Loading...
HomeMy WebLinkAbout026-1011-80-100 STC - 104 AS BUILT SANITARY SYSTEM REPORT :r OWNER S' T C, COU N j y ~..GPf,ING OFFICE ADDRESS SUBDIVISION / CSM# LOT # SECTION T-,Y~ N-R ,LS_W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET F SYST G 4 ~USF, yc d~ 3 75 INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. • o BENCHMARK: ALTERNATE BM:,5~ SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: 11 iLiquid Capacity: Setback from: Well House _-2.z Other Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: 42 Length Number of trenches Distance & Direction to nearest prop. line: f Setback from: well: IC~l House--2,/_ Other ELEVATIONS Building Sewer _9,5-~g.4 ST Inlet: 2 ; ?k ST outlet: PC inlet PC bottom Pump Off Header/Manifold X 95- Bottom of system_ Z4 T-. Existing Grade 9'Final grade C Sid DATE OF INSTALLATION: PLUMBER ON JOB: l LICENSE NUMBER: INSPECTOR:® ✓ 3/93:jt Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County- -Safety and Buildings Division ST . CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitar1f§r77 ,F y1§: Personal information you provice may be used for secondary purposes [Privacy L , s.15.04 (1)(m)]. GGyy 7 Er6WoIVAVme: `K1C.1' ftf Town of: State Plan ID No.: CST BBMElev.: 11 Insp. BM Elev.: BM Description:Kl Y ll)llCl Parcel Tax No.: cot 00~ p JT grr 12 12 G. TANK INFORMATION ELEVATION DATA A9700482 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic \4Cc-k 1200 Benchm k qs I~I?j )01 q?, I O6 Dosing k\ tZ, 2 -1 78 Aeration Bldg. Sewer Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet (o. ~j TANK TO P / L WELL BLDG. Air Intake ROAD Dt Inlet Septic o 2~/ ZC/ NA Dt Bottom Dosing J NA Header/ Man. ,.qa cJ3g Aeration NA Dist. Pipe g.022 CI :5 eJ Holding Bot. System TOO Gr2.413 PUMP/ SIPHON INFORMATION Final Grade •5 , ?-7. q Manufacturer Demand S}.~,vldNti,,1~e_ Co Model NqZl~ GPM ft Friction stem TD Ft TDH t_ I 25 ead Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM E RENCH Width r Length No. Of Trenches PIT No. Of Pits Inside Dia. Li id Depth DIMENSIONS 12 DIMENSIONS i SYSTEM TO P / L BLDG WELL LAKE / STREAM ~EACIHING Manufacture . { SETBACK AMBER INFORMATION Type O X tuber- System:(.,V,+- . OR r DISTRIBUTION SYSTEM Header / Manifold b Distribution Pipe(s) d x Hole Size x Hole Spacing Vent To Air Intake Length _c,' Dia. Length ~ Dia. Spacing H 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 discrepancies, persons present, etc.) LOCATION: RICHMOND 4.30.18,SE,NE 1171 STATE HIGHWAY 64 Itowj o-~ tre4~ b,r'NCK C,19 ovL 6V-1 .5 ewe✓. PI nryW I I nrequ hred? a rev s o Yes C No Use other side for additional inform5tion. 17A hd 1 s 1 SBD-6710 (R.3/97) Date Inspector's Sig ature Cert No. ADDITIONAL COMMENTS AND SKETCH r SANITARY PERMIT NUMBER: shingtonADvision SANITARY PERMIT APPLICATION 201eE. W and ldings ve. %6consin P.O. Box In accord with ILHR 83.05, Wis. Adm. Code ox 7969 Department of Commerce Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County ' than 8 112 x 11 inches in size. 42~& • See reverse side for instructions for completing this application state ani t ~ermit Number The information you provide may be used by other government agency programs ❑ Chec iTc f revisidn /to pr-eviou"s application (Privacy Law, s. 15.04 (1) (m)j. