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032-2071-20-000
y o N o° o 3 o a~ o y O EA 3 0 O U). ~Y c o c o I. 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'D' m j. 7 o a Z M N U~ m o M v Z ~~ai v co Q LL c6 N c n m- O N C c0 C •Q t E Q Z m 3 0 3 it roN Z w C) Z o E N 4.; o of O Z I ~ V M C) d D e- ~ Z O 7 O Cl Z \ N to F- r ~,j m a Q E E U) ) 2 S u c D c co 0 =3 > CD c = O _m N O O j ` Z 'r, N 0 'IT N la ~Z = z co I 00 E N N Q y d N E Q f0 ,w 'C U cu W d m U 0 O a n I M =3 N fq N E F- F- H = cu o C p O p a a a a a a 3 0 tq -c rn rn !w N J U Q o O U N N Z v~ a) C. l i LL O O E N M I 0] d y O CO) N d Q Z 11a +R. w O U I, N a Iv 'r C O N C 9 L) O O V N^ H j a N N U CL N0 0 1 4: n O y l N C E cQ N O N O - O C N N cV 0 p c y t qS N c\ o ~ In -O rn 2 ~ ~ C N LO 2 7 Z O C N O O p nr a ~~ww E s c I, c = I L) 0 O N U STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER Jdn>AA("E 0 5<0" CAOI:),S ADDRESS SUBDIVISION / CSM# LOT SECTION/,3_T 30 N-R W, Town of~ S SA' r ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ~O j~pus~ d~ ~~61~GG L//r/E W~LI INDICATE t1oRTt1 ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole BENCHMARK: J~. f~~~;/ jl/pE ,4T /Q~ ALTERNATE BM: A( rr1maM AE /-)A F/ SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: Liquid Capacity: Setback from: Well House Other Pump: Manufacturer Modelt Size Float seperation Gallons/ le: Alarm LO c_5-. on SOIL ABSORPTION SYSTEM Width:-- Length _S ) Number of trenches Distance & Direction to nearest prop, line:_ SOZ17- Setback from: well: (S' House - * Other ELEVATIONS Building Sewer ST Inlet. ST outlet PC inlet PC bottom Pump Off Header/Manifold Bottom of system Existing Grade Final grade DATE OF INSTALLATION • / Y PLUMBER ON JOB: M LICENSE NUMBER: 3;Z o S INSPECTOR: 3/93: jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Laborwnd Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Pe1NBTXgAW: SCOUT CAMPS, INC. ❑ City ❑ Village R Town of: State Plan o.: Somerstat CST BM Elev.: Insp.. BM Elev.: BM Description: Parcel Tax No.: t70Z~®, / «S/_ a TANK INFORMATION ~Ct~- ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark D /o© Dosing t Aeration Bldg. Sewer Holding St Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet Vent TANK TO P/ L WELL BLDG. A irito ntake ROAD Dt Inlet Ar Septic NA Dt Bottom Dosing NA Header /Man. -S$b Aeration NA Dist. Pipe 4:8 8 G y-, 7 / e4-25S 45.7U Holding Bot. System D~ 7 9u 8 9 PUMP/ SIPHON INFORMATION Final Grade 0`l Manufacturer Demand Model Number GPM TDH Lift I-Loss Friction System TDH Ft Head Forcemain Length J_Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 1-- DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING manufacturer: SETBACK INFORMATION Type O 11*1 , CHAMBER Moe Number: System: /(o OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing I -J 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 E] Yes El No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Somerset.13.30.29W, NW, NW, Scout Camp Road d ,a ,w - s C Plan revision required? ❑ Yes ❑ No / Use other side for additional information. 1/7 Iqy SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: • 4 SANITARY PERMIT APPLICATION ~ILHn In accord with ILHR 83.05, Wis. Adm. Code Co R - Attach complete plans (to the county co only) RU ) x tt x h inches in size. py for the system, on paper not less than STATE SANITA Y PERMIT # 8% 11 2- -See reverse side for instructions for completin this a r ~O 1. APPLICANT INFORMATION - P g PPlication. ❑ Check if revision to p evious application LEASE PRINT ALL INFORMATION. STATE PLAN I.D. NUMBER PROPERTY OWNER PROPERTY LOCATION PROPERTY OWNER'S MAILING ADDRESS T 3d , N, R LOT # E (o /0L`' N CA BLOCK # CITY, STATE ZIP CODE PHONE NUMBER I III, N T SyDB2 SUBDIVISION NAME OR CSM NUMBER If. TYPE OF BUILDING: (Check one) ❑ State Owned ❑ VILLAGE NEAREST ROAD ❑ Public rX 1 or 2 Fam. Dwelling-# of bedrooms PAR EL TqX NUMBER( ) / i~ uT III. BUILDING USE: (If building type is public, check all that apply) C) a - 01) 1 ❑ Apt/Condo E ~~U~U 2 ❑ 00 Assembly Hall ~ 3 El Cam 6 11 Medical Facility/Nursing Home 10 Aground 7 ❑ Merchandise: Sales/Repairs ❑ Outdoor Recreational Facility 4 ❑ Church/School 11 11 Restaurant/Bar/Dining 5 ❑ Hotel/Motel 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 9 ❑ Office/Factory IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) 13 ❑ Other: Specify A) 1. ❑ New 2. 0 Replacement 3. 1:1 System Replacement of 4.0 Reconnection of System Tank Only 5- El Repair of an B) El A Sanitary Permit was previously issued. Permit # Existing System Existing System V. TYPE OF SYSTEM: (Check only one) Date Issued Non-Pressurized Distribution Pressurized Distribution 11 ❑ Seepage Bed Experimental Other 21 ❑ Mound 30 ❑ Specify Type 12 0? Seepage Trench 22 El In-Ground 41 El Holding Tank 13 ❑ Seepage Pit 42 ❑ Pit Privy 14 ❑ System-In-Fill Pressure 43 ❑ Vault Privy VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2• ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERCi RATE ' /SD REQUIRED (sq. ft.) PROPOSED (sq. ft. 6. SYSTEM ELEV. 7. FINAL GRADE 7 3 ) (Gals/day/sq. ft.) (Min./inch) 20 ELEVATION VII. TANK CAPACITY ~ Feet INFORMATION in allons Total # of Feet New istin Gallons Tanks Manufacturer's Name Prefab. Site Tanks Tanks oncrete Con- Steel Fiber- Plastic Exper. Se tic Tank or Holdin Tank struCted 9 ss App Lift Pum Tank/Si hon Chamber co ! OLlJN VIII. RESPONSIBILITY STATEMENT / I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plu s Signature: (No Stamps MP W No.. Business Phone Number: Plumber's Address ( treet, City, State, Zip Code : .j 5 ~ 66s IX. COUNTY/DEPAR ENT USE ONLY T ❑ Disapproved Sanitary Permit Fee (includes Groundwater Approved ❑ Owner Given Initial Surcharge Fee) a e ssue Issuing Age e Adverse Determination I O©- X. CONDITIONS. OF APPROVAL/REASONS FOR DISAPPROVAL: 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 Coed will the apermit pplicable. ssuing.authority. 3. All revisions to this permit must be app 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 m i to ed. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 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: owner's name and mailing address. Provide: the legal description and parcel tax number(s) of 1. Property 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. lons, numb VII. Tank information. Fill in the capacity of every new asind/or constructed andltank ma~erialalComplete foerall tanks and manufacturer's name. Indicate prefab or royal only if tanks received septic, pump/siphon oduct approval fgrotanks for m DILHRhts system. Check experimental app experimental p VIII. Responsibility statement. Installing plumber ber musts gn name, license cat on formber with appropriate prefix (e.g. MP, etc.), address and phone number. P IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8'h x 11 inches must be submitted to the county. The tot Ian, drawn to scale or with complete dimensions, location of plans must include the following: A) p p holding tank(s), septic tank(s) onther treatment tanks; building sewers; distribution boxes; soil absorption l systems; replacement syst m streams and lakes; pump or sip ho elevation ints; areas; and the location of the building and controls; dosenvollume elevation d fferrencefsrfrictionoloss; pump C) complete specifications for pumps 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 of surcharges (fees) for a number of 1983 Wisconsin Act 410 included the e Ct groundwater. regulated practices which ca The monies collected through these sur estabes are u ed for monitoring groundwater, ground- water contamination investigations and t of standards. SBD-6398 (R.11/88) Y P UC INS pocr iaN o- OL-At r !29X &AA APPI?vaeo cotlep. :30" I- 'ep~ 6 ' SXVEm Ec, 9y,87 l3/7 _ Top to S~cEL P,pF EL, /oo,a t yf/Siav6 S• r. /000 ALT 0/7 - NE coMnrE,Q pRrio EG . 8G •a ~ EX/5rlw& ~G. SCACE yp (--r/ 300 GL . Jfoct sE ,qtr Ek/5TIN ~ sysreM WEtt ~ j 02. s yo a ~ Q, TRENC Nrrs DI'? ORAWIN6- Fok" 11-8- 9 D RAWIN6- 13y, .IJV6IAN11E~4D Scour cjnp5, JAC , , -z A L4 4, $(o 4NDERSOM SCO"r C-AIV, RO, 586 VAcce y tMew 7/ 1404tcre,ov 601 . 579108,2 S0117ee5er Wl' - 5'Ya26- I-M,f jv 3XO S- Wisconsin Department Industry, SOIL AND SITE EVALUATION REPORT Labor and Human Relations Page 1 _ Of Division of Safety & Buildings _ in accord with ILHR 83.05, Wis. Adm. Code •`°-COUNTY Attach complete site plan on paper not less than $ 1/2 x 11 inche iry Plan must include, but St . Croix not limited to vertical and horizontal reference,:point (IBM), direction f slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance toA crest road. 032-2071-20 APPLICANT INFO RMATION-PLEASI5 P'RINT`A ;L 400, RM j DATE REVIEWED BY '4TI PROPERTY OWNER: IndianHead Scout Cam S, OPERTYLOCATION LOT NW 1/4 NW 1/4,S 13 T 30 N,R 20 4*0 W PROPERTY OWNERS MAILING ADDRESS -7~ d~ OT # BLOCK # SUED. NAME OR CSM # 186 Andersen scout Camp Rd.na na na CITY, STATE ZIP CODE ❑CITY ❑VILLAGE Houlton, WI. 54082 5]fOWN NEAREST ROAD Somerset Cout Cam Rd. [ j New Construction Use [xjc Residential / Number of bedrooms 3 j~ Replacement [ j Addition to existing building [ j Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 7 bed, 2 - 8 2 Absorption area required 643 bed ft2 563 2 gl~ try' 9P~ trench, ft Maximum design loading rate • 7 bed, gpd/ft2 - 8 trench gpd/ t2 Recommended infiltration surface eievatiori(s) 94.87 ft (2S referred to site plan beenr_ttmark) Additional design / site considerations na Parent material stream terrace Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL I MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for system ®S ❑ U ®S ❑ U EIS ❑ U El ❑ U I ❑ S ®U ❑ S 1 SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure D/T in. Munsell Qu. Sz. Cora Color Texture Gr. Sz. Sh . Consistence IRoots GP T Bed Trend 1 1 0-13 10yr4/3 none sl 2mgr mvfr gw 2m .5 .6 2 13-2 10yr5/4 none ,..vs..:.:.> sil 2cpl mfr gw lm np .2 Ground 3 28-4 7.5yr4/4 none is Osg mvfr gw if .7 .8 981f. ft. 4 40-12 7.5yr4/6 none cos Osg ml na na .7 ;.8 Depth to limiting factor +120" Remarks: Boring # 1 0-7 10yr4/3 none sl 2mgr mvfr gw 2m .5 •`-6 2 7-26 10yr5/4 none sil 2fsbk mfr gw lm .2 .3 3 26-84 7.5yr4/6 none Ground cos Osg ml na na .7 :.8 elev. 97.62 ft. Depth to limiting factor +84" Remarks: CST Name:-Please Print Gary L. Steel Phone: Address: 715-246-6200 1554 200th. Ave., New Ri hmond, Wi. 54017 00 00 Signature: Date: CST Number: 9-8-94 cstm 02298 Page 2 of PROPERTYOWNER Indianhead Scout CAmp SOIL DESCRIPTION REPORT PARCEL I.D.# 03202071-20 Structure (Roots GPD/ft I Consistence BBed iTmrch I Mottles (Texture Gr. Sz. Sh. Boring # Horizon Depth I Dominant Color Du in Munsell . Sz. Cont. Color mfr gw 2m • 5 .6 none sl 2mgr 1 0-8 10yr4/3 3 sil lfsbk mfr gw lm .2 .3 2 8-40 10yr5/4 none cos Osg ml na na •7 Ground 3 40-10 7.5yr4/6 none 98.7ee1~ee11* ft. Depth to limiting f+ 00" Remarks: i i Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) r r STEEL'S SOIL SERVICE Gary L. Steel Indian Head Scout Camps, Inc. CSTM2298 NW4NW4 s13-T30N-R20w 1554 200th Ave. MPRSW 3254 town of Somerset (715) 246- New Richmond, 54017 6200 N 1"=40' BM.= top of 1" steel pipe at el. 100' Alt. BM.= NE corner of patio at el. 86.27 44 ~17o 58 e- ~"z~c zs 3, ~6 3~, ~8 3900' 1B M Gary L. Steel 9-8-94 ST. CROIX COUNTY ZONING.OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the /t'TU2 /'9i~iQTy 7.~ residence located at: Sec./TAN, R-.gjQ_W, Town of dMERS~T Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced ACII Did flow back occur from absorption system? Yes No_X_(if no, skip Approximate volume or length of time: next line) gallons minutes Capacity: Construction: Prefab Concrete _V_steel Other Manufacurer (if known): Age f Tank (if kno (signature) DQAfAu1A1 r&~iTr (Name) Please Print (Title) - MpPS' J 3aos- (License Number) (Date) Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR-83, Wis. Adm. Code (except for inspection opening over outlet baffle) Name fi/'7iPT Signature M MPRS 32a.~' 5/88 s t STC - 1.05 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County MAILING ADDRESS_4Z3~ PROPERTY ADDRESS (location of septic system) Please obtain trom the Planning Dept. CITY/STATE /~_~/~~j<''/~~c'/~/ e,4 70/✓ / cZ PROPERTY LOCATION 1/4, - 1/4, Section /y T 0 N-R Z~ _W TOWN OF ST. CROIX COUNTY, WI 7 SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAPVOLUME , PAGfi 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 tfiat owners of all new systems agree to keep their system properly ;;taintaind. File propuli`y f)wnt'.! (?I'itCS ik) .`,l. ('11)I,\ ~,c )II~L^ .i and-by-a mater plumber, journeyman plumber, restricted plunwul or a lilcensed Mum ergvlerifyl nil) that (111 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. VWe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the , _t,dards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has beet) maintained must be completed and returned to the St. Croix County Zoning Offi-per within 30 days of the three vear exoir date. SIGNED: DATE: $t. Croix County Zoning Office Government Center 1101 Carmichael koao Hudson, WI 54016 11/93 ` S T C - loo 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 .`5f the permit issuance. Should this development be intended for resale by owner/contractor, (spec house), then a second form sh::•wld. be retained and completed when the property is sold and submitted i-o this office with the appropriate deed recording. Owner of property/' Location of 'property__ 6 /4 1/4, section %y , Tao N-R Zo W Township ~-Ma i 1. i n g a d d r e ss Address of site ,,!r~._._.ivvE Subdivision naive Lot no. Other homes on property'? yes h,3 Previous, owner of property Total size of property G-IldlC4uS Total size of parcel _ Date parcel was created _ Are all corners and lot lines identifiable? X Yes No Is this property being developed for (spec house) ? Yes X No Volume /p and Page Number Z01 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL UP THE REG-LS"T'ER 1t. 0EL-3),". 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 CERTIIF71:~JATTON I (we) certify that all statena enty on this form are true to the best of my (our) knowledge that I (we) ant dare) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of ZhF -.',-aunty Register of Deeds ;as Document No. _?2/?_i own the proposed site for the s(,e and ewage f disposal f system) orr I ently (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. i~ .ignature of Applicant Co-Applicant ~-7 Date of Signature - Date of Signature DEED THIS INDENTURE, made by Indianhead Council, Boy Scouts of America, a Minnesota non-profit corporation, Grantor, hereby quit-claims to Indianhead Scout Camps, Inc., a Wisconsin non- profit corporation, Grantee, for a nomint%0Y :onsideration, those t; lands in the Town of Somerset, St. Croix County, Wisconsin in Township Thirty (30) North, Range Twenty (20) West, 1. That part of Government Lot 3 described as the fractional Northwest Quarter (NWI); Government Lot 4, also described as the West One-half of the I'M Northeast Quarter (Wj NEj)*; Government Lot 5, 7 also described as the Northeast Quarter of the Northeast Quarter (NEI NEI); all in Section EXEMPT Fourteen (14);* except that part south and east of town road. 2. Government Lot 1 in Section Eleven (11); 3. Tk 3se parts of Government Lots two, three and four (2, 3 and 4) and the Northwest Quarter of Southeast tREGISTE_R OFFICE Quarter (NWj SEJ) of Section Twelve (12) described as follows: sTi. ClRoi7C co., Wls. Recd for R this- 26tb- Commencing at the South quarter corner of said day cd___ARri _--A.D.19-74 Section 12; thence North 2200.551, assumed bearing, along the quarter section line to the t--s~-4-- ' point of beginning; the zce N67°51'E 64.481; Thence N70°27'E 254.101; thence N27°57'E 140.301; erofdeeae thence N35°39'E 168.601; thence S44°18'E 181.90'; t_ience N43°57'E 225.581; thence N300201W 209.701; thence N51°25'E 179.401; thence N52°59'E 219.501; thence S16040'E 27.001; thence N780031E 364.33' to the East line of Government Lot 4; thence N00051E 372.16' along the East line of Government Lot 4; thence N85°22'W 730.251; thence N0°36'W 739.331; thence N780531d 144.72' to the edge of the bluff; thence N78°53'W 50' more or less to the St. Croix River; thence southwesterly along the St. Croix River to the West line of said Section 12; thence South along the West line of Section 12 to the SW corner of Section 12; thence Northeasterly in a straight line to the NW corner of SE} of the SWI of said Section 12; thence N87°41'E 260.661; thence N31°29'E 209.851; thence N17°58'E 327.551; thence N71°58'E 358.301; thence N36°39'E 222.601; thence N64°19'E 182.901; thence N82°54'E 144.751; thence N67°51'E 74.52' +t.o ....4.,+ .,f haori nninL - v. g uTsuoasTM `uospnH AauaoTTV `ujmq '3 g2nH ;Aq poT3vap TuownaTsuT STU e?~@aT uoTssTwwoD AK uuT t ~~as `aTTgnd A t"40H oadS '8 •BTT.-o4Tn~ s eCq `uoTTeaodaoa pTEs To poop aqT sv s o Kans sv TuawnaTsuT BuToSaaoT eqT paTnaoxa AagT T~uT .~aaT;; paSpajesouXaV pus uoTTvaodao3 pTVs 3o AavTaaaag pue TuepTsead eqj o oqMvans eq off. umoux am oT puv `juawnajsuT 2uTo2ojoT pa InanDaxa 30 suosaed eqT eq oT u^ouK am oT uoTTvaodaoo paWqu oAoqv UM uvwaox pur `TuapTsaad `TTUPuBU 'S wvTTTTM ~Sa~TaaaaS `sTT S 3v i~L6T TTadd So Avp sTgT `aw aaoTaq dwsa ATTVuosaad ( Almnoo AHSwdH ss ( (esosHxxlw 3o Hivis Aivleaaas `s ICAS • H uvw K WOPT ~ad ` TepuUH 'S w'OTTTTM [4Tn Ina `gingnoo Qd3Hmaxi Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No-: GENERAL INFORMATION 289310 Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.: INDIANHEAD COUNCIL BSA SOMERSET CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 032-2071-20-000 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 TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake 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 TDH Lift Friction System TDH Ft Loss Forcemai n Length Dia. I f Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMEN I N LEACHING SETBACK Manufacturer, SYSTEM TO P / L BLDG WELL LAKE / STREAM INFORMATION Type O CHAMBER Model Num er: OR UNIT System: DISTRIBUTION SYSTEM F eader / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent o Air Intake ength 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 ❑ Yes E] No E] Yes No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: SOMERSET 13.30.20.774,NW,NW ANDERSON SCOUT CAMP ROAD Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: Safety and Buildings Division ~~■~.nr• SANITARY PERMIT APPLICATION Bureau of Building Water System 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County ` than 81/2 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permits Number -IO The information you provide may be used by other government a enc rams ` U/O Y Y 9 Y P 9 71 Check it revision to previous application (Privacy Law, s. 15.04 (1) (m)]. * Q vs &n "11- State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION Property Owner Name Property Location /V -X 11r t/ilo 1' S~ 4014174) 1/4, S /3 T 3 d , N, R ~O W Property Owner's Mailing Address Lot Number Block Number ~.