Loading...
HomeMy WebLinkAbout020-1270-10-000 ~ O O y O M ti ! Vy ~ y C O O O I N O L" ~ I GL I I N ! ~ Z I ~ ~O I LL c 3 I v I 3 Cl) I a~ rn Z E 1 ~ v ~I o z r ~ v I a m 0014 N F- fn I o I O z a C U w O fA F- r C E 72 2 M N 01 ~ O m ui CD 0. m c c I (~D a) Z5 d v L O 0 O C Q m Q z co D ~ O M N Z m I ~ d tq y M d N C Q d N N O p G G a .a L N L) E r rr w °v O ~co0 0 O ain Zo I ' CL IL IL a • a co J U ~ rn } O v,8 t~i Q O N = CO E " Q O O co N 0 d 0 N N Y a) <1 ^i O C) O y O O M C C E N I- M d' M Or Cl) O co D. U d O O O O O O O O O N N r O r F- m E O- N v c~ n (D 40. n C fn 0 O O O 01 N N O) N d C N ~ N N 7 O N E m U ~N O N 2 O z C rL fn O ~ I V = € v1 m ~ € a EL ` a • a m :2 m 0 a. 0 U) FORM - STC - 104 AS BUILT SANITARY SYSTEH REPORT OWNER Scc.n•► AV lAar TOWNSHIP H4 4 or7 SECTION Z / T?_I_N-R_Zf W ADDRESS &PX P"zg Z-- ST. CROIX COUNTY, WISCONSIN SUBDIVISION ,~a6 s La K~ LOT_..70 LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM it I Lx) CL Y ~casa. ~ ,I Rio ae'xW8 Ff Y b u+..Il-y Q I INDICATE NORTH ARROW BENCHMARK: Elevation and descriptions i~o%P~- 5~ c,,Mar i;; /Do.O~ • r tin~wt = l .8 S Alternate benchmark Tome1F -4, SEPTIC TANK: Manufacturer:_ Ly~~ sml Liquid Cap. 1PRO Rings used-Manhole cover elev: 7_Final grade elev: 8. Tank inlet elev.: ~assv Tank outlet elev.: 10•/z- No. of feet from nearest road:Front , SideX , Rear Ft. //O From nearest prop. line:Front , Side, Rear Ft. /OO r No* of feet from: Well g'S'0 , Building:„ / 7 (include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE J I 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 Trench: Seepage Pit: Width: Length 36 Number of Lines:-_3_Area Built Exist. Grade Elev. ~9.S`y Proposed Firial Grade Elev. g.sb Fill depth to top of pipe: Y4 No. feet from nearest prop. line:Front Side, Rear X Ft.(.0 No. feet from well: ///~_No. feet from building 0 HOLDING TANK Manufacturer:_ ,!%A 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: Wellbuilding_nearest road Alarm Manufacturer: INSPECTOR: 12 DATE: PLUMBER ON JOB: LICENSE NUMBER: . 2- 6/90:cj 1~q 1 l qj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING LABOR &.HIJMAN RELATIONS DIVISION P.O. BOX 79 ON- TE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION SW 4 , NWT ,6 S e c . 21,T21-R19 (If assigned) I.D. Number: Town o Hudson Lot 0 CONVENTIONAL ❑ ALTERATIVE Dorse Dr. Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF ERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Sam Miller Box 282, Hudson WI 54016 5L 9/ BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. V T REF. PT. EL /Z r / 9:r Name of Plumber: MP/MPRSW No.: County, Sanitary Permit Number: Dou Strohbeen 5432 St. Croix 35544 SEPTIC TANK/ 7. S~2 MANUFACTURER: /l) IQUID CAPACITY: TANK INLET EL TANK OUTLET ELEV.: WARNING LABEL LOCKING COV R ES NO PROVIDED: 96, 3a' PROVIDED, (Ni / d( ❑ YES BEDDING: CIA.:/ V&*T MATL.: HIGH WATE NUMBER OF ROAD: / PROPERTY WELL ( BUILDING: VENT TO ESH • , Q`C~• ALARM: FEET FROM LINE: AIR INL T: ❑ YES I(~'IVO ❑ YES ~j ~ NEAREST t DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: P N MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑ YES ❑ NO E] YES -1 NO ❑ YES ❑ NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF TY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF ❑ YES ❑ NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER MATERIAL AND MA or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue. CONVENTIONAL SYSTE . //,5X~ BED/TRENCH WIDTH: L O. OF