HomeMy WebLinkAbout51492-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
OR
SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 51492 Date: 12/18/2024
Permission is hereby granted to:
William Nystrom
79 Pine St
Dover, MA 02037
To:
construct accessory in-ground swimming pool as applied for. Pool equipment must be located in the
rear yard with a minimum 15' setback to lot lines.
Premises Located at:
1815 King St, Orient, NY 11957
SCTM# 26.-2-43.6
Pursuant to application dated 10/28/2024 and approved by the Building Inspector.
To expire on 12/18/2026.
Contractors:
Required Inspections:
Fees:
SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00
CO Swimming Pool $100.00
Total $400.00
wilding Inspector
� TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 htt ,s:Y/www,sotitlioldtowiln .(Inv
Date Received
PERMITAPPLICATION FOR BUILDING
r
6 f L
For Office Use Only
PERMIT NO. Building Inspector:
0(
4
Applications and forms must be filled out in their entirety. Incomplete ,
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date: I D lag
OWNER(S)OF PROPERTY:
Name: SCTM# 1000- _
Project Address: I&S,
Phone#: Email:
Mailing Address: 9s- .
CONTACT PERSON:
Name: w w)a
Mailing Address:
Phone#: (� _ Email: o
U3� - 53 '� Kam
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name: -Paiyl `
Mailing Address: 4
Phone#: U ` 0-3 —1 S Email: Gt�-n
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
[�bther Ncv w � :4 �I
$ A
Will the lot be re-graded? ❑Yes&O Will excess fill be removed from premises?\,;?Jes ❑No
1
PROPERTY INFORMATION
�, Sty — yyU
Existing use of property: RaLL'y Intended use of property:
an P= Ct -Pox4L) i VV k
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes Po IF YES, PROVIDE A COPY.
ihaheck Box Aftelr Reading: The owner/contractor/design professional Is responsible for all drainage and storm water issues as provided by
nter 236 of the Town Code. APPLICATION IS HEREBY MADE to the Building Department for the Issuance of a Building Permit pursuant to the Building Zone
Ordinance of the Town of Southold,Suffolk,County,New York and other applicable Laws,Ordinances or Regulations,for the construction of buildings,
additions,alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code,
housing code and regulations and to admit authorized inspectors on premises and In building(s)for necessary Inspections.False statements made herein are
punishable as a pass A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
Application Submitted By(print name): mevC-Urrl b *uthorized Agent ❑Owner
Signature of Applicant: Date: ID)ab)SL4
STATE OF NEW YORK)
COUNTY OF
z ,r t being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the
(Contractor,Agent, orporate Officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application;that all statements contained in this application are true to the best of his/her knowledge and belief; and
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this
-. i 1 r
2,jrdayo
f C �
Notary Public
=Public-
FERREMI
tate of New York
PROPERTY OWNER AUTFIORIZATiON
6430360uffolk County(Where the applicant is not the owner) pires Mar 14, 2026
I, residing at
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
Print Owner's Name
L --- 2
Building Department Application
AUTHORIZATION
(Where the Applicant is not the Owner)
,p
lW,111 If 44 6 kill */residing at
(Print property owner's na e) (Mailing Address)
do hereby authorize /e 41,(_ -s
(Agent)
Katrina Mercurio to apply on my behalf to the
Southold Building Department.
Uiew
(Owner's S gnature)—4k� (Date)
(Print Owner's Name
---------------------------
Scanned with
CarnScanner:
t w workers' CERTIFICATE OF INSURANCE COVERAGE
vo Compensation
Board NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW
PART 1.To be completed by NYS disability and Paid Family Leave benefits carrier or licensed insurance agent of that carrie
1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured
PATRICK'S POOLS INC 631-941-4113
PO BOX 3024
EAST QUOGUE,NY 11942
1 c.Federal Employer Identification Number of Insured
or Social Security Number
Work Location of Insured(Only required if coverage is specificallylimitedto
certain locations in New York State,i.e.,Wrap-Up Policy) 262929943
2. Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier
(Entity Being Listed as the Certificate Holder) ShelterPoint Life Insurance Company
Town of Southold
54375 Main Rd 3b.Policy Number of Entity Listed in Box 1a"
PO Box 1179 DBL318565
Southold, NY 11971 3c.Policy effective period
05/13/2024 to 05/12/2025
4. Policy provides the following benefits:
® A. Both disability and paid family leave benefits.
