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HomeMy WebLinkAbout042-1056-90-140 Parcel #: 042 08/10/2005 08:57 AM 1056 -90 -140 PAGE 1 OF 1 Alt. Parcel M 20.29.18.316C -50 042 - TOWN OF WARREN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 02/10/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - BADLANDS GOLF CORPORATION BADLANDS GOLF CORPORATION 1018 80TH AVE ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1030 80TH AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 3.110 Plat: 4700 -CSM 18 -4700 042 -04 SEC 20 T29N R18W PT SW SW & SE SW SEC 20 Block/Condo Bldg: LOT 01 & PT NW NW SEC 29 CSM 18 -4700 LOT 1 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 20- 29N -18W SW Notes: Parcel History: Date Doc # Vol /Page Type 03/03/2004 755756 2520/466 LC 02/10/2004 753832 18/4700 CSM 07/25/2001 652035 1686/609 WD 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/22/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.110 42,000 15,000 57,000 NO Totals for 2005: General Property 3.110 42,000 15,000 57,000 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 r t County'. Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 463095 0 GENERAL 1,4FORMATION (ATTACH TO PERMIT) pate Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. OS W p Z = T . /D •# Permit Holders Name: City Village X Township Parcel Tax No: Badlands Golf Course I Warren Townshi CST BM Elev: I Insp. BM Elev: I BM Description: Section/Town /Range /Map No: o ) (50.0 CST F3 vv` 20.29.18. TANK INF RMATION ELEVATION DATA TYPE MANUFACT�Fj N , J- CAPACITY STATION BS HI FS ELEV. ~/ � �• —IUD C-,�/� W Septic � Z 70 Benchmark LS / gib O � • D Dosing ` 4 Alt, BM l0 Aeration � Bldg. Sewer �(os c 7-�� Holding St/Ht Inlet O p TAN ETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic , I / Dt Bottom , 13, (P-o �r Dosing L u p t r Header /Man. ! -4o / tit, D Aeration Dist. Pipe 0 - r Holding Bot. System 2�' J 3 S -ZD 1 0 f• o' PUMP /SIPHON INFORMATION Final Grade � �U � �- fz Sep Manufacturer Demand St over GPM L-9 u Model Number TDH Lift Friction Loss System Head TDH Ft r Forcemain Length r Dia. ff Dist. to Well SOIL ABS ORPTION SYSTEM ED Width Length I No. Of Tomes- PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth TITW E _ NSIONS O 0 3 .}-- _ A SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Man rer: INFORMATION CHAMBER OR Type Off Syspem:n r C UNIT l_Y� J 1 1 0'+ 4+,t Mode ber: DISTRIBUTION SYSTEM Header /Manifold D x Hole Size / x Hole Spacing Vent to Air Intake Length 33 •Dia rr L ngth � . Dia Spacing 3 . 3 3 3 /�b 2- 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 - 111 Yes [] No [J Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 13. /4 Inspection #2: 1 / f{ Location: 1030 80th Ave. Roberts, WI 54023 (SE 1/4 SE 1/4 20 T29N R18W) NA Lott l / Parcel No: 20.29.18. 1.) Alt BM Description = t 2.) Bldg sewer length = `� - amount of cover = 3(. �� t Plan revision Required? Yes f No pGT. 1 9, Use other side for additional informa ion. SBD -6710 (R.3/97) b L - C n _ s � Insepctor s Signature Cert. No. Safety and Buildings Division Copy • ` 201 W. Washington Ave., P.O. Box 7162 i seansin Madison, "' 33794 --2162 Sanitary Permit Numbs to be fill De ardnent of Commerce (fig 266 -3 31 ° ;. Sanitary Permit Applica on° Plan ®s� In accord with Comm 83.21, Wis. Adm. Code, personal info on may be used for secondary purposes Privacy Law, s 1 1 a f ± 1 Project Address (if different than mailing address) a I. Application Information — Please Print All Information �-- ._, _ 103 ' ' Owner's Name Ar ( BaW4it4 `�„� . # Lot # Property owner's Ming Ad dress (fYi`f —''77 yq - 9 / City, Sta Zip Code Phone Number 0 e %'7 �lJ I �� �i�+ T 8 9 N; RiltE lo& ll: Type of.Bnilding (check all that apply) 1 or 2 Family Dwelling — Number of Bedrooms C 15TI CSM Number 13 Public/Commercial — Describe • T OO 3 Z I ❑ State Owned i ❑City �Village[ownshiQ of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. I ' New System Replacement System ❑ Treatmmt/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New list Previous Permit Number and Date Issued Before Expiration Plumber Owner 1V. Type of POW173 System: Check all that a ❑ Nm — Pnr w-i7M I, i3ramd in. of suitable soil 224 = of suitable soil ❑ At4h de ❑ Single Pass Send Fdte ❑ rush AV nd ) Pressurize -0n ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ p� Chamber ❑ Drip line ❑ Gr avel -less Pi ❑ Other (explain) ! f Project �4 .AA's Date . Dispersal Area Req ' (sf) Dispersal Area (sf) I System Elevation N �� 6 00 lG67 00 1 0l• ?.� t.4 Number Adab Site Steel Fiber Plastic of Units Concrete Constructed Glass e ✓ -�- - , sa po sibility for inetaWfion of the POWTS shown on the attached plans. ignature MP/MPRS Number Business Phone Number -- t Ali- e"; W rG GtfL c� �? C7 - S .� Sanitary Permit Fee (includes Grondwater Jas Si ) ? a - r rovat i , K�^►.v' �� p v� S G�.2 tom' - - -- d / maintained llpy ;d by plumber. 3 maintains - s- 5 ds U 1� o ore tl� _ wee► rr,a elm I r l &Ches in F3-33 SBD -639$ (R. 01/03) �., � i � , � I a. � � ,' . .. , ' , + .. , ', i t � .. 1 l f o 0 f > lr l� G( O u r j Q A f .A O J 0 %A - J N r+ ri 9 40 4 Cl rr CIO rr rj -4.i o � d 1 Safety and Buildings ' commerce.wi. OV 4003 N KINNEY COULEE RD g LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i scons i n www.commer isco goWsb, Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary September 15, 2004 CUST ID No. 139462 ATTN.• POWTS Inspector TODD L SINZ ZONING OFFICE T L SINZ PLUMBING INC ST CROIX COUNTY SPIA E5609 708TH AVE 1101 CARMICHAEL RD MENOMONIE WI 54751 -5520 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/15/2006 Identification Numbers Transaction ID No. 1058882 SITE: Site ID No. 689398 Gordy Perry Please refer to both identification numbers, 1030 80th Avenue above, in all correspondence with the agency. Town of Warren St Croix County SW 1/4, SW1 /4, S20, T29N, RI 8W Subdivision: CSM No. 753832, Vol. 18, Pg. 4700; lot 1 FOR: Description: Proposed Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 979969 Maintenance required; Replacement system; 600 GPD Flow rate; 21 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 101), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 /01); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD - 10691- P(N.01 /O1). • The pressure network is to be constructed in accordance with publications SBD - 10706- P(NO1 /O1) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems - Version 2.0" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/8 1)". • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided p g p g q g P per Comm 84 product approval conditions. Collclit olic l �� p k l i E�eDr..,..._ ! TODD L SINZ Page 2 9/15/2004 • Comm 83.22(7) - A copy of the approved plans specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department which may include local inspectors. Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm WiSMART code: 7633 jswim@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 Henry F Grote Ep 8 z1904 Ty e Gordy Perry - Mound Q�Dn V s D'r, Construction Materials and Techniques r All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD - 10691 -P (01 /01) Pressure Distribution, SBD- 10706 -P (01 /O1) Location: Lot 1, CSM 753832, v 18, p 4700 SW '/4, SW '/4, Sec. 20, T 29 N, R 18W Town: Warren County: St. Croix Date: September 15, 2004 Owner: Gordy Perry Address: 1028 70'' Ave. Roberts, WI 5 3 Plumber: Todd S nz Signature: — /\/ License: MP 139 2 Attachments: SBD -10577 - Plan Approval Application SBD -8330 Page 1: cover 2: design criteria & calculations 3: plot plan AND BUILDINGS 4: system cross section plVls!DN D SAVVY 5: plan view, lateral