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Home My WebLink About032-2147-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Sofety and Btilding Division INSPECTION REPORT Sanitary Permit No 506129 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: Stanwa , Jeff & Anna I Somerset, Town of 032 - 2147 -30 -000 CST BM Elev: Insp. BM Elev: BM Descri tion: Section/Town /Range /Map No: 106 /00 V 15.31.19.1284 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic B enchmar k / c,=_> G.(�� /pb•6 Boa. o Dosing Alt. BM 6"r �o a!- /,3/ tt Y Aeration Bldg. Sewer V o 3V Holding ' t Inlet Hey a TANK SETBACK INFORMATION S Ht Outlet . Of 1 6 YX I TANK TO Py , W L BLDG. Vent to Air Intake ROAD Dt Inlet lei Septic + cJ Dt Bottom 75 Dosing eader/ an. - c3 Aeration Dist. Pipe Holding Bot. ystem ,t Final Grade 3. 2. 7 PUMP /SIPHON INFORMATION Manufacturer U Demand St Cov r �� 2. $� GPM G Model Number V f. TDH Lift Friction Loss Sys ea TDH Ft Forcemain Len ia. Dist. to well SOIL ABSORPTION SYSTEM Z Q, BED /TRENCH Width I Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS i SETBACK SYSTEM TO P/ BLD WEL LAKE /STREAM LEACHING ManufacUjawr+ -- INFORMATION CHAMBER O .1 —pTl M� r A) T f S stem: U mber: YP Y '7 I SD Mod el Nu DISTRIBUTION SYSTEM w a� /fH,aderllanifold Distribution V I x Hole S' e x Hole Spacing Vent Air Intake / I Pipe(s) / 4f �h,d Length Dia Length Dia Spacing �O zvf 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 rd k Bed /Trench Center Bed /Trench Edges Topsoil Yes No Yes N COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1:/ / Inspection #2: / / JR Location: 540 214th Avenue Somerset, WI 54025 (NE 1/4 SW 1/4 15 T31 R1 9W) Oak Haven Lot 13 Parcel No: 15.31.19.1284 1.) Alt BM Description � 2.) Bldg sewer length f go 4 % > V7 y0, i -J&� /L i - amount of cover =q Plan revision Required? Yes o Use other side for additional information. Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) t ldme commerce.wi.gov Safety and Buildings Division County nt . 201 W. Washington Ave.. P.O. Box 7162 "� Madison. WI 53707 -7162 Sanitary Permit Number (to be tilled in by Co.) epa of Commerce 5 � a Sanitary Permit Application State TransactiortNu b er vern In accordance with s. Comm. 83.21(2). Wis. Adm. Code. submission of this form to the appropriate gomen a / C unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are Project Addre (if different than mailing address) submitted to the Department of Commerce. Personal information you provide ma r ary SO/t I �rS f u oses in accordance with the Privacy Law, s. 15.04 1 (m), Slats. �i /O I. Application Information — Please Print All Information 7 Property Owner's Name Parcel # J e At' ol Aida S� w� R 1 2007 0 32 - � l y7,T0 - ago Property Owners Mailing Address Property Location - b O 7 G� f r':t�� Sr ST. CROIX COUNTY Govt. Lot Cit} . State Zip Code Pho � y,, 5 '�V y,, Section /J — 501"el �� _ / �Zr 7/1 __Z' T 31 (circle one II. Type of Building (check all that apply) � / Lot # T N: R i9 E orW 1 or 2 Family Dwelling — Number of Be rooms v Subdivision Name V� Block # 04,k HQ 0 e— ❑ Public /Commercial — Describe Use ❑ City of El State Owned — Describe Use CSM Number ❑ Village of ( A ® Town of Sto In e,re f- III. Type of P : (Check only one box on line A. Complete line B if applicable) A. OK New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. El Permit Renewal E] Permit Revision ❑Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that a Iv C Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreat nt Device (explain) V. Dis ersalfrreatment Area Information: G"v Design Flow (gpd) Design Soil Application Rate(gpdsn Dispersal Afia Required (st) Dispersal Area Proposed (sf) S stem Elevation Da 0.7 8 57 VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units � o D New Tanks Existing Tanks - 5 po U / � _ o Y ` y 2 R l.. � a v� cn is. U ci. Septic or Holding "rank ' / v � Dosing Chamber (, N'I1. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown a attached plans. Piu—ml,r*s Name ( Print) Plumber's nature MkV PR tuber Business Phone Number P' n�:f s Address (Street. City, State, Zip Code) z 11 L ounty/De artment Use Onl Permit Fee Date Issued Is mg Agent ignahrr Xppro ed ❑Disapproved 11 $ y _( �/ 2 �7 / �� Owner Given Reason for Denial � 3 / (o I\. Conditions of A proval/Reasons for Disapproval SYSTEM OWNER: 1 Septic tank, effluent filter and j dispeCsal cell must all be serviced / maintained as per management plan provided by plumber. All setback requirements must be maintained as per applicM and submit to the County only on paper not less than g 112X 1 1 inebes in size SBD -6398 (R. 01/07) Valid thru 01/09 Ll AIl.1' X , . Ao U GL NI 23 Y oe A f yfc, - 'J�2 n� L oe� i -- wl - le ------ --- ArP - -- -- ------ cc /(S 2, Ak P2 ..- ,}._- -.• - -- -- `�' ---_. '�. -._ --�_ ..�-- ..._..� }---._ T -- 1 - " j + - --"r . -...�— - t•. {�^T' - may - - �� -- - � --- - �_- '*.. —. _ -. • ; H use I i I U ;To _. ' � � t �' � 6 i ! i ` � i --�-- � s � --�_ -- ' i � � _ 1�' _� `r i i � � i � t I � � � ` � � i 7 � e j i I � i � i � y i � �� E i � � t . E I 1 y__._— ' y_____�. � _ � _ _ i ` 1 ; _ � f ' I ` 1 � 1 � i � ` ! f _��.�..__._ 1 `__.. � ._. � r � � _ � � I a i I � p 1 `' � i� � i' i '.. i i , i Z r �_ -- -- _......__.:. _._.— _ _.�_...�._ _—i. -- �--- �-�.�. _. _ _._ _ _.�.. .� _ . .. i � 1 __ — ..t..��. ___ _._ _�.�_ _..—.. __._i —. _.�._�..._ —t �-- __t.,_�y._. j, i � � � � �. i � i '. 1 ' I � F - 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 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.D. -� percent slope, scale or dimensions, north arrow, and location and distance to nearest road. n 1 rig OJT- — ,L - 7 — Please print all information. Rev' ed b Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). �3 U Property Owner Property Location Govt. Lot NE 1/4 S 114 S T 31 N R 19 FAor) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 11160 190th Ave. 1 k Haven City State Zip Code Phone Number ❑ city ❑ Village ® Town Nearest Road Elk River MNI 55330 (61 2) 441-8888 Somerset 21 a New Construction Use: CR Residential / Number of bedrooms 4 Code derived design flow rate 60 '�`� GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material outwash Flood Plain elevation if applicf(ble "`' ft• . UL General comments and recommendations: ST CRO(x 7► trenches @el. 98.50, spaced to code 4.00' below grads CO - FFlCE '! ❑ Boring # Boring - -\ 1 Ground surface elev. 102 50 h limiting factor +1 . ft. Dept to mng a 00. irr ,' Pit 5 lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary s GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -13 10 r4 3 none sl 2csbk mfr gw 2f sl 2msbk mvfr gw 1f .5_ .9 3 26-1C 07.5yr4/6 none ms sg ml na na .7 1.2 i i Boring # Boring F ® Pit Ground surface elev. 102.50 ft. Depth to limiting factor + in. Soil Applicatio n 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 -12 10 r4 3 none sl 2m r mvfr aw 2f 5 3 27 -1 6 non Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg /L ffluent #2 = B D 5 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Gary L. Steel 02298 Address Ddte Evalu n Conducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 715 - 246 -6200 r Property Owner Gerald J. Smi th Parcel ID# pending Page 2 of 3 ❑ Boring # Boring _ n 3 pi Ground surface elev. 99.20 ft. Depth to limiting factor +1 00 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ffF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 2 12 -267.5 r4/4 none is oSg mvfr qw if .7 1.2 3 27 -100 7.5 r4/6 none ms osg ml na na .7 1.2 F-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil A plication 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 F pit Boring # Boring ❑ Ground surface elev. ft. Depth to limiting factor 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 ' Effluent #1 = BOD > 30:5 220 mg/L and TSS >30:5 150 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 need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. SBD•9330 (R.6/00) STEEL'S SOIL SERVICE Gary L. Steel Gerald J. Smith 1554 200th Ave. CSTM2298 NE4 SW4 , 515 T - New Richmond, WI 54017 MPRSW -3254 town of Somerset (715) 246 -6200 lot #13 -Oak Haven This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may may not be as shown as permanent lot lines were not established at the time the test was conducted. N 1" =40' - - BM.