❑ B. Disability benefits only.
C.Paid family leave benefits only.
5. Policy covers:
2] A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law,
0 B.Only the following class or classes of employer's employees:
Under penalty of perlury,I certify that I am an authorized representative or licensed'agent of the insurance carrier referenced above and that the named
insured has NYS Disability and/or Paid Family Leave Benefits insurance coverage as described above.
6/20/2024 V4a=4r.
Date Signed By of insurance carrier's authorized representative or NYS Lice(Signature p nsed Insurance Agent of that Insurance carrier)
MP Telephone
Number
516s 4 A and 100 Name and Title LeSton WeISh,Chief Executive Officer
If 5A are checked,and this form is signed by the insurance carrier's authorized representative or NYS
Licensed Insurance Agent of that carrier,this certificate is COMPLETE. Mail it directly to the certificate holder.
If Box 4B,4C or 513 is checked,this certificate is NOT COMPLETE for purposes of Section 220, Subd.8 of the NYS
Disability and Paid Family Leave Benefits Law. It must be emailed to PAU@wcb.ny.gov or it can be mailed for
completion to the Workers'Compensation Board, Plans Acceptance Unit, PO Box 5200, Binghamton, NY 13902-5200.
PART 2.To be completed by the NYS Workers'Compensation Board (Only if Box 4113,4C or 5B have been checked)
State of New York
Workers' Compensation Board
According to information maintained by the NYS Workers'Compensation Board,the above-named employer has complied with the
NYS Disability and Paid Family Leave Benefits Law(Article 9 of the Workers'Compensation Law)with respect to all of their employees.
Date Signed By
(Signature of Authorized NYS Workers'Compensation Board Employee)
Telephone Number Name and Title
Please Note:Only insurance carriers licensed to write NYS disability and paid family leave benefits insurance policies and NYS licensed insurance
agents of those insurance carriers are authorized to issue Form DB-120.1. Insurance brokers are NOT authorized to Issue this form.
DB.120.1 (12-21) 11111111°°°!uiiiiiiiiuiiiiiiuiiiiiii�Niii11111
AC V. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/°°",Y"'
081
231
2024
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does notconfer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT Nicholas Zulkofske
Brookhaven Agency,Inc. P NE 631 941 4113 FAX 631 941-4405
100 Oakland Ave,Ste 1 I certificates blookhavena enc .com
Port Jefferson,NY 11777 IU§MRER(S)8FFOR IN C VERAG
INSUggEt A., Philadelphia Indemni Insurance Com an
INSURED Merchants Mutual Insurance Company
Patrick's Pools,Inc. Wesco Insurance Com an
PO Box 3024 INSURER D:
East Quogue NY 11942 INSURER E
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
)NgR DDL SUB POLICY SI"P POLICY EXP LIMITS
TYPE OF INSURANCE POLICY
X COMMERCIAL GENERAL LIABILITY EA H OCCURRENCE $1,000 00O
�
L"_.1! DAMAGE TO RENTED 100,000
A CLAIMS-MADE OCCUR Ea III) -
X Contractual Liabili PHPK2658571 02/28/2024 02/28/2025 M DEXP An one arson $5,000__
PER NAL B ADV INJ RY $1 000,000
7OMER7
L AGGREGATE LIMIT APPLIES PER: NERAL AGGREGATE $2,000,000
PPOLICY'I i a E0 ❑ LOC P CTS- COMP/OP A $2,000,000
$
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $500 000
B X ANY AUTO
BODILY INJURY(Per person) $
�.
ALL OWNED SCHEDULED X X CAP9267113 07/12/2024 07/1212025 BODILY INJURY(Per accident) $
AUTOS AUTOS
NON OWNED PROPERTYDAMAGE $
X HIRED AUTOS X AUTOS
UMBRELLA LIAB OCCUR EACH OCCUR EN $
EXCESS LIAB CLAIMS-MADE AGGREGATE
WORKERS COMPENSATION X PER OTH-
AND EMPLOYERS'LIABILITY
ANY(Mandatory
N/A E,L.DISEASE-EAEMPL EMPLOYEE 100000
ry EL �.
C (Manda ory in NH) EXCLUDED?
