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Wisconsin f3epartment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 488201 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you ;provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)J. Permit Holders Name: City Village X Township Parcel Tax No: Regan, Kieran I Richmond, Town of 026- 1161 -14 -000 CST BM Elev: Ins Elev: BM Description: Section/Town /Range /Map No: V. (D ?& I J' - � �,�e k �� �. ` jai 15.30.18.1237 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic � s Benchmark ' osing � L _ � / Alt. BM . eration Bldg. ewer H olding St /Ht Inlet St /Ht O utlet - TANK SETBACK INFORMATION . TANK TO P/L) WELL Vent to it Intak e ROAD DTInlet ep lc o B ottom / 13.' osing Header/Man, b� , t era ion Dist i e o rng, 1331. Syste r � I al Uracle � � r tP N INFORMATION ,! �. �, y�,, 3sc] anu ac eman V" GPM model um er ,, r r 6, 4 , it 6.52. ,1(_• I . . F ricuo - n7- oss s ystern �ZJA 1, Lreemain Le i . 1 SOIL AB50RPTION 11 E" f DIMENSIONS ScIEZZ INFORMATION S ( t CABER O Vy .: I U15TKIBUJIUN 5Y5TEM . . __ .1 7 — x MOW Sp3cilly Leng[h 1 Dia Len'gth Dia Spacing �,...._ x Pressure Systems Only xx Mound Or At -Grade Systems Only I Depth over - Bed /Trench Center �'rl+ Bed/Trench Edges Topso l Yes No a Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1 - Ge e +�' Inspection #2: Location: 1537 127th st New Richmon , WI 54017 (NW 1/4 SE 1/4 0 Unknown) Cherry Knolls 1st Add Lot 14 Parcel No: 15.30.18.1237 1.) Alt BM Description =d P ' C� / GI 2.) Bldg sewer length amount o cover= r 4t'•d.kk.:,.q '.. Plan revision Required? Yep No Use other side for additional glormaUon. - Date - - Insepctors Signature - - SBD -6710 (R. 3/97) , �. t ��` -i.�' ,, j-f -" j� , •xl a. _, f 'tS'.. t . `. '� y x. v) :.l�Mt.. . AA Safety and Buildings 'uiSdon County n 201 W. Washington, P 0. Boi 162 �'� , l� f o) Aff Iv Madison, 3707 7162 C � nit Number (to be filled in by Co.) sconsin (60 -31 1 8 l Department of Commerce State Plan I.D Number // Sanitary Permit Applic 'on 2 3 0 06 / lk In accord with Comm 83.2 1, Wis. Adm. Code, personal informati ou may be used for secondary purposes Privacy Law, s15.04(1) T . /X CO NT e t Add ss (if different than mailing address) I. Application Information — Please Print All Information � /Std 7 / Z Property Owner's Name Parcel r # # Block # Property Owner's Mailing Address Property Locati 3 S O's Q O 412V4, r` A Section City, state ode Phone Numb 6r l (circl N; RX� W II. Type of Building (check all that apply) Ok 4S '5 JOJ Subdivision Name CSM Number or 2 Family Dwelling — Number of Bedrooms /� 1 * E]City � El Pu blic /Commercial — Describe Use _ ❑V' agC ownship of r ❑ State Owned — Describe Use Z C-& L5 (i G a t ^ �`� �` 'b III. Type f Permit: (Check only one box on line A. Complete line B if applicable) " A. a System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of El Permit Transfer to New Before Expiration Plumber Owner ,u IV. T ype of POWTS S stem: Check all that apply) _ Pressurized In- Ground ❑Mound > 24 in. of suitable soil ❑Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland Ell Pressurized firround ❑Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter chin Chamber ❑ Drip Line ❑ Gravel -less Pipe Other (explain) V. Dis ersal/Treatment Area formation: Design Flow (gpd) Design Soil Applicati9n Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (s System Elev ti ozz. VI. Tank Info Capacity in Total Number Manufacturer Prefab Site S el Fiber Plastic