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HomeMy WebLinkAbout020-1376-62-000 ti c o 00 p ° 603 , M 0. 0 � o I a `n N_ N O O N M 7 N 4 .N E a" c ti m i � a i CD cu c 0 v z ,N I c _ > LL LL c u j C O 00 c: Q � m z � i', 0) m d H a m E z � N w z d O ' u !n P O O_ N m E _N N O n1� N c _ N O O O • �V � O .0 a ^ C 0 O Q O z z z z o N E _.. co c U- .. N N N N N N - C N o o a o 3 N N N N E _ CL (n co o H H H ►i n g c c 3 O N ) `o o ° o 3 N N LO W _ O y O N Z N O O N N m e� N v N in co IEZ m U- °' .. C O O N C O O W �© O M c O t O 0 J j V W M o 3 m e £ C L O N L v7 N C M 0 N N N 0 LO M C V O G O N C O N w N z N C (n C) 04 Lo BD • ice.' o M U) M o z Y <� �► r 4 i E a • CQ G y V d C r �►i t A 0 a 0 in u T Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 1 "ISCOnSln Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce (Submit completed form to county if not [Privacy Law, s. 15.04(1)(m)] state owned.) Attach compl p (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. County s State Sanitary Permit Number Check if revision to previous application State Plan I. D. Number Cr ` z I. Application Information - Please Print all Information Location: Property Owner Name Property Location 5k) 1/4 SW A, S T I-f N, 4 fE (or) W Property Owner's Mailing Address Lot Number Block Number 1V ( 3 5 - 3 r. L City, State Zip Code Phone Number Subdivision Name or CSM Number II. Type of B ilding: (check one) y ❑ cit ❑ 1 or 2 Family Dwelling -No. of Bedrooms: ❑ Village ❑ Public /Commercial (describe use):_ `� Town of ❑ State -Owned Nearest oad ,1 ��. Parcel Tax Number(s) III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) , Gj 3 a A) 1. / 9 New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System $) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) )1 Non - pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: 2) 1 5 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation .2. VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks ❑ ❑ ❑ ❑ 1 Z,S f � �� / �w ❑ ❑ —r- ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume resp onsibility for installation of the POWTS shown on the attached plans. Plumber's Name (print) Plumber's Signature (no stamps): MP/MPRS No. Business Phone Number )�krn;� r",I�, Z Z / L//;Z(/ � 7 Plumber's Address (Street, City, State, Zip Code) IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) Approved ❑ Owner Given Initial Adverse Surcharge Fee) Determination S , C) 0 / Z X. Conditions of Approval /Reasons for Disapproval: SBD -6398 (R. 07/00) SwcvslY7ag NAP /I w J�aua.� t oo -- Z.a T, `. ;zy, i r Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code �` Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must County J j 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)). w. Z Property O ner Property Location p Govt. Lot 5W 1/4,(,1/4 S Y T .2 T N R g E (or)® Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# C' State t 7 Zip Code Phone Number ❑ City Village [Town Nearest Road New Construction Use: ❑ Residential / Number of bedrooms Code derived design flow rate _ ^ _ GPD El Replacement F1 Public or commercial - Describe: Parent material Flood Plain elevation if applicable ft, General comments �T z g � 0 an re mendations: Z , / Boring # ❑Boring � �� Pit Ground surface elev. �r _ ft. Depth to limiting factor 13Y 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 0-1J /019 312 — oe tf a , < 3 0 -13) v y Jn �►� Z� Boring # ❑ Boring 1 7 Rj pit Ground surface elev. / q 2 ' � � ft. Depth to limiting factor 1 Z. 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 idde ZS /1 t3 Yk y/ J s In c 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 Name (Please Print) lgnature CST Number Z2 /Si Address Date Evaluation Conducted Telephone Number S T A Nt v D /do 9 2 3 t 7/) 4 .. Property Owner Parcel ID # Page Z of 3 ® Boring # p❑p�� Boring J LlJ Pit Ground surface elev. �� �° S 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 6 - l y .31Z S G hia S /� ✓ Z ^ . A Ye y/ .21n C" m ie, I is , S�� , � ✓ 3 - 1zrovP , s iris -- .7✓ FY-1 Boring # G❑ Boring Qty da i Pit Ground surface elev. a 7 ° `` ft. Depth to limiting factorY 90 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 