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HomeMy WebLinkAbout034-1087-60-001 0 3 0 r O 6F� v 0. 0 C N r. o c a U p o cp O C C O O O a) e 3 r- o -, 0 o N N 'p c a O !-� E E a m � c N Q) N i N 'o a X o U 0 00 O N I — C j N p M I'. o oo'� o «� p0 U ° C.) a " i on. w w o _ c r 0 a ) 2- E N c a) ° � pocUcc� Q) a ° o ° ' a.2 z mo E c "p Cj U p"pU 3 N N O c U f9 LL. C a) —Y > c C Q) N� U EEO a) .m O a@ m N E O a N Q Q U O N N L o c C O N d E O O Z d O W d m N H z O Z d c C O N d Z c N I- N c _ E a � o N Q O CL O o m z z m z N n N y T t E In E a1 LO i w m O O O C o w N W u7 fn fn f/� j N a o 3 o N N J U r- oo z M N O co D N N ,-- z N p O O .E- N m � N A ►� C" O od U � O C y C CO O O a Q Ei CD I-- C L Lo N Q E C v 4 0 a1 Lo a1 c C) rn a u 'E C1 a� • �, M � n j t 1 ca 0 M 0 O y � O N to (n N d z CC m CL R • R a y u y y E L c c ° "�� A o a m O in 0 AFFIDAVIT OF a Z $ 1 CORRECTION KATHLEEN H. WALSH Ibcument Number REGISTER OF DEEDS ST. CROIX CO., VI (ME'OR PRINT CLEARLY i BLACX 9 RED M RECEIVED FOR RECORD h ere b y 11 / 13/2006 09: 00Ah swears or afl'ums that a certain document recorded on the .? 5 day of CORRECTIVE AFFIDAVIT S1'7E7nB6 - .208 4 (year) in volume EXEMPT # Page , as document munber 3 5.�1 which was recorded REC in 5- D ) X County, Static of l�Visoomin. contained the following TRANS FEE: 13.00 T error (if more space is needed, please attach addendum): TRA FEE: COPY FEE: CC FEE: PAGES: 2 �0 T�' L0T 6 E,1'CEP7- I 57"S /TAE V/L L h� O)C H AS R6Zoied e- /� Yuwm E t 3 13 �o5e 3q 2 G�tivnGn� AFR ANT makes this lf fi-davi for the purpose of cornctin� �a o Nam Aa Faum Add= as follows (if more space is needed, please attach addendum): 2, l� S, �, 7 a� � d' .��c,� �d 10 l�iAvvrr/1�c c -uA�/ ' C ci ur,� S�al3 /h oc+ jmd/ A0- of Alen I�d e °�� 03 f- l'pf7- 60-001; 0 3c{- 1 -X 6-00) Z803� Ra Z 3 Weatliation ��,,E — �ly 79 ?6J' 03y /0��7 59-0; o3y ions- i�-o�a� AFFIANT is the (check one): d 3 `1 -10,?e - 10 S ❑ Drafter of the document being corrected. -Owner of the property described in the document being corrected. O - Other (explain: _ � • Tire original document (in part or whole) [B is O is not attached to this Affidavit Of owl doamaent is not attached, please attach legal description and names of grantors and grantees). State of Wisconsin ) County of St. Croix ) ) ss. S c kyo r c (r afI'wned) before m 06 this .-- Notary Pdblic, State of w iscx�m• �, 2007 My 6tamission (is)- NPR" , &T. ,WA RAFTED 4Y: . PA-A-, --� W- 411Av This insa utnetu p is df 1 1 s not (clock one) a convoyaatx of real property as per S. 77.21 {ij VNb onsia 3tatutts. (A Wlstonaia Real Bagtte Trsnsfar Return lid fpr iwontmtta flag tlo �onyr real tuottti►•). •N=w of perama dSn4 la any upK* mnu be geed at prided s4 pm. 6 353 1 6 � KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX Co., WI RECEIVED FOR RECORD Document Number Document Title 09/25/2006 02: 30PK St. Croix Count AFFIDAVIT County EXERT li Affidavit of Reconnection to Existing POWTS TRANS F EE: 11.00 COPY FEE: Y�Ef 1,P CC FEE: 2 PAGES: 1 Name — (Owner) Typed or printed being duly sworn , states, under oath, that: 1. He /she is the owner /part owner of the following parcel of land located in St. , Croix County, Wisconsin, recorded in Volume 1393 Page 3ga Document Numbe St. Croix County Register of Deeds Office: Recording Area s A parcel of land locatyii in the Ne %4 of theSW/ ' /4 Name and Return Addres of Section <j -f -� c. T N — R 1 5 W, Town of Sp -IA1 F/L - A , St. Croix 10 7 �rK � �1,• / � Get fi County, Wisconsin, being duly described as follows (include lot no. and C N ��� ��. , o subdivision/CSM or detailed legal description): i Ld TS S V � xcOPr 9 f E-ST PD 6*2 Parcel Identification Number (PIN) g �o y As owner of he above described property, I acknowledge that the existing Private On -site Wastewater Treatment System (POWTS) serving this residence s s not) undersized bVcurrent code standards for a bedroom 1 -2 family dwelling. The system components have been inspected and certifie by a licensed master plumber to be in good condition and appear to be functioning properly. There was no indication of failure i.e. ponding or surfacing of wastewater in the distribution portion of the system at the time of inspection. I understand that the issuance of a county sanitary permit to allow the reconnection of the septic system does not imply that the system meets current code sizing requirements, nor does it imply that the system will continue to function after it is placed back in service. I also acknowledge that I will disclose this information to any future parties interested in purchasing this property. Dated this 2-15 day of 5 \ �Z Z ,,.