Gallons Gallons of Units f L Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the uLty for installation of the PO shown on the attached plans. Plumber's Name (Print) PMP/MPRS Number Business Phone Number Plumber's Address (Street, City, State, z / «6 �i VIII. County artment Use Onl Sanitary Permit Fee (includes Groundwater Date ssued Issuing ent Signa re tam ) pproved ❑ Surcharge Fee) caner en Reason enial "j ✓ IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: I . Septic tank, effluent filter and dispersal ceN must all be servites I maintalned as per management plan plaintaiMed 2. AN setback requiremef►ts must m as per apple able code / ordWinces• Attach complete plans (to the County only) for the system on paper not less than 8112 x 11 inches in size SBD -6398 (R. 01/03) a/ f tq 26 ::lfi:.E i tli�n' `1,: ir.., : M' < 71 • 1 1 ' r, !� p.. J6Q.97S � tJ �71Sc•�;j Nl , �tC: j 9.''fjb �tl�g ?3rd ES I *PRESSURE N PROJECT Kieran Reaan 35605 Margaret St. Aot 101 Romulus MI 48174 NW 1/4 SE 1/4S 15 W TOWN Richmond COUNTY ST. CROIX MPRS S Bird 226900 DATE 5/18/06 BEDROOM 4 CONVENTIONAL XXX IN -GONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1200 # of chambers 48 BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark SYSTEM ELEVATION 96.4/96.3 3.3' below q Property Line Well is to meet all setbacks required by WDNR Plans Designed Using Conventional Powts Manual Version 2.0 Lent >6 „ Standard Biodiffuser f Cover Leaching Chamber o with 25.0 ft2 of Area 5' Lon Grade at System Elevation 34 Please note: further testing was done to possibly increase the lower rate and perhaps lower system Pro 4 Bedroom elevation. Testing such a large area House does not accurately give one a proper tested area! 30, B -3 ST 95' 50' 1 %Slope 1 ' 11a. b1� 2 -3' X 122' Cells with >3' spoacing B -2 Vents B.M. * 33' Alt.B.M. 136' 9 Property Line LOT PLAN PROJECT Kieran Reaan ADDRESS 35605 Maraaret St. Aot 101 Romulus MI 48174 NW 1/4 SE, 1 /4S 15 /T /R 18 W TOWN Richmond COUNTY ST. CROIX 5/18/06 BEDROOM 4 MPRS Shaun Bird 226900 DATE CONVENTIONAL )00( IN.GR6 D PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1200 # of chambers 48 IL BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100° Filter BEST Filter ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark SYSTEM ELEVATION 96.4/96.3 3.3' below qrade Property Line Well is to meet all setbacks required by WDNR Plans Designed Using Conventional Powts Manual Version 2.0 Vent >6 „ Standard Biodiffuser of Cover Leaching Chamber with 25.0 ft2 of Area 5' Long 11 " Grade at System Elevation 3 4" Please note: further testing was done to possibly increase the lower Pro 4 rate and perhaps lower system Bedroom elevation. Testing such a large area House does not accurately give one a proper tested area! 30, B -3 ST 95' 50' 1 %Slope 1 ' 2 -3' X 122' Cells with >3' spoacing IF B -2 Vents B.M. * 33' A1t.B.M. 136' 4 91 Property Line RECEIVED Wisoorsin Department of Commerce SOIL E1 ALUATION REPORT Page 1 of 3 Division of Safety and Buildings i p p 4 1 Wi wfli't' m 8 � s. Adm. Code County St. Croix Attach complete site plan on papa not le=® {>res in ize. Plan must include, but not limited to: vertical nd hont (BM direction and Parcel I.D. Pending percent slope, scale or dimension , nee to nearest road. Please print all iMormadon. R Date Personal information you provide may be used for secondary purposes (Privacy Law, a. 15.04 (1) (m)). s O Property Owner Property Location wr 7 4 E Derrick Gov Lot 1 1/4 SE 1/4s 15 T 30 N