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HomeMy WebLinkAbout020-1295-70-000 y v o R N p (A on 0 0. 0 q ~ O 7 r„ C c ~ I 10 c x ~ N ICI o I Y i w I I ~ I o z °o I c L r LL C ~ Y Q ~ o N V 'IT z r $ rn a m N F- (n O C 'a m O Z a c w 0) Z d ° o (n F- r to N C F L7 N a) Q m O ~ (D `O 0 • Al a ~ 'G 0 I 0 m O m Q w 0 Z co z N r c O N CO N ~ C co 0 V 72 LO to 0) Q) O o o a n m cn o O O O a_ m Z •N 0 a a (L a _ m 2 LO U) N J U p rn rn ~ LO E O O N O N (D CO d 0) ~I } 00 7 O C © U O O O O o X 0 0 O~ O O O. C N r V i" ~ C E C N C C O 0 O L O - M e9? -O ` (p O _0 r~l N y N r j~ Z' C 0) • yam,' O N S I N O 15 E L) y (n C~ O O %t C i a M O U a 2 0 (cn 0 °o O e~y N o Z t kn 0 0 N h N i V I ~i N O z 7 O {L c 0 3 ~ I O 04 Q v O Z m IL m N H fA C O O Z a d Z z U) H r N E -2 41 M 7 N I C • 7 O co N 0zz Z w R cm CL M O Of a A IL N O p O o E ' N 7 7 o ~ w I al co o •N I~aaa Z f6 C N IL o N B 'D r p fA fA O J = pmj pmj Z c E~ co a m 'o N Q m 2 C d Q Z U) co 7 ) O O 0 O y C co E O O M C pp N co ~i am N O Op C _O O rn~ ~ ~ _O O c d C CF co N 'O N O C O •O O N 2 J N O Z Z (n C~ v v~ c`, ~o € a • CL 2 dam E c c ~1 A C)CL2 ~0 co0 I f STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER e .iii,14A` ADDRESS LZI SUBDIVISION / CSM#<<h LOT # SECTION Ry T~_N-RW, Town of ST. CROIX COUNTY, WISCONSIN /cxV PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM dt:z INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: ALTERNATE BM:/' SEPTIC TAN / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: IdeeAl; Liquid Capacity: /ego Setback from: Well WdIlHouse r/ Other Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: / Length ~313- Number of trenches Distance & Direction to nearest prop. line: Setback from: well: Dkld House ~-Other %lS J 5~-._ 10, ELEVATIONS Building Sewer ST Inlet ; - 41t( ST outlet PC inlet PC bottom Pump Off Header/Manifold Bottom of system) Existing Grade Final grade J~ DATE OF INSTALLATION:,/ I -7 'y PLUMBER ON JOB: LICENSE NUMBER:' - INSPECTOR: 3/93:jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human platoons INSPECTION REPORT ST. CROIX Safety an48uildsigs Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Permit Holder's Name: ❑ City ❑ Village ❑ Town of: State PI o.. MILLER, GREG X CST BM Elev.: 7 Insp. BM Elev.: BM Description: Parcel Tax No.: A r /O - /0,0, U (12 A9600324 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark -7~'06 Dosing Aeration Bldg. Sewer 5 9 5 -13' Holding St/ Ht Inlet 3' 9'~l. 4/9 TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic > r n0 NA Dt Bottom 50 Dosing NA Header / Man. '7- 9 3 3 Aeration NA Dist. Pipe 55' Holding Bot. System T_7 PUMP/ SIPHON INFORMATION Final Grade 75' y p Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft Head Forcemain Length Dia. Dist. Towels SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~a 8.5 / DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Typeo rp CHAMBER Moe Number: System: 3,5-, '5~ g 1 tt - NJ/A 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 Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Hudson.24.29.19W, SW, NW, Lot 44, McDiarmid Plan a 'Ion required? ❑ Yes No Use other side for additional information. ~f q Cy~.~~~+~ SBD-6710 (R 05/91) Date 1 °p ' or's Signature Cert. No. L ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: • I SANITARY PERMIT APPLICATION Safety and uillngWater Sn Bureau o off 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 County 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 ❑ Ch,eck i ronf io previous application IPrivacy Law, s. 1 5.