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HomeMy WebLinkAbout032-2100-00-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 538826 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)]. Permit Holder's Name: City Village X Township Parcel Tax No: Falkenha en, Stan & Laura I Somerset, Town of 032 - 2100 -00 -000 CST BM Elev: Insp. BM Elev: IBM Description: Section/Town /Range/Map No: 1a (, gl. f t +. , 26.31.19.955 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic � Benchmark 10• Q /8 , . Vx b�-` ti 1 Dosing r Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD DtInlet Septic Dt Bottom Dosing f, 3 In Header /Man. Aeration Dist. Pipe 5.75 Z,(, 75 Holding Bot. System Z4 Final Grade ?� Z Q T PUMP /SIPHON INFORMATION J Manufacturer Demand St Cover _ ui 5 �t GPM Model Number TDH Friction Loss S s ad TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION 4YS TEM BED/TRENCH Width Length / I No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS `� SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufac .Lu r INFORMATION CHAMBER OR Type Of System: ( UNIT ModeCxJ Number:L '4 �� LL /1 DISTRIBUTION SYSTEM < Z ( + 2 Z �•o� Header /Manifold 0 I/ Distribution x Hole Size x Hole Spacing Vent t Intake Q Pipe(s) Length �/ •� 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 Seeded /Sodded xx Mulched Bed/Trench Center i • �G Bed/Trench Edges Topsoil \ es 7 No es F No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1960 62nd Street Somerset, WI 54025 (SW 1/4 NW 1/4 26 T31 R1 9W) Pinecliff Lot 10 Parcel No: 26.31.19.955 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = x� Plan revision Required? Yes N0 �� V Use other side for additional information. Date Insepct#ignatur Cert. No. SBD -6710 (R.3/97) Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 538826 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)]. Permit Holder's Name: City Village X Township Parcel Tax No: Falkenha en, Stan & Laura I Somerset, Town of 032 - 2100 -00 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: 26.31.19.955 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length 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 Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil 0 Yes R No ❑ Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1960 62nd Street Somerset, WI 54025 (SW 1/4 NW 1/4 26 T31 R1 9W) Pinecliff Lot 10 Parcel No: 26.31.19.955 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? ❑ Yes ® No Use other side for additional information. Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) commeme:wl.g V Buildings Division County r R CE�� Jasb' n Ave, P.O. Box 7162 S co ns i Medi WI 53707 -7162 Sanitary Permit Number (to be filled in by Co.) M o f 5 J ' State Transaction Sanita P 'ca on In accordance with s. Comm. 8321(21 W . Adm. SM16 this to the unit is required prior to obtaining a G lgtitQ for ject Address (if different than mailing address) submitted to the ante wi th t of Co on you provide maT • / 11746 � Z in accordance with the Privacy Law, s. 15. 1 m Stars. ( � 1 • ^d / L Application Information - Please Print All Informati Proper AQ RR A fa�4W 8 A65-c- 0 �r�2- 2,106 -W ac�c7 Property Owner's Mailing Address Property Location ^ �5 / Govt Lot City, State l Zip Code / Phone Number -y t1,9-6 s r Y., (� (^ f y,, Section Sbl� G"ET W1 S1402& '11 l - T : R�Eorb Its Type of Building (check all that apply) Lot # K or 2 Family Willing- Number of Bedroom Subdivision Name Bl PD Gu ❑ Public/Commercial - Describe Use ❑ City of ❑ State Owned - Describe Use r CSM Number ❑ Village of Z 1 tZZ G +c+�C A Town of snm� 2c. E III. Type of Permit: (CheckoolyoneboxonlineA. Complete line Bitapplicable) A. Q New System joeplacement System ❑ TreatmentMolding Tank Replacement Only ❑ Other Modification to Existing System (exp ) /y g