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022-1061-10-000
Wisconsin Deparent of Commerce PRIVATE SEWAGE SYSTEM County: Cn St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 515133 0 GENERAL INFORMATION (ATTACH TO PERMIT) 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: C udd, Jesse & Kathleen I Kinnickinnic, Town of 022 - 1061 -10 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: ) 60 G 5 21.28.18.3308 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER , f CAPACITY STATION BS HI FS ELEV. Septic ` Benchmark 9f2 CT t Dosing � Alt. 9eraterr Bldg. Sewer qZq- Holding St/Ht Inlet �1. Z$ SZZ. - 6 TANK SETBACK INFORMATION St/Ht Outlet TANK TO jP/L 1 WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 7 166 / Dt Bottom 3 Iz. $�{ Dosing Header /Man. Aeration Dist. P pe 5 •$ yic. Holding Bot. System 7z S• 3 PUMP /SIPHON INFORMATION Final Grade 3. 9'2% • ' $ Manufacturer Demand Str S � 5 GPM �"� "I�u Cam Z .5 q. Model Number ?Y5 4 � J TDH Lift Friction Loss System HeA T H L Ft -7. 6 7 Forcemain Length Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 89 SETBACK SYSTEM TO D P/L BLDG c WELL a LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR f Type Of System: I ! Z -7 / / �/ UNIT Model Number: u DISTRIBUTION SYSTEM ZZ E z/ L✓ Header /Manifo Distribution x Hole Size x Hole Spacing Vent to Pyy Ir�f�ke a L Dia / Length Dia ` Spacing \ I \ , SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Deptti,Qf xx Seeded/ odded Mulched Bed/Trench Center Bed/Trench Edges Topsoil \ \\ Yes 0 No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1124 River Drive River Falls, WI 54022 (NW 1/4 SW 1/4 21 T28N R18W) metes & bounds Lot Parcel No: 21.28.18 30� F' CZ U �Z v� c,✓ S re�,,� 5' 1.) Alt BM Description = G Q� D �( G J L 2.) Bldg sewer length = 9Z � - amount of cover Plan revision Required? [7] Yes X No TT Use other side for additional informati l b �l SBO -6710 (R.3197) Date Insepct s Sig re Cert. No. I _ PAID ��'U cl � f � 4 commerce.whgov Safety and Buildings Division County ` 11 / � a 201 W. Washington Ave., P.O. Box 7162 C o sconsin Madison, WI 53707 -7162 Sanitary Permit Number (to be filled in by Co.) Department of commerce Sanitary Permit Application State. Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental AA unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide 1'CMi "'VE cOndary 7 p urposes in accordance with the Privacy Law, s. 15.04 I m , Stats. L L Application Information - Please Print All Information Property Owner's Name AUG 05 2009 Pa # �y C 9 �� 7Z - co c) - io - Property Owner's Mailing Address FICE Property Location 3 3 d PLfINNING & ZONNJG OF i l V v 1 y Govt. Lot WIN State Z Code Phone Number ��� � / -3 "_� 1 // /� Q ] VV /., 1/l! /., Section Z 7/5� 6 5 V/ T �N R 1A c o �n if. ype of Building (check all that apply) Lot # !f f � 1 or Family Dwelling- Humber of Bedrooms __. ___ ..__. Slll?diy�SiQn Name Block # ❑ Public/Commercial - Describe Use I '� ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of ' R- Townof INAllL fCIAIA'fG III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. )k New System p y g p y g y ( ❑ Re Re S ❑ Treatment/Holdin Tank Re Onl Other Modification to Existin S B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV.Type of POWTS S stem/Com onent/Device: Check all that a 1 ' Y Lfti / .Non- Pressurized In -Ground ❑ Pressurized In- Ground q At -Grade ❑ ound > 24 in. ofsuitable soil ❑ Mound < 24 in. of suitable of ❑ Holding ank ❑ Other Dispersal Component ex lain _ Pretreatment Device ex lain K P P ( P ) Q ( P ) V. Dis ersaVrreatment Area Information: De Flow Flow (gpd) Design Soil Application Rate(gpdst) Dispersal Area Required (so Dispersal Area Proposed (st) System Elevatio s 0 V1. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units D v o v New Tanks Existing Tanks c �U rn LT a Septic or Holding Tank A i Dosing Chamber � VII. Responsibility Statement- I, the undersigned, assume responsibility for Installation of the POWTS shown on the attached plans. Plu ber's Name (Print) / Plumber's Signature MP /N40FA Number Business Phone Number O L o N - Z2 7 1 7 1 1 1-- 2 23 YW Plumber' Address (Street, City, State, Zip Code) Z Z VII Count /De artment Use Onl Approved ❑ Disapproved Permit F!�_ Date l!sW4 suing A igna e C1 Owner Given Reason for Denial ei� IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: �U 1 Septic tank, effluent filter and Jt� S _ dispersal cell must all be serviced / maintained 2. All as per management plan provided by lumber. W mot' B btptf@lil�t6ilM1L['}' and submit to the Cou ty dfi ly on pi,p r no less than 8112 11 Incpes 1 e as per applicable code /ordinances. []p R. 07) Valid ( 0 thru 01/09 .