Loading...
HomeMy WebLinkAbout040-1236-00-000 CItOIX COUNTY ZONING UEI'AR'I'MI:N7` . / AS BUILT SANITARY Owner ;� ` Ile s� _J Address b6 City /State � C•OUt�TY � �. Legal Description: Lot Block � t t Subd'vision/CSM # l'0 G Town of PIN # D D -1336 -pp -app SEPTIC TANK — DOSE CHAMBER — HOLDING TANK INFORMATION: Tank manufacturer Y C S6 ize ST/PC / U N IVY Setback from: House Well P/L Pump manufacturer del � Alarm location ` o ©y $ 0 (HOLDING TANKS ONLy) Setbacks: Service road Vent to fresh air intake Meter location Water Line Alarm location SOIL ABSORPTION SYSTEM: Type of system: Width Length /0 Setback from: House Number of Trer}ches 0 P � Well �v p/L 3. Vent to fresh air intake fir' ELEVATIONS: Description of benchmark 70,4 e &- g POO Description of alternate nchjnark Elevation O4. & q, 4J� � , �F ^ ✓�, Elevation Building Sewer M ,5, ST/HT Inlet � ST Outlet- PC Inlet PC Bottom Header/Manifold , s!/ Top of ST/PC Manhole Cover �� • .S Distribution Lines (h� a Bottom of System Final Grade ( ) G►� Date of installation /D // Permit number State plan number Plumber's signature icense number / Date Inspector Complcic plot plan Wisconsin Department of Commerce Safety and Bijildings Division PRIVATE SEWAGE SYSTEM Count INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: f Pe ersona on you provice may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. 320265 - PP , e : BRIAN ❑ City E] Village Town of: State Plan ID No.: TROY CST BM Eley.:- Insp. BM Elev.: BM Description: Parcel Tax No.: lov % 2�ce- i - ja 040 1236 -00 -000 TANK INFORMATION ELEVATI N DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. ptl D6 Bench sa 2. / 0C1 Dosin C 6 ` Aeration Bldg. Sewer r Holding St * Inlet � TANK SETBACK INFORMATION St/ Ht Outlet TA K TO P/ L WELL BLDG. Air I to ROAD Dt Inlet Airintake Septic �� i I' NA Dt Bottom r l ca7 Dosing NA Header / Man. Aeration NA Dist. Pipe HoIcI Bot. Syste PUMP/ SIPHON INFORMATION / Final Grade s �'a� Manufacturer C -1 Demand - WIa.M 6 e �•l� / 63 �► 1 Model Number , 04 3�71 .gGPM TDH Li ft Z(O L oss riction Systems TDH Ft HH Forcemain Length Dia. 2'. Dist. To Well SOIL ABSORPTION SYSTEM BED Width 1 Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIM I N .0 DIMENSION SYSTEM TO P/ L BLDG WELL LAKE /STREAM STREAM LEACHING Manuf r r: SETBACK ` INFORMATION Typeot CHAMBER Syste :n Vek6j' �✓J � ��.r. OR UNIT M r. DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size Hole Spacing Vent To Air Intake Length a v Dia. Length Dia. Spacing S x w e.. 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 El Yes ❑ No E] Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: TROY 3 .28.19,SE,SW 527 GILBERT ROAD — COUNTRYWOOD LOT 49 Plan revision re quired? [/(Yes ❑ No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Ygnature Cert. No . v V i sclliinsin Safety and Buildings Division SANITARY PERMIT APPLICATION 201 W. Washington Avenue P O Box 7302 In accord with ILHR 83.05, Wis. Adm. Code Department of Commerce 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. St'.0 ! • See reverse side for instructions for completing this application State Sanitary Permit �Numb Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04 (1) (m)]. E] Check if revision to previous application State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N Prope Owner Na P opert Location Q 6YI S' I /4 5 /4, S 3 T i d, N, R�' E (or)o PropgrltfOv�ner�s M;�Iina,Address Lot Number Block Number a { V4 of Ci St to FIttS t J Zip Co �� `h� e um er Subdivision NamNr CSM N mber 1 ZF " l i i I II. TYPE OF BUILDING: (check one) ❑ State Owned its Nearest Road ❑ vii age �. Lj Public 1 or 2 Family Dwelling - No. of bedrooms Town OF I1')S Il III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number( er. 1 ❑ Apartment/ Condo Q �0 106 -4!) 