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HomeMy WebLinkAbout032-1008-60-100 i STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ( rrA.IL ADDRESS 23 54(0 U SUBDIVISION / CSM# LOT # SECTION___~/_T .3/ N-R W, Town of /v SO'i'zt40 ST. CROIX COUNTY, WISCONSIN P ]AN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Y 'n/ J &J ~ N ~M a N --I INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: v- ALTERNATE BM- PTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: -41eyp q' Liquid Capacity: ~o Setback from: Well SSA House Other Pump: Manufacturer Model# size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: Length Number of trenches Distance & Direction to nearest prop. line: Z 74,2- Setback from: well: House 3S Other ELEVATIONS Building Sewer ST Inlet: / . ,3' ST outlet: PC inlet PC bbottom Pump Off Header/Manifold 47<01, 6 Bottom of system Existing Grade Final grade/OO i DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/93:jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No-: GENERAL INFORMATION 299024 Permit Holder's Name: ❑ COity ❑ Vil lllage Town of: State Plan ID No.: ARNDT, CRAIG $ jjuujjEj~ ~T CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: ~G✓ GU /(]~).~/o ~a« QS i~ 032-1008-60-000 TANK INFORMATION ELEVATION DATA A9700345 141_:21z1419,7 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic (,C) 5 f nC Benchmark 3,0' Dosi a,a0 A-0 K Aeration Bldg. Sewer Holdin 101, St/, Mf Inlet TANK SETBACK INFORMATION St/ Outlet TANK TO P/ L WELL BLDG. ventto ROAD Dt Inlet 3 Air Intake Septic NA Dt Bottom Dosing NA Header, 4%m- 771 ' Aeration NA Dist. Pipe , ( g 7-? Holding Bot. System 611 93, 77 PUMP/ SIPHON INFORMATION Final Grade 33 Manufacturer Demand ?7.7e Mo Number GPM TDH Lift Loss ion stem TDH t Force Length Dia. Dist. To S IL ABSORPTION SYSTEM BED/TRENCH Width / Lengt i No. Of T enches PIT No. Of Pits In i d Depth DIMENSION 27` DI E SYSTEM TO P / L BLDG WELL LAKE/STREAM L G Manufacturer: SETBACK MBER INFORMATION Type Of p~ / Mode um er: System: C", vt; bed 35 S "'OR UNIT DISTRIBUTION SYSTEM Header /-Merrffltd- Distribution Pipe(s) i >Depth Size x Hole S acing Vent To Air Intake c/ Length _ i ~ Dia. ~ Length ~ Dia. SpacinSOIL COVER x Pressure Systems Only xrade Syste ly Depth Over Depth Over xxx Seeded/Sodded x Bed / Trench Center Bed / Trench Edges T❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: SOMERSET 4.31.19.52,SE,NE 2374 50TH STREET Plan revision required? ❑ Yes [a 'No 71 1~w 0 1 Use other side for additional information. 97 3 SBD-6710 (R 05/91) Date Inspector's Sign ture Cert No. J ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: SANITARY PERMIT APPLICATION 201E WashngtonAve sion Wisconsin P.O. Box 7969 Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI W707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. S!. Gi»l L • See reverse side for instructions for completing this application State sanitay Permit Nu ber i✓ a 49 The information you provide maybe used by other government agency programs E] Check it revision to pre~~~{{{ous application (Privacy Law, s. 15.04 (1) (m)]. S~ ow, . State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATION Property Owner Name P perty Location ~1/a 4,S T N,R E( Property Owner's Mailing Addr6if Lot Number / Blpkk Number City to , Zip Code Phone Number Subdivision Name or CSM Number / oZ m Z.Jr ~t~-Zo (/5)ay - jo 3 33 II. TYPE F BUILDING: (check one) ❑ State Owned city Nearest Road C Public 1 or 2 Family Dwelling - No. of bedrooms Town OF o~~s S E~ III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(/s), 1 ❑ Apartment/ Condo / • J Sa 43 v /v O '66) _/00 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.