HomeMy WebLinkAbout040-1294-30-000 Parcel #: 040 - 1294 -30 -000 10/18/2005 08:06 AM
PAGE 1 OF 1
Alt. Parcel #: 16.28.19.1688 040 - TOWN OF TROY
Current I, 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
DAVID G & LAURA A FRANTA O - FRANTA, DAVID G & LAURA A
408 E 104TH ST
BLOOMINGTON MN 55420
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 516 E COVE RD
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 2.320 Plat: 2331 -PINEY WOODS SUBDIVISION
SEC 16 T28N R19W SW NW LOT 13 PINEY Block/Condo Bldg: LOT 13
WOODS SUBDIVISION
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
16- 28N -19W SW NW
Notes: Parcel History:
Date Doc # Vol /Page Type
05/03/2005 793934 2795/302 WD
01/10/2005 784517 2728/275 LC
07/23/1997 418/476
2005 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/23/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.320 80,000 0 80,000 NO
Totals for 2005:
General Property 2.320 80,000 0 80,000
Woodland 0.000 0 0
Totals for 2004:
General Property 2.320 80,000 0 80,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch #:
Specials:
User Special Code Category Amount
i I Charges Delinquent Char
Special Assessments Spec es a g q g
Total 0.00 0.00 0.00
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
463389 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)).
Permit Holder's Name: City Village X Township Parcel Tax No:
Franta, Dave & Laura Troy, Town of 040- 1294 -30 -000
CST BM Elev: Insp. BM Elev: BM Description: Section /Town /Range /Map IV
jo „ (a )4 %2 Z.28.1
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Se 'Atic I h ` ttM Benchmark O � �,!
�-v i
Dosing L 6WU4, Alt. BM
Aeration Bldg. Sewer d �.� 90 • p.1
Holding
St/Ht Inlet
TANKS TBAMINFORMATION St/Ht Outlet
TANK TO /L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic �. Dt Bottom
Dosing t t t } 3 ( Header /Man.
Aeration Dist. Pipe •�� �O . oho
Cs� .z c ,
Holding Bot. System .2
Final Grade
PUMP /SIPHON INFORMATION
jFoircemain nufacturer Demand St Cover
GPM O , A-0 del Number ti � n • 4 g
I
O� H Li t Friction oss Systemm Hem T j_ Ft V5. -IV 2 • J Leng 1 Dia. i� Dist. to Well "
SOIL ABSORPTION SYSTEM
TRENCH Width f Length N0.JJf ren es PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIM 1 /,Z
SETBACK SYSTEM TO P/L BLDG IWEL L LAKE /STREAM LEACHING Manufart rer
INFORMATION CHAMBER OR
Type Of system: 3D � %, 1 1 UNIT Model fibe
N r:
DISTRIBUTI _ -x STEM -{ N . /1 (j�lL
Distribution x Hole Size x Hole Spacing Vent to Air Intake
• Pipe . FLength Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed /Trench Center Bed/Trench Edges Topsoil Yes No Yes No
CO NT I clud co a discrepencies, persons present, etc.) Inspection # : _� Inspection #2:
Location: 516 ast Cove Road Hudson, WI 54016 SW 1/4 NW 1/4 17 T28N 1P 1 P ii ne y Woods of 13 �.-, Parc I No: 7.28.19.1688
1.) Alt BM Description =
2.) Bldg sewer length S tl��
- amount of cover = ( p Jr. ��/�• J 4�.. a r. O •� LS
Ir -too
Plan revision Required? "1 Yes No ,�j„
Use other side for additional informa olf n. — __ L. ��_.___
Date Insepctor's Signature Cert. No.
SBD -6710 (R.3/97)
Safety and Buildings Divis' County
201 W. Washington Ave., P 7162
N Visconsin Madison, WI 5 Sanitary Permit Number (to be filled in by Co.)
