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631- 589 -8100
83.12 -1 -15 & 83.12 -1 -16
BOX 30
Separate Sewerage System- to conalet' of v v v Gallon Septic Tani and_T'
TBD
. To becoastracted b y
Water SdPP17 Pabllc'S6pply From
or XX Private Sapply Drilled by Norman Andersor
Other Regafrements
� or tI represent that tam wholly m he.des gn and) ocati
above
described will . be con3tructed.,as shown on the•approved amendment there i
place, in good- operating condition any part. of said sewage -disposal.:'
once of 'the approval of .the Ceitificate of 'Construction Cortiplian'ce
wiIl �ba iocaie6as `ihorvhon's hie .approved'pIan.and that,said welbwill'bi-ir
County Department of Health.
Date " T Apri 1 t9, 1992 Signed;
r 1 Northridge Rd ,
Address-
APP ' ROVED FOR CONSTRUCTION: This approval expires one year fr
m
revoable. for cause or may tie'aended'orimodified,when considered nei
requires- a new -. permt ,Approved ".for disposal of dOrYlGit IC 3a}l itary,7
,ddroas ;
ddreee '
c Putnam_,Valley,. NY
i• of the proposed�=system(s) 1) thatthe separate . "sewagedisposal system
to' of ,Construction Compliance •saLSfaetory to the Commissioner 64.1-1ealthwill
id tiie'owner "his wccessois;'heirsor assigns by:the` builder, that said builder will
m during the Period of- two (2) years irhmediately.following thedate'of the issu-
e o�iginat system or any repairs.theretd`2)atAat the drilled well _described above
d, in'sccordance.. dli, "the standards, rules and_,ra u a ons' of . the.. Putnam
R y�y
P.
E11/1_ R.A.
License No '611.45
ie ;date issu6d unless .construction of the building has been undertaken and is
y „by' "the .Commissioner of Health. Any change-or alteration of construction
e.,and /or private wafer supply-.onty..
Date: By Title
M
f
FC ,
JOHN KARELL .Jr., P.E.. M.S.
Public Health Director
DEPARTMENT OF HEALTH .
Division Of Environmental Health Services .
110 Old Route Six Center, Carmel, New York 10512
(914) 225 -0310
April 21, 1992
Bather Noviello
i Northridge Road
Peekskill, NY 10566
Be: Proposed SSDS: Schneider
Lincoln Street
(T) Putnam Valley
TM #83..12 -1- (10 -12) (15 -A).
Dear Mr. Noviello:
Review of plans and other supporting documents submitted at this time relative to
the above - captioned project has been completed. Comments are offered as follows:
1. Design data sheet notes "see map charts" in the section titled design..
Proposed design is to be noted. Revise design data sheet accordingly.
2. Deep test hole data has not been submitted., Additional deep test holes are
to.be witnessed by a representative of this Department.
3. Neighbor Notification is required as outlined on the Guidelines enclosed.
4. Percolation test data for-P. H. #3 notes "N.A." please clarify.
'_-5._ _Narth arrow has not been shown or ..is not no Pd as such.
6. Standard Construction notes 2, 3 and 5 are not noted or are incomplete.
Required notes have been enclosed.
7. Deep test hole soil data has not been noted on plan.
Upon Receipt of a submission, revised to reflect the above comments, this
application will be considered further.
Very truly yours,
Robert Morris
Assistant Public Health Engineer
RM /jp
OHNa7 ��++ '. - .
. ®Btll®®®® E®y r"®®.fie �.
CONSULTING ENGINEERS AND LAND SURVEYORS �-
BSBIC KM, NY 10566
(91@) 737 -1056 L�
In U
PUTNAM COUNTY :DEPARTMENT OF HEALTH Lea.. 5..
.DIVISION OF ENVIRONMENTAL. ,HEALTH SERVICES ( ! = �-
110 Old Route 6
..Carmel, 'NY 10.512
Re: PROPERTY OF SCHNEIDER
LOCATED-AT LINCOLN STREET & OSCAWANA LAKE ROAD
TM 83.12, 1, 10 -12 & 15 -19 & FRANKLIN STREET
Gentlemen:
This letter is to authorize MATTHEW A. NOVIELLO, P.E., a duly
licensed professional engineer to apply-for a Construction Permit
for a Separate Sewerage Disposal System and or Private Water
Supply, to serve the above noted property in accordance with the
standards, rules, or regulations as.promulgated by the Commission
er of the Putnam County Department of Health, and to sign all
necessary papers on my behalf in connection with this matter and
to supervise the construction of said system or systems in con -
formity with the provisions of Articles 145 or 147 of the New York
State Education Law, the Public Health Law, and the Putnam County
Sanitary Code.'
