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1 ~ pnsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of
it and}iuman Relations
f)ivision of Safety & Buildings in accord wit is. Adm. Code
COUNTY
Attach complete site plan on paper not less than 8 1/2 es IIg~s~ize. Plan i clude, but
not limited to vertical and horizontal reference point ( ectior(d i~Y f slop e,:a or PARCEL L . #
dimensioned, north arrow, and location and distance res p
REVIEWED BY DATE
APPLICANT INFORMATION-PLEASE PRINT INFORRATI9,,fv, `
PROPERTY WNER: C ' ~ROPERII, CATION
1/4 1/4,S T ,N,R 0 (or&
t
PROPERTY OWNER':S ILING ADDIJESS ~t3 4 LO K# SUBD. ME OR M#
CITY, ST TE ZIP CODE PHONE NUMB ❑VILLAGE ,MOWN NEA T ROAD
( )
] New Construction Use [>d Residential /Number of bedrooms [ ] Addition to existing building
[ J Replacement [ ] Public or commercial describe
_,,__trench, gpd/ft2
Code derived daily flowC~ gpd Recommended design loading rate y bed, gpd/ft20
Absorption area required Z4~f bed, ft2 ' s/ trench, ft2 Maximum design loading rate -7 bed, gpd/ft21S _trench, gpd/ft2
Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark)
Additional design / site considerations
Parent material Flood plain elevation, if applicable "'j ft
I- I
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U=Unsuitable fors stem ®S ❑U MS ❑U 1ZS OU 12 ❑U ❑S OU ❑S MU
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Botlxlary Roots GPD/ft
in. Munsell Qu. Sz. C4. Color Gr. Sz. Sh. Bed Trench
424 A- -
Ground _
elev.
O ft.
Depth to
limiting
factor
Remarks:
Boring # l
257
Ground
elev.
AL ft.
Depth to
limiting
factor
> fnl
Remarks:
CST Name:-Please Print Phone:
Address:
Signature: Date: CST Number:
PROPERTY OWNER SOIL DESCRIPTION REPORT Page
PARCEL I.D. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
24
Ground -
elev.
Jig ft.
Depth to
limiting
factor
> r~Y
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
/
0-,27 ~9
tiii: 4 •i:
A) 1,4
Ground /
elev.
Depth to
limiting
factor
Remarks:
Boring #
t>v:
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
J
131
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STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER, - e4
ADDRESS_&/ _
SUBDIVISION / CSM#
LOT #
SECTION 1:7_T `,ter N-R 2 W, Town
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
iz
'INDIC TE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK:,„
ALTERNATE BM:
SEPTIC TANK PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Liquid Capacity:
Setback from: Well--,44Z_ House -Other
Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:
Alarm Location
SOIL
ABSORPTION SYSTEM
i
Width: -Length Number of trenches
Distance & Direction to nearest prop. line:
Setback from: well: House Other
ELEVATIONS
Building Sewer ST Inlet. ST outlet
PC inlet PC bottom Pump Off
Header/Manifold g7~~ Bottom of system 9/~-l
Existing Grade Final grade
DATE OF INSTALLATION:
PLUMBER ON JOB:
LICENSE NUMBER:
INSPECTOR:
3/93:jt
s Wisc6R&&n 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
Permit Holder's Name: ❑ City ❑ Village Town of: State PIA WO.:
SPRINGSTROH, PAUL
C T BM Elev.: Insp. BM Elev.: BM Description: SOMERSET Parcel Tax No.:
--d ~Ci~ C'l f o ~ F'o a e Coy-/,7
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic if , e J~ Benchmark
Dosing
Aeration Bldg. Sewer S 95
Hold' St X Inlet
TANK SETBACK INFORMATION St /)A Outlet (o j' 95!
TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic > 3 NA Dt Bottom
Dosing NA IFIMan.
