HomeMy WebLinkAbout034-1052-60-100
N p 60).
d
h CD
4
w
t3 N
e d
O L
N ~ I
a rn
0
d M
M
ui
v7
N
N
N
a
0 d)
Z N C Q
L
C Z 00)
{i O N
5 co
3 ¢ CL
I
O
N
Z N
E
u') LU O
v\
Z
W a m
O
N H Z
O_ Z d
N o I
N H r N Z
E a
M
•N L c
O I
0 Z Z O
N
C.4 j d N
CO 1 12 -
C9 C)
20 (D 0
In 0 CL 0
ca U) E
FL U) U Q Z °
'N o a.aa
i a
N 3 rnrn
ri o in
i i c D
to J V Ornrn
I~'=
N Q
0
O O
E
m
d
U v ¢ Y cn co I
~l ° w w
~i O C N C
m O N CV
cu 0
d Cl
cc ~ m c o
M
I
C O N
O IN m N (9 r 0)
H N C L w 7 5; C E O
0 It cc Lo
R O N O N U
r 1 M C6
AAjA O N V) 2 M O Z N Z Y 2 to
m ~o
# a L: CL
c
0Uiti
A tia2
Parcel 034-1052-60-100 06/09/2006 05:49 PM
PAGE 1 OF 1
Alt. Parcel 23.29.15.3658 034 - TOWN OF SPRINGFIELD
Current *1 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 - MAHONEY, TIMOTHY J & CYNTHIA A
TIMOTHY J & CYNTHIA A MAHONEY
844 CTY RD W
GLENWOOD CITY WI 54013
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 844 CTY RD W
SC 2198 GLENWOOD CITY
SP 1700 WITC
Legal Description: Acres: 5.010 Plat: 3742-CSM 13/3742
SEC 23 T29N R15W PT NE SE BEING LOT 1 Block/Condo Bldg: LOT 1
CSM 13/3742
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
23-29N-15W
Notes: Parcel History:
Date Doc # Vol/Page Type
10/18/1999 612265 1464/83 WD
10/18/1999 612264 1464/82 WD
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 06/24/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.010 31,450 193,950 225,400 NO
Totals for 2006:
General Property 5.010 31,450 193,950 225,400
Woodland 0.000 0 0
Totals for 2005:
General Property 5.010 31,450 193,950 225,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 543
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
I
Parcel 034-1052-60-000 06/09/2006 05:36 PM
PAGE 1 OF 1
Alt. Parcel M 23.29.15.365A 034 - TOWN OF SPRINGFIELD
Current *I 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 - MAHONEY, BARRY M & MARY BARBARA
BARRY M & MARY BARBARA MAHONEY
3244 90TH AVE
GLENWOOD CITY WI 54013
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description
SC 2198 GLENWOOD CITY
SP 1700 WITC
Legal Description: Acres: 34.990 Plat: N/A-NOT AVAILABLE
SEC 23 T29N R15W NE SE EZ-UT-1263/624 Block/Condo Bldg:
EXC PT TO CSM 13/3742
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
23-29N-15W NE SE
Notes: Parcel History:
Date Doc # Vol/Page Type
08/20/1999 608925 14501255 LC
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 05/26/2004
Description Class Acres Land Improve Total State Reason
UNDEVELOPED G5 24.990 20,600 0 20,600 NO
PRODUCTIVE FORST LANDS G6 10.000 18,000 0 18,000 NO
Totals for 2006:
General Property 34.990 38,600 0 38,600
Woodland 0.000 0 0
Totals for 2005:
General Property 34.990 38,600 0 38,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
-
ST. CROIX COUNTY ZONING DEPARTMENT
AS BUILT SANITARY REPORT
Owner -1,4 o
Property Address' gPa C o
City/State 6~ ety err d c~ 14. kz r tz,;~/? a
Legal Description:
Lot Block - Subdivision/CSM # 4~ /12/
4[6, '/4 61F t/4, Sec. 2,~, T21N-R J W, Town of ..SMjiv 9 Ci e-1- d PIN # 0,//- /dam ' ~ ~ e~c?
SEPTIC TANK DOSE CHAMBER HOLDING TANK INFORMATION: Y
Tank manufacturer Mi' ' s" %RN Size ST/PCAj / e Setback from: House Well P/L 22
Pump manufacturer Q-rd :-,f /.d Model ^kPo 41
Alarm location s nti;v T
(HOLDING TANKS ONLY)
Setbacks: Service. Vent to fresh air in Water Line
Meter location
Alarm location
SOIL ABSORPTION SYSTEM:
Type of system: d u iyl- Width - r Length Number of Trenches l
Setback from: House hA. Well PAL IL!q" Vent to fresh air intake
ELEVATIONS. .
r'
Description of benchmark ..SPI 6 .4 k rife ~ Elevation
Description of alternate benchmark S P/ /t /;V / g l f .e4 , x2A it Elevation 40 ,
Building Sewer ` ST/HT Inlet ST Outlet PC Inlet
PC Bottom ~?9, -7 2 Header/Manifold Top of ST/PC Manhole Cover f2.-
Distribution Lines(/) 5~",, y j r ( )
Bottom of System ) J O ( )
Final Grade Q) y ( ) ( )
Date of installation AP LZIrf Permit number s State plan number 2Y,1,2
Plumber's signature f~d License number.' Date/d
Inspector k a:i -e - ~t
Complete plot plan Or
NOTICE: Please provide the following:
• A plan view sketch showing everything within 100 feet of the system.
• Two horizontal reference points to center of septic tank manhole cover.
I
• Show alternate benchmark, if applicable.
