HomeMy WebLinkAbout020-1295-10-000
-0 C)
a) C)
3 o
a O 60)
M a o
~ I
o I
o
U
N L I
~ C
h
r I
x
Q in
N I
h
y Y
w I
Y
a~
00' ~ I
0
C Z
W o I
LL C a
0 0
Q
I 'IT
a)
w Z
E
O Z 000
Z
m
IL m
N F- Z
I
0 Z d c
aoi Z o I
U) t- c I
m
9
N C I
M CD
C
N o 0 0 0 I
Z4: 0 C=)
•1~l d L t N m N N
c O Ir-- w C) C)
c 'o
O o 2 Q Z O v N 04
v
Z F- Z Z Z o o
N m E
_ N
N I
o ~ C d ~ c
U) co
0 0 3 a s
• o a a a
a U
N m o vii ~ LO LO U)
N J U a) rn rn } a) I
v rn o I
~V O Q 0~2 N I
7 O
a CL
ml (n m N
m ¢ } m
en
o
C7
~ y
O O 7 N C
GO N r
0 o o a"i Q c d R o0 o f
a) C,
LO (n E 'o r- C)
v O 0) o a)
't y a~ H c co
of con °
•~l O N S U N O Z N g
CC _ I
ew
V t/] y l4 £ d
0- L: IL
• c~ a m d c
m
~w
0
_1 co n~.m 0 inU
STC - 104
AS BUILT SANITARY SYSTEM REPORTf
OWNER K E /ZqQ ETN 1F ~
Uar t C RLstE►Us~N
ADDRESS 670 /`~ISI~I ~I~ # Z!O mot '
~Otn ~13U `lei ry N , 56/25'
SUBDIVISION / CSM#_ SSuNQ((~~ LOT #
SECTIONT 2'N-R~W Town of
y~p~J
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
'Jo MINA AJUS0 dW N)61802 iw t LOTS It'r 146 TI MC OF
t S 7tt ~ on/
lt9o wEL( Oro ?aopezry ev '*T rrevi'L- Oi iv~►sr.p~ ~r►
i
~ B
i
lZ
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
.
BENCHMARK: SnuT ft 6451 OQW jk
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: &:2~: Liquid Capacity: 1z00 GA
Setback from: Well'House ' Other
Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: 5 Length 75 Number of trenches a2
Distance & Direction to nearest prop. line: Sjr F2ofh EF%,i T
Setback from: well: f $0 House Z$ Other
ELEVATIONS
Building Sewer ST Inlet, y.~ ST outlet
PC inlet PC bottom Pump Off
Header/Manifold'7s 7 $,65Bottom of system F`66- 9"
Existing Grade Final grade
DATE OF INSTALLATION:
PLUMBER ON JOB: -BILL A AAS 7
LICENSE NUMBER: (oaa~
INSPECTOR: tN119{ty
3/93:jt
i
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
Pe&kY9'1biN9&, KURT & ELIZABETH ❑ City ❑ Village Q Town of: State Plan No.:
Hildson
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
s 0
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Benchmark
Septic lr~vc ad. (p /DO
Dosing
Aeration Bldg. Sewer //'00" /o 5-163
`
Holding St/ Ht Inlet a
TANK SETBACK INFORMATION St/ Ht Outlet oS 3
TANK TO P/ L WELL BLDG. Vent to ROAD Dt Inlet
Air Intake
Septic r S NA Dt Bottom
17
Dosing NA Header / Man. 12, eQ
Aeration NA Dist. Pipe
Holding Bot. System q,
6 5-1 /00.
