HomeMy WebLinkAbout026-1115-40-000
o6
N
a 4 b
o ~ I
ry L
c
a 0
0
o !I D I
X
h B
y '
o I
c I
N O
0 ;p
C z N
U. C -
O Ca
m
° N
Q 00
I
3 M
v z
y I
Z = O
I
Z y
m
° w CL
0
o z d
m Z d ° ~ o
v) P ;Z c a) z
yU 'D 2 ch
CD C;
^V N O O
m N
N N
N N C
U) a) 0
• : r IL
.
C -0
° O
N Q O w
N 3 ~ZmZ -
O z
V p y > N
L co
d
r U
CL CY)
3 N
O ~ c E °
c a
N N
a3i N N N o w
0 0 O d d Z°
•rv a 'aaa
N g
O N pOj N
fn U rn rn ~
.0 m
°
N ~ O O
N ° O LO
C iC d `Z }
> 7
C O N N
00 3 O N C
O 2 C C CV CO
O O
0 0 f- N N D. D. CU p p
0 -0 04 C14
LO In E E
W C C L o o v
r
C 6 E ^ ~ Cl) o `v H I- 04 y 0 0 N O N Cn
[mil/ s~
CA a
2 5
_1 A va ~l'0000
V
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER ~1 C~ c-L~ 1~ I 0 k v"
~o ~~M~VI t^~ " a
ADDRESS
SUBDIVISION / CSMJ W~/ a~A ui2 LOT
SECTION- T 30 N-R W, Town of
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
I~
~s -S°~
J
~r
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK : r 1^ 1'1 at
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Liquid Capacity: Setback from: Well House Other
t Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:
Alarm Location"
`.SOIL ABSORPTION SYSTEM
Width: / Length -50 Number of trenches
Distance & Direction to nearest prop, liner QD A) ONJ
Setback from: well: House SDI Other
ELEVATIONS
Building Sewer ST Inlet. / 5/, o~ ST outlet
PC inlet ~ _ PC bottom Pump Off
Header/Manifold ?g Bottom of system '3
Existing Grade
Final grade ,/G)
DATE OF INSTALLATION:
PLUMBER ON JOB:
LICENSE NUMBER: l 4~13
INSPECTOR:
3/93:jt
Wiscbnsin 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 2M24
Permit Holder's Name: ❑ City ❑ Villaige Town of: State Plan ID No.:
1LLOlq RIVER JO Vi NTURE RICHMAIDiS
CST BM Elev.: Insp. BMElev. : BM D cription: Parcel Tax No.:
/oo, YJ 16.~91 yf' as
TANK INFORMATION ELEVATION DATA A9600230 Jd %f"
TYPE MANUFACTURER CAP STATION BS HI FS ELEV.
Septic 2a) Benchmark 5-, 93
Gl, GlJ
Dosing' vs . b•3a ~o <a(~
Aeration Bldg. Sewer
Holdin St / Inlet
TANK SETBACK INFORMATION St/ I~ Outlet /4U,
TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic ] d 2Z NA Dt Bottom 177t
Dosing NA Headed S/ qAa'
Aeration NA Dist. Pipe 6, W ' 9930'
Holding` Bot. System fall 9~, 3?
PUMP/ SIPHON INFORMATION Final Grade as 16 6,f
~
Manufacturer Demand ; T a 4,;' 11013.31
Model Number GPM
TDH Lift Lriction Syste H Ft
Forcem Length Dia. Dist. To Well
Head
SOIL ABSORPTION SYSTEM >6s.93
No. Of Pits inside Liquid Depth
BED/TRENCH Width// Length / No. Trenches PIT,_
DIMENSIONS 1~ :5 DIME ' N
Manu
SETBACK SYSTEM TO P / L BLDG WELL LAKE/ STREAM LEACHING
INFORMATION Type O ile, CAN y CHA Mode Number:
System: 4 / NIT ~J
DISTRIBUTION SYSTEM
Headed Distribution Pipe(s) -Ho1e Size x Hole Spacing Vent To Air Intake
Length /vIt~ Dia. Length _YL Dia. Spacing._
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems
Depth Over Depth Over xx Depth Of x ed / Sodded x ed
Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes E] No F E3 Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: RICHMOND.I.30.28W, SE, SW LOT 144TH ST
~B
~ v Yt.~ C A' ~~r r
r!~/✓)'I ~!:,2.~- Ems" _ ~s'Y~ ~i~ ~ ~ ~ ~ CC
Plan revision required? es ❑ No
Use other side for additional information. ~G ZZ S~--
SBD-6710 (R 05191) Date Inspector's Signatu a Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
SANITARY PERMIT APPLICATION couNTY
~'el`r■Iln In accord with ILHR 83.05, Wis. Adm. Code
aYr C v"o lX
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than .205;;10
8% x 11 inches in size. ❑ Check if revision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER PROPERTY LOCATION