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATION Prop y wner N e Property Location 1/4 1/4, S T~ , N, R 4or Prbpectm O n , Mailing Ad ress Lot Number Block Num r City ate Zip Code Phone Number Subdivisio N me or S tuber D a ( ) IL TYPE BUILDING: (check one) ❑ State Owned -7 Ity Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms - I ❑ Town OF 1 III. BUILDING USE: (If building type is public, check all ~ that apply) Parcel Tax Number(s) 1 _E] Apartment/Condo l / • J0, 1k, 1611- 80 - I w 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel / Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check'only one box on line A. Check box on line B, if applicable) A) 1. IN New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an -----System System Tank _Only- Existing System ________-Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 [A Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench , 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy ,14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./iryth) Elevation Feet Feet VII. TANK Capacity in gallons Total ' # of Prefab- Site INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel Fiber- Plastic App. New Exist in strutted glass App. Tanks Tanks Septic Tank or Holding Tank s+ ❑ ❑ 0 ❑ ❑ Lift Pump Tank /Siphon Chamber El ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the ndersigned, assume responsibility for inst atioR of a onsite sewage system shown on the attached plans. Plumb r' ame- Pri ) Plumbe s Si tU S) MP/MPRSW No.: Business Phone Number: Plu ber's A dress (Street, City, S te,Zip5pdj IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved nitary Permit Fee (Includes Groundwater ate Issued Sul g Agent Signature (No Sttmps) Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6398 (8.11/96) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3151. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide"the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County / Department Use Only. X. County / Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. /~/<s'~(~e~i~d~✓a G✓~ .DSO/7 S,~'~~ ~f~ s.~'C T~©~-1~/~~ will i n 'Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings page of Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal ce pofrlt M), direction and percent slope, scale or dimensions, Za, n and di to nea rest road. Parcel I.D. # APPLICANT INFORMATION ~rimation. Reviewed by Date Personal information you provide may be y purposes (Privacy Law, s. 15.04 (1) (m)). tw-VA I~ • 97 Prope er : t;! U 77S, Property Location CgGIX Govt. Lot 1/4 - 114,S T N,R E (or~ Property Owner's Mailing Address Lot # Subd. Name CSM# VX ZONIN(iO401FlCE 5-4.7( P/A f Stag Zp Code e ❑ qty ❑ village ®Town Road CiLtj New Construction Use: 0 Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow i`1CJ gpd Recommended design loading rate -,.