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HomeMy WebLinkAbout032-2047-60-050 ~ I C c o O ° v I I ~ I o I 0 N O. N y ~ I Q I y I b ~ Z C LL c O Q N _ co ~ Q m I ~ N I rn = o z ~ U) a m 0 o z c v c o m Z d c o (D z c -o v M N rn I CL y a C U m O O O Z CO z Z o N z I 'a 1 N d N 't I Z; E co m 0- 2 T p O ~l N O N_ d 42 co C a a m N Q o !I N N N 3 U • rra o a a a EL E U p co co N (31 a) v Z O N O N > to Q E a M IL C m N LO O O C 00 N C C O~ O N C N U p p N = C t u.) N c E N N N 0 (0 :1 cq a) 'a LO 7 Z' ~ -74 N M E j CO (0 U C~ d M a v ~ xt a L a • C~ G d .V N C t~ E 0 C c 13. 30. 19. ( '0'12c STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS SUBDIVISION / CSM# LOT SECTION . TR(I N-R~W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 100 ✓ D r~ D V ' 0° ~ I ya _ _ INDICATE NORTH ARROW Provide setback and elevation information on reverse of this -form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: ~ir aim ALTERNATE BM: EPTIC ANY~ / PUMP CHAMBER / HOLDING..TANK INFORMATION Manufacturer: 412 e it Liquid Capacity: /ydd Setback from: Well_7Z-_ House Other Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: Length S,;OJ Number of trenches Distance & Direction to nearest prop. line: / ? r 4 7 " Setback from: well:. jMt House_~ Other ELEVATIONS yBuilding Sewer ST Inlet: ST outlet PC inlet PC bottom Pump Off Header/Manifold q LJ. D 1( Bottom of system v~ Existing Gr d6 Final grade DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/93:jt ~IaiS~t~AYhrW?E ttm TCtYNMtd tY 13.30.194UV E S"00 Mm County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division ST_ CROTY GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: 193466 Permit Holder's Name: ❑ City ❑ Village ❑xTown of: State Plan ID No.: D, HARQT.D SOMERSET MW E ev.: , Insp. BM Elev.: BM Description: Parcel Tax No.: x.60 /,.-V. a) ' 12 s / - - 012- 204760000 TANK INFORMATION ELEVATION DATA A9300128 ~41fiv TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark , W /,06. 6D Dosi I f Aeration Bldg. Sewer (o $ 9/ f Holding St/ I -h Inlet 9(01, Re TANK SETBACK INFORMATION St/ Outlet 6. d2~ 9 Vent to TANK TO P/ L WELL BLDG. Air Intake ROAD Dt Inlet Septic NA Dt Bottom i Dosing NA Header/-PA". f 8 ~ 9 , 08 Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufact Demand s 3.3 Model Number GPM TDH Lift Friction m T D H t Lo S ea Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM J$/ Length No. Of T enches T ENSI N f Pits inside Dia. Liquid Depth BED/TRENCH width~ DIMENSIONS SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHIN Manufacturer: SETBACK CHAMBER INFORMATION TypeO 9.3 OR UNIT Mo tuber: System: /0 DISTRIBUTION SYSTEM Header /ARaRi#ekf' fi Distribution Pipe(s) f f, x Hole Size x Hole Spacing Vent To Air Intake Length la i Dia. Length Y~ Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over It „ Depth Over V If xx Depth Of xx Seeded/ Sodded xx Mulched Bed /T.cenel4 Center 5/0 - Bed /TrewEh Edges _ 4 Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) I LOCATION: SOMERSET 13.30.19.6720 (150TH AVENUE) l , !~&~4,erj a/ q4e~Af ~04AX~Ae. x4A Plan revision required? ❑ Yes D1l10 Use other side for additional information. ~P off, 1,9 SBD-6710 (R 05/91) Date 4 Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ° DIL.HR SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05, Wis. Adm. Code • STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than l q,3 6 V 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 OW ER PROPERTY LOCATION SU>14 SW Y4, S 13 T30, N, R E (or) PROP O JWNNE 'S MAILING ADDRESS LOT # BLOCK # V d1 1-seaA. CITY, STAT ZIP ODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER - Lto air II. TYPE OF BUILDING: (Check one) ❑ State Owned O CITTLYAGE N REST ROA 59 WINZ-? & SOvlle)r,s 2 . ❑ Public W 1 or 2 Fam. Dwelling-# of bedrooms PARCEL TAX NUMBER(S) III. BUILDING USE: (If building type is public, check all that apply) _ oZQ y , 6G 7 C> 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 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.E1 New 2.K Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.0 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 Q Q Feet % 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 strutted Septic Tank or Holdin Tank dd ei b Lift Pump Tank/Si hon Chamber Vill. 