HomeMy WebLinkAbout020-1332-30-000
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER R GV4~z-o
ADDRESS 13:53 A-w ,~q+u K-.e e 2R ►
~v cPS04• , LAJ S ~,Cd l So
SUBDIVISION / CSM# L A" S i~ i 1t; LOT
SECTIONT a~ N-R I W, Town of h~u S O h
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
1 J
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK: Sa +,~-r° Q
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer:; Liquid Capacity:
Setback from: Well 2 House, Other
Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: Length l / S Number of trenches
Distance & Direction to nearest prop. line:-
Setback from: well:,3"/ -House I G Other
ELEVATIONS
Building Sewer ST Inlet: ST outlet:
PC inlet PC bottom Pump Off
Header/Manifold Bottom of system
Existing Grade Final grade
DATE OF INSTALLATION: C
PLUMBER ON JOB:
LICENSE NUMBER:
INSPECTOR:
_~?79
3/93:jt
Wisconlin Department of Commerce PRIVATE SEWAGE SYSTEM Count
'ST. Safety and Buildings Division INSPECTION REPORT CROIX
GENERAL INFORMATION (ATTACH TO PERMIT) SanitarMrgwv9.:
Personal information you provice may be used for secondary purposes [Privacy L kw, s.15.04 (1)(m)).
~TafflcleLsPaQUe ,,D [h9t,5,[6jillage C] Town of: State Plan ID No.:
CST BM Elev.:, Insp. BM Elev.: BM Description: Parcel Ty2ldo-;13 32-30-000
09
TANK INFORMATION LEVATION DATA A9700247
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark - '
Dosing
Aeration Bldg. Sewer
Holding St/Ht Inlet 7.> a /
TANK SETBACK INFORMATION St/ Ht Outlet f 2 c 2,
TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic > 3 _ NA Dt Bottom
Dosing NA Header / Man. 8" Z 6
Aeration NA Dist. Pipe
q51 9 5-
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade qq
Manufacturer Demand
Model Number GPM
TDH Lift Lrictio System TDH Ft
oss Head
Forcemain Lengt Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width 1 Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSION 116-' l o-J DIMENSIONS
SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING manufacturer:
SETBACK
INFORMATION Type O CHAMBER model Number:
System: 3 01A, OR UNIT
DISTRIBUTION SYSTEM
Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length Dia. Length Dia. Spacing
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 tf Bed /Trench Edges Topsoil El Yes C] No ❑ Yes E] No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: HUDSON 27.29.19fpW,NW 790 gW-ILFRED ~RDgA&B LOT 3
iCA"C~!iL~c~ l.~r/ i~ /~z.B .za✓, ,t..L-d~✓..-, r..~ >
c
f.. F n
/LQJ`~.J,j13•~+ GY~-~ --Q'3L .4~L 0't
Plan revision required? ❑ Yes ff"No
Use other side for additional information. 8 a_
SBD-6710 (R.3/97) Date p or's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
Safety and Buildings Division
v~■~nr,. 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 8 112 x 11 inches in size. 54, . Cr N
• See reverse side for instructions for completing this application State Sanitary Permit Number
C?` 917 4j- O~
The information you provide maybe used by other government agent programs ❑ Check if revision to previous application
IPrivacyLdw, s. 15.04 (1) (m)]. 7q0 W/ /7k Cy A0/ State Plan I.D. Number
1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION
Property Owner Name Property Location
r 04d 1/4 r..t) v4, S o[ f T q , N, R /Q E (or~
Property Owner's Mailing Address Lot Number Block Number
City, State Zip Code Phone Number Subdivision Name or CSM Number
Gt-Cl -i5 4 ( 73r/ 5, I
II. TYPE OF BUILDING: (check one) ❑ State Owned Ity Nearest Road
❑ vll age
Public 1 or 2 Family Dwelling - No. of bedrooms .61 Town OF !5®rt/ C A- A, 4e-
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
1 ❑ Apartment/ Condo a-7• aC7. /9. /7413 v- i33,,? 0
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. R 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 ❑ Seepage Bed 21 ❑ Mound 30 ❑ 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
*10 11.25" /3~t r iL/c ~5~3 Feet ,Y,3 Feet
VII. TANK Ca
in galtoacits Total # of Prefab. Site Fiber- Exper.
INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
New Existing strutted
Tanks Tanks '
Septic Tank or Holding Tank f/S`D ,p44 J en 2"? k<. l ~ ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite se age system shown on the attached plans.
