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Wisconsin eepartmer'it of Commerce
Safety and Building Division PRIVATE SEWAGE SYSTEM LP
n
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT) 158
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)j.
Permit Holder's Name:
City Village X Township Clow, Linda CST BM //Ellev: /l Insp�. Elev: BM Description: H udson, Town of 00 ( D y v ,v U. 0
TANK INFORMATION 5
TYPE ELEVATION DATA
MANUFACTURER CAPACITY
STATION BS HI FS
Septic ELEV.
Benchmark
Dosing co• 7 04•S/
►1d) f , 1/— Alt. BM
Aeration
BI g. e r
Holding d
t /Ht Inlet
d
TANK SETBACK INFORMATION St/Ht Outlet v
TANK TO P/L WELL BLDG. Vent to Air Intake T /SC4 U
ROAD Dt
Septic
Dosing
ead tom
Aeration t, 7'7
Dist. Pipe t,
Holding
Bot. System
PUMP /SIPHON INFORMATION
Final Grade
Manufacturer Mid 5 r! L7 j `
Dem and S> Cover
Model Number Dem
'T 1
TDH Lift Friction Loss stem Head
TDH Ft 7
Forcemain Length D' Dist. ell
SOIL ABSORPTION SYSTEM
BED /TRENCH Width
DIMENSIONS / Z Length / No. Of _ the PIT DIMENSIONS No. Pits
Y Inside Dia. Liquid Depth
SETBACK SYSTEM TO
INFORMATION P/L Type O stem: BLDG WELL LAKE /STREAM L CHING Manufacturer:
f Sy CHA OR
T Model Number:
DISTRIBUTION S ST M
Header /Manifold Distribution
Pipe(s) x Hole Size x Hole Spacing Vent to Air Intake
Length Dia Length Dia
SOIL COVER spacing
X Pressure Systems O
Depth Over nly xx Mound Or At -Grade Systems Only
Depth Over
Bed/Trench Center Bed/Trench Edges T Depth of xx Seeded /Sodded
Topsoil xx Mulched
Yes
COMMENTS: Inspection #1: d No
Yes N
(Include code discrepencies, persons present, etc.) Ins �/
p / � � Inspection #2:
Location: 560 Spurline Circle Hudson, WI 54016 (SW 1/4 NE 1/4 16 T29 R19W) NoZth Line St ion I Lot 14
1.) Alt BM Description = / , Parcel No: 16.29.19.905
2.) Bldg sewer length =
- amount of cover =
Plan revision Required? Ye 0
Use other side for additional information.
1 i
SBD -6710 (R.3/97) Date Ins
epctor's Signaftre Cert No
Parcel #: 0 20 - 1159 -62 -000
06/24/2011 11:27 AM
Alt. Parcel #: 16.29.19.905 PAGE 1 OF 1
Current 1K 020 - TOWN OF HUDSON
Creation Date Historical Date Ma # ST. CROIX COUNTY, WISCONSIN
Map Sales Area Application # Permit # Permit Type # of Units
00 0
Tax Address:
Owner(s): O = Current Owner, C = Current Co -Owner
LINDA W CLOW O - CLOW, LINDA W
566 SPURLINE CIR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): = Primary
Type Dist # Description ` 566 SPURLINE CIR
SC 2611 SCH DIST OF HUDSON
SP 1700 WITC
Legal Description: Acres: 2.620 Plat: 05- 006 -NORTH LINE STATION II
SEC 16 T29N R19W NORTH LINE STATION II
LOT 14 Block /Condo Bldg: LOT 14
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
16- 29N -19W
Notes: TDate arcel History:
Doc # Vol /Page Type
7/07/2000 626006 1524/552 yp
7/23/ 1997 862/446 O C
7/23/1997 823/138
07/23/1997 784/616
2011 SUMMARY Bill #: Fair Market Value:
Assessed with:
0
Valuations:
Last Changed: 08/16/2010
Description Class Acres
RESIDENTIAL Land Improve Total State Reason
G1 2.620 67,300 196,000 263,300 NO
Totals for 2011:
General Property 2.620 67,300 196,000
Woodland 0.000 0 263,300
0
Totals for 2010:
General Property 2.620 67,300 196,000 263,300
Woodland 0.000 p
0
Lottery Credit: Claim Count: 1 Certification Date:
Batch #: 140
Specials:
User Special Code
Category Amount
Total
Special Assessments Special Charges Delinquent Charges
0.00
0.00 0.00
0 Cou ty Sanitary Permit Application ST. CROIX COUNTY WISCONSIN
V �c;� h Chapert 12 St. Croix County ni r a
?09X 0, ation you provide may be use PLANNING & ZONING DEPARTMENT
[Privacy Law. S. 15.04(1) u ST. CROIX COUNTY GOVERNMENT CENTER
P� 1101 Carmichael Road
Hudson, WI 54016 -7710
Attach complete plans for the system on pa er not less than 8 -1/2 x 11 inches in si e )386 -4680 Fax (715)386-4686 .
