HomeMy WebLinkAbout182-1016-70-000
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Parcel 182-1016-70-000 04/25/2005 10:31
PAGE 1 OF i
F
Alt. Parcel 311801-12-04-00-00-000 182 - VILLAGE OF STAR PRAIRIE
Current X' ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): * = Current Owner
* FOSS, ROY & BEVERLY
ROY & BEVERLY FOSS
544 5TH ST
STAR PRAIRIE WI 54026
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 544 5TH ST
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 1.250 Plat: N/A-NOT AVAILABLE
SEC 1 PRT NW NE S 100' OF N 200' OF N1/2 Block/Condo Bldg:
NE LYING WLY OF APPLE RIVER VIL STAR
PRAIRIE FKA PARCEL 164C EXC S 100 FT Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
01-31N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1096/288 QC
07/23/1997 415/26
2004 SUMMARY Bill Fair Market Value: Assessed with:
53801 156,300
Valuations: Last Changed: 09/08/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.250 50,000 95,700 145,700 NO
Totals for 2004:
General Property 1.250 50,000 95,700 145,700
Woodland 0.000 0 0
Totals for 2003:
General Property 1.250 50,000 95,700 145,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 114
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
r
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER 2
ADDRESS 511
SUBDIVISION / CSM#
LOT
SECTIONT ~J 1 o f ~'_II
N-R
W,
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
INDICATE NORTH ARROW
Provide setb ck afitl6elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK:
ALTERNATE BM:
EPTIC TANI / PUMP CHAMBER / HOLDING TANK INFORMATION
y Manufacturer:
Liquid Capacity: ~Q
Setback from: Well~s0 House Other
Pump: Manufacturer Modell Size
Float seperation Gallons/cycle:
Alarm Location
':SOIL A$SORPTION SYSTEM
Width: Length Number of trenches
Distance & Direction to nearest prop, line:
.11
Setback from: we11:1C)L
House Other _Zg~ / ELEVATIONS
Building Sewer/ Q/, ST Inlet. / ST outlet".
PC inlet ~ PC bottom Pump Off Header/Manifold
Bottom of system
/j
Existing Grade Final grade 9 p`
DATE OF INSTALLATION, ~
g I-9~
PLUMBER ON JOB:
LICENSE NUMBER:
INSPECTOR:
3/93:jt
Wisonsin 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 268535
Permit Holder's Name: ❑ City ❑ Village XI-Town of: State Plan ID No.:
FOSS, ROY Star Prairie
Insp. BM Elev.: BM Description: Parcel Tax No.:
CST BM Elev. :
t zo, f,/ ",j
TANK INFORMATION '/ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic ,J Benchmark , u7 71
Dosing
Aeration Bldg. Sewer
Holding St/ Ht inlet 68'
TANK SETBACK INFORMATION St/ Ht Outlet
TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic NA Dt Bottom
Dosing NA Header / Man. 17
Aeration NA Dist. Pipe i,vu 9G
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand 5 , 3 7 /U a ✓5~
Model Number GPM
TDH Lift Friction System TDH Ft
oss Head
Forcemain Length Dia. Dist.Towell
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS ASS / DIMENSIONS
LEACHING Manufacturer:
SETBACK SYSTEM TO P/ L BLDG WELL LAKE /STREAM
INFORMATION TypeO - CHAMBER Model Number:
11 l J /US /DO 5l- nL OR UNIT
System:
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: Star Pr~airie.1.3/1.18W,NW, NE, 5th Street
Plan revision required? ❑ Yes eNo
Use other side for additional information.
SBD-6710 (R 05/91) Date sfpector's Signature Cert. No.