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 ature: (No Stamps) MP/MPRSW No.: Business Phone Number: J~~ 14 if-., I Agek5!= 4~~, PI b is Addres7(s rest, itt Mate, Zi Code): l • , loor 196/1 60 &0 IX. COUNTY/DEPARTMENT USE ONLY Y❑ Disapproved Sanitaa Permit Fee (includes Groundwater Date Issued Iss ing Agent Signature (N~Stamps) Approved ❑ Owner Given Initial Surcharge Fee) 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 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 revis € ns to this permit must be approved ':y the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer /Renewal Fcrm 381) 6399) to be submitted to the i ~;r,i;ty prior to installation. 5. Onsite sew :,e nr nnust be properl~> mei.-,tairied. The s3ptlt tank(s) must be ru,rFed by -a-licensed pumper whenc v+~r iFPCIUSSSE'y, usually every 2 to 3 years. 6. If you have que<tir)rs concerning your onsite sewage system, contact your'!ocPl0.code~tkirrinistrator or the State of Wisconski, Safety & Buildings Division, 608-1 66-3815. 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. 11. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. 111. 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 C1eck appropriate box depending on system type. VI. Absorption system information. Provide all information requested in #1-T VII. Tank information G ll in the capacity of every new aid.or exFs inr; tank, list the. tF a ! r~<ai~Fns, n umber of tanks ao.'i -,,3:riufa.,turer's name- Indictle, prefab or E,ite consito ted and tank ,r;aieiial f omr,`..ete for all septic, p-.; s p° o;) and.bolding tanks or 'Ihis system. CheO on "_s01s, received pproval from DiLiIP. VIII Respons,!` lity :statement installing plumb-ir s~ io fill in name, ~(;er,se number with at7prc _ rr,;-;e pre'ix (e.g. MP, etc.;, ~Adres and phone number. Plum bei -;lust sign appli .hil-)n form. IX. County/Department Use Only X. County/De < iment Use Only. Complete pans and spec f;cations not srra'ier than i3'/. u 11 ir: F s - >me t be . ubryJtt d :c thr; county. The Ci?ans mI;S ?.it=Ge''. fol;owing' Al, plo , drawr: to scale! J coij~plF'r.n ~l, sj.lY,3 ri>C'•~.ti01 of : " G holding t~. as or ocho h :i Lanes; h,ilri; : s. tlv r: r F ; afer service; Streams of ! !c ~ wp cv siphon tanl,• !r Y~;tiCn boxes. +.)o -,ib9or!_itF+if :.Vwr~ r ,-iisn "Men!: System wea's. ar:ci lhet ;:J :.18 buii('i';g, nr i7ontai ii itlC l I€..7' 5' 1.~oints; C) complete 1, ; ati _5r S for pumps and t.or.,irc);s; rose vc . i,:o, ^ievatijf ic",, rl Ioss; pump performance curve; pump model and pump manufacturer; D) c s section of the soil atj!;orption system if required by l`*e ounty; t')s oiktest data on a 115 form; and F) ail 4;7tng intorrnation; - - - - - - - - - - - - - - - - - - - - - GROUNDWATER SURCHARGE 1983 Wiscons;n Act 410 included the creation of surcharges (fees) for a riumo-~r of regulated pract • es wh'c`~ can effect gr oundw ler The mon es cof'',ected t rc,.. 31 these sr.rcharyci arm eri~sec for monit~rir_r cgric%ndvvAer s ro!:rl S- wa w •r.ontamination intrr it i,l` !rrTS and G'Sta` iic'i i F if starirtfkrds _ SBD-6398 (R.11/88) ~r 174 • G~ z ® e- V L, 3®uf ~nk 5l Jig tj a` s~ V PLOT PLAN PROJECT _YV/L/✓~Yt/ ADDRESS e,941 13 V < luJ yys'rrc- 1rj 114 ~ 1/4/S /T © N/R If W T WN a.~. COUNTY G S3`°6j MPRS Byron Bird r. 18 DATE 1 BEDROOM CLASS PERC ~CO TIONAI~ IN- ROUND PRESSURE CONVENTIONAL LIFT- MOUND- HOLDING TANK SEPTIC TANK SIZE LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ABSORPTION AREA PERC RATE S BED SIZE Benchmark V.R.P. Assume Elevation 100' Location of Benchmark * H. R. P. ~ Y- C-1--/3~ - - (O Borehole Q Well Scale Feet 0 Perc Hole System Elevation Uent 12" rade TYPAR COVERING 2" 12" 3' 4 6' Q 3' 3' (D 3' I 8 Sewer Rock 12' 18' 3y y 3y i 414 14W ~ I I of ~ I I JA i\ b l~' 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 f not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PAR L I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION 141a 10 e L-Z &A y GOVT. LOT 1/4 4, 1/4,S N,R E (or PROPERTY 0 ER':S MAILING ADDR S / LOT # BLOCK # SUBD. NAME OR CSM # J O~7 L 420 Z-) CITY, TATE - ZIP COD PHONE NUMBER ❑CITY ❑VILLAGE OW NEAREST R 04D ~X1 !S" o 7 (r 6 Sag/ e,n a [ ] New Construction Use Residential / Number of bedrooms 3 [ ] Addition to existing building Replacement [ ] Public or commercial describe Code derived daily flow _1 gpd Recommended design loading rate gybed, gpd/ft2 . 