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HomeMy WebLinkAbout026-1141-20-000 az;�- a. 14� Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 sconsin Personal information y may ou p rovide be used for second p urposes Madison, WI 53707 -7302 Department of Commerce y p p [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not Q — - 0 ?- / state owned.) Attach complete plans (to the county copy onI44Z the system, on pape n l ess t 8 -1/2 x I 1 inches in size. County State Sanitary P it mber heck if revision to previous application State Plan I. Number A I. Application Information - Please Print all Information Location: ll - , Property Owner Name / Property Location AP C �' �G 4� it < {, f ( � R 1 8 2002 -SL;.IW4 1/4, S V (or Property Owner's Mailing Address Lot Number Block umb �— ST. CROIX COUNTY '� 33 ,'�� g • IQZ� ZONING OFF City, State % Zip Code L Phone Number 7Su N e or CSM mber 11 . T e of Building: (check one) r �/ ❑ City 1 or 2 Family Dwelling - No. of Bedrooms: ❑ Village ❑ Public /Commercial (describe use):_ of ❑ State -Owned 3 1 &&K dj 3 l // 3 ' 5 tl 9 ��-Ltm. G" wt v l (0/ .I n s� �C Cdr Neares Ii (I P c f ax N )+ 0 ' O6-6 III. Type of P mit: (Check only one box on line A. Check box on line B if applicable) A) I _ 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System $) 1 Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) S O 4 -pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: " aI TevS ec, G elegy, V. Dispersal/Treatment Area Information: . 1 15 1 (p 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. Syste levation 1 7. Final Grade Required Proposed Rate (Gals. /day /s .) (Min. /inch) ( Elevation IL 7,, �z/ - Z VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility for igAap of the POWTS shown on the attached plans. Plumber's Name (print) Plumbe ' igodure (no stamps): MP/MPRS No. Business Phone Number Plumber's Address (Street, City , State ode) IX. County/Department Use Only y _ ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued s ' Agent Sig (No stamps) Approved ❑ Owner Given Initial Adverse Surcharge Fee) ) if U Determination�(� X. Conditions of Approval /Reasons for Disapproval: re vrsP ��• �� ,/PSf SBD -6398 (R. 07/00) � v PL T PLAN and Soil Test Plot Plan LOT 2 c) 'Duc k- Ord G � PROACT P.C. Collova Builders Inc. DDRESs 705 ctv Rd E Hudson Wi 54016 SW 1/4 SE 1/4s 33 /T 30 18 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 3/20/02 DATE BEDROOM 3 CONVENTIONAL XXX IN -GR N RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1209 # of chambers 39 BENCHMARK V.R.P. Top of 2" Pipe ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H. R. P Same as Benchmark B.M. SYSTEM ELEVATION 96.4/96.3/96.2 #1 Property Line Vent 80 > 12" S!rade ewinder High Set @ 3.5' Below Grade 20' ' Capacity Leaching tY g Vents 0 of Cover Cmber 10 B -3 6, Long 16„ 4' at System Elevation 3 4 40' a Plans Designed Using 3 -3' X 82' Cells with >3' Spacing 80' ( t Conventional Powts o Manual Version 2.0 B -2 This is a revision to a previous plan � / M 23 � )Ven N r tv f 6L 30' Pro 3 Bedroom House 121 st. Ave Wisconsin Department of Commerce SOIL EVALUATION REPORT page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County /r / 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 horizontal reference point (BM), direction and Parcel I.D. i� 7, 77 � �d percent slope, scale or dimensions, north arrow, and location and distance to nearest road. R R l Please print all information. view Y Dat r� ,1 1 Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Y �T/ (/ d Properly Own Property Location Govt. Lot Z S3 T 3 N ; 7E ( W Property Owner's Mailing Address Lot # I Block # Su or City tats Zip Code Phone Number ❑ city ❑ Village Town Nearest Road New Construc ion U!7e� idential /Number of bedrooms _ Code derived design flow rate �� _C GPD ❑ Replacement // ❑ Public mercial tribe: __— Parent material Flood Plain elevation if applicable ��� ft. General and recommendations: 01 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 GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 -Eff#2 J/ A LS.z� Boring # a Borng 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/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 - Eff#2 3 01 .01 62 3 - Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 159 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) gnature CST Number w ti �ji`�t,� I Zer, 6 ress Date Evaluation Conducted Telephone Number r y Property Owner C Parcel ID # Page 9 of 3 wing # A Boring F Pit Ground surface elev. 0 + 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 f o -� r3IL S ,- 2 - s/ G' s 1.