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HomeMy WebLinkAbout040-1284-80-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division ' INSPECTION REPORT Sanitary Permit No: 399484 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID N�� 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 -80 -000 CST BM Elev: Insp. BM Elev: BM Description: �, TANK INFORMATION U ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark , LID Erg -sue-- Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet 73 -SY TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic �tJ I Dt Bottom Dosing Header /Man. f I ,lao 4 Z • ZS Aeration Dist. Pipe Irj, (00 , 2 • Z� Holding Bot. System ) 9�•/p r PUMP /SIPHON INFORMATION Final Grade I Z . O k1w 9 3 Manuf cturer Demand St Cover r GPM C? /S Model Nu er TDH Lift Fn oss ISystern Head Ft For main Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM S S RENCH idth r Length No. Of Trench PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENS S 3 93 SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR T6I0O\V�F Type Of System: f z UNIT Mo I Number. l l DISTRIBUTION SYSTEM Header /Manifold u IDIstribution x Hole Size x Hole Spacing Vent to Air Intake 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 I&I Yes [W No ❑ Yes ❑ No OMME TS: (Include code di crep ncies, per ns pr se t etc.) Inspection #1:_ - Sw 0(v / Inspection #2: -- — — 7 ` — Location: 491 Bauer Road Hudson, WI 54016 (NW 1/4 NW 1/40(9 T28NN��R19W) The Orchard Lot 18 Parcel No: 09.28.19.1612 1.) Alt BM Description = — T, 2.) Bldg sewer length = A f c! - amount of cover = 7 Plan revision Required? (] Yes X No Use other side for additional information. L ��° D Z _ D to Insepctor's Signature Cart. No. SBD -6710 (R.3/97) a/l 31 o 9 g�{L Sanitary Permit Application Safety & [3u a s Division In accord with Comm 83 nm Code 201 W Washington Ave. PO Box 7302 See reverse side for instruct �!� I ti g,tltis application `°�',�,„`��' � Madison, WI 53707 -7302 Wisconsin Personal information you pr d �d3e use�fmr sccondary purposes (Submit completed form to county if not Department of Commerce (Priv s. l5. (1)(m)J state owned. Attach complete plans to the count c f stem, a et'not less than 8.1/2 x I I inches in size. State Sanitary Perm N ber ❑ f� if revis o previous a Pill State Plan 1 D. Number cou CAD VC, 319 C F - 6 L A lication Information - Please Print all Infor a s Location: Property Owner Name Property Location ✓' Sit � i F t£! } f iY IA Cl�tl4, S T;? �N, R/ ) E o W Property Owner's Maihng Address Lot Number Block Numbei Cit �� y, Slate Zip Code r Subdivision Name or CSM Number Uso� �! 5 dl� 27� E �2C /lr +� ❑ City 11. Type of Building: (check one) ❑ village ❑ 1 or 2 Family Dwelling -No. of Bedrooms : _:?_L IqTown of ❑ Public/Commercial (describe use):_ i ❑ State - Owned = - 3' 9 3 , -7 S e Q ( ) -5 N est Road P/ c"N2c l t _ t Parcel Tax Number(s)d d ` ZS OC III. T e of Permit: Checonl k one box on line A. Check box on line B if a licable 5 C7 2 6. ❑ Addition to A) 1. New 2. ❑Replacement 3. ❑Replacement of 4. Existing System S stem system Tank Onl Date Issued I'cmmit Number B) . ❑A Sanitary Permit was Previously issued IV. Type of POW'1' System: (Check all that apply) R- JC �� / f 1 (iS♦w f� , � 7 Ion- pressurized in- ground L_ C. ❑ Mound ❑Sand Filter ❑ Constructed Wetland ❑ Pressurized In-ground (e f ❑ 1lolding Tank Single Pass O Drip Line C.1 At- ride ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dis crsal/Treatmcnt Ar Information: I .Design Plow (gpd) 2. Di S A�/di 3. Dispersal Area 4 Suit Application 5. 