtained for testing. The results of that testing will be
sent to you as soon as we receive them back from the laboratory.
At the time of inspection, the sanitary system appeared to be
functioning properly. The inspection of this sewage disposal
system was based upon a surface inspection of said system, and
did not involve any excavating or chemical analysis.
Accordingly, there is the possibility of hidden defects in the
system not discoverable by this inspection. This does not in
any way warrant or guarantee the continued proper functioning or
operation of this system. It is recommended that the system
should be pumped once every three years. Therefore, the
prolonged life of this system may be dependent upon proper
maintenance of the system.
'n erely,
Ma J nk' s
Assistant Zoning Administrator
cj
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Di4ision
INSPECTION REPORT sanitary Permit No: 463099 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 Holders Name: City Village X Township Parcel Tax No:
Rivard, Paul Jr. Somerset Township 032 - 1080 -80 -000
CST BM Elev: 1� Insp. BM Elev: BM Description: I J ` Sectionrrown /Range /Map No:
_1 28.31.19.391 F
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic 3 �D�d Benchmark , ��
�5
( aa Alt. BM
Aeration Bldg. S er
t
Holding St/Ht Inlet
TANK SETBACK INFORMATION St/Ht Outlet rg > 7 3 S
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic �7 56' 7 140/ �(o r laILo r Dt Bottom
Dosing Header /Man,
to 9z -- r-
Aeration Dist. Pipe Q Z ct Z • 4
Holding Bot. System
See., C,460
PUMP /SIPHON INFORMATION Final Grade
Manufacturer Demand St Cover
GP Z
Model NU( ber
TDH Lift Friction Loss ISystem H Ft i z
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 3 Z : ��� '
SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Manufacturer: ,
INFORMATION Type Of System: ��� I� CHAMBER UNIT OR Model Number: r ,
I �^
DISTRIBUTION SYSTEM 1 �w
Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air In Ake
Pipe(s) N1�11
Length�Z Dia 1 L ngth Dia \ Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over Depth Over xx Depth of Sodded xx Mulched
71 7 � Yes O
Bed/Trench Center , cg Bed/Trench Edges ` Topsoil `
\ No Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2:
Location: 1960 42nd Street Somerset, WI 54025 (SE 1/4 NW 1/4 28 T31 R1 9W) metes & bounds Lot Parcel No: 28.31.19.391F
i
v
1.) Alt BM Description ='I Ga J eti�
2.) Bldg sewer length = U6
- amount of cover
Plan revision Required? [] Yes No Use other side for additional information. F k s l
Date Insepctor ignature Cert. No.
SBD -6710 (R.3/97)
Safety and Buildings Division County n i
201 W. Washington Ave., P.O. Box 7162 ' • ( r
A ir Madison, WI 53707 - 7162 Sanitary P77 to be filled ut by Co.)
(608) 266 -3151
Department of Commerce
Sanitary Permit Application '' S Plan I.D. Number
In accord with Cotton 83.21, Wu. A Code, persoaal information G`
may be used for secondary p Pri m) Prof Address (f "fferent am mailing address)
4 s
I. Application Information — Please Pont _ _ �,�
- _DAD Z YO
Pmp q Owul Name 51 Lot N Block #
r ZoN "'
V G
Property Owners Mailing Address2 °
� � >Z
City. State Zip c Phone Number
6
X IL T e of Building (check all that apply) !� Subdivision Name CSM 4mba
2 Family Dwelling -Number of Bedmoms
Publiacommercial - Describe Use
Gry Yillagel
state Owned - Describe use .-
1 T C l ( _
III, Type of permit: (Check onl one box on line A. Complete line B if applicable)
A. New System System TreatmwVHoldng Tm k Replacement Only Other Modification to FAisdna System
List Previous Permit Number and Date Issued
S. Permit Renewal Permit Revision Change of Permit Transfer to
Before Expiration Plumber Owner l
IV. a of POWTS S (Check all that appl
on - Pnssuriud W43round Mound 2:24 in. of suitable soil Mound < 24 in. of suitable soil At -Grade Single Pass Sand Filter
Constructed Wedand Pressurized in-Gro d Holding Tank Peat Filter Aerobic Treatment Unit Recirculating Sand Filter
Recirculating Synthetic Media Filter
Drip Line Gravel -less Pi /
japilber Raw(gp
Applic
Plow (gpd) Design so
V. Di tment Area
De ormation: P System on
Del il ation dsf) k ea Required (d) ,
�
VI. Tank Info
Capacity in Total Number Manufacturer Pretab Site Steel Fiber Plastic
Gallons Gallons of Units Constructed Glass
New Existing
Tanks Tanks
SePtieor Holdrag Teak
Aerobic Treal Unit
Dosing (lambs
VD. onsibili Statement I, the nod ed, p#bWty for installation of the 11.'OWTS shown on the attached
piumbees ame (Print) Plu i 5 t X = t ; k ± ! tE MPRS Number Business Phone Number
Plumber's Address (Seel City, State. Zip rtment Use Onl Da lss
owner Given Reason for Denial
aiag Sig, !I Steps)
Sanitary Permit Fee Nudes Grtxttidwater
ppm Disapproved Surcharge Fee) ` 1 /�
1
IX, ditions of Approv"easons for_D_isaPProust
S STEM OWNER: �Zv W" G � i �GvYt G
1 Septic tank, effluent filter and
dispersal cell must all be serviced / maintained p
as per mans ement plan p rovided by plumber. tI �A-
2. setback requirements mus ramr airteQ- - /f /� !7`C�� , ^
�er applicable code /ordinances. J7 �_y/ '7
> Anal County only) for the system on Paper not lessthan gt/Z x 11 lncbes size
P19 N
PROJECT Paul Rivard 1960 42nd St. Somerset Wi 54025
SE 1/4 NW 1 14S 28 /T 31 W TOWN Somerset COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE 10/7/04 BEDROOM 3
CONVENTIONAL XXX IN- GROUND P #SURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22
BENCHMARK V.R.P. Top of Telephone Box ASSUME ELEVATION 100' Filter Zabel A -100
❑ BOREHOLE O WELL * H. R. P. Same as Benchmark
SYSTEM ELEVATION 92.4/92.3 4.5' below qrade
100'
Scale is 1" = 40'
Couldesac unless otherwise
42nd St �� noted
Vent Plans Designed Using
Conventional Powts
3 Ven - 5' trench Manual Version 2.0
*
Q / approx. 80
long
0 '
Comments: a water softner
25' 2 -3' X 69' discharged into system killing the
Cells with >3' bacteria and caused premature
5' Spacing failure. Also, the septic tank is
made of fiberglass and is probably
35' not state approved.
