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Home My WebLink About020-1402-15-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACIai TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's ame: City Village X Township Hokeness,Jon Hudson Townshi CST BM Elev: ~~ Insp. @M~I~ : BM Descriptio ~ ~ ~ / ~~~ ' n ~ ~~ ~ ~~! ~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration ~ / ~~ I w /~ /~ /Q I Holding TANK SETBACK INFORMATION TANK TO P~ WELL I~~T BLDG. Vent to Ai Intake ROAD Septic ` ~/ > it ~ ~~ Dosing Aeration = Holding - PUMP/SIPHON INFORMATION Manufacturer errand G Model N er TD i n Loss System Head TDH Ft Forcemain Length Dia. ~ . SOIL ABSORPTION SYSTEM / `7' / ~ ~f 4 county. St. Croix Sanitary Permit No: 420799 State Plan ID No: / Parcel Tax No: 020-1402-15-000 Section/TowNRange/Map No: 11.29.19.2526 ELEVATION DATA STATION BS HI FS ELEV. V` Alt. BM ~-- n// Bldg r ~t,~,[h ,6. S, ~S~ ~. 6 SUHt Inlet SAN ~O ~~~~ ~j• ~~ - (~ SUHt Outlet s G~ t'v C ~ I • a ~ ~ /I Dt II t ~ ~ Dt Bottom i `~ eaded an. ~ ~~ P: ~- Dist. Pipe .~ ~(~ t.,t ~ ~{/ lI ~ ~,, S~ Bot. System Final Grade ~0 9.0 St Cover ^ a- 7 /o ~. 3 ~ +~ .~tti oI d~ BED/TRENCH DIMENSIONS Width ~ Length ~" No. Of Trenches Z PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth ~ ~ ~~ SETBACK SYSTEM TO P/L BLDG WEL LAKE/STREAM LEACHING Manu rer INFORMATION CHAMBER O Ty f System: ~ t 20 / 775 ~ ~ UNIT Model I umber. ~~ DISTRIBUTION SYSTEM eader anifol~ Len th Dia Distribution ~(!~ Len th Dia as q x Hole Size x Hole Spaci ~ V SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over ( ~ Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~ /~ ~ Bed/Trench Edges Topsoil ~ Yes ~ No ~ Yes ~ No COMMENTS: (Includecode discrepencies, persons present, etc.) Inspection #1:~J~~ Inspection #2: ! / Location: 1024 Cresent Cir Hudson, Wf 54 6 (SE 11/,4~SE~1~/4 11 T29N R19W) Misty View Lot 15 ~~ Parcel No: 11.29.19.2526 p 1.) Alt BM Description = S~v~~~~""'-"` ~Q~, ~./~ ~~ iR,~j~/y~, ~~a,~Y+'~--` •/j3 2.) Bldg sewer length = ~~j ~ 1 ~~ a~~ - amount of cover = Plan revision Required? i, :` Yes jNo I /~ O 3 Use other side for additional information. ~ ~ _ ___ SBD-6710 (R.3/97) Date Insepctor's Si nature Cert. No. 1Q,nd . d ~ ` . ng e t to Air intake f- / ~ 102 ~ C~SC6UT~ C(Q.f__1_E Safety A Buildings Division Sanitary Permit Application 201 W. Washington Ave. lseansiin In accord with Comm 83.2 i. Wis. Adm. Cale PO Box 702 Madison W133707-7302 p~partmant of Comm~-os Personal infottnation you provide may be used for secondary purposes , (Srrbiirit corrrpleted form Io cotmly if not [P-ivacy Law, s. 13.04(ixm)) stale owned. Attach co (ate lam to the count co oast for the s tam on a r not less than 6 -i/2 x 1 I inches in:iu. C~rN ~ ~ , ~,, State Sanitary Pegrmit Number O Check if revltMn to previous application 2~ Sute Pbn I. D. Numbs I. Ilcation In[ormation -Please Prlnt all Information Location: _ __ Property Owner Name ~}t -- -1 6f ~ Properly i.oealirnr r Z~d~ - Properly Owner's Mailing Address ---~~--- -- ' ~ st I/4 ~ 1/4,S T N R~~li or Lot Number Block Nunrbar ° V ~ ~ / - V e / Ci~fty,//S41e Zip Cate P17i~ ~ u{u ~ ~_-~ OFFICE r - ~ Subdivision Wme or CSM Number - J e5 / I r aJ W ti Type o[ Buildings (check one). sa ~ w, d,,ns 1 or 2 Family Dwelling - No of Bedrooms: p r;ly O vill . -- .