✓ -� .3 .3 Ali All F Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Appli cabon 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 M E] Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description- Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •Eff#1 •Eff#2 Effluent #1 = BOD > 30 1220 mg/L and TSS >30 < 150 mgll. ' 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. seo -9330 (R.600) Wisconsin Department'. of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Bujing bivision INSPECTION REPORT Sanitary Permit No: 404968 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: P.C. Collova Builders, Inc. I 'Richmond Township 026 -1141- -000 CST BM Elev: Insp. BM Elev: BM Description: l (4 l f La k Ek TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark / �� D ' 1 as Cs , I o / Dosing Alt. BM L n < 16,1 Aeration Bldg Sewer l /`� �� �� e7, An. O Holding S t Inlet Ht Outlet 0 9S 7 TANK SETBACK INFORMATION TANK TO P/L WELL I BLDG. Vent to Air Intake ROAD D Septic 1 r Dosing Header /Man. C)` 7 7 b G?•3� Aeration Dist. ipe / /9 e p ih s L Holding Bot. System 7� b� yG �S$ . 7. /-. y Final Grade jr`' PUMP /SIPHON INFORMATION M 3. C) 00, � Manufact rer G emand St 'Co r Z < �y 2 av� 2 Model Number TDH Lift Fric ss System Head TDH Ft Forcemain h Dia. SOIL ABSORPTION SYSTEM BED NCH Width / [ength / No. Of Trenches PIT DIMENS NS No. Of Pits Inside Dia. Liquid Depth DIMENSIO SETBACK SYSTE TO P/L JBLDG WELL LAKE /STREAM LEACH NG Manufac r r: (CHAMBER, INFORMATION Ty p Of System: C 6 j In� 1 f '' Gl� / Model Number: i DISTRIBUTION SYSTEM Header /Manifold P 12jWt1 YS �p x Hole Size x Hole Spacing Vent to Air (Intake Length � � Dia Lengt Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over /2 (�� ✓ Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/ r enter Bed/Trench Edge Topsoil / �:� - Yes No Yes 1x No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / C21 Inspection #2: Location: 1182 121st Ave New Richmond, WI 54017 (SW 114 SE 1/4 33 T30N R18W) Duck Por7_�E�pe Lot 20 Parcel No: 33.30.18.1124 1.) Alt BM Description 2.) Bldg sewer length - amount of cover ='� (A p�ruy V deq) _ Plan revision Required Yes N _ o — I Use other side for additional information. 1� - -� Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) l 1 ► L� G C 7 s. ' Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 - Madison WI 53707 - 7162 Site Address ns�n sr Department of Commerce aG pZ 0 /z9 Sanitary Permit Application Sanitary Permit Numb C (&S in accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision may be used for secondary purposes Privacy Law, s15. 1 m I. Application Information - Please Print All Information GO .Number V Property Owner's Name Parcel N ber o26 - - 2c� -ouv .2 C. C,� l- w t31�Qi, Prope Owner's Mailing Address M � Property Locado �f FtO�X GE i4 ',i: S LiN. R Z 11 V19 City, State Zip Code P Lot Nilm Block Number v^ --- Subdivision Name CSM Number . Type of Building (check all that apply) 2 C.3. �W , S / " ❑City r 2 Family Dwelling - Number of Bedrooms . r ❑V' e g ❑ Public /Commercial - Describe Use lip t I nn Nearest Ro oa a / ❑ State owned r%i�gn�6L3 ` x �t. ��' r�CY / �/ M. Type of Permit: (Check bn1j one box on line A (numbering scheme for internal use). Complete line B if applicable) A For County use ew 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Addition to S stem I I Tank Onl y I Existing System B. ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use)- • " zt n - Pressurized In- Ground 210 Mound 47 ❑ Sand Filter 50 ❑ Constructed band Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Li 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other - V. Dispe rsal/TYeatment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elev Final Grade Requtr Pro s ed Rate(Gals./Days/Sq.Ft.) (Min./Inch) , �� Elevation A i , VI. Tank Info Capacity in Total Number Manufacturer Prefab Site 'Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Dosing Chamber VII. Responsibility Statement- I, the undersign , e responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' i cure MP/MPRS Number "\ Business Phone Number eat � Plumber's Address (Street, City, State ode) YL VIII eTiartment Use Onl Approved ❑Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Initial Adverse ZS �� Determination IX. Conditions o f Ap o T, Disapproval T,u,r,Qr CRX�L l�s�b0[ (�wr -w. /� �✓, .x�H• �Ysrllw. 