Plumber's Name: (Print)) Plumberr''ssSiignatu:(NoStamps MP PRSWNo.: Business Phone Number:
Q y.< 5'~i~i cc L►'l Q t ✓ ~..G!%L°~_7'U .~'~.2- i~/-7 ',.g ~'~e - 31.~ l
Plumber's Address (Street, City, State, Zip Code):
a,c/ L./.` yard
/Z 2~0 e, -1,17- R el
IX. COUNTY/ DEPARTMENT USE ONLY
❑ Disapproved S itary Permit Fee (Includes Groundwater Date Issue Issuing Agent Signature (No Stamps)
❑ Approved ❑ Owner Given Initial Surcharge fee)
Adverse Determination V
CONDITIOIS$ OF APPROVAL/ REASONS F~ORDI~OVAGL~L:~
re-~-~! L.Jee'1
SBD-6398 (R. 05/94) DISTRIBUTION: Original to county, One copy To`. Safety & Buildings Divi.ion, 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 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 applica':ion 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 -,urve; pump model and pump manufacturer; D) cross section
of the soil absorption system if required by the county; soil test data on a 115 form; and F) all sizing information.
GROUNDWATER SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (-'ees) 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-
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Wisconsin Department of Industry, SOIL AND SITE EVALUATION
Labor and Human Relations Page 1 of 3
'Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Adm. Code
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County
include, but not limited to: vertical and horizontal reference point (BM), direction and S t . Croix
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. #
020- io~y-qv
APPLICANT INFORMATION - Please print all information. Reviewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner' Property Location
Richard Stout Govt. Lot NW 1/4 NW 1/4,S 2 7 T 2 9 N,R 19 1 (or) W
Property Owner's Mailing Address Lot # Block# Subd. Name or CSM#
1353 Awatukee Trail 3 Badlands Prairie
City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road
Hudson WI 54016 (715 )5496731 Hudson Badlands
® New Construction Use: E] Residential / Number of bedrooms 6 Addition to existing building
❑ Replacement ❑ Public or commercial - Describe:
Code derived daily flow 9 0 0 gpd Recommended design loading rate . 7 bed, gpd/ft2 8 trench, gpd/ft2
Absorption area required 12 8 6 bed, ft 2 1 12 5 trench, ft 2 Maximum design loading rate .7 bed, gpd/ft2 " 8 trench, gpd/ft2
Recommended infiltration surface elevation(s) 9 5 . 9 3 a 1 t 9 4 . 5 2 ft (as referred to site plan benchmark)
Additional design/site considerations useB 1 -B2 -B3
Parent material Glacial deposit Flood plain elevation, if applicable ft
S = Suitable for system Conventional Mound In Ground Pressure AT Grade System in Fill Holding Tank
U = Unsuitable for system S ❑ U E N S ❑ U n s ❑ U ff] S❑ U ❑ S [n U ❑ S t] U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2
in. Munsell Ou. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots
Bed ,Trench
1 1 0-1 7.5yr2.5 1 none L 2mabk mfr cs 2m .5 ,.6
2 16-40 10yr3/4 none sil 2mabk mfi cw if .5 .6
Ground 3 40-96 10yr4/6 none ms osg ml cw .7 .8
99 el9v4 ft
Depth to
limiting
factor
9 6 in.
Remarks:
Boring #
1 0-1 7.5 r2.5 1 none L 2mabk mfr cs 2m .5 .6
2 2 16- 0 10yr3/4 none sil 2mabk mfi cw if .5 .6
3 4.0- 10yr4/6 none ms osg ml cw .7 .8
Ground
elev.
10 0_._-ft.
Depth to
limiting
factor
94 in. Remarks:
CST Name (Please Print) Signature Telephone No.
Address Date CST Number
.>ROPERTY OWNER Richard Stout SOIL DESCRIPTION REPORT Page 2 of 3
PARCEL I.D.#
30ring # Horizon Depth Dominant Color Mottles Structure 2
in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots
Bed Trench
3 1 0-1 7.5yr2.5 1 none L 2mabk mfr cs 2m .5 .6
2 114-41 10yr3/4 none sil 2mabk mfi cw if .5 '.6
_~round 3 41-96 1 0yr4/6 none ms osg ml cw 7 .8
lev.
9 9 .off.
)epth to
miting
Astor
in.
Remarks:
3oring #
1 0-30 7.5 r2.5 1 n
4 2 30-4 10yr3/4 none sil 2mabk Mfi cw if _9 '-6
3 48-9 10yr4/6 none s osg ml cw .7 '.8
around
98. gl~ tt
)epth to
imiting
actor
95 in.
