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HomeMy WebLinkAbout022-1088-20-000 County: Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 567276 0 (ATTACH TO PERMIT) State Plan ID No. GENERAL INFORMATION Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. City Village X Township Parcel Tax No: Permit Holder's Name: 022-1088-20-000 River Falls SBCP Investments LLC, c/o Scher Kinnickinnic, Town of _ CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No: ^( 30.28.18.471 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. LA.y S Septic ti = Benchmark .5 a } ; 1 9 Z 9` Li ►G x:r L.. 3 Alt.BM / ` 1 _w GOJ✓`. q-. (e 'rZ • te DA�,o� , Po a K, Bldg. Sewer / ,15 qb, 3$ Holding St/Ht Inlet .1.' . 65 vs• S 5 St/Ht Outlet ��$5 �$ . 35 TANK SETBACK INFORMATION o Air Intake ROAD Dt Inlet TANK TO L� P/L WELL BLDG. - � � 1 d 0 111.. yo ,-•- — / / �J� Dt Bottom �` Septic 7L 27 3 S 7 �� c7 Header/Man. ,2. g./. Dosing Yo Aeration Dist. Pipe /14► a6eJ+v $4'/• -Holding Bot.System N' 1^' is V 8 s•b t 110.-7 Ss, -A Final Grade �`*•� 4 Z•3 J �1. {_o....) i5.C# gl• (� PUMP/SIPHON INFORMATION Le...� d�- • ¶4.2., Manufacturer Demand St Cover 13...s. f LI.(p R Z.L. l.�n.�� Model Number TDH I lft Friction Loss System Head TDH Ft Forcemain Catjthr .Di . Dist.to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length / No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. `-Liquid De DIMENSIONS 3 `2- 1 1 C A Ci�JC1 `- SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufactur ,c. '` �� INFORMATION Q ' CHAMBER OR yw . v TypC.+6 System: ate` 2( �6� / / ' `� SD UNIT Model _ey f, I 1J S DISTRIBUTION SYSTEM (1.1111.• kua / /5 4-15 4 15445 = ( 6 fba ie..Q.. x Hol Size x Hole Spacing Vent to Air Intake /� HeaderlManifo �� Distribution �i� 104'64 4- Pipes) - Length Dia T Length Dia Spacing �' SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over Ixx Depth of xx Seeded/S ded xx Mulched p t Bed/Trench Edges Topsoil Is No es No No es No Bed/Trench Center �'�-� g COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2: / / Location: 154 State Hwy 65 River Falls,WI 54022(SW 1/4 NW 1/4 3300 T28N R18W) metes&bounds Lot Parcel No: 30.28.18.471 ,'t �`l�' 6' 1,,,g,,b.- d-- /6 cd k d'^—. 1.)Alt BM Description= / 2.)Bldg sewer length= yZ �� 5 5uw� -amount of cover= / 1 Gam_ n i 010•51 (0 (iv, vv.o54. 4 ai�' 4.....a p.A Go eX.A Plan revision Required? 53 Yes No 11 i3 Use other side for additional information. l L. / • G v��75 Date Insepct'r's Si.j ture Cert.No. SBD-6710(R.3/97) 1 a- 4.) f? 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I C o 3 a y c c c 1 es u) c I O o I°— m o 0 o Eo E o o et VN n U N N c c U Ci r0 1 = C C O 0o » C a) C CO CO C N 0 C a) a) C O- co U LL N- a) C c C N r I ° N a) .O .O 1 FN N N c j 1� 7 m N t 7 • „fi O M Y CY to O Z e CC CC 2 (n J O Z N Z Z E = E U et ii • @ €v) ; Ti i 0 .. ii a a) a a 114 .� ' ` d a a Z'• a d a) „, , • a) c rw ` 2 Oc ° °A Oa- nc , 0 u) C) i`,` ' Safety and Buildings Division '� _ 201 W.Washington Ave.,P.O.Box 7162 r=_ Sanitary Permit Number ita be tilled r€r I»€`c s. D ! I IAa n 53707-7162 `o S i, State Transaction Number ' Sanitary Permit Application Transaction In accordance with SPS 35321(2).Wis.At#m.Cade,submission of this form to the appr,, i-governmental unit is rerpthed prior to obtaining a sanitary permit. Now:Application forms for state-owned POUTS are submitted to Project Address(if different than mailing addresss the Department of Safety and Professional Servies. Peasonal in€oms•tioa y O for secondarg ' �j € purposes in accordance with the Privacy Law,s.15.04(11(ml,Slats. # /�j '/-... I. Application Inform Sion—Please Print All Informa•t n r o 1 Property er's Name f Jt.t,. alt. / NOV 2013 Parcel# s �VUV ? Lti I� L litre 1feilis . P-iG : Os- GUS Si LNU(X LOUN l Y' Property Location P��-.