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HomeMy WebLinkAbout040-1218-30-000 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER C~ ADDRESS ~ d 'co SUBDIVISION / CSM#~P~~ LOT SECTION ~ T -1B N-R 1Y W, Town of % ay ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHiN,100 FEET OF YS EM Wet. yy7^ 7V A V 161, T/ r7~ ~J ti~ T~ 9C..Sa a 30 - CATE NOR AR OW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: 161 !'`fo ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: t,Jee'4r C, P Liquid Capacity: 00r) ~ Setback from: Well 7 Y' House ~2i other Pump: Manufacturer Z64 Model# Size Float seperation Gallons/cycle: Alarm Location :SOIL ABSORPTION SYSTEM Width: S Length S8 Number of trenches a Distance & Direction to nearest prop. line: 61_/ /b/ ' Setback from: well: 167" House -75- 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: 8 - 4y PLUMBER ON JOB: / LICENSE NUMBER: INSPECTOR: 3/93:jt Labor and scoh in Department PRIVATE SEWAGE SYSTEM County:ST. CROIX i Safety and Buildings Division INSPECTION REPORT (ATTACH TO PERMIT) Sanitary Permit No.: ► GENERAL INFORMATION 21 RFAR3 PeH it HpI s N KICHARD ❑ City El Village Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: l /off - cJ'y a s TANK INFORMATION ELEVATION DATA ~i TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark S'v ~ ICJ Dosi g Ob& /,-S-0 /U , _?2 Aeration Bldg. Sewer Hol ' St/ Inlet 97S TANK SETBACK INFORMATION St/ Outlet (p% 99, 6,0 TANK TO P/ L WELL BLDG. Airi to ntake ROAD Dt Inlet Ar I Septic >SC~ 7 NA Dt Bottom Dosing NA Headerh r. Aeration Dist. Pipe ~1 ' „ 98' 3 Holding Bot. System , PUMP/ SIPHON INFORMATION Final Grade Manufur Demand a;v j' 3,,6r Cd~ O~,<J9 Model Number GPM o*o~ c!~°~ ` Hr 8 (47 66 TDH Lift I Friction S stem H Ft Loss Force Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH width Length i No. Of Trenches PIT f Pits Inside Dia. Liquid Depth DIMENSIONS S~ DIME I N SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type O CHAMBER e Nu System: -C re er1r,, DISTRIBUTION SYSTEM Header /Aftw4low= ri Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake i Length Dia. Length 2 S Dia. ~ Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Syste y Depth Over Depth Over xx Depth Of xx ded / Sodded Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes E] No ❑ Yes COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION : Troy-5.28.19W, SW, S7$ ot 11, County Road FF / CS- A Plan revision required? ❑ Yes o Use other side for additional information. I SBD-6710 (R 05/91) Date Inspector's Signatur Cert No. SANITARY PERMIT APPLICATION cou 'DILHR In accord with ILHR 83.05, Wis. Adm. Code) STATE SANITA Y PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than ' O 3 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. PROPER OWNER PROPERTY LOCATION StJ Y. YGd 1/4, S T2.8, N, R /9 IL(or PROPERTY OWNER'S MAILING 7yWArDJD FSS/ 9 LOT# / BLOC 405 Cj IsTCQ VG! CITY, STATE ZIP CODE PHONE NUMB R SUBDIVISION NAME OR CSM NUMBER C/e" V/ eM II. TYPE OF BUILDING: (Check one) 11 State Owned ? ❑ VILLLLAGE : Tro C NEA A, kJ RO F / ❑ Public El 1 or 2 Fam. Dwelling-# of bedrooms -1 RTCOEWL /NTrA~~X N MB C• w~~~ 111. BUILDING USE: (If building type is public, check all that apply) 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 70 Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 40 Church/School 80 Mobile Home Park 120 Service Station/Car Wash 50 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. IU New 2. 