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HomeMy WebLinkAbout1835DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 35.06 -1 -17 BOX 16 Oil jr�Wf 01835 COUNTY OF R DEPARTMENT OF HEALTH - Division of Envizromnental station DESIGW- I!ATA"SHEET - SEPARATE SEWAGE SYSTH�M FIIB N0. _. �.1�i.�KZ' OaerSf". C #AJ?�GS 1?A'4Y YeaanAddres& 19L B /P f' -. ¢ Ste'V GAA - Located At (Street) Sec. Yff Lot (muclt—e nearest cross street) Municipality , ' R ® N Watershed MW K ®AI& C ®r y.... SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED 14ITH APPLICATION 3 4 Notes: 1) Tents to be repeated at one depth until approximately equal soil rates we obtained at each percolation test hole. All dsta to be submitted for review. 2) Depth meanuremsnts to be made from top: of hole . Hole Number CLOCK TTNE- PERCOLATION PERCOLATION Nan Elapse -Depth to Water Water Level No. Time Frcm Ground Sm-fam in Inches; Soil Rate Start Stop Alin, Start 3iopr Drop in ANWin.di'opr Inches Inches Inches 1 3 42 2 1°' -30 /V ?a ®2 � > �?• Z744fe -PA sr? .?7 3® 'r ;zd > ?.d 3 4 Notes: 1) Tents to be repeated at one depth until approximately equal soil rates we obtained at each percolation test hole. All dsta to be submitted for review. 2) Depth meanuremsnts to be made from top: of hole . 54" 1- ..72m I. 78" 84" INDICATE LEVEL AT IMCH GROUND WATER IS ENCOUNTERED' > INDICATE LEVEL TO WHICH WATER LEVEL RISES- AFTER BEING ENCOUNTERED TESTS MADE BY.2 Q pj JUS(p.�'..tP / DATE j4 . JU '9 DE GN Sbil Rate Used A6 b 2 o Min/I" Drop-. S'.D ® Usable Area Provided Noe of BedroomaSeptic Tank Capacity Gal Masonry Absorption Area Provided By L.Fwt 36 "; Other .Name 8115130 SsQC;1,ATES Signet Address: CONSULTING ENGINEERS �I• : w7l. M R1LiCg• N. _Y. _- • _ _SEAL t County, Health Department Soil Rate Approved® . Ft. /Galo Checked by Dated j S.D. 27.6 (Rev. 5 ®24 -66) (February 189 1969) I (DEPARTMENT WELL COMPLiETION REPORT " !' PUTNAM. COUNTY ' OF HEALTH 3/71 Division of Environmental Health':Services COUNTY. OFFICE BUILDING -- CARMEL, NEW YORK "ihls reptrrt Is to' bE 'completed by weU' driller eQ'SUb' mir ed"tu County Health' Department together with. laboratory - :report; of analysis oif water sample indicating water is of satisfactory bacterial quality before . certificate of construction compliance-is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION NAME ADDRESS. OWNER z z I . LOCATION (No. B Street) (Town (Lot Number) OF WELL (("77'jj�� BUSINESS ❑ ❑ ❑ PROPOSED (DOMESTIC ESTABLISHMENT FARM TEST WELL USE OF WELL ❑ ❑INDUSTRIAL ' ❑CONDITIONING ❑ ((SSpe ify) SUP Y DRILLING �''j � COMPRESSED af6TARY ❑ CABLE OTHER ' ❑ ❑ EQUIPMENT AIR PERCUSSION PERCUSSION (Specify) CASING LENGTH (feet) DIAMETER(Inches) WEIGHT PER FOOT ❑.WELDED RI O ❑ CASING �j NO ' DETAILS ,� THREADED YES NO YES ... L J YIELD HOURS. G.P.M. ❑ BAILED ❑PUMPED. COMPRESSED AIR YIELD (G.P.M.) ' TEST :; WAVER MEASURE FROM LAND SURFACE— STATIC(specifyfeet) DURIN Y ELD TEST (feet) Depth of Completed Well LEVEL ^ _ iq feet below Land surfaceQ. MAKE LENGTH OPEN TO AQUIFER (feet) SCREEN DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL Diameter of well including RAVEL SIZE (Inches) FROM (feet) TO (feet) PACKED: gravel pack (Inches): DEPTH FROM LAND SURFACE .Sketch exact location of well with distances, to at least FEET to FEET FORMATION DESCRIPTION two' permanent landmarks. z ' t . 