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020-1165-62-000
n N Q C d ~ ~ 7 A 1 3 ~: I N w~ ~, Z o w l , ~ Aa 7 ~ ~ O ~ p ~ ~ a •" o y ~~ ~.. a y ~ N ~ C <D _ > >~ u0i K ~ N N d N (D ~~ O O ~ 7 f~D ~ CO W ~ p O ~ l N M lD C7 _ m m Ru v IA ¢ ~ ~ a ~ o ~ ~ l p p 0 ` Z O N p N O T. { ~ C (p a O O O o- N O ~ C ~ a Ul ' N N ~ D O O ~° ~ fD '~ m - v ~ A m ~ - ~ o ~ ~ ni rn 3 ~ r. a ° ~ .. y o =; ~ 3, - ~ ~ °0 5~ Q ~ o m y G7 ~ ~ '~ ~ ~ C ~ C ~ ~ m C7 a 3 ~ ~ ~ ~ ~ ~ ~ ~ - o ~ C ~ a W N a ' 3 0 o ^f ~! ~ CD '6 O p~ n (D "= ~ D ~ .. N j fD fD Q ~ °' ~ ~- C G ~ "~ m N0 o' - ~. N v C ~ f~D ~ Z O a _ ~~ N o ~ ~ N Z S ~ O m ~ m a x a ~ T. v N ~ ~ ~ p N ~ N O x .. N N _~ ~ C. m ~ ~- a v r. Qo w N d Q i O fD f!i ~ O S~ p0 Q C7 fA Q ', ~' 'L n ~ N O C r3+ ~ 3 fD 13 n C1 A 3 ~ 1 d m 3 = 3 ~: ,~ x~ ~ ~ y O~ ~ ' ! _ V N ~ O C d N O Z Z m ~ CD O ~ m m ~ Cn ? ~ rn N '. ~ --~ _ U7 J 7 (D p O ~ O O N C: W W O O CD O p N N ~ ' , O Of ~ ~ z ' a C1 y U a ~ ~ ~ ~ m _ C A A m Z ? ~ O ~ ~ O C ~ ~ 'D A ~ •• O O O o ( -D ~ ~ ~ O) " ~ co ~ o ~ N fA fA ~ a v o v ~ ~ ~ ~ ~ A v, m 0 3 v ~_ ~ ~ m ~ ~ .. m ~ N Z W Z D a ~ O ~ ~. m o ~ m ~ ~ N (D 61 ~ C ' fD ~ ~ a 3 m ~ -~ -i to ~, o .p Z ~ ~ C ~ Z a V~ ~ ~ < (ND V o. ~ z ~ ~ ~ 3 ~ `° m ~ N Z N A w ~ ~a O C Q. ~p - C1 N N O~ a ~ N ~ ~ ~ ~ 4 ~ N ~ °' n m (D a w N 3 m N O O O i ~ O EA O 4t O ~ T C 3 a • Wiscon§in Department of Commerce Safety and Buildings Division GENERAL INFORMATION PRIVATE SEWAGE SYSTEM INSPECTION REPORT (ATTACH TO PERMIT) rersona~ ~mormauon yvu prvv~ce may ue useu wi secunaary purposes ~rnvaCy ~aW, S.1b.U4 (1)(m)] Permit Holder's Name: ^ City ^ Villa e ^ own of:. Morrissey, Michael & Jill Hudson Township CST BM Elev.:- Insp. BM E{ev.: BM Description: ~ ~ ICU ~~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic (N~ s ~ 4!U c7 __---- -- Aeratiop Folding TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. vent to Air Intake ROAD Septic 7 ~d/ ~s~ ` zo` -~ ~ NA D Ae 'on NA Holding PUMP /SIPHON INFORMATION Manufacturer Demand Model Number .-~° G TDH Lift--'~ friction stem TDH F F~rc'emain Length Dia. Dist. To SUILAKSORPIIUN SYSTEM 17 ~,~.~ „!_ _ c ~a~~ BED / Width Len th i / No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIME ~ S L DIMEN I N SYSTEM TO P! L BLDG WELL LAKE /STREAM LEACHING Manufa turey: SETBACK ~y INFORMATION T O MBE Moe umber: ype f 3~ ~ ~~ ~ ~S`~ T /'' System: ~ i [ DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake /n ~/ Length ~r Dia. / r/ i ,~e Length Dia. ~vr~r Spacing ~ ~ ~ / > yrj` SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed !.Trench Center Bed !Trench Edges Topsoil ^ Yes ^ No ^ Yes ^ No COMMENTS: ((In lude c de dIS repal~~e r o eye in5pc°rlutt rri: i ~ c~ lll~u~~~l~ll,~~• Location: 939 Mi~Ce Circe, Hu~son, W1 ~~~~ ( 1/~~ I~ 17 T29N R19W) - 17.29.19.1008 Parkview Estates Addn. IV -Lot 91 .I \ 1.) Alt BM Description = fo}p o ~ ~~e/' >tie,~'1E' ~ Giio/ `~ J P ~-~~ ~{ t'~ % war t~~,~ 2.) Bldg sewer length = ~p ,. -amount of cover = ~ SYs~ ~ 3 1 ~r( /PTWtG~-~0Lt.1"I~ QA~.dr ~lt~~ /G~.-- ~(':l/ N`. qtr ~/6~0ti` l0~,~ l/~CY, Plan revision required? ^ Yes ~~ No Use other side for additional information. Z p~ (9 ( / SBD-6710 (R.3/97) Dat Inspector's Sig ture Cert. No. ELEVATION DATA Coun ~t. Croix Sanit~r~~~r,(njt No.: State Plan 122DSS44No.: Parcel Tax o.: 020 ~ 165-62-000 STATION BS HI FS ELEV. Benchmark ~ ,~3 D ,~ l00 Alt. BM (,~~ ~,~ Z Bldg. Sewer ' /Ht Inlet " St Ht Outlet ~, Z ~` S~ ~ Dt Header /Man. ~, 3 ~ ~S ~ y ,`!- Dist. Pipe Q TZ ~, ~ S`. ~ Bot. System ~ ~ T 7 9 .9 Final Grade 3,~ ~d~•l 3 St cover ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: __. ~ ~ ~ ~ ~ ~ i ,..aw ~,. Wb.._~~_ ~.. _ ~rv.W~~~,a_~~ s Wisconsin Department of Commerce _ _ ~ Q GC v%G~~ ~~r/ SANITARY PERMIT PLIC ~ ~ In accord with ILHR 83.05, Wis. Ad d ~ -_-~-?! Safety and Buildings Division 201 E. Washington Ave. P:O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, o r n~#~I~l ""° ' ff~~` unty'' f ' C than 8 vi x 11 inches insize. - ... `- ~ ~01 • See reverse side for instructions for completing this application i ~ ~ ;. ~ i 5 eanit~ry rmit Number The information you provide may be used by other government agency programs ~'~ ` ~~~` i~~' ~Check if Yevis n to previous app ication [Privacy Law, s. 15.04 (1) (m)]. ~ ,, %C~ 51,PIan I.bjNumber `~ ! I. APPLICATI N INFORMATI N -PLEASE PRINT ALL INF R ~ * " Property Owner fNam c ~ ~ a ~P,l ss-~ P prtAr Locakion- ' h/ ~ ~/ati 9., T , N, R E (or) W V. a 9 i Property Owng~s~^ ~ ing Add ~ 'tJ ~l 1~ C 1 RC_ Lot Number Blo k ber Cit ate ~ ( yU 1" n Zi Code p _ Phone N b r (~'j IS') ~$ ~ 7 ~ Subdi n N e or CS N tuber t~ ~ (r J aN F" ~ vs - S C. a A II. PE F B LDING: (check one) ^ State Owned ~ ity Neare R d r ^ Village ~ ~ Public 1 or 2 Fami1 DweNin - No. of bedrooms kPSON ) 2G Town of ~ ) ~ -'~ ~ ~~ . ln~.,p. III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s ~O L ~~~~ ~ ~ 4~1-~°~-ooa 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 t2 ^ Service Station /Car Wash 5 ^ Hotel !Motel 9 ^ Office /Factory 13 ^ Other: specify IV. TYPE OF PERMIT: (Ch ne box on line A. Check box online B, if applicable) A) 1. ^ New . ~Replacemen 3. ^ Replacement of 4. ^ Reconnection of 5. ^ Repair of an ,______System _____ 5 stem __-_____-_TankOnly______________ Existing System ________ ExlstingSystem 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 21 ^ Mound 30 [~ Specify Type 41 ^ Holding Tank 42 ^ Pit Privy 12 eepage Trench 22 ~ In-Ground Pressure C \ f x ~J 3 a 13 [Seepage Pit J 43 ^ Vault Privy 14 ^ System-In-Fill ~t w~ -~c 01- x 31. t 7~3 . VI. ABSORPTION SYS EM F FO ATION:76 3Z 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Pert. Rate 6. S ste ~ev. 7. Final Grade ~ Re ul,~ed (sq. ft.) Proposed (sq. ft.) (Gals/ y/sq. ft.) (Mi /inch) ~3 x g CD ~ ~ ~ n a~l ~ V Feet Feet V J ~ 5 (~ .. . d VII. TANK INFORMATION Ca acft in allons g Total # of Manu turer s Name Prefab. Site con- l s Fiber- Plastic Exper. New Existin Gallons Ta k~ ~ t~ ~ Concrete strutted tee glass App Tanks Tanks uSl ><) ~!v Nt`' eptic Tank ~"" ~C~O(2 ~ e f l;+Z ^ ^ ^ ^ ^ Lift Pump Tank /Siphon Chamber ^ ^ ^ ^ ^ VIII. RESPONSIBILITY STATEMENT ~ ~ R.oeM arJ r u -NS ~aJ R~b>', y ~ I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plu tier's Si ature: (No tamps) MP/MPRSW No.: Business Phone Number: ~rn aau /r1 et ~(~ Uri ~ a~ ~} o j j - - 40~ Plumber's Address reel, City, State, ip Code r~?v ~ 3~ ul~n~ „ )st- ~~°~l ~- IX. COUNTY / DE ARTMENT USE ONLY rOVed pp ^ Disapproved ^ Owner Given Initial Sanitary Permit Fee (i"dudes Groundwater surcharge Fee) - ate ssue ~ ~ Issu~n g Signal a (iUo Stamps) ~ ~ ~i Adverse Determination a ~~ ba ( G~ Jl. ~.VIVUI I IVIV~ Vr~AjI't'KVVAL/ KCA~VN~ rVK fUI~Af~f'KVVAL: a1/~ - X01/1 ~ O SBD-~ ~ ~ ~~) DISTRIBUTION:. Original to County, One copy To: Safety 6 BuiMings Division, Owner, plwwber INSTRUCTIONS 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 priorto instal{ation 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, 608-266-3151. To be-complete and accurate this sanitary permit applicatian must include: i. Property owrer'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 online 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 al! information requested for numbers ?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 inciude 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 mainslwater 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. .T.. _ . ,..__. _.__. ._ / .. _ .l0 and Sd e zthnde.r . A I Pr•k v w S11>h S iLt ,(e 0 Al I . Sk1TMQw Popp W9if e2I 1INP N(it e paIa(QN't ld-s ► i Web- hg.n rpntlaict4 1 35- .__.__ I b C ri,b,, ccfr,,r..s.itr>,., D- 3x75 Trowck, s [3� 4 MQ�k —rtia�silo',lo' � for o1 S-4v11G MaNhol--e SIlitic-a5)siei's- i Coles. k-e\l= '06.0 36' PI 1 (3-PN c., Ivi p R - {•� �$ �3h11 ��u Tip b-c Oa 4( row.Int 3 0 y 14.4r., 'a' 1� vp��e k ij 5. r. cog we off !.►ouSR �il� �� �� ��o�` CBI �o dub tsd, I o 1- S 'st9A,►c s 3 k>0Ap 38, a= So)1 rfis / R Drti e C..6 iV 1,1 i [GitlaPQ Wpk1 fPI'-PA Sy.s1 - --- �._ g L — j_l___- — - 13z:A 0 tv, TN)-,ill 5 j5**6/ . _ ,Nhl Gizpne 7/-00 o o R _ , o c Ni Zo I -41 ti- --aoi--• -.---- 2-5E 'El ED -C X 0) el ---- - 47 Ni/ - cti(l)(1) :OW DU) 1:7>:: 45 „, -i I n c O O 0 0 0 L 3 O i L 's O .- -0 L 2 - 'tom co O N 6 F- -9 (n U p, (1) >, LU _\ v) to 0 D .t-. a al '—' RS 0 L \ ,"'. , , L-, \ cp - D _c (.) 0 = co �oa�v�a , V o) a.0) a? CD C_J LL 0 = � ! 9avv,� O . . ,� oN __7__ a. • • • • • Wiscon'sirl Department of Commerce SOIL AND SITE EVALUATION .: Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Page 1 of 3 A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 8'/z x 11 inches in size. Plan must County direction and include, but not limited to: vertical and horizontal refe St. Croix r percent slope, scale or dimensions, north arc d,ldi~ti distance to nearest road. . -. parcel I.D.# ~r< ~.. ' _ - `- ' 020-1165-62-000 ID# 17.29.19.1008 APPLICANT INFORMATION - ~rds8 pr~n allinfo Lion. 04 (1) (m)) 15 s ac t w P i ~ ` R ~ g D t . . . v y . , r poses ( secon ~ p Personal information you provide may be or Property Owner "` ` ` ' - ' ~ Michael & Jill Morrisse ~„ '~ ~ , ,,„. ~., ~ Property Location Govt. Lot Nw 1/4 SE 1/4 S 17 T 29 N,R 9 w Property Owner's Mailing Address ~ ti~ ` E;. ~ Lot # Block # Subd. Name or CSM# 939 Mike Circle ST ~" ~$ 91 Parkview Estates 4Th Addition City St ~,~~,~iQ C,aQ~,q~er : ,.`~~` ` ~ ^ City [] Village ^Town Nearest Road Hudson W 5 1,6 715-386;,~A~9Q.'` Hudson ~ Mr1ce Circle ~ c tl I ~ of bedrooms 4 ^Addition to existing building ^ New Construction Use: ^ Replacement ^ Public or commercial describe Code Derived daily flow 600 gpd Recommended design loading rate •7 bed, gpd/ft~ .8 trench, gpolftZ Absorption area required 857 bed, ft2 750 trench, fCz Maximum desi n loading rate .7 bed, gpolftZ .8 trench, gpolftz ~ ft (as referred to site plan benchmark) Recommended infiltration surface elevation(s) T~~' ~3 Additional design l site COnSlderationS ~~ trenches using nigh capacity infiltrators. Install Bull run valve to allow future use of existing hydrolicatty Parent material Glacial outwash ~ Flood lain elevation, if a livable na ft S=Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U=Unsuitable for system ®S ^ U ®S ^ u ®S ^ u ®S ^ U ^ S ®U ^ S ® U r u n ~ v u^ l~T~ _~c~r ~ ~~ /~Y Rrt-l/R ~ Boring# 1 Ground elev 99.15 ft Depth to limiting factor >107" 2 Ground elev 99.22 ft Depth to limiting factor >109" Depth N K^l '~ ~^•~ ! y Dominant Color r ~ Mottles Structure t d B R ots GPDfft2 Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. en Consis oun ary o Bed Trench 1 .0-31 10yr2/1 None sl 2msbk mvfr cs 2f 0.5 ~ 0.6 2 31-41 7.Syr3/4 None Ifs lmsbk mvfr aw if 0.5 0.6 3 41-45 10yr4/6 None is Osg ml cw - 0.7 0.8 4 45-62 10yr4/6 None s Osg ml aw - 0.7 0.8 5 62-88 7.Syr4/6 None s&gr Osg ml gw - 0.7 0.8 6 88-107 10yr6/4 None s Osg ml - - 0.7 0.8 r ~ ~• Remarks: 1 0-9 10yr3/2 `~ None sl fill lmsbk mvfr as 2f NP ~I NP 2 ~9-33 10yr2/1 None sl 2msbk mvfr aw if 0.5 0.6 3 33-48 10yr3l4 None sl 2msbk mfr cw - 0.5 0.6 4 48-60 10yr3/3 None sl 2msbk mfr aw - 0.5 0.6 5 60-66 7.Syr4/6 None gr.ls Osg ml gw - 0.7 0.8 6 66-107 10yr4/6 0 &gr Osg ml - - 0.7 0.8 ~~`\~• `l (Q~ Remarks: _ "' ~-, ;ST Name (Please Print) Signatu e: j - _ , Telephone No. -~`,; ~ ., ~,~_ 715-248-7767 James K. Thompson l=/' c - address A.C.E. Soil & Site Evaluations Date CST Numt~er Ref # 340 Paulson Lake Lane, Osceola, WI 54020 6/7(00 3602 1249 taROpER11f OWNER: Michael & Jill Morrissey PARCEL I.D.# 020.1165-62-000 ID# 1729.19.1008 3 Ground elev ao ut e Depth to limiting factor >114" Ground elev Depth to limiting factor SOIL DESCRIPTION REPORT ~ 2as Page 2 of 3 A (' F. Cnil Rs Cite Fvahiatinns Depth Dominant Color Mottles Structure istence Roots Bounda GPD/ft2 Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. ns ry Bed ~ Trench 1 0-9 10yr3l2 None sl 2msbk mvfr cs 2f 0.5 ~ 0.6 2 9-18 7.Syr4/6 None sl 2msbk mfr aw if 0.5 ! 0.6 3 18-24 10yr4/6 None Is Osg ml cw - 0.7 ~ 0.8 4 24-72 10yr4/6 None s Osg ml aw - 0.7 I 0.8 5 72-114 - IOyr6/4 N &gr Osg ml gw - 0.7 ~ 0.8 o~''v `~ s .-~ ti~ ~ 1 I 1 • ~' KemarkS: nonzons ~s as 4 contaui to ro wooic~----` ,i Ground --- elev Depth to ' limiting factor Ground elev Depth to limiting factor ~ ~oo~t'~~ol ~ocLd / Ou-~ne~' ~' /~~'C-kQL~ ~~~~~ ~or/'~SStj. 9a9 rYI,•~ L';i'cLe ~.d 5 ur,, W i. S f~0/G ~. n ~'-_ S/,~,3' ~.3a~'3 Scn.le : ~ = s~o ^ Soil Qdscr7/a~on /~' Lo ca f,'~r~ St . e.~p:,r Co' ., u.~/, ~yr's~;~~/1;rS1~ ~ o ~ Soi l Q 6Sorp~io7 3 5 y gEcw,, .~' ~!e% = 9S!SO' _. b ~Q,AyC E,r;sE,- W ~ tan ,C. o ---- -~ ~ i 'I bdr,n, O i /'C Sick,+c o ~.-- wt N a``'ES~ . E/ec/~ Qf S, T. ou.f c..l E , 9s ~s' _--- Al.~ . d. ~, : lo~,J o ~ / cK~o~dct.-E,~~a,E 5. E. G.r+-ner- o~ kc~uS(. Clyv. = io/.25,' ez 2/O. G~ 5 die ~'ma~ ~C'oa~n/ D~~ ~ ~~~ ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certif that I have inspected the septic tank presently serving the ~~- Ae ~ J~~~I 02~IS" residence located at: ~_;, S~ ;, Section ~~, T~N, R1~W, Town of ~uDSbrS Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced: ~, ~ ~ I ~uui~ Did flow back occur f m absorption system? Yes No (If no, skip next line) Approximate volume or length of time: Capacity: Construction: Prefab Concrete Steel gallons Other minutes Manufacturer : ( I f known) : ~„~"yes-e -Z Age of Tank (If known): la ~~~ ~_~ (Sig ture) 1'V1P s~-e (~ Ins ink L~~ ~ ~WK1Z (Title adU (Name) Please print ~aa 9u~ (License Number) Date Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code ) Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR 83, Wis. Adm. Code (except for inspection opening over outlet baffle). Name ~ ~ 170 Yh,~Q ~ S~YZ S ignature MP/MPRS o~a g ~ ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address Property Address ~'~ , (Verification required from Planning Department for new construction) City/State ~~~~ o,~, Parcel Identification Number ~a (~` ~ ~ ~ ~' ~ a` OtJU LEGAL DESCRIPTION Property Location N~ %,, ~ ~ '/4, Sec. ~ ~ , T~N-R~W, Town of N In 0 I o I~ Subdivision ~p~ I~ ~ 5~ 1~~ -~ S ~ ~~" A C1 d ~~ ~ b i~ ,Lot # Certified Survey Map # _ ,Volume ,Page # Warranty Deed # ~ 3.~ ~ ~U Volume O ~ ,Page # ~t- Spec house ^ yes ~' no Lot lines identifiable, yes ^ no SYSTEM MAINTENANCE 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 pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeymanplumber, restrictedplumber or a licensedpumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three ye expiration date. (/ ~/ s/~ SIGNATURE OF APP I ANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. L .~''' .~ / ~ C)© SIGNATURE OF APPLICA DATE ****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed ~. aocuMEr~r rto. WARRANTY DEED STATE BAR OF WISCONSIN FORi4 2-1982 ~3~~~0- ~., Y: ;7~~AGE~ ..San--E-~_Mi. L.~ex.,_.s _s.ing.l~. pe.r.so.n_ ....... ....................... conveys and warrants to .'..-M-I-C-h a e 1 F . MO Y [ I S-S e_y-- d.^ r1-----_.--- J i-11 . M.---Mors i.sse.y...--hus.tzand ._an.d...w-i_f ~,---as .............. _s u.r v i_v o.r.sh.i: p.-.m.a-r..i t.a.l---fix o p.e c.ky ................._- . the following described real estate in -...-....-~.k-•...~i.r.Ql-X-.__-.._.-._--County, State of Wisconsin: iNt3 SPACE RESERVED FOR WECORD~N6 DATA a~a~aT~a-s o~~~ ~~ ~I~ ~~~ Rt~'d f~}or Ro~ord ~A~ 2 ~ ~I~i~~ ndl 8 : 00~ A M ~A~iw O ~~f-~wA.~CX. a R~MIr d Dads `ichael F. Morrissey PETVRq -~ 5996 N. Stagecoach T Oak Park Heights, MV 55082 Taz Parcel No________________•_--.._-------_ Lot- 91 Park View Estates Fourth Addition in the Town of Hudson. i'KANS ; ' ~~~ PED This - i,S---nO.t__- homestead property. #ix) (is not) Exception to warranties: EXlsting highways, easements and rights of way of record. Dated this - 21st -- ------- --------- day of _.- __. __... _- __ _ _ -_ -. ....