~l,~e,q`e_ City, Si Zip Code Pho a Number Subdivision Name or CSM Number .T 2v~ 1#%' J'Si0 Z (029 ZZLI-/j"g II. TYPE F BUILDING: (check one) ❑ State Owned City ~ Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms VII an OF C_.v~rVN / t~5~1 S III. BUILDING USE: (If building type is public, check all that apply) Parcel T x umber(s Co- K,0 rd act 1 ❑ Apartment/ Condo 3. 3 0 • i c • 77// 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 5 ❑ Hotel /Motel 9 ❑ Office/ Factory 13 W Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1..x'1 New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5_ ❑ Repair of an System System Tank Only- ___Existing System ________-Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued 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 12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 10 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 Feet Feet VII. TANK CapHExistin in gTotal # of Prefab. Site Fiber- Ex er. INFORMATION New Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App Tanks w 4usl-8,rstrutted Septic Tank or Holding Tank .g$ S 10 ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber S~ ❑ ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibilit or i II tion of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plu ur (No Sta S) MP/MPRSW No.: Business Phone Number: j:w- Plumber's Add; ss (Street, City, State, Zip C6Z e): f'~'.!i 7' Tom r~ S a IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sa%ary Permit Fee (Includes Groundwater ate ssue Issuing Ag nt Sig o mp pproved ❑ Owner Given Initial (Z~es rcharge Fee) s 6e s Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety 8 Ruildings 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 a 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 and 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 leclal 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 on 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 for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/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 1/2 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 contamination investigations and establishment of standards. STC - 106 PRIVY INSTALLATION AGREEMENT St. "roix County, Wisconsin PRIVY INSTALLATION AGREEMENT -COPY TO BE ATTACHED TO THE SANITARY PERMIT APPLICATION. Propert ner(s): Reserved For Recording Data Mailing Address: ~j Locate /V i'"~ N u~fr S I, T -TJN R r-W W City. Vilfaownship 0sf:~/ Pa.cel TaK Number: Legal Description: 1- No plumbing will be installed in the privy. 2. No plumbing will be installed in the premises served by the privy unless a code compliant soil absorption system or holding tank exists, or a valid sanitary permit to install such a system has been issued. 3. A privy vault / pit shall maintain minimum setbacks as specified in Table 1. Table 1 Well Building Lake/Stream Additional County Setbacks Open Pit 50 Ft 25 Ft Min. 75 Ft Sealed Vault 25 Ft 25 Ft Min. 7S Ft 4. Privies for public buildings shall comply with ILHR 52.63, Wis Adm. Code. 5. Privies used for one- and two-family purposes shall be constructed in such a manner so as to exclude flies, rats and other vermin. Doors should be self-closing and vault ventilators should terminate at least one foot above the roof. 6- A privy vault shall be constructed of watertight plastic, fiberglass, coated steel or monolithic concrete. Materials shall comply the intent with ILHR 83.20, Wis. Adm. Code. Counties may, by ordinance, establish minimum sealed vault sizes and type or construction within the guidelines of ILHR 83.20, Wis. Adm. Code. 7. The privy shall be kept clean and sanitary. The contents of the pit or vault shall be disposed in accordance with NR 113, Wis. Adm. Code. 8. This agreement shall be binding on the owner, their heirs and assignees. This document shall be recorded by the register of deeds in a manner which allows its existence to be determined by reference to the property where the privy is installed. Printe Owners Names Subscribed and sworn to before me on this date: Owner s) Signature Notary Public My commission expires on: NOTE: This document was drafted by the State Department of Industry. Labor and Human Relations, Bureau of Building Water Systems. J FRED C. ANDERSEN SCOUT CAMP a CANOE a TO BACK PACK P~J JET O RACK © CAMPING AREA ADIRONDACKS L g'C • a 0 0 Q T TRADIN PETERSON I - BALCONY O POST PARKING SHELTER 3 CAMPMASTERS PETERSON 2- NO BALCONY SHELTER 2 _ TRAINING ~,O J~V N BUILDING sf~ a X L.a?fr~'yL O SHELTER I w E AD NO f1 Troo p (Shepley) j x S. t N S v PETER 1 X V X RANDALL P O f~rJr ~45 SHELTER JQ~~EV SHOP ~~v HO k LGY ~ r ,'nom GOODO RANGERS HOME 4 ~V J MEDICINE NO SHOP O because of the narrowness of the Fred C. Andersen Scow Camp property, this map has been distorted VAN KREVELEN in o-,ier that relative positions may be more clearly SMELTER shown. The map is approximately 2 times wider than it should be to match its length. p .u.. U~ ✓I C31 N O t C~ E ~ ~ O c z c> c E rc w- _ c > c w rn c a 3 - ca -0 E m cc ° z O ° > n o ` a> > c W .N a ca 'O > N 3 a a> A ~ 0) z 0) a O N` a u EE u cn L [a •CIO C N Z o n CM y O.° _ a o o y o g C p is Q L E N 2c > RE E sap E a r; o o x r>Y c c R C 16 ca y W CV O t ~fn 3aoE3a ae oU r _ ` N . O CJf C C_ L O° O N 4> •C p m •3 C f- E o a' a N w .[n cc O G N 6> az cc 3 H inn c ° o am c r O N C o In c ~ Q 'n y.,. 3: U -j CD cu in `>o Eacv1 a"c~accc y N° L N C to N M d 0.> w 3 C L [a N U> a> v 3 c v c I co o > o c v rn c Ca U 'C c o° c o L c r E" CD y 0 <T C C7~ m t [ (n c 7 O U C W t6 O_ 0.) N _ V N L V O~ a = C N 0) 0 3 N 7 0 0 L CC L L O O ccs .`r O L 3 t M 0) id y f 3 N c o(n _j J E 3 o c 3 0-0 N > N O r c> O C C 'v ca 3 y N c~ 0 cm A n> on [a o a> E c aV. E o E o a, cc cc _ i=. ~ C O ~ 3 fa • 33c~ U °~3 I~ ca O ` O LA J C v CL m I w O a ° p N ` ti• 1 - O O C c0 tC cu I i / o ` E v In cu a> E c:, a J fn O cj> - O N G N .G C` Y= 0° t ' z o d ca c v cc co '0 L [a i o o p 3 4°v3 Uc ° a J.ncae cc -i LLI 110 _~~`\\v ~O IIO~L O I10~` 8 Z Q _ ° c co ° N C7 W O Z [ IL a. O ' Q _ J1: O Q1 x• to 00 Q S \ I Z M F. m Q Z I ~ 00 w W iCP 00 I m N I~. _ N Lf1 C) r I LLI 0 LA C) (9 60 Ln V) - w _ ~ • ~ 1.8/£ g 118/£ g z ' 00 d M ~ • 1119 00 W L • m I:L l I L: Q C7 z I U v U- L N I W W L) L) C13 v ' ao 0 LL/ o I IF- z Z. o~ cnW O U) IN H 00 CC U) O(A.~ 3 -UU-j IW H f1' x O o N } _ J-~cr U- N ~F- 2 Z Q Q F- Q N X p GW/, W O w W N fA Z- W N O aw %A~ 4i Y w h _ ►1 Q Q V N 11 U c? V ~ w a ' ZN a h~ +1, .a I I I. - l ~ b O ~ u - ~ 111 1 k S u I 'e 1 r r 9 to ~ - I I N W Q a N 40 oc I 1 a v y o ,t ti Q A ~ Z I ~ a o a HR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY -Attach complete plans (to the county copy only) for the system, on paper not less than NITARY ERA 8% x 11 inches in size. ❑ J21f h o co -See reverse side for instructions for completing this application. P I.D. NU o 1. APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION. STATE PLAN I.D NUMBI PRO OWNER PROPERTY LOCATION '/a 1ref'Y4, S L T 30, N, R cab PROPERTY OWNER'S MAILING ADDRESS LOT # (Or) qr BLOCK # CI TY- STATE ZIP CODE PH E NUMBER SUBDIVISION NAME OR CSM NUMBER a~ S3" 02 z z 2 y-i /tom 11. TYPE OF BUILDING: (Check one) ❑ State Owned NE REST ROAD ❑ VILLAGE ❑ Public ❑ 1 or 2 Fam. Dwellin /rlaq Ld•car g-# of bedrooms - q Ax NUMB 111. BUILDING USE: (If building type is public, check all that apply) ~O 7 -30 74~? 1 ❑ ApVCondo ~ 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational 3 ❑ Campground 7 ❑ Merchandise: Sales/Re airs 4 El Church/School p 11 El Restaurant/Bar/Dinin 8 ❑ Mobile Home Park 12 ❑ Service Station/Car VI 5 ❑ Hotel/Motel 9 ❑ Office/Facto ry 13 2 Other: Specify dg4k IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1.14 New 2. ❑ Replacement 3.E1 Replacement of 4. ❑ Reconnection of 5.0 Repair of System System Tank Only Existing System Existing ES 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 30 ❑ S eci T e 12 El Seepage Trench 22 ❑ in-Ground p YP 41 El Holding 13 ❑ Seepage Pit 42 1-1 Pit Privy Pressure 43 Vault Pr 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. F REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) E VII. TANK CAPACITY INFORMATION TY Feet in allons Total Prefab. site New istin Gallons Tanks Manufacturer's Name Con- Steel Fiber- Alai Tanks Tanks oncrete structed glass Se tic Tank or Holdin Tank Lift Pum Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for instal on of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plum Si ature//: (No Stamps '/i~G MP/MPRSW No.: Business Phone Numb 007 Plumber's Address (Str)et, City, State, Zip Co IX. COUNTY/DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (In( ludes Groundwater Date issued Issuin Agent ❑ Approved El Owner Given Initial ^ Surcharge Fee) Signatu (No Stamps) AA.--- Determination U 5= X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: 51313-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS A sanitary permit is valid for two (2) years. Dour 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. All revisions to this permit moist be approved by the permit issuing authority. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6,:99) to be submitted to the county prior to installation. d by lcE:nsed Onsite sewage systems ~~iust be prc,periy rnaintai~,ec. The septic tank(s) must be pumps -5 pumper whenever necessary, usually every 2 to 3 years. 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. complete and accurate this sanitary permit application must include: >roperty owner's 'name and mailing address. Provide the legal description and parcel tax number(s) of vhere the system is to be installed. - ryp6`of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. 3uilding use. If building type is Public, check all appropriate boxes that apply. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. Type of system. Check appropriate box depending on system type. Absorption system information Provide all information requested in 41-7. Tank information dill in *he ~,pa,ity of ever, new and or existing tank, ist V`utal ga lor. 1+~ u o tanks and manufaOurer's nay °e. Indicate prefab or site co Mi ucted and tank c lerial c ' 1,.-,r a!/ septic, pump/siphon and ho :f ng tanks for this syste n• hF:ck experi!rientai 3; rova Ui ;cs receivef: experimental product aoc;r"t%,"l from DILHR refix i;e. Responsibility statement lristalling plumber ss `:r i w narne, license n. beY with appr=p,.; g MP, etc.), address and, r- one number. Plurr.uer ,~..st sign application fc!-n. County/Department Use Only. County/Department Use Omy. 11 es mu Complete plans and spec. f` a,icrs not smaller h a e'orhwith complete b men , 't,; tf c ' of on of he plans rmst include the -e •ot pia, ,e;vit.!~; holdinn tank ~ (E'r tre~z`rnr'ft toss s, ~;nC1 seAe ueIIS W~~. (s) Fppti r t3'k r,N S SSFiY streams and lakes, n0Q)p Of _fi~l+.= + ,c±IlK$ !iStrltl,~titvi{ soil atlsogttion systei o iht ocas . cn , . w -J': `ig serl-d !3) ~,o .'l end vertica, elevati. 'f areasand ' C) complete _pec lfications fo r ur ips and controls, dose .,,olume; elevation differences; t; c t TOSS; I)um:.1 performance curve; pump model and pump manufacturer; D) cross section of the soil &bs~jrpxion system if required by the county; E) soil test data on a 115 form; and F) all sizing information. - - - - - - - - - - - - - - - - - - - - - GROUNDWATER SURCHARGE 33 Wisconsin Act 410 included the creation of surcharges (fees) for a number of 3ulated practices which can Ff ect groundwater. + i ? `-ia'T•3E. •.1sGd fl?r 3vlt?r' `^..lvt'i3e~', -lie e monies r ~fc:d iter contaminalion IntroS~ ) f r "S and ~rSta~i~,'~I}ti•(.r ; S c~!:.~4."4'> 4 3D-6398 (R.11/88) FRED C. ANDERSEN SCOUT CAMP D CANOE ~P RACK 2 TO BACK PACK %,I J~V O CAMPINGAREA V~ Q1 a\J~a ADIRONDACKS 0\* 04 TRADIN PETERSON I - BAL O POST PARKING SHELTER 3 CAMPMASTERS PETERSON 2- A SHELTER2 O nt TRAINING BUILDING r ~ 4~ x ~6 W E SHELTER I AD NO f~ T~'od~0 L7J (Shepley) l k - t 1 ~ 6 4 -fr PETER v RANDALL SHELTER JQQ~~V OSHOP ~J H011Q Z-Z ~P GOOD RANGERS HOME MEDICINE NO SHOP O Because of the narrowness of the Fred C. Andersen VAN KREVELEN Scow Camp property, this map has been distorted SHELTER in order that relative positions may be more clearly shown. The map is approximately 2 times wider than it should be to match its length. I A b " A a 1 x o m o n ~ D 3 s z 3 1 ~ i ~ j Uc#r1TJtm-,rR UyT 12.30.20Fr&t SEWXGE~~~N SCOUT labor andd H Huummaan Relations Aj 'Safety and Buildings Division INSPECTION REPORT oun y: GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary PermitNo.: Permit Holder's Name: 13 ❑ City ❑ Village ❑Jown of: State Plan ID No.: BM Elev.: Insp . BM Elev. : X BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA A9300080 TYPE MANUFACTURER CAPACITY STATION BS HI Septic FS Benchmark Dosing Aeration Holding Bldg. Sewer TANK SETBACK INFORMATION St / Ht Inlet St/Ht Outlet TANK TO P/ L WELL BLDG. Ventto Septic Air Intake ROAD Dt Inlet Dosing NA Dt Bottom Aeration NA Header / Man. Holding NA Dist. Pipe PUMP/ SIPHON INFORMATION Bot. System Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System e TDH Ft Fi Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of TreDIMEN I N nches PIT No. Of Pits Inside Dia. Liquid [ DIMEN I N SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type O System: CHAMBER Model Number: DISTRIBUTION SYSTEM OR UNIT Header/Manifold Distribution Pipe(s) Length Dia Length Dia. Spaci x Hole Size x Hole Spacing Vent To Air in ng SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over Bed /Trench Center xx Depth of xx Seeded /Sodded Bed/ Trench Edges Topsoil xx Mulched COMMENTS: (Include code discrepancies, persons present, etc.) ❑ Yes ❑ No ❑ Yes ❑ Nc LOCATION: SOMERSET 12.30.20.760A,NE,NE, ANDERSON SCOUT CAMP RD. Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature • Cert. Nc ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: DOCUMENT NO. STATE BAR OF WISCONSIN FORM 5-1982 1111, 11.1E RESERVED FOR RE PERSONAL REPRESENTATIVE'S DEED 488875 - - VOL-- 970PAGE 397 1 UGISTCR16 C C0 ix - Irene spring-- rn-------------------------------------------------------- Redd fQ! RPC4 S L P 2 219! _ as Personal Representative of the estate of Milton E. Meinke_____ a1 4:45 ("Decedent"), for a valuable consideration conveys, without warranty, to ReglslerofDee& Indianhead Scout__Cair¢?s, Inc., a Wisconsin corporation _-,Grantee, RETUQ10 ,jQ1n the following described real estate in - St. Croix - _-county, ~ Wef - 430 1 j 30 Second St. P. P. p, State of Wisconsin (hereinafter called the "Property") I _ _ .----------Hudson;-W, -54i Tax Parcel No: ---032-20E All that part of Government Lot Two (2), located in Section Twelve (12), Township Thirty (30) North, Range Twenty (20) West, laying South and East of the following described line: Commencing at the Southwest corner of GovernmE Lot Two (2), thence running northeasterly in a straight line to the NorthweE corner of the Southeast quarter of the Southwest quarter (SEi SWI-4) of said Section Twleve (12). l -401.00 Personal Representative by this deed does convey to Grantee all of the estate and interest in the Propel the Decedent had immediately prior to Decedent's death, and all of the estate and interest in the Property Personal Representative has since acquired. Dated this 29-t11 day of --------------------July--------------------------------------- 19-92 -------(SEAL) -t-- Irene Springyborn Personal Representative Personal Representative AUTHENTICATION ACKNOWLEDGMENT Signature(s) ---Irene Springborn, Per_s.__________ STATE OF WISCONSIN Representative of the estate of Milton E. as. SANITARY PERMIT APPLICATION COU~T~ ~-MILHR In accord with ILHR 83.05, Wis. Adm. Code 1 ~ STATE SAN[ RY ERN -Attach complete plans (to the county copy only) for the system, on paper not less than 8% X 11 inches in size. STATE PLAN I.D. NUMB! -See reverse side for instructions for completing this application. 1. APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION. PETITION PROP Y OWNER FOR VARIANCE ❑ YE PROPERTY LOCATION Iz %4, S / T , N R W PROPERTY OWNER'S MAILING ADDRESS LO NUMBER BLOC N BER SUBDIV I N AME CITYE ODE PHONE NUMBER CI tj TY A v / f~O v? ~lj j 17[~~/ ❑ VILLAGE : NEAR AD LAKE OR LAND N. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family OR K Public (Specify),yp III. PURPOSE OF APPLICATION: (Check only one in ##1. Check 2,3 or 4, if applicable) 1. a. 9 New b. E1 Replacement c. ❑ Replacement of d. E1 Reconnection of e. E1 Repair of an System System Septic Tank Only an Existing System Existing Systel 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. E1 Alternative C. ❑ Experimental 2. a. ❑ System b. ❑ Holding c. E1 Pit Privy dX Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. ❑ Seepage Bed b. ❑ 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): VI. TANK CAPACITY Feet ❑ Private El Joint El INFORMATION in allons Total of Prefab. Site New xisting Gallons Tanks Manufacturer's Name Con- Steel Fiber- Plastic Tanks Tanks Concrete strutted glass Se tic Tank or Holdin Tank 1 Lift Pu i hon Chamber ❑ VII. R S ONSIBILITY STATEMENT I, the undersigned, assume responsibility for install 'on of the privates wage system shown on the attached plans. Ply ber's Name (Print): Plumber's ature: (No S ps _ 'IEfP/MPRSW No.: Business Phone Number: Plumber' A dress (Street, City, State, Zip Cod Name of Designer: S~ -M,, 0 -7 Ill. SOIL TEST INFORMATION r fill Certified Soil Tester (CST) Name CST # CST's ADDRESS (Street, City, State, Zip Code) Phone Number: IX. C UNTY/DEPARTMENT USE ONLY ❑ Disapproved San'tary Permit Fee Groundwater pproved ❑ Owner Given Initial Surcharge Fee Date Issuing A ent Si a (No St Adverse Determination Q('y S 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 THE APPLICANT: This sanitary permit is valid for two (2) years; 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; All revisions tQ 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; Changes in ownership or plumber requires a Sanitary-Permit Transfer/Renewal Form (SBD 6399) to be submitted to the. county prior to installation; 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; 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. be complete and accurate this sanitary permit application must include: Property owner's name and mailing address. Provide the legal description where the system is to be installed; 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; 1. Purpose of application: Check only one in #1. Complete #2 if permit is for tank replacement, reconnection or repair; J. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; 1. Absorption system information: Provide all information requested in #1-6; (I. 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; JII. Responsibility statement: Installing plumber is to fill in name, license fo form. number winh adesi ppropri me prefix (e.g. MP, etc.), address and phone number. Plumber must sign application applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/ Department Use Only; application is disapproved. X. Comment area for use by county or resaon given when app 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 corrrplete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; welts; water mains/water services~. streams and lakes; dosing or pumping chambers; distribution boxes; andfvert carpe' ovation r systems; rePcecemeri ; system areas; and the location of the building served; B) on poi 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 Groundy ater - a included the creation of surcharges (fees) for a number of regulated practices which Wisco in`s 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- water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398 (R.03/86) Wiscahsin D@Mrtment of Industry, Laboran8 Human Relations PRIVATE SEWAGE SYSTEM County: Safety and Buildings Division INSPECTION REPORT St . Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary -Permit No_: NE PIE Sec. 12,T30-R20, Boy Scout Ca Permit Holder's Name: i,p 149130 Indi anhead Council El City El Village E] Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: Somerset Parcel Tax No.: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELI WSeptic Benchmark Bldg. Sewer j St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/ L WELL BLDG. vent to ROAD Dt Inlet Airlntake Septic NT NA Dt Bottom Dosing NA Header/ n. Aeration NA Dist. P' e Holding B . System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Dema Model Number GPM TDH Lift Friction System T Ft Forcemain Length Dia. Fi D . To well SOIL ABSORPTION SYSTEM BED /TRENCH Width gth No_ Of Trenches PIT No. Of Pits DIMEN I N Inside Dia. Liquid De{ DIMEN I N SETBACK SYSTEM O P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type O CHAMBER System: Mode Number: OR UNIT DISTRIBUTION SYST M Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing vent To Air Intal Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems only xx Mound Or At-Grade Systems Only [D:e Over Depth Over xx Depth Of Trench Center [fS eed ed /Sodded xx Mulched Bed /Trench Edges Topsoil Yes ID No COMMENTS: (Include code discrepancies, persons present, etc.) ❑ Yes ❑ No Plan revision required? ❑ Yes ❑ No Use other side for additional information. E M_ SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ` NO E: ,Thls,p!ocument is to be recorded in the Tract Index PRIVY the oNSe Of ARegister T IO pl/ AGRE Deeds E the EMENT COPY TO BE ATTACHED TO PLB. county indicated below. PROPERTY OWNER: 67 WHEN APPLYING FOR A SANITARY PERMIT MAILING ADDRESS: LOCATION; ✓Z'~ ~2s 4 A vE S 9 M ~u/~Q CITY, • VILLAGE OR TOWNSHIP-: S ~~rV ~YJ L n (Or' J f FR' -L ~ /,I /v/ COUNTY: 1 (we) acknowledge the following privy installation conditions: PR I U Y S z z; z 1• No plumbing will be installed on the premises. Plumbing meal any c /YnG 2s Fu M water distribution and drainage systems, including hot W.I. ans an tankwat urea, softeners 4-1 ( - YPiping, fixtures, equipment, devices or a "s T Cnn0 1 C 2. The privy will not be erected within 50 feet of any well, stream or lake, countenances in connection with and water heaters connected with such water and drain thoroughfare and 5 feet of a property line. Set backs not mentioned shall not be less than those shown 25 feet of a door or window of any building, 10 feet of the line of any stri 3. The privy will not be installed on soils that do not have at least 3 feet of soil below the bottom in section H63.10 1 or bedrock. Where these conditions cannot be met a vault constructed in accordance with sectio of the proposed ( excavation that is free of periAdministrative odi 4• The soil condition has been verified b 63.18(6), Wisconsin Administrative Code be u certified soil tester as signed here. by an appropriate county official or SIGNgTU AN ITLE: 5. The privy will be installed: (mark one ❑ over a soil it ~ 6. This agreement shall be binding on the owner(s) or h and assignees. OW S): STATE OF WISCONSIN la OWNER(S): Personally came before me this day of to me known to be the persons who executed the foregoing instrument and acknowled ed the sa THIS INSTRUMENT DRAFTED BY; DrI'HA`::BD~-6432(R.3/82) No ARV PUBLIC g rne.= "COMMISSION EX r r FRED C. ANDERSEN SCOUT CAMP CANOE Q TO BACK PACK P`JQ~~ O RACK CAMPING AREA XADIRONDACKS YA L41 s~ . O O O ~ TRADIN PETERSON 1 - BA POST PARKING SHELTER 3 PETERSON 2 - CAMPMASTERS SHELTER 2 TRAINING N BUILDING 20 aQ 9 ~ W ADIR NDACK SHELTER 1 p (Shepley) 1 ? S PETERSONS o RANDALL SHELTER JQQ~~V SHOP H IVY v GOOD RANGERS HOME ~J MEDICINE AND SHOP { O Because of the narrowness of the Fred C. Andersen 4k A Scout Camp property, this map has been distorted VAN KREVELEN ~r in order that relative positions may be more clearly SHELTER shown. The map is approximately 2 times wider than it should be to match its length. Alrl I1 ~~NIlAI'I. ~ 8 0 ~ Ix A I~ n U O 1 r x D a po n T D Z o s D z jo T D r m 3 x ~ U ~ P k D r°• e?4 ~ • R, I LATRINE WASHSTAND . URINAL :0 O 00 BASIC LAYOUT GENERAL Floor: smooth finish, such as steel- frame support; accessible frorr Provides toilet and washing facilities troweled concrete, for easy sweeping, sides. for 30-boy troop and water for cooking, washing and flytightness. cleaning, fire protection, etc. (Drinking Structures: simple frame construction, Water: horizontal pipe with tr water from nearby drinking fountain). no doors or windows. Avoid sills and perforation to direct water into Check local ordinances and soil other construction interfering with on-off valve; stop valve to maximum flow; hose bibb belo conditions. Vault latrine may be swPPoing and washing. water source. Water demand. 11 required. LATRINE: peak; 250 gal. daily average. LOCATION Light and ventilation: natural, by Waste: 200 gallons per day. means of 6-nch space at bottom of Place at center of each troop site. w REFERENCES alls and 12i-inch space at top. Do not Locate at least 150 feet from any well or use electricity-a lantern is used for body of water and with ground sloping night lighting. Screening interferes D20-Troop Site Development away from structural where possible. with cleaning and ventilation. Conservation. REQUIREMENTS Dry Pit: permeable masonry sidewalk, WASHSTAND: This structure is designed for ordi ` nn tlonr Trough. 5-foot long climate conditions. In cases of unL 9 steel with wind or snow loads or other stre! ire: V-shaped anti-splash bottom; pipe inllnw advice of local consultant ENGINEERING SERVICE DES Boy Scouts of America - 1A""_+ WASHSTAND/LATRINE STANI SET 2x2 OR SHOCK CORD i , SO LID IS SELF-CLOSING 3/4" PLYWOOD PARTITION ~ 1 \1 ' SHELF ABOVE J F END VENT HOLES - IEACH SID_E_ - - - - - - - STAINLESS STEEL SEAT TURN EDGE OVER I 2x2 PARTITION BRACES 2x4 - - ° REINF. 4" CONC. SLAB., -X x- -r zza SEAT DETAIL 2x6 SHELF WOOD SEAT BOX DETAIL, DESIGN STANDARD D-30A WATER PIPE WITH T~--3//44" _ " HOLES SPACED 9'0.C ON BOTTOM OF PIPE Oo _j m 101. co 2" r 00 ' M 00 11/4" PLASTIC ; • • . , • PIPE 8 3/8 4'/a" 8 3/8" ' cD REMOVABLE 11-8 7 8" CAP FOR CLEANING FLOOR OPENING FOR FOREST ALL-STAINLESS REINF. 4" STEEL TOILET SEAT ASSEMBLY MFG'D BY: CONC. SLAB REHCO CORPORATION / 5 HOOPER AVENUE LOS ANGELES, CALIFORNIA 90001 B - - - - - - - TROUGH I 77 (STAND DETAIL o o SLOPE _ 0 _0" URINAL to LL STRAINER 11/4" TAIL PIECE DETAIL N 1'A PLASTIC Pil'E r n„ INDUSTRYTM SAFETY & E INDUS , REPORT ON SOIL BORINGS AND LABOR AND P.O. PERCOLATION TESTS (115) HUMAN RELATIONS (ILHR 83.0911) & Chapter 145) MADISON L CATION: SECTION: TOWNSHIP E 4A1, tZ- /T,~o N/ (or) W L NO.: BL . NO. SUBDI ISION NAME: CO~ Y: OWNER' NAME: MAILING ADDRESS: USE 3 MIAA, o NO. BE RMS.: COMMERCIAL DESCRIPTION: DATES OBSERVATIONS MA E Residence PROFILE DES RIPTIONS: ER O ATnIO /v New ❑Replace LEI. gRATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND PR URE: SYSTEM-IN-FILL HOLDING TTAANK: RECOMMENDED SYSTEM: (optional) ~S U NS CCU 11 ❑S1! ❑S U If Percolation Tests are NOT required DESIGN ATE: under s. ILHR 83.09(5)Ib), indicate: LF'loodplain any portionof the tested area is in the , indicate Floodplain elevation: 1~_J4 1 1. . F . - I PROFILE DESCRIPTIONS ~S C BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNES OLOR, TEXTURE, AN NUMBER DEPTH *N, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) ?~of s!a 13- j2, B- Z - NO P.E t. A. S AS. g v' 83 B- o u& $3 .75 .t. 01. -I s ~B-.s.4. B- B- PERCOLATION TESTS TEST NUMBER EP HES AF TER IN LOL E INTEST T ME DROP IN WATER LEVEL-INCHES PERIOD 1 PERIOD 2 RATE MINI PER PER INC P- P- 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 zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction ar of land slope. SYSTEM ELEVATION t E I 3 r e R 3 h z ' E I r.:-.., ,l"jY ~1 ~ ~ s i. } 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 M A't 0. - Location of property60P114 v;e 1/4, Sectio~` T7-40 N-RXo W Township Mailing address 3, f,3 00Q~, Address of site Z r V Subdivision name WLot no. Other homes on property? -YeS-X_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 X_No Volume -5/-D and Page Number 20/ as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER & THE SEAL OF THE REGISTER OF DEEDS. certified surve In addition, a y, 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. and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said svstem_ A-A tH- L__ . GWIN. GILBERT & `GWIN w s a a„ i rF . ~ et a , r DEED THIS INDENTURE, made by Indianhead Council, Boy Scout America, a Minnesota non-profit corporation, Grantor, hereb i quit-claims to Indianhead Scout Camps, Inca, a Wisconsin no profit corporation, Grantee, for a no-mina -onsideration, lands in the Town of Somerset, St. Croix County, Wisconsin Township Thirty (30) North, Range Twenty (20) West, M: 1. That part of Government"Lot 3 described as the ti fractional Northwest Quarter (NWI); Government Lot 4, also described as the West One-half of the Northeast Quarter (WJ NEJ)*• Government Lot 5, also described as the Northeast Quarter of the EXEMPT Northeast Quarter (NEI NEI); all in Section Fourteen (14);* except that part south and east of 2. Government Lot 1 in Section Eleven (11); 3. Those parts of Government Lots two, three and four ( and 4) and the Northwest Quarter of Southeas ftEGIS`tER OFFICE Quarter (NWJ SRI) of Section Twelve (12) described $T. CROIX O.. WIS. as follows: Recd for R this- l6tb_ Commencing at the South quarter corner of said day of__ 'Eri __A.D.19_74 Section 12; thence North 2200.551, assumed t._1Q4 , M. bearing, along the quarter section line to the point of beginning; thence N67°51'E 64.481; . Thence N70 27 E 254.101; thence N27°57'E 140.30'• =y erof thence N35°39'E 168.501; thence S44°18'E 181.90'• thence N43°57'E 225.581; thence N30°20'W 209.70'; .thence N51°25'E 179.40'; thence N52°59'E 219.501• thence S16°40'E 27.001; thence N780031B 364.33' to the East line of Government Lot 4; thence N00051E 372.16' along the East line of Government Lot 4; thence N85°22'W 730.251; thence N00361W 739.331; thence N78°53'W 144.72' to the edge of the bluff; thence N78°53'W 50' more or less to the St. Croix River; thence southwesterly along the St. Croix River to the West line of said Section 12; thence South along the West line of Section 12 to the SW corner of Section 12; thence Northeasterly on a straight line to the NW corner of SRI of the SWI of said Section 12; thence N87°41'E 260.661; thence N31°29'E 209.851; thence N17°58'E 327.551; thence N71°58'E 358.301- thence N36°39'E 222.601; thence N64°19'E 182.901; thence N82°54'E 144.751; thence N67°51'E 74.52' to the point of beginning. except the tracts and subject to the easements describes in the deed from this Grantor to Olga M. Schroeder re- cordeddAinfVolume;492, pages 286 & 287, index #313649 anti N United States Department of the Interior NATIONAL PARK SERVICE ST. CROIX NATIONAL SCENIC RIVERWAY W REPLY REFRt TO: P.O.130X 706 ST. CROIX FALLS, WISCONSIN 54024 July 31, 1991 L1425(LOSA) Mr. Honer D. Miles Camp Consulting Services 8023 Ingleside Avenue, South Cottage Grove, Minnesota 55016 Dear Mr. Miles: We have received your request to construct field latrines and a fence on th4 Indianhead Scout Camp property, Tract 12-152, within the Lower St. Croix Nationa: Scenic Riverway. Ranger Joseph Hudick of our staff has been on the property many tines arc inspected the property from the river on July 28, 1991. He has reviewed your plans and the proposed building site and, based on this inspection and hii recommendations, your request is permissible under the terms of the scenic easement presently in effect on your property. However, you should note that our permission is only provisional and is contingent upon your compliance witl all other applicable land use controls. In effect, our contingent approval indicates only that the Riverway scenic easement conditions are fulfilled. It in no way evaluates the merits of the proposal in relation to local zoning or Wisconsin Department of Natural Resources (DNR) requirements and thus does not preclude or supersede any action(s) by those units of Government. Therefore, you should be aware of the need to comply with the regulations, ordinances and land use controls of Somerset Township, St. Croix County, and the Wisconsin DNR, to whom copies of this letter are being sent. Your cooperation in complying with the terms of the scenic easement is appreciated. Sincerely, A f. OL Anthony L. Andersen Superintendent NAMML PARK SERVIC Somerset Township /-Bt:-Croix County cc: 119 Wisconsin DNR ■ 1916 -1991 1 r { A ~z w` ' . ~ Vim. b , 25 r- G D FOO --~.j.-- - ~r o T~ ` Lr -'r rA) • : L0 I '1\. F c L I c ~ ~ I• v I N b r- tA o I 19 rn ~N m Z T x sM ~ N ~ o ti ~ Z P a o.~. 1' o x n i -C r~ n 0 I Q •o I L i II - f m r z - - - iN Z -1 A W, rr\ loot -n O O ; �D rn N v C OD a N o A O O O O O 0 0 w N O N W C. D E CD , CA w w N SCUM (inches) -°_ -+ k y a 0 rn rn N o ,� Sludge (inches) a N OCo 0. N N Z z z z z E Pump Tank o CD V C Q 0 0 0 0 o �0� n ° O W w N iu m SCUM (inches) ? ,A IV pmt O 5 7 r O GZ o - N cn Sludge (inches) S. G) 3 0 0 0 0 o n Pump Tank 3 0 0 0 0 o SCUM (inches) 0 0 0 o Solids(inches) r O C a o C n 9 n n n Liquid a 0 m Appearance 0 o 0 0 0 0 o Pump Tank tD 0 0 0 0 0 3 T Bubble Pattern » a n Hm O N M M rn rn Air Filter Cleaned c m33 M m m z m Inoculant o: 0 w D n CO w CD ° °' Replenished (0 C O o 0 0 0 o Bubble Pattern 5 c CL co zm M M M M M Air Filter Cleaned m O -L O O � � a z z z Inoculant tp O o CD o v o Replenished "' O n U) 0 ; D 0 0 0 Bubble Pattern c C _ O a G D sy a 2 < rt 3 M M M M Air Filter Cleaned M m m m m Inoculant a W CD Replenished W 0 0 0 0 o Scum (inches) N� W W (> r o o -4 k w Iw w w Sludge (inches) S. A \ O (o r p ` 0 0 0 0 0 Pump Tank `m 3 �. N m ,. O r M M � b° (D d �° Filter rt N CL a a Cleaned o rt � i O O a WO N N N N N Q N N O W W W W O/ `„' C Q. w _ O O O O O ."h D A W N O CO w 0 = '" n n n CD (D m M Tank Contents # a s m m w m tD (D � O W N N A 7.5 amps o -0 N Qo 0 � A c O N O N L i v C1 C7 C7 n n n - 'C i O M m m m m Sim/Tech -� O CL c, m m v m o� n = 7 7 3 7 7 p N 0 0. M Q a s �, F�Iter Cleaned y Cn � �' O n) m 0 r o q� O 3 3 V 43 tD O o 10.2 Amps o c m fl? co 3 < O 3 !y L) 0 9 9 n U) (D v n Sim/Tech ' ' 3 m Filter Cleaned Cn M o. n a a Ia. 0 0 0 0 0 Pump 00 o ° ° 0 0 0 0 Alarm a rA CD CD est End Z O O1 o East End w°D — r M O M O s ,i � West End s' 3 .* 3 CL CL o- East End o''� ° O n CL O M ib 0 West End N C o 0 tD 3 � OOD East End — 0 0 0 o �est End C a ° S C. 0 0 0 o East End 'a w tc 0 -L Q 0 O =r cOc i � G West End r 1; ° � *C n CO) o East End O 3 rt D 3 CD West End r n ° O a1 e� 3 m � s i n o - O CD c East End O �_ 0 O N � ? O CD v West End or to C W ° a V O East End — O O o 0 0 o West End .� ° H S CL N 0 0 0 o East End 'a 0 M M M M M n POWTS Operating Properly %s u' o 0 0 0 o p D O --s o 0) w w w m m 0 C O o. N N N N C ry Np e� D W N -. 0 N OD O 0 C7 v _ aD co w N Scum (inches) - � 4k G y a --s CD to ,Op CR co N o �, Sludge (inches) a G) to N O U) cp et "O C N N p u o v z z z z u 0 0 0 o a Pump Tank e = c n m ° O CO w N 3 Scum (inches) N N C 3 s r xi o —1 I O o 7 N � O� 4 N w a F Sludge (inches) 7 u a- a r O = O a1 'a 0 0 0 0 Pump Tank v =. o o o o Scum (inches) (..),3 N 0a o o o Solids(inches) o d G= Y- ib 5 c m Liquid r -P- � d m al m Appearance < O 0 0 o Pump Tank CD O 0 0 0 Bubble Pattern S _ .�, n � a ID �n -< -< -< -< Air Filter Cleaned cc m 70 s3 m m Z m Inoculant co m „D,I n ° C" Replenished `° - . C O on 0 0 0 0 Bubble Pattern a c C • a z O t_ m m m m Air Filter Cleaned a 3 p -� O O m Z m Z Inoculant a it CD co o ° ° Replenished • "' N 21. n to W n 0 0 0 Bubble Pattern ? y E C o, om G < Sri: . i-3o m m m Air Filter Cleaned F. d r 0 CD CD 4:6 3 0 3 V) -< -< -< -< Inoculant a N -p 4 ! ' r Co Cl) CD Cl) Replenished °' O 0 N iy o o 0 0 0 Scum (inches) — ) rya r 0 W O p 3 0 0 0) Z " D Ill CO w CO Ca Sludge (inches) a 5 C O v O 0 0 o 0 Tank = = = N 0 A- O O 0 0 0 m -0 3 • i ZIT i Filter m 0, o cp Awe a a n a Cleaned = p ... x lb % ' 2 — . s."... 0 0 0 o O v m C.) pp a rn w w w 0 m c O ci 0 0 0 0 0 0 tD 0 3 n Z., N fs O 8 W • m Tank Contents y p. Ili• m w w M M W 0 = 0 N O N M A 7.5 amps N N CO c O N O O N C) C) C) C) c -s -0 - n i i CD a n Sim/Tech - C') G 0. a a a < Filter Cleaned a y 0 o Ot -. ID CD r �' ° ' 3 o 3 3 N c 0W O "C at o 3 5 10.2 Amps o -a a O 0 -I 3 o o C) C) w N '• .d a X ( a d d w O. Sim/Tech o� N = m Filter Cleaned al CD a c . n o. o 0 0 o Pump 0 n s o CD o 0 o o 0 o Alarm x. w W GI 'ti W 0 West End r Z 0 — — r o Ch o East End m 3 �: l � � A Cl) n O 4 CD m- c m West End Or CD m O, 3 ` , c 0- 0. East End N N if = E -4. n w 3 " m O West End i N a C .. o * tD O c 0 East End d 3 - 0 Q 0 0 o West End n G O g- O 0 0 0 o East End d O O to 0 " 3 O S C 7 G West End g C O (n N �* M ''* Z East End a) S r D 3 C °r 0 3 -n m West End m m Q, 3 p1 m —N w (Dm' 0 = 0 0 O m m , p n A c N m c n n East End a y i = a O -z rt o N N o West End co F Z W — to c° a y East End N = 0) 1 5)) 0 0 0 0 West End .p ? 