Loading...
HomeMy WebLinkAbout032-1066-10-200 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix Safety and Building Divisior' INSPECTION REPORT Sanitary Permit No: 420381 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: Kammerud, Jason Somerset Township 032 - 1066 -10 -200 CST SM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV. Septic - 3 ^ Benchmark Dosing Alt. BM Aeration / Bldg. Sewer 3 0 9 Holding,_ St/Ht Inlet 106. St/Ht Outlet . TANK SETBACK INFORMATION 166,37 TANK TO P/ WELL ] BLDG. Vent to Air Intake ROAD D1 Inlet IF Septic Dt Bottom ��- i� � 3 Dosing Header /Man. sl 05 97' Aeration Dist. Pipe ) 2 • 5 , t ��' Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Z �� 7, Manufacturer Demand St Cover Mode umber TDH Lift Fri Oss System Head TDH Forcemain Length I Dist. to well SOIL ABSORPTION SYSTEM BEDITRENCH Width } Length + lNo. Trenches PIT DIME ONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 SETBACK SYSTEM TO P/L BLDG WE L LAKE /STREAM PEACHING N Manuf�_ rer: INFORMATION Ty p f System: AMBER O `` t — 7 S.}1 ! UNIT Model Number: :5 1 i► 4—L DISTRIBUTION SYSTEM 0 Header /Manifold Distribution x Hole Size x Hole Spacing� Air Intalfe�„ /1 (/ t t Pipe �/ 5h g r7 I / I �Cl� 1 1-ength (,J Dia /_ Len th Dia S acin SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only d f Depth Over „i //S/ Depth Over xx Depth of xx Seeded /Sodded ched Bed/Trench Center G Bed/Trench Edges Topsoil v%" yy g p Yes No �' Yes No COMMENTS (Include c e discrepencies, persons present, etc.) Inspection #1:�/ 1d �-- Inspection #2: / / Location: 727 72nd Street Somerset, Wt 54025 JNW 1/4 SW 114 24 T31N R19W) NA Lot 7 Q Parcel No: 24.31.19.328A20 1.) Alt BM Description= o Sofinvl s G ' r' , 'n 2.) Bldg sewer length = 13 r W, � S 4 o d s , — �Q,�,,8,,1�, , - amount of cover = / A-4 �`--� �"i' "",.� Jyc�lL " 3 � Plan revision Required? ' ,;, Yes L_ ' No Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's ignature Cert. No. Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 ST L(�lX ��consin Madison, WI 53707 - 7162 Site Address G� Department of Commerce Q / 9 • / & "� �2'� 2 ✓ t . Sanitary Permit Application Sani 1 0 3 Permit Number 8` I In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑Check if Revision may be used for second purposes Privac Law, sl5.04(1)(m) I. Application Information - Please Print All Information - _D State Plan I.D. Number Property Owner's Name Parcel Number .J ksc K.A&NE 03 2 -t 4 k - # - 20a 3z$ -•4 1 Property Owner's Mailing Address Property Location / _T N A�fl ST. Vi / <;S Z T31 N,R City, State Zip Code one Number Lot Number Block Number T Subdivision Name CSM Number bS CE�I� W 1 &1 EZa - 715 - W 0t Z II. Type of Building (Check all that apply.) ❑ City 1 1�L1 or 2 Family Dwelling - Number of Bedrooms IS ❑Village • Public /Commi�l - �es�ribUs` • State Owned ` Iy� l� Townshi Barest Road �- t X 4 2 t4 L `T Z m (� - III. Type of Permit: (Check only one box on line eA A. Numbering is for internal use.) (Complete line B, if applicable.) A. 1 New F20 Replacement System 3 ❑ Replacement of 6 ❑ Addition to System Tank Onl Existing System For County use B. ❑Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of POWT System: (Check all that apply. Numbering is for internal use.) 44A- Non - Pressurized In- Ground 21 ❑ Mound 47 11 Sand Filter 0 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 