sL /1 UL -30 Vo y Y/ y ,r 6/' I ZS , s' Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2 i Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mgA. ' Effluent #2 = BOD < 30 mg/- 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. SBD•8330 (R.6/00) Si✓._ -w.. -y Tea 9 N.R -_- Lo r_ 4 7 � a � A r I Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building.Division INSPECTION REPORT Sanitary Permit No: 395264 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: Smith, Shawn I Hudson Township 020 - 1376 -62 -000 CST BM Elev: Insp. BM Elev: BM D scription TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic I � Benchmark Dosing = Alt. BM Aeration Bldg. Sewer,/ l 3 Holding S Ht Inlet S t Outlet ll TANK SETBACK INFORMATION �o• �y �� TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 75-, 2,f Dt Bottom Do sin - - -- - _ Header /Man. -- - Aeration Dist. Pipe la./ _ p 21 ,V�el Holding Bot. System 4 ! �/. s 86 . 6� _ y0 C 3 - M f L Final Grade //- Ys PUMP /SIPHON INFORMATION r¢ _ ? Z - Manufacturer Demand St Cover Model Number TDH Lift Friction Loss System Hea TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM S , j e BED/TRENCH Width Length , o. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 Cl , 7 Z SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM _L '°t!Al Manufact INFORMATION �Svww+s+eJc "R Type Of System: y� / Mode m er: ` v IU - lI . [[ 5 DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake i �7 ) _.— f � Pipe(s 1 Length 15 _ 1S Dia Length - 2 S Dia Spacing 2— SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded Mulched Bed/Trench Center T Bed/Trench Edges Topsoil Yes [] No [a] Yes No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1:�/ ZS / b� Inspection #2: Location: 894 Fraser Lane Hudson, WI 54016 (SW 1/4 SW 1/414 T29N R19W) Sweet Grass Farm L - Parcel No: 14.29.19.2323 1.) Alt BM Description = /' / hI wit � ;, ^ 2.) Bldg sewer length - amount of cover = > y Plan ' revision Requ�C�d�� Yes � No ns rr q f Use other side for additio information. l 4 D.t. 7 nsepcto s Sig tune Cert. No: SBD -6710 (R.3/97) �, �.� td -t 6�RM7'vl D� !�- I o d 5 e o a �Q Z 7 z L� Z� - a-3 8� Fey�- L)-ki a Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21. Wis. Adm. Code 201 W. Washington Ave. i� �� See reverse side for instructions for completing this application PO Box 7302 ". V. I SCOnSln Personal information you provide may be used for secondary purposes Madison. WI 53707 -7302 Department of Commerce (Submit completed form to county if not [privacy Law, s. 15.04(I)(m)) state owned.) Attach com lete plans (to the county copy only) for the system. on paper not less than 8 -1/2 x 1 1 inches in size. County ( State S to Permit umber ❑ Check if revision to previous application State Plan 1. D. Number 3� S�Z� ---• I. Application Information - Please Print all Information 12 1 Location: Pro erty Owner Name 7 Property Location /4 - /4, S Q T ,N. R I or W Property Owner's Mailing Address Lot N umber Block Number I )'J 4 1 111 Jn (CaJ Atrr� - - I_ 111 City tat zip Cbde )) ,, on ` 'm r t 2fIp1 W I Subdivision Name or CSM Number II Type of Building: (check one) uL GOFFICE \ ❑ City 4P I or 2 Family Dwelling - No. of Bedrooms: ❑ Village ❑ Public /Commercial (describe use): i j ' Vaown of 13 State-owned A27YI III Type of Permit: (Check only orc box on line A. Check box on line B if applicable) Nearest Road A) 1. New System 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Addition to Parcel Tax Number(s) System Tank Only Existing System 1 0 d / 3 )6, ' - (. L - (3 Od B) Permit Number Date Issugd �` N ` a3a ❑ A Sanitary Permit was previously issued 10. d� IV. Type of POWT System: (Check all that apply) * A - QO 4"Non pressurized In ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade L2 3/x 9'3 , i ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation 600 O 0 15 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 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ VII Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. I mber's Name (prin P er' Sign atur stamps): MP/MPRS No. Business Phone Number � v y Plumber's Address (Stre t, City, State, Zip Code) VIII County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issui g Agent Signature (No stamps) Approved ❑ Owner Given Initial Adverse Surch a Fee) dO Determination ?,ZS _ • . 