HomeMy WebLinkAbout020-1084-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
(ATTACH TO PERMIT) 538713 0
GENERAL INFORMATION State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m) }.
Permit Holder's Name: City Village X Township Parcel Tax No:
Gavin, Gary Hudson, Town of 020 - 1084 -30 -000
CST BM Elev: Insp. BM Elev: / BM Description: Section/Town /Range /Map No:
/u B 41 ( 6ST 29.29.19.337A
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER K,/,, .S CAPACITY STATION BS HI FS ELEV.
Septic Benchmark /�
2 �. Cz 3 J Z.(t i Alt. BI(p C_ d , ( Ott . 46 LA) l..J /
/�a 1 ak 62 J Bldg. Sewer ���r
Holding j ' St/Ht Inlet
``-
St/Ht Outlet
TANK SETBACK INFORMATION Y 3? 93, 17
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD ,Qt-Ialct Z I
0... . 7r7tio c i f
Septic
` °i 07 /6 � °ttem t a - 4-- 1c.b 91 • s5
Dosing 76 c� / 'J•- 7 /t Header /Man //. 6 / d . / <
Aeration Dist. Pipe /
l(4 96 ,15
Holding Bot. System
Final Grade
PUMP /SIPHON INFORMATION T.4' q3.
Manufacturer Demand St Cover
GPM ) / 7- 5
�` GGJ-Cti. J
Mo m er
DH Lift Friction Loss S - ead TDH Ft C --......„.„.......
Forcemain eng Dia. Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width / Length / t t— No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. 'Liqui Depth
DIMENSIONS 3 ( 4 2 l e �.
SETBACK SYSTEM TO 0 P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer. p, r kJ,
INFORMATION / i CHAMBER OR HV'
Type Of System: , /
64 t/' -4) (J /g 57 � I c � r w C /�_ UNIT Model Number.& L � / ' G j
DISTRIBUTION SYSTEM 7 r-� 7 j6 /6 ..7 / r4.
Header/Manifold Dia Lengaanifold l t Distribution x Hole Size x Hole Spacing Vent to Intake
Length /�
'T Pipe(sth ) Dia Spacing •-•.............. N, \` y w- 1-lc,w� c3•.t1
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only 6 IJ / (Neu,. a
Depth Over / Depth Over xx Depth pf xx Seeded /Sodded xx Mulched
Bed/frenchhCCenter 3 ( Bed/Trench Edges *\ Topsoil \ Yes 0 No Yes Ea No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / /
Location: 446 Frontage Road Hudson, WI 54016 (SE 1 /4 1/4 29 T29N R19W) Presidential Estates Lot 1 Parcel No: 29.29.19.337A
rY /
1.) Alt BM Description = i-c� Gbi .b( W 01r 6 Z J a ,.— (0 I
2.) Bldg sewer length = r
- amount of cover = E k G1 �c. �.i i �'+
1 I
Plan revision Required? M Yes EN O /MA '"�/ Use other side for additional informatio, ))) ' D� �a tp D,5 �.
SBD -6710 (R.3/97) Date ' Insepctor's Si• ature / Cert. No.
L
,
commerce.wi.gov Safety and Buildings Division County /���
201 W. Washington Ave., P.O. Box 7162 ���C�fDi .�'
i sc o n s i n Madison, WI 537 Sanitary Permit Number (to be filled in by Co.)
Department of Commerce , j
it 1 7
Sanitary Permit App . - O State Transaction N er
In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission o this font-To the appropriate govemmental
unit is required prior to obtaining a sanitary permit. Note: Applic. ' • • • ••• • . •• • . • .1 are Project Address (if different than mailing address)
submitted to the Department of Commerce. Personal information •u ro
p EIVE113 seco• ary II
.0 .oses in accordance with the Privac Law, s. 15.04 1 m Stats. / i /
I. A • • lication Information - Pleas.` 'nt All Information (� r J '
Property Owner's Name O
OCT 2 0 2010 1 Parcel # 020 a; - _.
