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016-1026-70-300
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Permit Holder's Name: City Village X Township Anderson, Leonard Glenwood Townshi CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ., / /,~~ (J Dosing Aeration l ~ L T Holding TANK SETBACK INFORMATION TANK TO /L WELL BLDG. Vent to Air Intake ROAD Septic ~ / ~~/ ~ / i Dosing Aeration Holdi PUMP/SIPHON INFORMATION rer SOIL ABSORPTION SYSTEM /~ ['.Gt~..~...1a.P~1,oJ/~. 0/ ELEVATION DATA County: $t. CroiX Sanitary Permit No: 420442 0 State Plan ID No: Parcel Tax No: 016-1026-70-300 STATION BS HI FS ELEV. Benchmark /b,'7 i~v, ~ /~Ya Alt. BM a ~~ ,~ ~ .L / 0~3. ~ Bldg. Sewer ,,Q,S StlHt Inlet 2 • L d~• t SUHt Outlet ? 3-3 Z /07~ Dt Inlet -~ Dt Bottom ~ J~ Header/Man. Dist. Pipe D rT G1'iYr1 S~ Bot. System ~'~ ~ Final Grade 3.v ~ 7. 7 i St Covef /~~ ~Z f~` ~ -- 20 .G, BED/TRENCH DIMENSIONS Width .3~ Length ~Z•~I No. Of Trenches ~~ PIT DIMENSION ~~ No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/L ~ BLDG WELL LAKE/STREAM LEACHING CHAMBER OR anufacj ~/ /~ I PLC rT'~ ~'~~ Type_Of System: ~~ ~ ~~ / ~~ /~ UNIT Model Numy~r~ / , t DISTRIBUTION SYSTEM Header/M~pifpld ~ / l 1/ Distribution Pipe(s) / ~~h ~ f ~ x Hole Size ~ x Hole Spacing Vent to Air Intake D Length Dia L. J ~ Length Dia Spacing / SOIL COVER x Pressure Svstems Onlv xx Mound Or At-Grade SYStems Only Depth Over „n , nx/ " _ Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trenr,h Cen~ ~ ~ ~ O V" Bed(Trench Edges Topsoil , Yes ~ No [~ Yes a No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: _/ o/~/~ Inspection #2: / / Location: 1598 Rutson~Road Glenwood City, WI 54.0~13~((SW 1/4 SE 1/4 12 T30N R15W) NA Lot 2 ~ Parcel No: 12.30.15.203a30 1.) Alt BM Description = /0 pl ~ ~~G ~'~~" 1~~~~QU/ .7„t~ _p~y~0~~ ~ 2.) Bldg sewer length = ~~ ~~ 1 r - amount of cover = ~' ~ l/ ~(- ~~~ awn ~,(e , 11~ ~ „ , ~ ~ ~~7~~ ~~~_ Plan revision Required? ~j Yes [ l ~-hJ-~ - -- ~ i ~ i Use other side for additional information. ~ r 6 ~ l !~ ~ __ ~3'V+^- SBD-6710 (R.3/97) Date Insepctor's Sig ature Cert. No. ~._ i?il At ac6 omple~ ( the County o y) for We syst on paper not less 81/2 x 11 inches in size. Safety and Buildings Division County q ` ~ ~ ' 201 W. Washington Ave., P.O. Box 7162 ~S COns jn Madison, WI 53707 - 7162 Site Address Department of Commerce ~p_ ~.. Z 3 d/( rj" ~j~p~ Sanitary Permit Application S~~y Permit Numbe r in accord with Cotnm 83.21, Wis. Adm.- Code, personal information ~ E ~ V E D J ~~ /~ (~~/ ~~+ eck if Revision 7 °"" / / ° ma be used for second ses Privac Law, s15.04 )(m) I. Application Information -Please Print All Information Sra Plan I.D. Number Pro Owner's Name azcel Number 2 ST.CR0IX000NT ~ ,.~Q~~.7Q~jBQ roperty Owner' ' ing Ad s ,.-~ ZONI - J ~ rry Location _ ~~ /~ ~ ~'` ,~, 5 ~k; S~~` T ON, R, City, State Zip Code Phone Number Block N r ~ , ~' 7 ~5 ~ ~~9 i n N~ ~~c' t~Z CSM Numbe 11~ ~ w..1-- X ~J t l(J O Type of Building (Check that apply.) I ,, ,~ w -- ~ ~ O City 1 or 2 Family Dwelling -Number of Bedrooms ~~~J~[~}' T l ^ Vill ^ Public/Commercial -Describe Use age O State Owned / ownshi ~ ~ ~D ~~~~ ~,~ Neazest Ro 3 ~ ,~, III. Type of Permit; (Check only one box on line A. Numbering is for internal use.) (Compl ete line B, if applicable.) `~' 8 s meW 2 O Replacemem System 3 ^ Replacement of Tank Onl 6 O Addition to Existin S stem For County use B' OCheck if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of POW'I' System: (Check all that apply. Numbering is for internal use.) !o ,~! i~t/SC I~f,Nt:! 44~i Non -Pressurized In-Ground 21 O Mound 47 O Sand Filter 50 O Constructed Wetland ~d 3l •~ -~ 22 O Pressurized In-Ground 41 O Holding Tank 48 O Single Pass ~ 51 O Drip Line 45 O At-Grade 46 OAerobic Treatment Unit 49 O Recirculating 30 OOdter ~ I~'-' V. Dis rsaUTreatment Area Informat ion: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate S stem Elevation Final Grade Required Pro s Rate(Gals./Days/Sq.Ft.) (Min./Inch ' levation, /~~/'~ c../IJIJ ~D~ r ~ ~Q~~~ ~Q~jj~'' , VI. Tank Info Capacity in Total Nuli-tber Manufacturer Prefab Site aSteel Fiber las Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank VII. Responsibility Statement- I, the undersigned, assume responsib' ' installation of the POWTS shown on the attached plans. Plumber's Name riot) Plumber's S' MP/MFRS Number Business Phone Number ,(~ ~(~ ~~~II Plumber's Address ( t, Ciry, State, tp C e) VIII. ount /De artment Use Onl Approved Disapproved O Owner Given Initial Adverse Sanitary Permit Fee mcludes Ground ter h S F ~ Daaa~~~eee Issued (~/ ' ' / suing Ag t Si o Stamps) Determination urc azge ee) ~~S ~_ ~ O % /// ~~y~,~ . Conditions of ApprovaUReasons for Disapproval S-~'~-~-, tt~'-=~ 2~ - Z~f `Z6 s~'i ~ d-~~r~-.d'ad' ~x.. Gnvd'a'wU b~,BI ~ 6 2 o~C~ ci ~ ' ~ '~ tr-' ,~t ~ -!