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HomeMy WebLinkAbout026-1163-14-000 3 0 d. O 6-0 O h a+ 0 o a° o ~ m °n N ~ C N it y o mL c )i. s a - c 00 'x y O' W ~C N LO r O M c O N lr to O 'C 7 L O 7 N to O Q I O O c Z L) m " 0 cc cc a- 7 ~p OD O. U. O O = O 3 C~ m N O 0 y 3LO €20 E Q c cu w O N C fV N O = O of I Z a M LO Cl) N H U) j c O O Z :t V ~ c N H c Z cm N co f6 j a a~ cn • A~ d L L O a c O_ 0 N Z Z E z c _0 E ~ - N O j O N IL c Lo o O G CL E N -6 .t U) U) w E o0 0E 333 o cn Z o a a N a y (j J V OOi OR Q~l N N ~ N ^I Q o m 3 ~ L 'D N ~ O_1 N 1O ~j O O c O tp c IV E cl 9 0 Cl) 0 v a 0 O r v cMO °r _ o c o E O p c~ c r 7 N_ O E d 'D H c 'n FBI c'l U O O N E U O N Q: I N O Z G d is a • CL e~ ~ c ~~ww 2 _1 A 0 n. 2 l 0 U) Q Parcel 026-1163-14-000 08/08/2005 05:13 PM PAGE 1 OF 1 Alt. Parcel 25.30.18.1264 026 - TOWN OF RICHMOND Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 05/07/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - TOBERMAN, BRIAN BRIAN TOBERMAN 1410 130TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1410 130TH AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 3.130 Plat: 10/03-HOLLOW POND 026/04 LOTS 1/16 SEC 25 T30N R18W PT SW SW BEING HOLLOW Block/Condo Bldg: LOT 14 POND ('04) LOT 14 (3.130AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 25-30N-18W SW SW Notes: Parcel History: Date Doc # Vol/Page Type 02/01/2005 786270 2740/410 WD 05/07/2004 761870 10/03 PLAT II 2005 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/21/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.130 35,400 86,600 122,000 NO Totals for 2005: General Property 3.130 35,400 86,600 122,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 S f d c d 4-1 cf) 1~,F11 C ; 0 Z O QN ~CNT N. F I i y_& =r y vi O ? W ICI I N CL N p N 03 0 C t- M OD -4 C` -4 a o 3 ~ CD a to ' N 3 ~ O) O O } O O 0 J` I t cn C D eo ~a c m co c d N Q c° C 0 CD s a " N N N C i CD Z rn C) r o co "Mo 0 z 0 a o c D C) 0 a, N o N 3 d 4 CL 3 z z O N z ~ o n D m v O 0 A CCD c CD CD c d m w m a o z 3 1 N O p Z lD v a A o' c w A w n O CL z C En H :U CD ~ v O pj Q (D N O d U7 ~p a WO N O. < N T O = LU C N Z O) Dm-0 41 Cil w ' n 'm N O 7S, fi ' A v W N C t-A 0 A O O ~ C ~ O b O ti STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ,I C rv y M YZ -e l ADDRESS /`//6 /,3CitLi ~ & SUBDIVISION / CSM#C~ LOT # SECTION T 3D N-R_ZF W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM D J h v b p0 '/'0G G d Q INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: r C,4 y GJ e-/( ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: Liquid Capacity: laealloOd Setback from: Well Y3 House Z (J ` Other Pump: Manufacturer 6o".4ee Model# Size Float seperation Gallons/cycle: Alarm Location a e SOIL ABSORPTION SYSTEM Width:-,2,y Length 4lL& Number of trenches l Distance & Direction to nearest prop. line: ,2O Setback from: well: 3~3 House Other ELEVATIONS Building Sewer ST Inlet: ST outlet: PC inlet PC bottom Pump Off Header/Manifold Bottom of system Existing Grade Final grade DATE OF INSTALLATION: `x_02 PLUMBER ON JOB: C ~Z&=--~ LICENSE NUMBER: ~/ylbZ INSPECTOR: 3/93:jt 9 Safety oand f Building Water Division Systems ~•■~r■■,• SANITARY PERMIT APPLICATION Bureau 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 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. • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide may be used by other government agency programs Wt-h..k it revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Property Owner Name Property Location Ter-,, 1/4S/j 1/4,S d$ T3Q ,N,Rj~ E(or) Property O er's Mailing Address Lot Number Block Number a s City, State Zip Code Phone Number Subdivision Name or CSM Number ,FM C: )Ial,4 14J II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ city Nearest Road E] ❑ To Village ' d 1 ~Q T~ Public 1 or 2 Family Dwelling - No. of bedrooms Town of •rro.F. ill. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 2 p 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. g 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 R1 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41E] Holding Tank 12E] Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13E] Seepage Pit 43 ❑ Vault Privy 14F] 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./inch) ;rs8d Elevation d / KGB / ~ Feet f 7,,8LS Feet VII. TANK Ca in galio acity Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Existin strutted Tanks Tanks , A Septic Tank or Holding Tank ~U~ C 6~CtfQ C ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber - ( ' ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite se. ge system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (N Stamps) PRSW No.: Business Phone Number: AZ Z lumber's Address (Street, City, State, Zip Code): M. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issue Issuing Agent Signature (No Stamps) F1 Approved ❑ Owner Given Initial Surcharge F ee) Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: INSTRUCTIONS 1 . A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe 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, 608-266-3815. i 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. PAC. Goulds Submersible Effluent Pump 3871 EP04 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. tic cover with integral handle Motor: Available for automatic and and float switch attachment • Farms manual operation. Automatic • Heavy duty sump ` • EP04 Single phase: 0.4 HP, models include Mechanical ■ Points. Power Cable: Severe du 115 or 23t in V, overload 60 Hz, 1550 Float Switch assembled and • • Water Dewatering transfer RPM, built erload with preset at the factory. rated oil and water resistant. automatic reset. ■ Bearings: Upper and lower 0.5 HP, SPECIFICATIONS • EP05 Single phase: 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing Pump: EP04 built in overload with ■ EP04 Impeller: Thermo- construction. • Solids handling capability: automatic reset. plastic Semi-open design 3/4"_maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING -.Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. SA• Canadian Standards Association •:Total heads: up to 24 feet. with three prong grounding • Discharge size: 11/2"NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo- (CSA listed model numbers • length, 16/3 SJTW with plastic enclosed design for end in "F" or "AC. Mechanical seal carbon- improved performance. ) rotary/ceramic-stationary, three prong grounding plug BUNA-N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 1040F (400C) continuous superior strength and 140°F (600C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10- • Capable of running dry without damage to s 30 1,. components. Pump: EP05 8- • Solids handling capability: 0 25 34" maximum. a W • Capacities: up to 60 GPM. x s 20 • Total heads: up to 31 feet. • Discharge size: 11h" NPT. Z 5 • Mechanical seal: carbon- 0 15 rotary/ceramic-stationary, _j 4 BUNA-N elastomers. o i-- - - - - • Temperature: 3 io 1040F (400C) continuous - 140°F (600C) intermittent. 