•** =r �V, . Via,•• y - ��" � � AUTHENTICATION ACKNOWLE0GME . Signature(s) STATE OF WISCONSIN ) Q` „•.,,., :. )ss. authenitcated this day of St. Croix County. ) � Personally came before me this day o Z QU {a the above named 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 acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY Notary Public, State of Wisconsin (Signatures may be authenticated or acknowledged. Both are not My Commission Is permanent. If not, state expiration date: necessary.) Date: JQ 3 "THIS PAGE IS PART OF THIS LEGAL DOCUMENT — DO NOT REMOVE” This information must be completed by submitter document title. name & return address. and PIN frf required). Other Information such as the granting clauses, leagal description, etc. may be placed on this first page of the document or may be placed on additional pages of the document. h kk Use of this cover page adds one page to your document and $2.00 to the recording fee. Wisconsin Statutes, 59.517. Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 108 GENERAL IN90RMATION (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: Schreiber, Steve & Christine I Springfield, Town of 034 - 1087 -60 -001 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 28.29.15.567B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head T DH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number. DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over T T Depth of odded xx Mulched Bed/Trench Center Bed/Trench Edges psoil xx Seeded /S Q Yes 0 No Yes :N,] COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: I / Inspection #2: I I Location: 2933 72nd Ave. Wilson, WI 54027 (NE 1/4 SW 114 28 T29N R15W) Plainview Acres Lot 1- 8BIk20 Parcel No: 28.29.15.567B 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? 0 Yes Ej No Use other side for additional information. — Date Insepctor's Signature Cart. No. SBD -6710 (R.3/97) 0 CO) O 3 y c C7 � > > 3 r° A� O c .°. 0 7 N F • a 3 m y m co d C. m co � u, a cn - O (D � rn o CD o _ < ° W °° !mil 7 tll CD co � N CL (D W 7 ox; o m M� O N C (� A W : Z N W o n r Cl) ° N a V a 000 �• a4 � = y N N v � ER �vv0 B _a m v o m 3 O N N N z W Z O D a I 0 5 C� l�r • (D y m w c C N C C CL CD r CO) I n C3 a j' z 0 I Z N w m�°D CL cD Z G � A ° ri fA N .T1 fD ? N 7 O 11<4 0 D Q c A CD Q O O O - N a G O (D O 3 o a °. <, O O Q. O N ° cO 0 C m > > m ()M o'0 m 3 O �p CD ° O = O O O.�- Cn 7 C p fi fD c C Q < 7 y (D O A v n3 m coa -4 N O O O1 X, -° f� N y fD 3 m h O a o '0 CD 01 7 R fD fD C fL] y N N — 0 O O O. q n S N 0 07 0° O li O CD A O_ lv CD < 00 Cq O &9 O v c� CD ° '- i � ` County Sanitary Permit Application ST. CROIX COUNTY WISCONSIN In accord with Chapert 12 St. Croix County Sanitary Ordinance PLANNING & ZONING DEPARTMENT Personal information you provide may be used for secondary purposes ST. CROIX COUNTY GOVERNMENT CENTER [Privacy Law. S. 15.04(1)(m)] 1101 Carmichael Road ' Hudson, WI 54016 -7710 (715)386 -4680 Fax (715)386-4686 Attach complete plans for the system on paper not less than 8-1/2 x 11 inches in size County Sanitary Permit # ❑ Check if revision to previous application srr_ -O (2'? 1 .I r `/ 33 T� AVM 1. App lication Information - Please Print all Information Location: Property Owner Name �� + � � � 1/4 � 1/4, Sec Savir nrT 1 Q Q 6 N, I R E (or Property Owner's Mailing Address Lot Number Block Number a�t 1 ST. CROIX COUNTY ity, ate Zip Code vision Name or CSM Number 1triu 5`/6 3 1 T e of Building: (chedk one) -❑Village own of 1 or 2 Family Dwelling - No. of Bedrooms: Public/Commercial (describe use): P91 1v(�' FW AD ❑ State -owned Nearest Road / II. Type of Permit: (Check on line ;on eck box on line B if applicable) Q / Parcel Tax umber ec A) 1 Repair Reconnection ❑ Rejuvenation Sanitation B) ��� J 1 / U Z Permit Number Date Issued i1 d¢ lD �F ❑ State_Sanitary Permit was previously issued IV. Type WT System: (Check all that apply) Non pressurized In-ground / a ❑ Mound ? 