detail ON pENCE 6: pump tank exit detail SSE CORRE 7: pump curve 8: system management page 1 of 8 I Design Criteria Residential Wastewater Contaminant Load: 30 mg/L < BODS < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L Bedrooms x 100 gal/bedroom /day x 1.5 1_0 gallons /day hydraulic load Design Calculations In situ designed loading rate (9 13 6 gallons /sq. ft. per day Depth to estimated high ground water Z� in. Depth to bedrock Z. in. Cross slope at system o � % Force main length 2'D ft. of L in. Manifold /header length ft. of Z in. Drain -back 5� gallons Lateral length 3 @ S b. ° ft. of `` in. Lateral elevation ft. @ bottom of lateral Lateral hole size ���b in. in. ( 3 S� ft.) Spacing holes /lateral S holes total Lateral volume gallons Total lateral discharge rate _ S.6b gallons /minute @ 2 ' ft. head Network pressure compensation losses Elevation difference Friction loss ft. @ gallons /minute Total dynamic head \ S Z ft. Pump /si)5�on 414- gpm @ Z- ft. of head Manufacturer 0 Model # Z Dose volume gallons Lift/sioon tank wS ti za _ d w 7�_r gallons Septic tank gallons Effluent filter 0� ^co Measurement pump on and off S n in. Height alarm from tank bottom b in. Reserve capacity gallons specs.calcs.res Page Z of v J y s r-A , N (+ d ri o 4 d c47 r r Vi jo u^ � 4 � d C} K vt qJ H d v 4L CL V . 0 A 0 k�� i i i i 1 . 10.0 12,3 O• 1 OL a 1�► o +�.: `vt trv.�`S � i.�.v r►1....� Z _ ^ ° }�o r► o.� � � 4oc.� �� LLQi Mp '1 ^ +O \ 41Pnr ► \1' 1` � Z �'�V 1G LJhI//.`' l I I I P • xt� o� w,7vw.�aw ct "c I1A,N WEATNEaPRG�F LOCKING COVER JLNCTIG. Lc/Ai,'N iuG QUICK D,�CCVUCCT —� 4 � S IL � 4 �. PIPE 3 no NOISTuRbED Sol L. 24 I. D. I I c" 4c v.�- g' awaovio A 2q, co l�P-SY.E.T 3bM"J � 4 Rub P^ 4 F 1 AL I 3' DK-c a z „ Go KH E LT 10 r+.S x`- ? I, o v Cfl t 2�.o.p I `O O or r ~-O U22,•14 RA PwyP CoNt.QFT'c SEPTIC e SPECIFI'CATIOIJS 6 DOSE Tc .��' TAW M S A►JUFACTU QLIM9ER OF DOSES: TAWK SIZE : Z S� ' GALLOWS • .DOSE VOLUME r ALARh /144dUFAC7UF,LR; S `� � �v� IWCLUOING OACKFLOW: r0DCL WUP14ERC e � 1-4 `� CAPACITIES. A - 2c�' 0 11JCHC5 OK SWITCH TyP[: Q'r` "�b Z 34.14 GUMP /1A►JUFACTURCR; �OQ ov �SS,3 C • S` C) IUCHES OR ;,A MODEL WUMDCR: INLHEJ OR JWITCH TyPC: VA PUMP AWD ALARIA ARC TO DC MIWIMUM 0I5CHARU ROTC 33 '� G ►M INSTALLED OW SEPARATE CIKC� - VCRTiCAU DIFFCRCWCf DETWECW PUMP OFF AWO DISTRIbUTIOW PIPE.. ' FEET + MIQI#1 UM KJETWORK SUPPLY PRESSURE . , , , , . , . • , • 2 S� _ FCET - + FEET OF FORCE MAIN X 2._� F � �+� Z Z _ - -- IoortFRICTIO►1 FACTOR., FEET TOTAL OyWAMIC. HEAD = LS `S Z FEET IIJ IAA TERWAL DIMEW610WC OF TAWK: LEWfsTH ;WIDTH : ;LIQUID DEPTH IL 1 'r TOTAL DYNAMIC HEA6 /CAPACITY HEAD CAPACITY CURVE PER MINUTE EFFLUENT AND DEWATERING V) MODEL 152/153 w w MODEL 152 153 50 Feet Meters Col. Liters Col. Liters 153 5 1.5 69 261 77 291 12 40 152 10 3.1 61 231 70 265 0 15 4.6 53 201 61 231 = 20 6.1 44 167 52 197 30 z 8 — 25 7.6 34 129 42 159 r 30 9.1 23 87 33 25 a 20 35 10.7 -- -- 22 85 ° 40 12.2 -- -- 11 42 4 Lock V 38.0 Ft. ( 11. 6 m),44.0 Ft ( 014508 0 20 40 60 80 100 GALLONS LITERS 0 80 160 240 320 6 1/4 3 271324 5 /8y FLOW PER MINUTE - a i CONSULT FACTORY FOR SPECIAL APPLICATIONS 3 T 4 • Timed dosing panels available. e • Electrical alternators, for duplex systems, are available and supplied with 3 , 3 an alarm. 1 . • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik -Box available fo1'outdoor installations. See FM1420. • Over 130 °F. (54 °C.) special quotation required. - -' 1521153 Series 1 8 1521153 MODELS Control Selection i Mod el _ Volts-Ph Mode Amps Simplex Duplex F N152T 115 1 Non 8.5 1 2or3 BN 115 1 Auto 8.5 Included 2or3 sKZOes E t 52 230 1 Non 4.3 1 2or3 BE152 230 1 Auto 4.3 Included 2or3 N153 115 1 Non 10.5 1 2or3 BN153 115 1 Auto 10.5 Included 2or3 SELECTION GUIDE E153 230 1 Non 5.3 1 2or3 1. Single p i g gyback variable level float switch or double 1 BE 153 ! 