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HomeMy WebLinkAbout026-1117-20-000 O O I Q' O N 1 0 ~ Ol N ~ 4 li O I V h O N 'r O i ~ I Q ~ N 0 aNi ~ I V z co LL c ~ 0 'a 0 I I 4 o z € .-~LU am o O z a c 0 fA H r ~ Z v 2 Cl) N m .5 1 C cc N CL c a cp w • ` o N a E N 3 zco z z I a~i ~ d c I N ~ c I 1~1 w "Its N III O G: t6 ~ , c CL c 3 o y g rc c as ~ 3 Cl) Z 3 3 3 n a o z •Naaa N Y N to J V rn rn D M N N O 0 E m a c y d a in m o > > O p C W C r"~ O c E C ao (O f- t0 O j /1 V d Q N O L7 O 00 O C p G C 0 0 O M U L a~+ 'D C~ 0) H M ~ 3 N H , 40* - c? _.2 0 y E m y •O O O N O z C (n c CO t/~ r ~ .a m a I 3 L: CL r*w; w E ` 'c c S r A ciao oa,c°~ w STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER wl /1D (.t~ ptvr--),- ADDRESS_ x,50,5' ~v c.~S SYac SUBDIVISION / CSM# LOT # r.~ SECTIONT , 36 N-R W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EV RYTH NG WITHIN 100 FEET OF SYSTEM t a ti Q 701 s -fi INDICATE NORTH ARROW soy L Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tangy; manhole cover. r BENCHMARK : ~6P S tl Y` U2. 54, he 1 D , ALTERNATE BM. OF 73 J SEPTIC TANK / N Manufacturer: Liquid Capacity: Setback from: well N/~--- House Q1, Other Pump: Manufacturer Model# V, Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM /oZ -bves width: Length 7a Number of off. Distance & Direction to nearest prop. line: ea gS i Setback from: well: 104- House Other ELEVATIONS Building Sewer f QS,.~ ST Inlet. /0 71 38~ ST outlet 40 7,/90 PC inlet PC bottom Pump Off Header/Manifold / 03. L Bottom of system Existing Grade /Ofa ...Z Final grade DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/93:jt wbonclDepartment Industry, PRIVATE SEWAGE SYSTEM County: Labor annd Human n Relations ST. CROIX Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Permit Holder's Name: ❑ City ❑ Village ❑ Town of: State Plan o.: WILLOW RIVER JOINT VENTURE X CST BM Elev.: Insp. BM Elev.: / BM Description: Richmond / Parcel Tax No.: </,z4 TANK INFORMATION ELEVATION DATA zv~ , TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ~e (2, Benchmark Z / , /1~1 Dosing U 4 D 3 Aeration Bldg. Sewer Holding St/,pff Inlet , /0 7, s3 TANK SETBACK INFORMATION ta St/ Outlet 7, Z22 7./ 7 TANK TO P/ L WELL BLDG. Ai Inke ROAD Dt Inlet _ Septic ~ NA Dt Bottom Dosing NA Headers 3~ dSSG~ Aeration Dist. Pipe Hol Ing Bot. System / P1V V UMP / SIPHON INFORMATION Final Grade Mang and ~'i &qr s-, Model N GPM T LSystem TDH Ft ForcemaFi Dist. To well SOIL ABSORPTION SYSTEM th qL No. Of renches PIT No. Of Pits Liqu id Depth BED / TRENNH WTypeof/~a, IMEN SETBACK PBLDG WELL LAKE / STREAM Manufacturer: INFORMATION CHAMBER Mode Number ( C~r OR UNIT DISTRIBUTION SYSTEM Header/ N~ai#e}d Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake i Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-G a Systems Depth Over 3 n Depth Over l~ -y xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center `~6 ` j Bed /Trench Edges Topsoil E] Yes E] No ❑ Yes El No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Richmond.1.30.19W, SE, SW, Lot 30, 144th Street r , i ~ 4e-i K/' Plan revlslon r We. ❑ Yes [9-No V/J Use other side for additional information. Q / SBD-6710 (R 05/91) Date Inspector's Signatu a Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: I Safety and Buildings Division SANITARY PERMIT APPLICATION Bureau of Building Water System! 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. ST f`C) • See reverse side for instructions for completing this application state san rygler Number The information you provide may be used by other government agency programs ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Property Owner Name Property Location a:.rt u n i sC.0 f, -S1= 1 /4 e 1/4, 5 T , N, R j Wbr) W Property Owner's Mailing Address Lot Number Block Number 150 5 411, (PS A a City, State Zip Code Phone Number Subdivisio Name or CSM umber W 32 Z (715)a (oe o~ w ©w-& II. TYPE F UIL )ING: (check one) ❑ State Owned O !t( Nearest Road vilae Public 1 or 2 Family Dwelling - No. of bedrooms To wn OF III. BUILDING SE: (If building type is public, check all that apply) Parcel Tax Number(s) 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 on line B, if applicable) A) 1. 