HomeMy WebLinkAbout042-1024-40-100 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
395299
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 Holders Name: City Village X Township Parcel Tax No:
Nelson, Gary Warren Township 042 4024 -40 -100
CST BM Elev: Insp. BM Elev: BM Description:
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark /
Dosing Alt. BM
S
Aeration Bldg. Sewer 71
Holding Y St/Ht Inlet
SUHt Outlet
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet -
Septic - / / j t Dt Bottom
Dosing / _ Header /Man.
.�
Aeration _ Dist. Pipe c:,
Holding Bot_SysteT.
PUMP /SIPHON INFORMATION Final rade
Manufacturer Demand St Cover
GPM
Model Number
TD H Li Friction Los,- System Head " JTDH F
Forcemain Length
I Dia a Dist. to well i
SOIL ABSORPTION SYSTEM { �,� ;; 1, �. ', . �,•__,, _-
BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS
SETBACK SYSTEM TO P /L� /L �
.; LDG WELL LAKE /STREAM LEACHING MaA fact r
re
INFORMATION CHAMBER OR' ����
Type Of System / ! f/ UNIT Model Npmbgr: 7
DISTRIBUTION SYSTEM t,
Header /Manifold Distribution x Hole Size x Hole Spacing FgffRovAir Intake
/ I / Pipe(s) .i
Length Dia �� Length ( 1 Dia i I pacin � � d
SOIL COVER x Pressure Systems Only xx Mound Or At - Gr ade Systems Only
Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed/Trench Center. < t /__ Bed/Trench Edges Topsoil Yes No [] Yes ❑ No
COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 1027 110th Street Roberts, WI 5 023 (NW 1/4 SW 1/4 9 T29N R18W) NA Lot 1 P arce l No: 09.29.18.138A20
1.) Alt BM Description
2.) Bldg sewer length
amount of cover =
Plan revision Required? *Yes [W
Use other side for additional information. L
Date Insepctor Signature Cert. No.
SBD -6710 (R.3/97)
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Safety and Buildings Division , Coawty
6
AN I w 201 W. Washington Ave., P.O. Box 7162
*1scon,s � Madison, WI 53707 - 7162 Site Address t✓
Dep artment of Commerce
Sanitary Permit Application Sanitary Permit Num r
In accord with Comm 83.21, Wis. Adm. Code, personal information you pr C1 Check if Revision 3q�Qv f
ma be used for seco ses Privac Law, s15. 1 , !
L Application Information - Please Print All Information INuer Plan I.D. Number 1,J14 Property Owner's Name / d (]t�C� Number O
Property is Address ty Local S N R
ity, State Zip Code P Number 0' mb Block N bar
ubdivision Name SM - umber
p . 4ts�' Uo /
If Type of Building (check all that apply) ❑City
1 or 2 Family Dwelling - Number of Bedroom — ❑Village
❑ Public/Commercial - Describe Use loTownship ^ `�
❑ State Owned Nearest Road
M. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable)
A For County use
1 19 New 2 ❑ Replacement System 3 ❑ Replacctnent of
76 Addo S sum Tank Ord ' m
B. ❑ Check if Sanitary Permit Previously Issued
Permit Number Date Issued
IV.Type of Permit: (Check all that apply)(numbering scheme is for internal use) '
44 tat nl Non - Pressurized hr- Ground 210 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland
22 ❑ Pressurized , roun d 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line
45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ R irculating 30 ❑ Other _
V. D' ersat/Treatment Area Information: - iX
Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System E uoa Final Glade
Required Proposed Rate(Gals./ Days /Sq.Ft.) (Min./Inch) Elevation
�- -
Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Vf Gallons Gallons of Tanks Concrete constructed Glass
New Existing
Tanks Tanks
Septic or Holding Tank f �^
Dosing Clamber _
VII. Respon4lbility Statement- I, the undersigned, a responsibility for installation of the POWYS shown on the attached plans.
Plum s e ) Plumber's Si MP/MPRS Number Business Phone Number
S
Plumber's Address (Street, City, State, Zip Code
'�J—r
VIII. County /De artment Use Onl
Approved ❑ Disapproved Sarin Permit Fee (includes Groundwater Date Issued Agent Signamn (N Stamps)
❑ Initial Surcharge Fee)
Owner Given tial Adverse 6(]
Determination
1X nditolns �f �trov 1/�tea ons, for Disapproval
$went t ter o stale an maintained per manufacturer's recommendations.
