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HomeMy WebLinkAbout026-1151-21-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division �� n )' y � "[ k th � I NSPECTION REPORT sanitary Permit No: 420471 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: �aG , �� S y . a f/_0C Orf, Daniel T. Richmond Townshi CST BM Elev: Insp. BM Elev: BM Description: w.fl' ( ego .o' In.�Q i s cs Rte# TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ,* Benchmark 5 #12 Sara, l ug. a e Dosing vc�u Alt. BM 1 'O'• M 1 Aeration Bldg. Sewer 13.0 9Z.oS' Holding St/Ht Inlet , J Aj 9 , • Og 1 TANK SETBACK INFORMATION St/Ht Outlet JY,30 o.g TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ��\ I Dt Bottom 1 1 Dosing Header /Man. Aeration Dist. Pipe �S • V �•�6� Holding Bot. System iw q 3 .6 Ito - • b 1 PUMP /SIPHON INFORMATION Final Grade �QS� �• 10.0 gS:lZ Manufacturer Demand St Cover PM Model Numb TDH Lift ction s System Head T Ft Forcemain Lengt Dist. to Well SOIL PTION SYSTEM l' 9111111WRENCIf INidth Length No. f Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIME 2� � SETBACK SYSTEM TO TJ /L JBL IWELL LAKE /STREAM LEACHING M fa u r: INFORMATION CHAMBER OR 21 `+ - Type Of System: V. t N� C' UNIT Model Number: /I IX DISTRIBUTION SYSTEM 6 b Header /Manifold ,t Distribution x Hole Size x Hole Spacing Vent to Air Intake K Pip Length 0v Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil — Yes No Yes u' No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:&hAq / 07-1 o� Inspection #2: —1-1 Loca5ion: New Richmond, WI 54017 (NW 1/4 SE 1/4 20 T30N R18W) Wa�l(droff Meepgows L t 21 Parcel No: 0.30.18. 1.) Alt BM Description = °' r ta 1 ) , " % S ( 2.) Bldg sewer length = I 3"� db�sC ��tt� 6 ' ' - amount of cover = 50 � L K ( p�Orv��, .�„„� Z,'''Q 3) SAJS � . � � -� a cy1 Plan Use other de for additional Yes , No 44,Lc information. i r � � SBD -6710 (R.3/97) �DBt4%. w nse pctors Signature Cert. No. f Safety and Buildings Division County 201 W. W as hi ng t on Ave., P.O. Box 7162 N *is oonsin Madison, WI 53707 - 7162 Site Address Department of Commerce o -/i -d Z 3 D/3 d u r Sanitary Permit Application Satti Per Fa �q In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision may be used for secondary purposes Privacy Law, s15. 1 I. Application Information - Please Print All Information I.D. Number Property Owner's Name Parcel umber - property is Mailing Address ?. i Pro tion�74!!S / L22 T b� City, State Zip Code Phone Number umber Black Number , // 1 Subdivision Name um r c !J "ff II. Type of Building (check all that apply) fw tY ❑City 1 or 2 Family Dwelling - Number of Bedrooms yt b'`' ❑Village ❑ Public/Commercial - Describe Use Opts Township ❑ State Owned Nearest Road III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if plicable) A. For County use 1 New 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Addition to stem Tank Only Exis ' stem B. ❑Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) .V- —!aD 44 0 Non - Pressurized In- Ground 210 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ pressurized In -Ground 41 ❑ Holding Tank 4.8 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Rec acing 30 El other V. D' tment Area Information: n Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate( Gals. /Days/Sq.Ft.) (Min./Inch) Elevation �-' - / VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank r - basing Chamber VII. Responsibility Statement - I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber' ame (Print) I Plum s � MP/MI'RS Number Business Phone Number PI is Address (Street, City, State, Zip 6UO VIII. Count /De artment Use Onl Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) K Approved ❑ Disapproved Surcharge ) ❑ Owner Given Initial Adverse /) 2 �'_ I� Kg� �,� — Determination IX. ffl Conditions of Approval/Reasons for Disa//p++provali�, Attach complete plain (to the Couaty only) for the system on paper not less than 81n x 11 inches In be SBD -6398 (R. 05101) L V M N M 1-5 Y \ O o d \ � icy - cy r Y ru w C� Y cp r wiscofisin Department =of Commerce SOIL EVALUATION REPORT Page I of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code S� _ Crd►x Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal referen �+ �d�_ ,,,.