HomeMy WebLinkAbout026-1119-15-000
Wisconsin Department of Commerce County:
PRIVATE SEWAGE SYSTEM St. Croix
Safaty and BuiAing Division
INSPECTION REPORT Sanitary Permit No:
453066 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:
Strehlo, Bill Richmond Township 026-1119-15-000
CST BM Elev: j sp. BM Elev: BM Description: Section/Town/Range/Map No: "/C~A B3 e.n A . 22.30.18.710
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
w j;4)MP 4-100 W.
Septic / Benchmark
AL
Dosing Alt. B
Aeration Bldg. Sewer ~
`f•° Ioy ~Io
Holding St/Ht Inlet p r
8 03.40
TANK SETBACK INFORMATION St/Ht Outlet y.bo o;. 40'
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic ? I (yz) r Dt Bottom
25' 23
Dosing Header/Man. o
Aeration Dist. Pipe
Holding Bot. System 4>K_X 6411")
Final Grade
PUMP/SIPHON INFORMATION y--0 p3.
Manufacturer emand St Cover
G 2.Ig 0(o,2.2~
Model ber
TDH Lift riction Loss System Head T Ft
Forcemain Length Dia. Dist. to Well
SOIL ORPTION SYSTEM
R CH Width Length S` No. Of Trenches PIT DI NSIONS No. Of Pits Inside Dia. Liquid Depth
DIM ,
ALI
114 sV~Q \J
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Man ctrLeU:I '
INFORMATION Type Of System: CHA BET OR 'lam lJt'~bs~/
V • 21 Olt Model Number: It
DISTRIBUTION SYSTEM J
Header/Manifold Distribution x Hole Siz x Hole Spacing Vent to Air Intake
Pipe(s 2j l
Length Dia Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges Topsoil
Yes No , Yes ~ No
COMMENTS: (Idode ~iiscre. ncies, persons present, etc.) Inspection #1~w1~~ 0 Inspection #2: ~f-r^
ept
Its WtJQ d+;
Location: 1287 146th Avenue New Richmond, WI 54017 (S 4 NE ` ea _ e,,• arcel No: 22.30.18.710
1.) Alt BM Description = g T t~Qr mwA f
r
2.) Bldg sewer length = Z} fs+•~} (02•Z3~ ~.dc ` 10(.T *r Sa+
-yagm~ouu t of cov~re=. is y l°•r.~ /el. }g' fi4S~ • laili o,~s.+a. ~ w~-' -
3) Sn ray v ' wk - 3L ~.Qaw' G.•~6 (ot.~.`p 444 ' Ioe.4z'
QV -
Plan revision Required? Yes No \3 G 1
Use other side for additio in tion.
s D-6710 (R.3/91L A Date Insepctor's Signature E:~~~~~"' "u ert
~t~ s T e054 - B;
1 toe, - 27 f
Safety and Buildings Division County
201 W. Washington Ave., P.O. Box 7162
Viseonsin . Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.)
(608) 266-3151 453 OG
Department of Commerce
State Plan I.D. Number
Sanitary Permit Application
in accord with Comm 83.21. Wis. Adm. Code, personal information you provide
may be used for secondary purposes Privacy Law. s15.04(1)(m) Project Address (if different than mailing address)
1. Application Information - Please Print All Information 7 y~
Property Owner's Na me p Parcel N Lot N Block /f
Anew S fi-
Property Owner's M ailing Address Property Location
S,~ %;~u,Section .2-2
City, State !Zip Code Phone Number
9- 7j_2 (circle one) -
161,45W /~A7~ w T 3-J)_ N; RZf'_E of 1~ -
II. Type of Building (chec all that apply)
3 ( I" Subdivision Name CSM Number
IFS 1 or 2 Family Dwelling - Number of Bedrooms
❑ Public/Commercial - Describe Use
El State Owned - Describe Use ❑City_❑Village IPTownship of d
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A. "ew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System
❑ Chan List Previous Permit Number and Date Issued
B. El Permit Renewal El Permit Revision ge of El Permit Transfer to New _
Before Expiration Plumber Owner
TV. Type of POWTS System: (Check all that apply)
P "Non -Pressurized In-Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At-Grade ❑ Single Pass Sand Filter
❑ Constructed Wetland ❑ Pressurized In-Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter
❑ Recirculating Synthetic Media Filter 9 Leaching Chamber ❑ Drip Line ❑ Gravel-les Pi ❑ Other (explain) t I
V. Dispersal/Treatment Area Information: LC z e- EIL ' . Z,S 3
Design Flow ( Design Soil Application Rate( f) is rsal Area Required (sf) Dispersal Area Pr System Elevation C- 3 /00. 3
T
i' /A 0•
y59 z ~ - ' C-i -f? P
VI. ank Info Capacity in Total Number Manufacturer Site Steel Fiber Plastic
Gallons Gallons of Units ✓ Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Fioldiwg~
Aerobic Treatment Unit
Dosing Chamber
VII. Responsibility Statement- I, the undersigned, assume responsib' ty for installation of the POWTS shown on the attached plans.
