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HomeMy WebLinkAbout026-1130-17-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 488232 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: .f 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: Gas ord, Christopher I Richmond, Town of 026- 1130 -17 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: :. +. " " 25.30.18.877 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing A(t. BM Aeration Ehdg. Sewer Holding St/Ht Inlet 0 r'�f St/Ht Outlet � . Y �- r ?°x , TANK SETBACK INFORMATION I TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom _ a - _ Dosing Header /Man. O Aeration Dist. Pipe r Holding Bot. System j,1a to Final Grade PUMP /SIPHON INFORMATION 50 7 �1 �cx Manufacturer Demand St Cover GPM �t t �{. ^4 " Model Number TDH Lift Friction Loss System Head T DH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM EEdfTR _NC Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufactur r: INFORMATION CHAMBER OR _ , 1 ' f Type Of System: UNIT y Model Number. DISTRIBUTION SYSTEM V Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(sT _._ y ` i Length Dia Length Dia Spacing 1 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 Q Bed/Trench Center Bed/Trench Edges Topsoil y;; Yes No ® Yes � No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / =' �'�� + -'{ Inspection #2: • - - - - < - l Location: 1408 138th Ave. New Richmond, WI 54017 (NW 1/4 NW 1/4 25 T30N R1 8W) Red Pine Corner Lot 17 Parcel No: 25.30.18.877 1.) Alt BM Description = - 'A- ,,,- r' 2.) Bldg sewer length = ' - amount of cover = Plan revision Required? 0 Yes No t ,� :/ `) i Use other side for additional information. i '• -° ` t `° } Date Insepctor's Signature Cert. No. SBD -6710 (R.3197) t . Safety and Buildings on County S 241 W. Washington Ave., ., _ 7162 Vsconsft Mxlison, WI 5 Sanitary Perm'(to belled in by Co.) Department of Commerce Sanitary Permit Application Stage Plan D. Nt�„ber In accord with Coffin 83.21, Wis. Adm. Code, personal inf rtmation you provide may be used for secondary purposes Privacy Law, si5.04(i)(m) Pmject Address Vfdtflerent than mailing address) L Application Information - Please Print AN Informs ' n O p� r ��h 1 O 1 Pro s Name JUN 14 2006 Parcel Lot it Block a AVA `s 0 O il a Property Owner's Mailing Address ST. CROIX COUNTY Property Location 6 WW II - T S to - Fh . 1 / y W V, LY W %, Section City, State Zip Code Phm� Numbw Il. Type of Building (check ail that apply) R �of'7 T D N: a ( ' , ._, I or 2 Family Dwelling - Number' of Bedrooms ubdivislon Name CSM Number ❑ PublkXomtnercial - Describe Use -P ✓' U State Use aity IJVilhW Wownshipof kr 0 0 vim% III. Type Check oa o e n lice . C line B if a A. pkNPw Cyetr n Rnr.M_Lg.n.nr C.�,emm 11 T.wg�n a.t�lt7p/ nn T Q��,t.��» �. r'1 Ote i:'�."dfficcato" w Ex-fir .ci�aw.i. B. ❑ Permit Renewal 1 ❑ Permit Revision ❑ Change of ❑ Permit Transfer m Nesv List Previous Permit Number and Date issued Before Expiration Plumber Owner IV. Type ofPOWTS Systenc Check an that a pply) Nmr - Pnessurized In- Ground ❑ Mourn 2:24 is of suitable soil ❑ Mound <24 in. ofsuitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ t'1KketnMN_,r_I WHIaMI n —i—r In_!',m -nil n 4GI.ti..g T. -1, r'I A wnt,:.. u Recaculatmg Synthetic Media Filter OLeachnChamber ❑ Li GnaveMiess Pi ❑ Other (explain) V. DispersaVrreatment Area Information: Design Flow (gpd) I Design Soil Application Rete(gpdst) Dispersal Area Required (st) Area Proposed Of) I System Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steil Fiber pl Gallons Gallons of Units Concrete Constructed Glass New I 66stion Tanks I Tha ks septa Tank c� s Ii A-oW T—tme1 Unit t +�/ i� 2 S� f ilmaB '- rimer VQ. Responsibility Statement - 1, the respoadbility for of the POWTS shown on the attached pbw& Phi Name Pjambee s Si re RS umber Business Phone Number c u ; V\ Ifs S Plumber's