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HomeMy WebLinkAbout030-2038-50-100 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER O/y ADDRESS 7Ns% ~du L Tvn/ GfJ; ` s Y~~2 SUBDIVISION / CSM# LOT # SECTION, g_5' T _N-R_:90 W, Town of T7pSa ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM A/ 3 Tor ~ 160o 64L. J$%-r, Cam. r3~ e~ OJ 3 ~o INDICATE NORTH ARROW Provide setback and elevat-ion information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover.. 210Z03d SN I 07i :u39wflN 3SN33iq :20C NO 2339Wngd h 6 p~, = NoI1,KI'I~ZSNI 30 Silva p ape.zb TeuZ3 ape.z0 buzgszxs utagsAs 3o m0gg0g p pT03Tupw/xapeaH 0 gaTgno ZS 'gaTul ZS / .tames butPT?nS sHOis~a~H ~i it s~fr1 1. ff Tango --Z-asnoH ~,Vo• :TTam :moz3 No-eggas S~ : autT • doid gsa~eau 0-4 uozgoa~iQ aouegsTo ugbua'I -=ugpTM H3ssxs xoisaxosav ulos uotgeooZ m.~eTti :aTo o uozgE~adas gEOT3 az .S # TapoS^I za~ngoe3nue .zaug0 asnoH TTaM :mo.z3 Noegqas J 000/ :AgTOedeO pTnb-crj :.z9jngoe3nueyl NOIIVMOaNI XNVI" DNIGgOH / uauHvHo aHna / YNvi ozsass YiS 3ZKN2i31,`ItI LQCAUQtlpert"tofjQAj4 ph. 25.30. Labor and Human Relations %1VXfE S IA&AY TflfSth Stre "Ciounty: Safety acid Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) sanitary ermit o.: Permit Holder's Name: ❑ City ❑ Village f_1 Town of: State Plan D No.: RE St- Jos-pb ev.: Insp. BM Elev.: BM Description: X Parcel Tax No.: TANK INFORMATION ELEVATION DATA A9400112/ TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. ' Septic Benchmark .5f' 64 66 Dosing ' ,ter -o,~ Y, ai Aeration Bldg. Sewer S 2!o fd/~o 7 St/yft Inlet TANK SETBACK INFORMATION St/ Outlet Verit TANK TO P/ L WELL BLDG. Air Ito ntake ROAD Dt inlet Septic NA Dt Bottom Dosin NA Headers <ab ' 9 Aeration A Dist. Pipe S q9 Holding--- Bot. System 90 l PUMP/ SIPHON INFORMATION Final Grade r Manufa Demand K3 Model Number GPM TDH Lift I Loss Friction e m TDH Ft Force Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length r No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS IM SETBACK SYSTEM TO P/L BLDG WELL LAKE STREAM INFORMATION Type O /per,,-- 1 3 C H A System: 61- 1 0! OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s)~ x Ho Size x Hole Spacing Vent To Air Intake Length Dia Length 33 Dia. tf Spacing tv SOIL COVER x Pressure Systems Only xx Mound Or At-Grade S ms Depth Over r Depth Over ~f xx Depth Of xx Seeded/ Sodded xx Mulched Bed/ FreTrttrCenter z7 Bed, dxsaci E ges Topsoil ❑ Yes ❑ No E] Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: St. Jose ,25.30.20. NE, NW, Lot 2, 25t teat EY Plan revision required? ❑ Yes Use other side for additional information./ D-6710 13 05/91) Date Inspector's Signature Cert No. 11LHR SANITARY PERMIT APPLICATION 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 a0 $R@j 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 %A/&/%, S j` T Q, N, R ® E (o W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # an x 5 ;H Sim CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER A 15911989- V 7 3 . TYPE OF BUILDING: Check one CITY NEAREST ROAD 11 ( ) ❑ State Owned VILLAGE ❑ Public 1 or 2 Fam. Dwelling- # of bedrooms 3 PARCEL TAX . NUMBEHIS) III. BUILDING USE: (If building type is public, check all that apply) -20-349 d O 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. DQ New 2. ❑ Replacement 3. El Replacement of 4. ❑ Reconnection of 5. El 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 L,i REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION " ju 0 41qc6i 5;Z Feet 16,V- Feet VII. TANK CAPACITY Site in allons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New istin Gallons Tanks Concrete structed glass App. Tanks Tanks Septic