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HomeMy WebLinkAbout022-1085-50-100 I N o° c 4 a I ° I © I 0 ~I I l'I I z I I v I 'a z I c LL c a ce) a I'I Z co ~W C i2 U) o W ! a m z o I o z a m Z = z N H (D z E '2 c+) ~KJ Of .a r a • N c 0 c O o z z z N _ OD N "its a N t6 E Vl rn y a E CL e w° ` O m o A d ~ O 00 N G Q d m N Q o ov U) U) (n E c Z N > 0 0 0 d 3 Z° •rv ~aaa CL o N LL Lo U.) N N J U t rn rn N izz 'a o N_ iY5 O O O = 3 0 V N q tv Q m O O O O N C cy) o N O Gx 7 co O ~O m H s{ f6 E 'D N N V L UC c c a O W G Q N N O w Y O a O ~ O 06 V N ~r~j • 7.~ N m C O N O E y O N Y X N O _ z cn H f Q • a y '2 `m a w r A o a m o N 0 A Parcel 022-1085-50-000 07/11/2011 03:19 PM PAGE 1 OF 1 Alt. Parcel 29.28.18.461A 022 - TOWN OF KINNICKINNIC Current IXI ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner 0 - PESKAR, VERNON E VERNON E PESKAR 113 S LIBERTY RD RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 4893 SCH DIST RIVER FALLS SP 0100 CHIP VALLEY VOTECH I i Legal Description: Acres: 35.141 Plat: N/A-NOT AVAILABLE SEC 29 T28N R1 8W NE SE EXC PT TO CSM Block/Condo Bldg: 10/2885 & EXC AS DESC IN WD-1115/157 EXC AS DESC IN WD-1190/172 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 29-28N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1190/172 WD 07/23/1997 1115/157 WD 07/23/1997 428/199 2011 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 09/07/2010 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 18.141 2,900 0 2,900 NO AGRICULTURAL FOREST G5M 2.000 5,000 0 5,000 NO MFL BEFORE'05 CLOSED W8 15.000 37,500 0 37,500 NO Totals for 2011: General Property 20.141 7,900 0 7,900 Woodland 15.000 37,500 37,500 Totals for 2010: General Property 20.141 7,900 0 7,900 Woodland 15.000 37,500 37,500 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 F n 07 O 3 w n d r~ o ~ c o `o1 .r m m \ 1 m (1) F z N3 7" N) 0 A 0'i 3 w vi O O N O 7 t0 N iV • S c .-s 00 a > N j 1~1 rryll M 42 --j CD m 00 I w co Z m 3 ai p l 7 M C O O O O a 3 'd 7 f'1 0) fr O J~ to 0) v'i C4 r O O 6 a 6 ~p m w ~ m w a `G j = N W CD 0 N N 3 O " A W o a 0. O O m N N M Q Cn cn _0 T -V O O O G ( lu 3 y o ''i o D `may 6 V D a N 0 m a O CD * N N co N A a o z z N - D D o 0 n o N ^ Q- 0 m o l~l • o ~ vy I $ c 3 o 3 m m y cn c A Z M I v 0 2 0 CD II o' W ~ m 00 , a 3 A ~ z °o fT U) 00 3 CD A 47 i a? D a A 0 3 n=i c Z a o a n m I I A I ti ~ o I I w ~ o (D ° s 0 0 m, C) '.I y i y ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 - (715) 386-4680 January 20, 1993 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite soil investigation of the Vernon Peskar property, located in the NE1/4 of the SE1/4, Sec.29, T28N, R18W, Town of Kinnickinnic, St. Croix County, WI., has been conducted with the assistance of Tom Wang, CST# 2860. This onsite revealed suitable soil for onsite sewage disposal to a depth of 39" while meeting the requirements of the A + 4" rule. This site should be suitable for new construction utilizing a mound septic system having 12" of sand fill or an At-Grade system. Should you have any questions, please feel free to contact me at this office. Since ely, mes K. Thompson Assistant Zoning Administrator cc: file rvN ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE ~ I^'t 911 FOURTH STREET 9 HUDSON, WI 54016 (715) 386-4680 January 20, 1993 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite soil investigation of the Vernon Peskar property, located in the NW1/4 of the SE1/4, Sec.28, T28N, R18W, Town of Kinnickinnic, St. Croix County, WI., has been conducted with the assistance of Tom Wang, CST# 2860. This onsite revealed suitable soil for onsite sewage disposal to a depth of 42" while meeting the requirements of the A + 4" rule. This site should be suitable for new construction utilizing a mound septic system having 12" of sand fill or an At-Grade system. Should you have any questions, please feel free to contact me at this office. 