24 in. suitable soil ❑Mound 5 24 in. suitable soil p a d A +0 ❑ Sand Ater ��6t - ❑ Constructed Wetland ❑ Peat Filter ❑ Drip Line ❑ Pressurized in -ground ❑ Holding Tank ❑ Single Pass _ ❑ Other ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating V. Dispersal/Treatment Area Information: v AA/)t J S / / - /LZd v / L/ 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed (Gals. /day /sq.ft.) (Min.lnch) Elevation Tank Information Capaicy in Gallons Total # of Manufacturer Prefab Site Con- Steel Fiber- Plastic New Existing Gallons Tanks Concrete structed glass Tanks Tanks N 0 a ❑ ❑ ot ❑ p ❑ ❑ ❑ 1. Responsibility Statement I, the undersigned, assume responsibility for repair/ reconnenction /rejuvenatioMnstaBation of non - plumbing for the POWTS shown on the attached plans. A license is not required for terralift repair installation of mbing sanitation tem. Plu er's Name (print) um s ature ( o st MP MPR N Business Pho umber 1 Piumbe);,s Address (Street, Ci State, 1 � � ,y 0 7 7 �f 117(oun Use Only I Disapproved Sanitary Permit Fee D41te Issued L,tsswrn�gAg t natu (N stamps) Owner Given Initial Adverse Determination� - ° X. Conditions of Approval/Reasons for Disapproval: 7 ce- )V67?d 1,& )j t SYSTEM O IFQ C TG eptic tank, effluent filter and t7w kJO( 7a PLACE /\/eu— Mdd 1&'!e �0 m dispersal cell must all be serviced / maintained p/ J / ���� A � o �� � /�� -1 T /— �✓� �� as per management plan provided b plumber. 2. All setback requirements must be maintained i \ �CUI'Y7 ( - FOLD %3 VS� as per applicable code /ordinances. J � Co _ o dP LET 4 / �L'oy 65)Z C �IEG� � ��L �r n/Cr Y')/j v &Wi P /P6� oo D,C'41AY - 162 6 - 7�Wk. U k pe p— ; �- loo �� .� �'O/��7c' L�sT �JGr its � '7�2� d �-, . ; i �Zc l s 2�1 'a3 lam /� IPAAAY, #12Y33 t7 C . m I � � I � i 1� 8' S 1 - y x uMQ�r� Tim M rr asTo r f ��75yg o ca _ c o m W 0 Z U 0 U m Q Q v.. y C ° W O m m m W H Z O y W w c W v O Z JZ w Ito N v Wy �a a 0 Z� ' o o c o W S' E € ,; c lU Z 10 o o am ° E o f ° m c EQ v 2` 3r W D m y W O W C . j W O C 0 m CL N D w L� m �W a° O �E y m i, E 5 Q � c r Q '. s a.c o CL - ` O `oN 0 IL n w y° � N z z w c n t 0 a y _> _3 �� �� m� N =_ 'C.. y y W W x ~ x f C O W m y ° U C .t. y m y C ; m W _ Z M a m p ` 0 `O a p` S :° m r a 3 O m Y 2 " 7 ` O_ y C 3 L ` W 3 W 3 N W L L O d C —. fl_ !� W b1 Ol p) m 3 m 'c E .. . p c W z y N c ° c m m m E = c I- J L W O m° m e L m m" ° Q m m m L) �' Q W �� � 0 o �E `-c �y _ E mE N W I � ° 8Y �E E �« �� �o . a w w W Z U w Oz 0 � W �0 Cn � _ flC Z F— > Z U) W D U) p 5 (1 ) LE W ('� m _3 CI CI(J) Z Z !"1 W uj j 0 00 D V Z �U U ,— W N ° Q w O _ Q j � �Z U a W � D O O CL t— a o w � ? W A � m Q m > W CD 0 VI v 0 w 2 w m O o W w Z Z a. Lei ;,> Z D 3: m Q u, O = O a. E— i— )4 VE 2 3 3 d G rn z o� p i i PR°PCPTY OW N0 ` 1 UInR T) m M rrrt1 7 ��7Syg 9 E r a ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the '�f-V , A • residence located at: ' /4, S W '/4, Section , TownN, Range Town of S iin10-FiE/ n , St. roix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirelnents of Comm. 8A.25, and it (they) appear(s) to be functioning properly. -- ( 33 7- Most recent date of service PEA 7- d�� 6 Did flow back occur from absorption system? Yes No (if no, skip next line.) Approximate volume or length of time: gallons minutes Capacity: 1 Construction: Prefab Concrete_ Steel Other Manufacturer (if known): Age of T k (if known): 1 Ti 1►'c i T r� FS �R�� (Licensed mber Signature) (Print Name) /Ywr a- y/pAt 3ed R ST (Title) (License Number) MP/MPRS (Date) Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer S 4 I E 0,6 Mailing Address /O 7 W I N D d t A M Property Address 2q 33 76-\� nd y1 V� (iUI LSQ 6J 7 (Verification required from Planning & Zoning Department for new construction) City /State W J L1 p t W-T- Parcel Identification Number 0 6 3 LEGAL DESCRIPTION Property Location' /4 , S0 i/4 ,Sec., TN R _ZS Town of SPR11 FWD t1� RSf !�T 3 Subdivision PJAT 0 f ,i-) 4914 .2. �j .rGc/ } Lot # /— Certified Survey Map # , Volume , Page # Warranty Deed # l� D Volume 2 F6 3 Page # 1 Spec house yes 00 Lot lines identifiable yes 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 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. 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. I /we certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number o edrooms SIGNATURE OF APPLICANT(S) DATE ** *Any information that is misrepresented 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 Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) ST CIRD CO 0 A A IL UNTY PLANNING & ZONING MEMO DATE: OCTOBER 24, 2006 �rf TO: STEVE SCHREIBER, PROPERTY OWNER Code Administradon FROM: PAM QUINN, ZONING SPECIALIST 715 - 386 -4680 RE: PERMIT #STC- 0108 FOR SANITARY RECONNECTION TO AN Land Information & ` EXISTING POWTS Planning 715 -386 -4674 Real Propeny Enclosed is a copy of the Affidavit of Reconnection recorded on 9/25/06. 