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HomeMy WebLinkAbout020-1321-20-000 -0 0 O v). c o c C o -p m o ~0 E C N L ~ a) m ti cu U C a) b N c ca O N r O O O -p (0 w m 91 O ~7 co w ~ ~ C C C z a) a> E 3 5- p 4 U U. O (1) tEE C, N O a 7 C D 0.0) 0 Q 2 c v 3 0 3 z E o ~ v o z `m m a Co F-z 0 0 z d c e{ O fn F- r m N z C ~ •p N N M a a) C a) CK c r CL ~ C O U O a)~ z 1- Z o N z p N ~ 16 E Y N L > C - 0) N d L Q) C o o a o N d O O LO O O O Z •rv _aaa by c c4 to -j 0 cn rn rn p z ca O N 41_ I N •O M SE 0 O m p C N Q co E2 C 0 0) O . O Lo 3 (D O C N p- ~O O O t \ N N V L' N Oj co (n c: E N C U) 00 - a) O 7 N - co a) tyj' O' N 'Np a) : Z' ~ M n L6 =3 • ~Vl L' O r- 2 N O N to E L) [n cO ~ £ L L: 0 m xt a a w • ea a w .2 d ~~`Irwwrl E c c _1 A 0 a 0 U) V STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER s A M ( LL E ADDRESS -ZL- Cok AW4E ~v Q :SON v1 1 5~f~(~ Irv C> 3a K, 5'(oi~ SUBDIVISION / CSM# GOeI} l~l(r ALL LOT # Z SECTION T a~ N-R~ Town of^N t50 ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM i r ' 1161 `e i ~ I ,tar ~p(~Sf , J ' I r <o/'~ICA6~, 1 3$X~ 17 SS' " ° T• 3 V1, S$ ie -pip ~ Zo - doh INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: aw s e `Aler 79, Z p •'l ~s F-- ALTERNATE BM: yzo >i> SEPTIC T / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: L/~ Liquid Capacity: /^00 -b Setback from: Well House Other Pump: Manufacturer Model#Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: l~ Length Number of trenches Distance & Direction to nearest prop. line: 11S Setback from: well: House Other ELEVATIONS Building Sewer ~ 5T Inlet: ~~o-~~ ✓ / ST outlet: r~ PC inlet PC bottom Pump Off Fµ = 8$3 A44 ! 478-'$$.!-X- Header/Mhifold Bottom of system Existing Grade)"= (I. Final grade I! 1 DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: I INSPECTOR: 3/93:jt 322.00' N89°5411" E 13 0 Q v~ i LINE OF THE NW liq - OA I 208-86' 56700' 1 HWL = 904.7 - 1279.86'- z LOT 2 0 LOT I ® 2.11 ACRES 92,085 SO. FT 2.19 ACRES f 95,279 SQ. FT El ED 2.01 ACRES EXC. E S-MT _ -87,556 SO. FT 1.71-ACRES EXC. ESMT. Q g 74,488 SQ. p ~ O Tfl LOT 3 p - ~y25°° A~3o / 2.59 ACRES 112,886 SO. FT \ OPD - 25 ACRES . EXC F ESMT p EXC 97, 975 S0. FT. o / AI3~ LOT 7'D 2.75 AC 2~. 00 C!op - - ~2 / 5 1;9,779 i \ n v 4 -124.00' _83.00- -GRANGE U P t 13 - 98. ~0'- - - 79- S86°05'56" Ju 20700 14' i t/ oCP_ LOT $ / gyp. 2.85 ACRES Q i ? 124,222 SO. F T LOT 7 3.29 ACRES 143 347 SC. FT. S~'UR VE DAT v 3.21 AC EXC ESMT. D J~ w 139,949 S0. FT. Ll A0 4 o 0~j 10 00A 4 .3 .4 . i 3 2.00' N89°54' 11"E 1320 96, NORTH LINE OF THE NW 1/4 208.86' Q HWL ° 904.7 0 - 1279.86' - 56700' I LOT 2 0 , ® 1 N 2.11 ACRES LOT 1 :I I Co 92,085 S0. FT 2 19 ACRES Ell I [D f 95,279 SQ. FT 2.01 ACRES EXC. E S MT w 87,556 S0. FT 1.71 ACRES C„ESMT./ Q~ 74, 488 S T i LOT 3 \ a 06 All 2.59 ACRES 112,886 SO. FT. 1 22 O / pP 25 ACRES Exc. ESMT p \ © \ ' 97, 975 S0. FT. ° tv) OP o" LOI y25~ 2.75 Ac 20700 / t 1!9779 G1 - 4 124.00' 83.00' /O 5~ GRANGE 0° ! C, i u s o JAL P 13 -98.00'--- - - -109.00,-- S86005'56"W 207.00' "b j / 14 1 ' LOT 8 2.85 ACRES Z- i 124,222 SO. F T LOT 7 40 3.29 ACRES 143,347 S0. FT 96 ; 9-' 3.21 AC EXC ESMT CURVE DATA ~ J• A 139,949 SQ. FT. `,7RVF ~G^ RA. 04, Gj LVJ ~ X d i b 2 23: / \~a i?