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HomeMy WebLinkAbout020-1357-18-000 (3)u Industry Services Division County /�wY ,, /a t 1400 E Washington Ave ff�� Sanitary Permit Number (to be filled in by Co.) P.O. Box 7162 Madison, WI 53707-7162 t, # XK State Transectiat Number Sanitary Per Application In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) is required prior to obtaining a sanitary permit the Department of Safety and Professional Services. Personal information you provide may be used for secondary purpoum in accordance with the Privacy Law, s. 15. 1 XmJ Sw. (Sk A,4r- Parcel # I. Application Information - Please Print All Information Property Owner's Name ] S4 OAV/I7CpAP✓K, 357 X-0 Property Owner's Mailing Address Property Location vet% F1+G-11� FGV"�) GovL Lot Section z-3 City, State Zip Code Phone Number'/., 14u � � �t]l jy0/ clrc►eone T ! N; R �� E oicnj U. Type of Building (check all that apply) Lot � J # Subdivision Name I or Family Dwelling -Number of Bedrooms / 7V6<6f Z # Block Z- -)j �i5 /�5 ❑ City of ❑ Public%Commtercial - Describe Use CSM ❑ State Owned - Describe Use ❑ Village of )�11 Town of AW 66- Number III. Type of Permit: (Check only one boa on fine A. Complete line B if applicable) A, ❑ New System 'Replacement Sysum ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS S m/Com nent/Device: Check all that a n-Pressurized In -Ground ❑ Pressurized In -Ground ❑ At{imde ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Corrtponent (explain) ❑ Pretreatment Device (explain) V.DispersaliTmatn st Area Information: Design Flow (gpd) Design Soil Application Rate(gpdst) Dispersal Area tired (st) Dispersal Area Proposed (sf) System Elevation `spy 75' VI. Tank Info Capacity in Total # of Manufachrrer o Gallons Gallons Units E k e u" y Y New Tanks Existing Tanis y ri U in w on S rJa is. C7 C4 c� lot) M` � VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the PON'TS shown on the attached plans. Plumber's Name (Print) Plumber's Signature JtVVMPRS Number Business Phone Number '�EiTR I -IA N6,5 - zz�a� pis-s�9-z�s� Plumber's Address (Street, City, State, Zip Code, 14 5 z � l loj) l A �7 G �Z VIII. Court /Departmeut Use Oaf ❑ Approved ❑ Disapproved Permit Fee Date Issued Issuing Agent Signature S ❑ Owner Given Reason for Denial IX. Conditions of Approval/Reasons for Disapproval Atemb to complete plow for the system and submit to the County Only on paper not less than a in r i I muter m sue SBD-6398 (R. 08/14) ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the followir (Street address) '3 at: 1/4, 5 Fti 1/4, Section Town of �-41,/ </)"J residence: 1)A(Ar)r Town m 2(� located N, Range_W, St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of SPS. 384.25, and it (they) appear(s) to be functioning properly. Most recent date of inspection or service Did flow back occur from absorption system? Yes No (if no, skip next line.) Approximate volume or length of time: gallons minutes Tank Capacity:16 C G Construction: Prefab Concrete x Steel Other Manufacturer (if known): I/() e Age of Tank (if known): Permit number (if known) (Lice sed lumber S ture) (Title) I� 1 15 / / --� (Date) 45 �14 i\ � 6 S (Print Name) (License Number) MP/MPRS Form to be completed by licensed plumber (Dept of Safety and Professional Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 2/2012 PAGE 1 OF 4 In -Ground Gravity Plan Index & Cover Sheet Component Manual Design References: Version 2.0, SBD-1 o705-P (N.01/01, R. 10112) Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Dispersal Area Cross -Section &Plan mew Pg 4 of 4 Management Plan Attachments: Enclosures: POW rS Application for Review Soil Evaluation Report & Site Map Project Name / Description Owner Name(s): �if1 . L STE PW iC K: (�S D l l qf� Phone: Owner Address: Project Address: �NAL URr- F-Aghi Zip: ff1C,1 Govt. Lot: rL k� 1 /4 of s av' 1 /4, Section zj , T ,H N-R 161 EH or W J6 Township: I i u<0 J Ct, County: �; - c��� X Project Parcel ID M 0 1-70 - i � - Goo Designer Information Designer Name: �;ti'1 z1 —� �����'�'�� Phone: 7j5 - : ;7 Designer Address: K1 Ve-_ r t�THut;�S Cf. y � ,y hZ���/, wI Zip: ........ ._'#i.,._ E-mail: N Nskerdestun L; n"4-f V0K ­C6JvN This License Number 1 %!9 - CC Remarks: Signature: z2hyz/ Date n each submitted copy. 11-j7 Z�17 stamp. NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. Z.531 —46cg�5 PLAN VIEW e • -I ~ 1 IP�N Pita �4r rlaarN PQov�e�rt„� � �c,�v. ioo.00 �N1C'/ t'>"2 ,ktd4 • �i O�+,l r N 0�? I �iaN �qo%Qry ZAk Ae r7f egrn,,)Ws �G�'*1S gyp• I 0 —.61 V,4 r 8 �z j 3'X logf 33 h 7'I 173' L.v..rerC�cL I 3,1 fi,omo Fleuf /DOGG t �jL�l�C `%�SrJK 91 io �Ew �ESiOrN�t • x� v IPdc 3 �AQoo-,�s IQo�o5L9 (� 13�h2itGt pju Sid INDICATE NORTH ARROW IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Qu1ck4 Standard-W Chambers . 