~n~ - ~,4, (r ~ le.uut.e~ 3 6 .,~P-c.~ . c~l° ~C ~ 0 . . / At ace plete~ (ty m~~ y~) r~ u~,tLg au paper not tas 81n : ll inc>MS io she .a~ e~#- ~ ~ X 3 ~SF3 l Safety and Buildings Division County o ` ~ ~ 201 W. Washington Ave., P.O. Box 7162 ~S~~~S, ~ Madison, WI 53707 - 7162 Site Address t De artment of Commerce `j" ~(/i3p~ Sanitary Permit Application Sanitary Pertmt Number In accord with Comm 83.21, Wis. Adm. Code, personal information ~ E I V E D 1~~ eck if Revision 7 / ma be used for seco sec Privac Law, s 15. )(m) I. Application Information -Please Print All Information Sta Plan I.D. Number Pr Owner's Name 1 Number Z ST. CROIX COUNT i ~ ,. (Q p'; ~ ~ 70 -~ j B 0 operry Owner' Address ii ZONI rty location ~~ /~, i~ S J 54; S/~ T oN, R J City, Slate Zip Code Phone Number Block N Wy f ~ ~/ 1 V ~ ~ J ~~ ~l(J~~ 1 n N~ ~s ~Z CSM N - UJU1l~ ~ , tJC.l O Type of Building (Check that apply.) ^ ~ ^Ciry ~ 1 or 2 Family Dwelling -Number of Bedrooms O~ ^ Village O Public/Commercial -Describe Use own hi O State Own d s e ~ ~/ ~o C~a~~ ~,~ Nearest Road- 3 ~ ~~ III. Type of Permit: (Check only one box on line A. Numbering is for internal tile.) (Compl ete line B, if applicable.) A. 1 New S rani 2 O Replacement System 3 0 Replacement of Tank Onl 6 0 Addition to Existin S stem For County use B' OCheck if Sanitary Permit Previously Issued Permit Number Date Issued lv Type of POWT System: (Check all that apply. Numbering is for internal use.) is D t ~C /KI-Gl 44~ Non -Pressurized In-Ground 21 O Moues 47 O Sand Filter 50 O Constructed Wetland ~d 3/•~ 22 ~ Pressurized In-Ground 41 O Holding Tank 48 ~ Single Pass ~ A O Drip Line 45 O At-Grade 46 OAerobic Trvzttnem Unit 49 O Recirculating 30 OOther +~ /~'+ V. Dis t'salll~eatment Area Informat ion: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate S stem Elevation Final Grade Required Proposed ,,, Rate(Gals./Days/Sq.Ft.) (Min./Inch evasion ~~ (ADD VJr~`/!~"} 5 ~~o~.~ io~~~r , o VI. Tank Info Capacity is Tocil Number Manufacturer Prefab Site Steel +r Fiber lactic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tatilt Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsib' ' installation of the POWTS shown oa the attached plans. Plumber's Name riot) Plumber's S' MP/MFRS Number Business Phone Number ~© ~~~~1 Plumber's Address ( t, Ciry, State, tp C e) VIII. ount /De ant Use Onl Approved Disapproved O Owner Given Initial Adverse Sanitary Permit Fee includes Groundwater D Issued ~a suing Ag t Si o Stamps) Determination Surcharge Pee) ~ ~~S ~ C~ O . Conditions of AgprovaUReasons for Disapproval S~"~'~r,~-~°~' `i( Z l - ZEE "~ sC~' i k~.p d ~t,tr?'~d' tx~ ~ b.m-:8! f~ 6 2 °~ ~ ~ ' ~ ~ ji /Yi t ~1hry - ~C~fd- ~' Gtr-" ~l? I'~G- 40 4 ~ leGl~v 3 f~ u J P fF~.. Z ~~~~: a-Wv~,t.- u/ pZct~'S /~' tit I ..1~% G ~ N d+~G-C QV1 ~~fi~r Sm •~ - ,v c,~ N~ ~ 3 3 0 ~S `7da.n rP s'!wt w~~ -~~'~~ (do~7~ L ~d~ ~. ~3 ~, ~~ ~~n ~~ _ /DV @ ~ld~~~" ~ ~ ~9 -J 5~~ ~,~ o '~~ - ~ p l62 ~~ /~~~ ~-~ -8-1 6a , t o~•9 ,u ~ lV_ a ~ ~ ~~~~.. ~F of Q No~~ ~, ~~ ~` Sc ~ 1 ~. ~ •,_ y o ~ ZO y0 ~~ ~,u ~j~ .~rA~~~?KId ~ ~ ~OD boo : n3~.~ ~ ~9.z`t9 slcl~ ~~rpOs~~ ~~ s~~ /ls 1 .3 ~p D~.f~'~,c..~-r Cl~~ w w N~ ~3 30 ~5 `1 ow n ~ 61~ w~ ~ t ~ ~ ~ ~,' ''~ ,~ ~,; /~7-~l~d ~~-'~~ ldo~7~ L t ~~' ~ ~ _ Gov ~ ~~d19~~ pp~, L /~ ~~O O~ t `p~ o ~ / ^'°%~~ ~-~ ~D B-~ ~ o~,~ N a ~~ ~° ~, ~ ~'~ ~o o ~8ir ~vv~ N~~~ Scan (~ ~„_ yo .~. ° Z° No 1 ~U a2 g = 3 °°f P.D ~o ad ~.l ,~,~-~- = , s y ~ ~ j~ ~~ ~~ .h~A~N~K,a/6I ~ app boo : 3/./ . /9, z9 Sit// pT..poudP ~o slc 1 ~s ~~o p-1.f,~~..o..s C~r-~, .. r~RIGtI~~L SOIL EVALUATION REPORT Wisconsin Department of Commerce Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code nun Attach complete site plan on paper not less than 8'/z x 11 inches in size. Plan must include, but not limited to: vertical and horiz ren~, direction and parcr percent slope, scale or dimemsions, no arfb~t,'an. Ibcation an • lance to nearest road. Please p t`a~Lrnformation. ~~ " ~e 1f , Personal information you provide t~e`ased fors ses (Privacy Law; s. 15.04 (1) (m)). `.• ropey wner c~. ~~ rope oca ion 1365 . Page I of 3 Certified Soil Testing St. Croix 016-1026-70 ~ ~' By ~ Date r~%_Y//~_- /O 2 ~ ~ Z (.1 Anderson, Leonard L~ ~~ 1 ?~ ovt. Lot NW 1/4 NE 1/4 S 13 30 N R 15 W Property wner s ai mg dre s ~~~ ~ _flpt o lock # Subd. Name or CSM SP t~ i n ~ ~ ~ 1600 Rutson Road -' S ~• F~ • • ~J7N ~" ,Code Ph tuber City St te~ Village Town Nearest Road / J~ Glenwood City ~ WI ;~C113. 