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HomeMy WebLinkAbout026-1126-17-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 488180 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: Watson, Jerry & Jenifer I Richmond, Town of 026- 1126 -17 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: I4. $O M4 4 (Y\ 12.30.18.778 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER n•ss CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing p Alt. BM J1 o Or o va a Ta 1 o L ZS , � kUer✓ �, Aeration Q Ridg. SeWer 7.3Z /o Z• . c1A - H olding St /Ht In TANK SETBACK INFORMATION S t /Ht O $ • S� 16b. 7S! TANK TO P/L WELL BLDG. V ent o Air In ROAD Dt In ep is Bottom �I ( 3� 3c) 97. osmg Header/Man. Jl• 'E z b q7 • 7 era ion Dist. P ipe 1).-71 OP. fo� o mg U01. System /Z. $ 96. F inal ra e PUMP /SIPHON INFORMATION anu ac urer eman Cover GPM t kt-,- Ce 3 • �l0 /65 •� [vi ociel numDer i nc ion Loss j Syst em ea orce m e ia. DIMENSIONS INFORMATION CHAMBER OR 15Z � (� UNIT �o�Je. `a /cd 7 iSo /U� L)ISTKIBUTION SYSTEM ,( J Pip s L�`�• �r Length Dia Length Dia \ Spacing x Pressure Systems Only xx Mound Or At -Grade Systems Only Bed /Trench Center 3 3- 9 Bed/Trench Edges Topsoil Yes No Yes 7 o r COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1656 Waters Edge Drive New Richmond, WI 54017 (NE 1/4 SW 1/4 12 T30N R18W) Water's Edge Lot 17 Parcel No: 12.30.18.778 I FCI� 1.) Alt BM Description = / �1/�a• 2.) Bldg sewer length - amount of cover = r Plan revision Required? _' Yes KNo ir�se cto natu Use other side for additional information. Bate P SBD -6710 (R.3/97) fety and Buildings Division County 1 W ,ton e., fis n, 707 1. ttitary ennit ytpby{ / in by Co.) -3151 � t 5�( Department of Commerce Sanitary Permit Applic ' AY 1 ( State Pl I.D. Number in accord with Comm 83.21, Wis. Adm. Code, personal information ou provide may be used for secondary purposes Privacy Law, s15.04(1 m) ddress (if dill t than mailing address) Uj Ct X �d I. Application Information — Please Print All Information Property Owner's Name Parcel # t # ! `7 Block fi , Property Owner's iling Address i t Property Location O �. N lJ A) W /., Section / o� City, State Zip CC �J Phone Number L o n s T 4; RE o W II Type of Buildinjj0heck all that apply) S Subdivision Name CSM Number AJ I or 2 Family Dwelling - Number of Bedrooms P%� 4— —� � . S ❑ Public/Commercial - Describe Use ❑ State Owned - be Use ❑City_❑Village Township of n 11I. Type of Permit: (Check only one box on lifiCA. lComplete line B if applicable) A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System List Previous Permit Number and Date Issued B. [I Permit Renewal 11 Permit Revision 11 Change of ❑ Permit Transfer to New Before Expiration Plumber Owner IV. Type of POWTS System: Check all that Apply) Bar lit t 5(Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound <24 in. of suitable soil ❑ At-Grade ❑ Single Pass Sand Filter 11 Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Pat Filter ❑ Aerobic Treatment Unit 11 Recirculating Sand Filter El Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line Gravel -less Pipe ❑ Other (explain) V. Dispersaffreatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation o VI. ank Info Capacity in Total Number ufacturer Prefab site Steel Fiber Plastic Gallons Gallons of Units (,3 �� 5� I Concrete Constructed Glass N ew Existing Tanks Tanks C � Septic Holding Tank erotic Treattuem Unit Dosing Chamber VII. Responsibility Statement- I, the undersigned, ume res risibility for i f the POWTS shown on the attached plsns. P Business Phone Number m s Name (Prin P bet' Sign ture RS tuber Plumber's Address (Sweet, City, State, Zip Code) VIII. Coun /De artment Use Onl Sanitary Permit Fee ' eludes Groundwater Date Issued Issuin Agent Signatu (No Stamps) tKARproved ❑ Disapproved Surcharge Fee) ❑ eason or ial IX. Condition of ppro 3 a S S A1 — Cc" — 1, SYSTEM OWNER: Q �� 1 Septic tank, Illfflu and U dispersal cell must st ail be serviced /maintained 10.0 W 4d�;� # as per management plan provided by plumber. 