HomeMy WebLinkAbout038-1197-90-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
' 420307 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:
Wilson, Burton I Star Prairie Township 038 - 1197 -90 -000
CST BM Elev: f Insp. BM Elev: BM Description:
1 co ► a cx�. v' Z " Q UC ( C.ST - 1Q-f E • gw� k�LceQ
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS o HI I FS ELEV.
Septic � i�,� Benchmark #Z_ Z • . •
Dosing Alt. BM
Aeration Bldg. Sewer
3.3q q s ,s'
Holding St/Ht Inlet 4 3 . W
TANK SETBACK INFORMATION SUHt Outlet $•� c J3.SD�
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic 3D ►� � , —_ Dt Bottom
Dosing Header /Man.
Aeration Dist. Pipe , p
Holding Bot. System •9� 9/ 2
•�o '
�
PUMP /SIPHON INFORMATION Final Grade
Manufacturer Demand St Cover
GPM
Model N er
TDH Lift Fri ' n Loss System Head H Ft
Forcemain L th Dia. _7 7`0 Well
SOIL AlRtORPTION SYSTEM 22) c Ae.
BED /TRENCH Width Length f LNo. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 3 ► �•��
SETBACK SYSTEM TO P/L IBLD46 ]WELL LAKE /STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type Of System: ► 1 UNIT Modet N ber: 11 •[
CJVA Z ►�
V ► ., _
DISTRIBUTION SYSTEM 4e lip (-
Header/Manifold (�i u Distribution x Hole Size x Hole Spacing Vent to Air Intake
'{ � ( P,pe(S
Length Dia Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over IDepth Over xx Depth of eded /Sodded xx Mulched
r
Bed/Trench Center Bed/Trench Edges Topsoil � Yes [W No [W Yes ❑ No
( COMMENTS: (Include cc�c� di epencies, persons present, etc.) Inspection #1: dc' /� Inspection #2: * 7 7
location: 1323 216th Avenue New Richmond, WI 54017 (SW 1/4 W 11413 T31N R18W) Pine Acres Lot 48 Parcel No: 13.31.18.1043
Lb Alt BM Description = 7� `-"'^' °'Y`� / 51 �� '
2.) Bldg sewer length
- amount of cover = �$ �•
I N) c*A'V_* go_ 41 "�- 1 -A. 1 k
Plan revision Required? fNi: Yes No
Use other side for additional information.
SBD -6710 (R.3/97) Dat Insepctor's Signature Cert. No.
Sanitary Permit Application Safety & Buildings Division
`� In accord with Comm 83.2 1, Wis. Adm. Code 201 W Washington PO Box 7302
isconsin See reverse side for instructions for completing this application
Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302
Department of commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not
,? - S *?v 2.6 1 state owned.)
Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size.
County / State Saniu it umber �❑ Check if revision to previous application State Plan I. D. Number
fTGA
I. Application Information - Please Print all Information Location:
Property Owner Name
° Property Location
AD
RE �°
� — S /4 /4, S T,! 7 /,N, R C 4 V(
Property Owner's Mailing Address ? Q �Z Lot Number Block Number
j�I ' 1 �
City, State Zip Code Phoggl ytrfbe Subdivision a or �Feneber—
r
II. Type of Building: (check one) n p ❑ City
k 1 or 2 Family Dwelling - No. of Bedrooms : � ❑ Village
v (describe use):_ Li J
fj Xr own of
/ . q,
❑ State -Owned tp'wl'WV� 's�� (o ! t ,P�i�t �� d / �I eA I
l t �C� ,D l i/ Nearest Road 16
000 /C Parcel Tax Number 2 0
"Permit: heck only one box on line A. Check box on line B if applicable) /�' , I- - / ! 4 4 3 /
A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6 0 Addition to
System System Tank Only Existing System
$) Permit Number Date Issued
❑ A Sanitary Permit was previously issued
IV. Type of POWT System :.keck all that apply)
g _ Non- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland
❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line
❑ At -grade ❑ Aerobic Tre Unit _❑ Recirculating ❑ Other:
31. l lu�rl (✓ Ck.,,
V. Dispersal/Treatment Area Information: a I ( L {lQ y
1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Ap ication 5. Percolation ate 6. System Elevation 7. Final Grade
Required Proposed Rate (Gals. /day /sq. ft. (Min. /inch) T�, / = !? Elevation
VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks Con- Con- glass
New Existing crete structed
Tanks Tanks
/�R./ f ❑ ❑ ❑ ❑
❑ ❑ ❑ ❑ ❑
VIII. Responsibility Statement
I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (print) Plumber' ature (no stamps): MP/MPRS No. Business Phone Number
i
Plumb s Address (Street, City, State, Zip Code)
IX. County/Department Use Only
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date I sued suing Ag nt Signature Ps)
