HomeMy WebLinkAbout026-1160-03-000 ,consin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
efely a,yd Buing Division
INSPECTION REPORT Sanitary Permit No: 48$267 0
'GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, 0 5.04 (1)(m)].
Permit Holder's Name: City Village X Township Parcel Tax No:
Beebe, Dwight I Richmond, Town of 026 - 1160 -03 -000
CST BM Elev: Insp. BM Elev: BM Description: Sectionrrown /Range /Map No:
23.30.18.1209
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic L'9 ( 6 C � ( Benchmark lip
Dosing Y u Alt. BM 4n" -
Aeration Bldg. Sewer ""
4577 2. zG
Holding St/Ht Inlet
St/Ht Outlet
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
�^
Septic I Dt Bott o s-
12 of /z. 1�•3
Dosing 0 7 _ Header /Man.
Aeration Dist. Pipe
Holding Bot. System
Final Grade
PUMP /SIPHON INFOR TION 13 3
Manufacturer ITT emand St
L r �}
C� /lQ7ll GPM il S, y i O7l C1 ' ✓�� S "�
Model Number cm ( 1c -74
TDH Lift Friction Loss stem Head T Ft
Forcemain Length a. t i ist. to Well 'p
SOIL ABSORPTION SYSTEM g 1 = VV
BED/TRENCH Width Length N PIT DIMEN ION Pits Inside Dia. Liquid Depth
DIMENSIONS '
e
SETBACK SYSTEM TO P/L tj JBLDG IWELL ILAKE/STREAt LEACHING Manufacturer.
INFORMATION I CHAMBER OR
Ty Of System: t I �!� [ I U Model Number.
r" G ' a i �? - r t o l
DISTRIBUTJON SYSTEM • a -
H der/Manifold Distribution x Hole Size I x Hole Spacing Vent to Air Intake
Pipe(s) ___ >
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 0 Yes No Yes �: No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: // �ot3 v pection #2: / /
Location: 1356 146th Ave. New Richmond, WI 1/4 NW 1/4 23 T30N R18W) W it M wy Parcel No- -3 30.18.1209
1.) Alt BM Description
2.) Bldg sewer length
- amount of cover 7r Plan revision Required? Yes o Use other side for additional information. SBD -6710 (R.3/97) t I epctoes Signature Cert. No.
av
Safety and Buildings Di County is'
201 W. Washington Ave., Bo io2 S l t C�/tw
I visconsin Madison WI S - Saniury Permit Number (to be filled in by Co, I
De artment of Commerce
X515 z� 7
State Plan I.D. Number
Sanitary Permit Applicat n
in accord with Comm 83.21, Wis. Adm. Code, personal informad u provide
may be used for secondary purposes Privacy Law, sl5.04(l)(m) Project Address of different than mailing address)
I. Application Information - please Print All Information
RECEIVE
Properry Owner's Na me Parcel a Lot N Bloc a
b fah t & (4 "f 1 E 6 ' A D • 63
Property Owner's M ailing Address Properry Location
i
Ll ST. CROIXCOUNTY 5'�tl u. A_)w A.Section 23
City. State Zip Code j
reticle one)
QW �1 >C�m� cl T 3U N. R T E t V L
II. ype of Building (check all that apply) _Aa
Ck/�/ SV Subdivision Name CSM Number
J I or 2 Family Dwelling - Number of Bedrooms �J AOS
❑ Public /Commercial - Describe Use
s 6 q it ��',a c ��Township of t a p
'❑ State Owned - Describe Use T DI� Cep l.t, � 1 j'� 1 ?' Z� '�'" � C.JAA, JC>'_ Il g /re
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A
New System ❑ Replacement System ❑ Tratment/Holding Tank Replacement On:y Other Modification to Existing System
B. Permit Renewal ❑ Permit Revision g st Previous Permit Number and Date Issued
❑ Change of Cl P�rmn Transfer o ` cs
j Before Expiration Plumber Owner
N. Type of POWTS System: (Check all,that appl
Non - Pressurized In•Ground ❑Mound >, ;A in, of suitable soil ❑Mound '_ :n o' surtr -le so:. ❑ At•Gradc Single Pass Sand Filter
Constructed Weiland J Pressurized In- Ground J Holding Tank ❑ Peat File: _ ,e .br " yn i Recirculating Sand Filter
i
Recirculaung Synthetic Media Filter ❑ Laehing C hamber ❑ Drip Line � ❑ Gravci -,css P:,:c Other (explain)
V. Dis ersaIrTreatment Area Information:
Design Flow (gpd) Design Soil ppl!;#6n Rate(gpdst) Dispersal Area Required (sf) Dispersal area Proposed (st) System Ele on
VI. Tank Info Capacity in Total Number Manufaerurer� Prefab site Ste e i itxr Plastic
