HomeMy WebLinkAbout020-1319-60-000 ST. CROIX COUNTY ZONING DEPARTMENT, %,1
AS BUILT SANITARY REPORT
Owner t
Property Address x'
City /State
Legal Description:
Lot ;� Block Subdivision/CSM # STc�'o,-' x G s
t/4 T /a, Sec. -�2 d . T Al N -RAW, Town of PIN # Oa U L 1�1ri — (,on
SEPTIC TANK -- DOSE CHAMBER -- BOLDING TANK INFORMATION
Tank manufacturer I2�, `clu/ ps ?`c-y y Size ST/PC / �d Setback from: House & Well tlJ P/L 2�LL
Pump manufacturer g5ou 1e1 s Model
Alarm location Sao c—
�—
(HOLDING TANKS ONLY)
Setbacks: Service road Vent to fresh air intake Water Line
Meter location
Alarm location
SOIL ABSORPTION SYSTEM
Type of system: Co,✓ Width -5" Length 2? Number of Trenches �
Setback from: House - ` Well � P/L • /d ' Vent to fresh air intake �2-5'-'
ELEVATIONS
Description of benchmark 4.9 < Elevation /mod -
Description of alternate benchmark dr 5 1 ra da"_.y Elevation l e7. S�
Building Sewer ST/HT Inlet V7 ST Outlet PC Inlet
PC Bottom �3 �S Header/Manifold Top of ST/PC Manhole Cover /�
Distribution Lines
Bottom of System O S'G� 9l O 97 .�S O r' V
Final Grade
Date of installation /� /9 9 Permit number State plan number
Plumber's signature �/ r License number Date/--j /
Inspector ,�e l rtio e A n14 H���;� � GU Complete plot plan �
k
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a
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
5 �
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3
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o
INDICATE NORTH ARROW
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count y=
'Safety and Buildings Division
INSPECTION REPORT ST. CROIX
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: --
Personal information you provice may be used for secondary purposes [Privacy L 21 s.15.04 (1)(m)]. 324613
fRMX Eder§ fM AND CARRIE I DfH faw lage Town of: State Plan ID No.:
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel `6106 -1319-60-000
.:
.s � S
160 1
/
TANK INFORMATION ELEVATION DATA A9800501
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Vk - Ben r 7�
Dosin gD� I IO7, S
Aeration Bldg. Sewer �,� ge- r*r ,
[ Holding I St Inlet �j.ZS' 6 1 - 7.S - 5 -
TANK SETBACK INFORMATION St/ Outlet
I ntake
TANKTO P/L WELL BLDG. Air to ROAD Dt Inlet
ir
Septic 30 NA Dt Bottom
Dosing NA Header / Man.
Ink
Aeration NA Dist. Pipe (_ �
q &
Holding Bot. System
c.� /b•B b•9/
PUMP / SIPHON INFORMATION g L Final Grade,,,, -'2 fpd,
Manufacturer Demand • ! Off. 3g
Model Number V� f� (? GPM
TDH Lift .b'� Friction Sy tem, TDHI,2.A Ft
Forcemain LengtFl s Dia. " Dist. To Well
SOIL ABSO PTION SYSTEM 7,•(04,
BE REN Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIM N DIMEN I ON S'
SETBACK
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufac INFORMATION TypeO / — CHAMBER Moe Number:
Syste en��4 �5 N OR UNIT
DISTRIBUTION SYSTEM
Header/ Mani old Distribution Pipe n / x Hole Size x Hole Spacing I Vent To Air Intake
Length 6') Dia. Length Dia. Spacing 7 A< z
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 ❑ No ❑ Yes ❑ No
COMMENTS (Include code discrepancies, persons present, etc.)
LOCATION: HUDSON 2 8.2 9.19 , NW , SW 735 CROSBY DR S T. R I Lr"ST LOT 20
04 , VU bnil tv
l
Ztk awl a 4 e ) e
I
PJ r�vQiiln required? Yes ❑ No
Use other side for additional information.
