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HomeMy WebLinkAbout034-1004-50-000 SstBt,� L4—' D St;I71tAC Permit A I'IG On Safety & Buildings Division Y pA 201 W. Washington Ave. In accord with Comer 83.2 1, Wis. Adm. Code PO Box 7302 scoms L' See reverse side for instructions for completing this application Madison, WI 53707 -7302 Qaepartment at4:orttmecee Persona: infomation you provide may be used for secondary purposes (Submit completed form to county if not [Privacy Law, s. 15.04(1 )(m)] state owned. Attach complete plans to the comity ecoy only) for the system, on P a Off not teas than $ -1/2 x 11 inches in size. q Stater yit N=arnber Check i revision to previous applicato0n State Plan 1. D. Number � p Q .3� 1 I. A lication Intormation - Please Print all Information Location: Property Owner Name Property L�o T 7 a 1/4 U '4 S le N, or W - 1 , L G� Lot Number Bl Number Properly owner's City, State Zip Code, + Subdivision Name or CSM Number _.... ,> c' c . ' dl 3 ❑ City V. II. Type of Building: (c eck one) Al! *y I ❑ village Lr I or 2 Family Dwclhng - No. of Bedrooms : Z S� N r"t I Town of d ❑ public/Comnaercial (describe use):_ S Pte/ O Sta caned Nearest Road Z -e 3D j III, 1C a of Permit: Check on1 one box on line A. Check box on line B if a licable" 5 6. Addition to A) 1. Now 2. t 3. 0 Replacement of 4. Existin S stem S rem S tern Tankk Onl Date Issue Permit Number B) O A Sanity Permit was teviousl issued IV. Type of POWT System: (Cheek all that apply) � Mound O Sand Filter 0 Constructed Wetland 0 Non - pressurized In- ground Cl Single Pass O Drip Line O Pressurized In- ground O Hotdirg Tank E 3 At e 0 Aerobic Treatment Unit ❑ Recirculatin 12 Other: V. Dig A 3. tspe ersa.!/Fre itmetit Arealnformation: Pd 1, Flow ) 2. Dispersal rea tsa Area b. Soil Application 5. Percolation Rate 6. m vau 7. Fins tirade Rau (GalsJdaylsq. tt) Win /inch) ] 4', Elevation Requ � i � red� Proposed Capacity in y Total # of anufacturer Prefab Site Steel Fiber- Plastic VII. Tank Gallons Gallons Tanks Con- Con- glass Information Crete strutted New Existing Tanks Tanks p O ❑ S Zi �t�u _.— WI ❑ O ❑ VIII. Responsibility Statement { tiro urtdersi assume reshonsibiti far. instai:ation of the PO e N ohed lens' S;mss phone Number P umbels Name (pant P um ignature no stamps): S r� Z57� �.�1 �:S PI s Address (Stroet, City State, Zip C c 5� !A Z IX. CouutyPDepartmenfi Use Only i Is r ; Agent Sign (No stamps) ❑ Disapproved Sanitary Pemu {fee (Includes Gtoundwaur Date Issued '17 Approved O Owner Given Initial Adverse Surcharso Fee "�` l \ 37 `�t� (W"b Zed Determination X. Conditions of Approval /Reasons for Disapproval . ih�l s a, A OA 5 4A pA CSC s IS 14 A.Vb t 2� G CiC OV v �s TW► 3e�� da_ �� �k Yo Apt nl - 1 _.fir,S s O W IVC— .�, W) , .VC c iotIAIW Ctry, Ct�e S/vt3 Ilf E FF ttuS 3 ozq Cft(-- Safety and Buildings k AA 401 PILOT CT STE C WAUKESHA WI 53188 -2439 = TDD #: (608) 2648777 �sconsin www.commerce.state.wi.us/sb Department of Commerce 1 www.wis 1� Scott McCallum, Governor 4 Philip Edw. Albert, Acting Secretary L V September 27, 2001 CUST ID No.224617 S : POWTS Inspector LYLE J MYERS�� '�.` ,. ONING OFFICE NORTHLAND PLUMBING INC � ` ST CROIX COUNTY SPIA E1556 ST RD 64 1101 CARMICHAEL RD BOYCEVILLE WI 54725 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/27/2003 Identification Numbers Transaction ID No. 676789 SITE: Site ID No. 636687 DEDRIC BAZILLE Please, refer to both identification rtumbers, 1199 HWY 128 above; in 01 correspondence with the agency. TOWN OF SPRINGFIELD, 54013 ST CROIX COUNTY NEIA, NW1 /4, S3, T29N, R15W FOR: OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 813966 DISCRIPTION:300 GPD MOUND SYSTEM. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Waste Treatment Systems" SBD - 10691-P (N 01 /01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD - 10706 -P (N 01/01). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • Maintenance information must be iven to the owner of the tank explaining g tin that periodic cleaning of the filter is P g p g required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19 Wis. Stats. q , • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with g 1? the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. A copy of the approved plans, specifications and this letter shall be on -site during construction an open en to I inspection by authorized representatives of the Department, which may include local inspectors. All permits Y P P LYLE J MYERS Page 2 9/27/01 required by the state or the local municipality shall be obtained prior to commencement of construction /instal lation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 THOMAS J PERKINS POWTS PLAN REVIEWER, INTEGRATED SERVICES `S de� 763 (262)521-5064, 7:30 -4:00 TPERKINS @COMMERCE.STATE.WI.US Safety and Buildings # 401 PILOT CT STE C WAUKESHA WI 53188 -2439 s TDD #: (608) 264-8777 hsconsin www.commerce.state.wi.us /sb Department of Commerce www.wisconsin.gov Scott McCallum, Govemor Philip Edw. Albert, Acting Secretary September 27, 2001 CUST ID No.224617 A7TN.