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HomeMy WebLinkAbout032-2163-07-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 420792 0 L 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: Grand Properties L.P. I Somerset Township k - 1 CST BM Elev: f Insp. BM Elev: ' BM Description: ' Sectionlrown/Range/Map No: W I E) cs l_ 814.L 14.31.19. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic I Benchmar W O?� g.r a8.�Z Qa, Dosing 40 Alt. BM 3 1 02 . 4 1' Aeration Bldg. Sewer z p , Holding St/Ht Inlet r $ .bo 99• �Z ANK SETBACK INFORMATION SUHt Outlet g• $3 9.29 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic t ! Dt Bottom 1(� > 2� Dosing Header /Man. �� • 3Z ! Aeration Dist. Pipe Holding Bot. System PUMP /SIPHON inal Grade ON INFORMATION �•iG et Manufacturer Demand St Cover O' •�3 I GPM Model Numb TDH Lift .. ction Loss System Head TDH Ft Fo ain Length I Dia. ell SOIL ABSORPTION SYSTEM — 7 BfD REN H Width Length # No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. T uid Depth DIME I NS 3 ; 7 Z SETBACK SYSTEM TO /L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION Type O stem: ' CHAMBER OR C C -- wsi?tQ ! +� 1 I _ UNIT Model Number: �' • O I DISTRIBUTION SYSTEM Header /Manifold N Distribution .. x Hole Size x Hole Spacing Vent to Air Intake Pipe ' Length Dia Length Dia pacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of T7�ded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil J Yes �� Yes �t No No 1 COM NTS: (include, c discrepencies, persons present, etc.) Inspection #1 CR/ ZW; Inspection #2: 2 " M42 Jw r Location: 2nd St New Richmond, WI 54017 (NW 1/4 SW 1/4 14 T31 R19W) Gavin's Acres Lot 7 Parcel No: 14.31.19. 1.) Alt BM Description =7 o`P .,.n& &C ` CNj� 2.) Bldg sewer length = 29 - amount of cover = ' S ��4. . � C u `tom`„" �W J►lR — `� ` V . 3) oh s • / ie * � cs s z __& h Plan revision Required? Yes XNo i m. 107 li Use other side for additional information. _ �76 SB -6710 (R /97 Date f�1n epctors Sign Cert. No. t8 T5 °°- -�y�d� j' Safety and Buildings Division Count ` ` � 201 W. Washington Ave., P.O. Box 7162 COO i V �seon S n Madison, WI 53707 - 7162 Site Address Department of Commerce (¢ -- ST 'N A Sanitary Permit Appli M 42-0 Sanitary Permit Number Dk dAREE OV ED personal' In accord with Comm 83.2 1. Wis. Adm. Code, ' orma ❑Check if Revision ma be used for secondary purpose Privacy Law s15. 1 m I. Application Information - Please Print All Information State Pl I.D. Numbe PR 1 4 2003 Property Owner's Name Parcel N ber ST. CROIX COUNTY ` A Property Owner's Mailing Address Prope do 7 1 Z 14VAeo 57, -SuIZ - e /b0 'A K /7 T3 N.R I / i City, State Zip Code Phone Number Lot Number Block Number Subdivision Name CSM Number S it ��5 WI SvoZs svoz >- 7i� - 3��7 iat� 6,4v1,v' kegs � II. Type of Building (check all that apply) �� °"'� . ❑City ® 1 or 2 Family Dwelling - Number of Bedrooms ❑Village ❑ Public /Commercial - Describe Use 12ITownship S ❑ State Owned Nearest Road ZI tC 6 0 TN s� III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A �to ounty use I ® New 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Ad System Tank Only Eris ' B. ❑Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) 44 19 Non - Pressurized In- Ground 21❑ Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. DispersaMeat ment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals./Days/Sq.Ft.) (Min./Inch) Elevation �s® 13 653 r e7 VI. Tank Info Capacity in Total Number / Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks tat/ Z #,Sdi A_/Do Concrete Constructed Glass New Existing Tanks Tanks ,urti r' Septic or Holding Tank IDDV oQ� �{,, ' KS CGA;( i Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature ] MP/MPRS Number Business Phone Number j riA) 5Ctjn)rrr 44 ;�2a23 Plumber's Address (Street, City, State, ' Code) VIII. Count /De artment Use Onl Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Approved ❑ Disapproved Surcharge Fee) ❑ Owner Given Initial Adverse Determination 3 1X. Conditions of Approval/Reasons for Disapproval prll sir WLY b,- „�a�.,A. " � : fk v -, Attach complete plans (to the County only) for the system on paper not less than $1/1 x 11 inches In size SBD -6398 (R. 05101) C� Ay��,S � c \ _ ,' DES L 7 APPRoY�M. r +-/ PV c Z Iu5PEC7 Geao t Jena,ve 3 1 QRCPeeTY Lin1E Tots o G Z " pvc. APB E_L. JD� OC -_ /Q_Z__ . J00 - A ALT An - To P o F- z- pvc 1p to S'Ys� End _F. L. 96so z - 1- 3X._68.31 a � o � I _ AL - � a 3 - io Z 100 943 i a U 4th 2 � 2 PRePUSEio ® _ ELL m, - GQAN .- PRoPE -- c+L "7'Z �J�}QD ,_ $u_�TF l00 X16 . /SETH_ -k _ : - ���tces IN s`wIY .. I G A VI N s i l A C e,ES L OT A? PRO y PVC Z IU5: c, G �qo� f JtN� &f- - r r -. - _ Vic( so _ - -_ _ �• MPEeT'Y Lin%ff /c "L loo q - SY5i 601 p _ _- ► i fi t- - _17 os ! tW4 i ��- / t 1 - 3 X 6Z. 10 03 Dr0DIFFU.S0 1 NO J_d 0 7 /00 9 t3 O `bfl P goo P F0 _ , _LL. OL _ GeAND PR a vEQ7�cs - cn r '71 tJ e _s� , ' Sc4 7 � : Vo?5 ��tcC'sE s` /c�2s 4 ._. .__..._.__. _ __. _.._ __. _. 1119 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt Attach complete site plan on paper not less than 8 % =x 11 inches in size. Plan must County St. Croix include but not limited to: vertical and horizontal reference Po int BM direction and f )� percent slo pe. scale or dimemsions north arrow and loca earest road. Parcel I.D. Please print all informaf f'� L,, L � V D R viewed By Date Personal informalion you provide may be used for secondary pu rivacy Law, s. 15.04 (1) 1� Property Owner .a c j' qro ocati n Grand Properties, LP Govt tot NW 1/4 SW 1/4 S 14 T 31 N R 19 W Property Owner's Mailing Address )iX 1TY BI do # Subd. Name or CSM# 712 Rivard Streeet, Suite 300 ---=� '' ' FFl( Gavin's Acres City State Zip Code Phone Number City Village ✓ Town Nearest Road Somerset WI 1 54025 1 715 - 247 - 5900 Somerset I 60Th St. ✓ New Construction Use: ✓ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material Outwash Plain Flood plain elevation, if applicable na General comments and recommendations: Area is suitable for a conventional system with a 0.7 gpd /sgft rating. Possible system elevation for Area I is 96.59. Slope is 8 %. ❑ Boring # Boring ✓ Pit Ground Surface elev. 99.97 ft. Depth to limiting factor >98 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Corm. Color Gr. Sz. Sh. - Eff#1 - Eff#2 1 0-9 10yr3/2 none sl 2fsbk mvfr as 2f .5 .9 2 9-18 10yr4 /3 none sl 3fsbk mfr cw 1f .5 .9 3 18 -30 7.5yr4/4 none Is 1 csbk mvfr gw ---- .7 1.2 4 30-98 10yr5/6 none ms Osg ml - -- - - -- .7 1.2 Boring # Boring ✓ Pit Ground Surface elev. 99.97 ft. Depth to limiting factor >97 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - E 1 "Eff#2 1 0-8 10yr3/2 none sl 2mgr mfr as 2f .5 .9 2 8 -18 10yr4/4 none sl 2msbk mfr gw 1f .5 .9 3 18 -30 7.5yr4/6 none Is lcsbk mvfr gw - - - -- .7 1.2 4 30 -97 10yr5/6 none ms Osg ml -- - - - -- .7 1.2 fl•e`t Y+b " Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mgA- " Effluent #2 = BOD 130 mg/- and TSS < 30 mg/- CST Name (Please Print) Signature: / �_� CST Number Thomas J. Schmitt ��- > �"�-� --`.