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HomeMy WebLinkAbout026-1011-70-002 c r d o d a Q = N Z O cn (n A a • C) O N w O O - S f) co i _ Q' 3 O C D CD L O d Z a U! O o 3 O O~ Oft W c m 0 ? go O N Q o co N 'I a j ^s \ 1 O C 7 nc C) 'I p Q O W ? N C f7/1 N p ra. !1 y - l~V v v? m a rn CD N a w tD (j 0 co 3 a a O o w s rn o N W co (o C- D n .Or. c N A A N C m 3 z OOO X,' t~l O 0 '4 * ; < Z n c N N fA 03 D v m T o v:3 o o in CD eo N a Cn °1 A cn m a ~ Z Q ~ Z W Z ' D CD 0 44 m O ° - N o CD (n Cl) (D O7 N v~ C C (D CND W (D a I 7 Z = co Z CD O cn c C1 O A Z = m a O j cn A ca - < O a z 1 A a7 3 z °o m N Z (D w D CL o d c Z C O ~ A ! A M ! fi ! A ' w O i N O I O V A 0 A Oip O~ CD W Hi O r C) * ° b C) ~ Parcel 026-1011-70-002 01/30/2007 03:58 PM PAGE 1 OF 1 Alt. Parcel 4.30.18.41C 026 - TOWN OF RICHMOND Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - ST JOHN, SUSAN K SUSAN K ST JOHN 1763 115TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1763 115TH ST SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.130 Plat: N/A-NOT AVAILABLE SEC 4 T30N R18W 1.13A LOT 1 OF CSM Block/Condo Bldg: 5/1474 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 04-30N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 698/467 2006 SUMMARY Bill Fair Market Value: Assessed with: 176659 199,600 Valuations: Last Changed: 06/19/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.130 28,800 126,800 155,600 NO Totals for 2006: General Property 1.130 28,800 126,800 155,600 Woodland 0.000 0 0 Totals for 2005: General Property 1.130 28,800 126,800 155,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 124 Specials: User Special Code Category Amount I I Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 i~ j Form-STC- 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP SEC. _ T ~N-RW ADDRESS ? ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT x~ LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of ILHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM - - i f INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer: Liquid Capacity: Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front, @Side,o Rear, O y, feet From nearest property line Front,O Side,O Rear, feet Number of feet from: well building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE ' , PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear, 0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: V Trench: Width: Z 2 Length: Number of Lines: - Area Built: , -7`-` Fill depth to top of pipe: Number of feet from nearest property line: Front, Side, O Rear, O Ft Number of feet from well: f,S'S Number of feet from building: 5-~ (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, OFt. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: % - Plumber on job: License Number: 3/84:mj MENT OF INDUSTRY, iNSPECTION REPORT FOR SAFETY & BUILDINGS H & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION BOX 796-,. BUREAU OF PLUMBING .IADISON, WI 53707 XXX CONVENTIONAL ❑ALTERNATIVE State PI,, I,D. Number. (If assigned) Holding Tank ❑ In Pressure ❑ Mound NAME OF PERMIT HOLDER. ADOR ESS OF PERMIT HOLDER'. INSPECTION DATE. S" an K. St. John. R. R. 2, Box 270, New Richmond, W1 11_ _1117ZI --IJO BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.'. CST REF. PT. ELEV SW NE, Section 4, T30N-R18W, Town o4 Richmond , Lot #2 Name of Plumber. MP/MPRSW No. County Sanitary Per- Number: Core Poweu 1563 St. Cuix 58890 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER / PRIDED PROVIDED YES ❑NO ❑YES EJ*O BEDDING'. VENT DIA.. VENT MAT IT HIGH WATER NUMBER OF ROAD: PROPERTY WELL BUILDING V. ENT TO FRESH ALARM FEET FROM uNE, , J AIR INLET ❑YES NO 7 ( ! ❑YES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER BI NGID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDEDPROVIDEDYES ❑NO LQU ❑Y ES ❑NO ❑YES ❑NO GALLONS PER CYCLE; ]7D CONTROLS OPERATIONAL. NUMBER OF PROEPERTY ...WELL BU ILDING I VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM L IN AIR INLET. i PUMP ON AND OFF) ❑YES ❑NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing It FN(itH ETER MATERIAL AND MARKING, or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BED/TRENCH WIDTH LENGTH NO OF IDISTR PIPE SPACING COVER INSIDE CIA SPITS LIQUID p TRENCHES MATFE IAL