• POWTS Inspector LYLE J MYERS ZONING OFFICE NORTHLAND PLUMBING INC ST CROIX COUNTY SPIA E1556 ST RD 64 1101 CARMICHAEL RD BOYCEVILLE WI 54725 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/27/2003 Identification Numbers Transaction ID No. 676789 SITE: Site ID No. 636687 DEDRIC BAZILLE Please refer to bpth dentiCation numbers,, 1199 HWY 128 above, in all correspondence with the agency. TOWN OF SPRINGFIELD, 54013 ST CROIX COUNTY NEIA, NW1 /4, S3, T29N, R15W FOR: OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 813966 DISCRIPTION:300 GPD MOUND SYSTEM. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Waste Treatment Systems" SBD - 10691-P IN 01/01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10706 -P (N 01/01). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. �1 A • Maintenance information must be given to the owner of the tank explaining that periodid le .0 131!�e filter is required. Access to the filter for cleaning must be provided per Comm 84 product . approit �� ��ts• � • A Sanitary Permit must be obtained from the county where this project is le ed in a a ith the q requirements of Sec. 145.135 and 145.19, Wis. Slats. CO� r • Inspection of the private sewage system installation is required. Arrangements for i ion shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), is. Stats. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits LYLE J MYERS Page 2 9/27/01 required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 ty , _ BALANCE DUE $ 0.00 THOMAS J PERKINS POWTS PLAN REVIEWER, INTEGRATED SERVICES WS ode" (262)521-5064, 7:30 -4:00 TPERKINS @COMMERCE. STATE. WI.US � I iviQund System �� � �f s Cover Page RECEIVED SEP 1 7 7001 Protect "valmle: Dedric °azille Mound SAFETY & BUGS, DIV j n,A,rer' n , D Razil I V YVllll J UIIIV VV\.111V VULI I V Owners ,Address 1199 Hwy 128 Glenwood City, Wi. 54013 Leaal Description NE - I '/4 I NW '/ Sec F T �N. R�S� W J Township Springfield I County Saint Croix n Subdivision t Lot# Parcel ID# 034 -1004- 50, 034 - 1005 -20 i Table of Contents p9 t 1 Cover page 2 Mound Sizing Calculations 3 Pressure Distribution Layout and Dynamics 4 Dose Tank / Pump Curve 5 Management and Contingency Plan 6 Plot Map I total # or pages: 6 Designer Name: Lyle Myers License rr. Iyir GG` 1 Date: 08/2912001 Ph # 715-643-2520 Cinnai•ilra !� Mniinri Svgtem nPcinn NAPthnrlc 1_1SPri P er "Mound Component Manual For Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD- 10691 -P (N.01l01) ner " Pressure Distribution Component manual for Private Onsite Wastewater Treatment Svstems" !Version 2.01 SRD- 10706 -P (N 101) t UFO b Spreadsheel provided bv: 3bAdvisement N12486 220th St, Boviceville, WI 54725 Ph: 715- 643 -6068 email: 3ba(o13b nt.com Mound System Page 2 of 6 Mound Sizing Calculations Project Name: Dedric Bazille Mound Site Conditions Design of Entire Fill Project Type: 1 or 2 Family D - Cell depth at upslope edge (D): 9.0 in. % Slope: 2 Flo Cell depth at downslope edge (E): 11.4 in. # of Bedrooms: 2 Distribution cell depth (F): 9.5 in. Depth to limiting factor: 27 in. Cover thickness over edge (G): 6 in. Absorbtion rate of fill material: 1 gallft` /day Cover thickness over center (H): 12 in. Absorbtion rate of in -situ soil: 0.5 gal/ft` /day End slope width (K): 8,0 ft. Effluent quality Eff #i - Fill length (L): 46.0 ft. Max BCD effluent value: 220 mg /l Upslope width (J): 5.8 ft. Max TSS effluent value: 150 mg /I Downslope width (Toe) (1): 10.0 ft. Fill Width (1/V): 25.8 ft. Design of the Distribution Cell Basal Area System Design Flow: 300.0 gal /day Basal area required: 600 ft Distribution cell width (A): 10.00 ft Basal area available: 600 ft Distribution cell length (B): 30.0 ft Area of Distribution Cell: 300.0 ft` Observation Pipes Contour Elevation of Mound: 98.80 ft Location from end of cell (Z): 5 ft System Elevation of Mound: 99.55 ft Final Grade of Mound: 101.34 ft Mound Plan View J 'Obset ation Pipes _ d'`- i7 ,J +, K:—� �� Distribution loll � - ti ; Tilled Area/Fill Material t� L , ' Mound Cross Section Final Grade s — - .