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HomeMy WebLinkAbout038-1185-20-000 r Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM County: g 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)). 353123 Permit Holder's Name: ❑ City ❑ Village Q Town of: State Plan ID No.: Town of Star Prairie ---- ---'�" CST BM E ev.: Insp. BM Elev.: BM I Description: Parcel Tax No.: to. O` I M-p' vC_ = CS'C j�N,t Z 038 - 1185 -20 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ' Benchmark S-�( Iaq O Z r Dosing Alt. BM 3- 10 (. 33' Aeration Bldg. Sewer Holding St /Ht Inlet 'E" -1 qb, TANK SETBACK INFORMATION St/ Ht Outlet 9( /yr TANKTO P/L WELL BLDG. Air to Ai i ntake ROAD Dt Inlet r —"—" Septic ? 1 10 3 NA Dt Bottom Dosing NA Header 1 Man. s g.s6 •5 ` 95 B Aeration NA Dist. Pipe Holding Bot. System 1:7( PUMP/ SIPHON INFORMATION Final Grade Manufactur`t,r. e — ma nd St cover D q• Model Number GPM TDH Lift L ion e em TDH Ft Fo ain I Length Dia. Dist. — To we SOIL ABS RPTION SYSTEM 8•Efl 1 RENCH Width Len h No O Trenches PIT No. Of its Inside Dia. epth . DIME 9 3 a DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHI G ufacturer: INFORMATION Type O 35 � r CHA NIT odel Number: System: ^' DISTRIBUTION SYSTEM Header /M M nifold Distribution Pipe(s) i , x Hole Size x Hole Spacin Vent To Ai; Intake Length i - Dia. L am ( Length _Q Dia. y Spacing �9O SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded 1 Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil E] Yes ❑ No C] Yes E] No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: Inspection #2: - -f- Locat 1394 211th Avenue, New Richmond, WI (SE /14, SE1A, Section 13 T31N -R18W �, - 2� q l•� 8u�. ,� IaN. of 5, m4rect6m +i mt-, to 5� � 5 x ,:.4+1',,.,. la.d✓ �1 O No as.-� l �-' one cex\►e� as� � - I 4 -o t plan revision required? ❑ No Use other side for additional information. 0'tj (q 0 ( SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. Safety and Buildings Division Visconsin SANITARY PERMIT APPLICATION 2 1 Box Washington Avenue Department of Commerce In accord with Comm 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 8 112 x 11 inches in size. y.a " • See reverse side for instructions for completing this application State sanitary Permit Number 3 31 Z3 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 INF RMATION Property Owner Name Property Location V 1 1 /4, S 3 T 3 , N, R l7 E (or) Property Owner's Mailing Address / Lot Number Block Number City, State Zip Code Phone Number Subdivision Name or CSM Number lo3eo_ -e- II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ it Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms 3 v o w a n OF c r ' III BUILDING USE (if building type is public, check all that apply) Parcel Tax Number(s) ('>, 3L I D . 733 1 ❑ Apartment/ Condo © 11 - Z - O - V 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. [a New 2. ❑ Replacement 3, ❑ Replacement of 4_ ❑ Reconnection of 5, ❑ Repair of an System System Tank Only Existing System Existing System B) ASanitary Permit was previously issued. Permit Number 353 IZ.7S Date Issued q 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 E] System -In -Fill 6 K 57 i ces VI. ABSORPTI SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade 4/'5 Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation Feet Feet Capacit VII. TANK in Ca allo g Total # of N Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturer s Name Concrete con- Steel glass Plastic App New Existin strutted Tanks Tanks r�77qp� Septic Tank or Holding Tank ? c m/ ❑ ❑ ❑ ❑ ❑ 1 Lift Pump Tank /Siphon Chamber ❑ ❑ 1 ❑ 1 ❑ 1 ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite se age system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stamps) MPRSW No.: Business Phone Number: �`lle'ane ,5'G/�ul�i,� ` o`� ?