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004-1046-90-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENER~~L 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 X Township Ta lin, Barr Cad Townshi CST BM Elev: Insp. BM Elev: BM De cripjion-: 1 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic I,r?.a1LV ! 000 Dosing / bD (~ Aeration Holding TANK SETBACK INFORMATION TANK TO A P/L / M WELL BLDG. Vent 'Intake ,[;20 D C Septic ` t~~ 1i I / / Dosing l- Aeration ~- Holdin `' PUMP/SIPHON INFORMATION Manufacturer Demand n'(a~ L GPM Mode! Number F! ~ ~ ~ '\ V TDH Lift ~ ~ Friction Loss System Head TDH Ft Forcemainr Leng ~ Dia. r ~~ Dist to well ~ ~ ~ .~ SOIL ABSORPTION SYSTEM ' County: St. CroiX Sanitary Permit No: 430052 0 State Plan ID No: Parcel Tax No: 004-1046-90-000 Section/Town/Range/Map No: 20.28.15.319 STATION BS HI FS ELEV. Benchmark ~ ~~ l u 3 0.2~ //Oj2 ~Od' o Alt. BM S r Co V BI g Sew ~ C~j2 I .2 5 /o y ~ t/Ht Inlet a' S" ~ ia. 9 ~ •~~ SUHt Outlet ~ Dt Inlet ~ / Dt BQtt9 j A ~ . ~p a~[ v0 `~ I .~ ,~ 6.0 9 ~Z~ ea a an. . ~ D Z. Z Dist. Pipe ~ ~~ ~ ~ -~; fl ~~ ~ I U /~ 2.lS Bot. S stem ~ Final Grade St Cover S~~ • rb ~ 7 /~p. Z /b d .U BED/TRENCH DIMENSIONS Width ~ Length ~ ~ No. Of Tre hes / ~~ PIT DIMENSION o. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM L CHIN CHAM R Manufacturer: T Of S ype ystem: ~ \ I w /QJ t _ ,r / Model Number: DISTRIBUTION SYSTEM Header/Ma f d ~ r~ I ` ~ Distribution r y~ ~ L ( S/ x Hole Size ~~ 3 x Hole Spacing ~ a Air Intake d Length Dia ength Dia Spacing / ~ 3. ~ SOIL COVER ~ x Pressure Systems Only xx Mound Or At-Grade Systems Only v Depth Over y ~ " Depth Over xx Depth of xx SeededlSodded xx Mulched 9 , ~ Q Bed/Trench Center ~ S Bed/Trench Edges Topsoil Yes ~ No Yes 1 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/~/ d ~ Inspection #2:~/~/ Q Location: 236 290th St SpringrrV__alley, WI 5 «?67 (NE 1/4 SE 1/4 2 T28N R15W) NA Lot ~lX Parcel No: 20.28.15.319~~ 1.} Alt BM Description = -s~ W v~ ~ ~ /~ ~ ~ _ jJ A 2J Bldg sewer length =(~j fr,2~~ S ~~lL ,~QJ~ J,~(,(q./ -amount of cover = ~ ? f U q ~ J _/ -- --- -- -_ . _ -- - - __ __ _ --- --- ~- r .y/ //II r/p /_ -- Plan revision Re uired. _ Yes I _~ No / ~ 2 ~ G~~~~ i ~ ~~___; Use other side for additional information. ~ _ _ ~(/ _ ~ ~__bJ . _ _ _ - - - -- - ~~!l~~V--__. . SBD-6710 (R.3/97) Date Insepctor's S' nature Cert. No. • Safety and Buildings Division County m m 201 W. Washington Ave., P.O. Box 7082 S ~ . C rd ~~( ~scons~n Madison, WI 53707 - 7082 Sanitary permit Number (to be filled in by Co.) De artment of Commerce (608) 261-6546 ~~~~ State Plan [.D. Number Sanitary Permit Application p In accord with Comm 83.21, Wis. Adm. Code, personal information you provid (pp 3 = Tn+µS 4 C~ba /„Q.~ maybe used for secondary purposes Privac Law x15.04 1 m jest Address (if different than mailing address) I. Application Information -Please Print All Inform ion Property Owner's Name p, ~ c~ ~y r. _. .~VIV ~ 2 L~~3 ~ r ~' ~ a `.',,~ Property Owner's Mailing Add , T. C I~ O I X C O U N-T Y A / ~ ~ rl ~O ~-h NG OFFICE ~ 2.~ 2 a `~ g~-. P I # Lot # Block # `fo cuue_ w'ci?~ Location ~ 5 Z City, State Zip Code Phone Number ! V ~~ti ~ ~~•. Section f~ 57r;ti VA~~e W~. ~ `~1~D1 115-~~8 - 3~~~D rck ne) T~N; R ~~Eor~ II. of Building (chex all that apply) a° ~n 5 n.~~- ~ S bdivision Name CS Number I or 2 Family Dwelling - Number ofredrooms ~ ~p.nefL - d ^ PublicJCommercial - Descn~be U ` "~ ~ ~ 'O ~ (~ , ~ r ~- GtfC --` ^State Owned -Describe Use t ~ " D,r = ~ /~ City ^Village ownship of Q G1 III. Type of Permit: (Check only one boz on line A. Complete line B if applicable) Qp -- 0 (o - - t~ 3l9 A. ew S em ^ R Iacement S tem yst ep ys ^ Treatment/Fiokling Tank Replacement Only ^ Other Modification to Existing System List Previous Permit Ntunber and Date Issued B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Petmit Transfer to New Before Expiration Plumber Owner IV. T e of POWTS S stem: Ch sll that a 1 -lrc. - t7U ^ Non -Pressurized in-Ground Mound n. of suitable