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• Parcel 020-1036-70-000 01/07/2005 11:03 AM
PAGE 1 OF 1
Alt. Parcel 18.29.19.157B 020 - TOWN OF HUDSON
Current 1XI ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): Current Owner
SAMUEL E CAMERON ` CAMERON, SAMUEL E
350 CASPERSON DR
HUDSON WI 54016-7420
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 350 CASPERSON DR
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 4.010 Plat: N/A-NOT AVAILABLE
SEC 18 T29N R1 9W NW NW THAT PART OF NW Block/Condo Bldg:
NE KNOWN AS LOT 2 C.S.M. 7/2053 INCLUDES
PCL 160B Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
18-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 845/407
07/23/1997 830/55
07/23/1997 725/18
2004 SUMMARY Bill Fair Market Value: Assessed with:
47877 237,300
Valuations: Last Changed: 10/26/2001
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 4.010 46,900 136,700 183,600 NO
Totals for 2004:
General Property 4.010 46,900 136,700 183,600
Woodland 0.000 0 0
Totals for 2003:
General Property 4.010 46,900 136,700 183,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 135
Specials:
User Special Code Category Amount
018-RECYCLING SPECIAL ASSESSMENT 27.00
001-WATER SPECIAL ASSESSMENT 0.00
Special Assessments Special Charges Delinquent Charges
Total 27.00 0.00 0.00
FORM - STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER S.., TOWNSHIP Z414-1-gon
SECTION /j_T-5E~N-R_ W j
ADDRESS ,-g Z_. ST. CROIX COUNTY, WISCONSIN
SUBDIVISION LOT Z LOT SIZED Af-
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
W~
No4ss.
G F „4 ~ ,8 XSD "
2yk3L SSASz
d
0 0 i
,s 33~o I~
o
0 4d
I
NO
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DIV.=/o N
A lot
1.yet, aL S E Co r, K,. r
1= /00-00' '
40
.Sca Ia ~ 01
-7NN\
4 INDICATE NORTH ARROW
BENCHMARK: Elevation and description: io-r p: SE 4,'$w-,E1= 100-0-o'
Alternate benchmark
SEPTIC TANK:Manufacturer:-Liquid Cap.
Rings used: 2- Manhole cover elev:3.IZ- Final grade elev: -~5
Tank inlet elev.: CP- 5 7 Tank outlet elev.: (P- 8 'L-
No. of feet from nearest road:Front , Side , Rear X Ft. ISSN
From nearest prop. line:Front , Side X , Rear Ft. 1o l'
No. of feet from: Well s S , Building: IS"
(Include this information in the above plot plan)
(2 reference dimensions to septic tank)
SEE REVERSE SIDE
i~
PUMP CHAMBER
Manufacturer:,/// Liquid Capacity:
Pump Model: Pump/Siphon Manufact.: Pump Size
Elevation of inlet: Bottom of tank elevation
Pump on elev.: Pump off elev.: Gallons/cycle:
Alarm: Man.: Switch Type: Location
Distance from nearest prop. line: Front-, Side_, Rear_Ft.
Distance from: Well Building
SOIL ABSORPTION SYSTEM
Bed yG~l~oN~l Trench : - Seepage Pit:
Width: E-Length yo ' Number of Lines: 3 Area BuiltZZD S?~ i
Exist. Grade Elev. 697 Z/ Proposed Final Grade Elev. l0 9. z l
Fill depth to top of pipe: ~f0
No. feet from nearest prop. line:Front , Side , Rear X Ft. VS"'
No. feet from well: 8 Z No. feet from building 3 z
HOLDING TANK
Manufacturer: / Capacity:
No. of rings used: Elevation of bottom tank:
Elevation of inlet:
No. feet from nearest prop. line:Front , Side , Rear Ft.
