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HomeMy WebLinkAbout020-1290-30-000 ti -O O Q O a) O 3 0 0 (a 4 V Q ti N ~ d y 4L N Z C 7 co LL o ~ I I 3 `Y) w Z E rn Z = o \r E ` O) a m N F- Z O Z c a lp F r C _ L a) N O O O O N ) O 4 N co \ - O cD O U - C -0 w - N Z m z O Z p N Lo y z w N p o '2_ ~ a N a) _ y a) a) n a O .a t :3 m co cn 0) U_7Vl C) 7 m w a. IL CL "oil EL U 7 O 0) O a) i ` ` (q J U j O tVl~ -1 LO r- ~D o0 C) O a N N _ O N N N O Cp r L CO a) to Q .a: Q Z w co O N C O C. O 9 O C U O O 0 7 w O m O) O i O O O c07 N 3 w a) n. O. C Q. O O _ N N N_ O 0) ~ C O O C N e ~p C U) 7 - CN -5- J- I try~', FBI O' N a N ~ a0i a) ~ ~ N m co cli C,4 O E cD a) ai E I'L • M CL d U i , Ili a) rr~wV i C C di j 1 A U a E ii 1 0 in U STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER 0.1 ADDRESS /..SAD y Z 7 Z '710 th r iM, /Yr/!) SOYI J&jw SUBDIVISION / CSM# 1- u M t3 I R D N I L L$ LOT # 3 SECTION -,Z TAN-R_11_W, Town of lo n ST. CROIX COUNTY, WISCONS Na-(,a PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM VA t LL FAR L- DAD i EA sr loT L i1NF Zoe ' R. M. T-,f eS T., lel one J SCALE /O , V NoT~, ~s 2-/7-91( WE L L yet s Npj- /,E7" W 8EE/y /A! s7-,4arP WELL rill Q ~ I~ ~ g Xy0 Ian 16 II i { INDICATE N RTH ARROW Pr vide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: 211P 0C 7s_rd,,?_A0A1F_ Mk ALTERNATE BM: /y P OP HoyscL fDt~ridee. ~idh SEPTIC TANK PUMP CHAMBER / HOLDING..TANK INFORMATION Manufacturer: 2i SCrr- Liquid capacity: 600('2 6A L. Setback from: Well '7 Z House /7 0ther%s Se. Lv7`/~I//- Pump: Manufacturer 11-14- Model# Size Float seperation Gallons/cycle: Alarm Location- -:SOIL ABSORPTION SYSTEM Width: Length yo Number of trenches Distance & Direction to nearest prop. line: 41s' /or7`Li Aaf Setback from: well: House 8 Other 7-0 /V ell. /ot / Ije ELEVATIONS Building Sewer ST Inlet; ST outlet O PC inlet-- PC bottom Pump Off Header/Manifold Bottom of system Existing Grade- Final grade DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/93:jt sA'11Q#llAart4Pj§9#U%;y7.29.19W,%j0XtE VE A8jjYSTEM ILLS, HI ounty: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: 1 999f;1_1 Permit Holder's Name: ❑ City ❑ Village R Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: t~ Parcel Tax No.: TANK INFORMATION r ELEVATION DATA A9300366 ;~117/l~ TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic `;,~°°'C'_ • / 6~~~ Benchmark Dosing Lr~ 97, Aeration Bldg. Sewer , d Holding St/Inlet 1 TANK SETBACK INFORMATION St/ HeOutlet 'o, 1,5e TANK TO P/ L WELL BLDG. Ae Intake ROAD Dt Inlet NA Dt Bottom Septic 70 64 Dosing NA Headers Aeration NA Dist. Pipe 1J,67' 91 4~ Holding Bot. System s 90. PUMP / SIPHON INFORMATION Final Grader S' Man Demand 77o~ /rlc~ /f dC~ Cov S. S/ Model Number M TDH Lift Friction e LTDH t Forcie am Length Dia. Dist. To wen SOIL ABSORPTION SYSTEM BED/TRENCH width Length No. Of Trenches PIT No. Inside Dia. Liquid Depth DIMENSIONS 'IF, 1 0 DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Man cturer: SETBACK INFORMATION TypeO /Ipw C,,~ 6Z CHAMBER odeINumber: System: c1 OR UNIT DISTRIBUTION SYSTEM Header/Me i Fold - Distribution Pipe(s) p x Hole Size x Hole Spacing Vent To Air Intake Length % Dia T Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade System my Depth Over Depth Over i. xx Depth Of x ed /Sodded xx ed Bed /T¢* Center 6 Bed /T+emc~h Edges - YV Topsoil E] Yes El No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: HUDSON.27.29.19W,NW,NE,LOT 3,,HUMBIRD HILLS,HILL F RD. Cei!' ~.P c.x ~--F' ~~d/, j1 ~ cdJ~-~B~ c~u yr C✓11--~.