0 U,~ ! U2n ~ 1Lh u tr►.+• 1/4,5w%, S T36 , N, R /&d r) W
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
/-SOS 7q,4 ZS /
CITY, ST ZIP CODE PHONE NUMBER SUBDIVISI0 NAME O SM NUMBER,
W f. l IOW" ~ h
.5 6 7 aAZ
10 I 6.1
II. TYPE OF BUILDING: (Check one CITY NEAREST ROAn
) ❑ State Owned D VILLAGE ~ G
_j )f1#1
❑ Public 1 or 2 Fam. Dwelling of bedrooms RCELTAX NUMBERO
III. BUILDING USE: (If building type is public, check all that apply) 6-24 1 ❑ Apt/Condo
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 130 Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. KNew 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.0 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 300 Specify Type 41 ❑ Holding Tank
12 Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy
13 ❑ Seepage Pit Pressure 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
C O-D o-0 7 S /p6~ Feet 0- Feet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Se tic Tank or Holdin Tank ~a~ 2 S Q -li^
Lift Pump Tank/Si hon Chamber F~+ EJ 0 1 L] 0 1 1:11 El
Vill. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plu er's Name ( r lumber's Signa re. No Stamps) MP/MPRSW No.: Business Phone Number:
o , IS~3 7/S-) 651-I-S'
Plumber's Address (Street, City, State Code):
/76,0 e cJ ~7
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued ssuing ent Signature (No S
Approved ❑ Owner Given Initial Surcharge Fee)
7117A4
Adverse Determination
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
t
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 ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399)-to be
submitted to the county prior to installation.
5. Onsit6sewage 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 & 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.
11. 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.
a
SBD-6398 (R.11/88)
I I 1 I
I ~ I I I ~ , ; I I I
I I
1
t (
1 I(/
fr ~
I i I
i I I
CSI 1! ? 7 r
f , ,j F~
5YY
I
' i I i I I
I i I I I I ~ I ~ ~ it ~•/v I I
I I I!~ i I j I
I
-I
' r
I
L_ f
I - r
I , I
~ I I I
+ r r -
1-
I
I I
, I
I ~ t I ! I I
I I
i I I
1- I 1
I ~ ~ I f j
~ I I I , I I t , j f ( I i
I I i I I l l t , i i l ;
1
I I I I I ~ I ! I I ~ ~ ~ I I
I I I I I i
i ~ I 1 F I .
I I , I I
I I I ~ ~ ~ ~ I- I I I
I
I- ~ - I t ~ _ ~ I I { I + ~ I- f
1 I I I
I ~ II i ~ I I
I I I~ ~ i ~ I I ! I
I
t
i I _
1
C ~ j I
I
I - I I I- t I ~ I ~ - r- I I I I
I it
-y-
~ i Ir
i I I ~ I I
1
jj
I I I t t
1
I ; I I i
I
I ,
r- ,
I I I i I 1 I ~ j I I I
i , I I ~ I I ~ i
~I
I I I- I f
it
1
I ! ; ; I
j ' 4 + I I I ~ i
i I l i I ~ II I i i ~ I
i I
I I
I
. I
,
- I
i
.
I - ~ I I I
;
f I '
I I ~ i
I I
, i
L
I
.
I
1
I i
W L D w Q4 ut 0-4
I"'~1 I PAGE OF
CrvSS Sec~lun o~ SySTen-~
Fresh Air Inlets And Observation Pipe
Approved Vent Cap
Minimum 12' Above
Final Grade
20- 42' Above Pipe _ 4' Coed Iran
To Final Grade Vent Pipe
March Hay Or Synthetic Covering
i Min. 2' Aggregate -
Over Pipe
01itrl6ullon
Pipe -1 0 0 0 0 0 -Tee
1 e a PIP* e
Beneath Plp a Perforated Plpe Below
o CoNVIng Terminating At
Bottom of slalom
6
Prupg5eiD Ptnkl: 11gre%cl<
SOIL. FILL
DISTRIBUTIOM PIPE
APPROVED S4YT-IETIC COVER
Ay9" OF STRAW
OP,
OF AGGREGATE N
/~r fe OF l2 -Z,i/Z AG GKEG. AT ~LEV of FEET
0I.5T1115UTIOU PIPE TU BE AT LEAST ~o IIJCHES BELOW ORIG"IIJAL GRADE
AQE) AT LEASTZO INCHES BUT 1,10 MORE THAIJ H2 IUCNES BELOW FMAL GRADE
MAXIMUM DEPTH OF FXCAVATIOO FROM OWWAL (3KAoF- WILL BE IIJCHES
MINIMUM 9EFrtt OF EACAvATION .ROM.. 0~I4IaAL ORAD€ WILL. BE ~ INCHES
SIGIJED:
LIGEUSE ►JUMBER: .