PIT DIMENSIONS t L A~ G G GRAVEL DEPTH FILL DEPTH IDISTH PIPE DISTR PIPE DISTR. PIPE MATERIAL. NO. DIS NUMBER OF PROPERTY WELL. BUILDING: VENT TO FRESH BELOW PIPES ABOVE COVER EL V INL T ELEV. END PIPES 1 LINE. AIR INLET. FEET '2_q~ NEARESTO--s G~ -I MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- ❑YES ❑NO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS ❑YES ❑NO ❑YES ❑NO jD11TH OVER TRENCH BED DEPTH OVER TRENCH: BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH LENGTH NO.OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL NO. DISTR JDISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV.. ELEV.' CIA.. ELEV.. PIPES. DIA.: ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS ❑YES ❑NO ❑YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PR OPERTV WELL. BUILDING. FEET FROM LINE ❑YES ❑NO ❑YES ❑NO NEAREST 4o 1A Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE TITLE. _ DILHR SBD 6710 (R. 01/82) EI ,onev APP LICATION FOR SANITARY PERMIT JldeL~ DILHR CQUNTY (PLB 67) UNIFORM SANITARY PERMIT # USTR4,LR60R SHUMRn RELRTIonS -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 81/2x 11 inches in size. -See reverse side for instructions for completing this application, PLEASE PRINT PROPERT`/ OI^INEI M91LING ADDRESS I PROPERTY LOCATION 1 G-Ffi'r S Q 1 /4 NR/4, S T , N, R 30 ) W TOU W@N O F : ( iY LOT NUMBER BNAME NEAREST ROAD, TAKE OR LANDMARK ST F,PLAN I.D. NUMBER TYPE OF BUILDING OR USE SERVED 1 or 2 Family Number of Bedrooms. 3 ❑ Public (Specify): THIS PERMIT IS FOR A: New System ❑ Tank Replacement ❑ Repair L~ Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. X Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total # of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: !nom IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): Z J Z- - Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installati n the private sewage system shown on the attached plans. Name of Plumber (Print): Sycfnn)ture SP/MPRSW No.: Phone Number: C12-1Z6Z141i s- 6, Plumber's Address: , i Name of Designer: C-i COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fe Date: ❑ Disapproved ❑ Owner Given Initial t ~ ~ (f I 7 Approved Adverse Determination Reason for Disapproval: Alternate course(s) of Action Available: DILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable. 10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system, depth of the system, type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan, drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin. APPLICATION FOR SANITARY PERMIT S T C - 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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - C ~ Owner of Property 5 u,s411 K► ST Y\ Location of Property Sw 14, Section T _3 0 N - R _ W 'T'ownship V Y1 2 ^c'I - Mailing Address - Subdivision Name c Lot Number Previous Owner of Property 1 6G m MCA)Cdlil 't'otal Size of Parcel L!' e u Date Parcel was Created _04 Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes --'k - No 6?,r Z167 Volume and Page Number as recorded with the Register of Deeds INCI 11W w,n T!i T i rAPPI, ] AT'T ON ONF OF TNF FOT,I,OWI NG : 1. Warranty Deep' 2. Land Contract 3. Other recordings filed with the Register of Deeds Office 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 the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION 1 (We) eeA iAy that a.U statementz on th4ls {onm aAe tAue to the best oA my (oun) Iznowtedge; that I (we) am (alie) the owneA (,s) o A the pnopvLty dens cAibed in -this 41 nAonmation {yonm, by vilutue o~ a waqAanty deed neco,,ded in the O{Aice o~ the County RegiAteA o{y Deeds az Document No. -~-•~d ; and that I (we) ptment-Xy own the pnoposed site. {yon the bewage po,5 6ystem (on. I (we) have obtained an easement, to hun with the above dcsnibed pnopeAty, {yon the co"tAuct,-on o{ said system, and the tame has been duly tecotded in the OAAice o{y the County Register o{ Deeds, as Document No. ) F SIGNATURE OF OWNER SIGNATURE;OF CO-OWNER (IF APPLICABLE) DATI? SIGNED DATE SIGNED ST C- 105 ti SEPTIC TANK MAINTENANCE AGREEMENT CD St. Croix County z d a H OWNER/BUYER S uSar, ROUTE/BOX NUMBER Fire Number CITY/STATE r hyytinc~ Lij 15 C ZIP PROPERTY LOCATION: 5&~ 4, k 4i Section_ T 36 N, R l8 W, Town of C'-_ onc) St. Croix