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Home My WebLink About012-1041-70-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division • ~ INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: City Village X Township Miller, Richard Erin Prairie, Town of CST BM Elev: Insp. BM Elev: BM Description: J oa Q YY1 i GSA' TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic (r te^x~\ F l~1 e~k.5 ~ 2: ~ s z c~ t ~6ECatiGit ~ a Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD ~~- Septic d- . ~;r 9 Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Frictio Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM ELEVATION DATA couniy- ~ St. Croix Sanitary Permit No: 506112 0 State Plan ID No: Parcel Tax No: 012-1041-70-000 Section/TownJRange/Map No: 18.30.17.2728 STATION BS FS +~ s- ELEV. Benchmark 2.2.. /'62 , z ~ Ob Alt. BM ~ r..k. V~.. Go~u. ~' ~ 1no , Bldg. Sewer x ~ {-~ St/Ht Inlet ~~ ' SUHt Outlet 3.5 98 . ~ Header/Man. 7.~ q5•Z Dist. Pipe ' d ~, Y ~.~ 9 • Z 4y. 8 Bot. System P ~ L $~/• z~ Final r d ~.. FYI ~ ~ fe,nc. 3 $, q4~ St Cove, ~,`P ~ ~ ~ l~! g ' e/ ~ v\ Z BED/TRENCH Width Length ~ No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ 3 7 b 3 f ~-~~ -- ~ SETBACK INFORMATION SYSTEM TO P/ BLDG WELL LAKE/STREAM LEACHING CHAMBER OR Manufacture~~ ~',`~r~ +- ~rt'~ Type Of System,: ,~.' CO wUe ~. ~ ~ •~•. y ~ ~~ / ~ ~ A 1 t UNIT . Model Number: DISTRIBUTION SYSTEM G:.,1~ dam-- 19 ,r/ / S .~/rr ~. 57 Header/Manif~ d ~~ Distribution x Hole Size x Hole Spacing Vent to A;~- Intaµ~ n'^ F-~'D 3 L/ L Z~ Di 7 Pipe(s) ` th Di S i \ L \ ~ f ength a a_ pac ng eng w SOIL COVER Y Prcccnrc S~ictnme Only YY Mnnnrl r]r Ot_(;rade Systems Only Depth Over / Depth Over xx Depth of xx Seeded/Sodded xx Mulche Bedlrrench Center /I "j ~ / (~ Bed/Trench Edges \ Topsoil Yes No `' Yes ! No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1552 County Road GG/ New Richmond, WI 540117 (SE 1/4 NE 1/4 18 T30N R17W) NrA Lortr Par el No: 18.30.17.2726 1.) Alt BM Description = ~~ 1~ l-oJt~. ~~ ~~~\ ~ew -04'~'1"~.e~ " ~'s~`~ (CC~ tti F~l~~S~.r.~ 2.) Bldg sewer length = ~c~~-: ~ Co~ ~` ~OOd ~ P'a.•..~~,1 - amount of cover = ~ ~ Ta'`'b ~ 2' "'~^ ~ ~~~'~ ° ~W~ /( ~ Z C.o~e,o~ W ~ ~oc.~, Plan revision Required? ', Yes ~No („j ' ~ b.? ' ~~ 3 7 Use other side for additional information. ` Date Insep Signa e Cert. No. SBD-6710 (R.3/97) ~~~,~-~pV Safety and Buildings Division County ~ ` r ~ 201 W. Washington Ave., P.O. Box 7162 ,/ L l ` _ an s ~ n Madlsa~, ~ 53707-7162 Sanitary Permit Number (ta be filled;a by Co.) sc ~epertment ~ commeroo 5 ~ (P l ~ Z, Sanitary Permit Application State Transaction Number ,__ submission of this form to the appropriate governmental Code Adm Wi 21 2 83 , . s. ( ), . Ia accordance with s. Comm. unit is required prior to obtaining a sanitary permit. N ate: Application forms for state-owned POWTS are be used for secondary vide ma ti l i f Project Address (if different than tiling address) y on you pro orma n submitted to the Deparunent of Commerce. Persona ' ~ ~ $ S Z G Q' State. in accordance with the Pri Law, s. I5. 1 m ~~ ~ I. A Hcation Information -Please Print All Inf lion - / o y~ / ~ Z t 0 - Parcel # d 7 Property Owner's Name it (I / ~' /~j X /J (~ /~' /) ~.~/ (/ / V ~ A ~ / / /~ G / oc i acs I j Property owner's Mailing ^ ~ / J ~ ~`" °II ~ Z e t G 4 ~ / ~ .