.:�. f r
Property 0 per's Mailing • ddress ST. CROIX COUNTY Property Location �� 7
.1 I -. . Ai PLANNING & ZONING OFFICE Govt. Lot (e IS
Zip Code Phone Number y, ,.._-5" /, Section ,---,7 9
circle o
IWI a. r
�C54 T- N; E
1. Type of Building (check all that apply) Lot # �9
1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name / / l
Block # /7 o4 4- d4-/ S -TES
❑ Public /Commercial - Describe Use ❑City of
❑ State Owned - Describe Use CSM Number ❑ of l
Vol ,2 Town of ,,,,_s-,1,-,)
>I
III- Type of Permit: (Check only one lox on line A. Complete line B if applicabl •
A.
❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
a of Plumber List Previous Permit Number and Date Issued
❑ Permit Renewal ❑ Permit Revision ❑ Chan
Change ❑ Permit Transfer to New
Before Expiration Owner •• t
..... IN • [e
IV. Type of POWTS System/Component /Device: (Check all that apply) Aids • t 4 Q '
%Non- Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil
❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain)
V. Dis • ersai/Treatm • nt Area Information:
Design Flow r Design Soil Application Rate(g. f) Dispersal Area Required (sf) Dispersal Area Proposed (s System Elevation
V . Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units o G a U g
New Tanks Existing Tanks •:.°. 2 U v "'
g / O /0 (� r n y to w 5
M r Holding Tank / 7L
_ M !n MI
VII. Respons bility Statement I, the undersigned, assume responsil;, ity for install" n of the POWTS shown on the attached plans.
Plumbe 's : Plumber's • igna MP/MPRS Number Business Phone Number
A AMP I � _ 7s c / i
Plumber's • ddress (Street, City, State, - • • • 0
VIII. Coun / Department se Onl it 1
r Approved isapprove Permit Fee Date Is ed Issuing t Signatu /�/
iven Reason r.IIenial
IX. Condit' �^itho asons for Disapproval : :: P t ' � /^ �
• a ,
1. Septic tank, effluent filter and '
dispersal cell must all be services / maintaineQ r „ _ 4..0 os4 t✓ k' 1*, C..
as per management plan provided by plumber.
2: An setback requirements must be maintained
Attach to complete plans for the system and submit to the Coun only on paper not 1 than 8 1 2
County Y P p no less n / 1 imp •: n'
SBD -6398 (R. 02/09) Valid thru 02/11
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CP441/4
CONVENTIONAL COMPONENT DESIGN
Residential Application
INDX AND TITLE PAGE
Project Name: l``'/ Kcf 64) l/t)
Owner's Name: / C
Owner's Address: �� � L K/f.e,
Livi e 14) .1 l/
Legal Description: r �y_ �; s ' _ 7 '9 i/ 2
Township:
X'
Subdivision Name: ,Es"'>rD. j6, -/
Lot Number: f
Parcel ID Number:
Page 1 Index and title
Page 2 Plot Plan
Page 3 System Sizing
Page 4 System Cross - Section
Page 5 Filter Specs
Page 6 Maintenance & Management Plan
Page 7 Septic Tank Maintenance Form
Page 8 Warranty Deed
'age 9 CSM or Plat
Designer /Plumber: A 4 ) License Number:
Date: , c ?� /d Phone Number 7/ - - 79/
Signature
Designed pursuant to the In- Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD- 10705 -P (N.01 /01).
Page 1
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Soil Absorption System Cross Section
ft
I 144 4' Schedule 40 Final Grade
PVC Vent Pipe
lArrth Vent Cap 4r _8 9,..5 ft
( Th
Leaching
Chamber
AI-- ft
System Elevation
ft Jft
Soil Absorption System Plan View
de ft
-3 ft 4 1111111111011111101=11111111111111111115:
Leaching
Trench 1
Vent Or Observation Pipe Chambers
11 .0 1 J II 11 1 1 1111 1 IIIIIIIIIUI I 0111111E— \ 4"Dia.