All setbacks to system and residential structure must meet applicable code requirements.
Property is zoned Ag- residential - only one principal dwelling is allowed on this property.
Floodplain mapping = Zone "C"
Attach complete pLwu (to the County only) for the system ou paper not kss than Sla x"lucha in size
SBD -6398 (R. 05101)
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Add 15T PAGE of
PUMP CHAMaEA CA055 SECTION AND SPECIFICATIOKS
L'3 VENT CAP
VENT PIPE
WEATHEKPKooF APPROVED LOCKING
JUWCTIOM BOX MANHOLE COVER WITH
25' FROM DOOR, WP WING LABEL
WINDOW Olt FRESH It�MIU.
AIR INTAKE
GRADE
I '1" M11J.
-T COQDUIT
lo•nl�l
11�
PROVIDE I - - - --
IIJLET � AIRTIGHT SEAL
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APPROVED JOIIJT A APPROYED JOIWT
I II W/ , PIPE
CXTENDIWC. 3' I I ALARM EXTEUDIWG 3'
O►JTO SOLID SOIL I II ONTO SOLID SOIL
d I I
OW ti
i
C: I
E. L E V. FT. PUMP --- - -J
b OFF
f I 0
COQCKETE DLOCK
RISER EXIT PERMITTED OIJLy IF TAWK MAUUFACTURER HAS SUCH APPROVAL
3 prPPRoVEa i3ECbii undcr T14NK
SEPTIC E SPECIFItATIOMS
DOSE '
TAQAS MAIIJUFACTURER: S ►J UMBER OF OOSES: �� PER DAB
TAM SIZE: Qx J GAL�LOQS DOSE VOLUME
I d
GALtOR
ALARM MAIJUFACTURCR: NCLUDIIJG 6ACKFLOW: 4 ��5�
MODEL 1JUMBEK: e �� �� CAPACITIES: A I • 3� GALL0144
SWITCH TYPE: �� .G !�a ,CC B =-— INCHES OR GALLOAJ
PUMP MAWUFACTURCR: 4 S' C = ` 1 _ IIJCHE5 OR ,L /� � GALLOU.
MODEL WUMBCR: D -_ ._INCHES OR /s7 GALLOUS
SWITCH T`JPE: J. ���5 � � MOTE' PUMP A*D ALARM ARE TO DC
MI►JIMUM DISCHARGE RATE �L�L — G PM INSTALLED OW SEPARATE CIRCUITS
VERTICAL DIFFERENCE OETWECU PUMP OFF AIIJO DISTRIBUTIOU PtPC.. J - 2 FEET A
4- MIUIMLIM NETWORK SUPPLY PRESSURE, . . . . . . . . . ��- FLET C � 1
+ FEET OF rORCE MA11S X 1„L_F>.onrr.FR ►CT10U FACTOR.. ,FEET
TOTAL Dy1JAMIC HEAD = / /y,, -91- FEET
I
IIJTERMAL DIMEMSI t OF TAIJK: LENGTH jWIDTlA jLIQUID DEPTH
GIGUE LICENSE NUMBER. � DATE:
Curves �t Pumps
e 1
MMR$ FEET
90
MODEL 38&5
SIZE 3 /4" Solids
—
70
2J WE10H - -� -
.......
wE07H—
I
s 50
40
10 30 WEWM
5 _
I
0 0 .
0 10 29 00 40 50 60 70 60 90 1W t10 120 GPM
0 1 l0 :4 m'rr
CAPACITY
'fGOUIDS PU 1a
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j`,+ '��� ;,t. I ^S;'.�y•l;'�r�"R'1 ' �j;1. ,�1rv, ' . ti , ?.� '1"'k, ...�c. , �!.I ,,: -':'• '' �
S. INC
METERS fEET
120 }-- --T MODEL 3885
t,o WE15HN I SIZE /l Solidlc
o0
30
90 I
BO
I
20
15
40 r._.._1__r•�
10
0 0 _.. _ ..
0 10 20 00 40 50 w 70 4 w 1 W 110 1 G PM
0 10 N 90 m'/h
CAPACITY
•,"6 QQwIa. Pump., Inc.