2 -T� 2•�� �`""'� V1A v< 2- " S Ot Cth" BuCI c� t r , 1 ,,, ` {acxwttvS she cc�i c •4r`erts. �= ,M+.+.07C C am. /v $�p�iL -�•1L '1't cK� tiA inch ( to ec l l - ) [m• rar! o n =not than SBD 398 (R. 05101) sus PLOT AN PROJECT P.C. Collova Builders Inc. A ESs 705 ctv Rd E Hudson Wi 54016 SW 1/4 SE 1 /4S 33 /T 30 /R W TOWN Hammond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 3/20/02 BEDROOM 3 CONVENTIONAL X00C IN- GROUND VRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 668 # of chambers 39 BENCHMARK V.R.P. Top of 2" Pipe ASSUME ELEVATION 100 Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark f.M SYSTEM ELEVATION 96.6/97.2/96.9 Pro a Line V ent ALong Sidewinder High Set @ 2.5' Below Grade 20 Capacity Leaching Chamber Vents 40' 10 B - " 34 " Grade at Syst em Elevation 40' Plans Designed Using / 3 -3' X 82' Cells with >3' Spacing 80 , � Conventional Powts o Manual Version 2.0 -B-? M 2 O i V 30' 20 G Pro 3 Bedroom House 121st. Ave PLOT ELA PROJECT P.C. Collova Builders Inc. Au s 705 ctv Rd E Hudson Wi 54016 SW 1/4 SE 1/4S 33 /T 30 /R W TOWN Hammond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 3/20/02 BEDROOM 3 CONVENTIONAL )00( IN- GROUND RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 668 # of chambers 39 BENCHMARK V.R.P. Top of 2" Pipe ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P Same as Benchmark B.M. SYSTEM ELEVATION 96.6/97.2/96 #1 Property Line Vent 2 .M. #2 > 12" Sidewinder High Set @ 2.5' Below Grade 20' of Cover Capacity Leaching Chamber Vents 40' 10 B -3 6' Long 16 �' Ac 34" Grade at System Elevation Z3-3 40' Plans Designed Using ' X 82' Cells with >3' Spacing 80' Conventional Powts o Manual Version 2.0 M 27, d' Vents 30' T 20' Pro 3 Bedroom House 121st. Ave Wisconsin Depar(ment of Commerce SOIL EVALUATION REPORT Page l of Division,of•Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County C rO 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 horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all info �i �� Reviewed by Date % Personal information you provide may be used for sewn ses (P 'vacy Law, s. Property Owner v �j Pr' Location 41 Gov t. o _SC 1/45E 1/4 S,3,3 T jp N R l E (or Iv Property Owner's Mailing Address t # lock # Subd. Name or CSM# _1b � 5 C (( �RpiX 2 1"O City State Zip Code P ona Number GOUR : ❑Village Town Nearest Road } ( P t c� and c /_=' ® New Construction Use: [M Residential / Number of bt�69fn I: Code derived design flow rate y 1 CI O GPD ❑ Replacement / ❑ Public or commercial - Describe A Parent material �/ Flood Plain elevation if applicable General comments .5Y5?Ztirt IC IC tl • 9 Z O and recommendations: #41 ele V. 5F6.3 Boring # Boring [� pit Ground surface elev. 9910 ft. Depth to limiting factor � 2 - 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 p - t 6 r& 2 Si l 2 mc b CS J V7C . S . S1 Z k 2. a+ aT- 20� Boring # El Boring R © pit Ground surface elev. 9q • 2-0 ft. Depth to limiting factor 70 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I 6-14 1 3 Z tr�r cs I� 5 S 5 i v Z n b S L 2rr k m Fr' S R6.6 0 * Effluent #1 = BOD > 30 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L CST Na a (Please Print) i nature CST Number Address Date Evaluation Conducted Telephone Number F 4!a vS Property Owner CO Li d VOk Parcel ID # Page ? of 1-31 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. ff *Eff#1 *Eff#2 2 12 -2$ 3 Z,S -C'b� 3 ZS ID-41, Lt k� L k m -Pr c 5 5 9 C a"+ 1� • Z.D F -1 Boring # El E] ❑ 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. Conk Color Gr. Sz. Sh. *Eff#1 I *Eff#2 ❑ 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 mg /L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -6330 (R.07/00) r i PAGE 3 OF NAME Co II o y LOT# 00 LEGAL DESCRIPTIONS E 'ISE'/<,S33T3o N,R 1 (Ora /SCALE: I "= Vo , LEVATION BM I DESCRIPTION of Z O%rc. A,'D o LEVATION BM 2 DESCRIPTION - &g al Z pdc D. I SYSTEM ELEVATION 4' � • Z O - -�- - ALTERNATE ELEVATION IG • SO I CONTOUR ELEVATION q $. gU X19• g a k spa z SIGNATURE ATE - y s� "q-" Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 Contingency Plan 1. If system fails, determine cause of failure, use alternate area and install new system or install system at a lower elevation. 