Department of Commerce ( � 8 �;3
Sanitary Permit Appli tion o� Plan I.D. Number N/
In accord with Comm 83.21, Wis. A y L Jrbvide G0 \- �
may be used for secondary 1 1)(m) G �(J\ Project Address (if different than mail• address)
1. Application Information - Please Print All Information ti
Property Owner's Na me Parcel # Lot y Block y
.R,4 V& " - -1-11 (
Property Owner's M ailing Address y� Property Location
o g �',9 -s r /o y K/ s T 5 4o VA )
City, State Zip Code
!6, %,Section
P / hone Number q� " J
�610/H//V f / t/"' u�sy� Chia • . 2. / �73 T 2-9 N R � / � E le W
II. Type of Building (check all that apply) 3 2 - S s
Subdivision Name CSM Number
or 2 Family Dwelling - Number of Bedrooms
� - - ✓l0 a /�Lt` y ����f
❑ Public /Commercial - Describe Use o^^ .-,I
❑ State Owned - Describe Use Wtt�w t ❑City_ ❑Village kownship of rR v
wt
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A- New System ❑ 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 Daw issued
Before Expiration Plumber Owner
IV. of POWTS System: (Check all that a I) 2
Non Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter
❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter
❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel4ess Pipe ❑ r (explain)
V. Dispe rsaUTreatment Area Information: Z ` 3G
Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area oposed (sf) bRystem Elevation
0 -7 1 to y3 C0 5"o y '
VI. Tank Info Capacity in Total Number anu M to \ Prefab Site Steel -Fiber Plastic
Gallons Galion of Units Weyuco (�• ) Concrete Constructed Glass
New Existing // -- ., r ew 4 " G .
Tanks T anks W/ U
Septic or Holding Tank 67V
Aerobic Treatment Unit //,w,
Using Chamber /_ 50 (!+ S o' /
VII. Responsibility Statement 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Na me (Print) lumber's Si cure MP /MPRS Number Business Phone Number
ZZ.Ce 3 -� -5 71 ' �� • 3 �l
Plumber's Addre ss (Street, City, State. Zip Code) 0 ��
: 12 VIII. Column /De artment Use O nly
Sanitary Permit Fee (in Groundwater Date Issued Issuing gent Signature (No Stamps)
Approved ❑ Dis rove Stucharge Fee)
❑ Owner Given Reason for Denial
TX. Conditions of Approval/Reasons for Disapproval
SYSTEM OWNER:
1 Septic tank, effluent filter and
dispersal cell must all be,gPrVit;ed / main fined
as per management plan provided by plumber.
2. All setback requirements must be maintained
as p erapplicable code /ordinances.
Attach complete plans (to the County only) for the system on paper not less than 91/2 x 11 inches in size
SBD -6398 (R. 01/03)
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ULBRICHT & ASSOCIATES CO.
281210th Ave. - Spring Valley, WI 54767 Reg• Desgmrs of EnWheeft Systems
715- 772 -3442 Private Sewage conwftnts
PROJECT INDEX t
PLAN ID # DATE ATIza 6 d s
OWNER tIl fIU/ rAV �� PHONE- t �7-
ADDRESS l� �/''S T �� S �� DO 1y► lw� �J /�{ /�'
LEGAL DESCRIPTION GOT 13 ' PI tU£ yI wooDs s:rfr -2 r)
15w, .to 5Wc - lee, T2 QN, /z/ f N o YO - /2-f 0 - &0-0
TOWN OF T cgo X
4 — COUNTY
CSTM
LOCAL AUTHORITY/ SUPERVISION ST. • GIGO l)e G--
PROJECT DESCRIPTION:
fee 3
7X44 *&IQY -
C P
P#_,oal
- 13 POWT SYSTEM I
iN60RPORATE PER SHAD 1�.71I� CI1
83.44(2)c A PROPER CO .�}g
FILTER MODEL # Ulbricht & Associates
Private Sewage Consultants
2812 1 Oth Ave.
67)?"/4�0 f: T ' SX Zz ,� Spring Valley, Wl 54767
nSZz
P9.1 INFILTRATOR SIZING WORKSHEET �O
P1.2 SYSTEM PLOT PLAN
P9.3 CROSS SECTION OF SYSTEM, WITH ELEVATIONS.
