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Home My WebLink About020-1395-70-000 — — - - Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix Safety and Buildir.g Division 0 % . INSPECTION REPORT Sanitary Permit No: 420668 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: Carriage Homes Inc. I Hudson Township 020 - 1395 -70 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 100 0 8 m 1 To 1 2 6- 1 t PVC p, 25.28.19.2464 TANK INFORMATION I ELEVATION DAT TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark IN n I '25� IS Dosing Alt. BM _ 7 Z� /b• g.. 6 Aeration Bldg. Sewer Holding St/Ht Inlet y. �► 9q.2y TANK SETBACK INFORMATION - �_ ? a 64-p - A loc� ri�kx- St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic di Plp� 2 32 , Dt Bottom Dosing 171 J Header /Man. Aeration Dist. Pipe 2,55 I Holding Bot. System Final Grade a PUMP /SIPHON INFORMATION Manufacturer Demand St Cover i I GPM YV\ VL 1r?✓ Z• 2/o f Dl - Model Number TDH Lift Fricti oss y Head TDH Ft Forcemain Length D' Dist. to Well ' "cs� Si SOIL ABSORPTION SYSTEM 5� BED/TRENCH Width Lengt S No. Of Trenches we >t- PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 9 SETBACK SYSTEM TO P/L JBLDG IFELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: -� Y / 0 � UNIT Model Number. /i DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake j �/ Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of I xx tlx-x Mulched Bed/Trench Center ' (� 2 1 / Bed/Trench Edges / To Yes No Yes [2 No 'j I �� fio � COMMENTS (Include code discrepencies, petso nS•pesent, etc. "Tris - -tion #1: /�� I Ion 2: / Location: 732 Regal Ridge Hudson, WI 54016 (NE 1/4 SW 1/4 25 T29N R19W) Scenic Hills Lot 70 Parcel No: 25.28.19.2464 1.) Alt BM Description = �S/•' }. C " i� �`l> A& V 2.) Bldg sewer length = A -+ ( Lb c (L— iK c�'&L - amount of cover = l fD ►'� 04 v+^ A'C ( PI., m N"'� G LL �� t�" ` V� U 3� pbh• V4t(I to •LIJ 15^ i►, uM 00_j,� kAl"Q ` mow- (�'� d_ 5 Q j j3'Dn O Plan revision Required? Yes KNo / / �I Use other side for additional information. V �j /-� O J __ ' Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) � 4 dgp C 10 m h.v, ",I, �2e �z,crrc -�aLe P r Safety and Buildings Division County i 201 W. Washington Ave., P.U. Box 7082 ST. CROIX ! Ivisconsin M adison, W i 53707 - 7082 Sanitary Penn! Number (to be filled in by Co.) Department of Commerce (608) 261 x{20 (0 Sanitary Permit Application S'tatc Plan I.D. Number In accord with Cormn 83.21. Wis. Adm. Code., personal idl miatm you provide may he mad tit sewndary purposes Privacy Law, A 5.04(l)(m) Project Address (it differartthw mailing address) L Application Information— Please Print Ali Informatkm - - -- — Properly ottilter's Nance Parcel H Lot # Block 4 CARRIAGE HOMES XXI, INC. 648604 70 Prtrpetiy owner's Mailing Address Property Location 6750 STILLWATER BLVD. NE /, SW r,, s�;� 25 City, State T.ap Code Phone Number NO. STIL MN 55082 651 - 439 -2414 T 29 x; R 19(c irtw ) IL Type of Building (check all that apply) nr 2 Family Dw.Uiag Nnrraher ofBe oorras 4 B EDROOMS Sratxttvtston Name CSNt ltiva 1 U Publi uxoniinmaal _otwibet 2Q, _ SCENIC HILLS Sta O..A Drib. U— UCaty_ Livittage f hrownxl:ip of HUDSON III. Type of Permit: (Check only on box on lin A. Complete line 8 if applicable) s S, �Q [ q, e1 q(a `l! A. t y New