715-265-42 ~ J Glenwood Rutson ,• Use: New Construction Residen i r of bedrooms 2 Code enve esign ow ra e Replacement Public or commercial -Describe: Parent material Sandstone Flood plain elevation, if applicable NA General comments and recommendations: install 2 - 2.7' x 81.25' stipulation 1 amber trenches (13 shells ea trench) for 2 br @ system elevation 2.5' below contour lines 104.5 below 107.0 ~~ Boring # ~i Boring Pit Ground Surface elev. 107.9 ft . Depth to limiting factor > 100 in. Soil Application Rate Horizon De th Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIft~ p in. Munsell Qu. Sz. Cont. Cobr Gr. Sz. Sh. 1 D-5 10YR 2/1 - sl 2 m gr mvfr cs 1f/m .5 .9 2 5-31 10YR 3/4 - sl 1 m sbk mvfr gs 1m .4 .6 3 31-63 10YR 3/4 - sl 2 m sbk mvfr cs lm .5 .9 4 63-100 10YR 4/4 - s 0 sg ml - - .7 1.2 i S ,s 3a -~ 3" w ^ Boring # ~ Boring I Pit Ground Surface elev. 107.7 ft. Depth to limiting factor 79 in. Soil Appligtion Rate Depth Horizon Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft' ~ In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 ~, 0-5 10YR 2/1 - sl 2 m gr mvfr cs 1flm .5 .9 2 ~ 5-22 7.5YR 4/4 - Is 0 sg dl cs 1 m .7 12 3 22-62 7.5YR 4!4 - sl 2 m sbk mvfr cs 1 m .5 .9 4 62-79 10YR 7/4 - fs 0 sg dl cw 1 m .5 .9 5 79-85 SSBR 4 ~ 9 is wea y cemen a ,rests an o ene ra ion ` Effluent #1 = BOD_ > 30 < 220 ma/L and TSS >30 < 150 mall 'Effluent #2 = BOD_ < 30 mgfL and TSS < 30 mgJL > _ - - o- - ame ease not gna ure: um er Henry F. Grote 222774 Address Certified Soil Testing ate Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 5475 9122/2000 715-233-0398 Property owner Anderson, Leonard Parcel ID # 016-1026-70-000 • Page '2 of 3 Boring # Boring Pit Ground Surface elev. 102.0 ft• Deplh to limiting factor 70 in. Soil Application Rate H i D th Dominant Color Redox Description Texture Structure Consistence Boundary Roots or zon ep in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-6 10YR 2/1 - sl 2 m gr mvfr cs 1f/m .5 .9 2 6-22 7.5YR 4/4 - Is 0 sg dl gs 1 m .7 1.2 3 22-48 7.5YR 4/4 - st 2 m sbk mvfr cs 1m .5 .9 4 48-70 10YR 6/2 - fs 0 sg dl cw 1 m .5 .9 5 70-75 SSBR 3 -~ rs is wea y cemente ,resistant to penetration a Boring # _l Boring Pit Ground Surface elev. ft. Depth to limiting factor in• Soii Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P ~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I I I I his report re iminary; site c eanng nee a to etter a me s opes; ma ize ouse ovation; set secon env mark; a a itiona pits (. ) Boring # ~ Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Appliption Rate Horizon ~ Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P i in. Munsell Qu. Sz. Conl. Color Gr. Sz. Sh. ~ I I * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L "Effluent #2 = BOD < 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. Sao-s,3o (R o7~00) Certified Soil Testlng Property Owner Anderson, Leonard Parcel 1D # 016-1026-70-000 Page 2 _of 3 ^ g Boring 3 Borin # - Pit Ground Surtace elev. 102.0 ft• Depth to limiting factor 70 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. 1 0-6 10YR 211 - sl 2 m gr mvfr cs 1f/m .5 .9 2 j 6-22 7.5YR 4/4 - Is 0 sg dl gs 1 m .7 ~ 1.2 --- ~ 3 ---- i 22-48 j 7.5YR 4!4 - sl , 2 m sbk ~ i mvfr - ~ ~ cs --~ ~ 1 m ~ -- .5 .9 r--~--- ~. _ 4 ~ 48-70 ~ Y01 R 612 - fs 0 sg ~ dl j cw ~ 1 m ~ .5 .9 5 70-75 i SSBR ---- ~ - ~ is wea y cemente ,resistant to penetration Boring # __j Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth ! Dominant Color in. '~ Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots t= ------- I i ----- i ~ i ~ ~ ~. - - - --- - - i I, _ ~ ~ ifs report Preliminary; site c eating nee a to better a me s opes; ma ize ouse ocaUon; set second enchmark; ad a diona{ pit(s) (?) Boring # ~~ Boring !Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth '~ Dominant Color in. ~ Munsell Redox Description Qu. Sz. Cont. Color Texture Structure j Consistence Boundary I Roots P ID i{~ Gr. Sz. Sh. I j i 1 -. i -- - - ---~- j j i ! ~ ~ ~` - r I ~ ~, _~. i f ~ -_ ~ -- - --- + -~ --t------ i i -- --- -- - --- -- .----r..-~ _ ~ rt r i j i j --,- --- -- _ - -- - - - - . _ - - -- --- T ~ Effluent #1 = SODS> 30 < 220 mg/L and TSS >30 < 150 mgiL "Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L 5 - l he 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 608-266-31 ~ I or TTY 608-264-8777. ,au-s,iu iR ~~~ooi Certified Sal resting I CI ~ .q) _~ ~3 ~c 090 ., s~ac~.. ~ z ~ ~ ~ ~ o L o g-o c ~',~ ~~ zzz~~ .~ is we ¢~ ate, o ~ ~~ a a~ ~ n r 'r ~~~ sit } ~r ~~~ ~-~'~' dpi N a~.~ ~ 1,~ .~i.Q.~ ~• 1 r ~- ~~ V~ o w~„ ~ o ~..~ 1.s w. 4 It Z~ t c,~ S ~sa~.~ ~~ M o1C„C~i+ wt i~ ~ ~'J ~~ ~ a,,,S-., ~: ,~ z - ~ t.,,, ca.;~ ~t~ ~ w. 3 ~~; ~¢ _ _ s •. ~. ~ , 1510 n r ~1w-`N 1':-1"S~3o-~S w .,.. '~ a.. C.A vy ~ ,... X.t bra,,. ~ ~..-. 1 0 ~ w...r~ S ' ~.+~ rs ..~. r ads aw ~L y`0 ~ •o ) `~vo.0) I~Z,J) ~. ~a s.. ~ (/(S - 3 Y `1 ~.. 4-- 3 - Z Z`F~ o ~... (t .•--~ -• ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~`"~ ~ ~ ~ /' ~ Cf~.