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012-1034-10-100
Wisconsin Department of Commerce ~ ~ PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION ° taTTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 'ermit Holder's Name: City Village X Township Cam bell, Jeffre Erin Prairie Townshi :ST BM Elev: Insp. BM Elev: BM Description: I d(~ ~ ~ ~ ~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ ~~yt~,~ ~ Z+ ~V Dosing 75b AerT' r~ ~ !~ I Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic / ~~ ! ~ ~ /~ . Dosing ~ ~ / I ` f -J / .~ Aeration Holding PUMP/SIPHON INFORMATION ~`1~ Manufacturer /~ , Demand ~ ~ p u GPM Model Number ^ ~ """ ~~r ~ y. TDH Lif~ Friction Los System Head TDH + ~ 4 • ~~ ' Forcemain Leng h , Dia. f I Dist. to well f ~~ Z SOIL ABSORPTION SYSTEM ELEVATION DATA County: ~ St. Croix Sanitary Permit No: 463113 0 State Plan ID No: Parcel Tax No: 012-1034-10-100 Section/Town/Range/Map No: 14.30.17.2086 STATION BS 3 HI FS ELEV. ~o` Benchmark ~ ~ oZ. ~ ~~ Alt. BM F;' 1,~,,, ~- . a yq ~ cP Bldg. Sewer + ~ ~~. SUHt Inlet ~` ~ ~~ ~ St/Ht Outlet L• ~ / ° 3 Dt Inlet \ ~ Dt Bottom ~ \ Header/Man. Z `~ /ob • ~ Dist. Pipe •~ ~ry ~~ • O Bot. System 3•~(o iob . r Final Grade ~ ~~ ~6/ ~ ~ St Cover ~` ~ 99 BED/TRENCH Width Length No. Of Trenche PIT DIMENSIONS No. Of Pits Inside Dia. Liqui Depth DIMENSIONS //tom KJ ~ ~ ~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: ~ INFORMATION CHAMBER OR Type Of System: r f [J ~ ~ ~ ~ ~ UNIT Model Number. ~ ~ I~ISTRIRUTInN SYSTEM Header/Manifold ~ Z I /~ s Distribution ~ ~ Pipe(s) ~, th ~~ Di S i \ /Z x Hole Size '~ U , ~'~ x Hole Spacing ~ - ~~ Vent to Air Intake J Length 7 Dia pac ng Leng a - i I, tti ~ ~. 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 BedlTrench Center ( ~ BedlTrench Edges ` Topsoil , ("' ~ + 1p \ ~`C Yes [~ No es ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: OQ• '~'(~~~'~~~+ I spection #2: / / Location: 1552 200th Street New Richmond, WI 54017 (SE 1/4 NE 1/4 14 T30N R17W) NA Lo ~~~~~71 Parcel No: 14.30.17.2086 1.) Alt BM Description = ~+ ~~ ~c:;2~ ` L-~t,~j Ot~.~ ~' f ~Inr..+w'S 2.) Bldg sewer length = ~-7 - amount of cover = ~ f / Plan revision Required? ~j Yes No ~ ~~ (~ I II ~~j Use other side for additional information. ~ I ~ "~' L.__ ~~ Date Insepctor' Signatur Cert. No. SBD-6710 (R.3/97) Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162. ~' nsin isco . Madison, WI 53707 - ?l~• .,.~- ~k Number !ta be filled in by Co.) Sanitary Permit i ~ (~8) 2~'3 ~ ` ~ / "~ 3 ~f 3 artment of Commerce De • ~ p ' 1~ Sanitary Permit Appli . i State Plan LD. Number , ~ ;. !, ~= e/y Adm. Cod rsotiat inf don you pro 21 Wis In accord with Comm 83 QT = I ~~ • f ~~ t v . , . may be used far secondary purpos y La , s .04(1) " ~ ~.4 ~w ~•` ojea Address (if different than mailing address) ~~ I. Application Information -Please Print All Irtf ~~ ,C~iN~~FF J/ ^'- y-y ST Z , Property Owner's Na me Parcel /{ ~~ Property O net's M ailing Addres Property Location City, State Zip Code Phone Number ~, ~ ® J w ~, ~. (circle ) _ / 7 E ~ - Tom? N; R l ) (check all that a of Buildin II T ~ . y pp g . ype S ~` Subdivision Name CSM Number for 2 Family Dwelling -Number of Bedrooms .~-.ca~-os:_ O.tiS ^ Public/Commercial -Describe Use ^ State Owned -Describe Use - - ^City ^Village it~'1°ownship of - ~ III. of Permit: (Check only one box on line A. Complete line B if applicable) Ty pe `~' ,, ~ L7 New System ^ Replacement System ^ Treatment/Holdin Tank Re lacement Onl g p Y ^ Other Modification to Existin S stem g Y B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner ][V. Ty of POWTS System: (Check all that a 1 ) ^ Non -Pressurized In-Grourxi ^ Mound > 24 in. of suitable soil I~'~found < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Ch bet ^ Drip Line Grav 1-less Pipe ^ Other plain) ZS - = ~ ' ~ • rsal/Treatment Area Information: >C /ot~ V. D • Design Flow (gpd) Design Soil Application Rate ispersal Area Requved (st) ~persal Area Proposed (sf) System Elevation ~ ~ ~o.ror VI. Tank Info Capacity in Total Number Manufacturer Prefab Site S I fiber astir Gallons Gallons of Units / Concrete Constructed Glass New Tanks Existing Tanks Z `'L Septic or Heldictg-Tank A Dosing Chamber - VII. Responsibility Statement- I, the'undersigned, assume respo "bility for installation of the POWTS shown on the attached plans. Plumaer's Na me (Print) Plum is Si gnature -i~P/MPRS Number Business Phone Number _ Fogerty Plumbing ~~ ~ T/~ - 3s - 9`0 Plumbt•~~e~ ~tZ~tt~~tate, Zip ode) 7/S-~v3S = 3 =2 ~G F/1~X Spooner, WI 54802 6,5'i- vt- a6 - VIII. Co se Onl 70 - 7 L Approved ^ D' ap rove Sanitary Permit Fee (includes Grouttdwater Date Issued uin Agent Signatu (No Stamps) ^ er. iven Reason fo nial Surcharge Fee) ~ ~'- ~ ~ ~ p,~ n IIX. Conditions of ApprovaUReasons for Disapproval 3) ~~~~ ~ `~ ~ ~ 0~0 d~QC ~ ~ SYSTEM OWNER: ~ n .n,t3'~ c ~ effluent filter and D` tic tank 1 Se ~ , p ~ ~ /~ dispersal cell must all be serviced ! maintained ~y i ~ ~o.~ Cvla-t~S ~ ~~ ~ o T- - ~ "~ - ~C~ ~ as per management plan provided by plumber. `- ~ ~j , "d t ~ --Qom ~~"~ 5 ~~ ~ I W ~ 2. All setback requirements must be maintained nn as per applicable code/ordinances. ~'~'T" t ~ rs?