3-ft Trench (down -sizing credit) WE son caamo ,z40 cai TYPICAL TRENCH CROSS SECTION VIEW I--- (No Sc_e) System Elevation`7� it (dal) Tanrc(s) Z V 51/,�J� SepBe Tank(s) Vok-e(ag gel gai tip go, LCI S1,0 E fkm t ewer t toast #.. A Provide mb*num 3 ft separation between bwx* es. Qu� ca�-W O6Stlfe"0nF4w TYPICAL TRENCH < (Show loretlon of tniet /outlet pie aoru,ectlon Plan view.) ama PW momiackaft PLAN VIEW (No Scale) -----—_----- ` A = 3.0 ft �___—'.r...._------jam-------��----_.�—_-�� (bct�l B — ft —I (typical) Quick4 Standard-W Chamber (rot-0 INSTALL PER TRENCH: ( by' .—no &15M W) ' J D WAA pmam d to mmub"W ra moss .-r Quidt4 Std-W @ 20 if EIM = 1_ ft + T Pairs of end caps @ 6 fe EISA0W- _�_ fe 31/� it= Requ[red tnnitradonArea= 4Z " m Proposed E1SA per trench a x Z_ trenchess = Proposed Total EI54 = 4qz It, Dks(rbutionn Method: , 114 "/ Pe ) z 3q 4fN1T5 X �� /j�v J' 2 TiZ�NGN�S 6 9 FT LA, �� ) 5,X lot ' %K&NeHle 5 f- - PAGE 4OF4 In -ground Gravity Management Plan IMPORTANT: The owner of this in -ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. _Maximum Dispersal Area Operating Limits: Design Flow = 4/�50gpd; BODS <_ 220 mgL-1; TSS 5150 mgL-1; POG 5 30 mgL" Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution I drop boxes) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Seotic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Slats. when the volume of solids in the tank(s) exceeds one-third (113) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturers specifications. A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: MC SFlIT-1G -a--TA �mTiL ti� Phone: i Local government unit: * CitX CCu i ('D.1�Jt",t i�U 7y LL�3'� E.;V Phone: /7,&V, Local government unit address: W zip: 5z(c�� Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384, Wisc. Admin. Code. Contingency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component may be abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. Th, am pa tur mL chi fie; • Eliminates pipe fittings • Fits on either end of the Quick4 Standard Chamber APPROVED in Quick4 Standard Chamber to w mxve lw 48" (EFFECTIVE LENGTH) MuitiPort EndCap ,i%ram,. r r ''" FRONT VIEW Typical Trench View Size 34"W x 53"L x 12"H (864 mm x 1346 mm x 305 min) Effective Length 48" (1219 mm) Louver Height 8" (203 mm) Storage Capacity 43 gal (163 Q Invert Height 8" (203 mm) .f business Park Road P.O. Bnx i58 Old Saybrook CT 06475 86O-5-; _-,M • Fax 860-577-7001 1-SO4'221-4436 i nit atorwater.com SIDE VIEW ,a,�.�,�::��• - _ _�_��_--fir; 18'' TOP VIEW tNFILTRATOR WATER TECHNOLOGIES STANDARD LIMITED WARRANTY (a) The structural integrity of each chamber. endcap and other accessory manufactured by Infiltrator (-Units-). when installed and operated in a leachfiel0 of an onsite septic system in accordance with Infiltrator's instructions, is warranted to the original purchaser j Holder') against defective matedab and workmanship for one year from the date that the septic permit is issued for the septic system containing the Units provided. however. that if a septic permit is not required by applicable lour. the warranty period will begin upon the date that installation of the septic system commences. To exercise its warranty rights. Holder must notify Infiltrator in writing at its Corporate Headquarters in Old Saybrook. Cannecticut ::ithm fifteen (151 days of the alleged defect. Infiltrator will supply replacement Units for Units determined by Infiltrator to be oohed by this Limited .RT Warranty. Inrtlirator s liability specifically excludes the cost of removal and•cr installation of the Units. (b) THE LIMITED WARRANTY AND REMEDIES IN SUBPARAGRAPH (a) ARE EXCLUSIVE THERE ARE NO OTHER WARRANTIES WITH RESPECT TO THE UNITS. INCLUDING NO tMpum WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE le) This Limited Warranty shati be veld if any part of the chamber system iS manufactured by anyone other than Infiltrator_ The Limited Warranty does not extend to incidental. consequential. special or indirect damages. Infiltrator shall not be liable for penalties or liquidated damages. including toss of production and profits. labor and tnate als. overhead costs. or other losses or expenses incurred by the Holder or any third party. Specifically excluded from Limited Warranty coverage are damage to the Units due to ordinary wear atxi tear. alteration. accident. misuse. abuse or neglect of the Units: the Units being SUbjected to vehicle traffic or other conditions which are not permitted by the installation