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HomeMy WebLinkAbout042-1046-50-150 (4)lUnt�tr ST. CROLY COUNTY ZONING DEPARTME 9 S / AS BUILT SANITARY REPORT Al owner D� 1'1 a.ov...,v,a AiAY� `ryFD Property Addrme /00S jooa A sr e GN/Smm ° 'Fi ,i,2r4qN$u,'F� F Legal Description: / Lot _BloBlock _ SubdiviR L6M q C NW'/. NO %, Sm. f]_. TA1`N-A/®W, sown of Wo^...... PIN# 04S-104(.-{•- SEPTIC TANK — DOSE CHAMBER — HOLDING TANK INFORMATION: Tack menufacbua'*1adw o.c..P /pC/.Low//omsctback from: House 9_ WeBIL_P/L_ Pump manuficturer 4" oa. Model N/oo-0 Alarm location #d '.dy, Z..:➢., .,.p„-, - d.... It-v^^af+ m'-sgtt,......tot,t.p•, AMZ..... i.wo 8'^8 Wrow p.� Setbacks: Service road Vent to fresh av�Wake��— Water Lino Mona location Alarm location SOIL ABSORPTION SYSTEM: Type of Width 3'1 Length / S 0 Number of Trenches Setback from: Hoaoc _ Wello P/L 3,0' Vent to fresh au intake # ems., al v... �..i t�•#wva ¢ ELEVATIONS: �y 3�" ' Descriptionofbencbmark t.ma-6: y - � Elevation /oc, Demripron of alternate bencbmerk .os' P �j t.„+„*�w..ab o ++� Elevation 99. a 0 ",&,.-Mal:4A . 9d'C..,.+:,.AAA7a 94.3y Building SewerB4 o J. SVHT Ides B8. S'7 ST Outlet8 B .3 i PC Inlet 8 ®• PC Bottom 9 4. 4 T Heedur/Madfold / 03, 19 Top of ST/W Manhole Cover 9 . Y Distribution Lines (l) 105.11 O ( ) Bottomof Syatm( Final Grade () () ( ) Date of Installation LJOITIPermit number 5a4 67 %., State Plan number II2A f 1 Plumber's sl c 1.J Liemse number AAT-1 d 0 Date Inspector t Enemnelnownmenlm wmnac. PRIVATE SEWAGE SYSTEM sdeyw euilaow GordonINSPECTIONREPORT GENERAL INFORMATION (ATTACH TO PERMIT) vwwnY Momlelbn youprm4enW auua MeeuurderypummealPnraw .8.tfiwl7lfmd NON aA°ImEeS EL tg age a no. mTBMElis Dr'. plop. GI G VGTION DATA 3:7503Y11" -AL4e.hs "MET. CNOIX Sey ° 3 10a6-50-100 A9800563 TYPL MANUFACTURER CAPACITY STATION as HI FS ELEV. Septic IAT•aI zfm Be c p if 261 IL1 IOG7 owing / ittt 9e R-L (11. 1N Aeration R'LXN Bldg, sewer IDS.Q'0�' Holdin it'Inlet p5, . I 8'Y.$% TANK SETBACK INFORMATION S /It outlet /DIn 17 8fr3 TANKTO PIL WELL aL G. gnlnub ROAD Dl Inlet D$.A 17.63 ST. / It Nor to NA a Bottom !K 71.23 YV• y Oosing NA Hastert Man. t{L2 Jos,{ Aemtian NA Dist Pipe fu.Z 8'03 105,1 Holding Rot syulm PUMP/ SIPHON INFORMATION 5, t¢M,P final Grade Manvfdeturer Of lit w �Demand Nl O TLi GPM gH F 4 S.'jD /OS•b IOU Motlel Numder atU"•'4 TDH J �$• FriRiorlS.S s term. TDLQ(°,7$t d'S. ib 1'>i• ND.A1 �y Dl•• Focernmon I LengmHZE' I Oia7 Doo TIWIII <4 SOIL ABSORPTION SYSTEM A14 ABA /DS.