HomeMy WebLinkAbout030-1094-80-000 t
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER
ADDRESS 7/ (v L L'/q S`
at) 5eA,- 1611
SUBDIVISION / CSM# ?j~~P /'T 1 LOT #
SECTION T N-R W, Town of .5%
Jv Csm 3~7~'
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
I
/000'5 '
N_~
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
s
BENCHMARK: A CAA-9s fOAD 4'L /OO,d
ALTERNATE BM: fl)D ~ ~1t;; ZPAGL Z :--L- /OO-15-,
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Liquid Capacity:
Setback from: Well House Other
PaIRP cturer Model# Size
Float separation Gallons
Alarm Location
i
SOIL ABSORPTION SYSTEM
Width: Length ~ Number of trenches
Distance & Direction to nearest prop. line: 6? Uy4F-S ,/eau ,4&g /?v,Fb
Setback from: well: House Other
ELEVATIONS
Building Sewer ST Inlet; ?6,10 ST outlet Q
PC inlet
Header/Manifold 27-72 Bottom of system
Existing Grade Final grade
DATE OF INSTALLATIO
PLUMBER ON JOB:
LICENSE NUMBER: 3.2.615
INSPECTOR:
3/93:jt
L %1,QertUtof4 melph. 32. 30. ~A SE ietG ~ST M East RO ounty:
a Labor and Human Relations INSPECTION REPORT
Safety and Buildings Division
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitaryermit 010 Ix
No.:
Permit Holder's Name: ❑ City ❑ Village 1~ Town of: State POW
, nsp. BM Elev.: BM Description: Parcel Tax No.:
TANK INFORMATION ELEVATION DATA A9400111
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic S N C. p' Benchmark w,
Dosing (os cv,95~
Aeration Bldg. Sewer
Holdin St/ FX Inlet 96,16
TANK SETBACK INFORMATION St/yi outlet
Verit
TANK TO P / L WELL BLDG. Airito ntake ROAD Dt Inlet
Septic NA Dt Bottom Yl*
Dosing- A Headed
Aeration NA Dist. Pipe
4old ng Bot. System A (1 ~ 12,
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand
716,
Mode er
TDH Lift Fr lc system TDH Ft
emain Length Dia. Dist.Towell
SOIL ABSORPTION SYSTEM
BED/TRENCH width I Length No. Of Trenches PIT No. Of Pits I ia. Liquid Depth
DIMENSIONS 5 DIM N
SYSTEM TO P/ L BLDG WELL LAKE / STREA ING Manufacturer:
SETBACK
INFORMATION Type O .ua CHA nJ p 3 o e Number:
System: tf ZSS,cJ 0 OR UNIT
DISTRIBUTION SYSTEM
Header / Mtrntfol-T- I Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
i ~C/
Length _jc Dia- Length Dia. Spacing i/1
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade S Only
Depth Over Depth Over xx Depth Of xx Seeded / Sodded
Bed /Trench Center -~j Bed /Trench Edges T Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: St. Joseph.32.30.19W, NE NW, Old "EH East Roa
J w -
tall
~Q~ ivC_ may/ t ! (Q C f-vt r, a ~c t^t ' f
Y3 /I
Plan revision required? t e No
Use other side for additional information. ~O
SBD6 10 (R 05/91) N Date Inspector's Signatur Cert. No.
~
JE~SANITARY PERMIT APPLICATION CO
In accord with ILHR 83.05, Wis. Adm. Code j do lX
STATE SANITARY PERMIT#
-Attach complete plans (to the county copy only) for the system, on paper not less than
8% x 11 inches in size. ❑ 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 INFORMATION.
PROPERTY OWNER PROPERTY LOCATION
RON S Y4 -Y4, S -3 T30, N, R 1,9 E or W
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
Y~7 6 rw. &1 *4 ( I IVA
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAM NUMBER
7 - U•3 7g3
11. TYPE OF BUILDING: (Check one ) ' ❑State Owned CITY NEAREST ROAD
VILLAGE ck5
TOWN OE: 6;
❑ Public ~1 or 2 Fam. Dwelling~# of bedrooms PARCEL TAX E
111. BUILDING USE: (If building type is public, check all that apply) 030 - 10911 -r9_0
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 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 in line A. Check line B if applicable) ,
A) 1. VW New 2.E] Replacement 3.0 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 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
t~' REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
50 E63 670 8 ~ Y, Feet Feet
CAPACITY
VII. TANK 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 -17 M I F]
Septic Tank or Holdin Tank 000 (~✓EE
Lift Pump Tank/Si hon Chamber
Vlll. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plu r Signature: (No Stamps) - -PPRSW N Business Phone Number:
D T 0~ ~ 4" --y 46 ,5 .
