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HomeMy WebLinkAbout028-1042-80-000 _.. 0 m . 0 � 4 � �� E ■ 2 � - � CO ƒƒ E o ° e M ƒ§ 8 e w/ 00 c m £ ■ ` £ ; :3 § / CL �' \ 0 CL 0) 3 OLL { in ■ ! E « E « £ I k c E e m r 2 2 i = A J. I \ Z \ / « / § E n e Cl) S � — CA c C � § 8 / 0 o o \ &- E / / \ 1 3E CA CO) CO) \ § OIQ E{ §/ J J 8 co 0 �f 0 N) & E ; � / 0 : / o � / I I M _ E ) m Oro / § § E � — � f j C6 � 2 z ca / k / z 0� ! 2 2 £ § z k r / § 2 ± CL ƒ 0 � # k � E } § } ( z < o i § % � ® Tj � ƒ � ® � \ m / $ @ ? # 0 E & ST. CROIX COUNTY ZONING DEPARTMENT 10 AS BUILT SANITARY REPORT Owner [b (, �� , . Address City /State 5 L��!�� , ;� �, s S - ST cao R C OUN1 Legal Description: Lot Block Subdivision/CSM # S %4 ,i ! J i , S e c . , T.. ' , N -R j�W, Town of PIN # SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer e, Size ST/PC cM from: House le Well 7 Pump manufacturer _ " � x Model i •' 3 Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent.to fresh air intake Water Line Meter location .- Alarm location SOIL ABSORPTION SYSTEM: Type of system: J2 1t Wider Len h 75� Number of Trenches �- Setback from: House §� Well ;t c� P/L e e ient to fresh air intake ELEVATIONS: Description of benchmark _ jj A / - / ? . � � Elevation Description of alternate benchmark E .� (�� Elevation Building Sewer ST/HT Inlet (�� ST Outlet PC Inlet / c PC Bottom �t %� Header/Manifold Top of ST/PC Manhole Cover 6� �6 Distribution Lines Bottom of System Final Grade Date of instatltion /�?/ Permit number / 5 State plan number Plumber's signature` g,a - =-License number Date -3 Inspector i �1�od w Complete plot plan a ` Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM County: INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary 1ei4 Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 3 Permit Holder's Name: p Cit Villa e Town. of: AKKE, AUDREY RUSYH�RIV9E State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: l� T _ � Parcel � : 1042 -80 -000 TANK INFORMATION ELEVATION DATA A9800328 TYPE I MANUFACTURER CAPACITY STATION BS HI FS ELEV. eptic p , Benchmwr 3 S �� 1 / oI� Dosing & Aeration Bldg. Sewer Holding ' A.5 �cf,v- St Ht Inlet y. 3 TANK SETBACK INFORMATION St /Ht Outlet TANK TO P/ L WELL BLDG. Ventto Air intake ROAD Dt Inlet _ �e NA Dt Bottom 7�] 12 -q �J2.9 / Dosing ' + Z I A Header / Man. Aeration oW -T NA Dist. Pipe -66 NA 3z 5 ' ;00 6 Holding w's''f ��� C'/. Bot. System T ' rig q9 .5 g PUMP/ SIPHON INFORMATION T S o a • y6 3g >n rna) Final Grade 7, 2•-7 r- !03 Manufacturer io ICY Demand 5 ,.K m-wr COve -.- - 7. 18 Model Number 5 �� 7 - Z_ PM TDH Lift Friction / I System TDH C Ft H Forcemain Length �� Dia. 2 Dist. To Well SOIL ABS TION SYSTEM ' ' 6 BED/ Width C'° Length No. Of Trenches DIMEN 1 N J PIT No. Of Pits Inside Dia. DIMEN I Liquid Depth N SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM L ACHING Manufacturer: INFORMATION Type qq Sys �/� j j0+ ` C NIT er: Mo � —""- OR UNIT DISTRIBUTION SYSTEM Header/ nif9ld �!