HomeMy WebLinkAbout012-1041-40-100
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Parcel 012-1041-40-100 12/13/2006 09:29 AM
PAGE 1 OF 1
Alt. Parcel 18.30.17.270C 012 - TOWN OF ERIN PRAIRIE
Current XI 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 - BALL, GREGORY J & MICHELLE A
GREGORY J & MICHELLE A BALL
1565 160TH AVE
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ` 1565 160TH AVE
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 3.390 Plat: 3254-CSM 11/3254
SEC 18 T30N R17W PT NW NE BEING LOT 2 Block/Condo Bldg: LOT 2
CSM 11/3254
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
18-30N-17W
Notes: Parcel History:
Date Doc # Vol/Page Type
07123/1997 1126/376 WD
07/23/1997 423/455
06/19/1997 1246/574 WD
2006 SUMMARY Bill Fair Market Value: Assessed with:
155956 169,200
Valuations: Last Changed: 05/31/2006
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.390 46,500 119,100 165,600 NO 02
Totals for 2006:
General Property 3.390 46,500 119,100 165,600
Woodland 0.000 0 0
Totals for 2005:
General Property 3.390 46,500 115,500 162,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 134
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
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-5 1997 0 S yy 3
S}: CROIX COUNTY ~ < 8 S" 19"97
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SURVEYOR'S RECORD
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UNPLATT LANDS
40IRTH, 290')
N00°16118"W 89.79' I Bearings are.referenced to the f the N ® a, 256.75' 33,04 18,tassumedoto beaNEN87°04e00"E~.
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STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER
ADDRESS
SUBDIVISION / CSM# LOT #
SECTIONJ?_TN-R`j W, Town of
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
HOW EVERYTH NG WITHIN 100 FEET OF SYSTEM
YuT
lr~~Ols~'/
ys
1' y
r
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK: ~o -
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Liquid Capacity:
Setback from: Well 9/~~ House Other
Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width' 2 _ Length 7,e' Number of trenches
i
Distance & Direction to nearest prop. line: z~
r
Setback from: well: House _ Other
ELEVATIONS
Building Sewer ST Inlet: 9-2 ST outlet:
PC inlet PC bottom Pump Off
Header/Manifold- Bottom of system
Existing Grade Final grade
i l
DATE OF INSTALLATION : ,ff O- 1n~
PLUMBER ON JOB:
LICENSE NUMBER:
INSPECTOR :
3/93:jt
wiscUnsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
Labor and Human Relations INSPECTION REPORT ST. CROIX
Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No.:
GENERAL INFORMATION 284211
Permit Holder's Name: ❑ City ❑ Village :gj Town of: State Plan ID No.:
KIMLINGER, GERRY ERIN PRAIRIE
CST BM Elev.: , Insp. BM Elev.: BM Description: Parcel Tax No.:
/4), 6!/ &-jo, cv `56~r7 i e a 41 pi~~71_ b", I j
TANK INFORMATION ELEVATION DATA II2o
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic 2 Benchmark
Dosi n
Aeration Bldg. Sewer 19
Holding St/ Vf Inlet
TA 14-K SETBACK INFORMATION St/ I;K Outlet 5, 2 gc ?i
TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
YLA-
Septic NA Dt Bottom /
NA HeademOAan. Dosing S5 Cs~
Aeration A Dist. Pipe
Holdin Bot. System
UMP /SIPHON INFORMATION Final Grade
Demand 3, 5-y-,
9 , a7
Ma turer
Model Number PM
TDH Li Friction Ft
Forcemain Length Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width/ Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS ~s DIMEN I
Manufacturer:
SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM LEA G-
MB
i r ! CHA W!lrn. r:
INFORMATION Type Of CHA
System: ORIJ IT
DISTRIBUTION SYSTEM
Header /Manifold ~l Distribution Pipe(s)/ / x Hole Size x Hole Spacing Vent To Air Intake
Length --AZ Dia. Length_ Dia. Spacing ~o
SOIL COVER x Pressure Systems Only xx Mound Or a Syste
Depth Over Depth Over xx Dept xx Seeded/ Sodded xx Mulched
Bed/ Trench Center Bed /Trench Edges To i ❑ Yes ❑ No ❑ Yes ❑ No
2,7
COMMENTS: (Include code discrepancies, persons present, etc.) 11 l~ 121
LOCATION: ERIN PRAIRIE.18.30.17W, W, NE, 160TH AVENUE
Plan revision required? ❑ Yes D'NO
Use other side for additional information.
