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HomeMy WebLinkAbout026-1131-07-000 n N Q 3 n d �1 O it f c , O j 3 n 4 A n CD Al • (D 3 < z .. _ O Cn T Z o z W -� v N• � N O = O O °D a N 3 v \ N c S CD 0 7 W O \ 0 0 m -1 of o o c m o m co 0) a o o C) - O Z to C 0] CD `ri z D C CD c_ D N a c CD c D 3 rt a rn m N N N z O m v O) m O ! m { C) N N W C) W (n Q C W ? 3 r. CL cn to to Qo Q v v O W m m N O N y V 0 C N ` .. M - (� N z o � y Eli D N o m $ m �• N !rl N CD C/) c W w Z m d A z m N C n - z O CL A I CL z 3 A g r: z N z j O A ? F 3 N O O m 0 O� Q O O'O 3 < o 3 cD e- C O c m m m N a N C y0o� ; z a O WD CD c O CD a -< O 0m a U ?7 O m N 3 3 S D) O d tp O j gm aD) �.. m 3 c • � R -a =1 m N D w 'O N 0 3 c — < m 00= O o 07 7 < N n n =. a O CD 7 D_ _ > ? W N m O N m Qo < tv (n W d O M Ui Ill A p V CD ! D ti o 0 a o CL �° Parcel #: 026- 1131 -08 -000 04/18/2007 05:12 PM PAGE 1 OF 1 Alt. Parcel #: 17.30.18.910 026 - TOWN OF RICHMOND Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - SICARD, MARK & MARJORIE MARK & MARJORIE SICARD 1018 159TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description " 1022 159TH AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.970 Plat: 0066 -B & R'S ROLLING ACRES 026/01 SEC 17 T30N R18W PT NW NW B & R'S Block/Condo Bldg: LOT 08 ROLLING ACRES LOT 8 1.970AC Tract(s): (Sec- Twn -Rng 401/4 1601/4) 17- 30N -18W NW NW Notes: Parcel History: Date Doc # Vol /Page Type 08/27/2003 737770 2391/463 WD 06/14/2002 681685 1910/56 LC 04/04/2001 642122 8/42 PLAT 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 04/22/2003 Description Class Acres Land Improve 1 Total State Reason RESIDENTIAL G1 1.970 31,200 74,900 106,100 NO Totals for 2007: General Property 1.970 31,200 74,900 106,100 Woodland 0.000 0 0 Totals for 2006: General Property 1.970 31,200 74,900 106,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: 146 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 430126 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: 0 ;* --113I Z5_7 Sicard, Mark I Richmond Township 0366 -980 CST BM Elev: Insp. BM Elev: BM De cription: Section/Town /Range /Map No: /00 . D 00 • d M �/ 17.30.18. ?0 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benc ark Dosing Alt. BM CO Aeration ` Bld . Sewer J _. (v Holding 1 StJFVInlet S /0 -( TANK SETBACK INFORMATION St/ utle 5'.rJU lo 3 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD I Dt Inlet �- IG 6y--5 Septic \ Dt Bottom Dosing / Header /Man. o / Aeration Dist. Pipe 4 i�QL G� 8 Z ? - `I Holding Bot. Syste F Grade PUMP /SIPHON INFORMATION Z oa 3 Manufacturer Demand St C ver 'IV 3 .13 v o, Model Number TDH Lift Frictio System Head TDH F Forcemain Len Dia. is. SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length / No. Of Trench PIT DIMEN No. Of Pits Inside Dia. Liquid Depth DIMENSIONS INFORMATION SYSTEM TO P/Lg JBLDG W LAKE /STREAM �H!AMBER ,r ef: Type f System: --YYoo// r i / M odel Number: D!§T IBUT10N SY T 44, — r v YOX Header/ anifold istribu n x Hole Size x Hole Spacing Vent �t'r Intake Pipe(s) / q /h 12 / ! Length _1 Dia f Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only a 0� Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Fj Yes is j No ! Yes [ !; No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / /0 Inspection #2: Location: 1018 159th Ave New Richmond, WI 54017 (NSW �1 /l4�NW 1/4 17 T30N R18W) Rolling$�„��G Lot 7 Parcel No: 17.30.18. 1.) Alt BM Description = �T ' W YGf`� yrc`���6P o� S�tc� D . 3S / �ifG�rt t (lOrwr+'J 2.) Bldg sewer length e� =/ D ,5 `tL � A � � �- Sl2o p ),A/ YbZvt�� - amount of cover = ((/ �,�� �� �yS'`` - /ozv�. - /�-• �ST� tom. • N. � • �/ Z3o-i,�+c� Plan revision Required? Yes No _ O o"_� Q 3 _i - G� -- Use other side for additional information. Zj �' SBD -6710 (R.3/97) / �/ �e KJ / / GC • i(/ c.