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040-1207-80-000
sconsig Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix S2fety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 515006 0 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: Strobel, Mark I Troy, Town of 040 - 1207 -80 -000 CST BM Elev: Insp. BM Elev: SM Descriptio Section/Town /Range /Map No: 9 - — 6 f GS 16.28.19.982 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER . ^ CAPACITY STATION BS HI FS ELEV. Septic ��� Benchmark �.` Z �O Z. 55 /b � 9V. 75 1'a la k 5Z<5 Alt B it." b 7 I, S5 Aeration Bldg. Sewer /` `C7 Holding St/Ht Inlet 5. 11 15. GS TANK SETBACK INFORMATION SUHt Outlet (p• TANK TO P/L WELL BLDG. Vent to Air Intake ROAD DtInlet Septic G �� t - 23 Dt Bottom � c7 z J Dosing Header /Man. 7 93. Aeration Dist. Pipe 93 I 7• Holding Bot. System . 9 SZ • 3 Fin I Gra PUMP /SIPHON INFORMATION �,� Manufacturer Demand St�Co` GPM ��.• e �J 1,75 Model Number n Z C TDH Lift Fricti s System Hea T Ft �+a•�t✓ l Forcemain L ngth Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Len th �( No. Of Tr enches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 ���► O " Jre+U1,G SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: tt INFORMATION CHAMBER OR Type m � /Z 33 UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold 1� Distribution x Hole Size x Hole Spacing Vent to Air nta L Pipe(s) 3( Length_ Dia / Length Dia \ Spacing \ SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only w Depth Over Depth Over ( Depth of xx Seeded /Sodded r Mulched Bed/Trench Center 41 T ! ` jr/Trench Edges \ / Topsoil Yes es No Y:�E]Njo COMMENTS: (Include code discrepencies, pe sons present, ef'c. a lnspe) on # / / Inspection #2: / / Location: 369A Milwauke Ro d Hudson, WI 54016 (SW 1/4 NE 1/4 28 T28N R1 9W) Glover Station Lot 28 Parcel No: 16.28.19.982 1.) Alt BM Description = PJ� -�`� 2.) Bldg sewer length = Z L - amount of cover = if/ i� Plan revision Required? ❑ Yes I No Use other side for additional information. [ C q � A , L__ 4 1 ' _j _ _ `� J SBD -6710 (R.3/97) Date Insepctor's Si nature Cert. No. r aor wrtitraeml.gov Safety and Buildings Division County gal W. Washington Ave., P.O. Box 7162 � S/ O j t� , x #�GOhr1 Madison, wI 53707 -7162 sanitary Permit Number (to be filled in by Co.) 5560 Sanitary permit Application tateTretsect,onNum P W In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriat mental / V unit is required prior to obtaining a sanitary permit. Note: Application forms for stn POWYS are submitted to the Department of Commerce, Personal information you provide may used for secondary Proj Address (if different than mailing address) purpos in accordance with the Priva Law s. 15. t m 3tats. ^ M �' I. A lication Informs"" - Please Print All l rmation -7 /' �¢ , I' , ukW . )v Pr Owner's Name / R Paroel # Property Owner's Mailing Address oyo- �za7- so - C 8� �, �� �p OCT 0 7 2.006 Location Govt. Lot `• `� SZ City, State Zip Code / 9 ST CF�� QTY S� '/' i11 %+, Section l 20 (Cblm* 0110) II. R3 ype of Building (check all that apply) elk C,4 Lot S7� T s N; R E E'yy or 2 Family Dwelling - Number of Be dr ( .? Subdivision Name ❑ Public /Commercial -Describe Use ✓� ' •OJS Block # Oelf f ° D . P EJ Cityof ❑ State Owned - Describe Use CSM Number � Village of Z CPi 5 ✓ Z 1 9' ZZ G. wUl Town of Tf'O fit. Type of Permit: (Check only one box on line A. Complets line B if applicable) A ' ew S stem R O lacetnent. Treatment/Haldin Conk Y ep g Replacement Only ther Modffication m Existing System (explain) �`--� System B. Permit Permit Revision Chan a of Permit Transfer to L" revious P it umber and ate is saied Renewal Before Plumber g New Owner Y 3 3�'a Expi ration IV a of YOWTS S stem /Com neat/Device: Check all that a pply) XL Non- Pressurized In- Ground U Pressurized In- oround Lj At -Grade Mound 2:24 in, of suitable soil Lj Mound < 24 in. of suitable soil Holding Tank r Dispersal Component (explain) OPtenestment Device (explain) V. DispersaMeatment Area Informa Design Flow (gpd) Design .Soil Application Rat e(g Dispersal Atr�e -a Required (s Dispersal Area Pro st)l System Elevation cQ 4 t �iJ ? �J 7 7 �i .� r �B a VI. Tank info Capacity in Total # of Manufacturer Material Gallons Gallons Units New Tanks Existing Tanks n _) /{/ Septic orHoldingTank �� (� Dosing Chamber "/ - r f" f VIL Responsibility Statement- I, the andemigmA, assume respoaaibilby for Installation of the POWT3 eM em the attached plans. Plumber's Name (Print) Plumber's Signature Number Business Phone Number .' l `cL 0 y Y 1 2 7 3 G — /— Plumber's Address (Street, City, State, Zip Code) VIII. Conn /b rtment Use on pproved Permit Fee Date G Issuing 3i _ Ovmer Give son for ia1 $ dp /d g DO IX. Coudi"j*# Wteasons for Disapproval 1. Septic tank, effluent filter and dispersal cell must all be services / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained Attach to complete plans far the system and submit to the Commy only m paper not 10011 ohm s t o x 1 I to o hm SBD -6398 (R T) Valid thru 01!09 01 /0 , �c aT ���gT f p3 LiDCp P Y ®a </a `Y v t p3 SOIL EVALUATION REPORT #2089 Department of Commerce in accordance wit Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Buildings Steel's Soil Service Attach complete site plan on paper not less than, 8% x 11 inches i size. must County St. Croix include, but not limited to: vertical and horizontal reference point ( dire n percent slope, scale or dimensions, north arrow, and location and dis a to est r ad. Parcel I.D. �ll Please print �_ 7� 0 (JU V �G Revie d By Date Personal information you provide may be use for seEb EQa Macy jLa, s. 15. 