HomeMy WebLinkAbout016-1079-95-100
STC - 104
IN
AS BUILT SANITARY SYSTEM REPORT
RECEIVED
OWNER_ Nov
G ST CNTY
ADDRESS X23 Cri{ IN
J ZONINGOFF CE
~v/~Nh✓0.'.2t7 GSTY 1~ 1G SyC)I ~ LP
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SUBDIVISION / CSMI
LOT ~
SECTION 3_(,_T' Se' N-R /_,Z'-W, Town of
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 00 FEET OF SYSTEM
-~U `
P"PJ~c
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16do 0A,
l5'
)7-5 ~ ~-1 'l !1'tdc'itJritJDeC~
3X 7:5., INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK: / n
ALTERNATE BM:
SE~TAMN PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: iquid Capacity:
Setback from: Well House Other,
Pump: Manufacturer - Modell-- Size
Float seperation Gallons/cycle:
Alarm Location -
SOIL ABSORPTION SYSTEM
Width: Length Number of trenches
Distance Direction to nearest prop, line:
Setback from: well-: 463 House Other
ELEVATIONS
Building Sewer f ' y
_ ~Iq•~l ST Inlet: ST outlet: cl~',q$''
PC inlet - PC bottom - Pump Off _
Header/Manifold Z Bottom of system q7241
Existing Grade Final grade -
DATE OF INSTALLATION: PLUMBER ON JOB:
LICENSE NUMBER: 01211 INSPECTOR: t 71
3/93: jt
Wisconsin 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 299124
Permit Holder's Name: ❑ City ❑ Village Town o : State Plan ID No.:
TIMM, JOY GLENWOOD
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
r'DD' / 00 -to ✓ D + Q 6 5--_1 n
TANK INFORMATION ELEVATION DATA A9700476
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic AA V,/ Q I Da o Benchmark ~.2°t )o3.2q ! DD .AD
Dosing
Aeration Bldg. Sewer .`~D g4.3R
Holding L' Mrlnlet ~.oo Z
TANK SETBACK INFORMATION S Outlet 41.3 q~.q q
TANK TO P/ L WELL BLDG. Ae Intake ROAD Dt Inlet
Septic 4 t / k, (~if Z p NA Dt Bottom
Dosing NA Header /Man. •75 q g Sq
Aeration NA Dist. Pipe ir g• q9
Holding Bot. System 6.417 47.2
PUMP/ SIPHON INFORMATION Final Grade Zr qq • De /
Manufacturer Demand
Model Number GPM
TDH Lift Friction System TDH Ft
Forcemain Length Dist. To Well
SOIL ABSORPTION SYSTEM
BED(TRENCH) Width f Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIM 2 DIMENSIONS
urer:
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING ManuXN
SETBACK
er:
INFORMATION Type Of CHAMBER
16 ' 3V ~~~/e CHAMBER Mod mb
System py~ (0
DISTRIBUTION SYSTEM :5\devj*4,e ve" 0\M~crS
Header/Manifold 3t x Hole Size x Hole Spacing Vent To Air Intake
Length Dia. Length G ZS' 9+a. Spacing [j /
S~ 7
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx De/pthf xx Seeded / Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges Topso❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, c.)
LOCATION: GLENWOOD 36.30.15,NW,NE 3237 COUNTY HWY "G"
I~ IM~+n of- (rve.•r ~ 6eeoj 6VGf -}hG 1✓1I~~ ~~~~5 .
Plan ~revision (requirreed? ❑ Yes ❑ No
Use other side for additional information. It tZ
1q71 F SBD-6710 (R 05/91) Date Inspector's Signature rt.
r
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
I
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SANITARY PERMIT APPLICATION
COUNTY
In accord with ILHR 83.05, Wis. Adm. Code
STATESANITAR PERMIT#
-Attach complete plans (to the county copy only) for the system, on paper not less than
8% x 11 inches in size. ❑ Check if revision to pr sous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPEBIY OWNER P.R'0 lf E'ggTY LOCATION
d C ~tW14 'I/4, S36 Z. U, N, R S E (or
PROPEFjTY O ER'S MAILING ADDRESS LOT # BLOCK #
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CS NUMBER
/ _3
CITY NEAREST ROAD /II. TYPE OF BUILDING: (Check one) ❑ State Owned VILLAGE . - rG 1'
❑Public 01 or2Fam.Dwelling-#ofbedrooms -3 ARCEL TAX NUMBER(S)
111. BUILDING USE: (If building type is public, check all that apply) Qv 3d . S
1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 70 Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 80 Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 130 Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. 7-New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.E1 Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit 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 Seepage Trench 22 ❑ In-Ground 420 Pit Privy
13 ❑ Seepage Pit Pressure 430 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~(s. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Q ELEVATION
L15-z) -7 C.3 t Z co ( c 2 Feet 991 Feet
VII. TANK CAPACITY Site
in aTotal # of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name oncretCon- Steel glass Plastic App
Tanks anks structed
Se tic Tank or Holdin Tank Q~F Jac(
Lift Pump Tank/Si hon Chamber
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plum is N me (Print): P1be ' Signa re: (No tamps) rP PRSW No.: Business Phone Number:
L4 Z4,
le4e-123 ~
Plumb 's Address (Street, City, St~te, Zip Co
6
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sa itary Permit Fee (Includes Groundwater Date Issued Issuing Age Si ature No
Approved ❑ Owner Given Initial y Surcharge Fee)
Adverse Determination X. CONDITIONS OF APPROVALIREASONS FOR DISAPPROVAL:
SBD-6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be renewed before the expiration date, and at the 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 ovinership 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 when;ver 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 & 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 syste n is to be installed.