PLAN VIEW
teal?,o
a3b`
l
l~
19,
Na ti.S -
INDICATE NORTH ARROW
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Buildings Division Countv
INSPECTION REPORT St. Croix
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)j. 353154
Permit Holder's Name: ❑ City ❑ Village Ijj Town of: State Plan ID No.:
Town of Springfield D y l 2 yy
CST BM E ev.:- Insp. BM Elev.: BM Description: Parcel Tax No.:
cse : "fl 5 :fie 4: = R I pending
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic p/6rp Benchmark
Dosing Alt. BM
Aeration Bldg. Sewer ,7v ,573
Holding St/ Ht Inlet 2.3-L 3
TANK SETBACK INFORMATION
TANK TO P/ L WELL BLDG. Ventto ROAD
Air Intake
NA Dt Bottom
Septic S 100
Dosing NA Header / Man. qs
Aeration NA Dist. Pipe 7•$8 9S.
Holding
I Y. Bot. System z S„ZS~
PUMP/ SIPHON INFORMATIO Final Grade L1 'i,
Manufacturer }I DergLand St cover ,01~ q3•g~
Model Number a 2$~ GPMt qc~ b5 p
TDH Lift Il,"I Fricti%,g4 Systems TD 1 ,03
Forcemain Length L Z Dia. n Dist. To Well
SOIL ABSORPTION SYSTEM
TR Width I Leng No. renches PIT DIMENSIONS N0.Of Pits Inside Dia. Liquid Depth
DI I N ~
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type O Model Number:
System: MW41~1 W 7 CHAMBER OR UNIT
DISTRIBUTION SYSTEM
Header / M fo Distribution Pipe(s) N x H ~ S~i~ e x H`ollee Spacing Vent To it Intake
Length Dia. Length Dia. Z o r To `
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 El Yes El No El Yes E] No
COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: /D//9/1-1 Inspection #2: to/z-/9?
Location: 870 County Road W, Wilson, WI (NE1/4, SE1/4, Section 23 T29N-R15W) - 23.29.15.___
q3.
a„
Plan revision required? ❑ Yes W No -
Use other side for additional information.
lv SBD-6710 (R.3/97) Date Inspector's Signature Cert. No.
• Safety and Buildings Division
*consin SSANITARY PE ~!T A 'TIO1~1' P 201 W. WashiingtonAvenue 0 Box 7302
In accord with I , Wk`e `i
Department of Commerce A.05 Madison, WI 53707-7302
• Attach complete plans (to the county copy only) fort a ste1bbwh Pa{3e,~ not less unty~
than 8 112 x 11 inches in size. S-T t%
• See reverse side for instructions for completing this ap ' on pC~t tate Sanitary PPer~mitN umber
Z000,116 -36 Personal information you provide may be used for secondary purposes > ❑ Check if revision to previous application
IPrivacy Law, s. 15.04 (1) (m)].
State Plan I.D. Number
1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION o~ la2
Pro rty Owner Name Property Location
00 A 1/4,S T~, ,N,R` lr)W
Property Owner's ailing Address v Lot Number Block Number
City, State Zip Code Phone Number Subdivision Name or CSM Number
If - "7
II. TYPE F B ILDING: (check one ❑ State Owned It~ Nearest Road
❑ Vil age
Public 1 or 2 Family Dwelling - No. of bedrooms Town OFS i+B C ,
111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) Sp -
1 ❑ Apartment/ Condo i?g 'a~r~ ®~De7
2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash
5 ❑ Hotel / Motel 9 ❑ Office/ Factory 13 ❑ Other: specify
IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable)
A) 1. Pl New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
System System Tank Only Existing System Existing System
i B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage.Bed 21A Mound 0 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In-Ground Pressure i )C9q 1~ _ I 1 42 ❑ Pit Privy
13 ❑ Seepage Pit , `f' ~U1/ilA~hJ 43 ❑ Vault Privy
14 ❑ System-In-Fill 3,q CAE
VI. ABSORPTION SYST I ORMATION:
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade
Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft_) (Min./inch) Elevation
Q 317-6- T Feet rJ, " Feet
VII. TANK Capacity acits Total # of Prefab. Site Fiber- Exper.
INFORMATION g Gallons Tanks Manufacturer s Name Concrete Con- Steel glass Plastic App
New Existing
Tanks Tanks strutted
Septic Tank or Holding Tank ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber ,f ® ❑ ❑ ❑ ❑ ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) Plumber' Signatuure:~(No Stamps) MP/ No.: Business Phone Number:
/l~C l v~ o~-r~•
Plumber's Address (Street, City, State, Zip Code):
!,>!j . C 0 D 4/ r
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved S nitary Permit Fee (Includes Groundwater ate Issued Issuin Agent Signat a (No Stamps)
OA roved Surcharge Fee)
pp ❑ Owner Given Initial -30~5-, db 11
Adverse Determination
X. ON IONS OF APPROVAL/ REASONS FOR DISAPPROVAL:
SBD- 6398 (R.11197) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber
• Safety and Buildings
10541N RANCH ROAD
HAYWARD WI 54843
Mir TDD (608) 264-8777
Visconsin www.commerce.state.wi.us
Department of Commerce Tommy G. Thompson, Governor
Brenda J. Blanchard, Secretary
September 08, 1999
CUST ID No.222234 ATTIC- POWTS INSPECTOR
ZONING OFFICE
GALE W SMITH ST CROIX COUNTY SPIA
3228 HWY 170 1101 CARMICHAEL RD E
GLENWOOD CITY WI 54013 HUDSON WI 54016
RE: CONDITIONAL APPROVAL
APPROVAL EXPIRES: 09/08/2001 - Identific ' bers
Transaction ID o. 241244
Site ID No. 179127
SITE: Please refer to both' identification numbers,
Site ID: 179127 above, in all correspondence with the agency.