Plumber's Na me (Print) Plumber's Si gnature 4AP~MPRS Number =Business umber
~0 r- ~Eo 9
Plumber's Addre ss (Street, City, State, Zip C e
VIII. Count /Department Use Only
Sanitary Permit Fee (includes Groundwater Date Issued is u' Agent Signature ( Stamps)
Approved ❑ Disapproved Surcharge Fee)
❑ Owner Given Reason for :Denial 200
IX. Conditions of Approval/Reasons for Disapproval 3 \ $ 1 5 1
SYSTEM OWNER:
1 Septic tank, effluent filter and
dispersal cell must all be serviced / maintained
as per management plan provided by plumber.
2. All setback requirements must be maintained
as per applicable code/ordinances
Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size
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Wisconsin Departnn ent of Industry, SOIL AND SITE E V A L IA ON REPORT Page 1 of 3
Lab~~and Human Relations
Dive ion of SAfety & Buildings in accord with ILHR 83'.05 VN'IS Alum. ipde
VRCEL r%7
Attach complete site plan on paper not less than 8 1/2 x 11 inches in e. Plan mast include, but . Cro'
not limited to vertical and horizontal reference point (BM), direction an~% of slope, scaleor .D. #
dimensioned, nor th arrow, and location and distance to nearest road. - c;_-.n_nnn
D BY DATE
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMAT~01ti lAfGoFr ~ftucu.
PROPERTY OWNER: RAOPEFITY LuOQAT-' N "
Richard Derrick , L~0 NE 114,S 22 T30 N,R 18) W
PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
1310 Hwy 1165" 15 Pondview Meadows
CITY, STATE ZIP CODE PHONE NUMBER E]CITY QVILLAGE ]TOWN NEAREST ROAD
New Richmond, WI. 54017 (715)246-5425 Richmond Hwy 65
[:j New Construction Use [ ] Residential / Number of bedrooms 4 [ ] Addition to existing building
I ] Replacement [ ] Public or commercial describe
Code derived daily flow 600 gpd Recommended design loading rate .3 bed, gpd/ft2 •4 trench, gpd/ft2
Absorption area required 2000 bed, ft2 1500 trench, ft2 Maximum design loading rate _ 3 bed, gpd/ft2 .4 trench, gpd/ft2
Recommended infiltration surface elevation(s) 99.9-100.78-101.5 ft (as referred to site plan benchmark) trenches
Additional design / site considerations recommend mound for system longevity
Parent material glacial drift Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem IRS ❑ U ®S ❑ U ®S ❑ U C$S ❑ U ❑ S 0 U ❑ S K U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trer
' 1 -14 10 r 3/3 none 1 2c P1 mfr w if n (.2
1
2 14-35 10 r 4 4 none sicl lcsbk mfr 9W if .2 .3
Ground 3 5-84 .5 r 4/6 none sl 2m r mvfr na na .5 .6
elev.
102.9t.
Depth to -gg . Dr
limiting
factor
+84"
Remarks:
Boring #
4Q if .2 .3
1 0-12
.:::..2:.:... 2 12-26 o O L e s Te W c l if .2 3
R j3 / /`~v ~e va~-~ P V -r
na .4 5
b~
Ground 3 126-80 S,~ e 'I~ ~ y i B ~C d 4y
~ f t va
elev. Lo
103.0 ft. S .~.,r ~.t to V
Depth to
limiting
factor
+80" hay c I!!~(Gt~/ ~l' Sy 5
9
Remark, <<9 ~.e 1 r~71 Q/ U
CST Name:--Please Print vo~Jr_ .
Address: 1554 200th. Ave ixiwimurgq w154017
Signature: 7. Date: 23_99 CST Number: m02298
J
PROPERTY OWNER Richard Derrick SOIL DESCRIPTION REPORT Page 2 ::4. 3
PARCEL I.D. # 026-1065-50-000 '
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
3<.; 1 - mfr C[w if n• .2
2 12-23 10 r 4 4 none sici lcsbk mfr if .2 .3
Ground 23-71 7.5yr 4Z4 none sl Icsbk mfr w na .4 .5
elev.