~^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 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 2 ❑ 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 (s . ft.) (Gals/day/sq. ft.) (Min./inch) Elevation 5 v e;_;~,?- l 6 q -3 .2 ]Feet ?e -2-Feet VII. TANK Capacity gallons Total # Of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturer s Name Concrete Con- Steel glass Plastic App New Existing structed Tanks Tanks Septic Tank or Holding Tank o- rIO 4J► e.e ( ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumbe ' ame: (Print) r Plum ignature: (No tamps) r P/MPRSW o.: Business Phone Number: rto i1 ~l 7lS ,?6 Plumber' Address (Street, City, State, Zip Code): Gs ( ~ ~O IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing A ent Sign re (No S ^ Approved ❑ Owner Given Initial Surcharge Fee) ~jf ~ ( , Adverse Determination vv X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: 3BD-6M (R 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. Ill- 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. PLOT PLAN PROJECT Craia Arndt ADDRESS 2367 45th St. Osceola Wi 54020 SE 1/4 NE 1/4s 4 /T 31 N/R 19 W TOWN N.Somerset COUNTY ST. CROIX MFRS BYRON BIRD JR. 3318 DATE 8/19/97 BEDROOM 3 CONVENTIONAL XXX IN-GR ND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 648 BED SIZE 12'X54' BENCHMARK V.R.P. Top of White Stake ASSUME ELEVATION 100' ❑ BOREHOLE O WELL -H.R.P. NE corner of Property 4 ANT SYSTEM ELEVATION 93.7 12" GRADE qTYPAR COVERING 12" 3' 3' R K >500' to West Property 460' Property 0 r.. B-1 60' V 0 3 edroom 30' ouse cX Rep A B-5 60' % Slope PLOT PLAN PROJECT Craia Arndt ADDRESS 2367 45th St. Osceola Wi 54020 SE 1/4 NE 1/4s 4 /T 31 N/R 19 W TOWN N.Somerset COUNTY ST. CROIX MFRS BYRON BIRD JR. 3318 ~ DATE 8/19/97 BEDROOM 3 CONVENTIONAL )00C IN-GR ND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 648 BED SIZE 12'X 54' BENCHMARK V.R.P. Top of White Stake ASSUME ELEVATION 100' ❑ BOREHOLE O WELL -H. R. p. NE corner of Property VENT SYSTEM ELEVATION 93.7 412" GRADE 13'6' PAR COVERING 12" 0 3' ER R K 12' >500' to West Property 460' Property 0 B-1 60' VY Prn A o3 B-3 30' droom Driveway 30' ouse Rep A B-5 60' % Slope Wisconsin Department of Industry, SOIL AND SITE EVALUATION Labor and Human Relations Page of Divisnn of Safety and Buildings in accordance with s. ILHR 83.09, Wis. J 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 reference point (BM), direction and S G rD percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # a©°-~P1 APPLICANT INFORMATION - Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location ?Gt r,' T' e U1 ❑ Govt. Lot JW"1/4/AZ1/4,S T .W,N,R E (K-W71 Property Owner's Mailing Addr Lot # Block# Subd. Name or CS # City State Zip Code Phone Number G I77 C ^ f c Nearest Road fCiG p1 , Opv Y~ G ❑ City LI Village W Town New Construction Use: Residential/ Number of bedrooms _50 Addition to existing building Replacement ❑ Public or commercial - Describe: Code derived daily flow S D gpd Recommended design loading rate bed, gpd/fit - 7f trench, gpd/ft2 Absorption area required bed, ft2 S 6 3trench, ft 2 Maximum design loading rate _ 2 bed, gpd/ft2_ -_a_trench, gpd/ft2 Recommended infiltration surface elevation(s) n2 ft (as referred to site plan benchmark) Additional design/site considerations ` _ ~ Parent material c i O VCc ccJ q 5 _ 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 5q S❑ U 9S ❑ U V~S ❑ U cgs ❑ U El S C3 U ❑ S au SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 Ground 13 o~ 3 I v. Depth to limiting factor in. Remarks: Boring # Ground elev. ; y~1 fit. 3 Depth to N limiting T_7 I factor fe~9 in. Remarks: + CST Name (Please Print) ignature lephone No. ~i Address CST Number G 4/f SOIL DESCRIPTION REPORT PROPERTY OWNER ru Page of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Ground lev. AX -2 1 100- 01 XL- Depth to limiting f for ~ ~G in. qf' Remarks: Boring # 2, Ground elev. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # _ O ~?4 Ground eft. Depth to limiting factor ~~in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBDW-8330 (R. 03/95) Soil Test Plot Plan Project Name' , " Byro Bird Jr. Address ~ YW/ ,7 SSG 5~~ o _ CM #3479 Lot Subdivision Date 4 1/4ST ?j N/RW Township EJ Boring O Well PL Property Line County BM or VRP Assume Elevation 100 ft. o~~,j, Sfu ~~Q~►~ - c ~l~.1d~ System Elevation 93 *HRP -5 0 5 X7 ~ f ~w y 0 i 1 t ~ . ~o ~ pf0 1I1 I p Ay b o' 1 Scale 1/4" = 10 Ft. When Dimensions aren't stated 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 1 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 reference point (BM), direction and Ci/✓NI f percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # lee - APPLICANT INFORMATION - Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Govt. Lot J 1/4h~ 1/4,S T ,N,R E Property Owner's Maili Address Lot # Block# Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road -New Construction Use: idential / Number of bedrooms Addition to existing building ❑ Replacement Public or commercial - Describe: Code derived daily flow gpd Recommended design loading rate =bed, gpd/ft2 trench, gpd/ft2 Absorption area required ~Lbed, ft2 r trench, ft2 Maximum design loading rate -_bed, gpd/ft2_._!2~trench, gpd/ft2 Recommended infiltration surface elevation(s)✓ ; ft (as referred to site plan benchmark) Additional design/site considerations - r- - Parent materials 4 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 ,aS ❑ U ®,S ❑ u „&.S ❑ U .-as ❑ U ❑ s [2eu ❑ S u SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench d ~ " - .rte f - ~ 4.1 ~v Ground ev. eft. , Depth to limiting factor Remarks: Boring # { J" d~w Ground dele~v. Depth to limiting factor in. Remarks: CST Na (~P/l~ease Print) Signature _ Telephone No. 7rp~ Addre Date CST Number PROPERTY OWNER ! cc.`d, SOIL DESCRIPTION REPORT Page 'of PARCEL I.D.ff Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed , Trench 4,14 - 13 X Ground ~twft F19 "001 Depth to limiting factor 3'7 Remarks: Boring # f' S, 110-50e~ f 13 Ground leev. Depth to limiting factor in. Remarks: ` Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # t jjZ Ground elev. eft. Depth to limiting factor in, Remarks: 6oriwg- # Ground elev. ft. Depth to limiting factor in. Remarks: SBD-8330 (R. 07/96) Soil Test Plot Plan Project Name Byron Bird Jr. Address e +10,AC5 CS M #3479 Lot Subdivision Date N1 / 4 4eu1 / 4 STZL N / R /1 W-*- Township //~reN- -q7- 47- Boring O Well PL Property Line County ~r ~°.~tvr>C BM or VRP Assume Elevation 100 ft.~ System Elevation *HRP lib per 49 Scale 1/4" = 10 Ft. When Dimensions aren't stated 564499 CERTIFIED SURVEY MAP Located in part of the Southeast Quarter of the Northeast Quarter of Section 4, Township 31 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin. Prepared for and at-the request of: OWNER: Craig A. and Anne M. Arndt 2367 45th Street NORTHEAST CORNER Osceola, WI 54020 SEC. 4-31-19 Drafted by. Kristi A. Eylandt (ALUM. CO. MON.) NOTE: The parcel shown on this map is subject to State, County and Township laws, rules and regulations ( i.e. wetlands, minimum lot size, access 1 1 to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office and the appropriate Town Board for advice. NORTHEAST CORNER OF THE N UNPLATTED_LANDS SE 114 OF THE NE 114 66' cd SEE SURVEYOR'S REPORT IN TH15 AREA 13311 NORTH LINE OF THE SE 114 OF THE NE 1/4 1 i "z W 37.24.