fl. 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 in 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 in ##1-7.
VII. Tank information. Fill in the capacity of every new and/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% 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, ground-
water contamination investigations and establishment of standards.
SBD-6398 (R.11/88)
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Wisconsin Department of Commerce ND SITE EVALUATION
Division of Safety and Buildings Page of 3
Bureau of Integrated Services ~II:s2 ILHR 83.09, Wis. Adm. Code
County
Attach complete site plan on paper not less th X111 ' ritust
include, but not limited to: vertical and horizo ference irectign.
percent slope, scale or dimensions, north I and distance to t road. Parcel I.D. #
197 ! vl~ --l~►~g _ 6~ ova
APPLICANT INFORMATION - Plea int alley*Non. ! Reviewed by Date
Personal information you provide may be used for urPoe~ w, s. /S ) (m)).
Property Owner Property Location
Jo ' ! m 1 6 Govt. Lot 1/4 1/4,S T 3O,N,R IS- Er(o W
Property Own s Mailing Address Lot # Block# Subd. Name or CSM#
IV/ I a(v 3 3 :k S re - A] A- nt,4 AJ #
City State Zip Code Phone Number El City ❑ Village 19 Town Nearest Road
iwrtir•1 W J- (?IS)a65=7v1~ ehwao Gour~
New Construction Use: Residential / Number of bedrooms Addition to existing building
❑ Replacement ❑ Public or commercial - Describe: _
Code derived daily flow L gpd Recommended design loading rate S bed, gpd/H2 d - (o trench, gpd/ft2
Absorption area required 'q D d bed, ft2~ i~trench, f0 Maximum design loading rate 0- bed, gpd/ A--j(p-trench, gpd/ft2
Recommended infiltration surface elevation(s) 01 • OL ft (as referred to site plan benchmark)
Additional design/site considerations
Parent material Flood plain elevation, if applicable A1# ft
S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank
U = Unsuitable for system ®s El U Cgs ❑ u IRS ❑ u [as ❑ u ❑ s u ❑ s [R II
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
1 l 6-9 6 -YZ 31a d s; t 'n I- b k YY\ V C s !~1 -s o.
a 19-I 16 Y125-1 3 :511 a- rn !>bk rr tj 4 ` Lt-' 0.5 (v
Ground I y-.v , SYrz cryu i a m 5b k f Jr a c j 0$: 6.
elev.
s b k m i i- C o '1 :6.8
qUft. q 26.4 7- _U Y N new I s 1 M
5 5 W► rr Gr.~l D. , d$
Depth to 5 ~S'SS I U i2 J1, now
limiting to /l~'ffz S C~ QY L 5 r.. 5 ('i k vr.V YY
rector
i 15 H. Q, v b
~~in. 2 -70 D L02 I/3 /0L( P2 7/
Remarks: 70" tel- a "10+ a4 b 5" .L
Boring# A' as 4 •S 'D•(,
1 6-Y lD YR I +1 50"I S b k M
a F-13 v Y2 31-3 A(JY C 51 ( Zk n,s b k rv►i1 rr f) I-f . S: -('0
3 3-I$ i6vZW4 f) (IN a rti,sbk 'n r cw I-F D.5 : a(P
Ground lva$ lOYo2 (3vn5 6 k &5 ,d-(o -3/t, Klew
elev.
31 1oY*1 n I s 5bk r„uPr c;,~ e-6
fc
!-y 0 2 58P S 5 M1 cr,✓ dt d S
Depth to
limiting 7 yla-(10 /0 1.5 I +ns 61k m vii G,uJ - d• v g
factor g o 1,5 10 S'►2 Jro Hari! s J a «,s b k MV G S in. Remar s:
CST Name (Please Print) _Signature Telephone No.