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Property Owner Name t Property Location "x1/4 1/41S T N, R / ' E (or Property Owner's fling Address- Lot Number Block Number City, S e Zip Code Phone Number Subdivision Name or CSM Number J -7 II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ City Nearest Road ❑ Village Public 1 or 2 Family Dwelling - No. of bedrooms Town OF `l r Parcel Tax Number(s) III. BUILDING USE: (If building type is public, check all that apply) 1 ❑ Apartment / Condo 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 online B, if applicable) A) 1. r4 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 Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 1.1$Seepage Bed 21E] 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 Feet Feet TANK Capacity VII, INFORMATION in gallons Total # of Manufacturer's Name Prefab. Con Steel Fiber- Plastic Exper. New Existing Gallons Tanks concrete strutted glass App. Tanks Tanks Septic Tank or Holding Tank ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. PlumberhName: (Print) Plumb Signature: (No stamps) MP/MPRSW No.: Business Phone Number: Plum is Address (Street, City, State,, Zip Code): ~E IX. COUNTY / DEPARTMENT USE ONLY E] Disapproved Sanitary Permit Fee (includes Groundwater Date Issue Issuing Age t signature (No S ps) ,Approved Surcharge Fee) E] Owner Given Initial Adverse Determination l X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SRU-6398 (R. 05/94) 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 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 11. 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 number" throuch 7 VII. Tank information. Fill it the capacity of every new/or existing tank, list the to',al allons num )E:r of tanks and manufacturer's name, indicate prefab or site constructed and tank material. :cr :)lete f, :dt' „3,;;ic, purr-p/siphon and holding ta-?ks for this sy,Aern. Check experimental approval only if tanks receive experi,7~en1,)l - -oduct approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in game, license number v^)Hi, approDrla'e -refix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only X. County/ Department Use Only. • a""O ICano= Sma Ie, t lar x I Cr. •c rrT 1 t E _ my r: 1a must ,•i, IiIi ICi VVI, raj o,ot t~.lr l<Sep',C hu.i:4- ~ served; ti _:r per_~~r: T3~!.~ r c; ~~~mpC r, 5ssectton J ~,l s 0 t' _ 1 C1a J rt _0 1 TIa110n. GROUNDWATER SURCHARGE 1983 VV6consin Act 410 in-hided [he creation of surcharges ( gees) for a number c- !a1,(,.,.) i- dhir.il can effect caroundwater Tf.e rno:-es co:lected t rcugl: these surcharges are used fe.r monitoring grounclwa~ : ~.ontam; r. i ,vestigat,or.s and establishment of standards- ~ ...v i r'L.HIV PRO4E is CT's`-'---~ -ADDRESS%~t~--~/~~- i/4, -'N/Rid W TP1A/N COUNTY MPRS Byron Bird Jr. 3318 DATE / BEDROOM CLASS PERC - CONY ' IONALZ IN-GROUND PRESSURE CONVENTI NAL LIFT- MOUND HOLDING TANK SEPTIC TANK SIZE T~ ~~,~"LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ABSORPTION AREA PERC RATE BED SIZE' ~s \ Benchmark V.R.P. Assume Elevation 100' Location of Benchmark- * H.R.P.----- 0 Borehole Q Well Scale Feet - O Perc Hole System Elevation j Uent 12 Grade TYPAR COVERING 12' 3' 4 6' O 3' 3' O 3' X3'3' 6 , Sewer Rock 1 2' 1 8' n Jam, a Wsronsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 3 Labor and Human Relations _ Division of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code COU: G 7~ Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or P ~.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION E, ED a I a,DAT PRgP_ ERTY OWNER: PROPERTY LOCATION V GOVT. LOT Slv 114 ti (A) 1/ PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME ~E CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE N G~• { E C~i ~v.