0 o a) a N o o o East End 3 o ,ra. -< -< -< -< Cl) � W POINTS Operating Properly Page 1 of 10 EXISTING POWTS EVALUATION - TIER 1 1. SITE MFORMATiON A. Property Owner: Name: Fred C Anderen Scout Camp Mailing Address: Phone: B. POWTS Location: Street Address: 186 Andersen Scout Camp Trail Ho ulton, Tax Parcel ID: Legal Description: 1/4 NW 1/4 Sec T 3 N R 1 9E Township: Somerset County: St. Croix II. STRUCTURE SERVED BY POWTS A. Type & Use: Residential: C] YES ® NO Number of Bedrooms: Design Wastewater Flow: gpd Commercial: 0 YES ❑ NO Design Wastewater Flow: 2062.5 Business Type: B. Comm: 111. CONSTRUCTION MAINTENANCE HISTORY A. Date of Comstruction: B. Sanitary Permit No.: C. Repair / Modification Permits: D. Tank Last Pumped: E. Inspection, Servicing or Maintenance Agreements: F. Additional Information: IV. DAY OF EVALUATION A. Date of Field Work: October 23, 2010 B. Weather Conditions: C. Occupancy: Ocd ion �t f El NO Horne Occupants Hoe at Time of knepec lRon• ] El 1V0 Tier I Evaluation i NO s e ons d IL o 0 MO B Tank Treatment Train Page 2 of 10 (Ali tanks supplied by Wieser concrete) Tank # 1 — W1565 Grease Interceptor Capacity = 20MMMSMav X 49i1MWM x 7 tours 22x1 meal periods Capacity -1400 gallons (D Tank # 2- W4200- 4200gallon Setting Tank /� (3 day Retention Capacity) 576 gallonsiday, 220mg11_ 1300 _ . ....... Tank # 3 -W3000 /1800- 3000gallon Tank with 3 Sludgehammer S-46 units 1800 gallon Effluent Filter Tank with Polylok 525 To ]dOtll'CD Y 2 ` Tank # 4 - WLP750 -750 gallon Mound Dosing Tank _ Using Duplex Pumps With Simtech STF —100 Effluent Filters To MOUND Y 2 Page 3 of 10 TANK i (Grease Intercentorl A. may: 1565 gallons B. Tankage Dom Less than 1• of Grease/ Scum. 12" of Sludge C Construction Material: Precast Concrete D. Manhois Risers & Covers: L c8W & opensd:[ m O t�, 1�J_ Manhole Locaf xs): Over rust Baffle Center l _ Over Outlet Depth Above or Below Grade: • Locking Devices Present NO Warning Label Present NO Appear to be Watertight 71YES NO Root Infiltration NO Sigucturally Sound NO Coven Replaced & Seaumd: E. overall Tank Condition: POOR FIFAIR GOOD Appears to be WetarligAEMYES NO Root I fiiltrad YES 12 NO t—� 7�. F. Inlet: Water Flow Not Caused by Fixture l�e l ]St EADY FLOW G E Baffle Material: P1a8bC Bad c GOOD G. Outlet: ComponerNOWFLE []FILTER Baffle Pla8tic Betfle Filter Make & Model: NA Fier Condition R VO LEAN IRTY Filter Cleaned During Inspection H. Liquid Level: []HIGH O Liquid Leve� �-I IORMAL IGH [�OW Liquid Depth: 4 Scan Depth: I l Talk More Than 1/3 Sofiftl Vff NO Tank Pumped for Evaluation NO Tank Pumping Reoommended: §NO 1. Conditions Duri Cond our Below Water Line0P00R OFAIR OGOOD Flowback:[]YES mNO IF YES: Little flowback: Steady & Substantial: J. Setbacks: Separation Distance from: Wei(s): + 100 feet Structures: + 10 Feet Property Lines: + 100 Other: K. Location: Area Subject to Receiving Runoff' NO Tank is located in or under a structure L. Comments: Tier I Evaluation Page 4 of 10 TANK 2 (Settling/ SeoticTank) A. Cam: 4200 gallons a. Tankage Description: Less than V of Scum 15' of Sludge C. Construction Material: Precast Concrete 0. Manhole Risers & Covers: L � a 1�G1 _ center �. _ over ova�c _ Depth Above or Below Grade: Locking D No Warning Label Present. ZJYES No Appear to be WaliertightOym NO Root kalion NO Structurall Sol t6YES NO Covers Replaced & Se vied: E. overall Tank Condition: POOR FAIR 6gGOOD Appears to be Wmwkozulm NO Root killitrationj3YES t( � F. Inlet: water Row Not Caused by Rxl re Use O L] '•�_�- . S TEADY FLOW �E Bailie Material PI88bC BeHle GOOD G. Outlet: Cam _ _ _ _Q3 FLE LTER Baffle Baffle Fier Make a Model: NA Filiw Cord lion R LEAN LIDIRTY Fkw Cleaned During InspectionOYES MNO H. Liquid Level: Li LMMOJOR SAL [3-11tH CILOW Liquid Depth- 72 - kc h es Sc rn Depth: 7 ki ch Tank More Than 1/3 So11dB• YES NO Tank Pumed for Evaluation TIVES E NO Tank Pumping Recom mended: NO I. Conditions During Pumping= Ca XKM Be ow Water Line 00R AIR OGOOD ; $ ONO IF YES: Little fbwback: Steady & Substantial: J. Setbacks: Separation Distance from: WeN(s): + 100 feet Structures: + 30 Feet Property Lines: + 100 Other: K. Location: Arm Subject I0 Receiving Rurwff� E NO - Tank is located In or under a struct re NO L. Comments: Tier I Evaluation • Page 5 of 10 VIN. PRORE IMENT A. Pn3treatment Component: 0 YES ❑ NO B. Type: Siudgehammer S46 C. Manufacturer: Sludgehammer D. Date of Installation: E. Component Installed: To Rejuvenate Fang SysWMQYES HNO Component of a New SystemUXES NO F. Component Appears to be Functioning: ;JtZ,T,�ES ONO G. An Alarm Is Activated at the Time of Evaluation: DYES ES m NO H. Completed Copy of Most Recent Component ��^ Q Inspection / Maintenance Report Attached: GDYES (if Ma inspection has not been completed within the last six months a recommendation should be made that the pretreatment unit be inspected by the contracted maintainer.) Tier I Evaluation - - 1 ♦ A W R MAINTAINING YOUR SLYWHAMMER INSTALLATION Now - Most Counties and regulators will require that some sort of maintenance contract be filed between the homeowner and licensed maintainer. - Contact your SludgeHammer representative for a generic maintenance contract form. - Typically maintenance inspections 4 be required on an annual or bi- annual basis. Maiatenam Procedures: I. Open all manhole access: coven on the septic tank and air pump basin. Are the liquid levels at the correct height? Is there a slight earthy odor? There should not be a septic ode Y Is air bubling into the SludgeHammer compartment? The bubbles should be about 1 -2 centimeters. If the bubbles are larger than Scm, there may be a diffuser problem. 0 Is the h" PVC air line in good physical condition? Check for leaks or rocks. i Remove and replace the bactetia innoculum. Simply cut zip -ties and install new bag. Evaluate air pump. Remove set screw on back which exposes a coarse air filter. Y / Remove air filter and tap off dust. d Wipe bugs and dirt out of air pump basin. 4 Are electrical connections within pump basin compliant? V Remove and dean septic tank effluent filter. V Evaluate effluent pump for proper operation. Are electrical connections for effluent pump compliant? L� Replace and fasten all access coven. o � Record any metering or monitoring data, if applicable. 7 PO 5 r 2. Open Inspection caps on dispersal system. inspec p ip e s? Is there effluent standing n the i s g P� P Pe 0 Are there any spots on the surface of the ground that indicate ponding? N 0 3. Additional review Are there an repairs necessary? -- y P Are there any code compliance concerns? O Page 7 of 10 TANK 3 (Aerobic Treatment Tank) A. may: X 000/1800 gallons B. Tankage Description: 0' of Scum No Sludge C Constriction Material: Precast Concrete D. Manhole Risers 8 C Located overs: & .� ❑ Manhole Locadon(s): Over diet Beal Center _ Over Outle Depth Above or Bebw tirade: it AbMat V% do Locking Devices Present NO Warning Label Present NO Appear to be W NO Root ktlwaalkin NO Structural cSound NO Covers Rep' F 1 i Secured: E. Overall Tank Condition: POOR FAIR 69 GOOD Appears to be W ES NO afar Root InfIkaUon NO F. Inlet: Water Flow Not Caused by Fixture UseLpwP LJS' EADY FLOW G54OmE Befrte Material: Plastic Bgryft NG GOOD G. Outlet: ComponerriO3AFFLE C)FILTER Sam Magarik 4' PVC T same Filter Make &ModelP 525 Filte r Caiditlori OOOD CLEAN IRTY li Filter fed During Mtspeckon NO H. Liquid Level: Liquid LaveOJORMAL []HKiH OLQW Saim Depth: Talc More Than t/3 SoCds. NO Tank Pumped for Evaluadom No Tank Pumping Recommended: NO 1. Conditions During Pumping: Co~ Below Water LIME]PO R AIR OGOOD Fbwback [Z]NO IF YES: Little flowbadc: Steady & Substantisi: J. Setbacks: Separation Distance from: Well(s): + 100 feet Structures: + 80 Feet Properly Lines: + 100 Other: K. Location: ENO Area Subject to Receivkip Rurwtf�- =ES Y is kx�ed in or under a struckxe (YES NO L Co mments: in inlet manhole and 1 S46 in middle manhole of 3000/1800 oai aerobic treatm tank. Tier I Evaluation Page 8 of 10 Vill. L A. Capacity: 750 gins B Construction Material: Precast concrete C. Manhole Risers & Covers: NO Riser 4r Above Swour%*V Grade NO Locking Devices Present Waring Label Present NO Appear to be W NO Rod kdbzd xh NO Access to pump adequalle NO Covers replaced i secured' NOW Nero D. overall Tank Condition: POOR AIR ®GOOD Appears to be Water li YES NO Root khtiltrNOW NO E. Vent: is Tank Vented Approved Vend Cap NO F. Setbacks: Separation Distance from: Well(s): +100 feet Structures: + 100feet Property Lines: + 50 feet Other: G. Liquid Quality: CLEAR THICK ® FLOATERS RCLOUDy SCUM SLUDGE H. Alarm: ONO I. Pump Controls: Oper -93YES ONO J. Pump: oper allonelLB YES ❑ NO K. Siphon: Sipim P'esent NO Trkwftl ENO Water Level: Affl BEL,W BELL L. Location In Landscape: U Area Subject to Receiving Ru noff:OYES m NO M. Electrical Connections: SIDE of manhole riser 4;0m Wowwproof JuNO Box Cortains Water' NO Box Contains Sod: NO Condillon of Conneckons: GOOD ••• The obctrical Cornmc ons how EM for Code compliance. patty general condition is noted. N. Comments: Dose tank contains 2 um s with SIM/TECH STF -100 effluent filters .Both► were clean at the time of in Tier I Evaluation Page 9 of 10 DL SaL ABSORPTION AREA A. Type: IN- GROUND IN- GROUND PRESSURE AT -GRADE MOUND OTHER (type) B. Distribution: O GRAVITY O DOSED [Z]PRESSURE C. Configuration: ❑TRENCH m BED D. Dimension: Length: 131 feetteell WkM feet/cell Number of Cells: 1 Total Absorption Area: 37m 5`aft_ E. Depth: Grade to Top of Unit: 12 inches inches Grade to Infiltrative Surface: 91 5 inches inches Where Measured: nhsary part F. matsrist of Construction. [Z] GRAVEL ❑GRAVELESS Specify Product: G. Observation Ports: Present:OYES Number: 2 Terminate at: Top of Unit Dis Ujdo n Pipe Midtratne Surface Other H. Effluent Dh&budon: Disirbtdion Box0YES ®NO Drop Boot: C]YES m NO Material. c4ndiltim, — Access: Above Grade At Grade�� – Below Grade Condition: 1. Flushing Apperatus: Preserd.OYES 0 NO ❑ UNABLE TO LOCATE Flushed for Evalustion:60YES F1 NO R S[]3LUDGE[]0THER J. Seti>,adcs: Separation Distance from: We#(s): +100 feet Structures: + Property Lines: +100 feet Other: K. Observations: General Condition: Good Pw*Qr VJN0 dac4h of 0 Surface Appearance: Lush egemlion NO S NO Porded• S NO Breakout NO Location: Runoff Area NO ffic: Tra NO ther O. L. Comm ents: There are 2 n-tou identical in size Both are in the same condition This report serves both mounds. Tier I Evaluation I Page 10'Gf 19 X. pDU MMTION Of FUNCTION: A. Discharge: 1, the sy stem dwh&WV to the surface of the ground?QYES [Z)NO Is the system discharging to surface wateh?C)YES mNO S. Backup: into the structure served by the system NO is there > bac into yes, is the backup due to a blockage prior to thptic e se N NO is the c auhse of the backup downstream of the septic talk C. Comments: XI. OBMVATIANS &COMMENTS The Aerobic T reatment Unit and the whole Septic System appe to be operating properly- X 11 . BECOMMENDATIONS No pumping needed at this time. X111. EVALUATOR Name: John Schmitt Business Name: John Schmitt Septic System Services Address: 616 15nth Ave .nrlM sstaiai, �wfl CAI175% Phone: 715 The information contained herein is true and c o rre c t to the best of my knowledge as observed on the date of evaluation. All information reported is based on the condition of the system at the time of evaluation. This report shad not be construed as a warranty, either expressed or implied, that the system win function property for any particular user or for any period of time in the future. MPRS 223760 Signature Credential & ID Number ` October 24,2010 Date XIV. ATTACHMENTS A. Records: Sanitary Permit(s) Maintenance Reoord(s) Approved Plan Servicing Contracts) Original Sod Test Deed Atfidave(s) Site Diagram S. Additlond trhcinded: Operation & Maintenance / Users Manual Informational Guides (list): Tier I Evaluation XVI. CC: Realtor Owner Lender Buyer County Other 0 0 Q> 0 0 00 ". p 6r3 0 ur o°n N N 0 0 r; O C y O N pp L O O N r O N �O L j . 12 fl O E- XEc y O. 3 0 N L N 2 cD ti E N w @ U x N N Lp L >, Q N N r U c 3 C E O CD C 7 0 4) L M CA N U v .> co N . N c 'O W � to ... C O) Fr N O O 'o T- U) :3 0 T a) wT •N O LO "6 - U m (p a U y .0 w Q� (pry C N ap O) N '', N O Y a) o 0 > C O O y C 'C y y N -- O N LL c z �� c z oU mE LL co N «. Y. p N N N L a 3 a) N 3 ay- c m� ° a c 2 oo m a3i maw Q Q N a L E Q a c o ots c) d' N O C'4 N > > W z y 0 y O > O E O E N Z �: O t O w Ln p LO E O z S N` v y y ce) CL CL O o y 0 O j ' O O O z I •U Q' r co f6 7 y 1p O y fq I• W y N Cc � O Q N E d C N E N CL N O y I O y U • N -� U) L L (01) C C Q C C IY� N O Q Q 0n O Q N ZZ _ a Q = C N LL N E c R E o In y ° y_ a 0 a ) E a Lo ' E a R U co y d w @ y G) i I �n a V o a U . E 'm o o to N v) o � F I u 0 F- H H � cn u) 0 0 0 X 0 0 0 •)V ;� N a n. a N a a s y ` FL • co 'O y Z Q m� } U N U o _ N x ui 0 m e3 m y r' m F�)1 E a_ QI z ;n E v- Q> t cp pl N w N N R ❑ o U N y U N N o o c o N c p c l o H c o E O r- FO - ''., (n m C N C c U d p Tr N C in ^ 0 (n E @ y 0 o o y> o v cs y o m • y O fn C O y Q' z C N O V rj� I' a a 5° a w a w • .M G N .V N C N C c I, A U a ! 0 0 U O (D U I O o 0 on a �1 0 c m m F A v m vl F owl j o o 3 m w a o w w < • :T �? = . c , co N rn N O. N CD 0 W� N W O O � o ^ N N ry fi«f N O N CD O "S \ Q J 0 C) 00 -70 Ck O n n --I A O �O1 O O O l� 3 7 NO„ O C N c n o r 7 y m c, z D m a 3 � O cD c'. O N a H M N 3 `, �, @ N d ' C) i r �y (� z D O (D (O O N .fir. C a a CD n Cl) w cr c, -a 3 m �v m = 'o (D m 3 I o. N zmz� � o o O D j m O= :L1 C_ O' c O f0 O co d T1 1 N 7 o p Z <D A Z 3 p +n I C O � * z w CL m — '0 3 � ! A ; O n A i Z 0 3 to Z N i O £ A I N p O y 3 a " _ 0 7 N 0 T D v CD m m o a � (n ca N o obi o 3; 5�. o O Zip y 7 W O O N N CD O O O �O 4 Q CD ° O o CD % a ti Page 1 of 1. Pam Quinn From: Jansky, Leroy G - COMMERCE [Leroy.Jansky @Wisconsin.gov] Sent: Friday, November 16, 2007 8:15 AM To: Pam Quinn Subject: FW: Anderson BOy Scout Camp Trans ID 147969 1 am also forwarding this memo to you (please send to Ryan) too. Bratz is on vacation until 26 Nov so I would get an answer until then. If John comes in for a permit you may want to ask him these same questions if we don't alread have the ansewers from Bratz. In addition, I'd like to be notified when this system is going to be installed so I can be there. Leroy G. Jansky, PSS, Wastewater Specialist Wisconsin DComm - Safety & Buildings Division 13 E. Spruce Street Chippewa Falls, WI 54729 (715) 726 -2544 Voice (715) 828 -5902 Cell (715) 726 -2549 Fax leroy.jansky @wisconsin.gov From: Jansky, Leroy G - COMMERCE Sent: Friday, November 16, 2007 8:07 AM To: Bratz, Charles L - COMMERCE Subject: Anderson BOy Scout Camp Trans ID 147969 After all the talk about Sludgehammer -like units yesterday I just want to make sure that the ATUs being used in this project are approved for: a. High strength wastewater. The approval letter refers to wastewater from dwellings which would be <= 220/150/30 load. I recall you mentioning a kitchen and maybe a dishwasher for this project so maybe there is a mess hall and a high strength load? b. Flow. There must be 6 -8 of these units in the tank if the entire flow is being treated or is just the flow from the kitchen undergoing treatment? if there are a lot of units, access may be a problem unless there is a special cover designed to allow for maintenance. Leroy G. Jansky, PSS, Wastewater Specialist Wisconsin DComm - Safety & Buildings Division 13 E. Spruce Street Chippewa Falls, WI 54729 (715) 726 -2544 Voice (715) 828 -5902 Cell (715) 726 -2549 Fax leroy.jansky @wisconsin.gov 11/19/2007 O d f C 1 O A 7 fD ,� xc h O O �cr d ° N OO_ Cl) A W W N (D I cn O m ° N M Z Z _ O ( ^\ N 0) C Z (D (D N N N NO c- C" z O_ Cl) cn O � �. T -4 ti O O ' COi C/) O -4 WO � O 3 o °� !�► in c n o O D m 3 0) (n � a N N W T N 3 0 (0 N ry N fl_ (A�Af m ,Cl 0 c0 cD D n r to ° o = N o c fl fl n .. a CD CD O O O =3 m "Im.�e c to to to m N CSD I v v d N n m O 3 QO S CD c N 3 N O 0) 9 3 m 00 S m r. rn a a N N N° D D o o O c Z a � a Cn P% . rn ° c N CD n '00 CD CL _Z Cl) A n 3 N ^D 0 w a 0 a , — Z T O -. A O N 3 ° N Z 0 A CD O 0 c O o N Q 3 3 a _.m m-0 0: 7 N C — C W =) Z C -n a) a 0 4 m ° CD fU S CD S N C N ' m O S N 0 m 60 cl) d 5 CD m m j 0 o' W 7 N O CO O: Q° cn p 2 O = W O t N S n O (D O 9� � v m A (n 0 O O O O A i r ° b tEn 0 c o g a p CD ? O C. V Page 1 of 2 From: Jennifer Shillcox Sent: Tuesday, October 16, 2007 11:05 AM To: 'Mike McCarthy'; 'bagency @sbcglobal.net' Cc: Kevin Grabau; Becky Eggen Subject: RE: Boy Scout Project Permit Approval Hi Brian and Mike, I am tied up with BOA preparations this week and won't have time to write a letter until at least next week. Brian, I have attached the correspondence between myself and Mike McCarthy regarding the a legal, nonconforming status of the camp. After consulting with our Corporation Counsel, we concluded that adding a new building to be used for training purposes, which have always been a key component of the camp /institutional use on the site, would not increase the nonconformity of the use and would therefore not require a special exception permit to bring the use into compliance with the current zoning ordinance. It will still need a sanitary permit and any building permits as required by the Dept. of Commerce. Let me know if you have any questions or need anything else from me. Thanks, Jenny - - - -- Original Message---- - From: Jennifer Shillcox Sent: Monday, October 15, 2007 11:29 AM To: 'Mike McCarthy' Cc: Kevin Grabau Subject: RE: Boy Scout Project Permit Approval Mike, I'll try to get a letter out to you today. Jenny - - - -- Original Message---- - From: Mike McCarthy [ mai Ito: mmccarthy @northernstarbsa.org] Sent: Monday, October 15, 2007 9:53 AM To: Jennifer Shillcox Subject: FW: Boy Scout Project Permit Approval Jenny, See the message from Brian Wert below. Can you give me a letter stating that we have the approval from the county to move forward with this project. Schmidt and Sons is taking care of the plan for the septic and they have applied for the permit for the septic system. Let me know if you need anything from me. Thanks! From: Brian Wert [mailto:bagency @sbcglobal.net] Sent: Friday, October 12, 2007 3:15 PM To: Mike McCarthy Subject: Re: Boy Scout Project Permit Approval Mike, file://S: \zonshare \Potential BOA or LUP \Exempt - NO Permits \2007 Scout Camp no SE -L... 8/20/2008 Page 2 of 2 You'll need to get a letter from the County Zoning office. If there is any plumbing in the buildings, you will need some type of septic permit or connection permit. This is a commercial building in the ag -res district; it will probably require a conditional use permit from the County or a special exception. Sincerely, Brian Wert Mike McCarthy 4nmccarthy agnorthernstarbsa. org> wrote: Based on what I forwarded to you on Wednesday, from St. Croix County, is there anything more you need from me to approve the permit for our new building at Fred C. Andersen Scout Camp? I file: HS: \zonshare \Potential BOA or LUP \Exempt - NO Permits \2007 Scout Camp no SE -L... 8/20/2008 Wisconsin' erartmentofCommerce PRIVATE SEWAGE SYSTEM County. St. Croix i,tyand Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 514836 0 GENERAL INFORMATION 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: I City Village X Township Parcel Tax No: Indianhead Scout Cam s, Fred C. Andersen S Somerset, Town of 032- 2071 -20 -000 CST BM Elev: Insp. BM Elev: BM Descrip Section/Town /Range /Map No: 13.30.20.774 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. ,77 I61 /ao Septic Benchmark �' , `t�� 3.75,�,�5 _ t , 121 .. l Bldg. Sewer i�i'rdb ~.' 