� -._� Obsen;lotion Pipe Synthetic: Fabric -- :- G Distribution Cell r System Elevation_ w ` - t Cover N4ataria17 � f 1 Lateral Q Fill Material-- -°'} _ E Invert - -- Tilled Area '{ Slap E – Forcernain - 'S.�,�s-tern Contour Notes: Fill material to consist of ASTM C33 Sand Distribution cell aggregate to comply with Comm 84.30(6)(1) Synthetic Fabric covering on cell per Comm 84.30(6)(g) Distribution Cell to have minimum 6" aggregate below lateral and 2" above. Mound System Page a of 6 Pressure Distribution Calculations Project Name: Dedric Bazille Mound Lateral Layout Lateral /Manifold Design Lateral elevation: 100.1 ft Lateral diameter: 1 ' /z In. Rows of Laterals: 3 Lateral spacing (S): ft Manifold type: center Lateral to cell edge: 1 ft Orifice diameter: o.i� In. Lateral discharge rate: 4.12 gpm # of Laterals: 6 System discharge rate: 24.72 gpm Distal Pressure: 5 ft Manifold diameter: Z • In. Lateral Length: 14.5 ft Manifold length: g ft Orifice Spacing /Distribution Forcemain Friction Loss Orifice spacing (X): 18.32 Inches Forcemain length: 55 ft Orifices per lateral: 10 Forcemain diameter: 2 In. Avg. ft' /Orifice: 5.00 ft` Friction loss in forcemain: 0,745 ft Lateral Side View �°Ir � Manifold e. l Lateral � Late. 1 Lateri.l Length Lateral Length Lateral Plan View - Lateral Length — ( Turn -up t• %-.?ball valve. or cleanout plug — S r o) r ❑ -�- Orifice on bottom of FFY ateral s and forcemain to comply kvith lateral equally, s ication.s per Comm 54.301`2)(e) Forcemain connection via teo or cross to manifold at any point Clean Out Detail Observation Pipes Clean -rout plug —Firal Grade. mar ballValve ?' `� `•r VVe",er tigl;t ca or pi t_t31A�n � t wurip,k1or t Box y Note C:Ici_et Cullair r 6" tw4inirnurn may t.e used in LrrigSw e_p9L I place of bar or two 45's ' —3!S" Bar Lataral Mound System Page 4 of 6 Septic, Pump and Dose Tank Project: Dedric Bazille Mound Tank Information Dosage Volume Pump tank manufacturer: Wieser Concrete Does forcemain drain Pump tank size /model: 600 back to tank? Pump tank gal /inch: 16.76 Lateral void volume: 9 gal Tank bottom elevation (inside): 90 ft Dosage to absorbtion Cell: 46.0 gal Septic tank manufacturer: Wie Concrete Forcemain volume: 9.6 gal Septic tank size /model: 1000 Total dosage: 55.6 gal Pump and Filter Total Dynamic Head Pump Manufacturer: Little Giant Are laterals highest point? Pump Model: 9EH if not, enter highest elevation: 0 ft Effluent Filter: Zabel A100 System head (distal x 1.3) 6.50 ft Vertical Lift ( "D° to lateral) 9 ft Note: Access opening of sufficient size to be provided to allow removal of filter, opening to terminate at or above grade. Friction loss in forcemain: 0.75 ft Pressure loss from filter: C � ft Total dynamic head (TDH): 16.30 ft Pump Tank Diagram ��r`ratartigf,t t- ouk:.u73 :�o>a_r 4 Inch 'y Vlith Warning LaLlel Minunum —° f- Finishp -d Dose Tank Levels Gra idP_ In. Gal Atte.rn�ite CLAP-4 N A Reserve 18.5 309.8 Lnc. ier,, Elect per Comm B Pump off to Alarm 2.0 33.5 and rrce rin i NEG gi 3O C Total Dosage 3.3 55.6 rraap ; �i� D Effluent depth for pump 12.0 201.1 Total Capacity: 35.8 600.0 SIInh0n E Ii_. Pump Curve: 9EH ICS FLOW- LITERS/HOUR 4 MCI 2446 30 no 30 f w 7.5 w s Pump must be capable of: 24.7 GPM 5 and head pressure of: 16.3 Feet I a.s 0 0 0 20 40 64 so Litde Giant ILDW- GALLONSJMINUTE 9EH FIurP PERFURMANCE CURVE 1151 60HZ r� Mo und System M anagement Tian pursuant to comm 83.54W. A. C. page 5 of 6 f Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surface discharge, treated effluent levels, etc. The owner or owner's agent is required to submit necessary riiaiiiteiiance repoiis to the appropriate jurisdictlun acid /or the uepaiiiiierit. Sep T_ JC�.1L11: 1 U111�. Septic tank(s) are to be inspected routinely and maintained by department approved individuals when i n-c -s y i � accor dance 4-ith their apps ovals. The use of chemicalivioiogicai "treatments" is not required or I recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety ` and Buildings Div.. Effluent filters are to be removed & cleaned as necessary with provisions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge /scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and 1 disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight I and of good repair. 1 PumplDose Tank If an effluent filter has been installed in the pumpldose tank, it must be removed & cleaned as y noC °SSanl with nrnvisions to keen Snlirig from nnccinn fin Oho mound Comnonent during removal J, . N . M , r ......