instructions: failure to maintain the minimum ground covers Set forth in the instaMtion instrMlions: the placement of improper materials into the System containing the Units: failure of the Units Of the septic system due to improper siting or improper sizing. excessive rater usage. improper grease disposal, or improper operation: or any Other evert not caused by InrrM-- This Limited Warranty shall be void if the Holder fails to COW,' with all of the terms set forth in this Limited Warranty. Further• in no event shall Infiltrator be rdsponsible for any loss or damage to the Holder. the Units. or any Oft party resulting from in,Wation or shipment or from any product liability (farms of Holder Or any third party. For this Urged Warranty to apply. the units mast be installed in accordance with all site conditions required by state and focal codes all other applicable lar's and I111"refOr s custatta' instructions. (d) No representative of Infiltrator has the authOrity to & for extend this Limited Warrant)'' No warranty applies to any party other than the original 01 The aboYe represents the Standard Limited Warranty offered by Infdtrator.r. Adc number Stales and Counties have different warranty requirements_ lacy purchaser ol Units silo Infiltrator's Corporate Headquarters in Old Saybrook. Connecticut prior to SLCh purchase, to obtain a copy of th-- applicable warranty. and should care" read that warranty Prior to the purchase of Units. uNww. _ _ srj _ tared ! o11nf7Vdtor i"latef 7ewhnoso9ies. t(dfttta, b a registered trvlemarx °t France. tnfilu-WOr "04.water Ted-ologies i5 a registered trademark in taexico. U.S. Parents:.1,7;9.o'bt; 5.017.031: 5.156.•tab: 5.336.017: 5..101.I %, 5.401;159: 5.511,903: 6.716.163: S-Sla-778: 5.639si tlematks of tnldVator lYater eUrilocc-Tzs• dents pending. lnfiflrator. EGua . Quick4• and We` 03M tiro rtg1 PosiLOCk. Oj,C Ut. t1lgamay, S5noploVk and are 0 Contoua. fmcroLeachtn9• Q°or�'m Gr. tom• Wed trademark of TUF TM INC. t11tra-Rib is a trademark Of iPEX InC. 0250011 Pol Lok is a trademark of PoWk. it- TUF-TITE is a fegisler - etved. Printed in US A e-• 2013 InfdVatu Water Teennr�to9iea �. An igtuis vas SAFETY AND BUILDINGS DIVISION Plumbing Product Review P.O. Box 2658 Madison, Wisconsin 53701-2658 TTY: Contact Through Relay Scott Walker, Governor Dave Ross, Secretary September 26, 2013 (Revised November 13, 2013) INFILTRATOR SYSTEMS INC. GOVERNMENT AFFAIRS DEPARTMENT 4 BUSINESS PARK RD PO BOX 768 OLD SAYBROOK CT 06475 Re: Description: LEACHING CHAMBER Manufacturer: INFILTRATOR SYSTEMS INC. Product Name: QUICK 4 STANDARD-W Model Number(s): QUICK 4 STANDARD - W (EISA for chambers with or without fabric = 20.0 sq. ft./chamber, EISA for end caps = 6.0 sq. ft./pair of end caps, Laying length of chamber = 4.0 ft., Laying length of end caps = 1.0 ft., Width = 34 inches, Height = 12 inches, Max. depth of bury = 8 ft-, FOR BED INSTALLATIONS, MAx. DEPTH OF BURY IS REDUCED TO 48 IN.; Open Bottom area = 9.64 sq.ft./chamber, 3.5 sq.ft./pair of end caps) Product File No: 20130191 The specifications and/or plans for this plumbing product have been reviewed and determined to be in compliance with chapters SPS 382 through 384, Wisconsin Administrative Code, and Chapters 145 and 160, Wisconsin Statutes. The Department hereby issues an alternate approval to s. SPS 383.44 (5)(a) & 384.5 based on the Wisconsin Statutes and the Wisconsin Administrative Code. This alternate approval is valid until the end of September 2018. This approval supersedes the approval issued on 1/24/2008 under product file number 20070551. This approval letter shall be incorporated with your previously approved plans and/or specifications approved under product file number 20070551. This alternate approval is contingent upon compliance with the following stipulation(s): • This product must be installed in accordance with the manufacturer's printed instructions, product approval, and plan approval. If there is a conflict between the manufacturer's instructions and the product approval and/or plan approval, the product approval and/or plan approval will take precedence. • When this product is installed in a dispersal cell that is sized based on the EISA rating stated in the regarding block of the product approval letter, this product must receive wastewater having a BOD5 value between 30 and 220 mg/L and a TSS value between 30 and 150 mg/L. • When this product is installed in a distribution cell that is sized based on the EISA rating stated in the regarding block of the product approval letter, this product must be installed in individual excavations that create a row of chambers that are horizontally separated from other rows in other excavations by at least 3 feet. The 3-foot measurement is measured between the closest outside edges of the leaching chambers. • When this product is installed in a distribution cell that is sized based on the EISA rating stated in the regarding block of the product approval letter, the distribution cell design must allow at least six inches of ponding in the chambers without backflow of wastewater into the drainpipe that discharges into the chambers. 