HomeMy WebLinkAbout006-1069-60-000 V
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER James Dittman
ADDRESS 2043 Hwy. 64
New Richmond, WI 54017
SUBDIVISION / CSM# N/A LOT # N/A
SECTION 31 T 31 N-R 16 W, Town of Cylon
ST. CROIX COUNTY WISCONSIN
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SHOW EVERYTHING WITH I 100 FEET OF SYSTEM
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Yom' V J { A J
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INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
Y l
BENCHMARK:
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Liquid Capacity:
Setback from: Well House Other
Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:
i
Alarm Location
SOIL ABSORPTION SYSTEM
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 Bottom of system
Existing Grade Final grade
DATE OF INSTALLATION: 1178194
PLUMBER ON JOB: Byron R. Bird
LICENSE NUMBER: 1309
INSPECTOR:
3/93:jt
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
Labor and Humar'Relations INSPECTION REPORT ST . CROIX
Safety and Buildings Division
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
`
Pbrs$ IQ d R Narrt~ __ES ❑ City ❑ Village i Town of: State Plan o.:
1T,I'MA1V F JAM I r1%71 ^n I
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
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Z A9400402
TANK INFORMATION I ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic
~U Benchmark 33 /00-
Dosing
Aeration Bldg. Sewer g 6-
Holding St / Ht Inlet /0-7/ '90, id'-TANK SETBACK INFORMATION St/ Ht Outlet 0.9 y 90,39
Vent
ir Ito ntake ROAD Dt Inlet
TANK TO P / L WELL BLDG. A
Air
i
Septic I 5 Jf I J S ' NA Dt Bottom
Dosing NA Header / Man. a,-7 7 $ 3, 5
Aeration NA Dist. Pipe /a $ gg
Holding Bot. System 3, 7S g g
PUMP / SIPHON INFORMATION Final Grade q,7 5 q/, 5 9
Manufacturer Demand
Model Number GPM
TDH Lift Lriction System TDH Ft
Forcemain Length Dia. H Dist. To Well
SOIL ABSORPTION SYSTEM
BED /TRENCH Width I Length No. O renches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS .V DIMENSIONS
SYSTEM/50 p P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK _
INFORMATION Type O CHAMBER r / / ~ ~ ~Jr Model Number:
System: C W OR UNIT
DISTRIBUTION SYSTEM n<~
Header / Manifold Distribution Pipe(s)// x Hole Size x Hole Spacing Vent To Air Intake
Length Dia. Length 27 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 ❑ Yes ❑ No
COMMENTS- (Inclu a code Zscrepancies, persons present, etc.)
sue Zt--
-arG WCZ - , 1.:,..
LOC~N: Cylon.31.31.16W, ~Z, Cghway 64
9
r /a ;Z J 7
2
Plan revision required? ❑ Yes ❑ No ,
Use other side for additional info (c° E'
rmation.
SBD-6710 (R 05/91) Date Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
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SANITARY PERMIT APPLICATION
V'~L~■7~R In accord with ILHR 83.05, Wis. Adm. Code COUNTY
• St. Croix
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than 0) C! 0 f d~
8% x 11 inches in size. ❑ Check if revision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER PROPERTY LOCATION
James Dittman NW 14 NW y4, S 31 T 31 N, R 16 E (or)
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK N/A
2043 Hwy. 64 N/A
CITY, STATE JZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
New Richmond W 54017 715 4615197 N/A
II. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD
❑ State Owned 0 VILLAGE : Cylon 5t. Hwy. 64
❑ Public ®1 or 2 Fam. Dwelling- # of bedrooms 4 PARCEL TAX NUMBERO
III. BUILDING USE: (If building type is public, check all that apply) oO~Q ~O~ 1 - D ' WO
1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
40 Church/School 8 ❑ Mobile Home Park 120 Service Station/Car Wash
50 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 ❑ 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
600 857 864 7 87.55 Feet 91.3 Feet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Holdin Tank 12001 1 L f ~LWtt-[IR F1 F] F] I [I F-1
Lift Pump Tank/Si hon Chamber t'
VIII. RESPONSIBILITY STATEMENT
1, the undersigned, assume responsibility for installation of the onsite sewag ystem shown on the attached plans.