� =Owner's Mailing Ad --,,.. t I ?l/i / FI'C'A C er A .)ti!1 l'6' /G Govt.Lou (i'171.21 ) , ICity,State , / 1 Zip Code Phone Number Z ;, Scotian !free 4'a� 61 MII 1 ) .� z/2271' 1r /)7- 1 7/ l T c9S' R �t`'e II.Type of8tttildtng(creek all that apply) ,�/ u I Subdivision Name iv"Ki I or?Family Dttctling-Ilttmbefo€Becirr}o ( I I cr Cl2 v�e_J I B1uWA P 1 U Public/Commercial-Describe Use ..-__nt,{)\ JD.City of I ;0 State Owned—Describe Use_ __ f M Number {1 'I Village ut . 1 0Tt ttc€� / ' c 1/ t0,46+— CeJ / i5i16 -1 S /7/V 1���/ ..._ ' 111.Type of Permit: (Check only one boa on line A. Complete line B if applicable) c I . i 0 New System Replacement System 0 TreatmeniiHolding Tank Replacement Only iL Other Modification to Existing System to Blatt; tt}t i i i- List Previous Permit Number and Date Issued B. 0 wit I 0 Permit Revision 0 tit ofPlwniwe, 0 Permit TratRSfer w Nets I 0...17,2-- r� Before Expiration I 1 Owner '"ll �� r/c`GL ii Iv.T o e of POW" S•stem/Corn I anent/Device: (Check all that a •I ) /1 IfG..°.: 0 Ph, /. on-vressurized In-),round 0 Pressurized In-Ground [1 At-Grade 0 Mound>24 in.of suitable soli 0 Mound<24 in.of mutat&soil Holding Tank 0 Other Dispersal Component(explain) 0 Pretreatment Device(explain) - V. r', a --I Tr- -- - t Area Information: Design Flow(gpd) Design Sail Appt` anon Ratc(gpdsft Dispersal Area Required(sf) Dispersal Area Proposed I ' l System Elevation 4 5 / l�G' /-,L2/Z- 86.�-Ste;s'My� h'3. S' Vi.Tank infer Capacity in _ Total g of Manufacturer ( 3 1 Gallons Gallons Units i -1 I.,? T Existing Tanks e 13 g u = = I t Septic ra Ittatfing Taak 1C '1 L G\,11 6 S el- 1 F Boxing amber NIL Re Responsibility moment-t,the undersigned,assume respessibilitty,for installation of the PORTS shown ar the stteeikd plaint. Plumber's Name(Print) ' Pi , .a Signature ` MP ' tumt:er Business Phone Number j lC« ''' A �� . ,..,1 ' I� ; ,�7Yd9 17/SJ-9375'.''56- 1 Plumber's Address(Street.City.Stare,2i, ode) P+ /kV v�' '` ' '' t / I/ • /- ' ' 2 i . VII S,, , * ■ .,eat Ilse Ont. / WAIMI Permit Fee Date ssucd 1 Issuing" it. Approved r. ,. ,/ S 'j 75' da i! I 1 /3 3 • ,� : veal Rees. for Denial II I Ix Condit6treffittlimmeessons for approval 1; Septic tank,effluent filter and 3) 61,1 6J�a-en • dispersal cell must all be servk is I maintained C 1 as per management plan provided by plumber. G-e. \,..0.4., C-4 2. Al aattgtcir requirements must.be:'m i es per applicable code t drdinenees. _ Attach to complete plans for the system and submit to the County only on paper not less than 8 in x 11)aches in site SBD-6398(R. 1111I) Pg 1 of Private On-Site Wastewater Treatment System(POWTS) Index and Title Sheet Owner XG1 /15 linen t5 T f le Sal eden y., Project Name and Sys Type: G'-__C Li 7 `"/ ' Location: 1 /l , " rL 4` L , /' . ,e),>/ StreetArldres I/b11) Legal #0,.criptio r , it tLi1 / Township/County Design Criteria(Check one): Holding Tank Component Manual: In-Ground Soil Absorption Component Manual: u SBD-10571-P(611111999) 0 SBD-10567-P(R. 611999) 0 SBD-0855-P(3 7)Version 2 SBD-10705-P(N.01/2001)Version 2 Y I C4€X Contents: Page,: 'it ,l tti it ee Page, r11 / i ff Iteet i is 17 ll Page if: PC Pages: Gl ei." (ezi Page 5: 1 `� '� /4 Page 6: Page 7: Page 8: Page 9: Attachments: Aura ri signer: 16,1 1 S ik_) )ef Signed: '' Z Credal/* tuber: !'