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PP P '7 Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix rui ding Division INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) State Pla ID No: 3 �7 0 Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)I. I+ Permit Holder's Name City Village X ownship Parcel Tax No: CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: add 6,11 c5T . 1 7, , / 47 TANK INFORMATION ELEVATION DATA i o TYPE MANUFACTURER r AJ CAPACITY STATION BS HI FS ELEV. Septic 1.1 Z • Benchmark S i� W(��5 J d-- Z • /OQ O Alt. BMl a L' 60 ��� . Aer tion L Bldg. Sewer Holding 7 SUHt Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD DWRiet, Septic 7 gad A14 35 _ oksatecn aJ / 8(p Z� -2 � N� 133 i _ Header /Man. 'U-7 � �G Aeration /� Dist. Pipe /3, 3. Holding rA Bot. System F' al Grade PUMP /SIPHON INFORMATION Manufacturer Dem and St Cover fr rl li g2 � Fu. 7 Model Number TDH Lift Friction Loss Isystem TDH Ft 2. e.9 . o Forcemain Length Dia. Dist. to well 71 Z rw c Il R� SOIL ABSORPTION SYSTEM BEDITRENCH Width Length / No. Of Trenches PIT DIMENSIONS No. Of Pit Inside Dia. Liquid Depth DIMENSIONS � 8� SETBACK SYSTEM TO O P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: {C INFORMATION CHAMBER OR Type Of System: 1451 N O- UNIT Model Number: DISTRIBUTION SYSTEM 1 Header/Manifold j Distribution I x Hole Size x Hole Spacing Vent to Al r I take 1-ength / O T P,p(s) � �.. Dia Length Dia _ Spacing �— SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over I Depth Over - Depth o j xx Seeded /Sodded xx Mulch d Bed/french Cent M / / Bed/ I rench Edges \ Topsoil i V \ \\ s Q No M M No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: F ►� 1 C G JL� �L Ga Je,4 W Parcel No: 1.) Alt BM Description 2.) Bldg sewer length = ' - amount of cover = Plan revision Required? ❑ Yes XN, Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor ignatur Cert. No. Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 nsin Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) �j Depar Commerce (608) z66 -3151 Sanitary Permit Application State Plan l l � mbcr In accord with Comm 83.21, Wis. Adm. Code, personal ' c /v may be used for secondary purposes Privacy La , s15. � Project Address (if different than mailing address) / I. Application Information — Please Print nformation 75 q � P11 A� -.4 A Property Owner's Name WIV Parcel # Lot # Block # ST. CKUIx COUNTY b ' ID zz Gv 6Qb Property Owner's Mailing Address Property Location �4'7 l 9 3 0 / 41 * ��o r � C. /., J �' 'V., Section City �/��State � / �� �j Zip C(ofde "� -P7ho`ne NumLber Z.� y rV �C 1 rl/ ¢ [ �' ` ! 17 " Z J 6 f f �S ci nc) T � 11. Type of Building (check all that apply) N: R� r kL 'ok i4 Subdivision Name CSM Number WI or 2 Family Dwelling - Number of Bedrooms Q /�� � ❑ Public/Commercial - Describe Use aK.. (J� *&e, ❑ State Owned - Describe Use 2 t 2Z.} Z City_0Villagc 91 f applble) ownship of Ill. Type of Permit: (Check only one box on line A. Complete line B iica A. New S X ys ❑Replacement System ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POTS System- Check all that appl ' - Jon - Pressurized In - Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter Cl Constructed Wetland ❑ Pressurized In- Ground ❑ Holding ank ❑ Peat Filter ❑ Aerobic Treatment Unit Recirculating an Filter ❑ 8 ❑ Sand Ft B Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Prip Line ❑ Gravel -less Pipc ❑ er ex i ) V. Dispersal/Treapment Area Information: - r 1-CAc Design Flow (gpd) Design Soil Application Ra pdsf) Dispersal Area Required (s Dispersal oscd (s System Elevation �ao 1 I 1 85, 7 ✓ 37' `f o `19.0 e cs VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units C crcte Constructed Glass New Existing Tanks Tanks Septic or Holding Tank .