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HomeMy WebLinkAbout020-1294-40-000 ~ o M C Z C C C Y ~ C = O O: Q N d Z ~ 3 o 0 Z 0) 'G I rn L LL c0 N 'CS N 'p v 3 z E rn z O z N I- Z C C7 O Z ! GUi 'Z ~ O ~ VS F- O N . c ~ 0 v 0) _ N N (rJ Cn c O Mrr O O • tit d L t ON Q U O c0 c O Q = N N Z F Z Z o 'o r Lo_ CD E W _ N E o a•m N 0 CL Ufl co N F- F F- 4 -J U O O O n • r►,~ m o CL a a s o N m r- N V) U rn 1), O z: O 00 O ~ II~~YYyy~~ ca 7 LL m CL ♦ N Q } C O N In iy O p N S O O c O d N CL O C Z O O O O ~ C c q~ ~ 4-r ~ O Y~ ~ N N O N L" N Oj N O W LU N N _0 _0 4 • T~ C64 O O O O U O N = ~ N O UJ E m U w m a a i a T CL a) a a. U C C 7 U a c I,', 0 cn U ST. CROIX COUNTY 1 WISCONSIN ZONING OFFICE rrrr~ ST. CROIX COUNTY GOVERNMENT CENTER r~•' _ 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 SEPTIC INSPECTION / WATER TEST REQUEST FORM Please specify desired test(s) & remit appropriate fee with application. Outside water lines are often turned off during winter months, making access to the home necessary. Please make arrangements with this office to insure that entry can be gained. ❑ Water (VOC's) $185.00 0 Septic $50.00 0 Water (Nitrate & Bacteria) 45.00 ❑ Nitrate & Bacteria ID' Water (Lead Concentration) 21.00 retest $15.00 Owner: 'VIA) V0,0V E'S Requested by:~,p )/A)yD,p C-- Address : Address: /S/j~ cam,, .S7- ZIP / ZIPO//= Telephone W: ( ) Telephone W: (2LL!r) &8 ,t- ,L2y Property address (Fire W & Street) : Z/07 Location: Sec. , T _N, R W, Town of Realty firm: Lock Box Combo: Closing Date: TO BE COMPLETED BY PROPERTY OWNER PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORMS Water sample tap location: Is the dwelling currently occupied? ❑ Yes 0 No If vacant, date last occupied: Age of septic system: Septic tank last pumped by: Date: Previous Owner's Name(s): - - - ~x Have any of the following been observed? ❑Y ❑N Slow drainage from house. X ❑Y ❑N Sewage Back-up into dwelling." ❑Y ❑N Sewage discharge to ground surface or road &it ph. ❑Y ❑N Foul odors. G~~C'~ % - Other comments relative to system operation • 01, I certify that the above information is complete and true to the best of my knowledge. OWNERS SIGNATURE: DATE 9 1/94 62-6 -(25i`4-4-d--o ae) lad. 2,51 H. H5-5- OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION IN TO BE COMPLETED BY INSPECTION AGENCY System design &/or permit on file? []Yes ONo Soil series per SCS Soil Survey: sheet # Type of soil absorption system: OBelow grd OAt-Grd OMound Approx. size -'X []Gravity ODose []Pressurized . Ft.2 OBed OTrench ODry Well OHolding Tank ❑Outfall pipe OBSERVED DEFICIENCIES []Other []Unknown Septic tank Setbacks: ❑House OWe11 OProp. line []Other Dose tank Setbacks: ❑House []Well []Prop. line OOther []Locking cover []Warning label OPump/Floats []Alarm OElec. wiring Soil Absorption System Setbacks: OHouse []Well []Prop. line []Other ❑Ponding: []Discharge: General comments: INSPECTORS SKETCH OF SYSTEM LOCATION N Inspector Title STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNERS SON EtiS ADDRESS /~,Q L, A 1~ L~4 a tJ SUBDIVISION / CSM# 'yb.1LOT # .