2. All setback requirements must be maintained �Q as per applicable code /ordinances. Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) ' l pl ; o �� r _� - N� s i b — f3O 1 1e1_c.� 4 _ J w�� o A1,6 3 , Ste W �o _ P f . ,C� Alt B 40�� OV i : : � a , �Q r , : : : I ® _ P �. V � +�j } -kh ty•pr �I, LOCL. so �� AI �� 3 �` �g u-) J 4 C oo CJ e r c� C�u�t N w ate ►mss 9 �d� ' 1 ~✓_ t *e . rs �` ►�5 o r a.� s.e �c. � � �s� ��. �P► S (v a on a -3 1 y l i �m Q Pvc fo C L too- 4Alt r3�, "aJo�'� e Cd � g PeP _ a Wisconsin Department of Industry SOIL AND SITE E V A L U AT I O Page 1 of 3 Labor a.tkl Human Relations Division of Safety &Buildings in accord with ILHR 83.05 W ..�► COde •� OJd TY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. PI st in �. % Croix not limited to vertical and horizontal reference point (BM), direction and % o Qb e, scaler r 2 00 PA _ L I.D. # dimensioned, north arrow, and location and distance to nearest road. _ �J 1 x en APPLICANT INFORMATION— PLEASE PRINT ALL INFORMATION �.� '� 5 C ao RE BY _ DATE c o�" F• A AFc-e • o zcc�{ PROPERTY OWNER: P LOOP ON GO M '- ' ^ S T N,R *(or) W Derrick Const., Inc. �' is PROPERTY OWNER':S MAILING ADDRESS LOT # NAME OR CSM # W * S 1505 Hy. #65 17 na & CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE MOWN NEAREST ROAD New Richmond WI. 5 []d New Construction Use Residential / Number of bedrooms 4 [ ] Addition to existing building I ] Replacement [ ] Public or commercial describe _,_ be gpd / Code derived daily flow 600 gpd Recommended design loading ra d, ft 2 2 � 2 Absorption area required 1200 bed, ft 1000 trench, ft 'M ximum design loading rate . 5 bed, gpd /ft .6 trench, gpd /ft 2 Recommended infiltration surface elevation(s) 96.90 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material lat aci a7 dri f . Flood plain elevation, if applicable —n ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem KI S❑ U Z S ❑ U [2S ❑ U El S ❑ U EIS ®U ❑ S O U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Y Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench �- 1... !`? 1 0 -11 10 r 3/3 none 1 • 2 11 -26 10 r 4 4 n Ground 3 26 -84 7.5 r 4/6 none s1 11s 2msbk mvfr na na elev. 10 ft. Depth to limiting factor q g g q +84" Remarks: Boring # .5 1 0 -14 10 r 3/3 2 14 -37 10 r 4/4 none a: S ................. 3 — f na na .5' .6 Ground 37 84 7 5 r 4/6 none sl is 2msbk my r -J elev. 100. (R. Depth to limiting factor + Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Aa, New Richm2ed W154017 Signature: Date: 6 -14 -2000 CST Number: m02298 PROPERTYOWNER Derrick Const. Inc. SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.DA Pending a Depth Dominant Color Mottles Texture Structure Consistence Y Roots GPD /ft Boring # Horizon in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0 -15 10 r 3/3 none 1 2msbk mfr cs .5 .6 •� 3 2 15 -35 10 r 4/4 none sicl 2msbk mfr Qw if .4 .5 Ground 3 35 -84 7.5 r 4/6 none sl is 2msbk mvfr na na .5 .6 elev. 10 ft. Depth to limiting factor +84" Remarks: Boring # 1 0 -10 10 r 2/2 none 1 2 1 mfr cs if .5 .6 2 10 -27 10 r 4/4 none sil na qw if n .2 Ground 