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Home My WebLink About040-1045-60-100 (2)sMry.m s�iup oh.aa„cmh.rm PRIVATE SEWAGE SYSTEM LOunry St Croix INSPECTION REPORT nP.mu No 61]835 GENERAL INFORMATION (ATTACH TO PERMIT) Go,ml don,mn Yee ODIC,elWW NUIMP spotallvemz4- DAVID BRUMMEL ma wl.2e rom¢TOWN OFTROY eTOO u 040-1045-60-100 m HOD p imp We ,®oFm o°rt °p 1a0N28.19.150G TANK INFORMATION ELEVATION DATA MANUFgCNRER CAPACITY STATION BB III FS ELE9 SeWc / �5 � 2\ Demhm 2.6L I04.3b W,.su W p IdL R 3zD AD M Anlek,I dmwjeae.sNrer xealre - _ -- srmnmd i TANK SETBACK INFORMATION III 0utlD TANK 10 PILtWELLWELL LC iwaa ROAD OR lnld 6wwepnnlnnmgg SO ROD 3 / AenMen G®I>pdIB6 E2 S.S HOIdg Ad 6pdm PUMPISIPHON INFORMATION EMal Graa So Menuledurer Dementl GFN 61Cmm umhe Model Nbole, Ye � L 3� ISI Hod IT7 F1 sr FpNemah Leber D�#_bek L °uh D°.; Ta. he, wEDrel P.¢ DO' LCud Dmth wn<5 sysTEM TO P SLGc wELL I(FJsireEAm �/ — .M< tRe"2 W.F� ro,�(P�..m«1TweR 54' °X"lool 111 >)m' DISTRIBUTION SYSTEM (y455p.ah, I'IL\ ,NeInPh Dl CR ah. °icx. Leo& o-sF„+m mar ems l I. SOIL wph Owr aPq a..• .°.° e°°X.. mm"Id .�, Gm.r ...h Eam, I , N° Y.. � D° COMMENTS 3 oduFde iCo•cd^e cmecmeeoces. Person'a �preR®Fm, Wc), {� `YIsol pealex31S441zo ym¢porx LOOOI 453 HW35-�WB11,4 11AflSMOnO', Si SS' wazIBIOg¢weCy. -aLdme �4b �p q ct' Ly r<cel�Q aYr y1�i(L¢I aD l a+ (� AND 2 �/ ( IV ` gj.P.r �:' 01T" ¢ c N ( T'cow NofQ/ 5w P`P+e�VMAB0 D s° SRN 2cA,o �� IlMetly Enrarme awpn 10TEWWhglen Rw ymw Pamn NmIMmW fllW In 4Cn1 \.�� MAR 02202 �Iz Y PPlic ' r, eu:l,zl w„ Aar I. nFlr6 v a,, ""40°'•'� awm W mW m ,: m,w-Isw are Jm....b MEw.n.w�,o(..,a,.�a�nlR..nna+n.�p..,ow �,rm wl wlq Wme A455 woow,-11 l,PaLwl m.mw H. 35 I.A Ik.fbe wbe-Plow Pne+All hlormeMe Irmenborne Emd8.wVAw m,p S(W...... ooixJ m6 w IMSMIW p mryom, b b ,u udm Newer Lmum gNWL 4eveim Ip CM.EIw o- FlowNord, m• WS rywry DN k1Fwerp bowl IL Ty" of BepJbL ROe[L all loot Ypplyl ❑Iw imllrl Illq-homer FEeLww Im Nerc _ ®w611KwnmaW I.mlbLw 53:5Gvo 57-v✓(0 NA plwe. ❑Cw •r ❑nwri bAme.wa ❑ ai ®, FILI'MraiNimit C I we hoewfw.L Con Mellne9ife ❑Na. Srynn ® mlm5nlmn ❑Tnumnwlrvmnd inl NW6vmlwy ❑clwwar-Ip-r�m,�I.I,.mrz�InNe. ❑mewllfumwEumq Spm Implore °� IK.w ❑rater u.mm 'Piw�,m Lm rw„nn rclml�N mev.e leer nmWr 1 m I %u 196a- "w lo2�sa' IV T of POWT�m/CYrmlm (Genk ell lhPl epEl� - dJ. Avmefl rrvmm�a ul ammo .. cmu<' m.alM ea ® nm o p rr 1. crwlna ❑ m ❑ m ❑ ti,aPna<n In arwluele Ml ❑Ilnlelnx9w\ ❑Ixnn olrw,a Cwllpnllelgeylnm ❑1'nu �LL'mlrne mll` a V Os m"ri Area WfnemcYom f 3 r m,w rlo.(W) aSoil ApPneam .weW+n In.mAAwa Nmal u15 n6maAln Ian sSww FJwum 533 761 m uaP 07 VI. Took lore cimaar,(emw /C6 loc LF g@y Ajg r imoib �r.ys �k sl SgmwlMYyTN 3w IWI, IOT S3M 5 Wlm Cwwae m(e __ _ VII. W Suuseeb Lueeewoyagwwerwpw6pYryrwMPoNIS mewuMpYr Perim N ermI6ir owlwml waw 9,mw P�Merim ik /K'1J(✓L� flamb r AWm ISawL Cry SAME LPCOde 586 Valley View Tnll.%rab . Wl 1e025 VIIL Cnue Ne tlmen+UU OoI �Mpmna ❑Ir povW Pmnn Fw �y uN g,Sgry Slp/I S .5'w� ! L 'IpJyl MC"dki,ne a Apo .... MwmwnAir OwopWm'ol i y4a }W SYSTEM OWNER 0 �.,(� ' �'" + d"ropl mlem,eS rwµV i mamma blIN{S 57 -.r. (" o ll _tovAAl o:p ntebeilplkn ProvdeE py plumber, 1., liRgy�El GACQ , aP6639 (lW311eI RECEIVED 5-6u+ + 514�p4tm Mc JV4 FEB 0 2021 SYSTEM PLOT PLAN Project Name. Design StuY¢Roaco Wr N4--. N SAves PAwnaee�...