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CROIX COUNTY WISCONSIN JrJ) GpvM In accord with Chapert 12 St. Croix County Sa in PLANNING &ZONING DEPARTMENT �Olfb7+' Personal information you provide may be used for s condary purpo ST. CROIX COUNTY GOVERNMENT CENTER [Privacy Law. S. 15.04(1)(m)] �� 1101 Carmichael Road PV Hudson, WI 54016-7710 (715)386 -4680 Fax (715)386 -4686 Attach complete plans for the system on ap t less than 8 -1/2 x 11 inches in size. County Sa i ary Permit # ❑ Check if revision. us application C � I. A lication Information - Please Print all Information Location: T � Propert Owner Name /7 p, / Ll /) c S W 1/4 �1 /4, Sec Y IN ss r N, R E (or W Property Owner's Wailing A ,p O� d Lot Number Bloc 2S , y 3 ity, State Zip Code Phone Numer Subdivision Name CSM Number __+�; - ZID - 53 -6 7 - 5 7 II �T of Building: (check one) f _ ❑City ❑ Village own of � 1 or 2 Family Dwelling- Na. of Bedrooms: < �iS � , � El Public /Commercial (describe use): v (rA L L _ 10 State-owned Nearest Road II. Type of Permit: (Check only one box on line A. Check box on line B if applicable) Parcel Tax Number(s) A) 1 Repair 1 2.0 Reconnectio 3.Won- plumbing . ❑Rejuvenation �/ 9 5 �� 3 U Sanitation ` / �J B) Permit Number Date Issued ❑ State Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) ❑ Non - pressurized In- ground ❑ Mound >_ 24 in. suitable soil ❑ Mound <_ 24 in. suitable soil ❑ Mound A +0 ❑ Sand Filter ❑ Constructed Wetland ❑ Peat Filter ❑ Drip Line ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass QY6ther ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed (Gals. /day /sq.ft.) (Min. /inch) Elevation VI. Tank Information Capaicty in Gallons Total # of Manufacturer Prefab Site Con- Steel Fiber- Plastic New Existing Gallons Tanks Concrete structed glass Tanks Tanks ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ VII. Responsibility Statement I, the undersigned, assume responsibility for repair /reconnenction /rejuvenation /installation of non - plumbing for the POWTS shown on the attached plans. A license is not required for terralift repair or the installation of non - plumbing sanitation system. PI tuber's Name (print) Plumb 's Sig t e (no stamps): MP /MPRS No. Business Phone Number Plumber's Address (Street, City, Stale, fj Code) AY AL 1 4 VIII. COUM Use Only Disapproved SaPer Fe Date Iss ed issuing Agent tur stamps) Approved Owner Given Initial Adverse � � J/ / g a Determination IX Conditions of Approval /Reasons for Disapproval: J /� f� Q ¢ ( / /� - W U % X1 4 s / 30 � A " . M (lilll (llil lll(I 1(l(l li(I(lill[ ll(I lli(ll I(ll lilt Document Number J Document Title 914006 BETH PABST St. Croix County REGISTER OF DEEDS ST. CROIX CO., WI Non Plumbing Sanitation Affidavit RECEIVED FOR RECORD // 03/31/2010 04.1OPM !'Al l� pay)a 1 � _c�4 E,S AFFIDAVIT 1 EXEMPT f Name — (Owner) Typed or print�i REC FEE: 11.00 being duly sworn , states, under oath, that: PAGES: 1 He /she is the owner of the following parcel of land located in St. Croix County, Wisconsin, recorded in Volume 1.841 Page 388 Document Number 671861 St. Croix County Register of Deeds Office: Recordinm Area ( " A parcel of land located in part of the SW '/4 of the NW 'A and the Name and Return Address NW 'V4 of the SW '/4 of Section 14 , T 28 N — R 16 W, Mark D. Hughes 2405 Larpenteur Avenue Town of Eau Galle , St. Croix County, Wisconsin, being duly I Lauderdale, MN 55113 described as follows (include lot no. and subdivision/CSM or detailed 008 - 1040 -95 -300 legal description): Parcel Identification Number (PIN) Lot 3 of Certified Survey Map recorded in Volume IS, Page 4212 as Document No. 663277 1. A Soil Evaluation Report for this lot was completed on 8/21 /01 for installation of a mound Private On -site Wastewater Treatment System (POWTS) and is on file with the St. Croix County Planning & Zoning Department. 