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HomeMy WebLinkAbout040-1284-50-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division � INSPECTION REPORT Sanitary Permit No: 405160 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: Miller, Sam I Troy Township 040 - 1284 - 50-000 CST BM Elev: Insp. BM Elev: BM Description: / t cro .O TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark - Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet g q8g S r � TANK SETBACK INFORMATION St/Ht Outlet C1 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic b Dt Bottom Dosing Header /Man. S Aeration Dist. Pipe r 13.1 . �' Holding Bot. System 2 93- 7 PUMP /SIPHON INFORMATION Final Grade z �a a 1 .60 IF Manufacturer GP man d St Cover pC –7 2 - 1 OZ- o tl I Mod Number TDH Lift F' ion Loss System Head TDH Ft Forcemain ength Dia. SOI SORPTION SYSTEM BEN idth Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS '3 J � SETBACK SYSTEM TO T BLDt WELL LAKE /STREAM LEACHING Manufacturer c. INFORMATION CHAMBER OR Type Of System: . UNIT Model Nu bed: - DISTRIBUTION SYSTEM Header /Manifold t ( Distribution x Size x Hole Spacing Vent to Air Intake PkiijLS 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 Yes ] No [I Yes [_ i No COM MEN T S: (Includ de c pencies, persons present, etc.) Inspection #1: - fj / - -- i —>' � Inspection #2: ' X--� 64' Location: 481 Bauer Road Hudson, WI 54016 (NE 1/4 NW 1/4 9 T28N R19W) The Orchard Lot 15 Parcel No: 09.28.19.1609 1.) Alt BM Description = UW_ � lc 40 .. "*I� fir. 2.) Bldg sewer length = Z - amount of cover Plan revision Required? ; Yes No Use other side for additional information. _� -__ — -- -- -- �- - Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division 201 W. WatttioSton Ave., P.O. Boz 7162 T` G� �sconsin Madis WI 53707 - 7162 A De rtment of Commerce san Permit Number Sanitary Permit Application " I G o in accord wish Comm 0.21. Wis. Adm. Code. persood information You Proves 0 Check if Revision MY used Pri Law 915. r � AB _ PMaaa hint � CC 1 V Staoe Plea I.D. Number Parcel Number O9 • i8. � e aptoweses Name 002 —trno E 1 0 2 0 - 1 Z8 - S° /LL 2--- uti S �'� l� properly Location s Addnae G ��NZY � . �a j� Owme lfailio� �X �x S T. ��o r , I /..� � N1NG GF llz� � � N �'�i• S T � N R B yp Phone Number Lot Number Bloelt Number aw. sow Subdivision Name CSM Number oruNR20 * GYM 3. U. T[ pa a>< BWWiK (� all dud app4) �� 1%1 or 2 F=* DwdW6 - Number of 8earoem• � age ° Deacdbe vac i T2D ❑ PabliNCoonaea fN '7 S" Nearest Road -F��� S7: � M LL.._ •- p�(t; (t wit 0 * ale box on Um A (numbeI�W�for Internal tus). =p line B U applicable) ❑ Addition m A. 1 ew 2 0 Tank Onl Existing stem atom Permit Number Date Issued B. 0 Chock it Sattiltsy Permit' Issued N. Tyr of Permit: (Cheek an that apply)(aambednB scheme Is for Internal use) Iu- Ot�ou� 210 Mound 47 0 Sand Filter SO ❑ Constructed Weila , 22 0 p 41 Q I ;OW313 Tank 48 0 Single Pass Sl Drip Line 45 0 At -Grade 46 0 Aerobic Treatment Unit 49 0 Ree' 30 0 Other V. Area Information' Percolation Rate System Elevation Final