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HomeMy WebLinkAbout020-1264-50-000 O d O h ~ O 69 ci M tl N O� CO tl h O 1 I N I O L �L I y I W C Z LL c 3 a Cl) N Z E Z = O Z 0 IL m 0) N I- Z C O C o O Z V v aUi Z Z N H r v m N im C @ N y N Q z m z _ N _.. z 7 C 7 CV E E o i rn a 'M .��. y � y ooca` � L c to to ti j 2 u EL in .� 000 o g C N �l N IL �1 O O N J V = rn co co } (D 'L+ 6) O O a j :3 m U a c T+ ° co O _o E O �r o C O N 3 I � C V a 0 \ E 'y 'D N V COQ CO - C U) C) w".4 0) co O N O (N Z —11-0 W g °L CO .r a EL a d d a t`iv y E E c °' Parcel #: 020-1264-50-000 o2ios/2oo5 09:30 AM PAGE 1 OF 1 Alt. Parcel#: 29.29.19.1286 020-TOWN OF HUDSON Current Xi ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): *=Current Owner *POLINSKE, DALE R DALE R POLINSKE 510 COUNTRY VIEW RD HUDSON WI 54016 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *510 COUNTRY VIEW RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.000 Plat: N/A-NOT AVAILABLE SEC 29 T29N R19W 2 ACRES PT NW NE,SE NE Block/Condo Bldg: &NW SE LOT 19 ROSSING'S COUNTRY VIEW FIRST ADDITION Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 29-29N-19W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 855/433 2004 SUMMARY Bill#: Fair Market Value: Assessed with: 49327 199,100 Valuations: Last Changed: 10/29/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 30,000 124,000 154,000 NO Totals for 2004: General Property 2.000 30,000 124,000 154,000 Woodland 0.000 0 0 Totals for 2003: General Property 2.000 30,000 124,000 154,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 141 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 -u-OMIAERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715 - 962 . 3121 800 - 962 - 5227 , . ST, CROIX ZONING REPORT NO.! 17754/01 PAGE 1 ST, CROIX COL)NTY REPORT DATE: 2/06/92 COIIRTHOUSE DATE RECEIVED! 2/05/92 HUDSON[ WI 54016 ATTN! THOMAS C. NELSON /2 v1,Y3 OWNER! Da Le Polinske LOCATION! 510 Countryview Rd., Hudson COLLECTOR! M, Jenkins DATE COLLECTED! 2-04-92 TIME COLLECTED! 3lOOpm SOURCE OF SAMPLE! Kitchen faucet DATE ANALYZED12-05-92 TIME ANALYZEDl2lOOpm COLIFORM! 0 /100 ml INTERPRETATION! Bacteriologically SAFE NITRATE-N! < 1 ppm Above 10 ppm exceeds the recommended Public Drinking Water Standard, Coliform Bacteria/100 al Nitrate-Nitrogen, mg/L 9 10 LAB TECHNICIAN! Pam Gane �,pDli[NOENr WI Approved Lab No, 19 IL < Means "LESS THAN" Detectable Level Approved by! �'� ® PROFESSIONAL LABORATORY SERVICES SINCE 1952 ST. CROIX COUNTY ZONING OFFICE 911 4th Street Hudson, WI 54016 Telephone - (715)386-4680 The St. Croix Co. Zoning Office offers the service of septic and water inspection to Lending Institution, Realty Firms , and private individuals. COMPLETION OF THIS FORM IS ESSENTIAL SO THAT THE PROPERTY CAN BE LOCATED. Please provide the following information, enclose appropriate fee made payable to ST. CROIX CO. ZONING, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. WATER TESTING--------- FEE.$ 25.00 (For nitrates and coliform bacteria) WATER TESTING------------ FEE:$175.00 (VOC'S) SEPTIC SYSTEM INSPECTION---------------------FEE:$ 25.00 PROPERTY OWNERS NAME: DA LE -380 / 6 - I r PROPERTY OWNERS ADDRESS: .j(O e'0QWtW(JC TY: }i'G(V,>C1kS I(J I Legal Description 1/4, 1/4 , Sec. , T N-R W, Town of- ,Lot No.12 ,/Subdivision- T S FIRE NO. LOCK BOX NO. ` , 0 �O� & / J U -zr � 6 Color of house .Realty sign? PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP, i.e. , COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual requesting services: Telephone No. REPORT TO BE SENT TO: CLOSING DATE: Signature: 0 '00 rt _ 0�j-&1676 ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse JO 911 4th Street Hudson, WI 54016 Telephone - (715)386-4680 The St. Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion of this form is essential so that the property can be located. Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. WATER TESTING----------------------------FEE: $ 35.00 (For nitrates and coliform bacteria) WATER TESTING FEE: $185.00 (For VOC'S) SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00 (Determines if system is properly functioning at time of inspection) ke PROPERTY OWNER'S NAME: PO L_=,,�- (ye PROP. ADDRESS: 510 cn Aw It w W CITY ds Legal Description 1/4 of the 1/4 of Sectio , T N-R Town of � � Lot Number Subdivision: FIRE NUMBER LOCK BOX NUMBER Aotdri�00 Color of house- &26WO Realty sign by house? 0 If so, list firm: PLEASE INCLUDE, IF AT ALL POSSIBLE, A HAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be //gained. Firm or individual requestin services:_IJc.t�� el k'y\- -�- Telephone Number REPORT TO BE SENT TO: t G a 510 Cot,W c s 1 CLOSING DAT Signature �e b5�5-� IONW ,CO"ERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715 - 962 - 3121 800 - 962 - 5227 FAX - 715 - 962 - 4030 ST. CROIX COUNTY GOVERNMENT REPORT NO.'# 45873/01 PAGE 1 CENTER RFPORT DATE: 8/03/93 1101 CARMICHAEL ROAD DATE RECEIVED: 7/29/93 HUDSON, WI 54016 ATTN: THOMAS C. NELSON OWNERS Dale Potinske LOCATION: 510 Country View Rd., Hudson COLLECTOR'# M. Jenkins DATE COLLECTED: 7-28-93 TIME COLLECTED: 11'#30am SOURCE OF SAMPLE*# Outside faucet DATE ANALYZED447-29-93 TIME ANALYZEDS2t00pm COLIFORM,MFCC; 0 /100 mL INTERPRETATION'# RacterioiogicaLLY SAFE NITRATE-N'# < 1 ppm Above 10 ppm exceeds the recommended Public . Drinking Water Standard, 1� Coliform Bacteria/100 mL ` p� Nitrate-Nitrogen, mg/L OD ` sT S 1993 N c CU LAB TECHNICIAN! Pam Gane <a .O``.NDEOENDfNT 4, WI Approved Lab No. 19 i; SA < Means "LESS THAN" DetectabLe Level Approved by'. ® PROFESSIONAL LABORATORY SERVICES SINCE 1952 Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER Scz �f/i ��Y TOWNSHIP I�e �<cs N-R -z-� SEC. a Ta�_ ADDRESS ­ 8 Z ST. CROIX COUNTY, WISCONSIN fcc1 s •'A 4 U LOT 9 LOT SIZE SUBDIVISION ,l 7�/ � �� PLAN VIEW 0 a0' Distances and dimensions to meet requirements of 11HR 83 6 v��%" .(ZO CAN SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Loth 19 1 Sy srt 5 ea '� ' Q.)`�i WLII �}ou5ci \\v 5H rP1$� 0 is 4t , INDICATFJ%ORTH ARROW BENCHMARK: Describe the vertical reference point used I /01 P,'ua SW 161- �o► nQ✓ Elevation of vertical reference point: [DO-0':_ t,7® Proposed slope at site: Q1, SOwtti SEPTIC TANK: Manufacturer: \,0 Liquid Capacity: \©00 ckp�_\ Number of rings used: ;7� Tank manhole cover elevation: . Tank Inlet Elevation: _%7 �q-3ank Outlet Elevation: Number of feet from nearest Road: Front 10 Side,o Rear, O feet From nearest- property line ' Front,OSide10Rear,� S feet i Number of feet from: well , building: 159 (Include this information of the above plot plan)( 2 reference Septic tank) ced REVERSE SIDE j PUMP CHAMBER J� Manufacturer: A/ Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear,0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Lonvcn %o, f Trench: Width:/$ Length: 3(a Number of Lines: 3 Area Built: Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, © Rear V pt .3o Number of feet from well: -6--c Number of feet from building: 41s_ (Include distances on plot plan). SEEPAGE PIT Size: //(/# Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on. any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Coracity• Number of rings used: Elevation or bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector• ' v Dated: Plumber on job: , License Number: 3/84:mj ♦ :DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS P.O.13 & HUMAN RELATIONS \ PRIVATE SEWAGE SYSTEMS DIVISION P.O. ISON,WI ,1}/ BUREAU OF PLUMBING r�ADISON,WI 53707 (" (�"- NW4NE 4,T29N-R19 ,� � ' El CONVENTIONAL ❑ALTERNATIVE State Plan I.D.Number .