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HomeMy WebLinkAbout032-2129-10-000 « K o . \ ow a �� \�m 2 kr =k2 < �kcci §§)§) '0 - 2 zz —=� k j co��`�� . 0 m.ce� o � 1. t�w » z = ) ) �\§U) Ee /�k7 /]j d§§� Q. < LL 0 moo » ° $ \ ^ k � . e . z ƒ Q § z \ z / \ \ 0 2 ■ - ° @ z m _ l } z \ © tM 7 r ƒ §A » § . ) Q }cal " ' k .. \ I m £ E cc CD C § \ E o IL �k m .. o 000 z -� . E a a a . I t ; U) \ 0 \ § E ¥ z § 3 S U) 2 = E§ § Co ƒ CL g % $ < 7 ] 2 � E ® k o b CO § e C u 0 0 k § # cc ) k k E \ \ § f ) - \§ A m q o z/ \ 2 « \ � - . , _ — " a \ E ) k a § . o J a j 2 v GENERAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR01 REAL ESTATE TOWN OF SOMERSET COMPUTER NUMBER 032 - 2122--10-000 Parcel Number 13.30.19.1152 Claimed Date Re- certified / / Relate Num OWNER NAME: First BRIAN K Last BOARDMAN CO -OWNER Mailing Address 1593 89TH ST City NEW RI State WI Zip 54017 - Type Vol Page Doc # Rec.Date Type Vol Page Doc # Rec.Date HISTORY WD 1861/ 87 674559 03/26/2002 / PROPERTY ADDRESS: H SD Apartment Post Office 189TH MI Sch: 3962 - NEW 1Cf�ND Special District: (1) 1700 - (2) - (3) - W ITC Plat Code: Last Changed on: 04/29/2002 Book Number: 1 SECTION 13 TOWN 30N RANGE 19W 1 /4160 NE 1 /440 NE Map Number: 00 - Sales Area: Parcel Control 0 TAXABLE Number of Units: ZONING: Permit Number: Type: Bank Numbers: 174 -Prev, F5 -Next, F6- Legal, 177- Value, F8- History, F10 -Exit, F12 -More I LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SOMERSET COMPUTER NUMBER 032 - 2129 -10 -000 Parcel Number 13.30.19.1152 OWNER NAME: First BRIAN K Last BOARDMAN PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment 1593 89TH ST SECTION 13 TOWN 30N RANGE 19W '/4160 NE 1 /440 NE Line Description Line Description TOTAL ACREAGE 3.070 PLAT BOARDMAN ESTATES LOTS 5/15'00 LOT05 BILK 01 3 T 9W NE N 15 LOT 5 BOARDMAN ESTATES 16 17 04 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit .._ .. .. . 0 10 ■ -u n 2 g § § a) § / $% n E�2 k , § 1 0 4 � Q e■ m E z °§ 0 C w S + E E o = ; M . w \ E \ , \ E / 3 \ / } o Q $ _ - 7 \ / } _ i § § � g ■f ƒ 8 0 � ID ■ / / / ± i % S �, /ƒ \ k §j § r 2 § \ / ) $ \ CL / ) k C \ n r co _ = f \ rr tr \ M a u 3\ f z 0 0 0 0 Or o 0 :2 % R § P� z Ch / ?m § > § E ) §' E , z 0. E = z \ 0 o \ E § 0 \ 2 ƒ m , ; , / ® CA ƒ § ; z m 2 w ca & . c m § z 0 $ CL $ R } / ) W E § \ 2 / 2 co , z % \ I , ; e00 0w CL © ƒa a \ 2 2\ƒ n � s � � , ; E 2 >g2t2 f�� \k� of j g�EE& 3 C 0) ( R \ > af = , '. ±m= c ,w C $gq § i (D } �\ zz ; j o =CD CL CD CD 7 k�{ 2 0 ■ b w < % \ ? o \ � o 0 k \ 2 GENERAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR01 REAL ESTATE ERSET COMPUTER NUMBER 0 2 - 2046 -10 -000 Parcel Number 13.30.19.662 Claimed Date Re- certifie � � � I � �, /4 OWNER NAME: First Last NKA BOARDMAN ESTATES l / v '/ � CO-0 ER Mailing Address C /' City State Zip Type Vol Page Doc # Rec.Date Type Vol Page Doc # Rec.Date /�Gf 3 a fr HISTORY QC 1346/196 58450508/06/1998 / PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name- Type SD Apartment Post Office School District: 3962 - NEW RICHMOND Special District: (1) 1700 - (2) - (3) - W ITC Plat Code: Last Changed on: 10/24/2000 Book Number: 1 SECTION 13 TOWN 30N RANGE 19W %160 1 /440 Map Number: 00 - Sales Area: 5 Parcel Control 3 ASSESSED WITH OTHER Number of Units: ZONING: Permit Number: Type: Bank Numbers: F4 -Prev, F5 -Next, F6- Legal, F7- Value, F8- History, F10 -Exit, F12 -More LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SOMERSET COMPUTER NUMBER 032 -2046- ar ber 13.30.19.662A OWNER NAME: First Last NKA BOARD ESTATES PROPERTY ADDRESS: Hse # D -- Street Name -- Type SD Apartment SECTION 13 TOWN 30N RANGE 19W 1 /4160 1 /440 Line Description Line