(,i1'l.1Yl E�l� ha lNl SBD -6398 1/ V j G �- � << 4 0, pal �z 00 SR Soy Pc uj j(° i t alga' V 4 ov a � Eco A b T q 00 v a � s COMBINATION SEPTIC/DOSE CHAMBER TANK & PUMP SPECIFICATIONS PER COMM 84.25 CODE CHANGES 2/1/2004 Access Opening, not top of cover, Access Opening, not top of cover, must a dead to a point no greater must e„tend at least than 6" Below Finished Grade 4" Above Finished , G rade Cover with CA'INEI� rx.� Y r 1 4 Locking Device 1TV 6 '64y (typical) Finished Grade /Z # '/V jV.11h Um t Sew - - -- � Min. 23" > 36 F1- >4 , Access Opening O r? 1NSULA'M Min. 23" Access Opening PI 2 �il/G ,�bp c�iriAi� Oulu Effluent Filter j 1A/ /7 Union ,2oYEP PIRG 3 Pr Inlet Baffle ON`1a .SOS -/D .SO /L i Pump Ola 3 " Saved ar r a w- ( ei uri e w1; A C'2n�r 2" tuyv s4A& ed eT Two Compartment Septic/Pump Tank / f ms o on vide M ,64- SPECIFICATIONS TANK MFR: DOSES PER DAY: TANK SIZE: SEPTIC 0OD GAL. DOSE VOLUME: Z GAL. DOSE 9&�V GAL. (INCLUDES FLOWBACK &<20% OF DWF) ALARM MFR: , �f CAPACITIES: A = ,ACHES = GAL. MODEL # - Switch type: c - q--t B = — 2 — INCHES = l'!` GAL. PUMP MFR: C = INCHES = / ffi'Z GAL. MODEL M P 1 SWITCH TYPE: Fto A+ D = (�_ INCHES = ' 3 1 ibAL. REQUIRED DISCHARGE RATE GPM PUMP & ALARM WIRING PER COMM 83.43(8)(e) VERTICAL DIFFERENCE BETWEEN PUMP OFF & DISTRIBUTION PIPE (LIFT) = FT. MINIMUM NETWORK SUPPLY PRESSURE (DISTAL & NETWORK PRESSURE) = + O FT. 4D FT. OF FORCEMAIN x q, // FT. /100 FT. FRICTION FACTOR . %)/. = + FT. TOTAL DYNAMIC HEAD (TDH) Zz FT. INTERNAL TANK DIMENSIONS: LENGTH ; WIDTH ; LIQUID DEPTH MP SI NATURE: LICENSE NUMBER: Z 2 /M�R�3' G A APR -12 -2005 16:28 FERGUSON ENT HUDSON 715 386 6144 P.01 HdOULDS PUMPS �� Submersible GkkfP-0 Effluent Pump PE wmw PUMP SPECIFICATIONS MOTOR FEATURES Pump — General; General: t Corrosion resistant •Discharge: 1'A" NFT if Single phase construction. • Temperature_ 104 (40 °C) • 60 Hertz ■ Cast iron body. maximum, continuous when • 115 and 230 volts s Thermoplastic impeller and fully submerged. • Built-in thermal overload pro- cover, • Solids handling: 1 /2" tection with automatic reset ■ Upper sleeve and lower maximum sphere, • Class B insulation. heavy duty ball bearing APPLICATIONS a Automatic models include a • 011-filled design. construction. float switch, • High strength carbon steel M Motor is permanently Specially designed for the a Manual models available. shaft. lubricated for extended following uses: • Pumping range: see PE31 Motor service life. • Mound Systems performance chart or curve, • .33 HP, 3000 RPM ■ Powered for continuous • Effluent/Dosing Systems PE31 Pump: • 115 volts operation. • low Pressure Pipe Systems • Maximum capacity: 53 GPM • Shaded pole design ■ All ratings are within the • Basement Draining • Maximum head: 25' TDH PE41 Motor working limits of the motor. • Heavy Duty Sump/ PE41 Pump: • .40 HP, 3400 RPM ■ Quick disconnect power Dewatering • Maximum capacity: 61 GPM • 115 and 230 volts cord, 20' standard length, • Maximum head: 29' TDH • PSC design i 15 or d ut y 16 /3 S with d ing P Pump: PE51 Motor. plug • Maximum capacity: 70 GPM • .50 HP, 3400 RPM ■ Complete unit is heavy duty, • Maximum head: 37' TDFI • 115 and 230 volts portable and compact. METERS FEET • PSC design ■ Mechanical seal is carbon, 40 ---,• I ceramic, BONA and stainless PE5i I I - I I MODELS: Pfi31, PE41, PE51 steel, 3$ I 1 I I I I I HR .33 .40, so ■ Stainless Steel fast eners. —� 2 GPM 30 ••PE4. - . I ' AGENCY USTINGS 1FT .i. „Q I 11 I !' i fill zo Tested to UL 778 and 15 I I �. �_, ► 1 1' CSA 222108 Standards ' I - ' i I i I I By Canadian stan�rds o I I ' file # M Assoda6on .., i I I I I ;• „L ! I I I I I. I - I Gourds PwnpS IS ISO 9001 Registered J. 0 • 0 10� 20 30 ' 40 50 I I I 60 70 I GPM SO 0 5 10 15 m Goulds Pumps ® 2004 ITT Water Technolog APACTY Effective June, 2004 9Y. �� RPE31141 < & ITT IndUStrleS k*4 STANDARD CHAMBER 52" Quick4 Standard Chamber 48" (EFFECTIVE LENGTH) E ff j r— AX 44 12* A T 96, s i 4 6" 34" SIDE VIEW SECTION VIEW MultiPort End Cap a 16". 