ST CROIX County, Town of SPRINGFIELD; CO RD W, GLENWOOD CITY 54013
NEIA, SETA, S23, T29N, R15W
Facility: BARRY MAHONEY MOUND CO RD W, GLENWOOD CITY 54013
FOR:
Object Type: POWT System Regulated Object ID No.: 486486
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in
chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements.
The following conditions shall be met during construction or installation and prior to occupancy or use:
1. This plan action is subject to designer comments on the plan.
2. The orientation of the mound system must be such that the mound's longest dimension is perpendicular
to the direction of maximum slope.
3. The area 25' below the downslope edge of the mound must remain undisturbed.
4. Maintain well and waterline set backs per COMM 83.10(1) and 83.14(4)(a).
A copy of the approved plans, specifications and this letter shall be on-site during construction and open to
inspection by authorized representatives of the Department, which may include local inspectors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction/installation/operation.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead. -
Sincerely, DATE RECEIVED 08/11/1999
ry.;
J ✓ r FEE REQUIRED $ 180.00
-ti - FEE RECEIVED $ 180.00
PATRICIA L SHANDORF, POWTS P N REVIEWER BALANCE DUE $ 0.00
Integrated Services 11
(715) 634-7810, FAX: (715) 634-5150, M-F 7:45 AM - 4:30 PM
PSHANDORF@COMMERCE.STATE.WI.US WiSMART code: 7633
I G,, i
D - O O
t~ t
u I~. -r E
- --a-_-- - _ I _1 -1-~
vii. R _~~l,-~,d~ ! - - - as - -
- - _ _
4 j - i I'PIZ~ 't s zl#y A~ j i/
I , I
- - i- -
1 j I ~
O
I
Page~Of
COMBINATION SEPTIC TANK/PUMP CHAMBER
. (No Scale) 4" C1 Vent Pipe with
A roved Lockin Manhole Cover Approved Cap, +25' pp g From Buildings
With Warning Label Attached
Weatherproof Approved _
Warning Label Junction Box Vent Cap
12" Minimum
Final Grade 6" Minimum 4' Minimum
l 6 MTaximum 4" C.I. Quick
18" Minimum 7 Insp. Pipe Disconnect
1/4" Weep
1 Hole
Baffles D '
1J 1
~ 1 * I 1 A ~ i
Alarm
6' B * On 1
1 C
*APPROVED Off 6'
JOINTS WITH APPROVED PIPE D
3' ONTO Conc. Block '
SOLID SOIL
i
3" of Beddi nq Under Tank
Note: Pump and Alarm Are On Separate Circuits Number of Doses: 3 Per Day_ '
Gallons Per Day/ of Doses: /.r~ Gallons
Volume of Backflow:........-=Gallons
Tank Manufacturer: /1~l /dice P.<-te"'N Pf e G~~L Total Dose Vol ume = Gall ons
Tank Size-Septic/Pump: o Ga lons Alarm Manufacturer: t`_7- ~ ~ ~ f--,sjc~
Model Number: /o / # Gy Capacities : A inches or~~3 Gallons
Switch Type• + Be nches or 3 Gallons
Pump Manufacturer: G o 4 A - + Cinches or~-Gallons
Model Number IF Po + D inches or Gallons
Minimum Discharge ate: a2 a",c~ P M Total.....- inches or Gallons
Vertical Difference Between Pump Off and Distribution Pipe: ,,q Feet
Minimum Required Supply Pressure :.........................+_3,2{Feet
_r_Feet of Force Main x /Friction Factor/100 Feet: eet
Inch Diameter Force Main
Total Dynamic Head Feet
/ ~ ,-,1! Pe /N e T-~ - - - ` T--~- • ~ ---i~` ~.t..li.L. 1 i niti it nnntti ~ Q ~ 9
lntierna 1 1 dD& U 1111Cn5 1 UnJ : pLt!119 II w 1 U wn 1 1 y" l u W,-r O
~ f ZL ; License Number,2 Date 4?- - 9 Signature _ ~
12 DIUST'RIAL RD. ~ GOUI
O e _,4 &,.,r
i s WI 64016 sub e
rsible
- Effluent Pump
3871 EP04
EP05
APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron
Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer,
following uses: • Capable of running lubrication and efficient strength, and durability.
• Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas-
• Homes components. tic cover with integral handle
• Farms Motor: Available for automatic and
• • EP04 Single manual operation. Automatic and float switch attachment
Heavy duty sump phase: 0.4 HP, models include Mechanical
Points.
• Water transfer 115 RPM, , built 230 in V, 60 Hz 11550 Float Switch assembled and ■ Power Cable: Severe duty
• Dewatering overload with Y
automatic reset. preset at the factory, rated oil and water resistant.
SPECIFICATIONS • EP05 Single phase: 0.5 HP. ■ Bearings: Upper and lower
115 V, 60 Ilz 1550 RPM, FEATURES heavy duty ball bearing
Pump: E
P04
tutlt in overload with v EP04 Impeller: Thermo construction.
• Solids handling capability 2utomatic reset. plastic Semi-open design .
'/4" maximum. • Power cord. 10 foot v;iti pump out vanes for AGENCY LISTING
• Capacities: up to 55 GPI standard length, 16/3 SJTO rye:hanical sea! protection.