2. An existing structure on this lot is being used as a habitable dwelling, but contains no plumbing for potable water and/or wastewater. Occupants of said structure utilize a composting toilet for disposal of human waste, which was authorized by a non - plumbing sanitation permit in compliance with Sections 12.A. l .g and 12.3a.2 of the county sanitary ordinance. 3. No plumbing may be installed in the premises served by the non - plumbing sanitation device until a sanitary permit has been obtained for installation of a code - compliant POWTS. 4. This agreement shall be binding on the owner, their heirs, assignees and/or land contract purchaser. I also acknowledge that I will disclose this information to any parties interested in purchasing this property in the future. Zoning Authorizatiol -4 41Z Date 7'NAk cf4 a oZ0 / U Dated this 3 1— day of ar z° �� • v AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) )ss. St. roix County. ) -�� r authenticated this day of Personally came before me this 4,�� day of QiO10 the above named 9r _ to me known to be TITLE: MEMBER STATE BAR OF WISCONSIN the person(s) who executed the foregoing instrument and p i�ft� e (If not, same. ��� authorized by § 706.06, Wis. Stats.) � gip• . THIS INSTRUMENT WAS DRAFTED BY '�.. Q r� 0 V Notary Public, State of Wisconsin (Signatures may be authenticated or acknowledged. Both are not My Commis si n is -^ anent. If not, state expirati necessary.) Date: O G / "THIS PAGE IS PART OF THIS LEGAL DOCUMENT — DO NOT REMOVE" This information must be completed by submitter: document title. dr return a d _ . and PIN (if required). Other information such as the granting 0$tdtes, leagal description, etc. maybe placed on this first page of the document or maybe placed on additional pages of the document Nate: Use of this cover page adds one page to your document and 52.00 to the recording fee. Wisconsin Statutes, 59.517. Owner: Hughes, Mark D. Computer #: 008 - 1040 -95 -300 Address: 2405 Larpenter Avenue Parcel #: 14.28.16.207A30 Lauderdale, MN 55113 Municipality: Eau Galle, Town of Address: 355 250th Street Baldwin, WI 54002 0211212010 Larson, Scott D. Daniel Sitz Received complaint from Town chair. 0211712010 Larson, Scott D. Daniel Sitz Sent letter. 0212412010 Larson, Scott D. Daniel Sitz Scott called (715.556.7337) - said that he has owned property for a year and has a soil test. Said he lives in the old farmhouse with a composting toilet - no running water. He said that if the Town won't let him live there then he will move somewhere else. Need to check with Town about building permit issues. 0212612010 Larson, Scott D. Daniel Sitz Spoke with Todd Dolan. He said that he didn't think there would be too much he could do if the structure was just moved onsite unless there was new foundation or something built. I called Scott back and left message asking about times to meet for an inspection. 0310312010 Larson, Scott D. Daniel Sitz Called Scott. Set up meeting onsite next Thursday with him and Todd at 1 pm. 0311112010 Larson, Scott D. Daniel Sitz Met Scott and Todd Dolan (building inspector) onsite. We looked through the house. Todd said that Scott will need to set house on a cement foundation. I didn't find any indoor plumbing or water. He has a composting toilet which he will need to get an after the fact sanitary permit for. The greenhouse with the dish on it actually has tools and machinery in. The toilet is a Sun -mar Excel NE sized for 2 adults or 1 family. The original farmhouse is 768 square feet (2 story). The additions are another 128 square feet. 0311212010 Larson, Scott D. Daniel Sitz Called Scott and left message for him to check measurement of house again and call back to set up appointment for sanitary permit. He called back with new measurements of 24.5 x 16.5 for the house (x2), 19x8 for the addition, and 8x24 for the green house portion. This totals 1,152.5 square feet. Called back and left message requesting him to come into the office soon to get a permit. 