System U Rep►acenem System ❑ Tr estrrtenaUdnig Tank Replwemad Only ❑ Outer Modification to Existing system I-st Previous Permit Number and Date blued R. n PtrmitRenewal U Permit Revision U Change of Pcrmit.'rransfertoNew Before Expiration Phtmber Owner IV. Type of POWTS S . tern: Check all that a i 15 P IODIFFUSER CHAMBERS AN ZABEL FILTER — OD 11 N. -Preac 6=d ]a- Cifuund L] Mound_ 24 in. ofsuitahle soil U Mound < 24 in. ofsuitable soil ❑ At -Gtadc Lj Single Pass Sand Pilttr Conwucsed wetland Ll IYessuriad in-cmour d L l iioi" •Pout U Peal F;ttw I I Aerabic - ftm n ent Unk Il Rmw"uting Sarxl t=amer Rwirnmlating Sytuhetic Media Filter U Izachingehamber U Drip Line U 6ravet -less Pipe ❑ (bher (,explain) - - -�� V. Dispersal/Treatment Area Information: Design Flow (Spd) i iLl. a Suit Application —n (Wdf) Dnpe l Area R;nR' t (ai) iliy,e I Area Pn jwv. tl (4) Sysden! Elevation 600 .7 1 857 882 1 90.85 VL Tank Info Capacity in Tout Number manufachuw - Prsi'ab site Steet Fitxa' Plastic talon (lapses ofiinirs Concrete Constructed Glass New ExistM TA,4s T-cs �enr`e�rrl °leIanF 1 1250 1 WIESER YES VII. Responsibility Statement i, fie tmdersigned, a worn � of the. ]POWYS straw■ an the attached plum. Plumh6 's Name (Print) Plum _ fM1'RS Ntanbtr FAmaitmcaa i'Mame Nmrmber TODD FEATHERSTONE 242514 715 - 381 -1704 Mumber's Addren (Street, City, Statc ` ode) P.O. BOX 4 67 - 368 TO ROAD - HUDSON, WI 54 VIIL u Cont tDe artment Use Onl _ .... - �Aperroved U Disapproved Sanitary Permit kee (includes Groundwater IYUe Issued Issuing Agent Signature (No Stamps) ZZS-� L� Owner Given Reason for Ihmrmiai -- IX. Conditions of ApprovaU for Disapproval e 1 m g cz. .off /.TZ Vfft _nn..••----__ - -� -- Attach cawpiru playa (te tore County ady) fw Qw system ao Few "less one alrz x11 inchmm in stmt • ruf.A4 SAX QtypZMif.Lil r .10 F: N. Z ;o Z aFed VqV OO:OV:6 :aural SOOZ /S /Z :a;ed NIA3N : 3NOlSa3Hld3d OOOl :waJj • •- z • Sit �+7!t1y� Mir si a "w I g o "7. Z �o z aped Wd OO Ob 6 aw!1 6002 /6 /Z :@4e0 NIAIA of 3NOMAH1H33 0001 :woJ3 From: TODD FEATHERSTONE To: KEVIN Date: 2/3/2003 Time: 9:40:00 AM Page 1 of 2 FACSIMILE COVER PAGE To :' KEVIN From : TODD FEATHERSTONE Sent : 2/3/2003 at 9:39:58 AM Pages : 2 (including Cover) Subject : REVISED PLAN LOT 70 THANKS, TODD ( O DD ' 6n �� ,e„ �S; &V-Q0 tb �� c f i vew CLCce S5 AKA L 1 r 6 Y , oot ro¢ . M . ♦ y v r y f 2 l f t "s,-� W ")consinl)epartrnent of Commerce SOIL EVALUATION REPORT page I of Division ofiSafety and Buildings in accordance with Comm 85, Wis. Adm. Code CW* C o i Attach complete site plan on paper sot less than S 1/2 x 11 i Plan must 5 Include, but not limited to: vertical and horizontal ptt Parcel I.D. percent slope, scale or dimensions, north arrow, a and distance to arest road. 0 � - /3 S - - 26 - COD Please Print all n. ; > by Date 1 Personal information You provide may be used for se oa e�y PaR+o l� " 6 1 ) (M))• Property Owner ju /^ Property ocautxi tot n/ F 1/4g,) 1/4 S ZS T Z q' N R R E (or)d@ Property Owner's Mailing Aiddress 4 y Cp4 M � Lart # t3bck # Subd. Name or GSNYf (CJ ZO S- � iIIWGr - 'fie WC'Ofifi �� S G ` City State Zip Code Phone ❑ Village Town Neared Road ►fit A. M 9Z_1 ( �"�i' lr�i ® New Construction Use: ® Residential i Number of bedrooms 3 - V Code derived design flaw fate DSO 1(o Q o GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material OU fc. J" Flood Plain ele�iation if ft- General comments S S yyL G ! e 0o, f.b /� - �X--�?T� Low e V a and recommendations: I �� Q �.