!// f '2,29 M9 : /7/p ST.CROIX COUNTY 3 C't 6 SEPTIC TANK MAINTENANCE AGREEMENT `AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 115(J _2!l G' 5 7#"t/21s ....- 1/6/ ,-- e4 r Mailing Address , 6)1 7Yr he l (s--el 'l e �& G isrz`'ij4J 6/,-/i A 55 " i, , '�9si Property Address 157 Cam'I Sj (Verification r-.uired from Planning&Zoning Department for new construction.) City/State Kra 1°t- EA- /%. '5 J2 arcel Identification Number ()2T2 /2 CJ,_G ' LEGAL DESCRIPTION /j fi r qq.. t , (10 Ya , Sec. 3G=' T ,A- N R/ W,Town of It ii/�1,C'��/12/2/(' Property Location� G�.� /a , , " Subdivision , Lot Certified Survey Map# , Volume , Page# . Warranty Deed# , Volume ,Page# . Spec house yes no Lot lines identifiable yes 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(1)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. Uwe,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 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 ar expiration date. I/we certify that all statements on th" form are true to the best of my/our knowledge. I/we am/are the owner(s)of the property described above,by virtue of a uty deed recorded in Register of Deeds Office. Nu ber of ,edrooms lig/ , ' .' "......_ 5 t LL 2--niiern,i,evA ii/if//..5- SIGNAT ' 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) a cil Oo kl Ov �' W o Al Nh ft — c3 M ` C- £ ri t -.. .t m M o T r • o t ■ � c v > � e i MI)44 N N v . :4\\ :,,, --A o,a a ° `sr y, - �, 1. X o •t1 n x cJ . � I ci A Alp Z' z I. r t•I k "ID.4 C.7-- -4.•-..., v ' 4. 4.) I L x v u v d • fi b cc .fi g, .4N 0-41 I z . 'z;k. i, r d 1G - V1 S 1.0 lk S, ?ix- f a-(' 6 Plot p J),, 6 - OP T!-e hcl� Sys-te,-, cc,s• ,a•ik 4 i4T J'! rheilie 44.4 i14s' ___,��( • ! TTTT f r /" 4 %tip „4„,/,‘,/e #0 rv,..stiy ® 4 s 3 , ® li Ss ii.e.--..,4 tt 3 ___>. in.T-54 f 3 ‘. e t Fc 4 dp _ i 7 ?j 0 .,.,4ry c tc . L�t,'C l2�t/)4� 4 l I ` --c +-r /)�' slape 4,n_ Pie t 7`a ,h �'.'I fir,lf.r (.L✓!,1 S' t Eye p� +.4.... 'lt O 4SC.v a24; A,,isCs 47117'. !� (L) ohscrva'r'iOh ?,p e, to �tHU»,�n� -,c —p p L•,dc__ rz.«,, ., ,..4.—, w 1 ?Pi'• , P 4 5.Cderoj vJ i,"o,„ 6 c_.-t-weeir p/y cs u.h;is ,''A, t'4.4k�YL(P . 9 cnK fo..t,., ryr `., • -31,\/.77..e..--, ____.4. Aribr ,,3• t�c•+cl� aY,' ,..,y a/Gk.ii4- 1'e c , a?? A - A (t},,n,,cdi Ar, ed teem chi) s,' .Z. mic c-,,,i it(....lafi/ohs 600 4-, i r gO cy, -(.</ =-'.Y/6) — reziJS -7 0 Mini i ,, , i iv i 5 chat itai 4 C 1 tx;I.E11 ,5 z 6 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 6 of FILE INFORMATION , ,r . - SYSTEM SPECIFICATIONS Owner - <I .-/it Z'roj 7'e'u 1 S �L'Cr W e a Septic Tank Capacity f 2(.5L, gal DNA ' Permit# Septic Tank Manufacturer 0 NA DESIGN PARAMETERS Effluent Filter Manufacturer Fd/' Jo k 0 NA Number of Bedrooms 4/ ' p NA Effluent Fitter Model 5,25-- 0 NA Number of commercial Units , p NA Pump Tank Capacity gal 0 NA Estimated flow(average) 40 6t LC gal/day Pump Tank Manufacturer 0 NA Design flow(peak),(Estimated X 1.5) ''',% ' galday .Pump Manufacturer DNA n,1.1 � �_� Pump Model D NA ' Rate rr,^� aUda fftz P _ Soil Application "J 9 Y Influent/Effluent Quality Monthly average Pretreatment Unit • 0 NA Fats,Oil&Grease (FOG) 530«tg/L 0 Sand/( ravel Filter D Peat Filter D Mechanical Aeratio Biochemical Oxygen Demand (BODs) 5220 mg/L n D Wetland ❑Disinfection 0 Total Suspended Solids (TSS) 5150 mgiL Manufacturer . Pretreated Effluent Quality • D NA Monthly average" Dispersal Cel(s) Biochemical Oxygen Demand (BORN) 530 mg/L 0 In-ground(gravity) D in-ground(pressurized) 0 At-grade 0 Mound Total Suspended Solids (TSS) 530 rr►g/L 0 Drip-line ❑Other: Fecal Cofiform(geometric mean) 510'cfullOOml Maximum Effluent Particle Size Y,inch diameter tn`n-comme'dal)wastewater and septic tank effluent. .« Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every 0 months 0 year(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one-third(xV of tank volume inspect dispersal cell(s) At least once every D months 0 year(s) (Maximum 3 yrs.) Clean effluent filter d At least once every g 1.1 0 months *year(s) inspect pump, pump controls&alarm At least once every 0 months 0 year(S) 0 NA Flush laterals and pressure test At least once every 0 months 0 year(s) 0 NA Other At least once every 0 months 0 year(s) 0 NA Other: At least once every O months 0 year(s) 0 NA m4' . l'eCoNsReel Off ea%1-g,n, Alter 04 cc very are'iis•4�e1,ecom�,.e d t,4 rt MAINTENANCE INSTRUCTIONS you.i c/er+, Psi-lee. every Poll to ire.iJa Av-t 4.uw d t..r•�4 the wo:fer Inspections of tanks and dispersal cells shall be made by an individual carrying one of tf�e 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(Y)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 ch.NR 113,Wisconsin Administrative Code. The servicing of effluent filters,mechanical or pressurized POWTS components,pretreatment components, and any other maintenance or monitoring at intervals of 12 months or less 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 START UP AND OPERATION 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 tanks)removed by a septage servicing operator prior to use. =u.yuanc to Comm 83.54, Wis.Adm. Code d ci b d - Sectic Tank The static lank shall be maintained septic tank shall be ll disposed b na a in by an'individ of certified to service septic tanks unders.281A8,� The of the . septa filter shat be wilt NR 113.Wis.Adm.Code. The operating conditional the septic tat and ensure proper be The filter once '13 y by ti The outlet fie.-shell be ,used as nscasssrf to may off the mien. The removed should not be removed unless provisions are awe to retain solids in the tank that is enclosia. If the trier is an ate,the ntibe f. the alarm is accveted continuously. t Mier mat it e surge flo*s area' d g continuous al m. septic tank shat have is when the volume of sludge and scorn in the tank emeeds113 the amid volume of - the tank. if the contents of the tank are not moved at the lime of a tdennid the-meter of when the net service needs is be permed to awn loss =dm=�� or addves lo sic pr i s not naked. (Minn.lguirlingit shit be approved br sepic lank use by take t of Caanahhxho.Sdetjr and - Ehnen Tank ' ?i pump(erg)tank shali be Inspected at least once every3 years.AI switches.slams,and pumps shall be tested b very proper operation. It an diluent iris installed with ere tank I shall be • and At-< ads C. • • .ent and Pressure Distribut on S stem .