Plumber's Name (Print): Plum 's Signature: (No S mpo MP/MPRSW No.: Business Phone Number:
Byron R. Bird 1309 715 6878317
Plumber's Address (Street, City, State, Zip Code):
1359 100 St. Amery, WI 54001
IX. UNTY/DEPARTMENT USE ONLY
X❑ Disapproved Sanitary Permit Fee (Includes Groundwater a e Issued issuing A m Sign mps)
1ko Surcharge Fee) l O
Approved F-1 Owner Given Initial
Adverse Determination t%nt
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROYAL:C~~y
SBD-6398(R.08/93) 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 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 & Buildings Division, 6018-266-3815.
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 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% 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, ground-
water contamination investigations and establishment of standards.
SBD-6398 (R.11/88)
November 1, 1994
IV
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Cn r l/~ JAMES DITTMAN
2043 Hwy. 64
New Richmond, WI 54017
NW4, NW4, S 31, T 31, R 16 W
Township of Cylon St. Croix County WI
4 Bedroom Replacement System
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Wisconsin Department of Industry, . SOIL AND SITE EVALUATION REPORT Page of c3
Labor and Humen 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 i ches in size. Plan must include, but S7`
not limited to vertical and horizontal reference point ~49ticlnj, % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and dist r
APPLICANT INFORMATION-PLEASE P AL~,jNF R M A T REVIEWED BY DATE
Tba
PROPERTY OWNER: R PERTY LOCATION
010 . LOT Nal 1/4 Atw 1/4,S,31 T 3 % AR AG E (or)(0
PROPE OWNER':S MAILING ADD ESS ~r # BLOCK # SUED. NAME OR CSM #
a?l1 _
CITY, STATE' ZIP C E ~`B JN NUMB a, CITY ❑V GG g]fOWN NESARES ROADG y
[ ] New Construction Use [.1 Residential / Num a A [ ] Addition to existing building
(o(] Replacement [ ] Public or commercial describe
Code derived daily flow ,00 gpd _ Recommended design loading rate r 7 bed, gpd/ft2 trench, gpd/ft2
Absorption area required$$7 bed, ft2 75U trench, ft2 Maximum design loading rate . 7 bed, gpd/ft2 trench, gpd/ft2
Recommended infiltration surface elevation(s) 1 s`a ft (as referred to site plan benchmark)
Additional design / site consid rations
Parent material I Flood plain elevation, if applicable ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable for stem ® S El U ®S ❑ U ®S ❑ U ❑ S FU ❑ S eU ❑ S ® U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Structure GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Bartdary Roots Bed Tmrtch
jo Y1.211
q /W YAP 'YIS
Ground 3 y //0 Y/y
elev.
9~ Y6 ft.
Depth to
limiting
f>7•z
Remarks:
Boring #
1 Q T /o!'~ sa /y► Z jests i~~ ,
h2 ~ ~
+ iyrZ cis _ >
Ground
elev y 96 sYR y/~ S . i - 8
3 ft.
Depth to
limiting
factor,
7 ,
Remarks:
CST Name: Ple Print , Phone: 7
Address: 3 7 Z J11)(0 b( s'7' Am-,x Signature: Date: CST Number:
~U-.?C ~ Y aye 4
PROPERTY OWNER SOIL DESCRIPTION REPORT Page 2 of 3
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
h]itti.:v%}r.
Ground 3 O. SG 7 3 Y~ S Alz y 1
elev.
ft.
Depth to
limiting
fact
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
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Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of
=i►abor and Human Relations
/'Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY
J
' Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but ~
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
PROPE! OWNER: PROPERTY LOCATION
c~.n~c~% A.kC_-r GOVT. LOT 1/4 A10 1/4,S ?f T N,R ,j E (or)~
PRO, TY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
.2o'v'~ 1.4tv C.-/ ~
'1TY, STAT ZIP CODE PHONE NUMBER []CITY ❑VI IAGE MOWN NEAREST ROAD
Ir t.
i C
` Au - -.C w~ya, 7 (ifs yL ~i i C ~c> r,
[ ] New Construction Use [Al Residential / Number of bedrooms ( ] Addition to existing building
Replacement [ ] Public or commercial describe
Code derived daily flow (_'y gpd Recommended design loading rate _ , _Lbed, gpd/ft2 ~ trench, gpd/ft2
Absorption area required FS -7 bed, ft2 ?J CT trench, ft2 Maximum design loading rate_bed, gpd/ft2 trench, gpd/ft2
Recommended infiltration surface elevation(s) S ft (as referred to site plan benchmark)
Additional design / site co siderations
Parent material O,t~ .40644( Flood plain elevation, if applicable ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U= Unsuitable fors stem ®S ❑ U ® S ❑ U PIS ❑ U ❑ S U ❑ S ®U ❑ S KU
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 Trench
l
FT-
1::..