��d 1,5 Plumber's Address (Street, City, State, Zip Code): IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate ssue Issuin Ag ❑ Surcharge Fee) ent Signature (No Stamps) Approved Owner Given Initial �.�s�, Adverse Determination f - 1 - 1 2 '"&D X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (R. 4/99) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber c�7Goab�f"zy s' %Y 1,3 P/ FO iCo ���aT� S r ra `r'� i N D � o �6CaL 5,c-. Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Bureau of Integrated Services in accordance with s. ILHR 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. # 3 , 33 3g-- 1$5-20 - �0 APPLICANT INFORMATION - Please print all information. R viewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location S' 7 f_ � A/ r Govt. Lot 1/4� l; /4,S I3 T N,R E (or) N Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# / 9 t t Z? e y y. %e _1Z I I -4L it- .e Fla ."- City State Zip Code Phone Number ❑ city El Village Dd Town Nearest Road y 3 vs e— New Construction Use: ❑ Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow � gpd Recommended design loading rate ? bed, gpd /f? trench, gpd /ft Absorption area required a IY bed, ft .6 tr ft Maximum design loading rate _ bed, gpd /ft trench, gpd /ft Recommended infiltration surface elevation(s) �V l ft (as referred to site plan benchmark) Additional design /site considerations Parent material 4. 6)4.154 Flood plain elevation, if applicable - It S = Suitable for system Conventional Mound ❑ u In G El Ground Pressure AT -Grade System in Fill Holding Tank u= unsuitable for system s❑ u S S u S El u ❑ S f u El u SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD /ft g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench / l .0 7.S R .3 / S.` l 02 13 3, S F a & If M v X S Ground 2 !7 �•� /� J .� .� D 5 elev. / Depth to limiting factor / L,Q _in. Remarks: Boring # s s 16 S- �. Ground elev. lift. Depth to limiting factor I in. Remarks: CST Name (Please Print) Signature Telephone No. re a ri Z -S �6re Y �J ��s- - .3 Address Date CST Number 1 4 ?D c 7f /Q� /' So v uJ .` 5 Q / 3 Q PROPERTY OWNER s� °� �aa�. y SOIL DESCRIPTION REPORT Pag of PARCEL I.D.# Boris # Horizon Depth Dominant Color Mottles Structure 2 Boring in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed ,Trench ! 3 7 .5 ,Q Z Yh iJ y Ground 3 A l ° ! elgv. Depth to limiting S ( factor 1 in. Remarks: Boring # -[ .2 -3� 7 y �a b V r A S //= r 2 l 7.S �P Ground elev. Depth to limiting factor J 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 # ' i f 6 )n Ground elev. v ,aft. Depth to limiting factor /jO - Remarks: Boring # Ground elev. ft. ' Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) I 0 25 P14 . j T Iq i 3 mac. T __-- __ e hngut n Avenue n NN & ConS i n SANITARY PERMI pLIC/4TI,,. 