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HomeMy WebLinkAbout038-1213-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety aAd Building Division INSPECTION REPORT Sanitary Permit No: 453467 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: LaCasse Develop I Star Prairie Township 038 - 1213 -30 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: / CC I /tt[: c`j - j 11.31.18.1164 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic e i S � , Benchmark 5 � ,� , / rr1 � ad Alt M Aeration Bldg. Sewer Holding St/Ht Inlet 7' ;1 c TANK SETBACK INFORMATION St/Ht Outlet 7 Z ZS TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Ai I N q_ 7 ` O / j Dt Bottom Dosing � Header /Man. Aeration _ _ Dist. Pipe Q cl 7 � o Holding Bot. System C c' C'• �� PUMP /SIPHON INFORMATION Final Grade 0 kG 5 Manufactur - -- Demand St Cover t / rt GP /v tr Mod I Number TDH Lift Friction Loss Syst ad TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width i i No. Of Of T renches PIT DIMENSIONS No. f Pits Inside Dia. Liquid epth DIMENSIONS SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREA LEACHING Manufacturer: + INFORMATION CHAMBER OR Type Of System: Z..7 , ;w' UNIT Model Number: A �; DISTRIBUTION SYSTEM 1r1 6 , C, Header /Manifold fi Distribution x Hole Size x Hole Spacing Vent to Air In e , Pipe(s) Length Dia 1 1-ength _ _ Dia Spacing �� ve ' , SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only °~ xx Depth Over / Depth Over xx Depth of xx Seeded/Sodded Mulched Bed/Trench Center Q Bed/Trench Edges Topsoil I No Yes � No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 2241 122nd Street New Richmond, WI 54017 NE 1/4 SW 1/4 11 T31N R18W) River Place Lot 3 Parcel No: 11.31.18.1164 1.) Alt BM Description 1 2.) Bldg sewer length = �� - amount of cover = i Plan revision Required? [ :] Yes o Use other side for additional information. SBD -6710 (R.3/97) Date Insepcto0e /ign Cart. No. Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 i seonsif n Madison, Wl 53707 — 7162 Sanitary Permit Number (to b filled in by Co.) Department of Commfce (608) 266 -3151 L L f Sanitary Permit Application State Plan I.D. Num . In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, s15.04(1)(m) Project Address (if d fYerent than mailing address) I. Application Information — Please Print All Information 2 t` / Z 21 51, Property 0 er's me Parcel # of # Block # 0 39 - / 213 W ei Pro rty wrier s Mailing Address Property Location �� 6 y! <. 7 b - City, S e Zip Code Phone Number 4 1 /4 1 /4, Section _'L""�R� (ci le one) if. T ype of Building (check all that apply) T,�,, 4 N; R or W 1 or 2 Family Dwelling — Number of Bedrooms Subdivision Name ❑ Public/Commercial -- Describe Use El State Owned — Describe Use 1 57 - , e LS - 7 �, ❑City_❑Vil ge Io hip of VA III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A ' 4New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ 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 T e of POW System: Check all that a pply) N — Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade . 0 Single Pass Sand Filter 0 Constructed Wetland Q Pressurize 7,LeachinGround 11 Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit El Recirculating Sand Filter 0 Recirculating Synthetic Media Filter Charnbek Q Prip Line, U Or' el -less PiK ❑ pthcr (explain V. D13 er3al/Treatinent Area In ornruliun -- Design Flow (gpd) Design Soil Application Rate gpds� Dispersal A[Ca Required (sQ Dispersal Area Proposed Elevation Tank Info Capacity in Total Number Manufacturer Prefab Site Steel ibex Plastic: Gallons Gallons of Units Concrete Co trusted Glass T Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber V VII. Res onsi ili Statement- I, the undersigned, assn responsibility for installation of the POW FS shown on the attached plans. Plumber' N e n Plumber' Sign / MP/MPRS Number Business Phone Number u er's ddress tree ity, State, ip ode) --� VIII. n /De 189 Onl PProved ❑Disapproved Sanitary Permit Fee (iris )odes Groundwater Date Issued 4=uingt re tamps) Surcharge Fee) 0 Owner Given Reason for Denial IX. Condid" olfA� p�roval/Reasoos for Disapproval �G q TO �[ SYSTEM OWNEH -" �� eptic tank, effluent filter and dispersal cell must all be serviced / maintained S 5P�c��t -o'er � �%C�c� A?4"6 — as per management plan provided by plumber. 