230 1 Auto 5.3 Included 2 or 3 g P 99y piggyback variable level float switch. Refer to FM0477. O CAUTION 2. See FM0712 for correct model of Electrical Alternator E -Pak. All installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10 - 0225 used as a control activator, specify duplex (3) licensed electrician. All electrical and safety codes should be followed Including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). or (4) float System. o� RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 7 Louisville O , KY 40256 -0347 Manufacturers of . SHIP TO: 3649 Cane Run Road rip ® Louisville, KY 40111.1961 QV4L /TY PUMPS S NCE ���/�7 u (502) 778.2731. 1(800) 928 -PUMP http://www.zoeller.com FAX( © Copyright 2000 Zoeller Co. All rights reserved. System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, TL Sinz, 715- 235 -2644, or the St. Croix County Zoning Office, 715- 386 -4680, should be contacted for assistance. General Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a dose tank or compartment to allow a dose to be accumulated, a pump and controls or automatic siphon, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. 1. If the septic tank is installed prior to sheet -rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2. Install water - saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or dose tanks are no longer used, they must be properly abandoned. 11. If construction timing and weather could create a frozen infiltration system, weather - proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. 12. If possible, the upslope toe of the mound system should be landscaped with additional fill to blend this area into the upslope natural grade; this will minimize the possibility of the system trapping surface run- off; final settled slope should be 2 -3% over the system or 2 -3% diverting surface run -off around the ends of the system. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the dose tank must be pumped, and the filter must be back - washed into the septic tank to remove accumulated material. System use may require more frequent filter cleaning; initial inspections of the filter should be made every 6 months until a minimum time sequence is determined. 4. Periodic observation pipe inspections should be made by the owner to examine the state of the in -situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area. 11. Warning: Do not enter septic, dose or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and/or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM owner/Buyer Mailing Address' • � G� O � 3 '1 Property Address (Verification required from Planning Department for new construction) SR5 !�C':6' j Parcel Identification Number City/State��� LEGAL DESCRIPTION S T; ! N- VL W , Town of property Location `�4, , S ec. Lot # Subdivision � CC3Et Q DO Certified Survey Map # • - 75 73 ?'3 a , Volume Page # 14K 7 SS Volume Z 5 Page # Spec house Q yes no Lot lines identifiable yes Q no �' F P� t wastes. Proper maintenance cc 'TEM em could result in its premature Improper use and maintenance-of your tic syst if nee ded b a licensed Pumper- What you put into the system consists of pumping out the septic tank every theta years or sooner, system. can affect the function of the s eptic tank as a treatmen, . stage in the waste disposal ed b the owner and by a Departm a certification form, sign Y The property owner agrees to submit to St. Croix Zoning that that (1) the on -site wastewater disposal system masw plumber, journeyman plumber, restrictodpiumberor a licensed pun�s tic tank is less than 1/3 full of sludge . is in proper operating condition and/or (2) after inspection and pumping (if necessary), the Sep the private sewage disposal system with the standards ' Uwe the wed h read the above requirements and agree to maintain