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HomeMy WebLinkAbout020-1390-01-000 $ 0 2 $ \ 0 & o � \ 2 0 ] 0' 2 � 8a2f / . tff/}¥ ti @ $\$ �/ ` ��/# &g # Egoo=n ¢ fa2�3e /\}\d\/ 2o . okCN= ) }§\/\- ) {/�5G 3 ) 2 o / �( §\§) 2 =/\§ 2%� ) \ � Um f &) ) o § b$27\ < zeox2ao m } § 2 § ) z k / 7 D z E / (D ] � -� § 3 ) q 6 \ Q ) ) / .. E z U) § Eee D / R E© § ) ) \S § CO k k k -� k / 2 2 a CL 0 \ U) 7 7 0 z 2 \ _ 7 o2 $ 4 ) ( J z m j , § S % \ ) \ / \ : d 0 S } § � C e ; _ § $ c = ) / � G / $ $ 2 2 / 40. m a o � g z o a g & . n a ! = co § \ k \ [ 0 z $ /z 2 / J 2 m § — : " m ; � . / \ (L k k ) DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDING LABOR&HUMAN RELATIONS DIVISION P.O.BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES&APPLICATION MADISON,WI 53707 State Plan I.D.Number: NW!,-,NW!-,, S29,T29N-R19W ® CONVENTIONAL El ALTERATIVE (if Town o� Hudson ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE' VFW Pot 2115 County UU, Hudson, W1 54016 1�- 13 � 3' -'0'6_'0� BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: W P Siam SchumakeA 6382 St. cu ix 119 39 3 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVDED: ❑YES ❑NO ❑YES ❑NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING:I VENT TO FRESH ALARM: FEET FROM LINE: AIR INLET: ❑YES ❑NO ❑YES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF) ❑YES ❑NO NEAREST---110- SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: 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: BED/TRENCH WIDTH: LENGTH: NO.OF DISTR.PIPE SPACING: COVER INSIDE DIA.: #PITS: LIQUID TRENCHES: MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV.INLET: ELEV.END: PIPES: FEET FROM LINE: AIR INLET: NEAREST—� 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 I 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: [--]YES ❑NO ❑YES ❑NO NEAREST Sketch System on Retain in county file for audit. Reverse Side. sIGNAruRE: TITLE: ZGnCVIg SBD-6710(R.06/88) 1 Adm SANITARY PERMIT APPLICATION COUNTY TOiLHR In accord with ILHR 83.05,Wis.Adm.Code ,�'T, C,ALIx STATE SANITARY PERMIT# '/ 93 23 —Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 8%x 11 inches in size. '592-6 —See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES)nJ NO PROPERTY OWNER PROPERTY LOCATION //-,A/ Aj '/a /4, S T , N, R /? E(Or)(9 PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER t t F- BLOC SUBDIVISION NAME K� `/A C CITY,STATE ZIP CODE PHONE NUMBER Ej CITY NEAREST ROAD,LAKE OR LANDMARK - yD�` i 1 _VILLAGE 66 PT T II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family OR N Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in#1. Check#2,3 or 4,if applicable) 1. a.KNew b. ❑ Replacement c. ❑ Replacement of d.❑ Reconnection of e.❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit## Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in#1 and only one in#2) 1. a. Conventional b. ❑Alternative c. ❑ Experimental 2. a. ❑System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound I. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. 9 Seepage Bed b. ❑seepage Trench c. ❑seepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): w ®.Private ❑Joint ❑ Public G -3 �� '� 1�• Feet VI. TANK CAPACITY Manufacturer's Site INFORMATION in allons Total #of N Prefab. Fiber- Exper. New xistin Gallons Tanks Mame Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank Oro �. Lift Pump Tank/Siphon Chamber El 1-1 ❑ Li ❑ VII. RESPONSIBILITY STATEMENT 1,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. :,,er's Name(Print): Plumber's Signature:(No Stamps) PRSW No.: Business Phone Number: << c a fti 3G h-N BV, Plumber's Address(Street,City,State,Zip Code): Name of Designer: p Vlll. SOIL TEST INFORMATIGW Certified Soil Tester CST)Name CST# 3 CST's{{AD SS(Street,City,State,Zip Code) Phone Number: 5' l IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Stary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) pproved ❑ Owner Given Initial �zni1 Sfl�,cha_rge Fee Adverse Determination l\X�J X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMGT APPLICATION TO THE APPLICANT: 1. This 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. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 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. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of_Wisconsin, Bureau of Plumbing, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description where the system is to be installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. 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. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. 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; dosing or pumping chambers;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. GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater bill- Ground �t�f included the creation of surcharges (fees) for a number of regulated practices which Wisco Ill's ° can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried nBBS(1t0. is used in your building is returned to the groundwater through your soil absorption o system or the disposal site used by your'holding tank pumper. The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398(R.03/86) NAoT IVA♦.p scp7i c 5r5Te ` N � lam a h N Pa,A',V oJ Ao-f j i � f \ Z e l�aa C1rQ A R.07, ONSITE SEWAGE SYSTEM A"p"k P erml 0 V E 0 EPT O:INDUSTRY, IAWR AND M&P,14 W71014, 04MMON OF SAFETY A149 BViLOWS SEE CORRESPONDENCE .Q� 4 a r r A 183 OL 5'RopG. � / 1 r y /42 � /Q0 X 2.,iA -=-Are 4. ra Te ro 4 9 D A.4 19YA 4K ZI 4�A tp �r l G AD 34 w e*�'i (� lk.'.t���� PAGE OF rC) 15 y r ��J��{ Lt� U .�•' �°��� Fresh Air 111101• And Obabrvellon Pipe r ^ v ANrwod Venl Cep Mlt 12"About r Fln!W 1 Grade 20-42"Above Pipe _4"Cost Iron ZZ To Final Grade Vent Pipe th CJ Marsh Nar Or SynlMlk Cwe,Mg r e ' Mtn Y"Aggregate ©t M Over Pipe i Distribution tr Pipe —Tee 1 M.' Beneath Aggregate a Perforated Pipe Bel p o I—covellse Tortninerid f� Benorn Of Orstom co O C Propose D f 1 q cl< �L'.1tJ•.� lor'1 / � // � � . SOIL FILL DISTRIBUT101.1 PIPE APPROVED SifWPETIC COVER 2"OFA6GREWE --� r ' '—MATER14 OR 9" OF STRAW OR MARSH HA`� %i Ca4 4e'OF 12 -2t AGGREGATE ELEV. OF "Ke FEET,- 3 DISTRiR'JTI01J PIPE TU BE AT LEAST ._ INCHES BELOW ORIGIIJAL GRADE AAIL' AT LEAST20 INCHES BUT MO MORE THAM `i2 ILIC14ES BELOW FINAL GRADE M IMM ®EPrH of EXcAVAT1,00 FROM ORI WAL 6KAoF. WILL BE INCHES MINIMUM OEPrki OF EACAVATocM Mom 01K141NAL GRAPE WILL BE INCHES SIGAIEO: LICEUSE DUMBER: ' DATE : 110 � , r: ,. ' 'ti .�, r± ' � � � .. P" V � �' �' d. a ~fS 7 :F y,. •� �Tn, •� HOLDING TANK CROSS-SECTION AND SPECIFICATIONS " Approved Approved F Manhole Cover w/ ,� S•u5f°c� U,�Go� Warning; Label 4" C . I . 12" Min Vent Pipe i � 25' From Final Grade I 4" Min Any Door or I -�' Window Approved Joint - '- 1$ Min Water Tight i Seal �. High :Water Note: C.I. Alarm 1 tch blind Ptuf; Usc FAI 7'D $.�a _ _ _ __1 1'n Seal Unused S ECIFICATIONS Approved Joint w/ Openings TANK Manufacturer 0ee� �oy�"'7` ,�-�ecluc s C .I . Pipe Tank Size :_hQ( Gallons Extending 3 ' Onto Manufacturer: Solid ,Soil Model Number : Switch Type NUMBER OF BEDROOMS: d 3" Approved Bedding; OWNER 'S NAME: 11&dse y P/%J ADDRESS : of 7-v Z:k&It U N LEGAL DESCRIPT ON :&Wk,A&AL_1%,Sec . 