HomeMy WebLinkAbout040-1260-60-000 : 91
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM / C n St. Croix
Safety and Building ion "
INSPECTION REPORT Sanitary Permit No:
(ATTACH TO PERMIT) 420731 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:
Erdman, June _ Tro Township 040 - 1260 -60 -000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
115-D 1 ( 6a I 0f"r J 0 4 - [ O P 4 6 I 18.28.19.1395
TANK INFORMATION EL WION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
osin Alt. BM �z
Aeration Bldg. Sewer 3.33 X0
Holding (jSp Inlet ZS too
TANK SETBACK INFORMATION t/ utlet 6 Sa too. �b
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic + (S ¢MD Z:;� + I � Dt Bottom
Dosing Header /Man.
Aeration � —�_,\ Dist. Pipe 4.3� �� • SO
Holding Bot. System
77
PUMP /SIPHON INFORMATION Final Grade
Manufacturer Demand St Cover
GPM 3•Y?j (D�j
Model Number
TDH Lift Friction Loss System Head TDH Ft
Forcemain Le Dia. o well
SOIL ABSORPTION SYSTEM I
BED/TRENCH Width /, L Of Tr nches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS `e 0 cr p
SETBACK SYSTE TO P/L JBLDG IWELL LAKE /STREAM LEACHING anufacturer:
INFORMATION Type Of S stem: CHAMBER OR
Model Nwah r.
DISTRIBUTION SYSTEM
Header /Manifold Distributio �] x Hole Size x Hole Spacing Vent to Air Intake
9 ry Pipes P g ` f -
1 Lenth Dia Len is S acin
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 R Yes [J No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: bl / 1") / Inspection #2: ! /
Location: 382 Whitetail La River Falls, WI 54022 (NE 1/4 NE 1/4 18 T28N R19W) Deer Valley Lot 16 Parcel No: 18.2p.19.1395
1.) Alt BM Description = c� S l � _wAA k ad1K,, ` .� ObbeJ.r4 (� �?
2.) Bldg sewer length = 1,r6 L l �tl Q�,d�j mil , (,V 1(,{ 61•(��D,l��,' ,�, � 1-wpb
� - amount of cover= Wo(t bg qL;wdw.jr CoWA S� �� J�.� r_ t 0'
Plan revision Required? :, Yes No �,, t�,r f , -�
Use other side for additional information. l� �_. "�!!^ t, �`'`
SBD -6710 (R.3/97) Date Insep or's Signature
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Safety and Buildings Division County
201 W. Washington Ave., P.O. Box 7082
` , Madison, WI 53707 — 7082 Sanitary Permit Number (to be filled in by Co.)
ScOnS,i� (608)261 -6546
Department of Commerce ,20 :�3 t
Sanitary Permit Application State Plan I.D. Number
In accord with Comm 83.2 1, Wis. Adm. Code, personal information you provide
may be used for secondary purposes Privacy Law, s15.04(l xm) Project Address (if different than mailing address)
I. Application Information - Please Print All Informatio 11Nf100 XIO240 , ' s
Property Owner's Name c o o 7 T U IA' Parcel # t # Block #
J ' 1A.jN , P PrA YV\Q i G ` t7 111 1L
Property Owner's Mailin Address /� r� v Property Locatio T
V Q Oct.Q. Q3/ 1 �l t7 '/4, Section -
City, State Zip Code Phone Number
4 wIr a �Ra[ (circl
II. Ty of Building (check all that apply) T N; RE o
pe
I or 2 Family Dwelling - Number of Bedrooms F'(ec.J = C$
Subdivision Name CSM Number
❑ Public/Commercial - Describe Use 1 r
❑ State Owned - Describe Use Z X ❑City ❑Village ownshi of
_ � r
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A ' XNew System y El Replacement System ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
IV. Type of POWTS System: Check all that appl
Vf
Non - Pressurized In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑
Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑
Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain)
V. Dispersal/Treatment Area Information:
Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (so System Elevation
7 , -5 � / Io, 7S
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New I Existing
Tanks Tanks
Septic Holding Tank `
k
erobic Treatment Unit
Dosing Chamber
VII. Responsibility Statement- 1, the undersigned, OisuibVesponfibility for inst of the POWTS shown on the attached plans.
