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HomeMy WebLinkAbout038-1118-50-000 0 CO) O 3'0n b W CD a o T d :r r � d U) m CD w N 0 n 4) ( m y 0 p W 0 i; C w �'! • N C � N N C CD 7 O to CA C co 0 CD N CD 41 N 7 �, r � N O ' 7 Q 7 N Q 7 Q' 7 N CD R O pp n v Q-0 l) DO p 0 V 3 CD C `I 3 N C 0 C- O 7 N Q 7 O O w C O v> z 0 z D cn z cn z D o. a °1 0) t c4 D <: D Ia) - cQ D cii D I� w ! C 3 a ° 3 ° 0 co W Nco N (D (D CD O O CD O Q N c CD O 00(n orto 0 0 0 0 p p o a a 3 i I CD . z z o g 0 0 C) G) 1 :9 C) G) c 0 m m 3 v m m 3 yCA to CD p ( p 0 M N to 3 CD CD O 7 CD Of 9 G7 Q 7 7 7 cn CD - O fn f/1 (n !/1 K 3 � CL a ? N 0 0 _ y O m a0 0 °: m m0 O o a v ° a a C4 ° a yam �' m y O N y O CD CD C1 (D C N a CD w CD oCD 3 ° r �, Q ° Z o o' CD o = Z o p ?D- �- C6 I -I CO O ('p O 7 O N C 7 A Z CD C) O Z O .� ' A O °L vD 3 CD o� j. OR CD I CCD < C`° m W CD 5' CD W "a _ w < v; < 0 m CD a 3 C A X y Z -• A I a a) ?: �' y m 0 a c 7 ?B'CCDD 0 Q a CL =rrr a a N =r d :E CD o o z g@ CnCD o z a O CD v CD 0 t y-O- CD N CD 0. N 3 m O 3 m O ( < o CD N O p C fi d D O N � fD 0) 0_0 v °' c° 0) cn e m o ° m ° o ° ` ° m 3 0 o w 3 o a ° ao to 3 ° ao m 3 fi O O X N O ( 0 ( � O X N O A N CD X0 CD 0) N B O O C ID 0 0 0 0 0 = O O O C 0,3 6 o Q3 o o� ti C �'O d (DD S - o Op. I O 0 �Ow mow a 0 0 m m tw 0 o o o ` o a 0 C) CL 0 N Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 463035 0 (ATTACH TO PERMIT) GENERAL INFORMATION' 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: Schaffer, Jacob I Star Prairie, Town of 038- 1118 -50 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: (�p.p� �po .a `tie CSt - R�►M ( 29.31.18.490FJ TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 2� L Benchmark S r M 4E) / Dosing Alt. BM Aeration Bldg. Sewer of ing St/Ht Inlet - f TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. V ent o it Intake t Inl p B ottom e is 22 osing ea er an. era ion is . ipe o mg o . System Ina ra e PUMP /SIPHON INFORMATION m anufacturer Demand St GPM +��� "'"'^�r'°`�t- �•� p o e m er I U11 i is ion oss ys em meaa ore m- I Lenc tn ia. DIM r 3 gar,es ( 3 INFORMATION �y� CHAMBER OR \ 17v / UNIT (Z u U15 UKIBUTION 5� -5 1 T1 I IVU Spauhly Le gth �Dia Spaci x Pressure Systems Only xx Mound Or At - Grade Systems Only Bedrrrench Center Bed/Trench Edges Topsoil Yes No [] Yes [] No COMMENTS (include code discrepencies, persons present, etc.) Inspection #1:1222 Inspection #2: Location: 1955 93rd reet Somerset, WI 54025 ( E 114 NW 114 29 T31 N RI 8W) m es ce 8.490FJ 1.) Alt BM Description - t'` " " "° •, 2.) Bldg sewer length = 2 S ob - amount of cover =H} cl-m--, °Iv 'f°, 3 ,maw � o�,.o. 5 �. �� 8'• 6 �`l) s � .� Plan revision Required? Yes No Use other side for additional information. — -- -bate ' Ins 12/22/2004 08:36 7152687080 GILLE TRUCKING PAGE 02 joy Aloey a t t ' j op 1r , 1yh i i �; 12/22/2004 08:36 7152687080 GILLE TRUCKING PAGE 01 won Gills; Tiucling & Excavating, Inl o 352 140' Street Amery, WI 54001 Phone: (715) 268 -6637 Fax: (715) 2687080 FAX TRANSNffrrAL 'jjjjjj EIQ I pj Fes; '7 -aS - ye S4 } JE) n S/ belly Date: a - O Pages: a CC: 0 Urgent 13 For Review 0 Pleas® COMMOnt E7 Pleaso Ra0y 0 Pl aw RseyCfe C��pdQ4CL p10 �Ic �r 3" 3(,-) 1 N g f f C 0r151'\i�� Notes; 'may Ml `M ti'F•:Ir: h t"ry'.77"'T� dt.;Y'ro ._� ,rpa'7.uK; ..,��,, ,,.. �,._.. p�. ya"' .t •: r«' `- Li��"?;�. 115;�'#:i'� * d'4': r ,.. Y. ✓',?x.P i:. ti''w � fiti: ��'�('� a, h'�}yF,a +.?r kt3i...0 <:Y., � �X'�wil' !. KY„AT: '"iai' � r. �:,� • ��A � �t 'I. �},�' 11„„ `� q� b k S x ��•:' gN`d"�r,�^.�35>e? uY•, yip ',v:•rw.r'�a..:.�,h.:i`:}n <�y +� � A a�` ) v a�" \Q "�1.:�r.:;;' t� "v ,,»a y:; q,� �.:u q t ? ;. { 6 �, ? 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Jessie Nye_ Subject: 463035 Gille - Schaffer Location: Star Prairie, metes & bounds, Sec.29 Start: Wed 12/22/20 3:30 PM, i End: Wed 12/22/2 4 4:30 PM Recurrence: (none) 038 - 1118 -50 -000 29.31.18.490FJ 1955 93rd Street i 1 ` - n m o > ■ - � o \\7 % \ \f . _ � 0- z o #_ \� a) o g =; f P § C) W = - , k E i � $ § g E� m $ 22 °C- ■ _ o � � (4) F § m J ■ e z > E F� � 3 R CO > ; cn � \ � S$I r ® 1 0 2 CO g E c (D ■ _ �. , � 0 0 0 � � " 2 2 § § § k� r \ § ca ■ In i 2 o f (D R o� ƒ : £F&S\ « J � ) / m [ 2 \ § ® ƒ E 0 g 7 K Rm ! a �� . CD _ �< 0 \ \ k \ me` c a , o # z ! CL 2 _ / f \ @ ¥ CD M ■ m , CO \ \ / = m - E,%- oCL $'a0 k \/� § $ §Jf&@ƒ R j \CD \$J/ 2 E =/ CD a) = ®q » \ K §�±E } , Ufa\& o��3E . , CL � a) /CD \ \ ; 0 -4 § =R 3o ° ƒ oo 2 ;:L CL 2 0 \ « � \ ; \ � � \ ( j , o � % d Buit gs D arty ` ,�� 1 ngton e., P.O. Box 7082 onsin adis n, WI 7079�> Sanitary ermit Number (to be filled in by Co Department of Commerce (608) 26546 z9 O 4 3 Sanitary Permit Applieatio S ?. Cf�01xCUttNestate P LD.Number In accord with Comm 83.2 1, Wis. Adm. Code, personal information LINING lIIF may be used for secondary purposes Privacy Law, s 15.04(1)(m) rojec Address (if different than mailing address) I. Application Information — Please Print All Information I l e A ST - Prope Owner's Name / Parcel # Lot # Block # Pr �%� Owner's Mailing �� Property Location z/po T Y , Y10 City, tate V., Section ry. Zip Code Phone Number ,, ,, (� . 