� Distribution Pipe (s) Length 1 Dia. Length 7O q " (0 Yf x Hole Size x Hole Spacing Vent To Air Intake 9 Dia. Spacing 4SrM 5644 &77 Zoe SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over �� Dth ver xx D epth Of xx Seeded /Sodded xx Mulched Bed /Trench Center nchEdges To soil p ❑Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: RUSH RIVER 35.28.17,SW,SW 11 COUNTY ROAD Y Q) AqA Plan revisio requiredl? ❑ Yes No Use other side for additional information. ' PC SBD -6710 (R.3/97) Date Inspe or's Signature A s c onsi n SANITARY PER Safety and Buildi s Division MIT APPLICATION ' Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969gton Ave. Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. S� (1-7/ec x • See reverse side for instructions for completing th' licat n State Sanitary Permit Number The information you provide may be used by other gover Invent age • y [Privacy Law, s. 15.04 (1) (m)]. programs * ❑ CheAi!isio previous application I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N State Plan I.D. Number Property Owner Na /10 Lo /-S /� 9� P l Opert Location Propert Owner's Mailin Address J l /`( 'SiZ /4 �� 1/4 S ,3S T a, ?, N, R / 7 E (o,62 (y 3 Lot Number Block Nu mber State Zip Code �- , Cot , Ph ne Nu b bdivision Name or CSM Number mad (�!-) I 1�1�/. C! F C�v1 fCYyi E I. TYPE F B IL ING: (check one) ❑State Owned It Village Nearest Road [r i El Public 1 or 2 Family Dwellin - No. of bedrooms eu,5 1 tfid e_/ �� . Town OF III. BUILDING USE (If building typ iss public, check all that apply) rcel Tax Number(s) 1 [1 Apartment/ Condo `� � (•� 7� t ��� 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 E] Campground 7 E] Merchandise: Sales/ Repairs 11 4 ❑ Church/School 8 El Mobile Home Park El Restaurant Bar/ Dining 5 E] Hotel /Motel 12 E] Service Stat on /Car Wash 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• ---Sy em ____ Sy tem 3 ❑Tan mentof 4 ED 5 E] Repair of an k On --------- ___ only Existing System _ Existing System B) E] 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 [1 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 Seepage Trench 22 E] In-Ground Pressure �/'[J 13 Seepage Pit 42 ❑Pit Privy 14 ❑ System -In -Fill - 43 [3 Vault Privy VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 12. Absorp. Area 1 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System EI v. 7. Final Grad Required (sq_ ft.) e Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) ��0, E.pr� J © e l eet g9_5 — Feet VII. TANK Capacity INFORMATION in gallons Total # of Prefab. Site New Existin Gallons Tanks Manufacturer's Name Con- Fiber- Plastic Exper. Concrete strutted Steel glass App Tanks Tanks Septic Tank or Holding. Tank f©®a ®m® C U) / >rS �� ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ® ❑ ❑ El ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Nam (Print) Plumber's Signatur :(Nos mps) MP /MPRSW No L ! Business Phone Number: Plumber's Address (Street, City, State, Zip Code): 3 ©� J.