County Sanitary Permit # ❑ Check if revision to previous application
5 C - (' 5
I.
Application Information - Please Print all Information
Property Owner Name Location:
/ r
!,, tl ,ND 1. Q W 1/4
Property Owner's Mailing Address T N, R E (or W
Co (.Q S PV 9 L ��� �' : , �f Lot Number Block Number
City, State �' (/�. tl N , L j
eh D �� r one Numer
Zip Code Ph
/ d Subdivision Name or CSM Number
SCI
La of Building: (check one) /� I w `�N s *77 OA-
W1 or 2 Family Dwelling - No. of Bedrooms: 3 LE AY ❑ Village Town of
El Public /Commercial (describe use):
(, ❑ State -owned
V II. Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Road
i.al Repair 2. ❑ Reconnection 3 .❑Non- plumbing 4. ❑ Rejuvenation Parcel Tax Number(s)
Sanitation
B) Permit Number
State Sanitary Permit was previously issued q Date Issued
V. Type of POWT System: (Check all that apply) `
v X_Non- pressurized In- ground I q
❑ Sand Filter 11 Mound z 24 in. suitable soil ❑ Mound <_ 24 in. suitable soil 11 Mound A +0
❑ Constructed Wetland
11 Pressurized In- ground ❑ Peat Filter ❑ Drip Line
❑ At -grade ❑ Holding Tank ❑ Single Pass
❑ Aerobic Treatment Unit ❑Other
2 V.
Dispersal/Treatment ersal/Treatment Area Information: Recirculating
Desi n Flow Ir r� D Y L�U/ p U S Ir
1 � 9 (gpd) 2. Dispersal Area 3. Dispersal Area . Soil Application Rate 5. Per l
coation R 6. System Elevation 7. Final Grade
� #. Required P�capess�t_ (Gals. /day /sq.ft.)
-7 1. Elevation
VI. Tank Information Capaicty in Gallons Total # of
Manufacturer Prefab Site Con Steel Fiber -
New Existing Gallons Tanks Concrete structed Plastic
Tanks Tanks glass
❑ ❑ ❑ ❑
❑ ❑ ❑
❑
II. Responsibility Statement ❑ ❑
I, the undersigned, assume responsibility for re /re connenction /rejuvenation /installation of non - plumbing for the POWTS shown on the attached plans. A
license is not required for terralift repair or the installation of non - plumbing sanitation system.
Plumber's Name (print) I mber's Signature (no amps
nl1 (� MP /MPRS No Business Phone Number
Plumber's ddress (Street, CityState, ' C )
L VIII. Count Use Onl
® Disapproved Sanitary Permit Fee
Ap Given Initial Adverse 2 Da te Issued ssuing Age t Si atur stamps)
Owner
Determination Z � ,2L)
X. Conditions of Approval /Reasons for Disapproval:
SYSTEM OWNER: ��V/Qzo1-1''
1 Septic tank, effluent filter and
dispersal cell must all � serviced / maintained U /l
` Y as per management plan provided by plumber.