2 ----r-------- - - ---1----- 5 0 00 10 20 30 40 50 GPM , , , 0 2 4 6 8 10 12 mo/h CAPACITY ©1995 Goulds Pumps, Inc. Effective May, 1995 R7R71 Goulds ' _ 6 Submersible Effluent Pump 7 ,1 n 6 C`~J 9 EP04 5 3871 4 EP05 3 2 DIMENSIONS PARTS (All dimensions are in inches. Do not use for construction purposes.) Item Description 1 Impeller EP04/Impeller EP05 2 Rugged thermoplastic base 3 Rugged thermoplastic pump casing 4 Mechanical seal 11 MAX. 5 Ball bearings 7'/z 10'/e 1'/z NPT 6 0-rings 7 Power cord 8 Oil filled motor 3% Cast iron motor housing/_ 4,/ 9 stator assembly'- 10 Thermoplastic motor cove 9% r 6" MINIMUM WATER LEVEL WHEN SUPPLIED WITH FLOAT SWITCH MODELS PERFORMANCE RATINGS Order No. HP Volts Phase Max. RPM Solids Power Cord Wis. Total Head Gallons Per Amps Handling Length (lbs.) (ft. of water) Minute EP0411 115 12 10' 20 EP04 E 5 53 - EP0411A 4/0 115 12 10, 21 10 46 62 EP0411F* 115 1 12 1550 W. 20' 20 15 36 56 EP0411AC* 115 12 20' 21 20 21 47 EP0511F* '/2 115 13 20' 21 24 0 38 EP0511AC* 115 13 20' 21 28 - 24 "A" denotes automatic operation. Pump includes float switch. 31.5 - 0 "F" denotes CSA listed with 20 foot power cord. "AC" denotes automatic operation, CSA listed with 20 foot power and switch cords. * CSA listed units. * * 230 V models consult factory. GOULDS PUMPS. INC. WATER TECHNOLOGIES GROUP SB.ECA FALLS NEW YORK B148 SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. PRINTED IN U.S.A. PAf t ;F PUMP CHAMBER CR055 SECTIOIJ AND SPECIFICATIMS VC JT CAP 4`C.I. VEA1T PIPE f r-T WEATHERPROOF APPROVED LOCKIQIG > ?-5' FROM DOOR JUIJCTIOtJ BOX MAMHOLE COVER - , WIMDOW OR FRESH 12"MIU. AIR IMTAKE GRADE I I I `i" MIIJ. ~ Is•r~IU. COIJDUIT \ 11l IAILET PROVIDE AIRTIGHT SEAL i III A I ~~I I III I (I ALARM B I II I I *APPROVED i om JOINTS WITH I ELEV. FT. APPROVED PIPE 3' ONTO PUMP OFF D SOLID SOIL COLICRETE BLOCK RISER EXIT PERMITTED OIJLy IF TAUK MAUUFACTURF.R HAS SUCH APPROVAL SEPTIC E SPECIFICATIOAJS DOSE TAUKS MAUUFACTURER: )02,d 7-'eP%. 1 IJUMBER OF DOSES: PER DAM TAWK SIZE: 1000 GALLOMS DOSE VOLUME / G~ ALARM MAUUFACTURER: Z eG'G.~o-tryyl IMCLUDIMG BACKFLOW: Y ~ - GALLONS MODEL IJUMBEK: GI CAPACITIES: A=_,Z 3. sdIUCHES OR 660-' GALLOLIS SWITCH T`,lPE: i - ex--GB INCHES OR 616)_ GALLOI IS PUMP MAAIUFACTURER: C. = ~Q INCHES OR IL?l GALLONS MODEL AIUMBER: 4•0 ~ y r^ DINCHES OR Z06_ GALlOMS i SWITCH TYPE: LNG MOTE: PUMP AMD ALARM ARE TO BE MIUIMUM DISCHARGE RATE GPM INSTALLED OM 5EPARATE CIRCUITS VERTICAL DIFFEREMCE BETWEEU PUMP OFF AMD DISTRIBUTIOM PIPE.. 1_ FEET + MIMIMUM METWORK SUPPLY PRESSURE . , FEET + 7d FEET OF FORCE MAIM X F~100 rtFRICTIOU FACTOR. a' 7f FEET TOTAL DbMAMIC. HEAD - la, 2F FEET IAITERAIAL DIMEIJSIOMI. OF TAIJK: LEIJC,TH ;WIDTH ;LIQUID DEPTH I SIGAIF n: Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor andHumanRelations INSPECTION REPORT ST. CROIX Safety and Building's Division (ATTACH TO PERMIT) Sanitary Permit N0.: GENERAL INFORMATION 284161 Permit Holder's Name: ❑ City ❑ Village Town o : State Plan ID No.: MORTEL, JERRY RICHMOND CST BM Ele++((.: Insp. BM Elev.: 71sa,0101-e- ription: Parcel Tax No.: ~OJ , Gd ' 11,10 . a) as P A~Z TAN K INFORMATION ELEVATION DATA -IS e/97 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Cc'.5 r') Le- tea. r Benchmark 3 U{o~ /Gt ,0111 Dosing Aerati Bldg. Sewer Holdfrfg St/I Inlet 9 ,3 TANK SETBACK INFORMATION St/ I Outlet 3 Ssl TANK TO P/ L WELL BLDG. VVe Air Intake ROAD Dt Inlet 3s-' ZZ, 7Z Septic >SU( NA Dt Bottom Dosing NA Wan. Aeration NA Dist. Pipe Holdi Bot. System 7 3~~ ~tZYI PUMP/ SNFORMATION Final Grade Manufacturer Demand o-C Model Number GPM cud jk,-6 TDH Lift Friction m std TDH Ft ar~~ fR,~f arc!, Fi ~ Forcemain Length Dia. a Dist. To well -5-0 9y l, SOIL ABSORPTION SYSTEM BED / Width fc ! LengtFy ? R No. Of Trenches PIT PIE I No. Of Pits Inside Di uid Depth DIMENSIONS (p J LEAC anufacturer: SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM - INFORMATION Type O CHA ER Model Number: System: CsnJ OR'UNIT DISTRIBUTION SYSTEM Header / Distribution Pipe(s) r N x Hole Size x Hole Spacing Vent To Air Intake Length Dia. ~i Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Syste F Over ,1 Dpth Over ,l c xx Depth Of xx tided / Sodded xx Mulched Trench Center a~ - 240 Bed/ Trench Edges - 30 Topsoil ❑ Yes E] No ❑ Yes E] No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: RIC OND.25.30.18W, SW, SW 130TH AVEN W n(~it~QL. e, b?, Cf 1<t Lc v)~Q R.,? 