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HomeMy WebLinkAbout020-1288-00-000 M O oa o h ~ C d pv O I i i O> N Q (0 N ! OIL N p N o co Y3va,NoEm CO N D m 04 a z o N co N N U o)o Zf - N CCo.O - N s Ica Z!0 o U co C N d Co 0 M O O co 4 O CD E Q rnE os c a c z Q. -O c _ m E o Y ti c o m o 'a n o o m x m x Q N~o 4 Nry 3 Cl) v a> z y m Z w o z d d P w a m N F U) O O z d v 42 v M zF- d o 0 r I' a z c O v M N 0) Q O N N O N C U) 0 O m o O o Q w z m z o N z i U) - o C U) Y ME ~ , }y m Q .r v LL o d O O o o a M o E C) b/1 o c0 FN- H 'U") O O O a a a EL g 7 Q V1 C In In N (0 a) ° O ~ N N C O O w~ j LO co m CL -6 ca N N ~ a N N ~j O 0 N c IV O O t,0 C U') N j 00 r o °d 3 S O N c~ ~m ry\ o o n a CN o a N L "s ~ w N E O Cb p N N C N t . "O N V oi (D c co N O E tn. Thy)3 -0 C) o v ~ E d i V] d a y a* a L: 4) a w • C. `~1 A Ua~ '0Vo STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER 'j~A'-(L LUN,0E/-~ lSA!» J l t L ~ ADDRESS V1 F- 4- t 4/f PL) 40 uJ r z-yo / SUBDIVISION / CSM# W ELL Y66 Q LOT # O SECTION Z / T 2-1 N-R Town of H®V14 ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM / ~i2 A R ~ ~ ~.lf11/E 6£ yZ WELt- oSs~ 2-7 / 4i Ida ZN'SZ, ~ilo -5 CA r~ 5 L/ SrtM aL._ yg 0 0 ~ g I S S ~ ~k~`'__~ I X11 a r /V(tTE If L 14 C- INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: lOP of TtL,PLO• AT Nw. 100, pp' ALTERNATE BM: Tot' of /fcDasE f60NAAT/O/V F/- 3,SS - ~O~ !oS SEPTIC TANKPUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: [~/~/SEA Liquid Capacity: /DD0 lg4L.• Setback from: Well House 3 Other /z' r"o l>~.Q~Nf~,~' Pump: Manufacturer Model# - Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: Length y0 Number of trenches Distance & Direction to nearest prop. line: /5 ' I?-" NEST L o7- 4 E- Setback from: well: //0 • House Other /z 'ro 577- ELEVATIONS Building Sewer ST Inlet. B S= %-70 ST outlet g,~{S 9G•3S PC inlet - PC bottom - Pump Off FN: y• 1.1: 9w.0(- Header/ManifoldR,K,9.3s; 1!;.%fBottom of system Existing Grade')'y~ Ioo'7S'Final grade qyr 1190, 75- AA A N *o LE 2,~ 1 N6 S S. y 9 Sao DATE OF INSTALLATION: a PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: Wisconsin 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-: 29,931 2 Permit Holder's Name: ❑ City ❑ Village Town o : State Plan ID No.: LUNDELL, ERIC/SAM MILLER CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: y & led r~ Is l . TANK INFORMATION ELEVATION DATA S TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark / ~r ne U Dosi ng ~ ~ y /'/l • SU Idl, 6 Aeration Bldg. Sewer Z+ Holdi St/ Inlet ' 9l1(1/1~ TANK SETBACK INFORMATION St/Outlet Vent TANK TO P/ L WELL BLDG. Air Ito ntake ROAD Dt Inlet Air Septic NA Dt Bottom Dosin NA Header-/_ 9,161. S, 9 Aeration Dist. Pipe 35 9f S Ing Bot. System 7O d 9 PUMP/ SIPHON INFORMATION Final Grade 636/ Ma rer mand 7- rlA.s C...Q , Model Number GP TDH Lift L tion System TDH Ft Head Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length / No. Of T enches PIT No. Of Pits Inside Dia. DIMENSION lQ DIMEN I LEACHING durer. SETBACK SYSTEM TO P/ L BLDG WELL LAKE /STREAM M INFORMATION TypeO /1~,,~ CHA C<rt~ ~ i Model Numer. i / 5 s NIT tem: y DISTRIBUTION SYSTEM Header / ManifyId Distribution Pipe(s) x Hole Size x Hole in9 Vent Intake Length Dia. Length 37 Dia. Spacing G SOIL COVER x Pressure Systems Only xx Mound Or At-Grad yste Depth Over Depth Ove es xx Depth Of xx Seeded/ Sodded xx Mulched Bed / CenterS~ - ~ Bed / "free Edg K - 7 Topsoil E] Yes [3 No E] Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Hudson.21 29.19W, SE, NW, Lot /10, Prairie Bane Plan revision required? ❑ Yes 0-114o Use other side for additional information. S Q~ T 0 r SBD-6710 (R 05/91) Date Inspector's Signature Cert No. I ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ^~wE^ Safety and Buildings Division ~~■■_r■r. 