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HomeMy WebLinkAbout020-1376-41-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division INSPECTION REPORT i • GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may tie uses for seconaary purposes trnvacy yaw, s.ia.u4 ti~tm/i. Permit Holder's Name: ^ City ^ Villa a Town of: -resel. Dennis Hudqson Township ANK INFORMATION TYPE MANUFACTURER CAPACITY Septic p Dosing ~ ~-L~ Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Airlntake ROAD Septic S 3D ~ 3 ~ -. NA Dosing ~~ ~ ~ 2 ~ I ^~ ZZ ~ NA Aeration NA Holding J `k'~ PUMP /SIPHON INFORMATION Manufacturer a~'' Demand Model Number $~ GPM TDH Lift Lriction System TDH Ft Forcemain Length N~f Dia. z '/ Dist. To Well e•~u ~ ef[•AOnT~Aw~ CV~TtwA /. _ 1 _ 11 A Count Sit. Croix sanit3r~3991 No.: State Plan ID No.: _._~ Parcel Tax No.: 020-1376-41-000 STATION BS HI FS ELEV. Benchmar Z , (~ o3sS~ ~8 . Alt. BM Bldg. Sewer St/Ht Inlet q•(o0 X3.95/ St/ Ht Outlet It)' ~ 3•SS"r Dt Inlet Ic'fl3 cj3.s'LI Dt Bottom 13'(O~ ~j.~,S/ Header /Man. ~~~ ~~ • S~" 1 6+st-~+Pe s`e Bot. System Final Grade ~ ~ 5.~~, 3'~'° °~, •~ / over ~`t'C` ~' I O ~' ' `f 5 th li id De TR Width Lengthy Trenches PIT o.Of Pits qu p Inside Dia. 1 3 r ie2r rr~~ 3 DI EN I N SYSTEM TO P / L BLDG WELL LAKE /STREAM LEACHING Man adurer. ~Qt;,~ c SETBACK CHAMBER er: N M INFORMATION Type O ,O~ Z Sr -- OR UNIT um o a System: (~,cJ• r~~e•Tn~nr ~TtAQ1 ~V~TC11A V ~.i ~ ^~wv ..v.. r ..... Header / Ma i old ~ h ~ Dia .... Distribution Pipe(s) Len th x Hole Size x Hole Spacing Vent To Air Intake . Lengt g All ~•A\/CQ .. Drnee.~rn Cvctame Only YX Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ^ Yes ^ No ^ Yes ^ No ncnnr• inn A nCr]P_ Ct1An 2: ~- ~ COMMENTS: (Include code discrepancies, persons present, et-: " - - - Location: 956 Florence Lane, Hudson, WI 54016 (SW 1/4 NW 1/414 T29N R19W) -1429192302 Sweet Grass Farm -Lot 41 '>~•PS~S S~ 1.) Alt BM Description = 2.) Bldg sewer length = 13 r to •q1 •3a~ -'- S 2S -amount of cover = ~ ~2 `~• 96•S6 ~ ~ ~, (a g-~ -~ `IS: 20 Plan revision required? ~~~'Ye~i ^ No Use other side for addition ~ orm ion L Date SBD-6790 (R.3J97) ~N~"„~ _ 76~~1 ~bJ ~, l~ 8•SZ 9s ~3' Inspector's Signature Cert. No. -~1i ~ ~ ~ A Cl _:.:: . ~,$70 ~I~OQ,E~U L.~4nIF, -• Safety & Buildings Division ~ Sanitary Permit Application 201 W. Washington Ave. ` ~ /Bat'iOl ~Si~/1 In accord with Comm 83.21, Wis. Adm. Code Po Box 7302 Madison WI 53707-7302 oepartment of eomm®rce Personal information you provide tray be used for secondary purposes , (Submit completed form to county if not [Privacy Law, s. 15.04(1)(m)] state owned. Attach co lete tans to the coun co onl for the s rem, on a et not less than 8-1/2 x 11 inches in size. County' ~ Stau S~upi Pertn~ Number D Check if revision to previous application State Plan L D. Number I. A lication information -Please Print all Information Location: Property Owner Name ~...