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HomeMy WebLinkAbout020-1380-30-000/* Wisconsin Department of Commerce Safety aftd Buiidifgs Division GENERAL INFORMATION Pe it H der's Name: Miffer, dam ^ city ^ ~~~senT ~ ship CST BMElev.:- r Insp. BM Elev.: ~ BM Ders~cription: CC~-7 t~ •~ ~~ipw- ~ C 5T" ~3''~ ~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic (~,~ ~l S~YL_,. (2. $~ Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. vent to Air Intake ROAD Septic 2S' ~ ~s! `~' NA Dosing NA Aeration - NA Holding ' DI IMD 1 ~ID41AN1 IIUFARMATIAfU Manufa urer Deman Model Numbe GP TDH Frictio S stem T Ft L Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM ~zri~ ~ ~ ~ _. ~,o.Y- ~a-3~ 3 'r"~ P~, PRIVATE SEWAGE SYSTEM INSPECTION REPORT (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy Law, x.15.04 (i)(m)] ELEVATION DATA c°unt8t. Croix Sanitas~~t~gi~No.: State Plan In ~D INO.: Pa rce l~~K,Np.380-30-000 STATION BS Ht FS ELEV. Benchmark (o, (Q~ ~oro.la (mD . D ~~. Bldg. Sewer St/ Ht Inlet of • 07~ q ~.~ r St / Ht Outlet ~'. 3 ~ ~'(~ .$'Y ~ Dt Inlet Dt Bottom Header/Man. II'~ i R .~p$ Dist. Pipe «• ~!• !I 9~,,,~*gj Bot. System 2. ss !2 . $~} [Z•~ 9 3• ~~ Final Grade cover ~~~ g o . U r ~~ TRENC Width r Len N . f renches PIT No. Of Pits Inside Dia. Liquid Depth DIM N ~ ~~ DIMEN I N SYSTEM TO P / L BLDG WELL ~ LAKE J STREAM LEACHING Manufacturer SETBACK r~ INFORMATION TypeO ~+~ ~ CHAMBER OR UNIT Mo a Num er. tl System: ~~N.~ , 2 nISTRIRl1TInN SYSTEM ~ Sfl Header !Mani old rr Distribution Pipe(s) x Hole Size x Hole Spacing I Vent To Air Intake Length ~~ Dia. ~ ia. ~` ZC+ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of *-xx Sgeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ^ Yes '~] No ,• ^ Yes ^ No C~MMENTS: (In u.~~o~ discrepancies, persons present, etc~nspection #1:~~8/®~~'lnspection #2'~-'t-'h -Lo`catlon~ 652 PackeCrD'i'ive, Hudson, WI 54016 (NW 1/4 SW 1/4 11 T29N R1~.W.) - 1129192356 Homestead-1st Addition -Lot 30 ~"~" 1.) Alt BM Description = 5~, ,ti~.,r-UtbUL. ~,ou'v'~ 2.) Bldg sewer length = ZS•a ~, .. ' -amount of cover = ~ Z`f 5~ C~'`~`-'' __________ ~~ ~ 3 W e1JQ. t~v,$-Src,~.~ `~ ~ ~,,,~,~ Is.Q~Q, t~tuy'~ ' .. PI n rev v required? Yes ~ No l Use other side for additional information. ~ ~ C ~' SBD-6710 (R.3/97) Date Inspector's Signature Cert No I~I l~< ,~ ~~. ~~• • • (Orj'~, ,~~dL, ~ Sanitary Permit Application Safety & Buildings Division 201 W. Washington Ave. In accord with Comm 83.21, Wis. Adm. Code PO Box 7302 See reverse side for instructions for completing this application f ~~ Madison, WI 53707-7302 irt Personal information you provide may be used for secondary purposes SCOnS Oepertment of Commerce (privacy Law 15.04(I)(m)] s (Submit completed form to county if not , . state owned. Attach tom lete