HomeMy WebLinkAbout038-1136-40-116
d
eo
o
co
CD I
N ~ c I
N
O N
U I
O I ~ O
N o I
o I
r
M 4)
4) I
o I
0
V z° I
C y ~
lC
U.
o 3 o I
3 w o E I
CD
I
~ z I
co
Cl) _ o
" o
Z
Cl)
z a m
c I
o z c I
d z E Z
~ I
M
` N N 7 I
p'~//1 C t0 I
'n a I
c
) °
o O
z z
Q ° m
°
I Z
C, C
N
cl,
N
Cl)
co E ' I
0
~y~~y d - ~ ~ G c c°
`l N I G G a m O N
Q O 1 v r U) I
z M> o 3 3 a m
E z°
•N ~aaa v, I
a iz
13
o tn I
Q N U1 z rn rn 4)
o
O ' 00
~i N N N C N
N
U) m w (O
m c d I
1V so co, N H e o E
Q d ~ v c 0(D 0)
)0
U, C -0
v N CO C C d C C Gl M
NH N .PZ 'fl W ~O I
L'ri r d co
h C_ N
M m e ~ v O V=1 O~ U
• O M U) ! Z N O Z Z M 2 fA
V ~o € a
m
E ! c C,
~1 A 0 ~ai0
I
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER ar,
ADDRESS.
SUBDIVISION / CSM# LOT #
SECTION T~ N-R W Town of
ST. CROIX COUNTY, WISCONSIN
LAN VIEW
SHOW EVERYTHING 171THI 100 FEET OF SYSTEM
G N
6
C~
\
1 1 ~ ~
r'
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
a
BENCHMARK: ALTERNATE BM:
G~/"h Cr
PTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer:e ~S
Liquid Capacity:
Setback from: Well D e use '
Other-
Pump: Manufacturer Model
# Size
Float seperation
Gallons/cycle:
Alarm Location
:SOIL ABSORPTION SYSTEM
Width: Length -
Number of trenches
Distance & Direction to nearest prop. line:
®o ~
Setback from: well:_
House__.o_ Other
4 6 4
ELEVATIONS
Building Sewer O
ST Inlet._ ST outlet
PC inlet PC bottom
Pump Off
Header/Manifold "Bottom of system
Existing Grade Final grade
SAP
DATE OF INSTALLATION:
PLUMBER ON JOB:
` -J t-
LICENSE NUMBER:
INSPECTOR:
3/93:jt
wa . consin Department of Industry, PRIVATE SEWAGE SYSTEM County:
tabor and Human Relations ST. CROIX
Safety and Buildings Division INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-:
PeNE Holder's N CHme: RIS ❑ City 11 Village Town o : State Plan o.:
WMAN, 1i
04- PrairiQ
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
/OD,
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic / Benchmark
Dosing
Aeration Bldg. Sewer ~f 32 97 o6 '
Holding St/Ht Inlet 5,g'3' 9S SS
TANK SETBACK INFORMATION St/ Ht Outlet 3 '
TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic NA Dt Bottom
Dosing NA Header / Man. g~ 5!s' qa, C j
i
Aeration NA Dist. Pipe 7G
Holding Bot. System 9 s~' e
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand tr"`,"E:}
g, 5(
Model Number GPM
TDH Lift Friction System TDH Ft
Head
Forcemain Length Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS ~a L5~l ' DIMENSIONS
SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING manufacturer:
SETBACK
INFORMATION Type of /ham Moe Number:
System: 'acs' 5 , CHAMBER (9 > 75 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 E] No E] Yes E] No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: Star Prairie.33.31.18W, N 1/2, NW, SW, Lot 2
Plan revision required? ❑ Yes Q' No Use other side for additional information. W dc) /
SBD-6710 (R 05/91) Date Inspect`s Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
I
I
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, r I
than 8112 x 11 inches in size. Cr • See reverse side for instructions for completing this application State Sanitary Permit Number
.~e79-,;z
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)]. t/
(-L State Plan I.D. Number
1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION
Property Owner Name Property Location
~t /4 ~ /4,5,33T.3) , N, R 1 E (o
Property Owner' Mailing Address Lot Number Block Number
I- A
C-9 P ,6l? .L~
City, State Zip Code Phone umber Subdivision Name or CSM Number
I. TYPE F B LDING: (check one) ❑ State Owned El it~ ` Nearest Road
Public 5,1 or 2 Family Dwelling- No. of bedroom own of +
III. BUILDING USE: (If building type is public, check all that apply) - Parcel Tax Number(s)
1 Apartment/ Condo 0_3UQ
2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 100 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 : f New 2. E] Replacement 3. ❑ Replacement of 4. E] Reconnection of 5. ❑ Repair of an
System
System Tank OnlyExisting System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-P essurized Distribution Pressurized Distribution Experimental Other
11 Seepage Bed 21 ❑ Mound 30 E] Specify Type 41 ❑ Holding Tank
1 ❑ 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
Re uired (s q- ft.) Propose d (sq. ft.) (Gals/day sq. ft.) (Min./inch) q d' Elevation
D Feet Feet
VII. TANK Capacity
in gallons Total # of Prefab. Site Fiber- Exper.