R 18 E (or)W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1438 County Rd G 14 - Cherry Knolls 1st Addition City State Zip Code Phone Number oCity Village Miown Nearest Road New Richmond I WI 1 54017 1 ( ) County Rd G New Construction UseE] Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD 0 Replacement Public or commercial - Describe: Parent material Glacial outwash J6 $ Flood Plain elevation if applicable NA ft. General comments This site is suitable for a conventional below grade system. and recommendations: a Boring # [] Boring Q Pit Ground surface elev. 99.36 ft. Depth to limiting factor >94 in. Soil Appl ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Efr#1 *011#2 1 0 -12 10yr3 /3 - Is Osg mvfr as 2f 1 .7 1.6 2 12 -28 1 4/4 - sl lmsbk mfr cw 1f .4 .7 3 28 -53 7.5yr5/6 is Osg mfr cw - .7 1.6 4 53 -57 7.5yr4/4 sl lmsbk mfr cw - .4 .7 5 57 -94 7.5yr5/6 J A Osg ml - - .5 1.0 35 ❑ 2 Boring # Pit Ground surface elev. In g 99.99 >96 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/IF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "Eff#2 1 0 -18 10yr3/3 - is Osg mvfr as 2f .7 1.6 2 18 -96 7.5y6/6 - fs Osg ml - - .5 1.0 1 �0 • - 17q p • Effluent #1 = BOD > 30 220 mg& and TSS >30 150 mg/L ' EfBuent #2 = BOD < 30 mg& and TSS < 30 mg& CST Name (Please Print) — _ Signature CST Number Thomas C Nelson - � �� 227387 Address Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, WI 4/1/04 715- 246 -2454 Property Owner Derrick Parcel ID # Pending Page 2 .= of 3 Bonn # Boring g E] pit Ground surface elev. 99.74 ff. Depth to limiting factor X94 F -7 1 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Stnxxure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. "Eff#1 "Effl/2 1 0 -16 10yr3 /3 - is Osg mvfr as 2f .7 1.6 2 16 -26 1 4/4 - is Osg mvfr cw if .7 1.6 3 26-42 7.5yr5/6 - fs Osg ml cw _ .5 1.0 4 42 -94 7.5yr5/6 - s Osg ml - - .7 1.6 11 D Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Applicatiori Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/R in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "Efr#2 Boring # Boring g Pit Ground surface elev. ft Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Sure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 I "Etf#2 Effluent #1 = BOD > 30:E 220 mg/L and TSS >30 < 150 mgA_ ' Effluent #2 = BOD <_ 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608- 264 -8777. 31113- 8330Teat (R07/00) l -Cherry Knolls 1st Addition Lot 14 / 16 Scale 1" = 30' BM1 Top of iron pipe 100.00' BM2 Top of conduit 99.92' 98' B2 99.99 B3 99.74 N ort 04 95' B3 1% slope 71' 169' No B1 B2 ■ 100' 9' BMl 33' —► SW lot corner pT q — Thomas Nelson 227387 jr 1 \Vr1V TT . LOT 26 79,957 sq. ft:' -'S . rn, EXTENiSION J ` 1.84 acres to _ `s6.� L. B. 0. = 975.0' G°' Ui t'Uj cD ono \, j �`� z Z 80' Temporary \ Cul —de -Sac Easement tijl- co to be Ext/ngulshed upon �' Extension of the Road Easement ^�- � / o . LOT >5 • tK �,�' y � �h 98,426 sq. ft. / 2.26 acres . tK L. B. 0. = 975.0' 6 �� �� .� � - 0 312 � •� r\,�,�\� • i / 30' Orainage� Easement LOT t4 hh �S8 g0 • 93,166 sq. ft. �� �d 2 .14 acres , � POND L.8.0.=975.0' h1h�` 6( ,��� t? H.W.E =971.15' ,+ v ! 379. g / N84 '17 "w 104.98 99.74' 1 6 ' 479 I. LOT 9_ Corners fq // fin: lWater — no 66.99' p CHERRY monuments set 33' 12 — STAEEI / — — — LOT 11 NW —SE I 33' i KNOLLS _ _ - - - -- -- �� SW —SE j . — ..— I.. —..