0312512010 Larson, Scott D. Daniel Sitz Scott came in. We filled out the permit. Scott paid. Later, permit was reviewed by Pam. Found out that Scott does not have the deed yet due to a land contract. Need to have owners signature. Pam handling permit application. ST CROIX CO &A IL UN"Iy PLANING &, Z0NNG March 29, 2010 ft` � Mark Hughes 2405 Larpenteur Ave. Lauderdale, MN 55113 RE: Non - plumbing sanitation permit - Town of Eau Galle Parcel #008 - 1040 -95 -000; Computer #14.28.16.207A30 Code Administrate 715 - 386 -4680 Dear Mr. Hughes: Landlnformation & This is to notify you that an existing structure on the above property at 355 250 Street is being used Planning as a habitable dwelling and is being occupied by Scott Larson. Mr. Larson has a land contract with 715- 386 - 4674 you for purchasing the property, but until the contract has been satisfied and a deed transfers title, you are the responsible property owner. Although no plumbing has been installed within the Real P rry structure, a composting toilet is being utilized for disposal of human waste. Our records show that in 715 -4677 2003 and again in 2006, our office received complaints that previous land contract purchasers were R cRre living on the property without any sanitation devices, which is a violation of county ordinance g 5 - 386 - 4675 12.1F.b. On Febru 17 2010 Mr. Larson was notified that he is in violation of both county ordinances 12.1.F.b and 12.3(A)(1)(d): "A sanitary permit shall be obtained by the property owner, his or her agent or contractor, before any POWTS or non-plumbing sanitation system may be installed, replaced, reconnected, restored, or modified." To resolve this current violation, Mr. Larson has submitted an after - the -fact application for approval of the composting toilet. Before I approve this permit, an affidavit must be signed, notarized, and recorded with the St. Croix County Register of deeds to disclose the lack of plumbing within this structure. An August 2001 Soil Evaluation Report is currently on file that documents an acceptable location for 1 installation of a Private On -site Wastewater Treatment System ( POWTS) on this property. At such time as any legal property owner wishes to install a well, interior plumbing within any structure, and a POWTS on this site, a separate sanitary permit must be obtained from our office. It is important to correct this situation as soon as possible. Please complete the enclosed affidavit form and submit it with the appropriate recording fee to the Register of Deeds office within 10 days of receipt of this letter. Their mailing address is 1101 Carmichael Rd., Hudson, WI 54016. Should you have any questions, please contact me at this office. S' , amela Quinn Zoning Specialist Enc. (2) cc: Dan Sitz Code Enforcement Scott Larson, purchaser Town of Eau Galle ST. CRO /X COUNTY GOVERNMENT CENTER 1 101 CARMICHAEL ROAD, HUDSON, WI 54016 7153864686 FAX PZ@CO.SAINT-CROIX.WI.US WWIN.CO.SAINT-CROIX.WLUS Document Number I Document Title St. Croix County Non- Plumbing Sanitation Affidavit Name — (Owner) Typed or printed being duly sworn , states, under oath, that: He /she is the owner of the following parcel of land located in St. Croix County, Wisconsin, recorded in Volume 1841 Page 388 CON Document Number 671861 St. Croix County Register of Deeds Office: Recording Area A parcel of land located in part of the SW %a of the NW t/4 and the Name and Return Address NW %a of the SW %4 2405 L of Section 14 , T 28 N — R 16 W, Mark a Hughes La Hughes Avenue Town of Eau Galle , St. Croix County, Wisconsin, being duly Lauderdale, MN 55113 described as follows (include lot no. and subdivision/CSM or detailed 008 - 1040 -95 -300 legal description): Parcel Identification Number (PIN) Lot 3 of Certified Survey Map recorded in Volume 15, Page 4212 as Document No. 663277 1. A Soil Evaluation Report for this lot was completed on 8/21/01 for installation of a mound Private On -site Wastewater Treatment System (POWTS) and is on file with the St. Croix County Planning & Zoning Department. 