Plumber's Address (Street, City, State, Zip Cod :
VALLgrx 1 ~01"
Se 7-
IX. COUNTY/DEPART NT USE ONLY
❑ Disapproved Sanitary _Permit Fee (Includes Groundwater a a su Issuing Agent Sign lure (No Stamps)
Approved El Owner Given Initial fCi'( y/~} Surcharge Fee)
Adverse Determination r7 " 10 IA
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
> I
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sa'hitar•y permit may be renewed before the expiration date, and at the time cf rene%~d any new
criteria in tl-e Wisconsin Administrative Code will be applicable.
3. All revisio,r; to this permit must be approved by the 1;em,-it issuing a-Ithority
4. Changes ir. -.rtvriership or plumber requires a Sanitary ? mit Transfe,/ Fenewal Form 8 I <sggj to be
submitted tc, the county prior to installation.
5. -Ortsite ser ti?-'ems mVst be properly maintained s,ptic tari0s~.) mr,st be puin$ fed -'licensed - -
pumper whonever necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, coritaci your local code adr7 ~nistrator 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 nairne and mailing address. Provide the legal description and parcel tax mimber(s) of
where the system is to be installed.
II. Type of buddi,-)g being served. Check only one and complete of bedrooms if 1 or 2 Family Cwelling.
III. Building Use. If building type is Public, check all appropriate boxes thai apply.
IV. Type of permit. Check only one in line A. Complpte line B if permit is for tank replacement, :!connection, or
repaig
V. Type of system. Check appropriate box depending en system type.
VI. Absor^t'r:n s r In^m information. Provide all information requested #1 7.
VII. Taal rs 3tion. Fill in the capacity of ;very new and/or existin,; w:. ;;sl tt e iota' „wig .ier of
tanks ~ ' anufacturer's name. Ir)dicate prefab or site const; u.~ i ar,.- lank marten i.~l. + ,n r• for all
sep /3!phon and holding tanks for this system. Check exs+.rir!u:rl:~l approaa, _An' eceived
s: , a al p, nduct approval fror-n DILHR.
Vill Nesoean~z!r irity statement. Installing piumter is to fill in name, iirrry n,.-rnber with a,jpre~i)t j- prefix (e.g.
k1P,, € t<:. ..ddress and phone number. Plumber must sign app!lci t inn form.
IX. ;cunty% ep4r;ment Use Only.
X. cur;?y% sk>,r!m4nt Use Only.
u:arse;rs~°,. ,d i-yin and specifcst;ort clot smaller than 8'/, x 11 inches m:r>+ + t 3 ot,r,fy. Thc~
r r:ns r rte.::;de the followi ; 7. - : plot plan, drawl,, to scale or `with ^•n r,
h air+,r~, ,eptir tank(s) or, (.,her treatment tanks; building sY r.. , i +te service;
Sire~pr+:.:+4 + taK;t-' < --rump or s!phun tanks; distribution boxes, soi, ab`-•, ,t.r>t= rar;t sysic+n"?
ar^n > ,,cc j i of the building ser'.-` cl, 8) horizontal
C) cornpiele >Nti. _ , ions for pumps and controls; dose volume: ie.vat or, difference:, tr ic[i io ;s; pump
performance curve; pump model and pump manufacturer; D) crux s sect on of the s&! absorption system if
required by the county; E) soil test data on a 115 form; and F) all .!zing information.
I''
GROUNDWATER SURCHARGE"
.
198 Act 41., ,nc~:~c,e~d .n., c:°eaue, i of .~urchar_Ir,, {'ells for r.rr a,:~r; o,°
r~r,.ria ,+r r - . c .e vfhici, flan r r,,ct c ;rnr4w °ts r.
The 's s. '.Fd fhrojq. !f-,w s?;rcha.~ ;l
wrier i.oi, Jgn-,ination It•t;F~r ~r'stC)tl am.) yStal1. i;1 t .t.i r'; cf
SBD-6398 (R.11/88)
. ys
iI
w
Ql-
s~ 2
1
I~ aa iU
? _J ~D O
2.1a i
\ ; 1
f
~a o.
,
~ v
\AN
/ J
A'
P
w
.~/~P~fovese,: ~ a 30
Ito
DAWAf
~ to ' .1 e S• ~ ~ .