12" 34" SIDE VIEW TOP VIEW FRONT VIEW INFILTRATOR SYSTEMS. INC. STANDARD LIMITED WARRANTY (a) The allucbxal hte^ of each chamber, end plate, wedge and otter accessory mer"Aecturetl by Inatrator ('U ft% when petaled and operated h a leachfield of an orefte septic system In accordance with InWtretoes hetrimtbre, Is warrarned to the original ptsdtaser rHotder9 against defactive materials and worWneltlp en for one year from the date that the septic permit Is issued �or the septic system oorteWng fine llrgts; prodded, however, O It a septic pemnit Is not roglie0 by applcable lsw, the =period will begin upon tine date that ittalalallan a rite septic system corrsrharncas. To exercise its warrant' rights. Holder moat rwtiy hMrat« h writing at Its Corporate Headquarters In Old Saybrook, Corrtecicug wfthh fifteen (1 . . . . days of the alleged deed. hatrat« wr soppy repiacenhent tagta i« urge detamtkbd by Willrator to be covered by this United Warranty. InNlreta^s lebat' spetdflcay eztludes the coal of removal and/« installation of ma urge. O Tb THE UNITS, IIINCUJD NG NO IMPUTED REME DIES IN `a ARE lTY THERE ARE � WITH RESPECT SYSTEMS INC (c) This Limited Warranty shall be void if arty pan of the charrlber system Is menuteatsed by anyone other then kJAaetor. The Urged Warranty does not extend to Incidental, consequential, special or hdiract dernages. InI trot« shall not be Ilabe f« Penalties «liq damages, Including loss of Environmental Onsite WBstewatw Solutions Production and Profits, labor and materiels, overhead costs, or other laeaee or expenses Incurred by the Folder or any mind party. Spook* excluded nom tkrgted Warranty coverage era dernage to the urge dire to ordinary wear and tear. alteration, accident, rNanse, abuse «neglect a the units the Uge babe But>bctad to Venice traffic or other conditions which are not Pertained by the Installation Instructions; failure to mantel, the 6 Business Park Road • P.O. Box 768 mhitrxxn ground covers sot form In the Installation instruction; the placement of irroroper materiels Into the system mnpahng the urge; faw.e Of Old Saybrook, CT 06475 the « e Urdthe septic sYeem due to itrtproper aging or Improper siting. r siti excessive water usage, Irnproper grease d « disposal. htproper oPerato « n; an other event not caused by hmo-atw.. This urged Warranty shell be vole I the Holder fella to comply with al ply w al a me tame ad form In cols United 860- 577 -7000 •FAX 860 - 577 -7001 Wa rranty ««.rot event shall be r «�;.�d« �« this to pw, �rt� °In�led � or ancs 800 - 221 -4436 wain el alts candticns requited by state and local codes; all other applicable laws; and InlYtratab Installation hetrucdors i Holder. representative a hWSat« has the au tlwriy «ex to dhange tend ft Urged Warranty. No warranty applies to any party Other man the Will - n et The above represents the Standard Urged Waranty offered by Infiltrator A Whited number of steep and co urn es have d oerem warrant' regtire- nnsms. Any Ptsdmw Of U afraid contact itdltrator's Corporate Headquarters in Old Saybrook, Carnadicut, prior to such pumhas% to obtain a copy of the applicable warranty, and should carekiy read that warrant' prior to the purchase of Use. U.S. Patents: 4,759,661; 5,017,041; 5,156,488; 6,336,017; 5,401,116; 6,401,459; 5,611,903; 5,716,163; 5,588,778; 5,839,844 Canadian Patents: 1,329,959; 2,004,664 Other patents pending. Infiltrator, Equalizer and SldeVVWKW are registered trademarks of Infiltrator Systems Inc. Infiltrator Is a registered trademark In France. Infiltrator Systems Inc. is a registered trademark In Mexico. Contour, Contour Swivel Connection, MbOLsaching, PoyTuf(, SnapLock, ChamberSpaoer, Posil-ock, QuIckCut, QuickPlay $LrCV Lff0 PAPER and Quick4 are trademarks of Infiltrator Systems Inc. 0 2003 Infiltrator Systems Inc. Printed In U.S.A Q011203HP -0 'AA. I D Wisconmn Departrnent of Cormeme SOIL EVALUATION REPORT - -� I of 3 jUlt Division of Safety and &M ngs Q in accordance with Conan 85, Wis. Adrn. Code County ST. CROIX Attach complete site plan on paper not less than 8112 x i 1 inches in size_ Plan must ina t uie, NA not limited to: vertical and horizontal reference point (W, direction and Parcel I.D. q ,� Percen slope, scale or dimensions, north arrow, and location and distance to nearest road_ • 1 8 • 330 °lease print aJ1 information. n Re by ' /0 Personal information you provide may be used for seewda s. 15.04 (1) (m)). - 7 Property Owner Property Location DOUGLAS CURD 009 Govt, Lot - - -- NW 1/4 SW 1/4 S 21 T 28 N R 18 E (or)W Property Owner's Mailing Address tot # Block # Subd. Name or CSM# 1645 River Ridge Road j CROtX GDUB lCE -- 9 . (0 4�/�p City State Zip Code Phongp dy []Village Town Nearest River Falls, WI 1 54022 ( 715 ) 425-6873 River Road a New Construction UseEj Residential ! Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: Pa vial � •t ' q �, PI J l/1Q rW_ - - outwash � � � Flood Plain elevation if applicable General cornownts and recd ons:' ' vim P'" "`� ? Conventional In- round trenches -- 0.7 loading rate s! �' Giavaa Pew 3 �e-c� ahe cc� 302) �-�, - I rfn/ - i - ea lo�l 1 # [] Boring . -����, 'u yig . El Pit C-" x surface elev. 100.42 ft 929. to limiting factor 102 in. / sod Application Rate Horizon Depth Dominant Color Redox Description re Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 1 0 -3 10YR2 /2 — is 3f -msbk ds cs 3vf-m 0.7 1.6 2 3 -13 10YR2 /2 is if -msbk ds cs 2vf -m 0.7 1.6 3 13 -24 10YR4 /6 — cos osg di as 3vf-m 0.7 1.6 4 24 402 10YR5/6 s osg dl -- -- 0.7 1 . 