2ames ely, K. Thompson Assistant Zoning Administrator cc: file DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION P.O. BOX 76 LABOR AND PERCOLATION TESTS (115) MADISO N WI 53707 HUMAN RELATIONS HR 83.0911) & Chapter 145) LOCATION: SECTION: p. q.~ HIP UNICIP ITy: LOT NO.: BLK. NO.: SUBDIVISION NAME: E'14 'S E M /M0 N R/O L (or) it CO ~TY: OWNER ER'S NAM MAILIN ADDR SS: CC Ki e USE DAT S OBSERVATIONS MADE NO. BEDRMS COMM R A DESCRIPTION: PR S: A N TESTS: (Residence NNew OReplace 3 / as/ 93 RATING: S- Site suitable for system U- Site unsuitable for system Q n~ i a 2T1 m Th Sa ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: STEM-IN-FILL HOLDING TANK: RECOMMENDED STEM:(optional) Osou ©s au as®u r[:]StS]U Osamu If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUP DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK,) B- 161, L) /IV D F Y" F' O-a "ie s i 2y-36 D~ Bn si 3 lne- Pk 6i B- ar s' bah A 2" i6yt in S rv Dr &J.% B- /a'I oa. Y L'' -a~i'~ I s ay'' S'2Dr 6n s; V/4,do `b S 1 B- D- " rae are P s z B- 3 5`9 " oa. yd ~~'~biSll 19-36"140 si(&) B- 5,9 - 56/ /m- g, //',A es6h e 56`4S PERCOLATION TESTS &)I N,-k Qn d s TEST DEPTH WATER IN HOLE TEST TIME DR I WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. p I D RI D PERIOD 3, PER INCH P- q 0 36) s 8' P- a o 30 /b I3 37 .9 V P_ O I NA, I~I P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percen of land slope. SYSTEM ELEVATION A7 O i i Fc~ e 01 /10 0, o; j - Irk V- V16~h N'' A& r- ' k4 Jd I 1 + j F I k i ! I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME print : TESTS WERE COMP ETED N: s 1 C, 93 ADD E s . 500-4 CERTIFICATION UMB R: IPHONEMBE ( tional): alfO']' 1 CST SIGN E: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. , DILHR-SBD-6395 (R, 10/83) -OVER - L ny0l 3-0 n C rw 0 i c o ee _1 T ? w (n S= n I ~ O o3i o N a N o cNC N• OD 7 N N I-I CL m m y A o' o p ° Z' m y 3 m N p', go 00 2 n o coa> > 0 rn O rn 3 a o W C) a o O fu r ° v> D ~ a 'tom. m m C `C cn ° co a w n CD f- n r Ul m co CO D m CD CO -n Cl) U) Ln L" Z • °a o 0 0 0 D 'o c o p D (a cr cl 0 CD CD Cil o Si 9 3 = CD N S~ 3 C1 m N CA :3 m I Z N O O I D D c CD n • I ~ I OIQ C w cu Z N N I O y A Z n A z 0 Z N CL m 0 m z Cl) w I y z m W I I a a ~ o - I m m c oz a N I I a I ~ I A I A I ~ I A c~v I ti I °o a I o b °e CD q ~v I ~ a o O a :E ° CL Parcel 022-1085-50-100 01/24/2006 05:12 PM A PAGE 1 OF 1 Alt. Parcel 29.28.18.461 B 022 - TOWN OF KINNICKINNIC Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - ROBEY, DANIEL A DANIEL A ROBEY 130 LIBERTY RD RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 130 LIBERTY RD SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 4.859 Plat: N/A-NOT AVAILABLE SEC 29 T28N R18W PT NE SE BEING LOT 1 Block/Condo Bldg: CSM 10/2885 3.159 ACRES & A PARC DESC AS N00'W 1322.71 FT; TH S 89'W 644.62 FT Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) ON S LN OF NE SE; TH N 00' E 54.00 FT; 29-28N-18W TO POB OF PARC TO BE DESC; TH CONT N 00' E 54.05 FT; TH N 62'E 372.32 FT; TH N more Notes: Parcel History: Date Doc # Vol/Page Type 09/16/2002 690290 1976/223 QC 07/28/1998 583837 1343/522 QC 07/23/1997 1190/172 WD 07/23/1997 1119/174 AF more 2005 SUMMARY Bill Fair Market Value: Assessed with: 143905 319,600 Valuations: Last Changed: 08/11/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.859 80,000 243,100 323,100 NO li Totals for 2005: General Property 4.859 80,000 243,100 323,100 Woodland 0.000 0 0 Totals for 2004: General Property 4.859 40,000 178,000 218,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 