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Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of
Labor and Human Relations
•DssiSv~ of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code
s' COUNTY
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road. 0 3 U gab
APPLICANT INFO RMATION-PLE RINT ALL INFOR ATION REVIEWED BY DATE
PROPER OWNER: '----PROPERTY LOCATION
GOVT. LOT 1/4 VA) 114,S T N,R (orU
1 - ~a,2'Q PROPERTY OWNER':S MAILING ADDR SS LOT # LO K # SUBD. NAME OR #
42
CITY TATE ZIP CODE PHONE NUMBER CITY VIL GE ®fOWN NE EST ROAD
New Construction Use,W Residential/ Number of bedrooms [ ] Addition to existing building
Replacement [ J Public or commercial describe
Code derived daily flowCe,,,!~,O- gpd Recommended design loading rate _~bed, gpd/ft2-trench, gpd/ft2
Absorption area required S5;3 bed, ft2 7~p trench, ft2 Maximum design loading rate _,~bed, gpd/ft2 trench, gpd/ft2
Recommended infiltration surface elevation(s) 7;?R ft (as referred to site plan benchmark)
Additional design / site considerations
Parent material - Flogd lain elevation, if applicable ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U=Unsuitablefors stem ®S ❑U WS ❑U 0S ❑U EIS ❑U ❑S mU EIS ®U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Bordary Roots GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
'd ;~2 17 1 8
S
Ground J1, s 111,122
~ele,,v~.
ft. -
Depth to
limiting
factor
> 9~
Remarks:
Boring #
•:.~:ccx•::•:
Ground
elev. .Y _
ft.
Depth to
limiting
factor y 07
v
Remarks:
CST Name:-Please Print 77 Phone: rf
Address: ti, 6
Signature: Date: CST Number:
PROPERTYOWNER~ SOIL DESCRIPTION REPORT Page,,,~ of-1-
PARCEL I.D. #
Depth Dominant Color Mottles Structure GPD/ft
Boring # Horizon in. Munsell Qu. Sz. 22nt. Color Texture Gr. Sz. Sh. Consistence Bax>dary Roots
Bed Trench ~
Ground
I
elev.
~~ft.
Depth to
limiting
factor
} 9/
Remarks:
Boring #
\vi' /,,,,C•~
I
&I Z
Ground
elev.
_
A/A /j
~QQ ft.
Depth to 2~2-6-7 /0 Y,< A114
limiting
factor -
s~
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
yR9
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
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STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER_ _a~~1e>? y/-0
ADDRESS
SUBDIVISION / CSM# LOT
SECTION / T a~ N-R Qo W, Town of
7
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
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p~ 1~~ rcr►~ . CAP l l ¢d
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1
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic 4ar* manhole cover.
1
BENCHMARK: - ~r
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Liquid Capacity:
Setback from: Well House Other
I
Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: 5 Length 75 Number of trenches 77-
Distance-&- -Direction-- to--nea-r-est -pr-op I i-ne _ _ - /az _ _ _ -
Setback from: well: .5"7"6" 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 INSTALLATION: ~I- Z
PLUMBER ON JOB:
LICENSE NUMBER:
INSPECTOR:
3/93:jt
I+~~rr~par-t4~+trftof~il+Ot~i~H 1.29.2t3~y~9i~E~~~I~WA~S~~, CEDAR CDRTVE WEST
ounty:
lyboranc HurnanRelations INSPECTION REPORT
iafety aAl Buildings Division ST. CROIX
(ATTACH TO PERMIT) Sanitary Permit No-:
GENERAL INFORMATION
208939
Permit Holder's Name: ❑ City ❑ Village R Town of: State Plan ID No.:
S ev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
SQ-;Cvt~ 030--2020-60-000
TANK INFORMATION ELEVATION DATA A9400055
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
/pv-
Septic q~ts I ,1) Benchmark (Wl
i2i
Dosing
Aeration Bldg. Sewer
Holding St/ Ht Inlet L L q5 ? /
TANK SETBACK INFORMATION St/ Ht Outlet
TANK TO P/ L WELL BLDG. AirI to ntake ROAD Dt Inlet
Air I
Septic 7a sl 2SD ~2,O 'b` -',2u' NA Dt Bottom
Dosing NA Header/Man. 7,-73 q5
-7.79 5>()
Aeration NA Dist. Pipe 7, 9;_ 4q4.Cf1
9y .89
Holding Bot. System y q 3e/
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand S.5~) q7, 3
Model Number GPM
TDH Lift Friction Syesatee TDH Ft
Forcemain Length Dia. Fi Dist. To Well
SOIL ABSORPTION SYSTEM
BED / TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS n DIMENSIONS
SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK
INFORMATION Type Of lztAt) CHAMBER /_7 7 57'/ OR UNIT Model Number:
System: q//2, d_, 1
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 ~F l a Depth Over v{ p xx Depth Of xx Seeded/ Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges ' - Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)' tt.._,~.
