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HomeMy WebLinkAbout020-1032-00-000 4. o az'i °o I 0 o I ~ c a 0. O ~ I °o I I M I E y o I 4 c 0 U I a Q) N C_ aL.+ o Q cD E O O z " C LL C O 'D Q ~ M z (j v o z ~ m m I 0 c I o zv' c d Z v ° o tq F- ~ O 'o I J L4 Q o m v I N C N ~ ~ I • N C C O cu 1 O z z N z N V- N E O y t0 L d . U) CL « c y i 4 O 00 N j in a a LU ~p N E c H F- F- -2 .o vv N 3 3 ° Z) 4 (on o O O O z o CL IL IL a o LO U.) y fA V -j 0) 0) J z O N - Qn) N .C Lo 0) I~+~y O d C 0 a-. m O CO N CC) N N n C 7 o C:> 0 O Q. N C O ,C. O O C O N C LL O T L N Q V M0) L 0 C O- 'v.r C O C O N a N O -a • Ia N O N co O N m tJ y O O = LL N O (n R i ~ I m df EL ,0 Q m .2 d c rr~~ 'sY5TeAf STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER 1301-3 ADDRESS /O 0 I-N SUBDIVISION / CSM# N'7f • T # SECTION T 21 N-R /y W, Town of ~ u f~S O~ ST. CROIX COUNTY, WISCONSIN PLAN VIER SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM S,eQ ~4-t-T~l P/0-r p1 oR1GNNL INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. To o s v) vEys 4Lv oov h/v 13 5 - llf4i ri~v G-- BENCHMARK' Flo vp P ,/f / ~v G 70 7. Q TOP o fm coA, "f-e- 10 Ck ~ Ole eC T ~G~` ors ALTERNATE BM: _ emu) ~oBO S/ I>/.vG- G~~~-~0 1?n~~~~ SEPTIC TANK nvrun ~~'YH~S~P~-DER Manufacturer: P" aGTS Liquid Capacity. t'I Setback f r. om : Well House f l Other ~j Pump: Manufacturer ~ Modell ize Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM ter' Width: 7 Length_ _ (ny~ Number of trenches Distance & Direction to nearest prop. line: >:Z-90 v/ D/:~EGGT~o v S Setback from: well: House Other ro o well 4010ep To P,-rz ELEVATIONS Building Sewer 713.. 5o ST Inlet. 20 ST outlet 112. ' ` o PC inlet PC bottom Pump Off Header/Manifold / Bottom of system 5-92-2 13,0-ot P/i Existing Grade S:~- Final c 1p~ ~L4,~,` p Dp . DATE OF INSTALLATION: 5E pr. ~y, is C 1If 5 PLUMBER ON JOB: Zo6Ep -r LICENSE NUMBER: r ~ S 3 : -7 INSPECTOR: M AP~ ~~~P 5 3/93:jt r 4 cn O o 'i N p Ln o o G Q _s xsy' h i 41 vv, lb4 5'V 6p 0 \ N ooh ~ a z ~ ' r ~ a 7v o o, cam,. a; m Z NN IN • LA 0 Z fit NY (A O'D "Ilk 17 .Wisconsin Department of Industry, Labor' SEWAGE SYSTEM County- safe and Human Relations ST. CROIX Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: '1W4 rG'=l AftR, ROBERT/MARGARET ❑ City ❑ Village k, Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: t~ Parcel Tax No.: 107, 7c) 7. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic S Benchmark Dosing Aeration Bldg. Sewer ?13 3v-~a Holding St/ Ht Inlet v TANK SETBACK INFORMATION St/Ht Outlet ~ia,9D Vent TANKTO P/L WELL BLDG. Airito ntake ROAD Dt Inlet Ar Septic ° NA Dt Bottom -71O" well- iii Dosing NA Header/Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction Syestem TDH Ft Forcemain Length Dia. FFii Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS fi 5/` y 2- DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type Of =z,L CHAMBER Model Number: System: 2r3 0" 3 lfxto_ r OR UNIT DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. I 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 El N ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) (VWINw-4 LOCATION : Hudson.17.29 . I9W, AJE ,N A , Priester Lane Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. FiilPt ~ Ic~~ ~~i~~ TEn G.v • tf vV~o ,..r SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05, Wis. Adm. Code cT; STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 8% x 11 inches in size. ❑ Check if revision to previous application -See reverse side for instructions for completing this application. ,I STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. r V iA) IJ L~ N• /4' . PROPERTY OWNER PROPERTY LOTJ- 7N G R,p t3E'Q•r t MA P-5Af ET F+s H JMV V~ 6 i '/4 N1 /4, S 17 T N, R I T E (o W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # 14 1eav.4. ST- CITY, ST TE ZIP CODE __~PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER !;T ~4V f A) . 