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HomeMy WebLinkAbout030-2108-50-000 ST. CROIX COUNTY ZONING DEPARTME � AS BUILT SANITA .Y REPORT r Owner lgr,i A5�1 f Proper Address City /State :�jL `,/•�{42E'a,. ` G��,' Legal Description: r ��� 1 Z `�° Lot _7 Block Subdivision/CSM # [K ,E t /, A6, Sec. - - z - , TON -R,LW, Town of - PIN # 6 _30 -- I GCS{ -- D 0.?0 fou9- 3G SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION Tank manufacturer Size STO ,.. � Setback from: House 10 WellfO P/I, :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 r Type of system: Width 3 Length 7S Number of Trenches 2 Setback from: House Well P/L �t Ya Vent to fresh air intake 100 -t- ELEVAT IONS: Description of benchmark _ Elevation Lc-l Description of alternate benchmark _ (�t/aC Elevation . Building Sewer q / STMT Inlet q� r�— ST Outlet - t PC Inlet „ PC Bottom Header/Manifold 90. SSC Top of ST/PC Manhole Cover C/ ( &,- J_r Distribution Lines () f7 6- 9- 7 '? ( ) Bottom of System( Zk `� () �� • ( ) Final Grade () `l - -3 () ( ) Date of installation ff /t'(Jl ermit number 3 � ' � - 1 State plan number Plumber's si natur License number L( Date Inspector Compicte plot plan *� T � L 1 FT 1 -- 1 r� Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count Safety and Buildings Division INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1) (m)]. 344651 Permit Holder's Name: ❑ City ❑ Village [ Town of: State Plan ID No.: an I Town of St. Jose h CST BM E eP Insp. BM Elev.: r BM Description: Parcel Tax No.: ao 1 0 I Oa � � � u . �Q - 2108 -50 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic �r� Benchmark os bry O Dosing Alt. BM Q.8 q 3. q Z- Aeration Bldg. Sewer q 3, Y-/ Holding St/Ht Inlet a.8$ q2- g TANK SETBACK INFORMATION St/ Ht Outlet /�,/ `32. 61 TANK TO P/ L WELL BLDG. Air I to ntake ROAD Air Septic '> ' O' NA Dosing NA Header/Man. ISM 2.0 Aeration NA Dist. Pipe r I �3 Holding Bot. System .zl .SS g PUMP/ SIPHON INFORMATION Final Grade 13.53 . a Manufact errand St cover )O�`� fS 33 Model Number GPM TDH Lift Friction Syeste DH Ft oss Forcemain Length Dia. H Dist. To well SOILABSORPTION SYSTEM j..�xrS . BED /TRENCH width Len No. f renches PIT No- Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSION SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufa�ctourer: INFORMATION Type of r IF CHAMBER Model Number- System: r Hdl• �- OR UNIT DISTRIBUTION SYSTEM Header / M nrfold Int « Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air ake Length`. Dia. Leng 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 ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: 11 //I' /4q Inspection #2: Location: 1185 64th Street, Hudson, WI (NEl /4, NW1 /4, Section 3 T29N -R19W) - 3.29.19.899 LU ,<J, -Ok' > 3o " sue � 4, — - W- r'2 e, Plan revision required? E] Yes No Use other side for additional infor at6. ('� 00 4 . 'Z SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. I ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: r 3 n a Am. a r j � � I s ° Y m fi S [# 4 m a f i , �.. q. s � t d , _ ., ... a .., m. mm s— ....�.. �........... E.M., . M.Mn S __a.. e 8 e..,.�.- .,.««,.w ... a � e 3 � Z S v t .... ..m.: . s.. s t M .• Ma r_ i i s I .Mn E 3 i i �n m L "', a MmM a . �. Mn ...... Safety and Buildings Division 14 sconsin SANITARY PERMIT APPLICATION 201 W. Washington Avenue P O Box 7302 Department of Commerce In accord with ILHR 83.05, Wts Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the sys fh, pa er t e s t r' unty _ 'than 8 1/2 x 11 inches in size. ^� � • �/"�� • See reverse side for instructions for completing this appl` n E�EQ Sanitary Permit Number -- ( 1� .. Personal information you provide may be used for sec nd ry pyr uses - 0 - Cq,eck if revision to previ us f application [Privacy Law, s. 15.04 (1) (m)l. i! ✓ F r / X r ,1� 77 \ Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT AL N Cl," perty Owner e rel P /4 oc `fi 3 T Zr, N, R ! 