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HomeMy WebLinkAbout020-1472-00-008 .Wiscons4i Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety 'arid Building Division S anitary Permit No: I INSPECTION REPORT 483963 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes Privacy Law, x.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Fine, Robert & Bethan Hudson, Town of 020 - 1472 -00 -008 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: la Q 41 / G 5T 22.29.19.2997 TANK INFORMATION k ELEVATION DATA TYPE MANUFACTURER �� CAPACITY STATION BS HI FS ELEV. Septic '57, r7 / Benchmark D ,� ti i r 1 L.. i ' / z so 5 3. 45 /Q3• S /LIB rrr,• / .� Pa 1 a s , z S Alt. B M � r.t 4....,. La,,•c.� 3 •58 ?7.137 Aeration Bldg. Sewer Holding St/Ht Inlet 5- ,/C /,/- Q TANK SETBACK INFORMATION SUHtOutlet 5. 77 9 7. Co? TANK TO P/ WELL BLDG. Vent to Air Intake ROAD Dt Inlet e" / Sys4 - ems- \ Septic 75 76 Dt Bottom 36 lL Dosing Header /Man. Q 1CIS C to• 7 7 Aeration Dist. Pipe Holding Bot. System 7. to8 ,S • 77 Ok Final Grade PUMP /SIPHON INFORMATION 5.62. ' S. Manufacturer Demand St Cover 3.50 �G g7 �. I Gay. 0 / Model N • •er TDH IL' Friction Loss 'System Head TDH Ft Forcemain L- • 1 Dia. •ist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length No. Of Trenches PIT DIMEN No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 Length 3 e �� �_ -_ -�_ I \ SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: • (. INFORMATION / / CH OR D.—....A. D.—....A. •, Type OAL �� S IE- / 33 6j •� ' f e _ UNI M odel Number: /�� .. , 4 , DISTRIBUTION SYST G. i ll I� / 5 � /y � /1 Ca: ^ h13 J2� r�J Header /Manifold 1 / Distribution x Hole Size x Hole Spacing Vent to Air Intak f Pipe(s) \ \ \ 5 ,Pa- (—et Length / � Dia it Length ■ Dia Spacing 9-0-0,5.—.......4._ SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only 7 lr ,A o.M Depth Over / Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center 2. ( .:: , (0 Bed/Trench Edges\ Topsoil \ Yes E3 No Yes a No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 825 Germain L ane 'I Hudson, WI 54016 (SE 1/4 SW 1/4 22 T29N R19W) Cedar Wins Estates Lot 8 Parcel No: 22.29.19.2997 L/ 1.) Alt BM Description = E' 1d-t� G a ` -e '` — �C .– co Ju� L a 2 Aj i., OP / 2.) Bldg sewer length = /F . f 2 c amount of cover = > If 0.SIQ ■ I Plan revision Required? El Yes o 29 JD AllrelEll U 3 "" Use other side for additional information._ t/ Date Insepctors • / Cert. No. SBD -6710 (R.3/97) i J • commerce.wi.gov Safety and Buildings Division County / it. 201 W. Washington Ave., P.O, Box 7162 , 5 / G Y / / c Madison, WI 53707 -7 : � Sanitary Permit Number (to be filled in by Co.) a li Department of Cornmerce #83 5G3 Sanitary Permit Application S ...----"`. - "'State Transaction umber In accordance with s. Comm. 83.21(2), Wis. Adm. Code, Submission of this form to the appropriate governmental ♦" unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS a - Project Address (if different than mailing address) submitted the Department of Commerce. Personal information you p d ��� r t purprposes es a in accordance ance with the the Privacy Law, s. 15.04(1)(m), S.04(1) (1)(m), Stets. 1111117:1411 3 ary . .."- 1. Application Information ,'P • ; se Prin f -, Information Property Owner's Name y % :...`' Parcel # ' fi © he- t /7 v � AUG p 6 2010 o _2n - <Y >z - ea -o'o8 Property Owner's Mailing Address CROIX COUN roperty Location (t Z99 7 ) 9 e i jk,,✓ evao of 3« P f,NNING ovt. Lot City, State Zip Code per & ZONING OFFICE _IX- y , Se/ y., Section 2e2_ 7 G` ,/..) !J CBSp , ( yD 5 /d (circle one T Z7 N; R /Q Eo II. Type of Building (check all that apply) dic Lot Ar 1 or 2 Family Dwelling - Number of Bedrooms p v Subdivision Name Bloc c �� w 1‘,P.5 .mss ? ❑ Public /Commercial - Describe Use ❑ City of CSM Number ❑ Village of ❑ State Owned - Describe Use �I 2 t 1 A'' . 