103•fV 4 71-84 5yr 4/4 ::20.5yr 5/6 sl n na na .3 .4
Depth to
limiting
factor
71"
Remarks:
Boring #
1 0-14 10 r 3/3 none 1 2c pi mfr if np .2
' 4 2 14-28 r 4 n ne sici lcsbk mfr if .2 .3
3 2882 7.9yr 4/4 none S1 lr--c;bk mfr
- na. na .4 .5
Ground
elev.
.I 04 f5
Depth to -
limiting
factor
+82"
Remarks:
Boring # -7 -9w
1 0-15 10 r 3/3 none 1 2c pi mfr if I-np .2
5
2 19-28 10yr 4/4 none scl lcsbk mfr if .2 .3
Ground 3 28-84 7.5 r 4 4 none sl lcsbk mvfr na na .4 .5
elev.
104. 51t.
Depth to
limiting
factor
+84
Remarks:
Boring #
Ground
elev. j
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
. .r
STEELS SOIL SERVICE
Gary L. Steel Richard Derrick 1554 200th Ave.
CSTM2298 SE4NE4 S22-T30N-R18W New Richmond, WI 54017
MPRSW-3254 town of Richmond (715) 246-6200
lot #15-Pondview Meadows
This soil evaluation was conducted to satisfy a zoning requirement, it may or may
not be suitable for your use.
N
1"=40'
BM.= top of SW lot stake @ el. 100.00'
Alt. BM.= top of NW lot stake C el. 99.00,
e~'h
o
lb~~ kG
p
N dI0
D 310
Ilk
Gary L. Steel
4-23-99
.
. Fogerty Piurnbing
#221180
28288 McKenzie Rd.
Spooner, WI 54801
(715).p35-9609
Cross Section of an Inground Component Cell
Using Leaching Chambers
ObservationNent Pipes
'oo/
Finished Grade= c3.o Finished Grade=
.z-
Slope % = 3 7 - -
Original Grade ~X y~
- - - Original Grade =
Top of Shell = ti' ~
- Of
System Elev. _ c- I
nc Treatment and Dispersal Zone
Limiting Factor
ObservationNent pipes to be constructed and
capped with approved materials for the particular use.
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FILE INFORMATION SYSTEM SPECIFICATIONS
Owner Septic Tank Capacity O al ❑ NA
Permit 3 Septic Tank Manufacturer S' ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model d 0 NA
Number of Public Facility Units XNA Pump Tank Capacity al IA
Estimated flow (average) gal/day Pump Tank Manufacturer A
Design flow (peak), (Estimated x 1.5) ySQ al/day Pump Manufacturer A
Soil Application Rate gal/day/fe Pump Model RNA
Standard Influent/Effluent Quality Monthly average' Pretreatment Unit PilA
Fats, Oil & Grease (FOG) S30 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BODS) 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) <_150 mg/L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) , ❑ NA
Biochemical Oxygen Demand (BODJ :5.30 mg/L In-Ground (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) <_30 mg/L ❑ NA ❑ At-Grade ❑ Mound
Fecal Conform (geometric mean) _<70` cfu/100ml ❑ Drip-Line ❑ Other
FMaximum Effluent Particle Size Ye in dia. ❑ NA Other: ❑ NA
: ❑ NA Other ❑ NA
*Values typical for domestic wastewater and septic tank effluent. Other. ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: [3 month(s) K ear(s) (Maxunum 3 years) ❑ NA
Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA
Inspect dispersal cell(s) At least once every: 3 [3 month( s} (Maximum 3 years) 13 NA
fit year(a)
Clean effluent filter At least once every: U ~th(s) ❑ NA
❑ month(s)A
Inspect pump, pump controls & alarm At least once every: ❑ year(s)
Q
Flush laterals and pressure test At least once every: month(s) NA
p year(s)
Other. At least once every: ❑ ❑ year(s) month(s) _ NA
Other: Q IVA
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 cell(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 (Y3) or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All 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.
2.
.,WT Uti AND OPERATION
For new construction, 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 and/or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tank(s) 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 cell(s) in one large dose, overloading the cell(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
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at-grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine. _
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: -
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or, must be taken, to provide a code compliant
replacement system:
~Q A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time. _
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
j The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site
evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank
may be installed as a last resort to replace the failed POWTS.
❑ Mound and at-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.
#221180
28288 c e n e Ra.