~ITIONAL COMMENTS AND SKETCH •
SANITARY PERMIT NUMBER: "
s f
Safety and Buildings Division
4tANITARY PERMIT APPLICATI~ 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.' ~t3 I
• See reverse side for instructions for completing this application State Sanitary Permit Number
49&05-39-
The information you provide may be used by other government agency programs ❑ Check it revision to previous application
(Privacy Law, s. 15.04 (1) (m)]. 1 State Plan I.D. Number
I. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION
Property Owner Name Property Lo ation
1/4 1/4, S N, R E (or)
O O
Property Owner's Mailing Addre Lot Number Block Number
City, tate, v 101 Zip Code `hone 11e ubdivision Name or CSM Number
54 10 _3;~41 0 It II. TYPE F B ( DIN : (check one) it
E] State Owned _ Nearest Ro d
VI age
Public 1 or 2 Family Dwelling - No. of bedrooms own OF ,5
111. BUILDIN USE: (If building type is public, check all that apply) Parcel Tax Number(s) _
1 ❑ Apartment/ Condo 4;- - /0 I & - 70
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 ______r_-'-`-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 79Seepage Bed 21 ❑ Mound 30 0 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
5Required (sq. ft.) Pr; g d sq, ft.) (Gals,/day/sq. ft.) (MinAnch) Elevation
,5~0 Z , L ► Feet ~ Feet
VIL TANK Capacity in gallons Total # of Prefab. Site Fiber- Ex er.
INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App
New Existing structed
Tanks Tanks
Septic Tank or Holding Tank ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber -114 ❑ ❑ ❑ ❑ ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewagesystem shown on the attached plans.
Plumber's Name: (Print) Plu r' ignature: (No Stamps MP/MPRSW No.: Business Phone Number: 0 1 Plu ;q's~Address(S r Wy,fAtate, Zip Code):
IX. COUNTY/ DEPARTMENT SE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater L;te ue Issuing Agent S' o Stamps)
5Approved ❑ Owner Given Initial Surcharge Fee) 3-
Adv erse Determination
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SOD-6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety & 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, 608-266-3815.
t
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.
fl. 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 3 if permit is for tank replacement, recoinection, or repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested for numbers 1 tnrough 7.
VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, numbe, 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.
• PLOT PLAN •
PROJECT Roy Foss ADDRESS 544 5th St. Star Prairie Wi 54026
NW 1/4 NE 1/4S 1 /T 31 N/R 18 W Vil la geStar Prairie COUNTY ST. CROIX
MFRS BYRON BIRD JR. 3318 7/22/96 BEDROOM 3
DATE
CONVENTIONAL XXX IN- UND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 648 BED SIZE 12'X54'
BENCHMARK V.R.P. Base of Bird House ASSUME ELEVATION 100'
❑ BOREHOLE (DWELL *H.R.P. Same as Benchmark
VENT SYSTEM ELEVATION 96.1
12" GRADE
6TYPPAR VERING
12;'K
5th St.
Well J2' Driveway
24'
Existing 3 Bedroom House 6'
Garage
72' o
c~
k52 d System to be
uried
DW 5' from P.L. 0 1 105'
B-3 15'
Overflow 12' X 54' Bed
04 -AL
Pipe jr
I 0'
Birdhouse
15' B-1 30' B-2 30' jftB.M.
'
77% 10-Ak
lope Vent
0'
Overflow
to River
Apple River
Wisconsin Department of Industry, SOIL AND SITE EVALUAT N
Labor-and Human Relations J Page of
Division,of Safety-and Buildings • in accordance with s. ILHR 83.09, Wis. m. 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 '5 T , ~
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel 1.D.. #
R
-70
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)). Y
Property Ow er Property Location
l Govt. Lot 114 Vr= 1/4,S T - N,R E ( W
re o-r
Property Owner's ailing Ad ess Lot # Block# Subd. Name orCSM#
City State Zip Code Phone Number ❑ Ci illage 0 Town Nearest R cog
r 0.t 5 4 Q ( ~._3734 ate- t
❑ New Construction Use: ,Residential / Number of bedrooms Addition to existing building
;►Replacement ❑ Public or commercial - Describe:
Code derived daily flow L gpd Recommended design loading rate o ~
7 g / bed, gpd/ft2. trench, gpd/fit
Absorption area required y~ bed, ft2J trench, ft2 Maximum design loading rate 2bed, gpd/ft2 - trench, 9Pd/ft2
Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark)
Additional design/site considerations
Parent material Flood plain elevation, if applicable ft
S = Suitable for system Conventional Mop d In-Ground Pressure AT-Grade System in Fill Holding Tank
U = Unsuitable for system S❑ U S❑ U ❑ U S❑ U El S U El S U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2
in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots
Bed Trench
0 y
Ground 100,
~fJ ~ ft.
