HomeMy WebLinkAbout038-1211-10-000 Wisconsin DQp rtment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division ,
INSPECTION REPORT Sanitary Permit No:
(ATTACH TO PERMIT) 479272 0
GENERAL INFORMATION 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:
Marek, Darin Star Prairie, Town of 038 - 1211 -10 -000
CST BM Elev: Insp. BM Elev: BM Descri tion: Section/Town /Range /Map No:
6U .$ 16 - 3 1 < 0 5 13.31.18.1149
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic d � Benchmark_ � /45 I S
Dm iag , l v� J AI BM i
Aeration Bldg. Sewer
Holding St/Ht Inlet
TANK SETBACK INFORMATION St/Ht Outlet ,
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic / / Dt Bottom
Dosing Header /Man. p d 25 7
Aeration Dist. Pipe 1 9 .1 95 . 7
Holding Bot. System CJG
PUMP /SIPHON INFORMATION Final Grade JO O
Manufacturer Demand St Cover / -
GPM 3. Co /b i
Model Number
"4 . - 7
TDH L' Friction Loss Syste d TDH Ft q
J 1 -
Forcemain Length Dia. Dist. to well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length 2 o. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS Z /_
SETBACK SYSTEM TO VVJJ P/L BLDG , �
W�EELLL� LAKE /STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type Of System: J UNIT
Model Number: S�—
Ge i\lU6 a J
DISTRIBUTION SYSTEM 6 1 Z z +-Z
Header /Manifold it Distribution x Hole Size x Hole Spacing Vent tto In tale
G / � Pipe(s) Z J �'O
Length 1 Dia Length \ Dia \ Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only 4
Depth Over Depth Over xx Depth of xx Seeded/ odded xx Mulched
Bed/Trench Center Bed/Trench Edges \ Topsoil
Yes No Yes L] No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2:
Location: 1367 212th A Star Prairie, WI 54026 (NW 1/4 SE 1/4 13 T31 N R1 8W) North ate Lo 59 Parcel No: 13.31.18.1149
1.) Alt BM Description = I C -J Q, �` �' S S 0 V"'_ 2.) Bldg sewer length
- amount of cover = /
Plan revision Required? F] Yes No
Use other side for additional information.
Date Insepctor's Sig ture Cert. No.
SBD -6710 (R.3/97)
Safety and Buildin s Divisio C
201 W. Washingtb ve. Sant ry Permit Number (to be filled in by Co.)
Madison,
60 1 7? Z7,?— DB
on si (
! l c State plan[ . Number
Sanitary Permit App icati A)
In accord with Comm 83.21, Wis. Adm. Code, personal informatio you irE �) (() i r, , Pro} t Address (if different than mailing address)
may be used for secondary Purposes Privacy Law, s15.04( )(m) z()N I N _ OFF -; L
- Please Print All Information T %I 1 � l 02 — � �'
�. Application Information
Parcel # Lot # Block #
Property Owner'
Property Location
Property Owner's Mailing Address
Section
(O Zip Code Phone Number T I N' ,rf ir o �
City state � �, / � (/ RL / f u Ceircl one)
e,� ►r�otTsc -- Subdivision Name CSM Number
II. T e of Building (check all that apply} 6 k 4 A � A101
G
or 2 Family Dwelling - Number of Bedr
❑ Public /Commercial - Describe Use /1 t 1/ OCity ❑vill shi f
S owned - Describe Use _191 -' I -..
