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HomeMy WebLinkAbout038-1209-60-000 Wisconsin Department of Commerce Count PRIVATE SEWAGE SYSTEM St. Croix Safety and Building Division ' INSPECTION REPORT Sanitary Permit No: 430272 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: LeQue Builders LLC I Star Prairie Township 038 - 1209 -60 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: tc� . 1 t; C', C 'T_ I l i C 6M /) 13.31.18.1134 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark �' 'Sx k� Zc 2 / x'00 A 5.15 r65.7� Dosing Alt. BM Tc �a���d y C' Bli1 {� .x•9 /�z , Aeration Bldg. Sewe Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht outlet g y9 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Cj Septic �) r k7c ♦ �' Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover r] 5q PM 2 / IYI cµ �,�1i 1 Mod611 ber TDH Lift Friction Loss System ead TDH Ft Force ain Length Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 70 i N s (" 64 on SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR F Type Of System: rtc .: / ►l a w\ 7 � f UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution i x Hole Size x Hole Spacing Vent to Air Intake / PipeO Length Dia �, Length Dia /J r Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: /Z / C'3 / I ecti=., s– I , 5 eFA 1 Location: 1330 212th Avenue New Richmond, WI 54017 (NE 1/4 SW 1/4 0 Unknown) Northgate II Lo) 44 Parcel No: 13.31.18.1134 1. Alt BM Description = U ck— 2.) Bldg sewer length (`1) - amount of cover = R - f�oyl'`y �ru7r� Plan revision Required? Yes V Use other side for additional information. ty SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. Safety and Disildhip iD m=on Cry 201 W. W Ave, P.O. Box 7092 SI Q, , m " Madison, WI $3707 - 7092 VIs4xmsIn S=iwY Permit Number (b be filled is by Co,) De rtmef+t of Commerce ( 26145" 4 f3 D al'2- Sanitary Permit Application one Plan J.D. In accord wit Center 8311. Wis. Adm. Cede. parsonal informsdon you provide OW be used for secondary purposes Privacy Lw. s15.04(1 (ifammut dow �g address) L Appikatia. toformtiN - Pbmse PriW Ap i Ovrrter's Nwa farted r Lot s '�� y Block r r )A 54 _ coo -tai✓ . t 1 3t'f Property Owner's Addms 3 ,� L D hope" teacation t 17.1 , Section City. State Zip Coder C� t T ELI- B L LZC °r ? L Z TYPC `"J of aq (twit au (best apM,) 3 P" S I or 2 Famt7y Dwelling - Number of Bedrooms stt6divioon Name CStvl Number PublicOCommereial - Deaenbe use t9 r D State Owned - Describe Use 0CAY! PilWV * of ` r i 11L Type of Pwa ft. (Cbmt oatly one box m five A. Compkte Mae B V app able) A. New System Rcpiactrstat SYtsem D T Took R Only D Other Modifiadiom is System B- D Penuft Rmvwal O Petmk Revision O Clump of O Permit Trsms to New Liar Pyevmm Permit Number sad Dane issued Before aviraoon Plumber Owner W of POwrs Cbeek ai) twat Noa Prastaniaed hrCnmmd ❑ Mound >24 m. of solvable swl ❑ Maaod < 24 m. of swW ble east ❑ At- tarade ❑ Sable Peas 5sod F*- ❑ Coesnucted wetleead O Pratinsed to -catmmd O Holdi g Taak O Pbat Fika ❑ Aerobic Tr+mawat taut O Ret g Saaa FWar 0 Media F*w OLAINCOUSChamber 013wipLine X6W..WwPipe ❑ other V. DiwersaVIVeduient Ans. lZ lion: Dear Flow (8Pd) � Sod ) Ae� (sn Area ( Skvetioa to 9SSS % Toad( info Capacity in Total Numbs efab Site Stud Fiber Plastic CAIM s (`ulloos of tails i'.00eeote Constructed Ghss 11e.r tbcrtiq Tole Tado sepeie Hamm TOR& AcrebieTnotwi t(Joie Domit Yil. neat L, the �, regraal6W tar et the POWTS Whom N the ateaeldei plans Phmeber's Name ': S' $ Busiom Plum Number V u.s��S [S Pimaber's AWren (Street, Cky, Sucre, Zip Code) S Atj VUL Coca U On Approved D Ditaplwaved Sanwry P Fee (includes Qouadwma Bate timed Agent sign are Stamps) D Owner caw" Ream Denial Strt#rrge Fee) �{ .� ry , ..._- 4� p IX. C+NtiHioars of AppravaURwws for Aw - b� Aareb eergtrte pbut t» dw CNrty e.W fir lbe I I N pop- aM Ma Nra tii12 s 11 hales 1. star 5BD -6398 (R. 08/02) I JL CL ' ; S�''- ry``n�`'°`��' (.