Tank or Holding Tank -X~ I Ll L 1 0 El 1 1:1 Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plum r Signature: No Stamps) MP RSW No.. Business Phone Number: s3'" 3 Plumber's Address (Street, City, State, Zip Code). IX. COUN /DEPART ENT USE ONLY ❑ Disapproved Sani ry Permit Fee (Includes Groundwater a e h Issuing Agent Sig tur No Stamp ) Approved El Owner Given Initial Surcharge Fee) 14 1 Adverse Determination 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 INSTRUC'MONS 1. A, sanit ry permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renew4li any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions tc this permit must be approved by the.pern',it issuing authority. 4. Changes in ownership or plumber requires a Sanitary Perrnit Transfer/Renewal Form (3 [ 0399) to be, submitted to the county prior to installation. 5. Onsite sewage 4ystems must be properly maintained. The -2ptic tank(s) nrr .;t be pur,, r - Incensed - pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage systern, contact your local code adr!i istrator-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 acid 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 _~oielhng. 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, i.-connection, or repair. V. Type of system. Check appropriate box depending on system type. VI. AbsorpVcn system information. Provide all information requested in #1-7 VII. Tank 4iK,r oration. Fill in the capacity of e%,ery new aid/or exiS -ik. Jst thz total ; , liar of tanks and, manufacturer's name. indica.~ prefab or site construvt J ar•d tank material , ini- f,)r all septic, pun.p!siphon and holding tanks it:is system. Check ex-P r n..;,i:al approva; o ir,k.s received exr:er:rr, -nl,al product approval from D11101 VIII. Responsi6-ity statement. Installing plurnher is to fill in name; hi « ve nt?e~" with a+ - orwfix (e.g. MP eV J address and phone number Plumber must sign apr,~;c:ti on t in. IX. County/Eepartment Use Only. X. County/Ue:.artment Use Only. ^.)r7 n And specifications not sr~a.'ler than 4'/2 x 11 inches mu-7t 1:~ aubm tt3< t th r oui ty. The r'.=. ~iLa. ;_!!ig the folio.,virg: -V, plot ?5an, drawn to scale or -vile' c,.n din,,?- ti=,,n of `ank(s) or other t.Fri n-rtent tanks; building -e0:., wa,:.,.. service.; St:7Ir! a 4 thaS; l?Urrrp or siphon t$i~kr:: distribution bGxeS Si.+i: )trs,r` +uStE?i(i'< rN.~,,r,o~. ?system arras,; JYr!d 'he location of the buiPr' ,,ifE served; 9) horizontal ar=;< v a . _ lpv/ i?ice C) complete specifications for pun•pz and controls; close volume; o-lt vat )i' , ,°ference, Iricki. ;i loss; pump performam„e curve; pump model and pump manufacturer; D) cross sec', on of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) aH sizing information x:, - - - - - - - - - - - - - GROUNDWATE R SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can off=ct groundwater. The monies collected throng 1.1L-. s:~rrharges arr.:~se~~ >r crc. water contamination investigation"nd estabJishn e-n,.'•.-_f Stalerarc~,-. - SBD-6398 (R.11/88) AVO O D Z <o~ 6• 71- of •f loq s ysren 7E~ . 98. sz q 5 1 na ~ dy ct,100 o 5 foP s ~4fa prpL ce 0 n ~ m b CALF- yo' J OuTH vE dOT S?A1cE ),?AWIIV& FoR, S- 6-3G O)PJ wl.,v6- f3~: 13 9 r ;(S. 71f Sri 586 OAec, c l V1,640 r/? Hoctc,~'o~v a)l'. yo 8oZ Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 5 Labor and Human Relations Division'of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code ' COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but P-V ©!x 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. Z03 9 70 APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPER NER: PROPERTY LOCATION ~ GOVT. LOT 19r- 1 /4 f✓lJ 1/4,S ZIT 3 v N,R Zv f(or) W PROPERTY OWNER' JS MAILING AODRFqs-J # BLOCK # SUBDME 0 CSM # ? Z 5 ~v- 3, rv CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE 2rOWN NEAREST VD C S.