-I-bed, gpd1I? = 2 trench, gpd/fl2 Absorption area required i bed, ft2 ~'~S trench, ft2 Maximum design loading rate _-Z -bed. gpd/ft2 trench, gpd/(t2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design/site considerations Parent material Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ® S ❑ U 0 S ❑ U ®S ❑ U ®S ❑ U ❑ s O u ❑ S 15u] SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/1`12 in. Munsell Qu. Sz. nt. Color Gr. Sz. Sh. Bed Trench oj~j 'Ll-L 'JA Ground elev. s Zi J ft• , Depth to limiting factor in. Remarks: Boring # Ground lev ~ft. Depth to limiting factor in. marks: CST Na a ease P nt) Signature Telephone No. Address Date CST Number L SOIL DESCRIPTION REPORT PROPERTY OWNER t ~7 Page pf , PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Structure 2 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench o Ground S - elev. ~ft• ' Depth to limiting factor in. Remarks: Boring # _A =~s 3 - 7s- -AIZ Ground elev. 2z~ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # ; Ground elev. ft. Depth to limiting factor ,,~~'n• Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD-8330 (R. 07/96) Y, J"i LE . 4 i s Alaaluc 40 foe Ste- i C%j Bill CL a ° -l SG 7614 CERTIFIED SURVEY MAP Located in part of the Southwe Quarter of the Northeast Quarter and part oft Southeast Quarter of the Northeast Quarter of Section 4, ownship 30 North, Range 18 West, Town of Rich' and, roix County, Wisconsin. 01 MiM, Prepared for and at the request of: NE DIRECTION CE 4--0 -ft OWNER: Lt S 09'10'4 W 94.52' q/27/g W. T. Door, Jr. and Patricia L Door L2 s or 10'3 E 96.02' 7 P.O. Box 69 L3 S 56481 E 159.71' RONALD F. ' New Richmond, WI 54017 L4 S 27'3 '49 E 106.85' ? JOHNSON Drafted by. Kristi A. Ey andt L5 S 16.32'2 W 7Z.56' ®--1 186 L6 S 0955'0 E 11112.2l' S AMERY. L7 S 01'04'53 E 172.84' IS • NORTH LINE OF TH£ SW LB S 04' 13'15" E 132.95' F Q• 114 OF THE NE 114 1-9 S 32'24'59 W 86.07' ( S.T.H. "64" o NORTH LINE OF TH£ SE 1 4 OF TI/E AL1e aN CD O R. o. p ' Z---- . S.T.N. "64" - - - - - - - 0- N 8 b- CERTIFIED SURVEY MAP 3 w*913 EAST LINE OF THE WEST 1 112 OF THE S£ 114 1 0Cr LOT 1 f s! I d o OF IHE NE 114 I j DOC_ NO._396671 199, VOLUME 5 PAGE 1471 P' 1 p~Il f/ w l / I I w CERTIFIED SURVEY MAP of M N89~543 W M T I t ~ LOT 1 / ti4., Q- 127.90 Q DOC_ NO. 3461_81 _ ti y N VOLUME 2 PAGE 539 f m N NN -----I ! a R N 89.55'43" E 488.75' j W Z M N 89'3217' E 488.41'---- I t ~POLE o~ ---N 89'32117' E 532.49'--• i k a 127.90' SHED L1 - r7~N W~'N SB9'27'S91'W I L O T 2 a~`yN P .j L N ! O Q~~ P\\, t~ \ II I ?h LANDS ~ UNPLATTED nM I W~ ~~0 o~ I ~'K J Q, L3 ` I I aI Mi 2 I ~I oI ~I ~6 \ BM 2 1 I > 0 WI Q ~2 L4 (ni •'•(4II ~ ' o ZI wl > W1 21 1;5 / ~s I , L5 02 o 3r 01 A$ to 11* P 79 CERTIFIED SURVEY MAP W I \ ,W > * L7 LOT 1 jo / 4~;~;~~` X11 !I: j \ N DOC_ NO._368192 I / L 6~s~~`~~~ I: I VO LUME 4 PAGE 1020 .C9 1:1: i 1:1 L8 WEST 1/4 CORNER / .I \ SEC. 4-30-18 / EAST-WEST QUARTER LINE SEC. 4 \L9 (ALUM. CO. MON.) / I \ BM #3 `833.09'- 77_ ,73'------------ . _0 _ ~ . ZL££ HOW ZT MMZOA 0 • b 10 Z 1aa4S L1049 IM 'PuowyOla MBN 9Z£ x08 •O•d '19045 PJ141 IS03 60l 6l£1►-94Z (91L) 'ON QU04d ON1813NION3 IIAIO V ONLGA I 79N V Xq paJodaJd 9LOL6# 80f 31VOS ON, (Bull M•O•a tuoi; ,000 «V« IIV13a (Gull a.Jo4S woa; g j) Bull JooglaS sV papaooad =~j to aV' painsoaw =14 / v Z# We pojoH t Puno xr ~k N adld uoil NL puno3 O •1001 Joaull iod spunod £L'L ;o wnw',,L* uw o 0/ y` 6ul4619M adld uoJl ,.