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HomeMy WebLinkAbout026-1127-40-000 f Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division i INSPECTION REPORT sanitary Permit No: 399509 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: Marek, Todd I Richmond Township 026- 1127 -40 -000 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic W t Z � © Benchmark , 12.3 a`� CD, o Dosing 6 Alt. BM �-; 3 tZ . —9, Aeration Bldg. Sewer / 5. 15 • Holding St/Ht Inlet r TANK SETBACK INFORMATION St/Ht Outlet 1 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic , 3 S / Dt Bottom Dosing Header /Man. -fi r Aeration Dist. Pipe , I Z 474111 Holding Bot. System r Final Grade ' PUMP /SIPHON INFORMATION Manufacturer Demand St Cover Model Numb TDH Lift iction Loss System Head TDH Ft Force n Len th Dia. g SOIL ABSORPTION SYSTEM R NC Width L r No. 9f Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIME NS SETBACK SYSTEM TO P/L II.. JBLDG IWELL LAKE/STREAM LEACHING INFORMATION CHAMBER OR Type Of System: / r UNIT M I Number: J. 25+ 1 ?jZ DISTRIBUTION SYSTEM Header /Manifa t t Distribution x Hole Size x Hole Spacing Vent to Air Intake `. pipes w qS Length 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 —2 V ~ 4 - Bed/Trench Edges Topsoil J � Yes � No � Yes � No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: I) / I S / I Inspection #2: Location: 1335144TH STREET New Richmond, WI 54017 (NE 1/4 SE 114 25 18 Rich d Parcel No: 25.30.18.850 1.) Alt BM Description 2.) Bldg sewer length = 14 r - amount of cover = ,b" . 3 � ;au k -IIV 4. R Plan revision Required? ❑ Yes No , 22 C} g e other side f q( additional information. ) � ( ,,3 al �,�eAhev,. - f 9 me— . Date 41nseto s Sgnature Cad. No. *s ` 9 3 Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 lVi sconsin Personal information y p rovide ide ma be used for second p urposes Madison, WI 53707 -7302 Department of Commerce y p p [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not state owned.) Attach complete plans (to the county copy only) e>p�op er not less than 8 -1/2 x 11 inches in size. State Sanitary Permit Number r6v►siifti Q p^p - bus application State Plan I. D. Number I. Application Information - Please Print all Informat' Location: Property Owner Name Q Property Location Property Owner's Mailing Address Q 11n Lot Number Block Number Cp' S City, State Zip Code , )'hone her Subdivision Name or CS M N m r II. Type of Building: (check one) f � ❑ City 1 or 2 Family Dwelling - No. of Bedrooms : � d� �r f3 ta+- 5 � uvr. i 4CA ❑ Village Pu blic/Commercial (describe use):_ ArTown of X ❑ State - Owned 7 ";Fa Nearest Road �! t / / rr /_ !�a '.t1s i< Parcel Tax Numbers) � C(e c�P 7` r � G.s� G / O /�J III. Type of Permit: (Check only one bo on line A. Chec ox on line B if applicable) 2 3 PJ 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) IV " Type 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: L 11 A, s 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed S/ y Rate (Gal «da /sq. ft.) (Min. /inc �, _ - �, evation / �B� ✓ -mo -a A 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 / r2 -P � ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility fo installation of the PO WTS shown on the attached plans. Plumb Name (print) I Plumb i ature (no stamps): MP/MPRS No. Business Phone Number �,V 01-7 Yr u er's Address (Street, City, State, Zip Code) IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issum Agent Signature (No stamps) Approved ❑ Owner Given Initial Adverse Surcharge Fee) Determination Z Z l C<D X. Conditions of Approval /Reasons for Disapproval: 1. Effluent filter to be installed and maintained per manufacturer's recommendations. 