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HomeMy WebLinkAbout002-1013-30-101Nisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division j ~ INSPECTION REPORT GENERAL INFOF tAATION (ATTACH TO PERMIT) 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 Turner, Doreen Baldwin Townshi CST BM Elev: Insp. BM Elev: B Description: // ~0 ~ ~ d O ~ 3~ `~ ~ ~ !~r TANK INFnRM~TInN ELEVATION ATA TYPE MANUFACTURER CAPACITY Septic r~ U Dosing / l~ ~ t~ Aerati Holding county: St. Croix Sanitary Permit No: 395143 0 State Plan ID No: Parcel Tax No: 002-1013-30-010 STATION BS HI FS ELEV. Benchmark ~ ~ ~ ~ d /~ Alt. BM - 9 loo. Bldg. Sewer ~0 9- s S Ht Inlet 0 SbHt Outlet Dt Inlet Dt Bottom (2, Header/Man. Tw~ k ~°~9 Dist. Pipe ~. ~D ~ Bot. System ~ ~ ~ ~® I Final Grade ' St Cover Y - Ct~o. ~`,~ ~F -. ~ . ~C, ro . 3 l ~ . z TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic >~ ~ r ~ ~~ Dosing ~ L/ Aeration Holding PUMP/51PF1UN INFUKMAIIUN ~' jflp 5 ~ Manufacturer / Demand f rp GPM Model Number ~ Z ~ 3~ TDH Lift Friction Loss System Head TDH Ft $- ~ ~ - z Forcemain Length ~ Dia. Dist. to We~ j ) / ; L~ SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches DIMENSIONS ~ L SETBACK SYSTEM TO P/L BLDG WELL INFORMATION Type Of System: ~.,._. ~D >~_,)~ ~N~ Cy DISTRIBUTION SYSTEM PIT DIMENSIONS INo. Of Pits Ilnside Dia. y ~s' OR Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake ~ r, Z ~ Pipe(s) /~ ( i ~ Z S 3 // ~ iI Length Dia pac Length Dia ng / SOIL COVER x Praeci~re Svstems Only xx Mound Or At-Grade Svstems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ~] Yes L] No ~~ Yes ~~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/~Z/_~ Inspection #2:_~/~J~ Location: 2106 110th Afvenue Baldwin, WI 54002 (SW 1/4 SW 1/4 6 T29N R16W) N/A Lot ~S Parcel No: 06.29.16.87D / 1.)AItBMDescription= Sf LoUe/ y W Wbk//S~~ °~/~~/~~~// ~ Pawl~.q m~/' ~n,yy! 2.) Bldg sewer length ='~ ~ ~ ~ s' $~ 'G'/o~v~- !~'r//~"'SI'41. r J - amount of~ ver = q 1. ~ ~ ~y .J ~~I. ~~ ,_ _ Q ~Oc ~r ~ ter,. ~, _ / 3.) Contour = ~(~ '~'` ""~ Plan revision Required? [~ Yes ~] No ~ ~--'"f~ Use other side for additional information. - t~~ Date Insepctor's ignature Cert. No. SBD-6710 (R.3/97) ~ Safery a~xl Buildinga Division County ~ ~ v J ,~ j~-/~/~ 202 w. w ~ F'6r,$ox ?262 -~ =.~__..; ae ar~MY~s~~ M~ . Y~'~ ~S)7 t:'7Yb2 \,` Si~ta Add~+eee ~~-`~-~'------ tm~nt cf Commerce w,;~ ; ~ ~~ Sanitaacy Permit Ap a ,;~ `:,_-,, sa~ry Permit Number wlth Conte A8.Z1, wis. A4m. cone. you yravi~~1 .._ 3 ~S/~/3 be urea for st1. i m A. G" ~F ' ^ Check if Rev}sl~A ~ aPp>ic~:t Wormatloo - Plewro Priu! All ~~~t ^4 ~ I _,~. 9bao man I D, Nua~r Ptti>p~ty ~ G~ p-~.. L fra Property Owner's Mwl1ltsi Adrhrea ~ . Z ? /G+ . ~ ~' ,~~ g Property Locebon c~Y, 9ta~ 2tp Coda Pbone Number N R ,/ y~ Lot Number Bioek Numbsr ~i c ~ 7~ ~G--~ j/ Subdivisioa Naa-a C~`9M Nuatber II.'hype of Butlt#tt8 (clteclt Ali tLAt Apps), --, r 2 Pamlhr Awe111ag -Number of Bedrooms --~ / ~~ ~~ ~~~r s su,bn~ ~ ^Cily D Pt~llclCotntnmrcW -Describe I3sa ~VUlap~e ~ Stota t)waed ~ ~ ' r..f Neanaat R ~ I ~` III. 'T'ype oi!>P'el'~ (Check only one box on Bna A {rsumbarl~ ac3eeme for interact ttte). Compktt lice B If app b1e) A. -I-Tsw 2 ^ Roptacamaat Systaas 3 D Itapiacetaear at 6 D lufdidaa to For Couaty use Tank ~ S stem B• ^ Cheoft if Sutltaty Permlt Previously Issued P°~ Number Date Sassed I9, Tyke oaf Prsrntit: (Check all thct aPPly)Oaumber~ag scheme la for internal olio) 44 Q Noa •Pteaturiud Ia•(lround ~ (a ks~ ~) 47 D Saad t?fiter SO C] Conaalteted Wetland 2,2 ^ Peaaneised m-eitou~od a/i DTi~oklin~ Tanis 48 D Side Pass 31 ^ Drlp Line ~ D 46 ®Aerobic Trastmem Uait 49 D Recircuta 30 D Other ~~ Ai'eA Ltfa:matloa: = /O z~ 2 " DeriYa Flow (ttpd) ~ Diepersai Araa snit A pptkation Percaiatton Rata System 13Sevatfo» Pitul t}s~e i yS~ / Rate{(;alaJDays/~Fl.} {Mia./Iact-} Skvatioa V VI,1'aok Lrta CaP~iRY ip Totai Number F/ v ~ (~ l ~ ~ ,/ ~~~~ ~ -~ QWous 8at2oae of Tastits Mane;facturer Prefab Site Stoat F36er p~ic Naw ! coaarooe Caastnaoted plans Sepdc oe tiotdia~ 9kah - ~ ~ ~> Dodsr Ct~bar ~ b VII. flit 4tpteitieaM I the eoaaae r for iaetapatbn of ti+e POVN'I'8 ahor-a aso the tsetachad P1na:bm"s Nagle e N ber Business Phone Number Plumber's Address (Str+eet< City. State, 73p Code} ~ ~ ~ z ~ ~~ ~ ~ ~ `_1 vIIZ. coca vN ~'~'-~ ©pieapproved ~a ; ~ (imhde, Grauadvvatet Data Issues 2aauinj r-aent Siwatmre (No Stas~a) 0 owner ci<van IaiWsl Advane . 