6 Horizon 4 has 45 -50% cos. ❑ 2 Boring # © Borin 100.52 R�. 6 110 El Pit Ground surface elev. th to limiting favor in. Soo Appl Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfff- in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 1 04 10YR2/2 - is 3fsbk ds cs 3vf-m 0.7 1.6 2 4-18 OYR2 /2 — is ]f- -msbk ds as 2vf-m 0.7 1.6 3 18-46 10YR4 /6 — cos osg dl gs __ 0.7 1.6 4 46-110 10YR5 /6 — s Os dl — -- 0.7 1.6 Horizon 4 has some cos. * Effluent #1 = BOD > 30 220 mg/l_ and TSS >30 < 150 mg& ' Effluent #2 = BOD, < 30 mg/!_ and TSS < 30 mg/I_ CST Name (Please Print) ature CST Number Mary Jo Hollister Hollister's Soil Testing & Desi 224832 Address Date Evaluation Conducted Telephone Number W9875 690th Avenue, River Falls, WI 54022 07-18-07 (715) 426 - 1775 �I } Cudd, Douglas 3 Q ] { 2 3 Property Owner P • P t ! Page of Boring p El Pit 98.37 �oZ1 �b 112 ■ Ground surface elev. Depth to Inrating favor �. Sod Application Rata Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Rods GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I *Eff#2 1 0 -3 10YR2 /2 -- is 3f -msbk ds cb 3vf-m 0.7 1.6 2 3-12 10YR2 /2 -- is 2f -msbk ds cs lvf -m 0.7 1 -6 3 12-24 10yR2 /2 -- is If -msbk ds gs lvf 0.7 1.6 4 24 -33 7.5YR3/4 -- is Ifsbk ds as lvf-co 0.7 1.6 5 33-44 7.5YR4/6 — s Osg ml as -- 0.7 1.6 6 44 -52 10YR4/6 -- s Osg ml as -- 0.7 1.6 7 52 -112 IOYR5 /6 -- s Osg dl -- -- 0.7 1.6 1-1 Boring # Baring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Appl ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIfg in. Munsell Qu. Sz. Cont, Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-I Boring # Boring Pit Ground surface elev. f:. Depth to limiting !actor in. Sod ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDRfz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I "Eff#2 � ............. .. - �2 a .. _ ._, � -..,...... ,. _ .....: ieC , #2 Ell 5 < 30 rn grL a — id T, SS _30 fflg✓L Tl, s • . s r • - - - _.._ __ _ _. ___ _ _ _._____ __ _z -: e • _- a -- _- ' - '- - - - _ - -- I l owPlot Plan for WS 11DEAe an z-f SO Property Owner C ux)b 8MM-R, : e u� 1 " = 40,ft. Legal Description IOw €3F IIAE SW /g �s Zr (except where No -r g,� ,��$•��, �w�J k�aN�eK� ��c ; �sT. cRO�x Z _ Backhoe pat c��srr�,N�S�aNs► �` %r North 4 ) 7 --7-7 ROO , � .`Y� - C �'t m�4.1%/.,- .�'L '' l.'[i�C, Gia j • � I � • I� as of z �e F J a .r u j Y Site Loc 5EC, V&W f , mPlot Plan for `WI-r ars .� � ��� � x -- Propeny 4wne` c u� 8u 3ess� c u� I" = 40ft Legal Description Nw`Ig aF- ' e sw` /y, s?t� (except wkere not4 -V .Z%A R mj -Tow,i W- Z = Backhoe pit c--� Ww%comaI A). North �ftJD" i_nc+ivio.a Or- nvsouvAr. CNCn� Aw GL 44 37 CW --4 � J � o F �vc � . VR 6,t ��-�ysr� 41 11 J EL 1em: !L I Q k � s ke Locat - SEC. ev oR�vE ? SCALE IN FEET V 200 0 100 200 400 �2 1 X2 ,� i S C. 21 ® - - - - - ------------------ - - - - -- . - ► - -- --------------------- 615.06 m o o LOTI 330A -10 t r: 0 90.00 O� ` 0 I Q G ti c ?s 6 0 0 p , N PP' lIXe-,5 s a � '�o• �'� ® N 8� 330 co 170' �U'�w LOT 2 r � _ LOT 3 ' u � T I F to .r � 1 330A— 20 330A �O ,� up9 0 Go A � � , APPROXIMAI PROPERTY BENCH MARK: \ \ 40d SPIKE SET IN NORTH \ �� SIDE OF A 26" MAPLE ELEVATION= 931.41 'i ,•' moo S ORDINARY HIGH , WATER MARK 'P 7 5 , & IR A .4T RkF/?O MqR� H BENCH MARK: Af%A L-MIVr l^rr 1 ►1 el^l IT t ' � n � � � ;ice �7�� _ � !`wY Y N _ _• • .,�. zap ', , I � `'�„"r.:•�� ; °� s , v t L ti (F( } hh 4 g $ .. r m t'watf O �' - 1 �•: � -`lv. ft � �' ` "'� ` R I , iJ d"i EF wig 04 It ..c 14 i .f , ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Bier Mailing Address ( w R (0 " (! ��CL� Lr/� 5�*'?z Property Address M t e yL ( V e )�' (Verification required from Panning & oning Department for new construction.) IV FL& � p z -1 - /0 - /o d 0 0 City /State T Parcel Identification Number _ 7 LEGAL DESCRIPTION Property Location ' /4 , ' /4 , Sec. 2 , T Z 9 R W, Town of �( AMIC 10AJA116 Subdivision Plat: , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # ?2? Ur� (before 2007)Volume Z (Page # 6 Spec house yes Kno Lot lines identifiable Kyes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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 ( l ) 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. t 1 /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I /we certify that all statements on this form are true to the best of my /our knowledge. I /we am /are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms GNA6 / L / Oq —� SIGNATURE OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) i 89Z13 96QI ►� • �` {I STATE BAR OF WISCONSIZ U 1 k 1982 P 0 9 KATHLEEN H. MALSH REGISTER OF DEEDS LAND CONTRACT ST . CROIR CO.. WI Individual and Corporate (TO BE USED FOR ALL TRANSACTIONS WHERE OVER RECEIVED FOR RECORD Document Number $25,000 S FINANCED AND IN OTHER NON -CONSUMER ACT TRANSACTIONS) 08/19/2005 10:15AN LAND CONTRACT CONTRACT, by and between Douglas J. Cudd and Kathleen A. cXEK.";T 4 Cudd, husband and wife holding as marital DroDerty ( "Vendor ", whether . 