INFORMATION Gallons Tanks Manufacturer's Name Concrete Con: Steel glass Plastic App
New Existing strutted
Tanks Tanks
Septic Tank or Holding Tank 10QQ '511 ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑
VI11. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) Plumb gnature: (No Stamps) MP/MPRSW Nov.: Business Phone Number:
ra ~ ~ 0 / b~'-7bL~
Plumber's Address (Strget City, State,, ip Code):
IX. COUNTY / DEPARTMENT USE ONLY (7 f
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Age nature (N am )
Approved ❑ Owner Given Initial s~«nargeFee)
00/
Adverse Determination $ (JC %r6 a~ S.-~
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SOD-6398 (R. 05/94) - DISTRIBUTION: Original to county. One copy To: Safety & Buildings Division, Owner, Plumber
l
INSTRUCTIONS
x
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:
I_ 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/ Depai tment 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.
IJLU 1 PLAIN
PROJECT G Zr eLn
ADDRESS /1,01
~•-,~8,,,f
- 41;7
1/4,c) 1/4/S N/R W TOWN ~a COUNTY v
MPRS Byron Bird ~Fwi/s DATE BEDROOM
CLASS PERC„2~::- CONVENTIONAL IN-GROUND ESSURE
CONVENTIONAL LIFT MOUND_ HOLD G TANK
SEPTIC TANK SIZE LIFT TANK SIZE
DOSE TANK SIZE HOLDING TANK SIZE
ABSORPTION AREA -ZZ5-- PERC RATE BED SIZE ,/,Z.X
IL Benchmark V.R.P. Assume Elevation 100'
Location of Benchmark Q~, f
* H.R.P.
D Borehole Q Well Scale - - Feet
0 Perc Hole System Elevation
Uent
12'
Grndp
TYPAR COVERING
2"
4 4.
12" 3' 61 34
1 6 M Sewer Rock
1.2'
f
r
s
I
V 1
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, DIVISION
P.O. BOX 796
LABOR AND PERCOLATION TESTS (115) MADISO
N WI 53707
HUMAN ELAT40NS
(ILHR 83.09(1) & Chapter 145)
LOCATION: SECTION: O MUNICIPAL+TY: OT NO.:BLK. NO.: SUBDIVISION NAME:
Gs
/T Ill/ for /`mar<~ ~ r~ - I
OUN Y: MAILING AM SS:
/
USE DATES OBSERVATIONS MADEo?t~
NO. BEDRMS.: COMMERCIAL DESCRIPTION: R 1PERCOLATION TESTS: ;K OFILE DESCRIPTIONS: Residence i~ - - New ❑ Replace
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND PRESSURE: rEIS YSTEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM:(optional)
S DU OS ❑U S S ❑U EIS ®U
If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the /
under s. ILHR 83.09(5)(b), indicate: I` Floodplain, indicate Floodplain elevation:
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- ~ ~g
B- f7 9 Ap
B- 3 ZQell oA-0- / n s
ZZ2
-02
AL zz
B_
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP I WATER LEVEL-INCHES RATE MINUTES
NUMBER IfWiM@@ AFTE SWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 P R PER INCH
-t.e_ ;71 G C_
P-
P- B
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
,
( 7
11
r I
E ;
A ,i
4XI
,
E
d_
3 i
3
r\
4, 3b
E
E ,
E e
AWis I, tsigned, ereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in thonsin
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 COMPLETED ON:
ADDRESS: _ CERTIFICATION NUMB R: PHONE NUMBER (optional):
-7_
CST SIG TURE:
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 10/83) - OVER -
INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 •
To be a complete and accurate soil test, your report must include:
1. Complete legal description;
2. The use section must clearly indicate whether this is a residence or commercial project;
3. MAXIMUM number of bedrooms or commercial use planned;
4. Is this a new or replacement system;
5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER
SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS;
6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan;
7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing scale is prefered. A separate sheet
may be used if desired;
8. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent;
9. Complete all apropriate boxes as to dates, names, addresses, flood plain data, percolation test exemption, if
appropriate;
10. If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box;
11. Sign the form and place your current address and yur certification number;
12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL
AUTHORITY WITHIN 30 DAYS OF COMPLETION.
