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Home My WebLink About020-1370-42-000/* Wrsoonsin Department of Commeroe PRIVATE SEWAGE SYSTEM ~safetyasd Buildings Dnnsion INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal intormafion you provice may be used for secondary purposes (Privacy Law. s.15.04 (t)(m)). Permit Q is Name: ^ City ^ Village Town of: urans~Cl, ruce Hudson Township u. u... ~.c... I ...-,.. ~._. _.~_.. _. - __- t ~- ~~ . O ~ I ao . O~ t\ o~.~ ~ 10. o ~ `tom TeNK INFORMATION TYPE MANUFACTURER CAPACITY Septic z, ~ Dosing Aeration Holdin TANK SETBACK INFORMATION TANKTO P/L WELL BLDG. vent to ROAD Air Intake Septic y ~ ~ ~ ` ~ NA Dosing NA Aeration NA Holding PUMP /SIPHON INFORMATION .. Manu durer Demand Model Num r GPM TDH Lift ~ ion System pH Ft Forcemain Length Oia. 1-f Dist. To Well SOILAB~PTION SYSTEM~~~~~[~ ire, r nrc~ .v-u w..N6 r pnath i No.Of Trenches ELEVATION DATA I b ~ ~ `~ ` ~ ~ ~ ~X08 STATION BS HI FS ELEV. Benchmark vim' lo(o (oS ~f. ~• O ~ Bldg. Sewer ~S`~ qg. II ~ St/ Ht Inlet ~• ~ ~~- ~~ r St/Ht Outlet S,O~ q~-C~ ~ / Ot Inlet -- Dt Bottom Header /Man. Oist. Pip '~ fS , 12. r ~~'- Got. System `) • `~ q6 - 2~'I Final Grade ~ ~. `{'~ / ~ ~ (. 21 No. Inside 1 N 1 N "~ " ~~ 6"""' -""--- Man a urer: ,n- SYSTEM TO P / L BLDG WELL LAKE /STREAM BEACHING ~ .. ~ - ~ `~f SETBACK CHAMBER M e Num r: 1 FORMATION TYpeO Lam ~~f 3(/ ,~) ~--- OR UNIT ^ System: ~~ IBUTION SYSTEM y a Mani old Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. length i Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Oepth Over xx Oepth Of xx Seeded /Sodded xx Mulched Topsoil ^ Yes ^ No ^ Yes ^ No Bed /Trench Center Bed /Trench Edges C MMEN S: (Include code di reRancies, pe sons pAre,~ent,~Pection #1: off-/ 3l / ~( Inspection #2: `~--" Loc'ati~n: 999 Parkview Lane, Hudson, lyVl 54016 (NW 1/4 NW 1/416 T29N R19W) -1629192208 Parkwood Meadows -Lot 42 ~~~ ~ ~~~--C~~~, ~j~--~ ~~,) 1.) Alt BM Description =T~ 2.) Bldg sewer length = ~B•o -amount of cover = 18 k rr Plan revision required? ^ Yes ~ No 0 3~ o r < '~.) ~ ~ othe side for additional information. ~~ 't~Q. ~''~~• E. t~ ~ {,~Oate ,~ _ /Inspedo~ s Sgnature~ ~~ ~ p, ~ Cert Nor SBO-6710 (R.3/97) ~ ~ _ _ _ n ~[,r, ~,JUC~VVV~01.~ c~ ~l~J ~~ ~ /I W tT~r QIfLQJY~..~ ~D~' 5~4~ dl~!'ei1C ~" U -~;'oU /~~3G 9 ~ ~~9 I$kt;J l Ew E 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 SCOns®n Personal information you provide may be used for secondary purposes Madison, WI 53707-7302 department of commerce [Privacy Law, s. 15.0 2 (Submit completed form to county if not state owned.) Attach complete plans (to the county copy only) fo a m, on pa nqt s than 8 -1/2 x 11 inches in size. County State Sani Permit Number if rev' ion reviousAppL lion - ~ ~: State Plan I. D. Number S :~,~ Z6 I. Application Information -Please Print all Information ._:~r Location: Property Owner Name r , <~~ . i,i ~ ~ ~ ~ ~ R~ ~ i - ;, €f t , Property Location _ ~~ ~I N:~_ ,, ~ Nw'I/a NL~Ia, s ~T~ ~> R (or) Property Owner's Mailing Address ~ Lot Number Block Number /~ ~ \ City, State Zip Code otie - ~" `~ fy" Sub ivisron Name or.CSM Number i S ~, II. Type of Building: (check one) ~ ..