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HomeMy WebLinkAbout040-1202-40-000 Wisconsin P °party it of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety anc� '�Sldiny Division INSPECTION REPORT Sanitary Permit No: 117 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: Simpson, Marshall and Kathy Troy, Town of 040- 1202 -40 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 06.28.19.935 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dst. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK _ TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATIO F77 CHAMBER OR UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia 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 0 Yes 0 No Ej Yes TjNo COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 531 Nordic Lane Hudson, WI 54016 (NE 1/4 SE 1/46 T28N R19W) Nordic Heights Lot 14 Parcel No: 06.28.19.935 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Re quired? ❑ ❑ T _ r - -- r Use other for additional information, No SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. v �IC�I County Sanitary Permit Application ST. CROIX COUNTY WISCONSIN G p In accord with Chapert 12 St. Croix County Sanitary Ordinance PLANNING & ZONING DEPARTMENT Personal information you provide may be used for secondary purposes ST. CROIX COUNTY GOVERNMENT CENTER [Privacy Law. S. 15.04(1)(m)] 1101 Carmichael Road $ Hudson, WI 54016 -7710 (715)386 -4680 Fax 715)386 -4686 Attach complete plans for the system on paper not 8 -1 x 11 inches in size. County Sanitary Permit # ❑ Check if revisi revious atio 01%_7 Application Information - Please Print all Information ocation: Property Own er " e 1/4 1/4, Sec Al a ((11 Property Owner's M g A e s of Number Block Number 5 � ST. CROIX COUNTY it , S t ! Zip Cod Phon ub 'onName or C Numbe 1L / (/ J n (/ �� t C. 11 Type of Building: (check one) Mity ❑ Village 'MTown of [� 1 or 2 Family Dwelling - No. of Bedrooms: r—+ ❑ Public /Commercial (describe use): QL ❑ State -owned kPar re ad Tax Number ) It. Type of Permit: (Check only one box on line A. Check box on line B if applicable) A) 1'.�i'Repair 2. 11 Reconnection . ❑Non- plumbing 4. ❑Rejuvenation �� Sanitation B) Permit Number y' Date Issued State Sanitary Permit was previously iss ed ((( -���/ �! C/J) IV. Type of POWT System: (Check all that apply) Non - pressurized In- ground ❑ Mound z 24 in. suitable soil ❑ Mound :5 24 in. suitable soil ❑ Mound A +0 ❑ Sand Filter ❑ Constructed Wetland ❑ Peat Filter ❑ Drip Line ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Other ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating . Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade �150 Required Proposed (Gals. /day /sq.ft.) (Min. /inch) Elevation VI. Tank Information Capaicty in Gallons Total # of Manufacturer Prefab Site Con- Steel Fiber- Plastic New Existing Gallons Tanks Concrete structed glass Tanks Tanks ❑ ❑ ❑ ❑ ❑ VII. Responsibility Statement I, the undersigned, assume responsibility for repair / reconnenction /rejuvenation/installation of non - plumbing for the POWTS shown on the attached plans. A license is not required for terralift repair e i9ftallation of non -plum ing sanitation system. PW14 , s Nam print u (no m ): o Bus' s Pho r 1A A n Plumber's Address (Street, City, fate, Zip Code) P III. County Use Onl A 17 isapprov Sanitary Permit Fee D to Iss ed Iss n Agent Si at (No st Approved Owner Giv ni dverse `y�rfJ 22 C a 07 Dete ination 7 7 IX. Conditions of Approval /Reasons for Disapproval: SY 'CIA 011VI�IJM: I. sew httk,-~ ANsr str� dMarle WsM ed must am h fls#vkM — m m #�s'w � � prowMed