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Home My WebLink About1787DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 35. -4 -126 BOX 16 i yL Fr rm g f fir 44 ,X1 1 IN T r _ 2I�� L IN IL r I i , `� Ills , - il.L., '�- Ji-,, N ' • - . . . SIMON 01787 t, rF• . PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location Streef Address: Town/Village: Tax Grid # Map_? , Block` r Lot(s)/M Well Owner: Name: Address: '04 Mlpo'q PA :3 Use of Well: 1- primary 2- secondary Residential Business Industrial Pdblic Supply Air con eat pump gation Farm Test/monitoring Other(specify) Institutional Standby Drilling Equipment Rotary Cable percussion _X Compressed air percussion Other (specify) Well Type Screened Open end casing Open hole in bedrock Other Casing Details Total length _WV ft. Length below grade (,�ft. Diameter _in. Weight per foot lb /ft. Materials: Steel _ Plastic _ Other Joints: _ Welded ZC Threaded _ Other Seal: X Cement grout _ Bentonite Other Drive shoe: X Yes No Liner: Yes No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Wx -Yes-No Hours Second Well Yield Test _ Bailed _ Pumped Compressed Air Hours Yield gpm Depth Data. Measure from land surface- static specify R) During yield test(ft) Depth of completed well in feet Well Log If more detailed information descriptions or sieve amilyses_ . -.... are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface t✓ B S .... _ :. -- .. _ _ .... _ -.... ..... .. ... .. ::.... .:.� Al .11 If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information S' 3 Pump Type u Capacity Depth 12-5' Mode17620041 Z Voltage 23 0 HP 210 Tank Type M -302 Volume 7 YL7A GFV Date Well Comple d fo �� 3 Putnam County Certification No.. Date of a c Weil Driller (signature) /--'107060' fm3 i m rxact iocarion or wen with atstances�to_ at least two permanent landmarks to be provt n a separ4/,te sneevpian. Well Driller's Name z1jKfkLZ ,f , J02 Address: iL V//0 Y-1Y lid 05 Signature: White copy: HD Date: r f B, Yellow copy - Building Inspector; Pink copy - Owner; �copy Well driller Form WC -97 TNAM COUNTY DEPARTMENT OF HEALTH r IV--.OF E �gRONMENTAL HEALTH SERN710ES CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # ° Located at t A �_. A da Owner/Applicant Name N 11 CLIVL Formerly, Town or V MA0,-1WL Tax Map Block Lot Subdivision Name & e r W011 d Subd. Lot # Mailing Address Cd 8t " W00 41 Ar- r ee, /�a1f7ir ak Zip / Date Construction Permit Issued by PCHD /1-7 O 2– n j Separate Sewerage System built by ,% ' o ddress d �-O! �a wc�� Q— Consisting of J 6 d G Gallon Septic Tank and G C r� Other Requirements: ev Aalt-, �` 1 Water Supply: _ Public Supply From q ) Address or: Private Supply Drilled by RaQ n Address G SZ ! _ Building Type ! L5Te Has erosion control been completed? ff.? Number of Bedrooms :j Has garbage grinder been installed? I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved' plans and the standards, rules and regulatigr*.of the Putnam County Dfpartment of Health. Date: S -19 –0:1 Certified by Address P.E. R.A. License # SLc 1 Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals ubject to modification or change when, in the judgment of the Public Health Director, such revocatio , m ificatio r change is necessary. By: Title: % Date: ` White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Vi ll'>0 oc ff in , Sfreei Ad&egs:- - / ]Map Grid # Block Lot(s) Well Owner: Name: Address: 0 / Use of Well: 1- primary 2- secondary Residential Pu tc Supply Air`condllieat pump Irpr ation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion _ Compressed air percussion Other (specify) Well Type Screened Open end casing -X Open hole in bedrock _ Other Casing Details Total length _z�Lft. Length below grade a ft. Diameter in. Weight per foot lb /ft. Materials: Steel _ Plastic _ Other Joints: _ Welded 25� Threaded _ Other Seal: X Cement grout _ Bentonite Other Drive shoe: Yes No Liner _ Yes No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First _ Yes—No Hours Second Well Yield Test _ Bailed _Pumped Compressed Air Hours Yield gpm Depth Data Measure from land surface- static (specify. ft) During yield test(ft) Depth of completed well in feet Well Log If more detailed information descriptions or sieve analyses " are available, please attach. Depth From Surface Water Bearing' Well Diameter(in) Formation Description ft. ft. Land Surface e S If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information y5` Pump Type v Capacity )'Z Depth 3 3-S Model 7620-11 Z Voltage 2-3 0 HP Z, 0 Tank Type ty)(- 302, Volume ory Date Well Comple d !