B -1 A alve' 5 Vent
bet le " Standard Biodiffuser
20' 1 5' s1 a of Cover Leaching Chamber
15' with 31.1 ft2 of Area
ST d tank Huffcutt pumped 6' Long
buried 34 "
Property Grade at System Elevation
Line
100'
Driveway
40' Well
Existing 3
Bedroom
house
P19 N
PROJECT Paul Rivard 1960 42nd St. Somerset Wi 54025
SE 1/4 NW 1 /4s 28 /T 31 W TOWN Somerset COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE 10/7/04 BEDROOM 3
CONVENTIONAL XXX IN- GROUND PIOSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22
IL BENCHMARK V.R.P. Top of Telephone Box ASSUME ELEVATION 100' Filter Zabel A -100
❑ BOREHOLE O WELL *H. R. P. Same as Benchmark
SYSTEM ELEVATION 92.4/92.3 4.5' below qrade
100
Scale is 1" = 40'
Couldesac unless otherwise
42nd St. noted
Vent Plans Designed Using
Conventional Powts
350 Vents B-2 5' trench Manual Version 2.0
* approx. 80
long
0'
Comments: a water softner
25' 2 -3' X 69' discharged into system killing the
B -3 Cells with >3' bacteria and caused premature
5' Spacing failure. Also, the septic tank is
made of fiberglass and is probably
35'
not state approved.
B -1 A valve is to Vent
be installed if „ Standard Biodiffuser
20' 15 with 31.1 ft2 of Area
15,possible of Cover Leaching Chamber
5T d tank will be 11 "
Huffcutt pumped and 6' Long
buried 3419
Property Grade at System Elevation
Line
100'
Driveway
40' .Well
Existing 3 14
Bedroom
house
Wisaonsin Department of Commerce SOIL EVALUATION REPORT Page I of
Division of Safety and Buildings
in accordance with Comm 85, 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 not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. �3oZ
Please print all information. R Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). I I 6
Property Owner Property Location
� i Lr Govt. Lot 1 /4`j/f,�l l4 Sag T 3 I N R E( ) W
Property Owners Mailing Addres Lot # Block # Subd. Name or CSM# S
CZ%ci2�
1 as�
City State Zip Code Phone Number [:1 city ❑Village XTown Nearest Road
❑ New Construction us esidential / Number of bedrooms J Code derived design flow rate GPD
Replacement Public or commercial - Describe:
Parent material Flood Plain elevation if applicable ^ i� // ft.
�\
General continents / /� f
and recom Q �
mendations: —3 � J 13e
❑ Boring # Boring
pit Ground surface elev.94' ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 _ L 31z ----------- /0
Z 12-2V
J
ti
d q �—
❑� ring ® # J`-'�C't Ground surface elev. ' '` 3 ft. Depth to limiting factor �F `- in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff #1 I 'Eff#2
- D "_Jh
/
3 • 6
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 ` Effluent #2 = BOD < 30 mg& and TSS < 30 mg/L
CST Name (Please Print) re CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducte Telephone Number
1008 192nd Ave, New Richmond, WI 54017 �._ ��� 715- 246 -4516
I
r
Property Owner _ Parcel ID # Page of s
F Boring # ❑ Boring `
—Pit Ground surface ele Z 2— ft. Depth to limiting factor �� in. R*Eff#1 n Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Eff#2
/ 3 V __ o
I T
E 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/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I '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/Ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
' Effluent #1 = BOD_ > 30 < 220 mg/L and TSS >30 1150 mg/L ' Effluent #2 = BOD 130 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.
SB"330 (8.6/00)
Soil Test Plot Pla
Pro'6ct Name Paul Rivard
1 Sh B'
Address 1960 42nd St.
• Somerset Wi 54025
1�01 #226900
Lot - ----- Subdivision -------- Date 10/7/04
SE 1/4 N W 1/4S 2 8 T 31 N /R W Township Somerset
❑ Boring Q Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of Telephone box
System Elevation 92.4/92.3 *HRpSameasBenchmark
Od 100'
Scale is 1" = 40'
Couldesac unless otherwise
42nd St. noted
Vent
B -2
350 5' trench
* approx. 80
B.M. long
0'
Comments: a water softner
25 discharged into system killing the
B -3 bacteria and caused premature
5 , failure. Also, the septic tank is
made of fiberglass and is probably
35' not state approved.
B -1
0 '
10' 15'
ST
Property
Line
100'
Driveway —�- 40' lo( DWell
Existing 3
Bedroom
house
Maintenance and Contingency Plan for a Septic System
Maintenance Plan
1. Septic Tank is to be pumped once every 3 years.
2. Eff luent filter is to be cleaned once a year. Please note: a larger filter is being installed in
order to extend the maintenance interval of the filter.
3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of
the cells.
4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system.
5. The owner agrees to save this plan.
6. Do not plant trees nor park nor drive over system.
7. Watershed is to be diverted away from system.
8. Discharge into system is not exceed those required as per Comm. 83
Contingency Plan
Option #1. If system fails, determine cause of failure, use r is --rnate ar ea and install new
system in tested replacement area.
Option # Install system at a lower elevation, by removing chambers, removing biomat,
and install new system.
Option#3. No adequate area is suitable for replacement area, and system elevation
cannont be lowered. Install holding tank as last resort.
