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HomeMy WebLinkAbout161-1094-90-000 c O 3 d o d A (D 0 v W • °-' I I 3 ^� C M I v z ° 1 2 S O I w rn �C • AI N N O U1 N N -I g W 2: 'COD O v L m" N O N CD T. (Q N C/) O +' 7 N CC O O N 7' ° co p 3 O y N W C O O CL m <➢ m a CD m a m o y W c o o � o; O CL _ _ !� cn co co O 0 r N N O W = N C c a 3 Z v v v o °f �`'� • O O O io cn co� rye ° n 3 I'3 N to N o o m � o. G w ID x N o m -' I ccn v N ^� N < 3 O \�V` C 7 _ 3 Q OZ z z ( t p D 7 t+1 v N � !\I • o g cm cn I H C O N C =r (D W CD n a d 3 O = N CD Z C n O A 2 A n r i z o m_ rn a O a_ �o m CL z 3 A o cn o 3 z I � CD A Q a � � 7 I z a 0 I � � I a y I A I � I ya tt I N ti I o A I o I b N 3 I A N O dp C.a V Q O * y CD r' �s ST. CROIX COUNTY ZONING DEPART 7 AS BUILT SANITARY REPORT •, ",\ Owner Address nr ST 1 City /State H uns ano fib, .rya /G 1 '" ,, �ONCO C Rix 9,g�q ,t `, NC OFFICE �\ Legal Description: Lot OA Block Subdivision/CSM # r, D '/, 1 '/, �, Sec. L2 , T .1 -RHO W, Town of ,�f /D. �yo s.Q A� PIN # 1 4 / _lD 45 —Se —40- � 3 .a�. � o• 7 s z SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION Tank manufacturer Size ST/PC /.Z40/ Setback from: Housee{, Well P/L � Pump manufacture_ r_ Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Ven es 'r intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: 4MLTRA9'D� Width 3 Length 75 Number of Trenches 2 Setback from: House 3 6 Well P/L I ,?- Vent to fresh air intake ELEVATIONS Description of benchmark To P /I/LU Lo T S T XS' Elevation _ / ,00, /2 Description of alternate benchmark Elevation Building Sewer ST/HT Inlet ,�� ST Outlet PC Inlet PC Bottom 1 Header/Manifold Top of ST/PC Manhole Cover Distribution Lines 9 7, 13 (,1) I� 7� /3 ( ) Bottom of System (() 93 7- 75 ( ) Final Grade (/) / oU. S 1,60, Date of installation 6" / / Permit number 3 / 6 �/� State plan number Plumber's signature - License number J 10 Date IZ9198 Inspector Complete plot plan sr a i 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 eCs _1_�e . f�.L I •.. /200 6c s r• �Pf i j ///04,S`_ r/IeA'(ems ' r �jztU� 5'64-G L j - ye, • INDICATE NORTH ARROW Wig onsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Buildings Division INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: p Y Personal information you provice may be used for seconda u ❑ r oses [ Privac a Law, s.15.04 (1 )(m)). 315842 ' m SUSAN NOag VHL�DSON wn of: State Plan ID No-: No.: CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel Fax No.: 161- 1094 -90 -000 106. 0 6 J 6 6 -' (6` ) q t @'.;' TANK INFORMATION ELEVATION DATA A9800231 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic`' ' Benchmark �� a' �.' Gov l co Dosing Aeration Bldg. Sewer Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. vent to ROAD Dt Inlet A,, Intake Septic �" v S " NA Dt Bottom Dosing NA Header / Man. q y q q -7,1 3 Aeration NA Dist. Pipe Holding Bot. System PUMP / SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Fri n System TDH Ft H Rimin L gth Dia. Dist. Towels SOIL ABSORPTION SYSTEM BED/TRENCH Wid t Len tly ( No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSION LEACHING Manufacturer: SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM CHAMBER Model Number: INFORMATION S ype O pl c. "'j , ,� � _ OR UNIT System; DISTRIBUTION SYSTEM Header/ nifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia Length Dia. Sparing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over Fep th Of xx Seeded / Sodded xx Mulched Bed / Trench CenterU Bed /Trench Edges( soil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: NOR TH HUDSON 1 233 STATION CIRCLE NORTH j_ i.,` �/. � � ��,C � T` (:.'