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038-1138-95-100 (2)
. Form - S T C - 104 AS -BUILT SANITARY SYSTEM REPORT OWNS ^ ' &;V TOWNSHIP SEC. ss' T J N /,!!f -W ADDRESS �d �D lU �yr/�e_ ST. CROIX COUNTY, WISCONSIN r SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of IL- HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM �L A�rr1 a6 ` 100 " or d__ III ` o o — zoo I goo r5, INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer: C"ws' Liquid Capacity: Number of rings used: ---f- Tank manhole cover elevation: 2 3 O Tank Inlet Elevation: 9z Tank Outlet Elevation: 8 :F 1 Number of feet from nearest Road: Front,aSide o Rear, O feet -- From nearest- property line Front 10 Side @ Rear,19 C?ld z feet i Number of feet from: well )C/D5, building: 4&' (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity: 300 Pump Model: —'03 11 M Pump/Siphon Manufacturer: n u, Pump Size YR � Elevation of inlet: S rJ Bottom of tank elevation: es- ---!7 Pump off switch elevation: 8 Gallons per cycle: c2 Q Alarm Manufacturer: 41�t4X Alarm Switch Type: W-0A Number of feet from nearest property line: Front, O Side, O Rear, Ft. O�"'� Number of feet from well: l/3 Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: v Width: ,j Length: Number of Lines:_ Area Built Fill depth to top of pipe: 2 Number of feet from nearest property line: Front, O Side, O Rear,&Vt . Number of feet from well: Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom;7 seepage pit elevation: Area Built: Has either a drop box O or di ribution box O been used on any of the above soil absorbtion sytems? (Check on HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of nlet: Number of eet from nearest property line: Front, O Side, O Rear, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: arm Manufacturer: Inspector• Dated: Plumber on fob: UJ/ o-f.00' Zvt-4-2) too— License Number: 3/84:mj 00 p va c o o � � o W @ g � I N >oo N @ C N C Y U O U � � O @ I LT. p N 7 O LL-. (0(n U 5U •O Z @ D.c0 N LL o 0 @ N p @ C L O:2 .2) Q C 'O L � I Z Z m D C O C C7 -O co O Z d C a d Z d 2 C C Z N H c E N N M @ �co 7 N @ N N U) C N fU • pea O'- L L _ - c O @ O Q Z H Z � o N z Y a c I S1 od E y _ d ^r c CL L,, CL 'gyp ` @ c m U) 0 m ;! `m C7 o E o I; 3 C G a @ J UO j Z IN- IN- F _O 5 w a� o o o Z IL CL CL o s 00 co J Q a�i rn o �i Z 0 0 0 cl m E o o .� c •p N O C3i @ cl rp 0 0 3 06 H e ►�i + ° Q o ! a co to 0 yy � ~ c N c c C d p l O �2 III @ N N N N Z Z N cc) O to r N E E v • yam' o m rn o N FO- 10- () ►S► m m . V� IL EL L: ` 0 E to .0 C :: C Q u a 2 0 W u \ ° k § e % o _ § ¥ \ o ® / 0 / $ P k §x ;28 .&g%� / > / ® E\ R ) o §f{ a . « §\7 0 ƒ\ � / �§k0 . \ $ � © &o 8) 2kk0 c eEo , » , I \ ) 22222 \ QQƒ2/k < @\:� &f ( , � \ \ 4j 0 � 7 § (D m \ 7 g � B § :!t \ 2 . z - J c m w = J m k $ . � $ 2 N © j , e j U) ƒ g j , f \ \ z ƒ z § k " u £ \ \ \ ` E 7 u © ƒ © e ) § 2 (D \ A f ƒ \ I p / - " k 0 0 0 17 koK § CO o § 7 z \ \ § § \ 2 § ; SS = § & ® 3 \ ) ; / k 4 z / 7 < 0 0 E j \ \ 0 ) ) 0 2 e 2 @ [ % o o ; — / R ' ; o � $ \ z z { ) a : f 'Cl) \ \ : \ \ \ z $ / / 2 \ k � n . u 0. 0 CL 0 k k \ ( k o o o a ■ < o m u Parcel #: 038-1159-20-100 o2/2z/2o67 12:43 PM PAGE 1 OF 1 Alt. Parcel#: 34.31.18.743A 038-TOWN OF STAR PRAIRIE Current X ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner O-KUMM TRUST A KUMM TRUST A C-KUMM STEVEN J TRUSTEE KUMM STEVEN J TRUSTEE 446 S KNOWLES AVE NEW RICHMOND WI 54017-0000 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 0.000 Plat: 1974-GERMAIN &HANNER ADD SEC 34 T31 N R1 8W GERMAIN&HANNER ADD Block/Condo Bldg: LOT 02 LOT 2 EXC PT TO HWY PROJ D#627083 ASS'D W/038-1138-95-100(570A-10) Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 34-31N-18W Notes: Parcel History: Date Doc# Vol/Page Type 09/06/2001 656090 1715/256 WD 09/06/2001 656087 1715/239 TD 08/31/2000 629109 1539/39 CA 08/31/2000 629108 1539/34 CA more 2007 SUMMARY Bill#: Fair Market Value: Assessed with: 0 038-1138-95-100 Valuations: Last Changed: 07/27/2000 Description Class Acres Land Improve Total State Reason Totals for 