*Z X laS • 1 o pao398 ;o (Ll luownuoyy jauaoo uo!1aaS A1unoo Y / ~ :aR3S3'i j / ,SL•894 3.£4,SS.68N=b } ;80.44- .14'884 3.LL,L£.68N=W-, 3ldOS ON J --.e4•z£5 3~ct.z£.esN- «8« IIV13a (NON •oo •wmv) 8L-0£-4 '03S OL L W8 M3NHO3 4/t ISM b ~3S 3N17 df31YVnO 1S3AI1SY3 Zid OM M .9£.Z4.86 N------------ - - - - - T .tL`91r94------ - --.80'££9------- _ - - -~~~~-e~ A N F6 'Od 1 76LI 's9e l WSO 30 3N17 HjnoS . .4Z'SS ° i 3,~Z.L t A0N r. - m w -01 £4 35Vd L 3Wf110A 61 1 / W8 1 n 800662 'oN '~0~ 1 m °D Z dVW ~3naf1S o3l~ila3~ ' 'fix ~a o I j 0,e yb H3AI8 A0Z11A 96.99 = NOIIVA313 I*~~NNa ns o ~~~i,~ 3did N081 d0 d01 31VOS ON Ol-~ £ 'ON Navw £ We IIV1.3a 1N3W3SV3 AVMaVOH ,99 • ~,rr. inn AUiiWV 09•L9 = NOIIVA313 I /b0 981.1--fl I H 3did 30 d01 A NOSNMOf Z 'ON >18V NaVW H 39'o'2lVJ ,>N38 we I ■ I 31 d QTVNOl Z4'L9 = NOIIVA313 I M.£4,SS. 8Sa21 G$/,Y. 3did NONI d0 d01 t *ON >INVw H N38 3.5.£.9£. 9N~ r _ ~ -O a 2~~ tJ N18 I 9- X c Ch SUOV Z£'£ t 6£S 3JVd Z 3WfIl0%1 # ! 'izl rn l~ OS 8041099 °cgl o i ; A 'LdM3N~l0 3Nn 3moHS oL v3w l8 L9bf 'ON 'O04 Z I g ; f lLi 3JVd 5 3Wf110A S383V 00'41 170i sw3J ~ ~g 8 Tts§s~-ow TTo~ ~ os 9£o'ots dVW A3nans 03I~112l3~ z I s L loi ~NIW2131 1V031 OL V3W N NI N I w WT T3AHnS 031-41103 S380Y 0 t' L L ORI -m WNW LA 'bS 9l4'S84 *-3Nn 2I omm of Yaw I I ~ ~ ~ ~938P j A----- ------o CERTIFIED SURVEY. MAP, Located in part of the Southwest Quarter of the Northeast Quarter and port of the Southeast Quarter of the Northeast Quarter of Section 4, Township 30 North, Range 18 West, Town of Richmond, St. Croix County, Wisconsin. SURVEYOR'S CERTIFICATE l:, Ronald F. JfrlrnRnn, a RPgi.sl:P.rP.d Wisconsin Land Surveyor, hereby certify that by Elie direction of W. T. Doar, Jr., I have surveyed, divided and mapped a part or the So►rthwest• Quarter of the NortheaRL- Qnarl•er and part: cif the Smithpast Quarteir' of the Northeast Qnarl.pr of. Section 4, Township 30 Norl•h, Range 10 West, 'Down of Richmond, St. Croix CirunLy, Wisconsin dPRcribed as follows: Commencing at Lhe Rant. Quarter Corner of said Secl:i,c:)n 4; thence, on an assumed hearing along the Past:/went. Quarter line of said Section 4, North 119 degrees 42 minutes 36 RPV0n(lR W#-RI: a distance of 633.09 feet; thence North 00 degrees 17 minutes 24 RpoontiR East a distance of 55.24 feet; to I:he point of beginning or t•i►e parcel I:o be deRrribpd; thence North 55 degrees 30 mirmEes 32 seconds KQR1. a diRl•anae of 504.21 feet to the most PaRLerly uorner of Not. I or n rPrl.irimi aprvPy Map recorded In Volume 4, page 1.020 of Braid Maps in said County; thence, along the northPaRter.l.y line of an id toot 1., North 55 degrees 30,cinutns 32,se,conds West a distance of 403.38 feet; thence Nort:h.00 degrees 32 minutes 01 seconds West a disianr.e of 314.89 feet; thence South 09 degrees 27 minutes 59 RecondR West: a diRtAnCe ar: 1.27.90 fPPt; "thence North ` 00 degree: 32 min►teR 01 spronds West a d.istanrp of 126.13 feel-.