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HomeMy WebLinkAbout020-1001-40-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT S nitary Permit No: 569559 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Collins, John E. &Anne I Hudson, Town of 020-1001-40-000 CST BM Elev: Insp.BM Elev: BM Description/: Section/Town/Range/Map No: / (�(�a.�2. c.,�" 07.29.19.2D TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER ;,�e� CAPACITY STATION BS HI FS ELEV. Septic � • � Benchmark Dosing Alt. BM "r ✓V�, /D to D Ae < Bldg.Sewer Holding (" V St/Ht Inlet T7 a TANK SETBACK INFORMATION St/Ht Outlet 4.to TANK TO �P/� WELL 5tL`G Vent Air Intake ROAD Dt Inlet Septic Dt Bottom-7166 166 Dosing Header/Man. Aeratio Dist. Pipe Holding Bot.System Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM I ��• Z Model Numb TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dist.to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG IWELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type Of System: CHAMBER OR -6 UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold IDistribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia I Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded Mulched Bedlrrench Center Bed/trench Edges Topsoil Yes 0 r No 0 Yes ❑ No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2: Location: 1042 GOLDEN OAKS DR Hudson,WI 54016(SE 1/4 NE 1/4 7CT229N 1319W) metes&boundsL4ot 5, /I Parcel Nq�07.29.19.2D 1.)Alt BM Description= �• �K. GaJ -- �xl) I-ZX ^'k r1, f 2.)Bldg sewer length= �jr1S Gd 1 5o -amount of cover= PPP Plan revision Required? ❑ Yes No Use other side for additional informati n. V SBD-6710(R.3/97) Date Insepctor's Sig r ure Cert.No. IM-1060 General Specifications and Illustrations LIFTING STRAP LIFTING LUG RISER CONNECTION (TYPICAL) R L) (TYPICAL) The IM-1060 is an injection molded two piece mid-seam plastic tank.The IM-1060 injection molded plastic design A A' allows for a mid-seam joint that has precise dimensions 0 for accepting an engineered EPDM gasket. Infiltrator's t 0%0 a 0 b 62.2 gasket design utilizes technology,from the water industry 0 %0 115801 TERIOR to deliver proven means of maintaining a watertight seal. EXWIDTH The two-piece design is permanently fastened using a series of non-corrosive plastic alignment dowels and locking seam clips. The IM-1060 is assembled and sold through a network of certified Infiltrator distributors. 117.0[3226]EXTERIOR LENGTH TOP VIEW oum.Er Working Capacity 1094 gal(4141 L) or Total Capacity 1287 gal(4872 L) 7 54.7 Airspace 16.5% [13891 EXTERIOR Length 127"(3226 mm) SEAM CUP HEIGHT Width 62.2"(1580 mm) (TYPICAL) LIFTING STRAP Length-to-Width Ratio 2.3 to 1 (TYPK�4AL) Height 54.7"(1389 mm) END VIEW Liquid Level 44"(1118 mm) Invert Drop 3"(76 mm) 04[1021 0 24[6101 ACCESS OPENINGS WITH LOCIONG LIDS(2) PVC OR ABS 0 4(1021 PVC OR Fiberglass Supports 2 INLETTEE -10-2[2601 FREEBOARD UTLET TEE Compartments 1 or INLET 165% 10 t2[2601 FREEBOARD ABS AWORS 5% 6 AIR AIRISPACE OUTLET W Maximum Burial Depth 48"(1219 mm) PER 3.0 [761 PER C-f H CODE Minimum Burial Depth 6"(152 mm) 44.0 1 FIBERGLASS (11181 FIBERGLASS Maximum Pipe Diameter 6"(152 mm) SUPPORT