HomeMy WebLinkAbout25-38S/f,;."'^ ^S-UO^b
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Industry Services Division
4822 Madison Yards Way
Madison, WI 53705P.O. Box 7^ \^ (Ta [^ [|Madisor.WlN^ [[s ^ 1!
County
Bayfield
!ary.t(iry Permit Number (to be filled in by Co.)
SS- SSS
Sanitary Permit Application NAY ° 1 202 •j StajtWransaction Number
In accordance with SPS 383.21(2), Wis. Adm. Code, submission ofthis form to the appropriate governmental unit
is required prior to obtaining a sanitary permit. Note: Application forms for state-owned p6W(lfeltifc teubmitttjaitity
the Department of Safety and Professional Services. Personal information you provide may be used for secondary
purposes in accordance with the Privacy Law, s. 15.04(l)(m), Stats.
US^jbct Address (if different than mailing address)
2388 Raven Ln. Solon Springs, Wl
I. Application Information - Please Print All Information
Property Owner's Name
Edward D Hoover
Parcel#39408
Property Owner's Mailing Address
PO Box 24
Property Location
Govt. Lot
City, State
Maybell, CO
Zip Code
81640
II. Type of Building (check all that apply)
1 or 2 Family Dwelling - Number ofBedrooms _2-
D'ublic/Commercial - Describe Use
IState Owned - Describe Use
Phone Number
970-629-1441 -'/4,_.'A, Section 17
Lot #.45 _N R 09 _EorW1Subdivision Name
Block #
CSM Number
#2359V13P351
Qdty of _
IVillage of.
TlTown of Barnes
III. Type ofPOWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C if|
applicable.)
A.lew System (Replacement Systen >ther Modification to Existing System (explain)[Additional Pretreatment Unit (explain)
B.|Holding Tank I In-Ground
(conventional)
I|At-Grade I Mound Individual Site Design [Other Type (explain)
c.Renewal Before
Expiration
Revision [Change of Plumber 'ransfer to New Owner!,ist Previous Permit Number and Date IssuedNA
IV. Dispersal/Treatment Area and Tank Information:
Design Flow (gpd)300 Design Soil Application Rate(gpd/sf)
0.7
Dispersal Area Required (sf)428 Dispersal Area Proposed (sf)452 System Elevation
95.5
Tank Information
Capacity in
Gallons
New Tanks Existing Tanks
Total
Gallons
# of
Units
Manufacturer 11'§ _§(S 0
Septic or Holding Tank 750 750 Superior Precast
Dosing Chamber
V. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print)
Jason Kuettel
Plumber's Signaturj MP/MPRS Number675751 Business Phone Number
715-798-3355
Plumber's Address (Street, City, State, Zip Code)
PO Box 66 Cable, Wl 54821
VI^County/Department Use Only
Approved/n Disapproved
D Owner Given Reason for Denial
Permit Fee
W^ &o
Date Issued
<^/^5'rnfoL Issuing Aj^gnt-STgnature /
'^A/l/f' :/^!.,/'l/i^
Conditions ofApproval/Reasons for Disapproval
5^ (^^a^-A^t ^G^ ^
^^A r-
Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x II inches in size
SBD-6398 (R. 02/22)
SOH TEST.^' 2S^-^
^s..~%
^•^h ^<^ Wisconsin Department of Safety and Professional Servises
S^-oo7>[^
Soil Evaluation Report
in accordance with SPS 385 . Wis.Adm Code
iujillEi il
^ I
MA'
i!'^
Attach complete site plan on paper not less than 8% X 11 inches
Plan must include but not limited to: Vertical and horizontal
point (BM), direction and percent slope, scale or dimensions,
location and distance to nearest road.
Please Print All Information
Personal information you provide may be used for secondary
(privacy Law,s.15.04(1)(m)).
:hes in size
il reference
lorth arrow,
>urposes.
