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042-1090-80-200
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)], Permit Holder's Name: City Village Township Dan Jacobs TOWN OF WARREN CST BM Elev: Insp. BM Eler : BM Description: ?' 2. 1 4) S'Z t C 5T- f 3 A&* Z — V\OU _ v TANK INFORMATION TYPE j MAN U FACTU R R CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic > 14 Zoo, Dosing Aeration Holding I ""', - I f PUMP/SIPHON INFORMATION Manuf cturer Demand PM Model Nu er TDH Lift ction Loss System Head TDH Ft Forcemai Length Dist. to Well SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 648481 State Plan ID No: Parcel Tax No: 042-1090-80-200 Section/Town/Range/Map No: 32.29.18.499B-20 STATION BS HI FS ELEV. Benchmark rl DZ 2- Alt. BM Bldg. Sewer •�D r J oo .S'z St/Ht Inlet ,4 3rD707 St/Ht Outlet � 3,2 e Dt Inlet Dt Bottom Header/Man. no Llzr Dist. Pipe Bot. System - j0• Z,GZ Final Grade 2, St Cover r 2- -T�V �D�.•V� l���z TRENCH DIMENSIONS Width r Length 10 `''PFer gysf -lower No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/L BILDG WELL LAKE/STREAM LEACHING CHAMBER OR UNIT Manufacturer: �_vx4-6aA� Type Of System: C�tA�r� o ��-� VV � > zo(o3 � � Model Number: D.J_;d, DISTRIBUTION SYSTEM V Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake } 25 Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: Include code discrepencies, persons present, etc.) Inspection #1: °%31�y3 Inspection #2: ovation: No Address Ava ble 1.) Alt BM Description - gY iv\,510, 11�b (1) ALAR-s VW1-k-CLdQ 4� go%_ - � o 6" k -�2. Bld sewer len th = ,o`�[�yM�I �S� &< a�c g 9 `-{ 3 ,t J � Sao � l - amount of cover = s �Z �.k.� - a� �'"'�` - �'� S �" G o • r d[ ' Z ,� f f � Se.lSyv�cw�6o le — � - 3) . D r c Seer , vAL+ — \ % u r Le �- � Plan revision Required? ❑ Yes �No Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. rs q) D rV �, %v�.,n,� c S c n C/ka ram- his 11� o rK RAA t S w [ �2 Ve.n P a'►'t�' � �,. f Industry Services Division 4822 Madison Yards Way aS MAY 2 2 2023 Madison, WI 53705 P S P.O. Box 7162 Madison, WI 53707-7162 St. Croix Coui-t LL C {n��tll L 0, l Itl i it • F,-Vej . r �Application In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. I. Application Information - Please Print All Information I � Property Owner's Name [ Z, 3, f Property Owner's Mailing Address 0 City, State Zip Code I Phone Number T4--jo t) 1 f � :5— L,�') 1454(-Oc;�. Ihr Type of Building (check all that apply) ✓ 91 or 2 Family Dwelling - Number ofBedrooms 11publ ic/Commercial - Describe Use Lot # Block # County �- —6- " i.)4 (,�� Sanitary Permit Number (to be filled in by Co.) ?491 State Transaction Number Project Address (if different than mailing; address) o 3 � Parcel # 6 42 — I ogo — 8a - Zed Property Location Govt. Lot 1 2 1�4 Section T -' N R1:LE rr� Subdivision Name City of State Owned -- Describe Use CSM Number LiVillage of Dcc, a loft 211 j " Town of1z�� /z e v _. III. Type of POWTS Permit: (Cheek either "New" or "Replacement" and other app 'cable on line A. Check one box on line B. Complete line C it a p p tic A. E�j ew System Replacement System ather Modification to Existing System (explain) EAdditional Pretreatment Unit (explain) B. - - _ _ Fl folding Tank In -Ground E]At-Grade Mound conventional) C. ❑ Renewal Before Revision Expiration TV I` mare al/Traafmant Aron send Tank 1nfnrmntinn= Individual Site Design I 10ther Type (explain) ange of Plumberransfer to New Owner List Previous Permit Number and Date IswuedVq, I N\ Design Flow {gPd)Design Soil Application Rate(gpd/s� llis ersal Area Required(s� Dispersal Area Pro osed(sf� System ;levatiki ss�e _10 S /Ze" 4;11 Capacity in Total # of Manufacturer , Tank Information Gallons Gallons Units f [�, U New Tanks Existing Tanks �� �� V Xf `'�' _ a. U V = rli cn �0 � ix, C a$ 4-, Septic or Holding Tank/ C� -- Dosing Chamber V. Responsibility Statement- the undersigned, ass u a sponsibility for installation of the POWTS shown on the attached plans. Plumb ignature MP/MPRS Number Business Phone N mber z z 71f� L PI u ber's Name (Print) 1. Plumb4'sddr2 ess (Street, City, State Zip Code) V 1. County/Department Use Only pproved ❑Dis Permit Fee Date Issued Issuing Agent Signature C eason fir Denial ?