11 At-Grade 46 ❑Aerobic Treatment Unit 49 11 Recirculat' 30 Other V. Dispersal/Treat ent Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals. /Days /Sq.F . (Min. /Inch) / z Elevation 9 Sty V-54 C1'8 /ez VI. Tank Info Capacity in Total Number Manufacturer Prefab - Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank / /tY) x: X Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume respo sibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) lumber's ' nature PRS tm Z ber Business Phone Number � EFF �x 4 2�Z'-IZ, ��5-21' -2Ni Plumber's Address (Street, City, State, Zip Cbde ? © 20 x Z-9 5 uj�ss -lx VO S16611 VIII. County/Department Use Onl Disapproved Sanitary Permit Fee (includes Groundwater ❑ Date Issued Z Agent Signa re (No Stamps) /I Approved Owner Given Initial Adverse Surcharge Fee) ZZS� l�Q �Z \ Determination IX. Conditions of Approval /Reasons off• Disap ova1 - 6,p- �pp Attach mplete pl s (to the C my only) for the system on paper not 1 than 81/2 x 11 inches in size �— CU c d� 0 �-�- iJ 2 8l 1 / J 1 Z. t S �F O vw ►s p _ /N ,� 1n pt., S � Kn�c U►� tJw '1q �:w I �`I S- 24 'rZ\ N, (Z I� W_ ZSBb 3o - T N NZ P d SCEbLA 1n/ ( - r 41)26 V IAP R- . 222 2,9 \ 1:3og d r3 r � 3 BEO,e.00� rdo �fl2►� l� FIJN A21L = `fb P L9 F M A(Z v—no r x£ t�ST tt = lob tt SO IL �b 2 1N GS Ti2ElXgeEs VI Li NAVE it STAWAKD WFIC , DAN S b� KAY r� NW 'lei - S- 29 `rZl N, 2 I V✓ Z SBb 20 TR NZ SCE ®LR 1�It � HoZb U' A PRS ZZ32y2 TI g� f � t7 t r5 G 3 Em X-t n dousre r,^e GL- YC- -IBC£ ft t - L = ion Cf `JCIL . br -J UUS O JEE�o C=, WL ln�£� K� SHPT IC `tAfJ K- �� Wk=vdn Depa tmsntof Commerce SOIL EVALUATION REPORT page of—a Division of 1111adMty and 9uiklings In socorde nce with Cornm W. Wls. Adm. Code Attach complete of plan on paper not Ives than a 112 x ,1 1 inches In size. Plan must + D Include, but not limited to: vartical and horizantsl reference point (BM), d rectlon and Parcel I.D. O 3 a — o 1. (o — J v _ o v nca � pormttslope, scale or dmsrnions, north arrow, and location and distance to nearest road. Wo 5a. r re. I,,, Ph a se print all lnlloratat/on.;._..-, =b, PwwW Wwm**w v= Provide may bo wed for OufDo•« (Privacy�k t s. 15.04 (1) (m)). Z PrOperOYM1af Location �.'` Lot NW1 /45LJ 1/4 S�y T31 N R 9 E( W Property ownses Mailing A ddW c Lpt # �,, Block # Subd. Name cr CSI# a 3 6 P 35 ' Cibr State Zip Code .j � ❑ Village ® Town Nearest Roc S or.,e►r5e+ (, 1 5y Da$ `' �1 � � p . S o Nv1 a r` e-h- r ® New Construction Use: 09 Residential / e derived design flow rate GPD y ❑ Replacement ❑ Public or - F�irrentirpllerfal C31 9 Mood Plain elevation ff'"Ocable R Genval nrrsMa �e cor, r , *, ' and r+eoorrMnrnt►daflas: 9 F o �' p ,- � ►,,. ,� r y 5 ; � `; a - 3 ' x ` s S > -t-.t �98.Yb'� T. a C97.90') Re piac P -4 ' TkEhLkcS I T 3 45.LO'a , C 95 .oy' M # �, pit Ground surface elev. Depth to limiting factor t a In. Soll Icallon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPPX In. Munseq Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#Z <o 2 M f r F . 