Dated: Apri 1 1, 1992
-Countersigned:
A6 AxFViA,?,F
MATTHEW A. NOVIE 0, P.E.
Lic. # 061145
�C�S�(x�4�IDQGxB��6(X
JOHN S. ROMEO, P.C.
1 Northridge Rd.
Peekskill, NY 10566
(9.14)--.7377-1056
Very ruly yours
Owner
90 Lake Drive
Address
Lake Peekskill, NY 10537
City, State Zip
JOHN S. ROMEO, P.C.
CONSULTING ENGINEERS & LAND SURVEYORS
1 NORTHRIDGE ROAD
JOHN .S :RQMF.,O;PE,.L$.(.1924:) 991).
,. -. , ...., ..,... _ .
JOHN C. HOFFMANN, LS
(914) 737-1056
ROBERT J. ROMEO, SURVEY MANAGER FAX (914) 737 -9333
April 9, 1992
PUTNAM COUNTY BOARD OF HEALTH
Old Route 6
Carmel, NY 10512
Attn: Mr. William Hedges
Re: SCHNEIDER WELL & S.S.D.S.
r -. TM -83.12, 11 10 -12. & 15 -19
`TOWN OF PUTNAM VALLEY
Dear Bill:
Enclosed please find the original application for well and
septic. systems approvals for the above captioned property.
Included are the following:,
1. A signed Engineering Authorization.
2. Two sets of House Plans.
3. Four signed, sealed prints of the S.S..D.S. design.
4. A Well Construction Permit Application.
- 5_,. A: S::•_ S: D., S...:. CQnjstruc .tion_-�Permit. :�App]A.cation:
6.
Three signed and sealed
Design Data
Sheets.
7.
-A bank teller's check in
the amount
of $300.
Kindly approve the plans and return them to me. If you
would like to inspect the site with me please give me a call.
Very truly yours,
JOHN S. ROMEO, P.C.
by: � I��''f '10,;
_ Mq!) Matthew A. Noviel•o, P.E.
DEPARTMENT OF HEALTH
Division of Environmental Health Services
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
'a. V a t ••- -.- -tea rte..... r- ..,�_. ...r -..:
APPLICATION TO CONSTRUCT A WATER WELL
PCHD PERMIT #
WELL LOCATION
Street Address
Lincoln Street
Town/Village/City Tax
Putnam Valley 83.12,
Grid Number
1, 10 -12 & 15 -19
WELL OWNER
Name
SCHNEIDER, 90
Mailing Address - - - --
Lake Drive, Lake Peekskill, 'NY 10537
- (Private
O Public
USE OF WELL
- primary
- secondary
®XRESIDENTIAL
ElBUSINESS
® INDUSTRIAL
. ❑ PUBLIC SUPPLY O AIR /COND /HEAT PUMP
O FARM O TEST /OBSERVATION
O INSTITUTIONAL O STAND -BY
O ABANDONED
0 OTHER (specify
.®
AMOUNT OF USE
YIELD SOUGHT
5 gpm /# PEOPLE SERVED 5 /EST. OF DAILY USAGE 600 gal
REASON FOR
DRILLING
XM NEW SUPPLY OPROVIDE ADDITIONAL SUPPLY
OREPLACE EXISTING SUPPLY ❑DEEPEN EXISTING WELL
®TEST /OBSERVATIONT
DETAILED
REASON FOR
DRILLING
A new home,will
be cons ruc e
WELL TYPE
(OX
DRILLED
❑DRIVEN
ODUG
GRAVEL
® OTHER
IS WELL SITE SUBJECT.TO FLOODING? YES XX NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
Lot No.
WATER WELL CONTRACTOR: Name .Norman Anderson ; 'Inc . Address: Putnam Valley
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE:
YES XX NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN:
LOCATION SKETCH & SOURCES OF CONTAMINATION
[]ON REAR OF.THIS APPLICATION
(date)
PROVIDED
SE A T
(signature)
PERMIT
TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted under the
provisions of 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 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 attached to this permit.
3. Submit a Well Completion Report on a form provided by the Putnam County
Health Department.