6 trench, gpd/ft2 Absorption area required J00 bed, ft2 trench, ft2 / Maximum design loading rate "Ted, gpd/ft2__.,~trench, gpd/ft2 Recommended infiltration surface elevation(s) / ft (as referred to site plan benchmark) Additional design / site considerations Parent material A-16."s 6.4 Flood plain elevation, if applicable ft '7 S = Suitable for system CO VENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM Iv FILL HOLDING TANK as j2F6 El U E3 U 'I&S 13 U =Unsuitable fors stem S ❑ U U El S IA~U ❑ S SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsel Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tmnch t{ g-- *.11: Ground 1 Z-Z 4 JdVr viw 5 L j)7 4.4 A rr G'✓ /y,I elev. Depth to limiting factor 8 Remarks: Boring # I / rV cam. S• 6" d V r 41144 dL 'Z; Ground - r + G r elev. 9 ZL ft. Depth to limiting facts Remarks: CST Name:-Please Print Phone: Z ~ J i Address: C) c1 CIO Signature: ~j ~V I Dater CSPber. 0g PROPERTY OWNER '*#(Iro GSLMJ SOIL DESCRIPTION REPORT Page of- 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 r 3 6-10 i0v el L 2 36 10 r q1y one w •s Ground Ivyr ~6r ley. ft. Depth to limiting factor L ys 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 6Remarks: 0 6R05/9 2) SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ADDRESS: FIRE NO: z J 3 -70 LOCATION: _1/4, SW 1/4, SEC.S3T3d N-R- TOWN OF:~ ST. •CROIX COUNTY_ SUBDIVISION: LOT NO. 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 a 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 rec.eive a grant to help with the cost of the 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 the St. Croix County Zoning a certification form, signed by the owner and by a master 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. Certification from will be sent approximately 30 days prior to three year expiration. 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 form must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: DATE:_ ~-/S ',yam St. Croix County Zoning Office 911 4th St Hudson, WI 54016 V 5TC-loo . This application form is to be completed in full and s' the o~~ner(s) of the property being developed. An lgned es will only result in delays of the y inadequacies development be intended for resale bytowissuance. Shs ner/contractor ould 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 Location of property 1/4 A1•/4 , section ► T3e) N-R 19 W Township Mailing address 9_0-9 /-7 Address of site subdivision name Lot no. other homes on property? .eyes No Previous owner 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 X No volume-SL- and Page Number 2.2) as recorded. with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING; A IIAIZItA ITY DEED which includes a DOCUMENT NURBER, VOLUME AND PAGE 1IUMD1 R & 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 u 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 the owner() f the property described in this information form, by virtue sof oa warranty deed recorded in the office of the county Register of Deeds as Document No. a and that I (we) presently oo:n the proposed site for the se age disposal system or I (we) obtained an easement, to run the above described rt for the construction of said system, and the same hasopbeen,duly recorded in the office of County Register of deeds as Document No. si n ture 2 g of 4p~licart Co-appl cant r Date of Signature Date 01 Signature . Y 'DOCUMENT NO. YOOTOAOE-To CKNntMR hawas" Clow F W1 Wj s, lir a TO 300NSIN-F ORM 17 7 (Rev. 1953 323257 STATE OF THIS SPACE RESERVED FOR RECORDING DATA REGISTERS OFFICE ST. CROIX CO., WIS. KNOW ALL MEN, That , Harold Rivard and Theresa Rivard, Recd for Record thiS_?