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HomeMy WebLinkAbout038-1206-60-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division + INSPECTION REPORT Sanitary Permit No 430321 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: Mau han, Rex I Star Prairie Township 038- 1206 -60 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 14.31.18.1111 TANK INFORMATION V ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing I (C� J f Alt. BM Aeration Bldg. Sewer g n Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet (� 9V 70 , TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ' Dt Bottom Dosing Header /Man. Aeration Dist. Pipe ref a � k L- Holding Bot. System 9 ("05 - t X 7 Final Grade PUMP /SIPHON INFORMATION Manuf cturer Demand St Cover Model Num tom-- � a✓jj sti , L ins �. 97,e) TDH Lift Fri ' ^ Loss System Head TDH t F emain Length Dia. SOIL ABSORPTION SYSTEM BED/TRENCH Width ' Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Die. Li ' DIMENSIONS r, SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer INFORMATION CHAMBER OR Type Of System: :r',w UNIT Model Numbe,� COnurcrt�i�ane>� Z� ^-3 l :� d." JLL L, DISTRIBUTION SYSTEM '- Header/M ni* Distribution ( I x Hole Size x Hole Spacing ent it In�� 5 �-- .r Pipes) Lengt Di Length Die 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 ✓V 3 p j f Bed /Trench Edges ,, 7 L/ Topsoil Yes 1 No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 9 /29/ `� Inspection #2: Location: 2150 127th Street Star Prairie, WI 54026 (SW 1/4 NE 1/4 14 T31N R18W) Prairie View Estates L P el No: 14.31.18.11111 'S e&SJ �.ds rn2� �he+S 1 - _7 - I Sde-t) v X / - -% - ? L 1.) Alt BM Description = ti l �S ` I d : ci.n - t ,r P(4 5-t. C chi 5 K 2.) Bldg Bldg sewer length - amount of cover = l C� T -- — - -- — — — — Plan revision Required? ! i'. Yes No r— � --7 I Use other side for additional information. �" �� SBD -6710 (R.3/97) Date I epctor's Signature Cert No Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 St. Croix N visconsin Madison, WI 53707 — 7162 cite Arlrlrecc Department of Commerce * 2US0 /2-7 Sanitary Permit Application sanitar p� _ 13 'z In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision may be used for secondary purposes Privacy Law, s15. )(1p� •,.....•... I. Application Information — Please Print All Information t t ¢ r *a . I tate Plan I.D. Number Property Owner's Name arcel Number Rex Maughan �;i 0033 Q 38' lzo(0 O Property Owner's Mailing Address qroperty Location N11743 13 Street --- --~ - ---° °� SW % <; NE %4; S14; T31N, R18W City, State Zip Code Phone Number Lot Number Block Number Downing, WI 54734 1- 715- .X4-5-(4CI 1 6 NtA Subdivision Name CSM Number er . i V; C Lj C ie5 II. Type of Building (check all that apply) t Os S [I City X 1 or 2 Family Dwelling — Number of Bedrooms 4 5 . ❑ Village ❑ Public /Commercial — Describe Use X Town Star Prairie ❑ State Owned '3 t K .�' - __�1 CTH C oad III. Type of Permit: (Check only one box on line A (numbering scheme for internal use $. omp ete line B if applicable) A. 1 X New 2 ❑ Replacement System 3 Replacement of 6 11 Additionto For County use System Tank Only Existing System B Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) 44 X Non — Pressurized In- Ground 21 ❑ Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treat nt Unit 49 ❑ Recirculating n f Pther V. Dispersal/Treat ent Area Information: po Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation ISystbrn Elevation Final Grade Required Proposed Rate(Gals. /Days /Sq.Ft.) Rate Elevation W • g (Min. /Inch) #1 96.7' 100.7' 600 857.1 ft2 .7 N/A #2 %-40 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic 1250 1250 1 Skaw Precast X - -f C__ VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumb ' , ignatur MP/MPRS Number Business Phone Number Thomas D. Gustum 227618 715) 658 -1344 Plumber's Address (Street, City, State, Zip Code) N13450 937 St New Auburn, WI 54757 VIII. County/ e artment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing gent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Initial Adverse Determination IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER 1 Septic tank, effluent filter and dispersal cell must all be serviced /maintained as per management plap provided by plumber. 2. All setback requirAmante ... ust he maintained as per applicable t�chg�pte(� (to the County only) for the system on paper not less than 81/2 x I1 inches in size SBD -6398 (R. 05101) ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND n OWNERSHIP CERTIFICATION FORM Owner/Buyer e✓4���ir1 Mailing Address t ~ 1 9, 3 t�� � � �Ut� =%k clg ; l,-)I SI( ~ 73y Property Address a J a? `7'`�' �''� t (Verification required from Planning Department for new construction) City /State pvc Parcel Identification Number L&J" �'C LEGAL DESCRIPTION Property Location V4, V4, Sec. �� T3_N -R L'LW, Town of nn \11 e-U3 Lot # i.�C� " �P Subdivision 1 Cl. � �� � Certified Survey Map # �— , Volume ` . Page # Warranty Deed # 3 S 3 , Volume 2- G2 , Page # Spec house g yes ❑ no Lot lines idenr r u , SYSTEM CE q / , Improper use and maintenance of your septic system could result in its I Q � X 'roper maintenance consists of pumping out the septic tank every three years or sooner, if needed V U at into the system can affect the function of the septic tank as a treatment stage in the waste disp The property owner agrees to submit to St. Croix Zoning Department k __ by the owner and by a mastcrphunber, journeyman plumber, restricted plumber or a licensed pumper vern . me 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. we, the undersigned have read the above meats and to maintain the private sewage disposal system with the standards U �� agree erstgn 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 expiration date. /11 SI GNATURE OF APPLI 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 roperty described above, by virtue of a warranty deed recorded in Register of Deeds Office. 4 /0 /� IGN TUBE OF APPLIC DATE ****** A be' revoked b the Zoning Department. * * * * *« information that is mis-re resented may result in the sanitary pe rmit mg Y An o Y P Y *« 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 1 � 1 Gl U m Q Z O V CL Paz e 7 . tY Z ~ fq M a w �G O E U a cn t a Q n w ch _ � 'v m go Q!n lk N _ Q N m � m Np r(1) o Y ` m ri � 7 / O Ccc U a CL o . c cc / m o o n U X 11 0 _ ol ED QD w �w W o 8 8 J U m �V J J ,� N II II II U) O . N m m t J_ n. i J = 00 4 w ' I on J s iii �S �15 .a L Z 3 � Q m N ? E aX U 0 Q oa w Ov m co o v U t° N rh N _ n O m N m n cu o c d = n CL U CL n o - $ n 8 � co J N p cn w w U O ,► 11 11 f A m in in J a 00 a v m Q 4 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page - L— 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 point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. pen Please print all inf9rratian -; . R iewed by Date Personal information you provide may be used for secoptliry purposes (Privacyt,�w, s. 15.04 (1) (m)). ` . o r 3 Property Owner roperty Location EwlenPro rties Ltd. ro L sJ � `G A. Lot SW 1/4 NE 1/4 S 14 T 31 N R 18 (or) W Property Owner's Mailing Address # Block # ir Subd. Name or CSM# 1430 220th. Ave. 1 �� 16 ' View Estates City State Zip C(1de Phone Numb City ❑Village R) Town Nearest Road S Mot)( _ New Richmond I WI 5407,J 715) 2918 ® New Construction Use: [2 Residential kNum of bedrooms Code derived design flow rate tine GPD ❑ Replacement ❑ Public or commetcfal i descOlbo: t ' Parent material outwash Flood Plain elevation if applicable na ft. General comments and recommendations: trenches @ el. 96.70' F I Boring E] Boring g Ground surface elev. 100.1 0 ft. Depth to limiting factor +1 00 in. Pit 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 -11 10 2/2 none L 2msbk mfr cs if .5 .8 .4 . 