201 W.Wa P O Box 7302 Department of Commerce In accord with Comm 8 OSkYViS. A Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the y3# m, not less Co'vnty r than 8112 x 11 inches in size. • See reverse side for instructions for completing this a I'�" aC ,S�G'Iro f p g p 'ion, c� ? Stake Sanitary Permit Number Personal information you provide may be used for secondary purposes �- tytZ�;�Ca ZCheck if revision to previous application IPrivacy Law, s. 15.04 (1) (m)l- g�1 77/ �taC' 1,., 7 Z// V C State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL ION Property Owner Name Pkob etion .s-E 1 /a, S / T3f . N, Rl E (ol Property Owner's Mailing Address Lot Number Block Number .2l S xo* Ad ? City, State Zip Code Phone Number Subdivision Name or CSM Number 11. TYPE F BUILDING: (check one) ❑ State Owned Cit Nearest Road Public 1 or 2 Famil Dwellin - No. of bedrooms e Village OF r III. BUILDING USE (If building type is public, check all that apply) 14avh Parcel Tax Number(s 1 ❑Apartment /Condo d'`��'_ / /8S .2 o— O ( �' -���✓ 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. W New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an ------ System ________ System Tank Only Existing 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 to Seepage Trench 22 ❑ In- Ground Pressure , , 42 C] Pit Privy 13 ❑Seepage Pit � S XS7 lA o o,� 43 E] Vault Privy 14 ❑ System -In -Fill VI. AB SORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade /��j Required (sq_ ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation .S'l'0 , �` !v 9�, a Feet 04,.6 Feet VII. TANK Capacity in gallons Total # of Prefab. Site Fiber- Plastic Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- steel glass App. New Existing structed Tanks Tanks Se tic Tank 4 ulL I`eY..✓ 91 ❑ ❑ ❑ 1 ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ I ❑ 1 ❑ 1 ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite se ge system shown on the attached plans. Plumber's Name: (Print) Plumber's Signatu No Stam s) M PRSW No.: Business Phone Number: Il a rn sc u ma ,° a �4� fld 1a 3&t4 Plumber's Address (Street, City, State, Zi Code): IX. COUNTY/ DEPARTMENT USE ONLY ❑Disapproved Sanitary Permit Fee (includes Groundwater ate Issued Issuin gent Signature (No Stamps) A roved ❑ Owner Given Initial Surcharge Fee) pp Adverse Determin 0 //� Q Z7 gq X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: Aj . 44. Fl.ecl � �►,�G SBD -6398 (R. 4/99) DISTRIBUTION: Original to county, One copy To: Safety & Buildings Division, Owner, Plumber SC o �MAI 7k .S 73¢ OG i Pi, e Gi u 1 V - a wises "sin Department of Commerce SOIL AND SITE EVALUATION Page 1 of - Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Gille Trucking & Excavating, Inc- Attach complete site plan on paper not less than 834 x 11 inches in size. Plan must County include, but not fimited to: verticat and hori and zontal r n M), direction _ St. Croix percent slope, scale or dimemsions, north arr ` a0dt ,c tiorvt�d ance to nearest road. parcel LD.# ( „✓ , APPLICANT INFORMATION - !ease prinii;,r�i info n. Re _ B — Personal information you provide may be u seiconda � cy Lbw s 15.04 (1) (m)). Date/ Property Owner Property Location t - Case ,Dan_ - , -� ❑” f . ovt. Lot SW 1 /4 SE 114,S 13 T 31 N,R 1$ W� Property Owner's Mailing Address rail of # Block # Subd. Name or CSM# 323 Sawmill Lane - A ' _ tir'UNTY �° 2 ❑ - - ❑ -- Prairie Flats City State ip toy ❑City ❑Village ❑Town Nearest Road New Richmond WI 5 /7 ; ^ X15 - Star Prairie Hwy 65 ❑❑ New Construction Use: Resi a of bedrooms 3 ❑Addition to existing building ❑ Replacement ❑ Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate .7 bed, gpd/ft? 8 trench, gpd/ t Absorption area required 643 bed, ft 562 trench, fF Maximum design loading rate .7 bed, gpd/W .8 tr ench, gpd/ftz Recommended infiltration surface elevation(s) 20 ft (as referred to site plan benchmark) Additional design / site considerations Parent matedal -WASH Flood plain elevation, if applicable -- --- ft S= Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U= Unsuitable for system KS M U j � S ®U S® U ❑ S M U ❑ S ®U ❑ S® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft Boring# Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. C onsistence Boundary Roots Bed Trench 1 1 0-15 7.5Y - - - - -- SIL 1FABK MVFR AW 1VF .2. .3 2 15 -32 7.5YR4l6 CL 1F MVFR AS 1VF 2 .3 Ground 3 32 -99 7. 