Trench 2 Header
Leaching Chamber Specifications
Manufacturer And Model 2f-1 44
EISA Rating (: -(7) sq ft per chamber Soil Application Rate gpd/sq ft
I gpd Design Flow + 7 Soil Application Rate + 4 ,-Q6 EISA = Chambers
2 rows of chambers each.
Page of
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f
iii OK Inc INSTALLATION INSTRUCTIONS �,
nt
irro+aliccs it Precast, Zee'- PL-525/PL-625 F 1 LT E R
& V`astevsfer Products A Drvisnn of Po o Inc.
INSTALLATION INSTRUCTIONS
Center filter
�� F with opening / ,
.W- _' n .. t ( tr r .f .. . s•
3.- -. v m.c $ y . ` v-. T ' E- 1 r.
�f I I E
1 0 Rim. f 'c
x • f• q . ..
a5
to
S
e
1
Additional pipe or
Polylok Extend & Lok't
for ceritenng G lue
Ste p 1:
Step 2: Step 3:
(A) Locate the outlet of the septic tank. (A) Before installation, place the (A) Glue the filter housing on the
(B) Remove tank cover and pump tank filter housing on to the outlet pipe. outlet pipe.
if necessary. (B) Make sure that the housing (B) Insert the filter cartridge in the
is positioned so the filter can be housing, making sure the filter
removed from the tank for cartridge is properly aligned and
maintenance and service. completely inserted in the housing.
IVIAINTENANCE INSTRUCTIONS
i ■ 1 : 1 , 'j f h l i tilig ^�.c� `E .. o� \,`. .: air ''. -� r s
`2 f ' r� ; - '-='1,,---'-'-''.'17-----' b
s
y
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_
Step 1: Step 2: Step 3:
Locate the outlet of the septic tank. q
Remove tank. ( A) e tank cover an
d u
m
A p p ( ) Insert the filter cartridge back
DO NOT USE PLUMBING if necessary. into the the housing making sure
' WHEN FILTER IS REMOVED (B) Pull the filter out of the housing, the filter is properly alighed
(C) Hose off the filter over the septic tank. and completely inserted.
1 1 USE RUBBER GLOVES Make sure all solids fall back into the (B) Replace septic tank cover
WHEN CLEANING RLTEP.
septic tank.
I
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page (p of
,—,LE INFORMATION SYSTEM SPECIFICATIONS
PerMit 4 no, c ❑ NA
• Septic Tank Capacity gal
Septic Tank Manufacturer 14)i .
.,e ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
u -be- of Bedrooms 1 a ❑ NA Efflyent Filter Model • ) O) ,(' ❑ NA 1
• �i"/5/1/4" 0NA
Number of Public Facility Units 3&` NA �� Tank Capacity !J‘� gal 1
stimz`ed flow' faveraae; �� gal /day Tank Manufacturer lL) ,-,./e-5 ❑ NA s
)
Design flow (peak), (Estimated X 1.5) �`-�; gal /day Pump Manufacturer • • ❑ NA
Soil Application Rate / '
i , � gal /day/ft Pump Model ❑ NA 1 2
' Standard influent /Effiuent Quality Monthly average'` Pretreatment Unit 1il NA
Fats, Oil & Grease (FOG) !30 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter I
Biochemical Oxygen Demand (BOO 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5_150 mg /L ❑ Disinfection ❑ Other:
u 9
E i
Pretreated t„ [uent Quality Monthly average Dispersal Cells} f7 r v a,
Biochemical Oxygen Demand (BOD 530 mgfL )g hi- Ground (gravity) ❑ In- Ground (pressurized)
Total Suspended Solids (TSS) 530 mg /L lm NA ❑ At -Grade ❑ Mound • Fecal Coliform (geometric mean) 510` cfu /10Om1 ❑ Drip -Line ❑ Other:
r ✓+aximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA
Omer j , Other:
{ ❑NA 0 N
- Values typical for domestic wastewater and septic tank effluent ( other ❑ NA
vi AlNTENANCE SCHEDULE
Service Event Service Frequency
inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA
12: ear(s)
Pump out contents of tank(s) When combined sludge, and scum equals one -third ( % of tank volume ❑ NA i
4
, -specs dispersal celi(s) At least once eve every: ❑ month(s) (M 3 ears) ❑ NA .