2007: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2006: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch#: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel #:' 038-1138-95-100 02/22/2007 11:28 AM PAGE 1 OF 1 Alt. Parcel#: 34.31.18.570A-10 038-TOWN OF STAR PRAIRIE Current X ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner O-KUMM TRUST A KUMM TRUST A C-KUMM STEVEN J TRUSTEE KUMM STEVEN J TRUSTEE 446 S KNOWLES AVE NEW RICHMOND WI 54017-0000 Districts: SC= School SP=Special Property Address(es): "=Primary Type Dist# Description SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 12.700 Plat: N/A-NOT AVAILABLE SEC 34 T31 N R1 8W SW SW LOT 14 OF CSM Block/Condo Bldg: 5/1493 EXC PT TO HWY PROJ D#627083 INC 038-1159-10-100,1159-20- Tract(s): (Sec-Twn-Rng 401/4 1601/4) 100,1159-30-100(742A,743A 8t 744A) 34-31N-18W SW SW Notes: Parcel History: Date Doc# Vol/Page Type 09/06/2001 656090 1715/256 WD 09/06/2001 656087 1715/239 TD 08/31/2000 629109 1539/39 CA 08/31/2000 629108 1539/34 CF more... 2007 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/12/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 12.700 85,500 311,800 397,300 NO Totals for 2007: General Property 12.700 85,500 311,800 397,300 Woodland 0.000 0 0 Totals for 2006: General Property 12.700 85,500 311,800 397,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 562 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 O LCj11[ oJ1-;'1 rj i4LMIJOA 'uap60 - H sl*ueJd Aq pa}le.Ap juawn.alsul siul a `a m �alinvwL� 0- N6407:floz cNV SZS NISNODSI1 '13uS213WS Yd 9At^ANt1143ed1YG:) S-0 Z L XO 8 ' k zgnaz) xlo,a is I 33,00 0 _ 213NNVH 't/ NHOf Iz - Nlb'W2130 '3 421b'M43 ° MO 1DI C. MON Ip1�6�43► I CO I a 10 WEST LINE OF o I z THE SW1 /4 GERMAIN A D HANNER ADDITION 1p IO 1 �- 165.82' 160.00' 160.00' r $. D I Im o 9°.�, 485.82' S0007'04'W I ' I o Id -( I D O 1 I TRUE BEARING c°- 1 6 6 � � � `Z —? AQ 0 >� O to r I �I"�I m Q v, I'A I D o G 0 w oo Cl o fj 1 !33' 33' T N N I D 1111 I �mj 0 I= . . � � ° o jm 1 a z � D 1W Iz S m -�N' y O b — O I Z cn I 0_ ..e Im $ m = IC 1 r' I� Iz I iD 1 318.00' S 0.07' a)04"W co°'Sri v m w co I n� N I z Iip 318.00 NO' 07 04"E. gi ;0 p X-17 1O 616 N ">1 I�' ID I 0 -< I C 8 co 1 . 1 O Ql. �. e1+ �A•'JG1x'{ir:� F f,:� N I ti (f Z - 1 dt1kF?J 1��R� of co 133' 33� C2 ' V C 318.00' II' N0°07'13"E 493.09' no o I EAST LINE OF SW I/4 OF SW 1/4 UNPLATTED LANDS ^' �� '� UNPLA7TED LANO� NISNOOSIM 'A1Nnoo X10210 '1.S '31211V'dd 2]V-LS QJJ JO NMO1 'M8 L21 'NL£1 'ti£ NOIID3S d0 t/ LMS 3H1 d0 tr/ LMS 31-11 NI C131VO01 —4�s- dVVV A3A21f1S G31d 112130 ' � rvGE: vJ I C� DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX.7969 BUREAU OF PLUMBING MADISUPI,WI 53707 5`10-4,SW-4,S34,T 3 IN-RI 8W IN CONVENTIONAL ❑ALTERNATIVE State Plan I.D.Number: Town of Star Prairie L�Holding Tank El In-Ground Pressure ❑Mound (if assigned) Lot 14 Germain & Hannon _ Im NAME OF PERMIT HOLDER: JADDRESS OF PERMIT HOLDER: INSPECTION DATE: David DeGear 1050 Neal Avenue South, Afton MN 55001 7'j' 0 ? BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV.: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Gary L. Steel 3254 St. Croix 92527 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LAB L LOCKING COVER PROVIDED: PROVIDED: DYES ONO ❑YES ❑NO BEDDING: VENT CIA.. VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM. FEET FROM LINE: AIR INLET. DYES ONO ❑YES ❑NO INEAREST DOSING CHAMBER: MANUFACTURER: 7INGS: LIQUID CAPACITY. PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: E ONO ❑YES ❑NO ❑YES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY IWELL BUILDING.IVENTTOF ESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) DYES ONO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH: LENGTH: NO.OF DISTR.PIPE SPACING. COVER INSIDE DIA. 14PITS LIQUID BED/TRENCH TRENCHES MATERIAL: PIT DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH JOISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL. NO.DISTR. NUMBER OF PROPERTY WELL. BUILDING: V NT TO FRESH BELOW PIPES: ABOVE COVER. ELEV.INLET.ELEV,END: PIPES: FEET FROM LINE: AIR INLET. NEAREST-1 