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HomeMy WebLinkAbout016-1054-70-050 Q o ° I ro 0 a v a o U r.. o o L © N C) N a - CO -Z y O . O >O N y C > M N v 0 O U O N Co CD ,16 U O C O Q C! In oU) a~ o h (D fns U 0U') > N N 0 Co Z L > N W Li c -oo a M to o a)cooac - o c a - O 3 L c p) L N E Q cn O (n Q co Q Lo W E O R O M W 0. m N F- Z C a I c a m O z Z :!t c ~ I w m Z to F• ~ m z c E ' O co _0 0) N Q a o v I y ) • A~y11 M L 00 IL w► c O LO O cr- Z Z z N N O i R y C - i N y Q l0co O O O U O D a N U) E h r U O LO O E ~ N II (L U) 0 0 O z o •►rv j' in Q Q Q m SN: a c w. g 7 O N 0) a) (n J V N O) O (D O i L m ~ CL atf 'C d Q ~ is L" O V N y C) C N C O 3 O E O y C <QP \ o~r°co a Q a0)oo p ~ o - c c 0 cfl r V a o C °U 0 c ° a a~ F c 'D Q 00 c o l 3 Z 0 04 U) C4 C) z ~ ~ w III' E v~ L L EL I' Lm d CL Z `~1 A U a 2 0 N 0 Parcel 016-1054-70-050 09/13/2007 11:12 AM PAGE 1 OF 1 Alt. Parcel 24.30.15.382A 016 - TOWN OF GLENWOOD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - SCHROEDER,CORYJ CORY J SCHROEDER 1442 DUNN-ST CROIX RD DOWNING WI 54734 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 60.000 Plat: N/A-NOT AVAILABLE SEC 24 T30N R15W NE SE & INC N 1/2 NW SE Block/Condo Bldg: SAID SECTION Tract(s): (Sec-Twn-Rng 401/4 1601/4) 24-30N-15W NE SE Notes: Parcel History: Date Doc # Vol/Page Type 01/02/2001 636095 1571/394 WD 2007 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/26/2006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 57.000 3,900 0 3,900 NO UNDEVELOPED G5 1.000 100 0 100 NO OTHER G7 2.000 9,000 116,700 125,700 NO Totals for 2007: General Property 60.000 13,000 116,700 129,700 Woodland 0.000 0 0 Totals for 2006: General Property 60.000 13,000 116,700 129,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 STC - 104 AS BUILT SANITARY SYSTEM REP OWNER ADDRESS (J Z SUBDIVISION / CSMJ LOT SECTION ~Ts ~C N-R /:C_W , Town o f y ST. CROIX COUNTY, WISCONSIN PLAN VIER SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM INDJCATF f4op,i'li hR1201d J Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic Lank manhole covet_ I BENCH14ARK: y7 rC C-~ ~i ALTERNATE IIM• SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: Liquid Capacity: i Setback from: Wel l House Other P ac urer Modell Size Float sepet.ie.---- alp Alarm Loca ion SOIL ABSORPTION SYSTEM Width: Length Number of trenches Z.> Distance & Direction to nearest prop. line: S7 l L Setback from: well:- House- Other I ELEVATIONS Building Sewer I ~a ST Inlet. ST outlet PC inlet P` bottom Pump Off f--' Header/Manifold Bottom of systems, Existing Grade , GFinal grade DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: M INSPECTOR: 3/93:)L Wisco'Ain Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Pet1&d 3 : DAVID ❑ City ❑ Village ® Town of: State Plan ID No.: aLENwoon CST BM Elev.: Insp. BM Elev.: BM Description: ~i Parcel Tax No.: TANK INFORMATION ELEVATION DATA 7/6"'- TYPE MANUFACTURER STATION BS HI FS ELEV. Septic Gr Benchmark 0~ Dosi n f Aeration Bldg. Sewer - 571 Hoding St/IVInlet L5 ' -2 76 TANK SETBACK INFORMATION St 1,W Outlet (2-17 Vent TANK TO P/ L WELL BLDG. Airito ntake ROAD Dt Inlet Septic ,,(74 NA Dt Bottom Doman NA Header / Man. Aeration NA Dist. Pipe Q Q{, f Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade M faet~rer Demand Model Number GPM ion System TDH Ft TDH Lift LOSS Force „ n Length Dia. Dist. To Well hi SOIL ABSORPTION SYSTEM BED/TRENCH width i Length / No. Of Trenches No. Of Pits Inside Dia. Liquid Depth DIMENSIONS S 90 DIMEN SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACH f cturer: SETBACK 9 AM , C BER Model Number: INFORMATION Type 0 44 J 'ea" RUNIT System:>/ ~c>2 DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x -Hole Size x Hole Spacing Vent To Air Intake Length Dia Length 2 Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade S Only Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx BseVTrench Center !