HomeMy WebLinkAbout020-1411-15-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Building Division
INSPECTION REPORT
GENERAL INFORMATION (ATTACI4 TO F''~RMIT)
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
'ermit Holder's Name: City Village X Township
LaCasse Develo ment Hudson Townshi
:ST BM Elev: Insp. BM Elev: BMpDescription:
/on . (~ G ud air
TANK INFORMATION
TYPE MANUFACTURER CAPACITY
Septic ~ ~Q~C-~ ~ ~ O
Dosing
Aeration
Holding
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD
(Septic I L s / I rsvr S 1~.I C.~'7 ~ I ~~ ~
PUMP/SIPHON INFORMATION S
Manufacturer ~ ~ Demand
GPM
Model Number
TDH Lift Friction Lo System He~ TDH V Ft
/~
Forcemain Leng Dia. Dist. to well
SOIL ABSORPTION SYSTEM
ELEVATION DATA
county: St. Croix
Sanitary Permit No:
453204 0
State Plan ID No:
Parcel Tax No:
020-1411-15-000
Section/Town/Range/Map No:
13.29.19.2585
STATION BS HI FS ELEV.
Benchmark
(0.~7
to o_ a
Alt. BM
l o P
5~•`~
ioC•7~'"
Bldg. Sewer
3 .FSS
/d 2 . $
SUHt Inlet
S ~~8
1 ~a .42
St/Ht Outlet
r!~.O
/bb~7
Dt Inlet „`
Dt Bottom
~-
___
Header/Man.
oo
q ..7a
Dist. Pipe
~ ~°
7.6 0
s 7
Bot. Sy to
g.
Final Grade
S Oo
/O! - -7U
St Cover ~ ~ ~~
BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS ~
3 ~
a ~o s ~h ea .
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type Of System:
I O /
~~
ri 4 dr'1
~
UNIT
Model Number:
~~~ 5
DISTRIBUTION SYSTEM
Header/Manifold
~ ~~ Distribution
Pipe x Hole Size x Hole Spacing Vent to Air Intake
Length~~ Dia Length Dia Spacing
SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Svstems Onlv
Depth Over ~
Bed/Trench Center ~ ~ ~ Depth Over
Bed/Trench Edges ~ ~ I ~
1P xx Depth of
Topsoil xx Seeded/Sodded
~ Yes No xx Mulched
- r,,;
? Yes No
~
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~?{~/~~/ O ~- LL Ins
Location: 821 Hillside Trail Unknown (NW 1/4 SW 1/4 13 T29N R19W) Alexander Meadows Lot 15 Parcel No: 13.29.19.2585
P~ e,/ p0~
1.) Alt BM Description -~1~~
2.) Bldg sewer length = °~ `~ ~
- amount of cover = ~ ~ Gpv,p,~
Plan revision Required? I information I No ~ ~ j ~~ ~ r I', ~,` ~ ~ - - - --~ ~/Tr')9~~ _-
Use other side for additional '~j I yb ~ ~~'
SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No.
Safety and Buildings Division County ,
201 W. Washington Ave., i'.O. Box 7162
iseonsin Madison, wl 53707 - 7162 Sanitary Permit Number (to be filled in by Co.)
(608)266-3151 2~
Department of Commerce 7 J
Sanitary Permit A pli~~!'UF~?~ State Plan I.D. N
per
Wis. Adm. Code
In accord with Comm 83
21 nal information you provide
,
.
,
may be used for secondary purposes Priva y Law,
(1)
m Project Address (if different than mailing address)
~
2 2004
AY
I. Application Information -Please Print All Informati n
1 CRUX il~Uly l ,_
Prope 0 er's Name ZONING OFFICE Parcel # of # ~S Block #
l I OZd - ( - / '- OtsU S
Property Owner's Mailing Addr s Property Location
t - Section ~
~~'/.