�11.= ew-Vor BEDI ENC Wmm F Ienem r No.orTmmer PIT DIMENSIONS No. or To Imideoia. Loua^mn SYSTEM TO P/L RLDG WELL LAKEiSTREAM LEACHING no mor WIDE" CHAMBER a Nom INFORMATION N Y/ y 00. UNIT Earl DISTRIBUTION SYSTEM Nee M)r� r son epe e e Hoe sound m oAlrlma me1F I(1 o w.� engtn pia. I /> SWI Nar wrl S SOILCOVER a Pressure Systems Only .s Mound Or At -Grade Syrtems Only D.pnovm term or a..aadrmee.d .mwdwe arenm�ceme, em IT=Edefo Tomoe or. ON n ❑re ON, Pmo lfa COMMENTS: (include codediscrepandes. persons present, etc.) 10.77 gay✓ 12H 2 LOCATION: WARREN 17.2 .18,14il 1005 �GOTH AVENUE 1•�T 1 tea.» © Piowtll./ -.Uhe. I0.77 r00, 6ai 4r6, NRa eDaua(-'�•iWp ,,00 ea.Q=�Vau %r 71 fuA 1 buyld �e H.f �LI aft Gwsc Itclyl�hli.gv- T•P'O� wonsEI ,Te i ga6Q�ln i "at No,.G i a' At Frye 't Uow{ey.vh61`,'M�"cwi �-L.lcd/A1-Gr*c..E C*-P'aaT" ��� Plan revs whefor add] pYes �O fP /I(1 PUse lanother side loratltlitional information . LJ_I�CLL Imcenoiasi N 58681101P.SH]) 01m � I 'I' WaterPro De-,,. H 4-„.,d.,,,,_. 6tat TD 147 A;w 1 4. — 343 a" / r on ib Y b' 5 .Pimv SS � 3=3y. Moreno Supplies Curporalihn I5WlW 18I1151laM Eden Prairie. MN 553EH1894 Telephone'. 612-937 9666 WATS. W-752.8112 Fax 612-937-8065 co ;rn/1 iiii<r sa10y oa emla,a water Sco ©IWH SANITARY PERMIT APPLICATION µZid,n9wCM s, in accord with M1H R 8305, As"a.[We Scribe 69drn<re Mani w15320) M69 complete To a county copy Ondo Tor me Tys ,on paper not G(O cparri loan no x 11 inshossinsithe . e Sae reverse area flat linstructions; far completing this application a sa iby>aarrjalfffera�borr e lntormmree rat provide may be used byaNw go,nnmem agency law rams pa4Ma i mmwuyn�p ohGpdu�Rn IPnw. .o . cr LawsSol eel .1061 1. APPLICATION INFORMATION oI Propenyowwrxame All- 11jor m u are Low f4i T ,N, E(Or yowneu Mani.0,{� �y Platt Mal lM YE t+ Gy.S t barrel P ""WIymp�eee�� Suatlxinon Ham a or CSM Number a (j/S1AG�TDEB :(che[xone) ❑State Owned J it xed vubli[ tOr2 FamilyDwelling-No. of bedrooms i 9eo Arco Ill. BUILDINGUSE: u11,11 gtype 15Pi check 0 able apply) °T=" .1hon) P/ u EY(2 —/DM6— 50 —2 D 0 1 0 Apartment/Conde 20Pepsi Hall 60 Medical Fmil'Ity/ Nursing Home 100 Gabber RecreaVMal Facility 30Campground T O Merchandise: Sales/Repairs 110 Rmmordm/6ar/Dining 40 Church 15chool 80MomeHcarry k 120 serviceStation/CNWesh 5❑Hotel /Motel 90Off¢e/Factory 130 Other: scenty IV. TYPE OF ERMIT:(Check onlyone boronline A. Check of on line a, if applicable) A) 1. ew 2, 0 Replacement 3. 