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OF PHONE ( 1 32-38 AREA CODE NUMBER EXTENSION ❑ FAX ❑ MOBILE AREA CODE NUMBER TIME TO CALL TELEPHONED LEASE CALL - CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU RUSH RETURNED YOUR CALL SPECIAL. ATTENTION MESSAGE Cei2e_ c 1 S Lk 5 IGNED lid FORM 3002P LITHO IN U. S. A. ` ~ VVJX( i Parcel 018-1054-20-100 10/11/2006 12:08 PM PAGE 1 OF 2 Alt. Parcel 24.29.17.377A-10 018 - TOWN OF HAMMOND Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - THORSEN, MARY B MARY B THORSEN 2022 HWY 12 BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ` 2022 HWY 12 SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 9.218 Plat: 3886-CSM 14/3886 SEC 24 T29N R17W PT SW SW FRL BEING CSM Block/Condo Bldg: LOT 1 14/3886 LOT 1 9.218AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 24-29N-17W SW SW Notes: Parcel History: Date Doc # Vol/Page Type 02/23/2004 754832 2513/558 SWD 08/08/2003 734461 2353/231 SD 08/01/2000 627327 1530/429 WD 07/23/1997 769/402 more... 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/06/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 9.218 43,400 134,500 177,900 NO 05 Totals for 2006: General Property 9.218 43,400 134,500 177,900 Woodland 0.000 0 0 Totals for 2005: General Property 9.218 43,400 124,200 167,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch 157 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel M 018-1054-20-100 10/11/2006 12:08 PM PAGE 2OF2 Parcel History: cont. 07/23/1997 702/01 G b Form - S T C - 104 ' AS BUILT SANITARY SYSTEM REPORT •OWN&t /y - TOWNSHIP SEC. T ,~2N-R_~7W ADDRESS ST. CROIX COUNTY, WISCONSIN II SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of ILH-R 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 93, \ \ IDoo C'W~ INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: lG~(Q { Proposed slope at site: C SEPTIC TANK: Manufacturer: Liquid Capacity: Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front, (71\ Side,0 Rear, O feet From nearest property line Front,V;~Side,0 Rear, O n vd,J feet Number of feet from: well ca 0C) 7 building: P ` (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE i i PUMP CHAMBER ` Manufacturer: Liquid Capacity: Pump Model: PUT* /Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: ~0C) Number of Lines: Area Built: 27 Width( ! Length: i Fill depth to top of pipe: C-A Number of feet from nearest property line: Front, Side, O Rear,0 Ft.~ Z Number of feet from well: 7Z~1-5~ Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid.depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box been used on any of the above soil O absorbtion sytems? (Check one),,,", HOLDING TANK Manufacturer: Capacity: Number of rings'used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, O Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: !1 Dated: Plumber on job: License Number: 3/84:mj PUMP CHAMBER r Manufacturer: Liquid Capacity: Pump Model: Pu /Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch, vation: Gallons per cycle: %w Alarm Manufacturer: Alarm Switch Type: Numberlof feet from nearest property line; Front, O Side, O Rear, Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width Length:/ Number of Lines: Z Area Built: Sf.1U'6"' Fill depth to top of pipe: ~c7 Number of feet from nearest property line: Front, Side, O Rear,0 Ft Number of feet from well: ' Number of feet from building: ~p (Include distances on plot plan). SEEPAGE PIT / Size: / Number of pits: Diameter: Liquid epth: Bottom of seepage pit elevation: ea Built: Has either a drop box O or dist ibution box O been used on any of the above soil absorbtion sytems? (Check one) HOLDING TANK Manufacturer: Capacity: Number of ring used: Elevation of bottom of tank: Elevation 9,,f/inlet: Number pf feet from nearest property line: Front, O Side, O Rear, O Ft. Number of feet from well: / Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: ZZ- Plumber on job: l License Number: 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS ON P.O. BOX 7969 BUREAU OF PLUMBING MADISON,^JV= •5370 XXCONVENTIONAL ❑ALTERNATIVE state PlanLD.N~mber III assigned) ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION D F H Q ( Joseph Dohman) Batdwin, BUT 54002 NCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN REF. PT. ELEV.: CST REF. PT. ELEV