�,g; n and Parcel I.D. percent slope, scale or dimensions, north arrow, and loca n anc�ilgrllAerl� roa Please print all infonnati n. �� vv �� 1 L J J Rev' wed by Date Personal information you provide may be used for secondary pu ses (P i, La 1 ) (m)). Property Owner Prope Locat n ( ' "00 �y,#NT& I 1/4S E 114 S 7o T 3Q N R I E (oro Property Owner's MailLn Mail' Add r s # Subd. Name or CSM# . 2- 1 S City State Zip Code Phone Number ❑ City ❑ Village [gTown Nearest Road Wi 154 61col VVL r<C� c ea New Construction Use: [�g Residential / Number of bedrooms 3 Code derived design flow rate O O GPD ❑ Replacement � Public or commercial - Describe: Parent material _ ou T W 4 Sln Flood Plain elevation if applicable //g-- ft, ti General comments t,1 (� f , �( /, o J and recommendations: 'n Y / _ l c J Cl p, p i) F T Boring # ❑ Boring 6 Ground surface elev. ��� ft. Pit Depth to limitin g factor I 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 I 6 IU 31 — si I Znybk rnP, CS I v 5 • 8' jin F2-1 Boring # ❑ Boring pit Ground surface elev. % yd ft. Depth to limiting factor I? L_ 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 U - g (6,j 3�2- - s'f I 2 fy'l C- C Z - 8" - 121 m rr z Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number �--__ 2533b Address Date Evaluation Conducted Telephone Number SBD -8330 (R07 /00) Property Owner L)0-W m Parcel ID # Page L of F3-1 ❑B c� Boring # Boring f 5 � d ft. Depth to limiting factor 2 5 in. Pit Ground surface elev. g Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz rn in. Munsell Qu. Sz, ConL Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Q -13 I 312. _ 5 1' 2 abk S I v Z 5. C-k 2 k y _ 1 �� — r p — — 1. ❑ ❑ Boring # Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ Boring # Boring Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 -264 -8777. SBD -8330 (R- 07/00) I - r • Property Owner t�_J(J -(c_3 Parcel ID # Page of 3 F3-1 Boring # Boring a Pit Ground surface elev. / S' d ft. Depth to limiting factor 2 S in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I 0 -1 3 l0 3)2- _ 5 t. 2 c:b S5 5 • Z f3- g Si m, 2 k _ 3 y -I l �t� r ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate ; Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 -264 -8777. SBD -8330 (RO7100) PAGE 3 OF TAME I.� � r� I LOT# z( LEGAL DESCRIPTION '+,f X l-�F 1 4 ,S zG T � ,N,R, 1 E(or) SCALE: I "= BM 1 ELEVATION /00 - C) BM 1 DESCRIPTION /fit. /• ;7 m BM 2 ELEVATION 16, BM 2 DESCRIPTION 4o p a SPC, ZO SYSTEM ELEVATION q1, o ( U ALTERNATE ELEVATION 70, 0 cN CONTOUR ELEVATION 9y- So 7 S Sb Y 2 u� �l Frd ry -0 7- s r-- l C , GNATURE _ - ` .. y DATE -IERS I 9 -10 167.00 26'31'08" N50'15'01 "W 76.61 77.30 N63'30'35 "W N3E 11 -12 233.00 21'21'11" S79'19'57.5 "W 86.33 86.83 N89 59'27 "W S61 r EACH PARCEL ON THIS MAP IS SUBJECT TO STATE, '-------------- - -- COUNTY AND TOWNSHIP / NOW462(ri LAWS, RULES AND REGULATIONS (I.E., '� 327'00 • WETLANDS, MINIMUM LOT / SIZE, ACCESS TO PARCEL, / h I ECT.) BEFORE PURCHASING / W PARCEL THE ST. / CROIX COUNTY ZONING / 20 �\ r OFFICE AND THE TOWN OF / �' RICHMOND FOR ADVICE. :Res ; 4co / LOT 22 O ' FT / ��'� 2211 ACRES 942.0 ; A• / (96,324 SO. FT.) LOT 21 �•._.._.._.._.._ / 2.760 ACRES / (120,220 SO. FT.) / • / / 90 [� OWNER'S CERTIFICATE OF DEDICATION @ AS OWNERS, WE HEREBY CERTIFY THAT WE CAUSED TI- DESCRIBED ON THIS PLAT TO BE SURVEYED, DIVIDED, DEDICATED