~ L /~ Phone $ ~ _~, o~ /i/Y ~/ . y y n S ti 2 ~ Q 7, p City, State /, //~ / '") °~ ~J ~ ~ / ° ~ / ~~ , ., ., i ., ec o ~'~ l / ff /~ ~ li , 7 ` / /s 1/V J ~~¢~CJ /c._.+ E r W Y ~ N; R/_~ UfV _ _ ~ # _ - ) ~ lith t-a l k h i u - _ ~ pp y a a ng (c ec ild of B II. Type Subdi ion Namc r 2 Family Dwelling - Number of Bedrooms 1~ Block# 1 ^ public/Commercial -Describe Use ^ ^ City of I q ^ State Owned -Describe Use 3 A , Off- ~,~ ~,~,~ ~w ~ / CSM Number ^ Village of L ,p ~~ ' ,~' ' G~wv~.L.x~-d! G~~ a ~L. 0 rG' ?/ ! Town of !~ / III, Type of Permit: (Check only one box on iine ~. Complete line B if applicable) A' ^ New Syatem Replacement System ^ Tresuzrent/Holdiag Tank Replacement Only i ^ Other Modification to Existing System (explain) B. ^ Permit Renewal ^ Permit Revision , ^ Change of Plumber ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration I Owner IV. a of POWTS S stem/Com onent/Device: Check all that a 1 -Pressurized ia-Ground ^ Pressurized In-Ground ^ At-Grade ^ Mound ? 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ Holding Tank ^ Other Dispersal Component (explai}t) ^ Pretreatment Device (exp V. Dis ersaUTreatment Area Information: ! ~ ~ ~ ""' Design Flow (gpd) Design Soil A Gcation Aa Disposal Area Acquired (st) Dispersal Area Propo System levation VI. Tank Info Capacity in llons G Total Gallons # of Units Manufacturer -~ a New Tanks Existing T ales ~ I ~ / ~ °.l ~ Septic or Hotdiiig Tank ~ 6 ! ~ _ BLS .,Z~ u jt Dosing Chamber VII. Res onsibili Statement- I, the undersigned, responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum rgnature MP/IviPRS Number Business PhoneNu/m/bar Plumber's Address (Street, City, State, ode) ~ / ' ' /~ '1 ~ v~ N ~ ~ / ro~, VIIL Cozen /De artment Use Onl ved A roved rea emut Fee Date Issued Issuing t Signature ppro pp ~ ~$ ~5r7 3 Z8 `07 vner Given Reason for ial . IX, Condi ' s o A~aURe9sons for Disapprgval 3' bl ~, 5ys~'~z.,,~- o b~ '~ ° 1. tMlk. elfhient t8hr shd acs ~11 G o ~ . dspefsal CeA mast aU / aintain = I ~ ~ px marragamenr p~atr proviaea oy piumcer. 2 11N ssback rsqui-ements must be majintainsd p!f a system sad sabmh w me County only on paper not lets than 8112 x 11 inches in du SBD-6398 (R 01/07) Valid thru 01/09 ~C7 ,~~ - P T PLAN PROJECT Richard Miller ADDRESS 1552 Ctv Rd GG New Richmond Wi 54017 SE 1/4 NE 1/4S 18 /T 30 /R 17 W TOWN Erin Prairie COUNTY ST.CROIX 3/20/06 BEDROOM 3 MPRS Shaun Bird 226900 DATE CONVENTIONAL )00C IN-GRO PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000/261 LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1 157 # of chambers 57 ,BENCHMARK V.R.P. Bottom of Garage Siding ASSUME ELEVATION 100' Filter BEST Filter ^ BOREHOLE O WELL *H.R.P. Same as Benchmark Alternate Benchmark SYSTEM ELEVATION 94.7/94.3/94.0 4.5' below grade Top of Garage Slab @ 100.0' Well is to meet all ~~ ~ setbacks required by WDNR Plans Designed Using Conventional Powts Manual Version 2.0 Existing 3 Bedroom House _ 25' ' Property Line 20 80' ~ , ST 1000 gallon ~ Old Drywell to 10 be pumped and buried D W , 4' Long112" Z.