3 I �T lu (circ le off) / hJ« � Mn I S - S - //? S7 - aYS Uzi/ L� ocA� II. Type of Building (check all that apply) ,`�, �� T N; R b h ( ❑ 1 or 2 Family Dwelling - Number of Bedrooms t Subdivision Name CSM Number / ❑ Public/Commercial- Describe Use / 1/ 9/9 1 Gt(LL�Ct ❑ State Owned - Describe Use r n i ❑ a ownship of O III. Type of Permit: (Check only one box on line A. Complefe line B if applicable) A. .� New System El 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 99 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 D 'p Lin ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rat gpdsf) Dispersal Area Required (so Dispersal Area Proposed (so Syst Elevat y � - �"�'? 8 o f VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks I Tanks Sept or Holding Tank ! ?too l Z O .z X Aerobic Treatment Una _ Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installatio the POWTS shown on the attached plans. Plumber's Name (Print) is Signatu M PR her Business Phone Number Plumber's Address (Street, City, State, Zip Code) S VII oun /De artment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Dat Issued ssui g ) ng Age t Signature Stamps) L Surcharge Fee � 6 � y ❑Owner Given Reason for Denial SU> IX. Conditions of Approval/Reasons for Disapproval 3 M 0-, 4� YSTEIVI UWNIRl 3,S "Z �, �e2Z G� 1 Septic tank, effluent filter andr�''� _ - U dispersal cell must all be serviced / maintained V�-�° �C, Qlc f ?J Q as er mana ement plan provided by p 2. All setback requirem 4 as per app Ica le codelordinanc ,r CSr Cau.�G��� a Attach comp to plans (to divtounty only) fqr the system on pa r of ess ha 8112 11 i hes n siu �14v G /7Cn �A�/`) SB - 02 v � - f D �° -�-�' a Zr NwS.2 3 I /4 / ,e/fiv S..4, 44" 7"�v. .28' !9 c: /c 97, 0 9S; 8 -h'1 , mot AV ig rn �1 F • • 32, g3 £(ds d► Pa��3 is ��av � o rtwm $Ase Q 1J - DA - J� Fed rl �A-4c (00 H a A 3 td r V03 � c e z z • m 1 N m 1 U e O _. m0 — ' RI 93RD STREET 4J'. SOO °55' "E C t rn ICD CA n o� O m F m lIl D .A N 0 1 *1 N Ir m z iz o, I o (z m �o t,ti'ZS� S i OP m If 14' Zf4 _ O W I 1 < + r 00 r m� I D O O i z - d � � S� 10 ._ - r W __. Ir u ' -7j05; 11A a N e n CA 179.38' Ifi1.57' icy ~ d ° I �— LA -V W �- lu Z g 6b . , / O p \y\ 5 / s y j, -d 088b- GtiZ -STG•' uosiiueH 4oeC /44oe.i8 sAe0 e8T :TT 60 61 udH L63 ,� 1 ���" -4D /9ss 9 3AP245 51 � ORDINARY HIGH WATERMARK DESCRIPTION CHECKLIST Form 5500-46 Rev. 2-83 Observer - 7a- QLO �►D J-1 waterway Property Owner �� C 6 ►n p�,e� l0 L ! r' 7� / r .s i ✓i �-� �" LOCATION ' V4 LJJ �. Section Town N Range r Town of County of DATE 2 � � � Hour Day Month LO Year WEATHER II LL-J Wmd Direction W Temperature Wind Speed l � l PHYSICAL SETTING 2 ° I Q I Bank: Height I I Ft. Slope Wave Height Ft. L� L - 1 �, ) f Distance From D ' Ft. Slope OHWM To Water's Ft. Beach Width Edge ' O Assumed sex e L G-7-10 O M.S.L.D. (Describe references r ; o o Ca. O I.G.L.D. on back of form) �G+ o Water Level $ D Other f . �, �'E.,t c O Assumed I O M.S.L.D. (Describe references Field Book Elevation of S� . L�j O I.G.L.D. on back of for Number OHWM ❑ Other -ly -ol OHWM DESCRIPTION - to o banie- Description Item Bed material adjacent to St l +• C� 1 J S {ee OHWM Factors affecting location of - Nt h W r or% OHWM (e.g.. structures, shore protection, shore configuration, fetch) uv Indicators and procedures used � _ to determine OHWM w--��- General vegetation types below OHWM General vegetation types above OHWM If photographs taken, how many? ) What type of photographs? Where are they stored? �Kv►iY� b k�\ c�— Fier 19 01 11:01a Tom Conover 7635440415 p.3 4b- DO- j t -e is m ,y 6b v,- �L 51.eA— F- ers �l s' \a I � 9,3 5 7 � 1n -r) O/j S 5oz-A P C7-7 JOINS 02 I ' �F • f ZONE B Z NE A 3126/76 o ZONE B -1 � ZONE C / co O � 861 ` � k M n ° I ZONE B--- N 2 O � G Q 8 — AREA NOT INCLUDED SOMERSET I U 5a ZC 83 ;835 830 St. Rt. 64 829 f O N 