Grade Design Flow (jpd) Dispersal Area Dispersal Area Sod Application Elevation Rapired Proposed Rate(Gals.mays/Sq.Ft.) (MI►•Anch) q33 %p m Total Number Prefab Site Steel Fiber Plastic VI. Info Gannets of Taub Concrete Constructed Glass GABON New BzWiei T ioptie ter Holding Tdc T.,�., bi)i tatelntn - I, thx , ` ->» rerpona for iustallation of the POWTS shown on VII. the attached plans. k1piMPRS Number Business Phone Number Piumber's Name (Print) Plumber•a SW* gu ae Phtmber's Andreae (sneer. city. Srata. Zip C"' ) �• /De ent Use Onl Issuing Agent Signature (No stamps) Sanitary Permit Fee (includes Grqudwater Dace �� 'QApproved 0 Disapproved Surcharge ) ❑ Ownrer Given lotial Adverse Detetmimlim IX. Cetsditiooa of ApprovaUluawos for Disapproval ` S jv-"�L -0� (k"- AWeh astptMt pt9rr do tYe Coaa4 only) for tine 874010 M MPs+ law than i111: it lae6eo Y size Sr -6398 (R. 051" ✓5 K S'tm «�� l �-+ o� cALE 4 0 '� i� `/�l/ lSm vE2 � �+v N k .a - �ri WEL 0 � �5- QTR Lj 3 , b ? 8 d 114E Col #lS" yk/ 3AvE2 koA4 y /j,. C ' � .gyp® 3� 4 s � + kl _ � k i ry ;� N W E LL I Y o 1 3 p - raj iV`c 14 Lv� I S ASS f a ©f r�JFA STAIC&. El / oy, oo t 1393 Wisconsin Department of Commerce SOIL EVALUATION REPORT page I of 3 Division of Safety and Buildings - A.C.E. Soil & Site Evaluations maaxxd�ce wilt) �gmrri 85, Wis. Adm. Code Attach complete site plan on paper notlsss than 8% x 11 inches m ails `f?lari must County St. Croix include, but not limited to: vertical and hftontal r en o�M (BM) c(iredl(on and — percent slope, scale a dimansionw, north arrow, " 01 and distens a t nne�est road. Parcel I.D. ��.� x 040- 1039- 60 -000, ID#9.28.19.132 Please �rint all ftlon.� By Date I'Monw Wormatim you provide m y be used for WW Wary Pe 4 Y Law s t` 04 (i) (m}). VF 1 � operty Location Property Owner F y �� ! . L ot NE 1 NW 1 S 9 T 28 NR 19 W Miller, Sam _ Property Owner's Mailing Address Z �r t�` ^�,, Lot # Block # Subd. 15 Name or CSW P.O. Box 151 - f� �✓ J— — Plat Of Miller's Orchard City State Zip Ph I City J Village ✓5 Town Nearest Road Hudson I WI 1 54016 (715) 386 - 2769 Troy Bauer Road JM New Construction Use: 4M Residential I Number of bedrooms 4 Code derived design flow rate 600 GPD J Replacement I Public or commercial - Describe: — Parent material Glacial outwash _ Flood plain elevation, if applicable na General cornrner>ts and recommendations: Recommend installing 2 trenches at 3'x 90.625', using 29 high capacity BioDi fuser infiltrator chambers at system elev. = 93.50'. Bonng # —I O Y' Pit Ground Surface elev. 99.41 R Depth to limiting factor > 124" in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W 'Eff#1 *E 1 0 -12 10yr211 none I lfsbk mvfr gs 2f 0.4 0.6 2 12 -20 1Oyr3/2 none sl 2fsbk mvfr cs 1f 0.5 0.9 3 20-28 1Oyr4 /6 none gr.Is Osg ml cs - 0.7 1.2 4 28 -53 1Oyr6 /4 none s Osg _ ml gs - 0.7 1.2 5 53 -124 1Oyr5 /4 none s Osg ml - - 0.7 1.2 3• s up — -- - - - - � ° IZ doV • 92 Boring # Boring IM Pit Ground Surface elev. 98.00 ft. Depth to limiting factor >128" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' -Eff#1 - Eft#2 1 0-33 1 Oyr2 /1 none I 1 fs mvfr gs 2f 0.4 0.6 2 33-40 1Oyr3/2 none sl 2fsbk mvfr cs 1f 0.5 0.9 3 40-49 1Oyr4 /6 none gr. Osg ml cs - 0.7 1.2 4 4L 10yr6 /4 none s Osg ml gs - 0.7 1.2 5 76 -128 1 Oyr5 /4 none —`- — s — -- Osg ml - - 0.7 1.2 " Effluent #1 = BOD ? 