� c CcJ rs IX. LINTY/ DEPARTMENT USE ONLY [] Disapproved Sam ary Permit Fee (includes Groundwater ate Issuing A ent Sig at re (No amps Approved ❑ Owner Given Initial 60.., Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL REASONS FOR DISAPPROVAL: SBD-63 I (8.11/96) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, plumber t A /d l r 1 a r- 3 J 7 IOU G �1,j PiA- k 63 i rAG.0 or frel,b All And 0 bL*1rJj1un Pip. Approved Vint Cop M lnlm vm I1" Aho.s —I l:, ads 41' Afur PIPS _. �� Casl I­ 10 final Grade - — Vent Pip, Ma, 11 -Y 0, Sfnlhallc C.—I.g — Wn c'" A OIIraCala _ 0 or Plpa 01 -111ballon -- PIP, 0 0 o 0 0 — 7o• _ 6 AGar•pol• 14neath Plp• 0 PnlOrol@d Pip@ BUow o Coupllnp T.rminallnp AI 110110111 01 System � I , SOIL FILL D15 n %I BL17'1 1.1 PirE APPROVED SyWTMETIC COVER 2 "OF -- I `�– • .— s, ,,,. 'MATERIAlL on q" of STRAW OR MAP SO NAy L E V. O F -- f F r f - -- _30 .FL4 V. O C)IS F,In ;TI AI I'Ir' Tv gk t.. I,IvCuES 8,E! w O R I O G NkAA L (;,,Ft A.O,E 'A,�IIIJ A ;t; L L n °� I 1 I J,C A N 4 2 IN,C Irl . i ,Ll L L O W F,t fj /.�L Gtr, !yO.E 'y /1AX11." ` `A N -prij (jr 1:_X cAv1\rioiu rg aK &wu 69Ao>- WILL BE -3 M ©Epn, OF F F WILL BE Lo IticNr L IC I.i ►IIIMµE i?: _j� � - �1�/ D r t : - -- -- -- —f _PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS PAGE OF VENT CAP 4"C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING 25' FRGM DOOR, JUNCTION BOX MANHOLE COVER WINDOW OR FRESH 12 M::I• AIR INTAKE I GRADE I `" MIN. I® "MIN. CONDUIT ` -- \ - - - -- 18 MIJJ. 11� fAll_.F:l --r- PROVIDE I - - -_ -- AIRTIGHT SEAL APPRD`JEC JOINT A I V W /C.I. PIPF I II W/C =vED jc)NTS EKTENDIAIC. 3' PIPE ONTO SOI.ID SC.;. I I ALARM EXTEUDING 3' B I I I ONTO SOLID SOIL I I C I I o I I I 1 PUMP --� D � OFF c}� ` Do COAJCRETE BLOCK RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL SPECIFI CAT IOKIS SEPTIC AND r DOSE TA�JKS MAMUFACTURER: � �5 B R O _DOSES: .,izrz C U C�o TANK [� 1C. 8 ba y --, ._ � y __ G LLOtJS DO E VOL�ME r/ A�� IS AL ARM MANUFACTURER: S`,I�¢' 1� INCLUDING BACKFLOW. GALLONS MODEL NUMBER: f kl I ©� 33L��LJ d SWITCH TYPE„ dRX CAPACITIES: A = INCHES OR GALLONS �?T • � 3.3,�/ PUMP MANUFACTURER: _ f B= INCHES OR G <4 1,' - L 0 U S DC� -� INCHES OR �D A_LOIJ5 MODEL NUMBER: 3 3 IAJCHES OR 3 GALLONS SWITCH 1'yPE: ��7 �L'LJjl ^^1� NOTE: PUMP ANp ALARM ARE TO BE PUMP DISCHAR4E RATE dam- GPIA INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE B' WEE1J PUMP OFF AND DISTRIBUTION PIPE.. /"9 FEET + MI,JIMUM NETWORK SUPPLY PRESSURE . . 2 + _ 2 O MAIN X r • • • • . .. FEET FEET OF FORCE / IooFT.FRICTION FACTOR._ / FEET TOTAL DYNAMIC. HEAD = / FEET INTERNAL DIMENSIONG OF TAIJK' LENGTH ;WIDTH ;LIQUID DEPTH i SIGNED: �-Z_`� Wiz ''=` LICENSE NUMBER: -11�- DATE: -'� rn H LU W HEAD CAPACITY CURVE 4% - - -- 6v4 -r "53 -55" SERIES —45'a 2 5 TOTAL DYNAMIC HEAD/ FLOW PER MINUTE 4% EFFLUENT AND DEWATERING CAPACITY Q —1 1 20 HEAD UNITS /MIN /2 - LU 6 FEET METERS GAL LTRS m 43 1 1 1 / 2 NPT Z 5 1.52 43 163 V 10 3.05 34 129 15 4.57 19 72 Q 15 19.25 5.87 0 0 z 4 D � 10 Q - -- - — ~ 2 5 9 5 /le l 0 US GALLONS 10 20 30 40 50 - 3 .