SW SW, Section 24, T29N-R17W, Town o~ Hammond Name of Plumber. MP/MPRSW No.. County. Sanitary Permit Nu mher. Ga,,ty Steel 3254 S Ctca~x 58878 SEPTIC TANK/HOLDING TANK: MANUFACTURER LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLETZELEV WARNING LABEL LOCKING COVER I O 0 9 9G . J P OV DED: PROVIDED. YES ❑NO ❑YES ❑NO BEDDING. VENT DIA.. VENT MATL,. HIGH WATER NUMBER OF ROAD: PROPERTY WELL BUILDING'. VENT TO FRESH C t// ALARM FEET FROM r7 uNE AIR INLET. ❑YES NO ❑YES NO NEAREST ~C/ lv (JO B DOSING C AMBER: MANUFACTU ER BEDDING. LIOUID CAPACITY PUMP MODEL PUMP, IPHO M NUFACTIIRER WARNING LABEL LOCKING COVER PI IDED. PROVIDED: ❑YES ❑NO / ❑YES ❑YB ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIO A NUMBER OF PROPERTY WELL IL DING VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE I AIR INLET PUMP ON AND OFF) ❑YES N NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LF,(JH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BED/TRENCH WIDTH LENGTH NO OF DISTR PIPE SPACING; LONER INSIDE DIA SPITS LIQUID DIMENSIONS TREVC~ES , . i MArERIA;' PET H < _ O o' GRAVEL DEPTH FIL DEPTH DIST IP , DISTH PIPE DISTR. PIPE MATERIAL. NO TR NUMBER OF PROPERTY WELL. BUILDING. VENT TO FRESH BE LOW PIPES ABOVE COVER ELE INLFf ELE V. END AIR INLET. PIP FEET FROM LINE ~d0 GZO CZ6 NEAR EST-o- MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- ❑ YES ❑ NO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCHBED DEPTH OVER TRENCH: BED DEPTH OF TOPSOIL. SODDED SEEDED MULCHED CENTER EDGES ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH NO. OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVFR TRENCHES. DIMENSIONS MANIFOLD PUMP ELEVATION AND MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO DISTI DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV.. ELEV.. DIA. ELEV.. PIPES DIA.: 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: IN UMBER OF PROPERTY WELL: BUILDING. ~ FEET FROM LINE ❑ YES LJ NO ❑ YES L:1 NO NEAREST ICY lc - i • ~ G Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE. TITLE. DILHR SBD 6710 (R. 01/82) Wisconsin APPLICATION FOR SANITARY PERMIT (LIDILH COUNTY - DEI=FIRTR1EnTOF IPLB 67) UNIFORM SANITARY PERMIT # InOIJST R V, LR60R & HumRn RELRTIOn5 70a -Attach complere plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'/zx 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPEV~PY OWNER / MAILING ADDRESS 72- PROPS Y LOCATION CYi4: VII=[:AGE: usJ 1/4501A S 2C/ , T_-,~`, N, R/1_7 (or) W TOWN OF: LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER L _A/ TYPE OF BUILDING OR USE SERVED 1 or 2 Family Number of Bedrooms. 4j ❑ Public (Specify): THIS PERMIT IS FOR A: ❑ New System ❑ Tank Replacement ❑ Repair Replacement Soil Absorption System ❑ Revision ❑ Privy Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. ❑ Seepage Bed N~ Seepage Trench ❑ Seepage Pit ❑ Holding Tank System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total # of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity c Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): d El Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name lumber (Print): Signature: 1451~- IVF/MPRSW No.: Phone Number: Plumber's A.dress: Name of Designer: COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved G' ~'/~~u ❑ Owner Given Initial e " ! Approved Adverse Determination Reason for Disapproval: Alternate course(s) of Action Available: DILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable. 10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system, depth of the system, type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan, drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin. 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 Location of Property CG , Section T 9-Y N - R W Township!?` Mailing Address r Subdivision Name Lot Number Previous Owner of Property t (lr Total Size of Parcel Date Parcel was Created Are all corners and lot lines identifiable? i Yes No Is this property being developed for resale (spec house) ? Yes No Volume C and Page Number ~ as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract 3.