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12/17/2004 07:57 AM
Parcel #: 020-1240-20-000 PAGE 1 OF 1
Alt.Parcel#: 21.29.19.1243 020-TOWN OF HUDSON
ST. CROIX COUNTY,WISCONSIN
Current OX
Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type
00 0
Tax Address: Owner(s): *=Current Owner
* HANSEN, RICHARD E&KRISTA K
RICHARD E&KRISTA K HANSEN
827 HARBOR VIEW RD
HUDSON WI 54016
Districts: SC=School SP=Special Property Address(es): *=Primary
Type Dist# Description *827 HARBOR VIEW RD
SC 2611 SCH D OF HUDSON
SP 1700 W ITC
Legal Description: Acres: 2.081 Plat: 2135-JACOBS LANDING 2ND ADDITION
SEC 21 T29N R19W NW1/4 OF SW1/4&SW1/4 Block/Condo Bldg: LOT 21
OF NW1/4 LOT 21 JACOBS LANDING SECOND Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
ADDITION
21-29N-19W
Notes: Parcel History:
Date Doc# Vol/Page Type
12/01/2003 747928 2465/470 WD
10/31/1997 567789 1274/001 WD
855/310
2004 SUMMARY Bill M Fair Market Value: Assessed with:
49283 246,000
Valuations: Last Changed: 04/29/2002
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.081 30,400 159,900 190,300 NO
Totals for 2004: 2.081 30,400 159,900 190,300
General Property
Woodland 0.000 0 0
Totals for 2003:
General Property 2.081 30,400 159,900 190,3000
Woodland 0.000 0
Lottery Credit: Claim Count: 1 Certification Date: Batch#: 131
Specials:
Category Amount
User Special Code 27.00
018-RECYCLING SPECIAL ASSESSMENT
Special Assessments Special Charges 00 Delinquent Charges 00
Total 27.00
Form - S T C - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP j I u d'SoNk SEC. ac T �N-R��
ADDRESS god 2 Z ST. CROIX COUNTY, WISCONSIN
SUBDIVISION LOT Z LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of IIHR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
i
Y
I pf:44.w4 y
TI
IL
r y
INDICATE NORTH ARROW
i
BENCHMARK: Describe the vertical reference point used
f `
Elevation of vertical reference oint: 5. �
P - /moo Proposed slope at site:v-5;j St'_
SEPTIC TANK: Manufacturer: �,y @;S�'Y Liquid Capacity: 10 00 D
Number of rings used: �, Tank manhole cover elevation:
Tank Inlet Elevation. .1 ,= q 7 Tank Outlet Elevation:
Number of feet from nearest Road.: Front,Side,Q Rear, O C 's feet
From nearest property line : ' Front,0Side,0Rear,0 X93 feet
Number of feet from: well (�3 � building:
g: t
(Include this information of the above plot plan) ( 2 reference dimensions to septic tank)
SEE REVERSE SIDE
!r
PUMP CHAMBER
Manufacturer: �11 Liquid Capacity:
Pump Model: Pump/Siphon Manufacturer: Pump Size
Elevation of inlet: Bottom of i.ank elevation:
Pump off switch elevation: Gallons per cycle:
Alarm Manufacturer: Alarm Switch Type:
Number of feet from nearest property line: Front, O Side, O Rear Ft.
Number of ,`,Pet. .frr m_, w-ell,;_. - -- -
Number of feet from building:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: �'$�; /1,��.'�;�,a� I Trench:
Width: lS� Length:�� / Number of Lines: 3 Area Built:C9"FSfTT
Fill depth to top of pipe: �fO
i
Number of feet from nearest property line: Front, O Side, O Rear,0 Ft .cc/
i
Number of feet from well:
Number of feet from building: y` �
(Include distances on plot plan). -P �Z•3e_
SEEPAGE PIT off I l•ro 9.-ZJ,y0 (f
Size: ( � Number of pits: Diameter:
Liquid depth: Bottom of seepage pit elevation:
Area Built:
Has either a drop box O or distribution box O been used on any of the above soil
absorbtion sytems? (Check one) .