_n_d--- indiyid ally and as husband and wife day of-r831tuet---- A.D.19-Z4 part -iEaof the first part, in consideration of the sum of at----- 213Q---_ M. - -Sixteen _Thnusand_and na/ 00- - - - - - • - - - Dollars, - in hand paid by Bank of Somerset Regbtei of naerb a Corporation duly organized and existing under and by virtue of the laws of the RETURN TO _Wiaeo gin located at Snmersst , Wisconsin, party of the second part, the receipt whereof is hereby acknowledged, do 1.q_ hereby grant, bargain, sell and convey to the said party of the second part, its successors and assigns forever, the following described real estate, lying and being in the County of St Crni it , State of Wisconsin, and known and described as follows, to-wit: A parcel of land located in the SW-1 of the SWJ of Section 13, T 30N, R 19W, Town of Somerset, St.Qroix County, Wi. being further described as follows! Commencing at the S4 corner of said Section; thence Westerly along the South line of said Section 1723.60' to the point of beginning; thence Northerly parallel with the East line of said S4 566'; thence Westerly parallel with the South line of said Section 983' more or less to the West line of said Section; thence Southerly along the West line of said Section 566' to the Southwest corner of said Section; thence Easterly along the South line of said Section 956' to the point of beginning. I Except that part on the Southerly boundary being used for Town Road right-of-4aye with the VdvA gw and appurtenance to the am bWon`ias, and all of the rash, issues and profits whieb.may arise or to be had '[IQ NA'1 AN D TO HOLD the same to the wid I" of die saad part, its wcoaaors and aseigos tarevdr:: ' T r ld iv ar , : . P~ 04* Slat part, eR tae r~ c~ ~lL *ei "d MU ( P, ssieeuton sed• 7<aes, o malit iP tl'~ ` ° 'tom r " ~ _ sMt3d 40'tt Yood~ if<A ; ekk to the ptw~ise. above 11bnvft" Ne kw, in { .p % 44 "may _i ib►6Yil ~r t ~ pl aT o*, aid pRet ft ! ~yNAd~~M~~~dllii-1t~trawlA ~ fie` Ilw t+w%~r,r %f. ~ a~ 4' ~ et-q nLlw7fnsr+t c'~ ~ ~r ~ id(r+'Pa"~ s. . z~ AAfT ,y , Q c ~ytplsot!'aMigns, ogvenoat _and agree -_*t1, titt,V j sold pw ror the second :past. its tlpooeth Mots ac ads 6m on against 1as or datma& by fire tour the sum of ~F' w► b.:,~:a~'?+e y t► 1 +'f y or over, In (nsnranoe oa mpanies •of their QhOlgo to be approved by the said party of the second part, its successors or assigns, such insurance to be payable in case of loss to the said party of the second part, its successors or assigns, as its mortgage interest may appear, and the policy or polries of insurance to be held by the said party of the second part, and to pay when due and payable, all taxes and assessments now or hereaftgr assessed or levied against this mortgage or the note secured thereby and on the real estate, described in this mortgage, including every mortgage Interest which said party of the second part, its successors or assigns may have or be deemed to have in such real estate by reason of this mortgage, and to deliver to the said party of the second part, its successors or assigns annually, prior to the first day of May, receipts showing due payment thereof; hereby waiving and releasing all rights of offsets or deductions against the indebtedness secured by this mortgage, because of the payment of any such taxes or assessments; that the interest of the mortgagor - and also of the mortgagee, in such real estate shall be assessed for taxation and taxed together,'without separate valuation, to the mortgagor heirs and assigns; and in case of any failure to keep or continue such insurance and to deliver the same as above provided, or in case any such taxes or assessments remain unpaid after the expiration of the time in which they are due and payable, the said party of the second part, its successors or assigns may effect an insurance upon said building or buildings to the amount above named and may pay such takes and assessments with accrued interest, officers' fees and expenses thereon and the amount or sums so paid shall be immediately paid to the said party of the second part, its successors or assigns, and shall, unless so paid, be added to and be deemed part and parcel of the money secured hereby, together with