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HomeMy WebLinkAbout030-1083-30-200 ~ v o I O 69 H tV 0., ~ O N O C i I ~i I, I d v z° LL c0 I 3 v ~ I Q M v I (D z 0 N o V 0 z a m N H z O Z ~ c I ~ I N H r ~ ~ v ~ I 0 0 00 •N a to s ~ N I 0 0 z m z 0 N Zo N Z c I ~a Y D1 N U) 42 O i d d a 0 v) w v) E c0 z M> P P P a O o aaa N _ R a 3: ~ o N 3 m U) J U d 0 00f > - LO a) c C N ON N 00 0 co c a 0 N v U) N 'p d Q Sn !d p 7 a~ U) cl 0 O O H = O C C E 't co C14 rrO e° M a a c a N N M a C E E C N p C co o H =0 % o a(D y a~ c a°i ° ~n - w r • 1V O N (n L) O Z (n O ~ r 4j r= at ° L: a 4-~ r V co CL a) r`N o m 3 o • FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER Rj~EL_~ BL-~ TOWNSHIPS SECTION_,.22_T_.~n_N-R e W ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION ,,6F LOT LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 3G~ ~ L/ b , JD INDICATE NORTH ARROW BENCHMARK:Elevation and description: Alternate benchmark SEPTIC TANK:Manufacturer:_ Liquid Cap. Rings used:. Manhole cover elev: ~GJFinal grade elev: Tank inlet elev.: Tank outlet elev.: No. of feet from nearest road:Front , Side , Rear Ft._o?S-D~ From nearest prop. line:Front , Side, Rear Ft. No. of feet from: Well 4~ , Building:- J (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE r { PUMP CHAFER 1 Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufact.: Pump Size Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons/cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop. line: Front_, Side_, Rear_Ft._ Distance from: Well Building SOIL ABSORPTION SYSTEM Bed•_ X Trench: Seepage Pit: Width:- Length '9" Number of Lines: - _Area Built Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to top of pipe: , J-~/ No. feet from nearest rop. line:Front . , Side , Rear.L-Ft. ~ No. feet from well: No. feet from buildin HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front Side , Rear Ft. No. feet from: Well building , nearest road Alarm Manufacturer: INSPECTOR: DATE : _ )0-, PLUMBER ON JOB : LICENSE NUMBER : 6/90:cj I11~ 6? 1 06Q I Wisconsin Department of Industry, Coun y Q Labor and Human Relations PRIVATE SEWAGE SYSTEM St. Croix eafety aM Buildings Division INSPECTION REPORT (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATIONNW4, SW4, Sec. 29, T29-R1 9, Town Rd. 149164 Permit Holder's Name: ❑ City ❑ Village ® Town of: State Plan ID No.: Gordon Camprell St. Joseph CST BM Elev.: Insp. BM Elev.: BM Descr tion: Parcel Tax No.: 030-208-330-200 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic & s G21& Benchmark ~~-'d. , 60 ' Dosin ~ p UU~if W Aeration Bldg. Sewer 1,v? 99 g$, Holding St/FK Inlet 2-74V ?9',a21 TANK SETBACK INFORMATION St/ V Outlet a' 9 s O5+ Vent irito ntake ROAD Dt Inlet TANKTO P/L WELL BLDG. A Ar Septic 90r ® NA Dt Bottom , Dosin NA Header fRAea, 7,07 , 8 Aeration NA Dist. Pipe 4 9 -719, 93, Holding Bot. System 7, 92 PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand M e Num er GPM TDH Lift Friction tem TDH Ft Forcemain Length Dia. Dist. Towe SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PI Of Pits Inside Dia. Liquid Depth DIMENSIONS-_ A &0 DIMEN I N SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type i a CHAMBER Mode Nu System: ,3D ~ OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size 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 xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil El Yes E] No ❑ Yes E] No COMMENTS: (Include code discrepancies, persons present, etc.) , Plan revision required? ❑ Yes 2<0- Use / other side for additional information. !D / 9( Erl ~)l SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. SANITARY PERMIT APPLICATION DILHR In accord with ILiiR 83.05, Wis. Adm. Code COUNTY STATE SANITARY PERMIT g 1 -Attach complete plans (to the county copy only) for the system, on paper