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HomeMy WebLinkAbout030-1074-60-200 o 03 ~ a ~ c I 0 4 0 Y , C h w V O N m cz~ N O 'O O a LO O ) tl ~ N L ~ L GL w C 3M U s O. CL N E N c m 0) 0 co o ° c Z ° N U. c NN ~ a N I m~ Q.t cc I CD~ I Z N CO E O -O w O M Z 4) ° O d m co F- U' O O z ° v N 0 aUi Z to N N N Cl) E -2 N n 'C N N I N ~ ° L CL - • C C O co O Z H Z z N 0 ~l o d C V N E C N 0 = R CL co a w 0 I 0) N d o ° °'rcra V) U) = FL ) z > 3 3 o a Z •N a oaa 0) U1 J V U) 0) 0) rn > ~ I Q N N 0 N c ° O N O CD E 'O m a N N C7) N 'p d Q C7 t6 O h 7 w ° 3 E N S E O o ff d N a rn o E C W N 4 cl =a CF V O 1- 0) O a) N v 1 N N ~ O M O U) T ~ .Nd. N H C= O) co • O U. O co U) Q N O N 2 C:9 r2 (n V v~ d ~o € a EL L IL • c~ a m .2 m rrww m c _1 A va~',ov~iv ' a t STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER AN/J C= 2.SO Z' ADDRESS 731 A01~5- 6-6 SUBDIVISION / CSM# U LOT SECTION N-R_Lj W, Town of r s ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM N 5NE~ 3 - sx So i REUc~~s WALL / ~ I I II, I y~ i SCALE gous~ 800 C-/1t- . /9-00 C-AL . S. T, INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. t BENCHMARK: -8-67,'01-7 DF S/D/N(r ~7 F ~HEO EL. /OD, U ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: /UEE/CS Liquid Capacity: IZ60 5,7- &000, PC Setback from: Well So 7` House 2 *-Other Pump: Manufacturer ~9,E:a457 Model#Z!2_ Size Float seperation Gallons/cycle: : Z q, y Alarm Location SOIL ABSORPTION SYSTEM Width: Length SO Number of trenches _Distance-&-Direction -to-nea-r-est--prop.-I-ine -Be Setback from: well: /0 House 78' Other 3Q ` Sh/eO ELEVATIONS Building Sewer ST Inlet. ST outlet 8 5~ PC inlet__M, 9'2 PC bottom Pump Off R*3.2 Header/Manifold Bottom of system 93,5- 7 Existing Grade Final grade 9 DATE OF INSTALLATIO 9-~ Y I/ PLUMBER ON JOB: LICENSE NUMBER: 32oS INSPECTOR: 3/93:jt • Wisconsiri Department of Industry, County- Labor arCJHumanRelations PRIVATE SEWAGE SYSTEM ST. CROIX Safety and Buildings Division INSPECTION REPORT (ATTACH TO PERMIT) Sanitary Permit No-: GENERAL INFORMATION 61 P ANDERSO1+~;me.7EROME ❑ City El Village1 Town of: State Plan ID No.: CST BM Elev.: Insp. BMM~ lEElev~~:ll BM Description: Parcel Tax No.: l / ~UU . Uv~ Q TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic p S d y' Benchmark p 1 elP 60 Dosing n5 Aeration- Bldg. Sewer 1P Hol St/of Inlet 1:5-1-691 TANK SETBACK INFORMATION St/,~K Outlet /5 p ?yes TANK TO P / L WELL BLDG. Ventto Air Intake ROAD Dt Inlet ~116,071, C3 Septic >50 ,fC) NA Dt Bottom _j/ Dosing ,>756' NA Headers Aeration A Dist. Pipe ~&y~yy 9 3R Bot. System t9 3 l~' H d 1 Z,~2/___ PUMP / StF%gMNFORMATION Final Grade i aZ I Manufacturer o/ Demand 5,56 1 Model Number` g GPM r 83,391 x Friction S stem oX TDH Lift. L IY TDH Ft(,/ /2•c~b'~ Forcemain I I Length Dia. " Dist. To well SOIL ABSORPTION SYSTEM -QED/ TRENCH Width Length No. Of renches PIT, No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 5 DIMENSI SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHIN; Manufac r. SETBACK CHAMBE INFORMATION Type O Dp14 _ Model Number: LC 'rGN ;c1 T System: DISTRIBUTION SYSTEM Header /A;s=Wwe- Distribution Pipe(s x Hole Size x Hole Spacing Vent To Air Intake Length Dia Length Dia. `f Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Of xx Seeded / ed xx Mulched i Bad-fTrench Center Std rTrench Edges Topsoil es 171 No El Yes E] No COMMENTS: (Include code discrepancies, persons present, etc.)-V~/'' LOCATION: St. Joseph. 