�� Putnam County Certification No. D0 3 Date of Rep rt Well Driller (signature) NOTE: Exact location of well with distances to at least two permanent lAndmarks to be provi n a sepai*6 sheet/plan. Well Drille. Signature: White copy: Address: Date: Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 - �: J BRUCE. R. FOLEY ua ; RETTA MOLINARI• RN., M.S.N. Public Health Dlrtuor Grclor - Qf P tru Sarvlcu _.._. - - - DEPARTMENT OF HEALTH __ _ .... 'I Geneva -Road _. Browster, New York 10509 Ea*ccmcAUI HWtk (914)211.6130 Fuc(914) 211.7921 Nur&Lq.Scrrica (914)271.65n --- WIC (914)-27F=6671 .Fik(91,0271.60 :S .. - E&r1y'751cr i0oo (914)11f• 6014 Fradool (914) I71-6M Fix (914)17x• 6641 E911 ADDRESS -YERIFICAITON FORM OWNERS NAME: W l NDOM- �- 0M56 i� Ate.___... 'T'A.X• MAP NUMBER -- ' _ ... S o .4 ° IAP. _...:_' ........ - E911 ADDRESS; TOWN: A, 2 AUTHORIZED TOWN_9.MCIA -,:. (Signature) PATE: The Putnam County Department of Health = will not issue a - Certificate of Construction Compliance- unless the above form is. completed; i.e., a legal E911 address is assigned by an authorized town official. This form-is to be submitted" - Nxith the application for q Certificate of Construction Compliance. (E,911 WRFI" __ ...... PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES. GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM 4 Owner or Purchaser of Building Tax Map Block Lot I . J+Q _T PP( Building Constructed by TownNillage 24 Location - Street Subdivision Name Building Type. Subdivision Lot. # I represent that I am wholly and completely responsible for the location, workmanship, material, construction an'd"drain *age of the sewage -treatment system serving th"e"abovi;e-desc'riL)ed'property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition. -y any `Farr -of said-system constructed 6y'me which fails-to operate for-a period' of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system,except where the failure to operate properly is caused by the willful .or negligent j4ct.of the occupant of the building utilizing-the-. System--- The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the"failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Month Day Year Ge4dfral'Co n-tractoor'(Owner.) - signature W WD �4114 //Pl & Corporation Name (if corporation) Address: g C01-WkjVqdD ff illt State eg —ti t eCoLl A1,Y, Zip / (�C, Signature: io owfil Title:-- VP ew,1;TyV(-T141 Corporation Name (if corporation) Address: _$ COWA)4�06)2 Aetilf State APrtgj "&V kl-( Zip Form GS-97 EM LORETTA MOLINARI Public Health Director ROBERT J. BONDI County Executive DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 Harry Nichols, P.E. Patterson Park Suite 106 2050 Route 22 Brewster, NY 10509 Dear Mr. Nichols: May 24, 2004 Re: Proposed Compliance: Wyndham Homes, Inc. 118 Apple Hill Road, Lot 44 (T) Patterson, TM #35.4-126 Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. Comments are offered as follows: 1. The SSTS has not been constructed as per approved design. 2._ _ _. Trench length exceeds 60' feet.. The. maximum -trench -length allowed utilizi, a_ gravity system is 60' -feet. 3. Curtain drain location has not been shown. The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard. If percolation tests were not witnessed by a representative of the New York City Department Environmental Protection on this lot, percolation tests must be witnessed by a representative of this Department. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Ve ly yours, RM: hm Robert Morris Senior Public Health Engineer , YML ENVIRONMENTAL SERVICES � 321 Kear Street _ 10598 800 ' - ----- Albert H. Padovani, Director LAB #: 93.400826 CLIENT #x 57197 NON STAT PROC PAGE: 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ WYNDHAM HOMES 8 COLLINWOOD DRIVE BREWSTER, NY 10509 DATE/TIME TAKEN: 04/20/04 DATE/TIME REC'D: 04/20/04 11:35A REPORT DATE: 04/28/04 PHONE: (845)-279-2022 SAMPLING SITE: 118 APPLEHILL RD SAMPLE TYPE..: POTABLE : BREWSTER NY PRESERVATIVES: NONE COL'D BY: KAREN SAMPERI TEMPERATURE..: < 41'' NOTES...: KITCHEN TAP COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 04/20/04 MF T. COLIFORM ABSENT /100 ML ABSENT 1008 04/20/04 LEAD (IMS) 2.8 ppb 0-15 ppb 9101 04/20/04 NITRATE NITROG 2.99 MG/L 0 - 10 9139 04/20/04 NITRITE NITROG <0.01 MG/L N/A 9146 04/20/04 IRON (Fe) <0.060 MG/L 0-0.3 mg/1 2037 04/20/04 MANGANESE (Mn) 0.045 MG /L 0-0.3 Mg/1 2037 04/20/04 SODIUM (Na) 30.2 MG/L N/A 04/20/04 pH 5.7 UNITS 6.5-8.5 9043 04/20/04 HARDNESS,TOTAL E04 MG/L N/A 04/20/04 ALKALINITY (AS 42.0 MG/L N/A 04120/04 TURBIDITY (TUR '<1 NTU 0-5 NTLj- -. COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATE (WAS NOT) OF A SATISFACTORY SANITARY QUALITY ;3 THE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION., Pb/Cu LEAD limits for p EPA Lead & Copper than 10% of their than 15 ppb and a treatment must be potential. ihlic schools are set at 15 ppb. Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER value of 1.3 mg/L, else water undertaken to reduce the waters corrosive Fe/Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg/L. Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg/L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg/L of Sodium is suggested. February 24, 2004 Robert Morris, P.E. Putnam County Health Department One Geneva Road Brewster, New York 10509 4- Harry W. Nichols Jr., P.E. Patterson Park - Suite 106 2050 Route 22 Brewster, NY 10509 -i'e1 (i45) 279 -0003...., Fax: (845) 279 -4567 Email: imengineer@aol.com Re: Individual SSTS Compliance — Wyndham Homes, Inc. 111 Apple Hill Road - Lot # 44 Deerwood (Windsor Woods) Subdivision Town of Patterson, NY T. M. # 35.4-126 Dear Robert: Enclosed are the following: 1. Five (5) prints of Drawing 5-44, "As -Built SSTS ", dated 04/19/04. 2. "Certificate of Construction Compliance for Sewage Treatment System": - 3. Three (3) copies of "Guarantee of Subsurface Sewage Treatment- System", dated 01/09/04. 4. Laboratory Report, dated 04/28/04. 5. "Well Completion Report", dated 05/03/04. 6. Application Fee in the amount of $300.00 payable to Putnam County Health Dept. 7. "E -911 Address Verification Form ", dated 05/07/04. .If there are any questions concerning the enclosed, please call. Very truly yours, PW. Tio Jr., P.E. HWN:gav 03 -056.44 YML ENVIRONMENTAL SERVICES 321 hear Street `Yorktown Heights, N Y 5 Albert H. Padovani, Director ~ LAB #: 93.400826 CLIENT #: 57197 NOW STAT PROC PAGE: 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~^~ WYNDHAM HOMES 8 COLLINWOOD DRIVE BREWSTER, NY 10509 SAMPLING SITE: 118 APPLEHILL RD : BREWSTER NY COL'D BY: KAREN SAMPERI NOTES...: KITCHEN TAP ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE DATE/TIME TAKEN: 04/20/04 DATE/TIME REC'D: 04/20/04 11:35A- REPORT DATE: 04/28/04 PHONE: (845)-279-2022 SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE..: < 4C COLlFORM METH: Ml--' ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RESULT NORMAL - RANGE METHOD pH pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pH lS ' E OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNEAUM CONCENTRATIONv BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG/L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG/L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0-70 MG/L VERY HARD WATER: ABOVE 300 MG/L MODERATELY HARD WATER: 70-140 MG/L !.MG/L.* MILLIGRAM PER LITER . SUBMITTED BY: ' 0 fitclv Director ELAP# 10323 PUTNAM COUNTY DEPARTMENT OF HEALTH .`.r: DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION 7112 -lo y -Qk r: Date: � � o Inspected by: C, KOe O Street._Locat' ,: :fit 4 &�& 4, Zo,a Owner Town G�,�r7�TCsoit/ Permit # - �Z � - o;L TM # 3 Subdivision Lot # �f 1. Sewage Svstem Area a. STS area.located as per approved plans ........................... b.. Fill section - date of placement 3:1 barrier Lgth. Width . Avg.Dpth c. Natural soil not stripped .................................................. d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course/wetlands.. : ................................... II. Sewage System a. Septic tank size - 1,000 ........ .1, 250 .. ....... other ........:....... b. ' Septic tank installed level ................ ............................... c. 10' minimum. from foundation .......... ............................... d. Distribution Box 1. All outlets at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. .. Minimum 2 ft. Original soil between box & trenches e. Junction Box - properly set .......... ............................... 6. rent' cF es 1. Length required 4 i� % Length installed l/ % 2. Distance to watercourse measured -} i o o Ft.......... 3. Installed according to plan ............................... 4. Slope of trench acceptable 1/16 - 1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6.\ Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100 % ......................... 8. Size of gravel 3/4 - 11/2" diameter clean ....................: 9. Depth of gravel in trench 12" minimum ....... :........... 10. Pipe ends capped ........................ ........................:...... g... Pumi) or-Dosed Systems- - -- - _. _......_ 1. Size of pump chamber ................ ............................... 2. Overflow tank ............................. ............................... 3. Alarm, visual/ audio ........:........:.. ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle........... M. House/Building a. house located per approved plans........ b. Number of bedrooms ............................ IV. Well ........ Well located as per approved plans . ............................... b. Distance from STS area measured / j, ,I_ ' - ft........... c. Casing 18" above grade .................. I ........... , .......... I...... d. Surface drainage around well acceptable ....................... V. Overall Worlananshiv . a. Boxes properly grouted :.................. ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box . ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain &.standpipes installed according to plan.. f. Curtain drain outfall protected & dinto exist watercourse g. Footing drains discharge away from STS area ........ h. Surface water protection adequate .:.i. Erosion control provided ................ ...................... Rev. ?2/02 APR -19 -2004 10:16 AM HARRY W NICHOLS 914 279 4567 P.01 i' 01 1 Pi1TNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES &F, MMS.T. DE MIA :ibi2E TiON For:. Fill Date: .Saa L /su Trenches PCHD Construction Permit # Located: 62f LS N11>I (T) M fA1j &-%aj Owner /Applicant Name: KRAL TM Slack 4 Lot 12 Formerly_ _ Subdivision Name :�eeb Subdivision Lot # M Is ' systelm" fill completed ? ". Date: ea - t6- Is 'system complete? Ves Date: eu- i if - oy Is system constructed' as per plans? yes Is well drilled? Date: __ ey- [d• 0 M Is well located as per plans ?� Are erosion control measures in place? Yst . ,.....,,;,. I cettit?y that the system(s), as listed, at the above premises has been constructed and I have inspected and verified their completion in accordance with the isue_d PCHD Construction Permit and approved plans and the Standards, Rules and Re gui Nadi nam County Department of Health.A *�, y Date: Ada 1 O4 Certified,by: / R * ps RA esi si ti LORETTA MOLINARI Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 April. 21, 2004 ROBERT J. BONDI County Executive Harry Nichols, PE Patterson Park,'Suite 106 2050 Route 22 Brewster, New York 10509 Re: Field Inspection — Wyndham Homes Formerly G.J. Development Corp. Apple Hill. Road, (T) Patterson Lot # 44, TM# 35.4-126 Dear Mr. Nichols: The above referenced separate sewage treatment system can be backfilled. The following comments must be corrected in the field. 1. Additional silt fence needs to be installed per the approved plan. If you have any further questions, please contact me at 845- 278 -6130, ext. 2261. Sincerely, Gene D. Reed Sr. Environmental Health Engineering Aide GDR:cj O rl - L~ LORETTA MOLINARI Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 July 12, 2004 Harry Nichols, PE Patterson Park, Suite 106 2050 Route 22 Brewster, NY 10509 Dear Mr. Nichols: ROBERT J. BONDI County Executive Re: Field Inspection — Wyndham Homes Formerly G.J Development Corp. Apple Hill Road, (T) Patterson Lot #44, TM# 35.4-126 ..... ....... . The above referenced separate sewage treatment system can be backfilled. - Thore are, no-,open, comments _to,be,addressed at_this time. If you have any further questions, please contact