Address (Street City, Stat- , Zip Code) Vin. (26untr rtmant Use Onl pproved ❑ Disapproved Sanitary Permit Fee ncltdes Groundwater Ira Issued mg A Si S ) Surcharge Fee) 0 ) /� 11 Owner Givat Reason for Denial (J Q� IA. ionriitioffi of Apprnvauiceasons for 013approvai SYSTEM OWNER: 1 Septic tank, effluent filter and �{y(l� G�" r dispersal cell must all be serviced / maintained as per management plan provided by plumber. G�� 2. All setback requirements must be maintained G ��� as per applicable code /ordinances. Attach c -gftte plam (m am City any) for dw system on paper sot Sees alas 6117 z 1i inebm is sim SBD -6398 (R. 01/03) FA, 7z (Z� eI I S J E - p - — 0,6 4 Bin -TUB s� Io't — �� i� LT f3 jj r �j . E r ,1 K) W V S7S w Vi - � Pt C© 17 � muvil l' C b ; X cA.X2- \• ` 't = CCU , Q tiT 45� \ t Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County St. Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontallBM, direction and Parcel I.D. percent slope, scale or dimensions, north a r on p pnd ifir Lance to nearest road. Please pri ai Jarflorm� ion. ; h Rev' wed By Date Personal information you provide may be ✓tdTgr secon q (PrivaoxL�W, .15.04 (1) (m)). .[ s Property Owner Oroperty Location �L :G vt. Lot NW 1/4 NW 1/4 S T 30 N R 1 8 or) W Oak Property Owner's Mailing Address 1 -L t # Block # Subd. Name or CSM# 1611 Hwy. #10 N.E. .. ' iDu Yr , _ 17 City State Zip C : i� hc�r City ❑ Village (2 Town Nearest Road S rin Lake P k f New Construction Use: Residential / Numbe`rof s 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material gl drift Flood Plain elevation if applicable na General comments I r I and recommendations: trenches spaced to code @ el. 97.10' cok Boring 1 01 n Boring 00 Fm k 1001, F i l g] Pit Ground surface elev. .6 ft. Depth to limiting factor +100 in Soil lication 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 . (p 2 11 -28 7.5 4/4 none sicl 2msbk if .4 .6 3 28 -10 7.5 4/4 none sl 2msbk mvfr na na .5 .9 mo t- 9�•�0 �a Boring # El Boring 101.10 +100 Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication 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 2 9 -24 10 5/4 none sicl 2msbk mfr qw if .4 .6 �f 3 2 4/4 none scl 2msbk mfi qW na 4 6 4 (45 4 4 none sl 2msbk mfr na na 5 9 (o Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg /L uent #2 = BO < 30 mg "d TSS < 30 mg/L CST Name (Please Print) Signature CST Number Gary L. Steel 02298 Address Date Evaluationtonducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 11 -16 -2000 715 - 246 -6200 Property Owner Oa.k4J00d Land Dey Parcel ID # pendi ng Page 2 of F - Boring # Boring 3] pit Ground surface elev. 1 00.10 . ft. Depth to limiting factor 74 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 1 0 -20 10 2/2 none L 2msbk mfr ClW 2f 8 � 10 4/4 none sicl 2msbk mfr 9W if ,i 3 36 -74 7.5 4/6 none is OSCT mvf .� 4 74 -88 5yr 4/4 none scl M F-41 Boring # Boring pit Ground surface elev. 10 ft. Depth to limiting factor +88 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 e A 80-88 - 44 PA)ne FRS -nsg— ml na na .7 i 2!:::::1 - 2- Boring # Boring El Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff#2 ' Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SOD -8330 (R.6=) l r STEEL'S SOIL SERVICE Gary L. Steel Oakwood Land Development 1554 200th Ave. NW4NW4 S25 T30N - R18W CSTM2298 town of Richmond New Richmond, WI 54017 MPRSW -3254 lot #17 -Red Pine Corner (715) 246 -6200 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test Was conducted. A " =40' AD.= = top of SW lot stake @ el. 100.00' top of Nh t survey 'stake 2 el 99.90' i i �t o Gary L. Steel 11 -16 -2000 Fy At LOT is 8 , 66, 454 SO FT. 10 53 M ARES ^ / , t. �'S2'26'E 00' iMoo' LOT 26 � � ' w �� . 