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020-1180-10-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Gra es, Michael Hudson Townshi CST BM Elev: Insp. BM Elev: BM Description: /6~ d o0 o T o TANK INFORMATION 3 ~ fah , -G ,~ ~-F ~ (Z, TYPE MANUFACTURER CAPACITY Sep • ` ~ sit -~ d o f o ` ~ ~tnJ J ~ l ~ ! J v Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. s Vent to Air Intake ROAD Septic I ~>~ ~~~ ~ ate ~ ~ g' ~ .~,„sp. Aeration Holding PUMP/SIPHON INFORMATION Manufacturer ~__ Demand Model Numb TDH Lift tion Loss System Head TDH F Forcemai Length Dia. to Well SOIL ABSORPTION SYSTEM l ~ /'.tilvy.~, h~.~ ~_ ELEVATION DATA county: St. Croix Sanitary Permit No: 430373 0 State Plan ID No: A Parcel Tax No: 020-1180-10-000 Section/Town/Range/Map No: 28.29.19.1131 STATION BS HI FS ELEV. Benchmar3 ~ ~ ~ ~b b / ~v. ~ Alt. BM $-~ ~~~ Bldg. Sewer ~~ ~ • ~~ / 3- S tlnl~) / J~ ~~- tn~' 7 _ / 7- b 0 Dt Inlet Dt Bottom ~ ~.~~ ~~ ~ Heade /M S ~ s o Dist. ' ~ ~ e ~ X0.3 9~ Z Bot. System ~ a ~•3r Fin I Grade .~.-d - s D 3 •~f St Cover - v~,c~J S ~ s 3. ~ `l • ,~ BED/TRENCH Width ~ ~ Lengt~ No. Of Trenches PIT DIM ONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 ~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHI Ma cturer: j ~ // ~~ INFORMATION CHAMBER R ~ ~p,,~ ~ ~ f "~'^"' -s"~c~ ' Ty Of System: S~ ~ ~-~y~ , > ~ / DN j jj 'T 7r Model Number: DISTRIBUTION SYSTEM Jf.o'Y° - Header/Manifold v ~ ~ Distribution,,, Pipe(s) ~Q/ ~ ~ ~ ~ (1 / x Hole Siz x Hole Spacing J Vent to Air k Length 1~ Dia Length Dia Spacing SOIL COVER ~ ~ x Pressure Systems Only xx Mound Or At-Grade Systems Only ~~ ~ Depth Over ~. Depth Over xx Depth of xx SeededlSodded Bed/Trench Center ~ ~ Be~l/Trench Edges / Topsoils / /.n '.~1 . .-~. 1~ ~ /M L.///S /IOO./L. ~,~~2~3~~s No ~~12d~ Mulched ~~~ Ves No v~ /~ Jrv~a- - ~ ~ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection :_~/ l /~ Inspection #2: rb/ Location: 553 Dru Drive Hudson, WI 4016 SW 1/4 NE 1/4 28 T29N R19W Cedar Hills Estates II Lot 3 /Parcel No: 28.29.19.1131 ( ) 1.) Alt BM Description =~~ t~ -Tom""'''~- ~~~ ~~ „_ ! SG~/U 5~~~~- ~J 2.) Bldg sewer length ~-g'~! -~'~- " /) ~ ~~ /~ ` - amount of cover = !~ ~ L~ LH~ ~ JLa t-~ ~.~''`~O 3 ~~a-t-~- s~` l - _ Plan revision Required? jJ Yes ~o I ~,rL(7Z~ - ~ ~ Use other side for additional information. '_v a ~~ ~ Q ~=1-~._._-_ ___! / L',~ Date ,/! ~ ~ I(nsepctor's Sign ture ~/ ~ Cert. No. SBD-671~1R~.3/9~~/ /~ K~"~ ~ `~/`,-i/p„_ _,Q~ GL/~~e~~y/RX.G /~).2~ ~//~b ~G~/yL~~'7rvYt ~ Z nr I ~ y~ ~~ i~,1~Y"~ ~!J (.Ff/ J~O ~C~iLsE~l~~" ~~ .T~sc~{ I~CQ~aO~ ~ Safety and Buildings Division r ~ 201 W. Washington Ave., P.O. Box 7082 ~~CO~S',n Madison, WI 5370? - 7082 rtment of Commerce 08) 261-6546 Sanitary Permit Application In accord with Comm 83.21, Wis. Adm. Code, personal information u rovide may be used for secondary Purposes Privacy I. Application Information -Please Print All Information Property Owner's Name t f t'l l G~~ i ~ ~~ VC14' Property Owner's Mailing Address SS 3 D~ f~~ - w,s15~ [~~~/~® ZONWG OFFICE ~,uy, ouue Zip Code j~~SO^~ ~v/. S~o~C~ II. Type of Building (check all that apply) ~l or 2 Family Dwelling -Number of Bedrooms c~h ^ Public/Commercial -Describe Use O •,v ^ State Owned - Descn'be Use III. Type of Permit: (Check only o Comple A' ^ New System Replacement System ^ T a B• ^ Permit Renewal Before Expiration ^ Change of Plumber Phone Number ?/S•3d'~ •3y~ sT c,E~oi ~. Permit Number (to be filled in by P ~~Nu ber t Address (ifdifferent ~-~ 3~ Parcel # t # Block # ono • i/~o • to • av~' (.113 Property Location s~ ~., ~~%., Section 1 ~j (circle T ~ N; R [ E `~J Subdivision Name CSM Number • ^City_^Village ~1'ownshi of >~ U~ ~~ ~- line B if applicable) molding Tank Replacement Only ^ Other Modification to Existing System ^ Permit Transfer to New List Previous Permit Number and Date Issued Owner IV. Type of POWTS System: (Check all that appl ) Non -Pressurized In-Ground ^ Mound >_ 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized in-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculatng Sand Filter ^ Recirculating Synthefic Media Filter ^ Leaching C ber ^ rip Line ^ Gravel-less 'pe Oth Isi V. Dis ersaUTreatment Area Information: ap Design Flow _ ) Design S it plication Rye( f) Dispe Req~ (sf) DisPgrsa~~Proposed (sfj Sys~evatiotya~~ VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber P Gallons Gallons of Units Concrete Constructed Glass New Existing e' Tanks Tanks ~/NS~/l.. Septic or Holding Tank ~ ~ / 2. ~~ !- e "t~ti ti Aerobic Treatment Una / ~ i VII. Responsibility Statement- I, the undersigned, assume responsibility for iastallattoo of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Si re ~IoIP/MPRS Number Business Phone Number R. 2~rbQ ~~~ ~~t~ yz~~~S 7is~~~a•~ .2 Plumber's Address (Street, City, State, Zip Code) /,, , VIII. Coun /De lartment Use OnIY Approved ^ Disapproved Sanitary Pertnil Surcharge Fce) ^ Owner Given Reason for Denial IX. Conditions of ApprovaUReasons for Disapproval SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced /maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. (includes Groundwater Date Issued I sui Agent Signature o Stamps) 3) ~ 5~~~ . ~' ' G.6~"IC.t ~ ~' (~ ~ CST' t>~ SS 'mow. S. ~w•~ 0 • ~'~,p~r't"T set s~s~• .y`tl Imo. ~ ~ ~ ~: (~ 0 Attach eompkte plan: (to the Cwoty oely) for thesystem eapaper not ku thaa 81/2 :11 inches In slu `~) Ort s~s~. z~ ~ '~ ~ 3- ~n~etiat•eo'tti.. ~ SBD-6398 (R. 08/02) ~, ,~,,~ ~ 5: ~ c¢.. .5 ~.- ~{'- ~se~lLtd?*~+ . !~ I~ ~f 1~iP/~~1~~ ~~T 3~ .r-- ~~~5 ~~~ ~~ D~ ~-~ ,a ti ~vs~ -~., 5~ y~ ~ R~' ~,,,,,~ . 4 ~ C~ 9j-~ ~ gµ ~~ " (~ o ~D ~ NI ~ ~ -gyp p 0~ ~~/'~ ,_ s ~sr p ~N~ p, D ~ ,- v£~ ~a~. Pte' ~b~-- y i5 ~ ~ - -^ - -i ` ~~~ o~ ~ o= ~ ~. ~ 9 . u5 I ~ i i i S ~s i~ I /~' l i 5~~~ ~ I ~c~ ~ i I~ ~'~ a i_ p__ ~ e ,, ~ ~ ~ ,. q `~' I i ~ , p i II 3~T~~u~ 1 ~ p1~~ ~ ~ i i d-c' S r ~G ~ r ~ ~~ l i y ~ I y l ~~ ~ ~ ~ ~'sX ~ ~ ~ ~ `~~ • O c~ ~' Z of ! ~ I~ 3D~ o ,< Igo ~G ,. ' 8 slur ~I' ~~ o ~ ~, . ~~~ 5~ I1J9 BHP IrAN~ ~ ~5 / v~ - SS' o c G~%E~ ~ ~ ~ ~ ;~ ~ft~ ~ ~ ~ y ~~ ~~ ~ °t ~ .