�f,J� (If assigned) Town of Hudson , ���"+/� Holding Tank ❑ In-Ground Pressure ❑Mound Country View Road NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Sam Miller Box 282 Hudson WI 54016 ld y�d'f /0;6d BENCII MARK(Permanent reference point)DESCRIB R DIFFEENT FR07PLA� �) 77JJ REF PT ELEV.: CST REF PT ELEV.- Name of Plumber: MP/MPRSW No Coumy: Sanitary Permit Number: Dou las 5432 St. Croix 128643 SEPTIC TANK/HOLDING TANK: 7UFA)TURER: - LIQUID CAPACITY: TANK INLET ELEV.. TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVI ED: PROVIDED �� v P'e 1 ` +� l 1 �- 0 I (�J� YJYES ONO OYES O BE 1 VENT D A. VENT MATL- HIGH WATER IN UMBER OF ROAD: PROPERTY WELL- JBU/ILDIN VENT TO FRESH ALARM FEET FROM LINE � / �, / /, 1lAIR INLET ❑YES NO 1� ❑YES O NEAREST \o[ I ' DOSING CHAMBER: MANUFACTURER. BEDDING: LIQUID CAPACITY jP1 I MO DEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO 10YES ONO OYES ONO GALLONS PER CYCLE: PUNDC NTR L P RATIONAL: NUMBER OF PROPERTY WELL BUILDING VENTTOFRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET: PUMP ON AND OFF) ❑ ONO NEAREST SOIL ABSORPTION SYSTEM.Check the soil ois a at the depth f plowing LENGTH DIAMETER MATERIAL AND MARKING or excavation. (if soil can be rolled into a wi ,construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: �+4 WIDTH LENGTH. NO.OF DISTR.Z;PACING: 5,ERIAL: .INSIDE CIA.. #PITS-. LIQUID BEpI it.6 14 TRENCHES PIT DEPTH: �kOrjT t1NkS R/ GRAVEL DEPTH FILL EPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO.D NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH RE LOI Vy PIPES gBOV COV�R ELEV.INpLET.EL N�DL- '`'� (� PIP - LINE / AIR INLET:OM N ARESI Q MOUND SYSTtr.? Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- ❑YES ONO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER ITEXTURE PERMANENT MARKERS: OBSERVATION WELLS OYES ONO 1OYES F-1 NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED. SEEDED. MULCHED: CENTER. EDGES: DYES E NO DYES ONO OYES ONO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH. TRENCHES: LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: 0�3fEN5fi�NS '' MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL. NO.DISTR. JDISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING. ELEV.: ELEV.. DIA.. ELEV.. PIPES: DIA.: IxLEVAT"AM T #ItN HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED 1itATIC3N` PLANS. ❑YES ❑NO ❑YES ❑NO MMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET F DYES 1-1 NO DYES El NO PIEEix`iF�, , tern on Retain in county file for audit. le. SIG RE: TIT LC,� 16710(R.01/82) v4 c , LlILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05,Wis.Adm.Code COUNTY STATE SANITARY PERMIT# -Attach complete plans(to the county copy only)for the system,on paper not less than ❑ !a (p y3 8%x 11 inches in size. Check i revision to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D.NUMBER 1. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION �- " ¢ &)Y./t/A '/a,S Z TZ , N, R / E(or W PROPERTY OWNER'S MAILING ADDRESS LOT# BLOCK# w y I Z S Z_ CITY,STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER II. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD ❑State Owned VILLAGE � Sa o G� ❑ Public 1 or 2 Fam. Dwelling�#of bedrooms PAR EL AXNU BERG III. BUILDING USE: (If building type is public,check all that apply) )Z `d G 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. 