0 New 2. ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an SystemSystemTank 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 11 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank ❑ 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 I i -7 g r i o n)IA- /d `f e Feet =7Feet VII. TANK Capacity gallonTotal # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel lass Plastic App New Exist in strutted g Tanks Tanks Septic Tank or Holding Tank Q~t <oti ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ u VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for inst tion of the onsite sewage system shown on the attached plans- Plumber's Name: rint) PI tier's Sign ure: ( o Sta s) P/MPRSW No.: Business Phone Number: J~_ rs 163 Sf Plumb is Address (Street, City, State, Zip C de): I l0 4 - Sj v IV 5V0 IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanit ry Permit Fee (includes Groundwater Date Issue Issuing A ent Signature (No S) Surcharge Fee) Approved ❑ Owner Given Initial 4 Adverse Determination l/d X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6398 (R. 05194) DISTRIBUTION: Original to County, One copy To: Safety & Ruildings 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 4wage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3815- To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. 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 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 contamination investigations and establishment of standards. d R ~ T ; I i i t ! f r j --i I t ~ i i i s ? 1 I r 11 f ' -7- 7 { ! ! , f t k ! . I t s , F , , ! i + 4 I 1 1 1 , . Ink, f : r , , i { 4 f ' , . ! , : i t i t ! g i f , • ISv PAGE OF rUSS ec~ l00 o A Systern ~ ~ Fresh Air InIals And Observation Pipe u----Approved Vent Cap Mlnlmum 12' Above Final Grade 20- 42' Above Pip* _ 4' Cast Iron To Final Grade Vent Pipe Marsh Nay Or Synthetic Covering min. 2' Aggregate I Over Pipe - Distribution Pipe - 0 0 0 0 0 -Tee 6' Apgregal4 a Pertoraled Pipe Below Beneath Plpe o -Coupling Terminating At Bottom Of Sy11em . ~~cJ.•.T ton SOIL FILL DISTRIBUTIOU PIPE APPROVED ~IMTNETIC COVER OR Z"oFg6GR~GATE, c ~c ~ w-MA OR ti Alts" OF STRAW ~ ,sARSU NAy -LIZ ' ° (e .0F12-21/i AGGREGATE ELEV. oFA19FEF-T_.. DI•S-1-11115tUTIOU PIPE TU BE AT LEAST INCHES BELOW ORIGIUAL GRADE ArJU AT LEASTLO INCHES BUT l.10 MOP, THAI) 42 IIJCHES BELOW FWAL GRADE MAXIMUM DEPTH OF EXCAVAT100 FROM ORIGINAL ORAK WILL BE INCHES MINIMUM ACQT•tt of EACAVATION FROM 01KI(AWAL GR49E WILL BE :W INCHES SIGUED: LICE►USE DUMBER: DATE: Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor 4nd Human Relations - Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY St. Croix Attach complete site plan on paper not less than 8 1 Whei irr size. Plan must include, but not limited to vertical and horizontal reference 'direction arld 0) b* slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and di 46 nearest road. 026-1117-20 REVIEWED BY DATE APPLICANT INFORMATION-PLEASE f 17 ALL INFORMATIOk PROPERTY OWNER: PERTY LOCATION Derrick Construction, I GOVT. LOT SE 1/4 SW 1/4,S1 T 30 N,R 18 XKor) W PROPERTY OWNERS MAILING ADDRESS # BLOCK # SUBD. NAME OR CSM # 1505 H #65 ZU na Willow River Meadows RelyViichmond, WI. 540TI CODE R I NVMBE 2 f ❑CI y [:]VI MOWN NEAREST ROAD Richmond 144th. st. [x] New Construction Use ( x] Residential / Number