HomeMy WebLinkAbout020-1168-20-000 Wisconsin gepartment of Commerce County:
PRIVATE SEWAGE SYSTEM St. Croix
Sitfety and'3uilding Division
INSPECTION REPORT Sanitary Permit No:
383819 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:
B'ornstad, Dennis I Hudson Townshi 020 - 1168 -20 -000
CST BM Elev: Insp. BM Elev: BM Description:
90 1 1(11 ,90 1 p-c
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic I Benchmark
�w OCR 6 z• ys 3 e 9 d
Dosin Alt. BM
Aeration Bldg. Sewer
Holding St/ t Inlet
� qs 3
TANK SETBACK INFORMATION sU t Outlet
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic , , S� q Dt Bottom
Dosing- Header /Man.
I 'y 96
Aeration - Dist. Pipe L T. qy
- � 9,t�8
Holding Bot. System v/e
le .v
�, /
PUMP /SIPHON INFORMATION Final Grade t 46 q
M ufacturer Demand St Cover
Model Number
TDH Lift riction Loss System Head TDH F
For main Length Dia. Dist. eII
SOIL ABSORPTION SYSTEM s a C'L
BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS zJ 6Z � 3
SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM G Manufacturer.
INFORMATION C A OR S
Type Of System: IT
i
5-2,5- Model Numb
DISTRIBUTION SYSTEM
Header /Manifold Distribution iz le x Hole in Vent to Air Intake
x Ho Size S pacing 9
u a
Pipe(s) /J "' r f
Length Dia 1 Length 6L•.S Dia Spacing % � �S
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over Depth Over xx Depth of eeded /Sodded xx Mulched
Edges Bed/Trench Center Bed/Trench Ed ITopsoil xx S 9 IR Yes 0 No ' Yes :E]:No]
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 8 /4/ 0 / Inspection #2:
Location: 1060 Cottonwood Drive Hudson, WI 54016 (SE 1/4 NE 1/4 12 T29N R20W) Ranchwood Lot 3 J Parcel No: 12.29.20.1040 /
1.) Alt BM Description =46 0 r Wed SY (c+— G
2.) Bldg sewer length = 1 / 0 - / 5 Z I
- amount of cover = 7 3 r D v d;y-
Plan revision Required? Yes V No
Use other side for additional information. Ute SBD -6710 (R.3/97) a Insepctors Signature Cart. No.
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►o6t.� Co 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* Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302
Department of commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not
state owned.)
Attach complete plans (to the county copy only) for the s stem on paper not less than 8 -1/2 x 11 inches in size.
County State Sanitary Permit Number ❑ � i reri o vious application State Plan I. D. Numbe
- —v`
I. Application Information - Please Print all Informatio ,a >, Location:
Property Owner Name - ki r r �* ; t. ( Property Location /
(('�' � J\ .1'.'+--
4•J
h 1A "`;" 5 G 1/4 /l�C 1/4, S I` T ,N,X (or) W
Property Owner's Mailing Address 5 " t tir.' +i Lot Number Block Number
t c • j 4
City, State Zip Code Phon Subdivision Name or CSM Number
7C � „ r
II. Type of Building: (check one) ❑ cit
RL 1 or 2 Family Dwelling -No. of Bedrooms: ) ❑ Village
❑Public /Commercial (describe use):_
Town of
❑ State -Owned UD jCj1�
Nearest Road
P-
3 %3 Parcel Tax Numb er(s) W 2c _L )
III. Type of Permit: (Check only one box on line A. Check box on 1' e B if applicable) la . Z9 , aa, I D L}o
A) 1. kNew 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to
System System Tank Only Existing System
$) 7��er Date Issued
❑ A Sanitary Permit was previously issued
IV. Type of POWT System: tCheck 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 0 Recirculating ❑ Other:
V. Dispersal/Treatment Area Information: ✓ a�
1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate ys m evat n 1 7 Final a e
^� Requi}red�/I^g Proposed Rate (Gals. /day /sq. ft.) �y�r Elevation
C/• Cd�J J ! C Ami ' ( r — 93 70 r
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 ❑
VIII. Responsibility Statement
I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (print) Plumber igna a (nos p MP o. Business Phone Number
�. /� ° ► _err -
Plumber's Address (Street, City, State, Zip Code)
tl1(,
IX. County/Department Use Only
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps)
)&Approved ❑ Owner Given Initial Adverse Sarge Fee)
Determination 12A S. M z — I l — Z6to
X. Conditions of Approval /Reasons for D' p roval:
SBD -6398 (R. 07/00) �����4 5�5 5S` oe(1iti2ezJ-0 Cook .
