HomeMy WebLinkAbout030-1019-70-100
~ -0 00
C o a
00 O °
c
r: ~q O
o y o
`a
C.
O
O
N
O r
x
.p
O ti
c
C ~
~ N
O
~ y
C
U
o a
C Z W
3 (
LL c m
O O)
:d 00
Q
V II ~ ~ I
rn ~ C I
Z O
Z m m
N w a m
V)
c
0
O 2 c O
N O
d Z d' 2 c
N N N p
CD E
2 Cl)
(D M
J a
c
• Ail d
c c O U
Z H Z
® O O Q
~y c Z
co C (0 U
O N = C
M N
10
V O y L co = °O C)
O O a E N N
:3 CO
h w Q O f/~ N fn j U O O
NW~J Z Lo > 2 U)
•~i _ro O O Z O O
ti oIL IL CL ►i g
rn rn y
rn U')
a 00
„1 o ~I rn °o
C O
N O N
~r "p r
l
y c
\j ° °0 3
►~i C N N W
Q o 3 a°i N c c°'a a °O °O °O
r-- cu a
s N N
~ O O ~J C O N ~ vq n _
C4 iz 3 N
rw Lo 'a LO
'I ° N U O
N O U
_
• y'r,' O O U) v> N O N=5 co
V ~ E d
A U a 2 0
y U
s
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER
ADDRESS jffZ%/dJS'o~
SUBDIVISION / CSM# LOT # T"
SECTION T --24? N-R_& _W, Town of .577-
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
U P L
1
S e
k
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
T I,
BENCHMARK:
$'G yj cL s ~f S
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Liquid Capacity: jZ;e ~
Setback from: Well 5-0-4- House ~Y Other
Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: Length 7 -5- Number of trenches
Distance & Direction to nearest prop. line: -,I6/v--
Setback from: well: 4607- House 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:
PLUMBER ON JOB: LICENSE NUMBER:
INSPECTOR: sJ~
3/93:jt
Wisconsia Ddpartment of Industry, PRIVATE SEWAGE SYSTEM County:
tabor and Human Relations INSPECTION REPORT ST. CROIX
Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No-:
GENERAL INFORMATION 268552
SCHMIT, r T ENCE T ~,ty ~OIS ' Town o : State Plan ID No.:
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
TANK INFORMATION ELEVATION DATA A9600265
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic o? Benchmark
Dosing
Aeration Bldg. Sewer
Holding St/ Ht Inlet
TANK SETBACK INFORMATION St/ Ht Outlet w3' 9
Verit
irIto ntake ROAD Dt Inlet
TANK TO P/ L WELL BLDG. A
Air
Septic r/a• >50• ay' - Zd NA Dt Bottom
Dosing NA Header / Man. 5 2 oy 3~
X-' a4. k
Aeration NA Dist. Pipe 6' d3 bU
Holding Bot. System L~8'1 ~1, ~a 3.3L
9 to a, 3a
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand 7 Y
Model Number GPM
TDH Lift Friction System TDH Ft
Head
Forcemain Length Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED /TRENCH Width Length ~ i No. Of renches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 0 DIMENSIONS
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK CHAMBER
INFORMATION Type O Moe Number:
System: ~i ~1A 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 Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION:
ST.JJO}S/EPPH..5. 29.1,9W, SE, NW, 42nd Street
Plan revision required? ❑ Yes [5"No
Use other side for additional information. &ftj
SBD-6710 (R 05/91) Date ns is Signature Cert No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
Safety and Buildings Division
e.~■~nr,t SANITARY PERMIT APPLICATION Bureau of Building Water System
201 E. Washington Ave.
In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969
Madison, WI 53707-7969
0 Attach complete plans (to the county copy only) for the system, on paper not less County 1
than 8 112 x 11 inches in size. S . CrB I x
0 See reverse side for instructions for completing this application State Sanitary Permit Number
The information you provide may be used by other government agency programs E] Che t vl Ion to previous application
[Privacy Law, s. 15.04 (1) (m)].