Plumber's Na nt) Plu er' Si cure /MPRS tuber Business Phone Number
a 0
^�
Plumber's Address Street, City, State, Zip Code)
A ti 4 2 4J `
VIII. Coun /De artment Use Onl
X Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing gent Signature Stamps)
Surcharge Fee) `�
❑ Owner Given Reason for Denial 25
IX. Conditions of Approval/Reasons for Disapproval � r
4%, 60 •w s sue. e t
X AA �
ttac com -- t - e plans (to the County �°11 ly) ro the system on paper not less than 8112 x 11 inches In size
IMbrttti�° CAS a SiC �"s
SBD -6398 (R. 08/02)
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Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3
Labor aad Human Relations
Division 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. #
040 - 1070 -10
dimensioned, north arrow, and location and distance t ` n � R VIEWED BY DATE
APPLICANT INFO RMATION- PLEASE PRI I tl YN�..,
a -r
PROPERTY OWNER: , Jy C PROPERTY LOCATION
Derrick Construction, Inc. Ufa GOT. LOT NE 1/4 NE 1�4,S 18 T 28 N,R 19 (or) W
PROPERTY OWNER':S MAILING ADDRESS j - - -- �� LOT BLOCK # SUBD. NAME OR CSM #
1505 Hwy #65 .I yr '
CITY, STATE ZIP CODE t �A k / Y [ OTOWN NEAREST ROAD
New Richmond, WI. 54017 �' 5t 03 Tro
NJI
4 Addition to existing �] New Construction Use k ] Residential/ Nu � � � [ ] g buildin g
[ ] Replacement [ ] Public or commercial c
Code derived daily flow 600 gpd Recommended design loading rate _ bed, gpd /ft 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) 96.75 ft (as referred to site p benchmark)
Additional design / site considerations. - na
Parent material outwash Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL J MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem CAS ❑ U �S ❑ U CAS ❑ U ®S ❑ U �] S ❑ U El ® U
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 Trerldl
1 0 -24 10 r 2/2 none
2 24 -42 10yr 4/4 none sil 2msbk mfr 9w 2f .5 I.6
Ground 3 42 -84 7.5 r 4/4 non cos 0SQ ml na na .7 .8
elev. nwar
l OQ,-5- ft.
Depth to S "
limiting
It
factor qb . f
+84
4S 1
Remarks:
Boring #
2msbk mfr cs 2f .5 .6
1 0-16 10yr 212 none
2 16 -32 10 r 4/4 none sil 2msbk mfr 2f .5 .6
Ground 3 32 -84 7.5 r 4/4 none cos 0SQ m1 na na .7 i.8
elev.
99 ft.
Depth to
limiting 33��ti
factor
+84
Remarks:
CST Name: -- Please Print G4ry L. Steel Phone: 715 246 - 6200
Address: 1554 200th. Av . New Richmond 54017
Signature: Date:_ `— 6_5 -99 CST Number: m02298
PROPERTYOWNER Derrick Construction SOIL DESCRIPTION REPORT Page 2 ,pf 3
PARCEL I.D. # 040- 1070 -10
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bo rxivy Roots GPD /ft
..................
in, Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Teich
.................
..................
.................
..................
3 .. 1 0 -18 10
2 18 -34 10 zr 4/4 none Sill 2mshk mfr aw 9. f .5 .6
Ground 3 34 -96 7.5 r 4/4 none cos OSQ ml na na .7 .8
elev.
99. Sit.
Depth to
limiting
factor
Remarks:
Boring #
1 0 -14 10 r 2/2 none 1 2msbk mfr cs 2f .5 .6
'4 2 14 -25 10 r 4/4 none sil 2msbk mfr C1w 2f .5 .6
3 25 -96 7.5yr 4/4 none cos 0SCf ml na na .7 !.8
Ground
elev.
