HomeMy WebLinkAbout040-1289-25-000 Parcel #: 040 - 1289 -20 -000 04/27/2007 04:29 PM
PAGE IOF1
Alt. Parcel M 18.28.19.1646 040 - TOWN OF TROY
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 - RUPPERT, PAUL J & MEGAN
PAUL J & MEGAN RUPPERT
513 4TH ST N
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): ' = Primary
Type Dist # Description ' 362 ENGLISH CT
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 2.000 Plat: 1940 - ENGLISH ESTATES 02
SEC 18 T28N R1 9W PT NW NE LOT 2 ENGLISH Block/Condo Bldg: LOT 2
ESTATES
Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4)
18- 28N -19W NW NE
Notes: Parcel History:
Date Doc # Vol /Page Type
05/04/2005 793983 2796/060 WD
04/10/2003 716743 2201/491 WD
2007 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/23/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 80,000 0 80,000 NO
Totals for 2007:
General Property 2.000 80,000 0 80,000
Woodland 0.000 0 0
Totals for 2006:
General Property 2.000 80,000 0 80,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch M
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
430140 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:
Johnson, Jason I Troy Township 040- 1289 -25 -000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
18.28.19.1646
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
Dosing Alt. BM 77
Aeration Bldg. Sewer
Holding St/Ht Inlet
St/Ht Outlet
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. NV7t to Air Intake ROAD Dt Inlet
Septic Dt Botto
Dosing Hea r /Man.
Aeration D' t. Pipe
Holding Bot. System
Final Grade
PUMP /SIPHON INFORMATION
Manufacturer Deman St Cover
GPM
Model Number
TDH Lift Friction Loss System Head TD Ft
Forcemain Length Dia. Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of T nches PIT DIMEN NS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 1 i
SETBACK SYSTEM TO P/L BLDG IWELL I LAKE/STREAM' LEACHING Manufacturer:
INFORMATION HAMBER OR
Type Of System: UNIT Model Number:
DISTRIBUTION SYSTEM
Header /Manifold Distribution x Hole Size x le Spacing Vent to Air Intake
Pipes)
Length Dia Length Dia Spacing
SOIL COVER x ressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over f3epth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges Topsoil Yes Le] No Yes j No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / /
Location: 362 English Court Hudson, WI 54016 (NW 1/4 NE 1/4 18 T28N R1 9W) English Estates Lot 2 Parcel No: 18.28.19.1646
1.) Alt BM Description =
2.) Bldg sewer length =
- amount of cover =
Plan revision Required? Yes No Use other side for additional information. � J
SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No.
,\
Safety and Buildings Division County
201 W. Washington Ave., P.O. Box 7162
Vsconsin Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled i )
Department of Commerce (608) 266 -3151 3 0 �D
Sanitary Permit Application State Plan I.D. Number
In accord with Comm 83.21, Wis. Adm. Code, personal information you provide
may be used for secondary purposes Privacy Law,_s15.04(l)(m) G Address (if different than mailing address)
. ___
I. Application Information - Please Print All Informati n
Property Owner's Na me Parcel // Lot k Block #
Property Owner's M ailing Address Property Location
City, Sta Zip Code one Number .�K t'A, A4 'k,Section
l S` (circle
II. Type of Building (check all that apply) ee ._ ." T N; 8 of
5
r "
P� Subdivision Name G i Number 1 or 2 Family Dwelling - Number of Bedrooms � s+�• 4i ��. ,
❑ Public /Commercial - Describe Use
G
El State Owned - Describe Use 2 r ( 91. X 0 O S � ❑City_ Village$Township of
III. Type of Permit: (Check only one box on line A. Complete line B if applicable) O 40 - /Z 89 . _
A' New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
IV. T ype of POWTS System: (Check all that appl — 10D E
X Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter
❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter
❑ Recirculating Synthetic Media Filter ,Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain)
V. Dispersal/Treatment Area Information:
Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation
o?
S
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Holding Tank 9
Aerobic Treatment Unit
Dosing Chamber
VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Xa me (Print) Plum s S` g re t MP /MPRS Number Business Phone Number
1 ber's ddre ss (Street, Cit , State, Zip Code
""J 1dr S
VIII. County /De artment Use Onl
Approved El Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature o Stamps)
Surcharge Fee) Z2s
11 Owner Given Reason for Denial �
IX. Conditions of Approval/Reasons for Disapproval
Attach complete plans (to the County nly) for the system on per not less than 81/2 x 11 inches in size
• r.