-C~ /' .S ~ ~ Mailing Address k~ / 5 d , , ~~ a Property Address "~'~ ~' ~`-~' (Verification required from Planning Department for new construction) City/State ~~' ~~ vt %~~ ~> ~~~' ~c `~ Parcel Identification Number ~~.. 3a. /S-. ~a3 ~~ 3d LEGAL DESCRIPTION ;~ ~ Pro Location '/., ~y~'- '/., Sec. 1 TAN-R / ~ __~, Town of ~~ ~~~ ~ ~ ~ %l-~`~ . per' Lot # Subdivision ^/ Certified Survey Map # tPIP(n ~ ~ ,Volume S Page # Warranty Deed # ,Volume .Page # Spec house ^ yes ^ no Lot lines identifiable ^ yes ^ no SYSTEM MAINTENANCE 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. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastorplumber, journeymanplumber, restrictedplumber or a licensedpumper verifying that (1) the os~site wastewaterdisposal system is is 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 Zoning Office within 30 days of the three year expiration date. ~~ ~~~~~~ SI ATURE OF APPLICANT ~~iDZ- DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) lmowledge. I (we) am (are) the owner(s) of the property descnbed above, by virtue of a warranty deed recorded in Register of Deeds Office. / / tJI3ATURE OF APPLICANT DATE *****« Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. *"`**** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed POWTS OWNER'S MANUAL MANAGEMENT PLAN FII.E IN ORMATIO Owner ^ Permit # ~ DESIGN PARAME IItS Number of Bedrooms 100gpd/bedroom ^ NA Number of Commercial Units -- NA Estimated flow (average)* gal/day Design flow (peak), estimated x 1.5* gaUday Soil Application Rate gaUday Influent/Effluent Quality (NA^) Monthly Average** Fats. Oil & Grease (FOG) < 30 mg/L Biochemical Oxygen Demand (BODs) S 220 mg/L Total Suspended Solids (TSS) _< 250 mg/L Pretreated Effluent Quality ^ Monthly Average*** Biochemical Oxygen Demand (BODs) ~ 30 mg/L Total Suspended Solids (TSS) 5 30 mg/L Fecal Coliform (geometric meant 510}cfu/100m1 Maximum Effluent Particle Size 1/8 inch diameter *Wastewater Flow Verification on and calculations: (Other than bedroom based) ** Values typical for domestic (non-commercial wastewater and septic tank effluent. ' ***Values typical for pretreated wastewater. SYSTEM SPECIFICATIONS Septic Tank Capacity gal ^ NA Septic Tank Manufacturer ^ NA Effluent Filter Manufacturer ^ NA Effluent Filter Model ^ NA Pump Tank Capacity gal ^ NA Pump Tank Manufacturer ^ NA Pump Manufacturer ^ NA Pump Model ^ NA Pretreatment Unit ^ NA ^ Sand/Gravel Filter ^ Peat Filter ^ Mechanical Aeration ^ Wetland ^ Disinfection ^ Other: Manufacturer: Model: Dispersal Cell(s) In-ground (gravity) ^ In-ground (pressurized) At-grade ^ Mound ^ Drip-line ^ Other: ^ Leachin Chamber Manufacturer Model ' ` Approval Stipulation Soil Application Rate ~ d/fl Area Req.~Q~ Absorption Area Credit per unit ft2 Minimum Number of Chambers ^ Aggregate Design Flow/Loading Rate= min Materials: all materials must comply with WI Adm. Code COMM84 and be installed per manufacturers specifications and approval letters. DESIGN CRITERIA ^ "Wisconsin At-grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.a1.1990) ^ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 _ ^ "Design of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems" Publications 9.6 ^ "Design of Conventional Soil Absorption Trenches and Beds". RJ. Otis - ASAE Publications 5-77 and "Design Manual - Onsite Wastewater Treatment and Disposal Systems". EPA 625/1-80-012 October 1980 ^ SBD -10570-P (R.6/99) "At-Grade Component Manual Using Pressure Distribution" ^ SBD -10567 P (8.6/99) "In Ground Absorption Component Manual" ^SBD -10705-P (N.O1/Ol) "In Ground Soil Absorption Component Manual" Version 2.0 ^ SBD -10628-P (N.6I99) "Recirculating Sand Filter System Component Manual" ^ SBD -10656-P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" ^ SBD -10572 P (8.6/99) "Mound Component Manual" ^ SBD = 10691 P (N.O1/Ol) "Mound Component Manual" Version 2.0 ^ SBD - 10595-P (8.6/99) "Single Pass 8atd Filter Component Manual" ^ SBD - 10657 P (8.6/99) "Drip-line Effluent Disposal Component Manual" ^ SBD -10573 P (R 6199) "Pressure Distribution Component Manual" ^ SBD - 10706-P (N.O1/O1) "Pressure Distribution Component Manual" Version 2.0 ^ Drip-line Effluent Dispersal Component Manual for Multi-flo Onsite Wastewater Treatment Units MAINTENANCE MONITORING SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every ^ months year(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one-third (1/3) of tank volume Inspect dispersal cell(s) At least once every ^ months year(s) (Maximum 3 yrs.) Clean effluent filter At least once every ^ months j~ year(s} inspect pump, pump controls & alarm At least once every ^ months year(s) ^ NA Flush laterals and pressure test At least once every ^ months ^ year(s) ^ NA Valves