132 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Co- FILED t A.q 0 1 00 1995 ► MAR _ 8 19i IfATHLEEN H. WALSH /6 Rejister of Deeds 526343 SL C/°'X Co., W1 ST. CROIX COUNTY SURVEYOR'S RECORD ~ N CERTIFIED SURVEY MAP VERNON E. PESKAR Part of the Northeast 114 of the Southeast 114 of Section 29, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin. p Indicates 1" x 24" iron pipe weighing 1.13 lbs./lin. ft. set. W 'Z- 3 Owner's Address: o 113 South Liberty Rd. ? River Falls, WI 54022 E /ia COR. SEC. 29, r 28N, R / B W, O (COUNTY SURVEYOR'S MON.) v ~I y 04 3 UNPL A TTED LANDS o 2 ml O Cn n _ ~I o J 7 N 89. 10'00"E 282.20' W W o a AID a 1240.00' 142.2C' u o 33' 33') Q o a W W N Q W N (n I I 7 Q q Z I ` O N J) L O T l 3 3 DI Y~ to 3.139 ACRES U K 41 N r R I In .3 /37, 59/ S0. FT, m I O V ti~ 2. 884 ACRES EXC. ROAD R.O.W. W o ICI IE5,612 SO.FT. (n I • a pl O O J O RI O oI _ , 2 ~I N 00.00' 00 "E 54.00' 600. 00' ~144.62' I J S 89.10'00"W 644.62 S LINE NE 114 SE 114 UNPLATTED LANDS N This instrument drafted by Laurence W. Murphy M SCALE I"= 100' O 25' 30' 1001 /50' 200' 300' 400' SE CO R. SEC. 29, T 28 N, R 18 W, ( l•"'X 24 " IRON P/ PE SET) ,,~IIf111t/fll~i CITY OF RIVER FALLS ^ ,`%%11\SCONS/,' J ~I APPROVED BY • LA ENC M ' W URP °C TITLE LZZIZI DATED-3 -Z)./- ~S ~n 1713 .l► RIV FALLS,..-' S F WISC. Q` LAN Vol. 10 Page 2885 Q { * ' , 111111 Certified Survey Maps sa r urence W. Murphy St. Croix County, Wisconeij, s y- w~ Registered Land Surveyor Dated: December 26, 1994 "Re,4 sed this 3f ivh day of January, 1995." SHEET 1 OF 2 I STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER C~,6 ADDRESS 11 CJr SUBDIVISION / CSM# LOT # SECTION / Tr-c) vN-R_,5 W, Town of ?-~o t m 10 ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM INDICATE NORTH ARROW',' I i Provide setback and elevation information on reverse of this form- . Provide 2 dimensions to center of septic tanE, manhole cover. 4, 1 BENCHMARK: ALTERNATE BM' SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer Liquid Capacity: Setback from: Well y`~L1 House Other Pump: Manufacturer Model#~~~~~ Size J Float seperation Gallons/cycle: ld~, Alarm Location Lj T SOIL ABSORPTION SYSTEM Width: Length ~ el) Number of trenches Distance & Direction to nearest prop. line: ~N Setback from:. well: House Other ELEVATIONS Building Sewer ST Inlet. ST outlet PC inlet PC bottom Pump Off Header/Manifold Bottom of system Existing Grade Final grade DATE OF INSTALLATIO : ~I PLUMBER ON JOB: ' l~Ctv~~i LICENSE NUMBMFM 1 l INSPECTOR: 3/93:jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and HLman Relations INSPECTION REPORT R • x Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Permit Holder's Name: ❑ City ❑ Village Town of: State PI ROBEY, DANIEL CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: Gr~• O~ Gl~, ~ c~.~ ~ s TANK INFORMATION ELEVATION DATA LV. TY PE MANUFACTURER CAPACITY STATION BS HI FS ESeptic i L!'cc/Q e~yj ,Ore - 03 Benchmark , 7~ lam, 66' Dosing ~Girr i'1 tt5 / 90 / Aeration Bldg. Sewer C~ D Holding St/ FW Inlet TANK SETBACK INFORMATION St/( Outlet Ventto TANK TO P/ L WELL BLDG. Air Intake ROAD Dt Inlet d7l Septic a NA Dt Bottom Dosing NA / Man. $4 ' /C) Aeration A Dist. Pipe ae q lb/ S S H Bot. System 5 a /0/,,,1-3 PUMP/ SIPHON INFORMATION Final Grade d, y oa, Manufacturer 1 J - Demand °rJ A41 Model Number Z6 L GPM TDH Lift Friction System TDH Ft ,61 Forcemain Length 35 I Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED /TRENCH Width t Length ! No. Of Tr nches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ ~ IM EN -STO W, SYSTEM TO P / L BLDG WELL LAKE / STREAM LEA Manu a SETBACK INFORMATION Typeo , t T CHAMBER Moe Number: System: ud OR U DISTRIBUTION SYSTEM Manifold ~7 „ Distribution Pipe(s) / 0, x Hote Size x Hole Spacing Vent To Air Intake Length O Dia. a2 Length !Q~ Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over e" xx Depth Of xx Seeded/ Sodded xx Mulched Bed /3 kMf enter Bed/ T6saZ4,E-dges , /O Topsoil 6 E] Yes No ❑ Yes El No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: /Kinnickinnic.29.28.18W, NE; SE, Lot 1, Liberty Road I s-1 1 7".