Loading...
HomeMy WebLinkAbout038-1206-90-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and iluild,$g Division • INSPECTION REPORT Sanitary Permit No: 463391 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)J. Permit Holder's Name: City Village X Township Parcel Tax No: Halle Custom Homes Inc. I St. Joseph, Town of 038 - 1206 -90 -000 CST BM Elev: Insp. BM Elev: BM Description: n 3 Sectionrrown /Range /Map No: J G 13.31.18.1114 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ii Benchmark G'3 3 �� 102.7 " -L Dosing A � Alt. BM �� 2 .Z(0 /64 uq �J ' T 1 Aeration Bldg. Sewer 95 56 "Q Holding St/Ht Inlet ( St/Ht Outlet 7 q TANK SETBACK INFORMATION ( • 56 gt!v Z TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 1 � /� Z- Z7 ! Dt Bottom Dosing / Header /Man. 7 1 7 + �� Aeration Dist. Pipe -7 I �� Holding Bot. System -7 ck Final Grade o,� PUMP /SIPHON INFORMATION 3 .S 1 / ' Manufacturer Demand St Cover 1 f m6 Model Nu er aF 1,AA 1 S TDH Lift Friction Loss System TDH Ft Forcemain ngth Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width , Length , No. Of Trenches PIT DIMENSIONS No Of Pits Inside Dia. Liquid Depth "�� DIMENSIONS Z ` ( (Z� Z ` Cep N% _1 ____1 � SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: \ INFORMATION CHAMBER OR 1 �� Type Of System: rr t � UNIT Model Number: ^ J' •.� �( DISTRIBUTION SYSTEM 1-7 e' 3 �-�• Header /Manifo� /� Distribution x Hole Size I x Hole Spacing jv!njtc, /fir Intake ` Pipe(s) \ ` t Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only TV Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed/Trench Edges \ Topsoil Yes No Yes No I . COMMENTS (include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 2163 126th Street Star Prairie, WI 54026 (SW 1/4 SE 1/4 13 T31N R18W) Prairie View Estates Lot 19 Parcel No:'13.31.18.1114 1.) Alt BM Description = °F "'r- / �, k ' � . t L, O ✓� 2.) Bldg sewer length = 7-7 • Cu�-�, - amount of cover = - - - - - - Plan revision Required? Yes No C o �35 J Use other side for additional information. - Date Insepcto ignature Cert. No. SBD -6710 (R.3/97) �� �� n 201 WTWhingtR 9082 �� / . ct_a C �scons�n WI 53707 - 7082 Sanitary Permit Number (to be filled in by Co.) Department of Commerce )261 -654 05 339 Sanitary Permit Appli t15.04 on IN State Plan I.D. Number 1 ®' " �OFF OUNT'Y In accord with Comm 83.21, Wis. Adm. Code, p ersonal ii ICE may be used for secondary purposes Privacy Law(1 )gIQNG Proj ect Address (if different than mailing address) I. Application Information - Please Print All Information Z* 2-1 b3 X26 . Property O er's Name Parcel # Lot # I 6� 38 '/ Zo 6 - W.- - coda Property Owner's Mailing Address Property Location m4 //13 1 G City, State Zip Code Phone Number �y � , �. Section /S 1 1 G f 7 f ; -7 J ,� r 13 T 3� N; R ( cEcle eta) II, Type of Building (check all that apply) S bdivision Name CSM Number 1 or 2 Family Dwelling - Number of Bedrooms =a.AS � � ❑ PublidCommercial- Describe Use ❑ State Owned - Describe Use ❑City ❑Village wnsNp of 4I /'d tt't. III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. `New System 11 Replacement System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System B, List Previous Permit Number and Date Issued ❑ Permit Renewal ❑Permit Revision ❑Change of El Permit Transfer to New Before Expiration Plumber Owner IV. Type of POWTS System: Check all that appl 00 Non - Pressurized In -Ground ❑ Mound > 24 in. of suitable soil < t- _ Mound 24 in. of suitable soil ❑ A Grade ❑Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter Ching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treat ent Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (so Dispersal Area Pr System Elevation ys� v3 66 9s VI. Tank Info Capacity in Total Number Manufacturer Prefa Site Steel Fiber Plastic Gallons Gallons of Units J� r /� Concrete Constructed Glass New I Existing t►'/ o-b� Tanks Tanks Sept) or Holding Tank / 000 /OVV Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installatio f the POWTS shown on the attached plans. Plumber's Name (Print) PI is Signatire MP umber Business Phone Number ffe Plumber's Address (Street, City, State, Zip Code) 3,1 /yo 71 S� iq� � • Gil S Savo / VIII. Coun /De artment Use Onl l� Approved prove Sanitary Permit Fee cludes Groundwater Date Issued Issuin Agent Signature (No Stamps) Surcharge Fee) ❑ Owner tven Reason for ial IX. Conditions o A rov al SYSTEM OWNER, 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. g 2 All setback requirements must be maintained as per applicable code /ordinances Attach complete plans (to the County only) for the system on paper not less than 81/2 z 11 inches In size SBD -6398 (R. 08/02) P! ©r /ate. Ak L o 1 q a 6 Lo.r �j s` Z A /00 qo pf VC tA * -3o 4A -c 9 co py E/� 9�;G 1 41o Ak 'el lwe Z A /oo v� O /QQ 6 n� e 7T t/ B� Z N 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 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference poinit1m),direction and Parcel I.D. percent slope, scale or dimensions, north arrow,Afid location and distaiabe to nearest road. Peuding Please print aN information ev' ed b; Date j Personal information you provide may be used for secondary Kurpoaes 4, (r'wdcy Law �Z Property Owner Prop Location Ew len Properties, Ltd. .' L;:Uta GK)!4. tot 1/4 114 S 14 T31 N R (or) W ,u Property Owner's Mailing Address l( ,x Lo `# I I Block # Subd. Name or CSM# 1430 220th. Ave. ?',1 na Prairie View Estates City State Zip Code Phone W �,,' City ❑ Village RkTown Nearest Road New Richmond, I WI. 1 54107 1715),248 -731 Star Prairie " " r ® New Construction Use: ® Residential / Number of bedrooms d Code derived design flow rate tine GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material outwash Flood Plain elevation if applicable na ft• General comments and recommendations: trenches @ el. 95.60 �� Boring � � t� . 20� f � • Borin # El g ®Pit Ground surface elev. 99 60 ft. De th to limitin g factor +100 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 1 -13 10yr 2/2 none L 2msbk mfr cs if .5 .8 ,( sicl 2msbk mfr ClW if .4 .6 r � no ne ms OSq ml na na .7 1.2 •� F-12 Boring # Boring Pit Ground surface elev. 99.40 ft. Depth to limiting factor +100 in. Soil A lication 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 I 'Eff#2 0 -10 10yr 2/2 none L 2msbk mfr cs if .5 .8 ,gyp 2 10 -30 7.5 4/4 none sicl 2msbk mfr gw if .4 .6 3 30-100.5 4/6 none ms osg ml na na .7 1.2 •� i Effluent #1 = BOD > 30 5 220 mg/L and TSS >30 < 150 mg /L uent #2 = BOD < 30 mg/L and TSS 5 30 mg/L CST Name (Please Print) Signature . CST Number Gary L. Steel ' 02298 Address Date Evaluation Conducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 11 -30 -2000 715- 246 -6200 Property Owner Ftal an I?X n - T f e , Ltd, Parcel ID # pending Page 2 of 3 F- Boring # ❑ Boring 3 ® pit Ground surface elev. 99.60 ft. Depth to limiting factor +100 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -13 10 2/2 none L 2msbk mfr Cs if .5 .8 • (P 2 13 -27 10 4/4 none sicl 2msbk I mfr qw if .4 .6 3 27-42 7 4/4 none Cog Q59 ml aw na 7 1.2 42-100 7 -5yr4/6 none nis Oscr ml na na .7 1.2 •� F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil ApElication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ 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 GPD/fF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I Effluent #1 = BOD > 30 5 220 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 (R6=) r F STEEL'S SOIL SERVICE Gary L. Steel Ewlen Properties, Ltd. 1554 200th Ave. CSTM2298 SW NE' S14- T31N -R18w New Richmond, WI 54017 MPRSW -3254 town of Star Prairie (715) 246 -6200 lot #19- PraikieView Estates This soil evaluation was conducted to satisfy a zoning requirement, it may or say not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. /N A " =40' ABM.= top of 1" pvc pipe @ el. _1 /Alt. BM.