2 7 ONE . ONE C 826 821 M ZONEB ZONE B—' Mlnneap��l5 St paui JOINS 15 co le v o l CD 1 OD 0 01 + \' V OD _. - `'� N OD \� ( f 93RD IC! rn O to ' I is ro CD Q i ' -p 214.5 , --1 8 Q,N O_ L4 2 6 o ,m o Iw rn im I (D O D N S&P 6rd a. C-A9, +' i o f e,- 1 f:: f hv, s Q Ro pe r r `E y a j-�ris j ous fsr� datvc (,- (u�dc wLa^ A. A,cfi lt� (4 S +:11 Wisconsin Department of Commerce IL EVALUATION REPORT Page of ��W Divirir; i of Safety and Buildings I in accordance with Comm 85, Wis. Adm. Code County � ' Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. DO percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 3 $ — 1 1 — 5 0 Please print all information.. r 2 Z Date �7 Personal information you provide may be used for seconds purpo 4�) ). �/i /Vb" 0 O Property Owner PMP§rty Loc ation ��, - vt. Lot 6 1/4 �/4 Sag T N R E (or Property Owner's Mailing Addre lam . Block # Su . Name or CSM# G� 0 `t'h .�T 1. 91Y Pei 17 vooc City State Zip Code Phone 4umbd CIty ❑ Village Town Nearest Road ZONING 0 F /p P $ ( I) - tr P ► 3rd New Construction Use:g Residential / Number of bedrooms Y Code derived design flow rate (o GPD ❑ Replacement p ❑ Public or commercial - Describe: Parent material 0 V - tW ek - S L-% Flood Plain a evation i ap licab a tt. General comments= S V S 5LS -t' t� $ � Dr` -} �•� L.� .S .7 and recommendations: 11 r4 m a. b e- For `1' h'. s t3�.lA �. ', � oh .+�. �- 'aS :i• ¢. .. �• f, • rT *T, 3 (qcp.yy')pUCG�I.o ✓.° F-i I Boring # �❑a Boring tat Pit Ground surface elev. 99• y G C S ft. Depth to limiting factor 9S in. Soil Appl ication 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 95 H��l A - t. ® Boring # ❑ Boring Pit Ground surface elev. 1 001 .So ft. Depth to limiting factor / e1L0 in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 -t y �S FS L & i%S 1 V . Y v-, ay oYt2`I _.___ -__. 5L ES-4 K c�.� . !o ssl 3 1 y_3 7.6 r 7 ta 3 r -t- - .3b �„ t & (o * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg& and TSS < 30 mg/L T Name (Please Prin Signature ST Number dress D e Eva nation Conducted Telephone Number a7 00 LLIX 5 q o oZ• - K te Hy { a Property Owner �G�G..1'�G✓' Parcel ID# Page C;Z of 1 31 Boring # F1 Boring Ea Pit Ground surface elev. DoZ .5 P ft. Depth to limiting factor oa a in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 L a L55 K AS at, , P ID 'try 7.510 S L. w Boring # ❑ Boring Pit Ground surface elev. /b!. 9 ft. Depth to limiting factor rS in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAf in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Ef1#1 *Eff#2 T - tfc v . F-1 Boring # E] Boring 11 pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *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. SBD -8330 (R.07 /00) i We .t. 1 +79.5//' T -4 --4 .. n • V 0 0C cr d Z r� o p tA w W 13 Tj l 0 N JAI ONh 7vs)6 LA I J. d A V a � -34 p ' B6i1�j" k Q h ' - UO O Oro► (6 C a— a ty ca cia ca oo CL M p C'1 a1 M • � , al 2 V — 06 3 w � b • POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of 2 FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity Z db a l ❑ NA Permit # Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units g Pump Tank Capacity al ❑ NA Estimated flow (average) A�o (� gal/day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) OZ gal /day Pump Manufacturer ❑ NA Soil Application Rate 0,1 gal/day/ft' Pump Model ❑ Standard Influent /Effluent Quality Monthly average* Pretreatment Unit NA Fats, Oil & Grease (FOG) 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) <_30 mg /L l� NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y. in di ❑ NA Other: ❑ NA Other: ❑ NA Other: e ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every 2- 3 ❑ ear(s(s) (Maximum 3 years) El NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: 2 -3 ❑ yearlsl s) (Maximum 3 years) ❑ NA month(s) ❑ NA Clean effluent filter. At least once every: �3 ❑ year(s) ❑ month(s) ❑ NA Inspect pump, pump controls & alarm At least once every: ❑ year(s) Flush laterals and pressure test At least once ever ❑ mo year(s) p NA P y� ❑ yearls) ❑ month(s) Other: At least once every: ❑ year(s) ❑ NA Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page 2 pf ?