ABBREVIATIONS FOR CERTIFIED SOIL TESTERS
Soil Separates and Textures Other Symbols
st - Stone (over 10") BR - Bedrock
cob - Cobble (3 - 10") SS - Standstone
gr - Gravel (under 3") LS - Limestone
's - Sand HGW - High Groundwater
cs - Coarse Sand Perc - Precolation Rate
med s - Medium Sand W - Well
is - Fine Sand Bldg - Building
Is- Loamy Sand - Greater Than
'sl - Loamy Sand - Less Than
'I - Loam Bn - Brown
'sit - Silt Loam BI - Black
si - Slit Gy - Gray
cl - Clay Loam Y - Yellow
scl - Sandy Clay Loam R - Red
sicl - Silty Clay Loam mot - Mottles
sc - Sandy Clay w/ - with
sic - Silty Clay fff - few, fine, faint
'c - Clay cc - common, coarse
pt - Peat mm - Many, Medium
m - Muck d - distinct
p - prominent
HWL - High water level,
surface water
Six general soil textures BM - Bench Mark
for liquid waste disposal VRP - Vertical Reference Point
TO THE OWNER:
This soil test report is the first step in securing a sanitary permit. The county or the Department may request
verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system
and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary
permit must be obtained and posted prior to the start of any construction.
J,Q
'S~>199 r
p 4 ► '8:ao
st ~0 pe C(
512312
CURVE DATA(I-2) LINE DATA (2 -3)
Radius 1692.06' Bearing S05°57'03"W t-'
Central Angle 06°48'43" Length 69.41' En 0
0
0 Chord Bearing S02°32'41.5"W p rt.
o
Chord Length 201.05' N a
P Pi
N Arc Length 201.17'
0o F' Tangent Bearing S00051'40E p
Tangent Bearing S05057,03 W UNPLA I T I_D LANDS M
ro
''y West Line of the SW} of Section 33 c
0
100TH 0 -1
(D rt,
ISTREET
S01010'04"E~ w
0
S01010-04"E 74455 Ff,
x-~ P61
N N 1814
.72' 438.52, JS00°51' 40273.52' 306.03' 309.79' w T17
Cl) C)
N
o w o N rn o z
0 0 -3 0 au 0, .
z
CD o
w o o
co
io
o O
Ffi
cn E) w rh
T 0
cn MiF a (D
A z
O w W
E
1 N
T ~07 \-1 I U7 I
F.. D N J Cr
I - CO ~ x co IC- I-h c--)
- _ I'D 17 0 - \ O 'z rn
Cn ;;0
' N N \ N I U (p
00 00
Ij 0 ~
205.15\ " 136.00' w i N co P.. s 1-1 N01°10'04"W 341.15' '-1 0 d
w
Z `o N I
txj ~ I I w Cn
o 0 I0 V v w C
Cr S r II N N
a I y -p 4 H M
m rt 0 Iz N ' o N IY O -M o a+ (J -G
H 2 lU l0 Z o
T N N l0 I/ z
et
0 C I L~ D ►(M co r-n + N F /
:3 Ln
F A co a I01 _O
ff
9 C1 O ~y
CO VI A, II N .n N I~'
v F Vt / rn to 00,
I i
0 0 m T
x 0
" N
Z N F N Ul rt
F cc v o O x 0\ H
p z n\ n r O
w ME
to co CJf'1 V A V7 \ \
CD E
F N N N N
.C N a N D o
Ih 1
-n
x x n o m -7 9 7
rr n rt n D (n
/ rt
m
x \ \
n a[ n ae fi
UNI'Y
\ \ r•I
N01010' 04"W 744.55'
UNPL/2TI TED LANDS (D
O D I 0 '4 racorded
K r~•' V . s aii 30 days of
roval date
w 17i; 'shall be
)omval
v r•
CD U:) x
N o o td: void n
F d 0
N
dear ings are referenced to the 0
W'st Line of the SW} of Section
7 N O
y 3, assumed to bear S01°10'04"E
VOLUME 10 PAGE 2726
STC - 10 0
This application form is to be completed in full and signed by the
owner(s) of the property being developed. Any inadequacies will
only result in delays of the permit issuance. Should this
development be intended for resale by owner/contractor, (spec
house), then a second form should be retained and completed when
the property is sold and submitted to this office with the
appropriate deed recording.
