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HomeMy WebLinkAbout020-1303-00-000 r ST. CROIX COUNTY ZONING DEPARTME AS BUILT SANITARY REPORT e Owner Property Address City /State Legal Description: Lot .,,FS Block Subdivision/CSM # V4 ,4/L 1 /4, Sec - TAN -R,&W, Town of PIN # SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: 7� Tank manufacturer lu i��,<!; Size ST/P W / Setback from: Hous Well 72 P/L Pump manufacturer Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: , �f, Width -- Length Number of Trenches Setback from: Housed Well 9,5 P/L -1— Vent to fresh air intake T ELEVATIONS Description of benchmark e ? Elevation D, Description of alternate benchmark i Elevations Building Sewer `s - ST/HT Inlet 9,7� / ST Outlet %/, . PC Inlet PC Bottom Header/Manifold 7 Top of ST/PC Manhole Cover Distribution Lines () 91 () ( ) Bottom of System O . 94, �� -- _ ( ) ( ) Final Grade () ,242 ( ) ( ) Date of installation / / a Pe mit number State plan number Plumber's si g nat License number (:: ;7 � Date r Inspector Complete plot plan � NOTICE Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW y eus� i INDICATE NORTH ARROW Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count y INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No -: ST . CR IX Personal information you provice maybe used for secondary purposes [Privacy Law S.15.04 (1)(m)]. 344508 Permit Holder's Name: ❑ Cit ❑ Villa le Town of: State Plan ID No.: GRUBE, KEVIN iUDSON CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: " a , � 020- 1303 -00 -000 TANK INFORMATION EVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. SepticS Z Benchmark Dosing 4#— 0 w Aeration Bldg. Sewer Q/g' Q7 -3G Holding St/ Ht Inlet gyp �$" 2. /O TANK SETBACK INFORMATION St/ Ht Outlet O,-P3 TANK TO P/ L WELL BLDG. Air I to ntake ROAD ir Septic 1�ppt' NA Dosing NA Header / Man. gel, 5 Aeration NA Dist. Pipe � 7 Holding Bot. System PUMP / SIPHON INFORMATION Final Grade 8,3 . Manufact r Demand �y„�q Q. �S `73 Model Number GPM TDH Friction System TD Ft ead oss Forcemain Length Dia. Fi Dist. To well SOIL ABSORPTION SYSTEM $ / Width I Length I N f T PIT No. Pits Inside Dia. id Depth EN I N a- 7 DIMEN I N SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHIN )VKhufacturer: INFORMATION Type O ( 1 q 0 r CHA NIT M I Num er: System: tj DISTRIBUTION SYSTEM Header / M f old (� Distribution P H Ve nt To Air Intake Lengt Dia. Lengt x tZ( 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 El Yes ❑ No ❑ Y ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) .rte LOCATION: UDSON 27.29.19.1498,SE,NE 759 ORIOLE LANE �zl o k �14 1 s �°tx r Plan revision required? ❑ Yes No Use other side for additional information. 1 0S I OZ 0 - Ajr j S Z SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. I ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: i " �m " E f " E 3 - . __ F " 3 . F a � � 3 a I E ° � o 3 r v � i #t € E E F e a i 3 E ,, a,. 