tans to the coun co onl for the s stem, on a er not less than 8-1/2 x I 1 inches in size. State S nary IemytNumber ^ Check if revision ~vious application County State Plan 1. D. Number ~~ ~~ I" l X. °' ~ ~ A licatioin Information -Please Print all Information ~ ~~ I ` Location: . '~ Property Owner Name Rr • ) ~~~ ~ `` ~ ~ `' ~ " Property [.ovation ',1 q : R~ /E o W S ~ T Z~ N /11U~/4 J ~/4 y~ t - 11L 1' ~, 1. E rZ ... l 5 r-1 ~L1 1 , , , , Lot Number Block Ntrmber property Ovvrre~s Mailing Address ~ - _~ . ' State Zip Code ° Phone Numb Cf~('j;X y City Subdivision Name or CSM Number , ~ -~~ r. ~ ~.:, N~ marl w1 ~ a! ~ ~ ~~~~ No)~l~~ ~TEq tst~4dd, ~,. ,•~ j II. Type of Building: (check one) C f Bedrooms :~ - ' 2 N ~ lli ^ city ^ village f 3~ _ L o. o ~ ~ , , ng - 1 or 2 Family Dwe ~ ~I Town o public/Cotnmercial(describe use):_ ~~.„-,~- ~ ~) v I~ S ~ ~/ , ^ State-Owned Barest Road AC ~. E 2 ~4 110E ~~ 3~X`i3.15 T2E'NCf1ES(3rod~~F'~sa./S = 17,7 F7' .~~ Parcel©2o bC1fs - o-o III. T e of Permit: Check onl one box on line A. Check box on line B if a livable !(. ~ R , R • 6 ^ Addition to 5 • A) I. ew 2. ^ Replacement 3. ^ Replacement of 4. Ercistin S stem stem S stem Tank Onl Permit Number Date Issued B) ^ A Sanita Permit was reviousl issued Type of POWT System: (Check all that apply) 30 ~ [- ~ ~ 3~~ S IV d d W l . 'Non-pressurized In-ground L E ~ C !+ ^ Mound ^ Sand Filter ^ Single Pass an et ^ Constructe ^ Drip Line ^ Pressurized In-ground , ~ ^ Holding Tank ^ At- de 'i -T~ENtN 3 1(9 3 ~~ S ^ Aerobic Treatment Unit ^ Recirculatin ^ Other: V. Dis crsal/Treatmcnt Area Information: Design Flow {gpd) 2. Dispersal Arra 3. Dis~,crsal Area 4. Soil Application 5. Percolation Rate 1 h 6. System Elevation Elevation rode . ) Required Propped Rate (GalsJday/sq. ft.) (MinJinc Z Z t 13,5 9$'S .~(t.z~ 531F~ C~Od SooF+ VII. Tank Capacity in Total # of Manufacturer Pre! .b Con- ' ' Site Steel Fi ass Plastic Con- g anks T Gallons Gallons Lt[orn-ation Crete strutted New Existing Tanks Tanks ^ ^ ^ ^ 12~o I W~ ~SE,Z EPT-L X ~ ^ i , ^ ^ ^ ^ ~z-~t3E1 long I1.'~ 2 VIII. Responsibility Statement the undetsigrted, assume res onsibili ~ f<,r installation of tl,e POWTS shown on tine attached laps. 1 l3usincss Phone Number _ , I'IumMr's Si nature no sta s : MI'/hiP1tS No. Plumlx~'s Namc Unint) ~ g ( ~ ) 7 ~ ~ ~ 3 ~' / ~ ~j ~p 5 Z te paNE~c_. % Itit-~ Z~ So 3 ~ D C Plumber's Address (Strcet, City, State, 7,ip Code) '``'~ol~ b70 N~>\C~E2 ~IDra~ a~4 I-4udsoN ~ 1X. CountylDepartment Use Only Sani Pemrit Pce (Includes Groundwater Date Issued ~ Issuing Agent Si lure (No stamps) y ^ Disapproved Approved ^ Owner Given Initial Adversr. Surch e Pee ~ ~ p .~~~ Dctennination X. Conditions of Approval /Reasons fo~rl Disapproval: F I ' ~ ~ ~"~~ ~ ° ~ ~r~ i S ~ S t ~}- ~ ~~ ' t9uS . ~~ t,S CJ~:a2Crtn~~ /MD~t~11.