SBD-6710 (R 05/91) Date Inspector's Signature Cert. No
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
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. '5~z e~z'
• See reverse side for instructions for completing this application State Sanitary Permit Number
A qa I
The information you provide may be used by other government agency programs ❑ Check it revision to previous application
[Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number
1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION
Prop Owner Nam Property Location
J` 1/4 Al - 1/4, S T. • , N, R 000
Property O isMailing Ar ss Lot Number Block Nu ber
Ci y State Zip Co a Phone Number Subdivision Name or CSM Number
J ( ) I oZ
I. TYPE F BUILDING: (check one) ❑ State Owned ❑ city Nearest Road
❑ Village f
❑ Public 1 or 2 Family Dwelling - No. of bedrooms Town OF
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
1 ❑ Apartment/ Condo
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. Lg Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5_ ❑ Repair of an
System System Tank Only______________ Existing System Existing System
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 JA Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy
13 ❑ Seepage Pit 43 ❑ Vault Privy
14 ❑ 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
Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min. 'nth) Elevation
Feet -Feet TANK Ca acit
VII. in gallons Total # of Prefab. Site Fiber- Exper.
INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App
New Existing strutted
Tanks Tanks
Septic Tank or Holding Tank S ❑ ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑
VIII. RESPONSIBILITY STATEMENT
I, thl? undersigned, assume responsibility for ins Ilation of a onsite sewage system shown on the attached plans.
P/MPRSW No.: Business Phone Number:
M
Plu b s Na : (P t) Plumb "s Si atu ZS)
lumbers ddre et, city, Sta, Zip Code) /J' 7"
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sani ry Permit Fee (includes Groundwater Date Issued Issuin Agent Signature (No Stamps)
YApproved ❑OwnerGiven Initial /Q~ p
Ad verse Determination !J J.. P
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD-6398 (R. 05/94), DISTRIBUTION: Original to County, One copy To: Safety & Buildings Divi ion, Owner, Plumber
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be 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:
L 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 of 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 is to 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 1/2 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 115 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.
.41
1-2
137
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-Wiscbiitri Department of Industry, SOIL AND SITE EVALUATION
. Labor aid Human Relations Page / of 3
Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis.
Attach complete site plan on paper not less than 8 1/2 x 11 inches in siz u410i County
include,but not limited to: vertical and horizontal reference point(BM 'e n j/ `� , �®y/
.�t r percent slope,scale or dimensions,north arrow,and location and d' o near d.