— . 1 The pump, float switches and alarms must be inspected at least every three years for proper operation. Pumpldose tank should be routinely inspected to be watertight and of good repair. Mound and Lateral System The mound system component must remain free of ponded surface water prior to pump operation. If 4 inches ` or more water level is detected in the observation pipes, the owner must be notified of possible problems/failure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing /maintenance (i.e. excessive walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities and/or possibly cause it to freeze in winter conditions. it L- fl _ -. A ._�. ll .-__.-1L_ using 11 -- Lateral diStllUUtlV(I pipes JIIVUIU LJC IIUJf ICU VUVICMCU every IO ffIVIIUIJ UJIIICJ IIIC laedllUUt polilLS at each eilU of the component to remove scum that may clog orifices. Performance Monitoring: n ...-i VV monitoring is a b ,a...,._ al a le o nce c• 11 V ' : VI at ai.. a: s r'CI i f Vtal lC'.e must ILAJL LJC done 1Cl VI Il.e every LI IrCe yeal 5 I VIIVVII ig ' the ins U le time VI 1 a problem, complaint, or failure. Contingency Plan: I If the septic tank, pump tank or any of their components therein (including floats, alarms, pumps, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can t operate as designed. if the mound component cannot accept wastewater or ponds wastewater to the surface, the component must be repaired or replaced in its current location by either: extending basal toe to provide added absorbtion area; or by removing the clogged bacterial mat,aggregate cell, and distribution piping within the mound and replacing said components in order to return system to proper working order as required. i I I C r � Sck Yn �r1'C � h I�r eg 8, w1 Co ma& - r + ye /16-o id x 30 d� R.C15' vvl Ott nS �� 11_Z D�Srn� gu-r ra.J 4 A) _.. fir,w 3 �l9NT�tt 2 C 3i42tltC.e� film Pwv RU Lc AJc j Jr oZq Wisconsin Department Industry Labor and Human Relations SOIL AND SITE EVALUATION REPORT Page \ of 3 • Division of Safety 3 Boil ngs in accord with ILHR 83.05, WI Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but- not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D.;s dimensioned, north arrow, and location and dstance to ne b34 „ tri(A - S O - 1140 APPLICANT INFORMATION- PLEASE PRIN \ L`Jlj�a - D8 DATE PROPERTY OWNER : y PROP TY LOCATION LEE L � ..i •� It��� Iv E 1/4 NJ 1/4,S T z-O ,N,R 1 S E( yy PROPERTY OWNER` MAILING AO ti ; ; LOT:, BLOCK I SUSO.NAMEORCSM # ��J CITY, STATE -PI'IONE NLIM9 E��x ❑ ILLAGE ®TOWN ' NEAREST ROAD O3 `; E�15) - fir :i�Rt►�Gt New Construction Use Residential ! Nu o r f bedrooms �? (j Addition to existing building 1?4 Replacement j j Public or commera Code derived daily flow 300 9Pd Recommended design loading rate bed, gpd/ft — trench, gpd/ft Absorption area required Z S 0 bed, ft Z S 0 trench, ft Ma:dmum design loading rate bed, gpd/ft -S trench, gpd/ft Recommended infiltration surface elevation(s) q q - 8 It (as referred to site plan benchmark) Additional design / site considerations h W" kW 8 .� 3 Z ' Bep , m I Z . 12,` p F S P2,� F—LLL Parent material 1 oin $ Lo mss cu ter - 17 q Flood plain elevation, if applicable .ti Y� It r u Suitable for system COWDmONAL MOUND MROUND PRESSURE AT -GRADE SYSTEM N Fill, t{=WG TANK = Unsuitable for stem 0 S EIU I ZS O U 0 S OU CIS O U ❑ S �U [I ® U SOIL DESCRIPTION REPORT ta>� tZA�fl Boring # Horizon Depth Dominant Color Mottles Texture Structure Cons GPD /fi Gr. Sz. h. Ba y Roots in. Munsell I Ou. Sz. Cont Color + G f � S Bed n� n, -LO l .. � o o �, 2 31 -- s t t Z�' � k v,�`F� �g vvi . S , � • 5 ,., 1' S 17, M��- as Ground 3 SSD LD`L2 ` elev. V 3 -� . �re.s1s sl t vesbh m �>^ :. . Z •3 .-- q a.) ft. Depth to Hailing f actor Remarks: Boring # o _� Loy tZ 3L Z S Z _ > Z $ 31• R3�6 sly Z b m e - ,S fl Ground elev. ft Depth to limiting factor 3l Remarks: T Name: -- Please Print Phone: Arthux L. We erer 715 -425 -0165 ress• e firer Soil g 1 Tesfiing &Design Service -P.O. Box 74 River.Falls,WI 54022 . Sgnahue. ,J� Date: CST Number:. " S -Z'-00 220254 PROPERTY OWNER \CuTZLM SOIL DESCRIPTION REPORT f � PARCEL I.D. # 63y l bo 4 S6 - ONO Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft In. M Texture Consistence n, unsell Qu, Sz. Cont. Color y Roots Bed .,;.. �;. Gr. Sz. Sh. Trey sb wi 'a Cl -2� l U 1 V 31 S1 t Z wf s bk �n `f H Cg • S ' .6 • S Ground 3 Z") S� LO `t (?