State Plan I.D. Number
1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION
Property Owner Name Property Location
1/4, S~5 Ta , N, R/,0 E (or)
Property Owner's Mailing Address Lot Number Block Number
aG e
City, State Zip Code Phone Number Subdivision Name or CSM Number
( ) / h'7
II. TYPE F BUILDING: (check one) ❑ State Owned o 't ea st Road
01 Village
Public 1 or 2 Family Dwelling - No. of bedrooms Town OF
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number (s)
®v ?o
1 ❑ Apartment/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 13 ❑ Other: specify
IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable)
A) 1. gNew 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
G'd 1 17-1-0 1 r ~ Id-f Feet ~ Feet
VII. TANK Ca
in gallons Total # of Prefab. Site Fiber- Exper.
INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel lass Plastic App
New Existin structed g
Tanks Tanks
Septic Tank or Holding Tank
El El
Lift Pump Tank /Siphon Chamber ❑ ❑
VI11. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite se age system shown on the attached plans.
Plumber's Name: (Prim-t+) Plumber's Signature: ( Stamps) /MPRSW No.: Business Phone Number:
A J t'
Plumber's Address (Street, City, State, Zip Code):
IX. COUNTY / DEPARTMENUSE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issue Issuing Ag nt Signature (No m
` /
.21~pproved ❑ -Owner Given Initial Surcharge Fee)
Adverse Determination ~t~~"G®
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD-6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS y =
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 thissanitary 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. T e of ermit. Check onl one on line A. Complete line B if i for
yp p y permit is tank replacement, reconnection, or repair.
V. Type of system. Check appropriate box depending on s ' m
yste 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 8 112 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.
------------------------------------------------------------------------------------7---------------
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.
57e
'
G
a 6 ~ ,~Gf
(V 3.'7'
w"
1
4y G
II
pt ~
•
h
1b
F
3.,
h
k ~
n o R
i
i~
7 .3
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3
Labor and Human Relations -
Divisioriof 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. pending
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
Hank Fogelberg GOVT. LOTSE 1/4 NW 1/4,S 5 T 29 N,R 19 9(or) W
PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR FM #
275 192nd. ST. v,,%, X na csm pending
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE [MOWN NEAREST ROAD
Star Prarie, WI. 54026 (715 248-3003 St. Joseph 42nd. sT.
[ New Construction Use [ :4 Residential / Number of bedrooms 3 [ ] Addition to existing building
( ] Replacement [ ] Public or commercial describe
Code derived daily flow 450 gpd Recommended design loading rate • 7 bed, gpd/ft2 .8 trench, gpd/ft2
Absorption area required 643 bed, ft2 563 trench, ft2 Maximum design loading rate • 7 bed, gpd/ft2 .8 trench, gpd/ft2
Recommended infiltration surface elevation(s) 103.45 ft (as referred to site plan benchmark)
Additional design / site considerations ssytem area cut and backfilled to code
Parent material glacial drift over outwash 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 fors stem 91 S ❑ I. nS ❑ U M ❑ U ® S ❑ U ® S ❑ U ❑ S T3U
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 10yr3/3 none 1 2msbk mfr gw 2f 7 .6
1
2 10-21 10yr4/4 none sl 2msbk mfr gw if .5 .6
Ground 3 21-34 7.5yr4/4 none is Osg mvfr gw na .7 .8
elev.
106.45 ft. 4 34-84 7.5yr4/6 none cos Osg ml na na .7; .8
Depth to
limiting
factor
+84"
Remarks:
Boring #
1 0-7 10yr3/3 none 1 2msbk mfr gw 2f .5 .6
2 2 7-15 10yr4/4 none sl 2msbk mfr gw if .5 .6
3 15-84 7.5yr4/6 none co s Osg ml na na .7 .8
Ground
lev
109.2 ft.
Depth to
limiting
factor
+84"
Remarks:
CST Name:-Please Print Gar L. Steel Phone: 715-246-6200
Address: 1554 200t . Ave., N ,9w Richmond, WI. 54017
Signature: Date: CST Number:
2-21-96 cstm 02298
2 3
PROPERTY OWNER Hank Fogelberg SOIL DESCRIPTION REPORT Page~of
# pending _ r
PARCEL IA
Boring # Depth Dominant Color Mottles Texture Structure Consistence Boundary GPD/ft
Horizon Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
0-9 10yr3/3 none 1 2msbk mfr 2f .5 .6
M 3
2 9-26 10yr4/4 none sil 2msbk mfr gw if .5 .6
3 26-53 7.5yr4/4 none sl 2msbk mfr gw na .5 .6
Ground
elev.