�c� �? c� 0 - - � � I - ! - -- - - - - -�-� � � Sir � I I ' ��Li r_ � —�— E � V I I I I I ! �� i I I I i I I I I I i t � {{ 1 { I , I " I , T ........... - j J% 7 J P i 1 c J ------- _4 C� It -- - ---- — ----- � $ \�5�� N� ���s f Cdr toLVI Vvot � s - `y Y� 3T 3 /V ( 7 � fi No ZQ� Le)r 4L � S4 c SAA� 133c)� i l Wa'r't ! c Q "Pvc a a a r r b I 1 � ,_ _. _ - - - -- � _ - _ , _ „ .. _ __ _ '. �. -. 4 Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3_ Labor and Human Relations srision of safety &Buildings in accord with ILHR 83.05, 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 St. Cr not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 038- 1055 -10 APPLICANT INFORMATION— PLEASE PRINT ALL INFORMATION R VIEW DBY TT DATE 9 l G PROPERTY OWNER: PROPERTY LOCATION Greenwood GOVT. LOT NE 1/4 SW 1/4,S 13 T 31 N,R 18 9(or) W PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK # SUBD. NAME OR CSM # 1 416 Third St. 44 na NorthGate CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE JaOWN NEAREST ROAD H udson. W ) [� New Construction Use [ Residential / Number of bedrooms 4 [ ] Addition to existing building [ ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate - 7 bed, gpd /ft gpd /ft Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate _gy bed, gpd /ft trench, gpd /ft Recommended infiltration surface elevation(s) 95.85 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ®S ❑ U El S ❑ U ®S ❑ U ®S ❑ U IR S ❑ U ❑ S Eau SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft ................. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 1 0 -11 1 2 11 -24 10 r 4/4 none sici 2msbk mfr rjw if - 4 - 1i Ground 3 24 -84 7.5 r 4 6 none elev. 99 ft. Depth to limiting factor +84 X21 Remarks: Boring # 1 0 -12 10 r 3/3 none 1 2m-bk mfr if 2 12 -21 10 r 4/4 none sicl 2msbk mf Ground 3 21 -30 10 r 5/4 elev. 9 9.6 ft. 4 1 30 - 84 . Depth to r limiting f % - A actor NOV 13 1 ST C Remarks: �'` COUNTY CST Name: -- Please Print Gary L. Steel Phone: 715- 246 - 6200`` Address: 1554 200th. Ave. New Richmond 54017 _ P \ ` Signature: Date: 11 -4 -98 CST um ! r: m02298 PROPERTY OWNER Greenwood EriterrorjGA SOIL DESCRIPTION REPORT Page 2 of° 3 PARCEL I.D. # y Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft .................. in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed Trend ................. .................. ................. .................. ' > 1 0 -11 10 1 2msbk mfr qw if .5 .6 2 11 -22 10 r 4/4 none sici 2msbk mfr gw if .4 .5 Ground 3 22 -84 7.5 r 4/6 none cos oSq ml na na .7 .8 elev. 99 ft. Depth to limiting factor +84 Remarks: Boring # 1 0 -11 10 r 3/3 none 1 2msbk mfr if .5 .6 4 2 11 -26 10 r 4/4 none sicl 2msbk mfr qw if .4 .5 Ground 3 26 -84 7.5 r 4/6 none cos osg ml na na .7 .8 elev. 99.4 ft. — Depth to - limiting factor + 84 Remarks: Boring # 1 0 -9 10yr 3/3 none 1 2msbk mfr gw if .5i .6 , SEEN S '? 2 9 -17 10 r 4/4 none sicl 2msbk mfr qw if .4 i .5 Ground 3 17 -24 10yr 5/4 none sil lcsbk mfr gw na .2' .3 elev. 4 24 -84 7.5yr 4/6 none cos osg ml na na .7 .8 9 9.6 ft. Depth to limiting factor +84" Remarks: Boring # Ground elev. j ft. Depth to limiting factor f Remarks: SBD-8330(R.05/92) STEEL'S SOIL SERVICE Gary L. Steel Greenwood Enterprises, Inc. 1554 200th Ave. CSTM2298 NE4SW4 S13- T31N -R18W New Richmond, WI 54017 MPRSW -3254 town of Star Prarie (715) 246 -6200 lot #44 NorthGate This soil evaluation was conducted to satisfy a zoning requirement, it may or may 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 1 " =40' BM.= top of 1" pvc pipe C el. 100' Alt. BM.