MOUND SYSTEM: 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. OIL COVER TEXTURE PERMANENT MARKERS JOBSIRVATION WE LLS DYES 1:1 NO DYES 1:1 NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH Of TOPSOIL. SODDED SEEDED MULCHED CENTER: EDGES: DYES E:1 NO I DYES ONO DYES El NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH TRENCHES: LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL. NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING ELEV.. ELEV.: DIA.. ELEV.. PIPES DIA.: ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING' DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS 1:1 YES ONO 1-1 YES ONO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER QROPERTY WELL: BUILDINGFEET FROINE: DYES 0 N DYES ❑NO NEAREST 2 /00.ZF F S /0i,2* 2 ,i e-f �5.� - Sketch System on f Pu ry1�� -r "F= 12 .0&' Retain in county file for audit. �p7i}pyr� �S; 9 Reverse Side. 00" 2 PVG SIGNATURE: TITLE. DILHR SBD 6710(R.01/82) Zoning min ,�@ r fj�a,•� . INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO THE APPLICANT: 1. This 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. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed rooms, etc.), depth of system, or type of system; 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. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 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 where the system is to be installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only-if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; Vl. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. 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. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. 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; dosing or pumping chambers; 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. ------------------------------------------------------------------------------------------------------------------------------------------------------------ GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public.debate. The groundwater bill Ground MAK '— included the creation of surcharges (fees) for a number of regulated practices which Wisco EI 'S a can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried easurla is used in your building is returned to the groundwater through your soil absorption o system or the disposal site used by your holding tank pumper. I The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- t water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398(R.03/86) DILHRSANITARY PERMIT APPLICATION COUNTY / ONES In accord with ILHR 83.05,Wis.Adm.Code STA SANITARY PERMIT# —Attach'bomplete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 8%x 11 inches in size. —See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES ®NO PROPERTY OWNER PROPERTY LOCATION David DeGear SW '�4SW Y4, S34 T31 . N, P18 f[(or) W PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME 1050 Neal Ave 14 n Germain & Hannon CITY,STATE ZIP CODE PHONE NUMBER 7n CITY NEAREST ROAD,LAKE OR LANDMARK Afton, Minn. 55001 n a ❑ VILLAGE:Star Prarie Golf Course Rd. 11. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family 4 OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in##1. Check##2,3 or 4,if applicable) 1. a. © New b. ❑ Replacement c. ❑ Replacement of d.❑ Reconnection of e.❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit## Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in##1 and only one in##2) 1. a. ®Conventional b. ❑Alternative C. ❑ Experimental 2. a. ❑System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. ❑ seepage Bed b. 0 Seepage Trench c. ❑ SeeDacle Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): 1000 1000 99.18 Feet ®Private ❑Joint ❑ Public VI. TANK CAPACITY Site Mnks n allons Total ##of Manufacturer's Name Prefab. Con- Steel Fiber- plastic Exper. INFORMATION ew xistin Gallons Tanks Concrete stCon- glass App. Tanks Septic Tank or Holding Tank x 1200 1 Weeks Concrete ® ❑ Lift Pump Tank/Siphon Chamber x 800 1 Weeeks Concrete ® El ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name(Print): Plumb s ignature:(No mps) KiMPRSW No.: Business Phone Number: Gary L. Steel 3254 5-246-62 Plumber's Address(Street,City,State,Zip CkqAK L Name of Designer: 988 N. Shore Dr. New Richmond. 