�— 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valley View Trail, Somerset, WI 54025 6/13/02 715 - 549 -6651 Prdperty Owner Grand Properties, LP Parcel ID # Page 2 of 3 F3 ] Boring # Boring ✓ Pit Ground Surface elev. 97.42 ft. Depth to limiting factor >96 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10yr3/3 none sl 2mgr mvfr as 2f .5 .9 2 8 -16 10yr4/4 none sl 2fsbk mfr gw 1f .5 .9 3 16 -21 7.5yr4/6 none Is Osg ml dw - - - - -- .7 1.2 4 21 -96 10yr5/4 none ms Osg ml - -- - - - - -- .7 1.2 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 GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 a Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = SOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD <_30 mg/L 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 .....7 motPriol ;n — .4-1v. f--.f T1-- t. fo,# t _ Aonarlmnnt at r.I1R- 7�F_1I GI — TTV !.(1R_7(.A_R777 9 3o a, $ �, p T / 9r aw ftzs �c �eS 11. N ' ta ;7,7 Ai - r r ly3r q m P r a p,r4nrps 1 Ly `. - owt a S �`• m t` Sig. i e S 6 L&I 50- Mers��i r,.� sic— Sys', t4,/J. S Lo 4 7 Dav gc dvs (7 s) S11 - -S/ g r 3 l N R 19 a nS 4'1 � isw rP POWTS OWNER'S MANUAL St MANAGEMENT PLAN Page of SPECIFICATIONS SYSTEM ' FILE INFORMATION � Owner Septic Tank Capacity 1000 gal �re Grand Properties L.P. Permit # Septic Tank Manufacturer O!` " 4.�pl92 Week s C . P .•r: DESIGN PARAMETERS Effluent Filter Manufacturer Zabel } . yam ON Number of Bedrooms 3 O NA Effluent Filter Model A -100 Number of Public Facility Units IN NA Pump Tank Capacity gal ■ NA` ,'^ Estimated flow (average) 300 gal/day Pump Tank Manufacturer ■►' Design flow (peak), (Estimated x 1.5) 450 g al/day Pump Manufacturer ■ NA Soil Application Rate gal/day/ft' Pump Model r Standard Influent /Effluent Quality Monthly average* Pretreatment Unit ■ NA' Fats, Oil & Grease (FOG) 530 mg /L 0 Sand /Gravel Filter 0 Peat Filter�r Biochemical Oxygen Demand (BOD 5220 mg /L 0 NA 0 Mechanical Aeration 0 Wetland Total Suspended Solids (TSS) 5150 mg /L 0 Disinfection ❑Other.^ Pretreated Effluent Quality Monthly average Dispersal Cell(s) O NAy Biochemical Oxygen Demand (BOD 530 mg /L ■ In- Ground (gravity) '0 In - Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ■ NA O At -Grade 13 Mound w Fecal Coliform (geometric mean) 510' cfu /100ml 0 Drip -Line 0 Other: . Other. 0 NA Maximum Effluent Particle Size Y in dia. 0 NA �.. Other: 0 NA Other: O,NA` *Values typical for domestic wastewater and septic tank effluent. Other: O NA MAINTENANCE SCHEDULE Service Event Service Frequency 0 month(s) (Maximum 3 years) O NA' . Inspect condition of tank(s) At least once every: 3 ■ year(s) Pump out contents of tanks) When combined sludge and scum equals one -third (Y of tank volume O NAB 0 month(s) , r Inspect dispersal cell(s) At least o nce every: g ( Maximum 3 years). ■ yea month(s) Clean effluent filter At least once every: � earls) 0 � 0 month(s) Inspect pump, pump controls & alarm At least once every: 0 year(s) 0 month(s) ■ Flush laterals and pressure test At least once every: 0 yearls) O month(s) 0 Other. At least once every: 0 year(s) S Q Other: DyN j:. MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certification• Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer;' Septage Servicing' Operator.