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028-1029-80-100
Parcel #: 028 - 1029 -80 -100 12/08/2006 08:51 AM PAGE 1 OF 1 Alt. Parcel #: 24.28.17.183A -10 028 - TOWN OF RUSH RIVER Current ' X I ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 10/21/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner TODD A & ELIZABETH A DOORNINK O - DOORNINK, TODD A & ELIZABETH A 2069 30TH AVE BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 0231 BALDWIN - WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 9.999 Plat: N/A -NOT AVAILABLE SEC 23 & SEC 24 T28N R1 7W PT SE NE SEC Block/Condo Bldg: 23 & PT SW NW SEC 24; COM W 1/4 COR SEC 24; TH S 89'W 440.96FT TO CTR LN CTY RD Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) Y; TH NELY 25.51 FT; TH CONT ALNG CTR LN 23- 28N -17W SE NE N 18' E 244.41 FT; TH N 89' E 1672.73 TO 24- 28N -17W SW NW E LN SE(S /B SW) NW SEC 24; THS 00' E more Notes: Parcel History: Date Doc # Vol /Page Type 10/21/2004 777627 2680/137 WD 07/23/1997 913/422 07/23/1997 742/108 07/23/1997 729/584 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 166117 Use Value Assessment Valuations: Last Changed: 05/19/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 35,000 268,900 303,900 NO AGRICULTURAL G4 4.999 800 0 800 NO UNDEVELOPED G5 2.000 3,500 0 3,500 NO Totals for 2006: General Property 9.999 39,300 268,900 308,200 Woodland 0.000 0 0 Totals for 2005: General Property 9.999 1,600 0 1,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 � } � o m ce Z 7 � %�• � . � k ƒ ;a E \ §\2; 7 G\ /§\ ? z Q Cc , 5 � 2(D LL_ 0 Ak§Q ■ tC:2a =0 00 m < Z m r- . \ / % a ■ $ $ \ z t % } 2 � § ED Cl) \ z z / � $ � t \ r k k k 0 2 o a ) § I \k zz E z :c z a a a % g m Ln Ul) ca � ■ � Q � � S B 2 � 2 / D co c I � , o'er § ° § k . $ c o= R E� k 1 J E § § § k C n )\ 2 7 2 % k f E§ I ¥{ f 0 - \ ) �k 0 2 / \ e 2 2 § . .. cd E $ S? c a § cool J a 2 3 3 J Parcel #: 028 - 1029 -90 -100 12108/2006 08:37 AM PAGE 1 OF 1 Alt. Parcel #: 24.28.17.184A -10 028 - TOWN OF RUSH RIVER Current X_', ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 10/21/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - JON -DE FARM INC JON -DE FARM INC 2061 30TH AVE PO BOX 144 BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 0231 BALDWIN- WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 9.999 Plat: N/A -NOT AVAILABLE SEC 24 T28N R1 7W PT SE NW COMM N 1/4 COR Block/Condo Bldg: SD SEC 24; TH S 00'W 1323.31 FT TO NE COR SE NW & POB; TH CONT S 00'W Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 330.92FT; TH S 89'W 1316.07FT; TH N 00' 24- 28N -17W SE NW W TO N LN SE NW; TH N 89'E 1316.35FT TO POB (9.999AC) EZ -1- 1190/056 Notes: Parcel History: Date Doc # Vol /Page Type 02/27/2006 819350 WD 03/02/2005 788576 2757/337 WD 10/21/2004 777628 2680/139 WD 09111/2003 739643 2407/49 V 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 166119 37,500 Valuations: Last Changed: 04/12/2006 Description Class Acres Land Improve Total State Reason PRODUCTIVE FORST LANDS G6 9.999 35,000 0 35,000 NO 04 Totals for 2006: General Property 9.999 35,000 0 35,000 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 0 0 0 Woodland 9.999 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 0 i o Cc, m V 7! CD k 0 z 0 4L z -4 0 co K) =r ID :3 g CD 1 2 3 CD 00 co CD to 3. 0 C) 0 ■ - 0 CD OD (D a 3 U, -4 o co z > F� 0 CD > r- 0 _0 03 CL 3 v lo 0 0 CD "Alm CL 0 o -< 0 0 0 X : cn U) M 3 T M 3 0 0 o -V z ■ ■ (D > 0 cr T a J ii CD z z > > o 06 (D CD 0 a 3 z CD -4 CA ii: z 0 ;a 0 + z 0 a CD G) 0 0. CD OD CL g Z ;o X 0 z -4 Iq z m 3 z > - 0 8 0 JR 2. n CD CD : ;:W . . . C M M - om a 0 C 5 . 0 z C w 063 0 E — i =r c CD r (D co U) CD (D 9 = ) CD o m CL CD CD 0 CD ID @ CCDL C L U) 'a CD (D w > \ 9D 0 CL 0 te 0 C, Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division t. INSPECTION REPORT sanitary Permit No: „ 479213 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: Doornink, Todd I Rush River, Town of CST BM Elev: Insp. 8M Elev: BM Description: Section/Town /Range /Map No: / VV� 24.28.17. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic J ,/� J �, n� S /Z4a) Benchmark . 71q Q7,q` Dosing `7 K Alt. BM r 0<<05 ewer 11''6 9 / . 3 Holding Q � SVHt Inlet 13 9 � , 0 � � TANK SETBACK INFORMATION St/Ht Outlet �— TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet �- Septic t j Dt Bottom > / AA — 457 57 1 .73 90 - 2 Dosing 7 / 4 57 ' Header /Man. -7•6 J66 4L-; Aeration Dist. Pipe -7.6% 1 /m .,3'9 Holding Bot. System -,, % 7.75 9 4 '71 Final Grade a 161 11 4 ( 4P d.bs PUMP /SIPHON INFORMATION COQ Manufacturer Goa GP ^a nd St Cover G „ i Z c Z fa Model Number PC , i ( Z.Z. 24 y- o ,, 1 3,46 99 � 0 to TDH Lift Friction Loss System , Head ,Co Head TD Et y, ?3 b, 39 6b Forcemain Length ; Dia. it Dist. to Well ,,, , I SOIL ABSORPTION SYSTEM BED/TRENCH Width i Length No. Of ench PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 07 p _-7 '�-- "� SETBACK SYSTE TO � - L+ P/L JBLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION e stem: i CHAMBER OR Type Y ' � _ i� , I n UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold i li Distribution r� i x Hole Size x Hole Spacing Ven Air I ake (� P O 111 Length W Dia , /� Length �� T 6 Dia , Spacing 3 $ / 6 v SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over i Depth Over xx Depth of xx Seeded /Sodded j xx Mulch d Bed/Trench Center ' 7 �r. Bed/Trench Edges Topsoil t J s I No s k fl No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / 1 d S Inspection #2: Location: 239 County Y Unknown ( SW 114 NW 1/4 24 T28N RI 7W) NA Lot 4 c O Parcel No: 24.28.17. 