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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 7 of
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code "
County i C ad ll S4
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 I tion and distance to nearest road. G �G - Its (� _G CTO'
r., .
Please print a (i{t�rr► Reviewed by Date
Personal information you provide may be us o ,` eCondary purposes v w, s. 15.04 (1) (m)).
Property Owner �� AR Property Location
Govt. Lot - S )r 1/4� J^ �
1/4 S'� T N R� or) W
Property Owne 's Mailing Address --+ c � y ' � Lot # Block # Subd. Name or CSM#
/ ?.��� � j�� riCS'lWcUcc
City State Zip Cb'de P '� ❑ City ❑ Village [Town Nearest Road
New Construction Use: Residential / i40mber of bedroom - Code derived design flow rate d ®d GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material T L * Flood Plain elevation if applicable ft.
General comments // 7
and recommendations: � ;,Y e,t -- tl ' T 141 a/ 0 K I k r
G q e i� D �Cc e ors.
® Boring # ❑Boring � < -%"► GC[ a� rN �e
IR Pit Ground surface elev. J " ft. Depth to limiting factor 0 4-P - in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
S`G
Boring # ❑ Boring q
[I Pit Ground surface elev. / ft. Depth to limiting facto in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2
&rn Sb L'S v 3'
2 3 ni 1cr Cl- - Z
* 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 Signaturp CST Number
Add ss 4 Date Evaluation Conducted Telephone Number
/�j -� SS✓ .�� ew/. 7S- y�-jo��
SBD -8330 (R07 /00)
Property Owner 1 1 ✓L S Parcel ID # Page of
Boring # ❑ Boring
P Pit Ground surface elev. 6- -50 ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
6 r - /1 1 o, " �� ` zrn ` S-
-5Z
-
-
F] 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 /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
❑ 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 /ft
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.
SBD -8330 (R.07 /00)
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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I_ of
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code County
St. Croix
Attach oomplete site plan on paper not less than 8112 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 020 - 1168 -20 -000
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all.ln "a o i.` Reviewed by Dare
Personal information. you Provide maybe used ;,d Purposes {Pr�va¢Si LBrv, s. 15.04 (1) (m)). z — ((—
Propertyowner Irk
(► RropertyLocation
i fC U SE v4 NE
114 Sig, T 29 N R 1 g (or) W
David Swanson vt Lot
Property owner's Mailing Address C f ) FLoj # Block # Subd. Name or CSI#
658 Galahad Rd. N. tip 2(i(j na Ranchwood
City State Zip C rx In City ❑ Village ® Town Nearest Road
Hudson, WI. 54 * x `7 Hudson, Cottonwood Dr.
® New Construction Use: ® Residential mt�ei?�!Z t Code derived design flow rate 4 GPD
❑ Replacement ❑ Public or slcdb ��
Parent material glacial ciri ft Flood Plain elevation If applicable _ ft•
General comments
and recommendations' trenches 4.00' below grade spaced to code
Boring # ® pit Ground surface elev. 98 it, Depth to limiting factor +8$ in. � icatlon Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP
in. Munsell Qu, Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2
1 0 -7 10yr3 /3 none 1 2msbk
2 7 -22 10 r4/4 none scl 2msbk mfr qw if .4 .6
3 2 7.5yr4/4 none scl 2fRl mfr yw na .4 .6
4 43 -88 7.5 r4/4 none sl 2msbk mfr na na .5 .9
44
2] Boring # ❑ Boring
2 Pit Ground surface elev. 98.90 R, Depth to limiting factor +86 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDIff
in. Munsell Qu. Sz Cont. Color Gr. Sz. Sh. 'Eff#1 •EW2
1 0 -7 10yr3 /3 none sl 2mgr mvfr gw 2f .5 .9
2 7 -14 7.5 r4/4 none scl 2msbk mfr gw if .4 .6
3 14 -86 7.5 r4/4 none ms Osg mvfr na na .7 1.2
p q.