1 had 715 - 386=4677 been given information over the phone regarding the location of the existing POWTS, which resulted in my using Evelyn Spielman's property description instead Recycling of property formerly owned by Jeff Spielman. Now that I have received the permit 715 - 386 -4675 application and have copies of the correct deeds for Lots 1 — 8 in Block 20 of the Village of Hersey, the Register of Deeds office recommended that an affidavit of correction be recorded. I drafted a form for your signature, which does require notarization. If you will complete and return the correction affidavit to the zoning department, I will submit it to the Register of Deeds for recording. The original document #835316 will be attached to the correction. The reconnection permit was issued 10/24/06; please contact Tim Mittlestadt for owner's copies of paperwork and to arrange for reconnection to the POWTS. Thanks in advance for your cooperation. I . ST-CRoix COUNTY GOVERNMENT CENTER 1 lO 1 CARMICHAEL ROAD HuDsoN, Wl 54016 7153864686 FAx PZ @CO. SAINT- CROIX _WI.US WWW.CO.SAI \NI.US I - 835316 `l KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO,, WI RECEIVED FOR RECORD Document Number Document Title 09/25/2 006 @2: 30P![ St. Croix Cou AFFIDAVIT EXEMPT # Affidavit of Reconnection to Existing POWTS REC FEE 11.00 TRANS FEE: COPY FEE: S' CC FEE: l-p PAGES: 1 Name - (Owner) Typed or printed being duly sworn , states, under oath, that: 7 1. He /she is the owner /part owner of the following parcel of land located in St. Croix County, Wisconsin, recorded in Volume 13 Page 3qQ Document Number 51,2 St. Croix County Register of Deeds Office: Recording Area A parcel of land located in the * 7 '/4 of theSW / ' /� 2 f `lame and Return Addreas of Section g f-- LQ rc 4 T — 701 N — R �j W, Town of SejQIA/C F / �L )\ , St. Croix !� 7 County, Wisconsin, being duly described as follows (include lot no. and subdivision/CSM or detailed legal description): L I e- "—f - f li' o ! LO TS S V � k 7C �PT" 9 fT. E W17 SlD F 03q 0 S- - O L- a eK l y v 1 LL 4C� O F 1 fI � - Parcel Identification Number (PIN) As owner of he above described property, I acknowledge that the existing Private On -site Wastewater Treatment System (POWTS) serving this residence � s not) undersized 6 current code standards for a _3_ bedroom 1 -2 family dwelling. The system components have been inspected and certifie by a licensed master plumber to be in good condition and appear to be functioning properly. There was no indication of failure i.e. ponding or surfacing of wastewater in the distribution portion of the system at the time of inspection. I understand that the issuance of a county sanitary permit to allow the reconnection of the septic system does not imply that the system meets current code sizing requirements, nor does it imply that the system will continue to function after it is placed R also acknowledge that I will disclose this information to any future parties interested in purchasing this property. ..... Dated this 2 day of '5 — �� ,,. �+• Vv AUTHENTICATION ACKNOWLEDGMEN... Signatures) STATE OF WISCONSIN ) )ss. autherntcated this day of St. Croix County. ) Personally came before me this A5 day of 2 Do {Q the above named 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 acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY Notary Public, State of Wisconsin (Signatures may be authenticated or acknowledged. Both are not My Commission is permanent. If not, state expiration date: necessary.) Date: 12V 3 f d /,a "THIS PAGE IS PART OF THIS LEGAL DOCUMENT— DO NOT REMOVE" This information must be completed by submitter: document title. name & return address. and 'SIN, (if required). Other information such as the granting clauses, leagal description, etc. may be placed on this first page of the document or may be placed on additional pages of the document. Note: Use of this cover page adds one page to your document and $2.00 to the reggn9aa fee. wsconsin Statutes, 59.517 AFFIDAVIT OF Document Number CORRECTION (ME PRINT CLEARLY IN BLACKfit RED M AFFIANT, �? 'V� S WR,67Bj� here swears or affirms that a certain document recorded on the -- day of 200 G (yw) in volume page . as document number 2231 & which was recorded in r.01 X Canty. State of Wnc onsin, contained the following error (if more space is needed, please attach addendum): ¢ �� LE6�14. b E5CR/1'?7 a1J r LU TS' �` l-DT" 6 EXCEPT 9 PT, STS /1�E 77� _8z_ a Cr— /y, V/ i_ L_ A -6 OF H& - 3 /0 6 AS R'eZaedi� lr4 Y ourno E 13'13 p� e �3�`q� 2 xxo � / AE�FIANT makes this Affidavit for the purpose of coMing' tea abovo Name mod Retum Addms as follows (if more space is needed. please attach addendum): 157 - - L oTS �; 2; If. 5, rv, 7 a n c✓ d' � �oc,� �d lo twin/ ,Dmiu V A X In Ordj "`Ira/ A0- of -11ie- Vs/ y e ��/-12� -re C ci ua- /6 13 J ! 0 3Y-W 7- 61 9-00 1; �D �a Q 2 3 � I on Phimba ! kS f- eCdr'dG� in Yolu�ne Z 3� JOGtc rn end /U� ,bar 740 b� D3Y- /o�� S�OrX1� o3y /oar i�-o�a AFFIANT is the (check one): d 3 (-/ /OJ'f ' /0 S O Drafter of the document being corrected. OYOwner of the property described in the document being corrected. 