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5-1/1-&140
STC - 104
AS BUILT SANITARY SYSTEM REPORT ~~~77~
OWNER /Ly o/- 4 f;V Sr472VC'ifAJ~ ,4[
ADDRESS /33g C~,u.,,Ty T/~u,vK V
SUBDIVISION / CSM## /0'L /O P6 LOT #
SECTION ?S- T 30 N-R -?o W, Town of S5' Jp S -CPM
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
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PRJ EPTY
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a ct, ~mC'NTS
Soc~TN A,pJ~~~prY ~ I.Vt
INDICATE NORTH ARROW
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Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK: '0 )KE rN ~i Gnl PbsIr 49644-A/. = /CJo, c'
ALTERNATE BM: AJA
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: wiFse~f Liquid Capacity: 16-6S
Setback from: Well 36' House /y' Other AIA
Pump: Manufacturer /V4 Model# A//} Size A/A
Float seperation ill /4 Gallons/cycle: A/4
Alarm Location AAA
-;SOIL ABSORPTION SYSTEM
Width: S Length l05 ' Number of trenches
Distance & Direction to nearest prop. line: go, G'j
Setback from: well: 9,9, House Other A/a
ELEVATIONS
Building Sewer ST Inlet, 0_ Gov" ST outlet 97a _iv
PC inlet A/A PC bottom A/4 Pump Off AJA
Header/Manifold 90,20_ Bottom of system li~3
Existing Grade Final grade /3
DATE OF INSTALLATION:
PLUMBER ON JOB:
LICENSE NUMBER: /V l/epAe5 3.39
INSPECTOR:
3 / 9 3 : j t
Wisconsi.'rDepartment oflndustw PRIVATE SEWAGE SYSTEM Count
4aborafid Hx,man-Rel2tions " INSPECTION REPORT y ST. CROIX
Safety and Buildings Division
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
PeFAMrmitH LUTHERAN F-1 City E] Village C1 Town of: State Plan o.:
!Tt St - -Tnsef)h
CST BM Elev.: Insp. BM Elev.: 7f 7B:M:Diescription: H X Parcel Tax No.:
OCR
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic r. LS~S~ Benchmark //D
s
Dosing
Aeration Bldg. Sewer
Holding St / Ht Inlet y' 2&'
TANK SETBACK INFORMATION St/ Ht Outlet D,d~ 9/•0
TANKTO P/L WELL BLDG. Ventto AirIntake ROAD Dt Inlet
Septic >s a y. NA Dt Bottom
Dosing NA Header / Man.
i0. S~ o. R
Aeration NA Dist. Pipe iv.~s' go,y~
Holding Bot. System t,, v9', 04.
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand
Model Number GPM
TDH Lift Friction System TDH Ft
mead
Forcemain Length Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED /TRENCH Width '5 Length I No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS DIMENSIONS
SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK
INFORMATION TypeO CHAMBER model Number:
System: ,yy~, 30 ' (o~' 02 OR UNIT
DISTRIBUTION SYSTEM
Header /Manifold Distribution Pipe(s) 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 Systems Only
Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched
Bed /Trench Center Bed/ Trench Edges Topsoil ❑ Yes ❑ No F] Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: St. Joseph-25.30.20W, NE, SE, Lot 5, Cty Road E & 27th St.
r
Plan revision required? ❑ Yes ❑ No
Use other side for additional information. / 1961~a,,,, G
SBD-6710 (R 05/91) Date o 6r's Signature Cert. No.
SANITARY PERMIT APPLICATION
D1LHR` COUNTY
In accord with ILHR 83.05, Wis. Adm. Code ~V - ~
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than ~ ~j J,,
8% x 11 inches in size. ❑ Che~tr-evisldntSp~lousapplication
-See reverse side for instructions for completing this application. STATEN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER PROPERTY LOCATION
'/4, S T_76, N, R ao E (or W
PROPERIFY OWNER'S MAILING ADDRESS LOT # BLOCK #
CITY, STATE ZPHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
C-1 ITY
11. TYPE OF BUILDING: (Check one) El State Owned N VILLAGE : NEAREST ROAD
JQWW OF: r J cm!k,~-
L X NUMB ( )
N Public ❑ 1 or 2 Fam. Dwelling-# of bedrooms _ PA
III. BUILDING USE: (If building type is public, check all that apply) _
1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 100 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 in line A. Check line B if applicable)
A) 1. ® New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.E] Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit - 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 19 Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy
13 ❑ Seepage Pit Pressure 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) ELEVATION
4..5- - Q -00 J9,' Feet Feet
VII. TANK CAPACITY Site
in gallons Total #of Prefab. Fiber- Exper.