9 C2 ;fi _c ' V Plan revision required? s [:1 No Use other side for additional information. Tt I I SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: e SANITARY PERMIT APPLICATION BureaSafetyu o oand ff Building Systems ding Water 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 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. S+- Cr61 / • See reverse side for instructions for completing this application State Sanitary Permit Number 0?Fy/&/ The information you provide may be used by other government agency programs ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]: State Plan LD. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION Property Owner Name Property Location ft C A ld 1/4 S,4d 1/4, S ytS' T N, R C E (or) Property Ow er's Mailing Address Lot Number Block Number a?S-S-9 City, State Zip Code Phone Number Subdivision Name or CSM Number II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ City Nearest Road ❑ vll age ~ -7/1 ❑ Public 1 or 2 Family Dwelling - No. of bedrooms Town OF r roewA 1 4/ C_ III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo CA 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. INJReplacement 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 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 PJ 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./inch) ,:5 Fd Elevation a c~ jad of CV0 5" ~ Feet Qr~?d Feet VII. TANK Ca in gacit all0 5 Total # of Prefab. Site Fiber- plastic Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- steel New Existin strutted glass App. Tanks Tanks Septic Tank or Holding Tank QC in ,-te4kj P, c;evrJ ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite s age system shown on the attached plans. Plumber's Name: (Print) Plumber's Signat o Stam s) MP PRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): 6 r IX. COUNTY / DEPARTMENT USE ONLY X I ❑ Disapproved Sanitary Permit Fee (Includes Groundwater FDate Issue Ulssuing Signature (No Stamps) Surcharge fee) Approved ❑ Owner Given Initial Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6398 (R. 05/94) DISTRIBUTION: Original to Courdy, One copy To: Safety & Buildings Div.,Ion, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe 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, 608-266-3815- 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 81/2 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. 3cad.~ /"~YD' U ~aav v~ h $9!^e rck-a s 3 ~PG C/ yV 4 ~c~`t~t C~S Off/ Y' j-``®- F Wiscqnsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 La~,or and Human Relations Division of Safety 8 Buildings in accord with ILHR 83.05, Wi-S. , Cw-.G4de'.,. • COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size, Plan t'nust include, but St. Croix not limited to vertical and horiiontal reference point (BM), direction and ° Pope, s ale or QPICEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 1 026-1073-001 3r ! _ZVIEWED BY DATE APPLICANT INFORMATION-PLEASE PRINT ALL INFORMA 191 Y PROPERTY OWNER: 66 PROPERT t10 ATIbN ° OVT. LOT 1/4 "'**}A,S T 30 N,R 18Mor) W Jrr Mortel PROPERTY OWNER':S MAILING ADDRESS x eL K# ,StiBD' AME OR CSM # CITY, STATE ZIP CODE PHONE NUMBER ❑ IL OWN NEAREST ROAD Emerald, WI. 54012 (715) 265-7384 Richmond 130th. Ave. [ ] New Construction Use [x] Residential / Number of bedrooms 4 ( ] Addition to existing building ( Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate • 4 bed, gpd/ft2 •5 trench, gpd/ft2 Absorption area required 1500 bed, ft2 1200 trench, ft2 Maximum design loading rate • 4 bed, gpd/ft2 .5 trench, gpd/ft2 Recommended infiltration surface elevation(s) 95.80 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material pitted glacial drift Flood plain elevation, if applicable na It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U=Unsuitable fors stem ®S ❑U FA S ❑U ®S ❑U [as ❑U ❑S iaU ❑S OU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tfench '....1....'