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Home My WebLink About030-2139-03-000 Wikonl§in Departrwnt Of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 453460 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 Pa el Tax No- Miller, Sam St. Joseph Townshif' CST BM Elev: r Insp. BM Elevt BM Description: Section/Town/Range/Map No: ub.O bp.O Description: .29.19. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark IMP Dosing Alt. BM Aeration Bldg. Sewer ~ `1 y \ o • I r Holding St/Ht Inlet (a 'T ) Q ,gyp It V {,gyp a ~0 TANK SETBACK INFORMATION St/Ht Outlet 9,1D 109.3q' 1o 1o8.3Y TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic > Dt Bottom Dosing Header/Man. ~3•~ ~t g9. ti Aeration Dist. Pipe 3•~ e1D t to. Holding Bot. System r ,jh t4A CA to Final Grade ' APUMP/SIPHON INFORMATION b Manufacturer Demand St Cover C.~ GPM IrD V` Lut Model Nu er Qr CIO . v TDH Lift riction Loss System Head DH Ft Forc ain Length 1777o ell f~ , t b ~p SOIL PTION SYSTEM /TRENC FI, idth~ Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIM S OOGNj_ZS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Man rer: INFORMATION CHAMBER OR Type System: AJ I UNIT I 'O ' Model 'baer:l/ 1 *1 DISTRIBUTION SYSTEM . a.0. Header/MaWfolld P. III Distribution x Hole Size Ix Hole Spacing Vent to Air Intake ?,JW Lj, Pipe ' 5p Length c• 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 E Yes U No Yes ~ No `•I3N(y, (Incl a code dis-cr ncies, er!ons tc.) Inspection # XKLQ4-1-ft-q-n~_ Inspection C- j cation: 1156 56th Stre t Hudson n 54016 (SW 1/4 NE 1/4 4 T29N R1 9W) Park Hollow Lot 3 arcel N 19. w+►ow 1.) Alt BM Description = 5'T. / I C ~ J 2. Bldg sewer length 9 6 S - amount of cover 1 1;. Plan revision Required. ! _j Yes No Use other side for additional information. ~4P 1 1" Date Inse ctor's Si9nature Cert. No. p SBD-6710 (R.3/97) f Safety and Buildings Division . County 201 W. Washington Ave., P.O. Box 7162 Sr) C, ~ d N Madison, WI 53707 - 7162 Sanitary Permit Numbcr (to be filled m by C:. *sconsi; ( 608) 266-3151 Department of Commerce 1-1s - Sanitary Permit Application Stale Plan `D ~lumb/"~ In accord with Comm 83.2 1, Wis. Adm. COde,•personal information you provide N 7 may be used for secondary purposes Privacy Law, 05.04(1 Xm) Project Address (if different than mailing add,-, / 1. Application Informadon -Please Print All Lnformatl - Property Owner's Name Parcel N Lot q Blame S n~ ! R3 r, .a a9 t 01:1 c' 3 _ o Proprny Owner's Mailing Address I Pr y Location ,vt ~kox ~Sl s.--_ ~ SW Section r City, state Zip Code Phone Number ✓~s W ( S `/01 ~'r 3fYt,-L769 Z (curie ) 11. Type of Building (check all that apply) T / N; R~E / or 2 Family Dwelling - Number of Bedrooms Subdivision Name C M Numcm S Public/Coaune vial - DescribeUu IT 1) 0 W ❑ State Owned - Describe Use 13-EIII-l^Tr ❑City_❑viline Township of S, ,k ` t :.0 iF/ T era. ill, Type of Permit: (Check only one line A. Complete Line B if applicable) A. New S s ❑ Replacement System ❑ TreatmeadHolding Tank Replacement Only ❑ Other Modification to Existing System list Previous Permit Number and Date lssucu fi ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New Befog Expiration Plumber Owner I V. Type of PON'CS System: (Check all that apply) _ Non -Pressurized In-Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At-Grade ❑ Single Pass Sand Filter ~i Co sstnscteG Worland ❑ Presstuucd In-Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Rec cutlatin Synthetic Media Filter hin Chamber ❑ Drip Line ❑ Onvel-less Pi ❑ Other (explain) V. Dis ersal/TreatmentArea Inf rmatlon: k' (JS Design Flow (gpd) Design Soil Application Rate(gpdso Dispersal Area Required (so Dispersal Area Proposed (sf) System Elevauou 1. Tank info Capacity in Total Number Manufacttuer Prefab Site Steel Fibe: Gallons Gallons of Units Concrete Constructed Glass Now Existing Tanks Tanks -pix or Holding Tank Azrobic Tmumcot Unit - C.sing Chamber LA-) itesponsiblllty Statement- 1, the undersigned, assume responsibility for tnstallatlon of the POWTS shown on the attached plans. Pluutbzr's Name (Print) Plumber's Signature MP/MPRS Number Business Pbone Number s c (1~=lJOa1 ¢.,l) ~d I~Lr Z2.5'D 3 ~o !v ~ 2- d i6S- /9 L ? Plumber's Address (Street, City, Stare, Zip Codee))/ n to-) 0 (1 Ua1~~ r °e @. 