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Home My WebLink About030-2102-10-000 Parcel #: 030 - 2102 -10 -100 08/22/2007 09:03 AM PAGE 1 OF 1 Alt. Parcel #: 29.30.19.830A 030 - TOWN OF SAINT JOSEPH Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 06/09/2006 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - DAVIS, JACK G & MARILYN J JACK G & MARILYN J DAVIS 468 HIGHLAND VIEW HOULTON WI 54082 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ' 468 HIGHLAND VIEW SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 3.649 Plat: 5202 -CSM 21 -5202 SEC 29 T30N R19W SE SW LOT 30 HIGHLAND Block/Condo Bldg: LOT 30 HILLS 2ND ADDN NKA CSM 21 -5202 LOT 30 3.649) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 29- 30N -19W SE SW Notes: Parcel History: Date Doc # Vol /Page Type 05/02/2006 824141 CSM 02/20/2001 638867 1589/196 WD 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 04/16/2007 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.650 82,800 225,300 308,100 NO Totals for 2007: General Property 3.650 82,800 225,300 308,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 06/1912007 Batch #: 07 -06 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wscansin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division Cougty:CCOIx INSPECTION REPORT §? : Croix INFORMATION (ATTACH TO PERMIT) Sa 3�r�A n NO.: Personal information you provice may be used for secondary purposes [Privacy . s.1yv5.04 (1)(m)). State Plan ID No.: p fis�',IV21 er's Name: ❑City `fit i1 �6Se T 1 o wnship — CST SM Elev.: Insp. BM Elev.: BM Description: J Parcel Tax No.: � .� I $w [ e%t SE* e C 5 7 6l^n I 030 - 2102 -10 -000 TANK INFORMATION ELEVATION DATA J' ` (q r g3O TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic I Benchmark 1.10 1 09.1 D CRD. O gam, g �,DQ 2 Alt. BM Aeration Bldg. Sewer Holding St/ Ht Inlet 4 TANK SET ACK INFORMATION St/ Ht outlet (0 , TANK TO P/ L WELL BLDG. ventto ROAD ftE Inlet `{ • to v d �(- S`0 Air Intake z o �f . Septic Sn 2 / / NA E. o o Dosing > `{D 3 ' NA Header / Man. Aeration NA Dist. Pipe $ (.Z (o • L 99•c. � Holding Bot. System q '71 . PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand` I L� o l D6 • Z Model Numbe pM 1 T TDH Lift Fr 'on System TDH Ft Forr.e Length Dia. Fi Dist. Towed SOIL ABSORPTION SYSTE 5 1 a,.G., BED/TRENCH Width Le h t No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth D IMENSIONS 3 3•+ - Z DIMEN I N LEACHING Man ` alcSu SETBACK rer�,�� SYSTEM TO P / L BLDG WELL LAKE /STREAM 1. - - { f - ' �� CHAMBER a Num r: INFORMATION Type OR UNIT — u System: (.0m AJ • 8 DISTRIBUTION SYSTEM , , Distribution Pipe(s) x Hole Size x Nole Spacing Vent To Air Intake Header / Mani > /m, Length 1 k , Dia. aun SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over I xx Depth Of xx 'Seeded/Sodded xx Mulched Bed /Trench Center Bed /Trench Edges ' Topsoil ❑ Yes ❑ No ❑Yes C] No IN o nspection Lie �#ililh4f�4�4@t Ig4iRl1d "• litffl$°�"�I� 19$ /4 29 T30N R191W) - 293019830 Highland Hills I - Lot 30 1.) Alt BM Description 2.) Bldg sewer length= 3D. D - amount of co � Z�Z-�° �- Plan revision required? ❑ Yes JA No oe o a l _( Use other side for additional information. OEEH SBD -6710 (R.3197) Date Inspector sSignature Cert No \� Y � \ � o. o '� -- � �--/ �1� ®a ,s �, ' ° ; ''�° �" c�� °5 __ � � � �� f , VtEhr -- Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 ® ISCOnSin Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce (Submit completed form to county if not [Privacy Law, s. 15.04(1)(m)] state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x I 1 inches in size. County State Same Pe it Number ❑ Check if revisiort:l0 p vious application State Plan I. D. Number G�� ► FLU ,� I. Application Information - Please Print all Information r Location: Property Owner Name ` . Property Location y IT&zI &(Z Z 1/4 114, N I N, R'E (,(W Property Owner's Mailing Address — Lot Number Block Number