3Z.5. 0~] lx. cots~tlos» of ~ 3 D /// _t®ar Dlsapprorni ~ ~/.off /;,. _ ~,..e C ~~ . ~ ~. cep, a~a~ ~ '7~a on Y~i~' ~aot !su ttatn 8111 a 11 taChM to Nse ~ ~. 0$41) Wisconsin Department oflndustry, SOIL AND SItE EVALUATION REPORT Labor and Human Relaitons Divisio~ofSafety & Buildlnas :_ ___:_~ ___,~ n ~ ~n nn nr ur._ w~_ n_~_ Page 1 of 3 ... •w ......... ....... .....,...,,, ...,..........,.,..,, COUNTY but Attach complete site plan on paper not less than 81/2 x i i inches in size Ptan must include S~ ~ e'~`x , . not limited to vertical and horizontal reference point (BM), direction and ~a of sbpe, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. O Z Z - l ~ ~ 3. 3t, APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE R•~.j ~ r I,~y PROPERTY OWNER: PROPERTY LOCATION C-~zPS~`S1prvRt, 5W ~ ~~ 01= ~~~ fl-ft.R~ t`'l~ll1~~-( `C„fC~TRS-N GOVT. LOT - 1!4 ._ 1/4,S (~ T Z9 ,N,R j b E ( W PROPERTY OWNER':S MAILING ADDRESS • LOT # BLOCK # SUBD. NAME OR CSM # 1 ! 4'3-t z7 O `ni - CITY, STATE ZIP CODE PHONE NUMBER ^CTTY ^VILLAGE .®TOWN NEAREST ROAD h S t} b 3 3'~-Dwtn~, w1 S~tooZ• t~[s) Gf3~f. 2613 ~f~L,pwt Fit. ll v~• [J~ New Construction Use [,kJ Residential / Number of bedrooms ~ [)Addition to existing building [ j Replacement [ j Public or commeraal desaibe Code derived daily flow 6oD gpd Recommended design loading rate ' ~~ bed, gpd/ft2 - trench, gpolft2 Absorption area required ~ bed, ft2 S 0u trench, ft2 Maximum design loading rate •4 bed, gpd/ft2 -5 trench, gpd/ft2 Recommended infiltration surface elevation(s) 1 O 1. n ~ ft (as referred to site plan t~enchmark) Additional design /site considerations WJUU1..~j w/ 6 ~X y~I ~ ~ - r'l t r..r • \ 2 Y Ot=- S`i~~ {=r ~~ _ Parent material Lo~~ oU~lt. -~-t~L. Flood. plain elevation, if applicable N•fl. ft S =Suitable for system CONVENTIONAL MWND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FlLL HOLDING TANK U=Unsuitable for s stem ^ S !~U I~ S D U D S ®U ^ S ®U D S ®U D S ® U SOIL DESCRIPTION REPORT Boring # .`~~x:: Ground elev. 94_ Yft. Depth to limiting factor ~~5. Boring # by Z ~, ~` Z ti~~ Ground elev. ~o~,sft. Depth to limiting factor Z--~ " Horiz n Depth Dominant Color ~~ Texture Structure Consistence Bounda Roots GPD/ft o in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. ry Bed tertctt o -9 10`1 R- 31 z - s ~ I Z S b 12 Y"`f3- ~-S - . S - ~ 3 i4-3o -~.S~tz~ly - s~ ~esl~ ~u~~. ~S -- •~! -S 4 30-~ ~ . ~ •S ~ IZ.3! ~ L-S~ R S~>3 S I O ~ wt v`f't~ - • 3 ~`~ G -~ S ~ 4 O Remarks: o _$ ti0 `'1 z 3 ! Z "' s t 1 Z~ 5~ k m ~i- ~-S _ •. S ' .b Z. $ - i9 ~ - S `11Z y! - S i e 1 ~--~ Sbk rn'~-- e.S • ~[ € . S ~ 19z~ ~~Sy23~y - si~l les~k ~~~ cs - -Z•3 z,-So ~•SHtZ fly C~ -a• `iRS/~, sI ~, ~.fh .~~,y ~ ' r ~, ~ CEIV ~: . ~~ ~ Remarks: Name:-Please Print Arthur I,. We erer P~ne~ 71s gerer Soil Testing & Design Service-P.O. Box 74 River Fal ature: Date• 1 ~F~ ~ ., 22o2s4 PROPERTY OWNER _ SOIL DESCRIPTION REPORT page Z.of •~ PARCEL LD. # cl ZZ_ l0 \3- 3u Boring # a~"''? ;;~ { 3:::::: Ground elev. ~3R • aft. Depth to limiting factor 29 ~ Boring # fi~ ;~::; ~~ z ~;~~ Ground elev. ft. Depth to limiting factor Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont Color Texture Structure Gr S Sh Consistence Boundary .Roots GPD/ft 0 4 toti~ ~lz . ~ sil . z. . Z'Fs~ w,,~ cS - Bed Trer~d~ .s .t, Z 3 q Z9 zq-v7 , .S ~ ti ~~ ~•S~rz.~~ - ~~.S`-tt~ s~~ sic.) s1 is 2~s b~ o~ -~ ~fl- wtv`~1- es - - • ~l . s • 3 •y 24t ~ s' i rsemarres: rsemarKS: Boring # ~~ .. ;~~ i Ground ' elev. ft. i Depth to limiting factor j Remarks: Boring # ~~ E Ground elev. ft. Depth to limiting factor Remarks: cnrl no~NR nc ~nn~ PLOT PLAN Page ~ of 3 SCALE 1"= SO' Q.io`~-~ ~~~=1- ~. ~oo•o' ay S"H~sN,.~w"DtA. Pvc ~IPE_ wl ,-- _ _ __. - - -- ---- YNv sue, ~ib ~~ Ml" lktt-sT 2. S ' F~~-e~ h Sri t~fi :. _ w~,L k K -~ Y So' k k e~L+-I ~~y • n Do tioT ~,PrttT o~ ~~ 2`. n1S~iRg 'mss ~~ _~~ ~' . i ~ ~.. `o / ~~ ~ //` .~ ' ~ i 8M lt, 2 ~ ~o~O .