�T n inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks,o measure the volume of combined sludge and scum and to check for any back up or ponding of effluent,on the groudsurf,., The dispersal call(s) shall be visually inspected to check the effluent levels in the observation pipes and to,check for'any�,pottdin of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires , e immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any . tank equals one -third (Y or more of the tank volu[ne, the; contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter: NR Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters; mechanical or pressurized components, pretrea et1 units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintalner. ays of completion of any service event A service report shall be provided to the local regulatory authority within 10 d*; Page of 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(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may'result in the backup or surface discharge of . effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls t o restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space 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: ■ 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. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. • 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 IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name John Schmitt Name Owners choice Phone ( 715)-549-6651 Phone 1 11 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Owners choice Name St. Croix Ct . Zonin Phone Phone ( 715)-386-4680 This document was drafted in compliance with chapter Comm 83.22(2)(b)0)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. 1 ST CROIX COUNTY • SEPTIC TANK MAIIJTENANCB AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer i re 6; Eenj A- /nJ 6 ae A 6ea wfei i s L / Mailing Address 7, gq u .4,e - S u , 7 - c /DO -S©hJ fe5e7 G tJI .SYOZ �1 Property Address -P a 11-k -+ • V (Verification required from Planning Department for new construction) 0 3�L - /OPJ -Bo- -0 City/State Parcel Identification Number x'L - to yi 10 -moo LEGAL DESCRIPTION Property Location '/, %, Sec. T 3 / N -R�LW, Town of 5o n c� � Subdivision tG A y iU S d C k' & s . Lot # Certified Survey Map # , Volume . _ Page # Warranty Deed # t x'75 3 , Volume a'V . Page # -5 8 J Spec house ® yes ❑ no Lot lines identifiable ® yes ❑ no SYSTEM MAINTENANCE Improper use and maintenanceof 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 mastor plumber, journeyman plumber, restricted plumber or a li cense d p 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. Uwe, 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 of the three year expiration date. S APPLICANT DATE OWNER CERTIFICATION I (we) cer that all statements on this form are true to the best of my (our) knowledge I (we) am (are) the owner(s) of tify the propprty described above, by virtue of a warranty deed recorded in Register of Deeds Office. r',N,'" Ak�-. 3 12, SI0 ATURE 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 . N U 1952P 585 667537 STATF BAR OF WISCONSIN FORM 2 . 1999 KATHLEEN H. VALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., VI This Deed, made between Walter E. Germain and Debr C. — RECEIVED FOR RECORD Germain, husband wife, __- — 08 -20 -2002 9:30 AN WARRANTY DEED - - - EXEMPT 1 Grantor, and Grand jp�j erties, LP REC FEE: 11.00 — — — TRANS FEE: 916.50 -- — — — COPY FEE: CERT COPY FEE: Grantee. " "— — PAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Cr _ County, State of Wisconsin (if more space is needed, please attach addendum): The W 1/2 of SW 1/4 of Section 14, Township 31 North, Range 19 West, Recording Area St. Croix County, Wisconsin, EXCEPT: 1) Lots I and 2 of Certified Survey Map in Vol. I, Page 236, Doc. No. Name and R1`Oft OGLAND 332995; 2) Lots 3 and 4 of Certified Survey Map in Vol. 3, Page 746, Doc. No. ATTORNEY AT LA P O 353786: B OX 3) Lot 5 of Certified Survey Map in Vol. 9, Page 2454, Doc. No. 480266 HUDSON 4) Lots 3, 4 and 5 of Certified Survey Map in Vol. 10, Page 2889, Doc. No. 526637. 