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Wisconsin Ucpartment of Industry, SOIL DESLKIPTION REPORT P.O. 7969 wings Division
' Labor and Human Relations P.O. Box 7969
_ (Attach Soil Profile Location Map - To Scale - On A Separate, Signed Sheet) Madison, WI 53707
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y HOMESITE SEPTIC PLUMBING CO.
855 O'NEIL RD., HUDSON, WIS. SQ16 ~ z z/d'Z
r- ROBERT ULBMHT
AS. MASTER PLUMBER LIC. NO. 3307 M.P.R.S.
s r ;.!rf. IFISTALLE'i & DESIGNER LIC.1J0.008f33 ! DvC~
Additional Remarks.
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Other Site Features:
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v Wisconsin Department of industry, SOIL DESLt<IPTION REPORT Safe tyy a Buiiurngs Division
Labor and Human Relations ry~ A P.O. Box 7969
(Attach Soil Profile Location Map - To Scale - On A Separate, Signed Sheet) Madison, WI 53707
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lot Lega Description ystem eometry an Dept pe a^ Aspect
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~ HOMESITE SEPTIC PLUMBING CO.
655 O'NEIL RD., HUDSON, WIS. 5406 ~~BL
ROBERT ULBRIGHT C' r -r
AS. MASTER PLUMBER LIC. NO. 3307 M.P.R.S.
'.N. 1F?G)TALLEl & DESIGNER LIC.140.00863 / QUC`~
Additional Remarks: " o
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Other Site Features:
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CST Signature Date Signed Telephone No. CST #
Limiting factors/Depth:
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Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM c u ty:
`La~orandHuman Relations INSPECTION REPORT St. Croix
Safety and)i<uildings Division Lot 102
(ATTACH TO PERMIT) Sanitary Permit No-:
GENERAL INFORMATION SW, SE,Sec. 17,T29-Rl9,OverlookPass 149241
Permit Holder's Name: ❑ City ❑ Village ❑ Town of: State Plan ID No.:
B&H Development Hudson
CST BM Elev.: Insp. BM Elev.: Description: Parcel Tax No.:
& 7 BM 020-1282-10
TANK INFORMATION ELEVATION DATA I Ail
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark d' X,CB~
Aeration Bldg. Sewer
Holding St/ FK Inlet &'/6'-h/ ,
"
TANK SETBACK INFORMATION St/(Hf Outlet V03,4 96,20,
Verit
TANK TO P/ L WELL BLDG. Air Ito ntake ROAD
Air
Septic > 5-1 NA D
ID g--- NA Header4ldwa_ 7'7
yi-~ 9lO,71o~
Aeration NA Dist. Pipe
Holding Bot. System `f
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand 010 S5,7 ~ 5
M Number GPM
TDH Lift Friction System TDH Ft
Forcemain Length Dia. Fi
SOIL ABSORPTION SYSTEM
BED/TRENCH Width , Length 1 No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS S2- 3 1 61 EN I N
SYSTEM TO P / L BLDG WELL LAKE / STREAM LE ING Manufacturer.
SETBACK CHAM
INFORMATION Type O (Le,71ji- Mode Number:
System: OR UNIT
cLS S~GJ
DISTRIBUTION SYSTEM
Headerl+AaoA*W- n Distribution Pipe(s) r „ x Hole Size x Hole Spacing Vent To Air Intake
Length Dia. Length SU Dia. Spacing &L
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 30 - ~ Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
/CO M~ENT. S: (Incclude/code discrepancies, persons present, etc.)
Zi'72E`..-' F~•
Plan revision required? ❑ Yes
Use other side for additional information.
SBD-6710 (R 05/91) Date Inspector's Signature Cert. No.
