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Wisco rtmento Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3
D" of safety a Buildings in accord with ILHR 83.05, Wis. Adm. Code
[REVIEWED u Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point
(BM), direction and % of slope, scale or ARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road. 0 3 2 - 2 017 -10
APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION BY DATE
PROPERTY OWNER: PROPERTY LOCATION
Mike ! GOVT. LOT 1/4 NE 1/4,S 5 T 30 A 19 :j (of) W
PROPERTY OWNERS MAILING ADDRESS LOT* BLOCK # I SUBD. NAME OR CSM #
2040 Oriole Ave. N. 10 Cedar Valle ]Estates
CITY, STATE ZIP CODE PHONE NUMBER []CITY []ViLLAGE (MOWN NEAREST ROAD
Stillwater, M. 55082 (612) 436 -6172 Somerset 180th. ave.
[xj New Construction Use [ 21 Residential / Number of bedrooms 3 [ ] Addition to existing building
�) Replacement [ I Public or commercial describe
Code derived daily flow 450 gpd Recommended design loading rate • 7 bed, gpd/9 - 8 trench, gpd/ft'
Absorption area required 643 bed, ft 563 trench, ft Maximum design loading rate • 7 bed, gpd/ft2 . 8 trench, gpd/tf
Recommended infiltration surface elevation(s) 95.37 ft (as referred to site plan benchmark)
Additional design /site considerations a1 f- _ 4Fi . Cjo' ayat Ai
Parent material pitted glacial i al drift Flood plain elevation, if applicable na It
S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL I HOLDING TANK
U= Unsuitable for s stem ®S ❑ U O S ®U ®S ❑ u ❑ S M u ® S ❑ U j ❑ S ® u
SOIL DESCRIPTION REPORT
Boang# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh, Bed jTrench
A. 1 0 -12 10yr4 3 none sl 2mar mfr QW 2f .5 .6
1.Y
2 12 - 10 r4j4 none s l 2mqr mfr gV if .5 .6
Ground 3 38 -80 7.5 r 4/6 none ms MCI r na na .7 .8
dev.
98 ft.
Depth to
limiting
factor
+80
Remarks:
Boring #
bk m fr 2
.
{ � s
,4/4 none
mfr f .5: .6
*: 2 11- 7
Ground 27 -78 7.5vr 4 none ms 0sa ml na na
elev. 9 11 j,
99.9 ft.
Depth to X\
limitin
factor
+7R cn J U L �
Remarks: s 'r o ICF_ �;
CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200
Address: 1554 200th. NewaichM2nd, WI 54017 £
w
1'
STEEL'S SOIL SERVICE
Gary L . Steel 1554 200th Ave.
CSTM2298 Mike Lundberg New Richmond, WI 54017
MPRSW 3254 NEkME a S5- T30N - -R19W (715) 246 -6200
town of Somerset
lot #12 -Cedar Valley Estates
1 "=40'
BM.= top of SE lot stake @ el. 100'
Alt. EM= nail in Oak tree el.101.15'
Ch`
ZO �?
P l'`
S
y 44
?a 22' 3o r
Gary L. Steel
5 -30 -97
ST. CROIX COUNTY ZONING DEPARTMENT -- ;
AS BUILT SANITARY REPORT
Owner t o n aJ d J f J - -Lc-r
Address _ Y,5
City /State W h / k 6 eav
Co
Legal Description: ++
Lot l0 Block Subdivision/CSM # ljq Il
%4 NE t /4 /JE Sec. S , T N -R /9 W, Town of 5c PIN
SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION
Tank manufacturer 1AJ e.6elr Size ST/PC / Setback from: House Well P/L
Pump manufacturer Model
Alarm location
f
(HOLDING TANKS ONLY)
Setbacks: Service road Vent to fresh air intake Water Line
Meter location
Alarm location
SOIL ABSORPTION SYSTEM
Type of system: Width Length Number of Trenches
Setback; from: House Well P/L Vent to fresh air intake
}
ELEVATIONS
Description of benchmark Elevation
Description of alternate benchmark Elevation
Building Sewer S s ST/HT Inlet W ST Outlet PC Inlet
PC Bottom V" -4 Header/Manifold 1 Top of ST/PC Manhole Cover X7.
