HomeMy WebLinkAbout030-1072-10-000 J
A;
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER Jo4f? ~o~ti"yt
ADDRESS
•
SUBDIVISION / CSM# LOT #
SECTION~_T_,10 N-R~W, Town of
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
a°°
5 1 I %
~b p
20
04
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
0
' I
BENCHMARK: ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer Liquid Capacity:
Setback from: Well ~J House 33 Other
Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: 12 Length y ~ Number of trenches
oZ
Distance & Direction to nearest prop. line:
Setback from: well:_ House Other
i
ozn//1~ 106.6
ELEVATIONS
Building Sewer d ST Inlet: ST outlet O
PC inlet PC bottom Pump Off
Header/Manifold Bottom of system
Existing Grade O -aJ Final grade Sg'<~
DATE OF INSTALLATION:
PLUMBER ON JOB:
LICENSE NUMBER:
INSPECTOR:
3/93:jt
LCYC IT]I 4 aarS :t o#r'tlilsWph. 26.30 - IINVAff SMAG Wenue County:
Laborr and Homan Relations INSPECTION REPORT
fafety and isuildings Division
41111111111,
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitar rmi
Permit Holder's Name: ❑ City ❑ Village ❑ Town of: State P
X
r nsp. BM Elev.: BM escripti Parcel Tax No.: -7 a 0 a0.
TANK INFORMATION ELEVATION DATA A9400118
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic S Benchmark //a
Dosing
Aeration Bldg. Sewer / o,i3
Holding St/ Ht Inlet N ivy; 3S~
TANK SETBACK INFORMATION St/Ht Outlet 3_ ~oS J.7
TANK TO P/ L WELL BLDG. AirI to ntake ROAD Dt Inlet
Air I
Septic 3 S ` yq 3 NA Dt Bottom
Dosing NA Header / Man.
Aeration NA Dist. Pipe
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand hob
Model Number GPM
TDH Lift Friction System TDH Ft
Loss Head
Forcemain Length Dia. f Dist. To Well I F
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length I No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS /3- DIMENSIONS
SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK CHAMBER
INFORMATION TypeO~i Mode Number:
System: o OR UNIT
DISTRIBUTION SYSTEM
Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length Dia. 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 ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.) ~ Ik 4,q)
LOCATION, z_-3elseph.26.30..19W, N44, NE, 140th Avenue
S
r .
p h
f"k,
a
f 7A
Plan revision required? ❑ Ye ❑ No
Use other side for additional in ormation. fJ ti ~f ~ y_df
SBD-6710 (R 05/91) Date Inspector's Signature Cert. No.
r
ADDITIONAL COMMENTS AND SKETCH i
SANITARY PERMIT NUMBER: 4
i
j
m
E
7-aLHR SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code COUNTY
~eynwKUasw,w„~w,v~ ►
swn,~rs G/►'O ~
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than x8q 9 5
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
/a 't/a, S T N, R E (o
PROPERTY OWNER'S MAILING AD ESS LOT # BLOCK #
CITY, STATE ZIP CODE w PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
V2r
0 NEAREST ROAD
II. TYPE OF BUILDING: (Check one) ❑ State Owned VILLLAGE ;
n
~5C
OF:
❑ Public g 1 or 2 Fam. Dwelling-# of bedrooms PAR GEL
Ill. BUILDING USE: (If building type is public, check all that apply)
1 ❑ Apt/Condo O o7a -~O
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
30 Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 80 Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 90 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 4.0 Reconnection of 5. El Repair of an
7N
System ystem 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
130 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
d k el ?f 17 017 Feet Feet
CAPACITY
VII. TANK Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION Manufacturer's Name Con- Steel Plastic
New istin Gallons Tanks Concrete structed glass App.
Tanks Tanks
Septic Tank or Holdin Tank
Lift Pump Tank/Si hon Chamber El F F] 0 1 L-1 F-1
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plumber's ' nature: (No Stamp) MP/MPRSW No.: Business Phone Number:
ti
Plum is Address (Street, City, State, -Zip Code): _
/1'2 ~iK D~
IX. COUNTY/DEPARTMENT USE ONLY 1000,
❑ Disapproved San'tary Permit Fee (Includes Groundwater a e Issued issuing Ag nt Signa No Sta s)
Approved ❑ Owner Given Initial 1 Surcharge Fee) /
ZX J s 2
Adverse Determination
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
a
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, 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 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 holdingtanks for this system. Check experimental approval only if tanks received
experimental product approval from DILHR.