• Total heads: up to 24 feet vJ1h three prong grounding SP Canadian SlandardsAssocialion
• Discharge size: 1 NPT plug. Optional 20 foot ■ EP05 Impeller: Thermo- CSA listed model numbers
• Mechanical seal: carbon- length, 16/3 SJTW with 033.1c enclosed design for
rotary/ceramic-stationarythree prong gtounding plug i proved performance. end in ' F" or "AC".)
BUNA-N elastomers (standard on LP05). ■ Casing and Base: Rugged
• Temperature: t~e,moplastic design provides
104 T (40,C) core ruous s.:;.erior strength and
140" F (60,C) intermittent co-osion resistance
• Fasteners: 300 series R1ETERS FEET,
stainless steel. 10
• Capable of runnirg i
dry without darnaga to 9
components. 3 I -*-5 GPM t
Pump:EP05 e ! I 2.5 FT
• Solids handling capability: o psi
4' maximum. W I i
• Capacities: up to 60 GPM.
v
s
20
Total heads: up to 31 feet. ~
• Discharge size: 1 Yi NPT.
• Mechanical seal: carbon- 0 5 15
I I
-
rotary/ceramic-stationary,
BUNA-N elastomers. 0 4 t` i - I EPO',i
• Temperature: 3 10 11041 continuous
1 0160^C) inter ' tent.. 2 EPO4
! t
0 00' 10 -1 20 30 40 50 GPM
L -L
p 0 2 4 6 6 to 12 l /h
mIh
CAPACITY
®t 995 Goulds Pumps, fnc.
' Effective May, 1995
Ia3e71
Wisconsin Department of Commerce SOIL AND SITE EVALUATION 3
Division of Safety and Buildings Page of
Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code
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 reference point (BM), direction and S Cy G /
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. #
j?gyCCr~ )'iNl M/i/7 crv y 1~r.-E
G' d L'J
APPLICANT INFORMATION - Please ' o
rmation: Re =iewed D ate
Personal information you provide may be used for seco a oses (Priv y Law, s. 1504 (1) (m)).
Property Owner 0 Property Location
G' f Go Lot 114 114,S,2 T N,R 40r) W
fit. Property Owner"s Mailing Address dot Block# Subd. Name or CSM#
~*01-k 1999
Y f" [M
City State Zip Code r \h
city Village Town Nearest Road
6 eM tv 'oo/ )o2
S' °i~ d d
New Construction Use: Residential / Number of bedrooms Addition to existing building
❑ Replacement ❑ Public or commercial - Describe:
Code derived daily flow gpd Recommended design loading rate o 2 bed, gpd/ft2-1-7-trench, gpd/ft2
Absorption area required bed, ft2' rench,h, ft2 Maximum design loading rate _bed, gpd/ft2 e 3 trench, gpd/ft2
Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark)
Additional design/site considerations 41,4
Parent material + L. 1.+k r/ j_,- Flood plain elevation, if applicable ft
S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank
S [ U ❑ S ®U El s u
U = Unsuitable for system ❑ S ( U s F-1 U ❑ S ®U El
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
sdir /C)V
a. - /o 5-.4 G-Gv M
Ground , AS FA b 1"V M lo
elev.
q"fit. MAP 5" s a e A6x y r 12 1,3
Depth to
limiting
factor
/ in.
Remarks:
Boring # d
1,0v)? 31.1 - S' 97hixils- Al S OM
c2 'q, JS /'0Y e -2 MIA ec Al
• 0 O.S
R A111 .5 A-d v v~
Ground AM Y
elev.
Depth to
limiting
factor
min. Remarks:
CST Name (Please Print) Signature Telephone No.
Address r Date CST Number
az Gv O eh, AV ' 7L- 2
Jr` 9 /'7
PROPERTY OWNER kidit lVAhomey SOIL DESCRIPTION REPORT Page of
-
PARCEL I.D.# aw- 14-5-.2 -Ae,
Boring # Horizon Depth Dominant Color Mottles Structure 2
g Texture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
s s a M 6
1.2 M 44 Al 1;:~~ ,37
4S a r - f` v" 6 - Lt) t ye~ o ~ o~.
Ground Lk
elev.
y ft. r ,~o s a s 8 S6 M yr z 1
Depth to
limiting ,
factor
3o-in.
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in.
Remarks:
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
Boring #
Ground
elev.
ft.
Depth to ,
limiting
factor
in. Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in.
Remarks:
SBD-8330 (R. 07/96)
L
' O
I
A~u
84/1
t - - _ - _ -
JIII
I
tt v, v, co
a - - -
-~j l
cr,
_ 1
-A~v-, 4"
I L-1
i
-
17
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
. AND
OWNERSHIP CERTIFICATION FORM
Owner/) .914 V NX ko Ale Y
22
Mailing Address
Property Address ~S O T
(Verification required from Planning Department for new construction)
City/State Parcel Identification Number
LEGAL DESCRIPTION
Property Location A/,F Sec. T_2 % N-R_ZJ-W, Town of
Subdivision , Lot # 4-
Certified Survey Map # , Volume , Page #
Warranty Deed # Volume Page # .2.~
Spec house ❑ yes DO no Lot lines identifiable A yes4f 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, restrictedplumber 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 year expiration date.
-77 1
SIGNATURE 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 of a warranty deed recorded in Register of Deeds Office.
X
SIGNATUR9 OF APPLICA 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.1^ 50PAG[ 255
STATE BAR OF WISCONSIN FORM 11 - 1982 1& U$925
LAND CONTRACT RKATHLEEN N. WALSH
Individual and Corporate
EGISTER OF DEEDS
(TO BE USED FOR ALL TRANSACTIONS WHERE OVER ST. CROIX CO.