2. All setback requirements must be maintained CzC�' t� ('Gfi��7n1
as Nei app;; argyle coueiorginances. lS-4,B. k— ✓a Q O
r� Chi
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner /fir-
Mailing Address
Property Address
(Verification required from Planning & Zoning Department for new construction.)
City /State. Parcel Identification Number �0 �� 2
LEGAL DESCRIPTION
Property Location' /4 , '/4 , Sec. �, T 29 N R_W, Town of Ytdl� 0
Subdivision Plat: , Lot #
Mran urvey Map # ,Volume ,Page #
Deed # �lf ( � i Page # ume 2007 Vol before oZ �5 a
( ) / � y ,
Spec house 11 yes 61 Lot lines identifiable Wy ❑ no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
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. Owner maintenance
responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & 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.
I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin.
Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning &
Zoning Department within 30 days of the three year expiration date.
I /we certify that all statements on this form are true to the best of my /our knowledge. I /we am /are the owner(s) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
Number pf edrooms 3
c
SIGNATURE OF APPLICANT(S) DATE
** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * **
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. 09/07)
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Form -STC 104
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP SEC. T --N -RW
ADDRESS 6t) c; '% ST. CROIX COUNTY, WISCONSIN
SUBDIVISION J .. �i: �,�,�� L OT
LOT SIZE
,d --�
PLAN VIEW
Distances and dimensions to meet requirements of I•ZHR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
r
1
/y
1
INDICATE NORTH ARROW
tanvnWADV. T. 41— tlkn vnrf-iral reference point used � /yt• },•t._ L% ` l�5
DEPARTMENT OF INDUSTRY INSPECTION REPORT FOR SAFETY & BUILDINI
LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISK
P.O. BOX 7969 BUREAU OF PLUMBIP
S.t.''SgNYwl 55��, C ❑
T29N — R19W ONVENTIONAL ALTERNATIVE State Plan 1. D. Number:
Town I of Hudson ❑ Holding Tank ❑ In- Ground Pressure ❑ Mound of a��l
Northline Station p
NA AllenMlMiller � 53000 INSPECTION DATE
th Street North, Hudson, WI 54016 111 30 :
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: FEE. PT. ELEV.: CST REF. PT. ELEV.
Name of Plumber: MP /MPRSW No Sanitary Permrt Number:
William Schumaker 6382 St. Croix 96041
SEPTIC TANK /HOLDING TANK:
MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER
C
.� PROVIDED: PROVIDED:
�3 �r t�o�p SYES ON EYES �<NO
BEDDING: VENT DIA.: VENT MATL: HIGH WATER NUMBER OF ROAD: PROPERTY WEL BUILDING: VENT TO FRE
ALARM -. FEET FROM LINE AIR INLET.
n
OYES �,NO �/z DYES KIND NEAREST i ll ki'i d r d�
DOSING CHAMBER:
MANUFACTURER BEDDING. LIQUID CAPACITY. PUMP MODEL. PUMP /SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
❑YES ❑NO DYES ONO I OYES ONO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF''. PROPERTY WELL. BUILDING. VENT TO FIRE
(DIFFERENCE BETWEEN FEET FRO LINE' AIR INLET'
PUMP ON AND OFF) ❑YES ENO NEAREST
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH J DIAMFTIR MATERIAL AND MARKING
or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN
the soil is dry enough to continue.)