2L 21 GI,,,� e,t`g KTo of {�LtGe3o,,IJ III. Type of Permit: (Check only one b x on line A. Complete line B if applicable) A. .New System y 0 Replacement System ❑ Treatment/Holding Tank Replacement Only 0 Other Modification to Existing System (explain) g List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber 0 Transfer to New Before Expiration Owner IV. Type of POWTS System /Component/Device: (Check all that apply) N on- Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treat nt Area Information: I - r'CEi� p 7 f(- l Design Flow (gpd) Design Soil Application Rate pdst) Dis i - : ' equired (s Dispersal Area Propos sf) System Elevation _ eQe' , 7 8 7 /6 a71 _ s •, -eZaw co.. VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units o - g New Tanks Existing Tanks / d c . 6 w c7 a a r r Septic or Holding Tank - ! du , r cs ,,,, X Dosing Chamber VII. Responsibility Statement- t, the under8lgned, assume responsibility for installation of the POWTS wn on the attached plans. Plumber's Name (Print) / Plumber's Signature PRS Number Business Phone Number / I/ a 44 cc i Gt, ma � /iPsr � r, 2 2 7 7 7 a 7 /S`3, -51 Plumber's Address (Street, City, State, Zip Code) /G 74 � c, o /`� / /o, -r/_ Q©r,f- &J / ' A- o/ r6 VIII. County/Department Use Only / Approved I Disapproved Permit Fee Date issued .t� Issuing A Signature / 1 owner Given Reason fOr Den : $ 1 05' l� r 16 4.1■-I IX. Cunditifeasons for Disapproval 3\ � 0 C � fy �'� , / o 1. Septic tank, effluent filter and J n dispersal cell must all be services / maintained €�, -- 1 +e1� � as per management plan provided by plumber. ' 1 2.. AN setback - requirements must be maintained ` bi - e�t to I- NO f � as fpal. Vec tb �io comp(e ens or 'e system and submit toth1County only on paper not less than 8 U2 x 11 inches in size SBD -6398 (R. 02/09) Valid thru 02/11 ' lit- 5L- 4 5-,,r-_, I t 9 Gl I y{ �r 1)(44a.:"%te_ -- C e-JA /Lt/A.e- V CC ,i 2 2 Q ro .17-•/' i� y I EA 'o 1 a 5c - � p /V �3 + y 6 4 A 8L4AAA- V • N ., , RECEIVED RALL0 Wisconsin Department of Com ; erce DEC ZQO OI' EVALU RT Page 1 of Division of Safety and Buildings ST. t C. 85, Wis. Adm. Code Attach complete site plan on .: per of less • • in size. Plan must County 1-- 1 r o f include, but not limited to: ve a: an. orizontal reference point (BM), direction and Parcel I.D. C 47)--- percent slope, scale or dimensions, north arrow, and location and distance to nearest road. U — 1 DCL d Please print all information. Revie Date Personal information you provide may be used for secondary purposes (Privacy Law. s. 15.u4 (1) (m)). a% 1 (/ Property Owner a Property Lor'tinn • ; Z Q t-) . — 1 i A Govt. Lot 5 1/4501/4 S22.,T (a.9 N R 1? E (. Oil Property Owner's Mailing 2 ` Address Lot # Block # Subd. Name or CSM# 4 / Cit State Zip Code Phone Number ❑ City Village aTown Nearest Road it L.--)0.-, 11u\ 1 < =4 1 (113)_;g 3 AL 4.01,- 1 &Pm ir„ / 06 /_ . New Construction Use Residential / Number of bedrooms2 Code derived design flow rate Y_ l'%,__ GPD ❑ Replacement ❑ Public or commercial - Describe: -- - - - - -- -- - -- Parent material 0,—,f/.. Flood Plain elevation if applicable .4 "'9 ft. General comments � c ' Z eal _ at / 472,(A and recommendations: t'5 A _ - r " S 2 / sbo e le va,r/uir\- o E1 Boring ,,�r� '� # /In L Pit Ground surface elev. i ft. Depth to limiting factor /0 U in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 0 l l / - ------ EVIIIDENIIMMEINNINI - 6 / 0 2 i► - 3 -WIFA WRIMPAPAISMMENNWEr 3 36 - a. 'AM • - -- 01111ralffil m / INSIMMINIF — ❑ Boring I I a"ing # p;t Ground surface elevA0 r ft. Depth to limiting factor / in. I Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots �Etf# GPD Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ( o ►rNt ( -- 5 ( a te, r n i <> a► , c ).b —34. I 6._) , C I , e rn s IC rn -r 5 1 -c-7:' . Li • I •••"""ii 9. „ Effiuent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L , Bird Plumbing, * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/l. Sig �� CST Number CST Print) Shaun Bird 226900 , . D ate Evaluation Conducted Telephone Number Address 715- 246 -4516 1008 192nd Ave, New Richmond, WI 54017 / a- /),,,- O • 0 1 Property Owner Parcel ID # Page of I 1/43 ,- ❑ Boring 1 Boring # SCI Application Rate I Pit Ground surface elev. ! o ft. Depth to limiting factor /t7� V in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Etf#2 1 i — i z ter 3/ — s 1 are, m rc 2 4 /a 2. 