108.3 4 53-98 7.5yr4/6 none S Osg ml na na .7 .8
ft.
Depth to
limiting
factor
+98"
Remarks:
Boring # 1 0-9 10yr3/3 none 1 2msbk mfr gw 2f .5 .6
2 9-50 10yr4/4 none scl 2msbk mfr gw if .4 .5
4 w
3 50-64 7.5yr4/4 none sl 2msbk mfr gw na .5 .6
Ground 4 64-11 7.5yr4/6 none S Osg mvfr na na .7 .8
101. 7 ft.
Depth to
limiting
factor
+115"
Remarks:
Boring # 2f .5 .6
1 0-8 10yr3/3 none 1 2msbk mfr gw
5? 2 8-54 7.5yr4/4 none scl 2msbk mfr gw na .4 .5
3 54-63 7.5ry4/4 none sl 2msbk mfr gw na .5 .6
Ground
elev. 4 3-11 7.5yr4/6 none S Osg ml na na .7 .8
108.2 ft.
Depth to
limiting
factor
+1101,
Remarks:
Boring #
4\\-
~ii:C}~::i:•~::tiii:>
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(R.05/92)
-
STEEL'S SOIL SERVICE
Gary L. Steel HANK Fogelberg 1554 200th Ave.
CSTM2298 SE4NW4 S5-T29N-R19W New Richmond, WI 54017
MPRSW 3254 town of St. Joseph (715) 246-6200
t lot #2-csm
N
1"=40'
BM.= bracket on power pole @ el. 100'
X00
IC D A 0 P6e-Y'r
c
100 '4,
i
Gary L. Steel
2-21-96
- ~ 2
FILED 1
L MAY 2 9 1996
KATHLEEN H. WALSH
eeds
9 Register 111
St. Croix Co.= WI ?
544383
C ER T I E .I ED S UR V E Y MA P
Located in the Southeast quarter of the Northwest quarter of Section 5,
Township 29 North, Range 19 West, Town of St.Joseph, St.Croix County,
Wisconsin.
Owned by: Hank Fogelberg
400 South Second St.
Hudson, Wi. 54016
UNPLATT_E_D _LANDS
(SOO°20'08'IW 588.26')
fi SoR°o2'o5"W S 00' 02' 05"W 588.30' Soo-02'05"W
l~ 30781 EAST LINE OF THE SE114 3347.30=
N1/4 Corner of THE NW 114. S1/4 Cor.
Section 5 tn; S,ection 5
LEGEND
_J1 N lL 0 T 4
Section corner
monument, Berntse w 463,007 Sq. Ft. (10.629 Ac)` ~I I
I
cap. Includingg right'-of-way. NI (\j
• 1"X24' Iron pipe 461,846 Sq,<Ft, (10.603 A)~) I
weighing 1.68 lbs/ LL ~ Excluding right-of-way.: r CSI ~ I
d l O
lin. foot set. o w It
(R) Previously recorded. w z I J
information.
M :1 o o ~-I
-x Fence. N .
.I
-----Proposed drive-
way
way - must LUi
maintain 200 UJI W 3
foot separtationQ- c~ tV QI MAY z 1
-11 to S 00'10'57"E 524.54' O cS
Q.1 (11 296.80' 227.74' tV - - -
Zi %1tUIX COUNTY'
Lot 5 ~I j:.aMensfve Plaridt
176,315 Sq. Ft. (4.048 A) 0) ~ ® m jl ?oning and
Including right-of -wa SHED SHED -
Y• ao CtI •~cs committee
170,522 Sq. Ft. (3, 915 A) Z o o to Z) I
Excluding right-of-way. rn rn Q), not recorded
Lot 6 LO co to o , )1n 30 days of
135, 850 Sq. Ft. (3. 119 A) w w !LOT 5 M W In to
~ ~ ~nproval dater
Including right-of-way. v n cr) n j;5 - t.rovalshaGtse
in , 130,727 Sq. Ft. (3.001 A) a iv !L0)T 6 ~I ~OI ..;s ,,eAd
Excluding right -of -way. I 3 ~i J I
ro m Co LJ
U
250' Z
BUILDING SETBACK
V V D O to
,r~ININ11//III' I , ^ SOO°47'2"E SOO°47'216"E O_ r=i LINE
GON 66.0 296.79' a 229.54' N _
~~!.r•••••+.. S1A 40_ -29rt .8D ` "227.62 cp
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
/ Sit. Croix Countyty
OWNER/BUYER L 4Q&,t V J W Cy- 1;~ex e_
MAILING ADDRESS j1a G' A c- ,~z 7"c Gi e C4 cJ 4 Al
PROPERTY ADDRESS / l 7)? (location of septic system) Please obtain from the Planning Dept.