2. An existing structure on this lot is being used as a habitable dwelling, but contains no plumbing for potable water and/or wastewater. Occupants of said structure utilize a composting toilet for disposal of human waste, which was authorized by a non - plumbing sanitation permit in compliance with Sections 12.A. l .g and 12.3a.2 of the county sanitary ordinance. 3. No plumbing may be installed in the premises served by the non - plumbing sanitation device until a sanitary permit has been obtained for installation of a code - compliant POWTS. 4. This agreement shall be binding on the owner, their heirs, assignees and/or land contract purchaser. I also acknowledge that I will disclose this information to any parties interested in purchasing this property in the future. Zoning Authorization Date `7'nAAc Dated this day of AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) )ss. St. Croix County. ) authenticated this day of Personally came before me this day of the above named to me known to be TITLE: MEMBER STATE BAR OF WISCONSIN the person(s) who executed the foregoing instrument and acknowledge the (If not same. authorized by § 706.06, Wis. Stats.) f THIS INSTRUMENT WAS DRAFTED BY fn 0) CL lD tp 0 �- 0 r+, C o �. Cr o acs o 0 CA r� 0 cn p e 3 S r � ro 3 M 0 m v 0 M r- v 0 C 0 W 6 < rt 3 c, M Sri- n CD cu a = 3 0- 0_ lD � cn m to (D S rt ? 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Code Certified Soil Testing C ounty Attach complete site plan on paper not less than 8Y: x 11 inches in size. Plan must St. Croix Include, but not limited to: vertical and horizon nt (BM) direction and e, scale or dimensions, nort w, a t' Parcel I.D. percent slope, 2� p � cpti n distafir�e to nearest road. acr / Please prirmatio Revie Date s x' Personal information you provide m d for s a ur (PriveGy l aw; .15.04 (1) (m)). P rope rt y wner ropey Location O. Lot SW1 /4 NW1/4 S 14 28 NR 16 W rt P roperty Owner's ing re - t: of # Block # Subd. Name or CSM THW N ST t pox Z'PInding City St t Co er cti Cit Village Town Nearest Road Woodville WI 715 - 69 Eau Galle 3�j� 250Th St. New Construction Use: Ig Reside bedrooms 3 Code derived design flow rate 450 GPD Replacement IS Public or commercial - Describe Parent material t il l Flood plain elevation, if applicable NA General comments and recommendations: install 4'x 112.5' rock unit mound on 100.0 contour as upslope edge of rock w/ 17 sand fill for 3 br a Boring# Boring Pit Ground Surface elev. 99.6 ft. Depth to limiting factor 16 in. P 9 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPM' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 1 0 -3 10YR 3/2 - sl 2 m gr ds cs 1f /m .5 .9 2 1 3-9 10YR 3/2 - sl 2 f sbk ds cs 1M .5 .9 3 9 -16 10YR 4/4 - sl 2 m sbk mvfr cs if .5 .9 4 16 -26 10YR 4/6 f2d 7.5YR 5/8,5/3 scl 0 m mfi - - 0 0 i I F il Boring # Boring VA Pit Ground Surface elev. 101.5 ft. Depth to limiting factor 19 in. P 9 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 -4 10YR 3/2 - sl 3 m gr ds cs 1f /m .5 .9 -- .- ---t -- -- 2 ! 