\ 9 9 3 ~ ~(; / a~u ~s_ /~ ~o ~~ ~.. 1DO.b, ~~ °F $~ ''~\,` Nt ' W 1. ~ ~ Loo 5 ~-_ wt~lvt-~ "fib '8~ -~fi 4~ti'8T 11U~,..s1p_'1 ~. 4F: v.~tf b3 Cast S'td' l.~ttST 'So' ".t' CL, o: W. t<tn~, - w~{-l;: ~.'~ "C WL0 3T t2'c^S'CtL. t CT? V l , ~~o ~+ ~v~ -/ . i M g°--`l3 ~~ ~~~~2-~~~- y~~`~~g (715 ) 425-n~ ~5 Tg0057b CST Signature ~ Date Signed Telephone No. CST # Wisconsin Department oflndustry, SOIL AND SI~"E EVALUATION REPORT Labor and Human Relatwns Division of Safety 8 Buil~ngs ;,-.~....:aa ~i uo 0o n~ ur n,~..., r`,.a,. y Page 1 of 3 ......,.,.,.., ....... ...,.,..,..., ..,,...........,,,.... COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size Plan must include but ST ~ ~''~`x , . not limited to vertical and horizontal reference point (Bfvq, direction and % of sbpe, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to neazest road. O Z Z . I ~ ~ 3 ; 3ij APPLICANT INFORMATION-PLEASE PRfNT ALL INFORMATION REVI DBY DATE PROPERTY OWNER: PROPERTY LOCATION ~`t10rVAt SW / r~, aF Sri') Ftf~h~ h'1 ~..U~~-( ~,f'O~.ly GOVT. LOT _ 1/4 1/4,S 6 T Z9 ,N,R 1 ~ E ( W PROPERTY OWNER':S MAILING ADDRESS. LOT # BLOCK # SUED. NAME OR CSM # llg~ z?_O `Tlt - CITY, STATE ZIP CODE PHONE NUMBER OCITY QVILLAGE .®fOWN NEAREST ROAD. V S ~} 6 3 3~-Dw-ti wl S~tooZ 1~/S)684r- Z6 /3 ~s~~.pwl fln~ 1.1 v~• [~ New Construction Use [xJ Residential / Number of bedrooms ~{ [ ] Addition to existing btu~ng j) Replacement [) Public cr commeraal describe Code derived dairy flow 600 gpd Rer~mmended design loading rate ~_bed, gpolft2 - trench, gpolft2 Absorption area required ~O bed, ft2 S Ou trench, ft2 Maximum design loading rate •~ bed, gpd/ft2 - 5 trench, gpolit2 Recommended infiltration surface elevation(s) 1 O 1. o ~ ft (as referred to site plan benchmark) Additional design I site considerations 1`9UUI•..p w/ 6 ~x y~ ~ ~ - I"1. i ru . 1 Z " p>`- 5`II~ ~t ~~ . Parent material Lo ~~ oU~1'L Tt ~L Flood.plain elevation, if applicable N. fl . ft S =Suitable for system CONVENTIONAL fuIWND IN-GROUND PRESSURE AT-GRADE SYSTEM pV FlLL HOLDING TANK U=Unsuitable for s stem D S I~jU (~ S O U ^ S ®U ^ S ®U ^ S ®U ^ S ® U SOIL DESCRIPTION REPORT Boring # 'iaiaiky ua ~ }: ~_: Ground elev. 9R. Y ft. Depth to limiting factor 30' Boring # z ~#; ~~ Z ~~ 5,:~ Ground elev. 1o~.Sft Dep>h to limiting factor ~--~ 4 Horizon Depth Dominant Color ~~ Texture Structure ~~ Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. N g~ retxfi 0-9 lp~~ 3lZ - s•t l Z -sb12 wi`{~- ~-S • 5 -~ 3 Zy-3D -~.S~lZjly - s~ lesb »~u~~ e-s -- •~( -S y 3o-Y ~S . ~ •S `~ R-3ly ~ L-S`7 tL S~£i S I O ~ vn v`~l- - . 3 ':. ~`f G -~ S ~- ~ k O Remarks: o~~ to~lt~-3fZ - sll Z~Sbk m'F-- ~-S _ ..s.~ Z $-t9. 1-S `~ Iz y~ - S i el ~-~SUk h~`~- e-S "' •~(` . S 3 t9 Z~ ~•S y2 3/y - stcl leS~~ -m~l-~ ~S _ .z...3 ~ z,-so ~•S bIZ ply CL ~ • H RS/~, s I o~, ~m.f~ - . 3 ` .y Remarks: ~TName:-Please Print Arthur I;. Wegerer ~10ne' 715-425-0165 ~eg rer Soil Testing & Design Service-P.O. Box 74 River Fa11s,WI 54022' . iignadxe: nn Date: CST Number. C~L~ ~'`~,1~,~ ~`~q-~t~ L/-~-~ 220254 PROPERTY OWNER ~rta~~ SOIL DESCRIPTION REPORT PARCEL I.D. ~ c~ ZZ_ ~p 13_ 3~ Boring # E:~ ~~.~ 4 Ground elev. ~3R • aft. Depth to limiting factor ~9w Boring # ~~ ~: ~i K^:~Z> Ground elev. ft. Depth to limiting factor Page ?-of De th Domi t C l Horizon p in. 0 4 nan o or Munsell Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence . Boundary ,Roots. GPD/ft Bed Trench tok~ ~1z sll z.~s~ w,,`~ cS - .s .6 Z 92-9 Z • S y IZ fir/ ~ sic.) 2`gs b1-c ~ ~- es -- ~( , s 3 zq-u7 ~-s~rz.~! ~•s`-fR sly sl 1s o~ mv~~- - ~ 3 •y e 2~} `~ i I ~ i t ncinains. nernarKS: Boring # t~~ ~m .~,.,. E I Ground ~ t elev. ft. Depth to € . limiting factor Remarks: Boring # I. Ground € elev. ft. Depth to limiting factor Remarks: _ inn n^~N^ nc•nn. P~QT PL~ Page ~ of 3 SCALE 1"= SO ' ~y"~'~~1 -- ~1..~. {,OO~O' p-~,_S"r-n6N,-~~y"Di(~. PVC ~'tiPE: tiIILfl'f7f-. -~ ~' 1~~ ~" ~ ~ ~Z. ~j' H. ~ L4 ~~ ~a T f a t h ~~~. , ~ov sr. ~iD di'e` ~" U~'3T Z S ' ~2.~r? r`?C7~.wi~ ,_ __ w~ k K ~ Y So' k 4. n Do No-~- e-~,PR-e.T otZ ~~~ ~~~~ n~ST~2$ `mss ~~ ~~ i ~ / ~ ... ~ ~~ / ~~ 8~1 t'f`.2 ~ mob .3 Q.B ~j u v-, ~ x..