12— i \ G • m5 I� ^ , c \A) ' ,./ 3 M J Mill .. . > - 2 /. ■ MEI ME I I Boring # ❑ Boring ❑ it Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Etf#2 ❑ Boring # ❑Pit Ground surface elev. ft. Depth to limiting factor in. Sort Application Rate - Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 , 'Eff#2 , Effluent #1 = BOD, > 30 < 220 mg/1.. and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg'L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an altemate format, please contact the department at 608- 266 -3151 or TTY 608- 264 -8777. SBO.8330 (R.6/00) • Soil Test Plot Plan Project Name Dave Alwin Sha ' ird Address 413 6th St. N Hudson Wi 54016 e` #226900 Lot 8 Subdivision Cedar Win's Estates Dail 12/12/05 SE 1/4 SW 1/4S 22 T 29 N /R19 W Township Hudson El Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1/2" pipe 5" above grade System Elevation 98.5/98.0 *HRpSame as Benchmark Alternate Benchmark Top of 1 /2" pipe 5" above grade @ 100.0' • • Scale is 1" = 40' unless otherwise 492' Property Line noted B -1 E 9% Slope a.; 20' 30' 40' B.M. �AtI.B.M. 20' 171 B -3 65' 225' • B -2 103.5' 100.5' I 3 try'' < • /11 v Germain Way } Soil Absorption System Cross Section re 1 ft ■ Final Grade I 4" Schedule 40 /� PVC Vent Pipe � t� ft With Vent Cap q5 7 l ea mbe ♦ 4* s ft Chamber System Elevation ft ft Soli Absorption Slattern Plan View ft ff. ft {IIIIIi 11111ii1i1111111111111111illlll1111 11111 1IIIIIIIIIIIIIII 111111111I111121111111 I —1-1-ft 1 Trench 1 Leaching Vent Or Observation Pipe Chambers —1 111111M llllilllllllli 1 i 1111111111 1111 111111111111111111111111111111I111 I III111.C--\ pia. I Trench 2 Header Leaclinq Chamber Specifications Manufacturer And Model .4/l • `/ 7 r, EISA Rating a d so ft per chamber Soil Application Rate - 7 gpd/sq ft 65 gpd Design Flow + - 7 , Soil Application Rate .t. ,$ ? EISA = `_ Chambers 2 rows of .- chambers each. i Pag of . • SEPTIC TANK & PUMP CHAMBER 'OSS SEC ION AND SPECIFICATIONS 4" CI VENT PIPE 12" MIN. ABOVE GRADE E a WEATHERPROOF > 25' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MA OLE COVER FINISHED GRADE -- WARNING LABEL 4" CI RISE .� / _..jam____ -_ " MIN. 18" 1N.6"MAX. ** ---_ .�- s*'","" ll " ,I"""'r` ' I ~err,., INLET 1---- ' WATER TIGHT SEALS CAS- , TIGHT � \fAPPROVED A SEAL ' � � JOINTS WITH APPROVED -4 - ,+_ALM APPROVED PIPE 'IPE 3' r .;,._ ON 3' ONTO INTO SOLID ' 1 SOLID SOIL )01t PUMP OFF ELEV ELEV. FT --- I P OFF ** RISER EXIT PERMITTED ONLY S b- IF TANK r, MANUFACTURER ..;. ...._.� HAS APPROVAL 3" APPROVED BEp1AING LU DER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE TANK MANUFACTURER : ZZ tf , .-P� NUMBER DOSES PER DAY : TANK SIZES: SEPTIC i` 5 GAL. DOSE VOUJME INCLUDING 1 9 GAL. DOSE 2 c GAL. FLOWBACK: ALARM MANUFACTURER: leyeLtTR+-r\ CAPACITIES: A = a'3,. INCHES = Jb . GAL. MODEL NUMBER: W.24 4 SWITCH TYPE: Ms.gs B = 2 INCHES = GAL. PUMP MANUFACTURER: Gittv� g C = O INCHES = J to% GAL. MODEL NUMBER: v_n d ! SWITCH TYPE: yr e. C D = _ I d INCHES = a,to GAL. REQUIRED DISCHARGE RATE _ _ 0 GPM PUMA' 6 ALARM WIRING AS PER ILHR 16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP Q1'F AND DISTRIBUTION PIPE . . it)._ _ FEET + MINIMUM NETWORK SUPPLY PRESSURE . . , , — 2.5 FEET + (0 FEET FORCEMAIN X Q,,LtFT /100 FT, FRICTION FACTOR FEET T,OTA,,L DYNAMIC HEAD = ` 1 FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ✓ ; WIDTH ; DIAMETER -_ LIQUID r 38 � • Q i C,-AL pee 1 SIGNED: 4 ° e. -4 -•-- - -- LICENSE NUMBER: ypi.D..7 q9 rU DATE: 1/88 . GouLvs PUMPS Submersible ers ibie Effluent Pump i IIMMIIIINIIIIIINIIIIII 411 lr EPO4 $I 1 EPOS { 3 • EPO5 impelier. Thermoplas- • Bearings: Upper and lower APPLiCATd • grade turbine fogod fo r high tic endosed.design for heavy duty ball bearing Specifically designed for the lubrication and efficient improved performance. construction. following uses: heat transfer. • Casing and Base: Rugged • Effluent systems thermoplastic design provides AGENCY LISTING • Homes Available for automatic and superior strength and corrosion as tan dim StandaidsAssedation • Farms menus! operation. Auto- resistance. • Heavy duty sump mark models include ■Motor Housing: Cast iron (CSA listed model numbers end • Water transfer Mechanical Float Swrtch for effident heat transfer, in "F" or "C °.) • Dewatering assembled and preset at the factory. strength, and durability. SPECIFICATIONS • Motor Cover: Thermoplastic Goulds Pumpsa no 9 001 FEATURES cover with integral handle and • Solids handling capabNity: float switch attachment points. ' /+" maximum. • EPO4 impeller: Thermoplas- • Power Cable: Severe duty • Capacities: up to 60 GPM. tic Semi -open design with rated oil and water resistant, • Total heads: up to 31 feet pump out vanes for mechanical • Discharge size: V/2" NPT• seal protection. • Mechanical seal: carbon - rotary/ceramic- stationary BUNA -N elastomers. • Temperature: 104°F (40°C) continuous ... .... :....._.._.}.....__.... METERS FEET i ... . i _.. _._. 140°F (60°C) intermittent 10 1 1 i t • Fasteners: 300 series c,�M — • stainless steel. ' _.._ ...........__.__.____ -._ s ii • Capable of running 1 ._.. I 2S FT dry without damage to a ' ._.._ _.._ 1 � _...� _._ ._;. __� _ ...____�._........... components. 25 1.,... i .. 1 .. Motor z _ ,.., _.__ -a.__ _ �— j I I v 6 20 !... i • EPO4 Single phase: 0.4 HP, — 115 or 230 V, 60 Hz, 1550 5 RPM, built in overload with °, "' ' T 0 ts� t EP automatic reset. a 3 , • EPOS Single phase: 0.5 HP, o ' � �. _--- . - .._i .,. i 4 • 115 V, 6 Hz, 1550 RPM, 3 t0 ! . _..__ ._..G -_... EPO4 i... - built in overload with i ; I 1 _ automatic reset t 1 • Power cord: 10 foot 5 L.__ 1. _ r standard length, 16/3 o Q 1. SHOW with three prong _....3 _.._.__.,. as so GPM ...... .:. . . ... grounding plug. Optional 20 0 10 20 � foot length, 16/3 SJTW with s t o t z m =Jh three prang grounding plug o 2 a s (standard on EP05). CAPACITY Goulds Pumps ITT Industries ® 2000 Goulds Pumps Effective February, 2000 83877 • POWTS OWNER'S MANUAL. & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity i,� 5 E7 gal ❑ NA � .£ �i er \ N t. — � - Permit Septic Tank Manufacturer 1 �5.e,R.._ ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer 'r y,c j 4r ❑ NA �t Number of Bedrooms it CI NA Effluent Filter Model '.'° ❑ NA Number of Public Facility Units Q NA Pump Tank Capacity g O l7 dal CI NA Estimated flow (average( CO Pump Tank Manufacturer \e- Se. R. - ❑ NA �>���d l�Y , Design flow (peak), (Estimated x 1.51 b 0 O 8 y rump Manufacturer G © ti• l ., -, ❑ NA ❑ NA Soil Application Rate ei�d lr /f Porno Model S tandard Influent /Effluent Quality Monthly wangle' P retre a tment Unit 0 NA Fats, Oil & Grease (FOG) 530 mg /I. 0 Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /I. Q NA 0 Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg1L 0 Disinfection 0 Other: Pretreated Effluent Quality _ Monthly average Dispersal eII(a) ❑ NA Biochemical Oxygen Demand (BOD . 530 mg /L 0 In- Ground (gravity) ❑ In- Ground (pressurized} Total Suspended Solids (TSS) s30 mg /L 0 NA 0 At- tirade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /1OOml 0 Drip-Line ❑ Other: Maximum Effluent Particle Size Y in dia. 0 NA Other _ ❑ NA Other w 0 NA Other; ❑ NA J Otitiert ❑ NA *Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE Service Event Service Frequency ,,,--•- ❑ month(s) Inspect condition of tank(s) At least pnoe every; (Maximum 3 years) ❑ NA P I years) _ Pump out contents of tank(s) When combined sludge and scum equals one - third (Y of tank volume ❑ NA inspect dispersal cell(s) At 'at once every: 1:1 month(s) (Maximum 3 years) ❑ NA �year(s) / ❑ monthls) Cl NA Clean effluent filter At least once every! /� / a year(a) ___ ._ — - ❑ monthls) ❑ NA inspect pump, pump controls &alarm At !sea t 01100 every: �'--• ❑ year(s) 0 month(s) ❑ NA Flush laterals and pressure test At least pace every: ❑ year(s) - - -_ ❑ month(s) ❑ NA Other. At (east once every: — O -� year(s) - Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS inspector; POWTS Maintainer; Septage Servicing Operator, Tank inspections must include a visual inspection of the tank(a) to identify any missing or broken hardware, identify