2 1 -25 0 mfr 4 3 none sicl 2msbk 9w if 6 3 5 -100 .5 4/6 none osg ml na na .7 1.2 c a - F -21 Boring # Boring Pit Ground surface elev. 100.7 ft. Depth to limiting factor + 1 00 in. Soil Appkafion Rate Horizon Depth I Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fti in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 I "Eff#2 1 10 2/2 none L 2msbk mfr cs if .5 .8 none sicl 2msbk mfr qw if .4 .6 -1 7 5 4/6 none ms osq ml na na •7 1'2 " Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L Vuent #2 = B2 2 5 : 5 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Gary L. Steel 02298 Address ` Date E luation Gen ucted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 12 -1 -200 715 - 246 -6200 Property Owner awl Qn 12m Ltd. Parcel ID # myding Page 9_ of 3_ Boring # ❑ Boring 100.70 +100 pit Ground surface elev. ft. Depth to limiting factor in. - To 7 fl - Application 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 -10 10 3/3 none L 2msbk mfr cs if .5 .8 2 10 -21 7.5 4 none scl 2msbk mfr 9W if .4 .6 3 21 -26 10 5/4 c2p7.5yr 5/8 sicl M na gw if .0 .0 4 26 -10 7.5vr4/6 none ms Osg ml na na .7 1.2 g' F-I Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Ap licetion 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 Boring # ❑ 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/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I `Eff#2 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 (R.6100) Wisconsin Department of Commerce SOIL EVALUATION REPORT Page - 1 —of 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 point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. pending Please print all inWmatlon: — Reviewed by Date Personal information you provide may be used for s6cO66ry purposes (Prtvac!• W, S. 15.04 (1) (m)). Property Owner roperty Location EwlenPro ies Ltd. �" Q "G vt. Lot SW 1/a 1/a S 14 T 31 N R 1 (or) w Property Owner's Mailing Address L # Block # Subd. Name or CSM# 1430 220th Ave. = 116 Prairie View Estates City State zip Cade Phone S7 � Olx = City El Village ® Town Nearest Road New Richmond I WI 5401,7 715) 248M 11 ZrANINQ ® New Construction Use: ® Residential uniber of bedrooms : Code derived design flow rate _ 6On GPD ❑ Replacement ❑ Public or coma 14_ OleSCnb Parent material outwash Flood Plain elevation if applicable na ft• General comments and recommendations: trenches @ el. 96.70' Borin g # Boring 100 9 pit Ground surface elev. + 100.10 ft. Depth to limiting factor in. Soil Application 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 -11 10yr 2/2 none L 2msbk mfr cs if .5 .8 2 1 -25 10yr 4/3 none sicl 2msbk mfr 9W if .4 .6 3 5 -100 .5 4/6 none MS 2s9 ml na na ' 7 1'2 - Boring # E l Boring 100. +100 LX 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/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 10yr 212 none L 2msbk mfr cs if .5 .8 none sicl 2msbk mfr qw if .4 .6 - 7 5 4/6 none ms Osg m1 na I na .7 1.2 • Effluent #1 = BOD > 30 220 mg/L and TSS >30 _< 150 mg/L Vuent #2 = BO < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Gar L. Steel -�� 02298 Address Date E luation ucted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 12 -1 -2 715 - 246 -6200 i STEEL'S SOIL SERVICE Gary L. Steel Ewlear Properties, Ltd. 1554 200th Ave. CSTM2298 Sw4NE' S14- T31N -R18w New Richmond, WI 54017 MPRSW -3254 town of Star Prairie (715) 246 -6200 lot #16- Prairie View Estates 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. 