by P�nbsr• 2. As sac r6***W1ft f11 4d to m6kftkw ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer �� ! VP SOA REC Et V E Mailing Address j 3� 1 ! SEP 0 5 2007 Property Address ST. CROIX COUNTY (Verification required from Planning & Zoni Auction) City /State Parcel Identification Number LEGAL DESCRIPTION Property Location ~1 /a ,�' /a , Sec.1, TOEN RZ�_W, Town of Subdivision , Lot # �. Certified Survey Map # , Volume , Page # Warranty Deed # � 2LO , Volume , Page # 3� Spec house yes no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to ndle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a lice ed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal syste . Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordi nee. The property owner agrees to submit to St. Croix County Planning & 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 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. 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 Planning & Zoning Department within 30 days of the three year expiration date. 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 the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms (}r— ,�/ � /0/ SIG ATURE OF LICANT(S) DATE ** *Any information that is misrepresented may result in the anitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed fro the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) 2 n ■ § n o : ■ I E § � § � 2 � $ % m E 2 T CD m . i § $ Iƒƒ/ o \ G 2/ 7 2 _ S' r- ^ 2 E' � m 9 - @ E a E m §\ 2 w a$ ^ 7 2 §§ o § } m / \ ® in / / § ƒ § ° ( — — § ■ U, o o 0 o E 0 CO ° ° @ ( ( C E § $ \ A " a, 2 E / o o R 0 o e e a C © / $ 0 / k k i 2 0 Cl) C) ° c r , :2 j o 0 0 CD \ �- » r / ] § ■ ■ ( . 0 \ \ . � % � � m cc ; 5 , �: PA to i ± @ 2 z z co z \ � / ? > � \ q m / ( J '0 c j k\ ® ` = \ CL z ] R ■ $ o E § 2 z § q 7 i / z $ m C § E & § "n I E z % 2 A t E � St � � k � $ � � 2 � I [ o ON < § ) )0 $ : � P #: 040 - 1202 -40 -000 01/13/2006 03:23 PM PAGE 1 OF 1 Alt. Parcel #: 6.28.19.935 040 - TOWN OF TROY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner MARSHALL L & KATHY J SIMPSON O - SIMPSON, MARSHALL L & KATHY J 531 NORDIC LA HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 531 NORDIC LA SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.010 Plat: 2204 - NORDIC HEIGHTS ADD SEC 6 T28N R1 9W 2.01A LOT 14 NORDIC Block/Condo Bldg: LOT 14 HEIGHTS ADD Tract(s): (Sec- Twn -Rng 401/4 1601/4) 06- 28N -19W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 812/342 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 103620 179,600 Valuations: Last Changed: 07/22/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.010 55,700 117,200 172,900 NO Totals for 2005: General Property 2.010 55,700 117,200 172,900 Woodland 0.000 0 0 Totals for 2004: General Property 2.010 55,700 117,200 172,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 205 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT dNER ���(�( / %S �� TOWNSHIP U SEC . T �h N, R W ADDRESS ST. CROIX COUVrY WISCONSIN. SUBDIVI ,' /t, S LOT /j/ LOT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 0 0 , . oo ____t_ ::T _4 JF ` I 3 • I I i ! — di zate Nort A j SEPTIC TANK(S) MFGR. CJQiSe/ s CONCRETE X STEEL NO:_ rings on cover a 2 Depth 6 PUMPING CHAMBER SIZE PUMP MFGR. MODEL NO. GALLONS Per Cycle TRENCHES NO. of width length_ area BED NO. of lines ,� width length f6 area 6 v depth to top 07 pipe a" NUMBER OF SEEPAGE PITS Outside diameter total pit area AGGREGATE / �y '' PERK RATE AREA REQUIRED ( /�` AREA AS BUILT 6 °' Disclaimer: The inspection of this system by St. Croix County does not imply