_ 1 0- 10 r3 3 non 2msbk mfr cs 2f .5 .6 2 19-24 10 r4/4 none sicl lcsbk mfr if .2 .3 Ground 3 4-80 7.5 r4/4 none sl lcsbk mfr na na .4 .5 e~ev. 98 • ft. Depth to limiting factor +80" Remarks: Boring # -9 10 r3/3 none 1 2msbk mfr cs 2f .5 .6 ' 2 ' 2 -30 10 r4 4 none sicl 2msbk mfi CIW if .2 .3 Ground 3 30-70 7.5 r4 4 none sl 2m f -,g-w- if 1 .5 .6 elev. 4 0-80 7.5 r4 4 none sl lcsbk mfr na na .4 .5 99.3 ft. Depth to limiting fa,g,, Remarks: CST Name:--Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 200th. v . New Richmond WI 54017 Signature: Date: 9-19-96 CST Number: m02298 -7 1/ PROPERTY OWNER Jerry Mortel SOIL UtSGMII' I WN ntrun rayo 2 u.= PARCEL I.D. # 026-1073-001 De p Dominant Color Mottles Structure GPD/ft Boring # Horizon P Texture Bw-xdk3y Roots in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trends 1.6 1 0-15 10 r3 3 n 1 2msbk mfr 2f .5 rIlii3. sicl lfsbk mfi gw if .2 .3 c:n2 15-36 10yr4/4 none Ground 3 36-80 7.5 r4/6 none lfs osg mvfr na na .5 .6 elev. 99.0 ft. Depth to limiting Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor 11 1 Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) STEEL'S SOIL SERVICE Gary L. Steel Jerry Mortel 1554 200th Ave. CSTM2298 WIWI S25-T30N-R18W New Richmond, WI 54017 MPPRSW 3254 town of Richmond (715) 246-6200 N 1"=40' BM.= top of well casing C el. 100' kG~ ~`)j(I Q, A T ,,)r 1 tip ~ C pry ~a~ ~ 1070 i Gary L. Steel 9-19-96 STC-1.05 SEPTIC TANK MAIN'T'ENANCE AGREEMENT St. Croix County OWNER/BUYER VVl 60_,E_~L' MAHJNG ADDRESS ZS~ 6bjkr9&1, CD Z PROPERTY ADDRESS I I D l?~ ~ . IU Q D OCR MInWr 51100 j ~~(location of septic system) Please obtain from the Planning Dept. CITY/STATE KL~W (4-hlK 0 -O. W -7 PROPERTY LOCATION 1/4, SW 1/4, Section , T_ao _N-R_L_W 7) 1 TOWN OF "(11 fn QL4 , ST. CROIX COUNTY, WI SUBDIVISION '(j P<- LOT NUMBER _ CERTIFIEDSURVEY MAP VOLUME , PAGE , 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 113 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, m 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 ye expiration date. SIGNED,, DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WT 54016 11/93 Z0 39Vd dd9f L9 86:TT 966T/LZ/60 S 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. ~A Owner of property ~ ' C~ Location of property /41/4, Section T 30 N-RW Township 1n~K Mailing address 2-S~3 Address of site~y 21L±Kkk1 SZ_ Subdivision name U r- Lot no. /)►'4" Other homes on property? Yes X No Previous owner of property onek Total size of property V(U ) Mf , Total size of parcel '40 Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed, for (spec house)? Yes __LNo Volume 0 and Page Number gZqel as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description 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 office of the County Register of Deeds as Document No. I''IS- e , 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. -.2 4r j nature of Applica Co-Applicant o?-7 Date of Signature Date of Signature E0 39t+d der L9 86:TT 966T/LZI60 iA CiC A.MiNT NO. STATE BAP OF ♦Y C:it 0NS*N I'URV 11 THIS 5°?, c RE .ii': w~« FOR R~~OPJ•N, DA LAN - CONT;iACT ''•'i 1,°fs 1-• ~1 Ind i i! , a C- yr ' Ay ITo 11F. FO? A IA. T,iY_ 4 TION' NVII~i F Oi8.4: ■p~ ~t~ r - $2-, -00 1~ FINANr EP AND IN o?i'ER NON-:UN,. tiM^'R >W -a a Ac'T 'rR:iNjq^TiC,Ntil P Y i by a^1 bete. Thy Fzu t-,1 L1c din k f 4 1 an_n-~-fir tilm~ntalir.y of the United States, - - -"~erdvr", OI 8:30 A w` o:l~ or al re) ar-1 Jerom< A, Mczr t r 1 and D, J 1~rte >a-s ~1~~ . an 1 jA i f Q _-,b0ld ,J:1l3 a5 j sll? P-,vorshijD marital- pr"UpE - "iPurc`~ wl;ether one or morel. A sx y N V , als anal ao eBs to convey to Purchaser, upon the prompt and full per- of this co: trzict by PUrCha>er, the following property, together with the t " , . r7`ttS, f laces and o*,hrr appurtenant int.