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HomeMy WebLinkAbout030-1093-80-000 i 0 j O O 0 ~ N y `7 5Q N CO O C C C P. m N O € ~Np O I N ~ U C 00 C C (6 N ~ C Y y ~ y Y a~ ~ I NN3 I Q c C O LS C O M v O "O 0) y Ew O c 00 CD m E w ti 0 0 - m C C Z W O. N V O C 7 70 N a 3 o LL o 4) L- N O.(0 O O (p N X Q Z~ Ctp Cl) -S Z N W E Z = 00 Z ~ a m 0 Cl) M F- ~ C O C z U O 2 :!t ' ~ ~ ~ I I 30 w "O d C H r c (D -21 O 0I O Cl) (D m N CL 3 4) O U) C • ~l d r- 00 g C C O U O O O Q E (0 Z f- Z Z) N _ z U') N O > A y N 0 d C d w O C MO) . tl) N d d O~ 2 ° Coco. a Z N> H F F- _3 E w O CL (L IL (n ~"•ti W CL O co c) 0 0) M O `l U) ~ Z U) CN -0 N rn 00 0 ~►J N N L ~0 00 O M to V j cM z N ~i C0 r Q O n 1 od n a) v d d > o m I 0 N y p m O m N C O E (D O (0 O :3 o c) 0 O 6E O C c a N_ N N_ N co co Cl) a. O O N G N C 7 co M M N - w z: n co N O r O 0 Z (n • y' o M 0 a o r xt d v d m a s at ° ! a • ~ O. O .V d C ii rrww O (C 3 ! 3 O `~1 A ti o.2l,OusV a S(G STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER f1~1 ✓ id rl ADDRESS O/c( E 0"d SUBDIVISION / CSM# C5-i (l al 3 LOT # Z SECTION ;?'2- T 36 N-R__J1 W, Town of ~f 96 esi1A ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM i t ~ i ti 0 1 ,St n i INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: /P4e,*,~,"i1 f~Fu9 r f ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: I'jioe ks 6"10, Liquid Capacity: law Setback from: Well (a& House S 5 Other Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: S Length 6 ® Number of trenches 2 Distance & Direction to nearest prop. line: /e2- Setback from: well: I'ZO House Other ELEVATIONS Building Sewer ST Inlet: ST outlet PC inlet PC bottom Pump Off Header/Manifold Bottom of system Existing Grade Final grade DATE OF INSTALLATION: PLUMBER ON JOB: P/7111- LICENSE NUMBER: INSPECTOR: 3/93:jt Y~ L &TaQk1pertF5Lntofj9WH 32.30 • A,1 AjE SEWAGE S E101' OLD E ' Labor and Human Relations INSPECTION REPORT Safety and Buildings Division (ATTACH TO PERMIT) Sanitary -Permit o.: GENERAL INFORMATION Permit Holder's Name: ❑ City ❑ Village R Town of: State Plan D o.: n p. Rh41ev1I.F, B Description: X Parcel Tax No.: TANK INFORMATION ELEVATION DATA A9300040 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet Vent TANK TO P/ L WELL BLDG. Airito ntake ROAD Dt Inlet Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft Loss mead Forcemain Length Dia. Dist_Towell SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS LEACHING Manufacturer: SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM INFORMATION Type O CHAMBER Model Number: System: OR UNIT DISTRIBUTION SYSTEM Header T Manifold Distribution Pipe(s) x Hole Size L x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of Fxx Seeded / Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: ST. JOSEPH 32.30.19.342B,SW,NE, LOT 2, OLD E WEST Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: DILHR SANITARY PERMIT APPLICATION couNTY In accord with ILHR 83.05, Wis. Adm. Code STATE SANITARY PER IT # -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ 8% x 11 inches in size. Ch 2k i rev sion to rev ous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION A"LA, S t.1 Y4Ak '/a, S 1Z T ' 6, N, R 19 X(or)Q) PROPERTY OWNER'S MAILING ADDRLIESS LOT # BLOCK # f n ,16,5 d £ Z / If ,7 CITY, S 944M /Zie J5, 3 TATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 81.15; 4161e 11. TYPE OF BUILDING: (Check one) CITY FNEI EST ROAD ❑ State Owned O VILLAGE : h 61 ❑ Public 121 or 2 Fam. Dwelling-# of bedrooms A L ( 111. BUILDING USE: (if building type is public; check all that apply) 636` 16 93_ 0V --0 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 40 Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 1130 Other: Specify IV. TYffPP~E OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. IQ New 2. ❑ Replacement 3. ❑ Replacement of 4.0 Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 12. 