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HomeMy WebLinkAbout026-1038-50-100 . STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS SUBDIVISION / CSM#LOT SECTION___42 T, Td N-R~&__W, Town of- ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Y/ WCLI 1~ E3nL G'- g s. ~o r GV I i INDICATE NORTH ARROW Provide setback and elevation information on reverse of this-form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK : ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: 1~Jt ~s Liquid Capacity: i Setback from: Well. House Other Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location ..SOIL ABSORPTION SYSTEM Width: 4~2 Length Ys' Number of trenches Distance & Direction to nearest prop. line: j/ Setback from: well: House Other ELEVATIONS Building Sewer ST Inlet; 9Z-5 ~ ST outlet PC inlet PC bottom Pump Off Header/Manifold Bottom of system Existing Grade y Final grade~y DATE OF INSTALLATION:. y- 7- 9_7 PLUMBER ON JOB: ~ L LICENSE NUMBER: INSPECTOR: 3/93:jt /neir~`iartn>to9, 12.30.18PAIVA(TE 5,AGE SYSTEV'F~. ,LOT 1 County: -Labor and Human Relations I Safety and Buildings Division INSPECTION REPORT ST. C GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: 193433 Permit Holder's Name: ❑ City ❑ Village [Town of: State Plan ID No.: RICHMOND ev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 1/00.0 11L~o c ~ . 1,= 026-1038-50-000 TANK INFORMATION ELEVATION DATA A9300093 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic _ Benchmark y C 7y /Ov, 0 Dosing Aeration Bldg. Sewer 97, o,& Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet 'r 7 Z TANK TO P/ L WELL BLDG. Airi to ntake ROAD Dt Inlet rl Septic has- / 9 > / r NA Dt Bottom Dosing NA Header/ Man. ~t 03 qi -71 Aeration NA Dist. Pipe q Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade =t b q Manufacturer Demand Model Number GPM TDH Lift Friction Syestem TDH Ft Forcemain Length Dia. Il--ff Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trgnches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS / a 7S DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O CHAMBER , Model Number: System: 1301 /1- OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. 1..' Length Dia. ' Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over 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.) LOCATION: RICHMOND 12._30.18.178,SW,SE,160TH AVE.,LOT 1 E c Plan revision required? ❑ Yes ❑ No Use other side for additional information. 7 1-7 J931 SBD-6710 (R 05/91) Date ,.,inspector's Signature Cert. No. e ADDITIONAL COMMENTS AND SKETCH z SANITARY PERMIT NUMBER: d I =:TEilLHR SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05, Wis. Adm. Code STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ / ? -12/3-3 8% X 11 inches in size. Check re sion 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 S T , N, R (or PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK Cl e~ - jj; STA ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER II. TYPE OF BUILDING: Check one CITY NEAREST ROAD/ ( ) ❑ State Owned VILLAGE : , OF: _1ze, ❑ Public ~ 1 or 2 Fam. Dwelling- # of bedrooms PAR L AX NUM ( ) III. BUILDING USE: (If building type is public, check T11 apply) O A cq „ /Q 3 /tad 1 ❑ Apt/Condo 2 ❑ Assembly Hall 60 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.E1 New 2. [Z Replacement 3. ❑ Replacement of 4.E] Reconnection of 5.E] 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 M Seepage Bed 21 ❑ Mound 300 Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 1140 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./ rich) ELEVATION 9 S- Feet Feet 12, VII. TANK CAPACITY Site in allons Total iv of Prefab. Fiber- Exper. INFORMATION Manufacturer's Name Con- Steel Plastic New istin Gallons Tanks Concrete strutted glass App. Tanks Tanks Septic Tank or Holdin Tank O f Za~ F-1 F1 I F-1 1 0 1 F] n Lift Pump Tank/Si hon Chamber Vlll. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for instal ation of the onsite sewage system shown on the attached plans. P r' Name (Print): Plumber' ig lure: (No mps) MP/MPRSW No.: Business Phone Number: I ~S umber' Address (Street, City, State, ip Code IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sani ry Permit Fee (Includes Groundwater Date Issued issuing A e!m Si re ( Stam Surcharge Fee) Approved ❑ Owner Given Initial 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 8 Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. Y 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 mustbe 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'.eystem is to be 4no.0116d. 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 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; 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. l i 1 SBD-6398 (R.11/88) I vlv i I I I . I, I r T I I i ~ I I ~ ' I I , ~ i I 1 I 1 I r 1 - - - i` i I I ' I I I I ~ I R ' i ~ I I I I ' I i ICI I T ~ I r I I , I I I t I - I ' r 1 i l I~ i I I T.- -r I+ I I , I ~ I I ~ ~ ' I it I i. I. 'i I I I I 'I I I I I I I 4 t i , I - r i i i r 4 j! ~ I ~i I ~ I' ' _ { ' ~ i ~ ~ ~ ~ i i ~ i -~-i ~ - - - - i . - I ' j __~.~~._.__L I - I ~ I i _ ` _ ~ - i ~ I i i _ _ ' i _ _ _ _ _ _ _ y ~I i I ~ ~ i ~ i i j i ~ I I ~ - I i i i ~ I ~ ~ i ~ r ~ - _ _ i i i ~ - I I ~ ~ i ~ ~ ~ I ~ _ ! i j ~ ~ ~ ~ I. I j - I ~i i ~ i _ i i ~ i PAG C or Ct`vSS' S~c~lu1~ 41r la ~r1~ St►: /~S'y • /~a ~ jE 114611. Ak Wets Asd 96601VqUell pipe ~ O.r/sti6,~,la ~js , MAIN .w li=M•~• t•, . , ve /I.M bN• YM1 P116 `i frw~Mlk C•.•.Iw~ • O iPip~M.•telb - " pipe TN • ~t!6 ..L..t.:7_7741 8erw•a PIi6 F441610194 Pipe below • 1C•Mllwf TrwM•4101 8 Al •ll6w 08 816100 • Pip o~c►~ ~in..I r~c~c 97 p 9. ~I~va~ bon sio1L ~1Lt.' 0I3TRIBUT101.1 PIP[ APmo%to svpicTIC Cow I-T oF J~6GQCGAIE "-MATER1^1• CR V OF s-mm- OR MAR 0. ►'.AV ELEV. oF• 'Ybg, "oars-a'~s AGGKCGNTC FE~T... .•,ti~~• .r~~. CISTRIAUT'J:J PIPL To be AT 4Ch><~ IWCHCS 6CLOW ORIG'IWAI. AUV AT. 1.114%ST&O IWCHLL OUT MO MOP%C THAN tit IuCHcS BELOW FINAL rilt/tOL MN MM DEPTH OF EXCAVATIO W F+,oM 10•16WAL 6KA09 WILL, 9E IWC.HES 1"UK1MVJ• ©EPri OF EXCAVATION FOIA, O~14114AL GRAD. w1t.t. bC INcHcS sl~uco: - • . ticscm SC 1JUMOER: - ~~S •~ti-'.r E-Z 'r"` 1;~,tront,n Deoa•tr^•r•t o1 Irduttry, Libor and humanRNIpOnt ~Vll Utbt nli Mute 1161 vrls (Attach Soil Profile Location Map • To Scale • On A Separate. Signed Sheet) M ci ion, :.I ,S1::' tuf~O~e /01 VM.Oaf/ Page 'r - Y IM0IYY Y/0 •aMr►Wr Afy MO•Yaa• t 11000 l/ .oo•es/ r:v _ /r.rl p awr 10a0e/0 e•e~. let.ra fowwaw ~Krtr 110RtNC 114-<z 114 IT la/rY1t/1 WAfJ/11 ~ LOT Gsstr BLOCK sUBDIVIlION 14 `wlr► alruel B • Morton Depth Dominant Color Mottles Structure In Munsell t, ont. 01 r Tee! r Gr. t. h. C n Itten e A llnuun9 Facleu leaoingc;p0 IQ n. t in of Oegt Trentn 0.0 -27 al A A I/ 7 (j • Monson Depth Dominant Color Mottles Structure In Muntttl u COnt.C Color T / r 4nnune Faered lwbn pGv6%o n Cr. St. h. --Consistence R Ott Boundary Oeolh Trench 0, Elev a 31 Morton Depth OomanantColor Mottles tructure Muntell t. on Color Texture itr ltrlNilne Feelerr Leaping GPO W n. t, h. Consistiln(ir Roo Boundary 040th trench sod A-9 .1q/ e Elev I 1. CJ ALZ 9A .AJ r B- I Mor.lon Ototh 7.7 A-111 Color Mottles In. Mvn NI ltructure lrrtwung FAClelr leao^gGPO,1p n. S .Con .Color T sure Gr Sh on is n Roots egyndsly Owlh bench eel Elev = B- orlon Depth Dominant Color Mollies In M n ell Structure llnMling Facterr, loaongGPOeo n. Cont. -OV St. I r T e r r St. h, n I n Rots Boundary Oepu Trench e.a r Elev : Additional Remarks: RECOMMENDS SYSTEM TYPE: J'R 9 7) - _ - Qb c cy.. ( l Other Site Features:' s O Astute $ytlem Elevation Vale Signed eteohoneNo. 