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HomeMy WebLinkAbout026-1115-50-000 ~ o 0 03 °u> N ry 0 O C N L tV io 'a O O O r ~ I d O LL ~ I 46 N C z L LL L ` ~ N N~ Q U ~ 3 co zvi I co E 0 zo O O I') w a 00 C O O z c v m Z a ~ o I N f- "O N 0) N 7 c cn_ z Ix O C N N • a ~ O I ~ 0 f6 O Q w N 3 Zco Z O z N a) 2: L (a C( a T) d i N J O O p O d .O N '(6 O 0 0 0 4 Z o -o CL CL a O. o of 0) 0) } w J U rn rn ~ ~ a I 0 I C,4 0 E z a) m a N O O O O N Q C!1 Q w O ~ 00 C ~ O~1 C i Q eC O N 0 U a' o rn °r> (0~ L c a c o O 06 Y N j~ 'O V C,~ O Y O C N O N O c) E cc, F- r F C*? 0) E 16 •W14 O O Y N O z a (n V ~ L dt al liar t A va2l,lowLO) STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS Flo / yy'`~ SUBDIVISION / CSM# / 4` ~ LOT ~ I SECTION 'r T.3 p N-R_jB W, Town of C N r14D41z~ ST. CROIX COUNTY, ;WISCONSIN PLAN VIER SHOW EVERYTHING WITHIN 100 FEET~~OF SYSTEM j 19 I _ 79 I ~ a , 12,0 "I N D 1 CATS NARRO i. .S /!I c` hr : Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic Cant. manhole cover. BENCHMARK: ALTERNATE BM: ju tf- ~e9U , 7'3 SEPTIC TANK / PUMP CHAMBER / HOLDING TANK IN ORMATION Manufacturer: J►~/, o~J/T (a~•cr Liquid Capacity: /?,o e) ,'rr ~ Setback from: We11~1 `louse 7~6- Other Pump: Manufacturer - Model# Size Float seperation- - Gallons/Cycle:' Alarm Location i SOIL ABSORPTION SYSTEM Width: Length 1 Number of trenches ~cp Distance & Direction to nearest prop, line: Setback from: well: ouse Other I ELEVATIONS Is i Building Sewer 3 ST Inlet DD• Q SbT outlet '7/ PC inlet PC bottom - - Pump Off Header/Manifold 9, S~ Bottom of system,Z D`'"' Existing Grade &I, 7-da2~ Final gradeAt 7i/vz'a DATE OF INSTALLATION: ! z /i~' ~`J=1 PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: tJ r Y+^ `ef17/~~ r . r 3/93:jt `Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION P~r~i1`I P r', N AY L. ❑ City ❑ Village A Town of: State Plan o.: CST BlM1~EEllev.: Insp. BM Elev.:, BM Description: ~i Parcel Tax No.: 160. CJ ,2 .ne a'-s 106 Z~- j TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. " 0116161 Septic Benchmark 5,03 5!S 110 Dosin s, -16 0,70 Aeration Bldg. Sewer 3 St/,~OC Inlet TANK SETBACK INFORMATION St/*Outlet SL TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic NA Dt Bottom Dosi NA HeadertMal-r (p 9jn oS Aeration NA Dist. Pipe 9S~ HOlding Bot. System -7G,5-7' 7 193 PUMP/ SIPHON INFORMATION Final Grade M ufacturer D and Model Number GPM TDH Lift Friction System TDH Ft fE main Length Dia. I-f Dist. To well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length r No. Of Trenches P No. Of Pits InsidgDia. iquid Depth DIMEN I N w DIMENSIONS LEA Manu acturer. C- . SETBACK SYSTEM TO P/ L BLDG WELL LAKE/ STREAM Mo a Num er. INFORMATION TypeO /7e-.- CHAMBER System: R UNIT DISTRIBUTION SYSTEM Header/Manifold „ Distribution Pipe(s) X, Hole Size x Hole Spacing Vent To Air Intake Length L_ Dia. Length Dia. Spacing 2 - SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Sys Only Depth Over ~i Depth Over xx Depth Of xx eded / Sodded xx Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) oooo4 Richmond.1.30.18W, SE NW, Lot 15, 144th Street LOCATION- "S i~ff. ' Y'6 ~l Plan revision required? ❑ Yes 0 ~a t/7 Q Use other side for additional information. T ,SBD-6710 (R 05/91) Date Inspector's Signature Cert - No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: Qv l SANITARY PERMIT APPLICATION l.