~ cLS ~.~ ~.L JeGe~.ti. rK r___.~__ ,.---. v~ ~ D ~" ! ~ ;- ~~- ` ~ '~ ~ r ~, t, ~- ~ fir, ~- f f2FNcN~ 5 ~ Nousa~ ~~~ ?p.~I~t~~FFusarsFhfJ st'L~ L~VFL. -- ~. ~, ` O / ~ O I`` \~\J ~ ----~~...~. V ~._ ~... . ___ . c o ~ I~,. ~ ~' ~'' '7-~ 3~8 RE~h T ~ _ _ _ _. ~~ = Boa , a~ ~ ~~t'1. . ~' A ~ ~.~-~~ ~ $S 1 ~T 8. . 3/~~~QEgA~,. T jfl YY( VL< < L L ~ ti .~o,m.~ ~ T~6~ ~ LoT ~ ~-c L' t~~ los 2 ~~~~ 20~ i 3 ~~ ~o , o~, c Tf4~ ~D a 1 t~ .~',~ ~. i D ~ ,~ ~ ~~ PC I~- 7 C ~ -r J~ ~: ~( ~~ ~~~ \4 ,~ -[ ~ 3 ~ 7 S• ~ ~K~G /a ~ y ° Q~4 aoo M 4E ~~~~ sP1 ~T t~Y,~L ,~~~ 30 ~(3~as~~Ffvs¢rsFRcf1 t- ~, ~ ~ o- . s, g ~ ~~~ ~ ~o c~tc '~T -~,, ~ " o w zr! ~~L F ~ ~7~ ~-~ ~ ~~, `mil" '~ ~. ,.,\ -cam ~ ?' "~..' ~~~ ~ . ~~,~`~, A ,b. ~ ~ ~ , a ~. ~~ 3~8 RE6 ~~ - I oa , a~ ~ ~`~,,,. `' -.J ~ ~ ILLS ~ ~ S ~ ti ~~a ~ ~ ~ T~ d¢ b LoT ~ ' a ~T 8, , 3~~"REg,~~ ~, ~e,4r` ~,~ti (052 f ~4~1F~ ~ ~ 1~0 ~p • o~ ~ ~~ z.' Tex ~~ ~*©Zo•i3~ ~ %t~~a~.~ ~zz s a 3 G /'~l ~.~. i 5~r ST~i'1"~ ~ 1, = %3rS ~ r'~'' ~r~7'~ s Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT in ~rrnrri~nrc with r`rmm RS Wic Ar1m C:(X1B 1296 page 1 of 3 A.C.E. Sal & Site Evaluations County Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference direction and Parcel I D percent slope, scale or dimemsions, north anow, and and disfariceto nearest road. . . 54A 19 30 ID# 11 29 1012 020 . . . - - Please print all in~nn~~ion. •~ ~ ate Personal informatbn you provide may be used tors@~d`ary purpose~rivay aw, s. 15.04 ('~.~(m)). , ~~ 'L~ ~e~ 1 Property Owner ',:.-~~ `.. Pr Location Miller, Sam ~~-' ~ Govt. Lot ~ NW 1/4 SW 1/4 S i i T 29 N R 19 W Property Owner's Mailing Address _ _ ~ S ~ ' ~ Lot # Block # Subd. Name or CSM# P.0• Box 151 ~ -'~ 5t ;;RC+~- 30 Prop. Ist Addition To Homestead City State Zip ode';Phone p pK~iGE ity •,, ~ Village ~ Town Nearest Road ~ N1N Hudson WI 54016, ~ ~( ~~) 386-2769, • , `~,`j` Hudson Packer Drive ~ New Construction Use: ~/ Residential /,off ti~ertis _f Replacement _j Public or commercial -Describe: Parent material Glacial outwash General comments and recomn~ndations: 4 Code derived design flow rate Flood plain elution, if applicable 600 GPD na a Boring # J Boring /~ Pit Ground Surface elev. _ 99.54 ft. Depth to limiting factor > 128" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIft~ 1 0-9 10yr4/2 none sl 2msbk ds as 2f,im 0.5 0.9 2 9-32 10yr4/4 none Is imsbk ds cs if 0.7 1.2 3 32-66 10yr4/4 none s & gr. Osg dl cs - 0.7 1.2 4 66-128 10yr6/4 none s Osg dl ~~ - - 0.7 1.2 q3.S'-0 '~t.`t`b l~e•`f a Boring # ~ Boring Pit Ground Surface elev. 98.84 ft. Depth to limiting factor > 131 " in. Soil Application Rate Horizon De th Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft' p 1 0-16 10yr3/3 none sl 2msbk ds as 2f,1m 0.5 0.9 2 16-22 10yr4/4 none gr.sl 2fsbk dsh cs 2f 0.5 a9 3 22-29 10yr4/4 none s Osg dl cs if 0.7 1.2 4 29-131 10yr5/4 none s Osg dl - - 0.7 1.2 ,_.