HomeMy WebLinkAbout030-2100-10-000 Wilconsin Department of Commerce County
Safety and Buildings Division PRIVATE SEWAGE SYSTEM
INSPECTION REPORT St. Croix
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 370312
Permit Holder's Name: (]City ❑ Village ❑)Town of: State Plan ID No.:
ueller, Eric St. Joseph Township
CST BM Elev.: - Insp. BM Elev.: BM Description: Parcel Tax No.:
10:4.05( I I ;�M t-l5ED CST 030 - 2100 -10 -000
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic SEfL wu Benchmark co , { o n . O S
Dosin CO+Mt>t0- ASK Alt. 1.32 ICE -l3
Aeration Bldg. Sewer ts. �ie`� 12.20 1o3.Z5'
13•
Holding St / Ht Inlet 32
[02. 13
TANK SETBACK INFORMATION St/ Ht Outlet •—
Vent to �
TANKTO P/L WELL BLDG. Airintake ROAD Dt Inlet —
Septic *> SD ' * o NA Dt Bottom
Dosing � �. - ..( NA Header /Man.
S ee_
Aeration A Dist. Pipe bcl.,r
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade t
Manufacturer myas Demand St cover
Model Number Vim — 40 GPM Oct. S
TDH I Lift friction System TDH Ft
m ead
Forcemain Length is Dia. of Dist. To Well
SOIL ABSORPTION SYSTEM s o
8M ENCH Width length N Of Trenc PIT No. Of Pitd Inside Dia. Liquid Depth
DIMENS DIMENSION
SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manu `
CHAMBER r�EwIN
INFORMATION System: Cvv - 12 � �IaD OR UNIT Moe C c -t rf
DISTRIBUTION SYSTEM
Header / Manifold Distribution Pipe(s) x Hole Size I x Hole Spacing Vent To Air Intake
Length TiOl 1 Dia. n �► I
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 ❑ Yes [] No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
Inspection #1: 12 /o }/ ao Inspection #2• —7t7l
Location: 400 126th Avenue, Hudson, WI 54016 (SW 1/4 NW 1/4 2 T30N R19W) - 323019816 lodgre Meadow -Lot 1
1.) Alt BM Description cu. �rav e- "�- '^•y`°O I(• _ I o3 • , s
2.) Bldg sewer length = (,o .o t l o • t5 = fos.3° 9c I�.t.S
- amount of cover = X60" So il t.oue, - / Z I[. 30 _ (off . IS �•s5 = t °Z.90 q•4s'9 f� 5a
3 (.0 s(*Y• �� �eruQtl= I,e I•k'C -�+"'� 3 l2 •yo = (o3.a1'
Plan revls`We uirdd? Yes X No
U e of er side for addlt nal In o cn aatlon. 1 Z. C
—1� t ' 1 Date Inspector's Signature Cert. No
D -6710 ( .3/97) .
Saf 'i; E � bpi ag:; Division
Sanitary Permit Application 1 Wv v& 1 Box
0 302
1 *14; ansin en oa
In accord with Comm 83.21, Wis. Ad Code Nladis; WI _13707 -7302
Department of Commerce Personal information you provide may be used for secondary purposes (Submit comple - e:; 1167• i o .nty if not
(Privacy Law, s. 15.04(1)(m)] V ; t owned.