-
Spw ner
1-548111
~
POWTS INSTALLER POWTS MAINTAINER (715) 535-9609
Name I. (x~ v - Name
Phone u7'/S_ ~3 _ - 16 j F 1 pq Phone 11__
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name C64, iry J
Phone Phone 6"
This document was drafted in compliance with chapter Comm 83.22(2)Ib)(1)(d)&(f) and 83.541), (2) & (3), Wisconsin Administrative Code.
(
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Ownerr- /~rGt rr~e~~fG o
TT. /!r ti
Mailing Address &ily t,&
Property Address /,9f7 (Verification required from Planning Department for new construction)
City/State RA'JS//!rad , Ltm- Parcel Identification Number o16 - = a■~- o~'
LEGAL DESCRIPTION
Property Location S;' 1/,, 114, Sec. 2Z , T_Ze_N-RW, Town of ~z~i~ry~yyl~
Subdivision
=
-,Lot #
Certified Survey Map # Volume . Page # -
Warranty Deed # 719 yr?S 9 . Volume -21e Z . Page #
~ -
Spec house D yes fla/no Lot lines identifiable 1"Yes 0 no
SYSTEM MAIMNANCE
I 'I 't ause and f Yew septic system coiddresait m its pcesnatote failmeto havRe wastes. Proper maintenance
consists of pump out the septic tank every three years or soot if needed by a licensed pumper. What you put into the system
can affect the function. of the septic tank as a t nument stage in the waste disposal system.
The Pr'opaity owner agrees to submit to St. Croix Zoning Dot a certification fond, signed by the owner and by a
rnasterplumber, joarneymanplumbey restrictedp!ambar or a>i edpnmperven ymg that(1) the on-site Wastewaterdisposal system
is m pmpa operating c ap and/air (2) after impeetion and pumping (if necessary), the septic tank is less than 113 full of sludge.
Uwe, the u nde igmed have read the above nvarements 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 Resoueces, State of Wisconsin. Certification
stating that your septic system has nmuntaimd mast he completed and returned to the St. Crone County Zoning Office within 30
days of &t daze year
SIGNATURE OF APP CANT DATE
OWNER CERTIFICATION
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 descrbed above, by ' e of a warranty deed recoided in Register of Deeds Office. -
SIGNATURE OF APP i DATE-
Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. sssss.~
Include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
J 2 1 0 2 P 3 9 6 70485'3
KATHLEEN H. WALSH
• STATE BAR OF WISCONSIN FORM 2 - 1999 REGISTER OF DEEDS
Document Number WARRANTY DEED ST. CROIX CO.. WI
RECEIVED FOR RECORD
This D Kurt O. 1 '
Deed, made between Lindquist and KeIle 01/07/2003 09:30AlI
Lindquist, husband and wife,
EXEMPT
REC FEE: 11.00
Grantor, and William W. Strehlo TRANS FEE: 114.00
COPY FEE:
CERT COPY FEE:
PAGES: 1
Grantee.
Grantor, for a valuable consideration, conveys to Grantee the
following described real estate in St. Croix County,
State of Wisconsin (if more space is needed, please attach addendum):
Recording Area
of 15 tat of Pond View Meador in the Town of Richmond, St. Croix Name an RetrAQ OGLAND
r "I~
nty, Wisconsin. dffil5
ATTORNEY AT LAW
. P.O. SOX 359
L HUDSON, VVI 54016
026-1 119-15 _
Parcel Identification Number (PIN)
This is not homestead property.
CK) (is not)
Exceptions to warranties: Easements, restrictions and rights-of-way of record, if any.
Dated this day of January 2003
* * Kurt ROLtuist
• * Kell a Lindquist
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) Kurt O. Lindquist and Kellie Lindquist, husband STATE OF WISCONSIN )
and wife, ) ss.
County )
authenticated t is ~ G day of January 2003
2n ~ I Personally came before me this day of
the above named
* Kristina Ogland
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
Attorney Kristina Ogland Notary Public, State of Wisconsin
Hudson, WI 54016 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. Information Professionals Company, Fond du la,,, wi
STATE BAR OF WISCONSIN e00-655',j21
WARRANTY DEED FORM No. 2 - 1999
• WEST LINE ❑F THE SE1/4 ❑F
S00°16'13" E 1325
5' 320,96' 278,82'
229,38'
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Pam Quinn
Subject: #453066 Fogarty/Strehlo - FINAL
Location: (Richmond, Lot 15, Pond View Meadows)
Start: Wed 6/9/2004 1:00 PM
End: Wed 6/9/2004 2:00 PM
Recurrence: (none)
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