~ >j~, C ;~'s,`~t ~,n/) C~~ /x~/l~ e / ' C:"'~•''`, G`l i .ft/r Plan revision required? ❑ Yes ❑ No / Use other side for additional information. I'd SBD-6710(R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: G~~C;Y !',~G C r iC~f'✓GG-~~'--'-CL-~ . ~ ~r~,~ J~~'~~G=-r~`+~ ~.,.C ~~..do.•,. ar I ` SANITARY PERMIT APPLICATION ' ■ COUNTY In accord with ILHR 83.05, Wis. Adm. Code STATE SANI ^iRy PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 9 O' 1X 15 8% x 11 inches in size. ❑ Check if revision to pr ious application -See reverse side for instructions for completing this application. STATE P N/I.,D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERCOWNER PROPERTY LOCATION ~l E'% aJ~S ~ T ,N,R E(or PROPERTY OWNER'S MAILING A RE LOT # BLOCK # CKY STATE ZIP CODE PH NE NUMBER SUBDIVISION NAME OR CSM NUMBER ^ II. TYPE OF BUILDING: (Check one) CITY NEAREST RO D ❑ State Owned O VILLAGE : d in ~A` ❑ Public 1 or 2 Fam. Dwelling-#of bedrooms PARCEL TAXNUM ER(S) 111. BUILDING USE: (if building type is public, check all that apply) x/11 1 ❑ Apt/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 80 Mobile Home Park 120 Service station/Car Wash 5 ❑ 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. ~ New 2.E1 Replacement 3.E1 Replacement of 4.0 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 4 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) ELEVATION V 3 ~ 3 , O . U Feet / / dIP. ~ Feet VII. TANK CAPACITY Site in allons Total #of Prefab. Fiber Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank ova 7~S /~'Ca5 Lift Pump Tank/Si hon Chamber S t C ( r VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for ins allation of the onsite sewage system shown on ched plans. M Business Phone Number: Plumber's Name (Print): P b s signature: (No S m s) I' e- L Plumber's Address (Street, City, Stat, ip Code f( 1i ell I A) 9y) Z)45 IX. C LINTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued I ng Agent Signatu a (No Stamps) Approved El Owner Given Initial Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(R.08/93) 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 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 41-7. 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).: ba~ ~F og 3//~; /95 TdN kl~E X 95-4014'7 e~►wi lo- Tw n s 4/ , II rtc bN > 5 o' Fro S sTe ~ AND FA(ol PAMK A-z 16D~O S, 0 G rj Slee rmec fOST W/ p'rkil e hLvktr f 166 /0'/11.x. c3 t 5 q, 1~ anl e s s J7 0 ~e ~ 'CJ , a~~ ; 'z~ ~x •T'otia i~ ~1r1 a t;~ rv D h,~.£.s.. ~lJ' ~~ze 011"1 m h )MO J SONGS S-is, P~~v aTE • 0nally cot,ditt OD o f ~p41 1REU - ON ~,g4p ~ N y14p141~5 o~• ay~s1~ 6 i~l . ~D~ D i7 ~ a _f o p 3 l1LliC~y` 1 ~f?S. Q/ t3 • a U~ v 6i p RECEIVED 1, 6 5 0 l MAR 2 0 1995 Uk SAFETY i 8LD6S. Dllt. ~,R{~. 6CD, "-.ft ~ C Mani rvld Pipe QV S954 0147 pv~ \ -V L. ms+ hole shoal& 6c, hcxv ~0 endt CAP 115 and MA F+ 1 g 3.0 F 1- X i~ckts y Inolt (11k.--~- I n ch 1 &4ec&.l dIG • 1 Il~ trl Ck (o) mo.~i~ol~! dia. %nc6 (el 0 'nolit per pope I/ muerl ,e.ltu.