~ O~ s u ~ / ' 35 3~ ~; ~S D I o I C L 2 ~. U~.sRiCl-~T & ~i~~O~IATE~- CO. - _ ~ ~ _ 655 O'Neil Road ~ Hudson, Wl 54016 Aeg.,Designa-s of EngineeHng Sysfem.< Private Sewage Consuifanfs 715-386-8185 PROJECT INDEX PLAN I D # DATE s~ • ' ~ OWNER ~I/l~~ (~'iP^^~ ~ErS PHONE 3~~ ' ~1~~ y s% ADDRESS 's-S ~ --1~ ~ ~ ~ ~ . ~ (~ ~ SO ~ S' ~/O/ ~p LEGAL DESCRIPTION GOT 30 C~~ ~i/~S' ~ST~-T~S ~- f7i',J o20 • /!~'p • /D ~0-d 0 Slc~, /V f~, S ~~, T1-~'~v, /E' /S'Gv TOWN OF ~UD.s~'J COUNTY ~ ~ ~~~ K-- CSTM ~• ~6~~/~,t ~ ZZ~ ~ Z~ LOCAL AUTHORITY/ SUPERVISION ~~• ~j,l( G1`~ zD'v% 'uCs---- PROJECT DESCRIPTION: s-~~~~ ~ ~ ~ N~ ~~ ~ _A G ~ ~~ ~~T ~ ~ ~•~ ~i~~ ~ ~ ~~ ~~~~ T~. f~xrs ~iti ~-- sl ~e ~e ~ti~~~~ ~~~~~ ~~~ %~~ ~~ ~ Ulbricht & Associates Private Sewage Consultants 2812 10th Ave. Spring Valley, WI 54767 /~/~ /c'S ~ ~ 3 75 ~~ ~~ _ o Pg.l INFILTRATOR SIZING WORKSHEET Pg.2 SYSTEM PLOT PLAN Pg.3 CROSS SECTION OF SYSTEM, WITH ELEVATIONS. p~ a ~~ ~~ .. .. .. \~ ' T y ~ o '-~ ~. rn ~ ~.~ ~~ ., 0 ~ b b ~~ ~ ~ ~ ~. 'N Z 0 ~ `° 0 W `~~ n~ ~ ~~ o .~i ~ r ~~ c ~ ~' O ~ ~~ ~ ~ ~ ~ ~ ~ .y ~ ~ ~ o ~ ~ ~~ ~ ~ ~ y ~ 0 ~j v ~1 ~~ ~ ~ o~ - _-~-- _~ ~_ .` ` 0 ~h h m N 00 ~~.; w c ~ ~, ~, ~ ~ ~ .. ., ~~ "t~ ~~ C c~ vl °~ ~. 3a s--- ~~~5 ~i ~ l~ ~ ~'~ o~ 15~ ~ ~ ~5 ~ 5~ y~ ~ R~' C~ s ~sr fib' p koN~ b p, D' ~~ v~~'~ Pte' ~ y / - - - -, ~ ~B, y o f o j ~, i'o ~~ ~ Ig~~3~~ ~ Iii ~'I°i .u ~~ ~ I I I I I i ~ ~~ ~ I i t ~_ ~ _ _Is ~ I ~ I'. q~' ~ a~.o o / ~~~ ~~ ~; ~aP ~ ~~ ~y T~ 3~' f I ~ ~ 1 ~ p~~~ 5~ ~~n ~ ~l V y o,yy ~~ Z ~o ~ r 3a -' o 0 ~~~ s~ INg BHP /~/f,~~ ~ 'IS ca~~ ~~~ ,~ ~,. ~~T~ ~ l ~ ~ S ~~' /A /~J I I I ~ i I i I I~~ 'mil, ~ ~~ ~~~ ii xl ~ , I ~I~ I~ li ~` 11 I i o ~ ia; ! I I' a~s° 57~M d ~ Igo ,~~g~. 32 ~; ~ ss' ~~ o~ o~ ~ (fib a ~y e 3S~ ~ 3~ O~ • D c L c L ~~ ~~ l~ vl ~9f~P~aU~ a~ iivs~~~ ~lv.v ~ ~~ _ ~ v~-~T- 1 i!l i ~~ ~g 3 M ii C,F/cv~~tr~D ~ i Sfi~NGG ~~ '(p ~~ ~NS~~cT/ov ~~~ ~r~i sc~, qo --~~~c 9~t~~c-- ~~~ ~ 7"iP~ti c~ -- _ , _ _ ~I . I S S T~~ y ~i~v, ~~.So, C~'t~ SS Sic ~ ion o~ T~'~~~s' ~~ i~ T ,.a ~~ ~~q f~,Ac~ T~' „~~~~tviv~,~ '~ ~p~~~ 3 'aC G '~ ~ .c ov~ w ~~ ~ l . ~ SQ ~T, r¢ia~.~'vU~j C.~j .~I cry ~ Sic T~'o.~ I t/~ --- 1 ..~, ~9P~~U~1~ v~ti 7- c~ j~ G,v itfs'~11~'t T/ov f1 ~~- ~~~~ 1 s~.9o ~,~E ;~~,„~TOe" I-.-oar a~° ~ ~ - 1, - - ^~._... F~iu/S~FD ~~~• 9~~~c-~ T~P~ti c~ ,i .. OWNER's MAINTAINCE pF ~ .•~~., SEPTIC SYSTEM POWTS (landowner maintenance of thisssr$pefisible for servicin Y proper operation and g is necessar Regular periodic inspections and system. The owner is refOr the safe healthy operation of. this maintenance/inspection 9eired by code to submit ports to the controllinall necessary 9,authorities. SPECIFIC CONTACT AGENTS ~- / * Governmental authors t ~~ ' ~ipOr~ G ~~~ Y/ inspectors: * Licensed installer maintenance ~~ ~~ responsible for Users manual: providing an operation/ ~ 7~- • 3 ~~f L- * Licensed serv~Ce / inspection l'3L~.U /~l®/~~r~~v S ~ -~ _ agent other than installer: * Electrician, for pump, electric controls, wir' ing units: ~~ IMPORTANT OWNER MAINTENANCE 1• Winter traffic RE UIREMENTS area shall not beledding, shoveirin permitted g' etc.) across the the cell, freezin ~ °r frost can/will penetrate into winter,(a vacactionuprihe system' Discontinuos use lead to freeze p' resulting in no water usein the ups' ) can also 2• Water conservati hydrolicall ~ needs tO be exercised! desi Y overloaded and desi:royed, ZhisrsvSStem can be fined for a maximum hem was wastewater flow of ~ g ls. dail 3• POWTS are ~ a Y- not designed to ~- ' disposal unit accomodate wastes from Any introductfonr any other unnatural sources of wastebage destroy this s of such waste materials will overload and ystem. 9. If a power oi2ta e in a 9 occurs, or a pump fails, it ma cell temporary overload of effluent bein Y result . which may adversely impact the cell pumped into the recommended that a licensed allowin pumper em (leakage). It is Consultg the pump tO return to ptY the dosing tank, your installer immediatelsing the correct. amounts. g• Ne Y for advice. glect of the vegetative traffic preventive cov~o (the .cells can lead insulation & REGULARLylso can destro failure. Compaction or WATER THE V Y t he system. It IS NECESSARY Toeavy the ystem beneath EGETATION OVER A SYSTEM!! grcovwr, IS NOT sufficient Effluent in alone t0 maintain a 6• Periodic inspections b necessary. Inspection Y;the owner, or his wryer,,,... ._ ~.,~,. L, wrscOnsin ~ of Corrxnerce SOIL EVALUATION REPORT Division of safety and BWdmgs Page ( Of Attach cannpiete site plan cKt paper not less than 8 t/2 x 11 inches in size. Plan must include, but nbt limited to: vertical and horizantat reference point (BM}, din:dion and petceM slope, scale ~ dinfensiOns, north arrow, and location and distance to nearest road. Parcel I.D_ ~ Z ~ • // 60 ' /O ~~ o Please paint all tnformatton. Persgal IMormation Y'a+ Pr'ovide ~Y be . s. 1 b.o4 (t? 4m1!• 'wed by Date . 2 1 P /~i Jl~~r./.7/~/.~ /~/`r 7~J Cmvt. lAt~ ~ W 714 ~~14 S ~g T ~ ` ht R ~ ` rE or W () Property Qamer's MaiHrg ~ 1 ~ Lot # Block # Subd. or CSMlt S/tat,e 7~ UI,S~~/ W~ 3 ~ S7P Wixf~~.: ~: ~" " ^ Cily ^ VHa9e Town ~f'U~ SO / NTearest Road ~/PiilE- i ~ GC / . n . ./ i ^ tYew ~~~ I~Replacement Use: I~ Residential / Number of bedrooms li ^ P -Code derived design How rate ~~ GPD ub c or com Parent material /o~sS D U>~~ mercial -Des ~ OVA _ _ _ F7~ Plain elevation if appligbte N f} _~~~ . General corr.ner~ts and reoorrurrendatiors: /'i~ SofG PrT"~ / ff-D S~4 c~~,~ r To vx r'sr~-~G- -ryS 7 E-H '~¢,. ~i4rli ti ` ~T~~ S STe'•N % 5 '~i~ /.u GoI~E" C4.~ /~:q~,~i SDi/S ~y.vv Crly ~. G~"~T- `' e te ~ ~-- .a- B vi/ y,4-!u~ e /~v~ GGt~2 . e ~~d-e - , t----, ~ ~.Pl~'t ~ Ground surface elev. ~ ~' 1 ft. peptfi to rrt~g factor ~ r y st. Soil Rate tformott ;Japih Uortrt-arst Redwt Descx~iort Textue Strudeue Cor>sistence Boundary Roods GPI in. MenseH thr. Sz Conk Color Gr. Sz. Sh. 