INFORMATION New lExisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Se tic Tank or Holdin Tank
Lift Pump Tank/Si ion Chamber
VIII. RESPONSIBILITY STATEMENT
1, the undersigned, assume responsibility for installation of the onsits sewage system shown on the attached plans.
Plumber's Name (Print): Plumber's Si ature: (No Stamps) #P/MPRSW No.: Business Phone Number:
rho v _
Plumber's Address (Street, City, State, Zip Code): 61/
O^1
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No Stamps)
VApproved El Owner Given initial ;d!T Surcharge Fee)
Adverse Determination CJ
X. CONDITIONS OF APPROVALIREA2SONS FOR DISAPPROVAL:
,cy •i'~litn,¢..:.~ a. ~~v-~r►-~ -~ruce.~ `~`L-d.v'~-c~ ~
SBD-6398 (formerly Plb-67) (R. 11/88) 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 the time :f 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 (SBO 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 & Buildings Division, 638-266-3815.
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 in 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 in ##1-7.
VII. Tank information. Fill in the capacity of every new and/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 syste=m. Check experimental approval only if tanks received
experimental product approval from DILHR.
Vlll. 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/a x 11 inches must be submitted to the county. The
plans must include the following; A) plot p,an, drawn to scale or with cornplt+e dimensions, location of
iho!aing rank(s), septic tank(s) or other treatment tarks; building sewers; wel water mains. water service;
s'reams and lakes; pump or siphon tanks; distribution boxes; soil absorption, .system:; replacement system
areas; and the location of the building served; B) horizontal and vertical elev <tion refererrce points;
C) complete specifications for pumps and controls; dose volume; elevation dMerence ; 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.
- - -
GROUNDWATE19 SURCHARGE
19P3 Wisconsin Act 410 included fhe creation of surcharcles (fees) for a nun?L^r <.?f
regulated practices which can affect groundwater.
T h,_, (..,Oocted through thcr_e surcharges are rased for (n.,,r,rtnting +rc .,Erna' ttE r, 9r~s~nJ
watt-r c,orl arnination investigations and establishment elf ,ari±~larus.
SBD-6398 (R.11/88)
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This a~ar~r¢~er, ! goes not include review ol
%u eny plUmBing upstream of the septiclhol ing
tank. See s~. pion ILHR 82.20, Wis. Ad in.
Code to ciete n-c„ine whether plan submittal nd
approval is required for that plumbing. ~
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Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page L of S
labor" Human Relations
Division of Syafety,$ Buildings in accor6witb1LF 883.0a jis~dm. C,Qde COUNTY
2 1
~Gr
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but PARCEL I.D. #
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: n-, PROPERTY LOCATION
R M tl ORL ' r Y LUTW Q,A N 1. 41ACA GOVT. LOT N JE 1/4S Lr 1/4,S7-S T 3=~ N,R 20 E (or) W
PROPERTY OWNER':S MAILING ADDRESS Lg# BLOCK # SU~. NAME OR CSM #
CITY, STATE ZIP CODE `HON, NUMBER ❑CI❑V~LLAGE OWN NEA¢J:SSTT RQAD
~-J
'[de~ New Construction Use [ J Residential / Number of bedrooms [ J Addition to existing building
Replacement [PQ Public or commercial describe
Code derived daily flow gpd Recommended design loading rate O bed, gpd/061 trench, gpolft2
Absorption area required bed, ft2 trench, ft2 Maxi um design loading rate a-7 bed, gpd/ft2 trench, gpd/ft2