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A. system ❑Replacement System ❑ Treatmentll-Iolding Tank Replacement Only ❑
Other Modification to Existing System
❑
List Previous Permit Number and Date Issued
13. ❑permit Renewal El Permit Revision Change of ❑ Permir Transfer to New
Owner
Before Expiration
Plumber
IV. a of PO S stem: (Check all that APP ) ❑ Si ass Sand Filter El
> 4 in. of suitable soil � ❑Mound < 24 in. of suitable soil ❑ At -t Trade g1 P ❑
Non essurized In- Ground ❑ Mound - -
❑Peat Filter ❑Aerobic Treatment Unit ❑ Recirculating S Filter
Constructed Wetland [] In- Ground El Holding Tank ❑ Gravel -less Pipe [] Other (explain) �� Q
Chamber [] Dnp
Line s
Recirculating Synthetic Media Filt g D S stern I levati n
V. Dill ersal/I�reatment Area orntation: �l yea Required (sf) Dispersal Area Proposed (s t) � �
Design Soil Application Rate(gpdsf) ( i ��G1 l9
Design Flow (gp d ) /s
Prefab Site S 1 Fiber Plastic
Number Concrete Constructed
Total ber Manufacturer Glass
VI. Tank Info Capacity in
Gallons Gallons of Units
New Existing
Tanks Tanks
Septic or Holding Tank
.Aerobic Treatment Unit
Dosing Chamber
me responsiD'iGiy for installahRos N the pOWTS shown on the ness
V Responsibility Statement the undersig assu Phone N e — )
Pltunber' ame (Print)
Plumb ignature ��
Plumber's Address (Street, City, State, Zi ode)
lssuin ent Signatur o
VIII, nn /De artment Use Onl Sanitary Permit Fee (includes Groundwater Date
Issued
Approved ❑ - sapprov Surcharge Fee) 27 6
❑ wner Giv for Denial
DL Conditions of App al/Reasons or isapproval
SYSTEM OWNER:
1', Septic tank, effluent filter and
dispersal cell must all tag services I maintaw
as per management plan provided by plumber.
2. AU setback requirements must be maintained
as p applicable code I ordinances.
o the County only) for the system on Paper not less than 812 x 11 inches in sire
Attach complete plans (t
SBD -6398 (1t. 01/03)
PLOT PLA
PROJECT Damn Marek ADDRE 1,306 210th Ave New Richmond Wi 54017
NW 1/4 SE 1 /4S 13 /T 31 N/R 18 W T Star Prairie COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE 6/21/05 BEDROOM 3
CONVENTIONAL XXX IN- GROUND PRESS CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 allons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22
BENCHMARK V.R.P. Top of 1" PVC Pipe ASSUME ELEVATION 100' Filter Zabel A -100
❑BOREHOLE O WELL *H. R. P. Same as Benchmark
Well is to meet all SYSTEM ELEVATION 97.0/96.9 4' below qrade
setbacks required by
WDNR
Pro 3
Bedroom
House
210' Property Line
Plans Designed Using
Conventional Powts 30'
Manual Version 2.0 STO
Vent 2 -3' X 69' Cells with >3'Spacing 30' B -4
>611 Standard Biodiffuser 95'
of Cover Leaching Chamber B -2
with 31.1 ft2 of Area
20'
6' Long 11.99 B -3
3471 Grade at System Elevation
15'
56'
20' Vents B -5
72'
35'
B -1
20'
0 , 183' Property Line
A1t.B.M. @ 1" pvc
ipe @ 101.1 B.M.* 194'
(; o-% P
105' W y
PLOT PLA
PROJECT Darren Marek ADDRE L06210thAve New Richmond Wi 54017
NW 1/A SE 1 /4S 13 /T 31 N/R 18 W TOW Star Prairie COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE 6/21/05 BEDROOM 3
CONVENTIONAL XXX IN- GROUND PRESS CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 allons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22
IL BENCHMARK V.R.P. Top of 1" PVC Pipe ASSUME ELEVATION 100' Filter Zabel A -100
❑ BOREHOLE O WELL *H. R. P. Same as Benchmark
Well is to meet all SYSTEM ELEVATION 97.0/96.9 4' below qrade
setbacks required by
WDNR
Pro 3
Bedroom
House
210' Property Line
Plans Designed Using
Conventional Powts 30'
Manual Version 2.0
S
Vent 2 -3' X 69' Cells with >3'Spacing 30' B -4
>6„ Standard Biodiffuser 95'
of Cover Leaching Chamber B -2
with 3 1. 1 ft2 of Area 20'
6 Long 11 B -3
3419 Grade at System Elevation
15'
56'
20' Vents B -5
72'
35'
B -1
20'
20' 183' Property Line
A1t.B.M. @ 1" pvc
ipe @ 101.1 B.M.* 194'
105'
OUIL AMU "ail I t tVALUA i IUN K 1 rap 1 a
aid Flumrn, FpNactas
of 9atety a BuitaNrgs in Acoord with ILHR 83.05, WiS. Adm. Code
Attach complete site plan on paper not Use than 8112 x 11. inches in size. Plan nsust include, but St. Croix
not limited to ve *al and horizontal reference Point (BfM, d�rectbn and % of slope, scale or PARCEL I.D. 8