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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of
Division of Safety and Buildings
in accordance with Comm 85, 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 not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all infor� Rev' wed b Dat
Personal information you provide may be used fors n �u 4 (P , Va aw, s. 15.04 (1) (m)).
Property Owner r�\ Property Location
R X ov. t Lot 1!4 114 S N R E (orVj
Property Owner's Mailing Addr ss �. It # Block Subd. Name or A
city tats Zip Cod „ ,.� Phone b>tir X City E] Village - jA Town Nearest Road
l ric3t
,1 �., C0JNTY c -
New Construction Use.,Z Residential / tsltiljL bedroo Code derived design flow rate - - GPD
[] Replacement Public or comme I -� i
Parent material Plain elevation if applicable ft.
General comments
and recommendations: �ysh— 9S G
F-/1 Boring # ❑Boring
pit Ground surface elev. ft. Depth to limiting factor �$_ in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. CqAt. Color Gr. Sz. Sh. *Eff#1 *Eff#2
Pi I A I
d ,
Boring # ❑ Boring q,
Pit Ground surface elev. [_ ft. Depth to limiting factor > in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz
in. Munsell Qu. Sz. C nt. Color Gr. Sz. Sh. *Eff#1 *Eff#2
s
*
Efflijent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effl nt #2 = BOD, < 30 mg /L and TSS < 30 mg /L
CST Nam PI se Pri ) Signature CST Number
ZZ
Address ate Eva ua n Conducted Telephone Number
o4 1421E 1) _� Ae v
- /- -.3�
SBD -8330 (R07 /00)
Property Owner ��, / /�Y Parcel ID # Page of
Fil Boring # E] 13 Boring F
Pit Ground surface elev. 97-ZZ— ft. Depth to limiting factor �� in.
I Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2
I
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I
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S
i
❑ Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
F-1 Boring # [] El Pit Boring
Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
* Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 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.07 /00)
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POWTS OWNER'S MANUAL 6Z MANAGEMEN F PLAN Page of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner' Septic Tank Capacity al ❑ NA
Permit # Septic Tank Manufacturer ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer C3 NA
Number of Bedrooms [I NA.
Effluent Filter Model ❑ NA
Number of Commercial Units [9 NA Pump Tank Capacity gal ❑ NA
Estimated flow (average) gal /day Pump Tank Manufacturer s ❑ NA
Design flow (peak), (Estimated x 1.5) j gal /day Pump Manufacturer s ❑ NA
Soil Application Rate gal /day /ft Pump Model ❑ NA
Influent/Effluent Quality Monthly average* Pretreatment Unit ❑ NA
Fats, Oil 8t Grease (FOG) 530 mg/L ❑ Sand /Gravel Filter ❑ Peat Filter
❑ Mechanical Aeration ❑Wetland
Biochemical Oxygen Demand (BODs) 5220 mg /L ❑ Disinfection ❑Other:
Total Suspended Solids ( T55) s 150 mg /L Manufacturer
Pretreated Effluent Quality ❑ NA Monthly average* * Dispersal Cell(s)
Biochemical Oxygen Demand (BODs) :530 mg/L 0 In- ground (gravity) ❑ In- ground (pressurized)
Total Suspended Solids (TSS) 530 mg/L ❑ At -grade ❑ Mound
Fecal Collform (geometric mean) 510' cfu /100m1 1 ❑ Drip -line ❑ Other:
Maximum Effluent Particle Size A Inch diameter
* Values typical for domestic (non - commercial) wastewater and septic
tank effluent.
* * Values typical for pretreated wastewater.
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every ❑ months 18'Year(s) (Maximum 3 yrs.)
Pump out contents of tank(s) When combined sludge and scum equals one -third (Ys) of tank volume
Inspect dispersal cell(s) At least once every ❑ months Z year(s) (Maximum 3 yrs. )
Clean effluent filter At least once every ❑ months Ci `year(s)
Inspect pump, pump controls 8z:alarm At least once every ❑ months year(s) CI NA
Flush laterals and pressure test At least once every ❑ months ❑ year(s) gNA
Other: At least once every ❑ months ❑ year(s) ❑ NA
Other: At least once every ❑ months ❑ year(s) ❑ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master
Plumber; Master Plumber Restricted Sewer, POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank Inspections
must Include a visual inspection of the tank(s) to Identify any missing or broken hardware, identify any cracks or leaks, measure the
volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal
cell(s) shall 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 ponding of effluent on the ground surface may Indicate a failing condition and requires the immediate
notification of the local regulatory authority.
