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HomeMy WebLinkAbout030-1069-95-000 (2) I o ao d ! o h P E d N X33 O==LL I i 0 oMJ-cp a3 a) M ts OM i p O °d -0 y N ~M c Lf) J C :s O v CL E ~ Y~ca) C J O 0 a oa o ° m co yrn~ c Z w c m O c o V LL u o v moo; o 0 mvv c (D -0 E Q °a 3 a7 M I ~ d ,It 0) _rn w _ o V 0 C, 1i m 0 N f2 z d m 0 0Z l' a0f Z a ~ ° C O fA H r Z c E -0 1 .0 co a1 y a (D U) 0 a L 0 A m O z co z z N 0 R E C N Iu~ ~ U 0d. as 0 ~ ° °o Cl) ~ c o a .0 "0 U) Q) cn boo ° Z ' 0 as :p z •N =aaa n. I ~ I B 3 mJC) I~rn~ ~ I O E N O Y 0 O O 0 t0 m C I _ a 0 o l l Cl) a H ~j O O 3 Cl) N c 1~ rr r O, N H w tOp V 0 0 CL O O CL C m N a as E i° v w O N 0 O C C ° o o ai cC°o y t LO f' _C N • 00 ° M ' Y w ° `n O E m y O co fn lL 41 O Z c fn O ~ CC 4) a s IL: a~ • a d .2 d `N E c 2 ~ A uIL oU)0 Parcel 030-1069-95-000 02/11/2005 09:37 AM PAGE 1 OF 1 Alt. Parcel 26.30.19.2521 030 - TOWN OF SAINT JOSEPH Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner L S&PAMELA ROESSL(# A/B) FRICKE " FRICKE, L S&PAMELA ROESSL(# A/B) 200 N MISSISSIPPI RIVER BLVD ST PAUL MN 55104 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 3962 NEW RICHMOND j 3 (oI'3~3 SP 8040 BASS LAKE REHAB DIST SP 1700 WITC Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE SEC 26 T30N R19W PRT OF GL 3 Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 26-30N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1087/589 PR 07/23/1997 1087/587 QC 2004 SUMMARY Bill M Fair Market Value: Assessed with: 5314 58,800 Valuations: Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 0 57,800 57,800 NO Totals for 2004: General Property 0.000 0 57,800 57,800 Woodland 0.000 0 0 Totals for 2003: General Property 0.000 0 52,200 52,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount 040-OTHER ASSM'T SPECIAL ASSESSMENT 329.30 Special Assessments Special Charges Delinquent Charges Total 329.30 0.00 0.00 ST. JOSEPH 'W' PAGE 44 1500 1100 SUNDANCE PASS 1200 T ARROWOOD TRL UOMESTEAD TRL 1400 O K u r o 7S y E 501h ~,Tpp 13 4a r7ga+ v~ ~ em ,fns ~'.,e C r+ R ~ '9,9 a FA IN 7awiy, q' c~ w ta'f_~ a Vol M ~ ~j~jGG ~dgg I Hd N~ BIRCH ' }'~,a~ ex r ST ~ ~Eoo d a~~gm= 0,9 oGt! 'DTll„' v bd d' Etl LN vfi. w . R, -I ,pi R' csx t9 ii p x or - :5D ~rrn ~Dg'N~3 EC 7pp.. ~R ~vi pCpC x i. Mr" V @ "J'. Rv v. Gavin 19 b 70 ~P ¢ y y 0. ~ f d I M N°' xgg~3v r~+ t.& x Mss as ~o{0N°Cd ,fro ^ v k moen w ~ all n N m s v ® a O m 0 KR 5o - a RW5 A ►~y S ~o 60th ST m 1 61st cC' Ix w N" vm row S & R ADFN EZ off' -C-) w DS 6K m wD y, n ~>mo 62nd ST D 64th ST oo o ss s um N 037 ° q RCS owl Barnard V cc s 9a o = m & Bettye O ~y sx s r w a£ m Ni KrattlaY-6 O a - k@ " &MI x ssL d~ N B$ G r .x 3< V+ r J. 8 1&G 15 a r m 101 Ai " v' red" a $ to o to - a a w~ - ° o y It'i G O~ 1i~ 0 74 _ n O y`b_ ~.~y -9_ 4 fo J - to Qy W ~1 ~ B- Lake ae r ~ ~N o m ~ be y ; ~I-~ .r w R a op S'k LX mp aN` pNp Zg p H 10 r v a~m~ Vy~ O tO N ;t M 4` Q dp b m q S nR G1 Robert & t W W e D to Z Shirley Ba'm`:c p N /`t rt fp 6 R i Orf SO a s X37 0 6 BASS LAKE zpM -n ~a 4i mom' ,Q mg a RD tea. S ~D z~0 ~z { I z ao ~o N w oo rn L o o ;M, a D- m G o f9.4 N 8th z a ~ so 0 r N D a RID E U ft .+°e s~ N 6 N 8 `i I P1illlPPWe n w N n av Is eke N O 92.. FUa N * o >Z°' rL Beer 111 " 80th ST - --~.r uwara - ..w to - _W - -z p J8[M 19 I- - - - - - - w Simon- etal P 20 i t 8 o ! 83rd ST 72 Thomas ° I !~v 91 11 .1 00 ~m I ..irk a r m~ .f. d v m 85th ST Gloria m w a `4 .C n dos- Basel 34 N a D S m O q Mg p 05 gl a tC I m w a & tirr R°6 Yk . 