-.. In amk uo w p" �wew.co"mea �uow RMI m� A a sole r•ev oe+ommn .omn� manors o s.Mm am En m iww T aym eommm mwium wm EA,Tm M. prnru.�m..�..�or.�. Rey lFe FeNnplp Ty.3x UEaw Dwd Uac.B n. LY EZ fM Mach El.N sws Bz no. e.�m El xea. • w.p ..w(30V ya MR0 Gene p.Mw w Veuns UA emWu M,, pmgf To Beueneo.e em,q uw SMI Gen+ veMYq Eenan]Ant a n Pm,,Amwr 9-MR storm B'Mma EM EIWV Imaellm eB- n mmwn pnwgb J � NgeweY ]5 � M G] SYSTEM PLOT PLAN Project Name Aves Design $ILIEIG wwpn ra, svewm,.w, wwum. e. N Pulsoneered ... 'onnp.�deny °i' jim B all ASTUSIondual Swk 1"=8G' U IS) 120 Bu. Eerao nm0 11 Somali avovmcur we�en�vuo box you, wi n mvuwl wreu loin pi �G oddeM Lim a.eain 4 wa''%az'"sz fi LWEZ Flow rmn[B E1 850 i3 ]n50 E2 Pow Yenc� Ei550' D 300 EE Flow rmncn Ed=950 P•opcxC Clay " Eldm6YIIpp we'll al Grade Y vedm9 td Gran Fenno Lou —Evia n Gra p r To Bew Pnoorao Peril Lot y@ Q sew � N vra din¢L w]]a mB a �o �seE.Ildn Buildingp Bepo[ia y� Be VJ e 00) P9 • �. ` 1 Sal land 99 Dnvrur Dndawaru Xi9MaY 35 96 _-PrepaM blue_ 9] Pa g¢ 3 IL U ..,s, Mm6Iq OF INmr6lRY SERVICES VI Lost PILL�x sx, ��y� �9tr Il"t_._ vh� From, Erna. owsmmr March 2, 2020 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES. 2022-01-02 Plan For" PWTS-03200QLC IOHN F SCIIMOT 61615MAle ,-_ ��-dw i.•.f Swnnac: WI 54025 SITE: Aves Design Studio existing building 4551POV35 Toxmo"fray Saint l Cmmty, Tole Amount: V5000 FOR: In -grouts CamFmem Normal -Vet 20,SBo10705- PMman, R10112) Amount 533 GPO r£noloren d FELL, Dnow) Mler ewi¢Requved The eubmaLl 11111mcd Wovc has been rc¢wW fm cmfo ntt with rpphonblc Wrvconun Admmmove Cons, eMWissmoli Suwles The submnml has been CONDITIONALLY APPROVED Thrssysimrstobe hoomml estimated it accor anw who T, md,i approved pinns and wnb any mmpommmanmlfsl mhormalabove The It as de ims! in roper 1010illed. WSswmm, idom et is mpnneble for romplmnw wNr all mode Normremenm No person may enaage m or wort err Plumbing In Oe men unlm I¢cmN W do so by drc Depanmem pays 145 GA yu. The folloxmil a ndwons shell M met during m isuue on an mwllarmn and prom amFanry or met POnTS m sued 1e1JmmIIw ennru It" Illy' • Front dopenal area poor and during constructions 0 wood dmwrbm¢. wmpacum and ase of do site With nex rannuedon, It La mcunrmendW wr W ssmau the pump in de dove um4 unml the IanYs or PrnrpW plot W hmnmwnn occuat wmtewner 4eorated from aomraunn clearing oregmpmenr and Wols random left non con JUSKM mode: shall at be dr.mugcd into me dra ere hhmi to the pnva wssmwaM oea aWal IPL waste genemeedrhallbe pmpnly disposed of missile or oR spexitc plven mrteee water from POSTS Art, All plpine ehalL Cmfmm W SPS Table 184 lost and Spy Table 15a MM Inrloe mall at beyond to feat I SPS 382 301rye) Tons twellmon W fall,. sit nunafam IraawmnnWomu VerlQ peopeT'lioelal poor la mrYllatmn Owner Respousibilllies • The.urnint farm, and cash Ibequent owner.shall because acopy of this I beef I minding 