LIQUID SUPPORT (TYPICAL) DEPTH (TYPICAL) WITH BAFFLE Weight 320 lbs(145 kg) WALLWHERE REQUIRED SIDE VIEW TANKTOP CONTINUOUS HALF GASKET TANK INTERIOR SEAM CLIP ALIGNMENT DOWEL TANK BOTTOM 4 HALF 4 Business Park Road P.O.Box 768 Old Saybrook,CT 06475 660-5777000-Fax a60-577-7001 MID-HEIGHT SEAM SECTION INFILTRATOR" 1.800-221-4436 systems Inc. wwwrifiltratorsyswmiscom U.S.Patents:4,759,661;5,017,041;5,156,488;5,336,017;5,401,116;5,401,459;5,511,903;5,716,163;5,588,778;5,839,844 Canadian Patents:1,329,959;2,004,564 Other patents pending.Infiltrator, Equalizer,Quick4,and SideWinder are registered trademarks of Infiltrator Systems Inc.Infiltrator is a registered trademark in France.Infiltrator Systems Inc.is a registered trademark in Mexico. Contour,Microl-eaching,PolyTuff,ChamberSpacer,MuttiPort,PosLock,OuickCut,QuickPlay,SnapLock and StraightLock are trademarks of Infiltrator Systems Inc. Polyl-ok is a trademark of PolyLok,Inc.TUF-TITE is a registered trademark of TUF-TITS,INC.Ultra-Rib is a trademark of IPEX Inc. 0 2013 Infiltrator Systems Inc.AN rights reserved.Printed in U.S.A. IM02 1213 Contact Infiltrator Systems' Technical Services Department for assistance at 1-800-221-4436 Oa�'S dr � E,+"i5�in��.radc a-ILd, tic y u�a qa/aQZ v e: = sw p .1o11Z 601den GizXs 0OV f/ctclSor�, .J(. S5�/� JiM 1lE`9, 3X.-7 T. 041, lxl S4 n� use it e 6ar,79 7./o ac-re-lc �XiSfiitq 14:5 d cC �r2�gEv.-y daU/ ex-36 prde,7 5kkC1 Mpele: (;role a.� wL1�7a� -.rl,Q /,Gdd�cY, Sew GhA.n .i/ J.T� ")L 5-,zs" EX%S n �ee/5�'c '' 1_S� �F', E:Q` Co ypse. Tcn� • ! Ct oicE/ft. -Ev (�Caban Jan ecl APL/ SPS 3�3,�• ✓C f1'S.T./+�./J8S ^%*, a in f awE o�S.T. �' �` G►f cJ�ar,�¢.Cfs�gi�° � o > EXi 5!u rl /B X S3' \ : A o /o -,,t es a�%sPers /Ce/% >/av'�ro►r,�,sp�r•sc� M N N M III O O cu N O l E N-0 N E N Lea; p I' D7 O. N in C O O �O L p M icy N 0 I II �0 .,•M 0)E L.N Y a) - c N-YM w5.O N 0M C y C c0 N �6 a N O)N UN � E O (6 d� C N T N O fpn N .N L as C Z N N N•p C Z '�Y '= a)7a w C N C O m LL C N O) LL C U w O O CC O NU) �? 7.' 3 c 3 ac:._ . v 3a.N � N v N N X,p a 0 0 N> N E Q Z W w Q c N N.y 3 M CL o x H z H LLJ E E O z = p ;.+ p a' 0 m as H a a m a m I I c t7 O Z c c o N 0 N aci �' m N H E E N N N N N N • N N N a o N a 0 ('I (o o Q Q (o o a�i Q o Z z z 0 z m z N Y _LO N d d E 3 —, E 0 12 06 a +g o a c N m a� 3 a xooa x 'ooIL E p co H H ' r p H H IN- ' en a � u, 333 ax Y O O O Y 0 0 0 • oaaa oaao. IL a 4i z W W o o 0 � (n lA J U D O Z o Z O N O 0 O ° C9 r Z O U `O OO w O O N 0 0 LO � O 'O C 0 0 ._ 'p j O� m e m c a o rn d Q A () c 9 _ Q z (n ca �i ¢ ¢ "V Q 00 0 .6 N C C 06 H C i+ O C w O O 'O w O V 'O E M U O 0 0 t t U a o N O N ` E O N E E C 'O N N_ Q 0 D7 C (p w w +p c + C y C Cy1 (D C 'p0 .0 W N V 'p0 C C O O • ,�,� I O 0LL7 O Z x Z O z !n z z (n I y Y E I w E ma 3 #t a (L a tom• � °• m •2 m m c m y c t A cia2 'IioU ) u 0 ((1) u atr+ rT County 1 Safety and Buildings Division St.Croix $ 201 W.Washington Ave., P.O. Box 7162 Sanitary Permit Number(to be filled in by Co.) P$ Madison,Wl 53707-7162 6-6 q 57��7 Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate governmental unit N4 is required prior to obtaining a sanitary permit. Note:Application forms for state-owned