Description TOTAL ACREAGE 28.290 PLAT LOT BLK 01 SEC 13 T30N R19W 196 02 EST 21 A CR_ E , 16 03 ALS COM NE COR SEC 13;TH S 17 04 89 DEG W 1323.75';TH S 00 18 05 DEG W 737.12' POB;TH N 89 19 06 DEG E 694.70';TH S 00 DEG W 20 07 584.95';TH S 89 DEG W 21 08 694.63';TH N 00 DEG E 22 09 580.51' POB (9.292 AC) 23 10 (OR THIS PARCEL CAN BE DESC 24 11 AS THE NE NE EXC LOTS 25 12 1,20 CSM 12/3295) 26 13 NKA BOARDMAN ESTATES 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit I • ST. CROIX COUNTY ZONING DEPART` AS BUILT SANrrARY REPORT , h Owner A ezu Property Addre s ' City /State ,,17 r 0PF /GE Legal Description: Lot -- Block - Subdivision/CSM # r '/a A�f 1 / a, Sec. 2,1, TAN -R-Zj W, Town of - �,t ,zxnrel PIN # OCLCJ2 SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer - Size ST/PC /r9 / Setback from: House - Well yl, P/I. 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: Width Length Number of Trenches Setback from: House ?- , -- 7 Well j�L_ P/L :_ Vent to fresh air intake ELEVATIONS Description of benchmark Elevation o" n Description of alternate benchmark Elevation Building Sewer a ST/HT Inlet �,.;L2— ST Outlet 97 PC Inlet PC Bottom Header/Manifold WW Top of ST/PC Manhole Cover ,2 , (Lz Distribution Lines Bottom of System Final Grade () 9Z/4 () ( ) Date of installation,/ P mit number .?` yS.S State plan number Plumber's signature License number ; , 1- 1�Y Date 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 I 9 G' 4-2 ' h ys , i INDICATE NORTH ARROW 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)]. 338855 Permit Holder's Name: j ❑ City ❑ Village Ug Town of: State Plan ID No.: BOARDMAN, BARRY SOMERSET CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: o;Lr" a 032 - 2046 -10 -000 I V — TANK INFORMATION ELEVATION DATA 119 Rqiaz TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. eptic W ¢- e�r'✓L S �� Ben o 3.q2- A�� 9 /c Dosing (4- I Aeratio Bldg. Sewer y 'rD - 7 Holding St/ Inlet TANK SETBACK INFORMATION th .vkU (91a Outlet P / L WELL BLDG. A i r ROAD Dt Inlet Int ake nt Septic -1 NA Dt Bottom Dosing Header / Man. Aeration NA Dist. Pipe ?7 Holding Bot. System ° f. �( 93. PUMP/ SIPHON INFORMATION Final Grade �; 71 97. Manufacturer mand 0 60-e4 Model Num G TDH Lift Friction em TDH Ft Forcemain I Lengt Dia. Dist. To well SOIL ABSORPTION SYSTEM - BED/ ENCH width / Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Dept N ION � 7 DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING anufadur INFORMATION Type CHAMBER � / �V OR UNIT odel Num er: Syste O : 6�t1kK n DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) , x Hole Size x Hole Spacing Vent To Air In Length � Dia —1— Length 7 Dia. Spacing T - kPi z - 7 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 I I ❑ Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) ` D 3 LOCATION: SOMERSET 13.30.19.662A,NE,NE 899 1 AVENUE =\ Ik 9 --lop d 0 o 0/4 / -i GI Plan revis rrequired? ❑ Yes No 'Ise other side for additional informatl S J-6710 (R.3/97) Date Inspector's S nature Cert No ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: e < t i < < < 6 E € 4 «.. ,e am . . sep e e 9 t k } i e i { S � i t I i g E t r < t m E e t i Y m ee � ._.. ww � t � E e mm - i } a t 3 W r � t -- — -------, _ e e..� _.�:... .. ae.e.., mm e. € _ .. A.e.� ..., y .n. ., m e ...... .... _ . ;,..�. m € .�.. s as i i r 6 F + e � .m . ,. .. .. s ...... .. ... .. _.. , m _ ..»