3. Replace any other failing components as needed.
Plumber: Shaun Bird 715 - 246 -4516
St. Croix County Zoning 715 - 386 -4680
Pumper Tom Mondor 715 - 246 -5148
Shaun Bird #226900
ST CROP C0UNTY AGREEM
SEPTIC rI'ArM
' ENANCE
OyN-ERSMP C TIFICATION F
t'
pwnerlBuYC
Address plzwling Departmcut for new construction]
Property (V required Pram a— /D g�" X�
parcel Identification Number
ritylState 39
L EGAL — DES� �
— 1 N -R W, Town of
T t #
p erty
1 iL =— Lo
P
Subdivision . Page #
Volume
Certified SurVey M # , f3 ( , Page #
Yv
olume S
Te j�(� ee # es Q no
, r a"t3' identifiable
Lot 11I1eS i
S house Q YW�
the Private sew fz mature failure to handle was tes. Proper mainten
CYSTE _ CE of your Septic system could result in its p a licensed pumPei What you gut into the system
every
ars or soon"+ if needed oral system.
�i out she sePti a at stage in the Waste disposal the o wner and by a
cons ction of the septic tank as
c Department a Certification form, signed by
an affect the
fun that {1) the on -site wastewaterdiSP °Sal`m
to subunit to St. Croix Zo,,W Dep rverifying 113 full of sludge-
The property owner agrees �ctedplutnber or s licensed p�Pe the septic tank is less than
ber, ourneYmanPlumber, re2 after inspection and pumper (� necessary)
masterpl op g condition =&or () sal system with
is in prop the standards
ee to n. age disposal
eats agr maintain
Department of Natural Resources, State of WisconsO�Ce Certif 0 ce
Ilwe, the uadersi8ned have read the above of mm and the
herein, as set by the Dot . t"i"ed must be completed and' 1 eturaed to the St. Croix County Zoning
set forth, t our septic s ystem has been main g stating thre Year cxPiratioa date 1 7 - � DE
SiGNA m To r OF PLI
CANT
' knowledge. ( am (arc) the owner(s) of
F>z'FTCATION form arc true to the best of my {our
OA C nt on this
I {we) certify that � scau� s of a wanaaty decd recorded in Register of Deeds Office.
the property
described above% by virtue 1-6
DATE
d from the Regist
d t being revoked by the Zoning Department. « « « «•«
isl NATUU OF APPLICANT
ssssss An information that is tnis- �n�nud= nay molt in the sanitary pew
Any Deeds office
warranty eeer of Dce deed
ss Include with this apptication: a (tamped if reference is made to the watiann'
a copy of the certified survey maP
Parcel #: 032 - 1080 -80 -000 10/11/2004 11:24 AM
PAGE 1 OF 1
Alt. Parcel #: 28.31.19.391 F 032 - TOWN OF SOMERSET
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): * = Current Owner
PAUL L JR & DOROTHY A RIVARD ` RIVARD, PAUL L JR & DOROTHY A
1960 42ND ST
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1960 42ND ST
SC 5432 SCH D OF SOMERSET
SP 1700 WITC
Legal Description: Acres: 5.000 Plat: N/A -NOT AVAILABLE
SEC 28 T31 R19W 5A W1/2 OF SW1 /4 OF SE Block/Condo Bldg:
NW
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
28-31N-19W
Notes: Parcel History:
Date Doc # Vol /Page Type
2004 SUMMARY Bill #: Fair Market Value: Assessed with:
190,800
Valuations: Last Changed: 07/24/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.000 72,400 101,800 174,200 NO
Totals for 2004:
General Property 5.000 72,400 101,800 174,200
Woodland 0.000 0 0
All 5.000 72,400 101,800 174,200
Totals for 2003:
General Property 5.000 72,400 101,800 174,200
Woodland 0.000 0 0
Total 5.000 72,400 101,800 174,200
Lottery Credit: Claim Count: 1 Certification Date: Batch #: 102
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
DOCUMENT NO. QUIT CLAIM DEED
STATE OF WISCONSIN -FORM 11
THIS SPACE RESERVED FOR RECORDING DATA
'REGISTERS OFFIC:E
THIS INDENTURE, Made this da of ST. CROIX co,, WIS.
A. D., 193-3,between Paul Rivard a/k/a Paul L. Riva
'Rec'd for Record this-_ 27th
day Of ------ A.D. 192
Y— of the first part, and
Paul L.Ri vard,
Jr. & Dorothy A. Rivard_,__,
husband and Wmer of Deeds
wife
part ijeS- of the second part. RETURN TO L. R. Reinstra
W I t n e s 9 e t h, That the said part y— of the first part, for and in consideration New Richmond, I V
of the surn of One poll ar---(-$J- OD) and other--va1uable----
consideration
Dollars, to in hand paid by the said partieS-of the second part, the receipt whereof is hereby
confessed and acknowledged, has-----.- given, granted, bargained, sold, remised, released, and quit-claimed, and by these presents d(P-S - give,
grant, bargain, sell, remise, release and quit-claim unto the said parties
_ of of the second part, and toth-Pirheirs and assigns forever, the
following described real estate, situated in the County of - - ST. --CROI-X-----,,---- and State of Wisconsin, to•wit:
The West one-half of the Southwest one-quarter of the
Southeast One of the Northwest one-quarter,
consisting of approximately 5 acres, of Section 28,
Township 31 North, Range 19 West, St. Croix County,
Wisconsin.
FEE
EXEMPT
The purpose of this deed is to correct the description in
that Quit Claim Deed dated March 27, 1973, recorded March 30,
1973, in Book 496, Page 1, Document No. 315264 of the St.
Croix County Register of Deeds office.
To Have and To Hold the same, together with all and singular the appurtenances and privileges thereunto belonging or in anywise
thereunto appertaining, and all the estate, right, title, interest and claim whatsoever of the said part -Y of the first part, either in law or
equity, either in possession or expectancy of, to the only proper use, benefit and behoof of the said part of the second part,
their heirs and assigns forever.