°194 /~ ao~ ~.. LDO.p. "t o~ $~ '~`` NL ' l~ 1, ~ ~ ~-- w~pvM7 'Tb ~ f}T l~Sr9 T 1l O' P1z-oYt T11''~ cff d F V S tf. 63 C~~2 4si' LAST So ~ ~.~ `Ti1t. ~- o • W . Li/vE - ~K 1. e~'U~Z ~.S T~ V~0 gT R~Y2l CT7 V F. \1~ `C1} s-ti t+-1 o 8.~ r~v~ M ~ fz2. `~2~~r~.-t_ g q - `l3 y`~~`~9 (715 ) 42.5-ni ~5 i40057b CST Signature ~ Date Signed Telephone No. CST # : ' ~ ~ ~scons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi.us/sb www.wisconsin.gov Scott McCallum, Governor Brenda J. Blanchard, Secretary July 13, 2001 OUST ID No.226900 SHAUN R BIRD 1008 192 ND AVE NEW RICHMOND WI 54017 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/13/2003 A7TN.• POWTS Inspector ZONING OFFICE ST CROD~ COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Doreen Turner - 110`s Avenue St. Croix County, Town of Baldwin SW1/4, SW1/4, S6, T29N, R16W FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 801100 Identification Numbers Transaction ID No. 660266 Site ID No. 632576 Please refer to both,identification numbers, above, in all corres ondence with the a enc . The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: . • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10706-P (N.O1/O1). In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. The owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound manual, and section VI of the pressure distribution component manual are complied with. A copy of this letter including instructions and information regarding proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • A state approved etlluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. SHAUN R BIRD Page 2 7/13/01 • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, Gerard M. Swim POWTS Plan Reviewer -Integrated Services 608-789-7892 Mon -Fri 7:15 AM to 4:30 PM j swim@commerce.state.wi.us FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DLTE $ 0.00 WiSMART code: 7633 cc: Doreen Turner t • ~ ~ PLOT PLAN PROJECT' Doreen Turner ADDRESS 100 W. Emenson Ave #301 W. St. Paul Mn 55118 SW ~ i / 4 SW i /4 S 6 /T 29 16 W TOWN Baldwin COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE6/26/01 BEDROOM 3 CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND ~~ SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 450 # of chambers none BENCHMARK V.R.P. Top of 3/4" Pipe ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL sH,R,p, Same as Benchmark SEE CORRESPONDENCE SYSTEM ELEVATION Plans Designed using mound and pressure manuals version 2.0 4% Slope Area 15' below system is to remain undisturbed Alt. B.M. ~~ B-3 Huffcutt combo tank ,~ Excavating is to be done in a manner to divert runoff away from system ~ Tank is to be properly Pro 3 bedded and provided with Bedroom lockdown covers with House approved warning labels P.o•w•T•s• RECEIVED Conditionally ~ JUN 2 9 2001 pppROVED 4 pEPARTMEN ETY AND BUIfLD1tiGE SA FET i~ B L D G S D I ~^ NIS40N ~ SEE CORRES . ~~eGE 1 /4" = 10' H.R.P B.M ~~ / 0/, ~ 99' 10 0' ^ B-1 101' ^ g _ Well is to meet all setbacks found in comm. 83 Highway 63 110th Ave y" 1 p D3 ~,». , :. ~~ f ~ ~ }~ : ~ ~-, s_ 44y ~~~~~ ~ ;~ Sri. .cg•.p ?"'`9 „~ ,;t "a' ~ ~, ~ a e -.a......, R.., ,, , y .~, ~».........„~,....,.,_~.... , . - ~ .., • ~ Desi~ er ~ ~~ b~ Q V ~ Ho . Date 'Q `~~-~ ~ O ,_--_ ~+" Observation Pipe Perfaratad Below Filter Fabric A37l~I C-33 5 o n d ~~ Tapsafl r...J ~ 7. Slope ~ ~ ~` ~""~ r n u-/° s I xon-Woven Filter Fabric r Distribution Pipe E t =. Forte Main F~ort~ Pump G BedOl~~-2z Drain Rock Cress Section Of A_Mound ~SYSteen Usin A bed Far line Absorption Areo ~ _~.., A „~ Ft. s ~ int. I ~8 FL.• • K.,~_D~ft . ~ ~Ft. ir~b? ~ J Ft '. F ~fis `Plowed LOyer ~~ / ,~ ~ / 1' .~ iil..S- ~ G~ ~y 4~Obt-ervotion Pip• ~ A its To yio !3 "" t .._ _......._ ......_.. _... _....,........ ..._ .~ D Distribution ged p{ ~E'.. Z y~ ~'iPe Droin Rock Y 4 Ob>cervotian Pipe Permanent Moricer~ Pipe vw Rods Plop View Ot Mountl Utin~ A Bed Far Tie Absorption Areo ~..~.~ -~-- K .~-•. - , `Farce Moin Frain Pump PAGE O!