~WTrench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: GLENWOOD.24.30.15W, NE, SE, DUNN-ST. CROIX ROAD ; j % c 7`D C OY Q 71 1 Plan revision required? ❑ Yes to Use other side for additional information. 0D-6710 (R 05/91} - Date Inspector's Signat a Cert No. -,`I"~< •c <'z.~k~?"-. tom" LU ~ '~1+~ ~I~'J~,.~~ CJ-~' e~LC~~i~~w~~ ~?"'k..<' l~Ct T ro:w:.o SANITARY PERMIT APPLICATION Bureau o oand ff Buil Safety BuildiinWaterSystem Division 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 e than 8,112 x 11 inches in size. tl • 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 ❑ Check it revision 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 D -f !/!o( q,4 .V 14 S' • 1/4,S,2 T _7e ,N,R /,j'A1jbr) W Property Owner's Mailing Address Lot Number Block Number / f Cr o / a/ „ City, tae Zip Code Phone Number Subdivision Name or CSM Number 11. TYPE OP'BUILUINIU: (check one) ❑ State Owned ❑ city Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms ❑ Town Village OF C7 C/ fJdf NJV - tid0S5'G O/ ~ 111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment / Condo a /Z-- w.5' 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. D6 Replacement 3. Q 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 NJ 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 ®O Required sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Mina/inch) J'9-// S Elevation y~ / 02 ©p ZI 7p Feet .4#7-1fpFeet VII. Ca acit TANK in g I I o s Total # of Prefab. Site Fiber- Plastic Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel lass A New Existin strutted g pp Tanks Tanks / Septic Tank or Holding Tank X ~2 Lv~ .S ® ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ 11 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (N Stamps) MP/#t461=0011MNo.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): r 70 67Z to w O d4/ p IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Issued Issuing Agent Signature (No Stamps) gApproved Surcharge Fee) ❑ Owner Given Initial / Adverse Determination X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SBD-6398 (R. 05/94) DISTRIBUTION: Original to Counly, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS • r - . r 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. 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. Ill. 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 10 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 is iding tank(s), septic tank(s) or other treatment tanks, building sewers; wells; water mains/water servi(e; stre iris r,:1 lakt~s; pump or siphon tanks; distribution boxes, soil absorption systems; replacement system areas, and the to-lion 0 the building served; P) horizor.-tal and vertical elevation reference points; C) complete speci fication,~ for pumps anc controls; dose volume,- elevation differences, friction loss; pump performance curve; pump model and {:ump m,~_nufac'.urer D) crosssection of the soil absorption system if required by the county,- E) soil test dataon a 1 15 form; and F) :)I 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. i I 17 ' - o - - - I - - - - A~j i j al ~ - - - - i-- - - a e I o 0 0io /O G P, xrl - I i j I - _ ~ - - - - - ~ - I - - - , - - --I- _i--- I i i -r-- I--- I I -i--- I s ~ I ' _ ~ Z ~ .__s..----_-~ ~ V i ~I _ . l ~ 1 - - - ~ - _ .1~_ fi---- , ~ ~ i ~ I i I~' ~ ti~- ~ - I j i I - ~ ~ ~ I ; ~ I- - - , _ _ - ; I ; _ ~ _ - ~ _ - - - - l - ~ _ ~ y- ~ ~ r ~ ~ _ _ - - - - - _ ' - i_ _ - - - - _ i _ ___i-___.....