__.... -.-.-(SEAL) ____- - - --- ~ ---------...---...(SEAL) AUTHENTICATION Signature(s) authenticated this ___.__._day of___________________________ 19-____. TITLE: MEMBER STATE BAR OF WISCONSIN (If not- ---------------•----------------•-•------------------------- suthorized by § 70G.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY ..A_t t_9r._o-e y---pa v_~.d-._J ~.__.~s_t_z_e-~n------------------ -- 6-L 1.---2 n-d-_ S t_._..._ H~ d_~ o_n...-.-w-I---_.-S 4 01- 6--•--- (Signatures may be authenticated or acknowledged. Both are not necessary.) larch ._ 19g$ ~~cC'~:!v" r" .. ~! . ~.C~/~ . _ _ (SEAL t S.an._E, Hi 1-l.er_. - ... _. _ .(SEAL1 ACBNOWLEDOMENT STATE OF WISCONSIN ss. ST .•--CR-OI-X--------------- County. Personally came before me this ._2.lst.----day of --------•---tta-r-ch-----------------~ 19-~8__ the above named --San--F-'---Mil-le-~-E - a- S.~ ~g.i-e.-_pe.r_~?[1; ~-- r - to me known to be the person -._...--_. who exectr~ed't}tjj foregoing instrument and acknow edgQ the same. ?J f/~7 a Marlene M. Peterson -... Notary Public _.._.--.._St. Croix .-..-__Counh•, Wis_ My Commission is permanent. (If not, state expiration N ~ I ;, v A I ~ ~, i m ~ .~ 1 .1 ~a!°3!' e ~ ~ O V ~ I_ti I I I N89°52~40"W 20= drivewa . e ement 92 ~ pQ 1.608 ACRES ,, 1 j F ~ 70,040 S0. FT. ~~. `- _ - _ _ _ 1.166. ACRES ~ I , 50 T82 SO FT ~ 93 1.373 ACRES 59,754 S0. FT. ., ~r J 0 0 ow 3 o~ 00 m .~ a~Tes" ~~ ,' J w Is7°2TS6" 9 I I ~ I~ 1.016 ACRES b N ~ N i ~ ~ N 44,338 S0. FT. to 43.695 SQR 1.019 ACRES 1 W 1 $, ~ 3 ® ~ 44, 3a3 S0. FT. ~ _ ~ ~+ o ~, I j a~ ~~` z ~ i ~5 z °~~` 249: 8~1'' o°°~ ~e%, i ~ ~ ' ~°p ~ 206.02' 206.02 -- - 6 ~ ---------------------1 ~--------------------------- N89'15 14 E N89°15 14 E 412.04 DRIVE _ S89°1514"W 412.04 . ..,. ~' ----------- 412.76' ------- ~_:~-~ _ - ' ~,0 1 1 C I w,iQ 1 4NJ g ~I '0 3 M; OUTLOT I I 6.771 ACRES 294,941 9Q. FT. e~. **~ I \ 1 R6' --- I'~ 206.02T - - - - - - - -- ------ 206.02 J„ I ~~4 I 0 I I N 1 1 ~g 112 ~ 0 113 w ~ ~ 1.031 ACRES ~ 1.031 ACRES 1 44,908 SQ. FT. b N 44,908 S0. F 1 1 ~ a~ ~ ---412 ~ .z ~ -- 206.02 _ --- ~w ~ r~g b' 0 cn' ~ (n N89°15~ 14" E -~----- ~----~- ~•~'os ~ ; Q ~ ~ 90 0 o g9 - I 920. I ~0 I - ~, ~ 1 0~ ' I ~h~ o; I M ~I I QI I ~ O $v ~~jj 1 I O aD • ~ I I i `_ '~, o ~ N8 ~ ~~ ' ' 412.00' \~ ~ NgpP14` 13"E ~ ~ 3 w I 206.00' - - - - 206 - -~ - ~° ~ 207.10 1 rt) ~ ~ 00 -., ~ ~ ~ 1 ~ 0 1 ~ I cn 1 z 1 O II M I' I / ' 1~~•4s~ss•®I Z I ~, .. N ~ ~ 1 •~ ~ ,, • ~•~ __~~~_ ~ ~ 70,040 $p, F 478.C SCALE IN FEET 0 100 200 30C LEGEND SECTION CORNER MONUINENT~ ~RIY?5EN p 2"'x30" IRON PEE WEK~HNVG 3.~i Lg~/LI~ OOF~VERS ARE SlAKEO WITH I X24' IR01 ~ 2" IRON PIPE FOUND • {" IRON PIPE POUND -'~ UTILITY EASEMENTS 10' IN WIDTH NOTE ~ ALL PIPES ARE ROUNDS DIAMETER C ~ Q LANDS NOTES ALL LINEAL MEASUREMENTS HAVE BEEN MADE TO TFiE NEAREST ON Form - STC - 104 "` • AS BUILT SANITARY SYSTEM REPORT OWNER `y( //ce- TOWNSHIP /714 o i, SEC. / 7 T a9 N-R/, p ADDRESS G '7,/ /-370 ' f 2 ST. CROIX COUNTY, WISCONSIN SUBDIVISION 6c I/i,d.&F LOT 9l LOT SIZE /' 49/9l A e 0/ 5 PLAN VIEW Distances and dimensions to meet requirements of ILHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 207f 6Vo w..\\ w ` I' • Cnre 5 d oast \b z y x i q' 'of z YY'r6' '4 �0 '0 i-1S 0 30' - - - .: w - .\V• _ .sue go �,, Scala Ile"= IO' 510tki. 5 w. &m. 1 /o-r -F • \fr .5cA %� /D �•H6 �/��NOS�.IC� I . .. C'"ok �49.,0 --INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used / /47' 44J ed✓I/ Q/ Elevation of vertical reference point: /®O.O ' Proposed slope at site: .2.j.St.4.4 SEPTIC TANK: Manufacturer: 4t'e,'S ¢r Liquid Capacity: /Ooo 9a1. Number of rings used: / Tank manhole cover elevation: /D 33. /p Tank Inlet Elevation:/1)/. SO Tank Outlet Elevation: /o/•/O Number of feet from nearest Road: Front,O Side,O Rear, 470 feet From nearest property line : Front,OSide,ORear,, 90 feet Number of feet from: well (D ( / , building: /7 4` .2c-' tLJCoi4�Q- n (f,c. sc. (Include this information of the above plot plan) ( 2 reference dimensions to septic tank) SEE REVERSE SIDE APPLICATION FOR SANITARY PERMIT 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 SCJL '(l'\\ \\cLv Location of Property A' '' 1 E 1, Section , T N-R /' P Township #tc • Hailing Address Rk f ,goy# 2 ' L • Address of Site 494- 5 lark 1l.'000) 65T<.r¢.s /7 u A.S o„t IL) i / Subdivision Name ,Par k ,7.5�ct.tc,s ,W Lot Number C / Previous Owner of Property Da i f.0. Total Size of Parcel L o Date Parcel was Created 3///g Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? X Yes No Volume and Page Number 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 refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (We) ce tti.6y .that a.