1 .#67 ;- �+fts '_ Inlet- /9• �� TANK SETBACK INFORMATION ..'. .:, �_ d" . ` . �,, f TANK TO P/L WELL ff3LPQ. Vent t Air Intake AOA9 r Dt Inlet � DtBottom 25 `72 Dosing t i Header /Man c +A- ifY. (Y10 -j #- •� 4`t•1`7 Aeration. z 3 Dist. Pipe J y K� I Z . 0 9 9 - � F�Idin9 Bot. S stem S. c� t.: �1�. 9 , 5 '%2 . Z'7 PUMP /SIPHON INFORMATION f Final Gra +7,9 9 .4 Manufacturer 1 r ��• , Demand St Cove GPM Model Number 441 / I n 1 \31 � TD ift I r;. Frict' / / System Head TDH j ; ., Forcemain Len Iti Dia. a9 Dist. to Well SOIL ABSORPTION SYSTEM D4-LA 0n BED /TRENCH Width 7 Lengt , No. Of nches PIT DIMENSIONS No. Of Pits Insid Dia. Liquid Dep / DIMENSIONS 3 7 e r 4 � SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type f System UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold ibu s Ditrtion r r p O t 3 i x Hole Size� x Hole S; i� Verygto A Intake Length - 7 Length ��'g Dia �• `� Spacing V SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Onf `, Y Y Y Y Depth Over r Depth Over xx Depth of r ., xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ! Yes No Y No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: /�/ on #2: Location: 186 Anderson Scout Camp Road Houlton, WI 54082 (NW 1/4 WW 1/4 13 T30N R20W , >35 acres Lot Parcel No: 13.30.20.774� w 1.) Alt BM Description � • ^>w � � e tr `. .�.�. „� .� ..at, _ l' I M's 2.) Bldg sewer length (� i i , ► ` 3 • 2,, , - amount of cover = ; t �� � t -: • -:" i TO '"`-- 4 ., T I Plan revision Required? ❑ Yes No /a Use other side for additional information. L__ SBO -6710 (R.3/97) Date Inse or's Sign re Cert. No. Safety and Buildings Division County A F 201 W. Washington Ave., P.O. Box 7162 " SCO�S�� Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) (608) 266 -3151 L — ILI 83 D epartment of Commerce Slat Plan I.D. Number /y7.� 7(,9 Sanitary Permit Application ��((��,, In accord with Comm 83.21, Wis. Adm. Code, personal informal n you tirdlT — 9 may be used for secondary purposes Privacy La 1 xm) 2Q� Projec Address (if different than ailin h g address) W a 1. Application Information - Please Print All Information OV �.( 2 d y 144Zs U '5e-a-4- C4.•� Lot Block # Property Owner's Name # �• l Property Owner's Mailing Address Property Location / - 71 C � 7 " A, Section City, State Zip Code Phone Number UL TOM W ma y, ircle9ttce) J7� S.S / T N; R Eo W I. Type of Building (check all that apply) cSM Numbe Subdivision Name ❑ 1 or 2 Family Dwelling - Number of Bedrooms Public/Commercial -Describe Use Ti�" ❑ State Owned - Describe Use ❑City_ ❑Village Township of �SO/'?S'ET III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. It New System El Replacement System ❑ Treatment/Holding Tank Replacement Only El Mo ' ication to Existing System List Previous Date Issued B. ❑ Permit Renewal ❑ Permit Revision El Change of ❑ Permit Transfer to New Pe Before Expiration Plumber Owner IV. Type of POWTS System: Check all that appl ❑ Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil i Mound <24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter 8 Aerobic _T reatm r ent Unit ❑ Recirculating Sand Filter ❑ j Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) C l SD i V. Dis ersal/IYeatment Area Information: 0 & 'b d Design Flow (gpd) Design Soil Application te(gpdsf) Dispersal Area Requir (sl) Dispersal Area Propose sf) System Elevation Sew. • is VkL- - s � 0 '2076 VI. Tank Info. Capacity in Total Number Manufacturer Pre Site Steel Fiber Plastic Gallons Gallons of Units Con rete Constructed Glass New Existing L L Tanks Tanks (Olt Septic or Holding Tank (� r !�- Aerobic Treatment Unit v Dosing Chamber yja 71 Q ` E VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' Signatur PR umber Business Phone Number LAW Plumber's Address (Street, City, State, Zi ode) S8 Vill. County/ e artmen Use Onl �pproved 11 Sanitary Permit Fee (includes Groundwater Dal Issue Issuit Agent Sig atr o Stam Surcharge Fee) / ✓ V C c 3 �. 0 ❑ ven Reason enial J IX. Conditions of Approval /Reasons for Disapproval SYSTEM OWNER: 1. Septic tank, effluent lifter and . a - e,c-�- W� pGn"^ �•�, dispersal cell must all be'services / maintained / as per management plan provided by plumber. 2. All setback fequirements must be maintained as per applicable code / ortknalum. Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size �t� SBD -6398 (R. 01/03) ry fn R, n rn A n O R R W \ Z o T, n � z ft, o n � Z + i r � a n _ � z c m � � n rn � s c � 3 \ a Fn m Vi 1 N \ b O r I v 1 U 3 3 1 s o a (PIE I N m r ci ms l oo r a Safety and Buildings 4003 N KINNEY COULEE RD commerce .Wl.gov LA CROSSE WI 54601 -1831 ■ ■ TDD #: (608) 264 -8777 ��O �' www.commerce.wi.gov /sb/ Department of Commerce www.wisconsin.gov Jim Doyle, Governor Jack L. Fischer, Secretary November 13, 2007 CUST ID No. 223760 ATTN: POWTS Inspector JOHN F SCHMITT ZONING OFFICE SCHMITT & SONS EXCAVATING ST CROIX COUNTY SPIA 586 VALLEY VIEW TRAIL 1101 CARMICHAEL RD SOMERSET WI 54025 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/13/2009 Identification Numbers Transaction ID No. 1475969 SITE: Site ID No. 730176 Fred C Anderson Boy Scout Camp Please refer to both identification numbers, 186 Anderson Scout Camp Trail above, in all correspondence with the 'agenc Town of Saint Joseph St Croix County W1 /2, NW 1/4, S13, T3 ON, RI 9W Subdivision: CSM V905, P110 37.0 Acres FOR: Description: Mound 2 cells w/ A'B'U / Commercial (Camp Facility) / Sloping Site Object Type: POWTS Com onent Manual Regulated Object ID No.: 1157722 Maintenance required• ,738 G D+Wow rate; 21 in Soil minimum depth to limiting factor from original grade; System: Mound Compone anual - Version 2.0, SBD- 10691 -P (N.01101), Pressure Distribution Component Manual - Version 2.0, SBD- I0706 -P (N.01 101); Aerobic Treatment Unit, Commercial System, Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. • This approval does not include plans for the general plumbing systems that are required for this project. The grease interceptor is part of the general plumbing review. • The three Sludgehammer S -46 units must be installed in accordance with the manufacture's printed instruction and system sizing criteria found in Comm 83, Wis. Adm. Code. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence.i { G,,I, • A maintenance and monitoring contract for the Sludgehammer S -46 units are required for as long as the unit is in service. SEL �uf • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c JOHN F SCHMITT Page 2 11/13/2007 • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. The force main is to be installed in the down slope area, The trench for the force main may not be wider than 12 inches. Track type tractors or other equipment that will not compact the area are required. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of See. 145.20(2)(d), Wis. Stat • Comm 83.22(7) A copy of the approved plans specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerel Fee Required $ 275.00 Fee Received $ 275.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II, Integrated Services WSMART code: 7633 (608)789-7893, 7:45 am - 4:30 pm Monday - Friday charles.bratz@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. SCHAH T & SONS EXCA YATING INC. � > 1 `� '100 j 386 6'ALLEY" VIEW TRAIL SOMERSET," 47 54025 MOUND SYSTEM FOR: FRED C. ANDERSENSCOUT CAMP ADDRESS 186ANDLRSENSCOUT CAMP TRAIL, HOLILTON,, RI S - 4082 LEGAL NW114, NWl S13, T30N, R19W 7 066AS1 -IIP.- ST. JOSEPH COUNTY: ST. CROLX CONTENTS Page 1 Plot Plan Page 2 Calculations Page 3 SludgeHammer Letter Page 4 SludgeHammer Specifications Page 5 Tank Treatment Train Pages 6 -9 Tank Specifications Page 10 Mound Dosing Chamber Cross Section Page 11 Pump Specifications Page 12 Pump Curve Page 13 Mound # 1 Cross Section Page 14 Mound # 2 Cross Section Page 15 Mound # I and # 2 Distribution Lateral Layout Pages 16 & 17 Management Plan Page 18 Notes Attachment I Soil Evaluation Report Attachment 2 Mound Component Manual ( Version 2.0) SBD- 10691 -P (N. 01 /01) Pressure Distribution Component Manual( Version 2.0) SBD- 10706 -P (N. 01 /01) IV MPRS: 223760 NT OF COMMERCE AFT ANU, ILCi?YGS Date: November 7, 2007 rcESP NDEtJC Page 2 of 18 GALLONS CALCULATION The Fred C. Andersen Scout Camp Training Facility will serve: 40 people at camp (day & night) or, 100 people at camp (day use only) Up to 200 meals per day (2 meals per day for 100 people) Also, the building has 7 floor drains ( 2 Floor drains in kitchen ) ( 4 Floor drains in bathrooms ) ( 1 Floor drain in laundry room) Residential Strength Wastewater Calculation: 40 people (day & night) x lOgal/day = 400gal/day -OR- 100 people (day only) x 3.5gal/day = 350gaUdav 7 floor drains x 25gaUday= 175gal/day RESIDENTIAL STRENGTH WASTEWATER TOTAL 575 gal/day at 220mg/liter BOD High Strength Kitchen Wastewater Calculation: 100 people x 2meals/day x 4 gal/meal = 800 gal/day (kitchen waste only, no dishwasher) HIGH STRENGTH KITCHEN WASTEWATER TOTAL 800 gal/day at 1200mg / liter BOD ESTIMATED FLOW COMBINED TOTAL 1375 gal /day at 790. 1 mg/liter BOD DESIGN FLOW TOTAL = 1375 gal/day x 1.5 = 2062.5 gal/day BOD CALCULATION 575gal/day x 220mg/L BOD x 8.33/1,000,000 * = 1.1lbs BOD 800gal/day x 1200mg/L BOD x 8.33/1,000,000* = 8.Olbs BOD (600mg/L after going thru grease interceptor) Total 9.1lbs BOD (* Conversion factor for gallons to liters and milligrams to pounds) Page 3 of 18 SludgeHammer 336 Sella ision R Group Ltd. 336 S. Oivisian Road Petoskey, MI 49770 Ph: 1.231.348.5866 TO Free: 1.800.426.3349 Fax: 1.720.834.3102 www.Slud&eHammer.net 1 -� 4 l`. November 1, 2007 Sirs: As Technical Director and President of SludgeHammer Group Ltd. I certify that the SludgeHammer® device, when applied using standard engineering calculations for aerobic digestion as outlined in the USEPA Manual of Practice for Activated Sludge Treatment is capable of reducing BOD to the desired amount in the application described in this permit request. While the SludgeHammer S-46 model is certified in Wisconsin for "residential" waste it qualified for certification with data demonstrating the capability of reducing BOD in a standard single family home from approximately 300 mg /I to less than 30 mg /I, a reduction of greater than 90 %. The nature of the organic waste in the permit request is such that there is no reason to expect that digestion will be any less effective than with standard residential waste. This is especially so given the fact that the target goal in the above request is 220 mg /I. Design estimations of the Anderson Scout Camp indicate the potential generation of approximately 9 Ibs of total BOD per day. This is derived from the cumulative values of two separate waste sources. A standard S-46 unit aerates at a sufficient rate to degrade approximately 3 lb of BOD per day. Thus reducing the proposed effluent from 1200 to 220 mg /I (a reduction of 980 mg /I or 6.52 lb) could be done with three S -46 treating approximately 3,028 liters (or 800 gallons per day). The plan will incorporate three S-46 SludgeHammer units in the treatment train, more than adequate for the above treatment goals. We hereby request the State of Wisconsin give us permission to install the SludgeHammer S -46 unit as part of an engineered design for the system described in this permit request. Respectfully, I Dr. Daniel Wickham Technical Director and President SludgeHammer Group Ltd. Pet S. Division Rd. SludgeHammer Petoskey, MI 49770 Ph: 1.231.348.5866 Toll Free: 1.800.426.3349 Fax: 1.720.834.3102 www.SludgeHammer.net SludgeHammer Specifications The SludgeHammer represents the first significant advance in Aerobic Bacte Generator biotechnology since we presented our original technology over five years ago. During that period, this technology has been installed in thousands of units. Drawing on this extensive experience coupled with an active R &D program directed by the originator of the ABG concept, Dr. Daniel Wickham, r y we have dramatically improved on the original with the SludgeHammer. ..... s Q. specifications 5 -86 unit °��a� � S -46 unit Recommended Recommended for larger residences for single- family and commercial residences up to applications. 4 bedrooms. Dimensions: Column diameter at top: 12" 12" Column diameter at base: 15" 15" Total height: 36 36" " r Electrical Service: 110 V, 60 hz. - 15 amp" 110 V, 60 hz. - 15 amp. ZIN Power draw: 60 watts — 1 amp 40 watts — 0.5 amps Air delivery rate: 3.5 CFM @ 2.0 psi 1.7 CFM @ 2.0 psi Liquid mixing rate: 30,000 gpd @ 4 foot depth 22,600 gpd @ 4 foot depth Fixed film utilization factor: 350 gal. /ft2 /day 240 gal /ft2 /day Organic digestion rate: 3 -6 Ib /BOD /day 1.5 -3.0 lb BOD /day Minimum depth of tank: 40 inches 40 inches Maximum depth of tank: 84 inches 84 inches The SludgeHamriier Single chamber tanks: Minimum 800 gal. Minimum 500 gal. continues to meet UPC Maximum 2,500 gal. Maximum 1,500 gal. code and the IAPMO IGC 180 -2003 standard Multi- family or for Aerobic Bacterial commercial installations: S -86 Sludgehammers can be Generators. installed in multiples with supplemental air diffusers. Domestic SludgeHammer - Group Ltd. headworks strength: 5 -10 lb/SOD/day for single provides design consultation S -86 with supplemental air. and engineering for Maximum tank volume: industrial applications and Contact your local dealer community scale systems. High strength loads: for design details. Visit www.SludgeHammer.net for information on availability in your area as well as for SludgeHammer " - Group Ltd. recommends installation in tanks providing a dealership opportunities- minimum of 2.5 -3.0 day hydraulic retention time. Air pump 110 Vac Au line in basin " Service " A¢rotbic ext¢ria _ Vi6nrous Gtntr)ll¢n circul]tion Sf;tem (All tanks supplied by Wieser Concrete) Tank # 1 — WI565 Grease Interceptor Capacity = 200meals/dav x 4aal/meal x 7 hours 2x2 meal periods Capacity =1400 gallons }... C) - - - -- Tank # 2- W4200- 4200gallon Setting Tank (3 day Retention Capacity) 576 gallons/day, 220mg /L BOD Tank # 3 -W3000 /1800- 3000gallon Tank with 3 Sludgehammer S-46 units 1800 gallon Effluent Filter Tank with Polylok 525 To MOUND r 1 Tank # 4 - WLP750 -750 gallon Mound Dosing Tank Using Duplex Pumps With Simtech STF —100 Effluent Filters To MOUND Y 2 Page 6 of 18 691" 93" 57" Z N m NI-- -i 29" r r 0 / m 0 m T �< I �m II II 43" / O c 54" n D - Z D m m cc > n C Z C ...� (n , c O v' D n Z N D 0 O r cn C m Z D C m -m-I om N� ° � rmgr (A n n D Z n n (nz zZ m0�°ZmD 0 DZ � Z ° D m nC p C - _ip(7)zA,�rZ TT O ca D CO ti D =p Dp �0� = -40.K (n T N n p C N C r N ^ m m m m Z .- Zm Dm O <r - 8 M . . VJ C Z (n m I� 07rm0co N - m o 0 m (A O ° m m m cn cn . r� — D n N c r (mn , 0. � I cn m ° O (n D N O 0 0 m ° n D O0 ^ 4 \ J Z z ° D Z D �r n n m n O N NJ ul m _o ( Z � 0 J m r `� 'n T J lJ m n ° ° O X K m m m z U) 0 W1565 -MR MIESER GURGRETE SCALE: 1/4 " =1' REV N0. DATE: = 0 DRAWN BY:SWT 0 \ z SEPTIC MANUAL W3716 US HWY10. MAIDEN ROCK, WI 54750 DATE: JANUARY 2001 0 REV. JAN. 2005 800- 325 -8456 FILE: W'1563GI —MR Page 7 of 18 98j" 79" 96" 2 v+ m S 1 - - - - - -- - -- - - - - -� I I I I I I i I i I I I I D D m 5 ,. i 5„ m 0 m I I I I I 41 li 882., I I m m X X j i I i • I I I I t y I I L- - - - - -- ♦ I -------- z 0 N c > 77" m D Z m _p n Z (i > --I m Z m 7 m (° -i 0 > r D K: D Z r Z D m Z N Q m m m Z -4 rW r2�C)W �Z m m D 0 0 0 z aD 0prWZ_ZOOr- O O -0 z D O Z °Z :IZ 0 m-IrZ Z C W D =c�0 n - 2 -=i0�0 to x � \ m n mO O DO r - (D .. r .. L4 0 c: rmi m ?m Dm JC -- O� I v C D O O 00 mmW N� OJJ�ON- m 4:16 V) n G N (n fTl D r N 0 O N O \ (Ac)m r W 0 o O Z z D mmm W "' o I n N Z =r Z ° x D C D J N m 0 D Z7 ^l z Z 5 0 0 r � z Z r m n Z m Ln m \ m W4200 MIEGER COOCAETE DRAWN BY•SWT REV N0. DATE: Oq o SEPTIC MANUAL MAIDEN ROCK, W1 /PORTAGE, Wt/ FOND OU LAC, WI DATE: JANUARY 2001 �' REV. JAN. 2005 800- 325 -8456 . FILE: W4200 Paire 8 of 18. 90" 1008" 79" cn " I �, rri J z i 5„ WOm DX1 D Q 5„ I m 0 m X r m n cc m 1 m ,. 80" D z x cn — D O �7 C 77 m Z rri D � z C TI C7 D ` C C O O N p Z r O m N N� z D D r r Z �r07�r2�n07� n r-I Z� N D 0 n �.�D -4D mO�omm>00D- Z `�_, -a r �•• X Z 0 -0 O�0 a =o --j �i Fz ° A (A Q m � W D m0 D C) -� �" Z-10 -3 .. O a n m n m n mz° > r - �•• r .. C4 o C �C mZ X -�-� N C Z N Zr I r u' MM 0 oN Q n mm m D- m D m n� m D � _ 1 A O Ov cnm� D r ivcp CO � � n M O N ° W0 r W' W 0 mm O Z U) Dr mDm CO t7 0 �O n O C7 -1 n > �Z =rz 0O X 0 O D n . � Z^ ;o O N N D � ° m :U n O m r -� M n m 0 n 7 O cn > V c O - n r n n Z m L `l m \ = W3000/1 r SCALE: 1/4 " =1' REV N0. DATE: 0 M IHIEGER coRGRETE DRAWN BY:SWT � Z SEPTIC MANUAL MAIDEN ROCK, N/PORTAGE. WI/ FOND DU LAC, Wl DATE: JANUARY 2001 ° REV. JAN. 2005 800- 325 -8456 FILE: W3000 1800 Page 9 of IS 61' 84" 42" z N r V) \ \ / D I y \ \ r m 4 „ m 1 cnom I a C 3,. 46„ a > 11 X m II m m \ m X _ ! MD ii 40,. O m D - z N D m K Z C D r 2 r Z Z O -�+ z Z O O D m m 3 -4 r D O -- a - -1 z Z _ D Z z DOZ gr�omKnC) L' Zr� m D Z ' G� ' 1 2 n p D G�aD r*ipnCmDO � Z ° rrcn Cr -a SCN70 ( C5 =CG j ==f*1�r O ZZ C rG� Z n2 N�r� I rn�?prnmW t S M .. DO < �Zm D C1 m � mr- v M 2 = =\ /� � m W (� O° C Q C? D N -D IN S N I .. 