Wijco!.sin Dep&tment 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 1/2 x 11 inches in size. Plan must include, but St. Croix
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road. 026-1115-40
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
Derrick Construction, Inc. GOVT. LOT SE 1/4 NW 1/4,S 1 T 30 N,R 18 :R(or) W
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUED. NAME OR CSM #
1505 Hy. #65 14 na Willow River Meadow
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE MOWN NEAREST ROAD
New Richmond, WI. 54017 (715) 246-2320 Richmond 144th, St.
New Construction Use [ Residential / Number of bedrooms [ ] Addition to existing building
j ] Replacement [ ] Public or commercial describe
Code derived daily flow 450 gpd Recommended design loading rate • 5 bed, gpd/ft2 . 6 trench, gpd/ft2
Absorption area required 900 bed, ft2 750 trench, ft2 Maximum design loading rate .5 bed, gpd/ft2 .6 trench, gpd/ft2
Recommended infiltration surface elevation(s) 100.91 ft (as referred to site plan benchmark)
Additional design / site considerations area of B-3-4-5- system el. 98.3
Parent material pitted outwash 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 for s stem [2S ❑ U 10 S❑ U Z S ❑ U RIS ❑ U Q S ❑ U ❑ S ® U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
1 0-10 none 1
2 10-28 7.5 r4/6 none sil lfsbk mfr gw if .2 .3
Ground 3 28-78 7.5 r4 6 none Ifs lcsbk mvfr na na .5 .6
elev.
101.18 ft.
Depth to
limiting
factor
+78"
Remarks:
Boring #
1 - 1 r2 2 none 1 2msbk mfr cs 2f .5 .6
2 2 9-24 10 r4 4 none sicl if r mfr 9W if .2 .3
MEMO
Ground 3 24-63 7.5 r4 6 none lfs lcsbk mvfr gw na .5 .6
elev. 4 63-78 10 r4 4 c2 7.5 r5 8 sil m na na na np .2
101.2 ft.
Depth to
limiting
factor
63"
Remarks:
CST Name:-Please Print Phone:
Gar L. Steel 715-246-6200
Address: 54017 m02298
1554 M)Dth.Ave., ew Richmond,WI.
Signature: Date: CST Number:
6-12-96
PROPEMYOWNER Derrick Const. Inc. SOIL DESCRIPTION REPORT Pane 2 of .3
PARCEL I.D. # 026-1115-40
Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tram
rnfr 2f .5 .6
2msbk
31 0-10 10 r
none i
3/3
2 110-241 7.5 r4 6
Ground 3 24-80 7.5 r4
elev.
101..8 ft.
Depth to
limiting
factor
+80"
Remarks:
Boring #
.5 i .6
1 10-13 10 r2 2 none 1 2rnsbk mfr CS
4
2 13-28 10 r4 4 none girl lfsbk rnfr aw -2 -3
U
Ground 3
elev.
101.1 ft.
Depth to
limiting
factor
+78"
Remarks:
Boring #
1 0-12 10 r
<< 5 2
Ground
elev.
100.8 ft.
Depth to
limiting
factor
+74"
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
I
Remarks:
SBD-8330(8.05/92)
STEEL'S SOIL SERVICE
Gary L. Steel Derrick Construction, Inc. 1554 200th Ave.
CSTM2298 SE4NW4 S1-T30N-R18W New Richmond, WI 54017
MPRSW 3254 town of Ri-chmond (715) 246-6200
lot #14-Willow River Meadows
N
111=401
BM.= top of NE lot stake @ el. 100'
e
Z to
GAry L. Steel
6-12-96
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER \1ur0I~v~-~. ~t y-Llcfic.ly~ C-/o Mto-~ 'L 9-, --sty, ,
MAILING ADDRESS Hwy b!~ ~ (bOX 4, ~Lw P C44 &4090\tj
PROPERTY ADDRESS n (D (6 t ~ A 1- l(location of septic system) Please ` .tlain from the Planning Dept.
1 4 C;' +0 t -I
CITY/STATE v~
PROPERTY LOCATION 1/4, SW 1/4, Section ~ , T '7?0 N-R 1 00 W
TOWN OF V21 L4A aD , ST. CROIX COUNTY, WI
SUBDIVISION W I V_QW 124 x)10 L- WNLOWS , LOT NUMBER I
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.
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 ex ' atton date.