__ LITERS 0 1 1 60 160 FLOW PER MINUTE CONSULT FACT OkY FOti 6NlECIAL Aii- 'L. LA'I i6fd • Piggyback Mercury Float Switches • Available with special cord lengths of 15', available. 25', 35' and 50'. • Variable level long cycle systems • Alarm systems available. available. • Duplex systems available. Standard cord length - automatic 9 ft. Standard cord length - non - automatic 15 ft. M53/56 SERIES Control Selection 1. Integral float operated mechanical switch, no external control required. Model Volts -Ph Mode Amps Stm l Duplex 2. S 1 - - -- - - in g le P widoangle mercury float switch or double piggyback mercury float M53/55 115 1 Auto 8.0 1 or 1 & 7 — switch. Refer to FM0477 N53/55 115 1 Non 8.0 2 Or 2 & 6 30 r 4 & 5 3. Mechanical alternator 10 -0012 or to - oo75 - - - -- - - - - - --- 5— - D53/55 230 1 Auto 4.0 1 Or 1 & 7 -- 4 See FM -712 for correct model of Electrical Alternator, "E Pak ". E53/55 230 1 Non 4.0 2 or 2 & 6 _3 or 4 & 5 - 5. Sensor mercury float switch 10 -0225 used as a control activator, with E -Pak (3) or (4) float system. 53 Series - Wt. 23 lbs. ­3 H.P. 55 Series - Wt. 25 lbs. -.3 H.P. 6. Four (4) hole 'J- Pak ", junction box, for watertight connection or wired -in simplex or duplex operation. P/N 10 -0002. 7. Two (2) hold "J- Pak', junction box, for watertight connection or splice, P/N 10 -0003. For information on additional Zoeller products refer to catalog on Combi nation Starter, FMO514; Piggyback Mercury Float Switches, FM0477; Electrical Alternator, FM0486; Mechanical Alterna- nator, FM0495; Alarm Package, FM0513; Sump /Sewage Basins, FM0487, and Simplex Control A r .t ` 1 1 ' r <lu aIl110 f1 the lo Box,FM0732. u lrr.;:eI stun Safety .ind Health Act tiSHA, ` RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. Z ` 3280 Old Millers Lane Manufacturers of .. . Of`L 77. P. 0. Box 16347 • Louisville, Kentucky 40216 (502) 778-2731 •FAX (502) 774-3624 QUALITY PlJMPB f1NC1 /g ,7y Labor and artroentoflndustry, Hu man Relations SOIL AND SITE EVALUATION REPORT Labor nd Hu Page 1 of 3 Oivlsion of safety a Buildings in accord with ILHR 83.05, Wis.. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but Ste. �"� u not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I. D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION T DAT PROPERTY OWNER:p � g' PROPERTY LOCATION 7 8 / 1 1 ° ���B SAT StiJ va SW va,S 3S T Z PROPERTY OWNER':S MAILING ADDRESS $ ,N,R VI E { W 1oL q �} LOT # BLOCK # SUBD. NAME OR CSM # CITY, STATE ZIP CODE PHONE NUMBER El CITY EIVILLAGE $ . IN)1J ;-j 1 SVp� ` cx1 ) 684_ k) 2 D �1Z N CoVrv`ty ti [J� New Construction Use [4 Residential / Number of bedrooms z [ I Replacement [ I Public or commercial describe [) Addition