0 c : ^ ,a 66,000 SAX FT ; sv . N r x 52 ACRL - 5 8 LOT V O 64 656 SO FT. co l � N N N r 61 ACRfS J, � i�� \ l ^ rl r 00 �� O V IWE SW - 114 GIB' Ta f NJ F 114 -- '26'E 330.00' r • MH LINE LOT 27 SM- 27'09»w MA TRH UNE SEE SHEET 2 \ LOT 16 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address _`� 7 Q�� S r ,� R �; C� w� o r� d , W1_ _'C1017 Property Address 14 (A [ 3 $y l _ 4u {� (Verification required from Planning & Zoning Department for new construction.) City /State N•e iC� m oAA ( - Parcel Identification Number a�p— 11 3p LEGAL DESCRIPTION ` g 7 -7) Property Location '/a , N "� 1 /a , Sec. aS , T �� N IS W, Town of Subdivision � _2 ra C C r Lot # T`L. Certified Survey Map # , Volume , Page # Warranty Deed # Co � , Volume , 7�1 7 Page # � Spec house yes no Lot lines identifiable es , 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 Ys eP g P responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, 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. Uwe 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. Numb bedrooms I SIGNATURE OF AP 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) POWTS OWNERS MANUAL & MANAGEMENT PLAN P age, of FILE INFORMATION Owner. SYSTEM PECIFICATIONS Permit # Septic Tank Capacity f p� al ❑ NA �i Septic Tank Manufacturer ` e ❑ NA PARAMETERS Effluent Fitter M�tufacturer ❑ NA Number of B _3 ❑ NA Effluent Etter Mode l L S ❑ NA Number of Units NA Pump Tank Capacity ❑ NA Estimated f al 30o al /da Pump Tank Manufacturer ❑ NA Design flow {peak), (Estimated x 1.5) Pump Manufacturer Soil Application Rate <J Q al /da ❑ NA Pump Mode! NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit Fats, Oil & Grease (FOG) 5 ❑Sand /Grave( Filter 0 m /L NA 9 ❑Peat Fiber Biochemical Oxygen Demand (SOD 5220 mg /L ❑ NA ❑ Mechanical Aeration 13 Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quafrtv Monthly average Dispersal CeN(s) A Biochemical Oxygen Demand (BOD 530 mg /L r / �In- Ground (gravity) ❑In -Gr d (pressurized) Tote! Suspended Solids (T5S) 530 mg /L �J NA 0 At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 efu /1OOml ❑ Drip_Line ❑Other Maximum Effluent Particle Size Y in dia. p NA Other. Other: ❑ NA ❑ NA Other. ❑ NA "Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service FreggencY Inspect condition of tanks! At least once every: ❑ months) ear(s) (Maximum 3 y"m) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one -third %) of tank volume ❑ NA Inspect dispersal cells) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA year(s) Clean effluent fifter At least once every; ❑ month(s) 13 NA � yea►(sl Inspect pump, pump controls &alarm At least once every: ❑ month(s) ❑ NA ❑ year(s) Flush laterals and pressure test At least once every: ❑month (s) Other: ❑ year(s) ❑ NA At least once every; ❑ mon'th(s) NA' Other. ❑ ysuts1 ❑ NA 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 r broken hardware, ardware identif an cracks or leaks, measure the volume of combined sludge a and Scum m and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(sl shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one - third %) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 115, 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 s12 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. START UP AND OPERATION Page of . For new construction, prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cools). 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 soll conditions are frozen at the infiltrative surface. Curing 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 cools) 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 Pings; 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: ( A suitable replacement area has bean 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 suit" 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. ❑ 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 BASSES 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. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER E Name c O .tZ rS Na1TTe Phone S Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY ` AUTHORITY Name Name S fit` rt i tA- Phone Phone LS 3 This document was drafted in compliance with chapter Comm 83.22(2)fb)f1)(d) &(f) and 83.54(11, (2) & (3), Wisconsin Administrative Code. EZ1203H vvvvevv % ^,;' '' '� ••` ••."• vvvo vsvvovv °,.; _ ' fit •• ' ^�` •'' +� jr_.: evevvve sysysoo •• ,• vvvo 24" Pee .�` • , �'�•ry v vo ^o "' ove 4.625 e .. it vvv Vov sv vvv vvv • • vov 1 � 1/2 Clrc. — 18.84" vvv vvv evv vvv vvv vvv V vv vvvo vov vvsVVVV o eVVVOVOVVOO vvoe vv vvvvevv vVeVVV vvvvvvv VVVVVVV vOV OVVV VVVVVVOO VVVYvvo VVeOeVV - 24tt 9 Bottom 36 12 -1/2 DIA. (typ.) Void Volume - Void Coefficient in Aggregate given at 57.4%. Soil Interface Area 1n. V j:t so Ft Sidewall (2 Sidewalls) 2 + 18.84in O.D. of 4" pipe = 4.625 inches 12in = 3.14 Void volume per linear ft. = 3.14 • ( 2.31256 )' • 1 ft = 0.117 fN 12inlft Bottom IR 2.00 O.D. ofcentercylindcr a T2.5 inches Total Soil Interface Area 5.14 SQ.1�7 Void volume in aggregate of center cylinder = 3.14•( 6.256 3.14 • 23 ' 125ia 1 ( ltzidrft) ( 12inrft / .574 - .422 ft' O.D. ofoutside cylinders = 12 inches / Projected Trench Area Void volume in outside cylinders - 2.3.141 t2 6 / ft) •'574 - .901 fN Sidewal l Height = 12 in. •2 - 2.00 Sq.Ft. t = Void volume at bottom between cylinders — r( 24m 6in ( bin �' Bottom 36 in. = 3.00 Sq.Ft. 11126,rft • Iz6 /ft '' 1 J '0.215 W Projected Trench Area a 5.00 Sq.FL 12in /ft l Void volume - at outside bottom corners (112 of void volume between cylinders) 0.215 ! 2 - 0.108 ft' Total void volume — 0.117 + 0.422 + 0.901 + 0.215 + 0.108 = 1.763 cubic ft I ft Gallons per It = 1.763 X 7.48 - 13.2 >!alions ner Ilnr�r rr . It / 36 Y/O = �� ErS Aggregate Trench System EZ1203H EZ ow Rin g ( ndustrial Group 65 Industrial Park Rd. Oakland, IN 38060 SGtE FILE NAM2; Qt203H -vsi SHEET: 1 of t it -27-01 t U 1884P S STATE BAR OF WISCONSIN FORM 1— 199 6 7 8 1 0 7 WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., MI Document Number RECEIVED FOR RECORD This Deed, made between Oakwood Lan Development Inch Corporation , Grantor, and Christopher B. G��� Grantee. 05 -06 -2002 9:30 AN Grantor, for a valuable consideration conveys to Grantee the following .IARRANTY DEED described real estate in St. Croix County State of ExFJ+{GT s Wisconsin (the "Property"): REC FEE • 11.00 TRANS FEE: 113.70 COPY FEE: C£RT COPY FEE: PAGES: 1 Recording Area Name and Return Address Christopher B. Gaspard x Red Pine Comer New Richmond, WI 54017 02 611 30 1 7000 Parcel Identification Number (PIN) This is not homestead property. (Is) (is not) Lot 17, Red Pine Comer, St. Croix County, Wisconsin. Together with all appurtenant rights, title and interests. None Grantor warrants that the title to the Properties good, Indefeasible in simple fee and free and clear of encumbrances except Dated this 15th day of April 2002 (SEAL) (SEAL) Oakwood Land Dev to nt, Inc. . 'A "t SEAL (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, } as. Y SWATZI Hennepin County authenticated this W N T�P� Personally came before me this 15th day of C74TF_ OF O NS�� Agnf, 2002 the above named Oakwood Land Development, Inc. By Greaory J Peterson as Vice President to me known to be TITLE: MEMBER STATE BAR OF WISCONSIN the person who executed the foregoing Instrument (If not, and a nowt dge the same. authorized by §706.06, Wis. Stats) THIS INSTRUMENT WAS DRAFTED BY Coldweli Banker Burnet Notary Public, State of Wisconsin 1501 W. 80th Street Bloomington, MN 55431 My commission ' permanent. (If not, state expiration date: 2 -20664 5 �1� 1S ) (Signatures may be authenticated or acknowledged. f Both are not necessary.) Names of persons s[Qning in any capacity must be typed or printed below their si nature. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co, Inc. WARRANTY DEED FORM No. 1 —1998 Milwaukee, Wis.