CONVENTIONAL SYSTEM:
WIDTH: 1 1_ENG H IN_0__0_F PIPE SPACING. COVER INSIDE DIA. - . #PITS. LIQUID
^ THE N �, M ERIAL' PIT DEPTH
GRAVEL
DEPTH FILL DEPTH DISTR. PIP DISTR. PIPE DISTR. PIPE ATERIAL: NO. R. NUMBER dl=' PROPERTY WELL BUILDING: VENT TO FRE
BELOW PIP C L ABOVE COVER. ELEV. INLET ELEV ENO. PIPE LINE: AIR INLET:
FEET FROM
NEAREST
MOUND SYSTEM:
Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM
and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA-
DYES NO
meets the criteria for medium sand. TIONS MEASURED.
❑
SOIL COVER I TEXTURE JPFRMAIIENT MARKERS OBSERVATION WELLS
❑YES ❑NO OYES ONO
DEPTH OVER TRENCH;BED DEPTH OVER TRENCH /BED DEPTH OF TOPSOIL SODDED SEEDED: MULCHED.
CENTER. EDGES:
❑YES O NO ❑YES ONO DYES 1 NO
PRESSURIZED DISTRIBUTION SYSTEM:
�ww WIDTH: LENGTH. NO. OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER.
i+'R1Ftir, • " TRENCHES:
,'. MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING.
ELEV.. ELEV.: DIA.- ELEV.. PIPES. DIA_:
g 1 g � j. S°)I`Ftl��#k'TON HOLE SIZE HOLE SPACING: DRILLED CORRECTLY. COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED
PLANS.
A DYES 0 N OYES
PROPERTY WELL: BUIL
❑NO
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER DING:
BEE T OM LINE:
S
EYES ❑NO ❑Y S ❑NO NEARES `
)o
is
1 i i S -tom"
Sketch System on Retain in county file for audit.
Reverse Side.
I S/NATURE : TITLE:
nj
DILHRSBD6710 /82) Z oning Adm•
E DILHR SANITARY PERMIT APPLICATION COUNTY
In accord with ILHR 83.05, Wis. Adm. Code
°°��...........� STAT p A�NITARY PERMIT #
V (D0 1
—Attach complete plans (to the county copy only) for the system, on paper not less than STATE PLAN I.D. NUMBER
8% x 11 inches in size.
—See reverse side for instructions for completing this application. PETITION
1. APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION FOR VARIANCE ❑ YES U NC
PROPERTY OWNER PROPERTY LOCATION
SGT' /4 _ V,o '/4, S j T , N, R E (or
PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME �yL
CIT , STATE ZIP CODE PHONE NUMBER NEAREST ROAD, LAK OR LAN DMARK
e 1 Eje VILLAGE : D
II. TYPE OF BUILDING OR USE SERVED:
Number of Bedrooms if 1 or 2 Family OR ❑ Public (Specify):
III. PURPOSE OF APPLICATION (Check only one in ##1. Check ## 2,3 or 4, if applicable)
1. a. 0 New b. ❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e. ❑ Repair of an
System System Septic Tank Only an Existing System Existing System
2. ❑ A Sanitary Permit was previously issued. Permit ## Date Issued
3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements.
4. ❑ The System is shared by more than one owner /building. Attach Common Ownership Agreement to County Copy.
IV. TYPE OF SYSTEM: (Check only one in ##1 and only one in ##2)
1. a. KPonventional b. ❑ Alternative c. ❑ Experimental
2. a. ❑ System- b. ❑ Holding c. ❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP
In-Fill Tan k
V. ABSORPTION SYSTEM INFORMATION: (Check one)
1. a. ❑ s eepacie Bed b. ❑ seepage Trench c. ❑ Seepage Pit
2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY:
(Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): �� �•
Feet ZPrivate ❑Joint ❑Public
VI. TANK CAPACITY Site
in 9 alions Total ##of Prefab. Fiber- Exper.
INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks strutted
Septic Tank or Holdin Tank DCiC .c tom^— ❑
Lift Pump Tank/Siphon Chamber ❑ ❑ I ❑ ❑ ❑
VII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the private sewage system sho on the attached plans.