-~~~ ct. ~~-PiI ~~.c,GC' . Plan revision required? ❑ Yes NO Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signatur Cert. No. r ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: SANITARY PERMIT APPLICATION COUN E0:__Gz~_j ILHR In accord with ILHR 83.05, Wis. Adm. Code 77 CCI STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than El 8% x 11 inches in size. cn k if revision to previous application I{ -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION - 4 IY7 /lPl" mom"' Y, S Z 7 T Z , N, R / E (or PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # s 0,0Z- Fr NUMBER SUBDIVISION NAME O SM NUMBER CITY, STATE ZIP CODE PHONE l1 f m s-, W_-r S 2Yf. Z 7& f II. TYPE OF BUILDING: (Check one CITY N AREST ROAD ❑StateOwned VILLAGE ~.SOh ~A,Pjy!/24 2 .4,1 ION RF ❑ Public to 1 or 2 Fam. Dwelling~# of bedrooms 3 AR 'PCEL NUMB ( ) III. BUILDING USE: (If building type is public, check all that apply) D Z _ Z g 0 3'D 1 ❑ Apt/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 in line A. Check line B if applicable) A) 1. ~0 New 2. ❑ Replacement 3. ❑ Replacement of 4.0 Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ® Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 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./inch) ELEVATION ,I.50 (D C/ S -7 ZO O. 7 S y .00 ' Feet gZ. SO Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New lExisting Gallons Tanks Manufacturer's Name oncret Con- Steel glass Plastic App Tanks Tanks strutted Septic Tank or Holdin Tank 10kno W SQ~ F1 [:1 1 L-1 El Lift Pump Tank/Si hon Chamber Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No S mps) © MP/MPRSW No.: Business Phone Number: o S ro as o~ ¢~~3 a y T 3 2 3 3 Plumb is Address (Street, City, State, Zip Code): IX. LINTY/DEPARTMENT USE ONLY Disapproved tary Permit ee (includes Groundwater ate Issued Issuing Age t wgrim Surcharge Fee) ,,6Approved ❑ Owner Given Initial Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-8398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber a. INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your-sanitary permit may be renewed before the expiration date, and at the 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- maintalned. 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 & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: I: 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 in 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 in ##1-7. VII. Tank information. Fill in the capacity of every new and/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% 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) alt 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, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) - Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page ! of „ Labor~nd Human Relations Division of safety 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 OWNER: PROPERTY LOCATION -S~ / &Ltle, GOVT. LOT N j 1/4 NLC 1/4,S-27 T Z. N,R 9 E (or) W PROPERTY OW ':S MAILING DRESS Lcs BLOCK # SUBD NAME OR CSM # 'T+20 ' -r (2 6R -k% fh / i2 ly LCS CIT1 STATE Lit ZIP CODE PHONE NUMBER []CITY []VILLAGE OWN N EST ROAD Nbh c1- ~'!-A 0 ) ( ) ~5c~w OLA~1~15 New Construction Use [G~f Residential / Number of bedrooms [ J Addition to existing building j J Replacement [ J Public or commercial describe Code derived daily flow 5~~? gpd _ 4 Recommended design loading rate bed, gpd/ft2 trench, gpd/ft2 Absorption area required 645' bed, ft2 trnch, ft2 Maximum design loading rate _bed, gpd/ft2 g trench, gpolft2 Recommended infiltration surface..etevatign(s - %'Ro ft (as referred to site plan benchmark) Additional design / site considerations = 'Rll. o 6L.