1 If yieIcNas tested at different depths during drilling, list below 1 PEiT GALLONS PER MINUTE 'CC?,oAETED DATE OF REPORT WELL DRILLER (Signature) II Municipality saner o. rchaser of building r _4': 'Building Constructed' by Section .Location - Street Block ' °,Buildi Z�pe Lot ,.., GUARANTY OF SEPARATE SEWAGE SYSTEM I represent that I'am wholly and completely responsible for the location, �`r ,,.workmanship, material,.construction and drainage of the sewage disposal system. serving the above described property, and that it has-been constructed as.,'shown on r t the approved plan or approved amendment thereto, and in accordance with the' tandards, rules and regulations of .the Putnam County Department of Health, and hereby' guaranty the owner, his successors, heirs or assigns, to place in good operating condition -any part of said system constructed by me which fails to operate for a period of two years immediately following the date of initial use of the sewage disposal system, or `,:'.any repairs made by me to such system, except where the failure to operate properly Cz is caused by the willful or negligent act of the occupant of the building utilizing the s• stets . The undersigned further agrees.to accept as conclusive the determination of the Director of the Division of Environmental Health Services of the Putnam County Department of Health. as to.whether or not the failure of the system to operate was ,caused --by- the- w -llful:: ar_ iegligen ..a _t of the occupant of - the:_ - building - utilizing the - �, system. �... .- ..__..._._. ____..__.._... _._.,_..._..._.._�. _,...Q.. .. t. Dated this day of 19 Signature -r Title c (if co poration, give name and address) L -r -- - rr - - -r- . r-- r- rr-------- rr- r--- -rrr--- rrr- -- -r rr-r, -- -- -7L--- -- .�'.}------- - -r-��- THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. - GUARANTOR IS REQUIRE TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. Division of Environmental Health Services Putnam County Department of.Health 5 , _ MPUTNAM CQUNTY DEPARTMENT._OF_.HEALTH Separate Sewerage System0 Municipality CONSTRUCTION PERMIT Located at( 'j Section Block Subdivision IY_5 Lot Job a5i.A3 Owner `6{1, <)s? ,G `t `)L -,r >Addressl .:IKC— lfl r���r� Lot. Area �ZI ;(- . Building Type T >U i 1.� -_X -- ��04 cif drooms Total Habitable Space sq.ftt. at6, 8ewerao , §Zstem to consist of al. Septic Tank lineal feet wad4�h trencxs rr To o Aotrapted by Address, . µfiat "er Public, Supply from y tJ Private Supply.to be drilled by Address : v ;her, Ra'Q Ir.rS en.ts s:oprc er��; the 4, T_ em_ wholiy� and_ -conipl_ately :re- sponsible -for the des igr� and Location of the proposed systems) 1) that the se arate`sewa e-,cEs " uooaal system—above described will be. constructed as s o the approved p-Laxi or approved amendment thereto and in accordance : with the standard5,: rules and regulations of the., Putnam County - Department` of Health; - arid that,-" on completion thereof .a "Certificate of .Construction C.ompliancef6 s4tis_ 1 . °rectory,to the Commissioner of Health will be submitted to the ­Depart . :.ti.t� and a written guarantee will be ,furnished the owner, his successors, hairs op assigns by the "builder, that said builder will place in -good operati.ag Oandi'tion 'ark ar'.?; of said 'sewage.: disposal' system during, the �e'r od of two { 2) years inre4 {i a ely f owing the date of the insurance of t Ye_ alp "roval of .tai© Cert fi0ate' of. C r ,�truction. Compliance :.of the :original s .stem or, any repairs thereto; 2) that the . drilled,. well deseribd� e 1 be located..as shown 'on the approved p awn and that sa�c���re� �w� cue:. insvalied in accordance with the. standards ' rules and' re u1,'atiai ?? oil v�%,Put:nam Court T r 'mot 3 f Department Health. .Gate iS./ % �� Slgnr:d •a .