1.) Alt BM Description 1� 2.) Bldg sewer length = 76 - amount of cover = ' S �_ 36 7 �g Z L l 7 qZ � Plan revision Required? _I Yes /O (lb S i Use other side for additional information. �_._..__ _. _ _ L_____ 4Signre Date Ins Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division County M m 201 W. Was ' Ave., P.O. Box 7162 t. Croix ponsin Madi 53707 - C(� Sa 'tary P t Numb 2 be filled in by Co.) Department of Commerce G.i r Sanitary Permit Applie n s X00 Stat plan LD.Number ! D. 5 1 _ tt- f In accord with Comm 83.2 1, Wis. Adm. Code, personal i ati you p 1 , 3 X17 may be used for secondary purposes Privacy Law sl )(m) duN ojec Address (if different than mailing ad I. Application Information - Please Print All Information Z�N�NG Y2� Property Owner's Name Parcel # Lot # - t .►-c Block # _ �Y , Todd & Liz Doornink Property Owner's Mailing Address Property Location 2069 30th Avenue SW NW City, State Zip Code Phone Number / +, ' / +, Section 24 Baldwin, WI 54002 715- 684 -2461 28 1 7 (circle one) (� c� T N; R _ft II. Type of Building (check all that apply) $ t l.I� IMF ✓ 1 or 2 Family Dwelling – Number of Bedrooms 4 Subdivision Name CSM Number Public /Commercial – Describe Use ❑ State Owned – Describe Use 0Cityj[:1VilIageE1rownship of Rush River III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. Il New System ❑ Replacement System ys ep ys ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System I B. 11 Permit Renewal 13 Permit Revision ❑Change of ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber I Owner t( 1 �f IV. Type of POWTS System: Check all that ap 1 X f¢ — ❑ Non – Pressurized In- Ground © Mound > 24 in. of suitable soil 0 Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter 11 Constructed Wetland ❑ Pressurized In- Ground ❑ Hording Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ® Gravel -less Pipe Q Other (explain) / V. Dispersal/Treatment Area Information: — tD Z. M Design Flow (gpd) Design Soil Application Rate(gpdsf) ispersal Area Required (sf) Dispersal Area Proposed (sf) ystem Elevation 600 0.6 0, 3 U4) 7 600 600 102.5' VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units /(( f l` Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 1200 1200 1 Weiser x Aerobic Treatment Unit Dosing Chamber 800 800 1 Weiser x VII. Responsibility Statement - I, the undersigned, assume respgosiollity for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's 'gnature MP/MPRS Number Business Phone Number Roger Nelson MP226497 715- 273 -4444 Plumber's Address (Street, City, State, Zip Code) IV 122 East Summit Avenue Ells orth, WI 54011 VIII. County/Department Use Onl El Approved El Disapproved Sanitary Permit Fee 'ncludes Groundwater Date Issued Issuing A t Signature (No S ps) Surcharge Fee) 11 Owner Given Reason for Denial IX. Conditions o ppr v easons for Disapproval _ SYSTEM OWNER: 3) -�- 1 Septic tank, effluent filter and dispersal cell must all serviced / maintained �V✓ U_ t� (�-r -lL -2f� as per management pl provided by plumber. .. vow J 2. All setback requirements must be maintained as per applicable code /ordinances. Attach complete plans (to the County only) for the system on pT not less than 81/2 x 11 inches in size / SBD -6398 (R. 01/03) VL /LVV7 VL.Jo rnn f10 4(d V444 NLLSUN 10005/005 D e tag'` W e, s r. Ta. k I � e at 5 W 5oe .. O WELL :, �- � � - Q � �t�rd o•ti Aws �� Todd fiaoen, n •1 z z6 7 D O ef a� APR -12 -2005 16:28 FERGUSON ENT HUDSON 715 386 6144 P.01 HGOULDS PUMPS Submersible Effluent Pump PE " 'E'NT Pump a•� SPECIFICATIONS MOTOR FEATURES Pump — General; General: ■ Corrosion resistant • Discharge: 1''A" NPT • Single phase construction. • Temperature: 104OF (40 0 U • 60 Hertz ■ Cast iron body. maximum, continuous when • 115 and 230 volts N Thermoplastic impeller and fully submerged. • Built -in thermal overload pro- cover, • Solids handling:' /," tection with automatic reset ■ Upper sleeve and lower maximum sphere, • Class B insulation. heavy duty ball bearing APPLICATIONS float Automatic models include a • Oil- filled design. construction. float switch. • High strength carbon steel ■ Motor is permanently Specially designed for the • Manual models available. shaft. lubricated for extended following uses: • Pumping range: see PE31 Motor: service life. • Mound Systems performance chart or curve, • .33 HP, 3000 RPM ■ Powered for continuous • Effluent/Dosing Systems PE31 Pump: • 115 volts operation. • low Pressure Pipe Systems • Maximum capacity: 53 GPM • Shaded pole design ■ All ratings are within the • Basement Draining • Maximum head: 25' TDH PE41 Motor working limits of the motor. • Heavy Duty Sump/ PE41 Pump: • .40 HP, 3400 RPM ■ Quick disconnect power Dewatering •Maximum capacity: 61 GPM • 115 and 230 volts heavy duty cord, 20' standard length, hea 16/3 SJT with • Maximum head: 29' TDH • PSC design hea or duty volt grounding PE51 Pump: PE51 Motor. plug. • Maximum capacity: 70 GPM • .50 HP, 3400 RPM ■ Complete unit is heavy duty, • Maximum head: 37' TDH • 115 and 230 volts portable and compact. METERS FEET ' PSC design ■ Mechanical seal is carbon, 40 r. _ ceramic, BUNA and stainless PE5ii MODELS: K31, reoti, FE5T steel. i I 35 HP:33, . ao, so ■ Stainless steel fasteners, 10 2 GPM I i 3 AGENCY LISTINGS r i 1 FT I s 25 U I I ` I I ! 