0 Replacement of 4, 0 Reconnection of 5, 0 Repair Of an ______System..... .. System _____________ Tank Only__ ___________ ExistingsYstem______.._ Exialin45xi R) ❑A sanitary Permit was previously Issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check onlyone) NOm0.esur"w DiahiWtion P %dD6tiNtion Evpermenra/ Other 110 Seepage Bead2101GlOund 3005pecify Type 410 Holding Tank 1203eepage Trench 2201n-Ground Pressure _ 420 Pit Privy 13 0Seepage Pit 430 Vault Privy I405ys wn InFill VI. ABSORPTION SYSTEM INFORMATION: L Go Ions Per Day 2. Absory Area 3. All Area 4. Loading Rate S. Pert Rate 6. System El¢v, l Final Gade Elevation R¢gmredl .Ill PropOsetl lsq_hJ (6alartl sq.h) (Min/inch) / loco sm 3 a rs>.et D VII. TANK INFORMATION pllons "ga Total IF of Manufacturers Name crab. s Fiber. Eve New Existin LIT if Tanks Gaimns Tanks c c 9 �nd 1 glass APP 2BPaycki Lift Pump nE v 1 1400 Vill. RESPONSIBILITY STATEMENT I, the undersigned assume responsibility for installation Of the farate Sewage system shown on the attached plans. uate;raame'. Van llmTriennial or � P mMr y/5=7l/fir 12-2 ar-evi - .mpre SAd a eeayrr. met: IX. COUNTY I DEPARTMENT USE ONLY ❑D,capprovetl Perpp ee enue me'40".an, 'gApproved 00wner Givenlnilial e�a Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR 015APPKUVAL: Surely um oweepa RAVWARDW156*-810] ` isconsin Taemy G.Thommzt, on.Gover Department of CommercePhilip EM. A16u1, Itling Stationary Oct0harn, 1998 CUST W No.259518 AM P0112SMSP£CTOR ZONING OFFICE IILBRICRT AAS801]ATBS ST CROUt COUNTY 05 CTIEM RO 1101 CAIUAICHAELRD HUDSON WI 54016 HUDSON WI 54016 BE: CONDITIONALAPPROVAL APPROVALE%PRIES: IoR]rzDOo Ideotifiution NUNbeR Transaction ID No. 182612 Slk ED No. 162217 STEE; Plaee mfmb MWitlentifiutiwaumbae, She M: 162217 tabu well corrc wiW the ST CROIX CCuner, TCwa of WARREN NWII4, NW 114, Sp, T29N, RIBW DAN RAMANN RESNENCE SEPTIC SYSTRAd FOR Description: MOUND SYSTEM, 600 GPD 0bjeRType:POWT8oS= RegWatrAObjecal1 431220 The mbmitW due Led above Me been miewetl for concurrence with applicable Wncomiv Arnie" row Coda used Wisconsin Statutes. The submihul has have CONOMONALLY APPROVED. The