4 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 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 12. 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) 7 7.84> hIVWION ~Z50 7d 70 •7Fs ?"Z 94•50Feet e>> 8'a Feet VII. TANK CAPACITY Site in allons Total #of Prefab. Fiber- Exper. INFORMATION New i din Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks strutted Septic Tank or Holdin Tank Lift Pump Tank/Siphon 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): Plumber' Signature: (No S ps) MP/MP$S1pC1V0.: Business Phone Number: ir>' ~Z2 7/5 77 3zif~ Plumber's ddress (Street,/City, hState, Zip Code IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sant ry Permit Fee (Includes Groundwater Date Issued Issuing Agent Sign ps Approved ❑ Owner Given Initial I ~v C-Surcharge Fee) Q- 0 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 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. Onsife 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 3% 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; close 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) Joe TIMM EXCAVATING Z SHEET NO. ~ OF Route 1 Box 192 Q WILSON, WISCONSIN 54027 CALCULATED BY ~rl" \ DATE - v~ (715) 772-3214 (715) 386-5443 MPRS #3224 WI MPCA #696 MN CHECKED BY DATE SCALE ' . ~~ny-ems ~ I ' ..........5 : . < , . r . . iQ;... U.. T _ . N~ . 4S . b ei" D i rz S© 61 l i 6 /d $~1 = -PDT i ,fQ/l _Z _ GS , o..' ~ , . . PRODUCT 205-1 ~ Inc. Groton, Mass. 01471. To Order PHONE TOLL FREE 1-80225-M JOB PI.<Cf~Lcdd T'oG/Bl/ TIMM EXCAVATING SHEET NO. Z_ OF Route 1 Box 192 WILSON, WISCONSIN 54027 CALCULATED BYF 'f 'Opfo" DATE (715) 772-3214 (715) 386-5443 MPRS #3224 WI MPCA #696 MN CHECKED BY DATE SCALE I _ y V ` R ` off... TF~ /,4$ PRODUCT 20.5-1 a Inc., Groton, Mass. 01471. To Order PHONE TOLL FREE I-B00-225-M Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 3 Labor and Human Relations Division of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY sr, c,0o,•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 LD.,If dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION '!>R - ?,ecA k RD C, I4 A p LE y GOVT. LOT S w 1/4 SW 1/4,S 5' T 2 N,R 17 E (orc PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM If IqO u 1&ar j?D • C1 tlle&) 50/3 CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE @FOWN NEAREST ROAD WIS. Ij unSoN SLIOI& cars) 3$6- 5-Ll) -f'Roy cry. R©. F~ ( New Construction Use ( Residential / Number of bedrooms -3 (J Addition to existing building Replacement [ ] Public or commercial describe y5o ~0 0 Code derived daily flow gpd G yY.