Property Owner:
Edward D Hoover
'roperty Owners Mailing Address:
PO Box 24
City
Mavbell
fv' New
Parent
Seneral
System
I- Replacement
^
icement
/laterial:
omments
levation:
itate
Co
Zip Code81640 'hone Number:0
Number of Bedrooms:Residential .—..—. -. ^—-..~.
P Rjblic or Commercial - Describe:
Outwash
< Recommendations:
95.5 Load Rate:
2
Flood Plain
0_7
Page:J_,i.of 6
.U! ii! H..J ';,..°1;.'),';ounty: ' .- . .,...^, „..,.
Bavfield
'arcel I.D.
39408
!eviewe<^B^//^7/J?late:7/J? J^/^^
'roperty Location
S17,T45N,R09W
Site Address or CSM and Lot #
2388 Raven Lane ^.,7 £^1 ^3^9
Town
Barnes
learest Road:
Raven Lane
Flood
Applicable:
Elevation
Code derived design flow rate:erived design flow rate:
'lain if applicable
0
o.ll_Ra_na6., 92..33
Ground surface Elev: Depth to Limiting Factor:Bor.1,7 Rt -—.---^--^ ^^^..^^......a.^^..^
Horizon
1
2
3
4
5
6
7
Depth in.
0-12
12-30
30-120
Domm.Coloi
Munsell
7.5YR2.5/1
7.5YR4/2
7.5YR4/4
Redox Description
3u. Sz. Cont. Coloi
N/A
N/A
N/A
Fexture
SL
LS
MS
Structure
Gr.Sz.Sh.
2MSBK
OSG
OSG
^onsistence
MFR
ML
ML
Boundary
cs
cs
N/A
Roots
3CO
3M
1F
r Bor.f7 Rt Ground surface Elev: DePth to Limitin9 Factor:
99.33 Ft. 120 in. Elev. 89.33 ft
Horizon
1
2
3
4
5
6
7
Depth in
0-10
10-28
28-120
Domm.Colo
Munsell
7.5YR2.5/1
7.5YR4/2
7.5YR4/4
Redox Description
3u. Sz. Cont. Colo
N/A
N/A
N/A
Fexture
SL
LS
MS
"Effluent #1 = BOD 5>30<, 220 mg/l and TSS>30 ^ 150mg/l
CST Name (Please Print)
MarkS. Thompson I
Address: 12006 N US Hwy 63
Hayward, Wl 548431
Structure
Gr.Sz.Sh.
2MSBK
OSG
OSG
Consistence
MFR
ML
ML
Boundary
cs
cs
N/A
Roots
3CO
3M
1F
300
To 95_52
Soil Application Rate:
GPD/ft2
*Eff#1
M
OJ'
17
EWt2
1^
M
L6
Soil Application Rate:
GPD/ft2
*Eff#1
M
OJ
&7
Eff»2
1^
1A
L6
y "Effluent #2 = BOD 5 < 30 mg/1 and TSS ^ 30 mg/1
Signaturp/^7 / / •''^-^ y
Date EvaluationCotfducted:
.-Tuesday May 13,2025
CST Number: g^ggg
Telephone Number
715/699-4081
SBD-8330 (R04/21/
Property Owner:Edward D Hoover Parcel I.D.39408 Page: |0) |2f6| 1
U I MAY 2 1
Boring # 3
Horizonl
1
2
3
4
5
6
7
)epth in
0-14
14-25
25-120
Boring # 4
-lorizonl
1
2
3
4
5
6
7
)epth in
Boring # 5
Horizonl
1
2
3
4
5
6
7
3epth in
Boring # 6
Horizonl
1
2
3
4
5
6
7
Depth ir
p Ground surface Elev: Depth to Limiting Factor:
98.25 Ft. 120 in. Elev. 88.25 ft !
3omm.Color|
Munsell
7.5YR2.5/1
7.5YR4/2
7.5YR4/4
Redox Description
2u. Sz. Cont. Coloi
N/A
N/A
N/A
'exture
SL
LS
MS
Ground surface Elev:Bar P? Pit t 0 Ft.