_ 3)(- r S t 5 A, S 1 ti 1 e 5�k 1vt `{�t- - - Z •3 �-$ It. Depth to limiting factor Z1y Remarks: Boring # � ++: . •.i•.v: is ii Ground elev. — ft. Depth to limiting factor Remarks: Boring # Ground elev. It. Depth to limiting factor Remarks: 3oring # 5 g ;round Nev. It. )epth to imiting actor Remarks: PLOT PLAN Page 3 of 3 SCALE 1 "= yp ' 0 0 1 F �'Ptr�k. �j p.� �:. ✓ J (.cj f eN � SYRD (` 3�i� SrJh'LP \ \ b ►tx, MJ 7r1'iloa -' 25 � z °h 5 z � SZ ! �> p O-O"'bPN UR- a a g�� D)p— ', Lo C'�lory S ti 1`lq K l2 0> ©0_13 zzozsy 5" Z -OD ( 715 ) 425 -ni 6S CST Signature Date Signed Telephone No. CST # I ST CROIX COUN n' SEPTIC TANK MAINTENANCE 1�GRELMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address Oi Property Address (Verification required from Planning Department for new constructi a) City /State /State �+� �., �'� �' C- � Parcel Identification Numbe 3 `! ao `�- tY .6 3 "s 6* L D_ESCRYPTION W, Town of : n 'A Property Location � %,, ,.� �ri�, ' /•, Sec..�._� T�N'� �-- ,�. Lot # Subdivision Surve Map # Volume _ . Page # Certified y � z n Deed # Volume � 7� Page # W Spec house Ci yes (3 no Lot lines idelltifiable yes O no fir. i, �,� t►.r s iNTF,N improper use and maintenance of your septic system. could result in its premature failure to handle yo Proper sys�t � into the consists of pumping out the septic tank every three years or sooner, if needed o a licensed pampa . in the waste disposal system. can affect the function of the septic tank as a treatment stage Department a certification: form, sighed by the owner and by a The property owner agrees to submit to St. Croix Zoning D ep that 1 fo on site wastewaterdisposal system !Plumber joutneymauplumber, restricted plumber or a licet3sed Bumper verify () tic tank is IM than U3 full of sludge. is in proper operating condition and/or (2) after inspection and pumping (if necessary)+ the sap Uwe, the undersigned have mad the above requirements and agree to maintain f the Natural State of Wisconsin` Certific a ant of Commerce and the Department �� office within 30 set forth, herein, as set by the DePardn stating that your septic system has been maintained must be completed and ratumed to the St. Croix County days of the three year expiration date. ``1 DATE SIGNATURE OF ICANI 0 MR CERTYFICATION I we am ( are ) the oW110 > of I (we) certify that all s t a tements on this form are true to the best of my ( our ) knowledge- ( ) the property described above, by virtue of a warranty deed recorded in Rellister of Deeds Office. DATE SI TIME OF APP ANT De ent. st + * ** A information that is mis- represented may result in the sanitary permit bring trucked by the Zoning p artm t« Include with this application a stamped warranty deed from the ftg�er of Deeds office deed a copy of the Certified survey map if rnf�cence is trade in the warranty �o 'WL 157? PAGI 519 - ' 636326 STATE BAR OF WISCONSIN FORM 2 -1999 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number I ST. CROIX CO-, WI This Deed, made between Charles D. Kutzler - -._ RECEIVED FOR RECORD _ 01- 05-2001 10:30 AN - WARRANTY DEED __ -- EXE "PT 0 Grantor, and Dedric K. Bazille, a single person _ CERT COPY FEE: COPY FEE: — ..----- - -- - -- —' TRANSFER FEE: 270.00 RECORDING FEE: 10.00 - — PAGES: I Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix __ _ County, State of Wisconsin (if more space is needed, please attach addendum): East Half of Northwest Quarter (E 1/2 of NW 1/4) of Section Three (3), Recordi Area Township Twenty Nine (29) North, Range Fifteen (15) West. g Name and Return Address Thomas A. McCormack EXCEPT, property described in that certain Warranty Deed to the State of 1020 10th Ave. Wisconsin, Department of Transportation, recorded January 5, 2000, in Baldwin, WI 54002 Volume 1486, page 29, as Document No. 617354. 034 -1004- 50,034 - 1005 -20 _ Parcel Identification Number (PIN) This is not homestead property. )770 (is not) Exceptions to warranties: all easements and restrictions of record. Dated this _29th — day of Del; mber __.— . 