-X IoAeml >.0-=L5F+ PWIVATE E ,61 STEM 0t u Conn,*,t o ~ ~~~Y 3 )9& APPRG DEPT. OF INDUSTRY, LABOR OMAN RELATIONS DIYI ETY N BUILDINU Co NDENCE Page - Of _ S95-40147 Straw, Marsh Hoy, Or Synthetic Covering •A9FAI C-3-3 Distribution Pipe Medium Sand 6" Topsoil F 3 E " Y Z. % Slope Bed Of 2 %2 Force Main Plowed Aggregate Layer (6" Below Pipe) D I.0 Ft. E 1. ~ Ft. Cross Section Of A Mound System Using A Bed For The Absorption Area F Ft. G ~.d Ft. A Ft. H 1.5 Ft. Signed: B Q Ft. License Number: K 10 Ft. Date: L Ft. Ft. I 1Y Ft. a" ~orc,eb►~h W~ Ft. L. J Observation Pipe 01 A Distribution Bed Of 2N- 2 YgTEM ,~.a,QA~~ ~Fe AGE Pipe W •ttjorj ~ly Observation Pipe Permor~ ~kers ti RE~~~S ~ ~,gOR v03 M LDIN65 ~ D'i1g1R't' p 1N off(. Plan View Of Mound Using .A Bed For The AA o on sa e NO~~GE R S SEPTIC TANK E PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS S95-4014'7 4" CI VENT PIPE 12" MIN. ABOVE GRADE 6 WEATHER PROOF 25' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVER FINISHED GRADE ' 6* RISER W/ PADLOCK E WARNING LABEL g~WA E S~6$" MIN. E G AD 4" MIN. 18" IN. CWw AX. ~ t** LET W T10Nq i ~ oA i EALS GAS- TIGHT: „ A SEAL ' APPROVED PIPE R N~E --I_ ALM JOINTS W/ CI S B , PIPE 3' ONTO LODTO ON SOLID SOIL IL C PUMP OFF ELEV._2t- FT. - - OFF RISER EXIT D t:~j PERMITTED ONLY IF TANK MANUFACTURER HAS APPROVAL 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS 15. 6511AI PTIC / DOSE NK MANUFACTURER: rY1 iL~(,t)e.`3TlPtPCG 3 NUMBER DOSES PER DAY : NK SIZES: SEPTIC ►Q~ GAL. DOSE VOLUME INCLUDING DOSE (p GAL. FLOWBACK: GAL. LARM MANUFACTURER: Gj~ ~QC'fCO CAPACITIES: A = lq_ INCHES = 301 GAL. MODEL NUMBER: jot - o ( H SWITCH TYPE: HQ B = 2 INCHES = 1 , 70 GAL. MP MANUFACTURER: C = INCHES = /2Ca. GAL. MODEL NUMBER: SWITCH TYPE: Np WEo3G D = .Z INCHES = 190• Z GAL. . SQUIRED DISCHARGE RATE _,Ja_ GPM PUMP 6 ALARM WIRING AS PER ILHR 16.23 WAC ERTICAL DIFFERENCE BETWEEN PUMP O' .:'F AND DISTRIBUTION PIPE . _ FEET MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . 2.5 FEET ~S FEET FORCEMAIN X 1, 4 FT/100. FT. FRICTION FACTOR . yam FEET TOTAL DYNAMIC HEAD = ia,9(p FEET NTERNAL DIMENSIONS OF PUMP TANK: LENGTH WIDTH DIAMETER LIQUID DEPTH 4 r' IIGNED: -y L~+ LICENSE NUMBER: , DATE: /88 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY; DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX N WI 539069 HUMAN RELATIONS ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: ON Off HIP UNICIPA ITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: COUNTY: OWNER' YER'S NAM MAILING ADDRESS: L/ 1'Je " USE DAT S OBSERVATIONS MADE NO. BE RMS.: COMMERCIAL DESCRIPTION: PR FILE DES RIPTIONS: PER LATION TESTS: Residence XNew ❑Replace 1/0 9 7 RATING: S= Site suitable for system U= Site unsuitable for system Q I f It N l Tim 1 trim Jt1 n CONVENTION1A''L: MOUND: IN-GROUNccD-PRESSURE:SYSTEccM-IInN-FILLHOLDTANK:RECOMM ENDED fitYST ~Y ©ccJ ~111' Y OS ©U ~J'r'U ❑S~U If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the ndicate: Floodplain, indicate Floodplain elevation: under s. ILHR 83.09(5)(b), i _ PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- J Ail/ B- ,yard s i a o 2 2 ~;n S tv 04 Ends B- ZOO, -)vi /s i 0,/" W D4 6ns~ 5'a'=~o`b~ S1 B D- 6"rae areJ t I P s~o 66~~a';~h S B- 3 ~a Ooh, /9-3b" 4p s i (uJ /tdrd bnd3 B- 6'~a" h S 5~~56 "~aC,~i~+es7`ohe 56 ~~7a',b~ PERCOLATION TESTS f Irk 6n d S TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERI D3 PER INCH P_ el 0 3v a '9p P_ ` 0 30 13114 37 P_ U P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION O 41 ks h'►, =~rc~ sEfie_~ ~ Fev~_ce 1°oS.~F_ t~ o ram e nt, ..9 _ 'char ohe..,~iP.~. 1~Q• o._/o N~ a ~a ~ _ PP., _ f . 9 10 r V J 3 E D a r t , .c g x.L X l E E r o I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMP ETED N: S d 1 a`/ 93 ADORES f CERTIFICATION UMB R: PHONE NUMBER (optional): L e r I Ao !~25 5~1 CST SIGN E: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER - • r ` VPLE. Ti J 170 ~ iJ JFT i DR P IF r _L )''car nr feievation) dot's nC ' nW address and 3 _ _ 77 _-g pE uC r'tfLl'._~ _.l„ a. r 5. 