1[X. Conditions of Approval /Reasons for Disapproval: � �. NNa.•,,�.�exc t�n>zr� re- ea+�u��a ��S. pk(,l "&4-4 wu.tJ low �na�, SBD -6398 (R. 07/00) ' pep i E ra oS�e ,; r r, i r Liz l i cAl..LL 'Wisco nnm Department of Commerce S OIL AND SITE EVALUATION Division of §afety 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 S -N C__ -Q-v percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # APPLICANT INFORMATION - Please fi ` I P {'1�l � YY rM ; 8 , HC�'1: =ewed by Date Personal information you provide may be used for second Fpikposes (Priva l-aw, s. 15.04 (1) (m)). c Property Owner 3 Property Location \• A Govt. Lot s� 1/4S1�U 1 /4,S Ly T ZC( ,N,R / E (or) 4 Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# City State Zip Code `Phone N;isn r ❑ City ❑Village Town Nearest Road GQ sor CJ ( S4e icP (?�� )x`19 - 4r7 3l f4L�) Frr, --.- (ov L aNew Construction Use: EffResidential / Number - of dd`f`6oms 3 - y Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 6 U C) gpd Recommended design loading rate ? bed, gpd/ft trench, gpd/ft Absorption area required bed, ft 75-0 trencch, ft Maximum design loading rate >2 bed, gpd/ft a trench, gpd/ft Recommended infiltration surface elevation(s) 'S' -3 ( ft (as referred to site plan benchmark) Additional design /site considerations / �Lf' S ' 3 7 Parent material 0 f c-1 Q SGi Flood plain elevation, if applicable S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ED S ❑ U ® S El O s El ® S El U ❑ S E U ❑ S ® U SOIL DESCRIPTION REPORT Boris # Horizon Depth Dominant Color Mottles Structure GPD/ft 9 Texture Consistence Boundary Roots . rty in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Y \ s b 15L r� rib kah. a LS \ y r .s f - �, _ 6 � 16-7-q ,e r VA poak Ground C) 5 i t.5 .� , elev. Depth to limiting factor 9S in. Remarks: Boling # ` 0 - p bk Ff2 �S Z -w Z to V V. Ground elev. Depth to limiting factor 9 ct in. Remarks: CST Name (Please Print) Signature Telephone No. Adom S ,Le✓ �� )Zy 7 -yodg Address Date CST Number 2t t 3 5f. 5o rye l PROPERTY OWNER "5, ?UU SOIL DESCRIPTION REPORT Page. of R PARCEL I.D.# BOring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench K.. 1 0 10 3 mot= CS 1 ur t s Ground 6_lia 0 elev. t7-ft- Depth to limiting I elf- factor — 6C in. SS 2 /1 (. 2 Remarks: Boring # : 1 -i3 5L 1 w rr.�� C 1 �►�- ,� S r� yZ o Ground elev. g 9.$7 ft Depth to 20 limiting factor 99 in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # 1Z lo Z - s L w= 1� ►� C s s v v-, -% CS , S '• 6 wt: OS h Cs Ground NJ elev. Depth to 52•� $�' limiting ; factor q'I in. Remarks: Boring # Ground elev. ft. , Depth to limiting factor ' Remarks: SBD -8330 (R.9/98) PAGEaOF__3_ NAME S+6u LOT# 1,97 LEGAL DESCRIPTIONI��, '14S(, A,S �W TZq,N,R Ii E (or1 w) SCALE: 1 "= r BM 1 ELEVATION 10 ' 0 BM 1 DESCRIPTION ? " D I c��J, w/ t �ac� BM 2 ELEVATION BM 2 DESCRIPTION Z ") p�T lath W / 11Gi SYSTEM ELEVATION 9 5 , 3 I ALTERNATE ELEVATION C l CONTOUR ELEVATION ' W Fo o < -L M • 1 a 3 ©5 SIGNATURE J DATE `� r 08/21/2001 09:24 7152686637 GILLE TRUCKING PAGE 08 R Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant t:) Comm 83,54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWT,I) shall include information and procedures for maintaining the system within the parameters of Gomm 83 and 84, and the conditions of approval by the departm ant, agent, or governmental u nit. 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 Q: mponent Manual for Private Onsite Wastewater Treatment Syste ms SBD- 10567-P (R.6/99;). Table 1; System Design Specifications 5anitai Permit Number b 3 Number of Bedrooms Design Flow - Peak (gpd) Estimated Plow - Average (gpd) Septic Tank Capacity a) 27 � Soil Absorption Component Size ft DF ie of Wastewater Domestic Table-2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption component Design Flow� Peak (gpd) 2 Z — oo Maximum Influent Particle Size (in) 1 / 8 Maximum l ►OD (mg /L) 220 MaximunifSS (mg /L) 150 "able 3: Maintenance Schedule Septic; 'tank Inspect and /or service once eve 3 years Outlet f=ilter Inspect once a year and clean at least once evory 3 years Soil Absorptiori Component Inspect once every 3 years Septic Tank The septic: lank shall be maintained by an individual certified to service septi; tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in acco -dance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, 13r'ease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operatii ng condition of the se and outlet filter shall be assessed et least once every 3 yeani by inspection. The buflelf@6 shall be cleaned as necessary to ensure proper operation. 