~t~dl ~'"" ~~- ~ }~ 65 Attach complete plans (to the County only) for We sy em on paper no[~ma~ alrx x [i mcnes m sae ~ _ /~ ~yl~~ toe-- ~p«5... ~`- ~~`Y~ ~ u ~ . ~3) ~" l ~, 0 20 ,o ~~ f~.ya~ aoslk (F~eae) i mee - +o n. Proposed 4 Bedroom Home l2 Acre Pa-~cel Proposed 4"Astor Buildweg Sewer 98.00' 99.00' Page 8 of 8 1'ropos Wieser Concrete 1250/750 Combination Tank w/a A-100 Filter Cu~rertt Sordh P/L Easement required for sanitary system, posed 2' Sch. 40 rceMain Proposed 65x100' •und Cell w/a System Elev. of 100. 0' Note: Maintain well and waterline setbacks per Comm #1 BM =Top of 1-1/4" Steel Pipe aQ Base of Large Elm Tree ARP =Same ASSUMED ELEV. = 100 - B~ 2 =Top of Concrete Corner Post-Flaggeal Elev = 100.27' Site Plan For: Jeffrey L. Campbell Parcel in the SE1/4-NE1/4 Sec. 14 T30N-R17W Town of Erin. Prairie -St Croix Co. 200th S~ Drive BM -O 99.00' ~~ CppY commerce.wi.gov ^ ^ iscons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce.wi. gov/sb/ www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary September 30, 2004 CUST ID No.224059 KEITH E STONER 23220 WOOD CREEK RD SIREN WI 54872 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL- APPROVAL PLAN APPROVAL EXPIRES: 09/30/2006 SITE: Jeff Campbell 1552 200th Street Town of Erin Prairie St Croix County SE1/4, NE1/4, S14, T30N, R17W Identification Numbers Transaction ID No. 1054301 Site ID No. 657065 Please referto both identification numbers,. above, in all comes ondence with the a enc . FOR: Description: Proposed Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 976726 Maintenance required; 600 GPD Flow rate; 21 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual - Version~2.0, SBD-10691-P (N.O1/O1), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.O1/Ol); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD-10691-P(N.O1/O1). • The pressure network is to be constructed in accordance with publications SBD-10706-P(NO1/O1) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems -Version 2.0" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81)". • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • Comm 83 22(71- A copy of the approved plans specifications and this letter shall be on-site during construction and open to infection by auth®rized representatives of the Department which may include local S. inspectors. gp.. h.5%'.ff 4t t .. If r ~ y ~~ ~ '1s '~ V.'~ ~ KEITH E STONER Page 2 9/30/2004 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) -The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Gerazd M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. -Fri. 7:30 am to 4:15 pm j swim@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Fogerty Plumbing & Perk Testing, Inc. (plans mailed to) Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Jeffrey L. Campbell Mound Owner's Name: Jeffry L. Campbell Owner's Address: 1552 200th St. New Richmond WI 54017 Legal Description: Township: County: Subdivision Name: Lot Number: Parcel I.D. Number: Plan Transaction No.. 715-246-7357 Parcel in the SE1/4-NE1/4 Sec. 14 T34N-R17W Erin Prairie St. Croix NA NA Block Number: NA Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifiications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan . a~~~ ~~~ n~ u i n ro r ~ u ~ ui... Designer: Keith E. Stoner~~~ * ; •'"~ ~''••.; ~ L`~nse Number: Designer# 1575-007 Date: 08/09/04 ? s e-r R •': P~~e Number. 715) 653-2324 Signature:.. _ ~~ ~ C Mound Component Manual for ~1i 2.0 SD&10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01!81) Version 3.11 (R. 06/01) ~ ~' ;. _ Page 1 of 8 Utdlti~ulY GF "~i ETY xn~ . .. stE cord-~~ r,~~~_~_.~._ _. Mound and Pressure Distribution Component Design Design Worksheet Site Infor mation (r or c} R Residential or Commercial Design 400.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 600.00 Design Flow (gpd) 1.50 Site Slope (°lo) 98.85 Contour Line Elevation (ft) 21.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 100.00 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality {1 or 2) Pressure Disribution Information (c or e) c Center or End Manifold 3.00 Lateral Spacing (ft) 4 Number of Laterals 0.125 Orifice Diameter (in) (e.g. 0.25) 2.33 Estimated Orifice Spacing (ft) _ 2.00 Forcemain Diameter (in) 115.00 Forcemain Length (ft) 88.00 Pump Tank Elevation (ft) 6.50 System Head (ft) x 1.3 11.60 Vertical Lift (ft) 2.90 Friction Loss (ft) 21.00 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o tions choice 0.75 -- t00 x 1.25 x 1.50 x x 2.00 x 3.00 x Treatment Tank Information 1250.00 Se tic Tank Capacity (gal) Wieser Concrete Manufacturer Note: Sand fill (Dj calculations assures a Table 83-443 in-situ soil treatment for fecal coliforrri of <= 3g inches. 6.00 Cell Width (ft) Are the laterals the highest point in the distribution ~~ network? Enter Y or N If N above, enter the elevation ft) of the highest point. 7.14 ft2/orifice Does the forcemain drain back? Y Enter Y or N 18.76 Forcemain Drainback (gal) 90.29 5x Void Volume (gal) 109.04 Minimum Dose Volume (gal) 34.60 System Demand (gpm) Manifold Diameter Selection in. dia. o tions choice 125 x 1.50 x x 2.00 3.00 Gallons/lnch Calculator (optional} Total Tank Capacity (gal) Total Working Liquid Depth (in) gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 7$7.64 Dose Tank Capacity (gal) Zabel Filter Manufacturer 18.12 Dose Tank Volume (galCn) A100 Filter Model Number Wieser Concrete Manufacturer Project: Jeffrey L. Campbell Mound Page 2 of 8 Mound Plan View 1_ 1110 B • ' ~Observatinn Pipe ' Q .~. K ' O ;_.•.i' - .