1551 o &rj. Y = GY7 A' A II. TYRE OF BUILDING: (Check one) CITY NEAREST ROAD ❑StateOwned ❑ LAGE (•4u19S0A.) ❑ Public L ~J 1 or 2 Fam. Dwelling-# of bedrooms "3 P17D OWN OF. ARCEL TAX NUMBER(S) Ill. BUILDING USE: (If building type is public, check all that apply) ©Z o - 1032- d 0 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 30 Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 40 Church/School 80 Mobile Home Park 120 Service Station/Car Wash 5 ❑ Hotel/Motel 90 Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. IJ New 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 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 220 In-Ground 42 ❑ Pit Privy 130 Seepage Pit 2 Pressure , 43 ❑ Vault Privy 14 ❑ System-In-Fill 2- T'jeir:I4-Ax-,"S EA< S l S 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 REO ,WIRED (sq. ft.) PROPOSED (s q. ft.) (Gals/day/sq. ft.) (Min./inch) -710 7` -f1/ATION Gf V /7 6 p© • 00 /V A Feet Z/ G r Feet '3; 1 CAPACITY VII. TANK Site in allons Total of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New xisting Gallons Tanks Concrete glass App. Tanks Tanks structed Septic Tank or Holding Tank PA)aL e D_ F Lift Pump Tank/Si hon Chamber [71 F-1 VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) M117 vIPRSW No.: Business Phone Number: Ro5EIeT' Zl~hel ti% 33t 7 &_5 3~G-P1 Plumber's Address (Street, City, State, Zip Code): IX. C UNTY/DEPARTMENT USE ONLY ❑ Disapproved Sa ary Permit Fee (Includes Groundwater Date Issued Issuing ent Sign ture (No mps) Approved El Owner Given InitialSurcharge Fee) Adverse De termination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety s Buildings Division, Owner, Plumber t F L 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 revisior>p 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 & 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. 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. SBD-6398 (R.11/88) p Zo. N o Z D p b z o ` . 0 G a\C) `4C D J- w d = r--- L O -s xs~' jo, - o• y II o N ~ ~ y y '^a m y v 'Re t4r- A S a n y w -c G 0 N I G G Rr ~ ~ ~ v 7U 715 CA 011 R, r 70 Fresh Air Inlets And Observation Pipe Approved Veet Cap i A Minimum 12' Above _ 111 Final ore de it l-IA11511ED T~P~-~ c ff - / ~ O 4' Cost Iron 3(p ' Above Pipe _ Veal f'lpe' 1s Final 6redo tyalholic Covering min. 2' Aggregots Over Pipe 0 Oislribulion - Tee pipe o o o o o Co ' Aggregate t o pottkated Pipe Below Beneath Pipe a - Cmolaj TormInelln4 Al v ` _6y 57r Bottom Of Syslem ~3 . Rio. D W Fresh Air Inlets And Observation Pipe h Approved Vent Cap 13 Minimum 12' Above t/ final Grade F-I o lS viED GR j T R t a c H- -7 _ 4' Cast Iron IAZ 36 ' Above Pipe Vent pipe' ~ 'to Final Grade ' O ~ ' Synlhelic Covering 'U Min. 2' Aggregate Over Pipe Distribution - Teo pipe 0 0 0 0 0 . a ' Aggregate 0 Perlbroled Pipe Below Beneath Pipe 0 -Coupling Terminating At Bottom 01 S.rslom -711,o , oc s' O 2 v ~o V •V ~ W U Cn \ \ ~ D D t ~ o m ; s ~ 41. 354. 