any cracks or Teaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to cheek the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (3/ or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code, Ail other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page of START UP AND OPERATION seance of painting products or other chemicals hemil areal cellist. If high concentrations are detected have the h n of the tank's) removed by a septage servicing operator For new construction, prior to use of the POWTS check treatment teals) for the pr that may impede the treatment process and /or damage the use. System start outages shall not occur when soil l abovirnormalfh ghwater )levels.rWhen power is restored the ex e su w rf discharge of Du ge to theis pump tans may flit above n e Serv;b Operator prior to discharge o acherged To the dispersal g L io n in have contents dose, nts of the overloading ump tank removed by aySeptagin ri eg the pump controls to power effluent. Th to the avoid i uen nts pur situation or have contact the content powr effluent pump tank. Plumber or POWTS Maintainer to assist in manually P disturb m compact, the area restore normal levels within the pump Do not drive or vehicles over tanks and die ode slo ea ption area. or park over, or otherwise Ion the life of the within 15 feet down slope of any mound or at -grade rove the performance and prolong diapers; disinfectants; the Reduction or i scion y wipes; e lo b the ondoms ; cotton swabs; grease h dental floss; eat scraps; medications; 011; POWTS: antibiotics; p pump) r; fruit cigarette and vegetable peelings; gasoline; grease; founda i (sump pump) painting products; ; Pesticides; sanitary napkins; tampons; and water softener brine• taken to insure that the system is properly and safely ABANDONMENT When the POWTS fails and/or i permanently taken out of service the following steps shall be in compliance with chapter Comm 83.33, Wisconsin Administrative Code: y in abandoned o its sealed. • All piping to tanks and pits shall be disconnected and the abandoned , Q� o� by a Septage Servicing Operator. • The contents of all tanks and pits shall be removed and properly • After pumping. all tanks and pits shall be excavated and removed or their covers removed and the void space filled Witt soil, gravel or another inert solid material. Quids a code complier CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or.must be taken, to pr absor o ant stem: ant soil Pti acem system: for the location of a replacement n replacement utilized f infringed ups P i be infr n9 ❑ system. sui replacement rplace area has been evaluated and may lion and should not be d be protected from disturbance and come to protect the replacement area w area shout P Failure P system. The replacement ae dwells. systems mu. setbacks from. existing and proposed structure. lot lines � and replacement area. Replacement sYat d the establish st required 'an to e 4 insult in the need for a new sell and site evaluation 0W1 tine. advances in POW1 at that .n advan comply with the rules in effect 88�Ti g ❑ t suitable a holding tank area is nstalled as a last resort replace the failed i POWTS s s back and/or soil o a h olding tank Y technology ,,. to • /4/ .r ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at 1 ce. Reconstructions of such systems must comply with the rules in effect' at that time. infiltrative surfs /OR INSUFFICIENT OXYGEN. DO N AND Oi GASSES CUE LETHAL RESCUE «WARNING» > TREATMENT TANKS MAY CONTAIN LE ENTER PUMP AND PUMP OR OTHER NT TANK UNDER ANY CIRCUMSTANCES. NTH MAY RESULT ENTER A SEPTIC, PUMP OR OTHER T REAT ME PERSON FROM THE INTERIOR OF A TANK MAY SE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS MAINTAINER POWTS INSTALLER Name Name � � a yr � . 1 ^ 1.' u a Phone `one , ? l i- - a ,e4• 1 -- - 41'%Z/ SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHO ITY� Name Name 54 G , je 74 -i Phone Name �/5 -3.6.4 -`A( $d This document was drafted in compNance with chapter Gomm 83 2 2(2)(b) { fl(dt &Ifl and 83. 