PUMP/ SIPHON INFORMATION Final Grade ~S- 70 3
Manufacturer Demand
Model Number GPM
TDH Lift Lricti System TDH Ft
Forcemain Le h Dia. H ',pc I Dist-To
SOIL ABSORPTION SYSTEM
BED/TRENCH width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 5' .s ' -DIMENSIONS
LEACHING Manufacturer:
SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM
INFORMATION TypeO CHAMBER Model Number:
System/) OR UNIT
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 - 3 Topsoil ❑ Yes ❑ No C] Yes E] No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: Hudson.24.29.19W, NW, NE, Lot 38, Benoy Drive
0 d/
'tu'u, Z-41
Plan revision required? ❑ Yes dN0
Use other side for additional information. jgo C/ 1 r cc,.a G a
SBD-6710(R 05/91) Date Inspector's Signature Cert No
i ..-moo
STC - 104 Q Snn p
AS BUILT SANITARY SYSTEM REPOR
OWNER-K0121 .4
1 ZnlaETN C, H"kISTE~'115~'I✓
ADDRESS (0 70
-)Onp 3o Al , N w , 55125
SUBDIVISION / CSM# S_uN f?) 6e C- LOT
SECTION-24/ T Z9 N-R__Z4?0 Town of
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
i-ousE s ow N)E180a "ub STS 1Fr rt4C- TIME' OF
J Sntc
Wo wEu oW r~aoP~ry c~ ~T r~rw~- oti ~warr~c.►~r,
i
i
j , l5 tb~ A~
y~~9 r o~Q, /7'
~~s Aw A0
3
i
~Z
1
r:
INDICATE NORTH ARROW
l
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
_ n
SANITARY PERMIT APPLICATION
LHR In accord with ILHR 83.05, Wis. Adm. Code COUNTY
C-4-0)
=:Z_
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than -V,-5-9l03
8% x 11 inches in size. ❑ Check if revision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
P OPE TY OWNER PROPERTY LOCATION
/'UA.) 4 it Y4, S T W, N, R E (o
PROPERTY OWNER'S MAIL NG ADDRFSS LOT # BLOCK #
r
CITY, ST E ZIP CODE PHONE NUMBER SUBDIVISION NA YE OR CSM NUMBER
II. TYPE OF BUILDING: Check one CITY " . nNREST ROAD
( ) ❑ State Owned O VILLAGE : c
❑ Public K 1 or 2 Fam. Dwelling of bedrooms A ELT NUMBER( S)
III. BUILDING USE: (If building type is public, check al that apply) QaQ - /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
50 Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. ~4 New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.0 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 on
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy
13 Seepage Pit Pressure 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) 1+,1610 ELEVATION
600 15 -0 .1 610:%,0 Feet d3!~ Feet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Hold in Tank Ido O 2
Litt Pump Tank/Si hon Chamber
I Ll El El 1:1
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: (No Stamps) MP/MPRSW No.: Business Phone Number:
2 &_~Z L S~396~
Plumber' ddress (Street, City, Stat Zip Code):
a 65C;- ss GU
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disappro Sanitary Permit Fee (Includes Groundwater aDate uIssuing A nt Signaure ( ps)
Surcharge Fee)
jR/Approved Owner Gived ven Initial)~/S-
Adverse Determination d w
Las
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) 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 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 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
Statq 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.
111. 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.
'S►\ .
SBD-6398 (R.11/88)
~
all
C,
ca
~o S
s z
vi
p vu a~
o?
Q Q
3
a~
V
10
• Wisconsin Department of Industry, SOIL AND SITE EVALUATION of 3
Labor and Human Relations spy-iV[O a
Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis 7 a,C Y
c.. ,t
Cou b U
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. parcel !5
APPLICANT INFORMATION - Please print all information. Reviewed b Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property OwmaF lgvy~ Property Location p ~p
ever 0 ~/;ZrtQ><t~ri C~~PiSTENSE~✓ Govt. Lot NU) 1/4 N ~ 1/4,S 27 T 2- N,R E (oro
Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 1 ~~I e$
Ce 748 145A4uooP - zoo 3S i 5o A3 1210 6-E' J
City State Zip Code Phone Number Nearest Road
~000p3vgl 55/25 ( 0/2-) Jr7f- 2POD ❑ City U ❑ Voillage U Town ~E,(~p y
['New Construction Use: B 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 ' 8 trench, gpd/ft2
Absorption area required ed, ft2 9 3 trench, It 2 Maximum design loading rate bed, gpd/ft2 • -?trench, gpd/ft2
Recommended infiltration surface elevation(s) s'ue' P! 3 ft (as referred to site plan benchmark)
Additional design/siteconside 'ons lfAgX ,vEE17 TO Zlfe=7- 6W0k5-D ?~PE.u~P$ -v?Dvti°
Parent material c s y /3U'e&h41fP7 - S/~.r~Dy DUTIU `j Flood plain elevation, if applicable It
S = Suitable for system conventional Mound In-Ground Pressure AT-Grade / S~ystee in Fill Holding T-an~k
U = Unsuitable for system [✓]~S ❑ U ❑ S L'T U S El U F-1 S L~'U Lrf s ❑ U ❑ S 2 U
SOIL DESCRIPTION REPORT 6'` e- s' v
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
119 ille - 51 /7'S,k 5 e5 z i- - : -s
15 X" 7 -.9
Ground 3 12'31 A9 y
elev. 0 Z/ ft. - /o ye y - cs o d~ ,
Depth to
limiting
factor
> 9~ In.
