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HomeMy WebLinkAbout042-1057-20-600 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 567223 0 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Dalton, Steven M. Warren, Town of 042-1057-20-600 CST BM Elev: Insp BM Elev: BM Description: Section/Town/Range/Map No: 20.29.18.319A60 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic / Benchmark Z , Dosing Alt. r Aeration Bldg. Sewer ( C -/np b 3 7 c-1, ~ s Holding St/Ht In t....-.~ St/Ht Outlet " TANK SETBACK IN ORMATION ed ' TANK TO PL W,,FLL- BLDG. Vent to Ai I take ROAD Dt Inlet Septic 1 / / I VI !So Dt Bottom Dosing Header/ n. j 1.-7 1 Aeration Dist. Pipe" C '3 . Holding Bot. Syste Final Grade n PUMP/SIPHON INFORMATION t-~' ' .i ~Manufacturer Demand St Cover GPM 3, C: Model Number r TDH Lift Friction Loss em Head TDH Ft C'c..• f I ! I Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM I cciA ' ~,5 BEDITRENCH Width ) Length No. Of Tre h -7 PI IMENSI S No. Of Pits Inside Dia. Liquid Depth DIM SETBACK ENSIONS fa INFORMATION SYSTEM TO P/L BLDG WELL LAKE/ EAM CHAMBWHING ER OR M ~C c e fi aT ✓4 l~ ~ Typ ystem: - { UNIT Model Number: DIM IBUTION S STEM k Gu e , S e'THeadeWanifold Distribution tf f x Hole Size x Hole Spacing Vent to Air Intak I t Pipe(s) Length Dia Length Dia Spacing 7I SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded 1xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil 0 Yes 0 No [7a] Yes H :No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: UI / 1 ~ Inspection #2: 1 / Location: 823 106th Stre obe~( if 54023 (SW 1/4 SE 1/4 20 T29N R1 8W) NA Lot 6 Parcel No: 20.29.18.319A60 1.) Alt BM Description = G-t Lk - 2.) Bldg sewer length - ~f,.7 - amount of cover = Plan revision Required? 0 Yes o Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. S-~ .4, q 2.00 V4 ~r ILIA C CA_ 0 SDP o I-IN ~ana7uEyTO~ County X Safety and Buildings Division s p S 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) ~l P S Madison, WI 53707-7162 5('0 7ZZ~ 4 1 Permit Application State Transaction Number In accordance wi 3.2 is. Adm. Code, submission of this form to the appropriate governmental unit is required prior to ini a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provi ay be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1)(m), Slats. I. Application Information - Please Print All Information C) Property Owner's Name Parcel # 042.., 16f 7. 70 L/ ~144 N 0("T ©3 Zv -ZS-is ~~~gh- o Property Owner's Mailing Address 1 sr Property Location f 1 7 3J CR~~X cOVN Govt. Lot ,/Yo City, State Zip Code Phone Number 5 tJ , , IA q /a, 10 /a, Section ~ U on J-)40 z -J T Z < N; R /,OcirclEor V) 5d~~~iL II. Type of Building (check all that apply) Lo or 2 Family Dwelling -Number of Bedrooms Subdivision Name Af o Qk 0 B oe # ❑ Public/Commercial - Describe Use /OlO~6 ❑ City of ❑ State Owned- Describe Use CSM Number 4FT"74& p❑~Village of IJ Town of W a /l-/t- l Q; ~7 +47 e (3 cd~ III. Type of Permit: (Check o ly one box on line A. Complete line B if applicable) ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) A. New System List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that a 1 Uon-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretre evice (explain) V. Dis ersal/Treat nt Area Information: 8 d Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal roposed System Elevation j-7,) `a G80 Clio. V VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units p c New Tanks Existing Tanks i c w Y a ,ca ce Septic or olding Tank © 0 0 I h 6c, V Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POW TS sho the attached plans. P ber's Name (Print) Plumber's Signature M P Number Business Phone Number 8 A c ~t £ 1,~, A Z Z L 87 7- 915--Y91 8 Plu ber's Address (Street, City, State, Zip Code) Z 1. 5- 9 Cei1SG C~1.u lYV -ft- - kKLK LAJ, . 