of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued --*44L 7 B. ❑Permit Renewal Permit Revision ❑Change T Before Expiration Owner ' e IV. Type of POWTS S em/Com onent/Device: Check all that a ; ❑ Non - Pressurized In -Gramd ❑ Pressmu ed lr.Ground ❑ At -Grade ❑ Mound 24 in. of suitable soil ❑ Mound <24 in. of suitable soil p116 ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) C &Aj V. Dispersalf](7reill tment Area Information: Design Flow Design Soil Appl' ion Dispersal Area Required rsal Area Proposed fZ Ystem Elevation �54�! '�� 1 4Qu �C �c I� •`Z VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units d o -0 o New Tanks Ex T r� v • i /� W 1 / t '� U i C7 C Septic or Holding Tank Dosing Chamber VII. Responsibility Statement - I, the undersigned, assume responsibility for installation of the POWTS showqAn4e attached plan& Plumber's Name (Print) I Plumbe S' RS N ber Business Phone Number T U ,z f� z / IiK 279 91 Plumber's Address (Street, City, State, ZP. ode) • Qo n. sy VIII. Coun /De artment Use On Approved rsapprov Permit Fee Date Issued Issuing nt Signature van Reason for De $ ( ` 75 • 1 7,2. �I IX. ConditWNtweasons for Disapproval 1. Septic tank, effluent finer and dispersal cell must all be services / maintakted as per management plan provided by plumber. 2. 'AN setback requirements Must be maintained Attach to complete plans for the system and submit to the County only on paper not less than 8 112 z 11 inches in size L A FAWY J it &Ggl) s wy N�� S 20 - T31 1 1 w 1 laz oo SM . `Tam OF sbv%e5cr wl 5'1b25 X 23 S &Vse ALT. i3. M- SySO :14a)N 6 1nl -cxS G B TA IJ - TAN r-S `TD a5 ►JS TEP 70 S-RR5 F Rw.> ,1 & VHMAQ K 7bP 6r S.E. L- Diza.1ER. S-r y.C- EL. GOO ' a. Air. 13ErJntlAAL4 - G NRAV ❑ S6 L 73M li U SP.A,6 1 " 4() CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: f'�J Q� - F - (-\L K1 0 Owner's Name: Owner's Address: Z N, ST So Rrt W 5 Legal Description: SW N VJ S 73 f N , lf� w' Township: ZSO ERS eT County: S1 C Qd� Subdivision Name: i�E CIF Lot Number. 1 Parcel ID Number. 03 - z- - ?-iop " (-A - 0 Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing & Cross - Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenanc Form Page 8 Warranty Deed Page 9 CSM or Plat T Attachments: Soil Test & House Plans Designer /Plumber: Pf License Number. 2 X3 2 y� Date: 49 7 / Phone Number Signature a Designed pursuant to the In- Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD- 10705 -P (N.01 /01). Page 1 `Tam OF Sbv%Q3rr Wl 5`�Ib2S 'q &DfwG)NA i ovSE �� i3.M- sy 4 cF4a) 6 WC-Cr -S - TA OY INSfO W 70 SlFkR5 F"V A 'kMAR. K - rbF t) r 5.6. ��£R. S'tky c - EL. z100' Atc. 'F- NetllnAe4 - L NRAU ig bk& :; 9L *- l0,. 8N n Sots. V U StAL6 1 " 4() Soil Absorption System Cross Section 103,7 ft 4" Schedule 40 Final Grade PVC Vent Pipe With Vent Cap • ft Leaching __ Chamber ~- System Elevation ft >3ft Soil Absorption System Plan View 64 ft ft { ft Leaching Trench 1 Vent Or Observation Pipe Chambers 4" Dia. Trench 2 Header Leaching Chamber Specifications Manufacturer And Model X'naK> tiT'QR„ EISA Rating sq ft per chamber Soil Application Rate - 7 gpd /sq ft (►OO gpd Design Flow 7 _Soil Application Rate - LID EISA = = Chambers 2 rows of L tK chambers each. Page of C4 `D o N Q u o 0i A W _ z W W = ° ¢ ° W 7;7 A � � W Q Q d CY - WWQ (� � W LD Q ¢ �D/- n i 0� '—' W of o m w L Woj o o i H J � W _ Q Z `D w 3 u Cl) a F- ¢ oW a a W0� 0 U W � W 3 �, CD J W Q � 0 W F— J H W /-� � P1 M W l J l V INGROUND SOIL ABSORPTION MANAGEMENT PLAN PURSUANT TO COMM. 83.54, WIS. ADM. CODE General This system shall be operated in accordance with Comm.82 -84 Wis Adm. Code and shall be maintained in accordance with its component manual [In- ground Absorption Component Manual for POWTS Version 2.0 SBD- 10705 -P (n.01 /01) and SSWMP publication 9.6 (01/81) and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic tank or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm. 83.33, Wis Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers, and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed and watertight upon the completion of service. Any opening deemed unsound ,defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis Adm Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of the triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maxium scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Dept. of Commerce. Pump Tank The pump tank shall be inspected at once every 3 years. All switches, alarms and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Soil Absorption System No trees or shrubs should be planted on the absorption area. Plantings may be made away from the cell's perimeter, and the area shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than foot or for vegetative maintenance) on the area is not recommended since soil compaction may hinder aeration of the infiltrative surface within the system and snow compaction in the winter will promote frost penetration. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired of replaced with a component of the same or equal performance. If the dispersal area fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Replacement in a suitable area nearby is also an option at which point a diversion valve will be installed between the old and new systems to allow dispersal cell rotation at a schedule to be determined at the time of cell replacement. ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following rgsidence: (Street address) lc'G6 6Z O 57 located at: 5 VV '/4, lVk/ 1 /a, Section 2L , Town Range )9 W, Town of , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of Comm. 84.25, and it (they) appear(s) to be functioning properly. Most recent date of inspection or service Did flow back occur from absorption system? Yes No (if no, skip next line.) T Approximate volume length of time: gallons minutes Tank Capacity: IE Construction: Prefab Concrete x Steel Other Manufacturer (if known): S Age of Tank (if known): Permit number (if known) �a�7 (Lie s d Plumber Signature) (Print Name) o ( AJ /n P2s 2 232 y 2 (Title) (License Number) MP /MPRS 2-) (Date) Form to be completed by licensed plumber (Dept of Commerce Chapter 5 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 9/2008 U 2413P 430 P.S 74Q1 KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 1 - 19999 REGISTER OF DEEDS WARRANTY DEED ST. CROIX CO., WI Document Number RECEIVED FOR RECORD This Deed, made between Michael J. Hartman, a single person 09/18/2003 02:00PM WARRANTY DEED EXDNPT # Grantor, and Stan D. Falkenhagen and Laur L. Falkenhagen, REC FEE: 11.00 hus band and wife as survivorship marital property TRAYSFFEE: 1470.00 CC FEE: PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Lot Ten (10), Pine Cliff in Town of Somerset, St. Croix County, Wisconsin; Recording Area Name and Return Addmss The RiverRank P. O. Box 188 Osceola, WI 54020 032 - 2100 -00 -000 Parcel Identification Number (P" Together with all appurtenant rights, title and interests. This is homestead property. lCtY Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and ordinances of record and will warrant and defend the same Dated this 1 day of September 2003 • • Michael J. Hartman AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. Polk County ) authenticated this day of y day of Personal! came before me this September , 2003 the above named * Michael J. Hartman TITLE: MEMBER STATE BAR OF WISCONSIN ' (If not, to me known to he the person(s) xecuted foregoing o d � '• authorized by § 706.06, W is. Stats.) inst ument and ackn ed T141S INSTRUMENT WAS DRAFTED BY + !�I?