County, Subdivision Lot number/. I Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists 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 treat- ment 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 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 veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), 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. Ho E I/WE, the undersigned, have read the above requirements and agree Cn to maintain the private sewage disposal system in accordance with H the standards set forth, herein, as set by the Wisconsin Depart- ~v ment 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. SIGNED v J i Z - DATE St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. v w r x S s ~ m m =r~ pm~~~op r ° (p (p o (D 7C A A fD 7 N 0 ~ a S~'w ca cro -0 'Col) I(OD om =r CD 31. 0 N o 'R c m o cD p 1 W* T ca, TO co e > > o 13:woo ,~C- cwcv; R. 0 wSDc ,s mww~,. Ch - ° °w(UD o R~o v a v ~D ' < ° a:0- co Qo v cDN~ oDc .o~ O ^°A 1=wA~c c =r a- O ° Co ID. C o f CD c m ° co cD o~ w cn Z y n o z w =r w 0 = $ am0 3ID lD ~c1DnC -r ,Dca a - V. W a ci ; a m w ?a(o w U) V CL c 3°o vID°w°? CD C Er 0 w 19 CO CD 0 rl CD In cr '~►a fm E,< cD cD -i ° - 0 NO = ~c0 a 1 o= CO :03) 3 C7 1Tt wow c(DCCv, o aaa ma nod Q3 su -=r rrno G5D l< ~coo ~ cD0 0 ! r j a°a °ccaw 1~ UC) Boa w.•.A ~ a C = C (D O 17 vAr, o~ 00 3 -a° p o ~p w 3 a v,' 0' a o < o d= e a I i DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABO-R AND PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN RELATIONS \ / MADISON, WI 53707 (H63.09(1) & Chapter 145.045) LOCATION: SECTION: ISIfDN NAME: TOLHIP/MkMFCIP ALi TY: LOT NO.: BLKO.: SUBDIV N/R : R (or) W ' / CO)I NTY: OWNER'S/BUYERS NAME: MAIL IN ADD ESS: / USE DATES OBSERVATIO S MADE/ NO. BEDRMS.: COMMERCIAL 7DESC-RRIIP-TION: PRFILE DESCRIPTIONS: PERCOLATION TEST Residence ? 10New ❑Replace L5 RATING: S= Site suitable for system U= Site unsuitable for system y CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYST M-IN-FIL HOLDING TANK: RECOMMENDED SYSTE : opt (ional) 13S ❑U ~S ❑U [AS ❑U US ZU ❑S Bt / -1 If Percolation Tests are NOT require DESIGN RATE: / ~ [Floodplain, any portion of the tested area is in the / under s.H63.09(5)(b), indicate: indicate Floodplain elevation: L ~F L PROFILE DESCRIPTIONS BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEpi}F}N= OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B 7 * i;' 7~ ia, i7 - B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER Wef4US AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH P_ P- r _ 71, 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. r-\ -~G__._ _ SYSTEM ELEVATION K.- / ,C s t I I f t _ - I x ! { / .S y, - 1 7 7 ` , I t { f t( ~ y ufU 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. NAM rint): TESTS WERE COMPLETED ON: _kj DDRE$S: CERTIFICATION NUMBER: PHONE NUMBER (optional): ~i CST TU L BUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. SD- i3 i5 (R. 02/82) OVER x i s.Js L l~ h fsN%L L E Yi -Starr a GG,otd_ ev iF iii "'P; .7 e? .7 c 'Auta l tii=t i r~, and pJ~'' z-allona t6~s rp~ i= € -Q ell t of a." _ me G . ,..E FtaS , 3 o ; s. ui.~ a 'av _ ell ~~y: a~ttip :'I, -1 o' ri"Y 1. .;.?i97-C 913? n t? KSa pt 5' 1`f i?t .ti 1Z~ i'1 ®'tP rR SuS~n 57 ^r/ ® n PACE OF t" U 5 S C I U r1 C) i~ I•J r i~ ~ y S WE 5e-,-q ' 3U , !d w Fresh Air Inlelc And Observation Pipe ;1) 1n(^a'1~ D ~---Approved Vent Cap Minimum 12" Above Final Groda 20- 42" Above Pips _ 4" Cast Iron To Final Grade Vent Pipe Monh Hoy Or SynlMllc Covering min 2" Aggregale Over Pipe Distr Pi lb e ullon - p 0 0 0 0 0 - Tell 6" Aggr egole o Perforated Pips Below Beneath Pipe _ 0 Coupling Terminaling At Bottom 01 SyUem r SOIL FILL DISTKIBU~~'10~.' PIPE APPP_OVEO S`1jN-r IETI(- COVED "-'-MATT=Rtltl "P q11 ~F STRAW 2"OFA66, RFGATE--''~~ OR/~ARSN HAS s °R i _ OF,~ - 2 / AGGREGATE ELEV. of/a'. FEET-, DISTRIRiUIT10K) PIPE TCO BE AT LEAST IUCHES BELOW ORIGIUAL GRADE AWL AT LEAST LO IUCHES BUT 1.10 MORE THALI lie INCHES I)LLC w FItJAL GRADE MAXIMUM DEPTH OF EXCAVATI00 FKOM OKI&V A.L 6KADF- WILL BE yl I"CHES tGtMAL (3R49i+ WILL gE IMcNES M1141MUM ®EPrtt OF EACAVATIOW FK01A 04? SIGHED: C~ J .~i LICEUSE DUMBER: f 1 DATE : A) i Rio -7o A r- _ A) E 5 T3 i _ IUU. a,~ t Lx /0 A&I Q ,I Al v,Yl P© ~ %I)r m P 15 ~ II i J y. F - Z