& statements on this 6onun ah.e .t'cue .to .the best o6 my (oun) hnawtedge; that I (we) am (she) the owneh(b ) 06 .the pnopeAty descit}bed in .this .in6onmati.on 6onm, by viAtue o6 a wan'tanty deed neconded in the 066-tce o6 .the County RegisWi o6 Deed ah Document No. 041 ; and .that I (We) pncsen.tey sun the phoposed site bon ,the sewage disposaI system (on I (we) have obtained an casement, .to nun with .the above descAibed pnopehty, bon. ,the constAucti.on o6 said b y6 te.m, and .the dame has been duty neconded .tn the 066.tce o6 the County Reg•i.. .ten o6 Deeds, u.s Document No. 3, 31/ 1 . SIGNATURE OP OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) 7: g' DATE SIGNED DATE SIGNED DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS Dlvlsla P.O. BOX 7969 BUREAU OF PLUMBIN 7,7Mi~7A~DIS~O~wN, WI 53707 1V W'~~` Ji, S17,T29N-R19W SIX CONVENTIONAL ^ALTERNATIVE State Plan LD. Number: III assigned) Town of Hudson ^ Holding Tank ^ In-Ground Pressure ^ Mound Lot 91 ParkView Estates IV NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Sam Miller Route 1 , Box 282, Hudson, WI 54016 ~ -c~ fog ~~ ,'c7 c) BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELE V.. rvame or numoer: MP/MPRSW No.: Coumy: Sanitary Permit Number: Douglas Strohbeen 5432 St. Croix 99046 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELE V.. TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER l(~(~ u~~+~~ ~r~a PROVIDED: .YES ^NO PROVIDED: ^YES ~IVO BEDDING: VENT DIA.: VENT MAT L.: HIGH W ATER NUM BER OF ROAD: PROPERT Y WELL: BU ILDING VENT TO FRES ALARM. FEET FROM LIN In ~ AIR INLET. ^YES ~~'id0 ~ ~/.L- ^YES VIVO NEAREST ,(~~ ~ LD~ 7L'~ ~'~ DOSING CHAMBER: MANUE ACTURER. BEDDING: LIOUID CAPACITY. PUMP MODEL. PUMP/SIPHON MANU FACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ^YES ^NO ^YES ^NO ^YES ^NO GALLONS PER CY CLE: PUMP AND CONTROLS OPERATION A L: NUMBER OF PR OPERTV WELL. BUILDING: VENT TO FRES (DIFFERENCE BETWEEN FEET FROM LINE. AIR INLET: PUMP ON AND OFF) ^YES ^NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing ~e ,cT~+ DIaMErER MATERIAL AND MAR KING or excavation. (lf soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN f`ANVCIUTIABIAI CV CTGM• BED/TRENCH WIDTH. LENGTH. NO. OF CH E DISTR. PIPE SPACING. COVER M ' INSIUE DIA.: #PITS. LIQUID DIMENSIONS ~ ~~ TR N ES ~ I ~ ATERIAL PIT DEPTH: GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL NO. I rR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRE; W PIPES BE LO ABO VE COVER. E L EV. INLET ELEV. END. PIPES: O LINE. AI R INLET: ` _ V~~ } ~ / ~ p /~ -l'1 ICI ~Q t C0~ O~ ~~ ~ N EA R EST - -- ~ ~ r~ ~~ ~.Id '~' Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ^YES ^NO ^YES ^NO ^YES ^NO DEPTH OVER 7RENCHBED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED SEEDED. MULCHED: CENTER. EDGES: ^YES ^NO ^YES ^NO ^YES ^NO PRESSURIZED DISTRIBUTIAN SVSTEM~ WIDTH: LENGTH. LATERAL SPACING: GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER. BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING. ELEV.: ELE V.. DIA.. ELE V.. PIPES: DIA.: ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED PLANS: ^YES ^NO ^YES ^NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE: (1~ ^YES ^NO ^YE ^NO NEAREST . ,f..v Z, G~ " ~~ / ~.`1~ Sketch System on Reverse Side. DI LHR SBD 6710 IR. 01 /82) Zoning Administrator S ~. ~ ~ . S ~' Retain in county file for audit. n sANITARY PERMIT APPLICATION COU v' X ~ DILHR Adm Code Wis In accord with ILHR 83 05 . . . , ~~ °~°-•-.~..........~. STATE NITARY PE IT # ~~v -Attach colYlplete plans (to the county copy only) for the system, on paper not less than STATE PLAN I.D. NUM ER 8'/z x 11 inches in size. -See reverse side for instructions for completing this application. PETITION ^ I. APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION. YES NO FOR VARIANCE PROPERTY OWNER PROPERTY LOCATION 5~ „~ 1M~, ~~ ~.~- /4 5 E'/4, s Tag , N, R E (or PROPERTY OWNER'S MAILING ADDRESS ' ' LOT NUMBER BLOCK NUMBER SnUBDIVISION NAME - ' ~ Z g Z ~ Q ~ q To, r ~ a uJ ES CITY, STnTATE rr ,, ZIP CODE PHONE NUMBER CITY NEAREST ROAD, LAKE OR LANDMARK ^ VILLAGE : .. u 4 O WZ • 54f7 ~ (0 1 s ~~o bCO~Z SO ~ II. TYPE OF BUILDING OR USE SERVED: ~~` Number of Bedrooms if 1 or 2 Family ~ OR ^ Public (Specify): III. PURPOSE OF APPLICATION: (Check only one in #1. Check # 2, 3 or 4, if applicable) 1. a. ~ New b. ^ Replacement c. ^ Replacement of d. ^ Reconnection of e. ^ Repair of an System System Septic Tank Only an Existing System Existing System 2. ^ A Sanitary Permit was previously issued. Permit # Date Issued 3. ^ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ^ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. F SYSTEM: (Check only one in #t and only one in #2) IV. TYPE O I ~I 1. a. ~ Conventional b. ^ Alternative c. ^ Experimental 2. a. ^ System- b. ^ Holding c. ^ Pit Privy d. ^ Vault Privy e. ^ Mound f. ^ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. See a e Bed b. ^ See a e Trench c. ^ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): 3 REQUIRED (Square Feet): ~ ~S ~T PROPOSED (Square Feet): ~Y$ S ~ ~ ~ 9 S ~ Private ^ Joint ^ Public Feet VI. TANK CAPACITY in allons Total # of ' N f t M Prefab. Site Con- Steel Fiber- Plastic Exper. INFORMATION New fisting Gallons Tanks urer ame anu ac s Concrete structed glass App Tanks Tanks Se tic Tank orHoldin Tank ~ t-c,/~i 2./ ^ ^ ^ ^ ^ ^ Lift Pum Tank/Si hon Chamber VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name (Print): ~~i?? ~ 51~ - ~ Ply~ber's Signature: (No St ,m ) MP/MPRSW No.: ,` ,;~~~ ~ X32- Business Phone Number: 2~~ ~~ ~ ~~ i G du / ~ / Narry~ ~D~igner. ~ r r PI ber' Address (Street,Cjty, State, Zip Code): ~ ! ~ ®~ VIII. SOIL TEST INFORMATION Certified Soil Tester (CST ame CST #/ S9 s . ~h~,' s f aj~,~ s CST's ADDRESS (Street, City, State, Zip Code) Phone Number: s ' . S D/ /.s 38~- 98 // tau ~ /c.. - ~s GrJi IX. COUNTY/DEPARTMENT USE ONLY ,Approved ^ Disapproved ^ Owner Given Initial Sta~nitary Permit Fee ,M Groundwater Su rge Fee ate ~ r ~~ ~~ Issuin Agent Signature (No Stamps) l:.Y ~ ~~ ~ ~ S ~~ J ~~ Adverse Determination ' • ~' X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber INFORMATION- & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO THE APPLICANT: 1. This 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. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 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. Private sewage systems must-be properly- maintained. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Prcperty owner's name. and mailing address. Provide the legal description where the system is to be installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in #1. Complete ;<$2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in #1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for a// septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. 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. Fill in designer name if applicable; VI11. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8'/z 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; dosing or pumping chambers; 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 bylhe.county; E) soil test data on a-115 form. GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater bill included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that is used in your building is returned to the groundwater through your soil absorption system or the disposal site used by your holding tank pumper. Groundv~ater -~''~--~ Wiscor~sin'S' buried reasure The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398 (R.03/86) ~~, APPLICATION FOR SANITARY PERMIT SIC- 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 tv this office with the appropriate deed recording. Owner of Property sQ,~(Y1 1(h`~ ~~a,r Location of Yro/perty _ ~~,(~ ~ S E ~y, Section I "] , T~N-R~~~ Township - ~cc 4 50/1 Nailing Address _- ie,e ~/ ,8o y ~ Zg Z --~~.c ~s o ~ w~~S . S `~O/~ . Address of Site ~~ ~~ ~a~k (l.'duJ ESTtf~s~ lo't ~kcT/ ~udsoK w~ s-~o~~ . Subdivision Name _~ct/' k 1/,' ~~ ,Es7"c~~-o.s ~]~_ .Lot Number ~ 9 ~ Previous Owner of Property ~~,r I' a, ~ l;t.~ ¢,~~- Total Size of Parcel ~~ O ~ Q .p c ~vs Date Parcel wee Created 3~~~ $ Z Are all corners and lot lines identifiable? ~ Yes No Ie this property being developed for resale (spec house) ? ~~ Yes No Volume S and Page Number ~ as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warrantq Deed which includes a Document number, volume and page number, and the Seal of the Register of heeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. ~ If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OIVNER CERTIFICATION i (tVe- ce~tti.6y that a.Q,f ~s.tatement/s on ~hi~s ~o~un ace filcue Zo zhe beJs.t o6 my (oun) hnowCedge; .that I (wel am (cvicel .the owneh.(e o6 the pnopenty de~sch,i.bed ~.n .th,i.a inLnhmntinM Lnha. A.. ..;mot.... ,.~ .. .............a.. ~---' ~---• ~- ~ ., ., ... .. v ~ ~x~ ~ ~ ~, ~--i 1.1 H 41 4-i to ,'~) O W Va .fl O 7r ~ ~. .~ N JJ O ~I ~ r~ ,.~ a~ O ~ +~ "`~ a~i H D \ ~ ~ ~ to W ~ ~ s 3 , ,~ ~ a, w ~ .o on ~ i ~+ Ul ~~ ~ ~ (^~ ~ O ~ ~ ~~ ~ N ~O N ~r-I ~ ~O O ,; O .s ~ w a\ '~ z a b ~, ° a ~ ~~c x r g~ V '' Y a Z O v o' w a Z n v o' n m O n~ O 3 '9 n d r_ ~ ~»' ~ I ~ ~ ~ ~ n 3 '* `/1 .. I ~ O O~ Z N O O v a O ai O O cp0 ~ C V N ~ • E O O N O N I O ' O n N N N A N p O > ~'- o =` ~ ~ J \ 1 ~ ~ O O N ~ N co O o. W 7 ~ p ~ ~ m w m m w~ o O `3 ~ W ~ I ~ a cn Z D ~ a m ~ p? y ~ I , o D ~' , n a o m a = o 0 o I c ~ W a o 0 fD 2 O rn rn I g O ~ ~ ~ _ V z ~~ ~ ~ o o "' I o Z ~ J nrto N O C ~ ~ m ~ S ." 3 c I ~ a I ° °~ • OOOn 000 J ~ ~ o ~ ~ ~ ? o 3 ~ ~ ~ ~ ~ ~ I I ~ ~ I m ~ ~ ~ I `D ~ W A ~ ~ N M d ~ ~ r- S1 'O fD 3 m °' I o 3 d c m N z o o° z o ~ O O I D ~ ~ O D c u °' ~ m w ~ I o m m ~ ~ m ~ • -~ .CJ N '' y I c ;0 O m N -p c ~ ~ N O N ~ m (~ °- I m °- i 3 ~ ~ ~ I ~ ~ ~ ~ ~ o ~ ~ N N ~ C N C i ~ M a I I a A ~ ~~ I Z -I ~ W ~ ~ ~ ~ ~ I ~ z 0 3 c~ a ~ ~ I ~ m ~ A z ~ ~ ~ ~ o m w I ~m a ~ ~ c a ~ ' I _ ~ ~ ~ c I n v v c o a I ~ o a fn ~ ~ N I a M ~ t I ' ~ A N I N 3 a I ~ ~ _ 0 V C O O o w ?~ N ~ 4p N 0 0 I o 0 i., oG+o .. .ie'•' r,~~,'K V-~ t~~ ESTATES F~URI~-~ ADD!'l~~N . ~'~ ~-~ ` At SCr~VlS1CN l..CCATEQ.~IN~~TNE "~C'+a--SY~IW~MNi~S£~t~~-ir,~ cCT~t~C^N~,I~7y, T29N.. R19~N.. TCi',+a1N : CF' I'~A$CN., aT. CRGX CAUt.t t t, Wl.,~.,n s,7tN - ~ •.?~ . ' ... r'~t. :w ~.:. .. .. ~ ' C2.'tTITIC+1Tl: OT ?O'NNT7tYilSQlt3!R bTATZ Of ~73GCNSL~1) u.:~i,~,.. c •. t'r.• Cr10CC COt,"it jT ,~ I, 8evsrly ~1. 3otwaoi~.-b.iab t!a daty aI•etedt gvalltfsd'aad aetta` Tows?sas-wrar of tha Town of Ntalroa, do hrroby cattily that !n seeordaaos soeorda !a my otiie•, . t3srs are oo unpeld fasts ss ayaeial arreefrtunta as of . '' . on aay land iswlwriei to the •?lat of Park Vlsw La4taa Fowth Addirien. ~'-"~ . to Beverly . .,ohna own r~iainrei •TOwM HOARD Ri30L4TIOH • R%SOL i/ED, that tha Plat o! part Ylew [:antrf ~'ousth Addition fn tha Town o[ Hadron, P.arsel £., Wart and Heve A, 1Yrst, owner, is bareby approved by thr L+t- ppsov tt own rmwn ~ ~ T y // . D ijned owo t.natrma~i a aersbv eestliy that thr loretoinK tf a copy of x re•olutlon adopted by tM Town • Doard of eM'I'own of fludewa. Date own Clrrk 0711:IItR1t Ca'RTIFlCA?E OT DEtDI~~CATION d:•. tcusveM d~wn-t3eC~trapped and dedteated areseore.