Ground
elev. y.
J'L ft.
Depth to
limiting
factor
Remarks:
Boring #
;2 r > sy~ iii A'l ~,s - -
Ground y~ 5~/y _ Z CX , :r A4 q
elev.
0/ 1, s ft. -
Depth to
limiting
factor
7 s3"
Remarks:
CST Name: PI se Print l~ Phone:
Address: L .5 YC)c~ l
Signature: ' ~t~G . S V S~cy u~ber:
vPROPERTYOWNER 0:....~.-~ SOIL DESCRIPTION REPORT Page .2 of .3
PARCEL I.D4
Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
^ , ~ ~L o I V I `i1 I" ' • ICJ
Ground
elev.
%s S ft.
Depth to
limiting
factgL,
7
-
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft. -
Depth to
limiting
factor - -
Remarks:
Boring #
Ground
elev.
ft. -
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
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STC- 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNERIBUYER C`~ d- O
MAILING ADDRESS ';~00j TJw ~`'l U-W u~-~kd
PROPERTY ADDRESS
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE 2
PROPERTY LOCATION~I ' V R) 1/4, N k~ 1/4, Section 31 T 31 N-R W
TOWN OF ST. CROIX COUNTY, WI
SUBDMSION - LOT NUMBER
CERTIFIED SURVEY 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
ty 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.
SIGNED: C`--- -
DATE:'.
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, W1 54016 11/93
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 4"," Dwv, ~
Location of property Nlil~ 1/4 NW 1/4, Section 31 T 3( N-R 40 W
Township Mailing address
Lo -7 LA)
Address of site 0 Lp
Subdivision name IN Lot no.
Other homes on property? Yes No
Previous owner of property
Total size of property
Total size of parcel
Date parcel was created
Are all corners and lot lines identifiable? Yes No
Is this property being developed for (spec house)? Yes JL No
Volume and Page Number _60a 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. p9j05( , 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.
-zc 19Gs~
Signature of Applicant Co-Applicant
(067. 1;~,/
"?911-
Date of Sig ature Date of Signature
III
No. "S. Land Centrset-Insuranee Clause. (8TATE OF WISO NSM) Yahltehed by Ead Clatro Book & stadonerr (b•
(Sam 186.16 Wis. statutes) ♦ . Form ft U
VEWbi.5 Article of G greernent
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Made and concluded this 3 day of I Ia' ih , A. D., 1.9
by and between i. hu::',U a
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part of the firs part.
and - .(l tr)
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part of the second part it
fi itnrOjetb: First, That the said part of the second part hereby agree and bind {
legal representatives, to pay or cause to be paid, to the said part of the first part,
I heirs or assigns, the sum of _
' Dollars.
in the manner following: Dollars,
at the ensealing and delivery hereof:
III
I
_ _ III
The said payments to be made to the part of the first part, at I,
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an.-/ the same being intended to apply, when fully completed as the purchase money for the following tract, !I
piece or parcel of land, situated in the County of and State of Wisconsin, to-wit:
it
I
I it
,
The said part of the second part further agree that will pay when due and pay-
able, all taxes and assessments which have been assessed or levied on the above described premises since !I,i
'lw list %7ay of January, A. D., 19 and also all such as rimy be hereafter assessed or levied thei ern or
upCi) the interest r r d part of the first part in said prern:ses; and also all taxes and asst tis iients
w or hereafter assessed or levied against any n;ortgage which may exist against said premises or
rgair.:;+ tide rice rr the indebtedness securc:d by such mortgage or against the interest in said premises
of any party holding a c:t,rtga;;e against said pieniises during the term of this contract and prorni.rx
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and ag: ee that the interest of the part of the first part and the interest of the part of the
sec : ?,.art ri, sai,i real estate the interest of any party holding a mortgage against said real estate
the terns of this sh;dl he assessed for taxation and taxed together without :7eparate
val, io i as uniricumbared real estate aril sl.cal be paid by the said part of the second part and the
s.aird ;_+art of the second part hereby waive all rights of oiisets or deductions because of the payment
I
cf dry such taxes and assessmer.~s, until the aforesaid purchase money shall be fully paid, in the manner
J above stated.