� ti r l0 C Aerobic Treatment Unit Dosing Chamber t� VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumbcr' Signature MP/MPRS Number Business Phone Number -'772— - 3Z/ Plumber' Address (Street, City, State, Zi Codc) t 2� 0 LJ( &7?,l r. e, 1 z� _V"1111,County /De artment Use Onl Approved Disapprov Sanitary Permit Fee (includes Groundwater Date Issued Issuin ent Sign rc o Sea s) 0 0 Surcharge Fee) Ava 4e Owner rven Reason for Denial !i IX. Conditions of ApprovaVReasons for Disapproval SYSTEM OWNER: 1. Septic tank,,effluont filtor and dispersal ce0 must all be servicesbe services / ice as per management plan provided by plumber. 2 AN 30=k requirements must.be,maintained as per appDC" code / ord nan - Attach complete plans (to the County only) for the system on paper not less than 81/2 x I 1 inches in size SBD -6398 (R. 01/03) s l 1 L 1 z,2 r` n ti R t r 7 zZ L L �� CC3P`Y �7 �L r CONVENTIONAL IN- GROUND POWTS DESIGN Residential Application Index and Title page Owner's name: Y >;°IJ`C Owner's address: /3 Site Address: 171 0Z Legal Description: g P Town: h County: Subdivision Name: �dC/�j Lot No. Block No. _ Parcel Identification Number: Page Index Page 1 Index and Title Page 2 Plot Plan (May include septic tank and filter specs) _Page 3 Distribution Cell(s) Cross Section Page 4 Maintenance, Management and Contingency Plans Plumber Name: 1� ®7'+ Credential No. Z Z (L5X Plumber Address: �1 � 0 - Oz u), & Signature: / Date: f 4 - Phone No. 7l J 77 2,- Designed Pursuant to the: In- ground Soil Absorption Manual for POWTS Version 2.0 SBD- 10705 -P (N.01 /01) Page 1 of — VJI a Ti> F J 2. 0 b� Ib V, Lt f 8 iL _ _ 2,a6 System Management Management of this system is critical. As a condition of approval of these plans this system management section must be rep sewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, Roger Timm, 715- 772 -3214, or the St. Croix County Zoning Office, 715.3864680, should be contacted for assistance. General Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a dose tank or compartment to allow a dose to be accumulated, a pump and controls or automatic siphon, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. I . If the septic tank is installed prior to sheet -rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2. Install water- saving appliances whenever and wherever possible, 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5 Garbage disposals are not recommended; if you must have one, use it sparingly 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8 Avoid surge flows of water; try to spread laundry throughout the week. 9 Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or dose tanks are no longer used, they must be properly abandoned. 11. If construction timing and weather could create a frozen infiltration system, weather - proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. 12. If possible, the upslope toe of the mound system should be landscaped with additional fill to blend this area into the upslope natural grade; this will minimize the possibility of the system trapping surface run- off, final settled slope should be 2 -3% over the system or 2 -3% diverting surface run -off around the ends of the system. Maintenance I The septic tank must be inspected every three years by a properly licensed person. 2 If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids , olume equals one third of the tank volume. When the septic tank is pumped, any solids in the bottom of the dose tank must be pumped, and the filter must be back - washed into the septic tank to remove accumulated material. System use may require more frequent filter cleaning; initial inspections of the Filter should be made every 6 months until a minimum time sequence is determined. 