meal, as defined in chapter 10101(10). Wiewww$LLNkv, ie rcspomible lOr wmptimce wiW tll tOtle ttquvemevtl. The Rabbinate conditions Shop be ever during commuction or i:uWlaboo One met to ofeupaocr w ux: 1. That sea, eNon Is subject to designer com:rovh an We plan. 2. The orientation of the mound system must W such that the meantl4 longest diewasbu is perpeodkWvr m the direction of mulmum elape. 3. The area 25'below the dowrslope edge of the mound most remain undisturbed. A copy Of be approved plume, apaificatiom and thit ]error shall be oo-eik duntlg cooswetion soot open to irupectioo by euWovudrryrawmlivev ofNe Depu'me ,whicM1 maYircluae local iu+pecrors. Allpermie rebound by 0e amk or the local no:oiciWliry shop be obewed poor to comreaeOem of P.O.W. wmlmmtioaimlauatimwmpemdmn Condifi Inquiries emaemwg wacoaa.Poevawa may be mwemme at the teme lepbevamberbeted bemw, or ntdk.amata sun dds 1eNnhad. Ap BbmcerzlY. _...� DATE RHlFR'ED I01311998 MFNt 0 pro"o,<Nt `/.^—' / -Lime Mnq.�n FEEREQOIXBOS 180.0) SEE CORR PATIMS OFF,P NWNREVIEWER FEEREC131 O$ 180.W wtegakd Services BALANCE DUE S OAO (]15$34-0810, PA%:015p34-5l50,M-F7,45A1e-4:30PhI PSNANDORF®COMERCESTATE.WI.US ULBRICHT & ASSOCIATES CO 655 O'Neil Road, Hudson, WI 54016 715-386-8185 OCT i p ro�fon.. PROJECT I041VI1• DILHR Plan I.D. I Date Owner 2AN /11tM1t1VV Phone 715-306.7898 Address J607 /}SGE'.v Ae. #L/ ffuOdd✓ w�S54ot4 'Legal Description Gsy SGSZ SS. 00%/zi Py.. p3 yp 0/A/ °'1,T NW N!U°SEc. /7. Ts yA✓ Town of County sr-ci 0.5.T. �OQERr 21LQRlcI. T-124315 Installer Local Authority/ Supervision 5T cNpoex Cry. Z0A3 A!i DePT-. PROJECT DESCRIPTION New `o,�srRu�ro„/. FOR :F PROToor�a S/ t3jwM, sr•z e-o //a aye . Goa &s,fs. ID.}ic/ lots7�F/ow . (.z/3 GFOYr/.'-). 2�.L- Ma�T' iavtvr%rr� sa:c Resrxi'[iO✓ 115 o0/e /'K C CyEUICep Li yESin {� . o r Zb ". if vFz y GewO rN E��� fow D xa IVED - i ixw i.n,ww PLavo P9.t PLOT PLAN VIEWS ENC P7 /�_ q III � Pg.R SYSTEM CROSS SECTIONS a SYSTEM PLAN VIEWS MIN Pg.) PIPE LATERAL LAYOUT O`--...