513D-105134-E (N.10(97) File Ref: 13019102.DOC INFILTRATOR SYSTEMS INC Page 2 September 26, 2013 Product File No: 20130191 When this product is installed in a distribution cell that is sized based on the EISA rating stated in the regarding block of the product approval letter, this product must be installed in a distribution system, which has the top of the distribution cell at or below original grade. • When this product is installed next to each other in a distribution cell that is NOT sized based on the EISA rating stated in the regarding block of the product approval letter, the effluent distribution area is equal to the length times the width of the chambered area. The use of geotextile fabric in this type of installation is optional. When this product is installed with geotextile fabric on the sides of this product in a distribution cell that is sized based on the EISA rating stated in the regarding block of the product approval letter, the geotextile fabric must meet all of the following specifications: Geotextile shall be non -woven Weight shall be 0.35 ozlsq yd to 1.5 oz/sq yd Apparent opening size (AOS) shall be 20-30 U.S. Sieve (ASTM D-4751). The department is in no way endorsing this product or any advertising, and is not responsible for any situation which may result from its use. Sincerely, Glen A. Jones, M.S. POWTS Product Reviewer phone: (608) 267-5265 fax: (608) 267-9723 email: glen.jones@wi.gov Wisconsig Department of Commerce SOIL AND SITE EVALUATION Page j of 3 Buren n of Safely and er ices in accordance with Comm 83.09, Wis. Adm. Code Bureau of Integrated Services _ Attach complete site plan on paper not less than 81/2 x 11 inches In 4."Pla4Must : Cou /� Include, but not limited to: vertical and horizontal reference point (*i dj art* � ( - e� Ix parcel I.D. # percent slope, scale or dimensions, north arrow, and location and,flisl(ce to riin LU J,. " APPLICANT INFORMATION - Please print all lnf do .''" ! 2 1 �1 y -, wed by Date Personal information you provide may be used for seeondary purposes ( w, s. 15.00tf11b**x Pro Pey Owner Z ] ': Jl , (JO r! F� J . INS \ p l Q o of�1�1/4,S Z� T Z r ,N,R / I E (or) W CJ ` Property Owners Mailing Address Subd. Name or CSM# EvckG et S7 , s ArZwE City State Zip Code Phone Number ❑ City Village K Town Nearest Road � ";? /'Z" 065-/ ) .T - ti LJ&MOQ -T aA [<New Construction Use: Residential / Number of bedrooms Addition to existing building ❑ Replacement Pub&c or commercial -Describe: G� ,, Code derived daily flow `.-0 gpd Recommended design loading rate �� bed, gpd/ft2 btrench, 9Pd/ft� C Absorption area required bed, ftz 3?s ft Z Maximum design loading rate t�.7 b0 ed, gpd/ft —74—trench, gi�t2 1-,,trench, Recommended infiltration surface elevatfon(s)a4 r —4t -� 6' _ft (as referred to site plan benchmark) Additional design/site considerations Parent material 6 LA<IAL OLJTWAs-r Flood plain elevation, if applicable n S = Suitable for system Conventional Mound 00 S ❑ U In -Ground Pressure W S ❑ U AT -Grade 14 S ❑ U System in Fill ❑ S grU Holding Tank ❑S U U = Unsuitable for system S❑ U Boring # b " Ground v, 1 �2 ft. Depth to limiting factor > 1-23 in. n�u 0=0n0T Horizon Depth I in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft2 Bed . Trench — S,C 56K n, f GS _ .Z .3 8 � �.4 jA3 _54 Remarks: Boring # F� 3 Ground Depth to limiting factor � .ram o�..•.�.u�• i 3T me (Please P nt) n re Telephone No. a��Sy ouN �, �s6 4o�b Date CST Number PROPERTY OWNER AL I�Mis SOIL DESCRIPTION REPORT pdge. of , PARCEL I.D.li Boring # U Ground el ia��ft. Depth to limiting facjgr 711 in. Horizon Depth in. Dominant Color Munsefl Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots Bed ,Trench JZ.11 / y24. 4 S�� ! ms�� n, 'r GW 1 2' ,3 t4 3 7,sy.e 4 4 — SG n, S rn W -- wf-� • � Remarks: Boring # fi Ground elev. la-1 ft. Depth to limiting faCt9r 7 LLB —in. Remarks: Boring # Ground Depth to limiting Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/e Bed Trench -Z I /bye $, 1 y24 — SiL rhSb� m z Cw l .Z.:o.� 36 dye Sr L %n,sbK n, r G►,.