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) -t-I q1.50 ELEVATION 4( D 6" ,75 -r22 92. xFeet ~ V eet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank 14e>6 l c1 Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumb ' Name (Print): Plumber's Signature: (No Stamps) MP/MPRSW Ng- Business Phone Number: - W11 32Z 7Z l Plumber's ddress (Street, City, State, Zip CodA &L-1i i 677 A K6 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater [Date lpsued Issuing Agent Signatur (No Stamps) Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination I : ~ ~1-4 / I - 9 1' V!7' . CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-8398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS , 1, A:,sanitik y;permit is valid for two (2) years. 2- Y6ur'sahitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions tc~ this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/f=.t>rt;>wal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsife !ewage systems m--st be properi y -riairitaitied. The scpt r: tar >:'v,) must he-k°yrn~~ed by a li-,Jensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Propprty owner's name and mailing address. Provice the legal description and parcel tax number(s) of whefe'the system is to be. Pnstal-led. 11. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelliig. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. Vt. Absorpti,-~n system information. Provide all information regr,er=.°^d in #1-7 Vll. Tank mfg;, oration. Fill in the cape."ty of every new aid/or a"71k; ist the total !umber of tanks and n.anufacturer's narile dr~Fdic~rtt~ prefab or site constru•_~rx•d and tank :naterial. t •,r; r'1 4te lior ali septic, parr r/siphon and holding ?:inks ;his system. Check ex::,t;fimertal approval oiii~< inks received experiryi-Wai product approval from Dlt.. 01 Vlll Responsibility statement. Installing pluwkk,ar is to fill in name, h-t e number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumbei must sign appli(-; 'm i~' m. IX. County/ Department Use Only. X. County/Department Use Only. Car --'ell glans and specificatior° rot smaller than t3'/z must be ';ubfnittf,fd tr the, county. The plaris r.„.sl' include the following plot plan, drawr to ~'-6 ~F r - J'h complete ;?K,; rr :2t nrr of- hol 0 ;.-nk(sseptic tank,.) r.r *her treatm{-nt tanks; ho, ' . well:: vvav~?r ater service; streams -=ri7 lakes, pump or siph~,,, tanks; distribution bo- -a,,, t_~so~l~tion sycte°rr~; ral.1,•.:,.i,1e !t system areas; ar:tJ ` e Location of th ; ui'x':ng served, -13) horizor!. •rtica 31P1 :'1 , _ } f.rc - r in.t. C) complete specifications for pumps and controls; dose r r~; + elevation dif;erences fr cti-," ioss'pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin, Act 410 included the creation of surcharges (`e: , !oi- ; r.un: ? ar cf regulated practices which -an effect groundwater. The monies collected through Yhese surcharges are use~"-)r rgre+_.ndv a.:- ci:-4 AIL water contamination invesligatior~s and establis:nrneei -,t ~;a;,+'r ~ ds SBD-6398 (R.11/88) STC - 100 This application form is to be completed in full and signed by ,the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. ,Should this development be intended for resale by owner/contractor,(spec house), thenia second form should be retained and completed when the property' is sold and submitted to this office with the appropriate deed recording. owner of property /L./cam ~c nx n /~ru ~ Location