SYS em 46~: 4. no
AW/Af& /~aR (-6-9q )R,4 aw / 13 y .
I?o v T#06 .vEs
aniYo
~3y°~~ V qp ' N 1 ~ '
7c C
J
S ti b I
00 ~ 1 ~ ~ W
r
41,
a
t M 14
i +d vl
r i I Q AQ
~ 1 I I , ~J
l I ~ Z O C
y~ 1 O
to
~
, x
J 1 i UIL
1r
N
a
Q
~ V
J t
,a j~PRov~,o 30 4
Gav~/L
/f M
a
• S'T~' ~ L, , 3O
pR~tu~iniG /-oR ~ d -6-9Y ORAcvi,~tG- /3 y '~G~~K~-~
/?O)! 7lfo~iv~rES
V/& acD EAST. 586 v.a~cC y U~~w T2
Nu~svna !,U/`- 6'~« so/"i~~scr GUi - Syo~s'
~ ~~oS
4t6 o~ EA5:11
,I
,~p• x
I,
f oa
r
i
'WisconsinDepartmentofIndustry, SOIL AND SITE EVALUATION REPORT Page~of3
a r am Human Relations
t)i. son of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
S ; Ct~ta t x
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.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERIPWNER: PROPERTY LOCATION a
NO E ry E GOVT. LOT N C 1/4 Iq W1/4,S~'Z T 7jd N,R /9 E (or) W
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY E:VILLSkE OWN NEAREST ROAD.,
New ConsVuction Use Residential / Number of bedrooms 3 [ j Addition to existing building
j j Replacement (j Public or commercial describe
Code derived daily flow L'/SO gpd Recommended design loading rate O 77 bed, gpd/ft2 Q ~ trench, gpd/ft2
Absorption area required bed, ft2 S6 3 trench, ft2 Maximum design loading rate (:)--7 bed, gpd1ft2Q.jtrench, gpd/ft2
Recommended infiltration surface elevation(s) W~ • : ~I~F~ 9~ 3o ft (as referred to site plan benchmark)
Additional design / site considerations Lr~ 6-1 - qg c»
Parent material Flood plain elevation, if applicable ft
S = Suitable for system CONVENTIONAL MOUND li. _.'.)UND PRESSURE AT-GRADE Y TEM IN FILL HOLDING • K
U= Unsuitable fors stem 9)S ❑ U S❑ U Ll,S ❑ U 23 S O U S O U ❑ S U
SOIL DESCRIPTION REPORT
3oring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends
t. -i L I v~ C Z 4.4 3
Ground -7~ 3 4 •r
elev.
10-ofI. 7'-.11?_ 3 r+~ m 1 1 Q.7 K4.8
Depth to
limiting
factor
9 ai:
Remarks:
Boring #
A Q-i5 /0`>' 3! L, l r rr~r C 'e- O .A 3
A-a Ground 41-46 7.S 3 S l n,
elev. Q-~ nA OX
Depth to
limiting
factor
~o•Og
Remarks:
CST Name: Please Print w (~y 30tov:5x0ty Phone: 37EK-
Address: U •.(r` _ Cl ~ J ) `t
S' nature: l'C~ 1• Date: CST Number: !
IROPERTY OWNER SOIL DESCRIPTION REPORT Page 4 of S
AR,CELIA# NE NW B'Z -19
Depth Dominant Color Mottles Texture Structure Consistence Ba.uxi~ry Roots GPD/ft
Boring # kri,z in Munse I Qu. Sz. Cont. Color Gr. S::. Sh. Bed ranch
-i3 /4Y 3 r, ce n~ r o.A S
Ground 38-70 7.SY? -3/3 n, h, r L O l $
elev.
Cft. 0_,~7 y,~3 3 S .z. o? n$
Depth to
limiting
ctor
.-ZS
Remarks: ,
Boring # A i
I
19-41 ,2 q- S + Z (cif;' ~r r-
Ground tvz.5f
L
Depth to
limiting
factor
Remarks:
Boring # ~ s
_ L ! n, c r
A O.l~ .16ye- 3/e
~t K 1,3 -
.s 4 ,M c 101 - k I
Ground
y lift. $ -i!l 16YR
Depth to
limiting
factor
9.2.5
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(R.05/92)
s
A4,C 3 F 3
b ~ ti ~ ^I ~Nw 32-3c 9
-Z~7
rL,
r-
2
IVY
y ~ O
m ► ~
I A Z 7b
El rz:
V~ 2s
I
FORM NO. 985-A
N.C, MI. C.nparry ;y
V
m Pit IT r% O
APR 2o
AwFS o, 1979
5F
CERTIFIED SURVEY MAP %`w,fco&niy'
N NW 1/4 - SEC. 32 9 T 30 N 9 R 19 W Z
ASSUMED BEARING
ALONG " LINE FHSEC. 324 NI/4 CO R.