� — a.Z o.3 t_ 1 Sx2 4 -- S m 5 t-rzB 1SyR 4 4 `� A s factor I2� rn Remarks: Boring # Ground elev. ft. Depth to limiting Ll factor in. Remarks: SBO-8330 (R.9/98) ,*;I h�y11'r�c` �'��t -�3�3 . _ idcy�� r r ! I �•_ �rri�%1.7t � QL Y'r]17 1. �. IQ ? r r 9t v t_?; %•, ` v IVr -;-v: fib, V;lIN, LI QQ'V4I : �r911S1�7Z� 1 1 (Q£, t �r�qj)N-1 -E da >11w . Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In -Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In -Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Tnkln 9 • cvcfam nPsian Specifications Sanitary Permit Number i Z Number of Bedrooms 3 Design Flow - Peak (gpd) 570 Estimated Flow - Average (gpd) Septic Tank Capacity ( al) I tarp Soil Absorption Component Size (ft2) S z Type of Wastewater D mestic T�k�n �• Qnn ehanmtinn Comnonent - Limits of Reliable Operation Septic Tank Component Soil Absor ton Component Design Flow - Peak (gpd) tst70 a — as rns Maximum Influent Particle Size (in) 0 1/8 Maximum BODS (mg/L) 220 Maximum TSS (mg/L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the se and outlet fitter shall be assessed at least once every 3 years by inspection. Th outlet r shall be cleaned as necessary to ensure proper operation. The filter cartridge shou d not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the 0 Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 113 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being In full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption components operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. r y r vrtsaortsm DOWUMftt Of corm Sa" and 8t4*xp mosion GENERAL INFORMATION PRIVATE SEWAGE SYSTEM INSPECTION REPORT (ATTACH TO PERMIT) P*=nal kdomtA6on YW provlce My oe USOa Wr seoondary p (Privacy Lz-. 9.15.04 (1)(m)l PeneitHolder's Name: iJ City O village Oxrownof: usdigian, Theodore Hudson Township CST M v.: Insp. BM E .. SM Description: (% t ✓ - - - ELEVATION DATA 1 ANK INI- KIVIA i IUN TYPE MANUFACTURER CAPACITY Septic b0 4 Dose Aeration Holt TANK SETBACK INFORMATION PUMP / SIPHON INFORMATION M"uiWurer Demand Model Number GPM TDH FrictionLoss TDH Ft Y,ofcernain I Length Dia. Din. To we SOIL ABSORPTION SYSTEM If / [ County: St. Croix Sanitary Permit No.: 384120 7-18-000 STATION BS 1­41 FS ELEV. Benchmark Alt. BM 2,61 Bldg. Sewer CS�/Ht Inlet , St Ht Outlet S Q Header/ Man. I' Dist. Pipe Sot System (L I L , T Final Grade St cover �` 5 BED ENC Width Len �_ No.Ol Trenches PIT No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P / L BLDG WELL LAKE / STREA L ( H ER Manufct r r: Type System: J 2-3 3 _ o e Num e 5 DISTRIBUTION SYSTEM Vent To Air Intake Hea er / Man; o Dist i cation Pipe(s) x Hoe Size x Hole Spacing Length Dia. Length�Dia._ Spacing Z� 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 Ped/Tren<hEdge$ Topsoil Q Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: `% 15 Inspection #2: / / Location: 849 Waldroff Farm Rd., Hudson, W1 54016 (NW 1/4 SW 1/4 23 T29N R191X� - 2329192092 Evergreen Estates H -Lot 18 1.) Alt BM Description = I ow e S4- arm 2.) Bldg sewer length = J Z ' -amount of cover = 7 3 3��/cf�. `gh 4a 4 �'r"al an revtsr r ilir ? ❑Yes 0 No Use other side for additional information. 6 SBD-6710 (R--VM pate inspect s 5 cure Cert. No. r •.� `\ \ NA/1TI./ �'AT%L7ivE7�1/ �-� 1%ON /'lJ'.E �fn'.7iiON /7J'E A /�/ip/�6/i�i L'L✓t, /7T /V.E. /-/LO/�F/iTi PLOT & CROSS 85•VT ION PLAM. • EctY = 99 �o' �:,n, ELev. ��oo.00' IAPPA 9". EXCAVATRA IM VA Ar6R Q� r� �NWL 1 � i�ityAtfiTY Lz NE � � � ova/.' 9ai r .khct. FoR /ZETE.Jh Ji.l 60' K" G � 69 t��.or fiasr �/taFrAfy \ Ls�Ve C` Li 9 ✓ �-- 30 �v 3 Qc �acE. QGt PRMACT 4 y /�YG J•vR ?S EFrG�u-r-,✓r �z�t C �ODU G.. L ff�..ZG TNK e,a�N /Y/moo �i�L FSUER 5'".Q� J'cvrFL 9n .CI�o6 ..!'rtise /ifi�C $'so NEtt —•' PjyC Hpy DAII W19t1�fF FAM1 /� /tYlJ? r� i.vA�' y� E h/f17 PROAEiifY " .S .QE�Y<ow•r `1Scx �o =/..2 .D�a, < Ju ���� _ CALK e,. 11-44 6i,6 C�BSf�tlA�fit�u C.6� Fti,si4 6"'fA t — -V' Ak- 15, r+ yo P pe MAx,.huM %" Adwr .44.t,,%A0 To �iNiSH GQ.4DE /7�i'✓��Y UL�YiV Po.v ' � Side View EkCVR ioA 14,4<H l om-,, �q Cv,< -rL-.r End View ST. CROIX COUNTY ZONING DEPARTMENT .W - r AS BUILT SANITARY REPORT Owner 1,9'000 �W �u s r�rG� �N Property Address 45/9' lyhLtl City/State 4U �4 o.J Legal Description: Lot / g Block f Subdivision/CSM # N&-) y, 4-1 /,, Sec. ,2� Tf!!l N-Ri1 W, Town of s,1.1J PIN # SEPTIC TANK DOSE CHAMBER — HOLDING TANK INFORMATION: Tank manufacturer Size ST/PC/000 / Setback from: House 7' Well Go" P/L 3� Pump manufacturer Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Meter location Alarm location Vent to fresh air intake Water Line SOIL ABSORPTION SYSTEM: Type of system:�R4� N Width 3 Length �g `� �� Number of Trenches Setback from: House 33' Well 73' P/L � 7 `� Vent to fresh air intake ELEVATIONS: Description of benchmark / *':;7Rc,Q *7 -'J 9 -�"T e wP'U4-e Elevation / 0 o -00' Description of alternate benchmark -A o P ay e r 4e `' zL Elevation 4�� Building Sewer / /3 " ST/HT Inlet /y 3 • "2:<� ' ST Outlet / J 3 ,SAS PC Inlet PC Bottom Header/Manifold _2j_�V' Top of ST/PC Manhole Cover /4L260• /,� Distribution Lines (A) �9.'70 (8) 9K '79 ( ) Bottom of System (A)`I IS / An q 17- 7S ( ) Final Grade (,4) /0 �i- ( ) ) 0 3, Sa Date of installation / /a/ Permit number " 9g12 State plan number Plumber's signature 'tense number .2�R S172 51 Date q1r16 I Inspector 04 17' jr Cotttpkte plot plan or Safety & Buildings Division j G; . —#-Sqj W c4uF�—_ r_Q. Sanitary Permit Application 261 W. Washington Ave. In accord with Comm 83.21, Wis. Adm. Code PO Box 7302 ®.ciiiO�iJr' �h See reverse side for instructions for completing this application Madison. WI 53707.730' be for secondary purposes Personal information you provide may used (Submit completed form to courtly if r Department of Commerce [Privacy Law. s. 15.04(1)(m)) state otvne; Attach complete plans (to the county co • onl�) for the system. on gaper not less than 8-1/2 1 I inches size. County. State Sanit Permit Number ❑ Check if revision w previous application State Plan 1. --0. Number �' QD/x - 1. Application, Information - Please Print all Information Location: Property Location Property Owner Name II 114, S TcXWELOf Lot Number Block Number property Owners Mailing Address AZ D City, State Zip Code Phone Number- Subdivision Name or CSM Number II Type of Building: (check one) ❑ City ❑Village 0 1 or 2 Family Dwelling — No. of Bedrooms:_ 19 Town of 0 Public/Commercial (describe use): ❑ State-owned III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Road Parcel Tax Number(s) A) 1. ® New System 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Addition to System Tank Only Existin S stem Z9420— - B) Permit Number Date Issued - P,q - 1 aO ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) O Mound ❑Sand Filter ❑Constructed Wetland ® Non -pressurized In -ground ❑ Pressurized In -ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line O At -grade 0 Aerobic Treatment Unit ❑ Recirculating ❑ Other: _ Dis ersaVrreatment 1. Design Flow (gpd) Area Information: f 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rote 6. $ tem Elevation \ 7. Final Grade Ti' Required Proposed Rate (G&Jdaylsq. R) (Minlinch) Elevation VI Tank Capacity in Total tl of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing Crete strutted Tanks Tanks / ❑ ❑ ❑ ❑ D VII Responsibility Statement I the undersigned, assume reWrisibility fer installation of the POWTS shown on the attached plans. Plumber's Name (print) Signature (no stamps). WIMPRS No. Business Phone Number LPlumber's �� i3--] - Wso z r2APlumb s Address (Street, City, State, Zip Code) VIII County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date issued issui g Agent Signature (No stamps) Approved El Owner Given Initial Adverse S°rcyprg cc io / Determination r IX. Conditions Approval /Reasons for Disapp al- o:S ei� j�_ W. L. LT32 0 m A4 ( u `tip d-t. SBD-6398 (R 07100) I ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Ow,�u�d„ QvsSv��y/a MaingArd:e::s Prod::txty A ddry Ss / ,(Verification required from Ptaaniag Department for acw conswmdon)�_ CSq• State �CSO N L.t// Pa=l Iden"mition Number DAD Prq:sty &O'lion V.. SW 'K. Sec 2 TjR�W, Town of ALA&VI^ Snot i�1i : ey_ rgn, Cr. ES' -ks . Lot # CK-law S;W-vey Msp #' Volume . Page # worie y 604 # d..?6 oAg Volume /S7i . Page # P/ Spec hDusetlin Lot lines identifiable ®yes ©no ImP vi rrae and maeimameof yoz sq*c"mcouldn=' t m its pre mWare#ui m haadZe +area ProQer mamtcsa�scc exseesiaft esSpuiYip:::sg au do wore taisk every dmee yeas or if needod by a licrosed� pmm. whatou ypar:mto tbi' siem aw-d feet tbe'b m %= of the septic lank as a tieabmemt sts�e is the aaabe disposal systtxb . - : • 'Ibe' Hof �y osayer ;ryioes to sabmit m St t� � Deportment a veatoa io'm4 srigtsed by tbs awrmed-. snd by a tmat�ccpitroo j--:-ameymsnp=mbor,maiaeodp or&Hmsodp=pervmifyin dw(t)tbeoDziw 3ww&tFr itsysie� is in ;toper ei� Ca ;u� ooadituan atsdloi (2) otter iaspextSafs ssfd Pttmpm: of r� tbse septic it�nk is less than 113 Sail i�°�tirdgo. Uw e•iil wd bwe m.d dw above req*ewean and apese to tsaainUM the private seswate disposal rystetfl grim tbe':.fsmds�C sect fir tlt, �m;. u;s sex by rim Ae�arttlasmt of Cefmmeree smd mO De pucmens esf Ntanl Reroin ccs, State of �PViscoeisia ;tip "I l tisat )ScO�' .. V& ayafem boa been manh=cd m=t be cowpleted w4 zcbn od to the St Croix Canty Zani% O�stci�ti 3 days. Odic Sate ;roar a vi ation data. <z2�9 ` ` I UWATUPW OF APPUWIY DATE : : I (veti). c+:il y that ali statemc= on this fora are true to the bent of my (our) knowledge. I we am (arc) the o ziin(s) of the V4peety ttes y.ribed above, by virtm of a warranty deed recorded in Register of Deeds Office. Q Or AliJttl :4.