= top of 1" pvcpipe @ el. 100.00' Alt. BM.= top of 1 ".pvcpipe @ el. 97.40' 2 -� 0 �1 Gary L. Steel 6 -1 -2001 Parcel #: 032- 2147-30-000 04/13/2007 12;43 PM PAGE 1 OF 1 Alt. Parcel #: 15.31.19.1284 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - STANWAY, JEFFREY B JR & ANNA L JEFFREY B JR & ANNA L STANWAY PO BOX 362 SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description " 540 214TH AVE SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 3.000 Plat: 2232 -OAK HAVEN 032/01 SEC 15 T31 N R1 9W NE SW LOT 13 OAK HAVEN Block/Condo Bldg: LOT 13 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 15-31N-19W NE SW Notes: Parcel History: Date Doc # Vol /Page Type 12/01/2006 839842 EZ -U 07/18/2006 829916 WD 03/23/2004 757308 2531/476 QC 03/23/2004 757307 2531/475 QC more... 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/24/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 48,000 0 48,000 NO Totals for 2007: General Property 3.000 48,000 0 48,000 Woodland 0.000 0 0 Totals for 2006: General Property 3.000 48,000 0 48,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Mailing Address —70 7 — 6a,,0,` -SA SO/h e� ' Property Address 5 .2 1� Sor ne�S .et car S"�/6Z (Vcrilia,tio ;� rccluir��l born 1'lunniup c1 Cooing Department for new construction.) City /State 5017'c.^sel- Parcel Identification Number LEGAL DESCRIPTION v Property Location �� std S �S , 3 / N R � W, T 01V111 Subdivision coo 17 veer Lot # Certified Survey Map # — , Volume , Page # _ warr Deed Volume Page Spec house yes no Lot lines identifiable es no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pwnping out the septic Lank every tluev years or sooner, if needed, by a licensed pumper. What you put iauc, the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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. 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 Planning & Zoning Department within 30 days of the three year expiration date. 1/ Wu certify that all statements on this !w•u, arc rue to the best of my /our knowledge. 1 /wc am/are the owner(s) of' property described above, by virrrue of a warranty deed recorded in Register of Deeds Office. Numb f' b ooms SIG URE OF APPLICANTS) DATE ** *Any information that US, nusrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Off de and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page / of ° FILE INFORMATION SYSTEM SPECIFICATIONS Owner 7 � � �'�� CU& Septic Tank Capacity l D gal ❑ NA Permit # J Septic Tank Manufacturer Weems' ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model G I C j® ❑ NA Number of Public Facility Units JR NA Pump Tank Capacity al .® NA Estimated flow (average) 7� gal /day Pump Tank Manufacturer I$ NA Design flow (peak), (Estimated x 1.5) gal /day Pump Manufacturer RNA Soil Application Rate e gal /day /ftz Pump Model 9 NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit I& NA Fats, Oil & Grease (FOG) <_30 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODO <220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) Q NA Biochemical Oxygen Demand (BOD _ <30 mg /L El In-Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) <30 mg /L IN NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency inspect condition of tank(s) At least once eve ❑ month(s) (Maximum 3 ears) ❑ NA n`' 3 IN year(s) y