~.:. B "' -t J -~ A z I i~ L Mound Component Dimensions A 6.00 ft E 16.08 in H 1.00 ft K 9.26 ft B 100.00 ft F 9.50 in z 8.27 ft L 118.52 ft D 15.00 in G 0.50 ft J 7.30 ft W 21.56 ft 600.00 (ft2) Dispersal Cell Area 1426.70 (ft2) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 101.89 (ft) :, F////J F 100.10 (ft) --- ' Dispersal CeA ~:: = Elevation ,~: .. ~; -~` G • H Dispersal Cell ' ~ ~ 100.60 (ft) Lateral k--~-r---r:~ : ~., • invert D : ~ 1 ~~' . 98.85 (ft) Contour Elevation Shading Key Topsoil Cap '''{" Subsoil Cap • ASTM C33 Sand x -~ b. Tilled Layer Q5 Aggregate 1.5 % Site Slope Geotextile fabric Cover m fl, t- Dispersal Cell See lateral details on c °- 1 5 ft ., Page 4 for number, size, ~ c w ~ ~ ':~ O ~~ ~ and spacing of laterals. Laterals are equally • F ° m ,~ 0.5 ft Typical Lateral ~ ~ spaced from the distribution cell's " 'j s centerline in the *"-'~ A -"~ distribution cell (AxB). Project: Jeffrey L. Campbell Mound Page 3 of 8 Center Connection Lateral Layout Daigram --- -- Force main connection via tee or cross to manitotd at any point. ~E P •= Turn-up v~t~sll vaMre~ a ~E- X---~,f deanout.pJug Hales dried on the battom of the latest. Laterals are identical Laterals & (once main of PYC Soh 40 per COMM Table84.34-5 "1' ~~ Number of laterals Lateral Diameter Lateral Length (P} Lateral Spacing (S) Lateral Flow Rate System Flow Rate Total Dynamic Head 4 Orifice Diameter 1.50 in Orifice Spacing (X) 49.20 ft Orifices per Lateral 3.00 ft Orifice Density 8.65 gpm Manifold length 34.60 gpm Manifold Diameter 21.00 ft Forcemain Velocity Dose Tank Information Electrical as per PIEC 300 and --- Comm 16.28 WAC Tank component is properly vented Wlesef COf1Cr@te Ca a ~ 757.64 Volume 16.12 Manufacturer Gallons gaUinch Dimension Inches Gallons A ~ 26.24 422.92 B 2.00 32.24 C 6.76 109.04 D 12.00 193.44 Total 47.00 757.64 A f3 C D Disconnect ~_ tank. Alarm Manuafacturer S. J. Electra _ Alarm Model Number 101-01H _-~- Pump Manufacturer Goulds Pump Mode! Number #3871 EPOS Pump Must Deliver 34.60 gpm at 21.00 ft TDH Project: Jeffrey L. Campbell Mound 0. 7.141 ft /orifice 3. Locking cover with warning label and locking device and sealed watertight 4 in. min. E- Alternate outlet location Forcemain diameter ~ 2 in. Weep hole or antl- siphon device P4 ump off elevation (ft} 89.00 Dose tank elevation (ft} 88.00 Page 4 of 8 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shalt maintained in accordance with its' component manuals jSBO-10691-P (N_01ro1) and SSWMP Publication 9.6 (01181)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may tie present that could cause death. Septic and pump tank abandonment shall be to akx;ordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS kpmponents. Septic or pump tank manhole risers, access risers and covers should lie inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Seatic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of Nre septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet fitter shalt be Leaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the fitter when removed from its enlosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank ext~eds i f3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain Tess than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Puma Tank The pump {dosing) tank shall. be inspected at least once every 3 years. Alt switches, alarms, and pumps shall be tested to verily proper operation. If an effluent fitter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may tie made around the mound's perimeter, and the mound shall lie seeded and mulched as necessary to prevent erosion anti to provide some protection from frost penetration. Traffic {other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installs#ions (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mglL TSS, and 30 mg/L FOG for septic tank effluent or 30 mgJL BODS, 30 mg/L TSS, 10 mglL FOG, and 10'' cfuf100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice leaning is required to maintain equal distrbutian within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic falure requiring additional, more frequent monitoring. Contirwencv Plan If the septic tank or any of its components become defective the tank Or component shall be repaired or replaced to keep the system in proper operating condition. I# the dosing tank, pump, pump controls, alarm or related wiring becaries defective the detective components} shall be immedrately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically logged absorption and dispersal media, and related piping, and replacng said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Jeffrey L. Campbell Mound Page 6 of 8 • Site Plan Page 8 of 8 For: Jeffrey L. Campbell Parcel in the SE1/4-NE1/4 Sec. 14 T30N-R17W Town of Erin Prairie -St. Croix Co. 0 2a Sao cm~ ~°°'` c~~ 200th S~ 1 htoh = 40 ft DITVe 98.00', Proposed 4 Bedroom Home i` 99.00' %~ / 12 Acre Parcel ~ /' Proposed 4"Astor Building Sewer Propos ll~eser Concrete 1250/750 Combination Tank wfa A-100 Filter current South P/L {,~ Easement required for sanitary system. prop~~ 2' Sch. 40 ~orce Main \\ Proposed 6'xI00' ound Cell wla System Elea. of It10.,~0' Note: Maintain well and waterline setbacks per Comm #1 `_ BM =Top of 1-U4" Steel Plpe@ Base of Large Elm Tree~taked ,` ~E- HRP =Same ~~~ ASSITMED ELEV. = 1011 \ 98.00' - B~ 2 =Top of Concrete Corner Post-Flagged Etev = 100.27' #1 ~- BM --~ 99.00' U/R.It.C I I IH W U {ICIH ,Nt LA.'~ MI tl ~ - 1.1 t. t J VVIL `YIILV/-f t tVt t t \i~/ V/ \ t 1'GI~tS V~ p ~t, ,, , ~ {~ ~ f ~ ,. ~ . , , . ~.