0 Other (explain: / �. The original document (in part or whole) [Q is O is not attached to this Affidavit Of orkhW document Is not attached, please attach legal description and names of grantors and grantees). Signed: s ' State of Wisconsin ) ) ss. County of ) Subscribed and sworn to (or affirmned) before me this day of s Notary Public. State of Wisconsin My Commission (e)pires) (is): — AiS INSTRUMENT WAS DRAFro BY: This instrument p is 01 (check one) a coaveyasice of real proper as s. 77.21(1 wiscCosin Statutes. - - (A Wisconsin Real I:attttt0 Transfer Return is rq�itirt d for tints dik do ooavey r •Nimes or penm stsnins in any Gawk r aMat be WW or Wk blow theirs amine. I 8353 1 6 KATHLEEN H, h►ALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD Document Number Document Title 09/25/2006 02:3013M St. Croix County AFFIDAVIT EXEhWT # Affidavit of Reconnection to Existing POWTS REC FEE 11.00 TRANS FEE: COPY FEE: CC FEE: -� PAGES: 1 Name - (Owner) Typed or printed being duly sworn , states, under oath, that: 1. He /she is the owner /part owner of the following parcel of land located in St. ` Croix County, Wisconsin, recorded in Volume 1_3 Page 3 pia Document Number 5157 R9 St. Croix County Register of Deeds Office: Recording Area / o2� Name and Return Address A parcel of land located in the Ne ' /o of they/' /< of Section .5 r-e j P4,- T� N — R 15 W, Town of _ - AIC F / E7 St. Croix !--7 County, Wisconsin, being duly described as follows (include lot no. and subdivision/CSM or detailed legal description): "`�� �'` - ffi' 5q a LOTS S V (P 'EX P7 9 fT. E ST S,D 6-7 03q - O g J�-�oO -OU Parcel Ide Number (PIN) ) eL-al✓« i , VII- L44-16 aF 14 sl As owner oUhe above described property, I acknowledge that the existing Private On -site Wastewater Treatment System (POWTS) serving this residence s s not) undersized 6Vcurrent code standards for a -- bedroom 1 -2 family dwelling. The system components have been inspected and certified by a licensed master plumber to be in good condition and appear to be functioning properly. There was no indication of failure i.e. ponding or surfacing of wastewater in the distribution portion of the system at the time of inspection. I understand that the issuance of a county sanitary permit to allow the reconnection of the septic system does not imply that the system meets current code sizing requirements, nor does it imply that the system will continue to function after it is placed back in service. I also acknowledge that 1 will disclose this information to any future parties interested in purchasing this property. Dated this 2 day of 5t� {. 0 � t * °'��-'� r� 5c Li r .e i ��/' * i cn c _'(r, � i ►- AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ass. authenitcated this day of St. Croix County. ) Personally came before me this A_ day ofs' � Do - the above named 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 acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY �e yF? sc. r � b r � � j�c.)��i;, Notary Public, State of Wisconsin (Signatures may be authenticated or acknowledged. Both are not My Commission is permanent. If not, state expiration date: necessary.) Date: I Q 3 / 0 "THIS PAGE IS PART OF THIS LEGAL DOCUMENT— DO NOT REMOVE" This information must be completed by submitter. document title. name & return address and PIN (if required). Other information such as the granting clauses, leagal description, etc, may be placed on this first page of the document or maybe placed on additional pages of the document. Note: Use of this cover page adds one page to your document and 52.00 to the recording fee. Wisconsin Statutes, 59.517. I- I I 1 , t•'I 4A/l I ' e " r r ' �I sW *� V +�,' � � � L /BERTY , J- s' - T 7 ns v F77 3A l U JN� VC' U I - tt I i i HA PP k H Y °� " - 77 , 1 1 d S T. iz ' le.:.. , �.... r.._T . -.. ., - -e - 6e ....• <. - eo I „ 6d`_i .. .. { - 'a 'p_'I' --- -. "T — Ae` G R.A -N.. ,(/yrl.•e - lt:,t Je /I ny .. , /s 4 s - ,S F'<t! A CIE. <1 N • s " �' +ri �"E't�.. (',I� / 1 1 3 I 5 • _ /� } `/ ..� �G� r 4 a ' I •I• V I'� j 7 �en/'U / ricl'S yl ao I �9� 4 °r f 6 /()J Czi: v / ` G 1.1 'J. It -- I`� / I a ` P n i --•_ � ("in,. fur -a.. /A93 m u..�4.� e I e � I 4 I I 1 • pp ' fJ� 1 4 � n' - $ f/o1'rast PG7 6.e.t•.o., ,Bw,zf.w __....._ _... dhtzt the uzl/uiz. i7c t'n CSCe COrr rc�+resesufco.� aFdhc 7'ounlcrt �r/7lersey us surv�ed / "b ' y rne/l or. vzal /tvac7erElu/ c!z E7. �.•nf rir:lo!• llle/•eoF 6 cclwsc-' orc&r Nte —d � • cen r/ .Th•at Sau7l.Pla t u sitzEEOtecZ�orri t/z.t� r6. I - �'(.S!►' J uuf1; 'casE Quartz( �e .B oF�eeCwri�a Tave+t /zE� «.r �v✓5� erz . "L'o�zneslu�v_ 7'we�zf�Z lYirze'(zz9� Vorfl.