1 < is C- (u, 00 -1 WILLOW RIVER DR 1 Z£ 3'JVd N31THWA S5 3'JVd aNOWHOIH O N ZZ M a ~ ~ N z qc) DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING LABOR & HUMAN RELATIONS DIVISION P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION MADISON, WI 53707 State Plan I.D. Number: NE 4f SE 4, Sec. 26,T39-R19 (If assigned) Town of St. Joseph CONVENTIONAL El ALTERATIVE El Hol ing Tank El In-Ground Pressure El Mound nn-rArnn-n ~ NAME-OF HYAR: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Walter Fricke 372 St. Peter St. #218, St. Paul 3. BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: -CST REF. PT. ELEV ,(/g Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: I.JC/ Calvin Powers Jr. 1563 St. Croix .135466 SEPTIC TANK/HOLDING TANK: i ( r MANUFACTURER: LIQUID CAPACITY: TANK INLET ftE TANK OWtETft-EV.: WARNING LABEL LOCKING CC) _ r PRO IDED: PROVIDED: (S F1 ` Cam.-- J, . 5 YES El NO ❑ YES NO BEDDING: i+E#F DIA.: I MATL.: HIGH WATER MBER ROAD : PROPERTY WELL: BUILDING: VENT O FRESH C J. 11, ( ALARM: FEET FROM LINE: r AIR INLET: ❑ YES NO YES O NEAREST -4110- DOSING CHAMBER: 50 Q MANUFACTURE IPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: F70-01 YES L] NO ❑ YES ❑ NO ❑ YES NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF ❑ YES E] NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING: or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: BED/TRENCH WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID ~ _'5 oZ / TRENCHES: r MASERIAL PIT DEPTH: DIMENSIONS / CIO 7 GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. I TR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV. INLET: ELG~~V E .ND, PIPES: FEET FROM LINE: ,~1 rf r / AIR INLET: ~elzk / NEAREST "'w C, >Z MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ❑ YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑ YES ❑ NO ❑ YES ❑ NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO. OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEVATION AND ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: ER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO COV ❑ YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS:,, FEET FROM LINE: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST--111111- tr 1 CC~?,'7 . Sketch System on etain in county file for audit. Reverse Side. SIGNAT E: TITLE: _ SBD-6710 (R. 06/88) v 1 .72ILHR SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05, Wis. Adm. Code STATE SANITARY PERMIT -Attach complete plans (to the county copy only) for the system, on paper not less than 8% x 11 inches in size. ❑ ch5ck`tfre~on to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROP RTY WNER PROPERTY LOCATION %,$,2Z UW, N, R ji(ort9j 4VVV_ZERTY OWNER' M LIN ADDRESS LOT # BLOCK # AJZ_ CI ZIP CODE PHONE NUMBER SUBDIVISION NAM OR CSM NUMBER r II. TYPE OF BUILDING: (Check one) ❑ State Owned . VILLAGE : NEAREST ROAD =14 RF~. ICEI TAX Nu { ❑ Public W 1 or 2 Fam. Dwelling- # of bedrooms III. BUILDING USE: (If building type is public, check all that apply) 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 70 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 130 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ❑ New 2. PK 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 n 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 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (so. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION St 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 structed Septic Tank or Holdin Tank ® C Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installationa onsite sewage system shown on the attached plans. Plumber's ame (Print): Plu is ign ure: o S S) MP/MPRSW No.: Business Phone Number: Plum is Ad ress (Str at i ,State, Code): IX. COUNTY/DEPARTMENT USE ONLY Issuing gent Signs o sta s Disapproved Sanitary Permit Fee (Includes Groundwater mill Approved ❑ Owner Given Initia Surcharge Fee) Adverse A/6- X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: - SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety a Buildings Division, Owner, Plumber INSTRUCTIONS , E s 1. A sanitary permit is valid for two (2) years. 2. Your sanitary 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 to this permit must be approved by 'the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed 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. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. 11. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. Ill. 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. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. Vill. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; 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 (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) a i • APPLICATION FOR SANITARY PERMIT 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), then a 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 Location of property _&2_'1/4 -5:4 1/4, Section N-R/aV Township SY, 'J'_ "".wiz Nailing address Address of site Subdivision name Lot number Previous owner of property Total size of parcel Date parcel was created Ate all corners and lot lines identifiable? as o V Is this property being developed for resale (spec house)? es No Volume and Page Number 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, and 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 he best of my (out) knowledge; that I (we) am (are) the owner(s) of the p operty described in this information form, by virtue of a warrant ed r rded in the Office of the County Register of Deeds as Document No. ; and that I (We) presently own the proposed site for the sewag isposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has been duly recorded in the .Office of the County Register of Deeds, as Document No. 1. Signature of Owner Signature of Co-Owner (If Applicable) Oate f Sign tute Date of Signature 4, . + .i% . ` Y c ~ k~ - E ~ `a J" v~.~.a ii `v =y7 . t r. r` a y .i r,= ~ _ r- _;~;r. Y' ,r z 1 ~ II i ,T .a. STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County . t ' OWNER/BUYER (ti ~ck1 ! - + ROUTE/BOX NUMBER FIRE NO. CITY/STATE _:~~j~ zip PROPERTY LOCATION: &eC_114 .5Z 1/4, Sectyion`_2~, T,S N, R ,,Z W, Town of St. Croix County, Subdivision 4/ , 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 for a MAXIMUM of $3000 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 systems properly maintained. The property owner agrees to submit to 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 form 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 Department of Natural Resources. Certification form must be completed and returned to the St.Croix County Zoning Office within 30 days of the three year expiration date. r SIGNED DATE St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 (715) 386-4680 Sign, Date, and Return to above address DEPARTMENT