HomeMy WebLinkAbout020-1452-02-000 t
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
463323 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:
LaCasse Development Hudson, Town of
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
/ (3 ov\ c i 113.29.19-6160%
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Z G— Benchmark �L
[3esipg Alt. BM
Ze�l,� -� I I P'j, r- s; �t z . �.
Aeration Bldg. Sewer
Holding St/Ht Inlet
TANK SETBACK INFORMATION St /Ht outlet 5. 32,
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic .7 5a` I Z7 1 Z, DtBottom
Dosing _ _...... _ .. ........... _..._ Header /Man.
ff 3
A n Dist. Pipe
Holding - — - Bot. System
PUMP /SIPHON INFORMATION Final Grade 7 $ 9 ?
Manufacturer Demand St Cover I 45
Model Number -~
TD Lift Friction Loss System Has J T 5H Ft
Forcemain" ength - Dt2. Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width / Length / No. Of Tre (� PIT DIMENSIONS No. Of Pits inside \ Liqui Depth IMA
DIMENSIONS �l� Z 1 roc
SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
+ (v7�ti.
Type Of System: (} '7 6 q ' ' �{ UNIT Model Number:
Co,�u2 � 4 7 ?7 1 Z
DISTRIBUTION SYSTEM
Header /Manifold / Distribution x Hole Size x Hole Spacing Vent to Air ntake .
/ Pipe(s) i/e w + ^
Length s Dia Length \ Dia Spacing �'� 3�
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed /Trench Center 2 Bed/french Edges ` Topsoil \
J t Yes E No � � Yes (�] No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2:
Location: 805 McCutcheon Road Hudson, WI 54016 (SW 1/4 NW 1/4 13 T29N R19W) Bluebird Meadows Lot 2 Parcel No: 13.29.19.
1.) Alt BM Description = PC.�'
2.) Bldg sewer length = ,`7 -7
- amount of cover =
Plan revision Required?
[ Yes XNO i �77
Use other side for additional information.
Date Insepct s Sign ure Cert. No.
SBD -6710 (R.3/97)
r
Safety and Buildings Division Count
m 201 W. Washingto 162
,scOi��ii� Madison, W 3 Sanitary Permit umber (to be filled in by Co.)
(608) 5� D
Department of Commerce 32-3
Sanitary Permit Applicatio E � = v tale I.D.Numbler q
In accord with Comm 83.21, Wis. Adm. Code, personal information 3u provide r" / _
may be used for secondary purposes Privacy Law, s1 5.04(i m) Project ddress (if efferent than mailing address)
I. Application Information - Please Print All Information k /,
Property Owner's Name _ r Parcel Block #
operty Owner's Mailing Address ftpeity Location
City, S Zip Code Phone Number
Sl� %., �Y., Section
(circle )
(� T Q N; R ci or
II. Type of Building (check all that apply) d
J6-1 Subdivision Name E£M- Nmft
� 1
,�rl or 2 Family Dwelling - Number of Bedrooms � J
❑ Public /Commercial -Describe Use /+ h —
❑ State Owned - Describe Use 4 6?5)- cat- S ❑City ❑Vil a U�Tewns ip of
III. Type of Permit: (Check only one boa online A. Complete line B if applicable)
A.
New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System
B, List Previous Permit Number and Date Issued
❑ Permit Renewal ❑Permit Revision El Change of El Permit Transfer to New
Before Expiration Plumber Owner
IV. Type of POWTS System: Check all that a
% Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑
Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑
Recirculating Synthetic Media Filter 14 Leaching Ch ❑ Drip Line ❑ Grave - ess Pipe El Other (explain)
V. Dispersal/Treatment Area Information: �' '
Design Flow (gpd) Design Soil Application RateftW Dispersal Area Required (sf) Dispersal roposed (sf) System Elevation
7/ `? !� /
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Holding Tank
Aerobic Treatment Unit f
Dosing Chamber "
VII. Resp nsibility Statement- I, the undersjgned, as,0me responsibility for installation of the POWTS shown on the attached plans.