Aeration Dist. Pipe
Holding Bot. System 9-3f`
PUMP/ SIPHON INFORMATION Final Grade 9c/ ~9i
ufacturer Demand
Model Numbe GPM
TDH Lift Friction 51 E 11111
Force n Length Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Li uid Depth
DIMENSIONS ~a S DIM
SYSTEM TO P/ L BLDG WELL LAKE/STREAM anu acturer:
SETBACK
INFORMATION Type Of i12~,~ , CHA ER Moe Num er:
System: Cr,n(,1; UNIT
DISTRIBUTION SYSTEM
Header Manifold Distribution Pipe(s)/ x Hole Size x pacing Vent ToAirlnt ke
Length Dia. Length Dia. Spacing
SOIL COVER x Pressure Systems Only xx Mound Or - rade Sys s Only
11
Depth Over Depth Over xx Depth Of xx Seeded/ Sodde
Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes E] No
COMMENTS: (Include code discrepancies, persons present, etc.)-V
cS2~)G ~
LOCATION: SOMERSET-17.31.19W, SW, NF, LOT 3, RICE LAKE ROAD
Plan revision required? ❑ Yes 21N o /
Use other side for additional information. A Ir
SBD-6710 (R 05/91) Date Inspector's Signat re Cert. No.
ADDITIONAL COMMENTS AND SKETCH :
SANITARY PERMIT NUMBER:
i
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P
S
Bureau. o off Building Water Systems
safety and SANITARY PERMIT APPLICATION Building
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
q( ) 7 g$
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 I.D. Number
1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION
Prop "O ner Name Property Location
( 1/4 1/4, S T , N, R ,E~(orW
Property wner' Mailin d Jess Lot Number Block Number
L!
rt ate Zip Code Phone Number Subdivis n Name r CSM Number
( )
Neare t Road
II. TYPE F BUILDING: (check one) ❑ State Owned ❑ ctyyage
Vill
❑ Public 1 or 2 Family Dwelling - No. of bedrooms ❑
&ff Town O
111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
1 ❑ Apartment/ Condo 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 / Mote[ 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 S. ❑ 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 ❑ 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. nth) Elevation
Feet / Feet
Capacity Site VII. NTANK FORMATION in gallonTotal # of Manufacturer's Name Prefab. Con- Steel Fiber- plastic per.
New Existin Gallons Tanks concrete strutted glass App.
Tanks Tanks
Septic Tank or Holding Tank ® ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑
VIII. RESPONSIBILITY STATEMENT
I, the u dersigned, assume responsibility f 9r ins llation of he onsite sewage system shown on the attached plans.
Plumber's me' P t) Plumb sSi a tMP/MPRSW No.: Business Phone Number:
P16rrrb er's Address (S4eet, Ci , State i Cod
r 1
t
4-1
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Issued Issuing Agent Signature (No Starpps)
XApproved ❑ Owner Given Initial Surcharge Fee)
Adverse Determination `7 -5-9<
X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL:
SRD-6398 (R. 05194) DISTRIBUTION: Original to County, One copy To: Safety Ruildings Division, Owner, Plumber
j
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 8 1/2 x 11 inches must he subr itted tr.) the county. The plans must
include the following: A) plot plan, drawn to scale or with complete dimension., location of holding tank(s), septic
tank(s) or otht,r treatment tanks; building sevvers; wells-, water mains/waterserv ;e; streams and lakes; pump or siphon
tanks; disfi-~:ut~on hoxe , soil absorption systems, replacement system areas; anti the locctioi, of the building served;
B) honzo, ,al and vertical elPVal.ion reference points; C) complete specification; for pumps and (ontrols; dose volume;
elevation differences; friction less; pump performance curve; pump model and pimp monuf. ct_ rer, D) cross section
of the soil absorption system if required by the county, E:) soil test data on a 1 15 -)rm,- 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.
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ga A44 see
9;7,
Sic
PROPERTNOWNERJ2eL 2'~j SOIL DESCRIPTION REPORT Page,&9 Of'
PARCEL LD.#
Depth Dominant Color Mottles Texture Structure Consistence Bax>dary Roots GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tnch
A 14
Ground A)Z J
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
R;,
Ground
elev.
ft.
Depth to
limiting
factor
>
Remarks:
Boring #
~27 Z
.hi
Ground
elev.
,02Q ft.
