HomeMy WebLinkAbout040-1246-00-000
\ STC - 104`
AS "UILT SANITARY SYSTEM REPORT REC,EIVE9
_ DEC, ? iS97
OWNER C-: J-wt j~+a ST CROIX -4vg:~ is
COUNTY
ADDRESS ZONINGOFFICE
- 51JBDIVISION / CSMI_ LOT #
SECTION =T~N-R 19 W, Town of
ST. CROIX COUNTY, WISCONSIN 6`{0- I ar~L-ov.OV~
PLAN 'IEW
SHOW EVERYTHING WITHI 100 FEET OF SYSTEM
v
1
f
rt
T
Tit INDICATE NORTH ARRO
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
f r
BENCHMARK: lM' / j 3 ~S
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer:- (,j Liquid Capacity: /01,5
d
Setback from: Well House Other
Pump: Manufacturer- AI A- Model# Size
Float seperation Gallons/cycle:
Alarm Location-
SOIL ABSORPTION SYSTEM
Width:
Length- Number of t 7
Distance & Direction to nearest prop. line: So,
Setback from: well: House Other
ELEVATIONS
Building Sewer 1, ST Inlet: (p ST outlet: 8 $ (3 ,
PC inlet Af PC bottom Pump Off
Header/Manifold ~ 75, 7 Bottom of system
Existing Grade Final grade OP-1
DATE OF INSTALLATION:
PLUMBER ON JOB: ~r1
LICENSE NUMBER:'-
INSPECTOR: # '(5-13
3/93:jt
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County:
Safety and Buildings Division
INSPECTION REPORT v , CVO /A
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: ❑ City ❑ Village M Town of: State Plan ID No.:
pelrilc~K Con rvvfioV1 Tro
CST BM Elev.: 97:3.195-1 Insp. BM Elev.: BM Descrip/Y~on: Parcel Tax No.:
3•$s To oT ktal ml ~K l/1~ 0~0 -12-elo - w . v d v
TANK INFORMATION ELEVATION DATA DO
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
se ti j' /Z~ Bench ar ,q 8'g.;~ 357
,Z
Dosing Att 6AA'~ 7z 7-2,'
F-vt
Aeration Bldg. Sewer
Holding Inlet G13~` g
TANK SETBACK INFORMATION /.4t Outlet
TANK TO P/ L WELL BLDG. V-Q jntake ROAD Dt Inlet
e ~ t 1 NA Dt Bottom
Dosing NA Header / Man. •32 X 75; W
Aeration NA Dist. Pipe /YSI- 75W
Holding Bot. System 1,54 7 .S
PUMP/ SIPHON INFORMATION Final Grade ,p
Manufacturer Demand , Wan ~ V. C/61
Mod umber GPM
TDH Lift Friction System TDH t
ead
oss
Forcemain Length Dia. H Dist. To Well
SOIL ABSORPTION SYSTEM
ED TRENCH Width Length No. Of s PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSION ( DIMENSION
SYSTEM TO P / L BLDG WELL LAKE / STRE M LEACHING a
SETBACK CHAMBE
INFORMATION Type O r Mode Number:
System NIT
DISTRIBUTION SYSTEM
Header/Manifold Distribution Pipe(s) x Hole Size ole Spacing Vent To Air Intake
Length V Dia. Length ~I Dia. Spacing AS 7W 4x H 7_7Z SQL
SOIL COVER ~f x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx D xx Seeded/ Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges Topsoil ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
+o 6e, Iv4 +D 2q 49 Ov&✓ Are-k rt tl" r~ pc. Af -h-me
&T1 ✓4 ~1 ~ 6 w#6 6o, ` III 72•` <l p~/G✓ A e ~5fr~l.
(2-P40f Y, - TOP u r i wvSe, dyAd l _ ar havl V~/l
of 1
I V14)
Plan revision required? ❑ Y s [R No
Use other side for additional( inftorma~tioon►.~ t2
SBD-6710 (R.3/97) Zf/ " { Date Inspector's Sig to ert N
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
i
I
_ yF
Safety and Buildings Division
Visconsin SANITARY PERMIT APPLICATION 201 E. Washington Ave.
In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969
Department of Commerce Madison, WI 53707-7969
0 Attach complete plans (to the county copy only) for the system, on paper not less County
than 8 112 x 11 inches in size. C; ("O" _Sr 0 See reverse side for instructions for completing this application State SanIR Perm m it Number
The information you provide may be used by other government agency Programs d'pre-mb
❑ Check if ion t
vi us application.
[Privacy Laws. 15.04 (1) (m)].