Plum er' a Prin Plum is Sierra MP/MPRS Number Business Phone Number
- Phh ber's Address (Street, City, S , Zip Code
VIII. oun /De artment Use Onl
Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater D Issued I ing Age t Si ature o Ps)
Surcharge Fee) ,� D�
El Owner Given Reason for Denial 00
IN onditiona,of Approvons for Disa�prova�l ,, �� /,, `J " � � ' (�l lam✓
A ^ �, �� � � GO dZ•ti
eptic tank, effluent filter and rryy/ �3 -, % v q 1
dispersal cell must all be serviced / maintained tN Pt YL� y'�" L
as per management plan provided by plumber.
2 A
� setback requirements must e" main
as per applicable code /ordinances
Attach complete lane to the County on for the m r
Pk P ( tY only) a syate on paper not legs than 81/2 z 11 inches in size
SBD -6398 (R. 01/03)
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ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer 6,_�7�Q
Mailing Address C. l c
Property Address &
(Verification required from Planning Department for new constructioro
City /State �- ;�,, Parcel Identification Number 0�
LEGAL DESCRIPTION
Property Location 6 W V4 , tit b) V4 , Sec. L : , T Z J N R ) I W, Town of
Subdivision a L A ► r 1. C � to 3 , o/ e %{ � � ¢ �,) , Lot # .
Certified Survey Map # , Volume , Page #
Warranty Deed # 72o. a 3 6,v, , Volume )6 L/ / , Page # 3 9 c l
Spec housd yes o Lot lines identifiabl yes no
SYSTEM MAINTENANCE
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 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 § Comm 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County 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 Commerce 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 Zoning
Department within 3 days of the three year expiration date.
.01 0 5
SI NATURE OF APPLICANT DATE
OWNER CERTIFICATION
I/we certify that al statements on this form are true to the best of my /our knowledge. I/we am/are the owner(s) of the
pro cribed a ove y virtue of a warranty deed recorded in Register of Deeds Office
Z / zi oS
A OF APPMrMqT DATE
Any information that is misrepresented 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 and a copy of the certified survey map if
reference is made in the warranty deed.
I
POWTS OWNER'S MANUAL & MANAGEMENT PLAN,.; Page - of
FILE INFORMA ION SYSTEM SPECIFICATIONS }
Owner Septic Tank Capacity : al ❑ N/� L
1-4 Permit # I Septic Tank Manufacturer t ❑ Ni, {
DESIGN PARAMETERS
Effluent Filter Manufacturer ❑ NF,
Number of Bedrooms ❑ NA Effluent Filter Model _ ❑ NA
Number of Public Facility Units (� NA Pump Tank Capacity al NH
Estimated flow (average) Pump Tank Manufacturer Nil {
gal/day
Design flow (peak), (Estimated x 1.5) al /d Pump Manufacturer ANA
Soil Application Rate s Pump Model
al /da /ft
Standard Influent /Effluent Quality Monthly average" Pretreatment Unit
Fats, Oil & Grease (FOG) 53 mmg/C -- ❑ Sand /Gravel Filter ❑Peat Filter
Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration [3 Wetland
TS 5
150 m IL ❑ Disinfection ❑ Other:
Total Suspended Solids ( Si g 1
Pretreated Effluent Quality Monthly average Dispersal Cell(s)
❑ N!
Biochemical Oxygen Demand (BOD 530 mg /L In- Ground (gr avity) ❑ In- Ground (pressurized)
Total Suspended Solids (TSS) S30 mg /L XNA ❑ At -Grade ❑ Mound
Fecal Coliform (geometric mean) 5 ° cfu! 01111 ❑ Drip -Line ❑ Other;
Maximum Effluent Particle Size Y in dia. ❑ NA Other; ❑ Nf+
Other. ❑ NA Other: [3 NA
*values typical for domestic wastewater and septic tank effluent.