2q ,T W N ,R Vic_-W TOWNS HIP/N P! : U-4srJ.A) COUNTY: .9 a I�_ SIGNED : -GsLA au LICENSE NUMBER: AO DATE: _ ' �` �► ' ;� 1ELATIONS ."rL 4/86 Y �S/aJ su.,y kJi i p 70 AI .AP d AC 8 88" 05078 DEPARTMENT OF REPORT ON SOIL BORINGS AND ----.zAFETY & BUI S IN[)USTR� DIVISION LA AND PERCOLATION TESTS (115) P.6. BOX 7009 HUMAN RELATIONS 1 V MADISON,YVI 53707 09(1)& Chapter 145.045) ' :1d EC T� TOWNS UNICIPALITY: OT NO.:BLK.NO.: SUBDIVISION NAME: , N / / H/R►q#(O Cf So Pv COUNTY: OWNE p S AM AAILI _ SS: 1 ST C weN IX k to U.' k e DATES OBSERVATIONS MADE : ODESCRIPTIONKIPTACOLATION TS: et JuNew ❑Replace �-� 3/ /9F3 ; A&V / � pp SATTRt1' RATING:S-Site suitable for system U-Ske unsuitable for system &b UUR 14A -r S �• M .❑� 1 � Q� � a�L Os G T9fVK:RECOMMENDEDSY�ST�SYSTEM: �a�1) If any portio If Percolation Tests are NOT required bESIGN RATE: mof the tested area is in the under s.H63.00(5)(b),Indicate: C��S$ + Floodplain,indicate Floodplain elevation: NA t>r-� PROFILE DESCRIPTIONS BORING TOTAL �QMI DW ATER INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMI3ER DEPTHM ELEVATION V TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) B- 717. m!SZ• > 71",RL .TS S� it"e-QN C5t6R B- Z 1/0-1a3 91.10 7.0.Ott LLT�S 16"' a t L 71 "8p c'e 16,A 37$'.N is 914 > O.SQ ALLrs /0"apr4 Sf C ea Qoq al(C.'k At"90NIMS B-' 1 .9Z y- /b.4 "8<<TS " N " RCS 4* �h IMS /66,V4 A&Wjr > !.00 Qti S,C "Qa.� C-SY C,Ia 39" eery YNS B- PERCOLATION TESTS TEFr DEPTH WATER IN HOLE TEST TIME LEVEL—INCHES RATE MINUTES NUMBER tlWW AFTERSWELLIN INT RVAL-MIN. PEA10D I PEA QD2 PERIOD3 PER INCH P_ xla.ur I '2 * 'a Z <3 P- 3 �> 2 *> I <3 P. 7 11! D <3 P- w PLOT PLAN: Show locations of percolation tests, soil borings and t i nsions of suitable soil areas. Indicate scale or distances. Describe what are the hori- Zontel and vertical elevation reference points and show their loca ' n on plot plan. Show the surface elevation at,all burings and the direction and percent of land slope. L S' r EM ELEVATION 42.09 alt_ - - �, ! t'00/SYSTEM r L OT_ (.'o�,l�.�:(FTE: 5t�►$'wtALk NE�r � i- � A T PA Ur- LE5T LEYA-r low = /pp. �O r R •3 p.z Ivq' l N o l I i TH Ll IQ 730 _;'Jr�M.I I N IC`- Cx-1°�.,�1 S i p1.► C�� 40 1 � Sc A l L' Esr Baca O. ' ' 6 P ' 40, o Woob 76NCk Pjt ST' 1,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 date recorded and the location of the tests are correct to the best of my knowledge and belief. NAME pr nt : TESTS WERE COMPLETED ON: MAt'va)f A614 nj too 1.. K 'ky-,/N6INC �g�g CERTIFICA`II N NUMBER: PHONE NUMBER(optional): $%40 CST ATURE: DISTRIBUTION:Original and one copy to Local Authrnity,Property Owner and Soil Tester. G N H a ST C - 105 r a H SEPTIC TANK MAINTENANCE AGREEMENT 0 St . Croix County z d OWNER/BUYER P }- J r" ROUTE/BOX NUMBER Vt� Fire Number CITY/STATE 1 \l.•�SJ►.� �.•� .� I. IP ` elv l('a PROPERTY LOCATION : Section s T J'� N , R /'� W, Town of l `� t�S�` 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 , I if needed , by a licensed septic tank pumper . What you put into I the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St . Croix County residents may be eLigible to receive 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 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 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 . 