Vlll. Responsibility statement. Installing plumber is tofill 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 tarks; 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; (Jose 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)
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER
MAILING ADDRESS /moo
PROPERTY ADDRESS S 5<0 / 7
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE
PROPERTY LOCATION 1/4, 114, Section -24 TN-R / W
TOWN OF ST. CROIX COUNTY, WI
10,
SUBDIVISION LOT NUMBER
CERTIFIEDSURVEY MRP , VOLUMElo 6 PAGE ~ _ O, LOT NUMBER
Improper use and maintenance of your septic system could result in its premature failure to handle
wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed
by licensed septic tank pumper. What you put into the system can affect the function of the septic tank
as a treatment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost
of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County
accepted this program in August of 1980, with the requirement that owners of all new systems agree to
keep their system properly maintained.
The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner
and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1)
the on-site wastewater disposal system is in proper operating condition and (2) after inspection and
pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum.
I/We, the undersigned have read the above requirements and agree to maintain the private sewage
disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR.
Certification stating that your septic has been maintained must be completed and returned to the St. Croix
County Zoning Officer within 30 days of the three year expiration date.
SIGNED:
DATE: dM
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
i
STC-100
This application form is to be completed in full
fthe owners) Of the property being: developed. a inndegned by
will only result ~n delays of the psrmit i An
ssuance y' 9uacies
development be intended for resale by owner/contr rhtould this
house), thenl~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 Ir °
v 4'/_
Location of prop ertyJ--44-/l/4 Section o?G
Township
Mailing address i
Address of site
Subdivision name
---.Lot no.
Other homes on property?
yeS----~-_No
Previous owner of property oy, `i0GC ,ffry
Total size of parcel ~`?"~5 5•~m•-,
Date parcel•was created
!'Are all corners and lot lines identifiable?
--_~Yes No
Is this property being developed for (spec house)?_Xes
_No
Volume f~and. Page Number O
of Deeds. as recorded with the Register
INCLUDE WITH THIS APPLICATION THE FOLLOWING: _
A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE
NUMBER & THE SEAL OF THE REGISTER OF DE'
certified surve EDS. In addition, a '
y, if available, would be helpful so as to
delays of the reviewing avoid
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
best of my (our) knowledge that I (We) am the
the property described in this information form tb a owner(s) of
warranty deed recorded in the office of the County Regiuster~.of
Deeds as Document No.- / a 1
own the proposed site for the sewage disposal t syI (we stem) rr I e( we)
obtained an easement, to run the above described t for
the construction of said system, and the•same hasopbeen,duly
recorded. 1V/the m office of County Register of deeds
No. as Document
g azure o applicant Co-applicant
or Signature
Date of Signature.
VOL 1061PAGE 360
D0(._.UMENT ST.kT.' H \ R OF WISCONSIN FORM 11-1982 THIS SPACE RE:.ERVED FOR RE.:OH--G UATA
LAND CONTRACT
w Ind-dna and 1 -po-W
r") 1W r SF.I' Ylrlt ;1.1, Tn%N' .A'TIONS w1WHE OVFK
• s c,,uu ~ IS i l" \::,'f'D 1ND iN W HF:It NON-('ONSI,'NIER
51.2140 r rl?ANjt( HON8i
REGISTER'S OFFICE
Donna Mae Coughlin, Mar K. ST. CROIX CO., %M
Contract, by ar,d between - ---------____---.--y_ - P^:'df,,rRecerd
Matthews, Yvonne E. Furr and James W. Simon, as tenants
in•_UITl1i10i1- ----(:;Vendor", JAN 2 4 1994
whether one or mare) and-_John M. _Coughlin- and Mary Beth '
Ar[haud, hu;~band--and wide a~ -surv_iyorship_marital ro ert • ~t A.
P-P y P~ M
- (Purchaser", whether one or more).
Vendor sells and agrees to convey to Purchaser, upon the prompt and full per- ~Z8:3
WofDwft
formance Uf this contract by Purchaser, the following property, together with the
rents, profits, fix',,,-es and ether appurtenant interests (all called the "Property"),
in -------------L,-. Crolx....... County, State of Wisconsin: RETURN To
Tax Parcel No.
