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HomeMy WebLinkAbout020-1380-31-000Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)J. Permit Holder's Name: City Village X Township Hali, Jr., Richard W. Hudson Townshi CST BM Elev: Insp. BM Elev: BM Descri ion: .~ TANK INFOIRMATION (Vj s,d~~ ,,,,~ ~„~„„~ ~~ (~,,,~.tzdl ~ ELEVATION DATA TYPE MANUFA U ER CAPACITY Septic ~~-S t ~ Dosing Aeration Holding TANK SE~ACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ? ~ 2 0 / _----- Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand Number Loss SOIL A RPTION SYSTEM / '? ENC idth Lengt No. Of Trenches DIM S ~ Q-~~~~__ p ~ SETBACK SYSTEM TO V T .~P/L/ B DG INFORMATION Type Of System: f ~ t~,,,v }Sa ' go DISTRIBUTION SYSTEM Ft county: St. Croix Sanitary Permit No: 408270 0 State Plan ID No: Parcel Tax No: 020-1380-31-000 STATION BS HI FS ELEV. Bench rk D Alt. B T Bldg. Sewer SUHt Inlet 3 • ~a `~. 32 r SUHt Outlet f Dt Inlet Dt Bottom Header/Man. lO.;'p f 9~ 22 Dist. Pipe ~. ~tf~ f R~-3L Bot. System ~ r 12.88 Final Grade 3 •9~ ~$'~/ Sr:~f~eaer r~r~n•• ~~ ~~ i e . o ~ DIMENSIONS INo. Of Pits ~{ CHAMBER OR ~- "'~"- I UNIT Model Number: I~ « Header/Manifold U Length Dia Distribution Pi (s) Len Dia Spacing x Hole Size x Hole Spacing Vent to Air Intake 7 9D , 1 SOIL COVER x Pressure Systems Only xx Mound br At-Grade Svstems Onlv Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center BedlTrench Edges Topsoil ~ Yes ^ No ~] Yes i~ No C\COI~AM;~ (Include code d' crepGLncies, persons present, etc.) Inspection #1:~/ ~0 / o z Inspection #2: ----~--,-- oc n: 646 acker Driv Hudson, WI 540 6 (NW 1/4 SW 1/411 T29N R19W) Homestead-1st Addition Lot 31 Parcel No: 11.29.19.2357 ~j; T: r'cw~ S 1.) Alt BM Description = `~ 2.) Bldg sewer length = Zo ~ -amount of cover =~ ~7 'j(e « ~ Q'Z, 4 $ a/ t _ /' ,~/t ~_ ~. ~wj~1/.~ Z-~-- Cam, cd.~n ,21~6~. t3 S ~ ~` [ao ~~~~ i lam. ~ -, - - _ __ _ PMa re~ Required? ~x'!, Yes 1No ~I~ D ~ C Use other side for additional information. `O ~ ~ ~~ L_ ~v: ~ ~ ~' SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. LL In CN_ ~a.~lf~o n D Safety do buildings Division 201 W. Wadtington Ave. Sanitary Permit Appiicalion PO Box 7302 ~seonsjn In accord with Comm 83.21, Wia. Adm. Code Madison, WI 53707-7302 o~partmsnt of Commsros Persona info lion you provide may be used for secondary purposes (Submit completed form to county if not d y [Privacy Law, a. 15.04(I)(nr)J ~ j(, 7 itste ovmod. Attach com late Ians to he count co oral for the a tam on a r not less than 8 -1/2 x I I inches in site. Coun ~ ~ State Sanity P 2 umber O Check if revision to previous application State Plan I. D. Number I. A Itcallon Intormation -Please Print all information Location: Property Owner Name _ JL~p2i~ ~ ' ~Pl l~(t P~~rgopierty Lo~caltion FF QQ ~( /v~/4SW I/4 St'' T~ !N R' E _____ Property Owner's Mailing Address ~ ~ o ~ ~e-~~ C~.~, x ~~. / , or Lot Number Block Number 3 ~ City. State Zip Code Phone Number ~ ~~ ` ~E~ Su iviaion Name or CSM Number ~ uDSol l . S ~Ul 4 CE1 I p~• ~~ A u~ ~o-~I~'e II Type of Building: (check one) ^ city or 2 Family Dwelling - No. of Bedrooms:~_ _ $ 2002 ~ O village " ' O PublidCommercial(describe use): ~UL 9 I owrr of __ O Stale-owned _ ,.