P State of Wisconsin. Certification eat of Commerce and the Department of Natural Resources, Zoning o ffi ce within 30 set forth, herein, as set by the Departm co mpleted and retuned to the St Croix County stating that your septic system has been maintained must be comp days of the three year expiration date. 423 �+\ V � � DATE SIGNATURE OF APPLICAN OWNER CERTIFICATION otu knowledge I (we) am (are) the ownerts) Of I (we) certify that all statements on this form are tune to the best of ma Dads Office. the property described above, by virtue of a warranty deed recorded in Register ;131 G/ — � ANTDATE SIGNATURE OF APPLI s s F ssasss A information that is mis- represented may result in the sanitary aermit being revoked by the Zoning Department. warranty deed from the Register of Deeds office •s include with this application: a stamped if reference is made in the warranty decd a copy of the certified survey map 1 L - RIGINAV 2089 SOI 7rpen APO T P 1 of 3 Wisconsin Department of Commerce 9 Division of Safety and Buildings in accordance with Wis. Adm. C Certified Soil Testing Attach complete site Ian on paper not less than 8'% x 11 inches in W Co tY St. Croix p p p p ; ZU include, but not limited to: vertical and horizontal reference point (Bnd percent slope, scale or dime north arrow, and location and dr er (_ 0 I Par I L D. Or OF ICE 042- 1056 -70 -115 Please print all information. ' - g G Rev' we Date Personal information you provide maybe used for secondary purposes (PrA4 (1) (m)). Property Owner //�� Property Location 42 1 Perry, Gordy CD Govt. Lot SW 1/4 SW 1/4 S 20 T 29 N R 18 W Property Owner's Mailing Address Lot # Block # Subd. Nam 1028 70th Ave 1 # 753832, V 18, P 4700 City State Zip Code Phone Number 1 City . 0 Village 0 Tow Roberts WI 1 54023 715 - 749 -41507 Warren 1 80Th Ave. _-j New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD { Replacement Public or commercial - Describe Parent material loess over till & limestone Flood plain elevation, if applicable NA General comments and recommendations: install 10'x 60 rock cell mound on 100.0 contour as upslope edge of rock w/ 1.25' sand fill a Boring # ,. Boring le Pit Ground Surface elev. 100.0 ft. Depth to limiting factor 27 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 1 0 -11 10YR 3/2 - sil 2 m sbk mvfr gs 1f /m .6 .8 2 11 -20 7.5YR 4/4 - sl 2 m sbk mfr gs 1m .6 1.0 3 20 -27 5YR 3/3 - scl 0 M mfi cs 1 m 0 0 4 27 -36 LSBR Boring # _j Boring 16 Pit Ground Surface elev. 101.4 ft. Depth to limiting factor 54 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -6 10YR 3/2 - sil 2 m sbk mvfr cs 1M .6 .8 2 6 -16 10YR 4/4 - sil 2 m sbk mvfr gs 1M .8 3 16 -29 7.5YR 4/4 - sl 1 c abk mvfr gs 1 m 4 .7 4 29 -54 7.5YR 4/4 - sl 0 m mvfr cs - .2 .6 5 54+ LSBR ' Effluent #1 = BOD 30 < 220 mg /L and TSS >30 150 mg /L • E uent #2 = BOD < 30 mg /L and TSS _< 30 mgr CST Name (Please Print) Signatu CST Number Henry F. Grote A D � 222774 Address Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 8/22/2004 715 - 233 -0398 Property Owner Perry, Gordy Parcel ID # 042 - 1056 -70 -115 Page 2 of 3 a Boring # Boring Pit Ground Surface elev. 96.8 ft. Depth to limiting factor 21 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 1 0 -9 10YR 3/2 - sil 2 If sbk mvfr gs 1 m .6 .8 2 9 -17 10YR 4/4 - sil 2 m sbk mfr gs 1m .6 .8 3 17 -21 5YR 3/3 - scl 0 m mfi cs 1 m 0 0 4 21 -26 LSBR 47 Boring # iJ Boring Pit Ground Surface elev. 98.2 ft. Depth to limiting factor 58 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -9 10YR 3/2 - sil 2 f sbk dsh gs 1M .6 .8 2 9 -17 1 OYR 4/4 - sil 2 m sbk mfr Cs 1m .6 .8 3 17 -28 7.5YR 4/4 - sl 1 m abk mfr gs if .4 .7 4 28 -42 7.5YR 4/4 - sl 0 m mfi cs .2 .6 5 42 -58 5YR 3/3 - scl 0 m mfi - - 0 0 6 58+ LSBR F-51 Boring # A Boring Pit Ground Surface elev. 102.5 ft. Depth to limiting factor 53 