Other: ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
❑ month(a) ' (Maximum 3 years) ❑ NA
Inspect condition of tank(s) At least once every: earls) „
e and scum equals one -third JY8) of tank volume ❑ NA
Pump out contents of tank(s) When combined sludge q _
❑ month(s) um 3 ears) ❑ NA
� dispersal cell At least once every: � earls
(Maxim y
Inspect disper 1 (s 1 Y )
months) 13 Ni i
every: Clean effluent filter AS 4-�� st once ry � year(s) _(
❑ month(s)Nf "
Inspect pump., pump controls & alarm At least once every: ❑ ear(s) __'
❑ month(s). Z Nh
Flush laterals and pressure test At least once every: p year(s)
Other: ❑ month(s) ❑ NA
At least once every: ❑ year(s)
Other; ❑ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surfacr,.
The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires thu
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one -third (Y3) or more of the tank volume, the entire
and disposed of in accordance with chap
O perator ter NR 113, _
contents of the tank shall be removed by a Septage Servicing P ,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer,
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
GMW 14101
Page 4 of
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or, other chemicals
that may impede the treatment process and /or damage the dispersal collie). If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(*) in one large dose, overloading the collie) and may result in�ths backup or surface discharge of
effluent. To avoid tMe situation have the contents of the pump tank removed by a Septage Servicing Operator priouto restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually - operating the pump' controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at -grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides ;; scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings fealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septago Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
, �d__ , A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be Infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new sojl and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in affect at that time.
0 A suitable replacement area is not available due to setback and /or soil limitations, barring advances in POWTS
technology a holdi tank may be installed as a last resort to replace the failed POWTS.--.1- -° 9....r
D T e haq n be evaluated t ntify a suitabl rep cement are Upon failu of he POWTS a it and site
a ion u be pe formed to ocate suitable placem nt area.. no eplac ant area availa a e ing tank
may b inst ed as a la res to replace he f ' d POWTS.
0 Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
< < WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES DEATH MAY RESULT, RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER rt�reso:3
Name Name
t
Phone —_ Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name '
Phone Phone "it
"his document was drafted In compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.640), (2) & (3) Wisconsin Administrative Code
E
v SOIL EVALUATION REPORT 1482
Wisconsin Department of Commerce Page 1 of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel's Soil Service, Inc.
Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must County St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.
Pending
Please print all information. vi B Date
Personal infonnalion you prov' be usedw mmdarypur es (Privacy Law, s. 15.04 (1) (m)).
�14N •) �
Property Owner sF <` Property Location
LaCasse Development, In` . r Govt. Lot na SW 1/4 NW 19 S 13 T 29 NR 19 W
Property Owners Mailing Addr ss a q Lot # Block # Subd. Name or CSM#
p . ii 4
573 Cty Rd "A" U 2 na Bluebird Meadow
City State ,dipcidg, l?h9►1 Number City Village Town Nearest Road
Hudson ° T� ' FVfS -381 05 Hudson McCutcheon Rd
16 New Construction Use: jM Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
I Replacement I Public or commercial - Describe:
Parent material Sream terraces and pitted outwash plains Flood plain elevation, if applicable na
General comments
and recommendations: Conventional system, system elevation 93.40ft. Trenches spa d na and depth to code 4.50ft below grade. '
Q
Boring # J Boring t
0 Pit Ground Surface elev. 97.90 ft. Depth to limiting factor 100 in. Sol Application Rate
Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDKF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 - 10 10yr3/1 none sil 2msbk mfr cs 1f .6 .8
2 10 -25 10yr4/4 none sicl 2msbk mfr cs na .4 .6
3 25-46 7.5yr4/4 none sl 2msbk mfr cs na .6 1.0
4 46-74 7.5yr4/4 none ms osg ml cs na .7 1.6
5 74 -100 7.5yr4/6 none cos osg ml na na .7 1.6
q3. cAn
2 Boring # I Boring
❑ 1/ Pit Ground Surface elev. 97.90 ft. Depth to limiting factor 100 in. Soil Application Rate
p 9 ��
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -16 10yr3/1 none sil 2msbk mfr cs 1f .6 .8
2 16 -29 10yr4/4 none sicl 2msbk mfr cs na .4 .6
3 2 -86 7.5yr4/4 none ms osg ml cs na .7 1.6
4 86 -100 7.5yr4/6 none cos osg ml na na .7 1.6
o
* Effluent #1 = BOD? 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD S30 mg /L and TSS < mg /L
CST Name (Please Print) Signatur : CST Number
248956
David J. Steel
Address Steel's Soil Service, Date Evaluation Conducted Telephone Number
994 200th St., Baldwin, WI 54002 8/20/2004 715 - 684 -5680
4
Property Owner LaCasse Development, Inc. Parcel ID # Pending Page 2 of 3
a Boring # Boring
Pit Ground Surface elev. 94.50 ft. Depth to limiting factor 100 in. Sol Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -15 10yr3/1 none sil 2msbk mfr cs 1f .6 .8
2 15 -24 10yr4/4 none sicl 2msbk mfr cs na .4 .6
3 24 -77 7.5yr4/4 none ms osg ml gw na .7 1.6
4 77 -100 7.5yr4/6 none cos osg ml na na .7 1.6
F-1 Boring # I Boring
_J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
F-1 Boring # - I Boring
J Pit Ground Surface elev. ft. Depth to limiting factor in. Sol Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
* Effluent #1 = BOD 5 > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD <30 mg /L 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.