~~ww. 0~.~~~~J ~ SRN ' ~ HI ~1 r~.~ ~'~"`7 Attach complete site plan on paper not less ttran 81f2 11 itrr2res n si irtdude. but not litttiled lo: tre~6t:a1 and h ' P~ (~~~ p~p'~81~1~at!'ld~ p~~ef I.D. ~/2 '~ /©•~ - /6~ ~ arrerrsions. rtaA perrent slope. scale or d ~ ~ t' a WE+aSe ~)n1! 1 C U "J ~} tIOD Rr' b7- p l t~ersonat ldormaerr{t ra pta~ids trratr ~ {rcea tur rn ` ~. 1 ~~ b owner LL ~ F Gant. Lot ,s,~ 1K/YF' U4 'S T ~ - N R f E (or ~ ; Owner Mang Address Lot d 8bctc 0 Subd. Name ar CSIuOt SS2 ~ s /Z ~::~/zcs Cdj- Stale Zip Code Phone Nu mber ^ City ^ Viage C~-T'own N~rest Road '`~ sT /l/rw on v t 7/ ) 7 ~ [New Uottsbtr~ott lJse: ~ResideMial I Number of bedrooms ~_ Code derived design loMr role ~~l~ ~ Desad~e: l 3 i - c ar aormrerr a ^ ~ ^ Plrb Parent material .~'~.E' % .~'6 Ffood Plain elevatio n if appicade /y~A - _ tt Citrteral oomrrrer>!s artd ~®uaD -- f 1 s~.. ^ i / , ~ ____~ - ~ ~ Gramd su[taoe elev. ~J, G tt Depa~ to ~n9 r~a~or~='- ~ gpp~on Rat R t GPD/R= tiaimn Oeplh ~ Oaminant trArrrrse0 Redorr OesaipEion Clrt Sz. Cant Color Texture Slrrrcerre t'~r_ Sz Sh. Carrsistetroe Barndarr s oo _ F~ 'E~ 'EIl#2 ~ _ S SrL _ - ~ z _ .,~ - srL .3 Z ^ e°'t"y ~~ # [,,~- P8 G~rasrd surface elev. ~~•,~ tL Depdt b inrNrg factor 3~_, in. Sal gppSCetion Ratr 6POdll= Horizon Oepfh in. Dominant Riedar Dew~pliort aV. Sz Co>d Color TexMae Struchue Gr. SZ Sh. Carwislerroe 8orndary ~ 'E1~1- 'EtN2 p - L ~- .Sl" .2 C s ~ . &~ ..i - -- L /~i C S - , o - Ls - ~~ L LS ~ t:lnUBllt ~1 - 80Dy > 30 < 22Q flf0ll_ and TSS >~ _~ 1 one ~T /~~.~r .A l~ _ ~~.-~r ~ 50 mp1L ~ 82 - CDs ~ 30 mglL and TSS < 30 mgu. t~ Number ~~ ~2 Zll~d Telephone NtttrlDer r Property Owner Sis~'LL Parcef ID # ~~1 _ fo 3~.~ ~~t~ Pa9e ~ of -~ "'~ Boring # U Boring [~ pit Ground surface elev. _~. ~ _ ft. Depth to limiting factor _ 2~- Sal ication Rate i H th D Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff zon or ep in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. J~a"7~' 'Eff#1 'Eff#2 -i~ • s- 3 '- SrL ~ ~S ~ _ - rG c ~' emu/ / G ~ #3 r~.y .F U Boring Boring # pit Ground surface elev. ________ ft. Depth to limiting factor _ _ in. Sal ication Rate l C tion Descri d R Texture Structure Consistence Boundary Roots GPD/fF Horizon Depth in. o or Dominant Munsell p ox e Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 U Boring Boring # Ground surface elev. _ ft. Depth to limiting factor in. pit -- Sal ication Rate t T Structure Consistence Boundary Roots GPD/fF Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color I ure ex Gr. Sz. Sh. `Eff#1 'Eff#2 ' Eff{uent #1 =GODS > 30 < 220 mg/L and TSS >30 < 150 mglL 'Effluent #2 =-BODS < 30 mg/L and TSS < 30 mgfL The Department of Commerce is an equal opportunity service provider and employer. if you need assistance to access services or need material in an alternate format, please contact the department at 608~(>=31$~l or'f~'Y 608-264-8777. SflD-8330 (R.6/00) 2~ ~ ~~ l \ t ®~ ` ~ O N I~ / i /o ff~ ~~° ~ w o -~ -R ~' Z a ~ e O O j~q C Z `~ i 9~ a Z ly 0 R 0 f~ 1 ~~ M /~ a r n g O Y .~ 4 b n Z A 7 ~r ~ f' A '~ N 4 ~ ~` n n qk y A fl O O V ~ 4 a V .PR I 0 J4 b z 0 0 ~~ n e n ~h \ ~ Y ~ ~ ~~ a o ~1 V O N pq ~ ~ OD N ~~~N~ w~~--~~ ~-'fD ~_ ~ ~ N ~ ~ 00 ~NQ p ,~ 3 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page _.~ of _~ I~ivisinn of Safety and BuikllnaS in accordance wrtn c:omm tsa, wrs. Ham. ~.oae - County ~1 t Pl T ~ an mus Attach complete site plan on paper not less than 8 112 x 11 inches in size. include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. ictanra to naa road. percent slope, scale or dimensions, north arrow, Please print all in pD rma rtla~r. ~ ~ f V ~ ~ Reviewed by Date Personal information you provide may lse used for seco ary purposes (Privacy Law, s. 15.04 (1 (m)). Property Owner M ~ R ® 2 Br~perty ovation S ~~ .~. ( Govt. Lo ~ 1/4,/(J r1l4 S I ~ T a N R ~ ~ E (or Property Owner's Mailing Address ~ ~' '~ ZOfJINC OFF! Y t # E Block # Subd. Name or CSM# City State Zip Code Phone Number ^ City Village ~ Town Nearest Road . I C~ t- ''' ~ ~ /~Jt~-v ;c t~.'~ ~5yo/~- (7~S) -73~ ~D - ~~ n ~~ S New Construction Use: alp Residential I Number of bedrooms ~_~ __ Cade derived design flow rate ~S~~~O --_ GPD ^ Replacement T~ ~ f ^ Public or commercial -Describe: _-_-__-_-_---_--_------------------- fl U1 ~ • -_---_--- Parent material _--1,-iJ.~_---_- --_---_- Fbod Plain elevationrf applicable _-_-! General comments $y~~ ~~U, ~d~ '~$ ' and recommendations: Pc~n ~bvr el ~ V' • 99.90 ' Boring Boring # ~ ® Pit Ground surface elev. _~~___ ft. Depth to limfing factor ~~- in. Soil ~~ Rate h l i t C D tion Redox Descri Texture Structure Consistence Boundary Roots GP DIfF Horizon Dept in. or nan o om Munsell p Qu. Sz. Cont Cobr Gr. Sz. Sh. *Eff#1 *Eff#2 2 >/ /(o ~S/ M- ScL a 1'1'1. r C S - ~ ~/ . ~o Boring # I~~ Boring qG ---_ I.~t Pit Ground surface elev. L7. j~ ft. Depth to limfing factor ~ ~ - in. Sod icatiort Rate H i De th Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft~ or zon p in. Munsell Qu. Sz. Cont. Cobr Gr. Sz. Sh. *Eff#1 *Eff#2 p- / 3/~ - Sr / and /j'1 /~ L S ~v ~I /~ o -- ~ / ~ ~w - * EiflueM #1 = BOD > 30 < 220 mg/L and TSS >30 < 15U mglt_ - ttrtuem rcc = avv ~ ~v myr~ zanr ~ ~~ ~ w ~~y~~ CST Name (Please Prin ature CST Number 0~ q~~ Date Evaluation Conducted Telephone Number ~ ~ . ,~. ~ w/. s' 0 3 iy o3 ~~..