�t.r • i Priscilla R. Dorn Cutler, Attorney at Law _ Notary Public, State of W iscon Osceola, Wisconsin 54020 My Commissio " perman t. pt, state ex p date: (Signatures may be authenticated or acknowledged. Bath are not necessary.) l v F • ) • Names of persons signing in any capacity must be typed or printed below their signature. Imorme6on Professionals Comperry. Fond du Lac. WI STATE BAR OF WISCONSIN " 2021 WARRANTY DEED FORM No. 1 -1999 0 � x 0)0 / , ; § r to 0 7 0 ° qƒ ƒ m S - I E g t m l 3 5® - cn . / 2 & o � Q @ E ; @ ° �. ■ ƒ o 0}) c CT } o@§ Q ~ E E 2 Q to Er § ƒ f © C m > k CD a $ co $ 0 0 a 0 \ § =� � ® e @ z § § i § 0 CO) rr 0 J m T 2 i § 0 0 0 0 ; 0 % % % ■ e / § § ■ ■ ■ \ ° 7 § E ; E V o v— n_ � f A 2 09, - 0 3 .. � § ; Z � k ° \ CL \ I c jo < CD \ 3 CL . 2 , 2 ■ . o a rk: z ■ ■ a � Z R w � i CL� 77 § e 2 2 ! § � o % Ik £§ � CL \k % ) A 0 CD 7 � d � � R 14 � 14 � 2 � � K o � < t § CD ~ � ST. CROIX COUNTY ZONING DEPAR", AS BUILT SANUARY REPORT ` Owner Property ddress �' \orv;Nc, o 7,y City /State 64 i 4 4 Legal Description: Lot �� Block - Subdivision/CSM # e L 1 /a, t /a, Sec. , T yLN -R_L�_W, Town of PIN # A ! ? -, SEPTIC TANK — DOSE CHAMBER — HOLDING TANK INFORMATION: s T Tank manufacturer - Size ST/PC Setback from: House �= Well /�,4 P!L Pump manufacturer Model Alarm location ' (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: 2g, , Width _12 Length Number of Trenches Setback from: House - .Z1 Well P/L Sl__ Vent to fresh air intake t //w ELEVATIONS Description of benchmark Elevation _4,/,t Description of alternate benchmark Elevation ,,6 4. gy'_ Building Sewer - 9,f-e , )7 _ ST/HT Inlet . 9/., .Z!2 ST Outlet _,2,. , lg _ PC Inlet PC Bottom Header/Manifold lo Z Top of ST/PC Manhole Cover Distribution Lines Bottom of System Final Grade () /D 9 () ( ) Date of installation �i l9g Per it nu er 77 State plan number Plumber's signature License number Date Inspector �,)i -) Complete plot plan r* 1G NOTICE Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW j / 55" i � 3 p i -I = 70 S INDICATE NORTH ARROW Wisconsin Department of Commerce Count PRIVATE SEWAGE SYSTEM y:ST. CROIX Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary3Crgry7j7.. Personal information you provice may be used for secondary purposes [Privacy LaX, s.15.04 (1)(m)]. fiffHE ipNanFeARTNERSHIP /M . HARTM F N )aIER\9Bqt� ❑ Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: Parcel T03 2100-00-000 TANK INFORMATION ELEVATION DATA A9900042 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Zc7O Benchmark Dosing , /3 T' S o(o •8 �f Aeration Bldg. Sewer 3.3d- , 0 Holding t # Inlet TANK SETBACK INFORMATION 9/wOutlet / 9/ q4•Y� TANK TO P/ L WELL BLDG. Air I to ntake ROAD Dt Inlet Air Septic >10V ' p � NA Dt Bottom S g qz- Dosing /aD ,> /ap '05 0 ,� NA Header /Man. // 07. 2' Aeration NA Dist. Pipe f/ �• �J Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade ( /o DS. Manufacturer Demand .3, �/ / Ir.0 Model Number (.Je_ 0 3 (-- GPM TDH Lift Q Q3 Lriction e Syestem TDH (5, �Ft oss Forcemain Length j�Yp Dia. " Dist. To Well >wb SOIL ABSORPTION SYSTEM B I Width i Len No- A#�reRrhes PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 2 • 5 '7 /- o s DIMENSION SETBACK SYSTEM TO P / L BLDG I WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type O �r• _. , CHAMBER Model Number: System: Lo" • > I OD > OR UNIT DISTRIBUTION SYSTEM P7 . r5/ Header/manifold u Distribution Pipe(s) q x Hoe Size x Hole Spacing Vent To Air Intake Length �p Dia � Length �r• 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 ❑ Yes E] No El Yes E] No COMMENTS (Include code discrepancies, persons present, etc.) L SOMERSET 26.3 1.19,SW,NV 1960 n 62ND STREET — PINECLIFF LO ��7G C•d"a./ �� D `� (_,.� {� r� /` , S GV��iF- u*QA«� -�i.Fi �M. . wp l A4, 61% e s Cam- K��.- poi• L8 ro =. Plan revision required? ❑ Yes J§ No 2 Use other side for additional information. 