City, to Zip Code �o Number ,. Subdivision Name or CSM Number t Aawle mil` ✓� /� ( qs �'� 'ti " ��/.. it. e of Building:, check one) ❑ city 1 or 2 Family Dwelling - No. of Bedrooms: '❑ Village Public /Commercial (describe use):_ —s own of 5Y . ❑ State -Owned Nearest Road Parcel TaxNumber(s) e�30-o2 Dv� /Z, III. Type of Per mit: (Check only one box on line A. Check box on line B if applicable) '3 9'3 a A) 1. EWew 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System B) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) [(Non- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland 4 ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ``l ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: S� V. Dispersal/Treatment A rea Info rmation: O • ,m 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area . Soil Application 5. Percolation Rate . Syst 7. Final Grade Required Proposed Rate (Gals. /day /sq. R. (Min. /inch) _ evation S � /c9o.S" c�v, �o v _ v c>. VII. Tank Capacity in Total # of Manufacturer Prefab Site r- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks -K 51 —t— G ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plum 's Name (print) Plumber's ature (no stain MPIMPRS No. Business Phone Number Plu is Address (Street, City, State, Zip Cod�e IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued s 'ng Agent Signa (No stamps) Approved ❑ Owner Given Initial Adverse SurchAge Fee) Determination 22 X. Conditions of Approval /Reasons for , Disapproval: .QX� -. l L W ae_ 5 � � /-tT � K&t - o• z s� se�� > f) - Ito - iL-- - n- - A [� c Q C-j SBD -6398 (R. 07/00) PLOT PLAN PROJECT Jade Davis ADDRESS 12039 Gantry Ln. Annie Valiev Mn. 55124 SE 1/4 SW I /4S 29 /T 30 N/R 19 W TOWN St. Joseph COUNTY S CROIX MFRS Byron Bird Jr. 220527 DATE 30-01 BEDROOM 3 CONVENTIONAL X XX t -Grade CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 &260 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ' 13 LOAD RATE .9 ABSORPTION AREA 500 # of chambers 30 BENCHMARK V.R.P. top of SW lot stake A SSUME ELEVATION 100' ❑ BOREHOLE 'D WELL *H.R.P. same as BM SYSTEM ELEVATION T- =1 .5T -2 =1 00.7 Road ... j 3 I PL Garage 3bedroom house 3' st 50• It BS nQ' 15' B_, ob pipe PL 36' 4' 93.75 3' 40' B1 B4 15' 45" 75' BM 348 PL PLOT PLAN PROJECT Jack Davis ADDRESS 12039 Gantry Ln. Anda Vallav Mn. 55124 SE 1/4 SW 1/4s 29 /T 30 N/R 19 W TOWN S t. Josep COUNTY ST. CROIX MPRS Byron Bird Jr. 220527 DATE 5 -30-01 BEDROOM 3 CONVENTIONAL XXX t -Grade CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 &260 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE 13 LOAD RATE •9 ABSORPTION AREA 500 # of chambers 30 '► BENCHMARK V.R.P. top of SW lot stake ASSUME ELEVATION 100' ❑ BOREHOLE O WELL *H,R,P, same as BM SYSTEM ELEVATION T- =10 .5T -2 =10 -7 Road Drivew y 3 I PL Garage 3bedroom house 3' st 50' st B5 1 7 nQ' .._ ._ob pipe PL 36' 4' 93.75 3' B 40' B1 B4 15' 45' 75' BM 348 PL Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page i of —_ Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but ca ' S rkroix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or P AR 7t n, c� dimensioned, north arrow, and location and distance to nearest road. e APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION c. Ie_ 131 TE PROPERTY OWNER: PROPERTY LOCATION �� N E Y , Joanne Persico GOVT. LOT SE 1/4 1/4_ ClIVOE E (or) W PROPERTY OWNERS MAILING ADDRESS LOT # I BLOCK # SUB CSM # 400 S. Second St. 30 na CITY, STATE ZIP CODE PHONE NUMBER ❑CITY El (TOWN ST ROAD Hudson, WI. 54016 b15) 386-9060 Co. Rd. 1 *1 [x] New Construction Use [ Residential / Number of bedrooms 3 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate __ , . 5 bed, gpd /ft trench, gpd /ft Absorption area required 900 bed, ft 750 trench, ft Maximum design loading rate _ bed, gpd /ft gpd /ft Recommended infiltration surface elevation(s) 100.90 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material pitted glacial drift Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem K7 S ❑ U CAS [I U R7 S ❑ U ® S El E] S ❑ U ❑ S Q U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft 1 - Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0 -23 10 r3 3 none ' S 2 23 -46 10 r4 4 none Ground 3 1 46-64 7.5 r4 4 none ' elev. 1 4 164-84 7.5 r4/6 none ms os - Depth to limiting factor J ai) +84 Remarks: Boring # •r 1 10-12 10 r3 3 n 2 < 2 12 -30 10 r4/4 none sicl 2 ' Ground 3 130-46 10 r5 4 none elev. 4 146-84 on sl m 7.5 r4 4 none 2 sbk mvfr na na .5 .6 y / 1 04.2 ft. Depth to limiting • cf oa.t.R.K factor +84" Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. M6., New &c Q_nd, WI 54017 Signature: Date: 11 -11 -96 CST Number: m02298 PROPERTY OWNElU Persico SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.D. # Pending l Lot #30 Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft Boring # Horizon in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 1 0 -8 10 r3/3 none scl 2msbk mfr 9w 2f .4 .5 .t 2 8 -20 10 r4/4 none sici lcsbk mfr 9w if .2 .3 t Ground 3 20 -41 7.5 r4 4 none sl 2csbk mvfr 9w na .5 .6 r elev. 1 4 41 -84 7.5yr4/6 none is osg mvfr na na .7 .8 •� Depth to limiting factor { l oo , +a4 Remarks: Boring # 1 0 -10 10 r3/3 none sil 2msbk mfr cs 2f .5 .6 4 2 10 -30 10 r4/4 none sici lcsbk mfr gw if .2 `:.3 L 3 30 -43 7.5yr4/4 none sl 2csbk mfr gw if .5 .6 Ground elev. 4 43 -90 7.5 r4/6 none cos osg mi na na .7 .8 104. Depth to limiting factor +90 Remarks: Boring # 1 0 -12 10 r3/3 none sil 2msbk mfr cs 2f .5 ` .6 S 2 12 - 10yr5 /4 none sici lcsbk mfr gw if .2 .3 .2 Ground 3 31 -84 7.5 r4/4 none sl 2msbk mvfr na na .5 .6 , elev. 103. Depth to limiting factor +84 Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel Joanne Persico 1554 200th Ave. CSTM2298 SE4SW4 S29- T30N -R19W New Richmond, WI 54017 MPRSW 3254 town of St. Joseph (715) 246 -6200 lot #30- Highland HIlls Second Addn. 1 =40' BM-= top of SW lot stake @ el. 100 Ao" f h h � 6 � � o Gary L. Steel 11 -11 -96 POWTS OWNER'S MANUAL 8L MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner L �! ' Septic Tank Capacity / 610 g al ❑ NA Permit # Septic Tank Manufacturer 1r5 ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer C ❑ NA Number of Bedrooms ❑ NA. Effluent Filter Model ❑ NA Number of Commercial Units ❑ NA Pump Tank Capacity gal ❑ NA Estimated flow (average) gal /day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) gal /day Pump Manufacturer ❑ NA Soil Application Rate gal/day/ft' Pump Model ❑ NA Influent/Effluent Quality Monthly average* Pretreatment Unit ❑ NA Fats, Oil at Grease (FOG) :530 mg/L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODs) :5220 mg/L ❑ Mechanical Aeration ❑ Wetland Disinfection ❑Other: Total Suspended Solids (TSS) <_150 mg/L Manufacturer Pretreated Effluent Quality ❑ NA Monthly average** Dispersal Cell(s) Biochemical Oxygen Demand (BODs) :530 mg/L Kin-ground (gravity) ❑ In ground (pressurized) Total Suspended Solids (TSS) :530 mg/L ❑ At -grade ❑ Mound Fecal Coliform (geometri c mean) :5104 cfu/ I OOmi ❑ Drip -line ❑ Other: Maximum Effluent Particle Size A inch diameter * Values typical for domestic (non - commercial) wastewater and septic tank effluent. * * Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every ❑ months year(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one -third (36) of tank volume Inspect dispersal cell(s) At least once every ❑ months year(s) (Maximum 3 yrs.) Clean effluent filter At least once every ❑ months year(s) Inspect pump, pump controls &&arm At least once every ❑ months ❑ year(s) XNA Flush laterals and pressure test At least once every ❑ months ❑ year(s) )4 NA Other At least once every ❑ months ❑ year(s) ❑ NA Other At least once every ❑ months ❑ year(s) ❑ 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 (ys) 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 ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatement components, and any other maintenance or monitoring at intervals of 12 months or less 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 For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(cl rpmnvpri by a cpntavp cprvirina nnpratnr nrinr to iicp. Page of 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. ABANDONEMENT 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 ch. 