\-i,, (( ` ~ IiI Type of Permit: (Check only one box on line A. Check box on li B i6ip (g)Fi~E Nearest Road ~ i ~ Z p ~ ~ ~ A) 1. New System 2. ^ Replacement 3. ^ Replacement 4. ^ Addition to Parcel T--~ "----`--'-` S stem __ 'l'ank Onl Existing System ~.~ " D ~ ~ 31 - Ot~fl ! , o~ _ _ B) Permit Number O A Sanits Permit was reviousl issued hate issued IV. Type of POWT System: (Check all that apply) Non-pressurized ln-grgr~n•t ` (~ ( n n ^ Mound O Sand filler O Constructed Wetland , Pressurized In-grounc) (~~~-Nq~~S {.~a~ O Ilolding'fank ^ Single Pass i7 Al-grade 2 3 r X r ~ erobic '1'rea4n ~ ri1 _Recirculalin O Drip line ^ Ot r. `r ~ ~ V Dia eraaUTreatment Area In[ormaliott: 1. Design Flow (gpd) 2. DrspersalArca Re uired 3. Uiaperaal Area P d 4. Soil Application S. Percolation Rate 6. System Elevation 7. Final Grade ~~ ~ q ~s~ ropose 8c~ kale (Gals./Jay/aq. h.) .~7 (Min./inch) ''? 4a.3a Elevation 9.80 Vi Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Intormation Gallons C;allons 't'anks Con- Con- glass New Existing crate stnrcted Tanks Tanks ,----- ---- ~U ------- --- ~ --------- -------------- ~tt --- ----------:5--- ___ --• ---. ---- - - - a ---- -- O O o o o a O o VII Responsibility Statement I the underei ned assume res nsibilit for installation of tho POW'1'S shown on lire attached plans. Plumber's Name rat) Plumber's Si a1rr;( tamps): • MPRNPRS No. - ~. ~u,~. s~~~ ~~ ~a as ~- o ~ - Uuslness Phone Number '~ ~ ~ - 3 ~ ~ ,g a~ b ~ ------ Plumber's Addrcsa (Street, Crty, State, Zip Cod ------~-- ---- - - ~ 6~ ~ ~w ~ ~ ~ei,n s a~ ~' '~ S ~ ~ l ~ VIII County/Department Use Only ,Approved ^ DlaapprOVed O Owner Given Initial Adverse Sanitary Pettrril Fee (Includes Groundwater Date Issued Surcharge ) Iss in Agent Signatttre tbmps) Determination 22~ - 1X. Conditions of Approval /Reasons for DisapprovalQ"` ~~ / _!" ~~ _.~.~. _~. Q .1'In~iO--~~S.~:d_e_uliadec.~.. _- ~~ i_ ~ add fio ... i ~~~,~~~~ ~ehct (IINt '+' ---- - _ _ -- T~p ~~ 3)s~~f~b~~ v ° low ~ 2 ~ ~ ~eti ~ ~, 1Y1 p+~K ~I-~v - 4y~73 ____. ,_ ., ,: b t. r , ~ ~ ~ ~a pQs yp / 4A ~ (~ p ~lfl ~~ S G Y `~~ i a ~ ~ ~ t~ p ~ u' ~~i Ub ~i ~ f~ n ~~ OO {' c ~.~ d ~ ~- .--, Sp L ~ . _ . 9 a. 3 ~ ~ m ~, ~ N ~ ~ ~ m ~~m ~ ' i .~% ` ~ ~ E c N ~' M ,~ ~ .. ~ ._ . .�. -1---- -6-- .l __,,._. 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(n " ? • • • • Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT ..r'I.~nro .uiFh r`rvnm Rai Wic d'tm (:lY1P 1297 p~qe 1 of 3 A.C.E. Sat & Site Evaluations -- - - --- - - ~ County -- Attach complete site plan on paper not less than 8'/: x 11 inches in s¢e. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I D percent slope, scale or dimemsions, north arrow, distance to nearest road. ~, ~ °R~ . . 020-1012-30 ID# 11.29.19.54A Please print a o~mation. ~ By per; Personal information you provide maybe ett~o~ secondary pu~oses (Privacy Law, s. 15.04 {t) (m)). i Z Property Owner ('~ i'. ,' ~ ~~~ ~:- - operty Location Miller, Sam ~' t p G .Lot NW 1/4 SW 1/4 S 11 T 29 N R 19 W Property Owner's Mailing Address -._( S ~ n ~ ~ LUU C' # Block # Subd. Name or CSM# P.O. Box 151 •- ' ,;, r 31 1st Addition To Plat Of Homestead City Stat ' Code Ph~~t4rflber '~ j City ~ ~ village Tv~m Nearest Road Hudson WI 4816 Z~~~86 276 '' Hudson Packer Drive ~•r r , ~ ~ ~/ New Construction Use: ~ Resic~n~al f Qlutn ~ T 4 Code derived design flow rate 600 GPD ~ Replacement ~ Public or c - ascribe: Parent material Glacial outwash Flood plain elevation, ff applicable na General comments and recommendations: Boring # -) Boring ~ Pi > 132" i t Ground Surface elev. 96.82 ft. ! Depth to limiting factor n. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft2 1 0-10 10yr3/3 none sl 2msbk ds as 2f,im 0.5 0.9 2 10-23 10yr4/3 none Is imsbk ds cs if 0.7 1.2 3 23-48 10yr5/4 none s & gr. Osg dl gs - 0.7 1.2 4 48-132 10yr6/4 none s Osg dl - - 0.7 1.2 av~" 9Z ,98/ q2, 3i , o~ g2- r ~- S'e ~ Boring # :=::~ Boring Pit Ground Surface elev. 96.57 ft. Depth to limiting factor > 129" in. Soil Application Rate Horizon th De Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIft~ p 1 0-6 10yr3/3 none sl 2msbk ds as 2f,im 0.5 0.9 2 6-15 10yr4/3 none Is imsbk ds cs if 0.7 f.2 3 15-55 10yr5/4 none s & gr. Osg dl gs - 0.7 1.2 4 55-129 10yr6/4 none s Osg dl - - 0.7 1.2 at- a2-. 8 $~' 3. ~ "Effluent #1 = BOD ~ 30 < 220 mg/L and T S >30 < 15 mg/l. "Effluent #2 = BODS <30 mg/L and TSS <~0 mg/L CST Name (Please Print) Signatu CST Number James K. Thom son s-- 3602 Address A.C.E. Soil & Site Evaluations Date 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. 95.77 ft, Depth to limiting factor > 126" in. Soil Application Rate i ti D R d T t Structure Consistence Boundary Roots : Horizon Depth Dominant Color escr p on ox e ex ure *Eff#1 `Eff#2 1 0-8 10yr3/3 none sl 2msbk ds as 2f,lm 0.5 0.9 2 8-21 10yr4/3 none is imsbk ds cs if 0.7 1.2 3 21-63 10yr5/4 none s Osg dl gs - 0.7 1.2 4 63-126 10yr6/4 none s Osg dl - - 0.7 1.2 t (• ~ 3- Boring # ~ Boring d Pit Ground Surface elev. 91.07 ft. Depth to limiting factor > 122" in. Sal Application Rate l C i ti d D R Texture Structure Consistence Boundary Roots Horizon Depth or Dominant o ox escr p on e *Eff#1 *Eff#2 1 0-19 10yr3/3 none sl 2msbk ds as 2f,lm 0.5 0.9 2 19-30 10yr4/3 none ~ ~ 2fsbk dsh cs 2f 0.5 0.9 3 30-36 10yr4J4 none is Osg dl cs 1f 0.7 1.2 4 36-122 10yr5/4 none s Osg dl - - 0.7 1.2 ^ ~j ~ Boring Bonng # 91.35 ft. Depth to limiting factor > 125" in. Sal i/ Pit Ground Surface elev. - Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots : `Eff#1 `Eff#2 1 0-10 10yr3/3 none sl 2msbk ds as 2f,im 0.5 0.9 2 10-21 10yr4/3 none Is imsbk ds cs if 0.7 1.2 3 21-59 10yr5/4 none s & gr. Osg dl gs - 0.7 1.2 4 59-125 10yr6/4 none s Osg dl - - 0.7 1.2 * Effluent #1 = BOD ~ 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mglL and TSS < 30 mglL 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. r ~~. 3 of 3 L'c~C-cJe-Sac • E/Qda-~ian .~ ~ 5~i~: i': s~o /0~3/ P~cP. /'-`,gaff. to /~/d of f,6mc'.rEca.:d Sce. /l, T . a~F'f<upCsorl, ~`.CroikCo.~cJ/. 8l ^ ~s ~ ~~ °10 ~~ B3 a L~. 6. TPo!" 3fe ~~o~ ~.c i63'2GSf ~ _ ^ ,. ~ ez BV Bcnc1~ /vta.~,~: 70,o a Fes„ ~~,bo.r: AS,surntdelt~ ~Pe~' ~ /,297 /. 