State Plan I.D. Number
1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION
' PropertOwner Name - v Propert Location
_r, I
.SWt/n 1/a, S ICJ T a 9, N, R r) W
Property Own 's Mailing Address Lot Number Block Nu ber
(OS
City, State Zip Code Phone Number Subdi i Name or CSMP ber
II. TYPE F ILDI G: (check one) ❑ State Owned itNearest Road
❑ Village
Public 1 or 2 Family Dwelling - No. of bedrooms own of
Alines W
III. BUILDING SE: (If building type is public, check all that apply) Parcel Tax Number(s)
1❑ Apartment/ Condo C) J~ D i s 14 SO "a 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. New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
------System System Tank OnlyExisting 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) 37 / Elevation
(p /e~CSa ~.~~D ~b-/Feet .~et
VII. TANK Cap city
gallons Total # of Prefab. Site Fiber- Plastic Exper.
-INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel . lass App.
New Existin structed 9
Tanks Tanks
Septic Tank or Holding Tank
/ 42-50 ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑
I ' X _L4Q`
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for' Ilation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Prin P tuber s S gnatur : (No Stamps) /MPRSW No.: Business Phone Number.
Plumber's ( dress (Street, C y~S{tate, Zip Code): Qk&MnI4
nto9 4u P_ iNiv-9 IX. COUNTY/ DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Ag ntSignature (N tam
Approved ❑OwnerGiveninitial Surcharge Fee)
Adverse Determination jy 6 ~
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD-6398 (H 11/96) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber
I
it 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, 608-266-3151.
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 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 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.
t
i
Id G '
0
t
I ~
v
PAGE OF
Crv S S
Spec Ion o.~ ~ 3r1~ S~ s~~~ '
• F~~►A All Inlat► And Obtalvatiolk Pipe
15oS ~w~ 1oS
A, PDBoF
Aaa~ool• Vial cap acs,
►IlMipuia 12-Abe,* M10 J Lem
` IlnaI Clods 0t
• 'Tr o y u : ll
20. 42'Abooo Plpp 4' Cool boa T,ro
+ To final Otuo Vonl Plpo W O~~
~ao• IIO 0, s atM_k Co..,,.
Ooat2PI 99140olo
0111fteY110a
I'Ia• o . Too
6oaail4 ►Plpa
° Parla~ta~ pipe
Coptt°~ Twa,laoltno Al
• oolloa~ or a1►laq
Npolf.D Fins-1 grs%cl-c 3 7/'
VCUJ Ion
SOIL FILL.
DISTRID.UTIOkI PIPE
2u Of AGGREWE- ~ APPROVEO 949THETIC cOVCR
MA7r:RIl~t- OR 9" OF STAAW
HA•.i
ELEV. OF~/T/Jl,~, a f.t0 F:z-2l/e AGGREGATE 'P v
DISrR115UT10N PIPE TO DE AT LEAST
AUU AT LtA.STtO 11.JCHEy BUT L10 MORC H 1mCHE5 SCLOW ORIGIQAL C,RAOE
AN 42 UJCI{ES BELOW FIMAL GRADE
MAX"UM 1XPrH OF FXe/1V ,
ATIo
I.D ~i(019 OR16VJAL 69ADE WILL Sr, 1'Vt11MVlM 0"I OF EXCAVAT10" ROA IGINAL - INCHES '
CaR~D Will. gE INCHES
31GIJE,O: i
LIC CIJSC UUMBE I2: I~
DATE
. 110
Wisconsin Deparmwnt of Industry. J I L AND 5(T E EVALUATION REPORT Page 1_ of I
Labor and Human olauOns
Giviston of Satan s Buildings in acco rid with ILHR 83.05. Wis. Adm. Code
COUN iY
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but ST. CROIX
PARCEL I.O. a
not limited to vertical and horizontal reference point (8M), direction and % of slope, scale or
dimensioned, north arrow, and location and distant d.