54,11 , (2 & ( Wisconsin AdrraiMatrative Cod ST. CROIX COUNTY 1 SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer 40 4" 4Q-4 5: 1% ( 1-12-) , Mailing Address la ° r1 01 'goL- I)U8 1r1 , a t • -C `-'le.tr c t r 1 Q .� Property Address � Ze (Verification required from Planning & Zoning Department for new construction.) City /State l 1 p 1 ' 1 W ' C I- f t) l / Parcel Identification Number O g 0 -- i q l 9- - 00 - .:00g 1 LEGAL DESCRIPTION Property Location t/a , S co 'Aa , Sec. , T N R � (7 W, Town of Al S o V1 Subdivision CI? r , i v1 P_ 5't , Lot # . Certified Survey Map # I I , Volume 1) , Page # (J d Warranty Deed # , Volume , Page # Spec house yes no Lot lines identifiable OP no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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 pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department 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/or (2) after inspection and pumping (if necessary), the septic tank is Tess than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. statements on this form are true to the best of m Uwe certify that all state /our knowledge. Uwe am/are the owner(s) of the my /our described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number o rooms g L/3 / /a SIGNATURE OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) . .� *+w., , .. s Z .per.° N th cp 8 a' se - , • -,.. ' .,� ..•, H.W.E. Ali g • , - a - -°- ii,..ce'..S :ems' � °`� ,,►�`° `..., rpm . r -r. • ' ° 4 ' ,„ !6, 0 • ,., —.... 04 `�•,5v ,. C . AVII4 l it* ! �° #�.� • ! w� � • «w � r ...e wow aw ,rw ...MOM 0 . ...._...,,e.e.,.. _. • e tiva 4 . ♦.� °. *"f wd,,, ....... z .. L 8.O. or 9135.5 DRAINA 8 9 w \\ w Re.. E'ASEMEN; 8. e as °pli i °ii v 903. q j Y L8.O. se . F L' 4 2.659 ACRES 115,519 SO. F. z . p L.B.O. illat 905.5 OR 915.1 81 ui NOTE BELOW IC . iw•rs �..wr ...w.i ' sa } Ste' • ill fil '°Y. _ ,fi' -"°.... t � s _ Lw8.u. a L B O. - 915.1 DRAINAGE EASEMEN r IN R£ / H.W.E. - 9111 Ft 213.56' 68.79' • S89 5127 W 282.35 z I kg SURVEYOR: SAN L LA N D Z S SU UR R VEYING COUNTY PLAT OF: CedarW Estates 2920 ENLOE STREET HUDSON, M 54016 LOCATED IN PART OF THE SE1 /4 OF THE SW1 /4 AND PART OF THE SW1 /4 OF THE SE1 /4, ENGINEER` SECTION 22, T29N, R19W TOWN OF HUDSON, ST. CROIX COUNTY, WISCONSIN. DRAINAGE EASEMENTS KIP JOHNSON 1 1 f ! f WM CONSULTING, INC. NO O MER OR RESIDENT SHALL DO NVYTHNO SIKH 2920 ENLOE STREET COUNTY TREASURER'S CERTIFICATE WOULD INTERFERE WTH OR CHANGE THE OPERATION HUDSON, M 54018 OF THE APPROVED COAP90EN1VE WATER F ASOOHS 0) DRAINAGE AND SOL EROSION PLAN FOR THIS PLAT. STALE F OWNER: LE 06, ao1,)o8 THIS INCLUDES RUT IS NOT UNITED TO BUILDING AND ALLAN CHILDREN, LLC. UPON, OBSTRUCTING ALTERING 150 01 FILING OR 413 810 STREET N. I. MGM SUNG NG TAL BEIE DULY ELECTED. GMIRro ACTNO E%CAVA7ING OR PUPATING IN ANY POND HIS SHO HUDSON, N 54016 NT IltEASURER Cr SL w CORNEE 00 1101!8( =WY MAT TIE REMINDS W 60100 E EASEMENTS, VOTER DRAINAGE DITCHES, NY OFML W NO SALES AILS ANO NO UNPAID 0C1 TALES 011 TOWN BOARD RESOLUTION WATER RUNWAYS, WATER CULVERTS, BERMS CR SPEOAL ASSE99IFN15 AII O =MEWS EST . (,vn�_ uv[CIWO ME NANO GRASS mama. . INCL.. 114 THE PMT OF CF ME ESTATES. TH fO, THAT E PUT Cr COMM. ESTER., IN ME TORN OF IXM . KWN 04000 LOCATION SKETCH CHILDREN. U.C. IWT OMER, IS Ear APPROVED e( ME TORN 60M10. TOWN OF HUDSON ( Anty, / ' 00 /J 6 OWNS AND, • . 7 I n7- // -- /1/ iwtA).en.nv.,i%llv... DATE Roeon / Dw TA J. -1 S.T. OWNS TREASURER MAN CXNR 2�� AC.ACF O[ I HERE. 6R11W MAT ME 000008x0 1S A 03P7 OF A 0(0041 106 AD(PRD BY ME 2706 AC. TOWN TREASURER'S CERTIFICATE Tow BOM10 OF THE TONAL OF 1AMSON. 210 A �/ EOM AG ■ 7/111.1111111 TOWN C OOO Wu /mil /�' �i'/istP, J /ill /o6 ua STATE x. COUNTY OF ST. wax)5a o L JACOVONE SYIM, BONG 11E DULY ELECTED, WMFlED MO ACME TOW TM CLEW 20266 AC TOT LOTS 1PEAWMFA CF ME roW OF XUOSw. DO XEBEB NER11K MAT N AttdDNIR 2517 ACA GE WM 111E 110 0 1 05 w YY RR11E ME NO UNPMO TA XES w SPECIAL ASSISMENTS A8 OF l. 7,,T D w MY LAND MIMEO M ME PUT / / Oi M AN3 [STAL 11 1 1 71(D SURVEYOR CERTIFICATE b l )Q r1(YI )/ 'S ©� 1 ill a �TREA9AEA DALE I. OGNAAS 1 UM; REGISTERED WSCGISN LANG BADLANDS ROAD (L43T v FLAT Tvl• w erAS Aka Sw#n0R. HEREBY P000 MAT N FULL ^Sy s% ' I 0' 1000 CE AM ME FR011T00 CHARTER 236 SECTION 22, T29N, R79W RUM h 13 T AI.TI� 1 0 ? O' ME WSDUN. STANDS MO TIE HUDSON. 