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 include 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- Table 1: System Design Specifications Sanitary Permit Number Number of Bedrooms Design Flow -Peak (gpd) (~0 u Estimated Flow -Average (gpd) Septic Tank Capacity ( al) a ~ ~~ Soit Absorption Component Size (ftZ) 8,s~ Type of Wastewater Domestic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soil Absorption Component Desi n Flow -Peak (gpd) _ g(o~' Maximum Influent Particle Size (in) - $ 1/8 Maximum BODb (mg/L) as o 220 Maximum TSS (mg/L) J SU 150 Table 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once eve 3 ears Soil Absorption Component inspect once every 3 years 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 septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as ner_.pccary to ensure groper 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 ~~ 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 of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the 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 device 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 septfc 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 cover 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 Management Plan fora Septic Tank and Soil Absorption Component Plantings ofdeep-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. When system fails, we will replace with another system at owner's expense. Alternate area must be left undisturbed. St Croix County Zoning Office 386-4680 Boumeester & Sons Excavating 386-9020 Tri-County Sanitation 386-2130 3 S'i' CRUIX C'Ol1N'1'Y 51~P"I'IC 'TANK MAIN'TENANCI? AGREI~MIsN'I' ANU OWNRRSIIIF CERrT11FICATION rORM Owner/Buyer ~ i ~ ,P i2. ~ ~ ~ ~ h t l ~ (~ > r Mailing Address ` ~ I ~ ~ ._~~ . ~ ku ~~ ~ ~ ~ ~ -- Property Address ~o~ .w (Verificativn required from Plarming Department for new construction) City/State _ ~ ubS ~~ ~1 Parcel Identification Number 4~U ` (~ ~ - ~® ~' d ~( (.d ~~'~~~~, Property Location ~ ~/,, S ~ Subdivision ~ ~~ ~ ~ ~ . Certified Survey Map # '/,, Sec. ~ ~ , 'I' °~ i N-R~W, 'Town of (kb.!'dIJ i'(bT ~fi ~dr~ Volume Page # Warranty Deed # ~yy ~"? ~ ~ Volume _1~ ,Page # ~~ Spec souse O yes,®, no Lot lines identifiable ~' yes O no 1 .` taapr+oper use and maintenance of your septic system could result in its prematwe failure to hsndle wastes. Proper maintewuoe eoruisb of puosping out the septic talc every three years or sooner, if needed by a licensed pumper. What you put into the ayatem can afTect the ftrrrclion of the septic tank as a trea4nent stage in We waste disposal system. Tire Property owner agrees to submit to St. Croix Zoa[ng Department a certification form, signed by the owner sad by • ~ ~sterptumber, jotuneyuraoPlumber, restrictedplumber or a licensed pumper verifying Wat (1) the on-site waatewatertiiepoeai cyaleas Pmi~ openNag condition and/or (2)` ~ iot~reotlon sad pumphrg (if necessary), the septic tank is lea Wan U3,slhll o[ dodge. Uwe, the undersigned have read the abov ~~ .,and agreo to rnaintaia the private sewage disposai sy ~~~'~0 alandacdt set [ort6„ herein, u set by the Department and the Department o[ Naturd Resources, State o[ Wifaoondny~ r"OertUkatios stating dot your septic system ha been nraint~ned moat be completed and returned to the St. Croix Cvunry Zoning OtRoe within 30 days o[ the throe year expiration date. ;;~;' ~~ . IONAT[JR>3 Ola APPLICANT ~ ' ~ DATE ,,,h, . 4.~~R CLRTIFI _s~rrt~ ~; ;, ~.' ~,;: ; i (v/e) etntif~r flat all stalemeata ontlt~, ftutp arc true to the belt of my (our) knowledge. 