At least once every ^ months ^ year(s) ^ NA Other: At least once every ^ months ~ ^ year(s) ^ NA Page of START UP For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation ofwater-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/iruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. ^ Valves Valves shall be operated in the following manner: ^ Alarms Alarms should be tested on a regulaz basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regulaz operating conditions, however water should be conserved until any problems with the system are corrected to prevent back-up of sewage into the dwelling or surfacing. INPECTI.ONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). ^ Septic Tanks Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any backup or ponding of effiuent to the ground surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. F,xposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one-third (lf3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning maybe necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. ^ Pump Chamber/Treatment Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hazdwaze and the condition of the filter. Any service needs or repairs shall be promptly taken caze of. ^ In-Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Page of :.>,~„ ^ Mound, At-Grade, In-Ground Pressure The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or dischazge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) yeazs. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with CO]VIM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. - The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. - After pumping, all tanks and pits shall be eicavated and removed or their covers removed and-the void space filled with soil, gravel or other inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ^ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement azea should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ^ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ^ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank maybe installed as a last resort to replace the failed POWTS. ^ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. «WARNING» ~ . SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CII2CUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMII~NTS tvame Phone Phone K:IWPDATA~EH~POWTS OWNER'S MANUAL.doc POWTS MAINTAINER Name Phone LOCAL REGULATORY AUTHORITY Agency. Phone Page of /~ Document Number ~~.~.1550pAGE264 QUIT CLAIM DEED 1..~.1~..:~.xxti...~.:...~~~_~,r'~c~`I~..._....s~.ks:~...lr..).i.~.~a~~,.m. ~_.~a~.z.risk, 1,sa.; ~.~_..__Gl~.......~.~A.t...V..1.`!.hC r.S.~*:1a..~1?......:MQ.x.~:~s~,.`.....>~1~~.`~'..~..k.~Y quit-clelms to....~~~1.1L1f.4.Y...l:~.....isl.....t'LS1ci~~.~,~C~l......4..~!1,.1~1.....~~Y..IA.~ki.! .1:!i.....Act..e:s~.~.Y.a ............................................................................................................... ..........................................................................tt......................,........,..__................_.........._- - the following deuritxd real eatale in...~.i...,.~KG:.I.~l ................................County. State of Wisconsin: ? ` ~ ~o.r~r o~ Lo-4 ,} Cdr C.~~ec~ 5ucvt-~ VYIa~ 1$)O dR~~~ -~-,zc-$7 cut~c~ reco.ro\r~\ t~~'ic\umc. 7 Q~t ~ f K16 hoc-~..r-r~ e ~t~ t" ~~ .5 5 13 . r .c,rJ,s iGg~ H 631659 KATHLEEN H. WALSN kEGI5TEk Of DEEDS ST. CkOIX CO., WI RECEI4ED f0R AECORD 10-12-2000 3:OD PM UUii CIAilI DEED EXEMPT d CEP.T CDPY FEE: CDPY FEE: TkAHSFER FEE: 13.80 kECDRDIHG FEE: 10.00 PP.GES: 1 Rewrding Area Neme and Return Addrea ~,,q.,q,,.d~ s~ e~ S r.,~„~ d t'T ~ /~ • 10,2 ? ~ -SD ` / 0 ° ~ ` ti'~' m e`,G~ ~~ g t 3 ~ ~ zek L°k 3 5 nt•-~h 3~ ~ e~~ (Parcel Identifieatton Number) Ylor~~ k o_sa corv~er °~ e~ ~l~er~ce Yla'c}~ a-hence t.:e>~ ~3,~asa ~ ~Q~~r,~ ~4~S~hr\;r`c~- 3GC, tis ec~ \rhe r~cF TAU ...............:..............liomectead property. Dated rhia.......1 ....................day oC.........4~.C..~............................ ;'491Q0 (Iti~e (is not) ACKNOWLEDGMENT srwTrs or wlscaNSQr ...... $ t_:.. ~ r O 1 X ....County. Personally came betorc me this.._~. ~...dsyoL..~.C t o,~3.~. T;..t.....2 fl 0 0 me.bovenamed William PitZrick, Sr. Charlene Pitzrick 7TI1.H: ME3M1(LR STATE HAR OF WIS(.`ONS(N ................................................................................................. authorized by SS 70f,.1K, Wis. Statutes) to me known to be the person.. 5....... who esecuted the (orogoln~ dHN..urgMr ,a y~~~/. itvtrumcnt and scknowl same. ,~~~~ $T~pd4 ... ... algnawre Kathleen = 9tt 111tL rt .~ ...~.....~{~..