7 • J. CST Name (Prlnt) cur stale tip r5L I I I r I I I I I I- ~ i I - = -I - { i I ; j LL I I---I I I L~ I I I - I j ' I I I ~ I I ' I I j I I I I i I ' I ! ' ( i 1 I I I I I I +I ' i I I I. I I I i I ~ ~I ~ I ~ I I ( _ I- I i I i I L I I i i 30, I _ I I f I I I I I~ I I ~ i I I i I ' ~ I~-~ ~ I - - - ` I j ! I i I ~ I I ! I ~ I i ~ _L i I ~ I ~1! ~ ! ~ i I f ~ ~ ~ I ' I ! I ! ~ ~L I 1 I ' I I ~ i ~ ~ I i I I I ' t I I I I i I I _ ' I ! , I ~ I I~ I I l l l l i,!~ I I I~~/ I l l~ l l ~ l ~ i l ~ l l ~ I I - 1 1 r I I ) i... I I i i ~ I I I I ~ I ~ I i I I I I ~ ~ I I I H I j I i I I r i i!! I I vi v t w , : i , I ! I f f i i I ~ I t , : I I I ' 1 J I - i I I i I : I I I : t ' I - 488305 CERTIFIED SURVEY MAP A PARCEL OF LAND LOCATED IN PART OF THE SW'--a OF THE SE'-a AND THE SE4 OF THE SW'- OF SECTION 12, T30N, R18W TOWN OF RICHMOND,ST.C a a N COUNTY, WISCONSIN. FILED 13EARINGSARE REFERENCED TO 0 SEP 0 9199210- 4 THE SOUTH LINE OF THE SWI/4 W ASSUMED TO BEAR S 89.59'09"W. NI N JAMES O'CONNELL Register of Deeds UNPLATTED LANQa SLCrOUCo.,WI S S 111 = 10 ' EAST 230.00 "k=L I 100 50 • 0 100 z LEGEND a m ST. CROIX COUNTY MONUMENT A 97 RECORDED . z°i LOT I of <I zi HE Q1 0 1"x24" IRON PIPE WEIGHING cp 00 1.68 lbs./ LINEAR FOOT SET. M M O O O0 o O0 1-1 WNER QI a- _ en ~1 KEITH TAINTER -J) F=-- 0e,214 so. FT. _ 1600 REDWOOD DR. APT. 101 i 2.4e ACRES -JI HUDSON,WI. 54016 =I Z 1 EXCLUDING R/W 0 z >I 115,804 ISO.FT. =1 _ BUILDING 2.66 ACRES 0 SURVEYED BY SETBACK --I-INCLUDING R/W---- W ABE LAND SURVEYING K P.O. BOX 325 W 1 NEW RICHMOND, WI 54017 0_ w) g Telephone (715) 246-4319 U ` .S 89° 59'-09'~W . S 89034' 30'V --S 89.59'09" W - - t6eeNt1► 2609.46' g 150.01 1, 80.00 c -s 89.3{'30"w a~o~e `~pG 1s0" 2652.03 y 2459.46' 160 th Avenue 2572. J ~e4 \ 5S~ J♦ (D 150.00' 80.00' m ~o S 89.59' 09" W S89 .34'30W ♦ S.W. CORNER '711 12 SECTION 12-30-18 S 1/4 CORNER 9•E. CORNER 1? RONALD F. = SECT ION'12-30-18 ( 1" IRON PIPE) e G~, n SOUTH LINE OF THE SW 1/4 SOUTH LINE OF THE SE 1/4. r f AM r= Y. s. <0~ UNPLATTED LANDS e.0°OIa1A SUR J - /v ott~a COUNTY GENERAL NOTICE: Each parcel shown on this map is subject to state and county laws, rules and regulations (i.e., wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office for advice. VOLUME 9 PAGE, 2539 yy This instrument was drafted by Paul Gibson.t . 0 )s C~1K C'R_a G ~M R~iy 0 SURVEYOR'S CERTIFICATE I, Ronald F. Johnson, registered Wisconsin Land Surveyor, do hereby certify that I have surveyed and mapped a part of the SWa-, of the SE; and the SE; of the SWa of Section 12, T30N, R18W, Town of Richmond, St. Croix County, WI; described as follows: Commencing at the S; corner of said section 12, also being the point of beginning of this description; thence along the south line of said SWa S89°59'09"W 150.00 feet; thence North 503.63 feet; thence East.230.00 feet; thence South 503.00 feet to the south line of said SE4; thence along last said line S89°34'30"W 80.00 feet to the point of beginning. Containing 115,$x4 square feet (2.66 acres). Subject to right-of -way for Town Road 160th Avenue as shown and subject to all other easements, restrictions and covenants of record. I further certify that this map is a true representation to scale of the exterior boundary surveyed and described; that I have fully complied with the provisions of Chapter 236.34 of the Wisconsin Statutes and the Land Subdivision Ordinance of the County of St. Croix and the Town of Richmond in surveying and mapping same. ~I 17'x; M42 na d o nson No. DatLy b 7~r P.ONALD F. S ~ n r, x w Ahi F?`i . 