►k' APPI:I DATE Any m&„usation dw is mis-cepresente dmay rexult in the smih" permit being revoked by doe Zoning Departroexar,:.+••.«, •' ill!la& w161 r-Glt applieaiien: a stamped wamnty deed from the Ragisdx of Deeds office a copy of the certified Purvey asap if reference is msde in rbe.varranty deed ce 39vd dd9t LS LS:ST 666T/9Z/L9 • STATE BAR OF•WISCONSIN FORM 2 - 1998 WARRANTY DUED F•'•'�'t r�•t� VOL Mina 71 'phis Deed, matlrbrnvr^n Kernon J_Bast and_,Donalda _ . -- ---- ---... ........ Grantor. anri Theodore 0., Ousdigian , 8 married person ... ur-.atna. lot a ,:alwisle cuaskieralton. catwoys at III warntts to Gr-.nrtm d,r followhq described real islet,, In .- $t. _CrZ4�XCounly. State of Wisconsin: Lot 1 lat of Evergreen Estates II, Town Hudson, St. Croix County, Wisconsin Escr•pl lottx in a arrautles: 656029 KATHLEEN H. YRLSH REGISTER OF DEEDS ST. CROIX CO., YI RECEIVE) FOR RECORD 12-n-2000 10200 AN wffd BTY KEEO EMMT I CERT CM FEE: COPY FEE: TIS11 RI FEE1 179.70 RECMDI116 FEE- 10.00 PAGES: 1 tom,--4-51'Ne . Name atal finis,, Atltlran is 020-13%7-IR-000 a Pared Idsrltcaaart Ntxrbor (AM This is not hatlesteadproperty. (is) (Is not) P Dawd tbi, _-27th-- d.y a Q—P;heg.. •----- . (SFAL) .fld-at...ca4._t'VJCe'u'_ �-.s-1 .� (SEAL) X-M,3.,L�. —__ • Qonalda J. Soeer-Bast - - - -- — ---- -- (SEAL) _ (SEAL) AUTIIEN'f(CATION ACKNOWLEDGMENT State of Wlsconsln. SAint ('rnim County evil Item ie..IINI Iles ___. _ day Ul _- , -- Personally came before me thls 77t — day of 1, DPnnmhPr ,•—, �Q.(L, the above Ra1TMd f • Kernon J. Bast and Donalda J. STeer-Bast i; _ _ _ _ _ __ TII LE MUMBLER S(AIH BAR OF WISC:ONSIN --- to nit k,lotnt to be the person S -Am executed the foregang 1_ arrt trod by SMOG, Wts. State.) butrontent and acknowledge the sane. THIS INSTIIUTArRY WAS OnAFIEU SY I' p 1: Notary Public. Stets '�ltxmsln My commission Is permanent. (11 not. slate expiration date; j) (Slptultacc rrl.ty autite Hated or acknowiedged. Both are nut Ircenetry) Notary Public •rl,.�.t.,.,,. r..n..t,. t.+.. a.+r,kr.. . St Ste of VAsconsin wvar•�:•,v•.t•r,ro.... r.anaa rlekv*Co..L- S1"ATE BAR 01; lvtgirWjVbN8rjL J. Burke hr��Ifm 1tinR �tN n DEEB FORA) 1%, 2 - —�— �+�••^• w+ �onsin V�iscDepartmentofIndustrySOIL AND SITE EVALUATION REPORT Lebor and Human Relations n_ Page 1 of 3 Irl duGulu wlul 1L.nn U-J.V. , TV— COUNTY l Attach complete site plan on paper not less than B 1/2 x 11 inches in size. Plan must include, but St. Croix not limited to vertical and fwrizontal reference point r nd % of slope, scale or location list n list rG�d PARCEL I.D. 020 1�2�-9fl dimensioned, north arrow, and and REVIEWED BY DATE APPLICANT INFORMATION AL INRMA7{4, PROPERTY OWNER: PROPERTY OPEATY LOCATION Kernon J. Bast 1 Al f GIDVT. LOT NW 114 SW v4,5 23 T 29 N,R lg 5dor) W PROPERTY OWNER':S MAILING ADDRESS Sl 9�9 L T # BLOCK 4 SUBD. NAME OR CSM�s 948 LaBAr e Rd. C�+x 18 na Evergreen Estates II CITY, STATE ZIP COD FIB CITY ❑VILLAGE RYOWN NEAREST ROAD Hudson, WI. 54016 ,715 75; Hudson Waldroff Fm. Rd New Construction Use jx) Residential / Nu b6dr 4 ( ] Addition to existing building Replacement [ j Public or oommeraal describe Code derived daily flow 600 god Recommended design loading rate .7 bed, gpd/ft2 .8 trench, gpolft2 Absorption area required 858 bed, ft2 750 trench, ft2 Maximum design loading rate .7 bed, gpd/ft2 , 8 trench, gpd/ft2 Recommended infiltration surface elevation(s) 99.00 ft (as referred to site plan benchmark) Additional design / site considerations trenches spaced to code 3.501 below grade Parent material pitted outwashplain _ Flood plain elevation, if applicable na It S = Suitable for system CONVENTIONAL ® S ❑ U MOUND ® S ❑ U IN -GROUND PRESSURE I AT -GRADE 30 S❑ U ❑ S ®U SYSTEM IN FILL C2 S❑ U HOLDING TANK I ❑ S K U U= Unsuitable for s stem Boring # Ground elev. 10o-o ft. Depth to limiting factor +841, Boring # 2 4; Ground elev. 100, 2 ft. Depth to limiting factor +841, SOIL DESCRIPTION REPORT Horizon Depth in. Dominant Color Munsell Mottles Cu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft Bed jfRinds 1 —12 10yr3/3 none 1 2irsbk mfr gW 2f .5 j .6 2 12-33 1Ory4/4 none sil 2nsbk mfr 9W 2f 3 33-84 7.5yr4/4 none Co s Osg m1 na na I I Remarks: 1 —15 10yr3/3 none 1 2msbk mfr gW 2f .5 .6 2 15-38 10yr4/4 none sil 2msbk mfr gw if .5 .6 3 8-84 7.5yr4/4 none co s Osg m1 na na .7 .8 i I Remarks: CST Name: --Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 200 ve. New Ric and WI 54017 Signature: n "o, Date: 6-17-99 CST Number. mO2298 PROPERTY OWNER Kernon Bast PARCEL I.D.