No. feet from: Well building , nearest road
Alarm Manufacturer:
INSPECTOR:
DATE : PLUMBER ON JOB :
LICENSE NUMBER:
6/90:cj
I hql mep
DEI;ARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING
LABOR & HlvtAN RELATIONS ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION
Pte. AO,~IBOQX~7965
MIS t1%1. JeC.18,T27-R19 State Plan l.D.Number:
VENTIONAL El ALTERATIVE (If assigned)
Town of Hudson Lot 2
CaS erson Dr. ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound
NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE:
Sam Miller Box 282, Hudson, WI 54016
BENCH MARK (Permanent reference pjoiiint) DESCRIBE IF DIFFERENT FROM PLAN. RE`F. PT. ELEV.: CST F. PT. ELEV.:
'Name of Plumber: /MPF~U No.: County: 'SarmtTr-y Permit Number:
,Doug Strohbeen 5432 St. Croix 135486
SEPTIC TANK/HOLDING TAN it
0 5•T We.tl,,o - r 8~ /
t f. L,
MANUFACTURER: LIQUID CAPACITY: TA LEV.: TANK OUTL T LEV.: WARNING LABEL LOCKING COVER
P,RRO,VIDEEDD~ PROVIDED:
Ca? " % a d. ~D / . 33 r ~Dq d? L~'YES ❑ NO ❑ YES
BEDDING: NT DIA.: VENT MATL.: HIGH WAT UMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH
ALARM: FEET FROM LINE: AIR INIL
❑ YES O 1 ~ ❑ YES NEAREST '>'/z
DOSING CHAMBER:
MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
❑ YES ❑ NO ❑ YES ❑ NO
GA NS PER CYCLE: PUMP AND CO ATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH
(DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET:
PUMP ON AND OFF ❑ YES E:1 NO
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: R: MATERIAL AND MARKING:
or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN
the soil is dry enough to continue.) -
CONVENTIONAL SYSTEM: ' = 2
,6 V BED/TRENCH WIDTH: L : N OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID
DIMENSIONS / TRENCHES: / MATERIAL: PIT DEPTH:
GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: Nil. ISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT
BELOW PIPES: ROVE CO~V~jE~R ELEV. INLE ELEV. END. PIPES: FEET FROM LINE: /r / ~ / AIR INLET:
-T~ Q(o, - y~ NEAREST C • >SO
MOUND SYSTEM:
Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM
slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW
❑ YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED.
SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS;
❑ YES ❑ NO ❑ YES ❑ NO
DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED:
CENTER: EDGES:
❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO
PRESSURIZED DISTRIBUTION SYSTEM:
BED/TRENCH WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER:
TRENCHES:
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING:
ELEVATION AND ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.:
DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO
INFORMATION APPROVED PLANS
❑ YES ❑ NO ❑ YES ❑ NO
PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING:
COMMENTS: FEET FROM LINE-
El YES ❑ NO ❑ YES ❑ NO NEAREST
Q ~tJr) ~ ~G~„c~y G.~ ~~->!.c'j-~_4;'~ 01~-2~/ S, cJ, C'~"Z''~-~'> Q' Q-~'o?~Z-`r.lr>7 Q.c.~,Q, ~ srt•~~~
c~a(= Q
Sketch System on Retain in county file for audit.
Reverse Side. SIGNAT RE: - / eT.LE:
SBD-6710 (R. 06/88) Q Cam'
~I~HR SANITARY PERMIT APPLICATION couN
-D-1`R In accord with ILHR 83.05, Wis. Adm. Code
STATE SANITARY PERMITA
-Attach complete plans (to the county copy only) for the system, on paper not less than Q(~
8% x 11 inches in size. ❑ Chet if, evision to pr vious application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PL ASE PRINT LL INFORMATION.
PROPERTY OWNER ROPERTY LOCATION
%&,C S V T Z~ N, R E (or
100" All, I& K:: VV PROPERTY OWNER' MAILING ADDRESS LOT # BLOCK #
Z Z.