7�' New 2. El Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.El Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit## — Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 PA Seepage Bed 21 El Mound 30 El SpecifyType 41 El HoldingTank 12 Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1.GALLONS PER DAY 2.ABSORP.AREA 3.ABSORP.AREA 4. LOADING RATE 5. PERC.RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED(sq.ft.) PROPOSED(sq.ft.) (Gals/day/sq.ft.) (Min./inch) ELEVATION 1S I> S &V8 O- Z- `' 3,C/):;'Feet qt­00 Feet VII. TANK CAPACITY Site in allons Total #of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Con Con- Steel glass Plastic App Tanks Tanks strutted Septic Tank or Holding Tank Dm d Lift Pump Tank/Siphon Chamber VIII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name(Print): Plumber's Signature:(No Stapp) MP/MPRSW No.: Business Phone Number: Plumber's Address(Street,City,State,Zip Code): or 6 � ,Q.', IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee(Includes Groundwater a e Issued Issuing Agent Signature(No Stamps) CKApproved ❑ Owner Given initial Surcharge Fee) Adverse D termin ti n X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(formerly Pib-67)(R.11/88) DISTRIBUTION: Original to County,One Copy To:Safety&Buildings Division,Owner,Plumber INSTRUCTIONS V ' 1 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. • 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete#of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these,surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398(R.11/88) b Y' tr Purchaser promises to pay when due all taxes and assessments levied on the Property or upon Vendor's intend 3 in it and W deliver to Vendor on demand receipts showing such payment. t'nrcli.:t L ah m all keep the improvements on the Property ins-red against loss or damage occasioned by fire, ex t. rut:led coverage pr7tM*"AMch other hazards us Vendor may require, without co-insurance, through insurers appr0Ted by Venriur, in the pint of li " :.- ...... . . . but Vendor shall not require coverage in an amount more R , than ti* Bala Tce owed under this Contract. Purchaser shall pa tlla insurance premrims when due. The policies shall c-,rilaru use titand:tad clause in favor of the Vendor's interest anrunless Vendor otherwise agrees in writing,the original of tell policies covering the Property shall be del oaitt'd with Vendor. Purchaser shall promptly give notice of ion to *€f 3•` ire unsure companies and Vendor. triless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall IN• ap• , Uo-restretation or repair of the Property damaged, provided the Vendor deems the restoration or repair•to bt t'r 1 nets r c•ry na Its not to comrnit waste nor a1wx waste to toe commie-•d on the Property, to keep the Propert; g in ,re„'d I,nanitebie condition and repair, to keep the Property tree from liens superior to the lien of this Contract,and g to r,•n:oly with all laws, ordinances and regulations affecting the Property. r t'endor agrees that in case the purchase price with interest and other moneys al.all be fully paid and all conditions 5. shall be fully performed at the tunes and in the manner above specified, Vendor w-ill on demand, execute and deliver to the Purchaser, a Warranty Deed, in fee simple, of the Property, free and clear of all liens and encumbrancer, except are) lien., o: encumbrances created toy the act or default of Purchaser, and exc•:pt: exis Ling„)tighway_.•....�.1t.. $8t 3 or West.fences .encroach_pn th1r:..Qr..adJQAn1nK Jand,..w4rranty tD. Imad••- between .such. fen�e3,-and..true,.descriptiun_,lines. -.•. _„ ............................................... .. ...... .................................. ............ ..._ . . __ _. ........ ............................................. . F ......---...I.................. ................ _. . ................ . .............................. Purchaser agrees that time is of the essence and (a) in the evert of u default in the payment of any principal or intert•st which r•ontinues for a period of ...60...days following the spi cified cue date or Ib) in the event of a default in l,erf,.r^ u'• of an': other obligation of Purchaser which continues for a l.eriod of..6.0.... days following written notice tten• i i,• X'en+,r (deiwered personally or mailed by certified mail),then tl a entire out-tanding balance under this contract x sr.all h:•,:vie it,:mi•diately due slid payable in full, at Vendor's option c.r.d w,thout notice (which Purchaser hereby w„i. t, %!tai l"rr:l•:r :hall also have the following rights and rune i!,- r<;:1,.ct't to any limitations provided by law) in t:,too=e provided by law nr in equity: fir Vendor may, tit h!, ption, terminate this Conu::^t and Purchaser's s' elanf.!r, ti!% ::n"f inters>t in the Property and rernc,•r the Nope•rt•; bash through strict foreclosure with any equity of r„ic:,:ptn,r: tr L. f ho:m d upon Pulcha­t', c!:li p:.•no nt oe te"• t nt:rr • tat t:vuliu;! had:cue, w nth interest thereon from tf.•• •inn•• • +, : T'" rate n tff t on suen date and otheramount duchercundctiinwhicheventallaruountsprevious ly` 1'••r,.+.+ ,r -hall he forefe:t,•i as liqui•i+ .•,! ,I;.n, :_e: f.,r :Tr• t•. :?':!1 1!ti- Cor.11:J"t ::rfl rr'ntrl for the• 1, I'n,p,rty i ;:, c!:aser fail; to redermr; or fit) ter:,fo .to.,c sue fir':-pul:Aw' performance of thus Cor:trac•t to eompll nnmed:atc and :::II payment of the entire out nand. ;;•h,1Lu"e. with inn,re a the-rt-n :it the rate m efft•ct on the date of r def:uta and r,tt.er amounts flue hereunder, in whico event the Property sl,x!l be auctioned at judicial sale and Purchaser, shall be liable for tiny deficiency-. or (iii) Vender may sue it L,y' for the entire unp:,id purcruse price or any portion V.tr,-,f; or (iyt Vendor may declare this Contract at «n end awl rtnu,ee this t'„n!ractasacloud on title in a quiet-title ' u,t.••+: a Use ,•,tuitablc• interest of 1'urr•haser is in-icr,ifieant: and (v► \'t ndor may have 1'u:chn•er ejecA•d from possession of the Trope rtv and have a receiver appointed to collect any rent, i—ii— or profit.: during the pendency of any action under (i), iii) or (iv) aboce.Nnhcithstal:di!!g any oral or written -tatenterits nr nctions of Vcndnr, an election of any of ti a forc�-oinr n rtiv&vs shall only be binding upon Vtnd,:r if avid wi.en pursued in liti¢•/tion and net: costs and expenses inclu,ing run—ir,l le attorneys fees or Vendor incurred to enforce an;: ran:r•,iy hereunder (w•-ether abuted or not o to the esttnt nc,t tr„'iit,ite,l he law and expense- of title evidence shall be added to pr:nc•ipal and paid by Purchaser, as in- rurre,l, and -hall he 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 hnme-t.ead �rtt•rc<t.to collect the rents, is-Rues, and profits of the Property during the pendency of such action, and such rents. issues, and profits when so collected shall be held aad applied as t}it(-:,tart shall direct. Purchaser shall not transfer, sell or convey any feral or t,,nitahle :r,terv%t in the Property (by assignment of any of Purchaser's rights under this Contract or by option, long-term lease or in any other way► without the prior written consent of Vendor unless either the nutstanding balance payable un,ler this Contract is first pai(: in full or the interest conveyed is a pitdcre or assignment of Purchaser's inter,•st under this Clint Tact solely as security for an indebtedness of Purchaser. In the event of any such transfer, sale or conveyance w•ithw;t Vcndnr's written consent,the entire outstanding balance payable tinder this Contract shall become immcdintclyd'te and payable in full, at Vendor'` option without notice. Vendor shall make all p%yrnents when due under an' mortgage out=landing against the Property on the date of thi- Contract texrent