~'/
City, S to ~
Zip Code
Phone Number ,
_
,
• (ctrc e o )
T~ N; R or~
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ildin
(ch
ll that a
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k ~i ~
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pp
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ype o
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ec
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on
ame
Subdivis
~1 or2FamilyDwelling-Number of Bedrooms
t,~
i
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D
i
^
a
-
escr
be U
Public/Commerc
~~
^ State Owned -Describe Use ~ tad-~~~
^City_^Vi uge,~Township of
III. T ype of Permit: (Check only one box on line A. Complete line B if applicable)
A' New System ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System
B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New
List Previous Permit Number and Date issued
Before Expiration Plumber Owner
IV. T e of POWTS S stem: Check all that a 1
Non -Pressurized In-Ground ^ Mound >_ 24 in. of suitable soil ^ Mounb < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^
Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treat ment Unit ^ Recirculating Sand Filter ^
Recirculating Synthetic Media Filter Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain)
Dis ersallI'reatmentAtea Information:
V ~'^ ~~
.
Design Flow (gpd) Design Soil Ap lication Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (st Syste Elevation
r ~
......
~S
VL ank Info apacity m, ota umber . " Maitufachirer ... Prefali - ~ . Site" '-, Steel' Fiber Plastic
Gallons Gallons of Units W / ~~ Concrete Conswcted Glass
New Existing [~,(~p,..
-
Tanks Tanks n 'r ~'
Septic or Holding Taak _ ~/
Aerobic Treatment Unit
Dosing Chamber ~, „
VII. Responsibility Statement- I, the undersigned, assume responsibility for instullation of the POWTS shown on the attached plans.
, !, ,; ,'.. ;, ,
Plumber's ame (Print) Plumber' .S re MP/MPRS Number Business Phone Number
s 3
Plu is ddress (Street, Ciry, fate, Zip e)
~''[~ - ~/
V[II. Coun /De artmentilse_Onl
Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued ui Agent Signatur (No Stamps)
Surcharge Fee) ~
^ O Reason for Denial
IX. Condition Approval its-fet~i approval
SYSTEM OWNER:-
1 Septic tank, effluent flltaf and
dispersal cell must all be serviced /maintained
as per management plan provided by plumber.
2. All setback re,quir~ments must be maintained
as per applicable eodelordinances.
Attach complete plans (to tae county onry) rot me system on paper nor Mesa .nnn o,... ,....,..~~
~( ~~
~~
SBD-6398 (R. 01/03)
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Wisconsin Department of Commerce
Division of Safety and Buildings
SOIL ~AL~JATION REPORT
,...I ...........:.~ .•___ o ,._~_
Page ~ of
County
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information. R viewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~ I
Prope Owner Property Location
Govt. Lot 1/ 1/4 S T N R ,r~(or) W
Property Owner's Mailing Ad ess -- -- -- Bloc # Subd
Name or CSM#
~_.
~~rF~~!~~~ .
- -
S
City tate Zip Code
~ hone Number ^ ity Village [Town Near st Road
-s ( ~ Y 1 X004 ' -~-
New Construction User Residential / N bergil lp~r~~;r Code derived design flow rate ~ ~ GPD
^ Replacement ^ Publ' or com ercial -~~FFICE
Parent material (~~~a.~ ~~ Flood Plain elevation if applicable ft.
General comments
and recommendations:
Boring # ^ Boring ,L
®Pit Ground surface elev. ft. Depth to limiting factor,~7,~ in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
~' ~ s
- ~ ~
- - -- ~
~ -
u.+ 9~ S~ /
3~ / ~ 2--
~ Boring # ^ Boring
~ Pit Ground surface elev. ~~~ ft. Depth to limiting factor .~ZS in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
- /~
-f-
,~ ., ~7 9
~ y
~ 9
4
~ - 1
~} • (~
~nl CI Il th 1 - DVUS ~ au < «u rngi~ ana 1 JJ Hsu _~ .i ou mg/L ' ttrlUenL ~L = tiUUS < 3U mg/L and 155 < 3U mg/L
CST Na eas rint,~ /~ Signature ~ ' ~ CST Number
// /F~ / )
Telephone Number
ru nvnm
s.
Property Owner J a~,~l Parcel ID #
Page ~_ of ~
^ Boring
Boring #
® Pit Ground surface elev. ~ ft. Depth to limiting factor ~(~ in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. ont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1
f 9
r
T
S 9 ~,
~- __.-.
~
~
/~ _ ~ <
^ Boring # ^ Boring
^ Pit Ground surface elev. ft. Depth to limiting-factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
^ Boring
Boring # Ground surface elev. ft. Depth to limiting factor in.