~._ O Public/Commercia) (describe uae):__ _.._.... O Sute-owned --- - _ __ --- -- - -__ _ _--- - age [~t'uvinr or u~S ~ III Type o[ Permit: (Check only one box on line A. Check box on line B il' applicable) l~ _ Nearest Road , ~° A) 1 ~ew S st 2 D Boa r • y em . Replacement 3. O Replacement of 4. O Addition to Parcel lax Number(s) B) S stem __ 'l'ank Oniy __ _ Existing S stem P __ - ~ - - I ermit Number D A Sanita Permit was reviousl issued hte bsned IV. Type of POWT System: (Check all that apply) l~on-pressurized in-$round ^ Mound O Sand riper O Pressurized in-ground ' ' O CunsUucted Wetland O Ilolding I ank O Single Pass O AI-grade ^ Aerobic'1'reahnent unit f' Recirculating O Urip line ^ Other. V Db eraairt'reatment Area In[ormaliott: _ ~ 1. Design Floor (gpd) 2. spenalAra 3. Uisperaal .Area 4. Soil Application 5. Percolation Rate Re uired P 6. System Elevation 7. Final tirade q roposed Rate((ida./dsy/aq.ll.) (Min./inch) Ekva VI Tank Gpacity to Total q of Manufacturer Prefab in[ormation (lallona Gallons 't'anks Site Steel Fiber- Plastic Col-- New Existing crate Con- glass atnrcted 'r'anks Tanks __.. . . - _- - ~_ ~ - i~~~=) ~ k ~ ~ ---- I ~ - 1 ~~ -- -o-- _-o-- o _ o --- , E ._ s --- - _ ------- -. -- -- -- -- _ --. _ - ~ a---- _ __o__._ _ o _ 0 0 Yfl Responsibility Statement 1 the trtttlerti ad assume res nsibilit for installation of the POW'I'S shown on the attached plans. ' Plumber s Na nt) PI er's gMtalrl; r10 agmpa):' i MP/MPRS No. -- - - ' ----' nuelnesa PlrOlh Number ~ 1 i ~ ~5 ' ' _ _ ~ ~~ r~~ Plumber s Address (Street, City. Slate, Zip Cod ------- ----- _..- _-.-` - _. _ /------- ---- O + ~~~ ~ i (~t/~ ~~~ VIII County/Depart ant Use Oniy Approved D Diapproved 1] Owner Given Initial Adverse Sanitary Permit Fee (Includes (;roundwaler Uete Issued SurcMrge Fee) is:wing AgealSigtttuNre (No Nalnps) Determination ~ ~ ~S 1- I ~ ~.D 3 air r....aru__ _ _r • ____ _ ^.~. a,vnvn^vns yr pprovat r/sceasons for utaappr vat; -3E N o ~~~ ~ ~ ~- l ~`~" :w`~it,otre"1a ~`` ~ ~~, c~J. L_ cr...e~__~.-_/~~-Q,,~~ o,~. ~o~`' t~s~-e-ew-+~ar : ~~~ v ~ Q ~r+nawt ~ ~ w~ot~4~~«-~_ ----- tttn ~1 - . ~ ~ ~f; ~. ~u / . . r ~ ~ ~ ~ ~l /J U/lGl. J / ~ c.. w ~ ....~ .r . ~.. ' ---< . _...____---.-- - - ~ m. _. ~v u.m~..e3 der.''. .. . ~N~-.~_. ~~.M_ L ._..._ J_~t~. .._....._._ i~,~ns~ ~ ~~y.Uy~....._....---_.__.._ ~ y~ ~,~ X13 N W i~ f _ .. ~~1~ k ;- ~ m~'a T~ 4~ Ipfi~- ~'' IJ;S ~ y ~ ~~e~v;gq•~u u~ r- ~o'~UM ~; q l~ s /~ ~I~t~ ~ ~ UU•U ~b ~ ~' u~ aye ,~~~~~ ~~~` r. w ~A~~~ ~~~'xl- ,~ c~w,~ C,2 s~ A,~,~( ti~ N N ~~ ~ ~ rn ~~~ ~~~~ ~.• ~ U E v N N m .0 ~~~ ~~~ ~~ y x vi ~ ~ ~ x C U ~ N r ~o ~~ ~- ~C p -- .1 ~ 1J ~ l l~ ~lv .t / r/ ~~ u~~ _S ~~ cl ~ u~i ncl~ rs . car-__~-1c~~'ctv~,,~'-~--_..._.. ---_ lY~.~l __-.-~,/~m_. ~vU.lY1~..e~~P..t~'.. _ .. ~~- a ~ d "~~a '(gyp o~ Ip~~, ~'' u'S ~, . ,. ,_ a--f~u~1.