2¢ 30.19W, SE, SW, 132nd Avenue ~ co 311 Plan revision required? ❑ Yes 0,N6 gr Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. SANITARY PERMIT APPLICATION v'~~-nom In accord with ILHR 83.05, Wis. Adm. Code Cou!g-- wV) STATE SA~AR~P f OMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than (1 g 8% x 11 inches in size. ❑ Check if revision to pr wus 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&aaaoyv t/4 W14,S j~ T2Q,N,R / (Orrlg) PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # 7,2 i ~E CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER WOn SY A/ W-51396-15-Y1 0 CITY II. TYPE OF BUILDING: (Check one) F1 State Owned ❑ VILLAGE - NEAREST ROAD TOWN ❑ Public 4 1 or 2 Fam. Dwelling--~#of bedrooms ~ PARCEL TAX NUMBER(S) 111. BUILDING USE: (If building type is public, check all that apply) 43 Q~ ~ Da 70 --10,2 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 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 50 Hotel/Motel 9 ❑ Office/Factory 130 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. [K New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.E1 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 420 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 L~ r Feet Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New lExisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Se tic Tank or Holding Tank s Lift Pump Tank/Si hon Chamber ® C Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumb Signature: (No Sta M RSW No.: Business Phone Number: n. . del IA/ -7,/ s -6s' A~114Ae -1- 11 -32 um er's Address (Street, City, State, Zip Code): IX. COUNTYIDEPARTM N USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Agent Signature (N Stamps) Surcharge Fee) Approved ❑ Owner Given Initialer Adverse Determination c~ X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: 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 Ibe 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, 60B-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. Vill. 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) G - S" ~nF g9 Apolaveo AyN c Pve?2 a ~.DC s Ysrc 1 3.7 ko AuE oR~tE~t. N t 1.13 rf J" , 13o rron o F S L~ pF Vll o CL. /D4►a s ys rely Et . 93, 5 7 S OO BM 80o Gc. P•C, ~ ~ TREkc~~S ~C Z" FaRcF G/Xc a#-I.# OQA/N /~AGC QRu PRoPoseo Moore PON n ORAu~~Nc- ~o~. G ~y- 9y DRACVIA(b- 13y, CQa/~lr AJVAERSON smllo,_-_ ~ 731 /3~Ka AUE. g~~ vA~ct vit TP, Nu~aso~v tt~/' • s yo/~ s©ri~/~s Wl' syoz /f Initials Date - Prepared By s/ -t~ ek „lL U _ - - Approved By - 5 WILSON JONES COMPANY G7202 GREEN 7202 BUFF d! DF IN U.S.A. 1 2 ce- - - - - - - - - 2I- 2 4' 6 I I I I II • 7 8 I ~ 9 10 10 i I ,2 ~j N ` 14 - - _ _ - - - _ _ I ~ __-ICI I 16 ill - - - - - - - - - S !17 2r, 20 i ~ 21 + 2, 22 22 i I 23 2.. 24 I } 25 2,5 26 ~.i- - 26 J I 27 27 ~26 :28 29 V 30 30 I 31 31 012 :32 r 33 r, 33 34 7 34 35 I 36 If _ - - e 37 37 1 38 j 38 - 39 . - r - -I 39 39 40 40 j Imlmis I Date l - - PrZT lrrd By i 2 3 i 3 8 I I ' I i i I { 15 16 I ; I a I 23 24 t ~G 30 2 3? 3 33 - 33 38 3 ~ i i 39 40 ~1L - - - - _ - 1' 1._---i__ I. PUMP CHAMBER CROSS SECTION ANG SPECIFICATIOIUS PAGF (e VEtJT CAP 'i"C.I. VENT PIPE WEATHERPROOF APPROVED LOCKING N - - -T 25' FROM DOOR, JUNCTION BOX MANHOLE COVER WINDOW OR FRESH 12"MIU. AIR INTAKE I GRADE I 411 COIJDUIT-- INLET PROVIDE I AIRTIGHT SEAL IA 11 I ALARM B 1-H, i0 *APPROVED I I ON JOINTS WITH I ELEV. FT. APPROVED PIPE 3' ONTO PUMP OFF D SOLID SOIL CONCRETE BLOCK RISER EXIT PERMITTED OIJLy IF TANK MANUFACTURER HAS SIKH APPROVAL SEPTIC E SPEC.IFICATIOI~IS OOSE TANKS MANUFACTURER: tjjGe ~ IJUMBER OF DOSES: PER DAS TANK SIZE:_ GALLONS DOSE VOLUME ` ALARM MANUFACTURER: TAME ALE r INCLUDING dACKFLOW: ! 