— on calls in the conveyance for the Prepare d for a at 7 Volume 699, Page 295, and th request of: gears this description was 0 WN E R - L. S. ,#1376, Dated 11/16/81. The iron pipe at the "monumented Steve Derrick -aid Deed and found iron pipe 1438 County Highway "G 59.73)�orth� and west of Said New Richmond, WI 54017 'acted regarding this. i. i ST CROIX COUNTY SBPTIC TANK MAINTENANCE AGREEMENT . ..AND OWNERSHIP CERTIFICATION FORM wnedB er 1 C�(1. ANN () C O I- ! -- �A failing Address roporty Address (Verification required from Planning Department for new construction) Ivistat N ��,J p,-�) Parcel Identification Number ,EGAL DBSCW ON '/ '/ Sec. C�� T '1= N -R�w. Town of �paty on � a, L # 'ubdi n �1-- �C`�2R -� i� r�� ► � . _�. motif Survey Map # . Volume '— — . Page W Deed # . Volume Page # - Spec ho ❑ yes 0 Lot lines identifiable Of yes ❑ no CE use and maintena,ceof your septic system, could result in its premature failure to handle wastes. Proper maintenance eoasists 0 r pumping ou t time septic tank every three years or soom, if needed by a licensed pumper. What you Put into the system can & t h e Amc ion, of the septic tank as a treatment stage in the waste disposal system property owner agrees to submit to St. Croix Zoning Department a certification, form, signed by rho owner and by a that( t) omrsitewastewaterdisposalsys m,ssax jo�ymnPl resWctodplumber or a licenscdpomperverifying t on- is loss than Ira full of sludgy is is operating condition and/or (2) after inspection and pumping (if ma the y)+ to maintain the private sewage disposal system with the standards have read the above nmgN and agree Codification Natural Resources, Stara of O f I1a � �, as set by the of Comnmrc+ce and the �P to the St. Croix County Zon Office within 30 stating t tic system has been maintained must be completed and returned expiration date. _ jjcc���� i & DATE MWAI OF LICAM O R R C O am are the o wncr(s) of that all statemncats on this foam am true to the best of my (our) knowledge. I ( we ) ( ) d abo by virtue of a warranty deed recorded in Register of Deeds Of= DATE APPLI «ss« «« Any infomiati t is mis4cpresontcd may result in the sanitary permit being revoked by t t. he Zoning Department. « « « « «« ss Ind a de with this application: a stamped warranty deed from the Register of Deeds office a copy of the c atifed survey map if reference is wade in the warranty deed 62009 KATHLEEN H. WALSH State Bar of Wisconsin Form 2 -2003 REGISTER OF DEEDS WARRANTY DEED ST. CROIK CO., WI bocument Number Document Name RECEIVED FOR RECORD 04/03/2006 03:10PH WARRANTY DEED EXEMPT 1 THIS DEED, made between Steven J. Derrick, a married person ( "Grantor," whether one or more), REC FEE: 11.00 and Kieran Regan and Colleen Regan, husband and wife TRANS FEE: 174.00 COPY FEE: CC FEE: ("Grantee," whether one or more). PAGES: 1 Grantor, for a valuable consideration, conveys and warrants to Grantee the following Recording Area described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ( "Property ") (if more space is needed, please attach addendum): kt* Estreen & 0gland Lot 14, Cherry Knolls 1" Addition. St. Croix County, Wisconsin. 