2. All setback requirements must be maintained as per applica* code /ordinances. _ d '0 Attach oomplete plats (lo the County only) for the system on paper not less than 81/2 x 11 inches in siu- SBD -6398 (R. 01/03) �w I I' - I X11 � I i I i i I II M - I , i I i i i I I i Z tk� s C /4Coo �G � w h v 1 'r o w a Q ed' .7 - o • V rzoonsin Department of Commerce SOIL EVALUATION REPORT Page 1 _ of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County St. Cr oix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. pending (� Y 2,1 3 — Please print all information. a 'wed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). (� Property Owner Property Location LaCasse Development, Inc Govt. Lot NE 1/4 SW 1/4 S 11 T 31 N R 18 X (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 573 Cty. Rd. "A" 3 na I River Place City State Zip Code Phone Number ❑ City ❑ Village [RTown Nearest Road Hudson I WI. 1 54016 (715) 381 -5405 [ New Construction Use: @ Residential / Number of bedrooms 4 Code derived design flow r a ` ` GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material ou w sb Flood Plain elevation if applirrable / r m''' r ft U'1 General comments e!( F f rs recommendations: l and recom -x zo 4 � ST cz� �ROIX trenches @ el. 97.90', spaced to code 4.00' below grade -', CO(iNry Boring A �` a Boring # f�1 99.90 1 r3G Pit Ground surface elev. ft. Depth to limiting factor it A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 1 0 -8 10yr4/3 none sil 2msbk mfr gw if .5 .8 •� 2 8 -30 10yr4/4 none sil 2msbk mfr gw if .5 .8 3 30 -12 7.5yr4/4 none grcos s ml na na .7 1.2 •� i Boring # F] Boring 2 ® pit Ground surface elev. _ 99.9 ft Depth to limiting factor 1 20 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fY in. I Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 1 0 -9 10yr4/3 none sil 2msbk mfr gw if .5 .8 .� 2 9 -25 10 4/4 none sil 2msbk mfr qw if •� 3 25 -12 7 5 4 ` ` Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg /L ` u #2 = BOW 30 mg/L a A TSS 5 30 mg/L CST Name (Please Print) Signature CST Number Gary L. Steel 02298 Address k-- - CgriduMed Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 6 -22 -2001 715- 246 -6200 r Property Owner LaCa SSe DeV - , T nC . Parcel ID # pen Page 2 of 3 F- Boring # [] Boring 31 0 pit Ground surface elev. 101.90 ft Depth to limiting factor 120 in. Soil Appl ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont: Color Gr. Sz. Sh. 'Eff#1 •Eff#2 1 0 -14 1Oyr4/3 none sil 2msbk mfr qw if .5 .8 •�' 2 14 -33 10 4/4 none sil 2msbk 3 33 -12 5 4 4 • a" F-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring # F1 Boring Ground surface elev. ft. Depth to limiting factor in. 1:1 Pit Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 * Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS 5 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (P-&M) Y STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 LaCasse Dev., Inc. New Richmond, WI 54017 MPRSW -3254 NE- SW' S11- T31N -R18W (715) 246 -6200 town of Star Prairie .lot D -River Place This soil evaluation was conducted to satisfy a zoning requireanent, it may or may not be suitable for your use. 'the location of the test may or may not be as sTxm as perAnanmt lot lines were not establiebed at the time the test was conducted. N 1" =40' BM.= top of NE lot stake @ el. 100.00' alt. BM.