1. L• i' i I' � I I .i.. i i i i I• C US c 20 i ..i . i ... F i . 1- . _ ; I Tested to UL 778 and i I I CSA 222108 Standards 0 15 I I - j I i ' - -r— - I ' av cx, Sbndv& nssoa, ' I I File #LR365U9 11 ' • + I �� I i 10 —' ,.� ____1.� � i I I • I i I � • ,� � I Gourds Punps is ISO 9001 Registered, ' I •j I i 1 I _ i 5 ' I• i I I j l j I I I I I _ i • ° ,III i 0 10 20 30 40 50 60 70 GPM 80 0 5 10 15 m Goulds Pumps ® 20" nT Water Technology, Inc. CAPACITY Effect "e'""e Zooa "E31/41 <& ITT Industries " Safety and Buildings commerce.wi. OY 4003 N KINNEY COULEE RD g LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i scO n s' n www.commer isco goWsb/ Department of Commerce www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary March 02, 2005 CUST ID No.226497 ATTN: POWTS Inspector ROGER D NELSON ZONING OFFICE NELSON PLUMBING ST CROIX COUNTY SPIA 122 E SUMMIT AVE 1101 CARMICHAEL RD ELLSWORTH WI 54011 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/02/2007 Identification Numbers Transaction ID No. 1113777 SITE: Site ID No. 695347 Todd & Liz Doornink Please refer to both identification numbers, County Road Y L above, in all correspondence with the agency, Town of Rush River St Croix County SW1 /4, NW1 /4, S24, T28N, R17W FOR: Description: Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1006534 Maintenance required; 600 GPD Flow rate; 32 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual -Version 2.0, SBD- 10691 -P (N.01 /01); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(1.0), Wisconsin Statutes, is responsible for compliance with all code requirements. CnuditA No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, stats. APP RN The following conditions shall be met during construction or installation and prior to occupancy or use: DEPARTMENT OF � OF FTEY Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE CORRESF "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /01) and the SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST (0 1/8 1) • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat I ROGER D NELSON Page 2 3/2/2005 • Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard, • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101. 12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 ' Fee Received $ 175.00 r Balance Due $ 0.00 Charles L Bratz 1 POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz @commerce, state. wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 I c MOUND AND PRESSURE DISTRIBUTION COMPONENT DESII� 8 Residential Application INDEX AND TITLE PAGE Project Name: 4 bedroom Mound system Owner's Name: Todd & Liz Doornink Owner's Address: 2069 30th Avenue Baldwin, WI 54002 Job address: Cty. Y Legal Description: SW 1/4, NW 1/4, S 24, T 28, N R 17 W Township: Rush River County: St. Croix Subdivision Name: Lot Number: Block Number: Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank ; Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications ;ENO A ERI Page 8 Plot Plan �"�os Designer: Roger Nelson License Number: MP 226497 Date: 02/23/05 Phone Number: 715 - 273 -4444 Signature: — [A 4 /1, 1,; ��— Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 4.0 (R. 04/03) Pagel of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 83 -44 -3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of <= 36 inches. 600.00 Design Flow (gpd) 13.50 Site Slope ( %) 102.00 Contour Line Elevation (ft) 32.00 Depth to Limiting Factor (in) 0.60 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 67.001 Dispersal Cell Length Along Contour (ft) = 8.96 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest oint in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) a Center or End Manifold 2.99 Lateral Spacing (ft) If N above, enter the elevation (ft) 3 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 3.75 Estimated Orifice Spacing (ft) = 11.12 ft /orifice 2.00 Forcemain Diameter (in) 20A0 Forcemain Length (ft) Does es the forcemain drain back? Y � 92.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 3.26 Forcemain Drainback (gal) Void Volume al � 40.04 5x o d (gal) � 10.17 Vertical Lift (ft) 0.22 Friction Loss (ft) 43.30 Minimum Dose Volume (gal) 7, 16.89 Total Dynamic Head (ft) 22.24 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options cho i ce in. dia. options choice 0.75 1.25 x 1.00 x x 1.50 x x 1.25 x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallons /inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1200.001 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Weiser 800 - 325 -8456 1 Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.00 Dose Tank Capacity (gal) lZabel 1- 800 - 22 1 -5742 lFilter Manufacturer 22.24 Dose Tank Volume (gal /in) IA100 Filter Model Number Weiser Manufacturer Project: 4 bedroom Mound system Page 2 of 8 vj1 vC1GVV3 VG . 