~F9~ 55 t l (4,/24/ fi'3 tt v pso ,J c Drag .grip [ New Construction Use [Residential / Number of b6drooms y [ J Addition to existing building [ [ Replacement [ ) Public or commercial describe Code derived daily flow 6'0 ° gpd Recommended design loading rate bed, gpd/ft2 - trench, gpd1ft2 Absorption area required - bed, ft2 1y°PO trench, 11:2 Maximum design loading rate bed, gpd/ft2- -trench, gpd/ft2 Recommended infiltration surface elevation(s) see- !'1 3 ft fa-s referred to site plan benchmark) Additional design/ site ' erations w TiP~.ucS D~ IV ' S~ NOTE raP /o w Par nt material -4CS Slaws 4S S rripE S~~T Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOU~FD IN-G D PR ESSURE ATG-AD❑ U ❑ SYSTEM IN RLL ❑ S HOLDING TANK U = Unsuitable fors stem 11 U S 11 U I IRS ❑ 3*1S SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bound3y Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tench [,3 z /Q /lP Sid L ~,P cs oaf , s Ground 3 l 36 /9YX (o - J;/~ ~71- s1fe elev. 70 ft. s/ If Si-w //7 17- Depth to © Sfi !7 limiting factor „ -~!7 /e~iP S/ S. 0, _sf 4 1( /-t'~/ Z Remarks: Boring # S~/ Z 56.~ tw S 1- . G S /;,n e57 Ground i►r f Q ~o elev ft. ly,, ~ /oY S/~ o s of rn S. O s lm a,e Depth to 01 limiting fact URIUMML Remarks: CST Name:-Please Print n~ C R-r L rj C r{1T Phone: 71s- 3 r6 . Address: K Ulbricht & Associates 7 - 95- CSTiyl -'If Q Z- 1!j! .4 V 1 !!!7, -4 to Sewage Consultants Signature: % 655 O'Neil Rd. Date: CST Number: Hudson, Wis. 54016 0 7n ~~ov PROPERTY OWNER SOIL DESCRIPTION REPORT Page? of 3 PARCEL I.D. # Z-07- Boring P/D(~E Depth Dominant Color Mottles Texture Structure Consistence GPD/ft # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.Boundary Roots Bed Trends :3..: o_ /o Sam/ 2,n, JAe I;vi 75e S , -5 , ~Z /6 yle s,/ 17"sM~_ fie s i-F 4~ .S Ground 7- ~ /o YlkO y~ eld ft. 7f S6~-~ Q Depth to limiting ~poy 614 factor /D YX s/ e!55 s - Igo Remarks: Boring # 2 - s s /OM i111_11 -7 A9 A'ZAe 40 7~~ Ground - 1,5 n elev. /eq Y 4116 ~~oG~t' TS d, S 7 d (60 it. of 2~ Depth to limiting factor Remarks: Boring # / S~~ L,i~. Sh.~ tin S .3 f z O Z7 31s / -f S ~iC ,~r„ ~~p s /f y S / -3 yl? / J~j Ground elev. ft. ` - De th to 3 D S~ ~D ~ TS S . d , S /M z 4"(* • -7 P limiting factor R mar e ks: Boring # i Ground elev. ft. Depth to limiting factor Remarks: con O•f• Afo ACInn% s ' 1 0 AV, 70 ~~~~R/PAD 85 CIO Lo T B ti ~°y RAce4eEr /)/'r-5 J woos 3 i IM S066ESTED TFe,jct%, Q I y ~G E lEUAT(o~S AppA V Q 3 30 J I 13y 76 N; -t to S 15 ~ low O I /N S tit// 3 Ti~~.c~ s g Fl y .S x /o o Cvid, 'P,eep /WOK 3 s - o ~,~Nt y 105 ~1 Q .3p ,~Q coo ~ ~ 0 3 1`~ rN Z ~ 3 3 15.59 y 69 00 0 • E ~Q5 2 32 87,581 SO. FT .p0 \ N.037SA. FT. Z 2.011 AC.~ Op. / N 89.00 / 0~ ep y5 • ~0 2 0 •s S 3400" MCO~P5k 393 ,5 • / / a~ / o 110 7 A ~cO10 / 200 0 \ N • i / \ 9 ~ g 6 / 2 42 a/. \tp TO 91,345 SO. FT. / ,,o N33°5400"/8.13' e p 2.097 AC, ~-L' N67 29'17"E . O -940' \Ad 9~ 43 _ 164.97' NJ O 94.09' d~ d 30' p~AINAGE • 0 EAikNT / o 9992,851-SO.-FT. / / / \2.132 AC. / i -P 0 lp.' 0$ Is., % \ 0A . 110,721 ` S0. Ft ~~P w \ Z~yO S 2.542 AC. qP Ati. 9 / s ~ / Os S N \oa \ y,, Oy 2 Oq0 \$g~~/f~~/asp ~~~•O 9 _pV~: I k/ . O° $\0 6P ~4 of . Q %60, 5 4- 103,989 SO. FT. A ti s, g~•0 'f.~ 2.387 AC. vy ~.20'~ y 5 JaQ~p. r/ ► II VI o S2 ~ ~ ~ 66 ' o ~ vNi o W 00. w a z w vF-i w ~(J POINT OF BEGINNING U. W co 3t . F- N w z ul o ~ M h 0 W W U_ N N z Z 0 OD 2 Q><J z 3915.10' E-W V4 SECTION LINE E IA CORNER r 1 4 ISO.00"• i N 90000'00"E 394.00' S. 90'•00'00 E---- --------314.00'---------- 1 34 260.00' Z . 87,665 SQ. FT. 3 N Nd~ 2.013 AC. / O ~~E J' ~ <4 cn~ / 3p W ~Og9 14 rN ~ N N 33 69 00' 00 ,0, Z 32. N 87, 581 SQ. FT / 1057.59 5 0+ 8,734 SQ. FT. Z 2.011AC.j 69 00 0 037 AC. •0p 0 N pp• S 33° 5400° E / 95 RM\ 45 / o- G O~Q► 2 3.93 200 ' / V 10 / i 00, 6 3 8 roll" O 42 5 o. a v• 919345 SQ. FT. / O 2.097 AV e7- / N 87° 29' 17" E _ O 259.02 R / / / / Z ag~►\ 30 164. ~ D fWAGEN O EASEMENT / \e° 92,851-SQ._r. ' m • \2.132 AC. ~\~~?2 45 0 % > 0 4~i O oo: \ D 1109721 SQ FT. °o 210 S 2.542 AC. ~P ae~ 2 .0 \O- J~ 00 c 45 X4,0 103,989 SQ. FT. vgao2'~ 2.387 AC. ~.2p 5 J~Q~i Nss~ =Z°w 9• ~'I• m J • 2 `!y 4 ` ` 66 • 0 uNi U ' 39 • app.