~ aye ~ y`~~~. ~ ~-R. c~ ~ ° a r~ Property Owner _~~~~L / -_-__ Parcel ID # Page _~ of _~ Boring # U Boring ~]D pit Ground surface elev. _ /6~7_ ~ ft. Depth to limiting factor _ ~(~! -_ in. Sod ~~ Rate t C l i D tion Redox Descri Texture Structure Consistence Boundary Roots GPDlFfz Horizon Depth in. or nan om o Munsell p Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#1 'Eff#2 I Z. o // /~ / ~~-3lv /6 r - -- , - s~'/ ~ ~ b / r r ~ ~ S - lv.~ - ~ ~.~ r - ~ . G , 6 ^ Boring # U Boring ^ Pit Ground surface elev. _________ ft. Depth to limiting factor ______ in. Soil lication Rate D th br i t C D Redox Description Texture Structure Consistence Boundary Roots GPDffIz Horizon ep in. nan o om Munsell Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#1 'Eff#2 [] Boring Boring # Ground surface elev. _________ ft. Depth to limiting factor ______ in. ^ Pit Sorb A lication Rate t C l i D x Descri tion R d Texture Structure Consistence Boundary Roots GPD/ft? Horizon Depth in. o or om nan Munsell p e o Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mglL * Effluent ff2 = BODS < 30 mglL and TSS <_ 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. sao-ssso ~e.mioo> PAGE ~ OF~ NAMF ~f~ Yr i ~~~. ~ ~ LOT# LEGAL DESCRIPTION S r ~ ~' ~' i4 S / ~ T ~~ N R ~ ~- Elor)~~ SCALE: 1" x ~!~ BM 1 ELEVATION ADO r U BM 1 DESCRIPTION ~ v~ l~ ~`~~ ~ ~o~ ~ ~ BM 2 ELEVATION J ~ ~~ BM 2 DESCRIPTION ~~ ~ 1,~/ ~ ~~r ~~ ~O j SYSTEM ELEVATION ~~/~ ~~ ALTERNATE ELEVATION ,ti,/~ CONTOUR ELEVATION ~Q' ~~ - - -. ,. 1v ~ ~~~ ~ ~R. _ ~ ~ ~ i i_, ¢~ ~ i off' ~ ~`~~ ¢ i ~Q ~'~ ~. ,` SIGNATURE 0 ~,~~~ d " ~~'` P ~ ~ o, a ~j ~ I c , ,~-9 ~ I pJ X C ~,~ 5 ` C~ 1_ L.d1~~ ~ p,~\ ~3 ~~'" DATE 3- ~'~--Q.3 ti .~ ST. CROIX COUNTY SEPTIC TANK 14IAA1NN'TENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner~r "'' ~ rsCL Mailing Address i s S-~ 200 /~ S1' ~~~~, ~ w2 S y~ ~ 7 Property Address City/State (Verification required from Department for new construction.) Parcel Identification Number ~/~- -/OT~ '-ODD ~--E~ LEGAL DESCRIPTION Property Location S~ %a , ~'/4 , Sec. ~ T 3a N R /7 W, Town of ~,r-i ~~'~.~~' Subdivision /2 Arei~' fA-R/yi , ~t # '` Certified Survey Map # i9'Ti~~~iYT' C Volume __ ,Page # • y.t / Warranty Deed # ~'7 9'.S-~ , Volume L ~ e ,Page # Yl3 Spec house yes ~ Lot lines identifiable 31~ no SYSTEM MAINTENANCE 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 pumper. What you put into the system can affect the fimction of the septic tank as a treatment stage in the waste disposal system- Owner maintenance . reslwnsibilitiesere specified in § Comm 83.52(1) and in Chapter 12 - SL Croix County Sanitary Ordinance. The property owner agc+ees to submit to St Croix County Zoning Department a certification form, signed by the ownex and by a master plumber, jotuneyman Plumber, restricted Plumber ~ a licensed pumper verifying that (1) the on-site wastewater disposal system is in properoperating condition and/or (2} after inspection and pumping (if necessary the septic tank is less than 113 full of sludge. Uwe, the undersigned have read the above requireomenis and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the D~artraent of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been mainlined must be completed and returned to the SL Croix County Zoning Department within 30 days of the three year expiration date. ~~,._-"scud ~ `~/~ ~,:, SIGNA OF APPLICANT ~ .r•~`-~£ ~' DATE , OWNER CERTIFICATION Uwe certify that all statements on this form are true to of my/our knowledge. Uwe am/are owner(s) of the property e, b a warranty deed reco m Register of Deeds Office IGN OF APPLICANT DATE ****** Any information that is misrepresented may result in the sanitary permit being revoked by the Zoning Department ****** Include with this application a stamped warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is wade in the warranty deed. Parcel #: 012-1034-~ 0-100 10/14/2004 11:38 AM PAGE10F1 Alt. Parcel #: 14.30.17.2086 ~ 012 -TOWN OF ERIN PRAIRIE Current ~X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: TER-RAE FARMS INC 1490 190TH ST NEW RICHMOND WI 54017 Districts: SC =School SP =Special Type Dist # Description SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Owner(s): * =Current Owner * TER-RAE FARMS INC Property Address(es): * =Primary * 1490 190TH ST Legal Description: Acres: SEC 14 T30N R17W PT SE1/4 NE1/4 COM SE COR TH W 390' N 1330' E390' S 1330' -POB 11.907 AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 14-30N-17W Notes: Parcel History: Date Doc # Vol/Page 07/23/1997 834/393 07/23/1997 736/165 ~ wM 2004 SUMMARY Bill #: Fair Market Value: Assessed with: ~ Use Value Assessment Valuations: Last Changed: Description Class Acres Land Improve Total State AGRICULTURAL G4 8.910 300 0 300 NO OTHER G7 3.000 8,000 65,800 73,800 NO Totals for 2004: General Property 11.910 8,300 65,800 74,100 Woodland 0.000 0 0 All 11.910 8,300 65,800 74,100 Totals for 2003: General Property 11.910 8,300 65,800 74,100 Woodland 0.000 0 0 Total 11.910 8,300 65,800 74,100 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 138 rTy_pe `!