~ ~O (!z) r~~~ ~ 33 5 7 5 K New Construction Use [c Residential / Number of bedrooms 3 ( ] Addition to existing building [ ] Replacement [ j Public or commercial describe Code derived daily flow s gpd Recommended design loading rate e 1, gpd/ft2-trench, gpd/ft' Absorption area required ~v- bed, ft2 .6& 3 trench, ft2 _ Maximum design loading rate bed, gpd/ft2 ,g trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site nsi erations - Parent material `i Flood plain elevation, if applicable r✓ lll It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL. HOLDING TANK U = Unsuitable fors stem [z~,S D U .CAS ❑ U ca~s ❑ U PcS ❑ U ❑ S 69I! ❑ S au SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench ;tK 4.0 C2 Z_ 10n y7l _ z axe `y~ l~ G ~5 z n~ S,( rn 4L Ground - 9Z eev.Z Depth to limiting c faCtOr t Remarks: Boring # 1144 , 4, L< 2 = I 2 mss Ground ev. 7f 00 g Depth to limiting Remarks: CST Name:-Please Print N - Phone: zln~9 Address: S4017 Signature: ate: CST Number: PR0,PERTY0WNER2gf~1 SOIL DESCRIPTION REPORT Page of, -3. PARCEL I.D.# 0 3C')- zn 3 9 30 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft /y] in. Munsell Ou. Sz. Cont. Color Gr. S&zz.. Sh. Bed ITmrch 19 )1Z -5/4 2 rY7 Ground 17' A/ z S/ zrn /v► ~c~J elev. 5 z /oL ft a '1/6, Depth to limiting factor Remarks: Boring # D Zrj'~ Ste' J ~o Ground 10 ye e S r lief Depth to limiting Remarks: Boring # p 414 Ground _8 O elevd3 Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) ` STEEL'S SOIL SERVICE i3s4 z©~-g,,gt,~ Gary L. Steel C.S.T. 2298 i WI 54017 MPRSW-3254 I -r~ ~-S O Y-) New Richmond, 246-6200 NC~ y~ N ~ y~~. s- ~~o,r-moo 0 lr• L Cornte oo~ ~I+rnr~`~~~t2 47 v 3 or•y 46' g .5 G' y • / W FILED g JUN 0I 19921, JAMES O'CONNELL 48401'3 Rye War of Deeds Cma C-0 W1 N CERTIFIED SURVEY MAP N v.° Located in the NE' -4 of the NWi and in part of the SE! of the NWZi v all in Section 25, T30N, R20W, Town of St. Joseph, St. Croix County, " o Wisconsin. LEGEND t z o B - Aluminum County Section Monument Found ~ d co • - 1" Iron Pipe Found W 4j p o - 1" x 2411 Iron Pipe Set, weighing 1.68 lbs. per linear foot , t f ` o .o - Existing Fenceline OWNER - Roadway Setback Line ~/~~lh• , Ken Hill 0 - Previously Recorded Bearing 234„ „ I 1 .gty. Rd. E b N Houlton•; )*1 54,082 m c ro NW Corner of UNPLATTED LANDS Section 25 N} Corner of ~o North line of the NW} Section 25 A` S880491504 S88049' 5011W 1291.94' a 1291.94' -*---"-7 4 I Ui } H a} 15.00 Acres Inc. R/W 0 01~ 'i ~9 CD 653,396 Sq. ft. Ln` ~3 14.79 Acres Exc. R/W - - ~ } } o 644,125 Sq. Ft. 221.78 1 v N88049'50"E 1293.13' loo I ~,I IIII 1266.62' 26.•51' o w ~ ° N 2 W I' r-c, W tM I N 15.00 Acres Inc. R/W Lps~~ U;~, ~ .r E _ o.o O F r c 653,402 Sq. Ft. cn I _ ..Qa H o U.) M = N 14.67 Acres Exc. R/W I 639,226 Sq. Ft. C14 Q) S8804915011W 1294.31' o v MI -1 LOT 1 1264.69' - z' 29,62' 0o' CO W 0 ►a w C.S.M. IN o o ro ri' - m Z-- 3 - PINE VIEW TRAIL N O V. 6, P. 1517 O$ : o 15.71 Acres Inc. R/W o r > I 684,453 Sq. Ft. Hl - --.o - 15.09 Acres Exc. R/W o v I d`6 090. g651, 358 Sq. Ft. SHED 'Go ~ 1 LOT 2 o~ S2~ rsHEO a } - c C, SB~~F I I U C S_M_ IN I \ hr~ \ 'HOUSE V. 4, P. 10621 S2500710 11W 10.00' 40 3 shy, I a°~ , d~ \ ? ~SBh 1 O 1 H I , 3.n. ~ qC a ✓ tc1s o ~ 80 t~ I 7 N1H ^ 4 4, VV \ v(: ~G ti ~N`°lA \ A • ► ,,,n d as ~ ro g x" N nr ff~.