Approved ❑ Owner Given Initial Adverse Surcharge Fee)) (�
Determination /�� {
X. Conditions of Approval /Reasons for Disapproval• 4,, ' 3 w4/ CB4A ✓k, C44,, e h Pw 1.
vs cam s ,
h Cam 2( > �'h
SBD -6398 (R. 07/00) '�) /�lG�n� s e�barl� . czww>✓ 0 11 ,Qd >
3�3
PLOT PLAN
PROJECT Burt Wison ADDRESS 2168 Shore Dr. Somerset Wi. 5
1/4 NW 1/4S 13 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX
MPRS Byron Bird Jr. 2205 DATE 7-29 - 02 BEDROOM 3
CONVENTIONAL XXX -Grade CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gal LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE 0 LOAD RATE .7 ABSORPTION AREA 642 # of chambers 22
IL BENCHMARK V.R.P. top of 2° PVC pipe A SSUME ELEVATION 100
❑ BOREHOLE (DWELL sH.R.P. same as BM
Vent SYSTEM ELEVATION T - 1= A -2 0
42"
Sidewinder High
Capacity Leaching
Chamber with 17.2
° A2 per chamber
Long 34" Flevation
180' ' -
1 PL
Drive / ,/ �O / B
25'
Yo �
15' 68 B3
t 0 ob pipe
garage
15' 220'
PL
3 bed
house
216th ave
i
PLOT PLAN
PROJECT Burt Wison ADDRESS 2168 Shore Dr. Somerset Wi. 54025
1/4 NW 1/4S 13 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX
`
7 7-29-02 BEDROOM 3
MPRS Byron Bird Jr. 2205 DATE
CONVENTIONAL XXX Grade CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gal LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE 0 LOAD RATE .7 ABSORPTION AREA 642 # of chambers 22
BENCHMARK V.R.P top of je&l . 6 g 4-1-� ASSUME ELEVATION 100'
❑ BOREHOLE (DWELL *H.R.P. sameasBM
Ar nt SYSTEM ELEVATION T -1�T -2 =92�
Sidewinde Hi h U
g 2 � Capacity Leaching ` Chamber with 17.2
t ^2 per chamber
Long Elevation
180' PL
1
Drive 3 B
25' _.
zs'
15'
t p ob pipe
garage
15' 220'
PL
3 bed
house
216th ave
w
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I 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 1/2 x 11 inches in size. Plan must a jr
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. ' �l �f 7 e7
D /y0 T�
Please print all infor Re ' by Date [��. \ I c n
Personal information you provide may be used for second ry purpD3cEGEI lktic, D 5.04( i (m)).
Property Owner / Property ocation
AUG 1 3 2 t. Lo � ,,�1/4 �/4 S T N R
Property Ow&&rs Mailing Address Lot # Block # Subd. Name or CSM#
6 O ST. CROIX CO N
-- P7 - C
Cit State Zip Code Phon E] Village 'Town Nearest Road L
r r
/4, New Construction Use. Residential / Number of bedrooms Code derived design flow rate GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent materia f ' �6vla 4 ai W ood Plain elevation if applicable � � ft.