`to the south line of Lot I of a Cerl•.i.r.ied Survey Map recorded in Volume 5, page 1471 in Raid County; thence, along last said south line, North 09 degrees 35 minutes 35 seconds East a distance of 1.27.90 feet -to the southeast corner of last said Lot l; thence, along the east line'of last Raid Lot 1, North 00 degrees, 32 minutes 01 seconds West a distance of 208.7l,feet to the south right-of-way line of state Highway Number 64, this also being the norLheast corner of last said Lot 1 thence, along said right-of-way, North 89 degreeR 24 minutes 19 seconds East a distance of 200.37 feet to Lhe northwest: corner of Lot l of a Certified Survey Map recorded in volume 2, page 539 im Raid County; thence, along the west. line of last said Lot 1., South 011 degrees 30 minutes.41 seconds East a distance of 320.24 feet to Lhe Routhwest• corner: of last Raid Lot 1; thence, along the south line of lasL said Lot 1, North 89degrees 32 minutes 17 seconds East a distance of 488.41 feet to a meander line established for purposes of this 'tlurvey along the westerly shore. of the Wi.I low River, this being meander point l; thence, along said meander line, south 16 degrees 32 minutes 24 seconds West a distance of 203,.50 feet; thence, continuing along said meander line, South l4 degrees 55 minutes 14 seconds East a distance. of 723.78 feet to the point; of beginning. Together with all .land lying betweenAhe above said meander line and the center line of said Willow River on the extensions easter.ly,,`!from Raid meander point 1 and the poi.nt.!of beginning.on the bearings of,-North 09 degrees 32 minutes 17 seconds Fast and South 55 degrees 30 minutes 32 seconds) EasL° respectively. Containing 610,030 square'feet, (14.00 acres). Subject to all easements, restrictions and covenants of- reroute' I also certify that: this Certified Survey' Map is a correctrepresentation to scale or Elie exLe.rior boundaries surveyed `and dpRcrabed; that 1 have complied with Lhe provisions of ChapL•er,:.~236.34 of the,,Wisconsin Statutes and the Subdivision Ordinance of the County of St. Croix and the Town of. Richmond in surveying and mapping the same. JO t, 1004S ZLEE HOW ZT RK1110e ~`'lir~.~~ans•~tib~~ • ~O 'A 3WV s se1.1-s ; NOSNHOf 'd 01VN0a {,t 46/r,z/b 00 '~►+U • 10" J O D ION st £V aced [ awn[OA ul deW XananS palJ!:Iaap pTes uoTuldo Xw uT 46nu41fe 'JantU M01ITM 8114 JO aaluaa a44 pue X1un00 plea uT £V 06ed T 81111110A UT pal,103aa deW Xana11S paT;TlaaD pTes JO BUTT 1saM ayl.uaaMlaq eaJe aqa of aI1T1 poo6 aoJ papadu aq dew 'aanlU MOITTM pies 30 lava aauMO puel GuTulOCpe 941 woaJ 'paaa ulrej3 lints v •paap dlueaaely a 4:ITM paaaaJaueal aq lava uoaaa11 paXan.rrlel (Z 1o'I) 101 ay1 J t autwaalap 01 'OVITl Jo uTeya a111 pue 'p9X9n.111a saT.repu11oq a41 MatnaJ Plnoys Xauaolle ue .1o uosJad 91'4!4 1l ' 506'[ u l Pa.Ie.,0) 8L'M 11 Be Jan!! U Mo[ f IM 8114 JO du'r ( aaluaa ayl pa:IeDO ( dne,l I anaT f dg 1 ' A:I ! 