1'crcolalion Rate G. System filevation Glewal on G rade / Required 5 T� Proposed 6q'634 Rate (GalsJday /sq fl.) (M inJinch) 01 VI1. Tank Capacil} in Total N of Manufacturer Pre! .b Site Stpel Fiber- Platic Gallot's Gallons Tanks Con- Con- g Information isting w L' crete strutted Ncx Tanks Tanks ❑ ❑ ❑ ❑ _ ❑ CO ❑ ❑ ❑ Vi II. Responsibility Statement I, the undersigned, a ssume res onsibil� for installation of the POWTS shown on the attached )In D P!um!ret's Tlamc quint) Hunt crliS nature (no tamps): MP /t 11 No usincss Phone Number � � c � ... fir. � �• ^' � - � � �% �-- P!umhcrs Addicss (Street, City, State, Zip Code) F11\_Coun(y/Dcpar(ment Use Only Santis I'amit Pce (Includ. Groundwater Date Issued Issuing Agent Signature (No stamps) ❑ Disapproved �" Sure e Pce) X Approvcd ❑Owner Given Initial Advcrsc, C � tp Dctennination + ,, X. Conditions of Approval canons for Disapp I_ •� �'t �/ G as 0 9gill All I L CyJA 0 LAIN�K AIIIIIIIA.4--AL Cs� L� `t.Oti„ 6 43 tA 4 i ` ri LA xb p �I f P ` t 1 6 in 4C U 4 kL i tj © M N 3 � IJ- Ll ID nn q 1396 W isconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in accorclance_wb Comm 85, Wis. Adm. Code AC.E. Soil & Site Evaluations County Attach complete site Man on paper not less than 8% x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, 960 arrow, qnd be 'on and distance to nearest road. Parcel I.D. 040-1039-60-000, ID#9.28.19.132 Please print aft lnti;lri�, By Date I , -, : Personal iniomation you provide m be used for LM, s. 19,04 (1) (m)). - �- I I I — I , !LAI, v),.kt, ZZ Property Owner i '0- P{openly Location Miller, Sam -0ovt- Lot NE 1/4 NW 1/4 S 9 T 28 N R 19 W Property Owns Mailing Address )A# Blw"bcl. Nam or CSM# P.O. Box 151 18 Plat Of Miller's Orchard 1 City state m Nearest Road ziolool*P" N _j City _j Village e To Hudson I W, I 4 -'� Troy I Bauer Road 01 New Construction Use. Residential / Number of bedrooms 4 Code derived design flow rate — 600 G1PD ] Replamnent Public or corrimercial - Describe: Parent material Glacial outwash Flood plain elevation, it applicable na General comrnents andrecommenclatioris: Recommend installing 2 trenches at Xx 90.625', using 29 high capacity BioDiffuser infiltrator chambers at system elev. = 91.00'. Boring # Ong lim Pit Ground Surface elev. 96.69 ft. Depth to limiting factor >126" in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfiF *Eff#1 *EfflQ 1 0-14 1 Oyr3/2 none sl 2fsbk mvfr aw 2f 0.5 0.9 2 14-21 1 Oyr3/4 none sil 2fsbk mfr cs 1 f 0.5 0.8 3 21-33 7.5yr4/4 none sil 2msbk mvfr aw 1f 0.5 0.8 4 33-40 7.5yr4/6 none Is I msbk mvfr CIS - 0.7 1.2 5 40-74 1 0yr5/4 none Is Osg ml gs - 0.7 1.2 b � / — 6 74-126 1 Oyr6/4 none S Osg ml 0.7 1.2 Boring # I Boring 0 Pit Ground Surface elev. 96.11 — ft. Depth to lim f actor > 128" in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' *Eff#1 *Efr#2 1 0-10 1 Oyr3/3 none sl 2fsbk mvfr as 2f 0.5 0.9 �t� 2 10-23 7.5yr4/6 none Is I msbk mvfr cs 1 If 0.7 1.2 3 23-69 1 Oyr5/6 none S Osg ml gs - 0.7 1.2 4 69-128 1 Oyr5/4 none s Osg ml - 0.7 1.2 Effluent #1= BOD 5 > 30 < 220 mg(L and TSS >30 <-,WMg/L E" #2 = BOD -5.30 mg/L and TSS <_X ffxyL CST Nam (Please Print) Signaltu CST Number James K. Thompson 3602 Address AC.E. Sol[ & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020 4/23/01 715-248-7767 1394 t ?roperty Owner Miller, Sam Parcel ID # 040- 10 39- 6 0 -000, ID #9.28.19.132 Page 2 of 3 F Boring 3 � # 1 Pit Ground Surface elan. 94.25 __ ft. Depth to limiting factor > 125" in. Soli Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Ef1#1 TO 1 0-8 1Oyr312 none sl 2fsbk mvfr gs 2f 0.5 0.9 2 8 -18 1Oyr3/4 none sil 2fsbk mvfr cs 1f 0.5 0.8 3 18 - 25 1Oyr4/6 none gr.Is Osg ml cs - 0.7 1.2 4 25-63 1Oyr6 /4 none s Osg ml gs - 0.7 1.2 