I Gallons Gallons of Units oncretc I Construc(ed Glass
1 11 New Existing I
Tanks Tanks �✓ Z Gb /w _ ` •,
Septic or Holding Tank i. /I ('G
aerobic Treatment Unit / !N �e
Dosing Chamber
VII. Responsibitit Statement- 1, the undersigned, assume respoatibllity for installation of the• POW TS shorn) on (he attached plans
Plumber's Na me (Print) Plumber' Si natur MP /MPRS N'umhcr Business Phone Number I
4 /7
Plumber's Addre ss (Street, City, State. Zip Cod
VIII. County/Department Use Only
4pprovcd isapproved Sanitary Permit Fee (include Grouncl a;c II sued Issuing nt Signa re o s
j Surcharge Fee) M �Q ��j
r Given Reaso r Denial
IX. Condit (ReasorLs for Disapproval tt��
4. Septic tank, effluent filter and
3 . ace s c`. YVI,IJt'.
I I
dispersal cell must all be services / maintained n � s ('.?�
as per management plan provided by plumber. VV n
j 2. All setback requirements must be maintained r /� I _ e d I 1� `� .5
as per applicable code / ordinances. p y ..�.ttc�/// j I i
J J I
Attach consolele plasu (b the County only) for the "stem on paper not less than 81 .: x I1 incbes in site
SBD -6398 (R. 01/03)
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FROM NORTHLAND PLUMBING, INC. FAX NO. 715- 643 -2520 Jul. 10 2006 03:39PM P5
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Bird Plumbing Inc.
1008 192nd Ave
New Richmond WI 54017
715- 246 -4516
Subject: Whitetail Meadows Soil Tests
To Whom it may concern:
I Shaun Bird did the soil tests on this subdivision known as Whitetail Meadows in
Richmond township. Aftbr a couple of installations, some of the soils were found to have a
more weak structure than what was found in some of the borings. In order to protect home
owners and contractors, it is my recommendation after discussing the issue with Pam Quinn
from St. Croix County Zoning office that the systems be oversized using a .3 loading rate
Instead of the original .4 rate. On the lots that were originally sized for a _5, 1 recommend
using a.4, not the new .6 that the state has suggested. The soils are what the tests indicate
but the large areas tested did not reveal some of the weaker structures that were found
upon installations. If a installer can prove otherwise, that the weaker structures do not exist,
then the installer should proceed with the soils that he /she believes are present.
Shaun Bird
CST #226900
z -d
d64 =Ti 40 sa Jdd
ST. CROIX COUNTY
WISCONSIN
�'.�✓ _ _ '"t, ZONING DEPARTMENT
�\ ■ w M rn�r ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
Hudson, WI 54016 -7710
Phone: (715) 386 -4680 Fax (715) 386 -4686
Memo to File
From: Pam Quinn
Date: 4/27/2004
Re: Sandy loam structure misinterpretation on subdivision soil reports
Recent soil on -site determinations have brought a problem to our attention. During these on-
sites, borings were excavated to confirm soil conditions where two conflicting soil reports had
been submitted for zoning department review. The soil profiles, evaluated by myself, Dave
Fogerty, and Dave Steel (all certified soil testers) differed from the original soil reports in that
massive (structureless) sandy loams were encountered in horizons that were described as having
either moderate, medium subangular blocky (2msbk) structure by Adam Schumaker or weak,
medium granular structure (I mgr) by Shaun Bird. There apparently has been a
misunderstanding between "structure" caused by handling samples of the soil during texturing
versus the soil characteristics in situ. The soil, when chunks were taken out of the profile to hand
texture, with pressure parted into "crumbs" that appeared at first to be subangular or granular in
shape. However, these were not true peds that broke apart along planes of weakness, but
fragments created by handling. The soil when observed in the horizon did not have distinct units
of structure and should have been reported as "massive ".