me at (845) 278 -6130, ext. 2261. GDR:km Sincerely, xo� -6. -F(-e-j Gene D. Reed SR. Environmental Health Engineering Aide PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES - CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # a _ oL Located at P P L�-- 41 u- P-0 6 Town or Village Subdivision name VX'CQA� 00b Subd. Lot # Tax Map Block Lot 12 �P Date Subdivision Approved 1 2 — ,, Renewal Revision Owner /Applicant Name G �� . �F U E LOP Iii E 10'� C W, Date of Previous Approval — Mailing Address l\ vi ��_ W �(:)At� yNT) RV�)GE, bN Zip I V 7(� Amount of Fee Enclosed] Building Type ] \\�E�JC,E Lot Area 1,0AAoEof Bedrooms Design Flow GPD So 0 Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of \ b0 n gallon septic tank and- bu-� Ov: --V�N C,\\ Other Requirements: 1' 01, (Q` 01' Cue-IN %\ N �W—N\ N To be constructed by 1- �J Address Water Sup"I Public Supply From Address PP y - .. y _... _ :.. or: Private'Su'� "1` D'riTl'ed b'` �� Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewagg treatment Ustem described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed Address R.A. Date License # 5 6 � 2 APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected'by the PCHD and is revocable for cause or may be amended or modified w n considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires anew permit. App rov or discharge of domestic sanitary sewage only. By: !,H Title:(( A-- Date :�-, 1 j-- White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 Harry W. Nichols Jr., P.E... Patterson Park, Suite 106 2050 Route 22 'Brewster, NY::105d1t3L, Telephone (845) 2794003 Fax (845) 279 -4567 . June 24, 2002 Putnam County Health Department One Geneva Road Brewster, New York 10509 Att: Robert Morris, P.E. Re: Individual SSTS Lot # 44, Deerwood Subdivision Apple Kill Lane Town of Patterson, T.M. # 35.4-126 Dear Mr. Morris: Enclosed are the following: 1. Five (5) prints of SS-44, `Troposed SSTS," dated 6/24/02. 2. "Short EAF," dated 6/24/02. 3: "Application for Approval of Plans for a Wastewater Disposal System." 4. "Construction Permit for Sewage Disposal System," dated 6/24/02. 5. "Application to Construct a Water Well," dated 6/24/02. .6. "Design Data Sheet." 7. "Letter of Autliorization`$c- Coipohi Resolution," dated 1%30/02. 8. Two (2) copies of Residence Floor Plan(s), for `Bedroom Count Only." 9. Review Fee in the amount of $300.00. We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Very truly yours, Harry WnNic is Jr., P.E. HWN:JM:jmm 02- 006.44 PUTNAM COUNTY DEPARTMENT OF HEALTH.... DIVISION OF ENVIRONMENTAL HEALTH SERVICES. DESIGN DATA SHEET'- SUBSURFACE SEWAGE TREATMENT SYSTEM J1 Owner C00. Address Pit► ND.._210GC� 1Vy Located at (Street) p ,\ "'M Kos _ Tax Map 3 Block Lot (indicate nearest cross street) Municipality &c-Q' N Watershed .... SOIL PERCOLATION TEST DATA Date of Pre - soaking �(�� — 2n —'-I (o Date of Percolation Test Hole No. , Ruh No T..me :: Start .Sitop El lD�In (ni D_e�pth to Water From. Ground SStarte (Incheps) Sto Water Level Drop:In Inches Percolation Rate 1VIio/Inch - 2-T 2 `2 2 3 ��23 -�i,50 21`12 4 -- -io,3 ,6- 11,010 3 0 21 21 1.12 �j2 - C9 0 .2. �1`,0 -1�;�� 20`/2 21 '12 2C� - 3 11;0 -2:10 _S0 20 )I2- 21 'lam 20 4 5 1 2 - -... 3 - 4 5 NOTES: 1. Tests to'be.repeated at same depth until approximately equal percolation rates are obtained at each percolation: test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 VV I Address Nicly �s W Signature: No.58924 O Design Professional's Seal ''EsS O . PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of _ GJ Development Corp. Located at 31 old Road T/V Patterson Tax Map # 35 Block 4 Lot " - )Vo Subdivision of Deer Wood Subdivision (AKA Windsor Woods) Subdivision Lot # Filed Map #91 Date Filed Gentlemen: This lever -is to authorize Harry Nichols :. duly licensed Professional Engineer or Registered Architect to apply for the required ,,�'astewater treatment and/or water supply permit(s) to serve the above -noted property in accordance .,rich the standards, rules or regulations as promulgated by the Public Health Directbr of the Putnan. County Health Department, and to sign all necessary papers on my behalf in connection with this maRer and to supervise the.construction of said wastewater tretment