~ILHR SANITARY PERMIT APPLICATION couN
In accord with ILHR 83.05, Wis. Adm. Code
STATE SANITARY PERMI #
-Attach complete plans (to the county copy only) for the system, on paper not less than 114 9C>9y 1
8% x 11 inches in size. 1:1 Check If revision topr vious application
-S@@ reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER PROPERTY LOCATION
e e e u~ Y4 t/4, S 7 Tel` 9, N, R E (or
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
Pao - ~
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM•NUMBER
CITY NEAREST ROAD
II. TYPE OF BUILDING: Check one
❑ State Owned VILLAGE
a-,dL-~
❑ Public 1 or 2 Fam. Dwelling-# of bedrooms PAR A . u
III. BUILDING USE: (If building type is public, check all that apply) a d~
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
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. XNew 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ 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 09 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) 9.r•sQ ELEVATION
GOG e 40 - 46 Feet ®o Feet
VII. TANK CAPACITY Site
in ailons Total #of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name oncrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Holdin Tank I _A~ ~T Fj Fj El 1 0 1 F-I
Lift Pump Tank/Siphon Chamber
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 Signature: (No Stamps) MPRSW No.: Business Phone Number:
/•a VC . ~r CJ ^ " 38'6 3t'V l
Plumber's Address (Street, City, State, Zip Code):
/oz s~
IX. COUNTY/DEPARTMENT USE ONLY
0 1 ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Sign No Stamps)
Approved E] 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
APPLICATION FOR SANITARY PJ;RMIT
STC - 100
This application foru► is to be completed in full and signed by the owner(s) of the
prupur•ty being developed. Any inadequacies will only result in delays of the permit
Issuance. Should this development be intended for resale by owner/contractQr,("spec
Ituudu"), then a second form should be retained and completed when the property is
suld and submitted to this office with the appropria;e deed recording.,
- - - - - - - - - - - - r - - - - - - - - - - - - - - - - - - - - - - - - -
owner of Property
J.ucat iutt of Property Section 17 T Z9 N - R
'J'uwnsl►1p /I,~dS
/
M,iI 11nb Address Zei- /o2 dverlook lJ//e ct! 21' ~aJ f- JT
• we •
l ~ds~v f. svo` 4.
Subdlvidiort Name
Lut Nuruber /0~ ff - -
Previous Owner of Property /nt!~ xi''7e%0^1
Tutal Size of Parcel l oet%e-
DjLu Parcel was Creuted
Are all corners and lot lines identifiable? x l Yes No
1b Lhis property being developed for resale (spec house) 7 Yes No
Vu ILane _ and Page Number ~9- as recorded with the Register of Dodd
INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING:
1. Warranty Deed
1. Land.Contract
3. Other recordings filed with the Register of Deeds Office
it, addition, a certified survey, if available, would be helpful so as to avoid delays
of Lite reviewing process. If the deed description references to a Certified Survey
map, cite the Certified Survey Map.shall also be required.
PROPERTV OWNER CERTIFICATION
1 (We) e-eAti,6y tka.t aU a•ta.temen A on tiliA. 60Am aae ttue to .the beat o6 my (uuA)
kuuw&dge; ttiuit I (we) am (ane) the ownefl o6 the paopen.ty de cAi.bed in .tia-4
t►isuiunat.i.un 6unm, by viAtue o6 a woAAan.ty deed neeoAded in the.066ice 06 .cite
Cuwity Reg.ie.ten o6 Deeds as Document No. 3950-Z ; and that I (we)
pAe,6etttCy own .the•pnopoaed aite 6on the sewage poa 6y4teM (un I (we) nave
ubtained an eaaemen.t, to nun with the above deecA bed pn.opeAty, 604 .tire i
euru6-tAue,tion o6 said 6y,6tem, and tile name has been duty %econded in the 066ice
u6 .tile County Re9i4 teA o6 Deeda, as Document No. 3 I~~~Za___-I
`SiGNA'i'UKE OF OWNER SLCNATURE OF CO-OWNER (IF APPL1CABLE)
121-71 ~ 0
UATL•• SIGNGD UATI: S1GN1•:U
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acts.
. laud included ,ri ~ ' o$,lrill~l+, ~dgs Second. L*L+'Q
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°+Pa><Cel 7., -Amdahl'.
u
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i i arib n+ Vol:: 517,
x page 114, .
