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HomeMy WebLinkAbout020-1112-40-000 , , 6% STC - 104 . REcEevED AS BUILT SANITARY SYSTEM REPORT JAN 2 0 199 _ IROIX OWNER_ -JOAN S~p~Z h14~~ ~tK SCOU NTY ZONINGOFFICE ADDRESS /0`/1 Ada,wt 4r,y-e- cff ~~o ~~~~soyt In/( 5~01(o SUBDIVISION / CSM#_ itt IPNb LOT # SECTION ~a _T D9 N-R_a W, Town of kUp~UN ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHI G WITH N 100 FEET OF SYSTEM l ~eDi~GOr, N~►~ I~IPn,~~le Is oVe~ 3~ s~sU T~N~~ 1 _ ICI ~N Pno~ Ii~'~ INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. t BENCHMARK: I1 PA `Tlo 10.6 ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer' Wz,-kS Liquid Capacity: /)00 Setback from: Well "F- SUS House a V Other y Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location :SOIL ABSORPTION SYSTEM Width: Length SO Number of trenches 3 Distance & Direction to nearest prop. line: Setback from: well: GlER so House-IL- Other - Hzl owl 4`1. SU - f-tih I V-33 Nepmr 43sa _ ~3.3~ Q ELEVATIONS CuufK TG •7 y Building Sewer ST Inlet. 45.3(0 ST outlet 9S.~S PC inlet PC bottom Pump Of Header/Manifold Bottom of system SO Existing Grade_ N - 9 $•3 g SIQI~ Final grade M 41- 'Ah L- IS-Ili 71-Ou DATE OF INSTALLATION: ~I y PJ97 PLUMBER ON JOB: LICENSE NUMBER: 37 o INSPECTOR: 3/93:jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor'and Human Relations INSPECTION REPORT ST. CROIX Siifety and*Buildings Division ' (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 284285 Permit Holder's Name: ❑ City ❑ Village Town o : State Plan ID No.: SPITZMUELLER, JOHN & KAY HUDSON CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 020-1112-40-000 Jo't> GD~ 'Se 6 ✓l t.✓ r! d`f C h TANK INFORMATION ELEVATION DATA A9700056 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic e.cy+( IZva Benchmark Sc. /o/• /~L7 Dosing Aeration Bldg. Sewer 5,755 q5-. 6/ Holding St/ Ht Inlet cl S.3 C. TANK SETBACK INFORMATION St/ Ht Outlet Vent TANK TO P/ L WELL BLDG. Aii tontake ROAD Dt Inlet rl Septic 72, 725- ZZ , 7 Z5' NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe 7-Z y,, 9" 3311 4i•92 Holding Bot. System 8,os 9361 C12-5 91 PUMP/ SIPHON INFORMATION Final Grade 6 g?.Z► Manufacturer Demand -5t 1N~,I~tale (o ' Gj6 7 ro Model Number GPM TDH Lift Friction stem TDH Ft oss Forcemain Length Dia. st.Towell SOIL ABSORPTION SYSTEM BED RE Width Length No. Of Trenches PIT No. Of Pits inside Dia. Liquid Depth DIMENSIONS .5 50 DIMEN I N LEACHING Manufactur r• SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM INFORMATION Typeo , CHAMBER Moe m er: System:CwvCwh-6,j ZS 4"C 4 OR UNIT DISTRIBUTION SYSTEM Asr-A z~z7 Header/Man old Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length 7t) Dia. ~L_ Spacing Co' - 7 ZS' SOIL COVER x Pressure Systems Only xx and Or At-Grade Systems Only Depth Over Depth Over Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No C] Yes ❑ No COMMENTS: (Include code discrepancies, persons resent, tc.) Trer►r h A wa, , 4-o Obl'a~v1 al/'9~/'1~ ~iov✓ LOCATION: HUDSON 12.29.20.457,NE,SE ADAM DRIVE LOT 1 Fyn ce_w Zo Plan revision required? ❑ Yes 0 No Use other side for additional information. 14j C R SBD-6710 (R 05/91) Date Inspe 's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ' , a Safety and Buildings Division SANITARY PERMIT APPLICATION Bureau of Building Water Systems 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. X5-4 , a • See reverse side for instructions for completing this application State SSSanniiittarryy PPeerrmitit Number The information you provide may be used by other government agency programs ❑ Check it revision to prev- ions application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION PrT rty owner Name Property LScation E (or)~ NIC1/4 S/. 