` 1 r' 3 112 , ~ property Location Q . ~ 17 N JJ Q ,~ 1/4 ~~l/4 S ~ /,N R,9E or W Property Owner's Mailing Address t ~ ,~ ~ • fi~ ' ~ ~ Liit ber Block Number $ 1~~c Nei vr~'~ ~i ~ N ~ ' IVEO EC N E , City, State . Zip Code Phone N m er< Subdrvisi n Name or CSM Number l WN IVew ~~~~ M ~,~ ~,P ~ ', ~~ 15 ~ G z sf r a ~ II Type of Building: (check one) •~-s der s S ~,~ 1 or 2 Family Dwellin ~e.1S - No 1'Lo~ of Bedrooms:~ ^ C"'~ D j a g , - ,_ . ~~OFFIC ~` f , ^ Public/Commercial (describe use): ' o ' l i3 State-owned .,~ ~: ` w ~ W 1~t pfON III Type of Permit: (Check only one box on line A. Check box on line B if apph g Barest Road ~f~ KQNC~ N~ A} 1. t4 New System 2. ^ Replacement 3. ^ Replacement of 4., ^ Addition to Parcel Tax Number(s) S tem Tank Onl Existin S stem J ' - -pr•,~p B} {] A Sanit Permit was reviousl issued Permit Number Date I~ue1J, / ~ ~~ ~~ IV. Type of POWT System: (Check all that apply) -1hE' - (t1'D [21;Non-pressurized In-ground ^ Mound ^ Sand Filter ^ Constructed Wetland O Pressurized In-ground ^ Holding Tank ^ Single Pass ^ Drip Line D At-grade ~ ~ ~~` ~ ~ , ~S ^ Aerobic Treatment Unit ^ Recirculating ^ Other: V Dis ersal/Treatment Area Information: 1. Design Flow (gpd) 2. DispentalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. ystem Elevation 7. Final Grade ~n V~ ~ ~ ReL{q~^ulired ~...J U ~ Proposed ~ I ~ ~ ~ ~ Rate (Gals./day/sq. R.) ~ 9 ~ (Min.linch) e /`7~t ~C) I v ~ ~ ~ 6k9va9ion I / VI Tank Capacity in Total t# of Manufacturer Prefab Site Steel Fiber- Plastic " Information Gallons Gallons Tanks Con- Con- glass New Existing Crete structed Tanks Tanks ^ ^ ^ ^ ^ VII Responsibility Statement I the undersi ed assume res onsibili for installation of the POWTS shown on the attached tans. ee I1 7a' S ' (o b-Q ~ 1 ,Plumber's Name {print) Plumber's ~4rto stamPsl: „° MP/MPRS No. Business RhoseNluttYex ', M ~, ~;,.~ • ~~ v ~~a ~ all ~ 1 s -~ ~c~- 9 a~ a plumbsr's Address (Street, City, State, Zip C ) '\ A VIII County/Department Use Only ~ A rov d ^ Disapproved O O Gi i I i l Sanitary Permit Aee (includes Groundwater Sur ar e Fee) Date Issued Iss ing Agent Signature (No stamps) , pp e wner ven n t a Adverse g ~ r Determination ~{ IX. Conditio s of Approval /Rea o4s for Disalfprov e ` S CJ~.A+~ I `~``~ ~ ~ t 5 ~ `~~ "E ~n+~.~ ` ~ ~ ~ , . ~~ ~~. c~. a,,, w~.eu`t/1~u.i -~ P.e„ tnnaw~. ~t,~ J'e. c.~-~. w~.Q..t~t~.~~''~ . ''//' _ , V ___.._____._. _._._._____ ~L~.C~..~.~.~! _. _-_5.~ e~~ ps. S . _ _._.._.__ ~ ~ 1 ,, °P °~ ~ ~P~ ~~ ~~~ ~-~cv = lu~.o RPuc~ mp~K ._ sv 3 ~ (..~. Spo t~ T ___._ Qs A I ~- p~„~ Bv~,c~ ~ n~~# ~o~ off- ~~~ Py ~ ~i lA fib, ~ ~,~~ (~.,Q \~ Irv- 9g y~~ ~f ~..~ U~kL ~ J / GC ~ Lv l 1 lU. G l J _.