SBD -6710 (R.3/97) Date Inspector's Signature Cert. No.
t
Safety and Buildings Division
S ANITARY PERMIT APPLICATION 2 01 W. Washington Avenue
1*6consin
In 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 1/2 x 11 inches in size. .S7 ,`
• See reverse side for instructions for completing this application State Sanitary Perm / Number
Personal information you provide may be used for secondary purposes ❑ Check if revi sion to pies application
[Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number
I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION �-
Property Owner Name Property Location
.5 e W 1/4 S� 1/4, S T a Q' , N, R E (or
Property Owner's Mailing Address 401 Lot Number Block Number
Lo-V G
City, State Zip Code Phone Number Subdivision Name or CSM Number
,j J.4 gdV ( ) `
II. Y BUILDING: (check one) ❑ State Owned ! t Nearest Road
p Village
Public 1 or 2 Family Dwelling - No. of bedrooms pk Town OF of v
III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s)
1 Apartment/ Condo O v a -
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. g New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5, []Repair of an
System ________System Tank Only______________ Existing System ________ Existigq� ystem
B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non- Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 p Mound 30 ❑ Specify Type 41 ❑ Holding Tank
1 e Trench
22 In- Ground Pressure 42 ❑ Pit Privy
2 'See a
p g ❑ c S 43 Vault Privy
13 ❑Seepage Pit X 7 ❑ y
14 ❑ System -In -Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade
Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation
l'Gd ,'S- G 7"5 GZ - 9r • G SFeet lel. eet
Capacity e
VII. TANK in gall Total # of Prefab. Site Fiber- Exper.
INFORMATION g Gallons Tanks manufacturer's Name Concrete Con- Steel glass Plastic App
� -- New Exn strutted
Tanks. Tan
In
eptic Tan 4H l�� .0 Y ❑ 0 0
Lift Pump Tank /Siphon Chamber (� I z d Am - ` e V.
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite se age system shown on the attached plans.
Plumber's Name: (Print) Plumber's Signatur • (No Stamps) /MPRSW No.: Business Phone Number:
1,a 4s , �a2 7TY4 S -/
Plumber's Address (Street, City, State, Zip Code j:
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (includes Groundwater D ate I ssued Issuin Agent Signature (No Stamps)
O Approved ❑ Surcharge fee)
� Owner Given Initial C !� w
Adverse Determinatio V //CD
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD- 6398 (R,11I97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber
-e fJe. a� � •� ,lJ � SGV l .�� fi � � v fi .s?�c�d'x s ad.�o.�
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rnr.,l GF
PUMP CH CROSS SECTIOIJ A SP ECIFICATIOUS
VCUT CAP
`"C.I. VENT PIPE
WEATHERPROOF APPROVED LOCKIAIG
>
25' FROM DOOR, JUMCTIOM BOX MANHOLE COVER
—
WINDOW OR FRESH I2 "MIU.
AIR INTAKE
GRADE I
(
`__ IB "Mlu.
colJOUIT ______ _
� 111
IAILET PROVIDE
_T
AIRTIGHT SEAL i I
*' A
1
I 1
1 1 1 1 ALARM
B 1 I(
c *APPROVED i i OM
JOINTS WITH
ELEV. FT. APPROVED PIPE __�
3' ONTO PUMP OFF
D SOLID SOIL
COUCKETE BLOCK
RISER EXIT PERMITTED OIJLH IF TAUK MAMUFACTURER HAS SUCH APPROVAL
SEPTIC E SPEGIFICATIOUS
OOSE /
TAMKS MAM UFACTURER: I(IUMBER OF DOSES: PER DAy
TAWK SIZE : e4f0
GALLONS DOSE VOLUME
ALARM MANUFACTURER: e. IPICLUDIMG BACKFLOW: 175 GALLONS
MODEL NUMBER: ;? y.2
CAPACITIES: A= INCHES OR _ E GALLONS
SWITCH TYPE: /hLlg
I B = Ira INCHES OR 4 2 GALLONS
PUMP MAAIUFACTUR><R: _ lsc9 � /J !/ C=- `�� INCHES OR 7 � GALLONS
I MODEL AfUMBER: _ �� 7 C/ D lt Z INCHES OR GALLDUS
i SWITCH TYPE: L'%,- NOTE: PUMP AUD ALARM ARE TO BE
MINIMUM DISCHARGE RATE y� GPM �IINSTALLED OM SEPARATE CIRCUITS
VERTICAL DIFFEKEMCE BETWEEN PUMP OFF ARID DISTRIBUTION PIPE.. _ L__ FEET
+ MIAIIMUM NETWORK SUPPLY PRESSURE , . , 4 K FEET
FEET OF FORCE MAIM X G2 F JjooFT.FRICTIO►,I FACTOR__ FEET
TOTAL DYNAMIC HEAD FEET
IMTERI.IAL DIMENSION,; OF TANK: LENGTH ;WIDTH ;LIQUID DEPTH
Goulds b o� �
Submersible
Effluent Pump
3871 EPO4
,i EP05
APPLICATIONS • Fasteners: 300 series • =erged in high ■ Motor Housing: Cast iron
Specifically designed for the stainless steel. ne oil for for efficient heat transfer,
following uses: • Capable of running lubrication and efficient strength, and durability.