~L`Llr■LLtt In accord with ILHR 83.05, Wis. Adm. Code Co STATE SANITARY PERM T -Attach complete plans (to the county copy only) for the system, on paper not less than 1 8% x 11 inches in size. ❑ Check revision dprevious application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPER OWNER PROPERTY LOCATION ~'/4/I,aGJ 1/4, s T39, N, R 1,5 E (or PROPERTY OWNER' MAILING ADDRESS LOT # BLOCK # CITY, STATE a)f ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 17tj E c '7 L / II. TYPE OF BUILDING: Check one CITY NEAREST ROAD ( ) 11 State Owned 1~ ILLA =N OF: Fje GE 1,t,_n,0A)D el-el ❑ Public X 1 or 2 Fam. Dwelling-## of bedrooms 'T PARCELTAX NUMBER(S) Ill. BUILDING USE: (If building type is public, check all that apply) 1 ❑ Apt/Condo 2 F-1 Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 El Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 40 Church/School 80 Mobile Home Park 12 ❑ Service station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Off ice/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. 9 New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.0 Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 1I Seepage Bed 21 ❑ Mound 30 ❑ Specify,Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION o.C U © o~co CxJ0 • 5 CCJ i 7 Feet , Feet CAPACITY VII. TANK Site in allons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New xistin Gallons Tanks Concrete structed glass App. Tanks Tanks Septic Tank or Holding tank /acq it )t / C--- T -rz ~C Lift Pump Tank/Si hon Chamber !!±L f mi VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plum is N me (Print): Plumb is Sig ure: (No Stamps) P/ F9MPRSW No.: Business Phone Number: Plumb 's Address (Street, City, tats, Zip IX. COUNTY/DEPARTMENT USE ONLY V ❑ Disapproved Sanjtary Permit Fee (Includes Groundwater ate ssue Issuing Agent Signature (No Stamps) Approved ❑ Owner Given Initial ~ ~ /T Surcharge Fee) Adverse Determination ~ (J X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: E SBD-6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety R Buildings Division, Owner, Plumber S 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 ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or :site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII Responsibility statement` Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatmenttanks; 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 ;yam. 1983 Wisconsin Act 410 included the creation of surcharge's (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-8398 (R.11/88) Sc ply ~l u1 S l ~ T 3 0, .c~ 18 ct~ . tY1s~.,a K n z•-~ JET 176 8 .S 77~Cc•z'?"" TpUMS K I P ZC 0"40A.) lam, ~Y 'tg~ c~ it.! ts~ ~is Sy7I s" ~ 2Sg loo 1 6n r yx 7F, tv IL c -i N V o J R _r ~ s A ~ ,..Z.~r:. K a li ~eT~. - is »s; _ v rn"UnsuiuaNafuirornuluwusuy, SUIL AIVU W I t tVALUA 1 IUIV HtHUM 1 rage 1 of 3 Labor and Human Relations Division ofSafe%& Buildings in accord with ILHR 83.05, WW; r" A COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in sie:jan =172 e, b St . Croix not limited to vertical and horizontal reference point (BM), direction anFJ 6ki6f slgp~e, W r PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road - APPLICANT INFORMATION-PLEASE PRINT ALL INFORMS TfbN 5 EVIEWED BY DATE PROPERTY OWNER: i.`• PROPERTY LOCATION Derrick Construction Inc. V-1 GOVT LOr c~ C_ 1/4 -1/4,S 1 T 30 N,R 18 ]Wor) W PROPERTY OWNERS MA!I_ING ADDRESS A # BLOCK D. NAME OR CSM # 1505 Hy. #65 illow River Meadows CITY, STATE ZIP CODE PHONE NUMQEq EiWOWN NEAREST ROAD New Richmond, WI. 54017 (71~ 24 -2320 Richmond 144th. St. [:j New Construction Use [x ] Residential I Number of bedrooms [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 45 Recommended design loading rate -5 bed, gp~2 -6 trench, gpdm2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate 55 bed, gpd/ft2 -6 trench, gpd/ft2 Recommended infiltration surface elevation(s) 98.40 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material pitted outwash plain Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IPRESSURE AT•GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ® S ❑ U ® S ❑ U S ❑ U ®S ❑ U ❑ S ®U ❑ S m SOIL DESCRIPTION REPORT Depth Dominant Color Mottles structure GPD/ft Boring # Horizon in. Munsell Du. Sz. Cont Color Texture Gr. Sz. Sh. consistence Band~ry Roots Bed Trertdt 1 0-12 10yr3/3 none 1 2msbk mfr 9w 2f .5 .6 2 12-30 10yr4/4 none s i l 2msbk mfr gw if .5 .6 Ground 3 30-80 7.5yr4/6 none sl 2msbk mvfr na na 1.5 .6 elev. 100.4 ft. Depth to limiting factor +80" Remarks: Boring # 1 0-11 10yr3/3 none 1 2msbk mfr gw 2f .5 .6 2 2 11-27 10yr4/4 none sit 2msbk mfr gw if .5 .6 3 27-82 &.%YR$?1P NONE SL 2msbk mfr na na .5 .6 Ground 1O 15ft. Depth to limiting factor +82" Remarks: CST Name:-Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 200th. Ave. New Richmond, WI. 54017 02 Signature: v Date: CST Number: 10-31-94 cstm 02298 PROPEWYOWNER Derrick Const. SOIL DESCRIPTION REPORT Page 2 of 3 PARCELI.D. dZ~-//'/S--SC3 _ Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bound3y Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed (french iX..~ 1 0-13 10 r3/3 none 1 2msbk mfr gw 2f .5 1.6 3 2 13-22 10yr4/4 none sil 11fP1 mfr gw if np i.3 Ground 3 22-30 10yr4/4 none sil 2msbk mfr gw if 1.5 1.6 elev. 4 30-88 7.5 r4/6 none sl 2msbk mfr 101.4 ft. Y gw na 1.5 !.6 Depth to limiting - factor +88" Remarks: Boring # 1 0-10 10yr3/3 none 1 12msbk mfr gw 2f 1.5 .6 4 2 0-25 10yr4/4 none sil 2msbk mfr caw if 1.5 .6 3 5-37 7.5yr4/4 none sl 2msbk mfr 9w na .5 .6 Ground elev. 4 37-88 7.5yr4/6 none co s Osg ml na na .7 .8 102.4 ft. Depth to limiting factor +88" Remarks: Boring # 1 0-7 10yr3/3 none 1 2msbk mfr gw 2f .5 .6 5 2 7-32 10yr4/4 none sil 2msbk mfr gw if .5 .6 3 32-86 7.5yr4/6 none sl 2msbk mvfr na na .5 .6 Ground 10177 ft. Depth to limiting factor +86" Remarks: Boring # iivtit 1:.i•~i:•i:ii Ground elev. ft. Depth to limiting j factor Remarks: SBD-8330(R.05192) STEEL'S SOIL SERVICE Gary L. Steel Derrick Construction, Inc. 1554 200th Ave. CSTM2298 SE4NW4 S1-T30N-R18W New Richmond, WI 54017 MPRSW 3254 town of Richmond (715) 246-6200 lot #15-Willow River Meadows N 1"=40' BM.=top of SE lot stake at el. 100' 10 / g 2 la~ Cop Gary L. Steel 10-31-94 i 00331 p 425.10 17 Outlot l . .7 ;fi , 07 Aar ° O zm Aaft » W x tll Z $ Zsi ~h a:w § 1= Aaft 16 Rive r 101 Aam i ~4y 3v M. A~ 202 Raw y Mea'do'ws 20 15 tt5 Aa.. 14 305 Z02 Asst a . 200 ~J w ~ ^ ~J' 4r too 11a ACM Y 121 Y 9 10 1x1.13 200 a 293.14 LOS ACM N ZOO ACM e w i '1 r^ n 100Aa+14 ^ sot 2 ADMI M . 22 too N 20i 211 W5 2! Public . ~ 3 ~ ~i» tsa 4" 74 » 23 LOG ~ « Z= Aar LOO Aw 229 209.30 2 4 50430 ov 102 ACM ZV o $a 425.25 e C 31933 e J W 25 LOS AtJt4 « 104 Aaft •so.•s N « 27 to : s 29 Z= Aam4 133 AaM 4 w 77.10 LO Aas9 WE" FiE 170.33 ~ .16037 -A 77.40 C'itj Of Now RiawrlaM N 26 H. ~ ° e e• LI t Aaft Z30 ACr" « 507.00 30 22a 429 2°0 1A.. . 21 1.03 S . 0 Cfllxlty AC GG 323.20 » V 32 33 a v 220 Aa" 1i4 ACM • ° 2 = 3 CL ca tit. Aaft M 103 Aaft 200.50 321.37 ?2t Highway GG (715) 246-232( ERRICK Route ;Q New Richmonc CONSTRUCTION Wisconsj- s - STC-105 SEPTIC TANK MAIN'T'ENANCE AGREEMENT St. Croix County OWNER/BUYER TI-GL MAILING ADDRESS ~O ~301c -IZ i'1? A•124 rc t ~4a Zb PROPERTY ADDRESS (Vocation of septic system) Please obtain from the Planning Dept. CITY/STATE Dew 124 c-H r A0 W O, \Al1 S 4C' 1 PROPERTY LOCATION `76 1/4, 1/4, Section I , T _J2O N-R L8 W TOWN OF 2:IL ima N_ ST. CROIX COUNTY, WI