HomeMy WebLinkAbout020-1303-30-000 • ST. CROIX COUNTY ZONING DEPARTMENT
AS BUILT SANITARY REPORT
Owner #
Property Address �/ . /V a
City /State N.
Legal Description: .�/
Lot 39 Block Subdivision/CSM #
V4 r /� '/4, Sec. ?,�, T - IN Town of PIN # O O - 3 D 3 ;�
SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION:
Tank manufacturer Size ST/PC/ 00// Setback from: House Well _ 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
i
Type of system: _ Width Length Number of Trenches
Setback from: House _$Q' Well — PAL ?s Vent to fresh air intake t /00
ELEVATIONS
�— /
Description of benchmark / `� � � ��� r fi � Elevation DO
Description of alternate benchmark Elevation
Building Sewer 1 , ST/HT Inlet 6v i /, ST Outlet / /, 4 / PC Inlet —'
PC Bottom — Header/Manifold 1 V, Y8 Top of ST/PC Manhole Cover
Distribution Lines (} 0 Y, S/ 9- () l0 y v — ! — ( )
Bottom of System () 1 0 c7. 9� r () /0 3, 6L3 ( }
Final Grade () / d / ( ) A ?,, e l ( )
Date of installation 1301 gPermit number 3aY State plan number
Plumber's signature License number 2; 35 7 Date -
Inspector (�
Complete plot plan �
i
NOTICE Please provide the following:
• A P lan 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
N
f 20O
1 1�
n
INDICATE NORTH ARROW
Wisconsin Department of Commerce
S PRIVATE SEWAGE SYSTEM 'Safety and Buildings Division Count Y ST. CROIX
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT) SanitaryY[%Ijv-:
P ersona l inf you provice may be used for secondary purposes [Privacy L r, s.15.04 (1)(m)J.
ERICKSONS,NaRICHARD [],Sjtv,l1 �Lillage Town of: State Plan ID No.:
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel B'" b! : 1303 - 30 — DOD
fl a� oc
TANK INFORMATION ELE ATION DATA A9800568 Lle
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
S eptic g fee - )o Be 1 - L/ /1( / D
Dosing �((. ('w Z7 /�( •%
Aeration Bldg. Sewer /,C _ c,1
[ Ho lding '-- St /yet inlet W / //. 7
TANK SETBACK INFORMATION St/ Outlet �. 20
TANK TO P / L WELL BLDG. Air intake ROAD Dt Inlet
Septic oL `� ,� ��� ?jL NA Dt Bottom
Dosing NA Header / Man. 1 I Jam„ /6 8
Aeration — NA Dist. Pipe , N %t I?
'y. t Z• DO
Holding — Bot. System
o a
PUMP / SIPHON INFORMATION Final Grade
Manufacturer Demand
Model Number — .–GPM
TDH ' Lrictiot� System _ _ TDH Ft oss
Forcemain gth^ Dia. �� Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width , Length t No. Of Trenches PIT No. Of Pits Insid� Liquid D th
DIMENSIONS 3 � DIMENSION
SETBACK
SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING manuf acturer:
�r
INFORMATION T� CHAMBER m od el Nu
pe Gvr OR UNIT
m er:
S st m D N
DISTRIBUTION SYSTEM A �-
Header /Manifold Distribution ipe(s) , , ole Size x Hole Spacing Ve
I nt To it Intake
Length Dia. Length Dia. Spacing 1� f
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.)
LOCATION: HUDSON 27.29.19,NE,NE 769 OR OLE LN – HUMBIRD HILLS LOT 38
oi
�vwlld
3, w�l ►�� o/v /lcc�' �f M s124
�3aq
Plan revision required? ❑ Yes C@ No
Use other side for additional information.
SBD -6710 (R.3/97) Date Inspector Signature ert.
SANITARY PERMIT APPLICATION S afety 0 E. Washng�Ave.
AisConsin P.O. Box 7969
Department of Commerce In accord with )LHR 83. 05, Wis. Adm. Code Madison, WI 53707 -7969
• 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. t, . r
• See reverse side for instructions for completing this application State Sanitary Permit Number
The information you provide may be used b other g overnment agency programs A? Z �ntZd ppfication y Q y y 9 9 y Q g ❑ Check
[Privacy Law, s. 15.04 (1) (m)]_ State Plan I.D. Number
I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N
P perty Owner Name Propert Location
r A a N F_1/4 L 1i4, S a1 T a, r N, R IQ +40r W
Property Owner's Mailing Address Lot Number Block Number
C . State 0 Zi Code Phone Number Subdivision Name or CSM Number
Ox A n 4 g ! �Vl A ( wirribiC
II. TYPE BUILDING: (check one) ❑ State Owned Ci Nearest Road
C] Village •
Public 1 or 2 Family Dwelling -No. of bedrooms Town OF H /1 r!