r
'�` year(s) Y 1
F A
6 Clean effluent filter At least once every:
❑ month(s)
5 114 year(s) ❑ NA 1
`,nsaer: pump, pump controls & alarm At least once every: ❑ month(s) g1 NA
�`' ❑ year (s)
• ❑ month(s) g NA
s,,, i „_, Ga end pressure test At least once every: ❑ year(s)
s: ❑ month(s)
At feast once every; ❑ year(s) > NA
Jig NA
_ 3
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 visual inspection of the tank(s) 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 celi(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface_ The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one -third (%) or more of the tank volume, the entire
contents of the tank shaft be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code_
Ali other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units. and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
Page OT
• START UP AND OPERATION
`or -ev co nstruction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process andfor damage the dispersal celi(s)_ if high concentrations are detected have the contents
of the tanks) 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 highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cefi(s) in one large dose, overloading the ceil(s} and may result in the backup or surface discharge of
effluent. To avoid this situation 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
estore 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: S_ 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.
;�.SANDONMENT
O hen 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:
o All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
0 The contents of aft 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 code compliant
replacement system:
LI A suitable replacement area has been evaluated and may be utilized for the location of a replacement sod absorption
system. The repiacement 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.
L A suitable repiacement area is not available due to setback and /or soli limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
y 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_
O Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time
< < WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN 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 OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
rODITIONAL COMMENTS
f OWTS INSTALLER POWTS MAINTAINER
Name I I ° Name
A — ) Phone .7g/ - ��/ 7 Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name
Phone Phone / —� - _? 1
-his docu. -e .: >:as a= :_-::-ante with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54 (1 (1), (2) & (3), Wisconsin Administrative Code.
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERIThICATION FORM
Owner
/Buyer (..) c C ),:�I
Mailing Address _ i./ ./ii, , ,, , ,� se. J j
Property Address p rty dr ss -��,,,
(Verification required from Planning & Zoning Department for new construction.)
City /State - Parcel Identification Number
LEGAL DESCRIPTION
Property Location i/4 ,
1/4 , Sec.,---?9 , T9 9 N R /9 W, Town of - zd/. so „) .
S u b division EJ%.lL= a)% - AT-5 LOt # / .
Certified Survey Map # , Volume 7” , Page # 9e .
Warranty Deed # , Volume , Page # .
Spec house yes 61 Lot lines identifiable yes o
SYSTEM MAINTENANCE AND OWNER CERl'IJICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on - site
wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is
less Than 1/3 full of sludge.
L'wwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
sta set r as set by the -+
standards s� � north herein. a� s... by u:.. Leparthaent of Commerce and the Department of 'Natural Resources, State of Wisconsin -
CerEfica io stating n statin that your septic stem has been maintained must be completed and returned to the St. Croix .. P y mp o th S C orx County Planning &
Zomn, Department within 30 days of the three year expiration date.
Y
-- Y �P
Uwe certify that aII statements on this form are true to the best of my /our knowledge. Uwe ani/are the owner(s) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
Numbe I f bedrooms ..?
.. ---...z.,-
6 %9 //,
SIGNATURE OF APPLICANT(S) DATE
"'Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * **
_- ::: de with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
- i ff7f.71Ce is made in the warranty deed.
_ R cQDK f P1G v we a P
uQCtamerl-r rip ST BAR OF - WISCV +R SIN `-++ + 11 `� i.lQ�a 4; TI`I& *PAL.4 A ESS.RViCO VOA IR =CORGI no OATH
J LAND CONTRACT
°1, ; ,k :. ' o... - _ i4 istinitanai nut Coiponate
` -' — alai a ii Si,u L it ifefa SNi!Cti i t11Tt IN iT gt NON.ESiaLliIEH
"°®''--- ACT T'TiAN3AC QN
TI °3 1 FP i3
E I ST. CROIX c0, WIS.