~ ~ l.oaated On iettem, 'e Lquat}y f~pec~e Ckg FlttsT t1eA.L l~itKT 'ra Gannet}pan r4 r ~, ~ ~/~.S' ' ~ ~ Oislrib~t~on p,p~ Loyouf Signed: ~. i tense Nu~aber : ~~_ ~j`~ ~ o Oats : ____~~a2 ~~- ~7/ ~ ~ ~t. ~ __`~._. Ff. Y °~ Jnches31 Ho}~ Diameter Ji~Inch Lateral ~~~ ~ inch{es) Manifold inches Force Mein " ~ Inches ~ of ho~eslpipe~ ~~nvert Elevation of later~als~ Ft,.. Performs a~ ~~P~~a!Qi~ SEPTIC TANK ~ PUMP v" GI VENT PIPE I.2" MIN ~ 25' FROM DOOR, WINDOW FRESH AIR INTAK£ FINISHED GRADE '''~~a 1~ ~r'~n. 18" ~MxN. N••C.z. C~rRU~o-~ Mtt IN 1•dQQ UT CEiAMBER CROS~~ S~:GTION AND 5PECIFICATTONS, ABOVE GRADE ~ NEATHERPROQF' OR J-~NCTION 80X APPROVED WITH CONDUIT MANf~OLE COVER W / PADLOCK B n f•----•-WARNING LABEL ~~~~ .,., t _ 1 --= ~..... 4 " MIN . ~~i~ MIM+ PRQVED J4tN'i'S MITH APPROYfO PIPE ~I~p ~SOEI WATER TIGHT SEALS F t ~T E R --,-~- APPROVED PIPE 3` ONTO SOL SOiI PUMP OFF £LE:V .~x~T. - x, d. s~ i~ 1' GAS- , '' TIGHT o ', A SEAL B ~ oN "~ s ~ OFF ~D 3" APPROVED BEDDING UNDER TANK / /~ ~~CONCRETE PAD SPECIFICATIONS ¢Q~lpro SEPTIC / DOSE TANK MANUFACTURER: NUMBER DOSES PER DAX : _„-,~_,r,^, TAtiK SIZES; S£PTrC GAL. DOSE VOLUME A OSE '~~~ GAL . ~boo~ INCLUDING F L4".•-BAC K : 7 ~ GAL . ~~ CAPACITIES: ~ S A = ~~~INCHES ~ ~~~ ~AL• „ G ALARM MANUFACTURER: "'~'"' MODEL MIMSER: ~ GAL . ? INC,HES s B _ '-' SWITCH TYPE: -~,~ •'~`'r~/~ ~ /' ""~" ~~ .S INCHES =~~~ GAL. PUMP MANUFACTURER: ,vim C = ~""'r' MODEL NUMBER : ~~r,~~,~ D = ~ INCITES = GAL. SW1 TC H TYPE : ~~ Try .~~~.~~ REQUIRED DISCHARGE RATEJ`~y GPM P6JMP E ALARM WIRING A5 PER ILHR 15.23 WAC FEET VERTICAL DIFFERENCE BETWEEN PUMP OFF AN'~ DISTRIBUTIQN PIAE Z EET 3 + MI UM NET'Wi3RK SUPPLY PRESSURE ~ FEET FORCEMAIN X•~ ,3 FT/100 FT. FRICTI + , . FEET ON FACTOR • • FEET ~~ TOTAE. DYN _ AMIC HEAD j t .95 ~,~ K ~ WIDTH ~ ~ DIAMETER -' UMP TAN INTERNAL DIMENSIONS OF i : L QG D ~~_ ~~. S IGNED: LICENSE; MJMBEP.:..%jv~~~~G DATE: ~v L7~~~ 1/8B rte. ~~ 1 Pumo Chataet~risties wa- uaa giiie i>~ siir~ao+KS sii~aoe~ sn~ao~l siii~aoA~ aw w~ 1s ~ lrb~er Sll~l Pd~ a Pe1M ft.G11. >I sso F#ae 141 t19 SAO Nerh 60 i ZO° f Nlaz. fluid MF~MA A YdvirMee ~ A Sim 1 1 ~" NrT Se1di a a~ ~~ ~~ ce~a ia~~, sml~ ~ s,bi, MatEsrl~I~S Of COnStru4ztion Performance Data 40 30 t zo i~ a ~a 20 3a sa ba ro t3P Total tisad (feN) 10 14 17 x1 ss Z, 30 i3 ~~~ 4. .Z 6.1 7.6 1 ti<PM t1JS, GPM7 f0 60 . 50 ~0 30 '0 10 Q . .~ .«y a.+l ~. tl. .ea 3.7ra° (ee.aal r~a!~ ~ . - `, ~'` _- i ~1 ~ I */ z ~` u a... ~ ~,.1{are,:: ,, !~ NYDROMATIC 1849 8a~y Rwd lahiond, Owo 41105 Yel:1t 4•~9-3612 Fax; 419-281.4087 Web SNc www.peafairpurrp.eonr SALES OFFitES iN All N1AlOll dtIES AND (OUNI>ifES Refer tv "i'oraps" in dre yellow pages of your phone direcsory for your broi Dislri5ator hemp: W-026680 1198 5M 11S l ~f ~~~., e•~/e° c,s~.x~l--~1 1. AN dlmorlsians in inches. IMehk for t~°'~~-s" i~~n-~I ! ialarnalku~al us~1. l~ ~` ~- -_ ' - 1 Maintenance and Contingency Plan for a Mound System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Dose Chamber is to be pumped at the same time as the septic tank. 3. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 4. Once every 3 years the mound is to be inspected via the inspections pipes in the at- grade. The laterals are to be inspected via the cleanouts. 5.Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 6. Pump and electrical components are to be checked at the time of the pumping. 7. Owner agrees to leave the area 15' below mound undisturbed. 8. The owner agrees to save this plan. 9. Trees, shrubs, and other similiar vegitation are not be planted on system. The system is not be driven over. 10. Effluent Quality is not to excede the requirements found in Comm. 83 Contingency Plan 1. Pump alarm goes off, call pumper and pump out dose chamber and septic tank if needed, then bypass pump float and try pump with out float. If this works, float is bad, replace float. If pump still does not work, check power at the pump with a electrical device such as a hair dryer. If no power, check breaker inside house and call a electrician. If there is power, then pump is bad and needs to be replaced by a plumber. 2. If mound fails, determine cause of failure, test another area or remove pipe and sewer rock, retill soil, install new mound system. 