Recommended infiltration surface elevation(s) +J p +C 3 6 V1 ft (as referred to site plan benchmark)
Additional design / site considerations
Parent material Flood plain elevation, if applicable It
S - Suitable for system §NVENTIONAL MO ND IN-GROUND PRESSURE A7GRADE SY TEM IN FILL HOLDING r
U- Unsuitable fors stem ® S ❑ U ffS ❑ U S❑ U S❑ U S❑ U ❑ S U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
- /0 'SL n, C~ m I S 2 .s
[3 A -7- Zf 16 3 1(0.5
Ground , 6C-S-o D A 4 - S ~ C S 7 •g
elev. r n,~r C 5 / Q,S 0.(~
9A -SA g o-! Y 4-6 S -
S rvt
Depth to 61-1/ dY 4/4- I
limiting
factor
'S
7 y :7
Remarks:
Boring # C S Z ,4 '•.4.~
13-2- fOYie 1
-71
Z IT 7-Z is 's - S O ,t' I o Z
zZ 1 4 4 5 i-E o tog
Ground
elev. - 4/-/,,;,/ p A,1
E.~l It RECEIVED
Depthto
0 C T - 1994
factor
>
Remarks:
CST Name:-Please Print Phone: 3z-6- 4 aiE~o
Address: n, x !-/uL,~►.~ i,.) i s4,n 16
Sign Date: Q^ CST Number: 3444
PROPEMOWNER SOIL DESCRIPTION REPORT Page L of 3
PARCEL LD. #1 - . , y- V. " 94- 4122 1
Depth Dominant Color Mottles Texture Structure Consistence Bound/ Roots GPD/ft
Boring # Horizon in Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench
IU-2~ 14YA 4 S Q r 4, 1 -FO.°7 0
Ground 2S-// 9 / O Yoh ~'>;G d r' 077
9I ft
Depth to
limiting
factol~
Remarks: r
Boring # -S Z T' 4
10's,
Q Cd- oy>e 3 1 L- ~
r
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13
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Ground
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Depth W
limiting
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Remarks:
Boring #
A 0-17 /W-3// sc d i . Z x'0.4 s
117-41 aye: 0 0
s r- I o. 7
141-142. 16'M Ground
elev.
C&66ft
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
It
Depth to
limiting
factor
Remarks:
SRn-R330lR.05/921
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Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page / of 3
LabLr arg Human Relabo
0iv`sion of,Aafet,y & Buildin& --44P► in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but S-1 4~ c) 1
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or [PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: ~l~ ~ PROPERTY LOCATION
7AMii_ cRCm iii LU-rW1E) AN l..~Ur2C,14 GOVT. LOT N 1/4`jLC' 1/4,SZST30 N,RZO E(or)W
PROPERTY OWNER':S MAILING ADDRESS LOL# BLOCK # SUN. NAME OR CSM #
t Eh CS M
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE OWN NEA ST f3QAD „
( ) `ST JCiSF tP~1 I , j•!
New Construction Use [ ] Residential / Number of bedrooms [ J Addition to existing building
j ] Replacement [41 Public or commercial describe C9 v ik-c 14
Code derived daily flow gpd Recommended design loading rate O,7 bed, gpd/ft26 trench, gpd/ft2
Absorption area required bed, ft2 trench, ft2 Maximum design loading rate a-.7 bed, gpd1ft2 0 trench, gpd/ft2
Recommended infiltration surface elevation(s) gW pA AC 3 [s iz ft (as referred to site plan benchmark)
Additional design / site considerations
Parent material Flood plain elevation, if applicable It
S = Suitable for system cWc VENTIONAL MO ND IN-GROUND PRESSURE AT-GRADE SY TEM IN FILL HOLDING T K
U= Unsuitable fors stem ®S ❑ U iS ❑ U S❑ U S❑ U S❑ U E3 S U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trer>ch
A 10-2 //QYyP, 3 -SL- ® rti CC rv, ` I S 2 4.
A z5 /n 3 M o.~
Ground I - S 0 .
lr -Z-q- D Y 10, 4 C S I
10-7 -
elev.
qg ft $ 76-6If nY A - 'P r
J 1" ni
Depth to aY 4 4 a 1
limiting
7 t7
Remarks: [
Boring # 10-7 j ( Cr tin ~ C 5 Z j o.4
77_ 0,_7 0
1-7- 7
ZZA 11 Ye- 4 4 rt , 1 w o -7 0% -7 1 C)
Ground
elev. AL -01 S~tC, e A
ft.