0 F, I/WE, the undersigned, have read the above requirements and agree N to maintain the private sewage disposal system in accordance with x the standards set forth , herein , as set by the Wisconsin Depart- w 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 . SICNEII,�A/CC_ DATE St . Croix County Zoning Office .til. - ►� ` �`� P . O. Box 98 r Hammond , WI 54015 r�60j\ t " 715-796-2239 or 715-425-8363 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/contractcgr, ("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 . U-F L4,) W!. ) //V Location of Property l y) �' ! L Section �y , T N - R 5 W Township Mailing Address L'k Subdivision Name _ Lot Number / Previous Owner of Property El m -f'r 1 �" ). he-, 11 jr, Total Size. of Parcel Date Parcel was Created Are all corners and lot lines identifiable? ^� Yes No Is this property being developed for resale (spec house) ? Yes Ix No Volume L4 and Page Number L� �5� as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office 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 the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION T (We) ceAti.6y .that aU a.tatementd on .tlu� 6oAm ane tAue to the but o6 my (ouA) knowledge; that `T (we) am (aAe,) the owgeA(h ) o6 the pnopenty danibed in .thy .irn6mnation j6oAm, by viAtue o� a waAAarity deed Aecoaded in the 066.iee o6 the County Regi.4-tee. o6 Deeds as Document No. "' /C��5 and that I (we) pusentty oun the pnopobed a.cte Got the .6ewage duposaZ 6ystem (on I (we) have obtained an eaeemen.t, to nun with the above descAibed pnonerc�ty, bon the con,6tAucti.ov, o6 said bystem, and the same ha/s been duty Aeeonded in the 066.iee o6 the County RegizteA o6 Deeda, as Docwnent No. ) . SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED I- i DOCUMENT NO. 252105 This Indenture Ma a this...........5th da,of.. .. September A. n., I9 57 Elmer U. .. between................................... �bm and Ethe! B. Da unR...�.ip_ wife........... ............................................... .............................................................................................:......................part.. dd...._._..of the first part and Hudeen...P.QSt.-..NQ..... .2115....oL...the....Yet.erabe.,.of F.oreign...W:are...of...the....United ._ - .... --Atat,eau..,:a...c.orperat i.an..............................................................__..........................................part..1. ............ of the second part, W I t n e e e e it h, That the said part-i0D....._......,of the first part,for and in consideration of the sum oL_One...Dollar.-----,- And...!other-...900d-_And....na-huable,..c.one1 d.6rati.o-n............................................_ _- ___._ to...thOW...........in hand paid by the said part..Y...................of the second part, the receipt whereof is hereby confessed and acknowledged, ha.XG........given,granted,bargained,sold,remised,released,aliened,conveyed and confirmed,and by these presents do.............. give, grant, bargain, sell,remise, release,alien,convey and confirm unto the said part,.-y..................of the second part...Its-..................heirs and assigns forever, the following described real estate situated in the County of........5-ta....Cr.oix................................and State of Wisconsin, to-wit: Part of the Northwest Quarter of the Northwest Quarter (NWi of NWT) of Section 29, Township 29 North, Range 19 West, Ste Croix County, Wisconsin, more particularly described as follows: Commencing at the Northwest (NW) corner of said Section 29, thence East alonj the North line of said Section 29 a distance of 68908 feet to a point, said point being the point of beginning, thence East along the North line of said Section 29 a distance of 225 feet, thence South a distance of 470 feet, thence West a distance of•225 feet, thence North A distance of 470 feet to the point of beginning, ' containing 2.25 acres more or lose, The consideration for this deed is less than $500,000 and therefore no revenue stamps are required, This instrument drafted by Kenneth He Hayes, 'attorney, Together with all and singular the hereditaments and appurtenances thereunto belonging or in any wise appertaining; and all (-state right, title, interest,claim or demand whatsoever, of the said part......lea.._of the first part, either in law or equity, either in pos>ession or expectancy of,in and to the above bargained premises,and their hereditaments and appurtenances. To Ilave and To Hold the said premises as above described with the hereditaments and appurtenances,onto the said part.