`\ 1133 h --------S 89'22'07" E 1159.96'-- - 1' 1 cV _X__ x x-x-x-X x-x-xX-X-X X-x-X-X X-X X-X- -X-X---X --------1122.72'------ - --T-~ 1 o co ~0 25.3f24.2f 28.11.`' j 11 I zr; o FENCE , 2 u; Q I I l--I ~ N M I ; NI W1 I L O T 1 ~S ; wI ; Z O~o. TOTAL AREA: Z 3 : 3 3 I I 1 ~I c JI 700,158 SO. FT. O O 1'- 1 .00~ .ry 16.07 ACRES j 0 31 C01 'lam AREA EXC✓_UD/NG R. 0. W.: m p iv 1,°n o I , N ¢I ?s 680,651 SO. FT. p M t `tl =I a-; b~. 15.63 ACRES 01 1 ►i1 F--~ Z 01 tis 35;45,,J 1 1 11 0,1 o 391.55 FILED s800 ` N 8972'07" W 427.00 = ' I AUG 2 7 1997 No- ~I,1 666 rn I KATiiLr-EN H. wAI.SFI g Register of Deeds w I SL Croix Co., WI y if' 1 ~ 33i = 1 1 I o CP. CID C; 0 /V J'N X-7 \,A CID RONALD F. S ;3: °i 2 N 1 JOHNSON * _ io ~1 p Q I ` s-t tab = ~s o Qi V 1 I I W I AMEF2 WIS.4 \0 rq Z Z I \ I . I 4b 0 _D1 ILI ~~t Np S U R O- reeett~°~~ 1 i i i # I 1. ~ 11_/ B T C - 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 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 ~ Location of property _fi-~ 1/ X1/4 , Section , T, /N-R / W Township --Mailing address s ~ ,:2- o Address of site Subdivision name Lot no. Other homes on property? Yes No Previous owner of prop ert ~ Total size of property ~ /15;= Total size of parcel Date parcel was created F112Wt Are all corners and lot lines identifiable? Sl Yes No Is this property being developed for (spec house)? Yes ,5e No volume 42,E and Page Number/ZZ as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which incluc'tee 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 references to a Certified 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 property described in. this information form, by virtue of, a. warranty deed recorded in the fide of the County Register of Deeds as DocQ0ent No. ~-Z~(~~ 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. cttt~lr Signat a of Applicant Co-Applicant Date of Signature Date of Signature STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Lroi" Coun OWNER/BUYER S7 a~~ MAILING ADDRESS PROPERTY ADDRESS.Z~, oZ 3 7 SD (location of septic system) Please obtain from the Planning Dept. ~Q CITY/STATE V PROPERTY LOCATION .Sf 1/4, Zf 1/4, Section / T _,V' N-R_4? _W TOWN OF -SGU~PIt-QPJ ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CER1711BUDSURVEY MAP , VOLUME 6 c AGE LOT NUMBER 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. SIGNED: DATE: (a - & St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 • _ I~ . - li eTATa GAR OI VA*C0WW" ~ /ORM tt 627 „ 1 r LwafD CorZUwcr-f r1.M.M W y~ 00CUMIKNT NO. PACE .a C.Tsrate THIS SPACC OUCKVeO FOO asWaWNe O&TA f 3'70044 M~ Ati7ldt,. REGI57ER5 offia ~Contok by am between J? At ill ar~d Fern ;i ST. CROiX CO, WIi► histi trd,lrw, _ (mss , !S %ed for Record AbAk day °2:30 F• a wh tber qM em sad c n to e8a b .aa.tsldi.. .btnibsio~i'i.smd ors-• SiH (-Purcbaser", whether ono w assn). ` Vardar Sells and agrees is coney to PGxhaser, upon the prosse seed fail per, to Mw of this eotrect by Pa de . the ~ Y. W94'Mw With ~ interes t+41 ~02~°osat. Cous-79 State of IPiseomd~r• nsr *e &Mtthft t QUM-UW of the Freest Quarter (M of D4la i i W4 of Section 4., T31N, R19N, E!a'tM the West 99.18 i; p. 0. Boot 337. 51120 et and ~ the North 99 feet thwwf p } O` m ' Tae< 14a1► Ito►..:N...~.~.._....._.~:....~-.....