WWC3714385 0511312024 05/1312025 �, 100 000
If es,describe under
E.L.DISEASE-POLICY LIMIT 500 000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required)
Town of Southold is included as additional insured per written contract.
CERTIFICATE'HOLDER CANCELLATION
Town of Southold,Town Hall Annex SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
54375 Main Rd. ACCORDANCE WITH THE POLICY PROVISIONS.
Southold,NY 11971 AUTHORIZED REPRESENTATIVE <NSZ>
1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
i
I
'n�" Workers' CERTIFICATE OF
aOAR m onunsation
Cop NYS WORKERS COMPENSATION INSURANCE COVE CRAG
1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured
631-996.4687
Patrick's Pools,Inc.
PO Box 3024 1c.NYS Unemployment insurance Employer Registration Number of
East Quogue NY 11942 Insured
Work location of Insured(Only required If coverage Is a lllcal(y llmlted to 1 d.Federal Employer Identification Number of Insured or Social Security
certain looadorrs In Now York State,Le.,a trap-tl"p dVlcy)9 Number
262929943
2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier
(Entity Being Listed as the Certificate Holder) Wesoo Insurance Company
Town of Southold 3b.Policy Number of Entity Listed in Sox"Is*
Town Hall Annex WWC3714385
54375 Main Road
Southold,NY 11971 3c.Policy effective period
to
3d.The Proprietor,Partners or Executive Officers are
Included.(Only check box Hall partners/officers Included)
QX all excluded or certain partners/officers excluded.
This certifies that the Insurance carrier Indicated above in box"3"insures the business referenced above in box 01 a"for workers'
compensation under the New York State Workers Compensation Law.(To use this form,New York(NY)must be listed under Item3A
on the INFORMATION PAGE of the workors'com�ransatfon insurance policy). The Insurance Carrier or its licensed agent will send
this Certificate of Insurance to the entity listed abov as the certificate holder In box"2".
The Insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy Is canceled
due to nonpayment of premiums or within 30 days 0,there are reasons other than nonpayment of premiums'that cancel the policy or
eliminate the Insured from the coverage Indicated on1his Certificate.('These notices may be sent by regular mail.)Otherwise,this
Certifloate Is valid for one year after this form Is Approved by the Insurance carrier or Its licensed agent,or until the poll,cy
expiration date listed In box"3c",whichever Is eadler.
This certificate Is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend,
extend or alter the coverage afforded by the policy listed,nor does It confer any rights or responsibilities beyond those contained In the
referenced policy.
This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect,
Please Note:Upon cancellation of the workers'compensation policy indicated on this form,ff the business continues to be
named on a permit.,Ilcense or contract Issued by+a certificate holder,the business must provide that certificate holder with a
new Certificate of Workers'Compensation Coverage or other authorized proof that the business Is complying with the
mandatory covMge requirements of the New Yq'i State Workers'Compensation Law.
Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced
above and that the named Insured has the coverage as depleted on this form.
Approved by: Nicholas Zulkofske
(Pditt name of representative or licensed agent of Insurance corder)
Approved by:
1 2� -LH(
( ignstu (Date)
Title: Authorized Agent
P p g
Telephone Number of authorized representative or licensed agent of Insurance carrier: 631-941-4113
Please Note:Only insurance carriers and their licensed agents are authorized to issue Form C405.2.Insurance brokers are M
authorized to Issue it.