Depth to
limiting
fact
Remarks:
Boring #
d~hffJ:'~n'~i
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page L. Df 3 ,
Labor and Human Relations
Division of Safety & Buildings 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 a~~2 4Z
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.. #
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY WNER: PROPERTY LOCATION
GOVT. LOT 1/4 1/4,S/,7T_?/ N,R (or)0
PROPER OWNER':S /MAILING ADD ESS LOT # BLO K # SUBD. ME OR SM #
CITY, ST TE ZIP CODE PHONE NUMBER []CITY VILLAGE 0 N NEA T ROAD
( )
WU/
New Construction Use Residential / Number of bedrooms _7 [ ] Addition to existing building
j J Replacement [ ] Public or commercial describe
Code derived daily flow _ gpd Recommended design loading rate Z_bed, gpd/ft2_,4_trench, gpd/ft2
Absorption area required Z,4~f bed, ft2 s/ trench, ft2 Maximum design loading rate yZ_bed, gpd/ft21S trench, gpolft2
Recommended infiltration surface elevation(s). ft (as referred to site plan benchmark)
Additional design / site considerations
Parent material Flood plain elevation, if applicable ,J 4 ft
S = Suitable for system CONVENTIONAL M UND IN-GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK
U=Unsuitable fors stem [9 S ❑U ~S ❑U 2S ❑U jgS ❑U OS LOU EIS 12IU
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. 25nt Color Gr. Sz. Sh. Bed Trench
Ground
elev.
,2i2_.,~2 ft.
Depth to
limiting
factor
> 9Z
Remarks:
Boring #
A
l
7' .9
Ground
elev.
2LL ft.
Depth to
limiting
factor
9l
Remarks:
CST Name:-Please Print Phone:
Address:
Signature: Date: CST Number:
.
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. . . . . . . .
:
CT QUA Fir, q COLRNED
SEC iION i7
3E RICE LAKE
T3t N, R19W
LOCATED IN THE SOUTHWEST QUARTER OF THE NORTHEAST Q
aj TOWN OF SOMERSET, ST. CROIX
o;
52299"7
° JNPLA/T£D LANr5
NORTH LINE OF THE SOUTHWEST QUARTER OF THE NORTHEANT~ QUARTER
3402 E 1330.73
530. 73 200.
300.00' 300.00
I_
0
a =
(n (o
° LOT 4 LOT 3
i 2 N /.k24f,396 0
Ilr o- Z LOT 6 LOT 5 W SQUARE FEET
s n W ?46,833 SQUARE FEET 220,892 SQUARE FEET
221, 540 SQUARE FEET 5.071 ACRES ACRES
^Q' 5.086 ACRES 5712 ACRES T O d
o m -4 Ir m (!I -4 Co w 2
(!1 0 C
a
2 N 0
I 1 `
An
-4
O f J / J
J _
N87°4941"E 493.59
4a m r NT~° SFr / 0 s Q
00,
6,9 zs
E
~Q3 W
LOT 2
N69 0 218.864 SQUARE FEET
1.024 ACRES
°Qp4o~A~ /9
1
D,
a AO. ro 'o
a ~
4 A C IWI/ +P bP a `"r~•
P
i G B6 W ♦fPU
10 16.29
\ o\ N87°49 41 E 872.13
4 ~
I ~
f~y ~ ~,9^ Oyn~ \
LO LOT
2 ~3 \ 3~i ,CSC n^ 218.254 SQUARE FEET
k O / p ~r J 5.010 ACRES
3 i
%
9j 00
BZi.43 627. 93
625 se' S87° 49' 41" W 714. 36~
- - - - - \
EAST WEST QUARTER LINE
UNPLATTfJ LANDS LOCH
CURVE DATA TABLE
C~r~:, Lo[ R.Idi~s C..ntril ord _hord '•rc ;y:nen! Ue U.~rn)s
P~ •io. L-gth '.3..arinq .crgth rarh
X50. C9' 5 ~I' Y4'°23'13"W `.68"-+ 8'W -ma
',67. (10' '6'ci 1'45 5,71),
'w 4.45 0a' x48'22'18"W 'I%1°OIl'u'W
IL"5'll 4"1H 1'. 'd 84 8. 75' o~z
24 ~....J :h l.hn' :F- x'1'00'26"N 4142....J ~c>n
I♦ -
rRE ADOWS
OF SECTION 17, TOWNSHIP 31 NORTH, RANGE 19 WEST,
Y, WISCONSIN.