Tho a 5L rn '71S'-448'- l 3q
Address Date CST Number
r4 1-5gSO 8376 S4--L,4 ~eu; Atkbutn, u)2 54757 2-5" 97 1119,74019
SOIL DESCRIPTION REPORT
PROPERTY OWNER JoU , r M M Page a of 3
PARCEL 1.134
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots Geptft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
3 6-9- 6 ItR 3( nelw 3171 in s bk m as of
$-13 /G y2 3 3 r) &-VLP 51-1 Msbe rrJhr a-w If 0-y :o-4=,
Ground 3 13-X (d lU s % 1 a H, s o k m i- C uJ l 0• - : O< (Q
elev. ~..JI
U-Laft. _ag , S y • ~
s l 59- m V - • -7
$ - t17 /0 ~,e 5-14, drug s M/ cc✓ - 0--7: o -(y
Depth to n
limiting (p 7-&( V vik 1( 4i i)OYa 15 I m 5 bk m vPr- c4-✓ - •7 6 8
factor ~.5YR s/ir
L- in. S Qv/l o a mS rn ~.S ' 0, (,p
Remarks: (S" GJa tc(
Boring #
0- 10-3j( sr ( a sbk mU r as m aS , alP
c} Q- S )Q 25 3 d 5i1 m56k mVJ r c,--f,) I -P
3 is--Ai iotiw- c4/& sl l ~.sbk wlPr cuJ s -0,40
Ground L.I 7-3 /Z (Ic Is m v ~'r C. W
ev. s m e r.~ 4:7 0.8
~ft. 5 3q-V U 4 ~ pane
(e 6g-6 4 161-fe h ova 15 rn s bk m v ccj-J
IDm ng '1 (D 3 DYic Sl8 s h►56K ,'r~ U - - OS; G r!o
factor
i-in. Remarks: wd-~ (
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
Boring # I o v- 31a 11 d k MA-
D, S 1 d (v
S ;
-13 ) o a,; unp 1 Msbk mA- auk 1 0, to
3 3-d0 7,5Ixq co 50,1 MSbk ((11 U) I 5 ;a
Ground ~rs~fe r• 1S I,,sk rr-,v lY Guy .1 'd-b
elev.
eft. -V we 67 (or 5 S m ; d 8
to -
Depth E±3-68 / 0 /2 Ul'~ P
limiting vl /L v /v 3 7 v~~c ~ / s 1 a►ns lox _ .S Q
factor
min. Remarks: ~a lec 1,3 Boring #
I
i
Ground
elev.
ft.
Depth to
limiting
factor
in. Remarks:
SBD-8330 (R. 07/96)
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G leh wood Ci+ j
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1 $ m ~ El /00~ of
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FORM NO. 985 A
FLC FYl~lar
Stock No. 26273 ~
9 ~ 9
t F,111~Nggl ' to
566'788 OCR N Ng o
r
CERTIFIED SURVEY MAP NO. 3363
VOLUME 12 ,PAGE 3363 ti
BEING A PART OF LOT 2 OF CERTIFIED SURVEY MAP NO. 1999,
7, PAGE 1999, LOCATED IN A PART OF THE N.E.1 /4 OF THE N.W.1 /4,
AND PART OF THE N.W.1 /4 OF THE N.E.1 /4 OF SECTION 36, T.30 N.,
R.15 W., TOWN OF GLENWOOD, ST. CROIX COUNTY, W.
N.W. Cor. N6.1 /4 Car.
36-30-15 15
0 36-30-
Fd. Berntsen Mon. 3 -3 -15 Fd. P.K. nail
N89'47'42"E 2627.51' Falls in Lagoons N89•47'42"E _2627.51'
70
T 14.20 923.31' -
3 ui
w z~z
(V I I I
cV W
3
M ii2
o 00 Unpl_att_e_d__L_a_n_ds i
-------------t---------- -i 4
j" -
- 105"E G 622.56-
$ N89'46'16"E 428.39' 10
N 172.54' 255.85' w
' o
ci ~c
3 i w l n N J
J m ~ ; Lo' iDT 3 4-N LOT 4 M~ 0
~I
`ta !SEE ca d- 621,989 S.F./14.28 AC. N M "-~I
I
C0
U-) 00 °
io rnrn ¢ELOW
GEo_a- O er
° I ~~'tp O I i O i !n c~
NN Z ! I U) i
C mo0a0 r'-- 33' f
33'--r
o~ 172.54, 1383.14-
S8947'42"W 1555.68' +
m n.ea I
LOT 3 Unplatted Lands
72,224 S.F./1.66 AC.