S000- 07-42 E (S01°-36'-15"W) CO. MON.
/ 2 8.70' 100 50 0 25 50 75 100 SEC. 32
QI Rio SCALE IN FEEbg • •
0
to 'o pF1AoV 519" 49'.Jeff
C. T 41
w
o \ w- w ty Q~P~ o f o
m
p .(0. s N?° 82 S O.
-3/1
W
, 99 4g, 4
5
380 9"0' l9 0~ 49-42„
'\o' OD
W z
N O
_ o _
5 5^ \01 T
6-56
PO• I~`i) u` •2,r.► ~ cn
Wo o
~ s~ LOT ( _ Co: rectiori
P~ c .P~ c • s -4 Vol. 5')c; P, rc 557 z
W
3? 4.9 3 A.
N ° 3.05 A. f:XCLUDING R/W z r
DRIVEWAY <o O %°o X05 m
ACCESS IS TO
BE LOCATED ~
ONTO THE TOWN
9
ROAD o
m O o
LEGEND °o, S 1/4COR.
CO. MON.
SEC. 32
' - - 3/4" IRON PIPE FOUND 0 110 0- - - I"X 24" IRON PIPE SET, O THIS INSTRUMENT WAS
WT. 1.68 LBS./LIN. FT 0t.,~" /N4P 10'-57"E DRAFTED BY GCS
- 90° R/W WIDTH \ F/U 8.75' cnA 78-83
~toaies~sraa~
~AJa„ A~ \ S
.~ty4 Q IV,
"fte
\
"N J, MAR 21 107 ` 0,s
GENE C.
sliArrE SI. CA01x cou,, i ; \ F
S-1325 Su COMP :EHPNSIVE PARKS PLAI miNG r, A
HUDSON AND ZONING COMhNiidb \ \ o
WIS. d APPROVAL OF THIS MINO„Lr
NaK+``•~ C pej S NOT -,.Ct,{ m
MEAN , _
• N_
w~;fl,gf d 4~~,a0o ;NG -SITE E OR SE;`,;,
TO I J
CURVE DATA TABLE
CURVE RADIUS CHORD CHORD CENTRAL TANGENT
N0. LENGTH LENGTI-I BEARING ANGLE BEARING
1-2 239.41' 143.14' S 17'31'-23"E 34-47=20" S 00 07'-42"E
VOL. 3 Ptl(iL 783 3-4 1064.38' 354.96' S440-3d-57"E 190- 11'- 50" S 34 55'- 02"E
Cs;t'1'IFllsU SUiZJLY 1`7llf'S 5-6 1023.13' 105.31' S 3752'-03"E 5~ 54'-01 S 34 55'-02"E
CROIX COUNTY, WI.
7-8 1014.38' 198.94' S 46 26'-42"E 110 15'-17° S 40-49'-04''E
V01=0 3 Page 763
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER Q6UA\ (1-F6C< f4ES
MAMING ADDRESS CCU. 1 ~ ~ ~ ~(-l D S 6 K) W l ~ ` 6 ~b
PROPERTY ADDRESS L 1~ } ST ~~CJ Wt ~4 6 6 ~v
(location of ~~se~~ptgqic system) Please obtain from the Planning Dept.
CITY/STATE ~UD 3 610 W t S Ca x~S 1 I-1
PROPERTY LOCATION 1/2, N 1/4, Section 32 , T U N-R W
TOWN OF ST. CROI K COUNTY, WI
SUBDIVISION LOT NUMBER
CERTIFIED SURVEY MAP 3563 q I , 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 disp'l system.
St. Cro' County residents may be eligitne to receive a grant for a maximum of 60%. of the cost
of rep cement f a failing system, which was in operation prior to July 1, 1978. St. Croix County
accepted is 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 zndition and (2) after inspection and
pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum.
l/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:::~~
I
DATI-
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 :4~00 PVC L'! \ t t U I f~l S
Location ~f prokerty 1/-L ~ W 1/4, Section T_Q N-R c _W
Township ~0 0, Ep" Mailing address
Eris7 WUb Sal,) W IS fartS« S`f0( ,
Address of site 41~ GLb ~.[s'` ~nsr ~umS6w UJ(SC 5-g6c(~
Subdivision name I~ k Lot no.