SUNVRY()f'S I-nlrtrlrAr•L
t. ,.:y L.a 'enter. Pry:.tr red u. s:'nna to '_rnJ '.ul Pryor, n<reby cer[r(•y r1.ac a .ull
vnp: Ien~e •n cne pro. of r,:ns of trapcer !:6 .f ~._In Sce ..aces, and :nd<r c..e
It[!:'tedeon Lynn P. af [n. lard .leacr beJdon coca plat, I ev su -yrd,•
Lh}-.FNII 1r; r.f and +.,ay{>rd N ICE. 7.AAEn VEAUri+S; !net ucn plaat _ 1-11ly rrpr.senc fe'na[<a a a. r
r,,,,n,. ,„,a „.,:,y ^.oa ndar aes rnd the -bo--n of tn. land wr Ned, andenac cola plea
rear
I'~•ni,. ,..and a cna 3 u ...,eat eve r of ^ ` Ttheeft'2ua of _ec-. l1, Tovnanap l' 1,1ch, .any.
L9 u-at, ^To..n of Scimersec.St. Crorc County,eNracona rn; odeacrr bed as fol loos:
• ..:.,1'•. !4" ,.,n . „In. a:y I.EN , .n.fa - mmenc rnq at ce Fast 1-t., Corner of :rd,i:cr ton l7; thence elo,q th. Ease eft
1luerter fr,v, south 87 Degrees +9 n. nu ce ;all _ ,Oda Neft a dtscance of .!10-0/
f fe<t
cne vouc heaa[ Corner of sera ioutn.+eat Que _ of cna Sortn<u[ Quart.[ ens cna WJItR o^..
:,.t . lo" n 1'1{.• a•'a'lha~'1 I.65 I..,.n l~' ti G:,i NNING; thence contrnurny al--.q s-rd .e South tl7 aegre<a +9 m nutea ll auconds -It
u.r Ir:.•..r :,t, 71 le feet to the soutn..e a ter lY yhc-o`eey of Prce :aka Poed; cnence .tong se rd r+gnt-
- - Utal lt/ !'.,n. .:c ~2 - drh u[ -vay, North 11 degree. 2) -n- s 11 1! o da .Vac f .1-h- of 311.56 tee. to cne rornt
of _u..cure of a 56'.00 foot red rus c c _ n outhaea[er ly vnoe central an gle
rn s 26 deyreea U in uea 45 .e _onda Ind In,- -hord beers North 55 deyrees 39 mrn
ucea 05.5 s _old a Nea[ andme a 260. 19 fact; [hence tang the a of saA c and
u
~ crghc-ur-.ey, northa.escer lyeedracance of 162.5] (eee co eon enae c line of a -1 eo[
s n lend descrrbed •-I a deed c r orded 'lot ume 771, page 266 r offt,e of tn. St. Crora
c Peyrs o[ Deeds: cnence along s! linty, North 00d.q[eea l9 m ,aces /6
To .ouncy
ondf Meactard rftance I y.6] feet: t,:, ce nlony c nr th l+ne of and pare1, North
y 69deq race 51 mr nucea 19 ....onda 4' It a dratance of _11?S9 [eat to cna '.eat Irn. of .a rd
sortneafc Qmrcer, Vence elony .ead Irn., w]r cn 72 deq[ees 06 a11. 73 seconds '.teat s
d--- of '+0.91 feet; [hence along the north lire of nerd soucnvest quarter of cne
Norchease Quarter, torch 87 degrees 71 mrnue.s 02 ....onda Eaac a dirt once of 1:70.77 fee•,
Ci~ cnece along [ Irn. of erd Sou tn.re st Quarter of cne No rth<ee[ Quetta r, South n3
Z east s
.1 drgn- 32 mrnuc ea 09 seconds Ee at a d+scantt of '.t52.6d feet co cne point :<g rnn rrq.
Yl •~w -ontar,rnq 1.175,162 .qua re .feet Ill. B72 aCr<sl.