Depth to
limiting
Oc r
in.
J, Remarks:
Boring #
(94
r Z r- .
~_9 s e
Ground
e v ft.
/epth to
limiting
A ~jor
j in. Remarks:
CST Name (Please Print) Sig a Telephone No.
Address Date CST Number
~IL DESCRIPTION REPORT •
PROPERTY OWNER Page of
PARCEL I.D.#
Boring # Horizon Depth Dominant Color Mottles Structure 2
Texture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed . Trench
Z r
Ground
I
Depth to
limiting ;
fact
7 n.
y Remarks:
Boring #
e
Ground AIX
/AMA.
Depth to
limiting
facto
Remarks://ST rte!~/J"~..0~/~.,_G~<«,'~•
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in. Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in. Remarks:
SBDW-8330 (R. 08/95)
! !
Soil Test Plot Plan
Project Name Roy Foss Byro Bird Jr.
Address 544 5th St.
Star Prairie Wi 54026 C~fM #3479
Lot Subdivision Date 7/22/96
NW 1 /4 NE 1/4S1 T 31 N/R18 W Village of Star Prairie
Boring O Well PL Property Line County ST. CROIX
, BM or VRP Assume Elevation 100 ft. Base of Birdhouse
System Elevation 96.1 * H R P Same as Benchmark
5th St.
Well Driveway
12'
24'
Existing 3 Bedroom House 6'
Garage
72' o
15' r
c~
T
105'
10'
0'
r, DW 5' from P.L.
CD B-4
Overflow B-3 15'
Pipe
0'
Birdhouse
15' B-1 30' B-2 30' B.M.
10' -Ak
7%
Slope
0'
Overflow
to River
Apple River
, . I
Y
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
O"., YF UYEIZ
004
MAILING ADDRESS, y ~ ~ T
PROPERTY ADDRESS
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE r
L ~PROPERTY LOCATIONO 1/4, 1lL -.__1/4, Sections T _N R l~ W
tOMO OF 't'f Ch ~t Sty ST. CROIX COUNTY, WI
SUBDIVISION ' LOT NUMBER
CERTIFIED SURVEY MAP , VOLUME AG 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 p-umper. 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 plurr# ler, 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 withthe standards set forth, herein, as set by the Wisconsin DNR.
Certification statinui that. your septic has been maintained trust be completed and returned to the St. Croix
County Zoning OT icer within 30.days of the three year'expiration date.
SIGNED:
DATE:
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
,5 .
• S_;T C - 100 •
1 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 c>
Location of property_21/4,&~1/4, section 1 T2 -R / W
,
5~'•
Township M[~~f cA~g~ Mailing addressy JrV
CLA" -a-
Address of site 47
Subdivision name Lot no.
Other homes on property? Yes No
Previous owner of property
Total size of property CS
Total size of parcel
Date parcel was created
Cl/
Are all corners and lot lines identifiable? Yes No
Is this property being developed for (spec house)? Yes 4_No
Volume _7 and Page Number l_'_ -6 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 QWNER 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 n the office of the County Register of
Deeds as DocQ0ent No.~L J-~5-_3 , 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
t office of the County Register of Deeds as Document No.