~ 0.S d.~I S w sy.. ^ City 1 or 2 Family Dwelling - No. of Bedrooms :~ ~ ~•••s. ^ Village ' f ^ Public/Commercial (describe us e ):_ ~ fown o ~ J ` ~~ ^ State-Owned /~ - 't/ _\ ( ~ Ne st Roa _ ~ ~ "1 ~ Z 3 ~3 ~~ ~ - /~ Paz Num aC ~ •~ - C:~~G `'~` _ III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) ~'. -- 3~~D _ ' -G a A) 1. New 2. ^ Replacement 3. ^ Replacement of 4. 5. 6. ^ Addition to System System Tank Only (~ . ~ <f, G ~ ,~ C ~ Existing System B) Permit Number Date Issued ^ A Sanitary Pennit was previously issued IV. Type of POWT System: (Check all that apply) 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: 3O - /'U' ~ 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) --- ~ 3 y~ Elevation o ~~o ~ ~ % ~< ~ , 7, VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing Crete strutted Tanks Tanks - GG J ^ ^ ^ ^ ^ ^ ^ ^ ^ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS show n the attached plans. Plumber's Name (print) Plumber's 'gnatur (no slam M PRS No. Business Phone Number ~ ~ 1~~~~ day®~.~7 7/5 - ~~~ ~ ~ s' ssJ(Street, City, State, Li ode) Plumber's Addre °- ~ / , ~ ~ l L f~ 6 IX. County/Department Use Only ^ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued ssu' g Agent Si tore (No stamps) Approved ^ Owner Given Initial Adverse Surch~ge Fee) Qp Determination ~Qt+~~ ZZS, `- Z 7.60( X. Conditions of Approval/Reasons for Disapproval: ~ ~ ~-! ( I~-- tv~~ ,~-~- ~s~Q.Q- ~ tE-, w . L l QUO ~~ s ~. ~,~ ~°~_ ~ 1_ - ~ O s S~ ks~~ ~.~~ ~~~ ~K ~ ~ -~.c~ lS ~~~~I-~-~ ~e.C6~.u~c~~ts SBD-6398 (R. 07/00) /V rr u~.~ ~" ^ w / ~ - ~ar~ ~ ~~ I ~ ~ a is ~ ~~ ~ r1=y7~o ~,.~ ~ ~~r ~o ~ ~ ~ a~ ~,~ ,~ ft~l" ~ . roe ' ~` v~--- ~ ~ ~ .~,, ~ ' - ~ ~ y~~ q~.so R ~ is ~~~- f ~~ ~1-y7.~~ ~~ - y~ ~o ~' 7` ` ~v~ ~" - .~, i 7 g~.s~ Wisconsin Department of Industry, Labos.and Human Relations Division of SzSfety & Buildings SOIL AND SITE EVALUATION.;:.~~~13T ,,- ~ ' Page 1 of 3 ~, '...-~° ~ ~ ~ COUNTY but - a er not less than 8 1/2 x 11 inches in size Rfarrmust inclfide Attach com lete lan on ite St. Croix , p p p p s not limited to vertical and horizontal reference point (BM), direction and % c~#sfgpe, case or ~ PARCEL LD. # dimensioned, north arrow, and location and distance to nearest road. - ~ ~;~," ~ 020-1028-90 APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION ~'. ~~ ~{~'?~ _ rY=~~. E EVIIEDBY ATE 2 ?.a01 PROPERTY OWNER: ,ROPE ~®T#~l N W R 19 ~ 4 9 T LaCas e Cu es Inc. , , 6c(or) NW t} G(~V ,~t4T 1VW 1/ ,S 16 T 2 / PROPERTY OWNER':S MAILING ADDRESS LOT ~. 