/ START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tankls) 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 mqpsures have been, or.must be taken, to provide a code mpliant replace nt system: A suitable replacement area has been evaluate &and y be utilized fo 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. T aluat a o ins ank e ai e rre3� FD P_ AI &J CaN S7R(XIA0� be ' R04 -118 ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name e�j Aj _s Name Phone 1 S' Z fj� (, (p 'j Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name 15t. C�Q l r�V Ilf -&Ojl / Phone Phone —71 S— 3 g(�_ (p This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.5401, (2) & (3), Wisconsin Administrative Code. 09/02/2004 10:23 7152687080 GILLE TRUCKING PAGE 02/02 ♦ T ST CROIX COUNT)' SEPTIC 'LANK MAINTENANCE k133REEMENT AND OW14ERSHIP CERTIFICATICY-1 FORM Owner/Buyer v a Le- 4 w Rp_o"1 Ce_ l5 Y PIV on a,�,o� pri or► Mailing Address Property Address (Verification required fkom Planning Department for new. oonstruction) city/State am e Z`� LJ L Parcel Identification Nul aber 3 LEGAL DESCRIPTION �-{ fiac,� � � -- e qq o F q , qqoT H/ Property Location ` /., N � Y,, Sec. a9 , T 3� N -Ra . W, Town of �t� r �r c. e Subdivision , Lot # i /' Certified Survey Map # rreGS �a�Vol Page # t L, Deed # :Z7.7' , Volume 2 , Page # ap pec house 0 yes C0 no Lot lines identit i.ablez yes ❑ no SYSTEM MAINTF&ANCE Improper use and maintenance of your septic system could result in its pr( mature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every duce years or sooner, if needed ba a licensed pumper. What you put into the system can affect the function of the septic tank as a treatrrtent stage in the waste dispa •al system. The roe owner agr ees to submit to St. Croix Zoni D i certification fa s b the owner and b p p rty aRC g epartYn rnt, gne Y Y a master plumber, j ourneyntau plumber, restricted plumber or a licensed pumper veri tying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if neces ;ary), the septic tank is less than 1/3 Rill of sludge. Uwe, the undersigned have read the above requirements and agree to maintain thl private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of N uturai Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and return rd to the St: Croix County Zoning Office within 30 days the ye a pantion date. kfm PI.ICANT DATE OWNER, CERTIFIC I (we) certify that all statements on this form are true to the best of my i knowledge. I (we) am (are) the owner(s) of the propa de hove, by virtue of a warranty deed recorded in Register ►f Deeds Office. /� V AGtCYRE O A PLICA .NT DATE Any information that is mis- represented may result in the sanitary pennil being revoked by the Zoning Department. *" Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey trap if reference! is made in the warranty deed 9/3/2004 10 :25 St. Croix County Sharon Fuller -> Schaffer, Jacob 2/3 • J 2252P 58Z� r I. - 7 a24B 35 STATE BAR OF WISCONSIN FORM 2 -19W Document Number WARRANTY DEED KATHLEEN H KALSH REGISTER OF DEEDS ST. CROIX Co., III This Deed, made between Arlin A. Axell and Jeanne M. Houle, RECEIVED FOR RECORD both single persons, 05/27/2003 09:30AM Grantor, and Jacob A. Schaffer and Molly G. Lawrence WARRE N j DE ED REC FEE: 13.00 TRANS FEE: 317.70 COPY FEE: Grantee, CC FEE: Grantor, for a valuable consideration, conveys to Grantee the PAGES: 2 following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area (See Attached Exhibit "A ") Name and 0Wss �Z 1, -A OGLA. ATTORNEY AT LAW P.O. BOX 359 HUDSON, W1 54016 038- 1118 -50 -000 & 038 -1118- 90400 Parcel Identification Number (PIN) This is Y'Gt homestead property. XIiX X00 Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this ZZ of May 2003 * + Arlin A. Axel] * + ean-ne M. Houle AUTHENTICATION ACKNOWLEDGMENT Signature(s) Arlin A. Axell and Jeanne M. Houle, both single STATE OF WISCONSIN ) persons, ) ss. �j County ) authenticated this day of May 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 acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY s Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, WI 54016 My Commission is permanent. (1f not, state expiration date: ignatures may be authenticated or acknowledged. Both are not necessary.) ) •Names of persons signing in any capacity must be typed or printed below their signature. intom,aion Prorewionls company, Fond du Lae, wi STATE BAR OF WISCONSIN 800-655 -2021 WARRANTY DEED FORM No. 2 - 1999 # 9/3/2004 10:25 St. Croix County Sharon Fuller - +Schaffer, Jacob 3/3 2252P Sgt EXHIBIT "A" A parcel of land located in part of the SE%Nw, Sec. 29- T31N -RISW described as follows; Commencing at the Northwest comer of Sec. 29; thence South 00 0 49 1 04't East, along the West line of the NWM of said Section, 1316.65 feet; thence North 89 