10 ft.
Depth to -
limiting
factor
+96
Remarks:
Boring #
1 0 -13 10 r 2/2 none 1 2msbk mfr cs 2f .5 .6
5 2 13 -27 10 r 4/4 none sil 2msbk mfr QW 2f .5 .6
Ground 3 27 -96 7.5 r 4 4 none cos 0SQ ml na na .7 1.8
elev.
1
Depth to
limiting IFS
fa +t�
Remarks:
Boring #
Ground
elev. j
ft.
Depth to
limiting
factor
Remarks:
SBD- 8330(8.05/92)
r — —
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STEEL'S SOIL SERVICE
Gary L. Steel Derrick Construction, Inc. 1554 200th Ave.
CSTM2298 NE4NE4 S18 T28N - New Richmond, WI 54017
MPRSW -3254 town of Troy (715) 246 -6200
lot #16 -Deer Valley
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'
— top of 1 pvc pipe @ el. 100.00
Alt. BM.= top of 1" pvc pipe C el. 102.70'
�d /
� k a
dL
2 n ,
Gary L. Steel
6 -5 -99
.I �► l.4 MC t�
EZ1203H
* of : s •R 'r, -a `�T- ^nom=•` :r: •":v` rR••r!
!•R
4.b25t1 VVW ..!
R• R!!
IT •!
•vR v•R T It Iry R!R d
1n c; 18.84-
sv♦ •
RRRRlR• • !RR•!!i y !• • •♦
•!!•RrR •tom •r!•R•TV
v RR ♦RR•r
•RRV•!!v!! !er•WTT
q 24"
Boftm
36 t/
ti...�a 12 -112" D.IA. (".) I
Void Cocl'rcicm in A
8gegatc given at 57.0%. Sol Iat.,,er•f_ uM A—,.. t7.D. ofd" 'E144 � Sq Ft
pipe - 4,625 inches 5idewtlll (2 Sidewa jk) • 2 8.84in
Void volume
per linear ft - ].44•( t � t2 "r2 = 3.14
?j.1f, •t0 °0.117 {t- BO IF
Uom
C4. D, of center cylinder = M5 inches 100
Void Total Soil Interracc Area
volume in aggregate of center
cylinder- j3,tg. Q._ "$;_ f21l25io ' $.1 -0$Q,
� � t2iarR �' .5 .422 Rs
0.D• oruutsde cylinders - 12 inches
Void volume to outstde find :. ( projected Trench area
ey ens = _ 3.I�1 ��°
112@�1n� • 5101 f1'
Sidcwall Height - 12 in. "2
= 2.00 Sq.Ft.
Void volume at l wttom Bottom =
between cylinders x 4� '
(/ i 36 in. = 3.00 Sq.Ft.
tt2inrry�t2isth 4_ . I
'� ( 3.1 t2 m g) Projected Trench Artier =
Vona volume at outside bottom carne" 41/2 orvoid volu 5.00 Sq.P't. �
Total void vo1 the between cylmders10.215 : 2 - 0.108 fN
time - 0.117 + 0.422 + 0:901 + 0.215 + 0.108 = 1.763 cubic R E ft
Gallons per 0 - 1.763 X 7.48 - 3 a i as er 1t� p
36 -s
C)
i _
Ep� Aggregate
Trench System
EZ1243H
65 §'industrial Gr ou _ �w
Industrial Pa Rd
00 10nd, TM 18060
sca1J F lu kAmt E2t2WN ,
St1tE7: t of t tr - 27 - ot 1
i
it I
. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of
SYSTEM SPECIFICATIONS S ❑ NA
7Permrrudt R1lAAT10N Tank Manufacturer , ES`p
gat
Septic ❑Dose ❑Holding Vol.
,ZO Tank Manufacturer ❑ NA
DESIGN PARAMETERS O NA ❑Septic ❑ Dose ❑ HotdkV vol. gal
Nor of Bedrooms ❑ NA
Number of Public Facility Units ❑ NA Eliter Manufacturer �.