The part of the second part further agree that the said part of the first part shall
insure and keep insured against loss or dunage the building now on said premises and such as may
hereafter be erected thereon during the life of this contract in the sum of at least I,IIII
Doll
against loss or damage by fire Dollars,
it
in the name of the part
of the first part as owner in fee, with clause in said policy that the said part = of the second part
hat, a land contract interest therein and the loss, if any, under such insurance shall be payable to the
said part of the first part to the extent of interest and the surplus, if any, to the
said part
if any, respecting such
such policy or policies des to be subject, held by the said part rights of of mortgagees, the fist part
ins
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heirs, legal representatives or assigns, as collateral to this contract; and the said part i. of the second
part shall pay the premium on such policy or policies when due, and in case of the failure or neglect of
the said part of the second part to pay such premiums when due, said part of the first part,
heirs, legal representatives or assigns may pay the same and charge the cost thereof
with interest thereon at the legal rate, to the said part - of the second part, and the same shall be
considered and taken to be an additional part of the consideration of this contract. 'I
11 The part of the second part further agree to hold the said premises from the date hereof, as l
the tenant by sufferance of the said part of the first part, subject to be removed as
ills
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tenant holding over, by process under the statute in such case made and provided, whenever
default shall be made in the payment of any of the installments of purchase money, interest, taxes,
assessments or insurance premiums as above specified; and also to keep the building , fences and
improvements on said premises in as good repair and condition as they now are, except ordinary wear and
decay, and not to do any act whatsoever which tends to depreciate the value of said premises.
Second, That the said part-. of the first part, hereby agree and bind il•,; , heirs, executors
and administrators, that in case the aforesaid sum of c.ic hund}°ed tirenty t.!,c;t Dollars,
with the interest and other moneys shall be fully paid and all the conditions herein provided shall be
fully performed at the times and in the manner above specified, tiny will on demand thereafter
cause to be executed and delivered to the said part _ic c. of the second part, or heirs
or legal representatives, a good and sufficient Warranty Deed, in fee simple, of the premises above described,
free and clear of all legal liens and incumbrances except the taxes and assessments herein agreed to be
paid by the part i of the second part, and except any liens or incumbrances created by the act or
default of the part j of the second part, th,J - heirs, legal representatives
or assigns
Third, It is distinctly agreed and understood by and between the parties hereto, that if the said
part of the second part shall fail to make any of the payments of purchase money and interest
above specified, at the times and in the manner above specified, or fail to pay the taxes and assessments,
or fail to insure and keep insured the premises herein as above stipulated, or fail to pay any or all
insurance premiums herein specified or violate any other terms or conditions herein contained, this agree-
ment shall at the option of the said part of the first part be henceforth utterly void without any
notice whatsoever, and all payments thereon forfeited, subject to be revived and renewed only by the act
of the part of the first part, of the mutual agreement of both parties; and whenever such default or
violation shall occur, the part of the second part shall have no further right to collect rents from
tenants, if any, of the said real estate, or any part thereof, but such rents shall be collected by, and helonp
to, the part of the first part.
The said part : of the second part further promise and agree that in case of the commencement
of an action to foreclose this contract and also in case of the foreclosure thereof,
will pay in addition to the taxable costs and expenses incurred a reasonable sum of money as attorney's fees.
Iin U11MC00 21 hereof, the said parties have hereunto set their hands and seals this I day
of , A. D., 19
r f
Signed e d in Pres e of //e 11 - :~~L._(Seal)
.(Seal)
_
...:(Seal)
Mate of aE!iioronoin,
County.( sx
Personally came before me, this tlk)l- day of A. D., 19
the abQvQ named
:moo me known t6 be the person who' execute t15e'foregoing instrument an# ac Howled ~d the same.
!l f
Notary Public, County, Wis.
U I , `\r' My Commission expires A. D., 19
%Pr~Ited bye
~~~'J,rr ~J3~.~-,, b9 .w1a. State. Provides that all lnatrn`nenta to be filed .hell have plainly printed or typewritten thereon the namen of the erwntors.
irrl'iGgl ti~L~lera and notary.)
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BOOK 48 PA~EbI)~
No. S-XL I.sai Centraet-Insurance Clause. (STATZ OF WISCONSM) Pnbllsbal by Sau Claire Boot & Stationers Ca.