} ,~ Garage B.M. '~ ST , 15 t$ ~~ B-1 20' 15_ _ - _ _ 170' with filter B-2 Scale is 1 = 40 Cty Rd GG wEll unless otherwise noted nVent >6" of Cover Quick4 Standard-W Leaching Chamber with 20.0 ft2 of Area 5.8ft^2/pair of end caps Grade at System Elevation AtI.B.M. 1 30' B-3 7% Slope 85' 3-3' X 78' Cells with >3' spacing 295' Property Line P T PLAN PROJECT Richard Miller ADDRESS 1552 Ctv Rd GG New Richmond Wi 54017 SE 1/4 NE 1/4S 18 /T 30 /R 17 W TOWN Erin Prairie COUNTY ST.CROIX 3/20/06 BEDROOM 3 MPRS Shaun Bird 226900 DATE CONVENTIONAL )O(X IN-GRO PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000/261 LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1 157 # of chambers 57 ,BENCHMARK V.R.P. Bottom of Garage Siding ASSUME ELEVATION 100' Filter BEST Filter ^ BOREHOLE O WELL *H.R.P. Same as Benchmark Alternate Benchmark SYSTEM ELEVATION 94.7/94.3/94.0 4.5' below grade Top of Garage Slab @ 100.0' Weil is to meet all Scale iS 1" = 40' setbacks required by Cty Rd GC WDNR wEll unless otherwise noted Plans Designed Using Q nVent Conventional Powts Manual Version 2.0 Existing 3 Bedroom House _ 25' ' Property Line 20 80' , , ST 1000 gallon ~ Old Drywell to 10 be pumped and buried D W , 170' with filter >6» Quick4 Standard-W of Cover Leaching Chamber 0 with 20.0 ft2 of Area 12" 5.8ft^2/pair of end caps 4' Long Grade at System Elevation Garage ~ At1.B.M. B.M. OST 15 25' B-1 20' 15_ _-_ 1 30' B-3 7% Slope 85' 3-3' X 78' Cells with >3' spacing B-2 295' Property Line . ~ "°~ RECEIVED ^ New Construction Use• Residential /Number of bedrooms y Code derived design flow rate 'y.TZ~ GPD Replacement ^ Publi or commerdal -Describe: _______. __ ~_____,______ __- Parent material d/~ ic,P/~~~ Flood Plain elevation if applicable /V,~.~ ft. and recommendations: ~ xcd~{,+G9~ ..% s/f ~ ~ /'1 ~' L~ .- ,, ,ry 9fv ,s System Type ~ /!~ ~~ ~ System Elevatio 'Wisconsin Department of Commerce .~,~ SOIL EVALUATIO REPORT Page of Division of Safety and Buildings in accord nce v~y~m8t t3~, ~81dm. C e County ~~ ~ ` Attach complete site plan on paper not less than 1/2 x 11 inches in size. Plan must indude, but not limited to: vertical and horizontal r ferena~eTp6'ir~d~IdE~fliit~Dt~Yi and Parcel I.D. / ~~~/ percent slope, scale or dimensions, north arrow, a d location and distance to neares road. ~ ! ~ j /-' ~~- P/ease print all information. Review by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~ 7 Properly Owner Property Location ~, t? ,~--~-. ~ ~ ~ ~ Govt. LotS,~ 1/4~~1/4 ~ T ~ ®N R E (or W Property Owner's Mailing Address /`~, Lot # Block # Subd. Name or CSM# J ! ®4~ S~- ~ .- City State Zip Code Phone Number ^ City ^ Village Town Nearest Roa a Boring # ° Bonng pit Ground surface elev. r ~ ft. Depth to limiting factor ~U in. Soil lication Rate Horizon Depth Dominant Cdor Redox Description Texture Structure Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. 'Eff#1 •Etf#2 l ~ ~a - 3/z. -~-~~ a ~m ~~ '' . G ~~ # ^ Boring 9 Pit Ground surface elev. // ~ ft. Depth to limiting factor ~~~• Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 -rte J.-~I~ ~ + .~ - 6~ 2 ~ '~~ $''' ~~ i ~' - Ca ,~ Effluent #1 = BOD > 30 < 220 mglL and T55 >30 < 150 - tmuent ~~ = rsw ~ su Rlg/L anc t ~ ~ sv mgrs ~{ ~~ ~p(~ p~~ CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ~ --~~- ~ ~ 715-246-4516 4 1 ~... Parcel ID # Page of Boring # ^ Boring (~/ / ~-{ , 5 b~S / it Ground surface elev. ~~/ ~' ft. Depth t limiting factor ` ~ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 ~ ,~ ? ^- ~ ,-, - pZ~~G 4 ~ V V C /, ',v r~~ //I/ ~ V / t Property Owner ^ gyring f Boring # ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure ~ Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon 'depth Dominant Color Redox Desciption. Texture Structure Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 'Effluent #1 = BODS > 30 < 220 mg/L arx: TSS >30 < 150 mglL 'Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. 