1~oQ `~L t.` SV FILL un /Dc artment Use Only _ Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater D re lssue¢., • suing Age Signature lo-4)s; Surcharge Fee) ' ~i gl 3 `G I . ❑ Owner Given Reason for Denial l'I Condidoos of Approval/Reas s for hap roval` !~h SYSTEM OWNER: `/~°'w retie tartEc-efftaEnt filter and ~i ~j dispersal cell must all be serviced / Intatned as per management plan provided by plumber. Z All setback requirements must be maintained as per applicable code/ordinances. Attacti complete plans (to the County only) for the system on paper not kss than 81/2 I I luclhes in site SBD-6398 (R. 01/03) 1' o ~9 M 13 d N ° n) r ~ p `d o 06 N 4Q d M La yQ W - Vl • S J ~ d 4 Q 4t c N ti _ o F'7,r ° o rv, (v 4c o ~ •o V N -7-7-3 0714~`& 3yl> PY, WELL- N y ~ jr 1n~ ~ W Y~ p m . ~ to clq` O m TIN r co N V\ ♦ • 6-4) _ r IN N ~y r f11 N `11 N P a uj BioDif fuser Specifications' , 76 00 0o coo 0o coo r--+C° o0 coo 00 c~ c~c~ cnerkw o c~c~ o° o0 °v oc° oo 0o c~c~ ~ g °O °°°v o0 00 DO Oc~o C° oo o0 cn~ f En0''Jiew 4 i 34, 1 . '41 Knockout Universal End Cap w 1 Available Sizes 1 4 S~IL EVALUATION REPORT Wisconsin Deparhnent of C Page 1 of 3 Division of Safety and Buildipce wit~r Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations d County Lon 1749 Attach complete site pr>ctre~ in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Pending from 030-1014-50-00 Please print all information. a wed By Date Personal information you provide may be used for secondary purposes (Privacy Low, s. 15.04 (1) (m)). Property Owner Property Location T Sam Miller Govt. Lot SW 1/4 NE 1/4 S 4 T 29 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# P.O. Box 151 3 Park Hollow City State Zip Code Phone Number City Village ✓ Town Nearest Road Hudson WI 54016 (715) 386-2769 St.Joseph River Road ✓ New Construction Use: ✓ Residential / Number of bedrooms 4 Coded rived design flow rpte 600 GPD r Replacement Public or commerc' I - Describe: p d to °,bou ago p9;, ~ Parent material Glacial outwash T) A Flood plain a vation, ' pplicable General comments -IP << / / and recommendations: Install tthr es at a v.98.00' using 39 leaching chambers. n~ I rr ❑ Boring # Boring ✓ Pit Ground Surface elev. 103.29 ft. Depth to limiting factor > 108" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft- 1 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10yr3/3 none sl 2fcr ds as 2f,lm 0.5 0.9 (P 2 8-37 10yr5/4 none sl 2msbk ds cs 1fm 0.5 0.9 (P 3 37-56 10yr5/4 none sil 2msbk dsh cw 1f 0.5 0.8 4 56-62 7.5yr4/6 none gr Is 0 sg dl cw 1f 0.7 1.2 5 62-86 10yr4/6 none s & gr 0 sg dl gs - 0.7 1.2 6 86-108 10yr5/6 none s & gr 0 sg F dl - - 0.5 0.9 H#6 contains 1 W -1 rZ' bands of 10yr4/4 Is at 1 z' - 20" intervals. Loading rate reduced to reflect reduced permeability of ho . ue to riding. Fil Boring # Boring ✓ Pit Ground Surface elev. 101.49 ft. Depth to limiting factor > 101 " 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 0-13 10yr3/3 none sil fill na na na na na na 2 13-22 10yr3/3 none sil 2fsbk ds cs 1fm 0.5 0.8 lP 3 22-32 10yr5/4 none sil 2fsbk dsh cw 1f 0.5 0.8 4 32-38 7.5yr4/6 none gr Is 2msbk ds cw 1f 0.5 0.9 5 38 44 7.5yr4/6 none s & gr 0 sg dl gs - 0.7 1.2 6 44-80 10yr5/6 ~e s & gr 0 sg dl gs - 0.7 1.2 7 80-101 10yr6/4 none s & gr 0 sg dl - - 0.7 1.2 * Effluent #1 = BOD 5> 30 < 220 mg/L nd TSS >30 < 1 mg/L * Effluent #2 = BOD . 30 mg/L and TSS <30 mg/L CST Name (Please Print) S CST Number James K. Thompson ignat 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, O a, WI 54020 11/132003 715-248-7767 Property Owner Sam Miller _ Parcel ID # Pending from 030-1014-50-000 Page 2 of 3 3] Boring # Boring ✓ Pit Ground Surface elev. 105.44 ft. Depth to limiting factor > 129" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots D/ffz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-11 10yr3/3 none sl 2fcr mvfr as 2f,lm 0.5 0.9 2 11-33 10yr5/4 none sil 2fsbk mvfr cs 1fm 0.5 0.8 3 33-53 7.5yr4/6 none gr Is 0 sg ml cw 1f 0.7 1.2 4 53-85 10yr4/6 none s & gr 0 sg dl cw 1f 0.7 1.2 . 