'Etf#1 ~>~ ~ d-(o /oyR313. SG ~ ~S'hK S ~S 3 .Y 6 ` I~ io S S D .. sG a2.P . '~ r ~, ~'L" 12~ 't' ~~ D . ~ iaq. (z oS,~ G .IZ 99 IZ g Z ! O ~ ~ ~~ Pit Ground surface elev. ~ it. Depth to limiting factor} ? in. ,... _ .. _ ~. _ _ .. . Private Sewage Consultants 2812 10th Ave. Spring Valley, WI 54767 /~'lii(~-e- ~ ~~P~j (~~~1-J~~ 020 • //~'O • /O •4~ Ply t>~er Paroet ID # ___ -- _ -- ____- _ -_ Z Pane of ~~ ~ ,~ ~ ~ Ground surface elev. ~ ~ O • L ft. Depth to timitieig factor ~ ~ in. Sail ~ Rate Fiorizan Depth Dorttinant Redox Desaip6on Texture Structure Consisttmce Boundary Roots GP t)IfP In. Munse~ Qu. Sz. Cont. Color Gr. Sz. Sh. •E1fAN 'Etf#2 ~ ~•iZ /oY~3 3 L /f.S ~ S 4~ rt •Y - ~ ~i%/ 5L ~ .~ ~,..efr a l,J .e0 ,tom 4 . ~ :S . v Boring # ^ Boring /pp . Z Pit Gnxtnd surface elev. ft. Depth to limiting factor 3a in. ~, ication Rate i{orizon Depth Dorr~natrt Redox DescripGorr Texture 51nx~ure Consistence Boundary Rants t,~P D/fF in. Munsei< Qu. Sz. CoM. Color Gr. Sz. Sh_ 'Eftg1 'Etf#2 1/ v /~ ~rI Q ~~ ~ boring ~~ • ~~ ,~~~`~ " 2Q ~ Ground surface elev. ft. Depth to )>rniting factor in. Pit c„~ e.v,r.~,., amore /' (.p Q Boring 7 / • o ~ 7 / d' ~~ # ~ Plt Ground surface elev. f[. De~h !o limiting factor ~. . ~ Rate D d ti i R d D Texture Structure Consistence Barxrdary Roots GP D1fF Notlzon epth ~. Dominant O or MunseA escr p on. e ox Ctu. Sz. Cont. Cobr Gr. Sz. Sh. •E1ptt •EffN2 o• g is yR 3/ S -~S~i~ S CS 3 . y • G 3 to s -~ s o ~.~ .~ t. L r~ 3.0 0 a~" ~Z . L $2. Z .3 ~•3 Efffuerrt #1 = BODE ~ 30 < 720 mg>i. and 'tS5 >30 ~ i50 ntg/l "Effluent #2 =BODE < 3U n1gA. arxf TSS < 3U .•'~_ ~i c ~ wiscatsin Depa~tt of Caranecce SOIL EVALUATION REPORT Division of Safety and Bulktrgs Code derived design flow rate Attach cxxnptete site plan on paper not tens than 8 1/2 x 11 inches in size. Plan must qty -_ inducts, but not limited to: vertical and horizontal reference point {BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print a0 Inf+ormatlon. ~~~ by gate Ptiaonal fnformstion you provWe maY tit useQ Tor seconCary t~ t~~Y ~'. s. 15.04 (r) (mjl. ProI~Y Owner Property Location Govt. Lot 1/4 1/4 S T N R E {orj W Property Qwners Mailing Address Lot # Biodc ~ Subd. Name or CStv!# State 7p Code Phone Number ^ City ^ Ytdage ^ Town Nearest Road ( ) Q New Coristruc~on Use: Q Residential / Nranber of bedrooms (~ Replacement ~ Public or cortanercia! - Descr~e: . Parent material _-- - ----- General oorrrrtertts and n~cxxrxnertdations: Flood Plain elevation if appligbte ft. ~9 ~ ~ ~9 ~.,,......, _...~,...., _~_ a .,_ ~u _-__..___.~~..... ....r.............«y.o ... Sal Rate Depth Dorrrinartt Retirnt Desaipfian Texfrxe Strudtue Consistence Baurdary Roots r,P D/fF in. Murtsefl t]u. Sz Cont. Color Gr. 5z. Sh. 'Eff#1 'Efff/2 # ~^7 Bain9 L,I Pit Ground surface elev. ft. Depth to feniting factor in. Sal Rate Horizon Qep3h Dominar+t Redox Oesaiption Texture Stnrr~e Consistenwe Boundary Roots GPO/tF irt. Munse4 Qu. Sz Cont. Color Gr. Sz Sh. '>~f#1 `Eff#2 timrent tr'r = et7o > 3l) < 220 mglt. aril TSS >30 < 150 mgA. ' EftrtreM #2 = BOD < 30 rngA. and TSS < 30 tngiL CST Name (Please Print) S'~gnature CSTIVurnber Address Date Evaluation Conducted Telephone Number Page of G D d ~C'~( 1>~~'U~-- 3~ ~--- ~~~5 ~~~ ~ p ~~ o~ i ~S~ ~ w ~v5 ~ ~~ y~ ~R~~ tf~ a ~ ~ ~~ ~M~ i~ ~~ ~~ ~o~ H~ ~ ~ ~D~ /~ ., 93-~' C ~-- ., Y s~ ~~ Yb ~~~, ~OD'dr ~ ~~ -'~ ~~ ~~ ,_ p _ _ ~ s .---- z °I~ / 85 D /~' 98~~ C~ c ~fl t Gv;E~P /D~ ~` ~ I A¢~~ ~~~ S ~~~ ss " ~'~" ,~ `~ a ~~~ a 3 ~ D , o~ . c v ~ v 1. ~2 _ _ ~ T~-- -S S 3 _ ~2Gc. ~~P - _ S~ _. p~o.~ <S yo/ ~ ST. GROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify~~ii that I have inspected the septic tank presently serving the CC ~ ~FL~ ~~~~,~ resid~e~nce located at: ~~ 1/~, fir/ 1/4, Sec. ~'~ T Z~ N, R ~( W, Tawn of ~~ "D's~~ 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 servfced ~b 3 Did flow back occur from absorption system? Yes ~ No (if no, skip next line} Approximate volume or length of time: ~ fi gallons minutes Capacity: /da'U ~ . Construction: Prefab Concrete ~ Steel Other Manufacurer { i f known) : CU %~S~IP ~~~ ~~ "U " Age o f Tank ( i f known) : j¢~f-.iD.~ l ~d (Signature) (Title3 (Name) Please Print (License Number} (Date} Ftlrrrt to be completed by licensed plumber (x.145.06, Wisconsin Statutes? or Licensed Disposer (NR 113 Wisconsin Administrative Code} Plumber (applying for sanitary permit) Certification: Irz 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). _~ Na1t~e_~• ~G~~ ~ ~~ Signature---.._._ IMP/MPRS 2~-- Ca 3 Z S Ulbricht & Associates Private Sewage Consultants 2812 10th Ave. Spring Valley, WI 54767 Uwner/Buyer Mai{irtg hddress ~ ~~ i ~~~A /~ .- w~ ~~d~~ Ptol~erty Address ~~'~ f~~_~~ ~ ~t l~ s G~'~ (~(~ ~~~j/C~+ Sc• (Verification required from Planning Department for new construction) City/Start' _(~ ail ~ Parcel Identification Number LhGAL llr,SCri)1C'1'~UN Properly Location7~ r/~, 1y'Z/'/,, Sec. ~'O , T~N- ~ W, 'T'own of ~~ Subdivision ibL Q ,Lot # Cet-fltied Survey i1->Cttp # ,Volume ,Page # // ~Vnrr~nrr+~y Deed N S~ 7~ ~~ , Volmne l/ ` ~ ,Page # ~" ~~ Spec house L7 yes ^ no Lot lines idenliGaUle~yes (~ no sYS~riun~ MAIN"1CENANCE hnproper ase and maintenanceof your septic system could resuh in its premature failure to handle wastes. Proper mainlenanr consists of pumping out the septic tank every three years or sooner, if nteded by a licensed pumper. What you put into tht syslei can affect the function o[ the septic tank as a treatment siege in the waste disposal system. . `[ he property owner agrees to strbmil to SI. Croix Zoning Department a certification Corm, signed by the owner and by master plumber, journeyman plumber, reslricfedpiumber or a ficensedpumperverifying that (I) tare ou-site wastewaterdisposa) systei is in proper orerating condition and/or (2) aRer inspection and pumping (i[ necessary), the septic tank is less than 1/3 tut! o[ sludge ' Ihve, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the siandatr set forth, herein, as set by Ilre i)epartmcnt of Commerce and the Department of Nalnral Resources, State of Wisconsin. Cettificatic slat+ng that ;~ont septic system , s been maintained most be completed and returned to fire St. Croix County Zoning O[[ice within 3 days f lt,e three ear expir n date. / ~~/ ~.3 s iNn~~ uRE or nrrf.. ~ ~r un~l~>; t (we) certify that all the open described above r 1tiNA~tUR.P Ol: APf r r R ~'r• Rrry infvrrnation that S"I' CIIUIX CUUN't'Y SEP'I"IC 'T'ANK II~AINTENANCE AGREEMENT ANU OWNERSIIIP CERTII:ICATION CORM ~N Icr»ents on this form are tn~e Io the best of my (our) knowledge. I (we) Am (are) the ovvntr(s) r virtue of a warranty deed recorded in Register of Ueeds Oftce. . 