2 171 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. f$ New 2 ❑ Replacement 3_ ❑ Replacement of 4 ❑ Reconnection of 5 ❑ Repair of an ------ System ________ System __ ____ ____ ___ Tank Only _____ -___ Existing System _________Existing System B) E] 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 1 1 21 E] Mound 30 [] Specify Type 41 [] Holding Tank 12WSeepage Trench 3 k160 22 ❑ I Grou E] d Pressure 42 Pit Privy 13 ❑Seepage Pit , ! r_ G I P �.�, *1 43 [] Vault Privy 14 E] System-In-Fill CT 9 "l A'- VI. ABSORPTION SYSTEM INFORMATION: cal 1. Gallo s Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Pert. Rate 6. S t Elev. 7. Final Grade �� Re (s q. ft.) Prop a (£q. ft.) (Gals/�y /sq. ft.) (Min./' ch) �, El�yoij)n 1 (, Feet m 6 Feet VII. TANK Capa ity INFORMATION In gallons Total # of r Prefab. Site Fiber- Ex per- Gallons Tanks Manufacture s Name Con- lass Plastic Ap Ric New Existin ,'� QS � Concrete strutted Steel g pp Tanks Tanks Septic an H ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ El El ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sew m shown on the attached plans. PI is Name: (Prin) Plu s Signature: ( Stamps) P/ Business Phone N mber: Zu a I Plumber' Addr tregt, City, a ipe): !� � d li IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved San Permit Fee (includes Groundwater D ate Is sue lssuin Agen Signature (No Stamps) 19 roved ❑ ' p�o - /� surchar Fee) Approve Owner Given Initial 0 9 / Z ;t Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: * tup raljj wt 4titl , below! 41 b awl W4r dvr;� C sfl _kbn. Cce� If_&O SBD- 6398 (R.11 /97) - DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, owner, Plumber N 1 . 7V�� � a one 4f Cr'lV �2e g CL 1b � Si p A:e C SLG �ci! fedc /� I l� Combination SegtAcTank and PUMP CHAMBER CROSS SECTION AkID SPECIFICATIONS PAGE S OF - VE IJT CAP WEATHER PROOF JUUCTIOM BOX . 4'C.I. VENT PIP i APPROVED LOCKIAIG � 10 t FROM DOOR, MANHOLE COVER :WINDOW OR FRESH I I Lvl�(2 fJ11JG L AgEC.. AIR IM TAKE c owlw �r If MILL Ib ---- - - - - -- 4 IUS�)eoo" PIPC ET PROVIDE - -- IWL _ AIRTIGHT SEAL I I APPROVED JOIIJT A I I I APPROVED JOIN PE or Tank construction i ' W /C.I, PiPE�PUc shall comply with ALARM ILHR ;3.15 and 33.20 s I i) I I I OW C I i LLEV, Fr I - t PUMPS J OFF O COMCKETE t �} q y J p BLOCK -1 1 RISER EXIT PERMITTED OULy IF TAW MAMUFACTURER HAS SUCH APPROVAL 3"ApPkaF` 1 8E00 t N� SEPTIC t SPECIFICATIOIJS DOSE TAWKJ MAMUFACTU WUMBER OF DOSES: 3 ` , S PER DAy TAWK SIZE bOU GALLOWS DOSE VOLUME z ALARM MAUUFACTUR.C.R: S`f S IMCLUDIWG B ACKFLOW: GALLONS MODEL WUMBER: I Q0 "IAJ CAPACITIES: A= L_ IMCHES OR LI00.0 GALLOU S SWITCH TYPE: �lQ LC-URY B = _! IIJCHES`OR '41-1 G�LLQU$ PUMP P'IAAIUFACTURCK: _ GC-)\J \---) S C - 8 ILICHE$ OR 1b 8 - y GALLOU5 MODEL ).!UMBER: 3 u1 k y D = INCHES OR 1 "S GALLOAIS SWITCH TYPE: __ Y1t1l,(1LR,S- MOTE: PUMP AIJp ALARM TO BC