'BLOCK # SUBS: AME OR CSM # 521 McCutcheon Rd. 42 ~'-~na---- - arkwood Meadows First Addn. CITY, STATE ZIP CODE PHONE NUMBER ^CITY ^VILLAGE ['OWN NEAREST ROAD Hudson, WI. 54016 (715 381-5405 Hudson McCutcheon [~dVew Construction Use ~ ] Residential / Number of bedrooms 4 [ ]Addition to existing building (]Replacement [ ) Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd/ft2 .8 trench, gpd/ft2 Absorption area required 858 bed, ft2 750 trench, ft2 Maximum design loading rate .7 bed, gpd/ft2 .8 trench, gpd/ft2 Recommended infiltration surface elevation(s) Area A=97.3/B=96.4 ft (as referred to site plan benchmark) Additional design /site considerations na Parent material outwash Flood plain elevation, if applicable na ft S =Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U =Unsuitable fors stem ®S ^ U ®S ^ U ®S ^ U ®S ^ U ®S ^ U ^ S CCU SOIL DESCRIPTION REPORT fJQ...)f~ J~„~,y,I,2~oo -a ~• ~'~ Boring # .................. 1 Ground elev. 101 _1 ft. Depth to limiting factor +90" Boring # 2 Ground elev. 101.3ft. Depth to limiting factor +90" Remarks: non-contiguous 8x24" sil lens C 60" CST Name:--Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 200th. A ew Richmond W 54017 Signature: __ Date: ~ 30-99 CST Number: m02298 Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed Trer>ch 1 0-11 10 r3 3 none 1 2msbk dsh 2c .5 ~ .6 2 11-30 10yr5/4 none sil 2csbk dsh gw lc .5 .6 3 3 - 0 7.5yr4/6 none cos Osg ml na na .7 .8 u 0 , ~ 9 T • ~ ~~ s,e+,r 'f S.l, wS•f'o ~n -,~ ~~ - Remarks: 1 0-14 10yr3/3 none 1 2msbk dsh gw 2c .5 .6 2 14-32 10yr5/4 none sil 2csbk dsh gw lc .5 .6 3 32-90 7.5yr4/6 none cos Osg ml na na .7 .8 ae PROPERTY OWNER LaCasse Custom Homes SOIL DESCRIPTION REPORT Pageo~ PARCEL I.D. # 020-1028-90 ~ ~~ ~ Boring # 3 Ground elev. 104.4 ft. Depth to limiting factor +100" Boring # 4 >' ................. Ground elev. g~ _ ti ft. Depth to limiting factor +90" Boring # ~5« Ground elev. 99.6 ft. Depth to limiting factor ~~ Boring # Ground elev. ft. Depth to limiting factor Horizon Depth Dominant Color Mottles Texture Structure Consistence Barr Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends 1 -11 10yr3/3 none 1 2msbk dsh yw 2c .5 .6 2 1-35 10yr5/4 none sil 2csbk dsh gw lc .5 .6 3 5-100 7.5yr4/6 none cos Osg ml na na .7 .8 / 4(, • )~ c~----- Remarks: 1 -13 10yr3/3 none 1 2msbk dsh gw 2c .5 .6 2 3-31 10yr5/4 none sil 2csbk dsh gw lc .5 .6 3 1-90 7.5yr4/6 none cos Osg ml na na .7 !.8 Remarks: 1 -8 10yr4/4 none 1 2msbk dsh gw 2c .5 ~.6 2 -26 10yr5/4 none sil 2csbk dsh gw lm .5 .6 3 6-84 7.5yr4/6 none cos ~- Osg ml na na .7 .8 Remarks: Remarks: SBD-8330(8.05/92) !' y , STEEL'S SOIL SERVICE Gary L. Steel LaCAsse Custon Homes, Inc. 1554 200th Ave. CSTM2298 ~4~4 s16-T29N-R19W New Richmond, WI 54017 MPRSW-3254 town of Hudson (715) 246-6200 lot #42-Parkwood Meadows First Addn. This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted.. /~ ~~=40' IBM.= nail in Oak tree C el. 100.0 iAtl. Bm.