DOCUMENT NO. 425,000 IS FINANCED AND IN OTHER NON-CONSUMER ! W I
ACT TRANSACTIONS) RECEIVED. FOR RECORD
Contract, by and between Raymond M. Mahoney and 08-20-1999 10:00 AN
Marie C. Mahoney, husband and wife LAND CONTRACT
("Vendor', EXEMPT N
whether one or more) and Barry M. Mahone C y and Mary Barbara ERT FEE:
COPY CORY FEE:
Mahoney, husband an wife, of ing as sure vors p TRANSFER FEE;
351.00
marital property ("Purchaser", whether one or more). RECORDING FEE: 22.00
Vendor sells and agrees to convey to Purchaser, upon the prompt and full performance PAGES: of this contract by Purchaser, the following property, together with
the rents, profits,
fixtures and other appurtenant interests (all called the "Property"), in
St. Croix County, State of Wisconsin:
Southeast Quarter of Southwest Quarter (SE k of SW4) and THIS SPACE RESERVED FOR RECORDING DATA
South Half of Southeast Quarter (S k of SE4) of Section NAME AND RETURN ADDRESS
Thirteen (13), North Half of Northeast Quarter (Nz of
NE4) of Section Twenty-Four (24), except West (W)
Two (2) rods of Northwest Quarter of Northeast Quarter 32 q6 Dom`
(NW4 of NE4) of said Section Twenty-Four (24). kid- sIIA13
North Half of Southeast Quarter (Nz of SE4) of
Section Twenty-Three (23), Township Twenty-Nine 034-1029-30-60-70
North (T29N), Range Fifteen West (R15W) PARCEL IDENTIFICATION NUMBER
034-1052-60-70
034-1053-10-20
This is not homestead property.
3W (is not)
Purchaser agrees to purchase the Property and to pay to Vendor at a place designated by Vendor
the sum of $ 117, 000.00 in the following manner: (a) $ 0.00
at the execution of this Contract; and (b) the balance of $ 117,000-00 together with interest from date
hereof on the balance outstanding from time to time at the rate of seven (7°r6 percent per annum until paid in full, as follows:
monthly payments of principal and interest in the amount of $890-00, commencing
one month from date hereof and on the same date of each month thereafter.
i
I~
i
Provided, however, the entire outstanding balance shall be paid in full on or beforeXdte two ( 2 ) years after the
date of death of Raymond M. Mahoney and Marie C. Mahoney. I'
Following any default in payment, interest shall accrue at the rate of 8 % per annum on the entire amount in default (which shall
include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance).
Purchaser, unless excused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonably anticipated annual taxes, special
assessments, fire and required insurance premiums when due. To the extent received by Vendor, Vendor agrees to apply payments to these
obligations when due. Such amounts received by the Vendor for payment of taxes, assessments and insurance will be deposited into an escrow
fund or trustee account, but shall not bear interest unless otherwise required by law.
Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any amount may be prepaid
without premium or fee upon principal at any time after January 1 19 98
~+r
In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long as the unpaid balance of
principal, and interest (and in such case accruing interest from month to month shall be treated as unpaid principal) is less than the amount that
said indebtedness would have been had the monthly payments been made as first specified above; provided that monthly payments shall be
continued in the event of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded herefrom.
i
Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except:
Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall be retained by Vendor until
the full purchase price is paid. y
Purchaser shall be entitled to take possession of the Property on date of closing 19
' Cross Out One.
STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc.
?NTRACT - Individual and Corporate For[q No. 11 -1982 Milwaukee, Wis.
c.
E961 - ii 'ON wao3 'utsuoasim jo leg ams - amiodto7 pue tenptetpal - 17V111N00 UNY-1