ATION: ST. JOSEPH 1.29.20.4W ,NE,NW,LOT 4261, CEDAR DR14 WEST
31 Lj
tit
!
Plan revision required? ❑ Yes ❑ No / _
Use other side for additional information. kzdc~q I F4/i
SBD-6710 (R 05/91) Date inspector's Signature Cert. No
ADDITIONAL COMMENTS AND SKETCH _
SANITARY PERMIT NUMBER:
•
SANITARY PERMIT APPLICATION . ;Ty
ILHR In accord with ILHR 83.05, Wis. Adm. Code co
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than q 3~
8% x 11 inches in size. 1:1 Check if revision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATIO~N+.
PROPERTY OwC R PROPERTY
Z% A1 E~TM&0/,OS Tot , N, R ;1-6 (Or
PROPER O itJER'S MAILING AD DR~SS~ LOT # BLOCK # /Z4
CITY, STAT o~ ZIP CPHONE NUMBEP SUBDIVISION NAME OR C~SN;NUMBE
4/111 r / ~
.Es S
II. TYPE OF BUILDING: Check one CITY NEAREST ROAD -
( ) ❑ State Owned VILLAGE : eQw
R-TOWN OF:
❑ Public ❑ 1 or 2 Fam. Dwelling-# of bedrooms PARCEL AX N B W )
111. BUILDING USE: (If building type is public, check all that apply) O p- Oo1-(~ - ~p0
1 ❑ Apt/Condo
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 80 Mobile Home Park 12 ❑ Service station/Car Wash
50 Hotel/Motel 9 ❑ Office/Factory 130 Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. ~ New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit - 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
12 2 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) V_ Q~ pELEVATION
laeD 7~ U Feet 7~j•S Feet
VII. TANK CAPACITY Site
in allons Total #of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Holdin Tank G0 ~2e.~ Cr
Lift Pump Tank/Si hon Chamber E1 - Fj F] F1 1 1-1 El
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumb is Name (Print): Plumber' ignature: (No S mps) MP/MP2_R)XAo.: Business Phone Number:
Plumbs s Address (Street, City, State, Zip Code):
3 C7 40 ZPL6 /-,f l Z )A - Olt
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sani ry Permit Fee (includes Groundwater Date sue issuing Agent Signature (No Stamps)
Approved ❑ Owner Given Initial jl Surcharge Fee)
fff~~• Adverse Determination D ( X~ A,
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Pib-67) (R. 11/88) 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 (SB`=) 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.
Ill. 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 13% 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 tan<s; 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) ho,izontal 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)
JOBS.
TIMM EXCAVATING OF 2
Route 1 Box 192 SHEET NO. T
WILSON, WISCONSIN 54027 CALCULATED BY DATE
(715) 772-3214 (715) 386-5443
MPRS #3224 WI MPCA #696 MN CHECKED BY DATE
SCALE
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PRODUCT 205-1 f~ Inc., Groton, Mass. 01471. To Order PHONE TOLL FREE 1-600-225-6360
JOB SY ~D/ ► 5~~~~i
TIMM EXCAVATING
Route 1 BOX 192 SHEET NO. ~ OF Z
WILSON, WISCONSIN 54027 CALCULATED BY DATE 3 - 3~ 7 1/
(715) 772-3214 (715) 386-5443
MPRS #3224 WI MPCA #696 MN CHECKED BY DATE
SCALE
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PRODUCT 205-1 Inc., Groton, Mass. 01471. To Order PHONE TOLL FREE I-000-2254780
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/ C3 \ LOT
42 \
6 F 422 D
66' EASEMENT /
t~E /
oR 426 H
225' 225' \
1 _
SE l/4 NW
I LOT 2 LOT 3 422 G
I 426 B 426 K-
PAGE 1433
- - - - 4 26 I xZk
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2:25' 1 225'
~fZ~f
422
426 E S23 /
426 D 4 26 fG 4 26 C
utnerw,se aus oiler
oD oenvery o, uie accepted veer to buyer on or oeuvre
66 is void and all earnest money shall be promptly returned to Buyer. '
67 This tran clio is to be closggd at the office of Buyer's mortgagee o at the office of
68 on or before~~T z'Y _1993 or at such other time and place as may be agreed in writing.