Added notation: on 4/23/04 Mark Iverson (Cedar Corp. certified professional soil scientist),
Shaun Bird, and myself did an evaluation of soils on Lots 6 & 9, Richmond Meadows where the
original soil report described the third horizon as sandy loam, "1 mgr ". On Lot 6 we checked
soil profiles within a POWTS distribution cell and then excavated a test pit on Lot 9. The sandy
loams in question were a weak, coarse to very coarse subangular blocky structure, where planes
of weakness were just discernible when peds were parted from the profile. The peds separated
with vM light pressure by soil tester. Sand coatings were observed on the ped faces in the Lot 9
soils, which supported the determination that some structure existed to allow water to move
through the upper portion of the sandy loam horizon. However, below the weak - structured soil
we found massive (structureless) sandy loams and the boundary between these horizons was
irregular, which would mean a distribution cell could encounter alternating weak and massive
sandy loam. Shaun said he would amend his soil reports with a memo recommending that any
sandy loams he identified as "1 mgr" or "2 mgr" be assigned a lower loading rate of 0.3 gpd/ft2
(see attached memo for Whitetail Meadows) to provide a larger dispersal area.
Page Two — Soil Memo 4/27/04
Massive sandy loams have been assigned a soil application rate of 0.2 gpd/ft with the code
changes in Comm 83.44 -2, effective as of 2/1/04. The application rates listed on the soil reports
were higher due to the structure having been described as either weak or moderate, which affects
the calculations for sizing of POWTS distribution cells. Obviously, one of the concerns is to
make sure loading rates for the soils are not in error and allow undersized POWTS to be
installed. For example, in December 2003, Lot 35 of Richmond Meadows subdivision had to
have its loading rate reduced to 0.3 gpd/sq. ft. when the installer encountered massive sandy
loam at the system elevation. The sandy loam horizon had been described on the soil report as
"lmgr" with firm consistence.
Leroy Jansky, Dept. of Commerce Regional Wastewater Specialist, has been consulted on this
situation and advised the zoning department to require on -site verifications for any lots with this
potential misinterpretation on the soil reports. All soil reports with sandy loam "1 or 2 mgr" as
its structure will be required to use a design based on the current code's soil application rate for
massive sandy loam @ 0.2 gpd/sq. ft. unless additional soil testing proves otherwise.
i
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code County �^ �
Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Review by ate
Please, print all information,
Personal information you provide mad( be used for secondary purposes (Privacy Law, s. 15.04 (1) (m))_
Properly Owner Property Location
J Govt. Lot ' 1 /4 S T N R E( w
%Gr✓ f✓
Property Owner's Mailing Address Lot # B1ock # Subd. me or CSM# IA
city State Zip Code Phone Number ❑ city ❑ Illage own Nearest Road
New Construction Use Residential / Number of bedrooms Code derived design flow rate �� O GPD
❑ Replacement ❑ Publi o commercial - Describe: - - - -- - -- - -- - --
Parent material Flood Plain elev tion if applicable
General mm n en
and reco data ons: s ��� �9, Vol o
Boring
mmdati lIS�L�S.,,/
f
# El Boring g .
ft. Depth to limit, factor in.
