HomeMy WebLinkAbout040-1279-70-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count
Safe -;_-rJ Buildings Division 6t. Croix
• INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
Personal infdrr'ation you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 383966
Permit Holder' , Name: ❑City []Village L1 q own of: State Plan ID No.:
Troy Development, Troy Township
CST BM Elev. ] Insp. BM Elev.: BM Description Parcel Tax No.:
0t10 /Z. 79'70
TANK INFORMATION ELEVATION DATA
!7. i'8- / IS 1,
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic
Dosing 4+,
r
Aeration Bldg. Sewer �rlot �( • g8 93�, 9fi f
Holding St/Ht Inlet C l ' 5 It 36 q3
TANK ETBACK INFORMATION St/ Ht Outlet q rel a ,T Y 13(-,1
TANK TO P/ L WELL BLDG. Airi to ntake ROAD Dt Inlet
Air I
Septic y 5D r 2 NA Dt Bottom
u
Dosing NA Header / Man. �j 3i r3 , 0 q ys
Aeration NA Dist. Pipe
Holding Bot. System 1s•3� 936. S2 /
PUMP/ SIPHON INFORMATION fto( ireee o l r ` 0. /
! r tt
Ma acturer Demand l C.ctr� 'D t{. 47411 ,07— r
Model Nu ber GPM
TDH Friction System T Ft ead
rc, n Length I Fi Dist. To Well
SOIL ORPTION SYSTEM (L3
TRENC Width I L th N - f Trenches PIT No. Of Pits Inside Dia. [ Liquid Depth
E N • j • ZS' DIMENSION
LEACHING Manu act
SETBACK SYSTEM'TO P/4 BLDG WELL LAKE /STREAM .-
INFORMATION Type Of CHAMBER Mod ' Num r•
System: �5 r OR UNIT
DISTRIBUTION SYSTEM
Header / Manifold (( Distribution Pi e s x Hole Size x Hole Spacing Vent To Air Intake
Length '
Dia. ngth
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 Inspection 1my rh No Ins a • ea# . No/
o gn� iet� �j� g bf ?4�E" r4 T28N R19W)- E g e Bl - of 37
1.) Alt BM Description J I , s ,
2.) Bldg sewer length= �� C
- amount of cover = l� -F-
Plan revision required? ❑ Yes No
Use other side for additional information. ) S O
SBD -6710 (R.3/97) to CS Inspector's Signature Cert No.
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Safety and Buildings Division County
201 W. Washington Ave., P.O. Box 7162 62vl
onSl Madison, WI 53707 - 7162 Site Address
V visc d
Depart ent of Commerce
Sanitary Permit Application Sanitary 39, _ 3 _ gtc 6
In accord with Comm 83.21. Wis. Adm. Code, personal information you provide ❑ Check if Revision
may be used for secondary purposes Privacy Law, s15. 1 m
I. Application Information - Please Print All Information State Plate r D_ xumt
Property Owner's 7ne Parcel Number
Property is Mailing Address Prop erty Location /�
''A:S` / T- N,R� E
City, State Zipotode Phone Number Lot Number Block Number
Subdivision Name CSM Number
II. Type of Building (check all that apply) ❑City
P or 2 Family Dwelling - Number of Bedrooms ❑Village
❑ Public /Commercial - Describe Use lirTownsbip
❑ State Owned Nearest Road
//idle
M. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable)
A For County use
1�New 2 11 Replacement System 3 ❑ Replacement of 6 ❑Addition to
system I I Tank OnlyExis ' stem
B. Check if Sanitary Permit Previously Issued Permit Number Date Issued
N. Type of Permit: (Check all that apply)(numbering scheme is for internal use)
44;R34on - Pressurized In- Ground 2111 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wedand
22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line
45 ❑ At -Grade 46 ❑ Aero k Treatment Unit 49 ❑ Recirculating 30 ❑ Other 0?1<Z
V. Dispers aVTreatment Area Information: a X11 J Cit - �.Svi
Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade
Required Proposed Rate({ ./Days/Sq.Ft.) (MinJInch) Elevation
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Tanks Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Hokling Tank
Dosing Chamber
VII. Responsibility Statement- I, the undersigned, assumes responsibility r installatio of the POWTS shown on the attached plans.