0 54 1 19$ East, along the North line of the SKOTIA of said Section, 1318.77 feet to the, Northwest corner of the SEUMN of said Section; thence South 00 East, along the West line of the S$ of said Section, 534.84 feet; thence North 88 East, 25.48 feet to the point of beginning; thence continuing North 88°04' ion East, along the South line of a parcel recorded in Vol. 909, page 174, 338 feet to a point 30 feet more or less from the waters edge.o£ the Apple River, being the beginning of a meander line; thence South 28 along said meander line, 200.24 feet to a point 27 feet more or less from the waters edge of said river, being the end of said meander line; thence South 88 West, along the North line of Lot 1 recorded in Certified Suzvey Map, Volume 2, page 533, 430.15 feet to the Northeast corner of said Lot 1; thence North-00 West, along the Easterly right -of -way of 93rd Street, 179.41 feet to the point of beginning. Including all lands lying between the above described meander line and the water's edge of the Apple River between the extension of a line bearing North 88 East from said beginning of meander Zane and the extension of a line bearing North 88 °04 East from said end of meander line. s LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF STAR PRAIRIE COMPUTER NUMBER 038 - 1118 -90 -000 Parcel Number 29.31.18 490 OWNER NAME: First JAC Last SCHAFFER PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment SECTION 29 TOWN 31 N RANGE 18W %160 NW '/440 SE Line Description Line Description TOTAL ACREAGE 0.820 PLAT LOT BLK 01 SEC 29 T31 N R! 8W PT SE NW 15 02 FROM NW COR SE NW GO S 214.5 16 03 FT; N 88 DEG E 173.9 FT; S 17 04 10 DEG E 352.5 FT TO POB: S 18 05 10 DEG E 181.1 FT; S 88 DEG 19 06 WTOER/WTNRDONWLNN 20 07 0 DEG W TO PT S 88 DEG W 21 08 FROM POB; TH N 88 DEG E TO 22 09 POB & INCLUDING ABD RD 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF STAR PRAIRIE COMPUTER NUMBER 038 - 1118 -50 -000 Parcel Number 29.31. �.49JOF OWNER NAME: First JACOB A Last SCHAFFER PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment SECTION 29 TOWN 31N RANGE 18W %160 '/440 Line Description Line Description TOTAL ACREAGE 0.000 PLAT LOT BLK 01 SEC 29 T31 N R18W .82A IN SE 15 02 NW COM NW COR, TH S 214.5 FT 16 03 N 88 DEG E 173.9 FT; TH S 10 17 04 DEG E 352.5 FT TO POB: E 133 18 05 FT, S 27 DEG E 200 FT, S 88 19 06 DEG W 192.2 FT NLY ALG RD TO 20 07 POB 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF STAR PRAIRIE COMPUTER NUMBER 038 - 1118 -90 -000 Parcel Number 29.31.18.490J OWNER NAME: First JACOB A Last SCHAFFER PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment SECTION 29 TOWN 31 N RANGE 18W %160 NW 1 /440 SE Line Description Line Description PARCE L VOLUME & PAGE HISTORY TYPE VOLUME PAGE DOC# NOTES . ►.WD 2252/581 722835 AXELL A &HOULE J TO SCHAFFER JACOB &LAWRENCE MOLLY ..WD 1129/357 0 ..WD 1081/610 0 914/129 0 788/602 0 653/585 0 Use Arrow Keys to Select, F7 -ROD, F10 -Exit �v S .e7 G / t Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page of tabor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTYeWNM. v}i,6" PROPERTY LOCATION A,QG /N 14 - ,4 Y5 GOVT. LOT SE 114 ,,V"1 Lq T 3 1 ,N,R /<f E ( ) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME QR CS # 7/'? /140 . 2E141D D I'll . !io% yi CITY, STATE ZV COD PHONE NUMBER QCITY IL GE WN NEAREST ROAD / /w�4T��' 1# , ssoi ( &lu 439- 7� 3 z lf! / 9 3 ,e,0 sr._ ( "New Construction Use ( Number of b6drooms (J Addition to existing building ( J Replacement I J Public or commercial describe !' 7 2 �� Code derived daily flow � gpd Recommended design loading rate bed, gpolft trench, gpd/ft 2 Absorption area required � bed, ft /0 3 trench, ft Maximum design loading rate 7 bed, gpd/ft ' d trench, gpol11 Recommended infiltration surface elevation(s) -f �4 •3 ft (as referred to site plan benchmark) Additional design I site considerations Parent material S 418 S Flood plain elevation, if applicable ft S - Suitable for system CONVENTI U M IN- GROUND PRESSURE A -G DE SYSTEM IN RLL HOLDING TANK U= Unsuitable for s stem L7 5 f�'S O U Ca-3' O U Cy'S ❑ U S E O U [I S C�It SOIL DESCRIPTION REPORT Botin # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft g in. Munsell Qu. Sz. Cont ConL Color Gr. Sz. Sh. Bed Tierch 0 - 3 Af y :2- S /.mil �'S 17A 7 'C LI/ z 3 ^� �sy s� �S ©s �� �s .0 Ground 3 / / G S� -S s �� 7 elev /OCa &b ft. Depth to limiting i factor 1 I Remarks: Boring # AS �° �ij qS N l op / p / yk° 3/z I z -7,s y /s 14n �s Ground elev. 3 A C I A S D, S IV Depth to limiting I factor Remarks: CST Name:—Please Print O t3 E �.. Phone: 71j 36; /�5-- Address: &-,j- y, j G'STiA! S��Z Signature: Ulbricht & Assoc cites Date: CST Nu bar: Private sewage consultants N 44 655 O'Neil , is. U �udson Wis. 64016 �n D This test site APP ROVED • for a conventional septic W15te • S�i/�,�'. AE G-�PoF�i��`�° � �, , • , PROPERTY OWNER SOIL DESCRIPTION REPORT Page of 3� PARCELIM. Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence BoAlay Roots GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tmndh v -/z /O 27^- 7 J�? 1 3 2- / S S 2 •7 11 -,� /o y Ground 3 - .S yve */, Depth to limiting factor 1>-y4;L F7F71 Remarks: Boring # _� �o ye 3/Z lo Y)e Ground elev.- A l ---- C's 0 S 'ot ft. r Depth to limiting factor Remarks: E Boring # ^ �int YS 37 L 7 L J OI D Sly 3 a Ground elev, /oaf_ ft. Depth to limiting facto Remarks: Boring # ; 13 4 Ground elev. ft. Depth to limiting j factor Remarks: q C 3 M 5'E7- Tod of r 0 13 • �z N� ,y �AOP . y3 � /fi✓wE 8 1 , 3(0 23D — I E V N dAV S /3 /0(0. /oo,i5 • _� - ro vAi � £'rf - 3 ,+t s 0 6 G ES 7 T Pe,) Cl(, if- 'IEV4 GoT 111&. Tip &Av 1" o /0 W Tien '73 leD ST. � ae Z ti 2 \ � `5 ae�• .\ 93 g\ 00 / N E Z� ZA r / e \0 A 6,L ENE +I \Ipe ► N I of I � I I NI L5' 191 ,f3£'6LI --I I N II I so �L in >I M ~II Sr I I Z I CL O I J I CSI ct 3 O W 8 _ 0 0..1 Ql t 0 a W I cD Q1I — (n ri 0_0 p I� �_ M Q 1 It � 1 N '�fi I W M OD >1 o N 1 O 0 3 g2 31 JI in w ZI m 01 gg2 5' 1 >1 co in —i N LL 1 z W JI I � 3 ZI u Q I U °" I ` o cr-I o w <1 at , z z N aw Q w w v � W l0 cr Q M N O W M ✓ ,09 191 3 „L0,66o00S '.Itb•6LI M„LO,99*OON 1�381S w o o � O N z w M z 01 N 0 U w DOCUMENT No. STATE BAR OF WISCONSIN FORM 1 -1982 THIS SPACa RSSERVtO Pon trCOROING DATA WARRANTY DEED �si�sa4 - 1081FAr io Thi Deed, made between .............. ............ . .. ........................... !' i• fi `v��� �i� _Rot'�xt..E.._..K�uw� -. anc�,_Dgioi es. .- ttluwe, • husband R� *W ROCIr�d ;! ...... and. V1fe.. - .................. .. ....... ....._....., Grantor, I ;:° J UN o � 1994 and .... . Beyesly ,I P. - -, .. Jalaorakj.. ............. - . .................................................. .................................. .------ ._._.._. ..._- •__••_• li �tdy^'�w I� .. ..................................... ............. ........................... Grantee, �t Yi Witnesseth, That the said Grantor, for a valuable consideration...... H --- -• - -•- • ............. .................. g . ...... St .__ ......... C - - - - - • - -- ' s to Grantee the fo described real estate in _ 1 A1X. TO ` y RETURN TO conveys e oown lnwf y+i6iw1r7 Jg1a n � County, State of W'sconain O Be X 3S5 j� {Itno�lss;n _mil s_�/ '�' i I Tax Parcel No: ................................... see attached Exhibit "A" �E�FMP�T" This ------- i.S --- t10t(;_....... homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And- ---- Robert. ..F..- _K1 "ukje-- �nc� -- Dolores "- Y '--- Kluwe - - - - -- - - warrants that the title is v good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and rights -of -way of record, if any. and will warrant and defend the same. 2 s*- Dated this ? -•- - - - --• -- day of --- - - - - -- May --------- - ----- - 19_ ...... -- •---- ------ .................... ........ (SEA T.) . ! U."- - -� —A- ( ..... ............ ..(SEAL) • Robert F. Kluwe -• ---- --- --------- - --•-- --- -- ---- ----------- (SEAL) !( oQa ° .. _ - --- --- -- - - - --------------- - -- - ---- - Dolores1 Kluwe i AUTHENTICATION ACKNOWLEDGMENT I Signature(s) ...... Robert F. Kluwe, . STATE OF WISCONSIN r I Dolores Y. Kluwe sa. •---- -- --- -• .... ........ 73` ........... ... ......... I authenticated this ....... a y y Of ...... Ka ... .......... 19.94 Personally came before me this ................. la Y o' ......... ......................... :., 19 ........ the above named Kristina0 land ---- - - - - -- -----•-------------------------------•----------......---•-•--•--- •• . -• •• -• ...••. - 9 - - - - -- .. -- O F WISCONSIN TITLE: MEMBER STATE BAR O --- --- -- . -•- - - - -- ---------- •----- - - •-- - - - - -- ---------------------------------------------- - - ---- !I (If I � ut not, d b 706. • Wis. St --- ... •..... person Who executed the II authorized b _ °' -• -•------ •-- ...-•--- ----- - °- ---- - Y $ 706.06, Wis. Stata.) to me known to be the - .- - - '•_-- -• - - -• foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY Kristina -----•------•---•--•-------••----•----- ••-------- ••-------- •-- - - - -•• it Attorney at aw it Sign • tur - •-...