soil Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Fiher ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe Other explain) V. Dis ersal/Treatment Area Information: 2 Design Flow (gpd) Design Soil Application.Khte(gpdsfl Dispersal Area Requ d sf) Dis 1 Area roposed (sf) System Elevation 30O ~~~ ~.,, 11 y1 ~~' t~~ lvl. ~ VI. Tank Info Capacity in Total Nu Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing /Tanks Tanks Septic or Holding Tank / 0~ ' DO d ~ 1 ~ N' X Aerobic Treatment Unit DosingCls-mber ~©O (~Ot~ ( r _ 1. E. y' X VII. Responsibility Statement- I, the undersigned, assume responsibility fWOr ins allation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum s Sign re P PRS Number Business Phone Number CI,w' ; s 3a u c r ~.. , fv- P as o (o $ u "11 s- Cc)~~- $t~ y Plumber's Address (Street, City, State, Zip Code) ~ 15 _ a'~ ~ -3q 3{ - _ ~ e N (o `l 8 3 t7o rw ~'•vs /~I : ~ 1 -? c~ ~ u truce c~ W i S' t-I 7 3 (c VIII. Coun /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuin Agent Signature (No Stamps) Surcharge Fee) 2 ~ ^ Owner Given Reason for Denial ~ 7~~- (7 IX. Conditions of ApprovaVReasons for Disapproval ` /~ n _ Attach complete pleas (te the County aaly) for the system oa paper not less than 8112 : I1 inches fa siu '~E- ~ aC~ ,t`er,~~~ vw>J.-o~-~ vwa.-.M~+a..r.a~ . SBD-6398 (R. 08/02) t~ ," i 3 ~^ 1 9~ ~ ~``III ~I s 6 ~~ a ~~ S .,.i ~r s d M A~ V ~+ J` S .r ~- ~ I .r r ~* N N I Z ~- r/, d J o J fl ~ ~ ~ d f ~' ~~ ~ 1 9 ~ ~, M ..~' 1`n ~ r ~~ ~v N ~~ ti ,. r-, v+ S •~ , ~' ~ o ~ - s~, ~ --~ ~' -~ 3 -~ o~ 3 n ?- u, o' ~ ,~, ~ -~, + r S r.3 3 a I~.~ ~~ d n N ~ ~~ u ~ ~ -~ ~' l ,~ ~~i ~ ~ ° ~ 2 Lr `~ ~ ~ l` ~~i 4i ,ter i~~ ~ 7yeyyy.~-}}~ J _ ~ ~ Q~ i y S'c.'~^ 'J~ ~• ..J ~ ~ ~- ~ P ~ ~~ g~ z ~ ,~ , ~ , n~ ~~ _ ' I Js ~ - 3 .~ ~ ,~ , ~ J ~ ~~ N -~ ~ 7 J -~ ~ •- ° ~ ~ •~ ~~ s~ J ~ a ~) '~ ~, V, --r d s ~ -~ "~ a~ ~- - s ~, M 9 ~ ,~ tr /. 5 a d ~ ~ . ~ ~ ~ U T - - - D~., 2 I L ~ ~scons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce.state.wi. us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary May 20, 2003 CUST ID No.220684 CHRIS M BAUER N6483 DORWINS MILL RD DURAND WI 54736 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/20/2005 ATTN. POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Barry Taplin 290TH St Town of Cady St Croix County NE1/4, SE1/4, S20, T28N, R15W FOR: Description: Two Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 904089 Identification Numbers Transaction ID No. 871683 Site ID No. 659322 Please refer to both identification numbers, above, in all correspondence with the agency. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems. VERSION 2.0" SBD-10691-P (N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10706-P (N.O1/O1). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. Cone • The off setting (D) is proposed to be at six inches from the bottom of the tank. The pump pad, along with the ~~~~ legs of the pump, may leave the impellers out of the liquid effluent before the pump off setting is reached. This should be checked at time of construction to insure this condition is not encountered. This setting maybe DEF`ARTMENI adjusted, with the inches coming from the reserve capacity area. ~{ N OF • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption SEE CORi31 area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. CHRiS M BAUER Page 2 5/20/03 • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, (~~~~ ~ ~ZS~~r~J- " Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Henry F Grote ,Certified Soil Testing Barry Taplin -Mound Transaction # Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD-10691-P (O1/O1) Pressure Distribution, SBD-10706-P (01 /0l ) Location: NE 1/4, SE 1/4, Sec. 20, T 28 N, R 15 W Town: Cady County: St. Croix Date: May 13, 2003 Owner: Barry Taplin Address: W. 3832 850th Ave. Spring Valley, WI 54767 Plumber: C i Bauer Signature: ~ ~ License # MP 220684 Attachments: 6748-Plan Approval Application SBD-8330 page 1: cover 2: pesi pn criteria & calculations ~C ^ c'~C R 3: lot lan GV G GY 4: system cross section ~• 5: plan view, lateral detail MAY 14 2003 lonaljy 6: pump tank exit detail ~+ ETY ~C gLDGS D~V~ •~~~D 7: pump curve SAF j~ coMMERC~ 8: system management ~~ ~N =SPONDENC page 1 of 8 Design Criteria ~t'S Residential Wastewater Contaminant Load: 30 mg/L < BODS < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L L Bedrooms x 100 gal/bedroom/day x 1.5 1 ~° gallons/day hydraulic load Design Calculations In situ designed loading rate Depth to estimated high ground water Depth to bedrock Cross slope at system Force main length Manifold/header length Drain-back Lateral length ~ Lateral elevation Lateral hole size 3~te in. ~ 3 hnlec/lateral ~ ~ I ~ gallons/sq. ft. per day ~, z o in. ~ 4 4 in. z-4 ft. of ~~1z in. `'~ ~ ft f ' Z. 2. I @ 3~.s ~ ~1.q @ 3.L. c~ i, b Lateral volume b•`'t Total lateral discharge rate ~~',tb Network pressure compensation losses ~'~'Y Elevation difference ~' • ~ ~~ Friction loss ~•}3 Total dynamic head te•~3 Pump/siphon ~a gpm @ 1Z Manufacturer ~~ ~' ~ .,., ~ ~-~ Dose volume ~ ~ ~z ~ Lift/sipl?on tank ~ : w~. ~ ~ - ~~ ~ w~ ,, Septic tank ,, Effluent filter ~aL ~'~`~ Measurement pump on and off 3. o Height alarm from tank bottom l ~ . o Reserve capacity ~~ °t specs.calcs.res . o rn. gallons ft. of ~`lt in. ft. @ bottom of lateral in. ( 3• ° ft.) Spacing holes total gallons gallons/minute @ Z'S ft. head ft. ft. ft. @ ~ ~ gallons/minute ft. ft. of Bead Model # S w `~ ~ ~ gallons ~ "`~ gallons t ~ gallons rn. rn. gallons Page ~ of g 3 ~^ ~. 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C. o ~+ a.v `-di 4b O ~+ ~ l a. `C"y p a~ lvY .a..q.-..tv•' 1 ,~o.,,, 1 ~I,g / ~ ~ ..~ 1 ~N. \ 1 b~~ +o,pta'~ 1 ~ Q1,4. 1 R1T•'1 ! b.~a ~ \ ~o i..b:o:1 Sa..~ ~~°~' ` z ~~ I za.4 C ~ `~L• c.w`c~..~a~c~ t C9•~q~ ~ 1 C~.S~ D.c~oZ,(~S~ ~g ~ ~ ~u~~Z~ Z. c,e~,. e.e., e ~( ~~ _ ~* , ., ~' F ~ ;; ~~ ~~ w ,;~ T 1~----- l S' _--,~~ •~ ,,. V ; n......,. 2.v 1' ~1~ ~I .~. L' _.~__ -• 4' ~• ~' 4'~• ~ `~ Z4.~~ ~~~~' _. "~~ l ~" ~ ~z.~~ p ~, y'~ ~ P v c c... ~ ~ .-a o~ ~ t v.~.., .` }; a,.. .,..~~~ b ~,. ~ o Tt` o ~•-, o ~ ~. o c.~. ~~ .~ N J ~ ~ ~. \ 0.'F ctN ~-t T Q•~, w:...n....~ ` • ~ , S V G .•,,. Q,. J..` C ~ ~f C L \ C. ~Q }'~-c~' ~ b,. e ~ ~ ~ U~ '~.pi • ~. 1'~ s" ` ~ QVL j~.h 4p ~o~.a.t ..•~n.. y ---se~--~ ~ ~ ~ •... ~ ~ w ~ O•. p.~.S tN l~li' P... ~ S ~~. 4v ~ l ~ a,....SZ ~ _ ~.. ~ ~' 3.a~' I~•S' 1.S' I 3.0' I 'i.~' ~ 3.0' I ~ ~ ~ ~,s,~, ~- • ~~i b ~ o l ~ o .. `.. ~ ¢r. •J~ ca~,,Jiw bO~ `: Cv 3 y. o •~ ~ s • ° 1 ~ a ~° ...,.. T o ~.•. »o... / V i 3 ~~~ ~ ~ ~ ~~~ Z~ -~.~~ ~~~~ ~~~ ~~ N o~-a. ~~~o~~,~ ~~+Fh ~. ``~ lr a1~ e b~ h S ~ g (~ °`~ - -- .• r~~~ 1 ~a Z ~~~ ,.~ PIPE 3 no t~NO~STUROEQ \ Sol ~ itic.t r ~ ~] n h ,'' ^^ u~ • Q.QV W SY,E.T 3b1,IrJ V D t1G w+ E C.T I o r+.S ~e~ q~s.~~' F ~ ~'~ ZSI~N i AL ~/~' ~-- O N ^ ~~ o,. ~~ ~„ I`Iz" W~A'~N~~PRCVF ~i~ JLNCT~OH 'i,~ ~ r T ~.I ~ _ ~~ r i ~ u r;~;,~r;~„ ~7 j G~ \ ~" ~ ~w I I .. 4 ~ I ~.' ~ , ~., `~ ~ ` I -. ;~_ - - %, - _ I ~ ~ / 3 0-~' c I ~ ~ 3 ~„ P urlP i C O ~C.R F~"c b~oG~C I 1 I SEPTIC t _ SPEC:IFI•CATIOLJ$ ~• OCSC T..-J•.S MAUUFACTURCR: ~ ~~~~ (JUMBCa OF DOSCS: ~~Z ~F_K ~.~ _ GALLOIJS DOSC VOLUMC Sc~ ~}I~.~~vs IIJCLUCIN(a OAGKFLOW~ ~'Zg ;,~__:n:; ALAR11 r1/WUF,~CTUf~CR: hODCL -•IUYtDCR: • 1 ° ~ ~~' `"~ CApACiTIES~ A- ZS~° IUCNCS Jn ¢~~ :,r__..: aWITCH TyPC: v~"r""~ wpb ~LMP P'1AIJUFAGTURCR: ~~~°`^•'~ `c CIJ~pC C.a ~'O iUC~CS CK ~~'~"~_ __..~. a MODCL 1JUMDCR: - SK'1Tfa- Zc~ !flICSPONp~N~,,C D~ r ~~ Iu~HES CR \"•`''~~ :.•,.:•_: ~wITCN TbP[; ~M2~.•4v " IJOTE: PUhP AuD 1.,.aR~~• „~; 1c e: h111JIN~UM OISCNA1lC•C RATE ~~'~ G-h1 INSTALLED 01J SEP~Z~"C :i.;:_ ~, ~~IJ Q J VCRTIC^~~ DIFFCRCIJCC DCTWCCU PUMP OFf ^UO OISTRIDUTIOAJ PIPE.. FECT b + Mi~.lIh1UM -JCTWORK SUPPLY PRCLSURTTE//. 2'~ FCCT+~~~S~ J+ i4 FCET OF FORCC MAIIJ X S.ob F/oorLFRlcTlo-J FI~CTOII. ~~}3 FELT ~ `~ - TOTAL Dy-JAMIG HChD - ~c.t3 FCCr /, ~, IlrTER-J^L. DIMC1J510-JC 'Of TA1JK: LEI.IGTH ~~'r ;WIDTH ~g iLIQUID pCPT ~ 3 l~ k~T ~J~~~~~ LO.CKING~GOVfiR --~ Lt/r4~N iNG .