dimensioned, north avow, and bcation and distance to nearest road. 3
APPLICANT INFORMATION- PLEASE PRINT ALL INI=ORMATION REYIEWEDBY DATE
PROPERTY OWNER: UOCK# OCATION
1416 Third St.
1311 NorthGate
Grelealwtac�ci $i rises 1w. GOVT. 114 SE 1 r 4 - 8 13 T 31 .N.R 18 Coo
PROPERTY OWNER'S MAILING ADDRESS SUED. NAME OR CSM #
CITY, STATE ZIPCODE PHONE NUMBER ILLAGE OWN NEAREST ROAD
wr- 54016 ( 71-4 396-3674 .1 Star- Ava-
Now CcrxshcdM Use () ReWersai I Plumber of bedrooms 4 ( j Addilion to eras N b Aing
i [ ReplaMmoM [ ( Puft or ow"erdaf desaibe
Code derived daily flow 600 gpd Recommended design loading rate ._ 7 _bed, 9PW_.,.&_each 9PdA
Almapdon am required _858 _ bed. 9 90 french, 0 Maximum deso reading rye .7 bed, gpdffll $ lfranch, gpd*
ReoDmrrrended i fftedan surface elevations) 97 .20 g (as referred !Q site plan benchmark)
AdOlonal design t site considers ions rra
PaK�erlt rrtaterlal
autyaja Flood plain elevation. R applicable na — ft
S = SttilaEile for system c�NVENTt U MOUND t1V0 0MO PRI:SSwiE AT cRAOE SYSTEM w FN. F+oLOwB TANK
U unsullaw Per 91 S O U 1� S D U I t s ❑ U ®S ❑ U ®S ❑ U 0S. [N U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Corlsslerm ftsd y Roots GPD1ft
in. Munsell Qu. Sz. Cons: Color Gr. Sz. Sh. Bed tftch
1
2 12 -26 10yi 4/4
Gmund 1 r
OS9 Da
etesr. -
1110.J
Do* to
Hmidng
Remarks:
Boring #
10-22 10yr 4/A Biel 2MAhk mfr gK -A! R.
E D
Ground 3 22 -30 10 r 5/4
1 a ft 4 .5 r 4/6
Doo to
�Ittiting
IBM
+84 /
Re s:
CST Name:- -Pleaw Print QM L. Steel Ptwne: 715- 246 -6200
Andress: 1554 200th. Ave.hNsw Richwor
AL WI SOL
Signatvrc: Date: 11 -7 -98 CST Number: mO2298
k in, Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3
Human Relations
ision 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. Croix
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 -95
APPLICANT INFORMATION— PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
V. ':�. e
PROPERTY OWNER: PROPERTY LOCATION
Greenwood Enterprises, Inc. GOVT. LOT NW 1/4 SE 1/4,513 T 31 AR 18 ft(or) W
PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK # I SUBD. NAME OR CSM #
1416 Third St. 59 na NorthGate
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE MOWN NEAREST ROAD
H udson.
