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HomeMy WebLinkAbout040-1281-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division k INSPECTION REPORT Sanitary Permit No: 408272 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: Derrick Construction Inc. I Troy Township 040 - 1281 -20 -000 CST BM Elev: Insp. BM Elev: BM Description: ( _ TANK INFORMATION V ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark C,Jr'�tSC. — �L. IUD Z•` loz. } J0.0 Dosing Alt. BM Aeration Bldg. Sewer �� A � QQ f Holding St/Ht Inlet S r f D f y 3 1 1 f TANK SETBACK INFORMATION SVHt Outlet / q3.9 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic (a (� r Dt Bottom Dosing Header /Man. SO q., .9 :. 'U `�- Aeration Dist. Pipe 1 7 62 � b qZ - eV Holding Bot. System )I y -03 )D. PUMP /SIPHON INFORMATION Final Grade Cb Manufacturer Demand St Cover r GPM S� 6a `i S9 Model Number TDH Lift Fricti oss System Head TDH Ft Forcemain I Le h I Dia. Dist. to We SOIL ABSORPTION SYSTEM L RE Width � Length No. Of Tre hes PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 68 -t _ _ , \ / L � SETBACK SYSTEM TO pa P /L C (BLDG WELL LAKE /STREAM LEACHING Ma INFORMATION CHAMBER OR IPDIFP%4d 6 Type Of System: / UNIT Model Number: �`- --� II" D S Y ST EM Header /Manifold � Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) 7,5 / Length Dia Length is 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 � Yes ®No COMME (Inclu a code discrepenci persons r e etc. Inspection #1: Ins ection #2: fc e-►, r — L — AV"& v mot` Q i $* ", C��^� Z 1Z p p � Lo oc cation' 24p Muuiirrfi= =. S i if rail on, W1 5401e(NW 1/4 SW 1/4 19 T28N R19W) Troy Village Lot 120 Parcel No: 19.28.19.1583 1.) Alt BM Description •"f'. iln i 2.) Bldg sewer length = Z O - amount of cover = (8` 5 Plan revision Required? W Yes [ No Use other side for additional information. SBD -6710 R.3/97 Date Insepctor's Signature Cart. No. comm 201 �yp� 7163 � Nioa. Wl SM -- 7142 StirA�iiaes Deperuneft of 7/0 7- p Sueftw Permit ' 8 is eeyooea.t�a C UM. mss. lld... c+a+e. per �1ie�7� r 0 �` Revisits ow bstmdlftw jum Pun LD. limb e L A 1001 - pi1rR FdW Af bf 11 p pseaet Nls�ier l�geap► Os�eer"s Nit R v � C.,� O U� p�eeyr Ler�io° • �3 W lM�grOwnrr'1�t�et�t �u`- "S A-S � T� N s � ' sm: TdpOsie ZONING OFFICE Sebiieilis� bans CSM NINAW Ina IZ i w 2 TiuN► DwdNM - N mbw arM.+r o.• 3 D o - lo�S, ?-S l>t, Tj�e arlrtait: l a■R Mrr as ire A she Dr fierl ark. ies s A. O %pkm rac at s CI AMeewoa • For s 3 � rise. s O s�e..re sue.. Tak go I DM bmd i. 0 cm* it &heir pwaft hood Ptawk rise bsr IY. � ar ltislt ai in "A l In �'""' D Ar w.e+d s!e) ca rt -ty rt+a t�a�ae�+ =10 t wmd 47 O s..+ POW so 0 ca.an.aea w.a.�a n 0 r.e.nrb.e t!<ie+ss.a 41 Hditt q D s� P�.e. s i O Delp tas as i) A *GM* W 0 AM OW TMMM • 0 30 0 0dW D Pip (jpQ Dt� Awn Axes SsiA//Wi } Tess �9enndsn abo sc� , at Aid raw plesfic vL TWA 1Ift cam► is Dom. aalkm tiYes �� � o© vases Acct VIL shM.ri.t r6, e. wr ww.ltra.r d. rods Mbom u am osi dw MIUL �r J a. � s "was is C o Qom`Vim"' 3; -7 < L " 5 /3-S r#rsise"s /ii*sss (Serset, dtf. saw 3ry Cads) VEL ue DOW UesW Isaft ASM (N Ste) AWwd Cl DbWmvd CID 0 v. w comes wot Ate M. p o w iffidess; of Apr „L,.., I inlou �n 1 r 1 i(�kr Attie! asseirle also iYe Ow” Sir "NOM M OMW erw aw au war. is ere CRT'LAgQR fR n i /(111 e � v111, Ct R lot U--) Po �� v Tm v�1� ,• ��� ao IL f &-/ — CIO -000 Afc3z�, '92p m �.,��� a\7f t ., o VC S (A Q C1 3 - 7 ` -c (. - , �'-- _ -L4o► 4 Q R�TBM`� AS -VA C° d, rn �G `a -7 '7,Q7 I� e � Lo Poi y Tay v ��� • �� a t� 1v,-e� mo rA 5 Y 0 c? re a us s f -15 (z 3, ma s� ! = 4 ACC f3h1`t l,H A ,- ✓ 1 2°+ Wisconsin Department of Commerce SOIL EVALUATION REP RT Page 1 _ of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County St. Croix Attach complete site plan on paper