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Home My WebLink About020-1376-52-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Buildings Division INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: 383996 Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: ❑ City []Village Town of: State Plan ID No.: arombek, Paul Wam nwid ownshi CST BM Elev.:- Insp. BM Elev.: BM Description: Tax No.: I 9 9 if 020 - 1376 -52 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic S 6 on Benchmark Z Ib3, `( 9 ? D Alt. BM Z. r� (� Aeratio Bldg. Sewer S 9 U —, Y( S, Y I q 7 S olding A/ Ht Inlet -5. 0 q /7. Z TANK SETBACK INFORMATION Ot Ht Outlet G, ZQ 9` TANKTO P/L WELL BLDG. Vent to ROAD Air Intake > / Septic � ) NA NA Header / Man. S 3 Y 9!5. e o ff N Dist. Pipe Bot.System r �Z fy. y PUMP/ SIPHON INFORMATION Final Grade urer Demand over 2 /d . Z Model Numb PM T Lift Friction tem TDH Loss Forcemain I Length Dia. Dist. To SOIL ABSORPTION SYSTEM /( s inside Dia. Liquid Depth Len �I! No. Of Trenches PIT No. Of Pits s 4 BED /TRENCH width 3 Le �o S Z [ D IMENSION S D Manu ur r• SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM r INFORMATION Type O 3 / 3 e! �� CHA IT Mo a Num ( er. System: (� 7 DISTRIBUTION SYSTEM Header / Mani old }� Distribution Pipe(s) i x Hole Size x Hole Spacing Vent To Air Intake Length I Dia. 7 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 xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, et �gspection #1: 9 I la I G/ Inspection #2: / Location: 949 Florence Lane, Hudson, WI 54016 (NW 1/4 SW 1/4 14 T29N R19W) - 1429192313 Sweet Grass Farm -Lot 52 L(, I 4 1.) Alt BM Description 41h" --%> 2.) Bldg sewer length = -t 2(0' � V�uu �Q 0441 .�� 5c� y - amount of cover = > ZO � �A S � C f i �•) QbScrV (r:P.ss iwS�a.��CA %� �```�L��c� � e� � .� S o� . `� .� �• Plan revision required? []Yes ® No Use other side for additional inform / tion. ENV SBD -6710 (A.3197) Dati Inspector's Si ature Cert No. Yd� � r d ,` .., `, 1 �..� I p� �, L� �4 1� �, �z� 9 + ' 'rL-D u5 c- (A, ' Safety & Buildings Division Sanitary Permit Application 201 W. Washington Ave. In accord with Comm 83.21, Wis. Adm. Code PO Box 7302 Department of commerce Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 (Submit completed form to county if not [Privacy Law, s. 15.04 ( 1 )( m )] state owned. Attach com lete lane to the county co only) for the system on paper not less than 8 -1/2 x 1 I inches in size. County � i' State Sanitary Permit Number ❑ Check if revision to previous application State Plan 1. D. Number sT � 3Y I. Application Information - Please Print all Information Location: o y Owner Name Pr""p ""petty Lgc t* o op o S ` U l/4 W l /4, S T ,N W or rewwrt Owner's Mailing Address _ Lot Number Block Number Ci State Zi Code P P ,� Subdivision Name or CSM Number , -,_ II Type of Building: (check one) a ) ❑ ci ty R ty 1 or 2 Family Dwelling - No. of Bedrooms , i ��"�J z ❑Village • Public/Commercial (describe use): ~' tkTown of rA • State - owned f _ III Type of Permit: (Check only one box on line A. Check beet on line B W ca J Ne st Road A) I. ,New System 2. ❑ Replacement 3. ❑ Replacement t, TQ Additiol , ' to Parcel Tax Number(s) System Tank Only tin st 2 -+ --�• a7 " O O Q B) Permit Num 'r r .�'\ Date Issued ❑ A Sanitary Permit was previously issued � \ GI . a313 tV. Type of POWT System: (Check all that apply)` (0'0 Non- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized in- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade -S r x ��' t ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V Dis ersaVrreatment Area Information: er — I. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. Sys m .levation 7. ra e Required Proposed Rate(Gals. /day /sq. ft.) (Min. /inch) �� levation y50 3T' 3070 - ? V� -7 s,9 49.77 VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks SC �� ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ VII Responsibility Statement - I the undersigned assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (print) Plumber's Signatpro;(no stamps): MP/MPRS No. Business Phone Number umber's Address (Street, City, State, Zip Cod 10.716 �� d VIII County/Depa tment Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) fil Approved ❑ Owner Given Initial Adverse Sure a a Fee) Determination 2 1424 ZA'O IX. Conditions of Approval /Reasons for Disapproval:" -Ye s� tom.. � .. 5� A, J, �,,l L ( tQ i �i r I • • • • (D O N N 2 - 11 (- Q °4eepep ° °e e ° °�. S Q n n J++ x w fu rn m 1 N = N a <6 N c c t n c� Cn (� a - U (D Q � tD � `G ° " v' ' cn n a a O -« ¢j tD CD -0 O O p (n a m - co cQ x =' CD C - 3 -- N w � � � v pqv 1 PH Ul x (D cy O= C � Vvp "p99y9 a I ! 3 OL O w -' _ -- � CD _. o -� Li 6 lgw,,j cn Cb Cf c �u y , N 1 h� o� I nes +d ,ol -Au4Md dwoo A M /l//�/VIl- V, _ A- �t/ofiN' {R ds 3 i I gtN� rnanK� IU a IU a3 1 )k1 },w A>�p 3 k 6835 � • �r3 y Y fl'bl UPEQ 49.7 C a) X In _ A d a4 C _ 1. � °A 4 O E ca :_ X C7 LO V � ♦- co LU N � 0 0 > C CO F ca ate•-- Oisdond4l]lepartment of Commerce SOIL AND SITE EVALUATION 3 Divisio"f Safety and Buildings Page — J — of 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� • percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # APPLICANT INFORMATION - Please print all in aW. Reviewed by Date Personal information you provide may be used for secondary puryd` 4 (Prkraiy Law s., 15.04 (1) (m)). Property Owner , �r , Property Location ptchaod £' Govt. Cot S(,J 1 /4 NW 1 /4,S I y T Oct ,N,R /q E (or) Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 1353 7r City State Zip Code Phone NumbeF El city ❑ Village D Town Nearest Road NU�JUY> UL ts (-115 ) 5 4 q01 �;: 1t!v�sc�r� /��cnc,` lun ® New Constructi n Use: ® Residential / Nifrrlper of heprwotrts. ` `/ Addition to existing building ❑ Replacement ❑ Public or commercial = f3esc ' Code derived daily flow Q gpd Recommended design loading rate • 7 bed, gpd/ft trench, gpd/ft Absorption area required S? bed, ft 7 .S0 trench, ft Maximum design loading rate _ bed, gpd/ft g trench, gpdHt Recommended infiltration surf a be ft (as referred to site plan benchmark) Additional design /site co �f. t- Parent material U u S VN Flood plain elevation, if applicable lel� ft S = Suitable for system Conve 'onal Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ®S ®S ❑ U ® S ❑ U Os ❑ U ❑ S �d U ❑ S O U SOIL DESCRIPTION REP T Boris # Horizon Depth Dominant Color Mottles Structure GPD /ft g Textur Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench I ' LI t6 3 i %( ( k m C . 3 «t< Z 13 -`!3 Id ( yLL CZ (6 51 ( �l L _ S ' •�o 2 m Ground — C, s elev. 97 ft. Depth to limiting factor !!ln in. Remarks: . I fol-L fu(L 14 Le 4f 10.si_ /(.. o 7� Boring # Z 11 p -yo )0 r `i � C2 - Z. i I 2 rnb k 3 CO -1 rn d s _ 8 Ground elev ; Depth to limiting factor AO Remarks f" °� Rv� APPt, 4S &rr I + f �reZ CST Name (Please Print) Sig re Telephone No. Address Date CST Number z�i3 G 5/ o., -� f C✓� Sya�S' - �/ -vc� zs-.3 3n SOIL DESCRIPTION REPORT PROPERTY OWNER � � � Page PARCEL I.D.# Boring # Horizon Depth t Color Mottles Texture cture Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz , Trench I \X 2 3 Z 12 38 1 o Z .5 r I Z r k m -�" Ground 3 38-Ilc i Y 15 t "Y11 c S — 1 g elev. 9�ft. Depth to limiting factor I iy in. Boring # Remarks: I Favk LU_ a �QAI � <S - �Us� L o tk"Fr__ Z, Yi I `l�`I Ground elev. C 1a`� ft. Depth to M,+ 9 5.3 ' w�{ � / limiting 3 .4 S1 (e g7. factor m in. �• i Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # o -! l 0 311 5( l bk s l u z 3 Z i+I- O w C� S ; 9 r 3 ( -io9 D mS 05S m1 Ground ; elev. 9g Uft. Depth to limiting ; factor t 09 in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) Wisconsin Department of Commerce SOIL EVALUATION REPORT Page A