6' D 39.1' °f l \ N \ C' IOD W \ 280-46, 225 A 237' '0 oCl m 0 1 n o 175.89 168.40 21 22164' 170.12 i t r o O)o A rn° o 0 o --I OD N m o 0 0 O N m N OD N 0) m O 0) O N (10 N ~ O) l0 tD 7 O O a, 192.99' / ~I ~ N 83 \ A CJ7 Q (0 N O N 00 fit' W K.s n s cn c --mss - f 09'~ ~ Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page / 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 CP01 not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # - D dimensioned, north arrow, and location and distance to nearest road. 0 lb - 16 .2 APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION O B F^5 ft I IJ (s U C R GOVT. LOT SW 1/4 NW 1/4,S /7 T z 9 N,R / 9 E (.r o PROPERTY OWNER':S MAILING ADDRESS 4#9FW SUBD. NAME OR CSM # Al 4' ( Ro,v s T-. 5'0 4X 1 CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE OWN NEAREST ROAD 5T• PAUL MCI r',v..~. SSt O S, (Q2/ 6115-- ~47F l-/UPS 0.) PAP1412--SX&L•N [q'ew Construction Use [ residential / Number of bedrooms Addition to existing building [ ) Replacement [ ] Public or commercial describe Code derived daily flow gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/ft2 Absorption area required bed, ft2 ~3 trench, 112 Maximum design loading rate / bed, gpd/ft2 trench, gpd/ft2 Recommended infiltration surface elevation(s) Se- 3 _ft (as referred to site plan benchmark) Additional design / site considerations w ~ S Par t material 54S S Jo P/,~l.~ 'FLT V U 7- w,4YA- Flood plain elevation, if a plicable 707.0 ft ~ M t. f / W EG- S oo N S = Suitable for system 'CONVENTIONAL MOU❑ U IN-GPUND U ESSURE AT-GBADE❑ U SYST IN FILL HOLDING TANK U = Unsuitable fors stem [Lt9R''$S ❑ U 211,01 ❑ Lis ❑ U ❑ S 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 Trends CS -2 lo Y, e r13 .-7 Ground /6 'V'1y - _S• s ~iC • 0 elev. ft. Depth to limiting factor Remarks: Boring # / o /D le 2/1- /S 'T/5 CS 8 F:<:z 2- 36 /0 O'Sq. Ground 3 4/ /O y S'. Sy U elev. ft. Depth to limiting fac` ! ' Remarks: CST Name:-Please Print T D Q E Q T- u L Q 12 I C t4 'r Phone:: 3'r'o • Address: (e S S O t-) t 1 L PD- 14L) D E o,) Z/ T -2 r $ r~ Z Z Signature: Date: CST Number: Tn&A ORIGINAL 61 PROPERTY OWNER ~f45 ~~N/ 13AUt'~e SOIL DESCRIPTION REPORT Page 2-of 3 PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Botrnlary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench v Ilan 77 } h z 6-30 /Q 3 41-4 s. D. S cox Ground 3 /6 'Zee elev, ft. Depth to limiting factor „ Remarks: Boring # 2- /7v 5 Ground:.. 3 /0 elev. ft. Depth to limiting factor ~Ice Remarks: Boring # K d io l~ 2-1 2_ S 411~; cs c Z oV .S. GroundY D • P elev. ft. Depth to limiting factor Remarks: Boring # c 'r••4 Ground elev. ft. Depth to limiting factor Remarks: con -1-0 Acme, I N rn N v~ m 4'i/~ ILI ~o \ o z N f1~ r G cN h IT, o rn ~ y i r c Q 0 O ~ p y O q c Z y 10 O ~ m ~o r ~2e p~Ac r+t.~T' \ V ~Zj -411 c Z LA r fi U~ V~► l~ rn Z ) s N In z t*, c a 00 (n rt, M T-- ~e L ~ a PR~Es' r~ L.,v STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER Bed fi4-s1f /NG-" ~~I l>E~' 6 /.2 ys = 9 MAILING ADDRESS 1416 141 sT', ,S-/- Xt4,i . 537/0 oo PROPERTY ADDRESS MTa V 0^ ( Ciq(7(Ce (locatio of septic system) Please obtain from the Planning Dept. CITY/STATE c~ SCV 1/4,~X1/4, Section T N-R 1 W PROPERTY LOCATION 1 TOWN OF ~f un`so.~ ST. CROIX COUNTY, V,1 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 needee 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: DATE: ~S - / - 6- St. Croix County Zoning Office Government.. Center.... 1101 Carmichael Road ljudson, WI 54016 11/93 s 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 130~~¢Sff LNG- ~i¢UEiE' Location of property Sw 1/4 "1114, .Section 17 T27 N-R If W Township quDS o--) Mailing address :5 T Address of site ~•/'fiGS P Subdivision name Lot no. Other homes on property? Yes X No Previous owner of property A Total size of property S^O t C~,G S Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house) ? Yes X No Volume /Of? and Page Number 2-3-)--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. 