� o�.it'arr�e �Vo Fz/fee �/6- 7res 2,1e eW Wwcu,..s ui: .'Chat &a/, - s&Aes are X e+ cet fAf, Z l7.z ch cold lot C n ee,V. tznc� iro>v � e an ce.nere s Ala �ttCdi uv tjze/ Jc I l i vr>urs, to earf fC.t /h t- Urce SaxEeeraEl //6� cSeGlwrtJ Dorn "er �f�iC Lt�2L - rfre o�flee rSuzef!=e )t�crC �zewttr• of <WCCH01V A 7 , 1 f� set . f e., ld e4,-ere.' Wild, MAE- 167erfcece; an+." uE tjaP/ O> r c�eSi er► f�v a�6� cfeclzon Corner :i:. fhc- eSou�eA,. fa , �; t/'the �ecE�aru L zhe' af' eSdE'd 45eazorz- (zS� a . T Rail (4z) trcc�tes Zor� vel•C - "" c/ SeaE, tvuZ ccL frcP/ On 4 - drzEeercth�j' %� 6ec fit o // /te Zi11'e' du- ee�z>�ccicu/zS CS Zycz T-rKaiZ- e3 /s,zelces Zor� vertzca7 i'e���Tzut scud iron hlurszurzen/.s c. �cL_i} /u r s ct correct rejo,"entcztEas� of aZZ �hG a tterior 6oursdce-ier o/ ai-e- Zcuz. Z �urz/ty clr t1�' aCzzz szozz s rru �.rr./e�ltee{ zl'c�1.iz f /�e �ruzzsiultS o/' C'Jzu� {er•.. /(,�/ u/ szlzf �teziseol d` ~ tetl - trees tn� �zerierJzru�. .S'ulic7iz��� cr�zc�- 1j1u�Pziu� e5i(.r�r� cum�L ` U 2803P 231 KATHLEEN H. WALSH State Bar of Wisconsin Form 2 -2003 REGISTER OF DEEDS WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD Document Number Document Name 05/17/2005 08:00AlS WARRANTY DEED E%WT # THIS DEED, made between Jeffrey Slilielman REC FEE: 13.00 ( "Grantor," whether one or more), TRAITS FEE: 150.00 and Christine A Schreiber anr3 , e- >A Srhrei bar wife COPY FEE : }�,chanri ( "Grantee," whether one or more). CC FEE PAGES: 2 Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant Recording Area interests, in St. Croix County, State of Wisconsin ( "Property") (if more space is needed, please attach addendum): Name and Return Address See Attached Exhibit "A" HIAWATHA NATIONAL BANK 207 S McKay Ave PO Box 219 Spring Valley, WI 54767 34-1062-20-12 034- 1087 -60 -001• 034 -1087- - 000.034- 1087 -90 -010; 034-1087-95-010 034-1087-59-000 _ 034 - 1088 -10- 010;034- 1088 -1(I -025 Parcel Identification Number (PIN) This is homestead property. Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated _ 5 11 Z (SEAL). (SEAL) * * Spi an (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) Jeffrey Spielman ST ATE ) authenticated on Z ) ss. ` COUNTY ) * Kristine Ogland r Personally came before me on TITLE: MEMBER STATE BAR OF WISCONSIN the above -named (If not, to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: Attorney Kristina Oaland Notary Public, State of Hudson WI 54016 My Commission (is permanent) (expires: ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED © 2003 STATE BAR OF WISCONSIN FORM NO. 2 -2003 Type name below signatures. INFO -PROTM Legal Forms 800. 655 -2021 www.infoproforms.com U 2803P 232 EXHIBIT " A " The land referred to in this Commitment is described as follows: Lots 1, 2, 4, 5, 6, 7 and 8, Block 20 in Original Plat of the VillagQ of Hersey. Part of the Southwest Quarter (SW' /.) of Section 28, Township 29 North, Range 15 West, described as follows: That part of the Southeast Quarter of the Northwest Quarter (SE% of SW %) of Section 28, Township 29 North, Range 15 West of the Fourth Principal Meridian bounded as follows: One the West by the East line of Brandt Road; on the North by the South line of Exchange Street; on the East by the West line of Adams Street; and on the South by a line parallel with a distant 50 feet Northeasterly, measured by right angles, from the center line of the main tract of the Chicago, St. Paul, Minneapolis and Omaha Railway (now the Chicago and Northwestem Transportation Company) as said main track center line is presently located and established. St. Croix County, Wisconsin. i Parcel #: 034 - 1088 -10 -025 10/20/2006 02:26 PM PAGE 1 OF 1 Alt. Parcel #: 28.29.15.567H -10 034 - TOWN OF SPRINGFIELD 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 CHRISTINE A & STEVE C SCHREIBER O - SCHREIBER, CHRISTINE A & STEVE C 714 292ND ST WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC SP 7059 SPRINGFIELD SAN DIST #1 Legal Description: Acres: 0.000 Plat: N/A -NOT AVAILABLE SEC 28 T29N R15W LOT 8 B LK 20 VIL HERSEY Block/Condo Bldg: & THOSE PTS OF ABANDONED ADAMS & EXCHANGE ST Tract(s): (Sec- Twn -Rng 40 114 160 114) 28- 29N -15W Notes: Parcel History: D T pe 05/1 2005 795068 2803/231 WD �� �I 04/16/2 1 660 174AI970 1 /06/1999 189 1393/342 m� 2006 SUMMARY Bill #: Fair Market Value: Assessed with: Valuations Last Changed: 06 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 1,000 0 1,000 NO Totals for 2006: General Property 0.000 1,000 0 1,000 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 1,000 0 1,000 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 Parcel #: 034 - 1088 -10 -010 10/20/2006 02:26 PM PAGE 1 OF 1 Alt.'