General comments
and recommendations: rj, /9V�c.
e
d
�� i3 6
Boring # F] Boring
—/�/
M Pit Ground surface elev. `tom ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
a
B ..Z
.0 1�
❑ Boring # ❑ Boring
Pit Ground surface elev. t ft. Depth to limiting factor in.
Soil Application 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
- 7 Ll
L p
9 •
r
* Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS _< 30 mg/L
CST Nam lease Print) t Signature CST Number
Addres A5ate Evaluation Conducted Telephone Number
SBD -8330 (R07166)
Property Owner r/ ✓��'/ � Parcel ID # Page of
5 Boring # t ❑� Boring 1,
1�4 Pit Ground surface elev. �`�( ft. Depth to limiting factor , l� < in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD 1ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I *Eff#1 'Eff#2
o � -�/ .,s-
s
F-1 Boring # E] Boring
❑ Pit Ground surface elev. ft. Depth to limiting facto in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2
F-1 Boring # ❑ Boring
El Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application 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
* Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L.
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777.
SBD -8330 (R.07 /00)
Soil Test Plot Plan
Project Name 1 36(,' BVrOn Bird Jr.
Address
CSAi #220527
Lot 04 Subdivision Date. County, �,
N /fa - Townshi
Boring ()Well PL Property Line# Alt. BM Oe�
BM or VRP
Assume Elevation 100 ft.
- H.R.P.
System Elv.
/ /' / r / " y'� G r-0
Sy �
�L
Wet
3�
� ?v
ST CROI K COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
J r
Owner/Buyer i ecc 7
Mailing Address ,. 2 l rc e -0'2< r 57, 7'� Z r
Property - Address
/3� 6
(Verification required from Planning Department for new construction)
City /State Parcel Identification Number A 3165 l2 ZC
LEGAL DESCRIPTION
,��1/�/4, Sec. T 3 N -R�W, Town of
Property Location '/s, 1,
Subdivision J'1 -2 / / Gz'-�5 . Lot #
Certified Survey Map # Volume . . Page #
Warranty Deed # 7 1 4 .2, . Volume Page # AR
Spec house A yes ❑ no Lot lines identifiable _Wy es ❑ no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system -
The property owner agrees to submit to St. Croix Zoning Deparment a certification form, signed by the owner and by a
master plumber, journeyman plumber, restricted plumber or a h eense d p um p er 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 Zoning Office within 30
days of the ear expiration dat .
1 , - 2
SIGNAI OF JkPfLICANT DATE
OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of
the property escribed above, ky virtue of a war deed recorded in Register of Deeds Office.
111 1,41: Z'e. ;L� -�
SIONA OF APPLICANT DATE
Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.
** Include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
�. 5
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POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner Septic Tank Capacity � a l ❑ NA
i m
Permit # Septic Tank Manufacturer L �� ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer 1 ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA
Number of Public Facility Units ❑ NA Pump Tank Capacity a l ❑ NA
Estimated flow (average) gal /day Pump Tank Manufacturer ❑ NA
Design flow (peak), (Estimated x 1.5) gal /day Pump Manufacturer ❑ NA
Soil Application Rate al /day /ftz Pump Model ❑ NA
Standard Influent /Effluent Quality Monthly average* Pretreatment Unit ❑ NA
Fats, Oil & Grease (FOG) :530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BODd :5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) :!9150 mg /L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BOD :530 mg /L A In- Ground (gravity) ❑ In- Ground (pressurized)
Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound
Fecal Coliform (geometric mean) :_10 cfu /100ml ❑ Drip -Line ❑ Other:
Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA
Other: ❑ NA Other: ❑ NA
* Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: ❑ m th(s) (Maximum 3 years) ❑ NA
earls)
Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volum NA
every: ❑ nth(s) IMaxlmum 3 years ❑ NA
Inspect dispersal cell(s) At least once e y
s )
P P l;�ar(s)
Clean effluent filter V ��.� 1 / At least once every: ❑ t ❑ NA
yearls
Inspect um um controls & alarm At least once ever ❑ month(s) year(s)
❑ NA
Ins
P pump, pump Y' ❑yearls)
Flush laterals and pressure test At least once every: ❑ year(s) (s► ❑ NA
Other: At least once every: ❑ month(s) ❑ NA
❑ year(s) Other: ❑ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
a visual inspection of the tank(s) to identify an
inspections must include p Y Y missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any bac k up or p ondin g of e ffluent on the ground surface.