Depth to
limiting
factor
> /n..6%
Remarks:
CST Name:Please Print Phone:
46iE~o
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Address: C~~ ~C l~C~ ~rJ ~Jj
Signat Date: Q^ CST Number:Z4
PROPERTYOWNER SOIL DESCRIPTION REPORT Page Z of
PAkEL I.D. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed Trends
3 ,4 l -c 2 a
Ground r t1i 07 0
lev.
~4 •l3 ft.
Depth to
limiting
fact
~z
Remarks:
Boring #
C5-1 %Oyre3 I Sl- ^r /h ,c -F 13.4
/nY~3 9 o
gz -rZ iaY ~ 4 S Q rti,
Ground
elev
9~ ft.
Depth to
limiting
factor
~ Ia,33
Remarks:
Boring #
A 0-17 ICS P-3 I
J ` ~r i7-4t /4Y►Q~ S tvt 7O;g
16'Yt~ 4 z4- C) 9r
Ground
elev.
6 •~~ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(R.05/92)
Cou'rry -1:eUNIt 141wA-1
' $E•.KµM ~Rk • 'S~K~ i u S~aP
S414 ELEV =iDo.o6'
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s FILED
0 0 i : 5 1994 0-
JAMES O'CONNELL j2
Register of Deeds
St Croix Co., W► f
CERTIFIED SURVEY MAP
LOCATED IN THE NE4 OF THE SE4 OF SECTION 25, T30N, R20W, TOWN OF ST.
JOSEPH, ST•CROIX COUNTY, WISCONSIN.
PREPARED FOR:
FAMILY OF CHRIST LUTHERAN CHURCH
NOTE• BEARINGS ARE REFERENCED -Q ;.I r7 .O CJ > Ww
TO THE EAST L INE OF THE SE 1/4. f~ ~J CL a ~ti' ro 7
f RECORD BEARING), ate. Ca C;: t. CI N
f" X • !r 5[
Pi p
E
i
S E 1/4 CORNER OF SECTION 25.
r E-W QUARTER LINE ICOUN7YMONUMEN7FOUN0.)j
__I
. . Ems' - -
N
5~"oQ,oo -f489038 '24"E _ m 1058.82; v "M'....
_!N L89-24'52" W 626.80'_ O- m in 558.82' a i
9 9. 8 9
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4 J1~-N89°24'52"W 431.78' O-~
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° 3 ;
I33 r` of i 3.23 ACRES a o° v
13
(140,765 S0. FT.) - O -
po .N 13.04 AC. EXCLUDING R/W N V to BUILDING SETBACK 1/01 3
1 1 32, 638 S0.FT.) e e LINE ro • _
1 o Z ^ PAGE 853 I;
It/~ 100' M
_r• W to C I O
I O 8,9° 38 24" W 500.00' O I Z.
`nN89038'24"E Q:
233.0 1 ' J•
:o I. ` 200.00
•0 in i G 33.01
I I•~ c a LOT 6 ' 3333
N 19.00 ACRES +100 rn~ ,o I LLE
I I
I f 8 27, 565 SO.FT.) ro F-~
18. 13AC. EXCLUDING R/W I
' f 789,631 S0. FT.1 v ~p~ Q•
300.00
S89°53' 2 9W
"
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71 I. 43' ~1y = 33.00' I a
S89°53'2 9 W 744.43
CERT!F!S IJRVc'Y AP
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VOL. 3 P A GE 8 J3 WW
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OJAE ~~G W z o~
O SET i "X 24"IRON PIPE WEIGHING 1.13 A, Wu
LBS. PER LINEAR FOOT. O I" IRON PIPE FOUND. `
SCALE I 2 0 0 Q v
S ; NjtAl
0 100 200 400 JAMES M. WEBER S- I 04
NELSEN- WEBER LAND SURVEYING
SHEET 1 OF 2 DATED_ %d-g4
94-113 THIS INSTRUMENT DRAFTED BY JIM WEBER REV. 9 -28-94.