3 t f ,Po wm z , c t s x 3 e t t � e i E .. { } Safety and Buildings Division SANITARY PERMIT APPLICATION 2 01 W. Washington Avenue 14 .4consin In accord with ILHR 83.05, Wis. Adm. Code P O Box 7302 Department of Commerce Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 1/2 x 11 inches in size. :S . • See reverse side for instructions for completing this application State rani ary Permit plumber 3VVs e Personal information you provide may be used for secondary purposes ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION i - Prope wner Na a Property Location _ r y 1/4 114, S T , N, R , 42 /(or&l Property Owner's Mailing Address Lot Number Block Number 7 — City ate Zip Code Phone Number Subdivisio me or CSM N b r ( ) r 11' TYPE F BUILDING: (check one) E] State Owned ❑ It Nearest Road ❑ Village Public E@ 1 or 2 Family Dwelling - No. of bedrooms 5ff Town of III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Num er(s) .2!7 2 9. 1q. P19A 1 ❑ Apartment/ Condo d ` / 3 D 3 - 10 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. ® New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an - - -- __System ________System _____________Tank Only________ - _ - - -- Existing System - _______ Existing Syste B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 EgSeepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure .10 42 ❑ Pit Privy 13 ❑ Seepage Pit �e3 X 73 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: Y76 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. ate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (scl ft.) (Gals/day /sq. ft.) (Min. /' ch) Elevati n 7 Feet Feet TANK Cap acit VII. I NFORMATION Con- steel in gallons Total # of Manufacturer's Name Prefab. Fiber- plastic Exper. Gallons Tanks Concrete glass App. New Existin structed Tanks Tanks Septic Tank g an ® El El 11 11 El Lift Pump Tank /Siphon Chamber Vill. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for in allation of the onsite sewage system shown on the attached plans. Plum a Name: (Print Plumb r' ture Stam ) MP /MPRSW No.: Business Phone Number: Plumber's Address (Stet, Cit , State, Zi ode): 15 oy .e e 4A JT IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater D ate Issued Issuing A t Si Surcharge Fee) gnature (No Stamps) / Approved ❑ Owner Given Initial o o b Adverse Determi ��� /ce) X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.1 1197) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber 1 INSTRUCTIONS ' 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608- 266 -3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. i v �. bl IX LA G -5 p �? i h 'Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division'of Safety and Buildings Page of —5 Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION - Please print all information. Revi ed by _ Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property ner Property Location Govt. Lot 114 1/4,S 7 T N,R �(or6 Property Owner's Mailing Address Lot # Block Subd. me or CSM# `— / city St a Zip Code Phone Number ❑ City Village Town Nearest Road r N] New Construction Use: Z Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow gpd Recommended design loading rate �Z_ bed, gpd /ft gpd /ft Absorption area required gy bed, ft _ trench, ft2 Maximum design loading rate _ bed, gpd /ft — trench, gpd /ft Recommended infiltration surface elevation(s) iG_ 7 It (as referred to site plan benchmark) Additional design /site co iderations Parent material Flood plain elevation, if applicable ' S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system s❑ u _Z1 S ❑ U ® S ❑ U ® S ❑ U ❑ S 2 U EIS X U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench A J, t S� Ground / �� F s Depth to limiting l factor Remarks: Boring # in Ig . r - s. / Ground _ g ele Depth to limiting factor Lor � — i n. Re rks: CST Name (Ple a Print Signature Telephone No. _ LZ =3 s Address Date CST Number S SOIL DESCRIPTION REPORT PROPERTY OWNER Page of PARCEL I.D.