3. Replace any other failing components as needed. Important Phone Numbers Plumber: Shaun Bird 715-246-4516 Pumper: Jerry Kolve 715-425-9188 St. Croix County Zonii Shaun Bird #226900 6/26/01 680 . POWTS OWNER'S MANtfA18t MANAGEMENT P~,A,N Pate ~ of DIESiGN PARAMETERS Number of Bedrooms ~ ^ NA. Number of Commercial Units ~'NA Estimated Sow {average) ~ ~, gal/day Design Sow {peak}, (Estimated x 1.5) ~---~ gaE/day Soil Appilcation Rate ~ ~ gat/day/ft~ lnfluent/Efiluent Quality Monthly average'" Fats, Oil lst Grease {FOG) s30 mg/L Biadlemlcal Oxygen Demand (BODs) s220 mg/L Total Sus ended Sottds (TSS) s 1 SO mg/L Pretreated 1'siYittent Quality DNA Monthly average* * Biochemical Oxygen Demand (i30Ds) s30 mg/L Total Suspended Solids (TSS) s30 mg/L Fecal Callform etrk mean) s 104 cfu/ 1 OOmI Maximum Effluent Particle Size % inch diameter l~ra~>r~T>i;w+~-ici; scH~DULE SYSTEM SPECIFICATIONS Septic Tank Capacity eao n NA Septic Tank Manufacwrer Q NA Effluent Filter Manufacturer p NA 1cfSuent Filter Model ~_~~ O NA Pump TaNc Capadty ~ gal O NA Pump Tank Manufacturer p Nq Pump Manufacturer - p NA Pump Model p Nq Pretreatment vn[t NA O Sand/Gravel Filter ^ Peat Filter D Mechanical Aeration q Wetland D Dkinfectfon ^ Other: Manufacturer Dispersal Cell(s) O In-ground {gravity) ^ In-ground (pressurized) D At-Erade `~14~iound O DrJ Ine Q Other: * Values typkai Por domesrk (non-commercial) wastewner and sePtk tadt efRuent. * * Valua tYpkal for pretreated wastewater. s.~I~ E~.,Itt ste~h Fregaeney inspect condition of tank(s) Pump out contents of tank(s) At least once every ,,,3 D months year(s) (Maximum 3 yrs.} When combined sludge and scum equals one-third (}~) of tank volwne inspect dtspasa! cells} At least once every ~ d months~isyear(s) {MaxJmum 3 yrs.} Clean eRiuent Slter At least once every ~ ^ months ,~ayear(s} ~ S' ~ ~ ~ inspect pump, pump controls gL: alarm At least once every .s ` q months year(s) D Flush laterals and pressure test At least once every ~ D manths~'year(s} O NA off' At least once every ^ months D year{s) ~FNIA ~' AL least once every O months D year(sy 'A'NA MA[NTE>htAIKCE INSTRUCI"IONS Ittspectiarts of tanks and dispersaf.celis shah. be made by an individual carrying one of the folbwing licenses or certiScatlons: Master Plumber; Master Plumber Restricted Sewer; POW'1'S inspects; POWTS Maintainer; Septage Servicing Operator. Tank impactions must include a vRuai Inspection of the tanks} to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and sand and to check for any bade up or ponding of effluent on the ground surface. The di~rersai cell{s} shalt be visttaily inspected to check the effluent levels in the observation p[pes and to check for arty ponding of effluent on the ground surface. The pondhtg of effluent on the ground surface may indicate a failing condition and requires the immediate nodticatbn of the local regulatory autharlty. When the combined accunwptton of sludge and scum in any tank equals one-third (ys) or more of the tank volume, the entlre contents of the tank shall be remcwed by a Septage Servldng Operator and disposed of in accordance with ch. NR 113, Wisconsin Adminisxrathre Cade. The servkirl~ of etiluent filters, mechanical or pressurized POWTS components, pretreatement components, and any outer tnaintenante or monitoring at intervals of 12 months or less shall be performed by a certified PC?WTS Maintainer. A setvke report shaft be provided to fire local regulatory authority within t q days of cornpieclon oP any service event. ST//iIRT UP A1~ID'QPERATION For new cotutivcttioti, prior to cue of the POW7'S check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal tail(s). if high concentrations are detected have the contents ,~ .~., P:er _ of System start up shall not occur when soil conditions are frozen at the lntittradve surface. l)tu'htg power outages pump tanks may fill above normal ltlghwater levels. When power 1s restored the excess wastewater wilt be dbcharged to the dispenai ceil(s} in one Iarge dose, overloading the ceif(s} and may resuR to the backup or surface discharge of effluent, To avoid this situation have the contents of the pump tank removed by a Septage 5ervking OperaWr prior to restoring paYwer to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating thepamp cont~ls to restore normal levels within the permp tank. fao not drive or park vehicles over