~....._..,$,~.............t.. . . t name ri • Names o[ persons ai&nins In any capably shovid tx typed ~ . ..... ................... n type or p G ~ , l X ~ ~, ~~ ~t„~ ~ ~ r S t L bD P or printed below theft signatutrs. ^ ~ . . , .... , . e..... u Notary ~• My Commlasion 4 permanent. (1( not, slattrllOp,,,.. •'' ~, • ' ^ ~~ .Sri /~ ~~ ~7 n r n.......---- ~ ~ ~ ~ ., ,~ os w~ , _. _ ..... _.. . .r 'Ittis instntmcnt was dratted by (type or print name) Oate:.......A.p Y.1. ~.....6..•' ......................... ...................... svnnw.rnn~~ nn ...................................................................................................................... type M print name FORM N0.985•A Stock No. 26273 ~~ i ~~ °o ` , V! \ ~ ` LOT 2 90539 SQ. FT. \<2.08tACRES> is CERTIFIED SURVEY MAP' NO. ``228 VOLUME ~ 5 ,PAGE ~22s PART O~ SAIi-TEST ~ 1d _ THE SOUTHEAST 1 4, SECTION 12, TOWNSHIP 30 NORTH, RANGE- ~~~ T, ART ERTIFIED SURVEY N0. 1810 VOLUME 7 PAGE 1810, LOCATED IN THE NO THE NORTHEAST ! j4, ~~ ~, v „~/~ SECTION 13, TOWNSHIP 30 NORTH, RANGE 15 WEST, ~~, n~ TOWN OF GLENWOOD, ST. CROIX COUNTY, WISCONSIN ~i J'~° !--' ~ frrj' Note: Each parcel on this mop is subject to Stats, County and Township laws, rules and regulations I (I.e. wetlands, minimum lot size, access to parcel, etc.). Before purchoaing or developing any lot, contact the ST. Croix County Zoning Office and the Town of Glenwood. UNPLATTED LANDS ~. ~' ~ PREPARED FOR N~ y°/ ,~~, ' LEGEND LA.ANDERSON N x8.43'31• w 1600 RUTSON ROAD ~ ~ GOVERNMENT CORNER 100.00' ti~ (AS NOTED) , GLENW000 aTY, wl 54013 ~`~ ~iy ~ FOUND 3/4 STEEL REBAR ~ ~<~'> , ,_. G~. q~ / ~ o SET. 3/4"X24• sTEEL DRAFTED BY• ~,,~- .y ,i...•, ., ., . REBAR WEIGHING 1.502 LBS. ~~ M• Ct.AR^~•r f~ `"~'~` ~/ ~• PER UNEAL FOOT. riann;r^ ~3 yOf O~ ~~ I () RECORDED AS UNPLATTED LANDS ~ ~' ~1' 2~~1 n ~ ~ N 82.26'07• W N 88.43'31' W 410.93' tt nog ~° ,; ,;: <~t~:;,,' / ! 40.46 `' 241.93' 169.00' `'~' ~ ~" .~ (FOR PolGRESS - ~k3 ~~° OUTLOT 1 ~ ~ E~~+) o o° S 88'43'31" E 2614.13' g 21950 SQ. FT, N 88.43'31' W ~ ~ ' 3'31" E 1576.06' a CQ.50tACRES> 66.00' ~..° ORTH UNE OF NE 1 4. SEC. 1 S 88.43'31' E 308.13' W ® ~ ' PT. OF BEG. ' S 88.43'31' E 663.94' a+ o NORTH 1/4 CORNER ~ °_ SEC.13, T3QN, R15W Di NORTHEAST CORNER FOUND. 1" IRON PIPE O~, ~ ~~ ~ tU SEC.13. T30N, R15W v~ ~ta,/~ .. , o "' FOUND ALUMINUM MONUMENT ~1' Z ~'~'~ '~% N 88.43'31' W 94.00' LOT 1 N ~~ 4 ~ pi c 3 90207 SQ. FT. ~ fl 'yj o ! <2.07tACRES) W a% ~ 3 •e~eseas~~ ~ a ~~ 'VC • -6' ~ ~ ~ m w * Dt7NAL0 M: * b ~ ~ ~ r CLARK y ~- ~ - s~~aeo ~ ~ C MENOMONIEr Q: ~N ~,/~~~. ~ ~ ~ ~~~ t~~Rf ~Q~`~~~ //-3a-oi /66b745 3 IL.. i 5 I~" Iii r:a KATHC~EE~i•' H. WAL5H REGI5TEk OF DEEDS 5i'. CkUIX CD. WI RECEIVED FOR RECaRD 12-~a-2ooi lo:oo an COPY FEE: 3.00 kECORDIHG FEE: 13.00 PAGES: 2 ~, ti~ ~Q ~ ~. ~/ r~ ~%~ S 88.43'31' E 335.00' ~, N 0 Z ~i A! ar ~ ~_ a= zi FORM N0.985-A Mewnva...n® Stock No. 26273 CERTIFIED SURVEY MAP NO. . VOLUME ,PAGE LOCATED IN THE NORTHWEST QUARTER OF THE NORTHEAST QUARTER OF SECTION 13, TOWNSHIP 30 NORTH, RANGE 15 WE5T, TO WN OF GLENWOOD, ST. CROIX COUNTY, WISCONSIN UNPLAtTED L.{NDS AE G~ARN~R fOUhID OINNV ' " ~ S dd~l?Jf" k' ~ G0. MQNf~~N7 S 88 43 31 E 653 53' t 41 S 88'43'31 " E 653.54' ~ ~ ¢ ~~i9d ~ N~.3'~!J'Ia$ iJ O~' NARTN LdNE !VE!/4 ~•JOJ ~4 C / ~~~ ~ a ~ f'nuw t~i~edvf3 >~ A LO 1 CSM 5 ~~ ~ r/s aF sFCnanr v~. T.natit ~aRC (~sx-n~a ,. As s aa~u'sr" p. ` SCALE: 1 " = 200' t 2 0 LEGEND o SET 3/4" x 24" RF-ROD WEIGHING 1.502 LBS~/Lf. ~ FO(IND 3/4` RE-ROD ~ SECTION CORNER AS NOTED ,PREPARED FOR: cEOR~ sERACK~ GLENwnoD arr, w1 W +N L 2 NM~4-l~I~ Nwi/r coT 2 3 429,85? SQL FT. ~ 9 8T ACRESt EXCLUDING ROAD S A(~tEAGE ,,, ~~~~ ie~ (__~ 43Q 165 SU. FT. 9,88 ACRESt ~~_ __ ~r .s ~ ° ~; J i~zoo• Sdd~1F9t O ~ ~ TNC av~ss W ~ s ~oaoo' - s aa'~t9s' E 3 ~ ~~ s~ c~aRn~t NR~r.-N~i. .n~~r .M~~r N 88'40'20" W 654.94' 1/ N P L A T 7-E D t A N D 5 _~`~~~or~rA~+~~~ FORM N0.985•A 4~n^~ Stock No. 26273 PART OF SECTION PART OF LOCATED. SECTION TOWN OF CERTIFIED SURVEY MAP N0. VOLUME ~ s ,PAGE _ THE SOUTHWEST 1/4 OF THE SOUTHEAST 1/4, 12, TOWNSHIP 30 NORTH, RANGE "15 WEST, AND LOT 3, CERTIFIED SURVEY N0. 1810, VOLUME 7, IN THE NORTHWEST 1/4 OF THE NORTHEAST 1/4, 13, TOWNSHIP 30 NORTH, RANGE 15 WEST, GLENWOOD, ST. CROIX COUNTY, WISCONSIN SURVEYOR'S CERTIFlCATE: PAGE 1810, I, Donald M. Clark, Wisconsin Registered Land Surveyor, hereby certif . That I have surveyed. divided and mopped part of the Southwest 1~4 of the Southeast 1/4 of Section 12 and part of Lot 3 of Certified Survey .Map 1810, Volume 7, Page 1810 located in the Northwest 1/4 of the Northeast 1/4 of Section 13, all in Township 30 North, Range 15 West, Town of Glenwood, ST. Croix County, Wisconsin, more particularly described as: Commencing at the North 1/4 Corner of said Section 13; ....., ; •. :,, thence S 88'43'31" E 663.94 feet to the point of beginning; .. `•'', , _ . thence continuing S 88'43'31" E 308.13 feet; ~ ~~~'~^'"" thence S 00'58'49" W 430.00 feet; ~ n c, ')(~~ ~ thence S 88'43'31" E 335.00 feet; ~}!:.