- Recommended design loading rate bed, gpdtIt • g trench, gpd/ft2 d Absorption area required bed, ft2 7 trench, ft2 Maximum design loading rate bed, gpd/ft2--trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design/ site considerations u56' -1-ISE0c"S OAJ Slops- col DRo P Sox D PS 7-d i B u rio A Parent material SC-5 7y 5,}n RE- :s Flood plain elevation, if applicable A/• It S = Suitable for system CONVEWQ U L MOUI IN•GRyND U ESSURE AT9-g- GRDE ❑ U SYYSTW IN FILL HOLDING TANK U = Unsuitable fors stem ld'S MS ❑ U LiJ3 ❑ as ❑ U ❑ S E-It SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft j Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Bouxtary Roots Bed much ,.r A f Ale -•7 io /Q -Y2- s., t, s~k n~.f R . G. s ~ f S 6 /G /o YR Y`/y T -P bK M-f P_ CS 2..f . y S Ground C G -yo 7,5YR y/(P o, G, s ee a_ - 7 • oC> elev /o i •G~ft. , Depth to limiting w F t f actor y ._.t u"RtSMALD Remarks: Y Boring # , z ~P, 1-5 2f . y s rh... A t 0-// /40 yR 2-1 2- 11 ~ s/ fo YR yl S•/ 2,tm, Sbk nr f ,t? C S Zf . s G 'x,:>< C , 32- 7.5 yR yl4 s Ground ` 103e1-aft. C L..1 -?g ~o y Iz 10, C, s d • Depth to limiting factor # y~ Remarks: CST Name:-Please Print 'Rp(at^ a T- u(„Q R 1 Gfn T Phone: 115- 306 • Q / S S Address: (o JCS p' H-U p,So.J W1. $VO[Co 3- tS- I T CSTM a.14 .02r Signature: Date: CST Number: ' This test site APPROVED for a conventional Sec system. Y 1 PROPERTY OWNER • H~~~~~r SOIL DESCRIPTION REPORT Page Of 3 PARCELI.D.# 4~ l( Clehe U t~(4D Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bouclary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trerxh w., r 3 o- io io yR 2-12- 5%/ 2. f s bk A+,Oe s zf . 5 - /0 y,e 5ht f e s z-f s Ground C 7,5 YR S D, C. S elev. /OO~C ft. Depth to limiting factor a Remarks: Boring # A P o- /o y,2 2/2• 5,•/ 2,f, S J& f s 2f . s G > :u 13 Z f /0 YID S 2 , 56,E ,,,r• 'F Q C s ~U . S , G S1 -71 Ground elev. y Q. 20 ft. Depth to limiting factor Re a Boring # s,/. l,f sh,~ f2 s ~f , y ; 5 { A , io R Z2/,Z. yA 2 , f, C s /vf N s•~ Ground 16-31 /o R y s,/ 2-. *A sbK l~► f 2 c s 2f ' elev. / D 75YR % ee y~.7o ft I Depth to limiting factor „ > Remarks: Boring # Ground elev. ft Depth to limiting factor Remarks: con onnn,o ncinm PLOT. hIAA3 . p~.3of 3 i~''`1Es,• r~ scp%ue ! I /3A CiV ACES i P ~ T S I 1 607 7 I rJ • N i So poSr hr sw IoT DoT _ I co Pat p- • Z 3,0 /03. (OR 5 r 697- 10 7' C o,Pv E',e 3 /00. 70 , 5 UGGt='STEO S y S T ElA ' Iau kTl oo = /00.0 N'tgt- TRE3ct, 9F.0 ~ IKID TPEOCG,. f?.~C7IOW TREOCG., fl'.5"0 , I PPWM 14 •r 12 \ f•,ipi go. R, Y. ~ I tart acati o. i. is ACKi 4 f • Ip \ . 1 too T. a , rota Ti0 i~..T. ~ 1. 30 .Cats 10 is* to, rr, r►' • t.i• &CACi 4r 13 rit,fi• f0. R, ~ f.of Kati fo Coal.ta a eeh~h rot. Tfo so. ff. r 'w HCTSON f mo 'T •"i .y. ~f t.1i KaCS ow ""'I"a of tt c noa i b 210.4 .r • % r: w/. 0/ ftCT~Oa~r~J• . M" ~ S a 9'• 31 3o W r. w a "Clio" f k 8 . a 40.20 . k4: ! 9~ S(!t!!J(Q JY!Y(z re J7 myrt J• M( JIU N 17`I . N15029'19' 40.00' 45.06 vN71053, 9• NOS031'30'E 417.96'' Nov -14' )Q*( X9.07' rfw.oo ur,ft rt►.f•' r, o fy; N rf 1V g NOW 7,1 'w 7 N 105.00' o 0. x t Naa' '4 347.00' s a 3 y ' r 4 =5 i ° ' • 3 606 $0. f, g = (7,101 i O 'S ft,Ni f0. /t. • ^ ; t+ tart •tati i•r• •CatsI ff tart KatS ZZ O ~ ~ a , ~ sr. is1 N. R. ' 8 7 I i.oo aact a •l Ste on, I Q 1, r i WEST LINE OF THE SWI/4 OF SECTION S N01021'32"E 992.85' 484.60' 508.25' p0 dy N lD ,o _ A O ~Op v ~1l. W OS 4 FO / D O m oG? m N titi N ~ w y~4 , Gti S ~ ivy 3 ~ ~o ~o p ps 3~, °j W s ,s , yo / 00 ~ N ~ W i ~I,yG awo -4 , ra Oil n 0 (A m O . N p~ 360 p 9 3?. 