~s 3k ~l.S~ fop v~ I~ ~" 7' I~ a 1, b ~Y`~'- c m b W i~ u~ r- ~ l~ S --._.Y-_.....-- -.. ,A I, -- - lam) I IAe~~~~ a ..-~ u~~~ l~ J'~. p,~,~( N W N C ~~ ~~~ 0 'N ~~ ~ rn ~ ~ c Nia. ro.0 [ C ~ C ~ ~~~ ~.•E ~ v ~ ~ O ~ EEv~ N N ~ ~ j N ~~~ c,, ~c/ io ~ X in t x U 'O c I ~I , il~~ ,~ (e~2;~e~ -~ z--z~a3 tNisoa~in tern of Commerce SOIL EVALUATION REPORT ~ Page ~ of Division of-Safely and Buildings _ in accoMance wdh t:omm ua, wis. Piam. ~-~ County ' ~" f Attach complete site plan on paper not less ttran 81/2 x 11 inches in size. Plan must include, but not Ircrrlited to: vertical arxi horizontal reference point (BM), direction and Parcel I.D. D 2 ~._ / l L ~ - ~ S ~ ~/~ - north arrow, and location and distance to nearest mad. scale or dimensions ercent slope I , p , Please print all infoi-matfon. by Date Personal inforrnaiion You provide may He used [w secondary pr+~~ (Priveaff law, s. 15.04 (1) (m)). G~ il'~ ~~~ ~ ~ ~ 0 Properly Owner ~~~ Property L ocati~on ~, Lot 5~ 1/4 SE 1I4 S // TZy N R l~ E (or~ Property Owner's Mailing Address - Lot # Block # 5 Subd. Narr>e or CSMI~ J v Trc~-- l'~5 ~ e l iet/ IS City State Z~s Phor~ Number ^ City ^ Village [~ own Nearest Road c1 UJl U ('115) ~ - ols d ^ ~- 4 [~ New Construction Use: [7 Residential l Number of bedrooms 3 - y Code derived design flow rate ~ ~ ~ d G ~'D ^ Replacement ^ Publ~ or cornmer~al -Describe: --- ` ' ft: Parentmaterial /•S U~~-S h Flood Plain elevation if applicabke ~ } ~ . " General ~«nrr>enrs Sy,S-~c ~ z l -c u . 9~ - ~ ~ ~ `. ,~, ~',, \ and recemmendatiorls: ~• •2(-e J • Q~Co . ~ `~ t~ ' r ,,.,~„ Bori # ~~S ~~~~~~~~~~ caul~Tv ; ~. ~ ~7t Ground surface elev. d ft. Depth to limiting factor ~ 2~ • . yn. ipi Pit ~ ZC~ryiP~Gi~F i1 Rate Horizon Depth Dominant Cobr Redox Description Texture Stnrcture Consistence ndary .., Roots f,< D/ftZ in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. ~-' `~ ~ ~ ; <~ s t 'Eff#2 ~ a_g ~ 3/z Sj ~r cS v 5 • g 2 g- I / y 3 5 m-~'r ~s -- . -7 /. 2 3 1 -120 1 y (~ -~-~ 5 d s m~ -" --- .~ /. Z °!4 Sb / ~ ~-:__ a # ° Bori~ ®Pit Ground surface elev. 7 9 ~~ ft. Depth to limiting factor ~ ~ ~v in. Soil ication Rate Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 i b-~0 ( ~lZ Srl abk m-Fr ~S v~ . 5 - 8' z lIJ Z3 t y~3 ~s r ~5 - /. 2 3 -I1 l0 ~ '- rns s ~ _ - / - 2 .8 .sr ' Effluent #1 = BOD > 30 < 220 mglL arxi TSS >30 < 150 mglL ' Effluent #2 = BOD < 30 mglL and TSS < 30 mglL CST Name (Please Pritn_t) ~~~ CAST Number " Date Evaluation Conducted Tel~hone Number A~~s 2tt'~ B~'' fir. ~,~~-~ . t,,~1 54oz~ /a /~--~/ C115~24~-`-l~ 8 property pwner ,-~Yl~-~ Parcel ID # Page ~ of Boring # ^ ~in9 ®Pit ~~~ surface e~v..L~-ft Depth to IimiEing factor ~ in. Soil tion Rate Horizon Depth Dominant Color Redox Description Texture Stnxxure Consistence Boundary Roots GP DliF in. Mansell Qu. Sz. Coat Cobr Gr. Sz Sh. "Eff#1 'Etf#2 l Q- 9 2 ~'~ I 2mab k -~-~r ~ s lv ~' . 5 .$ 2 9- I~ - S l m r c 5 - . -7 1.2 3 3d-I I$ ( to - mS 5 rn ~ - ^` . ~7 /. 2 2` C Buz !