13 C)T SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. I ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: Ir e 4 s r 3 9 A. m t ' 3 t P S # 9 i r.. 'a ; i i f 3 f 3 9 S E 1 [ i m " a E i a e i s q } F s f w� t F 4 j 4 � a j E � i 1 a r j t i i 4 t A q F' 1 q f q �. e " .. .. ..... �m .., i �. i i f F t t q + qs`, q Safety and Buildings Division SANITARY PERMIT APPLICATION 2 01 W. Washington Avenue N 4.4consin I n accord with ILHR 83.05, Wis. Adm. Code P O Box 7302 Department of Commerce Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. A j • See reverse side for instructions for completing this application State sanitary Permit Number 3� 7 7 7 Personal information you provide may be used for secondary purposes Check if revision to previous application (Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION Property Owner m Property Location _ 1/4 A l A j 1/4, S T3 , N, R (or Property Owner's Mailing Address Lot Number Block Number as- City, State Zip Code Phone Number Subdivision NaMe or CSM umber 11. TYPE OF BUILDING: (check one) ❑ State Owned ❑ It Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms ° ro w a n III BUILDING USE (If building type is public, check all that apply) Parcel TaxNumber(s) 1 ❑ Apartment / Condo -- 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church / School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel / Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) A) 1. 0 New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an ______System ________ System _____________ Tank Only______________ Existin�System ________ Existing System B) ® A Sanitary Permit was previously issued. Permit Number Date Issued ,,, 2-,12- 99 V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 JaSeepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure i 42 ❑ Pit Privy 13 ❑ Seepage Pit X7 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: I. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate S. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /' ch) Elevation T' Feet IA Feet Capacity VII TANK in g allons Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New ExistTank in strutted ZN Tanks eptic Tank ng an c — ❑ ❑ ❑ ❑ ❑ Lift Pump Tank zed ( ' S ❑ ❑ ❑ ❑ ❑ . RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for inst9llation of the onsite sewage system shown on the attached plans. Plumbe s Name Prints Plumber' Si to �(=s MP /MPRSW No.: Business Phone Number: u tier's Address reeet, ' Uty, State, Zip Code): / 9C 1 IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing A e Si at e o Stamps) App [] Owner Given Initial Surcharge Fee) Gam, Adverse Determinatio 7 24 f X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (8.11197) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber ` 1 INSTRUCTIONS ' 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe renewed before the expiration date, and at a timeof 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. 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. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608 - 266 -3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. 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. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 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; pump or siphon tanks; 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; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. ,d /J.c.�1C -� /�7�,C•� ,�� s� / ��t � �.� /ID,O � �����5 /orb �O � r 3� 33L- ,a 3`� turves C11 �► Mm" FEET DEL 36655 zs e; , _ - • - ±SIZE Solids W E t 5n 70 20 WE10n _;_ 10 WtO WEWI o L u Ii 10 6J 10 of w 1;, 66 1w GPM : Q m'M CAPACITY t ,,,, r,�. :,,...;�. , ; * ► .'N: Y• :t,: > „' ' - �.0ULD PUh1PS. INC. METER$ FEET - --�—�— I I —r—r —, N, , ; u D E L 3855 34 — I-- - - I -i - SIZE 1 /4 Solids I I r _ r - _. 