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with= as saseMa pnts8 pwpnses" aver the Easterly
k' e ~V,ks s 33 feet'.of.'said parcel' to Roger E. Hetchler as described
in Vol. 517, Page 114 324430
} ' - SUM= 70-the rigpt~q► ° LL a Ht. Croix County Trunk Highway
"D"_ and to telapbooa 'Raselse~~ adj~t: said highway as recorded
` fa the office of, saidis sds R ' w 2
r v p Purchaser agrees to purchasi , a-d'to pay to:Vendor at: St. Croix
Heights, Hudson, Wisconsin, t11e_>sast rchase lrice:'of $100,000.00, together with
sdditiowd payments per ; lot..
as ' follo+soi ?
Base Purchase Price. Zbe base . purehasa pr'.re of $100, 000.00
paid W following manner: $151000.00 at the
rt execution of this Contract, amd the balance of 885,000.00
;together with interest on such portions thereof.," shall
:remain from time to time unpaid,°at the rate of lOX per
annum, until paid in full, as follo%m:
(a) For each individual lot developed and sold by the Purchaser,
tiwh, x Purchaser shall pay to Vendor a $2,000.00 principal payment, to
be applied to the $85,000.00 base contract balance outstanding.
(b) A, mini•mus annual payment of $15,000.00 principal shall be
si•F. paid each year, excluding the year of sale. Each per lot
principal payment required above, shall be credited toward
this $15,000.00 annual payment.
(c) On December 1, 1985, and on December lot of each year
' thereafters ;Purchaser shall pay to Vendor the differential
between the required minimum principal payment of $15,000.00
and the total $2.000.00
per lot payments made during the
3 w preceding twelve (12) months, until the Base Purchase Price has
r' been paid in full.
(d) Interest on the principal balance of $85,000.00 shall accrue
3 r'' from the date of closing, with annual payments of interest due on
f, the lot day of December, each year, commencing December 1, 1984.
1 2. Additional Per Lot Payments. In addition to the foregoing Base Purchase
A*MMYAt iA Price payments, Purchaser shall pay to Vendor additional per lot payments
totaling not less than $150,000.00, as follows:
502SIM4 St. (a) No interest shall accrue on the principal sums paid to Vendor
"MOM. we, under the terms of this Paragraph.
snots
715.386.8234
Olt,
1 S y<{. ~r ' II.r
W~l
tb)~r Pa>chaees shall pay to Viadooc,-,the sun of $3,000.00 per
lot on rill=residential lots developed and sold by Purchaser, '
F-*Ubject'to the condition that the minimum amount of payments
C to be so" to Bertelsen under this Paragraph shall total
at Ieait $150,000.00.
(c) ` Daring each year of this Contract that there is an
' outstanding contract balance of the Base Purchase Price
_ (Paragraph 1(a)) there shall be no minimum annual principal
paysmnts under this paragraph. Commencing with the year
following completion of payment of the Base Purchase Price,
Purchaser shall pay to Vendor a minimum annual sum of
$15,000.00 per year.
(d) On the lot day of December of each year, Purchaser
shall pay to Vendor the differential between the minimum
animal payment of $15,000.00 as provided in this Paragraph,
and the total $3.000.00 per lot payments made during the
preceding twelve months, until the entire $150,000.00
minimum sum has been paid. Thereafter, if Purchaser sells
any lots in excess of 50 lots, Purchaser shall pay to Vendor
the sum of $3,000.00 for any such additional lot sold, up to a
total of 53 lots. ($159,000.00 total hereunder)
Purchaser shall not be required to pay monthly payments to Vendor sufficient
to pay reasonably anticipated annual taxes and special assessments.
Any amount may be prepaid without premium or fee upon principal at any time.
In the event of any prepayment, this Contract shall not be treated as in
default with respect to payment so long as the entire balance of principal, and
interest where required, is less than the amount that said indebtedness would have
been had the monthly payments been made as set forth above.
i
Purchaser states that Purchaser is satisfied with the title as shown by the
Abstract of Title submitted to Purchaser for examination, except:
I
Real estate mortgage to Sam E. Miller, dated February 1,
1980, recorded in Volume "608", Page 152, Document Number
362685. This mortgage shall remain the obligation of
Vendor, who shall keep said mortgage current and in good
standing. In the event Vendor fails to pay any required
mortgage payment, Purchaser shall have the right to make
such payment, and to deduct any payment so made from the
sums due under the terns of this Contract.