~I SECTION 0,9 T. 2c~ N-R W, Town of f1UDSnnf ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM .10, ItZ to ~ --o ~3a o '4' J -L_, (C DEC eAO~~ S uN ~F~G~ ~ Z ~NGD ~fEw le>t INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. L BENCHMARK' Z' ALTERNATE BM: ~5? P Lr(j if 4.(--- V. 4 ~Zg) SEPTIC TANK PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: Vr jeseR Liquid capacity: /64-6 Setback from: Well /DO House / J Other Pump: Manufacturer Model# Size- - Float seperation Gallons/cycle: Alarm Location ,:SOIL ABSORPTION SYSTEM Width: 5 i Length J©O Number of trenches 91 Distance & Direction to nearest prop, line: ' (,A'S7 pt- ~~ts? PI IV. Setback from: well: f/DO House- Other ELEVATIONS Building Sewer_ 9'35('Poi~T Inlet. a,b (T7.(-)ST outlet PC inlet PC bottom Pump Off ~-owcb4~k Jr. •7fi' I.'RN•N2 IS ~R3.25~ Header/Manifold Pftt L/,/r, Bo tom of system s- Z ~g Existing Grade 2,q kL~)Final grade DATE OF INSTALLATION: 141j'r1 PLUMBER ON JOB: J-EFF 7F)C LICENSE NUMBER: ' _T~~$dJr p~~O INSPECTOR: 3/93:jt wiscofi:rin 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 299105 Permit Holder's Name: ❑ City ❑ village Town o : State Plan ID No.: JONES, KEVIN HUDSON CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax -1294-40-000 10,0 7~ d < 0200- TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. I OD Septic S Benchm k .7- /00-7- Dosing Aeration Bldg. Sewer I3S q 7 T7 Holding tQl W inlet 2.(~D 9-7.6 TANK SETBACK INFORMATION 9/lit Outlet 2•g'S 97'3S~ TANK TO P/L WELL BLDG. ventto ROAD Dt Inlet Air Intake Septic ! pp"r D© t- + Zo NA Dt Bottom ,5,78' 9y• 2. Dosing NA Header / Man. /r q v -O5 Gt2 IRq.or Aeration NA Dist. Pipe y.,sf a'r G.q~' c/ 3•t Holding Bot. System 5.~ 5- PUMP/ SIPHON INFORMATION Final Grade 2 9-7.3 Manufacturer Demand ~.1 99 •oS c(I!•28' Model Number GPM I'•g1_ rti 9Force9k[Length Loss n s TDH Ft Did. Dist. To Well SOIL ABSO ION SYSTEM BED TRENCH Width S Length l W UIMEN I N No. Of Pits Inside Dia. Liquid Depth IWOW rer DIME SYSTEM TO P / LAKE STREAM LEACHING SETBACK CHAMBER Moe Number: INFORMATION Type O -3OR UNIT Systemco V DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia Length fsV / Dia. Spacing t✓~ lfs7/Z ZS~ -70 I SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over zx' Depth C f 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 24.29. 9,NW,NW 870 MCDIARMID CIRCLE - SUN RIDGE LT 31, ~Fc F ~_S G r za) -f ~a f w OIL We~f tat tires (97P.? ~ Plan revision required? ❑ Yes ( No Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signat e ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: 1 Safety and Buildings Division SANITARY PERMIT APPLICATION 201 E. Washington Ave. Wisconsin 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 count than 8 112 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Nuro')ber The information you provide may be used by other government agenc'y' programs ❑ Check i feJis n tdprbvl2fus application [Privacy Law, s. 15.04 (1) (m)]. S X70 1 cXi GLfmi,,, a V ; State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N Prgperty Owner Name Property Location ~/'W4 k'yr/'1/4, S T Z11 , N, R /J E (or)® Property Owner's Mailing_Pldress Lot Number Block Number City, State 77 n 67- Zip Code T(P hone Number Subdivision Name or CSM Number ) SdK) R 11. TYPE F BUILDING: (check one) ❑ State Owned ❑ ity Nearest Road ❑ vll age C I Public 1 or 2 Family Dwelling - No. of bedrooms -S To, OF V o M tN►t l: III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) t gq. O~ 1 Q . !q. 1y55 1 ❑ Apartment/ Condo 7 /l yb 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. V New 2_ ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System ________System_____________TankOnly- Existing System _________Exi--- -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 Seepage Trench 22E] In-Ground Pressure 42E] Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14E] 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) IZA01 7X. 95 5 Elevation `75 0 9 /00 , g ?3?feet 97 Feet VI 1. TANK Capacity Site in gallons Total # of Manufacturer's Name Prefab. Con- strutted Steel Fiber- Plastic Exper- INFORMATION New Existin Gallons Tanks Concrete glass App- Tanks Tanks Septic Tank or Holding Tank 15(05 J 1&-cleR. 23 El 1:1 ❑ ❑ 1 1:1 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) Plumber's Si nature: (No mps) MP/MPR$tM-Mo Business Phone Number: 3,96 Plumber' ddress (St e , City, State, Zip C IX. COUNTY /DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Agent Signature (No Stamps) Surcharge Fee) Approved ❑ Owner Given Initial 0 p~ Adverse Determination o X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD•63M (RA 1/96) DISTRIBUTION: Original to County. One copy To: Safety 8 Buildings Division, 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, 608-266-3151. 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 13 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,tsiphon 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 1/2 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. NI~✓ ~ A/W sic 2~ T Z 9, N, l9 of M✓LSAOiV To wJOSHJ P 4 v7 XI TOP 1 SvRJEYar2S sTi~ ELEv OQO 17 501L QD} M16 ~d TREES a i Z- 5 ;c1cx~ ~ 7~n~N<s / 1565 GA)- VV(65M 5. 7-n nl < CA PRo ~asF o IIED►?aa~r, /16 asE C_sti~.i4GE ~-~1lCt/MA ~K ¢w.v~'sE!!~i Crt'EE,~ c~oot7 f~.`oip: f,.e S % .~l~Y ? ~'ii~r /PG~SGlr✓ Wisconsin Department of industry, SOIL AND SITE EVALUATION REPORT / of 3 Labor and Human Relations w Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code X"%. In 1% rJ Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or t~R I.'D N s., f` dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION;` T PROPERTYA WNER: BUYER' PROPERTY LOCATION ~ /i¢/1/ /~~DoT77E GOVT. LOT ~/GiJ 1/4 .UU/ 1/4,,5.x' T"! V ' N E (ore PROPERTY OWNER':S MAILING ADDRESS LOT N BLOCK # SUBD. NAME OR CSM-V- elo Z3 30 //0 ~4v-e 31 1--- svv iP.GIrF CITY, STATE ZIP CODE PHONE NUMBER []CITY OVILLAGE (OPOWN NEAREST ROAD 13'41"044WN 40/. S 4 O o 2- (G/2) 77D - F/ 70 t-f U D,So tit ime [H'New Construction Use [ Residential / Number of badrooms 3 Addition to existing building [ j Replacement [ ) Public or commercial describe Code derived daily flow ~S0 gpd Recommended design loading rate bed, gpd/ft2 • 7 trench, gpd/ft2 Absorption area required bed, ft2 G y3 trench, 112 Maximum design loading rate bed, gpdffl - F trench, gpd/ft2 Recommended infiltration surface elevation(s) 5-~ Pik - 3 ft (as referred to site plan