tanks and dfspersa! cells. Do not drive or park over, or otherwise disturb or compact, the area wfthlrt i 5 feet dorm slope of any mound or at-grade soil absorption area. tteductlon ar ellrninatlon of the foiieowing from the wastewater stream may improve the performance and prolong the life of the POWTS: and; baby wipes; cigarette mutts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundatfort drain (sump pump) water, fruk and vegetable peelings; gasoline; grease; herbicides; meat scraps; medicattons; oq; pafndnpt products; pesticides; sanltarv naDidns: tampons: and water softener brine. AaANDONEMENT When the POWTS falls and/or is permaner=dy taken out of service the following steps shall be taken to Insure that the system is properly and safely abandoned In compliance with ch. Comm 83.33, Wisconsin Administrative Code, a An ptping w tanks and pits shag be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servidng Operator. e After pumplrgl;, aH tanks and ptts shall be excavated and removed or their covers removed and the void space filled whh soli, graver or another inert solid matetiai. CONT~NGEMCY PLAN if the POWTS falls and catumt be repaired the following measures have been, or must be taken, to provide a code rnmpifant replacement sysf+em: D A suitable replacement area has been evaluated and may be utilized for the location of a replacement soll.absorptbn sysoem. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks tkom existing and proposed structure, lot lines and wens. failure to protect the replacement area wil result in the need for a new soil and site evaluatbn to establish a suitable replacement area. tpaacement systems must comply with the rules in effect at that time. D A suitable replacement area is nat available due to setback and/or soli limitations. Barring advances fn POWTS technology a hoidirtg tank may be installed as a last resort to replace the failed PQWTS. O The site has trot been evahrated to Identify a suitable replacement area. Lipon failure of the POWTS a soil and site evahration must be performed to locate a suitable replacement area. If no replacement area h available a holding tank may be Irntatled as a last resort to replace the fatted POWTS. ,~ Mound and at-grade soil abeorpton systems may be reconstructed in place following removal of the hlomat at the fnfBpatlve surface. Recortstntcdons of such systems must comply with the rules tri effect at that time. < <WARNING> > SEPTIC, Pt~IMP AND OTHER TREATMENT TANKS MAY CONTAIN LETIHAI. GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPT{C, PUMP OR OTHER TREATMENT TANK UNDER ANY ClRCU1MSTANCES. DEATH 1MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY lift DIFFICULT OR IMMltilRf .i.. A~omoNAL cofrrlMENTs POWi'S li~ISTALLER lVarrte ~wwr~ Phone ~ - , ,d SEPTAGE SERVICING OPERATOR PUMPER ~' 'Sri ~ u r~%n1,tC. 7/ s ~ Y~~ ~`~ PO1K'I'S MAINTAINER Name ,~ /V-t.~ Phone i - ~ S"~ ~ F LOCAL R1i;GULATORY AUTHORITY ~ - ~? ~y d Agency .;5~-, Ceti ` w n / ST CROIX COUNTY SEPTIC ~'A1~K MA"INT~NANCL AC3RELMBNT ~. ~.. ~. AND OW,N$RSHIP CERTIFICATION FORM t ~- ~wt18r/Buybr ~~..G~.G ~ ~~ R'G il.,/ L • L.~K ~G /\ ~! 1('\~C ~ Yl ~ ~~ ~ r Mailing Address _-~(~ (~ fi ~fY1 ~ m~cm ~~~~~~ ~ ~ ~ ,~~ Pei 1. ~ IYl ~ ~ ~ I I $ Property Addrass t~ (Vet9Acatioa t+equired from Planning Department for now City/State Parcel Identification Number~~~~.~ ~~~~ LEGS DESCRIPTION /~ Pro Location~~ t/. ~~t b PAY , ~ /., Soc. . 'I%~N-R W, Subdivision ~ Lot # ~, Cert~led Surve Mu # -----~ Volume ~' .Page # ~/ Y P . Warranty Deed ~ ~~~-~ .Volume ~ 3 ~ .Page # ..~~ ~? Spec housa O i..ot lixtes identitxable s Q no ya~}~ Yatpt+opex use sad mainte~aaaaeof your sepdc sysdem could remit is its premature failure to handle wastes. Propar malatettaace consiata of pampiag oat rise septic taalc every three yearn ar soaa;er, if wooded by a licansed pamper, What you put Cato the system can affaet the Rtactiea of t1u sepdo task ss a tteatmemt stags is the waste disposal system. 