^ Pit Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
* Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L
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.
SBD-8330 (R.07/00)
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POWTS OWNER'S MANUAL & MANAGEMENT PLAN
FILE INFORMATION
Owner ~/_ , J
/' '
Permit ~ 5370
DESIGN PORAMETERS
Number of Bedrooms ^ NA
Number of Public Facility Units NA
Estimated flow (average) (~ al/da
Design flow (peak), (Estimated x 1.5) al/da
Soil Application Rate al/da /ft~
Standard Influent/Effluent Quality Monthly average•
Fats, Oil & Grease (FOG) s30 mg/L
Biochemical Oxygen Demand (BODE) 5220 mg/L ^ NA
Total Suspended Solids (TSS1 5150 mg/L
Pretreated Effluent Quality Monthly average
Biochemical Oxygen Demand (BODE) 530 mg/L
Total Suspended Solids (TSS) 530 mg/L ,~ NA
Fecal Coliform (geometric mean) 510' cfu/100m1
Maximum Effluent Particle Size Ye in dia. ^ NA
Other: ^ NA
*Veluea typical for domestic wastewater and septic tank effluent.
MAINTFNAN/_F Cr_NFrll11 F
SYSTEM SPECIFICATIONS
Pagn „~ of
Septic Tank Capacity al t~NA
Septic Tank Manufacturer ) - ^ NA
Effluent Filter Manufacturer O NA
Effluent Filter Model _ O NA
Pump Tank Capacity al ,l~NA
Pump Tank Manufacturer ANA
Pump Manufacturer -~-NA
Pump Model ~ NA
Pretreatment Unit
^ Sand/Gravel Filter
O Mechanical Aeration
^ Disinfection
^ Peat Filter
^ Wetland
^ Other: ~ NA
Dispersal Cellls-
In-Ground (gravity)
^ At-Grade
^ Drip-Line ^ NA
^ In-Ground (pressurized!
^ Mound
^ Other:
Other: p NA
Other: O NA
Other: ^ NA
Service Event Service Frequency
Inspect condition of tank(s) At least once every: -~ ^ month(s) (Maximum 3 years!
earls) ^ NA
Pump out contents of tankls) When combined sludge and scum equals one-third IY,1 of tank volume ^ NA
Inspect dispersal ce(lls) At least once every. ~ Ja earls) (Maximum 3 years) ^ NA
Clean effluent filter ,. --~ - At least~ona v
sDM° ~`~ ~ ^monthls)
year(s) O NA
Inspect um ,pump., controls,.,&.alarm , _....
P p east once every:
At I_ ^monthls)
~, O earls) ,~ NA
Flush laterals and pressure. test _._ _ . _ At least once. every: - ^monthls)
^ earls) ~1A
Other:
_.. .. ..........~....-.. _. ....._._...
_
. At least once every: ^monthls)
^ earls! -l~NA
Other:
. ..,........_..... W..~» ....
_.. ..
^ 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 visuat inspection of-the tankls) 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 cellls) shell be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of affluent on the ground. surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the•looal regulator~r authority. -
When the combined accumulatfion of sludge-and scum in any tank equals one-third IY,1 or more of the tank volume, the entire
' contents of the tangy shale ~be~ removed, by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative,. Cra~igi., ,
All other services, including but not limited ~p,~f« servicing of effluent filters, mechanical or pressurized components, pretreatment
unite, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
.. , .~ ~ _
A service report shalh be pro~ride~~d,to the local regulatory authority within 10 days of completion of any service avant.
GMW 14/011
~. ,;:. -,
. , c: r:
Page ~ of
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemicals
that may impede the treatment process and/or damage the dispersal cellls). If high concentrations are detected have the contents
of the tankls) 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 high star levels. When power is restored the excess wastewater will ba
discharged to the dispersal cellls) In ors large doso, overloading the De)))al and may result In the beokup or surfeo• dlsaharge of
effluent. To avoid this aituatlon 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:
e 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 cod@ compliant
replacement system:
A 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
_.....~,...,, ,...w.,.sechnology-a.boWing tank-may-be..inst.aUgd-as.a l~aesoriso caplace the.fa~ed 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-grad~a;, sgil .absorption, system$ may b~. deconstructed in place following removal of; the biomat at the
infiltrative. ut:facp.;: F3e~ctnstructioos~gf_such systems must comply with the rules in affect at that time.