• Effluent systems dry without damage to heat transfer. ■ Motor Cover. Thermoplas-
• Homes components. Available automatic d tic cover with integral handle
• Farms Moto or auomac an r. and float switch attachment
manual operation. Automatic
• Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points.
• Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty
• Dewatering RPM, built in overload with preset at the factory. 'rated oil and water resistant
automatic reset ■Bearings: Upper and lower
RP
115 V, 60 Hz, 1550 RPM, ,
SPECIFICATIONS ' EP05 Single phase: FEATURES heavy duty ball bearing Pump: EPO4 built in overload with ■ EPO4 Impeller Thermo-
construction.
• Solids handling capability: automatic reset. plastic Semi -open design
3 /i maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING
• Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal p rotection. P CO- CanadianStandaNsAssociation
s
- Total heads: up to 24 feet. with three prong grounding E EP05 Im eller. Thermo-
• Discharge size: 1 /i NPT. plug. Optional 20 foot P (CSA listed model numbers
• Mechanical seal: carbon- length, 16/3 SJTW with Plastic enclosed design for end in "F" or "AC ".)
rotary/ceramic- stationary, three prong grounding plug improved performance.
BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged
• Temperature: thermoplastic design provides
104 °F (40 °C) continuous superior strength and
140 °F (60 °C) intermittent corrosion resistance.
• Fasteners: 300 series METERS FEET
stainless steel. 10
• Capable of running
dry without damage to s 30 3:
components. s`
Pump: EP05 s;:
• Solids handling capability. o 25
VV maximum. w
• Capacities: up to 60 GPM. x s 20
• Total heads: up to 31 feet. N
• Discharge size: 1I NPT. z 5 % .eg
• Mechanical seal: carbon- 0 15
rotary/ceramic - stationary, 4
BUNA -N elastomers. w?p
Temperature: s 10
104OF (40 °C) continuous
140°F (60 °C) intermittent 2 — !
5
1
0 1/ ± OL 00 10 20 30 40 50 GPM
0 2 4 6 8 .10 12 m -/h
CAPACITY
Wisc,r Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3
Labor and Human Relations
Division of Safety & Buildings in accord with ILHR 83.05 WIS COde
>n'�a COUNTY
F� Y
Attach complete site plan on paper not less than 8 1/2 x 11 inches in si -M ist nclude, but ' St. Croix
o PARCEL I.D. #
not limited to vertical and horizontal reference point (BM), direction a Tof slope„E3cale or
dimensioned, north arrow, and location and distance to nearest roa ..;� 7 pending
APPLICANT INFORMATION— PLEASE PRINT ALL INFOR ANON
REVIEWED BY DATE
PROPERTY OWNER: I PROPERTY LOCATION
Brid eland Dev. Co mpany
, GOVT. LOT ' NW 1/4 SW 1/4,S 28 T 29 N,R 19 :j (or) W
PROPERTY OWNER':S MAILING ADDRESS BLOCK# SUED. NAME OR CSM #
11'736 1 17th S t `
CITY, STATE ZIP CODE PHONE NUMBER VILLA OWN NEAREST ROAD
Lakeville, MN. 55044 (61� 985 -5000 n Crosby Dr.