= top of 1 pvc pipe C el. 99.90 PA ti f a � �( v 0 Gary L. Steel 11 -4 -98 Ifin" nvwrarr c4remwoocl EntO rfse SDIL DESCRIPTION EPORT �- pop -Z-Of AL PARCELiz. Boring P Horizon Depth Dominant Color Mottles Texture Stnrcxure camisl rve O daffy Room GPD/ :.. In, Munsell Qu. Sz_ Cont. Color Gr. Sz. W Bed Bench 2 11 - 22 10 r 4 none sicl 2msbk mfr w if .4 .5 Ground 3 22-84 7.5 r 6 n e cos ml na na .7 .8 slow. 99 ft QepP m limiting . left +84 Reni�rks: Baring 1 0 -11 10 .r 1/3 none 1 2msbk mfr gy if .5 .6 2 11 -26 1 r 4 4 sici 2msbk mfr w [ if 4 : 5 Ground 3 26-84 7.5 : 4/6 none coa ml " na na . 7 .8 elev. NO to _ _ - facbr Remarks: Boring # 1 0-9 10yr 3/3 nose 1 2msbk mfr gw if ].4 1� 5 T2 . 17 mf w if Ground 3 17 -24 1 r 5/4 done ail lcsbk mfr cgr na elev. 4 7.5 4/6 none can osg . ml na 9 9.6 it, 10 + Remarks: Boring #i Ground elev. I Do to ---j7 Br ah Lvc' B "'�L r - _ G I t s*'tt j 4.6 2-) r�r �_ _ '_ iR1 ►T sr a -~ ` ti s sr s* { is 1r2 Cltc-."J° .# •.. IA ( rs f ! s+ s " :�� �s�►si t ss *ss " ^ # ( M"a„' _� #.r • a 2T,, � S Lauer - 41 : -a =� t' '�+ea "___'-- ,�.__'_._•__ _ v � s"�be t? t eze .e S. ?•FT w(lt?irap r? (_ 1, ' l.t?Q SV^##. j ( y } 36 rrt ; � a nea r3 • t 76) x T +�.9oi .. Q -ItS . .!#�j z' u ttl7! 43 V Ep Aggre I Trench S n E 03,11 Ystern j f Rin t Gr 0105 rk Rd, p0wTS OWNER'S MANUAL & MANAGEMENT PLAN Of SYSTEM SPEC ►T !!-S o NA ' Tan k Manufacturer gal TWETION livol. lC 30 * Z Tank Mrn ° NA PARAMt DNA 0 Sepdc Q Mae d Howler vol. s81 Nurrdser of a NA ❑ NA V Fi-ffuent Ear Ntarrufa Nurnher of Public Fadstity Uri" � Filter Model 0 Estimated Javent") ftow 3 0Z ❑ NA .Pump Msuwfachaer fi+t r Ip ftow . �rnated x 1.51 .50 l�anp Sod Apra Rate tY 11liorrttrly pretr+aafiraent tkwt Peat Filter ❑ MA model Standard ifAmt/Eifktard © Filter (3 f=ats, Gil A Grease (FOG) S30 mgt ❑ M Aeration U Wedarw 5220 M9& Q NA Biochemical oxygen Demand (8 15220 Di O Total Suspended SON& (ly) 5150 nV pretreated Effluent Quality Monthly average Manufacturer ❑ NA Biochemical oxygen Dome w (800r) 530 � D NA LDrip- 1 D tamed) TOW Suspended solids (TS') 530 �- ❑ Mound Fecal' COWOMI mss) S10 cfufl0tirnl ❑ Other. Y. in dia. D NA Maximurn Efflu nt Par ticle Size D NA D NA a NA • Vu , 8 types fat doh wastewstw and septic tank effluent. M UNTENANCE SCE Service F xPW'cY sarriea Event tenth {s) DVWIdmum 3 Vow* ❑ NA At least once every: sl Msbeci condition of tank(s) WWhen combined slime WW scurn gqug one-third W of tank volume D NA p ump ou t contenu of tankts) D When tie high water alarm is acdvatad {sl "Aal 3 >laam) ❑ NA c6ft) Inspect dispartsal At least acre even►- ? p{g) 0 NA Clean effluent filter At least once every: ❑ rsarttfr (s) O NA tnspect per. pump &alarm At least orate every: p rrrbrnt► 0 NA {sl Rush laterals and pressure test At least once e�Y= Cl years) D mfs) DNA At least wine every. ❑ NA fine of the following licenses or certifications= MAf nVtANCE WS'i'i RUCTIONS shed be made by an awymdtad cwrydng Operator (pumper). rts of tanks and dispersal Sewer, PYJWTS �: P01fVTS Nlaintaetar lnspectio ease. identify any cracks °r Mash Plumber; Maeasr Ply of the tank {s) W identify any of effluent on ere g ro un d o f Tank in•'spectlons nv-wt wcluda a visual try fax any back up or P leaks, measure the volume of combined sludge and scum a t in the observation pipes and to dwok;for ant check the effluent levels sur The dispersal cats) sholl sd vm Y o f effluent on the ground surface may ate a farm a� am Th. pondfirsg of effluent on the ground requires the mate notification of the local regulatory authority, one %) Or more of the tank volume, th' third When the combined actin of sludge OW scum in any treatment tan det p of in acordance with c hapter NA 113 entire contents of the tank shag be removed by a septa" � operator Wisconsin Administrative Gods• m or pressurized components, pmtreatmer All other services, indudin9 but net limited to the servicing p effl performed fitters. mechanical by a certi�d POWTS Maintain`- units, and any serAcing at intervals of 512 