REVIEWED BY OATS
APPLICANT INFO RMATION-PLEASE P Fft:At.L INFORM'A, ON
PROPERTY OWNER: PROPERTY LOCATION E 1/2S 24T 28 NR 20 W
TOM RUEMMELE & JOHN AND RUEMMEL2r~~U V LOT 114W 1/2S 19T 29 NR 18 -440) W
PROPERTY OWNER :S MAILI NG ADDRESS P~ ' ~OT 06('!Ht SUED. NAME OR CSM #
260 COUNTY ROAD F TROY VILLAGE
CITY, STATE ZIP C 0 PHO F..1 g CITY ILLAGE DOWN NEAREST ROAD
HUDSON WISCONSTN 540 (7 (b TROY
DC( New Construction Use PC I Residents 4 ( ) Addition to existing building
j I Replacement ( I Public or tom d
Code derived daffy flow 600 gpd Recommended design loading rate S bed. gOM2 t• 6 trench, gpdM2
Absorption area required ZDO bed, ftZ /000 trench. 9 Ma*num design loading rate bed, gpdM261 trench, gpd/ft2
Recommended infiltration surface elevation(s) BY DESIGNER ft (as referred to site plan benchmark)
Additional design I site considerations 5~e Ala 7-e-5 V AI 119¢~? E 3
Parent material Z.-04e.4:5 ~/OUTw45f7e Rood plain elevation, if applicable N/A ft
S = Suitable for system CONVENTIONAL MOUNO IN-GROUND PRESSURE AT GRADE SYSTEM IN FILL HOLDING TANK
U= Unsuitable for system I IsS O U I ®s D U CS ZU I❑ S Z U I 0 s I$U I B S 2 U
SOIL DESCRIPTION REPORT
Depth (Dominant Color I Mottles (Texture I Structure ICors~tt3nCe 8ou>Qey Roots GPO/ft
Boring # Horizon in Munsell Du. SZ.Cont. color Gr. Sz. Sh. Bed ITMrch
r4~ A 0-24 10YR 3/1 mfr gw 2vf-t 0.51 0.6
B 24-49 10YR 4/6 sil 2msbk mfr cs 2vf4 0.51 0.6
Ground C 49-72 10YR 5/6 s Os ml lvf 0.71 0.8
elev I
8$0. 5tt.
Depth to
limiting
factor
>72"
Remarks:
Boring #
A 0-17 lOYR 4/2 sil Zmsbk mfr cw 2vf- 0.5 0.6
43M B 117-39 10YR 4/6 ail 2msbk mfr cs 2vf- 0.5 0.6
C 39-72 IOYR 5/6 s Osg ml lvf 0.7 0.8
Ground
elev.
880.4 ft.
Depth to
limiting
factor
'72_
Remarks:
Narnr-Flew Print JAMES p. Fu ms Phonr. (715) 425-7831
OGDEN ENGINEERING CO., 113 WEST WALNUT ST., RIVER FALLS, WI 54022
Si err Dal.: L l0 9, CST Number7 CSTM03988
PROPERTY OWNER SOIL DESCRIPTION REPORT Page 2 ot_3
PARCEL I.D. s
Oeptn Dominant Color Moores Structure GF'Oirt~
Nonzon in I M n u Crnt col Texture I Gr. SI. Sh. Qnsismnce e N Roots Sea Trerx7t
Boring #
Al -20 1Q:XR_ 3/1 sil 2msbk mfr w of -f 0.50.6
F 432 B 0-43 10YR 4/4 sil 2mabk mfr cs of 0.5 0.6
C 43-72 TORY 5/6
Ground gs Osg ml lvf 0.7 0.8
elev.
877.2 tL
Depth to
limning
> 7211 I
I
Remarks:
Boring #
Al -12 lOYR 4/2 sl 2csbk mfr as 2vf- 0.50.6
56E
A2 12-32 10YR 3/1 sil 2
Bl 2-48 OYR 4/3 sil 3mabk mfr gw lvf 0.5 0.6
Ground
elev. B21 148-68 OYR 4/6 sil 2mabk mfr cs lvf 0.5 0.6
878.3 ft
Depth to B22 8-74 6YR 4/6 f2f 7.5YR 5/8 1 2mabk mfr leg lvf
6mi0ng c 4-84 OYR 6/6 s Osg ml lvf
fa= I
I
Remarks: -
Boring # I
A 0-16 110YR 4/2 1 I 12cp1 imfr law I2vf-fl NP 0.2
582.4 B1 I16-24 (lOYR 3/3 1 I 1
1 2msbk mfr w 12v f- 0 0.6
B2 24-37 110YR 4/6 1 sil 12msbk mfi I w 11vf 1 0.5 0.6
Ground elev. C1 137-54 110YR 4/6 1 I 11cghk 1
87LLft.
C2 k4-80 110YR 5/6 1 Is IDs Iml 1--- lvf 10.7 0.8
Depaf to i I I I I i t
Iin"M
7" 1 I I I I 1 I I
Remarks:
Boring # 1
Ground
elev.
tt
Depth to
limning
fat~Ot 1 I
Remarks: -
S80exi0fii.0alOSt
PAGE 3OF3
r
SITE PLAN
NOTES: DRAINFIELD TO BE A MINIMUM OF: 25' FROM DWELLING; 50' FROM WELL; 5' FROM LOT LINE.