0f:' D ON� N V n o mmco -iN gym � . C-) (7) < c ^' Nm- D> co o N \ g m C m ° v1 A 0O O� z --j 71 c> m-mm m07 o n \ - + m m Z ? m C n Z D� ° co O O m ° 0 N > v 0 0 0 n Z ° x z° -D i o F -4m N Z m O D n C Z r ° N m1 D S O m N xD n 0 m o mr n z m F O N m 0 r N N J m m m C7 Z O O C Z m A n m K: m m . I z m N \ O = WLP750 —MR SCALE: 1/4 " =1' REV N0. DATE: m p rl MI ESER conenETE DRAWN BY:SWT V Z SEPTIC MANUAL W3716 US HWY10. MAIDEN ROCK, N1 54750 DATE: JANUARY 2001 REV. JAN. 2005 800 -325 -8456 FlLE: WLP750 -MR Page 10 of 18 Mound #1 and Mound #2 Dosing Chamber Cross Section With Duplex Pumps (Specifications on next page) WEATHERPROOF JUNCTION BOX • APPROVED LOCKIIJG. HANHOIE COVER; 4 'Mlll: ABOVE' G RADE IJOTE: Y1.15TALL AUDIO OK 4 VEWT IYA50VC GR&DE VISUAL ALARM U LS• FROM 00 ALTER,( �,O►JSPIC000S LO- W1w00%Y OR FR.CS14 b \V 17 C H CAT10Q I .►.tR !).1TAxE PROVIDE AIRTIGHT SEAL I I I I MANHOLL I I I I MIQIMUM 2.14 I.O. t I I I I FOPCE MAWS I I MI 1.J IMUM L" Z. D• I r1YA I I I I I I I - - - - -- IIJLET f OUTLET I ex rEUOUJi: W iECT I I I I WJTO U3Jp1STj1R15E0 B 21' J I I I APPRovED \ C.Rouwo i i i 20 .28gaUin J01NT I PUMP ON I I I I I 1 I Elev 76.75 Feet D PUMP Orr SU9M1T'GO►JS'tR OCTAILS OF TA1.1K it S,TE COUSTRUC7ED Page 11 of 18 PUMP SPECIFICATIONS FOR MOUND #1 SEPTIC & DOSE TANKS MANUFACTURER: WIESER CONCRETE NUMBER OF DOSES +or- 9 PER DAY TANK SIZE: 750 GALLONS DOSE VOLUME INCLUDING BACKFLOW: 202.80 GALLONS ALARM MANUFACTURER: SJE RHOMBUS MODEL NUMBER: 123 CAPACITIES: A= 13 INCHES OR 263.64 GALLONS SWITCH TYPE: MERCURY B= 2 INCHES OR 40.56 GALLONS C= 10 INCHES OR 202.80 GALLONS PUMP MANUFACTURER ZOELLER D= 12 INCHES OR 243.36 GALLONS MODEL NUMBER: 163 SWITCH TYPE: MECHANICAL NOTE: PUMP AND ALARM ARE TO BE INSTALLED ON SEPARATE CIRCUITS MINIMUM DISCHARGE RATE: 49.2 GPM VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE: 16.50 FEET + MINIMUM NETWORK SUPPLY PRESSURE: 6.50 FEET + 55 FEET OF FORCE MAIN X 4.85 FT /100FT FRICTION FACTOR: 2.67 FEET + SIM -TECH STF -100 EFFLUENT FILTER 0.50 FEET TOTAL DYNAMIC HEAD = 26.17 FEET DIAMETER OF TANK: 79 INCHES LIQUID DEPTH: 37 INCHES PUMP SPECIFICATIONS FOR MOUND #2 SEPTIC & DOSE TANKS MANUFACTURER: WIESER CONCRETE NUMBER OF DOSES +or - -10 PER DAY TANK SIZE: 750 GALLONS DOSE VOLUME INCLUDING BACKFLOW: 202.80 GALLONS ALARM MANUFACTURER: SJE RHOMBUS MODEL NUMBER: 123 CAPACITIES: A= 13 INCHES OR 263.64 GALLONS SWITCH TYPE: MERCURY B= ;_INCHES OR 40.56 GALLONS C = INCHES OR 202.80 GALLONS PUMP MANUFACTURER: ZOELLER D = INCHES OR 243.36 GALLONS MODEL NUMBER: 163 SWITCH TYPE: MECHANICAL NOTE: PUMP AND ALARM ARE TO BE INSTALLED ON SEPARATE CIRCUITS MINIMUM DISCHARGE RATE: 49.2 GPM VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE: 23.40 FEET + MINIMUM NETWORK SUPPLY PRESSURE: 6.50 FEET + 120 FEET OF FORCE MAIN X 4.85 FT /100FT FRICTION FACTOR: 5.82 FEET + SIM-TECH STF -100 EFFLUENT FILTER 0.50 FEET TOTAL DYNAMIC HEAD = 36.22 FEET DIAMETER OF TANK: 79 INCHES LIQUID DEPTH: 37 INCHES SIGNED: LICENSE NUMBER: 223760 DATE: 11/4/2007 It00El 1161/4161 163/4163 Page 12 of 18 HEAD CAPACITY CURVE R. �. �n15 c L6 cx gyms t 8 3/t s 1.02 100 A9 11 231 61 231 `_ W MODEL 161/4161 - 163/4163- 165/4165 + 3.05 93 332 ms 729 w.s 229 . 6 1/2 - IS 4.37 M 322 w 221 w5 229 I I 1 m 9.10 76.5 297 !9 223 w 221 26 90 25 7.62 70 265 57 716 59 223 30 9.1. 6i.5 233 t 55 206 m 220 i M 46 172 s! 206 24-80- SD rl.l• N 7e s! 'a W / 5/41 65 w -819 '5 57 39 q fi 21.3. 1 225 55 7D u eo 2..36 ,a 36 6 11/32 z 20 163 /4 163 °° 27.`3 U 60 100 Lo" ""I, 56 aa e6.r I t6 I 1 1/2 • -11 1/2 NPT t 50 009920 r - 11 1/2 NPT (OR) q I Y -aNPT a t 2 a0 O Lf 111 a I , 30 8 4MP1 20 I 4 6t /at6t t0 8 9/16 0 U.S. GALLONS 10 20 30 40 50 60 70 80 90 100 110 I 6 LITERS 0 80 160 240 320 400 FLOW PER MINUTE SK374 Star,aard ali models .20 ft. cord -' , H.P. 161 MODELS 14161 MODELS + • + Control Selection listings Single Seal I Double Seat I Volts Ph Mode Amps Simplex Duplex CSA UL M161 1 - 115 1 Auto 15.5 1or1 &8 Y I Y F -6 / N161 I N4161 115 1 Non 15.5 2or2 &7 3or5 &6 Y i Y "' D161 - 230 1 Auto 7.5 1 or 1& 8 i Y Y E161 E4161 230 1 Non 7.5 2 or 2& 7 3 or 5& 6 Y I Y 4 H161 200.208 1 Auto 8.8 1 & 8 Y N - Q 1161 14161 200 -208 1 Non 8.8 2&7 3 or 5& 6 Y N 4 J161 ' J4161 200.208 3 Non 6.4 4 &6 3 &4or5 &6 Y Y F161 F4161 230 3 Non 5.2 4 &6 3 &4or5 &6 Y Y l I I I/2' - II 1/2 NPT G161 G4161 460 3 Non 2.9 4 & 6 3 &4 or 5 &6 1 Y Y I 2 - 11 1/2 NPT (OR) S - 8 NPT I Standard 311 models • 20 ft. cord •'.4 H.P. 163MODELS 14163MODELS Control Selection Listings Single Seal Double Seal I Volts Ph Mode Amps Simplex Duplex CSA UL M163 - 115 1 Auto 15.0 1 or 1 &8 Y Yom. N163 N4163 115 1 Non 15.0 2 or 2 & 7 30(5&6 Y , Yin 0163 - 230 1 Auto 7.5 1 or 1 &8 Y Y 20 7/16 E163 E4163 230 1 Non 7.5 2or2 &7 3or5 &6 Y Y H163 200 -208 1 Auto 8.5 1& 8 Y N 1163 14163 200 -208 1 Non S.S 2&7 3 or 5& 6 Y j N f J163 ' J4163 200.208 3 Non 6.0 4&6 3& 4 or 5& 6 Y Y^ 6 F163 F4163 230 31 Non 4.8 4 &6 3 &4or5 &6 I Y Y j SK1413 G163 I 04169 1 460 31 Non 1 2.9 4& 6 3& 4 or 5& 6 Y 1' Standard all models - 20 ft. cord -1 H.P. SEL TION GUIDE 165MOOELS 4165MODELS Control Selection Listings 1. Integral float operated 2 -pale mechanical switch, no external control Single Seal Double Seal Volts • . Ph Mode Amps Simplex Duplex CSA UL required. 0165 - 230 - 1 Auto 10.2 1 or 1 & 8 Y Y 2. Single piggyback variable level float switch or double piggyback E165 E4165 230 1 Non 10.2 2 or 2 & 7 3 or 5 & 6 Y Y variable level float switch. Refer to FM0477. H 165 - 200.208 1 Auto 12.6 1& 8 Y N 1 '1165 ' 14165 200 1 Non 12.6 2&7 3 or 5 & 6 Y i N 1 3. Mechanical alternator M -Pak 10 -0072 or 10 -0075. Refer to FM0495 J165 J4165 7.5 4&6 & 4 or 5 & 6 Y Y 4. Simplex three phase control panel. Refer to FM1228. F165 • F4165 230 3 Non 7.4 4&6 3 & 4 or 5 & 6 Y Y 5. See FM0712 for correct model of Electrical Alternator. G165 ' G4165 460 3 Non 3.7 4&6 3 & 4 or 5 & 6 Y Y 6. Variable level control switch 10 -0225 used as control activator, BA165 ' BA4165 575 3 Non 3.0 4 & 6 3 & or 5 & 6 N N specify simplex (3) float or duplex (3) or (4) float system. • No Molded Plug Lt listed unit available wath 20 Amp plug. 7. Four (4) hole J -Pak, junction box, for watertight connection for hard- wired simplex operation, 1M002. 8. Two (2) hole J -Pak, for watertight connection or splice, 10 -0003. o cauTloN For information on additional Zoeller products refer to catalog on Piggyback Variable Level Float Ail Inita!lation of controls, protection deices and n -ng should be done by a qualified licensed Switches. FM0477; Electrical Alternator, FMO486; Mechanical Altemator ,FMC495;AlarmPackage, electrician. All electrical and safety codes should be' c; lowed including the most recentNational FW732; and Sump/Sewage Basins, FMO487. Electric Code (NEC) and the Occupational Safety a. d Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. 0 Copyright 1998 Zoeller Co. All rights reserved. Page 13 of 18 Mound System Cross Section Straw, Marsh Hay, Or Synthetic Covering ASTMC33 Distribution Pipe Medium Sand 6 Topsoil " G F Sys. Elev. 92.75 feet Y y. Slope Bed 0f ��- 2 ji-2 Force Main Plowed Aggregate Layer (6" Below Pipe) D = 1.25 feet MOUND #1 E = 2.37 feet 14% Slope F = 0.79 feet G = 0.50 feet A = 8.00 feet H = 1.00 feet Signed: + l B = 131.00 feet K = 10.81 feet License number 9223760 L = 152.62 feet - J = 5.40 feet Date: 11/04/07 I= 18.90 feet W = 32.30 feet Z Alternate Position of Force Main L Observation Pipe F A 1/5 To 1/10 B From End of Bed K i+- -- = ----------------- ---------- - - - - -- - - - - -•� Force Main Distribution — Bed Of Z — 2 % Pipe Aggregate •I Observation Pipe Permanent Markers 115 To 1/10 B From End of Bed Plan View Of Mound Using A Bed For The Absorption r Page 14 of 18 Mound System Cross Section Straw, Marsh Hay, Or Synthetic Covering ASTMC33 Distribution Pipe Medium Sand 6 Topsoil " F c Sys. Elev. 99.65 feet u ` Y % Slope Bed Of 2 Force Main Plowed Aggregate Layer (6" Below Pipe) - D = 1.25 feet MOUND #2 E = 2.45 feet 15% Slope F = 0.79 feet G = 0.50 feet A = 8.00 feet H = 1.00 feet Signed: Z B = 131.00 feet K = 10.93 feet License number #223760 L = 152.90 feet J = 5.30 feet Date: 11/04/07 I = 20.50 feet 'j W = 33.80 feet Alternate Position of Force Main Observation Pipe 1 6 1/5 To 1/10 B From End of Bed K A i�---= -------------------------- --- - - - - -- ; - - I Force Main Distribution — Bed Of 2 "— 2 % Pipe Aggregate Observation Pipe Permanent Markers 1/5 To 1 /10 B From End of Bed Plan View Of Mound Using A Bed For The Absorption Area K Page 15 of 18 :Tur upwfth Cloanout P.caaas B x P a Ew VaNG PVC FO" Main Distribution Lateral •s PVC Manifold Distribution L atera l L L P P X X --r x X!2 — P 64.93 feet S 3_0 feet X 40 inches Hole Diameter 1/8 inch Lateral Diameter 11/2 inches Manifold Diameter 2 inches Force Main Diameter 2 inches � # of holes/pipe 20 Mound # 1 Invert Elevation of Laterals 93.25 feet Mound # 2 Invert Elevation of Laterals 100.15 feet Signed: License Number: 223760 Date: 11/04/2007 Page 16 of 18 11at�S WNER'S MANUAL & MANAGEMENT PLAN RLE INFORMATIOK- ' . SYSTEM SPECIFICATIONS Owner 4 'd Septic Tank Capacity 4 2 0 0 al ❑ NA Fre Q. Andersen Scout Cam Permit I _ Septic Tank Manufacturer Wieser Conc. ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer Simtech ❑ NA Numbef of Bedrooms 0 NA Effluent Filter Model STF -100 ❑ NA Numb" of Public Facility Units ❑ NA Pump Tank Capacity 750 a l ❑ NA Estimated flow (average) 1375 gal/day Pump Tank Manufacturer eser Conc . ❑ NA Design flow (peak), (Estimated x 1.5) 2062.5 gallday Pump Manufacturer Zoeller ❑ NA Soil Application Rate 0 . ( gal/day/ft' Pump Model 16 3 ❑ NA Standard lnfluent/Effluent Quality Monthly average • Pretreatment Unit ❑ NA Fats, 0(I & Grease (FOG) :00 mg /L ❑ Sand /Gravel Filter O Peat Filter Biochemical Oxygen Demand (BOOB , =0 mg /L IS NA 0 Mechanical Aeration O Wetland Total Suspended S ollds (TSS) 5150 mg / L ❑ Disinfection ❑ Other: Pretreatod Effluent Quality Monthly average Dispersal Call(s) ❑ NA Biochemical Oxygen Demand (BOOJ 530 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ At -Grade 0 Mound Fecal Collform (geometric mean) 510` cfu /100m1 ❑ Drip -Line ❑Other: Maximum Effluent Particle Size Y a In dia. ❑ NA other: ❑ NA See Tan Treatment Train Other: '- ❑ NA Other: ❑ NA ^ for other tanks . 3 , Pumps Values typical for domeatic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency "Inspect condition of tank(s) At least once every: 3 eoar�$)(s) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y,) of tank volume ❑ NA Inspect dispersal call(s) At least once eve Cl month(s) (Maximum 3 years) ❑ NA P P ev e r y: 3 07 year(s) Clean effluent filter At least once every: ® month ❑ NA Y Inspect pump, pump conVOis & alarm At least once every: 12 year(s)month(s) ❑ NA Rush laterals.and pressure test At least once every: ® ear(s)(s) ❑ NA 1 y Ouwr: ❑ month(s) ❑ NA At least once every: ❑ year(s) Other: ❑ NA Inspect Slud ehammer Un'ts yearly MAINTENANCE INSTRUCTIONS.` Inspections of tanks .and disparsal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POINTS Inspector; POINTS Maintainer; Septage Servicing Operator. Tank inspections must Include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal call(s) shall b e visually Inspected to check the effluent levels in the observation pipes and to check for any ponding of efWant on the ground surface -The ponding of effluent on the ground surface may indicate a failing condition and requires the Immediate notification of the local regulatory authority. When the combined _accumulation of sludge and scum in any tank equals one -third (Y,) or more of the tank volume, the entire contanta.of thai tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113 Wisconsin Adrttlnlatrative Code, AU other services, Including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment 'urdts,.and any servicing at 512 months, shall be performed by a certified POINTS Maintainer. A service report shall be ptovidad to the local regulatory authority within 10 days of completion of any service event. - Page 17 of 18 START UP AND OPERATIO1 For new construction. prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may Impede the tr#airaent ptocass and/or damage the dispersal call(s). If high concentrations are detected have the contents of the tank(s) ranwviid by 'a septape servtcIng operator prior %use, Systen'm start up shill not occur whin soli ccnditlons are - frozen at the Infiltrative surface. During power outages pump'tanks may fill above normal hlghwater levels. When power Is restored the excess wastewater will be j discharged to the dlspatsal calls) 6rone Large dose, overloading the call(s) and may'result in the backup or surface discharge of effluent. To avail this situation have the contents of the pump tank removed by a Saptage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. i Do not drive or park vehicles over tanks and dispersal calls. Do. not drive or park over, or otherwise disturb or compact, the area within 15 fast down slope of any mound or at -grade soil absorption area. Rgduction or eurnInation of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned In compliance with chapter Comm 83.33, Wisconsin Administrative Code: 1 • All piping to tanks and pits shall be disconnected and the abandoned pipe openings seated. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another mart solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or, must be taken, to provide a code compliant roplacemont rystem: ; '.:� - . l; 0 A sultable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacemant area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing ;and proposed structure, lot lines and wells. Failure to protect the replacement. area will result In the need for s new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. 0 A suitable replacement area is not available due to* setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. The site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a soil and site_, . evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank:`: may be installed as a last resort to replace the failed POWTS. Mound and at -grade soil absorption systems may be reconstructed in place following removal of the b(omat at the.:.. infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. «WARNING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER I Name' J ohn. Schndtt Name John Schmitt Phone - Phone (715) 760 -0486 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY " i Name' - �+ . �,,,. _.; , . MName w + . i e St — Croix Ct . Zonin Rhone 715 386 - 4680 r This document was drafted WconVtlance with chapter Comm 83.22(2)(bj(1)(d) &(0 and 83.64(1), (2) & (3). Wisconsin Adm"svativa Code. V `Wi CO SOI L #1575 s , nsrn L EVA UATION REPORT Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 6 Division of Safety and Buildings Schmitt Soil Testing, Inc. Attach complete site plan on paper not less than 8' /x x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 032- 2071 -20 -000 Please print all information. Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Indianhead Scout Camps Govt. Lot NW1 /4, NW1 /4, S13, T30N, R19W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 393 Marshall Ave. NA CSM V905, P110 37.0 Acres City State Zip Code Phone Number City D Village M Town Nearest Road St. Paul l MN 1 55102 715 - 549 -6641 Somerset i Andersen Scout Camp Road [51] New Construction Use: ❑ Residential / Number of bedrooms Code derived design flow rate 2737. GPD Replacement � Public or commercial - Describe: See Memo Page Parent material Glacial till (Amery- Cromwell Flood plain elevation, if applicable n/a ft. General comments and recommendations: Area is suitable for a mound system. Please see memo page. 1. Boring # J J Ground surface elev. 98.60 ft. Depth to limiting factor 21 in. ISoil Application Rate Horizon Depth Dominant Color Redox Description Texture 1 Structure Consistence Boundary Roots GPD /ft' in. Munsell Qu. Sz. Cont. Color I Gr. Sz. Sh. "Eff#1 'Eff#2 i 1 0 -8 10yr3/3 none sil 2fsbk mfr I as 2vf .6 .8 2 8 -21 10yr4/4 none sl 2msbk mfr gw lvf .6 1.0 3 21 -28 7.5yr4/4 c2 d0yr6�2 /6 + s! 2msbk mfr ' gw ( 1vf .6 1.0 4 28 -35 7.56/4 6 c2d 7.5yr6/6 / 7.5yr6/2 sl lmsbk mfi I gw I ------ .4 .7 5 35 -72 1 56/4/6 c2d 7.5yr6/6 sl Om mfi i 7.5yr6/2 I I ---- I -- - - -- 2 .6 I ! I w I Boring Ground surface elev. 98.60 ft. Depth to limiting factor 21 in. Soil Application Rate Horizon f Depth ! Dominant Color Redox Description I Texture I Structure Consistence j Boundary Roots GPD /ft' in. I Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#t 'Eff#2 1 0 -7 10yr3/3 none sl 2mgr mfr as 2vf if .6 1.0 2 7 -12 10yr4 /4 none sl 2fsbk mfr I gw + lvf .6 1.0 3 12 -21 10yr5/3 I none sl 2fsbk mfr i gw lvf .6 1.0 4 21-41 7.5yr4/6 c2do10yr6 /6 sl 2fsbk mfr J gw 1vf .6 1.0 5 41 -55 106/5/6 cif 106/6/6 Is lcsbk mvfr - - -- 10yr6 /2 I 95 I -- .7 1.6 6 55 -71 10yr5/6 none s I Osg ml i - - -- - - - -- 7 1.6 ' Effluent #1 = BOD 5> 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < 30 mg /L and TSS <_30 mg /L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt �G�`'v''��' �'� _ 227429 Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number 1595 72nd Street New Richmond, WI 54017 8/6/2007 715 - 247 - 2941 SBD -8330 (x.ovoo) Property Owner Indianhead Scout Camps Parcel ID # 032 - 2071 -20 -000 Page 2 of 6 3 ] F Boring # Ground surface elev. 92.20 ft. Depth to limiting factor 24 in. Soil Application Rate Horizon Depth I Dominant Color I Redox Description Texture Structure IConsistence l Boundary Roots GPD /ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. *Eff #t *Eff#2 1 0 -12 10yr3/3 none sil 2fsbk mfr as j 2vf C .6 i .8 2 12 -24 10yr4 /4 none scl 2msbk mfr gw 1vf .4 6 3 24-42 10 r c2d 7.56/6/6 5 3 - y / 7.5yr6/2 fsl 2msbk mfr gw .4 .8 4 42 -65 5yr4/6 c2d 7.5yr6/6 sl Om mfi - - -- - - - - -- 2 7.5yr6/2 6 � I i I Boring # Ground surface elev. 92.60 ft. Depth to limiting factor 21 in. Soil Application Rate Horizon I Depth' I Dominant Color Redox Description Texture Structure Consistence Boundary ! Roots GPD /ft in. Munsell Qu. Sz. Cont. Color I Gr. Sz. Sh. I *Eff 1 ' •Eft#2 1 0 -8 10yr4 /4 none sil 2fsbk mfr as I 2vf,if 6 8 2 8 -14 10yr5/3 none sil 2fsbk mfr gw lvf 6 8 3 14 -21 7.5yr4/6 none gresl 2msbk mfr gw 1vf ,4 -.6 4 21 -30 7.5yr4/6 c2d 7.56/6/6 grsl 2msbk mfr gw - - - -- 6 1.0 7.5yr6/2 5 30 -41 7.5 r4 4 c2d 106/6/6 - -- y / to r6/2 grlcos Osg ml gw ; 7 1.6 6 41 -52 7.5 r4 6 c2d 5yr6/6 ; -- y / 66/6/2 grlcos Icsbk mvfr gw .7 1.6 i 7 52 -75 