samieu8ls nags n%opq paiuud io padAl aq plnogs dtlaedea Aue ul $uluVis suosiad joNauteN „
-7r (i(.~essaaau
01y ~uoue.nd Ise 'IOU }1) •juauewiad si uois'stwul ' o, AIN IOU WE y)og -pa$p2lmou~ae 10 paleajjuayne aq ,feiit tainieu$ts)
•s•M 5C1uno : '3llgnd AMON
ZOOfiS IM 'utMpTeg
t "ti p .~~rfC , * x0Rwj0DDw ' Fj SeU 041
' l Al; A8 (J313V8(J SVM 1N34n81SN1 SIHI
r~ R 5yucs a i a$palmou>I3e pue luawntlsui
z
Sut6 airt~ ~c p:.~! ' ~Cuos.iad ays aq of uMou~ aw of SjeISst
C ' M'90'90L§ Aq pazuoglne
'IOU }1)
gLjLJnI ti e zeQ zpg d~Ly1 N1SNODSIM 30 NV9 3.LVIS 213HW3W :3Z-Il-I
pup ~1x • N dj.zeg ' dauogpN
•0 e7EJE N 'Aauol{eN -N puoUTAeU
paweu anoge a141 61 `
jo ,Cep ~ stgi aio}aq awe, ,(jieu siad 61 ' }o .(ep styi paie,uuayine
T T-UA0:) XZoao • qS
•ss ~
(s)asnieu$tS
'ul•suo:)siM }o ;)Iris
1N3L1I9Q31M0NXDV NOI.LVDI.LN3H1f1v
• auogeN ejegaeS auo e
u W •0 aiipyy
(Wgs) r),7 jtf" 7, r (1d3S)
auoueN • N z-1 eg + AeuoLjpjnN • yrN puoluApg
(zv3s) ~ (zvgs)
v~ mb 61 ` }o ,iep ~ IP
stye paieQ
T
('joatay iuawllijlnj ui apew aq of paap ayi jo uopnoaxa ayi ut ulof of saat$e pue Ailadoid i,afgns
ayi ut siy$u pealsausoy asealas 01 utatay suiof uoueiapisuo, algenlen a toj sopuan }o asnods agi Aitadosd ay jo taumo ue 1ou jl) •taseg3snd pile
iopuan jo su$tsse pue stossa„ns 'sanpeiuasaidai legal 'shay ayi jo siyauaq agi of atnui pue uodn $uipuiq aq lleys i,eiiuo:) styi jo stsual IIV
•aseq,tnd jo ilnejap loud to iuanbasgns .rayio $utntem lnoynm ilnejap ,Cue antem few sopuan
'1,etlUOD stye uO apew siuaw.Ced pasaptsuo3
aq llegs tasey3lnd ,(q apew os siuauiAud lle pue os op of sltej .sopuan ji aa$e$i.ioyq ayi of Ali,aiip siuauiAed y3ns a>Ieus hew tasegasnd •13etsuOD
stgi sapun anp uayi wriowe aiji jo iuaui<Ced Alawp saNew iasey ind paptnotd '(gaiayi liatn,as aiou ,Cue sapun so (iasey,ind Aq paiuei$ a$e$i.tow
Aue soj 1da3xa) i,esiuo:) stye jo aiep ay uo ,Cuadoid ay isuie$e $uipumsino a$e$uow Aue iapun anp uaym siuatuAed Ile aletit lleys sopuan
•a,pou inoystm uoudo stopuan ie 'llnj ut algeAed pue anp Alaietpawwt awo,aq lleys 13e11uoD styi lapun alge,(ed ameleq $utpueisino
aipua ays 'luastso3 uaiitlm stopuan lnogytm a,ue tanuo3 to ales 'tajsuetl gins Cut: jo Juana a i ul •tase ,s o ssaupaigaput ue to} 11,
y q nd } isruns se
.
,Halos J3esluOD scgi tapun lsalalut slasey3ind jo JuautuSisse to a$pald a sr paXanuoo isataim ayJ to llnj ui pled istij si 13etiuOD stye sapun alge fed
a3ueleq $uipueisino agi iayJta ssalun sopuan jo iuasso, uaiium loud agi inoyitm (item iayio ,Cue ut to aseal uuaJ-$uoI 'uoudo .Cq so 13es1110D stgl
sapun siy$u slasey3lnd jo ,Cue jo iuawu$tsse Aq) Ailadotd agJ ut lsalalut alcleitnba to legal Aue Aanuo, so llas 'tajsuesl 1ou lteys tasey,ind
•13astp Ileys uno3 ay se patldde pue play aq lleys pai3allo3 os uagm sigosd pue 'sanssl 'slual y3ns pue
uotiae y3ns jO A,uapuad ayJ $uunp Aisadosd ay j0 slyotd pue 'sanssl 'siuat ay113a1lo3 O1 'Jsaaami peaisawoq $ulpnl3ut Ailadosd 2y jo sama3at e
of luawiulodde agi o1 siuasuo3 sasey,tnd '1,et1u0D stye jo asnsoloaloj jo uou3e ,Cue jo Amapuad ay Suunp io Juawa3uawwo3 ayJ uodTl
luaw$pnf Aue ut a ti 3w a q s ue
Pastn3ut se 'laseq,ind g P. led Pue ledmuud of PaPPe ag iteqs a3uaP. ina a1o sasuadxa Pue meI Ag Pailg.tgold sou luaixa ays of (lou io paege
its 3
layiagm) lapunaiay Apawas ,Cue a3tojua o1 pastn,ui sopuan jo saaj sbusom algeuoseai $uipnl3ut sasuadxa pue siso3 Ile pue uope$utl ut panstnd
uagM pue }t sopuan uodn $ulputq aq Aluo ljeys saipawat $uto$atoj aqi jo ,Cue jo uotl32la ue 'sopuan jo suoti3e to sluawalels ualipm to leto ,Cue
$utpuelsgltmiON anoge (n!) to (tt) '(t) tapun uop,e Aue jo Aoilapuad ay $uunp sujosd so sanssl 'suas ,Cue 13allo, o1 pamiodde lmimal a aney
pue Aiiadold ayi jo uotssassod woij pai3afa tasey,snd aney ,sew sopuan (n) pue 'JUe,tjtu$tsui si sasey,tnd jo isasaim algeitnba ayi ji uop,e app
-iamb e ut alm uo pnol3 a se J3esluoa styi anowai pue pua ue w 13emuoD styi alel3ap stew sopuan (nt) to'joasagi uoptod Aue to a,ud asey,ind