Pg -4 if 11 It to 11
P9-5 OWNER MANAGEMENT PLANS & ZABEL FILTER SPECS
P9.6 (OPTIONAL) CROSS SECTION AND SPECS FOR DOSING TANK.
PG -7 (OPTIONAL) PUMP PERFORMANCE SPECS.
u %. i.Qt11 Plans Absorption Component specifications are ed
Treatment Systems.° ( Version F 2r0 )ri Onsi ate btWa stewate
e round
D 1075- P(NO1 /01, r
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/2 1
It_ J � i IN
. -
��- PWAW - -
OVER; see Reverse Side for Vent/ Observation Pipe Details.
I
of
- t� SEPTIC TANK &PUMP CHAMBER CR OSS SECTI AND SPECIFICATIONS
t
4" CI VENT PIPE 22" MIN. ABOVE GRADE & WEATHER PROOF
tiI >_ LO' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED
FRESH AIR INTAKE WITH CONDUIT MANHOLE C(
W1 PADLOCI
`�� WARNING Lf
If/ 4" MIN.
INLET
..� - GAS- ; t '
d ru�� TIGHT� ;
/9 A I SEAL
APPROVED
•CD. 4D f t L.Te �—
pUG P i PV ALM JOINTS W1 fo SOLID 019 / - -- ��i ON PIPE 3' ON
SOLID SOIL
SOIL q , ! " C 33
PUMP OFF ELEV . !p FT. j— { OFF '��` RISER E
PERMITTED
la D IF TANK
MANUFACTUR
3" APPROVED BEDDING UNDER TANK HAS APPROV
CONCRETE PAD
" SPECIFICATIONS
SEPTIC f DOSE Lv/e5e?4� Cp
TANK MANUFACTURER: NUMBER DOSES PER DAY:
TANK SIZES SEPTIC /1 CAL. DOSE VOLUME INCLUDING
DOSE GAL. / / . FLOWBACK �Z� GAL.
ALARM MANUFACTURER: GZ'UOl /V09 CAPACITIES: A = ��'� INCHES = 30Z) Gi
MODEL NUMBER: U. --
SWITCH TYPE:
B = 2 INCHES = 3 2- G)
PUMP - MANUFACTURER: ZOO // C = � - 73r INCHES = 1 2 - 2 GY
MODEL NUMBER:
SWITCH TYPE: P �C, •/ 740, 7' D = 1Z INCHES = 1 " 7
( GE
REQUIRED DISCHARGE RATE 25 GPM PUMP & ALARM WIRING AS PER ILHR 16. 23 G
VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE . g• FEET
+MIN UM NETWORK SUPPLY PRESSURE • . FEET
+ FEET FORCEMAIN X FT /100FT.FRICTION FACTOR . 6 FEET
TOTAL DYNAMIC HEAD = /�, S FEET
d // p a
INTERNAL DIMENSIONS OF PUMP TANK: LENGTH 70 WIDTH a y ; DIAMETER,
LIQUID DEPTH
y6/
SIGNED: LICENSE NUMBER: DATE:
.
1AII-e1' Tv P c SP
8OK - /ODa So 'e)f F G 6 4
oa �p.7D c& ! ty o
�
TAI, �f7" = �'.9D
SEPTIC TANK, per Comm.83.44 (2) (c) shall be equipped with an
outlet attached approved filter device (Zabel
5 (liter). Tank shall have an approved above
ground locking manhole cover for regular (every
12 months or less) inspection & servicing by a
licensdd service pumper.