__ _ * Effluent #1 = BOD ~ 30 < 220 mg/L and TSS >30 < 150 * Effluent #2 = BODS < 30 mglL and TSS <~0 mg/L CST Name (Please Print) S' ature: CST Number lames K. Thompson s-- 3602 Address A.C.E. Soil & Site Evaluations ate Evaluation Conducted Telephone Number Osceola, WI 54020 9/18/00 715-248-7767 property Owner Miller, Sam Parcel ID # 020-1012-30 ID# 11.29.19.54A Page 2 of _ 3 Boring # ~ Boring Pit Ground Surface elev. 97.54 ft. Depth to limiting factor > 129" in. Soil Application Rate i ti R d D T ture Structure Consistence Boundary Roots : Horizon Depth Dominant Color ox escr p on e ex *Eff#1 *Eff#2 1 0-6 10yr3/3 none sl 2msbk ds as 2f,im 0.5 0.9 2 6-18 10yr4/4 none sil 2fsbk dsh a 2f 0.5 0.8 3 18-22 10yr4/4 none s Osg dl cs 1f 0.7 1.2 4 22-129 10yr5/4 none s Osg dl - - 0.7 1.2 Boring # ~ Boring pi{ Ground Surface elev. 92.79 ft. Depth to limiting factor > 118" in. Sal Application Rate H ri th D l D i t C tion Redox Descri Texture Structure Consistence Boundary Roots zon o ep or om nan o p *Eff#1 *Eff#2 1 0-7 10yr4/2 none sl 2msbk ds as 2f 0.5 0.9 2 7-23 10yr4/4 none `5 imsbk ds cs if 0.7 1.2 3 23-71 10yr4/4 none s Osg dl cs - 0.7 1.2 4 71-118 10yr6/4 none s Osg dl - - 0.7 1.2 Boring # J Boring - Pit Ground Surface elev. 94.54 ft. Depth to limiting factor > 123" in. SaI Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' *Eff#1 *Eff#2 1 0-8 10yr4/2 none sl 2msbk ds as 2f,.lm 0.5 0.9 2 8-13 10yr4/4 none Is imsbk ds cs if 0.7 1.2 3 13-21 10yr4/4 none Is Osg dl cs if 0.7 1.2 4 21-59 10yr5/6 none s & gr. Osg dl cw - 0.7 1.2 5 59-123 10yr6/4 none s Osg dl - - 0.7 1.2 * Effluent #1 = BOD ~ 30 < 220 mg/L and TSS >30 < 150 mglL * Effluent #2 = BODS < 30 mglL 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. I~ d p 5`Q' L ~~oP ~~~~ ~~ p ~~r a Qr-cl, mo.rK: Togo o~ ~'6 "'rcba~ Xgssan,ed elev. ioo,vo: ^ ~io~ ~o ^ S~o~' ^i Penes P~. a\ • Elt dafi o,-~ Vie: /--~/~, . ~.wc.: TopoF~P'. ~cb~. E/Qv` = 9Q7z ~ . Prhe.s ~r7 o pc,~ /o t 30 o r p~oposQd ~fOrnC Srfc4d S2 e, //, T , t.~.~. ~ T ~ ~ I'~1 11. C,.~ 2 l ~- d -M ~ ~T~E' ~ ~ [. Q'7` ~ ~F~' _ - °~"`'.~ BioDiffurser Sp~~ficat~onS : ' T Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWYS) shall indude information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Tahle 1 ~ Svstem Design Specifications -~---- Sanita Permit Number Number of Bedrooms 4 Desi n Flow -Peak ( pd) ~ b d ' Estimated Flow - Avera e ( pd) o ~ Septic Tank Capadty ( al) 2 5 v Soil Absorption Component Size (ftz) 5 3 F ~ T e of Wastewater Domestic T~ti~e ~• Cnil Ohenrntinn Cemnenent .limits of Reliable Oaeration -r - Septic Tank Component Soil Absorption Com Went Desi n Flow -Peak ( pd) ~G