POWTS are submitted to Pro �i different iffeerrent than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary a V/ D purposes in accordance with the Privacy Law,s.15.04 1 m,Stats. I. Application Information-Please Print All Information S y "0 Z (jai Property Owner's Name 6 7P / 1# L�0 , 'IOU % I iG7 John&Anne Collins Property Owner's Mailing Address Property Loc 4'1ENT 6 Z /\ 1042 Golden Oaks Dr Govt,Lot 1� City,State Zip Code Phone Number `'/.,NE '/., Section 7 (circ Hu on,WI 54016 715 386-0636 T 29 N; R 19 E C—wl) II. ype of Building(check all that apply) Lot# 1 or 2 Family Dwelling-Number of Bedrooms Na Subdivision Name �+ Block# ❑Public/Commercial-Describe Use Na ❑City of ❑State Owned-Describe Use �� CSM Number ❑ Village of ivia Na g}ownof Hudson III.Type of Permit: (Check only one box on liqb A. Complete line B if applicable) A' ❑New System ❑Replacement System Tmatrumt/Holding Tank Replacement Only ❑Other Modification to Existing System(explain) Addition of septic tank&Filter B. ❑Permit Renewal ❑Permit Revision ❑Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV.Jde of POWTS System/Component/Device: Check all that apply) Non-Pressurized In-Gro ❑Pressurized In-Ground ❑At-Grade -❑ and> 4 in.of suitable soil El Mound<24 in.of suitable soil ❑Holding Tank Other Dispersal Component(explain "`��— ❑Pretreatment Device(explain) V.Dis ersalff'reatment Area Information: Pol Lok PL-525 effluent filter to be installed at septic tank outlet. Design Flow(gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required(st) Dispersal Area Proposed(st) System Elevation 450 Gpd Na Na Na 15 VI.Tank Info Capacity in Total #of Manufacturer , Gallons Gallons Units o v New Tanks Existing Tanks � ny tbk- Septic or Holding Tank 1,000 To be abandoned 1,000 1 1 Wies Concrete X Dosing Chamber VIL Responsibility Statement- I,the un ersigned, some responsibility for i lion of the POWTS shown on the attached plans. Plumber's Name(Print) lumber's Signatu re MPlMPRS Number Business Phone Number James K.Thompson _ �-- MFRS 30021 715 248-7767 Plumber's Address(Street,City,State,Zip CWel 340 Paulson Lake Lane,Osceola,W1 54020 VIII. oun /De artment Use Only Permit Fee D Iss Issuin ant Sign Approved 4 even Reason fo-,-Mnial 0L Cond�,�easons for Disapproval n i,- T�'lE''10 tank affluent filter ohd J) UPi tlispersal cell.rnust all be services I maintained n � 1 as per management plan provided by plumber. C.iadC� 7. zM sell at k fequitemertts>rtnust be maintained as per applicable Code/ordinances. Attach to complete plans for the system and submit to the County only on paper not less than 8 In x I l inches in size SBD-6398(R. 11/11) Index & Title Sheet - Septic Tank Replacement Project Name: Collins Septic Tank Replacement Owners Name: John&Anne Collins Owner's address: 1042 Golden Oaks Dr.,Hudson,WI 54016 Site address: Same Project Location Subdivision: Legal Description: SEli4 NEv4,Sec. 7,T.29N.,R. 19W.,Town of Hudson,St.Croix Co.,WI. Parcel ID#: 020-100140-000 Page I Index and Title Sheet Page 2 Site Plan Page 3 Replacement Treatment Tank Crossection Page 4 Filter Specifications Page 5 Septic Tank Maintenance Agreement Page 6 Conventional Dispersal Cell