Distribution Lines O / oS -v y O t 06 •sa ( )
Bottom of System O 103- O l aq-94 ( )
Final Grade
Date of installation / / Permit number J 15 Sq6 State plan number
Plumber's signature C, J 65 (f leer License number a 5- y Date
/p
Inspector
Complete plot plan Or
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety, and Buildings Division Count bT. CROIX
INSPECTION REPORT
GENIERAL INFORMATION (ATTACH TO PERMIT) Sanitarlism!!"_:
Personal information you provice may be used for secondary purposes [Privacy Ljw, s.15.04 (1)(m)].
Permit Holder's Nam e [] Town of: State Plan ID No.:
GILLITZER, hONALD
CST BM Elev.: Insp. BM Elev.: BM Dption: Parcel lion ��2110 -00 -000
TANK INFORMATION ELEVATION DATA A9800285
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Bench 11./2
Dosing 7 S 40 a
Aeration Bldg. Sewer
Holding t/ Inlet 23
TANK SETBACK INFORMATION St/
y 6 k Outlet
TANK TO P/ WELL BLDG. AiirIntake ROAD Dt Inlet
eptif �. 1 ' j � � NA Dt Bottom dv sQ
Dosing i! r / Lsi NA Header / Man. 97 `>(o_�_
Aeration NA Dist. Pipe o
0
Holding Bot. System D ,�
PUMP/ SIPHON INFORMATION Final Grade 2 lC>$
Manufacturer Demand p C Co •07 ra S•
Model Number 0 GPM '5,} J0(p
TDH Li - Frictiono System,/ D aj `d �?
Forcemain Length r Dia. Fi t Disf.ToWell
�
SOIL AB RPTION SYSTEM
BEDQjREA1CA Width 1 Lengt No. enches PIT No. Of Pits Inside Dia. ui Depth
DIME I N O Tr DIMENSION
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer
SETBACK
INFORMATION Type �/ CHAMBER Mode N er:
Syst m ti A - OR UNIT
DISTRIBUTION SYSTEM
Header / Manifold p Distribution Pipe(s) ` / x Hole Size x Hole Spacing Vent To Air Intake
Length -1 Dia. LengthDia. 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 ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons'present, etc.) 'a•
LOCATION: SOMERSET 5.30.19,NE,NE 1775 46TH ST — CEDAR VALLEY L 10
_� ,. n�� �� ..�- �. � � � sue► �I ��a, -, ,��
d-) 4- IN6 �el e4 /N- Oil
m ,v � L� t cam
ti y
Plan revision required? F1 ❑ No t
Use other side for additional I ormation. i 5 /
SBD -6710 (R.3/97) Date Inspector's Signature {
1 4 Safety and Buildings Division
sconsin S ANITARY PERMIT APPLICATION P Washington Ave.
Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code
P Madison, WI 53707 -7969
• Attach complete plans (to the county copy only) for the system, on paper not less County
than 8 112 x 11 inches in size. St. Croix
• See reverse side for instructions for completing this application State Sanitary Permit Number
ar <896
The information you provide may be used by other government agency programs heck if revision to previous application
[Privacy Law, s.15.04(1) /? L (p �� C S � � � State Plan l.D.Number
1. APPLICATION INFORMATION -PLEASE P ALL INF RMATION
Property Owner Name Property Location
t/a 1/4 9 T , N, R (o W NE Property Owner's Mailing Address Lot Number Block Number
4571 Carlo n Lane 10 1 - ----- -- "-
City, State Zip Code F (p' one Number Subdivision Name or CSM Number
T h r Mn ) Cedar Valley Estates
II. TYPE OF BUILDING: (check one) ❑ State Owned O C , It Nearest Road
0 Village
Public 1ZOr 2 Famil Dwellin - No. of bedrooms .3 Town OF
III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s)
1 ❑ Apartment/ Condo -S 9 0. 19. 1602$ 032 - 2110 -00
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. q New 2. ❑ Replacement 3_ ❑ Replacement of. 4. ❑ Reconnection of 5_ ❑ Repair of an
------ System System Tank Only _ `_ Vii;_(, ,, Existing SystemExistingSystem
- /7 1 7
B) E] A Sanitary Permit was previously issued. Permit Ddumber `,° Date Issued
V. TYPE OF SYSTEM: (Check only one)
I %L uJ" ;
Non - Pressurized Distribution Pressurized Distribution Experime Other
���
11 Seepage Bed 21 E] Mound r 1 74 pe If�6 ype 41 ❑Holding Tank
12 T Seepage Trench 'r CROP 42 Pit Priv
13 p Seepage Pit Sid.ew?_nd.er 22 ❑ In Ground Pressure SCp+lNTY 43 ❑Vault Privy
14 ❑System -In -Fill Infiltrator HN O
VI. ABSORPTION SYSTEM INFORMATION:
1 1�l
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loa lg 5. Perc. Rate 6. Sstem Elev. 7. Final Grade
450 R�T ed (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min-/inch) 1.103.9 Elevation
f(aa 595 . 2 . 55 2. 104. Peet 107 • 4 Feet
VII. TANK Capacity
in gallons Total # of Prefab Site
r . Fiber- Plastic per.