2000 . • Charles D. Kutzler — AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN _ ) Signature(s) — ) ss. St. Croix County ) authenticated this day of _ —� Personally came before me this 29th — day of ZOBCL_. the ahp% Qed — ° - - -- Charl D. Kutzler TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be erson(s) who exec �re$Qm) S (If not, __ -___— — -- instrume n ac ow edged a same: fl Q7 : - authorized by S 706.06, W is. Stats.) THIS INSTRUMENT WAS DRAFTED BY * Steven H. P = - - t - - Thomas A. McCormack _ _ Notary Public, State of Wisconsin ' My Commission is permanent. (1 not, state exPEtodaaie (Signatures may be authenticated or acknowledged. Both are not necessary.) --- c pember 15 —' 0 — ) Iriwmation Prolacsi als Company, Fw4 Ou Lac, WI • Names of persons signing in any capacity must be typed or printed below their signature. aoob55 -2021 STATE BAR OF WISCONSIN WARRANTY DEED FORM No. 2- 1999 I — y r fi l l , ✓ r Es CD IMP Ln of % / • EXHIBIT �•� :• �- © -• • 40 Shef40 Performance & Dimensional Data 30 1 1 F- 1 LU 20 Y. 10 0 10 20 30 40 50 60 70 GPM l , " (98.42) 6 (1 27) (168.27) 1.All dimensions in inches. (Metric for international use). 5" (1 3-7/8" 2. Component dimensions may f (98.42) vary ± 1/8 inch. 3. Not for construction purpose 1 unless certified. 3-7/8° DISCHARGE (98.42) 1 -1/2" NPT 4. Dimensions and weights are approximate. FLOAT SWITCH 5.We reserve the right to make revisions to our product and their specifications without notice. 11 -3/8 �Fir HYDROMATIC (288.92) 10- 3/16" (258.76) 3-5/8" 2" (50.8) (92.07) � 1 • replace such nonconforming material MANUFACTURER EXPRESSLY • ranty at the original point of delivery and DISCLAIMS AND EXCLUDES shall furnish instruction for its ANY LIABILITY FOR CONSE- disposition. Any transportation QUENTIAL OR INCIDENTAL charges involved in such disposition DAMAGES FOR BREACH OF shall be for t1* Buyer's account. The ANY EXPRESS OR IMPLIED Buyer's exclusive and sole remedy WARRANTY ARISING IN CON- on account or n respect of the NECTION WITH THIS PRODUCT. furnishing of material that does not INCLUDING WITHOUT LIMITA- Hydromatic Pumps warrants to conform to this contract, or to this TION, WHETHER IN TORT, the original purchaser of each written warranty, shall be to secure NEGLIGENCE, STRICT LIABILI- Hydromatic Pump product(s) that replacement thereof as aforesaid. TY CONTRACT OR OTHERWISE. any part thereof which proves to Hydromatic Pump shall not in any Some States do not allow the be defective in material or work- event be liable for the cost of any exclusion or limitation of incidental manship within one year from date labor expended on any such material or consequential damages, so the of installation or 18 months from or for any incidental or consequential above limitation or exclusion may manufacture date, whichever comes damages to anyone by reason of the not apply to you. first, will be replaced at no charge fact that such material does not with a new or remanufactured part, conform to this contract or to this This warranty gives you specific F.O.B. factory. Purchaser shall Written warranty. legal rights, and you may also have assume all responsibility and other rights which vary from State to expense for removal, reinstallation ALL IMPLIED WARRANTIES, State. and freight. Any item(s) designated INCLUDING THE IMPLIED as manufactured by others shall WARRANTY OF MERCHANT- NOTE: be covered only by the express ABILITY AND THE IMPLIED PUMP MUST BE REPAIRED BY warranty of the manufacturer WARRANTY OF FITNESS FOR AUTHORIZED HYDROMATIC thereof. This warranty does not apply A PARTICULAR PURPOSE, ARE REPAIR CENTER OR WARRAN- to damage resulting from accident, LIMITED IN DURATION TO TY WILL BE VOID. IF REPAIR alteration, design misuse or abuse. THE SAME EXTENT AS THE CENTER IS NOT AVAILABLE, EXPRESS WARRANTY CON - RETURN PUMP TO PLACE OF If the material furnished to the Buyer TAINED HEREIN. Some States do PURCHASE. shall fail to conform to this contract not allow limitations on how long an or to any of the terms of this written implied warranty lasts, so the above warranty, Hydromatic Pump shall limitation may not apply. I F L I'? o HYDROMATIC ® - Your Local Authorized Distributor G RO UP 1840 BANEY ROAD ASHLAND, OHIO 44805 U.S.A. Tel: (419) 289 -3042 it Tel: (419) 289 -8224 (Parts Distribution Center) 3 ` R Fax: (419) 289 -8058 (Parts Distribution Center Web Site: ww pentairpump.cor CH g� Item #: W -03 -408 1198 7M Part #: 5625 -408 -1 Installation and Service Manual HYDROMATIC SHEF40 Submersible /Effluent Pump �� HYDROMAT� i NOTE! To the installer: Please make I � HYDROMATIC ° . sure you provide this manual to the owner of the pumping equipment or to the responsible party who maintains the system. PENTAIR PUMP GROUP • t5 List I 26 27 25 29 0 28 24 1 23 22 2 21 i 3 20 ' 19 4 18 6 17 16 • 6 cm 7 8 9 10 11 12 13 14 15 Ref. Ref. No. Part No. Description at y. No. Part No. Descri tion Qt . 