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -10 1 OYR 3/2 - sil 2 f sbk dsh CS 1M .6 .8 2 10 -27 1 OYR 4/4 - Sil 2 m sbk mfr Cs 1M .6 .8 3 27 -33 7.5YR 4/4 - sl 1 m abk mfr gs if .4 .7 4 33 -53 5YR 3/3 - scl 0 m mfi CS - 0 0 5 53+ LSBR ' 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) Certified Soil Testing I r { r ,�.r � 0 J � � r .r I✓1 —� cIr a v v g S 0 g c✓1 ,p�` Lt ct 9 O s ? � ) u n �- d c � o n + , �, _, d �J d f J 7 -It r-74P �J • - 7 53832 VOL PAGE 4700 HATHLM H. liALSH REGISTER OF DEEDS CERTIFIED SURVEY MAP 02 C ROIX /2 0 GO., 30 WI RECEIVED FOR RECORD 02/10/2004 09:30At! LOCATED IN PART OF THE SE7 4 OF THE SW1 /4, PA RT OF CERTIFIED SURVEY MAP THE SW OF THE SW7 /4 OF S OF THE REC FEE: 13.00 NE1 /4 OF THE NW1 /4 AND PART OF THE NW7 /4 OF THE COPY FEE: 3. 00 NW1 /4 OF SECTION 29 ALL IN T29N, R1 8W, TOWN OF PAGES: 2 ARREN, ST. URODC COUNTY, WISCONSIN. OWNER SURVEYOR RICHARD 8 MARCELLA SCHERER EDWIN C FLANUM 1050 BOTH AVENUE NORTHLAND SURVEYING INC. LEGEND ROBERTS. WI 54023 856 A HWY °65" ROBERTS, WI 54023 ALUMINUM ST. CROIX COUNTY SECTION CORNER MONUMENT FOUND i NOTE: O 1" X 24' IRON PIPE SET WEIGHING A possible violation of the St. Croix County 1.13 IBS. PER LINEAR FOOT Zoning Ordinance will be created if the existing structure located within 100 ft. of the property line ever houses livestock or poultry. • 1 5/16" 0. D. IRON PIPE FOUND • • • . . . 100' ROADWAY SETBACK LINE Q SEPTIC LOCATED BY PREVIOUS LAND OWNER APPROVED ST. CROIX COUNTY T 0 t - Plarmltt Zar&V mW Pis C:>rm� U NPL_ATE _ m m f P -r-rER I FEB 1 0 2004 p - PB — If not r ecaded within 30 days of S I approval dais apprmSf sfraii be hull one — If, N84'43'10 "E 296.76' Z N SHED Z N 'C is Iz o\ �Z p p m i Z BARN �� f i v Q � v ( m �� o \ \ m '� io ° LOT 7 �iZ ' - Eq a 3.11 ACRES N Von ' m m - T C �k 135,591 SO. FT. ,P \ AD m O j W © O m A (N V . SHEDS m S1 CC' SE TION 20 _ 0 589 °71`(x1 W 2604.24` wHOUS• I z jECTION 20 SOUTH UNE OF THE S89 1 11 1 00"W 1155.94' SWt /4 OF SECTION 20 S89 374.2 S89 1'00 1 W 1074.03 =1 a N THE ` N1/4 CORNER NW CORNER Wt /4 OF SECTION 2 SECTION 29 SECTION 29 S89 °49'30wW 270.71' S87°SS'43 "W J _ 113_84' 80TH AVENUE _UNP_L.ATTED LANDS OWNED BY OTHERS SCALE IN FEET 1" = 100' SHEET 1 OF 2 SHEETS 100 0 100 200 Vol 18 Page 4700 I Parcel #: 042 - 1056 -90 -120 10/07/2004 PAG Alt. Parcel #: 20.29.18.316C -30 042 - TOWN OF WAR Current �X ST. CROIX COUNTY, WISCONS Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): * = Current Owner * RICHARD C & MARCELLA SCHERER SCHERER, RICHARD C & MARCELLA 1050 80TH AVE ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC 1 30 d- Legal Description: Acres: 7.540 Plat: N/A -NOT AVAILABLE SEC 20 T29N R18W P Block/Condo Bldg: & PT NW NW A D Sr AS CQNW G 1/4 COR SEC 20; TH N 89 DEG W 1043.30; TH S 10 Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) DEG W 47.58' TO NLY R/W OF A TOWN RD 20- 29N -18W SW (80TH AVE) POB; TH S 88 DEG W 125.85'; TH N 89 DEG W 270.71'; TH N 01 DEG E Notes: Parcel History: Date Doc # Vol /Page Type 07/25/2001 652035 1686/609 WD 2004 SUMMARY Bill M Fair Market Value: Assessed with: 111,500 Valuations Last Changed: 07/19/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 7.540 52,700 49 500 102,200 NO Totals for 2004: General Property 7.540 52,700 49,500 102,200 Woodland 0.000 0 0 All 7.540 52,700 49,500 102,200 Totals for 2003: General Property 7.540 52,700 49,500 102,200 Woodland 0.000 0 0 Total 7.540 52,700 49,500 102,200 Lottery Credit Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount 018- RECYCLING SPECIAL ASSESSMENT 15.00 Special Assessments Special Charges Delinquent Charges Total 15.00 0.00 0.00 U 2520P 966 75`'756 KATHLEEN H. NALSH REGISTER OF DEEDS ST. CROIX Co., WI LAND CONTRACT RECEIVED FOR RECORD 03/03/2004 11:30AN Contract, by and between, Richard C. and Marcella M. Scherer, husband