C405.2(947) www.wcb.ny.gov
• •_ ,^ A',M rowW7�/T&z=x.» n R NC MLlMzpa�ABnnM"�PW'�xM1MM.l'M�M.ag xP.a l �cxx C nw 1�14 M'NikM Ap YmN ow lmd 4Ml M0oM.&C�ONGpwe'A tltranraaFlXR
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PROPOSED SANITARY SYSTEM
sill°.msrum��ca i�Mnu1 wmrenuim:...:; mr res N'm'.tMui�ruu 1,000 GAL SEPTIC TANK... ,�
or I .��..,i i..m�r�r1,mww ii[u r T P,mm^R10' TKNw
rwgiAa B'DIA.x4'DEEP POOL«.. ,,„„- "«�-"•�,- „r„ + SITE DATA
S,jixF,,,, TA
" $i� `'`• , AREA=49,414 SQ.FT,
O, IA/OVVTS "�)" +wv ` r1°" "
S ^•^� � " �"°'^« "VERTICAL DATUM =NAVD(1988)
Mama uMt a..ID ry b*r m,., "� "de Cy °�
., ... „ .. . � "*. •DEPTH TO GROUNDWATER =60 FT
m^
6
GRASS � "NUMBER OF BEDROOMS(DESIGN EQUIVALENT) °5
IRa 7 c ,�» + « "MINIMUM REQUIRED LA OWTS CAPACITY =550 GAL
J ,+" ' A "PROVIDED I/A OWTS CAPACITY =700 GAL
grew PROPOSED 2 =400 SFSWA
STORY BARN "LEACHING SYSTEM REQUIRED
y, FFEL=16.0 •LEACHING SYSTEM PROVIDED =400 SFSWA
TEST HOLE PROPOSED
(SCDHS REF.NO.BB-SO-74) ny" POOL.FENCE cpypi'
O0'
EL=16.5 0.0' �tl 9 r
BROWN b
as PR a)POSED
SILTY LOAM
PROPOSED*
GRASS WELL
APPROX sOF 1.3' 2STORY *6M
av ADDITION PROPOSED R
BROWN LOAMY WATER
(a) ® A ,nM SERVICE + ENGINEER'S CERTIFICATION
8.0' Ot R a�1 rv�, w EXISTING VIER E TO BER ,'•d � M
} I HEREBY CERTIFY THAT THE WATER SUPPLY(S)AND/OR SEWAGE DISPOSAL
BROWN `'^� �' �'.' "V� i ABANDONED EXIS.�G wl- DIRECTSYSTEION.BASED UPON PROJECTS)FOR THIS CAREFUL D THOR0116H S R 1�R MY
COARSE
W%GRAVEL 'S d rir y a WELL FOR , Si'iE ANO&RT7N,lNOWA'N",R,CadNY% I S«ALL FA
SP A C � IRRIGATION CONFORM TO THE SUFFOLK COUNTY DEPAR TIJ EP3F S3O
( ) ONLY CONSTRUCTION STANDARDS 11I EFFECT AS OF O
GWE1:2.3 WATER]:N 142' � n, .,,,«✓� i ° h,M� r1t.�� gyp' S ,/'" �D PROPOSED r` �O " �M1 ; , LSD
BRO
COARSE AND �'t Iti.21R a,' '�'^ ,i / PROPOSED WATER
SERVICE � � s '
10%GRAVELISTORY
(SP) ADDITION
17.01 � s "Y ffi ' HOWARDW.YOUNG,N,YS.LS.NO.
4 ,Asn
HIGHEST EXPECTED 1H'. � THOMAS C.WOLPERT,N.Y.S.P.E.NO.61483
GROUND WATER EL-2,3 tl4 ` +¢ O ;P. i 7{d;t '+1 DOUGLAS E,ADAMS,N.Y.S.P.E.NO.80897
y a� SURVEYOR'S CERTIFICATI
NOTES n,� WE HEREBY CERTIFY TO8UZANNE NY1ST
L THE OWTS SHALL BE MODEL CEN•7 MANUFACTURED BY ka b WAS PREPARED IN ACCORDANCE WITH THE CODE
FUJICLEAN USA. ,. '+ 1+1M Q $ SURVEYS ADOPTED BY THE NEW YORK STATE AS
PROFESSIONAL LAND SURVEYORS. Or
2.THE DESIGN ENGINEER,FVJICLEAN USA REPRESENTATIVE,
AND SCDHS REPRESENTATIVES SHALL OBSERVE THE �"+' �i(j� r,
INSTALLATION OF THE OWTS AND LEACHING SYSTEM. w, »r HEALTH rEPANVtiE�NT USE
k APPROVAL FROM ALL THREE PRIOR TO BACKFIIL \ � To
3.THE SYSTEM START UP WILL BE COMPLETED UNDER THE �
DIRECT SUPERVISION OF A FUJICLEAN USA REPRESENTATIVE. 9;X.AY r 9 rye P p D N IEL W.WEAVER.