Remarks:
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed . Trench
Boring# 1 0-30 7.5yr2.5/1 none 2mabk mfr cs 2m .5 .6
5 2 - -sil 2mabk fi cw if _1i _6
3 58-I D3 10yr4/ none s sg 1 cw .7 -.8
Ground
elev.
9 9 5-2--ft
Depth to
iimiting
factor
1 Q3--in. Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in.
Remarks:
SBDW-8330 (R. 08/95)
~.a fi 2 ~ l
M
la7' 3 a/S~
ir'tttY'''
13 3
s ~
Q
It
U
Let
N o7"Y s-~9
~ .2 Svc P.'pe GJ aaov(~-~lfi f1.1vjjo. 0
I
I
BADLANDS PRAIRIE
?D IN THE NW114 OF THE NWIA SW1/4 OF THE NW114,
OF THE NW 1/4 . AND W112 OF THE SW 1/4 OF THE NE 1/4,
V SECTION 27, T29N, R19W, TOWN OF HUDSON, ST. CROIX
COUNTY, WISCONSIN.
UIYPLATTED LANDS
NW CORNER
SEC71ON 27 N e9•SYta^'w 9ADLARW N 89'55'18" W 1138.49' ROAD N
160.00' • ."1. DEDICATED TO IM PUNIC
I ^ - - I - -
- -
SENCHMAR K*
c 29 , 8 :i•I Iii.
3 , 1 R 111 I I I I 45 .
~ 71HG _._._.-L '^1I' 11x•.
'".11 i 1'e _ _ _ _
wI .8 I I 130 ACRES 44
FT. ? 1(1. 33 111 106 4434
ryryti III =1j1 III;
' 5 6935'18" E 630.34' - S 8935.16' E 499.21'
~i I all
i - -
1 III too' 2 1 1
1 i!! 44
THL
+ = 1 _ ! ! 3.00 ACRES 102.449 ACRES
!I 1}0,709 SO. FT.
111 ~ s
100•. - 100' Ill a S 893518" E 595.12• III^N
_ S 893516" E 531.47'
-•~I ~ 1 ~n Iii ,nl
;n 111 1d vn 43
1! 3 :w4!1
II '
111 111
I } .W THL - - - - - - - z z S0. ACRES
R- 114,043 FT.
100 SO
-c1(: F. 111 130.794 SO. FT. ;il 1. 1111
=ill r - X1114
i •Z ttl 11
111 8 4
r
j 11 Its` '
I 111 S 89'55'18" E 600.8x• :4 tt ` it`a. S 89359a" E 52107 -
m I f ql'"
f 16 111 - tt F t tt J .
42
iI 4 it
4 5 1j1
y o-*~
I Q so E : THL _ %ill
. 2-4a ACRES.
t 100`! 100 cqd~ I I 3.00 ACRES + 111 - 107,998 sa FT.
d I I N a ; - 130.699 S0. FT. 1 1 I III
11~ ~ 1 itl
1 0 'Ill N•± 1r! 1
1 G -IIf4.t i-! S 8935'18" E 614.69' '50• S 89'5511" E 505.60'
41
6 50.
'Ill
i ill
3 Il
,,u •W.L 41
I N
a = i t 100' 5 AI/
1
THL
111.2-627 FT.
1 a~ 191'oT w = °o 3.00 ACRES - ° 1j I i 11 1.az7 ACRES
130,703 S0. FT. xlll
Q 35.DC• \u III O +1!
' ~ JIB ~ i~=\ III. 7 I,
18934' 8935'18- E 615.44' S' 8955.18" E 538.41'
I !
.6s es Ilj \ °u U1 a U1
N.W.L 9220 m
a 6 111 III
4; 111 40
I Ilt:' \ THL
_
W RA S'BJSt• 3.01 ACRES 1I 11~
- X 131.170 50. FT. _ 2.65 t F~-19 E' i : 11 1 1~ 115.500
= ll = ~If•+~" 81.22~n !11 III '
y I IIF:' 4: 111 II' T~ 1 O E
~t 111 i ~1 5 89'WOG" E 543.78• N ~~•5' N.W.L - 911.0
7AD-- - 5 !193518" E 607.70 i I
361.6 205.96
MATCH LINE
8 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 property 1/4 1/40, Section 2 7 , TAN-R _W
Township Mailingaddress
Address of site e2A
Subdivision name
~~~i'~~ Lot no.