and wife LAND CONTRACT ( "Vendor ", whether one or more) and Badlands Golf Corporation, a Wisconsin EXEMPT # corporation ( "Purchaser ", whether one or more). Vendor sells and agrees to convey to Purchaser, upon the prompt and full performance of this contract by Purchaser, the REC FEE: 13.00 following property, together with the rents, profits, fixtures and other appurtenant COPYsFEE: 450.00 interests (all called the "Property "): CC FEE: PAGES: 2 Part of the SE 1 /4 of SW 1 /a; Part of the SW 1 /s of SW 1 /a, All in Section 20 and Part of the NE 1/ of NW 1 /; Part of the NW 1/ of NW 1 /a, All in section 29, Township 29 , Range 18 West, St. Croix County, Wisconsin, described as follows: of Certified Survey Map filed February 10, 2004 i Vol. 18, Page 4700, Doc. o. 753832. PIN 042- 1056 -70 -115, 042 - 1056 -80- 000, 042- 1056 -90 -000, 042- 1056 -90 -120 This is not homestead property Purchaser agrees to purchase the Property and to pay to Vendor at 1050 -80"' Avenue, Roberts WI 54023 the sum of $150,000 in the following manner: (a) earnest money of $58,045.99, (b) additional earnest money of $10,000 at the execution of this contract, (c) $30,000 not later than June 30, 2004, and (d) the balance of $51,954.01 without interest not later than June 30, 2005. Amounts payable to Vendor at the time of execution of this contract and at the time of final payment shall be net of Vendor's mortgage balances, deductions and closing costs. Following any default in payment, interest shall accrue at the rate of 6% 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 agrees to pay annual taxes accruing after January 1, 2004. There may be no prepayment of principal without permission of Vendor. Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination. Purchaser agrees to pay the cost of future title evidence. Purchaser has taken possession of the Property. 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 an amount at least equal to 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. 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 l U. 2520 P 967 . 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. 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 a month 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 a month 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: (1) 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 Purchasers full payment of the entire outstanding balance 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 (2) Vendor may sue for specific performance of this Contract to compel immediate and full payment on the entire outstanding balance, with other amounts due hereunder, in which event the Property shall be auctioned at judicial sale and Purchaser shall be liable for any deficiency; or (3) Vendor may sue at law for the entire unpaid purchase price or any portion thereof; or (4) Vendor may declare this Contract at an end and remove this Contract as a cloud on tale in a quiet title action if the equitable interest of Purchaser is insignificant; and (5) 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 (1), (2) or (4) 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 to a receiver of the Property 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 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. 2004 I t A " - (SEALj��'L L) and C. Scherer Marcella M. Scherer Badlands Golf Corporation By Gordon F. Pent', President - F ` (SEAL) ACKNOWLEDGMENT State of Wisconsin) 0 St. Croix County) SS Personally came before me on . e& 1 _ 3 , 2004 the above -named Richard C. Scherer, Marcella M. Scherer and Gordon F. Perry, to me known to be the persons who executed the foregoing instrument and acknowledged the same. Roper D. Severs /� Notary Publi b � kti�#d imires M4 510 *44 O � A WA l State of Wisconsin Drafted by C. W. Malick 2 l