-� AP1?ROVID FO:R: ONSTRTJGTION:. Thss approval expireszne ye fr�oiF the date {" 1 \ t `Ry ri i ✓ issued unl s construction of the bui -ding has �b$en,;� .4 *k—_ re�};.-and is re- vocabl e far. cause: ol� may be amaanded e ?riodified when enidred necessary by the Commiss.ioner� of HealthO Any c range or alteratsori csf construction requires res a &n- permit.' Approved for di_sposa f domestic sanitary sewage. - - Z Date:_ Ins p. INITIAL SITE INSPECTION Yes No Comments Property lines or corners found .... . . ... . Can estimate house location . o Will driveway need cut_, Must trees be removed -note these .. . . o Is deep hole representative of entire SDS area Additional deep holes needed. Sufficient SDS area available considering driveway cut,house location,, separation . distances, etc . . . . . . . .. . DEEP HOLE DATA Depth: Water elevation: Rock elevation: G Soils description: - Date: FINAL SITE INSPECTION- Ins p. b House located where shown on approved plan SnS neat �d hAre a-mDroved LGil�l,ll Ul l,t C11C:11 LL1Cd,�- U:L'CU. �Q 4 � � Width of trench average Slope of tile line and trencha.cceptable . x - _ 3 Room allowed for expansion trenches . . . . Over 50 ft. from swamp,watercourse Natura;1- soil- -not. stripped or-- _- SDS:'ar1a _- ...._ -:.. _._v a. _.. _ :..., _ _.....- .....� . .- ._:_._...._.......- ...____.,. unnecessarily graded . . . . . . . I. . o ` 10 Ft. maintained from prop.line and 20 ft. from house Separation of trench from house;14l etc. follows plaCk . . . . . . . o Number of bedrooms checks . o . .-3. . Stones, brush, stumps, rubble, etc. greater than 15 ft. from nearest trench k — 15 Ft. of peripheral soil. horizontally from trench.. . . . . . . . . ... . . . . . . . Junction boxes properly set Could surface run off from driveway, roads, ground surface, etc. channel near SDS a area . . _ Does lot drainage a ear O.K. in area of FINAL GRADING OF SITE ACCEPTABLE F CO>�Jj�'I Y DEPARTPjiENT OF HEALTH PUTNAM . N y 10512 Heal #h Serv►ces Carmel, , ®ivroron' of Env�runmenta r 5 P titter s h } r Town or vmage � R CO.N$TRUCT ~ ry• ATE.OF:- tON COMPLIANCE FOR SEWAGE 'DISPQSAL SYSTEM ,� 'CERTIF,IC_ lock ^'T7 } 'B 5 1 _ section r� j, kespr1ng Meadows Old= Route 22 Sublot 42- yob Located at InC. tot New York ` Forrester Builders to Bldrs Inc Address Brew 6 �` w�dtK; ch Owner F Orr2 ;s r- _ 3 It trap Sepaiate Sewerage SY•stem built SbY COT1C P/G Gal "sePt�c Tank 'r 3 27 f Imeal Feet Xa Consisting of .:9.0 Other- r m equireents Public SuPpIY From Bo d Pi Water supply y rtescan Wells X , r Private Supply Dulled BY Nrew YOr�C Route:52 Cannel _ Address s —_�t Issued r 3 Date a , No of Bedroom Residence } t r r yj, B,widin9 TYPe�, S;IONAL OF N yy yt which are Has Erosion Control Been Completed o c _ _ Health P y 9F" = Y at'tha systems) as listed,serwng th;e above premises were constructed essentially as y I•.cerhfy th G a attached), and m accordance wRh the standards rules and r@gulations plans filed and the L ptei(ibei ' =6 '97 3 ` certified by e I�Q •• h Date t �� �� _ t ` v, �� �'Kf ✓� '� .� a nitarY Address / = c �aryat th . comes ! a x ch a o may . public sanitary i m s shall promptly Oak and v ��s vats are =.1 r' =n remisesserved by the above syste O i /inY Pe`rsonl, occupy 9 P e Approval ;of the separate sewera98 system shall from ?such usage I shall ,become null and; void -lien a ":condit.io,ns resulting ssioner of;_Healt �g N royal` of the. private water wPP Y agailable -and the .app in, s k when the judgment of th to modrfiwtion or change- = subject T -T rtle 5) ? .