3omm.Color|
Munsell
Redox Description
3u. Sz. Cont. Coloi 'exture
Ground surface Elev:~' Borf^ Pit
0 Ft.
Domm.Colorl
Munsell
Redox Description
3u. Sz. Cont. Colo Fexturs
Ground surface Elev:~ Bar 1^ Pit
0 Ft.
Domm.Colorl
Munsell
Redox Description
Qu. Sz. Cont. Colo Fextun
Structure
Gr.Sz.Sh.
2MSBK
OSG
OSG
insistence
MFR
ML
ML
Boundary
cs
cs
N/A
Roots
sco
3M
1F
Depth to Limiting Factor:
0 In.
Structure
Gr.Sz.Sh.;onsistence Boundary Roots
Depth to Limiting Factor:
0 In.
Structure
Gr.Sz.Sh.;onsistenc(Boundary Roots
Depth to Limiting Factor:
0 In.
Structure
Gr.Sz.Sh.Consisteno Boundar Roots
»?'?•-'%
GPD/ft2
*Eff#1
0.6
0^
0^
Ef?2
Lfi
L6
16
3oil App. Rate
GPD/ft2
*Ef»1 Eff#2
Soil App. Rate
GPD/ft2
*Effl»1 Eff#2
Soil App. Rate
GPD/ft2
*Eff#1 EfW2
"Effluent #1 = BOD 5>30<, 220 mg/l and TSS>30 5 150mg/l affluent #2 = SOD 5 < 30 mg/1 and TSS <. 30 mg/1
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access
services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777
SBD-8330(R.07/00)
In; ^ ^, ^E
Owner:
System
Edward D
Elevation: 95.5
Soil Profile
Hoover
Load Rate:
Sheet
jSoiT
^.
Tester:
7 I System Elevation:
Page:
^VIarkS:
92.33
3 of 6 y "
Thompson
To 95.52
MAY 2 1 ZUZb !^
!. Zomncj D&pi
101
100
99
98
97
96
95
94
93
92
91
90
89
88
87
86
85
84
83
82
81
80
79
B2
99.33
'97 OJ.$
0.7
92.33
T3-
89.33
L.F.
101
100
99
98
97
96
95
94
93
92
91
90
89
88
87
86
85
84
83
82
81
80
79
B3 B1
Name:
Location:
Township:
County:
Lot #:
Owner Information:
Edward D Hoover
S17,T45N,R09W
Barnes
Bavfield
2388 Raven Lane
BM=100: Nail w/ ribbon on the base of tree near_B3
B1 =
B2=
B3=
Lake=
98.02
99.33
98.25
0
99'
BM B2^
98'
B1
B3
Prop
House
Well
0
<DI*<
2388
Raven Lane
ro(DI(D
0)
CST: Mark S. Thiompsoa/-"'
Only in Tested Area
1775'§8/ /
715/6ST9-4081
53I®_Q-00y33<G0CD%
3s
1~~-
1~-?c-n
13~£ni
(s=S
Enn-1
[Fm!
20' 40'so'
PAGE 1 OF 4
In-Ground Gravity Plan
Index & Cover Sheet
Component Manual Design References:
In-Ground Soil Absorption for POWTS Version 2.1 (May ^02?,;2^|D! li: 'I
Pg1 of 4
Pg2of4
Pg3of4
Pg4of4
Hi MAY 2 1 Zl^b
)1
Index & Cover Sheet
Plot Plan ggy^y ^ -^^ uep^
Dispersal Area Cross-Section & Plan View
Management Plan
Attachments:Enclosures:
POWTS Application for Review
Soil Evaluation Report & Site Map
Project Name / Description
Hoover 2 Bed
Owner Name(s): Edward D Hoover Phone: 970 -629 .1441
Owner Address: PO Box 24 Maybell, CO Zip: 81640
Project Address: 2388 Raven Ln Solon Springs, Wl
Govt. Lot: _ _1/4 of 1/4, Section^Z_, T45 N-R09 or W /
Township: Barnes County: Bayfield
Project Parcel ID #: 39408
Designer Information
Designer Name: Jason Kuettel _ Phone: 715 .798 - 3355
Designer Address: PO Box 66 Cable, Wl _ Zip: 54821
E-mail: tim@andryras.com cd I ipi'O'W S;.;?;
License Number: 675751
Remarks:
Signature:-€^.-^c^w
ji_Original Signature required on each submitted copy.