to existing building Code derived daily flow 30o gpd Recommended design loading rate — 9p� q trench, gpd/ft 2 Absorption area required - bed, ft Z bed, S D trench, ft Maximum design loading rate -3 2 , Recommended infiltration surface elevation(s) sue nR a �' 3 g g bed, filch rk) trees' gpd�t ft (as referred to site plan benchmark) Additional design /site considerations sEt Lp� 11Z�ti.1 a s W f T.A.4� Pyr-1 P E rarent material :S� t� e `}� L L Flood plain elevation, if applicable rJ • q , ft Suitable for system CONVENTIONAL ®S U S �ND U ESSURE AT GRADE SY T IN FILL HOLDWG TANK Unsuitable fors stem (� S ❑ U ®S ❑ U ® ❑ S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure in. Munsell Qu. Sz. Cont. Color Texture Consistence Bourxlarr Roots GPD /ft Gr. Sz. Sh. 0- `� Bed Trerxfi �o�, tZ � t Z — s�1 Z'4 sl�k rn�h CS 31L si I Z`� a Yn w S � Ground ,S ` -YCy — Gr s 1 1 i��' elev. 12 Vm U t' <-- — • y • S 1 03. o ft. 4 3D -60" Depth to limiting factor Remarks: Boring # >. Ground 3 Z�E3 S -- I-S `i lZ Y! S elev. ft s �0 S Y R- yllr 61� sl O* m `F4� -3 •4 Depth to f limiting �, f factor Remarks: S "T T Name: — Please Print Arthur L. We erer Phone- ress: 7 - 425 egerer Soil Testing & Design Service -P.O. Box 74 River F ; 5.02 Sgnature: Date: 3 � "M00576 PLOT , PLAN Pa 3 of -3 SCALE 1 "= 30 'F V� kke w�l.L �0 8F PrT L -�3T 50 ' �-or -t `nom ct+e NfO M'lE PUS C�tPN t -J/LA H. g'� � o l0 3 \ PVC b - L k13TYV L Z '11Z.f51JC� S 'X S' LOS.) B Z `R - l�►C S }' ac) k bzzp AT s! r Z 'TR�1JC� - tCH 3' X 7 S' Lo►�1� wl`il} s• 5 q \z- UIJI.'l pF "fttt F CA P4Ctiz! S�Da1 �0 to3_ ..lLeve �{ �`��►►�! F ��U eN L L�)P�`pty -� S i�T `T)�"lE [�_ �.or�l sT�-u c`7)ni� I , �� � 100 � \S0•t. �1f CST Signature 715 ) 4 5 -n1 n5 M00576 Date Signed Telephone No. CST # SEPTIC TANK MAINTENANC AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer (,1 /�,of' ,e /,Z -� Mailing Address Property Address i MdrIicatioa requi from P ''^^.w� """"'G IIeIIt for new cO�flllctioa) City/State � Parcel Identification Number - -0 a — — Sl 6 I.F,G& DES(`Rn� M O O Property Location 50J 4 S /, See. / Subdivision _ 7 W, Town of Gel tifed Satvey Map # Lot # Volume Page # wuranty recd # © a Volume page # Spec hom 0 3+eS 0 Lot lines identifiable byes 0. no �MANAxCI� . voasistsofpu � - tobaadlc cam at�et4he m of dw sq� taek oet� - as a ftate.m" Me Waste - casodPuaver. � dw system I. agrees to sabatrt to St Ckuac Zoaiag Dot oatibcatiou f m P =Wood lkmscd mW, signed by dye 4OW and by a P�raca oP� CM(ation aad/or(2) after onaad P� =V`er* agtbat(I) the on-cicowad=zter jam. PmP�.Clfncassary), me i tic- tank -is less .tlian Ili ruu of dadge. . t!