not less than 8 1/2 x._1 i size. Plan must include, but not limited to: vertical and horizontal raMrri �o M�,'direction and Parcel I.D. pending percent slope, scale or dimensions, north arrow �iori 9r , and'tgcatd <fi�tanct to nearest r ad. Please print all '. Ormatirpr� Rev' wed by Date Personal information you provide may be useddor'secondary purads4 y Law, s. 16x04 ) (m)). Property Owner ,'; Pt Location Derrick Construction, Inc. Gov- of , NW 1/4 SW 1/4 S 19 T 28 N R 19 YE (or) W Property Owner's Mailing Address S # Subd . Name or CSM# 1505 HY. #65 ''r Troy Village City State Zip Code PhontNumber n'~ ❑ Village ® Town Nearest Road New Richmondl WI 1 54017 (7 '5 j _ 3�C1:. { Troy Murfield Trail ® New Construction Use: R] Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material outwash Flood Plain elevation if applicable na ft. General comments and recommendations: trenches spaced to code 4.00' below grade Boling 7 10 1 g # g ® Borin Ground surface elev. _ • ft. Depth to limiting factor +110 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 I *Eff#2 1 0 -14 10yr2 /2 none L lc dsh gw 2f .4 .6 2 4 -22 10 r4/4 none sil 1f dsh qw if .2 .3 3 2 -39 10yr4 /4 none sl 2msbk mfr gw if .5 .9 4 9 -110 7.5yr4/6 none ms Osg ml na na .7 1.2 c134 Boring # [j Boring 2 ® pit Ground surface elev. 97 ft. Depth to limiting factor +110 in. Soil Application Rate Horizon Depth I Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I 'Eff#2 1 -13 10yr2 /2 none L lcpl dsh gw 2f .4 .6 2 3 -27 10yr4 /4 none sil lfpl dsh gw if .2 .3 3 7 -40 10yr4 /4 none sl 2msbk mfr gw if .5 .9 4 0 -110 7.5yr4/6 n one ms OSg ml na na .7 1 1.2 . B MOO ` Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg /L (fluent #2 - < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature . CST Number Gary L. Steel 02298 Address Date valuation Conducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 9 -22 -2000 715 - 246 -6200 Property Owner Derrick Const, Inc. Parcel ID# pending_ Page 2 of 3 F Boring # ❑ Boring 3 [ pit Ground surface elev. 98.30 ft. Depth to limiting factor +120 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 1 -8 10yr2 /2 none L lc l dsh QW 2f .4 .6 2 8 -15 10yr4 /4 none sil 1C P1 dsh gw if .2 .3 3 15 -36 10yr4 /4 none sl 2msbk mfr -jw if .5 .9 4 36-12C 7.5yr4/6 none ms Osy ml na na .7 1.2 Boring # Boring F - 4] :0 pit Ground surface elev. 98 ft. Depth to limiting factor +120 in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fti in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -12 10yr2 /2 none L 1cP1L dsh UW 2 12 -23 10yr4 /4 none sil M na gw if, .0 .2 3 23 -44 10yr4 /4 none sl 2msbk mfr w if .5 4 4 -12 7.5yr4/6 none ms Osq ml na ❑ Boring # ❑ Boring El Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication 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 Effluent #1 = BOD > 30 5 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS 5 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.6=) STEEL'S SOIL SERVICE Gary L. Steel Derrick Const, Inc. 1554 200th Ave. CSTM2298 NW4 S19- T28N -R19W New Richmond, WI 54017 MPRSW -3254 town of Troy (715) 246 -6200 lot #122 -Troy Village ,/-1 " =40' i BM.= top of l" pvc pipe by nw lot corner @ el. 100 ' /Alt. BM.= top of mid -lot survey stake @ el. 986, l ,4 1 � v a V° 33 5' Gary L. Steel 9 -22 -2000 'setter W avr SS e io'Dift r M �� v %- . 'open" a Pravides the lecfive is t ove lea s°�tnuln an masked Pr o vide an Open ice- It � ;Pillary act �n nI to alloy, effluen to an d thieved b all directions. This ha flow via SPECI "ttom with a o m fg the has beenBMr Swd � CAt1S: ant louVers a op i - h...........76 ; l '�' F' ft Unit the al ong the lull chamber flows ng the sides. Wolf) .............34• / Length d esig ned 76 '- tv Of Jn H e i ght ... 