& ~y5 r r~ 7~ ' jQLE A115 1 Parent material Flood plain elevation, if applicable ft S - Suitable for system cOO IVENTIONAL UND I ROUND PRESSURE AT-GRADE Y TEM IN FILL HOLDING T K U - Unsuitable fors stem Yd;! S ❑ U S ❑ U fS [3 U [K'S E] U 4S ❑ U ❑ S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bouxl3ry Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Titench El IQ' l L- I hK C A 6S ell 7-27 IQ 3 d `~L r /^ir C d.gQS~ Ground Z) 4 r ~eellevv Depth to limiting Remarks: Boring # o-16 16y~ 'Z 0.41 z 1022 joy?, I 04s6k t o .3 C r f~ .4 :as Ground 4S .16-Y e, I lex, 4~-,-t12 % Y>P r r~i 03 Depth to limiting Remarks: CST Name:-Please Print A~~~y JQI ~Jso Phone: 31~11~ _ OS O Address: Pp 41 1J'~1SdAl r' ) X Signature: Date: I /S 93 CST Number: r PROPERUQWNER s4e,, 4111-1-Z4 SOIL DESCRIPTION REPORT Page? of PARCEL I.D.# A10M !tX-s Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont Color Texture Consistence Boundary Roots Gr. Sz. Sh. Bed Trench 9-Z t d` L- f slot, r Ground zj-44 314 `J L (0. r 1L, l C 1 0A elev. I j i 945-1 ft. _S1 SL r rhv)r C / 0+C" Depth to ~4 ~l %l~yiP 4A 5 r r r,~ 1 Q•~ limiting , factor > zt),019 Remarks: Boring # y Ground elev. -Iz r0 414 s Q I f © d.g ft. Depth to limiting fa for L Remarks: Boring # V4 Ground r ©~:0T f t. x Depth to limiting f for .1or I T i Remarks: Boring # gy~£~•{'11}' ~}fi i~3n n'v'•?ii'4v?i:~i Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) I, 'p'S 4i o i I l~fn)C u tti~ p fi X- - Tt) P n r ~ ~ ~G X14 ~ F PcAAS -M i,. A ; "SIC Lx- CI, AJ E)P, i .E ~NVA'~ n~S A- To 14 t 4:57, M ~ 40.30 C-P 40 nI - rn si, S M /j?/,C / E ie 14 a M e / ~e p # IZ L S L 67 ~ 3 ~ ~ 7 96 ` •S y ~ ~.~r,,~ y oo " ~y''~ /o ~d' B;/yt, 7,, P of Ta~r~~o.,~ ~f sflcrv~✓' 8 t4 ILL PAR /N ROAD , F-ST to (i rt oC,Oe ~kok~ R, A4 T- P PEA SS fer hc/ ¢S~ kl. = Me,ov' L OT #z- L 3 , a7' 7t i ~ W ELL t ;17a d zv sd 9 , ~dkrc I !1 3s a/ i If/ z ~E S Q E y~ I i f I I ~rJ c 3 7' /a 7 H.~ a. D o, d d ~ I l 1 1V A yyj 10 C% 4: U -u I--------- -f- M . I I---- I I I Y ~ I i z co m I I I m I CA CA O I I I ` ~ I ~ I I I ~ I r I I I y' I A I I I j O I I I (id I I I I I -u I I I M -u U) U z I I I n C I A~ 1 rTi I I I N N W m Q ~Q I "0 h AI I I A R° X 0 .py 00 9 O 0 --1-1 ~O O X 3: rrI 0 Ej 7c z m -p b -D m 'Tt X0 "0 C z^ S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER Si~/y7 /yj/L L EI ADDRESS ~o X k 2. L FIRE NUMBER -7 90 CITY/STATE 12!4. os , i>z ZIP PROPERTY LOCATION: N0114, 1/41 SECTION_ Z 7 , T 9 N-R TOWN OF_ / el.S el , St. Croix County, SUBDIVISIONHV^ell°D YIZ d S , LOT NUMBER 3 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 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 fo~ 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/lle, 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 Co. Zoning officer within 30 days of the three year expiration date. SIGNED: DATE : / Z / 7 - 3 St. Croix co. Zoning Office 911 4th St. Hudson, WI 54016 STC - no This application form i's to be completed in full and signed by fthe owner(s) of the property being developed. Any inadequacies will only result ~n delays of the parmit issuance. ,Should this development be intended for resale by owner/contractor,(spec house), thenta 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 _5,41/77 Location of,property_I//l/4 )VAf 1/4, Section Z? TAN-R~ Township _#uel.So le--N Mailing address /s Address of site 2 %0 j/ 72, oQ ' Subdivision name_hA-/N Lot no. other homes on property? yes No Previous owner of property _r~4 ~,6; r~~aN to Total size of parcel Date parcel -was created -3 !'Are all corners and lot lines identifiable? X Yes No Is this property being developed for (spec house)? X Yes No volume/°?