6J rhA 110 e t i V444 NtLSUN - t LUMdINU IJ9 0 'J ,� �/ � - /Op�GO` /O�C7 vT 1� �L� l� • O r7 /l�uGfriww� Weis I2oo %v' 7T, f Ia �, r o t� L `F t s�sS � Pr 1� V 4 Aot C T , do ) �Gi Z � GOrltinT 79 r N, R 17 cJ � v° a� G� ay� d P } of Q S N R PORT Page 1 of 3 vviisoonsin Department D pv Division of Safety and Building C in accordance Cornln 85, Wis. Adm. Code � ��Y ST. CROIX Attach complete site plan on paper not less than 8112 x 1 inches �.si�e' include, tart not limited to: vertical and h orizontal reference 'nt (4AX.dinection and Parcel I.D. (Pending) percent slope, scale or dimensions, north arrow, and and distance to�. Please print all kdbrmatro S ZGNMG aFFIG by Date ^� Personal Wormation you provide may be used for secondary purpos s. 15.04 (1) (m)). J Q U c cU Pl Owner Property Location El TODD & LIZ DOORNINK Govt. Lot — SW 114 NW 114 S 24 T 28 N R 17 E (or) W Property Owner's Mailing Address Lot # Biodc # Subd Mam C SM9 2069 30th Avenue — — (Pending) City State Zip Code Phone Number ❑ Village JDTown Nearest Road Baldwin, WI 1 54002 1 ( 71 5 684 - 2461 C.T.H. Y Rush River R New Construction UseEj Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material till/outwash Flood Plain elevation if applicable NA fl General comments Mound System — 0.5 & sand fill — 0.6 loading rate and recommendations: ® Boring a Boring Boring surface eiev. 101.70 ft. Depth to knifing factor i n. Soil rGPD,/Wff Rode Q Pit Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Mun >,sell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#2 1 0-7 IOYR3/2 — I 3f- ma&sbk mvfr as 3vf-co 0.6 0.8 2 7 -14 10YR4 /3 — sil 2f -mabk mfr as 2vf-co 0.6 0.8 3 14-26 10YR3/6 — sl 2fabk mfr as 2vf-co 0.6 1.0 4 26-3 I OYR3 /6 s&gr OS9 dl as 2vf-m 0.7 1 1.6 5 31 -33 10YR3 /6 — s & gr Osg dl as lvf - -f 0.7 1.6 6 33-60 10YR3 /6 — s & gr Osg d) — -- 0.7 1.6 (Horizon 3 has 15 -20°/. gr; horizon 5 is ented Boring 32 F 1 2 bring # Pit Ground surface elev. 98.30 fl Depth to limiting factor n. Rate Horizon Depth Dominant Color Redox Description Te)hme Struclure Consistence '•eB Boundary Roots GPDW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 '002 1 0 -12 10YR2 /1 — 1 3f-ma&sbk mvfr ab 3vf-co 0.6 0.8 2 12 -32 I0YR3 /6 sl & gr Ifabk mvfr ab Ivf-co 0.4 0.7 3 32 -70 — (Pockets of c W / cemented layers of s & gr _ -- -- ' Ef &rent #1 = BOD > j0 220 mg& and TSS >30 150 not ' Etlltmit #2 = B(3D < 30 mg/L and TSS < 30 nglL CST Name (Please Print) nature CST Witter Ma Jo Hollister 224832 Address Date Evaluation Conducted Telephone Number W9875 690th Avenue, River Falls, WI 54022 11-18-04 (715) 426 - 1775 III Property Owner DOORNINK, Tod & Liz Parcel 10 (Pending) 2 g) Page of 3 Borg aBoring [a Pit t3roud s►xface efev. 101.60 to 9 �' in. Soh Bade Horizon Depth Dominant Redox Desaipfion Te due structure Consistence, = *EW1 Roans GPOW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh 281112 1 0-7 10YR211 — 1 36&abk mvfr ab 3vf-co 0.6 0.8 2 7 -15 10YR2/2 — 1 2fsbk mvfr cs 2vf-co 0.6 0.8 g 15 -26 10YR3 /6 — sl Imsbk mfr cs 2vf-m 0.4 0.7 4 26-36 10YR3 /6 — sl & gr Imsbk mvfr cw ivf-m 0.4 0.7 5 36-40 10YR3 /6 — sl & On► dl — lvUrn 0.2 0.6 (Horizon 3 has some gr) E So" # Boft Pit Ground surface elev. it Depth to limitirg factor m Soh Rafe Horizon Depth Dort Color RedOK Description Texture structure Consistence Boundary Rods GPD/fC` in_ Muhsell Qu. Sz. Cont. Color Gr. 8z. Sh. - Efa1 'Elrw F Boring S Pit Ground surface elev. ft. Depth to fad in' Soh Rate Horizon Depth Dominant Color Redox Description Texture Structure C.onsisterroe BAY Roots in. Mu sell Qu Sz. Cora. Color Gr. Sz- S -EW 'Eff#2 • Effluent #1 = 800 > 30 220 mglL and TSS --30 450 mglL ' Eilluect #2 = BOD < 30 nV& and TSS _< 30 mglL 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. SOD- 8330rcM ( LOW) �I s PLOIr ALAN P�3 z 55u oO.�Y TOW 5 •C IM-5v- 9y L w Mw/ wcm 0* , PwosEU 3 8 AC Q (ACFALp.4 l (A � pip E dO . iV Apv R oy. ZOO' J o X tax. }tous� �ac�q� ti aN sp vi c� Zy 05/03/2005 01:30 7153610236 MARQUTTE LEE PAGE 02 ST CROIX COUNTY SEPTIC TANK MAINTEIa ANCE AGREEMENT AND OWNERS141P CERTIFICATION FORM -r OwnerBuyer 4 �!- �OY r` t ►� Mailing Address o�C��O °� �J� g� -Q..of w i ,� UJI 54000- Property Address (Verification required from Planning Department for new construction) City /State Parcel Identification Nu er LEGAL bESCRYPTTON ) Property Location �l V., � �t1 1 4, Sec. �, T -R 1 7 W, Town of /?(J< Alt Subdivision — , Lot # Certified Survey Map # , Volume , Page # Warranty Deed #I 7 7 - 7 6 ` :2 , Volume Z 6 $6 , Page # Spec house O yes A no Lot lines identifiable 0 yes O no SYSTEM MAINTENANCE Improper use and maintenance-of your septic system could result in its premature failure to handle wastes. Proper maintenanc consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the syster can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal syster is iia proper operating Condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standarc set forth, herein, as sot by the Department of Commerco and the Department of Natural Resources, State of Wisconsin_ Certificatio stating that your septic system has been maintained must be completed and returned to the St. Croix County zoning Office within 3 days of a three year xpirat n date. �$IONA F 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) c the pro erty described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNAOJPI OF APPLICANT DATE- ssss�♦ An informatio _ Y n 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 05/03/2005 01:30 7153810236 MARQUTTE LEE PAGE 03 U 2 6 8.0 P ,'3 �-a�� - 7 STATE BAR OF WISCONSIN FORM 1 - 2000 KATHLEEN H. WALSH Document Numb WARRANT'! DEED RESISTER K OF DEEDS RECEIVED FOR RECORD This Deed, made between Jon - 1For1n„_Inc„ Grantor, and Todd A. Doornink and Elizabeth A. Doornink, husband and wife. Grantee. 