[ New Construction Use [ ] Residential / Number of bedrooms 4 [ ] Addition to existing building
j ] Replacement [ ] Public or commercial describe
Code derived daily flow 600 _ gpd Recommended design loading rate _ bed, gpd /ft trench, gpd /ft
Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate .7 bed, gpd /ft .8 trench, gpd /ft
Recommended infiltration surface elevation(s) 97.20 ft (as referred to site plan benchmark)
Additional design / site considerations na
Parent material oLtwash 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 91S ❑U ®S ❑U ®S ❑U ®S ❑U 0 CNU
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 jTrench
.................
1 -
- 2 12 -26 10 r 4 4 none sici 2msbk mfr 9X if -41 _C;
Ground 10 r 5/4 non
elev.
LOOM. 4 32 -84 7.5 r
Depth to
limiting
A4"
Remarks:
Boring #
2
2 10 -22 1
Ground 3 22-30 10 r 5/4 none sil lcsbk
elev. 4 30 -84 7.5 r 4/6 none Cos osci m
1
� f
Depth to
limiting �'' `
factor
+
Remarks:
CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 `"\ ZCOV+NG NTy
Address: 1554 200th. Ave.rAN#w RichmorW, WI AOL7 s
Signature: Date: : r:
11 - - 6siNuinbgr:, m02 &
PROPERTyOWNER Greenwood Enterpris SOIL DESCRIPTION REPORT Page ' .
PARCEL I.D. # 038 - 1055 -95
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
...':::..3..: 0-12 10yr 313 none 1 2msbk mfr QW
2 12 -26 inyr 4Z4 none sicl 2msbk mfr qw if .4 .5
Ground 3 na I na .7 .8
elev.
1
Depth to
limiting
factor
+ 84"
Remarks:
Boring #
1 0 -12 10 r 3/3 none 1 2msbk mfr if .5 .6
.. 2 12 -24 10 r 4 4 none sicl 2msbk mfr if .4 .5
Ground 3 24-30 10 r 5/4 none sil lcsbk mfr qw na .2 .3
elev. 4 30 -84 7.5 r 4/6 none cos osg ml na na .7 .8
100.9ft.
Depth to —
limiting
factor
+ 84 11
Remarks:
Boring #
1 - none 1 2msbk mfr Qw if .5 .6
5 2 11 -29 10 r 4/4 none sicl 2msbk mfr 9w if A .5
Ground 3 29-40 10 r 5/4 2d7.5 r 5/6 sil lcsbk mfr gw na .2' .3
elev.
4 140-84 7.5 r 5/6 none cos os ml na na .7 .8
1 . fit.
Depth to
limiting
factor
+84"
Remarks:
Boring #
13
Ground
elev. j
ft.
Depth to
limiting
factor
Remarks:
SBD- 8330(R.05/92)
STEEL'S SOIL SERVICE
Gary L. Steel Greenwood Enterprises, Inc. 1554 200th Ave.
CSTM2298 NW4SE4 S13- T31N -R18w New Richmond, WI 54017
MPRSW -3254 town of Star Prarie (715) 246 -6200
lot #59- 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 @ el. 100
Alt. BM.= top of 1" pvc pipe @ el. 101.10
o � Flo
l° V y
C
P r
i
5
.yo
8.1
s�
7V
Gary L. Steel
11 -7 -98
_ o
I U w t/N
I' o D Iv
z
10 o <
0 A %�
C. -,
r*i Ul w o0
�o 0o ry N 0'24'57' E 311.54' I c� ov o m fU
33 -- o u ry 0'52'34' E 284.26'
' ' I N O fU I
I
rn
A v, H N .
\ ? v( 3 Cn fV
I I 1\ \ z ° o o z IF)J
N \\ �O I CT) ti
00 0
_ l '
c 0 L
o cp, Q S
CD
0�
N D O� / `j s O �' j �s �� G V i
\ �r M Q°
/A O� p��`� Op� � S 0'52'34' i 6
l o
3 FO
I V
c26.