9 ~ ~~ 03 DATE represented may remit in the sanitary permit being revoked by the Zoning Department. •'r''#• '"~ lnclnde rvUtr thts at;pflcation: a stamped warranty deed from the Register of heeds oRict a copy of the certified survey map if reference is made in Ure warranty deed -~r .: ,~ _ , . ~ . .~ . DOCUMENT NO ' , 52'7646 ' k~.>RFtAtJ7Y DEER ~ THIS SrA~6 RESERV EU fOR REGORDINO D~f• ,STATE BAR OF WISCONSLY FORA 2-1982 ',' .t ~y - i REGISTER'S OFEICtw - .. __ ~ VOC ~.l ~ ~~as~ 2 ~ ( - 11 ST >rR~nr c~ a ~I I •~~ .~ •v.. ,:wW.Ji V David J. Kulzer and Peggy M. Kulzer, husband and ........... ........... APR $ 1 ]935 wife, as-,jgint_.tenants, ~ j i .. .................................... i~ 9:30 A.t~ .... ................. .. .................... .,t .._ ......... ....... ....................................................... ° r convegs and warrants to ......Michael. R. Graves and Darb~:ra:_7.:-:; j{ ~~^4,,,,~~ ~ ....Graves,.. husband- arsd- wife, - -... ..........: ...... ._ I` R ~~;~,-.,-~ ,J .. ... .._........._ R6TURN,..T~..I _. ~u f r . ...... .... ...... ............ .. ....... .... ........ .............. .................... 1tl V CY S~ 1 ~ ~ G ....... ; e3 the following des.-rihed teat estate in $t. Cr_Q1X '~I`'• f' 't~t s '' ~ ............. ...... .....--------.- County --__ --. -r:~~~._ -____ rt'/5~ '_ -_ State ~f Wisconsin: I Tax Parcel No- ----------------••--.-•°-.... Lot 30, Cedar Hiils Estates II, Town of Hudson, County of St. Croix, Wisconsin. ,~. t ~Li.~`.S~ j' ~~iL~t./~ .r`~: . ~. ~~ ~ 't ~I '1 ~ ~ O II O a a ` d. This ...1$..._ ................ homestead property. (isl +~ Exception to warranties: 3 0'~`~ Dated this .., _ . . .......................... ... ..... day of . _. . ...... .........._ - -..............._..__.....-_ -- ..(SEAL) --- --- ------------------------------------------ -------(SEAL) AUTHENTICATION Signature(s) --•------•---.° ........................................... authenticates: this ......._day of ........................... 19..._._ TITLE: MEMBER, STATE BAR. OF WISCONSIN (If not, -----°-•-----------•-•--------------------------••---....-- authorized by § ?06.06, Wis. Stata.) THIS INSTRUMENT WAS GRAFTED BY ---------------Kristina Ogland ...._.....-------------- • ---•--- Attorne at Law (Signatures may be authenticated or acknowledged. Both are not necessary.) s iu Ai. 4niic.cL ._. Ozer .... ems'- -- .... ... 19. 95 . _•---'"' ............ (SEAL) ACHNOWLEDGMI~NT STATE OF ~SUt as. MldShi An • _.•---County. Personally came before me this ._..3.~*__day of ---- -----.Marc~h ..................... 19...95. the above named ._.Aa~risi J_._.[Gal.zer._aid..Peggy-.~1,--KuJ~zeir_,._.-. --.husband.~nd.wi.fe~--------------•--- ----------------•-----.. to me known to be the person S__..._.._-. who executed the foregoinp~instrument and acknowledge the s me. !, c.-/...//.J !GEC ` ......... _.......... ^i1ANDiiA K ~iEl~a! ---------- - - Iis#+aA,r~t,sdC- ;.. - Notary `';<" ~7(~1 rY .County, Wis. My Come s .s #~ ate etpiration fIAfP' 10 \ p ~: ,. Y ~ -,. r. '4J, . w ~~<~ :.r y, .~:. A E COAII~ rc~r+oN a ~. ~~ PA M W ,/ ~~ 'J- N r _t~9~~EAl_ o+ e a -- s ~o '° /' ~ .!, :` ',4 ,~?~~.p. ,~, 1 ~ ~ ~ • ~~X O / o~`~ , . y L/ ~~~•~~ 1 ~ ~. P ~~~. ~-~~/ ~~6.4, ~ M ~-~ 9 ~9 b~. E ~ ~ 6 ~ f ~' ~ ~ i 121 ~ Ir~ W W W ~ ~ ~ • a » , w 1~ = • I W ~ s ~ : w ~ el » ~ ~ ' • ~ :: ~ d I ` 3 ~I a ~ 'p ~ A ~ ~ O o~ s ~ I ~ I i 00~ I I ~ {i~ IM Iii1.00 i __ , ,, ~~ ... 30 88805 S 0. F T. 2.062 ACRES ~. 31 90634 S0. FT. p 2.OT8 ACREB 1 ---r. N 1/4 fiORN[R fECT10N !~ T!!N. Rl1w .. Jessie Nye Subject: Location: Start: End: Recurrence Ulbricht, Grayes, 430373, Cedar Hills Est .II Hudson Tue 10/7/2003 9:00 AM Tue 10/7/2003 10:00 AM (none) Tank inspection 020-1 180-10-000 28.29.19.1 131 RECEIVED S'I'. CIZUIX (,'OUN'I'Y 'CONING DLPAii'I'MENT AS~[3UILT' SANITARY REPORT' OCT 3 ~1 2003 UWrret / ~~,'\~ ~ (-~~~ ll ~~yCS '/ ST.CR0IX000NTY !~ddt ^,^,S S S 3 ~/p~i( 3 ~~ • ~ ~lj 'f ZONING OFFICE CityiState /--~t~DSo~ Gt9/. S~1A' ~~~ . 3 ~ ~ .. ~~7 ~ l,r.~al Uescrfpl.ion: C,E_~ ~/~s I.,ot ~ Riock Subdivision/CSM # '/~ ~ '/~ ~, Sec., T~N-R~W, Town of ~~,5 Q P[N # SEPTIC TANK -- US + CIIAMI3LTt -- TTOLDING TANK INTOTtMA ION: ~ . New. ~ yo. > s~ N,~ Tank manufacturer lvi~~t ~ ~ .Size ST/PC ~-Si~ Setback from: Nvuse Well P!L Pump manufachrrer ~~_ Model ___ > ~ Alarm location (t[Ut,UiNG 'TANKS UNLY) J(J/j~ Setbacks: Service road Venl to fresh air intake Water Line Meter location Alarm location SOIL' A,I3SUIti' 1'IUN SYS'T'EM: ~ , j~~ODi~~~.S~S 1 T'ylre of system: Width '~ Length ~ Number of Trenches 2/ Setback from: ~[ouse ~' _ Well i~,['/~L ~f ~' Vent to fresh air intake > Z- S ~LEVATIUNS: } 75 ~ Z- To pr's ~~l,~ ~ . llescri,rlion of benchmark bescriplion of alternate benchmark ,~ I3uilding Sewer 1'C l3ottortt bistribtttivn Lines ( ) i3ottotri of System ( ) Dina) 3rade pG7". S- Elevation Elevation S'f/II'T Inlet ST Outlet PC Inlet 1leader/Manifold Top of ST/I'C Manhole Cover O O ~) () O ~) O ~, ~ 3 ,~ L~3~373 bate of installation / / Perntil number Slate plan number Clumber's signature License number ZZG37 S Inspector --~! L-/~(~ Ul N~ Ulbricht & Associates Private Sewage Consultants 2812 10th Ave. Spring Valley, WI 54767 N~~ Date / / a ~ Complete plot plan ~+ ~~ 0 ~ V~ O l~ ~ p, -F (AN'pC ~o ~ ono <, o. ., ~ vV ~ro~n' vV (Q1~~ \ ?~ S?o Ili ~ ~. Vv ~~~n ~ ~ ~l Cn p ~ ~ ~ I ~ ~ N v ~. N ~7 ~ ~ ~ ~~ ~ ~ ~~~y ~ ~ ~~ G O ~ ~~ io W I~ ~ ~ k I h c~ ~ . I I o0 I~ "' ~ ~ "` II~ 0 -, li II~~~~ _ _ ~~ ~ o _ I;~il ~ a~ I I ~ . -I i ~ I I ~ O Z - 1 1 ~^ 1 [ ,.~ 1 -11 a° Z -I C7S cn m~p ~ N ~ pA ~O m ~ D m ~ ~ ~ mom ~~ ~ Z ~~D ~ ~ mfr r• r o~ w- ~ vs 0 0 y I m -~ ,x ~ I v~ i 1 M ~ o ~ I ° l ~ ~ ----i ~ ° ~ I I I~ o ~ i c ~ ' I~ ~ -~ I I ~ I I ~ ~ ~ ~ ~' mil -;~~ I I ~ ' -~ ~ ~ ~ ~ `^ o ~~ ~ ~ Z w ~ -,. ~ w ~n h ~° O ~ "b ~ ~ ~ ~. 