54017 VIII. SOIL TEST INFORMATION Certified Soil Tester(CST)Name CST# Gaa L. Steel CST's ADDRESS(Street,City,State,Zip Code) Phone Number: 988 N. Shore Dr. New Richmond., Wi. 54017 1 246-6200 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sa nary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) Approved El Owner Given Initial I/��` ,tom Sy,[charge Fee Adverse Determination CIO X. COMMENTS/REASONS FOR DISAPPROVAL: �*(xe tad b� 1-k6 fy\a-s Q. t�t Isbn SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber APPLICATION FOR SANITARY PERMIT STC - 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 Cj. ,i- Location of Property p t J �6 ,DLO 14, Section 7> / , T 3 N-R ZI W Township 5+r,A I V0-c Mailing Address Address of Site /g Subdivision Name Lot Number ? , 3 c-j Previous Owner of Property v Total Size of Parcel -1 . V 3 c.vr Date Parcel was Created Are all corners and lot lines identifiable? �( ` Yes No Is this property being developed for resale (spec house) ? Yes _ No Volume a _ and Page Number _6M as recorded with the Register of Deeds. -6- 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 refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (We) centt6y that aQt 6tatements on thi6 604m ane true to the befit o6 my (ouk) hnow.tedge; that I (we) am (aAe) the owneA(.6) o6 the pnopenty de6cAi.bed in th.i.6 .in6o4mation 6o4m, by viAtue o6 a waAAanty deed neconded in the 066ice o6 the County Re9iAten o6 Veed6 ab Vocument No. if� ; ; and that I (We) pneaentty own the pnoposed site bon the 6ewage di.6pob .6y6 em (on I (we) have obtained an ea6ement, to nun with the above de cA bed pnopehty, bon the con6tnucti.on o6 said syetem, and the Game hae been duty neconded in the 066.ice 06 the County Reg•idten o6 Deeds, dA Doeament No. �/ 3 I . SIGNATURE Old OWNER SIGNATURE OF CjOWjqER (IF APPLICABLE) DATE SIGNED DATE SIGNED DOCUMENT NQ. STATE BAR OF WISC N S I N ORM 11 1982 THIS SPACE RESERVED FOR RECORDING DATA LAND CONTRACT Individual and Corporate (TO BE USED FOR ALL TRANSACTIONS WHERE OVER 525,000 IS FINANCED AND IN OTHER NON-CONSUMER �E� � aF�CE ACT TRANSACTIONS) S�, . CROIX flog,, W& Contract,by and between Edward E. Germain, Recd- fOr ReCorld 9* 23rd John A. Hanner do'of Jan bD: 1927 jwhether one or more)and David DeGear • an Wendy J ( Vendor , 8-30 A DeGear, husband and wife, as ioint tenants ("Purchaser",whether one or more). Vendor sells and agrees to convey to Purchaser, upon the prompt and full per- formance of this contract by Purchaser, the following property, together with the rents, profits, fixtures and other appurtenant Interests (all called the "Property'), In St. Croix County,State of Wisconsin: RETURN TO Tax Parcel No. Lots 1, 2, and 3 of Germain and Hanner Addition to the Town of Star Prairie. r' Lot 14 of the Certified Survey Map filed in Volume 5 of the Certified Survey Maps on Page 1493 as Document No. 398580, being a part of the Southwest Quarter of the Southwest Quarter (SW14 of SW's) of Section Thirty-four (34) , Township Thirty-one (31) North, Range Eighteen ' (18) West. This is not homestead property. ()s) ps not) Purchaser agrees to purchase the Property and to pay to Vendor at __ a designated place the sum of$ 17-000-00 in the following manner: (a)$ 1 ,?O no at the execution of this Contract;and (b)the balance of$-1-5-,284.98 together with Interest from date o5 r,xa � il. at111Uehar:. .... until paid In full,as follows: Monthly payments of not less than $170.00 to be applied first to interest, then to principal, with the entire principal balance due and payable five (5) years from the date of closing. Upon an additional payment of $12,000.00 to be applied toward outstanding principal, seller shall release by warranty deed Lot 14. All other terms shall remain the same. Provided,however,the entire outstanding balance shall