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HomeMy WebLinkAbout032-2075-30-000 evy Cq O � � I e a� °o t N U N I O � i O O ,ts 7 tz� C N m f0 a a a Z c c _ � Li c o o rn CL E Q U I � o I z E � w I N z ; 0 O z ° w a m �r z o c C7 cc O z a N O U) F- r E z -a N M p •� '0 L p 0 z z o Q o N .. z I LO C'41 C jp .j N .. A m 1� z p. p Q �w ¢ � oivivai E z a33 o R U) 0 0 0 z 'N i oN — rn rn to J U s rn rn p z Q�v W N �1 CO = Cl) ml a Fn w m � d ¢ z in o I � I 0 3 a CD Q O p ° m O C t7 N V = N r - �_ I C Lo N z N C N O O O O • 7a C O C,) O V y o U) o o z - F- z U) O w A: li I v� ;) R d a r S dt 2- L a w • at CL m ;2 d o o c c o r_w1 A 0(L2 oinci Parcel #: 032-2075-30-000 02/06/2006 08:56 AM PAGE 1 OF 1 Alt. Parcel#: 14.30.20.787A 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 SCOUT CAMP LAND&BLDGS INDIANHEAD SCOUT CAMPS O-INDIANHEAD SCOUT CAMPS,SCOUT CAMP LAND&BLD( 393 MARSHALL AVE ST PAUL MN 55102 Districts: SC=School SP=Special Property Address(es): "=Primary Type Dist# Description SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 23.000 Plat: N/A-NOT AVAILABLE SEC 14 T30N R20W 23A N 23A GOV LOT 4 BOY Block/Condo Bldg: SCOUT CAMP BUILDINGS&LAND Tract(s): (Sec-Twn-Rng 401/4 1601/4) 14-30N-20W Notes: Parcel History: Date Doc# Vol/Page Type 2005 SUMMARY Bill M. Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/09/1992 Description Class Acres Land Improve Total State Reason OTHER X4 23.000 0 0 0 NO Totals for 2005: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2004: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch#: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7969 BUREAU OF PLUMBING MADISON,WI 53707 El CONVENTIONAL ❑ALTERNATIVE State Plan l.D.Number: `� NE 4NL 4Sec. 14,T30-R20W F-1 Holding Tank El In-Ground Pressure 1:1 Mound [If assigned) r, Town of St . Joe - � NA�Obf RMIT HOLDER: ADDRESS OF PERMIT HOLDER: CTI N D E: r WFred Anderson Scout Camp 186 Anderson Scout Camp BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: CST REF.PT.ELEV.: nn �� II II P REF.PT.ELEV.: CC IN...of Plumber MP/MPRSW N... County: Sanitary Permit Number: Calvin owers Jr. 1563 St . Croix 128652 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: OYES ❑NO I DYES ❑NO BEDDING: VENT DIA.: I VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM: FEET,FROM LINE: JAIR INLET: 1-1 YES FIND ❑YES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER. BEDDING: LIQUID CAPACITY PUMP MODEL. PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ENO EYES ENO OYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBS R'OF -PROPERTY WELL. BUILDING. VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) ❑YES ❑NO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until FORGE MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH: LENGTH. NO.OF DISTR.PIPE SPACING. COVER JINIIDE DIA.. #PITS: LIQUID EEOITRENCH ! TRENCHES. MATERIAL: PIT DEPTH. DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR.PIPF DISTR.PIPE DISTR.PIPE MATERIAL: NO.DI STR NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES ABOVE COVER. ELEV.INLET ELEV.END. PIPES-. FEET FROM LINE: AIR INLET: NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ❑YES NO SOIL COVER ITEXTURE PERMANENT MARKERS OBSERVATION WELLS ❑YES 1:1 NO DYES NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED. SEEDED. MULCHED. CENTER. EDGES. ❑YES ❑NO ❑YES ❑NO ❑YES E NO PRESSURIZED DISTRIBUTION SYSTEM: BEtITRE H, WIDTH LENGTH TRENCHES LATERAL SPACING GRAVEL DEPTH BELOW PIPF FILL DEPTH ABOVE COVER. MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL. NO.DISTR. DISTR.PIPE DISTRIBUTION P E MATERIAL&MARKING. ELEV.: ELEV.: DIA.. ELEV.. PIPES: DIA.: E�,EI/ATI4)N ANQ I1TpI�TIt� , HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED eQ7�M,f4TION I PLANS. YES NO El YES 1:1 NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER O'F, LINE:ERTY WELL: BUILDING: FEET FROM �?� ❑YES 1:1 NO El YES 1:1 NO NEAREST Qj , _ z �- Sketch System on /�,�8 ✓ Retain in county file for audit. Reverse Side. r-'� (V SIGNATURE: TITLE: DILHR S B D 6710 (R.01/82) SANITARY PERMIT APPLICATION 7DILHR' In accord with ILHR 83.05,Wis.Adm.Code couN —.�„a.�.... -11. STATE SANITARY PERMIT# -Attach complete,plans(to the county copy only)for the system,on paper not less than El � k � � 8%x 11 inches in size. f revis onto previous application —See reverse side for instructions for completing this application. STATE PLAN I.D.NUMBER 1. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. PROPERTY OWNER ,j, PROPERTY LOCATION Gv Ale %At F- %a,S /-'/ T__-�O , N, R cP0 1por)W PROPERTY WNER'S MAILING ADDRESS LOT# BLOCK# /lo NA- IV A, CITY,STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER .� o a�a pis 5P�9 G6y! NA, 0 CITY II. TYPE OF BUILDING: (Check one) F-1 State Owned VILLAGE:S-f NEAREST ROAD ��s�► MPublic 1:11 or 2 Fam.Dwelling-#of bedrooms— PARCEL TAX NUM ER( ) Gr III. BUILDING USE: (If building type is public,check all that apply) _367 1 ❑ Apt/Condo 2 W Assembly Hall 6 1:1 Medical Facility/Nursing Home 10 El Outdoor Recreational Facility 3 Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1.� New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit## — Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 X Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1.GALLONS PER DAY 2.ABSORP.AREA 3.ABSORP.AREA 4. LOADING RATE 5. PERC.RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIR D q.ft.) PROPOSED(s .ft.) (Gals/day/sq.ft.) (Min./inch) ELEVATION ,jBd �f+t 4d /_rte /O '9Feet •�/3 Feet CAPACITY VII. TANK Site in ga ons Total ##of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App T ks Tanks structed Septic Tank or Holdin Tank 0130 Lift Pump Tank/Siphon Chamber f /OAo DZm El _L11H 1:1 1:1 1 1:1 VIII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name(Print): Plumber's Signatur .(N Stam ) MP/MPRSW No.: Business Phone Number: 0,4AW1017.3; T�_ I Plumber's Address(Street,City,State, ip Code): IX. COUNTY/DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee(Includes Groundwater Date Issued Issuing Agent Signature No Stamps) Surcharge Fee) / Approved ❑ Owner Given Initial s.l.=_ Adverse Determination e X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(formerly Plb-67)(R.11/88) DISTRIBUTION: Original to County,One Copy To:Safety&Buildings Division,Owner,Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 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. Onsife sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the " State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. 11. Type of building being served. Check only one and complete##of bedrooms if 1 or 2 Family Dwelling. Ill. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. Vill. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers;wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398(R.11/88) DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, DIVISION LABOR AND HUMAN RELATIONS 1 PERCOLATION TESTS (115) P.O. BOX 7969(H63.090)& Chapter 145.045) MADISON,WI 53707 LOCATION: SECTION: WT : LOT NO.:BLK.NO.: SUBDIVISION NAME: NE 4VE 1/4 14 /T30 NAQ 6,)W St n/a COUNTY: OWNER'S BUYER'S NAME: RESS:St. Croix Fred C. Anderson, Scout Camp rson scout Camp, Houlton, Wi. 54082 USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMM RCIAL DESCRIPTION: PROFILE DE CR PTIONS: E O A ON TESTS: LOResidence day camp 53vew ❑Replace 11-12-88 8-10-89 RATING:S=Site suitable for system U=Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND PRESSURE:SYSTEM-IN-FILL OLDIIN.G.TANK:RECOMMENDED SYSTEM:(optional) ❑S QU 4R S ❑U ❑S J9U ❑S ❑S�U mound If Percolation Tests are NOT required DESIGN RATE: If any y portion of the tested area is in the under s,H63.09(5)(b),lndicate: Floodplain, indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS page 33 ROE BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DEPTH ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- 1 5.25 103.93 none >5.25 .83bl.1. 2.92bn.s.sil. 1.50bn. LS. B- 2 4.83 103.93 none >4.83 1.00bl.l. 2.83bn.s.sil. 1.00bn.1s. B- 3 5.50 102.26 none >5.50 1.00bl.l. 3.00bn.s.l. 1.50bn.1s. B- B- B- decimal' PERCOLATION TESTS LEVEL-INCHES RATE MINUTES TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LE NUMBER B" AFTERSWELLING INTERVAL-MIN. PERIOD 1 PEER LE PERIOD PER INCH P-1 2.00 none 30 3 3/4 3 3 10 P_ 2 27.00 none 30 5 4,12 4- 7 P- 3 2.00 none 30 2- 2 2 15 P-_ P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori• zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION 104.93 _ E 3I ! ,. i I ? IN 1 E i _ . D - l I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME(print): TESTS WERE COMPLETED ON: Gary L. Steel 8-10-89 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optionall: 988 N. Shore dr. New Richmond, Wi. 54017 -24 —6200 CST SIGNAT DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. , DILHR-SBD-6395 (R.02/82) OVER INSTRUCTIONS FOR COMPLETING FORM 115 - SRC}­ 5395 To be a complete and accurate soil test,your report must include. 