and/or.wat.er supply systems.!!.. �o� ?ormity °with the "provisions of "Article `i45 "and/oi 147'of fh•e Educai►on Law;+[he Public Hzal!, and the Putnam Co5ar Code. \_ .Nteho � tQ QQ` `9 Countersigned: yj R.A., # rn J No. 56124 O 'Mailing Address OFFS State, Zip SQ)1 Telephone: 6 �� r ° pO j Very truly yours -- GJ Develo ent -49or Signed: ,46wncr orPropcm) p sident Mailing Address: 11 White Birch Road State Pound Ridge New York Zip 10576 Telephone: (914-) 764 -4080 __ ... F,, -,., I %.:, PUI'NAM COUN'T'Y DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES AFFIDAVIT - CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT To: Public Health Director In the matter of application for: I, Gilbert. Johns.on..... . represent that I am an offteer or employee of the corporation and am authorized to act for: Name of Corporation: GJ Development Corp. Having offices at: 11 White Birch Road, Pound Ridge, New York 10576 Whose Officers-Are: President - Name: Gilbert Johnson Address: 11 White Birch Road, Pound Ridge, New York 10576 Vice President - Name: Address: Secretir -Name: Eleanor Johnson as 11 White Birch Road, Pound Ridge, New York 10576 Treasurer - Name: Gilbert Johnson Address: 11 White Birch Road, Pound Ridge, New York' 10,576— and that I am and will be individually responsible for any and all acts of the corporation with respect to the approval requested and all subsequent acts relating theret �� A Signed: Title: Sworn to before me this I day -of a-( c,K( (year) Notary Public tsoso- G. AWTONQ NOTARY PNo COIAN5012117 YORK Corporate Seal P IALIFlED IN - WESTCHESTER COU P" � Form CA -97 Presiden PUTNAM COUNTY DEPART LN iE \T OF HEALTH .. DIVISION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS REVIEW SHEET FOR CONSTRUCTION PERMIT r NAl,4E OF OWNER: STREET LOCATION: REVIEWED BY: RM, GR, AS, SRDATE: TXX M4P =: (CONFUt�%1ED) 1� .N DOCUMENTS Y (REQUIRED DETAILS ON PLANS CO\ I''D) - - �(__) PERMIT APPLICATION ' ; : U HOUSE SE«'ER -' /�" FT. 4 "0'; TI:PE PIPE CAST IRON 1VELL PERMIT OR PWS LETTER . �NO BENDS; MAX BENDS 450 W /CLEANOUT (,4(__)PC -97 RENEWALS LETTER OF AUTHORIZATION )SITE NOTE (\0 CHANGE) 4Ugf DESIGN DATA SHEET (DDS) FILL SYSTEMS CORP ORATE RESOLUTION 10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE (JSHORT EAF FILL SPECS.' FILL NOTES 1 -5 (__)UPLAIVS -THREE SETS U(�HOUSE PLANS -TWO SETS FILL PROFILE R DIMENSIONS Lti EX- PAINSIOs`1 AREA U VARLkNCE REQUEST (�lJFILL FILL GREATER THAN 2 FEET % SiJBDMSTON CLAY BARRIER C�6/ LEGAL SUBDMSION ,'PSUBDMSION APPROVAL CHECKED ' PERC RATE FILL CERTIFICATION NOTE. ' TDEPTH GAUGES VOL ON PLAN FOR RO.B., UNCL�.SSIFIED & Ib1PERVIO FILL REQUIRED DEPTH JS DRAIN REQUIRED SEPARATIO ' DISTANCE FROM TOE OF SLOPE ——CURTAIN WATERSHED GENERAL 'LOCATEII IN NYC ATERSHED ' TRE\CR ( ZPARkLLELTOCON&TOURS LF TRENCH PROVIDED GOFT MAX. ° (___) .. PLANS SUBMITTED TO DEP - DELEGATED TO PCHD - / '10� %OEXP,S.NSIOtiPROVIDED DETAIL/DUST FREE CRUSHED STONE OR WASHED GRAVEL. (� DEP APPROVAL, IF ItEQ'D "OBSERVED vUGEOTEXTILE COVER ( DEEP TEST HOLES SEPARk:TIO`( DISTANCES ON PLAN: FRO11 SSTS - �PERCS TO BE WITNESSED ( X10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL . EX-APPROVAL SSDS AD7, LOTS. �2p' TO EOU \DTION WALLS U �VExLANDS - TOW,N/DEC.PERMTf•REQ'D ?) Cis 100' TO WELL 200' I`ii.DLOD 150' TO PITS (� , , (� DATA 0;`i DD&PLANS. &:PERVIYT SA1vfE L%) 100' TO STREAM. WATERCOURSE, LAKE (iuc. espaa) PRE 1969 NEIGHBORNOTIFICATION (.-6UJ50' TO CATCHBASIN,35' STOR:tiIDRALN, PIPED WATER LETTER BI/ZBA �- --)�. - - C. � (10' TO WATER LINE (pits - 20') (, 100 YR. FLOOD ELEVATION W/I200' , J50'. ,TER >IITTENT..ARALN�.G,E- COURSE _: -- • • = -= .: - =- _ .,,.,._�, .w- ' ( =_) SDII; TESTLNG LOTS >10 YEARS OLD " `7 (��}300'/500' RESERVOIR, ETC. 150' GALLEY SYSTEMS. $EOUTRED DETAILS ON PLANS (j(__)10'.bILN TO LEDGE OUTCROP • -. SEWAGE SYSTEM PLAN - (NORTH ARROW), SEPTICTANK SSDS HYDRAULIC PROFILE GRAVITY FLOW (��10' FROM FOUNDATION; ; 50' TO WELL � WELL .. . COYST_ RUC' II9Y.NOTES_1- 15.._— .- ��-- ..._ -- _ .. — — - / DIZIENSIO:cST0PR0PERTYLI`(ES _._...