~' ~~ ' `' thence N 00'58`49" E 685.40 feet; thence N 88'43'31" W 100.00 feet; thence S 00'58'49" W 189.40 feet; ~~"`•" •`:~;:~;:~.•,:. thence N 88'43'31" W 410.93 feel; as'''"`' '~ . thence N 82"26'07" W 40.46 feet; thence S 53'43'40" W 115.58 feet to the point of beginning. Containing 202.696 square feat (4.65facres) more or less, and being subject to existing easements. That I have made such survey, land division and map at the direction of L.A.Anderson 1600 Rutson Road, Glenwood City, Wisconsin. 54013. That such map is a correct representation of the exterior boundaries of the land surveyed and the subdivision thereof made. That I have fully complied with the provisions of Chapter 236.34 of the Wisconsin State Statutes and the Subdivision Regulations of the Town of Glenwood and the County of ST. Croix in surveying, dividing and mapping the same. Gated this~~ day of ~ - 2001 +NeN~e ~~ G ~•N.S ~'•y .A Donald M. Clark, R.L.S. 1580 ~ ~' : ppP1ALD M. s ~ CLARK S-1580 4228 4228 MENOMONtL, " ~or~ l ~- .c•~c " ~'`,~,, ~ ~ !~ ~'~~~~ ~w ~- E ~ -~. ~J ~- - t~ ~ ~ / ~ ~~ r,~~ ~ ~c~~rT,~ ~ ~j ~ ,..T. 0/sue L.~'.an~-d to ~ / ~/3 P/ ~8~ 2~~/a~~.---- Private ®n-Site Wastewater Treatment System (POWYS) CGzd~~~~ 7 ~~~L Indez and Title Sheet ~ ,C,.r ~ Owner: ~ ~,n(~~ Jl,~,~ , Z !off ~~ ~~ Goy" / ~ Project Name < Location: Contents: Page 4: Page 5: Page 6: Page 7: Page 8: Page 9: Attachments: 1, h (i ll 0 Pi ., n _ Plumber/Designer: Sign Credential Number ~~-S©J~ Date• q' ~ ~-[' o~.. a q~~ v4 l~ II Page 3: See Pncle 70 2 1 S • 1 , ~ li t FA 6 P ~ xel necon n ~ ~ 1 z •1 W ~a~~ Melvin 66.8 273.5 g : ~ au 1 h & anda 1 • 15] 151 John xkelen D & Laura a Simonson 4s 5 vWfe,,,, Ih ~„n h ~a„„h } i Bush 6 ~ 3 -3 3 J c fi 3 4 Emma Nitche ~ h Thomas • i J Jackelen 5 s ~ 3 J 5 f Jeffre & +, M,,;ly° m4ma Laavrence Lake ~ Michael & .N ~ 12 ry 8 Dale & Majerus lpp.g a,~ y s<n° 3s Schug .N Sarah Cassellius ` x ~ Herman Pitt 135.5 E1vd Bahnub 10 4 % 7 111 • v 117 7 111 9 % g . $7 ' • 11 9 JOaM N 7 111 9 •7 10 9 N 7 s ~ y 3 ~ Beiends 117 Joseph 257.510 436 2 207.9 116 234 4 ~ $ ackelen J ~ 4y . , X Wl Kevm& 146 Little B h 1002 x•`. .CENTRAL 217 ~Hazold& u y n• 1732 Steven & Patricia Rodney & Roxanne Croes us y Lake m 92 pJlme Stack •~ • David • pl ~ Warner MardeHa 1075 M ll 1°seFh lr •1°%eph Richard • Genearevre~ve Ernest Sw ~ 38.3 ~ 158 GabOW2r ~ ~ Gordal 6c ? 126.4 Schug • • 114 arce a 4. • Prinsen ak 1°a;m Helgevold .1°aim Hdgevol & Patricia liacon Iackelen Severson 49 °„`O Y roa,be Tr elal $ m a Carol Adams - Frank & Frank • • Thomas & ~ ,,,~ xeN ~ Gerald ~~ Standaert 152 !T ~ a ~ Roger k Peter & Ile Donna Warner Lynette Schug y m ~ bbs ,Op 76'5 80 rt ~ R b ~ ~ ~ Helen Jerry Courtney Warner " ~ ~ ~ .-, ~ Ronald & oe<<s l0 o e & Melodee 151 S 3 - • ~ • • Stansbury 160 k Karol ~+ 200 160 DineBonte ~~ 226 0~ Forrest }~ 76 160 ~ o M ~ 203.3 Donald ~,,,,.al. ~ en'~ m u' Maes 0 ~a &1 B`B 40 g het tep f cy°w+ lames & ~ E 4+ ~ • • Peter & Sheila 160 Anderson • &Mary Bonte Olson ~ier• w Gladys tbnte ~ A °`d Z "~ 146 Wayne & • Newcombe Robert etal . ,y S Torleta • Trust effre & J y es.9 80 r2 v° ~ ~ ~ Earl ar 1° re Y David & Theresa clrlstopher 30 •wesle Fritz Aspllmd Sheila Wa ner 35 40 ~ O w st! Nieman Yoder Hoffman f l orie leuseu ~ Fh ' 71 2 16 0 g r x 77 2 r ~ 159 ~ . 80 *~ 5 • . 7 79 t 59 • Nict4ols r ~~ ~ l ~G s 40 " © Richard • ~ = ~ °Tp'; Herbert & Gregory cam' z ode 39s • ~ ~ r~ Isla e • YC Paul 6r 31.7 Mar ene oo se4ls %11 ~ 159 & Grace Robert & Theresa ~ J2 o Rose Luks pesmith ~ ~ xa°ps 4o Haas ~ ° b m~* 39 $ ~ !a, Susan I d ~ Obermueuer ~ ~^ °D Obermueller o'$ 6o td ~ Robert wester scon t, . G ,se zo regory , Swven m e ra _ -. 233 7 pq ~ 110 . Rhodes 70 Palewicz T~ a s~ , Ito 426 160 . • • ~ Barrirl er 74 t5 ~'•'~~ 80 ~ s Elwood h lames Jr & 39 5 wacam ksaan ~ ~ ~ 01 97.2 a 1°Yxt~ur Wayne 90 Schcenwetter Gib O n J Dona We : Y . Mai N » ~ ~+ ~ oe+ Peterson 217 4 d ld L Trust son Moe ~ ~ g = ~ ~ . Emera an Corporation Tunothy Anderson 80• 160 ~ G~ ~y~ 3 lla °~ ~ 5 ~ ~ ~ ~ ~ € $ David & 79 119.2 Fred & Barbaza w.a o lzo .. 4o Jo a ,., 0 6 lheresa H°rrman • Drinkman ,,, Rodney & ~ M d tt S h Larry & • • Frank, raig & • o~a ri & • _ ~ A d x bo • Sharon • ~ ,w sw loth ~ ~: • rd ar a c ug e 4 " 69 Kris Ohman gonna, M u sal 1 ~ ~ n erson ~ • Hess em & I a V Charlene Drexler . i 80 ma pBen~ sr Maureen 97 695 vkp . l 78 ~ . Ol n ~dYs Konder ` Clifford & V . o t Iaberee Icbey ak Lofty ~ ^ John Mce 200 77 Warner • ,~ v Jean Anderson • ~ ~ 1 142.5 ~ • Acres 167.6 >° ~$? ' ~ 80 ~~$ 121 my z 132.7 ~;• • Inc d 212 ~ 183 ?t Wayne 6 c Cynthia 198.1 " y ~ Steven ~ Thomas & ' n f ~ David ~ 70.1 • Robert Michael T° .l/ ~ . 