DIS R. PIP SPACING: COVER INSIDE DIA. # PITS: LIQUID / if TRENCHES: f MATE I L - IT DEPTH: DIMENSIONS 61 GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE IN ISTR. PIPE TERIAL: NO. I TR. NUMBER OF PROPERTY WEL BUILDING: VENT TO FRESH BELOW PIPS: AB OVER: ELEV. IN ELEV. ED: PPIPES: FEET FROM LINE: ,t / AIR INLET: (0 95 i S NEAREST O ~ ~ 5 -70 MOUND SYSTE S0~ fD• 7" , 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 COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKIN . ELEV.: ELEV.: DIA.: ELEV.: PIPES: 0 A.: ELEVATION AND DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDSTO INFORMATION APPROVED PLANS ❑ YES ❑ NO ❑ YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST---- ► lJ '~~-v im ~ 99.8 Sketch System on etain in county file for audit. Reverse Side. SIGN URE: TITLE: SBD-6710 (R. 06/88) / I C~ILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code CouN~e STATE SANITARY PERMI # -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ tt' 8'/z x 11 inches in size. C ec is ntopre ousapplication -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER C/C&~P~/ PROPERTY LOCATION S : S '/4 '/a, S Z / T , N, R /`J E (o PROPERTY OWNER'S MAILING ADDRESS LOT # TBLOCK# CITY, SATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER sor Sys/,~ 3Fl z7~ :5c 10 L'IA ' II. TYPE OF BUILDING: (Check one) El State Owned ❑ VILLAGE N AREST RS D f, 1Jmi ❑ Public ,2t1 or 2 Fam. Dwelling-# of bedrooms ~ PARCEL AX :NUMBER(r) O ^`v 0-2O- 1a~ III. BUILDING USE: (If building type is public, check all that apply) I 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 80 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. 9 New 2. ❑ 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 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 ~l s0 /s Co ~~S Q - 7 3 ?:3-00 Feet 6 -60 Feet VII. TANK CAPACITY Site in gallons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank A0001 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): Plumb is Signatur : (No Stamps) MP/MPRSW No.: Business Phone Number: Plu s PAd* ess (Street, City, State, Zip Code : ~Y 1 o'.' MX 7/4 old/ ~I IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date ssKuee+//~(~// Issuing Agent Signature (No Stamps) Approved El Owner Given Initial Surcharge Fee) 0 7 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 r i1. 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 couipty prior to installation. 5. Onsite sewage systems must be properly 'maintatined. 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. ll. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. Ill. 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. SBD-6398 (R.11/88) 1* ° .y Sit ~ d a ~ s Ilr s a e S~ d~ d u s 6 0 -b o S 1( 1n vi or pt' Zh Po- , T Fz-~ M d Q_ M I_ Pr \ u I 1 I c i ICI I ( <s jQu d a z ~ 0 1 9 s M J T ~ \ V~ V, r, v o z U N w F ~ o o~ o w n, z CL LLJ t2 o ~f-=y LLJ 2 I- O OF 2 T r tiro R~ Q x -6 rP R~ z T W n- ! M 4CI AO z0 U I w d "t V) 1 W I LL I I { 4. 101 1 1 I a I M 1 ~a 1 I I o j o V I I I U- z CL O N~ i I ~ I I i i _ I U . a i LL J o i V) a I LLI I Q I Co M M I I cfl I I i w I I d aw- I CL I I Q I IL ~ I w I I I U 0 ~ U I C9 I ~ I I ? I I I I Jld I I I I I ~ T I I I i E- °'a' I . I I I I, J . 