III. BUILDING USE: (if building type is public, check all that apply) Parcel TaxNumber(s)
1 ❑ Apartment / Condo 0. — 1 - 2 b3 ~ 30
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 online B, if applicable)
A) 1. W New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
______System____ - ___ System___ ________ __TankOnly_____________ Existing System ________ Exlstln�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 Trenchall 'f' .tW;tV_9W ❑ In- Ground Pressure l 42 ❑ Pit Privy
13 ❑ Seepage Pit . :r_,t l+Y L -`xA.5 r� "3 7 43 []Vault Privy
14 ❑ System -In -Fill.
VI. ABSORPTION SYSTEM INFORMATION:
1. Gallons Per Day 2. Absorp. Area 3_ Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade
Required (sq_ ft.) Proposed (sq. ft.) (Gals/da /sq. ft.) (Min. /inch) Elevation
b oo '750 Ito 3 , d. • � 1D3 Feet 1 6(p#3 Ca 1 Feet
VII. TANK in gallons Total # of Prefab. Site Fiber- Exper.
INFORMATION New Existin Gallons Tanks Manufacturer's Name Concrete st Con ed Steel glass Plastic App
Tanks Tanks
Septic Tank /�Q ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber ❑ 1 ❑ 10 ❑ I ❑ ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite wage syste how on the attached plans.
Plumber's Name: (Print) Plu 's Signat e: (No S P Business Phone Number:
NOM a 945
Plumber's A Tess tree ,City, State, Zip Co e):
/0
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit F (includes Groundwater Date I ssued Issuing n Signat re (No Stamps)
S �y •
Approved ❑ Surcharge fee)
Owner Given Initial �0 � {�
Adverse Determination `
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
S8D6M (R.11/96) DISTRIBUTION: Original to count One copy To: Safety s Buis Diwision, Owner. PIwrA r
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Wisconsin Department of industry SOIL AND SITE EVALUATION REPORT Page 1 of 3
Labor and iiuniari Aeladons
Djvision of Safety a Bindings in accord with ILHR 83.05, Wis. Adm. Code
O UN TY
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. 020- 1303 -30
APPLICANT INFORMATION- PLEASE PRINT ALL,INFORMATION RVIE DBY DATE
No,.. 2. 1984
PROPERTY OWNER: " ' PROPERTY LOCATION
Richard LaCa se GOVT. LOT NE 1/4 NE 1/4,S 27 T 29 ,N,R 19 Fdor) W
PROPERTY OWNER':S MAILING ADDRESS,'!Ts? LOT # BLOCK # SUBD. NAME OR CSM #
871 Kelly Rd. ST Ci na Hurrbird Hills
CITY, STATE ZIP PHOKEJ " ER ❑CITY ❑VILLAGE JUOWN NEAREST ROAD
Hudson, WI. 54016 ` / CR8Ibe5 15� Hudson Oriole Dr.
1 Now Construction Use (x I R u(ql�e0 _ 1 4 _ (j Addition to existing building
[ I Replacement ( ) Public or commerce gibe
Code derived daily flow 600 gpd Recommended design loading rate ____ bed, gpd/R .8 trench, gpd/ft
Absorption area required _ 858 bed, ft 750 trench, ft Maximum design loading rate _ bed, gpd/ft 8 trench, gpol111
Recommended infiltration surface elevation(s) 103.00 ft (as referred to site plan benchmark)
Additional design / site considerations trenches spaced to code, 3.50 , below grade
Parent material outwash Flood plain elevation, if applicable nor h
S = Suitable for System CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN PILL HOLDING TAN(
U = Unsuitable for stem ®S ❑ U ❑ S 12 U ®S ❑ U ❑ S 0 U ®S ❑ U ❑ S CCU
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Structure GPD /ft
Boring # Horizon Texture Consistence Boundary Roots
in. Munsell Qu. Sz, Cont. Color Gr. Sz, Sh. Bed Tiertdt
1 0 -14 10yr3/3 none 1 2msbk mfr gw 2f .5 .6
l .•<
2 14 -36 lOry4 /4 none sicl lcsbk mfr gw if .2 .3
Ground 3 36 - 84 7.5yr4/6 none co s Osg ml na na .7 .8
elev.