-Parcel #: 28.29.15.567G -10 034 - TOWN OF SPRINGFIELD Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co -Owner CHRISTINE A & STEVE C SCHREIBER O - SCHREIBER, CHRISTINE A & STEVE C 714 292ND ST WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC SP 7059 SPRINGFIELD SAN DIST #1 Legal Description: Acres: 0.000 Plat: N/A -NOT AVAILABLE SEC 28 T29N RI 5W LQLZBL 20 VIL HERSEY Block/Condo Bldg: ALSO THAT PT OF ABANDONED EXCHANGE ST Tract(s): (Sec- Twn -Rng 40114 160 1/4) 28- 29N -15W Notes: Parcel History: Date Doc # Vol /Page Type 05/17/2005 795068 2803/231 WD 04/16/2003 717488 2207/535 MISC 10/30/2001 660488 1749/270 QC 01/06/1999 595189 1393/342 TI more 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/03/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 950 0 950 NO Totals for 2006: General Property 0.000 950 0 950 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 950 0 950 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 Marcel #: 034 - 1087 -95 -010 10/20/2006 02:26 PM P A G E 1 O F 7 Alt. Parcel #: 28.29.15.567F -10 034 - TOWN OF SPRINGFIELD 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 CHRISTINE A & STEVE C SCHREIBER O - SCHREIBER, CHRISTINE A & STEVE C 714 292ND ST WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): • = Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC SP 7059 SPRINGFIELD SAN DIST #1 Legal Description: Acres: 0.000 Plat: N/A -NOT AVAILABLE SEC 28 T29N R15W LOT 6 BLK 20 VIL HERSEY Block/Condo Bldg: ALSO THAT PT OF ABANDONED EXCHANGE ST Tract(s): (Sec- Twn -Rng 401/4 1601/4) 28- 29N -15W Notes: Parcel History: Date Doc # Vol /Page Type 05/17/2005 795068 2803/231 WD 04/16/2003 717488 2207/535 MISC 11291506 WD 689/106 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/03/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 950 0 950 NO Totals for 2006: General Property 0.000 950 0 950 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 950 0 950 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 i Parcel #: 034 - 1087 -90 -010 10/20/2006 02:26 PM PAGE 1 OF 1 AIY: Parcel #: 28.29.15.567E -10 034 - TOWN OF SPRINGFIELD 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 CHRISTINE A & STEVE C SCHREIBER O - SCHREIBER, CHRISTINE A & STEVE C 714 292ND ST WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC SP 7059 SPRINGFIELD SAN DIST #1 Legal Description: Acres: 0.000 Plat: N/A -NOT AVAILABLE SEC 28 T29N R15W LOT 5 BLK 20 VIL HERSEY Block/Condo Bldg: ALSO THAT PT OF ABANDONED EXCHANGE ST Tract(s): (Sec- Twn -Rng 401/4 1601/4) 28- 29N -15W Notes: Parcel History: Date Doc # Vol /Page Type 05/17/2005 795068 2803/231 WD 04/16/2003 717488 2207/535 MISC 1107/459 WD 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/03/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 950 0 950 NO Totals for 2006: General Property 0.000 950 0 950 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 950 0 950 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 Parcel #: 034 - 1087 -80 -000 10/2012006 02:26 PM PAGE 1 OF 1 Alt. Parcel M 28.29.15.567D 034 - TOWN OF SPRINGFIELD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co -Owner CHRISTINE A & STEVE C SCHREIBER O - SCHREIBER, CHRISTINE A & STEVE C 714 292ND ST WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): • = Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC SP 7059 SPRINGFIELD SAN DIST #1 Legal Description: Acres: 0.000 Plat: N/A -NOT AVAILABLE SEC 28 T29N R15W LOT 4 BLK 20 VIL HERSEY Block/Condo Bldg: EZ- UT- 1267/588 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 28- 29N -15W Notes: Parcel History: Date Doc # Vol /Page Type 05/17/2005 795068 2803/231 WD 07/23/1997 1107/459 WD 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/25/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 900 0 900 NO Totals for 2006: General Property 0.000 900 0 900 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 900 0 900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 - Parcel #: 034 - 1087 -60 -001 10/20/2006 02:26 PM PAGE 1 OF 1 Alt, Parcel #: 28.29.15.567B 034 - TOWN OF SPRINGFIELD 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 Go-Owner CHRISTINE A & STEVE C SCHREIBER O - SCHREIBER, CHRISTINE A & STEVE C 714 292ND ST WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC SP 7059 SPRINGFIELD SAN DIST #1 Legal Descriptio 0 Acres: 0.0 Plat: N/A -NOT AVAILABLE SEC 28 T29N 15W LOT 2 BLK 20 VIL HERSEY Block/Condo Bldg: EZ -UT- 1267/5 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 28- 29N -15W Notes: Parcel History: Date