•nt do thla Platd. ~Wehalfoeestily t9at ;:a. Fslrt le : equlrrd by S. 236. lD or S, 231,,12 to Ge submitted to tier tolluHnR tot appror+l or ob;aeelon: Departcnert ~( Drvalopmaat lieowrtment o! Induetsy, Labes and Ftuman R+latio•tr, Town o! lludaon, Clgr o! Flsdroo and St, Csoix Co,cnty, Yl;TN3S3 the hand and real of eald ownesr thls~~- ,a day of ~~~.~• In psraence oi: -- _. ~ ~ /'1 , sTATS of wlsco:vstN) ~$ ' 3T, CROiX COUNT Y ) Yrrwnally came befo:a me thlr .' • -' .lay at /~ •+ %_~ • ~ the above namad Dartel l:, Werl cad 9svarly A. Wert, to rnr known to b. the peret:nr wAo exreoted the forrsoin~( Instrument sad acktwwladQrd the fame, ' Notrry Publle ma'r' J..... ~„(, , Wisconsin My eommiaelon explsar G//1~~~' . ~~~,~~ Mary nrch, lfotaey PubN< ~~, -,GERTIFTCATE OF' TO•NN CLERK f;-.STATE OF WISCON9tN) ~ . •~. SS: CROIX COUNTY ) - • i. Rits ;ierne, belnb tbs duly appointed, qualtiied and setinb ?own Clerk of tM 'Town o! a:•dson, Co herebj city that eopie of thlr Plat were torwssdad ns required by .~. 276, t2 on eMaT7° day of ~~, I9D4, sod Ihae v.ithin tha 2D•Cay lftnlt eet ty f, 238.12 (~) (no ob)set! ns to the plat have boen [iteA) (all ohf..c:7~na to •ha ; Jat havf born mst), Date iilt Norne, Town Clerk I I i i ... ~~jiJri j '• O .t+ ' ~ ~ i~N ... Ga'`'y'-.:'.s''^'t ~Jo 1 . 1 r, • .. ~ ~ ' • - ~,: I - ~ ~ ~ ~~Y~~ts CLRTtFiCJ1T=: Ir atrtuoS. Rrtoob. Aajdatrrod Wlxaaria land 9ttsvayovr ise.iry errtify to tha - ~ iaet ed i0'y psolNrioaal knae.-«{je. nadrs rt7trd,As rnd bellrli TAas 1 has~r attsr~yv+lr dindad rrxt raapyw4 Park Vrtnr £atater;fousth Additioa•. lotatr+l -e for 216:1/~ y tlrr SW 1/4 aad ti. N M:1 J 4 0! tie 5T1/4 oL Seerioa 17. T24`f, . R 1911+, Toara.o! Hadroa. 9t, Cwix Cooaty• W4reoaria; That I !save rwbla ateA auswyr [aad dlvlulot- aad plat by tia dluarsbn o! Darrel I. Olfasi ami Davastp.A. Walt. ovaarr o! aald la•Ki, deresiLed a lollop: ' Cotnotosc{aQ at.tha I1/4 cosaas o! acid Sadlea 17; tiaato 9i9.2.2b0"1N (aaastasad parsia~s rotot+eaaad to !ie aroanonratad YJ-3T :I t3T 1 /4 9aetloe Loa ci Secttoa l7, • baa:iy saartrsod 909'22.Ot"IV) (seoosde.l ar 36y 2 t•40"W on fiat Catrtlct+d 3vrvey loop sowriai ~ Yelrme I~ Pa li4)~ 1552,961 alora0 raW E:ASZ-WLtT' 114 S+ettoo llaal . thence s0"06ZlO~tlf-227.7'3~to the point oe boa . tianae N6'~32t40"1P 412.00•; tLaueo.. . ' NO"O6a50"S Iu.o0t a w swss.:ly siaLt-.Lw~u,. of c.... wu t.ae.; ts.ac. rryr~2t40:'N at,OCt a2ond raid latw.!-..sy lira; tl-•ueo SO'OJi•70"N 2Sl.•SO•; !hones ~ :i7!"Ibt~2!'Yf• 194.5•; tiaaca 379'15.14"W 216.7!•; thaaoo :175'37.OS"w 142. {7~; theaco S09"~YtLI"1t/ S;i'.OOa;.tbaae~ NO-O6.30"L 104.00•i tboaea 36q'13a14"MP St4.D0•i thanes NO'!vh0'•Z'l36,04•ithaeoo 9s9`lbt14" lul b6,Olrt ties»e 40'OSt30"1r' 716.;15•: fiasco .. . 30!'ISr14'!p~ 151.00+i eber-ca NO'S7ts1"X 5,1. lot; tbaaer S89'22t0!"t 7<t..90ti tieoea j 30'O6bOMM 204.{0!; thrnea N419'13•li"s 150.Ot1•; tiwaee 300N30"1I. S1i.97•; LJaoea ~ N09r-lSa14!'>C.1S0.00!pti.xe 3oeti.aatasly b6.21r alen~ tha aro.ot a Si5.91s• radius corwceneava tosti.,tat.rlr wl-eu chord Dsur34'SO+SO"C 6iT17~itheos.:Itcr1St14'•t ~ 57.Olti tltanee•3eotieaatotly.lSb.Sbt along lie art: o! a 3t7.00t'sadiea esrv eooeaw ~ NurtisKrrt1yy vioaa eio,rd baas~ 924 05.02"E IXS,SI•; tioaea 136'23.30"2' N1, l4t; . tha•we HTt38t50"t 160.96•; Banco N6t1S'14^ia41.DOt; tMoe•.90•Odt31"'M 100.001; tbaaeefbl!',3W70"1R 2S9.Ibsi thanes Souttuut.rlT l6.14t al the sro of r 217, 00• ' srttwatta'vs.owea~a Nostharirtasly. ~riier• ohosd boasia 976'piil6"L 9S.3a'; tti+ne• tiA!!IS71!"L', 920.OOt; thaeee tierthoastpsly 91.21a s1ea0 tlto asre`o! a 300Jh3• radtua ' eas+~-soasww Netthwerta=ly wsoae ehozd barza HOOr32t40'•z.90.lS~ tbaaee Nosth- werter1T11;l4tnlon tha'aso ei w 70x.00+ radius eur.o eanssv~ Nosthuttnrl~r +hora elws~d bras. N6r'3T•itr`'^7- 91,09'; thaete NO"O6t30"E 150.00•; tieaea Ny'1Sr14 4T0,436y tltawce 140.06t50"Z 634.56• to. thr poL+t o! 1»siw{nQ. , ZAat'soolr plat to a Bernet ropxoerrltat{oe rf aU th+ eMtosles boeedaaiu o! eho land rnsweyad pad ttr~ sebdlvlrioa thasre! rnada• sad Z1aa I Ra.e Tr11T earopllod with tLa psovlr/oea of Cbaptrs 236 0! tha t'lfreowa{a ' 9trerlet,• tM labdt+~irlwa aavt Zoalna RrXnlatlrna et St. Cseis Cawtty, Shr : owa v! ---~ lFcdrar •leidivtrloa OsdLraoee, and tha Clty n[ Hudwa 'Jubdlvistoe and 3~lstrta{ Or.li• '' _ _ •-.. .. .... ~- aanear, L raar+7lnl. dtvidia= atwt mal+pln0 the sareta, 1 ' Dated tili~,~, day o! t'1~~-+s , 198a ~ ~!~~ A~vlaad t t IitA detx e! April, 1964. ~Sraaar I. Aotch - A.~~L 421 lk:oad Sfroot t;l .~ 6~ >~' ~ ~, Hodrou. Miacoaala '16016 t' •. Otaq Q Ito ~+ COUNTY Z1ltAlVltIA•S C£ATITICATY ''ya bTATiti O!' Tl13CON3t~ ~; AtjR'~ I 1. Atttt^y Jwa 1.lvasrnoso• bo{n;l duly. eloctrd, gwl{liad and ae.inr Ir~auusrs al ' dt.. Csois CsoatT• de hosatry certify that thr rraovdr !n my ofNea claw or uarodramed fast aatar std oo uupald tasea as rpeelal rrrerrmantr ar of /~- •!/.t-.!