10 ft.
Depth to
limiting
faCtor
+84
3'' .t►
Remarks:
Boring #
1 0 -20 10yr2 /2 none sl 2m sbk mvfr gw 2f .5 .6
1 23 1 , 2 20 -90 7.5yr4/6 none co s Osg ml na na .7 .8
Ground
elev.
10 n,
Depth to
limiting
factor
+90"
Remarks:
CST Name: -- Please Print Gary L. Steel Phone: 715 246 - 6200
Address: 1554 200th. Aygd., New Richmoal,,Wl 5417
Signature: Date: 10 -28 -98 CST Number. m02299
1
PROPEMYOWNEIt "``' Richard LaCAsse SOIL DESCRIPTION REPORT Page of 3
PARCEL I.D. # 020 - 1303 -30
Depth Dominant Color Mottles Structure GPD /ft
Boring # Horizon Texture Consistence Bourd3y Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed lTmnch
3
>' 1 0 -12 10yr3 /3 none 1 lcsbk mfr gw 2f .4 .5
2 12 -15 10yr4 /4 none sl 2mgr mvff gw if .5 .6
Ground 3 115-90 7.5yr4/6 none co s Osg m1 na na .7 .8
elev.
1 04.9 ft.
Depth to
limiting
factor
+90 +
LZ
Remarks:
Boring #
1 0 -11 10yr2 /2 none 1 lcsbk mfr 9w 2f .4 .5
4 2 11 -15 10yr4 /4 none s1 2mgr mvfr gw if .5 .6
.. ........ ...
3 15 -82 7.5yr4/6 none co s Osg m1 na na .7 .8
Ground
elev.
10 ft.
Depth to -
limiting
factor
Remarks:
Boring #
1 0 -10 10yr2 /2 none 1 lcsbk mfr gw 2f .4 .5
4 2 10 -20 10yr4 /4 none sit lcsbk mfr gw if .2 .3
La
3 20 -80 7.5yr4/6 none co s Osg ml na na .7 .8
Ground
o d
elev.
1
Depth to
limiting
factor
Remarks:
Boring #
..............
Ground
elev.
ft.
Depth to
limiting
factor
M
Remarks:
SBD- 8330(8.05/92)
I .
R
STEEL'S SOIL SERVICE
Gary L. Steel i 1554 200th Ave.
Richard LaCasse
CSTM2298 New Richmond, WI 54017
MPRSW -3254 to o S 27- R19w (715) 246 -6200
town of Hudson
4 lot #38- Humbird Hills
N �.ofi J r� C
1 =40'
BM.= top of 2 pvc pipe rA el. 100'
Alt. BM.= top of 2" pvc pipe C el. 100.45' 4
�D
4
1 � 3
1
boo ' 16 , o` . 15 1 L
Gary L. Steel
10 -28 -98
I
J -
„ Page of 3
VPisconsln Department of Industry, SOIL AND SITE E V fr Tl ON R.E P O R T
Labor and Human Relations
Welon of safety 3 Buildings in accord with ILHR 81,05, Wis. Adm. Code r'
PUNTY
155T. , c�orX
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, Wt 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.
i
APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
MAILING ADDRESS
PROPERTY OWNER: f U, y� /,PQ �f iIS Ati,U a,PV WPROPERTY OCATION 114 *,c PROPERTY OWNE i /4,S �7 T 2 9 ,N,R /f E (or OWNERS �yi8 f�ipv£�!P /��I OCK
N SUED. NAME OR CSM # 334 �oB rs s �UMai PD H 1.05 Z I CITY, STATE ZIP CODE PHONE NUMBER LUGE WWN NEAREST ROAD L�
,/�jv �1N• 55 /0/ lG�) �i2 - 5SS5 +fUV_S0J
New Construction Use ( krAesidendai I Number of bedrooms Addition to existing buikfing
( ) Replacement [ I Public or commercial des cribe
ysa - 2 '- trench, 90112 Code derived dairy flow moo gpd Recommended design loading rate bed, 9Pdlttt
Absorption area required __ bed, 11 /& trench, ft Maximum design loading rate bed, gpd/ft , & trench, gpolh
Recommended infiltration surface elevations) -s-� P G • 3 ft (as referred to site plan benchmark)
Additional design I site considerations 7l S e 7 &Al S t y' 0, / -t �d/� wZ '9'00�� C y £ S
Parent material Flood plain elevation, if appliFable tip It
S = Suitable for system , AND �/ IN• PRESSURE AT GRADE SYSTEM N F�.L' SNt(i T 2T I
U- Unsuitable for s stem i� s u 0S Liu �'S a u o s a s C 1J
SOIL DESCRIPTION REPORT
Depth Dominant Color Moil Texture Structure Consistence Bou day Roots GPD /ft
Boring # Horizon in. Munsell 0j. Sz. Cont. Color Gr. Sz. Sh. Bed larch
l 2 - '� /0 3/2- s/ 1,40
. -S
Ground 3 2S
elev
q� I
Depth to
limiting S1
factor
7
Remarks:
Boring # F S�i� 1
z
Ground
elev.