�a pate'-- v :f e F- j BACTERIOi:4GY = PARQSfOLOGY • VIRt?i:OGY - 4 ANTIBIOTIC USEL SaTl48 { : ' SOURCE OF MAERtAL p RE4UESt [l t LL 'ep ❑SMEAR CULTURE Pli um Foxrest�r >rt1C1 "erS EJ [] klose . . . IO aE t 442,- ❑- Diphtheria roet Pina w 1. fungus pine . :❑ c. :'Lake . Sprngieadow v Dei 'opment aces ❑ a F { us: rom ❑' € r ❑= yr ❑' � PUTNA �1 (� IOS�1 LABORATORIES <3 ❑Ova -end P�6rasltes� ❑ Vir l Studies. x' STONELE1014 1VENUE CAF�MEL, "N Y ._ 10 -: 7 ENS: R S STAPNLOCO 'CCUS ❑'Aerobacter r:1 SENSITIVITY ❑ Nori -Remo Coag: To'Folfow,: ❑ Corynebactenum: Ch Oramphen�col Eschenchla Colistin Sulp ate,"`._ •• ❑ .Hemdlytic -Coag. To Follow : -_ ❑ Dec omycin ❑Coag: Positive ❑: Klebsielfa ,. N t Paracolo . DihydrostrePtEmycu ❑ ega ive. ❑, Batt � ryt romyrrn ,STRE . O OCCU EMOLYTIC_ ❑ ,Proteus. ' eomycln - _,Y ❑ A P a' . ❑ Gamma . ❑' Pseudomanas -, • ,- '.Nitroturanto1n - 01ntergi:occu "s` epic o Ent Path ge6s r Oxacillin'; ❑ Pneuiriococcus fl' -Found Papal a ❑ Neksena ❑Not' Found: ^ :Penicillin''- ph051 Hemo. _ . Tetracycline x .r TUSERCUL S SMEAR TUBERCUCOStS CULTURE riacetylo eau oiriy`cm ❑ Acid Fast -'Not Foun d' F1 eg:` or Acid Fast rrlpiei lip' " ❑ Acid Fast - EPUnd °-• Q Pos R _ 3 ' ❑ Smea Neg Lin rs, Routin _ t ❑' u tunes; ❑ 08�P Posrfrve of v' DEPARTMENY: OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278-6130 Fax (914) 278-7921 Timothy & Collean Murphy Old Route 22 Patterson, NY 12563 BRUCE =IL— FOLEY- Acting Public Flealdi Director August 14, 1997 Re: Addition - Murphy-Old Route 22 No increase in number of bedrooms (T) Patterson TM #35.6-1-17 Dear Mr. & Mrs. Murphy: I have received and reviewed the plans for the propbs* . ed addition to the above mentioned residence. The proposal for the addition has been approved as per plans bearing the latest revision date of August 13, 1997 and this Department's approval stamp. Based on the information submitted, the above mentioned addition is approved with the following, conditions: "1. The total number ofbedmoms must- remain, at three without prior approval by this Department, I" Thb afdA of th6 existing sewage - disposal must bEftf ed.- 3. All plumbing fixtures must be updated with water saving devices, i.e.,new low flush toilets, restrictors for shower heads and faucets, etc... Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Patterson. If you have any questions, please contact me at your convenience. Very truly yours, William Hedges Sr. Public H_ ealth Sanitarian Wf Vip cc: BI (T) Patterson G Westchester County Department of Health Division of Environmerital Sanitation ....AFFIDAVIT_,; CORPORATE OWNER...APPIrI�'ATION -- FOR PERMIT REQUIRED BY WESTCHESTER COUNTY SANITARY CODE (Please type or print in ink) TO: Commissioner of Health - In the matter of application for EO 19.S — _ _, represent that I am authorized to act for the c7 (Name of Corporati n"`�'' ", having offices at _____________ _____ ------------------------ �� _whose officers are President _ _ _ -�'=! _ — Cz' — _ GAY 0�� ���`)t'�(►'?AZ,0ec --K (Name & Home Address) Vice -Pres.t'----- - -r - -- (Name & Home Address) Secy ° — — — — — — — — — — — — — — — — — — — — — — — — (Name & Home Address) Treas. (Name & Home Address) by Resolution adopted C _ - _ _ — 19A. and that I am and will b 7-individually responsible for any or all acts of the corporation with respect to the approval requested and all subsequent acts relating thereto. ST Sworn to before me this day Signed of 19 Title Notary Public Form S.D. 28 September 30, 1969 TY CORO. DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 BRUCE R. FOLEY, R.S. ,,.... Acting Public- .Health _ Director ADDITION APPLICATION _ (RESIDENTIAL ONLY 06W 35• !o -1 -17 STREET: TOWN j2�Di� TX MAP # OLD 70- 4 - l 5 NAME:Tj&4 GotlA&4 MUg&{ PHONE 279 -29 tfl PCHD PERMIT # MAILING ADDRESS OUQ Ple 22TMrgW ST IZ . N I✓ [mil YO RAC LO ro9 Description of Addition C�of4r2 LrA 22tx[�t FAMILI &W ADDI'Tlp` 851- ATTAcWp "5 Number of existing bedrooms Proposed number of bedreoms 0 Any addition which is considered a bedroom requires formal approval of plans (Construction Permit) prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County Sanitary Code. Please submit this form and the following to PUTNAM COUNTY HEALTH DEPARTMENT, 4 GENEVA ROAD, BREWSTEP,, NY 10509, Phone 273 -6130 with the following information. 1. Certified Check for $100.00. 2. Sketch of existing floor plan (all living area including basement, if any) Non - professional drawing is acceptable. 3. ' Sketch of proposed__ f l oor plan. Non professional drawing is acceptable. 4. Copy of survey showing well and septic location, to the best of your knowledge. Include date of installation if known. Include all wells and septic systems within 200 feet of property line. Any questions please contact this office. OFFICE USE Comments and /or conditions application August 1995 il DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Gentlemen: BRUCE R. FOLEY. R.S. Acting Public Health Director Re: Residence Tax Map 7,42 Town According to records maintained by the Town, the above noted dwelling IS NOT in compliance with Town code and the total number of bedrooms on record is 3 This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: OTHER T J DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Gentlemen: BRUCE R. FOLEY. R.S. y ' Acting Public Health Director Re: � ✓y Residence / Tax Map 719 4/- -" 3S� l� -1--17 Town According to records maintained by the Town, the above noted dwelling IS IS NOT in compliance with ToNvn code and the total number of bedrooms on record is 3 This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: OTHER Al^ lip- &ftav Rnildinc, TncnPrtnr I ;a Putnam County 39256 Savings Bank Brewster, NY 10509 50- 7098/2219 DATE 6 -19 -97 PAY TO THE ORDER OF * * * * * * *PUTNAM 'COUNTY HEALTH DEPT. * * * * * ** 1° U T N A M CO. � � �tail� I�nn�� r• ;� SAV.BK. t *t Itnd utt� ':• 100.00 RE:TIMOTHY MURPHY S'ELLER'S CHECK:; 11'039 25Gila 1: 2 2 19709hi0ll: 898 0 C30 1.2 97��' e NIP F., ;4 a, DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 BRUCE R. FOLEY, R.S. Acting Public Health Director ADDITION APPLICATION _ (RESIDENTIAL ONLY h1raW 35. -I -17 STREET: az .ge, Or 22 TOWN TX MAP # OLU 70- -IS NAME :TttA j}`( �ColajE,%44 ML19M PHONE 119 PCHD PERMIT # 6 MAILING ADDRESS 11CQ P16 22 W146194Z t N 5W YO 9A= ( 0YO1 Description of Addition CbA =LrA 22 (x` FAM LL-r IkOM A0011W SEE ATT'ACIEP 5 Number of existing bedrooms_ Proposed number of bedrooms 0 Any addition which is considered a bedroom requires formal approval of plans (Construction Permit) prepared by a Professional Engineer or Registered Architecr, in accordance with applicable sections of the Putnam County Sanitary Code. Please submit this form and the following to PUTNAM COUNTY HEALTH DEPARTMENT, 4 GENEVA ROAD, BREWSTER, NY 10509, Phone 278 -6130 with the following information. 1. Certified Check for $100.00. 2. Sketch of existing floor plan (all living area including basement, if any) Non - professional drawing is acceptable. 