�R)
S z W
S 00 - -I ; Q
3 �g�i ,6t.Z� _ / S�, I COI I i � D
S _
A M \ / c °° C11 I i Q � W
L 4,• Z w -- v (O
100' ( � CJN
0 I GN
N . o t� A 240.91' I �
OD
co w Z z N 0'14'35' W 260.92' a1 v --- — 138 T"
OD O w D
0 -4 Cn Ul w w Z O] W — — — —
Ma intenance and Contingency Plan for a Septic System
..
Maintenance Plan
1. Septic Tank is to be pumped once every 3 Y ears.
r filter is being installed in
2. Eff luent filter is to be cleaned once a year. Please note: a large
order to extend the maintenance interval of the filter. the ins ections pipes at the ends of
3. Once every 3 years, cells are to be inspected via P
the cells.
a rees to limit greases, garbage, and water conditioner discharge into the system.
4.Owne r g
5. The owner agrees to save this plan.
6. Do not plant trees nor park nor drive over system.
7. Watershed is to be diverted away from system. per Comm. 83
8. Discharge into system is not exceed those required as p
Con ency Plan
If stem fails, determine cause of failure, use srnater±rd and install new
ption # . Y
em in tested replacement area.
tall system at a lower elevation, by removing chambers, removing biomat,
Option #2. Ins Y
and install new system.
area is suitable for replacement area, and system elevation
Option#3. No adequate
cannont be lowered. Install holding tank as last resort.
3. Replace any other falling components as needed.
Plumber: Shaun Bird 715 -246 - 4516
St. Croix County Zoning 715-386 -4680
Pumper Tom Mondor 715 - 246 -
Shaun Bird #226900
i
COUN'T'Y _T,AINT-
ST CROI CE AFLE
- PTIC- T� �MkNTEN
SE AND
CA TION FORM
O
ERTIFIWNB ,
pwnerA30
Mai ling M� Addr
artmcnt for new construction)
Address Pla�g D �'
property (v zequired ¢ °�
fication Number
p Identi
Cit /State ,Q
CROTION m of
- t
LEGAL. DRS T 2 - 1 N- W, To
/ �� 1 / Sec. �--= t ##
property Location �f�
o page #
Subdivision i Volume
Certified Survey NiaP 'Volume
Z� Z(p Page # l C�
���� eS pno
warranty Deed # Lot lines identifiab
Spec hound;/ 4 no rewature failure to e t OU Proper
ut in t o t sysW
1 ANCE tic system could Te Sult in i t s by a licensed p wha Y
ut ino the sys
SYS use H aute:. =nom of y years or sooner, if needed disp Sys waste disp and by a
i inS out the septic tank every b the owner
consists of p ump p treatuunt stage si y oral syst
can affect the function. of the septic tank as a nt a ce rt ifi c ation form, terdisp ewa cm
Departure that (1) the on -site asst 113 fittl of sludge-
s to submit to St. Croix Zoning d unVe1 verifying the 5eptic tank is less than
Zhe
property owner aSfee mstrictcdpl 'G1 °r a license ing (if necessary)
ey
p lumber , aurn� P lumber. ection P Syste with the standards
�ter p after �P vate sewage dispo cation
is in pro per operating coadibon and�nT (�) a � �c pri
ents and agree to ara atural i'esourc county Zoning Omoc within 30
Of �mmeree and the �� ent of N
1 d have read the above leto and to the St C
11we, the undas set by the 1?ep must be comp d nd returne
set forth, herein' system has
sta t your septic cxpu$ DATE
day f three year
Al -[TRh OF APPLICANT am ( the owuer(s) o
to the best of my (our) lmowledgc. I (nve}
OW 11110 CER�� 'xC— A-- �� this form are true inter of Deeds O�Ce � �/ r n 3
that all statements.oa decd recorded in Reg < G�
( crib of a warraat7' _._,_ -,r•--
the OP describedabove, b virtue DATE'
` De altrncnt. ss. «•.