�'h rri4��•l r�,l� U /� �.t i � r�4 ".(- � ,L �'U � � R >��" �� "(.. �..v.;,d� f a ,�. +Lr,, µ J! 1 rt . Z Plan revision required? ❑ Yes [ KNo Use other side for additional information. ..., Date . nsoli tors Signature Cert. No. SBD -6710 (R.3/97) t r Safety and Buildings Division SANITARY PERMIT APPLICATION 201 E. Washington Ave. Vi sconsin In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Department of Commerce 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. ,K0 f • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide may be used by other government agency programs ❑ check it revision to revlous 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 wv4 S 1/4, S /,2 T , N, R j e) E (or Propert Owners Mailing Ad ress Lot Number Block Number 421 City, State I ip Code Phone Number Subdivision Name or CSM Number II. E F BUILDING: (check one) ❑ State Owned il r JV02r# testRoad Public 1 or 2 Famil Dwellin - No. of bedrooms 'rown of 7A 7 /, G' III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo /6 10 -D® 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 pq 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) t Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 []Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 [3 Seepage Trench 22 ❑ In- Ground Pressure ^^�� 42 ❑ Pit Privy 13 [] Seepage Pit tt c � — 7 ❑ Vault Privy 14 E] System-In-Fill K tTti 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/day /sq. ft.) (Min-finch) Elevation ©O 43 o , ,S; . ,S Feet Feet VII. TANK Capacity Site Prefab INFORMATION in gallons Goons anks Manufacturer's Name Concrete Con Steel glass Plastic Appr_ New Existin - strutted Tanks Tanks 0o 20 El E] ❑ El ❑ P Lift Pump Tank /Siphon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plu a 's Signature: (No St mps MP/ RSW N Business Phone Number: Plumber's Address (Street, City, State, Zip Code): s S& (/ GG ojg T/� IX. COUNTY / DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (includes Groundwater ate Issued Iss in A nt S* ttrttt / / / ��� ture (No Stamps) Surcharge Fee) ` If Approved ❑Owner Given Initial � OZ� Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (R.11/96) DtSTBIBUTION: original to county. One copy To: Safety & Buildings Division, Owner, Plumber i t ! _ I : I I I Zl 1 `7 1 I ' W 4 � I Q. I s �I �j _ , A � I tip lo."i � ? /- /�T1��'TQ�S iJ i I t j I I N f 4 I ' _ _ !_... -_+ -t - i � i __� -�' � �fi� i 11f1� G I AT /= I �� L1 �• 1 fi - - - -- - � - _ I , I I I ' I i A 18, j j I w I i PApP — f l I , � i :,. i i • � I I I I : S'J I /o I P- 3 _ � TAT �r t � Y lLb I I , • /ZWirisitjo,� o SoS ( '/ i;v7-lt/lj'7- 2 - 27-cP5') /c)6---e1)v -sr- 6 y 2ozi,.. 