0 VIII. unt /De artment Use Only Approved lsapp Permit Fee Dd Is sure 10 iven Reason for enial $ Al/5 IX. Conditions of Ap al/Reasons for Disapproval /n~ SYSTE WNE 3)r)1!!d~l~, ~~d.,Q,~o 4 1.J. 1,` S ictank, effluent fifteran 1 ~r fd~ spersal cell must all be s rvkes I maintained yN a -Q a xxx as per management plan provided by plumbs 0 74 L l- J°< lv . J 1 Q 1 I 010ack 0MTft muctubaftwrWinw, ss p ,lp eal~I. cod. t or, rial~: Attach to complete plans for the system and submit to the County only on paper not ss than `8 1/2 x 11 inches in size 2r 6; h.1- 44 06 T-1- i SBD-6398 (R. 71/11) CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE " Project Name: -rd .1, Owners Name: t V g l ~d N Owner's Address: _ 930 9.x/ C Da 5-Y 0;7 Legal Description: ~Ec . Z-0 -r 9 A, Township: A- e kh County: I/' Subdivision Name: Lot Number. Parcel ID Number: Z O - 2-9- le- 1 Index and title Page Page 2 Plot Plan Page 3 System Sizing & Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer/Plumber: rac' Yaw I'~t, S License Number: Date: /D-L- L3 Phone Number 7/3- Signature Designed pursu to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01). Page 1 v I h O e C 0 3 b W 10 i Soil Absorption System Cross Section gS 0 ft k4"C Schedule 40 Final Grade Vent Pipe th Vent Cap ft a Leaching Chamber f ` ft System Elevation ft j- ft Soil Absorption Svstem Plan View ft i 3 ft ft Leaching Trench 1 Vent Or Observation Pipe Chambers ffMff=MB§M 4" Dia. Trench 2 Header Leaching Chamber Specifications FEISAR urer And Model ; C S U sq ft per chamber Soil Application Rate. ~ gpd/sq ft w = ~l Soil Application Rate Z EISA = J Chambers 2 rows of /7 chambers each. Page of 3s V7 ~ ~ L ~ ~ ~ ¢R 5 r V y v ~ E O. ~ ` O 1 L y CJ ~ > lC Ono 05: t. a J R !A y v fJ _ -gi p: C ci N 3 G c D r C li v Fy Z v rj " O v r. U t ~ ~ 1 • V U` - N v ON- ;J _ r. -'S r- O~ G, ° U V U E5 J a o r~ in t o g N D~ y - ~ y E o E c ~ U- I .nP.{ ..sr~-a v C F m U G vt r y ~gg Oi cr u v c I U ai E V L N 8m r [ I O U N rrC c y I N G U D IJ L y U I _O N 61 N F' [ o I ^ o t r? nC) O u - h U ~U I o I r : N u V vDi C t ow on s7 H POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner rt. v d N~- Septic Tank Capacity /0 D U al ❑ NA Permit # Septic Tank Manufacturer G ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer S 'f ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model 6 ❑ NA Number of Public Facility Units 49-NA Pump Tank Capacity gal Estimated flow (average) gal/day Pump Tank Manufacturer .13-NA Design flow (peak), (Estimated x 1.5) j gal/day Pump Manufacturer ZMA Soil Application Rate -7 al/da /ftz Pump Model 49-NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit ,2-NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODr,) 5220 mg/L -EI'NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BODS) :530 mg/L 19-In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) :530 mg/L L -NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 510° cfu/100ml ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size Y. in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ emonth ar( ►(s) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: m nth s) (Maximum 3 years) ❑ NA Clean effluent filter At least once every: ❑ month(s) 11-year(s) ❑ NA Inspect pump, pump controls & alarm At least once every: ❑ month(s) -B-N-A ❑ year(s) Flush laterals and pressure test At least once every: ❑ month(s) 'EMA ❑ year(s) Other: At least once every: p yea(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) START UP AND OPERATION Page of 'For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant repl ement system: )KA suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in. effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name w 5f Name Phone I y g i 3 g$ Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name e- E Name S t~~t. o i x a A- Phone t j y Phone /-s- - 3 V L g This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 511-t- C 2)') / +0 