69 Legal possession of property shall be delivered to Buyer on date of closing.
70 It is understood the property is now occupied by
71 under (oral lease) (written lease), which terms are:
72
73 Occupancy of /lo shall be given to Buyer o d ~~r
74 If Seller is permitted to occupy roperty after closing, Seller shall prepay occupancy charge of $ per day, which
75 (shall) (shall not) be refun ased on actual occupancy.
76 The sum of $ shall be withheld from the purchase price to be escrowed with
77 - -
78 to guarantee delivery of occupancy to Buyer AND FOR NO OTHER PURPOSE, which sum upon Seller's failure to deliver
79 occupancy shall be paid to Buyer as liquidated damages or returned to Seller if occupancy is delivered to Buyer on the agreed date.
.
S T C - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER- • /WA m ~Ae,/
ADDRESS FIRE NUMBER__. .
CITY/STATE- .✓eirr~ l,./,tS ZIP__ J~~~ /!P
PROPERTY LOCATION : NC 1/4 ,=1/4 , SECTION, Taf N- ~2R Ij ,r51
TOWN OF St. Croix 'County, ---~J
i
SUBDIVISION- ee 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 a 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 Co. Zonin Officer within
30 days of the three year expiration *da.
SIGNED: G
DATE/Z/p L~
St. Croix co. Zoning Office
911 4th St.
Hudson, WI 54016
P
S T G - loo
This application form is to be completed in full, and si ne
he owner(s)' of the property being, developed. .Any inad qu cies
will only result ~n delays o'f the drmit issuance. , h
development be intended for resale by owner/cohtractor d this
sec
house), thensa second form should"be retained and completed(w
hen
the property' is sold and submitted to this office with the
appropriate deed recording
,
of property t4d
Location of propertYA 1/4 _!/e2114 , Section 7
Township ,
Mailing address
Address of site
Subdivision name- le ~«.~s aloes'
Lot no.
Other homes on property? yes x No
Previous owner of property
Total size of parcel 6•1
Date parcel-was created
''Are all corners and lot lines identifiable? y
Yes No
Is this property being developed for (spec house)?„_Yes No
volume r__and. Page Number 7bas recorded with the Register
of Deeds.
INCLUDE WITH THIS'APPLICATION THE FOLLOWING:
A WARRANTY DEED which includes a DOCUMENT NUMDERf VOLUME AND PAGE
NUMBER & TIIE 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( the property described in this information form, by virtue sofa
warranty deed recorded n the office of the County Register5~'of
Deeds as Document No. , and that I (we)
own the proposed site for the sewage disposal system orrI e(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 County Register of deeds as Document
No.
signa ure o applican Co- pplicant-
of Signature Dat of Signature.
yLi,- a ~Human sm Departrne Relation lations Industry, SOIL AND SITE EVALUATION REPORT Page ~ of
Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPE OWNER: PROPERTY LOCATION
GOVT. LOT 1/4 1/4,S T N,R (or ffl
PROPERTY OWNER':S MAILING ADDRESS LOT # L K # SUBD. NAME OR #
CITY TATE ZIP CODE PHONE NUMBER CITY YVIL,., GE ~jiOWN N EST ROAD 11
- sT
7 7
New Construction Use-W Residential / Number of bedrooms _ [ J Addition to existing building
j J Replacement ( J Public or commercial describe
Code derived daily floe: gpd Recommended design loading rate ed, gpd/ft2 , g trench, gpd/ft2
Absorption area required 95' e bed, 112 7,~5-D trench, ft2 Ma)amum design loading rate ~_bed, gpd/ft2 f trench, gpd/ft2
Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark)
Additional design / site considerations
Parent material FIVain elevation, if applicable ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FlLL HOLDING TANK
U = Unsuitable fors stem ®S ❑ U COS ❑ U ®S ❑ U [ZS ❑ U ❑ S ®U ❑ S ® U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Bounfty Roots GPD/ft
Boring # Horizon in. Munsell GQu. Sz. nt Color Gr. Sz. Sh. Bed Trench
14
1
Ground _
elev.