3 27 -84 7.5 r 4/6 none si is 2msbk mvfr na na .5 `.6 elev. ,1 Qt. Depth to limiting factor +84" Remarks: Boring # 1 0 -16 10 r 3/3 none 1 2msbk mfr cs .5 .6 5� 2 16 -38 10 r 4/4 none sici 2msbk mfr qw if A .5 1 Ground 3 38 -84 7.5 r 4/6 none ms 0SQ mfr na na .7' .8 elev. 10 ft. Depth to limiting factor +84" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: l_ SBD- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel Derrick Construction, Inc. 1554 200th Ave. CSTM2298 NE4SW4 S12- T30N -R18w New Richmond, WI 54017 MPRSW -3254 town of Richmond (715) 246 -6200 lot #17- Brushy Mound Lake This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. N 1 " =40' BM.= top of 1" pvc pipe C el. 100.00' Alt. BM.= top of 1 pvc p ipe C el. 99.80' 116 ' 7 n r 2- 30 \ hk 1 ° ;= Gary L. Steel 6 -14 -2000 R LI P OF B! \ 12' Utilit \ TOWN RO AD PROPOS f ! --� LOT/1:9 .91675 SQ..FT. _ / 1 ; , 2.10 ACRES B 1 �OT 1 / Cn 0 o„ B05 19 9$358 -SQ.FT. / o 6 �3 2.17 ACRES 1oo1. B -4 of ° �' < � � 996.0 • B -5 a O o � �� Q 0 i I _"— 10 ` _ 20' 19 °9e Eo, ant h 0 1 104 99 / 001.3 4 —� �.� 1 I B -4 > x I 1008 L o T -� 8345 Q. \ • B • - �X 0 CR Q 0 °\ 1010 � o o�0 Q• B-3 1000.9 X B _ 1 I 96 /`-- g_ 2 I 3 2 0 1 00 ' 1002.4 86 SQ. T. r x 2. 3 CREW X X j O � I O 1021.8 ° c'�, o + ` 1005.0 r 1022.7 I x i \ 0 \ B�-2 100 200 FF �q, tP✓'S �2 d EZ1203H �! v0v ev vv t•• `' 4 •,�'• ♦M ,lt�• • ' '•�•' ♦vrveiv � ° sovevi , •• Vii "� :�'' , • vevvv•ee vvv .C' ore vvi 1 w•e 'a: :� .•iw' .c`. "... . `v.'^ vev �'} e v 4.625 e:.' ovv e o V 1 " 1 /2 Circ. = 18.84" Wee ee• •vo •er yr vi v e e v' 'v e e v evVeeoo • v rwrevveov eeovive eWeeev•• 7 eeeeevrievvve vv•O.Oe. rvo007V vivOe •v ♦Oe♦ Oi•i ♦r 7 24tt Bottom 36t Vold Volume il Interface Arga in. IQ EL so Void Coefficient in Aggregate given at 57.4%. Sidewall (2 Sidewalls) 2 . 1! : g = 3.14 O.D. of 4" pipe = 4.625 inches 12in lft Void volume per linear f1= 3.14•.( 2.3125ia ) • 1ft = 0.117 fN Bouom 2.00 l 12i./ft ) Total Soil Interface Area 5.14 SQ.FT 0. D. ofantereylittder+•f2.5 inches l Void volume in aggregate of center cylinder =(3.14 • ( 6.25in 3.14 • 2 l) • .574 = .422 ft `t2in /ft) (12in /ft ) O.D. of outside cylinders = 12 inches Projected Trench Area Void volume in outside cylinders - 2.3.1 6m *.574-.901 ft' Sidewall Height = 12 in. 0 2 = 2.00 Sq.Ft. i12inlft) � � Bottom = 36 in. = 3.00 Sq.Ft. Void volume at bottom between cylinders = 24in • 6in 1 -3 1 6� 12inift 72;1 I 12in /R) =0.1t5 ft' Projected Trench Area = 5.00 Sq.FL Void volume at outside bottom comers (lQ of void volume between cylinders) 0.215 ! 2 = 0.108 W Total void volume = 0.1 17 + 0.422 + 0.901 + 0.213 + 0.108 = 1.763 cubic ft / ft Gallons per ft = 1.763 X 7.48 = 13.2 ealions ner linear ft. 3(Q )C io ( = Sa EPS Aggregate Trench System EZ1203H EZ,low Ring•- Industrial Group 65 Industrial Park Rd. Oakland, TN 18060 tf `t SCALE FILE riAM Q7203H,1 SHM..1 0l 1 11 -27 -01 i POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pa of FS.E a�EORMATION SYSTEM SPf2E ATWW Owner Permit # 4 i J 1 ` � Septic Tank Capacity �� ai 0 NA Septic Tank Manufacturer � r � p NA DESIQN PAt»<AMETERS Effluent Frfter Manufacturer ` !? NA Number of. Bedrooms D0 NA Effluent Filter Model ❑ NA Number of Public Facility Units A Pump Tank Capacity al A Estimated flow (average) g altday Pump Tank Manufacturer A' Design flow (peak(, (Estimated x 1.5) o aUd Pump Manufacturer A Soil Application Rate o d Pump Model I;tN Standard influent/Efflu,lent Quality Monthly average' Pretreatment Unit Fats, Oil & Grease (FOG) 530 rng /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg/L 0 NA 0 Mechanical Aeration p Wetland Total Suspended Sobs (TSS) 5150 mg /L ❑ Disinfection O Other: Pretreated Effluent Quality Monthly average Disperse► 6eNls) DNA Biochemical Oxygen Demand (BOO 530 mg /L In- Ground (gravity) O In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L 0 NA ❑ At -Grade ❑Mound Fecal Coliform (geometric_ mean) 51 O` cfu /100mi !3 Drip -Line ❑ Other. Maximum Effluent Particle Size Y in dia. gNA Other: 0 NA Other; Other: D NA "Values typical for domestic wastewater and septic tank effl Other. 