Q9Q
- c / _i111
O o C _lj y;, ~ ~114a C
Douglas ashler R.L.S. No. 21+5 QF w~sC - C
y r~. A I E
A "I P.O. 6aa 32u eynq
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oc°rodfTyD~ AD...i~
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T a, R IT 1'(JIM Br?AND 0.60117(MN
Orr,
l ON SKETCH R!CE :Axe MF4- dS in .,e -o-n of b.0.. -1. n a. 7c.,
rreby appr'.,•.e•f =y,ef S-1iaet T.- 3oe[d
4E-i4• NE 'A 'El/. I .eo[Se 5:,C1ee[ - la--'.f.0. a - -
rf s :_sc.~_rodc4•r1 `
and
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
7
OWNER/BUYER (.Yl~tl S, > Y; S~ rc~ an n Y; n s
Of
MAILING ADDRESS l3ZZ~ ZOI h ay',Q i i~'YVq}'- ~j gz
are / 3
PROPERTY ADDRESS
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE JL~y~~w S£ T
PROPERTY LOCATION Sly 1/4, EA 1/4, Section l T
_3 1 _N-R 1
'SOWN OF ~G m~rsE~ ST. CROIX COUNTY, WI
SUBDIVISION f
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 1/3 full of sludge and scum.
UWe, 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.
A
SIGNED: cL <S c
~A
DATE:
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
S T C loo
This application form is to be completed i.n full. and signed by the
owner(s) of the property being developed. Any inadequacies wi.l_l_
only result in delays of the- permit issuance. Should this
development be intended for resale by owner/coil tractor., (spec
douse), then a second 1.01-111 should be retained and completed when
the property is sold and submitted to th.i.s office w:i-th the
appropriate deed recording.
owner of--- pro c-rt: t u • -S'-S-Pr~n sf ►o - avx ~J QCcnme L_ _~7Pr' n +Vo~
F~-,
l,o -atlon of property-5V3 NE--1 '~1, -ection
1' owtlsh lp 1 4 ''T - I'1 fZ
Mail. illy `lddres!; 1
en of site
Subd 1.v t s ton name Lot-, no.
Other homes oil property? - Ycei ~ ld0
R -
I'rev l ous owncr of pt: opcrt.Y ---~~1!1Y1__ - . -
n
'f'otal s1:,-.o of pt-cl;>crt.y
'I'otal size of pl-ircel.
Date parcel was created -
Are all corner_!; and lot lines ident if i,lble? No
is this, property being developed for (~_pcc house) ----_Ir No
Volume and Page Number recorded wi th the Register
of Deeds.
INCI,11M.' WITH THIS 7\PPI,TCAT1011 THE FUL 1,0WI_NC:
A WARRANTY DEFD %,,hich includes a DOCtih11~;1,'1.' HUMBER, VOLUMF AtdD PAGE
OF M I1:D,;. In ~tdrl-i-t-iorl,
NUhll)1',1: A1,11) THE T'HE ;;l':Af_, OF 7'111?
ccrtifi.ed survey, if: available, would, be hcA_pLul So a to avoid
del,lys of the reviewing procr~>: elf: the der d de-:cr. i.ption
references to a Certified Survey M`ip, the CertiJ_icd Survey Map
shl-111 ;llso be required.
PROPERTY OWNER CERTIFICATION
I (we) certify that all statement:; on this form arc true to the
04ltle T' (S)
be;t o - my (our) knowledge that I: (J''C) 1111 (are) the of. the
virtue of a
pr oper.t}~ des<:rihed in th.1s inform~lti on --m, by v
Wcu 1 anty decd 1-<. corded in the offs-c(. of: the Count ~1eP(:,gpresently
of
Deeds as Document No. , and that I (we) own the proposed site for the s(_w1-1(j(disposal sy:,tem or. :f (we)
obtained an easement, to run the (1Y:)ove described property, for the
construction of r:-ai.d system, and the: same 11`1s bccn duly recorded in
thr! office of the County P.egistcr of. Dcedr_; tr:; Document TIo.
r 1
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I VOL 112FA,E107
DOCUMENT NO. STATE BAR OF WISCONSIN FORM I1-198S THIS a1AC9 RESERVED FOR RECORDING DATA
LAND CONTRACT
Individual and Corporab
(To BE USED FOR ALL TRANSACTIONS WHERE OVER
Q-GIU1J OFF42
529011 $25.000 IS FINANCED AND IN OTHER NON-CONSUMER ],•c~
ACT TRANSACTIONS)
Lynn R. Tow, a/k/a Lynn Redd for Par. !
