Loading...
HomeMy WebLinkAbout020-1376-58-000 consin Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix .fety and Buiktir,g Division INSPECTION REPORT Sanitary Permit No: 479402 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: Runck, Bill I Hudson, Town of 020 - 1376 -58 -000 CST BM Elev - In let BM Descr' ion: Section/Town /Range /Map No: L h 14.29.19.2319 TANK INFORMATION V ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic / Benchmark O 1/� — Dosing Alt. BM&j� Gi 63 C� Aeration Bldg. Sewer � Holding St/Ht Inlet / o 6 TANK SETBACK INFORMATION trHt`— d •(� 3 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 0 l3_ l� �' Septic ` J O / 4J.BcttnQ I � • Dosing ` / i , \ J Heacler(N1an. �� Aeration ! � / Dist. Pipe 2- Holding Bot. System 3 ✓d 7 y S S� Fin Grade / Gj PUMP /SIPHON INFORMATION ��1�'.�t BQ_P.Z — Manufacturer Demand St Cover GPM Model Number 3D TDH Lift Frict�n Loss System *e ad, T J c 47 J\J Forcemain 1 11brigth Dia Dist. to We t SOIL ABSORPTION SYSTEM BEDITRENCH Width 1 Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 7 SETBACK SYSTEM TO P/L BLDG WE LAKE /STREA LEACHING � nufacturer e:T�,r INFORMATION CHAMBER OR Model Number. PA)U kIBUTION SYSTEM Header /M nifold f Distribution I x Hole Size x Hole Spacing Vent to Air Intake 1 -) - Pipe(s) — — Length�_ Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over I xx De pth of xx Seeded /Sodded jxxMu'ChedL_�,1 Bed/Trench Center Bed/Trench Edges Topsoil (( Yes J No Yes a No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 1 / Inspection #2: L� Location: 921 Florence Lane Hudson WI 54016 (SW 1/4 SW 1/4 14 T29N 19W) S weet Grass Farm Parcel No: 14.29.19.2319 L- 1.) Alt BM Description = 6&�C^ Sy S L 2.) Bldg sewer length = S o l � `ct� ' 13 _ 1 7 - amount of cover 1 Y Plan revision Required? l Yes ' _I No /- Use other side for additional information. I' ' ZZ US SBD -6710 (R.3197) Date � Ins n epctor's Signature — /�,� Ar Safety and Buildings Division County ! 1 201 W. Washington Ave., P.O. Box 7162 3A Madison, WI 53707 — 7162 Sa Permit Number (to be filled in by Co.) Department of Commerce (fig) � 9 Z Sanitary Permit A State Ian I.D. Number i In accord with Comm 83.21, Wis. Adm. Code perso o i prt r� j i %' may be used for secondary purposes Privacy Law, s Proj Address (if di rent than mailing address) 1. Application Information — Please Prin Information L� ]]O Rojy G t ' NI N,0FF E r, 8 Property Owner's Name f Parcel # Lo # Block # & l\ �u N Lt S Property Owner's Mailin Address Property Location a 20. k4 3 W '% W ' /., Section / Cit State Zip Code Phone Number + (circle one) { _ �D N �� T K REorW II. Type of Building (check all that apply) ( q—) 3 #-A- h Subdivision Name CSM Number 9 or 2 Family Dwelling — Number of Bedrooms L'i2Q� ❑ Public/Commercial — Describe Use 4 0 ❑ State Owned —Describe Use ity_ ❑Village �fownship of 0 /V III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A, &ew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiratfon Plumber Owner IV. Type of PO System: Check all that apply) 1 T . MNon — 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 VL g Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (expl V. Dis ersaVTreatment Area Inf rmation: Design Flow (gpd) Design Soil Application Rate( sf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks a. Septic or Holding Tank t -a41D Aerobic Treatment Unit Dosing Chamber �'v p V � Q �L f VII. Responsibility Statement 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Nam (Print) PI her's Si ature MP/MPRS Business Phone Number 71-S , l �i�^ DoLcMe:ei o��d I 7� y�' �I�of Plumber's Address (Street, City, State, Zip C VIII ount / cpartmenPUse Onl Approved El Disapproved Sanitary Permit Fee (includes Groundwater a Date Issued ssuing Agent ignatur o tamps) Surcharge Fee) � (/� � ❑ Owner Given Reason for Denial & IX . Conditions of Approval /Reasons for Disapproval """" ,�y SYSTEM OWNER: � fi lter e� „ � d a��r,syCX Septic tank, effluent f� �a and 1-61- l%Yt..