14" Width . ......... .. '3Qw ent S� o mP ctt b allow et ,,u t ide. The iouv,,, hwer t......-••....9w Height.... ....1 „ win Into acicfilt while Pre P into the B �ift - invert.. fi. 1 chamber sting it f rom Pupe� �d of e Sift wtf Of 12 or 17-, witfttand h H_ f 0 20 tr factors POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pa ___L of FfLE T SYSTEi1 SPECH1CATIONS own Septic Tank Capacity QU O NA Permit O Septic Tank Manufacturer g al .� � a NA OESWN PARAMETERS Effluent Filter Manufacturer O NA Number of Bedrooms 3 O NA Effluent Filter Model 00 O NA Number of Public Facility Units 19NA Pump Tank Capacity al 1-%NA Estimated flow (average) Pump Tank Manufacturer CiA Design flow (peak), (Estimated x 1.5) g aUday Pump Manufacturer IRNA Soil Application Rate d/d o? Pump Model b? NA Standard Influent/Effluent Quality Monthly average • Pretreatment Unit Q NA Fats, Oil & Grease (FOG) 530 mg/L ❑ SanUGravel Filter ❑ Peat Filter Biochemical Oxygen Demand IBOD 5220 mgiL ❑ NA ❑ Mechanical Aeration ❑ Wetiand Total Suspended Solids ITSS) 5150 mg/L ❑ Disinfection 0 Other: Pretreated Effluent Quality Monthly average Dispersal Ced(s) ❑ NA Bi x*wm(cai Oxygen Demand (800 530 mg& Wln-Grarnd (gravity) ❑ In- Ground (pressurized) Total Suspended Solids JTSS) 530 mg& O ]NA ❑ At -Grade ❑ Mound Fecal Colifonm (geometric mean) 510` cfu/100md O Drip - Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: 0 NA Other. ❑ NA Other: ❑ NA * Values typical for domestic wastewater and septic tank effkwd. Other: O NA MAINTENANCE SCHEDULE Service Event S Frequency Inspect condition of tank(s) At least once every: (3 rnonta (s) (Maximwn 3 years) El NA Pump out contents of tankfs) When combined sludge and scum squats one -third (Y of tank vokuns 0 NA Inspect dispersal ceNlsl At b O morithis) ast once every: �j ifs) (Mpdattx» 3 yeas) ❑ NA Clean effluent filter At least once every: 11 months) O NA I 2 ears) Inspect pump, pump controls & alarm At least once every: ❑ ❑ earls} VOWS) monthis) ,b4JA Flush laterale and pressure test At least once every: 0 month(s) JitNA ❑ ear(s) ottw: At least once 0 monthls) OrN every' O yawl$) Other: b' NA MAWTENANCE WSTRUCT10NS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following fcenses or certifications: Master Plumber; Mauer Plumber Restricted Sewer: POWTS Inspector: POWTS Maintainer; 5eptage Servicing Operator. Tank inspections must include a visual inspection of the tanks) to identify any missing or broken hardware. identify any cracks or leaks, measure the volume of combined sludge and senxn and to check for any back up or ponder of effluent on the ground surface. The dispersal cell(s) "I be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The pond'nng of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one - third !Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. AN other services, induding but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment 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 within 10 days of completion of any service event. GMW (4/01) For ZTARt AND OPERATION � .� of ON For now • tam to use of the POWTS that may impede the tr check treatment tank(s) for the presence of Pak" Products or other chemical t of the tank(s) removed Process and/or damage the dispersal celflsl. if high concentrations are detected have the content aeptage g operator Prior to use. System start OP shelf not occur when sett conditions are frozen at the infiltrative surface. During Power outages pump tanks may fill above normal highaw ow levels. When discharged to the dispersal cWs) I" per power restored the excess wastewater wig eeffluent. To avoid this � fie' a►ertoading the uelfta) and may resu lt le the backup or s situation have the contents of the pump tank removed by a Septage Service Operat urface discharge a W