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040-1027-10-000
. Croix Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St Safety and Building Division Sanitary Permit No: INSPECTION REPORT 164 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: YMCA Cam St. Croix Troy, Town of 040-1027-10-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 06.28.19.89 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header/Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) LLength Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes 2 No Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 530, 532 & 534 Cty Rd. F (multiple buildings) Hudson, WI 54016 (Gov't Lot 2 6 T28N R1 9W) 40 acres Lot Parcel No: 06.28.19.89 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? ❑s Yes [~Aj No - EL I _r Use other side for additional information. - - Date Insepctor's Signature Cert. No. SBD-6710 (R.3197) rJ ~ GOVED AN 1 %2012 11I County Sanitary err>ig# JkWJWqMan ST. CROIX COUNTY WISCONSIN In accord with Chapert 12 St. "s PLANNING & ZONING DEPARTMENT Personal information you provide "*TMea Tor go o'Tclary purposes ST. CROIX COUNTY GOVERNMENT CENTER 6 [Privacy Law. S. 15.04(1)(m)] Hudson, 110 1 aW I' 540116-7Road 710 (715)386-4680 Fax(715 386-4686 Attach complete plans for the system on paper not less than 8-1/2 x 11 inches in size. County Sanitary Permit # , ❑ Check if revision to previous application 1. Application Information - Please Print all Information Location: Property Owner Name 1 /4 'sue 1/4, Sec N, R E (or W Property Owner's Mailing Address Lot Number Block Number ity, State Zip Code Phone Numer Subdivision Name or CSM Number A 1 Type of Building: ( heck one) 1 I Mity ❑ Village IMTown of ❑ 1 or 2 Family Dwelling - No. of Bedrooms: 0 GI~~ V-~C. i LJCJ6k. LA)C- ® Public/Commercial (describe use): ~ .a ..fry. zw,, „iG t iu7 /1 r/0 Ziow ❑ State-owned Neare Road 11. Type of Permit: (Check only one box on line A. Check box on line B if applicable) T Parcel Tax Number(s) A) 1Repair 12.0 Reconnection []Non-plumbing 4. Rejuvenation Sanitation ,ko "14 `~.i B) Permit Number Date Issued / ® State Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) ® Non-pressurized In-ground ❑ Mound ? 24 in. suitable soil Mound 24 in. suitable soil ❑ Mound A+0 ❑ Sand Filter ❑ Constructed Wetland ❑ Peat Filter ❑ Drip Line ❑ Pressurized In-ground ❑ Holding Tank ❑ Single Pass ❑ Other ❑ At-grade ❑ Aerobic Treatment Unit ❑ Recirculating V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed (Gals./day/sq.ft.) (Min.finch) Elevation O J YA oa v VI. Tank Information Cap 'cty in Gallons Total # of Manufacturer Prefab Site Con- Steel Fiber- Plastic New Existing Gallons Tanks Concrete strutted glass Tanks Tanks ® ❑ ❑ ❑ ❑ im ❑ ❑ ❑ ❑ 11. Responsibility Statement l,icense the undersigned, assume responsibility for repair/reconnenction/rejuvenation/installation of non-plumbing for the POWTS shown on the attached plans. A is not required for terralift repair or the installation of non-plumbing sanitation system. Plumber's Name (print) Plumber's Si lure (no mps): MP/MPRS No. Business Phone Number 7 - 6- Plumbe s Address (Street, City, State, Zip Code) VIII. Count Use Only >(-Approved d Sanitary Permit Fee Date Iss d Issui Agent Si na g (No mps) Owner Giv g 'al Adverse ~I Z ~ 9- L Dete on li / IX. Conditions of Approval/Reasons1f1or Disapproval: /j (`lam G d~d~ r ow ~11~ w 11~~ ll de Ce J ; ~.-tAL1 AZ r ff r t; ~ : ~ E ai t 3 i t i y. I 0. I ~ v _ l r OA _ vi *V ` t H ? [ r Zappa Brothers Inc. 713 Sixth St. No., Hudson, WI 54016-1074 Office: 715-386-2850 Fax: 715-386-0323 F,Mad: zappabrothers0sbcgiobal.net January 18, 2012 TO: Ryan Yarrington St. Croix County Zoning Office 1101 Carmichael Road Hudson, WI 54016 Re: YMCA, Camp St. Croix POWTS (State of Wisconsin Permit #219010) Location: 532 County Highway F Date of Inspection: January 17, 2012 PM Inspection Performed by: Gary Zappa, Zappa Brothers, Inc. Date of Original Installation: November 3, 1994 Remarks: The POWTS is functioning properly at the time of the inspection. Sincerely, Gary T. Zappa MPRS 222373 State of WI M PCA 1171 State of MN y_ 4 i H ~ d CL U U l0 N 'N O V N 3 C N m 7 3 O 0 N .x E O N L ~r N y E m. U.' N', } ! ~ ~ ! i i - 4 {a t h:~ I 1 1 t: ~ , a EE i f ! i" I ~ ; , t t } € i" r a J i FFF ~ ~ ~ ~ I t ~ t f s` ~ 4 L e Y. o t ~ ~ L7 L.JU' Cm 0 41 a 4 m' ca "t a g a la t W 3 < a°~ a Ez i A W s c4 f zje 'S.2 dc ~m . 48 .84 b gd { M LD Cc C9 00000 {y}~~ ~y 9. m ~ ! " w lQ r N W 1~ LTJ 0 " (vj ¢ 4 ;Q rrrr O 1 - s 7 as j ~ . Y t b l i 5 j s is m! f ! i ."i 44 y ° ~ E d~ 'T N 04 X 40 r p ,D i H ~ [ F H w ; w w ! o ~ X [ H }i H H U W . iIt C-4 0 E-4 all ° w w a w aQ b j w! S r~ a UI C a Z 3 A G t~ iC- i~Y +-t J cam. d' V) z h a '3 .o .a a .o ,o .o a t e~! o w Vi go- C.4 o ' N cw 0 0 0 ts. F. 034 d y a LL ; ae z ; 0 0 0 n? ((1 ((1 per. to 04 0: W W d c c c c c (Ij a a a a a a A (4o cn E' H i 1rA~r t ! 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EO ~ tC p y d -0 0 p d 3 3 ~s 0 L ,j Z O W -1 ? e N JO N O (D CD W n MCI O -4 4~ R3 F3 0 0- 00 OD W ~p 7 = 0 N 0 O ~p v O n1 N Q 3 m O O O p O v O O p .7 O C) 0 (D 2) a a• W 0 O N Q CY, J t/' W w ao 3 o j' N I V . Op (D W CD 7 j ~1 ? CL O O Z N p O N» G C 3 Q CL p -nI m z 000 El O C• I 11 rE n cn ai z C ~ ~ W a y N Q C z y ~ I o D y, o ? O I! o' lV o m m o ~ cn _ c 1 J 13) CA p ul n O A Z n c i N O• A (Z 7 O W T G) 00 , o. s Z t °o 3 N co N x m w ~ ! N 3 I CD N N _y Ll 0 N 9 C z o 4 3 0 fp N N O -d (OD (D y `?7 co a: "3 O N CD C W O x ~Z (D ' N Q. A S' ' O N O CD Op ON A W o q N a C)p CD N ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner; &t ~~YIeA CAD Property Ad ess 632 e'fm. 4Q fi~7 City/State 1-a /J 5 o,.%J S-2/c~7/ c - Legal Description: Lot Block Subdivision/CSM # C. C ~T 1/4 t/4, Sec. , T2b'N-R /1 W, Town of o_ ~ PIN # SEPTIC TANK DOSE CHAMBER HOLDING TANK INFORMATION: Tank manufacturer 6a, e6,9P Size ST/PC1000 / Setback from: House Well -!22' P/L Pump manufacturer T- Model Alarm location (HOLDING TANKS ONLY) Water Line Setbacks: Service road Vent to fresh air intake Meter location Alarm location SOIL ABSORPTION SYSTEM: -jr,j,r-),L rnmi To'? Type of system: IVY Jc Width 3 Length ~S Number of Trenches Setback from: House o' Well b''g' P/L _ f Vent to fresh air intake -Iao ELEVATIONS: Description of benchmark Y L bhy? Elevation /DO. oo' Description of alternate benchmark Elevation Building Sewer ST/HT Inlet 4 . ~l ST Outlet 'Fz/$6 PC Inlet f PC Bottom Header/Manifold Top of ST/PC Manhole Cover/40- 4~f Distribution Lines O O ( ) Bottom of System g2 - 7 92 ( } Final Grade ()1, a ( ) Date of installation Permit number 39 y3 % S State plan number Plumber's signature License number a2 S7 Date / o Inspector Complete plot plan NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. Show alternate benchmark, if applicable. A/0 ` PLAN VIEW ol-o A,5 PC? e'ohe PR~p~ ~'+NSQLl7/~/U D/P6S L ~ Cw~dcr 5Q 3C p✓L Gs~c<u~~J(~h~ ~`b! V G~13 Alt. ~mU iC d3 3 g eoDm ~CM?d 7~N<c~'~ INDICATE NORTH r I Engineering, Inc. p Z 2125 UPPER 55th STREET EAST MVER GROVE HEIGHTS, MN 55077 t>" Q D OFF:651.552.0300 FAX651.552.0782 U www.m4-vk-fkv.oom Q M. GABRIEL P Q ❑ ❑ 1 APRIL 2000 5 S•r Camp.DWG rl a CAMP ST. CROIX a Q HUDSON, WISCONSIN 54016 (715)436.8428 wn. Q Q Q Q Q Q~ C3 Q Q Q Q a Q Q 13 a ~a Q Q Q Q e~ Q~Q Q QQ I Q Q D Q Q ~ Q° Q Q Q Q Q Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM County: INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Personal information you provice may be used for secondary purposes (Privacy Law, s.15.o4 (1)(m)l. 370385 Permit Holder's Name: ❑ City ❑ Village ❑ T n o : State Plan ID No.: St. Paul YMCA (Camp St. Croix), Troy Township CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel Tax No.: d 'g,) ie r 040-1027-10-000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Z /60 Alt. BM 1,93 d . Aeratioyr Bldg. Sewer 9 y 9s Holding Ht Inlet 95J y9 TANK SETBACK INFORMATION 6/ Ht Outlet TANKTO P/L WELL BLDG. Ventto ROAD Air Intake Septic 7 7-<" NA 13 Rdttom Dosi - - NA Header / Man. (4 Aeration- Dist. Pipe Holding Bot. System Z-~P Z . 9 PUMP/ SIPHON INFORMATION Final Grade G. ! 3 3 y Manufacturer Demand St cover 3 Lt Mode um e G TDH Lift Friction S stem TDH Ft I Loss ad I I Forcemafn Length Dia. D. welt SOIL`ABSORPTION SYSTEM BED / Width Le No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth !M 3 5 D EN 1 SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHM&I Manua ure SETBACK HAM r `r INFORMATION Type 50 ; n Z Mo um er. System: r-n J cf') J NIT 51 1A DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length67-Dia. Allt Spacing N x14 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched Bed/ Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #l: y 123lo/ Inspection #2: Location: 532 County Road F, Hudson, WI 54016 ( 6 T28r I 9W) 06281989 Government -Lot 2 1.) Alt BM Description= -oho a~ Cv.. er etc n ,srs u~~ 4/`~~rr 1 w 5 2.) Bldg sewer length= /61 /,(f E~ (~,tll~ ~~a~ Std l*Mp ~o~~ ve -amount of cover= >s l'(, esr hay 4 414(le1 4 a c©v~•~ ED lock "Ove QeajC Plan revision required? ❑ Yes M No Use other side for additional information. Z 3 p SBD-6710 (R.3/97) Date Inspe 's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH T SANITARY PERMIT NUMBER: s i , { I t S i 4-t ~m E i 5 E ~ ~ I r Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 NVisevnsin Personal information you provide may be used for secondary purposes Madison, WI 53707-7302 Department of Commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if trot state owned. Attach complete plans (to the count co only) for the system, on paper not less than 8-1/2 x I 1 inches in size. County State Sanitary Pumit Number ❑ Check if revision to previous application State Plan 1. D. Number t r ~j 25 1. Application Information - Please Print all Information Location: Property Owner Name Property Location A,.4L /hje,4 '5'r 1/4 I/4, S T -KN, Wqt or Property Owner's Mailing Address Lot Number Block Number 1573 C <T-V- , ~U , .'C 6ltt-1 2-- City, State Zip Code Phone Number hubdivision Name or CSM Number iDS ot/ Gt,, ~y0/ C. ( ~4- ) 3 F4, 4384 II Type of Building: (check one) ❑ City 1 or 2 Family Dwelling- No. of Bedrooms: ❑ Village ~ ❑ Public/Commercial (describe use): ATown of f W" Y ❑ State-owned III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest RoadZ-r-, Qo A) 1. ❑ New System 2. AReplacement 3. ❑ Replacement of 4. ❑ Addition to Parcel Tax Number(s) 28. System Tank Only Existing System Oa, [ 0 6170 13 Permit Number Date Issued A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) -I . Ion-pressurized In-ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In-ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At-grade t r 11 Aer bic Treatment Unit ❑ Recirculating ❑ Other: V Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals./day/sq. ft.) (Min./inch) Elevation VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks J& ❑ ❑ ❑ ❑ Doa /Dna l w, ~{5 ❑ ❑ ❑ ❑ ❑ VII Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (print) Plumb 's Si atur o s ~pfi ps): MP/MPRS No. Business Phone Number Plumber's Address (Street, City, State, Zip Code) Al 0:5~ VIII County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) ,Approved ❑ Owner Given Initial Adverse Sur ge Fee) j/ Determination dD - D 8'z t ~ IX. Conditions of Approval /Reasons for Disapproval: ~ Q ~ Sy~~ w~,..a~- ~Jt:u•v~ ~-''~*k- .~7 ~ u~ ~ S !L' ~CE+'.'A. ,>E ;all s~~a`"~-~S ww~►-~`~¢-- vV~e~... ~s ~ae~.c.ocQ2- - SBD-6398 (R. 07/00) ' J . l-'r(.i ~Qcall•P S l_,1 ~ bI~S SAO -r/~/C ~ ~%5 : ~ f ~ • ' PLOT M CROSS SECTION PLANS ZAPPA BROS. EXCAYATMlCi INC KUMBNO UNIT ~x{S?"I,cJ~'--• ~r~~i` /~,J.~~ /T,vf_1 l~ler-f: ~-cc pr-"~~j >D~ ~~E' PROJECT ' ' \ ~ ` 7 0w c~ F % c7 R1~r~o,~JYn ' ~1 ~UP~~cE •rr~~~r-~°ysi~Yt t - pF / ~~'I~~AT~Q~~/1~:sLJ~/UOE? /~ilrN ~IC.~fYffC{ry t~-f~{irI/rd~.~?S a - ys T~ xr~~r!+S z r nl,o 2~, -t~ tJcF$ /Sod/G.fc St,%IP `TrJK c J/' f{ /~!S'ao ?«aFL .Iv~I~~~t7rr': ~t~~ (r SCf{D S~WLP ,G,i VGt Y SCALE ' lc~ccc. rw7 il,E,j at= slorEo:. v AvP?ov o ~cQtJ/lri3~! G'.~ UCENSE:..~2 S`7 ' ,~~2 • DATE: F•NrSH ~QA/Jf j „ a/c saL TESTftrq !!Y: "\AK! M4M /~/'doy~ ~f{N✓1/4fR ~~.L~~S~~ ~L?/Ti"~jt~~ oC~1~."7 ~ / Side View &E VA 000 T Ell c H Bo iro.v. Aq So, c -asr End View 16' - _ - - - -i:- I 34' J 7S"' R- SroEc.l~►.~o~R ~tcn CAPA~rr~ /I'lvC)~~ . r # Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code 51-- ~ Ix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County en, include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 'ewed by Date Please print all information. K Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ZJ J • o-0 Property Q_wner Property Location ¢ '7 E (or) W S7' PAUL / ~ C-A Govt. Lot Z 1/4 1/4 S 6 T Z K R /n Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 53~ c -rte f- city State Zip Code Phone Number ❑ city ❑ Village 25Town Nearest Road „ , Oso.~l w( +sy~,~,~ (7i~) s 8 y3do 1 ROY GTN ❑ New Construction Use. Residential / Number of bedrooms Code derived design flow rate GPD Replacement -&--44? ❑ Publir or commercial - Describe: Parent material A L ! LL Flood Plain elevation if applicable ft. General comments and recommendations: ❑ Boring F Boring # R3 pit Ground surface elev. 99--Z ft. Depth to limiting factor 1~ 1 in. Soil Application Rafe li Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 -Eff#2 A 6-t6 L Z encibk rht CS 1 0, S 4 B, /6-36 /OYR 9 5) Z, ~b rn r CS O O 3 -97- X-111 16YA 41A.1 6 -'7 '12 s o ll3•~0 Bering # E] Boring Fil Pit Ground surface elev. Q J-7- IS ft. Depth to limiting factor / l ® in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg in. MunseII Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 A a-~3 jdyR3 Z ruQ~k M G5 d.~ d.Q ~I Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 mg/L ' Effluent #2 = B0135:5 30 mg/L and TSS < 30 mgtL _tR CST Name (Please int) Sig a e CST Nurrber b,RV~v ~NNsau -ziz 7~"7 Tess Date Evaluation Conducted Telephone Number Ate„ Z Zaoo 3 ~6 ~ag~ r Property Owners-78w4 YM C A Parcel ID # Page Z of F-31 Boring # ❑ Boring / KI pit Ground surface elev. /00.D ft. Depth to limiting factor, 3Z in. Soil Application Rate Horizon Depth Dominant or Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 A b-Zg IOYI~~~~ L z q6 rn GS Q S b Q Sl ,ev~q 5 ► ii ~K r GS 4 z Q .3 92- Z 1 i3 id'iQ 4 !h$ S~ m o? q'f.2~ 3 •2 Boring # ❑ Boring F-1 ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 ❑ Boring Boring # Ground surface elev. ft Depth to limiting factor in. F-1 ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#l 'Eff#2 ' Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30:< 150 mg/L • Effluent #2 = BOD, < 30 mg/L and TSS 130 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD4330 (FLOOD) ~ e r r Go, p , y ~ C _.b O Z - Z C6roN ~ ~ lw o . a ~ c 70 M N /1 rr( r, r z N ID r w Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soil Absorption Comp nent Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater T eatment System (POWTS) shall include information and procedures for maintaining the syste within the parameters of Comm 83 and 84, and the conditions of approval by the departme t, agent, or governmental unit. The approved plans and permits for system are on file at the unty zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and th In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Syste s SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number 340 S Number of Bedrooms Design Flow - Peak (gpd) q5"0 Estimated Flow - Average (gpd) 01D Septic Tank Capacity (gal) `f Soil Absorption Component Size (ft2) _ Type of Wastewater Dom stic Table 2: Soil Absorption Component - Limits of Reliable Operatio Septic Tank Component Soil Absorption Component Design Flow -Peak (gpd) 3 z a Maximum Influent Particle Size (in) 1/8 Maximum BOD5 (mg/L) 220 Maximum TSS (mg/L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once ev ry 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service sep c tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in ac rdance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portabl Restrooms). The operating condition of the septic and outlet filter shall be assesse at least once every 3 years by inspection. The utlet fil shall be cleaned as necessa t ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclos re. If the Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated co tinuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in he tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not remove at the time of an assessment, maintenance personnel shall advise the owner of when the xt service needs to be performed to maintain less than maximum scum and sludge accumulati n in the tank. Manhole risers, access risers and covers should be inspected for water tight ess and soundness. Access openings used for service and assessment shall be sealed wat rtight upon the completion of service. Any opening deemed unsound, defective, or subject to fa lure must be replaced. Exposed access openings greater than 8-inches in diameter shall be s cured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank f r any reason without being in full compliance with OSHA standards f r entering a confined space. The atmosphere within the septic or oth r treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Co a when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept omestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper an timely maintenance, and system use within or below the limits of reliable operation. Goo water conservation practices by all occupants and the installation of water conserving plu bing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of pondi , if any, in the observation pipes, and a visual inspection for any evidence of surface seepag or discharge from the component. On steeply sloping sites, areas of erosion should be identifie and reported to the owner for repair. The surface discharge of domestic wastewater o sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided pa icularly during winter months. The compaction or removal of snow cover over the compo ent may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is diffi ult or impossible to repair until weather conditions improve. In general, soil compaction ver this component will reduce diffusion of oxygen into the soil and dispersal cell, which m y lead to more intense, and earlier, organic clogging of the soil. 2 A Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep-rooted trees and shrubs directly over or within ten feet of th component should be avoided since root intrusion into the component may obstruct astewater flow. I i I I i i i 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Ct, Ll~ Mailing Address U of Property Address (Verification required from Planning Department for new construction) City/State ~`cSOfl (JU Parcel Identification Number t LEGAL DESCRIPTION rQ Property Location NE SWSec. rV , T N-R /I W, Town of Subdivision ym coq Co' *'p !~iL, G^5> t-4 Lot # 0 Certified Survey Map # Volume , Page # # a Warranty Deed # col 05-3 , Volume , Page # J - N 3G Spec house ❑ yes ❑ no Lot lines identifiable ❑ yes ❑ no a SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What y u put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed y the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site was water disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less an 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal sys em with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of W'sconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Z ning Office within 30 days of th a year a iration date. CFO S NA OF APPLICANT DA E i OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) a (are) the owner(s) of the property, described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIG ATURE OF APPLICANT DA E * Any information that is mis-represented may result in the sanitary permit being revoked by the Zoni g Department. Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty d ed . 1 H T.28N. - R.19&20 W +1101.1 E S 'loud Carrographics. lac. Sr. Cloud. MN 5610/ See Page 24 OW R 19W D1997 Cx ae -aruPhi- snc. sr. 01,nd. M,v 56J01 FN 7 aaig m MF + - 'O l en etal F g 120.09 FRee Frederi k = p 01 ysr' U D O N lRnert Tr kM R Lenertx F " UR 5 RL 11 713 St Croix High Ridge z In H•1~ Business BUD ON 35 Court s Park - 5m Tr x s s..ll r.... Nordk x S i-c small NkBC 1 1 S St Pa ghu Kathryn P 12.6 d yJyJ de Tulgren z Shirley 60.53 Rm w,kl 80.67 Enloe Small ckn ra i LLJ ~ Kk c 7~ p J m -oe Cy, < Tracts Palksen 233.7$ John r x.l Red Brick Julia Patri a S. rr 1'O Mal eY Addition Cemolau Cemd,o„s s s i 9 RR s 39.6 b RC 7.88 +T W Daniel d Karla Rx FF / m = 'A 23.1 Solb r6 Solbe n 31.9 David m w tea ~'rs smau Tracts 99 32 21129 Marjorie 154 - . = FF 2 FF 1 David 4 James & 2"a Red M n Hanson N + Sa dfa Margaret Back Norman Truse € B vmn*d 6 Woodruff Add. & Shirlee 55 NH 5 141.7 xw. v x g scull 30.32+.r rn,` traa sK 244.3 a F t= Feyereisen s.l aea o aA+ q g k ] 1 w 0 a w o - 7 rGkK R la .r ~ C r 192.83 a IL11 2 TR s., G1eBorY Genie Arabian, t Cedar 179 Glover s 3 m B.rren k 1<rrvM ws IrK65 .25 C i Park Eks M1 2 3 Paula bJ .2 alrUA Gr.er Y Ridge 116.98 ,w Ist6a~ 29. FAlwnd 295 u a^a E'1j1Y scull iraeY Sm Tr 35.29 W Arthur k n L Valle 8.31 10 C 28 ~ Y ~ Marilyn 1937 nd Feyercisen i g LQrI~ J, Ronald Bates Jack Co Sn,Tr uoi Rev Tr U Stanley Gagnon & June 40 w Glover -32 Mcelte S Tr Pond MG"- Erdman Perri E ' Isas M1 DkI 20 Station Tr Tru! Jr LRS LISIA a 272.25 s R,"M RodaM 41.6 i M FN 95.4 SdRltgen T&SM TkB 20 Trm "gm6<a Bq J5 2 93.87 . fa.r +s IS Mahoney 16 + ry Robert Bj, FRr Rv acmes 96 a e 3 7 L rape 95 w v c S John & 4 eal 25. cam, my~ David James & Herbert a war cr,± Nild Harriet s -.L'- Margaret pay off. CM Bye& Dennis : 4 Px Salmon _ P1 _ s cr s ax s Woodruff Schultz ter u+ 1555.2 1. - rroundation a + i RM s Me S 146.08 K °S N.6 122.22 ~Screait RA .x P6:T 20 Ms 47 S. ` James 40 John NYBaam 126.05 = 8~0 60 John & & Colette Bergman Paul & St Kemk Ruemmele 80 T<o Thomas Patrici Chales& 135 260 Sylla wfli ebst daN Croix bah er Ruemmele 14 Cove 3os 156.5 126.05 Webster Ro20 67 f% r% clos Farms 40 37.68 40 Hans Inc Ridge 2 Gent/ s.rr M. 1.8 1.1 Thorn. 120 Scott k Timper 43 Do ald 45.85 ca d„B„y k Robeft c 210.2 265.8 Pe sml n eta[ = Donald Br wn kTL 30.39 flaneS O1i cr 60 5 Orin & t small sz n nk & Lois Brown Country John pp rrx s Barbara Fra 1 "'M O Weber Cemohous 2.5 Oaks Si A \4 • Do ne K 00 40 •1 nw.aw lr kMyl x r 3 Brooke 1y °ys >3 &Ruth W&D i s-...» o i+ p W k Mary Ian M Alvin Marvin 4 Anderson RO1"OSCr 22 W.If nm op. s a E 36.n .N'erae & Lynn & Wanda a 80 61 52.99 rs la1 12 ov s 2 view Stock Cemohous b nd Tr s xr a Mr . = i 1 •.a:: ` o ^ ~ 199 157.5 U 170 own Hills 1 we is 8 a u U."I kE 1 V IK a s+cr.k v M_ J n Paul & + Mary N )rk1 NarachiWl ' 3 nom` Jar Delphirle Gerald D niel Dwayne v39.99 10 vaM 3 i sas, a x 2 1r + 9 Johnson Armbruster Frank & Lois & rson & aLT Cemohous P ron Jea / Robert A& 2 2 2 s 157.33 Carlson 123 9 94.5 Robert M 40 160 59.4 Carlson Racich Rosa FamLS 4x 2 151.7 3.9 + 3 53.87 : M MM 7 39 A TM0"" James & Audrey h k MMra Knabue I; H" I -,z Glen Kauphusman Davi &Cheryl Harold 41.85 Willi.. k Ka ren a & 323 Enter rises KaMen p " F & Georgia 80 Ce nohous Joan 197 D " 1 Holly- Ltd Michael C,: it Is" Moberg Morrow all Rod & Julie 72.65 Jen Bros 160 Tracts Trust 147 S 160 Bros John k Hahn 80 ,0 Alin 6. S L 56.13 Alin k R ~ Juvene 00 - T I.- StankY na ERMarri, Fm Tr & Nancy sdlkg k s~ ylander 1 Helen + w; ' n Nelson aa. 156.5 -S c e"o 6'1 Fam Tr 1 Gec rr Paul & 53 F 39.5 c~c o LE 0 s s+as Rosemary z 31 40 Nancy µ,hnk y5.,6 m r. -1 7K 7L 86.06 2 V- L 5' Ne' 192 Dusek 25 waham A„d1ey Weber MMoe w V TB Y3 3 104.32 AkM a 38 $lokesy schweirer 40 F. T+ M x 6.8 K L H y CK r. a r ae,... wl '4, 1 M 200 300 Pierce County 40U r 500 )0 600 p S."✓~ O e 0 to ® • O p ,g • ; :Q o j • s a ; e r. co • • °e p • • , s s , ~ s ° •e Q / • a ° e• L / p ° os • ° e • ° °p • p 7 0 s o e a ~ f e ° e vw • / e / e Y / L 3Jbd 1 / ' O f e• / s a s r.n e ° l9! 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OWNER OF PROPERTY Name Address (street, city, zip Code) ST. FOUL Yl`^A ( CY RE'l'A l y'RS K!',: S) 'LT . 1~ 1 HUDSON 54016 B. LOCATION OF PROPERTY WHERE SYSTEM WILL BE CONSTRUCTED ALTERED OR EXTENDED COUNTY ST. C.E',,--IX Check Ones CITY VILLAGE LEGAL DESCRIPTION TOWNSHIP - SAC 6 T28T rt20-1 °T s r C. IS-LOCAL PERMIT REQUIRED FOR THIS WORK? YES NO 850 ` PERMIT NUMBER D. SEPTIC TANK CAPACITY 1000 Gallons NEW INSTALLATION REPLACEMENT ADDITION MATERIALS: Prefab Concrete -7_. Poured in Place Steel Other NUMBER OF TANKS TO BE IsrSTALLED: L E. TYPE OF OCCUPANCY ,Check Ones One or Two Family Residence i T Commercial Industrial Other (Specify) Number of Persons to be Accommodated 3 Number of Bedrooms 7 F. APPLIANCES, ETCs Food Waste Grinder YES _ NO Automatic Clothes Washer y YES NO Dishwasher YES y_ NO Automatic Potato Peeler YES, NO Other (Specify) G. MASTER PLUMBER MAKING INSTALLATION Name: CARL hTr":S r? ? Address: 109 CO 1'.'i'4 CI.?L ST, 'License Number: HUDSON ':ISC-fTSINI ~ 44~ MP RSW Signature of Applicants C lY L Address: H. (To be Completed by Issuing Agent) Date of Application 7 7 Fee Paid $ Permit Issued (date) i 7D Permit Number % vZ < J • Agent (Name) Fc:•: Town, Village, City, 'County, etc. (Specify) Note: The application cannot be considered for filing until all of the above questions are answered and the fee paid. Agents will forward application, the fee of $I.OU :or each septic tanK and the third copy of the permit (canary) to the Division of Health. Checks and money orders should be made payable to the Division of Health. Do not write In space below - FOR DEPARTMENT USE ONLY 1. DATE RECEIVED' ACCEPTED BY RETURNED t (Initials) (Date) Sees Gor es.) FEE RECEIVED ✓ VALID. No. PERMIT NO. r{ ill es or No REVIEWED BY APPROVED _ DATE (Initials) Yes or No COMPLETE OTHER SIDE f J SEPTIC TANK PERMIT NO A R Z P O R T O N S O I L P Z R C O L A? I O N ? I S T AND :,OIL BORINGS TO DIVISION OF HEALTH - PLUMBING SSCTI6N P.O.Box 309, Madison, Wis. 53701 Pursuant to H 62, 20, ilia. Administrative Code P It R C 0 L L T 1 0 N T Z S T Test Depth Charaoter of Soil Hours Water Test Time Drop in or Level inohes Minutes Number Inches Thickness in Inches Since Hole in Hole Interval Second to Next to Last To Fall let Wetted Overnij!Lt -in Minutes Last Period Last Period Period Ono Inch Example P • 0 - 3611 ?9Soil 1011 Cla 261, 25. Yes or No 30 IA I L2 --.y-2 60 ~r I RECORD DATA FROM MINIMUM OF 3 TEST HOLES compute size of absorption area in accord with H 62.20 Wis. Administrative Code. S 0 1 L B 0 R I N G S- Minimum 3611 Below o posed Abso lion System Boring Total Depth Depth to Ground Water Depth to Bedrock Number Inches Observed Zstimated Observed Estimated Character of Soil with Thiokness in Inches Zxsaple B • 0 7211 720, Black To Soil 1211Cl G181' Sand 1814• Gravel 2411 R=RD DATA FROM MINIMUM OF 3 BORE HOLES YPE OF OCCUPANCY, RESIDENCES Number of Bedrooms y OTHER: (Specify) Number of Persons POOD WASTE GRINDER, Yes No -L Dishwashers Yes No .~i...Automatic Clothes Washers Yes No FFLUENT DISPOSAL SYSTEM- NEW EXTENSION ADDITION REPLACEMENT /t Tile Size No.Lin.Feet _ Trench Width Depth Number of Lines Seepage Bed: Length Width Depth Tile Size No. Lines Seepage Pits Inside Diameter Liquid Depth I, the undersigned, hereby oertify that the percolation tests reported o-% this form were made by me or under rl° super- vision in accord with the procedures and method specified in Chapter H 62.20 (13), Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of any knowledge and belief. NAME , C" 13r &)1221 / 4^t 1 4:'L TITLE: 11/P7: Type or Print REGISTRATION NO. or 7M-ASTER PLUMBER LICENSE NO. 7 ',7 ADDRESS i)) !I? f' fl t+ i f 7k ~ / • l`~~ A DATE _ 1l ~7 t' SIGNATURE i , n CO) O 0 Cn O 3 v 0 O of F C m F c d Q d A 7 N n' CQD_ 'O a c 0 CD m m p~ m 4 O m v O N (n l O 0) m O N- O a) A '1 • c CA fD n(D 0) Q CD CL N M N Q co O D 0 O < (D J 0 7 CD CO (D C C 00 N Cn N 7 O 0 n CD C7 o o w O n i D n o o 3 Cn n ~ N N O p M c m c w t~ m a Z D m a O Cn a (n ou m C O O n C O O n I C:o W 0 ir- -4 0) O W A (0 \ Cr OZ v CD O O CD v WO n r N N O C 0 0 o o cn (.n a ca U) go -0 M -0 O O O Qo O CO CO Q !2 << A O " A A MA ~ ~ -I V y CD Cl) Cn Cl) LA fn fn '.~I tT 'L O o 3 cr O 0 w m m vi, a m ( m (D N 'O CL (D d d : N A G CD CD = A lCD -n y • • N -n ~ U) 3 a) 3 ((D N 3 N (DD 7 7 - 7 7 _ N ^ Q. W Z Cr = Z O Cl) O c O D CL 7 O D (T) 7 a q (D 3 CD cCD -0 Zn (n o lair-1l CD D) _ cD 2 C O CND 0. 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Cn m h (D ao n 0 E I °c ~ I UL I ~ I e ( i } E }o a ca ° N y I Qom P Q a~ a) A Z' o'' a: o U) I ~ w LI m d 75 Co c 5 L N y (D Zo C r ~t ° y 25 O I N N ~L o mj a) E (D ` Q y w CD 22 w Or- - 25 0 5) 2 u) Z 'C V z c ~~+t c I d Z CU I~D C t C m U `p C m n LL C C LL C u x* 'm I LL C U fn C O O O Y y O La 0 E ao E3 ¢zvi€ILJ I 3 azU~ o I o I a ani a I v 00w €m am I am z o I `oza I 0 Z o I a J) F- E 'o E P I E 2 E M ° m 4) y g 4' S I 4' m E c 0 m c m I c y 0` p N N C a) t.= •N p 7 $ 7 O 7 Cl) L- N 01 h 0 U 16 I y .y G. Q a m z a z z o I a co z N co z I co c c ~ I N N S1 = m _ d m d - am) m d _ ami m !^y y u' a a~+ a s a`+ a c V I a M r~+ a v C C a (D p y a) o 00 p y d a~ U aI 0 0 0 a E a) N y ~ c• c IL 0 a) CD Z. U) U) o I zo ILL =333 acn 'DN (LU) 3 av~ •N 0aaa ~aa0 ~ I~aaa M a I ~ I ~ I CD co C in V c°o co co z o I I- 1- rn rn Z I o co co z ~l x N N tE N CD I N -40) 1 0 :3 4) co CD CD ayi co ayi m ayi rn Cl) o ° o) np d Q} in x Q}in m I x d Q}v~ N 0 0 (cc N H V N C O I U N N E- 0 Q v v E cu t~ I CO Q C) 0 0 c E c a o o I E c r C2 Ct N N au V p } O N 0 O N C aD I J CD 7 N ° 17 D 00 n N T' d co 2 a-i~ U n 0 y~ s 4) y o d o o U) o o o y o m y I rn o ~ r IU n y nvi • o o H in o z Z > o z c z } rn o z z 4) 40 IL IL • a u `m a d a a - E 7E y C c« c c A U a O ai v 0 U) 0 ~ y V I i Wisconsin Department of Health and Social Services ' Plb. 157 10/69 Division of Health n PERMIT APPLICATION for PRIVATE DOMESTIC SEWAGE SYSTEMS A., OWNER OF PROPERTY TYPE OR USE BLACK INK C " Address Fame (Streets City, Zip Code) County B. LOCATION OF PROPERTY WgrRE SYSTEM WILL BE CONSTRUCTED, ALTERED IR EXTENDED Check Ones ~i ~''A J / ~ I CITY VILLAGE LEGAL DESCRIPTIONS ✓ '-i V 0 __1L TOWNSHIP Str.: ct C. IS LOCAL PERMIT REQUIRED FOR THIS WORK? YES _ NO PERMIT NUMBER D. SEPTIC TANK CAPACITY P 0-"G Gallons NEW INSTALLATION REPLACEMENT ADDITION MATERIALS: Prefab Concrete Poured in Place Steel Other NUMBER OF TANKS TO BE INSTALLED: E• TYPE OF OCCU Cheek Ones One r Two Family Residence Commercial Industrial Other Specify Number of Persons to be Accommodated_ Number of Bedrooms ; y F. APPLIANCES, ETCs Food Waste Grinder YES NO Automatic Clothes Washer YES NO Dishwasher YES NO Automatic Potato Peeler YES \i NO Other (Specify) i G. EFFLUENT DISPOSAL SYSTEM NEW EXTENSION X ADDITION REPLACEMENT Tile Size No.Lin.Feet Trenoh.Width Depth Number of Lines Seepage Beds Length Width Depth Tile Size No. Lines Seepage Pits Inside diameter Liquid Depth E PT►RC0LATI0N TEST I Test Depth Character of Soil Hours Water Test Time Drop in Water Level Inches Minutes Number Inches Thickness '.n Inches Since Hole in Hole Interval Second to Next to Last Po Fall Yxample let Wetted Overni ht in Mi:nstes Lest Period Last to i Period One Inch P- 0 36" To Soil 10" Cla 26"es or no 30 1/2 1/2 1/2 60 3 3 Irk Q S RECORD DATA FROM MINIMUM OF 3 TEST HOLES { ompute.eize of absorption area in acoora with H 62.20 Wis. Adninistra; ive Code. S 0 I L B O R I N G S- Minimum 36" Below Pro osad Absorption S stem orirlg Total Depth Depth to Ground Water Depth to Bedrock umber Inches Observed Estimated Observed "Estimated Character of Soil with Thickness in Inches xample - 0t 72" 72" Black To Snil 12"• Cla 18"• Sand 1811, Gravel 24" / ~ 9~ o '•r In 1. l~ ~/i.a (•i 4 RECORD DATA FROM MINIMUM OF 3 BORE HOLES COMPLETE OTHER SIDS i Is the undersigned, hereby certify that the percolation tests reported on this form were made by me or under by supervision in accord with the procedures and method specified in Chapter H 62.20 (3)s Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of(~my knowledge d belief. NAME ~✓v"w`~~` OZ TITLE Type or Print) or MA TER PLUMBER LICENSE No. mp- .3 REGISTRATION NO. ADDRESS Ir DATE 10 1 L V SIGNATUFS MASTER PLUMB.4.'R MAKING APPLICATION C Signatures License Numbers MP RSW (To be Completed by Issuing Agent) Date of Application /1' y7 C% Fee Paid # f t Permit Issued (dat) dy ~t Permit Number Agent (name) For.. Town, Village, City,YCounty, sto. (Specify) Notes The application cannot be considered for filing until all of the above questions are answered and the fee paid. Agents will forward application, the fee of $10.00 and Copy (b) of the Permit (yellow copy) to the Division of Health. Checks and money orders should be made payable to the Division of Health. Do not write in space below - FOR DEPARMNT USE ONLY DATE RECEIVED ACCEPTED BY RETURNED (Initials) (Date) See Corres. FEE RECEIVED ~ VALID. NO, P£FttI'f N0. Yes or No) REVIEWED BY APPROVED DATE (Initials) (Yes or No) COMMENTS: 0NO' 0m0 nwO 3v0 Tom. O !D W 7 tD A W A7 • 7 CD CD 3 m cn~ z o~ <I -Ia Z ~t,3 C o Z ~rn°~ ~C O• co CD A w 3 N o 0 3 1 o m o CO 0 3 o' B. 'D w 0 3 m rn n 3 N COi o CD Q >9 S A to O D Z A CO) O D Z A In N W D j O c 0 0 4 n O 0 CD 0 f0 N O 3 a) A CAA .0 I 7 7 3 O tD C C 7 I W O p y 3 (a (A 0 (n C D a x cn D q a a, cn D a x a ' m 'Xi) N m N cn 'n a 'n W cn -4 n ~-P CD y co IO O N I (D y IW O O N CD W a O O (7 N C O N w l O @ ap) c 0 `o c p: j 0 ? A 7 A 7 CD CO CD ;u CD CO ;o 0 r- CO) CO ;u co CD 03 c N W W O y 0 0 0 y O co O e: I a l a n 3 -o z 0003 0003 00031 ry~ g nv n-2 S5 vy c yv c c v a c N' Nv o v v 3 CD a 3 CD o 13 m m d ,O G G IQ G O o fQ ~0 C G 6 0 E. A C 0) m d 'O C N I N O ~ t~D C I C ~ 2 CD Q 3 m ca I 3 r y t° c 3 y fO N .y.. CD CD 0 C a M D m o? I D M o? D 'WD o? O A I a p n CD C O '~D v C p '~D N C O~ C 'Od N CA C W N CA C N N p W cc O. CL O CL CL 3 CD 3 5 3 z m co m co -1 N v s ~ g I ~ ~ N 3 " z v a a n a z o 0 I ~ N p 0 0 CD CZ a 3 a a Z g g 0 r: ~ N 'D y ~ i H a y ~ < al O O -WO ~ I m 3~ 5'0 3 0' O m= vi o 0 . o: N 'O 3 `D y. N C I N :k 'D 3 p~j c N 0 7 0 Da) c CD CD CD C1. 