� ���' f/1/lk S�i,6 43 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 `� sconsin Personal information you provide may be used for second purposes p Madison, WI 53707 -7302 Department of Commerce Submit completed form to coup if not [Privacy Law, s. 15.04(1)(m)] ( p county state owned.) Attach complete plans ( the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. County e ^ ' State Sanitary Permit Number ❑ Check if revision to previous application State P lan I. D. Number Lf J Ko I. Application Information - Please Print all InformatfWr - ; --- _. _ Location: Property Owner Name C . R - • iN Property Location C — C�/ 'U Property Owner's Mailing Address / i Lot Number Block Num er 7,(- C City State t Zip Code tttlr►e Nud► er' Subdivision Name or CSM Number r II. Type of Building: (check one) . o 5 w ,x 014 c ❑ City 1 or 2 Family Dwelling - No. of Bedrooms :_ ❑ illage ❑Public /Commercial (describe use):_ � ® "^ ° ` A ' r ' °/;')� ❑ State -Owned I=rr Nearest Road � T ax Number(s) � A i Parcel III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) A) 1. ew 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System $) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV Type of POWT System: (Check all that apply) A on-pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area n 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Requir Proposed nO.1S Rate (Gals. /day /sq. ft.) (Min. /inch) T /,� Elevation 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 ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumb 's Name (Print) Plumber's re (no slam MP/MPRS No. Business Phone Number ti Pffimp&s Address (Street, City, State, Zip Code) IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued ssu' g Agent Signature (No stamps) Approved ❑ Owner Given Initial Adverse Surcharge Fee) / \ Determination $ 225— X. Conditions of Approval /Reasons for Disapproval: L n MAJt� 6, vA 9 SBD -6398 (R. 07/00) OT PLAN PROJECT -Lr� ADDRES �14 1/45 /T N/R W TOWN GOUNTXS� Y MPRS Byron Bird Jr. 2205 DATE 'rte BEDROOM CONVENTIONAL XXX A rade CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE ! �6® LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE , ABSORPTION AREA �L # of chambers ,BENCHMARK V.R.P. — T PL _ ELEVATION 100 ❑BOREHOLE O WELL *g.R,P, r t +. � IS3 r - L AT' Vent SYSTEM ELEVATION 3I� /- Sidewinder High 5r1 s'-} - Capacity Leaching Chamber with 17.2 6" t ^2 per chamber Long 34 79 Elevation >-� v ? � CiJ a, I� -. p OT PLAN PROJECT ♦ ADDRES�C /4 1� 1 /4S /' �jQ Ni 1 W TOWI�i � MPRS Byron Bird Jr . 2205 DATE r BEDROOM CONVENTIONAL XXX A rade CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE Q LOAD RATE , ABSORPTION AREA,0 i; 7# of chambers BENCHMARK V.R.P. - ` PL k� ;� �ASSUME ELEVAT 100' ❑ BOREHOLE `0 WELL * H.R.P. 7 - r-- >12" k69 SYSTEM ELEVATION of idewinder High Cove apacity Leaching hamber with 17.2 t ^2 per chamber Gradent System Long 34" Elevation , 9 am Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Dl ision of Safety and Buildings In accordance with Comer 85, Wis. Adm. Code Attach complete site plan on paper not less than 81/2 x 11 Inches in size. Plan must County �ir b i Include, but not limited to: vertical and horizontal reference point (BM). direction and parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to newest road. Please print all lnformadon. R by Date Personal infonnstion you provide may be used for secondary purpom ( *mq Law. s. %04 (1) (m)) 0 / 2 Property Owner i, �� Govt. Lot�� 1/4 � S T c� N R ,f )� /° � C.� E vrWP Property Owner's Mailing Address Lot # Block # Subd. or qs Mr g � e- 4. 