29"-. y_GALLONS MODEL AIUM6ER: CAPACITIES: AIUCHES OR 3/. GALLONS SWITCH TSPE: /"~c,PCLlQ / gc y INCHES OR 0B GALLONS PUMP MAIJUFACTURCR: - ZI E l L-12 IAICHES OR J L Y GALL01J5 MODEL DUMBER: 9B D--L~INCHES OR ILY GALLONS SWITCH TYPE: d-afC_L//1 Y NOTE: PUMP AMD ALARM ARE TO BE MINIMUM DISCHARGE RATE 3Q _GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFEKEAICE BETWEEU. PUMP OFF AND DISTRIBUTION PIPE.. 010 FEET + MINIMUM NETWORK SUPPLY PRESSURE , , . . " . . , , 2.5 FEET ♦ 1012 FEET OF FORCE FT,/ MAIN X ' / FRICTION FACTOR. sue- Ioo Fx _ , .4Z FEET TOTAL DyWAMIC, HEAD = FEET IMTERNAL DIMEIJSIOWS OF TANK: LENGTH-400. ;WIDTH 77 0 ;LIQUID DEPTH _ StGIJED: LICEAMSE DUMBER: 3203 DATE:l vvisconsin n o ^ us EVALUATION REPORT Page 1 of 3 LaboF and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY ' Att ach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. Croix 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. 030-1074-60-200 REVIEWED BY DATE APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION PROPERTY OWNER: PROPERTY LOCATION Jerome Anderson GOVT. LOT SE 1/4 SW 1/4,S 26 T 30 N,R 19 x:k(or) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUED. NAME OR CSM # 731 132 Ave. na na na CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE MOWN NEAREST ROAD Hudson, WI. 54016 (115)386-7539 St. Jose h 132 nd. Ave. (x]c New Construction Use [xJc Residential / Number of bedrooms 3 (J Addition to existing building Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 7 bed, gpd$ . 8 trench, gpd/ft2 Absorption area required 643 bed, ft2 563 trench, ft2 Maximum design loading rate • 7 bed, gpd/ft2 .8 trench, gpd/ft2 Recommended infiltration surface elevation(s) 93.57 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem t9S ❑ U )fR S ❑ U )a S ❑ U 30 S ❑ U ❑ S ®U ❑ S O 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 Trerxh 1..... 1 0-12 10 r3/3 . none 1 2msbk mfr Crw 2f .5 .6 2 12-39 10yr4/4 none sil lfsbk mfr gw if .2 .3 Ground 3 39-4 7.5yr4/4 none sl 2msbk mfr gw na .5 .6 elev. 4 44-94 7.5ry4/6 none co s Osg ml na na .7 ;.8 178.16 ft. Depth to limiting +9 factor Remarks: Boring # 1 0-16 10yr3/2 none 1 2cpl mfr gw if np .2 2.'> 2 16-35 10yr4/4 none sil lfsbk mfr gw if .2 .3 ~w........, 3 35-45 7.5yr4/4 none sl 2msbk mfr gw na .5 .6 Ground' elev. 4 45-86 7.5yr4/6 none co s Osg ml na na .7 .8 97.50 ft. Depth to limiting factor +86" Remarks: CST Name _Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 200~h. Ave., New Richmond, WI. 54017 Signature: _x 6-14-94 Date: cstm Z1 F mbar: ~ PROPERTY OWNER Jerome Anderson SOIL DESCRIPTION REPORT Page 2 of3 PARCEL I.D. W 030-1074-60-200 Boring # Horizon Depth Dominant Color I Mottles (Texture Structure Consistence Borrdary Roots GPD/ft in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. Bed iTrench 3 1 0-10 10yr3/3 none 1 2msbk mfr gw 2f .5 .6 2 10-29 10yr4/4 none sil 2msbk mfr gw if .5 .6 Ground 3 29-43 7.5yr4/4 none sl 2msbk mfr gw na .5 ! .6 97eI1~0 ft. 4 43-96 7.5yr4/6 none cos Osg ml na a .7 ' .8 Depth to limiting factor +96" Remarks: Boring # 1 0-9 10yr4/3 none 1 2msbk mfr gw 2f .5 .6 4.. 