Depth to
limiting
1
Remarks: _
FSil;
Name: — Please Print '� Q E '�- Z(L� ( Ck 7— Phone: 7 1 5 . 3 A; - e / I f 5
ress: 44i S O' N i [_ N u 'P.SOA)
at urs: Date: CST Number:
ORIGINAL
PROPERTY OWNER SOIL DESCRIPTION REPORT Page of -3
PARCEL. LD. f LOf 3� 11V --f1?1 f P 11111$
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bard3y Roots GPD /ft
In. Munsell Qu. Sz. Cor!t Color Gr. Sz. Sh. Bed ITrench
.3 l /o / o y y / S . 7�4 A ale
2- o 1 /i , aye 31z s� 2 sf✓,C m�► fib 2"S • S
Ground -/� /0 1/le at �/ O, S S
elev. S`
Depth to i
limiting
factor
7
Remarks: /
Boring # O D
El V - Lo 3/z- ;
Ground
elev.
/b /•6 2 - ft.
Depth to
limiting
factor
Remarks:
Boring #
/ 12 - /O lje Z S� / 7 fit? J Z ve
Ground
elev.
fQ /•
2-2- ft
Depth to
t
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
7
' r .
PROPERTY OWNER SOIL DESCRIPTION REPORT Page 2— of -3
PARCEL I.D. ! Got 11V-4 AP /111//5
Boring # Horizon Depth Dominant Color Mottles Texture Structure consistence Bouncl3y Roots GPD /ft
In. Munsell Qu. Sz. Coat Color Gr. Sz. Sh. Bed Trench
y / 0 fz- 101 31.2— — S
Ground "7 7 /D Yle p - S — S
elev. S
Depth to
Limiting
Fac���
Remarks:
Boring #
z 0 - yo /O y 3 Z S� /, 1,oi Q s ,
Yle
Ground
elev.
/o /-G 2 - ft.
Depth to
limiting
factor
7
Remarks:
Boring #
0 % /o 2,1 ,S/ / 7 If& tinf, S Z f • �l . S
Ground
elev.
LZ ft.
Depth to
limiting i
factor , I
Remarks:
Boring #
i
i
i
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
con coon,o nCm—
Lo T 4 39
q o " [S ((2
ye. Sz ` s U 6665 IreD SYsrz�r!
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3.68 ACRES LO
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RES i 116,990 SQ. FT p 1
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N89 0 43'5 5 ° W .473.39'
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ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer 3. t.,,,-4-
Mailing Address 9 Lg G�-a�w . + ew ,� _ tq L i eA k L - ti
ME W -
Property Address
(Verification requited from Planning Department for new construction
City/State � S� tom'• Parcel Identification Number OR - 13 03'3 0
LEGAL DESCRIPTION
Property Location NAL %,, y., Sec, 7 , T LA N -R W, Town of I u,.L4" --% ._...
Subdivision _ 14t t..., 141 L 4, c Lot #
lCertified Survey Map # S�a�9'�� . Volume Page #
Warranty Deed # �'� 3 g� 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 property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
masterplumber, journeyman plumber, restrictedplumber 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.
Itwe, 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 ee year expiration date.