INFORMATION an
Gallons Tanks Manufacturer s Name Concrete A
Con- Steel glass App.
New Existin strutted
Tanks Tanks
Se tic Tank r Holding Tank 1250 -• ° - 1 T PF T S ER ® ❑ ❑ ❑ ❑ ❑
Lift Pump Tan iphon Chamber 7 5n - - ° - 1 T]E S ER ® ❑ ❑ ❑ ❑ ❑
VI11. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) PI er's I n t e: (No mps) MPMMRM No.: Business Phone Number:
P TJL C.J. STEIL`1FR � ,_U5 -q5 (715) 4 ?.5- 5544
Plumber's Address (Street, City, State, Zip Code):
N8230 945th Street River Fa is wi 540?2
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate I ssued Issuing Agent Signature (No Stamps)
Fee)
Y Approved ❑ Surcharge
Owner Given 7/10/98
Adverse Determination
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SOD -63M IRA 1/96) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber
Safety and Buildings Division
NVIsconsin SANITARY PERMIT APPLICATION 2 1 Box Washington Avenue
Department of Commerce In 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 8 12 x 11 inches in size. 5 k r6 14
• See reverse side for instructions for completing this application State Sanitary Permit � Number
Personal information you provide may be used for secondary purposes ❑Check if revision to p reviou pplication
[Privacy Law, s. 15.04 (1) (m)].
State Plan I.D. Number
I. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATI N ��-
Pro y Owner Nam Prope Location
0 1 1/4 rt i 1/4, S f T30 , N, R Q E (o W
Property Owner's Mailing Address / Lot NugZber Block Number
I /- (� ---_
City, State I Zip Code Phone Number Subdivision Name or CSM Number
e j5w ( ) Ceding- dllC
II. TVPE OF BUILDING: (check one) ❑ State Owned 9_ I ;�] Nearest Road
Public R@ 1 or 2 Family Dwelling - No. of bedrooms Town OF ,e
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
1 ❑ Apartment/ Condo ® 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, [ANew 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
- ___/__System ________ System __________ ___ Tank Only______________ Existing System _________Existing System
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 � r� 21 E] Mound 30 E] Specify Type 41 E] Holding Tank
124 Seepage Trench , *'� 22 ❑ In- Ground Pressure - t ' 42 E] Pit Privy
13 E] Seepage Pit TA-C,'1rafar c • 0 ' ��• /, 43 ❑ Vault Privy
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. 17. Final Grade
�/ Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation
- 7 0 �(0 e (o S /O� , Feet T, Feet
Capacit
VII. TANK in Ca g Total # Of r Prefab. Site Fiber- plastic Exper.
INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Ste glass App.
New Existin strutted
Tanks Tanks
Septic Tank 16 On ❑ I ❑ ❑ 1 ❑ ❑
iftPumpTank r io I IV •f'+! k i 0 1 ❑ ❑ ❑ I ❑ ❑
M — RESPIU NSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
PI ber's Name: (Print) Pt is Signatu No Stamps) MPNMPR5y0.4@.: Business Phone Number:
P u t , - ly"
PI ber's Address (Street, City, State, Zip Code):
r l-tfall L `b z
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (include' Groundwater at ssue Iss n en i ature (No Stamps)
X Approved ❑ Owner Given Initial Surcharge Fee) yy��
Adverse Determination �CJ
X. CONDITIONS OF APPROVAL / REASONS OR DISAPPROVAL:
SBD- 6398 (R.11/97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber
1D/0 PlQry
yo
C� ( -e r; Ron a I ce G J I
� M f t4 /k c l, / 00, 0,
6F 16 I&A
C � 1
ra �er►tew t Rio r 1. e i !0
cJ� �
/000c SePfrc Tank
N
( Q I
T o o cj&I Pa s..p I'a (
6
Q I
Q
6 v
� n each o� i,;2- TrcrtcA4
rz
PUMP C11AM11FR CROSS SECTION AND SPECIFICATIONS
• q:
Vent Cap Approv >t0 ' ki��t
41ea then Proo Eye U
Junction Box Manho ov •'� - �
12" Min �. ? 4 - 7
Vent: Pipe
Final ' 4 11 sk jry
r
Grade
Conduit
18" Min
Al Approved
Joints w/
Inlet
• i �;; C-1- Pip e
Extending
Approved �;� 3' Onto
Joint wJ Solid Cro
C.I. Pipe
Extending
3' Onto
Solid b
Ground On
• - -� C
• •Pump Of f
Concrete Block' D
N
SPECTFICATIONS
TANK PUMP
TANK
e's�r Manufac Myers —
Manufacturer M E ya
Tank. Material: Concrete ?fodel Number:
79G Collons Switch' Typo ---
Tank Sizc: E
,Total Dynamic Head: 11.77
_CAPACITIES Pump Dincharge` Rate: 30 CI
'Total Daily Effluent: 450 _ Callor
A 21.3 or 362 ' Gallons Number of Doses: 3 Per Dc
�2 or x 34.2' Gallons Dose Volume: 160 Callor
8.82" or 158.2 Gallons Notes: 1. Sec pump curve for
p'- 12 11 or 204 Gallons additional performance
Total Tank = information.