7 N O CD j~ X D) - O N 7 7 I 0) ra. W R a) (D o a I F 8, . o a ~oCL o a I m coo m o N (D n,~ o Nd f ~ 0 3 C, a W~ a o = CD v 0) OD 'a CD o = y O 'r G) O X a y' CD Z. mo)3ov Nc _ ~3 m NO y rno ° A Eirn n: CO CD 0 Z q cc o:~ o x3 to m = O _ CD N -0 U) CI = 0) CD 11 ~ ym'S o3nM 0 3f~ o 7 CD AR I 3 3 d O O p N 30 7''p 9 L1 a - 0 am I 7 M -0 O 7 CD ~ ti O 0. 0 fD O-NS S<? y0_ N O S N O CD p d 7 CD O A O I CD CD a Q 0 CD 0 CD CD A~ ~U I L T :SAN 1 TARP REPOR T Tcaship Sec.,Tn„N, 2V Malt f iscoTI3in I 4.4. S1t~i#wi . Distances ~c dimensions to meet requirements of Sec. H62.24 f ` 77-- it t, c # k € ~ 1ff ;z`. A!a r ris f pt to ccx_ Dry ' vle z Typa of Aurregat~Tlm Covered I itk1 ~ ` .eaetopage s t~ Vent caps in place munber U~-C-d-~ The inspect on o~ this systen by Pierce Cca'rz y does ,not int' :r cca;~yslt:te t p alco wit State Adr4nistrative Codes. Thera are other are, tl,:t it is inoos;s5iblo spec . #t, 'trot of construction. Pierce County assmmf s no, 1z~~bi Litt' for sy .t.c::.^. ,t~perat140* sl -FLUMR ON JOB - 71 REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM San.itany Penm.i.t 7 • State Septic NAME Y Townbh.ip D S~. Cno.ix County r7L4 Loca.i•ore ec.i on _ SEPTIC TANK _ y• Size a_qg4a .tond. Numbers of Compan.tmen.t4 D.cA tance Fnom: We,tt fit..5 12$ oh gneateh atope j t Bu.itd.ing Wettand.a H.ighwaz it. i DISPOSAL SYSTEM • D.i.b.tance Fnom: We.t.t Sp -f-_ 6z. 12% ox greaten a.tope Bu.i.td.ing Iit. W e.t.tandz Ft. H.ighwaten it. FIELD DIMENSIONS: Width o6' .trench it. Depth o6 to ck b etow t i.te ~ Z-- .in. Length aS each tine q ~ it. Dep#h oS rock oven ti,te .in. Numbers. a6 t.,ned / Depth os .tite below gnade.n. Total .teng-th o6 .t-ine.b it. S.to pe o6 tnench in pen 100 it. D.c b #ance between .tine.6__6 _It. Depth..to b edno ck ~ . To#a.t ab,s onbt.ion anea(;32 6 6t2 'Depth to groundwater. 3~ ~ Requ.ined area it2 Type of Coven: ciie; Straw PIT DIMENSIONS: Number o6 p.it4 Gnave.t anaund pit, yea no Ouxa.ide d.iameten it. Depth b e.tow .in.tet it. 2 Tota.t abaoAbt.ion area it A Axea requiAed it INSPECTED BY TITLE APPROVED DATE 19 REJECTED ,DATE 197`. ^ I _ J m.m.ra..,tiiatic .u.... ..4. da.4tlda r,.,. _...__a.v a ..r.. EH 11 s Rev.9/i8 ` . REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES 6 / P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION: !'/,1Section _~,T? aN,R~9 W, Township Te0't' Lot No. , Block No. uuvr Lars I) }~qa;r of 3 , aunty s t. cA' o ► vn ✓ ' ; - Subdivision Name Owner's/Buyers Name: ST PAUL. ti' M C A, 4-7s cepw_ Mailing Address: TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL P~`ya->'~ C1>,Mp 6.R-0u► ►fl EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM x OTHER S-9- $a PERCOLATION TESTS N° `r ~rs G o~x-Y'~o DATES OBSERVATIONS MADE: SOIL BORINGS SOIL MAP SHEET NAME OF SOIL MAP UNIT PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD I PERIOD 2 PERIOD 3 P- P- l~ 'P(2e-O L A-17 I O &A -rm ' G.O t4 uc:r E 0 5Aw9 501 i- c o I TL o Q P- V X4.1 I L Ip ~S 514%v w ev S'O 1 i.- S u R-vc l=o IL S o k Cvu rc z 1: P- tr2ata~4G3~L~T 1►~D~UA-C~ AS L INtLEGS la, = GLA S l P- WO-C0 l.A-ri o 14 Z.A--re = 3.OTO 10 bye AA% 1 NLil. P L pl)(3~ 1 L .C.ILI C 11s1~ KY~ L.'MI r02 SEE Zl NoQ-r4 " SOIL BORING TESTS S I-r~ TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B- 1 q S" QC),0V_ '7 q S" 7-6" IN L Ts • 0 '41 s" 4" fr~,Z4" s% 3'7" cc. B- Z, q3" ooiAe 7 '9 '311 Iq" vbl I- -r', • s • 13" ors . S" ~'Is~ IZ"s+1 ° 34c ' c. S, B- 3 103" 1j 01Je > It73u I u 131 LTs • 2Z" Is ° I2" ~s • t`"si 3S" G.s B- 3" IVa0 ~ ? 93" 17 10,1 L Ts• 1- 4". sl- 13"3b"c.5 B- S 93" MONW_ } q3" 14-"81 L Ts~ 5" L ° 7k- 51 13s 17" sit. 37"~s B- 13 Ll-3ro JIL 0I.SO, PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy- Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. A~.~ 4,7Z 4 " tilolz-r.a 5 I-[C?' ~ol~tw►ta►D I NS~ir~.~.t:r-t+ o...o mr ~ ~ P~ R 61 r; ~ ~ ~ - 6A LAX I So' ` h Z $F1G` ~~S be , E ~ #-.l S 1,,cxv4rr1O x w, f s 10D12 61i3A '&z 61 a 1 E ~ 3 E W ti0 134- Or-7 46' !fN i ` PaN-T 0)4 GuP4A12K (-IH~ M~rlH ' $O~TK +ac+tiG ~ ~ I ~ ,b VIr:NT CAO 4 i I, the undersigend, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. Name (print) Certificati n N SS - 527 o. i Address /V. zoo 5-4{OZZ .Name of installer if known PAJL- R-, C000, Copy A -Local Authority CST Signature r P LB 6 7 State and County State Permit #01916 Permit Application County Permit # 0 77 for Private Domestic Sewage Systems County T 0 ^A ;y *DENOTES STATE APPROVAL REQUIRED / Date Approval Received from State if Required late Plan I.D. # Q ~h~ A. OWNER OF PROPERTY Mailing Address: B. LOCATION: Section r N, R 7 E (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village To ship C. TYPE OF OCCUPANCY: *Commercial *Industrial t r specify) *Varian Single family Duplex No. of Bedrooms No. of Personslj24 D. SEPTIC TANK CAPACITY Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete Poured-in-Place Steel Fiberglass Other (specify) New Installation Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefa concrete r~Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate,4444 Total Absorb Area 4-1--a142-sq. ft. New L' Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width _/Depth -Tile depth (top)No. of Trenches Seepage Bed:-k~ Length- 47/,/ Width. 42 k / Depth- k Le Tile depth (to p) ~ No. of Lines 4Z_ Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land----/ !r~ Distance from critical slope WATER SUPPLY: Private ❑ Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Cer " ied Soil Tester, NAME C.S.T. r4o OX4 and other information obtained f m (owner/builder). Plumber's Signature r MP MPRSW# Phone Plumber's Address ~ G PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drill d please indicate. i l I~~ ~k I I 1) ~ I IV r a 4_~_ m l l E 3 Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY p Date of Application tsL7 ~0~ Fees Paid: State As, Count 0707 Date 46 Permit Issued/Rejected (date) J!:~ - V-940 Issuing Agent Name Inspection 'Yes No State Valid# Date Recd 1. (white copy) 3, owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 7/1/78 ( DESCRIPTION OF - T E H-OLDIPtu TA!T?{ LOC.~T.TON t AND DRAIN FIELD. FOR THE DINING HALL SYSTEM The northeasterly conner of the westerly k i n f leg of the drain field is located 87 feet from the southeasterly corner of cabin ~4 7 % in a southeasterly diretion # 7 c The 4500 gal holding tank is a with . n._ i in ono the of the north and s of oath , the basketball court as the boandries they are extended to the west. The . ~he tank runs in a southwest torthsastly.direction. out are 11i 61, a The manhole and clean . partandr between i n a the healthgervice dir.~ction nd run The m I sta e to r fan out the drainafieldsgis Inn from the clean out. 45 feet From the soatheesterl corner 3~ _ it is .76feet to of the biff the T. y ( ~Y1~tishalt t ~ f -r WS I t'Obn. ~ -.a a I `R ^ F a I . ~ t i , QIC; ccc,21-' r I r, 1 I , , 1 t III ~1-•_„y~c x _ f F Distance A--from the southwest corner of the 133 court 12feet north. B--From that _ Point 33 Y~ west to the man hole~et dirctly HS!'XSIi uoi C --Fxom- the.center of :.the blacktop.. Path towards the junction of A and B 44 feet (easterly) will find S'r~ the center of the man. hole r^ PI O- Lac A -FlOfA5 - ( OIII.ThLfi'%-,~ I p IE- LT ee 4 J ~ P S ~ ks ~ r t i 5 1 QQ. . 8 f i t 3 S f f 6 Q 4f C) z Y i 3 i i 4 i s i } i s f CALCULATIONS ' j. i This exterior grease interceptor will serve existing dining hall at the YMCA Camp which at present has an interior ' grease interceptor. It appears that a fair amount of grease is getting through Z the existing grease interceptor. So, to prolong the life of the sewer s ste f y m. we .are., ro osin the installation p p g of an exterior g. grease interceptor. i I SIZING ILHR 82.34 (5)(b) 2b. M= 450 meals/ day served G= 3 gal./ meal served H 6 hours/day meals are served P= 3 meal periods , M X G X H = 450 x 3 x 6 = 810 = 0 1350 gal. grease trap 2 x P 2 x 3 6 1 II ~ Use a Weiser 1565 gal. precast concrete grease trap. { r.. i 3 Page 2 of 4 t i } 1 a EXTERIOR GREASE INTERCEPTOR E FOR f i Greater St-.Paul Area YMCA r Camp Dining Hall s Located in the SE4,SW4, Sec. 6, T28N, R19W, Town of Troy, St. Croix County, Wisconsin. INDEX s i Page 1 of 4....... Title Page Page 1 of 4....... Index Page 2 of 4....... Calculations Page 3 of 4....... Plot Plan with Camp Buildings g Page 4 of 4....... Plot Plan with Sewer System t 3 Master Plumber: Paul C.J. Steiner #6780 Date 6&10A Page 1 of 4 State of Wisconsin , Department of Industry, Labor and Human Relations PRIVATE SEWAGE PLAN APPROVAL SAFETY & BUILDINGS DIVISION i Office of Division Codes and Application 201 East Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 k WEGERER, WEBER & ASSOCIATES Owner: ST. CROIX RIVER CENTER P.O: BOX 74 F 421 N. MAIN ST. C.T.H. "F" RIVER FALLS WI 54022 HUDSON WI 54016 { i RE:.Plan Number: 87-06832-S Date Approved: September 17, 1987 Gallons Per Day: 1,350 Date Received: September 17, 1987 Project Name: YMCA - IGP SYSTEM Location: SE,SW,SEC.6,28,.1.9W : Town. of TROY County: ST CROIX Fees Received (Priority Review): 260.00 The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter } 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are g stamped 'conditionally approved`. This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation { shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. 4 This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. I The Section of Private Sewage has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the I Wisconsin Administrative code. i 3 This approval is for the following components only. - REPL CONVENTIONAL 3 Inquiries concerning this approval may be made by calling (608) 266-3937. 'S' erely, G - F JAMES QUINLAN .,Section of, Private Sewage F Division of Safety and-Buildings PPP012/0009n/11 cc: ST. CROIX RIVER CENTER Private Sewage Consultant County ~UW-SSWMP Plumbing Consult--- B 98'4 $ 82 9 BS ~ 1NSTALI, C~xhi: • SeePAGe6Ep s F Qw v ,o 7 ~ O~NC MlLRlc: LEY,=100.a - 9TO.P OF SOUTH¢¢Ly v6NT GA.P - - I B'3 ~ACK.y{oE. So+L 1'1T (TYP.) • 97 It Pvc. S.~+o w^,,, /A457-AL1- D15 ral B. .BOK 1 7 bw Ga PQ Fotcc MA+N L..,,XtST 3000 .Al- 1NSTA L4 11.064.A1. SMPTlc. TA.µK I_ I CoS+~+c-~ 'r-A r.tK 4"fb G 1 . Cm V tT (,o VRT ' { i so DINT NC F{Ia.LL ~ann+~E ~ORTH WASTE SYSTEM S 1-TE. s£cF. w,oT~.l PvC I - I I I I 1 N'. SOY I I I .aL.10 WAL.~ (TYP.) I I I I I I 1 , I I I I I INSTAI.I. 95 3 E • PF-R-17. PVc "P+PE 3'Lr I SPACIMp @,(v' t(c0' I ~G ' u I I I I n I I , " I I I ~ I I i I LAND. SURVEYOR RIVE iALLS, WIS, 54022 4 r MAP etc. , z• -r A K)ot.-rL4 DAv.%TA SAIL 7- 1J 1 9 VJ KL aC-- 1 ~zu~r ~ 1 a D t=~ r1 R.r.~ N U ra rv G, t4 Ar is Qt: \4 t-p I a q ~ ..ter..-.. l-....~-K , -',.~-~i~ t.. ~+.)~`~..~.i f~,,k:,~.,?.~ orb v(, - 9S. a ~<c: { t:;..~~.,. , ti• ~ E::~ x, ~ in (cl tab ~'Q ~ r-'f, a . • Z 1 rw~ 4~ A hJ V . 2.5 C~fvl/ ~?eookOloy Ito ?eV00% 1.~5 E'= 1•Z,tS►'t~ ~rt,_ / ,a V1t ~-u tT.l S,7 ~•t,.~ •puMP&Q L•` lrT 4LG . y : I , rl I ~ \,,11\,h.a T~ tt±F .h NtYf y CAe. t-'v µ1v 1 ~ (c`~c~ Y' ,arc t'_r.UC~ Gn;I~~P< Una n/ G''~c.l.tta~ ~S l..J rid,„ 1,17, - 'lb tZ.Ob c My~ -.~',A J it, -T J ~ ~ ,rte -Z.. ? `,a C` 't - ~ . ~ 1 ►•.,lc,~«.S 1 c.. ~ - 1. l ~ V t Ct • Z • , r • '7 i F- AV Sea C, 04 M A SA~►er (AV rr 4 'S CJ sL7 .G T , ~wr I y. ",~.t SwaI"i V y /+1~ r".r rs~•IC'~.~ ~ -r~.~,5t tiff L, mL • Fes- vuw 1 t~ R~.~ t0 10 M z Gam. X.)•-t' C,\ t .w (e Zca U M. w. 0 `4 o a 1~~. b c o►0 pUw/\P. a~, ~DiSb ~.+f- w/o ~.llCcap.,• I e,~~c G~tLI~~t4N~r' b 1 Z vv Y $A(. NL- cl) Ake* f 4• F I A W i• f~ /y f~ a V y~ `J y 11..r 4 M 4e ev I I -A 10011 -r0l /LOY lt,"C w"~ 3 , to ll~ll1tt11111N111/lf)/! 00 JAMES IVi RPHY MU 1 2 7 9 9 Rlvctl FALLS, 'A WISC. I - .,r✓ err!!" N AL 1 e `y 1 fir 70 i c y~ 60 3,tyO PROJECT DETAIL DATA SHEET i NAME OF BUSIkES5 f`✓~ ; , . , NMI Cti.ft U+-9b M LOCATION ---Y - -r t street or highway or townsh ,p county LEGAL DESCR Pt I ON UWrIEft y ` VVr A. "ailing addrost ' 4-7S C*- b b,tilr -r. 'ARCHITCCT OR ENGINEER l,uo, kiY Address S14 - n -c W tiP 'S PLUMBElt p► 4 1Z.. CaaDO Address trz S 1~Wv~ . 5 sw-ra i. Check appropriate billld$no usage(s)',►nd fill i each usage listed.* ti the information rogues'ted oppo+s'ite Existing building y~ New building ddditton _ If add I t o--fin to exi s' l ng '~u i 1 d i ng attach deta led memo for each. Oriij in tettaurant 'Car spaces O Restaurant Seating capai'ty` (10 sq. ft./gj":tlri O Dining hall ..i.. Per meal served Motel Hotel Tot let, w6 to yest i No O O O Cottages Number of un t--" 2 Per%0h9/uhIt 4 persons/unit TOTAL Nl)MBI R"'6` 111NITS _ Churches .......i.'Number of persons kitchen Yes O Bar or cocktail lounge .6,... Seating capacity ( 0 ft. /person) No - O Nursing rest Number of beds O Mobile home p ark Number of units pendent (cam er trailer) p . 4 - nondepend6"t (mobile home) O Retail store r Numbe, Of employees Number of customers jf "sg. ftdop eion) t) Service station Number of cars served .(daIly) O school off Number of classrooms Meals` 'served yejj, Showers No ..ems provided Yes ;ido Factat* or office building ,,Number of persons (tote a i shi f (fy Apartments Number of bedrooms ( Other . Specify rt7w' ti4-r 2. Indicate whether or not the following facilities are connected: Food waste grinder Yes No ✓ Dishwasher Yes' No Automatic clothes washer Vas N Other . . (Specify) Automatic potato pee eT+r ~Yes fill in the appropriate Information for the following as Indicated: Septic tank capacity t~-retie, MAY 221980. p rated - - "3000 G.r Percolation test results y ATTACK PERCOLATION TEST` AND SOIL BORINdS PLUMBING SEC COMPLEtE OTHER SIDE f _ - - , ~ ~ ,a t , :a . , r i c.. t J ,r r, ~F"s ~rni ~ - I,i Y 3 ~ i ^ i+ 1 ~p w e ts:: ~ ~ ~ ; ~k Q~ s • s, ~ .t. ~ `i oi, ~ ~ yip rir area planned width GaG~ eepage -lvw 4 --roil ciWr. ? low linear feet ° ca depth planned width Seepage linear feet depth _ r Seepage pit planned outside diameter depth below inlet depth , roved plan for specifications and details. } q. See app • , . `0° , letin fotM! STATE DIVISION OF HEALTHWisca dING5SEC ION 51'gnatdre of person comp g P. 0. Box 309, Madison, ~ Approved: _ - Y A.0 57/ Date: Address: f4IS APPROVAL IS BASED ON STATE PLUMBING ~i d ~crr x I CODE REQUIREMENTS AND DOES NOT EXEMPT THE y INSTALLATION FROM CITY; VILLAGE, TOWNSHIP Date. /'fY OR COUNTY REGULATIONS OR PERMIT REQUIRE- MENTS AND SHALL BE VOID IF REVISED WITHOUT THE WRITTEN APPROVAL OF THE DIVISION OF HEALTH. DEPARTMENTAL USE ONLY fly fit { 11% I'BD MA's ~'tUrA IN SECTION ppppp- DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH State of Wisconsin SECTION OF PLUMBING AND FIRE PROTECTION P.O. BOX 309 MADISON, WISCONSIN 53701 T E L. 608-266-3815 i INALL CORRESPONDENCE REFER TO PLAN IDENTIFICATION NO. Y NAME OF PROJECT of TYPE OF APPROVAL S CIO v STREET AND NO. 0~ }y ~ ~Qtio CITY OR TOWN COUNTY STATE ZIP Cat OWNER Gentlemen: Examination of plumbing plans and specifications for the above-mentioned project has been completed. In accord with Chapter 145, Wisconsin Statutes, and Chapter H 62, Wisconsin Administrative Code, the plumbing plans and specifications are approved contingent upon compliance with the stipulations indicated on the plans. Please review your code for the requirements of each code section noted. The architect, professional engineer, registered designer, owner or plumbing contractor shall keep at the construction site one set of plans bearing the stamp of approval of the department. In the event installation of the plumbing improvements or system has not commenced with in two years from this date, this approval shall become void and new application shall be made for approval of these plans before work may commence. it In granting this approval, the Division of Health does not hold itself liable for any defects in plans or specifications, plan omissions, examination and reserves the right to order changes or additions should conditions arise making this necessary. This approval is based on Chapter H 62, Wisconsin Administrative Code, requirements. It shall be necessary to obtain and fulfill the permit requirements of the city, village, township or county in which this installation is to be constructed. Failure to obtain local permits will automatically void this acceptance. Sincerely, !/lstta~ James Sargent - Chief PLANS REVIEWED BY: DATE: cc: Owner DI LHR acal PI Plumber H& R (2) ounty Mfg. Rep. Bur. of Health Fac. & Services Sec. of Plat., Rec. & Env. Services ith - - e _ .'ANfl R MADISON, WISCON • r°, 608-266-3815-w ©JECT: nf,, c G. ;6'1r.'34 YV ID. F.. "~-+i-~i.:^7.~-ti-e+.-wa. A _ '+1M'a4'..•iw""i""!~.-"""-r~'.+tit?Ir+Lgriy~4:MY'w.•.=.r.+wi..i~..~.'~.'.~'~. ~.~t 's c ..k -d~x,~i p,~; ..a a.- yak s i.. , 4Nf= t~ 3J~ l~ 1 4~ V 1 .q f ~ • { N$*, f~ N o ,1ttM~ibciat4diIFt~ n iW-00- 440 c •;.c, 1 i' Iff 00 t .s t turrwtl:i1'~ r RS+na~lL a O*V Idl ng Of Is ►~t ela va#1► ' t » . +W'. ~ A r rp.. 71 fe~tz#'PtrsYaes.nl)Ilpi ~ J I~ -~t••~ T Y 4-4 f ~j^t r v 5/ 1l~s' y 'glans *ft fe}ur 4 ' 6 ,4tddi#j411.f4rrr~aecWlted.° L V • P%l Su*""j. n AJ{►'{a~ ti~c~ ir~gliet#te us'ly na+Ced_ ' Op k Y - El All infOrMation subig iit ef,sfi3J[! ¢signeck sealed or starnpr in' rdalli CO1 114 6 125:(2)(a) Wiseatl Alfi0bvit enclosed. lEt A4ternat6 sewage Disposal Syttvms-04outld Systems) q r PL B x~ (Appiicatiori fQr use of an-alternate system): County. ns4t'e required (1 copy#,• Design, calculations for p:essunzed distribution Crass section of mound, G7".tatetal layout. 0 Plan view of alternate. , *`'"ate S afRage Disposi+L$yst"s ;El Groland slope with 2" contours=in entire area of soil absorptni sytt~m eictetrleray 25' on all; sides. tr " 0 Elevation of permanent reference point (benchrruuk). fl Location of area suit able for replacement"system provid i test-data. Plot plain showing tot site-arod'alt:tateral distances from sewage''..disposal:syster~t o YetlNdir xantc to bldgs, lot lines, well, wa , El Construction detail of septic, bo144139"®r lift pump tank if site cc strutted or tank maflufaetulrer if,, ecas#. * 'El Construction detail and cl*s= ti}9ri~gf4,ail absorption system ~u "0* k El Stril L and percofaticsn Cest'on 11S W114 tleted by certi se tester=I'{ y). zr` ~ r ` D ~e'deta reWye to anticig8tecbt~q~sf bldg. 3 copies.of OILB Eb ene~sQd. 6 ~quftyI X e Deed riestriCticot- f'ldi nRT.ilirrks n y ,y Profr>a# holding taps: Hotdi+ talk sgr'eement signed by,~ovvner and bold unit ofgpre;nment (salt ple*, rlEclosed). Xi 9-tF~1'tinst8llirtg ho#d►ng t it tester statement fr$iq coca y Q!Ry► , + a Puff ; fdr t+~tlrat~p~9a~#d gallons.pPer cye ~{e f pqb b3l*uffing sire, pump curves, drawdown and average. ow rake GPM. s~ Q4°313(3t) or si pherl(s). Q > a rsnchlea~,tdfln) ? wYis pftMibing supervisb x? x . R 4 "~v SAS ~ y r' d 'b4 M ,e - - is Ohl 1 x 1 a _ a - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -ti 1 t a, t Y M.C.A. CAMPGROUND ~ Lor-Al-rlEo IW GOVT 1_0TS 1 1 2_ 4 PART OF SF.L.TION 6 \ T 28N, R19W , 'TOW>`1 OF TROY, S.T. CP-OIY- COUNTY WISCONSIM ON S17e Y~ASTC DlsPc)sA>_ ~ TO HUD601J (i 94 1 Mi~.~ ) YMCA /o CAMP i. 2 y 2 ~ Y W 0 LOCA'TIdN MAP I z u i o uo-\T ww_~ To J M M wv~~ GA4 LS U a J ~ 0 7 p 9 Q G 0 N ~ C J G•\• VrJJT ar V J 44 Q CL1<~/i: _ NJORI•u 5rre. = 99.2 So~Tw stTm = 97.4- I a I1 W cop I MLI<T : A.'O C. .I i i - - p 00TLXT : 2•,4> PVC. Pofl-e MAIµ 1, -E-- 31 ONTO 5•r I 1. ,.1. euco4sev to iN 4°~.L A. LR J Q 7 U>`1Of$TJRBLD -.Y_ HI .,A A E .Y 7 T. 5' ONTO V..I+t O1ST3Jir4}EO, .1 CL\~ ~~bVND , GRO UNO. Wisconsin Depa►rtseut of Health and Social Services ' Plb. #67 3/70 Division of Health SEPTIC TANK PERMIT APPLICATION -J-f a'/~j?~ ~~17 r'v1 ' TYPE or USE BLACK INK A. OWNER OF PROPERTY Fame Address (street, city, Zip Code) i ~ Be LOCATION OF PROPERTY WHERE SYSTEM WILL BE CONSTRUCTED ALTERED OR EXTENDED COUNTY Check Ones CITY VILLAGE LEGAL DESCRIPTION TOWNSHIP C. IS LOCAL PERMIT REQUIRED FOR THIS WORK? YES NO / PERMIT NUMBER D. SEPTIC TANK CAPACITY(' /1 Gallons NEW yINSTALLATION REPLACEMENT ADDITION MATERIALSs Prefab Concrete Pou,~ed in Place /l Steel Other NUMBER OF TANKS TO BE INSTALLED: ~:1 7f' III E. TYPE OF OCCUPANCY -Cheek One: One or Two Family Residence Commercial industrial other Speolfy) Number of Persons to be Accommodated Number of Be ooms F. APPLIANCES, ETC: Food Waste Grinder X YES NO Automatic Clothes Washer YES NO Dishwasher YES NO Automatic Potato Peeler YES NO Other (Specify) G MASTLR PLUMBER KAKING,INSTALLATION 'fir o 1 f.'~^, Addressa ( f - -g-jj r i e, n 'License Number: Name: O . HP yf ~ti1.,y L!~ pp4.Y l L f Signature of Applicants MP RSW Address:i z_1-1 t: -f',l f( i' f L~'l •_'1 i~c~ H. (T-o/be Completed by Issuing Agent) Date of Application Z C Fee Paid $ /f? Permit Issued (date) jy l U -7 Permit Number % • Agent (Name) V/--' Fcr: C,<-~tt t cl-i ' Town, Village, City, County, etc. (Specify) Note: The application cannot be considered for filing until all of the above questions are answered and the fee paid. Agents wila forward application, the fee of 3 L OG for each septic tanK and the third copy of the permit (canary) to the Division of Health. Checks and money orders should be made payable to the Division of Hesith. Do not write in space below - FOR DEPARTMENT USE ONLY I. DATE RECEIVED f IACCEPTED BY RETURNED t (Initials) D C (Date) See ;,o s.j FEE RECEIVED ✓ VALID. No. J PERMIT NO. k 'Nq REV IEWED BY APPROVED DATLi -f--~ r (Initials) Yes or No COMPLETE OTHER SIDE SEPTIC TANK PERMIT NO. R Z P 0 R T ON SOIL P Z R C 0 L A 7 1 0 N TEST A N D S O I L B O R I N G S TO DIVISION OF HEALTH - PLUMBING SECT16N P.O.Box 309, Madison, Wis. 53701 Pursuant to H 62.20, Wis. Administrative Code P Z R C 0 L A T I 0 N T E S T Test Depth Character of Soil Hours Water Test Time DrnP in or Level ohes Minutes Number Inches Thickness in Inches Since Hole in Hole Interval Second to Next to Last To Fall 1st Wetted Overni minutes Last Period Last Period Period One Inch Example P - 0 361+ To Soil 10N Cla 26+• 25- Yes or No 30 1/2 2/2 I L2 60 RECORD DATA FROM MINIMUM OF 3 TEST HOLES Compute size of absorption arse accord with H 62.20 Wis. Administrative Code. 4 S O I L B O R I N G S- Minimum 3611 Below o posed Abso tion System Boring Total Depth Depth to Ground Water Depth to Bedrock Number Inches Observed Estimated Observed Estimated Character of Soil with Thickness in Inches Example B - 0 72" 7210 Black To Soil 1211 C1 18" Sand 18" 4ravel 2+411 RECORD DATA FROM MINIMUM OF 3 BORE HOLES TYPE OF OCCUPANCYs RESIDENCE. Number of Bedrooms OTHERS (Specify) Number of Persons FOOD WASTE GRINDERS Yes X No Dishwashers Yes A No _ utomatic Clothes Washers Yes No EFFLUENT DISPOSAL SYSTEM: NEW EXTENSION ADDITION REP Tile Size No.Lin.Feet Treno Wid Depth Number of Lines Seepage Bed: Length Width Depth Tile Size No. Lines Seepage Pits Inside Diameter _ Liquid Dept2► I, the undersigned, hereby certifv that the percolation tests reported o• this form were made by me or under my super- vision in accord with the procedures and method specified in Chapter H 62.20 (13), Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. , NAME L"%C~ TITLE !J~ 9 'er 1 'x~~ Type or Print REGISTRATION NO. or MASTER PLUMBER LICENSE NO. 7 ~r ADDRESS zy 41''..'k '-S(~ I DATE lI ! 7 /G % SIGNATURE t fCt G 1 LC L E r Q CA 01 0 O y O p m f! 3 'a 0 p C A ID (D m m -0 7! V 7! m 9 Q o y o ~ o o o OD o 57 o H 0 0 Z ° H 0) 0 Z a m y 0) 0 a (D y o c) c CD D I o m ♦ p D -I o m m 3 0 m m~ 0 ° m 3 n o m N O w to d rn v v 3 N W m = m o°. v l ° v l a n v o CO Q 0 a o Cl) a o c'n ° a o f!1 °o r* N U) 1 N (A N N O O C7 0 w n m tD a CL c m vDi C° x a m ° a e (Q y co f~ y d w tj N CL co W 0. c o 0 0 l a _c o 0 o I oa _ o O rn °pp~ w l O m w O r w V A A N~ V A N ~ W W N: 90 Q° Q° CO CO Cn CO CO cn z o to n r us CO CO y co 0 to O O A ° C A A A N r? Q o 0 0 I ' 000~I 000AI 000' gg p g a a CL C: to (A CA CA CA CA ca (n 6 S' 3 ° C C I ° Cl 0 0 O c CD Cl C C 3 n 0 CD c 'a o v d v 'o m V -o' ai N N N 3 0, l 3 m l i 3 r r. a l a l 5a 5 O w 0 D CWD o= I D co o= D co _ a 7 c a° c a c !tl o I o o = O (D CD CD I CD ch CD CA M N I CD d co v <i hA O N O N O t,y~ V C: CD CD CD a I rL {a CD ip rn m rn CD rn -i to C C °a a A I 1 I M I' O N O I I a 3 I a 3 z 0 0 o ~ I ' N t0 N Z I y z CL I w * CD co O 7 O M CD y CNn N N o a C I p C a O mq a < 'co9Um G I v dv 0. C g A) CD ~O y'a O a xOO.C z a I y w OZ a 7c _ O w 'm 0 CL 53 Qa W a O 77CD =h cn p CD C) rn°oo ° o a~ my CD CD O) O CD 7 N 0 pp CD r_ X (a 5D -0 CD CL cn rna o no o 215- a ~t° O7 N~ ~i I n 0 CD '-c p N Q -I (n CD 3 m7wN o oCDfn 3~'D E? CL 3 O a a N N N 0 3 53 Sd 7 00 O y W CD C, . R M. p O? i N m °c 0 N a q 0 0 0 b ° m CD N ~69 0 0 0 0 63 O ti O .p O I O 0 0. 0 W ~i Wisco sin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: ' P YMCAIder's~~1MF ST. CROIX City E] Village R Town of: State Plan o.: CST BM Elev.: Insp. BM Elev.: ption: Parcel Tax No.: 777 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet Verit irito ntake ROAD Dt Inlet TANK TO P/ L WELL BLDG. A Air Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM Friction S stem Loss H LocemF H Lift yTDH Ft rai n n Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Di;. Liquid Depth DIMENSIONS DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O CHAMBER Model Number: System: OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil E) Yes No ❑ Yes E] No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Troy-6.28.19W, SE, SW, Gov't Lot 2, County Road F G~ Plan revision required? ❑ Yes ❑ No Use other side for additional information. I F SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH , SANITARY PERMIT NUMBER: E SANITARY PERMIT APPLICATION ~I`HR COUNTY In accord with ILHR 83.05, Wis. Adm. Code Croix STATE SAjdi TARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than -(a/ 6 8% x 11 inches in size. ❑ Check if revision to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION YMCA _ _ 'l4 %,S T28 N,R 19 )§dad W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # 532 rnimt:y rr tr GOV t Lot CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER Hudson. 154016 1(715 386-4380 11 1 ROAD 11. TYPE OF BUILDING: (Check one) State Owned n n 0 Public El l or 2 Fam. Dwelling-~# of bedrooms _ A PRCELTAX NUMB 5) - 111. BUILDING USE: (If building type is public, check all that apply) 040-1027-10 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ® Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ® New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 51-1 Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ® Seepage Bed 21 ❑ Mound 300 Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 220 In-Ground 420 Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 140 System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION 2400 3600 3600 .7 Feet Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name oncret Con- Steel glass Plastic App Tanks Tanks structed Septic Tank _14& - 3 110 Chamber 100~ 1000 1 Weiser N El I El 0 1 =0 I IF R1 VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's ign~ r (Stamps) MF*Jtt No.: Business Phone Number: Paul C. J. Steiner 1'- A 715 425-5544 Plumber's Address (Street, City, State, Zip Code): N8230 945th Street; River Falls, WI 54022 IX. C NTYIDEPARTMENT USE ONLY ssue issuing Age Signa o Sta ps) ❑ Disapproved San' ry Permit Fee (includes Groundwater L_7/_o~ ;tSj Approved ❑ Owner Given Initial rcharge Fee) Ad verse Determination X. CONDITIONS OF APPROVALIREASONS FOR DISAPPROVAL: t SBD-6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system into be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. 111. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) DOSED CONVENTIONAL SOIL ABSORPTION SYSTEM Page of FOR B`vTN \A ovSE S94-414,51 Go • t_-O T Z LOCATED IN THE 1/4 OF THE 1/4 OF SECTION 6 ,T 2,8 N, R19 W, TOWN OF -S-i2u`f , S~ , eRpV( COUNTY, WISCONSIN INDEX PAGE I OF 6 TITLE SHEET PAGE 2 OF 6 PROJECT DATA PAGE 3 OF 6 PLOT PLAN PAGE 4 OF 6 PLAN VIEW-CROSS SECTION PAGE 5 OF 6 PUMP CHAMBER PAGE 6 OF 6 PUMP PERFORMANCE CURVE PREPARED FOR - QF~~411t~t~..R Y''1 Iz- R C 1'1'1 P 5T • C 1`4 u 1 X S 3 Z C o ~1 v ~ sow, tv 1 s ~ X16 1v`~ AFTHUR L % ~ = Wi~C:En.Z 1 6-S:iP e &1S6ynRTH, i VJfS. PREPARED BY 4 " i. ®®r® 4, G N P WEGE>F=<EFZ SCI I L_ TEST X NG ~o - Z4- 9y AND DES I GIh! E-; T_= FtV = CE P.O. BOX 74 421 K. MIK ST_ RIVER FALLS. VI 54022 RECEIVED 115-4~J-0165 NOV 0 1 JOB NO. SAFEW i 81065. W. PROJECT DATA S94-41451 age Z of 6 This proposed system is to serve a bathhouse containing showers and toilets. The proposed building will also have 6 floor drains. Water conserving fixtures will be installed. The anticipated wastewater for the camp occupants is based on the code for Camps, day use only (15 gpd/person).Due to there being other toilet and shower facilities available and due to 12 gallon flush toilets and urinals in the men's area,it is very likely the actual GPD/ person will be considerably less. It is not logical to size this system at 40 gpd/person for Camps, day and night use. ANTICIPATED WASTEWATER 6 floor drains at 50 gpd = -----------------------300 gpd 90 persons at 15 gpd = 750 gpd 50 showers at 15 gpd = ----------------------1350 gpd TOTAL = - 2400 gpd SOIL ABSORPTION AREA The soils are sand and gravel with a loading rate of 0.7 gpd/sq.ft. 2400 - 0.7 = 3429 sq.ft. of absorption area. ( Minimum req'd.) A dosed 36' X 100' conventional bed will be installed providing 3600 sq.ft. of absorption area. SEPTIC TANK 2400 + 750 = 3150 gallon minimum capacity req'd. 2 tanks, each 1665 gallon capacity will be installed in series to provide 3330 total capacity. PU14P CHAMBER A 1000 gallon precast concrete pump chamber will be installed with duplex pumps and alternating controls. 1-10 T - S~P'R c 't~~2 s `Co ~E Z 1rt S 1 r`i S ►66s cock, C"?~cvrf ~`C w`LSe~Z camo ~'c1! Dv~LEX ZoLtt~' k) ie L" C Self ~w ~kGN S= Dv?LtiK C I S94=41451 coy' i ~G \ LuCp CUV\J $Y~<`rTC1i a 'a ~ x d• ~ I 1 S VrE Qom' ° ~TL 9 S 3 P t~R1~.t,vG ~ I/J A.JOi'~- T71 O 1~1~~GS~l~ OLI~G. I _ ~\AJ ~~6E y of 6 S94r41451 61 v~ 3' b' yt _ G ~ ~ m }-~i~~►J FtZ01~{ 6' u on y'~SouDwML PVC 4"»f O\SnLldvlipty piP>T4 Y'tl'1►JIFvL~ C StnPE ~'~kx. Z" -T~ of eN,~~ OnditiOnayY )PPIO C.1~0 S S a~s ~ S, hUM(aN ~ 5 OF VFU~- PIPS y UL~' p S1 ~ / PrPPROU~ C.~P ~''ys`~ 1 ~ESP014 C EK-\ST)►j Ca Rrv~ F »v\gT~'~ G12APd ~~gS t s o t L ~14L TT Y ` 4 2 '~'1'A ~1 W11~1'1 a~natiov ~ S` k"MeT\C MUQeV-tAJG ~ O J ELtV . 43- C) ~ 1 t P 1Z.~RR«''D PIPE: `Cn Z' ~ Z /2,' I~GGZ~ Gh-TE 20`' 8Fw►.J PtP~S t►~n 3u ~ lvwt c~'F Q~ Z" \'~OU~ PIPES. PUMP CHAMBER CRO55 SECTION AND SPECIFICATIONS PAGE OF vENT CAP ..894-41451 'i"C. Z. VENT PIPC WEATHER PROOF APPROVED LOCKING MANHOLE cIUKlCTION 90X COVER WITH WARNING LABEL 10' FROM DOOR, WINDOW Oft FRESH AIR INTAKE ;lyt i y"MIN. 10NS I 18". MI AI. * 1ap°5 CONDUIT-- \ p0PROVIDE I I IAILET GO AIRTIGHT SEAL I III I I I v APPROVED JOINT A Tank construction shall comply I ICI APPROVED JOIIJTS with approved with ILHR 83.15 and ILHR 83.20 I III pipe extending I I ALARM 3 feet onto a lastall duplex alternating controls with the alarm I i i I system being incorporated into the duplex controls solid s o i l . which will be activated in the event of pump failure, I ( ON simultaneously switching the remaining pump to Both sides Of C dosing on each cycle. I I taCLEV. FT. PUMPS,, OFF r 0 EL 9 O • V O COKICRETE BLOCK 3" APPROVI:p RISER EXIT PERMITTED ONLY IF TAWK MANUFACTURER HAS 5UCH APPROVAL. ggDplµ~ SPECIFICATIC)US DOSE W\-S@1Z cz*jcL_ere P VCTS NUMBER OF DOSES: 3 PER DA4 TAM MAKIUFACTURCR: TAWK 512E: \000 GALLOWS DOSE VOLUME 1 ALARM MANUFACTURER' S-M'ItM_1123 S251124 S INCLUDING OACK►LOW: 6oZ' ~ GALLONS MODEL DUMBER: ~b~ Kw CAPACITIES: A= 1 Z IWCHE5 OR GALLONS SWITCH TSPC: 5= Z 114CHES OR 5' " y G(LLOWS PUMP MANUFACTURER: ZA1LL M Cut M1lJLf Cis 23- IKICHES OR 63 L GALLONS MODEL NUMBER: S3 D- ~Z- INCHES OR 3'1y' S GALLONS TIbAm-L _ M.)VO A SWITCH TYPE' w1 2_CU~ZL( MOTE: PUMP AND ALARM ARE TO OE MIWIMUM DISCHARGE RATE '4 1_._GPM INSTALLED ON 5EPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AAID..DISTRIBUTION PIPE.. -7 FEET Ran . . ~ fi-tEt~ ♦ \b~ FEET OF FORCE MAIN X ~_F>j/oofT.FRICTIOU FACTOR. 32-S FEET TOTAL DtIUAMIC. HEAD = 6 aS FEET DIAMETER - ,I INTERIJAL OIME1.15101J~ OF TAKJK: LEKIGTH ;WIDTH 'LIQUID DEPTH BOTTOM AREA 231= GAL/INCH AS PER MANUFACTURER = zg,~1 GAL/INCH 0 1 Ph Gt 6 or= 6 - - w W HEAD CAPACITY CURVE a7i8 61/4 W "53-55" SERIES 45/8 25 m TOTAL DYNAMIC HEAD/ 47/8 FLOW PER MINUTE EFFLUENT AND DEWATERING m - HEAD CAPACITY 20 UNITS/MIN '/2 - a 6 FEET METERS GAL LTRS ~6 1 1/2 NPT W 5 1.52 43 163 m 10 3.05 34 129 15 4.57 19 72 15 19.25 5.87 0 0 Z 4 Q ~ 10 O ~ 2 -G, a5 5 ~0 91$/,6 } 41,o 0 I 7 US 10 20 30 40 50 11 I-JJ 33/32 GALLONS I I IF -4 L\~ LITERS 0 80 160 FLOW PER MINUTE 5 9 4 0 41 4 5 1 = R' t T I AU,_yRY FOR SPECIAL. APPLICATIONS _ • Piggyback Mercury Float Switches * Available with special cord lengths of 15', available. 25', 35' and 50'. • Variable level long cycle systems • Alarm systems available. available. • Duplex systems available. Standard cord length - automatic 9 ft. Standard cord length - non-automatic 15 ft. ;.ECTION GU!DE M53/55 SERIES Control Olectlon t. Integral float operated mechanical switch, no exteirial'@ontrol required. Model Volts-Ph Mode Amps Simplex Duplex 2. Single piggyback wide angle mercury float switch or double piggyback mercuryfloat M53/55 115 1 Auto 8.0 1 or 1 & 7 - switch. Refer to FM0477. N53/55 115 ' 1 Non 8.0 2 or 2 & 6 3 or 4 & 5 3. Mechanical alternator 10-0072 or 10-0075. D53/55 230 1 Auto 4.0 1 or 1 & 7 4. See FM-712 for correct model of Electrical Alternator, "E-Pak". E53/55 230 1 Non 4.0 2 or 2 & 6 3 or 4 & 5 5. Sensor mercury float switch 10-0225 used as a control activator, with E-Pak (3) or (4) stoat system. 53 Series - Wt. 23 lbs. -.3 H.P. 55 Series - Wt. 25 1 bs. -3 H.P. 6. Four (4) hole "J-Pak", junction box, for watertight connection or wired-in simplex or duplex operation. P/N 10-0002. 7. Two (2) hole "J-Pak", junction box, for watertight connection or splice. P/N 10-0003. For information on additional Zoeller products refer to catalog on Combination Starter. FMO514: CAUTION Piggyback Mercury Float Switches, FMO477: Electrical Alternator, FM0486: Mechanical Alterna- A~i s - .un~•oIS .,ic devices an• gone by a oua':fied nator, FM0495; Alarm Package, FM0513. Sump/Sewage Basins, FM0487. and Simplex Control nse _Ie r -:a A ; e;e x and safety cod? "n. 1b.