= top of 1" pvc pipe @ el. 9 9.70' D� t l r �� 3C? 0 UqC Garry L. Steel 11 -30 -2000 SYSTEM SPECIFICATIONS In- ground Soil Absorption Component Component Manual # -5A Project Name: " Distribution Cell Type Septic Tank Aggregate ❑ Non - Aggregate] Min. Septic Tank Vol. Req. W_ gal. `1'ype of Non - Aggregate Component Septic'] "ank Volume / Oo0 gal. Manufacturer Manufac rer Tvlodel Effluent Filter Manufacturer Z Number of Bedrooms Model _ M 0 0 O Soil Application Rate (DLR) 7 gpd /ft (Designed Loading Rate) Pump Tank Wastewater Quality Manufacturer Treated ❑ Untreated Volume Model Combined wastewater: Number of bedrooms _ 3 Distribution Component gal /day /bedroom x 150 Distribution Box ❑ Daily Wastewater Flow (DWF) Hydro - splitter ❑ Other Clear and graywater only: Manufacturer Number of bedrooms gal /day /bedroom x 90 Cross section of distri bution cell(s) Daily Wastewater Flow (DWF) _ S.Q'2 Blackwater Number of bedrooms gal /day /bedroom x 60 Daily Wastewater Flow (DWF) _ Dispersal Area (Aggregate) _7 __ ('2 U fe (DWl) Put) Dispersal Area (Mori- Aggregate) EISA Rating fe System sizing = DWF _ DLR EISA _) . a L _ _3_y chambers { (n F) (DLit} (EISA) Divertet valve ❑yes ❑no Manufacture ___ t9 as 4 o 11 ° wo cu o �; b cd a '. U ° ►' to p.. O U 4'-+ • N. F-1 O tz 0 COD b .0 I t W O o 0 � I POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of 2 FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity al ❑ NA Permit # 3 3 1 1 Septic Tank Manufacturer r - FcuTT ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer 6-f_ ❑ NA Number of Bedrooms 3 ❑ NA Effluent Filter Model — (Op ❑ NA Number of Public Facility Units RNA Pump Tank Capacity a l A Estimated flow (average) 3cro gal/day Pump Tank Manufacturer A Design flow (peak), (Estimated x 1.5) ai /da Pump Manufacturer � NA Soil Application Rate al/da /ft2 Pump Model A Standard Influent/Effluent Quality Monthly average" Pretreatment Unit ANA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Celi(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L gln- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /100m1 ❑ 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 tankls) At least once every: 3 earl 1(s) (Maximum 3 years) ❑ NA Pump out contents of tankls) When combined sludge and scum equals one -third (Y of tank volume ❑ NA ears) 13 NA month(s) (Maximum 3 Inspect dispersal cell(s) At least once every: ❑ earls) y Clean effluent filter At least once every: ❑ month(s) [3 NA Z J3 year(s) ❑ month(s) P LINIA Inspect pump, pump controls & alarm At least once every: ❑ ear(s) ' ❑ month(s) P VNA Flush laterals and pressure test At least once every: ❑ year(s) Other: E3 month(s) gNA At least once every: ❑ yearls) Other: R 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 inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. 2 2 Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tankls) 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. m wastewater stream may i the p erformance and prolo Reduction or elimination of the following from the Y p p 9 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. T alua ' o mg jank �� e ai e `�� A/ CoN577ecJ�Tt D+� b � Ro �trs �T� ❑ 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 tj Name ` Phone S', ( 3 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name S, C ( b V 24Af I /i C A I Phone Phone —7195;"— 3g(p_ 49 g7o This document was drafted in compliance with chapter Comm 83.22(2)(b)0)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. ST CROIX COUN'T'Y SEPTIC TANK MAIIJTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer ��,^ Mailing Address 1 1 13 Q `� Ike =' Property Address Q (Verification required from Planning Department for new construction) City /State Parcel Identification Number LEGAL DESCRIPTION Property Location 1 /4, i /4, Sec. , T N -R @Town of Subdivision < - � l u A 4 ► � C Lot # _. Certified Survey Map # , Volume . Page # Warranty Deed # , Volume , Page # Spec house CK yes ❑ no Lot lines identifiable 91 yes ❑ no SYSTEM MARgTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year a piration date. S A F APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (arc) the owncr(s) of the property described a ve, y virtue of a warranty deed recorded in Register of Deeds Office. 