~~ The South Vie-half. (Sh) of the NorthISUAt DMXtW (fit) of S+ectim 4, T31fi, RIM; "le Sautheans't Quarter (sW41 of Section 4, T31N, R19K E „ east comer Of the northeast 0A tw of the Southeast Quarter (iii of I tbance North along the zest lirw of said 40 a distance of 450 feet; eWnm ;lest 300 tsEti , thence South 450 feet to the South line of said forty.- theme > a distatioe 300 ;t Heck to the point of beginning; "is South am-half of the Stint Qum (Sh of W 'Nr Sects 4o ` RMa ' F~OCF the West One-half of the t Quarter of the South oWt QUftrW 06 Of sot of St); Of Sind of Section 4w T31*, , 2w Northeast Quarb", of the Southwest Quarter E' 8>aT the hest 6 rods of the North 40 ends Thk i hotiiestead property. (is) (M Gat) Pumbgw sgrow to purchase the Property, and to pay to Vendor st igatim___.°r......... tie sum e: in the following maaues: at the w"ution of this Coutraet, and the balance of $320,000.00 together, via boor" ft w do* - hereaf se such portions as remain from time to time unpaid, at the rate ot..fix--.~6) Per eat Pw " 1981 untie paid to felt, as follows: monthly installments of $2,062.00 per month Cog provided that the entire principal and interest shall be fully pei,d WiUdn qty-five (25) years; Purchaser, unless excused by vendor, agrees to pay monthly to Vendor payment suffietent rsaoushlY is a the psymaat of tans. apeeid assessments, lire and required insurance preseiums. To So extent rasslved bg Vendee, Vendor agrees to apply payment to these obligations when due. Such amount received by the Vendor fse VOYMN"t 49 into an escrow fend or truate account, but shall silt bsw lettered tans, assesssseats and hosurance will be deposited nukes otherwise reenired by law. that to peincils3• A AY payments *ban be applied first to interest on the unpaid balance at the rate apesised and 'H~ ` amount may be prepaid without premium or fee upon principal at any time after------ C1Q0jM........... 01 Iwo In the event of any prepayment, this contract shalt not be treated se in default with respect to psYmaf se long as the unpaid balance of prinelpnl, and interest (and in snob case scorning interest from mouth to month $bell be heated as awtpnid principal) is less than the amount that said tndebtedneA would have been had the monthly peymewls bees made as first speJAed abase; provided that monthly payment shall be cone need in the event of credit of OW p"M& of inauranee or condemnation, the condemned promises being thereaftar exeluded berdrom purchaser states that Purchaser is satisfied with the title as shown by the title evW..Aes submitted to Purchaser for examination except: VOL U.: I PAGE 173 r ises Y wr Fay when due all taxes and assessments levied on sloe Property or upm Vender's interpt is it and to deliver to Vendor on dearand receipts showing such payment. Purchaser shall keg the lmprevements on the Property insured against loss or damage occasioned by tire. 41- tended coverage perils and such otber hazards as Vendor may require, without co-insurance, through insurer appurored b vendor, in the aim of ~ 1._ BilT.d~l►f8.. llEt_., but Vendor shall not require may in an amount more than the ba:a m owed under this Contract. Purchaser shall pay the insurance premwms when due. The polkies 'Mn contain the standard clause In favor of the Vendor's interest and, unless VMndcr otherwise agrees in writing, the original of all policies covering the Property shall be deposited with Vendor. Purchaser shall promptly give notice of lop to insurance emnpanies and Vendor . U less Purchaser and Vendor otherwI si roe in writing, insurance proceeds shall be applied to restoration or repair cf the Proporty damaged, provided the Vender deems the restoration or repair to be economically