Doc # Vol /Page Type 05/17/2005 795068 2803/231 WD 10/30/2001 660488 1749/270 QC 01/06/1999 595189 1393/342 TI 07/23/1997 880/170 more 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06125/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 900 0 900 NO Totals for 2006: General Property 0.000 900 0 900 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 900 0 900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Del Total 0.00 0.00 Parcel #: 034 - 1087 -59 -000 10/20/2006 02:26 PM PAGE 1 OF 1 Alt. Parcel M 28.29.15.567A -10 034 - TOWN OF SPRINGFIELD 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 CHRISTINE A & STEVE C SCHREIBER O - SCHREIBER, CHRISTINE A & STEVE C 714 292ND ST WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC SP 7059 SPRINGFIELD SAN DIST #1 Legal Description: Acres: 0.000 Plat: N/A -NOT AVAILABLE SEC 28 T29N R15W LOT 1 BLK 20 VIL HERSEY Block/Condo Bldg: ALSO PT OF ABANDONED ADAMS ST Tract(s): (Sec- Twn -Rng 401/4 1601/4) 28- 29N -15W Notes: Parcel History: Date Doc # Vol /Page Type 05/17/2005 795068 2803/231 WD 04/16/2003 717488 2207/535 MISC 10130/2001 660488 1749/270 QC 01/0611999 595189 1393/342 Ti more... 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/03/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 950 0 950 NO Totals for 2006: General Property 0.000 950 0 950 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 950 0 950 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 U 2 8 4 8 P 5 7 8 tZI IL 4Z) 1S 2 1 STATE BAR OF WISCONSIN F6RM I -1998 KATHLEEN H. MALSH WARRANTY DEED REGISTER OF DEEDS ' Docu ment Number ST. CROIX CO., w I This Deed, made between Jame L. Schilling and Melba RECEIVED FOR RECORD Schilli hu sband and wife, — — 07/22/2005 10:20AM - - - -- - - - -- - — - - -- - - - - - -— --- - - - - -- - WARRANTY DEED EXEMPT # Grantor,and MCH Consultants, A W- iscon LL C ---- -- REC FEE: 11.00 -- -- — -- - - - - -- -- - - -- - - -- - -- - -- -- -- - TRANS FEE.- 6.00 COPY FEE: CC FEE: Grantee — — - ` PAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (The "Property "): Recording Area Name and Return Address Lot 3, Block 20, Village of Hersey. James H. Krave n Sec 28, T29N, R 15 W Attorney Law P hi \ ' PO Box 300 4 Glenwood City, WI 54013 034- 1087 -70 -000 It Number (PIN) This _ i s i na#emestead property. (is) (is not) Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements and encumbrances of record. Dated this 23r day of March 20 9 , ��e s�L. Schillin � � - -- -- . _Melba Schillinger AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) Jam L. Schillinger and Melba — ) SS. County. ) r Schill e _�_ _-- _______ Personally came before me this _ day of au henticated t s >f '' t 2005 the above named + J mes H Kra ve _ -- - - - -` - -� - -' T LE: MEMBER STATE BAR OF WISCONSIN - - to me known to be the person(s) who executed the foregoing (If not, _ instrument and acknowledge the same. authorized by § 706.06, Wis. Stam) TliIS INSTRUMENT WAS DRAFTED BY • James H. Krave, Attorney at La — Glenwood City, Wisconsin 54013 Notary Public, State of Wisconsin My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not ) necessary. ) — -- ------ -- .___,.._ —.— _ -- -- *Names of persons signing in any capacity should be typed or printed below their signatures STATE BAR OF WISCONSIN WARRANTY DEED FORM No. I - 194E INFORMATION PROFESSIONALS COMPANY FOND llli LAC. WI tla O- 655 -2021 Parcel #: 034 - 1087 -70 -000 10/2 0/ 2 006 02:27 PM ` PAGE 7 OF 1 Alt' Parcel #: 28.29.15.567C 034 - TOWN OF SPRINGFIELD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: _ , _ ti I „ Owner(s): O = Current Owner, C = Current Co - Owner MCH CONSULTANTS O -MCH CONSULTANTS 10TWINDMILLWAY GLENWO D CITY WI 54013 Districts: SC = School SP = Special Property Address(es): �, n -* = Primary Type Dist # Description * 2928 74TH AVE �S �� ' VVJ ✓J t�� /� SC 2198 GLENWOOD CITY SP 1700 WITC SP 7059 SPRINGFIELD SAN DIST #1 Legal Description: Acres: 0.000 Plat: N/A -NOT AVAILABLE SEC 28 T29N R15W LOT 3 BLK 20 VIL HERSEY Block/Condo Bldg: EZ- UT- 1267/587 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 28- 29N -15W Notes Parcel History: Date Doc # Vol /Page Type 07/22/2005 801082 2848/579 WD 07/23/1997 1041/213 WD 07/23/1997 695/156 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations Last Changed: 05/26/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 900 0 900 NO Totals for 2006: General Property 0.000 900 0 900 Woodland 0.000 0 0 Totals for 2005 General Property 0.000 900 0 900 Woodland 0.000 0 0 Lottery Credit Claim Count: 0 Certification Date: Batch #: 111 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00