That certain parcel of land or tract of real estate ]orated in the Northwest Quarter of
the Northeast =uarter (NWJ of NEI) of Section Twenty-six (2b), Township Thirty (30)
North, of Rar-ge Ninete-en (19) West, being a part of Government Lot "4", Mre fully
nescriL*,0 as follows: Peginning at a point on the North line of said Section 26, a
disf--rice of 1024.0 feet West of the Northeast craner of said Northwest Quarter of
Northeast Quarter (NWI of NE}); thence South 431 20' West, a distance of 125.4 feet;
thence North 681 04' West, a distance of 170.0 feet to the shore of Bass lake; thence
fallowing the shore Southwe5rerly around a point of land and thence Easterly to an iron
pipe stake located on said lakeshcre; thence North a distall,ce of 180.7 feet; thence
Fast a distance of 33.0 feet; thence North a distance of 128.5 feet to point of
beginning, the atx)ve parcel containing 1.65 acres, more or less.
This is_ not- . homestead property. ,
(is) (is not)
Purchaser agrees to purchase the Property and to pay to Vendor at Such place as designated
the sum of $__7_ ,.QQQ,_QQ___._-- in the following manner: (a) $-100.00
at the execution of this Contract; and (b) the balance of $71,9O - 0 . 00 , together with interest from date
hereof on the balance outstanding from time to time at the rate ot- SEE TERMS per cent per annum
until paid in full, as follows: Interest only payments at the rate of 47 per annum in the sum
of $239.67, commencing February 1, 1994, and continuing through July 1, 1994. On
July 1, 1994, the interest rate shall be adjusted to 6}% per annum, and payments in
the sum of $454.46 shall commence August 1, 1994 and continue on the 1st day of each
succeeding month,
Provided, however, the entire outstanding balance shall be paid in full on or before the-------- Ist--------- day of
Januazy------------------- XX2.002 ( the maturity date).
Following any default in payment, interest shall accrue at the rate of -6} per annum on the entire amount
in default (which shall include, without limitation, !r,ir.{-,ent 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 after-----.closing .___--___)tE9CXXXX'~®lt)
71s~![RMK~CX~l4CF[~OXDaQCBF@[Daailt]~F~himX~9effixhsffi2Lac76~~4ReItFi3kKX
In the event of any prepayment, this contract shall not be treated a= 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 sa,isfied with the tit:e as shown by the title evidence submitted to Purchaser
'or examination except: None
Purchaser a> rees 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 beentitled to take possession of the Property on----- -closing x
J...-.
LA.Nn CONTRACT-Individual and STATE. BAR OF WISI-('NSIN ,l Wis--n Lmal Blank Co. Inc.
Corporate F'OF)1 No. II - Mgt ) Mil-u- wla.
Purchaser promises to pay Shen due all taxes and as.es-nr_Lti levied on the Property -r upon Vendor's interest
'i.i it and t., deliver to Vem!or on den.ar,d receipts showing such payment.
Purchaser bhall keep the improvements on the Property in,u ed against loss or damn. occasioned by tire, ex-
tended coverage perils and such other hazards as Vendor may r,,Iu.re, without co-insurance, through insurers approved
by Vendor, in the sum of Mull-- insurable value but Verid,.r shall not require coverage in an amount more
t:.an the balance owed under this Co'tract. Purchaser shall pcy the .n:~urance premiums when due. The policies shall
contain the tandard clause in favor of the Vendor's interest ami, unless Vendor otherwise ..grees in writing, the original
of all policies covering the Property shall be deposited with Vendor. Purchaser s;:all promptly give notice of lose to
insurance companies and Vendor. Unless Purchaser and T'<uuor otherwie igree in writing, insurar.-e proceeds shall
be applied to restoration or repair of the Property darnaged, provided the Vendor deems the restori.tren or repair to be
economically feasible.
Purchaser covenants not to commit waste nor allow wa.,te to he conimitted on the Property. to keep the Propert. .~l
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 Prolerty.