C7 aJ! Filer Model Estimated (average) flow Q NA
Design (peak) flow
(Estimated x 1.5) O al /d Manufacturer
al/d /ft" 7Sand/Gravel l ❑ NA
Soil Application Rate ,
Monttilyy average' Pretreatment Unit
Standard Influent/Effluent Quality tester ❑ Peat : Fats, Oil & Grease (FOG) 53 �� al Aeration ❑ Wetl
Demand (BOD 5220 mg/L ❑ NA
Biochemical Oxygen (] Disinfection ❑ O��'
Total Suspended Solids (TSS) 5150 mg/L
Monthly average Manufacturer ❑ NA
Pretreated Effluent Quality Dispersal Cetus)
Biochemical Oxygen Demand (BOD 530 mgR X ❑ ln- Grouind (pressuized)
Total Suspended Solids (TSS) 530 mg& ❑ NA Irv-Ground (gravity} ❑Mound
Fecal Coliform (geometric mean) :5104 y in cfu/ dia. 10Um1 ❑ At-Grade ❑ NA ❑ Drip -
❑ Other:
Maximum Effluent Particle Size Other: ❑ NA
❑ NA
*Values typical for donnestic wastewater and septic tank affluent.
Otter: ❑ NA
NlrANr+tENAl1ICE SCHEDULJ: Service y
Service Event ❑ mon {gym 3 years} ❑ NA
l ndition of tanks) At least once every: ar (s)
❑ When combined sludge scum equals one -third {Y31 of tank volume ❑ NA
contents of tanks) ❑ When the high water alarm is activated
❑ rma+th(sl (M 3 Years) ❑ NA
Inspect dispersal cell(s) At least once every: years) LJ montfi(s) ❑ NA
Clean effluent filter At least once every: (s)
❑ monthtst ❑ NA
Inspect per, pump controls & alarm At tent once every: ❑ year(s)
❑.month {s? ❑ NA
Flush laterals and pressure test At least once every. ❑ year(s)
❑ months) ❑ NA
Other: At least once every. ❑ year{s)
❑ NA
0 hOr:
t - ----
MAINTENANCE INSTRUCTIONS licenses or certifications:
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following
Operator 1pumper }.
Master Plumber: Master Plumber Restricted Sewer, pOWTS Inspector, POWTS Maintains uer, SePta9
an y missing or broken hardware, identify any cracks or
Tank inspections must include a visual inspection of the tank(s) to identify of effluent on the ground
leaks, measure the volume of combined sludge and scum and a check for any back up or pon and to check for any
surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes
ponding of effluent on the ground surface-
The ponding of effluent on the ground surface may indicate a f condition and
requires the immediate notification of the local regulatory authority. rd When the combined accumulation of sludge and scum in any tree t t alon an eq uals sposed in
accordance with c _ hapter N R 1113, ank
entire contents of the tank shall be removed by a Septage Servicing
Wisconsin Administrative Coda. e servicing of efficient filters, mecha�a I or p components, pretreatmen•
All other services, including but not limited to th
units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority with 10 days of completion of any se rvice event. GMW (2102)
f -
START UP AND OPERATION Page of
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other
chemicals that may impede the treatment process and/or damage the sod dispersal cents). ff high concentrations are detected
have the contents of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil CO(Witions are frozen at the infiltrative surface.
During extended power outages pump tanks may fill above normal highwater levels. When power is ba
the ckup surface
a restored the excess
wastewater will be discharged to the dispersal cell(s) in orie large dose and may overload them resulting in the
discharge of effluent. To avoid this situation have the contents of the pump tank removed e a Sept ne n b g Operator prior
to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump
controls to restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal coils. Do not drive or park over. or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at -grade sod absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and rot
POWTS: antibiotics; baby wipes, cigarette butts; condoms; cotton swabs, p �g the life ; the
foundation drain tstmmp pump? discharge; degreasers; dental floss, diapers: disinfectants; fat,
arge; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps: medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is
Properly and safety abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of an tanks and pits shall be removed and property disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space fined with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cant be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
upn b
system. The replacement area should be
Protected from disturbance and compaction grid should not be infringed upon by
required setbacks from existing and proposed stricture, lot fines and welts. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
❑ A suitable neplacerrnent area is not available due to setback and/or soil limitations. Barring advances in POWTS
technology a holding tank maybe installed as a last resort to replace the felled POWTS.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and sit e
evaluation must be performed to locate a suitable replacement area. if no replacement area is available a holding tank
be installed as a last resort to replace the failed POWTS.
❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
< <WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IIYMOSSmE.
ADDITIONAL COMMENTS
I
POWTS INSTALLER POWTS MAINTA110ffl
Name r A ` S Name
Phone �S Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name 5
c
Phone Phone
This document was drafted by the staffs of the Green Lake. Marquette and Wad County Zoning and Sanitation agencies in compliance with
chapter Comm 8 3.22(2)(b)(1)(d) &(f) and 83.54(1). (2) & (3). Wisconsin Administrative Code.
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND .
OWNERSHIP CERTIFICATION FORM
Owner/Buyer
Mailing Address �� co Vc - 40A & 0 S o tit W1 5 Vo l (0
Property Address ° &4-4�4 7'E"Ta/ l— CALL
(Verification required from Planning Department for new construction)
City/State - #V `a So of �°� � Parcel Identification Number C' L/ O � L (4' (a O - -Q J -
LEGAL DESCRIPTION
Property Location %,, A t � F %,, Sec. �� . T N -R W. Town of / ac
Subdivision V4 f Lot #
Certified Survey Map # , Volume Page #
Warranty Deed # Z / S Volume 3 � Q . Page #
Spec house )(yes ❑ no Lot lines identifiablAyes ❑ no
SYSTEM MAINTENANCE
Improper use and maintenance of 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 agrees to submit to St. Croix Zoning Department a certification for, signed by the owner and' by a
masterplumber, lounwymanpl* ber, restnetedplumber or a licensed pumperverifying that (l) the on -site wastewaterdisposal system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 13 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
da a thre 4Tzri Scpiration date.
P6N ATURE OF APPLICANT DATE
OWNER CERTIFICATION
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
C above by virtue of a warranty deed recorded in Register of Deeds Office.
s �3
APPLICANT 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
WAIMANTY UF.F1) (Fortner Statutory Form). 9TATF. OF K'ISCONtiIN
Mlller•Umis Co., Minneiijolis, A;inn.
Form No. Y W.
25154
Whi8 Nbrlt#ltre, .Afade by Archie J. Waxon and Lois Waxon, his wife,
f 11rantor9 of St. Croix County, Wiwonsin, hereby convey and warrant, to'
Jack J. Erdman and June M. Erdman, husband and wife as Joint tenants
gran.te(S , of St Croix County,
Wisconsin for the suns- of One dollar and other good and valuable consideration
the followin.a tract of land in St. Croix County, State of Ti ° isconsin-
Northeast quarter of Section Eighteen (18), Township Twenty-eight
North, Range Nineteen (NE� 18- 28 -19)
(19) West, (28)
.
i
REGISTLORs OFFICE
5T. CROIX CO., VVIS.
t f(-.,r H&COM thin . -1M
dey A. " '1.1) . ,59
�.'..._ _- �), iVid Hope
f6glsicf of _
Deputy
;tt titttrus; Mlyrrrof, Thr seti(1 "-r S llrtuChr•rrunto srt the it ltrtnrl S,rrrrl .cr,r/ S lhi
14 th do (if August .�. 1). 1!J 59
SIGNED AND SEALED IN PRESENCE (1F "\
• � 1�C52 IL —_
I
lfugh _ F..__ Gw in
Lois Waxon
I
Harold Walbrandt (v!'.
�ltsrnnsin, 1 1
ainlnumy g7na japun awvN a/umaJhl
U9 6I W •h
s! •� uno -- -- — ai qnd fid77 o
�3 - q 'tnH
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