,N ,S, NOi
BETWEEN THE MAINTENANCE PROVIDER AND PROPERTY OWNER ,� IA/OWTS Fu j II C e a 1'p DAN'IEL A.NfEAVER,N. L.S,NO. 1
PROPOSED SANITARY ` ,* N O SURVEY FOR
HMUST BE EALTH SERVICES SUBMITTED
PRI SUFFOLK C OV+L RENT OF 4.AN EXECUTED OPERATION AND MAINTENANCE CONTRACTTe.ae+ � ncIUTAIW.aF
SYSTEM(ETdnsl9avlSaRGlary egaXLDC.OisdR %wuFFou.oc Coknq7v IDu IFAI re FN F f NrALTua SE IRVICLS
wv
ot
OWTS aEGIS'T1IATION BY THE SCDHs IN ACCORDANCE WITH System to be O F'ER ma FolR Au m:mvm F CONS RW-, OIN FoR A
ARTICLE 19 OF THE SUFFOLK COUNTY SANITARY CODE. &Na E Fm111 M R imiI.ry w4cF,AND SUZANNE NYSTROM
Accessary Barn(0 Bedrooms)
NOTES FOR , H„S,REF..�O I9 2a-0s7B at Orient,Town of Southold
SANITARY STRUCTURES � DATE eT 1S2024 � Suffolk County,New York
ABANDONMENT OF SA
r ABANDONMENTSNSTEMSIN-PLACE
H_AEL BE ABANDONED BY REMOVING ALL RESIDUAL SEWAGE �� -"#c. EXPIRES THREE YEARS FROM SIDATE OFAPPROVVAL. BUILDING PERMIT SURVEY
WASTES BY A LICENSED WASTE HAULER,REMOVINS THE TOP OF THE \
4 5.MUCTURB(S)BACOMAING WrTH,$UITA"SAND AND GRAVEL MATtWAL,AND LEGEND � � County Tax Map aiwta 1000 s-u- 26 BIoak 02 roe 43.6
COMPACTING. epees .
'.... BY REMOVAL CH =CHIMNEY FIELD SURVEY COMPLETED DEC.O ,2023
ABANDONMENT
MAP PREPARED DEC,it,2023
PROPERLNY MS MAY ALSO BE ABANDONED BYREMOVn,16 ALL RESIDUAL CMF -CONCRETE MONUMENT FOUNDffS
SEWAGE
WA TES BY A LICENSED HAU(.ER.REMOVING 7HE'EN�NTIRE'STRUCTURE(S), CM5 -CONCRETE MONUMENT SET \ ° '�^' ^�^.... Record Of Revisions .
WITH SUITABLE SAND AND GRAVEL MATERIAL,AND PROPERLY EOP =EDGE OF PAVEMENT tRP Rt P I(tNBi!'.1T11IAY 7H7iB c1M 1 M,1FtiD. REVISIAN DATE
COAMPACTING. OF SEWER PIPIN+NG V IFPF =FUTURE EXPANSION POOL IRON PIPE FOUNDRL1. .. .4!lN'. 1 e44 »», D TA 2 2024
AB NDONMENT _ �N 63I R52 S1ga qTM on
A '. ''SHALL BE OJT AND CAPPED AS A MEANS OF
OL ON PROPERTY LINE
ABBANDONMENT'.THE DEPARTMENT SHOULD BE CONTACTED FOR FURTHER OS -OUTDOOR SHOWER POST RAIL FENCE advance to schedWe NIBBp ionic).
AANDONMENT REQUIREMENTS,IF FUTURE CONSTRUCTION IS CONTEMPLATED
IN THE AREA OF THE ABANDONED SEPTIC SYSTEM. RO =ROOF OVER .. dw
SPF =SPIKE FOUND h'M
SPS =SPIKE SETav
✓'`
TWA,
MAND JCNONM R T O Ex" TING 5twnot DISPOSAL SYSTEMS,EITHER WIF =WIRE FENCE
'EN•PLACE,OR BY MUST BE CM17FIED BY EIT?ER A LICENSED DESIGN WSF =WOOD STAKE FOUND �� v 40 0 !D 4D BO 100
mawwwoomw
PROFESSIONAL OR LICENSED AS tNDI 1'eb By THE DEPAR T
ON THE PERMIT
TO CONSTRUCT.FOR PROJECTS SERVED BY MUNICIPAL SEWER ® _ =WOOD STAKEVLE tR .:� Scale:1"= 40'
gyp UTILITY POLE
DISTRICTS,THE APPROPRIATE MUNICIPAL AGENCY WITH JURISDICTION
• END OF DIRECTIOWDISTANCE 10 JOB.20O. 227_7 I OF 2
DWG.2023;Q227,,,E(w