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: t A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules In effect at that time. . Barring v in POWTS technolo available due to setback and /or soil limitations advances c • A suitable replacement area �s not g 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 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 IMPMURI F._ ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name i. Names c d Phone Phone 0 2 St g q — SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name g2 e,,Z2 z e Agency f 4/ - r x Phnna 7/5 =� `�' Phone i ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer -! a c / C' S Mailing Address / A a `'`� ''t "' / Property Address Lam (Verification required from Planning Department for new construction) ' 4 City /State Parcel Identification Number LEGAL DESCRIPTION Property Location Sec. '-'-� T_,?,N -R�W, Town of 15 e� 1 1� 1 "� �__ Subdivision �L G Certified Survey Map # �- , Volume . Page # Warranty Deed # J , Volume -,Page # Spec house ❑ yes, no Lot lines identifiable, 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 puper• What you put into the syst m em 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 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 Zoning Office within 30 days o e three year ex ' te. 6 0Z SIGNA 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 owners) of the property desc ' e of a warranty deed recorded in Register of Deeds Office. 22 s lcJ l SIGN TUBE 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 I V1.1 1589PAGE 196 638867 STATE BAR OF WISCONSIN FORM 2.1999 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Highland Hills, A Partner RECEIVED FOR RECORD 02 -20 -2001 10:50 AN -- — WARRANTY DEED — -- EXFKPT N Grantor, and Jack G Davis and Marilyn J. Da vis, husband and wife, CERT COPY FEE: COPY FEE: ib8 pO - -- — - -- TRANSFER FEE: — - - - -- — -- RECORDNG FEE: 10.00 — — -- — — — PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Lot 30 lat of liighl� HiIIs Second Addition in the Town of St. Joseph, Name and Return Address Croix County, Wisconsin. GF r 030 - 2102.10 -- Parcel Identification Number (PIN) This is not homestead property. Ot) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this ( S ' day of Februa 2001 Highland Hills, A Partnership • oAnn Per a� sico, individually and as Attorney in Fact for Roomer — — - Ruelin, Bruce a3AM ao AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) Highland Hills, A Partnership, by JoAnn Persico S ) ss. ffi individually and as Attorney in Fact for Roger Ruelin and — County ) IDe IL'tPZ9t11 atd J kaAm l u D authenticate thi ( of February ?�1 day of Personally came before me this _ . ' - -- the above named Kristina Ogland — — - -- _— — . - - - - -— — — TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, - instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY - -- - -- - Attorney Kristina Ogla _ -- —_ __- -_ Notary Public, State of Wisconsin My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessar).) Irdormalion Prorass —Is Company. Fond Names of persons signing in any capacity must be typed or printed below their signature. x. W S STATE BAR OF WISCONSIN WARRANTY DEED FORM No. 2- 1999 d4 Ul NI N, L p r w 1 4 *4 ul rI. 1 oil fi F, / ( re �_ • /� C14 I fIll cti. �� "� U i / 06 l � Ts� i ifl ( `� c7 CD x to \1 /* \ A Gill 'It Zl /c abed 99tIVIMUNI !Lg:Ol W/CO/W !2:09L 90C 94L NISNODSIM NOs(inH kJIV3U VNI03 A,