,oa P cel I.D.#
fRFCERIEg
APPLICANT INFORMATION - Please print all inf 'ytion. Reviewed by Date
Personal information you provide may be used for secondary purposes(Pri aw s.t 5.04(1)(rr4). -
Prope Owner / Prope +Location
,pp /4 +/ 1/4,S T N R E(or
iv
Property Owrf is Mailing Address �° /r Lot# Bloc ,,b'#,ubd.Name r CSM#
}-5avS' /I!1' '4-1101. VP- Ai"-
City/ State Zip Code Phone Number Nearest Road
1 ❑ City 0 Vill Town 4-4/,_ ,i--,-i,i) *.Xi C:///mt,Ion I t-,..4" l..S-40/7 I (7/`_S )---,24-Z..?7/ ,,,,,,,JA)
❑ New Construction Use: O Residential/Number of bedrooms " i Addition to existing building
N Replacement // ❑Public or commercial-Describe:
Code derived daily flow <ne90 gpd Recommended design loading rate , > bed,gpd/ft2 , s trench,gpd/ft2
Absorption area required , S' bed,ft2 75�O trench,ft2 Maximum design loading rate , 7 bed,gpd/ft2 , trench,gpd/ft2
Recommended infiltration surface elevation(s) ,51e, `> ft(as referred to site plan benchmark)
Additional design/site considerations
/
Parent material 7.6`/.0 O;.t.rs-,1 42/ .4-L12„gfx m0t.)1,S4-7ttiori;,Flood plain elevation,if applicable , ft
S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank
U = Unsuitable for system g S ❑ U 0 S ❑ U ® s ❑ u ❑s ❑ u ❑ s ,[K] u ❑ s El u
SOIL DESCRIPTION REPORT
Boring# Horizon Depth Dominant Color Mottles Structure GPD/ft2
Texture Consistence Boundary Roots
in. Munsell Qu.Sz.Co t.Color Gr.Sz.Sh. Bed , Trench
-Q / r-7 //Y .A4 s / / J ,MJIr" Rs ,/ i1/ : ,�
Ground 3 /lv S7 ZS //-V .1(// ‹of
sr is/ s-04 is)-7 /1_40 .i' 7 d
elev.
- ft. 3y91 le y°�// ,�/ l clime ,_ e,�,� / -- — , 7 :,f
Depth to
limiting
factor
>94' in. '
Remarks:
Boring# / / A(A, . si /„c. i // _
. ;.•... ? /5'.- -may / ,,u, /�' . 7 : ,
,2/Ground y
elev.
.-),'-%-2 je X�VI s- , r,/ s�/ — _ — , `7 : i
Depth to
limiting
factor
5 in. Remarks:
CST Name (P se Pri ) Signature , ` Telephone No.
l�`, �=�� C ,/'
Address CST Number
SOIL DESCRIPTION REPORT 1
PROPERTY OWNERC-177,c-1:1 1,4,47/,-,C! Page of
PARCEL I.D.#
Boris # Horizon Depth Dominant Color Mottles Structure G D/ft2
9 Texture Consistence Boundary Roots P
in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench
1,�� /,, ,. Jar l o s- /n . 7
Ground
Depth to
limiting
factor
�fl 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
'n' Remarks:
SBDW-8330(R.08/95)
i~sc°,~ . ~r, ~~oC /YdJ
3 Af
33
:
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix Cuuaty
OWNER/BUYER ' -'xl-
MAILING ADDRESS ;,~,,~,,a f -7
PROPERTY ADDRESS
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE
PROPERTY LOCATION XIIJ 1/4,k 1/4, Section T__ N-R-Z_W
TOWN OF Ae2A,ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER
CERTIFIED SURVEY MAP , VOLUME-_., PAGE , LOTNUMBER
Improper use and maintenance of your septic system could result in its premature failure to handle
wastes. Proper maintenance consists of pumping out (lie 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 treaUnent 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 I, 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.
1-he 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 (I)
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.
1/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, as set by the Wisconsin DNR.
Certification stating that your septic has been maintained must be completed and returned to the St. Croix
County Zoning Officer within 30 days of the three year expiration date.
SIGNED
DATE:
St. Croix County Zoning Office
Government Center
l 101 Carmichael Road
Hudson, WI 54016 11/93
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.
ownerof property! J""" -
Location of property AM) l/4_1/4, Section -,T N-R1~-W
Township A~ Mailing address
Address of site Subdivision name Lot no.
other homes on property? Yes_/No
Previous owner of property ~Qk AIler
Total size of property 171/3
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 No
volume /.Z6 and Page Number 3 746 as recorded with the Register
of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARRANTY DEED which includes a DOCUMENT NUMDLIZ, VOLUME AND PAGE
NUMI3ER AND THL•' SEAI. OF THE REGISTLR OF D1 EDS. In addition, a
certified survey, if available, would be helpful so as to avoid
delays of the reviewing process. If the dead description
references to a Certified Survey Map, the Certified Survey Map
shall 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) a►n (are) 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. .S"S G a /0 and that I (we) presently
own the proposed site for the sewage disposal system or I (we)
obtained an easement, to run the above described property, for the
construction of said system, and the same has been duly recorded in
the office of the County Register of Deed: a:. Document No.
