HomeMy WebLinkAbout038-1048-80-000 r
0 to Q I g n d
O _ 1
c+ s a, O
('o
M n a
M CD
� 0
_ _
O co O
0 0 0 Z N V? w < •
O O N
� O p>
(D Q. d C A I.r
N N C O 7 Cp
N N Q- ( (O N N Cp 't rl
0 0 � gy N CD CD p c, O O
0 0 � n n Q
v, p D o ??
3 m CD o p
C Q°
o _(y
0.7 i!r CD D C �' w 1
CD Cf` N co G CD
- m W
N C
W 3 ia.
O CD "�"' N 0)
CD CD (D
O L
N CD
, " ;� r y
o 0o S c C
z O O O �
oa co p rL
m < z �4
0 o C') a 3 N N o D
N N _v Cn cr 'U D O 01
O O O =T C R N .�•. tll S N
O1 O C N Ct 'O
7 (D = O (P
N
W
Z cn
D o
w O
0 CD
CD
CC N
CD h
N
N
C S CD
W (D (7 Q.
EL 3 41
z CD
O O tQ A Z (D
_.
0) O n
Q O
N Q A Z
0
S
Z
W A * C
G Z
0
O ! (n O
m z m
CD
=r CD a
o � �
B cn o'
0�mm °—' C
v
d cn
grn v w
co 5.
N (D m CD
D y 7 0'. j
N y
a CD
_ . CD N
N O N fi
O O 7 n
O N CD T
N
N x. (�
00 o O
O
Q
O
CD a
O b
° o CL a
INDUS T TR Y,, DEPAENT OF REPORT ON SOIL BORINGS AND SAFETY &BUILDINGS
INDUSY, DIVISION
LABOR AND
HUMAN RELATIONS PERCOLATION TESTS (115) MADISON WI 53707
(H63.090) & Chapter 145.045)
CATION: ECTION: TOWNSHIP/ LOT NO.:BLK. NO.: SUBDIVISION NAME:
NW ��4SE�/4 11 /T31 N / Star Prarie n/a I n/a n/a
C OUNTY: NER'S ME: MAILING ADDRESS: tg�9
k. Croix O Clay Edin 1 2220 127th. St., New Richmond, Wi. 54017
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMER IAL DESCRIPTION: PROFILE DESCRIPTIONS: PE TESTS:
IXBResidence 3 n/ )I New ❑Replace 4 -26 -90 4-26 -90
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: I MOUND: JND-PRESSUR YSTEM -IN -FILL r El s OLDING TANK: RECOMMENDED SYSTEM: (optional)
®S ❑ U ®S ❑ � CAS ❑ U Em ®u I conventional
if Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the
under s.H63.09(5)(b), indicate: n/a Floo indicate Floodplain elevation: n/a
decimal' PROFILE DESCRIPTIONS p 4 BrB
BORING TOTAL DEPTH TO GROUNDWATER- INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTFm. ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B -1 7.08 100.45 none >7.08 1.33bl.1. 1.08bn.s.sil. 4.67bn.c.s. &gr.
B - 2 7.58 100.85 none >7.58 1.25bl.1. 1.08bn.s.sil. 5.25bn.c.s. &gr.
B 3 7.25 100.40 none >7.25 1.25bl.1. 1.08bn.s.sil. 4.92bn.c.s. &gr.
B 4 6.91 99.73 none >6.91 1.08bl.1. 1.08bn.s.sil. 4.75bn.c.s. &gr.
B -5 7.42 100.80 none >7.42 1.25bl.1. 1.25bn.s.sil. 4.92bn.c.s. &gr.
B-
decimal PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES
NUMBER FTER SWELLING INTERVAL -MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH
P -1 3.50 none 3 4- 4 4 1
p -2 3.90 none 3 6 6 6 <3
P_ 3. 5 none 3 z 4 4 1
P -_
Fe�
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope.
SYSTEM ELEVATION 96.95
C _
�d - -
�_m �_..a'. —
,
�014., -.