10/21 /2W0�1 10:15A1!l Grantor, for a valuable consideration, conveys to Grantee the following WARRANTY DEED described real estate in St. Croix County, State of Wisconsin (the "Property ") EXEMPT # (if more space is needed, please attach addendum): REC FEE: 13.00 TRANS PEE: 75.00 See attached legal description. COPY FEE: CC FEE: PAGES: 3 Recording A ran Name And Return Address f Bakke Norman, S.C. 900 Main Street PO Box 54 Baldwin, WI 54002 Together with all appurtenant rights, title and interests. Q2$- 1029 -50 -000 Parcel Identification Number (PIN) This is not homestead properly (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements, highways, utility right,4 and reservations of record, and will warrant and defend the same. Dated this day of Octobe , 20,( 4. ` Jon^ Farm Inc. � * By can Doorninlc W AUTHENTICATION ACKNOWLEDGMENT 5ignattire(s) Dean Doornink STATE OF WISCONSIN ) ss. ) authenticated this / 112 day . 2004 ST._CRpIX County Personally came before me this day of October , 2004 the above named * Thomas R. Schumacher Dean Doornink TITL .: MEMBER STATE. BAR OF WISCONSIN (if not, to me known to be the person(s) who exocuted the foregoing authorized by §706.06, Wis. Stats.) instrument and acknowledged the same, THIS INSTRUMEENT WAS DRAFTED 13Y THOMAS R. S H[JMACH£R * _T_l:omas R. Schumacher BAKKE NORMAN S C SA);,bWIN. WISCONSIIN Notary Public, Stake of Wisconsin tSignatures may be authenticated or acknowledged. Barb are not neee� s ary,) My Commission is permanent. (if not, state expiration date: * Names of persons signing in Any Capacity musr be typed or printed below their signature. INFO -PRO (Rg0)655 -2021 BAR OF WIS www.infoltroforms.comSTn rP, r Q WARRANTY DRr•.D PC1RM No.1.21KID Parcel #: 028 - 1029 -90 -050 05/26/2005 PAG 0:47 AM I OF 2 Alt. Parcel #: 24.28.17.184A 028 - TOWN OF RUSH RIVER Current X_I ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 10/21/2004 00 0 Tax Address: Owner(s): " = Current Owner * TODD A & ELIZABETH A DOORNINK DOORNINK, TODD A & ELIZABETH A 2069 30TH AVE BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 0231 BALDWIN- WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 0.000 Plat: N/A -NOT AVAILABLE T28N R17W SE NW EXC PT DESC IN WD 7 Block/Condo Bldg: 2680/139 EZ -1190 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 24- 28N -17W SE NW Notes: Parcel History: Date Doc # Vol /Page Type 10/21/2004 777628 2680 9 WD 0 3 7/49 WD 5/16/2003 721713 QL( r more... 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 04/26/2005 Description Class Acres Land Improve Total State Reason Totals for 2005: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 05/03/2005 01:30 7153810236 MARQUTTE LEE PAGE 04 2680 P 1 .38 LEGAL DESCRIPTION Parcel "A" A parcel of land located in the SW'A of the NW' /4 of Section 24 and the SE' /4 Of the NE'/, of Section 23, T28N, R17W, Town of Rush River, St. Croix County, Wisconsin. Further described as follows: Beginning at the W'/� corner of said Section 24 (E' /4 corner Section 23), thence S89 °25' 1.7 "W 440.96' along the East - West '/4 section line of said Section 23 to the centerline of County Trunk Highway "X "; thence Northeasterly 25.51' along the arc of a 1284.00' radius curve concave to the Southeast whose chord bears N17 °26'28" E 25.51'; thence continuing along said centerline N18 0 00'37" E 244.41'; thence N89 °46' 13E 1672.73' to the East line of the SE '/4 of the NW %4 of said Section 24; thence S00 °02'49 "E 253.75' along said East line to the East -West 'A section line of said Section 24; thence S89 °46' 13 "W 1315.22' along said East -West '/4 section line to the point of beginning, containing 435,556 square feet (9.999 acres) more or less and being subject to any casements, restrictions and covenants of record. Parcel #:. 028- 1029 - -100 05/26/2005 10:42 AM PAGE 1 OF 2 Alt. Parcel #: 24.28.17.183A -10 028 - TOWN OF RUSH RIVER Current ' X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 10/21/2004 00 0 Tax Address: Owner(s): * = Current Owner TODD A & ELIZABETH A DOORNINK DOORNINK, TODD A & ELIZABETH A 2069 30TH AVE BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): • = Primary Type Dist # Description A SC 0231 BALDWIN- WOODVILLE AREA � SP 1700 WITC �C d— L( 2 Legal Description: Acres: 9.999 Plat: N/A -NOT AVAILABLE SEC 23 & SEC 24 T28N R17W PT SE NE SEC Block/Condo Bldg: 23 24; TO CTR LN CTY RD Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) Y; TH NELY 25.51 FT; TH CONT ALNG CTR LN 23- 28N -17W SE NE N 18' E 244.41 FT; TH N 89' E 1672.73 TO 24- 28N -17W SW NW E LN SE(S /B SW) NW SEC 24; THS 00' E more Notes: Parcel History: Date Doc # Vol /Page Type 10/21/2004 777627 2680/13 WD 422 07/23/1997 742/108 07/23/1997 729/584 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations Last Changed: 04/26/2005 Description Class Acres Land Improve Total State Reason Totals for 2005: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel #: 028 - 1029 -80 -100 12!0812006 08:40 AM PAGE 1 OF 1 Alt. Parcel #: 24.28.17.183A -10 028 - TOWN OF RUSH RIVER Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 10/21/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner TODD A & ELIZABETH A DOORNINK O - DOORNINK, TODD A & ELIZABETH A 2069 30TH AVE BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): "= Primary Type Dist # Description SC 0231 BALDWIN - WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 9.999 Plat: N/A -NOT AVAILABLE SEC 23 & SEC 24 T28N R17W PT SE NE SEC Block/Condo Bldg: 23 & PT SW NW SEC 24; COM W 1/4 COR SEC 24; TH S 89'W 440.96FT TO CTR LN CTY RD Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) Y; TH NELY 25.51 FT; TH CONT ALNG CTR LN 23- 28N -17W SE NE N 18' E 