30 < 220 mg1L and TSS >30 < mg1L ' EfFl #2 = BOD < 30 rng1L and TSS <.X mgA- CST Name (Please Print) Signatu CST Number James K. Thompson ag...-_ 3602 Address A.C.E. Sal & Site Evaluations Datb Equation Con ducted Teleplays Nurnber 340 Paulson lake Lane, Osceola, WI 54020 4/23/01 715- 248 -7767 � 1393 Property Owner Miller, Parcel ID # X0-10 60-000, Ip #9.28.19.132 Page 2 of 3 ] F Boring Bourg # 96.42 ft. Depth to limiting factor > 126" in. Pit Ground Surface ellev. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots *Eff#1 *Eff#2 1 0-8 1Oyr2/1 none SI lfsbk mvfr gs 2f 0.5 0.9 2 8 -15 1Oyr3/2 none gr. sl 2fsbk mvfr Cs if 0.5 0.9 3 15 - 22 1Oyr4/6 none gr. Is Osg mi Cs If 0.7 1.2 4 22 1Oyr6 /4 none s Os ml gs - 0.7 1. 5 60 -126 1Oyr5 14 none s Osg ml - - 0.7 1.2 F4� Boring # Baring " le Pit Ground Surface elev. 95.98 ft Depth to limiting factor > 123 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 1 0 -16 1Oyr2 /1 none I 1 fsbk mvfr gs 2f 0.4 0.6 2 16 -27 1 Oyr3/2 none sl 2fsbk mvfr CS 1 f 0.5 0.9 3 27 -34 1Oyr4 /6 non gr. is Osg ml Cs - 0.7 1.2 4 34 -71 1Oyr6/4 none s Osg ml gs - 0.7 1.2 5 71 -123 1Oyr5/4 none s Osg ml - - 0.7 1.2 o Boring Id� Id Pit Ground Surface rev. 95.38 ft. Depth to limiting factor > 120" in. Soll Application Rye Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 1 0 -20 1 Oyr2 /1 non 1 1 fsbk mvfr gs 2f 0.4 0.6 2 20 -35 1 Oyr3/2 none sl 2fsbk mvfr CS 1 f 0.5 0.9 3 35-46 1Oyr4 /6 none Is Osg ml Cs - 0.7 1.2 4 46 -78 1Oyr6 /4 none s Osg ml gs - 0.7 1.2 5 78 -120 1Oyr5/4 none S Osg ml - - 0.7 1.2 < > < 50 #2 BOD < 30 and TSS Effluent #1 - BOD � 30 220 mg/L and TSS 30 1 _ mglL Effluent s _ mgll. .30 mglL The ry pro vider and empl ff u need assistance to access services or t of Commerce is an eq ual oppo rtunit y roe pro you � e9 � nY se need material m an alternate format. please contact the department at 608- 266 -3151 or TTY 608- 264.8777. I ■ Soil C,dseraze,o, P;6- ♦ E/eda�'o•� C � , M � lot /S N,'IIe / 6 c•9 7;,- -7-oy Co; W! i / I / � I 1 1 � B2 '` \\ `, RsC loo. ` sSu.n e(e%' _ /00- co 1 p' T ol�oE 5 e 5. E: Carney o� / oa rC e./, ElerJ': /00.0 5 A /" I C�C-- T R i- eoe Q e- 07 ..�, s y8/ ,BA E2 k0 g Q Bi S 76" �� CEO OD DO =1 OO OD 00 OD OC OD COO Q1 OO DO Ol DO �� DO OD 00 DO DO o Chamber OD DO �� DO OD DO OO 00 DO Height IF 00 DD �� DD DD DO DD OO �� 00 00 00 � Do r� Qo 00 00 00 00 00 0o coo 0o Qo 00 00 '� 0 00 0 00 � � o ao 0 00 00 All three BioWuser sizes can - withst" H -1 n 0 lo when i['►WaW Wi P th "� y grate Chamber a 80!18. A rrlira- Height :01 40ver is req M10la�is. The End View 14 Bif�OMUOer i8 #or H -2Q i9ads• A of 18" of cover is 34' regW* : , K-20 Wads. 4" Knockout Universal End Cap Chamber 14 High 16 High Available Sizes Dimensions Standard Capacity Capacity Length 76" 76" 76" Width ; 34" 34 34" Height 11" 14" 16" Invert 6.5 9 11.3 10 7,� l f= Qi2c I-/ r9 fZ 0 L Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number $- i' ro Number of Bedrooms Design Flow - Peak (gpd) �© o Estimated Flow - Average (gpd) Septic Tank Capacity (gal) / z- 5 Soil Absorption Component Size (W) Type of Wastewater Domestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow -Peak (gpd) -�_.