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CON'NAI~V 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'~F'A TANK`NIAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
~..
POWTS INSTALLE ~' ; ~ ~. i .~. , ,:~
Name
Phone ~ ' `
SEPTAGE SERVICING OPERATOR lPUMPERL
Name .,,: ,. ~ _ ,. ~.. _ _ , ,
Phone ~ n .as:v ~rt~ .. ., i,_., a.•~-. _ ..
This documentwas drafted in oompfidnca-With ohapter Comm
POWTS MAINTAINER
Name
Phone
LOCAL REGULATORY AUTHORITY
Name
-Phone -~
st&If) and 83.6411-, 12) & 131, Wisconsin Administrative Code.
~i.-.~.~ :a. .
>, _,.w~ ,n~, ,_...
S'1' C1tOIX CUUN`l'1'
SLl''1'1C '1'.A1~K MAIN'1'LNANCL AGltl?LM>?N'1'
ANn
OWNI?ItSIIII' C1?It'1'II~ICA`1'ION DORM
Owner/Buycc ~_A ~~g.e. ..eJ.z.Ln(',,,~.~..'~ ItL~G
Mailing Address
I'c•ol)arty Address _,~ a I 1~ t, t
~ C -~/a ~ ~
Say o~~ ' ,~
(Vcrificalion [cquilccl lion! Planning Ucpalfnlcnl fur new consUuclion
City/Stale ~t!uLd,Se~k~ A r- _ 1'arccl Idcntiiicttlic-n 1Juntl,cr O2o -1~1(- /S-otrp[! 2s~rS~
I~I;GAL lli;SC1tI1''I'ION
I'rol)erly Location 9~Lw_ !/,, ~~ y,, Sec. ~~~ 'I' Z ~ It~_W, 't'own of
C/ _
SuUdivision I~'~~~Cy4-u..~P~;~~w~c~t,~s I.ot /i ~ 5
Certified Snrvcy Mttrl[ ~~
Warranty llecd #
Shec house ^ ycs,~l no
_, Vl,luntc Pngc ~l
Voluntc
1'ctgc fE
Lcl1 !toes idcntiliulilc (~ yes ^ no
SYS'1'LM MAIN7'I~NANC1!:
Improper use and n[aL[le[lanceuC you! septic syslcu! cool,! lcsult in its In culatnle tililule to handle wastes. I'ropermainlenaucc
couslsls of put»piug out the septic took cvc[y Ihlcc ycals ur sooner, if needed by a Itccnscd pumper. What you put into the system
caa affect the funcliou of the schlic teak as a t[eatulenl stage in the waste disposal systen[.
Tl[c property owner agrees to subnlil la Sl. Croix 7,oniug Ucpallu[cnt a cctli(icaliou lotto, signed by the owner and by a
nlastprpluulher, Journey[nan plun[ber, [csl[icJe4 plunlher or a licensed punlpcr vc[ ifyiug that (1) the on-site wastewat~erdisposal system
is in proper opcraliug conditim! and/or (2) after inspcclion and pumping (if ncccssaly), the acplic tank is less tl[au-113 full of sludge.
1/wc, the uudersigncd 1lavc read the nlu[vc [cquilcnlcnls and agree to nlaiutain the private sewage rllaposal system wills the eleudards
set Cortl[, I[erelu, as set try .the Dcpattn[cut of Conuucrcc and tllc Ucpatlnlcnt of Natural Resources, Stale of Wisconsin. Certification
slating that your septic system has bee[! nlaintaincd !oust he cunlplctcd and [cUnncd to the SL Croix County Zoning Oftice within 30
days of the llu a year expirstiorr date.
NA'I'U L~ Or API'LICAN'f DA'I'LY
oWNrR c><~R~rrirrc~`r>!oN
I (we) certify tl-at all slalcn-cnts un Ibis line! n!c Uuc to the I~csl of n!y (rnu) knowledge
the ,ropcrty dcscr' cd above, by villuc of a warranty decd lcculdccl iu Itcgistcr of Uccds OlTicc.