1 8522 -006 -3 PUMP HANDLE 1 17 5484 -003 -1 STATIONARY SHAFT SEAL 1 2 13439 -000 -1 MACHINE SCREW 2 18 5484 -001 -1 ROTATING SHAFT SEAL 1 3 13439 - 006 -1 MACHINE SCREW 1 19 149 -001 -1 0 -RING 1 4 6000 -053.5 WIREw/TERMINAL 1 20 14591 - 001 -1 STATOR-] 15V I PHASE 1 ' 5 8507 -013 -5 MOTOR HOUSING ASS'Y 1 14591 -002 -1 STATOR -230V 1 PHASE 1 6 176 -005 -1 HEX HEAD CAP SCREW 1/4 -20 3 21 145 -009 -1 HEX HEAD MACH. SCREW #8 -32 2 7 5482 -001 -1 SHAFT 1 22 14591 -010 -1 ROTOR -115V 1 8 8922 -000 -1 SPACER 1 14591 -011 -1 ROTOR -230V 1 9 65 -024.1 BALL BEARING 1 23 5617 -000 -1 PARRIFINIC OIL 0.19 10 517 -007 -1 HEX SO(. HEAD SCREW 1/4 -20 3 24 139 -014 -1 RING -SEAL 1 11 8521 -006 -1 BOTTOM PLATE 1 25 75 -004 -1 CORD NUT 1 12 14577 -000 -1 IMPELLER 1 26 6072 -001 -1 CORD GRIP SEALANT 0.01 • 13 1754 -000 -1 RED LO(TITE 0.02 27 13425 -062 -1 NAMEPLATE 1 14 176 -015 -1 HEX HEAD CAP SCREW 1/4 -20 4 28 14077.000 -1 PIPE PLUG 1 15 13507 -001 -1 LEGS 3 29 6072 -002 -1 PIPE PLUG SEALANT 0.01 16 8504 -005 -2 VOLUTE CASE 1 6 I Wwonsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, W is. Adm. Code A.C.E. Soil &Site Evaluations Attach complete site plan on paper not less than 8' /s x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimernsiois, north arrow, and ,(oc"a 1W distance to nearest road. parcel I.D.# APPLICANT INFORMATION - p/�a p�ait information. Revl d B Date , 1 Personal information you provide maybe used ry purpse s (Privacy i Law ,s. 15.04 ( ) m . a. Property Owner y , ropeRy Location Charles D. & Alice Kutzler vt. Lot NE 1/4 NW 1/4 S 3 T 29 N,R 15 W Property Owner's Mailing Address t # Block # Subd. Name or CSM# 1199 H 128 1, - ; f , Proposed CS 0 city State \, Zipr.Code Pltoftftlriber City E] Village ❑Town Nearest Road Glenwood City WI '54 3 ZgMfi:' W21 Springfield U.S. Hwy. 128 ❑ New Construction Use: N F;t ij en§4 i Number of ❑ rooms 2 Addition to existing building ❑ Replacement [--] Public or wMmefciard escribe Code Derived daily flow 300 gpd Recommended design loading rate .5 bed, gpolft .6 trench, 9pd/ft Basal area required 600 bed, ft 500 trench, ft Maximum design loading rate .5 bed, gpd/ft .6 trench, 9Pd/ Recommended infiltration surface elevation(s) 102.5 at 12° above 101.5 contour. ft (as referred to site plan benchmark) Additional design / site considerations Variance required to allow installation of mund system on 15% slope. Parent material loess over sandstone bedrock Flood plai n elevation, if applicable NA ft S- for system Conventional Mound In Ground Pressure AT - Grade System in Fill Holding Tank U= Unsuitable for system ❑ S® U N S U El ®U E] S® U ❑ S ®U El S® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consisten Boundary Roots GPD1fl2 Boring# H orizon in. Munseii Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 1 1 0 -9 10yr3 /2 None sil 2fsbk mvfr cs 2fm 0.5 0.6 2 9 -13 10yr4 /4 None sil 2fsbk mvfr cs 2f,m 0.5 0.6 Ground Oy 3 13 -23 1 r5/4 None sil 2msbk mfr cw lf,m 0.5 0.6 elev 99.91 ft 4 23 -27 7.5yr3/4 None sicl 2msbk mfr cw - 0.4 0.5 Depth to 5 27 -32 7.5yr3/4 flp7.5yr5 /8 sicl lcsbk mfr aw - 0.2 0.3 limiting _ factor 6 32 -48 7.5yr3/4 m3p7.5yr5/8 sicl Om mfi NP 0.2 27' Remarks: 1 0 -11 10yr3 /2 None sit 2fsbk mvfr cs 2f,m 0.5 0.6 2 2 11 -17 1Oyr3/4 None sit 2fsbk mvfr cs 2fm 0.5 0.6 Ground 3 17 -30 1Oyr4/4 None sit 2msbk mfr cw lf,m 0.5 0.6 elev 100.12ft 4 30 -42 10yr5 /4 None sl 2msbk mfr aw if 0.5 0.6 Depth to 5 42 -60 1 Oyr8 /4 None SSBR - - - - NP NP limiting Sandstone bedrock comprised of weakly cemented sandstone as determined by resistance to knife penetration. factor 42• Remarks: CST Name (Please Print) Sign re: Telephone No. James K. Thompson 715- 248 -7767 Address A.C.E. Soil & Site Evaluations Date CST Number Ref # 340 Paulson Lake Lane, Osceola, 54020 3/14/00 3602 1184 L. — PROPERTY OWNER: Charles D. & Alice Kutner SOIL DESCRIPTION REPORT „aa Page 2 of 3 PARCEL I.D.# prt of 034- 1066 -50 -000 A.C.E. Soil & Site Evaluations Horizon Depth Dominant Color Mottles Texture Structure sistence Boundary Roots GPDIft� in. Munsell Qu. Sz- Cont. Color Gr. Sz. Sh. Bed Trench 3 1 0 -14 10yr3 /2 None sil 2fsbk mvfr cs 2fm 0.5 0.6 2 14 -22 1 Oyr4 /4 None Sil 2fsbk m vfr cs 2f m 0.5 0.6 Ground - - -- -- - elev 3 22 -39 10yr4 /4 None sil 2msbk mfr cw if 0.5 0.6 102.91 ft 4 39 -44 7.5yr4/4 f2f7.5yr5/6 sl 2msbk mfr aw if 0.5 0.6 Depth to 5 44 -59 10yr8 /4 f1p7.5yr5 /8 SSBR - - - - NP NP limiting factor Sandstone bedrock comprised of weakly cemented sandstone as determined by resistance to knife penetration. 39" Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: ��E GC.S, h�wy. / .28 Owner 0 ,�' eltar /es 4t ce 1�ic E,�ler' Awyy i a i? P Ci or) Pr.pP&6 . d e.SM Fra" �s r' See. 3, T. 29r1 AP iSu9 n. P �1+ l 0 2 1•ZS ± � /3a0 4 "Elmfree.