119toksuffe mlat"se m props use mlmlan, oltheayewnor xM1allrt ropy at me m rearm eopti and maintenance manual andlor owners menial lm the POWTS demnNN in lino approval 8P8383.50111. Io mecant mmod Itimpnan eyamm 11 my arms component parts malfun ahrmm hmnd. the pmpeery owner must follow the cmhugenny plan as damnbed as in, opptoval plans A usly, of the approved plane, becaficanom, and get lever shall be anyoneww dngon ma,pi nagiecuw bytbw auvN tpn aentauve*of me Deparooca which May i" IMIC kind ina¢wa ctAffect rtymeel by the stale or me local mumapabty Judi be obtained moan to commencement f <onawntomtmYllanoniapenenn In granting may approval be Duane of lndmuy Setv¢es ricerves the nght W rrymrc'hums" of addmmu should andnlans arse making them nacuety for "a Imminence Aa wettest, site 101 13(3), nothing in this mtew shall bib... me dcamm, of me ruxpommilty for deugnmg a vfe building, x etumo or eompossm. Itpumei concemmg chis artespond<na< may be matle to me at be telephone number baud below, or at the address can do. Icombed The sous left mdybouse shall provide a copy of this letter and be POWTS management this to We owmr mM any when who am ,pym,u ,toribc matallon".0 mmum,w mmnteaana of the PoWIS Thanks, 7 Viw .him/ POWTS Plan Reviewer— Wastcwatu Specialist Department of Safety St Professional 5<rvunx l Dayton, of Industry Sereax email in, . dnI. u8,. Cell 608-5orer u 16-6134T1 CONVENTIONAL COMPONENT DESIGN INDEX AND TITLE PAGE Protect Name 0evill Name Oo,d B,emmel Game, a AEUreas PC Boy 433 0.ner rally WI a@l Legal Desoiprmn SWl/a Nei SI,RBN R19W Township Troy County Sr Crew Subdivision Name NA Lot Number. I Block Number Recall 10 Number 040 inns 60 IM Plan Tranlal No Pagel coder, and lank Paget Gallon per Day calculaLom one 3 Plot Plar Pagan Cast ng Septic Tank SdecnrcEmns Page Cnst ng Talk Cannibal page 320 Gallon Sept; Tank SpenLouOm Page I pill fare, information Page Spstem Sang BGoss Ydwn page CZ Fdw Information page l0 Management and mmOngemy Pla• Page 11 Sepu, Tank Maintenance Agreement Page 12 Warmly Deed Page 13 CSM Or Plat Attachment ba keguabon Report Attachment 2 Rial Plan Designer John ScImur MPRS 221760 Date 2/24/2020 Phone Number 7151600486 Signature IrvG,Ound So,i AbsorpOOn Component Manual Version Z DSB0.102oS P IN Ol/01) Page 1 Gallons Per Day Calculation FOR Aves Design Studio Building Aves Resign Studio is an existing business that manufactures they. The business empluys 10 employees and has 9 four drains. The building is serviced by 2- 1000 gallon septic tanks and a 24' x 52' rock & pipe soil absorption area. A nest' building is heing built that would necessitate rerouting the effluent line. Rerouting could require over 31N1 feet of insulated line as it could be located tinder parking Int. It Rase determined that a seem sod absorption area for the existing building mould he the most cost effective septien.'I he existing soil absorption area "ill he utilized for the seem building. Only residential strength mastecmer mill enter the scphe sptem. 