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HomeMy WebLinkAbout032-2122-10-000 WiisconsAn Department of Coffwwce Bu PRIVATE SEWAGE SYSTEM ou Safe n , t ,y Safety and Buildings Division Jt. Croix INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal iMommatlon you provice may be used for seoondary purposes (Privacy Law. s.15.04 (1)(m)). 3134148 Eein Hold Name: ❑ City Village ❑ own o : State Plan ID David Somerset Township E ev.: Insp_ BM E ev.: SM Description: Parcel Tax No.: isp . I ot9 • D' ( 1 c s T B►^,�;I` I 032 - 2122 -10 -000 v.�an .� ces,►� r "� TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic adD Benchmark (0-19 / I o'6 •18 / cc). D Dosing Alt. BM oq.y6 Aeration Bldg. Sewer Cs • $ 99. yo' Hq g St /Ht Inlet J:�.93' TANK SETBACK INFORMATION St/ Ht Outlet 8 •`{'O ct}.fiIQ' TANKTO P/L WELL BLDG. ventto ROAD Ut Inlet —'^� • Air Intake Septic > SO I 1 I ./ NA Dt Bottom �– Dosing NA Header/ Man. 3. D e tZ, 7- 8 Aeration NA Dist. Pipe `�2. 8 Holdi Bot. System NIP / SIPHON INFOR Final Grade / (_ 40 iLt r nufacturer St cover Model ber GP TDH Li riction S ystem TDH mead fiore e � main Length Dia_ Dist.Towell SOIL ABSORPTION SYSTEM Q � MOMIM TRENCH Width Length, No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth S i m 3 93•�S 2 DIMEN SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING MT4t ur r: – �_A_ 'ink! SETBACK INFORMATION TYpeO / / CHAMBER Model Numbe t � System: C iro' I t. `fs D2- IZS OR UNIT DISTRIBUTION SYSTEM Header / ni old 'r u Distribution Pi ole Size x Ho acing Vent To Air Intake Lengt Dia. gth 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 ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) _ - [O'D , 6'(�• Inspection #1: 0 6/ 15 /n 1 Inspection #2: - - f -� Location: 2115 76th street, Somerset, WI 54025 (SW 1/4 SE 1/4 13 T31 R1 9W) - 1331191100 Rocky Knoll Estates -Lot 5 ` y 1.) Alt BM Description A 2.) Bldg sewer length = 38 1 6 l - amount of cover =) 42" i'A Gavitr. Plan revision required? ❑ Yes No Use other side for additional information. l3 °o - S80 -6710 (R.3/9) Date Inspector's Signature Cert. No. Z I IS Cit, Sanitary Permit Application Safety &Buildings Division ' In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. scnsl See reverse side for instructions for completing this application PO Box 7302 Personal information you provide us condary purposes Madison, WI 53707 -7302 Department of Commerce (Submit completed form to county if not [Privacy > )(Ett �_ � state owned. Attach complete plans to the county copZo or the s m, on p I er ndt less than 8 - 1/2 x 11 inches in size. County State S itary tmit Num r- .7 ❑ Chilpl�o o previous a lication State Plan I. D. Number I. Application Information - Please Print all Inform till ` I Location: Property Owner Name z Property Location Z21) 44W a 7 — STIiX ' 1 1/ ` = 1/4, S T ,N, o Property Owner's Mailing Address - �� Lot Number Block be City, State Zip Code 3'(toire Number / Subdivisi Name or CSM umber L II. Type of Building: (check one) .rs ev 5 ❑ Cy V il la ge I or 2 Family Dwelling - No. of Bedrooms : Hus�cs2 �u+vj To of ❑ Pu /Commercial (describe use):_ ❑ State -Owned Nearest Road 3 ' x 2l ' 2 -- () „/ln S Parcel Tax Numbers) III. T ype of Permit: Check only one box on line A. Check box on line B if applicable A) 1. J29 New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Onl f 1 O 0 Existing System Permit Number Date Issued B) ❑ A Sanitary Permit was previously issued I O '12 1 ' 0 - 0 0 IV. Type of POWT System: (Check all that apply) — !Cv ,VNon- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland • Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line • At-grade ❑ Aerobic Treatment Unit- Recirculating ❑ Other: V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed (GalsJday /soft.) (Min. /inc Elevation U / � S G � `� VII. Tank Capacity in Total # of acturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks El 0 ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the un*rsigned, assume responsibility for installation f the POW shown on the attached plans, Plumbe s e nt Plumber's igna n s MP/MPRS No. Business Phone Number Pl ber's Address (Street City, State Zip Cc e) 4 IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Iss ing Agent Si ture (No stamps) X Approved ❑ Owner Given Initial Adverse Surchar Fee) S 2 280 Determination o�o� Cb X. Conditions of Approval /Reasons for Disapproval: - n ���,6U_f.Mp,l" t5 1'eb 1 � b� -�p r l` o M tl . .. .... .. ti s -- -- - 3$ - m 4 - - 4 fi - . a n S ON �t r N N q- \ - Wisconsin Department of Commerce SOIL EVALUATION REPORT Page Z of Division of Safety and Buildings In accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.O. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information R viewed by Date Personal hdb msbon you provide may be used for secondary purposes (Privacy Low. s. 15.04 (1) (m)). IF. 2 �1 Property Owner Property Location Govt. Lot , 1/4 1/4 S T N R E Property Owner's Maifing "row Lot # BI 0 7 1 Subd. Name or CSIM r z City State Code Phone Number cit [3 Village Nearest Road ( ) s 14 New Construction Used Residential / Number of bedrooms _ Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable •/ ft. General comments ✓ �I f j, �� tt and recommendations: �,� �' mj✓ /�t7d /fin �/ Boring # Boring a ®. Pit Ground surface elev. ft. Depth to limiting factor > /lam in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP M. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eif#1 'Eff#2 1 r i a Bori ng # Bori Pit Ground surface elev. � ft. Depth to limiting factor Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM In. Munsell Qu. Sz. Copt Color Gr. Sz. Sh. 'Eff#1 'Etf#2 fo 7 , • E #1 = BOD > 30 220 mg& and TSS >30 _< 150 mg& 11 * 1 eMX — M5 #2 = < 30 mgA. and TSS 130 mglL CST Signature v / CST Number — 1 :7 1 1 /'� I �7 q 3 Address' Data Evaluation Conducted Telephone Number I Property Owner Parcel ID # Page of F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor In. Soil icabon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 I F-1 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 GPDff In. Mumsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 I Boring # Boring F ❑ Pit Ground surface elev, ft. Depth to limiting factor In. Sol Applicatim Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDIf! In. Murnsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 • Effluent #1 = BOD, > 30 1220 mg& and TSS 3 , 30 _< 150 nv& • Effluent #2 = SOD, 130 mg& and TSS _< 30 rng1L 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. sso433Oca.6M) �_ .� '� _' _ '' ,, ®. t �_ _ � �� - -- ' �,� I \ _ � __ a � - ._ __ �� � _ '_ - cr. _ � � �>c � �� `,� � ' Vl ' _ \ o � ._ '� � � -- _ __� � � _� � �� ', �� __ �_ � _ ' -- � �_ °� - - - ``1 � :_ -_ � �' o _� �. . � .� � � � __ -� i p � - � � . _._. X 11. ��! # "'' - - - .- � �'° `�` � z � \ � M _ .