� `_ S (:� ��� dispersal cell must all be serviced / maintained . 7(d�l���'`""r" as per management plan provided b_ v plumber Z All setback requirements must be maintained as per applicable code; Anre�- ' Attach complete (to the County only) for the stem n paper u� � a th8112 ,,I1 riches in size I J �' �o � S q SBD -6398 (R. 01/03) � (/h t — i P Uj l� r AV-0re( N Wk/ ccJ/ nde is M/7 5 A"A Ad Wlblu lzc1 wrI 2,� i� F � ? _ 1 .�.,, &R;t&/�wn o- � '��v J LPNP Wils It " * - 1 --- r a� s I-�i`l ,,, • . • ' 1 r� A ' ;�►.�.r .sir ��.•r LOT • .7 ACRES IN► kA MIN BUILDiNG WE v ' a MON _ r r P� p /() t /-v S' a i O-UL zr 3S Al-} B M i ► � I � �''J�l ullin�t' �IGVh.Pi • j Sv c� 13Y r ` B 1y1�a �{ �d �c Lv� 3x 7�S b Q IApb ( -6v- , 6,5 Wjblu w � ► � 2 - 7, (A 1 1 4 - U u !� c LAN P Id s I t 0 1 82 PRIVATE SEWAGE SYSTEMS - II PAGE OF PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS VENT CAP y`C.I. VE'JT PIPE WEATHER PROOF APPROVED LOCKING JUMCTIOAI BOX MANHOLE COVER Z. FROM DOOR. 12'MIU. '.j k;CCw OR FRESH AIR ;A TAKE GRADE-- 1 y" MIIJ. I I � IB "MIAI. cououlr ` -- ---- - - - - -- Ie °M 11� PROVIDE I -- - -- INLET AIRTIGHT SEAL E APPROVED JOINT M/ /C.I. rIPE A APPROVED DINTS l.'C.:. PIPE LARM EXTENDING 3 EXTENDING 3 ONTO SOLID SOIL 0►,ITO SOLID SCIL B C ELEV. FT PUMP -� - - D CONCRETE BLOCK RISER EXIT PERMITTED GNLJ IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E SPEC.IFICATIOUS DOSE w V I P , 5 BANKS MAr.IUFACT'JRER: hh/\ NUMBER OF DOSES: PER OAy TANK !ZE : _ V� G NS DOSE VOLUME �� ( T p 1 Kf - INCLUDING BACKFLOW: C ( _GALLONS ALARM MANUFACTUR !q ?V�Jr MODEL NUMBER: NA CAPACITIES: A= LJ.INCHES OR riALLCUS SWITCH TYPE: B = INCHES OR GALLONS PUMP MANUFACTU R v� „ C= :NCHES OR !,A -LONS CR: KODEL NUMBER: v D = �.- INCHES =R GALLONS 5WI7CH TYPE: NOTE: PUMP AND ALARM ARE TO BE INSTALLED OM SEPARATE CIRCUITS MINIMUM DISCHARGE RATE E� r�i VERTICAL DIFFERENCE CETWEEN PUMP OF ND D15TRIBUTION PIPE.. V FEET / I + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . 2 . 5 FEET + 9 F E E T OF FORCE MAIN X a Dl F YoF tFKICTION FACTOR =�L�(- FEET TOTAL DYNAMIC HLAD - - FEET INTERNA'w DIMEIJSIONS OF TANK: LENGTH ;WIDTH ;LIQUID DEPTrJl SIGr,�EC: "" °"' LICEIJSE NUMBER: �� "� DATE: Wiscor i Department of Commerce SOIL AND SITE EVALUATION Division otSafety and Buildings Page 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 T - C i percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # OZa C3�6 -� =sow APPLICANT INFORMATION - Please prin {�#$rinatianw Re ' y Date ` Personal information you provide may be used for secondary (Pnvjy Law, s. 15.04 (1) (m)). 9 1 6 Property Owner s ( Property Location Govt. Lot 1/4_5&J 1/4,S T 2 5� ,N,R E (or& Property Owner's Mailing Address r i Lot # - Block# Subd. Name or CSM# G ras' City State Zip Code Phone Numb j% i Nearest Road ❑_ Villa ®- Town �v.CdSc>n 1 (`I l - �t t ! New Construction Use: ❑ Residential / Number of-Fietireortis Addition t existing building ❑ Replacement / ❑ Public or commercial - Describe q ( t.Q. Code derived daily flow [ ( o 0 gpd Recommended design loading rate � !be, d trench, gpd/ft20 Absorption area required �7 bed, ft 2 � trench, ft Maximum design loading rate d/ft trench, gpd/ft Recommended infiltration surface elevation(s) ft (as referred to sitenchmark) Additional des/site considerations L - Parent material OC� L" 3 �1 Flood plain elevation, if applicable 1� ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Hol i Tank U = Unsuitable for system [a s U 2s ❑ U S El [as El U El S 9P U ❑ S SOIL DESCRIPTION REPORT " b a4, RA. zjD4 40. - 1 Boring Horizon Depth Dominant Color Mottles Structure GPD /ft . . Cont. g in. Munsell Qu Sz Cont Color Texture Gr. Sz. Sh. Consistence Boundary Roots L Bed ,Trench Z 14) 'flq nik my Ground � t_ kp �5 QS C.S U C elev.