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HomeMy WebLinkAbout006-1000-50-025 Q c ro ° o O ~o bq o I tr ~ c 0. 0 a ~ I `e I o ~ 0 N r.; N I L I M ° N N c a O Z t0 LL C U O ~ . m I a I Q N M C z N co z o o z w a co H Z c o I 76 o z :t aUi z j ° o to I- 0' as E N ro 0 N 0- (n W O •MV d CA c - p ro Q z 00 z ° z N _ a ° c -ii U) E N a N a w m y 4 m L I ° 'a ° 0 0 0 z° •rNNV m v m a a a a ry I N J U U rn rn z My o rn aai o N_ 0) a) t-' u- 5 0 0 O 3 M 1 m y N ms, Y) CD 0 d Q } {f) Q N w to a O N C C -0 E O p a N C O 00 r O C O Q) C N CL ° O O O o C a) CO 00 O r F- 0 0 0 7 N Sri C Y MO N I- aal 07 • P> O M N O E U O O U > N O N Z U) 0) a o. •C~ O. Z V d y C `1 A 0 a O in u s " . Parcel 006-1000-50-025 02/23/2007 09:40 AM PAGE 10F1 Alt. Parcel 01.31.16.5A 006 - TOWN OF CYLON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 07/12/2006 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - WITTSTOCK, TAMRA L TAMRA.LWITTSTOCK -OI K/ST CROIX CLEAR LAKE WI 54005 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 1127 CLEAR LAKE SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE SEC 1 T31 N R1 6W 45.02 AC NE NW FRL EXC S Block/Condo Bldg: 99 FT Tract(s): (Sec-Twn-Rng 401/4 1601/4) 01-31N-16W Notes: Parcel History: Date Doc # Vol/Page Type 07/12/2006 829437 QC 04/25/2003 718780 2218/379 TI 09/29/1997 566003 1266/479 TD 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/13/2006 Description Class Acres Land Improve Total State Reason Totals for 2007: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 02/23/2007 09:40 AM Parcel 006-1000-50-000 PAGE 1 OF 1 Alt. Parcel 1.31.16.5 006 - TOWN OF CYLON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 07/12/2006 00 6 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - WITTSTOCK, RETIRED RETIRED WITTSTOCK Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 1127 CLEAR LAKE SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 45.020 Plat: N/A-NOT AVAILABLE SEC 1 T31N R1 6W 45.02 AC NE NW FRL Block/Condo Bldg: (SPLIT) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 01-31N-16W Notes: Parcel History: Date Doc # Vol/Page Type 04/25/2003 718780 2218/379 TI 09/29/1997 566003 1266/479 TD 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/13/2006 Description Class Acres Land Improve Total State Reason Totals for 2007: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 STC - 104 AS BUILT SANITARY SYSTEM REPORT o OWNER ADDRESS SUBDIVISION / CSM# .r: LOT" SECTION I T 3__1 N-Rj 4_W, Town of ST. CROIX COUNT-Y, WISCONSIN PLAN VIEW SHOW EV RYTHING WITHIN 100 FEET OF SYSTEM 30 q& INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. f BENCHMARK: ALTERNATE BM:~ f,- /0 SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer:- W4A Liquid Capacity: / elo 0 Setback from: Well MENOW House / Other dvnmww~ Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: Length / Number of trenches I WOW Distance & Direction to nearest prop. line:- Setback from: well: ..f House Other . ELEVATIONS Building Sewer ST Inlet: L / S 3 ST outlet: PC inlet ! PC bottom 400ftft- Pump Off Header/Manifold Bottom of system Existing Grade Final grade o DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/93:jt Wisco#idin Department of Industry, PRIVATE SEWAGE SYSTEM County: • Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 299030 Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.: WITTSTOCK, RODNEY CYLON CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: w , " "-13 A-1 iJ< 006-1000-50-000 TANK INFORMATION ELEVATION DATA A9700348 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark ' Aeration Bldg. Sewer Holding St/P Inlet S .Ld TA K SETBACK INFORMATION St/,!' Outlet ' TANK TO P/ L WELL BLDG. Ventto Air Intake ROAD Dt Inlet Septic >-_D~ NA Dt Bottom Dosing NA Headers /Q~ Aeration NA Dist. Pipe HQ,Wj1 g Bot. System /D.OS PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Loss ction Sy"em Ft Head Forc n Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width I Length / No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS &G DIMEN - SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING actur~c'° SETBACK CHAMP Moe Number: INFORMATION Type O pr,,- C ,,,i System: be c/ - OR UNIT DISTRIBUTION SYSTEM Heade M Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length _L~Z Dia. Length 3 3~ Dia. Spacing ~o SOIL COVER x Pressure Systems Only xx Mound Or At-Grade S Depth Over i, Depth Over , xx Depth Of xx Seeded/Sodded xx Mulched Bed /Trench Center r; Bed /Trench Edges- Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: CYLON 1.31.16.5,NE,NW 2509 POLK/ST. CROIX ROAD T ~ , Y, Plan revision required? ❑ Yes a' o Use other side for additional information. SBD-6710 (R 05191) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH . SANITARY PERMIT NUMBER: Safety and Buildings Division SANITARY PERMIT APPLICATION Bureau of Building Water Systems 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 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. Si. C4'G ] • 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 E] Check(~revisiont1pous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION Property Owner Name Property Location L )E 1/4 1~)v4, S T N, R j (p (or) Property Owne ' .Mailing Address Lot Number Block Number City, State Zip Code Phone Number Subdivision Name or CSM Number IL TYPE OF BUILDING: (check one) ❑ State Owned ❑ qtyage Nearest Road r r ~ E] Public 1 or 2 Family Dwelling - No. of bedrooms ❑ VIl Town of I-C~ 5f• III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number s) 1 ❑ Apartment/ Condo C<,t loc"(7 - `_j 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- EX 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 [A Seepage Bed IP X3(r 21 ❑ Mound 30E] 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. 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./inch) Elevation ~4 JC_~ Ll t y P q-1. 70 Feet Feet VII. TANK Capacity Total # of Prefab. Site Fiber Exper. INFORMATION in 9 Gallons Tanks Manufacturerrs Name Concrete con- steel glass Plastic App New Existing strutted Tanks Tanks / Septic Tank or Holding Tank 1 DUG ❑ ❑ ❑ ❑ ❑ 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 sSignat :(NoS s) /Nt1Vt~itlo- Business Phone Number: Plumber's Ad ress (Street, City, State, Zip Code): IX. COUNTY/ DEPARTMENT U ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Issued Issuing A ent Si s) Approved ❑ Owner Given Initial ~J~/Surcharge Fee) Adverse Determination 01&" ~ 7/~S! `7 - ✓ X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SHD-6398 (R. 05/94) DISTRIBUTION: Original to County, One cnpy To: Safety & Buildings Dim.ion, Owner, Plumber INSTRUCTIONS . ' 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe 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, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. 