-• ' be made :orand the p 't • or .we< to grow on the component. Plantings`may perimeter and the component shall be seeded and mulched as necessary - to prevent erosign and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the component is not allowed. Cold seather install- s tions require the component to be heavily mulched for frost protection. Influent quality into the at-grade system may not exceed 2Z ' 30 agile F06. Influent flow Ost$/b �Dg, 150 mg TSS and for this installation. �7 not exceed the matinee design flow specified in the permit The presume dkitribuOon system is lateral be a erg point at the end a each testis tt fs mcommem fqd that s compared required to ba ieetorben the 18 months.When Leg bus occurred amend Ptmam system ores ih:laled�o da4ratie�e Iodine equal dsbibution vain c doming h Observation pipes within the dispersal cell shall be checked for effluent pending. Pending levels should be reported to the owner and any levels above 4 inches considered hydraulic failure requiring additional, more frequent monitoring in accordance with• Coma 83.52 (2). General - ' is syiter shall be operated in 'accordance with Comm 12-84 Via.Ade.Code and shall be maintained in accordance with it!sr component manual SBD 10570-P- (1.6/99)*and local and state rules pertaining to system maintenance and maintenance reporting., Na one should overeaters . • '_ — PP M!'S comps In Comm 83.33w iMs.A�dss�t3odeewbes the tanks ore longer Sepia or tankasanide dams,mess doers and coma should be impectedhcorater lightness and soundness.'cress redound,daft*,aedforamina and SISUSSIOISI atpt be male eniallgiht upon the eewnletorh of senrice.-Any opening deemed bemused by an ub !te More most bereplaced.boded accosts openings greeter than& ahssindametershall --,. locking deice b pee+�eatauxaTdNhlni orhanss0totixed erhbpibb a fauk or edsrpsneat, the aspic ladternoycilts bspeoper beewnaAetemvsihs eakaretmppieatmthetlhet areeldtaedbi eepOse if - .pump.pumgcardedkaiaaoredebdaistgb esddedite reddeclireatsepoe ntslntbe- = rapendacwptacedwri rtea acmponmieffhas egedyn essoc , N. • at-grade comment fills to accept diet airatitt the gimlet surface, a >fastearater to �_ s nom be ! to install an aerobic; ' • the component. Additional site an soil• pre-treatment . ,nt' additiemal pis-may'8eed to be cram- to be Cane'ant ' ' Safety assn kilding! Division. .prepared and b? the Department of Ceessesce, Questions tip . - , operation or maintenance of tells system �be directed to • milk Coumty,Zemiag Office at - -'-11S.. Znak.,.6-Tc17 Pt O1O O O'1,( ` • the system installer at � • 115 q2.S- acts2 - ttoibri ,uc - ' =he teak mum enetarer at . $Op....32.3_IN.5t+ INACaeit . the effluent filter*manufacturer at ttf4 ..Z21.S1M Z Blatt- - rue. ouw -i • . 6 3 O-.$?0-4.1 ti P Goo-bs v Ow� V 0 Z W U_ E a% C o w > m 0$0 w o w E m ° o 'rn�a �m Q` W m w _m i. w c� 8 2'°m o w E a w . . o 2 N m 3 Z o.a, .a - § o c c 0 0 E w U o c °c 3 3 -ED Z p 0, w m�m� X E z Z c E E O m - - m w w c x U w w T. rn 2 y. z 0 K v U oo E `m _ �p Z as Q 1L' c - v E w VI •0 0 m g 8 E 8 '13 o ,i o z a, m W `m o m U t m ? m N 'o o m o .a Ore L CO Ii m 6 0 W IL U 3 d d a d d r�H y N O 3' K D 1n yO _1 R re re 3 1- V J I L. 1 .. ❑ 1 ■ I I I I I ulmc Cl) ° g§� B o 5. A �`l `' ' °` z ,. , o'''.1'.- . . .-, - 11;,-,.-,. ' ' ' \ ,,,,,, ' . — . 'N\ \ \ \ \ \\:\\\\, r - \y 4:,,..At- .'..-',..i,,ivt,„ 0- ,\ \ \\ \ '0.° . 4 '''-° \\' \ '''''''''*' ..i.: ''''''.\\ \ \ Q 4.i -''',. :4 \ LLI ."- '''s \ , ': 4‘fik,•'' . - 04. , ' \ O '.• „.., ''., . \ \ Wf ' . \`� , . Imo . t r u ,.-, a% '" P'''te ..\ . lig` "S �`. -A , , I iIIIIIIII1I III 1111 8 T 8 x:4118820 6 976542 BETH PABST REGISTER OF DEEDS d a o7 - /C92 ^o?()-006 ST. CROIX CO., WI d a a--/08 7- 96--dCk3 04/10/2013 11:52 AM THIS INSTRUMENT WAS DRAFTED BY EXEMPT #: AND UPON RECORDING RETURN TO: REC FEE: 30.00 FREDRIKSON&BYRON,P.A.