Attach complete plans to the county copy only) for the system, on than 8.1/:: x 11 inches in si e. -
County r State Sanitary Permit N mber 13 Check if revis' to r ieuy ippliq'ah7M St ite Plan I D. Numbs r
%tr
I. Application Information - Please Print all Information _ D.a cation: _
Property Owner Name , 1 ; ' Pr.. erty I cccaation 9
"l` a !�� �[ �(��•� I� r 14N 414 S _71_ 1 2� E or
Property 0 is Mailing Address t umbtrr Block Number
Z 5 7 ---
City, State Zip Code Phorlr Ntlier fir, , ` -S )division Name or CS`, qu:nbe:i _
ambow
II Type of Building: (check one) I 9 ❑ City
It 1 or 2 Family Dwelling - No. of Bedrooms:_ ❑ 'tillage
❑ Public/Commercial (describe use): 91 of�
Q State -owned ��
III 'Type of P"t: (Cherck only one box on line A. Check box on line B if applicable:) Wariest R,,. a / Z // - ,� 1+ �t
G_ - _
A) 1- New System 2. ❑ Replacement 3. ❑ Replacement of 4., ❑ Addition to Ps rcel Tax qumber s)
System Tank Only Existing System — Z/ V - D 0000
B) Permit Number
❑ A Sanit Permit was previously issued
IV. Type of POWT System: (Check ail that apply) M-- Iat f✓
16 Non-pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed 1Vea ;�d
❑ Pressurized In- ground h ❑ Holding Tank ❑ Single Pass M Drip Line
❑ At - grade 3 L� 6 ❑ Aerobic Treatment Unit ❑ Recirculating I:1 Other:
V Dispe rsal/Treatment Area Information: 1 C AP, / N F/ L -+-C
1. Design Flow (gpd) 2. Disper lArea 3. Dispersal Are j 4 Soil Application 5. Percolation Rate 6. System Elevatic i ; . ?ir al '.3rade
Requi 6r�-Z Proposed to (G ?l
c' s. /)j /sq. ft.) (Min./inch) (29 10 3 j r 9F HovaA0 ( g
--
VI Tank Capacity in Total # of Manufacturer Prefab Site Steel I : arr• 7 :Plastic
Information Gallons Gallons Tanks Con- Con- l�laas
New Existing crete strutted
Tanks Tanks _
ju
VII Responsibility Statement
I , u ersiimod, assume re's on i tali for installation of the POWTS shown on the attached plans.
Plttrn8WsName ptirlt) P:urnber`'Sign9ttire '( s): M /bii(*No. Business Plc, . ^ ;ucib. -r
Ig o 6e_i2 vr 2 7 7 3- WY6
Plumber's Address (Street, City, State, Zip Code)
VIII County/Department Use Only
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent 5iLuaian (NC ctEmps)
Approved ❑ Owner Given Initial Adverse rcharge Fee)
Determination oZoZ s I p —Z Z6DD� _
IX. Conditions of Approval /Reasons for Disapproval: / n �-
- toa� (
v nA X2 *.L �u. ` ��"`'� CD Ci ro, ,,, e�4-�, e -Ap Cc ou o,,. tL -Q f s e44., J L.0
P
PLo4- LA-
ti
4 L
fp
R
D �
LD -r
�Ob
�z6 ��
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 81/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 030 2100 - 10000
percent slope, scale or dimensions, norm anew, agd; FM1f►Tt tanoe to nearest road.
` 1 1 ? , Reviewed by Date
Please print a rPwwdni -
Personal information you provide maybe usedfa eeodndery purp#¢s (Privi6y,t4 W, h 15.04 (1)
Propertyowner . P rtyLocation
Eric Mueller . Lot SW im NW 114 S 32 T 30 N R 19 6c(or) W
Property Owner's Mailing Address ` r ` 1t tl Block # Subd. Name or CSM#
4625 Drew Ave. / S. 5 i cRC ?li; it na Ridge Meadow
City State Zip Phone NcAflio�t' Y City ❑Village ft] Town Nearest Road
Mpls, MN 1 55410 x,,61 St. Joseph 126th. Ave.
® New Construction Use: ® Residential / Nuiilber ref b�drob►i+`' ` y� Code derived design flow rate 450 GPD
❑ Replacement ❑ Pubic or commercial - 66 a.
Parent material Alacial drif Flood Plain elevation If applicable n•
Gener o trenches 3.00 below grade starting C el. 103.85' spaced to code.
for system longevity recommend a mound system, @ el. 106.85' based on contour line
of el. 105.85'
(] Boring
Boris # ® pit Ground surface elev. 103.05 ft. Depth to limiting factor +90" m, Soil Applicatio Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2
1 0 -12 10yr3 /3 none 1 2msbk mfr C1W 2f .5 .8 .S
2 12 -31 7.5yr4/4 none scl 2msbk mfr Qw if 1 .4 4
3 31 -63 7.5yr4/4 none sl 2msbk mfr gw if .5 .8 IS
4 63 -90 5yr4/4 none scl 2csbk mfi na na .4 .6 L{
] Boring # El Borin
F g 2 ® Pit Ground surface elev. 102.65 # D� to limiting factor +86 in.