� � � \ � �'' Z ao p o � � �� ^ . � �, - vI ' � ', - -� `� � �_ r � �� � �, -� � � � ,\ �� � � _ _ \� ��� `���� Irs �A�, G- G� %d'7.O'N... W � l �/V� a a Wisconsin Department of Commerce ~�' Division of-Safe and Buildings SO I L AND SITE EVALUATION Page of Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code ' ` i i �' County Attach complete site plan on paper not less than 8 1/2 x 11 inches in s ze• f'Idn must / �� include, but not limited to: vertical and horizontal reference point (BM , direption and / percent slope, scale or dimensions, north arrow, and location and dotance to n?av g§ (off} ( Parcel I.D. # APPLICANT INFORMATION - Please print all info m ion,... _ Reviewed by Date _A Personal information you provide may be used for secondary purposes (Pnvcy l,aw, s. 15:04 Property Owner Prop" Location 1 04- 6 1/4 ,5]:�— 1 /4, S 13 T �7 ,N,R S (or)o Pro Owner's Mailing Address Lot # Block# Sub Name or CSM L ioll 1_75 w� f� kP 7 r, Y Sub o c k y ESY-- City / State Zip Code Phone Number p ❑ City El Villa Z Town Nearest Road A/d,r0 -1 avl . we' (wr) y� M/ D lill e� f' 1 2/0 ''`' ce ,e New Construction Use: ® Residential / Number of bedrooms V Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow �Dv gpd Recommended design loading rate e S bed, gpd /tt • b trench, gpd /ft Absor tion area re wired ��� bed, ft �Q�� trench, ft s 6 p q Maximum design loadjng rate a bed, gpd /ft • trench, gpd /ft Recommended infiltration surface elevation(s) q1, 3 9 ('+' ( ri" 1t r ((as referred to site plan benchmark) Additional design /site considerations d Parent material & �� 9,x- C 2 �� �` 41 h Flood plain elevation, if applicable 10 ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ® S ❑ U ®S F l u ®S ❑ U ® S ❑ U ❑ S I ❑ S Q U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft . in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench o -� /�� s� S L /madk L c w 21n �s Ground 3 2 y yo /l1 j� % �� m S ©S C /� •7 •8 elev. y0 /� y — q z 7 �n ,v, SL 2iris6k Depth to limiting �� q/. 30 ; factor 7 1OZ in. 52. Z Remarks: Boring # �d/ /v4 SZ 110a 6.E C zu 2/17 3 ?946y AaM w . Ground 1 55' t Depth to limiting factor ' in. Remarks: CST N e (Please Print) Signature Telephone No. r ^ i can �a/ r►e // �- 745 Z `/7 - 0 - ? Address lU 17'^ AQ —e — / .2 3 1,7 ,71� tuber PROPERTY OWNER / ' SOIL DESCRIPTION REPORT 3 Page "of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench IVA S� �Iy1�61� C LCD Zvi o y •S Al Si Z 2 mss a5 Sti �� Ground 6 9y i�Y� j A5,4 OS ' dZ --- , - 7 . elev. 9 ls ff. Depth to limiting Rl , 30 fac in. • 13• S7. Y Remarks: Boring # CL py% % Q /A! S� °L 2r�ife Ili a J ryr e s e 6 3 2s 1 d Alk dnS ©s5 � Ground elev. Depth to limiting f��ccfor J 17 in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # j G'-h' /l f� /2 �j¢ �L �hl�bk 77 G GU 2M zo 3 zy�Y' 75/1? 4 sZ 2 Ground e lev. �ls ft. Depth to limiting � ff fa �r in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) J 'OWNER Page 3 of 3 Name /," �� C Brian Parnell Address / 3rY 0- wa l-u. 7� CST 231314 Z Date 10 LlrZ X9 Benchmark 1 Benchmark 2 ❑ Soil Boring i Suitable Area �1 " = 40' Scale I ! _ t i � a � 'GtC e^ f l M r y 0 0 7'LJU.OY' - - NI' 1 1 A W o - CD 07 C7 I a � z0 z / ZO j U D Ln —I I O m ` Np !� z O 04 Iv Ln- -<o �:/ z � � Q m rrl m c` >> W -' n (� 0. 1 U I m r` ' OD pt o X� Q OW mm m m ` I D o m W L C-),00 �LP C G4 n m (n c0 9 I I I I '. O I fTI I (� o� I L/) � , cn >> 1 X o �N o ,= m ...... rT, ! I z I 7000 x o N • Q o Z J. m D a / R =733 ° �. J O10 . 0 . Io .. G_ - L_160' � p0e Im '; _ N72•� ._ R=&G7 370. ._. "07 50 W D 3' 00 m I .+. N72 J7'00 "e 37p.33' 93.24' .. = 64' --gg O o '�0 .- - I2• V ' - R=267 S 1 42 J� o z t o r, rye r �o h ... NNO ,< ` I 47.91 L_gp � SM 1. m ._ A W p - p R y3y3 0 to u IT OZO 513.2Y— X 5.28' J0 a- N ,v W cn 0 —+ M M v r N i' a D.� O 4 ' O r-' �D Ir Q j A c� _. _I z Y cn . 