5YR5/3 - - - - -- S O - ML, - - -- - - -- 7 8 ele-- - -- - -- — -- - - -- --- - Depth to limiting factor Remarks: — — _— 1 0 -13 7_5YR2.5/1 - - - - -- SIL 1 FABK MVFR AW ]VF .2. _3 2 13 -30 7.5Y R4/6 - - - - -- CL 1FABK MVFR AS 1VF 2 3 -- — -- Ground 3 30 -96 7.5Y - - - - -- S O - NIL - - -- - - -- .7 .8 ele - — — — — - - -- - - -- vfA7• 'i- Depth to : 011 1 W limiting factor Remarks: - -- - - -- - - - - -- -- - - -- - -- — -- - - - - -- - - - - -- _ _. - - - - -- -`—_— — — CST Name (Please Print) Sig to Telephone No. _D ENNIS _G ILLE Addre T,r p t CST Number Ref # ,S, "L j/D T k,/T 0.-r / VN/97 4U 9 104 PROPERTY OWNER: Casey Dan SOIL DESCRIPTION REPORT Page 2 of _ PARCEL LD.# GMe Tnicking & Excavating, Inc. Depth Dominant Color Mottles Structure GPDlftz Horizon in Munsetl Qu. Sz. Cont Color Texture Gr. Sz. Sh. onsistence Boundary Roots Bed Trench 1 0 -15 7.5YR 2.5/1 SIL 1FABK M VFR AW 1VF .2. 3 3 - - -- - - - - -- M - — 2 15 -31 7.5YR4/6 - - - - -- CL 1FABK MVFR AS 1VF .2 .3 Ground - -- elev 3 31 -96 7. - - - - -- S O -GR ML -__- -___ 7 8 Depth to limiting factor 3� 96 in. - - - - -- -- -- Remarks: 4 1 0 -12 7. 5YR2.5/1 - - - - -- SIL 1FA MVFR AW 1 VF .2- .3 2 12 -29 7.5YR4/6 - - - - -- CL 1FABK MVFR AS 1VF .2 .3 Ground elev 3 29 -96 7.5YR5/3 - - - - -- S O -GR ML - - -- - - -- .7 .8 — -- -- AI 'Z Depth to limiting - - factor 96 in. - -- - - -- - - - - - - -- - - -- - - Remarks: 5 1 0 -12 7.5YR2.5/1 _ - - - -- S 1FABK MVFR AW 1VF .2. 3 2 12 -30 7.5YR4/6 - - - - -- CL 1FABK MVFR AS 1VF .2 .3 Ground elev 3 35 3 30 -100 7.5YR5/3 - - - - -- S O -GR ML - - -- - - -- .7 .8 -- - 1 003 to limiting factor 100 in — Remarks: Ground- - -- - - - -- -- - - - - - -- - -- - - -- - - - -- - - elev Depth to limiting - - -- — factor Remarks: Ala 7 P� �. 5w se l' y v S 3T, �lX� t� 1oT 97.0 ' �,m ✓ 0�0 -� /�f�c J��c Sao ' � !,/ C°s�ti 44 em I g� 3 to � 3 3(. bl I 1 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer � T ( 2CUC t, 'l4 T Mailing Address 21 (65 105 6 LA I� Property Address 13 TY 22 ('w` A'� �� � 17r+1 �l C�M O�J� , 'A)/ L546 (Verification required from Planning Department for new construction) City /State 1& QkCRM0dP , 21 Parcel Identification Number LEGAL DESCRIPTION Property Location 5 ' / Sg' '/,, Sec. 1, T 3 ( N -R 1 Q. W, Town of - 3TAR Subdivision P QAl !L i 6 V- LA TT S , Lot # Certified Survey Map # Volume , Page # Warranty Deed # of 0 S , Volume _ I , Page # 5 0 Spec house ® yes ❑ no Lot lines identifiable 0 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 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 1/3 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 septi Wstern has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 da the r xpiration date. 17 / SIGNATURE 617 APPLICANT DATE 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 erty escri d ve, by virtue of a warranty deed recorded in Register of Deeds Office. 