Pump out contents of tank(s) When combined sludge and scum equals one -third (%) of tank volume ❑ NA Inspect dispersal cell(s) At least once eve 3 ❑ month(s) (Maximum 3 ears) ❑ NA n'' 9 year(s) y Clean effluent filter / k - V% y At least once every: r 3 ® month )(s) ❑ NA ' nspect pump, pump controls & alarm At least once every: ❑ month ❑ yeaarr((ss) ) ) NA `'.;s` laterals and pressure test At least once every: ❑ month(s) year(s) 2 N ❑ year(s) At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When t "Ie ccrnbined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire =c ts-ts c: t`e tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, 4`, isc=- s �istrative Code. se including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment _ se-. at intervals of 512 months, shall be performed by a certified POWTS Maintainer. _ _ _ : s`a" be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION Page 2 of 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 um or p p contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to i restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or ark over, or otherwise disturb b 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 stem: 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 rya P r�/� Name Name Phone �/ — Z 4i J 3 2 03 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name / ?ncne Phone _ eat was d ass - __— "ance with chapter Comm 83.22(2)(b)(1 'd; &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. State Bar of Wisconsin Form 1 -2003 WARRANTY DEED Document Nu k ber Document Name THIS DEED, made between Brett C. Ellingson and Alison E. Ellingson, husband and wife ("Grantor," whether one or more), and Jeffrey B. iway Jr. and Anna L. Stanway, husband and wife as survivorshi marital prope ( "Grantee," whether one or more). Grantor, for a valua i le consideration, conveys to Grantee the following described real Recording Area estate, together wii It the rents, profits, fixtures and other appurtenant interests, in f Wisconsin "Pro if more ace is Name and Return Address St. Croix County, State o ( perry') ( p needed, please att h addendum): Maureen A. Wegleitner Lot Thirteen (13), Oak Haven in the Town of Somerset, St. Croix County Bakke Norman, S.C. Wisconsin. P.O. Box 308 New Richmond, WI 54017 t f I 032 - 2147- 30-000 Parcel Identification Number (PIN) This is not homestead property. j (is) (is not) Grantor warrants th4 the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Easements, highwaiys, utility rights, reservations and restrictions of record. Dated j f 114 l � 900(e L/ (SEAL ` (SEAL) * * Brett C. Ellingson c .... C, (SEAL) (SEAL) * * j Alison E. Elling AtJTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. authenticated on ST. CROIX COUNTY ) * Personally came before me on TITLE: MEMBE, STATE BAR OF WISCONSIN the above -named Brett C. Ellingson and Alison E. Ellingson (If not, to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) inst ment apA acknowledged the same. THIS INSTRUMENT DRAFTED BY: M fgr" aureen A. We 1 'tner X.P State o ,Nisconsin Bakke Norman, S. C. -New Richmond, WI 54017 Mir Commission ( permanent) (expires f (Signatures may be authenticated or acknowledged. Both are not necessary.) NO TI THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENT10FIED. WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 1-2003 * Type name below sig tatures. _ IJ L - �� I w 500'11'50 "E 588.83' KI 174.06' 197.60 217.17 OD CIL I v� QRAINAQE £A$£AI£NT >E NO2'37$9'E N I V 397.01' I w I - - -- w I � I I I I S00'1 1'50 "E i 33' 588.83' Ln , w w I I v N I I z I �� ni N N N -100'11'50" 211.75, — – – – i 588.83' ` "1, S rr., - - - - - -- I ° 41 I I It w w s Z N i � E '• `°- S00'11'S0 "E 151.29' bt a1' g I I I 588 -83' _ Z OD ' I � I : g� r �; j N Q N d I• N � n � tp�� V • / ap s � .61•c9 i w I I '� � - S te/ I w i 1 -10011' 50 "E 588.83' i T 1 •y •