'an vi LQCU Street j Sg 4 � ba l =tisQl? W! C-4016 , 026- 1161 -14000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated D �1_" Lo (SEAL) (SEAL) * *Steven .Derrick (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) Steven J. Derrick. a married De rson authenticated on STATE OF ) ss. COUNTY ) *Kristine O land TITLE: MEMBER STA E BAR OF WISCONSIN Personally came before me on (If not, the above -named authorized by Wis. Stat. § 706.06) to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: Attorney Kristina Ogland Hudson, WI 54016 Notary Public, State of My Commission (is permanent) (expires: 1 (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED 0 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 • Type name below signatures. INFO- PROT' Legal Fors 800- 655 -2021 www.infdproforrra.corn 1 Of 1 i -7Z � a 33 "E sr • • • ' • \ \� 212'60 c�' • • c p , NOTES / ELEVATIONS LOT26 cP. G$ 7 � MI BEARINGS A I 79,957 sq.ft. - LINE OF SE( 1.84 acres - - -' 85. - L. B.0.= 975.0' r EACH PARCI �ss�, . • \ - / \ O� COUNTY AN ��s • ' 7 -' / \ O WETLANDS, %P� \! BEFORE PUI )o cL 80' Temporary \� ST. CROIX 8 ^� v' BOARD FOR Cul— de-Soc Easement �L ro to be Extinguished upon v' \ . �.y��� + \ Extension of the Road °�; NO OWNER Eosemen t o "� LOT 1S INTERFERE COMPREHEN 1 •(L/ 4 ,h 98,426 sq. ft. THIS PLAT. ,16 0 , p f • • 2.26 acres OBSTRUCTIN .�' � L.8.0. =975.0 , 6 '� DRAINAGE E s�9 p S6? 0 g.1� rp RUNWAYS, 8 2 �. 9 y), S te h �h • • ' 8`319 '� E /2 / o- • >. F 65 SURLI 1 0 � � �• �o' i � . gs8 Eos ,�° The w EOT 14 �h/ / ' �0. 9.6 °o. the Con t r< -�' 93,166 sq. ft. '�� 72. MAD Line c 2.14 acres 19 L.B.O.= 975.0' ,ry / O �Q, sr� 9 C 66 I a sur % The b H. WE. =97J.0' p was t 379.99' t Off'' •15 114 c ' X04 98' 99.74' 1 c�5 I monu N84'47'17 W " 479.73 regar. � I I v,` CHERRY , - KNOLLS ;.99' ' LO 9 I I' ' LOT 11 s3�� � / LOT 10 - - - - I Prepared for and at the request of: OWNER: _ Steve Derrick 1438 County Highway "G" New Richmond, WI 54017 Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 C 7inte'sted y Plan Optiosystem fails, determine cause of failure, use alternate area and install new sys e replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option#3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715 - 246 -4516 St. Croix County Zoning 715 - 386 -4680 Pumper Tom Mondor 715- 246 -5148 Shaun Bird #226900 Parcel #: 026- 1161 -14 -000 05/25/2006 02:47 PM PAGE 1 OF 1 Alt. Parcel #: 15.30.18.1237 026 - TOWN OF RICHMOND Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type ®7/07/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - REGAN, KIERAN & COLLEEN KIERAN & COLLEEN REGAN 35605 MARGARET ST APT 101 ROMULUS MI 48174 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1537 127TH ST SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 2.140 Plat: 10/14- CHERRY KNOLLS 1 ST 026/04 LOTS 14/27 SEC 15 T30N R18W PT NW SE BEING CHERRY Block/Condo Bldg: LOT 14 KNOLLS 1 ST ADDN ('04) LOT 14 (2.140AC) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 15- 30N -18W NW SE Notes: Parcel History: Date Doc # Vol /Page Type 04/03/2006 822009 WD 05/25/2004 763731 2580/083 TD 01/31/2003 707784 2127/39 ALC 08/09/2002 686473 1944/309 m V p 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/20/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.140 31,900 0 31,900 NO Totals for 2006: General Property 2.140 31,900 0 31,900 Woodland 0.000 0 0 Totals for 2005: General Property 2.140 31,900 0 31,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 n o K y 0 c 2 ® % \ 2 R a J q wE2 M 7 � \i ® ƒ 7 2 / f ° § ƒ \ 8 j ° } 0 \ III) CD ° ° a) ° \ 2 \ @ \ \ / CO \ _ ` � a E g - \ ! @ = ;z g @ e \ / \ § f CL § \ m 5 § i o_ © 2 2 $ \ ° ` \ / \ \ 2 E 0 m r-3 2 2 2§\ PL - .� ® 9 0 'D - J i g k Ul > ;-4. \ \ C CL S = g $ \ 0 \ CL \ & ] / /j �. / ƒ m r 7 p n N . & § § z J 2 / / CL w ; { \ \ � \ C % 8 § _ � \ k k 0 CL \ \ 7 7 o \ @ 4 N z \ §_ » CD � \ \ CD / § a 0 % ] / \ G \ / g § \ \ 8 ¥ \ R ' § 7 % � \ S � , e 0 / ° \ @ i CD \ @ & \ a \ \