%ri a~ a ~ - 2' BI Boring # ^ ^ Pit Ground surface elev. ft Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Colo Redox Description Texture Structure Consistence Boundary Roots GP Dift' in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 a ^ Pit Ground surface elev. ft Depth to Irtniting factor in. ~ ° ~°~ Soil ication Rate Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GPI in. Mansell Qu. Sz Cont Cobr Gr. Sz. Sh. 'Eff#1 'Eff#2 "Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mglL ' Effluent #2 = GODS < 30 mglL and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. !f you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBU-8330 (R.07fOD) •J .~~ ~~R Property Owner `~ f(1L 1 ~ Parcel ID # ~ Z ~ 3 ~~ # ^ ®Pit Ground surface elev. 99 ~1 ° ft Depth to firniting factor 1 I $ in. ' Soil Rate Horizon Depth Dominant Colo Redox Description Texture SUudure Coru~stence Boundary Roots GP DAF in. Mansell Qu. Sz Cont. Color Gr. Sz. Sh. •Eff#1 •Efffl2 ~ -9 2 ~'i I 2,Y,~, k ~r c s 1v-~' . 5 .$ 2 ~- 3p ~~ - S 1 m r c 5 - . -1 /. 2 3 ~-I 18 l to -- ms 5 rn I - ~ . -1 /- 2 3~t.~ # ^ Ba--ng ^ Pit Ground surface elev. ft Depth to Nmitmg factor in. ~ Rate Horizon Depth Dominant Cob Redox Description Texture Shud~e Consistence Boundary Roots GP D/tf in. Mansell Qu. Sz. Cont. Cobr Gr. Sz. Sh. •Etf#1 •Eff#2 ~~ # ^ Borurg ^ Pit ~~ surface elev. R Depth b limiting factor in. Sal Lion Rate Horizon Dapth Dominant Cobr Redox Oesaiptiar Texture Stnxxture Consistence Boundary Roots GP D/tf in. Mansell Qu. Sz. Cont. Cobs Gr. Sz. Sh. •Eff#1 •Eff#2 • Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ` FJiluent #2 = BODS < 30 rrxyL and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBb-8330 (R07/00) • .. PAGE 3 OF~ NAME S~ y ~' LOT# JS LEGAL DESCRIPTION S ~ ~S E la ,S ! ( T zq ,N,R, l~(or~ SCALE: I"= ~D r BM 1 ELEVATION /D ~. a BM 1 DESCRIPTION a . ~ ~Q-}-1^ Z " I-/.~, ~ BM 2 ELEVATION ~'. (o BM 2 DESCRIPTION -bp ~. ja'{-/~ Z " l~Yi' G („ SYSTEM ELEVATION qL•~ ALTERNATE ELEVATION ~U ' Ste' CONTOUR ELEVATION ~v i lA- . ~ tip';/ ec. / +' X i ,~rnZ ,~, ~ v ~~ ~ , $_Z ~'° 6 ~ '~` ~~ ~' ~C'~ Z~~~~ ~~. I ~, ~ U~ ~~~ ~ a ~` ~~ ~ ~ ~~~ IN ' " ~ J7 ~ / en/v1 ~ O°~' ,.~ ~/ 0 SIGNATURE /O- Lo - U/ Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWYS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Table 1: System Design Specifications Sanitary Permit Number O Number of Bedrooms Design Flow -Peak (gpd) 4 t~~~ Estimated Flow -Average (gpd) ~~ b(z Septic Tank Capacity (gal) J l l1 Soil Absorption Component Size (ftZ) ~ h Type of Wastewater Domestic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow -Peak (gpd) O h 7 ~ Maximum Influent Particle Size (in) ~ ~ 1/8 Maximum BODS (mg/L) ~ ~ ~ 220 Maximum TSS (mg/L) } ~' , 150 Tab le 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septi tank and outlet filter shall be assessed at least once every 3 years by inspection. The ut filter hall be cleaned as necessary to ensure proper operation. The filter cartridge sh o e removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a conbned space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank maybe difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan fora Septic Tank