S[GNA'I`UR APPLICANT
I {wc) am (are) tl-c owuc[(s) of
.~ / Z ~/ e _
UATB
*'"**°'* Any iuforntation tl-al is nlis-lcl,resculccl play lcsult in the sanitary pet~nil being [evoked by the Zonittg Department. *****~
** I<[lcludc wltl! tilts appllcsUo[!: a stampccl waltanty dcccf 4[oln life I~r~gi~tcr of Ucccis olCicc
~• _. ~ - '- & COi:~'.(i.~ th„ CLlttI~IC~~'4GU~~ C:i'~l~P.(?. t~ iME~~C;ttl '?{t (jC ill (!!C•WafFaniy f~CC(!--~ -
1053
Wisconsin Department of Commerce SOIL EVALUATION REPORT p~ 1 of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service
County
Attach complete site plan on paper not less than 6'/: x 11 inches in s¢e- Plan must St. CfODr
include, but not limited to: vertical and hoozontal reference point (BM), direction and ^^'l
percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. d ~~ //~/- ~S'L..c.~C.J
pending
Please print all information. Reviewed Date
Per~on~ information you provide may ~ used for secondary purposes (Privacy Law, s. 15-04 (1) (m)). 3 a~ d
Property Owner - ~ ~ ~ ~,, raperty Location
LaCasse Development , Inc. vt- Lot NW 1/4 SW 1/4 S 13 T 29 N R 19 W
Property Owners Mailing Address Lot # Block # Subd. Name a CSM#
573 Cty Rd " A" A G G ~ ~ 2 ~ p 2 15 na Alexander Meadows
City State ip Ca~dg P~"i~UfX ~~ttJ~fvrT'r City Village Town Nearest Road
Hudson WI 54016zOtvi~Q~E138-1~`E405 Hudson Alexander Rd.
/'' New Construction Use: y' Residential /Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement Public or commercial -Describe:
Parent material Glacial Drift Flood plain elevation, if applicable na
General comments
and recommendations
: Mound Design, system elevation 99.45 ft based on contour line 98.45 ft (/0'~~~~~~e q,P~ ,3(0 ~~l
Boring # Boring
r Pit Gr
d S
rt
l
55 ft
99
2 72 i
oun
u
ace e
ev.
.
. n.
Depth to limiting factor Sod Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz
*Eff#1 *Eff#2
1 0-13 10yr4/4 none sl 2msbk mfr gw 1f .5 .9
2 13-26 7.5yr4/4 none scl 2msbk mfr gw na .4 .6
3 26 72 10yr8/2 sandstone residuum na na na na na .0 .0
^ Boring # Boring
/! Pit
Ground Surtace elev.
99.55 ft.
Depth to limiting factor 2
~`* in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftY
*Eff#1 *Eff#2
1 0-10 10yr 3/2 none sil 2msbk mfr gw 1f .5 .8
2 1 28 10yr4/4 none sl 1 csbk mvir gw na .4 .6
3 28 4 10yr8/2 sandstone residuum na na na na na .0 .0
tmuenr rc~ _ ~sw 5> su < zzo mg/L antl T55 >30 < 150 mg/L * Effluent #2 = BODS< 30 mg1L and TSS <~0 mg/L
:ST Name (Please Print) Signature: CST Number
3avid J. Steel ~L~~ _ .,~~ 248956
address Steel Soil Service ~ Date Evaluation Conducted Tel~rhone Number
1564 CR GG, New Richmond, WI 54017 8/3/2002 175-246-5085
Property Owner L-aCasse Development , Inc. Parcel ID #
^ Boring # ;Boring
Pit Ground Surtace elev. 96.20 Pending
'
ft. Depth to limiting factor
~72
in. Page 2 of 3
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
'Eff#1 "Eft#2
1 0-16 10yr 3/2 none sl 2msbk mfr gw 1f .5 .9
2 16-31 10yr4/4 none scl 2msbk mfr gw na .4 .6
3 31-50 7.5yr4/6 none scUsl 2msbk mfr gw na .4 .6
4 50- 2 10yr8/2 sandstone residuum na na na na na .0 .0
eorina # .Boring _ _ .. .. _ .