_
T_.
act by and p~t~ee
ndIJE) : pow, single:::::::::::: MAY 6 1995
ney Tow, a/lc/a ~.i
-•-persona---- - ("Vendor", at . 9:15 A P~
whether one or more) and....... Psq: S__.-Sprtpyotroh_and Jeanne L
Springstroh,-.husba33d.-14dfeL,---------------•----------------------- &Uuaiii Glut
("Purchaser", whether one or more). - Regi~terof Desc'z~
Vendor sells and agrees to convey to Purchaser, upon the prompt and full per-
formance of this contract by Purchaser, the following property, together with the CD
rents, profits, futures and other appurtenant interests (all called the "Property"), -
im S-L -Cxoix--.-----.__...--.---_-.-.--- County, State of Wisconsin: RIITU. T
KL" A.,vy%~ w r s(/0/ A
Tax Parcel No.
Lot 3, Rice Lake Meadows in the Town of Somerset.
MkN
This IS nOt homestead property.
= (is not)
Purchasers e_ea to purchase the Property and to pay to Vendor at ..place Vendor directs - -
the arm of _241`.~-------------------------•.---------- in the following manner: (a) i-32
at the execution of this Contract; and (b) the balance of ;.1Q.~QQ,QQ together terest from date
hereof on the balance outstanding from time to time at the rate of--Fight-. 01eMbglf pr66jcent per annum
until paid in full, as follows: Commncing on the 9th day of June, 1995, and on the 9th day
of each and every month thereafter, equal monthly installments of principal and
interest in the amount of $200.00.
Provided, however, the entire outstanding balance shall be paid in full on or before the 90h......._•....-- day of
may 19.98--- ( the maturity date).
Following any default in payment, interest shall accrue at the rate of-10 % per annum on the entire amount
in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire
principal balance).
Purchaser, unless excused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonably antici-
pated annual taxes, special assessments, fire and required insurance premiums when due. To the extent received by Vendor,
Vendor agrees to apply payments to these obligations when due. Such amounts received by the Vendor for payment of
taxes, assessments and insurance will be deposited into an escrow fund or trustee account, but shall not bear interest
unless otherwise required by law.
Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any
amount may be prepaid without premium or fee upon principal at any time.
In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long
as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated
as unpaid principal) is less than the amount that said indebtedness would have been had the monthly payments been
made as first specified above; provided that monthly payments shall be continued in the 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 coat of future tide evidence. If title evidence is in the form of an abstract, it shall
be retained by Vendor until the full purchase price if paid.
day of closing. KW=
Purchaser shall be entitled to take possession of the Property on *Crow Out One.
LAND CONTRACT-Individual and STATE BiA9 OE *ISCOAI#IN' : Wisconsin LKa( Blank Co. Inc.
Corporate FOREst!! Ne. it-1982 Milwaukee. Wis.
~0~~122Fa~~1n~
` Purchaser promises to pay when due all tares and assessments levied on the Property or upon Vendor's interest
in it and to deliver to Vendor on demand receipts showing such payment.
` Purchaser shall keep the improvements on 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, through insurers approved
by Vendor, in the sum of $ N/.4....................... , but Vendor shall not require coverage in an amount more
than the balance owed under this Contract. Purchaser shall pay the insurance premiums when due. The policies shall
,contain the standard clause in favor of the Vendor's interest and, unless Vendor otherwise agrees in writing, the original
of all policies covering the Property shall be deposited with Vendor. Purchaser shall promptly give notice of lose to
insurance companies and Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall
be applied to restoration or repair of the Property damaged, provided the Vendor deems the restoration or repair to be
economically feasible.
Purchaser covenants not to commit waste nor allow waste to be committed on the Property. to keep the Property
in good tenantable condition and repair, to keep the Property free from liens superior to the lien of this Contract, and
to comply with all laws, ordinances and regulations affecting the Property.
Vendor agrees that in case the purchase price with interest and other moneys shall be fully paid and all conditions
shall be fully performed at the times and in the manner above specified, Vendor will on demand, execute and deliver to
the Purchaser, a Wa.-ranty Deed, in fee simple, of the Property, free and clear of all liens and encumbrances, except
Easgnents~_restrictions
any liens or encumbrances created by the act or default of Purchaser, and except:
alad_ -r-i.gklta-d-c~ay.._Qf
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 ...60... days following the specified due date or (b) in the event of a default in
performance of any other obligation of Purchaser which continues for a period of._C2O--- days following written notice
thereof by Vendor (delivered personally or mailed by certified mail), then the entire outstanding balance under this contract
shall become immediately due and payable in full, at Vendor's option and without notice (which Purchaser hereby
waives), and Vendor shall also have the following rights and remedies (subject to any limitations provided by law) in
addition to those provided by law or in equity: (i) Vendor may, at his opti=ouch strict eforeclosurer with many nequity ro!