�ss�mcd eiev; oo.' GSO' =,E0 7hoQ 01 Q Sattt'k line • So, lw A PI-C. iNisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix Safety and Building Division INSPECTION REPORT sanitary Permit No: 399438 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)]. Permit Holder's Name: City Village X Township Parcel Tax No: Bazille, Dedric I Springfield Townshi 034 - 1004 -50 -000 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing / Alt. BM Aeration (� Bldg. Sewer Holdi t Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet U) Septic Dt Bottom. (aA) z , Z Dosing y/ rU y (d L Header /Man. 3 Z O .5. Aeration Dist. Pipe z a 4 /DO'V f ng Bot. System 3 • �� f' ? y PUMP /SIPHON INFORMATION SSs Final Grade Manufacturer Demand St Cover S GPM Model Number 0 LqJ TDH Li Friction p L�oss System Head TDH �Ft S3 , UZ s Forcemain Length r Dia. �� Dist. to well � > G SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Tre ches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS / S SETBACK SYSTEM TO P/L JBLDG WELL LAKE/STREAM L ufaoturer: INFORMATION � CHAMBER OR Type Of s UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake ! i Pipes) L Z Length �� , S Dia ( / Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil 127 Yes � No M Yes ®No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: /17 e Inspection A Location: 1199 Highway 128 Glenwood City, WI 54013 (NE 1/4 NW 1/4 3 T29N RIM) NA Lot A Parcel No: 03.29 1.) Alt BM Description = y� !, ve�G ✓�'" ly,. S�+»c 2.) Bldg sewer length = ±Z S! s s rL y {c ti _ S�t� s /t ylp TG� r - amount of cover = Sou�v� /(iv�d� CGS r� �o sC Q ✓ �oL 3.) Contour = �(. N, (Z� y Plan revision Required? [IK Yes KNo Use other side for ad Itional informatio � ,C. 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WI800NSN. / 110 NEWELL STREET .� ROBERTS, WI. 54023 OA.T NLNR�R NW CORNER SECTION 3 ( ALUMIMLNM CAP FOUND D �^ SB7 2 �►�Y"_._`' NORTN L7lE OF TFE Nw1/, - L +�- - - -- = BY: _ XCEL ENERGY ��p� UNPLAT[E UWDS - NKN ( X SEE NOTE BELOW ai a ll r THIS /J 1 z rA S . • . F1r1D FFF BEARINGS REFERENCED TO ION LIW- THE ASS TO BEAR SOD OO TXR C 3 DWELL 2w \ RAGE b -N - L .. - INDICATES SECTION CORNER CENTERLINE, MONUMENT ( AS NOTED - INDICATES i" X 24" ( 13 E DIAMETER) IRON PIPE WEIGHING IM LBS. / LINEAR -+�-- - INDICATES E FENCE. ....... - 1NDICATES 100' ST. CROIX COUNTY I� SHED SETBACK LINE FROM RIGHT- -OF-WAY-...... - INDICATES 50' STATE OF WISCINISIN SETBACK LINE FROM RIGHT-OF -WAY. Afom I C 1 C T"E D`'S s LANDS OW HEREON AR>PEAR AP LOT 1 ° BE SING NFn BY R OVED Z To Z XCEL ENERGY. BUT THE ACCESS IS A g WARRANTY DEED DE D F IN VOLLUMEE �D I 9 33� `1 � SQUARE FEET A I THE SIX aNn STER OCT 3 12003 11 OF DEEDS OFFICE. THE DEED ( g EVES TO THE GRANTORS. HEIRS a AND ASSIGNS. " THE RIGHT TO USE g WITHOUT COST TO THE GRANTEE AND M trot IroOrded WO 90 S AT THE GRANTORS OWN RISK THE gVmvW diMs GRX" s t PREMISES CONVEYED. WITHOUT pull std Vold PAYMENT OR RENT 90 LONG AS SAID USES DO NOT INTERFERE WITH PRESET OR FUTURE USES WHICH SAM GRANTEE . ITS SUCCESSORS OR ASSIGNSS MAY DESIRE TO MAKE OF THE PREMISES CONVEYED. Abp �•. ALL LOTS AND BLOCKS ARE HEREBY RESTRICTED e f ANY RG S SO THAT NO OWNERS POSSESSOR I14ER L .. OR ANY OTHER PERSON MAY HAVE ANY RIGHT OF DIRECT VEHICULAR INGRESS FROM OR ASS TO N RICHMOND a ANY HIGHWAY LYING WITHIN THE RIGHT-OF -WAY i wl t 03 I IR OF S.T H. 1 128'. IT IS EXPRESSLY INTENDED THAT • THIS RESTRICTION CONSTITUTE A RESTRICTION 4� . y _ .....•• � FOR THE BENEFIT OF THE PUBLIC AS PROVE ti IN S. 236.293 STATS. AND SHALL BE F]FORDEABIE SURV r BY THE DEPARTMENT OR ITS ASSIGNS. ANY q ACCESS ALLOWED BY SPECIAL EXCEPTION SHALL fri BE CIMFIR MM AND GRANTED ONLY THROUGH THE DRIVEWAY PEFi MING PROCESS ALL 5' PERMITS ARE REVOCABLE AND REVOCATION IS WON.CDMPEMSATORY. ADDITIONAL LAND N87 0 5426"W 33334' DIVISIONS, ORANGE IN LAND USE. OR FUTURE HIGHWAY PROJECT (S) MAY REQUIRE A PUBLIC ROAD INTERSECTION OR RELOCATION OF THE UNPLANNED IANQS DRIVEWAY TO AN ALTERNATIVE PUBLIC ROAD AT THE DIS0:1ETION OF THE DEPARTMENT. THE DEPARTMENT HAS GRANTED AN ACCESS FOR THE THE WESTERLY DRIVEWAY SHOWN HEREON AS WELL AS A SINGLE RESIDENTIAL ACCESS APPROXIMATI LY 4OD' WEST OF THE WESTERLY DRIVEWAY SHOWN HEREON. N9 S CALE IN FEET 1• - 150' PQCP/1W tlY: 0' 75 150 300' GOWBMG 1236MT.K V SA/4 C T M EEL R -BAR FO 3 17 (5/B" STE1:1. REAR FOUND 1 fENOCH M11� M WL60 THIS INSTRUMENT DRAFTED BY: (� )2M SHEU 1 (F 2 UJ JOSEPH W. GWIERG p J - Vol 18 Page 4642 ;Ito mss' Lff