Page 3 of 3
STEEL'S SOIL SERVICE INC.
David J. Steel 994 200' St.
CST - POWTSM LaCasse Development Inc. Baldwin, WI 54002
Lic. #248956 SW1 /4,NW1/4,S13,T29N,R19W Bus.(715) 684 -5680
Town of Hudson, St. Croix Co. Fax.(715) 684 -3449
Bluebird Meadow, Lot 2
This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your
use. The location of this test may or may not be as shown, as permanent lot lines were not established at
the time the soil test was conducted. Legend
p op 1 „ =40' Benchmark Ele. 100.0OFt
of 3/4” pvc pipe !
Q • Alt Benchmark Ele. 100.40Ft i
— To of 3/4" vc pipe
�-
P P PP
❑ = Borings
Boring Elevations
B 1 = 97.90Ft
B2 = 97.90Ft
� �7 �r B4 = oo.00Ft
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STATE BAR OF WISCONSIN FORM 1 -2000 -
KATHLEEN H. NALSH
WARRANTY DEED REGISTER OF DEEDS
Document Number ST. CROIX Co., WI
This Deed, made between Ronald G. Raymond, Loretta B. RECEIVED FOR RECORD
Raymond, husband and wife
08120/2004 11:55AK
Grantor, WARRANTY DEED
and LaCasse pevelopment, Inc , a Wisconsin EXEMPT #
coEporation
RfiC FEE: 11.08
TRANS FEE: 2250.00
Grantee. COPY FEE:
Grantor, for a valuable consideration, conveys to Grantee the following _ CC FEE-.
PAGES: 1
described real estate in St. Croix County, State of
Wisconsin (the "Property") (if more space is needed, please attach addendum):
Southwest 1/4 of Northwest 1/4 of Section 13,
Township 29 North, Range 19 West, St. Croix County,
WZ Recording Area
Name and Retu -n
3 C ;y! Ro
Hu 02.7 41 5 4 016
020- 1017 -30 -000
Parcel Identification Number (PIN)
Together with all appurtenant rights, title and interests. This not homestead property.
(is) (is not)
Grantor wan that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except
encumbrances of record
Dated this
* Ronald G. oretta B. Raym
*
ACKNOWLEDGMENT
;YF WISCONSIN )
Signature(s) "y�� c ) ss
V County.
authenticated this _ sonaliy came before me this day of
Aueust 2004 the above named
G. Raymond and
TITLE: MEMBER STA a • Raymond
If not, n an wi f
( to wn to be e tn who executed
authorized by §706. th o wledged the same.
THIS INSTRUM _..nrTED BY P01 Xs:z,
Redmon Law Chartered (Richard Lau) Notary Public, State of Wisconsin
2217 vine St., Suite 204, Rudson, WI My Comrnission is ermaneut. (If not, state expiration date:
Si natures ma be authenticated or acknowledged. Both are not neces
*Names of persons signing in any capacity must be typed or printed below their signature.
WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1-2000
Redmon Law 2217 Vine St Ste 204, Hudson WI 54016 -5864
Phone: (715) 3 86-0 100 Fax: (715),386 -0700 Redmon Law Chartered T4926305.ZFX
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