of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County s . c ra (r Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location 9 0t ir A S v �-- Govt. Lot SW 1/4 IJW1 /4 S I L j T ZQ N R E( r) W Property Owner's Mail' n Address Lot # Block # Subd. Name or CSM# 19 - , � 73 e e Zwee -+G SS City State Zip Code Phone Number ity village own Nearest Road ✓ct�sov� W S5'o /(-- I (76 S W - G 73/ 1 //u d o pq I 1orenCA- IN New Construction Llse[3 Residential / Number of bedrooms 3 _ I Code derived design flow rate 5 S 0 GPD n Replacement r.1 Public or commercial - Describe: Parent material 6 V S ln, Flood Plain elevation if applicable �� ft• General comments S y s f-4m R /L v 1 75 - -77 and recommendations: Q S' 7 7 ❑ Boring # 0 Boring ' Ground surface elev. �9 97 ft. Depth to limiting factor in. 13 Pit Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 I - Eff#2 I a - o. �3/ I sr lln /c Wl.r -5 I✓ z /3 -3 V1 51 ( Z �dS� » � c S z •y3 ?o 0.n u5 tn� S k3�1 m5 . `7 Z 9 7 Z Boring # n Boring pit Ground surface elev. 9? Y7 ft. Depth to limiting factor 0 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 d -(Z /b Y r3/{ — S,'( (vita blC -� ✓" S ( - Z Z lZ- $ l aYi Y/V — S(' f 2 ab e Wt C 1 3y - o v ,- Y/y C Sr I Z abt w�l- 9 S', r a,+ 1 K• �' ►�t� 3. "I . G s ` 1. o L� -- ' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Nam (Please Print) Signature CST Number N•t c, i -.,- Address Date Evaluation Conducted Telephone Number Property Owner " S ] L- T Parcel ID # Page Z of Boring #+ Boring a O pit Ground surface elev. � 3� ft. Depth to limiting factor / _ in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 G` IZ 16vrAlt — S,� Ipn c+b t 6.5 1 U� ' Z /Z -.3Z icy r / S:l Zmub /C nX--r' C5 — `'� D 's rti i , -7 Z R] Boring # Boring Pit Ground surface elev. — ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F-1 rl Pit Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 Effluent #1 = BOD. > 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. S130- 8330Test (R.07 /00) PAGEaOF__?:� NAME, LOT# 7 LEGAL DESCRIPTION S W `/4 Nw' /o,S I g T Z q N,R 1-1 E (or)( d SCALE: I t BM I ELEVATION ((� BM I DESCRIPTION fl QS- 1' vc p=er luf h wit Fl ,! Q q �, BM 2 ELEVATION_ 1 1, 7 I y BM 2 DESCRIPTION �T "p1 t 10,+ fie=( SYSTEM ELEVATION qs , 7 ALTERNATE ELEVATION q b CONTOUR ELEVATION no 5169 I A l b 1 SIGNATURE DATE I r 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 (POWTS) 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.6/99). Table 1: System Design Specifications Sanitary Permit Number Number of Bedrooms Design Flow - Peak (gpd) q U Estimated Flow - Average (gpd) d6ft 1`7- 3� Septic Tank Capacity (gal) to uU Soil Absorption Component Size (W) 3 7 S 2 - Type of Wastewater Domestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Abso tion Component Design Flow - Peak (gpd) LT&O --� z Maximum Influent Particle Size (in) 0 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 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 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 septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The out et filter hall be cleaned as necessary to ensure proper operation. The filter cartridge sh removed unless provisions are ma -rt'in so i sin 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 septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be 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. We CR aN O�IV , lui K � � aw i�-e�S �-�� , r-� � N p 1 1•'- e�.Np�e �� p �6 eeS� eh SUNS 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Ownerll ;uyerPIC4n E J �` Mailiog Adclnsa jOe awft ; A v P Vc jj h is Prop"- Address ue1 (Vmiscatioa requbW son, MauM DepubmM for ww construction) _`-jMC - CityJStete Lk-J V) b, Parcel Identification Number JA9AL RZ ACREMM Proporty Location 5w %., N' w , Y4, Sec. I H . TAN -R_j:� Jy Town of Muko yi _ . Sitbdivieiort �= CVMS Lot # 5. Certmil survey map # � - . volume . Page # f, ; Warmly Deed # ,) ej 0 . volume � 5 3 Page # Spec hom O yes &no Lot lines identifiable 52 yes O no *W= I aopsaper usewdsookwuncoof your septic symm 000ld resoh m its p temsaure foihnre to handle wastes. Proper maintenance consists a! art the septic tank every three years or sooner, if needed by a licensed pu Ver. What you pat into the syabm can affect dw h eadoa of do septic took as a h+eret shies in dw issue disponl system. 