QF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS ` INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 P.O. BOX 76 HUMAN RELATIONS (H63.090) & Chapter 145.045) EALOCATION- SECTIO~T OWNSH~M 'LI T'Y: OT NO.: BLK. NO.: SUBDIVISI N NAME: -?g 4 O S UYER'S NAME: MAILING ADDRESS: USE DATES OBSERVATIONS MADE NO. BEDRM=COMMERCI- DESCRIPTION: PROFIJVE DESCRIPTIONS: 1PERCO ATION TESTS: Residence ❑New ®Replace t RATING: S= Site suitable for system U= Site unsuitable for system ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) S ❑u ©s ❑U ; OS ❑u ❑S U ❑S ~U Funders.1-63.09(5) lation Tests are NOT require DESIGN ATE: [Floodplain, any portion of the tested area is in the (b), ind icate: indicate Floodplain elevation: .74 PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH T --2. syx , COLD TEXTURE, AND DEPTH NUMBER DEPTH=. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- - 7 - - B- B- B- PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER 1 -1-11- AFTERSWELLING INTERVAL-MIN. PERIOD PERT PE'R PER INCH P- P- ~ 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 t plot plan. Show the surface elevation at all borings and the directio and percent of land slope. n SYSTEM ELEVATION ~Al G~e~(;i~ pk; s € EE s ( i f I f I l E t i f ~ f i i t 3 ~ ~ E ~ l E ' i f! ! I I, the undersigned, 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 rint)• TESTS WFFRE COMPLETED ON: i~ 14~el JDR : /I C ERTIFICATION NUMBER: PHONE NUMBER (optional): CST T E: 4 DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. ' DILHR-SBD-6395 (R. 02/82) - OVER - j - i a INSTRUCTIONS FOR COMPL.ET~ ORM 115 - SBD - To be corn ii test, your report ' include: 2, I _ wheth i °sidence or cornmerci 1 , or cornmerc lined; 4, ri; 5. tl sui? A SITE IS SU`Ti;BLE FOR A HOLDING TANK ONLY IF ALL- O_ SYSTEM E OUT BASED ON r_ -ONDITIr B use the i ' i here for writi de descri, Id cor plot plan; LEGIBL, ``y locating locations. I ~„ig ` . -.f,-. red. A hc~r-x,r. tt~a k elevation i point are clearly sh, ~d are permanent; 9 tes, nan, food plain data, -colation test: exernp- 10 '!Ievati...I >PIY plAcc= A, in the appropriate box; l 1 r ddres, i, aian lit , as reraLri' )IL TESTS FIST BE FILED WITH THE Y V111 IT F. YS OF )N. _VIA, =TIFIED SOIL TESTERS Oth ' 1n':als 3") I O9 r I is ti in ;wring a s~ y F« The Coo! ` T lit is i I 1 I I I I ~ I I 1 I ~ I I I ' I~ I l i l t I I ; I r 1 II I , I I T I ~ I I ~ f I I I I I i I t I ! i i i I i I L --ham-- -r-r ---i-----1---i ----L-- - - - - V- - - - - i -1-- - ! 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I I n ( PAGE OF `,rtiSS SIcc~1o1, 2 O t' ~l Vrl~ J~S~en-~ Fre6h Air InJoh And Observation Pipe 3V V~• " "'L'S~~~ ~Appror~d Vent Cop Minimum 12` ADOV• Final Grod• mss`/~,;,,? 20-.2' Above Plpp -4" Cost Iron To Final Grede Vent Pipe MaM Mor Or Srnlhelk Covering Mon 2" Aggregal• - Ore( Pipe OIeL IDellon Pipe o 0 0 - Too - Se AV legal* Perloreled PIPa beige, Beneo Ia Plpe 0 o I-Cowplifte Twminoling At 9ollom 01 Slelem I I PDp~o~eD ~1~~-~ c~~HC~t / fl 7F SOIL FILL DISTRIBUTIOVI PIPE ' APPROVED $IWTNETIC COVER r, NW. •r ""-P1ATf-Ri&1- OR 4" OF STRAW 2"OFMriREGAlE OR MARSH HAy ELEV. OF(e? EF- Lei (or OF l2-21/2 AGGREGATE oP \\o'. D15TRIIjUTI0M PIPE TO BE AT LEAST INCHES BELOW ORIGIMAL GRADE AQU AT LEAST LO INCHES BUT AIO MORE THAI) 42. MICHES BELOW FINAL GRADE MCHES MAXIMUM DEPTH OF EXCAVATIOP FROM dKI WAL 6KAK WILL BE ITINCHES MINIMUM ®EF" OF FACAVATION FROM Ol,I41NAL (jRgpF- WILL BE SIGMED: f LICEAISE DUMBER: DATE: I la