1/4, S 1, T :;I, I? A Property Ow Aarlr c Lot Number Block Number d City, S ate Zip Code Phone Number Subdivisi n Name or CSM Num er ( ) y Q A) U_'47 II. TYPE F BUILDING: (check one) ❑ State Owned ❑ it Neare Road Village / ❑ Public 1 or 2 Family Dwelling - No. of bedrooms Town OF fiZa 111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) D 1 ❑ Apartment/ Condo fa• 9. ,9 0 4" 7A V 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 _`'New 2. ❑ Replacement 3. E] Replacement of 4. ❑ Reconnection of 5- ❑ Repair of an ----System System Tank Only- Existing System System ❑ 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 21 ❑ Mound 30 ❑ Specify Type 410 Holding Tank 12 " Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13E] Seepage Pit 43E] Vault Privy 14E] System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade r f\ Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) If 9y'~ El v i rb l0aV ISO U dft _ 8 ice. 4a rU Feet a 9~ ~ 0 Feet 1. c) VII. TANK Cap L_ 7.5 je J acity gallons Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existing structed Tanks Tanks lAbO 4 ❑ ❑ ❑ ❑ ❑ Septic Tank or Holding Tank Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. EjjL lber's Name: (Print) Plu er's Sign re: (NO Stamps) r P/MPRSW NO.: Business Phone Number: Plumber's Addres (treet, city, State, Zi Code): IX. COUNTY/ PARTMENT USE ONLY ❑Disapproved Sanitary ttPermit Fee (Includes Groundwater ate Issued Issuing Agent Signature (NoStamps) Approved ❑OwnerGiven Initial Surcharge Fee) 14-9-(7117 A 011) Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS t ; j 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit. Transfer / Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions-concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3815- To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling- III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type.,pf permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber into fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 112 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a~l 15 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. 'OSS 67 P L 07 A i,) i) - P 0 ~J 1. Cyl- A M C -S AN P S z► u~ ll NAM F i ►y u,,~, c 7' P L o L. - pc~ ~oe ~L.s FOUND To O~ SVK' oar I OD' FR(jr, St f~') c S~ s Pr. p z P At S F Ld} C(JIMPIQ x Nofie: ►S S~ C sys~e►h c Fr-um 4-0 o sxs~ 4-1 !V 8 Q w 4 . ~ 6 I v I .y sS ~:N ~ ~ n _ CLev I0D.V K atNC P lFV%h)4 lop of SuKV. 'r P A~ SE Lqt c m J0~1 ~ 1 I I N Q I'x.pla £RESII A C1: INLETS AND OBSERVII'r 01 - 71 CI:Q-S SECTION _ Approved Vent C-A Minimum 12" shove - I 9~j.3U m~~( A" Cast Iron Above Pipe Veni Pipe To rinal Graclc!- Wisconsin' Department of Industry, 2 Labor and Human Relations SOIL AN t a_ TION Page of ✓ . Dlvision of Safety and Buildings in accord .4' s. ILH is. Attach complete site plan on paper not less than 8 1/2 x 11 inchei jrj size. Plan must CoArity Include, but not limited to: vertical and horizontal reference point (BM), direction and, ST, C I X percent slope, scale or dimensions, north arrow, and location and distance to nearest'road. Parcel I.D. If e APPLICANT INFORMATION - Please print all Information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacyiaw, s. 15.04 (1) (m)). Propel Owner i 0~9 ~f/jE/SEA Property Location /V G/j~f~ EUE~O~. ~ 8joRnl5%,40 Govt: Lot NE 1/4 1/4,SIZ T 19 N,R ZO E (o'o% Property Owner's Mailing Address Lot # # Subd. Name or CSM# t~lo 9~7 / Block HA12rLnN D City State Zip Code Phone Number Nearest Road 131, IP, l t/v/~So,~ w/ 5yC!'