5 63 -125 1Oyr5 /4 none s Osg ml - - 0.7 1.2 34 �7-s` a Boring # Boring Pit Ground Surface elev. 90.59 ft. Depth to limiting farctor >121" in. Soll Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *EM *Eff#2 1 0 -13 1Oyr3/2 none sl 2fs m vfr gs 2f 0.5 0.9 2 13 - 24 1 Oyr3 /3 none sl 2fsbk mvfr cs 1 f 0.5 0.9 3 24 -34 7.5yr4/6 none Is Osg ml cs - 0.7 1.2 4 34 -75 1Oyr5/6 none s Osg ml gs - 0.7 1.2 5 75 -121 1Oyr5 /4 none s Osg ml - - 0.7 1.2 F5-1 # Boring _j Boring 01 Pit Ground Surface elay. 91.68 ft. Depth to limiting factor > 118" in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 1 0 -7 1Oyr3/2 no sl 2fs bk mvfr gs 2f 0.5 0.9 2 7 -17 1Oyr3/3 none sl 2fsbk mvfr cs 1f 0.5 0.9 3 17 -25 7.5yr4/6 none Is Osg m cs - 0.7 1.2 4 25-64 1Oyr5/6 no s Osg m l gs - 0.7 1.2 5 64 -118 1Oyr5 /4 none s Osg ml - - 0.7 1.2 * Effluent #1 = BOD s' 30 < 220 mglL and TSS >30 < 150 rng/L " Effluent #2 = BOD < 30 mg/L and TSS <,V mglL 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. f P�. 3 of 3 o � � G y� 0 ■ �s PM 1 0 9 i.O e 9so O � /p cein S S a Tf 9�0 o N ca goo e_ 1 d o w �Pf 1396 Tffi ©2 t C Al Ewl- H 7 Ffh1C teM 910C? �r; z� fr z z s© 3 Bi S 76" 00 0 00 00 00 00 00 00 00 OD OO �� OO i�D OO Q� DO DD OO OD OD DO OD Ol OD O Ol Chamber OD DO OD DO �� DO OD O OO Height OD DO OD D OD OO OO DO O Dl 00 OO OD OO LQ� �O CJ� Dt 00 Ol OD OO OD C;QI OO Ol ' I o = 0 00 00 00 � 0 00 0 AN three Rouser sizes can withstand M -10 Goads when ingeW With RrOWY graded Chamber aM g soils- AMU* Height of QQv64r is req 'H-1 loaO .The End View 1 �` BbDiffueer is ; ' I or M -20 bads. A of I SO of cover is 34' req l W,1449 loads. 4" Knockout I Universal End Cap Avcalable Sizes Chamb ; Length 76" 76" 76" Width 34" 34" 34 Height 11" 14" 16" v Invert 6.5 9 11.3 10 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 -34)91 AFAT Number of Bedrooms Design Flow - Peak (gpd) Estimated Flow - Average (gpd) p'D Septic Tank Capacity (gal) I Go Soil Absorption Component Size (ft 5'00 - 1510 CPA Type of Wastewater Dom stic S Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) 1 0 - '�6 c BN 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 clean 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 sept' and outlet filter shall be assessed at least once every 3 years by inspection. The utlet filte hall be cleaned as necessary to ensure p roper operat The filter cartridge shoo o be removed un ess provisions are made to retain solids o it ds in the tank that may slough off the filter when removed from its enclosure. If the 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 t performed t maintain less than maximum scum and a accumulation in the sludge needs o be ed o 9 P 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. 4c c� �� 13�aQ r Oc� ►� l b Q __ St L, O i Gov Z-- o vI vi I 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION NORM Omer/Buyer S' tn I L L Mailing Address —22 Property Y9 / v >✓� �20� r,% (Verification required from Planning Department for new construction) a � ,o � City/w* No - D s n 1-4 (A) I ,' Parcel Identification Number property Location'd L %, iv = ' /•, Sec. . 