/ and. Page Number Z 8 Z 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 & 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 Registerof Deeds as Document No. S"o L i e q , 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 county Register of deeds as Document No._5d 2-Z oq O signature of applicant Co-applicant -/7- y' .t Date of Signature Date of Signature. A .a,';T ii . OROIRO DATA 7 DOCUMENT NO. STATE BAIL OF WISCONSIN FORM 1-1982 THIS f/ACi RESERVED FOR RiC WARRANTY DEED ~ VOL REGISTER'S OFFICE This Deed, made between - iiumbird Land Corporation, ft:;c'd for Rccord A Minnesota Corporation authorized to do business in-.wisconsin................................................................... JUL 2 1993 . Grantor, at 4.20 P. rA snd- .8AW. Miller. of Deeds Grantee, Witnesseth, That the said Grantor, for a valuable consideration...... RETURN TO conveys to Grantee the following described real estate in _..$.t s...Cr.--• - -rPAX Gi~•~ County, State of Wisconsin: y Lots 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 and 12 in the Plat of Humbird Hills, Town of Hudson as filed Tax Parcel No : and recorded in the office of the Register of Deeds for St. Croix County on April 7, 1993 in Vol. 5 of Plats, Page ' 99, Document No. 497107. Lots 13, 14, 15, 16, 17, 18, 19, 20, 21, 12, 23, 24 and 25 in the Plat of Humbird Hills 1st Addition as filed and recorded in the Office of the register of Deeds for St. Croix County on April 7, 1993, in Vol. 5, Page 100, Document No. 497,108. cR roll . This in.-nQt......... homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And...Humtti rd-.k4knd--C.orl29r4tion that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements shown on the above mentioned plats. and will warrant and defend the same. Dated this _12th.----------••-----•••---•....... day of _..July.......................................... 19-93-.. Humbird Land Corporation, a Minnesota Corporation authorized to do business in Wisconsin (SEAL) By ---.....(SEAL) a Austin J. Baillon, President ---•-------•------•-----•----.-.-.(SEAL) (SEAL) ' AUTHENTICATION ACKNOWLEDGMENT Signature(a) STATE OF WISCONSIN --County.. es. day of authenticated this ........day of_______________ • 19 Personally came before me this July 19-.43.. toe aM1Vf`IkWed . .V - j% • Am. ti.A_ J.__ Ba llon,,_ President .o-•• - TITLE: MEMBER STATE BAR OF WISCONSIN (If not. n j " `•s , I M authorized by $ 706.06, Wis. Stats.) O to me known to be the person Iav}I~ ecuted tl>~ f foregoing ' trument and acknowledgAl salt ] Q t, THIS INSTRUMENT WAS DRAFTED BY U J N N V, v V{/7~Q•~•.•••.•• - v . s .Kueppersr..Hackel..lh.XueLpge.ra-----•-•------•-------•-. .L350..Capital.-Centrer.-St....Paul,.-BN- 5.5102- Notary lie .S-T....-.~ Wis. (Signatures may be authenticated or acknowledged, Both My Commission is permanent. (If not, state expiration are not necessary.) date- 19......... ) ` *Names of persons eicninz in any capacity should be typed or printed below their siffnatures. Y WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Leval Blank Co. Ine. FORM Ns. 1 - 198: Milwaukee. Wis.