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Home My WebLink About030-2131-30-000 i Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and,Building q?►ision , INSPECTION REPORT Sanitary Permit No: 453238 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: McLean, Bruce St. Joseph Township 030-2131-30-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: /()D- D 4117 23.30.20.1084 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic W L) L/) D Bench lark 1 / Q b Dosing Alt. BM 5TC-6 Aeration h ` i{ Bldg. Sew 7 ~q v t Holding St/Ht Inlet - I Z) St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic I / D t Bottom Dosing 15: / Header/Man. s, S~L- Aeration Dist. Pipe ( G .(p3 Holding Bot. System 1 0, f PUMP/SIPHON INFORMATION C~ Final Grade c~ Manufacturer GPmand St Cover 3 0~ Z Model Numbe TDH Lift Friction Loss ead TDH Ft Forcemain L ttr Dia. Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WEL LAKE/STREAM LEACHING M ufactur INFORMATION CHAMBER OR 1 Ty Of System: f UN Model Number: >5~ 'iln DI BUTION SYSTEM - Header/M ifold Distribution , x Hole Size x Hole Spacing Vent to Air `ake 1 Pipe(s) Length Dia G Length 1~ Dia Spacing-_ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only ;had Over Depth Over xx Depth of eded/Sodded T ulhed Bed/Trench Center Bed/Trench Edges Topsoil xx Se [M Yes 0 No Fw] Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:__L/gO/ Inspection #2: / / Location: 1434 Thelen/Farm Trail Houlto{n~,-DWI 54082 (SW 1/4 SE 1/4 23 T30N R20W) Settler's Glen Lot 30 Parcel No: 23.30.20.1084 1.) Alt BM Description S `S G J WVL 2.) Bldg sewer length u'Vl - amount of cover Y ~Y Plan revision Required? U Yes Vo Q Use other side for additional information. TSigture Dat e InsepctorCert. No. SBD-6710 (R.3/97) Safety and Buildings Division County 5-( C ! 201 W, Washington Ave., P.O. Box 7162 N)p6cohsin Madison, WI 53707 - 7162 Salutary Permit Number (to be tilled in by Co.) Department of Commerce (608)266-3151 5,3 Z3 State Plan I.D. Number Sanitary Permit Application with Conlin 83.21, Wis. Adm. Code, personal information you provide In accord may be used for secondary purposes Pri Law, sl _ Iq~:: r'Y- Project Address (if different than mailing address) 1 N3~ ~ Lctew r)f Y r 1. Application Information - Please Print All Inf IPM Block N Property Owner' Na me 4t., . iParcel fl L G~ C LEA- ~ p o 0 U Property Owner's M ailing Address ZOP iNV ,'rn` roperry Location I Ald I~~w' 4 4 6 ''/a,~~ '/a ,Section /FW Drt 5 City, State Zip Code Phone Number ~O (circle one) IL Type of Building (check all that apply) ri 3j~Q f Subdivision Name ~ CSM Number W1 or. 2 Family Dwelling - Number of Bedrooms i ❑ Public/Commercial - Describe Use 31 / L+2d C. • L • w'~C tS C ❑ State Owned - Describe Use G2 2)157. CAS "JI 17 -4UCA ❑City_❑Village 1erownship of 5"t SOS III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. J. New System ❑ Replacement System ❑ Treatment/I•Iolding Tank Replacement Only ❑ Other Modification to Existing System List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New Before Expiration Plumber Owner rV. T e of POWTS System: (Check all that apply) tp Non -Pressurized In-Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At-Grade ❑ Single Pass Sand Filter ❑ Constructed et an ❑ Pressurized In-Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter Leaching Chamber ❑ Drip Line ❑ Gravel-les ❑ Other (explain) V. Dispersal/Treatment Area Information: 't /1/PL h'Eon Ott/cl< 98 Desi n Flow (gpd) esign Soil Application Rate(gpdsf) ispersal Area Required (s~ is Area (sf) System Elevation~'15 3 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tans Tanks Z E A Septic or Holding Tank >e-- Aerobic Treatment Unit C1V t/t/ Cr C' Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plum is Na me (Print) Plumber's Si gnature MP/N404W Number Business Phone Number /ll o~ Z6 P 7 Z 73 -l~lc Plumber's Addre ss (Street, City, State, Zip C e) .S~6o VII ount /De artment Use