� ZS� :2 '" 0, k Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and plean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the se and outlet filter shall be assessed at least once every 3 years by inspection. TO. outlet filte shall be cl as nec u nsure " proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the r � Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep - rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. Th; 5 ; s Q s sfia w• �o - B ��e,� too vs " T ti a. / aP Vi e , - c d /d l ¢ ci.r(4_ Q L V; b¢. us � � 8, Jis - 3 Yom g GT Z_ Co G A Z- 3 ! ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION 0ORM O wner /B uyer 4- �2 i Mailing Address Property Address Address (Verification required from Planning Department for new construction) �► b p- /Z.`�`l - �� v -Oo City Parcel Identification Number y izvt- r .E&L DESCRIPTION /� ' /., Town of property Location - %, Sec. .__. ailvlaaa T f.- c-" 4A Lot # CetrdW Survey Map # � `f 3 ( P C , volume Page # S Warranty Deed # 3 a 9 . volume J. Page # 3 2 3 Spec Douse Q yes �$ no Lot lines idcntifiable;K Yes Q no Improper use and maintenanceof your septic system could result in its premature failure to handle wastes. Proper mtintewnce consists of pumping out the sep tic 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 muterplumber, jrnuaeymanp lumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system the tic tank is less than 1/3 full of sludge . is in proper operating condition and/or (2) after inspection and pumping (if necessary), sep I/we, the undersigned have read the above requirements and agree to m aint ain of Natural privat s se eadSuteal W isconsin' tem with Certifirtififi set forth, herein, u set by has of Commerce and the Department � office within 30 stating that your tic em has been maintained must be completed and returned to the St. Croix County . da of the ear iration date. 0 DATE I TURK AP L f � i ~ that all statements this form are true to the best of my (our) knowledge. I (we) am (are) the r daner(s) of may "bed virtue of a warranty deed recorded in Register of Deeds Offtce. •. i ©� n — 02-- R , DATE WTUM 0 J&P •sass• Any information that is misrepresented may result in the u the Zoning permit being revoked by g t- • Inelude with this appliettlon: a stamped warranty deed from the Register of Deeds of • t copy of the certified survey map if reference is made in the warranty deed STATE BAR OF WISCONSIN FORM 7 - 1998 632796 TRUSTEE'S DEED KATHLEEN H. WALSH Doe~ Number VOL 1555 PAGE 323 REGISTER Of DEEDS ST. CROIX CO., WI DANIEL S. SOLBERG AND KARLA J. SOLBERG RECEIVED FOR RECORD 11 -01 -2000 8:30 AM TRUSTEES DEED as Trustee of EXEMPT I