Management Plan Page 7 Parcel map Page 8 Deed Mater P her JRes *cteWd Service: James K.Thom son,De 't.of Comm.Credential#30021 Signature: Date: CSC 7 4/fl —f- Page 1 Of 8 Design pursuant to In-Ground Soil Absorption Component Manual for POWTS,version 2.0 SBD-10705-P(N.01101) �o/alp Oat's di Cie I Way P°r4;,%j . r-01 An►tc C'olli�s��. �p �oslZ 6o%yen GizXs�: 0 y(ccdson, .Jl. 55 /6 EXiS�in cve// ,Q/9�J.,7,,. oc/�ccd5u,,, pc% 0 o A.o-levl-sO-coo e 6si7j Z/o au"cs ,E ' K�Sr dzhcC 1��5�rydaCl� I FJ�rSfi'nc� �alde,� -5kRICl 1;7f.�1�tV�PII[ �OorGdC4,6 .4pp,(-cx,/o ca 4i a P/bPoscd c.J,t5,rc,, a �&P-5 %�g bulld:T wLt�7a�/�r�i-'rl,Q Sew !7u l %X�L-52 S' E�s�in/5 SEee/5�•c-fo-,,,�in at au E/kt. fv 6eaba i Jul c pg-el:5 3J3.33. 1/"Sa . 5/0 PdC fJ•S,T.�.t.ljdS ^. info o/'S.T. t �� Grd. u-E d!'nir ¢,(d OW6 ::;7,o6/Zrr��rrl S�i�'1�cC � o > EXiS�in /8 x,-5',3 \�� ; c: Ail loi, 4nes > -a D z N D m 53j" AS REQUIRED 66" z c D 42" 0 z m ;u 1 N m N) O m 3" 36" 5" �� °rn > 0 I II C a 10" -1-1 I ;�!6' ; s I D II ° N —i= = =D = I ha X m — C C_ rn X D O a z ° 39" D m N i D I N m D r C DC D r S C Z Z Fn rn Drn oj A 6DCo �CC >o N Z^gD 01-> PC O i A 2 m :C:-,, > CC C vx ao °m � � �cNi° c�° 2p��ZVii� �F2 -� m X °z g ANC �' cl to n� � c�`i. v=Z N� f-nz�� -D O ha Ex Z2 n D co v o < v � ) p n D z� D n W r v N0D FD s N 7 D M O En z �Q W °c o D 0 �O v z �m o m-,,m mo v M-0 n 0 n o -r1 z° c� c ov r 0p> DO cnm D m O �{ -{ n W r. D OD \ 2 z r-a �"�n -�-� M v o D al m 77 Ln Dom° mo _D o m Z 0-1 yU� '� O __4 O� \per O mo D N i- r r' -4 m a0 z rl{ -p m M N v 0 � OE O (n N co "0 z M ° m D 70 C m 0 4 N .2 r m 00 00 z r O m 3 z � m m X v \ (A WLP700/300-MR MIERER COIICRETE DRAWN BY; WCP SCALE: i/4"-l'-O' PRE-POUR: m REV. 0— SEPTIC MANUAL DATE: 00/00/00 DATE: POST-POUR: W3716 US HWY 10 MAIDEN ROCK, N 54750 A z 800-325-8456 FlLE: %M=-W f 1 � ` _�t .41pIGI Ig 6 VT BALL CHECK ��r ree.ey I I � I ti i ► 9 } t � • �► ,... `' OUTSIDE DOMETER 1159 ..40 SOCKET ,, qi ( 1� e �►. ,�, I .-fj► �;a► �'":�, !f•ttt�! �tftt�lftw •:_� ��r/:- ��fffffffffs! 11lrllf (FOR f-THIN WALL Pill PART 40,3DI42-R OR (FOR 110 MW PIPE) PART NO.3DI42-EUR ip RETAINI PRI 02 {f!-lfl FROM FLOATM 30142-525 1 HOUSING-POLYPROPYLENE Mill .� •- � � • w eY ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer John & Anne Collins Mailing Address 1042 Golden Oaks Dr. Property Address Same (Verification required from Planning&Zoning Department for new construction.) City/State Hudson, W1 Parcel Identification Number 020-1001 -40-000 LEGAL DESCRIPTION Property Location SE '/4, NE '/4 , Sec. 07 J 29 N R 19 W, Town of H u d so n Subdivision Plat: Na , Lot# Certified Survey Map# N a , Volume Na , Page# Na Warranty Deed# (before 2007)Volume , Page# Spec house DyesC no Lot lines identifiable dyesono SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in§SPS.383.52(1)and in Chapter 12-St.Croix County Sanitary Ordinance. The property owner agrees to submit to St.Croix County Planning&Zoning Department 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/or(2)after inspection and pumping(if necessary),the septic tank is less than 1/3 full of sludge. I/we,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 Safety And