70 N o - — -, - ` f ~ WEOSnn I I 50 - • , - � ,� � - rte 0 0 0 10 p 00 40 50 to 70 .. , w ..J f Hi iw GPM 0 m'm CAPACO . � we 0 ww. PwnP4.Inc. Cl1A• PA6E of PUMP C AMBER CROSS SE CTION AN SPECIFICATIONS VENT CAP VENT PIPE APPROVED LOCKING ri WEATHERPROOR — � - JUWCTIOM BOX MAWHOLE COV WITH 23 FROM DOOR, WAAJJItJG LABEL WINDOW OR FRESH IL�MIU. I AIR IuTAKE I GRADE — I y" MIIJ. -T COIJDUIT ` -- _ - - - - - - - -_ II.JLET PROVIDE I , - - - -- AIRT IGJ1T SEAL I III I I I P VC 0 lIJ A I I APPROVED JOIU' AP RO D J T I / I I W/ PIPE EXTEND ALARM 3' I I ALARM EXTC , UDIUG 3' OI. I II ONTO SOLID SOi. WTO SOLID SOI D I I I I O ►J C � I CLEV. FT. PUMP b OFF 0 COLJCKETE BLOCK RISER EXIT PER OAJL'd IF TA MAUUFACTURCR HAS SUCH APPROVAL 3" f4PPROVEa BE.GDING "Ildcr - rl%?4K SEPTIC E SPECIFICATIOKJS DOSE - r A W AS MAIJUFACTURCR: �� =�=' IJLL^10CR OF DOSES:._ PER DAB TA SIZE' d GALLOWS DOSC VOLUME 1j ��,�� 7 IWLLUUIWG DACKIF �� - T GALLON. ALARM MAWUFACTURER: 4 G MODCL IJUMOER: � }/ CAPACITIES: A = 1WCNESOR GALLOwl SWITCH TYPE' B= - ��-7— I►JCNES OR ''//�// GALLO►JS PUMP MAUUFACYUKER: C.IWCHES OR L>m GALLOUI5 MODEL AJUMOCR: �j° /r�- D - INCHES OR GALLOW , SWITCH T`JPE: IJ07E' PUMP AUD ALARM ARE TO DE IN5TALLEU OW SEPARATE CIRCUITS MIWIMUM DISCHARGE RATE— GPM VERTICAL DIFFER£IJCE OETWEEM PUMP OFF AUD DISTRIBUTIOW PIPE.. _ — FEET + MIIJ NETWORK SUPPLY PRE SSURE � . . . . . . . . . . . FEET + „��_ FEET OF FORCE MAIN Y, �Ls 2:7 >I/onrr.FRICTIO►J FACTGR.. _ FEET TOTAL - 7 HEAD = _ FEET WTERIJAL DIMLWSIO OF TAWK: LEWGTM IWIDTIN - iLIQUID DEPTH 51GUED:� _ SAYE: LICCOSE NUMBER: 7:� � Safety and Buildings Division ,- SANITARY PERMIT APPLICATION 2 01 W. Washington Avenue `Wisconsin In P O Box 7302 Department of Commerce accord with ILHR 83.05, WIS. Adm. Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County / than 81/2 x 11 inches in size. S' • See reverse side for instructions for completing this application State Sanitary Per Number Personal information you provide may be used for secondary purposes ❑ Check it revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N roperty 9wne r e a Property Location "V►CG�1�� ( 1/ 1/4, S T , N, R (or4g Property Owner's Mailing Add re s Lot Number Block Number 4 / City, State Zip Code one Number Subdivis Nam M u o mber 14L I ) II. PE F BUILD (check one) 9 e Owned E] it Nearest Road ❑ Village Public 1 or 2 Famil Dwellin - edrooms -� Town o Parcel Tax Nu er III. BUILDING USE (If building type is public, check \Ss/ (s • ►q •q S15- 1 E] Apartment/ Condo 2 [] Assembly Hall 6 E] Medical ing Home 10 E] Outdoor Recreational Facility 3 E] Campground 7 [] MerchanRepairs 11 ❑ Restaurant /Bar /Dining 4 E] Church/ School 8 171 Mobile H 12 E] Service Station / Car Wash 5 E] Hotel / Motel 9 C] Office / F 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Che bo on line B, if applicabl A) 1 g New 2 [] Replacement 3_ ❑Replace nt of 4_ ❑ Rec n ction of r of an System System Tank O Exis n ys fisting System B) E] A Sanitary Permit was previously issued. Permi umb a Issued V. TYPE OF SYSTEM (Check only one) Non - Pressurized Distribution Pressurized Dis 1bution Experimenta Other 11 Seepage Bed 21 E] Mound \\ \E] Specify Type 41 ❑Holding Tank 12 ❑ Seepage Trench 22 ❑ In -Gro nd Pressure 1 �J� 42 ❑ Pit Privy 13 ❑ Seepage Pit S 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATIO 1. Gallons Per Day 2. Absorp. Area 3. bsor��a 4. Loading Rate 5. rc. Rate 6. System Elev. 7. Final Grade Required (sq_ ft.) P posed (sq. ft.) (Gals/day/sq. ft.) (Mi Inch) Elevation t Feet Feet VII. TANK Capacity Site INFORMATION in gallons Total # of Manufacturer's Name Pfe b. Con- steel Fiber- Plastic Exper_ New Exist' Gallons . Tanks COnCr a strutted glass App. Ta nks Ta s Septic Tank I- Nel�iwenk ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATE ENT 1, the undersigned, assume responsibility for i allation of the onsite sewage system shown on the attached plans. P lumVbs Name: (Print Plumb r' Ign r q 5 s) MP /MPRSW No.: Business Phone Number: Plumber' Address (Stree , City, State, Zip Cod: IX. COUNTY / USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater I ssuin e t Signature (No Stamps) urcharge Approved E] Owner Given Initial Fee) Adverse Determination - 11 ; L�� X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: u G� ►w�h • SBD- 6398 (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a 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. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SOD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608- 266 -3151. •� To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Buildin use. If building type is public, check all appropriate boxes that apply. 9 9 YP P PP . Y IV. Typormit. Check only Q e on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. T stelb., Peck apprbp ate box depending on system type. A VI. Absorption s�st Provide all information requested for numbers 1 through 7. VII. Tank information. F�Y ever h acit of new /or existing tank, list the total gallons, number of tanks and Y 9 9 manufacturer's name, indica4prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. theck experimental approval only if tanks received experimental product approval from DILHR. VIII. 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. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 81/2 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 holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mainstwater service; streams and lakes; pump or siphon tanks; 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 manufacture[;. D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. - T•3/N/91 q u t wiscongi partme Industry SOIL AND SITE EVALUATION ' Labor art uman Relations Page of Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County 1 ; include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # APPLICANT INFORMATION - Please print all information Reviewed b _ .. P ate r Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (t) (m)). I "" Property Owner Property Location ,) 01 AA � • Y Govt. Lot 1/4 1 r �'' (or� Property Owner's Mailing Address Lot # Block# Su ame or 3 1 1 ' M6 city State Zip Code Phone Number Nearest Road ❑ Ci Town ViNage New Construction Use: Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow r196 gpd Recommended design loading rate 7 bed, gpd/ft trench, gpd/ft Absorption area required bed, ft2 2: n trench, ft Maximum design loading rate _ bed, gpd/ft — trench, gpd /ft Recommended infiltration surface elevation(s) /O 2 "13 ft (as referred to site plan benchmark) Additional design/site considerations Parent material 7 ffr > g / Flood plain elevation, if applicable It L UE - 11 uita ble for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Unsuitable for system ® S ❑ U S ❑ U S ❑ U ®S ❑ U El S ® U ❑ S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 3 a Ground s elev. /Z7 ft. Depth to limiting factor rT Remarks: Boring # _ Q Ground elev. Depth to 7,5' _ limiting 7 a factor min. Remarks: CST Name (Plea Pr' t Ll Signature Telephone No. Address Date CST Number SOIL DESCRIPTION REPORT PROPERTY OWNER J� Page of PARCEL I.D.# Boring Horizon Depth Dominant Color Mottles Structure 2 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench .6 C Ground elev. S s c 0 gepht limiting factor Remarks: Boring # w -4114 � S C1 Gr6l�nd, 3 7 " S elev. Depth to limiting factor Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GP /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # l &-7/ - U-� s Z& Al ;< f Grout• 7.5'S�G g elev. 4 Depth to limiting factor �79_in. Remarks: Boring # »iSoE %FS� , Ground elev. Depth to limiting factor in. Remarks: SBDW -8330 (R. 08/95) f! ! V / .. . _ r\ /7L i - OCT -09 -98 10:02 PM BELISLE EXCAVATING 7132473039+ P.01 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIF1 ON FORM Y 1 " Owner/Bu er / Mailing Address • D. 6 D IC , �t'Sc �v T_ Property Address (Verification required from Planning Depument for new construction) CitylState t 14 Parcel Identification Number 03D —, —06 LECAL DESCRIPTION Property Location 5b '' /., 0 /. ', Sec. a 2-> -'`'i'`'ts 6 , T � N- ' Town of �S Subdivision J /'7 C. C/ Iq Lot # � Certified Survey Map # n e , Volume . Page # Warranty Deed # 5� ! _ '� , Volume __� Page # Spec housexyes O no Lot lines identifiable )(yet Q no SYSTEN„MAINTENANCE 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 licensed pumper. What you put into the system can affect the flinction of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journoymanplwnbet. restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition andlor (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certelestion stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Of within 30 'ays the x 7 1 7 ex ' ation date. 9 T[, APPLICANT DATE ERTIFICAnON I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of the pro desc ' ed a c, virtue of a warranty deed recorded in Register of Deeds Office. ; 1 17, S A OF A#VLICANT D •••••• Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. •• Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed • 528739 St "` ` WARRANTY DEED SE CROIX C% N;4 DOCUMENT NO. if Red far R'lcirtl MAY 8 1995 Geo T. Pennock, a/k/a George Pennock, at I1: A.0 % Raglu-h^r11Daub conveys and warrants to Pinecliff Part_rr p TMIS SPACE RESERVED F RECORDING DA NAME AND RETURN ADDRESS the following described real estate is St, Croix IV` County, State of Wisconsin: (Parcel Identification Number) W1/2 of N141/4; SEl /4 of NW1 /4; NEl /4 of SW1 all that part of NW114 of SW1 /4 I ying Ely of Apple River and that part of SE1 /4 of SW114 lying Ely of Apple River; all in Section 26• and all that part of NE1 /4 of SE1 /4 lying Ely of the Apple Section 7• All in Tawnshi 31 North a 19 West St. Croix Count River of Sec � , p ,Rang , y, Wisconsin. i ST is not This homestead property. )W (is not) Exception to warranties: Easements, restrictions and rights -of -way of record, t if any. Dulled ibis 6 4 - 0 — day of (SEAL) (SEAL) .� George f. Pennock, a&& George Pennoc (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT tf T. Pennock a/ STATE OF WISCONSIN � I _ County. R a day of — May . 19 9 Personally came before me this day of Aw , 19— the above named 1 land T STATE BAR OF WISCONSIN pf !i authorized by §706.06, Wis. Stats.) to me known to be the person who executed the l foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY Kr istine Ogland Attorne at !� Y t L a Notary Public County, Will. (Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If not, state expiration date: necessary) •Names or p:ru)rw signing in any capacity shrwW be typed M printed below their signatwes. WARRANTY DEED STATE OAR OF WISCONSIN Wisconsin Legal Blank Co.. Inc- ' FORM No. 2 — 110 Milwaukee. Wes f GN SEE SHEET I LINE MAC 175.00' AN 307.19' 46.34' F0 1v 353.53' / / \ N87 ° 34'00 "Wm 528. 53' ry O '� Z 361 �• � M HWL = 862 �-7 13 ° \5 � .I� .. �.i ® 12 AL AK 6 6, I\ / 3.00 ACRES � \ x 130, 853 SO. FT. Z 3.02 ACRES \ 2.62 AC. EXC. ESMTT, 0 131, 409 S0. FT. \ � \ \ 114,001 SO. FT. CLn l 31 W 2.06 AC. EXC. ESMT. \ \ S L 89,979 SO. FT. S84 046'05 "E 351.60' Ln \ m rn `p 2.55 AC. EXC. ESMT. p'h III , 151 SO. FT. 0) BR v ' ' �� BO 3.09 ACRES A o BN 134,629 S0. FT. p BP O :K / N o y 3 . 0 0 ACRES 2.21 AC. EXC. ESMT - -\ •� rn '� 1 857 SO. FT. P o V 96, 344 SO. FT. � N BU M ,•• g 0 �^ O N 0 BL C-2 a' "{ N85 493.58' G ' w BY BJ BF 343.01' BT j BS 373.58 150.57' Bz $ 8 X 120.00* 9 p CD C? N 1 353 .53 Qo r � ry 3� I bblJ i stave: a3lN33IN3"3naR •,., -1