6*0 ON UNDER ti ^ i 0..807 �.��, (Nen6'444) /[ 060 ME 400 OF MAN C Li., wxR OF �9°, DAM ONE d• ME s0 /4 a• ME swl /r• DRAINAGE .W,'°•R [++DAM 191E O THE 0711M 0.F ME SE1/4 2. LAID, 1 NAVE SUMMED. OWED AND MAPPED To ' EASEMENT ,t0)., i i '' � 60344417 848.90' ' Ty N. Tv1A 4 N8950'11'E 306.00' 4 k w.... ».. GDMRN'8 0505705: THAT wDl PMT OGWE .7 TABLE •D' ��O )41008004 AJL 1)410 B Ara AT A DEANNC DIM %� n 9.Dr ]0.103' In.ea PM, IS LOCATED DADA MAT /4 MAT DI 722 5624' SW /4 NO PMT OF 111E 60/4 OF THE MAT. $ *2 ./.787251- 1•013, SEC1I04 20. 7201. RIB. TOM Cr HMS. ST. N 3 570310.5 1. 15451' 0100 COUNTY, M.N. CONTA*NN0 21.56 AGES 1 589111,554.41' 03 77770751• AL' 1 OF LAIN}, OEBUaSEB AS fWDw4 yyy A [W 42 y7 I Ku L(�T :p CCMYDIWO AT TIC SOUTH DUM1EB CORNER Cr ti 0 Ili O7 02214S46'W 18052' 114 ME _ _ _ SAID SECTION 221 THENCE 00 0 SECTION 22 TILE SOUTH TINE G' I U MEOW MEOW 17102 OF S0 SCALE IN FEET 1' -too' LOT 3 N A DISTANCE OF 38044 MET: 1 ® LOT2 Hiwo NO 11/01T- Cf --6AV Of 33.00 05ROROADANiTHE 100 0 100 g LOT 1 L -605.5 • 10 ^ 00 11. -WAY 52nr2�Tw G C F 67.00 112706 SO FT. LB.0. - 605.5 1 360 gars FIST MACE NOM MOM A DISTANCE 00 174.00 l 057,664 s0. Fr. A 0(17, THENCE 66031 A DISTANCE OF 26235 Lab T. CUSS . - FEET TO THE Mil. OF THE FAT Of HUDSON PLAY C{)@ 69a90.U� 1 I �'ffATCS ESTATES THENCE NaN WA D O AST UNE 00010 T A DISTANCE OF 1110.44 DI rem 15CE AMMO THE NOSH LINE OF SAID SOUTWA0T WM1FR OF THE S011N60T GUMMI OF SECTION 22 N9 A LOT N LOT 4 DISTANCE OF 510.80 FEET T1 ME NwTHVEST D3 . CORNER OF SAID SOUTHRE) DU7TER OF THE /..- .. -.. -. -.. 0215586 PT. 1P SDU OI 1 TEIST OlM111ER OF SEG11RN 22 MEP. MONO EASiEMENT \ \\ ' M1 0 84 MACE 0.r `.. l• _ - � -- r! THE ME SOUTHEAST OUNIIFR x661021 Amt OF E Ml1N_LANE : / O 7 .' j I €D DISTANCE OF 360,80 FEET TO THE MST UNE OF TIE • �AANG asp \, _ 1 : 0610' DIST ; 14 PLAT E 1 A ML . FUTS E 1 51755'07 10365' \ \o "� a / 20 WCE PS NORTHEAST 000 OF LOT 1 OF A COWED 02 S52Dyv7'E MAX \ t 500 Z - / . a ORANAO. 3 1 2' DA EY MAN MCC.. N MINE 10. PAGE 2071 03 52026 '497 MAT' / Y• . II 4. - - .. '" ' 9 \ • N..E . 1 FAm1ENT 1 >1 AT THE 07. CE COUNTY 601 101 ODDS C c4 DAD 197 6007 ' /- a = '. .. .. .... 9 ' .. . cN .. 8.,1524 c .N _Q - - - -_ I METIPE AIIND MEN NORTH HALE a SAH LOT L5 N695BY9T 0021' / �1 �' .: . . _2 2_22 - _ ._.. _.. _.._ 71' 1 1 106 ID LO FELT 1: D 6 N05'44YCw 111.40' / - - - 1 -+ 5• - _ i \ w � " ____ -`r ..A '..9 0 y L E � - . 1 -..- I M E THE NEST UNE OF SAD LO 1353319'W 'W A G2 500D051T IWST ��, �. • 'P ! }67 .} or 11 - I � DISTANCE OF 107.10 PIM TO 144E PONT O• / _ a.. 6 Fy D, . D _ _ ' I i ATDRE CFA 257.00 FOOT MEWS CU � � / - ' ;,. �'. 4 _ _ 1 ' 1 m • TE EASTERLY. 111111 A CENTRAL AN= THAT / / P ... �.`__ ______ _____ � � \''. Lay li 72S% A CAW0 MAT BEARS Z s ` \ ''.. or ' ........ \ \' - -- 31742773.17 6ivN 940 A n a Ma. 0 6005 airrc%MU o • S ` B . 0. . 905 " pF ,lnu cr .. \ $. LOT 5 SAID NEST LANE A DISTANCE OF 16x15 FEET TO THE 1 1 '. .. O c S E rNT.c 1, xlu ACRD MINT 0 'n DISTANCE 0 04 TO THE I I [LG? H. w e...$ I n 05.167 s0. n. PONT w BMW. 1 \ ' �.cF Leo. --1006 j .4,.. Lll r LOT 6 d - DATFIT TK TN DAY G: -i \ \ 0 T H y Bien xi di <. \ l 4� 2o 2 4 e N 3e49 s0. n. LOT 7 T L , LSO.. 9055 EL 91110 0 mama' - F� _ A J_ l oe__ '` ` L 8.0 . 900.5 w 9151 2]91 0000 SEE NOTE B40WLJLa EA.SCN007 Y " \ \ `OaF �J'^`^N�`� 11 G 00 NOTE BELOW 104.160 sa Fi. . 2AINER FED 1 LA0. . 6055 w 6151 910.0 E1 4..E - ' . \., 5w MO OMEN. NC. 0 +� ..150.33 E1 014.0 \ 12200' R 2920 OILOE 9TWLT _ NOTE: 1 SEE 1120E BELOW 9895 1'05'' 491.42' ILO a MATE IG F WLS A MAXIMUM 0 THE I J 1O ' - - - - - . MAXIMUM LENGTH OF \ , \ l V . (N8930'b "E 491.]4') MASON. N 5406 ,tip. I W 4'. WA ROAD E , I4 ", `4 .. -, _.. . - ,,S ^ a 4 7 ' DRAINAGE ' 1 2MLER \ ST. CROI% COUNTY ` ` I' 4 . EASEMENT 52146 J , PLANING A ZONING 1 \ I ' " „1 •TABLE •E• t\ 101 ' COMMITTEE ON JULY 15) 1.40. . 9 15. 1 i I . . 'A\i). 117 1 =Dm DISC ' '. 