- Z w co w m LOT _If POINT OF BEGINNING LL 3 31DGE a Cl) ~ >F PLATS _ lt! Z w o_ 71 Q o H www O m cn STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER f--r Ci ^ kri's 4C Ile, MAILING ADDRESS to a O 4vc m &J~ ; 011AI PROPERTY ADDRESS ~ % (location of septic system) Please obtain from the Planning Dept. CITY/STATE PROPERTY LOCATION [j 1/4, / ll'/ 1/4, Section T N-RAW TOWN OF J .1 ST. CROIX COUNTY, WI SUBDIVISION ro, ~H 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. [/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: a c~. 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 kr`-5 c. ` r Location of property st,~1/4 /Z ly 1/4, Section a S~ , T2_N-RW Township 4 udI O ^ Mailing address ~j l~ Address of site ~(o Mi 0+-a1- m, A Subdivision name S 1-; A! G Lot no. _ Other homes on property? Yes_ No Previous owner of property (-r'ec•n~~.(H l~arpr~~~ f C Total size of property 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 and Page Number as recorded with the Register of Deeds. I 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^~''~~ and that I (we) presently own the proposed site for the se age 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 off'c`~ of the County Register of Deeds as Document No. 2 Signa r of Applicant up-Appi 0~ s Date of Signature Date of Signature rte o ao i~y5 7c _ ~Qo •53!1074 fE1iSTATE BAR OF WISCONSIN FORM 1 - 1982~~ + WARRANTY DEED i i i , REGISTER` 7)FF OOCUME'VT NO. vOL 1141PA!E 88 ST. CROIReed foThis Deed, madt between Greenwood Enterprises, Incle, SEP Z 0 1995 ~i a Wisconsin corporation ii l ~1 4:45 P. M Grantor, a t - i er, t. t~"•~4+• t~ Ii j and Gregory M. Miller and Kriste A. Mille-r,' husband and wife as survivorship marita property _ RegietarotOeet~ Grantee, i ~I it of oII I THIS SPACE RESERVED FOR RECORDING DATA Witnesseth That the said Gra tor f a~ cable consjd ration dollar and other good and vii'Oble consi.geration NAME AND RETURN ADDRESS ~D•~i Miller conveys to Grantee the h1lowing described real estate is St. Croix Gregory and County, State of Wisconsin: 2980 Edgerton Street Little Canada, MN 55117 (Parcel Identification Number) Lot 44 of the Plat of Sunkidge 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 I This is not homestead property. 6islt (is not) Together with all and singular the heredimments and appurtenances thereunto belonging; And Greenwood Enterprises Inc warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and reservations, if any, of record i and will warrant and defend the same. Dated this dD~ day of September Gr ood Enterp 'ses, Inc Greenwood Enter > Inc. B (SEAL) (SEAL) BY: James E: Rusch, its president Ma Ru h, its secretary (SEAL) i 41, • R;2r-XNM AUTHENTICATION ACKNOWLEDG41 t Tor rryt. yr ~ O STATE OF WISCONSIN P•••••. ' Si natur James F._ RrrsehS its president f ST. CROIX County. r~t 0 authentiat this day of '19-95 Personally came before me this dl day of September , 192 the above named w Marv R= Rusch, is secretary . L 's Murray _ TLE: MEMBER STATE B OF WI NS11~1 (If not, to me known to be the person who executed the authorized by §706.06, Wis. Stats.) foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY Lois A. Murray, Zilz and Estreen ~o 621 Second Street Notary biic - - County, Wis. i (Signatures may be authenticated or acknowledged- Both are not My commission is permanent. If not, state expiration date: necessary.) eJCtesGirrJ 19~~_._.) 'Names of persons signing in any capacity should be typed w gtri~d below their signatures. WARRANTY DEED STALE BAR OF WISCONSIN Wisconsin Legal Blark Co.. Inc. FORM No. I - 1"2 Milwaukee, Wis.