SAY
N~~S
~A
SCALE: 1 40'
LET ~9
ZdT zo
NflL /-,V Bo~EGOE,e,
~LEv = 88 3.85
8 ¢30
o~e
6
43z
GoT / 7
OGDEN ENGINEERING CO.
JAMES FILKINS, CSTMO3988 Civil Engineers 8. Land Surveyors
/ 113 W. Walnut St. River Falls. WI 54022
DATE: ~d p;7 (715) 425-7631
r'
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER HIV t w_ o w DIEM rt-E /MVC44ke-L_ BLS
MAILING ADDRESS ISIS 4V4y ca s , ~.1~ w Q- L44 & ,0 W 0 , \,1qk S4-01-1
PROPERTY ADDRESS 3 13 S►~'. A~N c~ S 1''~u`w
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE 4Au o so b-L' \J41 4,0% %0
PROPERTY LOCATION '5\14 1/4, V3W 1/4, Section 9 T Ik N-R 9 W
TOWN OF I t~Y ST. CROIX COUNTY, WI
SUBDIVISIONS C~J~ ►'i-t~rc 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.
[/We, the undersigned have read the above requirements and agry to maintain the private sewage
disposal system in accordance with the standards set forth, herein. 2s set by the Wisconsin DNR.
Certification stating that your septic has been maintained must be comp;e::d and returned to the St. Croix
County Zening Officer within 30 days of the three year exp' ation date- ~O
SIGNED:
®~2 ~r g
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 \/Vtiu-caw Vwdn, )ayniT ~/ENru►2E/Iylt u~a~l.
Location of property ~1/4 9W 1/4, Section T ti4a N-R L9 W
Township Mailingaddress IScS 4W ,
Address of site J 13 Subdivision name ::FV alAa-4e Lot no.
other homes on property? Yes X No
~-yP M.r3Ed~'
Previous owner of property LObt~k=N'~- VIE
Total size of property 1.044b A-C,
Total size of parcel
Date parcel was created S 2'l - 9"l
Are all corners and lot lines identifiable? X Yes No
Is this property being developed for (spec house)? Yes No
Volume t-L41 and Page Number 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. Ot "IS , 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.
_5 q
gnature of Appli ant Co-App-licar.t
RIVER VALLEY ABSTRACT Fax:715-386-7664 Oct 24 '97 1040] P.01
r VOL 1271 FACE-151 ~ J
5599`5 , .
WARRANTY DEED
DOCUMENT NO. ST. CROIX 00, W1
hwdfnrthpor!
This Deed made between TROY DEVELOPMENT MAY, 2 7 1197t
Cop.PORATION, a Minnesota corporation, Grantor and P.m
WILLOW RIVER JOINT VENTURE, A Wisconsin mow, 7:-15
partnership,. Grantee, Aryww~ of Dow ai
Whameth, That the said Grantor conveys to
Qrantcc the following described real estate in St. Croix
County, State of Wisconsin:
Lots 24, 25 and 49 of the Plat of Troy Village in the Town of 'hay, St.
Croix county, Wisconsin.
subject to Deciatntions of Covenants, Conditions and Restrictions for Tax Parcel No.
Troy vinate, recorded in Vol.1241 Page 256, ad Doo. No. 559964 gB'i'jjgN TO:
and the Declaration of Golf Course Covenants, Conditions
and Easaments, recorded in Vol. 1241, page, 301, as Doc. No.559969 Robert W. Mudge, k. fl. Box 469
Hudsqk WI 54016
, all as appearing in the office of the Register of Deeds for St.
Croix County, Wisconsin, and such other easements, reservations,
restrictions nd reservations of record, or in. use. , .
This is not homestead property.
Together with all and singular the hereditaments and appurtenances thereunto belonging;
And Grantor warrants that the title is good, indefeasible in fee simple and free and clear of
encumbrances, and will warrant and defend same.
Dated this,,,$#-day of May, 1997.
TROY DEVELOPMENT CORPORATION
Charles S. Cook, President
STATE OF WISCONSIN
As
ST. CROIX COUNTY
Personally came before we thispfd a ~ mown to be the person who executed the foregoing nst meat and
corporation, by Charles S. Cook, its President,
=Uowiedged the same, being authorized so to do.
THIS INSTRtTNSENT DRAFTED BY:
Robert W. Mudge, Attorney
110 2nd St., P.U. Box 469 Notary Public, State f Wisconsin
Hudson WI 54016 My Commission (expires): -