Plum is Name (Print) Plum S,Number Business Phone Number
ZE "
Plumber's Address (Street, City, State, Zip Code)
3( /-"(
VIII. County /De artment Use Onl
Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agem Signature (No Stamps)
P--Approved ❑Disapproved
Surcharge Fee)
❑ Owner Given Initial Adverse ,v
Determination `
IX. Conditions of Approval/Reasons for Disapproval /
Attach complete plan's-(to a County only) for the system on paper not less than 81/2 x 11 inches in size
SBD -6398 (R. 05101) (J
Sanitary Per Application & Buildkgs Division
on,
In accord with Comm 83.21, Wis. Adm. Code 20i W. Washington Ave.
See reverse side for instructions for completing this application 7302
IVLon Personal information you provide may be used for secondary purposes Madis WI 53 -7302
Department of Commmea (Submit completed form to county if not
(Privacy Law, s. 15.04(1xm)] am owned
Attach comp etc plans (to the county COP onl the system, on paper not less than 8-112 x 11 in es to S
Saq#wy Perr& umber revision to previous application State an . u;
�
L Application Information - Pkase Print all Information, Location:
wear Nam / Property Location
O n 6 ^. f 114 j0/4, S , It
Prope Owners Mai l" Ad&ft LatNumber N
ll .sue # 37
X -e- umber vrs arse or CSM Number
d Type of Building: (check one) o Cl
J7 1 or 2 Family Dwelling - No. cf Bedrooms : Vil < < mown of
E3 Public/Commercial (describe use):_
D Stato-Uwned '
Nearest Road �� /
J 46 1 /e°
3 ` x . ZS r .t.+�,r.0• c�s arc `
III. Type of Permit: only one box on line A. Check box on line B if licable)
A) 1. JS New 2. El Rep meat 3. eat of 4. S. 6. 0 Addition to
Sys Tank Existing System
B) tmn aaa
O A Sanitary Permit was ttiwio issued Permit
IV. Type of POWT System: (Check all that apply)
❑ Non- pressurinod In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland
0 Pressurized In-ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line
At- ✓3 wtG. s Acp Treatment Unit ❑ Recirculating ❑ Other: /) n
—!a0 t�el
V. roal/Treatment Area Information:
rgn ow Area 3. Dispe o App n,. Percolation Rate 6.3yslem E n mat Grade
Required propose(�+al �uy�scl_R) (Minrnch) Elevation
jgeocl (p / l /sr �dat6„ �3s
VIL Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks Con- Con- Sly
New Existing c etc structed
Tanks i Tanks E3 0
❑ ❑ 13 ❑ ❑ C
VIII. Responsibility Statement
I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plem
Pl inabeft Name o• Bus iness
!VP �r
- 7az v
u actress Street, fate Zip ) r
c Jr�...
[/l� wn men
IX. County/Department Use Only _
Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued g �t (I ft
F Approved 13 Owner Given Initial Adverse S ° Fee) r tlp Z ST GFgfK
rs
s r Dina provsl: �� �lWFlfiit3FFlGt: q_
e
Z 5 a ':
s �...
SBD -6398 (R 07 ^
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Sanitary Permii Application Safety & Buildings Division
- ` In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave.
See reverse side for instructions for completing this application PO Box 7302
Vi SeonSin Madison, WI 53707 -7302
Personal information you provide may be used for secondary purposes
Department of Commerce (Submit completed form to county if not
[Privacy Law, s. 15.04(1)(m)j
state owned.)
Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size.
County State Sam Permit Number ❑ Check if revision to previous application State Plan I. D. Number
S 6 k 1 JW3 96 C,
I. Application Information - Please Print all Information Location:
Property Owner Name Property Location
617 ��f (? d; e 1/4 �g/4, S 7 L;, ,N, R� A (,
Property Owner's Mailing Addrifss Lot Number Block Number
Cl S 3
Ci State Zip Code Phone Number Subdivision Name or CSM Number
II. Type of Building: (check one) ❑ City
)' 1 or 2 Family Dwelling - No. of Bedrooms :JY ❑ Village
❑Public /Commercial (describe use):_
own of
❑ State -Owned
Nearest Road'
f � �J
-S K 2S � dos Parcel Tax Number(s)
III. Type of Permit: (Check only one box on line A. Check box on line B if applicable)
A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to
System System Tank Only Existing System
B) Permit Number Date Issued
❑ A Sanitary Permit was previously issued
IV. Type of POWT System: (Check all that apply)
❑ Non - pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland
❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line
At- rade ✓3..rC..S Aero is Treatment Unit ❑Recirculating ❑Other: /� n
�- f�
V. Dispersal/Treatment Area Information:
1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application, 5. Percolation Rate 6. System Elevation 7. Final Grade
Required Proposed Rate (Gals. /day /s . ft. (Min. /inch) Elevation
VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks Con- Con- glass
New Existing crete structed
Tanks Tanks
❑ ❑ 1 ❑ ❑
VIII. Responsibility Statement
I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (print) Plum - MP/MPRS No. Business Phone Number
2
Plumber's Address (Street, City, State, Zip Code)
!