Purchaser agrees to pay the cost of future title evidence.
Purchaser shall be entitled to take possession of the property on Closing.
Purchaser promises to pay when due all taxes and assessments levied on the
Property or upon Vendor's interest in it and to deliver to Vendor on demand receipts
showing such payment.
Purchaser covenants not to commit waste nor allow waste to be committed on
the Property, to keep the Property in good tenantable condition and repair, to
keep the Property free from liens superior to the lien of this Contract, and to
comply with all laws, ordinances al:d regulations affecting the Property.
Vendor agrees that in case the purchase price with interest and other moneys
shall be fully paid and all conditons shall be full performed at the times and in
the manner above specified, Vendor will on demand, execute and deliver to the
Purchaser, a Warranty Deed, in fee simple, of the Property, free and clear of all
liens and encumbrances, except any liens or encumbrances created by the act or
default of Purchaser, and except, subject to utility easements and covenants and
restrictions of record.
Bertelsen shall have the right to purchase one (1) lot from B b It for
the sum of 55,000.00. Bertelsen may select his lot after B b H picks its first
five lots.
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Osndor shall ooasent, to the platting of,,. the premises into residential's4100a by Purchaser and Vendor shall be under an obligation to approve
Nw~1a~ricate SuW~ Tiaioak plate pstpauced and- submitted by Purchaser.
Ia addition to the Warranty Deed Which Vendor shall deliver at time of r:. ti A
Ultimate Closing, Vendor shall execute and deliver to Purchaser, individual
WArranty Deeds covering the separate residential lots which Purchaser may sell,
"upon 'payment of the per lot payments set forth above. All costs of platting and
costa incurred in preparation of individual deeds shall be Purchaser's expense..-.'
Purchaser a£-ees that time is of the essence and (a) in the event of a default
in the payment of any principal or interest which continues for a period of 60 days k
c 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 60 days following
r written notice thereof by Vendor (delivered personally or mailed by certified mail),
tben:the satire outstanding balance under this contract shall become immediately
due:`and payable in full at Vendor's option and without notice (which Purchaser
hereby waives), and Vendor shall also have the following rights and remedies (subject
to any limitations provided by law) in addition to those provided by law or in
equity; (i) Vendor may, at his option, terminate this Contract and Purchaser's
rights, title and interest in the Property and recover the Property back through
strict foreclosure with any equity of redemption to be conditioned upon Purchaser's
full payment of the entire outstanding balance, with interest thereon from the
date of default at the rate in rffect on such date and other amounts due hereunder
t~ (in which event all amounts prev:oas ly paid by Purchaser shall be forefeited as
liquidated damages for failure to fulfill this Contract and as rental for the
Property if purchaser fails to redeem); or (ii) Vendor nay sue for specific
peformance 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
k 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 nay have Purchaser ejected from pobsession
of the Property and have a receiver appointed to collect any rents, issues or profits
during the pendency of any action under (i), 61) or (iv) above. Notwithstanding
any oral or written statements or actions of Vendor, an election of any of the
foregoing remedies shall only be binding upon Vendor if and when pursued in litigation
and all coats and expenses including reasonable attorneys fees of Vendor incurred to
f enforce any 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 incurred, and shall be included in any judgment.
s
Upon the commencement or during the pendency of any action of foreclosure
of this Contract, Purchaser consents to the appointment of a receiver of the
Property, including homestead interest, to collect the rents, issues, and profits
of the Property during the pendency of such action, and such rents, issues, and
profits when so collected shall be held and applied as the Court shall direct.
Purchaser shall not transfer, sell or convey any legal or equitable interest
in the Property (by assignment of any of Purchaser's rights under this Contract or
by option, long-.term lease or in any other way) without the prior written consent
of Vendor unless either the outstanding balance payable under this Contract is first
paid in full or the interest conveyed is a pledge or aseignment of Purchaser's
interest under this Contract solely as security for an indebtedness of Purchaser.
In the event of any such transfer, sale or conveyance without Vendor's written
consent, the entire outstanding balance payable under this Contract shall become
immediately due and payable in full, at Vendor's option without notice.