`we, tlye na~dLavearaa bye abotre o� f�, he ek gas set by do Depactmeat and agave to �iat:in se wag e Wi$1 &C staadatds Glonnmmce aad Qye tb your scl*c of N&tad Resew: State of Wis000sim- days- of do Have yta � � � �� �t be ooaiplcted sad n limed to the st Cmix County Zoning office � p � F M Ld DATE ovu . CER CATION I (WC) oet* that all statenuats on this fomn an t xuc W ab*M by Virtue of a warranty dood reco in � of � e' I (we) am (arc) the owaa(s) of D=& SLG IURf3 F . M s «« « «« AW DATE ��tion that is misted may tvsult in the sanitary permit being ttvoked by the Zoning ent S Dcpattm « «« ««« «« ludude frith MIS aPPUcatfon: a Stamped waccaaty deed from the Register of Deeds office spy of the certified tuney map is made in the warranty deed DOCUMENT NO STATE BAR OF WISCONSIN FORM 9 -1992 n+s srAcc ecstevco FOR s[COa01NO DA TA ! _QUIT CLAIM DEED 448500 _ ►_ -- -- REGISTER'S OFFICE _ John Richard Bakke, a /k /a R - Lard J. Bakke, ST. CO., $/`X /W IZ�7 J.--- Bax ke-,... a/ k/ .a...Ri-caard--Bakkw....- - - - - -. Reed for Racord ... ............... . . . . .. . . .. •................. . ........ Er.1-CAudr-ey- M. Bakke, • a kJ_a Audrey._ - Bakke JUN 0 61985 husband and vi e; `conveys E* " 8:30 A.M o n I+lbhard Bakke --- ariii ------------ ' - ... ....hU,§ band" _a nd vife� 1ding - - - as - satyrvo hi - -- - " "' ----- •- marital..Fi^o .e tY....._.... • -•• - -- ----- - - - - -- - - - - -- • - -- - - - - -- ----- -- -- ----------- St Croix the following described real estate in ................ ............................... County, State of Wisconsin: ,," , I Tax Parcel No: .............................. That certain parcel of property located in the Town of Rush River, more particularly described in that certain Warranty Deed from Nettie E. Bakke, to Richard J. Bakke and Audrey M. Bakke, husband and wife, as joint tenants, dated February 7, 1966, and recorded in the office of the RegiE.'er of Deeds for St. Croix County, Wisconsin, on February 7, 1966, in Volume 420 of Records, at Page 554, as Document No. 283344, EXCEPT those certain parcels of property conveyed to Craig R. Bakke and Patty Jo Bakke described in Volume It Pages 272 and 273, as Document No. 401658 and 101659. All of the above described premises being located in the Southwest Quarter (SW's) of Section Thirty -Five (35), Township Twenty -Eight North (T28N•), Range Seventeen West (R17W). r . EX dP? 1 This .. .. is homestead property. (is) XAR Dated this ___- _. - -.- -..- - -..1.1 6 day of _ . J'�� � 19 - - (SEAL) _.- --- - - - - -- - _.. -.. J Richa d Bakke - - - �-. j4°�sC� -- __(SEAL) - -- -- - ..... .(SEAL) � �r..c�J _. $' Audre�i M. Bakke AUTHENTICATION ACKNOWLEDGMENT Signature(s) - Joan Richard Bakke and STATE OF tvtsCOxsIN --- Audrey M. Bakke ss. - - -- -- -- -- -- County. authentic at thi . day of__T" 19 -_8.9 Personally came before me this ._ ....day of ' ,�/ -- -------- -- 19 -- -- _. the above named ... ----- - ..- --- - -- --- _ - -- TITLE: MEMBER STATE BAR OF W'ISC'ONSIN (If not. -- - -._..- - ' authorized b y ,� i0r,,06, Wis. Stats.) _ - to me kr.man to be -r nrr -on who executed the �aZ-fNERbL NOT� Y,.r - C"K ELA P x= C r:> R - F - 9 EAT F I- D Fo 2- A. [, L N Fw 1 + �v I Ll I t� A. f i s Y , i i 4 J f lw