Vendor agrees that in case the purchase price with interest and other moneys shall be fully paid and all conditions
shall be frilly performed at the times and in the manner above specified, Vendor will on demand, execute and deliver to
the Purchaser, a Warranty Dt„d, in fee simple, of the Property, free and clear of Al liens and encumbrances, except
any liens or encumbrances created by • the act or default of Purchaser, and except: Mun_cipal_-and zoning.-...
ordinances,-.easements- andof-- record._-
-
Purchaser agret;s that time is of the essence and (a) in the event of a default in the of an
interest which continues fora payment y principal or
period of ._9D...- 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 AM.... 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 hav- the following rights and remedies (subject to any limitations provided by law) in
addition t those provided by law or inequity: (i) Vendor uiay, at his option, terminate this Contract and Purchaser's
rights, title ant. interest in the Property and recover the Property- back through strict foreclosure with any equity of
redemption to he 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 dateand other amounts due hereunder in which event r-
paid by Purchaser shall be forefeited as liquidated damages for failure to fulfill this Contract and as rentalrfor the
Property if purchaser fails to redeem) ; or (ii) Vendor may sue 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 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.Notwithstandirg 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 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 any action of foreclosure of this Contract, Purchaser consents
to the appointment of a receiver of the Property, including ho! ,estead ir.terest, 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 Vender's written consent, the entire outstanding
balance payable under this Contract shall become immediately due and payable in full, at Vendor's option without notice.
Vendor shall make all payments wi-en 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 P,rrc aser
makes timely payment of the amounts then due under this Co ntra: t. Purchaser may make any such payments directly to
the Mortgagee if Vendor fails to do so and all na.,ments 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 he 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 of Vendor for a valuable
consideration joins herein to release homestead rights in the subject Property and agrees to join in the execution of the
deed to be made in fulfillment hereof.)
Dated this w day of _ /Ylac_
X19.
(SEAL)
Donna Mae Coughlin n M. Cough n
-tom (SEAL) i/~Y 1 4X14
--(SEAL)
M _K.. Matthews _ Mary Beth Arthaud -
.7, Ivy t ~c vL Z~ (SEAL) mm (SEAL)
Yvonne EA11FIZWENTTCATION es 'A H O W L E D G M E N T
Signature(s) STATE OF
a
s.
--------County.
authent. -ed this ......-.day of.......... 19--..-- Personally came before me this a3....-- day of
1993•-_ the above named
_
Donna...tae-- (o ZI!1_in
TITLE: MEMBER STATE EAR OF WISCONSIN
(If not, - - -
authorized b - - - - - - -
y x06.06, Wis.. tats.) to me known to be the person 5.-.---..-. who executed the
for in,,, instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY
,t.:.......,- ,
Reinstra, Van Dyk & :Needham, S.C. - C<~ r ' k
201 South Knowles -Avenue, Roic -I27
- -
New Ri-chmondr, 4II .5,4017
~7
otan Public o ~Q ty,
(Signatures may be authenticated or acknowledged. Both ~Ty ('ommi?siorv~jSy~GKWXq .t
rrr~ ;Q ~ pirateerr
%
are not necessary.) Y~
date: - -----------------19--- - )
ADDITIONAL ACKe\UUB EMIENTS ATPACHED
*Names f persons signing in ari car acid ...,ubl he q 1-1 or Printed "rilv. th. ir fyrna•are;.
LAND CONTRACT - individual and Corporate-State Hard AfaeetLFnl Form !Ut U "1982
F.,
f
VIL 1061►A~f 362
Ac'1,7vC,w7~DC~7TJ7'S
l
bTA fE OF I~. f v ti ~Q )
SS.
ral~~ CC[NTY )
Personally cane 1xefore rte thi s J ~ day of 199 1?) 0
Ole ilx-ve narr*-d Mary K. Matthews, to Re known to b -one of t s persons
whc; c•:.tcutLd the foiE<ycing in_;trur,ent and a(+r1c+w1,c3gtc1 the,s
NQTARY PU Il '.!M%z-S0 A
My Carr_; Exc,n Ali. 2$1997 I County Cc}
Comnissior, F~.=pirEs:~c~
STATE OF ~~IiaN1_2ct~ )
ss.
COUNITY )
Personally carne before roe thi 5 ~Q_day oft~--199
the alxve rz,n d Yvcrne E. Ftrrr, to me known to i)E' 0ve o t ee persons who
j ! ,xect,tec, the fereac i ng i nstnarlent and ackncuw c-dgE d the sane.
GAI
L CAULK!NS NOTARY PUBLIC -MINNESOTA
RENVILLE COUNTY 1 NOtax j Public
S-41,
• commission exp res A-9-9i f )Z l1l l U - - County,
8urrmission Pa-pires: T,►:~ trLgcL5
STATE;,, OF' C JFOR UA )
ss.
