Loading...
HomeMy WebLinkAbout020-1308-70-000 n CA o\ 3- 0 tz B % \ \ R a /�\ � . � . _ / / f z { o § < \ 12 0 / o , C: , � . \ . @ 2 / \ E + § \ \ 0) § { G ° CD / \ § / ƒ \ % \ $ ƒ 8 E 2\ a ' , : D ' I\ 2 i) Q g E ƒ >a =0 E (A _ \ a G & �§ §\ ; \ / / 0 0 \ \ \ : £ \ ¥ ~ . / ) k � § Q c 0 0 \ \ 0 0 0 \ \ , 9 g ■ U � CD 01 � R % / ` R . . . A / 0 R } @ 7 9 / § ) � { § §\ — , — « / § $ . z 0 . 0 2 \ \ g E 7 \ / . � { ) r � \ CD k z a \ 0 CD ) / « } k \ zb: $ $ CD C M a 2 CL 0 ( $ 5 f y 41 2 < ± \ } £ \ 0 % { 0 \ ƒ . � ® � \ � j \ ° @ / < 7 f o , R E 7 Wisconsin Department of Industry $OIL AND SITE EVALUATION REPORT p � 3 ' Labor and Human Relations Division of safety a Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D.8 dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION 1 E'. 4VA X oN GOVT. LOT WEST SE 1 /4,S 4, T 2 9 ,NCR- I q E PROPERTY OWNER' :S MAULING ADDRESS LOT # BLOCK i SU80. NAME OR CSM t 5 9 cT • 'RD . A 7 P IVrSAt-ST UtEc 3 CITY, STATE ZIP CODE PHONE NUMBER ociTY QVILIAGE OWN NEAREST RpOpQpp vOSo� outs . sva /c. (7i5) 396 HuoSo,J a r y. RP + 1-fNew Construction Use ( Residential / Number of bedrooms 3 y [ J Addition to existing buildling () Replacement (J Public or commercial describe YSo- Code derived daily flow &cv gpd Recommended design loading rate bed, gpd$ � tench, gpd10 Absorption area required bed, ft trench, ft Maximum design loading rate • r bed, gpd/ft •8 tench, W Recommended infiltration surface elevation(s) 5.e? .3 ft (as referred to site plan benchmark) Additional design/ site considerations S lop-e — �q! /o tr> Co�7a v�p Parent material ScS Flood plain elevation, if applicable N ft S - Suitable for system C MOUND —/ IN- GROUND PRESSURE AT -GRADE SYS FILL HOLDING TAW U = Unsuitable for system I CC'S O U I [IS L7U C$S ❑ U ❑ S CC 0 U ❑ S i=j(C0.S _1V ,,c SOIL DESCRIPTION REPORT �t� ESS�oF S /off_ Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. _ terdt io z// S Q°�2 Cs 3 - F .'7 Ground j -/r 1p /t G •S• • S G�ie �" • 7 •8 elev. fao..6 ft• Depth to limiting facfor Remarks: Boring # S 3 •7 ! z z ( -/ f o yg 4�k C S •"7 •� Ground 3 /O Ji' �r C ©,S' G�� • d elev. 7- YO fG Depth to limiting > f actor Remarks: CST Name.— Please Print Ro oea r -u L e R i C k T Phone: 71 3 AM - �9 185 Add ress: (0 �' Nei L 'R D. t+ W I S . St4o/ s'/ .2r/ cSrA 2 S L Signature: Date: CST Number: J t 7 ThlS test site AP PROVED fora convention P YS O R I GINAL w PROPERTY OWNER U'eoo ' SOIL DESCRIPTION REPORT Page? of - PARCELIA t L �� 7 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /f B t in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. � rends 0 -g /b v e t 7 ' 5 O S d_,O C f -• 7 2 3 /6 /o � y G y �y 3 y also- Cs — Y - S Ground 3 -f/0 *7. YR `v6e S a, S dk CS • 7 •0 /0 1 2. 1 It p /6 /e s/ �S �, s d� - •� Depth to = limiting factor Remarks: Boring # / p -Co /D V/ fV /� 75,6i� G�S CS 3 'F � •S I 2 - /Z 7.SV , es ; .8 3 -� /o Y,� sly c s. o, s �� ! • �' Ground elev. i /o 3 .2 � It Depth to l limiting . facto .� � 4 Remarks: Boring # O /() /O WZ CS 3 f S O C' 7 o- 7.s •s. ,s � s , -� .� YAP !4 .2 Ground elev. Depth to limiting factor Remarks: Boring # t i Ground —' — elev.. ft Depth to limiting factor Remarks: con 000^10 ncrnrn U�• cT— o R � r xZ • '?� (. w NN L V\ vi '1 ID V% c w --1 m 4 - rD L o c co �, D� m w rn c- m , c Ri f m o G d < 6 ` ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT FECE �( Owner City/State � / Address N �' $ yl�/ ' d / 6 � ST CROIX r' S� COUNTY Legal Description ZONING OFFICE �� Lot � Block Subdivision/9W # C Z LtZ /., Sec./ , T,2fN -R/ Town of PIN # G� SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer Size ST/PC / Setback from: House Q 2,fWeIL oL /L , Pump manufacturer Model— ' Alarm location (HOLDING TANKS ONLY) Setbacks: road Vent to fresh air intake Wat 'ne Meter location Alarm lo cation ___- -- SOIL ABSORPTION SYSTEM Type of system: Width Length �� Number of Trenches Setback from: House /�_ W 11 �." PAL 3O Vent to fresh air intake mgW ELEVATIONS Description of benchmark �Gt�.