IX. County/Department Use Only --
r �.. 7
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued t g 1�ge�t Sip re E ps)
Approved ❑ Owner Given Initial Adverse Surcharge Fee) 00 CIf
Determination 19 ��. 2 , ST d"
X. Conditions of Approval /Reasons fpr Disapproval: .� .. O 5
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pwaent alopr, eesls ar dlmens eestlen and dletanas to ne•nst rood.
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HOLLISTER'S BOIL TESTING
� Mary Jo HoUbtes
W9875' (AO`A Avenue
River Falls, Ali 54022
(715) 496 -1775
Date
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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page ot4L
Division of Safety.and Buildings
in accordance with Comm 85, Wis. Adm. Code
County
Attach complete site plan on paper not less than 8 1/2 x 11 inches In size. Plan must
Include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information. R viewed by Date
Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). M . ` !-M
Property Owner Property Location
CfAl\RLE5 S. 0001( 6eek - tt3f N� 1l4 ML - 114 S 17 T ZF� N R 19 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
1 ) 1 960 A16CR lEeA) ST, AE SUUT'E foo 3'7 — FAaLei3LLL�
City State Zip Code Phone Number ❑ City El Village - 91 Town Nearest Road
13L.A1 A) E I A W ISSq4q 1 (: b - 757- 7540g TIZO fiawntSVRt.LY- RP,
New Construction Use: P1 Residential / Number of bedrooms 4 Code derived design (low fate (00 a i �i�' G PD
❑ Replacement ❑ Public or commercial - Describe:
Parent material Srk Flood Plain elevation if applicable r y ` , A ft.
General comments 2TKv, ! I 1 FCEIVE� \
and recommendations: 5\15TeM T--Lj=V," 0" g f i
tiwV 0 7 2aoo
ST
Boring ZONING ,
g # = ,r•. oFS ,�r r
® Pit Ground surface elev. q 34 - 2 - ft. Depth to limiting factor 7 8 0 ' in. �� _Foil A Rife
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary I G
Fi 0
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. yEffffl - Eff #2
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5 27 -50 �,�ti 4/ 1 -s - 6.11 0,9
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5 Boring # 11 Boring
1,31 pit Ground surface elev. Q36,12 ft. Depth to limiting factor 7 7$ • in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft=
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Effluent #1 = BOD > 30 220 mg/L and TSS >30 150 mg/L 'Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) ature _ CST Number
M AM, JQ Hor_u5TE;K 2Z4g3Z
Address Date Evaluation Conducted Telephone Number
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Property Owner , COO K. C -MAKLe 5 Parcel ID # _ __ Page Z of
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Soil Application Rate
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In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777.
SBD-8330 (R.6 /00)
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x Private Onsite Wastewater Treatment System Management Plan
Septic Tank And Gravity In- Ground Soil Absorption Component
Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment
System (POWTS) shall include information and procedures for maintaining the system within
the parameters of Comm 83 and 84, and the conditions of approval by the department, agent,
or governmental unit. The approved plans and permits for system are on file at the county
zoning or health department.
This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground
Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD-
10567-P (R.6/99).
Table 1: System Design Specifications
Sanitary Permit Number
Number of Bedrooms
Design Flow - Peak (gpd) �p
Estimated Flow - Average (gpd) ob
Septic Tank Capacity (gal) E
Soil Absorption Component Size (ft
Type of Wastewater Domestic
Table 2: Soil Absorption Component - Limits of Reliable Operation
Septic Tank Component Soil Absorption Component
Design Flow - Peak (gpd) Z SIDG 9
Maximum Influent Particle Size (in) 1/8
Maximum BOD (mg /L) 220
Maximum TSS (mg /L) 150
Table 3: Maintenance Schedule
Septic Tank Inspect and /or service once every 3 years
Outlet Filter Inspect once a year and clean at least once every 3 years
Soil Absorption Component Inspect once every 3 years
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks
under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with
NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease
Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable
Restrooms).
The operating condition of the sepf nk and outlet filter shall be assessed at least
once every 3 years by inspection. Th outlet fi r sha cleaned as necessary ty re
pro eti. The filter cartridge shiou not be removed unless provisions are made to
retain the tank that may slough off the filter when removed from its enclosure. If the
r
r.' Management Plan for a Septic Tank and Soil Absorption Component
filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously.
Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The
septic tank shall have its contents removed when the volume of scum and sludge in the tank
exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the
time of an assessment, maintenance personnel shall advise the owner of when the next service
needs to be performed to maintain less than maximum scum and sludge accumulation in the
tank.
Manhole risers, access risers and covers should be inspected for water tightness and
soundness. Access openings used for service and assessment shall be sealed watertight upon
the completion of service. Any opening deemed unsound, defective, or subject to failure must
be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by
an effective locking device to prevent accidental or unauthorized entry into the tank.
No one should enter a septic or other treatment or holding tank for
any reason without being in full compliance with OSHA standards for
entering a confined space. The atmosphere within the septic or other
treatment of holding tank may contain lethal gases, and rescue of a
person from the interior of the tank may be difficult or impossible.
Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the
tank is no longer used as a POWTS component.
Soil Absorption Component
The soil absorption component serving this structure is designed to accept domestic
wastewater from a residential facility. The limits of operation of this component are shown in
Table 2.
The longevity of a soil absorption component depends greatly on proper and timely
maintenance, and system use within or below the limits of reliable operation. Good water
conservation practices by all occupants and the installation of water conserving plumbing
fixtures are key factors in extending the useful life of this component.
The soil absorption component's operation must be assessed by inspection at least
once every three years. The inspection shall include recording the levels of ponding, if any, in
the observation pipes, and a visual inspection for any evidence of surface seepage or discharge
from the component. On steeply sloping sites, areas of erosion should be identified and
reported to the owner for repair. The surface discharge of domestic wastewater or sewage
from the system is prohibited and considered a human health hazard.
Traffic around or over the soil absorption component should be avoided particularly
during winter months. The compaction or removal of snow cover over the component may lead
to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or
impossible to repair until weather conditions improve. In general, soil compaction over this
component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to
more intense, and earlier, organic clogging of the soil.
2
' 1
T
w Management Plan for a Septic Tank and Soil Absorption Component
Plantings of deep- rooted trees and shrubs directly over or within ten feet of the
component should be avoided since root intrusion into the component may obstruct wastewater
flow.
3
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT i
AND
OWNERSHIP CERTIFICATION FORM 1
Ownermuyer 7 v
Mailing Address / 5� 19 &�0 fY f 5 fc �/0 U
Property Address
(Verification required from Planning Department for new construction) -
City/State 7rr S�, !k /.5 Mn6 ///7 Parcel Identification Number C Y 6 163 71 60
LEGAL DESCRIPTION
Property Location 9 C %., C '/4, Sec., N -RLft—W, Town of
Subdivision �aG1 f F /31 L r { "f . Lot # 3 7
7
Certified Survey Map # Volume . .Page #
Warranty Deed # Volume . Page #
Spec house 0 yes ❑ no Lot lines identifiable (*yes ❑ no
SYS'MM MAIN7''ENANCE
Improper use and maintenanceof your septic system could result in its premature failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system,
The property owner agrees to submit to St. Croix Zoning Department a certification foam, 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.
Uwe, 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 year expiration date.
SIGNATURE OF APPLICANT DATE
OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the best offmy (our) knowledge. I (we) am (are) the owner(s) of
the property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
SIGNATURE OF APPLICANT DATE
« « « « «« Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * **
«« f Deeds office
Include with this application: a stamped warranty deed from the Register o
a copy of the certified survey map if reference is made in the warranty deed
CONTINENTAL DEV CORP TEL NO.757 -2532 Sep 07, >O 23:05 P.02
• ST CROIX coura Y
' SEPTIC TANK MA1NMANC16 AGREBkMT
AND
OWNLwRSH[P CERTIFICATION FORM
Owlter/Buycr _ Y_.. U,f'.k, F'',DIJ�'Y fJOY�
Mailing Address // �� � � ? /' ' '��..-7 c�YP,�7' . OG? //2c.
/) /)1v' 41q
Property Address
(verification required from Planning DopltbtttcUt l+ot ttew gonMt '►
C,ty/State [.� Parcel Identification NumbCW QqQ — /0
AL DESQUI TH N
Property Location _ ....... K. Sec. _ , T ^ Town of _
Subdivision &eZ fr : • 1 f - f Lot # J ., f
CertWied Survey Mnp It , Volume . .Page 0
Warranty Decd # , Volume Page #
Spec house 1� yet; U no Lot lines identifiable byes t7 no
L 1 5 XSTEM MA)N'j'plNAN
Improper use and maintcwmceof your septic system could tmsult in its prematurer failureto handle wastes. Proper maintenance
consists of pumping out tic septic tank every three yom or sooner. if needed by a licensed pumper. What you put into the bystuu►
can affect the Amcdon of the septic tank as a treatment stage in the wvasto dispose! system.