__ _-.._._i -1 __I _ _ _ ~__-~i I - ~ a - - u~ I i _ - ~ - i_--- ~ - -I_ -1 _ - - - - - ~ ~ 1__-I r- ~ I i r ~ ~ ~ _ ~ ~ I i_ _ I C ~ ~ j - - - - ~ I I ' ! ~ I I ,~i ~ I i - - - - I fi I ~ t--- - I ~ _ 1 ~ ~ J_ ~ ~ - ~ ~ ~ r; - - ~ - , ~ ~ i ` ~ - - - - - -?-!---I - I r-_ ~ . _ _ _ ~ - ----r - - ~ ~ ~ ; x - - ~ j ' - i l i - ~ 1 ~ _ - ~ - - - + - - j-y - - i , _ - - - --I-- - - i I ~ ~ -t - - -f - ~ _ ~ ~ j ~ I ~ I_. ~ IIIT} _ ,i. _ r _ f.~ n I I._-_ _ _J - ~ I r-~ I-- -I I i ~ i - - i____ I - - r- r ~ -C ~ ~ I - i _ ~ w . - - ~ I Y _ I _ _ •1 ~ ' ~ t I, - - - _ _ _ _ I ~ - ~ j I ~ - _ ~ _ i - _i - - - I- - ~ _ ~ -r- - - _ _ _ - - ~ - . f - - - - - - - - - - - ~ i C ~ ~ I _ I j - r- ---i _ - _ i- -i-- t 1 ~ - --i-- l-- - _ ~-_i_- L_--- ~ - ' I --I - - - - ---i-- - I i_ i 1 ~ - t--- I - ; ~ , _ ~ I I I ~ ~ ~ I ~ ~ i _ - - - r - - - - - - _ _ ~ ~ ~ ~ ' ~ _ I 1 i a . .i i L~ , ~ i ~ ~ i ~ r r- I i - - I _ ~ ~ I- ~ f - - - ~ i ~ i 1--- ~I ~ ~ a ~ ~ I- _ _ ~ ~ ~ I ~ I _ I i ~ ~ I - ~ I ~ ~ i ~ ~ ~ I i i - - ~ ~ - _ I. I~ - _ ~ - - - - - - ~ ,I ~ I , , ~ ~ - - I I _ ~ - - r---,- _ , 4---, _ ~ - _I- _ ~-F-i-- - 1-------~- i SOIL AND SITE EVALUATION REPORT pap ofd ILHR in accord with ILHR 83.05, Wis. Adm. Code i fa""e011".w.rr~w..ww~,aa COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but -s C O /X 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. a/&/` O O APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION I/ GOVT. LOT 114 1/4,S T p N,R tl4br) W VA 'C'y 'g PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 0 • 1 CI TATE ZIP CODE PHONE NUMBER []CITY []VILLAGE (MOWN NEAREST ROAD C--,4 e, A/_Wgol 610( - 5t, ma ZX Rd -Da I 1041VA, [ I New Construction Use [ j Residential I Number of bedrooms l,/ [ J Addition to existing building p(j Replacement [ J Public or commercial describe Code derived daily flow boa gpd Recommended design loading rate _bed, gpd/ft2_,S' trench, gpd/ft2 Absorption area required 00 bed, 11:2 1.2 00 trench, ft2 Maximum design loading rate ~,I_-bed, gpd/ft2_,,g~_trench, gpd/fl2 Recommended infiltration surface elevation(s) 'TE & Q, M. 7-2. 8.,' ?6 ' rt (as referred to site plan benchmark) t /V .0 Additional design / site considerations e Ai 9,4 e -5- Ao F -7 f,R Parent material GAA C / A L /iX L Flood plain a evation, if applicable it S = Suitable for System CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK to 1 S ❑U NS ❑U ®S ❑U ®S ❑U ❑S NIL ❑S FOU U=Unsuitable fors stem SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Baxtdary Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ranch /D- Ground FI-AX „r L• M F 6 elev. fr j,~ ft. Depth to limiting fa tok/., Remarks: Boring # 02 ti# ,2 8' C C~46 6: S N 3 L, ,s 6 Ground ' 1 Iev. 9 g&/a it. rr Depth to limiting A N jamJ t~ L 1 1 395 Remarks: ANINOU"lut CST Name:-Please Print 7' Phone: 7/ S GG~~ e !,v S~-t is Address: 2 /70 61Z e- w d ' Signature: _ Date: / 20 _ 9~. CST Number: PRWEMY OWNER DA mid Sa,~Agede p SOIL DESCRIPTION REPORT Page r? of 3 .PARCELCM Q 70 Boring # Horizon Depth Dominant Color Mottles Texture Structure C Sistence Baxxfiary Roots GPD/ft In. Munsell tau. Sz. Cont. Color Or. Sz. Sh. Bed ranch l O-/ o ~L. d F AS r- 60 VR 21V :M 2 Z. eL L! K 'Z CS Ground 3 ,2 / 6 Al Sd A- elev. - 8y, fk ft. Depth to limiting factor Remark:: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to - limiting factor Remark:: Boring # 13 Ground elev. ft. Depth to limiting factor Remarks: P4 -bl*ot Ott 11 I I ~ ~RiYeu _ I .77 I Al' f - J I i I ' r7 I iT I r--_► I , I l 1 I ~ T II i I I I I i I ~ ~ ~ I , I I ! I I j I I _ - - I- - - - - - r - -r - - - - - - I . I , I ;I, f ~ I. I II F 4 I I- ~ .I ~ `3 I i I I I r 1 I ~ L _114 1 1 I I - I --I-- ! F I I - I I I I 1 I I_ ~ I - ! I I I I I i C 1 7 I I i ~ ! i I i I ~ I i i_ I I l - - - - t - - - - - - - E - i -4- V i r t I I I I- I ~ I I I I I ~ I - - ' I I I I ~ I I - -I I l i i l I I~ I I I I STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/ 224 L id Sad .6,o e Gl/k MAILING ADDRESS PROPERTY ADDRESS (location of septic system) Please obtain from the Planning Dept. CITY/STATE ,aoGy,V I^ y , PROPERTY LOCATION 1/4, 1/4, Section, T .?O N-R W TOWN OF 6/ e_/V Gyo,o o/ 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. 