-- __- en ....................... Notary Public ..• - ---•--- - -------- - ---- --------------•- -- - -- -- - ---.... County, Wis. atures may - he auth . . . enticated or acknowledged. Both MY Commission is permanent. (If not, state expiration are not necessary.) date: ------------------------------------ 19- } •Names of versons signing in any capacity should be typed or printed below their signatures. WARRANTT DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co. Ina FORM No. 1-1982 Milwaukee, Win. • I . , � EXHIBIT "A" A parcel of land located in part of the SEUNW3(, Sec. 29- T31N -R18W described as follows: Commencing at the Northwest corner of Sec. 29; thence South 00 *49'04" East, along the West line of the NW34 of said Section, 1316.65 feet; thence North 89 0 54 1 19" East, along the North line of the SMNW3( of said Section, 1318.77 feet to the Northwest corner of the SEUNWW of said Section; thence South 00 0 44 1 42" East, along the West line of the SE3(NWU of said Section, 534.84 feet; thence North 88 0 04'10" East, 25.48 feet to the point of beginning; thence continuing North 88 °04'10" East, along the South line of a parcel recorded in Vol. 909, page 174, 338 feet ` to a point 30 feet more or less from the water's edge of the Apple River, being the beginning of a meander line; thence South 28 0 18 1 49" East, along said meander line, 200.24 feet to a point 27 feet more or less from the water's edge of said river, being the end of said meander line; thence South 88 0 04 1 10" West, along the North line of Lot 1 recorded in Certified Survey Map, Volume 2, page 533, 430.15 feet to the Northeast corner of said Lot 1; thence North 00 0 55 1 07" West, along the Easterly right -of -way of 93rd Street, 179.41 feet to the point of beginning. Including r: all lands lying between the above described meander line and the A water's edge of the Apple River between the extension of a line bearing North 88 0 04'10" East from said beginning of meander line r and the extension of a line bearing North 88 0 04'10" East from said end of meander line. f s.. r ;4 7 y; •% DCLCUMEJIT No ` �g- 3/ ���- 9 T ATF BAR OF i15!':VSIV- FORM 7 1 nt WAAPANTY DEED 3:573 VOL 547 fA "E L3a T HIS S PACE AESEFVEU fOFOR . OIIOING DATA .i Hv 'rills Dr.I'•D, _,.Thomas S. Moulton and Beatrice R. REGISTERS OFFICe _Moulton husband and wife, S7. CROIX CO., WI& Recd. for Record this 29th 1 _ day of Dec A.D I 76 I Grantor convoys and warrant■ to . Larry S. Isdahl .and _ — i Johanna Isdahl, husband and wife, t n• A.,�,�, _.... -_. _. _...._ - -.. Grantce for a valuable consideration - -. RETURN TO the following descrlbod real estate in ... _ St, Croix ,_. County, State of W1sc nsin: A parcel of land in the Southeast Quarter of the Northwest Quarter (SE4 of NW of Section Twenty- Tax Key r nine (29), Township Thirty -one (31) North, Range Tn'a'sN4T_ hcmrstradproperty. Eighteen (18) West described as follows: From the Northwest corner of said Southeast Quarter of Northwest Quarter (SE4 of NA) go South a distance of 214.5 feet; thence North 88 0 56' East a distance of 173.9 feet; thence South 10 0 25' East a distance of 352.5 feet to the point of beginning of the parcel to be conveyed herein; thence South 10 0 25' East a distance of 181.1 feet; thence South 88 0 56' West to the East right -of- way line of the town road located on the West side of said Southeast Quarter of Northwest Quarter (SE4 of NW4); thence North 0 0 05' West along said East right -of -way line to a point which is South 88 0 56' West a distance of 205.0 feet from the point of beginning; thence North 88 °56' East a distance of 205.0 feet to the point of beginning, meaning to include all that part of the abandoned town road known i as Moulton Road which is included in the above description. T"?..­ NSFER `' 05 Exception to warranties: FEE Executed at New n --hmond, Wisconsin hrti 15th ! ,I, ,f D W ember ro 76 . SIGNED AND SEALED IN PRESENCE OF / 1SF.ALI Thomas S. M -� ',"1 r � ' N/A - �,` scat _ /I - r�'� "�lnt ,SEAL) Beatrice R. Moulton. N/A SEAL' Signatures of Thomas S. Moulton and Beatrice R. Moulton authenticated this 15th Slav :,f December. , <, 76 - _ 57 ��.�► - -�- �� L/ G. E. Norman T_u+•: tt..mh.r �c;,re Ed;v f u.:,, ._;:, T +a+... -++n.� STATE OF WISCONSIN 1S. N/A C.)unty. t' Personally ;am <• ter (ere one, rh+ N/A the above named N/A t.) me known to tx• 'h, arson -Aho ese.uted the f,reguin(z =n"r .and ,. 'In v :+.!, :e.'