and Soil Absorption Component Plantings ofdeep-rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. When system fails, we will replace with another system at owner's expense. Alternate area must be left undisturbed. St Croix County Zoning Office 386-4680 Boumeester & Sons Excavating 386-9020 Tri-County Sanitation 386-2130 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIl' CERTII~TCATION FORM OwnerBuyer Mailing Address ~l~ `~' ~ ~P Y R ~~ Property Address I ~ a ~ ~, ~(' c... (Verification required from Planning Department for new City/State ~c.~r_:~~nn) (.1)~ Parcel Identification Number O - /~y~ -/~ -~ LEGAL DESCRIPTION property Location ~_ %4, S'~ '/., Sec. // , TAN-R_~W, Town of ~u,c~ Sam/ Subdivision / " r~~~'~" t~ V1~~ Lot # ~. Certified Survey Map # ~ ,Volume ~ ..Page # ~- Warranty Deed # ~v~0~~y ,Volume ~ Page # Spec house ^ yes ~no Lot lines identifiable yes ^ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastprplumber, journeymanplumber, restrictedplumber or a licensedpumperverifyingthat (1) the on-site wastewaterdisposal 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 Resources, State of Wisconsin, Certification stating that your septic m has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 o e gee yearS~.rati~date. OF APPLICANT l l (1..3 DATE v •• L, I (we) certify that a a tatements on this form are true to the best of my (our) knowledge. I (we) am (are) the ownei{s) of the pr escribed a by v' of a warranty deed recorded in Register of Deeds Office. ~ / / SI APPLICANT DATE ****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed U 1899P 578 LAND CONTRACT Document Number Fonn 11 V CONTRACT, by and between Richard 0. Stout, ("Vendol" whether one RA HLEEH H4NALSH REGISTER OF DEEDS , or more) and ,J,Qn R. Hekaness. ("purchaser", whether one or more). ST• CROIR CO, , pI Vendor sells and agrees to convey to Purchaser, upon the prompt and RECEIVED FOR RECORD full pertormance of this contract by Purchaser, the following property , together with the rents, profits, fixtures and other appurtenant interests 05-29-2002 10:20 AM (all called the "Property"), in St. Croix County, State of Wisconsin: LAND COf1tRACT EXEMPT i REC FEE: 13.00 'PRAMS FEE; 181.20 Recordin~~ FEE: Kbmon~Ba4r' 4 Hr1QS6T"VPrS4016 Jat~ STar,S f~ Scr , w I S't~( (o v-~~lO-3o ~~•~• of Misty View; Town of Hudson, St. Croix County, Wisconsin This Is not homestead property. Purchaser agrees to purchase the Properly and to pay to Vendor at 1353 Awatukee Trail, Hudson, 1M1 54018, the sum of 560,400.00 in the following manner: (a) $6,040.00 at the execution of this Contract; and (b) the balance of 554,360.00, together withrnterest from date hereof on the balance outstanding from time to lime at the rate of above the prime rate published by the Bank of Minneapolis, adjusted the first Monday of each calendar month hereafter, as follows: monthly payments of prinapal and interest, commencing 1 month from the date hereof and the same date of each month thereafter in an amount determined a 30 year amortization, provided, however, the entire