for any mortgage granted by Purchaser) or under any note secured thereby, provided Purchaser mnkes titrely payment of the amounts th.n due under this Contr:.c•t. Purchaser no-v. make anc such payments directly to to Afortcacee if Vendor fails to do so and all na;n;Pear so +Wade hr Purci aa,r +'rail he considered payments made on tF.is ('nr.!rnrt. 1'(riflor may waive any' default without waivinc nny other subsegl+tnt ,:r prior default of Purchaser. All terms of this Contract shall he hineine upon and inure to the hene3ts of the heirs, legal representatives, succeanrs and assigns of Vendor and Purchaser. (if not an owner of the Property the arouse of Vendor for a valuable eonsidernt}on 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.) leattd chi. 16th day of November 19 87 . Izl:al.r � ' v� tSEAL) or E. Rossin / Sam K. `filler ��'r� yL- .�(� ::.11 , (SEAL) Ruby )bailey AUTHENTICATION ACKNOW LEDGMEN iV `i:;nat•rrri-1 all parties ... SPATE OF WISCON�I`: } I ss. _.. ........... ........_. .......... . ' ....... .. . _ _County. t 11 :4 16tlijac of Snvemter .. 1987. Personally came before me tha ... _ .(ia of 19. . .... the above named .John H^%.Wo d _ _..._ ._ ..... ._ ..... : NIEMBI-A. ST.\T}: BAR OF WISCONSIN Wi-. St:1t?.) lio i... 1,� tl!e lc tint\TT t�? !�e• i T'Of��,l1 w}te C\:•C�tel L f„rc r.in in�tr:.�sr•a ..-:,! .,•.krnwif ice 2'r -a'^(-. John D. Heywood, Heywood, Cari S `lurra\ - Nudson, hisrc�n5in 54016 , . ,. :•?:. Coe 1:. n =. ',.1 ,r •, ,r ncl,,l” •i. C + M% t':,n re rn ..,',•... ,if not, state c\riration r � \ date. 13 ) I.:y\r a„NTR%I r— Inns.iAua nod c,trverate,—state nor of wi•r•endn, Ferns Vn`It—1',-: vow 4 VOCU NO 8TA'tS D"�f Tool it-MM ire 11Kq �70N ^ ACT tmAw" .. s'� i�-_ arBA........._..-....-............ ................. .San._E,,...�lt�ex--•--•--......._._. .............. . ....... � in moat) ............................................... .. ............ n�a ..foe+)• > *- _._;- do h{ �IMier s�cal app tO 008M a � parchr,the fouowm9 P bwaw by r r ail alMi 1 t r 71 ooe-6a1f of 1[ortheast Quarter �t east $ rods, and the Northwest -" the rter (1(W"�SFk). except ?asi<swd ,: ,` $N► r of $ottthsasi Section 29, T29N, 19ii. ' Wirth,b rods 2 G v 1� .>' w vq a vesia aR.20b . { fir 1 tM lew f _b tint f�riowiNg��: ta) asd E#1 tip Wbom e<i ►, :.�.._....------�r . fjo Idw at do interest to jamomy dip< � va the id fee e of pp tits balms a 3saeosil`! 11• , the a*&" balafee on Jarar7 t �,tIm to am !�!� 961011 be 0060 Y r. be by 2 ems, full. oaseb Vendor tee mismad Ow 4 10'9 loo =storm NMS + +�ar taw saM a" UPON wlMue a awasme�.a.i.w«a irrt..+oi< Y Ir Now 11111111111v �� so "a bs Prepaid � alrw m7 is saAmeet w the =paid a mam at tie 910 dMWMSVP%d e6d1 sat be t"I"d as i•4 !aeta�i►itirr s Mk'1M eM at W>�M>Wit"��(asi is such ew aae�t °tj w i ban the ,,,e at teat acid Ind o e.aitMrd L east Id r seRi� VA* t5t title as shorn by of ftW title evidenta. It titM aRideaea(a �fer.i f atu+f paid _+f .r atttil t11a tnll Pareeaw price�s the d*te t►a11 bee kUtW m tab P ion of the ProP�l► _:_ i` ti APPLICATION FOR SANITARY PERMIT S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. ------------------------------------------------------------------------------- Owner of property /01.�l�m✓ Location of property 1/4 lE 1/4, Section :Z-�Z _, TAN-R-&—ZV Township Mailing addressor Address of site �6:s%m ;E Subdivision name Lot number Previous owner of property /�or/�s� ,C°e,rs.'