(KNB) PAGES: 4 200 SOUTH SIXTH STREET,SUITE 4000 MINNEAPOLIS,MINNESOTA 55402 THE SPACE ABOVE THIS LINE IS RESERVED FOR RECORDING PURPOSES. SECOND AMENDMENT TO LAND CONTRACT 4 This Second Amendment to Land Contract (the "Amendment") is entered into effective as of April 1, 2013 (the "Effective Date") by and between River Falls SBCP Investments, LLC, a Wisconsin limited liability company ("Purchaser") and David Reisinger and Darlene Reisinger, husband and wife ("Vendor"). RECITALS A. Vendor and Purchaser are parties to a Land Contract dated as of February 27, 2006, which was recorded on April 11, 2006 as Document No. 822627 with the Register of Deeds of St. Croix County, Wisconsin, as amended by that certain Amendment to Land Contract dated as of March 1, 2010, which was recorded on March 2, 2010 as Document No. 912575 with the Register of Deeds of St. Croix County, Wisconsin (collectively, the "Land Contract"), relating to that certain property described as follows(the"Property"): The East Half of the Northwest Quarter of the Northwest Quarter of Section 30, Township 28 North, Range 18 West. Town of Kinniekinnic,'St Croix County, Wisconsin AND That part of the Southwest Quartet of the Northwest Quarter of Section 30,Township 28 North, Range 18 West, St. Croix County, Wisconsin, lying Northwesterly of the Southeasterly right of way line,based on the as built and traveled center line of State Trunk Highway No. 65 and State Highway Commission of"Wisconsin,Plat of Right of Way,Project T0171(4),dated May 21, 1965,of State Trunk Highway No.65. B. The parties acknowledge and agree that the outstanding balance of the Land Contract as of the Effective Date is$379,488.77. C. The parties wish to amend certain terms and conditions of the Land Contract as set forth herein. AGREEMENT For good and valuable consideration, the receipt of which is hereby acknowledged, the parties agreement that the above Recitals are true and correct in all material respects, and further agree as follows: - 1 - 1 of 4344755_1.doc The undersigned parties have executed this Second Amendment to Land Contract as of the date above first written. PURCHASER: River Falls SBCP C Inves e ts LLC \-/ By — �./I� Peter Scherer 1– President VENDOR: Tv2d" ie . David Reisinger 41-17 Oa nl•....._auu.-4 Darlene Reisinge STATE OF/t'i�t/ES ow/ ) )ss. COUNTY OF NpoiA/ ) Perez Thy,foregoing instrumen was acknowledged before me this /4—day of March, 2013, by rex ,the ,QaiheAi'T of River Falls SBCP Investments, LLC, a Wisconsin limited liability company,on behalf of the limited liability company. di_it:eat064_64.4 CARON R.ANDERSEN-BURCNETT COMM. *6067272 ;. •,,, Notary Public Notary Public ' =;� '' State of Minnesota t \``�‘‘%uuntisi%,� I .,.. Commission Expires 113112015 `�0�K..KLDET•4i• 0TAR , STATE OF ‘ C'.I151 n ) _ ; , *= ss. _* - * - COUNTY OFS It-.Q blx ) :N�•,'°UBL\G•: ?' �.,f OF V111SG.,S% The foregoing instrument was acknowledged before me this-k daVitiP1VltIrch, 2013, by David Reisinger and Darlene Reisinger,husband and wife. ,o_l_j_V% a ,t,c..4:,5,0:_c+, Notary Public Li..1/46ui w3 9- IK- 2ot6 . - 3 - 3 of 45344755 l.doc P A I_0 W i ofs (j cammer , 7 0 ()SOIL EVALUAT{O ORT / of 3 ,..-/ in arirfalice will Comm 85.Wm. Adm. Code Attach complete site plan on paper not( 1_8 1/2 x 11 sin size.Plan must �fi �'o ,.iC include.but not limited to:vertical and .. ■ : 1 ilerance pool(BM).tired=and Parcel iD. percent slope,scale or d'mensions,north arrow,and location and dance to newt road. 0.Z. ...../0 i G5's. .O- a O 0 Please print all information_ Or Date ? 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