�� 1
SIGNATURE OF APPLICANT DATE
OWNER CERTIFICATION
I (we) certify that all statements on this form are hue to the best of my (our) knowledge. I (we) am (are) the owner(s) of
the property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
d ue "k 1 0, 1 �& -, // //0/
SIGNATURE 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
v
VOL 1 "NIPAu 17
' DOCUMENT NO. WARRANTY DEED y
SPATE BAR OF WISCONSIN FORM 'L — 1982
I;
Humbird,Land" a Corporation I'
;JUN 21997
conveys and wa r:uits to Richard .N,. Erickson and Vickie L. 10:45 A. 5
Erickson. husband and. Wi fe... I -s'.�►4t.__ .4
t k:l
ti.e rolluwing described real estate in $.L.a..CIOiR ...County , -`-
_ . 7
Stale of Wiscunsin:
Lot 38, Humbird Hills Second Addition Tau Parcel No; ..............................
Town of.Hudson, St. Croix County, Wisconsin P
t
TRA
This . ..... i.$.nQx_ ". - „ homestead property.
(930 (is not)
Vx,- -ption to warranties:
Easements, restrictions and rights -of -way of record, if any
Dated this .. 21st......... . ......... day of May - - ...... _, 19.19.7 ....
_
- (SEA O HUMBIRD. LAND CORPORATION .... ..... ...... - (SEAL)
Austin J. Baillzn, Its President
- ----- ...._.....(SEAL) - _ ... ..............(SEAL)
AUTHENTICATION _ACKNOWLEDGMENT
Signature(s) ................................................... STATE OF 7190 ?iinneso a
33.
auillenticated this ...... day o- ........ ....... ... ......
-
--- -- - -- - -- ---- ------ -•- -- ...... - - -- - -- ---- --- ------ •-- ------- ------ -- --... Ramey-- •- - -- - --- -Count i.
........... 1J Personally came 3c ore me this ...,2.1Sx.....day of
1 s
....Ma .... . -- - - - - -- 19.91.•. the above named
A in President of.
--- ------------------------ •--•--- ......- - .- - - - - - *------ -- - - -- - - - - - --- _ Humb ird Land - - o.. ..... ..... ...
- -- rprat ion
Co -
TITLE-: MEMBER STATE BAR OF WISCONSIN
_ ...... .. ........ .. --.------ -- -... ............................
(If not,
authorized by 4 700.06, Wis. Stats.) --
.. ........... ........ . - -- -- --- ......... ................... ....
.
to me known to be the Fr -sir ............ who executed the
roregoin: instrument and adnowledge the same.
v+w�nr .+o., ti•
THIS INSTRUAIENT WAS DRAFTED BY ”
-,�
Humbird Land Corporation . .. ......... . .. t - •.trraRV 1C= M;�IiF' :i+
.Paul .�...Baillo. ' �,'WASH1N TO rlGQUNTy
...
--- ......... -- Notovv Public r; %
i/v{Alliwwl J t
(Signatures may be authenticated or acknowledged. Roth �lv C.onvnission is peer a -at. ([f not, stato expiry ion
are not necessary.) date: 4anuary 31, Qs)Q)
*Names of peons ,iicninsr in any cnpncity sh -Od he typed or Pri, i�I 1 , 1., i,
D F 1_lUlvJUlr*%U 11ILLb bt. AUUI HUN
' 'LOCATED IN PART OF THE NWI/4 OF THE NEI /4, NEI /4 OF THE NEI /4, SEI /4 OF THE NEI/4,
AND THE NEI /4 OF THE SEIM ALL IN SECTION 27, T29N,R19W, TOWN OF HUDSON.
N ST. CROIX COUNTY, WISCONSIN.
LEfiEtlQ
OWNED BY• B •wwlNUw tamrr t[crroN .gwrcxr rotwo
7� r«rDrwo IaND Gnro.ATgx � � (• wwr nrt ro.
I rfn eroN[G rw.mxv
!M xGrN Rwtnr !. as r qG n'[ ro.
1 Sr r•u. wn. blot 1 /t 1I[ Is.
•'� O P • t , !O• IRON nYt t[r, rtlmexo t•f t.f.
" Da�Rrenr. <
' erirG lD nNG. uaruuGrto
,B wlnr'r:'[.• G ro[ waoxao .a uf.
Iew lauA ruor.
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- f• n parcel shown on th,. d AIAP Iplftl subject ect to
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SECTION 27
.n... .tlon w to dl•t.,b •nr eurv.r •t•M, or eb. ".c. o al en
Inns r I in•.
tn• ai.tDI .n.. f • ...... .... o......1 : ttap. by •nron. i• • floc•uon et
t.cllon t)•. Jt o! Nlaconnn statute.. u 11 Guworle •.
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