-;4 -67, Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Lator and Iturnan Relations S INSPECTION REPORT ST. CROIX Safety fety and Buildings ngs Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitar284188 Permit Holder's Name: ❑ City ❑ Village Town o : State Plan ID No.: MILLER, SAM HUDSON CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA 3-)-1hz7 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic j,Jl ~s~j y Benchmark ~7d / `J ` Dosing Aeration Bldg. Sewer Holding St/IK Inlet TA K SETBACK INFORMATION St/ V Outlet TANKTO P/L WELL BLDG. Vent to ROAD Dt Inlet AirIntake Septic SO 9' NA Dt Bottom Dosing NA Headers 31,1W d, fie' Aeration NA Dist. Pipe ~ Holdin Bot. System 57 Pf, PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand pc~ .1c,7' Mod Number GPM TDH Lift Fri Syst TDH t Forcemain ength Dia. Dist. To well Fi SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~d DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING Many \ SETBACK INFORMATION Type O rj.,A„ CHAMBER Mode Num System: U~le 37/ OR UNIT DISTRIBUTION SYSTEM Header / mwn f6f t a Distribution Pipe(s) c x Hole Size x Hole Spacing Vent To Air Intake Length h` Dia. Length _~jL Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade S s On Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed/ Trench Edges Topsoil E] Yes ❑ No E] Yes E] No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: HUDSON.15.29.19W NW NW GRANGE ROAD J -9-- ttvc 0 -7~ 5 E.- C4,1--~^el~ Plan revision required? es low Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert No. ADDITIONAL COMMENTS AND SKETCH t SANITARY PERMIT NUMBER: Safety and Buildings Division ~.■...r.■. SANITARY PERMIT APPLICATION Bureau of Building Water System: 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 than 8 1/2 x 11 inches in size. - • See reverse side for instructions for completing this application State Sanitary Permit r The information you provide may be used by other government agency programs E] Check I-f revision fo previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION Property Owner Name P operty Location ~ /4 1/4, S /:S'- T Z9 N, Rlf E (frTW Property Owner's Mailing Address Lot Number Block Number ,r'W Z D6 Z_ 2-- City, State Zip Code Phone Number Subdivision Name or CSM- Number a~0-50 ff W / s y'n / 1(3rr.) a 6 0e,0N (f 11. TYPE F BUILDING: (check one) ❑ State Owned itr Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms. E3 own of (1, D.s0 l>! 111. BUILDING USE: (If building type is public, check all that apply) arcel 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 online B, if applicable) A) 1. [-New 2_ ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an -----System _____---System __TankOnly______________ Existing System Existing 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 210 Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12,9'Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 1 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 caSC~ Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) 87 g Elevation -,--a :3 (.®O - Sr Feet 2, Feet VII. TANK Capacity gallons Total # of Prefab. Site Fiber Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Existing structed Tanks Tanks Septic Tank or Holding Tank X ($t7D 5~~ ❑ ❑ ❑ ❑ ❑ 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. 