0� NA URE F 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 decd State Bar of Wisconsin Dorm 2 -2003 WARRANTY DEED Document Number Document Namc THIS DEED, made between EWLEN Properties LTD. a Texas Limited Partnership _ ( "Grantor," whether one or more), and H ALEE CUSTOM HOMES ( "Grantee," whether one or more). 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 Lot 19, Prairie View Estates, Township of Star Prairie, St. Croix County, Wisconsin. Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warrantie :E sernent restrictions and rights -of -way of record, if any. Dated EWL,EN Properties, LTD Hv f ,r 5. , `��� � j � - (SEAL) ;l ���� �` G> � .t��. /Opi fhFi (SEAL) * *By: Paul Anderson (SEAL) (SEAL; * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) authenticated on STATE OF f } l S ) ss. / uhf COUNTY ) * TL r M M `'R STATE B AR OF W !SCONS1N Personally came before me on (If not, the above -named EWLEN Properties LTD authorized by Wis. Stat. § 706.06) By: Paul Anderson to me known to be the person(s) who executed the foregoing THIS INSTRUMENT DRAFTED BY: instrument and acknowledged the same. Attornev Kristina Ogland Hudson, WI 54016 * z_­ Notary Public, State of /e S My Commission (is permanent) (expires OCiyiper L , .2cM (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: TI {IS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED �O 2003 STA'I'D; BAR OF WISCONSIN FORM NO. 2-2003 * Type name below signatures. IN1 1-- r.. 1 A00- 655 - 2Q21 www.infoproforms.com SARA E. MANZOTTI _ Notary Public, State of Texas ,, My Commission Expires i �:`, October 19, 2006 GC�CiJ 1J • C J ci- rtHL i i - -l! t LLUJH I t' • y 1'� l�� b ; '�hcs- - - - ..S r'rb. =4 NiJ. 4J'J MosAII! liiifi�Q 1/Gf'. M1 217,54' 23342 :40" DRAIVArrF-W7. y • � cn i �- 26 74•sea SO f7 1.71 ACWS 4'' • O - [ a tv • ,� M1N, F.f'E...�6t�Q . N its WOOVW2CW y o y � � � � � � � • 353.7'1' y • -.e TOW ROAD Nom *w • M � a N00'OC23'W 355.71' El J L ... . ... 31♦�7�' b'� 17504• , � � ,Ql 7!17 N. WEZZS,. o NOQ'QO'21rw . f �c c yt 63 /,?.2Z RcarreRS PRAIRIE VIEW ESTATES �a �. a� � . a, v� r� „��;��a v � f�� A�..�Ax, � ✓w, r• .� �, , . ✓�� A,��,e x � �:�_� e a I T z z -. ��sCOry YICNTY MAP � - - iv r — D NORTH _ 111 a o .: u,. a 2— .z�,s ESYL •.. . .- .s + < tD (ANDS •. " — ' 1613.19 589'01 WE [u f « 71A 33 2g 27 28 30 31 32 All c, ✓ v - .oa f• e� 3 n: 2 R9 z z. TOWN ROAD •�� o - .n -x. x . 11 0 25 ___ a.krs 4 • w e Q 18 e 12 o_ n 3 . z N8991 50 W 4504. n 7 s 24 v 5 1s a = 10 wAR4 xaLa[5 ;o 13 0 r ` 17 n� �e cwr zo..c s .---- x 1 20 x " i ,. f -`no- r � - fl � ° � sa9rorw'E 450 .42 + e e o a x 23 s 6 k- 5 o r , Y IA-s 9 I - - 6 Iry + - - 21 i 16 22 15 �` 7 1 8 I �f£' J J ����A'. � i tz �' S s6 /OP(5 r� `6.• °} . B6 a�5�r R iSJ�i�.s �r ma' "'. . L-- "� �+ .xrnrrr w.•mrrx '� SfS pCTNL `/ UNP LA TTf(' LAVD� NB858•I2 ". Tw 1/e 26 UNPLA TTE •[sr .,.rw.w ' °x ae 1 - 'A' ---.. N " 26t1.82� slsw.eu' 0 LANDS e: - - --- --- - •m • m C S.M. LOT 1 _. ;°SB➢83:w- , <.) oi, s - .1s u.. SHEET 1 OF 2 S i I• � I I g I I 210.00' -_ ._._ __ _ 210.00' —21( -- r N89'01'50 "W 1339.01' E ROAD­­ '"`" ' �► N89'01'50 "W 651.19' 3 3 305.00' -- i 34 i r2.5' � 8 I ' o , : ............................... ............. ............ o 18 1 IAN 95,191: 96,246 50. FT. 2.19 A C I 2.21 ACRES I MIN. F. F. E MIN. F. F. E. = 370, 0 r Ll S89'0 ' 34f s' AL -r. co ,` I N88'58 305.00 17 I I 87, 324 SC 20 I 2.00 ACRt Q' rn MIN. F.F. E. a t �~ 87,139 SO. FT. 3 I Go N m I � °� °° ° 00 2.00 ACRES o) 3 3 ( MTV F, F. E. = 374 0 0 k 4n $ I N N 7_ 1