In Witness Whereof, the said part -y— of the first part ha hereunto set hi s hand and seal this 26th.
day of September A. D., 19 73
SIGNED AND SEALED IN PRESENCE OF (SEAL)
Paul Rivard
(SEAL)
(SEAL)
(SEAL)
STATE- OF WISCONSIN,
St. Croix ) 6 °'
County.
Personally came before me, this 2 6th day of September A. D., 19
the above named Paul Rivard
to me known to be the person who executed the foregoing instrument and acknowledged the sa e.
NOTARY Yvonne Kuhn
This instrument drafted by I Notary Public St. Croix County, Wis.
MN
L. R. REINSTRA jM01001 State Jof VVIscogfPsC - ion (Expires) 4W May 3 0 , 1973.
MY Co ssion Explrev-y HIS
(8: 59.61 (1) of the Wisconsin Statutes provides that all instruments to be rworded shall have plainly printed of typewritten thereon the
_ the arenews, arsatees. witnesses and 00t1u7)-
QUIT CLAIM DEED-STATE OF WISOONSIN, FORM NO. 11 503MA-81
T T -31 -N • R- 20 -19 -W r
SOMERSET 4 N' PLA
j See Page 112 For Addltlonal Names.
(Landowners) FOLK CO. �0 B00
POLK/ST R I 500 uta-r X Bork 17 aB 3 3 V - 09ul °$ Pion
300 S u Wayne a Pat ^,,,d°" ,2 41 qj S
4 Farm Inc
1 David Peterson R"fe3s ter IR 9 r D7
D 3 Morten n 58 a
wo 72 v " 4 ICowski Dartme G erald r 6t 'q� m mfr+ f� 167
b rax><d � $ Farms lnr C 3s r..a La9entutt � 8 lM :o
+ It William cc 7 a 9- 154 waai '
ittiow 36 n
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• 7
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n Wbiv w 6 Susan 230th AVE 3 40
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eh1 91 114 Plourde M=0 Uldred
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,tr Family W 70 2-0 4 �
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I� = O 4 merset S p ° - 180th AVE
180th AVE SOMERSET'S' PAGE 62
4
"The Real Estate Guys" Team 1 Realty
David Bracht & Jack Harrison
712 Rivard Street, Suite 100
Buying or selling on this page Somerset, Wisconsin 54025
or Any other page call pa (715) 247 -5900
Dave & Jack! _ Toll Free: (888) 223'3283
II' Fax: (715) 2474880
�I
Dave's e-mail: dbracht @daveandjackacom
"You've got a friend
a the business!' Jack's a -mail: jarrison@daveandjack.com
in
i' Website• www.davidbracht.com
* AS BUILT SANITARY SYSTEM REPORT
OWNER Ca.L�t L � ,cx•�a ' TOWNSHIP ,y� �,- S �_1 SEC. i T3IN -R W
ADDRESS 16 20Y,& ST. CROIX COUNTY, WISCONSIN.
?-IAA.
SUBDIVISION 0 L [ynr Ss- LOT LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of H63
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
i d
LLI I: . I . J_ I
I di
ate N r h rr w
BENCHMARK: (Permanent reference Point) Describe:
Elevation of vertical reference point: / ,lD , / Slope at'site:
SEPTIC TANK: Manufacturer: Liquid Capacity: 1,2 S'D
Number of rings on cover : Tank manhole cover elevation:
Tank Inlet Elevation: Tank Outlet Elevation:
PUMP CHAMBER
Manufacturer: Number of gallons
Number of gal. pump set for a cycle gallons; Total capacity of
distribution lines gallon: size pump head;
gallon per minute horsepower ;brand name of pump
and model number ;
Type of warning device
HOLDING TANK: Manufacturer Number of gallons
Elevation of manhole cover ;
Type of warning device
SEEPAGE PIT SIZE; Number of pits feet diameter
feet liquid depth seepage pit inlet pipe - elevation
bottom of seepage pip elevation feet.
SEEPAGE BED SIZE: number offlines width length tile depth
SEEPAGE TRENCH: width length Q O
PERCOLATION RATE l AREA REQUIRED y AREA AS BUILT
INSPECTOR
DATED PLUMBER ON JOB
LICENSE NUMBER w
Wisconsin Department of Industry,
PLB -1 INSPECTION REPOR , Labor 4 Human .Relatio
Safety & Buildings Division
r Bureau of Plumbing, Platting Fire Protection
Me Bf P remises Date Fian I.D. No.
Street � oun y Sanitary
as er er Firm Name AGaress
I t a �r L l t r�•. ; ���• f t •,� ��ry ��7 sY6�
J ourneyman Plumber Address
weer Adaress
pit
i
f .
• t f i 1;
s
scusse M gna upe
)See Attached. r
DILHR- SBD- 6192(N.09/80) Signature of is .; n- i as pec�
White- Inspector - Yellow- tonal Inspector Pink - Plumber or Responsible Adyt Green -Owner
!X i
.... _. .._.:.,�.....,,..., .�..,.._.._..� ................r ,.�:,�.,..�. ..,. .. .«. ,n- .�..:........:..- ...: -. <,.. ... .+�.,wrw. -a::.. ... _.. ..