00 REC FEE: 15 one or more) and Jesse D. Cudd and Kathleen E. Cudd, husband and wife. TRANS FEE: 2646.10 holding as survivorship marita agrees property ( "Purchaser ", whether one or more). COPY FEE Vendor sells and a ees to con e y to Purchaser, u pon the prompt and full CC FEE: performance of this contract by Purchaser, the following property, together with PAGES: 3 the rents, profits, fixtures and other appurtenant interest (all called the "Property"), in St. Croix County, State of Wisconsin: see attached legal description: The Vendors herein retain the right to continue to maintain their garden Recording Area on the subject property for as long as said property is owned by the Purchasers Name and Return Address G Leo A. Beskar, Attorney 7 / The Vendors further reserve the Right of First Refusal should the RODLI, BESKAR, BOLES & KRUEGER, S.C. Purchasers be interested in selling the above described property. The 219 North Main Street, PO Box 138 Purchasers shall offer said property to the Vendors herein by giving River Falls, WI 54022 them a thirty day written notice of their desire to sell. If the written offer to sell is rejected, or has not been accepted by the Vendors within thirty days, then this Right of First Refusal shall be null and void and of 002 - 1061 -10 -000 no consequence to either party Parcel Identification Number (PIN) If the offer is accepted, then within fifteen days from the date such notice Is accepted, the Purchasers will provide a completed abstract of title or title insurance showing good and merchantable title of record with the sale to be consummated within forty five days after service of the Notice above specified, with said conveyance being made by warranty deed, free and clear of all liens and encumbrances. The Vendors herein agree to pay the real estate taxes on the subject property for as long as there is a balance remaining on this land contract. This is not homestead property. (is) (is not) Purchaser agrees to purchase the Property and to pay to Vendor at date of closing, the sum of $ 106.700.00 in the following inanner: (a) $ 20,000.00 down Davment by Aft, at the execution of this Contract; and (b) the balance of $ 86.700.00. together with interest from date hereof on the balance outstanding from time to time at the rate of 2.78 percent per annum until paid in full, as follows: Annual payments of interest only, with the full balance of principal and interest to be paid In full on or before December 31, 2007. Provided, however, the entire outstanding balance shall be paid in full on or before the 21 day of December 2007 (the maturity date). Following any default in payment, interest shall accrue at the rate of ¢% per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). $4?CD�'JGXO[Oi�7CQII Oilii7p3�7bidilitOfylC tXX�G8dt :3iEiYlild>}fs�EiKt�fextX3C�d 3b}Ll[Oi13��i3[ xs��xncoe��x�ax�:�>x llf; ��xar>vr�fr�s�f�ax��€a�at�r�csx al% x�l�dt xx9�i��oil�> r��xaxxil�xatxx1�3a1xext�axtx�aE���3���xaexa .���xai�ftxa�ttx�xatl�ilr�xac x�€ a�a» iaa�a�a�aal�ax� €xafa�xi��ac>wx�x Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any amount ma be re aid without premium or fee upon principal at any time after date of closing. , XXXX fiXaYo�is�fe7fe2bi }fet�is�t1it�E Wr3MK'K 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 remises being thereafter excluded herefrorn. P g Purchaser states that Purchaser 1 Is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: easements, restrictions, rights of way of record, if any. 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. • Cross out one. STATE BAR OF WISCONSIN INFO -PRO (800)655 -2021 www.infoprofomn.com LAND CONTRACT - Individual and Corporate FORM No. Il - 1982 U 2871P 020 Purchaser promises to pay when due all taxes and assessments levied on the Property or upon Vendor's interest in it and 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, extended coverage perils and such other hazards as Vendor may require, without co- insurance, through insurers approved by Vendor, in the sum of S land only 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 standard clause in favor ofthe Vendor's interest and, unless Vendor otherwise agrees in writing, the original ofall policies covering the Property shalt 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 ofthe Property damaged, provided the Vendor deems the restoration or repair to be economically feasible. 