ZOLLER EFFLUENT PUMP MODEL 98
14EA13 CAPACITY CURvE s
MODEL ..9N. ! e
• r/4
2s—
a s/a
m
is—
e
3/1•
to–
e—
t3 --
11.Z. t]AL t diS
tmRS
fQ J° 4. sa 6a 7a ao
so 160 240
0 FLOW PER MINUTE
- rou emnuu�akutiMtowttxa,wtf -
1/ttutM /ut0 bEW4rrRMA
!ArAtlty
YNtttl/M�q t=
Ftty Mtr[Rt drtt ttR• V
1 -•t
t0 3-06 - t
10 4.11 48 tyo
20 lit 45 tS
tax Vaht
CONSULT FACTORY FOR SPECIAL APPLICATIONS
• Eistirtcat alternators, for duplex systems, ar• avIllable and •Mercury float t witches are ava�abla for conic
suPPaad whh an @term. oNtng s � and
! blechankai sllernalora, 1& duplex syslems, are avalleble with a s Urea phase systems.
wtthoui tAarm @witch@@. ouble Pi99yback mercury float swdchea era evattable far
Vedable level tong cycle controls,
Standard au made - 1 «,•t ;� o r.tad rr»e set.EcTro" auto
WNghl 39 f6t / KID. pe t r�.r".wteeh,eo
l nnemdeonaolr
!N series t. SkV'* PrOgybaek maceiry itod two w d r Wul ►.d.
Mod el Yph_� pb_ Mod* A • etmOia atrot sttnetlott awhch. Mier to fMO.71. Aig►tbtetc enttcury, Lod
MFe i r r u � -- ---� -- Au tax 3. M#"" ap•rnsiot 14x072 w 1Q-0Oltf
0.6 — lot J&
~— 4. 6.o FMo7t2, ra oorrtct mod•) d EiedrlW Atttn alms.
OWNER MAINTAINCE OF SEPTIC SYSTEM
POWTS (landowner
maintenance of thisssy rstemsible for proper operation and
servicing is necessar Re gular periodic inspections and
syseen, y for the safe healthy operation of.this
The owner is required by code to sub mit all necessary,
maintenance /inspection reports to the controlling,authorit'
ies.
' SPECIFIC CONTACT ' AGENTS S� C � 2- 0 t; T�U�_
* Governmental authority/ inspectors: b � „/
O 7 Cp 0�
Licensed installer, res
maintenance "Users manua��nsible for providing an operation/
w4rcel, r ,1tf1
�'S 2-'2-� 7 5
* Licensed service f inspection agent other than installe
? — C 7Y Si4•tI i T 7
�lo1 ti
Electrician,
for pomp, electric controls
wiring units:
IMPORTANT OWNER MAINTENANCE RE UIREMENTS
1• Winter 'traffic '(s1 eddin
area shall not (. g shove*ing, etc.) across the
the cell, freezing pupmthees` y to frost can /will penetrate into
winter_ stem. Discontinues use
(a vacaction trip, resulting i.n the
lead to freeze up g in no water use
can also
2 • Water conservation need
h s to be
eslq- Lcally overloaded and destroyedSeThiOrsvSSeem can be
designed for a maximum wastewater flow of
t m 'Was
y5 gals. daily.
3 • POWTS are not desi geed t
disposal unit o accomodate wastes from a
, or any other unnatural sources of waste.
Any i ntroduction of such waste materials
destroy this system. will overload and
4' If a o
pwer Data .
In a P 01 ge occurs, or a pump fails, it ma y
cell y overload of effluent being result
which may adversely Pumped into the
a y impact the cell (leakage). It is
recommended that
allowi
licensed pumper empty the dosing
g the pump to return g tank,
to dosing the correct amounts.
Consult
your installer immediately for advice.
5 - Neglect of the V
erosion prev (the cells
traffic also ntive) can lead to fa insulation &
he t
can ilure. Compaction or heavy
REGULARLY WATER he system. It
the R THE VEGETATION OVER A S IS NECESSARY TO
system beneath IS NOT YSTEM•• Effluent
�L'cov�r, sufficient alone to 1 n
mainta;l a
6 - Periodic inspections b
necessary. Ins y the owner, or his a
Into the Pection pipes and gents, is
s ystem: on the Ports have been incorporated
Inspection pipes) mound basal area (effluent level
laterals, at # mound
terminals on
out:. The filter es tip - for fiushin the pressurized
ground Ystem in the g and cleaning the laterals
cover /manhole). Only (via a locked above
Person should be Performing his g a licensed properly qualibied
severe safety risks. d t work which involves
system's tre ?tment cel.tEsttaence of effluent health
11 also be Ponding in the
? regularly inspected.