Date: $A'/'t<>
Name:
Location:
Township:
County:
Lot #:
Owner Information:
Edward D Hoover
S17.T45N.R09W
Barnes
Bavfield
2388 Raven Lane
BM=100: Nail w/ ribbon on the base of tree near B3
B1 = 98.02
82 = 99.33
B3 = 98.25
Lake= 0
^^n^C^-^"-^S-rc^ £c. . °!5"^u
99'
BM B2~^
_$^pi2.nA& (- ?<fc<-<!,J>,-
-?$- l^/
or^M-o /S-C--731—
98'
B1
<Z)<£.45" <^'-<-c< c^--*^^"
^0
Prop
House
Well
0—IIsu•<
2388
Raven Lane
Only in Tested Area
roCDt"<(D
3'
03iU%CB
Q-00N03
—<„co0(D'Q
3s
rv;
c-~
r~--!
C-T
r^4
^=3,
iJ-LTU
•S d'
a=iR
[Fust
20' 40'80'
f^- <o~?^7S\
5/^/^S
IN-GROUND GRAVITY DISPERSAL AREA
Uniform Elevation Trenches with Quick4 Standard-W Chambers
3-ft Trench (down-sizing credit)
SOIL COVER
Septic Tank(s) Manufacturer:
SuDerior Precast
750 gal
Orenco
Septic Tank(s) Volume(s):
gal — gal
Effluent Filter Manufacturer:
gal
Effluent Filter Model #:: FT-0822
12"
min. trench
depth(typical)
34"s •:;•-.'•
(typical)
TYPICAL TRENCHCROSS SECTION VIEW
(No Scale)
Quick4 Standard-W
w/End Cap
(typical)
System Elevation = 95.5 ^
(typical)
(Show location of inlet / outlet pipe connection on plan view.)
Provide minimum 3 ft
separation between trenches.
Observation Pipe(typical)
Install per manufacturer's
instructions.
-c-
TYPICAL TRENCH
PLAN VIEW
(No Scale)
(typical)
INSTALL PER TRENCH:
A =3.0 ft
(typical)
Quick4 Standard-W Chamber(typical)
(mfd by Infiltrator Systems, Inc.)
•s,
i^0
LrTJ-L
^ '^
.'^^ Q=LTT;
11
+ 1
Quick4 Std-W @ 20 ff EISA/chamber =
Pairs of end caps @ 6 ft2 EISA/pair =
= Proposed EISA per trench =
x
220
6
226
2
ft2
ft2
ft2
Install pursuant to manufacturer's instructions. r;
CD
r-<-C3r~o
Firi;
n>0m
GOQ-n
•^
Required Infiltration Area =
trenches = Proposed Total EISA = 452
ft2
ft2
Distribution Method:
branched manifold
PAGE^O,F4
In-ground Gravity Management Plar|] E [r U ^ lp
IMPORTANT: II MM ^'• ^^
The owner of this in-ground gravity system shall be responsible for its perpetual operation and m^Qt^@te?e, PWau^ftW
requirements of SPS 382-384, Wise. Admin. Code. Pursuant to SPS 383.52 (2), Wise. 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), Wise. Admin. Code.