1 rqe pue a6pa l Mou3l ,Tw Ju asacl a41 oI ' Aanans b ► yl Ilu uMO11s WV pue .ranTU plea Jo 1k,aM pue lsea fit, At B t-OE-V • Oas Ju V/T JN 8111 Jo 0/t JS plea Jo shed 911:1 ua0m0aq X.iepunay ay-4 rq 5061 ui pa:Ia'txa :IT ae IJAIU M01ITM 8111 Jo .Id:IuiOJ 941 1ey1 uOT'UTdo Xw ST 11 •paulE•lgo uTlaetq p!es LIe11-I puel aaoul poop o1 11.1edddv paap spli 111.1"D •g •q ul 01-0c -V 'oa5 Ju V/t :1N aql Jo V/1 as' ay:1 do Z/1 3 Bill papaap uT1aeW plus 1Sel. Z[61 III •U[-0£-V 'rldS .10 V/t 3N alil J0 V/[ US pies Ili aanrU Mu[IcM By-1 JO lsea pue 111108 6uTXf I,Ilel lelll .1OJ uI:I.IeW weIITTM sBwel• u~ paap a anefi a0ue-181103 •;1 XJ1JB11 S061 tit 08 TV • a0-10V 0V a.I flux a41 pauMO all 6!1 Ban ru MOfl!M 941 Jo .laluao 411:1 Ju loom puel :Iaya aa3suea:l pfnoo ay aao3daa4:I ' U 1-0£-V 'Day Jo 0/1 UN 0111 30 0/1 AS a1l:l pauMU aDue•11:11JOJ • J • II S061 tit suualu sTgJ. 'UT-0£-0 ';,OS JO V/1 2N all:I 10 V/1 AS 4111 Jo%Z/1' 2 all-4 uT 1Sdaalu1 Z/1 POPln1 pu11 puZ a41 a0J w!elJ •11rllS Xq,pauTelgo daualyduo:) •a •H 0061 111 ' al~de(I jo S'l l d61ed ' U5 awn l uA JOW ' U l-0£-V • "s JO 0/1 AN dya Jo V / T US 01,174 30 Z / T 3 all"I III -I89Jalu f Z/1 V&PI^1'pun ue Nau r Otago :)auel>aua3 •:r •H 'Z601 uI 'spda(.l 30 8£ abed 'ZZ aW4j,bA,'EUUT 'AZ 4a.reW Pa4eT, Paz)(] a u!' O(-•U£-VI 'Bag 3o V/t SN ally Jo V/T SSj Ala It, Z/I M, agl pauTelgo a.ulelsUOJ •J' •H '01-0£-6 u01laaS 311 V/1 3N' Bill JO V/t SS 8114 J~ Z/1 1saM a4'.1 paXdnuuo a:►uWlallu.) •D •11 aw!a tl.,T4M le (spaaa Jo VTV. abed 1901 dwnIOA) 4~06T 111 -lnoge aide:, 'V/T UN dill 10 V/1 3S p'1e13 tit 'al)rl 61ITl,TnT[, agl se UMEH Mu[I'tM dlla JO auTl .Id1ud:, dll:I 6u1a11 ay-.1 Ju uurluaw :Isar) d11:I "lelll sleanaa uut:Isall[, uT XV&410.ld d1l:I auJ 40VA-I13gN ally 3u MdTna.1 V •.1dn!21 Plell Jo :1aaM Imu1:Idaaxd ad11o 11:1-!M 'aanrU M0[['!M 911:1 JO gull .la.lllau 0111 Jo 111aM puul all ' (.1eu11 -I etul.I:led pue *-IV '.1eu(I •.L 'M) uua.Idy adt1MU d1l:I 01 wPddP ' (661066 •lagwrlN 1u:-,u1r1DU(J) $paap Jo L t~Z o6ed I T1.0 auul 1 un u l- p0tbau:,0.1 ' paap X11le.1.I eM dy,i~ ~ •Mulo(l 6u1uuaea.r aag •delu sT44 uo uMO4s se Z 40-1 uT PaP111Ju! sl dIA114 Xan.Ir15 pdtJ► I.1dJ PTes anugv a4:I uT ,(laaduad d114 Jo :Iae11 •11:10M U1 af,ueU 'y`.I.IUN (It dpluuM0I 'V uurla S Jo Ja:Iaerlb :Ise011-1:ION ayl JO .Id:I.Ien0 lsea11.Inuy d4:1 ]u J1ell 'IseJ Lill paXanJns deW p!es ISU1I •aanTU M011TM all-.I Jo Bull .Id:Iua::) ay:l Jo -luum t'a:Iua0j eT 1X1unoz) xru.r:) '1S pTes uT aOMO apaaa Jo .Idlst6aU ay:I ur tV a6ed T awnlon uT pap.luDa.I (60066Z aagw11N luaumuoa) deW AananS P8Vj 1.4.IaJ a uu uMOys laDaed a.1De b(.gT a41 JO auTI aaaM all:l aO :I.Ied 'Xanans aLu-1 I,[, uaam an lawn Lai STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER rA I-R i G L(- J. D o A R MAILING ADDRESS ` 0 S o v. 69, K Q W R's CL► r no ►a C1 t W o S S+0 PROPERTY ADDRESS 11-71 S'"~H \ (o (location of septic system) Please obtain from the Planning Dept. CITY/STATE Sw ' y.i PROPERTY LOCATION S 1/4, N E 1/4, Section T N-R t &__W TOWN OF R ; c -h rr, a y ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP Sb"t b , VOLUME 12 , PAGET312, LOT NUMBER ~Z- 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 licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was 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 system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNE d -14 DATE: d G alb U St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 8 T C - 100 This application form i 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 resale 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 -jar i e- J. p Q,l.