6-• e 4T-. ao• s/•TE- to/ T. The,,..t OS o,� 9 - [a • 15 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page / of 2-- Labor and Human Relations 9 Division of Safety&Buildings in accord with ILHR 83.05, Wis. Adm. Code o yE?.S: ./fA ES 5 ,4�Ca i �o [ i-`•" N 3( LT-L A R oR . w , COUNTY Attach complete site plan on paper not ess than 8 1/2 x 11 inches in size.Plan must include,but sr• c-Ro r'x 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. /(P/ -/0 7 7 / ' 00 APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: L/ PROPERTY LOCATION g V/A) 3 l.ES//E # //i4E/1/ GOVT.LOT S(c.) 1/4s14) 1/4,S 12- T 2-17 ,N,R ZD E(or") PROPERTY OWNER':S MAILING ADDRESS LOT# BLOCK# SUBD.NAME OR CSM# 5" /3%&kri-loss- /3/4/ ie 2.Q sT.ceorx ST'A41-to,.3 CITY,STATE ZIP CODE PHONE NUMBER ['CITY �LAGE DOWN NEAREST ROAD rn,PSo� Cv/. Sz/Cyy, (7/s)36 • y�`/fl /t/o,Pr/t- gyPS-'0A- 1 Whew Construction Use [residential/Number of bedrooms 3 'i r+ [ ] Addition to existing building [ ] Replacement [ ] Public or commercial describe Code derived daily flow cpe'v gpd Recommended design loading rate • 7 bed,gpd/ft2 • ° trench,gpd/ft2 Absorption area required Y5 7 bed,ft2 750 trench,ft2 Maximum design loading rate . 7 bed,gpd/ft2 • "' trench,gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design/site considerations 5TRD'6-4�/ /PE ce7- t1 -vim c o.0 Cr- • ,u,vp pow T/PE•A..)c, S • Parent material 5C5 4/9 • P/A-/A.,'6e-z.D /5. Flood plain elevation,if applicable N•r9L• ft curcu/1 S k 5 4 D5 S=Suitable for system �CONV ZONAL m±oux IN G_ R DD ti ESSURE AT_GR�I BE❑U SYSTEM- IN FILL HOLDING TANK U=Unsuitable for system [�'S U L]'S ❑U LA'S D.S.- LE-S O U ❑S abl-' SOIL DESCRIPTION REPORT Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. Beded Trench �. / o-13 t oV �/,Z f j aM Ground w,A- ere - / elev. y/P.4vE// C .S. /oo.3o ft. 3 Z o y� s yR /� ( �,�, s� . 44,1,E..... c $ . 7 . 6) Depth to 96 '19c /O y - . 7 • 5' limiting y y� /� � s rs � � — factor 1, Remarks: Boring# liPME FikiiNg Ground ORIGINAL , . elev. ft. Depth to . limiting factor Remarks: CST Name:-Please Print go Qe ,r._. .0 L13 p t• C 4 r_ Phone: 7/573 pG • s/c:R5-- Address: (e 5 5 0 i N k'I.L ¶ O - H upS 0,� to I•S . 5 Li (o C5 %4/ 2 5/cf'2._ Signature: Date: CST Number: T41/(A* ileik i'CAAcef-- /¢S /pES v LT D f" A5C.•!rAo,.v i/✓A or- /3,4c� e /3/'7- G : ( o R' o/ -#' y .t °Tom a/Pi -,'t4 L 7 7 rt;PE-,yL G Airs c io p/ fv ;Jo 3 Pi x �s " ;s do w �,„6 c� f°4. IE•o / itii q o ? r ' ' ��y E��,4�s�� - 4-7/o�, 7o� � ' cr:-.: c" 1 a-S h l( ('' 4/4� s ys 7-E�5 C �,rJ s 4 o s rof��Aie ��/PEuT co��s � 4,�/-PC . k() t 4 PROPERTY OWNER SOIL DESCRIPTION REPORT Page of PARCEL I.D.# Depth Dominant Color Mottles Structure GPD/ft2 Boring # Horizon Texture Consistence Boundary Roots in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. Bed Trench ...:........::::. Ground elev. ft. Depth to limiting factor Remarks: Boring # 11 Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # j v ;"' Ground elev. ft. Depth to limiting factor Remarks: CDn eoonio nc/nrn r ti -- __ Alt''6-A 73o/(1 'S /f Sp AGT- - -- ----------- i I RE/oCATkO : / " z P /¢7- No/? CeiC5 7- L v T / �ogN&,e - E ie-vh 7-7o.4.) = 7 0 0 . 0 o _ _ f- yy' ilt /3 Z 2-61 ' - r /3 rC ( t. 38' 30, _ yy I/ I+ i— 85' ---— 0 1 ! 