. •`:•• .+ 4/A Thos instrument .c: dr.ifird by Doar, Drill, Norman & Bakke New Richmond, Wisconsin 54017 The use• . wltrr <.�..•,. Vii,. n.,: X11 .. F•. Name. of pers n ,vrif h,.+ M• r .,r printed N 1-ow t`­r WARRANTY DF.F11 -ITA rF 11AR Jt +r.e UNSIN. FORM NO 2 — 1971 LA COMTUCT- W lthouf� Insurance Clause. Stare OF WISCONSIN No. 35 M. C . rnu. CO.. NI .AVaa 306576 `this Article of Agreement, Made and concluded this ...................26th......: . ......................day of...........'............. JUne...... . ....._ ...................... ... A: D. 1971....., byattd between ........... Mcula4n...zr :r t pn... PPM pany....... Inc. ..........:... .............................._ ......_ .................. ......... .. p art ........................................ ............................. .. a - .. Y ........... of the first part, AMC; ......................... . S t Iedahl... and,_ Johanna _ Isdahl, ...husband _and wife I .i ....................................................... ............................... ... ...... ....... .........._......... ................ . ........ . ..... part ...... ...- ...... of the second part. I� ... ................... ... . WrrNESSrM:, Flasr, That the said part.le.s...of the second part hereby agree..... -and bind....._._ - ...their._ - . -..- ..-- ,- _ - -... ' a �{ ....................legal representatives, to pay, or cause to be paid, to the said part..Y.... .....of the first part, ........i• its ...... ....... . heirs prustg»b, the'sum of:;.. SIX.,.THOUSAND NO 100 ..... 6.:OOQ o9.) ....- .......... .... ... ...... -- ..collars, In the manner following:..ONE• THOUSAND AND...r?O /100...... .$.1..,.000..,.00) .. _ - ..- _Dollars. at theenaealing inte d at� 7 .. per a annum f on unpaid h balance, shall be paid in equal monthly installments of $69.42, over a period of 8 years, commence on August 15, 1971. I; r I r �i The said payments to be made to the puV .......... vf the first part at_ ........... Somer- set., ._ieiiscons.in............_._ _ __..... Add the salve. being Intended to apply, when fully completed, as the purchase money for the following tract, piece or parcel of land, situated in the Oounty of. St . C , ...... and State of Wisconsin, to -wit: I ' A parcel of 0.82 acres located in the southeast quarter of the kY northwest quarter of Section 29, T 31 N., R 18 W, further described as follows; from the northwest corner of said southeast quarter of the northwest quarter go south a distance of 214.5 feet,.thence North 88 East a distance of 173.9 feet, thence South 10 East a distance of 352.5 feet to the point of beginning for'thlp, ;= parcel to be conveyed herein; thence North 88 East a distance is of'1334, feet, thence South 27 East on a meander line along the h ih# r ' df ; App1j• tjV' er a distance of 200.0 feet, thence South 88 !; M 4i a dittain66 "of 192.2 feet, thence North 10 West along the ;! ft'i t'' 1the' 'of tha town road a distance of 181.8 feet to the point of 5, s • �begiinnirig; including all land between said meander line and Apple .� River. ;i ' # RESTRICTIVE COVENANT { - -ft is` further covenanted and agreed by the parties of the second part' s 4� 'thi:.:' i1Cti b b$ the second part, their heirs, executors, adminis ` Jrotors off' 089ii#ns will not at any time use or permit the premises to . be; f6r `the' ph rking of a house trailer, mobile home, camping j nds, n`jtitek yard, tavern or any other commercial, industrial or ? 1 litllei r ' U'i4 '*the* than agriculture. - oond'part further agree ....that........ they.......... will pay, when due and payable, all taxes �I IT ?rs itildbM beet ldd or levied can the above described premises since the lot day of January, A. D., 19 ........ , I, br levied thereon, or upon the Interest of said part. y - .. -... of the first part In said ;t 4 w or Wreafter assessed or levied against any mortgage which may exist against f�►de drsars secured by such n3ottgage, or against the Interest in said premises r� � •., � the term Of this contract, and promise. ...and agree...... that the of the. 00oW part In "M teat state, an d the Ili- •.al ►' teat; shall be Messed fbr taxation li, spas! 8�i *M by the said tiafr AOS..of the dMitotts"If osbabf the payment �iutotaw mattq� } In tM manner above stated. IfI H ��4 a �� z o r a �ci cL O o not AW, 916T Z aunt s0� xP u01ssiufw05711 ✓ 0TTgt� A�4o�I_uui6V luno0 uid uaH '0qgna /Ucyoft ° o Nvuona 'S idnd ji . 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