~"' )5/21/2 Reas n l Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 11.907 Plat: N/A-NOT AVAILABLE Block/Condo Bidg: _ Parcel #: 012-1034-~ 0-~ ~0 10/14/2004 11:39 AM PAGE 1 OF 1 Alt. Parcel #: 14.30.17.2086 ~ 012 -TOWN OF ERIN PRAIRIE Current ~X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): ` =Current Owner * TER-RAE FARMS INC TER-RAE FARMS INC 1490 190TH ST NEW RICHMOND WI 54017 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description "` 1490 190TH ST SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 11.907 Plat: N/A-NOT AVAILABLE SEC 14 T30N R17W PT SE1/4 NE1/4 COM SE Block/Condo Bldg: ' ' ' ' COR TH W 390 N 1330 E390 -POB S 1330 11.907 AC Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 14-30N-17W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 834/393 07/23/1997 736/165 9Afld CI IMMARV Biil #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 05/21/2003 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 8.910 300 0 300 NO OTHER G7 3.000 8,000 65,800 73,800 NO Totals for 2004: General Property 11.910 8,300 65,800 74,100 Woodland 0.000 0 0 All 11.910 8,300 65,800 74,100 Totals for 2003: General Property 11.910 8,300 65,800 74,100 Woodland 0.000 0 0 Total 11.910 8,300 65,800 74,100 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 138 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 - - Parcel #: 012-1034-10-'100 10/14/2004 11:38 AM PAGE 1 OF 1 Alt. Parcel #: 14.30.17.2086 012 -TOWN OF ERIN PRAIRIE Current ~X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): * =Current Owner * TER-RAE FARMS INC TER-RAE FARMS INC 1490 190TH ST NEW RICHMOND WI 54017 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description * 1490 190TH ST SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 W ITC Legal Description: Acres: 11.907 Plat: N/A-NOT AVAILABLE SEC 14 T30N R17W PT SE1/4 NE1/4 COM SE Block/Condo Bldg: COR TH W 390' N 1330' E390' S 1330' POB - 11.907 AC Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 14-30N-17W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 834/393 07/23/1997 736/165 20[ld SIIMM~RY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 05/21/2003 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 8.910 300 0 300 NO OTHER G7 3.000 8,000 65,800 73,800 NO Totals for 2004: General Property 11.910 8,300 65,800 74,100 Woodland 0.000 0 0 All 11.910 8,300 65,800 74,100 Totals for 2003: General Property 11.910 8,300 65,800 74,100 Woodland 0.000 0 0 Total 11.910 8,300 65,800 74,100 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 138 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 1 Document Number u.-ZSSa~ ~1~ GRANT OF SEPTIC EASEMENT AND EASEMENT AGREEMENT ,~ ,~ ~"'r. t~ ~.Z 774'959 1l KATHLEEt1 N. 1tALSH REGISTER OF DEEDS ST. CROIx CO., YI RfiCEIVED FOR RECORD 89IZ2/2084 8$:ABAM EASE?IEkT amt ~ REC FEE: 17.80 TRANS FEE: COPY FEE: CC FEE: PAGES: 4 Recording Area Name and Return Address Keeton J. Bast Edina Realty, Inc. Grandview Professional Building 400 South Secand Street Hudson, WI5401d ~~.30. ~7. a~7 Parcet Identification Number (PiN) ova - Jo~~ oo ~ ~ INFO-PRO (800)655-202t www.infoprofomu.com , U. 2660P 414 0~3 GRANT OF SEPTIC EASEMENT AND EASEMENT AGREEMENT THIS GRANT OF EPTIC EASEMENT AND EASEMENT GREEME (the "Agreement") is made by and between ~J~~'S 1 K~ ~ t~E ~~, 5~~ F •I~itE ~•~, and its heirs, successors in interest and assigns ("Grantor"), and Jeffrey L. Campbell, and his heirs, successors in interest and assigns ("Grantee"). RECITALS: A. Grantor is the owner of real property located in the Northeast Quarter of the Southeast Quarter (NE 1/4 of SE I/4) of Section 14-30-17 in St. Croix County, Wisconsin, more particularly described on the attached Exhibit A, and referred to in this Agreement as Parcel 1. B. Grantee is the owner of real property described as follows: Parcel of land located in the Southeast Quarter of the Northeast Quarter (SE 1/4 of NE 114) of Section 14-30-17 described as foIIows: ~yl Beginning at a point which commences at the Southeast corner of f j the South half of the Northeast Quarter of Section 14, Township 30 North, Range 17 West, St. Croix County, Wisconsin, thence West 390 feet, thence North 1330 feet, thence East 390 feet, thence South 1330 feet to the point of beginning. and referred to in this Agreement as Parcel 2. C. Grantor intends to grant and convey to Grantee, for the benefit of Parcel 2, an easement upon a portion of Parcel 1 on which Grantee intends to construct, use and maintain a residential septic system. Said easement shall be located over and across that portion of Parcel 1 more particularly described as follows: Located in part of the Northeast Quarter of the Southeast Quarter (NE 1/4 of SE 1/4), Section 14, T30N, R17W, Town of Erin Prairie, St. Croix County, Wisconsin, described as follows: Commencing at the East 1/4 corner of Section 14; thence N89°57'2?"W, slang the East-West 114 Line, 33.01 feet to the West right-of--way line of a town road (200 Street) being the point of beginning; thence continuing N89°57'27"W, along said East-West 114 line, 108.64 feet; thence SOl °OS' 18"E 139.35 feet; thence 889°57'27"E, 108.64 feet to said East right-of--way line, thence NOl °05' 18"W, along said East right-of--way line, 139.35 feet to the point of beginning. Said Easement contains 0.35 acres (15,136 sq. ft.). vss~~'y fi~sr ~~ Said easement shall be referred to in this Agreement as the Easement Property, and shall be for the limited purposes and on the terms described in this Agreement. U 2660P 415 ~,~ AGREEMENT NOW THEREFORE, for good and valuable consideration, the receipt and sufftciency of which are acknowledged, the parties agree as follows: 1. Grant. Grantor grants and conveys to Grantee a perpetual easement and right-of=way for Grantee to construct, reconstruct, maintain, operate or remove a standard residential septic system, including a drain field, upon the Easement Property for the benefit of Parcel 2, according to the terms contained in this Agreement. Z. Permitted Users. The easement granted in Section 1 above may be used by Grantee anal his successors in interest, tenants, guests, and invitees. The Easement Property also may be used by the Grantor and his successors in interest, tenants, guests, and invitees, so long as the use by Grantor does not unreasonably interfere with Grantee's use of said easement. 