Url,O MINIMUM DISCHARGE RATE 31 •`IY GpM INSTALLED OW SEP CIRCUITS VERTICAL DIFFEREMCE DETWECIJ PUMP Off AIJD.DISTRIBUTIQIJ PIPE.. FEET J` j -ljiIJIMUM WETWORK SUPPLY PRESSURE , _� FEET q SS FEET OF FORCE MAIN X �' F Y Ofr.FRICTIOU FACTOR - FEET 1.23 TOTAL OyWAMIG HEAD = FEET [ f 9' Pump chamber DIAMETER — IMTERLIAL DIMLWStO1J� OF TAWK: LEAIGTH ;WIDTH — ;LIQUID DEPTH y 38__ BOTTOM AREA - 231 = GAL /INCH AS PER MANTIPAr TTIDPU - 7 1 ri c - r_nT /TMOU Goulds N--P'Cr_e for Submersible Effluent Pump f 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. tic cover with integral handle Motor Available for automatic and •Farms manual operation. Automatic and float switch attachment • Heavy duty sump EPO4 Single phase: 0.4 HP, models include Mechanical RP M, , built in n overload points. • Water transfer 230 load with Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, automatic reset. preset at the factory. rated oil and water resistant. SPECIFICATIONS • EP05 Single phase: 0.5 HP, ■ Bearings: Upper and lower 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo - construction. • Solids handling capability: automatic reset. 3 /4" maximum. • Power cord: 10 foot plastic Semi -open design AGENCY LISTING • Capacities:, up to 55 GPM. standard length, 16/3 SJTO with pump out vanes for • Total heads: up to 24 feet. with three prong grounding mechanical seal protection. • Canadian StandanisAsso • Discharge size: 1 NPT. plug. Optional 20 foot ■ EP05 Impeller Thermo gp • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for (GSA listed model numbers rotary/ceramic- stationary, three prong grounding plug improved performance. end in "F" or "AC ".) BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 • Capable of running - -- - -- - - - - -- dry without damage to s 30 ' Y - components. sGt Pump: EP05 s - - - -- — �: ry - -- - • Solids handling capability: 0 25 ._,. zs FT 3 /4* maximum. w —_ � - - - -- - - -- • Capacities: up to 60 GPM. 6 20 • Total heads: up to 31 feet. • Discharge size: 1 NPT. z 5 - - - - - - -- -- • Mechanical seal: carbon- 0 15 rotary/ceramic- stationary, 4 BUNA -N elastomers. — -- - - - -- - _ _ -_ - -- - -- EPOS --- Temperature: ° 3 10 104 °F (40 °C) continuous 140 °F (60 °C) intermittent. 2 - -- - - EPOa _ - -- - __--- _ - - -_ -- 1 L::E i - --- 0— 00 10 20 30 40 50 GPM , 0 2 4 6 8 10 12 m CAPACITY Wiscon -in Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 1 bor 4m Human Relations g division 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 I PARCEL I. D. # dimensioned, north arrow, and location and distance to nearest road. 40- 1236 -00 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION Y aA E , 2 PROPERTY OWNER: PROPERTY LOCATION Richard . chard Stout GOV LOT SE 1/4 SW 1/4,S3 T 28 N,R 19 * (or) W TO OWNERS A IL 1 ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # Awatukee 49 na Country Wood CITY, STATE ZIP CODE PHONE NUMBER []CITY ❑VILLAGE OTOWN NEAREST ROAD Hudson, WI. 54016 (715) 549 -6731 1 Troy Tower Rd. [x] New Construction Use I ] Residential / Number of bedrooms 4 [ ] Addition to existing building I ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate _gy bed, gpd /ft gpd /ft Absorption area required 1.200 bed, ft 1000 trench, ft Maximum design loading rate ._ bed, gpd /ft gpd /ft Recommended infiltration surface elevation(s) 