[x)cNew Construction Use [ Residential / Number of bedrooms 3 [ ] Addition to existing building
j ] Replacement ( ] Public or commercial describe
Code derived daily flow 450 gpd Recommended design loading rate .7 bed, gpd /ft .8 trench, gpd/ft
Absorption area required 643 bed, ft2 563 trench, ft Maximum design loading rate .7 bed, gpd /ft .8 trench, gpd/ft
Recommended infiltration surface elevation(s) 98.05 ft (as referred to site plan benchmark)
Additional design / site considerations alt. system el. = 97.17'
Parent material outwash Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL MOUND GROUND PRESSURE 7AT- SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem Cis ❑ U iD S ❑ U IN- 1 S ❑ U S AD ❑ U ® S ❑ U Cl S ® U
SOIL DESCRIPTION REPORT
Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
...... _ 1 0 -14 10 r2 2 none 1 2msbk m
2 14 -29 10 r4/4 none scl 2m r mvfr
Ground 3 29 -82 7.5 r4/6 none s osa mvfr na na .7
elev.
100 ft.
Depth to
limiting
factor
+82
2 �
Remarks:
Boring #
1 0 -12 10 r2 2 none 2
2 12 -24 10 r4/4 none sl 2mcrr mvf
3 24 -84 7.5 r4 6 none
Ground
elev.
10 ft.
Depth to
limiting
factor
+84
Remarks:
CST Name. Please Print Phone:
Gary L. Steel 715-246-
Address:
1554 20 Ave. New ii s on WI. 54017 m02298
Signature: Date: CST Number:
6 -25 -96
PROPERTYOWNER Bridgeland Dev. CO. SOIL DESCRIPTION REPORT Page d. 3
PARCEL IA # pending
Lot #20
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourxiaty Roots GPD /ft
in. Munsell Du. Sz. Cont Color Gr. Sz. Sh. Bed ITImnch
3 1 0 -12 10 r2 2 none 1 if r mfr qw 2f .4 .5
2 1 12-23 10yr4/4 none sl lfgr mvfr gw 2f .4 .5
Ground 3 123-82 7.5 r4/6 none s osg ml na na .7 .8
elev.
101 ft.
Depth to
limiting
factor
+82"
Remarks:
Boring #
:- >- ::•::< 1 10-18 10 r2 2 none 1 2m r mfr qw 2f .5 .6
4i 2 118-34 10 y r4/4 none sl 2mgr mfr gw 2f .5 '.6
Ground 3 1 34-80 7.5 r4 6 none s 0SQ mvfr na na .7 .8
elev.
10 ft.
Depth to
limiting
factor
+80"
Remarks:
Boring #
1 10-15 10 r2/2 none sl 2m r mvfr gw 2f .5 .6
5 '" 2 115-27 10 r4/4 none sl 2m r mvfr if .5 .6
Ground 3 1 27-80 7.5 r4 6 none s 0sq mvfr na na .7 .8
99 e1y4 ft.
Depth to
limiting
factor
+80"
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD- e330(R.05l92)
STEEL'S SOIL SERVICE
Gary L. Steel Bridgeland Dev. Co. 1554 200th Ave.
CSTM2298 NW4SW4 S28- T29N —R19W New Richmond, WI 54017
MPRSW 3254 town of Hudson (715) 246 -6200
lot #20 - St. croix Estates First Addn.
1 =40'
BM.= top of SW lot stake C el. 100
�r
f✓ 0
�o
�M
i
Gary L. Steel
6 -25 -96
STEEL'S SOIL SERVICE
Gary L. Steel 1554 200th Ave.
CSTM2298 New Richmond, WI 54017
MPRSW 3254 (715) 246 -6200
To whom it may concern;
This soil evaluation was conducted to satisfy a zoning requirement,
it may or may not be satisfactory for your use. The location of the
system may or may not be as shown, as permanent lot lines had not
been established at the time of the test.
Gary L. Steel
• 10/07/98 WED 16:07 FAX 6514051622 Steve Hogan W001
OCT -07 -1998 LAM 1Ge48 ID:LACAS'W CUSTOM WMAR.S TEL %715- 391 —Gr.F1 Psei
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' �,
ST CRM COuMW
SEPIMC TAME MA04TONANCS AOR89ME NT
AND
OWNERSHIP CRRTIF[GTION DORM
Mailing Addrme yW ;l a Q t apt. -J& =° d 91.1— c - #.