4 Periodic observation pipe inspections should be made by the owner to examine the state of the in -situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5 If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6 The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. Avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9 Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10 Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area I I Warning: Do not enter septic, dose or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requiremettits of Comm 83.54 (2) Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and. installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 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 Attach complete site plan on paper not less than 8 V2 x 11 inches in size. Plan must St. Croix Include but not limited to: vertical and horizontal reference point (BM), direc 'u)n.an - arcel I.D. 6- 1022 -60 -000 Percent slope, scale or dimensions, north arrow, and BM referenced to nearer .all in viewed b Date Personal information you provide r ay iFj4poses Privacy Law, s. 15.04 (1) (m)) � /kJ 4 Property Owner Property Location Ste hen Herrold Govt. Lot SW v. SE % S 10 T 31 N R 17 w Property Owner's Mailing Address S 1 Lot # Block # Subd. Name or CSM# 1313 214"' Ave. ST. CROIx COUNTY I nvvLS l I w /,Sig -. �0 ucir.Qa "b� City State 1 P4MWG & ZONMQFFIGE ❑ City ❑ Villa 0 Town Nearest Road New Richmond WI 715 -248 Stanton 220 Ave. 0 New Construction Use: 0 Residential / Number of Bedroom Code derived design flow rate 900 GPD ❑ Replacement 11 Public or Commercial - De cribe: 0 Xja/► ?, ncr -f 0 2--u Parent Material Loess over Outwash Flood Plain elevation if applicable N/A ft. General comments and recommendations: > ' c W wm LA) 1 Boring # Boring H Pit Ground Surface Elevation 98.1 ft. Depth to Limiting factor >90 in. Soil AoDlication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/R in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Efr#1 'Eff#2 1 0-4 10YR3 /3 - SIL 2 -m -gr mfr gs 2f 0.6 0.8 2 4 -8 10YR3/3 - SIL 2 -m -bk mfr as 2f 0.6 0.8 3 8 -13 10YR4/4 - SCL 1 -m -bk mfr gs 1 f 0.2 0.3 4 13 -27 10YR4/4 - GRSCL 2 -m -bk mfr cw 1f 0.4 0.6 5 27 -90+ 10YR4/4 - GRS 0 -sg ml - 1f 0.7 1.6 5A 50-64 10YR3/4 • to 1' Lamella in Horizon #5 S 0- mfr ab - 0.7 1.6 not confinuous ❑ ❑Boring 2 Boring # 0pit Ground Surface Elevation 100.3 ft. Depth to Limiting factor >101 in, Soil ADDlication 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 'EfT#2 1 0-6 10YR3/3 - SCL 2 -m -pl mfr gs 2f 0.0 0.2 2 6 -13 7.5YR4/4 - GRSL 1 -m -bk mfr gs if 0.4 0.7 3 13 -26 10YR4/4 - GRSL 1 -co-bk mfr cw 1f 0.4 0.7 4 26 -101+ 10YR4/4 - GRS 0 -sg ml - - 0.7 1.6 *Effluent #1 = BODs> 30:5 220 mg /L and TSS > 3 <_ 150 mgtL *Effluent #2 = BOD <_ 30 mg/L and TSS 5 30 mg/L CST Name (Please Print) S' re CST Number Mark Iverson 46672 Address Date Evaluation Conducted Telephone Number P.O. Box 155 Hammond, WI 54015 September 3, 2010 715- 796 -5664 Property Owner Stephen H errold Parcel ID# 0 - 1022 -60 -000 page -- 2 - of 3 Boring 0 Boring g OPit Ground Surface Elevation 104.6 ft. Depth to Limiting factor >114 in. Soil Awlication 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 1 0 -7 10YR313 - GRSL 2 -m-gr mfr gs 3f 0.6 1.0 2 7 -19 7.5YR4/4 - GRSL 2 -m -bk mfi gs 2f 0.6 1.0 3 19 -31 7.5YR4/4 - GRLS 1 -co -bk mfr gw 1f 0.7 1.6 4 31 -114+ 7.5YR4/4 - GRS 0 -sg ml - 1f 0.7 1.6 I It 1 4 ❑ Boring Boring # Opit Ground Surface Elevation 97.2 ft. Depth to Limiting factor >I 10 in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell u. Sz. Cont. Color Gr. Sz. Sh. 