# Boring Horizon Depth Dominant Color Mottles Structure 2 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 3 Ground elev. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. , Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) w"x LA N, i c W � ` Il U r r �.r Wisconsin Department of Industry SOIL AND SITE E V A L QATI ON REPORT Page of 3 Labor and Human Relations ,, Division of Safety & Buildings in accord with ILHR 83.05, Wis; Adm, Code . OUNTY 5T. Ge o.- - X Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must includes; >ut . J PARCEL I.D. # not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or dimensioned, north arrow, and location and distance to nearest road. EVIEWED BY DATE APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION R PROPERTY OWNER: 11VR61A0 11 ' , v p O / d • PROPERTY LOCATION //L /' 0 ,tJ — OL,4 t .' GOVT. LOT 5 L�- 1/4 NF_ 1/4,S Z7 T 29 ,N,R I f E (or) W PROPERTY OWNERS MAILING ADDRESS / � P/OVv 6t �/� LOT # BLOCK # SUBD. NAME OR CSM # 33ee Av1PoB�TS S7 C l� 35 1 i-IVMRiRD Hillis t!P�tnS� Z CITY, STATE ZIP CODE PHONE NUMBER (]CITY QILIAG VE [aftSWN NEAREST ROAD T /�9 uG /1N• 2 -2- S +f uDSo".j New Construction Use I A I Number of bedrooms ` ' 2 f 3 (j Addition to existing building I j Replacement ( I Public or commercial describe f3-0 Recommended des' loath rate , bed, gpd/h ' trench, gI flow 600 � n9 Code derived dai gpd --�— Absorption area required Q 5 7 bed, ft 7✓ trench, P Maximum design loading rate L 7 bed, go/ft , d trench, gPd/11 Recommended infiltration surface elevation(s) c • 3 It (as referred to site plan benctunark) Additional design I site considerations �' �/� f�'`� E10& > Z O rieo^+ Parent material Se-S CG ��w►.Zc -7 S Flood plain elevation, if appliFable ti ft S = Suitable for system IoNAL MOUND �1 0 U ESSURE AT-GRADE r U O SYSTEM N FILL (] HO S TANK U= Unsuitable for system �0 U O S f�'$ SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure ConsLstenoe Boundary Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed mrxh /s ��, � �n vfiP Q S zf . � • � 3 Z �z - 3o 7 sy 1114 — s. Ground 3 0 9 /o ✓t 6e 9 �' -S - 0 , 5c" elev. it. nwtvm�L Depth to limiting hls test Sit0 PRO ED factor 8040 Remarks: Boring # !d -(-o log T� z 13 v -7 -5 Y� y/� s ©s _ - 3 O � /a/ 519 — c.s. O, S d� — 7 �•� Ground elev. ft. Depth to limiting fact Remarks: _ r T Name: — Please Print Phone: 7�5 3 dress: CQ�J S 0' Nt l L L� • R U D .J ��s • A&4/ o Date: CST Number: gnature: V ' �T PROPERTY OWNER SOIL DESCRIPTION REPORT Page Z of PARCEL I.D. R Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bwxby Roots GPD /ft In. Munsetl Glu. Sz. Cor!t Color Gr. Sz. Sh. Bed Tmnch CS ' Ground 3 3) - 9 /O elev. h. _ Depth to limiting tac�,i � Remarks: Boring # f 1 0- /0 QS 24 Ground elev. i ft. ; i Depth to limiting factor Remarks: Boring # f sd� �wr wle q s ,S . T22: Ground t elev. I ft. i Depth to limiting factor Remarks: Boring # I i Ground elev. rt. Depth to limiting facto Remarks: COM 0 ACIA l a� L Or r� � 3 0 l o A I Lo 0 O o o y e r. � ll 1 � Lfl w W m 4� m c I Q s vi r m 2 Dm Al o Z n I 2 .� N f NE q 1 473-3 4, N89 0 43' 55" W I 1 m� C9 D / r � z 'l 5 o p 6 o A CRES i w O 2 .11 A S F T. O m a �0 0 . 