Plumber's Name (Print): Plumber's Signature: (No Stamps) P PRSW No.: Business Phone Number:
Plumber's Address (Street, City, State, Zip Code): Name of Desig er:
III. SOIL TEST INFORMATION
Certified Soil Tester (CST) Name CST #
yy ,
T's ADDRESS (Street, City, State, Zip Code) Phone Number:
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved S Hilary Permit Fee Groundwater ate Issuin Agent Signature (No Stamps)
❑Owner Given
Approved Initial I , rcharge Fee
Adverse Determination j
X. C MMENTS /REASONS FOR DISAPPROVAL:
SBD -6398 (formerly Plb -67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber
APPLICATION FOR SANITARY PERMIT
STC - 100
This application form is to be completed in full and signed by the owner(s) of the
property being developed. Any inadequacies will only result in delays of the permit
issuance. Should this development be intended for rese by owner /contractor, ( "spec
house "), then a second form should be retained and completed when the property is
sold and submitted to this office with the appropriate deed recording.
Owner of Property A L mot- (� �(ob;
Location of Property S w WE It, Section , T N -R W
Township - �� C 0 r1
Bailing Address S S y A S_OJ o
�u cQS D n, LJ :N S Y o
Address of Site �.o l� N�c yQ� �� S� S `he �'.1�tc�e
C�� -L.�I S 1 s� �LJ � •� C� o i b
Subdivision Name
Lot Number
Previous Owner of Property Sh e c rh P e.csar�
Total Size of Parcel LeS
Date Parcel was Created
Are all corners and lot lines identifiable? Yes No
Is this pr�ope�rty being developed for resale (spec house) ? Yes t� No
r
---
Volume � and Page Number � �(� as recorded with the Register of Deeds.
000�LLM e.4� k U rA t4_ y 1(D to G7
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A Warranty Deed which includes a Document number volume and page number and the
Seal of the Register of Deeds In addition, a certified survey, if available, would be
helpful so as to avoid delays of the reviewing process. If the deed description refer-
ences to a Certified Survey Map, the Certified Survey Map shall also be required.
PROP ERTY OWNER CERTIFICATION
DOCUMENT NO. STATE BAR OF WISCONSIN FORM 11 -1882 TN15 SPACE RESERVED FOR RECORDING DATA
,. LAND CONTRACT
('��(�! B Individual and Corporate
�, i t! (TO E USED FOR ALL TRANSACTIONS WHERE OVER
-� () $26,000 IS FINANCED AND IN OTHER NON - CONSUMER
�LV� l; ACT TRANSACTIONS)
REGISTERS OFFICE
ST. CROiX CO., W15.
Contract by and between ____J : a
__Sherman__Peterson nd 7th
Peterson
f.ec'd. for Record this
y (?
- - - - -- ( Vendor , April A.D. 1986
- -- -- ------------------------------------------------------- - - - - -- -
whether one or more) and ____A�s3ri__M11eS_.s1?41._D�f ?J; j��__Mlle 1 r __ -_____ 8:30 A
-_- husband__ and_- wif --- t.enaja ts_-:____..____ _____________ _________ _________
__________________________________ ___ ____ _________ __ __ __ __ ( "Purchaser ", whether one or more).
Vendor sells and agrees to convey to Purchaser, upon the prompt and full per 1 ow of Deade
formance of this contract by Purchaser, the following property, together with the
rents, profits, fixt aI otter appurtenant interests (all called the "Property "),
Jt . r o ix County, State of Wisconsin: RETURN TO
Lot 14, Northline Station II in the Town of Hudson.