-/a " [ctA$ Pg.4 DOSING CHAMBER CROSS SECTION 1.'J M$ _O35glOj�l ” 1o7'es so i& oyai� si by I J I — af �� hs ` I;Igpa Hems Rim ma�l� aoi�osry �N s� @p� a0oµuuo@ Ili a IR 19 3 Sodoad P O Sod°� i � p�sodod'J � i/YM �-9vr N20 maw i ZS'ro/ l/'f arcs „he yim rv�uVn313 '15A5 %If Oc+'n°N Lb15399n5 t S(✓41kn3/� 5N115/X� = 0 slid �l�tr :. any �c oo/ •,INU£RT of InTERAIS 103.0E 'Qq, 20f5� r qdd rtlP °F InTEkAl5 /O3./4 • Topof Rxk lo3.3y` sysreH Straw, Marsh Hay, Or Synthetic Covering Medium Sondes /DisIribelion Pipe, Topsail (/0 % Slope Trench 01 1-- 2k Force r Aggregate undisturbed Sell Cross Section Of A Mound SyJlem Using L 9EpF4A1E Trenches For The Absuriellon Area A it Ft. B G3 Ft. C (o Fk. K y3 Ft. L /58 Ft. J Ft. PosiHod of Force Main I Ft. V Ft. L Plowed ��• $Z Layer g 2.O Ft. E 3 d Ft. F _ Ft. g �'-0 Ft. H 'S Ft. —M f w 1 Observation ">- Pipes Yc.x. vEUT PIPE L5'EROM DOOR, MUDOW OR FRESH AIR IRITAxE 4FAvr 6/ Rn �vs O f IEYA Ll•6 IULCT APPROVED JOIUT/ I R qC.Z. PIPE [xTEUDIuO J' COTO SOLID SOIL LLLx 9q'3° FT. PUMP CHAMBER CF055 SCCTIOM ARID SPECIFICATIOUS pAle l nP WEATHER JUUCTIOU GRADE PROVIDE AIRTIGHT SEAL pl000l py35 yoR (3, 3'� LOVED LOCKU G WEE COVER W/ ao#ojv% Am/ Y'MI1l. „y Ie'nmle.�nlCu• OLD GOIL ou �EVPi� RiStK E%IT PCRMInCD OML4 IF TAM MAUUPACTURtR HAS SUCH APPROVAL 'USE 3 �oC Na.Pc' EF SA.WD �Lq.EI(r BVTIct SOECIFICATIOAIS DOSE HR0Ea�kMA IgAe 7- �' 3 TAUW MPUUPp<TU0.E0.: IJUMOCR BOCCSI PCA M9 TAMA SIZE: /ionv­D GALLDAIS DOSE VOLUMC A& ALARM MAUUPACTURCR: W�� �' INCLU0104 SACRnOW: T�3D GA0.DUS MODEL UUMBCR: D'V L' CAPACITIES: Av rG WERESO0.f'OVL GALLOWS SWITCH TYPE: N�E{R}ryti'p✓ �/J� B. PxH%&OA SoALw Gus PUMP MAUUrACTUR[RI �'�.".�.�s� �Y�'E C"� C•7'z IW.Hts OR Zp0 CALLOUS MODEL UUMBERI f'I� 7Z/ O•�IACMfS OR �C_ GALLOWS LCH TUPt: ass✓aArK Oe. Fio+r SETS: PUMP AMD ALAAM ARE TG at MIUIMUM DISCHARGE RATE GPM i�WQS/TAL�•S U SEPARATE CIRCUITS VERTICAL DIETCREUCE CETW[CU u P Grr AUD DISTRIBUTIDo PIPE. FEET/ �AAxk SPECS } WI UM UCTW00.M SUPPlYP0.f66U0.C........... 2'B FC�C�J� EA TTP-A } FEET Or FORCE Muu x1'GirVonPRItr1DU PAno�RT./T-p/ s�L4 p4�1s 1lr y/I FT' TOTAL D9U/IAGMIEo HEAD = •�=\EET�', ��A p JAB IUTERUAL DIMCUSIOU[ Or TALK: LEAIGTµ eP x' 1' Io. �G �A ILIQUID DC/TH yO A, HEADICAPACITY CURVE - J"°` f"'^`P°' EEMMM�meo,®®mmmmm ® mmm®mv- m oEEEE�m®mmmm .1\...�®ommmmm pMMMmmii �® .eaa.n�SSO ■S SS�' S ON M..ELI..�a_ Lis ■ammmaam .\\."�m�m��� �oiiimoo® �� MEb\I��SmSSOSSSSS SSSS �SCaSSSSSS \`qqll�\ININNON l�m®m���m�m� �... 21% DO so ON O\MGIE\OEMM None E Mo\M110 N MEMMMI EE 11, VQIEI►E. MEMEMMEE MR11111 0 MEMMEN \3LIE17I INN REEEES= su►u� oMENI E,Mcsnn►.uuuM Ew WIN �0WIN ►go M.a.N= \MEM . Lis4111 0 116 4KNE ..LIME. 1101 O.■■■■■■■Om�m `� m m moom� ■■N\.