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 ofthis 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: no exceptions. Purchaser agrees that time is ofthe essence and (a) in the event of a default in the payment of any principal or interest which continues for a period of days following the specified due date or (b) in the event of a default in performance of any other obligation ofPurehaser which continues for a period of 45 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 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 Purchasers 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 (ii) Vendor may sue for specific performance ofthis Contract to compel immediate and full payment ofthe entire outstanding balance, with interest thereon at the rate in effect on the date ofdefault 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 attorneys fees of Vendor incurred to enforce any remedy hereunder (whether abated or not) to the extent not prohibited by law and expenses oftitle evidence shall be added to principal and paid by Purchaser, as incurred, 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 ofthe Property, including homestead interest, to collect the rents, issues, and profits ofthe Property during the pendency of such action, and such 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 ofany 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 Purchasers interest under this Contract solely as security for an indebtedness of Purchaser. In the event of any such transfer, sale or conveyance without Vendors written consent, the entire outstanding balance payable under this Contract shall become immediately due and payable in full, at Vendors option without notice. Vendor shall make all payments when due under any mortgage outstanding against the Property on the date ofthis 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 ofthis Contract shall be binding upon and inure to the benefits ofthe 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 ofthe deed to be made in fulfillment hereof.) Dated this OZ day of January. 2005 (SEAL) - 5FQ. (SEAL) * Douglas J. Cudd * Jes a D. Cudd (SEAL) (SEAL) * Ka teen A. Cudd Ka teen E. Cudd AUTHENTICATION ACKNOWLEDGMENT Signature(s) Douglas J. Cudd, Kathleen A. Cudd Jesse STATE OF ) D. j2vdd and Kathleen E. Cudd ) ss. County ) a t icated this a2 av January . 2005 Personally came before me this day of the above named * Leo A. Beskar TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the verson(s) who executed the foregoing (If not instrument and acknowledged the same. authorized by 4706.06. Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Leo A. Beskar RODLI, BESKAR, BOLES & KRUEGER- S C Notary Public. State of My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ,) Names of persons signing in any capacity should be typed or printed below their signature. INFO -PRO (600 )655 -2021 ww .infoprofomsxom STATE BAR OF WISCONSIN LAND CONTRACT - Individual and Corporate FORM No. 11 - 1982 U 20 ?1P 021 ?hat part of the Northwest Quarter.of the Southwest Quarter of Section 21; Township 28 :North, Range 18 West, Town of&innickinnic, St Croix County, Wisconsin described as follows:. Beginning at the southeast corner of said Northwest Quarter. of the Southwest Quarter of ;.Section 21; thence North 00 degrees 35'minutds 32 'seconds East, along the east.lini of said Northwest Quarter. of-the Southwest .Quarter, a distance of 872:40' feet to an-iron . is stake on the north 4anlc of the Kintiickiimic River, thence South 48 degrees 35 minutes 28 seconds'Wcst, a distance of 2Q0 feet; thence. South 76 degrees 19 minutes.28 seconds West, a distance of 100.00 feet thence South 07 degrees 35 minutes.28 seconds West a distance of 150.00 feet; thence North 76.degrees 54 minutes 32 seconds West, a distance. of 60.00 fed, thence Noith2I. degrees 54 minutes 32 seconds West, a distance of 250;00 . ,feet; thence North. 89 degrees 38 minutes 32 seconds West, a distance of90.00 feet; - , : .thence South 31 degrees 31' minutcs 28 seconds West, a distance of 100.00• feet; thence' South 09 degrees . 15 minutes 58 seconds Wcst,• a distance of 15.50 fact more oileas .to the ' ...thread'ofsaid Kinniclannie.River,at.the northeast corncr.ofthat certain Certified - Survey 'Map recorded in Volume 11, Page 31.32, on file in the Register ofDeeds Office, St. Croix- ' County,.riisconiiz; thcace South 00 degrees 06 minutes 33 seconds East, along the' cast . ;.'