= top of SE lot stake @ el. 99.60' C V X 9 0 m• Gary L. Steel 6 -22 -2001 POWTS OWNER'S MANUAL & MANAGEMENT PLAN, , Rage oF',:�;2_ FILE INFORMATION - " SYSTEM SPECIFICATIONS Owner rak -:1 Septio. Tank C;apsoity ;,,, al C3 Ni- Permit # r t" O Ni 3 Septic Tank, Manufacturer �1kr DESIGN PARAMETERS °" Effluent Filter Manufacturer ❑ NA Number of Bedrooms j ❑ NA Effluent Filter Model C7 NA Number of Public Facility Units Id NA Pump Tank Capacity al NA Estimated flow (average) al /da Pump Tank Manufacturer A NA Design flow (peak), (Estimated x 1,6) g al/da y Pump Manufacturer "'' `' "'' " '`" "' "" ' ' 13-NA Soil Application Rate al /da /fts Pump Model _0NA Standard Influent /Effluent Quality Monthly , average* Pretreatment Unit 16 NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter C1 Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) :5150 mg /L ❑ Disinfection Cl Other: , Pretreated Effluent Quality Monthly average Dispersal Coll(s) ❑ NA Biochemical Oxygen Demand (SOD,) 530 mg /L XQ ln- Ground (gravity) 3 In- Ground (pressurized) g Y p Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade 13 Mound i Fecal Coliform (geometric mean) 510` cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y. in dia. ❑ NA Other: G NA Other: ❑ NA Other: r.:``. <' ,,: ❑ 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: mont s O NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA y ( Inspect dispersal cell(s) At least once every: ea�(s)(s) (Maximum 3 yeas) ❑ NA Clean effluent filter S /� � least once every: 13 monthls) . ❑ NA J M y ear(s) Inspect pump, pump controls & alarm At least once every: ❑ month(s) )ANA ❑ year(s) . E3 monthilsllt;c L %14; NA Flush laterals and pressure test At least once every: ❑ year(s) CY Other; At least once every;. ❑ month(a) ANA ! O year(s) Other , O NA MAINTENANCE INSTRUCTIONSs Inspections of tanks and dispersal calls 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 looks, measure the volume of combined sludge and scum and to check for any back up or pondfng of effluent on the ground surface. The dispersal cells) shall be visually inspected to check the effluent levels in the observation pipes and to cheolt',W pondlnU of effluent on the ground surface. The pondin of effluent on he ground surface may indic r the g t g n y d sate a failing condition and equ immediate notification f 0 o the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or n)ore of the tank volume, the entire contents of the tank shall be removed by Septage Servicing Operator and disposo��. of In 1 i cordons ,With oh w ter NR 113, Wisconsin Administrative Code. A _4 1 ,:..,, .. All other services, Including but not limited to the servicing of effluent filters, mechanical or pressurized compgn®nts, pretreatment units, and any servicing at intervals of 512 months, snail 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 servi GMW (aro1) Y. Page ' -2 01 START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or, chemicals that may impede the treatment process and /or damage the dispersal collie), If high concentrations are detected have 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 excesp wastewater will bo discharged to the dispersal call(s) in one large dose, overloading the collie) and may result in backup - ouHaoe'discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prw. restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the'pum '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; herbicide$;; , aaraps; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed, • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator, • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void .space filled with soil, gravel or another inert solid material, CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide &.,code compliant replacement system: . 4 im t' 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 16fringed 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,­ ­­ 4 e a sit a not b n a aluated t ide tify a sul Is r lacement a. on failure of the POWTS a soil and site uati st perfor ed t ocate suit a replace ant If no rep came ea s all +pbl a ;hold tank y b instal as a last r s to replace t a failed POWTS. 17 Mound and at -grade soil absorption systems may be reconstructed In place following removal of the blomat 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 CIRCUMGTANCES," DEATH MAYMIKI T.-" RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name ,,,. „r. .;, , Phone - — Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY , Name Nanla - Phone Phone "' a�rC w"fw. ett•: .. This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.64(1), (2) & (3), Wisconsin AdmlNttrati" Code. S'T' CROIX COUNTY SEPTIC 'PANIC MAINTENANCE AGREEMENT AND OWMIRS1 111' CERTIFICA'T'ION DORM Owncf/Btiycr _ C role Mailing Address � T 3 Property Address ? / ;z 7� d '� (Veri[ieatiou 1equired lioul Planning Depallillellt for lle4V CnI1StItIC(IOII) City /State 11&'iLl t Gh UAZ .reel meni i emion Nlimi)er LEGAL DESCRIPTION Il Property Location •Al-L l /,, l /4, ,,cc. �, 'f'1N -lt ' W, 'I'owtl of , Subdivisio La Gtto.. . Lot # Ceriifietl Survey Rlnp 11 X� �G(Qc� _, Volume Page 11 Warr ncy Deed It (e 3� 2D 2 Volullic / Z Page I/ � �_• Spec house Ix yes El no. Lot lines identilmble [I' yes El no SYSTEM MAINTENANCE Improper use and maintenaoecof yom septic system could lcsul(in its III cnla (III e fh !fill e to handle wastes. Propertmaiufenaoce eousisls of pumplug out (Ile septic tank evety puce ycais or sooner, If heeded by a licensed pumper. What you put into the systeut can affect the function of the scptic (auk as a Meatmcnf stage in (lie waste disposal system. The properly owner agrees to s(rbohit to St. Croix Zo►ling Deparinlcnt a celtification form, signed by (he owner slid by a utaslerplutnber, journeyri►ar►pluuiber, iesiticicd plumber licensed pumper verifying that (1) the on -rifle wastewatcrdisposal system is in proper operatug condition and /or (2) nilci inspeclion and punhping (if nccessmy), the septic lank is less than 1/3 full of sludge. I /we, file undersigned have read (lie above m1iiifenlews and agree to maintain (he private sewage disposal system with (he standards set forth, herein, as set by.tlie Dcpailrucnt of Coaunerce and Ilse Department of Natural Resources, Slate of Wisconsin Certificaton Mating that your septic systeut has been maintained must be completed and tetut ncd to Ilse St. Croix County Zoning Office within 30 da f file (lire year expiration da(e. SIG A I'U Or APPLICANT I)A•TR OWNER CHURIVICATION I (we) certify that all stalcnlcnts on Ilhis firm, life ltue to the best of toy (our) knowledgc. I (we) ant (are) (Ire owuel(s) of the ll described bovc, by virtue of a wauauly decd lccoldc(I in Itegisler of I)cc(Is Office. / d S[GIJA` E OF I' 'LICAIJZ' llATLt * * * * ** Any inforilratioll that is ntis leincscnled may icsiM hi the sanitary pelntil being tevoked by (tie Zoning Department. * * * * ** ** Include will( this Rpfilicstion a stamped W�allailly dced from_ rise Vc.gister of Dascis office. 4 s coliv: 1 tlfc E:c.(ific(( Bill xc; lzin i` f31 011c is 441-a94 ill,,( tirtitraify°t(ettl'* IQ .rnl � �YPt' >E �t`9:� 639326 STATE BAR 00 WISCONSIN FORM 2 -1998 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Kevin Patrick Campeau, Jeffrey Allen RECEIVED FOR RECORD Campeau and John Michael Campeau, as tenants in common, Grantor, and 02 -27 -2001 11:00 AM LaCasse Development, Inc., a Wisconsin Corporation, Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee WARRANTY DEED the following described real estate in St. Croix County, State of Wisconsin (The EXEMPT N "Property "). COPx COP FEE: TRANSFER FEE: 1290.00 The Northeast Quarter of the Southwest Quarter (NE 1/4 SW 1/4) lying west of the RECORDING FEE: 10.00 Apple River, EXCEPT the west three (3) rods thereof; that part of the Southeast PAGES: 1 Quarter of the Southwest Quarter (SE 1/4 SW 1/4) lying west of the Apple River and east 122'" Street; and the Northwest Quarter of the Southeast Quarter (NW 1/4 SE 1 14) lying north and west of the Apple River, all in Section 11, Township 31 North, Range 18 West, Town of Star Prairie, St. Croix County, Wisconsin; and Recording Area _ a EXCEPT Lot I of Certified Survey Map filed November 3, 2000, in Volume 14 N f and Return Address Page 3988, as Document No. 632964. e Ir ¢ f 2, S 5 3 2 !Kn c -_: (P5 A ,;& c' Above described land is subject to an easement for ingress and egress to said Lot N ( :5 4o 1 `7 1 as described on deed recorded in Volume 1555, Page 37, and subject to all other easements, restrictions and covenants of record. Part o0jJ - 1048 -10 & 038 - 1048 -40 Parcel Identification Nuulber(PIN) This is not homestead property. Exceptions to warranties; Subject to all easements, restrictions and covenants of record. Dated this _ ?