73 L` E r" L_r'- i..,u bvt,=S$ &II&,. AYS OF CC Pv . IJNS FOR CERTIFIED OIL T u end Textums ; r~ibois 13 P3( r` s: ' (y Y R F <<r MOZ V, ~iC t rTl TO 0.1NER: This soil test report is the <r ep in securing a sani'_ary permit. The county or the Department may request verification of this soil t~:t in the field prior to permit issuance. A complete set of plans for e private sewage system and a permit application s{~~)mitted to the appropriate local authority order to obtain a permit. The sanitary permit must i -id posted prior to the start of any, ~ {on. 1 I ' FILE ^f'"" t 0 1 1995 ► WNLEEN H. WALSH 10 of Deeds 326343 scCroix co. W, CERTIFIED SURVEY MAP VERNON E. PESKAR Part of the Northeast 114 of the Southeast 114 of Section 29, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin. p Indicates 1" x 24" iron pipe weighing 1.13 lbs./lin. ft. set. W 3 m Owner's Address: o 113 South Liberty Rd. R W River Falls WI 54022 2 - E114 COR. SEC. 29, T 28N. R I6W, (ZI r /COUNTY SURVEYOR'S NON.) r N - N.I Q w W m ~ u, 3 UNPL A T TED LANDS ° i Q41 O H n o J w a o N 89. 10'00"E 282.20' W QC ;0 ° 07 ?40.00' 42. ' tID 2 2 4 I 31• 33'I Q o QIW = Z P I ° ' .N QI J 0 N V, a ~n a 2I " I~ V Q~ ,ti LOT l 3 "I A• f ° x e 3 41 , 3.119 ACRES, Q~ „1 " 9 137, S 91 $O. FT. m n I I /a 4 Z. 884 ACRES EXC. ROAD R.O.W. ~f ~1 ICI 125,6/2 S0. FT. • • Q of C 1 0 ~ Q ~ -0 IIi t 2 Q.I N 00 • 00' 00 "E 54.00' a 600.001 "4.00 ` I S 89 • l0' 00"W 644.62 7 S LINE NE I14 S:E 114 7 UNPLATTED LANDS " This instrument drafted by Laurence W. Murphy M SCALE l " 1 /00' 0 23' SO' 100' 150' 200' 300,' 400' NNW SE COR. SEC.iP9, r9#N, 11 /8W, 1 I x 24 " IRON P/ PE SET) % ro•, I/PI C I Of RIVER FALLS #o8 % 40 , i APPROVED BY ^ EN N ( l l~ r° ; W UAp i T I TL E DATED.J~-ZV-9S s _ 1713 1 a N RIV FALLS o' ,Ai 47 • WIBC. y '%,Fa LAND Val. 10 Page 2885 «~~lN111N1SA Certified Survey Maps W < 'Caaurence W. Murphy St. Croix County, Wisconr~" ra ti :X: Registered Land Surveyor Qn It", Dated: December 26, 1994 ur iv 716\4sed this 3(~'th day of January, 1995." SHEET 1 OF 2 Part of the Northeast 114 of the Southeast 114 of Section 29, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin. Description: That certain parcel of land located in the Northeast 114 of the Southeast 114 of Section 29 Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin, more fully described as follows; Commencing at the Southeast corner of said Section 29, thence N 0004410711W (assumed bearing on the East line of the Southeast 114 of said Section 29) a distance of 1322.711, to the POINT OF BEGINNING, of the parcel to be herein described; thence S 89010'00"W 644.62' on the South line of the Northeast 114 of the Southeast 1/4 of said Section 29; thence N 0000010011E 54.001; thence N 57039'16"E 424.751; thence N 89010'00"E 282.201; thence S 00 4410711E 276.00' on the East line of the Southeast 114 of said Section 29, to the POINT OF BEGINNINGS containing 3.159 acres, being subject to easement over Easterly portions of sold parcel for town road purposes as shown on this map and also being subject to easements of„,record. Dated: December 26, 1994 "Revised this 30th day of January 19915." Note: The parcel shown on this map is subject to State, County and Township,lews, rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.)-IttBefore purchasing or developing any parcel, contact the St. Croix County Zoning Office and the appropriate Town Board for advice. i State of Wisconsin) County of Pierce) I, Laurence W. Murphy, Registered Land Surveyor, do hereby certify that by, direction of the Owner, Vernon E. Peskar, I have surveyed and divided the lands shown hereon in accordance with official records, Chapter 236.34 of the Wisconsin Statutes and the Ordinances of St. Croix County and that this map and description are a true'and correct representation thereof. 