���l.�l�,r���� "." - �U.•f -jam ���/f._S' t �`
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page ' of
DiNsion of Safety and Buildings
Ir in accordance with Comm 85, Wis. Adm. Code
,
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County S T'
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information. ev' wed by Date
Personal information ou provide may be used for Y P Y secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property Location I 7
O N PC CE R.Ot�, L GGIO— t S 1/4&W 1/4 S 1 jZ�J N R 19 E( ) W
Propert y Owner's Mailing Address Lot # Block # Subd. Name or CSM# �l N W ODD S
S� C l 1uN� LAjj e
City State Zip Code Phone Number ❑City ❑Village ®Town : N &' rsYRoad` "
�1� FPcu_S I kj1 I 5 quZZ ( - ) tS) L -4 Z
New Construction Use: 9 Residential / Number of bedrooms �_ Code derived design flow rate _ b 0 GPD
❑ Replacement ❑ Public or commercial - Describe: , h JAP 0
Parent material C)U R SH Flood Plain elevation if applicable ST CROI ft.
General comments COUNTY
and recommendations: 3 t? ELLS 3 'Y- 2 , S' LoYJ G Itil L v,'j L'M OF 3
l'7U 1^'l 0 l— CQL.g �l1 Q b 30 nS�. C 'NNSE CAi M p
1 ❑
Boring # Boring -\'V
❑ Pit Ground surface elev. �� O ft De th to limitin factor `A • ��
P 9 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 -� LO`i6Z3L2 _ si I Z'-5 vn\j 0 -ki
g 9 l o � 2 3 � i, — S) � 2`� h k e_.t•" � -S - �,
3 �q -48 - ,.sLIiz3�Y — S�sr v s wi 1 •1 �. Z
❑ Z Boring # ❑ Boring
Pit Ground surface elev. ft Depth to limiting factor 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# 'Eff#2
Z $ -Z-` ibLl t2 Lkj -
� Z� -3u z•s�23�y is c� S �. 1 e-S — �� �-•Z ��
30=)8 10vr'--y & d 8 V►1 .� l.Z •�
9�• d
' Effluent #1 = BOD > 30 <220 mg/L nd TSS >30 _< 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Siggpture CST Number
220254
Arthur L. Wegerer 0. 1`31 13
Address W e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number
421 N. 1 --lain St. River Falls, WI 54022 tZ_I,es-Dl 715- 425 -0165
Property Owner �Zb �/a H L Parcel ID # Ib ] n ► G Page Z of
Boring # E] Boring 1 O � '
® Pit Ground surface elev. ft. Depth to limiting factor - 7 ' 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
L \o5b�r- wjfF - a-s `f
k- Z
❑ Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fl
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2
a Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft
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 = 13013 :< 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.6/00)
PLOT PLAN Page 3 of 3
Scale 1' = SD '
13 - z
o1= Fv" -E
LaP�3T �U� a- O1R�'D
LoT 14
" f" LL 91q PVC !?Ll?h bV / LfTf — - --
-.q
715 - 425 -0165 220254 - 3
c71 -31� l
CST Signature Date Telephone ado. CST No• Job NO.