... .. < n s b E k s t s < r Safety and Buildings Division Visconsin SANITARY PERMIT APPLICATION 2 1 Box Washington Avenue Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8112 x 11 inches in size. • See reverse side for instructions for completing this application State S Permit Number Personal information you provide may be used for secondary purposes ❑ Check if revision toprevious application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION Prope wner Name Property Location A I Z 1/12 Al 1 14, 5 T , N, Ror Propert 0 s Lot Number Block Num er Cit , ® tate Zip Code Phone Number Subdivision Name or CSM Number ( I. TYPE OF BUILDING: (check one) ❑ State Owned E] ity Nearest Road , Public 1 or 2 Family Dwe lling - No. of bedrooms p Town OF III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) I ,� 3O 19. (y( A' 1 E] Apartment/ Condo it2�a --�Dy O'IQ:V ! yr` -mies 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. jg New 2. ❑ Replacement 3. ❑ Replacement of 4, ❑ Reconnection of S. ❑ Repair of an 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 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 []Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORP SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System E 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. nch) Elevation Q Feet meet VII, TANK Capacity INFORMATION in gallons Total # of Manufacturer's Name Prefab. Con- Fiber- Plastic per. Concrete Gallons Tanks steel A glass App. New Existing strutted Tanks Tanks Septic Tank oploleldirrg-fidrrk Iwo — e R e El ❑ 1:1 1:1 11 Lift Pump Tank /Siphon Chamberl I I ❑ I ❑ ❑ ❑ 1 ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for ins , Yal � latiop of the onsite sewage system shown on the attached plans. Plum er' Nam . (P ) 1 Plumb "s n No a s MP /MPRSW No.: Business Phone Number: r _ P umber's Addr St�a, Ci , State, Zi ode): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate I ssued Issuing Agent Signature (No Stamps) I ! Surcharge Fee) ��� n ' Approved ❑ Owner Given Initial Adverse Determination too X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11/97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS t 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 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. I Ca") �9 9 - - - -- _ _- - _ .. -. _ r - - - - - - - -- - -.- ko a:� . ... 7 . _ r �f i G /, ° 89' i r , - Wiscpnsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page _ of 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 .5 /� percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION - Plea �jnt aft'rj# ation. Rev' wed y Date Personal information you provide may be used f se n�iars purposesZ vaGy s. 15.04 (1) (m)). Property Owner IV Property Location Govt. Lot 1/4 1/4,S T N,R / E (or& Pr perty Own 0s Mailing Address Lot # I Block Subd. Name or CSM# City State Zip Cger Nearest Road / ie b ❑ C ❑ Village El Town h t E c New Construction Use: Residerlfral um edrooms 3 Addition to existing building ❑ Replacement Public or commercial - Describe: Code derived daily flow gpd Recommended design loading rate 1 ,L bed, gpd/ft trench, gpd/ft Absorption area required y bed, ft 2 --Zlin-- trench, ft Maximum design loading rate bed, gpd /ft -<. trench, gpd Recommended infiltration surface elevation(s) ,93 ft (as referred to site plan benchmark) Additional design /site considerations Parent material j�� Flood plain elevation, if applicable ft I EEE Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank Unsuitable for system im S❑ U (A S ❑ U 2 S ❑ U ®S Flu ❑ S ® U ❑ S 1A U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench J Ground elev. ft ' — I Depth to limiting ; factor it a in. 5 Remarks: Boring # 9 Ground elev. ft• ' Depth to limiting fact > Y in. Remarks: CST Name (PI ase rint) / Signature Telephone No. Address Date CST Number r. 1 PROPERTY OWNER –,e SOIL DESCRIPTION REPORT PARCEL I.D.