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 • Attach complete plans (to the county copy only) for the system, on paper not less Cou than 8 112 x 11 inches in size-07 cx~-4~ • See reverse side for instructions for completing this application State Sanitary Permit Number 9 a 8 31 a-- 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 LKIC LlJ ~Li- S L.L>~= SE1A X1/4,5 'Z1 TZr N,R /yE(or W Property Owner's Mailing Address Lot Number Block Number ©Zv-z_ City, State Zip Code Phone Number Subdivision Name or CSM Number il~:5 Siyo/ 1(-39t) z.) 6 WELL s 2'-o sTAT/C~l N I. TYPE F BUILDING: (check one) E] State Owned E] City Nearest Road Villae E] Public 1 or 2 Family Dwelling - No. of bedrooms I] Town OF t~S © PiZA 1G? LAtN 111. BUILDIN USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment / Condo 6 20 -J`?-?7-0o 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. E] Reconnection of 5• E] Repair of an System System_ Tank OnlyExisting 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 MSeepage 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 61 4/ 3 "7 Feet 89,00 Feet lt VII. TANK Ca in gallaco s Total # of Prefab. Site Fiber- plastic Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel New Existin strutted glass App. Tanks Tanks Septic Tank or Holding Tank Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ El ❑ 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: ( Stamps) MP/MPRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): QR-Fr-d L- LAO- a 1 5 o I IX. UNTY / DEPARTMENT USE ONLY ❑ Disapproved Sar;itary Permit Fee (Includes Groundwater Date Issue Issuing Ag nature (No Approved E] Owner Given Initial Surcharge fee) ..~/i ~ ~d U~p Adverse Determination 16R) X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBO-6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety & Ruildings Divr ion, Owner, Plumber INSTRUCTIONS 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 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 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. Com olete for all se )tic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experiment,ri )roduct approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate )refix (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 sul: -Witted to the _cunty. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, locatio of r(1dine tank(s), septic tar•k(0 or other treatmr,nt tanks; building sewers; wells; water mains/water servire strer MS, n :1 lakes,- pump or siphon to i"s; JiSUC! 6ution boxes; soil absorption systems; replacement system areas, the lo~_.: nor cf the building served,- f ~a^z :~,+a! and ve-tl(,il ek>vz ton reference points Cl complete sped fic<)t.on~ 'or purer", a i,^ controls; dose volume- elevation di fferences, f -iction loss; pump performance curve; pump model and ump nI.3 . rer, M cross section - of the soil absorption system if -equired by the county, E) soil test data on a 1 is form; ant F) A >izincl information- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practice, which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. E ~ LA m oo ~ W ~ r >o o m m n ITT ~10~ aN ~ y z N o m 1 O d O n► a N 1 3 m Cl% r a? Z ^ m .Vi - - Q,--I 14 J-j - - N. 1 M h o w 6, p,Q/lj Co ho '4, m r ' W L'I w - i Nw ~ °1 Q s-ovr,~' toT O \r. O o~ O` a Q U N w w C/) \ CL O O v w a v a w oY > X O -H O F- ~ ~r O , W b 0 r r O X JS CL I ' V po zz F- a i U w z w 1i I ~ I I 4' Mtt„]] 1 I iI 4 a I I 1 i ~ I I I 1 Z t,. 1 w~ I I I a O r 1 3: 1 1 1~ U) ~ v1 I I I a I :a 'zc I I 1 O I i m i I I I Q I q' I w I I I ~ V I I I I a . ~ i a i i I 3 • I I U9 1 I O t- I I z I m y,. ' I o I I o o I I I w v i ~ a LD ~1.~ I I I ~ I 40 J I 1 I f-. I. qr C a y,-'Fr I hsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page / of 3 t;r and>loman Relations Divjsron 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 'S CQ6 i y 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. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY 0 ER: PROPERTY LOCATION 5.4 #7 X t-( ,&,e GOVT. LOT St 1/4 fgW1/4,S~I T 79 N,R / 9 E (or) W PROPERTY NER':S VILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 16 c4k6o CITY STATE ZIP CODE PHONE NUMBER ❑CITY pVILLAGE OWN NEAREST ROAD New Construction Use R1 Residential / Number of bedrooms Addition to existing building j ] Replacement ( ] Public or commercial describe Code derived daily flow gpd Recommended design loading rate 0.7 bed, gpd/ft2 C), % trench, gpd/ft2 Absorption area required 4 S bed, ft2 S6S trench, ft2 Maximum design loading rate bed, gpd/ft21.'trench, gpd/ft2 Recommended infiltration surface elevation(s)~~.,a Aftjs 9~5. coo ft (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable It S = Suitable for system CO VENTIONAL MO NO IN ROUND PRESSURE AST GRADE SYSTEM IN FILL HOLDING TANK U ®S ❑ U ❑ S U U =Unsuitable fors stem S ❑ U S ❑ U S ❑ U t3J S 11 SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Boundary Bed tench LIE L rr rye, 5bK r r $ 2 ,)r/ L? I1 Ground 7 D'/r s n'1 J elev. /00 4'LIL Depth to limiting factor Remarks: Boring # A lew/ 16\104 CS Z (F d t ~l '3 SQL r` I7,Tr' CW ~T ,'2 Cl Ground ~ ~ ~ 3 ~ ~ r ~ ~ ~ elev. ft. 0 Depth to 1 limiting factor 91- Remarks: CST Name.--Please Print hone: s6- ~o~a Address: P. 6 u ~SrJ 1 d . , ~$4 Signature: ~6~ Date: CST Number: S PROPERTYQWrNER`J~4MMlltc2 SOIL DESCRIPTION REPORT Page *Z of 3 aAROI:L I.D. # c.aY ID L.1 LL--, 'O'd f-C a Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence, Boundary Roots Bed re & A 0-I3 /DY 3 t L / rn sbk 1h r 5 Z 000,5- 10A/444 Z S: 1/^-s bk cw /-F Ground 2-/2Z C)Yo2 4 5 •h r 0.7 Q,$ elev. , Depth to limiting factor lb, 17 Remarks: Boring # Q o- ~dy+e3 - scs as 31 4 /4- 10, Ground ele ~ft. Depth to limiting factor Remarks: Boring # 2) 3 Ground ~ ele~v._ °7h3 ft. Depth to limiting factor 7 ,Og Remarks: Boring # LEI Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) 41P-~(_ L~►s~ ~i ~ 3 or 3 dT 1LEA46U hLC.J)kiL Ec.~V~T~c~ - >UD.C1c~ -C ' Sr K1Lt ~ ~ i r7l o~ ka.,A i qa I r ~ ~ I Q ~I C STC- 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County ~ .R G ~L NER/BUYF oW / MAILING ADDRESS BOX At- 2 t L /4a✓1~ 5 C V w ~ ~t7ty l4 PROPERTY ADDRESS 5 /l Re4IRlC-- Z-AkC- (location of septic system) Please obtain from the Planning Dept. CITY/STATE Pv D5oN W / S' y0 / PROPERTY LOCATION SE 1/4, Al k,,' 1/4, Section Z / T -Z-7r N-R / ~1 W TOWN OF f-fr tJ1~5 0th ST. CROIX COUNTY, WI SUBDIVISION W e ((5 -1::,496C !!STN'r I aN LOT NUM13ER CERTIFIED SURVEY MAP#7y6Sg, VOLUME 5 , PAGE?, LOT N-mBER i 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. 11We, 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 mamtaine st completed and returned to the St. Croix County Zoning Officer within 30 days of the three ear ex ration te. SIGNED: 22 DATE: 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 J~ C L AND L& 1-5-11 l 8114,02 Location of property a44--- 1141/4, Section -z- / , T z-% N-R / W Township Ut~SJ A) Mailing address 50 JC'~ Z F2. 1 y 10 SoN (-V ( -5-yo/4 Address of site _S/ /l< f1 ► IZ l~ Li¢A/E Subdivision name ult f i- - O - T7AT 1 a nJ Lot no. I CD Other homes on property? YesXNo Previous owner of property Alyl'r4 &&J F. L..1-- S Total size of property -2-, p Z '4 c Total size of parcel -7, o L t+<. Date parcel was created j z - 3 p _ry Are all corners and lot lines identifiable? ~C Yes No Is this property being developed for (spec house)? Yes No Volume '?Z8 and Page Number '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. //77 Zf/ , 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. 4/7 729/ Signatur of Applicant Co-Applicant I1 6 L7 Date of ignature Date of Signature i DOCUMENT NO. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA STATE BAR OF WISCONSIN FORM 2-1982 47"t291 vo( 1:.:8 x...:319 REGISTER'S OFFICE ST, CROIX Co., wi _Anit.a G. Wells a single woman.. Recd for Record DEC 3 0 1991 conveys and warrants to . John,•A, Elbert and..Eric J Lundell, as..Tenants..in Common.. an undivided..one-half interf:st...... Re9MINOfDeeds .each . . RETUPN TO . . the following described real estate in .....St. . Cr....oix ..County, . . . . . State of Wisconsin: All that part of the Northeast Quarter of the Northwest Tax Parcel No Quarter (NE}NW}) lying Southerly (Sly) of the Railroad Right-of-way; The Southeast Quarter of the Northwest Quarter (.°E}NW}); The East Half of the Southwest Quarter (E}SW}), EXCEPT r` part to Alfred L. Ekblad , in Volume 498, page 484; part to Leslie L. Swenson in Volume 498, page 504; part to Donald F. Johnsin, in Volume 500, page 525; and part to Donald L. Jordan, in Volume 580, page 354, all in Section Twenty-One (21), Township Twenty-Nine (29) North, Range Nineteen (19) West. I This Warranty Deed is given in full and final satisfaction of that original Land Contract between the parties, dated December 4, 1989, recorded December 13, 1989, at 11:30 A.M., in Vol. 858 of Records, on page 633-634 as Document No.454203, Office of Register of Deeds for St. Croix Co., WI. This . is not . homestead property. (is) (is not) Exception the warranties: Easements, restrictions and rights-of-way of record. (fated this .27th day cf December 19. 91 . - - - (SEAL) 1f ~•K .c. c~ (SEAL) • Anita G. Wells (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Sil;na e(s) OF Anita G. Wells, a STATE OF WISCONSIN si gl woman ; ss f County. alit a d It 27t4la of......December 1991 - - Fereonaily came before me this day of 10..... the above named Leo A. Beskar . TITLE: >fEMBER STATE BAR OF WISCONSIN - ( not, authorized by $ 706.06, Wis. Stats.) to me known to he the ner~on who executed the (urc,uin~ instrument and acknowledge the same. 7~4:S INSTRUMENT WAS DRAFTED BY Leo A. Beskar, Attorney RodR, 3eskar & Bo1es1_. S:C: , 219 North Ma_iu..S.t N„tnr> Put.lic TI. Ir , 'he a e Ic ted or acktimviodged. Roth >i ('onuni«ion is nernlanlnLlIf not. stale cst ration are not necessary.) date: 10 l 'Yemen of pennns =icninz in -y .ar- itY sh~.uld L•• I,:....1 ~I ~h•n WARRANTY DEED STArF 13AR OF W18CONSIN W~sc:xvn L~•::al f3f.lnh Co Inc