'the property owner asw to st bmit to St. Cnk Zomag Depmu=W a adiScation fann. sidpad by the owner ssd by a so"terpiu mbeeJoumoymon Plumber, raw dcledphi nberor a l coved F w* - r verifying that (1) the oasito wuinvasecdisposd system is in penµr opetafts condition and/or (2,+ aft iatpeWm and (if aweswy), the septic teak is low than 113 lbfl otdodge. Uwe, dw � odenigaed have read die and as m to maintain also private sewage disposal $yam wa ties standard: nt fl a d% 1 Nasia, a oet by the Depstum of bomererce and she Departn eot of Nataral Resources, State of Wis Cron Ming du t yogic septic system ha been n .aids od saws be completed end returned to the St. Croix County Zonieg Office wMa 30 . dap of W throe year expke don date. SIMATt M OF AIPUcANT DATE I (wa) codify tint an statements on We ferrn an t w to the boat of my (our) knowledge. I (we) can (wo) the owaer(e) of she pro"..► dasarlbW above, by vid w of a;rraaawy deed recorded in Register of.Doods Ofte. G SiI0NAI M OF APPLICANT DATE .n+aas Any hrtowntim that is mlatepor 'asay remit in the of shery pemait be" revoked by the Zo nin Deptermwrd. a..•ss •" Indnd{s wipe tlk ippliesdon: a dumped wappW deed bom flee Register of Deeds office a copy of to ondOW sunray map if reirenee is merle in the wanady deed V OL 1539 PAGE 81 629124 STATE BAR OF WISCONSIN FORM 2 -1999 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS 5T. CROIX CO., WI This Deed, made between Donalda Speer, a /k/a Donalda J. RECEIVED FOR RECORD Speers, a /k/a Donald J. Speer and Kernon Bast, wife and husband, 08 -31 -2000 1:30 PM a k a Donalda J. Speer-Bast - WARRANTY DEED E k 3 Grantor, and Richard O. Sto and Janet P. Stout, husband and w ife, C ERT ERT C COPY FEE: COPY FEE: -- - -- TRANSFER FEE: �— ___ -- - RECORDING FEE: 10.00 PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area All of the Plat of Sweet Grass Farm in the Town of Hudson, EXCEPT Lot I Name and Return Address of said Plat. �,A,1 r4 0 - This Deed is given to correct the ommission of additional lots in the Plat of 13s3 AW4rditt54 — rKj 4 - t I--- Sweet Grass Farm between the above Grantor and Grantee hereto in that P45o,J, GUt S?�pt (p certain Deed recorded in Volume IK 3 ? , Page Ga0 , as Doe. No. oa °I O S 020- 1021.60,01,0-1021. 80,020 -1021- 90,020 - 1022 -00 & 020 - 1062 -20 Parcel Identification Number (PIN) This is not homestead property. 0E) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this 1 ( day of August 2000_ D 1� + S eeq a/Wa Donalda J. S rs, a!k/a Donald J. Speer + croon Bast AUTHENTICATION ACKNOWLEDGMENT Signature(,) Do nalda Speer, a /Wa Donalda J. Speer,, a!k/a STATE OF WISCONSIN ) Dopaldl J. S cep rand Kernon Bast, wife and husband, ) ss. IlIIII3i County ) authenticated this 1 5? da of August , 2000 personally came before me this _day of the above named . Kristin Oghmd _ "rITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, instrument and acknowledged the same. authorized by § 706.06, Wis. Stars.) THIS INSTRUMENT WAS DRAFTED BY + Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, Wl 54016 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) + Names of persons signing in any capacity must be typed or printed below their signature. aAormabw Proraa,waala company, rood du Lao, va eaoasszo l WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 -1999 f +. 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