7- 5 85-129 10yr5/6 none s & gr 0 sg dl - - 0.5 0.9 zg H#5 contains 1/8" -1/4" bands of 10yr4/4 Is at 15' - 24" intervals. Loading rate reduced to reflect reduced permeability of horizon due to banding.. ❑ 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 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *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 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 = BOD5 <30 mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. It 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. . P, Lo ca ~~P~°~o. Sfr~'a Sc.Qle . i ' N - 118' i MarK= To of 3 " c. pipe. Ass u.r►e,d 4f e4P- .•o ~o Zt : D~tn (d \ ' ~ ■ ``''''til To of /wd- lcr o' / Town ~oad Ios / / Re "/7i/f p 30 f r ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer S 4 to ~Z_ L 4-r Mailing Address -7~" 7?-'/5-- Property Address C 5 (P STQ -E T (Verification required from Planning Department for new construction) % City/State /7u~so Z4, Parcel Identification Number X341 ' -994D LEGAL DESCRIPTION Property Location S W 1/4, '/4, Sec. , T 29 N-R Z9 , Town of Sf TDS~IN 3 Subdivision P -e k H O LL O W Lot # s ~ 9 oy Certified Survey Map # 74 Volume Page # r Warranty Deed # 7 / $'2-'/9' , Volume ZzI Page # Oo3 Spec house 0 yes ❑ no Lot lines identifiable Ryes ❑ 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 t 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 lumber journeyman lumber restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system master plumber, P 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 undersigned have read the above requirements and agree to maintain the private sewage disposal system with the sttndaids rtificadon set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Ce Office within 30 stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning O days of the three year expiration date. GNATURE F A~PLICANT 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 erty descri above, by virtue of a warranty deed recorded in Register of Deeds Office. _2A&17 e/3 / o NATURE 0 APP CANT 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 3 _ `e,v k Igo (J p ul tart= POWTS OWNER'S MANUAL Page of 2 FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity al ❑ NA Permit S Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer A $ " L O NA Number of Bedrooms t~L O NA Effluent Filter Model _ J a 0 ❑ NA Number of Public Facility Units NA Pump Tank Capacity al ❑ NA Estimated flow (average) gal/day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) 0 O gal/day Pump Manufacturer O NA Soil Application Rate- gal/day/ft' Pump Model ❑ NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODE) 5220 mg/L /XNA O Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD5) 530 mg/L In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 510' 100m1 ❑ Drip-Line O Other: Maximum Effluent Particle Size Y. in dia. ❑ NA Other: ❑ NA Other: ❑ 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 eve ❑ month(s) (Maximum 3 ears) NA years)) ~r ear(s) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) o a ❑ NA Inspect dispersal cell(s) At least once every: ❑ month( s) (Maximum 3 years) NA X year(s) Clean effluent filter O months S a t least once every: / - 2 ❑ NA )Wyear(s) Inspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ NA ❑ ear(s) Flush laterals and pressure test At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: ❑ month(s) At least once every: ❑ year(s) ❑ NA Other: O 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 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 dispo$ed 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 reportshall be provided to the. local regulatory authority within 10 days of completion of any service event. 