� d ri d w 8 9, o v_ -�a 0,-7 -l a s 1f4e I is �- 0, F Boring ❑ Boring .S tic G�� G 0 � � S/. # (� pit Ground surface elev. D O fL Depth to limiting factor )1(p in Soli Application Rata Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. Coot Color Gr. Sz. Sh. - EfW - Eff#2 1 o -IZ ! 3 2m k lvr 5 8 Z IZ-3q. l0 LS S 3 32 - 11 — 1b , 4 r'+LP mS U ► I Z Borg # Boring F pit Ground s"ce elev. elf R Depth to limiting factor 1 g in. Soli ApAcation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDNF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. - Eff#1 - Eff#2 o -1 I l3 5L: Z b f [_ C- s s 1 n-,Gr _ 5 8 3 4 m I - 1 I- Z Effluent #1 = BOD > 30 _< 220 mg/L and TSS >30 150 mg/L - Effluent #2 = BOD < 30 mg& and TSS < 30 mg/L CST Name (Please Print) nature CST Number 14C 14 te r- J Z5 330 Address Date Evaluation Conducted Telephone Number ZII TM 5 m t - ei Lo I 5gn2 f - 5- Property Owner 4r k� !' Parcel ID # _ Page z of _ 3 Boring # ❑ Boring ® Pit Ground surfaceelov. S CO d ft. Depth to limiting factor J fro_ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 * E D--Ig 10 3 2-rnahk G r s } �q3 a V 422&La A z ❑ Boring C9. Boring # J ❑ Pit Ground surface elev. ft. Depth to limiting factor in. SoN ication Rate Horizon Depth Dominant Color Redox Description Texture Struc tuie Consistence Boundary Roots GPDNF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. *Ef "E F �� # El Boring ❑ Pit Ground surface elev. _„.,_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 " Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 1150 mglL " Effluent #2 = BOD < 30 mg/L and TSS _5 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 OL07l00) PAGE 3 OF�_ NAME ►4 Y` k e.� LO - LEGAL DESCRIPTIONAIE ' /,Sw'�<,SzsT� N R !4 E ( or) SCALE: 1 "= BM I ELEVATION lOO CU BM 1 DESCRIPTION ( I gip, - N BM 2 ELEVATION 4 -ic) Sec - Z S BM 2 DESCRIPTION d SYSTEM ELEVATION }a p Sl7 ° to w e gS• o 0 X _ IL ALTERNATE ELEVATION dvp Rl•od Lowcr �q 6 0 CONTOUR ELEVATION $ q• oo - I G - v o M v ►s Sr�s o i�0 �, 1 VD /1 kL4 S . 7 ✓ k O O l ,n 1 o , SIGNATURE ♦ s / 'J/ rM pa ON 0/11", vg/A'!ft ■ ��j�;;�ai ice; �� M o! IN, YAM , 41F Az LIM ��► ," 4 , 1� ,, • .. �, �!' I� � y � �: / / / / % /Iii r,, �� i � 0, ,♦ �/j Iii 1 � ♦ �j�@ "�i,� -: 1 � � ' � ♦ �/ % i, Iii ♦ i �%' I// 1 i �i aJ I/ % � �I �I, ii P ".el % 1 .. Ii G , , I I� 1 � Ii• •. %;'� / I /// /ii i �i� I,; ii ' Iii,• �. � yJi► �i� /, / /�G,�I��i� i +,t/ � � /��/ �% ��jlGi,✓ � Ii i� �► � , r- 1/ 1,/ 1:S51 rul �i, s,;, � I, / � -- ►/ ► yam,; ,,, ♦ i G� I %� / // ♦ice ■ �■ e � „ ■ - 1i �i �� —~ - �:� . - -, �l %.. �� .� _ ,�. �. `� ■ � � ��® �� _ -- �� -- --- �- -, '�i __ ��A� ■sue 1 _. � ■ ■ �� ■sue r� _ ...