99.73- 98.22- 97.75 -97.25 ft (as referred to site plan benchmark) Additional design / site considerations trerrhes, if bed used badcfill to be to code or top fill .rEmoved firm area Parent material pitted outwash plain Flood plain elevation, if applicable na ft Mfor system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK s stem 13 El 11 S ® U CR El F7 S El ❑ 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 Texture Sz. Sh. Bed Trench 1 0 -12 10yr3 /3 none 1 2msbk mfr gw 2m .5 .6 2 12 -42 10yr4 /4 none sil lcsbk mfr gw if .2 .3 Ground 3 42 -90 7.5yr4/6 none fs Osg mvfr na na .5 .6 elev. 10 4.15 ft. Depth to limiting factor +9 0" Remarks: Boring # 1 0 -13 10yr2 /2 none 1 fill na gw 2f np inp 2 2 1 13-36 10yr2 /2 none 1 lcsbk mfr gw if .2 .3 3 1 36-53 10yr4 /4 none sil lcsbk mfr gw if .2 .3 Ground elev. 4 53 -90 10yr4 /4 none fs sOg mvfr na na .5 .6 10 Depth to limiting factor 90 " Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715 -246 -6200 you �oX Address: 1554 200th. Av . ew Richmond WI 54017 Signature: C7C - Date: 9 -22 -98 CST Na bon .. 002298 STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Richard Stout SE4SW4 S3 T28N - R19W New Richmond, WI 54017 MPRSW - 3254 town of Troy (715) 246 - 6200 4 lot #49- Countyr Wood I N 1 =40' BM.= top of elec. transformer base C el. 100' Alt. BM.= nail in Boxelder tree C el. 104.20' rl� ✓ 6. Gary L. Steel 9 -22 -98 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND ] OWNERSHIP CERTIFICATION FORM OOwner/Buyer Pk- l Q n (J" I A q"t - 30' 0 � Mailing Address x Property Address S°Z 0 Q (Verification r equired from Planning Department for new construction) RT MO OT City /State D - Parcel Identification Number 0 y Id A — ©o LEGAL DESCRIPTION 2 Property Location ' /4, S '/4, Sec. J , T �� N -RW, Town of D Subdivision Wd' , Lot # Certified Survey Map # Volume , Page # Warranty Deed # ��� , Volume / 3 , Page # f 3 Spec house ❑ yes �1 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 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 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 date. p - / ' SIGNATURE OF 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 property described above, by virtue of a warranty deed recorded in Register of Deeds Office. 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 Wisconsin Department t' e g Industry Labor and, H6 , man Relations SOIL AND SITE EVALUATION REPORT Pa 1 of 3 — DhAsion of %fety & Buildings in accord with ILHR 83.05, Wis. Adm. Code ) COU 4 o by e �� i��6t Attach complete site plan on pap of less than 8 1/2 x 11 inches in size. an must me u e, but . ; ° }S -. not limited to vertical and horizontal re nce point (BM), direction and % of slope, scale or , ' PARCEL dimensioned, north arrow, and location and distance to nearest road. / enc�' l APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION 1 ``% (.. 'fl ,Y DATE PROPERTY OWNER: PROPERTY LOC T1OfV Richard Stout GOVT. LOT ��4 S SW :.