CITY, ST TE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
CITY NEAREST ROAD SO
II. TYPE OF BUILDING: (Check one) ❑ State Owned
apt 3
LM OF: ❑ VILLAGE : 49~/
❑ Public 1Z 1 or 2 Fam. Dwelling- # of bedrooms 2- AR EL AX N UMBER(S)
D - j-'e'er
III. BUILDING USE: (It building type is public, check all that apply) )S-7 1-1,(13 --76
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 120 Service Station/Car Wash
5 ❑ Hotel/Motel 90 Office/Factory 130 Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. 1~ New 2. ❑ Replacement 3. ❑ 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
REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
y S d / S y 7 Z G 3 ~V y s Feet 7 G Feet
CAPACITY
VII. TANK in allons Total # of Prefab. Site Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name oncrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Holdin Tank OOd # w a i S c 1/
Lift Pump Tank/Si hon Chamber
VIII. RESPONSIBILITY STATEMENT
1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plumber's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number:
bay abd:0 r~ 2-117 3233
Plumber' Address Street, City, State, Zip Code):
-W- "4 N P~ C-k wl-O & w Z S D 1 -7
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing gent Signature (No S
Approved ❑ Owner Given Initial Surcharge Fee)
Adverse Determination S
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 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 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. Property76Wner'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 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; Jose 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)
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DEPARTI ,ENF OF, REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, DIVISION
LABOR AND,. PERCOLATION TESTS (115) MADISP.O. BOX 7969
ON WI 537
HUMAN RELATIONS 07
(H63.09(1) & Chapter 145.045)
LOCATION:K SECTION: TOWNSHIP/ LOT NO.:BLK. NO.: SUBDIVISION NAME: $W~tCr
/T2? N/R/9 s (o AC, roar Z- 111516. / eW
W '/a f'/ 1 14
COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS:
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DES IP IONS: R OLATION TESTS:
Residence New ❑Replace
S r
A,--,o' 1A0 ° 0 .Q_o1J)' OAM
RATING: S= Site suitable for system U= Site unsuitable for system PC, S G Z
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) 12 X S= i
®s0
U IRSE ®s❑u os u ❑s u CD &,r,,Lhj 18'x36,
If Percolation Tests are NOT required DESIGN RATE- I If any portion of the tested area is in the A11'4
.S
under s.H63.09(5) (b), indicate: Floodplain indicate Floodplain elevation:
PR FILE DESCRIPTIONS
BORING TOTAL/ DEPTH TO GROUNDWATER.41le"COV CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTHj#t. ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B If .S 107y, o,ue BIs1 , 11., S H gjo- /-Cs/.? s
B- 2- 60,0' f AJ S /o fan l S/ S
f If .1
B-3 '2. 9' Q~. I A dae_ I 1 X/s! An -C~ /L ~f 7.~ Ll
B- 7.S-' 111-It" o e_ 7 . !S/ 4 6 AA s . 7 RA 3. ! 7 8h h 5
5tg/ S/ Al 4,01 + Aft 411 /-r r7
B-
PERCOLATION TESTS
TEST DEPTHS WATER IN HOLE TEST;TIME DROP IN WATER LEVEL-INCHES RAPER INCII ES
NUMBER lPtQI•FE6 AFTER SWELLING INTERdAL-MIN. PERIOD t PERI002 PERIOD 3
P o 6 6 4_3
P_ Z- S'.0' 3 c- 3
P- 3 1.3 0 3 6 3
P-.
P-
P- _
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori•
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent.
of land slope.
SYSTEM ELEVATION
L4T
-
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A, 4A
II III
t,
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E
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-
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I E
I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin
Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
eQkL e,w~Z
>*-e; Sm4// ci-f hhvcw 2 o v .ew/ t4
AME (print) - TESTS WERE COMPLETED ON:
ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional):
S O C~ i sy'016 / / -
CST AT RE:
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBO-6395 (R. 02/82) - OVER -
S.TC - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
r
OWNER/BUYERd
' o
ROUTE/BOX NUMBER y-- Fire Number -
d
CITY/ STATE ZIP /4; r
PROPERTY LOCATION:'Vk/ k',A~f_k, Section, TAN, R
i
St. Croix County,
Town o f SubdivisionC,S-M, yrs;l A&ee , Lot number Z_
Improper use and maintenance of your septic system could result in
its premature failure to handle wastes.- Prover maintenance con-
sists of umin out the septic tank every three years or sooner,
if neededP P by a g e t~i c tank pumper. What you put into
b licenseds
the system can a ect t e'.unction o t e•septic tank as a treat
went stage in the waste disposal system.
St. Croix County residents-May be eligible to recieve a grant for
a maximum of 60% of the cost.of replacement.of a failing system,
whicc- -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 County Zoning a
certification form,. signed by the owner and by a mater plumber,
journeyman plumber, restricted plumber or a, licensed pumper veri-
fying that (1) the on-site wastewater disposal system is in proper
operating condition and (2) after inspection and pumping (if nec-
essary), the septic tank is less than 1/3 full of sludge and scum.
Certification form will be sent approximately 30 days prior to
three year expiration.
H
I/WE, the undersigned have read the above requirements and agree 0
to maintain the private sewage disposal system.in accordance with 9
the standards set forth, herein, as set by the Wisconsin Depart- a'
ment of Natural Resources, Certification form must be completed
and returned to the St. Croix County Zoning Office within 30 days
of the three year expiration date.
v('"
SIGNE
DATE
St. Croix County Zoning. Office
911 4th St
Hudson, WI 54016,
386-4680
Sign, date and return to the above address.
. APPLICATION FOR SANITARY PERMIT
9TC-100
This application form Is to be completed in full and signed by the ownez(s) of
the property being developed. Any inadequacies will only result In delays of
the permit issuance. -Should this development be intended tot tesale by
owner/contractoc,(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.