4-10 10YR 3/2 sl 2 f sbk ds cs if .5 .9 3 j 10 -19 10YR 4/3 - sl 2 m sbk mfr cs if .5 .9 4 19 -33 10YR 4/6 f2d 7.5YR 5/8 scl 0 m mfi - - 0 0 I common gy si coats on peas in horizon " Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L ff nt #2 = BOD < 30 mg /L and TSS < 30 mg /L CST N ame ease Print) Number i a ure: Henry F. Grote 222774 Address Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 8/11/2001 715 - 233 -0398 Property Owner Peavey, Bill Parcel ID # 5 acre CSM Pending Page 2 of 3 a Fi-1 Boring # Boring Pit Ground Surface elev. 99.4 ft. Depth to limiting factor 22 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots I = in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 -4 10YR 3/2 _ sl 3 m gr ds Cs 1f /m .5 .9 2 4 -10 1 OYR 3/2 _ sl 2 f sbk ds cs 1M .5 .9 3 10 -22 10YR 4/3 - sl 2 m sbk mfr cs 1M .5 .9 4 22 -32 10YR 4/6 f2d 7.5YR 5/8 scl 0 m mfi - - 0 0 common gy sl coats on pe s In onzon F4 ]Boring # . Boring Pit Ground Surface elev. 100.0 ft. Depth to limiting factor 17 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots = in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 -3 10YR 3/2 _ sl 3 m gr ds cs 1f /m .5 .9 2 3-11 10YR 3/2 _ sl 2 f sbk ds cs 1 m .5 .9 3 11 -17 10YR 4/3 _ sl 2 m sbk mfr cs 1 m .5 .9 4 17 -50 10YR 4/6 f2d 7.5YR 5/8 scl 0 m mfi - - 0 0 common gy si coats on pe s in horizon F-1 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 GP in. Munsell Qu. Sz. Cont. Color Gr, Sz. Sh. 1 Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L " Effluent #2 = BOD < 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) Certified Soil Testing j 4 rAl 3 � o � Ja KO ' b r 9 t1 ' 9� r4 a 0 .4- 0 ^ 1 6 s {— J C„ 0 0 Z \J 663277 KATHLEEN H. WALSH REGISTER OF DEEDS JAN 4 S REC IVED 11- 27 -2001 3:30 PM F L. 1 r il J r �. 2 w?.... ---� COPY FEE: 3.00 RECORDING FEE: 13.00 CERTIFIED SURVEY MAP WILLIAM AND JEAN PEAVEY Part of the Northwest 114 of the Northwest 114, the Southwest 114 of the Northwest 114 and the Northwest 114 of the Southwest 114 of Section 14, Townshi p g 28 North, R an g e 16 West, Town of Eau Galle, St. Croix County, Wisconsin. Legend: 0 Indicates 314" outside diameter round iron bar 24" long having a minimum weight of 1.13 Ibs./lin. ft. set. ° Indicates soil boring for proposed septic system. Lot Areas: ° Lot 1- 2.995 acres or 130,472 square feet. 0 2.695 acres or 117,404 square feet excluding road a UNPL LANDS right - of - way. Lot 2 - 4.203 acres or 183,104 square feet. k I I 5 88057'44 "E 32 0 .0 4 ' 3.883 acres or 169,139 square feet excluding road W W 2 . /8' 290.86' right -of -way. Lot 3 - 3.671 acres or 159,910 square feet. Q 6 3.171 acres or 138,113 square feet excluding road 0 ) ° right -of -way. 0 f 1 1 '� Owner's Address: W h I h 2530 C. T.H. "N" L 7' / "' Woodville, W/ 54028 2 3 z= o I C( 01,17y io S88-57'4 E /66.06' W ►� tip,' � U t 1 126.A p I 2 7.69' ;r:ay,; 01 M W cp I� 6 W y I V1 �' S88° 744 "E /53.98' 4� U. O� k ° z� ozl k \t N z o 3 � Q W W 4 N h N m o4I mzo j o H Q O Q O O SCALE / 200' Iq ° 2 1 215.99' 294.05' 0 50' /00' 200' 300' 400' 500' 600' 588° 5 '44 "E 320.04' Z ° This instrument drafted by Laurence W. Murphy Q Q I BARN O T 3 Dated: October 3, 2001 W a O Q Inv a b sNEO LAURE W. gnu HY 5 Report for Parcel #0081040953001 St Croix County, W1 Page I of 1 2009 Property Record I St Croix County, W1 Assessed values not finalized until after Board of Review Property information is valid as of 3123110 Years in red have delinquent taxes NOTICE; All payments received by County t reasurer will be posted the next clay. Property Description Billing Information Parcel ID: 008-1040-95-300 Name / Attn.: SCOTT D LARSON Map ID: 14.28.16.207A-30 Address: 2563 CTY RD G Municipality: TOWN OF EAU GALLE City, State, Zip: EMERALD, WI 54013 Public Land Survey: SECTION 14 28N 16W Ownership Quarter: SW Primary Owner: SCOTT D LARSON QQ / Tract: NW Secondary Owner: NO SECONDARY OWNERS LISTED Plat: CSM 15-4212 088-2001, LOT 03 Description: SEC 14 T28N R16W PT SW NW & NW SW Deed information BEING CSM 15/4212 LOT 3 3.671AC Volume Page Document # Property Address: 355 250TH ST 881305 Total Acres: 3.67 ACRES 870727 1 2859 029 802425 Assessed Value 1890 193 678930 Valuation Date: 10/07/2008 1841 388 671861 1663 220 648729 Assessment Acres Land Improved Total 1628 422 644078 Type Value Value