7 ! t lilGrc �" Cfty fate Zjp Code Phone Nu ❑ qty ❑ yipage JaTown Nearest Road New Construction User Residential / Number of bedrooms Code derived design flow rat GPD ❑ Replacement ❑ , Public or rcal - Parent material L C- i Gt Flood Plain elevation if applicable ft. General comments �r. • �� f y and recommendations: 51 Boring # Boring P! Pit Ground surface elev. 4. ft. Depth to limiting factor /� in. 1 SoN Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDM In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •EM01 •Eff#2 t� .� 93.3' Boring # Boring �-j -fS it Ground surface elev. ft. Depth to limiting factor in. Soli tion Rate Horizon Depth Dominant Color Redox Description Texture WR Structure Consistence Boundary Roots GP' In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Etf#2 7 7 140 �•io ST ,; p ON Z 9PN'NGQF1 Ir.E ' Effluent #1 • BOD, > 30 < 220 mg& and TSS >30 _ <.150 nqA. ' Effluent #2 ■ SOD, US < CST N (Please PrIOU T 3 turn; mbar Add / - Date Evaluation Conducted Telephone Number /f� � r Property Owner LfJf G ' ► Parcel ID # Page of Boring # ❑Boring . _ �f � 1 jj Pit Ground surface elev. " ' fL Depth to�imiti g factor in. —� Soil AP lication Rate Horizon Depth Dominant Color Redox Description ;: Texture Structure Consistence Boundary Roots GPD/ft In. Munsell Qu. Sz. Cont. CoIQr °.;': Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring # / o Boring Pit Ground surface elev. ­4 ft. Depth to limiting factor 711i 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. R 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 x,.150 mg/L ' Effluent #2 =.SOD, 130 mg/L and TSS < 30 mg/L The Department of Commerce is as 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. SBD6330 (R6=) : Soil Test Plot Plan Project Name Bill Stock Byro�ddJ ' Address 1478 112th St. New Richmond Wi. 5 CST #220527 Lot 7 Subdivision Rolling Acres Date 11/4 NW 1 /4 NW 1/4S 30 N /R18 W Township Richmond_ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft t of PL wood stake System Elevation 93. 3 H.R.P. same as BM p,3s' lowe # Alt. BM asum 100' -I��h 133 e/eva�l2s�.� top of wooden stake c„lso q" ca,,- s( 13� b-e- cz,+ 2.QS2iv'A- t a4 l co • o is �e lotiJ � .�Y►h� add per. 3' -� PL 200' B2 4 9 pv B4 45' Bl 1 30' 30' 5' B.M. 429' PL 97' 98' 99' POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ' of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity a l ❑ NA Permit # ®)2( i% `a �' 1 S� Gc� �,,, Septic Tank Manufacturer � // t ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer �C.e ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model B d ❑ NA Number of Public Facility Units NA Pump Tank Capacity a l gNA Estimated flow (average) I g al/day Pump Tank Manufacturer A Design flow (peak), (Estimated x 1.5) al /day Pump Manufacturer A Soil Application Rate al /day /ft2 Pump Model ANA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit XNA Fats, Oil & Grease (FOG) :_30 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODd :5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended S olids (TSS) :150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L - Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) :10 cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y. in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA * Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ eanl 1(s) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and sc m equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ yea�Is1(s) (Maximum 3 years) ❑ NA ❑ month(s) ❑ NA Clean effluent filter At least once every: ❑ year(s) ❑ month(s) d)NA Inspect pump, pump controls & alarm At least once every: ❑ year(s) l ❑ month(s) /M INA Flush laterals and pressure test At least once every: ❑ year(s) Other: At least once every: ❑ month(s) A ❑ year(s) Other: ANA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of :12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) Page 2 f � — START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS (o (,e -� S