• Effluent #1 = BOD ~ 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS <30 mglL and TSS <30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to aceess services or
Boring # _ _ ~ Boring
4
Page 3 of 3
STEEL'S SOIL SERVICE
David J. Steel 1564 Cty Rd GG
CST-PdWTSM LaCasse Dev., Inc. New Richmond, WI 54017
Lic. # 248956 NWl/4,SW1/4,S13,T29,R19W (715) 246-6200
Town of Hudson, St. Croix Co. (715) 246-5085
Alexander Meadows, Lot 15
This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for
your use. The location of the test may or may not be as shown as permanent lot lines were not
established at the time the test was conducted.
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STATE BAH OF WISCONSIN FORM I t - 1982
LAND CONTRACT
Individual and Corporate ~
. (TO BE llSED FOR ALL TRANSACTIONS WHERE OVER
525,00015 FINANCED AND 1N OTHER NON-CONSUMER
Document Number ACT TRANSACTIONS
CONTRACT, by and between. Renee E. Spott,a single-woman
("Vendor", whether one or more] and LaCasse Development, Inc.
("Purchaser"
whether one or more)
Vendor sells and`a
e
t
t Recording Area
,
.
gr
es
o convey
o
Purchaser, upon the prompt and full performance of this contract by Purchaser,
the following property, together with the rents, profits, fixtures and other
appurtenant interests (all called ttte "Property"), in St. Croix
County, State of Wisconsin: Name and Retum Address
I{rlstina Ogland
Estreen & Ogland
P.O. Box 359
Hudson, WI 54016
20-1017-70-000;20-1017-SO;and part of
20-1018-20
(Pazcel Identification Number)
All that part of the North half gf,the Southwest Quarter (N 1/2 of SW 1/4) and the Northwest Quarter of the Southeast Quarter
(NW 1/4 of SE 1/4) of Section 13, Township 29 North, Range 19 West located North of the railroad right-of--way and West of
Alexander Road.
This is homestead property.
(is) (is not)
Purchaser agrees to purchase the Property and to pay to Vendor at any reasonat.[P brat+~„
the sum of $ .' in the following manner: (a) $
at the execution of this Contract; and (b) the balance of $ ,together with interest from date
hereof on the balance outstanding from time to time at the rate of _ % percent per annum
until paid in full, as follows: - - - ----
provided, however, the entire outstanding balance shall be paid in full on or before the tl day of
_ _ _ _ (the matwity date).
Following any default ins payment, interest shall accrue at the rate of 8 % per annum on the entire amount
in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire
principa- balance).
Purchaser, unless excused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonably antici-
pated 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 taw.
Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal.-A~-y
arneurtt-may-be~prcpaid-wit~ItotsEgrerrri~nt-or-fee-trpott-prineipa}s6-efly~iate-trffer (OR)
there may be no prepayment of principal without permission of Vendor.* except as psov3. e n ddendinn
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 here from.
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. closlag date, except as
Purchaser shall be entitled to take possession of the Property on provided in Addendum
= Cross out one. '
LAND CONTRACT -Individual and State Bar of WisLronsin
Corporate Form No. I1-1982
Infennatlon Professionals Company; Fond du Leq WI 800-855.2021
~ .- lurchaser promises to pay when due all taxes and assessments levied on the Property or upon Vendor's interest
end 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 fire, ex-
;nded coverage perils and such other hazards as Vendor mayYet{uire, rsvithout co-insurance, through insurers approved
by Vendor, in the sum of $ full insured 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 standazd 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. Uhless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall
be applied to restoration or repair of the. Property damaged, provided the Vendor deems the restoration or repair to be
economically feasible
Purchaser•covenants nofto commit waste nor allow waste to be committed on the Property, to keep the Property
in good tenantable condition and repair, to keep the Property free from liens superior to the lien of this Contract, and
to comply with all laws, ordinances and regulations affecting the Property.