580.8330 (8.6/00) .""" Property Owner Parcel ID # Page of r IL `.~Z_1' Ong # ^ Boring / ~{ , S b / it Ground surface elev. b `~ ft. Depth to limiting factor j ~ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff° i n. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 /) l / / ? ~~ - ~ ~ ~1 ~ ~ a-1Z L ,~ ~J~G ~,~/ .~.~~ i/,~ - l~ t ^ Boring ~ Boring # ^ pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure ~ Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 •Eff#2 ^ Boring ~~ # Ground surface elev. ft. Depth to limiting factor in. ^ Pit Soil ication Rate Horizon 'lepth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GP D/if in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 'Effluent #1 =GODS > 30 < 220 rrg/L and TSS >30 < 150 mg/L 'Effluent #2 =GODS < 30 nrg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. seo-es3o (R.crool ' ~ Soil Test Plot ] Project Nar~ie Robert Olson Address 1365 290th St. Glenwood City Wi 54013 Lot ------- Subdivision -------- Dat SE 1/4 NE 1/4S 18 T 30 N/R17 W Township ErinPrairie Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Bottom of Garage Siding System Elevation 94.7/94.3/94.0 *HRpSame as Benchmark Alternate Benchmark Top of Garage Slab C 100.0' Cty Rd GG WEII Scale is 1" = 40' unless otherwise o' noted Existing 3 Bedroom House _25' ' Property Line 20 $ 0' ST 1000 gallon 10' DW 170' ,~ Garage ~At1.B.M. B.M. 15 B-1 20' 15' 10' 30' 85' B-3 7% Slope B-2 ' 99' 98' 97' 295' Property Line ~~ OwnerBuyer i ~ ~ ''~ Mailing Address ~`S ~~ ~~lC. L? V~~ ~I ~'~'~'"`~` ~l Property Address ~/~~~ (Verification required from Planning & Zoning Department for new construction.) City/State LEGAL DESCRIPTION ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Parcel Identification Number~~a ~~~~/~ ~~ ~~'~'`~ Property Location~~ 1/a ~,_~ 1/a ,Sec. , ,~-~. Subdivision Certified Survey Map # Warranty Deed # Spec house yes no 'p T ~~~ Fj~W, Town of !~/,!Fl / 0't~-U1_.[.~ . ~- Lot # Volume ~ ,Page # Volume ,Page # Lot lines identifiabl yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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 pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary),. the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify tall statem on 's form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property describ e, by v' f a anty deed recorded in Register of Deeds Office. .~~~/~~ SIGNA OF APPLICANT(S) DATE *** Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department.*** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08105) Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4.Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 Contingency Plan Option #1. If system fails, determine cause of failure, use alternate area and install new s stem in tested replacement area. Option # .Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option#3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715-246-4516 St. Croix County Zoning 715-386-4680 Pumper Tom Mondor 715-246-5148 Shaun Bird #226900 ~..,.. ST_ CROTX CL'tJNTY ZONING OFFICE CSRTIrICATION STATRMSNT FOR L7TILIZATION OF AN EXISTING 9EF'TZC TANK Thin is to certify that I have inspected the Septic tank pr®a~tl~r sarv~ng rkie , ~~G~ta ,,'~Q ~~~(/ ~ residanc~e .located et : ~,~,^'~L, /~~ '~. 