SIGNED: QQ
DATE: St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
STC - 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
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 \N L -ow ~~Yc'tL -\Jot V41- VeF-H g'6 C~/a M lc-t-{ -a- P-5M-V~'
Location of property 1/4 '5W 1/4, Section T N-R ta W
To ship C44 NA o t kO Mailing address 1r7 (0 C, L-3 yvd./ (oC
70 oX vet 12A c.*+Ma N Q , W l 574-01-1 7,
Address of site ~-1 (p (p X44 ~kw r2_1 c,+4 Mo X10 , \A1 I
Subdivision name WL-WW P~,\4<T. M~DoWs Lot no. _
Other homes on property? Yes X No
Previous owner of property 6ag!,w1 f~c 5c+h M t or
Total size of property 2 ArC,
Total size of parcel 'Z A,t , +
Date parcel was created to - l9 - 90
Are all corners and lot lines identifiable? X_Yes No
Is this property being developed for (spec house) ? X Yes No
Volume lbS 4 and Page Number `'YR 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. 4 5-2,-7 (o "1 , 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.
Z~ b'1
ignature of Appli ant Co-Applicant
Date of Sianat-urP
Oudatt
1.7
is %jrift:
RIV Wr
16
101 AC"
'y A0 A Me'a''dOws
. 2a ' - .
15 ZpsAif ; 1
2.14 ACM 1, •
2 OZ YAOfM• i 1
30
20! 13 21t '
2;1 Aar t Zoe ACM
9 „ 1 M.,
LM A"' ~ ZOO Aa w
22,
12
1 ' ;ios tts „e.2s ~ 1 . ,
PUbIld
23
N t
ZOO Aat Xn AaM
W 20.30 24
sosaa d' zoo ANN
Z 6 2.s72A~ot.
2OtAO
' 42524
25 $
2A, A"ft L" A
-27
44O.as• N i 2.32 9 2=
Aaft • AQW
0 4 ~ n•~ Wilow
a : ,
t0 A0"- w _ ♦ f~VOf
4"M cir of mm Fkftra4
$ '
a 3* _ i,26 s
HOW
. 1 . 2.30 AaW 4"
' so~.os .30 223 200
21,.03 0 2OtAa~t = Coup PAL GO
o ~
,"b
" 32 33
" OL • « n 220 Hatt "1st Aa' w ' .
F
x '31
1AT. AaN N 203 Aatt
200 SO 329.37 rn'
Highway GG '
(715) 246-232'-RRICK -
Route
New Richmorc
REGISTER'S OFFICE
. This 'Deed, made between ST. CROIX CO., WI
-Gertrude E . Schmi_t.. by_ Beverly. Buckner , Guard is Recd for Record
Oi;1, 231989
Grantor,
at
a8 : 00 A. nn
nd...._Michael•••R.....Stevens.,._.Wi.1l.i.am..H....-Derrj.ck............. ro Can J .
Will.i. am_.M.....Derr.ick,...Thomas E Der.r_ick..and_..... I V
Rona] d••-L.,_..De.rr_i.ck-__~$...t~.ilan.is.,.~, Reg r of Deeds
Grantee, I
Witnesseth, That the said Grantor, for a valuable consideration......
Gertrude E. Schm.it. by...Beyerl.y..Buckner
nr\unr~
conveys to Grantee ilia following described real cstnte in S.L • Qro i.x
County, State of Wisconsin: ,
Southeast Quarter of Northwest Quarter and
Northeast Quarter of Southwest Quarter of Tax Parcel No:...................................
Section 1, Township 30 North, Range 18 West.
This deed is given pursuant to the Order to Sell, dated October 16,
1989, and the Confirmation of Agreement and order, dated October 19,
1989, both duly authorized by Order of the Court and whereas the
undersigned, Beverly Buckner, is authorized to sell the same
by Letters of Guardianship certified on October 22, 1989.
fit!"~iv )FEB
x 1d 0
YM
This s not homestead property.
(is) (is not)
Together with all and singular the hereditaments and appurtenances thereunto belonging;
And..... Ger.tr_ude...E.....Schmit...by...Berner.ly..Buc.kn.er
warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except
easements, restrictions and rights-of-way of record, if any.
and will warrant and defend the same.
1e iv 89
Dated this day of .........OCtOber.........................................., 19........
.............................................•••••...................(SEAL) ~'^c~ .44E 4''c-c,F s~-tt/..........(SEAL)
Gertrude` E. Schmit by Beverly
B'acktll'Y' ► GUa-rdTa n
............................................................--•--....(SEAL) .......................................................••...........(SEAL)
•
"
AUTHENTICATION AC$NOWLEDGMENT
Signature(s) _ STATE OF WISCONSIN I
.Bever.ly Buckne.
. r ss.
.
K/•
authenticated this`~ ...day of ..October . 19 ....9 Personally came before me this ................day of