17 4~- ~ T.MENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDING .LNDUS DIISTRY, DIVISION N LABOR AND. PEI', OLATION TESTS (115) MADISOP.O. BOX 76 N WI 3707 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: ' TOWNSHIP/ O~1T NO.:BLK. NO.: S`UBDIVIISIIO1 NAME: S~tj '/a,tl j% Z / /bn N/R~OA(orN:V ~ QSQ~ '1I J/Q~AD~ L/Qn/I~f~1/4 COUNTY: OWNER'S BUYER-3-NAME: ]MAILING ADDRESS: -TC ~ arS MtcL1i i' _176v f3k6nK_P6A& l Ul&S6&) SJU7(~ USE DATES OBSERVATIONS MADE TS: NO.BEDRMS.: COMMERCIAL DES RIPTION: r}~ IPR F D S: PERCOVATIO~TES ❑Residence (ANY, (JJNew ❑Replace G Z/ C G 2Z Q6 8 _ 51Q -T "k- f c-•.. Z.~ ~ 'mod l LS RATING: S= Site suitable for system U= Site unsuitahle for system k!.(AQ4 CONTI ONAL: u M'S' ou IN-GRO NDPRES RE: SYSTEM-INO-FILLHO~LDING T : RECOMMENDED NvEnlj'I UNEM:lop9;4 If Percolation Tests are NOT required DESIGN _R A'rE: I If any portion of the tested area is in the under s. ILHR 83.09(5)1b1, indicate: Floodplain, indicate Floodplain elevation: 'Y h( L1, PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROU:_:-,IN.ATER-INCHES ' CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- / 7,-63 S .S ! t£ 7• 9',3~crs 79 L 2" MSS AS-~ R B- Z $ . 3 44.k~ 8 c cTS io ~eQ L MS ~C*+e "QI~N CS 4tc I _ B- ~ , 6? 97. l I ~ ~ ~ • 9. t~ l 2' ~ ~ "!Q , L 4 ~,t4Qnl S B- ~ ,SO g$•~ / - `?.Sn 3z'ee.~ ~'yts 4o'Betic~~~+~ B- 9,S$ g l 1~o rJL~ 9.5 ~4 ""8«zs S'~6R~L z o" KaBRa MS#Ga? ~8a.~,►MS~FGnc B- -6 KL TESTS TEST DEPTH WATER IN HOLE TEST -i iNiE DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER =FW AFTERSWELLING INTERVAI-_-:,IIN. PERIOD 1 PER D PERIOD PER INCH P. S•76 NoNIE 48.70 > > > <3 P- Z Z. s o o Q 9s,so > z > > < 3 P- •Ib No r 97.90---- ~2 > Z > <j`;, P- P- P- PLOT PLAN: Show locations of percolation tests, soil ;;rinjs and tha dimensions of suitable soil areas. Indicate scale or distances. Descr' a what are the hori- zontal and vertical elevation reference points and shoe, their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION / t , i 1 t 'v 4R°1 P-z r,~ i I T _ 44 j Pipe ki,- I, the undersigned, hereby certify that the soil tests rep:r;ed on this rm were made by me in accord with the p ocedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the L, ,Lion of the tsts are correct to the best of my, knowl ge and belief. NAM~j (printl: TESTS WERE COMPLETED ON: NCR v ~a l.I ~lSo►.! r _ u ?"W/~n 2Z M6 ADDRESS: CERTIFICATIO NUMBER: PHONE NU BER(optional): 407 SL Co N k r- 4cl CST SI ATURE: DISTRIBUTION: Original and one copy to Local Authority, Froperty Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER - STC - 105 H • 0 SEPTIC TANK MAINTENANCE AGREEMENT w St. Croix County r w OWNER/ BUYER c~ iri /m w 0 ROUTE/BOX NUMBER (3 -W.Z- z-- Fire Number ` 0 CITY/ STATE ZIP S d ( L PROPERTY LOCATION: .S Cc/ k, Section, T~_N. R , Town of F1kk0s ©vi St. Croix County, Subdivision Lot number Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed 'se tic tank _pumper. What you put into the system can aTfect the .unction ot the-septic tank as a treat- ment stage in the waste disposal system. St. Croix Count residents may be eligible to recieve 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 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 o to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Depart- ment of Natural Resources. Certification form must be completed •d and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNE DATE 02 S " `Id 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 STC-100 This application form is to be completed willsonlydresulteln delays of the property being developed. Y Inadequacies the pezmlt Issuance. Should this development be intended foz 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. Ownet of property 'Q,Jj Y'A- k\-. --1'-A-1-t5) ` 1/4 /4, Section - TJq Location of property X1 Township Mal l ing address Address of site -Ua' Subdivision name_~a._- -46s ''j Q' 74~ Lot number C/6) Previous owner of property Total else of parcel a.01 Date parcel was created 2 - -,:)L 2 R g' Ace all corners and lot lines identifiable? -.Yes o Is this property being developed for resale (spec house)?