not less than p, 8% x 11 inches in size. ❑ Check if revision to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PR PERTY LOCATION N, R V(or)(o PROPERTY OWNE M LING ADDRESS LOT # BLOCK # CITY TATE zip C DE PHONE NUMBER SUBD ISION NA E OR CSM NU BER II. TYPE OF BUILDING: Check one CITY NEAREST ROAD ( ) State Owned O VILLAGE ❑ Public ®1 or 2 Fam. Dwelling-# of bedrooms PARCEL TAX UMB ) III. BUILDING USE: (If building type is public, check all that apply) 0 SO/O$33ob?00 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 30 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 in line A. Check line B if applicable) A) 1. 0 New 2.E] Replacement 3.E1 Replacement of 4.0 Reconnection of 5.0 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 (s q. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION i ' i Feet Feet 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 strutted Septic Tank or Holdin Tank I F1 F1 I F1 Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installati n of the onsite sewage sy em shown on the attached plans. Plumbs s Name (Print)] Plumbs _s& natur MP/MPRSW No.: Business one Number: yi 9 Plum r' Addle (Street, City, State, Zip ode): IX. COUNTY/DEPARTMENT USE ONLY A❑ Disapproved Sa itary Permit Fee (include geroee Water a e Issued Issuing ent Sig a No S Approved ❑ Owner Given Initial / Adverse Determination / X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber 44 • APPLICATION FOR BAIIITART PTRHIT . B T C - 100 This application form Is to be conpintad in full and algned by the ovntt(t) of the property being developed, luny Inadoquacles will only result In delays of the pit rAlt Issuance, 'Should this davelopment be intended for rtaalt by owner/contrsctot,(apee haunt), then A second form should be retained and coupl■ted vhan t1)a property is sold and submitted to t h I a office vith the approptlatt deed reeordlnq. m - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~ ownit •at property Location of property _1/4 ~Me Bastion x-R9_V Township Halling addresr Address of site Ivbdlvlslon nawe A&4 ¢ E ?~i~ce • Lot number Ptevlous owner at property Total size of parcel t Date patcel vas created Ara all corners and lot linos Identifiable? ,Yes Xo is this pro patty being developed for resale (spec house)?- as xo Yolnp" .-2-and Page Humber recorded with the Register of Deeds. IIICLUDB ViT11 T11I9 APPLICATIO11 TI(Y POLLOVINCI J1 VAARXYTi DIED which Includes a DOCUHINT IMMOUR, VOL"z AND PAOI HUNIIR, and the BYAL OP T111. RROIOTBR OF' D$EDO. In addltlon, a cettlfIad survey, if available, would be helpful so as to avoid delays of the tevleving process. If the deed description ta(erencas to a CeiLiLlad survey Hap, the CattIflad Survey, Hap ihall also be required, live PROPERTY-OVIIER-CERTiriCATIOH---- ctttlfy that all statements on this form are true to the best of my (out) knovltdgel that I (ve) am (ere) t h a owner(s) of the property deacrlbtd In lhla Inlatmatlon (arm, by vlttue of at wnrrant deed recorded In t h a oIfIce of lht county Rtglatet of Deeds as Document 110, ev Presently own the proposed alto for the Deuage disposal s atenl and that t (vil obtained an easement, to curt ulth the above daacrlbad propertyi (v have conattuctlon of amid nyate►n, and the same has been duly tecordtel In the Iooflice of the CoVnty Ragt■tar of beads, as Document No. s 19 n a t v t a o O v n a r 8lgnature oL Co-Owner (IL Applicable! Date of elgnatuta I ' t i DOCUMENT No. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA STATE BAR OF WISCONSIN FORM 2-1982 472953 REGISTER'S OFFICE - - T. CROIX CO., WI Recd or Record Perch__Lake.•R J_oA.n-n..Persico_,•_-Roge_r-__Fjye_1~,n__end_-_Qr.uqe..P.et.ar.s.on of AUG271991 as tenants.. in oQmmo-n each an undi.vi.de~l..'1,12 II 10-50 A. M nte.rest....... conveys and warrants to .....Gar.dan...Campo_e1.1...and...Nanc.y..A.,._._ ~ of Dee& r ....._S_intintek...G-am{abe.L1.,•••husban-d--snd-•-w-i•fe-•.a~.