Other homes on property? Yes__X_No V. _
Previous owner of property j(.{~rvk~-S F61TI cc( iktoA (CAQ~ V . FAncLGI
Total size of property
Total size of parcel C) A 1
Date parcel was created MAQ Z I q`-1
Are all corners and lot lines identifiablE:? Yes No
Is this property being developed for (spec house)? Yes No
Volume_ and Page Number ~J 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 (AM) certify that all statements on this form are true to the
best of my (ww) knowledge that I (-ms) am (5m) the (it) 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. _ 4142-7., , and that I (ww) presently
own the proposed site for the sewage disposal system or I (-e)
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.
AIA
f~
Signature of Applicant Co-Appli nt
Date of Signature Date o:= Signature
i
' - III i• nOCUMENT No. WARRANTY DEED 1IIIS SPACE RESERVED FOR RECORDING DATA
_ t STATE BAR OF WISCONSIN FORM 2 1982
4'742'76 91`7 453
von PacE REGISTER'S OFFICE
- -
ST. CROIX CO., WI
Thomas_M. Fatt_icci and Karen V. Fatticci, ~I
II - - II Recd for Record
.-husband and wife_as point tenants
-
- - - - - - -
at 2 : 00 P . M
_ - - - - -
I!
c•onvevti and warrants to -R9ri~~.C1 N-...Z'r10.~1'lI"l,eS- -
W Register of Deeds
- - -
- - - - - - -
- RETURN TO
-
- iil
`t . CrOlX ---Count i
the following described real estate u1 y, - -
i i II
State of Wisconsin:
Tax Parcel No: i
Part of the N 1/2 of the NW 1/4 of Section 32-30-19
described as follows: Lot 1 of Certified Survey Map filed
April 20, 1979 in Volume 3, Page 783.
This Deed is given in fulfillment of that certain Land Contract ~i,
dated August, 1990, recorded August 21, 1990 in Volume 879, Page
201 as Document No. 461611.
I
it
is not
This - homestead property.
(is) (is not) j
I
Exception to warranties: easements, restrictions and rights-of-way of
record, if an,y.
Dated this _ 24th - - - - - day of -September - - 19-91
- - -(SEAL) - - - (SEAL)
Thomas M. Fatticci * Karen V. Fatticci
- - - - - - - - -
------(SEAL) _ - - (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE Oh' V~I$
ss.
~~l y
• Count
authenticated this -------_day of----_----.-_-------------- 19.._-_. Perspnally came before me this --..E'~Y.......day of
l=' - 19 the above named
c: c:. ~4 C
TITLE: MEMBER STATE BAR OF WISCONSIN
-
(If not-
authorized by § 706.06, Wis. Stats.) to me known to be the person S____------- who executed the
foregoing instrument and ac
MARGERY MILLER
THIS INSTRUMENT WAS DRAFTED BY
NOTARY PU~I.IC
1VICOLLET COUNTY
Kristina 0 land Lundeen
MY
Attorney at Law ~`_`f _ COMMISSgNExP~aESi69e,
- - - Notary Public IJ , !fit County, +J
(Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration
are not necessary.) --ti -5
date: 19--------•)
-Names of persons signing in any capacity should be typed or printed below their signatures.
j
WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc.
FORM No. 2- 1982 Milwaukee, Wisconsin
i
Parcel 030-1094-80-000 02/18/2005 03:35 PM
PAGE 1 OF 1
Alt. Parcel 32.30.19.344E 030 - TOWN OF SAINT JOSEPH
Current Xj ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): Current Owner
SCHWERTEL, RICHARD J & LINDA L
RICHARD J & LINDA L SCHWERTEL
416 OLD E EAST
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 416 OLD E EAST
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 4.930 Plat: N/A-NOT AVAILABLE
SEC 32 T30N R19W NE NW LOT 1 OF CSM Block/Condo Bldg:
3/783
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
32-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1110/183 WD
07/23/1997 917/453
07/23/1997 879/201
07/23/1997 688/242
2004 SUMMARY Bill M Fair Market Value: Assessed with:
5584 282,700
Valuations: Last Changed: 07/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 4.930 99,000 179,100 278,100 NO
Totals for 2004:
General Property 4.930 99,000 179,100 278,100
Woodland 0.000 0 0
Totals for 2003:
General Property 4.930 58,100 146,800 204,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 145
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00