10yr5 /4 clf 7.56/6/6 Icos icsbk mfr - - -- 7 1.6 7.56/6/2 F -s ]Boring # Ground surface elev. 87.70 ft. Depth to limiting factor 25 in. Soil Application Rate Horizon I Depth Dominant Color Redox Description Texture Structure Consistence Boundary f Roots GP f in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Ef` =t •Eff#2 1 0 -6 10yr3/3 none sil 2mgr mfr as i 2f,2vf .6 .8 2 6 -10 10yr4/4 none sil 2fsbk mfr gw j 2vf .6 .8 3 10 -25 10yr5 /6 none Sid 3msbk mfr gw 1vf .4 I 6 4 25 -34 7.5yr4/6 c2d 7.5yr6/6 sil 2msbk mfr w - - -- 7.5yr6/2 9 I 6 8 m2d 10yr6 /6 5 34 -71 .10yr5/3 106/6 2 sil lmsbk mfr - - -- - - - - -- 4c 6 i I * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 <150 mg;L * Effluent #2 = BOD -s 30 mg /L and TSS <30 mgiL 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. SOD -8330 (R.07 /00) Schrn�L* Sal Testing, Inc. II r Property Owner Indianhead Scout Camps Parcel ID # 032 - 2071 -20 -000 Page 3 of 6 a Boring # Q — Z Ground surface elev. 94.95 ft. Depth to limiting factor 23 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary I Roots GPD /ft I in. Munsell I Qu. Sz. Cont. Color Gr. Sz. Sh. I I I •Eff #1 'Eff#2 1 0 -8 10yr3 /3 none sil 2fsbk mfr as 2vf .6 .8 2 8 -12 10yr5 /3 none sil 2fsbk mfr gw lvf .6 .8 i 3 12 -23 10yr4 /4 none sl 2msbk mfr gw i ivf .6 1.0 4 23 -36 7.5yr5/4 c2d 1oyr6/6 scl 2msbk mfr gw 1 - - - - -- .4 .6 10yr6 /2 5 36 - 65 5yr4/6 c2d 7.Syr6/2 sl Om mfi - - -- j - - - - -- .2 .6 7.5 r6/6 I ❑ Boring # (� Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color I Redox Description Texture Structure (Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 i -- I I F -1 Boring # El Ground surface elev. ft. Depth to limiting factor in. ISoil Application Rate Horizon I Depth Dominant Color I -Redox Description ( Texture I Structure Consistence) Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff #2 i I I I i i Effluent #1 = BOD? 30 < 220 mg /L and TSS >30 <150 mg /L " Effluent #2 = BOD < 30 mg /L and TSS <30 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 altemate format, please contact the department at 608- 266 -3151 or TTY 608 -261 -8777. SBD•8330 (F- 07M) Schmitt Soil Testing, Inc. page y- Conducted by: Conducted For: Schmitt Soil- Testing Inc. Name: Indianhead Sout -Camps / Northern Star Council Thomas J. Schmitt, CST 227429 Address: 393 Marshall Ave 1595 72nd St. City, State Zip: St. -Paul, MN 55102 New Richmond, WI. 54017 Phone: 71 5-247-2941 Subd.Name: NA (37 Acres) Vol 905, PAge 110 Signatur / u� / Lot No.: NA Date 16 Legal Description: NWl /4 NWl /4 S li T30N R20a' Backhoe pit Township, County: Somerset, St. Croix County S Bench Mark El. 100.00' NE corner of cement cover of North Eastern most latrine l�, Alternate Bench Mark E1.90.88' Top of 2" pvc pipe ,' Scale 1- 40' ' � #1575 ) 10fsctonsiin SIL EVALUATION REPORT Department of Commerce ' _ jin with Comm 85, Wis. Adm. Code Page 1 of 6 Division of Safety and Buildings Schmitt Soil Testing, Inc. Attach complete site plan on paper no in size. Plan must County St. Croix 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. Please print all information, 032 2071 - 20 - 0 Rev D Personal infarnafion you provide may u (P Law. S. 15. (f) (m)). 166 y j i„_ 11Z 31W Property Owner Property Location ^. Indianhead Scout Camps Govt. Lot NW1 /4, NW1 /4, S13, T30N, �YY Property Owner's Mailing Address Lot # Block # Subd. Name or CSMd 393 Marshall Ave. NA I I CSM V905, P110 37.0 Acres City Sta t Zip Z NIN ber ❑ City [] Village ® Town Nearest Road St. Paul M Somerset 1 Andersen Scout Camp Road New Construction Use: ❑ Residential /Number of bedrooms Code derived design flow rate 2737 GPD ❑ Replacement Public or commercial - Describe: See Memo Page M 1 !7 Parent material Glacial till (Amery- Cromwell Flood plain elevation, if appli n/a ft- General comments and recommendations: Area is suitable for a mound system. Please see memo page. j Bonng # F ® Ground surface elev. 98.60 ft. Depth to gmiting factor 21 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munseli Qu. Sz. Cont. Color Gr. Sr- Sh. *Eff *1 - 0142 1 0-8 10yr3/3 none sil 2fsbk mfr as 2vf .6 .8 2 8- 2,....._.,...-- 10!W4._ none sl 2msbk mfr gw ivf .6 1.0 3 21 -28 7.5yr4/4 c2d 110yrW6 sl 2msbk mfr 9w 1vf .6 1.0 4 28-35 7.5yr4/6 c2d 7.5yr6/6 sl lmsbk mfi gw - - -- .4 .7 7.5yr6/2 5 35 -72 5yr4/6 c2d 7.5yr6/6 sl Om mfi - .2 .6 7.5yr6/2 J z ]Boring# F Ground surface elev. 98.60 ft. Depth to limiting factor 21 in. Sod Apple Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fts in. Munsell Qu. Sz. Cont, Color Gr. Sz. Sh. *EW - EfW 1 0-7 10yr3/3 none sl 2mgr mfr as 2vf,1f .6 1.0 2 7 -12 10yr4 /4 none sl 2fsbk mfr gw 1vf .6 1.0 3 12 -21 10yr5 /3 none sl 2fsbk mfr 9w ivf .6 1.0 4 21-41 7.5yr4/6 c2d 2/6 sl MW mfr 9w 1vf .6 1.0 5 41 -55 10yr5/6 C1 1� J 2 6 Is 1csbk mvfr gs -- .7 1.6 6 55 -71 10yr5 /6 male s 0s9 ml -- ---- -- .7 1.6 Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD <_30 mg/L and TSS <_30 mg/L CST Name (Please Print) Signature: �j' CST Number Thomas J. Schmitt �� "'`�' �-� 227429 Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number 1595 72nd Street New Richmond, WI 54017 8/6/2007 715 - 247 - 2941 SM4330 (xmroo) I _ Property Owner Indianhead Scout Camps Parcel ID # 032 - 2071 -20 -000 Page 2 of 6 Fil Boring # M Ground surface elev. 92.20 R Depth to limiting factor 24 in. Soil Awn R ate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#t -Eff#2 1 0-12 10yr3/3 none sil 2fsbk mfr as 2vf .6 .8 2 12 -24 10yr4 /4 none sd 2msbk mfr gw 1vf .4 .b 3 24-42 10yr5 /3 c2d 7.5 /6 fsl 2msbk mfr gw ----- ,4 .8 7.5yr6/2 4 42-65 5yr4/6 c2d 7.5yr6/6 sl Om mfi ---- ---- -- .2 .6 7.5yr6/2 4 ] Bonng # Ground surface elev. 92.60 ft. Depth to limiting factor 21 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in. Munsell Qu. Sz. Cont. Color Gr. Sz Sh. *Eff#1 Eff#2 1 0-8 10yr4/4 none sil 2fsbk mfr as 2vf,if .6 .8 2 8-14 10yr5/3 crone sil 2fsbk mfr gw 1vf .b .8 3 14-21 7.5yr4/6 crone gresl 2msbk mfr gw 1vf .4 .6 4 21 -30 7.5yr4/6 c2d 7.5yr6/6 grsl 2msbk mfr gw -- .6 1.0 7.5yr612 5 30 7.5yr4/4 c2d 1OVr6/6 � 059 ml gw - -- .7 1.6 1 r612 g b 41 -52 7_5yr4 /6 c2d 5yr6 /6 6yr6/2 grlcos icsbk mvfr gw ----- .7 1.6 7 52 -75 10yr5/4 cif 7.5yr6/6 ko5 lcsbk mfr ---- .7 1.6 7.5yr6 Boring F-sl # N Ground surface elev. 87.70 ft. Depth to limiting factor 25 in. lioil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *E11#1 Efr#2 1 0 -6 10yr3 /3 none sil 2mgr mfr as 2f,2vf .6 .8 2 6 -10 10yr4/4 none sil 2fsbk mfr gw 2vf .6 .8 3 10-25 10yr5 /6 none sid 3msbk mfr gw ivf .4 .6 4 25 -34 7.5yr4/6 c2d 7.5yr6/6 sil 2msbk rnfi 6 .8 7.5ytV2 9w - - - - -- 5 34 -71 10yr5/3 m2d 10yr6 /6 sil lmsbk mfr - - -- -- - - -- .4c .6 * Effluent #1 = BOD 30 -S220 mg/L and TSS >30 <150 mg /L * Effluent #2 = BOD < 30 mg/L and TSS <30 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. SBD -8330 (It07/00) sdwird Sop Tesft, bx, Property Owner Indianhead Scout Camps parcel ID # 032- 2071 -20 -000 Page 3 of 6 6 ] F Boring # El Depth ft. Depth to limiting factor 23 in. Ground surface elev. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Efl#1 *Efr#2 1 0-8 10yr3/3 none Sil 2fsbk mfr as 2vf .6 .8 2 8-12 10yr5/3 none sit 2fsbk mfr 9w 1vf .6 .8 3 12 -23 10yr4/4 none sl 2msbk mfr gw ivf .6 1.0 4 23 -36 7.5yr5/4 c2d 10yr6/6 sci 2msbk mfr gw - - -- . .6 10yr6/2 5 36 -65 5yr4/6 c2d $.5yr6/2 SI Om mfi - - - - - --- .2 .6 1 1 7 E Boring # U Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Cotor Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#i -EU#2 Boring # 11 Ground surface elev. ft. Depth to limiting factor in. 11 Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Efr#1 *Eii#2 * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < -150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS <30 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. S111"330 (8.07/00) sdai tt Son Tesov, Inc. Pagty Of Conducted by: Conducted For: Schmitt Soil- Testing Inc. Name: Indianhead Sout Camps/ Northern Star Council Thomas J. Schmitt, CST 227429 Address: 393 Marshall Ave 1595 72nd St. City, State, Zip: St. Paul, MN 55102 New Richmond, W1.54017 Phone: 715- 247 -2941 Subd.Name: NA (37 Acres) Vol 905, PAge 110 Signetur �� .�,,.�` Lot NO.: NA nak _ ' _ l /mac% Legal Description: NWll4NWI /4S13T30NR20W Backhoe pit Township, County: Somerset, St. Croix County A Bench Mark El. 100.00' NE corner of cement cover of North Eastern most latrine Alternate Bench Mark E1.90.88' Top of 2" pvc pike \ g� _ 93� /07� Scale 140' 1� �^�J`� Bey IN,� - 7 Go ►• E LF , , '`� 1 _ ~�� �27' / / _ _ , ly 1-1 1 N iy Mir � yy � ai cllr�E LA O rq' / 1 Page 5 of 6 Schmitt Soil Testing, Inc 8/6!2007 159572nd St New Richmond, WI 54017 Re: Fred C. Andersen Scout Camps Public or Commercial gAllons per day described 100 Day campers x 25 gal/day = 1000 gallons /day 300 meals x 2 gal/day = 600 gallons/day 9 floor drains x 25 gal/day= 225 gallons/day 1825 gallons/day 1825 gallons/day x 1.5= 2373.5 TOTAL GALLONS/DAY Upper Mound (Bores 1. 2, & 6 Depth to limiting factor: 21 Slope: 15 °l0 Contour Line El.: 98.40" Lower Mound (Bores 3.4. & 5 Depth to limiting factor: 21" Slope: 14 Contour Line El.: 91.50' CST 742 omas J. Schmitt ArciMS Viewer - Page G of 13 k http: //72.21. 230. 178/ website /LRPortal/ARCIMS/MapFrame .asp ?PIN= 9/21/2007 n N O 0 ln O ', y v n C a 1 (D CD (D -a �A (D 3 CD O \ 1 0 w Z S N Z O N 7 Cn ' N Z ° 7 C.J W <� • 0 as 0 3 o to o l m m 3 w o m° o N rn a, a � m D a ` Z N> m° N `J N N CD 03 3 C3A 0 0 1 CD AP O N N ' O CD 0 ( N N CL 10 a Q O > > (D C1 v N O ° o °o c 0 o 0 cn y � o A° m o O �+ 3 o _ no g CD y G n d G a) ►� lei tr Z D (D fl to < D a 3 ° CD a o y CL N CD a" y W a y m CL O CD CD CL CD i � -». O O �{ O (D(D j N A? O W O G N Q C CD 3 a • 0 0 0 0 0 0 � o' v ry� t�naiai0 0 ait�naic o v v n 3 Q v 0 n' (D t�+ N CD ,�. y N n m 3 m m 3 CD 3 0) rn — ? ' ` �I CL 0 z z�z� l z -1 z(D �' ° D o v D m o y '� m 3 c 0 CD m c CD c jo c co m v CD m fD g v J O O ' O O CD C6 O N a c CL z o ° c °c .. Z G CD CD N < Z 0 3, c, 0 3 Cn `a A N Z co N N) fD D a O w v CD �c Z D 00 nom° D 3 m 3 o a ad F v v a CD ��� Nv a) m O T N =r CD CD o N 0 T CD N G D a n . 3 tv G C N a 0 O. y a -n N Z G C) •w y o z O C CD 7c O CD M N CA �O n SC1S N 0 0 •�. Cn� <ON ;t ° C v D 3 0 c m o Zn aF3 CD °—' m e L CD —0.'o c m o c °ate N -4 =33Q N CD (D N fD N p CD x' n O y 0 N n . S CD - 3 X N C 0 O CD CO VN. w C.J y M (A CD 7 N CL A O O O C O O N 1 N 0 j : N CD CD 00 o o 0 c a ° o : O° CD r ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM 11\1'0fA cr ff�A,p SCocv. CA117'S Owner/Buyer f R4?,O S T Mailing Address IR AA4E12 S'F=V1 /'ocz ZL"J dO Zg Aeat rQlv 60" - ao Property Address (Verification required from Planning Department for new construction) City/State � II- T6 AZ W1 - Parcel Identification Number 6 32 -,,?D 7/ -Z - Oao 3�^ �07l�o LEGAL DESCRIPTION - Property Location , ; �, 1j1�l1 ' /,, Sec. , T 'W N -R W 7,T, Town of Subdivision Certified Survey Map # Vol e 94S . Page # 37Ac.2�s Warranty Deed Volume age # Spec house ❑ yes ZKn o Lot lines identifiable Eyes ❑ no 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 you 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 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/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that yqui,i�ptic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of th three ear expiration date. f SIG . ATURE OF APPLICANT DATE OWNER CERTIFICATION I (we ' that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the prope cnbed above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGN TURE OF APPLICANT DATE c *! * * ** Any information that is mis- represented may result in the sanitary permit being revoked by thozoning Department. i ** 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 deed i 35 I� �1« DQGUMF-NT NU. WARRANTY D EED Ta11S SPACF RESERVED FO.: P= C-R.111 I i VOL ♦,. l{ {. _. - _. IISTATI',:._A4.A ,��- aalccnnslo si c�<.TS.�. ....... - ._ ...:.: ll Ir _. ....o :.� va.u.vn..- -avonf -- -- a I� REGISTEWS .OEEICE , "I t, .v.en...9 a .meek,eo..and .KonicA J Weekgs,..... {{ ST. C.ROIX CO., Wt �f hueban'd and--- wfe_.. ----- . - `{ Reed for record i! fl_ - I 1. > V O 4 1992 i 1� convoy* And warrants to __ Zit[Ii131I1s*3C3.._ lMtillG_.C-rli¢ `d- '- --IJE►s .._ 8 fl t► 11 nG. ;�t �A/t1�. i- _ .. wa. �a..vrasf - i1t tTVtt rlCtzL.1L, - rron 3LS ?C'K. CO.:Lp.QCB.tSnn_._ – : -.... ...- .. - - "' ._.... - -* .. — __ , the following deaf! 'bed real estate In _.,_..._ S. t _.Croix .................County, t' State ..... of Wisconsin: I rax ParW1 No: The NWh of NWA of Section 1 , Township 30 North, Range 20 West. 1 _'!'F AN FEE I�I� u 11 ' This ? $...nR......... ',homestead. property. Qia� '(is not) _ If Exception to warranties: Building and zoning ordinances, reservations, `. restrictions, easements and highways of reco rds, if :any. D ated - this -:c. .................... day of ....... 0clober ......... ...... .. ....... .......(SEAL) .. fjL(v. ". .. f�/� "' "'..........(SEAL) , « ...Steven E Weel4es .... _.......... (SEAL) \\v.�!"�- `.= ���5!�.:._ ----- (S Monica ,3 "ekes AUTHENTICATION ACKNOWLEDGMENT Minnesota Signature(s) .......................... ....... __...................... STATE OF y'lW ss. I ........... •... - •. ................. Rams - - Y ...... ................. ,county. 23rd authenticated this ........ da y of ......................... _ 19 ...... Personally camp before me thla .... ..._ ........ day of O ctober --------- --------------- 19 - .92.. the above named - •_.--- _.SteaQn._.>a.�_. frleeke.s_. and__i�oni.ca._J.. TITLE: MEMBER STATE BAR OP WISCONSIN (If not, ..... .......................................... authorized by § 706.06, Wis. Stats.) - to me known to be the person 3 _..__ .who nxnc•xted the foregoing instrument and acknowledge the same. THIS INSTRUMENT WA5 ORAFTEQ BY, r . «.. . -. _ NELTON & SWANSCIN. ACtorne s 966t.a Qa35?�t 3 wwo��cW - --- --- --- -- --------- Nno2 A3swvH ¢ Y1RS3NlUW- 9I18(ld�N - ------- ___ Balsam- -Lalc� -. i�lisaszns_i ri _. ! --------- Notary Publi _:._.H3A3W l OUVHOW County, 'P ii (Signatures may be authenticated or ackn.wledged. Both My Com 'ss' I n no state expiration are not necessary.) s _lei ... . -. - - _ .:.Ante.; _ - - - - -- • --_ _... -- ............. a`J...-- ---•)- •N.n�® of Dereons "W".s is my especity a"uld he tYPc l or printed below their aignatuTC.^. 1 WARRANTZ DEED STATE BAR OF WISCONSM Wisconsin Legal Blank Co.. Inc. FDRM No. 2 — 1082 .Milwaukee. Wisconsin Document Number Document Title Maintenance Contract for Septic System This Maintenance Contract for a Private On -Site Wastewater Treatment System ( POWTS) is Between Northern Star Council BSA, Fred C. Andersen Scout Camp Training Facility and John Schmitt. Recording Area Date of Contract: 3111/2008 Name and Return Address: Location of POWTS: 208 Andersen Scout Camp Rd_ Houlton, WI 54082 Legal Description of Property: NW /4, NW 1/4 S 13, T30N R20W Arthur Marty 186 Andersen Scout Camp Rd. Houlton WI 54082 As Inducement to the County of St. Croix to Issue a State Sanitary Permit for the Above Described Property, We, the Owners Agree to the 032- 2071 -20 -000 Following: Parcel Identification Number (PIN) 1. The Owner agrees to have the POWTS inspected and maintained by a qualified maintenance provider. 2. The owner agrees to provide access to the POWTS for the qualified maintenance provider in order to service and/or maintain any and all components of the POWTS. Accruing to the maintenance and monitoring schedule provided by the POWTS manufacturer (including Sludgehammer Unit, St. Croix County Zoning Department, and Wisconsin Department of Commerce. 3. Minimum performance monitoring will include: a. Type of use b. Age of System c. Type of Fill Material Used (If Applicable) d. Nuisance Factors, Such as Odors or Complaints e. Mechanical Malfunction Within the System. Including Problems with Valves, Mechanical or Plumbing Components f. Material Fatigue, Including Durability, Corrosion, or Integrity of Construction and Design. g. Neglect or Improper use of POWTS. Examples Include Exceeding the design rate, Poor Maintenance of vegetative cover, unapproved covers over the POWTS or inappropriate activity over the POWTS. h. Pump Malfunction. Examples Include Dosing Volume Problems, Pressurization Problems, Breakdown, Burnout, or Pump Cycling Problems. i. Ponding in Distribution Cell. Ponding Prior to Dosing is Evidence of a Developing Clogging Mat, or Reduced Infiltration Rates. j. Overflow or Seepage Problems. Often Apparent When Sewage Effluent has "Ponded" at Surface of Ground. 4. The Owner further agrees to pay the qualified maintenance provider for all charges incurred while inspecting, pumping, or otherwise servicing and/or maintaining the POWTS in such a manner as to prevent or abate any human health hazard caused by the POWTS. r - ` , 5. The Owner agrees that if required by the qualified maintenance provider, to have any components of the POWTS corrected by a Wisconsin Licensed Master Plumber that has knowledge regarding the installation and/or repair of the POWTS. 6. The Owner contract is binding for two years from the date in which the final inspection is made for the fully installed POWTS. This date will be located on the inspection report filed with the St. Croix County Zoning Department. 7. The Owner agrees to contact the qualified maintenance provider to have the POWTS inspected and maintained annually (or at intervals required by the county or state governmental unit) after the initial two years. (Additional evaluations may be required if warranted by operational condition of POWTS.) 8. A qualified maintenance provider shall possess a POWTS maintainer credential from the WI Department of Commerce. 9. The qualified maintenance provider shall agree to submit an inspection report to the St. Croix County Zoning Department on an annual basis. (Or intervals required by the county or state government unit.) 10. Recordation/Acceptance Conditions. This agreement shall, upon execution, be recorded with the Register of Deeds for St. Croix County, Wl. By the recording of the easement, Grantee, or itself and its successors and assigns accept and agree to abide by all of the terms and conditions hereof. Qualified Maintenance Providers Name: John Schmitt Lic. 4223760 Qualified Maintenance Providers Signature: Z - - -The Following Requires Notarization— The Owner(s) Name: Nnt:/ Owner(s) Signature: �. r Personally came b ore me s day o 2008, The above -nam u To me known to be the person(s) who executed the forgoing Istrument and has/have acknowledge the same. . dN ICi:'t Y Ii6Ji�W 7VCIlu n+w.'w r�oka County C A ignature of Notary Public a dW tv connLk - ion bow 011311m eMCa Notary Public, State of r SLUDGEHAMMER GROUP LTD. Page 2 July 2, 2007 Product File No: 20070325 • The pirana Sludgehammer model S -46 must be installed in a tank or tanks that comply with the following: 1. Tank volume of the compartment or tank which will house the treatment device must be at least 300 and no greater than 1000 gallons. 