'I � N- R_1_l�', Town of - &bdivisi-on -}-� Q 4C N . Lot # • Calf I Survey Map # f„ S 3'h O . Volume . Page # Warren ty Dad # 15 3 A 7 9 6 . Volume S S� Page # 3 Z3 Spec house V yes [3 no Lot lines identifiable% yes E3 no i toper use and maimmnanceof septic system could result in its premature failure to handle wastes, Proper maintenance comises orwirrtpiag 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 a certification form, signed by the owner and by a The °:property t�wner agree to submit to St. Croix Zoning Departm wad>spoaal system mastetplumiW, journeyman plumber, restricted plumber or a licensed pumper verifying that (1 ) the tank is e on -site wa than steaaterer fan of sludge. is in proper operating condition and/or (2) after inspection and pumping (if necessary), see ywe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards nt of Commerce and t :et forth, herein, as set by the Deparhnehe 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 011ie within 30 da three year intion date. DATE S1014A OF APPLICANT ;• we that alt statements on this form are true to the best of my (our) knowledge. I (we) am (are) dhe'tf wner(s) of +. < ) cerafy de24r&4 above, virtue of a warranty deed recorded in Register of Deeds Office. D E 24 DATE SIONATURB LICANT •••••• Any information that is mihrepresented may result in the sanitary permit being revoked by the Zoning Departmen •• Include with this application: a � the cer e certified survey map Re g i ster re a is O made in the warranty deed r STATE BAR OF WISCONSIN FORM 7 - 1998 632796 TRUSTEE'S DEED KATHLEEN H. WALSH Doc~Nu"w voL 1555 PAGE 323 STGICROIXOCO., WI DANIEL S. SOLBERG AND KARLA J. SOLBERG RECEIVED FOR RECORD 11 -01 -2000 8:30 AM TRUSTEES DEED as Trustee of EXEMPT R DANIEL S. SOLBERG AND KARLA J. SOLBERG REVOCABLE CERT COPY FEE: TTU ATED APRIL 26. 00 - COPY FEE: TRANSFER FEE: 2880.30 RECORDING FEE: 10.00 for a valuable consideration conveys without warranty to PAGES: I SAM E. HILLER, A SINGLE PERSON Hvcrxtarv� a,l:, Grantee, the following described real estate in ST . County, ' am Return Adnram , State of Wisconsin: SAM HILLER I PART 0 F. NWk OF THE NWk AND THE S141C OF THE NWk AND THE `! P.O. BOX 151 HUDSON, WI 54016 NEk OF THE NWk AND THE NW OF THE NEk AND THE NWk OF THE SWk 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 500 "E ALONG THE WEST LINE OF 040 - 1039 -7n -000 SAIDNA 2626.30 FEET TO THE WEST QUARTER CORNER OF SAID Parcel identification Nutrtow 0" SECTION 9; THENCE SOO'45 "E ALONG THE WEST LINE SWk OF SAID SECTION 9 150.31 FEET: THENCE S56'2438 "E 70.00 FEET: THENCE N59 ° 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'FEET; THENCE N00 ° 21'49 "E 569.05 FEET; THENCE S88 ° 45'38 "W 250.00 FEET; THENCE N00 ° 50'54 "W 350.92FEET; THENCE S88 ° 57'07 "W 512.29 FEET; THENCE N00 ° 50'54" 100.00 FEET; THENCE N88 ° 57'07 "E 250.31 FEET; THENCE NO3 ° 10 1 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 "E 148.76 FEET; THENCE S2 °27'16 "W 256.95 FEET; THENCE N88 ° 57'07 "E 1065.55 FEET; THENCE N89 ° 12'30 "E 325.6t 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 "W 142.03 FEET TO THE NORTH QUARTER CORNER OF SAID SECTION 9; THENCE S89 ° 12'35 "W ALONG THE NORTH LINE OF THE NA 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. I , Dated this day of OCTOBER 2000 i . ecr (SEAL) a t0.s � /��,�n (SEAL) DANIEL S. SOLBER KARLA J. SOLBERG That" Tn s"e AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, ss. Count. P�^�Ily came before me this day of authenticated this day of (�� the above named TITLE. MEMBER STATE BAR OF WISCONSIN V U to (If no(, me known to be the person L who executed the foregoing authorized by 5706.06, Wis. Scats.) I strument and acknowledge the e THIS INSTRUMENT WAS DRAFTED BY C Ott - H EYWOOD& CARI. S.C. 204 LOCUST STREET Qf � WiSc HUDSON, WI 54016 Notary Public. State of Wisconsin My commission Is permanent. (If not. state expiration date. (Signatures may be authenticated or acknowledged. Both are not necessary) f r:•x ., al Pw -%-- -a ,n rY •,P-AY --M W 1YP" or Pnntoe Wto-r nrr ,itn.t.,.. TRUSTEE'S DEED STATE BAR OF WISCONSIN W SCOA,n lag.l gar Co. 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