r•Z r
•
Effluent #1 = BOD > 30 220 n1g1L and >30 < 150 mglL j ei , Effluent #2 = BOD < 30 mg& and TSS 1 30 m g1L
CST Name (Please Print) Sig CST Number
Gary L. Steel 02298
Address Date Evaluation Conducted Telephone Number
1554 200th. Ave., New Rich mond, WI. 54017 8 -30 -2000 715- 246 -6200
Property Owner D. Swanson Parcel ID# 020 - 1168 -20 -00 Page 2 of 3
Boring # El Boring
3 ® pit Ground surface elev. 100.4 ft. Depth to limiting factor +86 in.
Soil kvicatlon Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. MunseN Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 +Eff#2
1 -10 10yr3 /3 none 1 2msbk mfr gw .5 .8
2 0 -31 7.5yr4/4, none sici 2msbk mfr crw if .4 .6
3 1 -86 7.5yr4/6 none fs /sl 2msbk mfr na na .4 .6
B-3 3tratifted
i
# ❑ Boring
F4]Bodng ® pit Ground surface elev. 100.8 ft. Depth to limiting factor +86 in. Sob Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlff?
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Efi#2
1 -11 10yr3 /3 none 1 2msbk mfr gw 2f .5 .8
2 11 -38 7.5yr4/4 none sici 2msbk mfr gw if .4 .6
3 8 - 86 7.5yr4/6 none fs /sl 2msbk mfr na na .4 .6
F5� Boring # Boring
Q pit Ground surface elev. 96.40 fL Depth to limiting factor +84 in.
Soil ADMIcation Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDR
in. MunseN Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 0 -8 10yr4 /3 none T 1 2msbk mfr 9w 2m .5 .9
2 8 -30 7.5yr4/4 none scl 2msbk I mfr 9w if 1 .4 .6
3 30 -84 7.5yr4/4 none is Osg mvfr na na .7 1.2
wt q . qO
36
Effluent #1 = BOD > 30 < 220 mglL and TSS >30 < 150 mglL ' Effluent #2 = BOD < 30 mglL and TSS < 30 mglL
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
negd material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608- 264 -8777.
SBD4330 (RAM) ` _ -
STEEL'S SOIL SERVICE
Gary L. Steel David Swanson 1554 200th Ave.
CSTM2298 SE4NE4 S7 T29N - R19W New Richmond, WI 54017
MPRSW -3254 town of Hudson (715) 246 -6200
lot #3- Ranchwood
✓`l " =40 '
top of 1 pvc pipe C el. 100.00'
t. B .= top of 1 pvc pipe @ el. 101.90'
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Gary L. Steel
8 -30 -2000
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 83 g7
Number of Bedrooms
Design Flow - Peak (gpd)
Estimated Flow - Average (gpd) aD
Septic Tank Capacity (gal) cxSD
Soil Absorption Component Size (W)
Type of Wastewater DoYnestic
Table 2: Soil Absorption Component - Limits of Reliable Operation
Septic Tank Component Soil Absorption Component
Design Flow - Peak (gpd) tr� •Z Nt
Maximum Influent Particle Size (in) U 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 se nk and outlet filter shall be assessed at least
once every 3 years by inspection. Th outlet fi er shall be cleaned as necessary to ensure
proper operation. The filter cartridge sh not be removed unless provisions are made to
re ain so i s 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 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
flow.
3
r— -
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP C'- RTIFICA T IO FORM
Owner/Buyer ► S - r ,�
Mailing Address Lo J.