.
i
i
Y
1 N
,
} -
��' — — _ _ �� _ _ t
S �
NOV 2 0 1997
SUMS OR'S RECORD � �
� OC �H•
CD
D gJtd` 0', N 0
m . o cn
C) -4 Z �CdjJ�tCj W C7 D
G� w n "' t7
�70 m _
m rn N rn O N D o m m r� m z r- m x G�
C) O z a td r N o Z
i D y , Q
c)
tj
N I > M
° Z m
EAST LINE OF THE NEI /4 OF THE SW1 /4 TI
ii WEST LINE OF THE NW1 /4 OF THE SE1 14 m - - c°
CD CD M«p0 6� 4'44'20 "E `z mm Z w � °
d
l Z02 91' m z \ D
Iry - - - --
X98' M
I =
Z = � rro X Z Z
N N C. c m
�r in fJ� O \ p
m I o0 V o ��p LA 1 TI �7 d
o ( I N ° n I �rl Ln t "0 --I Z=
A I `a o to I it D d m c
m iz z ,,� m� iN ,�kSZ t� ;a m
p 00
7C) 00
1 ,
ID ,. W ° -m 0 W
I� i � t
M
170
m - rIr ❑ o w m cn D
Id z�z z� �2
o f p m m 1 £ Z
_ m
m jzm0 r i C3 r m °� X
o v mC, m s ter= n�z rr*t AS mz 0 ~Z
Z� °< \ suX6 M Z~m N p 10 M \ � —1 ?
m 2 < II � m RS. ° �TIZ O
IN
m mim �Im IrD��004 A ?moo oNr?
�I� o Cl ° � F 0m
n
o D
o C,) m r— x 1 3 p £
I p Ri d � o ° o i � , D z\
w I M I �' _ A z co
NOW I I NN OD Ir `� co
N
cn I N �G)...�. .0o Ul 01 W
Cn N Ln Cn N 0) •:
Ci N01'05'56 "E 1001.52' "'- rn -1� D £
r*i 4 ' c0 �i i --
- -' S01' -
_.
_�"01'04'54"W 1001.57' _
• ST. CROIX COUNTY ZONING DEPARTMENT
AS BUILT SANITARY REPORT
Owner
r
Property Address ���/�', sr 1
City /State _L,� o > t ,cE
Legal Description:
Lot . Block ' Subdivision/CSM #
Sec/,Z--, T -R� W, Town of v . �� r PIN # 3 -
SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION
/ Tank manufacturer 1���� Size ST/PC'' ?O' — Setback from: House- Well f "- P
Pump manufacturer _ Model
Alarm location
(HOLDING TANKS ONLY)
Setbacks: Service road h air intake Water Line
Meter location
Alarm locati
SOIL ABSORPTION SYSTEM
Type of system: Width Le gth 2 7 Number o - Trenches
Setback from: House z�L Well ti PAL Went to fresh air intake/ Z 0
ELEVATIONS
Description of benchmark Elevation/ �r C)
Description of alternate benchm k �- r Elevatio
Building Sewer, / ST/HT Inlet ST Outlet 2 , � - PC Inlet
PC Bottom — - Header/Manifold Top of ST/PC Manhole Cover 1 9 6 1 ,
Distribution Lines ( ) ( ) ( )
Bottom of System
Final Grade
Date of installation' % A�ermit num c State plan number
Plumber's signature License number ��� 7 Date // U
Inspector
Complete plot plan Or
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
l3afety and Buildings Division Count §T. CROIX
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitar* 149.:
Personal information you provice may be used for secondary purposes [Privacy L , s.15.04 (1)(m)].
SIMPSON, NROBERT ftl T�?wn of: State Plan ID N o.:
CST BM Elev.: Insp. BM Elev.: BM scription: Parcel IM {_:1048-80-000 16D I
TANK INFORMATION EL VATION DATA A9800529
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic 1 Z B e,
Dosing
Aeration Bldg. Sewer 7
Holding S Inlet
?, S 7.
TANK SETBACK INFORMATION Sy�t Outlet
TANKTO P/L WELL BLDG. A irintake ROAD Dt Inlet
Se p � 1`J �v r NA Dt Bottom
Dosing Header / Man.
Aeration NA Dist. Pipe
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer
Model Number GPM
TDH I Li L ys em t
Forcemain Lengffii Dia. Dist. To We
SOIL AB TION SYSTEM
BED / Width Length . -, No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
IM N ( DIMENSION
SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manu a to
INFORMATION Type r r CHAMBER M d el Num r:
Sy OR UNIT
DISTRIBUTIONS TEM
Header r fold Distribution Pipe(s) x Hole Size x Hole Spacing vent To Air Intake
Len th Dia. Lent /
Length g Ja Dia. Spacing � 7 `� V,
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems On y
Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No C] Yes E] No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: STAR PRARIE 11.31.18.207A,NW,SE 2240 127TH STREET - LOT 1
ra t 7q 16ti, ra tv �
Plan rev& uire ? ( E 0' ] f> Yes No ,
Use other side for additional informs {ion. ("' -- q.f5 ?