The property owner agues to submit to St. Oubt Zoning Doparlmant a cett3 MUM form. aygtaed by d owner mud by a
liuwwplumber. journeynuvt plwnbcr, wAtrietedplumbcrr or a licensod pungm v ffyfng plat (1) We o"to wasumaterdisposal system
is in proper operating condition and/or (2) after inspection and pumping (if neoMMY). foe septic talc is lees than 113 toll of sludge.
Ihve, the undersigned have read the above tequairaments and agree to maintain to private sewvage disposal system with the stuadards
set forth, herein, as set by the Department of Commerce and the Depo mesa of Natuml Rosman% Stilts of Wlisconsin. Certification
stating that your septic system. has been maintained must be completed and rearmed to 6e St. 401u County Zoning Office witbin 34
days of the three year expiration date.
sIGNAlURH 0V APPLICANT DATE
QVYNER. CL+'RTIMICA]
I (we) certify that all statements on this form are true to the best ofiaty (our) knowledge. I (we) art► (arc) the owne'(s) of
the property descn1W above, by vittoc of a warranty deed recorded In Register of Deeds 001ce.
MNATURI3 OF APPLICANT iDATL
I
•• «aa* Any information that is mks- represented may nsull in the sanitary permit being wvolmd by rite Zoning Depa=cat. * �• ""
Include with tWs application: a sranyred warranty deed fiom the RagisW of Doeds office
a copy of the catitlod ttttrvey map C t'etlltem is am$* in tad wanmty flood
I
CONTINENTAL DEV CORP TEL NO.757 -2532 Sep 07, >O 23:04 P.01
• ' CONTINENTAL DEVELOPMENT CORPORATION
r
'
11 AhPrdaen Street NE - Sulte' 100 - 9laine, AN F5'440.
Prune (763) 757 -7568 -• Fax (763) 757 -2532
Total Number of Pages (Including this Sheet):_
FAX COVER SWE
DATE:
TO:
COMPANY NAME::
FAX NUMBER:___,
FROM:_1 /11t !I
RE: � 7
__...? / A,
COPY TO FOLLOW BY U.S. MAIL: $YES __
COMMENTS:
Tee e f%
CONTINENTAL DEV CORP TEL NO.757 -2532 Sep 07.'0 23 :01Z r.0
ST MOM COUNTY
' SL'Y'Y IC TANK MAMBNAM AGREBMBN
AND
OWNERSHIP CE RTMAXION POW
owner /Buyer V
Mailing Address
Proporty Addi=s ✓
(Vedfieation required froaa Planning Dopa went tot pew Coaartrod* �-
city/State Perm) Ideatificaftn Numbs oqp — /A7 92Q
ZF.C.S
property Location / Y Y., % <, Sec. � 7 . T t L..L_ • Tnm of 4 . _ -
Subt ivision e- ._ . �,ot #
CertMod Survey Map # _ _ . Volume .pap #
Warranty Deed # K 3 Volume Page #
Spec house 0 yes U Ile Lot lines identifiable 9 665 ❑ no
SYSTEM MAlN77NANt'K
Improper use and anainwitance of your septic system could result in is pmutwe ham to dodk wastes. Proper artainteverm
oonsists of pumping out (lie septic tank every three yeah or sooner, if needed by a heoundpumpa. What YOU Put into the systenp
era affect the function of the tt oc tank as a ftamwat stage in the waste 415pooal systoett-
IU property owner agleas ro submit to SL 0soix Toning Deparlmmt a oeMadOu tam dpod by die owner and by a
.cite wastewater t systau
lumber oatrtc n ( umber, rescictcdplumbrxoratiee�aedpum�petvetflYloBthat (1)tbeon �a
mas�tCrp .J ra r t;.
1/3 full of sl
is in ptoptr operating condition and/or (2) alter won and pumping (if aooessaty), fine aP� 0& is less own adB
Uwe, !tie undersigned have rsmd the above requirements and agm a to m>tuftin the Pdvate *NOV dioposd. systma with the sb udarda
s set b the l. tuna of kMnmcwc and the of Mvxd Rosaaoeti. Stave of W'swndu ondfl dou
lid f hctrin, a I
orth, y �
stating oat your septic system has been naintamcd atast be completed and teanaaod to tiro SL Circlet Comity Zoning Onion wittdn 30
days of dic pious year expiration date.