■■■■■ammo®o \.■.\\■....�Sm��p lNo .■i\� 11 . 0 000a \1S■■■CN.,S�_ _ MIRE =■►\■■����■■ ■■�■ ■ ME40 Series 4/10 HP Effluent and Drain Water Pumps Performance Curve M000. W40 EPPLL PUP CAPACITY LITP PER 41N 0 50 100 I5O 200 250 300 350 40 12 35 0 N �i 30 v 25 B 19� 20 6 I 15 f 4 O 10 F 2 5 0 0 0 10 20 30 40 50 60 JO 00 90 100 CAPACITY OALLOM6 PER MINJTE F.E. Myrte. A Ponli it Company • 1101 Myers Parkway, Ash iald. Ohio 4499S19M 419/2WIl" FA%<I&Y80.WA TeIv98-0443 SE✓/��Ol+/NER: EGOO �y��y,.'�yt/ w a"' SOIL AND SI EVALUATION Pass DMMPSNeryuP euNeps In amodance•oth s. IIHR&R.gg• Wis. Rne[h Wrgele 4bgnnpparMkes Nen 612v111rcMeIn Me•. PMmuq �'Y IZNH. bvl rrtl XMleV b'. wgaleMhMmr�Mmuuaglnr (BMI, tlIrePnnwq WrmlticY. KeNaroAnwmxne.ruN Ymx.WM'elbiYq PMncalo neerxlmen. PemJ I. D. n _ O RPPLICRNI IN FORIMTON - Plaaaa plot all Mlpmallan. mw mrywwkrerowrvwma®rymervw.e ro-w lrl lmll. rG 9 i ppvserly� Boyelk :DAIQ }AMA NN % �Wire tuN rvwc x N.R EIuQ Rnpvly 0eri•la MCNrq Mbena �I NxV SI Num /00� /fvE CSH F P•' b' d Yd A4e5 Dlh Sole zb coa. Plvn. Naneer RoBeerS COL 55.,v"3 01S )794-3703 Nwre.r Ph•n �uM e 7 /F. il✓=' (y NexC wN Nae. LYPxNantlel/Nuruer olpNlmlu 3-11 .y®nn peWtlnBba'Nlry ❑RePleaemml ❑PUNCMLCMImmelDowdim'. ! cw tl«I..amn Mn {;O uvn R.n mll.mee E.lm melm rm �eea,uf 3 nnn�Pm�wrenPree C'Pv I-r. n'�w�m, n:.. Mwm�we.nPruwnauu Vim: svP*' �3 u.lm.Wmi —Jn usmn.gp+ n.P,n.I.raeelnnnemr.nn.n.a.,eenl.liQ .3 �00-. si • nc.. umlea mw.wn M.nn.ln eamnorl e.nWgN.aub.l.nn• sire' S0 ArR/F" "—+ a�W f:'.e .v0v�O srsT. Poem mm•nN%C 57 Ai .PPGF%Oy_ ReMdgn Nmuean. x.oPilobe N/i} n 6 6WbdeM �MtN 'LI'U M�aF/P Inol R njnue ❑V RT-0rW Spuminn"I IMPry Tvk I ❑8 'V VneNretlagwyBlem ❑8 L`ls ❑8 IJV QS ❑6 [Ow Hotlng # 13 io BOIL DESCRIPTION REPORT NONn uedh In nwomnt q rMWI wtlbe Du.SZOX# zbr slmeture Or. Sz. Sh. &XOXMe �x apivv2 W.Tm'ch / o-y 10YA 3/3 5j� 2msb,e &A Cs 3IC �- -/5 io re 3/3 5/4- /fs6K dS4 c 5 /of . z . 3 /-/ /0 Yle S/L /fs/ .n. fR C5 .3 /o c 2.A CL. zsya s/ -?P 7.56 cz SL /f na GKY t rYR SleeI Remarks: Aret- /J! *I Vjrvlm&4E �y i%e lelaelwP yY7Er/ o� sMEMM"MmM� ©�ms®MMmmr�® ©ems®�!r®® M"A�-RM OR"Mm, If=eWN �.. RanrerFe: B-.P. .PESTRi�T o,,. M Nune(I PrMI squne• Taegana W. -Rc Rser 7.11b Pictt.T' FMf TiCP,.a -rlc. 2 or_.R/ac /O" f, it ._ pow D2hVifE� wRr Z AvoiO 7�.