10 employees x 13 gallonsklay= 130gpd 9 Floor Drains x 25 gallons/day = 2259pd Estimated N'asteveater Flo" = 355gpd Design N astem titer Flo" 355gpd%IS=533gpd Septic Tank Capacity 533gpd A 2.088 = 1113 Gallons A 320 gallon tank mill he added to the existing 1000 gallon tanks to accommodate a Poll Ink 525 effluent filter. Pete! SYSTEM PLOT PLAN Protect Name. Aves Design Studio PIACPAddilms Bar eu Aaa So DeSumof u°sv.em p ae 9Yw no�.§uw �Erexww l °a eaew.lm.®wee,«ww truldw vw spool a o°a®un we90 Eiw L No. .. mow, .w s sa we I Growl acre Lw ec.°4 Co. tea, T13 qv pertr El%V R-UMUFla 1mov,461 7 TJ-Ix]V E2 Fkw um.YiE�OV Pigo..e W1 Ew°� VAroazw 9W,g VMY Gor Paw.a Ld GrAWA Palo, —TO Ve MCMmW i.rum Lm War GreM EnNpIG AWe Mqn eM1+rp Prepeye MMIAR Stoic 13"kartl Sopf BM .3 re 99'� `1— 1Q SNOk Ie� forw'4; Gaw .v D+w,ov 1p nren..vss � � i r�PmpflrY Page 3 WL P1OOO—ICI k TANK SPECIFICATION - oluwe0xs _ 1/L' .n». ssanC r OPAIR TJENI c siFSE. LOAFER »I,.' 00 . iIGILivAT ♦ yA .... FOOD INS' O 'r OF PANLEVEL z' OLD D OR. 02, _ WEIGHT LO 9J L05 MET AW ! unLL N 3M' FAEQUAL 's4i, GASi-E-4._ BIgI OREW.L lEn OF AND oVRET WAFFLE • _ ♦5R V9H. SEE Ki4, EI] ( bi T STALES SE ixAALI uaw AT A nm D./A .wn..L PUP 0Ew HOLE ftu�r LL/SEACAaACItt I O ALLwS L(W), .`XN P 0' UNIT JVATED SOL TANK API USED AS UP iT / IF FLAT, F sraw COLFA III FEIGNp MO LOT No .. rEsw no FF j LEST AF TAr.oL a h .m uxrs CO TAo WCMR COF ET uiI 22* of "ET s nrE aAaJ•Acrw¢o io FEETPAPr.cLLo Asn c-in. acwEa�cars ST. CROIX COLNTV ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF F.NISrING SEPTIC TANK(S) This is to cendj that I hate inspected the existing sepuc and or dose lank presently serving the following residence (Street address) ass Hwy ss _ located at: Nyy L , Hw I,, sc�hon to . loan za N. 10inge 19 Imtnor Trov St Croix ( ouut) N'Iwon.m Upon impcamn, I ccmty Ihm hme tonal the tank(. I. m the he>t of no knua ledge. w III canter In to the rcyuucmenlb of SPS 184 25, and it (thc}) appearO m be lunctuming properls Moss recent date of inspection orsert ice Did flow back Occur Roar dhsogmnn sy41enil Yes No x Ufno, skip next line 1 Approsunale tolunte or length oftimc gallons minutes Tank C'apaatq toga moo Consuacwon. PRcfnh Cancrele x Neel Other Manufacturer Uf known I Ngeof Tank(ifknoon) az mars Perrm,puunrber Hf knooN ionge C%j. JohnScnmm (ensed Plumber Signature) (Prins Name) MPRS 2237W Tito o I I mense Number) NIP MPRS -�- b-z Fomr Io he compined he licensed pluinher IDept ot'Safem and Professional Senlcn (hdpinr lo5 and, Ili IN. N mmnsm Statutes) or licensed disposer INS III Ni%con.w Adnumsirnnc ( odtl Rct 2 2012 Page 5 W320-MR TANK 3PECIFCATIONS ^rouRrt BEER ��.AS 1111 ME OF FM POST oo ANI) ) SET Sxa P STIRS "iw"MITI wo.r. n as urFITTS W�2 y - !. REM STIFF wJuuv.w 9• ST YEEO ' 1111son MEET EST,uuilrm) 1 rry I u ira cww r x.xe cwnn+ gy5 Y q "SC'K! D p TOR A PRWAPftWA OR L P 1 ar P"K, w IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with EZ1203HP Bundles In „ 3-ft Trench (down -sizing credit) t u n TYPICAL TRENCH LTNCH CROSS SECTION VIEW (WScott oe. nA. 95W TYPICAL TRENCH 'v.,1. .V.a YlS , PLAN VIEW ... INO Stak) — 10 Iy� qy IM1val Y r B B•H INSTALL PER TRi EZIMAIIii lyp") ne . hihn, nI