1) (m)). f Property Owner F roperty Location Mark Strobel D EC 0 3 2007 C ovt. Lot na SW1 /4, E1/4, S16, T28N, R19W Property Owner's Mailing Address t # Block # Subd. Name or CSM# 826 Wilcoxson dr ST. CROIX COUNTY 28 na Glover Station City State Zi j City ! Village Town Nearest Road Hudson WI 1 54016 715 - 386 - 4573 Troy Milkwaukee Rd 1 New Construction Use: 1 Residential / Number of bedrooms 4 Code derived design flow rate -L 600 GPD Replacement Public or commercial - Describe na Parent material outwash Flood plain eleva ion, if applicable na ft. General comments Conventional system, system elevation 9 Trenches spaced and depth to code 5.75ft below grade. and recommendations: F-11 Boring # Ground surface elev. 98.75 f Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Descri exture Structure Consistenc Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -16 10yr3 /1 none SH 2msbk mfr cs if .6 .8 2 16 -36 10yr4/4 none sicl 2msbk mfr gw na .4 .6 3 36 -51 7.5yr4/4 none sl /Is 2msbk mfr cs na .6 1.0 4 51 -120 7.5yr4/6 none Is osg ml na na .7 1.6 Boring # Ground surface elev. 98.75 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -11 10yr3/1 none sil 2msbk mfr cs if .6 .8 2 11 -20 10yr4 /4 none sicl 2msbk mfr gw na .4 .6 3 20 -54 7.5yr4/4 none sl /Is 2msbk mfr cs na .6 1.0 4 54 -120 7.5yr4/6 none Is osg ml na na .7 1.6 /I i 61 1 1911, * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD S30 mg /L and TSS < 30 mg /L CST Name (Please Print) Suture:- CST Number David J. Steel � /' Z� 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 1699 150th St New Richmond, WI 54017 11/30/2007 715 - 760 -0347 SBD -8330 (R.07 /00) Property Owner Mark Strobel Parcel ID # Page 2 of 3 Boring # �- Ground surface elev. 91.75 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 - Eff#2 1 0 -12 10yr3/1 none SO 2msbk mfr Cs if .6 .8 2 12 -31 10yr4/4 none Sid 2msbk mfr gw na .4 .6 3 31 -58 7.5yr4/4 none sl /Is 2msbk mfr aw na .6 1.0 4 58 -120 7.5yr4/6 none Is osg ml na na .7 1.6 �I T ❑ Boring # F Ground surface elev. ft. Depth to limiting factor 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 F-1 Boring # Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I `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) Steel's Soil Service STEEL'S SOIL SERVICE 3 of 3 David J. Steel Mark Strobel 1699 150th St. CST- POWTSM SW1 /4,NE1/4,S16,T28N,R19W New Richmond, WI 54017 Lic. #24 Town of Troy, St. Croix Co. Direct 715- 760 -0347 Glover Station, Lot 28 Fax 715- 246 -0318 Legend N 1 " =40' ♦ = Benchmark Ele. 100.00 ft e Top of 3/4" PVC pipe • = Alt Benchmark El 9.95 ft Top of 3/4" pipe E = Borings Boring Elevations B1 = 98.75 ft B2 = 98.75 ft B3 = 91.75 ft B4 = 0.00 ft I3 - z �1 SD ' . �� 5 7 29/2005 WE 11:37 VAX 715 386 4687 &T CRO 00 AEG OV pegaS ` 0001/002 2. ! �M. 2.65 ACRES ^� r oe • -Af '1 0 _ j fi 2.16 ACRES 0 '4 4 0. AT $8 054 Q8 W S - 2-41 ACRES ! • `Y " � 160.00` r ,•• 1s ��,� rMffw J. ,. g Z 0 '�' m 29 ACRES N 2 ACRES 2. 43 ACRES 188.00 =, . —140 •--120.00`- --` ".r ° SW4 2 d W 280A0 I a� MOWS OFFICE, Syr, 0011 M N01 low � SH, �� 0. loo MENT, BERNTS414 CAP* FOUND. ,R�>4Falr11� TH RIB iGHID1G 3.65 L1384/LINEAL FOOT? TH ils Gp�tNER3 STAKED WITH I X 24 ? .BS• / �.INEAL FOOT, M flee. lNG 1x68 LBS./ LINEAL FOOT NC NE !, • 1420 RECREATIONAL. TFkAIL, H/ ,,OME OWNERS ASSOCIATION, Cf �.• A ` kI& -INSTRUMENT ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND r OWNERSHIP CERTIFICATION FORM Owner /Buyer 6f- / Mailing Address fa4? 2 Property Address �fp (e rl''C(� (Verification required from Planning & Zoning Department for new construction.) City/State (��pn li(� Parcel Identification Number Q�{0 -12D7 8D — G10D LEGAL DESCRIPTION Property Location a Sec. �, T O?T N R / W, Town of Subdivision Plat: A/��/Pi �" . ' 7 ' ^ f",0,4/ , Lot # Z� Certified Survey Map # , Volume , Page # Warranty Deed #___1 4p k Z7 I (before 2007)Volume , Page # Spec house i : yes no Lot lines identifiable yes no SYSTEM MAINTENANCE. AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner raintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and /or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I /we certify that all statements on this form are true to the best of my /our knowledge. I /we arn/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number e ro IG - Ot APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV, 08/05) POWTS OWNER'$ MANP1 ,1, i c MANAGEMENT PLAN Page of FILE INFORMATION T SPECIFICATIONS Owner MUM $ C FICATIONS S • i BptiC lank Capacity � a S al ❑ NA Permit # $ eptic Tank Manufacturer �S ❑ NA DESIGN PARAMETERS �fflgiept Filter Manufacturer ❑ NA Number of Bedrooms NA fflus Filter Model j El Number of Public Facility Units Q NA Pump Tank Capacity el 13 NA Estimated flow (average) p p d Pump Tank Manufacturer � ,� r, c? R. ❑ NA Design flow (peak), (Estimated x 1.5) ID © I 'pmp Manufacturer Q %A-1 d ❑ NA Soil Application Rate I g N.rnp Model ❑ NA Standard Influent /Effluent Quality , Monthly ave PtrattAatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg/l. Q Sono. /Gravel Filter O Peat Filter Biochemical Oxygen Demand (BOD 5220 mg/l. P CIA C] Mechanical Aeration ❑ Wetland Total Suspended Soli (TSS) 5150 mg /L Q pi infection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cells) ❑ NA Biochemical Oxygen Demand (BOD.) 530 mg /L © ln- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L Q iVM Q At l3 Mound Fecal Co)iform (geometric me an) x10 cfu /1QRml P [drip -lane ❑ Other: Maximum Effluent Particle Size Y in dia. Q NA he "` 1:1 NA Other � Clthsrt . NA ❑ NA * values typical for domestic wastewater and septic tank eftNont. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At lea% Pipe every; E3 month(s) p 18[ ears} (Maximum 3 years) ❑ NA Pump out contents of tank(s) When comoirlod'sl g4m equals one-third %) of tank volume ❑ NA Inspect dispersal call(s) At iesllt ones gviiery; ❑ months) (Maximum 3 years) ❑ NA 7$ year {a) r 0 month(s) ❑ NA Clean effluent filter At least " eyAry: year( _ ❑ month (a) - � ❑ NA Inspect pump, pump controls & alarm At least ono$ oyory; ❑ year(s) Flush laterals and pressure test At least pnca every; 0 month(s) ❑ NA ❑ year(s) Other: ❑ month(s) El NA At )seat once a�ui9ry; ❑ yearis) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made ray on individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; PQWTS Iri ;pecior; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tankis) t&1dil h ify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum el?d. dba0k' for any back up or ponding of effluent on the ground surface. The dispersal cellis) shall be visually inspected to choo4 ofiivant levels in the observation pipes and to check for any ponding of effluent on the ground surface, The ponding of effll�ettt bn 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 so um 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 8erviQln6 dperstar end disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of ofluent filters; mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, $hail be parformad oy a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page _ of ......._ START UP AND OPERATION For new construction prior to use of the POWTS dhils f iytitweCir ti(uiR(o) for the presence of pa intin g Products or other chemicals that may impede the treatment process andlor darri lIlajl.