outstanding b lance shall be paid in full one ear f om the date of this contract, (the maturity date). ~g z~esr r(A.rrG s~. - d ~z a 4.K 1. rs rte' 7Mras 1!'3~'rA6t no. - forest i.,.rrtiy QkY. -t4' yn, /S In addition to the principal and interest payment, purchaser shall pay b35.00 a month to Vendor as and for real property taxes. Vendor will apply this to the taxes when due. Following any default in payment, interest shall accrue at the rate of 12°h per annum on the entire amount in defauR (which shall inGude, without limitation, delinquent interost and, upon acceleration or maturity, the entire principal balance). Purchaser, unbss excused by Vendor, agrees to pay monthy to Vendor amounts sufficient to pay reasonably anticipated annual taxes, special assessments, fire and required insurance premiums when due. To the extent received by Vendor, Vendor agrees to apply payments to these obligations when due. Such amounts received by the Vendor for payment of taxes, assessments and insurance will be deposited into an escrow fund or trustee account, but shall not bear Interest unless otherwise required by law. Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any amoum may be prepaid without premium or fee upon principal at any time. In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long as the 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 indeb[edness would have been had the monthly payments been made as first specified above; provided that monthly payments shall be continued i ~ the event of credit cf any proceeds of insurance cr condemnation, the condemned premises being thereafter excluded herefram. 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 absVact, it shall be retained by Vendor until the full purchase price is paid. Purchaser shall be entitled to take possession of the Property at Dosing on this Land Contract. • ~~ 9. pe......... y~. i e ~`r'' r ~,~~( ~{ ~. 4,.vc COUNTY PLAT OF: M I S~ VI LOCATED IN PART OF THE SE1 /4 OF THE SE1 /4 ANI NE1 /4 OF THE SE1 /4 OF SECTION 11, T29N, R19W, HUDSON, ST. CROIX COUNTY, WISCONSIN; INCUL OF CERTIFIED SURVEY MAP RECORDED IN VOLUM AT THE ST. CROIX COUNTY REGISTER OF DEEDS C I I BENCHMARK TOP OF 1 "--,, IRON PIPE ELEVATION 899.32 d04 ~ ~ ~ ~~ ~~ ~~ Q~ a• i ~~i _~ , -- ------------------- o d~ ~, O~ ~ ~ • a~ I ~ ~ n o~ ~ o ~j ~ r of I r ° d04 ~ ~~ ~ pcaEEa as Edo ~ ~E~~, paE~ ~ c~~ ------------------------ ------------ ~sas°~aoo"w~ S89°x2'38"W Sa8.96' 61.a x22.82' LOT 17 2.008 ACRES 87,4x3 SQ FT L.._.._.._.._ ,_.._. N~[`nII~L~,G.144~D L~ --------------- ~i~ ~ ~I~ ao I'~ N ~ .~ ~ <<:, ~. 299.3x' LOT 14 2.000 ACRES 87,12a SQ FT ~ ~ ~ ~~~~. i~~A .~: j ~ <~ I "' I ,~ ~` O oA ~ i I ~~1 ~M ~~I ~ ~,I I~ ~ I ~ LOT 15 ~ ~ ~ 2.001 ACRES ~ ~ 87,147 SQ FT ~ ~ ;- I ~ MIN. FLOOR ~ °• ELEVATION ~ ~ I ~ -~ OF 91300 I o~ m N 0 w J iw 0 ~.. ~.. ~~ Ly' ~ '~ ~_~~ \ `. HWL = 911.00 v~48~ ~ ~ MIN. FLOOR ~' ~~ m ELEVATION r ~i N OF 913.00 ~ ~ ~,, LOT 16 ,~ ~ ~`~~ 2.008 ACRES ,'~ a ~~~~~ 87,4x0 SQ FT o ~~ ~\ ~ ~ V V ' /~ /~~ C> e• r3 ~ ~ ~ / ~`SC m~l-~~ ry 0 S, .~ ~ n'~~a~~~ b~- ~ /~l ~ o ~ .