PlC
2c .,i� 4 ,.._ >.. _ .,.... ._._ Yc• " � " cif'� "'t � ri�s�t3tf iij4 �
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1
DEPARTMENT OF INDUSTRY INSPECTION REPORT FOR SAFETY & BUILDINGS
,LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O. BOX 7969 BUREAU OF PLUMBING
MADISON, WI 53707
12CONVENTIONAL ❑ALTERNATIVE State Plan I.D. Number:
' 1lf assigned)
❑ Holding Tank ❑ In- Ground Pressure El Mound
NAME OF PERMIT HOLDER: I ADDRESS OF PERMIT HOLDER: INSPEC ION DATE:
Paul L. Rivard, Jr RR# 1, B o x 204B, Somerset, WI
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELE V.: CST REF. PT. ELEV.:
SE% NW Section 28, T31N —R19W, LOT 1,Town of Somerset
Name of Plumber: MP /MPRSW No.. County: Sanitary Permit Number:
Richard Hopkins I 1059 St. Croix 38529
SEPTIC TANK /HOLDING TANK:
MANUFACTURER: r ^ LIQUID CAPACITY NK I L T ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER
/' _..� / ( ^ / PROVIDED: PROVIDED:
C am_/ e) U Iti DYES ❑NO DYES ONO
BEDDING: VENT DIA.: V NFM TL.: HIG WA ER I,IMB�C"R QI". .ROAD'. PROPERTY E: BUILDING: VENT TO FRESH
M. LINE: AIR INLET:
EET FROM
DYES ❑NO DYES ONO NEAREST
DOSING CHAMBER:
MANUFACTURER. 71N L I PUMP EL. PU IPHON MANUFACTURER. WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
O ❑YES ONO I ❑YES ❑NO
GALLONS PER CYCLE: PUMP AND ONT LS OPERATIONAL: NUMBER O PROPERTY WEL B DING: VENTTOFRESH
(DIFFERENCE BETWEEN FEET FROM LINE AIR INLET:
PUMP ON AND OFF) I DYES ONO NEAREST
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH o ET R MATERIAL O ARKING
or excavation. (If soil can be rolled into a wire, construction shall cease until FORGE
the soil is dry enough to continue.) MAIN
CONVENTIONAL SYSTEM:
f� WIDTH LENGTH: NO. OF DISTR. PIPE SPACING. COVER INSIUE DIA.. #PITS. LIQUID
. +F4 ESN� �,-r � TRENCHES: MATERIAL: 1T DEPTH:
GRAVEL DEPTH / FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MA ER199 L' NO. DISTR NUMBER:OF PROPERTY WEI,},,: BUILDING: VENT TO FRESH
BELOW PIPES. AB V COVER: ELEG le jT ELEV EN — )? R PIPES FAR EST LIN ! qIR INLET:/
Ss� G I ! FEET FROM
MOUND SYSTEM: - j t— 0
Mound site plowed perpendicular to slope
Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM
and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA-
meets the criteria for medium sand. TIONS MEASURED.
OYES ONO
SOIL COVER TEXTURE ERMANE: T M J OBSERVATION WELLS
❑ NO DYES ED NO
DEPTH OVER TRENCH /RED DEPTH OVER TRENCH /BED DEPTH OF TOPSOIL. SSE EDED. MULCHED CENTER: EOGES.
❑NO ❑YES 1:1 NO DYES ONO
PRESSURIZED DISTRIBUTION SYSTEM:
`rH WIDTH: LENGTH. TRENCHES LATERAL S AC G: RAVE D TH BE OW PIPE FILL DEPTH ABOVE COVER:
I
A:. MANIFOLD PUMP MANIFOLD DISTR. PIPE I MANI OL ATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL &MARKING:
ELEV.: ELEV.: DIA.. ELEV.: j PIPES: DIA.:
' LEVC ATION�t1 �ltsR!t I
05TR1SUT HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER M ERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
k111rOf�fiAf011`. PLANS.
DYES � NO El YES ONO
COMME NTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER PROPERTY WELL: BUILDING:
FEET FRC�IVI LINE:
I 0 ❑ YES ❑ NO ❑ YES 1:1 r, IUEAR R( 1
0 4 4h ul- V\1 F
0 � J5 b ��
Sketch System on Retaip in county file for audit.
Reverse Side.
SIGNATURE ,. „ TITLE:
DILHR SBD 6710 (R. 01/82)+
E wisconsin APPLICATION FOR SANITARY PERMIT
D1LHR S 4'��� �'x COUNTY
oEPR47TmEnT OF (PCB 67) UNIFORM SANITARY PERMIT #
InU
OSTRV,LRBOR 6 HUMRn RELRTIOnS ` /
— Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8' /2x 11 inc in size.
—See reverse side for instructions for completing this application. PLEASE PRINT
PROP E Y OWNER MA ING ADDRESS
� L
PROP RTY LOCATION
1 /4 //M /4,S , (or) W TOWN - se�ryl �r -5
LOT NUMBER B SUBDIVISION NAME EAREST ROAD, L*AKE6R LAr Bio4R�RK STATE N I.D. NUMBER sz V4 1 N 6a Z
TYPE OF BUILDING OR USE SERVED /l� • — — (J --QQ
7�4,1 or 2 Family Number of Bedrooms: Public (Specify): /I !-
THIS PERMIT IS FOR A:
❑ New System ❑ Tank Replacement ❑ Repair
Replacement Soil Absorption System ❑ Revision ❑ Privy
Alternate System ❑ Reconnection ❑ Petition for Modification
IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK.
❑ Seepage Bed >a Seepage Trench ❑ Seepage Pit ❑ Holding Tank
❑ System -In -Fill ❑ In- Ground Pressure ❑ Vault Privy ❑ Pit Privy
❑ Existing, For Which A Previous Permit Is On File, Permit # issued
❑ An Existing System That Has Been inspected And Is Compliant As Far As Soil Conditions.
i
Total #of Prefab. Site Steel Fiberglass Plastic
Gallons Tanks Concrete Constructed
Septic Tank Capacity
Lift Pump Tank /Siphon Chamber
Holding Tank capacity
Manufacturer:
IF THIS IS AN ALTERNATIVES STEFl COMPLETE THIS ❑ Mounct... ❑ In Ground Pressure
Total #of Prefab. Site Steel Fiberglass Plastic
Gallons Tanks Concrete Site
Septic Tank Capacity
Lift Pump /Siphon Chamber
Manufacturer:
PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY:
(Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet):
-S j 15e Private ❑ Joint ❑ Public
I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
Name of Plumber (Print): Signat 1 110 , /MPRSW No.: Phone Number:
�' /I &P s (fir► A y� 5'
P umber's Address: Name f Desi ner: 1
0 7
COUNTY /DEPARTMENT USE ONLY
Signature of Issuing Agent: Fee: Date: ❑ Disapproved
y�{
El Owner Given Initial
jX Approved Adverse Determination
Reason for Disapproval:
Alternate course(s) of Action Available:
DILHR -SBD -6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber
1
� 1
INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 •
To be complete and accurate the permit application must include:
1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in
a city, village or town);
2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant,
etc.);
3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks.