.line said Certified Survey Map, a'distancc of 46:00 feet more or-less to ati iron pipe.on the meander fine of said Certified •Survey'Map; thence continue South 00 degrees. .06 ininutes 33 seconds East, along said east.line, a distance of 8.00 feet to an awe point. in- said'line; thence South 51 - degrees 21. minutcs 44 seconds East, along said cast line, •a -distance 'of 32.10 feet to an angle point in. said cast line; thence South 00 degrees 06' minutes 33 sccondsEast; -along snit} east -line, a•distance of 630.63 feet to it s. intersection. with the south line of said'Northwest Quarter of the Southvicst Quarttr, thence South' 89 degrees .05 minutes 43 seconds East, .alocig said south line,'a distance of 546.1.9 feet to the... point of beginning.':Contai ng 9.26 acres more or less. _ Subject to town road.cascmrnt.over under and across thRt part.taken by Rivei Ihive arid- all other easemetrts.and restrictions of record, if any. U 2 8 7 1 P 0 17 at;D3<D -7 <D KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 3 - 2000 REGISTER OF DEEDS Document Number QUIT CLAIM DEED ST. CROIX CO., YI RECEIVED FOR RECORD This Deed, made between DOUGLAS CUDD a/k/a/ DOUGLAS J. C A MARRIED MAN 08/19/2005 10: ISAK QUIT CLAIM DEED ta" Grantor, and DOUGLAS J. CUDD and KATHLEEN A. CUDD, husband and REC FEE: 13.00 wife, HOLDIN AS MARI TAL PROPERT TRANS FEE: - -�- --- — COPY FEE: - - -- — --- - - - - -- - - - -. - — CC FEE: _� - -- —, �_ —_ - -- -- PAGES: 2 Grantee. Grantor quit claims to Grantee the following described real estate in ST. C ROI X - County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Name and Return Address LEO A. BESKAR RODLI, BESKAR, BOLES, & KRUEGER, S.C. ***SEE ATTACHED LEGAL DESCRIPTIONS*** 219 NORTH MAIN STREET, PO BOX 138 RIVER FALLS, WI 54022 022 - 1060 -95 -200 022 - 1061 -10 022 - 1060 -95 -100 _ 002- 1060 -95 -300 Parcel Identification Number (PIN) This is not homestead property. ( (is not) Together with all appurtenant rights, title and interests. Dated this day of January 20 * * DOUGL J. CU AUTHENTICATION ACKNOWLEDGMENT Signature(s) DOUGLAS CC)DD a/k/a/ DOU J. CUD STATE OF - -- - - - -- -- - -- - -- ) ss. — County 1 auth t at is d of J ry 1 2005 Personally came before me this day of the above named TITLE: MEMBER STATE. BAR OF WISCONSIN -- - - -- (If not, to me known to be the person(s) who executed the foregoing -- - - -- instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY -- - LEO A BE — _ Notary Public, State of — — ROD BE SKAR, BOLES, & K RUEGER, S.C. _ _ My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) • Names of persons signing in any capacity must be typed or printed below their signature. STATE BAR OF WISCONSIN QUIT CLAIM DEED FORM No. 3 - 2000 INFO -PRO (800 )655 -2021 www.infoproforms.com ST CRD�x COUNTY y F1, PLANNING & ZONING September 17, 2009 Fil e #. L U012 5 Jesse & Kathleen Cudd 1645 River Ridge Rd. River Falls, WI 54022 Code Administration 715 - 386 -4680 Re: Land Use Permit for Filling and Grading in the Shoreland District Land Information Planning 1124 River Drive 715 386 - 4674 Parcel #21.28.18.330B, Town of Kinnickinnic Real Property Dear Mr. & Mrs. Cudd: 715 - 386 -4677 This letter confirms zoning approval according to the plans you have submitted for Recycling 715 - 386 -4675 filling and grading an area of approximately 6,800 square feet within 300 feet of the Ordinary High Water Mark (OHWM) of the Kinnickinnic River to construct a single - family dwelling and private on -site wastewater treatment system ( POWTS) on the property referenced above in the Town of Kinnickinnic. Staff finds that the proposed project meets the spirit and intent of the St. Croix County Zoning Ordinance and Shoreland District with the following findings: 1. Filling and grading less than 10,000 square feet in area less than 300 feet from the OHWM on slopes less than 24.9 percent is allowed with a land use permit in the Shoreland District pursuant to Section 17.29(2)(c) of the St. Croix County Zoning Ordinance; 2. The filling and grading required for excavating the foundation of a single - family dwelling, with a walkout facing the river and a POWTS located within 300 feet of the OHWM are subject to Shoreland zoning requirements. The house and POWTS will be above the 922.0' floodplain elevation and will not be subject to Floodplain ordinance requirements. The project with utilize an existing driveway and the proposed single - family dwelling and POWTS meet all required setbacks and dimensional standards provided in the St. Croix County Zoning Ordinance; 3. The applicant submitted an erosion control and storm water management plan featuring infiltration trenches to receive