n.,, Mailing Address T5 4 15.4 1-f- _D1- S~-r,~~rt_ Property Address VZ :,s / y ~ "7 (Verification required from Planning & Zoning Department for new construction.) City/State w.a (,3f_+,5 Parcel Identification Number Z® - a g -1£~ -:3,, A LEGAL DESCRIPTION Property Location '/4 , '/4 , Sec. L O , T Z-1 N R 1 t W, Town of a~~e-n-cti Subdivision Plat: , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # (before 2007)Volume , Page # Spec house Yyes no Lot lines identifiable Vyes ] no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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 function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that ( I ) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1 /3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are t e to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed r corded in Register of Deeds Office. Number of bedrooms SIGNATURE OF APPLICANT(S) DATE *'"*Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed.. (REV. 08/05) 887468 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 01/28/2009 08:00AM CERTIFIED SURVEY MAP CERTIFIED SURVEY MAP VOL REC4FEE:PA15.005603 LOCATED IN THE SW Y4 OF THE SE Y4 AND THE NW Y4 OF THE SE Y COPY FEE: 2.00 OF SECTION 20, T29N, R18W, TOWN OF WARREN, ST. CROIX COUNTY, WISCONSIN, 389'04'58"W LEGEND WY. CORNER OF SEC. 20. S89°04'58"W~ 3915.39_ _ ( ALUMINUM CAP FOUND)+ - - - - (-i$ 1304.79' . - INDICATES SECTION CORNER co (AS NOTED) BEARINGS REFERENCED TO THE EAST - g 11 - INDICATES 1" IRON PIPE FOUND WESTY4 SECTION LINE OF SECTION 20. O - INDICATES V X 18• (OUTSIDE DIAMETER) ASSUMED TO BEAR S89.04"58'W. IRON RE-BAR WEIGHING 1.502 LBS / LIN. FT. SET ■ - INDICATES Y4" REBAR FOUND UNPLATTED l o INDICATES PROPOSED DRIVEWAY LOCATION LANDS I 5~ 49 o~ N89°04'58"E 562.28' - 7)5 W v OWNER / SUBDIVIDER STEVE DALTON - 816 106th STREET TO Dedicated the Public - ROBERTS, WI 54023 12' Utility Easement 01 ---wg-i§C - N89°04'5896.25' AVprox[MMS0Ujh1ih6 of ena I the NWY4 of the SEY. b w I LOT 8 87,120 SQUARE FEET (2.00 ACRES) Approximate North line of I Ne®•oassEas the SWY4 of the SE Y4. g I o 6' M ON LOORANAGE FA LnY $ $ i j LOT 1 Lu SHOWN 5 WILL BE MAINTAINED BY THE OWNERS OF THE LOTS SHOWN HEREON AND z i ^ PROPOSED 87,120 SQUARE FEET 12 IN ACCORDANCE WITH THE PROVISIONS SET FORTH ON THE DRIVE ( 2.00 ACRES) HOME OWNERS ASSOCIATION I AGREEMENT AS RECORDED IN I DocuMENT NO. I NW*W58'E 498.08' 1 MOM THE NETPROJECT AREA OF X17 Utility Easement LOT 6 J ~ W LOT 5. E) CLUDNG THE W SETBACK , i_ 'I FROM RIGHT-OF-WAY. THE DRAINAGE EASEMENT AND A I6' SIDE YARD 87,120 SQUARE FEET ° SETBACK- 33,030 SOUARE FEET 2.00 ACRES 1 0.76 ( ) LOWEST BUILDING OPENING = 993.35' `S 01V ELEVATION =1000.71' ELEVATION --MAX-_i •r• ti ~n N86.1B'42'E449.4T % lam S 2 - \ 263.01- Z~y j NEYJ R ..HIAOND = LOT 5 tvl 87,120 SQUARE FEET ;..yf~ - - \ , p $ \ (2.00 ACRES) j LOWEST BU ILDING OPENING = 993.35' S67°40'40"W \ o ,vez.4z?a► ~_~mAe-J 66.00' cc -i----- - \~'o • Z Vg` °4724"W 361.51' x Q, S82 I I \ ELEVA ON X97.14' LOT 4 C-aAK ~ I VCYL. 17, Pa 44" \`7G \ L®T2aSLM. XI \ V01- 17, PG. 441443 I------- _ Scale in feet 1"=120' I CALAL AV VOL. 17, PG. 4444 \1 \ ( 0 120 240 I SHEET 1 OF 3 DRAFTED BY: S.E.I. REVS~DOS oal roa 66 1 of 3 Vol 24 Pzre 5603 V Vol. 1568FACC 213 STATE BAR OF WISCONSIN FORM 11 - 1982 IEs35444 LAND CONTRACT KATHLEEN H. WALSH Indivtdual and Corporate REGISTER OF DEEDS (TO BE USED FOR ALL TRANSACTIONS WHERE OVER ST. CROIX CO., WI $25,000 IS FINANCED AND IN OTHER NON-CONSUMER DOCUMent Number ACT TRANSACTIONS) RECEIVED FOR RECORD 12-18-2000 9:30 AN CONTRACT, by and between Archie Denucci and Ella Denucci, as Trustees of LAND CONTRACT the Archie Denucci and Ella Denucci Revocable Trust dated September 14, EXEMPT N 2000, ("Vendor", whether one or more) and Steven M. Dalton, ("Purchaser", CERT COPY FEE: whether one or more). Vendor sells and agrees to convey to Purchaser, upon