AS REPRESENTED ON THIS PLAT, WE ALSO i+ THIS PLAT IS REQUIRED BY S236.10 OR S236.12 TO BE _ THE FOLLOWING FOR APPROVAL OR OBJECTION, ST. CRI PLANNING, ZONING AND PARKS COMMITTEE AND THE TO\ SIA CORNER WI , ESS THE HAND AND SEAL OF SAID OWNERS THIS_. SECTION 20J OF _ 200. I THE PRESEN E F� LEGEND DAVID WALDROFF IE WALDR F 9 FOUND ALUMINUM COUNTY STATE O F_ V--.e- _)SS SECTION CORNER MONUMENT COUNTY OF� FOUND 1" OUTSIDE DIAMETER IRON PIPE P _ � SONALIY CAME BEFORE ME THIS_ _____DAY FOUND 2 -3/8" OUTSIDE DIAMETER IRON PIPE 0 20Q,&,, THE ABOVE NAMED DAVID WALDR WAL ROFF TO ME KNOWN TO BE THE PERSONS WHO ­r Ttf� 1 \Ir \IT w►IT A111LIM rnrct+ TUr ar►V�Vc. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page -Lore FILE INFORMATION SYSTEM SPECIFICATION Owner Se tic Tank Capacity al o NA Permit # © Se tic Tank Manufacturer S o NA Effluent Filter Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Model ❑ NA Number of bedrooms o NA Pump Tank Capacity al grNA Number of Commercial Unit 46 NA Pump Tank Manufacturer ANA Estimated flow (average) gal/day Pump Manufacturer .rte NA Design flow (peak), Estimated x 1.5 ) gal /da Pum Model A Soil Applicatio Rate gal /dit /ft Pretreated Unit Ill fluent /1?ffluent (Quality Monthly Avcragc* a Sand /Gravel Filter n Peat Filter Fats, Oils & Grease (FOG) <30 ►ng /L n Mechanical Aeration a Wrlland Biochemical Oxygen Demand (BODs) 5220 mg /L o Disinfection o Other: Total Suspended Solids (TSS) < 150 m L Manufacturer Monthly Average" Dispersal Cell(s) Pretreated Effluent Quality O NA fa(In- ground (gravity) o In- ground (pressurized) Biochemical Oxygen Demand (BODs) <30 mg /L ❑ At - grade o Mound Total Suspended Solids (TSS) S30amg /L o Drip-line o Other: Fecal Coliform (geometric mean) <10 cfu /100mL Maximum Effluent Particle Size '/s inch diameter * Values typical for domestic (non - commercial) wastewater and septic tank effluent. ** Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequenc Inspect condition of tank(s) At least once ever o months d ear (s) (Maximum 3 rs) Pump out contents of tanks When combined sludge and scum equals one third '/� of tank volume Inspect dispersal cells At least once ever ❑ months .M ears Maximum 3 rs Clean effluent filter At least once every, 3o months ear(s Inspect pullip, Pump controls & alarm At least once every u months ❑ year(s) a'NA Flush laterals and pressure test At least once every ❑ months o ear(s) ONA Other: At least once every o months ❑ ear(s) A NA Other: At least once ever o months ❑ ears A 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 (%3) 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 ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatment components, and any other maintenance or monitoring at intervals of 12 months or less 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. 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 my impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tanks(s) removed by a septage servicing operator prior to use. Owner: 11)',91 a Pose System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal high water levels. When power is restored the excess wastewater will be discharged to the dispersal 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 soft absorption are. 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. ABANDONEMENT 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 ch. 