Soil ir;sttion Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/tF
in. Munsell Qu. Sz. Cont. Color Gr, Sz. Sh. ' `Eff#1 `Eff#2
1 0 -11 10yr3 /3 none 1 2msbk mfr 2f .5 .8
2 11 -28 7.5yr4/4 none s 2msbk mfr gw if .4 .6
3 28-44 7.5yr4/4 none f mvfr gw na .5 .9
4 44 -86 5yr4/4 none s (P1 2msbk mfi na na .4 .6 �
of
Effluent #1 = SOD > 30 5 220 mg/L and TSS >30 _< 150 mgll � ueM #2 = BOD 30 mg1L and TSS 30 mglL
CST Name {Please Print) Signature . CST Number
Gary L. Steel 02298
Address Date E luaWn Telephone Number
1554 200th. Ave., New Richmond, WI. 54017 9 -21 -2000 715- 246 -6200
Properly Owner E. Mueller Parcel 10 # 030- 2100 -10000 Page 2_ of 3
Boring # ❑ Boring
3 9 Pit Ground surface Bleu. 106. ft. pepth to limiting factor +88 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlff
in. Munsel Qu, Sz Cont Color Gr. Sz. Sh. 'Eff#1 •Eff#2
1 0 -10 10 r3/3 none 1 2msbk mfr 9w 2f .5 .8 S�
2 10 -61 7.5yr4/4 none sl 2msbk mfr 9w if .5 .9 ,5-
3 61 -88 5yr4/4 none scl 2msbk mfi na na .4 .6
T
F4 Boring # ❑ Boring
Pit Ground surface eiev. 107. 25 ft. Depth to limiting factor +90 _ 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 -10 10 r3/3 none 1 2msbk mfr 9w 2f .5 .8
2 10 -18 10yr4 /4 none sil 2msbk mfr 9w if .5 .8 ,5-
3 18 -40 7.5yr4/4 none sl 2msbk mfr 9w if .5 .9
4 40 -90 5yr4/4 none scl 2msbk mfi na na .4 .6 c{
F Boring
Boring # Ground surface Bleu. ft. Depth to limiting factor in.
❑ Pit Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ff
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
> < > < _ < <
- t. 30 150 m 'Effluent #2 - BOD 30 and TSS 30
Effluent #1 BOD 30 _220 mgl and TSS _ g!L 6 _ mg1L _ mglL
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.
saD4330 (8.6=)
STEEL'S SOIL SERVICE
Gary L. Steel Eric Mueller 1554 200th Ave.
CSTM2298 WIWI S32 T30N - R19W New Richmond, WI 54017
MPRSW -3254 town of St Joseph (715) 246 -6200
lot #1 -Ridge Meadow
✓1" =40'
✓ff_P. =top of mid -lot survey stake C el. 100.00'
Al B = top of 1 pvc pipe C- el. 10745'
o
Y
�o
�e
Gary L. Steel
9 -21 -2000
Combination Sep.tic;Tank and
PUMP CHAMBER C R O 55 SECTIOtJ A SP ECIFICATIOM S
VEUT C ^P WEATHER PKOOIr
Ju►JCTIOQ 00X
1(c. I, VEh1T PIP[ ,, APPROVE[) LOCKIKIG
' –.10' fRUM DOOR.' /`1AIJHOLE COVER. --Wrri
,jiQoow OR FRE51-1 T u'ARr o)IJ6 LrAp�L
ALK IuTAKE 1r} CZ)_DQI_r
f '
GRA C>6
`f NI►J. /
I i
r
- l
INLET � p(� — L PROVIDE
-ar �71C� - - - -- AIRTIGHT SEAL-
APPROVED JOINT �l A I I I APPROYED .