of, property 5'6J 1/4 X1/4, Section T 3C N-R L W Township Sl Mailing address Address of site Subdivision name_ e Si`'7 I 3 , Lot no. 2 --r Other homes on property? yes No Previous owner of property Total size of parcel o Ike Date parcel -was created 'Are all corners and lot lines identifiable? _ -Yes No Is this property being developed for (spec house)? Yes ~_No Volume 3 and, Page Numbers as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER & THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I(we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. 3(. 31x% , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of County Register of deeds as Document No. I Signature of applicant Co-applicant Date of Signature Date f Signature j STAf BAR 7 K'I U~ .`7 FCS 1 QC1 C, ~i M1'{=47 NO f RE vo; ,i,,! b4:', e 1 K V_ Gruel ~r ana Pa„. l_a J_ Perro;l (si11.31e),_ Riarlel. L. P,r on, (sIC4 ~~)A ...T.Fab._a-a. 19__81 AA. Cheryl J. Perron,- (sl._.gle)... . - a310:25 A. . - - - 3. Wi tlIC n` °•'Ql, That the sal, Grsnr.,oz, for s valua3 ie cu f_,, a loa.- One .($1•()0) Dollar and other good and_.valuaaC``})l e.-cons 1d ration • , fi° j ' - convey,, to t:r+a!It,~e the `.ollou:ing deac~..l a+., real estate, in _ -St. 411E .ix R URN TO County, State of Wisconsin: Tax Key No..----- - - - Lot 2 of Certified Survey Map as recorded in Volume 3, Page 856 on August 23, 1979. Subject to ease mints, restrictions and reservations of record, if any. This _-is_not----------- homestead property. (is) (is not) Together with all and singular the hereditaolents and appurtenances thereunto belonging; A,d Edward T. Johi_storl - - - - warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except and will warrant and defend the same. 6th Dated this - - day of - - - - ~ ~ - (St.~L :t - - ) - - u"'AL) • - --Edward. T__.J n- - (FAL) - c ACKN0Vf LED GM F,I T <O el LI TiA E NT I C ATYO N 'A -l•lu:• Signatures authenticated this day of STA_TF OF WfSef)hSt i tsit _ i9-- Minn. as. Washington . . .....County. ' Personally came before t.,e, this 6th...... -..day of Dec.,-. - he above named _ • 4ward T-...Johnston _ E410 rd - TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stets.) - - - TH,S fNSTRU~-aENT WAS JRdFT£O S`r to me kl/o `.n to~oe the p.' Son executed tl:e fore ping inst ozn-+'.. and cl no;cmme. '4 Anderson- Freitag, Inc. f New Richmond, Wis-onsin 54017 .Richaru G. `.rai Lag Notary Publf W' 4h t ~l, i on County, Nl;;,. (Signatu e, rray be auth,.lt`catcl or ackflow?edg d. Roth bty. Con r.is, nn is p n,.ati ,.t. (If not, state cY,)ir.tinn are not ncce4~ary.l date JUiy .31) 19 •Nxo. of v reins 5gn'r,y in sny cape:-'ty ahead •ao type! e,r p:-int<d b?ln, their aigca?r:r«v. l SY Z s 2's" O T YAK fl -A CO. Inf. For"4N_t ? i N ->a4_. Wis. (3"t S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUY ER_ /-ex 01,1" nz. f 6trn ADDRESS Q IJ 4' E'.c-41- FIRE NUMBER 45 CITY/STATE /_'c1(S ZIP PROPERTY LOCATION:Stl1/4 ,1/4, SECTION, T~N-R~W TOWN OF .1/ ~t , St. Croix 'County, ' SUBDIVISION C.5tk7 , LOT NUMBER Z 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 septic tank pumper. What you put into ttie system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification 'form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1). the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/Ile, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix Co. Zoning officer within 30 days of the three year expiratio te. SIGNED• ' DATE: St. Croix co. Zoning Office 911 4th St. C d Hudson, WI 54016 9xu~ S C S yZ ON C-Z- Soils 0ti1-,41;1- loom co,r+1ol-eX Safet Builu~ngs Division x 7969 = Wisconsin Department of Industry, SOIL DESU(IPTION REPORT P.O. lob Labor and Human Relations Madison, WI 53707 (Attach Soil Profile Location Map - To Scale - On A Separate, Signed Sheet) page of yiy- /ate ustomer Name i w uaUOn ate urnnt Lan Use or Vegetapve over Parent Matena s k/~S I XA /00 y P: rr4Fv o vT Estimated a shallowest roun water P ain E evation ustomer ress L ~ • • Y~ Gt,( ~ stem loa m Rate in a ons Per q. Ft. Per Day y- ~S County ax arce No. b+ ` Z 4 Rek 3 i ef31 ~ 3-13 Sf C,f~a~ <or- Lot Legal Description -FOWAN t o/c, eometry an Dept ope an Aspect No e t!i taLcsT~ [y S c1` . 