# Boren # Horizon Depth Dominant Color Mottles Structure 2 Boring in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed ,Trench 3� s' z Ground _ G elev. Depth to limiting factor 3� n. 0, 0 Remarks: Boring # 1 a Ground _ elev. ft. Depth to limiting factor 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 # O 7 .4" le Ground w — elev. Depth to limiting S� factor p • � 2- -in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) x'79 /ele - dx w /L,-,,omo4LJ s��r7 Ae lee s41-/ / I z V" L- 3 J a ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer & Mailing Address Property Address (Verification required from Planning Department for new construction) Ci ty /State _ Parcel Identification Number LEGAL DESCRIPTION Property Location A1Z '/4, C ' /a, Sec. ,, T.�N - R_Z _W, Town of Subdivision Lot # Certified Survey Map # , Volume , Page # Warranty Deed # ,Volume , Page # Spec house ❑ yes 0 no Lot lines identifiable 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 roe owner a g r ees to submit to St. Croix Zoni D a certification form sig b the owner and by a P P rh' 8r g P 8n Y master plumber, journeyman mber, restricted lumber or a licensed pumper verifying that (1) the on -site wastewater disposal system P P P P is in ro er operating condition and/or after inspection and pumping if necessary), the septic tank is less than 1/3 full of sludge. P P P g 2 () P P P g( rY) 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 d tzLt'� R_ C�-� Y Y P / / SIGNATURE APPLICANT ATE OWNER CERTIFICATION 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 described above, by virtue a warranty deed recorded in Register of Deeds Office. Ck/X/A z=:) /'�� / Z41 SIGNATURE OF PPLICANT ATE * * * * ** 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 + ` z VOL `��6 ��CE 196 • t� c r' t" STATE BAR OF WISCONSIN FORM 3 - 1 t ` 4505 QUIT CLAIM DEED } DOCUMENT NO. F Frank Keith Boardman a /k /a F. Keith Boardma single ST. CRCj!x CO., W! ners AUG 4 6 1998 i a quit- claims to Barry Bo ardman 9:30 A M R egtstar a! D�eda t the following described real estate in St. Croix County. State of Wisconsin: IHIS SPACE RESERVED FOR RECORDING DATA - r NE 1/4 of SE 1/4, SE 1/4 of NE 1/4, and the NE 1/4 of NAME AND RETURN ADDRESS NE 1/4 EXCEPT Lots 1, 2, and 3 of Certified Survey Map filed July 7, 1997 in Vol. "12 ", page 3295 as Document VAN DYK, O'BOYLE SILER, S.C. No. 561969, all in Section 13- 30 -19. Post Office Box 122 7 New Richmond, WI 54017 _0 32- 2047 -80 - 00 0 , _ C. PARCEL IDENTiFICAT NUMBER aj 032 - 2046 -10 -000 1 ( a d S , -his is n ot _ homestead property. )"Nit Os not) Dated this -� U day of t —_ —. A D, 19 98 � (SEAL) Frank - a�zko. tSEAL) - — (' Frank Keith Boardman — - - " "— (SEAL) __— - -- (SEAL) AUTHENTICATION ACKNOWLEDGMENT State of Wiscons=n, Stgnature(s) F rank Keith Boardman ;s County. 1 1,) 98 Pe:- .onally came before me this -- -.— day of authrntica this _ 0th day c,F , 19 , the above named • Hendrik W Van Dyk — -- TITLE: MEMBER STATE BAR OF WISCONSIN — - -- - (If not. - - - authorized by §706 06, Wis. Stats.) 10,11e + :own to K- the person who executed the 1, :egging instr ment and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY __ _ - -- -- -- Hendrik W. Van Dyk - VAN DYK O'BOYLE_& SILER, S. C. Posh ice -- fox -1ZT � -- ----- - - - - -- Ntxar' P,bhc, f sty con-,mission is ; ermant,lt Mate expiration date — 01 not—__ County, �Vis New Ric hmond, Wis consin 54017 — -- — Stgnatures Wray be authenticated ur acknow(edbed & »h are g 19` -- ot , necessary) ------ - -_. -- _ -- ) Wmea vt per..�ns �gnmg m Y .�aa�� � •ho,.id `x'ctx pnmv - - ow rhea aenawr�s rc rc STAtE BAR VF wiS( O"I% 'ti' -e7ii Bae QL It (LAi 1 DIED Form Vu. 1- 1082