� /22 Elevation Description of alternate benchmark a-.de i Elevation Building Sewer ST/HT Inlet ST Outlet- PC Inlet PC Bottom Header/Manifold Top of ST/PC Manhole Cover Distribution Lines () () ( ) Bottom of System Final Grade Date of installation .J / umber State plan number t Plumber's signature License number 3 - Date) / / 9T Inspector Complete plot plan or NOTICE Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW NO X10 ,j vP,vf I� 55 I 3� o � 3b D Z od. 50 ti S W cvt INDICATE N RTH ARROW NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW NO �1o � vP�zf I 56 1 ' G 3b D Z 0d B OV 50 �f v lvc�a�th., INDICATE N RTH ARROW Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County SafQy an8 Buildings Division INSPECTION REPORT Sk cf6, x GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No -: Personal information you provice may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.: Gc S CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: ' moo- I -7o TANK INFORMATION ELEVATi6N DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Benchmark 2 75 Dosing Aeration Bldg. Sewer ?') ,�J C 3� Holding Inlet pZ' '3 S.7( TANK SETBACK INFORMATION (3P IWoutlet L , 3� C? TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Zy NA Dt Bottom r Dosing Y NA Header /Man. (���(- ��.3� Aeration - NA Dist. Pipe (0.7o qG cog Holding Bot. System 775 9S. 0 =�� i r PUMP/ SIPHON INFORMATION Final Grade 47 7 92'.0) Manufacturer [ /Demand c �� a �3 l (-D•OS Model N er GPM TDH Li Friction S m 61H_ Ft Forcemain Length Dia. Dist. To well SOIL ABSORPTION SYSTEM (gW TRENCH Width Length ' r No. Of Trenches PIT No. Of Pits Inside Dia. Liqu Depth DIM N I N 151 1 — DIMEN I N SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREA LEACHING Man:ua INFORMATION Type 0��� ._I Ste/ 9 Q / r _ �� OR UNIT umber S : m `j CJ —� DISTRIBUTION SYSTEM hf --�, Tel! Header / Mar)ifold / � Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length I 1 Dia. Length Dia. L Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over I Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center " ` Bed /Trench Edges Topsoil ❑ Yes ❑ No es ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) l a '�o v v c4_l tv� vu)4 S4es,r � e rl CA V�� Ve C_ ; b Y- \od wUS' �flp (�'r`fyt1C j I1?✓� !t r T`���,i( C f h Plan revision required? ❑ Yes ® No Use other side for additional information. S SBD -6710 (R.3/97) Date spectcVs Signature ert. No SANITARY PERMIT APPLICATION Safety E and n Division Visconsin In accord with ILHR 83.05 Wis. Adm. Code P.O. Box 7969 Department of Commerce Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. :54 , C no j t-. • See reverse side for instructions for completing this application State Sanitary Permit Number 30 77S­0 The information you provide may be used by other government agency programs_ E] Check if revision to previous application ! 3 /� [Privacy Law, s. 15.04 (1) (m)]. f Afj) �/ "/� � L v V If rK J5• V State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Property Owner Na ,Pro4ert Loca / S � T , N, R ` (Or Propert O�ner;A Mailin�ddress Lot Number Block Number City State d Zip Code Phone Number Subdivision N o CSM Number I. PE F B I DING: (check one) ❑ State Owned ❑ Cit Nearest Road ❑ Village Public or 2 Family Dwelling - No. of bedrooms a Town of /-70" 01h 0 691 III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment / Condo & a 9+ 1 9 , ! sq& 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1 _-_p6ew 1 ❑ Replacement 3, Q Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Existing System Existing System ____ ___ ___ __ ______________ ________ B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11eepage Bed 21 ❑Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 E] Seepage Trench 22 E] In-Ground Pressure i 42 ❑ Pit Privy 13 E] Seepage Pit x 43 ❑Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Re wired (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft_) (Min. /inch) Elevation �. 4 Feet t feet Cap acit y VII. TANK in Ca allons Total # of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturer s Name Concrete Con- steel glass Plastic App New Existin strutted Tanks Tanks Septic Tank o o* ,� ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ 1 ❑ 10101 ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's )Iame: (Print) Plumber's Si re: (No St IMP/MPRSWNO.:� Business Phone Number: Plumber's Address (Street, CCty, S e, Zi Code): < IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Is Issuing gent Signature (No Stamps) / 1 Approved [:]Owner / Surcharge Fee) / Owner Given Initial Gj� �j7 g � Adverse Determination Q V // � X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBDMM (R 11/96) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber NLU I FLAN PR JECT C�C� ' ADDRESS S. � ,� 1/4 1/ ° /R W T N MPRS ' DATE 9 COUNTY S - roux BEDROOM CLASS PERC , 7 CONVENTIONAL IN- GROUND PRESSURE CONVENTIONAL LIFT_ MOUND_ HOLDING TANK SEPTIC TANK SIZE LIFT TANK SIZE .