�rlilo) If high concentrations ,are detected have the contents of the tankle) removed by a septage servicing opet itt f C '. • System start up shall not occur when soil condiUopil *#06 at 010 kr filt otive surface. During power outages pump tanks may fill above ho III hll (iyt, Vhen power is restored the excess wastewater will be discharged to the dispersal celUs) in one large doiid} f� i" ter 4Y . if !hd may result in the backup or surface discharge of effluent. To avoid this situation have the contents Q b r bye by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plurnbr#f �i( '{ � tEfti 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 d)spepgpll iq+ji0, or - -ark over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at- gradi aPjj ipl�I�la' 40ia Reduction or elimination of the following from thw Wnprove the performance and prolong the life of the POWTS: antibiotics, baby wipes; cigarette buttsl i t Ifi, degreasers; dental floss; diapers; disinfectants; fat; foundation drain {sump pumpi water; fruit and vi Irf 0; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; taitl+nh ill' } , p %firff'ktrine. ABANDONMENT When the POWTS fails and /or is permanently takehi tit "'f k8 {pg steps shall be taken to insure that the system is properly and safely abandoned in compliance with ol{opi)f}piI;',a�i Slfp+pnsin Administrative Code; • All piping to tanks and pits shall be discanrlii' Od N'Id klo pipe openings sealed • The contents of all tanks and pits shell be r r►`p�v{bti the rlfGt lily sl lritf3aso of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be #0$0.0 i r1d i ►hrtb! or t heir 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 fciHbl+Gii({q I7i�lilIli �vlf Olen, or must be taken, to provide a code compliant replacement system: 0 A sui #able replacement area has been evij; Ill y . l►i�1a for the lo cation of a replacement sail absorption -n system. The replacement area should be ot#+ i is rh ipf i*_*#ib find compaction and should not be Infringed upon by required setbacks from existing and propoibii �# , "wells. Failure to protect the replacement area will result in the need for a new soil and site table replacement area. Replacement systems must comply with the rules in effect at that time, D A suitable replacement area is not availo Ial dk I soil limitations. t3arring advances in POWTS technology a holding rank may be installed �I� k piM the failed POWTS. •1 �CI The site' as not en evaluated to identPo A lbtll # <��1�� area. Upon failure of the POWTS a soil and site 1 evaluation be performed to locate a iiliftR� If no replacement area is available a holding tank may b ail S a last resort to reQlaCa s . C3 Mound and at-grade soil absorption systaffi f Y t h�a In piece following removal at the - .biomat at the infiltrative surface. Reconstructions of such 4Yslfiaitilft IN the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT ' i #tTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BB {• • it ADDITIONAL COMMENTS POWTS INSTALLER TAiNER Name Phone "7 I ' _ 3 S 1 .2, J h( 1 SEPTAQE SERVICING OPERATOR {PUMPER) LATORY AUTHORITY Name , . ` P�II �-• GCo ► C � ° Phone — ,3� �o ' SE tr $ d This document wan drafted In compiiance with chapter Comm 4, 1i1+1f1 arid .N,6iai,i. 12i & 431. Wisconsin Administrative Code. SEPTIC TANK E :'UMP CHAMBZR CROSS SE CTION AND SPLUIr luAll�4aI 4" CI' VENT , PIPE ' 1.2 Mf% `A'EOVE GRADE 6 WEATHERPROOF > 25' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVER W / PADLOCK & FINISHED GRADE WARNING LABEL 4 " CI RISER - -- 4" MIN. ___--.l__7 la" I 6 11 MAX. { ' NLET c I` WATER TIGHT SEALS GAS- TIGHT i PPROVEU A SEAL ' JOINTS WITH PPRQVED --�-- i ALM APPROVED PIPE IPE 3' B QN 3 ONTO NTQ SOLID t SOLID SOIL OI L PUMP OFF ELEV .FT. -- + OFF RISER EXIT D PERMITTED ONLY IF TANK MANUFACTURER HAS APPROVAL all APPROVED, BEDDING UNDER TANK CONCRETf. PAD SPECIFICATIONS SEPTIC / DOSE TANK MANUFACTURER. NUMBER DOSES PER DAY: TANK SIZES SEPTIC gad GAL. DOSE VOII}ME INCLUDIN GAL. DOSE g M__ GAL. ALARM MANUFACTURER: 1 I g-0 s A" CAPACITIES: A = INCHES = GAL. MODEL NUMBER: , 4 v 2 INCHES = 32 GAL - SWITCH TYPE: �' r -- PUMP MANUFACTURER: gf C = INCHES = _L r_GAL MODEL NUMBER: a D : INCHES = GAL• SWITCH TYPE: /a�Ve_r , REQUIRED DISCHARGE RAT GPM PUMP !+ ALARM WIRING AS PER TLHR .16.23' WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE .. FEET + MINIMUM NETWORK SUPPLY PRESSURE 4MW FEET . .....,..,..... + - FEET FORCEMAIN X .f � FT1100 FT. FRICTION FACTOR . ,L X7_ FEET - TOTAL DYNAMIC HEAD _j ' — FEET OF PUMP TANK: LENGTH ; WIDTH_______; DIAMETER INTERNAL DIMENSIONS LIQUID DATE: SIGNED. �,�_ LICENSE NUMBER : 9.0 x/88 PUMPS [I GO ULDS Submersible Effluent Pump EPO4 a 3871 EP05 APPLICATIONS • Fully submerged in high ■ EP05 impeller. Thermoplas- ■ Bearings: Upper and lower Specifically designed for the grade turbine oil for tic enclosed design for heavy duty ball bearing following uses: lubrication and efficient improved performance. construction. heat transfer. ■ Casing and Base: Rugged • Effluent systems thermoplastic design provides AGENCY LISTING • Homes Available for automaticand superior strength and corrosion • Farms manual operation. Auto- Canadian SfandardsAmodation • Heavy duty sump matic models include resistance. • Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron (CSA listed model numbers end • Dewatering assembled and preset at the for efficient heat transfer, in "F" or "C ".) factory, strength, and durability. SPECIFICATIONS ■ Motor Lover Thermoplastic Goulds BPS is ISO 9oot ►ed• FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. 3 /4" maximum. ■ EPO4 Impeller: Thermoplas- • Capacities: up to 60 GPM. tic Semi -open design with ra Power Cable: Severe duty • Total heads: up to 31 feet. pump out vanes for mechanical rated oil and water resistant. • Discharge size: l Ib" NPT, seal protecfion. • Mechanical seal: carbon - rotary/ceramic- stationary, BUNA -N elastomers. • Temperature: 104°F (40°C) continuous 140 °F (60°C) intermittent. METERS FEET r- • Fasteners: 300 series 10 i .......... .. . I i 1 i stainless steel. 9 30 S GPM • Capable of running dry without damage to $ components. 25 ;... _ ._._.___. _ __ �..._._..._. o .. Motor: _ • EPO4 Single phase: 0.4 HP, 6 115 or 230 V, 60 Hz, 1550 RPM, built in overload with 5 automatic reset. c 15 a • EP05 Single phase: 0.5 HP, } EPOS g P o 115 V, 60 Hz, 1550 RPM, 3 10 built in overload with . .. _ . .... .. EPO4 automatic reset. z Power cord: 10 foot f .. _. 