Remarks: * f~X i 7 3 ay LPgLE~XP S
`l S
Boring # i D-~ /o ~ie ✓?/a- S~ /~vr.6,~ ie G5 Z -F
Z L -2-3 D S1 , zr- S .,r 3 3 -yo /o _ 9 'rv s, O Q c S - - 7
Ground Cvif~ ~lcJ BO 4P
elev
103, ft. a /oY e S, O
Depth to
limiting
factor
7 in. Remarks:
CST Name (Please Print) Signature Telephone No.
'Fo'5:E- IP T 1 b (F2 t' c(AT- '715 -3 ?6 8S
Address Date CST Number
Ulbricht & Associates / O - if- S CS X v y~ Z
P ivate sewage eonsui-wits
655 UNeii Rd.
Hudson, Wis. 54016
ORIGINAL
SOIL DESCRIPTION REPORT
PROPERTY OWNER Page of
PARCEL I.D.ff <or 3 Svc IP-
Boris # Horizon Depth Dominant Color Mottles Structure 2
9 Texture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
3 / 0-7 /o YAP 31.)- - s~/ sd,~ „~fe 6's f s ; .6
z -ZO /0 513 cs l 'S
Ground - Z /O S ~yL S ~N II Q LJ q C
elev. i q:
/a ft. s /G /f /;J1 79~ jr
- s ;
7,
Depth to
limiting ;
factor
in. / pp
Remarks: 14 - P CU t l~~i 5 .
Boring #
4 1191 3/a- S / / f 56,E es
2 Y,e 3/3 si/ /-74s6,e S 's
3
Ground $
elev.
G~ ft. III
Depth to
limiting
factor
~ in.
Remarks: 401e,1-Z,-V0 e0.17<4/,-IS 'f ~cr Sre-rtF~~ t~ v LD S
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
Boring # O -'P /D /Q 3/~ ~fsfe e S i y ,j
L - 23 /O Y,e 3/y 1- -Zf Sly ff' ct 5 , S • G
~ Q C S
Ground 3,f %Q e C.S 0-5
elev,-
Depth to ,
limiting
factor
Remarks:
Boring #
Ground
elev.
n.
Depth to
limiting
factor
in.
Remarks:
SBDW-8330 (R. 08/95)
i
V ~
W w
- F~ E~d y I R
53 UJ rn
N
z I
o t
'Ib
y% x o
w -h c
71
Q)b w
(3
o
,tA
,`-o - ~ o --------s fit----
'
V6
w _
\ z /
ado
F~sT t oT L,
7'07.}-/
T' CL #0165 Pol
TANK
St. Croix 'Counq'
. ..w.re.ar
WLENC ADDRESS
t !
_ t . ;r,` i'1k Dept.
( :1'~-~ ;i ,,%c ~^!4, ~'~:fii`1 j t iw,~S~ ~`!•~,..s i;,.7..i t . i
i -
J,
'f"f 'fi'r ~~r~4 i"ir•. L'C3.5..~,~ ~ % _ _ F( TV f C AT X.'L):\ AJKJ il~.tS q '7ti eti l}tiy 2... _._:.i +`-,C'l Y
c Cl.J L.TIMT Y NVI
T. C Fi4-
G eft' O
Vol,x~.` AG
":t .;sS~~''i3J1vc af'kj'`irti
a"d
'J :9 `S of pdl lh'nlwr' ` rt ir1 .n ' ' tt'ii Car` ,t 5 : ,er tfi'':dtc
'vl*'rat you S'yi" 1 cars t 1 iE ~~tS1 r41'-'.1 of t` t, septa _ ~ .