complete compliance with State Administrative Codes. There are other areas that it is not possible to inspect at this point of cons uction. St.'Croix County assumes no liability for system operation. Howeve if failure is noted the County will make every effort to determine cause of failure. GREASES AND OILS SHOULD NOT BE DISPOSED THROU H HIS YTEM. INSPECTO C� DATED PLUMBER ON JOB LICENSE NUMBER REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM San.itany Permit State Septic NAME _„Q/ Townah.ip� St. C County Location 1 G S if Sect,%on� lot N .iv.i.6 ion S EPTIC TANK Size It) a gattona Number o compan.tmentA I Oi.6tance 6nom. Wel ���� Building 1.2% .6tope `-- Highwa.ten PUMPING CHAMBER Size Ratton4 _..,Pump Manu6actunen Model Numbers H OLDING TANK k Size gattona Number o6 Compantmenta Pumpers Atanm Syatem O.iatance 6h.om: W e.IC Buitd.ing 12% atope_ H.ig hw aten____`_�_ ABSORPTION SITE Bed Ttench O.i atance 6 nom: Well ,��) � -Building � �� 1.2% 6tope Highwaten A BSORPTION SITE DIMENSIONS Width o6 trench l P 6t Requ.ined area /`5� 6t Length o6 each tine ^ � 6t Depth o6 rock below the in r f � o mbe n o6 ti-nea Depth o6 rock oven t.ite � in zax .length o t.�.nea 6t Depth o 6 the below grade � y .in is tance between ti,ne,6 � 6t Slope o trench 2j in. pen 100 � 6t y Tuiuk, absu&p.tion anea 6x Type o6 Coven: apen % atnaw PIT DIMENSIONS Numbers o p.ita Gnavet around pite yea no Out.6ide d.iametet 'Depth betow ,.in.E'e.t 6•t Total abaonption area 6t Akea uquiud 17 it l INSPECTED By y G( �.- TITLE APPROVED. DATE 19 REJECTED DATE 198 REASON FOR REJECTION Pl_4 63 REPORT ON INSPECTION OF SANITARY PERMIT # (1 1 N e and Ad ress of Permit Holder Person /Persons at Site (2 )Date of Inspection ress, icense o. o s a Ong Plumber Time of Inspection 3 )IN LLATION CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber ❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank [ System B ermanen reference Point) Describe: Elevation of vertical reference point: Slope at site: (5)MATERIAL AND DEPTH OF SEWER: (6)SEPTIC TANK: Manufacturer: Liquid Capacity: Tank Inlet Elevation: Tank Outlet Elev: # ft to lot or property line: # ft to well (7)DOSING TANK: Manufacturer: # of gallons: # of gallon pump set for a cycle gallons; total capactiy of distribution lines gallon; size of pump head; gallon per minute ; horsepower ; brand name of pump and model number . Is the warning device installed? ❑ YES ❑ NO Wired? ❑ YES ❑ NO 8 HOLDING TANK: Manufacturer of gallons ; construction depth to the cover ft; If septic tank is being used are baffles removed? YES []NO; ft from residence; ft from well; ft from property line. Type of warning device Is the warning device installed? ❑ YES []NO; Wired? []YES ❑ NO; Locking device on cover? []YES ❑ NO; Diameter of vent and material ; Distance from building to vent (9) SEEPAGE PIT SIZE: # of pits; ft diameter; ft liquid depth; ft to residence; ft to well; ft to property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than seepage pit inlet pipe - elevation ft; bottom of seepage pit elevation ft. (10) SEEPAGE BED SIZE: ft width; ft length; tile depth; lineal feet tile; ft to residence; ft to well; ft to lot or property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches Elevation of tank discharge line entering bed ft. 11 SEEPAGE R . Total length of seepage trench ft; width ft; tile depth ft; ft to well; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches; elevation of tank discharge line entering seepage trench ft. (12) Has system been installed in area indicated on EH 115? []YES ❑ NO (13) Has system been installed in floodway? []YES ❑ NO Floodplain? ❑ YES ❑ NO DILHR -SBD -609 N.0 /8 Signature of Inspector 7 State and County State Permit # PLB 6 Count Permit # Permit Application Y f County Private rivate Domestic Sewage Systems 9 Y *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: /, B. LOCATION: - ' /4 —5C - - ' /4, Section —.a, T_,ON, R__LJ Q (or) 6) Lot# _J 51 City Subdivision Name, nearest road, lake or landmark Blk# Village Township / C. TYPE OF OCCUPANCY Commercial * Industrial *Other (specify) Variance Single family X Duplex No. of Bedrooms _+� No. of Persons 14 D. SEPTIC TANK CAPACITY 1006 Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete Poured -in -Place Steel Fiberglass Other (specify) New Installation X Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured -in -Place Other (Specify) E, EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area sq. ft. (0 /3 ie�,�arec�, New * Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: — _Length 3(.a/ Width l A • Depth , 16 z i Tile depth (top - No. of Line - Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land Distance from critical slope WATER SUPPLY: Private © Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than p owner: I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH -115 prepared by the Certified Soil Tester, NAME K C'f!r C.S.T. # /S f% and other information obtained from (owner / LIJ r), � Plumber's Signature MP /MPRSW# 3 c;L4 Phone # JJ� — .R8e0 Plumber's Address A 06 PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. e , F e ; �A.. F F 3 E f � t i t ....., r { e� i 3 [ 3 } M� , I j € r i j € t e , r , t F g Do Not Write in Spa a Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application /9-�Q Fees Paid: State 3�` County �?S, �' Dat 1 — fJ Permit Issued /Rejected (date) g— /Y FQ Issuing Agent Nam Inspection Yes_ __No State Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4, plumber (canary copy) Revised Date 7/1/78 E 14 - 1i5 Rev. 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 - LOCATION /4 %4, Section L ,,T / N,R 2i_ &(orxi &> wnship or Municipality Lot No., Block No. i'��hQ / c- Pc i C`� fs County / Subdivision Name Owner's /Buyers Name: A/���5 ��L�C► �.I,cC'. �� j Mailing Address: 1 TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS /0 -,,2 7 -7 y ! PERCOLATION TESTS �- 7 SOIL MAP SHEET 73 NAME OF SOIL MAP UNIT PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTEF INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN P- e ci- Di9 / d - • P- 2-- y _<ee ScIr f ` L A"o 3 P_ ; I qe,, -!re- P- P- P- SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, MOTTLING AND DEPTH TO BEDROCK NUMBER INCHES OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B- 3 (��• O '�' // r� sr rrs PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on t e Ian the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy � ` ' ` In ate scale or distances. Give horizontal and vertical reference points. Indicate sl pe. '�;��� e E w, V i m E A v j 3y E �rLr J�s� O r� i A F � t F � 5' 4 � 6 1 , 4 i 6 I, the undersigend, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. Name (print) 5 t i r �s `' C?