5 standard length, 16/3 1 ti..... SJTOW with three prong . . grounding plug. Optional 20 0 00 10 20 30 40 50 GPM foot length, 16/3 SJTW with three prong grounding plug (standard 2 4 s s 10 12 m'/h (standard on EP05). CAPACITY Goulds Pu mps 0 2000 Goulds Pumps ITT Industries Effective February, 2000 83871 ! VIII! INII illli illll I {ill {1111 Ili! 111111 Ili{ liil * 8 6 6 2 7 1 1 866271 State Bar of Wisconsin Form 2 -2003 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI Document Number Document Name RECEIVED FOR RECORD 12/28/2007 10:40AM WARRANTY DEED THIS DEED, made between Mark A. Pilney and Laura J. Pilney, husband and wife EXEMPT if ( "Grantor," whether one or more), REC FEE: 11.00 and Mark C. Strobel and Liiah R. Strobel, husband and wife TRANS FEE: 375 .00 PAGES: i ( "Grantee," whether one or more). Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ( "Property") (if more Recording Area space is needed, please attach addendum): Name and Return Address Lot 28, Glover Station, St. Croix County, Wisconsin tiiv10 r VAiIay Ab e�tat:' 200 Hosfard St. P.O. lox 1 WI '1 040- 1207 - 80.000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and right -of -way of record, if any Dated December 7, 2007 (SEAL) r (SEAL) * * Ma rk Pilne (SEAL) .`. ' (SEAL) " * I Pi e AUTHENTICATI� ACKNOWLEDGMENT Signature(s) oPY P(/ STATE OF WISCONSIN ) ss. authenticated on St. Croix COUNTY ) R Personally came before me on Devembpr 7 - 9QQ7 * the above - named _Mark A, Pia,Ilgy and TITLE: MEMBER STATE Laura T. Pilney (if not, ! OF IS to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 70 . `�� instrument and acknowled d thq same. THIS INSTRUMENT DRAFTED BY: Reding & Pilney, PLLP * Virgin a R. Gartman 8661 Eagle Point Blvd, Lake Elmo, MN 55042 Notary Public, State of Wisconsin My Commission ki&fcauIi")(expires: November 27, 20 1 )1 (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 * Type name below signatures. 1 of 1 r vv�o 130 03 0 CD i b rr j oZ o N O ° N N 0 ,� A• m 3 W 4 - o Z N to L N p N °° n NO N (D V A W O t O O v O � 1 CL w Z cDn o c (D CD W x m CL ;o o n ti v 3 O O O N• 0 � � v v N w A Cn .. CD CD _ CD .. N o = C C C CD (D °1 s Z CO) ;z0 A � 0 W � C OD °) CL <� Z 3 A �* aD 3 m j m (n v o N. D C a - m _a - Z) � � m c (n a Z a CD 0 V N CD oa a CD 4 � o a rn CD m a �, _ d a � \ = T a:3 A C. Q N 3 c `^ ^' CD N CD a o CD ao w I . 69 O N CD 0 ` a, b Parcel #: 040 - 1207 -80 -000 01/25/2006 04:49 PM PAGE 1 OF 1 Alt. Parcel #: 16.28.19.982 040 - TOWN OF TROY Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner JAMES A HALL O - HALL, JAMES A W9655 770TH AVE RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 371 MILWAUKEE RD SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 2.030 Plat: 1993 - GLOVER STATION SEC 16 T28N R19W 2.03A GLOVER STATION Block/Condo Bldg: LOT 28 LOT 28 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 16- 28N -19W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 830/595 07/23/1997 776/501 07123/1997 589/147 2005 SUMMARY Bill M Fair Market Value: Assessed with: 103667 93,500 Valuations: Last Changed: 07/22/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.030 90,000 0 90,000 NO Totals for 2005: General Property 2.030 90,000 0 90,000 Woodland 0.000 0 0 Totals for 2004: General Property 2.030 90,000 0 90,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 � co ` �O H cv � � M O O o . a U , U r :: o N H H j - sd x W —+ co Z . 3 � H 7 _ cn H C7 PT+ a , J M !, r„ CV ::I ✓ N O L M z C'') 3 4u O En ca a pa 4 r. � ° z ° x w ul cn N N N •�I � 0 Imo , c P4 � ' DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS DIVISION P.O. BOX 7919 PRIVATE SEWAGE SYSTEMS BUREAU OF PLUMBING MA'dISON, WI 53707 SW,NE,S16,T28N —R19W CYCONVENTIONAL ❑ALTERNATIVE State Plan l.D.Number: (It assi9neal Town of Troy ❑ Holding Tank El In-Ground Pressure El Mound Glover Station Lot #28 NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER; INSPECTION DATE: James Hall Route 4, Box 337, River Falls, WI 540z'2 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: S Name of Plumber. MP /MPRSW No.: County: anitary Permit Number: Thomas H. Cody 6593 St. Croix 92479 SEPTIC TANK /HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LA ILOCKING L COVER PROVIDED: PROVDED: DYES LINO DYES ONO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: P BUILD ROPERTY WELL: ING: VENT TO FRESH J ALARM FEET FROM LINE: AIR INLET: DYES ONO ❑YES El NO I NEAREST — DOSING CHAMBER: MANUFACTURER. BEDDING, LIQUID CAPACITY. PUMP MODEL: JPUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: DYES ONO DYES ❑NO 10YEs ONO GALLONS PER CYCLE: PUMP AND WNTROLS OPERATIONAL: NUMBER OF PROPERTY WELL BUILDING V NT TO FRE H (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) ❑YES 1:1 NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH: LENGTH. NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA 7D PITS LIQUID BED /TRENCH TRENCHES: MATERIAL• PIT DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR, PIPE DISTR PIPE MATERIAL: NO. DISTR. I NUMBER OF PROPERTY WELL. BUILDING: V NT LE FRESH BELOW PIPES: ABOVE COVER ELEV. INLET. ELEV. END: PIPES. FEET FROM LINE: AIR INLET: NEAREST --► MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. DYES ONO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS ❑YES ❑NO DYES ONO DEPTH OVER TRENCH /BED DEPTH OVER TRENCH /BED DEPTH OF TOPSOIL. SODDED SEEDED MULCHED CENTER. EDGES. ❑YES El NO ❑YES ONO DYES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH: NO.OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER BED /TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. J NODISTR . DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV.: ELEV.'. CIA .: ELEV.: PIPES. DIA.: ELEVATION AND DISTRIBUTION HOLE E SIZE HOLE SPACING: DRILLED CORRECTLY COVER MATERIAL. PLANS CAL LIFT CORRESPONDS TO APPROVED DYES ❑NO DYES ONO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE: DYES ONO ❑YES ONO NEAREST Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: TITLE. DILHR SBD 6710 (R. 01/82) Zoning Administrato SANITARY PERMIT APPLICATION COUN Y �, Di � In accord with ILHR 83.05 Wis. Adm. Code STATE SANITARY PERMIT# 7 'I —Attach complete plans (to the county copy only) for the system, on paper not less than STATE PLAN I.D. NUMBER 8% x 11 inches in size. —See reverse side for instructions for completing this application. PETITION rpf 1. APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION. FOR VARIANCE El YES LEI No PROPERTY OW R PROPERTY LOCATION Gc a I t SW /UryJ S f Tv -, N, R � E ( PROPER Y O NER'S MA I ING ADDRESS LOT NUMBER BLOCK NUMBER S NAM C9 X 3 3 09 Vr t C9uer � IB TY, STATE ZIP CODE PHONE NUMBER CITY