^ ssLy (Ml ca;!ed the "Propec:y„) St. Cruix :scon3i.'! tf,. _ CA:1~lty' State of W l A-ruRN TO Quarter (SWi4), Section 25, New Lo,,,n #49-5a92-•r7 To,, !c!` tp 30 North, Ranga 18 West . Tax Parcel No. F ?iST144ER'~ OFFICT S'f. ckoix Co., tit! RaC d for R.-Cord OCT 0 9 1589 l00 A. M R;ny;s'+ of Ceode Tl.is ~i/sA not homestead property. ~V7~ (13 no.) Purchaser a Tees to urchase t:,e Prope-t; and to p y to vendor at Hwy 35 i orth, River Falls, WI Vh R(' -I of S......... in ti:e f:,!t ulnd n,. :r.er: (a~ $ 40-,000.00 at the execution of this Contract.; and (b) the ba'nr e<• of $ 135,000.00 t,_,'cer w'th ir.t IC,t fr i date hereof on the balance outstanding front tine tv t;n;e at ti;, rate of 9. 75-*- per cent ner a•:nun: u ail p<,id in full, as fO'"Ows: in monthly icistallments of $1,203.04 comr ncing 06/01/88 and continuing on the 1st day of each month th•renfter. P%rnen a Shill be secured by a d-tiry assignment. * Interest shall begin to accrue at date of closing and int.e'* -st Only payment- shall be :node on May 1, 1988. Provided, however, the entire ou _tanl •tb t a once st:i!! be raid in full on or bef,-,re the St _ day of M _rch... - 19 .93- (the rc<«.t ;rity dot Following any default in pa.,m,~nt, inter.,,„ <ha'+ at the ra'e of 1 1.75 °o l,r ann ,.a on the Entire amount in default (which shall include, without ]nr.itat.c:~, drliryuent :nt'r!-t ac-1, upon r_:1N or maturt_, tin entire principal balance). Purc'aaser, un',ess e7cused by Vendor, agz' es to pay n;(,n`Hl t«, Ven1)r air punt. suff'cirnt to 1) «y r ronsh! ti,-i. pR''A annual taxes, special as~essrnents, fire and req~lired ins irmWt- prenr anu when d ie 1 the ,•x1,:o rccuMd V.,._°1 J, a sses to apply pavrnent_s to these obiiga., urns A cn due. S ;ch amount,s rece.--i! by the Vender for pa' n •nt of to -C assessments and insurance will be deposteil into an =8cro,i- fund or tra-tee ac-.wit, b.it sh.a:l not bear rterresr, unl-,i ott-erwise required by law. Pajmt,,rts sli4l be appli?d first tu ,ntele~t or the -!9t:ce at 'i,t rase ,pr't ar d OA,n to ,r,nrip.a Any a - ,:art may be prepzid without premmium or fee upn^ g .a.c'p-1 at time after 19 (olt) f', in=re vuay be. no prepay'r.sent of prin`ip:tl vrit.b.lut p«.•.rr n Vc;dAr-* I' In the e -!nt of any prapayine % this contract a} _li n,-,t to tr .ftc; t= in defavi!t u .'r. 1 x.rrent lcr.g 8:, Vo, unpaid b+.la,-Ace of principal, and into, --t (i-1 in .uch ca acefu >t fr,rn , .nth t , 1«:: ?`i, ! al' to AL-! a3 %Mpaid principal) is less than the arnount trot sa;d i~«deb*_ed ;r..<s z~ ,...d r.a 'e been !.ail ti e rn'r n°.•ale a-, first specified above; provided that rn t,ir pi,r_~,.ts sF.all be cnl,'inu d r, ti,e c,cr,t n dit o; a;lv pr,r.cs,1; o" in~uranCe or conde , nation, the coo lknined p: _ ;se s 1:.;ng ! , r2after ex^lo i~d h, rz fr :n.. Purc`;ias_, s,a es that Purcha=e, is -.tisf, 1 wftt' tie till a ;o•~n b;, t` ;tie c . L-,s" c -ub to i' ,f !';.<tr fr,; zx.r.n-in?i3r =_ept: none 4WE prG.-40 a 1,, pay v ,z3 4,a 201 t r A A a s+~. n.rr,~, 1rr.Y9 on the Property or upon Vendor's intarartl t_,afpta 3t:t~wing , z pa:,---:11_ in it ar,,'7 Lo &'Uver U Ve+,47)r on de•r•.-and h Pu ,:bA .r 81 "11 .eat the tm r.+s r7&,•> on this f rc;~crty it -=d Y n n-t to s or d-rr n° o-coari.-nea by fire, ex- tend-4 covE.?~A p '!s sn attch otheg. h-?~r,~:G. ,:s VV4Ak,r nlAy re".3 r-, r_.`,c,rt c„ ...i enc., th"'lugh insuter5 a;)Proved ,but M e s - not r (uir Coverage in an an r ;n`, more 41'S by Vend r, in the suni •o. . $ r0-00.