+ed -n addition to the Box, FM0732. ...sf re;:ent ~±•i c,, a. _ (N£Cl any tn.= r_. ,,na' Safety and Health Act RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O.80X 16347 Louisville, KY40256-0347 Manufacturers of . O Z ~ ZZ7 SHIP T0: 3280 Old Millers Lane O o L (502) 778-27311 * 1(800) 928-PUMP `7Z14Z1rr PUA~PS SNCE 1,939 11 FAX 1502) 774-3624 Wisconsin Departrnent of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labia and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY sT'• GZ-01X Attach complete site plan on paper not less than 81/2 x,.11"inches in Ian must include, but not limited to vertical and horizontal reference point (BM), direotie o pe, scale or PARCEL I.D. # dimensioned, north arrow, and location and dista a to nearest road. APPLICANT INFORMATION-PLEASE P Ki,,:ALLINFOfRMAT~ON REVIEWED BY DATE PROPERTY OWNER: PRUZIVY LOCATION 1--q VIA 0- 1 - V., V-11 S`S . IX G . T 2- 1/4 - 1/4,S 6 T Z 8 N,R 19 E (a) V@ PROPERTY OWNER':S MAILING ADDRESS BLOCK# SUED. NAME OR CSM # - 5 3 Z C,t~vr.,~( F r - CITY, STATE ZIP CODE UMBER hiGyrY []VILLAGE GOWN NEAREST ROAD ~`'N\> sw'j , w 1 situ 1 b ( 6, y 3 & ~-tzo~ c~~~„ F Qa New Construction Use Residential I Number of bedrooms [ j AddibQn to existing building j) Replacement Public or commercial describe `r- Q S t C s ttywER,S RKit -y0v~_\a:Ts~ Code derived daily flow ZgtSU gpd Recommended design loading rate o bed, gpd$ 0-'6trench, gpd/ t2 K i Absorption area required 3q Z 9 bed, ft2 3 d413 trench, ft2 Maximum design loading rate Q• bed, gpd/ft2 a • 8 trench, gpd/ t2 Reoornmended infiltration surface elevation(s) 9.3 - O It (as referred to site plan benchmark) t: Additional design/ site considerations 30k t\-) u 1;Z>aSQD epuv~v~lwuf~c . `3 ill Parent material o ohs H Flood plain elevation, if applicable 1,. 3, A , ft S =Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN RLL HOLDING TANK U = Unsuitable for s stem ® S ❑ U ®S 1:1 U ❑ S 10 U ®S ❑ U ®S ❑ U ❑ S ®U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed tends ~I ~~..~...<:.<~ ) o-4u t~`1.1Z Z!{ S1` 2.►+tSbtit vh'~1~ Gk, - o.S 0.b ;g --4` Ground 3 17-Z3 -%S Ytz 31 3 - S i ti 2 F Sb1T Vh S o S 0. L elev. s 1 c g ~k f a c. g g8•Zft y 23-3S v-A v Depth to S 35-98 -)-S H it 916 S11 'L ~ 5~k CS - o-S ` o L limiting factor b V8-s6 -).syIZ yly s1b SL1 1 msb12 ,mot`E-cs - - b-hb 1% ti R Yl - S 4GV O Sg Yet I 0.8 Remarks: Boring # _ 0.S 0.6 0-8 1b`~tZ z!t S1~ Z l~`~ti- ?.~4.vv 4 V', Z g-ZO \k~' %t« -Z_ s l\ Z`~3Uk Yn C w 0-S :1).L hf SY:.:.. v. b 3 ZD Z~ ~.S 313 S11 Z ~Sb1T C S - 0.5 Ground _ elev. 26 -39 S `m_ 3 !y S I Q, Yn \j `V1_ c- S ci • y D-5 g8•Sft. S 3R-sy S ~1 ~ ~tIG s t I ~ Depth to Vq s1b h 'M C s o Z 3 limiting 6 s\4 -LL • s 4V- ti/y, ~5 HQ s/b S, > `n►sbk '2~ S - - factor >1-Lo 7 62-1Zn 1u`i2 yl - S~G~ O S'~ t,,t) - ~.7 u.~, Remarks: CST Name.-Please Print Arthur L. W e e r e r Phone. 715-425-0165 egerer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022 Signature: 9 V` Z__) ) Date: ` CST Number: q M00576 PROPERTYOWNERr~"( Y~-~ SOIL DESCRIPTION REPORT Page of PARCEL J.D. # Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench o-►U tu~~ zlf - S 1 ZmSbk c~ia. - o.S 13•6 ~~}~.:::'x} Z 1U.ZI ~ O `1 1Z Z(i S \ vn Sbh' ~~f4- G►•v - a. L o- 3 Ground Z)-30 7.5 `1R 3! SO \m SW yy fTv cS - 0.2. 0-3 3 - elev. 98•I ft. 30-q Z. ~•S I-j 2 3 1 - S) \CSbk v,\C,3 Depth to S Ln-Sy S KQ y 16 - S S Z'F sbk YA limiting t i factor b S~1- 6 D 1, S Y 2! 5'-1 Q S /f3 S j 1 1 s b h `F4- c s >11 -7 -118 1wivL Y) - S~6h O 2 9 ) - o•-) 0-b Remarks: Boring # 0-10 loge z lI Std Z~F P~~ti ~vu --Z y 10-!b Lo`112 i-Lz - S~1 Z`~Sbk wt'F~ CW-) - a,S o. b 3 tb-i3 >.S 1-tI;L 313 - si \ , sbk w, C i Ground elev. 23 39 7• S'~2 3!y - S 1 C Sbk ~n V'~V- C S o y'so. S qL-1 ft. 1Z ~H cS 'o,b S 39-513 ~•S~-tV- YIi, `t, De th to limping to S3 -5e) S YQ viv ~'t factor S `iR S1Y~ S1 S 1tn1 Sb12 FV Q p >~t 58-118 lo~V~- Y! SqGr. O g9 m _ v.~ v.$ Remarks: Boring# Z`QSbk m~ti ~w - o•So.~• R- 2-11 0-10 10~ 5 2 ~b-t9 ~o~rQ. Z.lz - s~ Z~'n1 wr cw - o,Z 3 1°I-Z7 7•S`19- 3 13 5 1 \ Sbk 1~~t. cS o. Z? 0.3 Ground elev. Z7-36 ~,S`gfZ 3/y s` \~Sbh Vv►v`Fh CS - o•`( 3.S q7•-1 ft. ; Depth to S'fR V& Si l Z`Qsb1z Y, C s - o•S S 36-Y~ limiting (E$-s7 7.S'?tZ S/Jy s`•1R 3/fi; Si, \wt Sb1•t )-n CS - - - S$Gh Remarks: Boring # 1Ja \ 1L1 ~3• 0 9 CLI) S s 4s lti S ~G Z Ground elev. ft VJ Vlt > O - UiV p S Ge- t IJO . Depth to M WI-LI N G 0- C- v'X S 1 N Z - P 0 L limiting G Y'1l~ ST ' U W B Tytlz f,-) t Zt S factor "-u GZM \b-L. w l 1`1 t 0 UQM Z I R.tz~ 5v Remarks: SBD-8330(8.05/92) i r IL 7J D Ij r I !v B ~JJ ° h1 i y k ~ ~ ~y ~ ~ r 3 1 ~ 1 vi a u -y _ ,y n, 2 o (r j 05 ao rev J I u I ~ f 0 °to ~ p V z° 4! o X ~ 3 ~ x i cl, rl)~ ry i.. v ~ ~ N r _ J ~►3~ c o 9 a a I STC- 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNEWBUYER YPACA of Ctrra ~c- 54. (2ayl - ~Q a~+ Croi,~ (N0rth~jh,,,) MAILING ADDRESS 53Z Cu-,v~ 14cid PROPERTY ADDRESS rj32 6o~n- f~-d.)oe% W l SY~~ (location of septic system) Please obtain from the Planning Dept. CITY/STATE ~3(~n W (o PROPERTY LOCATION 1/4, 5W 1/4, Section G T N-R _W TOWN OF T2 ST. CROIX COUNTY, WI T SUBDIVISION NA LOT NUMBER CERTIFIED SURVEY MAP , VOLUME , PAGE , LOT NUMBER Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expir n dat johfqj~koltkl SIGNED: ~l_ &9~CvfiVf D►~tc~ DATE: LE I q St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, Wl 54016 11/93 S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. owner of property Yryy" k of-- (5T-'PAU4-"'tC\j&C4 ft, S S c~Gl ~l~'' Location of property_ 1/4 SIAj 1/4, Section T?-A N-R~ W Township ~(C0~ Mailing address 5732-C0.-4-%j?jP-0gd / - C~(tN~CAofG.reu~tr'S~ Pwt. ) ItAJOt1, wt Sq0/(o Address of site S5Z C¢YvY• rv. S oN ur`IZ., `{~,ro~,w LAJG4~3 Subdivision name N yv~e. Lot no. kl0n-C, Other homes on property? Yes No Previous owner of property \N G.4 (Urr -t-,at hWe, Total size of property 3q(o ar-r s Total size of parcel t35 a,.oKS Date parcel was created Are all corners and lot lines identifiable? Yes No j Is this property being developed for (spec house) ? Yes _ (.XNo Volume ZIand Page Number 4KSas recorded with the Register II of Deeds. ( 6D p CS Atk ckct ) INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. Z/6 , Il/y ~ ?45' , and that I (we) presently own the proposed site for t e sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of the County Register of Deeds as Document No. LM G 5' John~~►~'I~ Sig ature of Appl cant Co-Applicant 1 1 /qq Date o Signature Date of Signature Vu L Z,t ~ 4 4 5 WARRANTY DEED STATE OF WISGONSIN-FORM No. I _ x. c. swsn co. x,a, s cc,oxns, xwxswca V 13719 I III _.....say of ! ~ rl ! Received for Record this. f TO j ~f ~j~~] nn n~J ~tY/ at Register of Deeds. ~ '11/ II 1, This ndenture/,,M/ade is......... ay of............ ~/l1-4 ,Abetween..G~ 114L4/.. ~n:.,l.Lf 7... . . J' y , q //yyJ/J t of the first part, and III / 1. l f?/.ir11Y 4411 ....C C EIJf ft4l (~AQ1K1.. Y C/ AI`~U ~JI/.-._............................... ...................~t._~ pti d (t~kt 1 LOi par .1 .......of the second part, 11 ,I WITNESSETH, That the s Aid part.,i.ta.... of the first part, for and in consideration of the sum ot...llL~~~~d....1X6L I . D~ ............................................................................._._-~le8acc, c ..-a..u:......... Ind' III to jC~ ..........in hand paid, by the said part..LA~......oI the second part, the receipt whereof is hereby confessed and acknowledged, ha.A..a..._ given, granted, bargained, sold, remised, released, aliened, eondeyed an confirmed, and by these presents do.!i........give, grant, bargain, sell, remiso, release, all n, convey and confirm unto the said part. o the second T~•~L ar /~lJ};,p(A.GMA.mM..•-....Min and assigns forever, the following described Real Estate, e... P Ip,, r situated In the County of St. Croix, nd State. t..Wisfconsin, to-wit: 0 p~ / 1 Y A&flut I~!I I N. Lo ibf.~Urfdrt,~ L 3),~.~ Q I G~.ai~~2d ®or,~i ~F9':°de~ol.aw~oraF~~~y!lfi,~/~'oi~o706;J',U.rcee ~i ICI I~ t Wet &UML, &att A04 tlzu~~Xlyl~ t TOGETHER, with all and singular, the hereditaments and appurtenances thereunto belonging, or in anywlsc appertaining; and all the estate, right, ~fll~ II part or In and what the above bargalnedapro nlsesimand their Heredltamontsiand App Lo runesrst part, eith law or equity, either in possession or ox pectaly of, In and to the TO HAM AND TO HOLD the said premises as above described, with the Heroditaments and Appurtenances, unto the said part..y of the second II part, and t.... emit s EVER. / o0 ~GG ~.T :,~Lt/42 ` 7' Llls AND THE SAID...I.~LL12/7L-. UUUUUU for... .......1.%!/~...........heirs, executors and administrators, do...!t......covenant, grant, bargain and agree to and with the said part... ....of the second part / tom o.. f .........heka-and assigns, that at the time of the ensoallng and delivery of these presents .............,h diL ...........................................................well seized of the premises above described, as of a good, sure, perfect, absolute and T- indefeasible estate of inherit ce in the law, In fee simple, and that the same are free and clear from all incumbrances whatever,.. I aaahhh li II U!4st /u4Gf/ - - ,M! 00 cued that the above bargained promises, in the quiet and peaceable possession of the said part...y.....of the second part, ........lwixs and assigns, against all and every person or persons lawfully claiming the whole or any part thereof,.... i ~11~I will forever WARRANT AND DEFEND. IN WITNESS WHE the Bald parttca......of the first part ho..~...hereunto set......... jVZU4 handra-•••and seoLt ...this..... I IIIIII day of A. D„ 191.1.... ~f/ I II Signedpnd Sealed In Presenc~ of ISEAI. ) ...tsEAL.) . ' . ~1~% N . .......................SEAL.) (SEAL.1 ~I OSTATE OF WI NSIN, ' St. Croix County. as 1 A. D., 19.3.1...... .~.CJ.l.!!Lfi.'................. ..............~~'~F- - . Personally ca before me, his.. ....day 1 (~I the above named.......... ..1~ 1.2~r e ~~Lf/ au/ LLl... ? ✓ . to me known to be the person.._°...who executed the foregoing Instrument and acknowledged the sa r Notary Public........................ ~ °County, Wis. `~~~CCC y My Commission expires . f2................... A. D.. 19.3.3 J`J~f•. i U , f ~ 111 i I I I ~~I ~I Ili ,I i i Qutr CLnts Dlastl• STAU OF' WISCONSIN-Foes No. I1 ~ A\ M. t. MILLI. CO . MILWIII[Lr 8.36 ? .il 4~ tl lJ This Indenture, Mad. tilts...... -.......2nd..... _ .....day of.......- -...March A. D., la. 60.. , ! 1 between..... F. H._ BATHKE, a..widower,:.unmarried. _ _ . - _ _ _ Part.....y. of the first part, t and - SAINT..PAUL_ YOIING..MEN.f.S -CHRISTIAN ASSOCIATION, . 8. Minnesota. corporation-.... . j party ..............of tho second part. 1 WITNESSETH, That the said part.y........of the first part, for and in consideration of the suns of. One.. Dollar . ($1.00) _ I j and other . vahuable..consideration...-_ - - - - - - - - - _ _.._~1Cmn1 to..... him . in hand paid by the said party p p of th. second art, the rocoi t whor.of is horoby contossed and acknowledged, riaB......... given, granted, bargained, sold, remised, released and quit-elahned, and by these presents do et;... give, grant, bargain, sell, rcullse, release and quit-clahn unto the said part. y of the second part, and to its successors........-J XAxand assigns forever, the following described real estate, situated in the County of......... St. Croix . State of Wisconsin, to-wit: All that part of Government Lot Three (3), Section Six (6), Township Twenty- eight (28) North, Range Nineteen (19) West, lying South and West o£ the following de- scribed line, to-wit; Beginning at a point on the East line of said Lot Three (3) Forty (40) feet North of the Southeast corner of said Lot Three (3); thence West on a line parallel with the South line of said Lot Three (3) a distance of Six Hundred Ninety-four and twenty- nine hundredths (694.29) feet to a point Forty feet North of the South line of said Lot Three (3); thence Northerly, in a straight line to a point on the North line of said Lot Three (3) located Seven Hundred Forty-three and seventy-nine hundredths (743.79) feet West of the East line of said Lot Three (3) and there terminating. i This deed is given and accepted for the purpose of defining and resolving all questions as to the location of the boundary line between the lands owned by parties hereto. I I i t _ I To HAVE AND TO HOLD the sumo, together with all and singular the appurtenances and privileges thereunto belonging or in unywise thereunto appertaining, uud all the ostute, right, title, interest and claim whatsoever of the suid part y. of the first. part, either in luworequity, dither ht possession or expectuncy of, to the only proper use, benetit and behoof of tho suid part _ y of the second purt,. its successors IfNIC uud assigns forever. I IN WI I'NESS WHEREOF, the said part. y . of the first part hit s_ . hereunto set his - hand.- and seal .this _ 2nd _ dayof.. March A. D..1a.60...-.. Sight d anti s(aled in ILfest•nre of (sl•:nt.) ~ F. H. Bathke ~ACGn~~ _ (,1;A 1.) t June 11. Hudson 7""s - - "~l ~C. •~~GC/1.Gtt-N~__ ~ •~ier~j (,riot-) - A_~~La``urence._Dav s--- _ (,1;A1.) I c r Ramsey. county. Personalty carte before me, this _ 2nd day of. March _ A. U., 19 theahovenamed F. H.. Bathke, a widower, unmarried Ito ut ipiw,Ii t.o Ile till larcson who executed the foregoing in- trument anal acknow4rdgIM •tht tnu . t ftCC'c1 t, ~ A l.ouren:,e k~avisl 1 ' i r kLC: , 7th Notary Public, .Rwni3ey ' - ( uun6,._ kx Minn. U ,y of__;,°_ilI'ch_ r,.,_.1~G0 My Commission expi s . j lit d fl( T 1)~~1, t__ ~'t/1. n. 1. L T +7 1' A , t } ~ t, cG L . 1;~4 tNl•r LII,t 0f 19bRJfq R'Isamsln Statutra provides that tj tr ~ enlIl>~he eGOrded ahrll hwe y p '~1t( J'tten rherrun the c.• names of the grantors, granters, wltneaaes and notary). BOOI(- , pUlnl rlntaor I I 28(S l% T /(/G~G~I/'.f,L//'~!~(~t~ -1G✓~ ~~[%/1! i/,~1~~,/ l of~Gtf ///1~/!2/l ~1ili~iGP~IGCi[Lr~//~~~('!`/l/07~ ~i'"/(/~ [;Ofd ..C/Jd~,t~~Cl,//~r[/, ;J,f'l!a'~c, ~ i /,1~~~~~L~il~.f:l~G?iC./1'✓,(~ i[(~ ~ Lfiff.(/, .a~T~;Q/ j / ~ . ~/~Q!%/~ ~C1~1/f d; ~~/07/1//YT 1i14GfilGt o /~i ,l~[,ri .11t~,1lAX~ /IZC!?/C,C('~f, /(.[~i r ~ ~ x,17 / A ?~LiGt/ /L!~ ~~P ~ P/U~P/Ifl~/uGl2U ~'~~1iUlcvc /I L~.(f ~!'i/ L [CABp% 4`~ ; ~i~,2cu~ G+u.ud~cr ~~~~,%/~yotz~~rQlU~t~~~ Le2 016111)~ ; lrrQ u.MIVIA~y Aye ~/~~j~.Lu ,/L/~!/~L.Gf-Gf~GCC~-Ct~'.T~L~~L (~LJ/. 6 3 ~Y-l~2'~,'L . ~;;~10~1'CL'f% ~i(./~rf ~ ~fir/lL//~it2'~ ~-llrn .C,flCsrl~/1o,~7[~~it ~ n ~1~J?~ ~xtr✓ v~iLat14e.E'.C' A~ &WI/ f 'aril ou ~~LGO /I~q/LtlPC~ 'gilrlrlGO/~ /lL~ ~a :~/o;~~~P /f22~u~61, n,t/fi, l!` X111, ~l cn y~fru~i./~ . o t'r ~ ~ ,rl?/l~lf~r~f ~i•~,ll,~'//'~i~tft~dy«%,/~~ ~01r.~~~Q~ . _ : b / / i ,1 ~~/~C~~AI~/1/Y•L-091 Il .Cll[2. III ~ Ill 11 ji I"I Ili ,I Ipli~l ply gill I, liil un III; i 7 J' 0 ~~5 :e !I - m ° ~ v1 o m f ° it T v C' cn m Z cn Z O C4 -G - c_ Z o o o © • n o f 3° n ? m °w n Fo co D 0 m m N D N N c° ° a y (nn 00 °D w a m can w l 3 o can N co o O c ro w W v <c d o H t a a 5 ar v~. o O v o m U) o M fl; !n D a x fn G D cD x' 1 CD ca y o. tr I (a <n N QQ- c a ~~~ol a W so O g 00 N w N I ~ N N Q° ~ IIo i O O W I CD p 0 w O p C N O .p N 0 0 .p. ' p. _n l 0 T T ~~3 ~~~3 x ovv 3 cr c cr vogo a _ CD a ro ° CL w 7 N 0 w z W Z a o D 0 o Do I o! r~,~~ a m o y l CD (D y~o ~,N~ _ ScI 1 `~y~t c CO m c m m w m 0 ° al rn d o{ CD z m c6 Ml N c6 rni to a 3 A CL o. 0 a rn V G) C W co 0 ( m a ° C. °o ° o M y Z N `Z C4 d a moo? a ~ dims a Zn 0) F) N(1) a m~ a c~iv a 10 p') y o d N O N A O a 'f1 I N p C N C 3 O=r CL 0 (ago, m Z 1 Q gy c m o D oaN w a m y S tD~.- fD y y," y y CD w W'a {D m3 Wcn an00,@ 1 a ~ i w~rsa ~ ~ N p is pom oc' a^~~ 1 N I m CD 7 m N C i o°'-'Z 1 ~-C~°N N N rn C 0 (D tv d coa DCD w o W O N a rn ti O O CD 6p b 0 0 0 0 N oA o o d 0 d w a FORM - STC.- 104 AS BUILT SANITARY SYSTEM REPORT 01414ER .~(Cs7 ,f,~qP `jT eolA TOWNSHIP_ :2r~ y SECTION T ,`,,P N-R _W ADDRESS ~~02 CT)' 7/< ST. CROIX COUNTY, WISCONSIN ZV14~,l f- a A/ SUBDIVISION /k,/ A LOT AIA LOT SIZE___AZ,Q PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 4/161-o'-70- -5'X1S /N weL T t~ L NvT~rAA: A/C"1JVA*JQK /\A~c IAJ 46sofpr,,,U Ae--h -,A-E y, /r7t7 ' ~f'v <7 CUr TU 7' / CET 0~ ~p ~I (:k u,?cA1&Wrs -s</ vy S~v To I C'.T / i ~X 7CNOL•Q S" ~.~oi•} 5'f/~ttc TNil~ 3S J 7;/,W 50 SS PVC NTo /0' I i g L7t.r of ~S ~',rt SzPr~c I/JN k.l,T/f /1 .-rte K cl Ass ,L~f°a.v ~c~ANcJuT/1iv5~'r~ruv ✓ek)r / li ST~rP S•c OA-5 ~cLi<r ~o Sc f<e- INDICATE NORTH ARROW BENCIMAM:Elevation and description:,Vq~~ V 'od- Alternate benchmark ^/,4 SEPTIC TANK: Manuf acturer:_ (,y Li quid CaP• i o A. Rings used:,Z~Ianhole cover elev: ,$'o'Final grade elev: 9g, so' Tank inlet elev.:-211,1V Tank outlet elev.: 93 No. of feet from nearest road:Front , Side , Rear From nearest prop. line:Front , Side Rear tio, of feet from: Well Vlco' Building: Sy- A/ (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: _ Liquid Capacity: Pump Model:Pump/Siphon Manufact.: Pump Size Elevation of inlet: _ Bottom of tank elevation Pump on elev.:_ Pump off elev.:Gallons/cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop. line: Front,, Side, Rear_Ft. Distance from: Well Building SOIL ABSORPTION SYSTEM Bed: 7~.Otrench: Seepage Pit: Width: ayr Length 35` Number of Lines: Area Built TyOs$Fr- Exist. Grade Elev.-92. 4-0- Proposed Final Grade Elev. ~9_ /0- Fill depth to top of pipe: 3-S, No. feet from nearest prop. line:Frontl, Side , Rear ~Ft.5a,-/' No. feet from well: V~0' No. feet from building i~y'w - y~l ~AJ HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front , Side , Rear Ft. No. feet from: Well , building , nearest road Alarm Manufacturer: INSPECTOR: DATE: o 13 / o PLUMBER ON JOB : ~ LICENSE NUMBER: 6/90:cj . DEPARTM:'r1T OF INDUSTRY, SAFETY & BUILDING INSPECTION REPORT FOR DIVISION LABOR & HUMAN RELATIONS P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION NE-. N YVI'S 707 ' GState Plan I.D. Numi J X44 i eC. T28-R20 CONVENTIONAL ❑ ALTERATIVE (If assigned) Town of Troy ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound Rd. F NAME OF PERMIT HOLDER: F532 ESS OF PERMIT HOLDER: INSPECTION DATE: YMCA c)f St. P Co Rd. F Hudson WI 1 13 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. LEV.: CST REF. PT. ELEV.: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Za:ppa Bros, I 0 St. Croix 128842 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER r PROVIDED: PROVIDED: r P-!Se-r cam,. ( -z 9~.y [!T ~ ❑ NO ❑ YES BEDDING: VENT DIA.: VENT MATL.: HIGH WATER UMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRE H ALARM: FEET FROM LINE: ! ( AIR INLET: ❑ YES O / C-`~ ❑ YES NEAREST 5 DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑ YES D NO ❑ YES ❑ NO ❑ YES ❑ NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: R OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FR LINE: AIR INLET: PUMP ON AND OFF ❑ YES ❑ NO NEAREST ~ SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIA ARKING: or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: Q~ © 5 BED/TRENCH WIDTH: LENGTH: NO. OF DISTR. PIP SPACING: COVER INSIDE DIA.: # PITS: LIQUID / 35' TRENCHES: " M IAL: DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIA N S R. NUMBER OF PROPERTY WELL: EILDINFA T TO FRESH BELOW PIPES- ABOV& COVE : ELEV. INLET: ELEV. END. PES: LINE: INLET: ~ FEET FROM NEAREST ~ / - MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ❑ YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑ YES ❑ NO ❑ YES ❑ NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: [__1 YES El NO YES ❑ NO ❑ YES ❑ NO ❑ PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH: NO. OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: ELEVATION AND DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO ❑ YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST Sketch System on e n in county file for audit. Reverse Side. S1 NAT E: TITLE: SBD-6710 (R. 06/88) ~ 54kW01- DILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUP" .a.,,.,,..a...,...,_..,e, . A"i STATE SANITARY P RMlT # -Attach complete plans (to the county copy only) for the system, on paper not less than f4/ 8% x 11 inches in size. ❑ Check !f revision to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. O & -j PROPERTY OWNER PROPERTY LOCATION o,- J uL Nf '/a '/4,S TN,R.2 O E(or W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # .3 F CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER S v 11. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD ❑ State Owned L~ ❑ VILLAGE : ~ ~7I _ Ibl Public ❑ 1 or 2 Fam. Dwelling-# of bedrooms L PARCEL TAX NUM E ) 111. BUILDING USE: (If building type is public, check all that apply) p 1 ❑ Apt/Condo / 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 90 Office/Factory 13 ® Other: Specify CAA-Z1V-r IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. N New 2.E1 Replacement 3.E1 Replacement of 4.0 Reconnection of 5.E] Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 M Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min..//inch) ELEVATION / _o IQ" a U :)P'/O , .5~ ? b 9S. Feet ~ Feet VII. TANK CAPACITY Site in allons Total of Prefab. Fiber- Exper. INFORMATION New P-xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed - c Se tic Tank or Holdin Tank tU So R F1 Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number: as_ _T.11 -•?O v S ~6- Plumber's Address (Street, City, State, Zip Code): rf I/, IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing A ent Signature (No Stamps) Surcharge Fee) pproved ❑ OwnerGlvenInitial C / / Avers Determination `-l 6 X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: 91 i SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety s Buildings Division, Owner, Plumber o- t INSTRUCTIONS ; 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. Vill. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SOD-6M (8.11/88) ~h. ~ x " SO S N ~ Cy ~ ~ h y C n ~ Z ~ L ~ 0 R~ W z"~m y b~ ~ < 'n v1 M ~ rL a oll C -L S a c ~ 1. N to s l~ Ora 0 2 44 o~ (ti W k ~ J C o -7 00, SEE C-OlAr-k", o 4 ~I i w N W y 0 ,U e rN U VA 1 D N w A a ~ 0 NSIT apt cif ~~id lJ? a N GE it z ~ J -i 19 m v n 4D rb z V \ n ? 0 71 f~~ r ' y3 W T-k 4, 47- r" ` U ,o'n r ON 1 \ w Ii SkIi C C 40671 r\ D rv Z c IJ 0 L o 1 G O ON N c rJ b C n o O i1 2 R D > l D c7 v \ 3 ~ Q N o D ~ ~ V1 _t D N x ~ n y ~ F U b N Z LA a z V V 1. Sq. 6 G 71 040-1027-40 NOTICE OF ASSESSMENT Town, Village, or City of: In"accordance with Section 70.365 of the Wisconsin Statutes, you are TOWN OF TROY < 1 hereby notified of your assessment for the current year 19 87 on the Parcel No.: 06 . 28 . 19 . 9 0 C r7 property described. IF YOU WISH TO CONTEST THIS ASSESSMENT, Legal Description or Property Address: fZ rs t, 1,, SEE THE REVERSE SIDE. SEC'. 6 T28N R 1 9W L Q 1. Land improvements/Higher Land Use $.8AC PT LOT 3 AS IN VOL Reason C.2• Change due to revaluation 149 P 288 for ❑ 3. New construction/remodeling/additions L d dv t Change ❑ 4. Correction of Error ❑ 5. Assessment of Omitted Property ! e ❑ 6. No Change C ❑ 7. Other YEAR LAND BUILDINGS TOTAL 1987 1980019800 ST PAUL Y M C A - 194 E 6TH 1986 2200 2200 ? ST. PAUL, MN. S5101 Total Dollar Assessment Increase is 17600 Board of Review/Assessors Date: 7-27-87 0 Meeting Location: TOWN HALL OPEN BOOK JULY 23 12 NOON For Additional Information Call: 71 5-262-5777 0. BOARD REVIEW JULY 27 10AM-12 1PM-4PM G y ~,_y y y 040-1028-50 NOTICE OF ASSESSMENT Town, Village, or City of: In accordance with Section 70.365 of the Wisconsin Statutes, you are TOWN OF TROY I{ hereby notified of your assessment for the current year 19 87 on the Parcel No.: 06 . 28 . 19.90D property described. IF YOU WISH TO CONTEST THIS ASSESSMENT, Legal Description or Property Address: / SEE THE REVERSE SIDE. SEC 6 T28N R 1 9W "-4 e Q 1. Land improvements/Higher Land Use 6.25 AC PRT LOT 3 AS IN VOLE ~Erti Reason Change due to revaluation 216 P445 ORD for Q 3. New construction/remodeling/additions 7. t 7% Change Q 4. Correction of Error Q 5. Assessment of Omitted Property Q 6. No Change f 1- L V r t ~'4` ❑ 7. Other LJ~ YEAR LAND BUILDINGS TOTAL 1987 13900 13900 ST PAUL Y M C A 194 E 6TH 1986 1550 1550 ° ST. PAUL, MN. 551 0 1 Total Dollar Assessment Increase s Board of Review/Assessors Date: 7-27-87 a 0 Meeting Location: TOWN HALL OPEN BOOK JULY 23 112 NOON For Additional information Call: 71 5-262-5777 a. BOARD REVIEW JULY 27 10AM-12 1PM-4PM X-q 3~ s U~ - 3. t NOTICE OF ASSESSMENT Town, Village, or City of: 040-1027-30 In accordance with Section 70.365 of the Wisconsin Statutes, you are TOWN OF TROY hereby notified of your assessment for the current year 19 87 on the Parcel No.: 06 . 28 . 19 . 90B property described. IF YOU WISH TO CONTEST THIS ASSESSMENT, Legal Description or Property Address: SEE THE REVERSE SIDE. SEC 6 T28N R 1 9W Q 1. Land improvements/Higher Land Use - 1 PRT LOT 3 AS IN Reason ❑ 2. Change due to revaluation VOL 216 P 445 for ❑ 3. New construction/remodeling/additions VOL 365 P 51 7 Change Q 4. Correction of Error ❑ 5. Assessment of Omitted Property r' ~ l~ iv r'r•-~ , ❑ 6. No Change - I Q 7. Other YEAR LAND BUILDINGS TOTAL 1987 133000 133000 ST PAUL Y M C A 194 E 6TH 19 6 75600 175600 ST. PAUL, MN. 551 01 Total Dollar Assessment Increase $ Board of Review/Assessors Date: 7-27-87 ! Meeting Location: TOWN HALL 1 OPEN BOOK JULY 23 12 NOON For Additional information Call: 71 5-262-5777 nnAOn 0Ck1TC11 Tru v . . i_ou-A- SAFETY & BUILDINGS DEPARTMENT OF REPORT ON SOIL BORINGS AND INDUSTRY DIVISION LABbR AND PERCOLATION TESTS (115) MADISON O 539069 HUMAN RELATIONS (ILHR 83.0911) & Chapter 145) LOCATION: SECTION: OWNSHI MUNICIPALITY: 17T NO.: BLK. NO.: SUBDIVISION NAME: NE1/4 NW 14 -7 /T z%N/R zoE (o W '-Rod - COUNTY: MAILIN ADDRESS: 53Z G ►`u ST. c.1~u 1.X M G I\ *x;>Sdv w syls / USE DATES OBSERVATIONS MADE NO. BEDR : COMMERCIAL D S R TION: TESTS: ISROFILE DESCRIPTIONS; PERCOLATION ❑Residence 7 Z-"2 tiDjtN Cf~$1 IJS New ❑Replace l _3~ - 9 Q 1 3~-q0 RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSUR : SY TEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) ®S ou ZS ❑u ®S au 0S EA rEIS .0u 1.L,'>. 3S' (!.O)UUNR~S-PWUP~L Beb If Percolation Tests are NOT re uired DESIGN RATE: 4 If any portion of the tested area is in the under s. ILHR 83.0915)lb), indicate: Floodplain, indicate Floodplain elevation: N' PROFILE DESCRIPTIONS BORING TOTAL DEPTH GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 1 `1D °I~.lo t~or~L 110 s ph~~ Z o1< z B- Z l~q a~. I > >o q 1, B- 3 1oq q~.s > 109 B- 1~`1 •8 > ) 01 w B- S 1~g q7.y > !oe B- 94 TESTS TEST DEPTH . WATER IN HOLE TEST TIME DROP I LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PER1002 P PER INCH P- 1 60 1C) k -li/ S P- Z 5. 1 r~ 2 z Z S P. 3 5 I p 31 131 1 l P- P- )1i 111U 2v COIFE. WM Dlmt U'1)0111 P)DES. Slut-'g- F~1.i1 tTD P G E t~lJVA6C. PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. 61- B~ Gt -I 3 ~I LLOT Si) SYSTEM ELEVATION TL' g Z- 4 _ _ _ ~ try I,Y ST G W L LO #t SiTl t.- f I f 4- L b 1.) C Ht t_-1 , lOO 0 N 1- + 1 _ 13 - AV "-v I G U b t N 1 ~ ~ j j ~ N t--~-_.. I 4-- 1, scr u 1't= , the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the proced s d et hods specified in the Wisonsin Administrative Code, ~p4i tp.Zt tt~{f t ec c ~ytd ,to~,~t Qf,t t@ tests are correct to the best of my knowledge ar e w, # :NA ME print : V/~1j{ANE) ~vf''LL tJ TESTS WERE COMPLETED ON: I~ DESIGN SERVICE DDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): P.O. BOX 74 421 N. MAIN ST. CST o 0o s~6 0I S_ vis- 016 S HIVER FALLS. W! 54022 CST SIGNAT RE 715-425-0165 40. z,ll ION: Original and one copy to Local Authority, Property Owner and Soil Tester. 5 (R. 10183) - OVER - T 1* b}= Z i v SOIL DESCRIPTION FORM Attach So I O lu Location Ma On a Su orate Shoo CLIEN VIA cA LINEAR LOADING RATE: PURPOSE E~kw~`~e RR Sut~ KIISOR'DoM Sbs`TtlM SLOPE' - DESCRIPTION BY At~`n-}UC~ L • I.yEG"2~ ASPECT' Es TeM ~'`r OATC oC~OO~~ 6,;S t lQ4 CURRENT LANG USE' ~D COUNTY/STATE ST C-IRZ C'C1VU`C~~ T W VEGETATIVE COVER: G12~SS LOT OESCRIPTION K~Ekq Nt,J!!t/ SEC. ~ ~ T~ N 1 Q 20W DRAINAGE CLASS' W ~1. O~2.R 1/~1~U T `TZk JtJ GALLONS-PER 39. FT. PER DAYi ION: S I I PARE TE T L (WDEPTIf: $O IL SERIES$ P I LUST CATI 1%1 ACS FIOR120N DEPIII MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS P11 •801AJDARY REMARKS (mist) G S:. Sh S Z 9-3z It-tip. 316 - 51 'F S biz lrl'F'►~ c S 3 3Z- ~o`-t lZ Y !6 S O s m C S Lk 6b -110 toLm sly - S , 3 S9 S ohs M 6RAL»'L >3~ N 6 Z 1 0-~3 lo~ttZ Z!Z - Si I ZMSlb CL"s Z ~T-ZS 10`18 3! - S l I S bit H I C S 2S-S7 to'R VAD S O S cS S o S r~ >`1 L.I S~_ lnq 1rz4k sill ~o~.l G 3 ~Q- S o- goy c~ Z ! i - s i 1 Z ~sek . r~ ' z $-3$ 10`12 31- Sl 1 1 ~b VA ~S 3 3$-63 10`tR ~/'6 - S O S.... CS 4 63-0to`/lZ S! - S O S !M 'I )wu M6 4 o - to lO 2 Z-1 - S ~ zi" SIOk 4.S Z 10-33 10`12 sil 1'fs~~ rn~~ ~S 3 33-~.6 lo~1R ~/6 S O S cs 4 66-b7 ►oti2 sl - S o s9 m 3 37-6y f 0 `y2 y!6 - S O Sg yYl S o MJ Lp. 5/ S OTW SITE FEATURES/N07ES: ~O-3D-4'D 000 576 LIMITING FACTORS/DEPTH: Signature Date CST k o 1r 8A TART PERMIT STC-100 . ' , This appilcation fora Is to be eomplatod In full and signed by the ovnet(s) of the property being daveloped. Any Inadequacles will only result In delays of the petmit Issuance. -Should train development be Intended got tesale by ls be retained tand he ownst/contractot,(spec houco), U.rn ~ndsecond submitted form should completed when the ptopetty is sold with appcoprlate deed recording. - r ft------------ ` Owngr of ptopetty Location of property ~ 1/4 MAJ 1/4# section ^i_.e T_....st..~'R ad r Township Melling address wn , F cE.S~ CA) t 5 o f Address of site Sa m"G fubdtvtslon name C-~;QU,cG IX it Lot number Ptevious owner of property W-Al", ~ +z~ w ' Total size of pascal 39G 40)~o` QLr-KS owned Y&-LA i^ m(jj tivl. orals Date parcel was etested N I O, Ate all cotnets and lot lines Identifiable? Yso No is this ptopetty being developed lot sasale topee house)?,-,- as o Voiume - and Page Humbat _ as recorded with the Register of Deed*. • - • - - - - - - - • - - - - - - - - - - - - - - - - - - - - - - - -r - INCLUDE - • WITH THIB APPLICATION THE POLLOVINCt A WARRANTY 0120 which Includes a DOCUMENT )(UMORR, VOLUME AND PAGE NUMBER, and the HAL OF THE R80tBTBR OF DEEDS. In addltlon, a cettifled survey, It available, would be helpful so as to avoid delays of the reviewing process. It the deed description references to a Ceitlfled Survey map, the Cettitled Survey map shall also be tequlted. PROPERTY OWNER CERTIFICATION I(va) certify that all statements on this form are true to the best of my (out) knowledge; that t two) am (ate) the owner(s) of the property described in this Intotmatlon [arm, by virtue of a wastanty deed tecoeded in the Office of the County Registet of Deeds as Document No. ! and that t (Wt) presently own the ptoposed alto for the sewage disposal system tot I (we) have obtained an easement, to tun with the above described property, tot the construction of sald system, and the same has been duly recorded In the Ottiee of the ounty Reglstec of Deeds, as Document No. Ig atute of Owner I Ca Signature of Co•ownat tit Applicable) ESCc t ir-t ' y hC G-~r- 4 CY4 Data of Signature Date of Signature • rt SEPTIC.TANK MAINTENANCE AGREEIIENT 0 St. Croix County OWNER/BUYER 00 ~ ROUTE/BOX NUMBER 'f2. 2 1c. cc~~ ~ Fire Number_ 3 3 03 CITY/STATE 5q N ~ PROPERTY LOCATION NtO, Section T2-8 N. R,~20 W. Town of `~TrV~A St. Croix County, Subdivision t\j Lot number Improper use and maintenance of your eptic system could res It in con- its premature failure to handle was ears or sooner, sists of pumping out the septic tank every three y if needed, by a licens'ed' 's' e. t'ic tank pumper. What you put into the system can a ect t e- unct on ox t e •septic .tank as a treat- ment.stage in the waste disposal system. • St. Croix County residents may be eligible to recieve a grant for a maximum of 60% of the cost.of replacement of a failing system, wh c was in operation prior to-July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new '~sCems agree to keep their system properly maintained. The property owner agrees to submit to St.. Croix County Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or.A licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper nec- operating condition and •(2)•after inspection and pumping (if apthan 113 proximatelyfull 30fdayssludge priordtoc~. essthe ary), cwillkbe gsentless Certification, year expiration. y I/WE, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as.set by the Wisconsin Depart- ment of Natural Resources. Certification form must be completed b and returned to the St. Croix County Zoning Office within 30 days of the three year expiration.date. SIGNED DATE_ St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address. J n v, O o (n O m n G O d C m E C O r m K T (D 3 NQ Cyl 3 a o O C~ 3 o co n CO Z a - cn y N S Z D o O W N N 3 o N N j W R• O S O 3 cn 3 (D O p 0 O h n O O cn 7 O Cl) C) N N N V1 O O C D c x' D P- x m m a cn O ° W y co o W o ' rn rn W! w j c ; V 25 iz Na w Lv ~ c w (n w n o c N co CO Co Co C'n N (D ID O O A r! a C7 C1 ~ O O O a l O O O c7 0 n a v_ T A l~~i a `c to y N cn (A N ° CL 3 'o 3 Ic v v v n~ (a v " N r 0 c m a H a m 3 .r O (Q z v v O D W o 2 y m o 2 ~y O a= a o= C N CP a b N M O O N• m m m m N C (D O 0 O cn C (D co CD N 0 (n < N G C: CD M L, CL ? O N A p ~ 3 O 7 O ~ I K] (Q I ~ O A Z ~ O I A O f R1 V W o N 00 0 3 0 ~ ~ N O m (D I o I CD Q W (D N O N N 6~ A Q C mco3~ p. `L ad00 0 o: C N 'WO ( _N O> to O N U) -n O * D O - 7 7c 3• 3 !'I C N A 0) z C G N _S OQ O FA O O. C7 - j N 00 5, (D I N C N p y (D Sp O r ((DD n N 0 7r NO O m 6 N x CD w O a CD O O N N U7 a. S A (O a. 0 Q N in co j Cl / j O (D a0.., N 7(n (D W Q O N t~j 0 c: co N C N C N O CD O 7 5 7r S: 0 w O - i O O p~ O. ~ , ~ •C CD N << O_ d K Vl 7 G v O en S n y N d o D O C.). N N W Go Z7 O 00 W 0< ~ (D F» 0 cs~ O w J~ O ~z O y (D C) O. 0 a '.+i y ° A.; RII I ' :;AN I'I'ARY ',:YS I t M ItPTORT i..:•o° IcL_. TUWNSHIP__ _SEC.1- T N, R W ST. CROIX COUNT WISCONSIN >11PrVISION LOT LOT SIZE PLAN VIEW "Aistances b dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM y D~~ ~ ` M lU A -r opt TAN% /S) GR. CONCRETE STEEL MF jz.