NEAREST ROAD, LAKE OR LANDMARK 4 � ��� VILLAGE: If TOWN OF� r trO II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family OR ❑ Public (Specify): III. PURPOSE OF APPLICATION: (Check only one in #1. Check # 2,3 or 4, if applicable) 1. a. 1:1 New b. ❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e. ❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit # Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner /building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in #1 and only one in #2) 1. a. �0 Conventional b. ❑ Alternative C. ❑ Experimental 2. a. ❑ System- b. ❑ Holding c. ❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In -Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. El seepage Bed b. Seepage Trench c. ❑ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4, ABSORPTION AREA 5. SYSTEM EI EVATION 6. WATER SUPPLY: (Min utes per inch): REQUIRED (Square Feet): PRtOrP,O,S, -E,D (Square Feet): () Q 1 4 , C'o c t • t Feet Private ❑ Joint ❑ Public VI. TANK CAPACIT Site in gallons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- plastic Exper. INFORMATION New xisting Gallons Tanks Concrete glass App. Tanks Tanks structed Septic Tank or Holding Tank 1 Qi _+_ Lift Pump Tank/Siphon Chamber ❑ FR VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name (Print): Plum s Signature: (No Stamp PRSW No.: Business Phone Number: I N 1 Z u er's Ad ss (Street, City, Stat i Code : Name of Designer: .t9 Vlll. SOIL TEST INFORMATION Certified Soil Tester (CST) Name CST # �^ u CST's ADDRESS (Street, City, State, Code) Phone Number: � a ls �- 5 cat �a5� -or IX. COUNTY /DEPARTMENT USE ONLY ❑ Disapproved Sa itary Permit Fee Groundwater Date Issuing Agent Signature (No Stamps) Approved ❑ Owner Given Initial �1 Su harge Fee''\\ Adverse Determination X. COMMENTS /REASONS FOR DISAPPROVAL: SBD -6398 (formerly Plb -67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber 1 INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT' APPLICATION TO THE APPLICANT: 1. This sanitary permit is valid for two (2) years; 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable; 3. All revisions to this permit must be approved by the permit issuing authority. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 4. Changes in ownership or plumber requires a Sanitary Permit Transfer /Renewal Form (SBD 639'9) to be submitted to the county prior to installation; 5. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years; 6. If you have questions concerning your private sewagq system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 608 - 266 -3815. To be complete and accurate this sanitary permit application must include: I Property owner's name and mailing address. Provide the legal description where the system is to be installed; II Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1 -6; VI. Tank information: Fill in the capacity of every new and /or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift /siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County /Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8'Y2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains /water service; streams and lakes; dosing or pumping chambers; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form. ----------------------------------------------------------------------------•------------------------------------------------------------------------------ GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the resu4 of over 2 years of steady negotiation and public debate. The groundwater bill Ground Ater included the creation of surcharges (tees) for a number of regulated practices which Wiscor S21'i'S can effect groundwater. The surcharge: took effect on July 1, 1984. Ail of the water that buried reaSur'e used in your building is returned t ? the groundwater through your soil absorption o system or the disposal site used by your holding tank pumper. 0 The monies collected through these surcharges are credited to the groundwate° f._;mal adminis- tered by the Department of Natural Resources. These funds are used for rrnonitcring gr o0WA- 1 water, groundwater contamination investigations and establishment of standa u_= Ground•,A ,, ate , , "s wort!: protecting. 3n -6398 (R.03 %86) S Y C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner /contractor,( "spec house "), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property �urHe -s ,t � � / r. • Cfo� d Location of Property — k, section N - R_ W Township rp d. rr : aim a. 33 Mailing Address' "' AA Subdivision Name Lot Number 8 ` Previous Owner of Property _ S f A �} r`�h�►f�/�;� (0e,�nl fS,�I./ (r�,/ live Total Size of Parcel O 3 Date Parcel was Created 9 - & — 2! p Are all corners and lot lines identifiable ? Yes No Is this property being developed for resale (epee house) ? Yes _� No Volume ']ZZ and Page Number ::�-� as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING 1. Warranty Deed 2. Lan Contract 3.- Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also be required. -------------------------------------------- PROPERTy OWNER CERTIFICATION I (We) eeA ti.6y that ate 6 to tementz on .th i.a 6onm an.e .tAue to the but o6 my (owe ) knowledge; that I (we) am (cute) the owneA.(a) o6 the ptopvLty debeh.i.bed in thiA in6oAmation 6onm, by viAtue o6 a wa4Aanty deed neconded in the 066ice o6 the County RegiAten o6 Deede as Doc ument No. ; and that I (we) pneaentty own the proposed zite bon the aeauage poaa�aya.tem (oa. I (we) have obtained an eaaemenat, to n.un with the above deseni.bed pxopeAty, bon the eona.tAucti.on o6 aai.d &y,6tem, and the same hae been duty neconded in the 066tee o6 the Count eg.i6ten o6 Deeds, as Document No. ) . S ATURE OF OWNER SIGNATURE OF CO -OWNER (IF APPLIC"LF) 3 2 0 DATE SIGNED DATE SIGNED !� DOCUMENT NO. ! STATE BAR OF WISCONSIN FORM 11 - 1982 THIS SPA(! RESERVED FOR RECO DATA i LAND CONTRACT Individual and Corporate _ 1i � (TO ICE USED FOR ALL TRANSACTIONS WHERE OVER n( r 7 E p FI �lJ�� � E25000 IS FINANCED AND IN OTHER NON - CONSUMER tEGIS RS O F C ACT TRANSACTIONS) .S1'. CRO {X CO., W15i (� 9ec'd. for Record lt>!is 8th l Contract by and between .... C. ._M.__ Bye_ and Denn?_s R. Ma g5 ----- -• - - -- -- - •--- _ - - - - -- dray Hof y A.D. 1 .8 I I Sch ultz -------•--------- •----------- •------ - -• - -- -- -- 3 $$s ----- - - - - -- ----------------•---- ......_...............- - -..__ ..._....._.. -- ._...__...... ("Vendor", 8:30 /� i ;i whether one or more) and .... James__A lt___________ ____________ ____..