Other homes on property? Yes De No
Previous owner of property
Total size of property l
Total size of parcel
Date parcel was created ,2
Are all corners and lot lines identifiable? No
Is this property being developed for (spec house) ? Yes No
Volume 2 / and Page Number Y`/yZ. 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. -F ~l , 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 the
construction of said system, and the same has been duly recorded in
the office of the County Register of Deeds as Document No.
Signature of Applicant Co-Applicant
Date of Signature Date of Signature
STC- 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER 3,j
MAILING ADDRESS /,3,5-
PROPERTY ADDRESS 7V7Q~
(location of septic system) Please obt in from the Planning Dept.
CITY/STATE p(~ ~o /,_J z
PROPERTY LOCATION /tip 1/4, t 1/4, Section 92 7, T~2 67 N-R_./~z W
TOWN OF Z S~G/✓ ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER
CERTIFIED SURVEY 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 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
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.
UWe, 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 retumed to the St. Croix
County Zoning Officer within 30 days of the three year expiration date-
SIGNED: ~_~_.C -
DAIT-
St_ Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson. WI 54016 11/1
553584
STATE BAR OF WISCONSIN FORM 1 - 1982
WARRANTY DEED
DOCUMENT NO.
YoL 3r214mcE442 .
This Deed, made between The NGL Cor oration vT CFiCI', ~.D,, V,j
a Wisconsin cor oration organized April 1, 1996 and c4. Rec'~d torRetwrn
i,
e w t t o scons n Secretary of State on
pr ~ f. DEC 2 0 1996
Richard 0. Grantor, i;
and Stout 3:30
P.-,.
m H'~...r~; _
Grantee,
Witnesseth, That the said Grantor, for a valuable consideration
conveys to Grantee the following described real estate in St. Croix THIS SPACE RESERVED FOR RECORDING DATA
County, State of Wisconsin:
'NAME AND RETURN ADDRESS
Richard 0. Stout
See Exhibit A hereto. 1351 Awatukee Trail
Hudson, WI 54016
020-1074-80-000, 020-1074-90-000,
020-1075--Dnn, n n-~n~~ ~n-000
PARCEL IDENTIFICATION NUMBER
$ TRANSFER
Grantor also quit-claims to grantee any reversionary right, title and interest to the
parcel described in Vol. 588, page 212, Doc. No. 354521, and in Vol. 588, page 214,
Doc. No. 354522.
This is not homestead property.
(is) (is not)
Together with all and singular the hereditaments and appurtenances thereunto belonging;
And
warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except
See Exhibit B hereto
and will warrant and defend the same.
Dated this 4th day of December
(SEAL) The NG Cor oration (SEAL)
,B Lt/
(SEAL) Robert Romeo
(SEAL)
'ice: VP P, CnIntr.,,,.r
ittf 1iEI'1TH'- O
ACKNOWLEDGMENT
Signature(s) Minn e s o t a
State %%xK
ss.
jl
authenticated this day of 19 Count .
TPersonally came before me this day of
YOt 172P Pm M
EXHIBIT A
Legal Description
The NGL Corporation to Richard O. Stout
The South Half of the Northwest Quarter, the Northwest Quarter of the Northwest Quarter,
and the West Half of the Southwest Quarter of the Northeast Quarter of Section 27,
Township 29 North, Range 19 West, Town of Hudson, St. Croix County, Wisconsin.
Except that portion of the Northwest quarter of the Northwest quarter of said Section
27 described as follows: Beginning at the Northwest corner of said Section 27; thence
along the North line of said Section 27, South 88 degrees 23 minutes 58 seconds East
160 feet; thence, diagonally, South 29 degrees 07 minutes 38 seconds West 338.27
feet to a point on the West line of said Section 27; thence along said West line, North
0 degrees 54 minutes 02 seconds East 300 feet to the Northwest corner of said
Section 27 and the point of beginning.
Subject to the right of St. Croix County for highway purposes as established by deeds
recorded in the office of the Register of Deeds for St. Croix County, Wisconsin, in
Volume 257, page 118 and Volume 302, page 24;
Subject to the right of way grant to the Wisconsin Telephone Company, recorded in
the office of said Register of Deeds, in Volume 472, page 85, document 305105;
Subject to the existing town road along the North line of the Northwest Quarter of the
Northwest Quarter of Section 27.
220798-1
l f * ,
iMPACE444
Exhibit B
Liens and Encumbrances
The NGL Corporation to Richard O. Stout
(i) Municipal and zoning ordinances and agreements entered under them, (ii) recorded
easements for distribution of utility and municipal services, (iii) recorded building and use
restrictions and covenants, and (iv) general taxes levied in the year of closing.
220798-1