Ul Pit Ground surface elev?-Z n9 Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Eff#1 'Eff#2
1 ---- -- �' p s s'
17-7-1 Boring d .Z
# Boring
9
Pit Ground surface elev/ � � ft. Depth to limiting factor in. Sod 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
- z A- 5/ c 1n,s w,7 3
I
Effluent #1 = BOD > 30 < 220 mg1L and TSS >30 < 15fA& Effluent #2 = BOD 130 mg/- and TSS < 30 mg1L
CST Na►r>Q (Please Print) I CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, WI 54 r - -0J 715- 246 -4516
i
I
Property Owner — Parcel ID # Page of
Boring # ❑Boring
I
it Ground surface eiev. 1 l �� 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/ - 5L zr-,,-/ a ,5'' ,7
s
t
ti
Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
F-1 Boring # ❑Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots 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 mgA. ` Effluent #2 = BOD, < 30 mg/L and TSS 130 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.
SOD4330 (R.6/=)
Soil Test Plot Pla
Project Name William Stock/Steve Dalton S
Address 1748 112th St.
New Richmond Wi 54017
STM 4#226900
Lot 3 Subdivision Whitetail Meadows Date 8/15/03
S 1/2 N W 1/4S 23 T 30 N /R18 W Township Richmond
M Boring ()Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of Survey Iron
System Elevation 89.4/89.0 *HRpSame as Benchmark
Alt. BM Top of 2" Pipe @a 100.2' Alt. B.M.
433' Property Line B.M.
Please note: Installer must
verify all lot lines and setbacks
before installation.
Please Note: Tested area
may not be suitable for Scale is 1" = 40'
desired building area. unless otherwise
Check system location 441'
before excavating. noted property
Line
40' B -3
93'
30'
92'
B -2 80'
6% B -1 5
Slope 100'
Pro Town Road
NMI Page 1 of 4
■
SYSTEMS INC
€nvirorinwrital C insr`te Wastewater Solutions'"
Leaching Chamber Design Spreadsheet
Project Name: Beebe - Conventional
Owner's Name Dwight & Cindy Beebe
Owners Address /-I \ S
* I x W G
Legal Description sw 7V %, I NW � %4 Sec 23 T 30 N, R 18 �W
Township Richmond
County Saint Croix
Subdivision Whitetail Meadows
Lot# 3
Parcel I D#
Table of Contents
pg-
1 Cover page
2 Calculations and Drawings
3 Management and Contingency Plan
4 Plot Map
total # of pages: 4
Designer Name: Lyle J. Myers
License #: 224617
Date: 7/6/2006
Ph. #: 715-WI-2520
Signature: �� Z
Design Methods Used
"IN- GROUND SOIL ABSORPTION COMPONENT MANUAL FOR PRIVATE ONSITE WASTEWATER TREATMENT SYSTEMS" (Version 1.0) SBD- 10705 -P (R.6/99)
110 it Infiltrator and the Infiltrator logo are trademarks of Infiltrator Systems, Inc.
SYSTEMS INC
Spreadsheet provided under license to Infiltator Systems, Inc by: 3bAdvisement N12486 220th St, Boyceville, WI 54725
I —
SYSTEMS INC Calculations and Drawings Page 2 of 4
Site Condit Infiltration Elevations
Site Type: Private Trench #1 Trench #2 Trench #3
%Slope 6% Contour Elev: 93.00 92.80 92.50 Ft 72.3
# of Bedrooms 3 Infiltration Elev: 88.00 88.00 88.00 Ft of
Depth to limiting factor 96 inches Limiting Factor Elev: 85.00 84.80 84.50 -,;rd
Soil Application Rate: 0.3 gal /ft ^2 /day Treatment and Dispersal Zone: 3.00 3.20 3.50 4.34
Effluent Quality Eff #i ._L- 7 Cover Material Required: 0 0 0 In v
Design Flow: 450 gal /day Finished Grade Over Cell: 93.00 92.80 92.50
Max BOD 220 mg /I
Max TSS 150 mg /I Distribution Cell
Choose chamb type:
Septic Tank Infiltrator Quick 4 Standard
Manufacturer: Wieser Concrete # of trenches: 14 •
Volume Chosen: 1000 Chamber Length: 4.00 Ft
Effluent Filter Selected: Zabel A100 Chamber EISA: 19.1 Ft2
Note: Access opening of sufficient size to be provided to allow removal of filter. Endcap EISA: 5.8 Ft2
Opening to terminate at or above grade. Required Infiltrative Area: 1500.0 Ft2
Actual Infiltrative Area: 1513.0 Ft2
Total # of Chambers: 78
Cross Section of Septic Tank Total # of Endcaps: 8
Combined Length of Cells: 320.0 Ft
12" Min Z Grad e Cross Section of Cell
Cover Material Observation Pipe
(if required) _ - Final Grade
All joints to
be water tight D3034 or Ground
Effluent Sch40 Contour
Filter Pipe
Leaching System
Chamber Elevation
3" Bedding Under Tank
�figlli
A6tM �� �"b�err�l�rxl t�rva�lan
Wrd'ik
rx4
ro l�lpe
PVC ppe
Infiltrator and the Infiltrator logo are trademarks of Infiltrator Systems, Inc.