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 is to 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 8 112 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. R s IVE_Nta - S,-713/=~l~u~ y ,?o 36 1 ~ r 3 ~ iac O O ~ ~ x t tA 80 M s Wiscorisih Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code - - COUNTY Attach complete site plan on paper not less than 8 =V s rrr§iie-.f must include, but St Croix ~ PARCEL I.D. # not limited to vertical and horizontal reference poi' directs and % sI e, scale or dimensioned, north arrow, and location and dist 46vonelst3lr q>i 006-1000-50 APPLICANT INFORMATION-PLEASE PR N _~ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: N PR TY LOCATION Rodney Wittstock f J~X G OT NE 1/4NW 1/4,S1 T 31 N,R 16 Odor) W PROPERTY OWNER':S MAILING ADDRESS BLOCK # SUBD. NAME OR CSM # 62 50th. st. na 45 acres CITY, STATE ZIP CODE PHO CITY [:]VILLAGE ]TOWN NEAREST ROAD Clear Lake, K. 54005 (715)2 lon Polk-St. croix Rd. ic] 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 .7 bed, gpd/ft2 .8 trench, gpd/ft2 Absorption area required 64, bed, ft2 963 trench, ft2 Maximum design loading rate ___7 _bed, gpd/ft2_,-8__trench, gpd/ft2 Recommended infiltration surface elevation(s) 97.70 ft (as referred to site plan benchmark) Additional design/ site considerations alt site system el.=98.80, Parent material pitted drift plain Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem CR S ❑ U ❑ S K1 U [RS ❑ U ❑ S ®U CR S ❑ U ❑ S 7 U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Roots GPD/ft Boring # Horizon in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. Boundary Bed Trench 1 0-4 10yr4/3 none sl 2msbk mfr cs 2f .5 .6 2 4-17 7.5yr4/6 none sl 2mgr mvfr 9W if .5 .6 Ground 3 17-82 7.5yr4/6 none ms Osg ml na na .7 .8 elev. 102.1 ft. Depth to limiting factor +8211 Remarks: Boring # 1 0-7 10yr3/3 none 1 2msbk mfr cs 2c .5 .6 2 2 7-24 10 r4/4 none scl lcsbk mfr 9w if 1.2 .3 MEMO 3 24-80 7.5yr4/6 none ms Osg ml na na .7 .8 Ground elev. 102.00 ft. Depth to limiting factor +8 Remarks: CST Name:--Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 200th. . New Richmo d WI 54017 Signature: Date: 8-7-97 CST Number: m02298 PROPERTY OWNER Rodney Wittstock SOIL DESCRIPTION REPORT Page of 3 PARCEL I.D. # 006-1000-50 Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench 1 0-5 10yr3/3 none sl 2mgr mfr gw 2f .5 .6 3. 2 5-14 10yr4/4 none sl 2mgr mvfr gw if .5 .6 Ground 3 14-88 7.5yr4/6 none ms Osg ml na na .7 .8 elev. 101.8 ft. Depth to limiting factor +88, Remarks: Boring # 1 0-6 10yr4/3 none sl 2msbk mfr gw 2c .5 .6 4 2 6-24 10yr4/4 none sl 2mgr mvfr gw lm .5 .6 3 24-80 7.5yr4/6 none is Osg mvfr na na .7 .8 Ground elev. 101.1 ft. Depth to limiting factor ±Rn ' Remarks: Boring # 1 -6 10yr4/3 none sl 2mgr mvfr gw lm .5 .6 5 2 -25 7.5yr4/6 none is Osg mvfr gw if .7 .8 3 5-80 7.5yr4/6 none ms Osg ml na na .7 .8 Ground elev. 100.7 ft. Depth to limiting factor +8 Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel Rodney Wittstock 1554 200th Ave. CSTM2298 NE4NW4 S1-T31N-R16W New Richmond, WI 54017 MPRSW 3254 town of Cylon (715) 246-6200 T N 1"=40' BM.= nail in Aspen tree @ el. 100' Alt. BM.= nail in Oak tree @ el. 100.30' /320 ' Lei 3~ f v4 k a ~s to ' O~o `6 I p zm~ tik o ~ ~ \q/ q0 ~.Z -Zo lost of Gary L. Steel 8-7-97 STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER MAILING ADDRESS f i2 e o'L I PIZ, fir PROPERTY ADDRESS (location of septic system) please obtain from the Planning Dept. 0 CITY/STATE C~/ 1 ol~Z~✓'_ PROPERTY LOCATION L -1/4, 1/40 Section , T._L N-R_J-(a_W TOWN OF , ST, CROIX COUNTY, WI SUBDIVISION , LOT NUMBER CERTIFIEDSURVEY MAP , VOLUME PAGE , LOT NUMBER 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 licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system' St. Croix County residents may be eligible to receivo a grant fdr'n maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system