'I E (or)pp � � J4 Property Owner's �„ g ddress� � � � � � �� � t m L � Block Number CiA t t J ee l! _ /, r Zip Cog O 2 2 (� ) r � Subdivisi Name o CSM �� r II. T F BUILDING: (check one) ❑ State Owned f o it CI Nearest Road tt ft Public 1 or 2 Famil Dwellin - No. of bedrooms Town OF .IT - JUST (, C f / II BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 040 - 2.1 04- 5 .� 1 ❑ Apartment/ Condo 3. 119. 919 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ 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. [5-New 2 ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5_ ❑ Repair of an ---- r- System -------- System Tank Only System Existing System 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 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 KSeepage Trench 22 ❑ In- Ground PresVe 42 ❑ Pit Privy 13 ❑ Seepage Pit o ? �A' ?j /. Z� a .? J e F V, ;o c4a.►,6 43 ❑ Vault Privy 14 ❑ System -In -Fill r o It - r, VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate S. Perc. Rate 6. System Elev. 7. Final Grade //;; Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) 0 " E� i C/l 1 750 73'0 - - ; Feet Feet Capacit VII TANK in Ca gallo Total # Of Prefab. Site Fiber- plastic Exper. INFORMATION New Existing st Gallons Tanks Manufacturers Name Concrete acted Ste glass App. Tanks Tanks p Ic Tan ank x f - f'..c/� CS -(e— 1 ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber I I I 1 ❑ ❑ 1 ❑ 1 ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stamps) MP /MPRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code T: IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit F (Includes Groundwater D ate Issued ssuin en Signature (No Stamps) Approved El Given Initial � QD Surcharge Fee) Z 3 9 y Adverse Determination 1d,6 X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11197) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber 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 S. 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. Ill. 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 isto 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. E co kAj &oti �a ir9 CT ^3 � s N i; i : I -- -- -;-- -- �- -1-- -- -- - -- Sys- �€ —� I I I I - ' 1 ' I I I i I /= v �c✓C �CL pr ' _. a...._ -- i r Wisconsin Department of Commerce SOIL AND SITE EVALUATION ) Division of Safety and Buildings Page / of Bureau of Integrated Services in accordance with Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches i slgf3 Plan mu* unty include, but not limited to: vertical and horizontal reference point ( (ylj; direction r percent slope, scale or dimensions, north arrow, and location and rstat�ce to neir Parcel I.D. # 03 9 57 -00a APPLICANT INFORMATION - Please print all information l ? Review by Date Personal information ry purposes (Pri ay�w, S. 15.0�(� you provide may be used for secorida ' � � ^ P . y f. / Property Owner 4 - ton r i q ri c4 ii B 517 E L.S4-r Govt. Lot k'�E 1/4 Af(A) 1/4,S T 2_j ,N,R �f E (or)© Property Owner's Mailing Address Lot # Block# I Subd. Name or CSM# city State Zip Code Phone Number [:1 u City ❑ Village Town Nearest Road « ^ w� yazz (7/5 4 1Z4 - 5567,j . />! New Construction Use: ® Residential / Number of bedrooms Addition to existing building A/A- ❑ Replacement ❑ Public or commercial - Describe: AIA_ Code derived daily flow — gpd Recommended design loading rate '' 7 bed, gpd/ft • a trench, gpd/ft Absorption area require ft 7> r D trench, ft Maximum design loading rate - 7 bed, gpd/ft trench, gpd/ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) � �lCy Additional design/site considerations ,5 Ci - go a3 : 'P4 C 'e41 / lez� 3 � (�PA Parent material Ct s J Flood plain elevation, if applicable Al A- ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system s ❑ u R1 S ❑ u ®S ❑ U I ® s ❑ U 1 [off s ❑ u ❑ s it u SOIL DESCRIPTION REPORT Boling # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench j O -/Z io y r -M 0 17 Si' z rn s°bk m fr GS 2 c.o Z - . (2 -30 /o lyje '` �j/ o h e S ,'c L 2, 0 sb k �r► 'r- GS /Gc / ; . Ground % 7ja S�- fL 5 17�t" Y►'i u' r- ✓ . 7 ; •S one i"S Depth to limiting fa r �in. p Remarks Boring # 3 32 #. 