4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of
square feet to be installed;
5. Complete the section on water supply;
6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi-
fication, place your license number in the space provided and sign the permit in the signature block;
7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the
permit;
8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67 -T) to be submitted to the county prior to installation.
Failure to comply will void the sanitary permit.
9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable,
10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system,
depth of the system, type of system.
11. All revisions to this permit must be approved by the permit issuing authority.
12. A complete plan including a plot plan, drawn to scale or with complete dimensions.
13. Horizontal and vertical elevation reference points that are permanent and clearly shown.
14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s)
to system, building sewer and vent observation pipe(s).
15. The permit issuing agent may require a cross section drawing of the effluent disposal system.
TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems
must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning
your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin.
Form - S T C 100
Owner of Property -1,2 111� 'Z. 9/ � �_rr
Location of Property s —` — i4 /,V T N R�W
Township S O mer S��
Mailing Address kf
Subdivision Name
Lot Number
Previous .Owner of Property t'2 u �. �jva rd
Total Size of Parcel 6 S
Date Parcel Was Created M a-Z- /91 3
Are all corners identifiable? _ Yes No
Include with this application one of the following
.Certified Survey Map
.Deed
.Land Contract, or
e ther Regal Document which describes the property
PROPERTY OWNER CERTIFICATION
I (We) certify that all statements on this form are true to the best of my (our)
knowledge; that I (we) am (are) the owner(s) of the property described in this
information form, by virtue of a warranty deed recorded in the Office of the
County Register of Deeds as Document No. & 3 ; and that I (we)
presently own the proposed site for the sewage disposal system (or I (we) have
obtained an .easement, to run with the above described property, for the
construction of said system, and the same has been duly recorded in the Office
of the County Register of Deeds, as Document No. U ).
l
SIGNATURE OWNER SIGNATURE OF CO -OWNER (IF APPLICABLE)
17
DATE SIGNED DATE SIGNED
L
Loan No. 11006326
MORTGAGE s 24sOW.00
THIS INDENTURE, Made this 4th day of January in the year of our Lord one thousand
nine hundred and seventy —four
- WITTNESSETH: That Paul L. Rivard, Jr and Dorothy A. Rivard his wife
of
St Croix Wisconsin
• County and State of AAJ02Qy,% (hereinafter called the "mortgagors," in consideration of
Twenty- -four thousand and __ _______— OLLARS
in hand pai b WASHINGTON FEDERAL SAVINGS AND LOAN ASSOCIATION OF STILLWATER a corporation
organized under the laws of the United States of America, having its principal place of business in the City of Stillwater, Minnesota, hereinafter
referred to as "Association" do hereby convey unto fire said Association, its successors and assigns, the following described real estate in
Wisconsin
St. Croix Count xxxXWxx, to -wit:
The West one half of the SW4 of the SEQ of NW4 of Section 28, Township 31, Range 19
St. Croix County, Wisconsin.
The mortgagors elect to be bound by the provisions of Section 278.101 of the
Wisconsin Statutes.
together with all rights, privileges, easements and appurtenances thereunto attached or belonging and the right to possession thereof and the rents,
issues and profits thereof and all improvements now or hereafter erected thereon, including all heating, air conditioning, lighting, and water supply
0pporatus, storm windows and doors, window screens, screen doors, window shade%, awnings, locks, fences, pees, shrubs and all other fixtures
and Improvements, all rights of dower and distributive shares and rights of exemption under homestead and other lows being hereby released and
waived; TO HAVE AND TO HOLD THE SAME, Together with all the hereditaments and appurtenances thereunto belonging, or in anywise opper-
taining, unto the Association, its successors and assigns, forever. And the mortgagors do covenant with the Association, its successors and
assigns, as follows,: First, that they are lawfully seized of said premises; Second, that they hove good right to convey the some; Third, that the '
some are free from all encumbrances; Fourth, that the Association, its successors and assigns, shall quietly enjoy and possess the some; and than
the mortgagors will WARRANT AND DEFEND the title to the someagoinst all lawful claims.
PROVIDED, NEVERTHELESS, That if the mortgagors, their heirs, executors, administrators or assigns, shall well and truly pay, or cause
to be paid, to the Association, its successors or assigns, at any of its offices within twenty
years from dote hereof, the sum of -four Uri 1S nd anti no 1Q 0... (249000 00) DOLLARS
with interest, according to the terms and conditions of a note bearing even Aote herewith, executed by the mortgagors, to the Association, and
payable as therein set forth, and shall well and truly keep and perform, all and singular, the covenants and agreements herein and in said note
contained, on the port of the mortgagors to be kept and performed, and shall repay any subsequent advances made by the Association to the
mortgagors, either to protect the lien of this mortgage, or by way of additional loan, or for any other purpose, then this mortgage shall be void.
THE UNDERSIGNED AS MORTGAGORS FOR THEMSELVES AND THEIR HEIRS, LEGAL REPRESENTATIVES, VENDEES AND ASSIGNS
FURTHER COVENANT AND AGREE AS FOLLOWS:
1. The mortgogors will keep the buildings, improvements and fixtures upon said real estate insured against loss or damage by fires,
lightning, windstorms and all other hazards in a company or companies satisfactory to the holder of the said note, during existence of the debt
hereby secured, for an amount not less than the unpaid portion of the indebtedness secured by this mortgage, against each of the said hazards and
all policies providing such insurance shall constantly be assigned, pledged and delivered to said Association, or to the holder of said note, as
additional security for payment thereof, and full power is hereby conferred upon the Association or holder of said note to settle and compromise all
loss claims on all such policies, to demand, receive and receipt for oil moneys becoming payable thereunder and to apply the some toward the
payment of said note, and in the event of foreclosure sale hereunder or other conveyance of the said real estate, the said Association shall hove
power to assign such insurance policies to the purchaser.