( /~BE~ . Q~IcK DI~C.a,~~cT--~ 4 ,, J, I -'T r ~; ..S Puma Charocteristica / /MOIK lhllt .~.• Sab~wrs~la Aldonetk FlLodals SNFi7CA1 F;atapiwer .34 MI Loud Ands 1.0 FMIa Skjed ~olO (~ 1 IL1JA. 15SC /is~f 0 1 Vek 11S NKtr 60 lerppOntwo 140'F A~lont NENU DosiSat A bsaario. LOSS A tRcciar Sho 1-I/2' N-1(Ji111A1~ So111ds Nudlinq 3/4' (191tNO) Wllt WOig~l ~0 6s. hwsr Cold 1 b/7, S1TW, 20' std. Materials of~Construction N~ SM>tlloss SHOT LlbriroiLp CIA Dioioctric W Motor Noa <Oa kea cm Cat ko« 1 Mladolical Sbvft SOd Sai Foos: CaiOOI/COradc Sod ~ A~.d Stool s sld.~tt s,'«I wss Iwlo-M r E >A< Ga MOII SlalrO lows R.w hII Noon ~tO E stk LOQs Eoglaoao~ T1tOlnnFkOlk fos)OOUtO S1iwtiOts SNtsl c Par~ArsYtdHCA ~QfO 1 I' b t • ~ >n s ~ r.~ io I o ' o ~ ~, Gpsh+1S•ilx 1 is to ~ urn/Sta.I t ~ ~ ~ Tofol liOwd hot I i 12 1 ~ ZO 2~1 Dimensiornal Data t. 1E Aaewoa~ b ~n I~~~~ i (oopaoau ATa.sio+s ~ ~: in~~ 1 Nv br c~~~ P~ aka cwlFia l Obsauan ail ~ ac ro~ ~~ S. On/Dfl Isrsi ar<sm61s b. Y. rwrn Ai r~ht +o mot, n~ a ou prilun o.d m.. Marts saflpul M~~ r,, . ~. i ', rl. `. ~ ~, ~ ~n cao~l =;~(~.r~ s :y~ s; "° (9S) is~~ i I~ HYDROMATIC "' ~ ~ !810 Saner Rsod Ashland, Oho 44145 Tel: 419•t89.3041 tix; 419•~81~4011 Woh Site: aww.p.nldrpump.tom SALES GFFIC[S IN All FAAJOA CRIES ANtI COUN7~It5 il~rn w: Wti2.8350 1208 4M C: 1999 H~drorndic' Purnps. Ashlgrni, C~uo. N! Rig - Yw~ A~~honzed Lord Csismburor - r~ `` ;~~i: `~YI ~ ~ _~ O ~~ i ~ , I . -- _ .. ..._ .... ..._T... .. ~. ...... . I-. ... -.. _.. -. i '.. _. T.... - _._ i , :. System Nlanagement Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, Chris Bauer Plumbing, 715-672-8224, or the St. Croix County Zoning Office, 715-386-4680, should be contacted for assistance. General Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of water which tlo~vs into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. 1 . If the septic tank is installed prior to sheet-rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2 [nstall water-saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly. 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. 1 f septic or pump tanks are no longer used, they must be properly abandoned. 1 1. If construction timing and weather could create a frozen infiltration system, weather-proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. Maintenance , I . The septic tank must be inspected every three years by a properly licensed person. ?. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. i. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must he back-washed into the septic tank to remove accumulated material. 1. Periodic observation pipe inspections should be made by the homeowner to examine the state of the. in-situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 5. The pumping components for this system include an alarm which tnust be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more titan one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down-slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. ~. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run-off into the s~ stem area. 1 1. Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.E-t (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, desi`;nin~~. and/or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 r' - ~ rORIGIi~~~ Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all information. iewed By Personal information you provide may b 15.04 (1) (m)). Property Owner Property Location 1733 Page 1 _of 3 Certified Soil Testing St. Croix 004-1046-90-000_ n Date Taplin, Barry Govt. Lot NE 1/4 SE 1/4 g 20 T 28 N R _ 15 W Property Owner's Mailing Address Q 2003 Lot # Block # Subd. Name or CSM# W. 3832 850th Ave. ------ City State ip C e b~I~Rb?