— DOSE TANK SIZE HOLDING TANK SIZE ABSORPTION AREA PERC RATE 7 BED SIZE 1,0" >e *!j/'y 16 Benchmark V.R.P. Assume Elevation 100' Location of Benchmar * H. R.P. O Borehole Q Well ee O Perc Hole System Elevation Uent 12" Grndp TYPAR COVERING 2" 12* 39 4` 6' O 3' 3' (D 3' 1 6" Sewer Rock 12' 18 r 13-3 f► Z � i 56 � 3� 1 Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division oft Safety and Buildings Page of Bureau of Integrated Services in accordance with s. ILHR 83.09,-lRl[is. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size! plan must NY include, but not limited to: vertical and horizontal reference point (1314), ark percent slope, scale or dimensions, north arrow, and location and dist�llc�o nearAt wd •' Parcel, h AD. # APPLICANT INFORMATION - Please print all inform�t" ) '' 'Rev- bt7�✓ ^ Date Personal information rovide ma be used for seconda u ses Pnvac w : 1 You P Y N P R� ( Y Lwfl t () ( tJT ! Property Owner ✓ Pr6�691io Property Owne Mailing A ddress c Subd. Name or CSM# A City State , Zip Code Phone Number ❑ City Villa Town Nearest Road 5� (21:5) New Construction Use: 'Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow �O0 gpd Recommended design loading rate bed, gpd1ft trench, gpd/ft Absorption area required bed, ft trench, ft Maximum design loading rate bed, gpd/ft trench, gpd/ft Recommended infiltration surface elevation(s) , e4 &ae 15 � ft (as referred to site plan benchmark) Additional design /site con . derations Parent material Flood plain elevation, if applicable A ZI O ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding U = Unsuitable for system s ❑ U 0S El • - El U • s U XS El El u El 'g SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD/ft 9 Texture Consistence Boundary Roots :„ in. / Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. / Bed , Trench Dem. Ground ' & Depth to limiting factor 3. Remarks: Boring # _ z= /Oy Vz ' S -1 �- Ground Depth to limiting f r a Remarks: CST N me (Please Print) /J ature ` Telephone No ��l.r -i — b / Address � Date CST Number / S � SOIL DESCRIPTION REPORT PROPERTY OWNER Page PARCEL I.D.#1 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 C3 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench j - rtrs Ground Depth to limiting factor ;7/- i II �►( Remarks: Boring # 13 Ground / e ft . Depth to limiting factor ,:V-aw Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # /Z , 5 C9 F ,a' 3 Ground 9 �lev. Depth to limiting factor 1 Remarks: Boring # 13 Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) Soil Test Plot Plan Project Name •SI -8 J 1 -gL Address Zel Lot 7 Subdivision Zl,.e-� Date C 1 /4�1 /4S /6 T�2� N /R/ W Townshi Boring O Well PL Property Line County .Sj� (liyl')c IL BM or VRP Assume Elevation 100 ft. a System Elevation *HRP . � T3 -3 20 3.!r b m' t a 'Pro Scale 1/4" = 10 Ft. When Dimensions aren't stated 1 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer le Z,/ Mailing Address Property Address (Ver required from Planning Department for new construction 9�t> City /State �4o r7 �.C/ f • Parcel Identification Number © � 3 LEGAL DESCRIPTION Property Location '/4, Sec., TN -R W, Town of Subdivision (J`/ e 5� 'e , Lot # Certified Survey Map # �`� 1 ' Volume , Page # Warranty Deed # 3Ej , Volume 1177 , Page # Spec house ❑ yes no Lot lines identifiable J. yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. 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 CoAnty Zoning Office within 30 days of a three year expiratio date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION (we) certify tha all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the p describ d ove, by virtue of a warranty deed recorded in Register of Deeds Office. U SIGNATURE OF APPLICANT DATE * * * * * * 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 Vi sconsin Safety and Buildings Division SANITARY PERMIT APPLICATION Po �Washin Ave. Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. 54 , C J ` > C,.- • See reverse side for instructions for completing this application State Sanitary Permit Number �Q ,775 Q The information you provide may be used by other government agency programs 0 6heck if revlsldn fo previous applicaNiar (Privacy Law, s. 15.04 (1) (m)]. n / t� �, -�� L_uj /- State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATII Property Owner Na ropert Location t ' Ld; 1 /4 1 /4, S �[� T N, x (or Propert Owner; Mailing A ress ; Lot Number ` Block Numb r Cit State � Zip Code Phone Number Subdivision Nagle or CSM Number c (7 /S _ � -1 a . TYPE F ILDIN : (check one) E] State Owned ❑ it _ -� Neafr est Road ❑ VII age El / Public 1 or 2 Family Dwelling - No. of bedrooms Town OF - 1 Lf /rte III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Retrea Tonal Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /BarMining 4 ❑ Church/ School 8 ❑ Mobilp Home Park 12 ❑ Service Station./ Car Wash 5 ❑ Hotel /Motel 9 ❑ Office/ Factory 13 ❑ Other: specify ' IV. TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) A) 1ew 2_ E] Replacement 3. ❑ Replacement of 4_ E] Reconnectionof 5 - ..❑ Repair of an System S ________ystem _____________Tank Only______________ Existing System _________Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number ,Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 1 " eepage Bed 21 [:]Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 In- Ground Pressure J 42 ❑ Pit Privy 13 ❑ Seepage Pit / X 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq ft:) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation Feet Y, Feet Ca aclt VII. TANK in allon Total # of Prefab. Site Fiber- Exper. INFORMATION New Existin Gallons Tanks Manufacturers Name Concrete strutted steel glass Plastic App Tanks Tanks Septic Tank or-� RL ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ 1 ❑ 1 ❑ 1 ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumbe=Sie: (No S,tam�7 MP /MPRSW No.: Business Phone Number: , / v � L 7 4 ? Plumber's Address (Street, City, St Zip Code): —5 { IX. COUNTY / USE ONLY E] Disapproved Sanitary Permit Fee (Includes Ground�v o (er ate ssue Issuing ent Signature (No Stamps) Approved E] Owner Given Initial /j�Z'�� r ; Surcharge Fee) / i f Adverse Determination l7 %/ 7� ', 4 r f' cc X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (R.11/96) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber �..1177PAG_32': STATE BAR OF WISCONSIN FORM . —1982 '"•"—�� LAND CONTRACT • 5 In &vidu,l and Corporate (TO BE USED FOR ALL TRANSACTIONS WHERE OVER S ?5.000 IS FINANCED %ND IN OTHER NON - CONSUMER S °` C 3f' 1 �`t s t �-•' 1 DOCUMENT NO. ACT TRANSACIIONSI' A+o&- irXn.V-:'7 ' MAY 10 1996 Contract by and between Vernon Waxon a/k/a FA 10.00 ' Vernon -E. Wa xon. -a Ire ne Waxon a a Irene S. _ j.7 I�i31c9I1��uSlbnd and wife_ _ j Vendor ~. i j _ ��,� ^ �• -�""�' whether one or more) and Peter S. VaClfl_SS afl - �flrl L. ; F �! �'�'s Vana sse, hu sband and wi — ___ ( "Purchaser whether one or more). Vendor sells and agrees to convey to Purchaser, upon the prompt and full perfor- mance of this contract by Purchaser, the following property, together with the rents, profits. fixtures and ither appurtenant interests (all called the " Property in TM19 SPACE RESERVED FOR RECONOttaG OATH . . St. Croix County, State of .Jisc:onsin _. —. _ — '�� - -- NAME AND RETURN AQDf1ESS`�.. —_ _ —__ . _ —_ _ _— Attorney isTina Ogland P 0 Box 359 Hudson WI 54016 + TRA SR -- �� 020-1030-1 020 - 1029 -90 (Parcel Identification Number) Lot 7, Pleasant View in the Town of Hudson, St. Croix County, Wisconsin. The parties hereto acknowledge that the above described property is located in a well advisory area. This i c Tint homestead property. (is not) Purchaser agrees to purchase the Property and to pay to Vendor at place Vendor directs the sum of S 35 .5)0.