--00 *1k than the balance owed un e.- th _ Co+ltrwte. Pur h s 11 p.y V. Al., .pren ;um.i cw, rn due. The policies shall cont:,iu the standard clan -e in favor of the VerA,), a rnirt~9., a: 1, u lt~. V.uder ath..r ism age -'s in writ;n#, the orig nag of all p) i ie-zi co if;g the Pncperty shy l b- deyasit d with V n P his rr sh~li pr ;•'ly give note of loss to insu.Rmlce comp,a.5r-A and Vend+>;. Unle: Pu°•.ls, and V_n.l-,r of aurae in writing, ina.rance proceeds slall be applied to rev'.oration or repair of the Pruperty dams ej, pr,>v +-t ti,r S =)r de-,c;s the restoration or repair to be ecor,onlically fe,..;ible. Pur,:h,= ov, ills not to coron"'It N•1`-%lV rn a'ow waste to to c,F ;sr.itzed on the Property, to keep the Property in goad to a.';}sir C[,nrlr.tioli 2,11»1 repkir, try t~* p th=: Property frie fry liens superi,r to the !ier, of this Contract, an to conlply with 201 IAW3, ordlr.arf~;a sad r a';=atlr,n„ tffe t;ng the Vendor la$re s that in ca.~ tl•.e pur°h ,e price with int i-<at arA et; n,o,:rya };+11 be fully paid ar.1 all condition, shall b fully p*rfort,re,' at the t r ;,y alai in the m tr,;, ;r ab-~ve Vri, lot aril! on de and, eaecut.e and deliver to the Purchnxer, a Warrant,, Dee•.% in f®e sicrvple, of the Property, free a Pl.rr of all lietas and encumbraincra, except any liens or encu+iebra,cea cr?;at:3~r by ih~z a:t or de',~;.lt of munfci-pa1 andzo.n_.i...n$ ~r~iiizsl4~':~., ea~enls:n.t`; for l>r.hl-i:• tit lltt.i.c•s, retcr:'r-d i,ni'crtnw rest riel-inns, and a well a :rt ernent in favor of Paul ancr Su s:rn Err b - • - _ _ . _ . Flpuse Other _mx ld_i.ns - S1(,OGQ.-0~ Purchaser agrees that tinge is of the c~sence and (a) in tL e of s. default in the pa'n-nt of any principal or interest which continues for a period of 1-.._.. days following the rp_ 'o-d due date or (b) in the event of a default in perfor:na,w.e of any other oblig;,tion of i'u.cbeser which continv<, G..•r a Lericd of .3n...... days following written notice thereof by Vendor (delivered per:;unally or nailed by certified t . ".-.e entire outstanding balance under this contr.e,:t shall become immediately due and Fvysble in full, at Vendor's opt-n% A:ti:uat notice (titbich Purchaser hereby waivos), and Vendor shall also have th following rights and ren)edX- l o4•jecY to any limitation; provided by lacy) in addition to those provided by law or in equity: (i) Ven=!or may, at hi:, terrninate this Con'ract and Purchaser's rights, title and interest in the Property and recorer the Property back ti,roAgh strict foreclosure with any equity of redemption to be conditioned upon Purchaser's full payment of tcc rnLtt c. rtsanding bal::ree, vvith interest th-reon from the date of default at the rat,: in effect on such deicer,.dotheramouoTs•aazTwreonder (in v,!,i,2he%cntnil amountspreviously paid by Purchaser shall be foife ed as liquidated damages for ftilure t+n fulfill this Contr-:A and as rental for the Property if purchaser fails to red<•n,); or (ii) Ven•.lor may- sue f r spexair performance of this Contract to compel immediat rind full payment of the entire out-standing balance, with inter _-2 thereon at the rate in effect on the date of default and other amounts due hereunder, in NO,.ich event the Prolwrty s}.alt to auctioned at judicial sale and Purchaser shall be liable for any deficiency; or (iii) Vendor may sue at lax for V, ect:re unpaid purchase price or any portion thereof; or (iv) Vendor may declare this Contract at an end an•l this Contractasacloud on title in a quiet-title action, if the equitable interest of Purchaser is in-gnificant; and (vi ~e-.