'Efr#1 'E02 1 0 -9 10YR3/3 - SL 2 -co -bk mfi cs 1f 0.6 1.0 2 9 -18 7.5YR4/4 - GRSL 1 -co -bk mfr gs 1f 0.4 0.7 3 18 -25 7.5YR4/4 - GRS 0 -sg ml cb 1f 0.7 1.6 4 25-49 10YR4/4 - GRCOS 0 -sg ml cb 1f 0.7 1.6 5 49 -110+ 10YR4/4 - S 0 -sg ml - - 0.7 1.6 Boring Boring # OPlt Ground Surface Elevation ft. Depth to Limiting factor in. S oil Applicatio n 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 * Eflluent # 1 = BOD > 30 < 220 mg/L and TSS > 30 _< 150 mg/L * Effluent #2 = BOD 5 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. Page 3 of 3 0 ft. 24 ft. 40 ft. 80 ft. The property lines from BM #1 are approximately 100 feet north, 500 feet west, 600 feet east, and 1000 feet south. BM#1 - Top of 314 "PVC Pipe 100.0' 0 .p B-2 100.3 i B-4 97.2 B -3 of 31 104.6 6M2 -�0 103 A B-1 10 2' 98.1 10 98• 9 6'• i, BM#Elevvatio f pti°n = Bench Mark 010v = Boring Location & Elevation Owner: Stephen Herrold Site Information: Completed By: Mark Iverson, PSS #197 1313 214th Ave. SW1 /4, SE1 /4, S10, T31N, R17W 680 Larcom Street New Richmond, WI 54017 Town of Stanton Hammond, WI 54015 St. Croix County 715 - 796 -5664 Phone: 715- 248 4725 CST# 46672 i I I i i i C .§ 91 o o N ll� O cl e'i M r N M co U-j 00 00 rL �D - O r L q Z M m d Z X v ° W co w LU U W �J zcn � wz C/) .6 w p m o w CD w J C) (7 C/) N m = = LC z F J ® F m �o O =Ln Lu ch = O c0 F— � z N F— W J � Q O l \ IIIIII! ill' Itll' I' I' I 1111Iill llllllili �� �I I VIII I i I I dllllilddild11�11111�19d�11116 i ddllllllliiilllll I IIIIIIIIIIIII Illlllilllillldililllillllllldili I I VIII III Ilillllll III IIilllilildd1111166 �Illdd!lildllll i 111661161 VIII II I I I I III I i d11161�6i�1� , � o - ! lOIiRI 'llllllllllllllllllllllllll III! 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IIIII�C�71f ►llllllillllllllll !11111 ►1:IC]III I' IIIUIIILIIIi !Illlllllllllllldll'IIPlillll i III li i i i i i i I� ► �►,► ii� i6�ibllbblilillll6bl�lillhblllllll�llbllilil�666 �i111 I�IIhIiI jI�I�I�Iiliq ►�� �II ; ��►jlj�;� I►�P��B ��� � � � I � ���� � �����;� !ii��� ��; �� I. i''i ��� � �; � �;� ��� i �� �� � �� I� �i� Ili � � �''i �lili VIII jj�ii �i� ■ _ Ill_L� � IIi► iiiiiiiiii�iiiii� ►�►��►�u�►���►��IIIIII16 � � � , i / = %i 111 i�llll /l / - • _ ,:.11llllllilllllllllli�ll, '� � � � il � ,�'� lllllllDllllllllllllllllllll /lll ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer i Mailing Address /� p� /� � l,t?GV „ �tmer, -►� Property Address 1 7 5 O< R D (Verification required from Planning & Zoning Department for new construction.) City /State Parcel Identification Number 3 6o 0Z 46 —Z�5W LEGAL DESCRIPTION �/ 5 Property Location ! /4 , 5 0 _ '/, , Sec. �b , T _3_N R 1 - 7 W, Town of Subdivision Plat: e96 h , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # (before 2007)Volume , Page # Spec house ! yes no Lot lines identifiable yyes ! 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. 1 /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 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 m /our knowledge. I /we anV t w y g are he o ner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms 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) I IIlIlI 1!111 Illll Illll lllll Illll Ill! llllll Ills Ill! State Bar of Wisconsin Form 2 -2003 8 7 6 5 4 9 1 WARRANTY DEED 876549 Document Name KATHLEEN H. WALSH Document Number REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 06/11/2008 12:15PH THIS DEED, made between Mitchell D. Foster, Sr. and Elizabeth M. Foster WARRANTY DEED husband and wife, EXEMPT ( "Grantor," whether one or more), REC FEE: 11.00 and Stephen.!. Harrold and Kathleen J. Harrold, husband and wife, as survivorship TRANS FEE: 894.00 marital property PAGES: 1 ( "Grantee," whether one or more). Recording Area Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant Name and Return Address interests, in St. Croix County, State of Wisconsin ( "Property ") (if more space is First National Community Bank needed, please attach addendum): PO Box 89 NPw Richmond, WI 54017 West half of Southeast Quarter (W 1/2 of SE 114) of Section Ten (10), Township Thirty -one (31) North, Range Seventeen (17) West, EXCEPT Commencing at the South Quarter (1/4) corner of said Section Ten (10); thence South 89 degrees 35 