3iCC . ~, TAN, R~„_q0, Town of i 1P~ $t . Crofx County, Wisccmain. upon ixispectio~n, ~ etxt3fy that I have found Lho tank arld ba-fflee to be is good co¢'YC'i tiara".~ and it agpeare to be functioning prapsarly. mast t3~ :cruised /l?~ / /a ~ ~ OJ ? laid f l~ back occur f tors absorption system? Yeses D3o ~ t if Yt4, skip next ~ppreximate vo5.ufne :ar 3.ength of tf.me: ________ ga+lons ~ ~si.matee Capacity:. Constx~uatiaa: Pre a Concrete feel Other Maaufaotttrer {ig ;cnO~+tl) . ,~~c^;/ N~ry,~.sL~ Age of Tank zf known3 : S P u ~- ~~d ti~ .~ 3 urge iNaraa, Please 'Qr rat 6" -- r~ ,.,, ~ - - ~ ~ tLi en~ Numbb '~' a~ _ -ate ~ ~ nat~~ Form to be cgmpleted by licensed p~.umbe.r is • 14~ . f16 , wiacpnein statutear? or licensed disposer {~ li3 =rTisconsir~ Administxat:,ve Cade? Fluinber {agplying for sanitary permit) Certification: Z27 ascceptirsg the above BtaLStnent regardissg existing s is tazik acnc~it~.on, I certify that the tank, to the beet of ~y knowl+~ ~ will eonfor~s to t~=e requirements of ILHR 83, '~Fis_ Adsr:. Code {except f spection eapdn3.nq over' outlet baffle?. t NatAe ~~r~c-zc,~ l5/,~ Signature MP/MFRS STATE BAR OF WISCONSIN FORM 1 - 1998 WARRANTY DEED Document Number This Deed, made between Robert H Olson and Susanne vlson husband and wife ,Grantor, and Richard J. Miller. single ,Grantee. Grantor, for a valuable consideration conveys to Grantee the following described real estate in St Croix ___ County State of Wisconsin (the "Property") 84337`"~- KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO., MI RECEIVED FOR RECORD 01 / 29 / 2007 08 : 20A1'l MARRANTY DEED EXEI~'T ii REC FEE: 13.00 TRA11S FEE : 550. 50 COPY FEE: CC FEE: PAGES: 2 RETUKty 1 C~ Burnet Title ?550 France Ave. S. First Floor Edina, MN 55435 aTTN_ Post Clc~sin¢ Central 012-1041-70-000 Paroei Identification Number (PIN) This ~ homestead property. (is) (is not) See Exhibit A attached hereto Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Properties good, indefeasible in simple fee and free and clear of encumbrances except Dated this day of anus , 2007. (SEAL) (SEAL) !Robert H. Olson Suzann Ison (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) ZINA i~t (l T~~~ r~ t ~ r~ ~ ~ ~ authenticatedY~,;~ATE 6b~o~1/ISCONSIN TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by §706.06, Wis. Stats) THIS INSTRUMENT WAS DRAFTED BY Coldwell Banker Bumet/Robert Nicholson 1301 Coulee Road Hudson, WI 54016 6-46147 (Signatures may be authenticated or acknowledged. Both are not necessary.) WARRANTY DEED State of Wisconsin, f.3 } ss. St. Croix County Personally came before me this day of ,~nuarv, 2007 the above named R I n d a OI on hu n n if to me known to be the person ho executed the foreg instrument and acknowl a the same. Notary Public, State of isconsin My commission is permanent. (If not, state expiration date: STATE BAR OF WISCONSIN FORM No. 1 -1998 Wisconsin Legal Blank Co, Inc. Milwaukee, Ws. EXH{BIT "A" Legal Description File No. 6-46147 A parcel of land in Section 18 Township 30 North Range 17 West described as follows: Commencing in the center of St. Croix County Highway "GG"; thence West along the South line of the Northeast Duarter of said Section 18 a distance of 295 feet; thence Northerly 330 feet; thence East 295 feet; thence South 330 feet to place of beginning.