�Z_5 Conditions QT rov, o r � al � ryE : VIL 1. Septic tangy, effluent filter and dispersal cell s 4L must be serviced / maintained as per m nage nt plan provided by plumber. . All setback requirements must b maintained a per applicable code / ordinances, Attach to cam )lete plans for he syst rr� an sub it to the Couneq o y o pal)( n�>t ��s an 1/2 x I I inch e in ireLyeQ `nQcylea� �aG- . �►t 5� 3b -{� zou rr) 01 /1 1 � System PLOT PLAN PROJECT Dan Jacobs ADDRESS 1038 65th Ave Roberts Wi 54023 SE 1/4 NW 1/4S 32 ry 2 9 N/R 18 W TOWN Warren COUNTY ST. CROIX SYSTEM ELEVATION 95.5/94.0/2.5 4.5' below grade 5/20/23 BEDROOM 4 DATE CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1250 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 919 # of cliambers 45 `,, BENCHMARK V.R.P. none listed on soil test. ASSUME ELEVATION 100Filter Lifetime Filter BOREHOLE WELL H. R. P. same as benchmark COPY Py 65th Ave Vent >6 1� Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area Cover , 4 Lon 6.6ftA 2/pair of end caps Lon g Nib Grade at System Elevation 4 Additional area is to be tested to expand system area. A new benchmark is to be established by shooting the elevation of one of the borings. 3-3' X 62' Cells with >3' spacing 7 Property Line Property Line & y 5 0' B-1 f�11.'100' 40 4 20% Slope R a Property Line PfQ,,4 Bedr6-1 House Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 05/20/2023 Owner: Dan Jacobs Location SE1 /4 NW1 /4 S 32 T29 KR 18W 65th Ave Warren Used: In -ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section Lh 4-6. Maintance and ntigency Plan 7. Filter Cross Secti n Signature t License numb r 26900 System PLOT PLAN PROJECT Dan Jacobs ADDRESS 1038 65th Ave Roberts Wi 54023 SE 1/4 NW 1/4S 32 ry 2 9 N/R 18 W TOWN Warren COUNTY ST. CROIX SYSTEM ELEVATION 95.5/94.0/2.5 4.5' below grade 5/20/23 BEDROOM 4 DATE CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1250 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 919 # of cliambers 45 `,, BENCHMARK V.R.P. none listed on soil test. ASSUME ELEVATION 100Filter Lifetime Filter BOREHOLE (D WELL * H. R. P. same as benchmark Vent 65th Ave Quick4 Standard Leaching Chamber with 20.0 ft2 of Area 6.6ftA 2/pair of end caps LGrade at System Elevation Additional area is to be tested to expand system area. A new benchmark is to be established by shooting the elevation of one of the borings. Neal 3-3' X 62' Cells with >3' spacing 40 V ')5 20% Slope 51 13-21 92 96' Property Line Property Line 5 0' )j , Property Line 100 10' /,S-I-, Pro 4 Bedroom B-3 House Cross Section of Quick 4 Standard Leaching Chamber Typical cross section for 2 of 3 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber 6.6ft^2 pair of end plates To be >1' above grade Vent Typical Installation 4 fvAll Grade �) 4) 3,so -to 4' ,A �030/34 Septic Tank X/ Finish grade elevation 100.0 Vent 1 4' Long 5' Lon I C) iL 4 ZUD; Grade at System Elevation 34 Grade at System Elevation 34 Spacing— 5 ) System elevations: A95.53 B94.07 C-92.5) Observation tube/Vent Same on other end To be located on end of Cells -da 15 chambers per cell A B C POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page, of �FILE INFORMATION Owner Permit # �)ESIGN PARAMETERS Number of Bedrooms El NA Number of Public Facility Units -9 NA Estimated flow (average) -gal/day 1 Design flow (peak), (Estimated x 1.5) gal/day Soil Application Rate al/day/ft Standard Influent/Effluent Quality Monthly average* Fats, Oil & Grease (FOG) --530 mg/L Biochemical Oxygen Demand (BOD5) �220 mg1L 0 NA Total Suspended Solids (TSS) :!9150 mg1L !Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BOD5) 530 mg/L Total Suspended Solids (TSS) <30 mg1L NA Fecal Coliform. (geometric mean) � 104 CfU/I OOM I !Maximum Effluent Particle Size Ya in dia, 0 NA !.Other: L NA J *Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE SYSTEM SPECIFICATIONS Septic Tank Capacity 4gal E3 NA Septic Tank Manufacturer r 0 NA Effluent Filter Manufacturer 0 NA Effluent Filter Model DNA 'Pump Tank Capacity gal NA Pump Tank Manufacturer NA Pump Manufacturer NA Pump Model NA Pretreatment Unit [I Sand/Gravel Filter 0 Mechanical Aeration E3 Disinfection 0 Peat Filter 0 Wetland 0 Other: NA Dispersal Cell(s) In -Ground (gravity) 0 At -Grade C1 Drip -Line 0 In -Ground (pressurized) 0 Mound 0 Other: 0 NA Other: 0 NA Other: 11 NA Other, 0 NA 01.4 Service Event Service Frequency �1 linspect condition of tank(s) At least once every: <-.., 0 month(s) (s) ( (Maximum 3 years) , Lig, y ears 0 NA IPump out contents of tank(s) When combined sludge and scum equals one-third (X) of tank volume 0 NA -i iinspect dispersal cell(s) At least once every: month(s) (Maximum 3 years) year(s) 0 NA I ^.lean effluent filter At least once every: 0 month(s) I�Lyear(s) [I NA Inspect pump, pump controls & alarin 1::Iush laterals and pressure test At least once every: At least once every: 0 month(s) 11 year(s) 0 month(s) 0 year(s) 0 NA NA IDther: At least once every- 0 month(s) 0 year(s) [D\N A hther: L-1 0 A I MAINTENANCE INSTRUCTIONS !Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: aster !Plumber', Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator, Tank inspections must linclude a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of i1c.,ombined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. 