the COPY FEE: TRANSFER FEE: prompt and full performance of this contract by Purchaser, the following property, RECaRDIECORDING FEE: 12 12.00 .00 together with the rents, profits, fixtures and other appurtenant interests (all called PAGES: 2 the "Property"), in St. Croix County, State of Wisconsin: The W 1/2 of the SE 1/4 of Section 20-29-18 EXCEPT Lot Recording Area 1 of Certified Survey Map recorded in Vol 6, page 1680, Name and Return Address as Document No. 414206 in the Office of the Register of Deeds in St. Croix County, Wisconsin. Ronald L.SI►er Van Dyk, O'Boyle & Slier, S.C. and Post Office Box Its New Richmond, WI 54017 That portion of the W 1/2 of the NE 1/4 of Section 29, T29N, R18W lying North of the centerline of that road known as 80th Avenue, Town of Warren, St. Croix County, Wisconsin. 042-1057-10-000 042-1057-20-000 (Parcel Identification Number) This is not homestead property. Purchaser agrees to purchase the Property and to pay to Vendor at 1171 80" Avenue, Roberts, WI 54023, the sum of $222,374.57 in the following manner: (a) $30,000.00 at the execution of this Contract; and (b) the balance ors 192,374.57, together with interest from date hereof on the balance outstanding from time to time at the rate of Seven and One-half(7.50%) percent per annum until paid in full, as follows: Monthly payments in the amount of $1,783.34, commencing on January 12, 2001 and continuing on the 12" of every month thereafter until paid in full. A balloon payment is due December 12, 2015. Purchaser may subdivide the premises with Vendor's prior consent. Purchaser shall pay to Vendor no less than 40 percent of die sale price received for each parcel sold by Purchaser following Vendor's prior consent. In no event shall Purchaser's principal and interest payments exceed $351,000.00. Any prepayment shall not cause the amount paid by Purchaser to reduce the overall payments to Vendor to a sum less than $351,000.00. Provided, however, the entire outstanding balance shall be paid in full on or before the 12th day of December, 2015 (the maturity date). Following any default in payment, interest shall accrue at the rate of 7.50% 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 tuxes, assessments and insurance will be deposited into an escrow fund or trustee account, but shalt 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. No prepayment without Vendors prior consent. In the event of any prepayment, this contract shall not be 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 be treated as unpaid principal) is less than the amount that said indebtedness would have been had the monthly payments been made as first specified above; provided that monthly payments shall be continued in the event of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded herefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: None Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall be retained by Vendor until the full purchase price is paid. Purchaser shall 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 Vendors interest in it and to deliver to Vendor on demand receipts showing such payment. Purchaser shall keep the improvements on the Property insured against loss or damage occasioned by tire, extended coverage perils and such other hazards as Vendor may require, without co-insurance, through insurers approved by Vendor, in the sum of the full 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 or the Property damaged, provided the V endor 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 dlis 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 ull liens and encumbrances, except any liens or encumbrances created by the act or default of Purchaser, and except: All Warranty Deeds given by the Vendors, in partial satisfaction or full satisfaction of the land contract. shall be given by those Vendors who actually hold title