~ S :t r NO. of rings on cover Depth. DRY WELL =NGitHS . N0. of width length -y area line T width-' length are: depti~ to top of pipe _ _ 'RAT AREA REQUIRED.. REA AS BUILT ~,c3aimer: The inspection oi' this system by St. Croix County does not iml)iy com1)1 tr Aimee with State Administrative Codes. There are other arvns that it is not 1)os,;ible inspect at this point of construction. St. Croix County az;sumon; Yio 1 iahi ii ty for tem operation. However, if failure is noted the County will make every effort to ,:ermine cause of failure. -ASES AND OILS 'SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. 'INSPECTOR ...I. rr" /h , DATED PLUMBER ON J013 jjLICENSE NUMBER' ~ ~ ~ ~ ~ .y ~ a.; ~ . ; . ~ 'a+..l ,w-.._ _ ~•a;,. , ~ i , 1:. 1 _ _ „ ` s ~ ~ ~ I i , r REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM ` San.i•taay Penm.i*9Z ` Saxe Septic NAME r' Town4hi S -r. Cno..x Count T 6Gt Loca.t.iox,5E S6jXjSect.ion SEPTIC TANb 0 1200 d I Size ,1,5 4-9-0 ga.Lton4. Numb ea 96 Compaa.tmen.t4 ___2 D.t4tance Fnom: We~Z 77 6,t. 12% oa gaea-teA 4tope it 6 11S/8~ - BU di g it. Weat.Land4 4A .2 1 SYST ISIOSAL E Highwa en Vii Lance Fnom: We.L.L it. 12; ox gaeaten 4Lope 6.t. Buitdin 6.t. W e.ttand4 Ft. tau/g Hi,9hwat n t. FIELD DIMENSIONS: . v Width ot ataench it. Depth o6 Aock below, .t.ite !1-2\ .in. Length o6 each tine 6z. Depth o6 hock oveA •t.ite z-- .in. Numbea. o6 t i.ne4 Depth o6 ,tite be.Low gnade2l-in. Toxa.L teng.th o6 tin 4 6#. S.Lope o6 txench 7i in pea 100 it. D"tance between ti ea it. Depth .to'bedxock it. To.ta.L ab4o4bx.ion an a_~~6x2 'Depth to gnoundwa.ten Requ.iaed anea t Type o6 Coven: Pape' A S#aaw PIT DIMENSIONS: Numb eh o6 p.itA GaaveZ aaound pit4 ye4 no Ar OutA ide d*.a et a 6.t. Pep.th below in.Let 6 . To.ta.L ab4o b on anea 6.t2. z Aaea equiaed 6 2 INSPECTED BY MA~PIL &ULAI TITLE APPROVED,DATE 19. REJECTED ,DATE 197. X~ _4 loaf Y /Fo E ~ ~ 2I lI ~I V /NSTa,GG / - 20:00 G+4 c. / - 2So0 GAC Y' 82 $AcKHoE So~~ SlzPTYC TANK, • i T LTYW~ /NST/i./-L OlST BaX 965 2"m Pvc Cota•cE N41N All' - PYL- 701(9 WALL ' n MAI", A 41• /-1•42.00 4,44- 14 ,+[y TANK ~ I I f 54.o P~V'.~ I I ;lll f •6 I LL 961 ' STAGG 60 2 95 I .Z I PA-IAI1V F1454-z" 964 I PSEMC-KMA[L1t: ELCY•=460.0 f 0_.f - C~°'fTOM 3OtLT ON Y`(. SIOG 01 YOTti tv. Pot~C 'CA.tpCIt.1 d ~J0L T 1A W 6.S C SYSTEM `J 1 Tt \ L.Y. H... r yS MIL C F- 1 4, C3, I 4 2i 1C 2/ 1 ff> G.1 . Tp 3' LSSeo/JD MCCAVSR'ION PVt F~2LL MAtN pISTGL~1sUT1O aw iOle LS00 ko0 4" 1. VC_ 'SDLIO WALL C YYA.) 6A♦ 4P~- ~ 4z~~CL`NLA~bC t j . E?TiC.. 7s -LKS DOSItVCy T/arlK - - - - - - - - - - - - I . t t If I ~ ► i~ II t i It i t:° - ~ ~us-raLL ~e-4 ps -~+I; P1g RF. tV ~ PIP& r g F ~Pn c e D Co'a g4• i C^_: 1 . a PL13 6 7 State and County State Permit # Permit Application County Per t d for Private Domestic Sewage Systems County Ste i` *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required d State Plan I.D. Z. A. OWNER OF PROPERTY Mailing Address: ~ f )ff?, 4 J B. CC'7l!ATIbN: C-0 %'/4, Section, T1, ~o / _4 E (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township D C. TYPE OF OCCUPANCY: *Commercial *Industrial `Othe t i n e Single family Duplex No. of Bedrooms No. of Pe ons_ D. SEPTIC TANK CAPACITY gallons No. of tanks +1?'~ HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete Poured-in-Place Steel Fiberglass Other (specify) New Installation Replacement Lift Pump Tank or Siphon Chamber Total gallons Pref concrete Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate .-Total Absorb Area sq. ft. New Replacement Alternate (Specify) Seepage Trench: No. of Li e I /Ft. Width Depth Tile depth (to . of renc es Seepage Bed:-Jr Length dth ~-Depth Tile depth (top No. of Lines q Seepage Pit: Inside d' eter Liquid Depth No. of Seepage Pits Percent slope of land !X0 Distance from critical slope WATER SUPPLY: Private ❑ Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Ad ' istrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Cert' ie Soil Tester, vJ~ ~7 NAME !✓6 C.S.T. #_35 / and other information obtained fro (owner/builder). Plumber's n -6 _ MO/MP W# Phone 2A!2 ! L/ 9' Plumber's Address PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. s r N ,cc e . 1 E Do Not Write in Space BeI R COUNTY AND STATE DEPARTMENT USE ONLY C! Date of Application Feexs Paid: State3a County " Date d Permit Issued/Rejected (date) +~O ` T _jU Issuing Agent Name t l inspection Yes _k_No State Valid* Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 7/1/78 GBH 115Rev.9/,78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES ~X ~ P.O. BOX 309, MADISON, WISCONSIN 53701 r- LOCATION: ''/a, Section (Of ,T?'N,R /g Lire W, Lot No. , Block No. Coun u i ts Owner's/Buyers Name: ? P.. Ue_ bd- Islon Name Mailing Address: TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL ~,2~Y4rEc,~tPl ,Qdv.~Co EFFLUENT DISPOSAL SYSTEM: NEW ?e REPLACEMENT ALTERNATE SYSTEMt42 OTHER DATES OBSERVATIONS MADE: SOIL BORINGS 5-B- 00 PERCOLATION TESTS 5-n 6nr4dL0t_t=0 SOIL MAP SHEET 79 NAME OF SOIL MAP UNIT PIA ~ L-f-Orr- PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS VWATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE E AFTE INTERVAL MIN/IN BER 1ST WETTED ELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- 0 uc 0Svuol{ Sots. Gn#Jr1. toN P- V e OU= St-CRn~~c C.pVN P-rKi~p~~l 1'T•{ S1►efWw~ AS ~O a, ZO•b tncut~s VR. = C~-as P- oarrC r 3. Z•,o 1 C3. 1.^% N P- M -5 1 w c W I P- K- ZLkCr c,►~ ~-t ~ u S: C 14- S . fit, U t T im-' CIZ BF-V 1` SoU, II S I Tt=' SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B- 1 C16 ~o>+wt 9S" Zo`I BI LYS • ZOI~ s) ' 1 °si~ ° (p" 14 • 3(p`~ m~. S B- IL R 0~` o NE > q011 Z.L Ts cl a c- i I • I " s i • 3" d. S B- '5 O" No~.t~ 7 p" ZO- 1 L 'r In" r.;(': 38" S B- `7(o`I oaf 7 '74 _7'''9 L 7's 11 11 1 • ti 5i 1 + 9" ,S• q"A.ZL S B- 5 o 7 74 `I I 1 "BI L TS ` 10" L l IS" 5i l 30" W` aj S B- A L~t1o v 0 PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy SJrE QC 4" ,Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. V,SbU74 51T,~•` ~ .o' •'e taD►ca~reS gtu.~uo~ t ~.a 3 .p 9 9>1 -777 9bs I ~1. ~ n F - s 5~~•, 13E5 9r<, $ ~1 tr . 3 , s , E T KO~ c~t d I y ~v IF € / 1~0 ~'O C7 S~K~Y 4-1 U I 1 ck•r~ Pow F 4 -Ili-et4-=~vo- 1, the undersigend, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. Name (print) Certification No. 5S- s-z~ Address 3 I 1~ Z t`'~ ST . 12 J- C+A 1-L..S wt5, 54OZZ Name of installer if known EA-J ` C.v0 9 Copy A - Local Authority CST Signat YMCA CAMP ST. CROIX -~P r d r A Branch of the A 4~ _4 tom] ~ L St. Paul Area YMCA Winter.- 475 Cedar Street, St. Paul, Minnesota 55101 ` Telephone: (612) 292-4115 (612)292-4120 aE Summer.• Hudson, Wisconsin 54016 Telephone: (715) 386-2662 June 4, 1980 Mr. Jim Quinlan Department of Industry, Labor and Human Relations Madison, Wisconsin Dear Mr. Quinlan, A plan for the installation of a drain field at Y.M.C.A. Camp St. Croix in Hudson, Wisconsin (State Plan #800-1692) was submitted to you for approval based on usage by 80 people. The maximum number of people using the facilities tying into the drain field is 60 people, six cabins with 10 people per cabin. We anticipate no future building or expansion of facilities tying into the drain field, and therefore, have refigured the size of the drain field, re- ducing it from 5,655 square feet to 4,400 square feet. The two septic tanks and pumping chamber remain as per an #800-1692. Sincerely, Michael D. Bussey Camp Director MDB/jf CC: Paul Cudd Will Mason i . , t. , • , i _ ,f i J . P' . _ . ~ } ~ ~ w , 5 * i .n n„~.w.. iE , ~ ~ ~4'i.~ .r r . r. . ~ - _ al 1 a . . ~ 60 . A/70 PROJECT DETAIL DATA SHEET NAME OF BUSINESS Y. M Lr LOCATION . -t': la street or highway 44tm~s+~ township count Y LEGAL DESCRIPTION e'ptt•.-r 0r_ 3 e S~• (v . "rZ'q h4 y Q. 19~W OWNER L~ AA C A Mailing address 4-'7,c-;, Gr,(TAp. ?AOL. Vu rz Z I P S S k3 ARCHITECT OR ENGINEER Address l to ZIP ~d.» > PLUMBER nd& 2, . Address \ 3~ T. Check appropriate buIIJIng usage(s) and fill In the information requested opposite each usage listed: Existing building X New building Addition If addition to.ex st ng ullding attach-eta d memo for each. O Drive In restaurant Car spaces O Restaurant Seating capacity (10 sq. ft./parson) O Dining hall ..........i..: Per meal served Toilet waste Ye No Motel O Hotel O Cottages ..Number of un tts 2 persons/un{t 4 persons/unit TOTAL NUMBER-UNITS O Churches Number of persons Kitchen Yes No O Bar or cocktail lounge Seating capacity (TO sq. ft./person) ( ) Nursing or rest home Number of beds ( ) Mobile home park Number of'units - dependent (camper.tralter) - nondependent (mobile home) O Retail store Number.of employees Number of customers 10 sq. ft./person)' Service station Number of cars served (daily) O School ,,,,,,,,,,Number of classrooms Meals served Yes No ..a.~... Showers provided Yes No O Factory or office building Number of persons (total all shirt-ST- Apartments Number of bedrooms (X) Other Specify flh1r_Lc-~T CL 000 _ 8o PU300% 3 G ty-1) a.W&K cgM4 4kM'r. BSfO~tNtc~w«~••i~ 2. Indicate whether or not the following facilities are connected: Food waste grinder Yes No ✓ Dishwasher Yes(ZA%ftKxg No Automatic clothes washer Yes Vj----,00wwNo Automatic potato peele Yes Other (Specify) No ✓ 3. Fill in the appropriate Information for the following at'Indicated: RE«IVkV -ZADOO Ar4- -MAY 2 2 Septic tank capacity planned 1-- i-saa G ~t 1980 Percolation test results - ATTACH PERCOLATION TEST AND SOIL BORING ANNN W-TION A COMPLETE OTHER SIDE , 3 y ' i . , r' 1} . ` , ~ s ' ' ~ P i", ~ ;F, _ R; ~ ~ , i I ' Seepage trench bottom area planned width r F linear feet depth ' Seepage bed area planned 5,100 width 4,0 ZqkI linear feet 95 x %o t_q5v depth 45 -rb a~rra►.~ nr- pro. Seepage pit planned outside diameter depth below Inlet depth q. See approved plan for specifleatlons and details. Signature of arson completing form: STATE DIVISION OF H6LTH, PLUMBING SECTION p P. 0. Box 309, Madison, Wisconsin 53701 cc, ~w!1. Approved: 'Gl /ddress: 3l¢' Z"V Date: ZIP OPZZ THIS APPROVAL 1S BASED ON STATE PLUMBING CODE REQUIREMENTS AND DOES NOT EXEMPT THE Date: Zv IM41 19"40 INSTALLATION FROM CITY, VILLAGE, TOWNSHIP OR COUNTY REGULATIONS OR PERMIT REQUIRE- MENTS ANO SHALL BE VOID IF REVISED WITHOUT THE WRITTEN APPROVAL OF THE DIVISION OF HEALTH. DEPARTMENTAL USE ONLY p NUMAN ~~tart4C=` , t;tFt'~x~~IV~F:NT OF(~(~(►;,TRY, LZIR AN RECEIVED r° MAY 2 21980 PLUMBING FFCTIO, State of Wisconsin ` Department of Industry, Labor and Human Relations Please Reply to: June 17, 1980 Bureau of Plumbing, Platting & Fire Protection 1414 East Washington Avenue, Room 88 Post Office Box 7969 Madison, WI 53707 Mr. Harold C. Barber County Office Building ` 1030 Davis, Box 227 Hammond, WI 54015 • Plan Identification No. 80-01692-A Dear Mr. Barber: Re: Y.M.C.A. Campground Sewage Disposal SE 4, SW-14, Sec. 6, T28N, R19W Town of Troy, WI Saint Croix County Enclosed you will find a letter dated June 4, 1980, submitted by Mr. Michael D. Bussey, Camp Director, stating that a maximum number of people using the south site facilities will be 60 not 80 as originally stated on the Plb 60's. Therefore the size of the bed will be 60 feet wide by 75 feet long for a total of 4,500 square feet. If in the future there are any additions to the system, then it will have to be evaluated and made to comply with ch. H 62, Wis. Adm. Code. Sincerely, L14erome Koepp, Chief Section of Private Sewage, Platting and Soil Testing JK:JQ:lh Enclosure $ cc: Mr. Leroy Jansky, OWS - District 6 - Eau Claire' f Mr. Michael D. Bussey, Camp Director eel Mr. Paul Cudd, Plumber 3 ~j n BQ Ip~' .719 Ogg, 4j cR F t i7f 3 YMCA CAMP-ST. CROOK l ' ~-t'~1Y `y~-f --try' 7 ~f,1''¢ = -41 A Branch of the S? `~-~~LS St. Paul Area YMCA .`~~t~x~r Winter.- 475 Cedar Street, St. Paul, Minnesota 55101' 2- \ \ Telephone: 16121 292-4119 I6121 292-4120 Summer.- Hudson, Wisconsin 54016 Telephone: (7151386-2662 _Et June 4, 1980 Mr. Jim Quinlan Q~00 14 Department of Industry, Labor D and Human Relations Madison, Wisconsin Dear Mr. Quinlan, A plan for the installation of a drain field at Y. M.C.A. Camp St.'Croix in Hudson, Wisconsin (State Plan #890 ) was submitted to you for approval based on usage by 80 people. T{e~m2~number of people using the facilities tying into the drain field is 60 people, six cabins with 10 people per cabin. We anticipate no future building or expansion of facilities tying into the drain field, and therefore, have refigur d the size of the drain field, re- ducing it from 5,655 square feet to 4,4 square feet. The two septic tanks and pumping chamber remain as per Ian Sincerely, 0 X 1 Michael D. Bussey Camp Director MDB/jf CC: Paul Cudd RECEIVED. Will Mason JUN 91980 ~sa...,LUMBING SECTION V o f o y o p se p 3 N 0 7 1 ° > > M CD -0 " 2. c CCD eo CD D m m CD ` 1 3 s: 3 r: p. .4.4 I fT M me! O Cn sn z F Z o G -1 Z N Z < o Z F Z j I rn °a • 00 3 Cn• 3 0 co o w I o o N o o f o o o (m 0 a < m 9 CD £D 3 a m ie" rn 3 a CD ~ m s m y w o D l Z m to o D l Z° rn Cn D o n,ti _ o m ti m n o g 0 CD CD 0 m -4 O ° d 3 ° m o Cn v ° U) m w \ v l C° v l v o CO o Q O ° a o cnl a o cnl a °o ° (n y N N H fyA C7 O ,Y C1 [7 w C C'! cn G D Co ° x' cn D A ~a x' U) C D a x' CD (d N a CJ) Co y y O. cn f0 y (n C71 N Z! -0 a h o o I a IW o o° I a m o o n~ 3 O_ w w w O rn rn W l O ° w V 0 0 O N W O N A A N' N o " I ! 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A e* o o o ~C y z I H D y z N G CD CD 66 a o 0 _ 7 I vo a -n -j o°-'mv~o°CKn a I ~aimnvSi a ~cnmWO (D 0) ao d m oC~ ° I -;ro a 'C 8,9 o m a N 3 n N l0 3 O ° CD 7 Z CA O O O S .y. •O 3 7 N. a) C I 7 N 5 CD 7 C (T N N T o m C CD 0) CD N - 7 CD ~~1 d- p +~OL'h 7- O N oa) o o v CD a a ° I o C-" a Z a I ~c_~i o a W CD U) (a 9 N =r CD 'a U) v vaw° ao s5 C° m ao I nm rnoo0 w•° O ao 3y, 7 0 CD 7 O O r- 0 0 (D ~CnCD C (D xC0?C. m_vm~a It, m3 3 ro~ I y rno an ~•4;rn e m 00 (n cr (a °m ° I CD CD Cy 7 °in A 87 -3 cnr I aCD O x0 I CD °CD y ~ =r -0 CD =r D°' y 0v° I s3 0a n n> m f a CD ~o o3 =CO 5' 1 oo ° N cn N y 1 ° Cn "(a CO S° N c C) °o~CD Co 0 o°m o rn CD a CA I ° ti O I O O b CD I CD CD a 0 0 i o o o a o a °o I o a ° N I I AS BUILT SANITARY SYSTEM REPORT OWNER /&4 C/- ~ 57 TOWNSHIP n 1-751 SECTION~_T-.g?-'F-N-R 29 W (o • ~L~ • I'l • 99 ADDRESS & ' ST. CROIX COUNTY, WISCONSIN SUBDIVISION A/A LOT NA LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ~x iST~au~ QR~ vEw~tY r Sr~RAor /~vvG.fc ~~oric T.~n~K ~~v rlingPK - ~ /SUB ~xi3TiNL Ar S Y54tAv as' ~ ~ 1 yE.vr~ INDICATE I ORTHI ARROW G" BENCHHARK: Elevation and description: '.OL F.cF✓- ioo• Alternate benchmark SEPTIC TANK: Manufacturer: -✓~~SE Liquid cap. ,-Ono Rings used: Manhole cover elev: 57c133 Final grade elev: /00-00-' Tank inlet elev.: 999,40 Tank outlet elev.: No. of feet from nearest road:Front Side , Rear Ft. 3.30' From nearest prop. line:Front Side , Rear Ft. 3/D No. of feet from: Well iSo, , Building: /s1, (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufact.: Pump Size Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons/cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop. line: Front_, Side Rear_Ft. Distance from: Well Building SOIL ABSORPTION SYSTEM Bed: Trench: ~kc v K-3 Seepage Pit: o7 x Width: Length 2. ~ Number of Lines : 1 Area Built,/ -?Ss~~T = .?Sc Exist. Grade Elev. 9y 60, Proposed Final Grade Elev. ff.40' Fill depth to top of pipe: 3-75~ No. feet from nearest prop. line:Front , Side 'Rear Ft.3-/o' No. feet from well: /So' No. feet from building 5~g HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front , Side , Rear Ft. No. feet from: Well , building , nearest road Alarm Manufacturer: INSPECTOR: DATE: PLUMBER ON JOB: LICENSE NUMBER: 33 IS- 6/90:cj ~j .~fpO 1eas- G. ~ r.~T ~p I County: LC9~( "1QRParf RQ)&f IiQ6str~8.19.89 , GWIV 1 E S~V~AC~t 51(? F' Labor and Human Relations INSPECTION REPORT Safety and Buildings Division ~ ST_ QROTX (ATTACH TO PERMIT) Sanitary Permit No.: !GENERAL INFORMATION 193367 Permit Holder's Name: ❑ City ❑ Village i Town of: State Plan ID No.: A TROY p. BM Elev.: , BM Description: Parcel Tax No.: ST Ins OZ~, G6 Xed.R 040-10 7-10-000 TANK INFORMATION ELEVATION DATA A9300027 q-93 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark . Dosi rn' Aeration Bldg. Sewer Holding St/ Inlet TANK SETBACK INFORMATION St/~K Outlet 03~ , $71 TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic / NA Dt Bottom Dosi nty- NA Header4.MAQ. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manuf Demand r , Model Number GPM TDH Lift Friction S st TDH Ft Loss Head Forcemain Length Dia. Dist. SOIL ABSORPTION SYSTEM BED/TRENCH Widt i Length r lo.OfT renches PIT No. Of Pits Inside Dia. Liquid Depth DIMEN I N ~J , 2,5 DIMEN oC SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING nufactu,er: INFORMATION Type O C,,A11. CHAMBER / Model Nu r. System: "T- OR UNIT DISTRIBUTION SYSTEM Header 14dFmTKTre- Distribution Pipe(s) i. x Hole Size x Hole Spacing Vent To Air Intake III Length _jZ Dia. Length L Dia. Spacing zz - SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only v er Depth Over xx Depth Of xx Seeded I Sodded xx Mulched -B /Trench Centerp - -Be* /Trench Edges 'r - Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: TROY 06.28.19.89,GOV'T LOT 2, CO. RD. F' 1,10 Plan revision required? ❑ Yes [14d66- Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: DILHR SANITARY PERMIT APPLICATION couNTY In accord with ILHR 83.05, Wis. Adm. Code STATE SANITAR ERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than El 8% x 11 inches in size. c/12 wn to pr vious application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION 14C A G' evr.WoT,2'/a, S T qV, N, R~ 9 E (O W PROPERTY OWNER'S MAILING ODRESS LOT # BLOCK # 5-311) C--r-y. CIT~ STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 3-13 - II. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD ❑ State Owned VILLAGE 5Zr Public ❑ 1 or 2 Fam. Dwelling- # of bedrooms - A PRCEL UM R( 111. BUILDING USE: (If building type is public, check all that apply) O yd~o4) ? 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility r n I s/Re airs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 120 Service Station/Car Wa 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13;K Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1., New 2. ❑ Replacement 3. ❑ Replacement of 4.0 Reconnection of 5.0 Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit _ Date Issued II V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 122 `SeePage Trench 22 ❑ In-Ground 420 Pit Privy 43 1:1 Vault Privy Pit Pressure 13 ❑ Seepage 140 System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE ~e+~ REOUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION a oc~o7S~SQ. fT. ~~o5cg Fr. ! ~-,30 'Feet 9q S0 'Feet VII. TANK CAPACITY Site INFORMATION in allons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. New istin Gallons Tanks Concrete glass App. Tanks Tanks strutted Septic Tank or Holding Tank /000 /000 Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's natu e: (No Sta ps) MP/MPRSW No.: Business Phone Number: ' mss- ~.vc . I~~iPS 33 ~5 ~~s' 356- S°Sn Plumber's Address (Street, City, State, Zip Codel: IX. COUNTY/DEPARTMENT USE ONLY ) Disapproved Sanitary Permit Fee (includes Groundwater a e sue Issuing Agent Signature (No S s 4 pproved El Owner Given Initial Surcharge Fee) 6 / Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 1 All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tack(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit y permrt application must include: 1. Property owner's name and mailing address. Provide the legai description and parcel tax number(s) of where the system is to be installed. It. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. Vt. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total ,gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 111 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; buildinc, sewers, wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes: soA absorption systems replacement system areas; and the location of the building served; B) horizontal .aod vertical elevation reference points; C) complete specifications `or pumps and controls; dose volurne; elevation differences; friction loss; pump performance cu(ve; pump model and pump manufacturer; D) .:rocs section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) a;l sizing information. - - - - - - - - - - - GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees; fc:i a rttlrrll,im,r of regulated practices which can effect groundwater. The monies ce'r .t ed t.hrough these surcharges are: used for rnonitoririg groundwater, ground- water contamination investigations and establishment of standards. 4 SBD-6398 (R.11188) Oa ~ ao w U Q y► ~ 3. i` ~ p y H W ~ n o ~ a 0 VA Z ~14 3 d ~a o 2 H ~1 1 R M 6 r 7- 7° a n 70 b V- z oh a'o-.~- Q • o PSI K A k Aec A r , 0 El d1o b `N p • ~ D 8 r ~ n b~ 4- 7o 3 r*% w o- - W ~ r W 0\ R ~ N t r. M All 00 °w3 Z w s ~ L\ o , 'kA g a ~ o > z n ONSITE SEWAGE SYSTEM e Z W W ~ "A" a E"' AmrPRu*v DEPARTMENT OF INDUSTRY, LABOR AND HUMAN RELATIONS ~1 A DIVISION OF SAFETY AND BUILDINGS n SIff CORRESPONDENCE co c' o r\ L4 1 M ~ <r% L a, s. a M 3 8 ~ y k z tA p► W . y k Z Z r 723 AN ~ n A Z h NSITAEWAG YSTEM ~ N i N ELA~10 a DEIIARTNic~n i 11,,~ ST~;`d, LABt R AND tz~ LiG d ` S,' f-ETY AND BU DINGSA 2 ~ Z kA 2 SE COR ESP ND CE moo- m o~ r S Z 0-V w a ~ ~ ' 1 4N N z y . Z N ~ o a b e t h '11 "1 1~A N t o ONSITE SEWAGE SYSTEM t Z AnPROIJ-mr% ° b DEPARTMEINT OF 1;nucTRY, LABOR AND HUMAN RELAMON! 3 UiViSiJie OF SAFETY AND BUILDINGS Cl~ q a 1 CORRESPONDENCE ~ z o 1 ~ i 11~ , A t3 e y e - NIS N H L b h ~n N ~ ~ J n gYgTE~ 1. ttoNS1T NAE G M r ~ ° ~ ~ x 1% cQ vs ~ U ~ M RELAS101~ • • ~ ' . ` ED s`IJ1fRy, 1308 AND G~ SETY AND BU1LDiNGS D1VI~iv j A4- CORRESPONDENCE XZ, 0 e LPN (A ,bA ~A . t 1 CAMP ST C IX ROI to xa. ro r, e~~ ~ c a T ~ o. R n N ~ y ? Qr. tD OR fl,. R r~ N n "3 D o w X c o a r y Oy ~ ~ i m a v 2~ p f ' m D 4 D V .5 7 ` a N n ~ N 0 m qq pi n z n j~ O N 1Y N ca d D F N N RO n n 2 F O z 0 R O Do J- ~ O R Zn m ~y£ D n HM O R R N O ID n D N f Z a G a R ✓ ry r ry a w a, Op n d d S R ' ro _ a V m o O R A c 7 fA 7 o D N O Q S ~ N fD ~ ~ f7* D N N 7 n ID (715)386-2662 (612)436-8428 ST PAUL AREA YMCA 1 554143 x ~ROPos~O ~ ~ ~ ~~V t Cam! ~ std Alzk-A i GPP F tr 114~ 1~N F L F-9 --x1ve O bo {Oo 5l PLAN 77..~ Scale. Date: Camp St. Croix MTM Drra. wn 0y: Pole Barn Remodeling Project No. ~ I REPT131 TROY ST. CROIX COUNTY ZONING PAGE 1 03/23/93 15:09 REQUESTS FOR INSPECTION WORK SHEETS FOR: 3/24/93 AREA: JT Activity: A9300027 3/24/93 Type: CONV93 Status: PENDING Constr: Address: TROY 06.28.19.89,GOV'T LOT 2, CO. RD. F' Parcel: 040-1027-10-000 Occ: Use: Description: 193367 Applicant: ST PAUL Y M C A Phone: Owner: ST PAUL Y M C A Phone: Contractor: STAHNKE, MARK E. Phone: 715-386-2850 Inspection Request Information..... Requestor: ZAPPA, GARY Phone: Req Time: 11:03 Comments: Items requested to be Inspected... Action Comments Time Exp 00012 FINAL INSPECTION Inspection History..... Item: 00012 FINAL INSPECTION ;v:iono scoDepartment of Industry, S 0 I L AND SITE EVALUATION REP 0 R T Pageof r Human Relations Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code ' COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but / Cko) X not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. REVIEWED BY DATE APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION PROPERTY OWNER: PROPERTY LOCATION C GOVT. LOT Z. 1/4 1/4,S 6 T Z$ N,R j 9 E (or) W PROPERTY 0WNPR':y LING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 45::. ( T V2 CITY TATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE OWN NEAREST ROAD vD~u ~t s461 ( )R%6-43-116 CTk ~r New Construction Use [ ] Residential / Number of bedrooms [ ] Addition to existing building j ] Replacement h4 Public or commercial describe Code derived daily flow gpd Recommended design loading rate Q •7 bed, gpd/ft2 d.% trench, gpd/ft2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate Q •'7 bed, gpd/ft2_0,1_trench, gpd/ft2 Recommended infiltration surface elevation(s) '75.6 ft (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable It S = Suitable for system c VENTIONAL MOUND IN- ROUND PRESSURE AT-GRADE Y TEM IN FILL HOLDING,~ K U= Unsuitable fors stem S O U S❑ U 4S ❑ U S❑ U S❑ U ❑ S L] SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench ITS" Z.5 1 L. sbK r C Z 0 4 0,S v4 v11 ~i OEMt g z o h ~0 4 3 S f L C 4P o.z n Ground $ 2! E S 41R .~7 Q, elev.9i. t. b .q s ry 1 1 O.7 i0.$ Depth to limiting ctw~ Remarks: Boring # z.L ~ _ 1-- 1 f sly r► ' 0.4 16S Z t•t' 3 4 ~P s, :10.'7- Ground v~ 9 ~ e. I nl 1 rn 1 ~O Ground I;irt. $ 6~y o 4 n,1 1 0.7 21o g Depth to limiting factor > 9-'Z Remarks: CST Name:-Please Print A'Q_ Nw~ ~7d,, Sa~J IS g ~w4 Phone: Address: S U~ w Signature: Date: CST Number. g z 9z 34gi RROPERTXQWNER YMr-14 SOIL DESCRIPTION REPORT Page Z of .PARCEL I.D. 9 Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trerxh a 4v q 4 i7 N Y~R I o~-j-~ o mind A 1byg, (Y) Ground 'Z''5 CA.-~ r Depth to limiting facto 7 DI •b Remarks: lob ~4y EQ u Ni4C~C(~°'f~1gLtF - CoYJck~Tt ~t''~CL Boring # .Y ZN 16 Y,~2 ~E p1.OLa t.arv t- L-:L. hl~ Ground q ~ /dY~2 ~4 1~'IS 1 Q l 0.g elev. 99 ft. Depth to limiting ct ~ Remarksf6/' LAYM I S th S LL) C6 w ETC Boring # /J /3"' 2/6 5 7s L, ' ~r Sb 'I'I rli~- 0.4 0-'5 X $ 3,~ ~o yle 4 3 S rh e Z. D. Z04 /O S 4 ,~G,R n, 47 Ground O elev. 0.7:0 g X3'8 ft. Depth to limiting factor ? Q:1r 17 Remarks: Boring # 0,4 0-5' $ zo a rl~ 3 g~ 1 nI P o qi) o. A Ground Z~ " Sd(t 1 C ,g elev. A'7 &A +A- 0-7 10-% bat. Depth to limiting factor3 Remarks: SBD-8330(8.05/92) SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ADDRESS: `~.'Z FIRE NO: LOCATION:, }f, SEC. _T Xf N-R,~_W, TOWN OF: ST. CROIX COUNTY SUBDIVISION: LOT NO. Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system: St. Croix County residents may be eligible to receive a grant to help with the cost of the replacement of a failing system, which was in operation prior to July 1, 1978. St Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to the St. Croix County zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification from will be sent approximately 30 days prior to three year expiration. I/WE, the undersigned have read the above requirements and agree to maintain the private sewage disposal system•in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification form must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: I DATE• 3 6Zi 3 r St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 STC-100 This application form is to be completed in full and sighed by t}le O ner(S) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor,(spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate-deed-recording. Owner of property PAUL ''4C . Location of propertyL,T I/+, Section ~ T42Y N-R~W Township 7 0Y Hailing address 1d11.14° 4GY~o Address of site 0~ r- l o Subdivision name rot no. Other homes on property? V es Y No Previous owner of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes _._,~_No Is this property being developed for (spec house)?_Yes _k,"No volume and Page Number as recorded. with the Re ister of Deeds. g INCLUDE WITH THIS APPLICATION THE rOLLOWING: A WARIUVITY DEED which includes a DOCUME NUMBER & THE SEAL Or THE NT NU2iI3ER, VOLUME AND PAGE certified survey, ItEGISTtij OF DEEDS. In addition, a y, if available; ;would be helpful so as to avoid delays of the reviewing process. If the deed description references to u certified Survey Map, the certified survey Map shall also be required. PROPERTY OWNER CERTIFICATION I(we) certify that all statements on this form are true to the best of my (our) knowledge that I t he _ a ro (we) m (are) e of p rty described in this information forby e virtue (s) of a warranty deed recorded in the office of the County Register of Deeds as Document No. own the proposed site for the sewage disposalt system) orr I e(wej obtained an easement, to run the above described the construction of said system, and the same hasopbeen,duly for recorded in the office of County Register of deeds as Document No. Ana r of ap~llcant . Co-appl cant -l S• ~ t • Date of Signature Date of signature c c o o eD CD o n ~G A ' d c ^ I 3 sk ~ ` 1 I A 3 z a z O to o OOf ? • O N 0 O N Q H N n y V O M N O x; O Co v aD I 0 O O O CL 7 y O ~ H W O c n I m ~ o ' O d a cn I03 w _ o CD c o r1V~i o cD I p j j ~ o OOD OOD c C1 C co) '4 v 3 Q OOO n ~i N 9 m A m co ui (0) a . "y 0 07 v v 0 0 CD a o ;t w o cD ni O1 V N c ~ - ID G !V I 3 w ~ I ~ o N d y O ~ N o. • (DD N ~ I m N w a co - c CD o 0 CD a "I V! nn Z X z 0 I z -irn T m N ao 0, 06 z o co I 3 ~ W o ~ I 33oNSO~ a v m -oc o wC - ~ o cn= om ~ o c~0= m 3 o0.d o v c dd0 -o' 0•~ o N C (7 7 O ~ ~ I c0 C m m Z a O U) I x -.,a Uvi m c N fD Z T. a v 0 3 ° ry v0, m a~ N0.o ~CL M~ 0 0 yA C D C Iv 14 W- O 7 d ' O 5~~0 dfyD n d A x N n fl) O I o D`.~ SO Cr d A O O g 0 M CD -L n ((~~'~i fn O to ID y fD 'i C' V+.1 D > C o a -4 a _0 N I m dp o ce I ts~ O ti as O i N ~i C!J CL y n m - - m z m , v y i tr! ~ % U~ I c 0 a r T p r c r c (I of, 00 v f~ ~'t = v~ 1 y ~ ~ Q 00 z CJZ z vT N c f W m I O 3 r, v J , r,+ 01 rr, i 4 i jl DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 SE14, SW1,4, S6,T28N-R19W El CONVENTIONAL UALTERNATIVE State Plandll.D. N-1- Town of Troy D Holding Tank U In-Ground Pressure D Mound If assigne CTY Road F A NAME OF PERMIT HOLDER: DDRESS OF PERMIT HOLDER: INSPECTION DATE: Greater St. Paul Area YMCA CTH F, Hudson, WY 54016 30 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN REF. PT. ELEV.: CST REF. PT. ELEV,: Name of Plumber: MPIMPRSW No.. County: Sanitary Permit Number: Paul C. J. Steiner 6780 St. Croix 99077 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV. . TANK OUTLET ELEV.; WARNING LABEL LOCKING COVER PROVIDED: PROVIDED'. OYES ONO DYES ONO BEDDING: VENT DIA,'. VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM FEET FROM LINE: AIR INLET'. DYES ONO DYES ONO NEAREST DOSING CHAMBER: MANUFACTURER. 7INGLIQUID CAPACITYPUMP MODELPUMP/SIPHON MANUFACTURERWARNING LABEL LOCKING COVER PROVIDED: PROVIDED: YES ONO OYES ONO OYES ONO GALLONS PER CYCLE: PUMPAND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL BUILDING. VENTTOFRESH IDIFFERENCE BETWEEN FEET FROM LINE AIR INLET. PUMP ON AND OFF) DYES ONO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing w ,T + [:1TER MATERIAL AND MARKING or excavation. (if soil can be rolled into a wire, construction shall cease until FORCE MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: _ YVIOTH: LE NGTH. NO, OF DISTR. PIPE SPACING. COVER INSIDE DIA.: #PITS: LIQUID BEDITRENCH TRENCHES MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH BELOW PIPES ABOVE COVER: ELEV. INLET ELEV. END. PIPES. FEET FROM LINE: AIR INLET: NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- O meets the criteria for medium sand. TIONS MEASURED. YES ONO OIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS OYES ONO OYES ONO L.EPT. VER TRENCH/BED DEPTH OVER TRENCH;BED DEPTH OF TOPSOIL. SODDED SEEDED: MULCHED: EDGES. OYES ONO OYES ONO DYES ONO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH TRENCHESNOOF LATERAL SPACING GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE JMANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEVATION AND ELEV.. ELEV.: CIA.. ELEV.: PIPES: CIA.: DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS OYES ONO _ DYES DNO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF LPROPERTY WELL: BUILDING: FEET FROM INE: OYES ONO DYES ONO NEAREST Sketch System on Retain in county file for audit. Reverse Side. sIG"7E' TITLE: Zoning Administrator DILHR SBD 6710 (R. 01182) TDILHR SANITARY PERMIT APPLICATION COUNTY ~i In accord with ILHR 83.05, Wis. Adm. Code SANITARY PERMIT # memo -Attach complete plans (to the county copy only) for the system, on paper not less than STATE PLAN I.D. NUMBER 8% x 11 inches in size. 9 766 3 1 7-5- -See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑ YES 10 No PROPERTY OWNER PROPERTY LOCATION (P,7 ,1 44.6 A _5,E % I'/4,S T ~ N,R PROPERTY OWNER'S MAILING ADDR SS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME CITY, STATE ZIP CODE PHONE NUMBER NEAREST ROAD, LAKE OR LANDMARK LZ_VJLLAGE : C . r 11, TYPE OF BUILDING OR USE SERVED: ~nr /y t 0 -f-CiC e .B ZZ6. Number of Bedrooms if 1 or 2 Family OR >9 Public (Specify): 111. PURPOSE OF APPLICATION: (Check only one in #1. Check # 2,3 or 4, if applicable) 1. a. 9 New b. ❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e. E1 Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit # Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in #1 and only one in #2) 1. a. X Conventional b. ❑ Alternative c. ❑ Experimental 2. a. ❑ System- b. ❑ Holding c. El Pit Privy d. E1 Vault Privy e. ❑ Mound f. X IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. seepage Bed b. E1 Seepage Trench c. ❑ Seepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): Feet O Private ❑ Joint ❑ Public VI. TANK CAPACITY Site in gallons Total of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank t Lift Pump Tank/Si hon Chamber VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name (Print): Plumber Signature.,(No,Stlmps) MPa4P',.f3Slty N Business Phone Number. lum er's Address (Street, Cify, State, Zip Co Name of Designer: / x VI 1. SOIL TES INFORMATION Certified Soil Tester (CST) Name CST # f I— 1 P C ADDRESS (Street, y, tate, Zip Code) Phone Number: IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature (No Stamps) Approved ❑ Owner Given Initial Surcharge Fee Adverse Determination X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO THE APPLICANT: 1. This sanitary permit is valid for two (2) years; 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable; 3_ All revisions to this permit must be approved by the permit issuing authority. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation; 5. Private s'ewage' systems must be pr6perly maintained-The septic tank(s) should be pumped bya licensed pumper whenever necessary, usually every 2 to 3 years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description where the system is to be installed; 11. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in #1. Complete #2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in #1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g. _ MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/ Department Use Only; - • . X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8'/z x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; dosing or pumping chambers; distribution boxes; soil 'absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form. GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater-bill Ground atBr'- included the creation of surcharges (fees) for a number of regulated practices which Wisco in's o can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buriedreasure is used in your building is returned to the groundwater through your soil absorption o system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- t water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398 (R.03/86) r_,AN Scale S ~ ate 4 b q F ;t S f .Al 00 I 9S 90 IEL 1.-7' o, of /~S E oN \ S III ~ ~ PE 1 1J p! L4 G 'EL , of prpl, A go.p Pq R l:rtiG Gb C, 35`oF N"~C _ G1 ~ ~R.cE ~r'c1nJ UZI ~52AU 1Bhch. RECMVW l! li G I 'i 1987 MRVIMARtNG SECTION ty~Tt: ; dv E~ u is > 50' w ~ or- sy.srr~i ►v~Z~ST Pz0?E~~ry L.~n~~ is 650sT.~c7N'~ 5706375 N GTES 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install cast iron pipe 3' onto undisturbed soil both sides of each tank. 3. Install permanent markers at end of each lateral. ( 8 required) 4. install 41t observation pipe Ni th approved cap.. ( V required) 5. Septic tank to be zSO© gallon. capacity as manufactured by 6. Bench Mark- ElevCraRt-ion E__-~~-ufluC.TS _ • e2~f7 W' Sr ; ;T -his system will serve a new building comprised of an assembly room, a classroom and offices. Three floor drains will be installed with four employees in the building. The assembly room can also be used as a classroom. Thirty-five people per room are anticipated thereby seventy could be present at one time. Data for sizing: Schools - classroom (25 per): 3 x 450 = 1350 4 employees: 4 x. 20 = 80 3 floor drains: 3 x 50 = 150 Total Gallons Anticipated = 1580 peptic Tank 1580 + 750 = 2330 min. req'd. A 2500 gallon precast concrete septic tank will be used. Soil Absorption System The soils are Dakota loam - Class 2 pert. Due to the necessity to dose the system, a pressurized bed will be used. 1580 _ .8 = 1975 sq. ft. reo'd. A 24' x 83' bed will be used providing 1992 sq. ft. of absorption area. 8'7063'75 5Ew FGE S~=~M pFOi'I k1E it~ona~ L~ Cort~ S ~ ZAa~~ ~ 6 _D1C1 t S{~F pEP ARC ~~1EN ~U~F P p`tiGE GGR~~SP RECEIVED P'' U r, 19 1887 r LD j iU h O F `D tS-PlJ 6 6P~ i=i~J1SN i G~=~~~ m so, r -;~►.f ~z. S a ~ ~ ~ - - ~ 1. ~ ~JZT7i 18v`no~.l Pl y A~~~~• z~~ ~ Wis. v`~ ,or,,a t n vu Pj\ON~' N yG . t~ SPF~ 5 =h E F Zp + i 4~1CAtJI-FpLD PVC LATE2A L z-5 ~ ~ ~3u~ C ~eR~-s~.ra~T r7~R1~cE.R Zy - - - - - s-- pVC FpRC`rtLN . ~ F"t. L~}~i 17U M P 8'7063'75 RECEIVED r;U 1 1)1987 ~r r r n','XI G .qFcTf n, kl Page --'S Of Y Ferforoied Pipe Cetall End View Perforated PVC Pipe End Cap 1 f~A 1okeoocce roves Located On 6ottorn, L;re ~ auotly Spaced J S R l+1P-,~ c~~ f-'T EtJL OF _ S i * PVC Force Main S I Q PVC Q ~ Manifold Pipe / i I i Disiri utian 87063" Pipe ILosi ! Hole Should Be Next 7o End COD End Cap P 39 Ft. t R FT W,GE SYSTEM 5 6 i~ P~iNATE SE iStribution Pipe Layout X 7 Z Inches Co ne f~Una y -7Z. Inches Hole Diameter Inch RE~Rj~oPds Lateral Inch(es) Manifold 3 Inches r tJJ ~PFy~~~~F, SAF Force Main Inches # of holes/pipe -7 E CJFiF~L`' Invert Elevation of Lateralsg3-6' Ft. pL~ ] ST1fO!_E 361 FROM "CSIOT-ER 3F FO~-D W I-N SvCC'~1!vG_ N o 4 c s_ AT -71 t' ? N TIZVA t_S . ST `TU BE cT T. T}tE G" D CAF, - RECEIVED [`Jul 101987 nvt1"nING3 SK-TION PUMP CHAMB-R CROS5 SECTION AUD .SPECIFICATIDUS np~G~ of -7 _ ---VF-UT CAP y' C. L. v t;! T PIPE WEATHER PROOF _APPROVED LO(!KItJG JUAJCT)DU BOX MANHOLE COVER r Lam' FROM DOOR, ►U. I wIItvDOW OR FRESH It TAKE I GRAD i ~ y" MIIJ. IiAl COQDUIT - ~a - - p,G IAILET It, IGHT SEAL I i~l f P f•ti~ I II' HPPRDVED J0105 APPROVED Jo1N7 W/c.z. PIPE EXTE I EXTE►JDIA1G 3' wl r-. MDtPIAJG PE ~ ALARM XTN 3' I OtiTO SOLID SOIL Ll> ONTO SOLID SOIL ~Pg~R 0 J I II B a~ , ~ 1 ~P / I 1 ow F F ~J fL S ELI- V.86-Snb F7 PUMP---_ OFF G D i L auE,~ B S. SO CONCRETE BLOCK RISER EXIT PERMI'7FED OIJLH IF TAIJK MAUUFACTURER HAS SUCH APPROVAL SP>=CIFICATIOUS 8706375 DOSE TA IJ KS MA ►J U FACT U RE R'WNEXSEER Co-QCRE`IE _R0b4S'NUMBER OF DOSES: PER DAB TAWK SIZE: GALLOMS DOSE VOLUME S.S. EL£G-LR4 SYS~~S IMCLUDIMG BACKFLOW: S3~ GALLONS ALARM MAUUFACTURER: MODEL UUM$ER: ~0~ lbw CAPACITIES: A= Z-7 IMCHE5OR ~5a9 GALLOMS SWITCH TYPE: B= ZQ- INC.HES OR GAL LOIJS PUMP MAMUFACTURI=R: ~~VV-~S pS ~~/~G. Cmr-HES OR S3O CALLOUS MODEL HUMBER: 3$$S - ~JP-0 S D=-L3 jmcHES OR 6 S GALLOA35 SWITCH TYPE: ~E~2GVlZ~ DOTE: PUMP AND ALARM ARE TO BE S. S Z IN5TALLED OIJ SEPARATE CIRCUITS _ MINIMUM DISCHARGE RATE GPM VERTICAL DIFFEREMCE BETWEEIJ PUMP OFF AUD D15TRIBUTIOU PIPE.. ? FEET pECEIVED MIIJIMUM METWORK SUPPLY PRESSURE . . . . . . . . . . 2.50 FEET + Z8S FEET OF FORCE MAIM x I°FYDnFKICTIOU FACTOR. Z'7`{ FEET )1987 t • Ei FEET Ml l"Al NO -grey"M TOTAL DyFJAMIC HEAD = -z fir, if IUTERUAL DIME-MSIOUS OF TAUK: LEM&TH i$e, $ WIDTH $ g$----- LIQUID DEPTH 5 r"~S pER h t~ Nv Ftt CT~~R ~In. Bo,,brt ,~r~, = 3.14 k - - Ih.3_ ~3) = S~3 C_ T-~'L, U fV US Q ►'C~E _1 or -7 S 1l ~ ~ 25 - I - -J 1 - I--- - - - I - 3 80 Sl/f. /4" SONdS I - - - WE15H 70 = 20 WE10H I - - - I I FJQ- 60 - WEOTH - - 50 15 WE05H 10 30 WE03M I I - - WE03L 20 i 5l 10 N _7 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM I + 6S.S2 + + 0 10 20 30 m'/h CAPACITY ~GOULDS PUMPS. INC. SDECA FALLS fEW YCW 43+46 METERS FEET . 120 MODEL 3885 35 SIZE 3/4" Solids 110 WE15HH 100 30 I 90 25 80 70 Q w 2 20 J F 60 0 ~ 50 WE05HH 15 40- i 191 10 3o Ski!" 20 5 10 0 0 0 10 20 30 40 50 6D 70 80 90 100 110 120 GPM t + + + 0 10 20 30 m'/h X1985 Goulds Pumps, Inc. CAPACITY 8706375 Effective July. IN5 PRESSURE SYSTEM 1 ~L _~'OR LOCATED IN THE SEA/y OF THE S1y~ljAF SECTION T Zv N, R 1° W, SIN. TOWN OF TR-yY , ST• ~_L_x COUNTY, wISCOr, INDEX PA GE 1 of 7 TITLE SHEET PAGE 2 of 7 WORKSHEET PA GE 3 of 7 PLOT PLAN PLAN VIEW-CROSS SECTION PAGE 4•f7 PA GE 5 of 7 DISTRIBUTION PIPE LAYOUT PA GE 6 of 7 DOSE CHAMBER PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR Is"r- CR l y- N'ati V ER IC1 T R C. -T ~-w~SO1J , ~ 1 S~ 016 8"063'75 PREPARED BY WGERER, WEBEE', AND ASSOCIATK - too=otcet 21 MAIN STREET t ~I BOX 74 4 N • t 4~.a~ RIVE? FALLS, WISCONSIN 54022 k# ~\SCONS/~ _ s ARTHUR L i - WEGERER = D815 P = ELLSWORTIi, 1 was. - Off. ••y......••'►•'•f 4, G N Aft, -/y -"7 1987 !„!!4+ 5!%.1Q' SlEcinn4 P~oSEcT iJO. 3~ - Z3 7 % ALI Y ADDRESS. . U 1 _ TuZ 50 X ~c,oJ QTY: yr H'S HUYLR'S NAME: i DATES OBSERVATIONS MADE - " PROFILE DESCRIPTIONS: PERCOLATION TESTS: USE - side NO. BEDRMS.: COMMERCIAL DESCRIPTION: ~Reside Pt$$r ~L~ it OF ICON LNew ❑Replace a I :,ce fTUCj • 6 t ) i ~ 1 N "A\ - - J N •n r~ u2_IA. ~ RATING: S= Site suitable for system U= Site unsuitable for system - - 1 M IN-FII_I_ HOLDING TANK: RECOMMENDED SYST M foprional) TE ~CONVENTIONAL MOUND: IN GROJND-PRESSURT Ej s u 1 N s l sue s ru r su- ry Percolation ests are NOT required DESIGN RATE: l a . coon of the t siu a,e a is n the l F ocd, a:r • evat,on J F ,odnlain, inn a e ,rider s. ILHR 83.09(5)(b), indicate: N - - PROFILE DESCRIPTIONS RORINGI TOTAL DEPTH TO GROUNDWATER IBS CHARACTER OF SOIL WITH THICKNESS COLOR, TEXTURE, AND DEPTH - NU IRERIDEPTH NQ' ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) _ - yv`p L )S; Z.6'Sn L; o.S'eh S J.; Z. l ` _G7_ S~__ - I `ML1T @ o'B1k- TS;O.S't3-"L;~.~'L~nS~,O•$rt3r1S1~: SY-\ ~B- i•-~~ q~.~' ivolJ~ 2.3`~ 3.0+ S~ ' 3.0` V~ S ~Gr -___`i rnoT CR L'TSC3Y~`VS~ `nS >7SeU>~ B- ~ ~ , ~ I ~ Z , 2~ tv OrJ ~ z . To 3• b ' o. a 'Eh LTS ; ~•b'~h L; 6-77-' .EYL S uh IB- ~ ~ ,lam' °►b-l ` >Jax~C 7 ~T c~ ~•o' 8) LTs,3 o'nL~ rn~ Z h+VT 2. S' ~I ` 1•Zr ~h L l_ 7' TS O.~i V! 51 PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING. INTERVAL-MIN. PERIOD t PERIOD 2 PER OD 3 PER INCH II ~ A. P_ No ~~Zes v►•~ vNSv o~ sol c S FbTz P_ o k-7.r-Nt' -rt-WQ A u b S L-(S P- P P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. q~ 7~ p E ~~VTA L~~ f- t SYSTEM ELEVATION ~1~1 e"2. lbt. ! 6' olv 'foA of 1 So u T~t~`2L`f Po ST OF SIGN ss a S I-F~E l_-0 C_tTo' so'-s. "?SO w. S~'j L-W-E IS Sol c • `J = 51•" 'e. C `rjy . t N ~(j 'jam ~ E PC's-: IJo L,c~C.1~'il:xl S t~t7Ch a TR C Y_ t sp ti G U. S t-f S12r-t S t ~ ' N Nov' aF 71-l S S A v t 1, ,he undersigned, h,•reby certify that the soil tests reported on this vr.- e ga r n n ; rd r•: th t, ?dw-:ynd,nethods specified in the Wisconsin Adt:rinistrative Code, and that the data recorded and the location of the tuts c' t r_ best o' in, ~c tg= nd "'E hef_ NF•.to1E !pi lit) _ Ii+=~ 5li'i:RF C:UMPLE`ED ON: JCEHI Ir ICP. ,ON NUMBER: PHONE NUMBER' optional): Lf kz) ✓ - - - - ,LS S~~N4TURE. I L1 i t;fBl' f ii)N v.~u,a! anti one copy io Local Auihowy, ± 2a Sol, Tester. DILHR-S9G-E -95 iR 701831 - OVER - Of Pi>R I PJIEty I OF REPORT ON SOIL BORINGS AND SAFE FY & BUIL DINGS INDUS`RY DIVISION Y P.O. Boy 7969 BOP, AN 'D PERCOLATION TESTS 115 MADISON, WI 6,3707 AN FIELATIONS l ~ (tLHR 83,09(1) & Chapter 145) I( LOT NO ~BLK. N0. ~SUBDIVISION'NAME: Iv jrA7(~)h. SECTION: TOWNSHI MUNICIPALITY 1 COUNTY: OWNER'S/ UYER'S NAME: MAILINADDRESS S~, _o 1 X S~. GIZQ 1X G ST.PF)UL_ NY.GT Yt-)CA . H • 1-~--- N4UtS,►.,, vj)SV C) I6 - -J+ - USE DATES OBSERVATIONS MADE - - - NO.BEDRIVIS.: COMME, CIALDESCRIP710N: (PROFILE DESCFIPTIO IS- PERCOLATION TESTS: r ~SEMIc 8 CiFfi/Ge I ~q'New ❑Repl S ace / :p, I'_JResidence N•f~• ~Utl_~1NG ` S1G.O, z~~ L - - - RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) ~ s ❑u ms ❑u XS ❑u EIS ®u DS ZU i;- If Percolation Tests are NOT required DESIGN RATE If any portion of the testes area is in the f under s. ILHR 83.09(5)(b), indicate: C.L SS Z Floodplain_indicate Floodplain elevation. PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-ltd CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH kft ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 0.6'~ rtL-1S;1,9'BhL;Z.6'LT-En S-4 Gr;o.y'LT- B- ~ g. S ~ q1.y ' 1J0►-~ > ~3- S ~ Qr1 S ' 3.0' LT. L n S d` G~' ~•O'~~1!snL TS ; 1-a`Bnl.~ 3n S 17 GI^ ©.S'ok~ti,L TS~0,B'$,tL;2.5'$nSig G1~•, 0 Z' B 3 ~S 3r 44 9~ ~orJL > 3 y.o`Bn S G~- yf,P~VwC O.~' LS1 LT$ Z• o' i r L; GySj kv S-" Z, S' OF -1p, t\ w, a S • 1' p)t.B>, L Ts ; ~.`6' 8n L G7 inn si 1 y Bn ' ' tvOcJ E 7 $ . (o ~ ` ~ ` C~ FL L TS ; Z. 9' ZR L , y. I S G~ B- ko PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES AFTER SWELLING INTERVAL-MIN. PERIOD t PERIOD 2 PERIOD 3 PER INCH NUMBER INCHES P_ P- P- P- F___ PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. g01~~Y~1 01=~ Q~JC i~At`l~ 1,~~~ SYSTEM ELEVATION o 2- SO ' i r 01.6 s y B.3 S ~:~Tti L~ Po s T o F- S t Z K gE).gS'oxi PIPE 97 -T_ s1 -7ks- c""C-T~~ 2- sc`5. 6S0 'bv.OF71~ $ y ~ ZU' toy rZV' ~ i \ 1` /t 1L~ T L! LINE 1S 650 r . C"f1ST so ' sw C3F- !9`/S-r~. 8.6) I g PCwPOS~~ 3t ~6. TD BE ZSo # We5'T tNN Lciewnw ? ' I 19 U. 1 B•S - J r(LR11)~~~ d `tawEti Sim 0~` 95 x / f I Ra.~ BRKtc - . 1, the unde,signed, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin i.dministrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. if AME (pant)' (TESTS WERE COMPLETED ON: j ~Z`~v~z L, w E~~~ ~ I D.)RESS IYJ_rt;-: V $6)( -L Z 6 CERTIFICATION NUMBER: PHONE NUMBERioptional): s w o Iz`rr1 , 1 --s a) L--- b 7 l S- 4 ZS- 016 CST SIG^ATUR.E: UIS I RIBU f ION: Ot gina, and one copy to Local Au'hor!ty, Property Owner and Soil Testes- f`!! HR -Sr^..!: (R. 10/83) - OVER - H z En H STC - 105 r 9 H SEPTIC TANK MAINTENANCE AGREEMENT H St. Croix County z d y YER 3 tri OWNER/BU rMCA ROUTE/BOX NUMBER G _T, y Fire Number CITY/STATE AIso' ZIP 7U~~p PROPERTY LOCATION: 5E4, Sw ~4, Section, TC2 0 N, R,~y_W, Town of T"D V St. Croix County, Subdivision Lot number Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. yo E I/WE, the undersigned, have read the above requirements and agree N to maintain the private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- 'v ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED ( 4~ ] DATE 131,0 i St. Croix County Zoning Office P.O. Box 98- Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. i APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the r property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property G ~"eoler S t &Z ~re 04 C ~ Location of Property k, Section T,-21?N-R_/ _W Township TrAv Nailing Address , L ZI & cis Address of Site (S~ me=- gzc g ,ny Subdivision Nameb .Lot Number Previous Owner of Property Yv GI~ ~V~-,s 1y~ Total Size of Parcel OD l I q O Date Parcel was Created a S NOD Are all corners and lot lines identifiable? Yes No Is this p opyerty being developed or resale (spec house) ? Yes _ No Z/ - IVV37 Volume .11447 and Page Number as recorded with the Register of Deeds. .-NOPREM 5717 INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and page number, and the Seal of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refpr- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION I ((fie) ce ti.6y that att sto tement6 on thiA onm aloe •tAue to the but o6 my ( oun ) hnowtedg e; that I (we) am (ane) the ownelc k f o6 the phopen ty des cA i.bed in th.i a in6o4mati.on 04m, by viAtue o6 a wa Aant deed heeonded in the O66ice o6 the Count a usteh v Ueed~s ae Documnt o. Yt yy s 6 e u ~ y4 335 ; and that T (We) phew en,tf.y i7i own the pnopoded ec.te bon th-e4 ewage di~spo~5 A0 em (o)t 1 (we) have obtained an eaeement, to hun with the above deaCAibed phopehty, bon the eondtnucti.on 06 aai.d b ya tem, and the dame heA been duty keeonded to the 066.tee o6 the County RegtiateA o6 Veeda, ab Voe meat No. 2/10q3 X S ) . SIGN Op ER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED ~.l : a . ,,.,.a ,.u-;r .n ~ ya_.. ::r+ sir-u-~ C~.'~ ~ --k~ ' - Y~ ' QUIT 01 AtU~`DLi D _ _ STATE 01", S('QNSIN FONU n 11 - t _:,~..~+.,1-_ r.';LLLLSIICO~l11lMlUCI[r,eaa d i S ih Ydenture lad ` s 4 _I ! o "this - 2 ay _ a twoell a Y.:1% BATHKB, ,ewidower, unwrried y f esflrst part, d._... NTAUL~COIJNG~N,~S CHRIST ON ~ z- - ~ ga ' x"Y ♦ _.'F" 3.. a , , ~ ~ is ~ ~ Iy,, _ a;;lriintiesota~'corporation * 3 ~ ~ p}!•' aTty~' t+~~'th'~seconds'Part 'i A -H • - ~ c.. ;.-:,,ate _ r ~ '~~..ai~^`r , f, - a* , TNESSETH That the said party °of the firstpnrt; for and lnbo 1deTatl of the sum of Qne~o~ l ar ($l p) 11 ~ ~,,;~•y..T", d thgr ra`luable csmside.r.4k 0A. to. him- n.hand paid by the said party tithe second part,Athe receipt wher f is-hereby _confossed andacknowle8ged, 7taB v a.V_ a. p..N +x 4+rz "•r .+Y' -,•f~a1„~, .'"'art " given;r'granted+bargained,4~sold "inised-tTeleased and qult claimed, and y these presents do.eB give grant; bargafrt, sell !~r 77 T. inlBe . elease and quit clalm unto the Bald Party of the second part d to>tits4successor8 r ]t1P747[and assigns ...tee. .yk,,~ "sF•' aE+' 3~ ? a+• jr- ..-~+a s . i 17 ' ore'~er t ollowingYlescribed real estate s1tuatcd jri theCounty ut_-: t Croix 0state of Wisconsin,to-wit: - w A11 that part offCovernment Lot Three 3) lSection Six (6), ownship Twenty-; igh 28)North;RangeiNineteenjl9)West;°lying outhfandWestofthee ollowingde cribed~l to wit : b b eginniat a pint?onithesEastjline+ fl{'said ng o Lot Three {3) Forty {40)ifeet North of the Southeast corner of>saidw:Lot Three (3 ; th'ence ir West4onsa*1ine~paralleltwith 3 the(South line', I! said 'LotMree'(3),aI'distance<of Six* Hundred .Ninety -four land%twenty- ninehtlndredths69429)feetto.apoint=Forty.=feeNorthofathe`bSouth lineofsaidLot Three (3);'thencekNortherly, in a straight`$line t e point.on the{North line. ofksaid K;= Lot Three-(3)~locatedcSeven'=Hundred FortY-three an sevent .79) y,-nine hundredths k'(743 " feet%Westy,ofthe )kEastAine" of*'said,Lot Three (3) °a dAthere~terininating. ; -'vtThis^•deed is;:given sand:acceptedffoi t fpurpose ofddefining and4tesolvingY ' Iii uestions astto=thetlocatio 4 n .of~the4boundary*l nelbetween sthe~ lands?owned by?parties l hereto. rf 1 '77, ,y O HAVE AND TO HOLD the. mw; together with all ,nnd singular lhe"nppurtenances and privileges thereunto belonging r i1i°envwlso illerounto aPPCItalntng slid all:ihe estate'rigllt~, title; in re L i ld cluiliiwhatsoover of.tl)e"said part Y.-:. of the ust,part;~,either in law or equity' in possessloil or expectancy of tu.tlio,only,proper use benefit and bohoof of the Said I a " )art y 4of the second part, itsAsuccessors.. ~]Srta>t5 and ssigns forever. x r 3N,tiYITNF.SS_NHEIiEOF, tho said part-.y of,the first part ha. hereunto set _ h his _ lland.::::and -4 peat r is _ -`7 ,*2nd ~a dayo~ ~ 'arch ~ ~ ~ 6U A .D.. 71 74 _ ~ ,)ffi.~,};i)r,l:,lnil tit,It•d In 1'Ir•~;iliceu( - ~ ~ ~-.:f,(s):n1.) _ F~sH %Bathke % REAL) ~'~'.~•r , - M ~TuneHudson q.Wls~ %c - 4 AL) A.ALaurence 4Qavis '~TATI 1611 1 R&asey. Umitj'` ~1'uwn illy t ume More pie; this March , A U 1).;,•60 > x- 3nd clc ati of K a tht 1Lovc n milli F H. Rathke, a .widower;'l untnarri ~T>. ufi v ,a11w me~kjjmV;it jo e~he jxr,un who executed the fort-groinb I . nliutni~vtd ackn6w1 tlbtrd Ihii- n .r r A u S CiY~S:, r~ tr a A tauren:e pevls~ 4.1 ft~L d 1olMheco;ci t! s kZth__ _ _ T Vot. r3'1'ublic twOeY r(fixiutl "l c`: Minn. w Ali, ~N(y 'ommi+sim expires ' ; , ~ X51?) day of .71c:3rCh_ 19Gg •f Seet~NfiMt~t (eft 9F~1N RIw<onrin iStrtuur provtdn that trument be worded shalt have plainly rlor n thereon the r ~ pAP n- F ama pt the Aek 101's. ~rsntrrf wttneun and notary): floor, :tiR": PtirxM1a @rs. t+b''n6F: ; . +d"b~)~{a :sv `1,'o- Ali f .sLarr ~',5fa:.w WARRANTY DEED STATE OF WISCONSIN-FORM No. I ¶u. I r. e. rxw ca. r.e. c,..w.ns, rara.eee YJ37J9 r Received for Record this.... ..__......day of nk _...-_6......... T A. D., 191...._.at_/(lLS...........M. N~ Register W Deeds. j This I1 a Cl} l u Cq l.l Made ibis day of..... - %/Q. A. D. 19-- III p. - botween--°;:1A1L~f11~_5~:,/..ld/ :.unrv.+--•_/ GQ~cC iJ.: GGd/~L[ ./vLSa.l t e~ f .f/ UL4(f. Nwt~uArt..~------°----------------...................... - i, ° / y/ /J - - - - - ° ~ - f- , P t.uA.__of the first part, and pr ..-----...._-_....~i/.~LL( ~s.-..Zf1f1.1 -l' 1~1~1fli -rL- 'W. S!~li' fl the second art WITNESSLTH, That the ~pid part..4"....of the first part, for and in consideration of the sum of--- 1 Ufa <Y cC at~d./ .•rt ClalleF........°---...._.-...___. _ I..........~ ....4~ O...U:.... t+ Ir to . LL-.._........._-.in hand paid, by the said part ..-(q~..--..of the second part, the receipt whereof is hereby confessed and acknowledged, ha.r/--a..- Ij given, granted, bargained, sold, remised, released, aliened, con6eyed nn Q/}}c-o,ppnfirmed, and by these presents do.1!..._._give, grant, bargain, sell, remise, release, II alien, convey and confirm unto the said part__ ..-_..of the second parWlalrl~C~ Qf~-•---Hefia and assigns forever, the following described Real Estate, situated in the County of St. Croix, ud StatoV Wisconsin, to-wit: i i /i~/ov/L1~/G Lf.LLt_al ALV (3),1,the4l tPJV/~u; C6l r, ~e f ec ) ~ 00 //,c~%~it, ~i`(~u g~-/I'~Lucrc.~..Q/ri >/.,rtiw,~xuv (/9~ ~.Gu~iu~GJ ~~,our,~,cn~%1[~.~tfiCtdtlL~J-,,uane~i~ ~~.~j• ~l°/I. I ~f III! IpA li I ~~~ia~~%G~~ G~'~~~~ • nI ~f1 ,tai - dce~~;~/..e.ete~~e/~.u..t..o~.~ ~ ~ N"" ~ . IAI 1 ~i iii III I I; '~I I;I TOGETHER, with all and singular, the hereditaments and appurtenances thereunto b.Aonging, or in anywise appertaining; and all the estate, right, j , Ju tltlo, interest, clahn or demand whatsoever, of the said part -".__of the first part, either in lava or equity, either in possession or expectancy of, in and to the IIP,. above bargained premises, and their Hereditaments and Appurtenances. i TO HAV AND TO HOLD the said premises as above described, with the Hereditaments and Appurtenances, unto the said part. y___ of the second part, and to...'~ Ll~/ ...M. /Y.... assi s O EVER. 9 0 I' .7h a AND THE SAID..... IjI) - - ° - - - - - - - - - - - - - - - I for... . ,.LAi..........._- 3911 heirs, executors and administrators, do covenant, grant, bargain arid agree to and with the said part... ......of the second part / __heles-and assigns, that at the time of the enseaifng and delivery of these presents I~ 1 lG!?~~~ll~ ...............-..................-...........---.---.....well seized of the premises above described, as of a good, sure, perfect, absolute and I I FF indefeasible estate of inhorit ce iu the law, in fee simple, and that the same are free and clear from all incumbrances whatever (I - - - - - - i and that the above bargained premises, in the quiet and peaceable possession of the said part-. --_...of the second part,r!!44~GLf1 heirs and assigns, against all and every person or persons lawfully claiming the whole or any part thereof,._ p N - - ~I will forever WARRANT AND DEPEND. IN WITNESS R'lIE O the said partct.A __of the first part ha...hereunto set_.__... Lt~ . handya--.and soaLa_..thls..-._/t`~ t i lull day of---------- - A. D., 1911_- ,i 14 . Sign ed~nd So died in Presence of i - - - - - - .ISEAL /~V - - - - - - - -------ISEALA j 'i INI i STATE OF WI ONSIN, ! ~iGJ t Pers onally St. Croix bfCounty. hiIss- / 3 l~ - ----day - - - - ------•A.D.,19---• the above named-- Ilpll - - - - III to me gown to be the person.- "'-who executed the foregoing instrument and acknowledged the s inni//..,, /11/1I i ' • II ~ ~YY Nctary Pubuc---.----------^ ~ Wletwf--------------county. Wis. I i My Commission expires-..- ._-A. D.. I9ll__ I I f ' ~ jlgJt i+ (~~~3 A (/1l-r~,/~/Y~~' 11J~~ r~~~C.UN.A ✓ o ' ~~lQ~~GZIs+a r.~lsze ~~i~..Lar:,~CG -t n, ouu uenc~,~, ~i~LLU.,1~(ur~~ ~~a ,~C~.v ~ outJ¢ //i.~~'7i' ..f/,~,,e~s~~i~f~'~CCill~o~2 Gf/~'~`~(~/co/~iZ ~C~~o✓j~r/ir,~~n/ ~d/u~~~~` f f p/~,.-i ~~J'ili1/(~ ~ ~bY. ~?''!~r ~ „'f1.(~ ~~~~~1t~yl.,~~^~"/1 ,!r 6~U / ~~i• J/I / /r ~~~iG74- AfIP" i rt'rMfn.t ,~~Q,~'%b' ~T f~1!✓~!I ,l1iL/1~% A,; ~y.Cy,(..f~~i'Lf?f'~ .d~1G%'L'!~~ ,~~'r'~iLP~ ~t/,~~`.(riL~,uv~ ~ e/,t~il~/l~iZr~ ~',f r/Ot~prY?f~9lfl~l ~ ~ -crv,fLf~esti/le,,CL~1lC'('~, •~,w ' ~ Odl~,fir~tiu+ i.~.~iid~au~! eJ.Lfl~j,~~~,ur2u (~%1,~./Cc~~ ~L~Lr2~~~•~ ,•y,/u LII.C~r /liG~flL~~~Gf?iZ[/1Gf ~~~/YDL(E~if~ ~tti(!i/~rl ff/f(~if~ fir. ~ o- ~l/~ ?~GsJE~ ✓~SfL~~Ec,~tLM~~a:42 hmfmw.ftit n!~,/1 ~fi~tr..~flGtrLl~~l71 Jn i 2,' r L~u~~,Grlel 1-14 V, h) aeCa2 ~i id ~~~/UC[.G l/ di~G'uh7~ ~-GGL,d • G~lu p~ ~CZir~l~ ll.(i/P.+vt/1~ /~D /rrtiiGl~Le C/ Lk'Lu~l 9 ` ~ oLGt~ V ~C~li .l~ rz, l - - - z- State of Wisconsin ` Department of Industry, Labor and Human Relations PRTVATf KWACE Pl. ON APPROVAI. SAFETY & BUILDINGS DIVISION 1~ v U tll;~1~ i I' AUiv °261087 ZONING QFFICE iii'~~ ,lt ~ r''illi li`'r•.~~ r, r i , .,.d. ,_cl~l. :!iJi ~e'l .I:~ ,}~I fl+jl i)li{ r• t~i„r~'. JIM; Ji khi;11.i ct. 1.9 M/ ;`r'.I fii {;.:tr !-%i i A 1;M.1t,t<i1 1'4 {r' i't 1act ',jow. X AI1 is i ? r . ii,f yi'l is t .I on, ,1 , 1 %.,j cii,li'1 i. I..1` ~+1• ..;':ii: i i. , i t:(~,` i tt'i I;[rttii,rtr..l t.,a+i'.', .,111Ct ,I, ri „?S.: „ r'1-i Cop {.ht I': +rla.. i,,,l h ~:"1 „ 1t?atFd for. . t , i .Ire ? .i, ,.~9 on i. ~,aC:.1.. , 1 ; mopkw ~ "Iw-! J,,.r, +I ~:f i.. .;'ia .i:.{ II. 145, wi ,'-"win ',1', (adlpn '.i-0 :,116 ~i Yl ""Vklii'ai 1',!F = I nj'i'.: f~{ I , u1u I P 1 i , 1 q i , , ,l v I , , up"n , . 4111') :11'1: r'• with Wt , i : ~ i . t , ; Mown ):I l!'a' I'1i.',!"r oil 0,014 s,w , 'il'!, b' or r, .'l. F217 iii ;.;O .,;'I 1-n , pl . ,...p. 'r')q 1.?w , i i r'.tA-r'.,, own iv I'11.n1.nod 10i i'I. I, H on 1h; 1 , it on i,ha ,,i r- ; ",Mii .r 1 .i ,i, i„i' inn ,;1i:.pr!I, r;'i!I r An fl,stea l- i'tn ~ 1 not 1 1,. ,ai:?14t i,}, in .y"r.r1. ,.i:l,.;t.,l c. 1 Ion ho _i Thin ,;ii`I,I i:w"I. will P;(I:il! 1-n y,`,..._ir;; MA (.hi. n„. IS1„ r.. -orii i ..e F.. rMi ti . It-PA i will xp `h day h ;Al,:! ai'17 avy x0101' 61xpirw; tlc:,it of e'I'1 101,,,:, ,t`Lvie;tc:j o il:ar. .;...'Na,-,:,ai'i 41,. Q',il t.:.," , i`f'•',11.1rws, `Uffl 1-.00. f~~r Ik{ j ',EIP C2 ~ ~I1~ " 1 iC. I) t r111 , +lu ~ 1 i l;~t~ '!i ('f i lz(>a 1'` , .:f ,i. {c'1;1 i,1 L}.'! .,Il-•il t,.r t"v ti': in W' t 1,ol i.i i'1) f[`c r'1;..:r'i.1i p1..lrhhin "r !h limp! of 00 'i•I :i. (~,1i1 t'i F;<:il,i 1 i'} + " 1,! Ci,.. v 11.1 ,Sc1.S+, r1 ;',4.::a 7 1 Cor thp Q nq : -',11'1j-<,17wn 40v 1li..ir.i ~~111•.lii~iit)ilii1i Ili.'ilr I-1, •:..i thI :;1In p ,:wa. 4: v 1 iii 1,:, by -{1i 17r'q f An 30- a DI LHR-SBD-6423 (N. 04/81) r State of Wisconsin ` Department of Industry, Labor and Human Relations Air SAFETY & BUILDINGS DIVISION W i t lit. ,<,fl h! , , s.E "r ({'1i1 ` Pi y ,ar ci (ti f~ 4`s ~ lr! ;'3~, ;.;;~r:;' ~ ,,.t ,~i";t" t!nrL~lit;°.j_t.i::'i;t:tt.at'?"~'~ DI L H R S B D-6423 IN. 04/81) I f State of Wisconsin ` Department of Industry, Labor and Human Relations SAFETY & BUILDINGS DIVISION July 16, 1987 201 E. Washington Avenue g File Number E-76423 P.O. Box 7969 i Madison, Wisconsin 53707 Mr. Robert Burow Robert David Burow, Architects 750 South Plaza Drive t Mendota Heights, Minnesota 55120 Dear Mr. Burow: RE: St. Croix River Center St. Paul Area YMCA, Owner Co. Rd. "F" tk Town of Hudson, St. Cro,, County Plan Number: 87-07-01VB Volume: 107,259.5 Cubic Feet Robert D. Burow, Suprv. Professional Building plans have been reviewed for compliance with the important code requirements set forth in Chapters 50-64 of the rules of the Department. The plans are stamped "Conditionally Approved", and construction may proceed subject to local regulations, but all items that are required to be changed by this letter must be corrected before commencing that part of the work. This plan has not been reviewed for compliance with Chapters ILHR 82-86, the plumbing rules of the Department. { You are hereby advised that the owner as defined in Chapter 101.01(2)(i) of ! the Wisconsin State Statutes is responsible for all code requirements not specifically cited herein. The building will be inspected during and after construction. The owner shall notify the state building inspector and the local building inspector before taking p ssession of the building. ILHR 50. Evidence of approval. The architect, professional engineer, designer, builder or owner shall keep at the building, one set of plans bearing the stamp of approval. ILHR 55.02(2m)(r_) Plans call for loft area, this area shall not be used for any purpose; detail 4-A5 I Mr. Robert Burow .L1 Ly. 3.6 , 1987 Page 2 ILHR 52.04(8) Toilet compartment shall be sized per Table 52.04-B. ILHR 64.21 The cast iron stove shall be a listed appliance and shall not be used for heating the building. ILHR 55.29 Mechanical rooms are required to be separated from the rest of the building. Plan shows a combined mechanical room and janitor closet. This combination in one room is not permitted. ILHR 55.29 Submit details of 2-hour mechanical room. ILHR 63.22 Underground duct shall be insulated. ILHR 50.12 Truss plans and calculations along with the proper fees and signed Plan Approval Application Form (SB-118) shall be submitted to this office and approved prior to installation of that component. All component plan application forms for buildings greater than 50,000 cubic feet in volume shall be sigr,ed by the building or component designer and the supervising professional of the project. ILHR 50.12 HVAC plans and calculations along with the proper fees and signed Plan Approval App' cation Form (SB-118) shall be submitted to this office and approved prior to nstallation of that component. All component plan application forms for buildings greater than 50,000 cubic feet in volume shall be signed by the building or component designer and the supervising professional of the project. This building is classified as No. 8, wood frame unprotected construction. Sincere y, i John S. -Eagon Chief Architect, Plan Review (608) 267-9706 JSE:skc:0499e cc: R-4 Lecy, (715) 345-5336, Friday Hudson Building Inspector St. Paul Area YMCA YMCA of Greater St. Paul 194 E. Sixth Street St. Paul, Minnesota 55101 CAMP ST CROIX ST. PAUL AREA YMCA 1 June 3, 198 Tom Nelson Zoning Administration St. Croix County Zoning Office P. 0. Box 98 Hammond, WI 54015 FROM: John Duntley, YMCA Camp St. Croix RE: St. Croix River Center Building On May 19, 1987 we discussed the St. Croix River Center building that the St. Paul YMCA Camp St. Croix intends to build at the camp in Troy Township. You indicated that the new building construction cost would need to be less than 50% of the total assessed value of the existing camp properties. As you requested, I have enclosed copies of our 1986 real estate tax statements which show a total assessed value of $515,205. I have also enclosed a description of the St. Croix River Center building which details the design, site plan and cost estimate of $240,000. Please respond as early as convenient with your approval so that our construction schedule may proceed. Thank you for your assistance. Sincerely., jo Dunt11 ey Camp Director JD/cal Enclosures COUNTY ROAD F HUDSON, WISCONSIN 54016 (612) 436-8428 Y.M.C.A. CAMP ST. CROIX HUDSON, WISCONSIN COMM. NO. 8607 PROGRAM REQUIREMENTS 4-16-86 ST. CROIX RIVER CENTER The River Center would satisfy the program requirements of an Entrance Pavil l ion, Tripping Center, Nature Center and Administrative functions. The building would be located prominantly on the entrance circle road convenient to parking and the camp commons. PAVILLION: As an entrance pavillion the building should visually welcome those who enter the camp and reinforce the sense of arrival. The pavillion should provide shelter for approximately four bus loads of kids or about two hundred. The pavill ion space would be used to welcome incoming guests and make group or cabin assignments. The pavillion would also function as a gathering point for external tripping and the nature program. TRIPPING CENTER: The tripping center or trail room would be located adjacent to the pavillion space with service access from the entrance road. The tripping center would provide space for year-round trip planning, packing work space, equipment storage, food storage, assembly/dispersal and equipment rehab. shop. The tripping center would be somewhat integrated with the pavillion and nature center functions. Assembly areas would include nature interpretive displays depicting habitat, geography, geology, history, weather, etc. The displays and facility would be arranged to communicate a concern for Y.M.C.A. and sound ecological values. NATURE CENTER: The year round nature center would be located adjacent to the pavillion space with shared functions with the tripping center and administrative facility. The nature center would include a classroom (or a conference space for about thirty, a nature laboratory and display storage space. ~iassroom space wouia be used for teaching nature groups, administrative conferences and for specilized trip planning. The nature l aboratory would be used by the staff and voI unteers to assemble displays and prepare work projects and experiments for the nature groups. The lab would include a sink, refrigerator and adequate work space. The lab should have direct access to the display storage space. - 2 - ADMINISTRATION: The administration area would be located adjacent to the pavillion with visual control of the entrance road and camp commons. The administrative area would include open office space for five staff members, a computer work station, a work room, director's office, toilets and access to the nature classroom for staff conference use. i i I Y.M.-C.A CAMP ST. CROIX ROBERT DAVID BUROW ARCHITECTS, INC. HUDSON, WISCONSIN 750 SOUTH PLAZA DRIVE MENDOTA HEIGHTS, MINNESOTA 55120 COMM. NO. 8607 PROGRAM COST ESTIMATE ST. CROIX RIVER CENTER KELLER CONSTRUCTION, INC. PAVILLION 56,000.00 4,000 sq. ft. x $14,00/s.f.. = $56,000 TRIPPING CENTER 1689712.00 NATURE CENTER ADMINISTRATION 4,064 sq. ft. x $36.00/s.f. = $ 152,712 Stone Fireplace............ = $ 16,000 I I SUBTOTAL $ 224,712.00 CONTINGENCY...... 15,288.00 TOTAL $ 240,000.00 i I i • i I I LLLLIj o 'l MJ I o ~ ifl ' 147 ob. , -9t 4. ,ro ~ w L, ~•rvr, 91 1 ~~.,w, ~ V I I I Jq fry J•! V C I I \ w do, 1 I j \ I I ♦ _ w- l 1 I I V I ~ ~ I I ~ i I I E E IPT 5 7 V % 1 I _ ^ 0 F47: I a ! -2v i ° i I I l ~ I ' F Flr ' 1 7+WV ffrn~ y -M s (I - tea. SO" ~ - ]fON c.nu - a< t kit o I 1 ~ a I ' 1 r s _ I O t~~ 1 I ~ y if~J~ t I a~ I I I *9J - --y-_ I - - 3J t I ` 1 s^ i y. I i , I! 5 FIFO 9 1 I fu Jn xa xa ~r~ su 1 ~ u I U r I I, '11 I ~ , I I III I' I I 11 I ~f .rl I II III II 1 I~ II II ul~';I" IIi ij~ • I I it I i~~ ~ 11 ~ ~'ll~- l I II I 1 I' I 1 I I I L ' III'!. I 11 I , i 1 I I I I ~ ~ ~JIA`\\ i 11 i it * ♦ , IIIIIt ,I i ~ ~ 11 11 ~ i y1 7 I I I ~I II 11 II I II II~i 11 ` II ~ li!I•; II II 1 li . IIII I~ IIIiI.I' .r j if w i1~I`I ii I 11 ii i II II I I _ ~ I II _ I i1• ~ Y II' I, II,; 41 I 11 6a . _ - ii I ~ •-I1 ~g I I - II I I J , 'I I III ~I • ii I UU .'I 11 ,III' . ; I I I I 1 ~ i '_'~1 I I! I I s ~R' 1 I 1 r u 1 w II O Y ~ ~ li'Iln , STATEMENT OF REAL ESTATE TAXES FOR 1986 ST PAUL Y1 0 C A T E ROBERT S BROWNS TOWN OF TROY O A ROBE OF TROY CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NUMBER SEE REVERSE SIDE FOR IMPORTANT INFORMATION c S R3 SON 47 COUNTY OF ST. CROIX 1 RECEIPT No. it R RIVER FALLS, WI 54022 BILL NO. 1.RSTATE OF WISCONSIN E THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 3, 484.77 R nsscssco vut,E Lasn AssESSCD Vnu;E IMVaovEmENTS ITorAE nss[ssED VALUE AVE. rosMT. ann~ [snr.