2 9-36 10yr4/4 none sil lfsbk mfr gw if .2 .3 3 36-44 7.5yr4/4 none sl 2msbk mfr 9w na .5 .6 Ground elev. 4 44-84 7.5yr4/6 none co s Osg ml na na .7 .8 97.40 ft. Depth to limiting factor +84" Remarks: Boring # 1 0-17 10yr3/3 none 1 2msbk mfr gw 2f .5 .6 5 2 17-4 7.5yr4/4 none sil 2msbk mfr gw if .5 .6 3 40-90 7.5yr4/6 none co s Osg ml na na .7 .8 Ground elev. 96.90 ft. Depth to limiting factor +90" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) . r r . STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Jerome Anderson New Richmond, WI 54017 MPRSW 3254 sE4sw4 s26-T3oN-R19w (715) 246-6200 town of St. Joseph N 1"=40' BM= bottom of siding of shed at el. 100' 13 2 X13 i f 1 I ~ VN Gary L. Steel 6-14-94 .r l l~ CERTIFIED SURVEY MAP Located in Government Lot 8 of Section 26, T30N, R 19W , Town of St. Joseph, St. Croix County, Wisconsin, and in the SW 1 /4 of the SW 1 /4 of Se T30N, R19W. Surveyed for: Brett & Mary Bader ~SGQNsl1yxHoulton, W i . 54082 % NOTE: This map is prepared pursuant to St. Croix Co. HARVEY p. > % Zoning Ordinance 18.02(4)(b)(3)' ' . sale or exchange of ` JOHNSON 9 land between owners of adjoining property. Town and = S-1899 County approvals are not required. The purpose of this HUDSON map is to revise and replace that CSM recorded in WIS Volume 7, page 1900, as Document #431100, on W$ , 1 October 14, 1989. APPROVED BY ST. CROIX y',0' U~` ` C1ertif eLot d Survey M Z°' CO NTY ONING OFFICE AS ap , 2 , 3 _pA-?~ _ A*7e.s~ ,og° \~s AI1fi PARCEL. '5 '3. Pond 6 6' 1 5 20~yA3a .-A ~vW DATE. 7 rRA I ~s -1951' L O T 1 GNATU e ines. Center- 189,529 S uare fe(t 4.351 Ac.) \''m 20' l q line of I 1m 132nd I U) Including right-of-way s Avenue 1 CJ Im 183, 785 Square feet (4.219 Ac.) 9~. I Qi W Excluding right-of-way O~ M ~1 0;1:' Surface .o~;~ zI ( I,~n drainage .oo ti0 \ 1 N 20' W1 I 9 305.00' N 00 15 57 E W I r 1 18.48 323.48' East line of the SW 1/4 w I of the. SW 1 /4 of zl zI 1 1 LOT 2 S ed Section 26 ~o i 1 I°o 307,051 Sq. Ft. (7.049 Ac.) 20/~ NOTE: 1" Iron North line) m 10' Including right -of -way h pipe is 0.40 south of the 1 sn Iv 298,487 Sq. Ft. (6.852Ac) of south line of the South l/2 ~ Iw Excluding right-of-way hed o a/ SW 1/4 of Section 26 of the I Z) I ti g V4 1, JA, SW 1/4 of 1 Qv 21 Section 10 10 W 26. I v1M vi5 e 2 zJ/ 0 1 I 1W S1/4 Corner (~I 1 Pool Section 26 I 1 13'• 884.39' T 30N , R 19W "E i 18.75 S90.OZS 39.13' 15'57.6 w N 00' 15'57"E 447.88' _ o South line of the g 16 6' I UNPLATTED LANDS SW 1/4 of Section a I - v to 2 6. -T~ 0 M U. o Bearings -referenced to the South SW Corner line of the SW 1/4 of Section 26, Section 26. W recorded as N89°45'03"E. L E G E N D a (2 C~j Section Corner monument This instrument dr ted by: ° 1 "X24" round iron pipe weighing 1.68 lbs/ lin. foot set. • 1" round iron pipe found. l (R) Previously recorded information. :a STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ^Azy E2 S o zy N AIIIIG ADDRESS :23 I 13.,2 UE PROPERTY ADDRESS &EW & (location of septic system) Please obtain from the Planning Dept. CITY/STATE ~f /2 50 Al ZVI'. -6-Y PROPERTY LOCATION ~5 j57 1/4, S 60 1/4, Section G T__30_N-R 9 W TOWN OF ST. CROIX COUNTY, WI SUBDIVISION 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._%at-you pu, into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Cro. County residents may be eligible to receive a grant for a maximum of 60%. of the cost. of rep went f a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted is 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 ~L 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: St. Croix County Zoning Office Government Center 1101 Cannichael Road Hudson, WI 54016 11/93 S T - 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 f 7 r. ,l 1 f s T~ v f' ~(.~-v s Location of property.L _1/4 5 ./1/4, Section ,~2 4. T 3o N-R J ~t W Township St ;7-a .3.