~ r~ A N e iNeR ~e~, Location of property S 1/L 9E 1/4, Section 4 N-R W Township R i c-~+ M o w.t Mailing address PO ok 6 9 -NQW 6%nhop UVis 5'F,p~7 Address of site 17 Subdivision name g $ ' a j N vo(12 ? e3'rtt no. Z.. Other homes on property? Yes----K--No Previous owner of property WJ-oD0Njk, 6- Total size of property b 0 01% O!R u &-"-0 4LA-S 1 yr. Q Q t~ C11AL6, Total size of parcel 610.0-is u~a~,tiq t`ir. dd cm&& Date parcel was created a 64-Y. 7M . i 91 Are all corners and lot lines identifiable? Y. Yes No Is this property being developed for (spec house) ? Yes ~C No Volume t2 and Page Number 3312 as recorded with the Register of Deeds. INCLUDE WITH HIS APPLICATION THE FOLLOWING: A WARRANTY DEED which in ludes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if av ilable, would be helpful so as to avoid delays of the reviewi g process. If the deed description references to a Certifi d Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the ro rt~f de cribed in his information form, by virtue of a recorded in the office of the County Register of Deeds as Document No. and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of the County Register of Deeds as Document No. D`ttJtJ Signature of pplicanI Co-Appl' ant ,ot301q-, ld~3d g1 Date of Signature Date of Signature I • 04 • y • ' VOL 1.273PAC145Z DOCUMENT NO. STATE BAR OF WISCONSIN FORM 11-1982 LAND CONTRACT Individual and Corporate 7 (TO BE USED FOR ALL TRANSACTIONS WHERE OVER $25,000 IS FINANCED AND IN OTHER NON-CONSUMER ACT TRANSACTIONS) REG~$TER' OFFICE Contract by and between W. T. Poar,___Jr._.-------- $T, CROD( CO, W! atricia__L.__ Doar - R99'd for Rt~v9N ("Vendor", 1 O CT V I9l rk D______ whether one or more) and----- N aaQ_Y._.Px,inc Daax ~ 4.00 P . ("Purchaser", whether &e' or more). "A+.,, Wa1•n Vendor sells and agrees to convey to Purchaser, upon the prompt and full per- Re tst~r ~I Dveds formance of this contract by Purchaser, the following property, together with the o rents, profits, fixtures and other appurtenant interests (all called the "Property"), ' St. Coix - _ Vin. County, State of Wisconsin: IRETURN TO W. T. Doar Jr. P.O. Box 69 New Richmond, WI 54017; Tax Parcel No. Lot 2 of the Certified Survey Map filed as document 567614 in the Office of the Register of Deeds, St. Croix County, Wisconsin on October 29, 1997 in Volume 12 on page 3372 TRANSFER This 15••-IlOt_--------- homestead property. (is) (is not) Purchaser agrees to purchase the Property and to pay to Vendor at the sum of $__15 -0Q_._QQ----------------------------------- in the following manner: (a) $__?lQthing............................. at the execution of this Contract; and (b) the balance of $ ___,_QQ_Q Q together with interest from date hereof on the balance outstanding X 6YANLNX*=X1W at the rate of----- elght------------------------- per cent per annum until paid in full, as follows : $15,000.00 on February 1, 1998 Z86I - IT •oN suaog 'ulsuoaely ;o zsg a38tS - alszodzoO pus lanplAipUl - IZ)VUINOO (INV'I S..,F~ 