The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one -third (Y3) or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters mechanical or P ressurized components, pretreatment
units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
GMW (4/01)
Page of
• START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at -grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
• A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
• A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site
evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank
may be installed as a last resort to replace the failed POWTS.
❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
< <WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name /`B n Name
Phone Phone —a
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY,
Name Oh- Name J1 J� Z O dt
Phone — .�Z 4L Phone
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.
`J 1931P 127 is
STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. MALSH
Document Number WARRANTY DEED REGISTER OF DEED
This Deed, made between Lakes and Hills, Inc., a Minnesota RECEIVED FOR RECORD
Corporation, 07 -23 -2002 9:30 AN
IARINIM DEED
Grantor, and Burton K. Wilson and T. J. Jane R. Wilson, husband EXDPT #
and wife, E
TRANS FEE: 80.70
COPY FEE:
CERT COPY FEE:
Grantee. PAGES: 1
Grantor, for a valuable consideration, conveys to Grantee the
following described real estate in St. Croix County,
State of Wisconsin (if more space is needed, please attach addendum):
Recording Area
Lot 48), Pine Acres, St. Croix County Wisconsin. Name and Ret"O"NA OGLAND
ESTREEN & OGLAND
304 Locust
Hudson, WI 54016
038 - 1197 -90 -000 _
Parcel Identification Number (PIN)
This is not homestead property.
QI) (is not)
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any.
Dated this �- l� day of July 2002
Lakes and Hills, Inc.
* * By: Ric r S. r4lson, Presiders
* *
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) Lakes and Hills, Inc., by Richard S. Nelson, its STATE OF WISCONSIN )
President,
ss.
4 � County )
authenticated thi day of Jul 2002
Personally came before me this day of
the above named
. Kristina Ogland
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, to me known to be the person(s) who executed the foregoing
instrument and acknowledged the same.
authorized by § 706.06, Wis. Stats.)
THIS INSTRUMENT WAS DRAFTED BY +
Attorney Kristina Ogland Notary Public, State of Wisconsin
Hudson, WI 54016 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 must be typed or printed below their signature. Information Professionals company, Fond du Lar, WI
STATE BAR OF WISCONSIN
800455 i 21
WARRANTY DEED FORM No. 2 - 1999
N
43 z
8,848 sq. ft. •W 3'4.5' 30 30.
370 ,- .02� 3 _ '
1.81 acres \ �, S7s
65,402 sq. ft.
1.501 acres
ly line of�y, 38 -4
.S.M. 9/2460. �^ \ \ d \
68,310 sq.ft.
1.57 acres
N 29'6 �� \
44 C50
68,765 sq. ft. C
1.58 acres
` clr 216 w
cs /C'1
�yti kg \ C68 /
N �
47 .� N
86,543 sq.ft. �°� • A (A
1.99 acres 49 1 m 50
8 �i 65,742 sq. ft. 66,326 sq. ft.
6 ,451 q.ft. 1.51 acres 1.52 acres .1
1. acres
- 2 090.08'-
177.28' 247.96' 260.22'
234.33'
M
1C
s parcels shown on this plot are subject to State, County NORTHGATE
is O.e. wetlands, minimum lot size access to parcel, etc.)
rcel, contact the St. Croix County Zoning office and the -- — — — — — — — — — — —
statement put on this plat at the direction of the St.
:s Committee.
This instrument drafted by Todd N