Only ET"Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued is nt Signatur Stamps) 6rV Surcharge Fee) 2 ❑ Owner Given Reason for Denial Q y 1X. Conditions of Approval/Reasons for Disapproval YSTEM OWNER: 3 Septic tank, a uen rifer and yyryy ~3 ~y S~~vZG~ ,~2t~ Ctrl/ dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD-6398 (R. 01/03) 6+ FLT rv ~P 2 z6Y97 Q R ,3ZS ~v M v off' 8IA ~l ~-7 Wo 4t4 Az2EA 83 6+ Z(oy97 nQ I k 32s Pto M Z ~4C g g~ ~ 8' 9 cc 1p Uv ~ 4o+3t) ~L+ A-r2EA g3 " ~#ffick47W STANDARD CHAMBER 52" Quick4 Standard Chamber 48" (EFFECTIVE LENGTH) 12 N milli ° MWN ANN 34" SIDE VIEW SECTION VIEW MultiPort End Cap A no 16" 12" fl Z j ;j 34" SIDE VIEW TOP VIEW FRONT VIEW Quick4 Standard Chamber Nominal Specifications MultiPort End Cap Nominal Specifications s Size (WxLxH)34"x.52"x12'' Size (WxLxH) 34x12' Effective`Length 48" Imielt Height 8".or-1 25 Invert Height 8" c { INFILTRATOR SYSTEMS, INC. STANDARD LIMITED WARRANTY (a) The structural integrity of each chamber, and plate, wedge and other accessory manufactured by Infiltrator ('Units', when installed and operated in a leachfield of an onsite septic system in accordance with Infiltrator's instructions, is warranted to the original purchaser ('Holder') against defective materials and workmanship for one year from the date that the septic permit is issued for the septic system containing the Units; provided, however, that if a septic permit is not required by applicable law, the warranty period will begin upon the date that installation of the septic system commences. To exercise its warranty rights, Holier must notify Infiltrator in writing at its Corporate Headquarters in Old Saybrook, Connecticut within fifteen (15) . • days of the alleged defect. Infiltrator will supply replacement Units for Units determined by Infiltrator to be covered by this Limited Warranty. "11 Aj Infiltratorss liability specifically excludes the cost of removal and/or installation of the Units. Q e (b) THE LIMITED WARRANTY AND REMEDIES IN SUBPARAGRAPH (a) ARE EXCLUSIVE. THERE ARE NO OTHER WARRANTIES WITH RESPECT SYSTEMS IN C TO THE UNITS, INCLUDING NO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. (c) This Limited Warranty shall be void if any part of the chamber system is manufactured by anyone other than Infiltrator The Limited Warranty does not extend to incidental, consequential, special or indirect damages. Infiltrator shall not be liable for penalties or liquidated damages, including loss of Environmental Onsite Wastewater Solutions' production and profits, labor and materials, overhead costs, or other losses or expenses incurred by the Holder or any third parry. Specifically excluded from Limited Warranty coverage are damage to the Units due to ordinary wear and tear, alteration, accident, misuse, abuse or neglect of the Units; the Units being subjected to vehicle traffic or other conditions which are not permitted by the installation instructions; failure to maintain the 6 Business Park Road • P.O. Box 768 minimum ground covers set forth in the installation instructions; the placement of improper materials into the system containing the Units; failure of the Units or the septic system due to improper siting or Improper sizing, excessive water usage, improper grease disposal, or improper operation; or Old Saybrook, CT 06475 any other event not caused by Infiltrator. This Limited Warranty shall be void if the Holder fails to comply with all of the terms set forth in this Limited Warranty. 