2. The mortgagors agree to pay all and singular the taxes, assessments, levies and encumbrances of every nature heretofore or hereafter
assessed against the above- described real estate before they have become delinquent; and if the same become delinquent, the Association or its
representotrves may at any time pay the some and the official receipts for taxes so paid shall be conclusive evidence of the validity and amount
of such coxes and assessments so paid.
3. If, at any time, the mortgagors shall be in default in performance of any of the agreements herein, or in the said note contained, the
Association shall, in addition to and without waivin other remedies, hove power and authority to take possession of the said real estate rind to
monoge, control and lease the sortie and collect all te rents, issues and profits therefrom and apply such income to pay all expenses of manage.
ment of the proNorty, taxes, assessments, insurance premiums, reasonable and necessary repairs, and to the payment of any indebtedness secured
by this mortgage.
4. The mortgagors hereby o% %ign to the Assactatton as additional security lot tlir payment of the above described note, any and oil rents
payable on leases now or hereafter existing an so.d premises, or any port thereof.
5. If the Association pays any prior lien from the proceeds of the iocri secured by this mortgage, it shall be subrogated to the rights of
the holder of such prior lien as fully as if such Gen had been assigned to the Association.
6. To pay upon demand interest on any sums advanced by the Association on principal, prior to the date the first monthlyy installment is
payable according to the terms of said note, from and after the date of such advances, and to pay upon demand all advances made by the Associa-
tion on behalf of the mortgagors for the purpose of paying taxes, insurance and other liens and all advances made to perfect the lien of this
mortgage, to protect the some against any prior bens, or for any other authorized purpose, including premiums, if any, which the Association shall
hove elected to advance on life insurance standing as additional security for the obligation secured by this mortgage, and that all such advances
shall bear interest at the rate provided iri said note, from the date of advancement until paid and all advances so made shall be included as oddi.
tionoi amounts secured by this instrument.
7. If the Association shall at any time be mode a party to any suit or proceedings affecting or questioning the title to or possession of, or
this lien on, the,soid real estate or any improvements or fixtures thereon, the mortgagors agree to pay all court costs and expenses and o reason.
able attorney's fee incurred by the Association in such proceedings and ,the lien of this mortgage shall secure payment thereof to the Association.
8. To keep said property in good repair and fully protected from the elements and if under construction to complete the some; to commit or
permit no waste thereon and to do or permit no act by which the property hereby conveyed shall become less valuable; not to remove or permit to.
moval of any buildings or other improvements, or fixtures of any kind from the said premises, and not to construct any new improvements, additions
to or structural changes in the present buildings thereon without the written consent of the Association, and that no fixtures will be installed sub-
ject to vendor's lien or other lien and should any be hereafter installed the lien of this instrument shall immediately attach and be prior and
superior to liens or claims of others.
9. If any port or oil of the funds advanced on this mortgage are for use in connection with the construction of improvements on the premises
above described, the mortgogors specifically agree that rf such improvements are not fully completed within twelve months from the date hereof,
the mortgagee may, at its option, elect to declare the entire unpaid balance on the note secured hereby to be immediately due and payable, and
may foreclose this mortgage, unless said balance, with oil interest accrued thereon, is paid in full within thirty days after written notice by the
mortgagee to the mortgagors that the mortgagee has elected to declare such balance to be immediately due and payable,
- - -_ BOOK 5,06 PAS E �UrI
BOOK
• 10.
a If demanded, the mortgagors agree the Association additional monthly installment of to 1 /12 of such amount as the Associa-
i tion - , Secretary shall estimate to be required for the purpose of accumulating a fund with which to , when due, taxes, assessments, and insur•
ancei on the mortgaged property.
' 11 . If at any time all or any portion of the above- described mortgaged property shall be taken or damaged by condemnation proceedings
under the power of eminent domain, all compensation awarded shall be paid directly to the Association and applied on the indebtedness hereby
secured.
"'I Mortgagors agree not to sell, assign, convey or mortgage the legal or equitable title or both legal and equitable title to all or any portion
of said premises without the written consent of the Association.
13. If default shall be made in the payment of said principal sum, or the interest thereon, or in any installments thereof, or in the repayment
of any subsequent loon or loons made hereundet by the Association to the mortgagors, with interest, according to the terms thereof, or in insuring
said buildings, or to the payment of taxes, or in the performance of any of the covenants, promises, or agreements of the mortgagors mods in the
above mentioned note, or contained in this mortgage, the Association, its successors or assigns, are hereby authorized and empowered, of their
option, to declare the whole amount secured by this mortgage immediately due and payable, without notice to the mortgagors, and to sell the hereby
granted premises at public auction, and to convey the some to the purchaser, in fee simple, agreeably to the Statutes in such case made and
PProvided, and out of the moneys arising from sole, to retain the principal sum hereby secured, the interest then accrued, and all stch sums as shall
Rave been paid for insurance, taxes, assessments, or for the satisfaction of statutory liens foreclosed or paid, including premiums, if any, which
the Association shall have elected to advance on life insurance standing as additional security for the obligation secured by this mortgage, with
interest thereon as provided in said note, and all other sums which shall then be due under the terms of this mortgage, together with all statutory
costs and charge for such foreclosure, and maximum statutory attorney's fees, and to pay the overplus, if any, to the mortgagors, their heirs,
executors, administrators or assigns.
Failure of the Association to exercise its rights under this paragraph in any particular instance or instances, shall in no case operate to
preclude the Association from enforcing its rights hereunder on any subsequent occosion.