'The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local I-egulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (�) or more of the tank volume, the entire contents of 1-he tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin IOArnlnistrative Code. 1�11 other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, land any servicing at Intervals of:512 months, shall be performed by a certified POVVTS Maintainer. 1� service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page Of i START UP AND OPERATION prior to use of the POVVTS check treatment tank(s) for the presence of painting products or other chemicals th-�t c For new construction, and/or damage the dispersal cell(s). If high concentrations are detected have the contents of themay impede the treatment process a tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. tanks may fill above normal high levels. When power is restored the excess wastewater will bo During power outages pump r surface discharge of effluen1t. discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup o To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. or ark over, or otherwise disturb or compact, the area within Do not drive or park vehicles over tanks and dispersal cells. Do not drive p 15 feet down slope of any mound or at -grade soil absorption area, and prolong the life of the P0WT:j':)': Reduction or elimination of the following from the wastewater stream may improve the performance antibiotics; baby wipes; cigarette butts; condoms', cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides-, meat scraps; medications; oil; painting products; pesticides; sanitary napkins,- tampons-, and water softener brine. ABANDONMENT ken out of service the following steps shall be taken to insure that the system is prope, y When the POINTS fails and/or is permanently to and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • Ail piping tot and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN followinmeasures have been, or must be taken, to provide a code compliijint If the POWTS fails and cannot be repaired the g replacement system: cation of a replacement soil absorption syst0m. A suitable replacement area has been evaluated and may be utilized for the 10 7he replacement area should be protected from disturbance and compaction and should not be infringed upon by requiijed setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the nEjed for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rulefI in effect at that time. available due to setback and/or soil limitations. Barring advances in POVVTS technology/ a ❑ A suitable replacement area is not aholding tank may be installed as a last resort to replace the failed POWTS. 0 The site has not been evaluated to identify a suitable replacement area. Upon failure of the POINTS a soil and site evalual�ion must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ay be reconstructed in place following removal of the biomat at the infiltra-tive ❑ y Mound and at -grade soil absorption sstems m surface, Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TA NKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFFICIENT OXYGEN. DO 'NOT ER ANY CIRCUMSTANCES. DEATH MAY RESULT, RESCUE OF A ENTER A SEPTIC, PUMP OR OTHER THE TANK UNDER PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name Phone '7/ mnwmm..*F� POWTS MAINTAINER Name Phone SEPTAGE SERVICING OPERATOR (PWIVIPERLOCAL REGULATORY AUTHOF31TY Name 252 4 6��y me Name Na _'� L,01001 Phone Z Phone This document was drafted in compliance with chapter SPS 383.22(2)(b)(I)(d)&(� and 383.54(l), (2) & (3), Wisconsin Administrative Code. 04.5200 .01 Gap between Case and Serpenline A Ide SECTION A -A )00 91 1.1921 59 7�-- r Li ``''���` File #: ST. C R Ol SANITARY SYSTEM .�" � NTY, Office Use Only -y'�OWNERSHIP/ADDRESS FORM rea ed2/2021 Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. once approved, this completed form and educational information will be sent to you by email. If you would like to view your issued sanitary permit online, you can do so by using the Pror)erty Files Scanned weblink, Phone Number (required) Email Address (required) Parcel Identification Number (found on the property tax bill) PropertyNEW sTEm- Locatio�_ /4,�/� , Sec.. T N R W Town of , .. Subdivision Plat; ,Lot # Certified SurveyMa # Volume #- p Pa e � J g +' 1 ACV Warranty Deed # before 2006 Volume Page # Number of bedrooms Spec house ❑ ye no Lot lines identifiable s ❑ no 0, F.F USETq` V °7fVLY' ... 6' New Property Address lo. 3 — [} (Verification of new address required from Community Development Department for new construction.) 