3. Purpose, Maintenance and Repairs. The purpose of the easement created by this instrument is to provide Grantee and the other Permitted Users use of the Easement Property for the limited purposes of constructing, using and maintaining a residential septic system. Unless there is a subsequent contractual agreement among the Owners of Parcel 1 and Parcel 2 that provides otherwise, and except as provided in Section 4 below, Grantee shall be responsible for ali costs and expenses associated with all construction, maintenance, repairs, and upkeep of the Easement Property and the Septic System located thereon. 4. Easement To Run With The Land. This easement and the terms and conditions in this Agreement shall run with Parcel 1 and Parcel 2 and shall be binding upon, inure to the benefit of, and be enforceable by Grantor and Grantee and their respective successors in interest and assigns. The easement granted herein is not separately assignable and may not be transferred separately from, or severed from, title to the property upon which the easement is situated, without the express written consent of all parties hereto. 5. Indemnification. Grantee shall indemnify the Grantor from and against all loss, costs (including reasonable attorney fees), injury, death, or damage to persons or property, including environmental damage, that at any time during the term of this Agreement may be suffered or sustained by any person or entity in connection with the Grantee's activities on the Easement Property, including, but not limited to, activities such as construction, use or maintenance of the septic system. b. No Public Dedication. Nothing in this instrument shall be deemed to be a gift or dedication of any portion of the easement granted under this instrument to the general public or for any public purpose whatsoever. Dated this ti~~ay of~7 • 2044. (Grant r) a (Grantor) Je re .Campy Grantee) ' d: 2660P 416 ~~J ACKNOWLEDGMENT STATE OF WISCONSIN )ss. COUNTY OF ST. CROIX ) Personally came before one this D~day of'~E~,Ej~ , 2004, the above named ~ Grantor, to me known to be the ho executed the foregoing instrument and acknowledged the same. ary Public,'State of Wisconsin commission ~-dY"a~C~~ NOTAH~t ~=;.~i3L'sG STATE OF WtSCONStN fCERNON J. BAST tea' F' 1~ ACKNOWLEDGMENT STATE OF WISCONSIN )ss. COUNTY OF ST. CROIX ) Personally came before me this~I~ day of5'~Q , 2004, the above named Jeffrey L. Campbell, to me known to be the person who executed the foregoing instrument and acknowledged No~(ry Public, Stag of lsconsin M~ commission ~G~~G~I~ This document was drafted by: LOMMEN, NELSON, COLE & STAGEBERG, P.A. Brent R. Johnson, Esq. Grandview Professional Building, Suite 210 400 South Second Street Hudson, WI 54016 Doc. #: 28199 NOTAF~'Y r'~~~.E~ STATE OF WISCONSIN KERNON J ;BAST V 1. ~ ~~~ °~ ~ w ~ v° ---~ ~ ~ ~ ~ / ~L ~~~, ~~~ ~~ ~ ~ `A ~ U ~ g ~ -~ ~ y ~~k._ 200TH ST. EAST LINE OF THE SE1/4 -~ m r z m ~_ ~ f ~ m z ~5£'6E l 3»8 6900 lOS = rn o _. ~` ~ ~ N ~ v ~ ~ Cn° ~ O ~ ~ o~soa ~vX N `~ o ~ ~ .5 M~ 1.900 l ~ 0D. ~ N w ~~~:,~~ ~z 0 N V W W O ~ ~~ 42 ~~ c ~o ~~ ~~ ~ ~ Z~ "y~ -i ~ ~`r ~C C C~ 1~ EAST LINE OF THE NE1/4 0 i0 3Jtid tJNIl~3lIbf1S aNC~H1210N 6iLi6bLSLL 8Z ~0i b00Z/E0/60 U 2501P 002 STATE BAR OF WISCONSIN FORM I 1 - 1982 ' LAND CONTRACT Individual and Corporate (TO BE USED FOR ALL TRANSACTIONS WHERE OVER Document Number $25,00015 FINANCED AND IN OTHER NON-CONSUMER ACT TRANSACTIONS) CONTRACT, by i-trei~tt T r ore F rms Inc. ("Vendor", whether one or more) an Jeffrey L. ~mobell (` rchaser", whether one or more). Vendor sells and a Q convey to Purch r, upon the prompt and full performance ofthis contract by Purchaser, the following property, together with the rents, profits, fixtures and other appurtenant interest (all called the "Property"), in ST. CROIX County, State of Wisconsin: Parcel of land located in the Southeast Quarter of the Northeast Quarter (SE 114 of NE l/4) of Section 14-30-17 described as follows: Beginning at a point which commences at the Southeast corner of the South half of the Northeast Quarter of Section 14, Township 30 North, Range 17 West, St, Croix County, Wisconsin, thence West 390 feet, thence North 1330 Feet, thence East 390 feet, thence South 1330 feet to the point of beginning. Recording Area ~~~~8i KATHLEEN H. NALSH REGISTER OF DEEDS ST. CROIX CO. , WI RECEIVED FOR RECORD 01/30/2004 10:00AM LAND CONTRACT EXEMPT # REG FEE: 13.00 TRANS FEE: 240.00 COPY FEE: GG FEE: PAGES: 2 Name and Retum Address BAKKE NORMAN, S.C. 314 KB~LER AVENUE NORTH AMERY, 154001 ~ 00 1M a ~ r S-F P o Bo X .S/{ F,a ld~.o i n ce) l .S~{oo ~ 1~,30.17.208B O / ~' !