Capacity Requi.rcd 758.40 Gallons 2. Pump and alarm arc to be
• installed on separate circuit
ALARM au per ILUR 16.19 NAC . _
?tanuf ncturer: level arm
Model Number:_ D
Switch Type. Float
Page 6 of 7
09 -1998 THU 14:12 ID:STEINER PLUMB & ELEC TEL:715 425 9818 P:01
L " Ws
b
FME Series
1/3 through 1 -1/2 HP
Effluent Pumps
Performance Curve
CAPACITY LITERS PER MINUTE
O 50 100 150 200 250 300 350 400 450
(00
28
90
24 N
UO M / s0 W
70 2U
60 D
z
is a
w 50
J tit S I Q
Q 40 O F
H _
O
r 30 e
20 3
4
10
0
O
0 10 20 O 40 50 60 70 80 90 100 110 120 130 .
CAPACITY GALLONS PER MINUTE
F.E, Myers, A Pentair Company • 1101 Myers Parkway, Ashland, Ohio 44905 -1923
419/289 -1144 FAX 419/289-86M Telex 98 -7443
K3327 7/91 PrinlW in U.&A.
• . wise Ln 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. Adm. Code
" COUNTY
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. rroix
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road. 032- 2017 -10
APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION )ff B DAT
a
PROPERTY OWNER: PROPERTY LOCATION
GOVT. LOT 1/4 1/4,S T N,R 1 (or) W NF
PROPERTY OWNERS MAIIING ING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
9n4n nrinlin Aare N_ Id /0 na Ced ar Valle Estates
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY [ ®TOWN NEAREST ROAD
( Somerset
( New Construction Use [x] Residential / Number of bedrooms 3 [ J Addition to existing building
[ J Replacement [ ] Public or commercial describe
Code derived daily flow 450 gpd Recommended design loading rate .7 bed, gpd /ft trench, gpd /ft
Absorption area required 643 bed, ft 563 trench, ft Maximum design loading rate .7 bed, gpd /ft .8 trench, gpd/ft
Recommended infiltration surface elevation(s) 104.90 ft (as referred to site plan benchmark)
Additional design / site considerations — 104.90
Parent material pitted glacial deft Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK
U= Unsuitable fors stem [9S ❑U ®S ❑U ®S ❑U Cis ❑U 12S ❑U El :E1
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
..................
.................
..................
.................
..................
.................
..................
1 1 - 5 .6
mfr CrW if .5 .6
Ground i I 9n_Rn na
elev.
1 08.5 ft.
Depth to
limiting
factor
+80
Remarks:
Boring #
none sl 2m r mfr 9W 2f .5 .6
2. 9 -22 10 r 4/4 none sl lcsbk mfi 9W if .5 .6
Ground 3 22-84 7.5 r 4/6 none is osg mvfr na 47, .8
elev.
1 07.3 ft.
Depth to
limiting
factor
+8 4" -. ST ROIX
Remarks: , ZONINGOFt`ICE .�
CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200
Address: 1554 200tb, Ave. New RichlbgAd WI 4017
Signature:
L J / Date: 6 -25 -97 CST Number: m02298
i
STEEL'S SOIL SERVICE
Gary L. Steel 1554 200th Ave.