� V�ft• , Depth to limiting factor in. Remarks: Boring # 6 -11 ( �-- 53 E Z Z 11 - = I ? k M Y- _" - a 3 2z r mS 'ml CIS $ Ground elev. Depth to limiting factor min. Remarks: CST Name (Please Print) ignature Telephone No. a ��- �i S S Z 7 Address Date CST Number Z l / a Sv.,,� —c S' f /fro S �'- `7 PROPERTY OWNER 5 `} SOIL DESCRIPTION REPORT Page 7 • of 3., PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Structure 2 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3` 0 16 31 �--- 5; 11 k fr fir c I v 2-: 3 2 12-2 t 1v' I V- Ground 3 ql �� ! 5 CS elev. Depth to limiting factor , lin. Remarks: Boring # l c s Ground \ elev. �3R, �!5ft• , Depth to + limiting R f in. Remarks: Plo4k Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /fie in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # &13 l b Z 5Z m vs' S Z 13 - ID 4 n,s m I Ground elev. Depth to limiting , factor 1 in. Remarks: Boring # A r 1111 Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) s r PAGE 3 OF NAME '� V� LOT#52 LEGAL DESCRIPTIO W %- /4 S TZ N R E or SCALE: 1 "= BM 1 ELEVATION 100' v BM 1 DESCRIPTION - 16,p 04 P• p, BM 2 ELEVATION BM 2 DESCRIPTION .W o j�7yGpj,& (Rte w /,Ct,, ! SYSTEM ELEVATION 9G • b 9 ALTERNATE ELEVATION 7-5 � S CONTOUR ELEVATION T' l LO • mI A aS s! 2 (jM I tl. SIGNATURE DATE 5 , ,l. y � , \ l i�..t. _ ..`t.`: 1 ''aft i,. t. \`i:'�:,.: `'�'.::: \j.' :.t v::,:. �t� ?' 't }`tit . \t` i��� •` tL'tii' �.�t't v , ,,. . , . a. ,,,.... :., a. ...,. .. .. .`Ae. . .,... ... , .. ...., .. .. .._,. t , d"•' Yom:•. v1 .. . . ... .. . . .. ... .. , ..... .,.. ,t ... .. ...,. ..... . , .. ........ .. ... .. 77 \. :::'1: ?j; ':,,,,Lt�,t ;s.t,t.:. .. i>,tiC•,. ,. . Al 1 .a. \ �'~: \ \ :: \`\ i, ♦:l'.::::. \tam`„?: ,... , i 'i7 So - OtNw - ]kj ..,.:...:.:., ... .,. .. ..., .... .. .. \♦ l`, ,..., �..,, ...,:., ";x.23;,,..... i ?i t i .. ... .... \...,.... t ,t t.v , \. , t,a SCE � t , 7F \ a \ 1, , , .\, .... .+,, .. .1 .. \ ... . „ .., ,,,....., .,.♦ „ a 1. \' \\' ,. .. , .. : ... ... .... .., .. .. .. , .. .. \. .. ,.. ,' \'; , �titi�`t':'•.;.- .. .::. ! ::: ''ii is �i` is ?i'; �.. ,.:. — a, ' ,a . ..•hlmti.. , a y M1 y Parcel #: 020- 1376 -58 -000 08/18/2005 09:57 AM PA 1 OF 1 Alt. Parcel #; 14.29.19.2319 020 - TOWN OF HUDSON Currant X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner WILLIAM B & GINA Y RUNCK O - RUNCK, WILLIAM B & GINA Y 1709 SHASTA DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 921 FLORENCE LN SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.450 Plat: 2530 -SWEET GRASS FARM LTS 1/78'00 SEC 14 T29N R1 9W PT NW SW & SW SW SWEET Block/Condo Bldg: LOT 58 GRASS FARM LOT 58 3.450AC EZ- U- 1558/119 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 14- 29N -19W NW SW Notes: Parcel History: Date Doc # Vol /Page Type 09/16/2002 690370 1977/176 WD 08/31/2000 629124 1539/081 WD 08/25/2000 628820 8/8 PLAT 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/06/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.450 51,600 0 51,600 NO Totals for 2005: General Property 3.450 51,600 0 51,600 Woodland 0.000 0 0 Totals for 2004: General Property 3.450 51,600 0 51,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 i ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer "k) i . 6 R V' %C V A -A 6 i � R 0­1 c.Y.- Mailing Address 3 (41 Ab 6-,, n;+ Q 166 W Property Address q� �(p Cc C -e— (Verificatio required from Planning Department for new construction.) City /State "")55A t i�J _ Parcel Identification Number LEGAL DESCRIPTION Lo+ 5-3 P i't iP S Property Location SW '/a , VV `A , Sec. I q , T 4 26_N RJW, Town H vcl3o'n Subdivision s i ee &ass 23 1 q Lot #,, Certified Survey Map # , Volume , Page # Warranty Deed # - , Volume , Page # Spec house _! yes�6o Lot lines identifiable_Vyes I 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 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 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 30 days of the three year expiration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I /we certify that all statements on this form are true to the best of my /our knowledge. I /we am /are the owner(s) of the property described above, by virtue of a warranty deed reco ded i Register of Deeds Office. 