Maximum Dispersal Area Operating Limits:
Design Flow = 30° gpd: BODs^ 220 mgL-1; TSS ^ 150 mgL-1; FOG ^ 30 mgL-1
Inspection Checklist INSPECT EVERY 3 YEARS
o type of use
o age of system
o nuisance factors (/.e. odors, user complaints, efo.)
o mechanical malfunction (/'.e., pumps, valves, switches, floats, etc.)
o material fatigue (/.e., leaks, breaks, corrosion, etc.}
o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes)
o neglect or improper use (/.e., exceeding design capacities, prohibited activities, etc.)
o extent of ponding in distribution cell prior to dosing
o dosing irregularities - if applicable (/".e., pump re-cycling, float switch settings, etc.)
o electrical components - if applicable (/.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 affluent or sewage back-up into structure served
Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)
o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis.
Stats, when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or
as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wise. 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 manufacturer's 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 Wise. Admin. Code. Report any component failure or malfunction to:
Name of individual or company:: Andry Rasmussen & Sons phone: 715-798-3355
Local government unit: Bayfleld GO. Zoning _ phone: 715-373-6138
Local government unit address: 117 E 5th St. Washbum, Wl _ Zip: 54891
Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wise. Admin.
Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wise. 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, Wise. Admin. Code.
Continciency 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, Wise. Admin. Code.
37:?TIC T.^IK CP.033 SECTION AND S?E:C CAT TO?
KDl fe I? 1^ U II [^
4" Sc:ri.LrOP'/C^INSP. p^?E 6^ "^I», A30VZ GRADI.CopT,") 111 MAY •./^ 7n?- lu!Yljheo ^1^-^^\& l^ ^dr^d^" u'^^*'t'^ ljl1 ^^R^ ^
BayfJdd Cc;, ?.oning Dept
FINISHID GRADE
, APPROVED
APPROVED
PIPE 3'
ONTO SOLIDson
-A P P R544££. &ft-?fcE — |
Ot( FILTER,
MFG. OKnc_o_
model ^ -PTo8^"2-
3" APPROVED B£3DIH£ Uh1)£R TAh'?v
SPECJFICATIONS
SEPTJC.
TAM:< MAWFACWRE?,: 5^^e«^s^ P^CoZfF
tAW SIZES.' SH°TIC ^•5'° GAL.
HANHOLE
W/ Lcck.4-
WWw^ cA0£L
-^" HIM.
-OUTLET
NOTES:
S5 - 00^2
Private Sewage System Maintenance Agreement
Owners) Name
i=Hw<w\ 0 \\oc>\!c^
Owner(s) MaHfng Addressft? ^^i/ H^l/^co e>[^oSite Address
^^^V,UA.. ^^,\o\ ^nTax ID #WQ^As owner, I (we) do" hereby cerSfy the private sewage system will be installed in
accordance with the certified soil tester's report and approved plans and specifications
on file with Bayfield County Planning and Zoning Department The system will be
operated in such a manner as to meet the designed plans, t (we) agree to maintain said
private system at the below listed location in accordance with rules established in the Wl
Adm. Code, as torn time to fme amended. (COMPLETE Legal is required)
J/4 of_1/4 Section l~\ Township <^<T N- Range (?c( Jw.
Additional Legal Description:
Town of L"^tA\ d'*'?{Acreage)Gov'tLot
Lot..BtocK_Subdivision
Lot.CSM #t^€\ Vol. l^ Paae'J<b1 CSM<pS~6?£?Lf^.^
OOCUMENT NUMBER2025R-607560
DANIEL- J. HEF-F-NER
REGISTER OF DEEDS
BAYF1ELD COUNTY, Wl
RECORDED
05/21,2025 AT 1 2:47 PM
RECORDING FEE: $30.00
PAGES: 1
Recording Area
Return
.1-;!nd Zffnirig D^rtment
lv|AY ? 2 2025 ^
Bayfifild Cu./_oriiny Oopt.'
23 In-ground gravity
D Mound
a In-ground dosed D In-ground pressure distribution Sewage System:
D At-grade Sewage System Q Other.
Septic Tank (system types A through E): The septic tank shall be pumped by a certified septage sen/icing operator within three (3) years of the date of
installation and at least once every three (3) years thereafter unless, upon inspection by a licensed master plumber or other person authorized to mate
such inspection, the tank is found to have less than one-third (1/3) of the volume occupied by sludge and scum.