Spreadsheet provided under license to Infiltator Systems, Inc by: 3bAdvisement N12486 220th St, Boyceville, WI 54725
Page 3 of 4
In- Ground System Management Plan pursuant to comm 83.54 W. A. C.
Owner's Responsibility:
The component owner is responsible for the operation and maintenance of the component. The
county, department or POWTS service contractor may make periodic inspections of the
components, checking for surface discharge, treated effluent levels, etc. The owner or owner's
agent is required to submit necessary maintenance reports to the appropriate jurisdiction and /or
the department.
Septic Tank:
Septic tank(s) are to be inspected routinely and maintained by department approved individuals
when necessary in accordance with their approvals. The use of chemical /biological "treatments" is
not required or recommended. If such additives are used, make sure they are approved by
Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned
as necessary, with provisions to keep solids from passing the septic during removal. No more
than 1/3 of the usable tank volume may be occupied by sludge /scum. 3 year inspection: If tank
has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance
with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not
recommend pumping of the septic tank, then the owner must be notified of when pumping should
be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be
watertight and of good repair.
Absorbtion Cell
The absorbtion component must remain free of ponded surface water prior to pump operation. If 4
inches or more water level is detected in the observation pipes, the owner must be notified of
possible problems /failure. The designed daily flow capabilities of the component should never be
exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to
grow anywhere on the component. Activities OTHER than mowing /maintenance (i.e. excessive
walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion
capabilities and /or possibly cause it to freeze in winter conditions.
Performance Monitoring:
Performance monitoring must be done at least once every three years following the installation or
at the time of a problem, complaint, or failure.
Contingency Plan:
If the septic tank or other components therein (including floats, alarms, etc) become defective, the
defective tank or component must be replaced immediately to ensure that the system can operate
as designed. If the absorbtion component cannot accept wastewater or ponds wastewater to the
surface, the component must be repaired or replaced in it's current location by removing the
clogged bacterial mat, aggregate /leaching chamber cell, and distribution piping within the cell and
replacing failing components in order to return system to proper working order as required. If repair
is not feasible, a new system is to be constructed in a designated replacement area
i
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
• AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer wt to hk� B�ESE
Mailing Address
Property Address
(Verification required from Planning Department for new construction) ,
Parcel ti
City /State Identification Number
LEGAL DESCRIPTION
Property Location S w '/4 , ,A W '' /., Sec. 23 , T N -R W, Town of r eM-04. I)
I
Subdivision Lot # 3_ .
.Certified Survey Map # Volume � , Page # 9�
Warranty Deed # �v� 7�' Volume . Page #
Spec house ❑ yes 4 no Lot lines identifiable '* N yes ❑ no
SYSTEM MAINTENANCE
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.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owder and by a
mast r lumber, journeyman lumber, restricted lumber or a licensed pumper verifying that the on -site wastewater disposal system
c P � J Yin P � P P Pe rrfying 1 ()
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.