benchmark) Additional design/ site cons' ations W/Sf- LD.vG- N/fAA06J 7,f e,044 l S .0-41 'rzio'&CL k'/~ /sow PIS- 7-Parent material 5G5 :5115 , Siff SZD1=0~E-v7%5 Flood plain elevation, if applicable ft v S = Suitable for system COL~S IO UL V70U UND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK UUnsuitable for s stem 2J ❑ U ©3~ U C47'S"-o U O S SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Bound3y Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 7[ z f -5" . G Y-4 31 S~/ Z + 56e r- u~' q-5, Z (e- /a Y~ 3lee Z f 56,e iw•~F Lc.v Zf S . C,, Ground 3 6- z z 75r YR ylle ~S 14, 4-M C S , ..-7 .0 elev. ft. /o 57iP471p-iD a at 5, - Depth to N limiting factor M MAL Remarks: Boring # d-/0 /0YR 3/~l mil fsd,& Q5 1 f . S G 'Z 2- /0-22 jp 1141 Z,wl Oil iYn die e v 3 2- 2 -36, /a y~e V6 Ground elev. 4/ P/ /o 516, 5TiPgT/,r;',w n-4S• O S 9a , /a ft. Depth to limiting factor Remarks: CST Name:-Please Print 12 0 6 E Q T- -M L 13 k i C kT- Phone: •715 396- 8185- Address: L~+ /0- CS/~,LygZ n~~e• V MT Numbec PROPERTY OWNER SOIL DESCRIPTION REPORT Page Z of 3 PARCEL I.D. # L,17' Sow e!D6%- Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bajid3y Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3+ - e yR 31 .S'// / nr -ro C / ti AL 3~ Ground l elev. 74~~o ft- 1-3 -JP Depth to , 7 limiting factor Remarks: Boring # Ground elev. 99- So ft. 00 yw 511,e Depth to / S S IX • 7 limiting factor Remarks: Boring # ~ o-~ Ile ^S,d& TLle a s /-f Y , s 3 lf-plj 7. Sr T i4TiD ,H•.q~,S Q S GQX QS Ground elev. 7 176, 9,0 ft. Depth to limiting factor Remarks: Boring # :M Ground elev. ft. Depth to limiting factor GvOD.C,7,s' STEAL y~Eu~E' PvS T If 7- gt ' ~Vw L e, T ~o•P.~ I ~3 LOT 3 1 \9a 79 10- in ~ M IgL W Q V' 5o, zo7 z. C~ TR w~ 4 S O L Fou.JD : To/) or- SvkaEyo~PS 1 51,5~Vf 710.J A47 0 ,0 _ 61,C0717-IoN .5 - v H 3 , o 61'.08"96 HOB' 12:34 F:k_1' 715 268 7408 IVILSff COS. OF MERY aTC - 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 _ K6U o N .4 `TVAcy __JbrJ a Location of property 1VW 1/4 A)iV3,14, section Z1 , T o?4N-R l W Township A[QS0 0 Mailing address Address of site $70 Al C'D1AQrtuO ei Rely _ Subdivision name ;50&) RIOAX Lot no. ~ other homes on property? Yes___X_N0 Previous owner of property ~ gam; ~t Qo,~p ~iyT.L~,i~PR►~ ~S_ ___-----~_~?G~---_- Total size of property 2 a 305e Total size of parcel ^ Date parcel was created Are all corner:: and ? of --lines idonti fiahle? Yes N e2-t1T h!?t:'"itj dF"a°e-~PJ,T?E?d for (SpcC' 1i01.aSE) T Yes ~.T Is this prop Volume` of Deeds. INCLUDE WITH THIS APPLICATION `%2 FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PACE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. Its 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. , and 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 thr construction of said system, and the same has been duly recorded -if! the office of the county Register of Deeds as Document Nc. Signs ure of Applicant Co-Applicant r STC-I05 SLI"I IC TANK rvLAJN'I,EN ONCE AGRIEVNI-E, t St. CnAx County OWNERIBUNTR K e- V J `j d- Tyra C it S MAILING A.DDR>E:,SS ' ~ 0 ?_2_ PROPERTY ADDRESS „t atbtl o f " id^nlil Dept. CITY/STATE L a ./a. "►M A!