__ ( DESIGN DATA: PERC & DEEP RESULTS �LOCATIO;i OF SERVICE COIECTI0. _ (2' CONTOURS EXISTING &PROPOSED (�UIII`i 15' TO PROPERTY LINE DRIVEWAY & SLOPES;, CUT SL_ OPE FOOTING /GUTTERICURTAIN DRAINS UU$I.OPE �jt SSTS AREA (520 °!0) �. USDA SOIL TYPE BOUNDARIES TITLE BLOCK; OWNERS NAME ADDRESS UUREGRADED TO 15 %, IF REQUIRED ) DOSE/PUMP SYSTEMS TMR, PE/RA; NAME, ADDRESS, PHONES PUMP NOTES ( _)DATE OF DRAWING/REVISION FERENC U DOSE 75% OF PIPE VOLUhIE/DOS-E VOLUME NOT 'DATUM REFERENCE DETAIL FOR FORCE MAIN, (PIPE TYPE, ETC.) U(�LOCATION OF WATERCOURSES, PONDS U PIT AND D -BOX SHOWN & DETAILED / LAKES,WETLANDS WITHIN 200' OF P.L. 1 DAY STORAGE ABOVE ALARti1 (�` UPROPOSED FINISH FLQOR AND BASEMENT ELEVATIONS CURTAP(DRATN WL—JEROSIOiN,CONTROL � WELLS & SSDS'S WAN 200' OF SSTS STANDPIPES, S' BOTH SIDES, DETAIL PROPERTY METES & BOUNDS la' MI:`! to CDS = >S %, 20'4 %; -25' -3°!0, 35' -1 % 1bo %-<i% FOR HOUSE WELL & 20' MIN to CD DISCHARGE /100' with 182 cons day discharge SSTS, ERSION CONTROL NOTE IlJLJ10' blhN to NON- PERFORATED PIPE COMMENTS: (REVSHEET)09101 /00 TEST PIT PROFILES Hole #_ Lot # el V Hole # Lot # Hole # G_ Lot #_. :: -.... Depth-to water , j, Depth to `rater 1®�� Depth to water Depth to mottling IJoAj F Depth to mottling. AID N i. Depth to mottling - Q&9 Depth to rock/imp. AjQAj9 Depth to rock/imp. Depth to rock/imp. ---" G.L. 1CCAc -in Nld'4 G.L. o�'� "y�Pf�ui� 'Q*vr t G.L. . 0.5 i+` �� 0.5 �v 75, 0.5 ill S 1.0 1.0 "7 13 r, 1.0 2.0 - S 2.0 2.0 3.0 3.0 3.0 i 4.0 4.0 4.0 5.0 5.0 5.0 6.0 6.0 6.0 r 7.0 7.0 TO .� . , 8.0 s 8.0 8.0 9.0 Mve 9.0 9.0 10.0 10.0 10.0 Hole # Lot # Hole #_ Lot #_ Dole # Lot # ...., Depth - to. water, • -lr�x3 - ': . Depth to water Depth to mottling AJJ) 9 Depth to mottling ,OoAVZ Depth to mottling Depth to rock/imp. Depth to rock/imp.. r Depth to rock/imp: G.L. G.L. G.L. 0.5 0.5 0.5 1.0 �' 1.0 1.0 2.0 2.0 2.0 3.0 3.0 3.0 4.0 ill /a , 4.0 4.0 5.0 5. .5.0 6.0 6.0 6.0 7.0 7.0 7.0 8.0 8.0 8.0 9.0 9.0 9.0 10.0 10.0 10.0 14.16.4 (9195) —Text 12 PROJECT I.D. NUMBER 617.20 SEAR Appendix C State Envi�onme��al_,Quality::Reviaw ENVIRONMENTAL ASSESSMENT FORAAJ..._,x., °._...,....,._, For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT /SPONSOR((''`` 11 {{^^ cap.] 2. PROJECT NAME 3. PROJECT LOCATION: n ^ r Municipality 1 p^ * � `� f �d County P LAN 4. PRECISE LOCATION (Street address and road Intersections, prominent landmarks, etc., or provide map) v 1 t � 1�'_ ['K �4 i�.Ja\ 5. IS PROPOSED ACTION: New ❑ Expansion ❑ Modiflcatlon /alteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: t Initially i.C3,� acres Ultimately `1Q acres 8. WIL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? 2Yes ❑ No If No, describe briefly 9. WH/yT IS PRESENT LAND USE IN VICINITY OF PROJECT? �J Residential ❑ Industrial ❑ Commercial ❑ Agriculture ❑ Park/Forest/Open space ❑ Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL) ?? ❑ Yes CJ No If yes, list agency(s) and permit /approvals 11. DOES ANY ASP CT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑ Yes No • if yes, list agency name and permit/approval 12. AS A RESULT O,F/OROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑ Yes No I CERTIFY THAT THE INFORMATION PROVIDED IS TRUE TO THEE BEST MY KNOWLEDGE— jOF V ` Wo-� " � ` `�' `- " T Applicant/sponsor name: ' `DLS) „8 Date: Signature: h�3 1411 L/ V If the action is In the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL Well Location: Street Add dress: Town/Village Tax Grid # APP L� �1 ,L PJ, T VEP,'SQ -U Map S Block Lots) Well Owner: Name: Address: 1 1 W q \-VZ t312C1a e--DAD G,J,DFVF�L'q[K Fv P000 R-Xt )G [-iIVY Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought 5+ gpm # People Served T -b Est. of Daily Usage _gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling ✓ New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes No Name of subdivision T-) F �- ±'-W O O) Lot No. Water Well Contractor: Address: Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: Town/Village �- Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separ a sh d Ian. Date:.- Applicant Signature: )�AAA-L PERMIT TO CONSTR CT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED -FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. y revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well revision certified by Putnam County. /' A Date of Issue °i' ry 9 2- Permit Issu' Date of Expiration �Vll v Title: Permit is Non- Transfertable ' White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION; OF—� ENVIRONMENTAL = HEALTH SER' I ESs - .APPLICATION FOR APPROVAL OF I'L;1S FAR r A, WASTEWATER. TREATMENT SYSTEM' 1. Name and- address.of.applicant:'' 8 -bV_:V� —_'Q9 +11 ,V 2. Name of project:"'�5 Location TN�TI TIT F.SO, 4. Design ProfessionalA ,Ni=t0 ,JZ,U.5. Address: 201;0 6. Drainage Basin: 1 '_ 6 D ?