Tax Parcel No- ----------------------------------
This ------- iS._.nOt--------- homestead property.
kW (is not)
Purchaser agrees to purchase the Property and to pay to Vendor at ----------- heir residence
------------ -- ------- --- ------ --- --- - -�
the sum of $___ LL, 9Q Q-QQ------------------------------------- in the following manner: (a) $ -_ -$21000 : 00____________________--__----
at the execution of this Contract; and (b) the balance of ........ ........... together with interest from date
hereof on the balance outstanding from time to time at the rate of ----- .---- 10---------------------------- per cent per annum
until paid in full, as follows: Monthly installments of: ,$125.00 beginning Maly 6 and
on the sixth day of ea6h Month tlaertaf ter .
one year from the
Prov
de however, the entire outstanding balance shall be paid in full on or before �XiXXXXXXXXXXXXX )dI xxk
- _date - - o this - contr CltJ -------- ( the maturity date).
Following any default in payment, interest shall accrue at the rate of .11- - - - -__ % per annum on the entire amount
in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire
principal balance) .
l�; �bK�XEI�IXIeI��E) 6�XXX��' i��' i4{$ �X�lX�RIi ��FcIXX�I�• X�k�4{ I��PR� ?k'XXX4$X���I€X��4I�X�#�I{�A�
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 XBXMXXXXXXXXXXXXXX)WXXXXWM
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
f
1 PAGE 2
f promises to pay when due all taxes And assessments levied on the Property or upon Vendor's interest
in 3t and to deliver to Vendor on demand receipts showing such payment-
Purchaser shall keep the improvements on the Property insured against loss or damage occasioned by fire, ex-
tended coverage perils and such other hazards as Vendor may require, without co- insurance, through insurers approved
by Vendor, in the sum of $ ---- NJ A____Vanan __Land_........ b4t Vendor shall not require coverage in an amount more
than the balance owed under this Contract. Purchaser shall pay the insurance premiums when due. The policies shall
contain the standard clause in favor of the Vendor's interest and, unless Vendor otherwise agrees in writing, the original
of all policies covering the Property shall be deposited with Vendor. Purchaser shall promptly give notice of loss to
in:surance 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
,,e.;:;omieally 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 frilly paid and all conditions
shall be fully performed at the times and in the manner above specified, Vendor will on demand, execute and deliver to
the Purchaser, a Warranty Deed, in fee simple, of the Property, free and clear of all liens and encumbrances, except
any liens or encumbrances created by the act or default of Purchaser, and except: Easements, Covenants and
restrictions - -o record ..--•------------•-------------•-•----------------•---- --- •-- -- ------ •----......•.....
---....--------------------------------------------------- - - - - -- ----- ••- •---- •--- •- • - -• - -- ------ ----- - - - - -- •• - - -- ------------------------------------
-------------- •-------- - - - - -- ------------------------- - - - - -- - -•• - -- -------------- --------------- - - - - -- ------------------------------------------------
--- - -----------•------- --- -------------------------------------- - - - - -- -------------------------------------------------------------------------
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 . ... 3_0_ days following the specified due date or (b) in the event of a default in
performance of any other obligation of Purchaser which continues for a period of ....30 -. days following written notice
thereof by Vendor (delivered personally or mailed by certified mail), then the entire outstanding balance under this contract
shall become immediately due and payable in full, at Vendor's option and without notice (which Purchaser hereby
waives), and Vendor shall also have the following rights and remedies (subject to any limitations provided by law) in
addition to those provided by law or in equity: (i) Vendor may, at his option, terminate this Contract and Purchaser's
rights, title and interest in the Property and recover the Property back through strict foreclosure with any equity of
redemption to be conditioned upon Purchaser's full payment of the entire outstanding balance, with interest thereon from
the date of default at the rate in effect on such date and other amounts due hereunder (in which event all amounts previously
paid by Purchaser shall be forefeited as liquidated damages for failure to fulfill this Contract and as rental for the
Property if purchaser fails to redeem) ; or (ii) Vendor may sue for specific performance of this Contract to compel
immediate and full payment of the entire outstanding balance, with interest thereon at the rate in effect on the date of
default and other amounts due hereunder, in which event the Property shall be auctioned at judicial sale and Purchaser
shall be liable for any deficiency; or (iii) Vendor may sue at law for the entire unpaid purchase price or any portion
thereof; or (iv) Vendor may declare this Contract at an end and remove this Contract as a cloud on title in a quiet -title
action if the equitable interest of Purchaser is insignificant; and (v) Vendor may have Purchaser ejected from possession
of the Property and have a receiver appointed to collect any rents, issues or profits during the pendency of any action
under (i), (ii) or (iv) above. Notwithstanding any oral or written statements or actions of Vendor, an election of any
of the foregoing remedies shall only be binding upon Vendor if and when pursued in litigation and all costs and expenses
including reasonable attorneys fees of Vendor incurred to enforce any remedy hereunder (whether abated or not) to the
extent not prohibited by law and expenses of title evidence shall be added to principal and paid by Purchaser, as in-
curred, and shall be included in any judgment.