D
SIGNA'IU" OF APPLICANT
OWNER. (:]t;R'I11t1CATIQN
I (we) certify that all statements on this form ate true to the beet QVM (out) I (WO) am (�) thO ownet(s) of
the property described above, by virtue of a warranty deed tecotded in Regisloe of Do$& Of ft.
SIONAlUR1? 01" Al'1'UC:AN'l' DATE
0 Any information that is nits- repceseatodmay taestrtit Into saiaifatp PVVxdt beh18
lQ1/dMd by *c Z*n'ag Department• •H�••
•• Include Mth this application: a smanWed warranty dead Atom the Reglt W of Dw& 091100 _ a copy of the cettined survey Mp.if tefbt+aaoe is node in &:* ouranty deed
1
• VUL 1589PAGE 486
STATE BAR OF WISCONSIN FORM 11 - 1982 I&389�6
LAND CONTRACT KATHLEEN H. WALSH
' Individual and Co W HERE
525, 00015 FINAN REGISTER OF DEEDS
FINA AND IN OTHER NON-CONSUMER ST. CROIX CO., WI
DOCUMENT NO. ACT TRANSACTIONS)
RECEIVED FOR RECORD
Contract by and between ARTHUR N. AND MARILYN E. 02 - 21 - 2001 10:30 AM
F EYEREISEN,TRI)'STEES OF TH Y FEYEREISEN REVOCABLE TRUST LARD CONTRACT
( "Vendor ", EXEMPT b
whether one or more) and TROY DEVELOPMENT CORPORATION GERI COPY FEE:
COPY FEE:
TMFER FEE: 3051.60
( "Purchaser ", whether one or more). RECORDING FEE: 14.00
Vendor sells and agrees to convey to Purchaser, upon the prompt and full performance PAGES: 3
of this contract by Purchaser, the following property, together with the rents, profits,
futures and other appurtenant interests (all called the "Property "), in
ST. CROIX County, State of Wisconsin:
THIS SPACE RESERVED FOR RECORDING DATA
S� OF S� OF SEA OF SECTION 8, TOWTNSHIP 28 NORTH, RANGE 19 NAME AND RETURN ADDRESS
WEST, ST. CROIX COUNTY, WISCONSIN EXCEPT LOT 1 OF CERTIFIED
SURVEY MAP IN VOL. 9, PAGE 2613, DOC. NO. 498385 AND EXCEPT H Y OD & CA RI, S.C.
PART TO GARY W. FEYEREISEN AND RONDI A. FEYEREISEN IN VOL. 2 LOCUST STREET, BOX 125
1375, PAGE 153, DOC. NO. 591110 AND EXCEPT PART TO JOHN R. H ON, WI 54016
KRAUSE AND JODELL M. KRAUSE AS DESCRIBED IN Q� 711' /`�`,�
EXHIBIT "A" !Z 7Y� Co r, (Z.
, 040- 2037 -60 -000; 040 - 1065 -60 -000
NWT OF NW'k OF SECTION 16, TOWNSHIP 28 NORTH, RANGE 19 040- 1067 -10 -000: 040 - 103 -80 -000
WEST, ST. CROIX COUNTY, WISCONSIN PARCEL IDENTIFICATION NUMBER 040 - 1067 -40
N% OF NE% OF SECTION 17, TOWNSHIP 28 NORTH, RANGE 19 WEST, ST. CROIX COUNTY, WISCONSIN
EXCEPT PART TO ERVIN F. AND CRYSTAL G. REGELIN IN VOL. 439, PAGE 60; AND EXCEPT PARTS TO
DOUGLAS AND SUZANNE CALDWELL IN VOL. 490, PAGE 232, IN VOL. 515, PAGE 437 AND IN VOL. 581,
PAGE 18; AND EXCEPT PART TO DAVID L. AND HELGA G. CROSS IN VOL. 468, PAGE 452; AND EXCEPT
PART TO ROBERT W. AND JUDITH A. TELLANDER IN VOL. 515, PAGE 435; AND EXCEPT PART TO STEVEN
ARTHUR RINTA AND CHERYL ANN RINTA IN VOL. 788, PAGE 122; AND EXCEPT LOT 1 OF CERTIFIED
This IS NOT homestead property. SURVEY MAP IN VOL. 6, PAGE 1564 AND EXCEPT PART TO
`' — ' o TT t) �j� C! fc JOHN R. KRAUSE AND JODELL M. KRAUSE AS DESCRIBED
Purchaser agreesxo pBur tie Prooperty aNd to pay to Vendor at SUCH PLACE AS VENDOR DESIGNATES
the sum of 8 1,017,200.00 in the following manner: (a) $ 220,000.00
at the execution of this Contract; and (b) the balance of $ _ 797, 200.00 , together with interest from date
hereof on the balance outstanding from time to time at the rate of 9% percent per annum until paid in full, as follows:
THE BALANCE OF $797,200.00 SHALL BE PAID IN ANNUAL INSTALLMENTS OF $159,440.00 PRINCIPAL
PLUS ACCRUED INTEREST AT THE RATE OF 9% PER ANNUM PAYABLE ONE YEAR FROM THE DATE OF