ptedun atpua ays soj mel ie ans stew .sopuan (ttt) to 'buat3yap ,sue ioj algetl aq lleys iasey3ind pue ales lwipnf 1e pauotlme aq Ileys kisadosd aqi
Juana g3lyM ut 'tapunatay anp slunowe .sayio pue ilnejap jo aiep agi uo i,ajja ui alei ayi ie uoa.sayJ isaialui ynm 'a,ueleq $uipuelsino aspua aqI
uO iuauiAed llnj pue ampawwl ladwo3 of 13eiiuo:) stye jo a3ueuuojiad 3gt3ads ioj ans Aew iopuan (n) io '(waapat of spej iasey,.ind ji Aiiado.td
aqi toj lemai se pue J3miuoD stye Ilylnj o1 atnltej ioj sa$ewep paieptnbtl se paijajioj aq lleys lasey,ind Aq pled Alsnotmud slunouse Ile Juana
y3tym ut) iapunaiaq anp slunowe tayio pue aiep y,ns uo i,ajja ui aiet ayi le iinejap jo aiep ayi woij uoatayi isalaiui yitm'a,ueleq $uipueisino
as iua ay1 jo iuaw,fed llnj staseq,snd uodn pauompuo3 aq o1 uoudwapat jo Ailnba ,Cue yitm amsolwioj Buis q$noiyi 113eq Auadotd aqi tanO3at
pue Ailado.sd ay ui Jsatatut pue app 'sig$u spasey,tnd pule i,eiiuo:) styi amutuual 'uoudo sty se SCew .sopuan (t) :Aitnba ut so mel Aq paptnoid
asogi of uoiitppe ui (mel Aq paplnosd suopeitwil Aue o1 13afgns) saipawat put' sly$u $utmolloj ay aney osle lleys sopuan pue '(santeM Xga1ay
.saseg3ind gatgm) axiou Jnoynm pue uoudo ssopuan 1e 'linj ui alge,(ed pue anp Alaietpawwt awo3aq llegs 13etiuo3 stgi tapun a,ueleg $uipuelsino
astlua ay uayi '(Itew paytua3 Aq paltew to Alleuosiad patantlap) topuaA Aq joalayi a,pou uaiium $utmolloj step 09 jo pouad a toj sanu sum
y3tgm saseg,snd jo uoue$tlgo tagio,(ue jo amou iojtad ut llnejap a jo iuana ay ut (q) io amp anp pagt3ads agi $utmolloj s,Cep jo pouad e
ioj sanupuo3 y,tym isasawt to ledtauud Sue jo suatuhd agi ut llnejap a jo iuana ay ut (e) pue amassa ayi jo si awn my saal?v .soyatnd
:idaoxa pue 'tasegmnd jo llnejap to i3e ay Aq paleat3 samesgwn,ua to suatl ,Cue 1da,xa 'sa3umgwn3ua pue suail Ile jo teal, pue aasj 'titadosd All
jo `aldwts aaj ut 'paaa AiuetteM a 'taseq,tnd ays of 13nt13p Pug aimm 'puewap uo llim sopuan'patjt3ads anoge tauuew aqi ui pue sawp aqi se
paussojtad Allnj aq Ileils suoutpuo3 Ile pue pled .(llnj aq lleys sAauow tayio pue isataiut yJtm a3ud asey3tnd ayi ase3 ui ieys saas$e sopuan
-(ltadotd ayi $uuaajje suopelam
pue sameuipto 'smel Ile gltm AIdwo3 o1 pue 'J3esluo:) slgl jo uatl ay o1 souadns suail wotj aatj Ailadotd ayi daa-I o1 'ttedat pue uoutpuo3
algemeual poo$ ui Aitadotd ay1 daa> o1 Aitadotd ayi uo palitwwo3 aq of 4sem molle sou 31seM 1111111100 01 sou slueuano3 tasey31nd
-algtseaj .Clle3twouma aq of ttedat to uotirioisai 2y1 swaap sopuan ay paptnotd 'pa$ewep
Aisadotd ay jo ttedas to uopmoisat of patldde aq Ileys spaaootd a3uetnsut '$utipm ul aat$e astmtagio sopuan pue saseg3tnd ssalun •sopuan pue
saimclut , ametnsut of ssol jo a,pou ans$ Apdwoid lleys taseg,tnd •sopuan gitM paitsodap aq lleys Auadosd ays $ultanO sat3tlod Ile jo leut$uo
aqi '$untsm ut saat$e asteuagro sopuan ssalun 'pue lsalalut sopuan ay jo tonej ui asnel3 ptepums ays uieiuo3 Ileys sat3tlod ayl •anp uagm
wntwasd a,uetnsut ay ,led Ileys sasey3snd '1,etiuoD stye sapun pamo a3ueleq ay ueyJ atow iunowe ue ui a$etano, astnbas sou Ileys sopuan inq
anT'a jjrgj jo wns ay ui 'sopuan Aq panoidde ssatnsui g$notyi 'a3uetnsut-oz) inogitm 'attnbat Aew sopuan se sptezey satpo y,ns pue
sluad a 1MAO papualxa '21g Aq pauotse3,o a$ewep to ssol Jsute$e painsut Aitadosd aqs uO siuatumotdwi ay1 dawi jleys iasug3tnd
-iuautAud Lions $utmogs sldla3at puewap uo
sopuan 01 santlap 01 Pug It ut lsalalut stopuan uodn to Aiiadotd 2y1 uo patnal sluawssasse pue saxes Ile anp uaym Aed o1 sastwotd tasey3ind
Ir
1 C
V
• S ~,~~Q99 ~ 10
Ep w
Qua:L3
ti
APPROVED
ST. CROIX COUNTY
Planning Zoning and Parks Com,~.;,.~o
,..,~s~oNs- CERTIFIED SURVEY MAP SEP 3 01999
VOLUME PAGE 3742 If not recorded within 30 days or
LJILE L. ELLIOTT ; BPProval date approval shall be
HyDSON oWl Z PART OF THE NEI /4 OF THE SE I /4 , SECTION 23. T2 aN , T Il► and void
`~<L7~95 TOWN OF SPRINGFIELD, ST. CROIX COUNTY, WISCONSIN
LOT I CSM VOL. I2, PG. 3289
I33'I33'IEI/4 3R.