1111t111f111/~~/i. .A  .Y. LAUR NC i m • W M P N s AILS, : J 'Laurence W. Murphy e istered Land Surveyor vol. 10 Page 2885 Certified Survey Maps St. Croix County, Wisconsin. SHEET,?_ OF ? • w Survey Map for Vernon Pesker: N q s N W Indicates 1" iron pipe found. W w x O Indicates 1" x 24" iron pipe weighing 1.13 lbs./lin. ft. c k set. W ` N N ~ W t y, N ~ W 3 3 2 x 4 N 89. 10'00"E 181.62' ~ O 433.37' W o 29.03' ~ W t • r Z O O J N O PARCEL A : IS. J _ IZ. E I/4 CON. SEC. 29, T28 N, N /9 We O 1.42/ ACRES j o E Cit I- y !COUNTY SURVEYOR'S NON.) 6/,9/3 SO. FT. 01 p f 1 e 1 9 50• A . 1 62 • Z n N 1~1! AZ N 1Z1.4 , VI .,9 LOT C. S. M., VOL. lO, N w Pj 661 PAGE 2885 W ♦ O O / A = ♦ o ~ ~ a O O M r1 W O O 2 ~ ~ b o a ; 0 644.62' /22.20' Z n a • O S LINE NE 114 SE 114 S 89 /0'00"W a ♦ w o n c SE CON. SEC. 29, T2BN, R/8 We Descriptions: I / " IRON PIPE IrOUNOI Parcel A: That certain parcel of land located in the Northeast 114 of the Southeast 114 of Section 29, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin, more fully described as follows; Commencing at the Southeast corner of said Section 29, thence N 00044'07"W (assumed bearing on the East line of ''the Southeast 114 of said Section 29) a distance of 1322.711; thence S 89010'00"WI644.62', to.the POINT OF BEGINNING, of the parcel to be herein described, on the South Line of the Northeast 114 of the Southeast 114 of said Section 29; thence continue 8,89010'00"W 122.201, on said line; thence N 0004410711W 276.001; thence N 89010'00"E 455.57'; thence S 62021'01"W 372.321; thence S 00000'00"W 108.051, to the POINT OF BEGINNING, containing 1.421 acres, being subject to easements of record. Parcel B: That certain parcel of land located in the Northeast 114 of the Southeast 114 of Section 29, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin, more fully described as follows; Commencing at the Southeast corner of said Section 29, thence N 00044'07"W (assumed bearing on the East line of the, Southeast 114 1/4 of said Section ?9) a distance of 1322.711; thence S 89010'00"W 644.62' on the South line of the Northeast 114 of the Southeast 114 of said Section 29; 'thence 0 N 0000'00"E 54.001,0to the POINT OF BEGINNING, of the parcel to be hereili described; thence continue N 00 0010011E 54.051; thence N 62021'01"E 372.321; thence' N, 89410'00"E 29.051; thence S 57039'16"W 424.751, to the POINT OF BEGINNING, containing! 0.279 acres, being subject to easements of record. State of Wisconsin) I, Laurence W. Murphy, R.L.S. do hereby certify that I have County of Pierce) surveyed the above described and mapped property 'according to official records and that this map and description are a',true and correct representation thereof. DATE 2- ZS-95 ~`,ep1/111b/~~ FLD SURVEY / - I - 93 Q /V WP SCALE / 100' QEIAYy~ L W M pE LAU REN C E W. AURPHY ? LAV N E HY 13 REVISED .%RI!VER FALLS,. REGISTERED LAND SURVEYOR ~ LOCATION 29 . 28 le RIVER FALLS, WIS. 54022 '9F SJ LAND STC-105 SEPTIC TANK MAINTENANCE AGREEMENT l St. Croix County OWNER/BUYER CGS I 'C I C'v MAILING ADDRESS ! UJ eU ~C PROPERTY ADDRESS . ' L1 (location of septic system) Please obtain from the Planning Dept o CITY/STATE el of r A - PROPERTY LOCATION IVF 1/4, 1/4, Section T ' L N-R W TOWN OF t P' m ST. CROIX COUNTY, WI SUBDIVISION Ay/~' LOT NUMBER I CERTIFIED SURVEY c/ b ~7 3 VOLUME 4~ , PAGE J, 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. 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 co pleted and returned to the St. Croix County Zoning Officer within 30 days of the three pr xpiratio date. 