" contract b y end between ___D li._ 8 .._Leleiis_._...._-__----- .. - --- kee'd for Record this 15th
._- -...___ aLkLa-- -.as.- Darner R _ . Lewis
Jere n 19 26
l' arla#3.or nano .fir. rnn'wl and -.. L :25 P • i /f i
s- , . =.rt- -- east' A Jzavin anti 1 Are A ti.eeen \ e ...ea 13 if !F
";,":11: Husband and Wife (`Purchaser", whether one or more).
' Vendor ;sells and agrees is convey to Purchaser, upon the prompt and full per- tailleggihr
• C1 , '.formanee of this contract by Purchaser, the following property, together with the
L'_ — .... .........4t4... - A .ru sf O +ka,• aterea...te ant int•reata Iall called the "Pronert9").
s -- E t' s.i County, State of Wi RET
. _ :. ,.IRN TO
P
C ' -- -- z r Park of SF3__ of SW1 of Section 29 -29 -19
tL _ ,ie.cr•ri a fell 1nem
Lot 1 of Certified Survey Map filed December
21, 1979 in Vol umn "4", page 903(No. 54) Tax Parcel No.
-
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i
- '11
..- Tr -
c. le.
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;I I -
'ell t!
- I
It T his i s not homestead property I
r; (i.) (is not)
where ever designated
Purchaser agrees to purchase the Property and to .pay to Vendor at ,
the sum of $ 14 000. t10 in the followin manner: (a) $ Z 1 S�G• �a
1 :AO the execution of this Contract; and (b) the balance of $ 11,4 , together with interest from date
• I hereof on the balance outstanding from time to time at the rate of 10 per cent per annum
4 a ntzi paid in full, as follows:
_�_ Payments of $200.00 or more to be paid each month beginning July 15, 1986
;T, and' "continuning each month there after.
5- it
{ - ]1 Provided, however, the entire outstanding balance shall be paid in full on or before the A lc day of
II --= 'sliJS]f' , WV" - _ (the maturity date),
Following any default in payment, interest shall accrue at the rate of ..1 % per annum on the entire amount
T 1n default' '(which shall include, without limitation, delinquent interest and, upon accel eration or maturity, the entire
▪ 1 principal 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
I tares, assessments and insurance will be deposited into an escrow fund or trustee account, but shall not bear interest
✓ 1 11 unless 'otherwise required by law.
-= r ' = Payments shall be applied first to interest on the un paid balance at the rate specified and then to principal. Any
1 ,
• I 1 amount may be prepaid without premium or fee upon rrincipaI zit any time after day __of__ 41g5ing_, 19 ('N§
XleetlUtrateC9C :1[)410X1PXO1 POTS LtX0(XleiX0111 :1)Cl itICO etYlis eta teg)(0fXXe0XteXA
4 t this. contract shall - in t aven.. of any prepayment, ceri_rac_ a__aL n_ A
t be treated as in default with respect to payment so long
i i as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated
▪ 11 as unpaid principal) is less than the amount that said indebtedness would have been had the monthly payments been
made' as fiat specified above; provided that monthly payments shall be continued in the event of credit of any proceeds
1: 1 ': „e •>.de,n>.atinn tha n ndemnod nrenlinna hainv thereafter excluded herefrom.
i 1 ... � i _._- _._a__ that r- .__i-____ t_ _ _.e_ ...:.A .L... ti eet el..." b th a;,le eo:don°o sir!'n » d 6A R,.•^haaor
.- .._ - II r- urcuaae� 09o...cm �.. «.. ........9.ow
I I for examination except:
t
u
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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 le paid. y'
Purchaser shall be entitled to take possession of the Property on JUNG. L'a9 , 1884._..
.Cron. Out One.
LAND CONTfACT— Individual and STATE BAR OF WISCONSIN w Neon sin Laval Blank Co. Ina.
Corporal. FORM Nu- 11 - 1952 1fl... Wie
•
FORM NO. 985•A
u”tt.Cenp
•
CERTIFIED SURVEY MAP
.