W /C.I. PIP[ I II W/ .I. tIFE�Rt
Tank _ II I uction I
shall comply with ALARM
AWW 83.15 and 83.20 rs I i l
I I
PUMP - -� ""�
b OFF
D
CoIJCRC rE
I
t
R151R EXIT PERMITTED CIJLtJ IF TAWK MAIJUFACTUFCR HAS SUCH APPROVAL j 3 RPt cy
SEPTIC E 5PCC.IFICAT10QS
DOSE
TnIJK MAUUFACTUCCCR: W�� �� CJ�JC`� IC PER C:�r
TA W K$ )) — IJUMBER OF POSES:
TA)JK GIZi� : __/ v — 1 0CU GALLO►JS 0056. VOLUME
ALARM f �'S ��t� J t�f�)"1 ItJCLUDIIJG OACiCrLL)W: r / G O ? �
MODEL uLMBER: �� �w _ CAPAEI711S: A_ A-7 OR 08 GALE CaIi,jS
SWITCH TUPC: I�l L1Z� -U�-Y
C �
PUMP hlA1JUFAC.TURCR:
IIJCHES 0R /St�� J'.,aLLC)U5
MODEL 1.JUMBER; M � 4.O _ p
IAICHES OR X33 -`� GP. LL DlJS
SWITCH TYPE: �L�2e�Y LOTE: PUMP A1JD ALAKr, NKE TO 6[
r
MIUIMUP DISCHARGE RATE ,;PM INN5T / ALLLED DIJ SEPARATE CIRCUITS
VERTIChL DIFFERENCE DETWCEW PUMP OFF AIJO..D15TRIpUT101J PIPE... /% �l/rEET
+ MIkJIMUM ►JETWORK SUPPLY PRESSURE FGET
+ FEET OF FORCE MAIti / 3 T X o FKICTIOU + FACroR.,.
/IO , F r. r EET
TOTAL OyJQAMIC HEAD -L FE ET l r / � GI�
Pump chamber DIAMETER –
11JTER.AIA1. OIMLM$10lJ1 OF TAIJK: L.EhL GTH
L I q u I o DEPTH
BOTTOM AREA —. 231 � GAL /INCH
M E40 Series
4/10 HP Effluent
and Drain Water Pumps
Performance
Curve
MODEL ME40 EFFLUENT PUMP
CAPACITY LITERS PER MINUTE
0 50 100 150 200 250 300 350
40 12
35
10 to
30
1Z 25 8
z
20 6
15
4 0
io
5 2
0 0
0 10 20 30 40 50 60 70 80 90 100
CAPACITY GALLONS PER MINUTE
F. E. Myers, A Pentair Company • 1101 Myers Parkway, Ashland, Ohio 44805 -1923
419/289-1144 FAX 419/289 -6658 Telex 98 -7443
K3326 7/91 Printed in U.S.A.
CD
ED
Q
co °
( u = _ rol
\} 0
!a =. 2 n cr m
|;
0-0
m
w=
2
"
CD
■ k / o
\ \ L CL C4)
° CD
m / , � �
� �
ƒa
03 0 / � m
// a g
[
- ] e
° /
§ �
(f �
»t
Q5 9
\\ ƒ /
($ G C/) m
@ E w _ »-1 O 2� a «
@ 7 =
�( §
- o G pCD�Cƒ ƒ ~�
� m = D. m \ �
T - 0 a l CT \
a
U 0 Q- -' 2 m � ƒ
�
0 Cl) o
C l<3 0 N
k 0 =,W
0 = o o =
CD * 5.
U
to CD _ %
CD
cn n k = $
N) w - / § k 3 3
cn A 0 \ -•,<
@
% X CD ] §
C=,)3 7 § a
|� \¢k H
0 k �0 A
/ k m W
§ \) 0 Invert 11
/ 7
. _ m
\ _
;
, )
��.-
i
Private Onsite Wastewater Treatment System Management Plan
Septic Tank And Gravity In- Ground Soil Absorption Component
Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment
System (POWTS) shall include information and procedures for maintaining the system within
the parameters of Comm 83 and 84, and the conditions of approval by the department, agent,
or governmental unit. The approved plans and permits for system are on file at the county
zoning or health department.
This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground
Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD-
10567-P (R.6/99).
Table 1: System Design Specifications
Sanitary Permit Number 12
Number of Bedrooms
Design Flow - Peak (gpd) 45C
Estimated Flow - Average (gpd) 3&D
Septic Tank Capacity (gal) MTD
Soil Absorption Component Size (ft?) z � ``n�,a•
Type of Wastewater Domestic
Table 2: Soil Absorption Component - Limits of Reliable Operation
Septic Tank Component Soil Absorption Component
Design Flow - Peak (gpd) L UO0 5 Z a a -
Maximum Influent Particle Size (in) 1/8
Maximum BOD (mg /L) 220
Maximum TSS (mg /L) 150
Table 3: Maintenance Schedule
Septic Tank Inspect and /or service once every 3 years
Outlet Filter Inspect once a year and clean at least once every 3 years
Soil absorption Component Inspect once every 3 years
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks
under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with
NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease
Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable
Restrooms).