860-577-7000 • FAX 860-577-7001 Further, in no event shall Infiltrator be responsible for any loss or damage to the Holder, the Units, or any third parry resulting from installation or ship- $IUU-221-4436 ment, or from any product liability claims of Holder or any third party. For this Limited Warranty to apply, the Units must be installed in accordance with all site conditions required by state and local codes; all other applicable laws; and Infiltrators installation instructions. (d) No representative of Infiltrator has the authority to change or extend this Limited Warranty. No warranty applies to any party other than the origi- nal Holler. The above represents the Standard Limited Warranty offered by Infiltrator. A limited number of states and counties have different warranty requim- ments. Any purchaser of Units should contact Infiltrator's Corporate Headquarters in Old Saybrook, Connecticut, prior to such purchase, to obtain a copy of the applicable warranty, and should carefully read that warranty prior to the purchase of Units. U.S. Patents: 4,759,661; 5,017,041; 5,156,488; 5,336,017; 5,401,116; 5,401,459; 5,511,903; 5,716,163; 5,588,778; 5,839,844 Canadian Patents: 1,329,959; 2,004,564 Other patents pending. Infiltrator, Equalizer and SideWinder are registered trademarks of Infiltrator Systems Inc. Infiltrator is a registered trademark in France. Infiltrator Systems Inc. rrECrceEVaarea is a registered trademark in Mexico. Contour, Contour Swivel Connection, MicroLeaching, PolyTuff, SnapLock, ChamberSpacer, Posil-ock, QuickCut, QuickPlay and Quick4 are trademarks of Infiltrator Systems Inc. 0 2003 Infiltrator Systems Inc. Printed in U.S.A. 0011203HP-0 v Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County 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. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Y Date 15.04 (1) (m)). S 2 -e 5/ Personal information you provide may be used f seco 7yz4fPrve®fFLauw GL Property Owner roperty Location ~~7 Y r Q C t.0 5 Govt Lot S' 114 S F 1/4 S Z >j T N R ZQ E (or) Property Owner's Mailing Ad s Ad S N l of # Blod, # Subd. Name or CSM# Village ® Town 'Nearest Road city State Zip Code Phonq$ err i ❑ City 13 a L 3s Jv s~ S` -MN5 Z( i4:?-)9 --ZT-q New Construction Use: ® Residential / Number of bedrooms Code derived design flow rate G C) O GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material 0U c.~J a $ L-N Flood Plain elevation if applicable ✓C/ / ft• General comments !5 yS f e /-eU_ 9 y S U and recommendations: ❑ Boring Boring # Ground surface elev. 99 / O ft. Depth to limiti ng factor in. Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 'Eff#2 -7 1.2 7-1 7Z Boring # ❑ Boring 9 / Pit Ground surface elev. % R Depth to limiting factor J5 in. Soil Application 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 -{Z IG SI CS ~v~ 5 g 2. 2-49 (D 4 S 2rr>S 1 C- 5 - L4 3 a cc~S Os mi - 1.2 g '90 S .2 < 30 mg/L and TSS < 30 mg/L >30 < 150 mglL ` Effluent #2 = BODs_ m Effluent #1 - - BODs > 30 < 220 g/L and TSS CST Name (Please Print) Signature CST Number P60m ncvw rra~r = Z5 3 3U`~ Address Date Evaluation Conducted Telephone Number 2w3 ~arr~r ~,l~J~ 5~OZ5 51 -,1 g - oz 0)5)Z47- 4~3 Property Owner ICYV1 Parcel ID # Page of 'J Boring#• ❑ B ng : . & Pit Ground surface, elev. 9~• ZlJ fL Depth to limiting factor In. Hoce Soil Application Ra Depth Dominant Color Redox Description Texture Structure Consistence Boundary Fo 3PD/ft2 In. Munseli Qu. Sr- Cont. Color Gr. Sz Sh. •Eff#1 •Effr12 b 6i I " 2r, ~o bk cS 5 Z -Z c `t I S c►• peo-shk C5 3 Z$-► 1 1 `-lILP r . ~ .Z Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting tailor in. Soil Application Rai 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 i Boring # ❑ Boring ❑ pit- ' Ground surface elev. R Depth to limiting factor In. Soil Application Raft Horizon fin, lh Dominant Color Redox DesMption Texture .Structure Consistence Roots GPD/ffz Munseti Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 - ' Effluent #1 = BODS > 30 < 220 mg/L and TSS 130 < 150 mg/L • Effluent #2 = BODS < 30 m gAa 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. SM1330 (807/00) r i PAGE_. ~5> 0F 3 NAME Co- r~ `o a -k LOT#30 LEGAL DESCRIPTIONSW Y S F `a ,SZ T 30 N R Z a E(or) SCALE: I"=D O l BM I ELEVATION rOU BM I DESCRIPTION,o/ 0~ ~~Yl N 13M 2 ELEVATION ?7 Z , S ~c 3 BM 2 DESCRIPTION D - - - SYSTEM ELEVATION y5 t SYSTEM TYPE CON'T'OUR