When the combined accumula a be remov edsb s ludge Septage Servicing Operator aequals
or l and disposed of in accordance with ch. volume, h
NR 113, Wisconsin
contents of the tank sh Y
Administrative Code.
The servicing of effluent filters, mechanical � or p ressurize d
or be performed by a certified POWTS Maintainer. a ny other
maintenance or monitoring at Intervals o
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process and /or damage the dispersal cell(s). if high concentrations are detected have the contents
of tae ca1)k(s1 r?moved by a sentage servicing operetor prior to use,
/V /L
Page —of.
System start up shall not occur when soil condlUQns art frozen at t)w InfRtrative surface.
During power outages pump tanks may fill above normal hlghwater levels. When power Is restored the excess wastewater will be
discharged to the dispersal cell(s) In one large dose, overloading the cell(s) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank mnovtd by a Septage Servking Operator.prior to restoring
power to the effluent pump or contact a Plumber or POWYS Maintainer to assist In manually operating the pump controls to
restore ncrmal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells, Do not drive or park over, or otherwise diswrb or compact, the are;
within 15 feet down slope of any mound or at-grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may Improve the performance and prolong the lilt of the
POWTS: antibiotics; baby wipes; clgarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; (at;
foundation drain (sump pump) water; fruit and vegetable peelings) gasoflrR, greastj htrbiddssj meat scraps; m%dicattuns; oil;
painting Products pesticides; sanitary navkins; tamoonsi and water softener brine.
ARANDONEMENT
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 safely abandoned In compliance with ch. Comm 83.33, Wisconsin Adm(nUvadvo Code:
• All piping to tanks and piu shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and plu shall be removed and property disposed of by a Septage Se rvicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, grave( or another Inert solid material.
CONTINGENCY PLAN
If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to prOvldt a code compliant
replacement syscerx►p�
A suitable replacement area has been evaluated and may be udlired for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be Infringed upon br
required setbacks from existing and proposed strucwre, lot (Ines and wells. Failure to protect the replacement area will
result In the need for a new soil and site evaluation to establish a sultaWe replacement ana. Replacement systems roust
comply with the rules In effect at that time.
0 A suitable replacement area Is not available due W setback and /or soil limitations. Barring advances in POWTS technology
a holding tank may bt installed as a last resort to replace the failed POWTS.
O The site has not been evaluated to Identify a suitable repfacemerit area. Upon failure of the POWTS a soil and site
evaluation must be performed to locate a suitable replacernennt arta. if no replacement area Is available a holding tank may
be Installed as a last resort w replace the failed POWTS.
Q Mound and at-grade soil absorption systems may be reconstructed In place following removal of the biomat at the
Infllua0ve surface. krconstrvctlom of such systems nwst.cotnply with the rules M 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 OTHLIR TREATMENT TANK UNDER ANY CIRCUMSTANCES.
DEATH MAY RESULT, RESCUE; OF A PERSON FROM THE INTERIOR OF A TANK MAY SE DIFFICULT OR
Impn%%iR1 F
ADDITIONAL COMMENTS
POWTS I smt POWYS MAINT 1 R
Name Na me
Phone � - Phone
SEPTAGE SERVICING OPERATOR JPUMPERJ LOCAL REGULATORY AUTHORITY
Name Agency
—
Phone _
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
QWN RSHIP CERTIFICATION FORM
Owner/Buyer
Mailing Address
Property Address
(Verification required from Planning Department for new construction)
City /State Parcel Identification Number
LE GAL DESCRIPTION f
Property Location-- '/4, _e '/4, Sec. , T _N -R Town of
Subdivision 41_�Sj" , Lot #
Certified Survey Map # �s 5`� , Volume � , Page #
Warranty Deed # , Volume , Page #
Spec house O yesFxf no Lot lines identifiable N yes O no
I
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 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 113 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 Zoning Office within 30
days of the three year expiration date.