___ { IV @owhlrr a f ........................... ............................... ( "Purchaser ", whether one or more). Vendor sells and agrees to convey to Purchaser, upon the prompt and full per - formance of this contract by Purchaser, the following property, together with the I I � rents, profits, fixtures and other appurtenant interests (all called the "Property "), in .................... 5t-L ... M. X ............................. County, State of Wisconsin: Ij RETURN TO Cashman s R iver Falls Realty, Inc. I j River Falls, WI 54022 Tax Parcel No . ... ......................... ...... Lot 28, Glover Station Subdivision, located in the NW4 of the NFi of Section 16, Township 28 North, Range 19 West. ji l This ....... iS not homestead property. I, (is not) • e a .. . o ....le ........... lease Purchaser agrees 250o00 pu rchase the Property and pa to — Vendor at ..._..a- -p-- -s�nab directed f the sum of ; ....... ____ -• -- ......... n following manner: (a)---- ._t_..._- I at the execution of this Contract; and (b) the balance of $._.__ 18,150.00. _ -•.. together with interest from date hereof on the balance outstanding from time to time at the rate of ...... 9 % ................................ per cent per annum until paid in full, as follows: Payments will be made each January 2nd, commencing January 2, 1986 in the amount of $1,500.00 to be applied first to interest then to principal. The entire principal balance shall be due and payable 3 years. from the date of closing. Provided, however, the enti� outstanding balance shall be paid in full on or before the ... ___.lst............. day of ............. -_-y .................. ____ . ( the maturity date). Following any default in payment, interest shall accrue at the rate of ----- ..._. % per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). Purchaser, unless excused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonably antici- pated annual taxes, special assessments, fire and required insurance premiums when due. To tine extent received by Vendor, Vendor agrees to apply payments to these obligations when due. Such amounts received by the Vendor for payment of taxes, assessments and insurance will be deposited into an escrow fund or trustee account, but shall not bear interest unless otherwise required by law. Payments shall be nnplied first to interest on the unpaid balance at the rate specified and then to princci�a]. Any amount may be prepaid without premium or fee upon principal at any time after ...... Mdy_j __ ____________ ... MR)N1 In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated as unpaid principal) is less than the amount that said indebtedness would have been had the monthly payments been made as first specified above; provided that monthly payments shall be continued in the event of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded herefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except for easements and restrictions of record. �i Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall j be retained by Vendor until the full purchase price is paid. Purchaser shall be entitle to take possession of the Property on ................ May-. 1.............................. 19.55.... it • Cmaa Out One. , HC 4dN,Ca,orq ,Y1 STATF: IIAR OF W119 N41N CO - -•- -- -•• ® FORM Nn. 11 — 1982 Stock No. 13011 Ill 711. PACE5 �3 ` Purchaser promises to pay when due all taxes and assessments levied on the Property or upon Vendor's interest in it and to deliver to Vendor on demand receipts showing such payment. Purchaser shall keep the improvements on the Property insured against loss or damage occasioned by fire, ex- tended coverage perils and such other hazards as Vendor may require, without co- insurance, through insurers approved by Vendor, in the sum of $ ...... P/L k . ............................... but Vendor shall not require coverage in an amount more than the balance owed under this Contract. Purchaser shall pay the insurance premiums when due. The policies shall contain the standard clause in favor of the Vendor's interest and, unless Vendor otherwise agrees in writing, the original of all policies covering the Property shall be deposited with Vendor. Purchaser shall promptly give notice of loss to insurance companies and Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall be applied to restoration or repair of the Property damaged, provided the Vendor deems the restoration or repair to be economically feasible. Purchaser covenants not to commit waste nor allow waste to be committed on the Property, to keep the Property in good tenantable condition and repair, to keep the Property free from liens superior to the lien of this Contract, and to comply with all laws, ordinances and regulations affecting the Property. Vendor agrees that in case the purchase price with interest and other moneys shall be fully paid and all conditions shall be fully performed at the times and in the manner above specified, Vendor will on demand, execute and deliver to the Purchaser, a Warranty Deed, in fee simple, of the Property, free and clear of all liens and encumbrances, except any liens or encumbrances created by the act or default of Purchaser, and except: .... estrictions, ................ eas ement G . and _=.v elaant .$ .of .rP40.Td' ._..• .................•-•--•--•------.......•-----•....-•-.._.........---•---•--.............._...................................•-•-•... ............------ •----- ...._.. ......................................................••---............-----. ......................... -• - -•• ............................................................ ...... .......... . . . .•. ---- - - - - -- ................................................... ....... -•---•---........-------•-•----••-------- .........._.