=top1 of 1" pvc pipe C _ ? `~~.~0 - ~ (~- ~~'"~- '~~` r_ _ _ CLe DO Gary L. Steel -30-99 o~ 5-11-1995 10-39PM FROM I,,,y,. ~,tz- csT 1~-y s~ ~~y„-gaw~•usye[w[[o~.ku[u[uwul' ,VIL A1~111 5~ 1 C ~G'VALNA I IVI~1 1SC1•Vl'f 1 s'~a~w' 18Do- and Humu+ F~elatiorrc • ~~ c+gare<y $ 8uildl^gs in accord with ILHR 83.05, Wis, Adm. Code COUNTY . St. Croix Artach complete site plan on paper not lass than 8112 x 11 inches in size. Plan must include, but PAR l {.D. e not limited to verricel and horizorRa) referenea'pant iBM), d'ireet-on and 9e of sbpe, stale 4r 020-1028-90 dimensioned, north arrow, and location and distarr~e b nearest road. R p ~Y DAT APPLICANT INFORMATION-PLEASE PgIMT AI.I INFp~RMATION ~ Z -~ 521 1~cG'utclveon Rd . 1, STATE ZIP CODE PH Hrydson, wI . 540 ~, 6 ~ (71~ GOVT. LOT 1VW 114 111fi1T 114,5 16 T 29 .N,R 19 tii~ar) W LOT a BLOCK ~ SU80, NAME OR tSM l< 42 as Packwood Meadv~ns .First Addn. i 1~iCCt$CtJIe1CR~ (~ddew Construction Use [x } Residential I Number of bedrooms 4 _ (] Ad6tion b existing buildMtg E 1 Replaa~nent ~ (} Public a aommerdai describe . Code derived daily Aow 600 gpd Recommended design loading rate .7 bed, gpd/1t2 . $ Vench, 91~ AbSprption area required S58 bed, ft2 750 trench,lt2 Maximum design bading rate -7 bed, gp0192 .8 Genoh, 9P~ Recommended inBlb'aUon surFace e{eva[ion(s) ~tsgra 1+x-97 3/~~r.R (as referred .b site plan benctwnark} addiitgnal design ~ site considerations Parent mater{al c~utwash Flood pert elevation, if applicable _~~ R S ~ Su{teble for 5y9tOsrn r~vFJYT1ONA1. MOUNO W.Gii0lJN0 PRESSURE ~ AT-GRAD SYSTa~n 1N Py.l NOLORtG TANK U ~ Urrsuitade for stem ®s ~ u . ~l s O u ®s C3 u ®s ~ u Gds D U ^ S f~U Qnu I~eSCRIPTIdN REPOR~1` Boring # . „" 1 Grourd eleV, 1f11~n• A~m~~ng . +90" Boring # ~2 Mound elev. 101 _'~fl. t~pth to rirniD'ng tacslor + " i Depth Domin8rlt~Color Mottles T®xture Structure ~ Consis~rtoe ~~ Roots GF'0/ d ittrtCh B zon Hor in Munsell ' f]u. Sz. Cont. Cobr tar, Sz. Sh, e 1 0-11 1 r3 3 none '1 2 2. 11-30 1Qyr5/4 none 8~.1 2esbk dt:h gw' iG ,5 ~ .6 3 7 , Syr4/6 Wane cos Osq all tie ria . 7 .8 • ~I ~~ '~ ,~ s 6 ~[ ~ ~ ,. ~~.~.~ [ Remarks 1 2 3 : 0-14 14-32 32-90 10yr3/3 10yr5/4 7.5yr4/6 none none none l sil cos 2tosbk 2esbk Osg dsh dleh tnl gw gw na 2c 1c na .5 d.6 .5 ~•.6 .7 ,8 Ytemarks: I'riet GAIY L. HX24" ail lens ~ 60" 17 !/ yd.Ll _ _ bare: Q!-~rL00 CST Number: rd0229e '7 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- Table 1: System Design Specifications Sanitary Permit Number 2!0 Number of Bedrooms Design Flow -Peak (gpd) Estimated Flow -Average (gpd) (~ Septic Tank Capacity (gal) Soil Absorption Component Size (ft~) - ~ Type of Wastewater D mestic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soil Abso tion Component Design Flow -Peak (gpd) 2 ~ Maximum Influent Particle Size (in) 1/8 Maximum BODS (mg/L) 220 Maximum TSS (mg/L) 150 C~4M-~ ~:~ 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 septi and outlet filter shall be assessed at least once every 3 years by inspection. T outlet felt shall be cleaned as necessary to ensure proper operation. The filter cartridge shou 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. 