91, SQ. �� _ Z LA 52 49 D � m o, 2'gs,w ti ��2 pT 35 o S -L 2.11 ACRES N tk I v EASEMENT LOT °964 2.53 ACRES SQ. FT. 110,208 \ ao � o 0 I p � \ �\. LO T 34 o o � o� \ � •�(�� ', 2 0 .02 ACRES _ \ \\ SQ. . 87,93 FTN• - hENT� 0 5� \ LO.T 27 . 2 1 4 RES PONbiNG \ \ • 93,106 Q. FT. 1�EASEN\NT \\ \ EL z972 \ f� a 46 198 S89°06'22"E 29 v' o :� 1 S• N LOT 2v, (� 2.23 ACRES 3 r"1 c�7,�78 SQ. F .4 I � Jun -15 -99 12:39P P.01 C ront COITNTV 1 r17M7Ir^ T,1 4ttf w,lA rAt7'FCIA hYrF' bf:Rf- 1- flfff-.tV l . rural rnva� Llw;vt_n�nir t.i iii c iv„ VWnrr/SU)Cf KE: UlN ORiol_e LAN r ��: �i„i�:. ii, ni ",. r ::r,. n �C ",,., �^ •.. ... f., r•rw rrIn S Tructlofl)_ NU D �.` c/'y `F (�'.lt1f�131Li I YA/t[ lLll:i l +l laLutavil ,v.••v �: - J' .f . S r i i t, air, 9 C nit I ,1-.1, . �J !'tOp�rTV I.00BIIOn 5 v., � ^ %i JL4 Z• ` , i�_ ^: W Town ni NUD5 � . ,-;Sion 44ZV-fnD ���� -S�I H S 2� iv: �J.i -_ . rage if Wi1r!r#nty Ntt3 vc.'Yd. fit'$ l� Lot {inr•c ;de.nti1tl`ble � �'i:$ C = u Iry iav u�ti SYSTEM ��Alfr �r:r,aiv iit< rtflFrOpGt use and mo::7tcnar,CC Of VOU7 sephC system CDUC1 rf�Uil in its p> 1auw+, w a,,.,,,.,. •- OC UA'i 1P1 out the iCphc tank eve l�lt[C tflfS 4f SOOntr, ii T7cCO'cu' It:CIISed pur LOA ;16t! "r. wh_r voli nut into lilt bybifto P p ��� g h ry Y y i f.0 ,.pe , r un street the aL=tian of the f:epuc lank as C trc3irric it Stage w Mc iw ;Ve U'l Si :Y2 1 rte property ownrt itgirct! io sjWTot :3 St. Croix Z; nf`.f ve"?T EM! a Ceniir_gtinn iorrn, blintd bix u In t y t er a 1•,-•L__ EccaSC'� ,_. r A veiyino that i i i t}Ie Ofi -6lit sy ir.'iS�C� "L t:: lSpeS3'slt!^ i fi7alCf liltf171ifiei )OSitTlCyii1011 f�' na f @aT(1<IC,:� vtr .,j...,•. -- ... a . .i r„ n - .F r!T F it nri;uf�ne. IA IR PrOpw 01 aaii g CO, w ; C.: ..,, v, t.f .. ,. ^. :1:C.r rtnn +n {t n i frnmr. ilt n('CesRarT 1, 1t1C lWh z, *pi �.i i�d.l ; • t 14- he Y .,y • ,n '.' n r� Y,w .n f__n Inp n },oyr rru n.rrmenTS and ag, CG lu chdifilL iFi i 12 GTt••'3',Z 5y1!cm w,ih the standards SLR �wh6 wwr.i ■a see w i}te 1rr,a rim Pi t of Ca ii llt3 iii uCV It Cla ��'�."fl RGS C�J.C. ^S, StAfe of Wisconsin. Certtf.catlon StMllry • (nil! Vflllr fen:lc System n¢S ft1A !l11 t:I11{. [ tri 4$ Vc Counry ZOn1ng Office - Iih!rt )C WY9 of the uitvv veiii GiiGi t•i Sr. ^. >.T1'•I�1D_ mil' I�A61 Ff - A V-r DAT _ a.a a�a ♦1. sv .__ A iwdi ccYrify Nt a.: ;cats cn„ ^,,; Mr of my (out) k'towltdgc f (we) lm (Ott) 6C Owssljai o, r T�, a::tn—i deac,, / d _' o _ ,�f _ .._...^ !ce:� rr. n -�r n RC2i6lef or needs Oil :ce Citt►J1.T'VRE OF APPI"1C'AL) PA Ib •�'�'• Any infort11at1On tha' is m is -re resente6 m 8 rt suit in the samisl a+il { r ^ke t itip innin P Y yv' B��= y '� � 8 •` Include with this /rtllleation: d StOmpCC wjuinry dcEu iiO- t`L Rgisitr. Cl 1 - 1 1r•QS niitCe d Lovy of OIC ::Cnjt'lcu Sur.-, ti !ti -m -No, Ic rnar1G In iitt wii�9n +i: uCG,'r. • a M7PA6Eb 7 '0" DOCUMENT NO. WARRANTY DEED STATE BAR OF WISCONSIN FORM 2-19821 584G79 Humbird La nd oration, a Minnesota Corporation ST. CROIX CO.. W1 ............ ... . ... I? .......................................... ... ........... ...................... Ree'd for nscord .............. ............................. - ............ ..... . ........... .. ..... ......................... . .... ..... ... .. .. •.• ..... AUG 10 1998 M Convey. , ; and %varrants to Kevin L. Grube and Kelly K. Grube, 9:30 A husband and wife - irewol - ik jo.