- •••-- ...... Purchaser agrees that time is of the essence and (a) in the event of a default in the payment of any principal or interest which continues for a period of .I ... days following the specified due date or (b) in the event of a default in performance of any other obligation of Purchaser which continues for a period of ..30.... days following written notice thereof by Vendor (delivered personally or mailed by certified ,nail), then the entire outstanding balance under this contract, - shall become immediately due and payable in full, at Vendor's option and without notice (which Purchaser hereby' waives), and Vendor shall also have the following rights and remedies (subject to any limitations provided by law) in addition to those provided by law or in equity: (i) Vendor may, at his option, terminate this Contract and Purchaser's rights, title and interest in the Property and recover the Property back through strict foreclosure with any equity of redemption to be conditioned upon Purchaser's full payment of the entire outstanding balance, with interest thereon from the date of default at the rate in effect on such date and other amounts due hereunder (in which event all amounts previously paid by Purchaser shall be :forfeited as liquidated damages for failure to fulfill this Contract and as rental for the Property if purchaser fails to redeem) ; or (ii) Vendor may sue for specific performance of this Contract to compel immediate and full payment of the entire outstanding balance, with interest thereon at the rate in effect on the date of default and other amounts due hereunder, in which event the Property shall be auctioned at judicial sale and Purchaser shall be liable for any deficiency; or (iii) Vendor may sue at law for the entire unpaid purchase price or any portion thereof; or (iv) Vendor may declare this Contract at an end and remove this Contract as a cloud on title in a quiet -title action if the equitable interest of Purchaser is insignificant; and (v) Vendor may have Purchaser ejected from possession of the Property and have a receiver appointed to collect any rents, issues or profits during the pendency of any action under 0), (ii) or (iv) above. Notwithstanding any oral or written statements or actions of Vendor, an election of any of the foregoing remedies shall only be binding upon Vendor if and when pursued in litigation and all costs and expenses including reasonable attorneys fees of Vendor incurred to enforce any remedy hereunder (whether abated or not) to the extent not prohibited by law and expenses of title evidence shall be added to principal and paid by Purchaser, as in- curred, and shall be included in any judgment. Upon the commencement or during the pendency of any action of foreclosure of this Contract, Purchaser consents to the appointment of a receiver of the Property, including homestead interest, to collect the rents, issues, and profits of the Property during the pendency of such action, and such rents. issues, and profits when so collected shall be held and applied as the court shall direct. Purchaser shall not transfer, sell or convey any legal or equitable interest in the Property (by assignment of any of Purchaser's rights under this Contract or by option, long -term lease or in any other way) without the prior written consent of Vendor unless either the outstanding balance payable under this Contract is first paid in full or the interest conveyed is a pledge or assignment of Purchaser's interest under this Contract soley as security for an indebtedness of Purchaser. In the event of any such transfer, sale or conveyance without Vendor's written consent, the entire outstanding balance payable under this Contract shall become immediatelydue and payable in full, at Vendor's option without. notice. Vendor shall make all payments when due under any mortg ige outstanding against the Property on the date of this Contract (except for any mortgage granted by Purchaser) or under any note secured thereby, provided Purchaser makes timely payment of the amounts then due under this Contract. Purchaser may make any such payments directly to the Mortgagee if Vendor fails to do so and all payments so made by Purchaser shall be considered payments made on this Contract. Vendor may waive any default without waiving any other subsequent or prior default of Purchaser. All terms of this Contract shall be binding upon and inure to the benefits of the heirs, legal representatives, successors and assigns of Vendor and Purchaser. (If not an owner of the Property the spouse of Vendor for a valuable consideration joins herein to release homestead rights in the subject Property and agrees to join in the execution of the deed to be made in fulfillment hereof.) T p� Dated this ......... .....�� 19k.1.... �— --- ---•---•- •---- ---•--......_. day of - ........ .....�_._._........---......... ---•- -._...... .._... (SEAL) iY>'�,e.e�-- r....._ . ..._� ................ (SEAL) C. M. Bye James A. Hall (SEAL) ......... (SEAL) A Dennis R. Schultz ... ............................... AUTHENTICATION ACKNOWLEDGMENT Signature(s) S R. .) .... chultz C• M. Bye and STATE OF WISCONSINT Dennis ---------------- •-------------- ...... Pierce sa. ............ ........................County. :au t• ated th �— d y of..fn/0_y_ ____ _____ ___ lg�,5 Personally came before me this . 6 th ....day of i �aY ......................... 1985 the ned . .. ................................. ................. .................................... ti 5turt J __, a ..... ......................... J .... -. ames A. Hall TITLE: MEMBER STATE BAR OF WISCONSIN (If not, ..................................... authorized by § 70(;.06, Wis. Stats.) :� ho axet�t � to me kn n a the per ...... the foregoi to n c,C LIC tr c t'nn acknowle e�j�e THIS INSTRUMENT WAS DRAFTED OY F' Lf PDb C. M. Bye, Attorney at Law ....... .. ..... . ..............,..............�• -- - -• - -• - •••• -. • .... �".. .. p . Davi E. Reis D C •., P. O. Box 167, River Falls� �- *...-..--• ................. ............................... F V11S ----------------------- ..................... .• Notary Public .............. Pierce Coun y, i o Signatures maybe authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration not necessary.) December , lies I of persons signing in an ca acity should be t yped or date: ......................... ............................... 19.........) Y p yp printed , -" their signatures. dw ST C- 105 SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County ty a OWNER /BUYER 4 ¢ 1 ejC' ,�I J4 ROUTE /BOX NUMBER ��- (� �Qy( '3_7 7 - Fire Number CITY /STATE r ZIP PROPERTY LOCATION: IW_�4, A Section 1C, TN, R _ W, Town of Mcep St. Croix County, Subdivision / er S- f&+, v, � Lot numbe Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper What you put into the system can affect the function of the septic tank as a treat- ment stage in the was -ate disposal system. St. Croix.County residents mY be- eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic •tank.is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 0 E I /WE, the undersigned, have read the above requirements and agree N to maintain the private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart - ry ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning OffiLe within 30 days of the three year expiration date. SIGNED �V p DATE St. Croix County Zoning Office P.O. Box 98• Hammond, WI 54015 715- 796 -2239 or 715 - 425 -8363 Sign, date and return to above address. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUI L D INGS D ON INDUSTRY, j LABOR AND PERCOLATION TESTS (115) MADISON W 53707 HUMAN RELATIONS • (H63.0911) &Chapter 145.045) LOCATION: SECTION: TOWNSHIP UNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: W _N��/ '/a 6 /T /R 1°lE (o �Y z2S -- GLOVER S - tue\J COUNTY: IQAtjE ' UYER'S NAME: MAILING ADDRESS: -� L/ 130�C, 33� ST'. C-9,01X `t4 R LL T)_ i v L-s InU ► 5 vO z.z USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: ER LATION TES Residence �/ N •A• New ❑Replace 3 _�_ 8 � 3— �Z -eS'] TS: RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: 4N GROUND- PRESSURE: SYSTEM- IN- FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) ®S DU OS ❑U �5 0 CAS u Ds 9u Z ljr::�s - I'CH s'xl 6 DESIGN RATE: y portion of the tested area is in the If Percolation Tests are NOT required If an /�. under s.H63.09(5)(b), indicate: - Floodplain, i n d icate Floodplain elevation:' ! `' PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER -I16 CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH 26t, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 1 �D•�' X00 7' tiC`1E - '_� DkhSt �7 j0 8'$hS! o -S _ B W�h1Ll. CENC``Tt� �s S.S $h Z �o -4' __ �o�.y' t ,►�l > vN'H' C5 1 Ts; va'%ASj1 ; o.s'Sh sl; 1 •3' 3n is ; B- 3 ' $n �kLy awl-, 1 S • y, s' Nc5yo Yn07Q 2.Z t, * b1CLzSi Ts j 2. - St i z•5 �3„ yu kLy_c,0n. TO 1.0 ipk4 .0' '7 8.3 ' \-o' 'ell Sl l a -Z� an S - B- vT\ STRZf--)GL4 C.FM . 1 S -s 1 w D 1 as - 3 , 6 -0, �p►ve $.3' O.�' �ns'\Ts•\•&'3 G1- S; s•7 Y » s 8.6 _qs.0' �0)►E > 8.(,I o.�' L3hs�l 15;- o' 3ns� l 1.z3rt 1s_; z.5'.B>,rtkc. B- C. 1C?hJR�p is • 3 • z' 8 >1 il S PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL- INCHES RATE MINUTES NUMBER FP 3 AFTER SWELLING INTERVAL -MIN. PERT D t PERT D 2 PERIOD3 PER PER INCH i<L. P. I S•►' N o I t z `'/1 1 1 I Z - 7 P_ 2 �/•3' No 10 1 / P- 3 3.7 ' tUo p t/ ( lam �/ 10 4 •0' 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. )1u 1T 1 1't �' �J T 1�r1 �� $� BuRkt{ArZbT- Sh7T1ZE Call P x r � SYSTEM ELEVATION - -- 1 i I I i o i I '.1es�� � � �— I ---a � O_,�, � rc• �JOQ'0 S i s' 7 - 1 _ l - SGt�t -!r 1 60' SEA- `t1uf�1 loo 1, 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 WERE COMPLETED ON: R714 UTZ LA-) ADDRESS: Z�V�'E !.! gt)x ZZ (o CERTIFICATION NUMBER: PHONE NUMBER (optional): �LL_SwnR s of S7 I - )\ S- Ll IS _Q0 64 CST SIGNAT RE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester, DILHR -SBD -6395 (R. 02/82) - OVER - DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY REP DIVISION LABOR AND PERCOLATION TESTS (115 MADISON WI 53707 HUMAN RELATIONS (H63.090) & Chapter 145.045) LOCATION: SECTION: TOWNSHI UNICIPALITY: OT NO.' BLK. NO.: SUBDIVISION NAME: GWw_ `jE '/4 1(n / T?a N/R )9 E (or W �?_rl r z8 C'wuGz S'TRTI ury COUNTY: N BUYER'S NAME: MAILING ADDRESS: S c�o�x �►��ES t�R�t. R lUt — =R. w 1 syo ZZ. DATES OBSERVATIONS MADE USE PROFILE D ❑ ESC RI PTIONS: PER OLAT 0_N TESTS: NO.BEDRMS.: COMMERCIAL DESCRIPTION: c� QResidence N - A Jew Replace 3 — 6 — al RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN- GROUND PRESSURE: SYSTEM IN -FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) ® S ❑U " S ❑U ,®S EJU D S ®U ❑ S R11 TR�UCS- Gt I s o0 If Percolat i on Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the * , under s.H63.09(5)(b), indicate: ' Floodplain, indicate Floodp elevation: 1 V A PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER -IIQ CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH W ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) - 7 'b .yt CQ tv�,►�,E 7 - t B- a �o•�' tiOZ.o' N`�� > lo•'� o- 8 �btzBr,ls IS �.S Br G► - is 's•y't -ran �s B- - B- B- PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL -MIN. —PE—wool P RI D2 P R PER INCH P- P- P- 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 ELEVAT _ m,�� -� v i T I , , - X`�.'�J:"�S . tN I I I j ( J - -� Ski X115 - t t � — ` i I - L , 1, 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 WERE COMPLETED ON: w�G ADDRESS: ��t.)�� l� �D k ZZ6 CERTIFICATION NUMBER: PHONE NUMBER (optional): CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR -SBD -6395 (R. 02/82) — OVER — 0fD a c 0 z C n m r* • w m n m cn rr cn n cn cn hi w x co O O rr r-n N O H 10 U) (D r+ C om N (D N t O a W W fU _ O ¢- rq" 0 rt n C P. O N, o O H, n 1 rn m v cn N CO 0. Own'er'.s name San. Permit No. H63.05 PLOT PLAN Show: Location of building served NA Dosing chamber FE Septic tank Vertical/horizontal reference point (i 9y 6 Building sewer Q System elevation is 93.3' Effluent system Q Well Q Replacement system area Property lines w /in 50' of,system F T Q Distribution boxes Scale = I%.=, 61z> , or dimensioned �jA - Pump and controls: Mfr. & Model No. Vertical Lift Size Force Main j Friction Loss T. D. H. Vol. Dist. Pipe Gal. per Min. Gal. per -Cycle Place check mark in appropriate box, indicating item is shown on plot Ian , below: tJcTC�; '• IJ �P�'� T W � � L Nw car= S k STS"► ���� , wa.. O i ° A J cn H vuSE � UI 83 p o �,D'oF u' CS �Z,So GR�w►� s4 W t � 9 �. GSN G �-a► �- S o o f 4 2 w�tS�R $ s' 3►� 81�RP. 9 9.6' o►v 1 "x 2- Woop ''TAke- L4 d VeNT w /RPP$wL m 0` Bri � HRP - �...tioo•p' �5-- - '_ - = _ — goo. 5 , ��uo er EwcN `r�,�.+c�+� o� "X ZN � 6 fs; goo• 11p�-g6 $S y''pERFCiRAT� PVC o \s1�2J8��� 'p t AE 1N C1N OF tzHCN �'R:c -�►C.0 z5 � !o d l,oT e QTW�IZ. �q , ti4o' By the granting or approving of the - above plan, or upon the event of a subsequent permit being issued, St. CroixCounty and theSt.Croix2ounty Zoning Administrator, does not assume or hold itself liable for any defects in plans or specifications, plan omission, examination oversight, construction, or any damage that may result in or after stallation. 4 N6W3 3-�3 P t _ r s signa ure icense o. ala e 3/ ©w i�Ep, 's t"3 Ar-1E s��-�oN - -__1ST � 3 o � Q � �,,, ��►JT p � E W / � � �•,_� -`„ �� Sri FILL- - � � R ?PRoUSU S' T1�cY� C - oov`2J1�6 oR 6" of I /z ? - -- B - ,4��R5'�ATc t}BvuE PIPE � 1S;521r'3 U�D►J A l'AE 1`a ce /y LAST CQ-lG0 : GlZP ZF AclJ't> /-T LEAST ZO )iJC�}�S $u'j lJ0 YfORr - n+hQ qz wzkC ES ze-Dw P�fAxlr)vr� D?TTl dF t�X CAUA'�01J � R� a ►6liJIrL C�1�R�J Lv� t�L T3 1 I" t Kl t M U" b ETA EX CA VA'C) W! 3 =; fZ M KU !- L $ :-S