be paid In full on or before the f i fteen day of January , 19 9 2 (the maturity date). Following any default in payment, Interest shall accrue at the rate of 10 % per annum on the entire amount In default (which shall Include, without limitation, delinquent Interest and, upon acceleration or maturity, the entire principal balance). Purchaser, unless excused by Vendor, agrees to pay monthly to Venda amounts sufficient to pay reasonably antici- pated annual taxes, special assessments, fire and rsi;liutrld Insurance PI'Mluma when due. To the extent reoelved by Vendor, Vendor agrees to apply payments to these obligatIlosig,when due. Suck amounts received by the Vendor for payment of taxes, assessments and Insurance will be deposited lnto 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 princl al. Any amount may be prepaid without premium or fee upon principal at any time after Jerry 15 19T (OR) In the event of any prepayment, this contrast 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 oountinued In the event of credit of any proceeds of Insurance or condemnation,the condemned premises being thereafter excluded herefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: Easements of record I Purchaser agrees to pay the cost of future title evidence. If title evidence Is In the form of an abstract, it shall be retained by Vendor until the full purchase price Is paid. Purchaser shall be entitled to take possession of the Property on Date of closing ,19 'Cross Out One. 2278 LAND CONTRACT—Indlvlduel and STATE BAR OF WISCONSIN NTF Corporate FORM rlu. 11 --1982 Nolco Forms,P.O.Box 1075,Green Bay,WI 51305-1075 �DOi4 ,r PAGE 6U0 Purchaser promises to pay when due all taxes and assessments levied on the Property or upon Vendor's interest Tn it and to deliver to Vendor on demand receipts showing such pa q yment. �A \ � Purchaser shall keep the improvements on the Property Insured against loss or damage occasioned by fire, ex- tri 'tended coverage pef4a and such other hazards as Vendor may require, without co-Insurance, through Insurers approved by Vendor, in the sum of$ NSA but Vendor shall not require coverage In an amount more than the balance owed under this Contract. Purchaser shall pay the insurance premiums when we. The policies shall `y contain the standard clause in favor of the Vendor's Interest and, unless Vendor otherwise agree?s `;n writing, the original P of all policies covering the Property shall be deposited with Vendor. Purchaser shall promptly give notice of loss to insurance companies and Vendor. Unless Purchaser and Vendor otherwise agree In writing, Insurance proceeds shall be applied to restoration or repair of the Property damaged, provided the Vendor deems the restoration or repair to be o, economically feasible. i Purchaser-covenants not to commit waste nor allow waste to be committed on the Property, to keep the Property In good tenantable condition and repair, to keep the Property free from liens superior to the lien of this Contract, and ({) to comply with all laws..ordinances and regulations affecting the Property. S� 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 I. 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: None i! Purchaser agrees that time is of the es ce and (a) in the event of a default in the payment of any principal or interest which continues for a period of Vd days following Ithe speolfled due date or (b) in the event of a default in performance of any other obligation of Purchaser which continues for a period of 60 .