CLOSING AND CONTINUING ON THE SAME DAY OF EACH SUCCEEDING YEAR UNTIL THE FIFTH
ANNIVERSARY OF THE CLOSING WHEN THE ENTIRE UNPAID BALANCE SHALL BE PAID IN FULL. ALL
PAYMENTS SHALL BE APPLIED FIRST TO ACCRUED INTEREST AND THEN TO REDUCE PRINCIPAL. IN THE
EVENT BUYER'S PRINCIPAL PAYMENTS FOR ANY ONE YEAR PAYMENT PERIOD EXCEED $159,440.00, THE
AMOUNT OIF SUCH EXCESS SHALL BE CREDITED TOWARD THE PRINCIPAL PAYMENT DUE THE FOLLOWING
YEAR.
Provided, however, the entire outstanding balance shall be paid in full on or before the 28TH day of DECEMBER
XUf maturity date).
Following any default in payment, interest shall accrue at the rate of 9 % per annum on the entire amount in default (which shall
include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance
Po y P P )
� t �mC �ntctraatEd 3 t , �p�at��3' x�dG� p�x8i 3xOtC [hdTtuotki}�[atatanxto3�ta:aesC �LC[I
�saxflx �xani>c ocxx3amx�o�c�xl�cisvrera�2��cxlxc�sc :�reesza2�t}rtgay�rseamsxaT�e�e
t �# 2evtl wxmxxecmr�hgximtY® odmadt ®cxlFTagcecica®csmt�lEema� itxueecraexmftioasRepo�SCert�x 2cuasc+teaac
k70s� RK9t4i1 �Ixevlt beecc�3d�xanh xsctla3tarwiatTa9Y�
Payments shall be applied first to interest on the unpaid balance at the rate specified and [hen to principal. Any amount may be prepaid
without premium or fee upon principal at any time A( kX Xxxxxxxxxxxxxxxxxxx ) , 5 WxxxgMlMY&�WJFWY4gfYe YAM*KK
2f: 9f2pR441t9a1nn2aft5�arttdpixFCx
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:
NONE
Purchaser agrees to pay the cost of future title evidence. if title evidence is in the form of an abstract, it shall he retained by Vendor until
the full purchase price is paid.
Purchaser shall be entitled to take possession of the Property on THE DATE OF EXECUTION 19 THI CONTRACT
Cross Ou, One,
STATE BAR OF WISCONSIN Wisconsin Legal Blank Co.. Inc.
LAND CONTRACT - Individual and Corporate Form No. 11 - 1982 Mitsaukee, Wis.
VOL 1589 487
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, exted�� ��Ipe
and such other hazards as Vendor may require, without co- insurance, through insurers approved by Vendor, in the sum of)
but Vendor shall not require coverage in an amount more than the balance owed under this Contract. Purchaser shall pay the insurance premium
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 r `p
regulations affecting the Property.
Vendor agrees that in case the purchase price with interest and other moneys shall be fully paid and all c ditto s shall be fully performed Q
at the times and nand in the manner above specified,Vendor will on demand, execute and deliver to the Purchaser, a. Pd, in fee simple, of
the EA5E NT ree COVENANTS s and e RESTRICTIONg 0 1 REDS n�umbrances c reated by the act or default of Purchaser, and except: VV
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 Vendors 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 (it) Vendor may sue for specific performance of this Contract to compel immediate and full payment on
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 safe 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 -
tide 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), (if) 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 tide 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 to
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 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 amount then due under this
Contract Purchaser may make 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 other subsequent or prior default of Purchase.