SBD -6398 (R. 01/03)
,
I ;
i
! i
!
:
r
Yr " ;
:
- -� -; - - -- -- _ - t- - - -- - -- - -- - - -�
,
4
1
X
all
YA
f �
Wisconsin 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
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 nearest road. pending
Please print all information. Pell/awed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 3 IL LkN
Property Owner Property Location
Thomas O'Leary Govt. Lot NW 1/4 NE 1/4 S 18 T 28 N R 19 IX(or) W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
389 Cty. Rd.'Y' 2 na En lish Estates
City State Zip Code Phone Number ❑City ❑ Village ® Town Nearest Road
Hudson WI 54016 (715)381 -5590 Troy urt
Ek New Construction Use: a Residential /Number of bedrooms 4 Code derived design flow rate f GPD
[I Replacement El Public or commercial - Describe: pmrna
Parent material out Flood Plain elevation if applicabl 4 �
General comments La
and recommendations
trenches @ el. 95.40', spaced to code 4.00' below gradehC
Boring
Boring # Ground surface elev. 9 9.40 ft. Depth to limiting factor 1 00 in i
Pit •- SS lication 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 -6 10 3 3 none L 2csbk cs if .5 .8
2 6 -32 10yr5/4 none sil 2csbk dsh gw if .5 .8
3 32-104 7.5yr4/6 none ms Oscr ml na
a* -7Y. a
F- Boring # F] Boring
21 pit Ground surface elev. 98.40 ft. Depth to limiting factor 1 00 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 I `Eff#2
1 0 -6 10yr3/3 none L 2csbk dsh cs if .5 .8
2 6 -30 10yr5/4 none sil 2csbk dsh qw if .5
3 30-100 7.5yr4/6 none ms Osq ml
�g g'
Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L e—)Vuent #2 = 2013 < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signature . CST Number
Gary L. Steel 02298
Address Date valuation Conducte Telephone Number
1554 200th. Ave., New Richmond, WI. 54017
8 -30 -2001 715- 246 -6200
Property Owner T'I O r Leary Parcel 1D # pending Page 2 of 3
F Boring # ❑ Boring
3 ❑ pit Ground surface elev. 96.60 ft. Depth to limiting factor 100 in.
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtfF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 I 'Eff#2
1 0 -6 10 3/3 none L 2csbk dsh CS if .5 .8
6 -24 10yr5/4 none sil 2csbk dsh CW 1f .5 .8
3 24 -10 7.5yr4/4 none Ms Os
F-1 Boring # ❑ Boring
E] Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 I `Eff#2
❑ Boring # ❑ Boring
El pit Ground surface elev. ft. Depth to limiting factor in.
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2
' Effluent #1 = BOD > 30:5 220 mglL and TSS >30 < 150 mgA- ` Effluent #2 = BOD 5 30 mglL and TSS 5 30 mg1L
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 (B.6100)
r '
STEEL'S SOIL SERVICE
Gary L. Steel 1554 200th Ave.
CSTM2298 Thomas O'Leary New Richmond, WI 54017,
MPRSW - 3254 NW4NE4 S18- T28N -R19w (715) 246 -6200
town of Troy
lot #2- English Court
This soil evaluation was conducted to satisfy zonin re it may or
not be suitable for your use. The location of the test may y eta y or may not be as shorn
as pernianent lot lines were not established at the time the test vas conducted.
N
1 " =40'
BM.= top of 1" pvc pipe @.el. 100.00'
alt. BM.= top of 1" pvc pipe @ el. 101.80'
(So
f _
IV
N)
X
l
4
n �
Gary L. Steel
8 -30- 01
POW'ES OWNER'S MANUAL & MANAGEMENT PLAN Fuse �of
FILE INFORMATION SYSTEM SPECIFICATION
Owner JaLl Septic Tank Capacity al o NA
Permit # 0 Septic Tank Manufacturer a o NA
-- Effluent Filter Manufacturer o NA
DESIGN PARAMETERS Effluent Filter Model - o NA
Number of bedrooms o NA Pump Tank Capacity al O NA
Number of Commercial Unit ANA Pump Tank Manufacturer :s NA
Estimated flow (average) gal/day Pump Manufacturer crNA
Design flow (peak), Estimated x 1.5) _ gal/day Pump Model ANA
Soil Application Rate al /da /ft' Pretreated Unit
III fluent /t?I'lluc11t Quality ;\'lo111116 \veragc"I n Sand /Gravel Filter o Peat I"ilter
Fats, Oils & Grease (FOG) <.W ink /l_ ( Mechanical Aeration o Wodand
Biuchemical Oxygen Demand (BODs) <220 mg /L o Disinfection o Other:
Total Suspended Solids (TSS) < 150 m >/L Manufacturer
Pretreated Effluent Quality O NA Monthly Average ** Dispersal Cell(s)
,$�In- ground (gravity) o In- ground (pressurized)
Biochemical Oxygen Demand (BODs) <3(1'rt�;�l. p At -grade o Mound
Total Suspended Solids (TSS) <30 me /l, o Drip-line o Other:
Fecal Coliform (geometric mean) <10` cfu /IOOmL
Maximum Effluent Particle Size '/d inch diam eter * v alues typical for domestic (non -commercial)
wastewater and septic tank effluent.