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 t~ 4 e f\ e Location of prope ty 1/45' 1/4, ection T ~ N-R IF W Township 1G12n/(' !;/!!/1 ~0 Mail ' rig address /f S L 1, be Address of site Subdivision name Lot no. Other homes on property? Yes k No Previous owner of property (fhQn N S al Total size of property j 1,5,2 W Total size of parcel, 1`✓j 9 14 Date parcel was created & Iq<71 Are all corners and lot lines identifiable? k-Yes No Is this property being developed for (spec house)? Yes A- No Volume Z ~ and Page Number l 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. j~D 700.2 , 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. 062 Si A X9_ nature f~Appl' nt Co-A lic t Date of Sicgnature natP of q i rrnatiirP + DOCUMENT NO. STATE BAR OF WISCONSIN FORM 2-1982 THIS SPACE RESERVED FOR RECORDING DATA WARRANTY DEED 52700 Vb:1.F~9E ST C o c, COFFICE Recd for Record Vernon E. Peskar MAR 9 7. 1996 at 9:30 ' ` AM conveys and warrants to Daniel A. and Lisa M. Robley, Kam",~• CJJi". as survivorship marital property Register of Deeds RETURN TO the following described real estate In S t . Croix County, ) - . State of Wisconsin: It . \0r Z~5 fS ax alelN, That certain parcel of land located in the Northeast 1/4 ofI tie Southeast 1/4 of Section 29, Township 28 North, Range 18 West, Town of Kinnic- kinnic, St. Croix County, Wisconsin, more fully described as follows: Commencing at the Southeast corner of said Section 29, thence N 00°44107"W (assumed bearing on the East line of the Southeast 4 of said Section 29) a distance of 1322.711, to the POINT OF BEGINNING, of the parcel to be herein described; thence S 89010'00"W 644.62'on the South line of the Northeast 4of the Southeast 4 of said Section 29; thence N 00000'00"E 54.00'; thence N 57039116"E424.75'; thence N 89° 10'00"E282.20'; thence S 00°44107"E 276.00' on the East line of the Southeast 4 of said Section 29, to the POINT OF BEGINNING,containing 3.159 acres, being subject to easement over Easterly portions of said parcel for town road purposes as shown on C.S.M. 526343, Vol. 10, P. 2885, and also being subject to easements of record; and A\9 o, Pc rcoA 6 a►o_S~r ~\4n~ a`a Conirlencing at the Southeast corner of said Section 29, thence N 00044107"W (assumed bearing on the East line of the Southeast 4 of said Section 29) a distance of 1322.71'; thence S 89°10'00"W 644.62' on the South line of the Northeast 4 of the Southeast 4 of said Section 29; thence N 00000100"E 54.00', to the POINT OF BEGINNING of the parcel to be herein described; thence continue N 00°00'00"E 54.05'; thence N 62021'01"E 372.321; thence N 89°10'00"E 29.05'; thence S 57039116"W 424.75', to the POINT OF BEGINNING, containing 0.279 acres,being subject to easements of record. This is not homestead property. (is) (is not) AS-N^r3 r ' Exception to Warranties: - Datedthi 25th dayof March 19 95 (SEAL) (SEAL) • Da L A. Rnbpv VOrnon F Peskar (SEAL)(SEAL) -.Lisa . M. Robey AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN SS. . Pierce County. authenticated this day of '19 Personally came before me this day of March 19 95.. , e m~` . Vernon E. Peskar,~•,~_~, c. Daniel A. Robley, Lisa M. Robley • -J TITLE: MEMBER STATE BAR OF WISCONSIN . r (If not, to me known to be the persons ,f"_eCted i4 authorized by § 706.06, Wis. Stats.) fore ng instrument and ac owled' S ? i~ ' THIS INSS UM//ENT WAS DRAFTED BY ~ Greta S Mack' Notary Public Pierce County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date: March 25 1995 Names of persons signing in any capacity should be typed or printed below their signatures. S52 NTF 0021 WARRANTY DEED STATE BAR OF WISCONSIN Nelco Tax Forms, P.O. Box 10208, Green Bay, WI 54307-0208 Form No 2 - 1982