- - - - - - - - - - - - - - - - - - - - - - - -
Ownet of property Q& Of /1/•~~~
Location of property &A~_1/4 i/41 section -/;T_...-• T-1.1'•R~
Township A
Mailing address „ ea„y Z--
Address of site C~~=~--- y~-
_~S b~ ~a% /+/a u ~4uc✓
subdlvlelon name
Lot number _ 7
Previous owner of property V"r:ei z A(C" 6dk ar
Total also of parcel 3 9 o ke c✓ S
Data parcel was created /O- /"7- 8'0
Ate all corners and lot lines identifiable? X_-Yes
Is this property being developed for resale toper house)?~,_Yes o
Volume _ 0 and Page Number SS as recorded with the Register of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWINCt
A WARRANTY DEED which Includes a DOCUMENT NUMBERp VOLUME AND PAOE NUMBER, and
the SEAL OF THE RIIOISTRR OP DEEDS. In addition, a certified survey, if
avallable, would be helpful so as to avoid delays of the reviewing process. If
the deed description references to a Ce=tlfled Survey Map, the Certified Survey
Nap shall also be required.
PROPERTY OWNER CERTIFICATION
I(Ve) c2tt1ty that all statements on this form are true to the best of my (our)
knowledge; that I (we) am (ace) the owner(s) of the property described In
this Information [otm, by virtue of a warranty deed recorded In the Office of
0S/ z9 9f~ ; and that I (we)
the County Register of Deeds as Document No.
Presently own the proposed alto for the sewage disposal system (or I (we) have
obtained an easement, to run with the above described property, lot the
construction of sald system, and the same has been duly recorded in the Office
of the County Ra stet of Deeds# as Document No. el;l q.~r 1.
-M I
signature t owner signature of co-owner III Applicable)
S - t o
Date of Signature Date of signature
t 0.30 rA~E 55
DOCUMENT NO. WARRANTY DEED I THIS *RACK wCaCRii.. row w[CORDINO DATA
STATE BAR OF WISCONSIN FORM 2-1982 11
- REGISTER'S OFFICE
Virgil-L. _ Neubauer Linda M.. Neubauer,..husband and i, Sr. CROIX Co., W1
wife . • • Recd for Record
_
BEC 2109
conveys and warrants to $am.E... Mil.ler,._4 $.jng1Q. ptir$on...... of 10:50 AM
ebs aMe►of Doetb
W
-
jj
' CTURN 7
'1 . . -
the following described real estate in ...-St,.
-Crai x .........County. JState of Wisconsin:
Tax Parcel No:
Part of the NE i of the NW i and Part of NW } of the NE of Section 18, Township i
29 North, Range 19 West, St. Croix County, Wisconsin des.-ribed as follows: Lots
2, 3 and 4 of Certified Survey Map filed December 9, 198" in Vol, tr7", Page 2053,
Doc. Nc. 443732.
TOGETHER WITH AND SUBJECT TO a 66 foot wide Private Road Easement as described in
Warranty Deed in Vol. "656°, Page 544, Doc. No. 381696.
~i
FEE
'i
T:cs . homestead property.
(is) (is not)
Exception to warranties:
Easements and restrictions of record, if any.
Dated this day of December , 1988
(SEAL) iSEAI.I
• Virgil L. Neubauer
(SFAL) L'C't~- X/z-e Art« (SEAL,
Linda M. Neubauer
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN
ss.
Ste. Croi.x_...-- County.
authenticated this ........day of 19...... Personally came before me this I day of
December . 19 88 _ the above nameti
V i r9i L,..Neubauer and Linda 11. Neubauer,
husband. and. wife
TITLE: MEMBER STATE BAR OF WISCONSIN
(if not
authori led by 1 706.06. Wis. Stats.) ..,,;o me known to he the prr>on s who executed the
„ furepgini; instrum :Ind at•knowledre the saw-.
THIS INSTRUMENT WAS DRAFTED BY '
- - ..r ~A.Ir' t •~'~t~I' N i
.502 Second .St_,..Hudson WI.. 5401F..... ' t +
+ r 1 ot:rw Piihlic St. Croix f'tttrnty. Wis.
(Signatures may he authenticated or acknowle(iVd ~'•I3otp My Commission is permanent.(If not, state expiration
are not necebsary.) Y 2 7
date:,'
aNanis of pttmna signing in any capacity tth-M h.~ tre•••1 . r printad f".1- it,
:r .i¢ru
i
VYAEEANTT DEED STATE BAR OF VVISCONSINI
F Nt••,n.in LN ItI:,• t'. L I
FORM No. PJA
t''t)nttf No. _ - IJML A tt•1