0 ~1 3 ,, f.. AS BUILT SANITARY SYSTEM REPORT Form-STC- 104 OWNER ~~~;~ ,<-ilc~~~~ _ TOWNSHIP /XGt,.~~~,,,~ SEC. '.Z. ~ T ,2~ N-R1~W ADDRESS ~Q ,~,_~QSQ,~ 41~ ST. CROIX COUNTY, WISCONSIN ~~~6~ G SUBDIVISION ~~o(L~ ~ "jjs LOT ;3D LOT SIZE ~ ~- dk~2 PLAN VIEW Distances and dimensions to meet requirements of IT,HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM _~ (U. ~~ ~. ~~aGc,S -~ _~ S ~ 30' ~- ~~ INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used ~~7,~.L ~, // Elevation of vertical reference .point: f©Pj, ~ Proposed slope at site: /~_ PUMP CHAMBER Manufacturer: Pump Model: Elevation of inlet: Pump off switch elevation: Gallons per cycle: 1 c 1 r '~ Pump Size 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: k Trench: Width: 1~'" Length: S?2 Number of Lines: 02 Area Built: ,(' /~ r Fill depth to top of pipe: y Number of feet from nearest property line: Front, O Side, O Rear,O Ft. O"' Number of feet from well: ,~~ " Number of feet from building: ~ ~~ (Include distances on plot plan). SEEPAGE PIT Size: Liquid depth: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Number of rings used: Elevation of inlet: Liquid Capacity: Pump/Siphon Manufacturer: Bottom of tank elevation: Capacity: Elevation of bottom of tank: 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: Number of pits: Diameter: Bottom of seepage pit elevation: Alarm Manufacturer: DEP,ARTMEIyT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS ,DIVISION Pr 0. BOX 7969 BUREAU OF PLUMBING MADISCtlI$, WI 53707 S(A1%,N~%,S28,T29N-R19G1 CONVENTIONAL ^ALTERNATIVE Slfass9ln~iD.Npmber ralUVl a~ Hud~an ^ Holding Tank ^ In-Ground Pressure ^ Mound (~ N E F E MI OL ER: ADDRESS OF PERM17 HOLDER: INSPECTION DATE: B.i,.~ Hahure,2e CT~I UU Bax 1901 Hud~sav~, wI 54016 BENCH MARK (Permanent reference point) ESCRIBE IF IFFER'E NT FROM PLAN. REF. PT. ELEV.: CST REF. PL ELE V.. Name of Plumber. MP/MPRSW No.. Cnunly Sanrtary Permrt Number: ~ _"_ GI,c.Q,?,%am SchumaFze~c G382 S~. Cna~.x 11220 SEPTI TANK/HOLDING TANK: M NUF CTURER. LIOUID CAPACITY TANK INLET ELE V. TANK OUTLET ELE V.. WARNING LABEL LOCKING COVER ~ r ~ ~ ~ ~ ~U O ~ P OVIDE D: PgOVIDED: j ^ ^ ', ~ - ~. .~, YES NO YES NO BEDDING: VENT DIA.: VENT T1 ~ HIGH WATER ~ I ALARM NUMBER OF ROAD: PROPERTYF LIN WELL. BUILUING I VENT T FRESH AIR INLET: / L_~ 1 FEET FROM x ~ ~ ~ j _ [ ~ ^YES NO ^YES ^NO NEAREST ~ V ~ 7 DOSING CHAMBER: MANUFACTURER. BEDDING- LIOUID Cn PACIiV PUMP MOUEL PUMP; SIPHON MANUF nCTUHEH WARNING LABEL LOCKING COVER PROVIDED. PROVIDED: ^YES ^NO ^YES ^NO ^YES ^NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LI"E AIR INLET. PUMP ON AND OFF) ^YES ^NO NEAREST-~ SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE I N~,1 H - DInMF rE Fs n1ATE HInL AND MAHKINc or excavation. Ilf soil can be rolled into a wire, construction shall cease until the soil is dry enough to continue.l MAIN CANVFNTIf)NAI SYSTFM~ WIDTH LENGTH NO OF UIS iH PIP SPn(:I N(, COVER INSIUE UTA =PITS LIQUID BED/TRENCH DIMEN ION ,+ ~ ~ 5 THE NC HfS ~ ~ M EHlnl PIT DEPTH. S S ; ~ ,., , :;NAVEL fIF PTH FILL DEPTR UIS7 H. PIPF UISTH PIPE DIS R PIPF MATERIAL NO DI- F NUMBER OF PROPERTY WELL. BUILDING: VENT TO FRESH BELOW PIPES ABOVE CO ER , 1 1~ El EV 'NLF f ELEV LNU / y / I ~ ~ G PIP FEET FROM LINE /O -7 ~ t1 q AIR INLET: c~ 1~ 0 l / ~' T V, t NEAREST- -i. / o'~U J MOI'YND SYSTEM: r 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 SOIL COVER rexruRE PFIrn7nNINrMnHKFHS oHSEHVnnoNwELLs _ ^YES ^NO _^YES ^NO DEPTH OVER TRENCH BED DEPTH OVFH TRENCH HEU UEPiH OF iUPSOIL SODUFU SEE UCD ~ MULCHED CENTER EDGES ^YES. ^NO ^YES ^NO ^YES ^NO PR FSSIIR17F1'l AISTRIRIITIf1N SVCTFM• WIDTH. LENGTH NO. OF LATE HAL SPACING GRAVEL UEPTH HE LOW PIPF FILL DEPT FI ABOVE COVER BED/TRENCH rRENCHEs DIMENSIONS MANIFOLD PUMP MANIFOLU DISTR. PIPE MANIFOLD MATERIAL NO UISTH DISTH. PIPE UISTHIBU iION PIPE MATERIAL $ MARKING ELEV.'. ELEV. DIA. ELEV. PIPES DIA ELEVATION AND DISTRIBUTION N HOLE SIZE HOLE SPACING CI:ILLEU COHHECTLV COVER MATERIAL CAL LIFT CORRESPONDS TO APPROVED INFORMATIO pLAN$ ^YES ^NO ^YES ^NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS. NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE: ^YES ^NO ^YES ^NO NEAREST ~~a 3~' ~~~ Sketch System on Reverse Side. DILHR SBD 6710 IR. 01/82) _ ~~ ~ ~.; ~: i' ~~`~ ~~ ~ t 1~ ~,_a ~ Retain ilicounty file for audit. SIGNATURE. \ TITLE. 1(1'1_ -1. 1 _ _ Zavii.nq Ad~niw,us~c.a~a~r. sANITARY PERMIT APPLICATION COUNTY C ~ Code ~ DILHR Adm Wis rd with ILHR 83 05 I D/ C . , . . n acco ~a STATE SANITARY ERMIT# _~~a~ n -Attach complete plans (to the county copy only) for the system, on paper not less than STATE PLAN I.D. NUMBER 8'h x 11 inches insize. -See reverse side for instructions for completing this application. PETITION (~j No ^ 1. APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION. YES L.~T FOR VARIANCE PROPERTY OWNER PROPERTY LOCATION . ~ . -~ay ~ W '/a '/a, S ~~ T 2 , N, R / E (or PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME CITY, STATE , ZIP CODE . PHONE NUMBER CITY NEAREST ROAD, LAKE OR LANDMARK ^ VILLAGE mac ~ ~ 11. 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_ltxisting 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. IV. TYPE OF SYSTEM: (Check only one in #1 and only one in #2) 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): REQUIRED (Square Feet): PROPOSED (Square Feet): ~ r- 3 5 S~ ~ rg~ Feet ®Private ^ Joint ^ Public VI. TANK CA ACITY in allons Total # of e ' N f t M Prefab. Site Con- Steel Fiber- Plastic Exper. INFORMATION New xistin Gallons Tanks urer am anu ac s Concrete structed glass App Tanks Tanks Se tic Tank or Holdin Tank (~'~ Lift Pum Tank/Si hon Chamber VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system sho non the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) MPRSW No.: Business Phone Number: " 1, •a .~ u ~ p~- G,/ ~ ~-- ~.