Maximum Influent Particle Size (in) -o a 1/8 Maximum BODE (m /L) 220 Maximum TSS (m /L) 150 Tahlra 3~ Maintenance Schedule Se tic Tank Inspect and/or service once every 3 years Outlet Fitter Inspect once a ear and clean at least once every 3 years Soil Abso tion Component Inspect once every 3 years i Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the se t' and outlet filter shall be assessed at feast once every 3 years by inspection. Th outlet filter haute h? ~laaned as necessary to ensure p opsc.operatiei~. 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 Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume 4-f scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of th'e tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole 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 devise to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank maybe difficult or impossible. Tank abandonment shall be in accordance with Comm~83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health.hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cgver over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 r .t Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep-rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. h i g ~i g f~ S --t s.. -n'l '~ a r ~~~~ ~~ Do~~lr ~ z.zsa3 G ~~ ~ - 38~. - y~ ~o 3 ~~Q~O/1,4OM Ola,vs~r Q wi ~c. B~ ~sQ~ if Jys-t~~ F,,. Is. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer S',d n-t ~% 1 L t~~ Mailing Address ~ OX '~ / S ~ Property Address ~O S ~' (Verification required from Planning Department for new City/State ~` ~ 1pSo N w t Parcel Identification Number o Zn ~ ~ 3g0 - ~O - C~0~7 ~F.(=Ai DESCRIPTION Property Location /`~ ~ '/,, 5 ~ '/,, Sec. ~ T ~ 1 N-R ~ ~ ~' W Town of ~ J '0 S O ~ subdivision ~ D M ~ S'T.~ ~ q ,Lot # -3 ~ Certified Survey Map # ~ 3 7 Z S ~ ,Volume 'g ,Page # 3 1 _ Warranty Deed # ~O ~` Z ~ Z ~ , Volume DSO ~ .Page # ~~'~ Spec house l~ yes ^ no Lot lines identifiable yes ^ no SYSTEM 1VLAINTENANCE Improper use and maintenanceof 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 master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal 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. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standard: set forth, herein, as set by the Department of Commerce and the Department of'Natural Resources, State of W isconsin. Certification stating that your septic system has been maintained must be completed and returned to~the St. Croix County Zoning Office within 3C da s of the three year expiration date. .._.