Upon the commencement or during the pendency of any action of foreclosure of this Contract, Purchaser consents
to the appointment of a receiver of the Property, including homestead interest, to collect the rents, issues, and profits of
the Property during the pendency of such action, and such rents, issues, and profits when so collected shall be held and
applied as the court shall direct.
Purchaser shall not transfer, sell or convey any legal or equitable interest in the Property (by assignment 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 amounts then due under this Contract. Purchaser may make any such payments directly to
the Mortgagee if Vendor fails to do so and all payments so made by Purchaser shall be considered payments made on
this Contract.
Vendor may waive any default without waiving any other subsequent or prior default of Purchaser.
All terms of this Contract shall be binding upon and inure to the benefits of the heirs, legal representatives,
successors and assigns of Vendor and Purchaser. (If not an owner of the Property the spouse of Vendor for a valuable
consideration joins herein to release homestead rights in the subject Property and agrees to join in the execution of the
deed to be made in fulfillment hereof.)
Datedthis ------------- - - - - -- 4th------------- - - - - -- day of -- •- - - - - - -- April_ ----------- - - ---- •--- -• -- - --- - -- -- .. - - - -., 19__86. -.
al' ` L � --- ------- - - - --- (SEAL) ---------- - (SEAL)
— --- - --
J. SHERMAN PETERSON ALAN MILLER
U� o � -�.?!� (SEAL)
�I�ZCt�fCe- CLu- /�x— �!� - -- (SEAL) `
MINNIE RICCI PETERSON aka MINNIE A. DEBBM MILLER
---------- - - - - -- ---------- PETERSON * --------- • --- -- - - - - - •--- - - - -- --- •• --- - - - - - - - - - - - --
AUTHENTICATION ACKNOWLEDGMENT
J. Sherman Peterson, Minnie RicciSTATE OF WISCONSIN I
• H
N
►-1
a
9TC -105 r
a
H
SEPTIC TANK MAINTENANCE AGREEMENT o
St. Croix County z
V' d
a
OWNER4UYER ALa `E - -) �'1i le.r �
ROUTE /BOX NUMBER _Fire Number
.CITY/STATE �l�(Spr S, ZIP SY 01
PROPERTY LOCATION: Section 1( , T_N, RW,
Town of St. Croix County,
Subdivision ck Lj,..e Ski: % #_ Lot numbe
Improper use and maintenance of your septic system could result in
its premature failure to handle wastes. Proper maintenance con-
sists of pumping out the septic tank every three years or sooner,
if needed, by a licensed septic tank pumper What you pdt into
the system can affect the function of the septic tank as a treat -
ment stage in the waste disposal system.
St. Ct' ix.County residents may be eligible to receive a grant for
a ma'kI.ium of 60% of the cost of replacement of a failing system,
which wag in operation prior to July 1, 1978. St. Croix County
accepted this program in August of 1980, with the requirement that
owners of all new systems agree to keep their systems properly
maintained.