ST CROIX COUNTY'
SEPTIC TANK MAINIBNANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Ownerffi,, Alf Uzfc �✓ /� 1I:;e,4 A) -/
Mailing Address /06 T /0 l 7 'lv S7r 3100) 'WW MA) . 5S �f.Z o
Gv / 0 . S Y&
Property Address /7 & J �
(Verification required from Planning Department for Wow construction)) -
Ci /State Parcel Identification Number ® • f &zv
LEGAL DESCRIPTION
W
r 4 Y4 Sec. `�' T N -R r � W, Town of
Property Location /, C
Subdivision
/ .PVC W 0 /' Lot # r
Certified Survey Map # , Volume . Page #
Warranty Deed # / S r � , Volume 2- 2 S . Page # 2 5
Spec house ❑ yes no Lot lines identifiable b yes ❑ no
�ySTFM 11�.AINTENANCE
Improper use and maintenanceof your septic system could result in its premature failure to handle wastes. Ptopermamtenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
masWplumber, journeyman plumber, restrictedplumber 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 113 full of sludge.
Ywe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30
days of the three ear expiration date.
SI OF APP CANT DATE
OWNER CER ICATI N
I (we) certify that all s tements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of
the properly descn above, virtue of a warranty deed recorded in Register of Deeds Office. S 05
TORE 6"PtICANT DDA— I
«««««« Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. « « « « ««
*« Include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
I
1
U. 2728 P 275 764517 WALSH
STATE BAR OF WISCONSIN FORM 11 - 1982 KATHLEEN O DEEDS
REGISTER OF DEEDS
LAND CONTRACT ST. CROIR CO., MI
Individual and Corporate RECEIVED FOR RECORD
(TO BE USED FOR ALL TRANSACTIONS WHERE OVER
Document Number $25,000 IS FINANCED AND IN OTHER NON - CONSUMER 0 08 : 00AN
ACT TRANSACTIONS)
LAND CONTRACT
CONTRACT, by and between Donald O. Rodahl and Joyce J. EXEMPT #
Rodahl, husband and wife as survivorship marital propertv, ( "Vendor ", REC FEE: 13.00
whether one or more) and David G. Franta and Laura A. Franta husband TRANS FEE: 420.00
and wife as survivorship marital property "Purchaser ", whether one or COPY FEE:
more). Vendor sells and agrees to convey to Purchaser, upon the prompt and full CC FEE:
PAGES: 2
performance of this contract by Purchaser, the following property, together with
the rents, profits, fixtures and other appurtenant interest (all called the
"Property"), in husband and wife as survivorship marital property, County,
State of Wisconsin:
Lot 1 , Piney - Woods Subdivision ,Town of Troy
. Croix County, WI
Recording Area
Name and Rehm Address
Leo A. Beskar, Attorney
RODLI, BESKAR, BOLES & KRUEGER, S.C.
219 North Main Street, PO Box 138
River Falls, WI 54022
040- 1294 -30 -000
Parcel Identification Number (PIN)
This is not homestead property.
(is) (is not)
Purchaser agrees to purchase the Property and to pay to Vendor at such place as reasonably directed the sum of $ 140.000.00 in the
following manner: (a) $ 35,00.00 at the execution of this Contract; and (b) the balance of $ 05.00.00 together with interest from date hereof on the
balance outstanding from time to time at the rate of 6% percent per annum until paid in full, as follows:
Monthly payments of principal and interest of $886.05, commencing February 5, 2005 and monthly thereafter provided the balance is
paid in full on or before January 5, 2020.
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Following any default in payment, interest shall accrue at the rate of 12% per annum on the entire amount in default (which shall include,
without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance).
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Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any amount may be prepaid without
premium or fee upon principal at any time after date of closing. , Ii1X�63pI(�
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:
Easements, covenants and restrictions of record.
Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall be retained by Vendor until the
full purchase price is paid.
Purchaser shall be entitled to take possession of the Property on date of closing.
* Cross out one.
STATE BAR OF WISCONSIN 1NF0 -PR0 ( 800)655 -2021 www.infoprotortns . com
LAND CONTRACT - Indivdual and Corporate FORM Na. 11 - 1982
.U; 2728P 276
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, extended coverage perils and such
other hazards as Vendor may require, without co- insurance, through insurers approved by Vendor, in the sum of $ full and insurable value
, 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 ofthe
Property damaged, provided the Vendor deems the restoration or repair to be economically feasible.