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 an returned to the St. Croix County Zoning Officer within 30 days of the ye expiration te. SIGNED: /qt- Cy DATE: ! yl~ - / St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, W1 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 Location of property N,,,r-: 1/4Sr-- 1/4, Section T 267 N-R W Township 6T1 e?k Gu o e o/ Mailing address Z?.e4 N - S- t- Gj~QG ~X /go/ 176 Gust! Address of site Subdivision name Lot no. Other homes on property? Yes No Previous owner of property Total size of property X C Total size of parcel / ;2 /,ldA ,e Date parcel was created ~3ro.4- Are all corners and lot lines identifiable? Yes X No Is this property being developed for (spec house) ? Yes A/ No Volume S'and Page Number L2,3 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. RZ y7(F;2. , 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 o A p scant Co-Applicant Date of Signature Date of Signature DOCUMENT NO. WARRANTY DEED - STATE OF WISCONSIN-FORM 9 17 8 it? REGI SI'ERS G F',Ci_ ST. CROIX CO.. James.--O t.-. HQf f,... S.i?tg~ e 1'fIIS INDENTURE, Made by.......... and Unmarried Man Roc 'd for Record th 23r~) day of__:`Sarch 100 NM1 eat R - - grantor............ of... ~Sti CT'O County' Wisconsin hereby conveys t. `f David-••-C...-.-SChroedQr..and.-.Shine .-..-t. - and warrants to. S.chroeder,-......... c~...and....Wife....as....Joint...Tenan s - j~ THIS SPACE RESERVED FOR RECORDING DATA grantee..,S Mr .........5 . Richard P. Rivard ' of St. ~ ..Croix . .............................County, Wisconsin, for the sum of. Ten ...Thousand Glenwood City, Wisconsin (.1.QOQ0.-QQ).~.-..:..-..:.•'.-..:..--- - Dpl.lars ' St . QrQiX County St<•ete of Wisconsin; following tract of landr. [he East Half (EJ•) of South East Quarter (SE4); and South East Quarter (SE0 of North East Quarter (NE4) all in Section 24, Township 30 North, of Range 15 West. Also the Milking MachimrMotor and pipe line in Barn, and Pump Jack on Well. ~ r r (DESCRIPTION CONTINUED ON REVERSE SIDE) . IN WITNESS WHEREOF, the said grantor......_.-..ha. •_.........hereunto set.......... hi.s hand .....__..._.and seal........-...this... Mar h day of .Sr............ A. D., 19.-19-6.1 IGNED A D.SEALEDXI PRESENCE F f j a~. > J ` ~G (SEAL) J one.*...Q-....-.# c.... 1 (SEAL) - Richard P.•... Rivard (SEAL) {A Lois...HOckensor. (SEAL) ~i STATE OF WISCONSIN, 1 ss St . CirO1X ..:..._....County } . Personally came before me, this 11_--.......day of.... March A. D., 19.61. the above named..... _.James............. 0..... Hoff -...._.._....r, to me known tat t fit- son.......... who executed the foregoing instrument and ackno vlyd~d the same 1.. ....Ri.chard...T. RittArd . r '(SEAL) ~r . j 1 Notary Public,........ L' - ro-ix ............................_.County, Wis. Mycommissiotrexry res..permanent A. D.,19........... "I'his instrument drafted k>,i'...... Rlchar_d;. P.... iyard . (Section 59.51 (1) of the Wisconsin Statutes provides that all Instruments to bo reSQ/r7ded shall have plainly printed or typewritten thereon the names of the grantors, grantees, witnesses and notary). ' . ~ E ' ` ~ , WARRANTY DEED-STATE OF WISCONSIN, FORM NOI ff"r 375 FA J~ t~ N. C. scars CO.. suweuRrr