•-m•ar.-i-ta•1 it surv_iun rshi{a..pro~er.ty--•------- . RETURN TO the following described real estate in S-t_•••Crc►ix=......... •••-••-••••..County, - - State of Wisconsin: Tax Parcel No: Lot 3 of Certified Survey Map filed March 21, 1989, recorded March 21, 1989 in Vol. 7, Page 2081 as Document No. 446270. This Deed is given in fulfillment of that certain Land Contract between the above named parties, said Contract dated November 2, 1990, recorded in the Office of the Register of Deeds for St. Croix County on November 19, 1990 in Vol. 1188611, Page 425 as Document No. 464259. ' v Ire This ....is not homestead property. (is) (is not) Exception to warranties: easements, restrictions and rights-of-way of record, if any. August 91 Dated this day of 19 ...........................(SEAL) ............................(SEAL) .I< JoAn!i---Persico e1 9B.r..- in (SEAL) (SEAL) * Bruce Peterson a/k/a Bruce T. . ''~et'e'rson AUTHENTICATION ACKNOWLEDGMENT Signature (a) JoAnn Persico, Bruce STATE OF WISCONSIN Peterson a/k/a Bruce T, Peterson, ss. - " * " 1Togex T{ueIn County. authe cat is day of....A...UgUSt 19 g.. Personally came before me this ................day of 19 the above named . Krishna 4gland Lundeen TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) to me known to be the person who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY Kristine Ogland Lundeen , Attorney at L`aw _ ~ - Notary Public ..........-rmanent.. If not County, Wis. I My Commission is , state I ( expiration (Signatures may be authenticated or acknowledged. Both are not necessary.) date: 19.........) Wames of persons signing in any capacity should be typed or printed below their signatures. T WARRA`VTV nrr-l c.•rn rr• nn'7 nn n-*^^.~~^ . (AMIAR21 ED 1~89r Q MAIO oaNEu 4462'70 CERTIFIED OURVEY PIAP LOCATED IN PART OF THE SWJ OF THE SW} AND THE NWJ OF THE SWJ, ALL IN SECTION 29, T30N, R19W, TOWN OF ST. JOSEPI'., ST. CROIX COUNTY, WISCONSIN. QWNEsIS Roger Ruelin JoAnn Persico Bruce Peterson 505 Galahad Rd. 131-A Willow La. Rt. 3 Box 56 d10;,vtAu9tit~~A North Hudson, Wi. Hudson, Wi. Hudson, Wi. bL' gis .a> W1 CORNER SECTION 29 54016 54016 54016 T30N, R19W ~jyo -EN LEGEND 4 Z 74007 FOUND, ST. CROIX COUNTY SECTION CORNER MONUtENT• I HUMSON 8 ? en Wtu s. q- O SET, 11' x 24" IRON PIPE WEIGHING 1.68 POUNDS PER LINEAR FOOv$1 aNVnps+ j0 ` p p ivQ SU RJR O~ 0 CURVE IDENTIFICATION NUMBER 0 unplatted lands owned by platter / o N I W S89o00'22"W 770.00' 382.69' 307.31' 80.0' 690.00' © 14, / ° Q ~6, 4,`Y co t5 v~ 167,368 sq. ft. (3.84 ac.)INCLUDING R/W o^ / "-U.J 157,119 sq. ft. e LU o EXCLUDING R/W O 4~ / (3.61 ac.) moo a o W O 00012211E ' ~,Oo 287.02' 258.87' J "L ¢ d G N 545.89' 33.071 M 3 m o + oe rn `J6~ 146,294 sq. a .36 a.•INCLUDIMG P/W \ S5301310111E 100.00' `\d 135,840 sq. ft. EXCLUDING R/W 3 N530131011!t:, 100.00' (3.12 ac.) dh- 0) \ a 84.55' c.i \ o N8 0 0' 2 2'' E I \ o\~ 306.89' 606.89 300.00' 15.45' 51.29 south line of the\`f o NW} of the SW} 167,830 sq. ft. (3.85 ac. )INCLUDING R/W o \ n a 158,667 sq. ft. (3.64 ac.)EXCLUDING R/W 1~ ' ~ \ _ N89000122"E 665.77' o ~ r 0 631.13' 34.64' a+ tea' U'l 'Oc 164,472 sq. ft. (3.79 ac.)INCLUDING R/W ~•rn 'w W 155,811 sq. ft. (3.58 ac.)EXCLUDING R/W 785..96' 165.36' 615.36' 450,001 \ 34.64' N8900012211E 650.00' \ C unplatted-lands-owned-by_platter \ AWWVED 66 FOOT WIDE PRIVATE ROAD EASEMENT O M C) M MAP P 1 1989 o ST.Ck,- ny SCALE Ii'1 FEE T ~ COWAMNS\* PAWS KANNW, / ANnZaNNGCauw+M 200 100 O 200 TSSECTION W CORNER 29 T30N, R19W this instrument drafted by Douglas Zahler job no..88-17 Vol. 7 Page 2081 04. Z ✓I try ~ ~ JIFA 18OZ 028d L •TOp LOVL N311V •asuedxe OTTgnd p aq pTnoM aagjpaaagq sgsoo eopuaquirw 'ppog OTTgna p sp A4TTpdioiunW p Aq nano U9xp4 ST APMpleog 94Pniad auq 3I •saauMo BUTUTOCpP auq Aq Pgea-oad paapgs aq TTeus 'peon paepuPgs v se ao-4PagsT -uiwpV bUTUOZ auk. 