SIGNA FRTIFICATION
LICANT DATE
OWNER C
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 escribed above, by virtue of a warranty deed recorded in Register of Deeds Office.
i /Si
SIGNATU OF PPLICANT DATE
* * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * **
i
** 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
1715
656130
STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH
Document Number WARRANTY DEED REGISTER OF DEEDS
ST. CROIX CO., WI
This Deed, made between Gordon A. Truesdill, RECEIVED FOR RECORD
09 -07 -2001 10:30 AN
WARRANTY DEED
EX - D
Grantor, and Gary D. Nelson and Jillienne J. Nelson, husband and wife CERT COPY FEE:
COPY FEE:
TRANSFER FEE: 105.00
RECORDING FEE: 11.00
PAGES: 1
Grantee.
Grantor, for a valuable consideration, conveys to Grantee the
following described real estate in St. Croix County,
State of Wisconsin (if more space is needed, please attach addendum):
Recording Area
Name and Return Address
Part of NW '/4 of SW '/. and part of SW '/4 of SW '/4 of Section 9, Township
29 North, Range 18 West, St. Croix County, Wisconsin described as
follows: Lot 1 of Certified Survey Map filed August 29, 2001 in Vol. 15, , ` �� k3
Page 4157, Doc. No. 655060.
042 -1024- 40,042- 1024 -60
Parcel Identification Number (PM)
This is not homestead property.
(K) (is not)
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any.
Dated this _1 :�o day of September , 2001
�� a l 4 � ZIZ
* * Gordon A. Truesdill
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
) ss.
y County )
authenticated this da of _
Pa ricia Goa e� s- Knutso Personally came before me this day of
September 2001 the above named
Notary Public Gordon A. Truesdill,
*
St of WiP• �7oons'n
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, to me known to be the person(s) who executed the foregoing
instru nd acknowledged the ;me.
authorized by § 706.06, Wis. Stats.)
THIS INSTRUMENT WAS DRAFTED BY
Attorney Kristina Ogland Notary Public, State of Wisconsin
Hudson, WI 54016 My Commission is pe anent. (If not, state expiration date:
(Signatures may be authenticated or acknowledged. Both are not necessary.) )
* Names of persons signing in any capacity must be typed or printed below their signature. Information Profassionais company, Fond du Lao, wl
800-655 -2021
WARRANTY DEED STATE BAR OF WISCONSIN
FORM No. 2 - 1999
1 `
Es55fC760
KATHLEEN H. WALSH
REGISTER OF DEEDS
ST. CROIX CO. WI
RECEIVED FOR RE
08 -29 -2001 9:00 AN
COPY FEE: 3.00
RECORDING FEE: 12.00
Certified Survey Map
Gordon Truesdill Jr.
Part of the Northwest 114 of the Southwest 114 and the Southwest 114 Of the Southwest 1/4 of
North, Range 18 West, Town of Warren, St. Croix County, fi I APPRO
L EG END : n ST. CROIX COUNITY
T,
Plan na Zrm`^ . -
al O INDICATES I "A 2 4 "1 RON PI PE WE I GH IN a I.15LBS. /L /N F SET.
IRIO.O') INDICATES PREVIOUSLY RECORDED DATA. 2 9 u
O INDICATES TEST HOLE ISEWERSI TEI.
INDICATES FENCE.
If not recoralww,ron.iu jays of
AUG approval date approval shall be
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UNPLATTED LANDS ROBERTS, W154023
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Jit I r S 89.44'48 "W 484.00' ^ { I
IN h?I h B. 67' 475.33' �► I
2.301 ACRES OR /Do, 219 SQUARE FEET V
2.?6T ACRES OR 99,754 SQUARE FEET in I
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UNPL TIED O 3 THIS INSTRUMENT DRAFTED BY
U Su m LAURENCE W. MURPHY
SW CORNER SECTION 9, 3
l2 "IRON PIPE FOUND) W Q 3
m W N h 011I�r�
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0. 283 ACRES OR / ?, 312 SQUARE FEET k O
0.266 ACRES OR //, 594 SQUARE FEET ? W O 2 1717
EXCL UO /NO R04 RIOMT OF WAY R 2 � W FA"
VAJ co F+ ( 4
SCALE I "= /00' -4 H L40 a 3oQ
O 50' /00' fso' 200' 250' 300' "ResvisW this 14th day of ., 200 ."
OATEp; ✓UNE6, 2001
sHEEr r ofs
VOLUME 15 PAGE 4157