a, ~ L~iLit""1J.9 ~i1,aw f?G yz S~!t~i"i,: t~ u~"' t i:I ~r'~.l 7l t•1, ~ til9:#ia;.lCii ~r Cr~ G w
S r>~": - %V'kti vein-3 r~~t ~'CCS ii'+ to J i%. It 1978, St. Crcwa
+av-nt..r: of ait :Itvl yybitCRS kls~ Ch i„
u;s r5cetfi,,T.;7eri°,
bo:;t" to St, Croix Zoning- v sign, ed by the c,wv,-'
tt t
f id$ Ut`t}~S t Us~tL C t1 ~ iUri7 i' f.~°i ^a.vti t t`~f7t~~4C c'r li t+ C 1; 7i1F11pCt Yti'"! y' lr l
r ~e 4.
r t t t ...)c ~ i'SZ f 3t! r'',E.I co nvitr. an,: after er 1.)5~'euU"') ;]ki
t 4ti5''t # 53ti sut 5 P 1
r a „ rk ~rsC k lwr11 i5 r i~ "t :`w :f sit dgd and qc°.u 1.
the lead thi , d?1Ct`il ,t.+t;; ;'{TiCilt° i :T ~(1, r aunt .r t G rs,~'ete sCwatJIL'
r tt+j?' raa 5.* }J1' the ($vrls' 1i
>y f tNlt l k[i a f. t f. )itr4
. Sat(L "T wa x it d~.a,. s Te
d tndl rc#~.rtd to the St, C-',Oix
k'p 9 fSt
It ;2ti! has, been i'1Et t _:wE 'lfilr 1 i t !"t ~C
Zc,. in 3C c:ays of +ahe t~,' ear t;xrtrat;on cute.
j {:..•iiJt;"a ~U'.irta„ 1~ t„t"'C1Cw JI _l I
L CFirlictlac;
MAP-30-'00 FrI 02:07 ID: TEL NC: #065 P02
S T C - 100
This applicatinr form 1s to be completed in fuj and signed by the '
owner(s) c.= the property being developed. Any inadequ&cies will
only rer.c:lt in delays of ti c- permit issuance. Should this
development be intended for resale by owner/contractor, (spec
house), then a second form shoulld be retained and completed when
the property is sold and submitted to `:'r.is office with the
appropriate deed re. ording.
1 LLI • I ✓ ? 191- C7wrir of property-__ fr rh_2.1,~_....._
Location of proper:t', /~)U) Ng-114, Sect,,::,. a~ rT N-RW
Township vd. ail Ing address s • oo 0.2101
Address of site W~'I -~-~e,,uo
;.sr homes .,,in property
Previous tawer of property
. i 1 i x e of rzoperty _--------r--
1 s i z e of Parcel Lau to parcel reated Uj
A lo: :ners and lot lines identifiable? -~---,Yes No
7,1-operty bring developed f tor (spec house Yes )C ,._No
Ume 4P _ and Page Number ~-7 as recorded with the Register
Deeds.
INCLUDE WT,TH THIS APPLICATION THE FOLLOWING:
A DEED which includes a DOCUMENT NIUMBER, VOLUME AND PAGE
MJMBE'R r:, % J THE SEAL O THE REGISTER OF DEEDS. In addition, a
c.•ert: fled survey, if available., would be helpful so as to avoid
delays c} the reviewing process. if the dead description
-references to a Certified Survey Map, the Cart.ified Survey Map
;b :t.l also use recpArt-d.
PROPERTY QWNER CERTIFICATION
I ;we, cart .fy that all statements on this for-m are true to tree
best cf my (cur) knowledge tha: T (we) am (are) the owner (s) of th
prop4- described- in this 7.rforrna.tion form, by virtue of a
deed recozdr.M in trip orrice of the County Register of
:'eeds as Document. No. 3 51 and that I (we} presently
own the proposed site for the sewage disposal system or T (We)
obtained an easerient, to run the at>ove described property, nor thR-
construction of said system, and he samF, has been dtliy rer_;crd'ed
the office of the C'cunty Register of Deeds as *)ocumeT u
53 5'~3
_ C _
t Applicant we ' PP' ica 9"
S nature.