rights, title and interest in the Property and recover the Property back B
redemption to be conditioned upon Purchaser's full payment of the entire outstanding balance, with interest thereon from
the date of default at the rate in effect on such date and other amountsdue hereunder (in which event all amounts previously
paid by Purchaser shall be forefeited as liquidated damages for failure to fulfill this Contract and as rental for the
Property if purchaser fails to redeem); or (ii) Vendor may sue for specific performance of this Contract to compel
immediate and full payment ~f the entire outstanding balance, with interest thereon at the rate in effect on the date of
default and other amounts due hereunder, in which event the Property shall be auctioned at judicial sale and Purchaser
shall be liable for any deficiency; or (iii) Vendor may sue at law for the entire unpaid purchase price or any portion
thereof; or (iv) Vendor may declare this Contract at an end and remove this Contract as a cloud on title in a quiet-title
action if the equitable interest of Purchaser is insignificant; and (v) Vendor may have Purchaser ejected from possession
of the Property and have a receiver appointed to collect any rents, issues or profits during the pendency of any action
under (i), (ii) or (iv) above. Notwithstanding any oral or written statements or actions of Vendor, an election of any
of the foregoing remedies shall only be binding upon Vendor if and when pursued in litigation and all costs and expenses
including reasonable attorneys fees of Vendor incurred to enforceany remedy hereunder (whether abated or not) to the
extent not prohibited by law and expenses of title evidence shall be aided to principal and paid by Purchaser, as in-
curred, and shall be included in any judgment.
Upon the commencement or during the pendency of any action of foreclosure of this Contract, Purchaser consents
to the appointment of a receiver of the Property, including homestead interest, to collect the rents, issues, and profits of
the Property during the pendency of such action, and such rents, issues, and profits when so collected shall be held and
applied as the court shall direct.
Purchaser shall not transfer, sell or convey any legal or equitable interest in the Property (by assignment of any
of Purchaser's rights under this Contract or by option, long-term lease or in any other way) without the prior written
consent of Vendor unless either the outstanding balance payable under this Contract is first paid in full or the interest
conveyed is a pledge or assignment of Purchaser's interest under this Contract solely as security for an indebtedness of
Purchaser. In the event of any such transfer, sale or conveyance without Vendor's written consent, the entire outstanding
balance payable under this Contract shall become immediately due and payable in full, at Vendors 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 he amounts
chaser
tract.
this Co
due
make he Mortgagyepe if Vendortfails to do oh and allupavments aonmade by rPurchaser shat be considered p3aymentsimade 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 Proper grtheesspouse in Vendor for a v of able
consideration joins herein to release homestead rights in the subject Property to join the execution
deed to be made in fulfillment hereof.)
Dated this ' day of
(SEAL)
" (SEAL)
-
Paulr ngstr
. Lynn-R. Tow=-•a/k/a-Lynn-Rodney_Tow, • .............S... Sp
a/k/a Lindley R. Tow (SEAL)
.(SEAL) C[llirtt<--
eanne L. Spri gat oh
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) Lynn R. Towz_.a/k/a Lynn Rodney STATE OP WISCONSIN
Tow, a/k/a Lindley_ R. Tow . Paul S. Springstroh, County. SS. Jeanne L. S - pry . l --.day of
of .,_..__.--Y_____.•-------119 95 Personally came before me this
authenticalteeddd tthhis d Ma
° ° 19__... the above named
Kristine Ogland
TITLE: MEMBER STATE BAR OP WISCONSIN
(If not,
authorized by $ 706.06. Wis. State.) to me known to be the person who executed the
foregoing instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY
Kistna_ Ogland
Atto a at_ Law Notary Public -•--•--••-County, Wis.
(Signatures may be authenticated or acknowledged. Both My Commission is permanent. (Ii not, state expiration
are not necessary.) date: 19--------•)
Wanes of persons signins in any cap"ity should be typed,'or pr{ t`d halow their signatures.
LAND CONTRACT - Individual and corporate - State Bar of Wisconsin. For. No. it - 1987