-,02 4 Mailing address -?:T i o~ y✓~s s~ y~~L Httel Address of site-'-? 3 Subdivision name Lot no. Other homes on property? Yes_ZNo Previous owner of property a-k ' E of n t c~ M Y tin ~~r Wit- v Total size of property _ Y. 35-/ Total size of parcel Al , _D7 3- l /f Date parcel was created v7 - `7 Are all corners and lot lines identifiable:? Yes No Is this property being developed for (spec house) ? Yes _Z"' No Volume _ and Page Number 610 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOW NG: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PA-OE NUMBER AND THE SEAL OF THE FISTER 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. 3 /l y 0 , 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. ignature of Applicant Co-App ican C7 14 Date of Signature Date/ ~ :E Signatur LI,I:D CONTRACT • • . ` 44498 " r W,9A,,E142 ~c REGIS'TER'S OFFICE SST. CROIX CO., WI Brett E. Bader and Cont •~Ct, b • and twee Reed for Record Mary M} Ba er,itis6_aud:and:w~le, as ( I, joint t enants vendor", . . Jerome A. Anderson and Phyllis .1. 10:00 A whether cne or more) and at M i Anderson, husband and wider as survivorsfri➢ I, I marital •-ro erty --p_...p------.-------- ("Purchaser", whether one er more). Qt~lsts:Of DNdi ii Vendor sells and tgrees to convey to Purchaser, upon the ; rotnpt and full per- formunce of this contract by Purchaser, the following property, together with the ! rents, profits, fixtures and other appurtenant interests (all called the "Property"), St.__Croix County, State of Wisconsin: „L,,,,o, ro in Edina Realty Hudson, Wisconsin 54016 ~ i' Tax Parcel No ~I Part of Covernment Lot "8" of Section 26-30-19 described as follows: Lot 1, Certified Survey Map filed October 14, ' 1987, in Volume "7", Certified Survey Maps, page 1900, as Document 0431100. I ~ y I, .L s~•~ I FEF i' Purchasers agree that there shall be no hunting of waterfowl on the lake surrounded by the four lots mentioned in the ,I Certified Survey Map recorded in Volume "3", page 759. I This is not homestead property. (is) (is not) any place designated by them Purchaser agrees to purchase the Property and to pay to Vendor at 34 900 00 in the Inllowin;; manner: (a) t .-.17,450.00...................... the sum of i i.. IT, 4-5-0-..0-0.-- to;:rther with interest from date at the execution of this Contract; and (b) the balance of j . . . . .--hereof on the balance outstanding from time to time at the rate of nine M) per cent per annum until paid in full, as follows: i ' On or before February 13, 1989, Purchaser shall pay the entire principal balance on the said land contract, together with any accrued interest on the principal balance, in one balloon payment. 13th Provided, however, the entire outstanding balance shall be paid in full on or before the..... day of February ,9-a9.. ( the maturity date). Following any default in payment, interest shall acc!ue at tl,e raft of per annum on the entire amount in default (which shall include, without limitation, d-.!hoji tnt interest atul, upon acceleration or maturity, the entire principal balance). Purchaser, unless ercused by Vendor, agrees to pay .n.:nr.thl%. to \•rndor ;nmwnts sufficient to pay rvwonably antici- pated annual taxes, special assessments, fire and required insurence premiums when due.To the extent received by Vendor. Vendor agrees to apply payments to these obligations when due. SL:ch amount, received by the Vendor for payment of taxes, assessments and insurance will be depus;ted into an c-crow fund or t.ru;tee ;cccuunt, but shall not bear interest unless otherwise required by law. Paynients shall be applied first to interest on the un;,•aid b%!ance It tl:e late_sp,,cifii~•tl and then to principal. Any fee ::•,n ),rara,al at catty time after. closing 19........ (OR) amount may be prepaid without premium or th- c nrrr-b --n 1+rrf r. -rc~ t t4 ) ' -"1 in n dt oath res)eect to pa>nicnt so long In the event of :any prepa':utent• th;s cuntrart <},.^-'.i r.--t Ic• tr`'..' , . as the unpaid balance of principal, and intcre:t (nt.d in ='•_c ca-,• ace:.:i .c enter, =t front nn,nth to month shall he treated 1.:i-;e been had the nwntbly payments been as unpaid principal) is less than tire ar.:nant that -ah1 it lt!,rc•t'nt made as first specified above; provided t!:at :wtit!Ily pa}scents shall he in the event of credit of any proceeds of insurance or condemn.:aion, t't, condcmrM premises leing t}ur(af'.r cx_!u?cd I:crefrnm. Purchaser states that Purchaer is Satisfied with *he a= -t'. n by the title evidence submitted to Purchaser for examination except: no exceptions r , t;,e {„rtu „f mt ;0,0 ract, it <}.a!I P:nclla,-,.r n:.rcrs t•t I`r, tl.,~ t , I` t.t. , . he retaine`I h n.!"r ,..ail t' • •il i ! ! t. c I ! , i t:e b0i►A:E143 i l~i,r 1 r 1...11 U.. I I! I',.,i. • - i I t ,r ,1 l b} tire, c,(-• •ttn,k I .,r,.r. r,l, •o.•1 tr •f 1..1 ..,I 1-k r u:.,; „ ,u.re, 1o..t n neat;,;. tt.: u. .urcr approve J inll iu:iut'.tIII~ v.tlut~ Ly tit tl,,: sung ,.t j . ,tut VcI:.!..r .hall n•.t n•,juire cu:tl t,;e in -,n auux.nt more than the I.A.a.ce nwe,l ur:,Itr tt,i.l l:untrtct. 1"41J.aacr ahali I,..y uic urpt(uuuuls wLcn due. Tim ptllcia snail contain the st:,tnl,a•1 ,Lin,. In t.,v: r of ti.e 1-et,!.r*, il:tt-st•-t .,I, 1, w.le_s %•en.h•r .,ll.crwi!e agar; in writing„ the original of all pobclts cuveru,g the 1'rul•crt) Aall lie d.p.,_,tt'i wltl, 1'cn:L.r. Purl.-,.-r ,Call pr,.ril,u) give notice of lass to insurance cuinpanits :u„1 Ver.d: r. Unlc.s 1'urcharcr ;ICd Vtndi r otl.crw,: a agree in writing, insurance proceeds shall be applied to rtsh,ratiun or repair of the Prupcrty damaged, plo%'lJ(A the: 1'cnd„r deems the restoration or rcl air to be economically feaslLle. Purchaser cuvcnants not tr• 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 tree from liens superior to tl,e lien of this Contract, and to comply with all lawn, ordicancte and rearulations arIect,ng the Property. Vendor agrees that in case the pur.hase price with interest and other moneys shall be full), paid and all conditions shall be fully performed at the times and in the manner above speclfitd, Vendor will en demand, execute and deliver to the Purchaser, a Warranty Ihed, in fce simple, of the Property, free and clear of all liens and encumbrances, except tions any liens cr encumbrances created by the act or default of Purchaser, and except: ....no e.xcxce p . . Purcha3er agrees that tinge is of the c>,(-nce and (a) in the event of a default in the pa)ment of any principal or interest which continues for a ptri,nl of .69.... days following the specified due date or (b) in the evert of a default in performance of any other obligation of Purchaser .which continues fur a penud of. QQ.... days following written notice thereof 1-y Vendor (delivered pers(oally or mailed by certified mail), then the cutire outstanding halancc under this contract shall become Immediately due and pa)ublc in full, at Vendor's option and witht.,It 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: (if Vendor may, at his option, tee