CITY/STATE , /,r .
PROPERTY LOCATION s 1/4, NW 1/4, Section --3- , T -2-9 N-R_Z!g_W
TOWN OF 1i4iw7" t.-_ As ST. CROIX COUNTY, WI
SUBDIVISION < /9-7 LOT NUMBER S
CERTIFIED SURVEY MAP.SY.7e-~,?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 expiration date.
SIGNED: 1 01
DATE: ? - Y-9G y/4G
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 Zqy> w &!Al,'"'T-
eLocation of roprTy 1/4 AW 1/4, Section S ,T-29 N-R_/9
Township si4it/T' ~SfaC1r¢ Mailing address ` 94 /tj cGa Z2Z6=,z..,i
442 I /
Address of site
Subdivision name Lot no.
Other homes on property? Yes No
Previous owner of property a-'e-df a
r
Total size of property -fl '4 ' 46's
Total size of parcel 4Z4ir- e ---j
Date parcel was created
Are all corners and lot lines identi fable? _ /Yes No
Is this property being developed for (spec house) ? Yes - _,-_No
Volume and Page Number J199Y 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. ..5Si5~383 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.
SS/s~383
-Jr
ignature o Ica Co- plicant
Date of Signature Date of Signature
;I
C State Dar of Wisconsin I onn 2 1992
J~ 4a~ti1 WARRANTY DEED REOISTfR'8%ME
• DOCUMEt'T t,0- voc 1181217 SEcAOOCCn,Wn
MAY 3.1 1996
{."Ink 1). ' oselber a sin,;le -,r-ran
2:00 P.M
l _ -KAQ. 4)A&-
- - - R4plab►aID«ds
conveys and warrants to Laurence- -Schnit and ,"tars
_-Schrnit husE~ r-Ki-and ~:ifeL-
II
I I THIS SPACE RESERVEO 'On RECORDING ^ATA
NAME AND RETURN ADDRESS IO.OO
- - - - ;I EQUITY TITLE 3~VIICE~8
the following described real estate in _ C:.Lx 4w SOVTHISE EET
,
County, State of Wisconsin: NU08WMA &M6
r
PFER (Parcel Identification Number)
FEE
Part of the Southeast Quarter of the Northwest Quarter of Section 5, I~
'1'mmship 29 North, Range 19 best, Torn of St. Joseph, St. Croix County, II
Wisconsin, described as Poll-ores: Lot 5 of Gctified Survey Hap recorded I~
in Volume 11 , Paste 3108 of C E rt i f ied Survey -Maps, as Doc.
No. 544383 it
it
i
I
it This is not - homestead property.
)(li (is not)
Exception to warranties: SaserlentS, restrictions atxO rights-of-way of record, if any.
I
I
Dated this Q day of
I'
I~
II _ (SEAL) (SEAL)
• Hank D. Fog 1hPro
(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
STATE OF WISCONSIN
Signature(s) 11 , f ss.
ST y r x County. ty`
authenticated Ihis . day of Personally came before me this day of
199b- the above named
clan. D. Fogelberg, a ci not P flPrann~
TITLE: MEMBER STATE BAR OF WISCONSIN -
(1f not, ---Djang-{t.--6a(fol1---
authorized by §706.06. Wis. Slats.) me known to be the person who executed the
Notary Public
State of Wisconsi/+? ag instrument and acknowledge the same.
,
THIS INSTRUMENT WAS DRAFTED BY
b, orrtey--IrL$L1Aa-Ogl.a e, - - Lq-~
.~r_~ o..tit:.- C~ 4^Or County. Wis.