/d~j altaetlwa tlw lards !weltod+d lathe Plat o! Park Vlow Yatrtrr ToesKh Addttan. ~-p-flf I ~ e*L~s7in.a/ .. • Dato only T:aarua'at r . ' ' /' - ' . ~ocflztc co~littTTlt~ Alaolurr~ti Thi• plst la haraby appsovod by thr 5t. Crois County Comprrhonrivr Parkr~ ?isaalnR and ?.onln3 Gommlttne, ,, Uatr Ghal~'!tw 13 94_ ~ Data - .. ._+~r_'._.-- Admla! rt rotor ~: ~. .. ~.: ~Lt~4Ttwc nre,..r 1 STC- 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER S~t/YJ /~I,~~%/ ROUTE/BOX NUMBER ~~'~~ (aoJr~2 ~Z Fire Number-- CITY/STATE~4lfS©/./ ~..Z ZIP rS~O~~ PROPERTY LOCATION:~_~, SE ~, Section~_, Tai 9 N, R ~ W Town of ~u~SO/~ St . Croix County, Subdivision~~k~/,~,vESTf~stT~, Lot number ~~ Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists 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 treat- ment stage in the waste disposal system. St. Croix. County residents m_~ a maximum of 60% of the cost of which was in operation prior to accepted this program in August owners of all new systems agree maintained. be eligible to replacement o July 1, 1978, of 1980, with to keep their receive a grant for f a failing system, St. Croix County the requirement that systems properly The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 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 Depart- ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. ,,ten SIGN ~/p~ DATE St. Croix County Zoning Office P . 0 . Box 98- Hammond, WI 54015 715-796-2239 or 715-425-8363 H Z H a r r a H H 0 z e 9 H H 0 z x H ro Sign, date and return to above address. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDING. INDUSTRY, DIVISION LABOHUMANP.O. BOX 7969 RELATIONS (H63.0911)& Chapter 145.045) LOCATION: , (SECTION: TOWNSHIP/ tfltti'Fy: OT NO.:BLK.NO.: S BDIVISION NAME: A A. '/t%` / 7 /T°�9 N/R/y LIo Has J / — etb-ii b!e' Wer/deJ W. COUNTY: OWNER'S/BUYER'S NAME:f 51. �'ro,;d_ _ 1�1 ./44.— IMAILING ADDRESS: T o,,-/- l�ok Bel /iial.,a•c, L�1�'s. • rtur4 USE 5i4 .NO BEDRMS : COMMERCIA ASCRIPTION: DATES OBSERVATIONS MADE rzb Resldrncs �/ PROFILE-DESCRTIPPTI NS; PERCOLATIONS: _3 New ❑Replace I / 7_V / d / T-ST SOo MA, PG- s( 6r8L .. / i RATING:S-Sits suitable tor system U.•Site unsuitable for system LLCI�i4t 11 SA.•4 4 y / d 4� CONVENTIONAL: MOUND: IN-GROUND-PRESSORE;�SIEM-IN-FILL OLDING TANK:RECOMMENDED SYSTEM:(option I [K S ❑u �s LI U [ W S __u Es (�,u I C s .L.u e *4�s £J ce.3 It Percolation Tests are NOT required DESIGN RATE j If any portion of the tested area is in the under s.f163.081611b),indicate: !/j) Floodplain, indicate Floodplain elevation: */A PRQFI E DESCRIPTIONStrrr !!! BORING TOTAL, DEPTH TO CCRQUN W�yATEA.4Mi-E6 CHARACTER OF SOIL WITH THICKNESS, COLOR,TEXTURE, AND DEPTH NUMBER DEPTH.m ELEVATION 48SERVE0 PEST'HTQHES'i' ;TO BEDROCK IF OBIERVEla(SEE AIBRV.ON BACK.) _ B- / ,7,5f /03.2 , eaciAie- 7 IC ',r' 41 _ 1f ICI /sot A #4 ry f I m11�I B. .2. . .? i/s .6 eh,/t 7 s"' /a 3. ' Aloe_ ? 2.s di. 4 Ors s r- ; / o gri /..‘t�r., 13-3 ?.S' /03,4' ,u ._ 7- r' , 7 B1/ji i'a F S1 raid S a- y 7•f ' /o42 j'. 46Dmq, 2 9.S-' .1- B!1 S /, 4 Bh /l,r frr:, ,?.Q 0.1 S ,t.74 etf.S B"..r ?.S." /az. 7' ,11# 1e...-- ? '7 6//s, • 7 �3•, s/, /1.2- Br• /.i ..� ? Y• X. 0 -s'* ry 0 �� rh -s' B- PERCOLATION TESTS TEST DEPTH a WATER IN HOLE TEST TIME DROP iN WATER LEVEL-INCHES RATE MINUTES NUMBER ING41G6 AFTER WELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PEflQD 3 PER INCH P- / r 3 ' O •t 6 t 44..,2',, P. t Aio -2,.. 4 `' < - P- P + 1 1 t . P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori• zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings end the direction end percent of land slope. SYSTEM ELEVATION 9q.,Sre ,^ is o _d -- _ __ _ -- i8,_ lei-__ ligeriz. . ----Efl 4904`3‘,1" _4ek_t_Zi _ lot o a 3 ,p _._. — rTQ \ i Q If A-_, _ ---1,...... ....0_....:_:. eic _ 3. ___It I IL__ _ IF riair....ftir Wilf..1.1 ilf),_ acky v. (;)"...r,4._ ,c7 _4141., 4. __ I =_�1 "_ ..___ \. ! --.-37. —lit I 1 it a ilt• 1'1/ , y Ski;414- 10 4' ...)1.4- f- -- 4. 1 C J I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified In the Wisconsin Administrative Code,end that the date recorded and the location of the tests are correct to the best of my knowledge end belief. NAME print TESTS WERE COMPLETED ON; ADDRESS: I2�+idas: f t C4.-‘�7`/b,�8r-j — l�'/�--'r CERTIFICATION NUMBER: PHONE NUMBER('ptional): 41 4 _Liev-c n . ih alsd,,,�,,j i. nlof T/. ' 9 al/ = 3,_ -T / CS TUBE: t ISTRIBUTION:.Original and one copy to Local Authority,Property Owner and Soil Tester, I IL RR-SSD-6395 IR.02/82) -OVER - Z~~~v~~ ___ ~~ o ~~~~. ~~ ~' ~ ~ ,w ~. a .y •r •- ~ a~ ~ c ^~ ~ . am ! --'- J F-1 i ~! . Y~ ~ V \ I 1!1 R + _., ~I ~~ i i fir 4' I ~' I I ;q- t I d I ~ a ~ i T ~ ' 1 `I- I ~~ ~ ( I I ( i l_ R .__ _ ~ 11 _ ~ . ' C~ ._.. M " ' ~+ ~d ~ . ~' ._ '~~ra ~. ~ ~ ~ c~ ~ , 0`- ~ ~ ~ ~- d ~ ~ ~• ~ u r ...,~~ ~„j,. d +~ S ,'' •~ w~ z h1-w- i ~ ~ u ~ ;V L -_. 'i1 -~ ~~. ~ .' :~ ~,; ~:,I ~ j ;V ~j + T ,.. ~: O` j ~ U. 1 ~; ~ ' ! ~l ~ I Q~ r+t ~ 3 ~ .~ '• ~ r.~ ~ I ;~ ~~ ~ ~ ~ a~ 7 ~v- ! ~ +~ •- ~ r I ,~ ~~~~ I ail .~~~ ~3 -Y ~~ •y J` .\ ''a > \J J F-- 0 .~~~ i ~s 1 ~ ~-- d ~ ~- ~ o- .~,. y per. N ~~a 4 u 7~ ~ Q i d v~` ~~ as ~ ~ J ~ ~~ -b ~ ~ da '' ~~'°~ ~ ': >S a ~~ai d >~~~xp W C~ ~ ~ ~ ~ d .~ ~ ~ ~ ~ ~ ~ j ~ L d '7 ~ d o a d L ~ d~o~~Q a~ d d ~ ~ h ~. d a ~ N ~ o` ~ ~~ .h a\ ._ ~ `~ 3 ~ '~ ~ ~ ~ ~, d c ~ ~' ~ ~ ~• - - - - J 1/1