Purchaser covenants not to commit waste nor allow waste to be committed on the Property, to keep the Property in good tenantable condition
and repair, to keep the Property free from liens superior to the lien of this Contract, and to comply with all laws, ordinances and regulations affecting
the Property.
Vendor agrees that in case the purchase price with interest and other moneys shall be fully paid and all conditions shall be fully performed at
the times and in the manner above specified, Vendor will on demand, execute and deliver to the Purchaser, a Warranty Deed, in fee simple, 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: no
exceptions.
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 30 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 mail), then the entire outstanding
balance under this contract shall become immediately due and payable in full, at Vendor" s option and without notice (which Purchaser hereby waives),
and Vendor shall also have the following rights and remedies (subject to any limitations provided by law) in addition to those provided by law or in
equity: (i) Vendor may, at his option, terminate this contract and Purchaser's rights, title and interest in the Property and recover the Property back
through strict foreclosure with any equity of redemption to be conditioned upon Purchaser's full payment 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 (i), (ii) or (iv) above. Notwithstanding any oral or written statements or actions of Vendor, an election
of any of the foregoing remedies shall only be binding upon Vendor if and when pursued in litigation and all costs and expenses including reasonable
attorneys fees of Vendor incurred to enforce any remedy hereunder (whether abated or not) to the extent not prohibited by law and expenses of title
evidence shall be added to principal and paid by Purchaser, as incurred, 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 ofany of Purchaser's rights under this
Contract or by option, long -term lease or in any other way) without the prior written consent of Vendor unless either the outstanding balance payable
under this Contract is first paid in full or the interest conveyed is a pledge or assignment of Purchaser's interest under this Contract solely as security
for an indebtedness of Purchaser. In the event of any such transfer, sale or conveyance without Vendor's written consent, the entire outstanding balance
payable under this Contract shall become immediately due and payable in full, at Vendor's option without notice.
Vendor shall make all payments when due under any mortgage outstanding against the Property on the date of this Contract (except for any
mortgage granted by Purchaser) or under any note secured thereby, provided Purchaser makes timely payment of the amounts then due under this
Contract. Purchaser may make any such payments directly to the Mortgagee if Vendor fails to do so and all payments so made by Purchaser shall be
considered payments made on this Contract.
Vendor may waive any default without waiving any other subsequent or prior default of Purchaser.
All terms of this Contract shall be binding upon and inure to the benefits of the heirs, legal representatives, successors and assigns of Vendor
and Purchaser. (If not an owner of the Property the spouse of Vendor for a valuable consideration joins herein to release homestead rights in the
subject Property and agrees to join in the execution of the deed to be made in fulfillment hereof.)
Dated this 5th day p of January 2005 /
1 "" CS �L� (SEAL) �L GGPG'L� (SEAL)
* Donald O. Rodahl *David G. Franta
5 44 o - �Pti�_ _ (SEAL) `� t i ti R �� �- (SEAL)
* ce PRoda * Laura A. Franta
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
) ss.
PIERCE County )
authenticated this day of
Personally came before me this 5th day of
JUL�E tn. January 2005 the above! named
�
Donald
aura AO.. F ran ta Rod hl, Joyce J. Rodahl, Dafi�;nmm
TITLE: MEMBER STATE BAR OF WISCONSIN n to me known to be the person(s) who a 141md the eofniv
(If not, instrument and acknowledged the Sam �* CJ ; u:
authorized by 6706.06, Wis. Stats.) O • . r
THIS INSTRUMENT WAS DRAFTED BY _ �•'� v'`I U I
Attorney Leo A. Beskar
RODLI , BESKAR, BOLES & KRUEGER, S.C. �ota6fPtiblic. State o conain F
o ssion is per anewt...(If not, state expirati
(Signatures may be authenticated or acknowledged. Both are not necessary.)
*Names of persons signing in any capacity should be typed or printed below their signature. INFO -PRO (800)655 -2021 W — infoproforn - cone
STATE BAR OF WISCONSIN
LAND CONTRACT - Individual and Corporate FORM No. It - 1992
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