~ s ~ P umber's Address (Street, City, State, Zip Code): Name of Designer: VIII. SOIL TEST INFORMATION Certified Soil Tester (CST) Name CST # a~^/ ~ CST's ADDR S Street, City, State, Zip Code) Phone Number: ~' s ~. ~ ~ ~'' s IX. COUNTY/DEPARTMENT USE ONLY ~`pproved Disapproved ^ Owner Given Initial nary Permit Fee LL Groundwater rcharge Fee g e Issuing Agent Signature (No Stamps) /` 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 & lNSTRUCTiONS 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 a# 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. Property 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; VIII. 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% 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 by the 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 GroundWat~r ---` included the creation of surcharges (fees) for a number of regulated practices which Wiscor~sirtr~ can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried ~reasure is used in your building is returned to the ~rouPdwater through your soil absorption, o system of the disposal site-used by your~holdirtg tank pumper.` The monies co{lected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- t water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398 (R.03/86) APPLICATION FOR SANITARY PERMIT STC-100 This application form is to be the property being developed. the permit issuance. Should owner/contractor,(spec house), completed when the property appropriate deed recording. ------------------------------- completed in full and signed by the owner(s) of Any inadequacies will only result in delays of this development be intended for resale by then a second form should be retained and is sold and submitted to this office with the ------------------------------------------------ Owner of property ~~~~~t'e• ~: G~o~,~-~/~ C( Location of property ~'~ 1/9 ~ ~ 1/4, Section ~ ~ , T~N-R~W Township G~Lt~sn..r~ Mailing address ~c~ l ~ ~u /,~wad~o~ L</r, 5'y dlF Address of site ~~ ~ ~e,~~i ~~ ~ Cl s ~a~Lso.,r~ ,z/ ~ ~ S~~T~ Subdivision name ~ ~y Zg/~ "l L's Lot number ,~ d Previous owner of property ~~~~.ve ~-ar`.S'O./ Total size of parcel ~ '~ t~~'Yc 4 Date parcel was created tit ~,v~,~ ~/~~,~ Are all corners and lot lines identifiable? _~Yes No Is this property being developed for resale (spec house)?_O~,Yes No Volume ~1~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 3EAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. ---------------------------- PROPERTY OWNER CERTIFICATION I(We) certify that all statements on this form are true to the best of my (our) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the Office of the County Register of Deeds as Document No. '~l 3 l ~ ~ ; and that I (We) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has bee duly recorded in the Office of the County Register of Deeds, as Document No. ~ <~ 1 ~ ~ ). ~,E:C~' ~l ~2-GG~kX~ Signature of Owner Signature of Co-Owner (If Applicable) ~ :..' ,~~ ~~ . :----.: ~N i~+~..:gt~ ~ >~,;.>i~~y~ ~,~~ e.~,....~ aeeeasui• ow*~ '.~.---:~~v1'i ~'~'r"i'i~ ~ ,~ ~ iT. CUQIX C4., W15. It'd, for laoorii ~& 11th y Just ~ 9 86• Contrii~ai, by and betwe.. llarr~C..J:..~,~!+~,-.~.4.~~!°»t.~..l d0 Oi~,,,,,,,,,,,~/~• _ ggpreaantakiv„e of the 6stat~ of Also ~r,~,~,.~a„~Iohu o! ~ UA. .~~~ru..k~ixi~s~i~ .~~k~l~ .,i~l~ i~i~ic~.~r~n..~•..~.~. tw..aer"• Janea nae21 whether cue or~. noose) and... tl#~3~~#d~~.!~s.. ~3~.+;..~......R,..,....,,.,~--.... ~, r••r ..e;.w ~ ~ ~. • .~s in$~e .man .......... ~~ .......... ("Pa rrduae~", w1lMhei< ea-e ee •a~e). vends:.ala .nd.a~rsss to eon•+r to ~rasehaae•: n~ai a» >vr~>rt ~usi itnll >~ deputy . formaass of this eontra9t by PurehaMr. ~ ~• M~etMr sritb.tDe ~:,,:;~- - rents, profits fixtures and other appneesuws~t (~q aaibd ~`"•)• - - in......... ...S.~.t:. Croix .............................. • ~ wi ~~~: w<n,w» ro .See legal Description oa Addeadua F. Ta: Parcel No.... . .: .,. .....:... •- _ .~ 73 86 ~ 3 S F'~ This ......~&..AQh.......... homestead property. 7flL$ (is not) ' to Vendor at such.,place as he sha~~nawe....~ Purchaser aQseee to purchase tiu Property and to par ••---... .. .. ..'. .... the sum of;. 192a500.0.0........•,,,;....;•,,,,,,,,,,,,,,,,, b tLe follovtina manner: (a) i• •6Q-•!~Q9..Q4.......:.............. ' ~QQ,QQ ._ to Cher with interest from date at the execution of thin Contrast; and (b) the balance of ;.,~,~~rs •°-••••••••-•• ~ s° ot ..............iep..~~.Qx•)........... pea sent per annum hereof on the balance oubtandini< from tune to tiaWt 4t the .rah until pwid is 1ni1. v follosn: See Payment Tesed~ on Addandu>i -. . ' 11th .......... day of shall M is toil on or bafo» the ............... Providsd, •howewr, the anti» outetae-dins balance P+h ......_...luzua... • ist..AO. (the maturity date). _ Following any default in payment, inteeeet ahall accrue at the rats of ...~Q.... % Per annum on the to ~ entire in default (which shall include, without lia4itatiap, ddingwat int~srest and, upon aceelsration or maturity. principal balance) Puschaen, odew sxcuted by-Vendor,, a;rer to NY 'to Yardos amounts sufficient to pay rewwn~lY ~uci- i~yr~a Deea~iums when due. To the entent reeeived by Ysndor, paced annual taxes, special as~lef-h. fi» and rpuir~d sat of Vendor apse to apply PaY~ ~ these ~bli~at3oM '~ ~' i ~Dv regivsd by the Vender for pah°° taxer, aaeesmsnte and iasusanea wlil M depoAiNd M1o M eila'4w ~ ~ trustee account, but shall not bar interest nnlas othecw4e requissd by 4w. 1 Ps~nwnts shall be appliei Aret to lnta~ ea tla unpaid balsA« et the rate speciAed and than to psindpnl. Any j amount u~sY bs prepaid without _psanium or fee upow principal at nay tima~ ~-?~~ at w long j I In .the event of any prepayment, thb contrast shag Act lm trwlsd ae in default with re~pest, to PaY~ ' as tM unpaid balance of principal, and. intsre~t (and in sash cw soeeAius interest from month to month shall be ~ bin as unpdd principal) b lea than the aa~oubt that said indsbiniaw gonld have been had the cPaym ~ made v ilnt epsatAed above; provided that monthly ~ M continued in the ersat of credit o! cur proceeds of irunrana~ or eadsmnation, the oondsmned prwnieee h~ thm'Mtbr aeludsd heesteom. i ---_L__-- -•-•--.a.. o....