2" IRON PIPE FOUND TO MARK t— '• -c 1/4 CORNER
0
CENTER OF SECTION 29,T 29N, \ SECTION 29
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• r,� • r9 BY FEDERAL B.L.M. RULES PURSUANT
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N p hp , 0 t a , TO ACT OF CONGRESS OF FEB .,1805.
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no S 0 II 59"E , I co v] 0 . 2" PIPE FOUND TO
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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page . / of -3
Division of Safety and Buildings
in acco • i - ' Comm 85, Wis. Adm. Code
County ' 4 ,
Attach complete site plan on paper not less tha •■■ 2 'l cs • si Ian must
include, but not limited to: vertical an. orizontal refer nce poi .ttion and Parcel I.D.
percent slope, scale or dimensions, • - . nd to d distan to nearest road. 020 - 08 -• • -. MC.
, tint afP � • .. ed by / Date
Personal information you provide may e used for secondary purp Orivacy r w, s. 15.04 (1) (m)). r ( 1 /6/2///o
Propee OCT 2 Property Location
L j . r ,/ , 4 0 20 I Govt. Lot ` 3" - A" 1/4 i 1/4 „ , _ N R E (or e
Property • , :r's Mailing Address 'G /X Lot # Block # Su Name or CSM#
. ".;• • ;. O N 1- - /AN _ �.v S
fir -te Zip C. •e Phone �,,f 4 ■ City v village Eirown Nearest Road
❑ New Construction Use: Residential / Number of bedrooms . 3 Code derived design flow rate l`,7`? GPD
X Replacement 1l ❑ Public or commercial - Describe: ____ __ _
Parent material .Yri7es Flood Plain elevation if applicable �� ft.
General comments
and recommendations: %AA I e . . o _% fi r ,' , 88. S
/ Boring # ❑ Boring
® Pit Ground surface elev. .g: 7 ,3 — ft. Depth to limiting factor > . ) in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "Eff#2
— / 3 /oegi ti 4 6ii r / ex4 ,Pa , 7° 8
q Q
Q 4
.3 .- ,7, /� >K ti / / s �;'h� y , , / /.� �' �/
d 1
it
(g■
1
Boring # [I Boring C
, 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/ff
P rY
in. Munsell Qu. Sz. Cont. Color l Gr. Sz. Sh. "Efff#1 •Eff#2
/ ()p— ,7 j0i.K�,6 ,d ,' (4isic)r , / Cas cizi i 7 G i ./ a
Q 4
a z3/ h9y / ,v 4 ,/s �� �, / aid .,?h, .7 //
,3 �/ is5�'�,4 _i. ! "- ,/ 1,2-7 , 7' /./ 1
<6 g 5
r /" li
• 411 - t #1 = - OD > 30 < • mg/L and TSS >30 < 150 mg/L • E n :0 30 mg/L and TSS < 30 mg/L
CST Na ' ease \ Signature CST Number
Address Date Evaluation Conducted elephone Number
__"75 O (2 le`, M --.5"_.7.6/ 7
Property Owner —?I (21 Parcel ID # Page of -
Boring # ❑ Boring /
` - ,J pit Ground surface elev. ,/j'.3 ft. " 'Depth to limiting factor ? /5 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2
R 4
�1 r�� ?r ' , 4 4
- -- `p 4
■.
1
!I
1 /6I
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/fr
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2
Boring #
0 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/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 •Eff#2
• Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg1L
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 (8.6/00)
Property Owner', i. Parcel ID # ` ' Page ca of
Bori #0 Boring
"� kU Pit Ground surface elev. 9/>-..4 ft. -- Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fW
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 •Efff#2
fi` /o� .� �� /i'„ ✓, .rr, / G3 S rh . 7 Z, 4
a r _ u
∎5 ! /� l6 l// 41 ,e). / /ri Q /, a
I
,s _
ft
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/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2
I Boring # 0 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/ff?
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 •Eff#2
•
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.6/00)
a .fAx , f , .5 -57 - 7
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