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) THE UNDERSIGNED DOES HEREBY
28TH DECEMBER 2000 PERSONALLY GUARANTEE
Dated this day of Yq PERFORMANCE OF ALL OBLIGATIONS
OF TROY DEVELOPMENT
/1 CORPORATION UNDER THIS
a i v u.�/ lei ,✓ (SEAL) I r �°" -`'� (SEAL)
ARTHUR N. FRYFRF.TS .N. TRUSTEE CHARLES S. COOK.GUARANTOR
���� (SEAL) (SEAL)
�RILYN E. FEYER SEN, TRUSTEE � L EFROE86F , JON BY:
*
CONTRWM, INCLUDING BUT NOT LIMITED TO, ALL PAYMENTS DUE THE VENDORS NOW OR IN THE FUTURE,
** See attached Addendum for additional terms.
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) o A r7Tiu.r N � F pyer else.n , State of Wisconsin,
ss.
a6" C. FBuee r,jSen .todelt L&L 6ok County
n p •� �
authenticated this p L day of %leC2M 6 f/( Personally came before me this day of
19_, the above named
TITLE: MEMBER STATE BAR CAVISCONMN
(if not, _
authorized by ¢706.06, Wis. Stats.) to me known to be the person who executed the foregoing
instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY
H EYWOOD & C ARI, S.C. SAMUEL R. CARI
2 04 LOCUST STREET, BOX 125, HUDSON, WI 5 4016 Notary Public, County, Wis.
(Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If not, state expiration date:
necessary) 19 J
• Names of persons signtng in any capacity should be typed or printetf below their signatures.
LAND CONTRACT - Individual and Corporate - State Bar ,� Wcanstd, Form No., if - 1982
t
. 1589PAQ 491
STATE BAR OF WISCONSIN FORM 7 - 1998 6.35939
TRUSTEE'S DEED K ATHLEEN H. WALSH
REGISTER OF DEEDS
• ST. CROIX CO., WI
Document Number
RECEIVED FOR RECORD
ARTHUR N. A ND MARILYN E. FEYEREISEN 02- 21-2001 10.30 AN
- -- - -- - TRUSTEES DEED
_ __ as Trustee of EXEMPT 6 17
T HE FEYEREISEN REVOCA TRUST CERT COPY FEE:
C0P1' FEE:
TRANSFER FEE:
-- — — RECORDING FEE: 10.00
for a valuable consideration conveys without warranty to
TROY DEVELOPMENT PAGES: 1
CORPORATION
Records 9 Arc a
Grantee.
the following described real estate in ST. CROIX County Name and Return Address
State of Wisconsin: T 0 DEVELOPMENT CORPORATION
12VOI CENTERAL AVENUE
ALL OF OUTL BL INE, MN 55304
2, 3, 4, 5, and 6, AND LOTS 2, 3, 4, and
10 OF THE PLAT OF EAGLE BLUFF, TOWN OF TROY, ST. CROIX
COUNTY, WISCONSIN.
EXCEPT THOSE PORTIONS OF THE FOREGOING PROPERTY THAT 040 - 1037 - -000 040 - 1065 -60 -000
0 40 - 1067- 1
ARE WITHIN THE LEGAL DESCRIPTION CONTAINED IN THAT iou 040- 1037 -80 -000
CERTAIN DEED FROM GARY W. FEYE EISEN AND RONDI A. Parcel Identificat N umber(PIN)0 0 -
FEYEREISEN DATED i a o / VOL.
PAGE `� Q `( DOCU NT N0. RECORDED
it
is
THIS DEED IS GIVEN IN PAR IAL SATISFACTION OF THAT CERTAIN LAND CONTRACT BETWEEN THE
PARTIES DATED RECORDED ?, I- U I VOLUME /S C /
PACE �1, AS DOCUMENT NO.
Dated this 28TH day of DECEMBER 2000
1 (SEAL)
MARILYN E. FEYEREISEN • ARTHUR N. FEYEREISEN
Trustee Trustee
AUTHENTICATION r ACKNOWLEDGMENT
Signatures) ,&itN�lP. N AxC ilill State of Wisconsin,
ss.
/I R , )y N I C+ J G C C 1. ✓ County.
/r� y Personally came before me this day of
authenticated this day of R/ «' 4 � , the above named'..
TITLE: MEMBERS TE BAR 0 ISCONSIN to
(if not, _.__ me known to be the person who executed the foregoing
authorized by §706.06, Wis. Stats.) instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED By —_
HEYWOOD & CARI, S.C. SAMUEL R. CARI
204 LOCUST STREET, BOX 125, HUDSON, WI 54016 Notary Public. State of Wisconsin
My commission is permanent. (If not, state expiration date:
(Signatures may be authenticated or acknowledged. Both are not — )
necessary.)
' Names of persons signing In any capacity must be typed or printed below their st8nat ire.
STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc.
TRUSTEE'S DEED FORM No. 7 - 1998 Milwaukee. Wis.
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