3 e4 Plumber's Name: (Print) Plumber's Signature: Sta MP/MPRSW No.: Business Phoae Number: Plumber's Address (Street, City, State, Zip Code): 1076 v rE7A- R io G JF IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sani ary Permit Fee (includes Groundwater ate Issued I ent Signature (No Stamps) Approved F1 Surcharge Fee) Owner Given Initial Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SOD-6398 (R. 05/94) DISTRIBUTION: Original to County, One ropy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS t i 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: 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 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 pre*ab 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. Vill. 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 8 112 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 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. f.- /Q ' sys 7`c,,z i / J TAX 0 2 4 $.h'1- ~••~RoN AT Sr ~dNfR El = ~~~Z 1,ooe y La T G/,dE cbg_ g6 " M Nod ~ , l w~ t- 10 ~ g~so ~ h - o f S 3 0 °•o ~ ~R-3 10 c• ~ E I tig• LoTcNt_ ~alA r . I O A~ t z I J~ ~ ~ Cl 2 ' I ~ ~ y 0 06 m L ILI v I m I z .p.. ° X W Z LA; m ~v " J J ~ N o o ~o ~ ' In LA Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page j of 3 Labo;and~uman Relations C;gision of afey & 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 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 REVIEWED BY DATE PROPERTY OWN,,ER: PROPERTY LOCATION 15,4M l ~f fLLEk GOVT. LOT N1~j 1/4 NLJ 1/4,SI,~ T 29 N,R E(or)W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SU_5P. NAME OR CSM # CdhIC.E Yl~l. CITY, STATE ZIP CODE PHONE NUMBER []CITY []VIL GE OWN NEAREST ROAD [0' New Construction Use K] Residential /Number of bedrooms N N < Addition to existing building [ ] Replacement Public or commercial describe Code derived daily flow gpd Recommended design loading rate ( .7 bed, gpd/ft2 D trench, gpd/ft2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate O 7 bed, gpd/ft2 6.% trench, gpd/ft2 Recommended infiltration surface elevation(s) ftlas referr to site plan benchmark) Additional design / site considerations 'So ~V a/~"r rc AoQs COP- JOL97- PP1Q6V' i_ Parent material Flood plain elevation, if applicable ft S =Suitable for system qgNVENTIONAL M UND IN-GROUND PRESSURE AT-,GRADE TEM IN FILL HOLDING T MK U= Unsuitable fors stem OJ ❑ U S❑ U OS ❑ U K S ❑ U S❑ U ❑ S [U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trendt cw -7 -50 16Y414 S rsi r Ground elev. 7 % ft. Depth to limiting fact t~ Remarks: Boring } g 1o'y~ 34 Cs 1 0 4 3 _1 f IQ '63 Ground elev. q~ ft. Depth to limiting fact 7 Remarks: CST Name:-Please Print ` Phone: / O O Q~@1/C J©•N~•~C»,~ Ll O Address: c u h~ti Signatur Date: z1 CST Number: PROPERWOWNER 7! /4 ? MILLE12 SOIL DESCRIPTION REPORT Page Z of ' 3 PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bound ay Roots Bed Trends in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench -4 v►e i n1 sld r~rt~ a 4 ,5 14-33 P- ja S s t Z M s b M Y ~r r c,J - .z 3 Ground 12 p-1P,4 4 r n7 f' ®7 O elev. Q2 ft. Depth to limiting factor Remarks: Boring # th r,? A D-'19 g p M 9r nj j X13 a ,7 D .1C Ground 7• s ye l /A D`/ 4 S r YL1 ( 0.7 i~ elft. z% Depth to limiting factor > Remarks: Boring # 4..: 0 vle3 L Ka /1, (4 LA3 16 6 9, T~RAA Ground _ elev - 2 l / nY~ 4 Q s ri~ r M j 6 Depth to limiting factor $ y 16,0 Remarks: Boring # v: nL ~ Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) -PA&L 3 0~ LLC i - 4o ~ N jo' Q ~ W r.r A7' ~7 ' ~2 STC- 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNERIBUYER 5' n- M / MAILING ADDRESS ?o V- ' w j_- e Z_ - PROPERTY ADDRESS 4; / Z 06b,4/-) (location of septic system) Please obtain from the Planning Dept. CITY/STATE 1-1'/d So P1 Q J/ _:s- y014 PROPERTY LOCATION /Yk/ 1/4, /f/U_~ 1/4, Section , T aq N-R iy w TOWN OF BUD S D Ill ST. CROIX COUNTY, WI SUBDIVISION L C y/ LOT NUMBER Z CERTIFIEDSURVEY MAP 5_rDtIr3 , VOLUME PAGE , LOT NUMI3ER ' 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. The 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, 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: _ DA 1-1 -I-q St_ Croix County Zoning Office Government Center 1101 Cannichael Road Iludson, AVI 54016 11/1 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 ~fW M ( t.-L-t f4--- Location of property IVW 1/4NW 1/4, SectioNZ- T :nN-RZ 1 W Township vy S o l.) Mailing address J3 o x " zjP V-D Sa~I cU 5/0 Address of site 6,/Z ,6~~¢iV ~E iE?a~¢ap Subdivision name (111ZI C31~ Lot no. 7-' Other homes on property? Yes~_No Previous owner of property Total size of property Total size of parcel Z. b/ Date parcel was created 9 - Z 5- 9S Are all corners and lot lines identifiable? k' Yes No Is this property being developed for (spec house)? X Yes No Volume /(y?-_ and Page Number /0,714 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY 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 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) am (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"~ ~yoo A , 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 Deeds as Document No. .Y3 yyov pig Fgnae tu of Applicant Co-Applicant Date of Signature Date of Siqnature ~ Stale Ral c~(~ .,,r.an T In:a ? 199 7 WAIt,WilY DtI'D DOCUMENT NO V/ - ! ap nJI :,;)`i ivl: !d ~7L - Douglas C. Katner, Bernard J. N=!t-,i n., SEA 2 Iy9b ---and Chris P. Neurivin - _ ~i 12:30 P.M Sam E; . M i 11 e r _ _ . - ~~a'iAs.._, f 3 conveys and warrants to _ _ _ _ Regia u( 7~-:19 , _ $PAr~( riE'~E I1y;!I G,_,N Hk C';)n L•r h.. DA'A 1 r _ _ IMAVE Aht) RE rUP%ADOil E,5 I~ I the following U serib•.d real estate ir: St . Cro i X County, Statc of Wt :o as n. - ~ X r i ffil r;~ (Paltcl Idtn:ifi:_atit;r Nunjtk::'~ i { ii NW1/4N5r1/4, Sec. 15-T29N-R19W, except Certified Survey Map recorded in Vol. 5, P-ge 1418 as Doc. No. 393288, and except Certified Survey Map recorded in Vol. 6, Page 1761 as Doc. No. 420E27. It I iI ~ 4 ii ~I II I. is not j~ This homestead property. I (is) (is not) i Exception towarra,ai,s: easements, restrictions and rights--of-way of record, if any. I Dated this ~/V' September 95 j 7 - - - day of _ - - - - - - , 19 _ iI li r _ _ (SERL) _f.ef~ti.~~J ' ~~(!/tt2~x-_ (SEAL) i 1 Douglas C. Katner Bernard J. Neuman (SEAL) - - f +►h (SEAAL) Chris P. ~n AUTHENTICATION ACKNOWLEDGMENT 1~ Q, n i" Signature(s) B€rl1_d2 a J-.-._. Neuman _ _ _ STATE Of 1~rE):.`tc li Chris P. Neuman ss. II L' a - County. { aothendcated this day of September , 19.95 '1} pan}}; bet2?r me this _ _ da of ~f f r rr L^v 199 `„~h c ra t.d C ti------ - u g 1 a s C. K a t t1 e e 4 j, . Kristinaglan3 - - 1`~~lp::, - - - - - - p. TITLE: MEMBER STATE BAR OF WISCONSIN _ s (1f not. ~Y a t N ~a r f authorized by §706.06, Ws St ,s.l to me kkxs»n to be .he ptr on 7x'~;,,i ex iurtis forrg~inK in,ir,sra~nt and a, knowled~ {tc~ .l G y r ' i r.-6. THIS INS ~RUAIENT WAS DFlAFTED E3Y ~ ~ ' ' 1 Kristina 0 land '•~..••t,'~' g