2Z2,3 (Staff Initials) (Date) This form must be submitted with all Private Onsite water Treatment System (POWTS) applications, New System, Include with this form a recorded warranty deed from the Register of Deeds office and a copy of the certi fled survey map if reference is made in the warranty deed, Community Development Department — Land Use Division 715-386w4680 St. Croix County Government Center 715-245-4250 Fax cddsccwi gov1101 Carmichael Road, Hudson, wl 54016 www,sccwi. ov State Bar of Wisconsin Form 11-2003 LAND CONTRACT (TO BE USED FOR NON -CONSUMER ACT TRANSACTIONS) Document Number Y Document Name CONTRACT, by and between Beverly Anderson ("Vendor," whether one or more), and Daniel B. Jacobs ("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 following real estate, together with the rents, profits, fixtures and other appurtenant interests ("Property"), in St Croix County, State of Wisconsin: Lots 1 and 2 of Certified Survey Map recorded 2/16/2018 as Volume 28 Page 6454, Document number 1061291 being located in part of the SE 1 /4 of the NW 1 /4 of section 32, T29N, RI 8W, located southerly of Town Road, Town of Warren, St. Croix County, Wisconsin. Purchaser agrees to purchase the Property and to pay to Vendor at Westconsin CU Acct # 3804 or in person with receipt the sum of $ 34,500 1 in the following manner: (a) $ 5,000.00 _ at the execution of this Contract; and 4II II I9II IIIII IIH C Tx;4421723 f 10611471 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI 02/22/2019 12:32 PM EXEMPT#: REC FEE 30.00 TRANS FEE 103.50 PAGES: 4 Recording Area Name and Return Address Daniel B. Jacobs 1038 65th Ave Roberts, Wisconsin 54023 042-1090-80-000 Parcel Identification Number (PIN) This homestead property. (is) (is not) This a purchase money mortgage. (is) (is not) (b) the balance of $ 29,500.00 , together with interest from the date hereof on the balance outstanding from time to time at the rate of 0 % per annum until paid in full as follows: Monthly payments in the amount of $800.00 each month due at the end of the month either to Westconsin CU Acct # 3804 or acknowledged in person at Vendor residence. December 2020 payment shall be 1,500.00 if the balance of the contract has not been prepaid prior to that date and no payments are in default. provided the entire outstanding balance shall be paid in full on or before 30 December 2020 ("Maturity Date"). Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. jQH00SE 0 NE OIE THE FOLLOWING OPTIONS• IF N PTION IS CHOSEN OPTION A SHALL APPLY: ® A. Any amount may be prepaid without premium or fee upon principal at any time. 0 B. Any amount may be prepaid without premium or fee upon principal at any time after, ❑ C. There may be no prepayment of principal without written permission of Vendor. State Bar Form t l -Page 1 0 2003 STATE BAR OF WISCONSIN St. Croix County 1061471 Page 1 of 4 CHQOSE ONE OF THE FOLLOWING OPTIONS: IF NEITHER IS CHOSEN.PTION A SHALL APPLY: ® A. Any prepayment shall be applied to principal in the inverse order of maturity and shall not delay the due dates or change the amount of the remaining payments until the unpaid balance of principal and interest is paid in full. ❑ B. 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 specified above; provided that monthly payments shall continue in the event of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded from this Contract. Purchaser shall pay prior to delinquency all taxes and assessments levied on the Property at the time of the execution of this Contract and thereafter, and deliver to Vendor on demand receipts showing such payment. Purchaser shall keep the improvements on the Property insured against loss or damage occasioned by fire, extended coverage perils and such other hazards as Vendor may require, without co-insurance, through insurers approved by Vendor, in the amount of the full replacement value of the improvements on the Property. Purchaser shall pay the insurance premiums when due. The policies shall contain the standard clause in favor of Vendor's interest, and evidence of such policies covering the Property shall be provided to 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 Vendor deems the restoration or repair to be economically feasible. ❑ Purchaser is required to pay Vendor amounts sufficient to pay reasonably anticipated taxes, assessments, and insurance premiums as part of Purchaser's regular payments [CHECK BOX AT LEFT IF APPLICABLE]. Purchaser shall not commit waste nor allow waste to be committed on the Property, keep the Property in good tenantable condition and repair, and free from liens superior to the lien of this Contract, and comply with all laws, ordinances and regulations affecting the Property. If a repair required of Purchaser relates to an insured casualty, Purchaser shall not be responsible for performing such repair if Vendor does not make available to Purchaser the insurance proceeds therefor. Vendor agrees that if the purchase price with interest is fully paid and all conditions fully performed as specified herein, Vendor will execute and deliver to Purchaser a 'Warranty Deed in fee simple of the Property, free and clear of all liens and encumbrances, except those created by the act or default of Purchaser, and: CHOOSE ONE OF THE FOLLOWING OPTIONS; IF NO OPTION IS CHOSEN, OPTION A SHALL APPLY: ❑ A. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination, at the time of execution of this Contract. ❑ B. Purchaser states that the following exceptions set forth in the title evidence submitted to Purchaser for examination, at the time of execution of this Contract, are unsatisfactory to Purchaser: ® C. No title evidence was provided prior to execution of this Contract. State Bar Form l 1 Page 2 C 2003 STATE BAR OF WISCONSIN St. Croix County 1061471 Page 2 of 4 CHOOSE ONE OF THE FOLLOWING OPTIONS; IF NEITHER IS CHOSEN, OPTION A SHALL APPLY: ❑ A. Purchaser agrees to pay the cost of future title evidence. B. Vendor agrees to pay the cost of future title evidence. Purchaser shall be entitled to take possession of the Property on 31 January 2018 _ Time is of the essence as to all provisions hereunder. Purchaser agrees that in the event of a default in the payment of principal or interest which continues for a period of 90 days following the due date or 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), the entire outstanding balance under this contract shall become immediately due and payable at Vendor's option and without notice (which Purchaser hereby waives), and Vendor may singly, alternatively or in combination: (i) terminate this Contract and either recover the Property through strict foreclosure or have the Property sold by foreclosure sale; in either event, with a period of redemption, in the court's discretion, to be conditioned on full payment of the entire outstanding balance, with interest thereon from the date of default and other amounts due hereunder (failing which all amounts previously paid by Purchaser shall be forfeited as liquidated damages for failure to fulfill this Contract and as rental for the Property); (ii) sue for specific performance of this Contract; (iii) sue for the unpaid purchase price or any portion thereof; (iv) declare this Contract at an end and remove this Contract as a cloud on title in a quiet -title action if the equitable interest of Purchaser is insignificant; (v) have Purchaser ejected from possession of the Property and have a receiver appointed to collect any rents, issues or profits; or (vi) pursue any other remedy available in law or equity. An election of any of the foregoing remedies shall only be binding on Vendor if and when pursued in litigation. All costs and expenses including reasonable attorney fees of Vendor incurred to pursue any remedy hereunder to the extent not prohibited by law and expenses of title evidence shall be paid by Purchaser and included in any judgment. The parties agree that Vendor shall have the options set forth in this paragraph available to exercise in Vendor's sole discretion. Following any default in payment, interest shall accrue at the rate of S % per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). Vendor may waive any default without waiving any other subsequent or prior default of Purchaser. Purchaser may not transfer, sell or convey any legal or equitable interest in the Property, including but not limited to a lease for a term greater than one year, without the prior written consent of Vendor unless the outstanding balance payable under this Contract is paid in full. 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 may mortgage the Property, including the continuation of any mortgage in force on the date of this Contract, provided Vendor shall make timely payment of all amounts due under any mortgage, and the total due under such mortgages shall not at any time exceed the then remaining principal balance under this Contract. If Vendor defaults under such mortgages and Purchaser is not in default hereunder, Purchaser may make payments directly to Vendor's mortgagee and such payments will be credited as payments hereunder. All terms of this Contract shall be binding upon and inure to the benefit of the heirs, legal representatives, successors and assigns of Vendor and Purchaser. State Bar Form I I -Page 3 0 2003 STATE BAR OF WISCONSIN St. Croix County 1061471 Page 3 of 4 Dated _ _s��T � L� VENDOR: PURCHASER: SEAL) .