Tt1RE OF PLICANr permit being revoked by the honing P
SIGNA y result in the sanitary
�, �{ that is mis -nPn�nted `.
Wan decd from made the Register of D office n deed
;eAtioa a stamped wa � ,ed survey map if reference is m the warts tY
•: IQClude with this aPPI a copy of the cer if
U. 2 826P 180 -7 c0lexlm-
KATHLEEN H. WALSH
STATE BAR OF WISCONSIN FORM 1 — 1998 REGISTER OF DEED
WARRANTY DEED ST. CROI
RECEIVED FOR RECORD
Document Number 06/20/2805 11 :30AN
This Deed, made between Earl L. Mielke and Nan J. Mi Ik 1rARRANTY DEED
husband and wife Grantor, an flar �n axek� 1`cWY ANTY #
Grantee. EXEWT
Grantor, for a valuable consideration conveys to Grantee the following REC FEE: 11.00
described real estate in St. Croix County State of TRANS FEE: 219. 0e
Wisconsin (the "Property " ): COPY FEE: CC FEE:
PAGES: 1
Recordina Area
Name and Return Address
��
- 1 �
('Rp4p SS�135- g''l�D
038 1211 10 000
Parcel Identification Number (PIN)
This is not homestead property.
(is) (is not)
Lots 59 and 60, Northgate 11, Town of Star Prairie, St. Croix County, Wisconsin.
Together with all appurtenant rights, title and interests.
Grantor warrants that the title to the Properties good, indefeasible in simple fee and free and clear of encumbrances
except
Dated this 20th day of June 2005
(SEAL) (SEAL)
Earl L. Mielke Nancy J. Mielk
(SEAL) , (SEAL)
*
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) WENDY SV4A I ZINA State of Wisconsin,
NE)T PUBLIC } ss.
authenticated t& E db}�f W I S CO N S I N St. Croix County
Personally came before me this 20th day of
June 2005 the above named
Earl L. Miele and Nancy . Miel h d and ife
* to me known to be the person who executed the
TITLE: MEMBER STATE BAR OF WISCONSIN foregoinq instrum nt and acknowled e t e same.
(If not,
authorized by §706.06, Wis. Stats) Al
THIS INSTRUMENT WAS CRAFTED BY Notary Public, State of Wisconsin
Coldwell Banker Burnet M ` rionC t -
1301 Coulee Road M y commission i rata en . (If not, state expiration date:
Hudson, WI 54016 �LI 1bN p
5 -36638 ll (()) )
(Signatures may be authenticated or acknowledged.
Both are not necessary.)
Names of persons signing in any capacU must be typed or printed below their si nature.
STATE BAR OF WISCONSIN Wisconsin Legal Blank Co, Inc.
WARRANTY DEED FORM No. 1 —1998 Milwaukee, Wis.
Parcel #: 038,1211 -10 -000 06/27/2005 10:35 AM
PAGE 1OF1
Alt. Parcel #: 13.31.18.1149 038 - TOWN OF STAR PRAIRIE
Current �X_, ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): * = Current Owner
EARL L MIELKE * MIELKE, EARL L
865 CHARLIE RYAN RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1367 212TH AVE
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 1.269 Plat: 2227 - NORTHGATE II
SEC 13 T31 N R1 8W NW SE LOT 59 NORTHGATE Block/Condo Bldg: LOT 59
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
13-31N-18W NW SE
Notes: Parcel History:
Date Doc # Vol /Page Type
06/11/2003 725406 2271/368 WD
2005 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations Last Changed: 10/13/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.269 26,900 0 26,900 NO
Totals for 2005:
General Property 1.269 26,900 0 26,900
Woodland 0.000 0 0
Totals for 2004:
General Property 1.269 26,900 0 26,900
Woodland 0.000 0 0
Lottery Credit Claim Count: 0 Certification Date: 12/0411998 Batch #: PRGRM
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
I