'rive propte'ty awaer agrees. to sabenit to $t. Croix Zoning Dapartment a certification form, signed by tha ownor cad by a master plumber, joutttcymaaplumber, t~estrietedpluAnbar or a ticxnsed pumper verifying that (i) the oa-site wastewaterd3sposal system is in proper operating eondttimt and/or {2) alter iaspccdoa and purctp lag (if necessary), the aeptlc tanic,is less than 213 Rtll of sludge. Uwe, the t~adersigaed bane road the above roquireanents cad agree to Aaaiatain the private sewage disposal system with fire standards sat fort>a, herein, as cat by ttta mat of C7ommerce and tiu Departineu! of Natural Resources, Stste of Wisconsin. Certificatien stating that your septic syatsm b:a been maiataireed mast be Meted cad raturnad to the St, (~oix Coumty Zoning Ot'1'tee within, 30 da f the 13uoe year e~~xpfratioa dom. C..~ 1a~71o SIQNATURB OF APPLICANT DATE ~-,V~..~IY,~R .C~~~, .~~rrnrr Y {we) certify that all atattaserits on tkis form are rata to the bast of my (our) lmowledga. the apariy described above, by virtue of a warranty deed recorded in Ragiatar of Deeds Of~'tcc. SIQNATURB OF APPLICANT t (we) am {sra) the owner(s) of ~~ DATE '"*'s** Any information that is n>is~epreaeated Array r~esuit is the sanitary permit being ravokod by rho Zoning Departmet •• Laeiude wt!lr.this applieatioa: a stamped warranty deed from the Tiegister of Deeds office a copy of tba cartiffed survey rriap ff reference is made is flu warranty deed ~. Tovm o ~~ '~t~ii. i533PAGE 162 ro • + STATE BAR OF WISCONSIN FORM 2 - 1999 E~27852 'r:C;'i ~!%_!~-r!y !-I. WHL SIi Document Number WARRANTY DEED . kFG:iL•:?CR OF DEEDi ci': ROS .. k CO. , WI This Aeed, made between Thomas M. Kasten and Melody A. kECEIVf.L' FOk kECOkD Kanten, husband and wife, ~ OA-Dd-200 _ 0 10:45 AM _, __ _ i -- IdAkkAHiY GEED __ Grantor, and _ Doreen E. Turner, a single person,- ~ __ - - E(E:"PT it !.EFT COpY FEE: _- CJi~~• crE. _ ~- - - - ?-;P.FSFEk FEE: 90.00 _~._- --- kE„GkDING FEE: 10.00 : OGI-, - - ---- -_ Grantee. : i 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): A parcel of land located in the South Half of the fractional Southwest Recording Arca Quarter of Section 6, Township 29 North, Range 16 West, Town of Baldwin St Croix County Wisconsin bounded as follows: Name and Return ppddd~ COi~11d R )t T , . , , B d e8 y tI@ 400 South 2nd Street , ~ Q _ ~l D 60 2 - ~d /3 oun ed on the east by the westerly right-of--way of State Trunk Highway N b 63 B d d Suite #i 15 um er oun . e on the north and west by Spruce Road (a Town Road) Bounded on the south b the th li f id S i 6 S HUdSOtI, WI 54016 q ~ , L l . (~ • 4 . y sou ne o sa ect on , t. Croix ~ ~ County, Wisconsin. 02.1013-30.000__ _ Parcel Identification Number (PIN) This __ is not homestead property. pf) (is not) Exceptions to warranties: Easements, restrictions and rights-of--way of re cord, if any. Dated this ,~~ day of Signature(s) AUTHENTICATION 2000_ / _--- + Thomas M. Kanten • Melody A. Kante ACKNOWLEDGMENT STATE OF WISCONSIN ) REBECCA J. PI-IgNEUF ~ St. Croix __ County ) authenticated this -day of NOTAAY PUg! IC ATE OF WISCONSIN Personally came before me this ~_~___ day of • Jul 2000 _ the above named Thomas M. Kanten and Melody A. Kanten, husband and wife, + -- TITLE: MEMBER STATE BAR OF WISCONSIN (Ifnoi, _ authorized by § 706.06, Wis. Slats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristine Ogland Hudson, WI 54016 (Signatures may be authenticated or acknowledged. Both arc not necessary.) Names of persons signing in any capacity must be typed or printed below thei to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. + Notary Public, State of Wiscons~ My Commission is permanent (lf not, late expiration date: - ~~~-~__ , sue- ) WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 - 1999 In/ormation Professionals Company, FonO ou Lx. VJI 800b55-2021 ~`~~' n ,' 86C~ Qom,' ~~ y ~ ~; LOT 4 --- ~~ _ $ LOT '~ Ova - ~ - r ,. CERTIFIED UR _ MA _ ~ Q' _ - ~ ~Q'i~ ~. ~/ Q N 87 B I ~' ~/ a Z l n ~/ ~ ~ ~/ J~ ' 2s~~~ I ~° 25g,o3 ~Q / 24g.57 / Q '~ ~ 26g 63 ~ /' ~m ~~ , ~~ o ~~ 36' a ~~ (L~ . ° LOT 2 ~',' m / ~ ~ QPG~ .. d' ~ • ~ / i G' JOB' etia9 ~ ,~ A / !~. ,~.,~'` ~JG~ ` O ~ ~' LOT 6 r li ' Q ' i ~d ~ '' ,,t VV i 90A-10 ~s~.~ / ~ r t~' r / ~7 C ' G ' ' ~ ~ -' M ~~~ ~ ~ ~ / ~ $7 C~ 1 ~33~ i 62 ~f64.55' S9S,7e1' '~- ---- ~_ ~= -' ~_ '_-'- _-..,_ .~,_ 110TH ;W COR. ---- SEC. 6 •. SEC. 6