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 Vendors option and without notice (which Purchaser hereby waives), and Vendor shall also have the following ights and remedies (subject to any limitations provided by law) in addition to those provided by law or In equity: (11) Vendor may, at his option, terminate this Contract and Purchaser's rights, title and interest in the Property and recover the Property back through strict foreclosure with any equity of redemption to be conditioned upon Purchaser's full payment of the entire outstanding balance, with Interest thereon from the date of default at the rate in effect on such date and other amounts due hereunder (In which event all amounts previously paid by Purchaser shall be forfeited as liquidated damages for failure to fulfill this Contract and as rental for the Property if Purchaser fails to redeem); or (11) Vendor may sue for specific performance of this Contract to compel immediate and full payment of the entire outstandng balance, with interest thereon at the rate in effect on the date of default and other amounts due hereunder, In which event the Property shall be auctioned at judicial sale and Purchaser shall be liable for any deficiency; or (iii) Vendor may 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 interest of Purchaser is Insignificant; and (v) Vendor may have Purchaser ejected from possession of the Property and have a receiver appointed to collect any rents, Issues or profits during the pendency of any action under (i), (ii) or (iv) above. Notwithstanding any oral or written statements or actions of Vendor, an election of any of the foregoing remedies shall only be binding upon Vendor if and when pursued in litigation and all costs and expenses Including reasonable attorney's 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 Property, Including homestead Interest, to collect the rents, issues, and profits of I the Property during the pendency of such action, and awn rents, Issues, and profits when so collected shall be held and applied as the court shall direct. Purchaser shall not transfer, sell or convey any legal or equitable Interest In the Property (by assignment of any I 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 Put almm-Is inlemat-u+iglw. ttt1Y contract solely as security for an indebtedness of Purchaser. In the event of any such.transfer, sale or veyance-withota viondar's written consent, tM eIRiliMe i uito ttdift balance payable under this Contract shall become Immediately due and payable In full, at Vendor's option without-notice. Vendor shall make all payments when due under any mortgage outstanding against the Property on the date of this Contract (except for any mortgage granted by Purchaser) or under any note secured thereby, provided Purchaser makes timely payment of the amounts then due under this Contract. Purchaser may make any such payMients 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 sixteenth _day of January 19 .87 6L � J D �-- --.4 (SEAL) __ (SEAL) Edward E. Germain David 0. DeGear (SEAL) /144 ' '�- (SEAL) ` i John A. Hanner Wendy J. NeGear AUTHEhkTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ss. St. Croix County. authenticated this day of '19 Personally came before me this 16th day of r January ,19 87 the above named Edward E. Germain, John A. Hanner, David 0. DeGear and Wendy J. DeGear TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me wn to e e persons who executed the authorized by§706.06,Wis.Stats.) for ing str nt and ach1hb i kWgdMe.eAM&A THIS INSTRUMENT WAS DRAFTED BY ACORN REALTY, TNC_ ennis Fleisehauer 245 Main Street Notary Public 9t; fi County,Wis. Somerset. WT 515 My Commission is permanen . (If not, state expiration (Signatures may be authenticated or acknowledged. Both date: September 10 , 19_9() are not necessary.) Names of persons signing in any capacity shoud be typed or printed below their signatures. NTF 2278A State Bar of Wisconsin LAND CONTRACT—Individual and Corporate Form No.11-1982 Nelco Forms,P.O.Box 1075,Green Bay,WI 54305-1075 L ' cn • H a • STC - 105 r a • H SEPTIC TANK MAINTENANCE AGREEMENT 0 St . Croix County z C7 a Jp C H OWNER/BUYER '7i Q,� �0. 4 ROUTE/BOX NUMBER (gyp Fire Number `t' CITY/STATE ZIP PROPERTY LOCATION : -5 LL)14, Section, T 31 N , Rte$$ _W, Town of e>&, � St . Croix County , Subdivision , Lot number Improper use and maintenance of your septic system could result in its premature failure to handle wastes . Proper maintenance con- sists of pumping out the septic tank every three years or sooner , if needed , by a licensed septic tank pumper . What you put into i the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system . St . Croix County residents may be eligible to receive a grant for e a maximum of 60/ 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 veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping ( if nec- essary) , 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 . 