of bedrooms 4 ( ] Addition to existing building j ] Replacement ( ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate • 7 bed, gpd/ft2 •8 trench, gpd/ft2 Absorption area required 858 bed: ft2 750 trench, ft2 Maximum design loading rate • 7 bed, gpd/ft2 •8 trench, gpd/ft2 Recommended infiltration surface elevation(s) area 1=104.5-#2=102.5 ft (as referred to site plan benchmark) Additional design / site considerations finished el. to be to code Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE] SYSTEM IN FILL HOLDING TANK U=Unsuitable fors stem ~#S ❑U IMS ❑U ®S ❑U 0S U ❑S ®U ❑S ®U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence I Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tmerch 1 0-10 10yr3/3 none 1 2msbk mfr gw 2f .5 .6 w~ 2 10-32 10yr4/4 none sil lfsbk mfr gw if .2 .3 Ground 3 32-98 7.5yr4/6 none co s Osg ml na na .7 .8 elev. 109.1 ft. Depth to limiting factor +98" Remarks: Boring # 1 0-11 10yr3/3 none 1 2msbk mfr 9w 2f .5 .6 2 2 11-26 10yr4/4 none sit 2msbk mfr gw If .5 .6 3 26-34 7.5yr4/4 none sl 2mgr mvfr gw na .5 €.6 Ground elev. 4 34-99 7.5yr4/6 none co s Osg ml na na .7 1.8 109.7 ft, Depth to limiting factor +99" Remarks: CST Name:-Please Print Gary L. Steel Phone: 715 246-6200 Address: 1554 200th. Ave., New Richmond, I. 54017 10-31-95 cstm 02298 Signature: Date: CST Number: PROPERTYOWNER Derrick Const, Inc., SOIL DESCRIPTION REPORT Page 2 ^of "3 PARCEL I.D. # 026-1117-20 Boring # Horizon Depth Dominant Color Mottles (Texture Structure Consistence Baxxbry (Roots GPD/ft in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed iTmnch 1 0-6 10yr3/3 none 1 2msbk mfr gw 2f .5 3 A= 2 6-24 10yr4/4 none sil 2msbk mfr gw if .5 .6 Ground 3 24-90 7.5yr4/6 none co Osg ml na na .7 .8 elev. 107.0 ft. Depth to limiting factor +90" Remarks: Boring # 1 0-010yr3/3 none 1 2msbk mfr ~2f .5 .6 s= 4 2 9-27 10yr5/4 none sil 1fsbk mfr gw if .2 .3 3 27-80 7.5yr4/6 none S Osg ml na na .7 .8 Ground elev. 105.7 ft. Depth to limiting factor +8011 Remarks: Boring # 1 0-8 10yr3/3 none 1 2msbk mfr gw 2f .5 .6 5' 2 8-24 10yr5/4 none sil lfsbk mfr gw if .2 .3 3 24-30 7.5yr4/4 none is Osg mvfr gw na .7 .8 Ground elev. 4 30-82 7.5yr4/6 none s Osg ml na na .7 .8 105.4 ft. Depth to limiting factor +82" Remarks: Boring # Ground elev. 1 ft. Depth to limiting factor - i Remarks: SBD-8330(R.05/92) STEEL'S SOIL SERVICE Gary L. Steel Derrick Construction, Ins. 1554 200th Ave. CSTM2298 SE4SWg S1-T30N-R18W New Richmond, WI 54017 MPRSW 3254 town of Richmond (715) 246-6200 lot #30-Willow River meadows 1,,=40' Bm.= top of mid-lot turn survey stake @ el. 100' t R IT r ~ ~ r t3/►'1 2~` f V7' S C' -6,, tx Gar L. Steel 10-31-95 • t it 11 } i ~1.. 11.~~ ' iJ) , , ' '1: ,',li ~1 , 11•.1 •.li' ~I~';~. i''~. • 1 • • : . 1 •,;1'il~i',~j' •1'ti•:~LI.1'1 •r~' i' . , • •1 t .I~ibl1':i•t .t 1 o0.1in • r Qat t f • ~1~ 1 1.7 ~•h 147A1IN . .1 1 ~ 283 ApM y . '1' • 'i{I :.i••1 d,f 1. / t . ' ~ ~t 16 ~ 1 1 . tot AorM I 4 Lm AU eadOws 2a • 1 15 zT4 305* 206 13 211 s V S AaM N 2AS ACM 341:/3 ' ' 9 10 - 161.13 283.14 tot AaM' n too AaN 3 - , 20o Aa * , 12 ~ios tts /3s.2t 1 ta+ Ao1M~ ~ . ; ~ 266 N6.7~ •3 1 ' ~ , 23 t &ACM 122 Aa..~,,~ too ACM 20A.30 24 a sa•sa ? ''2$ ~ '200 AdM. ' • 6 227 ACM L= ACM. « yD• ~ , Q*• 42525 • C 31633 Y 1 25 101 ACM g p' LU Aaft 40."- 27 29 ZM ACM Z= Aaft 4 1 n.eo WODW 67133 . •'2isr .7 60 Card m" Fddm. oed 26. 'sit ACM • 1 64 1 2.W AOM ' so7.o6 .30 An 226 no 211.03 0 206 ADD = Cax1 Rd. Gt3 ' = 323.xe Z ' N V • 32 33 2 t a „ 2.20 A" n/saA" ; N O , 31 1.81. A" ~ 203 AOf11L t 2ooso 6x637 rn• Highway GG (715) 246-232( RRICK Route Q New Richmonc Now CONSTRUCTION' Wsc°"S'r STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County WIL-1-oW VkVt5h- _'j- V'--a-LV OWNER/BUYER L/o V~ t~4 aE~- IZ. uc t4 S MAILING ADDRESS Imo IJo x tk~ W 12t4+Md ea0 oe \/V/ t 54o 1-1 PROPERTY ADDRESS 1-1S 3 ~4-4-Tt* ~T (location of septic system) Please obtain from the Planning Dept. CITY/STATE C+A-"0V40C W 1 544 1-1 PROPERTY LOCATION 5EE7 1/4, '_W 1/4, Section T 30 N-R W TOWN OF ~C.Ab4 e o t'10 ST. CROIX COUNTY, WI SUBDIVISION \t4VL w w Q-,V<n - M,*21-QowS, 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. 