HOLDING TANK
Manufacturer: Capacity:
IF
Number of rings used: Elevation of bottom of tank:
Elevation of inlet:
Number of feet from nearest property line: Front, O Side, O Rear, 0Ft.
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
i
Inspector:
Dated: Plumber on job:
License Number:
3/84:mj
—CEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS
'LABOR& HQP,#AN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O,EMX 7969
MADISON,WI 53707
BUREAU OF PLUMBING
NW4,SW4,Sec. 21 ,T29N-R19W ❑CONVENTIONAL ❑ALTERNATIVE Slate Plan 1.D.Npmber:
Ilf assigned)
Town of Hudson Lot 21 ❑Holding Tank ❑ In-Ground Pressure ❑Mound
Harbor View RD.
NAME OF PERMIT HOLDER: JADDRESS OF PERMIT HOLDER: INSPECTION DATE:
Sam Miller - �- ��`��
BENCH MAIPermanent reference point) ESCRIBE If DIFFERENT FROM PLAN. REF.�LEV.: CST REF.PT.ELEV.
I 'I W � � q� �n/
Name of Plumber: f.vvj VV�" S�
1"P'MPRSW No.. County $annary Permit Number:
Strohbee
SEPTIC TANK/HOLDING TANK:- 5432 129690
MANUFACTURER. L.IOUID CAPACITY: TANK INLET ELEV. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER
° /�/� /) J� C, (,,� PRAOVING PROVIDED:
V`� `� I' �/ ! aR ❑NO ❑YES NO
BEDDING: VENT DIA.. VENT MAIL HIC;H WATER NUMBER OF ROAD: PROPERTY WELL BUILDING. VENT TO FRESH
Iff n I— ALARM FEET FROM /�/ INE / qIR INLET
OYES NO (� ❑YES [NO N %J
DOSING CHAMBER:
MANUFACTURER BEDDING. LIQUID CAPACITY ]PUMP MODEL PUMPiSIPVf0N MANUFACTURER WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
DYES ONO ❑YES ONO ❑YES ONO
GALLONS PER CYCLE: PUMP n U CT T OL PEHATIONAL: NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH
(DIFFERENCE BETWEEN FEET FROM LINE AIR INLET'
PUMP ON AND OFF) ❑NO NEAREST
SOIL ABSORPTION SYSTEM.Check the soil moistur a 0 d t of plowing FORCE LENGTH DIAMETER MATERIAL AND MARKING
or excavation. (If soil can be rolled into a wire,cons u t n Shall cease until
the soil is dry enough to continue.) MAIN
ONVENTIONAL SYSTEM:
BED/TRENCH WIDTH LENGTH I NR DISTR PIPE SPACING COVER NSIDE DIA SPITS ILIOUID
DIMENSIONS RENCHES M ERI L' PIT / DEPt
1
G AVEL DEPTH FILL DEPTH DISTR.PIP' DISTR PIPE DISTR.PIPE MA tER1Al. DI PROPERTY WELL BUILDING V NT TO FRESH
BELOW PIPES I ABO E VER ELEV INLET ELEV.END PIPES. NUMBER OF LINE.
rl�l � �t a5 �a Gr FEET FROM AIR INLET
NEAREST— 7
MOUND SYSTEM:
Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM
and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA-
❑YES NO
meets the criteria for medium sand. TIONS MEASURED.
❑
OIL COVER TEXTURE
PERMANENT MARKERS I 1SERVATION WELLS
❑YES ONO DYES ❑NO
DEPTH OVER THE NCHrBED DEPTH OVFR TRENCH;BED =)PSOIL $OUDF.0 SE E D E D MULCHED
CENTER EDGES
DYES ❑NO EYES ONO DYES ❑NO
PRESSURIZED DISTRIBUTION SYSTEM:
WIDTH. LENGTH. TRENCHES: LATERAL SPACING: GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER
'•DIM,E'RON S' � TRENCHES:
aIMENSIC�Ns
MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL. NO DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING
ELOATIONAN ELEV. ELEV. DIA ELEV. PIPES DIA:
DISTRik�UTtON
INFO##"TION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
PLANS
YES LINO ❑YES —1 NO
COMMENTS: ERMAN NT ARKE OBSERVATION WELLS: NUMBER OF PROPER BUILD
TY WELL: ING.