2. Replace any other failing components as needed. Plumber: Shaun Bird 715 - 246 -4516 Shaun Bird #226900 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM nn Owner /Buyer �. (� H oVA 6 1� tt S ti Mailing Address - 7O , !� 0v • / d It Property Address - (Verification required from Planning Department for new construction) City /State Daz z C.L mm W.L Parccl Identification Number LEGAL DESCRIPTION Property Location '/,, '/4, Sec. 33, T O N -R W, Town of t Subdivision Lot it_. Certified Survey Alap tt , Volume Page It Warranty Deed it �n� 1 Volume Page It Spec lioust,4es ❑ no Lot lines i(icntif 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 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. I/we, the ivadersigncd 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 Zoning Office within 30 days of the three year expiration date. C 'a� 3 SIGNATURE OF APPLICANT 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 owncr(s) of the property described above, by virtue of a warranty decd recorded in Register of Deeds Office. 3 � 0 z • SIGNATURE OF APPLICANT DATE « « « « «« Any information that is mis- represented may result in the sanitary permit being revoked by tile Zoning Department. " Include with this application: a stamped warranty deed from the Register of Dceds office a copy of the certified survey rnap if reference is made in the warranty deed ��. �. ..� � � ' � . _ �r .•• .. t C ' .. ! r•. .�' � 1 y I� FROM P COLLOVR BURS INC PHONE NO. : 715 549 5911 Nov. 1E 2001 09:32AM P1 STAIERAKOF WISCUNSIN FORM 1. 1918 16 .4 - ay KATHUEEN 11. WALSH k WARRANTY DEED REGISTER OF DEUS U0 s I p 91. INVIX CO., W1 This geed, made hetwccn Kenneth L. Brown and 1(Athlcel ll B. k6CbM FOR =11" Brown, Husb sad Wife —�� y�� OL -18 iro01 9:43 LW _ YA MTV WU Gratstor, and p. G Collova OulldcrS, Inc. yW _ EXEWT I C1511 -COPY FEE. COPY RE! ,TitA1i M FEE: 828. Do — _ WM1,14 FCCL 10.01 ........m 1+ocE5a. 1 Cnntse. Gnntor, for a valuable consideration, conveys and wuranfa to t Grantee the following dwribcd tool esiote in St. Croix County, Stalc of Wisconsin; ! 2ecardia Ass Nax�c and I own Addren 01vid I. Eetraml 1*hat port of 89 114 SW 114 and SW 114 SE 1/4 Soo. 33 T30N - ?U8W doscTibnd 104 mast St. as follows: Lela 1, 2 and 3 of Cariirted Survey Map recattled In VOL 13 of Hudson, WI S4016 Cardfied Survey Maps, page 3698 as Doe. NO. 607591. SL CroixCauity,Wllconaul a •IOVO•coVW. ozo- t0roo -zo;. 026.1096.70.000 rowel Idend cation%xv irtb) This it no( holnestasd properly, (ire (is not) Exceptions to warronlies: Existing highways, emetncnts R rights of way of record. Daicd this of April 290) . Kenneth ):.. Brown • Kathloca B. Brown AUTHENTICATION ACKNOWLEDGMENT 37117E Or WiNconsin ) as. Sl®nature(a) _ St. Crota County. ) personally vomit before ma this ►3 day or smbtntieated this _— day of April 0 2001 the above named eoneth I, rolvn and KAtkleon B. Brown 71TW;'6�-4 Or WISCONSIN µ — to Inwe to bit she person(a) wbe eaacmed the roro8oing Wis. Stitt:.) WAS DRAFTEDnY A!t avid J. Sstreen 304 54016 Notary Yuhtie, S:m of Wisconsin (Siglulu -N* be authen(lesW er seknov.i z%& Both are :tot My Cammiodon is perms s ex ra oat a neeassarY•) ) "Names of tateans altlNns is in wwity OmId be tyotd or printed below dW, denaRree 27ATCBAN or WIWONSIN wApIMNTY fat:b ytj s rw i • me INFORMATION r %VyaaSMNAL COMPANY ROMP W LAC, W W0432 -10M J -J Lki 2 Q O V) 0 F_ Lj O I I f- z o- J Q Q000Q� I �` 45 0 J I _ I �Zzw0 O o °Zr�w o� 0/ I �T- °N(f) I / N o- O rn cat zUCn w0 I �/ c( 1^� �� •_ i .• i C M a Q N 0 , d QQ Z /� ♦ \ O 3 . * 1 00 V) .z ov ; I 0 rn Ln a co iV'. w ��� b ; O CVO CO r I C\l L� I I I M (n Ln co O� I I I I I JOINT I — II - - 3-94 1 1 l <Z 6F Zb C\2 I N C\2 o-Q �V cn O °_� I o 3 r c► \ iN�w35t to z M N I O r7 N c- dJ '� �� \ LO Q I c o CN co . \ Q\ �o �i° N 145. Q ° p� O \ N w � 1 © t Fw ao 6 h J N N ,— — �s csz r Z 0) '^ ,9 oo s b oqx I I a I I �k� o ; 3- 8S,Z020 N