032.1040 -80 -000 ;032.104 -10 - 000 - -_.— Parcel Identification Number (PIN) This _ is n —_ homestead property. oil (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. 2 u M Dated this C day of 2002 June • • Wolter E. Germain - • Debra C. Germain - AUTHENTICATION ACKNOWLEDGMENT Walter E. Ge rmain In d Debra C. Germain, STATE OF WISCONSIN ) Signatures) —_ — ) ss. husband wife, -- -- - County ) authenticated this day of _June _ , 2002 _ Personally came before me this __ - "— day of f the above named • KristinaOgland ____ - -_ - -- 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 OQiand _ _ Notary Public, State of Wisconsin Hu W t 544616 — My Commission is permanent. (If not, state expiration date: (Signatures maybe authenticated or acknowledged. Both are not necessary.) —. -- -- — — — —" — irdwrnationProta "is ComWnY. Ford du lw. WI • Names of persons signing in any capacity must be typed or printed below their signature. eoo4ss.;02t STATE BAR OF WISCONSIN WARRANTY DEED FORM No. 2. 1999 t EASEMENT - �. a� 00 -- 1297.29' -- 223 00 - 3 -0. — — — 332.43' — — — T c — 354.49— — 340.00' — — — — ...I...... .......... ............ ...................I........... w w LOT 7 LOT 6 S 3.04 ACRES N M 3.04 ACRES I z '`� 132, 455 SO. FT. � , 132.387 SO. FT. d z S a a z 354.49' 224.59' 932.7 935.19 N01'33'19 "W 933.68' I R= NO271'46 "E I N88*26'41 "E .-*,� 115.41' 46.33 I O I I I R= 587'48'14 "E 931.8 I I = I I I Q I � I I I i q � o �� �/ � G� I Z G I G/ I I — CENTERLINE — — — L *EST LINE OF THE SW 114 OF SEC770N 14 — — — — — — — — 60TH SI r) �~ 2568P 358 762121 STATE BAR OF WISCONSIN FORM I - 2000 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number I ST. CROIX CO., WI This Deed made between Grand Properties, LP RECEIVED FOR RECORD 05/10/2004 11:45AN Grantor, WARRANTY DEED and Michael J. Germain and Michelle M. Germain EXOPT i 15M REC FEE: 11.00 TRANS FEE: G COPY FEE: Grantee. CC FEE: �j� r,4- l sideration, conveys to Grantee the following PAGES: 1 scribetate in Croix County, State of Wisconsin (the Property ") (i f more spa a is needed, please attach addendum): Lot 7 Gavins Acres Recording Area Name and Return Address Mike Germain So Rivard St. Somerset, WI 54025 I 032 - 2163 -07 -000 ,�-- Parcel Identification Number (PIN) Together with all appurtenant rights, title and interests. This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions, convenants and rights -of -way of record. Dated this 4th day of May 2004 *Mi eal J. ermain * Michelle M. ermain * * AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) ) ss. St. Croix County. ) authenticated this day of Personally came before me this 4th day of May 1 2004 the above named Micheal J. and Michelle Y r PG ttt 4� M. Germain TITLE: MEMBER STATE BAR OF WISCONg��p B ( If not, tt ` .' ,y / A me known to be the person s who executed authorized by §706.06, Wis. Slats.) $ E 1 t"e fore oing instrument d acknowledged the same. THIS INSTRUMENT WAS DRAFTED ,>� 1 O LSON r Michelle M. Germain, 712 Rivard K <<; ,. •••' aJotary lic, State o isconsin Somerset, WI 54025 t G0 My Co ssion is permanent. (If not, state expiration date: ( Signatures may be authenticated or acknowled ed. Both are not nec t.� .1. *Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1-2000 E /MAX Team l Realty 712 Rivard St Ste 100, Somerset WI 54025 -7386 Phone: (715) 247-5900 Fax: (715) 247 -3622 M. J. Hinz T4179120.ZFX Produced with ZpForm- by RE FornnNet, LLC 18025 Fdteern Wile Road, Clinton Township, Michigan 48035, (800) 383 -9805