3. Sketch of proposed floor plan. . Non - professional .draw}.ng. J.s acceptable__.. '.. '.._'_ 4. Copy of survey showing well and septic location, to the best of your knowledge. Include date of installation if known. Include all wells and septic systems within 200 feet of property line. Any questions please contact this office. OFFICE USE Comments and /or conditions application August 1995 9 ioiao sinfief associates, Inc. 144 lookout paw stor,nine, rmw yat 12582 Owne/fax (914) 226-3408 2 l • Letter of Transmittal Date: - _ o.r ot� - Dco rrte i42 , F�k-f�Q Q . WE ARE SENDING YOU _✓Attached Under separate cover via the following items: _ Shop drawings _ Copy of letter _ Prints ✓Plans _ Change order Conies Date Na. Samples _ Specifications 1 merintinn f6' �IJ1`i�°l7 I Gf-t W -5ke: AMOUNT Of- $ 10000 're P 0-A•D 2 Co 23 ji? Am)rn o to j, ap9u GATT c) 3 Col 23► q-1 �,;xls-n a5l 4 Pg0P01*D pc.o 0 tL puw s w/ ppgo,ED a-61. 2 Af7 - 97Ul LT 3e?it 0 A l SLL VUA" THESE ARE TRANSMITTED as checked'below:- ✓For approval _ For your use _ _ As requested _ ✓' For review and comment _. FOR BIDS DUE REMARKS: Approved as submitted _ Resubmit r copies for approval Approved as noted _ Submit _ copies for distribution Returned for corrections _ Return _ corrected prints Other . , 19_ PRINTS RETURNED AFTER LOAN TO US COPY TO JMU2e4'-C ' 5 SIGNED: FtLG If enclosures are not as noted. 11-44 �c erLi u c t PA4 -- notifv us at once. J' 0 AP r • . �t► �1 • .• WTA r • • rr I� ►� �1 u:. V1a01O 'e COPY TO JMU2e4'-C ' 5 SIGNED: FtLG If enclosures are not as noted. 11-44 �c erLi u c t PA4 -- notifv us at once. � t f • / V� ucnaw County Department of Health iaisio of Environmental He lth Services ;proted as noted for conformance with xglicable Rules and Regulations of the jitnam County Health .Department... i t. r L2 n. MUr- PHY F, ��IdE--NG F- ' alD �T�. 22 I'A1`r���► -I , l•�.'i. TAA HAP Ho, oL V : 70 -14 -15 N 1-17 fy-VA C,P(73(q1 3 i Exe,T�4, mogm GL, 521 -011 --4-- uuufi 'Y De 0 t u (ilia ental alth se-rvic4ia ,:.vjSj nri -y -y Lronm, He conformance with Ze, the oved as noted for coT .-Olicable lu'les pc,.cfl- Ilations Of y Health DeP3Xtl"Ont- "Iltnam Count'- tr -14- G 9 -7 20F is CIA uuufi 'Y De 0 t u (ilia ental alth se-rvic4ia ,:.vjSj nri -y -y Lronm, He conformance with Ze, the oved as noted for coT .-Olicable lu'les pc,.cfl- Ilations Of y Health DeP3Xtl"Ont- "Iltnam Count'- tr -14- G 9 -7 20F --TWO 6.-f OF P, II 4 175 72 S t M E: t� T 7- C TAX HAP Ho, OLZ) '70- 14 -1F6 l4 .A�P 51 hl1-sq r 4 e44 • 7W 6T0fLMVILtp" H-Y, PH- 14) +oon and 22r;,- for '7-rVm-ent of Hea'lt)a Gourtl;]�De — --� - A,visiop of Environmental Health Servir 0'r oted for conformance with )-plicable Rules and Regulations of the ;utnam County Health Depaxtment.- T, + At p T! r C7t`T6 R+o 2oNe: -f_IO►`�_ "I_p:. N G v .L r H,( MIN. YAK r,-, r fot-1T i41 ?�8 74.1 FT• PRoPasED o5c(teer4ev • I, FbIzaW 3o FT, IF 21.7 PT a.3 Pevuisre, ( -e^ I- icoN1 +h 40•o FT to Re,weefc �('.•oopo9�p FAMILY (ZCONt;APVITIo�I 40, coo %Pc 21, `I lb 1.1 000 5a rt MIN, D, R FPa�T�� E - 14o PT pGqu2�iTto Hm. Ht. 3e' FT. IEXI9TINCo, DEcI4 To PEE (t- OMOVep, AVH• LOT WIDTH I5o FT. 1N 140.5 FT ' a5 FF.y "L, d IF ,. � Roo ' .i3- �,•..�� �� � -j.�r # W Qr �} I I y -� O i J 1 rff,i(2l. I.OGTI p.� 0l � � G u l Ir7 rsov .y 1RoJ , 6._I uF•. �.. 140.0.7. "� Po'E n, Te OI..O few P ^vcM cU T 7 :r PLOT PL/Al-I 5GP•l.e i = r70' jE{tED Apely Zoi -II�JG D17T�IC.T �•40 �FLiIDbr1'TI/•L ?�' fox A' jAC I-1/P No, r1Chl 35.G-I-17 oLP 70_4- 15 ! >f S�, �O• 012T�j,F �F OF NO y/ 61T E C7t`T6 R+o 2oNe: -f_IO►`�_ "I_p:. N G v .L r H,( MIN. YAK r,-, r fot-1T 40 FT. 74.1 FT• 5 i D E 3o FT, IF 21.7 PT a.3 Pevuisre, ( -e^ I- 'o FT. +h 40•o FT to Re,weefc LOT A( E/\ 40, coo %Pc 21, `I lb 1.1 000 5a rt MIN, D, R FPa�T�� E loo FT• 14o PT pGqu2�iTto Hm. 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