- A2'F.Y � w ------------------ (� PkoPoseD 40T M' Si7F 1.0 4ke5 "r yQj Iy PRopoSE O ^ HO�SI O � SCAGE: �"' 30 P%rs 1 9 � c ER/ST1N� f/EVkT4Nf CfAwTs) gY • 6; S U(>(ESTqV NOJafp J/' SY57. EIEVA-nv✓ WA ay" se.Tv fill ` as m ioa. sz ' SoLOT AeokSaP 5w LOT gH ScT .I-T i coR.�e LOT 4rPJA' . T4 ST CROIX COUNTY SEPTIC TANK MAINTENANCEAGREEMENT AND OWNERSHIP CERTIFICATION FORM �uyer %%/" ,I,t/ YA Mn NA! /t Mailing address 14,17 een !ripe -d L � p� Ih)ol5n GJ/ 5y01 Property Add= /005-/00"�Ale'Xober{5 Zd SHOZ3 (Venfwunurequirte gains Forms" pyanmem for now eaiswnion) aIAC. LtihStal�d{pli5 �p Parcel ldentlfiwlion Number U'^/2—/OY6—SOi��. LEGAL DESCRIPTION ��''� Properh Location '/., ,� /, Sa. T—VJ—N-Rjff,,I, Town of p I L A A a a Subdivision IAr a �. Corned Survey Map a 5G�' Volume 42 Page a' 33v8 Warranty Deed 4 s6 Z SS 9 Volume I A2Y . Page a . Spec beau ❑ yes ❑ no Lot Una identifiable F�yes O sw SYSTEM MAINTENANCE ImPmPeruvemdmab¢nevttofyomeepecs}aremwaW rtmlrw in prmaauehilurtbhaodkwuttr.Pmpermabremoce eootlN ofPompiog mntlre tepee dote every Wrs Yurs or waoR. Qoeddby aliamed PomPer. Whir You Pu[wb We ryekm cav eQecrthe [uvctiw of ape eeptic dote u a beamemsage w We weak Nryael ryalem. Tim PropmY Owens agrees b transit to Ste Crew lAOiog Imp&Wleut a "reification form, sigma by We room end by a mask[Plmober.loumeYmenPlrmber.rtrtrickdplumaermalicevulPumpav<mi[pvgW[(I)Weovsikaatlewatadapetrlryzkm u is Pmpm rPmamg ondleo au d/m(2) aett inspection used pimping (Qv"msary), be srpac lack is Ids ban Ili full of sludge. Yw; Wv undersigned have reed do abov, rtquirtmerk read agree as meiebiu tax tomato emerge disposal Memo was We rbuali anand, be"iaan WE by we pgarmentofc®mmeeread We Depnebeeot ofxalund P.emormse, Sate of Wivawiv.(�mlificaeon sating@ brow smec status a a men wina�mutt Im omp4kd and rtlwoW b the St. Qeu C turfs Inning Dtfiue wffiw )o �..y teds beyee reareReineon are sal SIGNATURE OF APPLICAM' pq]y OWNER CERTIFICATION I (we) "defy tine an Mkmmn OR chin fore am We to me Mat of my (our) koowkdge. I (we) an fuel the uwmrtx) Or rise PmKm attended tumor. by sveue of a wamory deed recorded in Register of Dells Once. p SIGNATURE OF APPLICANT DATE rear.. AVY infoedmlionrhaauntia-dePreamredmeYresuleu WesmiarY Pedmil Miogrtvok<d by We teeing DeParenene.""" •• monde with this application: a stamped warranty deed gram the Petitioner or Deeds Off" a copy of be eme9ed survey one Qrtrere=is ode m use wamrty deed