minutes 20 seconds East, along the South line of the Southeast Quarter (SE 1/4) of 036 -1022 -60-000 said Section, 1201.42 feet to the point of beginning; thence continuing South Parcel Identification Number (PIN) 89 degrees 35 minutes 30 seconds East, along said Southline, 320.0 feet; thence This is not homestead property. North 00 degrees 24 minutes 30 seconds East, 350.00 feet; thence North 89 degrees 35 minutes 30 seconds West, 320.00 feet; thence South 00 degrees 24 minutes 30 seconds West, 350.00 feet to the point of beginning, St. Croix County, Wisconsin. Exceptions to warranties: Subject to all easements, restrictions and covenants of record. Dated the 29th day of May , 2008. (SEAL) i stz - (SEAL) *Mitchell D. Foster, Sr. *Elizabeth M. Foster (SEAL) (SEAL) * * AUTHENTICATION MENT Signature(s) authenticated on STATE OF •WISCONSIN ) e� ) ss. CROIX COUNTY ) NOTARY TITLE: MEMBER STATE BAR OF WIS Ng" nally came before me on May 29, 2008 (If not, 7! above -named Mitchell D. Foster, Sr. and Elizabeth M. authorized by Wis. Stat. § 706. 9 ter to me known to be the person(s) who executed the yylsCp regoi ent ckno ledged the same. THIS INSTRUMENT DRAFTED BY: DF Ronald L. Siler, Van Dvk, Williamson & Siler. S.C. " C. r i A O T - 62 be 11 201 S. Knowles Ave., New Richmond WI 54017 Notary Public, State of Wisconsin My Commission (is permanent) (expires: 09/11/11 ) (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 C 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 * Type name below signatures. INFO - PRO - Legal Forms 800 - 655 -2021 www.inloprotorms.corn 1 of 1 Parcel #: 036- 1022 -60 -000 09/21/2010 02:29 PM PAGE 1 OF 1 Alt. Parcel #: 10.31.17.147 036 - TOWN OF STANTON Current ❑X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner STEPHEN J & KATHLEEN J HARROLD 0 - HARROLD, STEPHEN J & KATHLEEN J 1313 214TH AVE NEW RICHMOND WI 54017 -7447 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 39.050 Plat: N/A -NOT AVAILABLE SEC 10 T31 N R1 7W SW SE EXC COM S1/4 COR Block/Condo Bldg: SEC 10; TH S 89 DEG E ALG S LN SE1 /4 1201.42' TO POB; TH S 89 DEG E ALG S LN Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 320'; TH N 00 DEG E 350'; TH N 89 DEG W 10 -31 N-1 7W 320'; TH S 00 DEG W 350' TO POB Notes: Parcel History: Date Doc # Vol /Page Type 06/11/2008 876549 WD 04/13/1998 577019 1314/171 WD 09/11/1996 533611 1139/274 WD 10/20/1992 490275 976/129 WD 2010 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 04/02/2010 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 34.000 6,300 0 6,300 NO 00 AGRICULTURAL FOREST G5M 5.050 10,100 0 10,100 NO Totals for 2010: General Property 39.050 16,400 0 16,400 Woodland 0.000 0 0 Totals for 2009: General Property 39.050 16,500 0 16,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount I Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel #: 036- 1022 -50 -000 09/21/2010 02:29 PM PAGE 1 OF 1 Alt. Parcel M 10.31.17.146 036 - TOWN OF STANTON Current 1X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co -Owner STEPHEN J & KATHLEEN J HARROLD 0 - HARROLD, STEPHEN J & KATHLEEN J 1313 214TH AVE NEW RICHMOND WI 54017 -7447 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A -NOT AVAILABLE SEC 10 T31 N R17W 40A NW SE Block/Condo Bldg: Tract(s): (Sec- Twn -Rng 401/4 1601/4) 10 -31 N-1 7W Notes: Parcel History: Date Doc # Vol /Page Type 06/11/2008 876549 WD 04/13/1998 577019 1314/171 WD 09/11/1996 533611 1139/274 WD 10/20/1992 490275 976/129 WD 2010 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 04/02/2010 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 24.000 4,400 0 4,400 NO 00 AGRICULTURAL FOREST G5M 16.000 32,000 0 32,000 NO Totals for 2010: General Property 40.000 36,400 0 36,400 Woodland 0.000 0 0 Totals for 2009: General Property 40.000 36,500 0 36,500 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