VOLUME 10 PAGE 2829
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P D~SC12I PT I O1`I
C A parcel of land located in the NE 1/4 of the SE 1/4 of Section 25,
T30N, R20W, Town of St.Joseph, St.Croix County, Wisconsin, more fully
described as follows:
Commencing at the E 1/4 corner of -said Section 25: Thence S0047'54"W
along the East line of the SE 1/4 a distance of 372.01' to the POINT OF
BEGINNING:
Thence continuing S0047'54"W along said line 569.53';
Thence S89053'29"W along the North line of Lot 2 of the Certified Survey
Map recorded in Volume 3 of Certified Survey Maps, Page 853 a distance
of 744.43';
Thence N33008'57"W along the northeasterly line of Lot 4 of said
Certified Survey Map a distance of 444.58';
Thence S89053'29"W along the North line of said Lot 4 a distance of
300.00' to a point on the West line of the NE 1/4 of the SE 1/4 of said
Section 25;
Thence N0054'03"E 563.17' along said line to the NW corner of said NE
1/4 of the SE 1/4;
Thence N89038'24"E along the North line of said NE 1/4 of the SE 1/4 a
distance of 1058.82';
Thence S0047'54"W along the West line of Lot I of the Certified Survey
Map recorded in Volume 3 of Certified Survey Maps, Page 853 a distance
of 372.01';
Thence N89038'24"E along the South line of said Lot 1 a distance of
233.01' to the point of beginning.
Contains 22,2'3 acres subject to highway right-of-way conveyances and any
and all additional easements, right-of-ways or conveyances of record.
NOTE: THE PARCELS SHOWN ON THIS MAP ARE SUBJECT TO STATE, OalM AND
TOWN LAWS, RULES AND REGULATIONS. (i.e. wetlands, minimum lot size,
access to parcel, etc.). BEFORE PURCHASING OR DEVELOPING ANY PARCEL,
CONTACT THE ST.CROIX COUNTY ZONING OFFICE AND THE APPROPRIATE TOWN BOARD
FOR ADVICE.
SLJRVBY0R2 ' S C:aR.T I 1= I CATB
I, James M. Weber, registered land surveyor hereby certify: That in full
compliance with the provisions of Chapter 236.34 of the Wisconsin
Statutes and the provisions of the St.Croix County Subdivision Ordinance
and under the direction of the Family of Christ Lutheran Church, owners,
I have surveyed, divided and mapped the above described parcel of land
and that this map is a correct representation of the boundary thereof.
Dated this ~^day of v~ • 1994.
Rte' ~`JOSTH~S Z Tti Dp~n ofi s
>i~lt>tt
James M. Weber S-1804 `NS ~''oWO
NELSEN-WEBER LAND SURVEYING
JAMES M. it
WEBER
S- 1804 _
'j SPRING VALLEY
~p< WIS. r ~
VOLUME 10 PAGE 2829 I'Syq~/ C)
SHEET 2 OF 2 ~ 1S i R'
94-113 This instrument drafted by Jim Weber
s Pk
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%a
Charles R. Pace Wisconsin License #89
A RIVER VALLEY ABSTRACT
& TITLE, INC.
Pace Oppraisal
206 SECOND STREET - P.O. BOX 149
Real Estate Appraisal HUDSON, WISCONSIN 54016
PHONE: (715) 386-7772
~ 1-- ROGER D. BEVERS
' 1308 Sixth Street
(715) 386-6467 ABSTRACTS • TITLE INSURANCE • CLOSINGS
Hudson, Wisconsin
r,
A
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER Family of Christ Lutheran Church
MAILING ADDRESS 905 Colonial Drive - Hudson, Wisconsin 54016
County Roads E & V 17 -7 C v u .1 }
PROPERTY ADDRESS Y
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE Houlton, Wisconsin (St Joseph's Township)
PROPERTY LOCATION DIE 1/4, SE 1/4, Section 25 , T 30 N-R 20 W
TOWN OF St. Joseph ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER
CERTIFIEDSURVEY MAP 522151 , VOLUME 10 , PAGE 2 8 2 9, LOT NUMBER 5
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: September 12, 1994
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
1 ,y 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.