��4 �c „�. T 28 f *419 *Jor) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOC B Afdl� Mr'SM # ., 1353 Awatukee Trl. 49 na VOW X J CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE N _- -_,. - � ROAD Hudson WI. 54016 (715) 549 - 6731 Tro t+ ' w r Rd. [ New Construction Use [x] Residential / Number of bedrooms 3 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 5 bed, gpd /ft • trench, gpd/ft Absorption area required 900 bed, ft 750 trench, ft Maximum design loading rate • 5 bed, gpd /ft •6 trench, gpd/ft Recommended infiltration surface elevation(s) trenches 99.02 & 98.39 ft (as referred to site plan benchmark) Additional design /site considerations alt site= trenches C 98.39 & 96.46i' Parent material pitted outwash plain Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U =Unsuitable fors stem CRS ❑ U IR ❑ U 1 13S ❑ U KI S ❑ U [i ®U ❑ S M I) 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 Tre & 1 1 -20 10 r2 2 none 1 2msbk mfr gw if .5 .6 2 20 -39 10yr4 /4 none sicl lfsbk mfr gw if .2 .3 Ground 3 39 -88 10 r4 4 none fs OS9 mvfr na na .5 .6 elev. 99 ft. Depth to limiting factor Remarks: Boring # 1 1 0-10 10 r2 2 none 1 2msbk mfr 9W if .5 .6 2 10 -24 10 r4/4 none sicl lfsbk mfr gw if .2 .3 Ground 3 24 -33 10 r4/4 none sl 2csbk mfr gw I na .5 .6 elev. 4 33 -88 10 r4/4 none lfs osg MV na na .5 .6 10 2.05 ft. Depth to limiting factor + 8811 Remarks: CST Name: — Please Print Phone: Gary L. Steel 715 246 - 6200 Address: 1.554 200th. Mre., New Richmond WI. 54017 m02298 Signature: Date: CST Number: a� 4 -25 -96 STEEL'S SOIL SERVICE Gary L. Steel Richard Stout 1554 200th Ave. CSTM2298 SEg.SWg S3- T28N -R19W New Richmond, WI 54017 MPRSW 3254 town of Troy (715) 246 -6200 r lot #49- Country Wood l N 1 " =40' BM-= top of SW lot corner survey stake @ 100' x 5� Gary L. Steel 4 -25 -96 F wARRANYV DEED 5TEVF%J. LARSON andr4,NMY L. LARSON: W1 701X t'c_ '.k:f1t1j*tr 'Ve Or MC11ej. A i t 5 and wurauts W BRIA M W1L1AA_%1LS0% WO - 1 WD UA.%t*WN_ fi f whevieT )tv crr momi. Cowideradua of $1 1 4j tW other valuable considez.1nou. •"r following d real estate located in St Croi "j r­ nrjmr , W-, f irst Add fonn ai ;, e Towu of T roy . . $t Cru" k-­,1J ) ' vv ,jR WIFFH jmd SUBIFCT TO the ngh *S and obligation M the :otectivc C_ovem"IL.5 fr k;rucd in Dtw Nn, 543696, 'Ln tht C,ffWe Of the 5+i_ C` ►i)t? "c unity Register o. teals. LI -ility faWf-Wnt4�, hi g h way Sg&rark And ttnnporAry CW­0­&r. as �huvk­i en me Jed is Vol 6 Of naV, PAg DOC Nkv 54 - I _pilr 7 To Telep—rie R. Gr4nt reworded in Vol 4i l, PLaFe Yb ai lire tiu "4' cus rights of-wa), c--tftaum. !Q cast - s h xi of any CW1t[3Ut:q-UKt: 0 tb�c A Lie rem �)r eNpiratk w tint exzand - [) provided bN lax. _n;c!js stAtcd he rem ' I% homestead pt -)PE #v I HA t4 JA Of Apn 46 AVITU NT I r:_ AT ION ' � ' T k* I 's ls0J °+ ` P �0jrq'TIrrr, of 3trve, I I ' a rl�ct n Ta 'mi lt. y NTH' ' S I CROIX came kfort_ me this i Api I day or Apil I C)98. the above riaMed aaLl wit"! t me k-Ixy► to be thr perwln(5) who executed thr Tl NIF-MBER, STATE BAR OF )hqSC0N_S1N f j and ackilowled-ed the same, 'kit 1 _aOt , authoraed by Sec. 706.06, V is. $Wtt!j71#:i P011 NQl public s of Drafted Hy William L 'Gilbert, Attorney at Law Notary PtA--lic. St, Croix CoWisconsin _, Wisconsin ------------------------------------------ 1.. : I , 'i. i "r to I ------------------------------- - --------------------------------- ;1b"i 03 '96 10:16 ABC— •STILLWATER p, ri k4Y— 19 -98 02 :24 All P.01 aoOt *LDl!m MCLTY MUt+ t. 19vi,cs-LIP 13t3A tts2i �.IL'Tiy^i' t 47 d ' f ! ! • 2.03 •C, r; I t !� l r t I - .8 I ��• , °30, e I� �• fi r A P IT, . .00 1 . 61 Jill' OF Twe SW{/4 Ne9'09'2o'E { i I HE T 2 OF 4 SH11 TS I - i GCS l� G J 1 i I i