1 SIGNATURE F 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 y (, ( STATE BAR OF WISCONSIN FORM 1 — 1982 4 610528► WARRANTY DEED KATHLEEN H. WALSH �S� REGISTER OF REEDS DOCUMENT NO. 150 ST. CROIX CO. 9 WI Vol. PA6E i( RECEIVED FOR RECORD This Deed made between Daniel J. Casey and f44 09 -17 -1999 2:30 PM Betty D. Casey I' WARRANTY DEED EXEMPT N Grantor, f CERT COPY FEE: and Gr•ntt J - C and Caret n t7 Counter, COPY FEE: 2.00 TRANSFER FEE: 56.70 husband and wife as survivors marital RECORDING FEE: i Q.00 property PAGES: Grantee, Witnesseth, That the said Grantor, for a valuable consideratio I conveys to Grantee the following described real estate in St. Croix 4 THIS SPACE RESERVED FOR RECORDING DATA County State of Wisconsin: NAME AND RETURN ADDRESS Se orr T. ao-z a raR �( 2165 Gooses c,�atE RD Lot 2 of Prairie Flats Addition in the N SA/ RiCNo?oND .54W Town of Star Prairie, St. Croix County Wisconsin. 038- 1185 -20 -000 PARCEL IDENTIFICATION NUMBER ii it ii e This is not homestead property. {' (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; i And Daniel J Casey and Betty n Casey i warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except recorded easements , rights of way and covenants. and will warrant and defend the same. Dace It d this 17th day of Se emb r 19 nma�y.. 13RLGt� (SEAL) (SEAL) j el * Betty D. Casey Da i CA 5ey- (SEAL) (SEAL) 11 AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, ss. St. Croix County. authenticated this day of 19 Personally came before me this 17th day of September 19 99 , the above named Dania1 J Casey and * V D racay TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized b §706.06, Wis. Stats.) to me known to be the s, who executed the foregoing Y p erson s, instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY John D. Walsh — * John D. Walsh Notary Public, S Croix County, Wis. (Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If not, state expiration date: necessary.) NOv _mhar 29 _ 2001 , 19 .) JOHN D. WALSH Names of persons signing m any capacity should by typed or printed below iiv,r signatures. Wisconsi STATE BAR Ur WISCONSIN MY Commission Ex ires N018ry PPd n Le Bta ^! Co . Inc. ' VAR RA : 11' 1)I FY Norm no. i — 982 p OV. 2 ega 1#:,,Waukee. Wis • � N 44) bu ti OR cm W , oo ` cn of w 1 G f• ,. ' � r 1 ., A -Q N 00va00 I 1 9 O a aV K ■ u 00'00 O0 N M I rq S 00'001000 W 700.00' A p v $ J I 4 A^ 00'52'23" W 590.017' noosr>tr■ 7�/. /r � � M i p� r' o �� � oil �? r Naosfrf r � ' t ' • ! 1 7 N 00'52'23" W 321.90' p �s 1A 1 + � f -1 ......... ... � co . N i Cq •h ! 1 _ K N 395.1 8 - N IAIt or All Ill/4 +T- � __.►.- ...._..,i.-- „ - UNf'�AT6D s._T.IJr__. "65' LANDS rr ., i -_ C-7 ' 76 7 - }C JA µY 's ha � '7H /• '� a ^ �: . wMIW�4a1M�,.µ�.a - .: .. -tea blriiYarN'+.Y✓ i R iq r.iA{*�m > a* ' 45. j:ji }�Ojl :luta p S O cz 1p 5`4 11118 VS 3 M 24'3 — T 2" T 915/ 6 1 114 m T T DINING to LIVING ;=_; 91 x 17'1 A -- ---------- KITCHEN i GARAGE 11'x19'10 MxWll F-1 'r2 DN ih P FOYER BATH 11 x —7 m `, � � � z ° s' 2b�e'�z1o�I 24Z 1&1 UPPER/MAIN LEVEL PLAN LOT 2 PRAIRIE FLATTS SUBDIVISION; SE•1/4 of the SE.1/4ofSacl3T3llN-Rl8Vy 2- Star Prairie Township; St. Croix County, Vyl t- BEDROOM 117 x ill MASTER BDRM 11711 x 117 LIVING AREA 1108sqft 7 HOME TEC DESIGNERS AND BUILDERS L —L. i 45� DRAWN: SCOTT J. COUNTER 49V r 0 a,, 81175/16 5'411/16 8'5314 —23858 1 114 3 / 3 , 1'5 9/1 T — b I I I I I II II II FAMILY II I ; II I i I I I I z I I I 17i N G ARAG E 3 x a UP ( { N BATH 10'11x6' I I c�z) o � -- I ll I — STORAGE UTILITY ---------------- 10'11x57 I �HM / ` 23'913/18 lk CLOSET i 5'1 x 4'11 II I I I I LOWER LEVEUFOUNDATION LOT 2 PRAIRIE FLATTS SUBDIVISION SE -1H of Me SEAM 731N-R18W Shr Pn iM STUDY /COMPUTOR I I !` Townwp; St. awuCou*.M I I I I BEDROOM II � II LIVING AREA { 1108 $q ft HOME TEC DESIGNERS AND —— BUILDERS DRAWN: SCOTT J. COUNTER 27 3 3 1 3 6 I k I --11'1 t � 171 l� 49'9