~XTED Fua MnRKET vAl TAE STATE AID USED TO REDUCE TAXES 1 , 087 . - 24,600 57.600 62, 200 .7779 105"700' STATE SCHOOL CREDIT 351 .77- STATE GENERAL GOVERNMENT CREDIT 74-90- TASI.l. JURISDICTION 2. TAXES BEFORE ESTIMATED 3. ESTIMATED MAJOR STATE AIDS 4. TAXES AFTER ESTIMATED 1. MAJOR STATE AIDS & CREDITS USED TO REDUCE TAXES MAJOR STATE A- 13 NET TAX AFTER STATE AID & CREDIT 1 , 971 • 03 TATE 21.13 OUNTY 643.17 13T.83- 511.34 OWN OF TROY 210.98 119.26- 91.72 O CHL-HUDSON 2,391.84 784.07- 1,607.77 T OC SCHOOL DIST 1 217.65 51.91- 165-74 H R ! TOTALS 3;484.77 1.087.07- 2,397.70 i STATE SCHOOL CREDIT 351.77 t , 971 • O3 STATE GENERAL GOVT CREDIT 74.90- TOTAL DUE FOR RBL PAYMENT ► I NET TAX AFTER ST. AID & CREDIT 1,971,103 PAY TO LOCAL TREAS. B'02/28/87 C) OR PAY 1st INSTALLMENT 2nd INSTALLMENT IMPORTANT: BE SURE TH15 DESCRIPTION COVERS YOUR PROPERTY TOTAL NET TAX RATE .023978454 INSTALL PAY TO LOCAL TREASURER PAY TO COUNTY TREASURER MENTS SO6/T28/RT9 ACRES 55.440 OF. 985.52 983.51 PCL• 06.28.49.89 BY 02/2t/87 BY: 07/31/87 SEC 6 320N R1 9W ~S AC✓2f Gen Prof. SIRR,,A Special ChEL 35.41 AC GOV LOT 2 C ST 'PAUL Y M C A D, Ut ^.,PS. P,id Paid Del. .d Priv. Forest Paid and C~ 6. a[r2s 475 CEDAR STREET Ch" Paid C Pa'd TaANRI X ST. PAUL, MN. 551 Of TOTAL AMOUNT PAID QC VQS BALANCE P0111ON1. OR DELIQUENT TAXES DUE PAY TO COUNTY TREASURER RECEIPT (NOT VALID UNTIL CHECK HAS CLEARED ALL BANKS) PAID BY RECD BY DATE - STATEMENT OF REAL ESTATE TAXES FOR 1986 :ST PAUL 040-102670-001 T' . R'." ROBERT S BROWNE TOWN OF TROY L E CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NUMBER O A TOWN OF TROY - SEE REVERSE SIDE FOR IMPORTANT INFORMATION cs.. R3 BOX 17 COUNTY OF ST. CROTX A U'- RIVER FALLS, W# 54022 BILL NO. RECEIPT NO. 2R E STATE OF WISCONSIN R THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 501.10 ASSESSED VALUE Unp ASSESSED VALUE IMKO.VEMfNTS TOTAL ASSESSED VALUF AVE. ASS"', RATIO ESTIMATED FAIR MARKET VALUE STATE AID USED TO REDUCE TAXES 1 56 . 3Z #0,700 1120 11,828 .7779 1,5 ,200 -STATE SCHOOL CREDIT 50.58- 1. TAXING JURISDICTION 2. TAXES BEFORE ESTIMATED 3. ESTIMATED MAJOR STATE AIDS 4. TAXES AFTER ESTIMATED STATE GENERAL GOVERNMENT CREDIT 10.77- MAJOR STATE AIDS & CREDITS USED TO REDUCE TAXES MAJOR STATE AIDS NET TAX AFTER STATE AID & CREDIT 283.43 3,04 OUNTY 92 49 18.96- 73:53 OWN Of TROY 30.34 17.15- 13..19 T CHL-HUDSON 343.94 112.73- 231.19 O OC SCHOOL-DIST # 3#.29 7.46- 23:83 H R (-7 r'J OTALS - 501.#O 156.32- 344:78 -STATE SCHOOL CREDIT 50.58 263.43 l STATE GENERAL GOVT CREDIT 10..77- TOTAL DUE FOR FULL A PAYMENT ► NET TAX AFTER ST. AID & CREDIT 283..43 PAYTOLOCALTREAS.By2/28/87 c OR PAY is[INSi 4LLME14T 2nd INSTALLMENT OIMPORTANT: BE SURETHIS DESCRIPTION COVERS YOUR PROPERTY TOTAL NET TAX RATE .023978454 INSTALL- PAY TO LOCAL TREASURER PAY TO COUNTY TREASURER MENTS SO6/T28/R19 ACRES 48~900 OF► 141.72 141.71 PCL• 6_28-19.88C BY: 02/21/87 By. 07/31/87 SEC 6 128H R#9W 18A PERT SE Gen. ".P Special men.; Chg. NW =INCLUDING S 1/2 RR R/W ST PAUL Y M C A °aid a+s. Fzld Paid Dei. L'lil. . F- XV Oadw,R1 = 475 CEDAR STREET Che. Paid Cep PaIC .x Paid /3 4(✓e5 ST. PAUL, MN.. TOTAL AMOUNT PAID 5 GCV2S 55101 f BALANCE Po>TPONEO OR OEL pL,ENT rAXES DUE PAY TO COUNTY TREASURER - RECEIPT (NOT VALID UNTIL CHECK HAS CLEARED ALL BANKS) PAID BY RECD BY DATE STATEMENT OF REAL ESTATE TAXES FOR 1986 ST PAUL YMCA 040-1026-50 T RROBERT,S BROWNS TOWN OF TROY o E TOWN OF TROY CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NUMBER COUNTY OF ST • CROIX SEE REVERSE SIDE FOR IMPORTANT INFORMATION G S R3 BOX. 17 BILL NO. RECEIPT NO. rR RIVER FALLS, Y2 54022 E STATE OF WISCONSIN `~R THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 91 0.1013 ASSESSED VALUE LAND ASSESSED VALUE EVER VEMENTS TOTAL ASSESSED VALUE AVE. ASSMT. RATIO ESTIMATED FARMARKET VALUE STATE AID USED TO REDUCE TAXES 284 . 14- 20,750 750 735 21, 485 .7779 27~600 `STATE SCHOOL CREDIT 91.94- TATE GENERAL GOVERNMENT CREDIT 1 9 . 58- 1 XING JURISDICTION 2. TAXES BEFORE ESTIMATED 3. ESTIMATED MAJOR STATE AIDS 4. TAXES AFTER ESTIMATED MAJOR STATE AIDS & CREDOS USED TO REDUCE TAXES MAJOR STATE AIDS NET TAX AFTER STATE AID & CREDIT 515 . 17 552 5.52 -x68.11 34.46- 13365 TROY 55.14 31.17- 23:97 $ 06 DSON 625.47 204.94- 420.23 OOL D3S7 1 36.89 13.57- 43,32 `'7 R 910.83 284.14- 626:69_ L CREDFF 9 t . 94 AL GOVT CREDIT 19.58- TOTAL DUE FOR FUI L PAYMENT ► 51 5 . 1 7 _.,_.,,r 515. 1.7 PAYTOLOCALTREAS. 8,02/28/87 i `T^ STATEMENT OF REAL ESTATE TAXES FOR 1966 'ST PAUL Y M C A R 040-1030-80 ROBERT S BROWNE TOWN OF TROY L E O A TOWN OF TROY y CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL N'L MEIER CS R3 BOX t7 COUNTY OF ST. . CRO#X SEE REVERSE SIDE FOR IMPORTANT INFORMATION L R RIVER FALLS,. WI 54022 BILL NO. RECEIPT NO. AD ` E.. STATE OF WISCONSIN :.,R THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID S CREDIT 886.03 ASSESSED vnLUE IA~D I~-ES.EO VAII,E'nIPNOVFMENTC Ti)1g1 ASSESSED VALUE AVE. ASSMT. RAllp ESIIMAEEO FAIR nURNEi VAII'E STATE ADD USED TO REDUCE TAXES 276,40- 230, 9 0 0 20,400 .7779 26,900 STATE SCHOOL CREDIT 89.44- , L TAX- wfllSDalON 2. TAXES BEFORE ESTIMATED 3. ESTIMATED MAJOR STATE AIDS 4. loxes AFTER L<11AUTED STATE GENERAL GOVERNMENT CREDIT 1 9 , 04- MAJOR STATE AIDS a CREDITS USED TO REDUCE TAXES MAJOR STATE AIDS NET TAX AFTER STATE AID & CREDIT 501.15 STATE 537 5.37 COUNTY t63.53 33.52- 130:Ot jTOWN OF TROY 53.64 30,32- 23'32 CHL-HUDSOH 6108.15 199.36- 408.79 O 'YOC SCHOOL DIST 1 55.34 13,20- 42;14 T H 7 E d / OPALS 886..03 276.40- 609-63 0 ~o STATE SCHOOL CREDIT 85.44 Z j STATE GENERAL GOVT CREDIT 19. 04- TOTAL DUE FOR FULL PAYMENT b- 501.15 l7 { NET TAX AFTER ST. AID & CREDIT 501.. 15 PAY 10 LOCAL TREAS. 42/28/87 E IR PAY Ist INSTALLMENT 2nA INSTALLMENT I '.IMPORTANT: BE SURE THIS DESCRIPTION COVERS YOUR PROPERN TOTAL NET TAX RATE .023978454 INSTALL- PAY TO LOCAL TREASURER PAY TO COUNTY TREASURER MENTS S07/T28/R#9 ACRES 40.000 OF. 250.58 250.57 tPCL4 7~28.19..102 BY: 02/21/87 BY: 07/31/87 SEC 7 T28H R t9W SE NY ee PmP o al -11, Chg, T~~ JA } ST PAUL Y M C A P.f Paid PaiA Del. Ulil. P Foreal ltiwtliand 9 Q ✓ ChR. Paid c Pald Tat Faid 7 475 CEDAR ST. LLL 6 3 ST. PAUL, MH. TOTAL AMOUNT PAID 55101 TAXES BALANCE Po10 OR DfLIQUfNT DUE PAY - A V Y 10 TY TREASURER ER _ RECEIPT (NOT VALID UNTIL CHECK HAS CLEARED ALL BANKS) / PAID BY RECD BY DATE I T STATEMENT OF REAL ESTATE TAXES FOR 1986 ST PAUL YMCA LE ROBERT S BROWNE TOWN OF TROY 040-1024-70 O A TOWN OF TROY CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NU• C S R3 BOX 17 COUNTY OF ST. CRO'IX SEE REVERSE SIDE FOR IMPORTANT INFORMATION AR RIVER FALLS, WT 54022 Bill .NO. RECEIPT NO. E STATE OF WISCONSIN R THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 59 . - n-SSED VALUE LAND nssESSED VnIlT uuvovEMEATS IOTA) ASSESSED VALUE nvE-nsMr. R11111 ESTIMATED FnIR AARnn vnuLE t STATE 410 USED TO REDUCE TAXES 1, 4 0 0 1.404 .7779 1, 8 0 0 E STATE SCHOOL CREDIT 5, c l . TAxINC IuRISDIaRr\ 2. ux.. B.... R. fsnc.ATTU 3. E5U-TED MAIOR STATf AIDS 4, TAxE' AFTER ESTMATED ;STATE GENERAL GOVERNMENT CREDIT 1 • s STATE MAJOR STATE AIDS & CREDITS USED TO REDUCE TAXES MAJOR STATE AIDS NET TAX AFTER STATE AID & CREDIT 33 COUNTY 10.96 2.25- 6.71 TOWN OF TROY 3.59 2.03- 1.56 ;SCHL-HUDSON 40.73 13.35- 2738 to VOC SCHOOL DIST 1 3,70 Be- .2,,82 T H - R 671H TOTALS- 59.34 18.51- 40.83 'STATE SCHOOL CREDIT 5,99- STATE GENERAL GOVT CREDIT 1 .28- TOTAL DUE FOR FL/L~t PAYMENT ► 33.5. NET TAX AFTER ST. AID & CREDIT 33 P56 PAYTOLOCAtTREAS.BTV2/28/87 IMPORTANT: BE SURE THIS DESCRIPTION COVERS YOUR PROPERTY OR PAY ls1 INSTALLMENT 2nd INSTALLMEN TOTAL NET TAX RATE .023979454 I\STALL- PAY TO LOCAL TREASURER PAY TO COUNTY TRL: SMOT28/R19 ACRES 2.000 OF M p PCLM 06_28.19.838 OF► 33.56 SEC 6 T28N R19W BY- 02/2t/87 BY: 07Iclig, . Paul Syecial Chg. j PT SW HE THAT PT OF SW NE SY pAUL .YMCA PaiA° A. Pald NO i LYING SWLY OF RR R/W 11 Dc. Ulil. P„F.- w..dlam - FORMER 100' RR R/W 475 CEDAR C -d Cop Paid Tav Paid ST. PAUL, MN. TOTAL AMOUNT PAID C T °2 AC/ZI 33}01 BALANCE P057PONED M DELIQUENT 14X[5 DUE P,V TO COUNTY TREASURER RECEIPT NOT VALID UNTIL CHECK HAS CL EARED ALL BANK. _ PAID BY RECD BY DA T STATEMENT OF REAL ESTATE TAXES FOR 1986 ST 'PAUL Y M C A 1.E ROBERT S'BROWNE TOWN OF TROY 040-1030-50 OA TOWN OF- TROY CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NUMBER A U R3 BOX- 4 7 COUNTY OF ST. CROIX SEE REVERSE SIDE FOR IMPORTANT INFORMATION :L R R3YER FALLS, W1 54022 BILL NO. RECEIPT NO. E STATE OF WISCONSIN THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 1,059.8t T ASSESSED VALUE LAND ASSESSED -IMPROVEMENTS TOTAL ASSE5SED VALUE AVE. ASSMr. RATIO ESTIMATED FAIR MARKET VALUE STATE AID USED TO REDUCE TAXES 330 . 62 - 25 800 23,1300 .7779 32,t00':STATE SCHOOL CREDIT 106.99- 1,'TAXING JUkISDICTION 2. TAXES BEFORE ESTIMATED 3. ESTIMATED MAIOR STATE AIDS 4. TAXES AFTER ESTIMATED STATE GENERAL GOVERNMENT CREDIT 22.7E MAJOR STATE AIDS & CREDITS USED TO REDUCE TAXES MAJOR STATE AIDS NET TAX AFTER STATE AID & CREDIT - 599.46 TATE 6.43 6.43 OUNTY = 195.61 40.09- 155:52 OWN OF-TROY 64.16 36.27- 27.89 CHL-HUDSON '727.45 238.47- 496.98 0 OC SCHOOL;DiST 1 66:20 13.79- '30.41 H E R Cyr TOTALS—- 1,059.85 330.62- 729.23 STATE SCHOOL CREDIT 106.99- STATE GENERAL GOVT CREDIT 22, 78- TOTAL DUE FOR FULL PAYMENT 1- 599.46 NET TAX AFTER ST. AID & CREDIT 399.46 PASTOLOCALTREAS.602/28/87 JMPORTANT: BE SURE.THIS DESCRIPTION COVERS YOUR PROPERTY OR PAY 1st INSTALLMENT 2nd INSTALLMENT TOTAL NET TAX RATE , 023978454 INSTALL- PAY TO LOCAL TREASURER PAY TO COUNTY TREASL= MEN'TS S07/726/RT9 ACRES. 39.000 OF p, 299.73 299.7: PCL# 7.28_19.99 BY: 42/21/87 07!31!87 SEC 7 T28N R19W HE HW By. cR P p. p«al sal /3 EXC PUBLIC RD ST- PAUL - Y M C A Ta. Pa,d ,I Pmd Pa,d D%CIil. Priv. F- N.oelane AW2G 475 CEDAR ST, CnR Pad Crop Pzld T.. Pad Ci / 6 ST. PAUL, MN. TOTAL AMOUNT PAID 531- 01 BALANCE POSTPO\ED OR DEUQL'ENT TAXES DUE PAN' TO COL NTY TREASURER RECEIPT (NOT VALID UNTIL CHECK HAS CLEARED ALL BANKS) - ' PAID BY RECD BY DATE I 77 ` - STATEMENT OF REAL ESTATE TAXES FOR 1986 ST PAUL Y M C A TI 040-1027-30 -~R ROBERT S BROWNE TOWN OF TROY - ' CORRESPONDENCE SHOULD REFER TO THIS TAX P A TOWN OF TROY ARCEL NUMBER c s R3 BOX 4 7 COUNTY OF ST : CRO1X SEE REVERSE SIDE FOR IMPORTANT INFORMATION A U. RIVER FALLS.. WE 54022. BILL No. RECEIPT NO. T R-< R STATE OF WISCONSIN - ANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT THIS IS A MEMOR 7,444.36 ASSESSED VALUE LAID ASSESSED VALUEIMPROVfMfNTS TOTAL ASSESSED VALUE AVE. ASSMT RATIO ESTIMATED FAIR MARKET VALUE STATE AID USED TO REDUCE TAXES 2,322.27- t M600 f75,16CO •7779 225,700 STATE SCHOOL CREDIT 751.47 STATE GENERAL GOVERNMENT CREDIT 1 60 . 0 1 - 1. TAXING JURISDICTION 2. TAXES BEFORE ESTIMATED 3. ESTIMATED MAJOR STATE AIDS 4. TAXES AFTER ESTIMATED 4,210.601 21 0.61 MAJOR STATE AIDS & CREDTS USED TO REDUCE TAXES MAJOR STATE AIDS NET TAX AFTER STATE AID & CREDIT. , STATE 45.0 45415 COUNTY I' 1,373.97 281,63- 1,09234 TOWN OF TROY 450:74 254.77- !95`:93 SCHL-HUDSON 5,709.-58 1,674.98- 3,434.60 0 XOC SCHOOL DIST i 464.96 110,89- 354.07 H ~60 ~73 R C7 I~W _ _ 6Pt a d o5 TOTALS 7,444.36 .2,322,27- 5,122::09 STATE SCHOOL CREDIT 751 `5T,4TE GENERAL GOVT CREDIT 160:4017: TOTAL DUE FOR FL PAYMENT ► 4,210.61 i PEAR PD2l28/87 at . 7 1 n . F ' J l #A 1 tlW T 040-1030-70 R ROBERT S BROWNE TOWN OF TROY l E CORRESPONDENCE SHOULD REFER 1O THIS TA+ PARCEL NUMBER OA' NUN OF TROY SEE REVERSE SIDE FOR IMPORTANT INFORMATION Cs. R3 BOX 17 COUNTY OF ST. CROIX A U RIVER FALLS.- WI 54022 BILL NO, RECEIPT No. 1 RE E STATE OF WISCONSIN s R THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 1,047.12 "It"O' cALUF u-1 A,IOI I vuuE 1"11-IMI1T Tout Asslss1 vALUC AVE AS-T RATIO ESTIMMED FAIn KET VALLE STATE AID USED TO REDUCE TAXES 326.65- 24,-700 24,708 .7779 3j,800 STATE SCHOOL CREDIT 105.70- 1. TAXIAG JURISDICTON 2. TAXES BEFORE Ea HATED 3. E TIMATED MIOR STATE aes 4. TAXES AFTER FSTIMATED STATE GENERAL GOVERNMENT CREDIT 22.51 - MAJOR STATE AIDS & CREDITS USED TO REDUCE TAXES MAJOR STATE AIDS NET TAX AFTER STATE AID & CREDIT 392.26 .STATE 6.35 6.33 COUNTY 193.26 39.61- 153.65 ;TOWN OF TROY 6340 33.84- 27.56 O CHL-HUDSON 718.71 233.60- 483:11 OC SCHOOL DIST 1 65.40 13.60- 49.80 T 13 R - - E j FOYALS 1',047.12 326.63- 720.47 y STATE SCHOOL CREDIT 105' 70- 592 . 26 2 STATE GENERAL GOVT CREDIT 22,E 51 - TOTAL DUE FOR TOII PAYMENT ► j NET TAX AFTER ST. AID & CREDIT 592.26 PAY TO LOCAL SEAS. B02/28 /B7 0 OR PAY ISE INSTALLMENT ''1c INSTALLMENT 1 O 'IMPORTANT: BE SURE THIS DESCRIPTION COVERS YOUR PROPERTY I TOTAL NET TAX RATE .023978454 INSTALL PAY TO LOCAL TREASURER PAY TO COUNT' TREASURER MENTS S07/T28/Rt9 ACRES 40.088 OF 0. 296.13 296.13 PCL11 7-28.19.101 BY: 02121 /87 BY: 07/31/87 SEC 7 T28N R19W sw NH c n P P. R. I -RtO, iI ST'PAUL. Y MCA Pa'd A P"'d CI V D l Ulil. P F rest Noodland - yt / 475 CEDAR ST CUR. Pad CFrP Pala Pab <J U' 67 ST. PAUL, MN. TOTAL AMOUNT PAID 35701 BALANCE POSTED- OR CULIQ1E11 TAXES ~E ,YLf7 QI~R~G~ DUE PAYTOCO-7 TREASURER _ S/ tT r_o RECEIPT (NOT VALID UNTIL CHECK HAS CLEARED ALL BANKS) 1 , _-(7 Y'- /i u•! PAID BY RECD BY DATE 6 - ~^odutfiv2 ~~rr2~t ~uh~ Cis - STATEMENT OF REAL ESTATE TAXES FOR 1966 -STAR PAUL YMCA :R 040-1028-90 ROBERT'S BROWNE TOWN OF TROY O A TOWN OF TROY } CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NUMBER C S R3 BOX 47 COUNTY OF ST. CROi II SEE REVERSE SIDE FOR IMPORTANT INFORMATION A u RIVER FALLS, W I 34822 I R BILL NO. RECEIPT NO. E STATE OF WISCONSIN R THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 1,047.12 d~ 1 ASSESSED VAI UE LAND ASSES5EDVALL'EIMAE-EMENTS TOTALMSESSEDVALUE AVE. ASSMT. RATID ESTIMATED FAIRMARRET VALUE STATE AID USED TO REDUCE TAXES 326.65- 2 24.700 24,1!00 •7779 31B00.STATESCHOOLCREDIT 305.70- . _ ;I: TAXING JURISDICTION 2. TAXES BEFORE ESTIMATED 3. ESTIMATED MAJOR STATE IDS 4. TAXES AFTER ESTIMATED STATE GENERAL GOVERNMENT CREDIT 22.51 - MAJOR STATE AIDS & CREDITS USED TO REDUCE TAXES MAJOR STATE AIDS NET TAX AFTER STATE AID & CREDIT 392.26 STATE 6.33 6.35 COUNTY 193.26 39.61- 1.3365 TOWN OF TROY 63-48 33.84- 27,56 SCHL-HUDSON 718.71 233.60- 483.11 O NOC SCHOOL DIST 1 63-40 13160- 49x80 H E R TOTALS 1;047.12 326.65- 720.47 G Q :STATE SCHOOL CREDIT ;05.70- - y STATE GENERAL GOVT CREDIT 22". 51 - TOTAL DUE FOR FULL PAYMENT ► 392.26 9 NET TAX AFTER ST. AID & CREDIT 592-.26 PAY TO LOCAL TREAS. 082/28/87 m _ O 'IMPORTANT: BE SURE HIS DESCRIPTION COVERS YOUR PROPERTY OR PY 1st INSTALL" NT 2FEd INSTALLh1EN'I - TOTAL NET TAX RATE .023978454 INSTAALL- PAY TO LOCAL TREASURER PAY TO COUNT' TREASURER EVENTS S1D6/T28/R,19 ACRES 35«008 OF. PCL4 06.28.19..92 296.33 I 296.13 SEC 6 T2814 R19W Bv: 82/2.1/87 BY: 07/31/87 ' 35 AC PRT NY SE INCLUDING ST_ PAUL YMCA T,. ad x F Pad pad'a.cnR OLD RR R/W~ Del. L'lil. Pr Forest 1\oodlaM 475 CEDAR ST. ehR -d Ceop Paid Paid 3f_.0(CA1.6g ST. PAUL, MHO 3310 3 TOTAL AMOUNT PAID d LBALANCE POSTPONED ORDEUQUENTTAXES :g DUE PAY TO COUNTY TRB+SLRER RECEIPT (NOT VAUD UNTIL CHECK HAS CLEARED ALL BANKS) PAID BY RECD B1' DATE T STATEMENT OF REAL ESTATE TAXES FOR 9986 ST PAUL YMCA R ROBERT'S-BROWNE TOWN OF TROY 040-1028-80 CIA TOYN OF TROY IL, CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NUMBER C S ; R3 1909 47 COUNTY OF ST. CR03X SEE REVERSE SIDE FOR IMPORTANT INFORMATION A U RIVER FALLS, MI 54822 t R BILL NO. RECEIPT NO. E STATE OF WISCONSIN R - THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAX E5 BEFORE STATE AID & CREDIT 135.65 ASSESSED VALUE LAD A111111D VALUE IMPRDVEMENTS TOTAL A11E11 CD VALUE AVE. As1_. ESTIMATED FIR MARKET VALUE STATE AID USED TO REDUCE TAXES .42.31- 3,N20 0 3, 206 • 7779 4000 :STATE SCHOOL CREDIT 13.69- 1. 1. TAXING JURISDICTION 2. TAXES BEFORE ESTIMATED 3. ESTIMATED MAJOR STATE IDS 4. TA Es AETER ESTIMATED STATE GENERAL GOVERNMENT CREDIT 2.92- MAJOR STATE AIDS & CREDITS USED TO REDUCE TAXES "OR STATE IDS NET TAX AFTER STATE AID & CREDIT 76.73 STATE .B2 .82 COUNTY 23.04 5.13- 19.91 TOWN OF TROY 8.21 4.64- 3-57 SCHL-HUDSOM 93.11 30.32- 62.39 0 OC SCHOOL D3ST 1 8,47 2.02- 6.43 H E 7~y. _ R C9 rl TOTAL9_ 1'35.65 42.33- 93;34 .STATE SCHOOL CREDIT 1•3:69- ' i STATE GENERAL GOVT CREDIT 2-92- TOTAL DUE FOR FULL PAYMENT ► 76.73 2 NET TAX AFTER ST. AID & CREDIT - m 76..73 PAYTOLOCAL TREAS. B'O2/28/87 C IMPORTANT: RF SVRF THIS OR PAY IM 1\STALLMEXT I 2PA INSTALLMENT nF«RIPTVnN'Cn\'FRC -P PRnPFRTY n..-,n. - T STATEMENT OF REAL ESTATE TAXES FOR 1986 ST PAUL Yb8 C A R RROBERT S BROWNE TOWN OF TROY /y CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NUMBER OWN O C S A 11 R3 BOX OF 47 RDY COUNTY OF ST . CROIX SEE REVERSE SIDE FOR IMPORTANT INFORMATION A U RIVER FALLS, WI 34022 BILL NO. RECEIPT NO. I. R' STATE WISCONSIN E R THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 623.19 >ssessen auEE I AIIISSEO eALVE m,PROVEMP- Tool AfiESSED VALUE AVE. All" T. KATIO E4IMATED FAIR MARKET \ALUF STATE AID USED TO REDUCE TAXES t94.41- i i, III 0 14, 7IID . 7779 f8,900 . STATE SCHOOL CREDIT 62.91- 1 7. uxwc R6DICTION 2. TAXES BEFORE ESTIMATED 3. ESTIMATED MAJOR STATE AIDS 4. TAXES AFTER ESTIMATED STATE GENERAL GOVERNMENT CRED 11 1; 13•39- MAJOR STATE AIDS & CREDITS USED TO REDUCE TAXES MAJOR STATE AIDS NET TAX AFTER STATE AID & CREDIT 352 • 46 f STATE 3.78 3..78 COUNTY it5.02 23,38- 91.44 TOWN OF TROY 37.73 21.33- 16.40 SCHL-HUDSON 427.74 140.22- 287.32 0 VOC SCHOOL DIST 1 38.92 9.28- 29.64 H E K / TOTALS- 623.19 194.44- 42878 _ STATE SCHOOL CREDIT 62.91 -U, STATE GENERAL COVE CREDIT 1 3x39- TOTAL DUE FOR FUI I PAN'N FE NT ► 352.48 9 :NET TAX AFTER ST. AID & CREDIT 352..48 PAY TO LOCAL TREA5.B,02/l8/18 O OR PAY Ist INSTALLMENT 2nd INSTALLMENT .IMPORTANT: BE SURE THIS DESCRIPTION COVERS YOUR PROPERTY I TOTAL NET TAX RATE .023978454 INSTALL- PAY TO LOCAL TREASURER PAN' TO COUNTY TREASURER MENTS S07/128/Rt9 ACRES 35.000 OF 1. 176.24 176.24 PCL# 7.28.19.100 BY: 02/21/87 BY 07/31/87 SEC 7 T28H R19W 35A NW NW Gen. Prop. 5p 1 1 Special ChB. EXC PUBLIC RD III BEACH G L I ST PAUL . Y M C A Ta, NO A,.,, Peid Paid AS IN 436/348 Del VIII. P w,e.L N' odlnnd 473 CEDAR ST ehR P~~e amp Pea TeM Pam C7j 7 acres ST. PAUL. MH. TOTAL AMOUNT PAID 55101 - /I, / , 'E 'Q C BALANCE POSTPONED OR DEUQUENT TnzES g¢ DUE PAY TO COUNTY TREASU TA _ _ . - - - RECEIPT (NOT VALID UNTIL CHECK HAS CLEARED ALL BANKS) PAID BY RECD RY DATE - STATEMENT OF REAL ESTATE TAXES FOR 19x6. - ST PAUL Y M C A r 040-1028-30 R ROBERT S BROWNE TOWN OF TROY F TROY CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NUMBER O 0 S A R3 TOWN N O O -47 COUNTY OF ST . CROiX SEE REVERSE SIDE FOR IMPORTANT INFORMATION BOX AURtVER FALLS, 1111; 54'022- BILL NO. RECEIPT NO: IR E.., STATE OF WISCONSIN i; 'R THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 65.72 ASSESSED VALI'E UND ASSESSED VALUE IMPROVEMEMTS TOTAL ASSESSED VALUE AVE. ABSMT. RATIO ESTIMATED FAIR MARKET VALUE STATE AID USED TO REDUCE TAXES 2 O . S 0- ' 4.y35 II t 1530 .7779 2,00II STATE SCHOOL CREDIT 6.63- 1. TAXING IL06DIMION 2. TAXES BEFORE ESTIMATED 3. FSTIMATED MIOR STATE AIDS 4. TAXES AFTER ESTIMATED STATE GENERAL GOVERNMENT CREDIT 1.41- MAJOR STATE AIDS IS CREDITS USED TO REDUCE TAXES MAJOR STATE AIDS NET TAX AFTER STATE AID & CREDIT 37.18 TATS- .40 .40 COUNTY 12.13 2.49- 9-64 OWN OF TROY 3.98 2.25- 3D.7 32 H SCHL HUDSON 45.10 14. O VOC SCHOOL DIST t 4.14 .98- 3,13 T E R 7- TOTALS - 65-'72 20..60- 45-22 i STATE SCHOOL CREDIT 6 . 63- _ TATE GENERAL GOVT CREDIT . 41 - TOTAL DUE FOR FULL PAYMENT ► 37 . 1 B 2 .NET TAX AFTER ST. AID & CREDIT 37 • 18 PAY TO LOCAL TREAS. 42/28/87 O OR PAY Ist INSTALLMENT 2nd INSTALLMENT 'I IMPORTANT: BE SERE THIS DESCRIPTION COVERS YOUR PROPERTY TOTAL NET TAX RATE .023978454 INSTALL- PAY TO LOCAL TREASURER PATO COUNTY TREASURER MENTS $06/T28/RT9 ACRES 6.236 OF► 37.18 PCL4 Ob.-28.#9..900 BY: 02/21/87 BY: 07/31/87 SEC 6 V28N R'19W GR Prop. 1-11, Pe i.1 en4 T- S,11, 6.25 AC PRT LOT 3 AS TN` VOL . ST'PAUL. Y M C A Pam I A - Pxm P,m Dei. \VOOd:aM 2 #b P443 ORD c R UIi1. P res Pam c P N d Pa1E 3 /0 QuV476 -CEDAR ST. ST. PAUL, MN. 661 01 TOTAL AMOUNT PAID fHC rbFi BALANCE POSTPONED OR DEUQUENT TAXES sE DUE PAY TO COUNTY TREASURER RECEIPT (NOT VALID UNTIL CHECK HAS CLEARED ALL BANKS) PAID BY RTC D BY DATE T 040-1144-SO ILE. ROBERT S BROWNE TOWN OF TROY TOWN OF TROY CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NUMBER A L R COUNTY OF ST . CROI X SEE REVERSE SIDE FOR IMPORTANT INFORMATION G S R3 BOX t T AU RISER FALLS. WI $4022 BILL NO. RECEIPT NO. j E STATE WISCONSIN R _ THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID &CREDIT 4,444.00 ,I ASSESSED YALUE LAAL) ASSESSEALLE IMPROVEMENTS TOTAL ASSESSEDI\AIUE AVE. ASMT. RAl1O ESTIMATED fAIR MARRf{V.ALL;f STATE AID USED TO REDUCE TAXES 1.296.72- + 97 7S 0 97'7501 .7779 125; 700 STATE SCHOOL CREDIT 418.32- 1.1AxINGURSDIC~ION 2. TAXES BEFORE ESTIMMfD 3-73 ATED MMOR STATE AIDS 4.1AXES ATTER FSIIMAIED STATE GENERAL GOVERNMENT CREDIT 89 . Q7- • "OR STATE AIDS & CREDITS USED TO REDUCE TAXES MAIOR S1ATE AIDS NET TAX AFTER STATE AID & CREDIT 2,343.8079 STATE ' 23x3 2t3 I AUNTY 764c94 156.77- 608.07 +TOWN OF TROY 250.89 141.82- 109.07 CHL-HUDSON 2,844.31 932.40- 1,91!.91 D OC SCHOOL DIST t 258,03 61.73- 197.10 T H E R TOTALS- 4,444.00 1,292.72- 2,851--.28 a :STATE SCHOOL CREDIT 418+32- Z STATE GENERAL GOVT CREDIT 89.07- TOTAL DUE FOR FUIL PAYMENT ► 2,343.89 E NET TAX AFTER ST. AID & CREDIT 2,_.343.89 PAY TO LOCAL TREAS. Et'02/213/87 O OR PAY 1st INSTALLMENT 2nd INSTALLMENT IMPORTANT: BE SURE THIS DESCRIPTION COVERS YOUR PROPERTY TOTAL NET TAX RATE .023979454 INSTALL- PAY TO LOCAL TREASURER PAY TO COUNTY TREASURER MENTS S12/T28/R28 ACRES 5.120 Of o'. 1,171.95 1,171.94 PCL# 12.28.20.5748 BY: 02121/87 BY: 07/31/67 SEC 112 T28N R20W 5 . t 2A Gen. PET . p vial 1-11, Chg. GOV L 1 N OF S LINE G L 't OF ST PAUL . Y M C A Ta. Paid Asses, Paid Peld SEC 7-28-39 EXTENDED W DI.ULiI. Pnv.Porezl I,-dWd 475 CEDAR Chg. Paid Gfnp Paid Paid C~(~ 5 oACY?-r ST PAUL, MN D0000 TOTAL AMOUNT PAID BALANCE Po 70 COUNTY DELIQUENT TAXES 35 ' DUE PAY PAV IO COUNTYTY TREASURER _ RECEIPT (NOT VALID UNTIL CHECK HAS CLEARED ALL BANKS) - - PAID BY RECD BY DATE STATEMENT OF REAL ESTATE TAXES FOR 1986 ST PAUL Y M C A 'LE ROBERT"5 BROWNE 040-1027-40 TOWN OF TROY O.A ~ TOWN OF' TROY ~w CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NUMBER C S R3 BOX:.47 COUNTY OF ST. CR03X SEE REVERSE SIDE FOR IMPORTANT INFORMATION R; RIVER FALLS. W# 54022 BILL NO. RECEIPT NO. i P STATE WISCONSIN TAXES BEFORE STATE AID & CREDIT 93.27 F; R THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT ASSESSED VALUE LAND ASSESSED VALUE IMPROVEMENTS TOTAL ASSESSED,'ALUE AVE. ASSMT. RATIO ESTIMATED FAIR MARAEI VALUE STATE AID USED TO REDUCE TAXES 29.09- 2,2.. 2.200 .7779 2 800STATE SCHOOL CREDIT 9.41- 1: TAXING JURISDICTION' 2. TAXES BEFORE ESTIMATED 3. ESTIMATEo MmaR STATE AIDS 4.'-IS AFTER ESTIMATED STATE GENERAL GOVERNMENT CREDIT 2 . 9 0- MAIOR STATE AIDS & CREDITS USED TO REDUCE TAXES "OR STATE ADS - NET TAX AFTER STATE AID & CREDIT 52.77 -OUNTY ~ 1?.22 3.53- 13:69 OWN OF TROY 5.64 3.19- 2.45 SCHL-HUDSOH 64.01 20.98 4303 O VOC SCHOOL DTST 3 5.83 1.39- 4..44 T H / OfiALS. 9327 29.09- 64.18. STATE SCHOOL CREDIT 9.41 - Z `STATE GENERAL GOVT CREDIT 2. 00- TOTAL DUE FOR FULL PAYMENT ► 52.77 O --NET.TAX AFTER ST. Atb&CREDIT 52.77 PAY TO LOCAL TREAS. B02/211/87 m 0- - iMPORTAN E BE SURE?HIS DESCR PTION COVERS YOUR PROPERTY OR PAY 1St INSTALLMENT 21d INSTALLMENT TOTAL NET TAX RATE .023979454 INSTALL- PAY TO LOCAL TREASURER PAY TO COUNTY TREASURER MENTS S06/T28/R19 ACRES 8..888 OF. 50.00 2.77 PCL# 86.28.19.90C BY: 02/2t187 BY: 07/31187 SEC 6' T28N- Rt9Y Ge ProP. Spxial speala: chg. 8.8AC PT LOT 3 AS IN VOL ST - PAUL . Y M C A Ta. Paid Assess. Paid Paid 49 P 288 Del. U il. Riv. Ewe NoodlaM r G 6 o ac,,4 47S-CEDAR ST a Chg Paid Cop Paid Paid Y ST. PAUL.. MN+ TOTAL AMOUNT PAID if Y /Y / 0 cl.wo 551:01 BALANCE POSTPONED OR DELTRFAAT TAXES DUE PAr ro couNTV rRfnsuaER _ .L - . ' ' - RECEIPT (NOT VALID UNTIL CHECK HAS CLEARED ALL BANKS) ` PAID BY RECD BY DATE STATEMENT OF REAL ESTATE TAXES FOR 1986 - $T PAUL Y M C A 'yT 040-1144-70 tE ROBERT $ BROWNE TOWN OF TROY OA TOWN OF TROY CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NUMBER G S R3 BOX 17 COUNTY OF ST. CRO i lX SEE REVERSE SIDE FOR IMPORTANT INFORMATION R RILI = !.-.RIVER FALLS, Wt 54022 BILL NO. RECEIPT NO. E STATE OF WISCONSIN 'R "THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 339..16 ASSESSED VALUE LAND 1ASSESSED VALUE IMPROVEMENTS TOTAL ASSESSED VALUE AVE. ASSMT. RATIO ESTIMATED FAIR MARKET VALUE STATE AID USED TO REDUCE TAXES t 05.8 0- 1g a0o 8,800 .7779 411, 300STATE SCHOOL CREDIT 34.24- - -1. TAXING IURISDICTION 2. TAXES BEFORE ESTIMATED 3. ESTIMATED MAJOR STATE AIDS 4. TAXES AFTER ESTIMATED STATE GENERAL GOVERNMENT CREDIT 7.29 MAIORSTATEAIDS&CREDITS USED TO REDUCE TAXES MNOR SUTE MDS NET TAX AFTER STATE AID&CREDIT - 191.83 TATE 2.96 2.06 OUNTY° 62.60 12.83- 49.77 OWN OF-TROY 2054 11.61- 8.93 CHL-HUDSON 232.78 76.31- 1 SS .47 yr r H OC SCHOOL DIST t 21..18 5.05- H E R TOT'ALS' 339..46 105.80- 233;36 ;STATE SCHOOL CREDIT 34.24- - STATE GENERAL GOVT CREDIT 7. 29- TOTAL DUE FOR Fujjt AssMENT 191 . B3 2 NET TAX AFTER ST. AID & CREDIT 191.83 PAY TO LOCAL TREAS. B' Iff►S7 O R r PAV T 2nd INSTALLMENT PT cI ARE rHT=c~o,nnnA' rnvTPC vrn P PPnnPRrv -,.T., , . r r „ r/1!470~0A~A. O Ist INSTALLMEN nAY rn I nral T FACI PPP Pav m ~nI~TV *oAV mFp IMPORTANT: (@CAMP STot~ V, V 120 ~%53 ST. PAUL AREA YMCA ~7 AFC r a une 3, 1987 Tom Nelson Zoning Administration St. Croix County Zoning Office P. 0. Box 98 Hammond, WI 54015 I FROM: John Duntley, YMCA Camp St. Croix RE: St. Croix River Center Building On May 19,'1987 we discussed the St. Croix River Center building that the St. Paul YMCA Camp St. Croix intends to build at the camp in Troy Township. You indicated that the new building construction cost would need to be less than 50% of the total assessed value of the existing camp properties. As you requested, I have enclosed copies of our 1986 real estate tax statements which show a total assessed value of $515,205. I have also enclosed a description of the St. Croix River Center building which details the design, site plan and cost estimate of $240,000. Please respond as early as convenient with your approval so that our construction schedule may proceed. Thank you for your assistance. Sincerely, John Duntley Camp Director JD/cal Enclosures COUNTY ROAD F HUDSON, WISCONSIN 54016 (612) 436-8428 E ROSERI S SkOWNE ' TOWN OF TROY UIkRSE SEE E REVERSE SHOULD REFER TO THIS TAX PARCEL NUMBER O C 5 A R3 BOX f 7 COUNTY OF ST . CROIX SIDE SIDE FOR IMPORTANT INFORMATION AU RIVER FALLS, WI 54022 BILL NO. RECEIPT NO. L R STATE OF WISCONSIN E R THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 4,144.00 AS?f'd[U XAII E LAtiI ASMNID\All'1 IMPRO',ViNP 101AI ARPSED-111F AYt ASAAU BAT, KIH1VEp HIM MARXEI VAIld STATE AID USED TO REDUCE TAXES 1,292.72- 9 7 750 97,750 .7779 125; 700 STATE SCHOOL CREDIT 416.32- I-- I, X',.DI(nom 2.TA\f1 b6ol(1 [SnMAIfP 3. ESlm-111 AHiox>tAtf AID- 4. -E1 AFTER FATIMATEU STATE GENERAL COX'ERNMENT CREDIT 89.07- MMOR s1ATF - n 0-1111 us1D to REDL.u -15 MAIOR STATE AIDS NET TAX AFTER STATE AID & CREDIT 2,343.89 STATE 23.13 25;13 BOUNTY 764.84 156.77- 608.07 (TOWN OF TROY 250.89 141.82- 109.07 CHL-HUDSON 2,844.31 932.40- 1,911.91 0 OC SCHOOL DIST 1 258.83 61.73- 197.10 T li E ~/7 f R TOTALS 4,144.00 1,292.72- 2,85f.28 = STATE SCHOOL CREDIT 418.32- 2,343.891 STATE GENERAL GOVT CREDIT 89. 07- TOTAL DUE FOR IUI II PANNONE ► NET TAX AFTER ST. AID & CREDIT 2,.343+ 89 PAYTOLOCALTREAS w02/26/87 O OR PAY 1st INSTALLMENT Ind INSTALLMENT IMPORTANT: BE SURE THIS DESCRIPTION COVERS YOUR PROPERTY TOTAL NET TAX RATE .023976454 INSTALL- PAY TO LOCAL TREASURER PAY TO COUNTY TREASURER EVENTS S12/T28/R20 ACRES 5.120 OF► 1,171.95 1,171.94 PCLN 12.28.20.5748 BY: 02/21/87 BY: 07/31/87 SEC 12 T28H R20W 5.12A O,tPM... SI of SDPaIChB. GOV L 4 N OF S LINE G L 1 OF ST PAUL . Y M C A Tax P.ud A- Pard Paid SEC 7-28-19 EXTENDED W Del Uld. S, I`- 475 CEDAR Ch0. Paid Crop P11d T.. Pald 0 ST PAUL, MN OOOOO TOTAL AMOUNT PAID FS BALANCE POA1POm1DORDELR)UfNTTAXES DUE PAY 10 COUNTY TREASURER RECEIPT (NOT VALID UNTIL CHECK HAS CLEARED ALL BANKS) i _ PAID BY RECD BY DATE i STATEMENT OF REAL ESTATE TAXES FOR " 1986 ST PAUL Y M C A ie ROSERT S BROWNE TOWN OF TROY 040-1027-40 O A TOWN OF TROY - CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NUMBER C S R3 BOX 47 COUNTY OF ST. CROIX SEE REVERSE SIDE FOR IMPORTANT INFORMATION 1 R RIVER FALLS, Wt 54022 BILL NO. RECEIPT NO. AD ~ i STATE OF WISCONSIN 93.27 R - THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT •11Sb11U XOIUE IAW "I";" "III IMYXO"(M[N1S TOTAL A55155EU VAIUf AvI. AS.MT [SIIMATEU {AIR A.ARXt1 VALUE STATE AID USED TO REDUCE TAXES 29 . 09- 2 20 0 2,200 •7779 2 B 00 STATE SCHOOL CREDIT 9.41- ! T: TAXING JURISDICTION 2, TAXES BEFORE ESTIMATED 3. ETIMATED ANIOR STATE AIDS 4. TAxES AFTfR ESTI-TED STATE GENERAL GOVERNMENT CREDIT 2. 00 - _ _ MAIOR STATE AIDS 6 CREDITS USED TO REDUCE TAXES WABOR STATE AIDS NET TAX AFTER STATE AID & CREDIT 52 , 77 STATE COUNTY: 17.22 3..33- 13 69 I TOWN OF'TROY 3.64 3.19- 2.45 CHL-HUDSON 64.01 20.98- 43..03 0 OC SCHOOL'DIST .1 3.83 1.39- 4.44 H ~f E R TOTALS-' 9327 29.09- 64.41- z -STATE SCHOOL CREDIT s STATE GENERAL GOVT CREDIT 2.00- TOTAL DUE FOR FL'I I PAWENT ► 32.77 C9 } NET TAX AFTER ST. AID & CREDIT 52.77 PAYTO(OCALTREAS R•02/28/87 O 'IMPORTANT: NE SURE EII15 UtSCRIPIION COVERS YOUR PROPERTY OR PAY 1st INSTALLMENT 2nd INSTALLMENT I TOTAL NET TAX RATE .023978434 INSTALL- PAY TO LOCAL TREASURER PAY TO COUNTY TREASURER S06/T28/R19 ACRES 8.8011 MENTS OF► 60.00 2.77 •PCL• 86.28.19.900 BY: 02/21/87 BY: 07/31/87 8E8AC. PT8LOT13WAS IN VOL j P.,d ;.w moA, Pa;d 5-1 Ch{ ST PAUL.Y M C A 149 P 288 D.I. Unl. Pnx. Fa.M VROeI.nd 66 l(YgO (,cc V14 475- CEDAR ST. cha Pad onD Pae Tax PId ST. PAM,. MN. TOTAL AMOUNT PAID 1~ 1~ b ~1 cF~U - s3l_ 01 BALANCE P057PONEJ OR DEL"I"ENT TAXES DUE PAY TO COUNTY TREASURfIt i! RECEIPT (NOT VALID UNTIL CHECK HAS CLEARED ALL BANKS) - PAID BY RECD BY DATE STATEMENT OF REAL ESTATE TAXES FOR 1985 ST_ PAUL Y M C A T 040-1144-70 R ROBERT-S BROWNE TOWN OF TROY 'L E GA TOWN OF TROY CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NUMBER 1C 5 R3 BOX 17 COUNTY OF ST. CRO'IX SEE REVERSE SIDE FOR IMPORTANT INFORMATION ..AIR: RIVER FALLS, Wt 54022 BILL NO. RECEIPT NO. E STATE OF WISCONSIN - R THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 339.16 ASSESSED VALUB LANG ASSE55ED VALUE LMPRDI'IVW TU1AL ASSESSED vALUE AVE. ASSMT. Mt10 ESTIMATED FAIR MARMT VALUt STATE AID USED TO REDUCE TAXES 105.80- S o00 81 000 •7779 10,300 .STATE SCHOOL CREDIT 34.24- I.TAXINGNR1-ION 2. TAXI) RTFORF IAnMATfU 3. 1sTi.-D ASAOk SIat mM 4. TAXES AFTER BDAV.itO STATE GENERAL GOVERNMENT CREDIT 7.29- MAI IR STATE MtllA CRIDUS USLD 10 REDUCE /AXES .AMOK sun AIM NET TAX AFTER STATE AID & CREDIT 1 91 • 83 STATE 2.06 2.06 COUNTY 62.60 12.83- 49.77 OWN OF'TROY 20.54 11.61- 8.93 CHL-HUDSON 232.78 76.31- 156,47 0 l~ OC SCHOOL DIST 1 21.18 5.05- 16.13 ,T, V~ E R TOTALS 339.16 103.80- 233:36 STATE SCHOOL CREDIT 34.24 STATE GENERAL GOVT CREDIT 7. 29- TOTAL DUE FOR FC: E PAjj ► 1 91 . 83 l7 NET TAX AFTER ST. AID & CREDIT 191'.83 PAYTOLOCALTREAS.802~28/87 O OR PAY 1st IN5T 4LLVIENT 2nd INSTALLMENT 10-QYANT--Fc.o,I,cF,..-om,n, m,•T~c ••,.nr.a.,.. _ q!57090/4A 11 , ~n ,r s.cl ccn Tn mnvTS•.PC.SCImcP i _ - 04o-1oz7-1o LE ROBERT S BROWNE TOWN OF TROY O A TOWN OF TROY CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NUMBER G s COUNTY OF ST. CRO IX SEE REVERSE SIDE FOR IMPORTANT INFORMATION R3 60X 17 BILL NO. RECEIPT NO. AU RIVER FALLS, WI 34022 d.R.- STATE OF WISCONSIN E THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID &CNEDIT 3,464.77' N 111 00 AID USED TO REDUCE TAXES 1,087.07- AS xEI~\Mlt \.[•`fl\t.\FI\IVNAtM!'• il1lAlAtNFNtf:\,II:! ET11n+,TIDf,IRA+ARXfTIAII~E 1.77- 0a ,11 . A>tMI R,i 7779 K) 1.05 ,.7QC. STATE SCHOOL CREDIT 35 24,l>600 37,600 82.2 STATE GENERAL GOVERNMENT CREDIT 74•90- lAXIN(, II RINDI[ill In 2.'AMI H111- 1-Tn1A1J1 FSTIM,TFD MAK+: NTATE AIDS 4. TAtEI AFTER fATIlIAIED 1 , 971. a MAl- STAIE ern A LRrolrs 1-91` Io REDUCE IAAES MAroR S1An AIDS NET TAX AFTER STATE AID & CREDIT 21,13 21.13 643.17 13t.83- 311.34 TROY 210.98 119.26- 91.72 0 DSOH 2,?*31.64 784.07- 1,607.77 T OOL DIST 1 1.7.65 31.91- 165-74 H E R (17 3,484.77 1,087.07- 2,397:70 a OL c.RED1T 351 77- t ,971 . a3 RAL GOVT CREDIT 74:90 - TOTAL DUE FOR Ill I PAYMf NT ► EN 5T. AID &CNEDIT - 3,971.03 jg7PAY . B' 02/2$/67 I.I INSTALLMENI 2nd INSTALLMENT IMPORTANT: BE SURE THIS DESCRIPTION COVERS YOUR PROPERTY TOTAL NET TAX RATE . 023978434 TO LOCAL TREASURER PAY TO COUNTY TREASURER S06/T28/R19 ACRES 33.440 98'5.52 985.3 1 PCL06.28.19.69 02/2i/87 BY: 07/31/87 SEC 6 T28H RtSW ( IS q~rF~ G'n Pd TP.`„I S,.IMI CIq T~N 55.44 AC GOV LOT 2 ST PAUL Y M C A P^' A- °'`d ` U q Jul. Pnv. faN N'..dUnd C~ 6 Ct ♦23 475 CEDAR STREET (hg PAd oPPP.Id T"°•id i X ! I ST. PAUL, MN. 55401 TOTAL AMOUNT PAID GE ✓rJ DUE BALANCE IXTPAY TO COUNTY TREASU ERAS _ RECEIPT NOT VALID UNTIL CHECK HAS CLEARED ALL BANKS) - PAID BY RECD BY 0.71 I ! II STATEMENT OF REAL ESTATE TAXES FOR 1986 :ST PAUL Y C A 040-1026-70-001 T ' N ROBERT S BROWNE TOWN OF TROY L E CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NUMBER O A TOWN OF TROY SEE REVERSE SIDE FOR IMPORTANT INFORMATION Cs R3 BOX 17 COUNTY OF ST. CROIX 1;.IltER FALLS, W1 34022 BILL NO. RECEIPT NO. 2'R STATE OF WISCONSIN R THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 301 . 1 0 E AsTtssto v"wE LAND ASSESSED VALUE IMwovLME.IS TOTAL AsstsstovALJE A.E. AssM,. RAT,O fTT1ANTFD FANI MARAfl vASUE STATE AID USED 70 REDUCE TAXES 156.32- 1,1201 0Q 1t,a2a .7779 151201 'STATE SCHOOL CREDIT 50.56- STATE GENERAL GOVERNMENT CREDIT 10.7A7- 1. TXING IURISDICTKFN 2. TA- BF{DRF ESTIMATED 3. ETTIA+,TFD MAIOR STATE AIDS 4. TARES Af1FR ESTIMAT[D MAKM STATE AIDS A CREDITS USED TO REDULT TAXES MAJOR STATE AIDS NET TAX AFTER STATE AID & CREDIT Z83 . 4 3-04 OUN Y 92.49 18.96- 73:33 OWN OF TROY 30.34 t7."- 13.19 0 CHL-HUDSON 343.94 t12.75- 231.19 T OC SCHOOL DIST .1 31.29 7.46- 23.83 H R C7 S 7 501.10 156.32- 344:78 OTALS STATE SCHOOL CREDIT SD. 38- - I STATE GENERAL GOVT CREDIT 10.77- TOTAL DUE FOR FULL PAYMENT 0- 283.43 NET TAX AFTER ST. AID IS CREDIT 283.43 :PAYTOLOCAL TRHS.B 7 AY 1sT INSTALLMENT 2nd INSTALLMENT IMPORTANT: BE SURE THIS UESCRIPTION' COVERS LOUR PROPERTY TOTAL NET TAX RATE . 