Loading...
HomeMy WebLinkAbout032-2096-90-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM y: ' Safety and Buildings Division Count INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No -: ST CR IX Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)j. 344533 Perrr�tt9ftytL m ffOME DESIGNS ❑ ❑ city SOMERSETTown of: State Plan ID No.: CST BM Elev.-- Insp. BM Elev.: BM Description: Parcel Tax No 032 - 2096 -90 -000 TANK INFORMATION ELEVATION DATA fL4, 1 �, TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic, �� �� Benchmark Dosi ng >�l , �i1^ ! • ` , �� Aeration Bldg. Sewer Holding /.14t Inlet TANK SETBACK INFORMATION S Outlet ct(e,Gr TANK TO P/ L WELL BLDG. Ventto ROAD Dt-trtlet Air Intake Septic 5-p NA nr R�nm- Dosing NA Header / Man. : 2 ' 9 Aeration NA Dist. Pipe Holding Bot. System ir, t 93, s" PUMP / SIPHON INFORMATION Final Grade , y9• `!� Manufacturer Demand p?, �— �f'�''• Model Num r M TDH Lift L Iction Syestem TDH t Forcemairr Length ttii Dist. To Well "ABSORPTION SYSTEM -7S � e Width Lengt No. Qf Trenches PIT No. Of Pits pth p� DIMEN I N SYSTEM TO P/ L BLDG WELL LAKE / STREAM LEACHING SETBACK CHAMBER INFORMATION Type O � System: OR UNIT DISTRIBUTION SYSTEM Header / anifolcl ►r Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Lengt Dia. pa SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over cr 94e, h Over xx Depth Of xx Seeded / Sodded xx Mulched Bed /Trench Center 5 Trench Edges Topsoil [] Yes [] No F] Yes E] No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: SOMERSET 14.30.20.9 7,NE E 1545 OAKRIDGE LANE B �►1 / �� -l-Me X 11 M� 133) rs ,, /K , �Je- , wok K A Plan revision required? ❑ Yes A3 No Use other side for additional information. X SBD 6710 (R.3/97) a s�P�fo 3 � In r is Sign ure Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: E E rc , s E E F e e E a �g d � 2 3 3 3 , , , Ka . x f 1 gi , 3 t � a i 4 3 n € 1 —., " e E b € m r q = � 1 kk F ; 9 j w i ..,.�._... .... �., a— .... .. ,. .. .... _.. .... , a 5 € 4 ivision Safety and Buildings Vi sconsin SANITARY PERMIT APPLICATION 2 1 Box Washington / venue Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707- 302 • Attach complete plans (to the county copy only) for the system, on paper not less Coun �� than 8 1/2 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number Petsonal information ou p rovide may be used fo r ��7�3� y p y secon purposes ❑ Check i revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATI INFORMATION -PLEASE PRINT ALL INFOR ION Pro rty gwner Name pe ation 4 94= 4 v4, S T 3� , N, RZpC -Eet< Property Owner's Mailing Address n n L Num Block Number 07 r City, State Zip Code Phone Number Subdivision Name or CSM Number ( 651) Y30 -O o ' 11. TYPE OF BUILDING: (check one) E] State Owned o v illa e Neares �a Public 1 or 2 Family Dwelling - No. of bedrooms own OF III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) A 14 so . 7-0 1 v7 r 1❑ Apartment/ Condo 0 3a _ zi, D !/ r ` 0- 40 O 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational FaciIit 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. E] Replacementof 4 E] Reconnection of 5. ❑ Repair f an ____System -- System --- ---- - - - - -- Tank Only -------------- Existing System - -------- - Existin 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 g[Seepage Trench 22 ❑ In- Ground Pressure / 42 E] Pit Privy 13 El Seepage Pit ( 03 X �S� // 43 q Vaultyi y 14 E] System-In-Fill _ ,a - a X 3� 7 (o s VI. ABSORPTION SYSTEM INFORMATION: 1_ Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Pert. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft) (Gals/da sq. ft.) (Min. /inch) G Elevation 7 3 , S0Feet , Feet VII. TANK Capacity in gallons Total # of Prefab. Site Fiber- Plastic Exper. New Exist n strutt INFORMATION Gallons Tanks Manufacturer s Name Concrete ruct ed steel glass App. Tanks Tan tic Tan o l ❑ ❑ ❑ 1:1 1:1 lift Pump Tank /Siphon Chamber El ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. PI u e' Prin) Plumber' igna re: (N to ps) I&MP RSW No.: Business Phone Number: Plumber's Address (Street, City, e, Zip Code /D IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate slue Issuing nt Si ature (No Stamps) Surcharge Fee) pproved []Owner Given Initial 14 1� Adverse Determination Coe X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 IRA 1197) 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 A 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 into fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX_ County/ DepartmentUse Qnly. X. County / Department Use Only. :Complete plans and specify i ns not�maller the 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) j P r plan, drawn to scale:. Qr, w�ith complete dimensions, location of holding tank(s), septic tank(s) or other treatmetatanks; building sewers; w Is 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 & tion . « of the soil absorption system if required by the county; E) soil test data.on a 115 form; and F) all sizing informa ,fob- n. --------------------------------------------------- ------------------------------------------------ GROUNDWATER S611CHARGE - 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. (✓In ;c, M oore p es;� 4 750 SE:/l tr 41 Ild. sso pz i �rcen {ere eo u• n �� � �e s, a ScaQe_� / � yo , 1I0*66tiy, sea. If; ■ Sa'� obsarua' 3o n•, .P. zo w. P;t // K• D�So/►'le�e� e-oix �o•, W/. ■ 8 -S a-q IV Pr ■ �, � 0 i c`' h "h'� 0 P w o � Q Aj p \o ^ V v ?n D &" Y,(a:l in zo" rKQ/oIe tree. ■ 4 - of y Il y (s•Su wv-d /Od • co , N A. W • E l.e v wt tree. 99.70, T �sl3G. yrs , I Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, W is. Adm. Code AC.E. Soil &Site Evaluations Attach complete site plan on paper not less than 8' /z x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.# APPLICANT INFORMATION - Please print all information 032 2096 - 90 - 000 Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). rz D to Property Owner Property Location 9:57 1 Classic Home Design Govt. Lot NE 1/4 SE 1/4 S 14 T 30 N,R 20 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 6750 Stillwater Blvd. 9 NA Green Acre Country Estates City State Zip Code PhoneNumber City Village Town Nearest Road Stillwater MN 55082 651- 430 -0909 S ph �,,,.« Oak Ridge Drive New Construction Use: Z Residential I Number of bedrooms 3 ❑Addition to existing building ❑ Replacement L] Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate .5 bed, gpd/f 2 .6 trench, gpd/ft Absorption area required 900 bed, ftz 750 trench, ft Maximum design loading rate .5 bed, gpdff .6 trench, gpd/ft Recommended infiltration surface elevabon(s) 93.50'@ B -1, B -2, & B - 3. ft (as referred to site plan benchmark) Additional design / site considerations Install trenches using high capacity infiltrators. Dosing required to reach replacement