feasible. Purchaser covenants not to eats mit waste nor allow waste to be com pitted on the Property, to kcep the Property in good tenantable eondition and repair to keep the Property free from lens superior to the lien of this Contract, and to comply with ail laws, ordinances i4 regulations affecting the Property. Vendor agrees that in case the purchase price with interest and other coneys shall be fully paid and an conditions shell be fully performed at the times and in the manner above specified, Vendor will on demand, execute and deliver to the Purchaser, a Warranty De4 in fee simple, of the Property, free and clear of all lien* cad encumbrances, exempt any limes or encumbrances created by the act or default of Purchaser, and except : easemuats-an&- d................ when ha a agrees that time is• of the essence and in case of default in the payment of any principal or interest due, or In the performance of any of the conditions, covenants, or promises of Purchaser, and such defank shall esntinue for a period of dam then Vendor may, at Vendor's option, declare the contract at an end, all rights of the Purchaser under this agreement cancelled, and the amounts paid by Purchaser hereunder forfeited, the sans to remain Vendor's property rental of said premises and as liquidated ges for the failure completely to it= this agreement; and Vendor stall forthwith and without notice have the right of re-entry; or, at the option of Vendor and without notice to Purchaser, notice being hereby expressly waived, the whole amount of unpaid principal shall be dsenred to havo become due and ' ayabl% in ease such option shall be exercised, the unpaid principal and interest together with all sons which D1or have, brwr paid by Vendor as herein authorized with interest on such disburse- meets at the rate aforesaid sha8 ciflectnblb in a suit of law, or by foreclosure of this contra. in the same manner as if the whole of unpaid principal d been due at the time when any such default occurred, and the indebtedness shall mbraoe, with opaid principal and Intereek all the sums so disbursed with interest as aforesaid. In case of legal pro- ""dings to enforce any remedy beregnder, whether abated or not, all expenses, including reasonable attorney's fees, shalt be added to the principal, become doe as incurred, and in case of judgment shall be included therein. Upon the commencement or daring 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 daring the perrdency of such action, and such rents, issues, and profits when so collected shall be hold and applied coact shall direct. AN terms of this Contract 4an be binding upon and inure to the benefits of the heirs, legal re resentatives. - sueeessors 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 mods in fulfillment ber:to1.1_ _ Dated this 3.4t..................... day of ls$xdl............................... 19__81-.. r (SEAL) ..............(SEAL) • ColS.A.-.Ali Idt--------••---------------•--••. -e►t/ •rs-~/-tom i ---.......(SEAL) v~/Y1.i4...-• - . - - ....------(SEAL) - • . Atro!dt -ju. M' At~r~dt AUTHENTICATION ACKNOWLEDGMENT Signatures authenticated this 1f..... day of STATE OF WISCONSIN Na=h , 19__81_. ss A County. - - Personally came before me, this ..................day of s Allan O. Maki the above named TITLE: MEMBER STATE BAR OF WISCONSIN ' (If not, authorized by § 706.06, Wis. Stats.) ...................F _ THIS INSTRUMENT WAG DRAFTED BY to me known to be the person who executed the foregoing instrument and acknowledge the same. i~ - 1r . I11DV1(.~C1+t. 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