-
ft.
B7, ge -Sly
Depth to
limiting
factor
> 9~
Remarks:
Boring # /
,c 7 I ,
1114
Ground
elev. 41
Depth to
limiting
factor
Remarks:
CST Name:-Please Print Phone: - /
Address:
el /"9, 122 S- l
Signature: / Date: CST~~-7'/
DOG-UMENT NO. ~I WARRANTY DEED I, THIS SPACE RESEnVED ►OR REGOROINO DATA
II STATE BAR OF WISCONCIN FORM 2-1982;
506430 -VOL
rc~C1STE4'.^~ 0
DAVID ~:.CLkRK and CAROLYN J. CLARK. husband and wife ST,C D;X
Grantorsa Reed The ReoDrd
S EP 3 0 1993
conveys and warrants to ....STEPHEN__.....STOLBERG•.and..CAROLYN.M..... a~ 12:25 p,
..__.STQI.fiEAG,..hushansi and._wi s._as s>~zY~voxshig ~al.......
p>hQp~XL}is_.S'tTs1AZ~gg. Q Rre rAr cd De.lda
- • TO
.
.
.............S1Z....Cr9i.zc___._._......__....._..._.._.•.___.........County. RETURN
. seal . estate in .
the . following .
. described _
,
State of Wisconsin:
A parcel of land located in Govt. Lot 2, Sec. 1-29-201 Tax Parcel No: vi`....
Town of St. Joseph, being further described as follows:
Commencing at the center of said Sec. 1; thence NOD12W along the E line of Govt.
Lot 2 a distance of 238' to the point of beginning; thence W523.10'; thence N0012'W424
thence E523.10' to the R line of Govt. Lot 2; thence SO°12'E along said E line 424' to
the point of beginning.
TOGETHER WITH and SUBJECT TO reservations, restrictions, easements
and rights-of-way of record, if any.
This is. not__- homestead property.
(is) (is not)
Exception to warranties:
Dated this °'-7 day of September....... 19...93.
. DAVID ~p CLARK
•
...................(SEAL) `..............(SEAL)
--CAROLY.... J.--CLARK..........
AUTHENTICATION ACKNOWLEDGMENT
Signaum(s) ay_id- A._ Clark..•.--.....•_ STATE OF WISCONSIN
Gla>woly~a_
$iT-_ CRUX ...................County.
authenticate:th* . y of_-----,~I~_--- Personally came before me this 29th_--day of
-------September------------------ 1s.93__ the above named
ma-
David Glark and Carol na'__.J "Clak
TITLE ETE BAR OF WISCONSIN "If not...............••--............
is. Stags.)
6.CS, W
to me known to be the persons............ who executed the
foregoing instrument and acknowledge the same.
THIS INSTRUMENT WAS-DRAFTED BY
Attorney Barry G. Lundeen
MUDGE, PORTER LUNI) EN S.C: Notary Public County, Wis.
-1 10'-Second- Street,. Hudson-,--W3-•
-540-16
- ------nd- ----et - St._--croiX
(Signatures may be nnthenticated or acknowledged. Both My Commission is permanent. (If not, state expiration
are not necessary.)
date- 9 19--------•)
*Names of persons signing in any capacity should be -typed or printed below their signatures.
WARRANTY DEED STATE BAR OF nSCONSthi Wisconsin Legal Blank Co.. Inc.
ST. CROIX COUNTY
WISCONSIN
1 - L_ ZONING OFFICE
pINIfNUSm■ xr~~6
ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
r - - - - Hudson, WI 54016-7710
(715) 386-4680
August 4, 1994
Eastern Heights State Bank
Currell Boulevard
Woodbury, Minnesota 55125
RE: Septic Inspection for Stephen Stolberg
Dear Sirs:
An inspection of the septic system for Stephen Stolberg's property
was conducted on July 20, 1994. This property is located in the
NE, of the NW; of Section 1, T29N-R20W, Town of St. Joseph, St.
Croix County, Wisconsin. At the time of the inspection, this
septic system was found to be code compliant for a four (4) bedroom
home. If you have any questions with regard to the above, please
do not hesitate in contacting our office.
Sincerely,
Mary J. Jenkins
Assistant Zoning Administrator
mz