244.41 FT; TH N 89' E 1672.73 TO 24- 28N -17W SW NW E LN SE(S /B SW) NW SEC 24; THS 00' E more... Notes: Parcel History: Date oc # Vol /Pag Type 10/21 /2004 777627 2680/1 WD 07/23/1997 22 07/23/1997 742/108 07/23/1997 7291584 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 166117 Use Value Assessment Valuations: Last Changed: 05/19/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 35,000 268,900 303,900 NO AGRICULTURAL G4 4.999 800 0 800 NO UNDEVELOPED G5 2.000 3,500 3,500 NO Totals for 2006: General Property 9.999 39,300 268,900 308,200 Woodland 0.000 0 0 Totals for 2005: General Property 9.999 1,600 0 1,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel #: 028 - 1029 -80 -050 12/08/2006 08:42 AM PAGE 1 OF 1 Alt. Parcel #: 24.28.17.183A 028 - TOWN OF RUSH RIVER Current i X I ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 10/21/2004 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co -Owner 0 - JON DE FARM INC JON DE FARM INC 2061 30TH AVE BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 0231 BALDWIN - WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 0.000 Plat: N/A -NOT AVAILABLE SEC 24 T28N RI 7W SW NW EXC AS DESC IN Block/Condo Bldg: 2680/137 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 24- 28N -17W SW NW Notes: Parcel History: Date Doc # Vol /Page Type 10/21/2004 777627 2680/137 WD 07/23/1997 913/422 07/23/1997 742/108 07/23/1997 729/584 2006 SUMMARY Bill M Fair Market Value: Assessed with: 166116 Use Value Assessment Valuations: Last Changed: 0511112006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 28.340 4,400 0 4,400 NO UNDEVELOPED G5 4.000 7,000 0 7,000 NO Totals for 2006: General Property 32.340 11,400 0 11,400 Woodland 0.000 0 0 Totals for 2005: General Property 32.340 11,400 0 11,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel #: 028 - 1029 -90 -050 12/08/2006 08:43 AM PAGE 1 OF 1 Alt. Parcel #: 24.28.17.184A 028 - TOWN OF RUSH RIVER Current ; X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 10/21/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner TODD A & ELIZABETH A DOORNINK O - DOORNINK, TODD A & ELIZABETH A 2069 30TH AVE BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 0231 BALDWIN- WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 0.000 Plat: N/A -NOT AVAILABLE SEC 24 T28N R17W SE NW EXC PT DESC IN WD Block/Condo Bldg: 2680/139 EZ -1- 1190/056 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 24- 28N -17W SE NW Notes: Parcel History: Date Doc # Vol /Page Type 10/21/2004 777628 26801139 WD 09/11/2003 739643 2407/49 WD 05/16/2003 721713 2243/606 WD 1210/229 WD more... 2006 SUMMARY Bill M Fair Market Value: Assessed with: 166118 0 Valuations: Last Changed: 04/12/2006 Description Class Acres Land Improve Total State Reason MFL AFTER 2004 CLOSED W6 30.000 105,000 0 105,000 NO 00 Totals for 2006: General Property 0.000 0 0 0 Woodland 30.000 105,000 105,000 Totals for 2005: General Property 0.000 0 0 0 Woodland 30.001 105,000 105,000 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 i Parcel #:' 028 - 1029 -90 -100 05/26/2005 10:50 AM PAGE 1 OF 2 Alt. Parcel #: 24.28.17.184A -10 028 - TOWN OF RUSH RIVER Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 10/21/2004 00 0 Tax Address: Owner(s): * = Current Owner * JON DE FARM INC JON DE FARM INC PO BOX 114 BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description SC 0231 BALDWIN- WOODVILLE AREA SP 1700 WITC C 1 Legal Description: Acres: 9.999 Plat: N/A -NOT AVAILABLE SEC 24 T28N RI 7W PT SE NW COMM N 114 COR Block/Condo Bldg: SD SEC 24; TH S 00'W 1323.31 FT TO NE COR SE NW & POB; TH CONT S 00'W Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 330.92FT; TH S 89'W 1316.07FT; TH N 00' 24- 28N -17W SE NW W TO N LN SE NW; TH N 89'E 1316.35FT TO POB (9.999AC) EZ -1- 1190/056 Notes: Parcel History: Date Doc # Vol /Page Type 10/21/2004 777628 2680/139 WD 09/11/2003 739643 2407/49 WD 05116/2003 721713 2243/606 WD 1210/229 WD more 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 04 /26/2005 Description Class Acres Land Improve Total State Reason Totals for 2005: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 U 2757P 337 l6f3'76 STATE BAR OF WISCONSIN FORM 1 - 2000 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX CO.. WI This Deed, made between Jon -De Farm, Inc. Grantor, and Todd A. \ 1 RD Doornink and Elizabeth A. Doornink husband and wife Grantee. 03/02/2005 10:00 Grantor, for a valuable consideration, conveys to Grantee the following WARRANTY DEED described real estate in St. Croix County, State of Wisconsin (the "Property") (if more space is needed, please attach addendum): REC FEE: 13.00 TRANS FEE: 75.00 See attached legal description. COPY FEE: CC FEE: PAGES: Z Recording Area Name and Return Address Bakke Norman, S.C. 900 Main Street PO Box 54 Baldwin, WI 54002 Together with all appurtenant rights, title and interests. 028- 1029 -90 -000 Parcel Identification Number (PIN) This is not homestead property (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements, highways, utility rights and reservations of record, and will warrant and defend the same. Dated this 20 day of February 2005 * Jonft Farm, Inc. * B.y can Doornin AUTHENTICATION ACKNOWLEDGMENT Signature(s) Dean Doornink STATE OF WISCONSIN ) ) ss. ST. CROIX County ) authenticated this Z g day of F ua . 