FEET FROM LINE:
C� ❑YES 1:1 NO
❑YES El NEA
NO REST
s n V, ty.3
Sketch System on \
Reverse Side.
Retain in county file for audit.
SIGNATURE: TITLE.
DILHR SBD 6710(R.01/82)
SANITARY PERMIT APPLICATION
L.HR In accord with ILHR 83.05,Wis.Adm.Code co <
—Attach complete plans to the court CO STATE SANITARY PER IT#
P P ( county copy only)for the system,on paper not less than ❑ r 0��
8%x 11 inches in size. ¢"
Chec if evis.o to previous application
—See reverse side for instructions for Completing this application. STATE PLAN I.D.NUMBER
I. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER PROPERTY LOCATION
Srz"W Al Y*S' / %, S N, R P? E(o
PROPERTY OWNER'S MAILING ADDRESS LOT# 1 BLOCK#
a -001- Z K--- eC!
CITY,STATE I ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
El CITY II. TYPE OF BUILDING: (Check One) ❑State Owned ❑ VILLAGE NEAREST ROAD
u1so a bor -mow oa
❑ Public N 1 or 2 Fam. Dwelling—#of bedrooms R TAX.NUMBER(S)
Ill. BUILDING USE: (If building type is public,check all that apply)
0�o-
1 El Apt/Condo
2 11 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 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. [P 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 14. LOADING RATE 5. PERC.RATE 6. SYSTEM ELEV. 7. FINAL GRADE
REQUIRED(sq.ft.) PROPOSED(sq.ft.) (Gals/day/sq.ft.) (Min./inch) ELEVATION
�O )S (., '7y 3 Feet Feet
VII. TANK CAPACITY Site
in allons Total Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks I structed
Septic Tank or Holdina Tank 0010 Uj a,`
Lift Pump Tank/Siphon 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): P.lumber's Signature:(No Stamps) MP/MPRSW No.: Business Phone Number:
DoU rj7�ro�t� eP�t ` � 3 oil 7
Plumber's Address(Street,City,State,Zip Code):
R # ,v R f 4 4 /�,G ry�
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee(includes Groundwater Surchar Fee Fate IS'
ssuing Agent Signature(No Stamps)
a
Approved ❑ Owner Given Initial d O 9 I ff
Adve Det rminati n
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
;BD-6398(formerly Plb-67)(R.11/88) DISTRIBUTION: Original to County,One Copy To:Safety&Buildings Division,Owner,Plumber
INSTRUCTIONS t
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, 6()8-266-3815.
To be complete and accurate this sanitary permit application must include:
I. 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.
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. Cheek 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)
SQ rY/ �,'//Q✓ -T— rr 9 zr S ccc�, �y /O , s y 9/-
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NDUS TRY,TIy1ENT OF
INDUSTRY, REPORT ON SOIL BORINGS AND
N � SAFETY& BUILDINGS
LABOR E PERCOLATION TESTS (115) DIVISION
R
HUMAN RELATIONS P.O. BOX 7969
(H63.090) & Chapter 145.045) MADISON,WI 53707
LOCATION:5 SE ION: p p TOWNS IP
N w 1/ Z/ /Tz9 N/R/ 7 (or) � Y LOT NT:)BLK.NO.: SUBD1 1!: /N NAME: i7-
CoUNTY: OWNER'S 6 �S,yppAE: U�Sr I Z/ -1'4coQ5 `�4 Ll
`-*' MAILIN ADDRESS:
USE
��yyyy NO.BEORMS-: COMM AL D S RIPTION: DATES OBSERVATIONS MADE
IJResidence PR I 1 NS: A ION TESTS:
'KNew ❑Replace ���T /J /!99 15C
l I M- /z,/9$�
/cs 1goo� 4 S$ So►L.5 - ske - S4rrkt
RATING:Sa Site suitable for system U-Site unsuitable for system _
CONVENT( NAL: MOUND• IN-G OUND•PR URE: S STEM-IN-FILL HOLDING TANK:RE$COMMENau SYSTEM�(o tional)
CIS ❑U �s•�u (�s Du ifs ❑u DS �'u cotiv���lc��,,rt �
If Percolation Tests are NOT required DES( N RATE:
under s.H63.09(5)(b),indicate: If any portion of the tested area is in the
lJQSS I Floodplain, indicate Floodplain elevation: rV
DE{ PROFILE DESCRIPTIONS
BORING TO—TAL PTH T GR U
NUMBER DEPTH ELEVATION LAME -INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH
OBSERVED E - IGHES TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.)