~o (7i5 )3~~ B~~.S ❑ city ❑ village Ud' Town U ?'New Construction Use: Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow. 750 gpd Recommended design loading rate 1"~ bed, gpd/ft2 - trench, gpd/1`12 Absorption area required _~bed, tt 2 5 G trench, tt 2 Maximum design loading rate =bed, d/ft2 g gp trench, gpd/ft2 Recommended infiltration surface elevation(s) !&.3 ft (as referred to site plan benchmark) Additional design/site co erations 17~5, Iew 415 2 z!5-X U~Lcs Pare t m terials Flood plain elevation, if applicable fl All 2P N S = Suitable for system Conventional Mound T I In-Ground Pressure AT-Grade System in F- Holding Tank Eru U = Unsuitable for system E S ❑ U l~ S ❑ U [~]-Sl ❑ U IJ S ❑ U ❑ S ❑ S • SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2 Texture Consistence Boundary Roots Bed , Trench In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. of 1,W y3 s Z 23 /O & CS /f S , . G Ground 3'9Q 7J ~ 6C / .s. c2 / 7 r Q e ev. 70 Lft. 75 Yl, 3 l5 /f S 7, Depth to limiting factor 9 in. , Remarks: , Boring # ~ 2~=~ z . y /d ~ y S~/ ~fSl S e s if 5 ; , ~ 3 7,5s, afsfl1-1 Ground 7 s~ s 054- elev. 57 -L-~- , tt. Depth to limiting factor 7 9~in. Remarks: CST Name (Please Print) Sig Telephone No. 'POB4ERT- ZtLARic-~1 nature 7i - 3Q6-SP 18S Address Date CST Number Uibrlcht & Associates O y = p~ CST~f z yso.L SOIL DESCRI ION REPORT I PROPERTY OWNER Page Z of 12 PARCEL I.D.4 GD T ~ 1 ~AZXIW CS~ Boring # Horizon Depth Dominant Color Mottles Structure 2 9 Texture Consistence Boundary Roots In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 3 / 94 71-5 s,/ 2fs/ s s'3f S/ ~-f fL s GS L f- - 3 X X1 2 -/z o 3 Ground /o ye J// N k s CS ~!/7 elev. . eft. 7,5 S•' 054- Depth to limiting factor 2,/D _in. Remarks: Boring If /o 0 'Y" 4s,/ z-F sb S S 3 f 5 G Z -25 A0 cs /vf 3 2s S X 5 / s /W 15 Ground - -7 J y~ s' s r i 6 elev. Depth to - limiting factor q --1n Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD/fe in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # - J-- OV1 y 3 Ground 7 S D 1 elev. ft. Depth to limiting factor ? %_I- In, Remarks: Boring # Ground elev. Depth to limiting factor In. Remarks: SBDW-8330 (R. 08/95) y Pl. 3®f3 - 132= Go T l 133-,i 7, zv s 5GA 5 : I ' = zD • _ /3AG~ka~ P~'TS 13 .3 h~3 ~z ,131 G Yo g Y 3~ ` -45 Jill o n~ C-) orT, t 01 i C) S~L IM I / is All CP -v-:--- , r gas ~ m 30U' W Ogg 00 _ - t - - 1 / IV / 1 e~ O (IJ ~ Nov 2 KA7H 7' 1995 0. 1 LEENH ReDisterof 536753 Crotx _ w Om O ©D O O O O z Bearings are referenced to the °O U) z to z z zin z z 0 0 , N CO -4 0 n ni CO °o d East line of the SE1 /4 of Section p In 01 m 0 ° M m g$ 0 0000° w r o- m 4 o a o N j. Ln 'D y 12, assumed to bear S01 18 02 E. p, N 0 j OLn ON ON O~w . -12 - NI m m m m m m~ © O O V~T'y - a z us CD 0 CI 40 !0 40 N Al _ 2 . 'M SMALL TRACT p~eoic ~i cn 0 Z b1 ab West line of the NEk of the SE>4 'e ed r` N01°12' 36"W 660.22\ ° th ~o,~N•... r eZ~ i. C w 608.22 \ dl a6p'`6' rt 589.=N30047152'E I~ N o • I~ 61.14' \ I r Ln N b Co tIj OD V, N a> I-I o _ o ~r i r> 0000 x _ _ 'c 3 Gm') Ip N' rt p rJ 0 o o o rn m N N 1 jr `"F v fia p cwt -n 0 z 1 rn In Ir (D N " -n -n aK o 0 2 00 C'r pa ~*v > > to ~ 0 , r QQ+ 7r (D 0 - C) m m T 0 10) N rn AD OD'/ m f. tLi y It= C O C • ~a £ 0 1~~1 o T 1 to 3 ' ~ti1 5 16. r-: I 0 t N r z K 3~~ • I , m K W _ 4 ZO x T `D °0 N05°07'07"W ° I J z 320.76' NI I ° a r"► ' 1-I *11 0 ° a r -p O 0 00 .C R w N y N m+ f0 i1 n -3 r, N X S N O ~r4 I~ w N O • 0 m v O (i( '~I U) y M - C+ C P w \ 1 o Vr0 i I~ ~ rr cn z I a Iv to ON ~%00 IIr- ~ I~ fi , Ivryry m _...