2005 Personally came before me this day of February 2005 the above named Dean Doornink * Thomas R. Schumacher TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the oerson(s) who executed the foregoin¢ authorized by 5706.06, Wis. Slats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY THOMAS R. SCHUMACHER * Thomas R, Schumacher BAKKE NORMAN. S.C. BALDWIN, WISCONSIN Notary Public, State of Wisconsin My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) * Names of persons signing in any capacity must be typed or printed below their signature. INFO -PRO (800)655 -2021 www.infoproforms.comSTATE BAR OF WISCO WARRANTY DEED FORM No. 1 -2000 r U 2757P 338 LEGAL DESCRIPTION Parcel "B" A parcel of land located in the SE' /4 of the NW %, of Section 24, T28N, R17W, Town of Rush River, St. Croix County, Wisconsin. Further described as follows: Commencing at the N' /4 corner of said Section 24; thence S00 °00'06 "W 1323.31' along said North -South ' /4 section line to the NE corner of the SE' /4 of the NW' /4 and the point of beginning; thence continuing along said North -South '/4 section line S00 °00'06 "W 330.92'; thence S89 0 40'08 "W 1316.07' to the West line of the SE' /4 of the NW' /4 of said Section 24; thence N00 °02'49 "W along said East line to the North line of the SE' /4 of the NW' /4 of said Section 24; thence N89 °40'08 "E 1316.35' along said North line to the point of beginning, containing 435,556 square feet (9.999 acres) more or less and being subject to any easements, restrictions and covenants of record. I U 2 6 8 0 P 13 7 777627 STATE BAR OF WISCONSIN FORM I - 2000 KATHLEEN H. WALSH WARRANTY DE REGISTER OF DEEDS Document Number ST. CROIX CO-, MI This D ed, made between Jon -De Farm, Inc., Grantor, and Todd A. RECEIVED FOR RECORD Doornink and Elizabeth A. Doornink husband and wife Grantee. 10/21/2004 10:15AN Grantor for a valuable consideration, conveys to Grantee the following WARRANTY DEED described real estate in St. Croix County, State of Wisconsin (the "Property ") EXEMPT # (if more space is needed, please attach addendum): REG FEE: 13. 00 See attached 1 gat description. COPYSFEE: 75.00 CC FEE: PAGES: 2 Recording Area i Name and Return Address Bakke Norman, S.C. 900 Main Street PO Box 54 Baldwin, WI 54002 i Togethev with all appurtenant rights, title and interests. 028 - 1029 -80 -000 Parcel Identification Number (PIN) This is not homestead property (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements, highways, utility rights and reservations of record, and will warrant and defend the same. Dated this day of October 2004 * Jon F rm Inc. * B can oornink - AUTHENTICATION ACKNOWLEDGMENT Signature(s) Dean Doornink STATE OF WISCONSIN ) ss. ST. CROIX County ) authenticated is /� day , 2004 Personally came before me this day of October , 2004 the above named Dean Doornink * Thomas R. Schumacher TITLE: MEM 3ER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by §706.06, W is. Stats.) instrument and acknowledged the same. THIS NSTRUMENT WAS DRAFTED BY THOMAS R. SCHUMACHER * Thomas R. Schumacher BAKKE NO MAN S.C. BALDWIN WISCONSIN Notary Public, State of Wisconsin My Commission is permanent. (If not, state expiration date: (Signatures may b authenticated or acknowledged. Both are not necessary.) I .) * Names of persons si ning in any capacity must be typed or printed below their signature. INFO -PRO (800 )655 - 2021 www.infoprofomts.comSTATE BAR OF WISCO WARRANT DEED FORM No. I •2000 - - U 2680 P 138 LEGAL DESCRIPTION Parcel " A " A arcel of land located in the SW' /4 of the NW' /4 of Section 24 and the SE' /4 of the NEl /4 of "ection 23, T28N, R17W, Town of Rush River, St. Croix County, Wisconsin. Further described as follows: Beginning at the W' /4 corner of said Section 24 (E' /4 corner Section 23), thence S89 °25' 17 "W 440.96' along the East -West '/4 section line of said Section 23 to the centerline of County Trunk Highway "Y "; thence Northeasterly 25.51' along the arc of a 1284.00' radius curve concave to the Southeast whose chord bears N17 °26'28 "E 25 51'; thence continuing along said centerline N18 °00'37 "E 244.41'; thence M 9 3E 1672.73' to the East line of the SE '/4 of the NW '/4 of said Section 24; tht nee S00 °02'49 "E 253.75' along said East line to the East -West %4 section line of said Se tion 24; thence S89 °46' 13 "W 1315.22' along said East -West `/4 section line to the po nt of beginning, containing 435,556 square feet (9.999 acres) more or less and being subject to any easements, restrictions and covenants of record. 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O W " \, W WtVZ d ;� o { {w ul w N 0 3JQ o OWO of p I I J -' (D Q d OW I I t o�v�vn of f Z v s G '06Li 31f11Oh y /TMN V /F35 3LL dD 3Q 11SY3 -� a ! { NI T � R.UO ti05M 51N3d35Y3 Z I F & JErom ie 9E 6a e5z - - - - -- 03 CF O a >_ us U1 C9 M :P;-7 Cl! 30 O ZW ! 