~~Y City ~ Village yl Town Nearest Road ZONI Spring Valley i WI Cady 290Th St. New Construction Use: /' Residential /Number of bedrooms 3 Code derived design flow rate 450 _GPD _ Replacement ~ Public or commercial -Describe: ____ Parent material loess over till Flood plain elevation, if applicable __ NA __ General comments and recommendations: install 5' x 91.2' rock cell mound on 100.0 contour as upslope edge of rock w/ 1.4' sand fill Boring # _ _' Boring % , / Pit Ground Surface elev. 105 ft. Depth to limiting factor ~_in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots _ GPD/ft' _ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I "Eff#1 "Eff#2 1 0-9 10YR 2/1 - sil 2 f sbk mvfr cs 1f/m ~~ - .5 ~, .8 T--=---- - -- 2 9-16 10YR 5/4 - sil 2 m sbk fnvfr cs 1f ~' S 8 3 16-21 7.5YR 4/4 f2d 7.5YR 5/3 sil 1 m sbk mvfr gs - ', 2 I .3 4 21-28 7.5YR 4/4 c2d 10YR 6/2 sil 0 m mvfr - - ; 0 2 -~-- upslope of proposed system area a Boring # Boring 1 Pit Ground Surface elev. 100.0 ft. Depth to limiting factor 24 in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots i GPD(ft'__ ~ `Eff#1 `Eff#2 1 ; 0-12 10YR 2/2 - sil 2 f sbk mvfr cs 1f/m ~ 5 I~ .8 2 12-21 10YR 4/3 - sl 1 m sbk mvfr cw 1f i 4 ; .6 3 21-24 5YR 4/4 - sl 1 m sbk mvfr cs 1m ~ 4 ~ .6 4 24-32 5YR 4/4 fad 7.5YR 4/6,5/3 sl 1 m sbk mvfr - - ~ 4 ~ 6 Effluent #1 = BODS> 30 < 220 mg/L and TSS 0 < 150 mg/L ` Effluen #2 = BODS < 30 mg/L and T55 < 30 mgt_ SST Name (Please Print) Sign to CST Number henry F. Grote t 222774 4ddress Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 4/21/2003 715-233-0398 ~~ Property Owner Taplin, Barry Parcel ID # 004-1046-90-000 Page 2 _of 3 Boring # -_ t Boring /a Pit Ground Surface elev. 97.7 ft. Depth to limiting factor 28 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 1 0-13 10YR 2/2 - sil 2 f sbk mvfr cs 1f/m .5 .8 2 13-28 10YR 4!3 - sil 2 m sbk mvfr cs 1 f .5 .8 3 28-44 10YR 4/4 f2d 10YR 6/2 sil 2 m sbk mvfr - - .5 .8 --- --- i - I ~-- --- i - ~ I - ---- ^ Boring # -:~ Boring ~' Pit Ground Surface elev. 100.0 ft. Depth to limiting factor 2~. Soil Application Rate Horizon , Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence i Boundary ~I Roots _ ~PD($' ___ I~'Eff#1 'Eff#2 1 0-10 10YR 2/2 _ sil 2 f sbk mvfr cs 1f/m ~ .5 .8 2 10-20 - 7.5YR 5/4 - sl 2 m sbk mvfr j ~ cs i 1 f .5 -- - .9 3 120-32 7.5YR 5/4 f2d 10YR ti/2 sl 2 m sbk mvfr ', - - I .5 9 i ~~ -- -- -1 ------ i - ---i----- --- --- redoximorphic features become cap 7.5YR 4/6-5/3 below 26" ^ Boring # !- Boring ;Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence j Boundary Roots ~___~P~1fj? ____ ; 'Eff#1 'Eff#2 I i I - ---r----- ---- - I - - i ---- ----- -------- ~ ~~ - - - `Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L "Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8336 (R.07/00) Certifed Soil Testing i~ ,~ 3' ~^ _~ \_ '~' ~y ~, S 6 i n~ ~" ~~ S ~/ a J t 1 r~ I u .~ N ~' '~ -_ ~ 9 v Cv N _ ~ .s J - ~ C? M ^-- ~ Z ~- ~' s \ ~" s ~' d `' M ~ o 1~ `J - ~ ~ !, ~ ~ '' ~ .9 d~ ~ ~ ~~ U ~~ ~, "` I~~ ~ 9 `' -- _ _---1. a-~ - -- -- i u, ©g ~ ,~° 3 .s '.~ ~ ~ ~~~ 3 . D ~ ~ V J N V V1 ~ nJ' \ ^1 (ifJ, ~ 1 V' v ~ ~~ ~ q! a y ~~ j N ~., ~ d „ n fi ~ ~~ ~~' ~ f ~ ` ;~ ~~ ~ ~ ~ Z ~~ ~ i ~ o Z ~ C ~ ~. ~ 9 ~~ '^. != N , -~ + ~ ~,rl ~ ~ ~ ~ ~~ I ~- ~ r , f r_ ~ ~ ~ -~ '~ s ~ o o c ~l ~ ~ ... ~y '~ o a S M ~?' 9 ~J ~ po ~, O ~7' ~ i r- 9J, u b -T-- - - i .~ WQ 4 ~~' ,ti z POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 1 of FILE INFORMATION Owner ~u ry" Y -~~ 1~1 ~ n/ Permit # ~ ?,~ Jt-Z II DESIGN PARAMETERS Number of Bedrooms ~ ^ NA Number of Public Facility Units [9'~IA Estimated flow (average) ~ OQ al/da Design flow Ipeak), (Estimated x 1.5) y .S'O al/da Soil Application Rate (~ , I ~ al/da /ft2 Standard Influent/Effluent Quality Monthly average * Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BOD5) <_220 mglL ^ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODS) 530 mg/L Total Suspended Solids (TSS) 530 mg/L ^ NA Fecal Coliform (geometric mean) 510° cfu/100m1 Maximum Effluent Particle Size Ye in dia. ^ NA Other: ^ NA "Values typical for domestic wastewater and septic tank effluent. unrarrcunwrc crucn~u c SYSTEM SPECIFICATIONS Septic Tank Capacity (ODO al ^ NA Septic Tank Manufacturer ~ ,` y.. ^ NA Effluent Filter Manufacturer ,Z ~ e t" A-~ 00 ^ NA Effluent Filter Model -~ p d ^ NA Pump Tank Capacity (®p~ al ^ NA Pump Tank Manufacturer W ,' f- ^ NA Pump Manufacturer ~ r-~M a. ~ ~ ^ NA Pump Model ~ ~ C r 3O ^ NA Pretreatment Unit ^ Sand/Gravel Filter ^ Mechanical Aeration ^ Disinfection ^ Peat Filter ^ Wetland ^ Other: ^ NA Dispersal Cellls) ^ In-Ground (gravity) ^ At-Grade ^ Drip-Line ^ NA ^ In- ound (pressurized) ound ^ Other: Other: ^ NA Other: ^ NA Other: ^ NA Service Event Service Frequency Inspect condition of tank(s) At least once every: ^ ea~~sjls) (Maximum 3 years) ^ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ^ NA Inspect dispersal cellls) At least once every: ^ monthls) (Maximum 3 years) yearls) ^ NA Clean effluent fitter At feast once every: ^ month(s) Z- yearls) ^ NA Inspect pump, pump controls & alarm At least once every: ^ monthls) 3 l~yearls- ^ NA Flush laterals and ressure test P At least once eve ry~ ' ^monthls) ^yearls) ^ NA Other: At least once ever y~ ^monthls) ^yearls) ^ NA Other: ^ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS {nspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cellls) 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 regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third IY3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page ~ of ' START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the 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. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal ce(lls) in one large dose, overloading the ce(lls) and may result in the backup or surface discharge of effluent. 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. Do not drive or park vehicles over tanks and dispersal cells. Oo not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: 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 When the POWTS fails and/or is permanently taken out of service the following steps shalt be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • Alt piping to tanks 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 If the POWTS fails and cannot be repaired the following measures have been, or, must be taken, to provide a code compliant replacement system: ^ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ^ A suitable replacement area is not available due to setback and/or soil limitations. l,~ technology a holding tank may be installed as a last resort to replace the failed POWTS. Barring advances in POWTS Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name Chr` ,'S 3a u v- Phone '~ 1 ~ _ ~~a _ Bad ~ POWTS MAINTAINER Name Phone SEPTAGE SERVICING OPERATOR (PUMPER) AL REGULATORY AUTHORITY Name Phone LOC Name 5T'. Loot Csu..r.STY ~/~l~'G Phone ~-(5'. 3$6. `~00~ This document was drafted in compliance with chapter Comm 83.224214b11111d1&(f) and 83.54(11, l21 & (3!. Wisconsin Administrative Code. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~ ~ V' ~' v r~ a ~ , `~/ Mailing Address ~ .~ ~ 3a ~~ ~ } ~ f-t ~ ~ s !~~' ~ ;v 9 U ~ b (~ ~ 4l ~ ~ L~ ~ ~0 ~ Properly Address ~ ~ ~ '"" ~ r -236 ~~~ -~~ (Verification required from Planning Department for new City/State Parcel Identification Number ©C~'-~ - I ~ N (o ~- ~ 0 - 0 0 O LEGAL DESCRIPTION property Location Subdivision Lot # ~- Certified Survey Map # --`-~ _, Volume ,Page # 11tN ~ Cor~kcT ~e~ 3 ~~ ~( ,Volume ~~5~ ~ .Page # `'~~~• Spec house ^ yes no Lot lines identifiable eyes ^ no 'STEM 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 agrces to submit to St. Croix Zoning Department a certification form, signed by the owner and by a rnasterplumber, journeymanplumber, restrictedplumber or a licensedpumperverifyingt~at (1) the on site wastewaterdisposal system is is proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of~#he three yyayexpiration date. SIGMA OF PLICANT DATE OWNER CERTIFICATION 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 p rty descn above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGMA OF APPLICANT DATE ent. ****** ****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Departm %., ~ '/s, Sec. Z t7 , T~N-R I S ~V Town of c,~ ** 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 