-=----_- - - PROPERTY LOCAI TON W 1i4. JI(YI/ 11/4, Section aY T__~Z2_ ti-u__ ?-%y T01AN OF } t?1~, ST, CROIX COUAM Y, XN J SUIIDIVISION LOI 1NUr"'uiI':B __4L9?, ' nt 6O~'~ of t}le Co?i '1`C~:lua;~,Ft;~ili ~ 1 ! ir, :ir ?1 ; ~1'S:'~ i i, i ~}C'V~ ~ fall _.~r(,`•IA ~,=(7Lt)~.)' 3CCepLpd t11iS -f PY :LIl)_ tO kt:ep dleir system properly maintaintd. rllep,.- f u pt,-tj ov ,--F green tt1 t1u17;it L' a`, rc7t_- J il'.1 :i it r'llill?t!J["l corm, r.vr;cd by th~ !'wr+ ,er alid by a mater pdumble., Journeyman plutnber, ristrictc i plumber or a hcerlse.a pumper verifying; that (I'} the on-site wastewater .:isposal systen! is in proper operat,ng condition and after inspcction and pumping of necessa*-), the septic tafik is le 5s tha,^ 1!3 futl of sludge and scunr,, Me, the undersigned have read the-above ;M. uirements and agree to ;itaintAia the private sif.%vage disposal system in accordance with the standards sci forth, herein, as set by t1 e Wisconsin DNR, Certification stating that your septic has been maintained must be completed and returned to the St- Croix County Zoning Geer ?0 days of the ffimc rear"expiration date. 2 7 SIGNED: DATE: j~ 9-1 _ . - - - St. Croix County Zoning, Office Government Center 1141 Carmichael Road Hudson, WI 54016 11/93 s off: ~ - / d• VOL PACE EiEGISTE 554'743 'ST. CROIX co., W1 WARRANTY DEED ' fldtaReoora 4 JAN. 2 2 1997 tC 10:30 A. P~f Document Number: * LdA;L Register of UuaLi Return Address: ~nd Tracy F. Jones, 16072 6th Street North, Lakeland, MN 55043 r~ %u" ~g9y~3 Parcel I.D. Number: I D made between Greenwood Enterprises, Inc, a Wisconsin corporation, Grantor and Kevin N. Jones and Tracy F. THIS DEE , Jones, husband and wife as survivorship marital property, Grantee. WITNESSETH, that the said Grantor, for a valuable consideration of one dollar and other good and valuable consideration conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin: of the Plat of SunRidge II, filed in the Office of the Register of Deeds for St. Croix County, Wisconsin, on August 1, 1994 Lot 31, in Volume 6 of Plats, at Page 17, as Document Number 519728. This is not homestead property. es, Inc. wa Together with all and singular the hereditaments and appurtenances clear of encumbrancesgexsePt~easementsoresEnctionssand reservations that the title is good, indefeasible in fee simple and free if any, of record and will warrant and defend the same. .S r III Dated this day of January, 1997. GREENWOOD ENTE SES, INC. GREENWOOD ENTERPRISE INC. i' By: By. ary h; t taty - R t~s E. Rusch, its president 1 AUTHENTICATION ACKNOWLEDGEMENT its president STATE OF WISCONSIN ) IX. Signature James E. JR2us~} ) ss. au ted this fl8y of Jan ST. CROIX COUNTY t.~ SIGI HER Lois Murray - Personally me before me this Rusch, its secretary to : MEMBER STA BAR OF CONSIN day o}'J" rye 1997 the above named Mary HER . me kno to be the person who uted the foregoing instrument an sum ,t!e GAL Pn'nt ackno $e Gf-L-, THIS INSTRUMENT WAS DRAFTED BY: Lois A. Murray Public, State of Wiscon r g a~ L7 Zilz, Eust r Ogland My commission expires / treen ~ 304 Locust Street P.O. Box 359 Hudson, WI 54016 Brenda Poulin Wisc Notary Public ;tats of Wisconsin PE-5c