()Q _ in the following manner: (a) S 7 + 100.00 at the execution of this Contract. and (b) the balance of S 28 400 together with ieteren from date hereof on the balance outstanding from time to time at the rate of _ nine 96 /. percent r annum until paid in frill, as follows: Commencing on the 8th day of June, 1996, and on the 8th day of�each and every month thereafter, equal monthly installments of principal and interest in the amount of $255.52. Provided, however, the entire outstanding balance shall be paid in full on or before the 8 th day of ----- Ma}L-- _ —___, 19-98 (the maturity date). Following any default in payment, interest shall accrue at the rate of % per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). Purchaser, unless excused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonably anticipated annual taus, special assessments, fire and required insurance premiums when due. To the extent received by Vendor, Vendor agrees to apply paymeotstothese obligations when due. Such amounts received by the Vendor for payment of taxes, assessments and insurance will be deposited intoan escrow fund or trustee account, but shall not bear interest unless otherwise required by law. 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 a In the event of any prepayment, this contract shall not be treated as in default with respect to payment so lung as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be trea:rd as unpaid principal) is less than the amo mt that said indebtednes.; would have been had the monthly payments been made as first specified above; provided that monthly payments shalt be continued in the event of credit of any proceeds of insurance or condemnation, the condemrt�d 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. is f Purchaser agrees to pay tf 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 _day Of Closing. }99000= •Cross Out Oue LAND CON TRACT — Imhhidu :'and Corporate STATE BAR OF WISCONSIN WiSCOnsin Legal 04rult CA., Inc. FORM No. I I — 1982 \6lwauw vo, Ws. 'iCL 117 1 PAc: J2b Purchaser promises .o pay when due all taxes and assessments levied on the Propert ;•r upon k endor s interest in it and is deliver to Venjof :as demand receipts sho•..ing sn_h payment. Purchaser shall';eep the improvements on the Property insured against loss or damage occasioned by fire, extended coverage perils and s:-h other hazards as Vendor may require, without co- ;nsurance, through insurers approved by Vendor, in the sum of S - __N1A nut Vendor shall not require coverage in an amount more than the balance owed under this Contract. Purchaser shall pay the inso -ace premiums r wis due- The policies .hall contain the standard clause in favor of the Vendor's interest and. unless Vendor otherwise agrc -_s is writing, the ,vvginal of all policies covering the Property shal! 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 Vent:ar deems the restoration or repair to be economically feasiMr. Purchaser covenants not to commit waste nor allow waste to be commi,ted on the Property, to keep the Property in good tenantable :oe►dition and repair, to keep the Property free from liens superior to the lien of this Contract, and to comply with all laws, ordinances and m;ruiations aff ^ctina the Property. Vendor agrees that in case the purchase price with interest and other moneys shall be fully paid and all conditions stall be fully performed xi the times and in the manner above ,pecified. Vendor will on demand, execute and ieliver to the Purchaser, a Warranty Deed, in fee simple, of aflu: Property free and clear of all liens and pncumbran - es, qxc pt any I' ns or encymbrances created by the act or default of Purchaser, and ra,rpt: __ ase,nents,_ restr>ctlons _arl g [s -or` -or-way -co c�._ t Apy._ - -_ -_ Purchaser agrees that time is c! the essence and (a) in the ev _nt of a default in the payment of any principal or interest which continues for a period of __ -� days following the specified due date or (h) in the event of a defsoolt in performance of any other obligation of Purchaser •rich continues for a period of __ -_ days following written notice thereof by Vendor (delivered personally or mailed by certified mail); *sea the entire - utstanding balance under this contract shall become immediately due and payable in full, at Vendor's option and without notice is hich 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 !aw 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 esf the entire outstanding balance, with interest thereon from the date of default at