00, ly 0 (7 00 co N O X00 • 7 W W l••• i / OD ` v La D O n N O / N m o Ig N `r36o ~ / ~ r 3 Ir .00/ s {L .Oyu ~D po ~ n I / - I 1 Z No m w w ~ OD Uq I n 0 t1/ U) m m V) n N p py'1+ O Z CP U) 09 STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. JJCroix County OWNER/BUYER MAILING ADDRESS `1 C iLC' /~rf 6C J-z PROPERTY ADDRESS a /u- Fic (location of septic sy//s em) Please obtain from the Planning Dept. CITY/STATE A/u~ G(Jz PROPERTY LOCATION S'UJ 1/4, ~LJ 1/4, Section , T ;tk N-R W TOWN OF ~r07/ ST. CROIX COUNTY, WI SUBDIVISION C/PG.~- yJ LOT NUMBER CERTIFIEDSURVEY 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`. j, SIGNED: 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 1L i C /w~4 9 :2LI °,c/ Location of property w 1/4 S Uj 1/4, Section T Z,F N-R_2j_W Township Lev Mailing address L " ~a~ C~ .lee ~L OL.A » tip Address of site '6:5- a e-j Subdivision name Cllc4 ~41 Lot no. Other homes on property? n Yes~_No Previous owner of property oowlt ! Total size of property Total size of parcel a . $ R«e Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes K No Volume hP 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 recorded in the office of the County Register of Deeds as Document No. /77 1919, 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. Signature of A licant Co-Applicant Date of Signature Date of Signature yoS DOCUMENT NO. THIS SPACE RESERVED FOR RECORDING DATA WARRANTY DEED 517248 STATE BAR OF (WISCONSIN FORM 2 -1982 1 1 V O PAGE David R. Knighton w G~ L fr`. r. t nbed &r R&CWd r JUN 1' 1994 ; conveys and warrants to Richard C. Hadley and Arlue L. Hadley, t^ty 8.30. T A.1 tenants in common ~ . RETURN TO Richard C. Hadley the following described real estate in St. Croix County, / yUQ Cow,/ec A4 State of Wisconsin: ! Tax Parcel No; /o 1 -r0 - ! Zlif ' ~ Lot No. 11, Clearview Addition Subject to Declaration Establishing Protective Covenants and other easements of record. This is not homestead property. (is) (is not) Exception to warranties: Dated this day of • 19 (O-EAL) (SEAL) * * David R. Kriighto~ (SEAL) (SEAL) * AUTHENTICATION ACKNOWLEDGEMENT Signature(s) STATE OF SASI MINNESOT ss. Hennepin County. Personally came before me this day of authenticated this day of 1994 the above named David R Knighton * TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known a the person who executed the authorized by § 706.06, Wis. Stats.) foregoing in ent and ac I e same. THIS INSTRUMENT WAS DRAFTED BY r David J. Butler, Attorney at Law 6625 Lyndale. Ave So, Suite 526 * David J. Butler Richfield, MN 55423 Notary Public Hennepin County. MN (612) 869-7123 (Signatures may be authenticated or acknowledge ~ Both My Commission is permanent. (If not, state expiration are not necessary.) date: ) "110 J. BUTLER • Names of persons signing in any capacity should be typed or printed below their signatures. f NOTARY PUBLIC-MINNESOTA MY COMMISSION EXPIRES 44.0 WARRANTY DEED STATE BAR OF WISCONSIN T R • ASSOCIATION FORM No. 2 - 1982 4801 Hayes oa , I Wisconsin 53704