~ CO[ N-N )
Personally came l*~tore Trx this ay of rU6L u , 1994,
the above nanxxi James W. Sinlorr, to ;Z',e known to 'e me of ~e f~E-rsons who
tnr~nt ar:(' ackt~c 1E,gt the ,e.
NM
COMM. t99~602
NOTARY c'A'1~
,~pi.s - , Notes;-- lie
MAYQ,1N7 x .e County, c_ z-xe-1L.-
Carnnission
STATE OF
SS.
- YI L alt' c y -)Du ry )
Personally came 1,ofore. rle thi:;- ~tcluy of 1-1 F;199
thc? above nar+xxi ,;ohn M. Cc,ughIin anti I~asy F> th A aul, to known To
Yc- two c f the rk r~ons who executed the forego j .-g it stnck-nt i.rd
ackrcwlecigcrl `he
Notar}, Public
County,
CcnTrLissi0r1 spirt N Y-I7---
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page Of
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 m
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. 0.3 0 --/-0
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
Z-0 Ol.L ~j GOVT. LOT 114kO 1/4,S T ,p N,R E ( W
PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
o
CI , STA ZIP CODE PHONE NUMBER []CITY VILLAGE MOWN NEAREST ROAD
7/54L.2 Vg,,~4
[ ] New Construction Used]- Residential / Number of bedrooms? [ ] Addition to existing building
(}-Replacement [ ] Public or commercial describe
Code derived daily flow V_1P_W gpd Recommended design loading rate gibed, gpd/ft2 trench, gpd/ft2
Absorption area required - V~ bed, ft2 trench, ft2 Maximum design loading rate __~Z_bed, gpd/ft2 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 A 9k
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U= Unsuitable fors stem 5ZS ❑ U ❑ S U ❑ S U ❑ S U ❑ S RU ❑ S U
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
Ground
lev. 100,
,fit. -~;w low
Depth to
limiting
factor
7/a-a
1
6A~ Remarks: c~ a c~ ~T a y li
Boring #
G
-e I
`Ground...
elev. eo
Depth to
limiting
factor
Remarks:
CST Name:-Please Print / Phone: 6l~
r
Address:
Signature: ~ Date: CST Number:
40~ '1,9i~±?
PROPERTYOWNER-114 ! GE•~ ,.l~/,,, SOIL DESCRIPTION REPORT Page of
PARCEL I.D. #
Depth Dominant Color Mottles Texture Structure Consistence Ba~>dary Roots GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
Ground
elev. Y 70-1
Depth to
limiting
factor
j
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
FT
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(R.05/92)
Soil Test Plot Plan
Project Name Byron Bird Jr.
Address
-7 C 479
Lot -Subdivision Date
1/1/4 STN/R Township ~5 eo~
❑ Boring O Well PL Property Line County
* BM or VRP Assume Elevation 100 ft. ~L ~L A-- ~e- s rz!!!L H
System Elevation _ *HRP
r
(r~~.G
~O
I %N
~
✓ 4
.J~_ 1 y X
~yJ
,L
Scale 1/4" =10 Ft. When dimensions aren't stated
_ PLOT PLAN / s~oi7
PROJECT -:1 y/~/% Ci~Gc yl/~r/ ADDRESS ,zs' -5 Z14-ledf5K51e-
i c~ls~o
1/4/~/TO N/Rl W TOWN COUNTY
--!57- x/ 1/4 Tse,~f r~~
MPRS Byron Bird Jr. 3318 DATE
BEDROOM CLASS PERC~ CONVENT►ONAL_ IN-G PRESSURE
CONVENT ONAL LIFT_ MOUND_ HOLDING T lK
SEPTIC TANK SIZE o-~-o LIFT 4NK SIZE
DOSE TANK SIZE HOLDIi` TANK SIZE
ABSORPTION AREA PERC RATE BED SIZE /a2
Benchmark V.R.P. Assume Elevation 100'
Location of Benchmark
* H. R. P.
0 Borehole Q Well Scale Feet
0 Perc Hole System Eleva for
r
Vent
12"
Grade
TYPAR COVERING
2"
3 4 6' O 3'
I Sewer Rock
i 6 1.2'
f
1`u
io
V~
1i
J
V
1:5~0
1 j