1 Wis. Ivr) ~~~099091G4~~ VOLUME 9 PAGE 2539 Y S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER_. /h;"_,_- `~4 l ADDRESS y ~ V~l a1116 FIRE NUMBER._/~~i~_ CITY/STATE hzm_n~,-7.. / ZIP. cSV PROPERTY LOCATION:_'56) 1/4 ,_~5Z1/4 , SECTION-,Z-,-) , T,.22_N-R W TOWN OF (mil d-n©17C,r St. Croix 'Cou C ~ nt Y. 0_6n4_ 1 9 LOT NUMBER__L_ 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. Zoning officer within 30 days of the three year expiration date. SIGNED: DATE: St. Croix co. Zoning Office 911 4th St. Hudson, WI 54016 STC-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), thensa 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 I onu, To~ inT~ Location of property,Sl~L~ 1/4 '~~4114, Section T ~ZO N-R-Z2 W Township _ R; h yinr,n d Mailing address 16ntu Cut(" _-&U j 6I-h UJ' ~7U 7 Address of site VY~•P kq5 abo VIC, subdivision name Lot no.__/ C Srh 9 - ~!~.5739 other homes on property? yes x No Previous owner of property f ) I III ani _chk 0 j~ Total size of parcel ac_,U / Date parcel -was created Are all corners and lot lines identifiable? =Yes No Is this property being developed for (spec house)? Yes No Volume gZAand.Page Number 7 R 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 & 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 Ma shall also be required. Map PROPERTY OWNER CERTIFICATION I(we) certify that all statements on this form are true to the best of my (our . ) knowledge that I (we) an, (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in he office of the County Register of Deeds as Document No. the d6o8 , 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 County Register of deeds as Document No, ~/rf9~69 Signature of applicant Co-applicant Date of Signature Date of Signature i ' r-I:S ,vA~E RESE R'+ED:Ga a£CURO.NO DATA it DOCUMENT N0 LSTATE BAR OF WISCONS!11 =ORYVt 2-7983 WARRANTY DEED 489265 vot_ 972pA,,E 78 RAG;~T~R'S ~ i~ 7 - 3fi. iE4lX ~a.t / I at • t' rr ~ . c 1Z__PF+ ~ r hr iv • n CzV "It 1992 ya Sv.li7 NA conveys and warrants to _ - a 1:45 P. I lfl[l fdr Y1 ~L_ t~sl id _a&d.-_ WAFe-_ "I - teswe, of Deeds - RETURN TO I ,,3 the following described real estate in _ S t fa i X sCounty, I---" =-I State of Wisconsin: f y 7 Tax Parcel No: - 1 Part SW%SEL; 6 Part SE4SW4 12/30/18 (Lot 1 CSM 9-2539) -Town of Richmond, St Croix County, WI.described as follows: I Commencing at the Sa corner of said section 12, also being the point of beginning of this description; thence along thesouth line ~I of said 3W4 S89 59109"W 150.00 feet; thence North 503.63 feet; ,F I thence East 230.00 feet; thence South 503.00 feet to the south line it of said SE4; thencs along the last said line S89 34130"W80.00 feet , to the point of beginning. Conta?ling 115,804 square feet (2.66 acres). Subject to the right-of-right-of-way for Town Road 160th Avenue as shown and subject to all other easements, restrictions and covenants of record. I OD II ~I ~ .i I i, This 1 5 -homestead property. I~ (is) (is not) Exception to Warranties: 1i Dated this day of (SEAL) - -tSEAL1 ~i ISEAL) li (SEAL) - ;I AUTHENTICATION ACKNOWLEDGMENT i Signature(s) _ STATE OF WISCONSIN i~ ss y/ y T County. ~ ~ Per ovally ' me before met s ~--day of authenticated this day of 19 tg ~rhe above named i Oil TITLE' MEMBER STATE BAR OF WISCONSIN n (If not.-- to Te known to be the person.- .ia0o exli,GUle*1Ae: f ~ foreGo.ng instrument and acknowledge 6lfsam~;/, authorized by § 706 06, Wis. Slats.) THIS INSTRUMENT WAS CRAFTED Bv L~ ~~J-!An J~ 1. _ Notary Pubhc- - 451----- County. Wis (Signatures may :,e authenticated or acknowledged Both M,, C3mm.sssiion is permanent (if not. state expiration are not necessary.) date 19! 1 SB2 NTC 0021 'Names of oersons 5,g-,ng ;n vny capac,tr shouid oe typed or pr nied below t^eir s g at 'es WARRANTY DEED STATE BAR OF WIS :ONSIN Neico Tax Forms. I'O Box 10208. Green Bay 'NI 54307 0208 Form No 2-- ';42 ~ aim®YY I