AlammhunnuL l+rcBM+.Arm 761 � pptrAulon Auiu] 11 "Tee,PA1P1,,J 01, IISA Lriinched mmnJUA FSET Installation Instructions for EZpojj,Systems in Wisconsin .... _... .... ... er I y 5 li av 150 .A11 ei i5mSc14Wa[o 6 Lvu.n_i•.a, If o,.., If ,n.. i I„ F MaluMa and E9lranam Neer Inabllaal Inexacta s I If �.I j .. wEZfl E ..... ....... _... I........... I.... aLtAh, oil ra hl I IN I' ary ra s V rm III mall •te na,, J,.wcje III(i and IF ,'I n in ri nr+l. lne � Ir inrI U� t iJ N __ a .nPS r; Ne f ,B for u w.H+) I a+ F➢Xw un(y.rM m an nm r1. If o.,yr. a III ,panm 'or V e Fal if 1me <or'le.iry ou pr. nyr All If . aYS.g.1. wn nF .a(' ^n a'Me IIIae .. .... II aK al -n ins .PI .. 3 w.N n.l�r gw Wao . . e ec It (uy might 11 t if Y If, .. a1 11 1 If I j."I 1 11 n .. I r.,-r..,..e:em ,'1.e t]WH.OEO f+n, IIiro Faea 9 In -ground Gravity Management Plan IMPORTANT, The owner of INs in ground grai system sna'I be responsie., Ol is Colombo ooealion and mamlenan¢ pw want to rtyoei of SPS 382-3n4to°¢AtlmmLnnr n Vc:. anto born o' S I AlsrAdmnr system s�an My wnaial a human health hazard II not inevitable In accordance with this approved management plan Funhemlore all mapeclwn am maintenance activities "If W performed by a raplabrN PDWse estoppel in accordance with SP9 303 520) Ww Admm Coca DammiA O M. Design Flow 533 gpd. FOG, 5220 bol TSS 5150 III t FOG 530 fors Inspection Checklist INSPECT EVERY 3 YEARS type of use no a system nuisance Nctore U e N M v eMtWaNR eml marmanical malfunction u e mimK ewes switches costs alit l maieve faagu d e teas breaks Company etc I cl.ds vd_me. aa.se.. 9va'� - yher , I a dellP'or dui •Kur'enemoe - rygleotw^ _ r¢Mmg rosy' a[i PS p'O^ 00 arts' -PS c etl¢m .i jell Closing ercom4nlleAdippegdela pump b^pcunng ttions stions MaOiasc gs omatt costry, utr PMnprl0,l y fappb,'ce plyae 11 nQ (measure aferal*" IXaxpretroll; own alarms compare IO C gn efpp%IfKO pit) gslace thalateral Of laley onfce pl codex drarmarge d ellkienl Of xwapa bKkW in1O YrKlme xnM WinMnapee CMpkhpIMAINTAIN EVERY 3 YEARS for wean MCxury1 Sole and May ai rr re H.ly a.-".'erial or ],p<. a•. r - jr, s28'bVas Srats when Me volume of sociaa m the All aaceads onHmnd I113I the Igwd volume of the tal or AS byl by year vibrance insposal of rmlents shall W wKwayst to Net 113 Wx A6nm CPAe Effluent shall oeinep m NNy 3 yxn and see be cimM Wien nor Uto remove ads yet accwdrng to manobcover s specil4uwq Aanyone MO ass $ee gra than ti months System maintenance reports shall be submitted to rno proper loot government unit in toroidal wrial WS M SI WI AEMIn Code RW" any Camp "nl lYlYn Of maft MMn to Name of Imemual or cOMI Schroth& Sons Excavating. Inc one 715-760-0486 Local goverment red St Croix County Community Developement ph.. 715-3864680 ,mat gor¢r.,,, .ry In, West1101 Carmichael Road Hudson ZIP 53016 Any bervti opoi mt,s,al:... anal be ra'ed to fl-,"'n+eb p..,.