~ 1u~a~.~ .._. _ ____ __._ .__--_.-- _ , .~ ~~-y - ~ I _ ~~ fl-lu u F'_ l ~'~er~ ~a o ,~ fcP~,~ __ s , .1J 1`j ~ / ~~1 ~ t _ /'/ ~ a~ _5 ~~ ~ e cc1 r nr.~l ~ rs __ V J pN ~ ~ ~^N i S _.~.R-~s~- ._._..1.~i~/Vll~ ../r"m. ~ou /.r~~..e.~ ~e~'' .. .. ~._ ... [ _ CJ rra ~~(~L~ 5 ~.1 ~ \ I ~~1-~ ! _ _ _ ___--____ .i.w.i ~ Anse ~" .~~_y.U__~- .__----------- Roue rvlp,eK ;~ 33 ~:~ so ~~ .~ -~, --- as' A I ~- pa~~ ~ ~ . f~' ~~ B~,~ ~~ ~ Top off- ~n P~~ Ibfi~ ~„~,~ ~ ~~~ ~~i~~:9~.y~ fi-lu u F~ ~ /V ~a o .ISeP~~ O,, iv yS; aa` ~ y ~d~o~ ~d~ ' 1A'isctDepartment of Commerce SOIL AND SITE EVALUATION Divisior, of Safety and Buildings Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and S f , G percent slope, scale or dimensions, north arrow, and location and distance to nearest road. parcel I.D. # APPLICANT INFORMATION -Please pri ~ll.i~pfbrh~atip~., Personal information you provide may be used for sec ~ ~u ses (Privacy Law, §.:'4564 (1) (m)}. Property Owner (~ ~, . ~ ~` ~~ ~ - „-- ~ ~ . "'- r .party Location ~~.1~ C~ ~ ~ ~ ~Gc~. Lot S G.S by Page ~ of \~ Date i/4,U~ 1/4,S j r~ T Z ~ ,N,R ~~ E (or)~U Property Owner's Mailing Address -° ` ~. R~ ~ _ ~'~e tr. , ~ _ Loi ~ Block# Subd. Name or CSM# S ee ~- C~rc~ City State Zip Code °,` ,Phone Nurpt~er _ [~i City ^ Village (~ Town Nearest Road ~-}udSaY~ 1 i 10 .' .c ~JS- 3. ; ;'~ - J vr~ ~~ ~ ~F~a~~e-.l-cam- l~ r [New Construction Use: [Residential / fJuifib~nLbed-o6ms~ 3 - ~ Addition to existing building ^ Public or commercial -Describe: ^ Replacement / ~~\\ ~7 p Code derived daily flow ~V6 gpd Recommended design loading rate / bed, gpd/fl2 ~ b trench, gpd/ft2 trench, ft 2 Absorption area required ~_bed, ft2~ Maximum design loading rate bed, gpd/ft2 ~ g trench, gpd/ft2 Ci Recommended infiltration surface elevation(s) 1 S 2 3 ft (as referred to site plan benchmark) Additional design/site considerations a s~ ~ 3 Parent material U c..~-~-y-~ ~- ~ ~ Flood plain elevation, if applicable /li ~"-~ ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank ^ S ~ U U = Unsuitable for system [`~ S ^ U ~ S ^ U ®S ^ U [~ S ^ U ^ S ®U rryn1 cnu nFCr_RtPTInN REPORT IIPLJ l n.~ o Guer.Qr.!o 1 ~ ~ , Zljoo : E Boring # Ground elev. .ZSft. Depth to limiting factor 1 ! 1o in. Boring # Z Ground elev. 9Q. 73 ft. Depth to limiting factor I 1 `t(in Horizon Depth Dominant Color Mottles Structure B d R t GPD/ft2 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence oun ary oo s Bed ,Trench -t lL~ 3 L ~ S l mczb~ c ~~-~ • Z'. 3 2 ~ 3-~z 1 ~ ~ 3 ----- ' 1 Z ~. '~ ~ s -- . S ; - ~ Remarks: Z •s-y~ ( Iz_ 1 r 3 -~I -.----- 5 ~~ 1 c ~ - _ ~ ~ - c~ ~ ~ 9S.23 ' O Remarks: mss.... . ----------- ;ST Name (Please Print) S' ature Telephone No. Address ~ ~ ~ ~ (,~J ~ .~~U~ y-D~/ d' C~ ZS~ 3O~ 2/ l 3 ~ 5 ~o vv..A.r PROPERTY OWNER S ~~ ~'" SOIL DESCRIPTION REPORT PARCEL I.D.