~ P Q~ ~/pl SIGNATURE APPLICANT DATE ~. •=:v~WNER CERTIFICATION . ' ~ t'(we) certify that sii statements on this form are true to the best of my (our) knowledge. the roptlrty.deseribed above, by virtue of a warranty deed recorded in Register of Deeds Office. `A NA O1: ' 1?I.YCANT I (we) am (are) the owner(s) o 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 /~' Dlyl:unt9nl NtMntx9r tifA11'. DAR Uh \VI`•t a}^a1~N L11ftf,1p2 - 1`.IS)S W1ARR~ J1~~A><(~81 Mark D. ttOr;encran2 and This Ueed, made belseeen ._ _-_ ____.____ - -._ ___- -.__. Christina Rosencram , husband anli wife, ___ _ _.-- _ _ -_ . Granto. ann _ Sam E. Miller, a sinylc person, - _ _ ______ _ _ __ _ __ _ ---,--- Granlec. r Grantor for a valuable cunsideratiun. anwrys and Karr;uHS w (:rannr the Inlluwing St. Croix town Starr•of~Ytscunsirc described real estate In - _-.-__- . _ _--~ Y 622123 Y,RTHI..EEN H. WRLSH kEGISTEk OF DEEDS ST. CkOIX CO., WI kECEIVED FQR RECORD 05-01-2000 10:00 RII YRRRRNTY DEED EXEMDT Y CERi COPY FEE: COPY FEE: TRANSFER FEE: 900.00 RECOkD1N6 FEE: L0.00 DAGES: 1 ,, , . Namr1 a110 Helurn AAdrnss First Federal Savings Bank LaCrosse-Dladison 201 South Second Street Iludson, Wisconsin 54016 ' 020-1010--60; 02U-1012-40; and 02_0-1017.-10 • Parcel IACnuLCatgn Number (PIN; This_l s -_.___ . _ homestead property. (is) (is ooQ Part of the NE 1/4 of SE 1/4 of Section 10 and Yart of the N 1/2 of SW 1/4 of Section 11, ALL in Township 29 North, Ranye 19 West, St, Croix County, wisconsi.n described as follows: Cottlmenciny at the SE corner of the NW 1/4 of SE 1/4 of said Section l0a thence East 2739 feet; thence Nortlt 610.5 feet; thence West 1419 feet; thence South 544.5 feet; thence West 1320 feet; thence South 66 feet to the point of beginning. Exceptlorts w warranties: Subject to easements, reservations and restrictions of record. Dated this a ~ ~h'day of April _ _ 2000- ------------ --------- (SEAL) -L! `_~r^ - - - -- _ (SEAL) ttlC D_ kOSENC[tAPI - (SEAL) __ _ ~ (SEAL) ClIRISTINA ROSENCRANZ I AUTHENTICATION ACHNOWLEDCMENT Signature(s) audtenncated this day of - `_. -...- TITLES MEMBER STATE BAR OF WISCC pf nut. - ------ - authurized by §70G OE'i. Wis. Stars.) THIS INSTRUMENT WAS URAFTEU F EP ~ S NM~~t STEPHEN J. llUNLAP f • ;: Hudson, wisconsirt _ (Stgnatnres may be antbentirated or acknowledged. &yth ur nOl necessary) Slate of Wtsconsln, ss. St. CLOix C!n~ut~7y. Personally came before me this ~Sf daY ut Aril __ 2000 ,thcalrvvenamed _ Mark D. Rosertcranz and~_ Christina Rosencran•t, me kn wn to be the person __5._ i Iw rxecweA thr foregoing tnslr .nt Ixl arknowledgc Ilx• m ,~, / s • arletite~.-Schmidt ---.- Nntary Vublic. Starr of Wiscunstn My cvnnnlsston Is pennauent. (lf not, state expiration dale ----_~-- -14/20102_.__ . -.- _J ' Nanrs nr y.rs,nn aWnma ~+~ ,„, apse ay m, nl oe lypvd w ~nn,rd +rluw Ili•n s.Rn,n,~v S LAIE BAR OF NI(CUN9N wssonsa~~glat rYanh Co Inc WARRANTY UEf.U inRAl Nn 2 - 199a M/waJN. 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