SUBDIVISION VIJ I"-oW V,-t,\fQ t, M ~~o w 5 LOT NUMBER S CERTIFIEED 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 expiration date. SIGNED: DATE: ~t g St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 STC-loo This application form is to be completed in full and signed the owner(s) of the property being. developed. .Any inadequacies will only result ~n delays of the permit igsuance. Shoulthis development be intended for resale by owner/contractor,(spec house), thenla 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 L„ (f ~L• Location of property=1/4 111Y*41/4, section I 3a ► T N-R I~_W Township Mailing address L3oX ~►ihE ~l ~-oZ~ Address of site l"1 l0 4_-~ ~q~Gy -r~4- ~5 ► Subdivision name VLLwow C7 Lot no. _ Other homes on property? yes No previous owner of property \Af L1.,rNw 12t id Y c alj~ ✓L~ Total size of parcel AE.4c7, Date parcel .was created Are all corners and lot lines identifiable? ___.X Yes No Is this property being developed for (spec house)?___,Yes X No volume 1024 __s_. and. Page Number OS of Deed as recorded with the Register ' INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER & THE SEAL OF THE REGISTER OF DEEDS. certified survey, if available, would be helpful I o asd 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 orm, by virtue of a warranty deed recorded in the office of the County Registerof Deeds as Document No. 518240 , and that I own the proposed site for the sewage disposal system) orr I e(we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorde in the office of County Register of deeds as Document No. ►8 2.10 si nat a of applic nt Co-applicant Date of signature Date of Signature. DOCUM1;NT NO. + -WARRANTY D611D TH38 aTgCf; REBRRV aD 1V011 RECOROiNO DATA STATER TORT',bN FORM 9 -1988 VOL PAIF 5:L8240 5' wi~.i~w.,R~,vex...~Q~nt_.yr►~uxa.,..a~.1~~,s~:aaas~a..par~a~xsb~•p.....;a'0 ~ Rwird JUN 2 4 194 . conveys and warrants to .KgX7C~i..L~._Rittsl..$nfl..Bhsri..La__Ev ~ _•...-husband„and wii:e.~_.as-.~uryivorehip-,marital„property,___-- ~ ~ ' f RETURN TO l I the following described real estate in At t...grotx,,,• ........................County, State of Wisconsin: Tax Parcel No: I~ Lot Fifteen (15) Plat of Willow River Meadows 'I in the Township of Richmond, St. Croix County, Wisconsin i I ' t This ie-.nct.......... homestead property, (is) (is -not) Exception to warranties : Dated this .......1T.tIL day of Jund................................. 19. 4.... (SEAL) . . (SEAL) w " .)30 l~.. (SEAL) . * .Michsel.it... S.taveua AUTIIENTIOAlfION ACKNOWLEDGMENT Signature(s) STATE. OF WISCONSIN ss. .....SX~..~ixA 76.. .........County , ~.-14ath~ntiaated~3ri>s:..°:: dsy.......................... . PerillonlIlY a o1 }:38~_.._. .................J=86................., 1.9.9~i the above named Bonn .1 d a8..axr7aexA__A.,Wi3f,.J33•~r~ex..+7Ai~..-••--•--•-- TITLF.s MEMBICR STATE I3AR OF WISCONSIN yenturea„a,WiaCOnf~ixl par>~z<erahf~ (If not,._ - - authorised by 708,08, Wis, Sta VF4Y LOOPER to me known to be the person who executed the t4MW PWANNa of YYkwmka foregoing instrume and acknowledge the same, TI419 INSTRUMENT WAM ORAETEG BY ,-,-.Willow River Joint Venture 1505 Hi hway 6' 3 , T. 0. $cx A #IA&T-7. ~t .Qptx ~ mAl Notary Public ....9t..._Cax0. Countyl Wis. (Signatures may be authenticated or acknowledged. Both My Commission is •permanent.(If not, state expiration are not necessary.) dates 19.9$ amen of persons sisuias in any aapaoity should be typed or printed below their sieaawre,. l WARRANTT x8821 ~TATm AR OF W11CONSIN wisconeln Legal Blank Co., Inc. FOIf.N'No. s --1888 Milwaukee, Wisconsin