�J' ....... .. .. .. .... ....... . ...... I ................... ................... .............. I .......... l a t e r of Deeds ....... .......... .. ........ I ............ ....................... ....................... ... ... .... .. .... ................................ .................... . ........... ....... .... RETURN TO ..... ........................ .......... — . ........ — .... ................ C' . . ...... ..... ..... .................................... ..................... — ....................... . the following described re:tl estate in ............................ ................... County, State of Wisconsin: Lot 35, Humbird Hills Second Addition, Tax Parcel No: .............................. Town of Hudson, St. Croix County, Wisconsin TRAVSFER /0/ FEE This ........ i . s n - ot ........... homestead property. xj�vo (is not) Exception to warranties: Easements, restrictions and rights of record, if any Dated this .. . ......... 3 rd ..........................•... day of ....._... _.. -. August 98 ...... 11 ....................... ............. 19--- ............................. ....... .............................. (SEAL) HUMBIRD LAND CORPORATION .... ....... ................ (SEAL) .......................................................... . Y-: Austin ........ ........... ........................................................ (SE AL) - - - ------ ------------------ ........ ..................... (SEAL) ................ ................................................. . .... ......................... ............. ...... ......... AUTHENTICATION ACKNOWLEDGMENT Signature(s) ........................................................... STATE OF WX9)WXUN M I NNESOTJ RwnaeY ............................ County. authenticated ibis ........ d ay o = .......................... ...... Personally came before me this ... 3 Cd ........ day 01 ..hutgm§-t ..............................I 19.9$... the above named --A.us-t.i.n--J....Bai.1- ............................. ..................... on ................................................. TITLE: MEMBER STATE BAR OF WISCONSIN (If not ................................................. authorized by § 706.06, Wis. Stats.) to me known to be the person ............ who executed the f(Y t t andi"'aid Liall ill 1 THIS INSTRUMENT WAS DRAFTED BY PAUL A. BAILLON .......... kQTA MINN ... Humbird Land_�ion ........................ . . ppE a ........................ ................. Paul A. Bailloni WASHINGTON COUNTY ............................ ........ M C ornrrL F Vr@6.j8A.. al..2000 ... ---------------------------------------------------------- * --------------------- Notary Public ...Wa � L .......... M, N MN (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date: --- January 31 *K.20.00) - ----------------------- --- * .................. • Names of persona signing in any capacity should be typed or imiiacd below Owir sirnntures. ` ��Vl l�l • K F- --=LY \,\ t119 u'9s'w 473.19 P. INK- �- O 38 83 3 LOT 36 s �P f' SM ACKS � 11,9/1 :aft �'�%�;a• ' ''•K;�., LOT 35 � •� '�►. � z.11 ACRES .• • • !` �\ i `, •• t•,` '11 26 O � LCRES I LOT 34 8 0 • '� t 2.02 ACRES O I(v 17,932 to. FT. 1 L 0 7 T 2 1.14 ACRE: 93,101 so.fL pp " 191.70 W LOT 28 2.23 A CRES OTA 1 0. FT. j I • 33• � 33• + t t u E j LOT 33 u u t t a 1 1