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 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 Absomtion 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. ~- ~~ ~~ a~ q ~'°"~" v-~`_ sr c~-~. s~,.~._ aE ~ ~ ~c~.. c~~s~ a~ ~ ~ ~ 9y~ ~~~5) 3g~-y~g~ z~ S'1' CItO1X CUUN'1'1' SLl'"I'IC 'TANK MAIN'I'L~NANCL AGIZLLMI?N"T ANu OWNI?1tSI111' CI?1tTII~ICA'1'ION I~OItIvt 'Owner/Buyer S~~ J G~%rl%,S~ i~ ~,~li~ ',Mailing Address II'ropariy Address (Vetifcalion tc<pii~cd lion 1'laiwing Uct-atlmcnt liar ucw consUuctio I'~Cily/Slate ~~~~~~il//~ 1 I'arccl IJentificution Nutuher O~~o -ly~~' -~1~ LCGAL D1;SCRI1''I'ION Property Localiou ~~ '/,, ,~ '/,, Sec. ~_, 'I'~N-IZ~~W, "I'uwn of ,~K/ SuUdivisiou ~.~~,~i~e.~~,e~~giJ l -=j/.~-~,~i1~i~ _, Lut ~l y°2 . Cet•llfied Survey Map /t! , Vuluntc , 1'rtl;c ~~ Warruuly Deed t'E ~n ~ 3 y~~. , Volulttc ~ s~~, Pial;e ~I 3 ! ~P Spec house O yes uo I_ul liucs itlcnlilinhlc~yes 1.1 no SYSTrM MAIN'I'CNANCI~ Lntproper use and maiutenanccof your septic system could result in its p~cmahuc failure to Handle wastes. Proper maintenance consists of pumping out Ute septic lank every tl-ree ycais or sooucr, if needed by a licensed pumper. What you put into We system can affect lire fuuctiou of Ute septic lack as a lreaUncut stage in the waste disposal system. 'Tire property owner agrees to submit to St. Croix Zoning Ueparlmcul n ccrtitication fouu, signed by We owner and by a master plumber, joumeyrrtau plumber, restricted plumber or a licensed pumper verifying Ihal (1) the ou-site wastewaterdlsposal system is in proper operating condition and/or (2) a(ler inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. ', llwc~ Utc undersigned taut read the above requiicuunts and agree to maintain the private sewage disposal system with the standards set forW, here set by the Depariutent of Conuuerce and the Dep.~rtmeut of Natural Resources, State of Wisconsin. Certification ~, stating that yo eptic syst has been tnaiutaiued nwst be contpletcd and rclunted to the St. Croix County Zoning Office within 30 day~tf Utc Urr year ex dale. -~ /~ / ~ DA•rB O~Y_IYIJR CCRTII+ICA'f1O1~ I (we) certify Utat all slalcntcnts ou ibis furor aic tnic to the best of my (our) knowledge. I (wc) atn (are) Ute ownet{s) of Ure property descr'bed~aQ,b~ove, by virtue of a watrauty decd recorded iu Itcgister of Uccds Office. GUU~''`~"` / SIGNA OC APPLICANT ATB ****** Any iufonnation Thal is ntis-represented may result in tl-c sanitary pcuuit being revoked by Ure Zathtg Department. ****** ** Include wlllr this appllcal[on: a stamped warraaly deed from the Register of