is the warranty deed 2257P y~9 723669 /~ ~ STATE BAR OF WISCONSIN FORM 11 - 1982 ~ LAND CONTRACT Individual and Corporate (TO BE USED FOR A1-L TRANSACTIONS WHERE OVER Document Number 625,000 IS FINANCED AND IN OTHER NONCONSUMER ACT TRANSACTIONS) CONTRACT, by and between Rita M. Hampton, a single individual ("Vendor", whether one or more) and Barrv L. TaDlin and Susan M. Knoll, as tenants in common ("Purchaser", w e er o ore . en or sells and agrees to convey to Purchaser, upon the prompt and full performance of this contract by Purchaser, the following property, together with the rents, profits, fixtures and other appurtenant interest (all called the "Property"), in St. Croix The Northeast Quarter of the Southeast Quarter (NE 1/4 of SE 1J4) of Section Twenty (20), Township Twenty-eight (28) North, Range Fifteen (15) West. Vendor advises Purchaser that an abandoned well is located on the premises. No warranty or representation of fitness is made by Vendor. Vendor believes the well is useless. Purchaser accepts the premises "AS IS" including the abandoned well. This is not homestead property. (is) (is(is not) KATHLEEN H. li'ALSH REGISTER OF DEEDS ST. CROIX CO., MI RECEIVED FOR RECORD 05/30/2003 09:30AM LARD CONTRACT EXElPT # REC FEE: 13.00 TRANS FEE: 240.00 COPY FEE: CC FEE: PAGES: 2 Recording Area Name and Retum Address Robert J. Richardson Bakke Norman, SC S233 McKay Ave., P.O. Boz 399 Spring Valley, WI 54767 004-1046-90-000 Parcel Identification Number (PIN) Purchaser agrees to purchase the Property and to pay to Vendor at whereever directed, the sum of $8,_0 000 in the following manner: (a) $20.000 at the execution of this Contract; and (b) the balance of 560.000• together with interest from date hereof on the balance outstanding Gom time to time at the rate of 6_5 percent per annum until paid in full, as follows: Monthly installmentsofS500.OOpermonthwhichincludesinterestontheoutstandingbalanceat6.5%perannum. The entire balance shall be due one (1) year after closing. Provided, however, the entire outstanding balance shall be paid in full on or before the 22nd day of Mav, ~Q04 (the maturity date). Following any default in payment, interest shall accrue at the rate of 1Q% 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 taxes, special assessmenzs, fire and required insurance premiums when due. To the extent received by V endor, V endor agrees to apply payments to these obligations when due. Such amounts received by the Vendor for payment of taxes, assessments and insurancewill be deposited into an escrow fund or trustee account, but shall not bear interest unless otherwise required by law. Payments shat I 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 after June 15, ~ (OR) there may be no prepayment of principal without permission of Vendor.• In the event of any prepayment, This contract shall not be treated as in default with respect to payment so long as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated as unpaid principal) is less than the amount that said indebtedness would have been had the monthly payments been made as first specified above; provided that monthly payments shall be continued in the even[ of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded herefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except. none Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall be retained by Vendor until the full purchase price is paid. Purchaser shall be entitled to take possession of the Property on date of closinic. • Cross out one. STATE HAR OF W ISCONSIN LAND CONTRACT -Individual and Corporate FORM No. Il - 1982 ZzS~P yio Purchaser promises to pay when due all taxes and assessments levied on the Property or upon Vendors interest in it and to deliver to Vendor on iiemand 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 sum of Sn~/ ,but 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 insurance companies and Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall be applied to restoration or repair