2. Well setbacks to be maintained per NR 811 & 812. SBD -6398 (R. 07/00) " W i sconsin Department of Commerce SOIL EVALUATION REPORT Page 1_ of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must St . Cro ix include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and lo caiTr 8•nd distance to nearest road. - endiri s Please print all infprm4tr'bnr Rev' ed y Date Personal information you provide may be used for selton�ary'purposes*vacy Law, s.'15.U+� (1) (m)). Property Owner L -° Pr pQrtyy,Location R J C Develo ment INC. Govt Lot NE 1/4 SW 114 S T N R (or) W Property Owner's Mailing Address f- of Block # Subd. Name or CSM# 1868 Ct Rd. C ? �� `'' na R' Hills City State Zip Code .Phone NumberGO'u c6' © City;' El Village [Z Town Nearest Road 2 Richmond 130th. Ave. New Richmon WI 54017 (7 5) 24 ® New Construction Use: ❑ Residential / Number of beiietiofn ° 4 Code derived design flow rate 600 GPD =' ❑ Replacement ❑ Public or commercial - Describe: Parent material outwash Flood Plain elevation if applicable ft• na General comments and recommendations: trenches spaced to code 3.50' below grade a Boring # Boring 1 0 0. 1 0 ® Pit Ground surface elev. ft. Depth to limiting factor '+ 9 0 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -9 10 r 2/2 none L 2 .5 .8 2 9 -27 m .5 f 3 27 -90 7.5 r 4 none .7 1.2 4 F- Boring # R Boring 2 ® pit Ground surface elev. 100.6 Depth to limiting factor + 9 6 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2 1 0 -16 10 r 2/2 none L 2 .5 .8 2 16 -39 10 r 4/4 none .5 .8 ✓ 3 9 -48 7.5 r 4/4 none .7 V 1. 4 48 -96 7.5 .7 1.2 ' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 150 mg/L uent #2 = BOD < mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Gar L. Steel 02298 Address ate valdetion Co ucted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 10 -19 -2000 715 - 246 -6200 - 1 r � Property Owner R J C Developme Inc Parcel ID# pending Page 2 of 3 ❑ Boring # ❑ Boring 3 ❑X pit Ground surface elev. 100,0 Depth to limiting factor 9 6 in. Soil — Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 1 0 -11 10 r 2/2 none L 2 2 11 -20 10 r 4/4 none sil 2 3 0 -32 7.5 r 4 none is os mvfr ✓ 4 32 -96 7.5 r 4 non Boring # F] 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 /f in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. El Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fY 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.6/00) ■ STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 RJC Development, Inc. New Richmond, WI 54017 MPRSW -3254 to 4 S25 T30N - R18W 715 246 -6200 town of Richmond lot #40- Richmond Hills N 1 =40' BM.= top of 1" pvc pipe @ eol. 100.00' Alt. BM.= top of 1" pvc pipe @ el. 100.75' 0 6' P� 2 Yo Gary L. STeel 10 -19 -2000 I � / ` PLOT PLAN PROJECT / G //% ` �` rG 1 ADDRESS a I �f/' 1 /4 �,� 1/4S �S /T �� N/R �.C� W TOWN / g COUNTY 7/ •- MPRS Byron Bird Jr . 2205 DATE p BEDROOM C� 'CONVENTIONAL XXX A Grade CONVENTIONAL LIFT HOLDING TANK 'T MOUND SEPTIC TANK SIZE 4v26 d'--) LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE ABSORPTION AREA # of chambers 30 k BENCHMARK V.R.P. ASSUME ELEVATION 100' BOREHOLE • WELL 1 O H.R.P. A Vent SYSTEM ELEVATION _ r f_ S- �_�_ >12" Sidewinder High of Capacity Leaching Cov Chamber with 17.2 6' t ^2 per chamber Long 34" Elevation y D�� �a a -3 i gz AIL pa IU1� b ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND O WNERSHIP CERTIFICATION FORM Owner/Buyer Eo </C1 ,'�re / 1 Mailing Address _ l2 3 5� �J� ST Property Address (Verification required from Planning Department for new construction) Ll d —QOd City/State �c.