Uccds office a copy oC the ccrliCcd survey map if reference is made in Utc watrauty deed ~_ 5~ / FA,:E 396 ~ °~. STATE BAR OF WISCONSIN FORM 2 - 1999 623416 Document Number WARRANTY DEED k G T O E IS ER F DEEDS ST. CROIX CO., tJI This Deed, made between LaCasse Custom Homes In , c., a Wisconsin Cor ration RECEIVED FOR RECORD 05-22-2000 10:00 AM Grantor, and Bruce A. Turanski and Cynthia K. Turanski, husband EXE~lNATTN DEED and wife CERT COPY FEE: CORY FEE: TRANSFER FEE: 269.70 Grantee. RECORDING FEE: 10.00 DAGES: f 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 /~ .I.S2tsl2; Plat of Packwood Meadows First Addition in the Town of Hudson Nam d Retum Ad . dr~ss , St. Croix County, Wisconsin. / ~/ / ~~ /~/ /~~~i/ ~ ~ . J~ ~ ~ ~~,~ ,~ .tea/~ 026-1028-90 Parcel Identification Number (PIN) This is not homestead property. Exceptions to warranties: Easements, restictions and rights-of--way of record, if any. O{) ('s not) Dated this `< day of May 2000 AUTHENTICATION Signature(s) authenticated [his day of TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. S[atsJ THIS INSTRUMENT WAS DRAFTED BY Attorney Kristine Ogland udson, WI 54016 (Signatures may be authenticated or acknowledged. Both are not necessary.) Names of persons signing in any capacity must be typed or WARRANTY DEED LaCasse Custom Homes, Inc. ~,~~~~~ • Richard W. I.aCasse, President ACKNOWLEDGMENT STATE OF WISCONSIN ) Courtly ) Personally came before me this --~~~ day of May , 2000 the above named LaCasse Custom Homes, Inc., a Wisconsin Corporation by Richard W. LaCasse, President to me kno~q~~ tlx~rsgon(s)~who executed the foregoing instru wled ed th same. ~ L' >U ~-U No ary Public, State of Wisconsin M~o~~mission is permanent. (If not, state expir i n d i u„cu ucww ulclr 51~a[Ure. - liformation Prafusionala Company, Fontl Cu Lac, WI STATE BAR OF WISCONSIN eooass-~r FORM Na. 2 - 1999 ~~ , ~~~gG~~~~~~~~~~~ ~0 3 ~rn Z Q' ~Z ~rn aJ N n ~- N r7 ~ ti. Q. .r Q z r- N U Z ~X 0 ~~ Q -- U wn N -~ p U cn ~:C ~j o v -- W n '- pp 7' ~:.i _~ 4 U i ----~- .B6'6l Z ~" 1 ~.. `~ w ~,~~ ,_. 3 \, i v p r- ~, rn ~,-~ Z i~ ` in a •-r . , 1 Fig to rn ,,) w ~, u N o, ~n _ (V a M rn i;k 0 ~ ~ ~. ~i ~ ~ n u) ~~~~ ~~~ I AD X~ ~ ~ .~ I ~ '\ ~ ~ ~ ~s\ ~~ ~ - --____:=-s~~b ,OS' l 6l ,O0'i7, l 1 AS;''~t£ M „6£ ,6b,00 N of 12`•)',.x'-j r ~' ~ 6 o1Qi 4 ,A, \?~ 1~a ~ \ ~I~ G N 3 i s v, NV38 OL 03 ~9' NO1.173~ ~O b 1S3M 3Hl OI. 0~ b/l MN lHl. ~O b/i v.N (- 3F11 JO :~NI1 1S W3 `~!JNV l Cl~l_ ld~c-1N(1 ,T~'6l S' l 3 „l t ,~t'o00 S '~= ,zs~~sz ~ ` c, ~~.~ ~~ ~~ l ~O f ,n ;; v, ~.; C c C a 1 /'~ ' c) vi c ~ --. O rn ") ~. N rn 3 ~,, ~~ Q O •L) / \ ri ~ p o °_r? ago ~ . r o Z tp . ro V l..l <. ~ T ,~ tJ { 4, l,l (~ fY. / - ~~ ~ ~ ~' n ca - ~ /~- D nj ~ II :r ~/\ L p~1 . If)z ~ rr) rV ~ p N Of N N C7 . p ~t 2 c~ -r .t _,~j, _ - _ ~ N1;n.. -~" - - 1 4 ~ ~~3 J..-- M~I~~INd --i-- -_. 7n I x I l i I ~ I I