** Values typical for pretreated wastewater.
MAINTENANCE SCHEDULE
Service Event S ervice Frequenc
Inspect condition of tanks Al least once every o months ? ears Maximum 3 yrs)
Pum2 out contents of tanks When combined sludge and scum equals one third '/� of tank volume
Inspect dispersal cells At least once every o months ears Maximum 3 rs)
Clean ef fluent filter _ At least once every u months y ear s
lns pest pun un
>>, n p controls & alarin At least once cvcry a months o yuur(s) 6 N
Flush laterals and pressure test At least once every a months o earls ,� NA
Other: At Fast once every o months to earls atNA
Other: At least once every o months o ears ANA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall by made by an individual carrying one of the following licenses or certificatiun.-
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 ,111(1 .u.um in any tank equals one -third ('/3) or more of the tank volume, the Cate.
contents of the tank shall be removed by a Septui ;c 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 uny other
maintenance or monitoring at intervals of 12 woulhs or less shall be performed by u certified POWTS Maintainer.
A service report shall be providc to the lural i l.1i ;story mithority 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 septogo servicing operator prior to use.
Owner: L ad) PageaZof
)ystem start up shall not occur when soil conditions are frozen at the infiltrativc surface,
During power outages pump tanks may fill above normal high water levels, When power is restored the excess wastewater
mill 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
.vithin the pump tank.
Jo nut drive or park vehicles over tanks and dispersal cells, Do not drive or piu k over, or otherwise disturb or compact, I'hc
rea within 15 feet down slope of any mound or at -grade soft absorption are,
.eduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of
re POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants;
A; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications;
, il; painting products; pesticides; sanitary napkins; tampons; and water softener brine.
BANDONEMENT
Vhen the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system
s 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.
0 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.
'ONTINGENCY PLAN
t' the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
splacement 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.
o 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.
_.,
�o "'T he 'site - not'beeir - evaluated - to tdentify replacement area. Upon failure the POWTS a soihand
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
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at the time.
_ WARNING>>
- 'PTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASES AND /OR
SUFFICIENT OXYGEN. DO,NOT EN'T'ER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY
RCUMSTANCES. DEATH MAY RESULT, RESCUE OF A PERSON FROM THE INTERIOR OF A TANK
AY BE DIFFICULT OR IMPOSSIBLE.
DDITIONAL COMMENTS
WTS INSTAL POWTS MAINTAINER
Name Name
Phone - — Phone
PTAGE SERVICING OPERATOR PUMPER) LOCAL REGULATOR Y AUTHORITY
Name Name
Phone Phone - agl -1
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer --
Mailing Address r�l
Property Address fry f
(Verification required from Planning Department for new construction)
0 0— IZ8`1�21�— trort) l• �
City /State Ste"` = ' W ( Parcel Identification Number
LE GAL DESCRIPTION
I w of
�� i �� T� N -R_.�. , To /. /., Sec,
Property Location '�J
Subdivision
�-- ��,,��� .Lot # '.
'�-
Certiiied Survey Map # , Volume , Page #
� � 2Zo , q �9�
Warranty Deed # I f b `F3 , Volume Pa g c
Spec house 0 ycs o Lot lines identifiable yes O no
l
SYSTEM MAINTENANCE
improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenancc
consists of pumping out the septic tank cery 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.
w agrees to submit in St. Croix Zoning Department a certification form, signed by the owner and by a
The p o g
-
ourne man tuntbcr, restricicd plumber or a licensed pumper verifying that (1) the on -5110 1te disposal systrrn wastewatcr dis
masl�t plumber.) Y plumber.
i nspect ion and Pumping (if necessary), the septic tank: is less than 113 full of sludge
art liar 2 Pu P
tc in proper operating condition t I) 1�
nvatc sewn osal system with the standards a dis
clots and agree to maintain the p g P
l /we, the undersigned have read the above regwrem B
set forth, herein, as set by the Department of Coinmeice and the Department of Natural Resources, State of Wisconsin Cert,fircatiun
sletingl your septic syctern has been Owl filtawect must he completeri and retumcd to the SI ( County Zoning Office within 30
days the three year xpt Iron date.