# 020-1020-90 Boring # .`. ..shy 3a Ground elev. 101.7ft. Depth to limiting factor +84" SOIL DESCRIPTION REPORT Page2 of3 r Horizon Depth in. Dominant Color Munsell Mottles Gu. Sz. Cont Color Texture Structure Gr. Sz. Sh. Coruistence Bourrtaty Roots GPD/ft Bed Tmr& 1 0-14 10yr3/3 none 1 2msbk mfr gw 2c .5 .6 2 14-29 10yr4/4 none sil 2msbk mfr gw 2m .5 .6 3 29-39 7.5yr4/4 c2d 7.5yr5/6 sil 2msbk mfr gw 12f .5 .6 4 39-84 7.5yr4/4 none co Osg ml na na .7 .8 Remarks: Boring # Ground elev. 102.8ft. Depth to limiting factor 1 0-10 10yr3/3 none 1 2msbk mfr cs 2c .5 .6 2 10-23 10yr5/4 none sil 2msbk mfr gw 2m .5 .6 3 23-30 10yr5/4 62d 7.5yr5/6 sil 2msbk mfr gw 2f .5 ` .6 4 30-84 i 7.5yr4/6 none co sog mvfr na na .7 .8 Remarks: Boring # Ground elev. 102.5 ft Depth to limiting factor +841, 1 0-16 10yr3/3 none 1 2msbk mfr cs 2c .5 .6 2 16-36 10yr4/4 none sil 2msbk mfr gw 2f .5 .6 3 36--84 7.5yr4/4 none co Osg mvfr na na .7 .8 I Remarks: Boring # ;:':' Ground elev. ft. Depth to limiting factor Remarks: STEEL'S SOIL SERVICE Gary L. Steel Kernon J. Bast CSTM2298 Nti SW4 S23-T29N-R19W MPRSW-3254 town of Hudeen lot #18-Evergreen Estates II N 1 "=40 ' Ei.= top of 1° steel pipe @ el. 100.00` Alt. Br1.- --4, 4- ••;nn +raa a ai _ 99.30' i Gary L. Steel 6-17-99 1554 200th Ave. New Richmond, WI 54017 (715) 246-6200 IN PART 'IF TS3 lY► 4 Or TE.B SWf/4 AND IN PWir Or TSd SYf14 Of T8B NW1/4 ON TZ3N, 23, Afar. TOWN OF HUDSON ST. CROIX COUNTY. WISCON IN: BSING LOT Z PIED SURYRY MAP ASCOAMP IN VOLUMA 13. PAGS 3588 AT r" ST. CROIX COUNTY Of DZZDS orrlca. PREPARED FOR: LOCATION SKETCH KERNCN A BAST SdCTION 23 OONALOA J. SPEE.4-BAST 948 LASAPCE z0. ►ljC,,0 1 /`pf NUOSON. HI 34016 Z WJWALJ. .A&LES APE TO at FACED SUCA MAT 1ME IMSTALLA.ION WOULD y '421 STAKE. dt :NET u90y r,ANY l07 u•d CA51MET tL C5' ONO A 9AWY STAKE V ANVOK •S A'AOLA TOP Or SEC" 23632 r, u�A,4w] uN W&P ES 11 VI E►SEM IS as SET TORNALE FOR NE USE 40 .-TE Pugue UN —CS MAV04C K MCHr TO SMC ME AAEA. d4 US NAP (PEATI IS %AACr TO STAG C"FV. ANO TOl•N4.P A&A&d•S (LE. AETIAMT. w W LOr 9M ACCESS TO PARCEL ETC.). CO+CI 0[ 5f. Udz C01Mry PKOMA Y E TOM BOARD TOW AOMCE.NI Ah.-L Wj/" EVERGREEN ESTATES ---------------' ----------- LOT _16 I rzsn; wsl► I�IT_i4 cS89048'34'E) POE• 4 J'AeNT ecA 77A 824.77' 18 ! 2.532 ACRES 1 110,293 So. FT. f 400.95' --- -�i MYTH LINE OF rK 1v11. Or T.0 ..I,. — !; ' Va( 17 �( n N 2.SO4 ACRES 109,079 ACRES 33' 1 33' IN./ I 1 - zl c 3 N ' / /*12 c I / F 1 l 1 ..�........ SO- // 143.42 PAJW / O 143.42' — /L.... / 1 50' i 1`� : RADIUS PO:NT zz X � 2.500 ACRES 108,906 SO. FT. t'.� �°a �i o ♦♦ col 2.304 ACRES w i09,054 SO. FT. N D� D r7�•. InRADIUS I POINT 1 S epW ua o R- gO t o / TEMPORARY CUL-DE-SAC EASEMENT TO 9E REMOVED UPON EXTENSION OF ROAD 609.20' a l_ 7 8.4' +/- V 13?7.53' CftvE c.rA '1A/ 327.6 V) NON eca LOT mom unbis cwwAL m<u CTwo uAwc oa+e (rKirN AM LMIN fmarANTS (� 1674V 92'3t 13- S4677433'•V - MW 270Df Sln"4V .67"UM"V ® 23ur 92'ld2R- S46.24R2"Y 3377r 377Sr M0-A?3"V 570'�6'SML 'LATTED LANDS 1T znw zI-awn- S&E't&•54w G"s- aAw• Mry aav VA.-1- 16 233Zr ]TSd.&•• SSY..v rV 15L6.' 15445' SA'441VV SO3'4723- 11 2ww a3'•46'I.•' S16.5>16•V 1334w I37.33• A7.5.2 ry SW wis-E Or. C510DL 0%744 7C 41 '~ �� NW CORNER SECTION 23 ��aiil7� I 'LLM wu :CA.'N r?SEEm. Cd6wq MONUMENT `01MO LOCATan • r WON PIPE •aW.o OP SFCpT O 21 ! so- Ma- PIPC 5" rou-+w OATCZAI T 1A3 LP4 PEP UNEAA FOOT "G1ST8 NOIE' ALL OTNER LOT CORNERS MG%JWNTEDM011" 124' AOR POE YOGNING I,Ij L9S. PER UNCAP FOOT . . . ' . • . ' . ' • . . ' AOAawA7 SET84CX UNE (A3 9.0m) ? -- -- —_ — 12• AO[ VOUfl EASEYONT VTVTE EASENOITS NO •0.E CA RUw1EL n 71511j" ANT SWRA F pNEC E PRC?OSEO ORItE 0E w5COCONS14N9N Sign PYWC BODIES AND y I i1 O'Y, KSi.=� STOAY wA IFJE RE}EN9011 AREA 4 AWLS MO A NIGH mrER UME EUV-?04 WORE PUF4"ASIW LONr,G OTa10E A.Q v I u N NOTE A GRADING MAT w0UL0 ALTUt W, CAPAOTI OF ME STORY *AMR RETENTION AREA 1S PRONSIM Narc a PWlD.Gs ARE pft mTEa WTMN •� I ] }I ME STORY — ER RE7EI#rQN -REA I i3 PRFMNU=f.r REpORM DATA t EMSIING FEtNCEYK l LQT__4 I C._S_._X_.IN 1 1 • 131R I Y:_1fA_ FG._ 3234 1 $iI— — — — — — — seaae'oE-Esases_ WI/A CORNER SECTION --- a CORNER 23 BpbAuw II.SOS 5 OArjW ITna EL. a2T.75• KwL MCC 3 CERTIFIED SURVEY_A!!gP v a y'rr u7 1 VOL 13, FL. 3536 to Q 1 ac Z N85' / i 33.to, 9y 1' �i M 33' 33' %.g c 2.389 ACRES 104,066 SO. FT. _ o ? '� Ss4.14, $C2 i- \ 20 u 2.910 ACRES 1p1NT DRIVE — 126.776 SO, FT. I I •A I --------_�• 61933' 13 eENaYru cls S89a59' OATVY fate <S85'So C.S.!u IN N GOEE.027 V.- �C' PC__2727I o N = cr rno.,co SCALE IN FEET T' 60' ei I11 �.s