Power to the effluent pump or Contact a Pfu tuber or POWTS Mair►ta to assist in to restorin4 restore levels within the pump tank. Y oper�9 the controls tt dispersW Do not within t 5 feet down $ of any mound � calls. Da not drive or park over, or o disturb or comPact, the are soN absorption area. Reduction or emanation of the following from the wastewater stream may a WWO the performance and POWTS: and; baby wipas; cigarette butts; condoms, rca tan swabs; mss; dental floes; theas p�; diss the life infectants; s, of furl; the foumdatiob drain {sump Pu`P) water, fruit and table t Painting products, Pesticides; sanitary napkins; tampons; and er softener brmegrease, fner6acides; mace scraps: medications; on; ABANDONMENT When the POWTS fails and/or is Pmmwwndy taken out of service the following stets shall be taken to melba that the properly WW safely abandoned in cwn PgsncO With chanter Comm 83.33, Wisconsin Administrative Code; system is • All Piping to tanks and Pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and property disposed of b a y Ssptage Servicing Operator. • After pumping, all tanks and pats shah be excavated and removed or their covers removed and the void space filled with soft, gravel or another inert said material. CONTLO48ENCY PLAN R POWTS f W B and cannot be repaired the owing measures have been. or must be taken, to provide a code compliant from am T h e at replacement ent area has bleb eyed and may be utilized for the location of a rep�iscement sod absorption refired setbacks from existing area should be protected from did r ber" and � and should not be infringed upon by xiating arM proposed siruicluirs, lot Mwa and wells. Faikas to protect the replacement area wal result in the need for a new soil and site evaluation to establish a suitable rePlacernaft ate. Replacement systems must fly with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback end /a soil limitations. technology a holding tank may be installed as a last resort to replace the failed POWTS. Barring advances in POWTS Q The site has not been evaluated to identify a suitable repiacemerrt area. Upon f aikra of the POWTS a if ite . and s evaluation must be Performed to kncate a suitable replacement area if no replacement area is available tank a hoidirug may be installed as a last resort to repiaca the failed POWTS. ❑ Mound +Ear! st -grade writ absorption systerns may be reconstructed 'm place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WA> > SEPTA. PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL BASSES AND/OR MISW�RCWNT OXYGEN. DO NOT ENTER A SEPTIC RESULT. PERSON FROM THE MT�pR OF A TANK MAY BE OFMULT OR MON)SSIBLE. RESCUE OF A ADDITIONAL CCMiiM Rwm POWTS NEii►TAtLJB3 POWTS MAKTANER Name F C t ca Name Phone 5' L l'fnorie , �4 SEPTA SERYIgNQ OPERATOR fPUMP") LOCAL AE6ULATORY AUTHO§M Name Ffnorne Name Es Lo i/rZ0', Phone 3 (0 O This document was drafted in compliance with dwptw Conrn 83.22t2NbNt)4dj&(t) and 83.54tt). (2) It (3). Wisconsin Adrradstrative Code. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Z)E7a-ly j&o " Sirn44 S j l9" Mailing Address � y- I N S , 1k-i 8 0 - 1 Aty 044, Property Address �uP 6 / L- (Verification required from Planning Department for new construction) City/State , Ak 4s a H , �� Parcel Identification Number �© '" �$ J ' Zd - O Q 0 p SK3 LEGAL DESCRIPTION Property Location A-AJ '/4, '/4, Sec. T 2S� N -R W, Town of _. Subdivision y �� ��� E . Lot # Certified Survey Map # Volume gage # — —� Warranty Deed # L (0 o I -- , Volume l - , Page # 1 1 Spec house >(yes O no Lot lines identifiable yes O 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 to submit to St. Croix Zoning Department a certification form, signed by the owner and" by a master plumber, journeyman plimber, restricted