CSTM2298 Mike Lundberg New Richmond, WI 54017
MPRSW 3254 �4�4 S5- T30N -R19W (715) 246 -6200
town of Somerset
lot #12 -Cedar VAlley Estates
N
1 =40'
BM.= top of NE lot stake C el. 100'
Alt. BM.= top of mid lit survey stake C el. 98.40'
� (2
TT
St -�1fZ )', ,tw,.e <, 16✓ 7 /Q
,-
I
i
A
N
Gary L'. Steel
6 -25 -97
ST CROIX COUNTY
SEPTIC TANK MAINMNANCE AGREEM ?Nl'
AND
Q O WNERSIRP CERTIFICATION FORM
Owner/Buyer Af - 7
Mailing Address y� 7/ ��,� y/�� ,L e �✓��-
Property Address
(Vcrifica(ioa rcquimd from PU=iag Dcputaua( for new coasimctioa)
City/Statc �2 a i / Parcel Ideatification Number _c") S.Z - .-;—>O
LEGAL I)MCRWITON
Property Location ,� ` /<, ..- l
: /<, Sec. S . T�N -R W, Town of SS alv;A 'eS.
Subdivision / `1�
Lot #
CertMe d Satvey Map # Voltnme Page #
Waczaaty Deed Volume 13 #
Spec house ❑ yes C no Lot lines idcuti5.ab1e CYyes ❑. no
SYS'iF�Vi 4IAMTENA. IC9 s
Pa H ofd qg=codAvcs btmtft
eoasistsafpa�goa#.g� p .� .... - tA bandiewasUc 's.Propermaiatenancc
�a �e T1Ac a tt �cvmyt1W=.W=" ifwc cdbyv Y6=sedpcmFxc- . W1dt , =put.into Mc system
tats as.: t�rabmr�ttt:g�Cis the �iastc _;qvL
Zbe. S01m y oWaer n= to scbr* St. QQ'm Zoning - j =ffiufix form, rigncd by &a manes and by a
P7aplaa =SeW(edplamber "
is is PL°Pa oP�g aouditioa tadlor Cl) niter usspodian cord t�� �(1) the oaaitc w^astcwatcrdiisposal rystcm
.C1' M== y). the sc & ftnk-is J= f= W fa of du igr—
.. hm trad die onr tv
abgr Sad 9 C= to the pmratrc =wage disposal cyst= wiSt Qu c - Undo&
fob h=injts sd by tic DTwmcdof tad the Dcgut=at of N d=;l
- �y'� u'P� has'boca ; Stiic of Wes. e�fication
day%-of the 9= tmedmustbc eoarpletedand ntumrd to die St. t�oix.Cocsuty Zoning Office within 30
tioa date.
siGTrA APPUCAxr �7/ /
DATE
O'P(� MR CER' CA.Z'XON
I (Wc) � tt Y =cnft oa this loan ace h= to the bat of my (our)1mowicdgc. I (wc) am (arc) the ownct(s) of
ICY vc. by virtue of a wuraaty dcod ro=j od is Rcgista of Dcods Office.
DATE
Amy ia(bruis ion that is mkAq=cu9,od ma =It is 10 tanituy pcmnit being mvoiced by the Zoning Depa rtmcat_ • • • • •
•• Ladadc nith this apptica(tba; a ctuapod wuuma y dood fcvm the
ILcgidex of Doody oiioc
a copy of the cuatod cmcy m&p if mfc moe is oaade is the wmanty dcod
N SEE SHEE I E
w �M T 1
r �
a
, T --
S82
101.50
640
8
cp
13.61 ACRES
,157,310 So. FT.
Z (852.0) — Ti
o`
T6 - - - -- -- re�� r M d
107.72 -- -'t
10 S2 t o,1883.30
a ",\ N 5
40- S e °26 "W
�Oo 3.69 ACRES ► • I 3
(60,653 S0. FT.
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3.91 ACRES
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480 S0. FT. • p 1 9.87' 1 �
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.00 ACRES
s PRIVATE SEPTIC SYSTEM 3 I
� EASEMENT FOR LOT 10 3 I 130,724 SO. FT, i
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PRIVATE SEPTIC SYSTEM $ EASEMENT FOR LOT 8 O
w 288.87'
192.28' `L 2 2. 8
N88 26' 22 "E
1800.87 '
- SOUTH LINE OF THE NI /2 OF THE NEI /4 OF SECTION 5
�� ` ✓�_ . 553 , PG. ��+ i