to the property being conveyed. -Cross out one. LAND CONTRACT- Individual and State Bar of Wisconsin Corporate Form No. 11 - 1982 INFORMATION PROFESSIONALS COMPANY FOND DU LAC. W I 800-855.2021 _ vo1.156SPAGE 214 • - 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 45 days following the specified due date or (b) in the event of a default in performance of arty other obligation of Purchaser which continues for a period of 45 days following written notice thereof by Vendor (delivered personally or mailed by certified mail), then the entire outstanding balance under this contract shall become immediately due acid payable in full, at Vendor's option and without notice (which Purchaser hereby waives), and Vendor shall also have the following rights and rcnx-dies (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 for failure to fulfill this Contract and as rental for the Property ifpurchaser fails to redeem); or (ii) Vendor may site for specific perfomtancc 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 site at law for the entire unpaid purchase price or any portion thereof, or (iv) Vendor may declare this Contract at an end and remove this Contract as a cloud on title in a quiet-title action if the equitable interest of Purchaser is insignificant; and (v) Vendor may have Purchaser ejected from possession of the Property and have a receiver appointed to collect any rents, issues or profits during the pendency of any action under (i), (ii) or (iv) above. 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 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 of 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 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 cyuitable interest in the Property (by assignment of any of Purchaser's rights under this Contract or by option, long-temt lease or in any other way) without the prior written consent of Vendor unless either the outstanding balance payable under this Contract is first paid in full or the interest conveyed is a pledge or assignment of Purchaser's interest under this Contract solely as security for an indebtedness of Purchaser. In the event of any such transfer, sale or conveyance without 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 ofthe 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 lcx'-7 day of December, 2000. E- Z,,! 7 t (SEAL) _l) L`GNl /:Li1Yt (SEAL) *Archie Denucci, Trustee Vendor *Steven M. Dalton Purchaser r' -1c~~~~^~_ ~G~• „^~ll (SEAL) (SEAL) *Ella Denucci, Trustee Vendor * Purchaser AUTHENTICATION ACKNOWLEDGMENT Signature(s) rc(t i e DR Nv cc i ~E f 1u STATE OF ) o,A SA eve W~ Ua (4- COUNTY ) authenticated this 17 day of December, 2000. Personally came before me this day of j/7~ 'y7 v December, 2000 the above named /?Zc.~.lJ r~ to me known to be the person(s) Dp v who executed the foregoing instrument and acknowledge the same. * 7lor'!a TITLE: MEMBER STATE BAR OF WISCONSIN uth authrszed by § 706.06, Wis. Stets.) Notary Public County, Wisconsin orio a THIS INSTRUMENT WAS DRAFTED BY My Corrunission is permanent. (if not, state expiration date: Ronald L. Siler ) Van Dyk, O'Boyle & Siler, S.C. Post Office Box 118 New Richmond, Wisconsin 54017 (Signatures may be authenticated or acknowledged. Both are not necessary.) 'Names of persons signing in any capacity should he typed or printed below their signatures. LAND CONTRACT - Individual and Corporate- State Bar of Wisconsin Form No. 11 - 1982 INFORMATION PROFESSIONALS COMPANY FOND DU LAC, WI 8ee-855-2021 m 0 ga • ,o,9r r-1 R . . - nano -ro,csi ~ t twxwu nook . I I I ~ ~ 9 Z^ ~ 1 II ~ ~ i ~~i y t~ 1 II q o:`__'~ t L~N z • a! ~ ,h I it h m ~ ` ~ V n , p . 