100.00' i Alt. BM.= top of 1 11 pvc piep 2 el. 100.85' 3 t Gary Steel 12 -1 -2000 L Chambers Page 1 of 4 Cover Page Project Name: Rex Maughan Owner's Name Rex Maughan Owners Address N11743 130th Street Downing WI 54734 Legal Description SW NE Sec 14 T F - 3 - 171 N, R r 18 w W Township Star Prairie County Saint Croix j Subdivision Prairie View Estates Lot# 16 Parcel I D# Table of Contents pg- 1 Cover page 2 Calculations and Drawings 3 Management and Contingency Plan 4 Plot Map total # of pages: 4 Designer Name: Thomas Gustum License #: 227618 Date: 8/14/2003 Ph. #: 715 - 658 -1344 Signature: Design Methods Used "IN- GROUND SOIL ABSORPTION COMPONENT MANUAL FOR PRIVATE ONSITE WASTEWATER TREATMENT SYSTEMS" (Version 1.0) SBD- 10705 -P (R.6199) Chambers Page 2 of 4 Calculations and Drawings Site Conditions Infiltration Elevations Site Type:' Private Trench #1 Trench #2 Trench #3 %Slope 1 % Contour Elev: 100.70 0.00 0.00 Ft # of Bedrooms 4 Infiltration Elev: 96.70 0.00 0.00 Ft Depth to limiting factor 100 in Limiting Factor Elev: 92.37 N/A N/A Soil Application Rate: 0.7 gal /ft ^2 /day Treatment and Dispersal Zone: 4.33 N/A N/A Effluent Quality:: # Cover Material Required: 0 N/A N/A In Design Flow: 600 gal /day Finished Grade Over Cell: 100.70 N/A N/A Max BOD 220 mg /I Max TSS 150 mg /I Distribution Cell Septic Tank Choose chamber type: Septic Tank Manufacturer: Skaw Precast Infiltrator Standard i _ _ _ _ Septic Volume Chosen: 1250 Laying Length: 6.22 Ft Effluent Filter Selected: Simtech 110 EISA Determined Area: 31.1 Ft2 Note: Access opening of sufficient size to be provided to allow removal of filter. Opening Open Bottom Area: 15.50 Ft2 to terminate at or above grade. Chamber Height: 12 Inches Required Infiltrative Area: 857.1 Ft2 Total # of Chambers: 28 Total Cell Length: 174.2 Ft Cross Section of Septic Tank Cross Section of Cell 12° Min Grade Cover Material Observation Pipe (if required) Final Grade 18" Min - - Ground o ` All joints to Contour be water tight D3034 or Effluent Sch40 Leaching System Filter Pipe Chamber Elevation 3" Bedding Under Tank Plan View of Typical Cell Length 0 0 MM 5054 nlayerva{aon C7byervation Wld�, or 5ch 40 4" pipe pipe PVC pipe Page 3 of 4 In- Ground System Management Plan pursuant to comm 83.54 W. A. C. Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surface discharge, treated effluent levels, etc. The owner or owner's agent is required to submit necessary maintenance reports to the appropriate jurisdiction and /or the department. Septic Tank: Septic tank(s) are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemical /biological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned as necessary, with provisions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge /scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Absorbtion Cell The absorbtion component must remain free of ponded surface water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible problems /failure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing /maintenance (i.e. excessive walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities and /or possibly cause it to freeze in winter conditions. Performance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: If the septic tank or other components therein (including floats, alarms, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the absorbtion component cannot accept wastewater or ponds wastewater to the surface, the component must be repaired or replaced in it's current location by removing the clogged bacterial mat, aggregate /leaching chamber cell, and