DANIEL S. SOLBERG AND KARLA J. SOLBERG REVOCABLE CERT COPY FEE: - TRUST DATED APRIL 26, 2000 - COPY FEE: TRANSFER FEE: 2880.30 - RECORDING FEE: 10.00 for a valuable consideration conveys without warranty to PAGES: l SAM E. HILLER, A SINGLE PERSON Recnwrs7 Aron Grantee, the following described real estate In ST . County. '� OW Return Address ' State of Wisconsin: SAM MILLER j PART 0 F.THE NA OF THE NA AND THE SA OF THE NWk AND THE `' P.O. BOX 151 HUDSON, WI $4016 NEk OF THE NWk AND THE NWk OF THE NEIz AND THE NWk OF THE 1 SWAG OF SECTION 9, TOWNSHIP 28 NORTH. RANGE 19 WEST, TOWN OF TROY. ST. CROIX COUNTY. WISCONSIN AND MORE PARTICULARLY.- -,-_::___ -_:_ -- _ :- - -- DESCRIBED AS FOLLOWS: BEGINNING AT THE NORTHWEST CORNER OF 040 - 1038 -60 040 - 1039 -60 -000 SAID SECTION 9. THENCE S00 01 E ALONG THE WEST LINE OF 040 - 1039 -70 -non SAIDNW 2626.30 FEET TO THE WEST QUARTER CORNER OF SAID Paror witniftatiyl Ntntber (PBrt SECTION 9; THENCE 500 "E ALONG THE WEST LINE SWk OF SAID SECTION 9 150.31 FEET: THENCE 556'24 "E 70.00 FEET: THENCE N59 0 15'11 "E 850.85 FEET THENCE ON AN ARC OF A CURVE TO THE RIGHT 102.10 FEET AND WHOSE RADIUS IS 403.00 FEET AND CHORD BEARS N07'32'30.5 "W 101.78 THENCE N00 "E 569.05 FEET; THENCE S88 ° 45'38 "W 250.00 FEET; THENCE N00 0 50'54 "W 350.92FEET; THENCE S88 ° 57'07 "W 512.29 FEET; THENCE N00 0 50'54" 100.00 FEET; THENCE N88 ° 57'07 "E 250.31 FEET; THENCE NO3 ° 10'51 "E 202.31 FEET; THENCE N32'19'49 "W 95.25 FEET; THENCE NO2 ° 24'54 "E 136.96 FEET; THENCE S87 ° 34'25 "E 198.63 FEET; THENCE SO1 ° 54'33 "W 149.41 FEET; THENCE N89 ° 46'50 "£ 148.76 FEET; THENCE S2 ° 27 1 16 "W 256.95 FEET; THENCE N88 0 57 0 07 "E 1065.55 FEET; THENCE N89 ° 12'30 "E 325.61 FEET; THENCE S00 ° 47'30 "E 10.00 FEET; THENCE N89'12'30 "E 554.46 FEET; THENCE NO1 ° 23'32 "E 587.22 FEET; THENCE N55'31'03 "E 651.90 FEET; THENCE N38 ° 09'35 "W 413.25 FEET; THENCE S89'31'02 "W 142.03 FEET TO THE NORTH QUARTER CORNER OF SAID SECTION 9; THENCE S89 ° 12'35 "W ALONG THE NORTH LINE OF THE NWk OF SAID SECTION 9, 2666.45 FEET TO THE POINT OF BEGINNING, SAID PARCEL CONTAINS 96.52 ACRES AND IS SUBJECT TO ANY EASEMENTS OR RESTRICTIONS OF RECORD. Dated this day of OCTOBER 2000 (SEAL) i (SEAL) DANIEL S. SOLBER t KARLA J. SOLBERG Tram" Tnatee AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, ss. Count. authenticated this day of Ptt�pn�ly care before me this day the above name o L�iGLAIN�,, .d btl TITLE. MEMBER STATE BAR OF WISCONSIN V U to (If not, me known to be the person - , b - who executed the foregoing authorized by S706.06. Wis, Stets) I strument and acknowledge the e THIS INSTRUMENT WAS DRAFTED BY C rgy all HE YWOODiL CARI, S.C. 204 LOCU STREET o $mte of Wisconsin HUDSON, WI 54016 Notary Public. State of Wisconsin My commission Is permanent. (If not, state expiration date. (S gnatures may be authenticated or acknowledged. Both are not necessary) ' 14 M1 or Pe m .ian,tla M Mr C-WIty m W W typed a Pruned betow thew .taneW re. TRUSTEE'S DEED STATE BAR OF WISCONSIN w „cyan Leper Bt.nr Co K FORM No 7 - 1994 la"*w., w'.