5 FS le- r4 o r of L— ❑ eorkv 0 O Norkv [-Pit Ground surface elev. 10 1 7 , it. Depth to limiting factor In. Sol Application Rate Horizon Depth Dominant Color Redox Descriptlai Texture Structure Consistence Boundary Roots GPD/fF In. Mined Qu. SL Cont Color Gr. Sz. Sh. •E1M1 •Eff#2 V 5 L �o F S • Effluent #1 = BOD > 30;S 220 aVd and TSS >30 _< 150 mg& • Etttuerd #2 = SOD _< 30 nV& and TSS _< 30 mg1 CST Name a a i umber Y la Address a 7 l o e a o o rt `"` St , Date Evaluation Conducted Telephone Number or �- r" e - 0 7 - - . o v v - 71 i- -3 S $ l -� Property Oww kYi V1 `A C h) 1& M +0. Y N r% Pa ID # A C Pegs of H Pith . _ # Ground surface ebv: ' + � • It Depth to Iknitlrnp factor I b O in. - sod Appl ication Rate Horizon DspM Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPOW In. Munsed Ou. Sz. Cont. Color' " Gr. Sz. Sh. •Eff#1 • '002 a s 5 L S k .- CLO — . S 7. - D n1 L E �� e«kv # p Borkt0 • r Pit Ground surface elev. I k Depth to ik ftv factor d In. Sod icatlon Rate Horizon Depth Dorninant Color Redox Description Texture Structure Consistence Boundary Roots GPDM M. Munsed Ou. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 Sb V-- r. i . s 7 y rv% �. ►� . 5 . 9 b sb•in �.s�t S! `� �5 R FS b M y Boring ❑ � # pit around surface *Wv. R. Depth to dmitinp factor In. SoN Applicatlort Rate Horizon Depth Dominant Color Redox Dw6t1 w Texture Structure Consistence Boundary Roots GPD1fF In. Munsed Ou. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 w �4. 4 i • Effluent #1 ■ BW, 31 <_ 230 nglL and TO >30 <_ 160 ffW L ' Etiktant #2 = BOD. S 30 mQIL and TS$ 130 ffet 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, pleat contact the department at 608-266-3151 or TTY 608 -264 -8777. seo.sfs•pwool I. I : I i l : R ; L A P � - 4t t» I � q t + i - c7 �1 ' -f +__ �►-��_ I__�Q _ to iL cal - R ' f ' I I I , I I : ' . � t i i Pis �1 i 13 ' 71� I i , I • t ' : : f I , a I , ' - -- - i I- u5 4 j } } £ } t , f I i I 1 yak : , I a, : _ : d � Q_ , - I� I , I k. t 6 77 ts i obi ` i : ; i : � i .... __ -_ .. _ • � .. .: _ :- .i _ . - _ I I 1 ... ..._ � � r � f �� • � � �- i f � � ___.t..._�.- �_.- __..........__ _- L- .�.._- .- �- __._�,._...r - � � � � - '. i i � � t � - _ i � �� - 1 I •. I � � i i i I � i _ _' _ _... __�..._...� __� _ _.:.r. .. .. I � i � I "'i i i ; I i f ,� I � ,_ � i I I i _ ..rt � . I % .. .. ....�_ —t- I �'' � i - r _{ � f ! } f I � � . , I r f __ _ .� _ .... _.,. � - i . , ` � � , T r � � I � I � I t+ , y. J � j i r ( t � j I I �P -r- s � s � f i � � t ! � ! � i 1 I I _t._ I � � f ' i I � ! � � � f ' �-- 7t ff i I _ __ - - .__ _ - � -- � - -� � f �_ ._ � �-- --� �� I I i t� i �� � _ ,. , _.i ._,_ _,._ i . { _ fi -+_- i I i � � � � � t � i I i -- i � ; � I I i I r � � � —� i 1 I _ .. f � � � _ .� Ii f f r _._ f _ -- � - ---. - � -f - -- -_. � � __- . - - - -- -+ _ I �+ - -- 1 l • ._ �- � ,. i , i � � � + � i t I . :— 1 I 1_ i l I _� _..1._. _ - � _, _ t j . 1 � �- � - � � � � I i f I . .. � � � � fi I 1 � I � � � � i 1 i _ ... � .-- - _ ._ - � t :. � .. � -- -4. _ _ _ �. _ _.�. _ _...�_ . _.._�. I � i , I I � � I _} � • } �- � I t i { ; � ' , � 1 t � t . . l - � � , �_ , . ! � � , � � . I I I f I i � � , ! `' � i t �� _ : __� 4 � � ! � � ? � f �. + j t — — _ .... __ _ .. I P . _ _._ . � ' _. ._ ._ _ �_ — — _. , _ ; - I • � � � :. j _; _ � � i _ L _ _. _ __. _ _ ._ _. _ — -- � + _. I � � � � � r � f i � j � ' i - - -- - -— i POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of Z FILE INFORMATION SYSTEM SPECIFICATIONS Owner c'j Septic Tank Capacity a l 13 NA Permit # fZo 3 g Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms 3 ❑ NA Effluent Filter Model _ ❑ NA Number of Public Facility Units XNA Pump Tank Capacity a l KNA Estimated flow (average) 3 (YU gal/day Pump Tank Manufacturer RNA Design flow (peak), (Estimated x 1.5) `¢ s-b al /day Pump Manufacturer ItNA Soil Application Rate 0 al /day /ft2 Pump Model I&NA Standard Influent /Effluent Quality Monthly average" Pretreatment Unit MNA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Sus pended Solids ( TSS) :0 50 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD :00 mg /L �Zln Ground (gravity) ❑ In Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) :510' cfu /100ml ❑ 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 every: ❑ ear(s)(s) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ mo (Maximum 3 years) ❑ NA y Clean effluent filter At least once every: Z 11 mo nth r(s) ) ❑ NA r(s) ❑ month(s) 9,NA Inspect pump, pump controls & alarm At least once every: ❑ year(s) 7" Flush laterals and pressure test At least once eve ❑ mo ye ar(s) ry�,q p ever ❑yearls( �'"�� Other: ❑ month(s) NA At least once every: ❑ year(s) /k Other: MAINTENANCE INSTRUCTIONS c 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 the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page 7 f ' START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tankls) 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 to 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, ov 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 Name Phone 1 9 -F. 3 1 Tf Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Lft Cy—' qzq- 7 AJk Phone Phone 1(6 _ 90 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. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer MSt50 2U (p Mailing Address Z5 3 bq " AG U A W1 9 ,020 Property Address Z + (Verification required from Planning Department for new construction) City /State - &dM.USCT �J f Parcel Identification Number LEGAL DESCRIPTION Property Location I V ' / <, ' / <, Sec. 2 y . T Z? I N -R I 1� W, Town of S D nl��2S£T Subdivision Lot # _. Certified Survey Map # Volume l S , Page # 4 4 2-1 T Warranty Deed # (o 1 ? - 4 - Volume 1 O K - Y , Page # 0 2-,5 Spec house ❑ yes Jl no Lot lines identifiableg 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/we, 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. dt / A S NATURE 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 the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. S A R OF APPLICANT t 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 Ad �- 4 P 0 2 5 SATHLSEIf : ALSH REGIST%on M ' `ST. CROIR CO., YI RECEIVED FOR RECORD 08 -22 -2002 9:30 All WARM M REC FEE: 13.00 TRANS FEE: 21.00 COPY FEE: CERT COPY FEE: PAGES: 2 RewAft A N� aid adm Addrrs • o3a - /ors fo, o3a - /oGd /o "=S PAG9 IS Pit! OF %US LESAL Dorn n - Do WT RFl U" 'Ns ti�"rM� �rt1� �d Ibr w1�L.a �� wl �ip�gln�iwq, �p�M w�el1 w Aw rm t &low W &mw• «w aw be~ to &kpw pr $w. bnw.u...�q► k fir er «./�b�.t�r �� tK+ tlMr �0b «wr/ipit �ddr rwr jqs r ywr'IK..iw.r..t *Irow�� l+r.�sr, l �.tt s. WJt0A 20M FOCJJMEN.T NO. WARRANTY DEED 63'748 THIS DEED, made between Dennis M. Neumann and Dawn J. Neumann PFj CO s IA ISCONSIN husband and wife as survivorship marital property, Grantor Received for record this and Jason S. Kam merud, a single person ,Grantees 9th da'a of Jul'a PO 2002 at 10:OOAM Grantor, for a valuable consideration of one dollar and other good and and recorded in volume 911 records �rd� F•a ?e a8l valuable considerations, conveys to Grantee the following described real estate in of Cac rec N�. 