SBD -6710 (R.3/97) Date Inspector Signature Cent. N _
Safety and Buildings Division
NOsconsin SANITARY PERMIT APPLICATION 201 E. Washington Ave.
In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969
Department of Commerce Madison, WI 53707.7969
• 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. C r al',t
• See reverse side for instructions for completing this application State Sanitary Permit Number
�lv3
The information you provide may be used by other government agency programs ❑ Check if revision to previous application
[Privacy Law, s. 15.04 (1) (m)].
State Plan I.D. Number
1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION
Property Owner Nam P perty Location
/a 1 /4,5 T ,N,R/�E(or
Property O ner's Mailing Addres Lot Numbed Bock Number
Citx,State 0 Zip Code Phone Number ubdi n Name
a I b?
II. TYPE BUILDING: (check one) ❑ State Owned il r _ / oad
❑ Vll age
Public 1 or 2 Famil Dwellin - No. of bedrooms Town of
III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s)
1 ❑ Apartment /Condo / 3/• 1g. 2-,a7 "/0 / 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 _New 2 E] Replacement 3 E:] Replacementof 4 0 Reconnection of 5 E] 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) 1n4q 1 {AAy � '3l• 8, g ` - , W_e
Non- Pressurized Distribution Pressurized Distributi E Oth�} 'InA"�be:AIr-
11 []Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
1 Seepage Trench 22 ❑ In- Ground Pressure t , 42 ❑ Pit Privy
13 ❑ Seepage Pit 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. 7. Final Grade
Required (sq. ft.) Pr osed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) E -vat'
Feet Feet
Capacity
VII. TANK in Ca g gallons s Total # of Prefab. Site Fiber- Exper.
INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel plastic
New Existing structed glass App.
Ta ks Tanks
eptic Tank o 11t!1_ 0 E 1:1 1:1 El
Lift Pump Tank /Siphon Chamberl I El I El I El 1 11 El ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for instcoation of the onsite sewage system shown on the attached plans.
P Name: (Print) Plumber's g ur : (No St a m s MP /MPRSW N Business Phone Number: 1 01
Plumber's Address (Street, City, Sta�Zi Coe —
IX, COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Issued Issuing A ent Signature (No Stamps)
(Approved ❑Owner Given Initial �/ f- oD Surcharge Fee)
Adverse Determination You U ,
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBDW98 (FLt t/96) DISTRIBUTION: Original to County. One copy To: Safety 6 Buildings Division, Owner, Plumber
PLOT PLAN
PR6JECT Robert Simpson ADDRESS 2073 Co. Rd C Somerset Wi 54025
NW 1/4 SE 1/4S 1 1 /T 31 // /N/,& WN Star Prairie COUNTY ST. CROIX
/
MPRS Shaun Bird 226900 DATE 6/98 BEDROOM 4
CONVENTIONAL X>oC IN-60UND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1200 Gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .8 ABSORPTION AREA 763 # of chambers 24
BENCHMARK V.R.P. Base of Shed ASSUME ELEVATION 100'
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
SYSTEM ELEVATION 94.
Cksdff
Shed B.M.
5'
w
B -2 B -1
Vent 0
' 15'
cu
>12„ Sidewinder High
Capacity Leaching r
of Cover Chamber with 31.8
8W 16" ft^2 per chamber
6' Long
Grade at System Elevation
160' % 34"
2' ' Slope
25'
B -3
Rep A '1'
30'
80' Prr
Bedroom O we,
House
' 15'
B -5 B -4
127th St.
-7
1Mscons
d n Department of Commerce
• ' 2r�1 � �� .�_u� �_ . -.< - � ,� -o-. -. , � � c� ,.-•
Division of Safety and Buildings �. OIL AND S"TE EVALUATION a Page l of �
Bureau of Integrated Services In acxo ance with s. ILHR 83.09, Wis. Adm. Code `te
Attach complete site plan on size. Plan must County
include, but not limited to: v and horizontal' of wm poi ), direction and �� r
percent slope, scale or dim i ry Prrow, ,end location i to nearest road. l �
' nO �{ ] g Parcel I.D. #
LO 4 >= c �clx d `5 0 1 0 C2
APPLICANT INFORMA - P/emwjp# tt all i don. Reviewed by Date
Personal inforrnation you provide rlrg Law, s. 15.04 (1) (m)). / 1 --/ / -3
Party Owner -� Property Location
GOV . Lot && 1/4525F 1/4,S 1 T ,N,R E
Property Owner's Mailing Address Lot # I Block# Subd. Name or CSM#
02 D -7-:5 o � C
C* State , Zip Code Phone Number ❑ city village ja Town Nearest Road
New Constriction Use: 91 Residential / Number of bedrooms Addition to e)osting building
❑ Replacement m
/' Public or commercial - Describe:
Code derived daily flow b C� gpd mop , gp �
Absorption area required& bed, ft2 treat d* - trench,
Recommended infiltration surface elevation(s)F/—/' � wic hmark)
Additional design/site considefati �j
Parent material �� VIA' � � � ✓ � � 'e / ft
S = Suitable for system Conventional Mound , / sm in Fill Holding Tank
U = Unsuitable for system LA- ❑ U C at ! [� I� EIS P U
SOIL
Boring # Horizon Depth Dominant Color Mottle; uy Roots GPD/ft2
13 in. Munsell Qu. Sz. C ont Bed , Trench
1521 y- 00
Ground b v
�fL v-
9
Depth to
limiting
facto):
� in.