CURVE DATA
North is referenced to the north Curve 1-2 Curve 3-4
line of the Northwest 1 //4, which _..._.19
is assumed to bear N89'47'42 "E. Radius: 4148.80' 1983.13'
Central an le:l 05'35'11" 03'00'23"
Chord length: I 404.35' 104.05'
PREPARED FOR' Chord br N86'58'40"E N82'40'53"E
Arc: - -104.06
Mrs. Joy Timm i 404.51' ; 0
N11263 50th St. B•T. br ; N89 46 16 E N84'11 05 E
Glenwood City, Wi. 54734 F.T. br N84'11'05"E N81'10'42"E
S,,,,
°\\.•••.....S%/'LEGEND t
J
Government Corner (as note
a STEVEN J.••:
K "
c • • Set 3/4" x 24 re-rod
WAA
= weighing 1.502 lbs. lineal foot
~L - S-1610 ;A a Found 3/4" re-rod
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER -J
MAILING ADDRESS IL / l Z 3 ~S?~ S 7-2c -i ~c?r tJ~.J~~C JCo [ U r Sy 73 Y
PROPERTY ADDRESS ,_6),3'7 (location of septic system) Please obtain from the Planning Dept.
CITY/STATE _ _ _ ! L ~~iL~C~~Q} E~ ( , ry LCD t S J I
PROPERTY LOCATION ! ~U 1/4, 1/4, Section, T C~ N-R_L,~L_W
TOWN OF ~`L~=xet~~9r; ST. CROIX COUNTY, WI
SUBDIVISION X, A LOT NUMBER. t4k
CERTIFIED SURVEY MAP 1 3G j , VOLUME J2-, PAGQ~>, 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 receive a grant for a 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
d by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1)
le. 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
County Zoning Officer within 30 days of the three year expiration date.
v
SIGNED: ✓
DATE:
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
S T C - 100
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
house), then a second form should be retained and completed when
the property is sold and submitted to this office with the
appropriate deed recording.
Owner of property
Location of roperty 1/4 1/4, Section .J TN-R_L~W
Township CQ 7- AL~~' Mailing address It Z i,3
Address of site _ 7- - t 5 yo
Subdivision name rt1 Lot no. 3
Other homes on property? Yes___,K_No
Previous owner of property
Total size of property l
Total size of parcel / L
Date parcel was created G j 3 r• 7
Are all corners and lot lines identifiable? k Yes No
Is this property being developed for (spec house) ? Yes __X No
Volume ZZ-~-~- and Page Number YZ F~ as recorded with the Register
of Deeds.
INCLUDE WITH THIS 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 the office of the County Register of
Deeds as Document No. 7and that I (we) presently
own the proposed site for the sewage disposal system or I (we)
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.
Signat re of Applicant Co-Applicant
Date of Signature Date of Signature
~ 56~ .239 STATE BAR WARRANTY WISCONSIN DEEDM 1 - 1982
DOCUMENT NO
_ , - - - _ - :VOL 1-2 1_-au4
This Deed, made between E John Timm and Son, Inc. REGISTFR5 OFFICE
5T, l ROfOr IX RC WI
Grantor, O C T 2 1 1991
and Joy Timm
12:45 P M
Re 1st: ds
I Grantee,
Witnesseth, That the said Grantor, for a valuable consideration
St.. Croix THIS SPACE RESERVED FOR RECORDING DATA
~ conveys to Grantee the following described real estate in
I~ County, State of Wisconsin: NAME AND RETURN ADDRESS
See attached Schedule
N ~~a~3 SO~.~,
<~3
S
None. assigned
j' PARCEL IDENTIFICATION NUMBER
.I
FEV
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This is not homestead property.
II (is) (is not)
Together with all and singular the hereditaments and appurtenances thereunto belonging;
And E. John Timm and Son, Inc.
warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except
and will warrant and defend the same.
Dated this V day of October _19 97,
E. John Timm d Son, Inc...
v~r✓ AL)
tin
(SEAL) 4,1,
~I . E. John Timm, Presidents Q-~~~~ ;p
(SEAL) 9Y~ u•r-~ ,~rmm~ nayAL)
Maxine Timm, Secretary, no G, M.
OP
AUTHENTICATION ACKNOWLEDGMENT
E. John Timm and Maxine Timm State of Wisconsin;
Signature(s) ss.
County.
auth tired ay of October 19___27 Personally came before me this day of
d7 12:24 C 715 778 5505 GAV'1G Li11'1'' UFT'ICE IQjoo2
a
~ I
VOL 1271 PAu 4 79
EXHIBIT 'A'
Lot 3 of Certified Survey Map No, 566788, Volume 12, page 3363, being a part of Lot 2 of Certified
Survey Map No. 1999, Volume 7, page 1999, located in a part of the Northeast Quarter of Northwest
Quarter and part,ofNorthwest Quarter of Northeast Quartr of Section 36, Town 30 North, Range
15 West, Town of Glenwood, St. Croix County, Wisconsin.