(SEAL) .,(SEAL) SEAL ) AUTHENTICATION ACKNOWLEDGMENT Signature(s) authenticated on TITLE: MEMBER STATE; BAR OF WISCONSIN (If not. I - - authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: STATE OF WISCONSIN Ss. COUNTY Personally came before me Oil the above -named as_6 h to me known to be the person(s) who executed the foregoing dan--cal instrument and acknowledged the same. • Daniel B. Jacobs otary Public, State of Wisconsin My Commission (is permanent) (expires: 0q_ C 0 �A• 0 P OPWIS ZI (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONSTO THIS FORM SHOULD BF CLEARLY IDENTIFIED. LAND CONTRACT STATE BAR OF WISCONSIN FORM NO. 11-2003 * Type name below signatures. State Bar Form I I -Page 4 V 2003 STATE BAR OF WISCONSIN' St. Croix County 1061471 Page 4 of 4 �IIIII�IIIIIIIRYIIRIIIIIII6�����III�III��s���ll III It'll' 'III 'I I'M min' IpIIIIINIIIIIIIblllll ims aii�rlilllr%ili�C�7lli11111 ll��ll�li!,Il�ik 17 - tr r - 4 147 r - 7 11r 31-V 4'. 10 3W Ir - 5 tw r-r 7 - ir 7 Im r -Qr - - - - - - - WO LOFT XNSTS -4 14roc -------ii a L-.2 T - - - - - - - A. A 111111111111111101 N W PCA377'-2 Pc*ma&2 JVL xr.mblo -4-mm b ;t 30 DESIGN LLC 2.8 0 — — — — -- — — — — — — Atchitecterat Services 6m 0 (715) -- ----- ot Q-- T-=-] uym fmfill 248-3010 T 124 X 15-4 14-0 X I" B r TWATED208JOISTS Carwim S! 1 1 Ad*qU W-11 IVOC AddMW ON P%" Fm C a-wo — — — — — — — — — — — — — — — — — — -- - 2.8 C.31rr W-91 W-W h !241 C) Ph" Iad 24 —JIL 2agrLE22K ------ b 21 I PAWRY 12-0 X 8-2 Fff AddmM I W X 3-8 Pid AP"" d* 4. r(r Ir-71pr 7-51W I= . ❑ O- F to ti p i A WL 6 NOTICE! sFpiEc&i iniusus BUILDER TO VERIFYALL DIMENSIONS,SIZES, AND LOCATIONS AND REPORT b M b AW ERRORS PRIOR TO PROCEEDW3. 00 rJTCHEMN22K 7 Wr Ir. I* 2M X 15-4 In ALL CONTRACTORS WWT FAWNUAfM 3-0 DP 3-0 3. to THEMSELVES WrrH ALL fEDOAL.STATE. AM LOCAL BUILDING CODESW"CH. MAW %UTTIRt. 4w . r, — -1 AFFECT WAT*RW%LS OR EM040KT USED ONTKSPROACT FMOT SPOCIFOCALLYSTATED ON rows OR � aPEc�IrJLTIONa. THE CODE awu OUALMY AND GLAANTTrW&I AND 11ME OF ALL WORK 34• • 34 . b A W". R4-1843 - . .1 1 ". ... 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R, I I �, I I I , I I 1 I 111 I I 1 I I I I F I F I I a I I O I I I I I { I 1 W-W 7-91tr i-21/r ,a-0' r-10• f-r I 2r•21rr I I 1 I I I I ----_.——_.---------- L---------J BRACED WALL LINE PANEL DETAILS I ORACEO W Au $DIM RECTANGLE ls.s K 40-0 I "WALL HEIGHT WALLS StOPORTNG ROOF AND CEING ONLY EAVE40-ROW HEgfft Ra CONTUVOMY SIEATFED SRACED WAU.2 44 STIUJCTURAL PANEL SHEAT►wfG I I k 1 x•o- 1 I I I I I I I I I I I I I I L— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —" — — — — — -------- CQIa11rr Ph" FHvw •wrl CWN~ �' FPIg11■ _m_ conHlrr Aas«s CwINArI. AAS:Na � ++■.II NOTICE! BUILDER TO VERIFY ALL OWENSIONS, SIZES, AND LOCATIOW AND REPORT ERRORS PRIOR TO PROCEEDING. ALL CONTRACTORS MUST FAMLNR� THEMSELVES WITH ALL FEMPIAL.STATE. AND LOCAL SLIIONG CODES WHCIL N ANY MATTER. AFFECT MATEAMLS OR EOUPIENT USED ON THO PROJECT. F NOT SPECFC LLY STATIED ON PLANS ORS SAECW CATIOM. THE A"ROM6%TE CODE SHALL GOVERN SaE. GUALT'. AND GUANTMS AM SGM OF ALL Row ------------.. I I Ma A WMAL RELEASE a•1aET Daniel Jacobs 2 STORY UPPER LEVEL Pgrd I,w+R T,2904-2L-4 ow 4-18-23 em aluaol:a L+Y Ryw 2*.a' tr.a ,a.�. A4.2 so -o• so.I. 114' ■ 1'-0' P_ A Wisconsin Departmen Professional Server-Ac Division of IEW 41 1 HTA7V26MYWR8 ORT Page Of 3 00 10 0 a L_ J I in accordance with SPS 383, Wis. Adm. Code County ST. CROIX Attach complete than 8 1/2 x 11 inches in size. Plan must include, but 4(k and horizontal reference point (BM), direction and Pwxq I.D. ()L4 0 9 0 - S 0 - 2.1J C) percent dimensions, north arrow, and location and distance to nearest road. 0% P/ease print all information. Reviewed Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). qg /4 S 32 T (or) W Property Owner Property Location t] BEVERLY L. ANDERSON(Buycr: Daniel Jacobs) Govt. Lot- ---- SE 1/4 N N R 18 E( Property Owner's Mailing Address L Block # Subd. Name or CS ft 0 to n 'Z 1039 65th Avenue 2 45 - (,04 5 4 I City State Zip Code Phone Number ity[]Village [E]Town Nearest Road Roberts, r WI 54023 11 612 1 483-8826 I'll' I 65th Avenue New Construction UseE] Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe - Parent material sandy Flood Plain elevation if applicable ft. General comments Conventional In -ground trenches -- 0.7 loading rate and recommendations: Boring # j Boring Ground surface elev. 91.96 ft. Depth tc) limiting factor >100 in- G1 Pit Soil Ap2lication Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. SIB. Consistence Boundary Roots GPD/fF * Eff# 1 Eff#2 1 0-14 7.5YR2.5/2 sl 2f-msbk rn v fr La 2vf-co 0.6 1.0 2 14-36 7.5YR3/4 S OS9 dl cs 2vf-m 0.7 1.6 3 36-100 10YR5/4 Cos Osg dl 0.7 1.6 Horizon 2 has some gr. 2 Bori rig # U BOft 93.56 >1 10 ElPit Ground surface elev- ft. Depth to limiting factor in Soil 4plication Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz- Sh. Consistence Boundary Roots GPD/fF *Eff#1 *Eff#2 1 0-9 7.5YR2.5/2 2f-msbk mvfr cs 2vf-co 0.6 0.8 2 9-29 7.5YR3/4 Sil 2fabk rnfr cs 2vf-m 0.6 0.8 3 29-40 7.5YR3/4 sl 2fsbk ds Cs I of-rn 0.6 1.0 4 40-110 1 OYR5/4 Cos 0S9 dl 0.7 1.6 * Effluent #1 = BOD > 30 < 220 mci/L and TSS >30 < I Sn mn/1 * F-fflijpnt #9 = ROD <W mci/I and TSS < 3© mci/L -- .. 