11 /UP AND OPERATION Page Z of new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting t , ',fiat may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected havvehtheccontentls 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 fired 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 replace replace ent system; suitable replacement area has been evaluated and may be utilized for the location of a system. The replacement area should be protected from disturbance and compaction and should snot be infringedbupontlby 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. T ' ~J alua ' S b e ate '~f20}llfl 17~ VbP- AI~✓ CONS71RUc~llnCICJ nk ❑ 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. ADDITIONAL COMMENTS POWTS INSTALLER ' , b0 POWTS MAINTAINER WA) UA. S C AO 3 ar Name 'A rk AJ ~C L Name Phone (p (z , ~ps, 92 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name ( ZO Phone Phone This document was drafted in compliance with Chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.540), (2) & (3), Wisconsin Administrative Code. J 2214P 0 0 3 7162+9 Il KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 1 - 1999 REGISTER OF DEEDS WARRANTY DEED ST, CROIX Co., WI Document Number RECEIVED FOR RECORD This Deed, made between James E. Ebbe, an adult single man and 04/21/2003 03:00PH Thomas A. Ebbe, as custodian of Theodore A. Ebbe, a minor, under the Wisconsin Uniform Transfers to Minors Act WARRANTY DEED EXEMPT t Grantor, and Sam E. Miller TREC RANS FEE: 11.0050 COPY FEE: CC FEE: PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, state of Wisconsin (The "Property"): Recording Area Name and Return Address Sam E. Miller P. 0. Box 151 Hudson, WI 54016 L W 1/4 of the NE 1/4 of Section 4, Township 29 North, Range 19 West, S . 030-1014-50.000 Croix County, Wisconsin Pucel Identification Number (PIN) This is not homestead property. (is) (is not) r Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except continuing easements and restrictions of record, if any. Dated this 17th day of April 2003 ~~LyYnua_. ~ ames E. Ebbe • Thomas A. Ebbe custodain for Theodore A. Ebbe AUTHENTICATJQO£ --P4Cfftf ACKNOWLEDGMENT STATE OF WISCONSIN Signature(s) ry. St Croix ) ss. County. ) EBO Personally came before me this 17th day of x- 114 P- W1 ;d authenticated this day of % P April, 2003 the above named James E. Ebbe and Thomas A. Ebbe 111-0 ;4 1,- 'VFAf TITLE: MEMBER STATE BAR OF WISCONSIN to me k awn to be the person(: O executed the foregoing (If o4 Ins t d ac o ge t authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY William J. Radosevich, Attorney at Law D r~`e.s 502 Second Street, Hudson, WI 54016 Notary Public, State of Wisconsin (Signatures may be authenticated or acknowledged. Both are not My Commission is crmanent. (If not, state expiration date: necessary.) - r ) • Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY DCCD -aTATe BAR OF WISCONSIN ►ORM N. 1. 1511 INFORMATION PROPILSSIONALS COMPANY FOND DU LAC, WI 100.651.2011 Joint Dr,,ewoy225.62 £osemen t for - Lots 5 dt 6 `O ~•G8~ N87'39'06"E 234.87............... 0~~:5~'~ S8)• S \ :N t • LOT 4 y \ f ' :(-n 0) 131, 708 sq. ft. ' 3.02 acres N7- 00 "bo 4 i g0.27 , ' a t - LOT 5 • , I ~h h 132, 515 sq. ft. S85'35'35"E- - 304 acres 217 ` -69~ V I I °3 Ss• c.) -.250 o sz oCO LOT O 130,907 sq. ft. IV . 3.01 acres 367-7181' • 626; 98' ' . 4)~ LOT2 Joint Driveway Easement / x'j; LOT 1 132, 039 sq. ft. ~ sr 131, 306 3.03 acres 3.01 ac L . B. 0. =868. 0I LOT 12 -00• • I 131, 457 sq, ft. - S8513,51 „E _ : 3.02 acres : 58 9.4 5' Ln . 00 - : rn oo LOT 1 of w = N 1,253 sq. ft. N I ' o o' '.O1 acres I w 3 O N:........ 0. = 868.0' -----N89'08'08"E I Z' Wo 1299.79'--`--- 648.94' - 584.82'- - - - - - - 66.03' t - - - 337.84'- - - - - R- ROAD - S89.45'12'•W^-- _ 1299.62'---~- - 3yl> PY, y t ELL N ° ~ A W w p VU f t Ch ~ ~ .f ~ ~ of s o i p r s F U ~vo r r ~ 0 4 J6 ~A • „ N p ,o FlQ # n o N r i QQ - W 11 ~ o 02** Qof ~l