S 89e27'01'E 5291.35• E.-W. 1/4 LINE SEC
. 2 2
352.77'
4938.58' 319.77•
0
SEE PAGE 2 FOR o
r~ rp
WI/ COR. SEC.23 ENCROACHMENT
M
I
W I
I E-- '
~ el
I c`rc
3I WI
LOT 1 I
Z 440 218.197 SF-
5.01 I Ll
AC. wl V co Z
to w 197.784 SF EXC. R/W `O `O BI J
I ~
W 4.54 AC. ~I a
E"' 3 W I W
~n M v O
HI in i W
c1J
M N N N I E-
M M
O e ( e
R .71 O O O V C1"
Z U ' v~ v> W Z I
co I ~
N;.- 100'-►
I
z' I U)
ZI
PREPARED FOR: D I
TIM & CINDY MAHONEY ~I
925 RUSTIC RD 3 I
GLENWOOD CITY. WIS. W
54013
0
50
319.77'
N 89e27'01'W 352.77'
UNPLATTED LANDS I. 6 6' I N
LEGEND W
SET 3/4' X 24' IRON REROD. BEARINGS REFERENCED TO THE o N
0 WT. 1.50 LBS/FT. EAST LINE SEI/4 SEC. 23 N
(ASSUMED SOOe32.15'E) v
® FOUND 3' ALUM. MON.
SCALE I' - 100' w
N
09 FOUND STEEL SURVEY MARKER 0 50 100 200
■ FOUND 3/4' IRON PIN
SHEET I OF 2
Vol. 13 Page 3742
1
a6ed £ l *10A _
ZttL£
Z 30 Z 133HS
1101113 '1 AS
'301AOV M03 allVOS NMO1 31Vl8dOHddV 3H1 GNV
0313VM0 iN3Wf1M1SNI SIHl 301330 9NINOZ A1NnO3 MONO '1S 3H1 10V1N00
ON I SVH:)Nnd 3NOA38 (013 130MVd 01 SS300V
' 3Z I S 101 Ann I N I W SQNVII3M 1) SNO I v-In93M
GNV S31t1M ' SMVI d I HSNMOI (INV ' A1Nf100 ' 31V1S
Ol 103rans SI IV-Id SIHi NO NMOHS 130MVd 31-11
L6 NI
M00 b/631M03
'dOMd 319NIS 'V'M M.Z£.bI.OON
AS 0191 SIN. .9S'b M.8£.8£.00N
AS 13S 'A'd 'CA 31VOS 01 ION
'V'M 66'0££ M.bb.6S.88N
zmo lG 1333 66'02T M.05. £Z .68N
00 - TO
10-<m /,.Nl
• • .86'0££ 3.I0.LZ.68S•
e0-01 3N11 V/1 1S3M-1SV3 / +`R~e►ea ;,~~f~
-n o
cn c~
3.61 .91 .OOS •
Xmcn 98'b M.SO.Ot, .00N lM
m NOSOij
H ,
ice. 11 3 ) 692e '7 * A c/~ ; 0/17.g .7S
tnOn .Od G L WS0 ~ w
G) w 1 101 30 1N3WHOd02I0N3 3~~)•`
m i`;, Ato 0S Q
cn
SV G30HO03N 'V'M
M3NMVW A3AMt1S 1331S 0NnoA
11 VN Nd 0Nf103 v S I M ' Al 10 GOOMN319
3AV 4+06 OVZ£
a0M3M NOMI .b/£ ONf103 O A3NOHVW AMMVS
:M3NMO
aN3931
6661 'LZ M38W31d3S 03SIA38
6661 OZ 1Sf1Jf1V : 31V0
0021 S1M ' 1 01113 ' 1 3IA1
A3NOHVW AON10 GNV WI1 J0 1S3n03M 31-11 1V 30VW SVM A3AMf1S SIHI
' 3WVS E)N I a I A I a 0NV 9N I A3AMf1S NI
'A1Nf100 XIOMO '1S 30 30NVNIGHO 31-11 0NV S31nivis a3SIA3M NISN00SIM 3H1 30
W M N01103S 30 SNOISIAOMd 31-11 H1IM 031ldW00 AWA 3AVH 11VH1 A311M30 I
'OM00311 J0 SN01101M1S3M NO
S1N3W3SV3 M31-110 ANY GNV 130MVd OIVS 30 3NII 1SV3 31-11 9NO-IV AVM-30-1HDIM
1333 00'££ NY 01 103rans SI 0NV SS31 NO 3MOW S3M0V 10'S SNIV1NO0
130MVd OIVS 'ONINN1936 .d0 iNIOd 31-11 01 133A LL'ZS£ 3.I0.LZ.68S 30N3H1
:1333 b'9'819 M.SI.Z£.OON 30N3Hi
:133J LL'ZS£ M.I0.LZ.68N 30N3H1
1333 b9'819 £Z '03S aIVS b/1 3S 3N11 iSV3 3H1 DNO1V 3.SI.Z£.OOS
30N3Hi '£Z '03S aIVS M3NM00 H31Hvno 1SV3 31-11 1V ONINN1038
SM0110j SV 0361HOS30 GNV 'NISNOOSIM 'A1N(100 XIOMO '1S '013139NIUS
30 NMO1 'MSIM 'N6Z1 '£Z N01103S 'V/13S 3H1 30 V/13N 3H1 30 IHVd 30 NOIlV1N3S3Md3M
103MM00 GNV 3f1Mi v S I iVld S I Hl 331138 ONY 39G31MONN AN 30 1S38 3H1 01
1VHi A3 11M30 A831131-1 Oa 0021-S MOA3AMf1S aNVI a3M31S I D3M '1101113 ' 1 31AI 'I
N I SNOOS I A '11000 X I 0HO ' ZS ' GU I ADN I US .10 N10I
'1911 *N621 'C2 N0 I 103S ' V/ 1 aS aHI A V/ 13N aHI A IHVd
RDW " £ t W110A
RN HHAS HAM39
t