� y of February, 2001. 4*je wk C ea p John A'lichael Campeau !mil - j.q en Campeau — w AUTBENTICATION ACKNOWLEDGMENT Signatures) Kevin Patrick Campeau, Jeffrey llen Campgat and John Michael STATE OF WISCONSIN ) County a ,���,............ ) ;$t e!�`' day of February , 2001. a•, *; ,r-- d Personally came before me this day of 2001 the above named �t aril' O n d to me known fo be the FrM '�li $ A -TE BAR OF WISCONSIN person(s) who executed the foregoing instrument and ackthowledge L7 (I f� w the same. ' ! t altthorixed'by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Hendrik W. Van Dyk " VAN DYK, 0 &. SILER, S.C. Notary Public, State of Wisconsin My Commission is permanent. Post Office Box 118, New Richmond, WI 54017 (If not, state expiration date: ) (Signatures may be authenticated or acknowledged. Both arc not necessary.) 'Names of persons signing io any capacity should be typed or printed below their signatures WARRANTY DEED STATE. aAR OF WISCONSIN FORM No. 3 - IYY9 INFORMATION PROFESSIONALS COMPANY FOND OU LAC. WI 000 -855 -2021 STATE BAR OF WISCONSIN FORM 2 -1998 D 1 This Deed, made between. Kevin Patrick Campeau, Jeffrey Allen Campeau and John Michael Campeau, as tenants in common, Grantor, and LaCasse Development, Inc., a Wisconsin Corporation, Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (The "Property "): The Northeast Quarter of the Southwest Quarter (NE 1/4 SW 1/4) lying west of the Apple River, EXCEPT the west three (3) rods thereof; that part of the Southeast Quarter. of the Southwest Quarter (SE 1/4 SW 1/4) lying west of the Apple River and east 122 Street; and the Northwest Quarter of the Southeast Quarter (NW 1/4 SE 1/4) lying north and west of the Apple River, all in Section 11, Township 31 Recording Area North, Range 18 West, Town of Star Prairie, St. Croix County, Wisconsin; and Name and Return Address EXCEPT Lot 1 of Certified Survey Map filed November 3, 2000, in Volume 14, Page 3988, as Document No. 632964. Above described land is subject to an easement for ingress and egress to said Lot 1 as described on deed recorded in Volume 1555, Page 37, and subject to all other easements, restrictions and covenants of record. Part of 038-1048-10 & 038 - 1048-40 Parcel Identification Number (PIN) This is not homestead property. Exceptions to warranties: Subject to all easements, restrictions and covenants of record. V V Dated this day of February, 2001. vin a Ick C pea John Michael Campeau *Je y AI en Campeau AUTHENTICATION ACKNOWLEDGMENT Signature(s) Kevin Patrick Campeau Jeffrey STATE OF WISCONSIN ) All Campeau and John Michael )SS. Cam County ) authenticates! thiscx'' d y of February , 2001. Personally came before me this day of 2001 the above named to me known to be the Kr ist'ina Oaland erson s who executed the foregoing instrument and acknowledge TITLE: MEMBER STATE BAR OF WISCONSIN he same. (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Hendrik W. Van Dyk Notary Public, State of Wisconsin My Commission is permanent VAN DYK, O'BOYLE & SILER, S.C. (If not, state expiration date: Post Office Box 118, New Richmond, WI 54017 (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 WARRANTY DEED STATE DAR OF WISCONSIN FORM No. 2 - 1998 INFORMATION PROFESSIONALS COMPANY FOND DU LAC, WI 800- 655 -2021 I 11 f We 4r L invo e-orc 11 I I I. I ELEV.868. ( I - 952.9 942.6' X 955X x LOT B : x x.� (2 16R6 A R RES 8 I I I B-1 949. LOT X 2 333 AC ES X 9. (2 333 AC ES) lli 3W 37r 49. X 955.5 l I I LOT 2 x I_ X 1.847► ACR, S 943.3 9 54 9 (1.647 ACR S) ! ! s-2 0o L T 1 S 1.58 ACR �.� (1.36 AC 953.1. 36 ` H.W.L. 9 T3 '♦ 1,CT 14 9 iN 1 $ ACR .652 ACR S C ) ,. ( .442 ACR ) 941.7 , N ! ! Z x ' 951.3 / I X 0952: x / 952.9 �` x, $2 949.1 323' . x 942.6 }i. x tv a =, L. 1.3 '1.61 CR .9 R �AC, N A 1.64$ RE AS) .548 A $) 1 X 944,5 �. 1 9 953., 46.9 951.9. A X X a, F 16' 1 i x 952:9 L TS , ! . 1 ..59 ACRE 948.5 fl .59 ACRE 952.5 w+ w V —J X a', N to o \— ,. V �- 44 la b v m'