30' i ,f. 1 o • 3 1: h W 0 H Ili 1 SUGbE 5 T 1) `,- SYSTEM i � /�v�4 TronJs 7s 5 7 ! I 1 5C4L6-- . I `i - 3o • - /34 cA'A oe lairs. E1-LUAT(OK3S •••••i. o ' 7y. 7(0 1,6 (3 z /oo. 3 y 3 3 / 00, cy R , /co • zs, \ (3 S /oo, 32_ I (3 /00 , 30 W � \ 0� -- P 2 es. Z J Go%NTF"P TE$T cot»,7/out. Sv t),4.)y� No cwND .?3 Off' .2fo f/(�7 . ' DEARTMEI\IT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUST?Y, DIVISION LVAEi0R AND PERCOLATION TESTS (115) MADISP.O. BOX ON WI 79069 HUMAN RELATIONS s j (H63.09(1) & Chapter 145.045) LOCATION: SECTION: 'TOWN3I III'/MUNICIPALITY: 'LOT NO.:BLK.NO.: SUBDIVISION NAME: 5c ) 14 1/4 /2— /T29 NCR 20E (oW A/O, //vose i z 8 s--/Cpofx sT 7' ,t> COUNTY: • eitottEtrt/BUYER'S NAME: 'MAILING ADDRESS: 574. cA00/4( SAi/,COA CU1•T re/< c/o . 7/e/if Ad/3,f" N0•10‹,3C/M '4 Ce)/s, S re,/.6 USE DATES OBSERVATIONS MADE I � , NO,BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: i ee�i N• 1New ❑Replace -Z 0•2 7 ,-es! .Sjf 4,-tom_ AA-A '''),Iiii'� TINQX i able for stem U=Site unsuitable for system �C s ( 414 i VEN 'I1 ND.; IN-GROUND-PRESSURE: -IN-FILL'HOLDING TANK: RECOMMENDED SYSTEM:(optional) , 1.e 4_ ; s S U X. s u n s kill —is Eu a� T; v ;f_ /�'4/36 V\, ?urcolati Tests are OT equired DESIGN RATE: If any portion of the tested area is in the 9'i d'e 3.09(5)( .d/ate: CG,4SC _� Floodplain,indicate Floodplain elevation: (J i 1 rt,t PROFILE DESCRIPTIONS ,AS "7tCi r4,0_ f'+` • BORING TOTAL ELEVATION DEPTH TO GROUNDWATER CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH NUMBER DEPTH OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) 7.0 " 7.. ?-te- > , .s8•.ae,a,,,�.se /, /o ' AA,, /S y. yZ ' ,3- B �� l> cs ; GAP. w,4c, c,-e,- / o . 714 es -' 6-, . / ) • //7' Qa. 5eut.8t'/s .67'40- qs L /S .2.i7 eke, CS B 2- D /oD.3 y 7 D c . "/ &-&- 3.o Ziti C5 - iao_ G.,e , f /.yl, ' Dp 0,..,• cu t S-e. /s /, fa ' .& <62, /s 4 Dom- 'Al, B- 3 7S /o 'Sf 7S /61' oe.cs o G,e. w'//3N c,• 30 7f0 e,s '' 7i , ' . 7S 'At.(a..). �tt g t ,Q. /s, /,ds . ec�wj e /s, 2 ./7' al.CS B- X 7 3 /c& -i /v-- > 73 J,4E-.s 6.e. , .3./ r,+N Cs tV.0 . B-..c 7 2_ /00.32. Au-- 7 2 ' 1.02 ' e'. CS M - e y Cd-G- , i .2 ' i.*,v CS PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH P- iN e5 5T,fii.f COW 744/.41/,v T''' A'�/.K!. �..ra., • . ' . , 6 ,f 0 ' • M. P A Z . /,,) Les P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM 60 TTO'-t � /2 ^ exC7ft)I7 'i) 7 ELEVATION ( '0-�11- So Mrs e kS — ve,er,w fief /0 / „ s w GA-ND'", 'or /,e ). /eD ' � etavArio-) 00R - /00. C fr• kieATTO � CE �I .+o �� d or, $4Ct, ' (30, 4-5 . .. 3 a- ,s' •_• N / t-G S/'T�S 8, 4 X P, P'y i o N TAT,i e-4, 0-L r) TN '\ e5 _X_3 k t�*-sT- Z. 3 ta)-- This test site APPROVES �,� . k for a conventional septic systCm. ,, 1 I I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WARE COMPLETED ON_ R°B AT 1(68,P/. 