system location. Parent material Glacial till. Flood plain elevation, if applicable NA ft S- for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U= Unsuitable for system ®S ❑ u N S❑ u ® S❑ u ® S❑ u ❑ S® u ❑ S N U SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mottles Texture Structure Consisten Boundary Roots GPD/ft' Boring# in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 1 0 -4 10yr2/2 None A 2fcr mvfr cs 2f rn 0.5 0 2 4 -16 10 yr3/2 None sl 2fsbk mvfr gs 2fm,c 0.5 0.6 Ground 3 16 -25 10yr4 /4 None sl 2msbk mfr cw 2fm,lc 0.5 0.6 elev -- 97.65' ft 4 25 -38 10yr4 /6 None sic] 2msbk mfr cw 2f,lm 0.4 0.5 Depth to 5 38 -52 10yr4/4 None sl 2msbk mfr cw if 0.5 0.6 limiting factor 6 52 -98 10yr6/4 None s &g 0 sg ml - - 0.7 0.8 >98" g Remarks: Horizon #6 cosists of 10% cobbles. 2 1 0 -8 10yr2 /1 None sil 2fcr mvfr cs 2f & m 0.5 0.6 2 8 -18 10yr4/3 None sill lthinpl mvfr cs 2f,m,c N.P. i 0.3 Ground 3 18 -40 10yr4/4 None si 2msbk mfr cw 2f,lmc 0.5 0.6 elev 99.18'ft 4 40 -106 5yr4/4 None sl 2csbk mfr - if 0.5 0.6 Depth to limiting g factor (� >106" ' 0 Remarks: Horizons #2, 3 & 4 consilf of 10% sw and cobbles. CST Name (Please Print) Signatu k Telephone No. James K. Thompson 715- 248 -7767 Address A.C.E. Soil & Site Evahwti�ons Date CST Number Ref # 340 Paulson Lake Lane, Osceola, WI 54020 6/22/99 3602 1053 PRDPERTYOWNIER. Classic Home Design SOIL DESCRIPTION REPORT joss Page 2 of 3 PARCEL LDJ 032- 2096- 90-000 A.C.E. Soil & Site Evaluations Depth Dominant Color Mottles Structure GPD1, Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. nsistence Boundary Roots Bed Trench 3 1 0 -3 10yr2 /2 None sl 2fcr mvfr cs 2f rn 0.5 0.6 2 3 -12 10yr3/2 None sl 2fsbk mvfr gs 2f,m,c 0.5 0.6 Ground elev 3 12 -21 10yr4 /4 None sl 2msbk mfr cw 2fin,lc 0.5 0.6 98.45' ft 4 21 -35 10yr4 /6 None sicl 2msbk mfr cw 2f,lm 0.4 0.5 Depth to limiting 5 35 -64 10yr4 /4 None sl 2msbk mfr cw if 0.5 0.6 factor 6 64 -95 10yr6 /4 None is & gr. 0 sg ml - - 0.7 0.8 Remarks: Horizon #6 cosists of 10% cobbles. 4 1 0 -4 10yr2 /2 None sl 2fcr mvfr cs 2f,m 0.5 0.6 2 4 -19 10yr3 /2 None A 2fsbk mvfr gs 2f,m,c 0.5 0.6 Ground elev 3 19 -26 10yr4/4 None sl 2msbk mfr cw 2fin,lc 0.5 0.6 101.60 lit 4 26 -40 10yr4/6 None sicl 2msbk mfr cw 2f,lm 0.4 0.5 Depth to 5 40 -60 10yr4/4 None A 2msbk mfr cw if 0.5 0.6 limiting factor 60 -88 10 r6/4 None strat. 0 s ml - - 0.7 0.8 >88" Y g Remarks: 5 1 0 -8 10yr2 /1 None A 2fcr mvfr cs 2f & m 0.5 0.6 2 8 -19 10yr4/3 None sil lthinpl mvfr cs 2f,m,c N.P. 0.3 Ground elev 3 19 -49 10yr4/4 None sl 2msbk mfr cw 2f,lmc 0.5 0.6 103.0'ft 4 49 -97 5yr4/4 None gr. sl 2cs bk mfr - if 0.5 0.6 Depth to limiting factor >97' Remarks: Ground elev Depth to limiting factor Remarks: ter: \� Class ;c, g" D —� /� 4,750 5E: 11 b t 61 Pd. � 4 5s o 72 / —o 4. een ere b c' Co K n y yo a de S eC. /1; Q0 ■ Sa Obsaru don • Cr0 i X 6•, ■ 8-S d y res� de n ce t v y � f V Pn Maek/: 11a;I in 20 /Ka/�(e free. ■ 4 y (ssumtd elegy!`- �od.