Owner of property
Location of property 1111,E,)114 1/4 , Section, TN-R W
Township 7 Mail:kng address -
Address of site
Subdivision name Lot no.
I
Other homes on property? Yes No
Previous owner of property up- 'd s' u
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 ~No
Volume Z and Page Number 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 recorde in the office of the County Register of
Deeds as Document No.~ -'i , 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.
Si ature of~A licant Co-Applicant
Date of SignatuY Date of Signature
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
II'' St. Croix County
OWNER/BUYER
MAILING ADDRESS
PROPERTY ADDRESS
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE
tj I
PROPERTY LOCATION Lt~~ 1/4,-'! t~A 1/4, Section T N-R~_W
TOWN OF < 471 ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER"
CERTIFIED SURVEY MAP 3 - VOLUMES PAGF, 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 year expir i date.
SIGNED: J~
DATE:
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
t
T--
WARRANTY DEED THIS SPA" 1ef*VC0 FOR RIECONCINe DATA
i'T
j DOCUMENT NO. i
i STATE BAR OF WISCONSIN FORD[ 2-19=
AMISTERS OFFICE
f
a~, 'i w1.: 136ACE-19_ ST. ~ROIx co. this wii0tn
Q091'
day of Feb . A. D. 19
Wayne.,Straub•.and,• Adngg..S.Xub,t..ktusbad..and.......... 0; 8:30 A
wife as..jointt...............................................................
larnPC a i rnnrtall
conwyr and warrants to .Chs1s..P....Neuman..and.-Lynn..-ly.............
pp_n.,-. as marital property with rights of Deputy;
I
;
R[TURN TO
the following described real estate in ..........s~.T...~• county,
1i
State of Wisconsin: Tax Parcel No:
A parcel of land located in part of the Southwest Quarter (SA) of Section I~
Thirty-three (33), Township Thirty-one (31) North, of Range Eighteen (18)
West, further described as follows: Commencing at the West 1/4 corner
of said Section 33; thence South 010 10' 04" East along the West line
of said Southwest Quarter (SWI*), 66.00 feet to the Point of Beginning
of this description; thence continuing South 01° 10' 04" East 744.55 feet;
thence North 89° 28' 34" East, 1242.94 feet; thence North 01° 10' 04" West
744.55 feet; thence South 89° 28' 34" West, 1242.94 feet to the Point of
Beginning. Parcel contains 21.00 acres, excluding Town Road right of way.
Subject to an easement for Town Road purposes and all other easements of
record.
This conveyance is given in satisfaction of a land contract between the
parties, dated July 8, 1985 and recorded July 9, 1985 in Volume 715,
page 609-610, Document No. 403325.
FEE
This lS...AQt_......... homestead property.
(is) (is not)
Exception to warranties:
February .
Dated this 7.th.......................... day o - - - - 19.-8.6..
_ ---(SEAL)
.Way Straub
. /
Y.. (SEAL)
(SEAL) "xa'.. Alt
. Agnes _ Straub-._
AUTUNNTICATION ACHNOWLBDOMBNT
STATE OF WISCONSIN
signature (a)
--•---------y-- St. Croix County.
authenticated this ds of--------------------------- 19 Personally came before me this ...7th...... day of
February----------------- 19__86_- the above named
Wayne-_Straub_. and__Agnes_.B.trauh---------
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not,
authorized by 4 706.06, Wis. State.) to me known to be the,peT~,S.-_ who executed the
forego' g instrument rid ackno4llu* the same.
THIS INSTRUMENT WAS DRAFTED BY
- ~L.f-- L/L_-- - ~r.~•.-
. ee3ha... - -
Reinstra, Van Dy.. N
, Ruth A... 7o .n-sdrf-. e.
New Richmond!. .WI 54017 Notary Public . . BtU-r.Cbixr County, Wis.
` it of state expiration
(Signatures may be authenticated or acknowledged. Both Hy Commtsston- permanept (f•~f t
are not necessary.) date: 2 -2:• a
eNsmes of persons sirnins in any rapacity should be typed or printed blow th.ir .-gratures. ~fM
STATB BAR OF WISCONSIN Stock NO. 3OOZ
FORM No. I- 19X2