# Boring # Ground elev. att. Depth to limiting factor ~" in. Boring # y Ground lev. ~~tt. Depth to limiting factor min. Boring # 5 Ground elev. °19. /3 tt. Depth to limiting factor I I~in. Boring # Ground elev. ft. Depth to limiting factor ,~,. Page Z of Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed .Trench i b-~ ld r ~ S1 ~ ~5 Ivy ~z~-3 Z w- ~ ~i l3 Z ~- ~m.~. ~ ^ S , 51. ~ • ~ Remarks: o--I ICS ~ ~ ~ I m~.b~- mfi~ ~ s I v~- . Z ; . 3 3 ~-r~ y ~ -- s s m ~ ~s ~- - -~ . , $ .3 Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots PD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench ~ -12 lp 2~ S; ~, c. v~ . Z ~ - 3 Z ~z- ____~ ~' t ~ 3 20-1.1y S ~ ~ ~- . ~ ; . ~ Remarks: m. Remarks: SBD-8330 (R.9/98) PAGE~OF~ NAME S-~c~-I- LOT# y~ LEGAL DESCRIPTION SG.1'/.,GG1/4 S/y TZy N R/9 E (o~GV~ ~CALE: I"= ~(~6 ABM 1 ELEVATION ~(~, C~ BM 1 DESCRIPTION p a.LgG~~ (}~~7,'~ nth tar~oJ -- BM 2 ELEVATION I O . y~ BM 2 DESCRIPTION-~on_~ ~~ p; P.e. Iu,i-h „~~(.{Q~ SYSTEM ELEVATION ~ S,Z, ALTERNATE ELEVATION LcS. CONTOUR ELEVATION /~,ja- - -~~ - X t I I i 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- 10567-P (R.6199). Table 1: System Design Specifications Sanitary Permit Number Number of Bedrooms Design Flow -Peak (gpd) UU Estimated Flow -Average (gpd) ~~ G'O Septic Tank Capacity (gal) ~ a (} Soil Absorption Component Size (ft2) O~ ' ~ Type of Wastewater Domestic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soil Absor tion Component Design Flow -Peak (gpd) ~ S z_ as ~ Maximum Influent Partic{e Size (in) 1/8 Maximum BODS (mg/L) 220 Maximum TSS (mg/L) 150 Tab le 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years 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 se k and outlet filter shall be assessed at least once every 3 years by inspection. Th outlet filter shall be cleaned as necessary to ensure prover operation. The filter cartridge shou not a removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the ~~ ~ i d~R~v~l~ ~~„~ 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 pertormed 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 enfering a confined space. The atmosphere within fhe 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 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 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. hu N S y S~-e r, ~n i ~ S ~-e lam: ~ ~ ~ ~ p ~ p C.~ A n, t~~ Qfi a ~~ 2f R to.e-~ ~,,,a.,~,e.~c. . Sfi . c K. o \~ zt.N I N~ 6r ~; ~~ ~ 011- y~~~ rni co;,ufiy Pu~,p~~,~ 3~(~'al~b 3 ~^ ~ APR 2^r '01 1117 FR HP RIDECARE '~2 883 7110 TQ 9i71S38679~8'3-92© P.01 r RLdr+ Jui Y'I.JLY ~ SEp'TXC "f A1~K MAY A DACE AGRP.EMENT p~rlrtERSHII' CER'~CA~i~AI FARM OwacrfBttyer ~ Ar iuSaili~o8 Address t~ Ptoptriy A 'papa eat [or tzew cottsM>ta~) {Yarif catiaa required iROm Flsnnin8 ~ , f 1 Farccl YdeNificarion N ~ C;q,/S~te ~ ~~scn~~ ~~~ , T~N-K.1~l+W= Iowa of ~l~D o~ pmparty Locadoa 5~ '/., l~JI,J l., Sea 1.!'