<1 a to SPS:e-'n tt Cry Aemm Code Rascal or repacement of rafted or malfurfttnnmg componen s shall rot with Sure 383 Wuc Addl Contra No product for chemical Or drab al mloratlory of the COWTe may de used unbar approved by the aepanmem m acwMence with SPS days Wtac early Code Conunwl Pan in tine c.ert that any a to treatment :amponer a:'^a POWS carrot be repenoo d shall be replaced P. =uam m aplan 9ubrt'i ed intheappwp.nr^^beyrrrWewai W?pnval A oled�n.gtwud dnpen^mnerIIrI adanoonea ano repaced Oy a cudesomplvurg a.apmxl rurponem m a ptaC•iermm or aces of suluba eoia System Abandonment If use of this POINTS is discontinued it shall be abandoned it accordance with SPS 383 33 Wac Maim Col Page It ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Carybe Enyer David Brummel /Aves Design Studio Marlmg Addreaa P.O. Box 344, River Falls, WI 54016 Property Address.455 Hwy 35 Ifenficabon regmred from Planning& Zoning Department for vcw contractor) Clty/srnteHudson, Wl Parcel Identification Number 040-1045-60-100 LEGAL DESCRIPTION Property LocalranSW _'/., NW,_h10, Sec. _,T 28_NR19 _W, Towo ofTro y Subdivision Plat Lot # 1 CertiOed Survey Nap# e'/bb93 3 Volume (c, ,Page# 160110 Warranty Deed# 1113ef 1p (before 2007)Volume 'tZ , Page 0 Z2.0 bpechouse Dyetmo Ut WestdwnfiubleDyas0w, Mompm ee mad ,,,at aof concerns, y ma .old rcaulu Rprcm [e fa,lare mbwtllew s Proper Consists of pwgmg out the eepR tend every two years or sooneq if needed, by a Inwas,11 pumper Vlhat you put as me System canaft the firrictio, of the septic onk as a prompt stage m the waste dsspmal system Traermembnen<e responsibilities are specified in 6SPS 383 52(p end tit CluPte[ 12-SL Cmm Courry Saran" Ordmerce l'he property owner agrees to submit Ad St Crew County Planning& Zmmng Dipsomaniac a ce�Mcauon form, signed by the accused and by a master plumber Sou wiSmanprotect. mmcmd plual oralowest pump[[ venfymg that (I) me ad site rtodapmelrystemin props operating common smd/or(2) after accredited literature eon aartyl, (ifnetame sept¢wk to less Dan 1/3 Tell of sludge live, the undmiw® have mad the above mqunem is and ag,a to mmneun We pnvate sewage Slowvl imm, w,,the mmwi tit forth, hercm, w sea by due Depvrment of Safely And Prcfaslot Sessions and the Department ofNawral Rrsourwa Sine ofW,swrmm Cemor statmg fact yaw septic system has ball mammmed most be completed and reNmmi in the ST Croix Cmmty Plammg& Z.ome Depammew wnhm 30 days of We three yew expiration date lwe ccmtytlut It Statements Ad am farm ate are to the best of mount knowledge I'wo mNme the eumerys)ofNe property desmlvd alas, by sum, of a wmmmy&ad awrdcdm Rrg»crof Dods OITtt Number of bedrooms 533gpd SIGNATURE OF APPLIC NT(S) DATE II'Any ,,formation that Ia mmepmscned may result m the territory parent way revoked by the Planning & pan nmg Department... burden Ala We application a recorded Warranty deed from me Aeguter of Deeds 011ice and a copy oft[ certified society map if miumni made,, the wwwwr deed (ST cal I Oe nl of SOIL EVALUATION REPORT 020i9 SiSalary an, n arnnraa.a unn Cnmm 65 Wrs i0m Cost1 d J 5 Flohal 21 Sai IminxSIN Ti ma WnH my INI wl� P oin i pso"B mw a Si. tnnry Isra my maioorn nomama mneneilm IiL mlormaaoo O4010W Gs Ilm Pleese iall B W¢ aoamn iv i .na w.rr°,.. w4nlOwm VeM lxa un Br mrMl Oevrad SBnOra Owl. 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