interest thereon at the rate of ten per cent. per annum, and form a lien upon the premises so described. PROVIDED ALWAYS, and these presents are upon this express condition, that if the said Harold Rivard and Theresa _Rivard part _iesof the first part, . heirs, executors, administrators or assigns, shall pay or cause to be paid to the said party of the second part, its successors or assigns, the sum of Sixteen Thousand and no 100- - - - - - - - - - - - - - - - - - Dollars, according to the conditions of one certain promissory note _ bearing even date herewith, executed by the said _Harold Rivard and Theresa Rivard part ies of the first part to said party of the second part, and shall moreover keep such buildings insured as above mentioned and keep the policy or policies thereof assigned, as aforesaid, and shall pay all taxes and assessments herein above referred to, as aforesaid, then these presents and the said note- shall cease and be null and void. But in case of the non-payment of any sum of money (either of principal, interest, insurance premiums, taxes or assessments), at the time or times when the same shall become due, or the failure to perform any of the covenants or agreements by said part ies of the first part to be kept and performed, then in such case, or in either case, the whole amount of said principal sum shall, at the option of the said party of the second part, its successors or assigns be deemed to have become due and payable without any notice whatever, and the same, together with all sums of money which maybe or have been paid by the said party of the second part, its successors or assigns for or on account of insurance, taxes or assessments, with interest thereon at the rate aforesaid, shall thereupon be collectible in a suit at law, or by foreclosure of this mortgage, in the same manner as if the whole of said principal sum had been made payable at the time when any such failure shall occur as aforesaid; and the judgment or decree in the suit brought to foreclose the same shall embrace, with said principal debt and interest, all the sums so paid for, or account of, insurance, taxes or assessments, with interest at the rate aforesaid; and it shall be lawful in such case, or in either case, for the said party of the second part, its successors or assigns to grant, sell and convey the said real estate with the appurtenances thereunto belonging, at public sale, and on such sale to make and execute to the purchaser or purchasers, his, her or their assigns forever, good and sufficient deeds of conveyance in the law, pursuant to the statute in such case made and provided. And in case suit shall be brought for the foreclosure of this mortgage, the said t parties- of the first part for _ their - heirs, executors, administrators and assigns, covenant --and agree that _ they will pay to the said party of the second part, its successors or assigns, all expenses incurred for the purpose of the foreclosure suit, and in addition to the taxable costs in such suit a reasonable sum of money as solicitor's fees; to pe included with the expenses above mentioned, in the judgment or decree-and any attorney fees not to exceed the limits of the law. In Witness Whereof, the said part _ies of the first part ha Ye hereunto set their hands and seal this __-Iday of _ Aug11E_t__ , A. D., 19 -74- . II tT/-:I[_~ (SEAL) SIGNED AND SEALED IN PRESENCE OF Harold Rivard (SEAL) Theresa Rivard (SEAL) (SEAL) STATE OF WISCONSIN, St Croix SS. County. } Personally came before in this 1 day of August , A. D., 19 74 the above named Harold Rivard and Theresa Rivard to me known to be the person S who executed the foregoing itrs , ment ano acknowledged t same. ' t3hirl o on St Croix , This instrument drafted by !a Notary Public County, Wis.. y i, r Bank of Someeset 'J g 2 2 5/77 "~J'•. Y My Commission (Expires) (Is) 1_ UR - ` (Sectidh'89.51 (U'of the Wisconsin Statutes provides the, j1lruments to be recorded ebau have plainly printed or typewritten thereon the ~_11Ile names of the grantors, aranlees, witnesses and notary). ~+l 1 MORTGAGE-STATE OF WISCONSIN, FORM NO. 17 • c. MULE. co., MILWAUKEE