1-7 47.65 r(0NE > 17 '$L�TS
B- X6.91 4S• / No � >
B-3 .g3 9 ?
B- 0"g«-rs 3c� @.e
(q $p,,CS 4C,
B- 5 � � 45.0
-90 MS
B-
PERCOLATION TESTS
TEST EPTH WATER IN HOLE TEST TIME
NUMBER AFTERS ELLING INTERVAL-MIN. DROP IN WATER LEVEL-INCHES R RATER( INCH ES
tc P RI D 1 P RI D
P- ( 313 NONE w6a 3 C 3
P- 7.46 NoNG 43 8a 3 2 <3
P-
-�- A-T L
I P-
LOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
ontal and vertical elevation reference points and show their Iocatio6 on the plot plan. Show the surface elevation at all borings and the direction and percent
)f land slope.
SYSTEM ELEVATION 9 U
_ r _
T E4�Z-v
r
o� ` o ?t _
� - � _Puy`
( � ?
�Xls?INy
I ._ r
1 _
the and rsigned, 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
istr ri
>dmin ve Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
DAME(print): TESTS WERE COMPLETED ON:
ADDRESS .,' `r': ► INC
CERTIFICATION NUMBER IPHONE NUMBER(optional):
rrr'NL `.'r
CST SIGN (T,U__R__� .
)ISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester.
)ILHR-SBD-6395 (R.02/82) —OVER —
STC - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYERm %/,l�Y
ROUTE/BOX NUMBER /od X Z9 Z FIRE N0.
CITY/STATE u cr5mrt_ LC/ ZIP 's, 16/6
PROPERTY LOCATION: &1/4 St.(/ 1/4, Section -Z!./ , T�_N, R11-5)
Town of L&464 , St. Croix County,
Subdivision -So<<o Lot No
Improper use and maintenance of your septic system could result in its premature
failure to handle wastes. Proper maintenance consists of pumping out the septic
tank every three years or sooner, if needed, by a LICENSED SEPTIC TANK PUMPER.
What you put into the system can affect the function of the septic tank as a
treatment stage in the waste disposal system.
St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of
$3000 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
systems properly maintained.
The property owner agrees to submit to St. Croix County Zoning 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 (2) after
inspection and pumping (if necessary), 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.
I/WE, the undersigned, have read the above requirements and agree to maintain
the private sewage disposal system in accordance with the standards set forth,
herein, as set by the Wisconsin Department 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.
SIGNED C\.
DATE
St. Croix County Zoning Office
St. Croix County Courthouse
911 9th Street
Hudson, WI 54016
(715) 386-4680
Sign, Date, and Return to above address
" APPLICATION FOR SANITARY PERMIT
S T C - 100
This application form is to be completed in full and signed by the owner(s) of
the property being developed. Any inadequacies will only result in delays of
the permit issuance. Should this development be intended for resale by
owner/contractor, (spec house), then a second form should be retained and
completed when the property is sold and submitted to this office with the
appropriate deed recording.
---------------------------------------------------------
Owner of property <a n Pl //aj
Location of property YLV 1/4 x_1/4, Section -Z- / T_aN-R
Townshipc��C ,,
Mailing addresso,�#zg Z
�ttfsnh W._ ���LL
Address of site =';k r_4 ,6 S /Q„ _ate )A Lt)z
}
Subdivision name_ a e s IQ a� hG
Lot number z
Previous owner of property
Total size of parcel Z-/O da c cy 5
Date parcel was created /n—f
Are all corners and lot lines identifiable? X Yes No
Is this property being developed for resale (spec house)? �L Yes No
Volume !gas and Page Number as recorded with the Register of Deeds.