Pump Chamber (system types B, C, D, and E): The pump chamber shall also be rinsed and pumped out when the septic tank is serviced as provided
above. The switches and pump controls shall also be inspected and maintained to ensure operabiltty of said components.
Septic Tank Effluent Rlter (system types A through E): The septic tank effluent filter shall be inspected and maintained as necessary and in accordance
with manufacturer's specifications. Filter maintenance reports shall be submitted to the County as required by SPS 383.55, Wis. Admin. Code.
Private Sewage System Disoereal CelL(system types A through E): The private sewage system distribution cell shall be visually inspected by a certified
septage serwang operator, POWTS inspector, or licensed master plumber within three (3) years of the date of installation and at least once every three
(3) years thereafter to determine whether wastewater or effiuent from the system is ponding an the ground surface.
Mounds. At-arade. and In-around Pressure System Laterals (system types C, D and E): The laterals shall be flushed out and swabbed if needed when
the wastewater distribution cell component is inspected as provided above.
Ownerfs) agree ffiat failure to comply w? this agreement will result in action being taken to pay all charges and costs incurred by BaySeld County for
inspecffon, pumping, hauling, or otherwise servicing and maintaining the private sewage system tank in such a manner as to prevent or abate any
human health hazard caused by the system Bayfield County shall notify the owner of any costs which shall tie paid by the owner within thirty (30) days
from the date of notice. In the event the owner does not pay the exists within thirty (30) days. the owner specifically agrees that all ihe costs and charges
may tie placed on ffie tax roll as a special assessment for the abatement of a human health hazard, and the tax shall be collected aspmvidefi by law.
The terms and conditions of the variance shall be binding upon and inme to the benefit of all current and future owners of such property.
Owners) Nsme(s) — Ptease Print
^dkjL^tI 0. HQ^W
Subscribed and sworn to before me on this date:
^o^c^i 22, 202^
^-^—Notarfzed Owner(s) - Signatupa^}
^n^^^): /^^
Notary Public
My Commission Expires:4/?.l^
Drafted fay,:T,A- ce^t-^ Date-.^Z^^51
INOW01AUBACH'_NpTARYPUBUC'.SWTE OF COt.ORADO-WTAWlb5M44MSw_NVCON»IIB«ONexp»Mauttnm«
Proofed by: _
u/rorms/sanitary/sepBcmaintenceagFeementRevised June 2018
BAYFIELD COUNTS SANITARY PERMIT (#04)-25^8S
STATE SANITARY PERMIT
OWNER: EDWARD D HOOVER
GOVTLOT: LOT: 1 BLK:
CSM: 2359
1/4 1/4 SEC:17,T45N,R9W
TOWNSHIP: Barnes
SOIL TEST: 38-25
NEW SYSTEM
SYSTEM TYPE: Non-Pressurized In-Ground
PLUMBER: JASON KUETTEL
CHAPTER 145.135(2) WISCONSIN STATUTES
a. The purpose of the sanitary permit is to allow installation of the
private sewage system described in the permit.
b. The approval of the sanitary permit is based on regulations in force on
the date of approval.
c. The sanitary permit is valid and may be renewed for specified period.
d. Changed regulations will not impair the validity of a sanitary permit.
e. Renewal of the sanitary permit will be based on regulations in force at
the time renewal is sought, and that changed regulations may impede
renewal.
f. The sanitary permit is transferable.
History: 1977 c. 168; 1979 c. 34,221; 1981 C. 314
Note: If you wish to renew the permit, or transfer ownership of the
permit, please contact the county authority.
PREVIOUS PERMIT #:
LICENSE: # MP 675751
TRACY POOLER
Authorized Issuing Officer
DATE: 6/3/2025 Condition: Properly Maintain System Per Recorded Agreement
THIS PERMIT EXPIRES 6/3/2027
POST IN PLAIN VIEW
MUST BE VISIBLE From ROAD FRONTING THE LOT DURING CONSTRUCTION