months. shall be perf of arty service event- A service +Port shall be provided to the local regulatory ity within 10 days of coi+d+P GMW {2102 Page of START UP AND OPERATION . For new construction, prior to use of the POWTS check treatment tanklsl for the presence of painting products, solvents or other chemicals that may impede the tntstrnent process and /or dernege the soil dispersal CM(s). If high concentrations are detected have the contents of the tank(s) removed by a map tag n servicing operator prior to use. System start up shag not occur when sal conditions are frozen at the infiltrative surface. During extended power outages pump tanks may M above normal hiphwater Wvels. When power is restored the excess wastewater will be discharged to the dispersal cd1W in one hqp dose and may overload them resulting in the badcup or surface discharge of effluent. To avoid Oft situation have due corrter of the pump tank removed by a 5eptage Servicing Operator prior t sastoift power to the effluent pump or contact a Phnlbelr or POWTS Maintainer to assist in rnarmally operating the pump controls to restore normal evels within the pump ter*. Do not drive or park vehicles over tanks and dispersal nails. Do not drone or park over, or otherwise disturb or compact, the area within 1 S 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; cute butts; condoms; cotton swabs; mss; dental floss; ; disinfectants; fat; foundation drain (sump pump) barge; fruit and vepeta6ls peelings; gainfires; grease; herbic khm most scraps; medications; oil; painting prod, per. sanitary ; mow; and water softener brine. ABANDONNIE T When the POWTS fails and/or is permanently taken out of service the following steps shad be taken to insure that the system is Property and safely abandoned in compliance with chapter Comae 83.33, Wisconsin Administrative Code: AN piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed ed and property disposed of by a Septage SwvWW Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with sort, 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 camen rap'*� t� A suitable repfacecm�ar►t area has been evaluated and may be utilized for the location of a replacement soil absorption system. The rep�narnt area should be protected from distcurbnrx�e and compaction anti shotafd rot ba i�rifrilldpad upon lty refined from and McPosed strtaciure, bi Nrres and walls, failure to protect ttue rspiacemant area wN! rest* in the rood for a new sod and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect as that tirne. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank rosy be Installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replec;ement area. Upon failure of the POWTS a soli 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 faded POWTS. ❑ Mound and aft -grade sod absorption systems may be reconstructed in place fodowmg removal of the biomat at the infiltrative surface. Remistruc of such systems must comply with the rules In effect at that time. < <WA L%VW> > SEPTIC, PUMP AND OTHER THEATRU39T TANKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFFICIENT OXYGEN. DO NOT EN I ES A SEPTIC, PUMP OR OTH011 TREATMENT TANK UNDER ANY C1111CIMSTANCE& DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY IN ON44 KT OR PAPOSMILE. ADDITIONAL COMMENTS Prow I INSTALLER POWTS MAMITA Name 1 Name Phone ( Phone _ SEPTAGE SERVICING OPERATOR (PUMPE 1 LOCAL Ra?W"TORY AUTHONTY E Nerve I Phone S3� • 68� This document was drafted by the staffs of the Creen Lake, Marquette and Waushare Cowry Zoning and Sanitation agencies in compliance with chapter Comm 83.22(2)(b)t1 MGM and 83.5401, (2) & (3), Wisconsin Administrative Code. • ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM a L i ' Owner/Buyer Mailing Address 4J4 Property Address �- ✓ (Verification required from Planning Department for new construction) City /State Parcel Identification Number b A?c — I ap - LEGAL DESCRP'r'iVIN - �� 3 Property Location (V %,, IS � /, Sec -L-a, T-, -R W, Town of Z , Subdivision _ c� -- LA , Lot # Certified Survey a # y P Volume , Page # Warranty Deed # 2 Sou Volume Z , Page # 0 Spec house Byes ❑ no Lot lines identifiable Oyes ❑ 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 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. 