9fw "SIGNATU OF APPLICANT 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. 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 a ' shall include information Y ( ) and procedures for maintaining the system within the arameters of Comm 83 and 84 a r P 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 Specifica Sanitary Permit Number 17 - 7 9 q6 '2--- Number of Bedrooms Design Flow - Peak ( pd) (0 uU Estimated Flow - ( d) Septic Tank Capacity al I a L Soil Absorption Component Size (ft -- V - 5 1 6 Type of Wastewater Domestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak ( pd) j k v Maximum Influent Particle Size (in) s 1/8 Maximum BOD (m /L) V 220 Maximum TSS (mg /L) 130 150 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, Slats. 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 necessary to ensure proper 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. 9 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 l Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep - rooted trees and shrubs directly over or within ten feel 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 U 1977P 176 6 9 10 3 7 0 STATE BAR OF WISCONSIN FORM 2 - 1998 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number RECEIVED FOR RECORD This Deed, made between 09 -16 -2602 10 :15 AN RT( HARD p STOU aad9 J AN PIT' P . $TOU'1'� _ WARRANTY DEED husband and wife, _ EXDAF7 # Grantor. REC FEE: 11.00 and WTT.T.TAM B_ — R N K ajtd S INN Y_ RUIVCC[�_ __ TRANS FEE: 1a8.70 huGYtand and _ wif i COPY FEE: CERT COPY FEE: — PAGES: 1 — -- — —__ Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate In St. Croix County, State of Wisconsin: Lot 58, Plat of Sweet Grass Farm, Town of Name and Return Addr Hudson, St. Croix County, Wisconsin. 020- 1376 -58 -000 Parcel Identification Number (PIN) This i G no f homestead property (is) (is not) Exceptions to warranties: easements, restrictions, rights -of -way and covenants of record. Dated this 6th day of September 2002 (SEAL) (SEAL) * - Richard O. Stout Janet P. Stout (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, l! St. Croix County. J authenticated this day of Personally came before me this 6th day of September 20112 the above named Richard p_ Stout and Janet P _ NC)TARY PI IRI IC TITLE: MEMBER STATE BAR OF WISCONSIN S TATE OF WISCONSIN to (If not, me known to be tjj(j0__j."cuted the foregoing authorized by §706.06, Wis_ Stats.) instrument and acknowled samg: THIS INSTRUMENT WAS DRAFTED BY -.. Janet P. Stout 1353 Awatukee Tr. Hudson, WI 54016 Notary ublic, State of Wi c nsin My mr ission is perm ent. (If not, state expiir�ratti�ion.y �date: (Signatures may be authenticated or acknowledged. Both are not necessary) ' N.-- of persons signing in any capacity must be typed or printed below their signature. STATE BAR OF WISCONSIN Wisconsin Legal Blank nc lak Co_ I WARRANTY DEED FORM No 2 - 1999 Wwoukee, Wes. - M1N BUILgINQ . , } 2.52 ACRES hJ"- a 6"-0 109760 SO FT w imp t 0 N89°46'50"E 554.71' ! H.W.L. = 882 FM ; I- LOT 58 w 3.45 ACRES 150474 SO FT V MIN BUILDING ELEV. = 886.0 NW46'50"E 566.54' LOT 59 ELEBUILDING 88 0 w r � N � ~ 2.69 r ACRES S 2!i I 1169% SO FT co cn 25' I A N O_ N89°46'50 'F 566.54' 566,54' � 4 ' <J N LOT 60 2.60 ACRES 113472 SO FT 0 r_ \ NW46'50'E 569.30` 256.39' 312.92' a \ \ LOT 61 LOT 62 N Z \ 2.01 ACRES \ N � \ ' 87647 SO FT 1 \ � 2.16 ACRES Q \ \ 93898 SO FT MIN 1UILDING � 'N ELEV. = 900.0 Wo 29 cr