The property owner agrees to submit to St. Croix County Zoning a
certification form, signed by the owner and by a master plumber,
journeyman plumber, restricted plumber or a licensed pumper veri-
fying that (1) the on -cite wastewater disposal system is in proper
operating condition and (2) after inspection and pumping (if nec-
essa,ry), the septic 'tank is less than 1/3 full of sludge and scum.
Cerxification form will be sent approximately 30 days prior to
three year expiration. Ho
E
I /WE, the undersigned, have read the above requirements and agree N
to maintain the private sewage disposal system in accordance with x
the standards set forth, herein, as set by the Wisconsin Depart- b
ment of Natural Resources. Certification form must be completed
and returned to the St. Croix County Zoning Office within 30 days
of the three year expiration date.
SIGNED "
DAT 19 $ 7
St. Croix County Zoning Office
P.O. Box 98
Hammond, WI 54015
715- 796 -2239 or 715425 -8363
Sign, date and return to above address.
'� � ` � � 5 �/ % ��� S.w l6 ,1� � • %G e 3 T.-t /e .�/ �c✓� o � ���..aor/
3`
3s'
x
5 f` Tc-
sy �
00
3�
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Massless
DE^ARTMENT OF /b REPORT ON SOIL BORINGS AND S AFETY &BUILDING;
INOUStr RY , 6/
PERCOLATION TESTS 115 BOX 7 01
140.1 RE TIONS ( , P.O. BOX 796!
- -C (H63.09(1) IN Chapter 145.045) MADISON, WI 5370'.
c /�v� TOW HIP UNICIPALITY: OT O. I N A E: . U : E / T l9N /R #(or R X7 4 C
COUNTY: / /9 /L
.54 Croi � �5"t30 87�•� a)`' /�o,F1�7 � %�so /� /t i
E
B DATES OBSERVATIONS MADE
esidence - IO ~ New ❑Replace /I / TS:
RATING: So Site suitable for system U_ Site unwitabN for system �!
NV ❑q M IJN : ❑u OU F1 ryST MN-FIL _ S _ r1C7M LrOLDI NG ANK: REC MENDE SYSTE do )
u
If Percolation Tests are NOT required DESIGN RATE:
under s.H63.W5)(b), indicate It any portion of - the tested area is in the
Floodplain, indicate FloodPlain elevation: ON
"PROFILE DESCRIPTIONS
BORING TOTAL ELEVATION - AI ROUN!)WATER- INCHES A l; ElZ .SOIL y'4i THICESS, COLOR, TEXT
+:MI:!?E, TEXTURE—AND DEPTH NUMBER DEPTH 1 OBSE RVED - €s1'I ` "O BEaROCK IF OBSERVED (SEE ABBRV. ON BACK.)
72`, /Vane 1 F. sl /,;?Se,s/ .Sees / r ' 17 101
fI > •75 8161,91 A n sl 13 Z, /7 CS BA r
B- 3 0./7 ' 2, r,
B- y 9,sa 9s• 9� > 9, sa Bk� loY
3 A, S . t Bn r
B- 5 9
> 7 t s�'
,9 • Isl. I , 2"ls .S c s >- � � z,9L
B-
PERCOLATION TESTS
D _ PT H•, AFT SWELLING WATER IN HOLE TEST TIME INTERVAL -MIN:
INCHES , P 1 WATER L V L -IN HES RATE MINUTES
NUMBER
P. (pZH P I PER INCH
s P- O p
P -
P..
P. —
P
PLOT PLAN Show locations of percolation tests, soil bori -
nps and the _dirtcensions of suitable soil areas. Indicate scale or distaroes. Describe what are the hori-
zontai and vertical elevation reference points and show their location on the pwt . Show the surface elevation at all borings; nd the direction and
of told slope.
SYST percent
- ELEVATIONS,
3
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Gy -
i 3 _
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4
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