1 (we) em (are) the owner(s) o[ the Property des~cri/b~ed above, by virtue of a;writaaty deed recorded in Register of Ueeda Ollice. SIQNATURB OF APPLICANT 1• ~ ~ 2 ~--- ~ ~ ° '~" ~r: ~ ' ~ ` '~' DATB :, :;.i , ~:.;~;. *"*** Any infonnatioa that is mis-repr ~,ay fetal! in the sanitary permit being revoked by the Zooiag Department. •*~•~• .,s~ iacinde r-Ilh this appllcalion; a stsmped.~rarrr~ggr decd from the Register of Deeds ofTce ' a copy o[ dre certified survey map if reference is made in the warranty deed Lvt !! ~. STATE BAR OF WISCONSIN FORM (- 1998 I, 642720 ' WARRANTY DEED KATHt..EEN ii. WALSH ~~~ ~ REGISTEk OF DEEDS Document Number ~~~• PACE 568 ST. Ckf1IX CO. } WI RECEIVED FOR RECORD This Deed, made between Sam E . Mi 11 e r , 'I 44-15-2001 A:30 AM ^_a single person _ ---- ' ---. NARRAFITII DEED -R'ic ar W. Hall . Jr. , a sin le erson Grantor, 6ER CDPY FEE: •and ~ g p COPY FF.E: - 1RAHSFFlt FEE: 141.00 _ RECGRDT4G FEE: 14.00 PfGES: 1 ----- -- Grantee. Grantor, for a valuable consideration, conve s to Grantee the followin $t. CTO1X y described real estate in County, State of Wisconsin r (the 'Property): ,~ Hecordiry Area --... ;First National Bank of New Richmond Lot , Homestead 1st Addition in the ;, PO Box 89 Town of Hu son, roix County, Wisconsin. New Richmond, Wl 5b017 ii i- _____: __--:._----_-.. -_.._ _. _.__ ~ -.: _-~ 020-1380-31 I! Together with all appurtenant rights, title and interests. (SEAL) ~~-~U/tt~ "1 ~ ti) (SEAL) Sam E. Miller (SEAL) (SEAL) ACKNOWLEDGMENT Grantor warrants that the title to the Property is good, Indefeasible In fee simple and free and clear of encumbrances except ~' easeriteltts, covenants and restrictions of record, if any i; Dated this ~L ~ da of April 2001 I Y jl AUTHENTICATION Signature(s) authenticated this day of , TITLE: MEMBER STATE BAR OF WISCONSIN (If not. authorized by §706.06, Wis. StatsJ THIS INSTRUMENT WAS GRAFTED BY Heywood $ Cari, S,C. by Samuel R. P.Q. Box 125, Hudson, WI 54016 (Signatures may be authenticated or acknowledged. Both arc not necessary.) Cori ~e~.E.C.t~,.~~z.tt.~p Notary Public, State of Wlstonsln My co mts Ion is perr~ent. Rf • Names of persons signing m any ripaclty must lx typed or printed 6ebw their signature. ~ - ~- _~ ~~ _ ~~- ~` ~ ~~ ~ ~~ WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1 - 1998 Paircel IdenllRCaBOn Ntu}nber (PIN) This 1S nOlSomestead property (IS not) State of Wisconsin, ss. St. Croix con~,n~r~~~yttt Personally came before me this fit! .day of A r i l ~ , th~ove named Sam E. Mil er, a single person me known to be the person ins(racpent and acknowledge [he same who executed the foregoing ~! i i ii .~~; t • .. ;:i •~ . ~Qex~yfRtt~~-date: -) ~ ,' _1,~,~L._pV _....~... _: >> C ;I Wf7tonlin•Legal frank Co., Int. Milwaulce~, ws. .~ ~ ~ o - ~~ ~~ ~IL ~~ \~ Nrn y M„SS,6Z.OOS L l N01103S ~/ l MS - '6/ l MN ~0 NIA 1S'd3 ~n .St+'ZOb ~ ~ ~ bZ'8£ ~ S6'S6 ~ ~ ~ ~~ m O mQ n ~ a II ~ ~ I ~ ~ d O ~ N ~ U Q ~ w~~rn O Q~N O C'V 00 ~ tJ M V Q P^ :o M Q N ~ ~ ~ ~ ~ ~ btp ~ O o~ ao J N ~ ~ w Z ~ ~` ~ ~~ o s`~s .~ •~~ .n M Q N o0 . `d~ •n0~~ E~ 1 ~ \ ~ p ~ `~ ~ y SZ~ _ J c" ~ rn ~ ~ hy~ / ~ ~ ~ oo cv a ~ ~1. ~ 1 ~ ~ ~ rn o hti ~ O N ~ ^Ory / r J h ~ psi I, ,~ © ~ I ~ ,LL'l9Z M„£1-,~b.ZOS f- ' Z / Q \ /\ ~ // / I w ~/\ ~ cn o ~ ~ i ~, a o / ~ -i ~ o w~ ~ ~ /~° ° ~ / `` / ~. U ~ N ~ ~ Q) ~~ O ~ M ~= N ~ Z p / Q / Q ~ J NM ~ m. 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