'sazcc dq,8ls acs a l u~li' z4rF, adA3 a4 PInous S3. cosduo Bus ul 8uzu8[s suosaad do sawsN• ms ulS,l"'}T 9rP7?. ~w Vie' ,~y0000p C0 ~`r 1LL~ o a}gp (Aagssaaau you ass me uq a ' /~e 11 `10 ;I) uauguzaad st uotsstutulop eiyq Tog pa2palAtou3jou ao pajew u9gjw3 aq 1,eul s9.xngu2iS ) sim ' nop ® - Ti7X atlgna fagjo11 O---YES-" LTOv -s 11y--- pU©III7:{aT--d --'nsaA{------- - .k m . qzeWL21q ys•-LrA_TTaL-yl•: xog • p • M L-O(j J, °n JJr/'/// AS ❑31dVU0 SVM 1N3WnE1.LSN1 SIHl a W eseoeso a a~ almou3pg pug juaucnilsut 2uto8aao; a # i o tl'm ----guosaad eqj aq oq umoux atu o3 , (nuIS _si& 90.90L § Aq paztaoq}ne - 'you 11) NISNoosI& ao ava aSVZS 'fIamNaN : aZZIS z~oQ a~u-rxa hu~~ pu--oQ.._._r__xo-rz~ea ' .zIcsa-= Y'T- eT0T-T4'Va-- y . ~y paureu aeoge eq4 --E6--61 aQO ~Q ;o Avp-- stgq atu aao;aq ou ila Alluuosaaa 61 ;0 Bgp-------- SR4 p94uzqu9g4ng 440£ VOL 1?73FAU 53 y Purchaser promises to pay when due all taxes and assessments levied on the Property or upon Vendor's interest in it and to deliver to Vendor on demand receipts showing such payment., 'pd Purcha FpshV kim ovme on a Pr rty in red aga' t loss dio by fi ex- tended cover an sur h end may r uire, out co suransurers prov by Vendo in t f b Vend shall requir covera n an a ount re than th ala a ow unde his C tract urc er sha pay th insuran premiu s when e. Tan olici shall contai the andar clause favo of the endo inter and, u ess Ven r other, a agr in writ' g, the r'gin of a pol' es cov ing t Pro y sh be d osited th Ve or. Pu aser a 1 prom y give otice los to in an comp es a Ven . U s Pur aser a Vend otherw' a agree n writi , insur ce pr eeds all ap ed to r toat' n or r air of a Pro erty d aged, ovided th Vendor deems th restora ion or epa' to be cono ically asible. Purchaser covenants not to commit waste nor allow waste to be committed on the Property, to keep the Property in good tenantable condition and repair, to keep the Property free from liens superior to the lien of this Contract, and to comply with all laws, ordinances and regulations affecting the Property. Vendor agrees that in case the purchase price with interest and other moneys shall be fully paid and all conditions shall be fully performed at the times and in the manner above specified, Vendor will on demand, execute and deliver to the Purchaser, a Warranty 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: No - otfier--exceptions 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 -__10_-- 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 Vendo 's option without notice. ke al ayment when d under ny ,nor ge out nwng inst t Prop yon he da Ven s/e; this Cont ct (r IF a grant y Pu aser) under ny not ecured ereby rovi d Pu r 06 ely po he amo s then a and this Co act. P chaser y mak ny su pa nts d' ct to makes p ents made Purc er shall a cons' ered en ma a on the rtgage or fails do so all thi 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. r D ed this 3 O th . - day of O-- tobe-- 9-7. f 6fa ' (SEAL) (SEAL) ~ 16 W: Patrick J. Doar W. T. Doar, Jr. . ~l --j- (SEAL) -.(SEAL) Nancy Prince Doar Patricia L. Doar - - AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ss.