..-~ .a . Subdsvieian ~~ ~ a )'~ ~, V'oltune " Voluzn~ ~ Fsge # w,~~ty Dena # Lot lines identifiable ~ yes ~ na Shoo lsat:se C7 yep D no ~opa~e and~>+~ ~C ~"~ t Sn its prrxnat~ fame to baiedle wastes. Draper msiaxeona. caosista aL p ~ ~° +aPba iaah ewx7 three yeas er sooner. if needed by a licensed ptympex. W hat yon put into the ttyt~ aAt ~et.'t the limctieoa a~£ the teptit quit as a t:eatmtrdr stags m ~ ~~ di~asal rysum. 'ilia property o~ a~ees to tubra~ eo ~. Qobc zoning Dep:etm~mt a ce+Ri6~catiam ibrm, sited by the owper ~ by i pitttober. jO~~~ytr> remitted pbmsbtlt o< a lioeneed atntaprr venfY~S ~t (1) rile o~ +~+es~ratvrdit;posal stem is in ti g eooditiaa andlar (2) niter tuapet~oa and p~8 (if aaceasary~ t1u aeplit qak is 'les6 tltotn t!3 ~ of ahidde. ~, rya ~i~goad bsve nad the above ~ and ewe ~ maintain the prirate srwage disposal system with ll+e st~dssd~ ~ . as eee by tLe Dapatmsa~ of Cas~+ar'ee cad ~ ~~ of Na(nral Itesouroes, 5bte of 1~Viscvasin. Choy tb~ ~ trYt-~ ~ bttea taait~in~ ~ eo,atpiaeod cad to ffie Sc. e~aitc Cooa-t}- zoning Ofliee within 30 at the thta*R year aspiratim datle. ~ DATE ~'c, TixICATiON Y {~) eft that aII ~ od this fixer ase trae m the best of mi+ (out) iGaoWipdge. 1 {we) em {art) fire awttet(s) of ~ ~p above, by a a wan:nty dead recorded im ltegista oC Deeds OtTioe, ~ I:iCAt~ DA'C'!3 •••••• Apy ~OSmatiaa that ;: tnisyr~ may r~dt in the saniiery perroi4 beivr+8 revoloeci by ~ ~i ~• •••••• •~ lareture ••i14~ thin appiicalieta: s slantped warranty decd from the ~egistar of Deeds a copy of fire certif+ed tur+-ay a+ap if xefereoaeis neade un die warranty deed APR 2? '01 1i~14 71'53667989 PAGE.02 ** TOTAL PAC£.01 ** ~~;, STATE BAR OF WISCONSIN FORM 2 - 1998 ~ WARRANT/yTY DtE~rED Document Number ~~ ~I- j,J~ 1 Ch'~~ (~~0 This Deed, made between _,_,,_ _ RICHAR^ n_ STn[TT and .TANFT P $Tn_ i)T____.,_______,_ husband and wife, __ ----- ---- - _ _. -, Grantor. and DENN~-S-M--KIZ•ES~I an[I TFNNTFFR A KRFSFLt_ __ __husband and wife, ~_ ________ _______ ~. Grantee. Grantor, for a valuable consideration, conveys and warrants [o Grantee the following described real estate in St. CroiX _ County. State of Wisconsin: Lot 41, Plat of Sweet Grass Farm, Town of Hudson, St. Croix County, Wisconsin. 639903 Y,ATHLEEI~i H. WALSH kf.-'tiISTEk OF DEEDS S7. ~R!?IX CO. , WI RECEIVED FOR RECORD 0~-^6-c'001 30:~0 AN WARRANTY DEED ElFxPT k CEF.T COPY FEE: COPY FEE: TRANSFEk FEE: if6.70 REC9RDING FEE: 10.00 PAGES: 1 Name antl Return Ad ress ti~t~,~. ~ aw7~~ ~{4~ S . lit (-~-~-s gyn. ~ t.