- Other recordings filed with the Register of Deeds Office 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 the Certified Survey Map shall also be required. PROPERTy OWNER CERTIFICATION I (we) eeA-tc6y that a,U statements on .th.,6 4anm a/te tleue to the best o6 my auk) knowledge; that 1 (we) am (an.e) the owneh. (s) o A the pnapen-ty des ch i,bed in .thi4 in6o4mati,on 6o4m, by viAtue o6 a wa4Aanty deed heeoh.ded in the 066ice o4 the County Regis.ten. o6 Deeds az Document No. ~Z© ; and that I (we) pnebentey own the pn.opoaed bite 6o& the 6ewage disposat .6y.6tem (on I (we) have obtained an easement, to hun with the above desenibed pkopen.ty, Got the cons-tAucti.an of said system, and the same has been duty neeanded in the 066ice o the County Reg.i.d.teA o6 Deed6, as Document No. ) . l SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED H H 9 ST C- 105 r r 9 SEPTIC TANK MAINTENANCE AGREEMENT Ho St. Croix County z . t7 a OWNER/BUYER ✓ a ~,.._r- ROUTE/BOX NUMBER Fire Number CITY/STATE ZIP cam, PROPERTY LOCATION: Section T N, R _W, Town of ; St . Croix County, Subdivision Lot number I 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 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 systems properly maintained. 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. -3 0 I/WE, the undersigned, have read the above requirements and agree C to maintain the private sewage disposal system in accordance with x H I the standards set forth, herein, as set by the Wisconsin Depart- w 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.( S I G N E D . DATE St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. I v_ CA to v v~wroCD ~m~~•~o° x o o m 7 N 0 a3 o c r- Cc: N z ' ?o 5m v am m ° 0- 0 0 C m 0 m O to O 13 m (D n - a p o w x m 0 w co m m m m o~ .?0oo ~ o~-.~~w o 3 a m E o w o~~ w ~ =r ° 00 ~ca'a6,- 3 oc3oao M Z c~ av f ~ w m o..o ac1c 0 N m oo cv a D c ~.mo~ m ID -Ci 0 D Q G) .N-. ° 0 - w n ,nr 0 In = d am = w O O Q N C ANN m-N-90 Z 0 5D p Z New yf0 'D Mo -C-Dr CL ~a wo m vN 0 > > w =r CL (a U) v;wa ac0*m C 1T1 lK7; =r v ° v m= w M=r ca CD cn - CD CL Q (D o 0-gym ° w0 ~ m%`°c'~p °ao f N c_ a.a0i o m 3 w a a a m o° no cr a c~ w ° c to cu m 0 3 • 0 c ~ co a 0 0 N O > a0 0co c -gym c m S c CD w a O D ? ~ w =0 t~j o c m CL o O V A+ 3 0 3 • o* w a3. am ° 0 - CD o z c DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION (115) P.O. BOX 7969 LABOR AND PERCOLATION TESTS HUMAN RELATIONS MADISON, WI 53707 (H63.09(1) & Chapter 145.045) LOCATION:. SECTION: TOWNSHIP/M E1TY: LOT NO.:BLK. NO.: SUBDIVISION NAME: 15 /4 0 a /L~` N/R; 7>E (or) W ✓ is COUNTY:' OAS/BUYER'S NAME: MAILING ADDRESS: J USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: QResidence ❑ New e lace I RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) [If PNOT required DESIGN RATE: If any portion of the tested area is in the ndicate: j y7 ~Floodplain,indicate Floodplain elevation:/ ~Sidyls? PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL H THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTJ4+N, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- L Egli ~ 7 (1Ci~ =Sr' B- 3 76 B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER LUC~qS AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH P- 1 3 ti~ 314 7, Z 2 P- /UCH P- P- P- 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 and the direction and percent of land slope. SYSTEM ELEVATION P : 4C7 ~ . E ~5 E ir~ to 4 T i a I i E I 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, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (printi-n TESTS WERE COMPLETED ON: ADD~tESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): /~V W l Z Z 1 /~a - ' CST SIGNA E: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. 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Alapdo.ia ;o .zauMp 0 0 t I S - 111 .I 0 ,l • October 15, 1984 Hammond, WI. 54015 .Farmers Home Admi.nestration 1060 10th Avenue Bald,,tiiin, Wi. Joe Dohman Deer Sirs: In discussing with Joe Dohm.an the require-ments for a 1~u_Zdil permit I understood that the sanitary system -ermit had been recieved but the St. Croix County Zoning office has issued a violation against the town for issueing a building -11ermit in the absence of a sanit,,a,ry permit so it is necessary for the town of Hammond to revoke the building permit issued to Joe Dohman On October 6, 1984. When the Zoning violations tr~1 u__ l.iount',yy -2° C' C1 Y ..,,tc.u the periiit c ,'.n 1.--'Lns i ,t,d. Yoia- truly 6'4 1 ~6,u R. Chapin, e r>k Town of Hammond 1 o nmond, VII. 54015