ELEVATION ti~ rv ^ 782 , p U ~ 41.E Sys~"~_^ ~A•~~'~ ~9 Vv 00 - ~v SIGNATURE DATE - rJ Z ST CROIX COUNTY SEPTIC TANK MAINTEI?IANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer LJ(Q-- ti V C r Mailing Address ML) Property Address v+ 3 t? f `~Z Fk 0/1- (Verification required from Planning Department for new construction) City/State Parcel Identification Number? (Z Z l - hn " LEGAL DESCRIPTION c ~ Property Location Sec. , T 3b N-R_ZDV, Town of 5Y_ -5P4 Subdivision J L 5 rz~L.F , Lot Certified Survey Map # , Volume , Page # Warranty Deed # Volume Page # Spec house ❑ yes T-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 rnaintelianc consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper, What you put into the systei 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 master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal syste: 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 standan set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certificatic stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within days of e thr e year expiration date. Y/ o~ . SIGNATURE O 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) the plbpert desc ibed above, by virtue of a warranty deed recorded in Register of Deeds Office. t' C SIGNATURE 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 rU 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 3 Number of Bedrooms Design Flow - Peak (gpd) Estimated Flow - Average (gpd) Septic Tank Capacity (gal) Soil Absorption Component Size (ft2) Type of Wastewater Domestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) Maximum Influent Particle Size (in) 1/8 Maximum BODS (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 septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank 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 c 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. L~ e- - ;Q 0 AJ PI_ 9 '7~~- '2, -7 _ 7 2 3 c o l K CO o Nl/,1~ `7 ~S ~ ~b ~ 68 v ,u r 3 U 2 5 6 6 P 4 4 0 761854 STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD This Deed, made between Marquette & Lee Builders.LLC. Grantor, 05/0612004 03:30PK and Bruce C. McLean and Melissa M. McLean, husband and wife WARRANTY DEED Grantee. EXEMPT # Grantor, for a valuable consideration, conveys and warrants to Grantee REC FEE: 13.00 the following described real estate in St. Croix County, State of Wisconsin TRANS FEE: 281.70 (if more space is needed, please attach addendum): COPY FEE: Lot 30, Settlers Glen located in the Town of St. Joseph, St. Croix County, CC FEE : Wisconsin. PAGES : 2 Recording Area Name and Return - Address /--Q n d c~ Ji c.. Al ?00 V ; ✓a, ~K G So r ACS c:2 v0 N ar. to ; MNSsii,2 D30 ~ l•-3o-coo a - 3 - - a 1 w- 04 -r b ; G3a o -i d0u ~j -av 3 -7 -ooa -~0 -ya -od Parcel Identification Number (PIN) This is not homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rights-of-way of record, if any. Dated this day of March '2004 * * Marquette & Lee Builders, LLC AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF LJ I SC 6()S ss. County ) authenticated this day of _ - Personally came before me this 3U' day of - - , - _ March 2004 the above named Mar tte & Lee Builders, LLC _ * by Q Sfi71 _ - C ~l P rIl TITLE: MEMBER STATE BAR OF WISCONSIN ~~1 t 1 t t 1I its i ~ If not 0 F ! to me known to be the person(s) ( E ~i who executed the foregoing ~ authorized by § 706.06, Wis. Stats.) ```.`c'~o • . "tip ~i~~ instrument and acknowledged the same. THIS INSTRUMENT WAS DRJRFTFib~l~T Rj- _ _•y., Attorney Kristina Ogland Lin h _ Hudson, WI 54016 A Notary Public, State of 1 S t^/71 %y My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. }~gt~~e,,to( n1No`~` - 3 o2(~O.C) ) * Names of persons signing in any capacity must be typed or pnn their signature. information Professionals Co., Fond du Lac, WI STATE BAR OF WISCONSIN 800-655-2021 WARRANTY DEED FORM No. 2 - 1999 VMS dIG 1 ) ,.C trl sea 1 t i i • i~ Wpm Or 00 . :21 a A 1