~o•• ^'0 O. ° d t" 8 N W N r~^' •~l vO N ''O O O W _ V -O A ST(' - 1(IS SI"PTIC TANK MAINTE-NANC', AGREFINIFNI' St. Croix Count, OWN ER/1.111Y [,"R MAMING ADDRESS PROPERTY ADDRESS ! ~ ~~~_!/S' - (location of septic system) Please obtain from tllc Planning; Dept. I'ROI'1,R'T'Y LOCA'CIUNI/4, 1/4, Section 'I' N-It `ac) ~y TOWN OF ~I U ~ C> , _N ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAI' , VOLUME PAGE J0/0,oI-NUMBER _ 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 licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. 'llie property owner agrees to submit to St. Croix Zoning, a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping, (if necessary), the septic tank is less than 1/3 full of sludge and scum I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, Is sct by the \1►isconsin DNR Certification stating; 111,11 your septic has been maintained must he completer) and returned to the S( Croix Counly /rming; Officer within 10 days of the three year expiration date SI(iNl:l) I)A1'1: = SI ('rurx ('rnurty Zoll ng; ()llirr ( 4wellnnrnl l 'villel 1 101 Carnrichac) Road Ilnrl.,oll. \'.I '14016 11/'►~ . • S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. owner of property Loca4 ion of property N t 1/4 S t /4 , Section 1 , TQ9 N-R~W Township Mailing address Address of site %0 ~41 .d Subd i vision name ' 0v\ Lot no. Other homes on property? -Yes No Previous owner of property . ~4 I-o,r d De-Vel _ ~Total size of property off . l Qcrr S Total size of parcel = Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes -4-No Volume and Page Number 3/6 as recorded with the Register of Deed:. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRATITY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shalt also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on, this form are true. to the best of my (our) knowledge'that I (we) am (ate) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. 'jzq 9 and•that I (we) presently own the proposed site for the sewage disposal system or 'U (we) obtained an easement, to run the above described property, ror the construction of said system, and the same has been duly recorded in the ffice of the County Register ot.. Deeds as Document No. STgtature f pplicant Co pplicant t~.rt cat ~~r r;~t.urr. D;Ite Of Signature s + k State Bar of W'i,con,in Form 2 1982 53f 91(~ WA RRA\Tl DLED DOCUMENT NO F.%'. d NOV 3 0 1995 t B & N l an,1 Development, A 1disconsin Limited 11:00 A Liability Company _ - 3-?~~~stcrot D Otis - John J. Spitzmueller and Kay D. conveys and warrants to Miklai as__joint_ tenants - - - RESE W1 D F•?H HECC-ROIN.. ('A A >A(.~c _ _ i.JE AND RE "IRN ACUR O the following described real estate in --_Qroix County, Stare of Wisconsin: tParcel ldentifi,:ation Number) Part of the N1/2 of NE1/4 of SE1/4 of Section 12, T29N, R20W, Town of County, !disconsin, described as follows: Lot 1 of Hudson, St. Croix 'November 27, 1995, in Vol. 11, Page 3010, Certified Survey Map recorded as Doc. No. 536753. Are FER This is not - homestead property. W"s not) Exception to warranties: Easements, restrictions and rights-of-way of record, if any. ,1995 i+OVeClber, _ 2 - & d Land Development, a tdisconsin Dated this day of ti_ted Liabili y Company BY _ (SEAL) _ (SEAL) - (SEAL) (SEAL) - - s ACKNOWLEDGMENT AUTHENTICATION STATE OF WISCONSIN s ~ I vV~~"~ ss. Signature(s) County. dad of authenticated thisday of -N-Qv-ember--- .19 95_ Persoeallc came before me this 19 the atx,v.^ named Kristina Ogla - TITLE: MEMBER STATE BAR OF WISCONSIN who executed t e (If not. - - - to me known to be the person foregoing instrument and acknowledge the same. authorized by §706.06, Wis. S:ats.)