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set faith, 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 Zoning Office within 30
da f the three ye iration date.
1 K
SIGNA OF APPLICANT DATE
OWNER CERTIFICATION
I (w) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners of
ttt above, by virtue of a warranty deed recorded in Register of Deeds Office.
e X DC l ( G
SIGNATUkE OF APPLICANT DATE
« « «• «« Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.
** 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
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State Bar of Wisconsin Form 2 -2003 KATHLEEN H.
REGISTER OF DEEDS DEEDS
WARRANTY DEED ST. CROIX CO., WI
Document Number Document Name RECEIVED FOR RECORD
06/20/2006 02:25PH
WARRANTY DEED
EXEWT if
THIS DEED, made between O'Brien Builders, Inc., a Minnesota Corporation
REC FEE: 11.00
( "Grantor," whether one or more), TRANS FEE: 138.00
COPY FEE:
and Dwight Beebe and Lucinda Beebe, husband and wife CC FEE:
PAGES: 1
( "Grantee," whether one or more).
Recording Area
Grantor, for a valuable consideration, conveys and warrants to Grantee the following
described real estate, together with the rents, profits, fixtures and other appurtenant
interests, in St. Croix County, State of Wisconsin ( "Property") (if more space is � Estreen & 091and W i
needed, please attach addendum): 304 Locust Street 1 lol 0 3
Lot 3, White Tail Meadows. St. Croix County, Wisconsin.
Hudson, WI 54016
lk
026 - 1060 -03 -000
Parcel Identification Number (PIN)
This is not homestead property.
(is) (is not)
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any.
Dated O'Brien Builders,, Inc.
(SEAL) X ' n r 1 9 �EAL)
* le O'Brien, President
(SEAL) (SEAL)
* *
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) O'Brien Builders, Inc., a Minnesota
Corporation by Joseph A. O'Brien. President STATE OF )
authenticated on ) ss.
COUNTY )
*Kristina O land Personally came before me on ,
TITLE: MEMBERS ATE BAR OF WISCONSIN the above -named
(If not, to me known to be the person(s) who executed the foregoing
authorized by Wis. Stat. § 706.06) instrument and acknowledged the same.
THIS INSTRUMENT DRAFTED BY:
*
Attorney Kristina Ogland Notary Public, State of
Hudson. WI 54016 My Commission (is permanent) (expires: )
(Signatures may be authenticated or acknowledged. Both are not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
WARRANTY DEED ID 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003
* Type name below signatures. INFO -PROTM Legal Forms 800 - 655 -2021 www.infoprolbrms.com
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Parcel #: 026- 1160 -03 -000 07/10/2006 10:11 AM
PAGE 1 OF 1
Alt. Parcel #: 23.30.18.1209 026 - TOWN OF RICHMOND
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
01/02/2004 00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner
0 - OBRIEN BUILDERS INC
OBRIEN BUILDERS INC
1706 LARK AVE
MAPLEWOOD MN 55109
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1356 146TH AVE
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 2.840 Plat: 09 /97- WHITETAIL MEADOWS 026/04 LOTS 1/30
SEC 23 T30N R18W PT SE VFW BEING Block/Condo Bldg: LOT 03
WHITETAIL MEADOWS ('04) LOT 3 (2.840AC) Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4)
- N -1 W
23 30 E NW 8 S
Notes: Parcel History: 0
Date Doc # Vol /Page Type
02/20/2004 754730 2513/133 WD
01/02/2004 750596 09/97 PLAT
2006 SUMMARY Bill M Fair Market Value: Assessed with:
0
ValtlatlOriS:. Last Changed: 06/20/2005
Description Class Acres Land Improve Total State Reason
p P
RESIDENTIAL G1 2.840 31,700 0 31,700 NO
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Totals for 2006:
General Property 2.840 31,700 0 31,700
Woodland 0.000 0 0
Totals for 2005:
General Property 2.840 31,700 0 31,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: U Certification Date: Batch #:
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
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