Professional Services 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 Planning&Zoning Department within 30 days of the three year expiration date. I/we certify that all statements oFain form are true to the best of my/our knowledge. I/we am/are the owner(s)of the property described above,by virtue of a ty deed recorded in Register of Deeds Office. Number of be ms 3 K4 !S / /&1( TURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning&Zoning Department. *** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV.04/12) SoF�' Conventional Septic System Management Plan Pursuant to SPS 383.54,Wis.Adm.Code General The conventional septic system shall be operated in accordance with SPS 382-384 Wis.Adm.Code,and shall be maintained in accordance with component manual SBD-10705-P(N.01/01). All local and/or state rules pertaining to system maintenance and maintenance reporting shall be complied with. Questions on the operation or maintenance of the system should be directed to the installing plumber,Jim Thompson at(715)248-7767 or the St.Croix County Zoning Department at (715)386-4680. Septic Tank Septic tank servicing mechanics comply with SPS 383.54(1)(e). Septic tank to be located within 150'of service pad,with bottom of tank to be 515'below service pad elevation. The operating condition of the septic tank and outlet filter shall be assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR 113,Wis.Adm. Code,by an individual certified to service septic tanks under s.281.48,Stats. If the contents of the tank are not removed at the time of a biannual assessment,maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge accumulation in the tank.The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm,the filter shall be serviced if the alarm is activated. Septic tank manholes risers,access risers,and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound,defective,or subject to failure must be replaced. Exposed access openings greater than 8 inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with Comm83.33,Wis,Adm.Code when the tank is no longer used as a POWTS component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be approved for septic tank use by the Department of Commerce,Safety and Buildings Division. Soil Absorption Cell Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic(other than for vegetative maintenance)over the system is to be avoided. Soil compaction may hinder aeration of the infiltrative surface within and above the system and will promote frost penetration during cold weather months. Cold weather installations (October-March)dictate that the system be heavily mulched for frost protection. Influent quality into the system may not exceed 220mg/L BODS, 150 MG/L TSS,and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for the installation. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional,more frequent monitoring. Continaenev Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. Excessive ponding within the dispersal cell will be eliminated by installing a new soil absorption cell to bring the system into proper operating condition. Pg.6 of 8 i S w W �� t;,� •may�. O ivi #j t m Y Utz m ca `!C 7 O$ o ft . H ' ' rA FS- Ilk TROUT'ER �GSK 4 cc }� -o :.i co I DOCUMENT NO. STATE-BAR OF WISCM1114-FO1t*Z Box 492 PasE464 '" "' KC 313767 THIS SPACE RESERVED fql IIECdIDING DATA BY THIS DEED, Kendall B. Priester I rtEG1STER5 OFFICE ST,CROIX CO.,WIS. Rec'd for Record this-?th_ Grantor conveys and warrants to John E. Collins and Anne C. day of Degembe_r___A,D.19 12 Collinsx husband and wife as ioint tenants, ___At M. Grantee S • for a valuable consideration - RETURN TO r , the following described real estate In St. Croix.County,State of Wisconsin: A parcel of land known as Parcel #5 located in the Southeast Quarter of the Northeast Quarter of Section Tar-Key q 7, Township-29 North, Range,19 West, Town of Hudson, This is not homestead.Property. described as follows: Beginning at the East quarter corner of said Section 7; thence South 89°26' West (true bearing) 482•.70 feet along the South line of said Northeast Quarter; thence North• 0 046' East 634.33 feet; thence North 78036!.East 460.00 feet; thence Southerly along the Westerly right of way line of an existing Town Road to a point North-0°24f40" East 313 feet, more. or -less,'of said East quarter corner; thence South 0°24'40" West 313 feet, more or less, along the East line of said Northeast Quarter to the POINT OF BEGINNING. Also arl,• easement for an adcess road as described in the Affidavit of the Grahtdr-dated November 2, 1972, recorded in the office of the Register of Deeds for St. Croix County, Wisconsin, in Volume 491, page 207, document 313208. TRANSFER FEE f Exception to waapntiest Easements and restrictive covenants of record. Hudson i'. Executed et r Wisconsin 72 thi �,�Pda�y oP 19 SIGNED AND SEALED IN PRESENCE OF Kendall B. Priester ,SEAT.) (SEAL) (SEAT.) i t • i Signatures of i authenticated this 11th day of Decemhe; Title: Member State Bar of Wisconsin or Other Party Authorized under Sec.. 706.06 viz. STATE OF WISCONSIN St. Croix as' - County. Personally came before me,this day of 119 72 the above named Kendall B. Priester to me known to be the person_ who executed the foµ+go19 46 w�iaeat end ac edged the same. _ This instrument was drafted by �+ t.' Y I? ` - Darrell R. YWU ber John D. Heywood, Attorney—.at,-Law - Hudson• W13COriSri P 7 k_R v Notary Public ,St. Cr0 County,Wis. The use of witnesses is optional. f -, My Commission(Expires)(rs) 8-18-74 Names of persons signing in any capacity should be typed or printed below their signatures. �II M�I��rCpryrq� I l WARRANTY DEED-STATE BAR OF WISCONSIN, FORM 240.2- 1971 m� � 40 •Y P • ` 1 � a 1 e � ti, i •N � s• g t + � a • 4 • 18 • 1 + r • 1 NA Wow f� I ( • 3 i 1 a . , I t� Yl r �r, a"' a w rPg1 • t1 �► ® au � r + � x 5. • a �y� • .i •+ �i i• i� a ie 'a� :a ,a DEPTH Ell tIVG lUliM. W: ShOW�+ertfcet sans of atY t ,;`8Wf boils and the elf��ts of pM ; dowam. Deacrib f i8f8lEtC�Qt° C�MiF # @f1 the Plot S"ItoNr ttt@ rA t cw r RIO EUVATM C 77 L,-o .4#11 jo }} ! { Y f AM R 4 7 t i k awdfy that the soft tests ��tsd°tcR t�tis.fotrtt tnme 11ta(Je by t'ne fit:acCOid with the - - ` ded and the,tocadon of the teals are to the best of rrtY fCnawledge arad, is€;, t ' TES W NIPl MA'PtO t' � s - 44 i N . r ,' , i Tl#ater. 03MI)