►°u Total size of parcel Date parcel was created Are all corners and lot lines identifiable? X Yes No Is this property being developed for resale (spec house)? _Yes No Volume _ _and Page Number as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER, and the SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. ------------------------------------------------------------------------------- PROPERTY OWNER CERTIFICATION I (We) certify that all statements on this form are true to the best of my (our) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the Office of the County Register of Deeds as Document No. d 3 Z Z 30 ; and that 1 (We) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has been duly recorded in the Office of the County Register of Deeds, as Document No. //32- 7- 3© ) . Signs ure of Owner Signature of Co-Owner (If Applicable) I 47~ -7— <Ile Date of Signature Date of Signature i IIIi i I STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER A ZL&r ROUTE/BOX NUMBER '�DY Z 6 —z— FIRE NO. `��----- CITY/STATE ZIP PROPERTY LOCATION: 1/4 / F1/4, Section -Z-!Z T—�N, R_Zf _� Town of /7446 �� , St. Croix County, Subdivision lam „7t/ 1�� 4.' , Lot No. Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a LICENSED SEPTIC TANK PUMPER. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of $3000 of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of ALL NEW SYSTEMS agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Department of Natural Resources. Certification form must be completed and returned to the St.Croix County Zoning Office within 30 days of the three year expiration date. SIGNED DATE St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 (715) 386-4680 Sign, Date, and Return to above address • ;AFETY&BUILDINGS INDUSTRY, w wiw si"*.*NA V11 *Us,. I�i►�riFtl'illli'il�l."Ii J /MCi�1l M.+� DIVISION RELATIONS EMM� 1 1t5T5 (11:7) womow,w 633w ("63.0e41)&Ci)SPW 145.046) ^�f."°I'At �y OWNS f / �//, N W ' L`I � !�,�t (Or 1 �Jrl.n+ 9 {►'S�Ih `� f ice/ . , � ._ _._. f�_ DATI S 009011VATIONS,fNAI ME 01"I" COLAT11ON TESTS: rr!t�l 1w CO1al L DESCRIPi` �y�► Q p� tRat Reaitbttoe � (ii ry>l gJ Nsw CJ Replace 7-1 -�+ w.Rl►�r RATIM'.So Site sufta6Ms for system U-Site MrSWU de fw systene �� Sit- .?AT'r Rtj I.1 LL L K: OMMENDED SYSTtMoltaptionNl �ou Pus .ov as MV1�hf4'IfJi�ItIL. If 1swealotion Tests are NOT required DEW RATE: eqM J If any portion of the tasted area is in the 844 under s.146109(6)fb),indicate: _ U"As.'S t Floodpisin,indicate Fioodpiain elevation:-1 1 C PROFILE DESCRIPTIONS AL &R-lAQMgS, CHARACTER IL WITH N AND DEPTH ELEVATIOI TO E K IF OBSERVE EE ABBRV.ON BACK.11 B� 1 .67 96-39 -> 9.G`7 `B+&--g B- O i4 97.f`� N roX< dome 9-41 194t-LTS �1C'l •r1�. 2t1,► MS U'1904 CS 4 4k 4 & S 9-c-1 9�,.OU > 9.67 Z"Bt L'CS 2'I 4Rw L 31 ''9*%M S PERCOLATION TESTS H TWN L ST TIM AFTERS FLUNG MIINTERVAL- N. R! H 'LOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or diatences,Describe what are the hori- :onM wwl %wtical elevation referunce points and show their location on the plot plan. Show the surface elevation at all ht)rings and the direction and percent -)f lend Hope. SYSTM ELEVATION �3•c� r / p..3 p 1=ifs ir NMI r T 1 I,the wtdersigrwd,hereby cartify that the soil tests reported on this form were made by me in accord uvith the procedures and methods specified in the Wisconsin U rtinistrative Code,and that the dew recorded and the location of the tests are correct to the best of my knowledp and belief. NXM(print): _.__»___ 1_ES7'S W A l7f�PLTED ON: aAtvv )la Ruscu � x s � 1 � / CERTIFICATION NUMBER: PHONE NUMBER(optional): 'S cc ►Q "z;r ,�[c.9��.� � k/I ����t]Y 34 $SiC-4016 T SIG U", )ISTRIBUTION:01 iyiinal and ofw copy to Local Authot ity,Piopot iv ownev and:hell 7esiut. t I LHi�»SBOi-83>35 iW M is o f r- a � , Hw dJ Nt ad ' V IL y y uIc POO AZO I G 'S�':7`ty,., E/ - c/3,04 ,.du�4� .,��Yl'...oTe•�!!� O- Am rc s !� F An. /i./� pa- S. cv. Ce re..� E/_ Z.boo. o ' � 5 4 • �tP/� �R✓4 CpG�g i�j Vl'r k/ �oaq �a hl �S 4� I Q � Q - House. 299 4jct✓� i i ©s to 1 a i�L g3Q `d3• ra Ry s � zqr f