0 c/) 77 I O I m z " --� m I - n aom / 0 I� m \ z w ` D �m w Tt E l J I � 1 ,I I � �• � 0,3p I 1 I ��a015 '���'� 240.0 231.00 1 1 1 1 1 1 218.00' 33.'08' - -- _. -- -- — SOt'33'19 "E_.689:01 — -- - -. "�•� . E SE 1/4, SEC. 13 6 q SOS O\ S p _. D i UNP L ANDS MELVIN AND FRANCES BR` -AULL - - - - - -- ZONED AG —RES — — — — I � _ 5 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 qV Number of Bedrooms Design Flow - Peak (gpd) Estimated Flow - Average (gpd) 2 B'D Septic Tank Capacity (gal) Soil Absorption Component Size (ft') Z � � Type of Wastewater mestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) 4'uD 5 z - aS I ' nn 40 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 septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The Jutlet filte shall be cleaned as necessary to ensur proper operati 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 Com m 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. i Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic tial facility. The limits of operation of this component wastewater from a residen p onent are shown in P 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 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address , /�����' / /'� _ /.;w,7 Property Address o;? / 1 Cp - 61 'S± (Verification required from Planning Department for new construction) Ip City /State - Parcel Identification Number LE GAL DESCRIPTION Property Locatio ' /,, '/4, Sec., T -R W, Town of Subdivision Lot # Certified Survey Map # , Volume , Page # Warranty Deed # , Volume , Page # Spec house ❑ yes A no Lot lines identifiable)Rr 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 pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/w e, 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 da of the three year xpirati date. 'S IGNATURE 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 owner(s) of t Topacscribed a e, b virtue of a warranty deed recorded in Register of Deeds Office. �� ,/ 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 • VQI. 1520 PAGE 144 STATE BAR OF WISCONSIN FORM 2 - 1999 62502AL WARRANTY DEED KATHLEEN H. WELSH Document Number kE &ISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Michael J. Germain and Michelle M. RECEIVED FOR RECORD Germain, husband and wife, 06- 19 10:40 AM _ - -- _ - WARRANTY DEED Grantor, and Davi A. Re and Sue Reinhardt, husband a nd EXEMPT f _ CERT COPY FEE: wife, COPY FEE: - - - - -- -- - - - - - -- - TRANSFER FEE: 115.50 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 (if more space is needed, please attach addendum): Recording Area Lot , Pla of Rocky Knoll Estates in the Town of Somerset, St. Croix Name and Return Address County, Wisconsin. KRISTINA OGLANO ATTORNEY AT LAW P.O. BO W4016 HUh®ONr 15 Pt of 032 -1037-90-000 Parcel Identification Number (PIN) This is not homestead property. 0E) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of June 2000 "___ • 4a err ain pppppp //// « ------ - - -� — - - -- � Michelle M. G"afn - - _— AUTHENTICATION ACKNOWLEDGMENT Signature(s) Michael J_. Germain and Michelle M. Germain, STATE OF WISCONSIN ) husband a wife, ) ss' �f�� -- -- County ) authenticate th' '7` day of June 2DOO Personally came before me this _ day of , _ the above named " Kristina Ol and -- -- TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland — Notary Public, State of Wisconsin Hudson, W t 5401. _ _ My Commission is permanent. (If not, state expiration date: (Signalures may be authenticated or acknowledged. Both are not necessary.) — , _— .) ' Names of persons signing in any capacity must be typed or printed below their signature. irOwmatm Proraealmere company. Fond au Lae, wi STATE BAR OF WISCONSIN OW455.2021 WARRANTY DEED FORM No. 2- 1999 Ol cu ;m l/ 1 o V O + i o r z r ; o D p � � � J i �f � \ CS i' rri yJ – + z rn V 1 \. u I �_ ? N <_ I (o 0 �• '�:, 101 I — < R m N12- 1 . pp „� 3 . • I rn 00 ' 4�� 2 .31 0 0- h 932 _ O x- M ~ E 37p 267 1'14 4 fSMT �. 41.91 l.agp• �'riS`, 5 u 'r O < - • 0 0 \ - < 5. 7020 m �•C f z 00 Qq O - • . z CJ1 O Cn 0 � n `O v m m x. rr / Dod z D to r4 ` O D o