discharge from gutter downspouts for roof runoff. With conditions to install appropriate Best Management Practices (BMP) for sediment control e.g. silt fence or sediment "logs" between the construction area and the river, to maintain erosion control measures until self - sustaining permanent vegetation is established on all disturbed areas, to prohibit the use of phosphorous fertilizer to establish and maintain a lawn, to ST. CROIX COUNTY GOVERNMENT CENTER 1 10 1 CARM/CHAEL ROAD, HUDSON W1 54016 715 386 - 4686 FAA l Y implement the storm water management plan, and record an operation and maintenance affidavit against the property for the infiltration trenches, negative impacts to the water quality of the river will be minimized; 4. The bank of the river below the proposed house location is vegetated and will remain undisturbed with the exception of grading for the walkout foundation. With conditions for maintaining the current level of vegetative cover along the river bank to preserve wildlife habitat and provide further filtration of storm water runoff from the site consistent with the standards in the Shoreland District, the natural beauty and ecology of the river will be protected; 5. The St. Croix County Land and Water Conservation Department has reviewed the plans and discussed options for assimilating stormwater runoff from impervious surfaces. Steve Olson, Rural Land Specialist, commented that the applicant has adequately addressed the increase volume of stormwater runoff, that the proposed perimeter erosion control shall be maintained until the site has re- established self - sustaining vegetation, and the applicant shall record an operation and maintenance plan for the infiltration trenches on the deed to the property; 6. The Wisconsin Department of Natural Resources has reviewed the plans and commented in an e- mail dated September 16, 2009 that Mr. Cudd will need an individual permit for grading from the DNR. Carrie Stoltz, DNR Water Regulations, commented that she would like to see erosion matting used on steep slopes for erosion control as well as sediment logs. Based on these findings, approval of the land use permit is subject to the following conditions: 1. The applicant shall be responsible for implementing the erosion control and storm water management plan submitted, and as provided in the conditions below. 2. Prior to construction, the applicant shall obtain any other required local, state, or federal permits and approvals. 3. The applicant shall install silt fencing, straw waddles, and /or sediment logs as needed for control of contaminated runoff from the construction areas for the proposed house and POWTS. 4. The applicant shall maintain all erosion and sediment control measures until permanent, self - sustaining vegetation is successfully established on all disturbed areas of the site. 5. No phosphorous fertilizers shall be used on the disturbed areas of the site, unless a soil test confirms that phosphorous is needed. 6. The current level of trees, shrubs, and groundcover along the shoreline of the Kinnickinnic River shall be maintained. 7. Within 30 days of completing construction, the applicant shall execute and record an affidavit against the property referencing the operation and maintenance plan for the stormwater infiltration trenches with the Register of Deeds, and provide the Zoning Administrator with a recorded copy of this document. 8. Within 60 days of completing construction, the applicant shall submit to the Zoning Administrator photos of the completed project as viewed from all angles. The photographs must also show all storm water management measures installed and vegetation on the site. ST, CROIX COUNTY GOVERNMENT CENTER 1 10 1 CARMICHAEL ROAD, HUDSON, W1 54016 715 386 FAA This approval does not allow for any additional construction, structures or structural changes, grading, filling, or clearin of vegetation beyond the limits of this g� g request. Your information will g Y q remain on file in the St. Croix County Planning and Zoning Department. It is your responsibility to ensure compliance with any other local, state, or federal rules or regulations. Please feel ease ee r fee to contact me with any questions or concerns. Sincerely VIk Pamela Quinn Zoning Specialist /Zoning Administrator Eric: Land Use Permit Affidavit form Cc: Dave Phillips, Building Inspector, Town of Kinnickinnic Steve Olson, St. Croix County Land and Water Conservation Department Carrie Stoltz, Water Regulations Wisconsin Department of Natural Resources 890 Spruce Street Baldwin, WI 54002 i ST. CROIX COUNTY GOVERNMENT CENTER 1 10 1 CARMICHAEL ROAD, HUDSON, W1 540 16 715 - 386 -4686 FAA