� ®�n� �� ■ ��, � ■ �� POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 1 of 2 FILE INFORMATION SYSTEM SPECIFICATIONS Owner CARRIAGE HOMES XXI INC. Septic Tank Cap sal ❑ NA " Permit # L+2.0 (e(a Septic Tank Manufacture(/VIESER ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms 4 ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units M NA Pump Tank Capacity al ❑ NA Estimated flow (average) 600 gal/day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) 600 gal/da Pump Manufacturer ❑ NA I ' Soil Application Rate 7 al /day /ft2 Pump Model ❑ NA Stated Influent /Effluent Quality Monthly average" Pretreatment Unit XCj1A Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter 0 Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetiand Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal CBII(S) ❑ NA Biochemical Oxygen Demand (BOD :530 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y Other: in dia. ❑ NA 2Q4A Other. WNA Other. ZrNA i "Values typical for domestic wastewater and septic tank effluent. Other: W NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month( ) s) (Maximum 3 years) 13 NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ mon 1(s) (Maximum 3 years) ❑ NA Clean effluent filter At least once every: ❑ month(s) ❑ NA Bgrear(s) Inspect um um controls & alarm At least once every: ❑ mo ye ar(s) ❑ NA Ins P pump, pump ❑ yearls) Flush laterals and p ressure test At least once every: 13 month(s) ye ar(s) E3 NA P ❑ yea r(s) Other; ❑ month(s) KNA At least once every: ❑ earls) Other: ONA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW 14/01) I Page 2 of 2 START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER R Name r ST. CR IX C OUNTY Phone -7� _ ��(�/ Pho e 715- 386 -4680 SEPTAGE SERVICING OPERATOR (PUMPER) L0C HO Name Name Phone I Phone This document was drafted in compliance with chapter Comm 83.220(b)(1)(d)WO and 83.54(1), (2) & 13), Wisconsin Administrative Code. i 1 ,•.v.. . .qtr. r- ,..r.�•:•�. . . J.....�.. . .... . - _ - _ - - - - -- v - .• 11 , 1 1 -4 ST CROIX COUNTY • SEPTIC TANK MARTMNANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwraerBuyer Mailing Address (e 75 13 lVd, A 5-11 !/u rz�. v vuk property Address c , (Verification required A& Planning Department for new constntation) City/Statc Parcel Identification Number G �� 0 L_ OAL DESCRIPTION' property Location t /4, y., Sec. _ ___ —. T N- R______W, Town of Subdivision 5 FN ! /S Lot # Certffied Survey Map # , Volume . Page # Warranty Deed o , Volume Z . Page # 2 P5 # (- V�� Spec house ❑ yes no Lot lines identifiable yes Cl no SYSTjM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance couaists of pumping ou t the septic tank every three years or sooner, if mcded by a Uccused pumper- What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal by die owner and by system - The perry a certification form, signed a pro owner agrees to submit to St. Croix Zarong Department masw plumber. journeyer plumber, testnetcdphtmber or a licansed purr vmifymg that (1) the on -cite wa9tewaterdi4XHW Ovt= iU Prager operatins oonditiou "&or (Z) after inspection and pvmnping CI' necessary). the septic tank is Tess than V3 firll of sludge. Ilwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with t& standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wiac=hL 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 ,three -r date. SI AT " OF APPLICANT DATE C1WWNEER CERTIFICATTIOh I (wc) certify m that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the propcgy descriiWd abo , by virtue of a warranty deed recorded in Register of Deeds Office. SJOK ATLrIM OF APPLICANT RATE Any information that is mis- represented may result in the sanitary permit being revoked by the Zoaing