S' III, ur AC3pli Co-Applicant:
Dx+te of Signature Date of Signature
• 4
A'110 State Bar of Wisconsin Form 2 -_1962
5302 wARRANTY DEED
Beodl&076 S ME CE
ftd
DOCUMENT NC
JUN 16 X995
Brian Miller a
antee
conveys sad warrants two f"Pratd~3_ICi't4nQer suet L.
~ir_t inoR=. husband Alfa aTifB _ - i sr
M1 ~ ~
_ NAYt?ANOtWETLMfAt10~:"'~ ~ ~"R,~ ~ it .~Gx.
des'ified - t..Q. croiY ~5t„$' •'T O ~L:~ b<"a°, t``(Y ~ ~t•
lbE "owing ma! Ca<itE in
Cowuy, Stale of Wisconsin
(~arod id► risusbetl
1t parcel of land located in'the i46 thwest 'Quartet o!''_he Eortheaect~" ,
Quarter (MI/4 of NE 1/4) , section Eighteen (18'). at p ''hi * 1_1
(30) North, Range Seventeen (17),heste TO. Of &ia arsesis ft
Croix Counttyy, Wisconsin, )tore ftklly :'escribed`` as lo1lol~c .
Commencing at the North Quarter. corner' o "id ` Section is ass t the ,
Iwo
'00 - 98
point of bbe~gqinnirtd for parcel to be described: theme
14
of .'Tbtm s `istgrice'` .5Q F.
i S7• 04~ : &1fs aiong_ of
feet; thence South 1•' 22'` Seat, a dlotaneTe o! ,404 teed.
~
pipe : thence South 85' 4~ ` Mest :q',dist~utt bf 262 , 60_ tit , t4
fA7
pipe; thence worth 5° 05 • hest . a distaff of Io3 teat
pipe; thence South Be 260 Nest a distance of 726,11 t0*t to =n from ~
zest:. liner of said Section 18;
pipe and the North and South Qua t. z:
Y'
Description continues on reverse star`
A .
11ia 1 O not 6omesoad pioPertY• q _ Y .
(ir) (d not)
_ ft=Pd" to waffantim
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a r
omi_
$rian J lClier.. (UAL)
ACYNOWLFDGl1({ENt "
AUTHENTICATION
- - STATE OF vYIV ONSIN
-
'
1
I9 1B y came Ldore we 66 211
"
? 19 rile aboae
• so": Ik W it
Tr". MEMBER STATE BAR OF WLSEQNBIN a
:rlo esccalod floe
(R on.._
PUKO
"Idwrind by §706.00 Ns. Stars.} b me tgovro to lie the
bre6c io= iesunmuu and ackapo etdge ffie same:
a 600K1
thence North along said quarter line a-distance of 290 feet Yo
point of beginnfnq. Said parcel containing 7.43 acres,"including
Town Road„r ght of way.
This deed is given in satisfaction of that certain land Contract
ween =s the, grantors' and Gerald J. Kiwlinger and Janice; L.~
bet
Xislinger, husLal'd and wife, dated April 08, 1969, reeotdaA Aprils"x
vole k.w450* . Pages 427 ' and 428, Document ltq: _ Z9a8h4~ ~ `
09 1969 $
E•
Nb as a° distribution under the, MichieV
cA or.s further conveyed
t~etA • to . nrla n ' O. NJ Hear - by personal Represante4 s
i992-j d"dam $ emAe ' 2~5~; .I992 , : Y01 9 ;a y ?F
V bodueent No-• _ 489034.
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