Vendor agrees that in case the purchase price with interest and other moneys shall be fully paid and all conditions
shall be fully performed at the times and in the manner above specified, Vendor will on demand, execute and deliver to
the Purchaser, a Warranty Deed, in fee simple, of the Property, free and clear of all liens and encumbrances, except
any liens or encumbrances created by the act or default of Purchaser, and except: municipal and zoning ordinances,
easements and restrictions of record
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 30 days following the specified due date or (b) in the event of a default in
performance of any other obligation of Purchaser which continues for a period of 30 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 and payable in full, at Vendor's option and without notice (which Purchaser hereby
waives), and Vendor shall also have the following rights and remedies (subject to any limitations provided by law) in
addition to those provided by; law or in equity: (i) Vendor may, at his option, terminate this contract and Purchaser's
rights, title and interest in the Property and recover the Property back through strict foreclosure with any equity of
redemption to be conditioned upon Purchaser's full payment of the entire outstanding balance, with interest thereon from
the date of default at he 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 if purchaser fails to redeem); or (ii) Vendor may sue for specific performance of this Contract to compel
immediate and full payment of the entire outstanding balance, with interest thereonat the rate in effect on the date of
default and other.amounts due hereunder, in which event the Property shall be auctioned at judicial sale and Purchaser
shall be liable for any deficiency; or (iii) Vendor may sue at law for the entire unpaid purchase price or any portion
thereof; or (iv) Vendor may declare this Contract at an end and remove this Contract as a cloud on title in a quiet-title
action if the equitable interestof Purchaser is insignificant; and (v) Vendor may have Purchaser ejected from possession
of the Property and have a receiver appointed to collect any Yents, 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 in-
curred, 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 Fropertty, including homestead interest, to collect the rents, issues, and profits of
the Properly during the pendency of such action, and such rents, issues and profits when so collected shall be held and
applied as the court shalt direct.
Purchaser shall not transfer, sell or convey any legal or equitable interest 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 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 as 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 ConVact shall become immediately due and payab]e in full, at Vendor's option without notice.
Vendor shall make all payments when due under any mortgage outstanding against the Property on the date of
this Contract (except for any mortgage granted by Purchaser) or under any note secured thereby, provided Purchaser
makes timely payment of the amounts then due under this Contract. Purchaser may make any such payments directly to
the Mortgagee if Vendor fails to do so and all payments so made by Purchaser shall be considered payments made on
this Contract.
Vendor may waive any default without waiving any other subsequent or prior default of Purchaser.
All terms of this Contract shall be binding upon .and inure to the benefits of the heirs, legal representatives,
successors and assigns of Vendor and Purchaser. (If not an owner of the Property the spouse of Vendor for a valuable
consideration joins herein to release homestead rights in the subject Property and agrees to join in the execution of the
deed to be made in fulfillment hereof)
Dated this, 24th day of July 2002
LaCasse De ent, Inc. /
"~ 1 ~ - 4 Q_~jLLLr - (SEAL)
• Richard W. LaCasse, President Vendor
AUTHENTICATION
Signature(s) Renee E. Spott
authenticated this ay~day of . ,T_~ , 2002
-/ ~ ~ t~2fv~
+ .~fdith A. Remington
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not,
authorized by § 706.06, Wis. Slats.)
THIS INSTRUMENT WAS DRAFTED BY
Judith A. Remington, REMINGTON LAW OFFICES
P.O. Box 17?,New Richmond, WI 54017
(Signatures may be authenticated or acknowledged. Both are not
necessary.)
~~~ (SEAL)
• Renee E. Sport Purchaser
(SEAL)
Purchaser
ACKNOWLEDGMENT
STATE OF WISCONSIN )
ss,
ST. CROIX COUNTY )
Personally came before me this 24U1 day of
July , 2002 the above gamed
Richard W. LaCasse, President of LaCasse Development,
Inc.
(SEAL)
Vendor
to me known to be the person(s) who executed the foregoing
instrument and a m ~ledg al e.
~~
* ~1i1 S'`(( ~ b
Notary Public St. Croix County, Wisconsin
My Commission is permanent. (If not, state expiration date:
' .)
"Names of persons signing in any capacity should be typed or printed below their signatures.
LAND CONTRACT- Individaai and Corporate-State Bar of Wiaconiln Form No. I1- 19E2 Infomiafion Profesalonals Company, Fond du Lac, WI 8n0.655-2021
„a~•, j
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31,026 SQ. FT.)
_B.O. =984.0
SIN HOME
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(95,487 SQ. FT.)
L.B.O. =984.0
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( ,915 SQ. FT.) ~1
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UN~~ _ -- - - - -
~' . SCALE IN FEET'. 1" = 100'
_ _