0 E I/WE, the undersigned, have read the above requirements and agree N to maintain the private sewage disposal system in accordance with x the standards set forth , herein, as set by the Wisconsin Depart- ro ment 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 D A'1'E St . Croix County Zoning Office P .O. Box 98 Hammond , WI 54015 715-796-2239 or 715-425-8363 Sign , date and return to above address . DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR P.O. BOX HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON,WI 53707 (H63.090) & Chapter 145.045) I!OCATION: SECTION: TOWNSHIP/%46 ib�ffY: LOT NO.:BLK.NO.: SUBDIVISION NAME: SW ��,CW t/4 34 /T31 N/P.8 f(-0W1 Star Prarie n/a n/a n/a COUNTY: 9V 8W'S/BUYER'S NAME: MAILING—ADDRESS: St. Croix David DeGear 11050 Neal Ave. S. Afton Minn. 55001 USE DATES OBSERVATIONS MADE NO BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE S R A N T Residence 4 n/a RINew ❑Replace 4-3-87 n/a 771 RATING:S=Site suitable for system U=Site unsuitable for system CONVENTIONAL:IMOUN D: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTEM:(optional) ©S ❑U ❑S ®� x❑S ❑U ❑S ©U ❑S 0U conventional If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b),indicate: ClaSS 2 Floodplain,indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS Page 19 COC2 BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH U NUMBER DEPTR , OBSERVED EST. I HEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- 1 7.61 102.15 none >7.61 .92bl.1. 1.86bn.s.sil. 4.83 bn.s. . B- 2 6.50 102.68 none >6.50 .67bl.1. 5.83bn.s.1. B- 3 6.83 102.89 none >6.83 3.33 bn.l.s. 3.50bn.c.s. B- 4 6.92 102.20 none >6.92 3.67bn.l.s. 3.25 bn.s.l. .83bn.s.1. 1.42bn.l.s. 2.00bn.s.1. B- 5 7,75 102.74 none >7.75 B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD2 P PER INCH P- P P_ PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION Loi 7 I� T1 t t 'I 4l _ TN I I r I,the undersigned,hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME(print): TESTS WERE COMPLETED ON: Gary L. Steel 4-3-87 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): 988 N. Shore Dr. New Richmond Wi, 54017 2298 715-246-6200 CST SIGNAT. RE: "21, DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) --OVER -- David DeGear SW4 SW4 S.34-T31N.-R18W Town of Star Prarie zX Wo e--4'?4 y� P, Gary L. Steel 988 N. Shore Dr. New Richmond, Wi. 54017 NPRSW 3254 4 PAGE: CF PUMP CHAMBER CROSS SECTIOIJ ANG SPECIFICATIONS VENT CAP 4*C.Z. VENT PIPE WEATHER' PROOF APPROVED LOCKING 4�. JUAICTIOU BOX MANHOLE COV P-5' FROM DOOR, WIWDOW OR FRESH IL"MIU. AIR INTAKE. I GRADE 1 y.MIN. � is"rrlu. COIJDUIT -- ---------- PROVIDE INLET I --- -7 AIRTIGHT SEAL I I I I I I V I o APPROVED JOINT A F l te APPROVED JOIIJTS W/C.I. PIPE EXTENDING 3' I III ALARM EXTENDIWG 3' OUT-0 SOLID SOIL I I ONTO SOLID f01L B I I I I ON c i 1 ELEV. r FT. PUMP-� --� OFF D CONCRETE BLOCK RISER EXIT PERMITTED OAJLy IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E SPECIFI*GATIOAIS TANK MANUFACTURER: IJUMBER OF DOSES: PER DAH TANK SIZE: poo GALLONS DOSE VOLUME ALARM MAUUFACTUKER: ►C3l �`� INCLUDING 6ACKFLOW: GALLONS MODEL IJUMBER: �� CAPACITIES: A=_LSIL_IIJCRES OR ©Z' GALLOWS SWITCH TSPE: �r 5= Y.--IUCWES OR 89 GALLOUS PUMP MANUFACTURER: CD C v..1 __-- C= IAICHES OR . . -�,1-GALL01J5 MODEL NUMBER: 0.3�. D- - IMCHES OR GALLOUS SWITCH TVPC: ►, rL'V�ic.s^-�( NOTE: PUMP AWD ALARM ARE 70 B[ MINIMUM DISCHARGE -36 INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AUD 013TRIBUTIOU PIPE.. Z20 FEET ♦ MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . �- FEET ♦ .�D� FEET OF FORCE MAIN XLl—g�=.FloorLFRICTION FACTOR. FEET I L) TOTAL DIPJAMIC. 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