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Parcel 20.29.18.319A-60 042 - TOWN OF WARREN Current ❑X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 01/28/2009 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner STEVEN M DALTON 0 - DALTON, STEVEN M 930 BRAVE DR SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 823 106TH ST SC 2422 SCH D ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 2.000 Plat: 5603-CSM 24-5603 042-2009 SEC 20 T29N R18W PT SW SE; BEING CSM Block/Condo Bldg: LOT 06 24-5603 LOT 6 (2.000AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-29N-18W SW SE Notes: Parcel History: Date Doc # Vol/Page Type 01/28/2009 887469 EZ-U 01/28/2009 887468 24/5603 CSM 06/07/2004 765184 2591/048 TI 01/15/2003 705988 17/4444 CSM more... 2013 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 08/06/2010 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 2.000 400 0 400 NO Totals for 2013: General Property 2.000 400 0 400 Woodland 0.000 0 0 Totals for 2012: General Property 2.000 400 0 400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wis. Dept. of Safety and Professional Services SOIL EVALUATION REPORT Page of 3 Division of Safety and Buildings in accordance with SPS 385, Wis. Adm. Code County • ~.it~ d X Attach compl>lim* paper not less than 8 1/2 x 11 inches in size. PlanIqust include, but nt ertical and horizontal reference point (BM), direction a t Parcel I.D. percent slopem lions, north arrow, and location and distance nearest O Z - g 'I O print all information. n- i by ;;1,1112 Person or provde may be used for secondary purposes (Privacy Laws s. 15.04 (I~(j Property Ow Pr Location j L o) A, - Govt. Lof ty 1/4 3~ 1/4 S a T /Z-9 N R/,? E (or)q Property Owner's Mailing Address Lot # Block # Subd. Name o CSM# 930 Z>11 4 City State Zip Code Phone Number ❑ City ❑ Village ®Town Nearest Road O./Ynazu £-f "JI '•Y0LS' ( ) Lv ct.t_,C~ f ✓ /06 -f4 -Y4. New Construction Use: ® Residential / Number of bedrooms %J Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable ft. General comments and recommendations: ~ ~ Q I ~ ~ ' 47 / 2- ❑ Boring Boring # F-/1 ® pit Ground surface elev. g~ s ft. Depth to limiting factor / in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 * ff#2 S 74, 9'7 -7 S'9,,0-51Y S OJ 1-7- Boring Boring # ❑ Boring C , / 7 p 9 pit Ground surface elev. '1~ ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft z in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 01 ff#2 / / Ia ,c / - vac a 5 / SF . 7 oZ y/ bir . t, Z . ,3 ,S,j K Rs _ - , 3 Y/Y i All. * Effluent #1 = BOD > 30 < 220 mg/L an SS 30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Na ( lease Print) Signature CST Number ae5 111, 1~ - A~"A kz~~~ Z 2- Z 97 -JL- Address Date Evaluation Conducted Telephone Number Z 1, 5 1.5-0 ~uC K" fem. -Y'q .3-3 9- -7-/~ f9/- 3~e" SBD-8330 (RI 1/11) Property Owner Parcel ID # Page c2 of 3 Boring # ❑ Boring p O' F31 0 Pit Ground surface elev. 7 J ' ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 02 - q 7 D ~3~o D y~y C l /11, 17 b x Gt S ! 2-- 3 ~yo ~ 7.3y~ y~Y - ~ I - - 7 L Boring # ❑ Boring ❑ Pit Ground surfabe elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 * 02 Boring E Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. * ff#1 * 02 * Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2,= BOD 5 < 30 mg/L and TSS < 30 mg/L The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay. SBD-8330 (RI l/11) it 1 Property Owner Parcel ID # Page pa of cJa F-3-1 Boring # E] ® Pit Boring Ground surface elev. ft. Depth to limiting factor f in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft z in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. tf#1 * ff#2 C:;~ i 3 zfe a Y/y ( 44 1/7C S 1 z- • 3 I ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. * ff#1 * ff#2 Boring F-1 Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 *#2 * Effluent #1 = BOO s > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2,= BOD 5 < 30 mg/L and TSS < 30 mg/L The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay. SBD-8330 (RI 1/11) O a r lu- ,F s ~ 61 ~ h d r z F R Ilb v w ~ ILI\ 1.4 c Irk cl- o ~