•rr may have Purchaser ejected from possession of the Property and have a receiver appoint;! to col'<•ct any rent., a or profits during the pendency of any action under (i), (ii) or (iv) above.Notwith*tanding any oral or writt--r. s!a"rm<mts or actions of Vendor, an election of any of the foregoing remedies shall only be binloig up,,n Vendor if and pursued in lltiyation aril all costs and expanses including reasonable attorneys fee of Vcndor incurred to enforce a rem -ay hereunder (whether abated or not) to t: e extent not prohibited by law and expense: of title cvidenc_ sl;ell %e a•'_'-,i to principal. and paid by Purchaser, as in- curred, and shall he included in any judk.ncnt. Upon the commencement or during th p.nd?uCv of any a:-t,,n of foreclosure of this Contract, Pu-chaser consent; to the appeint_ment of a receiver of the Pr ty including } r ~,•r3ti `r-,merest, to coil ct the rents issues, ar.d profits of the Property during the pendenc of such and such rents- e~ . an,i profit, when so colle tM' shall be held and applied a, the court shall direct. Purchaser shall not transfer, sell Or convey any lei:tl or ey taf`ce interest in the Pr perty (by assignment of any of Purchaser's rights under this C,:,tract or by ola cn, long ternl Iea-e r•r in any other war) without the prior written consent of Vendor unless either th, utstar-ui„g balance payable ur J,:- :'•-is Contract is first paid in full or the interest conveyed is a pledge or assignment of Purchaser's interest un-ler thi- Cis .tract soley as security for an indebtedness of Purchaser. In the event of acy such transfer, sale or cnrcvey aece end.-r's u ritten consent, the entire outstanding balance payable under this Contract shall become inmlydiatelyd.;e and in full, at Ven ,r's option without notice. Vendor shall make all pa_rments viler d,;r under ant mort~.age nrastanding again:t the Pruperty- on the date of this Contract (except for any niortg;ag gra:.".ed by Purchaser) or -be a^ note sec.rrc•,i thpreby, prov;,.led Purchaser makes timely pay_Ment of the am ,ants then l ndt.r tl.i~ Cc.ntra,•r Pc:-c- er may- una' e any such payments directly to the Mortgagee if Vendor fails to do so ar ail ra:n,ent~ so made tr F^~rc*a<>__ shall he ccrside--ed payments made on this Contract Vendor may waive any default without waiving any other su~,-ei.,,nt or prior de°aul.t of Purcha-;;cr. All terms of this Contract sba!l t-e binding upon artgl inure to tl%e benefits of the heirs, legal representatives, succes,;ors and assigns of Vendor and Purrhas,r. (If not an owner c,! the Prope:-ty the 3r,ouse of Vendor for a valuable consideration joins herein to release home`ead rights in the s-ub,e t Property and agrees to join in the execution of the deed to be ma,'e in fulfillment he; e f.l Dated this 14th day, or pjd? Cil 19 88 FFI)FRAL LAND BANS OF ST. PAtl, n/k/a Farm Credit Bank of St. Paul e Q^z;.~ (SF:Ai.) ~ (SEAL) ny _ere) e A. Mortel Jr hnertz (SEAT.) +a r'.~~ (SEAL) Regional Vice President Attest Dianne J. Mortel AUTHENTICATION ACKNOWLEDGMENT Set „refs) of Jerome A. Mjrt.el _ _TaTF OF V-ISCOti iS 1 ~ nT ill n. J M;irtnl ( ss. . :LO1k _ _ _ County. .29:h day of a ,,.,•,1. 14th., MaCc nl t _ la 1. F e a.l_ nn t - 19 f this _ 89 the above nan,td Z ~ 3ercy Lehr, rtzr Regional Vice Pry ,idenE" L~-.o A. Beskar TITLE: NI FM 1 :R STATK BAR !iF «I -z' t;':silt IIf not _ a ;'t r iscd ~ U•].G.;, R its) _ a- r . t,~ t.. Phu eXycu+ i tt z - - _ r 'yi ~tJ PA;f ` r, AM-7-MAN To Lkw- This Land Contract dated March 14, 19r8 and recon'Oc Mr,rch 16, 198 x~3 at the office of the Register of Deers of St. Croix County, wilco sin, as Document `dumu :r 435988, in vol. 805 of records on Pa des 270--214, is to be rerecorded because when the document was recd dea M.-ch 16, 1488 the Land Contract was not not dated and did not have a slynatury on behalf of Federal Land Sank of St. Paul now known as Farm Credit Rank of St. Paul. Q x j I { a~ ''9