Prup.ty A*I mn 136 C= 464)f ... -
wea�im -
t�ty/&�c � +� #�^ -�.,. (��— Poo�cd Sdoatt5wiioa Irtattber �-� o ' � 3 I °► — � D
Hto -dY Loa d — VAL y.. ,L, 544 sec. I&— TA.N -Rl —W. Town Of
Lot * Z CJ
Gwsd Sorg Map g . Vabime _ Pm g
Wlortaaty Dead 0 _ •. � � . v wmo pw #
sw hom o yet Woo i of N mee' Womfiffable W''yms a no
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oeodtbd a. cite« �uemtaaslin .7aaarroawuaneatty.11�ap�pae ��a►wti�oms4�Ma
®~dw Leda. otdw GNP" +mt r..Wsmt.bje lr a.w.�me el4and
'ire ..68it to St CAk Uft Dmork o d a iM SM 04PM by rile of W 04 by 8
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ntl o�aM�tIRrYareb�NrJ �Ip��•• atien�aAaaaetwbni l�w�eebelgrarwr
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58822 VOL PAGE
Document Number WARRANTY DEED �k5
This Deed, made between,
Patrick P Westerham and Janell L Westerham
husband and wife Grantor, 0 FILE ,
and, ST. H Hogan and Carrie J Hogan ST. Inv hX� WI
husband and wife, as survivorship marital property G+arfte. OCT Q 1
Witnesseth, That the said Grantor, for a valuable consideration of one dollar and
other valuable consideration conveys to Grantee the below described real estate in a I OO PJ
St. Croix County, State of Wisconsin. \�
This is not homestead prop". Cmeda
Together with all and singular hereditaments and appurtenances ffreneunto
belonging;
And Grantor
warrants that the title is good, indefeasible in fee simple and free and dear of
encumbrances except Recording Area
easements, covenants, and restrictions of record, Name and Return Address
and will warrant and defend the same. Steven H. and Carrie J. Eorgan
(Parcel Idenufication Number) 4429 Wilderness Run Court
020- 1319 -60 Eagan NN 55123
Lot 20, St. Croix Estates First Addition in Town of Hudson, St. Croix County, Wisconsin.
TRANSFER
$ /7 E �
Datad ; s day of 199
'Pa 'ck P W st ham • ] m
11 L Westerha
AUT1,73TICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN
COUNTY ST. CROIX "�
PersonaNy camp before mg thi q Day f !"Ihe
above namer Patrick Y. esteitie d
authenticated this ^day of JancH L Westerham o t v e . to
me known to be the person(s) f esfc the• foregoing
instrument a novAedgp the W 4:
signature J e
type or print name s versa i
ty.` or print name
TITLE: MEMBER STYE BAR OF WISCONSIN Notary Pubk County.
(if not. `tity commission is permanent. (if not, state a )Viratieon date:
mrthorized by §706.06. Wis. Stets.) )
9 THIS INSTRUMENT WAS DRAFTED BY 'Names of persons signing in any capacity should be typed or
Robert F. Wall prirtied blow their signatures.
(Signatures may be authenticated or acknowledged. Both are not
necessary.)
' t
M "I 111"I
i -
! 1 8 1.93 AC. EXC.
I E SMT n L
Y 1 83 ' 960 SQ. FT
• I ch
a9 1 2.12
92,2
D� a 2.05
! 89, 2!
U N
O o
�F �� � A ao
'� •� Z h
HWL s 908.0 10 • i �i
/
� 2
A O / Z6 ;o AO / 00
�
z LOT 21
�s 1 2.03 ACRES
88 ,296 SO. FT.
6 � E
3 3 2 AC. EXC. ESKJT. - m SA6•la
•,
3'y'
87,342 S0. FT.
gA�` 30
1 ,
� GI 3x6.91' ,
�� tt► STgo Oa. ag "W
5
4 I LOT 22
2.60 ACRES
EI 113,460 SO. FT.
. _ • u..
1 2.41 AC. EXC. ESMTS•.
s e a 106, 159 SO. FT.
. 66 5T
609.72 831.72'—
E N89 49
iOAD
'00"E 1293.20'
SOUTH LINE, OF THE NWI /4 nor T,at