1 9,x, 0 1P5J /' LAM . 9101 Y61.10 WA .) ?t8'd9 Er S6931'05'W 207 if O SUHVG :' 26, 2005. 1 1 F2 NMT6'IS7 "' 1.07 ` A00 EASLNEN[ ES SJ9W 1ST .a r - - - -a r " # 8093 a -CT . NNE. 4411 DRAINAGE 73' MPS OFFICE EASEMENT 1 21x42' PS ' ST. CR0 CO. WE TABLE I 509451'27'W 28235 i 00 NIJ - 2.H..E B19.em WW �3'bIb I euRWC ml: . g I j! L.o Rv 569517]'' 17x48' I 1 ' I v1 I'2 '45YJT 1JSN' 2 +n��� tl of F NVJ ( )J35T 14).90' I cYUWG9LQ.'Q'I7AQ;T,ci m l '15) 1'll'C,.. -,0 )JDJ'S5T MW' - - - -- NaiTi ., 0f.4b1all FS 56 3: T.LT PAW F6 55517'191 Am' I ( �A�.� M yy1 N + I " sl6 • I B LANDS ROAD g NO f 1 ...diA. " , TI 1,_ f ° L AEG55 ff • 22 228 _ • ''L S 2 . ]0341' - J CORPORATE OWNER'S CERTIFICATE OF DEDICATION 36312TW 2507.03' G TRDED QIIIERINF SI •WR. SOUTH UNE OF ME 001/4 EEG 4 22 ALVN CMNOREN, LIT., A CORPORATION DULY 0100605 AND DIVING WOW AND BY WRIUE or 00 UK OF THE STARE OF WSW119N. AS 9E 410 641 y DESCEND 0009 HEREBY 1045 P TO I THAT SAC CGOORATIw c THE LANG ST. CROIX COUNTY PLANNING AND ZONING COMMITTEE RESOLUTION - i - ZP1'I_Y : WTaBm 0.H TIKE PAT TO e[ 81 SAC N ONE, . CAUSED AND E LAND LEGEND AS REPRESENTED w Ma PUT. NW CNHDRDL IAA. CAWS PURIM RROWED: THAT ME PAT 0.F =AMASS ESTATES w 110 TOW 0.F Hu0sa1, ALAN cm... Dcm... u0.. _ [�A,e _ TOTING =NS =SEW. 0040 1.4111.7 CERTFY THAT THIS RAT a RE011RED BY 8.216.10 w 32]412 ro BE ORNER, 1s HEREBY ARNO. TIE ST. wax CONN FLANM. AND ZONING CGwOTEE. SW WTIFD TO ME FOLLOW° FOR APPROVAL OR 04ECTw: TORN Cr • mum V CUTS. G7ETER IRON PPE WM. Ala 0.r. CROIX COUNTY PIA.. MAO 2.1. 1XWW11EE ;,0 ' / � , C� PiE o 2 -3/5 DUT9CE WARIER RDA W moms %06001 SAID ALAN CM... u0.. HAS CNN= THESE PERSON r ' !l/1r 9 Mme -� --d. o 001 2 2 PN NAIL A P TO BE MOM BY DAM 0.))0, MnOENr fl: I 1 SET 10 /6 01815E DIAIETER BY 18 ` `7 is D PIPE W]b11N0 x65 ILK PEA WEAN FOOT 0 WON MIS DAY 01 A„ 60J° / / LL OTHER LOT 1' OU 80 ./i/l r2 7 -/1 CP6 A wUNEmRFa T COMM, r 00516E warm e3' Ir lOw w nE PRESEPRESENCE 0.r. *0 )) i Ww PIPE VEIGIWO 1.13 US PA WEAR FOOT DBECTOR DARE MUM SETBACK (50 ARON RIGHT-Cf-WAY) - - KW /1�CMTDRBN, LL,1C� ' - -.- 12' W( WOE WS EASEMENT ( ) ,, 4Z CURVE DATA TABLE (ALL 01015s ARE N FTL1) EHSW10 ED. DA. ALAN. 60 CO OTT 0Am Rep. Cm. N'N Lee 1. 11 4011 6 9 006 Mc Roam S.••+'9• PROPOSED OR8wAY Lr.0 (0355 M (6003 Out - ( ]B617T2'6' 2 20' 1772.0616 44 20.5 (16aN)pu1T) Ml53 . CI 257.00 S112YM'N• 1500 06636.06'7 016 Mo'a 6002707'0 STATE OF \ l I 1 3 200 ROMMT 1173 7s1173 11455 120.50 NSY2.111 860'47044 H.W.E.. 9025 ow man ELEVATOR COAT(0 1i. Ew fey 04 167.00 5110'04 560'26'264 104.61 149.50 30047044 06784'124 - ARE 10770 PERSONALLY GA. BDCM 1I0 • STRUCTURES MAY B Art 2fti NAY . \ C5 50.00 45V4'10 NN•22'074 81.32 6293 X6,64'124 N22'60'0YE T . ! 2006, DAVID ALWN, PRESCIENT 0.i THE ABOVE ME C5 80.00 60 O'205 H160 ]77.18 442230024 1 07M'L'W ( ) RERECORDED BERING 0 INSTANCE NNOFN TO BE THE PERSON WC EIEOIWD FOE•• ,"" ' . TO MI0 2 60.00 600'21' x5212'N.S1 80.11 63.90 02 17 552230024 50236']14 L" .. 5015 1046 1551 04410 . OPD70 - 111E TO Y ON. AOMOE 1 W 1E SUCH MOMENT Cr : x " . . 3 90.00 03721" (7435'46.54 6244 64.35014 55137084 ME AFFECTED BY MULTIPLE LB. 211103 DDON OEYAT *0 T TUT NE DECO= ME • • • • s_ ,' ' •.T - 4 80.00 warn. 325•('524 <18.51 70.80 351'17064 3603)604 NOTE: 16.0. (LOWEST BUILDING PRE90DlT AS THE RID OF SAID W WwATW 8 Try' ; 5 50.00 5 250 ' 52514'54.5(' 6926 71.65 30024'164 0501225.8 OPENINO) 1*04 RESTRICTIONS DEPENDING UPON THE PLACEMENT OF THE SMUCIURE \ \ 6100 620'57 36136'2157 6246 42.66 5S0l4'25W 5 07M'b"W ' ' ' ' { - . ON R EDIT. ELEVATION SHALL BE A E9NE FOR DETERMINING PROPER NOTARY roam. co 6 60.00 4504'15 N6611LYW 20.12 2 068 sero NECAIT 357 YW ILL STRUCTURE EM ELEVATION AND TOPRIT ME NO SIZE AMMAN 0 •_ CAN 23100 5118'44' 1111628 154 75 20467 soo YW rrour AIL 24170 0 ARE MOWN= TO TIE NORM AMMAN 7 21100 174721" 56T7525'W 10625 507234 rs 67 5701727'' WATICAL DATUM Cr 153'. 0 27105'16'57.5.0 YY C06011fii01 - - � �6,Y GO 100 201434 05.62 50.0] 56048'200 N604704•W CB 147.00 27A74T 447338'07S0 56.68 42.65 56•47/00 360]7OR'W THI9 WSIRUYENT ORAFTD 137 VAW7 MANE JOB N0. 6N6 DATE 03/6/20'