2. Liquid level of the compartment or tank which will house the treatment device must be at least 38 inches and no greater than 72 inches. 3. Distance that the treatment device must be horizontally away from the tank inlet or the outlet of the first or second compartment or tank must be at least 6 inches and no greater than 36 inches. 4. The volume of the compartment or tank that does not house the treatment device must be at least 200 gallons and no greater than 1000 gallons. 5. Liquid level of the compartment or tank that does not house the treatment device must be at least 38 inches and not greater than 72 inches. 6. In tanks containing greater than two compartments, the above sizing requirements will refer only to the first and second compartments of such tanks. • This product must be installed in sewage treatment or holding tanks which were approved at the time of existing installation and /or are currently approved for new /replacement installations by this department and meets the sizing requirements for this product use. The department is in no way endorsing this product or any advertising, and is not responsible for any situation which may result from its use. Sincerely, Michael J. Beckwith, CIPE Plumbing Product Reviewer phone: 608 - 266 -6742 fax: 608 - 267 -9566 e -mail: mike.beckwith @wi.gov V SAFETY AND BUILDINGS DIVISION Plumbing Product Review commerce.wl.gov P.O. Box 2658 Madison, Wisconsin 53701 -2658 isconsin Department of Commerce Jim Doyle, Governor Jack L. Fischer, A,I.A., Secretary July 2, 2007 SLUDGEHAMMER GROUP LTD. DR. DANIEL WICKMAN 336 S DIVISION RD PETOSKEY MI 49770 Re: Description: SEWAGE TREATMENT APPARATUS (also see SEWAGE TANKS) Manufacturer: SLUDGEHAMMER GROUP LTD. Product Name: SLUDGEHAMMER - AEROBIC BACTERIAL GENERATOR Model Number(s): SLUDGEHAMMER S -46 Product File No: 20070325 The specifications and /or plans for this plumbing product have been reviewed and determined to be in compliance with chapters Comm 82 through 84, Wisconsin Administrative Code, and Chapters 145 and 160, Wisconsin Statutes. The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative Code. This approval is valid until the end of October 2010. This approval supersedes the approval issued on May, 23, 2006, under product file number 20050595. This approval letter shall be incorporated with your previously approved plans and /or specifications approved under product file number 20050595. This approval is contingent upon compliance with the following stipulation(s): • This product must be sized based on daily wastewater flow (gallons per day). The gallons per day value must be at least 150 gallons per day per bedroom. • The maximum daily wastewater (DWF) flow which may discharge through this product is 450 gallons per day. • Installation and servicing of this product must be in accordance with the manufacturer's instructions. A copy of the manufacturer's installation and servicing instructions must be given to the owner of the system. • When this product receives wastewater from dwellings, it will produce an effluent quality with a maximum monthly average value for BOD5 of less than or equal to 30 mg /L, TSS of less than or equal to 30 mg /L TSS and F.O.G. of less than 30 mg /L and fecal coliform of less than or equal to 10,000 cfu /100ml. SBD- 10564 -E (N.10/97) File Ref: 07032504.DOC r j�ro SEED 'Tnls sPAr L li PE6RVED FOR R ND ECORPt 'yYARf$AldTY .r.ATA: _,_.6QG.LM ErJT Nq - - z wi FORM 2 -- 198 R . Mltoh E_ Meinlse 1k� - ---- ----r= , "= _ ��,•.�c _ :�, - -_ �e man_ - _T = o As %varrawta- t a - - v c i given •,.FIeslc M _ co`caVeas ana !s_; - - -5- __ = - � _ - _ _W� k .s,__k3ssb ns3 a.Ud �rzts a _. r_x tal .sure arshklp t �° �U _- , - 4fi _.. _..__. -. _.. __ . _ ... ... .. ...____.. .. ._.. ...._.____° . _._ R4TLR1`i TO .,. i . Goan n `& Werth* -met P.O Box 106 the follow :nl; described rersCestate in, _3 $t Cr01X - Coun'Ly dSOn TiiZ = r 340 -� 5 ate -af W.iscoiisn: _ I3ti' -ax Parcel N p, par -;cel of land. in 8t C: 1X County, [aiscons n, described 2�s fol7outs: ,the LVtr7 o, `N G�3d of Srtctlon €l3, 2�ownship 3Q North Range ZU West r ,, •fir'• =' -- _ -- This 15 homestead property.: other eas Exception to warranties: ` ' WITH AND SLIi3.7E = TO and Err• CfJV nt��, ersants. ` reservations or 'restrictions of record,,, d I VanY,t this shall riot be deemed extenr] an y suolz ocher recorclecl °e:22csMdJn nces bev03n. the term established _by law therefor >,- n� -_ of>x 19 91" •IJated ti}is - 7t--- --`-• ��� - --• •- (SEAL) `- NLiltcin ---( . ;(SEALr ; AUTFYENT;I "CATION ACKN0WI T .E_]:)0 YDN _ SiSnaYiure(tt) STATE OF WISGO'NSIN A -- -- 8t ..__Cr - os� County. as. - - -_ = _ _lithenticated this day of -------------------- Personally came before me this -. _t._ .- _day, of _. - -. _.- •_ _,S3U_.�}� - -_ the .._ -T9 9�.._ ,above named -- -- -• - -- -- -- . I` � _tc..._.I:o�_n]zP single rnan a - TITLE' MEMBER STATE BAR OF WISCONSIN -- j � - TC - .--- . •- - authorized by § 706.06. Wis. Staw_i t r_:c kr — co be a Iye /-on j. who- executed the foregoing? strut t SY ack th,l ii r , IN- ^-.TRUMENT WAS DRAFTED 6Y �� _ , /!��ik!, - Atty -,_ ._?H?49•b.-H cwn_..- - r Iiu j in :_ V. 430 2nd St. Hudson z_ 54016 My Commission Notary Public Croix . - :... Count -r wig. f - - -_ - - - - " - - -- - - -- - ---- :s jii:rmanen *_. •i- f- asoE- etAte- �Kl►+r�oLaa�Y C (Signatures may be authenticated or acknowledged. Both are not necessary) drat* - °Names of person* signfalg .io nay a v..ity Shon!d be typed or I,rint. ^.d below LF.rir Yignnt�: res. UAn or QVISCOwTS'.N wARRANTY DEED U. z— V+. � co ����� '�'• I 1 Parcel #: 032-2071-20-000 03/10/2008 01:59 PM PAGE 1 OF 1 Alt. Parcel #: 13.30.20.774 032 - TOWN OF SOMERSET 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 O - INDIANHEAD SCOUT CAMPS, CAMP BUILDINGS & LAND CAMP BUILDINGS & LAND INDIANHEAD SCOUT CAMPS 393 MARSHALL AVE ST PAUL MN 55102 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 37.000 Plat: N/A -NOT AVAILABLE SEC 13 T30N R20W 37A NW NW BOY SCOUT Block/Condo Bldg: CAMP BLDGS & LAND Tract(s): (Sec- Twn -Rng 401/4 1601/4) 13- 30N -20W Notes: Parcel History: Date Doc # Vol /Page Type 07/2311997 979/282 WD 07/23/1997 905/110 2008 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/09/1992 Description Class Acres Land Improve Total State Reason OTHER X4 37.000 0 0 0 NO Totals for 2008: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2007: 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 nCW AIMENT NC] WARRANTY DEED 1 „ ,• ^•_...,..,. ...r n�.-r- =:.,•: n•r. It ti'7'ell ")'c: uAR Utz' FO iss�'. 5�.1a0 ►6L 17rw27 ' EO'SrFR'S OFMCE e;l s R, . You rtgquist ST. CROIX c o., VW ... ....... Read for Record __ ... ... DEC 2 8 1993 cony v+ and war•rar.t to -. _T , 4 -ton E. NLalnke Estate -- --•,- - -. ... a - ..... ... 15 t .. ... ....... .. 1 ©� Regi.er of Deeds ....... .... .... . ... ..... .. ._.. .._. ....... _.. .. ... tWhT$t Wertheimer, S.C. _... .. .. .. -..... 430 Second St. P. O. !9or. 106 5t. Croix County. Hudson, Wi 54-1 cne fr! lowing described real estate it . ...... ....... ...... . _......... ._... y. $teto of 'vF ii:..:,nei Qq p q7 Tar Parcel N OOd.£S:'�6a�J_1= 40..._._.... 032- 2070 -60 All of his one -half Interest in the fol.l.ok inq described propertva The Southeast Quarter of the Northwest Quar_ter (SO.- of NWk.) and the Southwest N rx of 'the Northeast CMarter (SW4 of mk) , except the East 330 feet thereof, all in Section 13, Township 30 North, Range 20 West, St. Croix County, Wisconsin. This iegai description has prev -cusly baen described a.._ T'he Southeast cmar er of the Northwest Ouarter and the Southwest (marrer of t o 1k >ruiea7(_ Vua• - iXi: of Sact_:o a 13, Township 30 North, Range 20 West, excepting that part of the Southwest Quarter of the Northeast Ouarter conveyed to Jerold 1-7. Wulf by Warranty Deed dated and recorded on Jura 26, 1964 in the office of register. of Deeds for St. Croix County in Volmte. 405, page S. This Warranty Deed is given in satisfaction of this grantor's one half interest in a prior Land Contract dated Ccb ber 27, 1975 and recorded - x7ve.:,,. ar 11, 1975 in Volunn 530, at Paqe 580 as Docimrent. M. 330204 in the office of the Register of Deeds for St. Croix County, Wiscormin. {i !1 This _..._. _ is not . property. ,� h i; (irk (is not).:; �i Exception to warranties: TCC -2-'S IM Tn1ITH AND SUBJECT TO any other easements, CCA7enants, iireservations or restrictions of record, if any, but this shall not be deemed to extend any I'such other recorded encumbrances beyond the tQxilt established by law therefor. I ii is �- // - - -- ....._.. _._ - -. - - jiJt'7tfL'_/r?_: Dated th day of .Pr IrJ. (SEAL) _ _ (SEAL) R it Men R. ii .......(SEAL) (SEAL) i �I AL7THENT10AI °I1DN ACKNOWLEDGMENT a #� Signature ( s) ----- -•--- --•- ------•-••---•-- ---•- . ..................... STATE OT` Stl =ZC3Q=XM F LORUX i ss ------------------ - .......... •-----'.County. 1 i; authenticated tFix ._..._.dac of -------------- 1�J_____ersona�ly came before me this �� .� day of .8_.._, the above named ------------------------------------------- -- ---- -------------------------- C »l R. Xoutl st -- -- - --- •-- -•---- ---- •----• -- - � ? � j � .... . .. ....... . ----•-- -••----••-- ••----- - - ---- ---- ----- -----------•---------- -•- - TITLi ATEMBER STATE BAR OF WISCONSIN (If not . ...... ___ _--- -_------ _------------ -- -----•-- authorized by § 706,06, Wis. Statv.) to me known to be the person .. who etecuted the fore> =•oin instrument and acknowledge the same. D TReS INSTRUMENT WAS DRAFTE BY ;• .���[:'..�,_ 7- /iii �.!j+ .. AttY,..Tuch_H Qwin ----------------- - _._... -. _. 430 2nd St., Hudson, WI 54016 /y!t -------- --- Notnr, Public ... ?_ .t`.. Ltl r F county. MK3 . FL, (Signatures may be authenticated or acknowledged. Both MY •- Y • state cspiration are not ary. .o'�'i'••••rY: J S S E. Nl1RST d et My- COMM191 MtCC235122 `^ ;•: FM AM- FsEn/uy 18. 1597 it •Names o[ persona .1—inc in ap.v --its wbo M be sped or , rm!"I b f — 'I" it - WA_RAANTY DEED STATE DAR OF WISCONSIN FORM No. 2 — 1'1M2 INriwn W', J 00CUMEN - 17 M0. ':'. STATE BAR OF WISCONSIN FORM 5-1982! rtuS ryPACE. RESERVED FOR H: CORDING OaTA PERSONAL REPRESENTATIVE'S DEED - t Irene L. Spri.nclborn •------------ - - - - -- --- - - - - -- ___ lton ._ ?ye i . _ ---- __-- _•• -• -_, as Personal Representative of the estate of �i • 12:15 P 1tilz„ _ r I - - -- -- •---------- ------ ------- - ---- ------ -----•-------- --- -• ("Decedent"), - f Yrene L. !1 �+ f for a valuable consideration conveys, without wagranty, to _ Sprino:iorn, Ethel C. Heuer, Herinirla A. Shoop, and ------------ I ---- - y NY. - N,aoheeJc; as tenants ar: C�mlKin Grantee, � — - -- --- a � --__ Lai�ih 01 Wertheimer, S.C the following described real estate in St f ro _ ........... Cc unty, i 430 Second St. P. Q. Box 106 State of Wisconsin (hereinafter called the "Property ") : ! _Hudson,_Wf_ 5401E3___ . (; j� Tax Pareel No: 032 - 2071 -40 032- 2071• -30 - - - -- 032- 2070 -60 i The SW of the NW's h7a -, the SEA, of the WK, and the S of tl taFk except the East 330 feet thereof, all in Section 13, 7tfvMship 30 i l North, Range 20 West, St. Croix County, r.'4isconsin^ i4 This is an exen transfer pursuant to sec. 77.25(11), Wis. Stats. ! i. ;! This Personal Pepresentative's D' d corrects and reconfirlrw a prior deer',. ` e -.-ePn the parties dated January 25, 1993 and recorded January 27, 1993 in Vol. 991, at Page 108 as Document No. 494397 in the office of the Register of Reds for St. Croix County, Wisconsin. (' 'c ij !i Personal Representative by this deed does convey to Grantee all of the estate and interest in the Property which the Decedent had immediately prior to Decedent's death, and all of the estate and interest in the Property which the I, Personal Representative hag 4 since acquired. 1� Dated this - ------ ------130,-------- ---- ------ day of ------------------------ - Jun e- _-- ---- --- -- ------ - ---- 19_..95 I ii iI !' 7 L ... - - ----------- (SEAL) ....... .......... .......... .---- --------- (SEAL) r • Irene L. Sorinq}�o „ --------------- -------- ------ ----- !j Personal Ropresentative Personal Rcpreeentati ii j� AUTHENTICATION AORNOWLEDGMENT " Irene L. Sprir.�born STATE OF WISCONSIN ii Sign .ure(t) 1 _EI_ , •=� - -L rn�r� e sa. 1 °................................ County. ! ii i, auth catcd r y of_ f, . `?e ............... 19.._' Q 5 Personalty camp before me this ---------------- day of --------------- 19 the above named TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats_) - -----------•------------------------------__...__._.------••-----••-.--•-.•-- to me known to be the person - _- ......... who executed the foregoing instrument and acknowledge the same. THIS ir,STRUMENT WAS DRAFTED BY Ate Hu H. Cawin - - - ... - ---- ---- -- -- --- -------- .. 430 2nd St., Hudson, WI 54016 ---- -- -- - -- ----------- ----------- - ---------- ---- -- --- - -- - - • . .. .................. ... .... .. ...... -- -- Notary Public ------- -- .. --------- .--County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date: ..--• ------- -- ------ ------ 19-------- -Names or persons signing in any capacity should be typrA or printed bel— their sieaatures. STATE LIAR OF WISCONSIN Wis —M. Legal Blank c 1.- PSIMSONA1, 1tErRESENTATIVE DEED FOAM No- 5 — 1982 NUI —kre. Win. 4 411!14 4 444 4 144 X14411441144441144! 141!1! Ull 1114 Document Number Document Title 87 0636 KATHLEEN H. WALSH St. Croix Count REGISTER OF DEEDS County ST. CROIX CO., WI AEROBIC TREATMENT UNIT (ATU) RECEIVED FOR RECORD SERVICING AGREEMENT 03/12/2006 11:20AM AGREEMENT EXEMPT • State Plan Transaction Number- S REC FEE: 11.00 PAGES: 1 �Ot2'rf+EkN Sf.+tc C OU �uc /L 13 , F�.Ef? C• �lnlOrKSE Name - (Owner) Typed or printed s C u r hart P Being duly sworn, states, under oath, that: 1. He /she is the owner /part owner of the following parcel of land located in St. Croix County, Wisconsin, recorded in Votume 977 Page Z YL Document Number 4 lo75 St. Croix County Register of Deeds Office: Recording Area A parcel of land located in the N '/4 of the JJ VJ'/4 of Section Name and Return Address 13 , T 3 O N - R of O W, Town of I NK N'1 0t.zr JS(p 401JAat1?5EN $GOUT CN1n, fe s e , rn6 Z5 , ET , St. Croix County, Wisconsin, being /401,11-TOAJ WE 5V09Z duly described as follows (include lot no. and subdivision/CSM or detailed legal description): ' 1q ` 1 f 03 Z - O - O - OD -��� Ajj D f- �v L) /`f Parcel Identification Number (PIN) Agreement Date: 3 1 1 ' O a CC 5 , u� / 3 wrt 5 • 3 ' ntv r 4 ✓L� Z 0 As an inducement to the county to issue a sanitary permit for a POWTS equipped with an Aerobic Treatment Unit on the above - described property, we agree to do the following: 1. Owner agrees to conform to all applicable requirements of Comm 83, Wis. Adm. Code relating to Aerobic Treatment Units (ATU) and the maintenance requirements for the proposed POWTS (Private Onsite Wastewater Treatment System) technology, if the owner fails to have the POWTS and ATU property serviced in response to orders Issued by the governmental unit or the Department of Commerce to prevent or abate a human health hazard as described in s. 254.59, Stats., the governmental unit (Town) may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 68.0703, Stats. 2. The owner agrees to maintain a contract with a licensed POWTS maintalner for the life of the system. The POWTS maintainer will perform periodic Inspections and maintenance as required by the manufacturer and the Department, Including, but not limited to: the blower, electrical controls, and treatment unit operation and sludge depth. These inspections are to be scheduled every 6 months for the first two years of operation and yearly thereafter. 3. The owner agrees to contact the POWTS maintainer immediately upon any malfunction of the treatment unit and to maintain the unit so as to not create a human health hazard as described in s. 254.59, Stats. 4. The owner recognizes that the county, Department of Commerce, or POWTS maintainer may make periodic inspections of the components to complete performance monitoring of the unit. 5. The owner or the owner's agent agrees to report to the department or designated agent at the completion of each inspection, maintenance or servicing event in a manner specified by the department or designated agent within 10 business days from the date of Inspection, maintenance or servicing. 6. This agreement will remain in effect only until the county office responsible for the regulation of POWTS certifies that the aerobic treatment unit no longer serves the property. In addition, this agreement may be cancelled by executing and recording said certification with reference to this agreement In such manner which will permit the existence of the certification to be determined by reference to the property. 7. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submit this agreement to the Register of Deeds, and the agreement shall be recorded in a manner that will permit the existence of the agreement to be determined by reference to the property where the Aerobic Treatment Unit is installed. Owner(s) Name(s) - Please Print Subscribe and sworn to bef me on this date: ✓ 37 er.� fil/ + ✓/9r 1514 K I AO L t � Notarized O j Signature(s) y Notary Public ;su:JME M. BR" :r: 'NJ�:Ir i'UtnC - Governmantal Unit Official Name, Title - Please Print n Expires[l•_Ogy(;0�(y �� MY Commiii6on met 01/31I210110 Governme, Unit Offs i Si at ra. e M 7 -1 lnfo Ion vide may be used for secondary purposes [Privacy Law s. 15.04(1)(m)) "THIS PAGE iS PART OF THIS LEGAL DOCUMENT - 00 NOT REMOVE" i 1rhis information must be completed by submitter document title, name 6 retum address. and M (if required). Other information such as the granting clauses, legal description, etc. may be placed out this J%st page of the document or may be placed on add/t/ona/ pages of the document Note: Use of this cover page add* one page to your document and 52.00 jo the AwordMo fee. W/sconsin Statutes, 59.517.