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: )21 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 the time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLRk POWTS MAINTAINER Name Name Phone yz4c Phone SEPTAGE SERVICING OPERATOR PUMPER) LOCAL REGULATORY AUTHORITY Name Name Phone ' Phone ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer � "� 1 6 L Mailing Address 'Ps'nIV Property Address (Vera ation required from Planning Apartment for new construction) City /State Parcel Identification Number ' LE GAL DESCRIPTION Property Location p rtY / <, 5r /4, Sec. T R�,_W, Town of ZL�4� Subdivision � �,t , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # q� 32-� , Volume d , Page # &33 Spec house yes Q no Lot lines identifiable yes O no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection.and pumping (if necessary), the septic tank is less than 1/3 full of sludge. 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 Zoning Office within 30 days of the three year z:r7ati date. SIGNATURE OF APPLI ANT 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 describe7ab e, by virtue of a warranty deed recorded in Register of Deeds Office. SId14ATURE OF AP ICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed " i 69 1 326 J 1 JA& &IPOF WSC FORM 2 - 1999 KATHLEEN H. MALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX Co., WI This Deed, made between David J. Waldroff and Julie A. RECEIVED FOR RECORD Waldroff, husband and wife, 09 -23 -2002 9:30 AM WARRANTY DEED Grantor, and Daniel T. Orf EXEMPT # REC FEE: 11.00 TRANS FEE: 112.50 COPY FEE: CERT COPY FEE: ' Grantee. PAGES: 1 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 Lot 2 , Waldroff Meadows II, St. Croix County, Wisconsin. Name and Return Address KRISTINA OGLAND ESTREEN & OGLAND 304 Locust Hudson, WI 54016 Pt 0 10- 1062- 10-000 Parcel Identification Number (PIN) This is not homestead property. (9) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this l CP t7� day of September 2002 xv� V ' * Davi J. Waldroff ' * Juli . Waldroff Alf AUTHENTICATION ACKNOWLEDGMENT Signature(s) David J. Waldroff and Julie A. Waldroff, husband STATE OF WISCONSIN ) and wife, ) ss. County ) authenticated this P day of September , 2002 Personally came before me this day of the above named • Kristina Ogland TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) �. THIS INSTRUMENT WAS DRAFTED BY • Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, WI 54016 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) •) a Names of persons signing in any capacity must be typed or printed below their signature. information p rofessionals company, Fora du Lac, WI WARRANTY DEED STATE BAR OF WISCONSIN 800-655-2021 FORM No. 2 - 1999 09126.02 THU 10:14 FAX 715 386 4686 ST CRX CO ZONING 004 9r s V —tiv Ial.uu 40v1 ua mou'lavl vv io.ol 11.JV rvor0Y43`W N; 11 -12 233.00 2121'11" S7919'57.5 "W 86.33 as.83 N89'59'27 "W st i M EACH PARCEL ON THIS MAP �� M_G ( G°�_ PL[R� L& IS SUBJECT TO STATE, / ° N�Bli°46'ZO� COUNTY AND TOWNSHIP LAWS, RULES AND .ar 327.ar REGULATIONS (I.E., WETLANDS. MINIMUM LOT / SIZE, ACCESS TO PARCEL, / h ECT.) BEFORE PURCHASING / OR DEVELOPING ANY W PARCEL CONTACT THE ST. CROIX COUNTY ZONING / �O �` r OFFICE AND THE TOWN OF / RICHMOND FOR ADVICE. $1ES L OT 22 ) /, X42 0 i r / x 2.211 ACRES + (96,324 SO. FT.) LOT 21 / 2100 ACI9ES / (120x20 SO, Fr.) I • r, s I If, -- ownEs CEPMPIOATE of DMCATI 0j ^^ AS OWNERS, WE HEREBY CERTIFY THAT WE CAUSED Ti ---�--- DESCRIBED ON THIS PLAT TO BE SURVEYED, DIVIDED, DEDICATED AS REPRESENTED ON THIS PLAT. WE ALSO THIS PLAT IS REQUIRED BY 5236.10 OR S236.I2 TO BE �f THE FOLLOWING FOR APPROVAL OR OBJECTION ST, CF PLANNING, ZONING AND PARKS COMMITTEE AND THE TO CORNER WI SS THE HAND AND SEAL OF SAID OWNERS THIS_ SSECTION20 r OF hn 200 • r .+� J ` ' I TF1E PRESEN E F� L DAVID VAIDROFF �WDR FOUND ALUMINUM COUNTY STATE OF_ � _)SS SECTION CORNER MONUMENT COUNTY f FOUND 1' OUTSIDE DIAMETER IRON PIPE: PERSONALLY CAME BEFORE ME THIS__ L1 ___DAY FOUND 2 -3/8' OUTSIDE DI IRON PIPE D _ _ 20P0�, THI: ABOVE NAMED DAVID WALDF VALDROFF TO ME KNOWN TO BE THE PERSONS VHO,, __t _ _ ._. .,, .� _ _ - - � rnnrrn�.,� •ue.rro ulr.T we,h wr,..,N h f`he7C�1 �'NC w C 1