14. Whenever the word "mortgagors" is used in this instrument it is intended by the undersigned to refer to and include the corporation,
the person or persons, both masculine and feminine, who sign this mortgage, and their heirs legal representatives, successors and assigns, and
also to refer to any subsequent purchasers or transferees of the mortgaged property, and it is �urther agreed that whenever the word "Association"
is used in this instrument it is intended to include the Association's successors and assiqnees.
IN TESTIMONY WHEREOF, The mortgagors have hereunto set their hands and affixed their seals, the day and year first above written.
Signed, Sealed and Delivered in the Presence of:
Z
• ,a. �_ f ____ -- L r7 .a� ;2; e" -� r ./ _ � (SEAL)
Paul L Rivard, Jr (SEAL)
G l . (SEAL)
Dorot A Rivard (SEAL)
STATE OF MINNESOTA
ss.
COUNTY OF _ Washington
On this 4th day of January A.D. 19 74 before me, a Notary Public
within and for said County and State, personally appeared Paul L. Rivard Jr. and Dorothy A. Rivard., his wife.
to me known to be the persons described in and who executed the foregoing instrument, and acknowledged that they executed the same as their
free act and deed.
My commission expires 19 Notary u t is o County, Minnesota.
° '" SALLY SWANSON
NOTARY PUBLIC, MINI:c:+OTA
WASHINGTON COUP:
My Commission Expdres Feb. 13, 199).
Prepared by Carolyn Peters of Washington Federal Savings and Loan Association, Stillwater, Minn.
SEND TAX STATEMENTS TO;
WASHINGTON FEDERAL SAVINGS AND LOAN
STILLWATER, MINN. 55082 •' 1
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DEPAP,TMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INOUS`FRY DIVISION
- LABOR AND PERCOLATION TESTS ( 115 P.O. BOX 7969
HUMAN RELAT+lONS \ MADISON, WI 53707
(H63.09(1) &Chapter 145.045)
LLOCATIO SECTION- p TOWNS HIP /MA44&GFP,A�Y: L O T N O.:BL NO.]SUBDIVISION NAME:
/4 d� 1 N /R/ IP(or) w i /!� !l� ,�/9
COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS:
e/O r dc
USE DATES OBSERVATIONS MADE 3
NO.BEDRMS.: COMM ER IA DESCRIPTION: PROFILE DESCRIPTIONS: I PERCO[fATrOWTESTS :
Residence A ❑New Replace
RATING: S= Site suitable for system U= Site unsuitable for system
CON ENTIONAL: MOU D: IN -GRO ND- PRESSURE:SYSTEM- IN- FILL HOLDING T NK:RECOMMENDEDSYSTEM:(optional)
S ❑ U ❑ U S ❑ U EI U EI C A, L
If Percolation Tests are NOT required DESIGN RATE:
Q If any portion of the tested area is in the
under s.H63.09(5)(b), indicate C, /qs S Floodplain, i n d icate Floodplain elevation: -7 i I
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER- INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTHMN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B- y 7 7, a 150 _ar R ,- 5 sc
B- 1 7 7 70 A0/_ 'J �-
B-3 °7 7 7o S
B-
B-
B-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES
NUMBER AFTERSWELLING INTERVAL -MIN. PER PER D2 PE RIOD PER INCH
P _ �� T 1 4 3
P- i2D
P- 3 O D .�
P-
P-
P-
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope.
SYSTEM ELEVATION
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I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin
Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NAME (print): TESTS WER COMPLETED ON:
JAI
ADDR LF5S r CERTIFICATION NUMBER: PHONE NUMBER (optional):
1 y` .s
CST SIG TUBE:
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
I LH R-SBD-6395 (R. 02/82) —OVER —
INSTRUCTIONS FOR COMPLETING FORM 115 - SRI - 6395
To be a complete and accurate soil test, your report must include,
1. Complete legal description;
2. The use section must clearly indicate whether this is a residence or commercial project;
1 MAXIMUM number of bedrooms or commercial use planned;
4, is this a new or replacement systeirl;
5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL
OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS;
6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan;
7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred, A
separate sheet may be used if desired;
8, Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent;
9. Complete all 'appr'opriate boxes as to dates, names, addresses, flood plain r=ata, percolation test exemp-
tion, if appropriate;
10. If the information (such as flood plain, elevation) does riot apply, place N.A. in the appropriate box;
11. Sign the form and place your current address and your certification number,
12. Make legible copies and distribute as repaired. ALL SOIL TESTS MUST BE FILED WITH THE
LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION.
ABBREVIATIONS FOR CERTIFIED SOIL TES'rERS
Soil Separates and Textures Other Symbols
st - Stone (over 10 ") BR - Bedrock
col} - Cobble (3 - 10 ") SS - Sandstone
gr Gravel (under 3 ") LS Limestone,
*s - Sand HGW - Nigh Gioun(i,.xater
cs - Coarse Sand Perc - Percolation =fate
coed s - Medium Sand Vtl - Well
fs - Fine Sand Bldg - Building
Is - Loarny Sand `j - Greater Thara
4 sl - Sandy Loam < - Less Thati
�l - Loarn Bn Brown
. srl -- Silt Loam BI - Black
si - Silt Gy - Gray
*cl - Clay Loam Y - Yellow
scl - Sandy Clay Loam R - Red
sicl Silty Clay Loam snot Mottles
sc Sandy Clay w/ with
sic Silty Clay fff few, line, fa ';r;
v Clay cc - cornrnon, Corse
or - Peat tnin - Many, nwd t--n
in - Muck d - distinct
• p - promi net) t
HWL - High water
Six general soil textures surface wafer
for liquid waste disposal SM - Bench Mark
VRP Vertical Ref; Fence Point
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TO THE OWNER:
This soil test report is the first step in securing a sanitary permit, The county or the Department: may request
ve Nication of this soil test in the field prior to permit issuance. A cornph to set of plans for the private
sewage system and a permit application must be subrnitted to - the approl.rrr<ite focal authority in order to
obtain <a permit. 'T'he sanitary permit must be obtained and posted prior to the s: -t of any construction.
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