(Soc. 286.16. WL Statute.) VW= Na as
llL jiz article of agreement
Made and concluded this 31. day of March , A. D., 19 72
by and between Herman A. Dittman and Mar'on A. Dittmali, husband EcUld wife
part ies of the first part,
and James L. Dittman and Carol J. Dittman, husband and wife
part ies of the second part.
ilil Unt0stj: First, That the said part ies of the second part hereby agree and bind themselve
their legal representatives, to pay or cause to be paid, to the said part ies of the first part, thejrr
heirs or assigns, the sum of One hundred twenty thousand and no/100 - - - - - - - - Dollars,
in the manner following: Three thousand and no/100 - - - - - - - - - - - - - - - Dollars,
at the ensealing and delivery hereof: and the $3000.00 down payment shall be by way of a gift
and in addition thereto, the sum of $1000.00 per year will be by way of a gift until
the total of $35,000.00 has been wady by gift. Parties of second part will by way of a
monthly milk assignment pay the sum of $5100.00 per year, which amount is the interest
at 6% on $85,000.00. That,at the end of 7 years in a addition to the annual gift of
$1000.00 and the interest on $85,000.00, there shall be a principal payment of $4000.00
per year on April 1 of each year, with the privilege to the parties of second part to
pay greater sums of principal at any time.
Taxes for 1972, to be pro-rated between the parties for months owed by each to the
date of this contract.
The said payments to be made to the part ies of the first part, at New Richmond, Wis.
and the same being intended to apply, when fully completed as the purchase money for the following tract,
piece or parcel of land, situated in the County of St. Croix and State of Wisconsin, to-wit:
SW~ of S* of Section 31 Township 31 North Range 16 West and SE, of SEJ of Section 36
Township 31 North a 17 Wost- and * of NE-41 of Section 20 Township 30 North Range
17 West. And of~ of Section 31 Township 31 North Range 16 West. And NWJ of
Section 31 Township 31 North Range 16 West, EXCEPT a parcel of land described as follows
Commencing 465 feet E of a point in center of State Highway 64 at NE corner of NW of
NW~ of Section 31 Township;31 NN, Range 16 W; thence South 465feet; thence East 165
feet; thence North 465 feet; thence West along the center of highway 64 to point
of beginning. It is agreed t,).at no timberm cut of uncut snail ber
removed witrwut permission of tine parties of the first part.
The said part ies of the second part further agree that they will pay when due and pay-
able, all taxes 15kiyessments which have been assessed or levied on the above described premises since
the 1st day of January, A. D., 19 72, and also all such as may be hereafter assessed or levied thereon or
upon the interest of said part ies of the first part in said premises; and also all taxes and assessments
now or hereafter assessed or levied against any mortgage which may exist against said premises or
against the note or the indebtedness secured by such mortgage or against the interest in said premises
of any party holding a mortgage against said premises during the term of this contract and promise
and agree that the interest of the part ies of the first part and the interest of the part es of the
second part in said real estate and the interest of any party holding a mortgage against said real estate
during the term of this contract shall be assessed for taxation and taxed together without separate
valc:ation as unencumbered real estate and shall be paid by the said part ies of the second part and the
said part ies of the second part hereby waive all rights of offsets or deductions because of the payment
of any such taxes and assessments, until the aforesaid purchase money shall be fully paid, in the manner
above stated.
The part ieS of the second part further agree that the said part ies of the first part shall
insure and keep insured against loss or damage the building now on said premises and such as may
hereafter be erected thereon during the life of this contract in the sum of at least
Flil.l insurable value Dollars,
against loss or damage by fire and extended coverage
in the name of the part
of the first part as owner in fee, with clause in said policy that the said part ies of the second part
have a land contract interest therein and the loss, if any, under such insurance shall be payable to the
said part ies of the first part to the extent of their interest and the surplus, if any, to the
said part ies of the second part, subject, however, to the rights of mortgagees, if any, res,ppecting such
insurance; such policy or policies to be held by the said part ies of the first part, themselves, their
heirs, legal representatives or assigns, as collateral to this contract; and the said part ies of 'the second
part shall pay the premium on such policy or policies when due, and in case of the failure or neglect of
the said part ies of the second part to pay such premiums when due, said part ies of the first part,
their heirs, legal representatives or assigns may pay,the same and charge the cost thereof
with interest thereon at the legal rate, to the said part ies of the second part, and the same shall be
considered and taken to be an additional part of the consideration of this contract.
The part ies of the second part further agree to hold the said premises from the date hereof, as
the tenant by sufferance of the said part ies of the first part, subject to be removed as
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