__-Yes 0 Volume and Page Number (6 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DElD which Includes a DOCUMENT NUMBERO VOLUME AND PAGE NUMBRR, and the BRAL OF THE REGISTER OP 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 Ceitifled Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I(Ve) certify that all statements on this form are true to the best of my (out) knowledge= that I (we) am (are) the ownet(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. 4'ei S Y /•7 f and that t (we) presently own the proposed alto for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, got the construction of sold system, and the same has been duly -tcorded In the office of County Regi t of Deeds, as Document No. A/ ~Y -7 i ure of Owner Slgnatute of Co-Owner (If Applicable) G-23--f Date of Si nature . Date of Signature g " nor.umr it NO WARRANTY DEED 1#415 5►M.t rlESfnvtn row 14rChaUl N4i UAIA STATE RAIL OF WISCONSIN FORA 2-1902 ~ . " 4 35 U~f1.7 nnr-__ REGISTER'S OFFICE ` 1,~►~►st ST. CROIX Co., WI i Recd for Record ' • V~iri;lnia M. Ranson, a single woman - MAR &z l ss « 8:00 A M 0111-~s aunt 1~•.rrnnls to Sao E. Miller, a single man ~ / 11.1•:,•., ,n , p, the (4.1h.winc deserihed real estate in St. Cruix L•nl1a~. State of We-.4consin: 1 Tax Pnrcel No:............................. West Half (W')) of the Southwest Quarter (SW't,) Ill Section E Twenty-one (21), Township Twenty-nine (29) North, Range Nineteen (19) West, St. Croix County, Wisconsin except that part South of the r•ublic highway and except Lots 5, 6, 7, and 8 of Certified Survey Map n Vol. 6, Page 1747, Doc. No. 419479. -5 That part of the West Half (Wit) of the Northwest Quarter (NW'L) of Section Twenty-one (21), Township Twenty-nine (29) North, Ran,-e Nineteen (19) West, St. Croix County, Wisconsin lying South of the right of way of the Chicago, St. Paul, Minneapolis and Omaha Railway Company. t t TRANSVEJA z T 1 This is not hnri r•rt+•ad prol•eri . kink f t.% lint) Y.serp•ec b• tlarrnnlirs: easem-_nts of record and protective covenants and restrictions of record, if any. g lolled Olk day or m r ( 111 88 i , U IaEA1.1 tSEA1.1 Virginia M. Hanson i 4 - ISEA1.1 ISEA1.► 4 } AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN 1 I gs I w Vl Count%, authenticated this day of 19 Persnnsdl% came before me this day or M A rL t - 19 88 the above named Virginin.M. Hanson TITLE: NF.bIBER STATE, RAIL OF WISCONSIN (It not. authorized by 4 nuts.. Wis. StatsJ Ito me 6nna'n In he the rerron who eseeuled the forecoin • truntent anti nikolowledpe the same. T•I'S INSTRUMENT WAS DRAFTED nV V: t 1, . . . M. ya,•Neywpocf, Carl & .Murray 11.0. !lox 229. Iludson, W1••. 54016 .]y f( `:ola•'• uAl(r P ``T 1'mtntc. ll'ie. (Sirnnturea cony he authenticated or neknnet•Irdued. Rath ?l%• t'••m•l04ph Upgnt11111tuI4•ttt.l1f not, slate ro- rating L me not neressary.) "Nameo of p•rw.n..t4t"im[ In any rapalily • L..n'.1 1. 1,1 ...1 1 ,r.r..l 1. " 11,. , • • . WARRANTT DURD STA•rp, nAn Of %ISCONI-N µ1••.n.," I.fbl RI"•,• I FflllM 11o 2- l-,' t,