023978454 LL- PAY TO LOCAL TREASURER PAY TO COUNTY TREASURER TS S06/;28/R19 ACRES 16,000 ► 141.72 141.71 PCL4 628.1988C BY: 02l 1 /S7 BY: 07131 /87 SEC 6 32811 R3 9W t 8A PRT SE - $-1 S,_I C%R. NW INCLUDING S 1 /2 RR R/W ST-' PAUL Y M C A m A..,,• Pud P.,d Del, Uni. PAV.I- wwdan0 =-.r- - 475' CEDAR STREET c R P.e c.PPAd ' clq 13 ~Ere5 ST. PAUL, MH. 551.01 TOTAL AMOUNT PAID i - BALANCE POSTPONED OR DfEIDUENT SATES - 6 5 cues DUE P,Y TO GDJNT' TREASL'ER RECEIPT (NOT VALID UNTIL CHECK HAS CLEARED ALL BANKS) PAID BY EC'D BY DA7E 1 -1- STATEMENT OF REAL ESTATE TAXES FOR 1986 S7 PAUL YMCA T : 040-1026-50 TION "L E RROBERT S BROWNS TOWN OF TRAY CIS TAX PARCEL NUMBER O A ~ TOWN OF TROY SEE REVERSE RSE SIDE SIDE FOR FOR IMPORTANT THISTANT INFORMATION COUNTY OF ST. CRO;X SEE RE S ; R3 BOX 17 A.U RIVER FALLS, WI 54022 BILL NO. RECEIPT NO. T R ; STATE OF WISCONSIN E THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 1910.83 R STATE AID USED TO REDUCE TAXES 284 • t 4- All" 111---M 'A"" A'.ASNAo A'.. uN,EDfAIRAMRM,.MUI 91.94- 28 75 Q A 735 2t,48 .3 .7779 27, 6 0 0 STATE SCHOOL CREDIT - STATE GENERAL GOVERNMENT CREDIT 1 9 . 58 1. TAXING IUR1sUI-ON 2. IAXLS III- ESTIMATED ESTIMATED MAKER TTMf AIDS 4. TAXES AFTER fST,MATED MAJOR STATE AIDS A ORE ITS USED TO EDUCE TAXES MAJOR STATE Alos5, 52 NET TAX AFTER STATE AID & CREDIT 513.17 TATE 3.52 OUNTY 168.11 34.46- 13365 TOWN OF TROY 55.14 31.17- 23 97 SCHL-HUDSON 623.t7 20494- 420.23 06 VOC SCHOOL DIST 1 56.89 13..57- 43,32 H (jyA ;06 R OTALS 910.83 284.14- 626:69 STATE SCHOOL CREDIT 91 .94 515-17 STATE GENERAL GOVT CREDIT t 9TOTAL DUE FOR FULL PAYMENT ► _ 5t3.17 PAYTOLOCAITPEAS.s,0212$/87 ~Ir l wr MLAL LJ 1 A I L 1 AALS FOR 1 V bb ST PAUL YMCA ~I.. 040-1024-70 R ROBERT S BROWNE TOWN OF TROY O A TOWN OF TROY CORRESPONOFNCF SHOULD REFER TO THIS TAX PARCEL NUA C 5 R3 BOX 17 COUNTY OF ST. CRO'IX SEE REVERSE SIDE FOR IMPORTANT INFORMATION A LI RIVER FALLS, WI 54022 BILL NO. RECEIPT NO. i R E STATE OF WISCONSIN R THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 59 n,.entD S.nt ln~u ..,(:,fn IAILE-IllkNtlie IOTAI ..S. DIALUE JAve. Ass+1T Ralo (STNgTED TUR MA4XFT VntUf STATE AID USED TO REDUCE TAXES 1 6 . B 1,400 1.400 ,7779 1,$00 STATE SCHOOL CREDIT 5.~ 1. 1AXIac, iuunnlcuus 2. 10X11 -1 Ill 15711111f. 3. « i-Tul -ioR STATE AIDe 4. IAXtl AFTER faueATED STATE GENERAL GOVERNMENT CREDIT 1 . i +.Aa1R 51A1t AILS, (REI1115 LSfn TO RUX)Ct TAU$ +.Aa1R STAIt Aron NET TAX AFTER STATE AID & CREDIT 33. STATE -36 .36 COUNTY 10.96 2.25- 8.71 TOWN OF TROY 3.59 2.03- 1.56 SCHL-HUDSON 40.73 13.35- 27.38 E> VOC SCHOOL DIST 1 3.70 .88- 2.62 H E C~ R 7-119 TOTALS 59.34 18.51- 40.83 .STATE SCHOOL CREDIT 5.99- STATE GENERAL GOVT CREDIT 1 .28- TOTAL DUE FOR FUIISI PAYA(FNT ► 33.5 NET TAX AFTER ST. AID & CREDIT 33.56 PAYIOLOCALTREAS.BNF2/28/87 OR PAY It INSTALLMENT 2nd INSTALLMEN IMPORTANT: BE SURE THIS DESCRIPTION COVERS YOUR PROPERTY I TOTAL NET TAX RATE . 023978454 INSTALL- PAY TO LOCAL TREASURER PAY TO COUNTY TREA MENTS S06/T28/R19 ACRES 2.000 OFD 33.56 PCLR 06.28.19.838 BY: 02/21/87 BY: 07/31/6. SEC 6 T28N R19W ;n PT SRR•;,I sP. .E CER; PT SW HE THAT PT OF SW HE ST' PAUL. YMCA T,• NO Aa n, P,a Paid LYING SWLY OF RR R/W f. o.•L LIIII. PIX-.F- w-dl,.d FORMER 1.00' RR R/W 475 CEDAR Chg. NO ow P,M T,c P,d ST. PAUL, MN. TOTAL AMOUNT PAID 55101 BALANCE P05TPUNfnO MUQUENT TAXO i DUE PAY TO COUNTY TREASURER - " - RECEIPT (NOT VALID UNTIL CHECK HAS CLEARED ALL BANK! PAID BY RECD BY DA'. ` STATEMENT OF REAL ESTATE TAXES FOR 1986 ST PAUL Y M C A tE. ROBERTyS BROWNE TOWN OF TRAY 040-1030-50 CIA TOWN OF TROY CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NUMBER C S R3 BOX- 17 COUNTY OF ST. CROIX SEE REVERSE SIDE FOR IMPORTANT INFORMATION i R• RIVER FALLS, VI 54022 BILL NO. RECEIPT NO. E STATE OF WISCONSIN E' •Ri THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 1 , 059. $S 1 JASSESSED VALUE LAND ASSESSEDV-11Pa(»'f++EN15 IOIAL ASSESSED VALUE AVE. ASSNT. RATIO ESTINUTfD FAIR NIARXFT VALUE STATE AID USED TO REDUCE TAXES 330.62 25 000 25,000 .7779 32,t00 STATE SCHOOL CREDIT 106.99- I : TARING JURISDICTION 2. TAXES BEFORE E5TP(ATFD 3. ESTI-TED ASAIOR STATE AIDS 4. TAXES AREA ESTI+MTLD STATE GENERAL GOVERNMENT CREDIT 22.78' MAIOR STATE AIDS, CREDITS USED TO REDUCE TAXES MNOR STATE BIDS NET TAX AFTER STATE AID & CREDIT 599.46 TATE 6.43 6.43 AUNTY 195.61 40.09- 155:52 OWN OF-TROY 64.16 36.27- 27.89 CHL-HUDSON '727.45 238.47- 48$i98 O OC SCHOOL•DIST 1 66.20 15.79- 30.41 H E R C~ TOTALS' 1,059.65 330.62- 729.23 STATE SCHOOL CREDIT 1.06.99- STATE GENERAL GOVT CREDIT 22.78- TOTAL DUE FOR FULL PAYMENT ► 599.46 NET TAX AFTER ST. AID & CREDIT 599:46 PAYTOLOCALTREAS.8O2e28/B7 OR PAV 1SE INSTALLMENT 2nd INSTALLMENT JMPORTANT: BE SURF: THIS DESCRIPTION COVERS YOUR PROPERTY I TOTAL NET TAX RATE .023676454 INSTALL- PAY TO LOCAL TREASURER PAY TO COUNTY TREASL MENTS S07/T28/RS9 ACRES 39.000 OFD 299.73 299.7: PCL• 7.2819.99 BY: 02/21 /87 BY: e7.'31/87 SEC 7 T28N R19W HE NW G-pw. I SP.EUI SPKQIChg. EXC PUBLIC` RD ST'PAUL.Y M C A -P..d A*...P,b P„e _ D.I. (All. Pnv. FpeR Woodl,nd C a4 475 CEDAR ST. CNR. P,1d C.P P,Id r,..4 ST. PAUL, MN. 55101 TOTAL A.MOUNTPAID BALANCE POSTPON EO OR DEUQUENT TAXES _ - ' DUE PAY TO COUNTY TREASURER RECEIPT (NOT VALID UNTIL CHECK HAS CLEARED ALL BANKS) PAID BY RECD BY DATE i STATEMENT OF REAL ESTATE TAXES FOR 1986 ST PAUL Y M C A 040-1027-30 T E R. ROBERT S BROWNE TOWN OF TROY OL A - TOWN OF TRO'!~ CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NUMBER COUNTY OF ST . CROIX SEE REVERSE SIDE FOR IMPORTANT INFORMATION G S R3 BOX 47 BILL NO. RECEIPT NO. I.AU RIMER FALLS, W1 34022 STATE OF WISCONSIN 7 .36 r- R THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT 'TAXES BEFORE STATE AID & CREDIT 2,444 322 . 27- . ASSESSED %ALUt LAND AsSESifD %-E -ROVE+IEMS TOTAL A55ESSID VALUE All. ASSUT R+nO ESIIwMEO FAIR -01 -OF STATE AID USED TO REDUCE TAXES , 751.47- 5,600 175.600 (7.7779 225y700 STATE SCHOOL CREDIT 160.01- _ STATE GENERAL GOVERNMENT CREDIT 4, 210.61 ' BIA+ATED 3. ESTI+MTED MAIOR STATf AIDS 4. TAXES AFTER EST+(ATEO 1 1•WNGIURISDIRION 2.lAXFS ffORFfSI A.ES STATE AIDS. CREDITS USED TO REDUCE TAXES MAORI STATE AEM NET TAX AFTER STATE AID & CREDIT MAIOR 45 15 STATE 45-TS COUNTY 1,373.97 281.63- 1,092:34 y tOWH OF TROY 450.70 254.77- 195.93 SCNL-HUDSON 5,109.58 1,674.98- 3,434.60 0 VOC SCHOOL DIST 1 464.96 110.89- 354.07 E C~ 6a~ 73 - R ~ qt a6os& TOTALS-- - 7,444.36 2,322.27- 5,122.:09 sIAIE $cHExx cl:nnT 751.47- 4,210-61 STATE GENERAL GOVT CRFDIT 760. O1- TOTAL DUE FOR FUj,l2~nZB/87 d_'J1 n. F1 I clnl nr+I rvFnSR _ L E ROBERT S BROWNE TOWN OF TROY CORRFSPONDENCF SHOULD REFER TO THIS TAX PARCEL NUMBER OA TOWN OF TROY SEE REVERSE SIDE FOR IMPORTANT INFORMATION C$ R3 BOX 17 COUNTY OF ST. CROIX AL' RIVER FALLS, WI 54022 BILL NO. RECEIPT NO. L R STATE OF WISCONSIN R THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 1,047.12 E ' +1>ESSL I+II VE I AV.. o+N•[US+:.L: ~avauTSat,T• I>I IIIE+.tavA-( AVE A,+AD N+TIn talMAnuFMe •,.xaET wluF ST ATE AID USED TO REDUCE TAXES 326.65- 24, 700 24, 700 .7779 31 , BOO STATE SCHOOL CREDIT 105.70- 1 2.T»E+BIEOxEt>o+•.•no J.F+IIM"TIPMARIKSTATEAIDS 4.T♦XNAFTENRIIMNED STATE GENERAL GOVERNMENT CREDIT 22.S1- +I VUN STATE nws a CBE, usm w 611OULI TAXES MAR. SE ATE urn NET TAX AFTER STATE AID 6 CREDIT 592.26 STATE 6.35 6.35 COUNTY 193.26 39.61 153.65 TOWN OF TROY 63.40 35.84- 27.56 CHL-HUDSON 716.71 235.60- 48311 0 OC SCHOOL DIST 1 65.40 15.60- 49.80 H C~ v a'*13 i YOULS 1,047.12 326.65- 720.47 I STATE SCHOOL CREDIT 105,70- z STATE GENERAL GOVT CREDIT 22.53- TOTAL DUE FOR FUI I PAN-11FIT ► 592.26 5 NET TAX AFTER ST. AID A CREDIT 592.26 PAVTOLOCAL EREAS. B'02/29/87 0 ~ OR PAY It INSTALLMENT 2nd INSTALLMENT I IMPORTANT: BE SURE THIS DESCRIPTION COXERS YOUR PROPERTY I TOTAL NET TAX RATE .023978454 INSTALL- PAY TO LOCAL TREASURER PAY TO COUNTY TREASURER nEENTS OF 0* 296.13 296.13 S07/T28/R19 ACRES 40.000 PCLM 7.28.39.101 nv: 02/21/87 BY: 07/31/87 SEC 7 T28N R19W SW NW c... T•EI„. XrI^' AI""''c''"' !~(/r ST PAUL Y M C A P'" JV F V Ct UEd. WIT. fu.,I WudLnA 475 CEDAR ST CA. P,., Crlp Pad 7,1 Paid ST. PAUL, MN. TOTAL AMOUNT PAID ' S5Y 01 - ~ / BALANCE POST.OnFD OR DFIR}UfnT TAXES '3~ / • I.S -/c fr Qn((_. DICE PAr iq CUUNTV 1RtA5UN[R LEI C-7C'/_ ~C1 36~L(`F(`. I ~ RECEIPT (NOT VALID UNTIL CHECK HAS CLEARED ALL BANKS) _ _ _ •Y 5~ T v ns pCH PAID BV RECD BY DATE 6/ 6 - !~^0 sr!ir!V2 6 V^/~ / C7$- JNRrnp /)"'Off STATEMENT OF REAL ESTATE TAXES FOR 1986 -ST. PAUL YMCA R 040-1028-90 (((t tE. ROBERT S BROWNE TOWN OFTROY } CIA TOWN OF TROY CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NUMBER lF{iJ C S R3 BOX 17 COUNTY OF ST.. CRO;X SEE REVERSE SIDE FOR IMPORTANT INFORMATION AL-U_ , RIVER FALLS, WI 54022 BILL NO. RECEIPT NO. E STATE OF WISCONSIN R SS7SSEU THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 1* 47.12 A VALUE LnNU ASSES<FD W WE IMFNfWEMESR 1TOTAL ASSTSSED VAtUF AVE. ASSMT. RATIO [SLMAT[D fMR MARKET VALUE STATE AID USED TO REDUCE TAXES 326.65- 24, 700 24,700 .7779 31♦800 STATE SCHOOL CREDIT 105.70- 1: TAXIr.c nlelsrncTlDN 2, 11111 BRONF f>TI+1R111 T. ISTIMATEn MAOR 57ATE AIDS 4. TAX[%AFTER ESTIMATED STATE GENERAL COVERNMENT CREDIT 22.51- STATE , MARX STATE AIDS A OR-TI USED TO REDUCE TAXES MAJOR STATE AIDS NET TAX AFTER STATE AID & CREDIT 592.26 COUNTY 193.26 39.61- 153:63 TOWN OF TROY 63.40 35.84- 27.56 SCHL-HUDSON 718.71 235.60- 483.11 o VOC SCHOOL DIST 1 65.410 15.60- 49~80 T H E TOTALS 1;047.12 326.65- 720.47 e STATE SCHOOL CREDIT 1:05;740- 'TAT' GENERAL GOVT CREDIT 22.:51 - TOTAL DUE FOR FUI L P{Y+IENT 111- 592.26 LZ NET TAX AFTER ST. AID & CREDIT 592-. 26 P{YTO LOCAL TREA5.42/28/67 C 'IMPORTANT: BE SURE THIS DESCRIPTION COVERS YOUR PROPERTY OR PAY 1SE INSTALLMENT 2nd INSTALLMENT TOTAL NET TAX RATE . 023978454 INSTALL- PAY TO LOCAL TREASURER PAY TO COUNTY TREASURER SD6/T28/R19 ACRES 35.:008 EXTENTS PCL• 06.28.19-.92 OF b.. 296.13 296.13 SEC 6 T28H R19W By, 02/21/87 BY: 07/31/87 35 AC PRT NW SE INCLUDING ST- PAUL YMCA T,n Pu :.d Spe1' Paid sl tnE {•¢ye. Pad spec OLD RR R/W Del. L-111. P„+.F.TR Xvooal.m 475 CEDAR ST. a. P.Id P11. P..d 7.. P.d } . fL 3SAGtCv ES ST.. PAUL, MNa 551 O 1 TOTAL AMOUNT PAID BALANCE POSTPO.ED OR DELIQUEAT TAXES yf DUE A• TO COAL— TREASLRER ~B RECEIPT (NOT VALID UNTIL CHECK HAS CLEARED ALL BANKS) I PAID BY RECD BY DATE T STATEMENT OF REAL ESTATE TAXES FOR 1986 ST PAUL YMCA R ROBERT S BROWNE TOWN OF TROY 040-1028-60 CIA TOWN OF TROY CORRESPONDENCE SHOULD REFER TO THIS TAX PARCEL NUMBER CS, R3 BOX 47 COUNTY OF ST. CROIX SEE REVERSE SIDE FOR IMPORTANT INFORMATION AR, RIVER FALLS, W1 54022 Y R' BILL NO. RECEIPT NO. E STATE OF WISCONSIN R THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 135.65 USfSStU \OLUf LASO AS>ES>lD+OLL( iMPROXFMEMS lUlAl ASSESSED VALUE AVE. ASSMT. RATIO 111-TED IMR MARKET VALUE STATE AID USED TO REDUCE TAXES .42.31 - 3, 200 3,200 .7779 40100 :STATE SCHOOL CREDIT 13.69- 1. TAXI.C I-SOICTON 2. TAXES BEFORE ESTIMATED 3. ISTIMATED MMOR STATE AIDS 4. TAXES AFTER ESTIMATED STATE GENERAL GOVERNMENT CREDIT 2.92- MAJOR STATE AIDS & CREDITS USED TO REDUCE TAXES MAJOR STATE AIDS NET TAX AFTER STATE AID & CREDIT 76.73 COUNTY 25.04 -5.13- 19.91 TOWN OF TROY 6.21 4.64- 3..57 SCHL-HUDSON 93.11 30.52- 62.59 0 VOC SCHOOL DIST 1 8.47 2.02- 6.45 H E - - R YOTALS 135.65 42.31- 93:34 a STATE SCHOOL CREDIT t3.69 - Z STAII GI NERAI (.()VI (RI OIT 2.92- TOTAL DUE TOR VIII rAV+II a9 ► 76.73 NET TAX AFTER ST. AID A CREDIT 76.73 r+5 TOLOCALTHEA5.n102/2@/@7 m IMPORTANT: NF 11 'Rr TI Ill nr,~v~mvlN c,III v++n. v rvnl.I vTV OR PAY TM INSTALLMENT 2nd INSTALLMENT fb~ T STATEMENT OF REAL ESTATE TAXES FOR 1966 040 1 U30Y6M0 C A R ROBERT S BROWNE TOWN OF TROY L E . CORRESPONDENCE SHOI'LD REFER TO 71115 TAX PARCEL NUMBER OA TOWN OF TROY c s R3 601{ 17 COUNTY OF ST. CROIX SEE REVERSE SIDE FOR IMPORTANT INFORMATION AU RIVER FALLS, WI 34022 BILL NO, RECEIPT NO. I R , E STATE OF WISCONSIN 623.19 R THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT .»LUEIn+unf ianu :.:E.yDla:rl l.fve~n;.:.T. anstssrnvnuiE IATE nci.T x.aln «naatD fAlx u.caTTUL'E STATE AID USED TO REDUCE TAXES 194.41- 1 14,700 14,700 ,7779 t B, 900 . STATE SCHOOL CREDIT 62.91- 1. Trull(. u~Rluncnu. 2. TAR« tllHRf fSliu 111 3. Ev111TED I-OR AAT' AIDS 4. TAAF. AFTER «n.laEU STATE GENERAL GOVERNMENT CREDIT 13.39- OX IsTATL A-l CRJNTS usD) TO RIOUCE TAXtS A.NLw STATE AIDS NET TAX AFTER STATE AID & CREDIT 332.46 STATE 3.78 3,.78 COUNTY 115.02 23.38- 91.44 TOWN OF TROY 37.73 21.33- t6.40 SCHL-HUDSON 427.74 140.22- 287.52 O VOC SCHOOL DIST t 38.92 9.28- 29.64 T H N E TOTALS 623.19 194.41- 428.78 z I STATE SCHOOL CREDIT 62.91- I 3'!2.48 j 'STATE GENERAL GOVT CREDIT 13.39- TOTAL DUE FOR WE I PAN' 1ENT ► 332.48 PAY TO LOCAL IREAS.42/L8/8T cc ;NET TAX AFTER ST. AID & CREDIT 0 OR PAY 1St INSTALLMENT 2nd INSTALLMENT IMPORTANT: BE SURE THIS DESCRIPTION COVERS YOUR PROPERTY TOTAL NET TAX RATE .023978454 INSTALL- PAY TO LOCAL TREASURER PAY TO COUNTY TREASURER ' MENTS S07/328/R}9 ACRES 35.•000 OF. 176.24 176.24 PCLt 7.28.19.100 BY: 02121/87 BY: 07/31/87 SEC 7 T28N R19W 35A HW NW c.A PxR, S.Oa N .,ICei I EXC PUBLIC RD 6 BEACH G L 1 ST PAUL Y M C A V•.1 A... P.-I P,W AS IN 436/348 LA•L UEIE. Pm. I.. IN i,ne 473 CEDAR ST ch.,", C~~"P.m TA.P,Ie 7 G!G✓~S ST. PAUL, MN. TOTAL AMOUNT PAID A C BALANCE POSTPONI Ot OIWU LS ~ C~61 33101 DUE PAY TO COUNTY TREASURER ASURER - - RECEIPT (NOT VAUD UNTIL CHECK HAS CLEARED ALL BANKS) PAID BY RECD BY DATE - STATEMENT OF REAL ESTATE TAXES FOR 19M.. , St ' PAUL Y M C A 040-1028-50 T LR BROWNE TOWN OF TROY o n TOWN ROBERT OF S TROY CORRESPONDENCE SHOULD REFCR TO THIS TAX PARCEL NUMBER C S R3 BOX :47 COUNTY OF ST. CROIX SEE REVERSE SIDE FOR IMPORTANT INFORMATION L R % RIVER FALLS, Wi 34022 BILL NO. RECEIPT NO: A D E.. , STATE OF WISCONSIN 'R THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXES BEFORE STATE AID & CREDIT 65.72 SSED VALVE LAND ASSESSrp T'KUE IMPRU•E.~F•.TS TOTAL ASSESSED VAtUF AVE MSAIi. 4ATK1 ESTIMATIO'AIR MARAET VMUE STATE AID USED TO REDUCE TAXES 28.50- - 1, 530 1, 550 .7779 2, 000 "STATE SCHOOL CREDIT 6.63- 1. TAXING JIMI 111ON 2. 1-11011DRI rsu,nATEn 3. Esn.ulrp.++IOx STATE. AIDS 4. I.AES AFTER ol-no STATE GENERAL GOV[RNMENT CREDIT 1 . 4 1 - -JOR 1-TE AIDS E MEN'S =DE TO REDUCE TAXES MAJOR STATE Alps NET TAX AFTER STATE AID & CREDIT 37.18 rTATE 12. 13 2.4 9- 9-64 OF TROY 3.98 2.25- t.73 HUDSON 45.10 14.78- 30.32 O VOC SCHOOL DIST t' 4.13 .98- 3.13 T H 6~ t E R TOTALS ' - 6572 20.30- 4522 i STATE SCHOOL CREDIT 6.63- -STATE GENERAL GOVT CREDIT 1.41- TOTAL DUE FOR FULL Y PAYMENT ► 37.18 L? - - .NET TAX AFTER ST. AID & CREDIT 37.18 PSYTOLOCAL TREAS. B ~~ETy2/ZS/S7 0 OR PAY ISE INSTALLMENT Ind INSTALLMENT IMPORTANT: BE SURE THIS DESCRIPTION COVERS YOCR PROPERTY I TOTAL NET TAX RATE .023978454 INSTALL- PAY TO LOCAL TREASURER PAY TO COUNTY TREASURER MENTS S06/728/Rt9 ACRES 6.250 OF p. 37.18 PCLE 06.28.39.900 Ly- 024021167 BY: 07131/87 SEC 6 T28N R4-9W G- POp_Sprci,l sPKmIUR 6.25 AC PRT LOT 3 AS TN VOL ST'PAUL.Y M C A T••P.m AE..E. P.u Paid 216 P445 ORD a1. RR. Peror Pn.. Fa. T TY. P.Xf (76 31 0/ ACvl'475 CEDAR ST. ceR P,e ,e nA,d TOTAL AMOUN X~ ST. PAUL, MH. T PAID 31/, Crl3 3310} BALANCE KIST-EDCADILIOVE\T TAXES 5f DL'E E`AylOC0ONTVTREA,j.I, .EI RECEIPT (NOT VAUD UNTIL CHECK HAS CLEARED ALL BANKS) PAID BY RECD BY DATE T STATEMENT OF REAL ESTATE TAXES FOR 1986 040PA O OY84 C A R' ROBERT S BROWNE TOWN OF TROY L E [ORRFG'O%DE NCF SHOI)lO RFFFR TO THIS TAX PARCEL HUMBER Cl A TOWN OF TROY SEE REVERSE SIDE FOR IMPORTANT INFORMATION CS R3 80X 17 COUNTY OF ST. CROIX A U RIVER FALLS, WI 54022 BILL NO RECEIPT NO. L R - F STATE OF WISCONSIN R THIS IS A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT TAXIS BEf(IRE ST -Of AID N CREDIT 886.03 »ISnUil,nl lA>n •L.wl-,nfrAeR,nI+,I,n 11 Af All'.Sm VAI Id t ..AD x,nu n+1,n0 rAiR Alw.n.Alut STATF. AID USED TO REDUCE TAXES 276.40- 28,900 20,900 A .7779 26,900 STATE SCHOOL CREDIT 89.44- 1,TAX- 10RUDiCTRm 2.TAU,REIORI fl-ATED 3.fl-ATlu AIMnR SHif AILS 4.,..1> AIII. Ill.-110 RATE GENERAL GOVERNMENT CREDIT 19.04- . AwOR SIATt AIDS A CRIDDS u1w TO Rfnuct „Afs I-IIC IIAU AIDS NET TAX AFTER STATE AID & CREDIT 501.15 TATS 5.37. 5.37 OUNTY 163.53 33.52- 130:01 j=OWN OF TROY 53.64 30.32- 23.32 CHL-HUDSON 608.15 199.36- 406.79 O YOC SCHOOL DIST 1. 55.34 13.20- 42,14 T R //,2 „ ,??F TOTALS- 886.03 276.40- 609:63 a STATE SCHOOL CREDIT 89 .44-.. z ► 501.15 STATE GENERAL GOV1 C RLDIT 19.04- TOTAL DUE FOR It'- I PAYNO NT "o I•AY, f 11(R ,t i BIAS P02/28/107 NIT TAX AF1IR 11 nu3 A rRtun 501, 15 c OR YAI' INSTALLMENT 2nd INSTALLMENT IMPORTANT: BE SURE THIS DESCRIPTION COVERS YOUR PROPERTY TOTAL NET TAX RATE .023978454 INSTALL- PAY TO LOCAL TREASURER PAY TO COUNTY TREASURER MENTS S07/T28/Rf9 ACRES 40.000 Of► 250.58 250.57 PCLM 7..28.19.102 BY: 02/21/8? BY: 07/31/87 SEC 7 128N R19W SE NW c_ Plp Spec,. sP wtchg Pad ST PAUL Y M C A T., P.,d Nod ' D.1. l1lil. Pnl. iureft I,oatll.nd - 611 9 r" P .'.S 475 CEDAR ST. Cn. P.,d oAP P-1 T., P.,d G < v~ ST. PAUL, MH. TOTAL A.SIOUNT PAID - 551 01 BALANCE Pf II PAY TOCOU .NTY TRfASU TIFASW III $S DUE AV TO C I _ RfR RECEIPT (NOT VALID UNTIL CHECK HAS CLEARED ALL BANKS) I _ PAID BY RECD BY DATE III Y.M.C.A. CAMP ST. CROIX 'HUDSON, WISCONSIN COMM. N0. 8601 PROGRAM REQUIREMENTS 4-16-86 ST. CROIX RIVER CENTER The River Center would satisfy the program requirements of an Entrance Pavillion, Tripping Center, Nature Center and Administrative functions. The building would be located prominantly on the entrance circle road convenient to parking and the camp commons. PAVILLION: As an entrance pavillion the building should visually welcome those who enter the camp and reinforce the sense of arrival. The pavillion should provide shelter for approximately four bus loads of kids or about two hundred. The pavillion space would be used to welcome incoming guests and make group or cabin assignments. The pavillion would also function as a gathering point for external tripping and the nature program. TRIPPING CENTER: The tripping center or trail room would be located adjacent to the pavillion space with service access from the entrance road. The tripping center would provide space for year-round trip planning, packing work space, equipment storage, food storage, assembly/dispersal and equipment rehab. shop. The tripping center would be somewhat integrated with the pavillion and nature center functions. Assembly areas would include nature interpretive displays depicting habitat, geography, geology, history, weather, etc. The displays and facility would be iarranged to communicate a concern for Y.M.C.A. and sound ecological values. NATURE CENTER: The year round nature center would be located adjacent to the pavillion space with shared functions with the tripping center and administrative facility. The nature center would include a classroom (or a conference space for about thirty, a nature laboratory and display storage space. Giassroom space would be used for teaching nature groups, administrative conferences and for specilized trip planning. The nature laboratory would be used by the staff and volunteers to assemble displays and prepare work projects and experiments for the nature groups. The lab would include a sink, refrigerator and adequate work space. The lab should have direct access to the display storage space. - 2 - ADMINISTRATION:. The administration area would be located adjacent to the pavi Ilion with visual control of the entrance road and camp commons. The administrative area would include open, office space for five I.staff members, a computer work station, a work room, director's office, toilets and access to the nature classroom for staff conference use. Y Y.M.-C.A CAMP ST. CROIX ROBERT DAVID BUROW ARCHITECTS, INC. HUDSON, WISCONSIN SOUTH 750 DRIVE 55120 COMM. 'NO. 8607 PROGRAM COST ESTIMATE ST. CROIX RIVER CENTER KELLER CONSTRUCTION, INC. PAVILLION....:........•..........................$ 56,000.00 4,000 sq. ft. x $14,00/s.f . . = $56,000 TRIPPING CENTER 1689712.00 NATURE CENTER ADMINISTRATION 4,064 sq. ft. x $36.00/s.f. = $ 152,712 Stone Fireplace............ - $ 16,000 SUBTOTAL 5 224,712.00 CONTINGENCY...... 15,288.00 TOTAL.............5 240,000.00 ill 1.1.1_ l LLLT • ~ ~ .rte ~ ~ ~ ••-a+°r •r•~~ i=,'~w~n \ r ~ u C t •~iy.~~ ~ j! r. f;• ' O;i i ~ •1 tilt: ~ ~ . o b. lP J / JF ' J Y a .,i i l l i • i 4. t' i ~wwfr, "~L1 i•.t'~ a ' z Jt? Iq J^ ~ I I a! ♦ / I I r~ k ! M t I nI I I u ~ ~ I , { t, I y .r• I I I I I - - I u I b j Wm 55r," I -d L-L I 1 ~ y I - 7.MY SS ]~M q~l 1 t • u ! 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O ~1 O C L~1 O -n C y G G O) y C N \ 3 3 s+ m CD o ° z w -o z co v Do Do 4 O a ti O ° y" c =r C ° ! !~1 = Cl CD N• CD O N• N a N a CD C COD O C CD O W C6 c6 Cl CD j CD 7 "I fp Z o Q a p Z tD Do' a G) F 0 Z N ° W A A N m 00 a ~ CL z o° °o cd m I 'n I ~ A N ym m~ 8 CD rlm a m c 0 Q,) -n a m c m m axe o o3 a ? c~ m =CL a Nv a ~.w`,~ coo nX ~ o o A ~•x o'i c o o O y C: O n Ol ' 7 7 fD 3 0-3 °m 11 ur d ~ N~co oz a CD N Z d a fDaa- @ CD o -I •p a ao ' g w o 3 PD g a a, 0 Sp an o a-I cn~ 9 c o v U) 0 p ~cn m -0 m OR ~ a^' ;o o ~ L c o fi y ~r~nf A• y m ~ mm~ a 3 zfO 'cr ~j M CD C3 C= =r :3 CL 5. 0 3 $CAW m> (D D O Our e Q w 7 ° -4 O (p (d 7 A S 3 7 d O E; g a 3a) CD CD CA 0. 319 30 t~ia (D O_ .O C7 -,a O•. O O O 3 c ~ a C) O p 0 i O a7`0) Ga-DO y f~D O y 3 n r~ aj O~ 7 'O O O w > 7 CD CD 00 00 c w a ' DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 SEA, SW'jS6,T28N-R19W CONVENTIONAL ❑ALTERNATIVE SlfassPlan I.D. Number: Town of Troy El Holding Tank D In-Ground Pressure El Mound CTH F NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER: INSPECTION DATE ? ~•30 St. Paul Area YMCA CTH F, Hudson WI 54016 .9,11e "7 BENCH MARK (Permanem reference De,m) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.. Name of Plumber: MP/MPRSW No.. Coumy: S-w, Perm., Number Paul C.J. Steiner I6780 St. Croix 102781 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV_ WARNING LABEL LOCKING COVER PROVIDED PROVIDED DYES ONO DYES ONO BEDDING. VENT CIA VENT MATL: AL gWATER NUMBER OF ROAD: PRNPE TY rL. BUILDING. JVENTTOFRESH FEET FROM AIR INLET DYES ONO DYES ONO NEAREST DOSING CHAMBER: MANUF ACTUR ER BEDDING' LIQUID CAPACITY 1=EL PUMP/SIPHON MANUFACTURER WARNING LABEL JLOCKING COVER PROVIDEDPROVIDEDOYES ONO DYES ONO DYES ONO GALLONS PER CYCLE: PUS OPERATIONA L. NUMBER OF PROPERTY WELL BUILDING IV ENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) OYES ONO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKIN(' Or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BED/TRENCH WIDTH: LENGTH NRENCHES DISTR. PIPE SPACING MATERIAL'. PIT INSIUE DIA UPITS DEOPTf) DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR PIPE DISTR. PIPE DISTR. PIPE MATERIAL. NO. DISTR NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH BELOW PIPES ABOVE COVER. ELEV. INLET ELEV. END'. PIPES FEET FROM LINE AIR INLET NEAREST------ MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. DYES ONO SOIL COVER TEXTURE JPERMANENT MARKERS OBSERVATION WE LL S DYES ONO DYES ONO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SEEDED MULCNEO CENTER EDGES DYES ONO DYES ONO DYES ONO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH TRENCHES LATERAL SPACING GRAVEL DEPTH BELOW PIPF FILL DEPTH ABOVE COVER DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE IMANIFOLOMATERIA1 jivo_DISTR 111~STR PIPE DISTRIBUTION PE MATERIAL &MARKING ELEVATION AND ELEVELEVDIAELEV. PIPES DA.. DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL V AL LIFT CORRESPO DS APPROVED 61 A OYES ONO DYES ONO COMMENTS: PERMANENT MARKERS: OBSERVATIO ELLS. , INUEMBFERA FET O LINt DYES ❑ ' YES ONOjNEAREST a .9 CoUQI. System on Retain in county file for audit. ) side. 1 ~ 't Vj SIGNATURE TITLE Zoning Administrator a ~8 '710 IR. 01 /82) DIL R SANITARY PERMIT APPLICATION COUNTY ~ X In accord with ILHR 83.05, Wis. Adm. Code ,EyJ 1~ STATE SANITARY PERMIT # /D 5 / -Attach complete plans (to the county copy only) for the system, on paper not less than STATE PLAN I.D. NUMBER 8'h x 11 inches in size. - N-0 3 -See reverse side for instructions for completing this application. PETITION M NO APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑ YES LsJ NO PROPERTY OWNER PROPERTY LOCATION PROPERTY O ER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME C T 1__- CITY, STATE ZIP CODE PHONE NUMBER 75 Fly- NEAREST ROAD, LAKE OR LANDMARK II. TYPE OF BUILDING OR USE SERVED: ~A Number of Bedrooms if 1 or 2 Family. LOR ® Public (Specify): /Yt C C III. PURPOSE OF APPLICATION: (Check only one in #1. Check 2,3 or 4, if applicable) 1. a. ❑ New b. X Replacement c. ❑ Replacement of d. ❑ Reconnection of e. ❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in #1 and only one in ##2) 1. a. -Conventional b. ❑ Alternative c. ❑ Experimental 2. a. ❑ System- b. ❑ Holding c. E1 Pit Privy d. ❑ Vault Privy e. E1 Mound f. A IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. Zseepage Bed b. ❑ Seepage Trench c. ❑ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): ' At ,Z0 o F16. J- Feet ❑ Private Joint ❑ Public CAPACITY VI. TANK Site in allons Total ##of Prefab. Fiber- Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank -ISM f!O ~2 ❑ Lift Pump Tank/Si hon Chamber W AIL Ej VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name (Print): Plum Signature: No to ps) MP/MPRSW-No.: Business Phone Number: Q C J S Tuzcj_tt~ lumbe 's Address (Street, Cit , State, Zip Code): Name of Designer: / 3 y "aeel VIII. SOIL TEST I FORMA ION Certified Soil Tester (CST) Name CST # jr" W4 e CST's ADDRESS (Stre ,Ciity, State, Zip Code) Phone Number: j IX. COUNTY/DEPARTMENT USE ONLY Disapproved S rotary Permit Fee Groundwater ate issuing Agent Signature (No Stamps) ICA Approved ❑ Owner Given Initial /a `va S r harge Fee Adverse Determination /b /11 X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION , TO THE APPLICANT: 1. This sanitary permit is valid for two (2) years; ` 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable; 3. All revisions to this permit must be approved by the permit issuing authority. A new perfhit may, be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 639T to be submitted to the county prior to installation; - 5. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a-licensed pumper whenever necessary, usually every 2 to 3 years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State Rf Wisconsin, Bureau of Plumbing, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description where the system is to be installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in #1. Complete #2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in #1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g.. MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; dosing or pumping chambers; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form. GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater bill ~ ,Grownd Ater included the creation of surcharges (fees) for a number of regulated practices which Wisco in'a can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reasure is used in your building is returned to the groundwater through your soil absorption o system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- t water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398 (R.03/86) r LU'i r L~ n - - - Q~G 3 0= -7 Scale 1"=(::,0' N y c T 0'I 11~ ySTEM SIVATE IT rX e' n~ ~i;iJ1AN RELA110"S f li!rJijrilRY, 1-1,~I;1 "B U1L►~!N DFAit!;EN T.~. r'`(j 1510,E U1" SAFETY r I,~~}[ 1 n 1 RA►J P 1 Fes' gEEt-ORRESPONDENCE / W 5.1 D a.3 P X1'1-tiL.g6.3S U' 4.6 P) oti wIU1:1oVAJ Q ~o~ 5'oF _ _ _ - - 1) _ - c~l~Otr~£X~sT►wG~ S1l l m X4~ S~ PVC O ;i P.1Jp pR-Y w~LLI. -To / BE ABP.~DO*.~~ R~ Fi ~t SAr..I ~ r W htH 1 G PAS-l~l N No"CL: ~2-~ \S_ y_ 5t,._ F't &l SYSTF►'~I I~RFA. - ' ~v~FS7 P_~OP~T`f toNE 19 -ISO t~ N OTES , 1. Elevations shown are existing ground elevations un `,-dtherwise noted. 2. Install cast iron pipe P onto undisturbed soil both sides of each tank. 3. Install; permanent markers at end of each lateral. required) 4. Install 411 observation pipe with approved cap. ( 2 required) 5. Septic tank to be -z.sc~o gallon capacity as manufactured by W l S EM Cp►J 0-P- ET& PTZLN CTS • sBQVi=fiv--_-------_--------------------------- 6. Bench Mark- Elevation t-AAJO SC-APE AS t-*A-s~bE~~ '11 D_ Page 2 of 7 WORK SHELT The system will serve an existing building which is presently used for administra- tive purposes. Due to the construction of a new office building, the future use of this building will be sleeping rooms. Seven rooms are anticipated with a max- imum of four people per room. The existing septic tank and failing dry well are not suitable for the proposed use. - Data for Sizing Camps, Day and Night Use 28 x 40 GPD = 1120 Employees 4 x 20 GPD = 80 Floor Drains 3 x 50 GPD = 150 Total Gallons Anticipated 1350 Septic Tank 1350 + 750 = 2100 Gallons minimum required. A 2500 Gallon precast concrete septic tank will be used. Soil Absorption System The soils are Dakota loam - Class 1 pert. An in ground pressure bed will be used. 1350 = 1.2 = 125 sq. ft. required. A 121 x 1001 bed will be used providing 1200 sq. ft. of absorption area. VIEGENED 1987 J J~ c Ross ! r.,j 1 S ?l Y. cwt 6 OR S 0 1 L f~ 1 L L~ 7, [ U~J~x'J i~.h C ~j'F;. S I f" ~ VJ l 1 O Qo-S E~~v~~u u pVC _ D1S~1Z )Bt ~l ZS?_ ~~Zr~Tb Z~/Z~` EGG TZE6ATE b 8 1 i1 r; E: i.a; rCt~;o y " 'p\r, h Ati.11 Poo - ArJEtJT ~A~ltc~~ I,, '1gg~ 3 oBStRVfi?1 DiJ 41 }iAltJ h P~nP . 7 SH913W NI OV3H -I V1O1 AGE 7 of r cD to co N O S T O co l + N ` _ - - O 4 f O 1 p co 4 CO O I _ Lij N 0 O O Q N ~ W D t 1-1 z N 1 I ~I 4 Z p C\i w CC i , ( I cD a: w CL w I C) , i I Z a: - i o O w CD CC F- co i J w J r I Q I U T I I ( ( N O F- l d O I N U Q I 1 d U IIII ~ Q aC 0 4 I l (Q~ V~ cr) - p co 4 I N O V CD + C) May O N f 11 p O N O co cD 't N O co cD lt' N N N r r- r r I- 133-1 NI Od3H IVIO1 `'l 10.0 ~2 ~ ~ 1 ~ 2 ~ I I f i / ~ V, \ i ! ~ ~ 7 l V ~ ~ yJ ~ - G ~z ~S I ~ (,1l az ~ ~ ~ ~ 2 State of Wisconsin Department of Industry, Labor and Human Relations 1 t SAFETY & BUILDINGS DIVISION r~ j, PRIVATE SEWAGE PLAN APPROVAL may; ~y ~f Office of Division Codes and Application 1~ 201 East Washington Avenue S= y P.O. Box 7969 4 1 w z®~ilol Madison, Wisconsin 53707 OfFiCE WE EBER & ASSOCIATES Owner: ST. CROIX RIVER CENTER P.O. BOX 74 421 N. MAIN ST. C.T.H. "F" RIVER FALLS WI 54022 HUDSON WI 54016 RE: Plan Number: 87-06832-S Date Approved: September 17, 1987 Gallons Per Day: 1,350 Date Received: September 17, 1987 Project Name: YMCA IGP SYSTEM Location: SE,SW,SEC.6,28,19W Town of 'TROY County : S'T' CROIX Fees Received (Priority Review): 260.00 The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval i.s based an Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved'. This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. I All permits required by the city, village, township or county shall. be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Section of Private Sewage has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the Wisconsin Administrative code. This approval is for the following components only: REPL CONVENTIONAL Inquiries concerning this approval may be made by calling (608) 266-3937. S' erely, p JAMES QUINLAN Section of Private Sewage Division of Safety and Buildings PPPO12/0009n/11 cc: ST. CROIX RIVER CENTER Private Sewage Consultant - County UW--SSWMP Plumbing Consultant yOwner Plumber Environmental Health D I L H R S B 0-6423 (N. 04/81) I ~PCLe F IN-GROUND PRESSURE SYSTEM FOR - 1'U't'111v1,STSZ/'tT?V~ $LDG. GPI PcT~1Z ST.PAUL AREA `t.M GA LOCATED IN THE E/yOF THE Swl/vOF SECTION 6 , Tza N, R 1 W, TOWN OF `Cf-,U `T S'C GRs. lx COUNTY, WISCONSIN. INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 of 7 WORKSHEET PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW-CROSS SECTION PAGE 5 of 7 DISTRIBUTION 'PIPE LAYOUT PAGE 6 of 7 DOSE CHAMBER PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR ST. GAM Y IR 1 V~R - CE1vTER Fr ~ ~sar~, _w ~ s~rof.6 PREPARED BY WMRER, 5I tB L'q AND ASSOCIATE eo®aoe~lalvOm 30X 74 2,211 ',AI I STREET `~CQ~~ HIVtR BALL", ;,lI3CONSIN 54022 a • = t ARTHUR L. WEGEREA = D•8f5 P fALSWORTH, S WIS. owe ~N~ 'RF falls 46 1 ENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS I USTRY, DIVISION P.O. BOX 796 LABOR AND PERCOLATION TESTS (115) MADISO N WI 3707 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: OWNSHIP UNICIPALITY: LOT NO.: BLK. NO. SUBDIVISION NAME: SE: 1/4 Sw~/ Tz%N/R )9E (o m~~ - - COUNTY: OWNER' UYER'S NAME: MAILING ADDRESS: S-r.<pkSjX R,IVfSR C E1V-rj=R ST"- C GR ST PAuL, AtfEf `thCA 0, , " ~soN W 1 Suol b USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: I❑Residence ~,,I\ M")A IS-MA-7uN ❑New Replace AVG. G, 19$"7 'BUG Z6~1981 8F, SLeeow 6 Wits mS FOR Z8 1''tsOP1.6~N1t~c~, s~ Pl.o~r 3 Fwo t D>zAmis RATING: S= Site suitable for system U= Site unsuitable for system r ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) ❑u Z$ ❑u$ ❑u ®u Zu ~Z'k10 lap aEM If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the N. under s. ILHR 83.09(5)(b), indicate: N3 • A • Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-I'5 CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTHfFl, ELEVATION OBSERVED EST. HIE-HEST- TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- two _r Ts, 1-y'8Y~ L ; S.g'B>t S C►- B- Z q.o' RSX 'I > `t,oI -Z -3, t1 Z.0, ; B- ~ ~'7 ~t t L~ ~ I PERCOLATION TEST DEPTH WATER IN HOLE TEST TIME DROP IN LEVEE. RATE MINUTES NUMBER IDES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD3 PER INCH P_ ► 5.9' S tFV_1 l L R $3,o Cd_ Ism C 3 P_ Z S.9' PJIJ tti L. -ss Z ?n A. U-MT. P_ 3 S, o' G P- C.L f P- Z Iff L- 17 6. y P- 3 PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION L 9 0.5 ' s• 8~ w.. _a'~ .:I i.o arr 4SQ1 O F T _ N E cJOR. Se (3,P `1 - q + s b /yr -sue, /Ay -~-~as 80©' ~sr. 'x.ls~a►~ wens, ' 9b _ F , 3 3 : -d._~5.4 _ --7 oN; what 0w 66 ) ILL. S) 3 E E E ~ alt do 16. s e.r~ ~E 111= 66' SE~• 6 I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print : TESTS WERE COMPLETED ON: Q 9-7 ADDRESS: _(.1Q- m y raC Zz6 CERTIFICATION NUMBER: PHONE NUMBER (optional): E~ L wo SY01 S-)6 -its-L/ZS-016V CST SI ATURE i or "UTION: Original and one copy to Local Authority, Property Owner and Soil Tester. 6395 (R. 10/83) - OVER - 4 i lok :~t T 115 - B,) - t. C S 1E I`ILED WITH THE Soil Separates and Textut~es wribols NC, ri01 i TO THE OVIVNER: This soil test repor 'unty or the Department may request verific it rthis soil test in e fn 'r-re set of plans for the private 1 and a permit application tae sui)m€, 'ca local authority in order to • The sanitary pert-nit m,..,. wt,,taincd ar. f:; t of any construction. H z En H 9 ST C- 105 r a y SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z d 9 OWNER/BUYERGfelter St ?zzztl Area YM Cat ROUTE/BOX NUMBER C~ T, R Fire Number CITY/STATEAtdEp Vy,.