~...... L ..t1.~.1 >dW'tLa tit111. MI ~o~ by the title svidenw submitted to Purchaser Purchaser promises to pay when due sll to:aa and aasdasments 1®vied on the Property or upon Vendor's in;'~r~~at in it and to deliver to Vendor on demand receipts showing such payment, ' Purchaser shall keep the improvements on the Property insured against loss or damage occasioned by Are, ex- ,:-•err~d~d coverage perils and such other hsaards as Vendor may royu-re, without eo-insurance; through insurers approved by Vendor, in the sum of ;............n/s .......................... but Vendor shall not require coverage in an amount more than Uie balance owed under this Contract. Purchaser shall pay the insurance premiums o/hen due. The policies shall a~nt.ain tt~e standard clause in favor of the Vendor's interest and, unless Vendor otherwise agrees in writing, the original of all policies covering the Property shall be deposited with Vendor. Purchaser shall promptly give notice of logs to in:=nrunce companies and Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall !'^ aP1'lied to restoration or repair of the Property damaged, provided the Vondor deems the restoration or repair to be ~' ~.wmically feasible. 1'urchsaer covenants not to commit waste nor ailovr waste to he committed on the Property, to keep the Propert:;- in ttoud tenantable condition and repair, to keep the Property free from liens superior to the lien of this Contract, and to compl~• with all )awe, ordinances and regulations affecting the Property. Vendor agrees that in cane the purchase price with )nterest and other moneys shall be fully paid and all conditions shall be fully performed at the times and in the manner above specified, Vendor will on demand, execute sod deliver to the urchaaer a ®tamp[ in tf simple, of the Property, free and clear of all liens sod encumbrances, except ~srsona7 Re~res~ngjv~ ~° any rena or cocain ancea crea y he act or default o! Purchaser, and except:....casecoetl>:lit..FiraLe~xlu~.. .:coveaaats..a£..reca>:d,..if ._anX,..and..zan~ng..axdi naaGa..>~a~u~zsulanl:a. .............................. Purchaser agrees that time is of~the essence sod (a) in the event of a default in the payment of any principal or intorext which continues for a period of ...6tQ... days following the apocified due date or (b) in the event of a default in performance of any other obligation of Purchaser which continues for a period of ..~2Q.... days following written notice tliereot' be Vendor (delivered personally or mailed by certified mail), then tl~e entire outstanding balance under thin contract shall become immediately due and payable in full, at Vendor's option and without notice (which Purchaser hereby «•ai~•cs), and Vendor shall also have the following rights and remedies (subject to any limitations provided by law) in addition to those provided by law or in equity: (i) Vendor may, at his option, terminate this Contract and Purchaser's rii;hts, title and interest in the Property and recover the Property back through strict foreclosure with any equity of reden-ption to be conditioned upon Purchaser's full payment of the entire outstanding balance, with interest the*eon from the date of default nt the rate in effect on such date and otheramountaduehereunder(inwhicheventall amounts previously paid b~• Purchaser shall be forefeited as liquidated dams%es for fniluro to fulfill this Contract and as rental for the 1'ropert}• if purchaser fails to redeem); or (ii) Vendor may sue for specific performance of this Contract to compel irnmr•diate and full payment of the entire outstanding balance, with interest thereon at the rate in effect on the date of dcfnciit and other amounts due hereunder, in .vhich event the Property shall be auctioned at judicial sale and Purchaser shall he liable for any deficiency; or (iii) Vendor may sue at law for the entire unpaid purchase price or any )+ortion t-~~•r~of; or (iv) Vendor may declare this Contract at an end and remove this Contractasacloud on title in a quiet-title .u•liun ii the equitable interest of Purchaser is insignificant; and (v) Vendor may have l'urchaeer ejected from possession of the Property and have n recoiver appointed to collect any rents, issues or protita during the pendency of any action under (i), (ii) or (iv? above. Notwithstanding any oral or written statements or actions of Vendor, an election of any of the foregoing romedtt±s shall only bo hindin upon Vendor if and when pursued in litigation and all coats and expenses including reaannnble attorneys fees. of Vendor~ncurred to enforce env remedy hereunder (whether abpted or not) to rho extent not prohibited b4 law and expenses of title evidence shall be added to principal and paid by Purchaser, as in- curred, and shall be included in any judgment. Upon the commencement or during fhe pendency of any action of foreclosure of this Contracts Purchaser consents to the appointment of a receiver of the Property, including homestead interest, to collect the rents, issues, and profits of the Property during the pendency of such action, and Such rents. issues, and proflta when so collected shall be.Reld and applied as the court shall direct. -. Purchaser shall not transfer, sell or convey any legal or eyaitable interest in the Property (by assignment of env cf Purchaser's rights under t%~ia Contract or by option, long-term lease or in any other way) without the prior written consent of Vendor unless either' rho outstanding balance payable under this Contract is first paid in full or the interest conve}•ed is a pledge or assignment of Purchaser's interest under this Contract solely as security for an indebtedness of Purchaser. In the event of any such transfer, sale or conveyance without Vendor's written consent, the entire outstanding balance payable under this Contract shall become immediatelydne and payable in full, at Vendor's option without notice. Vendor shall make all payments when due under env mortgage outstanding against the Property on the date of this Contract (except for any mortgage granted by Purchaser) or under any note secured thereby, provided Purchaser makes timely payment of the amounts then due under this Contract. Purchaser may make env such payments directly to the Mortgagee if Vendor fails to do so and all pa~•ments ao made by Purchaser shall be considered payments made on this Contract. Vendor may waive any default without waiving any other subsequent or prior default of Purchaser. All tprma of thin Contract shall be binding upon sod inure to the benefits of the heirs. legal representatives, successors and assigns of Vendor sod Purchaser. (lf not sn owner of the Property the eponse of Vendor for a valuable consideration joins herein to release homestead rights in the subject Property and agrees to join in the execation of the deed to be made in fulfillment hereof.) Dated this 11th June ................................................ day of ••---~ 19..86... ................................................................. (SEAL) ................................. ......... (SEAL) AIITB$NTICATION Siti;nature(a) ....................................••- authenticated this _.._.._.day of .................... ... 19......_ • ..Har>cy..J.....&teerart. ~ ~ ~ ' ,~~ .....................,,~ r.. ( >t William C. Harwell :'~% Q' J .. .....................................................y...~~..~ ~~a.• (V1 ~ ~•.O v ACKNOliiTL8DC4MSNT~'~,~7r.~':' . Q ,~, .,,~, 0 * ~ •~. . STATE.OF-WI9CONSIN '~r, ,, " r• . ss. ~>ia.. C)roix ....................County. Personally came before me this .1lth____.,day of ..........June ...............:........ 19. $~ .. the above named __Harry„J_t__ S tewart__ anc~ _ Wi~~ii}in _ ~,_. }~~~well .vGl j~~~e~r~ ~ ~ LAND CONTRACT ADDBNDUM Legal Description The N} of the N} of the SE~~ot Section Z8-Z9-19, except the South 100 feet of the East 565 feet thereof, and except a parcel of land located in the NE} of the 3E~ of Section Z8, TZ9N, it19W, Town o`t Hudson, 8t. C~~oix County, Wisaonsi~n, described as follows: Commencing at the E~ Corner of said 8egtion 28; thence 889°37'4.6"W_. (assumed bearing referenced to the monumented East-West } Section line of said Section 28, bearing assumed S89°3?'46"W) 23.78' along said East-West line to the point of beginning;_thenee continuing 589°37'46"W X301.48' along said line to the West line of said NE} of thg SE}; thence S 0~°03'44"W 661.63' along said West line; thence 'N89°34'48"E 761.9?'; theme N 0.05'12"W 100.00'; thence N89°34'48"E 535.40'; thence N 0.30'38"B 580.56' along the Westerly right-of-way line of U.S. Highway "12" to the point of beginning. NEj o! Seetlon 28-Z9-19, ~exeept that parcel described as Lot l of a C.S.M,.recorded in Vol. S of C.3.M.'a, page 862 as Doe. No. 359579 and except that parcel described in Vol. 583, page 527 as conveyed to~the Stete of Wisconsin. 3TC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYERS/~ ~~.. w~~/ ROUTE/BOX NUM`B`ER Cm ~k l~cG ~~,.,~,~~,,~ e~ •~ FIRE N0. `~_ CITY/STATE CJI,rt~s'ait/ ~/~ ~ ZIP .S~Y4/6 PROPERTY LOCATION: ~W 1/9 /(/ ~r 1/4, Section ~,~, T~N, R~W, Town of ~cc~ls dw , St. Croix County, Subdivision C'~da.r r1~~(,9 , Lot No. ~. 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 LICBNSBD SEPTIC TANK PUMPER. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of $3000 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 Auqust 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 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. 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 Department of Natural Resources. Certification form must be completed and returned to the St.Croix County Zoninq Office within 30 days of the three year expiration date. SIGNED ~~ ''~~~lLTifi~~%~:~'" DATE ~~'~~i' ~G ! / ,~,~~ St. Croix County Zoning Office St. Croix County Courthouse 911 9th Street Hudson, WI 54016 (715) 386-4680 Sign, Date, and Return to above address DEI'Ar~TMENT of REPORT ON SOIL BORINGS ANA SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND P.O. BOX 7968 HUMAN ~ELA,TIiDNS PERCOLATION TESTS 115, MADISON, WI 53707 IHg3.OS(11 & Chspte~ 145.045) A I 5v~ ~~ ~~~ ••~ p UNICIPALITY: 7 sZq N/R/~ (or ~uDsON 3~N0. L =NO.: SUED VI 0~1 NA C..~dkR. NILtS ~. SrClealx ,c.~ +~Qw~tc. CT--1''uu~~ •~ox 1g0) ~u~Sv+~t . ~a.e uw na USE N: r~ ~Reaidence f'~N K ~.. 14,New ^Replace So 1 L6 $Ael~ 6 ~~ Sn i LS ~ Cl RATING: S' Ske wkable for system U~ Site unwiteble for system CT T / 98F~ G~cT ~ / Q$$ 1z t; it d Q Ii'f" If Percolation Testa are NOT required DESIGN RATE: If any portion of the tested area is in the A under a.H63.09(6-Ibl, indicate: C t_WSS ~ (Floodplain, indicate Floodplafn elevation: NK ~,_ c,_ PROFILE DESCRIPTIONS BORING w AL AT -INCH HA A R O S IL WI HI K SS, L R, EXTURE, AND DEPTH f+IUMBER ELEVATION O V TO BEDROCK IF OBSERVED ! EE ABBRV. ON BACK.) B' ~ nj .~~ ~ 59 ~ 9'0~ 9 ~~"TS /40~ 6aN C` n9S ~G~ B- ~ q.9Z ~~J.J3 i~011~fr 1. /.7~' 11~~g'[LT~i /]~ ll ~~1,/~ Sr /7~~$Rw~~s R~I~R~-C-MIS ~1~ B- 3 ~SP,3 99_•7! ~ B F33 ~p"geMF'S ~~"QQ.~CSf6,t ~~•, ryS~G~e B-'~ 9.ao • ~~ 9q oN~ ~ 9 ~~° ~6 ~@~c~TS g-' B4~ c- r,s ~ ~a B-~ 4Z q'~,.~~2. ~ ?9.9Z 6"@~r.TS / 7~~6a.,.C-/HIS ~4 6- n„ ~ , PERCOLATION TESTS DEPTF~~ W E IN HOL TEST TIM NUMBER lr AFTER S WELLING INTERVAL-MIN. PER INCH P_ 1 S.7o nlotr, 99.60 3 '> 2 '~' < P_ 2 s .qo 99.30 3 ? Z <,3 P. S,oo ~. b > > < P- P. `t_E J p P Lt~- PLOT PLAN: Show locations of percolation teats, soil borings and the dimensions of suitable soil areas. Indicate scale or distangs, Describe what are the horl• rontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction end percent of land slope, SYSTEM ELEVATION 4 3 4 ~ gE,,,cµr,,N~~ . z "I ~o>N P-A,c ~LfVf~TIpN s J60,Obr LET 3 $-'~ / i ~!,' r`. F f bS~ o ~ I p~ I 4 i• . s $-3 ` \ $-1 P L ~ 1 ~' E ~i, ^ ~ - 4 N N ~' ~ wA 1' ~ i ~ j 1 F ~ O ,8.~. q8~_ ~~fo ~~ ~ (" ~y \~ TH ~~`r !'= 3d' ~i 6 ~ ~r1,1^ uJ e ~ ~ ~~ ~ ~rt 3 d ~i ,/ ~JJ/per y ~,o?sa SG// /'~ ~~ ,j ~ C r2 l/l < I G~J ~ c~f c~ ~a~CUi' L'v r l ~5-- (~ ~~ ~~~ ~ "~~D. ~ ~~ ~J I ~~ ry ,2 ~ ~ L ~~ ~ ~ i~ ~~:~d~. I' ~~ ,cry ~ 35 ~~ 600 5~~ ~ ~ ~5 ~~ ~-.~ ~ 5,~~-~ ~~ ~ 6(' G r (!` r/ ~ ~C ~ Cr~D n C 9 O o-a. r a ~ '+ o- ~