distribution piping within the cell and replacing failing components in order to return system to proper working order as required. If repair is not feasible, a new system is to be constructed in a designated replacement area ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSI-DP CERTIFICATION FORM Owner/Buyer -Qe- Mailing Address 1 `1 3 l 3C� Property Address 7'' ' �C,f , PE Qv It Z. (Verification required from Planning Department for new construction) City /State �Gr� Parcel Identification Number L-6 +- 1 �6 LEGAL DESCRIPTION Property Location V,, NE V., Sec. T 3 N -R_LS—W, Town of Subdivision , PC ci. � -C � 1 t✓t ,J �� °� . Lot # < <P Certified Survey Map # Volume , . Page # Warranty Deed # S 3 , Volume 2-3 !02 , Page # Spec house Ayes ❑ no Lot lines identifiable ❑ yes ❑ no SYSTEM MAINTENANCE Improper use and maintenanceof 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 mastor plumber, journeyman Plumber, restricted plumber or a li cense d p 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 three year expiration date. L ':�2Q' A&41� /-r / /4 <23 IGN TUBE OF APPLIqKNT 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 owner(s) of =;nbedabove, by virtue of a warranty deed recorded in Register of Deeds Office. / / 10N TUBE OF APPLIC 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 2362P 096 73S37121 STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER D EEDS CO. This Deed, made between Martin S. Hedlund and Brenda L. RECEIVED FOR RECORD Hedlund, husband and wife, Grantor, 08/13/2003 09:30AM and Rex A. Maughan Q`r^ Grantee. WARRANTY DEED ra tor, for a valuable consideration, conveys and warrants to Grantee EXEMPT # the following described real estate in St. Croix County, State of Wisconsin i is needed, please attach addendum): REC FEE: 11.00 t 16, Prairie iew Estates, St. Croix County, Wisconsin. TRANS FEE: 108.00 COPY FEE: CC FEE: PAGES: 1 Recording Area Name and Return Address KRIS"" `� OGLAND ATTO: AT LAW P.O. BOX 359 HUDSON, WI 54016 038 - 1206 -60 -000 Parcel Identification Number (PIN) This is not homestead property (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this t day of August 2003 * * Martin S. Hedlund * * Brenda L. Hedlund AUTHENTICATION ACKNOWLEDGMENT Signature(s) Martin S. Hedlund and Brenda L. Hedlund, STATE OF ) h usband and wife, ) ss. — -- - - - - -- _� County ) authenticated this I I day of August 2003 Personally came before me this day of the above named * Kristina Ogland TITLE: MEMBER STA E BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY A ttorney Kristina Ogland Hudson, WI 54016 Notary Public, State of 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 Co.. Fond du Lac, wi STATE BAR OF WISCONSIN 800- 655 -2021 WARRANTY DEED FORM No. 2 - 1999 FROM :EDI,NA RLTY NEW RICHMOND 715 246 7406 2003,07 -03 08:07 #388 P.01/01 T. l i • 1.77' ` y. ••v .+�4 a N ra t SR RV /r Y '4 - OF 7HE HIVE Y14, Sjz-�7 74 UNPLA ; 21 2 0.00 Sag'01`WE 2643.19' NGY'JN UNE G " ])yE , zaA0• aar slant xasf' A/NAOf ESwr. H, N_ r�d p S1<aa' 23 22. 30 31 32 � �33 . • • ' We sa f7 p 74, 6aa sa Fr. �` 74 6B9 S.9, rT. .� ACRES ;, 1.71 ACRE ' ., 71: 69e SC fT � •n 87.797 SC! Fr. f E�368p ,KIN. FIE- E436G 0 c 1.71 ACRD I. .9 � 1.71 ACRES 168�CRSS� ry � ,�01 ACRES � a 4ON. F— Fr-JSBO ANN. F.FE -J6e0 r: ' ANN. f.F.E-38e_0 8 W RFrw �56� o • ' `. L/NE ...... .. . , - I o ss�c;'r;:•e ;:�:.or :rte.. .� �� „ �, � - zratr_•° -- �rcr'-- •�° • `� SllGD7'5G E elt.ls F i■ Ji' UY✓ Ed�NFM �� Ar Sr gzsee SO Fr ra ' erizo�� s w ,� • . • • •�' • • 2 12 ACRES It . . - , I •. - ` � �• 8R-994 sa Fr. •5E i45 52 FT t n N S; 191 SG. 17 « ` 2.05 ACR: S' pq AVIV r.F.S. =37Q0 •KIN. 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