Owner of property Family of Christ Luth. Ch. - MN SO District (LCMS)
Location of property NE 1/4 SE 1/4, Section 25 T 30N-R 20 W
Township St. Joseph Mailing address 1339 County Trunk V
Hudson, WI 54016
Address of site 277 County Trunk E - Hudson, WI 54016
Subdivision name Lot no. 5
Other homes on property? Yes X No
Previous owner of property LaVerne & Elizabeth Anderson
Total size of property 22.23 acres
Total size of parcel 3.23 acres
Date parcel was created October 5, 1994
Are all corners and lot lines identifiable? X Yes No
Is this property being developed for (spec house)? Yes X No
Volume 10 and Page Number 2829 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. 467808 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.
Signat e of Applicant Co-Applicant
'r- f ire
Date of Signature Date of Signature
-Y~
t)04}tlc.'ENT NO. STATE BAR OF WISCONSIN FORM 11.19132 THIS SPACE RESERVED FOR RECORDING DATA
LANP ~oNTIUCT
Indlvi w a.d Corporate
(TO BE USED FOR ALL TRANSACTIONS WHERE OVER `
{26.00019 FINANCED AND IN OTHER NON-CONSUMER
IONS
4~'~8~15 ACf TRANSACT
REGISTER'S OFFICE
VOL 89 PAVE11J ST. CROIX CO., Wi
Contract, by and between LaVerae...An:der.son....-in:1 Recd for Recoro
ELizab:_th...AndP-rs.on,....hus.ha.nd.... and....wi.f.e
("Vendor", at .
whether one or more) and The...Ainnisata...S.3:1.th ' * 45 P.
District....of.....the....L>si..n zran... --h.urc.h.- eels.
......NLiSsQ!LCi.... S.yrl0,1 ("Purchaser", whether one or more). Register of Deeds
Vendor sells and agrees to convey to Purchaser, upon the prompt and full per-
formanm of this contract by Purchaser, the following property, together with the
rents, profits, fixtures and other appurtenant interests (all called the "Property'l, C W Ma 1 i C~.t , ESQ.
in 3.t...... Litt]iX County, State of Wisconsin: RETURN TO
413 Brookwood .3r, Hud3on
See Attached
Tax Parcel No...3 0,- 2 0.3 9.- 9 5
This -is not homestead property.
(ts) (is not)
y and to pay to Vendor at Wilson,
Parch f ; U T&urchase the Propert
qes
the sum of 1..0.., U010 IIO
in t r~ol(pyy Enner. (a) i
at the execution of this Contract; rand (b) the balance of i • • together with intereat from date
hereof on the balance outstanding from time to time at the rate of per cent per annum
until paid in full, as follows: Four (4) annual installments of $10,000.00,.
Installments are due on successive anniversary dates and shall
be applied first to interest and then principal.
/with interest
Provided, however, the entire outstanding balance shall be paid in full on or before the Pi-rst-°"'•`......"•°' day of
_ ............._...._........_........AL??f. 1....,199:3..:. (the maturity date).
Following any default in payment, interest shall accrue at the rate ofa.~t.0 per annum on the entire amount
in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire
principal balance).
lOaOrtQtrantttt3Ktn wx>x~avtatdbtlactx gK$Cfd4KC0)pa ItxS811L~1axOtc~
t K X Xfftntabxses;> KbM EWN"d II cKYMIt0tM9tasraaa
:%*q VW*ff*VAW* ia1 WVNI1 rftf[ncRat~krxatliaadc~Raa~can acnioa rtmRd~ae• 1aAheal~t«~t b e d
XKxlW "i" 1ia11i~ilSrl'pli;r}id W ~4ibif~611;61ri&1615~JfiiEr1F ddfe. EPF 1( i~~F~ciEii 'Srxtlie ~e~s)ldfr}Edf
xi~K lialuiatcltic g„~xatlllanleecetttllbt! mapoMoilt tatwcoQtco4Kruec YtINt IoK ttlcd~l7tllditfttt,?4f4K iQtblf Ytrft>afli(rlQxGiilit
~It11MaPli+ltar~i~e~t44x~i~xlaxx "
Payments shall be applied first to interest on the unpaid balance at the rate specified and then to princiaI Any
amount may be prepaid without premium or fee upon principal at any time after A.p-r- -1....1••••••••••••••••- .19..... 1 (efe
x9011411410W k19j Midwit >fEWMatot wItlcdlt9j*9dli1etaaUVftd,*A
In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long
as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated
as unpaid principal) is Ise than the amount that said indebtedness would have been had the monthly payments been
made as first specified above; provided that monthly payments shall be continued in the event of credit of any proceeds
of insurance or condemnation, the condemned premises being thereafter excluded herefrom.
Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser
for examination except:
None.
Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall
be retained by Vendor until the full purchase price is paid.
Purchaser shall be entitled to take possession of the Property on...... class.ing .....................................................»,19...........
*CFO" ort Da.
4 r.. STATE. H\R oV w_.,CUNSIN
I
VOL 097 rVA 11~ ~
Purchaser promises to pay when due all taxes and aaoessmenta levied on the Property or uponJi"or'41nterest
in it and to deliver to Vendor on demand receipts showing such payment. '
Purchaser ,hall keep the improvements or the Property insured against loss or damage occasioned by fire, ex•
tended coverage perils and such other hazards as Vendor may require, without co-insurance, rough insurers approved
by Vendor, in the sum of $ ...t1... a . but Vendor shall not require coverage in an amount more
than the balance owed under this contract. Purchaser shall pay the insurance premiums when due. The policies shall
contain the standard clause in favor of the Vendor's interest and unless Vendor otherwise agrees in writing, the original
of all policies covering the Droneey shall be deposited with Vendor. Purchaser shall eromptiy give not-ice of loss to
insurance companies and Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall
be applied to restoration or repair of the Property damaged, provided the Vendor deems the restoration or repair to be
economically feasible.
Purchaser covenants not to commit waste nor allow waste to be committed on the Property, to keep the Propertyy
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 ana 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: lV..one
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...... f Q............. days following the specified due date or (b) in the event of a default in
t ormance of any other obligation of Purchaser which continme for a period of.._'.? 9............ days following written notice
thereof by Vendor (delivered personally or mailed by certified mail), then the entire outstanding balance under this contract
shall become immediately due and payable in full, at Vendors option and without notice (which Purchaser hereby
waives), and Vendor shall also have the following rights and remedies (subject to any limitations provided by law) in
addition to those provided by law or in equit ; (iYVendor may, at his option, terminate this Contract and Purchaser's
ts, title and interest in the Property and recover the Property back through strict foreclosure with any equigoof
rigghZemplion to be conditioned upon Purchaser's full payment of the entire outstanding balance, with interest thereon m
the date of default at the rate in effect on such dat- and other amounts due hereunder (In which event all amounts previously
pQaid byy Purchaser shall be forfeited as liquidated damages for failure to fulfill this Contract and as rental for the
Property if purchaser fails to redeem); or (ii) Vendor may sae 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 Plroperty shall be auctioned at judicial axle and Purchaser
shall be liable for any deficiency; or SiiiL Vendor may sue at law for the entire unpaid purchase price or any portion
thereof: or (iv) Vendor may declare this C ontract 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), (u~ or (Iv) above. Notwithstanding any oral or written statements or actions of Vendor an election of any
of the orego rig remedies shall only be binding upon Vendor if and when pursued in litigation and ail coats 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 sny action of foreclosure of this Contracts Purchaser consents
to the appointment of a receiver of the Property, including homestead interest, to collect the rents, Issues, and profits of
the Property Burin thependency of such action, end such rents, issues, and profits when so collected shall beheld and
appGedas ecou shall direct othex than to rel t~ed ph-irch :ntity
Purchaser shall not transfer sell or convey any legal or equitable interest in the~rope Vky assignment of any
of Purchaser's rights under this Glontract or by option. long-term lease or in any other way) *it' out the prior written
consent of Vendor unless either ttla outstanding ba)ancc payable under this Contras: is first paid in full or the interest
ty for an indebtedness of
conveyed is • ledge or assignment o[ Purchaser's interest under this Contract soley as securi
Purchaser. In the event of an such transfer, sale or conveyance without Vendor's written consent, the entire outstanding
balance payable under this Contract shall become immediately due and pi.yable in full, at Vendor', option without notice.