� �c'"� Certification No. Address i� Q� �? A A A f .Name of installer if known Copy A — Local Authority CST Signatur r (All LA.) 6` k� CIO IN a s � 0 w : r JL v 7 v .4 ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This 's to ri tha h zms ected the sep tic tank presently serving the p P Y g located at: residence to r'1 c ' /4, ' /4, Sectio , own N, Range W, Town of U , St. Cro x County Wisconsin. Upon inspection, I ce tify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of Comm. 84.25, and it (they) appear(s) to be functioning properly. Most recent date of service "Y Did flow back occur from absorption system? Yvs No A (if no, skip next line.) Approximate volume or length of time: gallons minutes Capacity: Construction: Prefab Concrete >;� Steel Other Manufacturer (if known): Age of Tank (if known): (Licensed Plumber Signa (Print Name) S PC-1 � 5�� (Title) (License Number) MP/MPRS 1 x� (Date) Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) St.0 -1231 DOCUMEN riv. - _TATN' RAR- Or WISCONSIN FORM 1'1982 THIS SPACH PPSERVC0 Pon RECOROINO DATA WARRANTY DEED 437907 :34? REGISTER'S OFFICE This Deed. made between _. Roberi- L. Knui %_.i i .� S_ T_ CROIX CO., Wt Beverly. -3_ .Knutson, -- husband- -and wife as joint tenants. � ®C�4 for f�nCl�re� - - ------ --- - --- --- - --- •- ... ...... I ---- .... . .... .. . .. ......... ---- ------ --- - - ---- -------- --_-- - - --. - --• Grantor, JUN and.--.. Ml ar- s- ha -t -1-- �,.---Si -mpson -and Kathy - a.- •- aiaipak, ,,. -.. �_ 1:15 P A husband - and -- wife - -as -- survivorship.- marital - proptair -y - -- ---- .... - - --- ----- - ----- - - -- -- - -- .. _._ _ .... -_--- ----- -- ----- -- - -- ...... Granfce, Register of Deeds Witnesseth, That the said Grantor, for a valuable consideration. -. -_. ---• ------------ - - - - -- - - -- - -- - - - - -- -- -- ------- ----- -- - - - -- . conveys to Grantee r ^I ^wi ±gig• described real estate in - St .- CrO ix RETURN To 3ounty, Si.ta rr. `.: _c..,,_---- - Lot 14,Nord1c Heights Addition to the Town of 'Troy. Tax Parcel No: ---•----------------------•--•----- TRANSFER S FEE This 1 S -- -------- - - ---- homestead property. (is) (4KYX>9 Together with all and singular the hrreditaments and appurtenances thereunto b eIon ing: Robert L. Knutson and Beverly J. Knutson, husband and wfe n - - - - - - . ........... •-- -------- - --- ....... - ..-.-.-,-..-•----•---- warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, covenants and restrictions of record, if anv, and will warrant and defend the same. Dated this _.._ -1st I4'�y June 88 ---- - day of ........ -... _ 1 - --- -- --- ----- -- - ----- -- ------ ......... ------- --------- _ -- - -----_-- ------ ---- (SEAL) �i�'C�'�!.- //- (SEAL) Robert .. Knutson _---- -- ------ - ---- --- ------- ------ ---- - - - --- ---- - - - - -- - ----- --- ......... ............... ....... (SEA ....... (SFAL) Be rl Hutson " . ... - .. ...... ............._.. -.. -- * - -..._ .... . -..- ....... AUTHFNTICATICN A.CK110W7,F771iM�F�T Signature(s) _. --------------------------------------------------- - STATF. OF WISCONSIN I _ ------ -- --- -c-- --- - - - - -- ----------------------- St. Croix + authentnatnd LhiR /• • " "! r t QQ ' ------ -------- --------d: r ---- ------ -. _- 19----.- Person ».)]y carne !)PfOrP mb'r�,� •r; i�.S��,..:�s . ^.. BEkT June 14 _ - -.1 _ & -, n om n i .. ----------- ------------------------------- -- ---- Robert J. knuts.on..an Beverly --- ---- T. Knutson TIT7.F: �IE'MBFR STATF, PAR OF WISC;O'jtiiN _..... --- --- ------- ------- - -- ---- -- ........... ------. - ------- (If nut, ....... authnrizod by to me known to hr 11,w r.— i s_ - -_ __.- '• "t P­Thud the fnrr•,,fin? in ^frtlmrnt nnr — arm 51_e •') _ Tf+IG ICI ��PIlff _.�:T 'NA."•. r: ca�c - -r) nY J •_ � �� — = =�• HEYWOOD,.. CARZ - & - MURRAY by Samuel R. Carl -' Michael K. Gisvold - P.'0 'Box 229; - Hudson Wi - -- 54016 _. _crt:• . St. Croix C (Sivn»turr.c m-tv ho Huth 1 nr nk nn�c-tnr•..nr H, .`•f, !....- i- n ^rn f•' ,.nt. Olfn r ... r•,!'v).) June 24 YQ WARRANTY T)Pr.D ., ♦-- .. - .. � ,.. - f ^�.