�r' /C.fi�c� Parcel Identification Number 6 LEGAL DESCRIPTION /� Property Location / 1 4, y� ' /,, Sec. . T N -R�W, Town of � f e n c. Subdivision /'�,/ D� , Lot # Certified Survey Map # Volume , Page # Warranty Deed # 6 � � ©� . Volume 6 Page # :KS Spec house g yes ❑ no Lot lines identifiable N yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site 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 three yearexpiration date. YA SIGNATURE 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 theT d above, by virtue of a warranty deed recorded in Register of Deeds Office. SIG ATURE OF APPLICANT 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 POWTS OWNER'S MANUAL a MANAGEME PLAN rage of FILE INFORMATION SYSTEM SPECIFICATIONS Owne �c ) Septic Tank Capacity O al ❑ NA u 4 Permit # Septic Tank Manufacturer jcYe * ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer NA Number of Bedrooms El NA Effluent Filter Model ❑ NA �� Number of Commercial Units ❑ NA Pump Tank Capacity gal ❑ NA Estimated flow (average) gal /day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) gal /day Pump Manufacturer ❑ NA Soil Application Rate gal /day /ft' Pump Model ❑ NA Influent/Effluent Quality Monthly average* Pretreatment Unit ❑ NA :_30 mg/L ❑ Sand /Gravel Filter ❑ Peat Filter Fats, Oil Grease (FOG) ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODs) :5220 mg /L ❑ Disinfection ❑ Other: Total Suspended Solids ( TSS) :5 150 mg /L Manufacturer Pretreated Effluent Quality ❑ NA Monthly average* * ;I ersal Cell(s) Biochemical Oxygen Demand ( BODs) _3 m L (gravity) ❑ In- ground (pressurized) < 0 g/ Total Suspended Solids (TSS) <30 mg/L ❑ At -grade ❑ Mound Fecal Coliform (geometric mean) :510 cfu /100mI ❑ Drip -line ❑ Other: Maximum Effluent Particle Size A inch diameter * Values typical for domestic (non - commercial) wastewater and septic tank effluent. * * Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Frequency Service Event Inspect condition of tank(s) At least once every jEmonths Xyear(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one -third (A) of tank volume Inspect dispersal cell(s) At least once every ❑ months ❑ year(s) (Maximum 3 yrs.) Clean effluent filter At least once every months years) Inspect pump, pump controls ei:alarm At least once every ❑ months ❑ year(s) ❑ NA Flush laterals and pressure test At least once every ❑ months ❑ year(s) ❑ NA Other: At least once every ❑ months ❑ year(s) ❑ NA Other: At least once every ❑ months ❑ year(s) ❑ NA MAINTENANCE INSTRUCTIONS inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Mast Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspectiot must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure tf 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 nodflcadon of the local regulatory authority. the entire contents of the tanks When the combined a hall be I removed edsb s Septage Servicing Opera or l and disposed o)f o n accordance e with ch. I NR 113, Wiscom Y Administrative Code. The servicing of effluent fliters, mechanical or pressurized POWTS components, pretreatement 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 chemic that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the conter nr rhn rank(sj ramovP by ( i tentasz servicing operator prior to use . page — or_ System start up shall not occur when soil conditions are frozen at the Infiltrative surface. During power outages pump tanks may fill above normal hlghwater 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 badwp or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a $QPu a Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Malntalner to assist In manually operating the pump controls to restore ncrmai levels within the pump tank. Do not drive or park vehicles over tanks and dispersal ceils. Do not drive or park over, or otherwise dlswrb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption arra. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the lift 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; easolne; grease; herbiddes; meat scraps; medications; oil; painting products: aesticides; sanitary naokins: tampons; and water softener brine. ARAN DON EM ENT 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 opeoings sealed, • The contents of all tanks and pits shall be removed and property . dLtposed 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 of another Inert solid material. CONTINGENCY PLAN If the POWTS falls 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 replanent area. Upon fallure of the POW S 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. O Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the inflitradve surface. Re <onstivctlons 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. SO DEATH MAY RESULT, RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPMURI F. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name = o ,�- Na me e ire Phone — Phone / o? 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Ea"Mont 133' I i ------- - - - - -- --- - 285.82' -'- __ -__ -' --� I �------ - - - - -- 293.00' ----- - - - - -- —482.21' S00'1 3'53 "E ------- - - - - -' w N00'13'53 "W 586.01' — — — TOWN ROAD I — — — s — — — — — — 481.81' S00'13'53 "E ------- -'— Us N00'1 3'53 "W -- - - - - -- 225.69' -- - - - - -, I r - - - -- 197.00'-- - - - - -- - - - - - - I I o�i Droba9s Ea"Mont � U 33' po I N I I I I I O 100 I z 'o w z cnc '� V Va0 I I� i�:r L, ►v A� qtr p N 4• N n h) n a I • --I O a o cn O tJ v 4 I V1 �; U n (!� C t ~ ~ I N i ° 1 33' fn �t+1W — .._.._.. i._.._..— _ •rn / Gr N C 9 ; o 00 ::1 ao w I I I I I � I 221.97' 6600 1 ' 181.00' x ---w- 1414.35' - -- =� �-- ----- S00'13'53 "E - -- 2625.41 - -- 80' RADIUS TEMPORARY CUL —DE —SAC TO BE UNPLA TTED" L, REMOVED UPON EXTENSION OF THE ROADWAY. ------ - - - - -- - 0 x I I �� N zm a O c r '' `S A Q O i x �N 0 - 4 C M, > 'r 1 S = � v _1 O -0 Cl) - n (A NO N O N N z O tJ YD rC 3 O O C O rt N .�► ~' 0 CD m y S? A O O V a 7 w! 0 3 :V =r O D z m m % fT1 m o o' 3 I 0 O r w o y O 7 N �. 7 O N D 3 •p " O �'- z v 3 r '' z � m o — � 0 w w 8 rt • �.r 7 c p I N 7 14 C OD 0 ov v, 3 Gzi M o 0 0 vY_ 00 o m a Aj = c � 0 y 0 -1 5 m j >33 �m n o i° �a v z =7 0 ;v z N `t 0 ri 5. {0 .► x G = ? Q � o0 O � C gel_ 1618PAGE352 + STATE BAR OF WISCONSIN FORM 2 .1999 Document Number WARRANTY DEED 6'42802 YATW FFN H. WALSH REGISTER OF DEEDS This Deed made between RJC De velopment, Inc., a Wi sconsi n ST. rRoIx Co., WI Corpora _ P.ECEIVED FOR RECORD -- - - - - -- - - - -- -- -- - -- 04 - 16 -Pool 9:30 AM Grantor, and To ` — -- - WARRANTY DEED — - _ E1FMPT # - - -- ---- - - - - -- -- - -._ .--- - - - - -- - -- CERT COPY FEE: - --- - - - - -- - - - -- - - COPY FEE: - - -.- - - -- -. - - - - - TRANSFER FEE: 93.60 Grantee. -- - - - - -- -------------- - - -_ -- RECORDING FEE: 10.00 Grantor, for a valuable consideration, conves to G PAGES, I following described real estate in St. Croix rantee the _ y State of Wisconsin (if more space is needed, please attach addendum) aunty, Lot 40, Plat of Richmond Hills in the Town of Richmond, St. Croix County, Recording Area Wisconsin. Name and Return Address KRI "'A OGLANO AT :NIEY AT LAW D BOX 359 HUDSON, W! 54010 C Part of020- 1127 -36 Parcel Identification Number (PIN) This is not homestead property. Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. (9) (is not) Dated this Z I day of April - - 2001 RJC Developme Inc. _ _ E S �t - - - - -- AUTHENTICATION -- - - - -- Signature(s) RJC Development, Inc., a Wisconsin Corporation, ACKNOWLEDGMENT by - - -_ _ STATE OF WISCONSIN - ) ss. authenticated this Ofday of April 2001 --- - - - - -- County ) -- - -- - - - - - -- Personally came before me this -__ _ day of - - - -- + Krishna Ogland the above named - - - -_- - -� - -- TITLE: MEMBER STATE BAR OF WISCONSIN _ _ -- - -- -- (Ifnot, to me known to be the persons) who executed the foregoing authorized 6 706.06, Wisacknowledged the same. - gtats,j - - - -' -- instrument and ackn THIS INSTRUMENT WAS DRAFTED BY _ Att orney Kristi Ogl and Hudson W� 54016 - -- Notary Public, State of Wisconsin — M Commission (Signatures may be authenticated or acknowledged. Both are not necessary.) y is permanent. (If not, state expiration date: + Names of persons signing in any capacity must be lyp or printed below their i — ) signature. INOrmaiion Processionals Cwn WA F RRANT ST vent', aaaut.aawl Y DEED ATE BAR OF WISCONSIN eooass -zozi FOR _ M No. 2 1999 -- --- - - - ---