4 1 `��"J,F' `% h on 1 s in u-Pr- c- J v 4' . ! Ground - 1 n 7^ /h$ ►mil► . 7 v. 00 P r a o Depth to a limiting ' q f in. Remarks: CST Name (Please Print) // Si at Telephone No. David J. Steel 715- 246 -5085 Address Date CST Number 1564 Cty Rd GG, New Richmond, WI 54017 12--`7 % CST #248956 IL DESCRIPTION REPORT PROPERTY OWNER 0 4h Q c ��> � ram, Page of PARCEL I.D.# 0,3 - j � � S ^ /�- U O O Boring Horizon Depth Dominant Color Mottles Structure 2 g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench 3 0• idye° a one 51'4 2f»1, vyi CS ' z 6 V 1 1 3 o n e 'iC L 2 G v-% Pr Ground 3 7. s f /�S o n-e 5 i C L 3 m Depth to limiting ; fa or Tin. , Remarks: �•"' �'► Boring # l' 1 %b 2 n S E.. n,e ;cL z G 5 1Y► -F GS fGo , 5 R 3 3Z-Y 21n1 bh rn F r e- 5 /-4' 0 5 Ground 2 -�.b 7S /C� `��k 0 ✓! e V. Depth to limiting facipf We 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# -b' O we z m 5 bA t-M T-Tr C5 2 C fs:.b o n e :X m -r c S �. �o ��;• 5 3 m 5 k S Fr Ground 32 ,S oa-e S 4 m s b/f irU Fr n. -y , none mS 5 C1 IM I:- — . - 7 Depth to limiting M in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) c /C GC j IV,e 17C/ C411' 5 t3l "�> 3q 3c ;z 0 ,6 / C,4 4,ey eo )34, cv ` ,CiLf V, 43.) 44 133- 9 LJ 1 p e- Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Hyman Relations Division of sataty & Buildings in accord with ILHR 83.05, Wis. Afim. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but S t. Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 030 - 1008 -95 -000 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION E W D BY DATE - 7 z y8 PROPERTY OWNER: PROPERTY LOCATION Steve Henning GOVT. LOT NE 1/4 NW 1/4,S 3 T 29 N,R 19 ] j (or) W PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 1182 61st. sT. 9 na Buck Hill CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE MOWN NEAREST ROAD Hudson WI. 54016 (715 549 -6094 St. Joseph - C.T.H. " E " [x] New Construction Use jr, ] Residential / Number of bedrooms 4 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd /ft .8 trench, gpd /ft Absorption area required 857 bed, ft 750 trench, ft Maximum design loading rate .7 bed, gpd /ft a_ trench, gpd /ft Recommended infiltration surface elevation(s) 95.40 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem CAS El U CAS E] CAS ❑ U ClS ❑ U KI S ❑ U EIS ® 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 ITw& .................. .................. ................. .................. ................. 1 0 -13 10yr3 /3 none sil lcsbk mfr cs 2f .2 .3 1 ................. 2 13 -34 10yr4 /4 none sil lcsbk mfi gw if .2 .3 Ground 3 34 -84 7.5yr4/4 none ms Osg mvff na na .7 .8 elev. 9 9.4 ft. Depth to limiting factor ±Ra Remarks: Boring # 1 0 -13 10yr3 /3 none sil 2cpl mfr cs 2f np i.2 2 €« 2 13 -40 10yr4 /4 none sil lcsbk mfr gw if .2 i.3 3 40 -45 10yr4 /4 none sl lcsbk mfr gw if_ .4 .5 Ground elev. 4 45 -84 7.5yr4/4 none ms Osg mvfr na na .�., .8 9 9.3 ft. > �, Depth to r limiting r factor + 84 11 T Rolx wTv Z c)NIN0oFFl Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 s Address: 1554 200th. Ave. ew RichmoniQ WI 54017 Signature: Date: 7 -14 -98 CST Number: m02298 Steve Henning SOIL DESCRIPTION REPORT Page 2. 3 I ' PROPERTY OWNER g = Of PARCEL I.D. # 030 - 1008 -95 -000 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Baxxivy Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trerxh 1 0 -12 10yr3/3 none sil 2fpl mfr cs 2f np .3 2 12 -42 10yr4 /4 none sil lcsbk mfr gw if .2 .3 :..:::::::.....:.. Ground 3 42 -84 7.5yr4/4 none ms Osg mvfr na na .7 .8 elev. 9 9.3 ft. Depth to limiting factor +84 Remarks: Boring # 1 0 -17 10yr3 /3 none sil 3fpl mfr cs 2f np .3 .::::..........:<.:: 4 2 17 -35 10yr4 /4 none sil lcsbk mfr gw if .2 .3 3 35 -84 7.5yr4/4 none ms Osg mvfr na na .7 .8 Ground elev. 99.3 ft. Depth to limiting factor ±Rd , Remarks: Boring # 1 0 -12 10yr3 /3 none sil lfpl mfr cs 2f np 3 5 2 12 -36 10yr4 /4 none sil lcsbk mfr gw if .2 3 3 36 -84 7.5yr4/4 none ms Osg mvfr na na .7 .8 Ground elev. 99.4 ft. Depth to limiting factor +84 Remarks: Boring # Ground elev. ft. Depth to limiting factor F+1 Remarks: SBD- 8330(8.05/92) 0 STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Steve Henning New Richmond, WI 54017 MPRSW -3254 NE4NW4 S3- T29N -R19w (715) 246 -6200 town of St. Joseph lot #9 -Buck Hill N 1 =40' BI.