00 W ZW ti F- a`' � 6 Z6 11 .65 .b98LEi — - - -- P-!A 90 owN 2 -� �\ ` �G 3, by ANN I `« p r 7La d 7 1.FZ NOI1335 -v Y/T NJ 3 -0 3¢"1 1SV3 �` &fhr ZF, N�^ q Q. 000 - 7a 1 7 1 3 KATHLEEN H. WALSH STATE BAR OF W{ CON 2p�o REGISTER OF DEEDS 7 Document Number WE f 0 6 ST. CROIX CO., WI This Deed, made between Bruce J. Moll and Thomas Aaby, as RECEIVED FOR RECORD tenants in common 05/16/2003 09:30AN WARRANTY DEED EXEWT g Grantor, and Todd A. Doornink and Elizabeth A. Doornink, husband REC FEE: 11.00 and wife TRANS FEE: 300.00 COPY FEE: CC FEE: PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum:) The SE 1/4 of NW 1/4 and Part of the NE 114 of NE 1/4 of Section 24 -28 -17 described as follows: Commencing at the SW corner of said Recording Area NE 1/4 of NW 1/4; thence North on West line of said NE 1/4 of NW 1/4 23.33 feet; thence SEly 33.0 feet to a point on the South line of said NE Thomas A. McCormack 1/4 of NW 1/4, 23.33 feet East to the point of beginning: thence West Attorney at Law 23.33 feet to the point of beginning, St. Croix County, Wisconsin. PO BOX 2120 Baldwin, WI 54002 028-1029-60,029-1029-90 Parcel Identification Number (PIN) This is not homestead property. f (is not) Exceptions to warranties: Easements and restrictions of record. Dated this 30 day of (.! � 1 2003 * • Bruce J. Moll * * Thomas Aaby AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. St. Cr oix County ) authenticated this day of Personally came before me this 3�' r day of A j prc ;I , 2003 the above named Bruce J. MoD and Thomas Aaby * TITLE: MEMBER STATE BAR OF WISCONSIN tome known to �thlie erson who e4hed f c ego . .., . authorized by § 706.06, Wis. Stats.) instrument an d d the s (If not, e.. 3 �P s V i THIS INSTRUMENT WAS DRAFTED BY * ew 4, Ac Thomas A. McCormack Notary Public, State of WISCONSIN 'r ,.- �•� 4 Ba WI 54002 My Commission is permanent. (If not, statb , isa�itpdat : (Signatures may be authenticated or acknowledged Both are not necessary.) �_ ) * Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN INFO -PRO (800 )855 -2021 www.infoprofomu.com FORM No. 2 - 2000 2 6 4 4 P 2 3 7 772e4Ba KATHLEEN H. VALSH Forest Crop Law - Transfer Order REGISTER OF DEEDS issued by Wisconsin Department of Natural Resources ST. CROIX CO.. VI RECEIVED FOR RECORD Order No: 56 0031981 Effective Date: June 04, 2004 08/26/2004 10:00AM Pag I of 2 In the matter of the designation of land under Forest Crop Law ORDER Order No: 56 0031981 located in EXEMPT # St. Croix County, Town of Rush River REC FEE: 13.00 TRANS FEE: Formerly COPY FEE: Owned by: Bruce J Moll PAGES.' 2 Thomas Aaby Address: 1840 60th Ave Hammond, WI 54015 Upon the Petition for Transfer to : Register of Deeds: Return original document to: Petitioner(s): Todd A Doornink Department of Natural Resources. Elizabeth A Doornink Forest Tax section. P.O.Box 7963. Madison. W 1 53707 Address: 2069 30th Ave Baldwin, WI 54002 Bill the landowners for recording fee PIN: 028-1029-60 FINDINGS OF FACT I . Lands enrolled under the Forest Crop Law for a 25 year period have been transferred by Deed. The new owner (Todd A Doomink ETAL) has petitioned the Department of Natural Resources to continue Forest Crop Law designation for the parcel, agreed to comply with the terms of the Forest Crop Law, and certified an intent to comply with the forest management plan for the parcel. This is a complete transfer of land designated under FCL Order No. 56 003 1981. CONCLUSIONS OF LAW 1. The Department of Natural Resources, pursuant to s.77.10(i)(b). Wis. Slats., is required to issue an order continuing the designation of the Forest Crop Land under the new ownership. ORDER I . It is hereby ordered that the Forest Crop Law designation for the following lands be transferred to the petitioner(s) for the time remaining from the 25 year period of the original Order. Township 28 North, Range 17 West Parcel Identification No. Acres Section 24 SENW 40.000 Total Acreage for Order 40.000 Notice of Appeal Rights - See Reverse Date of Order: June 04, 2004 State of Wisconsin, Department of Natural Resources This instrument dratted by State or Wisconsin For the Secretary Ae 4�� Department of Natural Resources By Linda C. DePaul, Forest Tax Section Chief (ph. 608.266.3545) Signature olZinda C. Det�ttl, res Fo Sectio i hier, Burea Cu of Forest Management authenticated by: �� Date: June 04, 2004 Title: Member state Bar or Wisconsin or other party V.thorized under section 706.06, Wis. Stam Form ID: 2450.180(TE) F" AT T -28 -N • R 17 - W T-28 -N R -17- - � W See Page 112 For Additional Names. • • • << ••'� - -• :< ILW � TA See Page 135 -140 For Additional Names. ✓ER 1 900 sotn AVE 2000 2100 C harlene CN Allen Charles 1 11 ®` t Thomas J ■ Qumn u ■ 1 M erri tt & 80 27 Famu Hansen �quist i b .Isen Seaman ppert ■ q A &M e Lorraine w > Tnlst 119 Richard & Glen v 1 "C Merritt F thanes & lean ®' Owens 1 CO 80 1� X34 ^ 5 1 VE 1 0- Pearson >r Scbuebel g4 M ■ ■ kea�uener L ■ F enu ure a N Fier>i 1 37 102 !♦ Ti'm Maril & on L Ru a Smees ; Iarms S & K ! Pea- Bill ■ ■ Bruce I Her Steve Rq 21 + d Jr 122 .; z sn1 Inc 7 40 11., - - -� - ` boy bod Mann , Heinb h Heinbu eisn" Betty t` 114 50t AVE 40 J ` r i N is I ■ wflyn eeshr 1S °h°SO o &J 28 Earl & Mk yetslthia 75 rust K etal X 63 �' ■ ' I N ■ Gregg 3s ' Bo N ° "Margaret& ands& 3 J iji die w Zwald - I O " e Laura a v+ Ke,mn '� Erdman William A 4s Bishop Moe 36 3 W s 60 R 77 Rick I ■Volkert I O 3 1 K L Prtnrshp ' 11 ° $ e __�..... 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PC Kurt t Fairmont p 39 1 ao 3B 81 a d Glen ■ ■ Lan ther IncrnLe PJS� Farm a um Anacreon g c 1s N Z W c Spear Bossen V1 152 145 40 Inc Aab1 Inc IL Richad & Excavating N f� � �McCLt' SS Y 1 2 0 rt & t Kabo jr 40 64 '15, eheon 40 WJ1Js oo Clarence , J ames H ri en 0 J ngs �« 160 200 ' I it � � � ® ; � � Jacobson ■ I I Reil _ ■ _ 1 ont - _ O> 63 Edward 1 ■ } Claycomb I 1 o° m & r a erlm 1 —� ~ - -_■ — _i_ ___ Y � E1 40 79 401 18th AVE 120 f osse Zuettel DaAd is Dam . N PTV Charles 2 Dean s ■ Thompson " 4p 'u� &)9 � 27 ic Langer ick ■ 3 ■ Larry is �« 10 z K 9 40 40 ■ 1 ■ 1. 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