~ x(01, ~ `fi't ~- 3ro'7~t~ 020-1376-41-000 Parcel Identification Number (PIN) This i c nntiomestead property (is) ((s not) Exceptions to warrancles: easements, restrictions, right:s-of-way and covenants of record. Dated this 93,rd day of Fahruar~ ?001 t`-~e V.D-~G ~• ~ _ (SEAL) Richard O. Stout AUTHENTICATION Signature(s) authenticated this day of , TITLE: MEMBER STATE BAR OF WISCONSIN (If not. authorized by §706.06, Wis. Stats.) (SEAL) THIS INSTRUMENT WAS DRAFTED BY Janet P. Stout 1353 Awatukee Tr. Hudson, WI 54016 (Signatures may be authenticated or acknowledged. Both are not necessary.) ~ti~_ ~~. -A'`"t_ (SEAL) Janet P. Stout ACKNOWLEDGMENT (SEAL) State of Wisconsin, ss. St. Croix -Cotmty. Personally came before me this _ 23rd _ day of February 2 QO j ,the above named _ Richar3 O. Stout and Janet ~, - Stout ,~~ _ __ W me known to 6e f ed the foregoing Insuvmen d ackn e~~e . Notar Public, Stare of Wisconsin My commissigq is p~rmanent. (If not, state expiralior},rda[c: ~- o ~ --_. . ~O~_..) ' Names of persons signing in any capaciry must be typed or printed below their signature. STATE BAR OF WISCONSIN Wisconsin t.e9a1 Blank Co.. me WARRANTY DEED FORM No. 2 - 1998 nnawaukae. Wis. ~~ ~ iG~ X10 P i~ ~~ ~~ I I I I ~ I I I la 0 I I (~ IO~ ~~ 1~ ~~] to 2 N ~,. a N m W ~ V ~ O . ~ W1/4 CORNE SECTION 14 ~° i~ 1~ ~~ 4,Z1.~ _._._. ~ LOT 40 ~ i Z.1 S ACRES N 9871 a SG F r ~ s~4o so Fr - ~ - - -~ 1111 ~: MIN BUILDING ( ELEV. =951.0 I . I I I N65'Od•E 4e5. m I ~ . I I ~I N.W.L. = 95b.0 i i~ ~ I . MIN BUILDING I ~ I ELEV. =951.0 LOT 42 ~ ~, Cu 2.17 ACRES ~ 94497 SO FT ~ ~ ~ 4; ~ ~~ v • • ` w tl, . • }U w ~ . a ~r ~ / w ~' .• ^ ~ 2 ~ LOT 41 ~ ~ ! ~ Cz5 • 2.os ACRES . ev94a so ~r . • r • - +-== ~. i a I ~° 88d°a3'1S'E 423,7d' s.oa e BENCHMARK TOP OF ALUMINUM CAP ELEVATION = 911.01' USGS 1929 DATUM _ . - I r1T nn m I ~I $I I .~+ I 1-•~" ~ I ~I . I n c~ p ! ~ v n o d ~ f c d o ',, a K ~ ~ ~ ~ m C .O .~ 3 ~ - ~' ~ 3 ~ _ `•~ ~ ~ ~ c ' ~ ' i ~ ~ Cn "" T. T. ~ ° ~ ~ I c A ~ `< ! 1 m > > m ~ cu ~ ', o co -~ ~ ! N~ „, Q' Q O O N O ~ N~ W O~ ~ C C n 7 ~ O p ~ A~ o ~ ~ ~ N O II ~ / m N C c ii d1 ' ~ O •~ ~ ~ d ~ TI 1 ~_ p (D O 3 ' ~ O ~ ~ ~ r 7 / rz o N N o o li s p 1 ~• ~ a N .. ~ ~ t a o ~ 1 ~ ~ 'C ~ ? it M 1 . ~ 1 I W 'p ~ C ~ C ,,' A (n ~~yy V i c ~~ N N N ~ '! _' ~ ~ O• ~ O O o ! ! co 1 m ~ = ~ N ~ N 1 3 ~ ~ n, T v i .. ~ c °A o Z ~ Z ~ O '~ CA 7 ~ ^ N v -% O O 1 N ~ Q1 ~ w ~ Q ~ O ' -' ~ ~ryy~ j fD ~- ~. c ~ m V I 2 ' ~ -~'o n O A Z ~ O ~ Ivi ~ ~ ~ N a ~ a :P Z~ N ~• O ~ ~ ~ ~ N C77 ~ `'' W -~ ` ° A ~ ' Z ~ 3 ~ a 0 3 .~ a ~ r: ~ 5` x ~? Z ~ O ~ A A '~ 1 D. _. ~ ti ~ 2 a : ~ ~~ ~ ~ n (~ O N O ~ O ~~ w o ~ o a ~ ~~o ~ `~ ~ w ~ (D - (n O N ' y SO m d,O 47 ~ (D ~ y ti i 7 ~ O ~ ~ i 4 d f/i W - v N (•) y ~ ? ~ ~ ~ •< 7 7 ! ^S C N ~ ~_ ' . O N O Ii t ? ~ ~ ~ O v O ~_ n p c N ~ ~ N O. (D O _ ~ N (D ~ ^. -'. o „ti ~' m tic a En O "~ ~ w ~. ~ 'i ~ ` a o o ~ ~- ; ~ ,», ..,