= top of 2 pvc pipe @ el. 100 Alt. BM-= top of 2" pvc pipe @ el. 99.70' 6� � k � � � O 6 GAry L. Steel 7- 14 - -98 Gv""7 / —W This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the system may or may no be as shown as permanent lot lines had not been established at time of this test. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer flri Ct�' b7sTIU-I-n' Mailing Address 6'a �,.r SYL Property Address 4+N (Verification required from Planning Department for new construction) 03 © City /State Parcel Identification Number 0 a c - loo 1 3 0 LEGAL DESCRIPTION Property Location ' /a, ��/., Sec. 3 . T -RAW, Town of Subdivision C zz L , Lot # . Certified Survey Map # . Volume . Page # Warranty Deed # G 7 , Volume �' �� . Page # �- Spec house Al yes ❑ no Lot lines identifiable R yes ❑ 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 masterplumber, journeyman plumber, 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 that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days a three year expirari t . Q SIGN TURE OF APPLICANT DATE OWNER CERTIFICA TION 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 4 operty describe e, y virtue of a warranty deed recorded in Register of Deeds Office. ATU LE OF 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 ► vo►.1425PAGE 122 STATE BAR OF WISCONSIN FORM 1 - 1982 i6p2793 WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS DOCUMENT NO. ST CROIX CO., WI RECEIVED FOR RECORD This Deed made between STEVEN W. HENNING and 05- 10-1999 8:00 AM NORMA J. HENNING, husband and wife WIRRAFITY DEED EXEMPT # Grantor, CERT COPY FEE: and BRIAN D. ELLSTROM and SHARON A. HORNE- ELLSTROM, COPY FEE: husband and wife as survivorship marital property TRANSFER FEE: 132.00 _ - RECORDING FEE: 10.00 PAGES: 1 Grantee, Witnesseth That the said Grantor, for a valuable consideratio conveys to Grantee the following described real estate in St. Croix THIS SPACE RESERVED FOR RECORDING DATA County State of Wisconsin: NAME AND RETURN ADDRESS Barry C. Lundeen MUDGE, PORTER, LUNDEEN & SEGUIN Post Office Box 469 Hudson, Wisconsin 54016 030 - 1008 -95 030 - 1009 -30 PARCEL IDENTIFICATION NUMBER Lot 9, Plat of Buck Hill in the Town of St. Joseph. This is not homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And Steven W. Henning and Norma J. Henning warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except - none and will warrant and defend the same. Dated this 7t h A day of May ,19 99 (SEAL) (SEAL) * STEVEN W. HENNING NORMA J. ING i i (SEAL) (SEAL) I AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, ss. St. Croix County. authenticated this . day of , 19 Personally came before me this 7th day of May 19 Q() , the above named I I Steven W. Henning & Norma J. Henning i TITLE: MEMBER STATE BAR OF WISCONSIN (If not, ����,JLS � �. authorized by §706.06, Wis. Stats.) ` ���y ,.� �J►� _to m nown a the person s ho xecuted the foregoing $Is ment� acknowledge the s THIS INSTRUMENT WAS DRAFTED BY Attorney Barry C. Lundeen sv+� > MUDGE, PORTER, LUNDEEN & SEGUINr� C. ^�C '�` — lin Sprond Street, Hu o Wisco Notary Public, St. Croix County, Wis. 1 (Signatures may be authenticated or acknowledged. Bo en My commission is permanent. (If Rot, state expiration date: necessary) 19_.) Names of persons signing in any capacity should by typed or printed below their signatures. STATE BAR OF WISCONSIN Wisconsin LegalBlank Co., Inc. WARRANTY DEED Form No. 1 — 1982 Milwaukee: Wis. I o SOO S 00'01'40 ' W 367.40' CA 366.14 y OD 1126.64 - Z x � EA LINE OF THE NW1/ 4 OF TH I 0 WEST LINE OF THE NE1 /4 OF TH W • •P m C� CSI W O O CTr 00 IV N k N � N V � O 0 to n --Al _ �n III �m col = F m z m V 60 so .1 •O9• 437 m / z W 16 � 40- � � 0 .00' 46 (A C N 0 � � ` o • m --� �C/) VS -� O p•0 5 � i �' • �,p9 w w �n o� .{,w LN LA . �� p cn 0 << � � D ' ?�.• m �y O