Property Address 4 4 W aD ;
// ll (Verification required from Planning Department for new construction)
City/State `/ Parcel Identification Number �� ��(o U � d " 0 w
LEGAL DESCRIPTION
Property Location ' /.,' /., Sec., TN - W, Town of
Subdivision 61 Lot # 3
Certified Survey Map /# Volume , Page #
Warranty Deed # 3 c/5
Z . Volume SJ Page #
Spec house ❑ yes A no Lot lines identifiable A yes ❑ 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 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.
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
da of a three year ex iratio date.
/l3 /ADD
SIGNATURE LICANT DATE
OWNER -
ERTIFICATION
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
th rty described a ve, b virtue of a warranty deed recorded in Register of Deeds Office.
l/ l3/ ion
SIGNATURE OF LICANT 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
l
1564 76
• STATE BAR OF WISCONSIN FORM 2 - 1999 Es34571
KATHLEEN H. WALSH
Document Number WARRANTY DEED REGISTER OF DEEDS
ST. CROIX CO., WI
This Deed, made between David R. Swanson, a single person, RECEIVED FOR RECORD
and Rebecca L. Swanson, a single person, divorced and unremarried, 12 -01 -2000 2:30 PM
WARRANTY DEED
Grantor, and Dennis Bjornstad and Teresa Bjornstad, husband and EXEMPT D
wife, CERT COPY FEE:
COPY FEE:
TRANSFER FEE: 126.00
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
L 3, Plat of Ranchwood, St. Croix County, Wisconsin.
Name Zllz, Est �O &LAND
P.O. BOX 359 Ogland
Hudson, W1 54016
020 - 1168 -20 -000
Parcel Identification Number (PIN)
This is not homestead property.
CK) (is not)
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any.
i�
Dated this 3 day of der , 2000
V ��
* David R. Swanson * Rebecca L. Swanson
*
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) David R. Swanson, a single person, and Rebecca L. STATE OF WISCONSIN )
Swanson, a single person, divorced and unremarried, ) ss.
lI N&-�� (ems County )
authenticated t 's l 3 day of September 2000
Personally came before me this day of
the above named
r Kristina Ogland
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, to me known to be the person(s) who executed the foregoing
authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same.
THIS INSTRUMENT WAS DRAFTED BY
Attorney Kristina Ogland Notary Public, State of Wisconsin
Hudson, WI 54016 My Commission is permanent. (If not, state expiration date:
(Signatures may be authenticated or acknowledged. Both are not necessary.) 9 )
* Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals c ompany, Fond du Lac, vw
STATE BAR OF WISCONSIN 800-855 -2021
WARRANTY DEED FORM No. 2 - 1999
1 4 5b "'W _ I � �AA� \ \•1PS 89 ° V Z N 1.13'47W
W
33.06
0.00'
S 86 11'5d�W 75. 0 151.19
122.51' 182.13
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53,294 S.F. 0� Z S� tr
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16 a'. 6 to 1 0 > 19 a
'0 62,842 S.F. bp. 34,207 S.F.
1 83.71' 2 N 75°0�oo " •� '� Z
T W N 86°16s5'g' "W9,830 S : F . j 40
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23 �ss; 0 ? ,� °O�'2 "E Zg . i 19 2 . 97
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725.00' (D: 133.13 120.05
N 89004'17 go 758.00
INE OF THE NE 1/4 33.00 33.00'
TED LANDS
POINT OF E 1/4 CORNER SOU
BEGINNING SECTION 12
I T29N,R20W
1
7 �
�y \ EDGEWOOD E _II_
S87-48 12" W 2561.16'
971.07
78. 42 222.08' 100.00 100.00 100.00 ; 100.00 100.00
' ® y�� i� 15,
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40 (D 0 39 0 38 0 3 7 0 36 0 35
ro '. 29,381 S.F. _ M 21,486 S.F. wj 21,503 S.F. 21,503 S.F. bi21,503 S.F. 10 21,503 S.F.
N N N N N N
.� Z
15'
73.75 100.00 100.00' :100 100
..�. .\ 6 n S 87 W �i�r�u 555.08