Is in proper operating condition and (2) after Inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix--1 County Zoning Officer within 30 days of the three year , t' date SIGNET): DAB: ~•-`r ~ ~ ✓ . St. Croix County Zoning Office Government Center 1101 Carmichael Road 11/93 Hudson, WI 54016 S T C - loo This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/ contractor, (spec and should be to retained and complbted with when house) , then a second form the property is sold appropriate deed recording. owner of property e Location of property NjE- 1/4_ lam(-1/4, Section W r.4, 57- Township Mailing address ~n - C,o-. G, Vt- Address of site ' Subdivision name Lot no. other homes on property? Yes No Previous owner of property a cs C~- e r✓ cLoR ~~~~d r Total size of property 160 Total size of parcel Date parcel was created q'7 Are all corners and lot line identifiable? Yes _No Is this property being developed for (spec house) ? Yes No Volume and Page Number as recorded with the Register of Deeds. 7 Z-----•--.I ---------J---------------- INCLUDE WITH THIR APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. if the deed description references to a certified Survey Map, the certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in thq office of the county Register of Deeds as Document No. 7~__, and that I (we) presently ewage disposal system or I (we) own the proposed site or the sewage' obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of the county Register of Deeds as Document No. _ 1 ican Signature of Applicant l P ~t- D ate ~ `ems~aSignatu-re' I / Date of Signature ~ nG Wa. Q.~o.nr DOCUMENT NO. `ATE BAR OF WISCONSIN-FORM 3 ,y ~.:r~1'~ QUIT CLAIM DEED 650 jPACE RESERVE-- DP REC i)RDING DATA Rodney Wittstock and Nanc' a a_ "EG4STERS OFFICE Wondrch1 s tena tg in common ST. CPolx CO., W16, - Recd. fol c-c )rd this 2 quit-claims to The George and Florence WlttiCQCk --Family Trus- - - ~ a Rodney Wi day of August A.D. 198'3 t t s t o ~t~i e~ _ _ - - fit- 8 : ? 0 A . M. the following described real estate in Courtrv "tom of State of Wisconsin 4F-UAH TO i r Tax Key No. The Northwest Quarter (NW 1%4) of Se(tion One (1), ?tea.->>-ip Number Thirty-one (31) North of Range Number Sixteen {_161 West. i This conveyance is fee exempt according to Wis. Star :7.25(9) 1 This. is not---_ homestead property 01A 1 is not)) Dated this f C~ da% of - .C,1x 19 - $Z (SEAL,) (SEAL) R odnev i tt ,E t i c k (SEAL) (SEAL) Na•lc•; 2rh AUTHENTICATION ACKNOWLEDGMENT a Si nature, auth nticated this - day of STATE OF A ISC'_ %SIN I 19 82 ' SG Couni,, Pers_na_:. 7-_17.e Before me, this - day of L. J ebst2r the above named TITLE! MEMBER STATE BAR OF WISCONSIN (If not, authorized by `3 706.06, Wis. Stats. ) This instrument was drafted by rJ to me kn,--x , the person Aho rxecuted the fnre- L. J. ebster going rn-?r_ _ d ackno,x'p-3ged the same. 30 W_ Main Strout RIVER VIEW HOMES One mile North on Hwy. 46 ■ Sherry Gilbertson P.O. Box 222 Amery,WI 54001 BRINGING AMERICA NOME BRINGING ATRI(A _FUN. Office: (715) 268-9500 Fax: (715) 268-7057 QUALITY MOBILE HOMES ea I 1o KASTEII IEIIlIY KI/CNEN i 1 , qti-IOo lEp100N y1'. t':.j' 11' t!N ~i' °T v u..el« won 1 no ; 610400M K"00Y DING ROOM oEN „ 1.3 Ne. 1 t0' if F IT fl I B2%CT/SB28 18EDROOM - 211ATNS -CATHEDRAL TNRU-OUT 11,474 SO.FT.I OPTION DEN INTEGRAIRWELL es Include: All Hom • Vinyl Windows Residential Exteriors' • Oak Cabinetry *'OSB Sheathing • Glamour Baths * Full 15-Month Warranty • 6-Panel Raised Passage Dooors * Much, Much More! DELIVERED AND SET $44,900