�� w h Q� ■ (3- 3 I�. b.A1 _ ✓I in g �aPle wee. C .ev 99.70. I Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Huwn Relations Divisicei 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. # dimensioned, north arrow, and location and distance to nearest road. pending APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Leroy Urhammer GOVT. LOT NE 1/4 SE 1/4,S 14 T 30 N,R 20 Qgor) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 1501 Scout Camp Rd. 9 na Green Acre Country Estates CITY, STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE EgMWN NEAREST ROAD Houlton, Wi. 54082 (715)549 -6497 Somerset Scout Camp Rd. New Construction Use [xj Residential / Number of bedrooms 3 [ 1 Addition to existing building (] Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 5 bed, gpd/ft -6 trench, gpd/ft Absorption area required 375 bed, ft2 375 trench, ft Maximum design loading rate • 5 bed, gpd/ft - 6 trench, gpd/ft Recommended infiltration surface elevation(s) 97.32 ft (as referred to site plan benchmark) Additional design / site considerations system el based on contour line of el. 96.32 Parent material glacial drift 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 for system ❑ S 19 ®S ❑ U ❑ S 13U ® S ❑ U ❑ S ®U ❑ S CC 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 Trer& r l 1 0 -6 10 r2 2 none 1 12msbk mfr CIW 2m .5 .6 :...•A-.:_ 2 6 -20 10yr4 /4 none sil 2msbk mfr gw if .5 .6 Ground 3 0 -31 10yr4/4 none sici 2msbk mfr gw if .4 .5 96e1�v2 ft. 4 1 -47 7.5yr4/4 none sl Ilmsbk mfr gw na .4 Depth to 5 7 -72 7.5yr4/4 none scl m na na na np .2 limiting factor 47" Remarks: Boring # 1 0 -8 10yr2 /2 none 1 2msbk mfr cs 2m .5 .6 2 2 8 -19 10yr4 /3 none sl 2msbk mfr 9W lc .5.6 3 19 -32 10yr4 /4 none sicl lmsbk mfr qW if .2�.3 Ground elev. 4 32 -49 7.5yr4/4 none sl lmsbk mfr CfW na .4 . .5 96 ft X to 5 9 -60 5yr4/4 none scl m na na na n .2 ang �1l Remarks: CST Name _ Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Ave., New Richmond, Wi. 54017 9 -16 -95 CSTMO2298 Signature: Date: CST Number: l PROPERTY OWNER Leroy Urhammer SOIL DESCRIPTION REPORT Page? of 3` PARCEL I.D.0 pending r x tructure S Boring # Horizon Depth Dominant Color Mottles Texture Consistence (Boundary I Roots GPD /ft in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed iTrench 3 1 0 -7 10yr2 /2 none 1 2msbk mfr gw 2f .51 .6 2 -22 10yr4 /4 none sil 2msbk mfr gw if 151.6 Ground 3 2 -37 10yr4 /4 none sicl lfsbk mfr gw if .21 .3 96 ft. 4 7 -47 7.5yr4/4 none sl lmsbk mfr gw NA .4 .5 Depth to 5 7 -60 5yr4/4 none scl m na na na np .2 limiting facIf Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # i:tr `�Nf•:•,xiii:•: I Ground elev. ft. Depth to limiting factor Remarks: Boring # 1111. Ground elev. j ft. Depth to limiting factor i Remarks: SBD- 8330(8.05/92) I STEEL'S SOIL SERVICE Gary L. Steel Leroy Urhammer 1554 200th Ave. MPRSW 3254 NE 4 SEq S14 T30N - R20W New Richmond, WI 54017 town of Somerset (715) 246 -6200 lot #9 -Green Acre Country Estates l N 1 =40' BM.= top of NW lot stake C el. 100' )0 0 , A,-� z � 0 � 8 ` Z3• ,to �k� �pu1� ko �o Z ° lo .4".3 7 r Gary L. Steel 9 -16 -95 FROM PF0F E 110. Apr. 25 1 998 95: 01PM P1 lrV 4N l,mv"11 4:4; 1, 'ojlU mv ijGalJl' .J� a�vua„ ST Cppix COUNTY ; S2PTIC TAM MA rMjANtP, AGKE ,\q ? AND OWNWHM MTMCA.TION FORM Mail ng Adi)-ar;,s/ a� gag CVa�vxian tavaimd � P(ttnabng iapeatar�t: fctr aew txmth,u o� ' L , lr'ityra -�?• 3 z -t Pm' vty 40 ii -an V" . �� _ /,, Sm, .... -L-. i-'2.9N• Cam" w Town Qg vob=c� Page # _ vob= Poet 0, Way, � • i 1 Spa: .