Vendor shall make all payments when due under any mortgage outstanding against the Property on the date of
this Contract (except for any mortgage granted by Purchaser) or under any note secured thereby, provided Purchaser
makes timely payment of the amounts then due under this Contract. Purchaser may make any such Dayments directly to
the Mortgagee I Vendor fails to do so and all payments so made by Purchaser shall be considered payments made on
this Contract
Vendor may waive any default without waiving any other subsequent or prior default of Purchaser.
All terms of this Contract shall be binding upon and inure to the benefits of the heirs legal representatives,
successors and assigns of Vendor and Purchaser. (If not an owner of the Property the spouse o~ Vendor for a valuable
consideration joins herein to release homestead rights in the subject Property and agrees to join in the execution of the
deeds to be made in fulfillment hereof.)
Da day of 'ei / 199
!
n the Minnesota South I)istrictof th--a
~2 e ...(..L`.,. c.X (SEAL) Luther-a issol. i....Syno4SEAL)
L•sverne Anderson
..A.......nd... e....r..s.... 13y~f President
(SEAL)
L.? L'.... ; (SEAL)
eEliiab_th Anderson And..... ~-K ............................../~,Treasurer
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) _......Q.~..... ~.}✓!-ta r AO&J <
STATE OF Vn)itii~t .iC7
.............I..! ...............:Z'~"~.................................. C
..f.k ..befo.......Onnty.
P raonally ca re me this day of
/ ..z 7~..ot . t C :fi 1.... the above named
authenticated this a of .19..1V_
..:C.............................
.
G. 1 :lira -::.i
. ~t!.~l
TITLE MEMBER TE BAR OF WISCONSIN to me known to be the person .5 who executed the
(I not,_........ ~ _ foregoing instrument and ecknowiedge the same.
.
au onsed by 17 WK Wis. State.)
THIS INSTRUMENT WAS GRAFTED BY
n \
a....W.,-Mal.i.ck...... H..ldsan.,.... W-1
a
L Lt.L c t c:.......... i L .t :....w....:..
t y
No tie Count ,
(Signatures may be authenticated or acknowledged. Both My C s n lZeAinent. (tTrltot Mate expiration
are not necessary.) A:;
n
;Names of persons signing in any capacity should be typed or printed date . ~s.,.. 5 119 )
below their signatures. y . =
11 FINN I
VOL
8~ . A17
A parcel of land located in the NE 1/4 of the SE 1/4 of Section
25. T30N. R20W. Town of St. Joseph. St. Croix County. Wisconsin
Commencing at the E 1/4 corner of said Section 25; Thence
S0047'54"W along the East line of the SE 1/4 a distance of
372.01' to the POINT OF BEGINNING:
Thence continuing S0047'54"W along said line 569.53':
Thence S89053'29"W along the North line of Lot 2 of the Certified
Survey recorded in Volume 3 of Certified Survey Maps. page 853 a
distance of 744.43';
Thence N33008'57"W along the northeasterly lire of Lot 4 of said
Certified Survey Map a distance of 444.58';
Thence S89053'29"W along the North line of said Lot 4 a distance
of 300.00' to a point on the West line of the NE 1/4 of the SE
1/4 of said Section 25;
Thence N0054'03"E along said line to the NW corner of said NE 1/4
of the SE 1/4 a distance of 563.17';
Thence N89038'24"E along the North line of Said NE 1/4 of the SE
1/4 a distance of 1058.82';
Thence S0047'54"W along the West line of Lot 1 of the Certified
Survey recorded in Volume 3 of Certified Survey Maps, page 853 a
distance of 372.01';
Thence N89038'24"E along the South line of said Lot 1 a distance
of 233.01' to the POINT OF BEGINNING.
s
M
Family of Christ Lutheran Church x . . '
in
Houlton, Wisconsin
Jon T. Haakana, Pastor
Cffice Located At:
905 Colonial Drive
Hudson, Wisconsin 54016
(715) 386-9183
1 '
LUTHERAN CH THE
URCH
MISSOURI SYNOD