A 7 0 Ccr POWTS INSTALLER POWTS MAINTAINER Name r Name Phone Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name d n p Name L` f ^f� Phone ��� y Phone ''6 6 �� This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f► and 83.54(1), (2) & (3), Wisconsin Administrative Code. ST CROIX COUNTY • SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CER CATION FORM Owner/Buyer Mailing Address /117a © L4 e t ( '. Property Address (Verification required from Planning Department for new construction) City /State Parcel Identification Number LEGAL DESCRIPTION ,�,I Property Location y4, ! 1 /4, Sec. /T , T�N- RR.�W, Town of Subdivision ®� /f h y' e Lot # �. Certified Survey Map # (^� Volume ---- . .Page # Warranty Deed # ��� , Volume o? t.g Page # Spec house ❑ yes V( no Lot lines identifiable pr yes ❑ no SSTEM CE 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 mastorplumber, journeymanplumber, restdctedplumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal 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 days of the year expire ' date SIGN TORE OF 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) of the property described above, by virtue a warranty deed recorded in Register of Deeds Office. SI A OF AP ICANT DATE ****** Any information that is mis represented may result in the sanitary p g Y �8 >� •' 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 1 2206 P 319 717353 STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST, CROIX CO., WI RECEIVED FOR RECORD This Deed, made between William B. Stock and Roxanne Stock, husband and wife, 04/15/2003 09:30AK WARRANTY DEED EXDIPT # Grantor, and Mark Sicard and Marjorie Sicard, husband and wife, REC FEE: 11.00 TRANS FEE: 75.00 COPY FEE: CC FEE: 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 6 0P, B and R's Rolling Acre in the Town of Richmond, St. Croix County, Name and R �s Wisconsin. WIi IA OGL.AND ATi"C 7A' =y AT LAW 359 HUD'—"C,. :, VVl 54016 026 - 1131 -07 -000 Parcel Identification Number (PIN) This is not homestead property. N) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of April 2003 12 6 ' • Willie . Stock * ffo4ne Stock AUTHENTICATION ACKNOWLEDGMENT Signature(s) William B. Stock and Roxanne Stock, husband and STATE OF WISCONSIN ) w ife, ) ss. County ) authenticated this of April 2003 V � - z Personally came before me this day of the above named * K ristina 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, W is. Stats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY s 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.) , ) " Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals company Fond du Lac. WI WARRANTY DEED STATE BAR OF WISCONSIN 800{55 - 2021 FORM No. 2 - 1999 e UNPLATTED LANDS - - -- N89'53'20 "E ----- - - - - -- 2610.86' - - -- -- N89'53'20 "E - - - - - -- 1075.43 - - - -- UNPLATTED LANDS l - -K- .K-- -* - -* x-- -w- - -- x -x- *- - - -* --,r -,* -* --m -* --* -* - - -�r ---K -K --x � �c 1 .i► - NORTH LINE OF THE NW 1/4 230.02' 202.40' 200.02' 200.02' 28' 965.07 28' LOT5 -LOT 6 LOT7 LOT8 81,256 S0. FT. 86,289 SO. FT. 85,868 SO. FT. 85,868 SO FT 1.87 ACRES 3 1.97 ACRES 1.98 ACRES 3 3 1.97 ACRES N cO :n O N N M p 't :n N :n N C� Z O d Q d N O cV� • z 1 z 28• ` JV02'09 47 "w — i 38.27' / Yo 9 L ©Slobs F 119.20'— r — — — 200.02' — — — — — 200.02' — �9 ? N89'53'20 "E 519.24' X 49 4 0 2 � • _ TOW ROAD �- 40 N89'53'20 "E 520.12' 8s9 �e •••�•• - - -- 245.10' -- - ----- 275.02' - - - -- 12' UAL /TY EASEMENT , • I BO RADIUS \ IN, I / TEMPORARY CUL- DE -SAC- . EASEMENT TO BE REMOVED UPON EXTENSION OF ROADWA Y. LOT 10 LOT9 L O T 11 3 3 ,o 92,070 SO. FT. M 92,051 SO. FT. I r 97, 010 SO. FT !g 0 d ? c M 2.11 ACRES iv W� I 2.2.3 ACRES O M b O M 2.11 ACRES F.F.E. 947.5 O W z 0 F.F.E. 9475 W FF.£. 947.5 �k9 k S 8931 48 "w f38.75' — S