�iaose t l U." �' as � dues ad�figblC j� y. Wo , ' Tpal'h�aeaad,�ieaareaoesf a sYalenoec�ryrld raent#Sn � fssisx� to of P2 t m sba teak eveay ?Am= _ : hers tine 0 al.tiots of floe • *VtiC Unk as a ae�e„t A00 S e dp ei, yvu Pot i�O t s =M t ta�a � �� syseaaoL , ne op:vy 01sw xj a toe mit b 8t Cnt a f�a j aae , etittci mdpit>amkrrea tt+ o by eft oa •�d sir m �ur��p�'otie►ao+odamcvoi' �' 1�'�dpenq�cve�i'►��� }'fie . • � end C�. � t�tic•etafr � 4aa #�•�i3 "�:: Vwe, .Lo to M' a 4C ed how sea,d The *we xeqokcamm end. to maw she sei th, It�e�n ptivrmo - *PfA �:t eat by the i,�apertmeat oE �• '�°� lwboe> adm�tba �a�I�lsemvuccea ,8bebe�o'Wip; ' d`y� f ee t*"m#PfttfiR date, k!°d�d xaaseaad 5c C.�nd�c Causgr � p�ze: «'rhia 38. ! ((( DATB j ( ) tbat >aII, ehie &rm xza tnm ;m the 'bast of =W (ot�} koowWp, I twee) am (w) tAe ot+r ex(s) QF the p 2pom �secr�btd ve..ogr �rlie of a WSWAt dxd reaasdaQ to Rnwas o r Doeis ©fee_ 'tot; (Y APPLICANT 1DAU i I e�ari • Any in. vndcm tai it p{1G��dwy molt i, t�m tSL!{' y puma }f!ilt MV iw,, by the ZCnhig De �,1;;sr+eoss `� ht :lpds wirer• appi�erl6 a tgEattlnad wa�eatyd�ed ` fba Aaeisar of ])ands affiyce a ow of do eeedw my RMP if tefioada is M& in tote twwaknl r diced y �v STATE BAR OF WISCONSIN FORM 1 — 1982 60444 WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS DOCUMENT NO. ` "_. ST. CROIX CO., WI YGi_ 1�,tc�1.PAG: U2 RECEIVED FOR RECORD This Deed made between Carol I. Laitala, single 06 -04 -1999 9:30 AM WARRANTY DEED EXEMPT N Grantor, CERT COPY FEE: and Classic Home Design, Inc.,, a Minnesota corporation COPY FEE: TRANSFER FEE: 195.00 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 Cr oix THIS SPACE RESERVED FOR RECORDING DATA County State of Wisconsin: NAME AND RE lETM INC. SUITE 200 1900 SILVER LAKE ROAD NEW BRIGHTON, MN 55112 (661) 638-1900 FAX 638-1994 ]"5 25 032- 2096 -90 -000 PARCEL IDENTIFICATION NUMBER Lot 9, Green Acre Country Estates in the Town of Somerset, St. Croix Counyt, Wisconsin This is homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and covenants of record, if-any. and will warrant and defend the same. Dated this 13 day of May ,19 99 (SEAL) (SEAL) Carol I. Laitala (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of V10b000stKWinnesota ss. Washinc ton County. authenticated this day of , 19 Personally came before me this 13 day of May , 19 99 , the above named Carol I. Laitala single TITLE: MEMBER STATE BAR OF WISCO SI (If not ANNE7T, p THEIS • authorized by §706.06, Wis. StatsJ NOTARY PUBLIC t me known to be the person who executed the foregoing MY Comm. MINNESOTA . ■ Expires Jan. 31, p strument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY ■ Gregory A. Booth, atty at law StMr LMM FmW #200 New F32 ght , MNT 551 12 Notary Public, County, Wis. (Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If not, 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 Legal Blank Co., Inc. WARRANTY DEED Form No. 1 — 1982 Milwaukee, Wis. �1 J 0 ir L A � iv LP �! i� rn '313. 932.5 1 m u) • � 1 V; \ 3.00 ACRES : 1 130,727 SO. FT. TO •' i 1 ` p 41 pEpICAT� -PCB- L ,- C - 7 W ✓ `P ::LOT 9 3.00 ACRES •• / 130,724 SO. FT. %• / / Lai C' 64' 46 •� • % ' �, U e� 09�� 7 �,� �o• • �D� �jQ � l � � N / 0 /l $770 • 0 2Q .O J c a N 3700 944 3 I (1 �J 1 LOT 8 1 1 1 e. 3.00 ACRES v \ \ 130,725 SO. FT. iD i N � 3• 3 � �. \ 35. � 0 s, y*- �..�.._.. _. _..._ .: .., .. �`: __ ', ._ - �:: . I . . t ., ..._ .... ..... .., ... j P. - : ...:: . . - .. i „.._ .,: ,�.... a - �� "s i gags i� __ �'. �. �: Y r_ �' X .,.,. ,t -' ., 3' d ,, � �' ., _: �,' i _. � . ,�r r., ;...;;. _r ,. _ . .. �__ . _ : .. .... .. , ic,� h , ... a ; .. ��;: .. a ,, } , ' _ s } r �' h F :� � '. i x i {R$$ i' 77� 0 (! !! iY f .. ,. 'g'