urinate this Contract and Purchaser's rights, title and intere.,t in the Properly, and recover the Property back through strict foreclosure with any equity of ndentptiutt to be conditioned upon Purchaser's full payment of the entire ,ulAmi lu,g balance, with i tit crest thereon from the date of default at the rate in effect nn such date anti other antountsduehercunder(iii whichevenntall amounts previously paid by Purchaser shall be forfeited as liquidated damages for failure to fulfill this Contract and as rental for the Property if purchaser fails to redeem); or (ii) Vendor may 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 anti other amounts due hereunder, in which event the Property shall be auctioned at judicial sale and Purchaser shall be liable for any teficiency; 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 cgnitahle intcrc:~t of Purchaser is insignificant; and (v) Vendor may ha, -e Purchaser ^jected 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) ubove.Notw-itlnstai.ling 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 attorney's fees of Vendor incurred to enforce any remedy hereunder (whether abated or not) to Cie extent not prohibited by law and expenses of title evidence shall be added to principal and paid by Purchaser, as in- curred, and shall he included in any judgment. Upon the commencement or durin,,, the pendency of any action of foreclosure of this Contract, Purchaser consents to the appointment of a receiver of tht Property, including homestead interest, to collect the rents, issues, and profits of the Property during the pendency of such action, and such rents. issue3, anti 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 pledgee or assignment of Purchaser's interest under this Contract soley 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 iu.III ediatelydue and payable in full, at Vendor's 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 mortr;age granted by Purchaser) or under anv note secured thereby, provided Purchaser makes timely payment of the amounts then due under this Contract. Purchaser may make any such payments directly to the 11lortgagee if Vendor rails to do so and all payments so made by Purchaser shall he considered payments made on this Contract. Vendor may waive any default without waiving any other subsequent or prior default of Purchaser. All terms of this Contract shall be binding upon and inure to the benefits of the heirs, legal representatives, sucressors 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.) 13th February 88 Dated this day of 19...._.. (SEAL) _ (SEAL) Brett E. Bader Jerome A. Anderson • . ......(SEAL) `I~-.i.4`•--~ ..l~.d-.~~_.~~t~ .-(SEAL) { Mar f. Bader Phyllid J. Anderson AUTHENTICATION ACKNOWLEDGMENT Signature(s) _ _ STATE OF WISCONSIN ss. " St Croix County authenticated this day of 19...... Personals came before me this _13t h.....". day of February 1988... the above named . Brett E. Badert MarY M. Bader, Jerome A. Anderson, and Phyllis-" J. Anderson..-. TITLE: b1ENIBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Scats.) to me known to be the person ...S....... who executed the fojegoing instruutent and acknow!edFe the same. THIS INSTRUMENT WAS DRAFTED BY \ r~ Eric J. Lundell, Box.157 11 Alice J. `Vleischauer. New Richmond, t:isconsin 54017 . - - ntar: Puhli c ronnty, Wis \ . (Si;fnaUu-e may he :u,tl.:r•ti:•.,t~-1 ur 1:"•.tl, !.r• ! I'•.t!, N•. ('o:nnli- ht1'r'~'t~I t not, Mate expir: ,re 1 ..r- r .(~,in,• R'~+ lit ~y I r swe of wismr-In f) e