plumber or a licensed pumper verifying that (1) 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 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 t1m our septic system has been intained must be completed and returned to the St. Croix County Zoning Office within 30 days of three ear exp do ' e. SI A OF APPLICANT DATE OWNER CERTIFICATION I we) certify that all stat nt n this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the pro des ri a e, b virtu of a warranty deed recorded in Register of Deeds Office. - 7 !t O L D SI ATURE & 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 07/10/02 WED 13:28 FAX 715.386 4687 REGISTER OF DEEDS X003 1.fY) P u r L i KATH H. 45009 H REGISTER OF DEEDS STATE BAR OF WISCONSIN FORM 2 - 1999 ST. CROIX CO., WI WARRANTY DEED RECEIVER FOR RECORD Doeumant Numtwr 06 -12 -G001 8:30 AR This Dead, made between WRRRA} DEER El(E(1PT 111 M CERT CORY FEE: Tiny De ent Cotes atian, 8 Minnesota Corpora ion COQV FEE: TRANSFER FEEL 160.00 8nd Derrick Co .It,UCti�Sr121111{ + 3!e_3i1..... ,. .._ RECORDING Fa.F: 10.00 „ — _ • 8 WiSCanai�„CQrpo>;s1t1G1'1,.. ,. . . . PAGES: 1 Crotvur, fur a Valuable nnu k4 +iYIWn, cratweys anal %vatra ltu 10 Cla+tlty My fulluwillm dcseN d real estate In Se.�. Croi % Goiuny, SIaIe of Wlarousln: tat of t1le Plat of Troy Village 4th Cion in the Town of Troy, St. Croix County, NWm aM t'lotwn Addmss Wisconsin, ick Constru on Hoot 1505 , PO A Subject to Declarations of Covenants, Conditions and N. et>rrong T 54017 Restrictions for Troy Village, recorded in Vol. 1241, Page 256, as Doc. No. 559964, and the Declaration of Golf Course_ Covenants, Conditions and Easements,, recorded in Vol. 1241 Page 301, as Doc. No. 559969, 40- 1281 - - 000 ` all as appearing in the office of the Register of Deeda for St. Croix County, Wisconsin, and suem other Pavel I:14ftderAllon Nunw(FIN easements, restrictions and reservations of record, This -16 n0t nomv&uwdpropprL)C or in use, and the , ,Buyer" obligations contained in (W (is 1100 the Purchase Agramoent for this lot. I Exceptions to werrantics: Dated this 6 th day or. Jun2 2001 E (R W . _Charles S. Cools. President Troy Dcvelopttient Corporation iI (SEAL) (SE'ALI !i 1 AUTHENTICATION ACKNOWLEDGMENT Minnesota II Sigrlature(s) State of W +seonsFn. Anoka County li authendrarad this day of .,w.— Personally eime before me this —day of ( I June 20DI the atsuva remaC Charles S. Cook, P ;es dent 1'rov Development Corporation I' TITLE: MEMBER STATE BAR OF WISCONSIN w ll at not. _.. _ me known to be the person who executed the foregoing I aunwrized uy 5706.011. Wis. SPW Instrument rd acknowledge 1119 aegAa. .1 TAS INSrnumeNT WAS J3RAFrgO BY TROY D EVEWPI+ffsTPC CORPORATION N T14y L;� ]ifs 1' Notary Pubtic. Sp , o"leemelwAnalca County, Minn. Charles S. Cook, Presi My ctunmisston is parrrwnent, Of rot. state expiation date: fSignatutcs may be authenticated or acknowledged. Both are not Janlxary 31 2005 i necessary) , • f+I •rprru+u ugnryr N aq npuay +mnl Or lylke o, I + /Ii9N Ireluw tlrH i,gNenr. STATE BAR OF WISCONSIN elyet Co_ am. WARRANTY DEED FORM NO. i . 1994 NANCY � � kM.uuw. wta. A ' W COMAaMI� ES AAWARral.= � I I I01 I I ,, i WJ3 to is I b C! call In co vl I i W ! I = - II�IOI�ICUI Mo I hl° I ►�II� O Q O ,•� I ao SQI I oD 1'/ l M! J��v vlVl � W � I z �Ul (n MS 3H1 I I I (M „OF ,O I I Z I .L V99£ 3„ l i' M C4 i 90 .Z9'SL 00'99 L — — -- — — — L0 60 '� `I - 11 d�l1 _ M „sIZQ's� oE� — 110-- ,99,6 9Z3 _ 'L9*6b N £Z3 N ,OL i 1 '6 L 0 S Z0 ft0 _ 1 p• rn O 1 • r ' O — N 5 Vf N O I V) O to 1 3 1 0 o M WLC } O o vi N 1 N m ^- b�� N o ' i n I N< 1 0 1 In N c'! l!•3 g * ao e— con o M, N o ro O p N .— aQ z in o 00 ,Ol ' 1 z l 01 ,69'9ZL • .05'66 9 •. 'S ZS 3 90 , 99'ti£ l 134 ) ,OO* l 0 N L i o j I I U- � I.I O i ? t � 101 K I I ,