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Mus'Z£1s0o9ZN 111G OTo9S £ 3u6S,9ToZZN MuT01£To£SN OVER 16S hhZ 610Mo9TN ,u0010£osL 100'OOZ h £ ~ 191'9Z 111,9Z M116h19£ M iNi ZTo1 £ i4Z'S6 1L£'h6 M116h1TZOZ£N 119£,LIOLZ Z M11101£To£sN MuT01£tO IN 1£h'OZI 1Z9'8II MuTO,eSpS£N 110010£oh£ 100'00Z Z - T ONIHV39 9NIUV39 HION31 HION31 ONIUV30 31ONV HION31 838WAN a38M 1N39NV1 MOM OaV OHOHO OaOHO IVUIN30 SnIOvs 101 M n HrIEM, VlVa 2AW13 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER gm-.6a a':V44zz1_z ADDRESS: FIRE NO: LOCATION: A) 1/4, _0 1/4, SEC. 29 T__§~_N-R__19 W, TOWN OF: ST. CROIX COUNTY SUBDIVISION: t,~o ~,q,~LrjJ~ E LOT NO. 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 the 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 to help with the cost of the 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 the St. Croix County Zoning 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 (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification from will be sent approximately 30 days prior to three year expiration. I/WE, 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 form must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. ~Cc f+ (C SIGNED: DATE: St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION P.O. BOX 76 LABOR AND PERCOLATION TESTS (115) MADISO N WI 3707 HUMAN RELATIONS (H63.090) & Chapter 145.045) LOCATION SECTION: N/R G (o W NSHIP/MUNICI ALITY: OT NO.:BLK. O.: SUBDIV ION NAME: C UN Y. OWE R'S BUYER'S ME: AI LI ADD ESS: , ~nez,22 "44 ILL /'o5v/' USE DATES OBSERVATIONS MADE Residence NO. BEDRMS.: 1COMMERCIA DESCRIPTION: New ❑Replace PROFILE DESCRIPTIONS: 1PERCOLATION TESTS: ` 41-1 < / RATING: S= Site suitable for system U= Site unsuitable for system r ONVENTIONAL: MOUND: IN-GROUND PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) ®s ❑u ®s ❑u s ❑u a s [Zu EIS ®u If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS t42AZI2 g" BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND -DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED ES IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B_ n r /r B- 9,1 9,76 Al,-~,AIZ } - B- rr > B- _ a B- r _ ? S B- PERCOLATION TESTS EMBER DEPTH WATER IN HOLE TEST TIME DROP-IN-WATER LEVEL-INCHES RATE MINUTES INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD P R PE INCH I t /10 4;1_9 / P-_ P- P- 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 I T }.65f4l"-+-~ 1 7 ~ ~ 1 III ~ j i 1-- 1- 1 ( i I t y _.....,.._....m.. _ - . . _ _,1 i _ j..._...-- ' N l s r I I i ? i p i 1 -r - t ! i 1 ~ r 1 j i S Y I r 1, the undefsigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (pr'nt . ) TESTS WERE COMPLETED ON: j'" -Z a~IA)iEzz ADD SS: CERTIFICATION NUMBER: PHONE NUMBER (optional): CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - MONA G~~aJ (~~N'!J°b~~/ Nl~/~ ~w j`/SEeo.7~j~~ON~~g6✓ ~y I 7j 40 3~~6Zl~ 8-7 Ivr~ O~ A Zito Cr0SS Fn►n Air Inlel► And OD►uvollon Plpe (=)I- Approvid Vrnl Cop Minimum 12" AbOvf final Crad• JUp~~ tS~V _ 4• Carl Iron To e 20- 4;AqQisqOIS 1pr Vent Plp$ Morn Nof Or Sring 'Mtgol-e OOlrlriDallon - Tee Pip• 0 yo Perloroled Plp$ IreloBe 0 -Coupling T•rminating At Bollom 01 SWOM 9lon SOIL FILL DISTRIBUTIOI`3 PIPE APPROVED twT11CTIC COVC2 r o ,Ll Tepw\l- OR 9•• Of STFA~J OR MARSH HAS 2" of ^GGREGAlE tr° t/ AGGREGATE •p^~" T-LEV. odl~ 'L FEET - IIJCHES BCLOW ORIGIIJAL GRADE I(DQ PIPE TO BE AT LEAST DISTR%51JT AQU AT LEAST LO %IJCHCI BUT KIO MORC THA)J '12 IUCNES Or-LOW FINIAL GRADC C Iml•➢ FKOf'► o~iGtNA)- G~~o~ WILL DE _ ~J~/ - IIJCHES ~1AXtrtuM O~PrH OF ~X /~~AT (,1NAL ~R~D~ WILL ~E INCHCs 1' HJnVM O~Pni OF EX~AVAT~CO f-KOn I • l SIGNED: LIG E►J SC AlUMBE it: DATE: i~o