~ 3 ~ -! d ^ Parcel Identification Numbv (PIN) This IS NOT homestead property. (is) (is not) Purchaser agrees to purchase the Property and to pay to Vendor at 1852 Cri Rd G. New Richmond, WI 54017, the sum of$80.000.00 in the following manner: (a) $10.000.00 at the execution ofthis Contract; and (b) the balance of $70,000.00, together with interest from date hereofon the balance outstanding from time to time at the rate of¢%percent per annum until paid in full, as follows: Principal »nd interest steal! be payable in monthly payments of $840.40 on the first of each month beginning February 10, 2004. Provided, however, the entire outstanding balance shall be paid in full on or before the 10th day ofJanuarv, 2013 (the maturity date). Following any default in payment, interest shall accrue at the rate of ~% per annum on the entire amount in default (which shall include, without limitation, delinquent 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 anticipated 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. In the event of any prepayment, this contract shall not he treated as 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 he 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 satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: Purchaser agrees to pay the cost of future title evidence. Iftitle evidence is in the form ofan abstract, it shall be retained by Vendor until the full purchase price is paid. Purchaser shall be entitled to take possession of the Property on /at the time of closi~., ~' Cross out one. TE BAR OF W15CVNSlrv LAND CONTRACT -Individual sod Corporate FORM No. 11 - 1982 ~' 2501P 003 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 a1 deman8 receipts showing such payment. Purchaser shall keep the improvements on the Property insured against loss or damage occasioned by fire, extended coverage perils and such other hazards as Vendor may require, without co-insurance, through insurers approved by Vendor, in the sum of Sfull insurable value. but Vendor shall not require coverage in an amount more than the balance owed under this Contract. Purchaser shall pay the insurance premiums when due. The policies shall contain the standard clause in favor of the Vendor's interest and, unless Vendor otherwise agrees in writing, the original of all policies covering the Property shall be deposited with Vendor. Purchaser shall promptly give notice of loss to insurance companies and Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall be applied to restoration or repair ofthe Property damaged, provided the Vendor deems the restoration or repair to be economically feasible. 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 and regulations affecting the Property. Vendor agrees that in case the purchase price with interest and other moneys shall be fully paid and all conditions shall be fully 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 municipal and zoning ordinates and recorded easements and restrictions of record, if any. Purchaser agrees 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 )~ 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 ,}Q days ,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 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 effect on such date and other amounts due hereunder (in which event all amounts previously paid by Purchaser shall be forfeited as liquidated damages t'or failure to fulfill this Contract and as rental for the Property if purchaser tails 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 protts during the pendency of any action under (i), (ii) or (iv) above. Notwithstanding any oral or written statements or aMions 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 enforce any remedy hereunder (whether abated or not) to the extent not prohibited by law and expenses ot'title evidence shall be added to principal and paid by Purchaser, as incurred, 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 oY'a receiver ot'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, sel l or convey any legal or equitable interest in the Property (by assignment of any of Purchaser's rights under this Contractor 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 ofany 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 shall make all payments when 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 Purchaser makes timely payment of the amounts then due under this Contract. Purchaser may make any such payments directly to the Mortgagee if Vendor fails to do so and all payments 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 be 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 ~g day ofJanuarv , 2004. /V ~--^- /~/~'"tir (SEAL) l/~/~ * ~~/l (SEAL) ` Dennis Mitchell. Ter-Rae Farms, Inc. *~frey L. Campbell AUTHENTICATION (SEAL) (SEAL) Sienature(s) ~^~^~S M~~ct•~+-~- .T.erFF2r!Y L. Gw.+~P Ac'" authenticated this Z'`7 day of January , 2004 TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by X706.06. Wis. Slats.) THIS INSTRUMENT WAS DRAFTED BY THOMAS R. SCHUMACHER BAKKE-NORMAN, 900 MAIN STREET, BALDWIN. WI 54002 (Signatures may he authenticated or acknowledged. both are not necessary.) of persons signing in any capacity should be typed or printed below their signature. INFO-PRO (soo~ss-zo2l ww..•.intbproronns.com STATE BAR OF WISCONSIN LAND CONTRACT- Individual and Corporate FORM No. 11 - 1982 ACKNOWLEDGMENT STATE OF WISCONSIN ) ) SS. County Personally came before me this day of January .2004 the above named Dennis Mitchell Jeffrey L. Campbell to me known to be the person(s) who executed the foregoins instrument and acknowled¢ed the same. Notary Public, State of Wisconsin My Commission is permanent. (If not, state expiration date: