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HomeMy WebLinkAbout020-1294-80-000 o m °o, I M 03 to x cz N N ~ O N c O m •y rn ry o O 00 I 0 Q) a a~ e o y z c U. O CM~ CD °cMO Cl) N Z H O w 0 v N W a m N H Z o O Z c _ a~i Z o m N z c E -o O N M a) cc .5 1 C N O ~ O •N d U L O ~ C O Q Z F Z w z N ~ I E N W 2 CD 0 2! O c0 O• •w - c O O 0 ra O- :3 LO LO U) 0 U) M r r o d o a z •N ~ oaa CL B U-) to in J U rn rn } = O a I ~ V) y O7 N Cl 00 Al O O co y c In co O C N C :D [0 °m.4 o m n IL°o m l m F- _O o v v rI O rn 40 C O N N O T O , t L r -O C O) 'o O~ CD N • N' 7 N ce) O C E U O y„ O N 2 m N 0 Z- fn I v d m € a 2- L CL E v c c r A Q(L2 1On0 i STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS, SUBDIVISION / CSMf 'y LOT ti SECTION T2;~'_N-R. W, Town of - ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEE OF SYSTEM 8 r if' ~I c~ssawc /o~'D \ 1 Pr ~rrr , ~ a z r ~ vcr ES lTl-0 INDICATE' EJOR`lli ARROL' Provide setback and elevation information on reverse of this form- Provide 2 dimensions to center of septic tank manhole covet BENCHMARK: ALTERNATE BM: I SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATTQN f./. ~ pmO~ Manufacturer: Liquid Capacity: ~S. a Setback from: Well_-Vfl-((f House ls. .~-Other Pump: Manufacturer / o e`/ ModelV f 3 Size i1 Float seperation 13 Gallons/cycle: Alarm Location G-, eli" SOIL ABSORPTION SYSTEM Width: Length ` Number of trenches Z Distance & Direction to nearest prop. line: > 2d Setback from: well: /1/ c House > /OO Other )LEVATIONS Building Sewer 16'~ite / ST Inlet. ST outlet /o S~3 PC i n l e t 2 PC bottom /L,)/, ~G Pump Off 3 # ~r • ~ ~ i X03• y~ Header/Manifold# z /oA ey, Bottom of system Existing Grade 0 , 7( Final grade /OS• 7 DATE OF INSTALLATION: PLUMBER ON JOB: Z), Z7~ f LICENSE NUMBER: INSPECTOR: Wisconsin 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 Permit BENOY,r s Name: ❑ City ❑ village [J Town of: State Plan o.: CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA ?c%%l TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Gt~PS C~ Benchmark Dosing ( Xyr ~ o. u per' Aeration Bldg. Sewer Hold' St/y, Inlet s ' /DS, S TANK SETBACK INFORMATION St/ t outlet 6, 0a oS-Y TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake SUS 7-7 -1 Septic NA Dt Bottom 9, S~1 lOl 7- Dosing ><,-o NA Header/-M /02, Aeration NA Dist. Pipe 9,9oGa , !o3,s ` ? Holding Bot. System / a 9-? PUMP / NFORMATION Final Grade Manufacturer Demand IdF?q Model Number tt 'S ? Gy TDH Lift o4 I Lriction,7 i Syedem TDH q;4t Forcemain Length Dia. Ha Dist. To Wel SOIL ABSORPTION SYSTEM x,7=1 BED/TRENCH Width Length, ~i No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS e c12 DIMENSIONS SETBACK Manufacturer: LEACHING SYSTEM TO P/L BLDG WELL LAKE/STREAM INFORMATION Type 0 &w , CHAMBER Model Number. System: OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) / 11 / x Hole Size x Hole Spacing r Intake Length f / Dia Length (o d Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade ems Only Depth Over l Depth Over o ^ xx Depth Of xx Seeded/ Sodded xx Mulched Rad'/Trench Center 28 2) G 8ed7Trench Edges b 3(A Topsoil ❑ Yes ❑ No ❑ Yes E] No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: HUDSON.24.29.19W, NE, SW, HWY. 1 n _ r Plan revision required? ❑ Yes Eq-hts / Use other side for additional information. SBD-6710 (R 05191) Date Inspector s Signatur Cert. No. 1 J Safety and Buildings Division SANITARY PERMIT APPLICATION 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 13 than 8 112 x 11 inches in size. • 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 Y o previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Property O er Name Property Location T z , N, R E (or A 1i0 ja~ Proper y Owner's iling Addr ss of Number Block Number Cit Sta Zip Code Phone Number Subdivision Name or bel ru (p > 71 -37,A, I. TYPE F BUILDING: (check one) E] State Owned El City Nearest Road ❑ Village ❑ Public 1 or 2 Family Dwelling - No. of bedrooms Town OF L III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment / Condo © Z.o 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. Z New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5- ❑ 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 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 14 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) 0* / lo.k. 7 Elevation . 45T 6 3 g z o Feet lo. VII. TANK Ca in gallons Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass plastic App New Existing strutted Tanks Tanks Septic Tank or Holding Tank DOD ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber QO ~D ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of a onsite sewage system shown on the attached plans. Plum er's Name: (Print) Plum er's SignatAe. P}e•St ps) IWWMPRSW No.: Business Phone Number: Plu is Address (Street, City, tate, Zip ode): v o.Z 3 IX. COUNTY [DEPARTMENT USE ONLY ❑ Disapproved Sanit Permit Fee (includes Groundwater Date Issue Issuinc A Stamps) T ~Sy rcharge Fee) Approved ❑ Owner Given Initial 01 j W .`P 7-/2.95 Adverse Determination X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SRO-6398 (R. 05/94) DISTRIBUTION: Original to Couniy, One copy To: Safety & Buildings Division, 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 lint? 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/dr existing tank, list the total gallons, numbs: r 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 runty The plans must •iriMude the following: A) plot plan, drawn to scale ar with completedimensions locaticx:-z of io dine, tank(s), septic tarik(s; or other treatment tanks, building sewers; wells; water mains/water service, St-E, lak0 , pump or siphon tanks, distri't.ution boxes, soil absorption systems; replacement system areas; an,- the to ,ll., c the Luilding served; R) horn ~ni_aCand vertical elevation reference points, Cl complete specification, `o- pourif 1 a ic 'ont-01s; dose volume; elevation differences; friction loss, pump performance,,urve; pump model and n.imp manuf~ ci urer; D) cross section of the soil absorption system if required by the"county;J=) soil test data on a 115 fan-n; anJ F) ~I sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation'of surcharges (ees) 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_- I`S ~ 7 sGR /C / it ~ =D / ~G/F~ x ~ 6o raj, l ~ = ~fe N rn~Q /o r ~'o M Ua ~~e f L• t# as- 0 L S. r p<r 1~.~ I I sT S67 1.s• I #z x /57L 7- o68s~. 2 ~f _ X \J 2 r/2 PAGE CF I PUt"\P CHAMBER CROSS SECTIOt,I AMC) SPECIFICA*r10k!5 VCQT CAP `f"C.I. VENT PIPE WEATHERPROOF APFROVED LOCKIAIG JUMCTIOU BOX MAIJHOLE COVER Z5~ F R0.^1 DOOR, 9 WINDOW OR FRESH IZ"MIU. AIR IAITAKE GRADE I I I `i" MI KI. _ _ ~ 18" h11 A1. COUDUIT 11~ IKJLET PROVIDE I = AIRTIGHT SEAL * A III I III I I ALARM B I II I o *APPROVED i ow JOINTS WITH I ELEV. FT. APPROVED PIPE 3' ONTO PUMP----- ~ OFF D SOLID SOIL CONCRETE BLOCK RISER EXIT PERMITTED OKILy IF TAUK MAWUFACTURER HAS SUCH APPROVAL SEPTIC E SPEC IFICATIOUS DOSE TA►JKS MAMUFACTURER: IJLMBER OF DOSES: Z PER DAy TAKJK SIZE: If 7-0 GALLOKIS DOSE VOLUME ALARM MAMUFACTURER: IMCLUDIMG 6ACKFL.OW: 22S GALLONS MODEL KIUMBEK: CAPACITIES: A= Zd INCHES OR Do GALLOLIS SWITCH TYPE: B = Z IMCHES OR 11 t/- GALLONS PUMP MAMUFACTURER: _ 20 Cl/r/r!' C = /3 IAICHES OR A Imo/ GALLOWS MODEL MUMBER: D-_ J/ INCHES OR 7_ GALLONS SWITCH TYPE: MOTE: PUMP AMD ALARM ARE TO BE MIMIMUM DISCHARGE RATE 37 GPM INSTALLED OM SEPARATE CIRCUITS VERTICAL DIFFEKEMCE BETWEEM PUMP OFF AMD DISTRIBUTIOU PIPE.. $ FEET " + MIKJIMUM METWORK SUPPLY PRESSURE , . , -B-s- !t F rr•<k ~ '~F,,~~ FEET + FEET OF FORCE MAIN X F/ooFTYRICTIOU FACTOR.. FEET f,+,w1c G~peeti TOTAL DbMAMIC. HEAD FEET . IUTERMAL DIMEIJSIOWS OF TAKIK: LENGTH ;WIDTH -;LIQUID DEPTH y8 SIGNED: LICEOSE KIUMBER:~~ DATE: Dave Fogerty Plumbing 77- raw SEWER SYSTEMS & PERK TESTING FOGERTY HEIGHTS ROAD ROBERTS, 'WISCONSIN 54023 - T _ (715) 749-3656 t _ rV' }4,f "'n "S.sc t "sa 3,,. t L '"F'}^i Z"" star .:~9~~>5 s + an ' r s ~ »•i' ~ .~~ti ,~F r yr+ t o- `R t ~ F~ ~ at Y_ - a i _ ~ v'"i~"• +a+ ~1 X i i ) ~ 3` m ° - mot.. ~ r r ~ } a 's~ y ~ ' AV r Tom' /p1.7 e/w, /1--L-11 ze jo /0 37 ck7" : OhC I .r W HEAQ1 115 ACITY 110 CAP 32 ,OS CURVE 30100 95 28 90 26 85 I I EFFLUENT 24 80 MODEL p 75 MODEL 188 and 22 DEWATERING = 165 U ~ 20 65- Q Z 18 60 } p 55 _ F 16 50 MODEL 163 I MODEL 14 45 188 1T 40- 35 10 MODEL 30 MODEL 137, 139 185 SEWAGE and 8 T5 DEWATERING 6 i MODEL 15 MODEL 161 4 97 10 MODEL W W - 2 5 53, 55, 57,59 0 J i GALLONS 10 20 30 40 50 60 70 80 90 100 110 24 80 LITERS 0 80 160 240 320 400 75 22 FLOW PER MINUTE 70 20 65 p 18 60- MODEL Q 295 W 55 S 16 U 50 Q 14 45 MODEL Z 294 p . 12 40_ J MODEL 35 293 H 10 MODEL O 30 284 8 1 25 - - MODEL 6 20- 282 4 15 10 MODEL ZAZZIM O. 2 267, 266 ° 5 3280 Old Millers Lane GALLONS 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 170 180 190 P.O. BOX 16347 Louisville, Kentucky 40, 216 t LITERS 0 80 160 240 320 400 480 560 640 720 (502) 778-2731 FLOW PER MINUTE Wir,consin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 3 Labor and Wyman Relations Dision of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper nen' 17~ size. Plan must include, but not limited to vertical and horizontal rO(BM), dir % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and locatince~ne rest r APPLICANT INFORMATION-PL FOR N REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION GOVT. LOT /vim 1/4 1/4,S T N,R E or sw .2 9 / PROPERTY OWNER':S ILING ADDRE LOT # BLOCK# SUBD. NAME OR£SidF# ~ CITY, STATE ZIP C / f P ONE NUMBER ❑CITY ❑VILLAGE ❑fOWN NEAREST ROAD 44dgL_ 7M. VI New Construction Use Residential / Number of bedrooms 3 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow yso gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/ft2 Absorption area required bed, ft2 "S- trench, ft2 Maximum design loading rate bed, gpd/ft2 ,1, trench, gpd/ft2 Recommended infiltration surface elevation(s) W o ' :46Z io3.a ' ft (as referred to site plan benchmark) Additional design /site considerations Trcc ~`i ra ss. Parent material /I Flood plain elevation, if applicable ft rU= = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK uSuitablefEIS ❑U [IS 0U ©S ❑U EIS ❑U ❑S ❑[3s mU SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Bouinclary Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench ~r c s sir S Ground Z _/7 o- 3 / ;41e elev. /oy/C ft. 3 i7- k 0 f GS 7 Depth to N yG - ~a I S s 14, a s _ 7 . P limiting factor Sr Ga S 8.Z - - - • a •e T-- Remarks: Boring # -7 -2y y'/_7 1 5 1,4 PA Ground 7 elev /06 f~ft. y-s ~•r S m l o eo U'r Depth to limiting factor Remarks: CST Name:-Please P ' t / Phone: o co r f 7 - VS+% Address: d 3 p 70 pi 3 Signature: Date: CST Number: 32 3 3 ,R c D 3a Af PROPERTY OWNER SOIL DESCRIPTION REPORT Page_ z_of • 3 PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Barxiary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench ~ti~\v{lvv{vvfi:;:;: ~w 3 JI/ Ground elev. /oS.7loft. 30-`9 1•~-~•> / o s ( cs v ~ . Depth to ¢-/i S s hr / GS 7 i limiting factor 2 - 8v 5- - s 6 t l v a 6k v - - , Remarks:r > s o ? S. a,Z Boring # Ground 3 ~1-37 z.s- s o ,z, s Q elev. 3 - 5-3 S - -//P s ©s , / G S ? . 9 /oy/G ft. Depth to -6G - y 6 s~/~ v S - 7 ` . limiting 6 6` > B.e factor - Remarks: Boring # ..S- 0 -S .Z G S4K yy r wi ~o Ground .3 - 36 1, ~ 3 C s / 1, v ~r ~ s 2 v ~ s elev. ft. Depth to limiting factor Remarks: y - ?off ,f'/l Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) x DAVE FCQF.RV PLUFMNG C i U oonsed Pork est 9 piumber 113 Fp~e rry CNOW% O SIRoad ROSE FtTS. a~►V~1 54023 phone 749- /V ° Sca ~c o~ X - b 0 r ~{G { so "/2CYLf 3s9 JS7- ' z 6 K i,_- - - q \ r 1/L T~ ~~V c ors ON ~ ~ i i A-I STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER MAILING ADDRESS p0 (Ti ~'7' •T a~, _ c-c,er- _SYs/&/ PROPERTY ADDRESS c (location of septic system) Please obtain frm the Planning Dept. CITY/STATE "'A uc.1' L Y_y/L PROPERTY LOCATION 1/4, red 1/4, Section ;t T_~N-R__Zf W TOWN OF ST. CROIX COUNTY, WI SUBDIVISION Q LOT NUMBER -eE 4"Llor-OOLUME PAGE 17 , LOT NUMBER .?S- 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 thre year expiration te. SIGNED: DATE: 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 Location of property &z- 1/4 5-e4) 1/4, Section 3 ,TAN-R_Z2_W Township dY! Mailing address y'D ri r~ 4612 Address of site t Subdivision name Z~ Lot no. Js- Other homes on property? Yes No Previous owner of property Total size of property 2,•5- Q.G►ro4;~' 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 No Volume //D.)_ and Page Number 7 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. 3 3O 9 , 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. .1 1467 7 Sig ture o App icant Co-Applicant Date of Signature Date of Signature • Till:; 'iP\-. t tr.•EnV tip F,~R RE~r1R[iINV D4'~ ! WARRANTY DEED QOGUMENT NO. • I STATE BAR OF WISCONSIN FORM 2-1882. 523309-~_-- Gree,iwood Enterprises, Inc.,- a Wisconsin Corporation, . _ NOV 9 193 . At/ conveys and warrants to Duane- ,E.. -Benoy. and.. Angie M_. Be noy,,..- husband surv.ivo-rahip mar ital...p.rop~tmy_....... Heywood & Cari, S.C. _ . P.O. Box 229, Hudson, St.. CYOlx . the following described real estate in . . . . . . . . . _ _ ..County, State of Wisconsin. 20 ~Z 7,7 Tax Parcel No:...-...-••--•----- 8` a Lot 35 of the Plat of SunRidge II filed in the Office of the Register of Deeds for St. Croix County, Wisconsin on August 1, 1994 in Volume 6 of Plats at Page 17 as Document Number 519728. 37.03 This is not-----_- homestead property. (qX (is not) Exception to warranties: easements, covenants, restric~ions of record, if any. ~ ~~C~"~l~ ri2J is Dated this day of 94 James.. E._Ruscht-Pres-ident `far, R'. Rusch, etary/Treasurer . . (SEAL) AI - AUTHENTICATION ACKNOWLEDGMENT Signature(s) James E. Rusch, President STATE OF WISCONSIN ss. S_T. CROIX County. Personally came before me this _.-.-----day of authe ticated this~~_~day of._. c `t,~, g- - - - - - - - 19 94- the above namu1 - Treasurer....- --I. 1---------------- Mary-.R._.Rusch, Hody-nsky----•------------------- o~ Y P&. TITLE: MEMBER STATE BAR OF WISCONSIN _ 2' (If not, _u - authorized by $ 706.06, Wis. State.) to me knowr to ~l eW E R. executed the fore;;oinl; instrt en~~((~~al i}>♦M c' et same. THIS INSTRUMENT WAS DRAFTED BY %9 Heywood & Cari, S.C., by Walter Hodynsky t- P.0. Box 229, Hudson, WI 54016 Notar> Public _ St. ...County, W s. . (Signatures may be authenticated or acknowledged. Both My Commission is perman...it t[f not, state expiraytVn are not necessary.) date: l(i.--;~~-5 _ , 19?- -Nan._a of persona signora in any capacity should be typed or printed blow th-ir ¢nac. r..~.