Date of Issue: 19
Date of Expiration: 19 ermit Issuing Official
Permit is Non - Transferrable White copy: H.D. File
Yellow copy: Building Inspector
2/87 Pink Copy. Owner --
/1......�r� r.1_l 1
n l l r
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C_* TTY^ O_� = a
SP —T7 i . ON p1 _N
7 ?
ii=—'ds r_ = -
10� Drive�CS�-, =r e Trees, -
20' i'�
tG iC'_L- =�1C:1 _? 15
100 to 4: --l?; 200' i P..L.O.D, 15" _ -=s
100, to - -ea,
15, to
=ti
L�- -7 i^-ci,- lac= 7 =:0'.1
c_,^.1= ^_-_ ✓_
JJ L.7 'C _ ...G
10, to W=, .r Line to-1-:.s-20") / �
50' ir_, �-� =-
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10' ir=,, 50' to well
1=' Well to Pr �
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p-jighbor.notilEcati oLI
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'fill
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ee -th
I
100 Vr. =1 7l of ?,7.
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&
�D_: /= ._ =_c-
Dt. = = =1, i 12 _ over
ion
'S =r, ._rte_ 1 D_;_":S
pr-"Tiazy and
1 L Z - _
& SS�.J t C ;;�1 1 200 Of p-
&
sar lot)
C_* TTY^ O_� = a
SP —T7 i . ON p1 _N
7 ?
ii=—'ds r_ = -
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20' i'�
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100 to 4: --l?; 200' i P..L.O.D, 15" _ -=s
100, to - -ea,
15, to
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c_,^.1= ^_-_ ✓_
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10, to W=, .r Line to-1-:.s-20") / �
50' ir_, �-� =-
S-:;tic Taaks
10' ir=,, 50' to well
1=' Well to Pr �
PLmm aDUISI'Y DEPARTMEZTP OF HEALTH
Page
DIVISION O .. HEALTH , S] _7 CES
DESIGc DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO.
Owner. Schneider' Address Lincoln Street
10-12
Located at- '(Street) Oscawana Lake Road Sec. 83.12 Block 1 Lot 15 -19
(indicate nearest cross street)
Municipality Putnam Valley Watershed
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Date of Pre - Soaking 7 Feb 92 Date of Percolation Test 7 Feb 92
HOLE
NUMBER CLOCK TIME
PERCOLATION
PERCOLATION
Run Elapse
Depth to Water From
Water Level
No.� Time
Ground Surface
In Inches
Soil Rate
Start -Stop _.min.
Start Stop
Drop In
!�_: /In Drops
In&hs Inches
12:55 1:25 30
24 25,5
1.5
20
2 1:25 1:55 30 24 25.5 1.5 20
3 1:55 2:25 30 .24 25.5 1.5 20
4 2:25 2:55 30 24 25.5 1.5 20
5
#5 1 1:45 2:15 30 24 22 2 15
2 2:15 2:45 30 24 22 2 15
3 2:45 3:15 30 24 22 2 15 �,...
4
5
f
NOTES: 1. Tests to be repeated at same depth until approximately equal Soil rates
are obtained at each percolation test hole. All data to'. be suhnitted
for review.
2. Depth measurements to be made from top of hole.
rev. 9/85"
TEST PIT DATA.:RDQUTAED,TO BE- SUBMITTED WITH APPLICATION-
Page 4
DESCRI -PTI
ON
OF SOIIS EN( OM -IN TEST HOLES
DEPTH HOLE NO. 4 HOLE NO. 5 HOLE ISO. 6
G.L. Vegata,io ^� Vegatation Vegatatiorl
1' Top soil. Too soil Top soil
21 sandy loam sandy loam sandy loam
3' `
4'
5'
6'
7'
8°
.9°
10'
11°
12°
13°
14°
WiIROCTNI7�ATER - IS
Nflfl a
INDICATE LEVEL TO WHICH WATER LEVEL. RISES AFTER BEING ELMNTEPM N/A
DEEP HOLE OBSERVATIONS MADE BY: William Rundle DATE: 2/7/92
Lot 1 30 DESIGN Lot 1 8000
Soil Rate Used .Lot 2 20Min /l" Drop: S.D. Usable Area Provided Lot 2 6000
see map
No. of Bedrooms see map chart Septic Tank Capacity chart gals. Type concrete
see map
Absorption Area Provided By chart L.F. x 24" width trench
�91�'1
. -JOHN S. ROMEO, P.C.
Name by: MATTHEW A. NOVIELLO, P.E. Signature
Northridge Road
Address _..Peekskill, NY 10566 SEAL
(914) 737 -1056
THIS SPACE FOR USE BY HEALTH DEPART ONLY:
Soil Rate'Approved sq.ft/gal. Checked by Date
k.. --L
�.
APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM
Name and — Address of Applicant: JOHN and D[ENA 3[HNElDER
90 [dkS Drive
Lake Peekskill, 0537
-
2. Name of P -~ 'ect: Schneider house 3. Location Put V�]] ey
' 1 Northridge RU'
�
4. Project'. Engineer: MATTHEW A NOVIELLO P.E. P^E^ �. Address: Peekskill, NY 10566
License Number: 61145 phone: 737-1056
G. Tvoe of
______
Private/Res1deDtial Food Service Commercial
Apartments ______Institutional . ���ile Home Park
Of f1te BUi7diMg Realty Subdivision �ther (specify)^
7. Is this project subject to State Environmental Quality Review (SEQR)? N0'
Tvoe Status (Check Onel Type I.. Exempt
Type II. Unlisted
B. Is a Draft Environmental Impact Statement (DEIS) required? ..,.,',,,''.. NO
N/A
g' Has DEIS been completed and found acceptable by Lead Agency? ,...,..,,.^
]' Name of Lead Agency N/A
1 ^ ^ �m this project in an area under the control of local planning, zoning,
Yes
� ��[Qth��o�fi 'al�'_qrdi s? . .,.,.^��'��,���������������,/��^_������.'���i� '
�. If so, have plans been submitted to such authorities? .........,.^^,.'~^ Yes
'
3. Has prelimin ary approval been granted by such authorities? Date 8rantedP8UdiDg
t. Type qf Sewage Disposal System D'schar8e,...... Surface Water XXX Ground Waters
i. If murfaoe water discharge, what 1m the stream class designatioM?.....,.. m
'
i. Waters index number (surface) ,,,,,,,,,,,,,,,,,,,..............^.....^.. N/A
No
'. Is project located near a public water supply s .......^....^^^^^^
�. If yes, name of water supply Distance to water supply N
|. Is project site near a public sewage collection or disposal syStemY..... No
Name of sewage system Distance to sewage system
. Date observed: 23. Name of Health Inspector:
Project 600
Are. community water, sewer facilities planned to be developed within 15 years? No
Are any .sewage, d.is.posal.. areas. in- excess of 15% slope? ........._......:.., ..., , ..._ No
Tax Map ID Number ......................... ............................... 15 -19 & Franklin St.
Approved Plans are to be returned to: Applicant XXX Enginee;-
the application is signed by a person other than the applicant shown in Item 1, the
lication must be accompanied by a Letter of Authorization. Failure to comply with this
vision 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 Penal Law. MATTHEW A. NOVIEL_LO, P.E.
iATURES & OFFICIAL TITLES: Cti��
.ING ADDRESS: -'
Project Engineer
1 Northridge Road
Peekskill, NY 10566
Is State Pollutant Discharge Elimination System (SPDES) Permit required ?..
N/A
Has SPDESAFr i ~caL'fon-been submitted to local DEC Off sue ? ...............
. Is any portion of this project located within a designated Town or State
wetland? .................................. ...............................
No
. Wetland ID Number .......................................................
N/A
. Is Wetland Permit required? .............. ...............................
No
Has application been made to Town or Local DEC Office? ..................
N/A
. Does project require :a DEC Stream Disturbance Permit? ...................
No
. 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 or NO
No
Is project located within 1,000 feet of existence of abandoned landfill,
hazardous waste site, salt stockpile, landfill, sludge disposal site or
any other potential known source of contamination? ..............YES or NO
No
DESCRIBE:
Is there a local master plan or file with the Town or Village%
Yes
Are. community water, sewer facilities planned to be developed within 15 years? No
Are any .sewage, d.is.posal.. areas. in- excess of 15% slope? ........._......:.., ..., , ..._ No
Tax Map ID Number ......................... ............................... 15 -19 & Franklin St.
Approved Plans are to be returned to: Applicant XXX Enginee;-
the application is signed by a person other than the applicant shown in Item 1, the
lication must be accompanied by a Letter of Authorization. Failure to comply with this
vision 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 Penal Law. MATTHEW A. NOVIEL_LO, P.E.
iATURES & OFFICIAL TITLES: Cti��
.ING ADDRESS: -'
Project Engineer
1 Northridge Road
Peekskill, NY 10566
pumm aXNN DEPARTMU OF
DIVISION OF •• •: M v •EALTH SEMra+
DESIGN DATA SHEET— SUBSUFACE SEWAGE DISPOSAL SYSTEM
Owner Schneider
FILE NO.