the rate in effect on s-ich date and other amounts due hereunder s which event all amounts previously paid by Purchaser shall be forfeited as liquidated damages for failure to fulfill this Contract and as rental for s!e Property if Purchaser fails to redee -l); or (ii) Vendor may sue for specific performance of this Contract to compel immediate and full payment of the entire outstanding balance, witn interest thereon at the rate in effect on the date of default and other amounts due hereunder, in which event ::%e Property shall be aucticrocl at judicial sale an i Purchaser shall be liable for any deficiency; or (iii) Vendor may sue at law for the entire unpaid purchase price or any portion thereof; o, (i v) Vendor .nay declare this Contract at an end and remove this Contract as a cloud on title in a quiet -title action if tie equitable Intel -,t of Purchase: is insignificant; and (v) Vendor may have Purchaser ejected from possession of the Property and have a vccciver appointed to collect any rents, issues or profits during the pendency of any action under (i), (ii) or (iv) above. Notwithstanding any oral or .Titten statements or actions of Vendor, an election of any of the foregoing remedies shall duly be binding upon Vendor if and when pursued in irrigation and all costs and expenses including reascnable attorneys fees of Vendor incurred to enforce any remedy hereunder (whether abated or am' 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 acluded 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 pendancy of such action, atatd such rents, iss+ies, 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 uno. -r his Contract or by option, long -term lease or in any other wav) without the prior written consent of Vendor unless either the outstanding balance parable 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 z.c"rity 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 ttis 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 Pr. perry on the date of this Contract (except for any surtgage granted by Purchaser) or under any note secured thereby, provided Purchaser makes timely payment of the amounts then due under this Contract. Purchaser mac make any such payments di; ectly to the Mcrigagee if Vendor fails to do so and all payments so made by Purchaser shall be snsidered 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 , finding upon and inu•e 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' endor 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.) Q d Dared this - - -- 5-- N't - - - - - - -- day 96 of --- - - - - -. . - - - - -- -- - -• 19. 16 X (SEAL) !s>rsusa'"' - - - -.— (SEAL) a . Ve on Waxon, a/k/ Vern E. `-'axon Pe S. Va se _ — —..- (SEAL) — - _., (SEAL) Irene Waxo a/A / a Irene S Waxon Ta ri n � L a arse AUTHENTICATION ACKNOWLEDGMENT s .Vernon Waxon a /k /a Vern E. Waxon, STATE OF WISCONSIN rene Waxon, a7kja Irene S. Waxon, ss, 4 1 et el= -- s,,- .-- Vanasse -- 'Farr -l. Vanass\ - - -- County. QQ yi,, - - -- authenticated t is _ lJ_ day of __ __— Ma y_ — _ — , 19 Personally came before me this __ __ day of 19 -- the above named t f . Kristine Oglabd - - -- TfTLE: MEMBER STATE BAR OF WISCONSIN (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 Kristina Ogland •,.,, Attorney at Law Notary Public County, Wis. 'Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (if not, state expiration date: — %amcs of perame ,tgning ts env apa.nv Oh,wtd he tvpcd or printed bektw their ;ignaturo. L ♦NO CONTRACT — Ind4idual and Corporate — State Bar or Wixortin, Form No. 11 — 1082 ! rn OD q sN goo 00 , 00 " C - 307 7 6i N89 °57'26'#W 332.08 _o I a _ 89 0 3 2'28"E-216.77' o N N \\ \ to > ° m \ e -n M a C I 0J 4(n 0 r w_ o 12 z m m M \ \ m co N \ \ \ too 3 z 1 N 90 ° 00 00 E I Z \ O z z T _ I= I m \ -1 G) N ' LW Q1 / W E W I co r (A C-) ` O z mm �a N m -1 u) i � �\° q• I� ow C o 0 O / w D to n n � _ I c OD Cm O M ti can N —4 \ c U ) ° M � N \ �y N \ 0 0 N / 0% os H N mN � \ •6'�4 _ I' I 0 W N O w W Cl) n C - --N 90 ° 00 X 00 ° E - \�c i N OX0 0 9 3 r cn , I O r z o \ �G O Imo / C,v0 0 \ : 0 \ \ mam i ��3„ 11% # . -A : �i 1 0 0 loo I N D 10 m -n m ro / ) - En o N n W . Of O O (D (D ° o z / m X N �_ OD w ^, S� �� / /o! Z m mND'v rn � m m \ \ z � N / �► / z 0 v I 7 k1