Vendor may waive any default without waiving any other subsequen~ or prior
default of Purchaser.
-3-
N
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m3na 49.
~ i
All terms of this Contract shall be binding upon and inure to the benefits
r of the heirs, legal representatives. successors and assigns of Vendor and Purchaser
F = (If not an owner of the Property the spouse of Vendor for a valuable consideration
'Joins herein to role"* homestead rights in the subject Property and agrees to
join in the execution of the deed to be aside in fulfillment hereof.)
` Dated this 29th day of May, 1984.
t~.
VENDOR: PURCHASER:
f B•6 H EVELOPPENT, INC.
,o
BY: i C
Arnold R. Bertelsen a/k/a A. R. Berbal sen Donald E. Bjornst , President
ATTEST:
Virg a A. Bertelsen
William C. Harwell, Secretary
_ , A.: 1./~
Authentication:
y o
Signature(s) of mold R. B r Pls n,
j Viryinig A_ Be tale n' his wife-and
t gL
Donald 8_ Bjarnatad and William C. Q w~
Harwell. President and Secretary
respectively of $ 6 H_Develovment. Ipc.,
authentic ed'!l day of may., 19
i
William J. Radosevich
Member State Bar of Wisconsin.
This instrument drafted by:
William J. Radosevich
Attorney at Law
Hudson, Wisconsin 54016.
N
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ST C- 105 r
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SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
0
OWNER/BUYER
ROUTE BOX NUMBER o/ 102. Ov-_~r`azjC f S', Fire Number
CITY/STATE "Owrv -Z LP
PROPERTY LOCATION: Si SC ~4, Section T Z9 N, RIf (0,
I
Town of ~/~'l'ISon/ _ St. Croix County,
Subdivision )mxflo Lot number %l12,
I
Improper use and maintenance of your septic system could result in
its premature failure to handle wastes. Proper maintenance con-
sists 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 treat-
ment 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 systems properly
maintained.
The property owner agrees to submit to St. Croix County Zoning a
certification form, signed by the owner and by a master plumber,
journeyman plumber, restricted plumber or a licensed pumper veri-
fying that (1) the on-site wastewater disposal system is in proper
operating condition and (2) after inspection and pumping (if nec-
essary), the septic 'tank is less than 1/3 full of sludge and scum.
Certification form will be sent approximately 30 days prior to
three year expiration. o
:a
I/WE, the undersigned, have read the above requirements and agree
to maintain the private sewage disposal system in accordance with H
the standards set forth, herein, as set by the Wisconsin Depart- 'b
ment of Natural Resources. Certification form must be completed
and returned to the St. Croix County Zoning Office within 30 days
of the three year expiration date.
SIGNED
DATE
St. Croix County Zoning Office
P.O. Box 98
Hammond, WI 54015
715-796-2239 or 715-425-8363
Sign, date and return to above address.
Saksy & Buhurngs Division
Wisconsin Drpartmentof industry. SOIL DESCKIPTION REPORT P.O. Box 7969
LabCr and Human Relations Madison, WI 53707
SCS (Attach Soil Profile Location Map - To Scale - On A Separate, Signed Sheet) page of
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customer Name Soil Evaluation ate Current Lan use or Vegetative oveF Parent Materials
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ovnty ar arce ..No. Lp fjt /O Z System Loa mg ate in Gallons Per N. R. rev ay • ~Q~ a /ls
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ST GPD% X Z,7;b4u RiD E S Jt r fa,e T,PE.0 4('r$-
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Remarks: clayskins Loading
Horizon Depth Dominant Color Mottles Structure
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HOMESITE SEPTIC PLUMBING CO.
055 O'NEIL RD., HUDSON, WIS. 54016
T L z%~Z
ROBERT ULBRIGHT
rrS. MASTER PLUbfBER LIC. NO. 3307 M.P.R.8-
rf. ffY;TALLE T & DESIGNER LIC.1.*. 008 3
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Additional Remarks. r q
for
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Other Site Features:
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Limiting Factors/Depth: CST Signature Date Signed Telephone No. CST r
Soo-silo IN 01190)
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