{ ZIP PROPERTY LOCATION: -SE 14, SNP 14, Section T ,,2gN, R /9 W, Town of Trd V St. Croix County, Subdivision Lot number I Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, I if needed, by a licensed septic tank pumper. What you put into fI the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 0 E I/WE, the undersigned, have read the above requirements and agree N to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart- ro ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED ? R DATE St. Croix County Zoning Office P.O. Box 98- Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. Y APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in.full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property l 7 rea-YPr ~f &I ~I Yrn 1 AC. A Location of Property SOE Section , T,29 N-R2Y_ W Township Tr v nailing Address (e..__,r% /y& d snh L(/_;r adl6l& Address of Site tav, S V Subdivision Base Qtr Lot Number Previous Amer of Property Total Size of Parcel L f (DO to C,KS -TiAOL Date Parcel was Created I `C, 2 Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes - No 7-1 (1 V q S Volume / and Page Number w-p~-N Y as recorded with the Register of Deeds.. Is/ -7 INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and page number, and the Seal of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION T Vie) cvttik that a.tL statementA on thin onmi cute true to the but 06 my (oun) hnowtedge; that i (we) am (ane) -the ownen(,sf o6 the pnopenty de~scAi.bed in thiA .in6oima.ti.on 6o&hi, by viAtue o6 a waAAanty deed kecokded in the 066.ice o6 the !yy Ren a6 eedh ah Document No. u6,,J'A cgvn and that I (We) pne~sentty aun the p4opo pnopoded site bon the -sewage dusp-oA`Zg''4' A em (oh I (we) have obtained an ea.aement, to Ruff` with the above de cAi.bed pnopehty, bon the eonatnucti.on o6 eaid 6ystm, and the bame hae been duty econded in the 066.tee o6 the County Reg.i,dten 06 Veede, as Vocwd t No. J J i WC SIGNA Op OWNBt SIGNATURE OF CO-OWNER (IF APPLICABLE) ,qo DATE SIGHED DATE SIGNED WARRANTY DEED STATE OF i17SCONSIN-FORNf No. i - ~ - ~ - Z - _ Y. c. YYtn Yrc. n.no[tn, mYtmtt 1'17719 NUMBER ' .a.Jti f f/+.1 1 ( q n Received for Record this. day of pp S TO (111 ....A. D., 193J . at J~__ /LN,. ~bar~c~.e.~ O Rcglstor o, Deeds. Th i S n d e n lU Cel Made III-------------° day of......._...~/~/l - A. D. 19.3. ~act~)L.Ii........... between-- t,. / i2l. a tlL. X1.2 ~f/ - - - - - - - ; . -.A. 4 . Partaj-A- of the first part, and - LA L r 42 2/ Lz- - / part-f ..-_of the second part, WITNESSETII, That the said part-,tSA of the first part, for and in consideration of the sum of._.:1,Z. ..d. - f U° to-___------------ - in hand paid, by the said part... -._...of the second part, the receipt whereof is hereby confessed and acknowledged, haTs._ given, granted, bargained, sold, remised, released, aliened, con eyed an confirmed, and by these presents do. k..__._..give, grant, bargain, sell, remise, release. alion, convey and confirm unto the said part-Y. of -.._the second par La,47PAAo tA....-•-.bein and assigns forever, the following described Real Estate. situated in the County of St. Croix, ud State Wf Wisconsin, to-wit: .,fM•LLtr~~ atai~u ~t fin. G 7rr~~~~~~ `~J ~ j. a ~~c~,u~.~~',~l yooyamD~Ud{rL G~cc~rPrYie/~ ~3)/~:~Lufsv~~~Gu/(~Ju[ "4e`~l { Y ~ao~:~,~a~-uf, ~or-,€~ ~~9 •:~de~..~~~.~,ar-~~~~r~,ue:~~,o~t~o•~6~'; ~,r~.~. -~f,></.,P,>;t ~ 3 ~ir,~ ~o ,~~ire~.a~.~/~i~%~ia~•i~ ~~~,~1 ~acc~,[ .711 f ~ ~~~u~/~d~ - ~l~nu.PQ- ~a2# ~ l• 2 / fem. ~,u a,,f~-a- - ~.1sa~2ntea~.~ ~ - ~V f TOGETHER, with all and singular, the hereditaments and appurtenances thereunto belonging, or in anywise appertaining; and all the estate, rig2 title, interest, claim or demand whatsoever, of the said part-,[2o, ..of the first part, either In law or equity, either In possession or expectancy of, in and to the above bargained premises, and their Heroditaments and Appurtenances. TO HAV( ~L/ -AND TO HOLD the said premises as above described, with the Hereditamentg and Appurtenances, unto the said part-t.___. of the secon~ part, and to...tYllJ~l AND THE SAID - L- ~l!l% _[.f{-~ v / L 2( LCD - J..... - e.nd ad"nistrators, do.fecovenant, grant, bargain and agree to and with the rr>-_ for--. 1 2.(1G_------..heirs, executors- part..-<F..---.of the second part AL~n'f t ---°----hoka-and assigns, that at the time of the enscaling and delivery of these preset: QlYF ..-well seized of the premises above described, as of a good, sure, perfect, absolute ar,: indefeasible estate of inherco fu the law, in fee simple, and that the same are free and clear from all incumbrances whatever,--. - ° - - and that the above bargained premises, in the quiet and peaceable possession of the said part-- ..of the second part,a - . - - ..kal and assigns, against all and every person or persons lawfully claiming the whole or any part theroof,._ will forever WARRANT AND DEFEND. IN WITNESS WiIEV. the said parUAA._.._.of the first ;part ba--& ---bereunto set A?y"~/_ i/4--_-_---_-_/hhandd,4 and scald..-this.-_.. day of-------------- A. D., 12.31 Signedand Scaled in Presence of _--------------°---------[SEA=- /f g !!~V - ~11121fi------- - - - ------.-[sEA STATE OF WI ONSIN, St. Oroix Oounty. //eyy~~ /f - - - - - A. D., 19.3 - y --..day - - - t Personally before me, yhis - ,r - 1.~1Y1li'- J' ' the above named _.(2. ~LZL(itL~•~ Z..Lll r ~u~.~fl ° - - - . - to me known to be the person '-'-.who executed the foregoing instrument and acknowledged the s Notary Public . - - - Y County, W 1 My Commission explres._ ..f? A. D.. 191. CAMP ST C X 1- 0 to to • 14~J 1 O ~-.A rdn C Q rn R O m ro r 7 f n d R 1 S N 7 H o m o f°, D :A 'R'- A 3 N a~ o w ~ F...r H X' ol x N Q d ro0 7 88. S y r=+. ~ y p R n N G d O O ~ fo N j 'v 'O C v W d n F A ~ Q Q O r .roFC .r~l„ ,p \vi n 1~~~~ C ~ ro d U! ~d V ro` CC < m n: n 0, a ro 91 d M N R ro7 G n Z O r r Z n ~o i ~ R O D T O R rte- Z n m ~troa£ ❑ R f0 to ~ £ Mw O r' R ~ O n m n n D D R ~S 4 G ~ Z n n n r. ro ~ Sa ~ p r• Z O x R :3T 3 fA H ^ n \ d n ro ~ y m m n a 7 ~ ~ R ro m d n ro (715)386-2662 (612)436-8428 ST. PAUL AREA Parcel 040-1027-10-000 10/21/2005 01:49 PM PAGE 1 OF 1 Alt. Parcel 06.28.19.89 040 - TOWN OF TROY Current * ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - YMCA OF GREATER ST PAUL YMCA OF GREATER ST PAUL 2125 E HENNEPIN AVE #150 MINNEAPOLIS MN 55413 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 55.440 Plat: N/A-NOT AVAILABLE SEC 6 T28N R1 9W 55.44 AC GOV LOT 2 Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 06-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 2005 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 09/06/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 48,400 195,400 243,800 NO AGRICULTURAL G4 13.000 2,000 0 2,000 NO AGRICULTURAL FOREST G5M 29.000 76,150 0 76,150 NO OTHER X4 11.440 0 0 0 NO Totals for 2005: General Property 44.000 126,550 195,400 321,950 Woodland 0.000 0 0 Totals for 2004: General Property 44.000 202,700 195,400 398,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 040-1027-20-000 10/21/2005 01:50 PM PAGE 1 OF 1 Alt. Parcel 06.28.19.90A 040 - TOWN OF TROY Current j X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - YMCA OF GREATER ST PAUL YMCA OF GREATER ST PAUL 2125 E HENNEPIN AVE #150 MINNEAPOLIS MN 55413 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 29.680 Plat: N/A-NOT AVAILABLE SEC 6 T28N R19W 29.68 AC LOT 3 OF SW EXC Block/Condo Bldg: 26.22A IN SW COR NEXT TO LK ST.CROIX AS IN VOL 136 P27 ORD & VOL 365 P 518 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 06-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 417/518 2005 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/23/1995 Description Class Acres Land Improve Total State Reason OTHER X4 29.680 0 0 0 NO Totals for 2005: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2004: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 040-1027-30-000 10/21/2005 01:50 PM PAGE 1 OF 1 Alt. Parcel 06.28.19.90B 040 - TOWN OF TROY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner YMCA OF GREATER ST PAUL O - YMCA OF GREATER ST PAUL 2125 E HENNEPIN AVE #150 MINNEAPOLIS MN 55413 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 46.180 Plat: N/A-NOT AVAILABLE SEC 6 T28N R19W 10.83 A PRT LOT 3 AS IN Block/Condo Bldg: VOL 216 P 445 VOL 365 P 517 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 06-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 365/517 2005 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07119/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 17.600 3,400 0 3,400 NO OTHER X4 28.580 0 0 0 NO Totals for 2005: General Property 17.600 3,400 0 3,400 Woodland 0.000 0 0 Totals for 2004: General Property 17.600 3,400 0 3,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 6.00 Parcel 040-1027-40-000 10/2112005 01:51 PM PAGE 1 OF 1 Alt. Parcel M 06.28.19.90C 040 - TOWN OF TROY Current Xl ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Cc-Owner O - YMCA OF GREATER ST PAUL YMCA OF GREATER ST PAUL 2125 E HENNEPIN AVE #150 MINNEAPOLIS MN 55413 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 8.800 Plat: N/A-NOT AVAILABLE SEC 6 T28N R19W 8.8AC PT LOT 3 AS IN VOL Block/Condo Bldg: 149 P 288 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 06-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/19/2004 Description Class Acres Land Improve Total State Reason PRODUCTIVE FORST LANC G6 4.400 462,000 0 462,000 NO OTHER X4 4.400 0 0 0 NO Totals for 2005: General Property 4.400 462,000 0 462,000 Woodland 0.000 0 0 Totals for 2004: General Property 4.400 462,000 0 462,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 T D DEPAR:,'WNT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS L_'ABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 SF%,SGI%, S6,T28N-R19W CONVENTIONAL OALTERNATIVE StaiePlan lD.N-t- III assigner}) Town o4 Ttoy D Holding Tank O In-Ground Pressure D Mound Counta Road F NAME OF PERMIT HOLDER JADDRESS OF PERMIT HOLDER: INSPECTION DATE. A Count Highway F Ruckson W1 54016 BENCH MARK IP !anent reference pointl DESCRIBE IF DIFFERENT FROM PLAN REF. PT. ELEV.: CST REF PT. ELEV t N t Name nl Plumber. MP/MPRSW No. Counry Sanitary Permit Number: C St "nett 6780 St. Choix 112838 SEPTIC TANK/HOLDING TANK: MANUFACTURER LIQUID TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED. DYES ONO DYES ONO BEDDING. VENT DIA.. VENT MAIL HIGH WATER BER OF ROAD: PROPERTY WELL BUILDING- ALARM FRALINE: AIR INLET. DYES ONO DYES ONO IVENITOIRESH DOSING CHAMBER: ICI MANUFACTURER BEDDING 11111111I)CAPACITY PUMP MODEL PUMP/SIPHON MANUF ACTUHER WARN I NG LABEL LOCK ING COVER PROVIDED: PROVIDED. OYES ONO DYES ONO DYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) DYES ONO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moistureat the depth of plowing LENGTH 1111AMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH LENGTH NO nF DISTR. PIPE SPACING COVER INSIDE CIA VPITS LIOUID BED/TRENCH TRENCHes MATERIAL' PIT DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH UISTR PIPE UISTR PIPF DISTR. PIPE MAT RIAL. NO DISTR NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH BELOW PIPES ABOVE COVER FIEV .NLE1 ELEV ENU PIPES FEET FROM LINE AIR INLET. NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- DYES O NO meets the criteria for medium sand, TIONS MEASURED, SOIL COVER TEXTURE PERMANENT MARKERS 111II1111VATION WELLS OYES ONO DYES ONO Ep TH O VER TRENCSI BED DEPH UVFR TRENCH HEU JDEPTH OF TOPSOIL SODDED SEEDED MULCHED TER EDGES OYES ONO DYES ONO DYES ONO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH TRENCHES: LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL NO DISTR F I SIRPIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV EIEV DIA ELEV. PIPE ELEVATION ANO S IA: 'DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING T)F7ILLEDCORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS OYES ONO DYES ONO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER 01 PROPERTY WELL: BUILDING: FEET FROM LINE DYES ONO DYES ONO NEAREST i Sketch System on Retain in county file for audit. Reverse Side. SIGNATUH E: TITLE DILHR SBD 6710 (R. 01/82) Zoning Admjni DILHR SANITARY PERMIT APPLICATION COIN 0>61k In accord with ILHR 83.05, Wis. Adm. Code STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than STATE PLAt4 I.D. NUMBER 8% x 11 inches in size. g , Q 4-3 -See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑ YES NO PROPERTY WNER PROPERTY LOCATION S'/a J'W '/a,S T N,R tled W ,a c4 I YM CA PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME C. T_ d F CI Y, STATE ZIP CODE PHONE NUMBER NEAREST ROAD, LAKE OR LANDMARK .57Y 1 ,36, To Cu tt dlon U).7 L& TOWN OR 11. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family OR ~ Public (Specify): CQkrL Ill. PURPOSE OF APPLICATION: (Check only one in #1. Check # 2,3 or 4, if applicable) 1. a. ❑ New bX Replacement c. ❑ Replacement of d. ❑ Reconnection of e. ❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in #1 and only one in #2) 1. a. Conventional b. ❑ Alternative C. ❑ Experimental 2. a. ❑ System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. N IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. YLSee a e Bed b. E1 Seepage Trench c. ❑ seepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): q YO® / Feet 14"Private ❑ Joint ❑ Public VI. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name oncret Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank Lift Pump Tank/Si hon Chamber VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility forinstallation of the private sewage system shown on the attached plans. Plumber's Name (Print): Pl er's Signature, (No Stamps) MPAAARSSWAIo.: Business Phone Number: u C S e r~ 713' ~15~ Pjy mber's Address Street, City, S~ e, Zip Code) Name of Designer: Vlll. SOIL TEST INFORMATION Certified Soil Tester (CST) Name CST # CST's ADDRESS (Street, City, State, Zip Code) Phone Number: IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate 1 ing Agent Signature (No Stamps) Approved I ❑ Owner Given Initial ^ Su harge Fee Adverse Determination `thh X. MMENTS/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO THE APPLICANT: i 1. This sanitary permit is valid for two (2) years; 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable; 3. All revisions to this permit must be approved by the 'permit issuing authority. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation; 5. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed, pumper whenever necessary, usually every 2 to 3 years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description where the system is to be installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement,. reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; dosing or pumping chambers; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form. GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater bill Ground Ater - included the creation of surcharges (fees) for a number of regulated practices which Wisco in's e can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reasure is used in your building is returned to the groundwater through your soil absorption o system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- f water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398 (R.03/86) • IN-GROUND PRESSURE SYSTEM FOR LODGE BUILDING AT THE GREATER ST.PAUL AREA Y.M.C.A. County Road "F" Hudson, WI 54016 INDEX Page 1 of 7 .............Index Page 2 of 7 .............Calculations Page 3 of 7 .............Plot Plan Page 4 of 7 .............Lateral Layout Page 5 of 7 .............Cross Section Page 5 of 7 .............Plan View Page 6 of 7 .............Pump Chamber Page 7 of 7 .............Pump Curve Located in the SE4 of SW4, Section 6, T28N, R19W, Town of Troy, St. Croix County, Wisconsin. Prepared by Paul C.J. Steiner Steiner Plumbing & Electric, Inc. Route One Box 138 Bay City, Wisconsin 54723 Master Plumber: #6780 Date Page 1 of 7 CALCULATIONS The proposed New Additon to the Lodge building is for a set of bathrooms and a new entrance. The Lodge has a maximum capacity of 200 people, used only as an assembly hall. No offices or food preparations will be done in this building. SEPTIC TANK ILHR 83.15(3)(c)2 200 people x 2 gallons/person = 400 gallons 4 employees x 20 gal./person = 80 gallons Minimum capacity = 750 gallons 1230 SOIL ABSORPTION ILHR 83.14(2)(a) In-Ground pressure 480gpd t 1.2 = 400 sq.feet required : Installing 600 sq.feet. A. 7.5' x 80 bed will be used providing 600 sq. feet of absorption area. Vertical Difference between pump off switch and distribution pipe: 5.00' Minimum pressure 2.50' 240' of 2" force main x 2.0 fric.loss/100' 4.80 12.30 Use 2" force main with 12" laterals. page 71. L •+..cr%.r.roi.-.-.rg...,..wr,-.: i•w++R+-:.~~..~....~,.+e..,~ ,a.,.t3EY•.- -•-r'r«- J...-..r .-i.•r.-~.»~rty Perforated Pipe Detail End View )Perforowd End GoP PVC Pipe Holes Located On Bottom, ~p Are Equally Spaced Q , PVC Force Main * From Pump - X PVC Manifold Pipe Pipe Lost Mole Should Be Neat To End Cap Distribution Pipe Layout P ,3 7,!~ ' i S yZQ. SO I S Y ~!,^Ay Hole Diameter Inch d C Lateral ~z Inch(es) RIP Manifold a2 Inches Force Main " 02 Inches rc oS5 sECT~O ~ ~ A - - No SCALE a 0 4 6 1 e~ 40 oese eva7 /a rv ~r A6 ~v/'r0 OF- 8E Fiois+4 cU &mA0f. ,-AP PP-6v-'4) SNtiJTWE-ric,. i►- C0uC2avQr 0 5 4M M Evs~. 9~. ~o'. PVG oisrl2reurookj PrPe ~Z" to Zt 11 At7G~eeU,cT - 24'' Bfi~~ piptc AOUD Z" ,48o✓t PIPrc s PLAnJ S ON j s~"yv So. o' 7.6' t~ pBsE+~~~*~ Z" PAC--< 5 DT ~ - PUMP CiiAMRF.R CROSS SECTION AND SPECIFICATIONS Vent Cap T Weather Proof Approved Locking Junction Box Manhole Cover. 4 41, C . I . 12" Min Vent Pipe ; Final ' 4" Min Grade ' 18 " M i n Conduit' , 18" Min 'j; Approved • r i Inlet Joints wj C.I Pipe Extending A ~S \ { lit pprowed gyp 3 Onto Joint Wi g C.I. Piper. 01 id Gro A Extending 31 So lid to ::'Alarm B Ground B 14 el ZOO Pump Off Concrete Block DT w -jt SPECIFICATIONS TANK L PUMP i Manufacturer: _ (/v~QILS Manufacturer: A1110es Tank Material: ~oncrefe Model Number: -S I/ Tank Size /porl Gallons Switch Type oQf- Total Dynamic Head F CAPACITIES Pump Discharge Rate: -35! C1 Total Daily Effluent: IV90 Gallor A = a " or Gallons Number of Doses: 3 Per Di B . or Gallons Dose Volume: 3 t,~Gailof C W or 3fe Gallons Notes: 1. See pump curve for D',. 1e2. " or AOO Gallons additional performance Total Tank information. Capacity Required 9/3 Gallons 2. Pump and alarm are to be installed on separate circuit ALARM as per ILiiR 16.19 WAC. Tinnuf acturer: L e vet Alarm SIG.tai:0: Model Number:_ _ LICUNSE NUMBER: Switch Type. - f nnY" DATF. 888°04613p Sao/At - Features- Pump Impeller is recessed Powerful 4/10 HP Motor is Rotary Shaft Seal has carbon Micro Switch (SS4 A) has per- 'Tornado" type - operates oil filled for good insulation and and ceramic faces for positive mannnt magnet on switch arm for completely out of volute passage lubrication of bearings and seal. seal. Body is stationary, prevents activatiny switch. i frog full opening for flow of Overload protection built-in, has string or trash from winding ASS Plastic Oparatin9 Switch ~ liquids and solids. no starting switch or relay on seal. (SS4 A) has steel follower molded ' Motor Housing I$ heavy cast mechanism, Switch Housing (SS4 A) is into lop for activeft switch magnet. iron, epoxy coated. Stator is Thruat Washers and Sleeve completely sealed from sump pressed in for perfect alignment. Swings are oil lubricated for liquid, easily removed for best heat transfer. smooth operation, long pump fife. replacement if needed. Dimensions w l x 'f v t i . .8 f~f11 , i I ti. ~r , f._ Performance Curve 24 24 N 1 TY g isr 14 l 12 4 ` - " 2 V ` - - i 0 5 10 15 20 25 30 35 40 45 50 so g Accessories Performance Table Myers offers a wide selection of accessory items for use with the SS4 pumps: adjustable level controls, wet sump controls, alarm Total teat 2 4 6 8 10 12 14 16 18 20 22 controls, electrical control boxes and switdles, heavy duty check valves, p*Owene and fiberglass bait k Or,, Sae! Meters 61 1.22 1.83 2.44 3.05 3.66 4.21 4.88 5.49 6.14 6.11 6711eas Per Hear 3,600 3,6W 3,450 3,300 3,150 2,900 2,550 2,250 1,800 1,300 664 liters Per Naar 13,625 13,625 13,058 12,490 11,923 10,916 9,652 8,516 6,813 4,921 2,498 ° ®o Performance Capabilities p 0 ❑ ~ ~ . Capacities to 60 GPM 227 LPM Heads to 24 feet 7.32 meters Pump Down Range * 4 to 4V? inches 101.6 to 114.3 mm >F Solid Handling Capability %4 inch dia. solids 19.1 mm dia. solids a Liquids Handled Fresh, drainage effluent waste water j Intermittent Liquid Temp. 150°F 66T Motor Vio HP Electrical 1151230 Y., 12.0 Amps, 1 60 Hertz Dischar a 1!/z inch 38.1 mm } Auwmstic Model, (warwal pwM variable wdh switch). r1ec11+ a `z 6 t MVM L NOW F.E. Myers Co., Division of McNeil Corporation Ashland, OH 44805 (419) 289.1144 Telex W7443 III APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of Property G =1 er J t ypa ~C= YIMCA Location of Property S A5 ~C s~) 1%, Section , T~N-R~ W Township Trb y Nailing Address C , T -A Address of Site csle?-Ala gz-s e2 Subdivision Name .Lot Number Previous Amer of Property Vv GI,~ ~V~. Total Size of Parcel q_Qc Q C_ w-S Date Parcel was Created 0206 1011 S , l I A G O Are all corners and lot lines identifiable? Yes No Is this property being developed or resale (spec house) ? Yes _ No 7- Volume - and Page Number as recorded with the Register of Deeds. • s 71 -7 INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and page number, and the Seal of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as.to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION I (we) cehtti.6y that a t Atatement6 on this onm aAe thue to the bebt o6 my (om) knowtedge; that I (we) am (ane) the ownen(.df o6 the pnopWy deacAibed in thiA in 6okmation 6o4m, by vi tue o6 a wwvucn tyy deed neconded in the 06 ice o6 the Countyy Regi6ten o6 Ueed~s as fl cum N .71f! !Y4 ;3S ; and that I phewentty own .the pnopoa ed 4 to 6oh t e b ewage d i4poz .a ya em (on I (we) have obtained an eaa ement, to nun with the above dea c t bed pnopeh ty, bon the cons t~cuc ti on 06 asid system, and the dame has been duty neconded Ln the 066tee 06 the County Regiaten o6 Veeda, as Poemnent No.2/10,1 `t q.3_) . r 1-ec~lEt~" SIGN OLD ER SIGNATURE OF CO-OWNER (IF APPLICABLE) 97-3 ~ j DATE SIGNED DATE SIGNED r - L(J~ ! t -~1 _ _ _ /_r±.. ~ ~ ------(/f/_-.~~LU ~11/_~ ~Lf~.~►_.___ - _ ~~.fe~~ezu aroma _~iu.La+Llce~..- = ! A JCL ~ ~ ~ /V /LJf~ltff Lt/UlrK4..a G'ZUtdiG. GC,~ ~iv'2d l.L'•rr,.ruus.~.t ~.u~ r~ acs i1~i~GLf/1~ ~~r~~ '•f ,L~7~ ~i l o,r,~r //i~~'~ ~U ~"~~f~G~t• r~if P.^C~~/ro~1 Cf//'l'~~iul~~`~ .[/~~r'~t.~-r/~/c~rr/ ~~/a~r~s-~~~ 4u1~!! ry L1 f~~rr ,!If " ~c~je'MLt1, ~IlI~L /l ~f.71 /LL-;1 v. (/,rt!'/.{, .f, lf1f sli-.f.~~f:Lff 6~~Lt~~1lfl~rv: ~Lfl!/f /,.14,~ rf +~OU~7~i4tfryif// 0'j ~ •Lic, ~~/f(IAN~Il!!!11/s~!'(, .l./-v ~i r(f-7?9,~~,¢ °~.tl/Pffli/. 2.[ .6f~- ~c~~l/,;Or,~~ A~ /,.'L:°~~d~f22.•~eCPtn~/ i/~l~~,L/_,l~lE~llifCri/~~~ f~f~fU'~/: - c/ d'J/~.f~2Atcs y~.z+!,u/:,~~rc•/ r~C ~.E'~•[.(ljiti~r~.ci ~~~•:~Y,~ /1 frtlf~ ~~~~.f~ llfftr ~r~ fCl~~'u~iLLttU/,~l.Gfcfll~~'~~~~~ l ~~••Z,~r1"OIGd~if~(/.E-l~r~",~t!_,/~fril~f[if.(/.f~-~er,4~P.~ c~,•r%/O'rfpi;2fG"/G~'~'i[1r.Ec,;ttrt7.ls,jJ~t: ~11G ~!/Gik~ ,~!/Filfi.GfGtfll~ftf ~/•L (~/.l /T '~4fillLlGrf/~rGf ~c/~uULtf~ CU r. .f~llGsrll~.U,!L!1 n•i2.y i ,t I/,J"'zii '7yllGUd 61 / 1mM,-A,-11 e, U,ul'v~~1(~Ifl al 4 9A,d d if - V/, r~~c'~~u~ %oiL1~4~C'tc ~t/tCfi1r. Vo. 7`7 3lQP.(tiz •~au.~ ~ .71, a4wv 0"2 At .'(:r/'Lotf~ 1~i°Zll! J JS' V ~~~A1Lil1 ~2LLGv~/f art%~/,C.e ,~;l.Gf.2 ~ / - c/ Rj?Lklull~~L U ,t./ /7 / ~s'~`L'I' / 114AWO" / A '1 IBC O? .u4/1!/LCGytf.~f/1 ~/r/~{~('l,1lG'ZL/Cl/~lCfl/,r✓~ ~(1'1t/ti. h(AZ Ail) / iii Ott l`r~f/Cl~ GUtl ir►",A/ e c _ G~~~d ~ !cad: auua~ ~ Y~~9/Gay I~O~' ~ U t RARRANT)' D1:E•D STATE OF WISCONSIN-FORM No. 1 ~ w,- YI3719 (fit VLcit.. ~a .V/i. /8~ p Received for Record this..... .......day of % A. D.. 191.f- M........S ................./9.M. ........9.~...V NA~../~. .nu11 (t.l.[A.Q/f~/i...(V.. .~it,(/~i~/f''.✓.I.N/~.rYL.'......... 7 ~ Register o1 Deeds. d This (1 d e t1 tU re, Made~xhis....----- - day of. a4 : A. D. 193-L. between..: ~:?.1,i LZ!--`r:. 1M/1.. _ 1~L1-: (G~/~t ie ~l~ - a~......~LLf+ L L~aiw~ re<art!fa ii - part _e of the first part, and ~1ti'a.[aff~.[:1~yt~CtJ~rt,.C~%~2At't:~~r~lL~/Lc~r~~rcarfra--~r.~arQ! ' ......._...••-A......... part,.,E__..of the second part, ~ yt WITNESSCTII, That the r id pa t.AJOA~- of the first part, for and in consideration of the sum of._::1LU~i: d ~C l~G.... to ...............LLL4l (M ............/....in hand paid, by the said part...4 -.....o1 the second part, the receipt whereof is hereby confessed and acknowledged, ba-la._ 1 given, granted, bargained, sold, remised, released, allened, conlyed an confirmed, and by these presents do.S!..-....give, grant, bargain, sell, remiso, release, P alien. convey and confirm unto the said part..q :--....of the second Paz !,.Q/L(.(P".AA.o'ra,...-_-hetrz and assigns forever, the following described Real Estate. Situated in the County of St. Croix~ud State~f Wisconsin, to-wit: MGx ~ V✓ILL~LU~4..P/~ ~ (3 u sv • ~ ¢~a .er 'f.(/.~,et GSA -Ah% Pd 24 1~~1/I.Y~IAt(il%aet /1 /(.14 tlz>~t.~ i. ~~a~,~,~.~n ~ ' • TOGETHER, with all and singular, the bereditaments and appurtenances thereunto belonging, or In anywise appertaining; and all the estate, right, ! ' title, interest, claim or deniand whatsoever, of the said part.,_¢A.--of the first part, either in law or equity, either in possession or expectancy of, in and to the i I 1,. above bargained premises, and their Hereditaments and Appurtenances. TO IiAI AND TO HOLD the said premises as above described, with the Hereditaments and Appurtenances, unto the said part.- of the second r ; part, and to...W..6../.l' Li,V/PQMA AND THE SAID IIJ.e. - ~r/.~..-......1.[L ~ for.. .,(,U-------------- -......A?[.ll~..........heirs, executors and administrators, do...'•.-....covenant, grant, bargain and agree to and with the said J /j 1 part... E...__.of the second part !./CLldritr2tf/art t __hetxs-and assigns, that at the time of the enseallng and delivery of these presents q QiY2 well seised of the premises above described, as of a good, sure, perfect, absolute and j indefeasible estate of inherit ce in Lho law, in fee simple, and that the same are free and clear from all incumbrances whatever (I . N I and that the above bargained premises, in the quiet and peaceable possession of the said part-_ `y_...of the second part, F/lL0 i Ilri heies and assigns, against all and every person or persons lawfully claiming the whole or any part thereof,... j !en » will forever WARRANT AND DEFEND. IN WITNESS \t'IiE {'/Q//J• the said paruLA.._..of the first part ha ~2....hereunto set......... Li(rz/~.....-...._....hand,a.... and soaLrs ..this /0 I !n^i day of_ 1!! A. D.. 191.1..- Signedd Sod to Presence of l~I:.~LI~ ~8LAL.) ~ ~saAr..~ I .ft1i ^'-.-iONSIN, STATE OF! F \\7 Iss. St. Croix County. Pgrsona lly ca before me, s F/i. dsA. D.. ~ the above named. .~ilildlAl/ t to me rfown to be the person-.!-.who executed the foregoing instrument and acknowledged the s Notary Public__-__....._-_... ~r/C.... _..._.___....County, Wis. l^^1yi My Commission ezplres._..Jy~4t.4,..-fT _-...._..A. D.. I9.1.1.__ I i UUUUU ~I I ' I GI bpd ~J1 it 4 T TE t']N¢W1sCONSIAi t~oli o•all- - y. ~~~_"i~'i) ~ , ~ *~y ~ ; ~`x.'~.. 'av„`'...; as=• --.:r e ,e.-tia,Tecs'~rxrFUrtr.te~e I ILL Is 1W to re, ado till nd • • BY— - " ch . ~ ~A`~D betWW11 ~ H.' BATHICB 6 wlidoiwer tulmaTued ~ ~r.'-~xy..,,e,.," `a' .Y~ s.~ ~Y k~r~a .r : ~y`"•,F.t'tL~.",x. y `x~ 'e~.sc'~`-~ ° { r. a ho+tlrst?part, UNG !Minnea9taziorpo a- on Tea rq► tthe~se nap . SsETHThatthe9ldplirt4y f,'tTleftTSt orndi2yi o• ! e pllax' ($1D) ~A d thetc a a W;! blecteideir tion.k- 6 to ndiehe;sid party the econd partthe•ret elptwlie 8 reby nlos'sed laI W ed, ha6 yw a~~,- Y A^ filvon~~'kra rithN bnrbained^old+romised olegsodlmd qult Claimed link b~+theso pre~ents'do£a lve*grant. )wguin*zk~oll, "`f,~-ey rs A ~'°k -r AFC a:,# €c} s 3 r. + Srx+ oltiiso'fTO ease tnd quit claimyntDYliesn jiatt y bf the second pnrt;andto t8 166 iioiB AxIm[and assigns ' "rr•._ 1" _-~°~T... :T`.'~ - r ,y{~ .1.1! + 1 3`- 6 _ or~cr How nggSde* ~bed-reeltu8~fed n hheboSiuytryof t. Oxx tat Wisconsinlbo-wit 1. - "...,c++•~' K ,T:. t~,t„'at`-:«;4 N X11 hatpartoGover=entjLotTtiree3)_, actionSx(b),wrishipY enty- N 3 8) or_ t Ran e t g `~NiTleteein (1'9)X West; ying~8outh ndjWest f the ollowing a ,W if`ibe irie, to~wit, s eginning utapoinf on ~heEastlineof Lot~Three(3Forty40) eet North bf the Southeast Corner f d,Lot Three 3 h nee Weat on a line, aral161 he %#64- oftsaid Lot Ttliee, (3) eadistoncezof Six` Hundred ~linet -four and twent y - t " nine undredths' (fi94 29) feet to a#point~Portygfeeta4North'`oftthe South Mine of aid Lot z ' ree (3)f 4thel abANoitherly; iii at8trbight~lineyto adpointuol ihelNorth`41ine of aid LO_ Threetf(3)#located•Seven4Hundred;Forty-three;ardssiventymnlne,hundredths (74379) L-t ' eet Westof the East iineof ` yaaid~ Lot ;Three (3) Viand ` ltereteminating = 41.. This deed is igiven ind accepted4foi the urposOof defining and*iebolving . 714 ll t~estions~as tozthe3locatfon of It ouindory line etween he la nds ownedibyPartier hereto ,a' .z' ,r may. r r i ``}I x- 47- n r O )lAV£ ANM O HOLA 1.110, Me 0gether,.wlfh all " tnd singular ih© „ t 1 r.~teninCOStlhdprlvllegostheretlntobelonging f: it nvwistl;,theroiiii ffappertainin ~ ll;th0 tat0 ?ig~it tltio; interb t' I etali ;Wllatfioovernf;tho snld'part y i of th0 s"' artL~ er Im n e ult Fitt o zn ~+ro' its~ br Kt9p n 4 Y ~ pdsseSSloll or 6xPectnncy.'oJ t11o~g,1 tly roper~uso, benefit and bohoof of-1.110 said i,. a. t , a ¢rt 1 y bt . the second P x art * its Buccessors ?SQCISG and asslRns forover ' ~NiY2T1vF55 WIiEREOF tho Mild Part of tho flrst,p¢rt lia.s ? oieunto sot his y4 4 ++iUIEIIId. a and .t`" +.f1.` . - , {'i icy 4.. -r enl i~ 2nd ay of T~3Mar h A~lnis 6o Y ` * 11z 1Ly~` +i N+p4 r 1{> - ¢ Y ry,ro 4. . i. i'll tit aletl Itl I rv% nrt of t ° - 11. _T 'Hathke b ads x >tixA ~y va *d# ' Pv°+~~1 Af + rryy,,.... zti Z - Art. S -r~• aa.irlRamsey. .('oulii~ yr Kth- e p 1.P z:. . "a * ~ Yer~tlnlill~ cone ladore ntr;'ihts Ad as tiift t,f w~ rCh ,~p~l) t<194,60 . y h lio~e nvnttl 1F H..*Eathke I aL , dower, uiaarried t a h • 3~ ar x `g`mcikr~tnt{~l~tri i •,{IIC+ jK~rsc,n tihri erecit M. h fore 1r11 '1.'O .td m. 4 1.A*La`urn:e pevisti ; r, 117r,}teLi7Jtl t1l s ~th ~~~-11otarll.lllC, of kareh x~h__ " ` *°FNIy (:olnmIS lot) txjnn ; s4 } +t r r - zaM t1~tl) a F Go z f az ~'10 x- as r"` wA T r~L~7 t t~sD:I'1S' s`. ~ n.. F., JrWA. . ~ fin t+ Q r a<- +~~jf + -.;1\i~. ~-+:-n.n ~ a r ~ + zr it lrs,~i 1 ` : r . a- ~Y . -r- +~'a:-°.--s-. _ is _•5t_~~P~- _ __c ~ ~ ~ ..,a SertR4R 4t lE~! ~~l}~-R'I0cnndh litntute i priMAIi ihrf rument lr4 be eFb►dea shall htave plainly Hor'~j(exw~IHen thereon the am M the tirlntizn; gontcrs wltneun rand not■ ).4 V h eo;3t35 n 17'. R i t•~-». ' ,.`'1 ..i r H a STC - 105 r a H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z d H l S't~~I(.l a OWNER/BUYER AfeQ YM CA ROUTE/BOX NUMBER- T. E Fire Number CITY/STATE Al soh Wz ZIP p N R W PROPERTY LOCATION: Section , T ap , Town of Trov , St. Croix County, Subdivision. Lot number Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 0 r~ E I/WE, the undersigned, have read the above requirements and agree y to maintain the private sewage disposal system in accordance with x M the standards set forth, herein, as set by the Wisconsin Depart- ►o ment of Natural Resources. Certification form must be completed and returned to the St. Croix `"County Zoning Office within 30 days of the three year expiration .'date. SIGNED DATE St. Croix County Zoning Office P.O. Box 98- Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. DEPARTMENT OF REPORT ON SOIL WRINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND P.O. BOX 7969 HUMAN RELATIONS PERCOLATION TESTS (115) MADISON, WI 53707 (ILHR 83.09(1) & Chapter 145) LO Jig CA, ION: ' SECTION: TOWNSHIP LOT NO.: LK. NO,: SUBRf\IISION 1VA 014!0d I@! PAE!I;FY. /a . u.►/4 A NCR/ / ~ g COUNTY: OWNER'S/BU ER'5 AM : AILING A EW. CY M CA a # 3 Say 160 u USE DATES OBSERVATIONS MADE NO.BEDRMS : COMMERCIAL DESCRIPTION: I~ PROFILE DESCRIPTIONS: ER OLA ION TESTS: ❑Residence ❑New weLReplace o/p p RATING: S= Site suitable for system U= Site unsuitable for system S S CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) DESIGN RATE: If Percolation Tests are NOT required If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: < Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) I Z0 #'d B- Ba 1s,14 ~ C N "c . s 15!"crs 'J.2-go, '4`eocl loo. o 19 alwogy;t'lo g14 14 Sh /l p B c 0" a d-.2 . • S ' ers B- r 411 w l B 102 /15 B- NB 0 / , l . c s 94 12 s 9,, 3 • y "crs fan C PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. -PERIOD 1 PERIOD 2 P R PER INCH P- P- o~ I ~r • / s P- P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION oasts'-B _ W_.j " S cQ1e,' _ (4`. ,gorei~les Bean cA Mew eY k A ~ f 4C>n crle•~e _ ~ 3 ea1'~/'Q . /'Q c k I S slab of ivel;( _-too ;Ao' fa , tkPm u-p H Well _ t~__ _li!•Z. b Blow . a ' IOU ddijncj...to be _Seeved _.l o c.a fed f/e r-e I, the u at the soil tests reported on this form were made by me in accord 'K,,~he procedur iethods specified in the Wisconsin Ad n01 istrative Code, and that the data recorded and the location of the tests are correct to the best of my Itriowledge a elief. NAME( pr TESTS WERE-£OMP1.FTL2D ON: ADDR S CERTIF CA ION NUMBER: PHONE NUMBER (optional): 0 w r ;,3 3b7AI '3 CST S TUBE: 0 DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER - , ~,jl 01 W 'C ;,I! pro ;ec IF ALL -HE F I'_ TIFIED t~z t . c ; TO THE O_ ',A,, This sail test report is th t . , p in securing a sand Department may recluest verification of this soil _ 'Ie .1d pr I for the private S$LNBiJe system `td a p ltii' tr; obtain a permit, y F rn , J