~1 \ a tv n < C3 co SCALE IN FEET R F e r1't 0 200 400 600 M Th;, 4-1rur int drafted by Fran Blesk cek Proj. No. 80'-06-192 AUME 9 PAGE 2487 STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER 1\ t, _ OniLijo-r-, : SU MAILING ADDRESS 1 Z S 11-1, .XI ihd ° ~Oe~ d (Ld - S' PROPERTY ADDRESS J 3 2 (location of septic system) Please obtain from the Planning Dept. CITY/STATE 1l 4 a,, I PROPERTY LOCATION 1/4, 1/4, Section z.s T 3 N-R ~d W TOWN OF 'S4 .l n tom, p h ST. CROI K COUNTY, WI SUBDIVISION k,jI LOT NUMBER CERTIFIED SURVEY MAP 4 013 VOLUME 9 '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.,.Whaat-you put into the system am affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croi County residents may be eligible 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 -estricted 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 expir on date. SIGNED: G J DATE: 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 1 r\ EU G. Location of property l/4 1/4, Section T-31LN-RAW Township Ma.. ing address 1.3~e y 2 s T~ .S Address of site 3~ T~ ~i .auc U~ai~ Subdivision name SklAi GSrn Lot no. Other homes on property? Yes No Previous owner of property Total size of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? 57 Yes No Is this property being developed for (spec house) ? Yes X No Volume q and Page Number )N7 ~ / 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. -.5 o n111L , 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, ana the same has been duly recorded in the office of the County Register of Deeds as Document No. .Sad l 2,q Signature of Applicant C pplica t Date of Signatur Date oli: Signat re r ~i DOCUMENT NO. ~i WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA it STATE BAR OF WISCONSIN FORM 2-19821 500124 1 j o ~.Q1p_~~-_____ REGISTER'S OFFICE I i ST. CROIX CO., WI ...YAr=th.R._..Hil,l.. and. Vicky L,---Hili husbarxl -and-,wife Rec'd for Record ......i aviduail,y._.azld. each in. their, .owr>...ri.ght JUN 3 1993 at PZPAOSW :30 AM conveys and warrants to .~4..~V...Ferqus0n_alK_,Dawn..C._.B--___.-_-.... . Xrguaan,..husband. and_.wife,_as -joint..tenants of Derda _ ( $ Wertheimer, _ 430 Second St. P. O. Box 108 . -Hudson, W1 54016 the following described real estate in St.- cmix..................County, State of Wisconsin: Tax Parcel No: _030-2038-50-100 Iat 2 of a Oertified Survey Man recorded rune 1, 1992 in Volume 9 of Certified Survey Maps at Page 2487, as Document No. 484073 in the office of the Register f of Deeds for St. Croix County, Wisconsin. I~ it I~ This 1S_ not........ homestead property. (P6) (is not) tion to warrpntiys: 70(£I4 M WnM AND SUB= TO any other easements, covenar`.s, ~ excep II reservations or restrictions of record, if any, but this shall not be aemed to extend anylj such other recorded enctmlblrances beyond the term established by law therefor. i' i Dated this .....28 - day of.. - - 19.-93 i ~ -(SEAL) - - - .............(SEAL) ii 00/ Kenneth R. Hill -------(SEAL) - . ......(SEAL) ' _ Viclsl' L. Hill - . . . l AUTHENTICATION ACKNOWLEDGMENT ;I Signature(s) STATE OF WISCONSIN i Vicky_ L Hill 93 County. ~I 19.._... Personallcame before me this ay o i! authe ted ___da l...... ____Y-------------- 119 the above named it - G . . (lhrin a TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by 4 706.06, Win. Stats.) to me known to be the person who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY I~ Atty'--Hugh H,- (Uin ------4.'1Q_.AW-.,S.t,.i--Hww9Ih-M-54016---•--•-----•--- Notary Public _County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date- 19.-.......) 777 ~Nam* of persons signing in any capacity should be typed or printed below their signatures. 1 ~ .i WARRANTY DEED STATE BAR OF wisoaNStN Wisconsin Legal Blank Co.. Inc. r,M u y _ , . Milwal~kpn Wie -in /