The operating condition of the se tic tank and outlet filter shall be assessed at least
once every 3 years by inspection. T
'�"V filter cartridges ou no
itank that may slough off the filter when removed from its enclosure. If the
Management Plan for a Septic Tank and Soil Absorption Component
filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously.
Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The
septic tank shall have its contents removed when the volume of scum and sludge in the tank
exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the
time of an assessment, maintenance personnel shall advise the owner of when the next service
needs to be performed to maintain less than maximum scum and sludge accumulation in the
tank.
Manhole risers, access risers and covers should be inspected for water tightness and
soundness. Access openings used for service and assessment shall be sealed watertight upon
the completion of service. Any opening deemed unsound, defective, or subject to failure must
be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by
an effective locking device to prevent accidental or unauthorized entry into the tank.
No one should enter a septic or other treatment or holding tank for
any reason without being in full compliance with OSHA standards for
entering a confined space. The atmosphere within the septic or other
treatment of holding tank may contain lethal gases, and rescue of a
person from the interior of the tank may be difficult or impossible.
Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the
tank is no longer used as a POWTS component.
Soil Absorption Component
The soil absorption component serving this structure is designed to accept domestic
wastewater from a residential facility. The limits of operation of this component are shown in
Table 2.
The longevity of a soil absorption component depends greatly on proper and timely
maintenance, and system use within or below the limits of reliable operation. Good water
conservation practices by all occupants and the installation of water conserving plumbing
fixtures are key factors in extending the useful life of this component.
The soil absorption component's operation must be assessed by inspection at least
once every three years. The inspection shall include recording the levels of ponding, if any, in
the observation pipes, and a visual inspection for any evidence of surface seepage or discharge
from the component. On steeply sloping sites, areas of erosion should be identified and
reported to the owner for repair. The surface discharge of domestic wastewater or sewage
from the system is prohibited and considered a human health hazard.
Traffic around or over the soil absorption component should be avoided particularly
during winter months. The compaction or removal of snow cover over the component may lead
to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or
impossible to repair until weather conditions improve. In general, soil compaction over this
component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to
more intense, and earlier, organic clogging of the soil.
2
Management Plan for a Septic Tank and Soil Absorption Component
Plantings of deep- rooted trees and shrubs directly over or within ten feet of the
component should be avoided since root intrusion into the component may obstruct wastewater
flow.
3
i
911 ?'1935 94:28 7152737753 NLU.uUN rt~ur'tcur+u
ST CROIX COUNTY
SEPTIC TANK MAINTEN, ANCE AGREsEMENT
AND
OW NERSHIP CERTI FICATION FORM
OOw _ 1 L .-- n (f �1 • � L
'+riling Andre t: ZS o V sr �T L s 11A e'-1 ✓ 5 - � 1 C�
Property Addr ss _ 7z V-'1
(Verifieati rea reed om plattain Depa mtt en: or new construction)
O Z� �-� �}trc._
City /State W �+ Parcel Identification Number 0 0
U-q411-QM ILUMN
?rcpt[ty Locat on - r_,3 Town of
Subdiv - T& W - ,._.._, Lozz #
Certill?ed Su y Map _ , Volume , Page 4
Warrauty Deed 0 75 , Volume ! 2 , page #
She, house ❑ es % no Lot lines identi frable Oyes ❑ vo
S1`ti' A
NC
Lnproper se and tnaiatenanccof your soptie system could result in its premattue fai'.ure to bandl; w- asses, Proper tn.tintetunac
cotsists of Purr-Piz out the septic tank every three years or sooeer, if needed by a licensed. pumper. whot you put in:a the system
can affect the fw, ioa of the septic tank as a treatment stage in the waste disposal system.
The prop owner agrees to submit to S:. Croix Zoning Departmcn: a certification form, signed by the owner end by a
rnaacrpluaber,jo rueyr< tan plumber. reatricied tt( I )theon•sitewssieu. ystem
+: io proper operas a condition �n dlor (2j after itaspe p ump ing on and
p p g (if necessary), the septic rank is less dean L 3 full of sludge.