of the Property damaged, provided the Vendor deems the restoration or repair to be economically feasible. Purchaser covenants not to commit waste nor allow waste to be committed on the Property, to keep the Property in good tenantable condition and repair, to keep the Property free from liens superior to the lien ofthis Contract, and to comply with all laws, ordinances and regulations affecting the Property. Vendor agrees that in case the purchase price with interest and other moneys shall be fully paid and all conditions shall be fully performed at the times and in the manner above specified, Vendor will on demand, execute and deliver to the Purchaser, a Warranty 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, restrictions and rights of way of 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 ofd 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 9~ days following written notice thereof by Vendor (delivered personally or mailed by certified mail), then the entire outstanding balance under this contract shall become immediately due and payable in full, at Vendors option and without notice (which Purchaser hereby waives), and Vendor shall also have the following rights and remedies (subject to any limitations provided by law) in addition to those provided by law or in equity: (i) Vendor may, at his option, terminate this contract and Purchaser's righu, 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 amounu previously paid by Purchaser shall be forfeited as liquidated damages for failure to fulfill this Contract and as rental for the Property if purchaser fails to redeem); or (ii) Vendor may sue for specific performance ofthis 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 potion 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 statemenu or actions of Vendor, an election of any of the foregoing remedies shall only be binding upon Vendor ifand when pursued in litigation and all cosu and expenses including reasonable attorneys fees of V endor incured to enforce any remedy hereunder (whether abated or not) to the extent not prohibited by law and expenses of title evidence shad be added to principal and paid by Purchaser, as incured, and shall be included in any judgment. Upon the commencement or during the pendency of any action of forecbsure of this Contract, Purchaser consents to the appointment of a receiver of the Property, including homestead interest, to col leer the rents, issues, end 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, Fong-term (ease 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 Vendors writen consent, the entire outstanding balance payable under this Contract shall become immediately due and payable in full, at Vendor's option without notice. Vendor shat l 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 terns ofthis Contract shall be binding upon and inure to the benefits ofthe 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.) Dated this 2~1s d day of Mav, 2003. /~. ~ • IFI~f/Y» (SEAL) * Rita M. Hampton, Vend r (SEAL) AUTHENTICATION Si¢nature(s) Rita M. Hampton. Barry L. Taplin and Susan M. Knoll authe~nytyica~ted this ~_ day )o~f MD,av~ .2003 ~'r (SEAL) * Barr L. Ta lin Pu aser 0 s~iA/JG(NL ~ lD.C.Q__ (SEAL) * Susan M. Knoll, Purchaser ACKNOWLEDGMENT STATE OF ) ss. Countv ) Personally came before me this day of the above named * Maureen A. We¢leitner TITLE: MEMBER STATE BAR OF WISCONSIN (If not. authorized by &706.06. Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY ROBERT J. RICHARDSON, Bakke Norman, SC SPRING VALLEY. WI 54767 (Signatures may be authenticated or acknowledged. Both are not necessary J to me known to be the person(s) who executed the foreaoine instrument and acknowledeed the same. Notate Public, State of My Commission is permanent. (If not, state expiration date: of persons signing in any capacity should be typed or printed below their signature. INFO•PRO (800)655-mgt www.iafoproforms.com STATE EAR OF WISCONSIN LAND CONTRACT- lodlviduol rod Corponto FORM No. 11 - 1982