'rho filter cartridge should not be removed unless provisions art3 m re amT* solid in the tank that may slough off the filter when removed from its enclosure. If the 08/21/2001 09:24 7152686637 GILLE TRUCKING PAGE 09 Man,50ement Plan for a Septic Tank and Soil Absorption Component ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address / 0 - - 'efe y `%'3 - 2 Property Address FA a (Verification required from Planning Department for new construction) I Q City/State Parcel Identification Number 00, 13���— �z-0 LEGAL DESCRIPTION Property Location %., 1 4, Sec. 1, T �25 N -R /5 W, Town of Subdivision L # C 2- _ Certified Survey Map # , Volume , Page # Warranty Deed # 62 / 1 L Volume Ae , Page # /� y Spec house ❑ yes d o Lot lines identifiable A ❑ no SYSTEM MAINTENANCE Improper use and maintenaneeof 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 Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensedpumper 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. Uwe, 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 Office within 30 days of the. M;:::� ( W'_ 0. atl 40, S NATURE 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 mperty d ribed above, y virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented 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 a copy of the certified survey map if reference is made in the warranty deed STATE BAR OF WISCONSIN FORM 2 - 1998 653192 WARRANTY DEED KATHLEEN H. WALSH (� REGISTER OF DEEDS Document Number VOE1695PAGE124 Sr. CROIX CO., WI RECEIVED FOR RECORD This Deed, made between 08 -07 -2001 11:00 AM _ RTC Rf) rl STOITT and TANRT P RTOIIrP hnahand and wi fe , - - - -- - 9ARRANTY DEED Grantor, EXEMPT 0 - - -- . - - -- - -- --- - - - - -- CERT COPY FEE: and cSHAA J � ennIz H _ -- — - COPY FEE: TRANSFER FEE: 169.80 -- H USBAND AND WIFE RECORDING FEE: 10.00 PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys and warrants to Crantee the following described real estate in c Croix County, State of Wisconsin: Lot 62, Plat of Sweet Grass Farm, Town of Name and Return Address Hudson, St. Croix County, Wisconsin. F F Z- 020- 1376 -62 -000 Parcel Identification Number (PIN) This _i q not homestead property. (Is) (is not Exceptions to warranties: easements, restrictions, rights -of -way and covenants of record. Dated this 2nd day of Augusi 2001 Ric 0. S tout — (SEAL) _ Jane P. Stou (SEAL) (SEAL) -- (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, ss. St Croix _ County . authenticated this day of Personally came before me this 2nd day of AugUSt _. 2Q(l__ the above named Richard n, Stout and .TanPt TITLE: MEMBER STATE BAR OF WISCONSIN -- — — — (If not, me known to be ttN®r who the foregoing authorized by §706.06. Wis. StatsJ instrument and d op' W ISCONSIN KERNON THIS INSTRUMENT WAS DRAFTED BY J• BAS ___ Janet P. Stout 135 Awatukee Tr. - -- — — Hudson, WI 54016 Not Public. State of consm My commission is ermanelit. ((11 rioottstaale expiration date (Signatures may be authenticated or acknowledged. Both are not necessary.) Names of pers— signing in any capacity mug be typed or printed below their signature. STATE BAR OF WISCONSIN W,scons,n L_s i Bank Co.. hit WARRANTY DEED FORM 1 2 - 1998 Mtlwaukea, Wis. \ 25 Pf W 400.00' le. \ 61' 125.W \ �N N W t!, b WO s1 \ A J Nt N�►\ N \ \ Q o . t \ W Q S p b \ W W � . k 049 , I z Wt s \ ;k\ rN \ T z (0 \' 00 \ i I • j i � • 63d'a•ba � �� � 3� . . . . . . . . . . . . . . . . � . // C '/ e6 \ N � �.a1• N 10a.54' 10 a °' /� ' $Z O°Z $z ao� ., . • �° \ � — — — 10 1'3��.i . \• a z� \ p� N � f � _ •. . . . . . . . . . . + \ '