5 - --- - %V - --- - - CST Name (Please Print) Si e CST MARY JO HUPPERT(Hollistees Soil Testin &Design) 4z� "lowe- 224832 g a4v-, Address J Date EWuation Conducted Telephone Number 28497 King Arthur's Court, Danbury, W1 54830 10 - 269, 2017 715-426-1775 SBD-8330 (R071113) Property Owner ANDERSON, (Buyer:Jacobs) Parcel ID # -� Boring Boring # 100.51 Pit Ground surface elev. ft. (Pending) Lot 2 > 106 i/ Page Depth to limiting factor n. 3 of IQ^il Arw%iij-N^n C7-mt© I Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff *Eff#1 Eff#2 1 0-14 7.5YR2.5/2 S1 2f-msbk mvfr Ls 2vf-co 0.6 1.0 2 14-26 7.5YR3/3 S1 2 fsbk mvfr CS 2vf-ni 0.6 1.0 26-36 7.5YR3/4 S1 I f-msbk ds CS 0.4 0.7 4 36-106 1 OYR5/4 Cos Osg dl 0.7 1.6 L I Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. c"il Horizon Depth in. Dominant Color, Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/fF *Eff#1 *Eff#2 Boring # Boring H Ground surface elev. ft. Depth to limiting factor in. Pit I Soil Annficatinn Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/fF *Eff#1 1) *Eff#,- * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L SBD-8310 (R07 13) * Effluent #2 = BOD 5 -f 30 mg/L and TSS < 30 mg/L PiNpho. POMFOVO"W &VEKL�LL BWYEK C.)ANISL -3--AcosS ljpsn4WA SE'/4 M THE NWL4 Sse• .3z � wAwr T24AJ. MN". of k ritvvrrox. bu�� AbrA l �,cyarr,on/ � °0 o e - o a o //rii 2sO3&1a i -op ypv e.- 'CIS .Ss' Aera►Eago WsD l4ss�Mim), /00. pD � � +41PRD1�. Zpp � F IV EA JCPIKE IN TttcE 2ABov& Q.mevmn qLLSN ABZ- 'I3 a • -Ave . A V&. _ M d o - dal, 7 -0 7 N ORIGINAL SCALE 1 INCH =100 FEET 0 so 100 SCALE IN FEET Legend 0 Set Iron Pipe; I die x 18m long, weighing 1.13 lb per lineal loot • Found Iron Monument in place flat Q County Section Canner Monument g' Property Boundary Line -- -- — --- Drainage & Utility Easement Line Adjacent Boundary Line Right of Way Line 50' Setback Line Fence i Building .., t ( j Bearing and distance of record ` .-, Soil Test Location ' Monument sizes shown are O.D. dimensions. Beariasr Basis: The South line of the Nor&%Ost 114 of SSWOn 32, Township 29 Range 18 W., is assumed to bear AWM 88 degrees ,, minute ' seconds East based upon the St: Cron County Coorc inata Sys1.P. 8.5' s ZTH (ON UNE) Den Jacobs Greg a. LundgL st 1038 6 th Ave bt Craix Surveying Roberts M 54023 9r0gQsftwvixsurvieyin (715) 222-5544 Hudson, M 54016 L) ORIGINr--.�. St. Croix Surveyirq� (awwotl �Sj 1061291 BETH PABST REGISTER OF DEEDS CERTIFIEDSURVEY MAP ST. CROIX CO., WI RECEIVED FOR RECORD 02/16/2018 04:41 PM Located in part of the SE 114 of the NW 114 of Section 32, T29N, CERTIFIED SURVEY MAP R18W, Town of Warren, St. Croix County, Wisconsin VOLUME: 28 PAGE: 6454 REC FEE: 30.00 PAGES: 2 AVE I.P. (ON 297-64 3 33. 1 - 4' ROW LINE) S84! 196.53' .1 �01I' I F 1 6.6' C3 1 2-94.5B I.P. G2 33.15' 196.62 0. 2' S 4.4 33� 9 .96, \S82722_ . C5 c 6 PROPO'� SKARED 1.4 CC) 33.30' DRIVEWAY ENTRANCE CD 5.9' LOT 3 Cr UJ SHED a_ CD ► 6.49 Cn C-) 75' SETBACK CD ff-) �:: 3: UJ (D C:) FROM OHWL fle') yC� C) 4 rnC) 66' 87,141 SO. FT. (2.00 AC) 0) C) EXCLUDING ROAD RJW b93,628 SQ- FT. (2.15 AC) C) INCLUDING ROAD R1W 0. 8' < POND POND SHED Go 00 LOT I C14 4 103,607 SQ. FT. (2.38 AC) 7. 00 ft r%l 3r_ PO C) Ifi EXCI. UDING ROAD RIW co a' 1 111,350 SQ. FT. (2.56 AC) SHED Q p INCLUDING ROAD R/W 0 U89,157'44"F, Cn —6.0 LOT 2 170.00' N89'57'44"E 232-70' 216,957 SQ. FT- (4-98 AC) EXCLUDING ROAD R1W LAJ M 222,594 SO. FT. (5.11 AC) RIW :D co INCLUDING ROAD CO CD ��rz C) M Cn C-) Ln :z UJ W CD� W CD L I _'z (D ]E cn U af Cq Ul r,0 C-4 0E C'4 <D >< Cr 0 C:) 4 (D >< F V) LO UJ cf) UJ Co THE EAST —WEST I.P. 8.5' NORTH ('1/4 SECTION LINE (ON LINE) ti .44" N89*5744"E N89-57"**"E 600- NB9-57*44-E ✓; ,� 1317.34 ��. 3357.02'--f Seag�qg Basis.-. Legend The East - West 114 Section line of Section 32, �'°°° Set Iron Pipe,- 1"diarneter x 18"long, Township 29 N., Range 18 W, beers North 89 °°` 44 East based weighing 1 13 lb per lineal fbot degrees 57 minutes seconds upon • Found 1"O.D. /mn Pipe the St. Croix County Coordinate System. 00 0 County Section Corner Monument Survey Eo"red For. 0 Dan Jacobs Jb/ X Fence 0 noa- 1038 65th Ave 0'�C;% C' 6 Roberts W1 54023 Q'.