Date of ' 1 t ::.t u re r t. c S + n r, n 4 w
- i_ _ -
~ I
~7~~~ S'['ATE BAR OF WISCONSIN F()RN1 1 1982
5~'3t .
W'ARRAN'TY DEED
~c c,.:,, r t•li'? i; ~ oil ,a 41
REGISTER'S OFFICE i
I
II ST CROIX CO., W1
Read for Record ~
ll k e('d, rtljdr: hejv,,'en Gr;?E'?'i'JC., ,'-__TiT'l
,
1 /+1
i a 14151 OC ?,t5it1 corporation
_ sr 1.111 9:10
t\;•i Ch r'3 t, a5E!ii. A.
and 2. - _
tsur~banct a5 ~t~rti~r~rshap
~,a r 0--)t to ~ O _ I t3f of DBAISsf I
property
nt[ 'I
P CEpE E+' c"pFOrlC-
«'Iril41}'OttS fl~),,t ~,r? C r_1ac`tii,,t r .,c b i~1 ~a1o,n, _ ~ t,n~ - _ -
'r
I ,
t
cOnvtI", to Gra Fa t+a;1::,~~[ ' ,cr;hc rt:aC _..a'.r rJ1,S 114i e
ji ,ol-a.._
.2,
I
(t':.ri:C! lder)iiiiCaiiot; KUmbei)
1
j
,i c' 1 FIB ` t rR~ } Fa TI, file! in th - Office of ~~Iie Register F needs t.ar
21 August la 1994 in [Jolvme ) of Pllts~~ at PIF,oF'
i
J~~~. i~
3t„"[ ll 411.r el
.t t '~CJ it
r
I
i
~j I` tl`- }i1TllE,rs.i(t )rCF?eil}',
j; - I _ ~ , ~ fs[rl7)e;,t~ ~nd .jZpune~ ~r~:e5 then ,tat'~r '+'•n~lt:g,
°.c.. n)r!t' a-,d tT,,., and 2,ed; of :nChYt'lb~'3ntiC. i'?t;r.•!~? ll
i' II
7'c) fi?a?tlt a TE3trictl.TV J d 33 Vitt. ons, 1.L aIlly~ of rF .c
I I~
,i Sq ",C!i. 1 f i(;' l_ ' rCt'•C: PitC~-sartte. t
C:R7-r 'lottOC.-•i l e i '?I O c t c7 7 a r
r'F f,'>~W'WO{J t~J z:i rE Fa 7;6 M, GP. r'~1'rJ(~C)1, ' L•'..11 1E Yt~~7 L`
, . Y
A 1.)
F.7 AT
rt' T' cal c ?x. sra i;leni_ " . aa. cx ~G~!r1 lid
j STATE OF WISCONSIN)
Ir~R~R143 ACKNOWt.11;'i1C}"t 1
I~ COUNTY OF ST. CR()IX3
r S [
SIAt'f OF ~~t,.:ON S ,iN
T F1 Q 8.... . is ew . rr:... ~u Y _l~_.._
4k - day o£ Oe-tobsv, 192person
Who ex UM the £oregol g instrument and acknawl-edge srmtx r?unty
;dx9 e> c" ?G.xxxxxxxxxxXc Personae v came before care this day of I!
" "i•_ 4-cdheL- - 1995- the abcve teamed i
Mary ids s
Pcret.ary jgtt, lr)t8ry c t:lblic State o
to me knov,% t.~ re the •)er,rwho exccl)ted the
Ilk !'aregoing .a~tr~.une t anr,", ~ci'•. !y'e thr game
1 ; +1. kIurvay, Zilz ar,:! E trr:=n
ii St'r'eet-
W1 ~I 54016 Notary
Hudson, County, Wis.
~ d yuhlic
(,F, natures may be aathe,tac~itrc~i ,;tr ,l knowteI ,:o. Both are not. tiYy Commission a per;7aanent. (if a( A. state exp)ratton date:
ecemar ,
4 is gig„ i k in .:ay , r, _ •~~i,:~
u.;; sr aul hu [9F r mtc + F I r., t'u,
WARRANtY DEED srACF HA It OF WISCONSIN Wisconsin Legal Blank Co, Inc.
FORM No. I - 1982 Milwaukee, WIS.