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 three year a iration date. p SIGNED: DATE: S St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 sTC - ioo 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. \vL wo w P-Avv-+~ -\-401 u Ve-f4Tu n~G Owner of property p MtC+4-taEL S-TAEy<14S. Location of property S~ 1/4 c 1/4, Section TIC N-R l9 W Township c - r~.ta Mailing address PO D~~hF PACA4-0A0&tp , \ Ali S+-011 Address of site 1153 44T--+ ST- P-tu AAG N,D Subdivision name WI-ww r4vdL IUl~o~ws Lot no. 3 0 Other homes on property? Yes X No Previous owner of property sc44 M1 O Total size of property Total size of parcel Date parcel was created o - l q - 4 Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house) ? Yes No Volume '954, and Page Number 4-S9 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. 4 5'L'1(v 1 , 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. 4sz~~~ Signatu4eff qppi nt C o-Applicant //-l - 4J Date of Signature n~~;~ ,4-„~ DOCUMENT No. STATE LIAR OF WISCONSIN FORM 1- 1982, TLI S SPACE 1117,5ERVED FOR RECORDING DATA 452767 ~ GUARDIAN'S DEED REGISTER'S OFFICE This Deed, made between ST. CROIX CO., WI Gertrude E. Schmit by Beverly Buckner, Guard•i-a Recd for Record .............................................:......:................'--Gt•antor, at OGi i 231989 and_____Michael___R.•__Stevens, Will•i_am H_. _Derr•ick,• 8:00 A. M William M, Derrick, Thomas E -_•Derr•ick.•and••.••. I C~n't^NlX3C Ronald_•-L_,•-• Derri•ck..a.$•__tenants...Iji___common•••••••-•--• Registe►ofDeeds Grantee, Witnesseth, That the said Grantor, for a valuable consideration...... Gertrude E. Schmi-t by.•.Beverly_ Buckner conveys to Grantee the following described real estate in t. ~.r0.i•X..... nr.,DnN ,r, County, State of Wisconsin: I Southeast Quarter of Northwest Quarter and - - Northeast Quarter of Southwest Quarter of Tax Parcel No: Section 1, Township 30 North, Range 18 West. This deed is given pursuant to the Order to Sell, dated October 16, 1989, and the Confirmation of Agreement and order, dated October 19, 1989, both duly authorized by order of the Court and whereas the undersigned, Beverly Buckner, is authorized to sell the same by Letters of Guardianship certified on October 22, 1989. x i'LIC This i S not homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And..... Ger_tr_ude.__E_.._S.chmit___by._.Bever.ly..Buc_kner warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and rights-of-way of record, if any. and will warrant and defend the same. Dated this day of ctober 1989._.. (SEAL)-~ ~-E . (SEAL) Gertrude`E. Schmit by Beverly ` B'UCX ar•'f-GUafd1-an (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN Beverly Buckner ss. Y-/ ......................................County.. authentic ted this;~~ '___day of._October 19 89 personally came before me this ................day of j_llL~z l~ liGe -;--1 --6 19 the above named Kristina Ogland Lundeen - TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) to me known to be the person who executed the foregoing instrument and acknowledge the same. gttornay_-. at._Lair---------------------------------------- Notary Public County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (if not, state expiration are not necessary.) date: 19 i, 1 *Names of persons signing in any capacity should be typed or printed below their signatures. it l t~~.nnnnp•rv nr•rn ~T,Tt n„r ~r «,,rnv<,v