& Bearing and distance of record 0 50 100 Greg B. Lundquist Survey Note: This map contains areas that are subject to the Shoreland St. Croix Surveying SCALE IN FEET gr-&�stcroixsurveying.com i-=1006 Overlay Zoning District, Additional resftictions apply. Contact the (715) 222-5544 Community Development Department for further information. Hudson, WI 54016 SHEET I OF 2 2_ 10 St. Croix County 1061291 Page 1 of 2 ll CsT- a°►"' - a 31 Wisconsin De Professional Ser An" DMs o�I HTA7V26MYWRS._. ORT Page 1 ar 3 in socordenoe with SPS 383, Wis. Adm. Code s County T. C:R01X v� Attu cornthan 8 1 /2 x 11 inches in size. Plan must include, but Oil and horizontal reference point (BM), (hrecbon and Parcel I.D. O L41-- 1 O 9 0 - 9 0 ` 2 00 peroent., dimensions, north arrow, and location and distance to nearest road. Ploase paint &M Information. Reviewed Date Personal irdormahm you provide may be used for secondary pub (Privacy Law, s. 15.04 (1) (m)). I f Property Owner Property Location ; BEVERLY L. ANDERSON(Buyer: Daniel Jacobs) Govt Lot ---- SE 114 NW 14 S 32 T 9 N R 18 E (or) W Property Owners Malting Address LPity Block # Subd. Name or 101D I Z I l 1039 65th Avenue -- 2�6 - �q 5 q city State Pho ne Mmtmar []Village [DTawn Nearest Road Roberts, WI 54023 612 } 483 - 8826 65th Avenuc E] New Canstruction Use ■ Residential 1 Number of bedrooms 4 Code derived design flow rate 600 GPO 11 I�eplsoetwit Pubic or oommercisi - Describe: Parerd material sandy Flood Plain elevation if applicable _ N A �- Gerwal C01111 Conventional In -ground trenches -- 0.7 leading rate Z^AO& and roaommendations: 1 U � �9 # • Pit Ground surf*m elev. 91.96 ft � to Irr� factor 100 in. ❑ Sal bon Rate Horizon Depth in. Dormant Mur"W Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDM TIM "EfW 1 0-14 7.5YR2.5/2 •- sl 2 f-msbk mvfr cs . 2v f-co .. ...... 0.6 1.0 2 14-36 7.5YR.3/4 -- s 0S8 dl cs 2vf-m 0.7 1.6 3 36-100 1 OYR5/4 cos Osg dl 0.7 1.6 Horizon 2 hm sonw gr. 2 BWN # U g°dng 93.56 > 110 Ph Ground surface elev. f L Depth to lkmiting factor in. Sa Amiiratiort Rate Horizon Depth In. Dormant Color MWnsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz.. Sh. Consistence Boundary Roots GPD/W `Eff#1 •Eff#2 1 0-9 7.5YR2.5/2 -- 1 2 f-msbk mvfr cs 2vf-co 0.6 0.8 2 9-29 7.5YR3/4 -- sil 2fabk mfr cs 2vf-m 0.6 0.8 3 2940 7.5YR.3/4 -- sl 2fsbk ds cs 1vf--m 0.6 1.0 4 40-110 10YR5/4 -- cos Osg dl -- __ 0.7 1.6 t A- + CAL mmm# 4t - CfM'% -& In a 77n rnnA wu Tee yin r 1 rn rrw%A - ' FAY wvit to = RQD C 30 mail- and TSS C 30 ffKi , L.IJV.VM 04 rt It — UNNO w f.L.V 11 Fr 1,- w Iv 1 / VM = f VV 1..W ` �s..�w... .. — _ --- — — — �AW+r CST Name (Please Print} CST Number MARY JO HUPPERT Hollister's Soil Testin &Des( 224832 Address Dad EWuation Conduded Telephone Number 28497 King Arthur's Court, Danbury, WI 54830 10 - 26, 2017 715-426-1775 blou-033v txv If j j Property Owner ANDERSON, (Burr:Jacobs) Parcel ID # (Fcnding) Lot 2 Page 2 at 3 3 Bo" Boring # 100.51 El Pit Ground surface elev. ft. > Depth b limiting factorjQ6 in. Sod AppkatW1,11 Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/If in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Ef1#1 'EfW 1 0-14 7.5 YR2.512 g1 2 f-msbk my fr Cs 2v f-co 0.6 1.0 2 14-26 7.5YR3/3 -- sl 2fsbk mvfr cs 2vf-m 0.6 1.0 3 26-36 7.5YR3/4 -. s1 1 f-rnsbk ds a 1 of-m 0.4 0.7 4 36-106 10YR5/4 •• cos Qsg dl __ _- 0.7 1.6 Big # Boring . e2 Pit Ground surface elev. fL Depth to limWg factor Sad Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM F-- in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Efl#1 'EffQ v� "Z--. B,oring # FE6 Pit Ground surface elev. If. Depth to limbV factor in. 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':L: /b; � .. .. `.- 'i'��~��� '.� � .. ; . ..<. ,,Hl•zst .v. �.s.<r-4 '1M`4-^'t''=ss"-..^„•;. �,,,,.. :. <...�y:.,-. .. «1p�-. a..,.,.-'xtti- - ,p'1ft.r +k1 •-:ir<rt�-... ^1s.iis�gR-+„j..os' , WaM.wl'-��o-M�.R•.R: i�f: *r-w.F.gli;1U1¢r.. '!ll%IF".,ra iK• .,..,,q'Ly�y,.'r . i.r-ai 4 fir^ 9. :z .+ .'.z :-ls� .f,o-'.:.-«.w - sr . ro- SlopelWetland Exhibit csw'Beverly Anderson 103o65mAve � 5.9, Oftr2INU SCALE SCALE IN FEET 7]' LOT I D ---- onw� & (.01-W Eimmmnl Ulm Row" Of way Lm 4'r,mtxrw4 was shown am C.D. dknamio,&6. cr CY St. Croix Surveying T CRo �x COUNTY . . .......................... . . . ...... . .. ... ........... . . .............. STATE SANITARY PERMIT 0 :3 , L9 3 , 11 in X ?r 40-� rRI'm md, V lqj u N NOo .. . . .... .......... .... N PLUIVIBERsI-k��tN P�� R� LIC.# 22-4olibO TOWN VO"""k F W RRzc-m SEC_�,T 29 N 9 ANDAND/ORILOT 2 c5v%k (zg, 2bfjc-- k CHAPTER 145.135 (2) WISCONSIN STATUTES (� The purpose of the sanitary ur permit is to allow installation y of the private sewage system described in the permit. (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a specified period. (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. (f) The sanitary permit is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314 Note: 1f you wish to renew the permit, or transfer ownership of the permit, county authority. lease contact the cvun P