f" 7 Remarks:
Boring #
zn
•� �r e rn � - ��
Ground
Depth to � ,
limiting
in. Remarks:
CST Name (Please Print) Signature Telephone No.
tin r • 5 o2 62l
Address D ate CST Number.
Soil Test Plot Plan
Project Name Robert Simpson Byro ird Jr.
Address 2073 Co Rd C
Somerset Wi 54025 CSIM #3479
Lot 1 Subdivision Date 7 /20/97
NW 1 /4SE 1/4S11 T 3 1 N/R 1 8 W Township Star Prairie
Boring ()Well PL Property Line County S T. CROIX
BM or VRP Assume Elevation 100 ft.Base of Shed
System Elevation 9 4.5/94.0 *H R P Sa as Benchmark
140'
Shed
' 'j`B.M.
5 '
w
s° B -2 15' B -1
� o
coo Pri A C"
N 0'
160' %
12 B-3 lope
Rep A
0'
�15'
B -5 B -4
127th St.
1 0]/13/98 TUE 09:48 FAX 715 386 4686 ST CRX CO ZONENG uoo2
Standard Erosion Control Plan
I )WCH-I-n,('y Const Site 1 & 2 Fan.ffly I -
Ac rdinc to Chape;-; 1 jj 20
DvvcITb Codi., sc) j 'tosion C �)rltrol
ncels to bi'sor plan
nVIU: for faillify units r1its in
"re Ih-C ;""7'7 1
CC-AC, �fre- cnfioiced, This
Buildijig j "
I:
xrW-C<,u not re` {iuifcd bv i } b
an- &Z
kc- p J.q p
-1 -tha
- cor4quotion
I s ) a re morc a
IR*2 � - t. a i, d i
P�
rr te al 1,
Sic n ri
Natura
-
A)
a
o huddjjj, sitc
7
Block
�O
i n
d
I IL i, Y"
ca t
"I k
TUE 09:50 FAX 715 366 4686
ST CRX CC. ZONEM 00 5
'atc nIaU SAraterY by choLki th appropriatc b=
t S t ra 1. c'
Tempor-aly mc'as.
More:
Code, u I's lha, dIsn?7bCd 0'reas and Soilpiles le
,
inactie ftir exten4t, ' r, 4'!
-d P"H o" Time tl"e �'r 'ii -ei:! b%v' !ee'ivIg (beiiv�en Apnd I St c 5 'aprernber '5th), t
, )Y fit 3 er cover, 4v h u y e T i nf --
0 or rtfl;k
Pci subiji7 ! I
A � C �. (j o f S by fe-vcgctatiea Or officy means As s--- nN pmsible.
doww x)u? '311COjr SUWF pump otluct ater"SiORS.
h n ot JOE c ift c a tA q;4! 4-j jp, 7 0H 171 O-Vel
'h' '
I , � j V 0 5P0w5 and Sump
Vets be
as
ill"'TPM9 4*Jlmeat during dcwaterLng o;w..ratious.,
Note. Although not specific requiteJ ty C.'Ode, I
I' al sddirne'-t 'Udt'n
pumping OperadorL- be port behi�'rd a 'w!&n6m ba'-Tier U-edn�ost of !h sed. sriele5 oul.
Proper disposal of bUijdjnZ MAt WaSte� ,Cj that jX_)t,
,,ItAntw and dOris ale not C O ff-,i te
Maintersantae of Crosi"on Control placlkz ,
• Sc4iment will be •-ruoved ft= behirld _&Airncrif f"e.n and ba'ri"I" `a a' a dei-b
that is eq-,.!al tO hal the lbamtCs height.