----------------------------------------------------------------
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER, and
the SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if
available, would be helpful so as to avoid delays of the reviewing process. If
the deed description references to a Certified Survey Map, the Certified Survey
Map shall also be required.
---------------------------------------7---------------------
PROPERTY OWNER CERTIFICATION
I(We) certify that all statements on this form are true to the best of my (our)
knowledge; that I (we) am (are) the owner(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. y 3 S7 . ; and that I (We)
presently own the proposed site for the sewage disposal system (or I (we) have
obtained an easement, to run with the above described property, for the
construction of said system, and the same has been duly recorded in the Office
of the County R gister of Deeds, as Document No. 4-4'-S-Z/ 7
.�A r
Signature of Owner Signature of Co-Owner (If Applicable)
Date of Signature Date of Signature
no<.uti+fell NO WARRANTY DEED 1..S S.• E NrSInVIU FOR NILnnUU.y U...
STATF. IMI!, OF WISCONSIN FOR-M 2-1982
430417 -A. S051►A:E� REGISTER'S OFFICE
ST. CROIX CO., WI
Virginia M. Hanson, a single woman Recd for Record
1444 121991
« 8:00��� �n�M
r.m.r�< ;I n'1 •n,.Iraalx to Sam E. Miller, Ll Slllg;le man �y ��."'�Jam.
%gisw of Dorili
the folloalnl� dr-1111rd real estate in St. Croix t'•'Illal.
State of Wi.,consin:
Tax Parcel No: _. _. .. . ...............
West Half (141,0 of the Southwest Quarter (SW14) frl tiection
Twenty-one (21), Township Twenty-nine (29) North, Range Nineteen (19)
West, St. Croix County, Wisconsin except that part South Of Lite 1'ublIc
highway and except Lots 5, 6, 7, and 8 of Certified Survey Map n Vol.. 6,
Page 1747, Doc. No. 419479.
That part of the West Half (W'4) of Lite Northwest Quarter (NW'I.) of Section
Twenty-one (21), Township Twenty-nine (29) North, Range Nineteen (19) West,
St. Croix County, Wisconsin lying; South of Lite right of way of the
Chicago, St. Paul, Minneapolis and Omaha Railway Company.
$ 4191. 00
EEe
Thi, is not home l'•ad property.
fink I Is not)
t.• warranlirs easem-nts of record and protective covenants and restrictions
of record, if any.
INltcd llus d;l� rr( /fit r C it
. Is 88
1 i 1::11.► CJLsL Qc l�GQJ •�•-C,/1 S[.'A 1,1
Virginia M. Hanson
1�P.AI.I
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) _ STATF. OF WISCONSIN I
. .. ' ss.
` �� •�
authenticated this .... day of Iq `k Counts.
I'rr=nnallc came before nip this "t ` dae of
. .. . . ...... mA 'q I. , 19 88 the above named
Virginia M. Ilanson
TITLE: %jENtI3ER STATE RAH OF tt'I:;I'ONSIN
(If not.
authorized by S 106.06, Wis. Stab.)
to nu• 6n'nfn to he the iwr.�on the
fnn•coin• trunlrnl ai.uj ailcnoa'led�r lire s:ulu.
T•fi IN$TRUMC N7 WAS DRAFTED py
V
Lois..A. Murray, Ileywood, Cart 5 Murray
P.O.'liox 229, Hudson. WI 54016
ISienntun•s may be authenticated or nrknol�ied�rd. Roth �I` 1 ^•mli` ion u I 'A-Aaiu•IJ.t if n(,t. staff• wo— rati...I.
ore not necessary.) h
dat, . _7 •�y 19 .1
'Nam- of p.re.rrr, r:llnint in eny '41-01 -1..-I'll 1.. I"..I .. nl••I 1. '.w •h..r ,.. •.
WARRANTT DI:PD STA"I P. BAR OF tt IN(I)%,•V
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