__.._ ......... of the second part,and to.......its.s.......................................................heirs and assigns FORE E.R. And the said..............Elmer....._„A,.,elhm...and...Ethe.1....8....Dahm,...hia_.wife,__._....... _.. ._...._ ..................................................................................................................................................................................................._...................__...__ ._............. ... for.............................t he.ir.............._..._..........,.....heirs, executors and administrators, do............._....covenant, grant, bargain, and agree to and with the said party....................of the second part.............i.t 6.........................heirs and assigns,that at the time of the cnsealing and dc!ivery of these presents....they...are.........well seized of the premises above described,as of a good, sure,perfect,absolute and indefeasible estate of inheritance in the law,in fee simple,and that the same are free and clear from all incumbrances whatever........._____......... _...�. ....... ,---- - .................................__..No....exceptions.........___.......................___ _._................. - ................................................ .......................... ...,............... . ......... . ........... ..... ...... .. ...__. .. -and that the above bargained premises in the quiet and peaceable possession of the said._)art... y.___..._....Of the second part,_lta,.__-.heirs and assigns,against all and every person or persons lawfully claiming the whole or any part thereof,......-_..._ _.......«ill forever WARRANT AND DEFEND. In Witness Whereof, the said part....1613..........of the first part ha...Vie...............hereunto set.their.... ..--.hancLB..__. ..and sea1..A .............this..._...5th.............__.....day of....September..................__-.__ A. D., 1Z7... � 'IGNED AND SEALED IN PRESENCE OF - lV .......(SEAL) -, _ Kenneth H7�Zeel. Lthel B. Dahm ................................... . Norman E. Anderson - ...........(SEAL) I STATE OF WISCONSIN, Ste,...ZZ012.................._...County. Personally came before me,this...........5.th..............................day of.............-SQ ptomber...........................................A. D.; 19...5.7.. the above named...........F+'.1mer...M....D$h?jl..and.. +''thtB.1.,.Da...Dahnl.............a.::. _4.. i..:..................... ......................................................................................................................................................... '� ... •• \. .....--.................,..... to me known to be the person..A....who executed the foregoing instrument and acknoMl dgWthe same. Received for Record this............4th.................day of ...90t.00.r-..........A.D„ 19.5,7,...at..141QQ.o'clock.�A.t..M. (SEAL) tJ.� enneth...R ...Hayes................_........ l ...G' Not,; +ublic'.'::......$t,. Count egi er of Deeds ,$�. ► DrOix•-•••.•-...-- y,Lbts. My�tttrimis�fon ex pireg_4j�g.e....2Q........A.D.,1960..... e r Deputy Register of Deeds WARRANTY DEED—STATE OF WISCONSIN,FORM NO. t — _ V - •I A � N.C.YILLCM CO..Mll'H,11,'KCC