57LZo?, 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 Appl• ant Co-Applicant S -!a - Date of Signature Date of Signature • DOCUMENT NO. STATE BAR OF WISCONSIN! FORM 1-1982 rHiS Sr'ACE RESFRVFDFOn nECOROINra DATA WARRANTY DEED 522207 Herbert B. Ward .1. Ct-vix Co., %I This Deed, made between r^:'~ rS Cheryl D. Adkinson _ i (husband rS wife) OCT 6 1994 Grantor, 11:55 A. M and Robert P. Fashingbauer , u" & Margaret L. Fashingbauer ,....x1 a (husband b Wife) v 3f C-Aft Grantee, Witnesseth, Thai the said Grantor, for a valuable consideration nF.TUnN to conveys to Grantee the following described real estate in- St. Croix County, State of Wisconsin: Tax Parcel No: A parcel df land containing 5 acres, more or less. located in the North Half (N 1/2) of the Northwest Quarter (NW 1/4) of Section Seventeen(17), Township Twenty-nine (29) North, Range Nineteen (19) West , Town of Hudson. St. Croix County, Wiscons;n further descrioed as follows: from the northwest comer of said section 17 go North 89013' East along the north line of said section 17 a distance of 1711.1 feet, t:.-nce due south a distance of 712.3 feet to point of beginning for parcel to be herein conveyed; thence south 600' West a distance of 225.0 feet, thence due west a distance of 662.7 feet to the east bank of the east channel of the Willow River, thence North 42°0 east along a meander line on the east bank of said river a distance of 310.8 feet, thence north 12°57 east along a meander line on said river bank a distance of 157.3 feet, thence north 3500 east along a meander line on said river bank a distance of 136.8 feet, thence north 86°0' cast along a meander line on said river bank a distance of 74.8 feet, theme south 83°02' east along a meander line on said river bank a distance of 168.4 feet, thence south 25°31' east a distance of 285.2 feet to point of beginning; including all land lying between the above mentioned meander lines and said Willow River. Also including an easement for an access road for travel from the above parcel to the Town Road as now open and traveled. This is not homestead pr,,perty. (is) (is not) Together with all and singular the heredilaments and appurtenances thereunto belonging; - - And_ grantCr warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except and will warrant and defend the same. Dated this 24th dayot September 19 9~ (SEAL) (SEAL) Herbert B. Ward (SEAL) (SEAL) Chery D. Adkinson AUTHENTICATION ACKNOWLEDGMENT *1 Signature(s) STATE OF \Ai a ss. Ramsey County. authenticated this day of , 19 Personally came before me this 24 day of It tember 19 _I he above named -Her ert a-r Cheryl D.•Adkinson , TITLE: MEMBER STATE. BAR OF WISCONSIN (It not, to me known to be the person S who excuted the authorized by § 706.06, Wis. Slats.) foregoing instrument and acknowledge the sar,.e. THIS INSTRUMENT WAS DRAFTED BY c Notary Public County, %IVW y z' (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (it ot, state expiration are not necessary.; date' • • .19 ) 'names of persons signing in any capacity should be typed or printed below their signatures.IN ZAKXA ' NOTagy PUBLIC f.'!'INESOTA SB1 NTF 0020 WARRANTY DEED STATE BAR OF WISCONS NPAWS&YFa0k*rr8. keen Bay. W154307"0208 FORM No.1-1%2 MyCorr,rn Expires J_, 31 2000