8 & Jody Linda Weber o„a ~ ~,~ X 9s David 6i G H Irene & Evelyn Granica James ~ sw•.°~. m~ Smith wuhe ~~ Nora Shirley n Forrest Orton . Plass 120 • eta • ,~ ~ . Hanson 124 • Nehmedt ~ ,% .Ames Schroeder o . ~ . ~ ,~ ~ ~ ~ • G 37s ~ 155 5•x CD ~ 343 4. 4b • gN u~ ~ or/i • • • ~g~n 30 ~i 1•• JO~~ DBVId SCtlrOeder ~ t2 € ~ Fronds & Charles v O n v ~ ~ a M'~ Keith Iluum Luann J .~ ~ '.7 ~ Betty B l 3 ~ ~ D M&P ohn & Rose J Dr~tr 65.9 78 al ~ ~ Kathleen Obermueller & loan Desmtth ~ ~ ~ • ~ °in9OP'~~ Badour °°""'^ 75 3 218.5 ~q .Y~ 7 UC II t ~ ~ Monson McCutchin 170 a ~ ~ F•~lce„% Evelyn Ho mann ~ ~ . ~ ~ ~ ~ 80 140 „ i4 p u • 8l1 • • A O ` ii g d Z •g~ 80 Melvin, Duane& o ~alra o' Biue as cr ' ~ ~° loseph& Gloria Walz James&Patdda t tensen ch G L E N W O D D z. s d ~ °N 3 r3 $ Etleen Schreiber er Rose Mundt w" r s 6o Davie a d ~ ~ ~ ~ Kevin Sdueiber ~ ~ Walter 120 .18 n~aa~m CITY 119 3 " ~ ~ 80 40 ~ ~ Paley weudt 40 l c,°sda '° Albrecht • ~" ~o ' . City of 0 ~ 8,, • ~ 34z ~ 40 4a Glenwood City Burleigh ~ ° • Bru ce • ~ s r aU to ~ • R v one & Bonnie • "r ~ a ~ G 46 ~,s ~ 66.N Rand & 3r ICare nder 3t.8 ~ o" =^ Paul& iE Debra f Donald 6r Julie Frieburg • rthouse r 120 ~ n,eresaHoffman x s 61.9 117 14a •srn4•ec Bonnie DDrls C Brvre Dean Lelvlay & Wagner Andrew n7a4jorie ~ ~ T ortiy D • ~ ~ ~ ~ ~'" Scotty & Knsh Gun~rson Thompson R Konder Sherri (berg p~ 115 I ~d~ c m ~ ean Gt <R 65.5 Tei en g . l 39 a Teigen ~ • T & 190 ~ o ~ ~ ~ 180 Revert re"' & 1 'N ~ Hagen 114.7 x '.' a ~ Robert & a • V l b ~ gc 36 0°~ ~ °~ erry ~ ,~ e Rehwaldt f° k~ ~ Breazley Terrance & e m~ Sros y ~ptty - 281 5 ~iO1 D Deanna McGee '° ~ ° 4s.a or ° ; '~ cyntllia 19.7 ~a & Kristi . w ~Q r+ ~ p ~,$ Daniel& Kath ine Tuttle • S • ~ MB s7.z ~ z 0.viaa ~~~ Kusilek t2 ~ nlss Teigen •RobertCrosby 80 Steven SrMoru )amn • Nuvn 30 `~ 21 N 264.8 j ~ er Np ,me, ` ,~ ~ TI ant 40 "' kaw al 7 80 162 la ^ ~ DD x.l ~ Mr an . 4o Dnxkr 2 700 2 00 2 0 CI*x P~ nr. d.(1 zn nn 31 00 32 00 3300 i~ ' I " - Lr io Yt:~ 1550~AGE 2fi4 QUIT CLAIM DEED DocumenC Number ~nL3..l~.,.caxn....~~...:~L~ ~.x.~s;~....._..~,.1~._lr~.i.~.a ~~.r.~a...~...,~.z.r.;,.srk , ~ Y..,...5;~~.....c~.~.~1~.,~. ~.......A....PA.~.~.r.'~ c~14. ,.~ :,.».ikr.~:nd.....a.,nd.... ..;.~.~........st.~.......5.l~.r....V..i.~ ~~ Y.s~a~..~`....._~mszx.i~~,:,......~.~~.~~..x.~r qultclaima to....~.t~S;J.X1S:~.l~.l:!~....11.....~ilttlz.s~cn......s.~n.~.....~.~z~A~-Fr~.. .~......25..,~.~.Y.1 ............................................................................................................... the following described real state ln...~.i...~K4:.1.?5 ................................County, Statc of Wisconsin: t '~ `o} ,3 Cer~•~iec~ 5u.cve~! Wlae 1810 P(~t' O~ ` dRk~~ N-.2c- $7 v.rc1~ re:.orc\C.+ tc. tic\ume 7 °~I )-e c v r J, s 1~0, ge I g16 lac. t..m e r.4 +{ ,~~ ~ 5 13 . } $.~:..~~ oft- 4he 631659 KATHLEEN H. WALSH kEGISTEk Of DEED5 ST. CFDIX CO., WI RECEIVED FOk kECORD 10-12-2000 3:00 PM Dull CLAIM DEED EXEMPT 8 CEkT COPY FEE: COPY FEE: TkAHSFER FEE: 13.80 RECORDING FEE: 10.00 PRGES: 1 Recotding Arm Name and RUUrn Addrw ~~A~A'~~e~s~~d I~DO `~ ~ Pa~ C~/i. C~ i~me~~ct~iq 13o i-ae ~T ~/lo '/U.?'l ~ -SD ` ~ ~ a L~~ 3 S ot:,~n 3~''~ e~~ (Parcel Identi[indon Number) r1or~~ k o_S~ Corr\er ~~ E~ ~her+cE V1c'r~~ ~ ~ -\-hence l.~:e>~ 33 ~as> ~ '(~otni' °~tx-c\ihr\ir,c~. 3G~ ~ec-~ ~-he`ncF This ...............:. .......homestead property. Dated this.......1~.........._........day o[.........5,~.~../........................._......!19~Q (ic}w (is not) 1'HENTICQ~' _ \}^~~ // /~9~~7~J ~jo mD authenticated tl~is..:..L......day of...... _ ...................../............._Ye' ............._ ...~~t~1~~~......... ~.......1..`~/~~<...~.....5~. signatutc / ~ ~~~/<~ type nr print name ACKNOWLEDGMENT STATE OF WLSCONSB~t $ t. ~ r O l X County. Perwnally ame before me fhb..-~. T..day oL., Q,C t O b.~ r„t,,,,, 2, 0 0 0 _ thea6ove nameo William Pitzrick , S r . _._._._.._.._ ,_.,,,,_. -- - -__. Charlene Pitzrick TRl$ ILtE[NBeR STATE BAR OF WISCONSIN (1t not ................................................................... anthorired by SS 7tiC.06, Wis. Statute) • Nama of persons aignin& In any capacity should be lypcd or printed below th--et//r stgnQQratures. Thu instrument was dratted by (type or print name) to me known to be the person...s....., who aecuted the ftxegoln~ Irmlrument and scknowlfdg~tltF same. ~~ ~ N $T~ signature - ^ type P K a t h l e e n.~~ ?~.......,.~.P+"~• ,, or riot name .................................. • ~ .' ~~ Notary Publla....aa.1.,.. C r o 1 x .~~~, ~r~ ~~„\ My Commission b permanent. (1[ not, atatb,bp,,, .••' ~t,'• 00~ F ••«\a date:.......A.pr.i.~.....6 r a;......~:::.:::~.0.~,j........ avnrnv. rw ~ ~ nr