�E W ST 1:Nf %. . 35 01 7. Type of Project; Private/Residential Food Service Commercial- , ..Institutional MobikRome Park_. Office Building Realty Subdivision (specify) „. 8. Is this project subject•to.State Environmental Quality Review'(SEQO ' * - Type Status :(check one). .,, ....................... Type'i a. Exempt Type-II : Unlisted �� 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... D 10. Has DE IS been completed and found acceptable by Lead Agency? .... 11.- Name of Lead Agency'- 12 Is this project in -an area under the control of local planning, zoning,.or other ...._ _ .a.._ _ . _. __ oicials ordmances� 13. If so, -have plans been submitted to such authorities ,,..., - -Y4, Has. relimin :a royal been anted.b . such authorities? Date ' :anted P ,Y .PP. g? Y g 15. Type of Sewage Treatment System Discharge e ........ surface water groundwater 16.. If surface. water :discharge; what is the streamzclass' designation? :.: ':.;'', ` 17. Waters `index number (surface) ....:......... 18. Is project located near a public water supply system? .:.... .............................t, 19. If yes name of water su P P1 . y ; Distance to watertsu PP 1 ;T 20. Is project site near ublic'sewa a collection or treatment s' stein.':;...::. ;...::. P J P g y �...: ,� 21. Name of sewage system g ,y: g Y Distance'to sewa e s stem >. 22. Date test holes observed 6* 23. Name of Health Inspector 24. Project design flow (gallons per day) . ......... . 25. Is State . Pollutant Discharge Elimination System (SPDES) Permit required ?..: 26. Has SPDES Application been submitted to local DEC office? ......................... 1\ f PA Form PC -97 2- 27. Is any, portion of this. project located within a designated Town or State-wetland? A/0 28. Wetlands ID Number... ......... ............................... ............ w 29. Is Wetlands Permit required? ....................................... ............................... ... NO Has application been made to Town or Local DEC office? ............................... 30. Does project require a DEC Stream Disturbance Permit? .. ............................... 31. Is or was-project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal;. landfilling, sludge application or industrial activity? ............................ Yes/No )v D 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? ............................... Yes/No DESCRIBE: 33. Is there a local master plan on. file with the Town or Village? ......................... . 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to- project site ? ......... ..... I ............................ 35. Are an;y sewage treatment areas in excess of 15% slope? .. ...................:........... 36. Tax Map ID'Number .......................... ............................... Map S Block_L Lot Z� 37. Approved plans are to be returned to ..... Applicant Design Professional . G _ _;. NOTE;- Alhaplications for review and approvahof a- rlewSSTS "to be located within the NYC. Watershed shall be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department: Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP, for review and approval. If the application is signed by a person other than the applicant shown in Item l .,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. - I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the PenalAaw l SIGNATU ;S & OFFICIAL TITLES: --i 'd Z':r, r Z 0 Mailing Address (� �W' —ANY �t� r ,.4 DIMENSION CHART (in feet) Number A g C p 1 20 I S 2 58 54 3 .60 54 4 62 53 5 65 53 6 68 53 7 7z 56 8 77 60 9 61 63 10 86 66 1 69 62 17- 64 56 13 62 52 14 50 43 IS 42 37 16 32 .34 17 28 36 IS 43 31. 19 43 32 20 78 77 22 82 78 23 84 `►8 24 86 '78 25 89 So 26 93 83 27 98 81 28 104 9 1 V � oo f o A 2 105 °4358' L- 25.0o' R. 4 6.13` 2iI.Sp� �=4oer��16" `� N° L = 175.7g' e,, N 4"d SOLID PVC i 1p i Uk B - s 0 011 105043158' R = 46.13' . ; mom am 20I.2 - R oo' X11 L� ROAD APP► -E ,