Value I GI-Residential 3.67 32,700 14,500 47,200 Other Totals --> 3.67 32,700 14,500 47,200 Fair Market Value $45,600.00 Installments Assessment Ratio: 1,0346 Please pay your 1st installment or full payment to County Net Assess. Val. Rate: 0.015185331 Treasurer, 2nd installment to the County Treasurer. Period Due Date Amount School Districts 231 - BALDWIN -WOODVILLE AREA 1 01/31/2010 321.11 Tax Detail 2 07/31/2010 321.10 Total Taxes 642.21 Net Tax Before Lottery, First Dollar Credits 716.75 Tax Payment History Lottery Credit (-) .00 Date Receipt Number Amount First Dollar Credit 74.54 01/28/2010 26401 321.11 Net Tax After 642.21 Paid By: LARSON Amt. Due Amt. Paid Balance Net Property Tax 642.21 321.11 321.10 Specials Special Assessments .00 .00 .00 Category Amount Special Charges .00 .00 Delinquent Charges .00 .00 Private Forest Crop .00 .00 .00 Woodland Tax Law .00 .00 .00 Managed Forest Land .00 .00 Penalties .00 .00 Interest .00 .00 /� % Total 642.21 321.11 321.10 1 V, ZV http: / /stcroixwi. mapping - online .com /StCroixCoWi /PareelReport.j sp?keyword=O 0 810409 5... 3/25/2010 * 8 8 1 3 0 5 4 881305 KATHLEEN H. WALSH State Bar of Wisconsin Form 11 -2003 REGISTER OF DEEDS LAND CONTRACT ST. CROIX CO., WI (TO BE USED FOR NON- CONSUMER ACT TRANSACTIONS) RECEIVED FOR RECORD Document Number Document Name 09/11/2008 12 : 30PM LAND CONTRACT CONTRACT, by and between Mark D. Hughes, a single person EXEMPT / ( "Vendor," whether one or more), REC FEE: 17.00 TRANS FEE: 171.00 and Scott D. Larson PAGES: 4 ( "Purchaser," whether one or more). Vendor sells and agrees to convey to Purchaser, upon the prompt and full performance of this Contract by Purchaser, the following real estate, together with the rents, profits, fixtures and other appurtenant interests ( "Property "), in St. Croix County, State of Wisconsin: recording area Name and Return Address Lot 3 of Certified Survey Map recorded in Volume 15 on page 4212 as Mark Hughes Document No. 663277 bein g a of the Northwest Quarter of the Northwest 24 05 Larpenteur Avenue part Q Quarter (NW 1/4 of NW 114) and the Southwest Quarter of the Northwest Lauderdalc, Minnesota 55113 Quarter (SW 1/4 of NW 1/4) and the Northwest Quarter of the Southwest Quarter (NW 1/4 or SW 1/4), Section 14, Township 28 North, Range 16 West, Town of Eau Galle, St. Croix County, Wisconsin. 008-1040 -300 Parcel Identification Number (PIN) This is homestead property. (is) (is not) This is a purchase money mortgage. (is) (is not) Purchaser agrees to purchase the Property and to pay to Vendor at 2405 Larpenteur Avenue, Lauderdale, Minnesota 55113 the sum of $ 57,000.00 in the following manner: (a) $ 3,000.00 at the execution of this Contract; and (b) the balance of $ 54 , together with interest from the date hereof on the balance outstanding from time to time at the rate of 5 % per annum until paid in full as follows: Purchaser shall pay the balance of $54,000.00 plus simple interest at the rate set forth above, by means of monthly payments to Vendor in the amount of $500.00 per month, commencing on October 5,2008, and continuing each month thereafter, with payments due on or before the fifth (5th) day of each month thereafter until the entire outstanding balance of interest and principal is paid in full. provided the entire outstanding balance shall be paid in full on or before September 5,2020 ( "Maturity Date "). Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. CHOOSE ONE OF THE FOLLOWING OPTIONS: IF NO OPTION IS CHOSEN, OPTION A SHALL APPLY ® A. Any amount may be prepaid without premium or fee upon principal at any time. ❑ B. Any amount may be prepaid without premium or fee upon principal at any time after ❑ C. There may be no prepayment of principal without written permission of Vendor. State Bar Form I I -Page 1 ® 2003 STATE BAR OF WISCONSIN 1 of 4 1, 142 . a a 0 j I