• Breaks and gaps in s-t-dunclit be ICP2."rce
straw bales 'Ail` be replaced 1 3'sIc'. 11"re is thiee moplhl %
• All sedinjerit tha . due to x"'illbe ch UP beforn the clid
of the same boar lay
• All sedillien I t1 I Itjc)% (,,ff-5 te d Lv" to Momn t Cn VO! I. be dca rie'd U " 1. h<- Orld C) r Eh'
next workday, r,
• GYf."vCl wcce-�, drip'(-'; will be
All installed eros�irm
V N� nmititaired �ijj'j! �t�v p
protect atc. stabdiza-d.
hC .-Cby cen that I u n d e, r, i a m-j t h
s , I CX)1111 1)70v.�Swns of th- 11 'is,,a)p
DwelUng Code, and th-4t I 2 ccePt tCspansibUity - 4minK out the abo�"�' cf j , D 6i�
�*he code enrolcerne.,11 or Ca 1 ppmved
tigria Of applicant
j:,ublicarjor, lJr Rcn SrlluS.; L
..'blica.rion mc�v be freely dupjj� Spec;
CO Pe:: i11T a' tile throaqi
10/13'98 TUE 09:49 FAX 715 386 4686 ST (-'RX C'O ZONING 004
-Site Diagram-
Note: 'Ally
R. ,'naf)
r_7
01 0
_j
ej
.......... el
ii
.... ......
Site Diag Legend
C1 '0!
LINE
rYxy
1"V
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
A OWNERSHIP C FORM
Owner/Buyer
Mailing Address
Property Address
(Verification required from Planning Department for new construction)
City /State �G�„_� Parcel Identification Number tj d/ � ' Q
LE GAL DESCRIPTION
Property Locatior �, � IY l
� /,, /-� 1 /4, Sec T N- W Town of &���
Subdivision , Lot #
Certified Survey Map # _-S L 2 Volume 1 Page # 5x' .
Warranty Deed # fi b ���/ , Volume 2 7 `� , Page # �
Spec house ❑ yes,f�t Lot lines identifiable_-_Q�yes ❑ no
SYSTEM 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 function 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, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.
I/we, 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. Certification
stating that your septic system ee maintained must be completed and returned to the St. Croix County Zoning Office within 30
r a three year a on date.
SIGNATURE OF AP IC NT DATE
OWNER CERTIFICATION
I e) certify tha s ments on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of
pro described e, by 'rtue of a warranty deed recorded in Register of Deeds Office. �J
SIGNATURE OF PP CANT DAT
* * * * * * Any information that is mis -re resented may result in the sanitary P y 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
pCj 3 �
o
C)
sr ti
'�� V L o
LA
N
C) z r+ir c n n
�1 �rn m N N D o '' ;: r
m CA rn D o 0� C) CO X
C p '� z o
�O �S' -i`-' °� z
rs m
0 1 E £ D O M
° I EAST LINE OF THE NEI /4 OF THE SWI /4 r z o
WEST LINE OF THE NWI /4 OF THE SE1/4 o z I ° -� r
w ry 6 p I N "E n a m t ' °
- .202 91 — V
Ila + I+ `3998, m _ m 00
£ Z
\ 1 I z =
�ti
N 2 I N N x` Z Z£�
r 1 0 0
ru ,E
M 14 Lin
1
Z i O � 1 I j� on � L Z�
> -1 1 o m Io i 1� D ty I C
n _ rn rn �—� �*1 1 z /
z H Z I .9x �Z iN x SZ ilk r? � C3 00 7-1 M
F5 I� 2 Ui z 0 "I N, 1 J 111< °ON £? -�
ID W W �°
1� t--� r 2 2 (7 (� ! m = N A D
" �d '1 z 13 IZ �NwP+ zZ � ic
D z OV cn -q -q � ' � r ° C 1 , � k ,�Z A EI M r 2. M
1 m z o Z
V) mn N r 1� ! m o a "r ro1' 0;0 Z �. v� £
>t� x M
A a AIA �H w� m �tS'' - �i\/ �_ Ln
m
r*t CDr m AS, ° ����Z°
c0 1 < y �. ;u rn o m m m `� 1 sj, nZ z
\ \ oZ z . 0 (7
1 ' I A II N O) ti I(n Z
1 0 V m � x ° 13 a£
1 ty I c� \ I \
Q [I 0 ° OO/ 'D w z
N o ; 00 N OD I r ~ o 00
1 00 w �� o ° OD I C() �m
N . I . . . . . .N LqW . .00 L4 0
.-. W
O) I D
0 1 N01'05'56 "E 1001.52' - rn
co i n
8 05.0 9'
m 196.43 . rrj I �
S01 *04' —
01 04 54 " W 1001.57 ' 450.00'