2 7-c> S900 - .41oa i yGE- s`f TOS EP /y` st d ,PE.~IVr,P,f'.S ~ s Gr~ N SEC• 3"~ a R 1 ~W Structure Remarks: clayskins Loading TAE Horizon Depth Dominant color Mottles In. Munsell u. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Bounda ores Hand other GPD/ft. 0-l7- 10a 3/2- J,f, s6k nM''ie cw 3 3 $ 12 -2-f /vile s/y 1 s6& f~ 2v ~ea n~f 2 C cv 13 i Y--y"P /U Yw S/LQ 1"'5-k 69, - ':~7/E IIA riot v Tze-,) 9t!o, 5 - Structure Remarks: clayskins Loading !Ho %Domun r Mottles u. Sz. font. Color Texture Gr. Sz. Sh. Consistence Roots Boundary ores H. other GPD/ft.2 s./ 1, TSht .wtfR Si / 1, f, sb K n,•tf2 _ 1B 7v e'w IM 2 nt~ c c~ I,J e 4 ~'/e v,~ , , o,v of ~ • S ~o ~ Horizon Depth Dominant Color Mottles Structure Remarks: clayskins Loading In. Munsell u. St. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Boundary ores H and other GPD/ft.2 13 30 2 l1,4 cw • 3 /3, 5,9 t 57 MrXT~~~ aF I, C s~//0 yA" 41, in; tic, 5ie #"f/2 cr-u s/ v. s. 0 vet % •o.t~ _ _ rJ G ~ y~A Horizon jDepth Dominant Color Mottles Structure Remarks: clayskins Loading Munsell u. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Boundary ores H and other GPDA0 /o Y/P 3/3 A 3 Zf 4 2ti /0Y R f p- w 4-yo /oYX 51Si/ 21f,sbk nMr2 cw - <o 60 y,~ 4~CP - S D,, s .e c4, --AL &Ld=ahallaii Depth Dominant Color Mottles Structure Remarks: clayskins Loading In. Munsell u. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Boundary ores H and other GPD/ft.2 /v !oye 313 Si/, lr , ,F 4, fe 2rrf- cw '3 7 6 '4z /0-Y 14Y4 y S// ,f Jhk 'e zvf- e-w 3 I3 7- 3L ioYe 4/6 2--F k 32-L1 /0IYk y/(e S Sid 1 f, SbX ► a- Z1i lE F -7. 5 Vie ,q C L-sy 7•5 Yf -If/( /s I, vF f~ - ~w ~a y//y 7,5 Ye IS - C MOT TGi v /N JN G LV $ /'p tJ HOMESITE SEPTIC PLUMBING CO. of P~ T ~N 85S O'NEIL RD., HUDSON, WI5.5W01 R08EKT ULBRIGHT a'V Ly, ~O/~Q ` s -11S. MASTER PLUMBER LIC. NO. 3307 M.P.R.SL ',!N. IFI;7ALLE'i & DESIGNER LIC.140. OD663 ' Additional Remarks: v 1 8 3 - g y - 13 P4-re- , -1- - °t 3, 13 hAS loxawc- h'^T~~° o,z + F.vy 6 -e ax-,e~ y_T~'o.~ . l4 i 64, T&E/v c4- = 9~- .Sci ' ro 2 A Qe~.4 Garb 7-,r e.v a, = 9Z~ o ` , - ~i^ f3 yr Other Site Features: lZ" `Po/G- /WIlev /fr Boer- ~ S ~1,, - ZVP Z Limiting factors/Depth: CST Signature Date Signed Telephone No. CST # SOD-8330 IN 01190) To P of 23 7 f E ~E ~r roN - o o. O OLD E ~,1s i c Ic~~ E SET A,1 10 a ' 3 io 5 3z • n Its) A 4 f' ex- J I i 43 I f I / 13,4eello r TS JOB 4 M ~2 //6Y1 TIMM EXCAVATING Route 1 Box 192 SHEET NO. / OF WILSON, WISCONSIN 54027 CALCULATED BY DATE y - ~3 (715) 772-3214 (715) 386-5443 MPRS #3224 WI MPCA #696 MN CHECKED BY DATE SCALE _ IJK omjv e~ - . ~.~6 r ~,3.......: . Le~~: 6 5 . rL!~ lGoo' tJe ;.C f a r.l In L ~......7.... i.a ti. ? 00 f TDB c~... ~~e....,i~L,l. ` u 2 k j . j t~ 3 Q . I" i PRODUCT 2054 ~ Inc., Groton, Mass.01471. To Order PHONE TOLL FREE 1-800-2256380 ' JOB TIMM EXCAVATING SHEET NO. Z OF 2 Route 1 Box 192 WILSON, WISCONSIN 54027 CALCULATED By DATE ~'F3 (715) 772-3214 (715) 386-5443 MPRS #3224 WI MPCA #696 MN CHECKED BY DATE SCALE . . . . ' \ i.... C \ I f - r $ . . . 4 'I v 1~ b ~14SQ ~ • 6 x PRODUCT 205-1 Inc., Groton, mass, 01471, To Order PHONE TOLL FREE 1-800-225-6380