7— �lr E 9 vQ ADDRESS: • CERTIFICATION NUMBER: PHONE NUMBER(optional): ,eT 3 , dam, �, Ei L PS • ,/—/oDsoA) - &2/s • 5 / /�O $3-0 2 y9 2--- 326 8/83 S, e t'a'r,,2e 1/' , ,/(� 7GXzvrt iv6{ CST SIGNATURE: S a.8•rr, b y Sc4 CL/6r-ic. "-re - , DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) —OVER — ST CROIX COUNTY _ SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer s`� a �� �,-� <�°•� v t- p r Mailing Address - Z33 S 1 ArroN G 1,2. /1/'C Property Address L c, r z ' • * ` .1 , T (Verification required from Planning Department for new construction) City/State K;; c�. H u rl -S U Parcel Identification Number 4 I - 1 � q 4 - `� U - 0Ci LEGAL DESCRIPTION Property Location -.5 %., W %., Sec. I �.. T -R U W, Tevtn-of NL r-ii, Subdivision 6 I C 6 t x " :)1 C A t c ►� T ,rG a2.73 . Lot # Certified Survey Map # 2� -A > l; 3 , Volume . Page # 313 Warranty Deed # S 7 Y9 7 - 2 , Volume 130.5 . Page # - 36 Spec house ❑ yes g no Lot lines identifiable yes ❑ no SYSTEM KAINTENANCE 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, joumeyman plumber, restrictedplumt=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. 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 z �:. � fo od 57 49 17 STATE BAR OF WISCONSIN FORM 1- IW- j WARRANTY DEED DOCUMENT NO � �.- __ - - -- This Deed, made between JAMS V. SHITH and SHARON M- J S�. env hr CO.. W1 SMITH, husband and wife 13 i _ Gtraaaa: ' — 9:30 ` A M and SUSAN SHURTLBFF �'•� taJ.1aL. I� 1j Witnesseth, Tint the mid Gtaram for a vandble aocei� '• I4 r JS SPACE RESERVED FOA RECOMN3 DATA - -- - _ ! described ral estate is St. Croix conveys to Grantee the I011 ming , O VAIE AND R ETURN ADDRESS - County, State of wtscDnsin DAVID J. ESTREEN i� 304 LOCU I 54016 HUD�ONt !} 161 - 1094 -90 PARIM 0ENTiFICATM MPMER Lot 28, St. Croix Station in the Village of Nort Hudson. St. Croix Cotmtq. !� M2SFERR }� is n homesteW property ibis ii i � Together with all and singular the hereditamems and appu rtcnanacs dwreva- bdon0n& And James V. Smith and Sharon M. Smith war that the title is good, indefeasible w tee simple and free and clear of �es ercccpt none il ij I and will warrant and Mend the same. i 19 }' Dated this 12 day of �} (SEAL) ' (SEAL) TH (SEAL) %i . cvnsr�tm tw SMITH � it I ACKNOWLEDGMENT �I i! AUTHENTICATION ! Stage of Wisconsin, }� 'j S*Uture(s) ss j jt CKn cante before me this �1 a� II authenticated this day of • 19 — , 19 98 ,�haliaMe runkd Mar J V. Sm ith and Sharon th TITLE: MEMBER STATE BAR OF WISCONSIN (If not. to be the person 1 56 •'t€ authorized by $706.06, Wis. StatsJ w tae 1r Ewa e perso — ._ instnumma and the same Z �, ST. CROIX 343630 LOCATED IN GOVERNMENT LOT I OF SE 1/4 0 F THE SWI/4 OF SECTION 12, AND T HIGH WATER SHORE LINt ON 2/18/77 0 F SECTION 13, T 29N, R 2OW, VILI [LEV 693 WATER ELEVATION 674.7 U.S.G.S. 1929 DATUM 674.5 - APPROXIMATE Low VI LLAGE _ AT . 4 ELEVATION TM EN IRO AVUE AS o1.ATTEO. 1893, PLAT Oi NORTM ENO, S� 116 9 �� 57' 14 E 674.7 -WATER ELEVATION _"� _ _ _ -69.0 _ FEBRUARY 16.1977 . MN i •_: S' _$ _ 111.74' Iwa3' j . 11 ��• 239.65' 1,t. 110 .47 171.22 352.27' e �/ �� / e �sr 2� 194.7 7' /.4 ti 'd4. 281 69' s O• i / / I N 75• 12 0 1.04 ACRES ! "I / �/ / 10 10 1.53 ACRES a�s� .e, �� / L r , 10 ry 10 11 ° �� •, 4 / 1.52 ACRES a N J J 4MT/ 3i +Ji• - O 2 c�' 2 k, �� 170.Oe'1? 2 7- C*LINr w� 01 3O O 1 /' 41 9 100'SY N' GRAIN O r p �sA� fAil• N / /�i / % •� \`\\ ' 9 �y7 N88.34 W 13 / /�'� �' \ . $y�7 ACRES y d 6 100.00 S 60' 1 1.60 ACRES ; ` \ . 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