Uwe, the undersig d have read the above requirements and agree to mauitain the private sewage disposal system will the star3dards
sc* `oAh, herein, a set by tLe Department of Catnmeree and the Departrneuto`Nii ral Resources, State of W isconsin. Certuica:ior�
'' °tai yo so tic system has been maintained Must be completed and returned to the St. Croix County Zoniu� Office within :0
days o e ec y ar expiratiott date.
'. iot , 1R$ OF pL!CA)�tT / !
DATL-
0W Y i
[ (we) Bert fy that all statements ors chin form are true to the boss of my (our) knowledge, I (we.) am (ore) IN. owner(s) cf
the ;,rotxrty dose i d aba� , t:y � of a warranty deed recorded in Register of Deeds Office,
f� It
h
t OF 'PLICANT _
DA'Z'E
" "" Any info
titsn the is mis reproscnted may result in the sanitary Perm ii being revoked by tl,c Zonic,g peparrmcrt:.
'• ]nctude with ttti applrcation: a stamped warreary deed from the Register of Deeds office -M + -•
5 copy Of the certified survey map if reference is made in the warranty deed
STATE BAR OF WISCONSIN FORM 1 - 1998 625753
Wk32R1 M PAGE 4 78 S KATHLEEN H. WALSH
T. REGISTER OF D EED WI
Document Number
RECEIVED FOR RECORD
This Deed, made between DELTA C O NSTRUC TION, INC. 07-03-2000 9:30 AM
a Wisconsin corporation
iIRRRAkTT DEED
EXEMPT M
_ Grantor, CERT COPY FEE:
and E RIC J. MUELLER and CARLA SCHOLZ MUELLER _ COPY FEE:
husband and wife as joint tenants TRANSFER FEE: 225.00
- RECORDING 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
(the 'Property'): Area
Name and Return Addnips
Lot 1, Ridge Meadow in the Town of St. Joseph,
St. Croix County, Wisconsin.
030- 2100 -10 -000
Parcel Identification Number (PIN)
This is not homestead property.
(is) (is not)
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 — none.
30th June 2000
Dated this day of
DELI CONST UCT ON, INC.
lw
(SEAL) (SEAL)
. By: Virgil Fedorenko, President
—._ -_- (SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) State of Wisconsin, lI
St. Croix County. J
authenticated this day of ' Personally came before me this 30th day of
June 2000 , the above named
Virgil Fedorenko
TITLE: MEMBER STATE BAR OF WISCONSIN �,$ to
(if not, (;•:= `1_ %,�,' me known to be the person who executed the foregoing
authorized by §706.06, Wis. Stats.) r:!;ti I'` instrumen and ackk ledge-the e.
THIS INSTRUMENT WAS DRAFTED BY ` CIL Zf
Attorney Barry C. Lundeen 1Qr Ae/. l � i h -)
MUDGE, PORTER, LUNDEEN & SEGU S.G Notary Public. State of Wisconsin
110 Second Street, Hudson, Wiscons • 54016 My commission is ermanenI. (If not, state expiration date:
(Signatures may be authenticated or acknowledged. Both are not 3r
necessary)
'Names of person signing In any capacity must be typed or primed below it. signature.
STATE BAR OF WISCONSIN Wawnsm Legal Bunk Co.. Inc.
WARRANTY DEED FORM No. 1 - 1998 Muwaukee. Wu.
l
r
t �
Aid Na �
NW CORNER
SECTION 32
z
0
' z f6
�► I OT 2
VOL . 2 , F'G. CIS
im 0 - -- -- ___
nm W
� w
�m
:z
0
rn
S89'06' 12 ° E 249.99 t - NORTH LINE OF THE SN
rl
i� O
0)
p
t` s
n I -� z r
100 200
r
x;
V 15 1 T.
S89' 18' 14 ° E
` 278.00'
1
G7
LOT 2
3.07 ACRES
133,913 SO. FT.
0
\ 2.96 AC. EXC. I
128,773 SO. FT.
m
z \ 9
z O• 2 6 4' \
0 \
OD
ri
• \ �� ?/ X8 6
80' RADIUS \ �B
TEMPORARY - AC \
TO BE REMOVED VED U UP
ROAD EXTENSION
N
t0
S. M