13 NA MAWTENANCE SCHEDULE S ervies Event Serndce acv Inspect condition of tanks) At least once every ] • 3 $) (t{AahCknurn 3 years) ❑ NA VIn Pump out contents of tank(s) When combined sludge and scum equals one -third f y of tank volume p NA Year Inspect dispersal cellist At least once every: 0 month(s) (Ma>dfhattn 31) ©NA s} Clean effluent Filter At least once every: month CI NA Insp earls) ect Pump, Pump controls & alarm At least once every: months) 0 A years) Flush laterals and pressure test At (east once every: 13 month(s) NA Other: D year {s) At least once Q mamma) Other: et►ery' 13 years} NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal calls shalt be made by an individual carrying one of the following licenses or certifications: Master Plumber: Mash 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 twi(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 )invited to the servicing of effluent fitters, 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 shat) be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION Page of For new construction, pdOr 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 coil(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 shag not occur when sail conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal h0water levels. When power is restored the excess . wastewater will be discharged to the dispersal cells) in one large dose, overloading the call(s) and may result in the backup or surface discharge of effluent. To avoid this sit"atiOn have the contents of the pump tank removed by a Septage Servicing O perator prior to restoring power to the effluent pump or contact a Pktmber 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 We of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degressers; dental floss; diapers; disinfectants; fat foundation drain (sump pump) water; fruit and vegetable peelings; gasolne ;. 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: Ail 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 mother 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 r system. The replacement area should be r eplacement son! absorption protected from disturbance and compaction and should not bin infririgad upon by required setbacks from endstbng and proposed structure, lot Nines and wells. Failure to protect the replacement area will result In the need for a new soil and site evaluation to establish a suitabie'replacement area. Repl4comem 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 son{ absorption systems may be reconstructed in place following removal of the biomet at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WAINIINti> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GAMES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMW TANK UNDER ANY C ICUNISTANCES. DEATH MAY RESULT. RESCUE OF A "WON FROM THE FOR OF A TANK MAY NNE DiFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POYIfFS WSTALLER ravrrTS MAINTA Name Name Phone 7 S 5 1 3.5 Ph SEP'TAAE SEMI CING OPERATOR WU MPFR) LOCAL REGULATORY AUTHORITY Name S Name ST- � 4 ti 0 Phone Phone '� This document was drafted in compilance with chapter Comm 83.22(21(b)(i l(d) &M and 83.t34t1), (2) & {31, Wisconsin Administrative Code. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND • OWNERSHIP CERTIFICATION FORM` , Owner/Buyer _ <� , �. Mailing Address 100 0e' a-. Dt-�,c 63u 9W U eWsrs WL Sa4b 'Property Address 1 �4c� b d'LS fEb t as - DfLtY� � , (Verification required from Planning & Zoning Department for new construction.) Cit p�e"�N f 241 - 44 IOW O W 0L 44 1 t3' arcel Identification Number - l l..b . TT� LEGAL DESCRIPTION AA Property Location � t /4 , 5W '/4 , Sec. LZ , T 3a N R lb W, Town of l aO Subdivision k- , Lot # . Certified Survey Map # , Volume , Page # Warranty Deed # 0 0 -- L q- t 9 - '5 , Volume , Page # Spec house yes no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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 Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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. I/we, 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 Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my /our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms I NATURE OF APPLICANTS) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) 05/09/2006 TUE 11:46 FAX 715 386 4687 ST CROIX CO RHO OF DEE DS IZ002/002 824 KATHLEEN U. WALSH State Bar of Wisconsin Form 2 -2003 ST. DEEDS ST. CROI QIY CO., MI WARRANW DEED RECEIVED FOR RECORD Document Number Document Name 0510212006 10 -. 35AN VARRANTY DEED EXfJPT I TIM DEED, made between Erik AL Johnson and Sara R. Johnson, husband and REC PER: 11.00 Wife TRAINS FEE: 110.70 C'Grantor," whether one or more), COPY M' CC FEBs And Jerry Watson and Jenifer Watson, husband and wife PAS; 1 ( "Grantee," whether one or more). Recording Amu Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant Name and Retum Address interests, in SL Croix County, State of Wisconsin ("Property") (if more space is `�� lealse attach addendum): t 7 )Plat of Waters Edge In the Town of Richmond, St. Croix County, onsin. 026- 1126 -t7-000 Panel Identitication Numtxr (PIN) This is not homesmad property. (is) (n not) Exceptio arr ties: Easements, restrictions and rights -of -way of record, if any. Dated (SEAL) (SEAL) *Erik M. Johnson (SEAL) (SEAL) * ; Sara R. t neon AUTHENTICATION ACKNOWLEDGMENT Signatures) authenticated on STATE OF ) ) ss. C ) r TITLE: MEMBER STATE BAR OF WISCONSIN Personally came before me on (If not, the above -named Erik N Joh on and a ohnson authorized by Wis. Stat. § 706.06) � husband and wife to c known to be th (s) who executed the foregoing THIS INSTRUMENT DRAFTED BY: �. e�`O �S ins m o e s C. Attorne Kristine OrLau �G� •��� ! ' Hudson. W154016 xN .__e% " ' e Not Public, of C� My Commissio (is permanent expires: (Signatnrea mar be authendated er acknowledged. 8ot4 are ant necessary.) NOTE: THIS IS A STA FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED 0 7.003 STATE BAR OF WISCONSIN FORM NO. 2-2603 • 'Iyrpc name below signatures. INFO•PROTM Legal Forms attltF 05 W#W"opn nom \ \M►A T C y L /NE' z LOT 19 LOT f8 ; .> <i H.W.E. 996.0 .x TOTAL AREA: TOTAL AREA: J� Ej 92,691 SO. FT. 3 94.358 SQ. FT. 2.13 ACRES N 2.17 ACRES S °_. F.F.E. 1000.0 W <b' i ew b H.W.L. \ -` ,�0 �i �p� <v Q. 461 12' ,- 0J1 i �' 64b , '•�J OT 17 I� N ! � N N7 OTAL AREA: °j , ph 8 452 SQ. FT. °� • ® a' 1.9 CRES 1 I / / LC F �� ,i TOTAI i 96,18 ®• I 2.21 I t , N 4� cO TOTAL AREA: ? { 5755 ai ° 0 88,607 SQ. FT. 2.03 ACRES t 46 J ; L ai i 4 �g13' f • ; TC \ 9: 04 3 S � � 2. �a O \ \