Signature of ti6plicant do-Applicant
Date of Signature Date of Signature
DOCUMENT NO. i WARRANTY
~ STATE OF WISCONSIN -FORM 1 j~
• :r ll 1) / + f, II YOL5 fCF 2'
THIS SPACE RESERVED FOR RECORDING DATA
I.
THIS INDENTURE, Made this-Tenth day of....... u?.Y A. D. 19_..65 REGISTERS C1 r~
between ..H my S, _Lars. on and Mirln~ e..._LA.... I1,....b. S__ ST. CROix co.. ti~
w if e
Rec'd for Record this i J, th
i _
art..__....... of the first part, and
ie s - - . day of---='-' ~~r
R '
j oy Foss and Beverly i Foshts husband and wife.. .as. af_ ton
z._•. • a
15 n1.
Joint Tenants with rgs of survivorshi
j _ _ _p.r r
a
.
ra- - - i --e-•,•----- Wi- - s--- c on--s• •-•i--•n--. •
ir
Register ofh"iPE•
.part i.-....e8- of the second part,
Witnesseth, That the said part-AP-a. of the first part, for and in consideration
of the sum ~e...HUXICLVP-d...and.-N-o l100 ol la rs.__----- RETURN TO
Swenbyy & Son
to .....them-- in hand paid by the said part_........es of the second part, the receipt N( w I', hinond, :1 i.;:eonsin
whereof is hereby confessed and acknowledged, ha---- e. given, granted, bargained, sold, remised, released, alicnrd,
i, conveyed and confirmed and b these resents do Croixnt, bargain, sell remise, release, alirn,.<:onvey, and
part-19-a.. y P p h e fr i
confirm unto the said of the second aS hems and assigns forever, the followinn.,
described real estate, situated in the County of..._...._._ and State of Wisconsin, to-wit:
i
The South two-hundred feet (2001) of the North three-hundred
feet (3001) of that part of the North Half of the Northeast rluartev
(N-ff1NEk) of Section One (1), Township thirty-one (31) North, Range
Eighteen (18) West in the Village of Star Prairie, lying westerly of
the Apple River.
1
1
(IF NECESSARY, CONTINUE DESCRIPTION ON REVERSE SIDL)
Together with all and singular the hereditaments and appurtenances thereunto belonging or in any wkc
i appertaining; and all the estate, right, title, interest, claim or demand whatsoever, of the said part of the
first part, either in law or equity, either in possession or expectancy of, in and to the above bargained premises, and
their hereditaments and appurtenances.
To Have and to Hold the said premises as abbove des ribed with the hereditaments and appurtcmuucs, unto
themselves, thei
the said part.i.e.~... of the second part, and to. ,irs and assigns FOREVER.
And the said ..__._Henry...s.....Larson_._and._.Minnie.--I-,,-..La-
.
for...tkl l?IS4~.~1..:z...... tklQll?............ heirs, executors and administrators, do.......... covenant, grant, bargain, and
agree to and with the said part- es... of the second part, theltlSCLU.s...... he.;U?..... heirs and assigns, that
at the time of theensealing and delivery of these presents....... 4bU...ar:e well seized of the premise, ahovc
described, as of a good, sure, perfect, absolute and indefeasible estate of inheritance in the law, in fce simple, and
that the same are free and clear from all incumbrances whatever, and no exceptions
-
and that the above bargained premises in the quiet and peaceable possession of the said part_..eP of the second
part, the ir•.. heirs and assigns, against all and every person or persons lawfully claiming the whole or ally part
thereof, -.they.... will forever WARJRASNT AND DEFEND. e their
In Witness Whereof, the said art..- of the first art ha... v...._... hereunto set
n l I
seal..A. this..... `-I'911th_........ day of udy A. D., 19......E Q {n hand-(SIsand
AL)
SI D AND HEALED I SENCE OF - .~4--- -
ennrv Larson
Paul 0, Swen Minnie,I. Larson
(st:AL)
MISagt : -
~~YY