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 .lays of the year expiration date. iIGNA OF APPLICANT WNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of he roperty described above, by virtue of a warranty deed recorded in Register of Deeds Office. 3IGNA OF APPLICAN T DATE *•""` Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. ••• `•• ' Include with dais 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 �TATL� tlF �ISGONSlNTl7RM 1- 1998 7 7 3 (D m 1t y KATHLEEN H. WALSH t WARRANTY DEED „ REGISTER OF DEEDS ST. CROIX CO., WI Document Number II j RECEIVED FOR RECORD ii This Deed, made between Gr- e- ?- r*-' EnterPrises, Inc_ _ 06/25/2003 11:55AN I_ a Wiamncin ( -_ __ __- :j WARRANTY DEED EXEPPT i - - - -- -- - -- - Glamor REC j a Brian LeQue�LeQue Builders r•rc TRANS FEE: 11.00 nd - - -- - - - -,- - -. __ TRA FEE: 69 .90 2. - - -- -- - .. � COPY FEE: 2.00 CC FEE: - - - --- _ PAGES: 1 cramsR Grantor, for a valuably ronsld"ratiun, cnnv(- s lu Grant." the folluwin ii �I d.scrlb.d real.slaw In St. Croix Crsunty. SI:d" of Wis-11,111 is (the "Properly'): Ii n,.,,, „ A„ -. Name and Return Address Lot 44 of the Plat of NorthGate II, recorded in the I' Office of the Register of Deeds for St. Croix County, I &VIn�} R�r9 nr(� Wisconsin on June 20, 2001, in Volume 8 of Plats, at iI q0 d SOu TA` an 0 Page 55, as Document Number 648882. j (���(� (,Or z/e �kT ( 393184 li 038- 1209 -60 -000 — II Parcel Identification Number (PIN) This is not homestead property. (is) (Is not) II I I. I ii Together with all appurtenant rights, title and Interests. h I ! Grantor warrants that the title to the Property is good, Indefeasible in fee simple and free and clear of encumbrances except I easements, restrictions, and reservations, if any, of record. I 'i Dated this day of June 2003 II d SES, (SEAL) —_ (SEAL) ;! (SEAL) I III ii Rusch Sec/Treas I AUTHENTICATION ACKNOWLEDGMENT ( I l Slgnature(s) State of Wisconsin, i iv t inly. s. L I St. Croix Co1` authenticated this day of Personally came before me this 0, ye ttemeQ James E. Rusch its Presi R. Rusch, its Sec Trees TITLE: MEMBER STATE BAR OF WISCONSIN � C Qp (If not, me known to be the persons.._ -_ who eNt ly� to gV g�ioR authorized by §706.06, Wis. Stats.) instru nl and acknowledge the s nte. • 'r . ..' " era THIS INSTRUMENT WAS DRAFTED BY II ii Mary R_ Rusch _ Sandra Gehrke Notary Public, State of Wisconsin II New Richmond, WI My commission is permanent. (if not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not Septaw or 14 - tecessary) I� James of persons signing in any capacity must lie typed or printed below their signature. STATE BAR OF WISCONSIN wscas�� �uga: eia,+k Cu : \RANTY UEED FORM No. 1 - 1998 Mnweukee, Wis. J+ °° X o \.C( hh tqx cn i + �? ' ►� t i r + ,66Z X o x z N I O a X I t-� v _to Z_ K7; I I p \ x N ' � �• �, to + � b Z � � J v — ` c X N. 4 , p8 �► Q Ln -O I I 1 x {n O C� OD -. I Z � s I a I I o X 2 i' swcvz.v_r..;uis,rnsaw5n • b i NORTHCATE 11 M ,r:.> t.n ReS xeIt «m3w'riml 'i. IIi. T�_nu tvY.r. 's A' I �� -rs.� ' c N ('J SF: - , 7.,.ti .... R .... ........ .t- K i ou , j '• A.. .r », _. .. s. rom' n.mx«>mm a '.«'" s n .... ._ ?ii : � a /.. °/ .. e f , . n ;' .:� r.- P4 fp,vn « n Fn , « n ' ..... .. ' J s A E. ; :�:, 1 v t3) t 9( • p ns ,Y nll. 'f qfi Ml Sap 4 , ... » X i 4.. "WmtsOPPI(F mrx L:w,s Y'vwm:A)nry+W z �.�•°•, f �i rM:u:rvnxm.M,Mrl. I.ne,L Pa!