Department.' •* Include with this application. a stamped warranty deed from the Register of Deeds office a copy of the certified survey asap if reference is made in the warranty deed IN 1662PAGt.289 KATHLEEN H. WALSH Document Number Document litle REGISTER OF DEEDS ST. CROIX CO., WI t RECEIVED FOR RECORD 06-18 -2001 12:45 PH }:.. WARRANTY DEED EXEMPT N CERT CORY FEE: COPY FEE: TRANSFER FEE: 9900.00 RECORDING FEE: 14.00 ' PAGES: 3 Recording Area Flame and Return Address t..at,-1. T; Ole, I � . • IVc,,,s 13 r ;�1�,n MN dZo 10 - - 7 0 o v Parcel Ideutitication Number M 02- 0 ! vGy -Ci a - C) C) C7 Z 0 - i s '7 0 - C3 o - Cx00 020 _ lL) 7o " v " 0 00 0 - )e 7U -7 0 - "THIS PAGE IS PART OF THIS LEGAL DOCUMENT - DO NOT REMOVE" This information must U eompletod by subminet: doa tcstt tine, name ,& return address, and PIN (uf required). Oducr information such at the granting clauses, legal descript ion, ere. may be plated on thin first page of die doewnrnt or may be plated on additional pages of the doctmtaru ore: Use of dds cow page adds one page to your docummi and $ 2.00 to the rceor nr fee. Wueontin Stawei, S9.SI Z WRDA 2196 DOCUMENT NO. � xrAxumAmnY DEED � ~ or^rsorWISCONSIN-FORM y � /. �� " � ^ - &�&�^� VOL � u�K��~R�"� 29 THIS ` n"= °~^"" RESERVED FOR RECORD ="^ � THIS INDENTURE, Made ' --_"~ . / [ . RICHARD N IE0RS00 and JEAN M �� —'--'''�--_''''''--'--'_---- PEARSON, husband and —/. w1�e�_ COPY --------'----'--------'----'' -------'--------'----'-'--'--- '----�--'--------------�------_--.---.-.---.--..--------.-'_-.. of St' i . ....................................................... Wisconsin, hqreby conveys and warrants to C�}��IA{�� HOMES X%I INC., a |� �l��c�� —'--'---------------'---------! .. ...�'��'�'��'��'�'�.��.��.��'�� ! ---'---- | { �c_-- of Og�-Dg -..-- _($_-��)_' . .�� County, - �� - ^��^ valuable ^( Tif/\� --'-----''---''|' .�,/uer � ----------'----''-''---'--'''---'---'-|('-'' ' ��u ---__._--.--_._---''--'-_-----_----''___________.__.i � r � / �� U Uze following tract f land i |Jt CKg�X . County, Wisconsin: '��'��.�t��.�Kk}[tb��5t'��t�� 0�,) of the Southwest Quarter (SWI-,) of Section Twenty-Five (25) , Township Twenty-Nine (29) North, Range Nineteen (19) West, St' Croix County, Wisconsin, except Lot One of Certified Survey map filed June 29, 1994, recorded in volume lO, Page 2782, St. Croix County Register of Deeds, as Document 0o. 518444. See Attached Exhibit A � Parcel Identification Number � .| ' i / ! | ' i ' |. / ' ' , | ! � This is not homestead property ! In Witness Whereof the said gmotoc.§- 6aYl�...... 6*zcuoto set --- their.—.. 6xud.§ .- and ocul§i'' this ............................ 6uv of M'�Y-'_--'—._--- A. D.. XK.'Z&Dl SIGN AND SE N PRESE � O (SEAL) `.~.~ � -----'-' - m. e�au�um __�___�_____ (SEAL) � _---' (SEAL) ' -_-��--------�_---' / of -- .................. . � Personally came before me, &is. day of .�/ ��--'-` A. D, X)( ZQ01 Vol. .1662PAGE 271 EXHIBIT A Parcel Identification Numbers 020 - 1069 -70 -000 020- 1069 -80 -000 020 - 1069 -90 -000 020 - 1070 -00 -000 020 - 1070 -10 -000 020 - 1070 -20 -000 w LL Q !I 3N1 Mt Hlf%7Q• HNON ` 1['Slfl � 3 0!6 $ ki ar v R W . • c _ • e �MAONTMF& at a i I � : Moo•�rarwzas.�n � � / 4V PIN 1t sev_ _ Av • ......... ��• �°ri!�` O ` ` • soar sa Mom" �. v •\ 1 � I 1 Hs s .'10 a I9ffHS ffJS I �