1 9 St. Croix County, State of Wisconsin (the "Property "): Part of the Northwest Quarter of the Southwest Quarter (NW 1/4 of SW 1/4) and part f paa of the Northeast Quarter of the South st Quarter (NE I/4 of SW I/4) of Section 24, `- ` T31 N, R1 9W, described as follows: of Seven of Certified Survey Map filed December 7, 2001, in Volume 1 5, p age , Document No. 664325; RETURN TO: Together with an easement for ingress and egress over the Private Road Easement Mr. Jason S. Kammerud shown on Certified Survey Map in Volume 6, page 1623; P. 0. Box 405 Osceola, WI 54020 Parcel Identification No. "It 1 11tA 032 - 1065 -80, 032 - 1066 -10 This is not homestead property. Together with all appurtenant rights, title and interests. Grantor warrants that title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and reservations of record DATED this �~ day of July, 2002. (SEAL) (SEAL) Dennis M. Neumann "r) (SEAL) 1,1"11 Dawn J. Neumann AUTHENTICATION ACKNOWLEDGMENT Signatures of STATE OF WISCONSIN ) ss authenticated this day of POLK COUNTY ) Personally came before me this �_ day of July, 2002, the above named Dennis M. Neumann and Dawn J. Neumann , to me known to be the persons who executed the foregoing instrument and acknowledge the same. TI) E. MEM13�R STATE BR N0 1 , e'Of'Wiscon�in!Marcelta My commis.%io Is.per�maneht. r(If n , state expiration date: ) ApriF lAi 2005 ' t This Instrument Drafted by: LUDVIGSON & GALEWYRICK, S.C., ' Attorneys at Law Osceola, Wisconsin 54020 �I� �pNtlS I '' ►CO � F E 9r EE� o l �` Wl �Y • v o f the NorthglQ °untYl ,�/� Q �. �7 art rset. SA( O �. C IED or" P ome i < q ° •�''� J k. , R T I r r of the Sout Ro�9e Qu West, Town of S E. a ►vp te SUR ��� west Quarter 31 North. c �� << +�f1t1ietot wV art of the N - 24. Township o f Sec 2 Z Eocoted in Q o �� Southwest d at the reques sconsin• t of. a tv -K .i Wi �:: repored for an 2 �� � �+ 4 P C 2 — Z m OWER' N �mcn3 5 . O S.T.H 2039 5402 v Somerset. County and access m T y R. Dodge State. lot s ize, the St. N subject to Drafted by on this m °p is wetlands+ minimum contact w i•a any p arcel, for a dvice. . OTE: T►ie parce� develop in d regulations d in Boor 9 Town d 1 N laws. urchosin °r ropriat I 2 T fore Be E O fore P the Opp _ I to Parcel, Office an T F G � PP County Zoning l CER - B I Croix N N 0) o M 00 1 6 ^ ' —404.8 0 I w TIED LANDS ri m N I TO HWY. � � • � NO ACCE 299.04' ° NO2'29� -n OW C Tr 3 so 14 v i P in �Ol a C) a � o I o g6 a n o m ,p A y � w� G f o 0 c " a O L AO. O 1 1z 0 N 0 G 0 Qy t3o N n M to 5 I ) to y V q CP ao � U) 1. IZ 3z8 2 0 J l w iy wog T HE NW 114 �m / p EAST LINE l 1'' SW 1 4 INE NE 1 ; • N ' E OCsT s /4 ` o z -4 `^ a Z OF TH � 0 Cry �v VO N O to Rl� ��1.-• s 1 162 ! / �� �. > Q 1 I L4 P • 227-1"' a, co S02'29' 44 W �/ Z r pF LOT 8 N ao Z I Z � -� �. µCST o, UNE v w N O O o s ib`\ t I N N O, I WARR;N DEEP 483 0; °•�, F\� 'i SAS f� �m C 0 T FIED Y M 66•► I CER� — SU ROIXCChNrYn�n;�tE� I 0 Plann loo , I p 6 2001 100 tjoys tit ',pHIC , ADO I If not r l 1 SC feet l the FEET 1 inch ' apRTME A`S,Ti'M rnv. SCALE A 0 001 2 I I N•. RAN GE 19 W. REFERENCED TO jOB ored by BF IN OF S SEC� ON 2470 BEp HI$87 57'05 ~E• prepared �Uflin9 � ro � P' Inc. E I U IS AS SUMED 71 5) 246 431 WHICH Phone No. 246 -3830 715) 821 Fox N 5 54 ,0 P.O. Box 3 and 17 Vol • 15 Pag New Richm Sheet 1 of .._