OF ICANT DATE
OWNER- R TIFICATION are the owner(s) of
1 (we) certify that all statements on this form are true to the best of my tour} knowledge. I ( we) ) am ( are )
the r eny descri d a c, by vinuc of a %�arranty deed recorded in Register of Deeds Office.
J DATE
5 A RE OF PLICAN7
••• "• Any information that is mu- represented may result to the sanitary permit being revoked by the Zoning Department
•• include with this application: a stanipcd .varronty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
J 2 2 0 1 P 4 9 1 716743
STATE BAR OF WISCONSIN FORM 2 — 1982 REGISTER H. DRESS
REGISTER OF DEEDS
WARRANTY DEED ST. CROIX CO., WI
DOCUMENT NO. RECEIVED FOR RECORD
04/10/2003 02:45PI
Kernon J Bast and Donalda J. snacr -Bast. WARRANTY DEED
NUsbarlci anti I,, EXEMPT #
REC FEE: 11.00
TRANS FEE: 240.00
conveys and warrants to Jas on M. Johnson, a single perso COPY FEE:
CC FEE:
PAGES: 1
THIS SPACE RESERVED FOR RECORDING DATA
NAME AND RETURN ADDRESS
the following described real estate in -__St. Croix County,
_ t
State of Wisconsin: ��— (��.•_ �ifjlta 7 1 - /Y! j�lltic
Lot 2, Plat of English Estates, in the � � d �'• A4 - 115 -
Town of Troy, St. Croix County, 74614
040 - 1289 -20 -000 • �
PARCEL IDENTIFICATION NUMBER
This t homestead property.
(ts) XLta7G1
Exception to warranties: Easements, restrictions and rights -of -way of record, if any.
Dated this tthhis 2nd day of Apr A.D.,x9� 003
��e'C L 1 (SEAL) (SEAL)
• Donalda J. Sneer —Bast Kernon J. st
(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) State of Wisconsin,
ss.
$t. Croix County
authenticated this day of 19_ Personally came before me this 2nd day of
A pril , 2003 ,39t —, the above named
Kern ,7 Bast and
Donalda J. Speer -Bast
TITLE: MEMBER STATE BAR OF WISCONSIN
(11 not,
authorized by 5706.06, Wis. Slats.) to me known to be the perso who executed the foregoing
Pamela A. WillrM ack wlcd a the same.
THIS INSTRUMENT WAS DRAFTED BY Notary Public "d4 A I & 4. w
Kt -rnnn J - Bas State Of WISco
Noinry Public. _Sf. ee,, County, Wis.
(Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If not, state expiration date:
necessary)
Names of persons signing In any npxity should by typed or printed below (heir signatures.+
• • * � •, i I '
o y -'
� `' ' �� /•�
OMP
:��. � � � \ \` +�,., / . � • ,� , °lam
n �4�
III / III ��� \V 1'•�� i
♦I /�R• 1 �i�ir , • ` \ + \� \ \� \\ w\ .� vii - �I�/�`
M \
�/��
�.;��� \`\����� ♦ �� - wI` � /I��I♦ ��Ii��i•
%.�� .I� ♦ �.I �� I / ����/I �I / III
�/ �i',•� �i i\ \i�i �i / i /� /i / ice � i �-
< �. � •:� �� - -.- �� ♦iii /��i
/ ���, � .� � /I /jam ' � �\� \ \\\�yw .i � \ \ \�!���• � I � -
♦ � �� / //\ \ . � \ \ \ \ \\ �,;✓ .III IO /I
/\\\\\tip \� \� \ \` :
NIN
mm
lot
• � Y
• � 1 I I
I
Y
1 •�
n3llVn at33a �0 1Vld -
Z-
o N a
• J _
,i
� r
F!.
z - �
J U n
z r �
� O U
> r �
1 •
•
•
A
H -
•
•
� nVfAHJIH N
SkJ3Hl0 ne 03Nf.'10 SONV1 O311VldNf1