PaQ-p 1
Address Lincoln Street
10 -12
Located at (Street) Oscawana Lake Road Sec. 83.12 Block 1 Lot 15 -19
(indicate nearest cross street)
Municipality Putnam Valley Watershed
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBNBTI'f?A WITH APPLICATIONS
Date of Pre- Soaking 7 Feb 92 Date of Percolation Test 7 Feb 92
HOLE
NU, MER C= PERCIII.LATION
PERCOLATION
Run Elapse Depth to Water From
Water Level
No- Time Ground Surface
In Inches Soil Rate
'Start-Stop Min. Start Stop
Drop In Min /In Drop
Inches Did
nch.es
#1 1 10.46 11.16 30 24 25 3n
2 11.17 11.47 30 24 25 1 30
3 11.47 12.17 30 24 25 1 30
4
5
#2 1 10:49 11:19/ 30 24
1-1 :'Z0
3 11:50 12:20 30 24
4
G
#3 1 12:50 1:20 30 24 24 10 N/A
-1,, i 1.,:.20 "1, -:.50 30 24 24 0 N/A
3
1 :,50 `,'2:,20. 30 24 24 0 N/A
5. -
"C7',
N=: 1. Tests to be repeated�at same depth until approximately equal soil rates
are obtained at each percolation test hole. All data to -be suimitted
for review.
2. Depth measurements to be made from top of hole.
rev. 9/85
DEPTH
_ TEST PTT DATA RDQUIRED TO BE SUBMITI'ID WITH APPLICATION
u%SQ=ON Or SOMC * ENCOUly-ZETM IN TEST HOLES
HOLE NO. 1
Vega•tat i•Gr;z
1' Top soil
2' sandy loam
3'
4'
5'
6'
7'
•y:
10'
11'
12°
13'
14'
Pan(z 3
HOLE NO. 2 HOLE NO. 3
Vega tat
ion Vegata'tio� _
Top soil Top soil
si 1 ty 1 oam s,i l ty loam
7_N XATE -,I VEL RT :I IGI�, G ?QUND4� 'EN - S.. E'NCOUHTEREb, . > <No�1e :-
INDICATE LEVEL, TO WHICH WATER LL;%M RISES AFTER BEING E NMUNTERFD N/A
DEEP HOLE OBSERVATIONS MADE BY: William Rundle DATE: 2/7/92
DESIGN Lot 1 8000
Soil Rate Used Lot 2 20Min /l" Drop: S.D. Usable Area Provided Lot 2 6000
No. of Bedrooms see map chart Septic Tank Capacity see map char4als. .Type concrete
see map
Absorption Area Provided By chart L.F. x 24" width trench
Other
JOHN S. ROMEO, P.C.
Name by: MATTHEW A. NOVIELLO, P.E. Signature > __
1 Northridge Road
Address Peekskill, NY 10566 SEAL
(914) 737 -1056
THIS SPACE FOR USE BY HEALTH DEPARMI' ONLY:
Soil Rate Approved sq.ft /gal. Checked. by Date
�--- 46' 5' 37' 9• 30',111 3/4'
-�-- 52' 0'
5. 7' I d' 8• 6. 9 1 /ii 23 0 3/4' 7' 3'
18 O , 2642 1 O 2432 3046 }
F10fE 22X6 SF1(p 123 0 0 ,;,430 .230 13' 10'
2. 11 6' 10 1/4'
1248
o
m S 2' }FIII
} m 1 1/2' FILL o o 9 9
10' 6' •.�. 6• 1 1/4' 9' 5 1/2'. BATH 1
m m II
NOOK N O #2
rr
DINING 0 O BR #1
O n
ti V30 lSBO
I, KITCHEN m
II -
i I n 1 7• 9 1/4' 2. 0.
II ,
1 I 1/2• FILL 9
ATH #
m DESK TOP - CLG 9 O
Ac
_ - _ - N SBBO _ - O 5 PNL 1 C ELEC
o _
RCS 2_1.5' X 10_ NL 2430 2430 L DROP
9 v
•
of e. 6' 9' 9 3/4• .!i 3' 0' 3' 6' 3' 1' 1 10' 4 2/2'
HALL m 5
°m
3' 0'
a o
7 O
m '
LIVING RM m BR #2
Q 9
BR #3
n
° 6' 4 1/2''
1O
v,.
H FIN TO FIN
m
&:
M
9
20' 0' 9
10' S 1/2'
2' 0'
f!' 0'
iu
0 12
5' 1f' O 13046 9' f0' O 19046 9',1 3/4•
10. 6 3/4' O
3046 10' 2 1/2'
O 3046 7, 4.
4•
46' f' 37' 9'
28' 1 1/4
17' 6 -!2'
e
STLq
6' 5 1/2'
STUD TO STUD
.T'J024' 10 1 /2'
,
SGNNE /,DER
LYNWOOD
® ®
ORWN
BY:
DATE.
CHKD
BY:
_
DATE: '
PENN LYON HOMES.
INC.
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