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial Project, 3. MAXIMUM number of bedrooms or commercial use planned; , is this a new or replacement system; P. cornplete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6� PLEASE use the abbreviations shown here for writing profile descriptions and cornpleting the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test: locations. Drawing to scale is preferred. A sfr roar at€=sher?t may be used if desire(!; S. Male sure your benchmark and ve€tical elevation reference point are clearly shown,and are permanent; . Complete all appropriate boxes as to dates, names,addresses, flood Main data, percolation test exemts- tion if appropriate; io, It tt,e information (such as floo(i plain,elevation)does no,,apply, place N-A,in the aptarol>rizrfe box; 1 r, Sitln the form a nd place your current address and your certification number; 12. Make legible, copies and distribute as required. ALL SOIL, TESTS MUST BE FILED WITH THE LOCAL AUTHORITY VVITHIN 33 BAYS OF COMPLETION, ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Syrnbols st Stone (.)rier 1W,) BR Bedrock, Cob _ Cobb'(.' (3- 10") SS - San&s,tone clr - Gr :vel (under 3", LS Limestone s -- Sand HCVV -- High Groundwater cs - (:oarse sandlE Perc - Pc.ccd It on, Rage Fine e Sand Bloc, Buildin+:l Loamy Sand Greater Than sl _. &,ndy Loarn Less Than L oam Barr ',si' ..._ Silt Loam Bl ...._ Bit c< S Fill G _, iiM`}` Loam ; Yz�l`3t�i^ Sandy Clay LoEarn R Silty Clay Loatrt"� t�tot - IVlottte�< Clay r W ar,'itl-a -. Silty Clay fff ._ few; firat_,fra;nt Cl2y ar -- cornrn(mI,coarse pt f�trt rearm Marty, nee€iunl ,aa - k1u,ck d - distinct p.- prominecit - HWL - High v%,ater level, six cic nertal soil Lextt*t;s Sltrfacc v,?a%er for ligt.6d waste dispersal BN4,- Bench Mark VRP - Verti�l efer(;mce Point 1 . r• �a TO THE OWNER. This,soil test repo;t is the first stop in s(;curing a sanitary permit. The county or the Department may request vr,rification of this soil test in tine ficld ps-ior to permit issuance. A complete set of plans for the private se(s�age system and a permit application must be submitted to the appropriate local authority in order to o0iaain a peen t-The sanitary permit must be obtained and posted prior to the start-of ally construction. GWIN. GILBEF `tf Y 1 i -2 j52-6 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 nomin5AI .onsideration, those 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 /, FEE Northeast Quarter (WJ NEI)* ; Government Lot 5, 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. Those parts of Government Lots two, three and four (2, 3 and 4) and the Northwest Quarter of Southeast IiEGI!STeRc� OFFICE Quarter (NWJ SEJ) of Section Twelve (12) described t-T. CROIx�..O., Wis. as follows: Rec'd fof Recos1 1 fhi _26t> _ Commencing at the 'South quarter corner of said dAytrf_._ ri A.D.19-74 Section 12; thence North 2200.55' , assumed M. bearing, along , the quarter section line to the point of beginning; thence N67°511E 64.481 ; Thence N70027'E, 254. 10' ; thence N27057'E 140.301 ; ­ Sri o+ No& thence N350391E 168.50' ; thence S44018'E 181.90' ; thence N430571E 225. 581 ; thence N30°201W 209.70' ; thence N51025"E 179.40' ; ,thence N520591E 219.50' ; thence S160401E 27.00' ; thence N780031E 364.33' to the East line of Government Lot 4; thence N0005'',E 372.16 ' along the 'East line of Government Lot 4; thence N85°22'W 730.251 ; thence N0t361W 739.33 ' ; thence N78053'W 144.72' to the edge of the bluff ; thence N78°531W 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 SEI of the SWI of said' Section 12; thence N870411E 260.661 ; thence N310291E 209.85' ; thence N170581E 327.551 ; thence N71058'E 358.301 ; thence N360391E 222.601 ; thence N64019'E. 182.901 ; thence N820541E 144.751 ,; thence .N670511E 74.52' to the point of beginning. except the tracts and subject to the easements described in the deed from this Grantor to, Olga M. Schroeder re- corded in Volume 492, pages 28f & 287, index #313649 and the deed from this Grantor to Estelle B. Bancroft re- corded in Volume 495, ,pages 17 & 1s, in #314816, all in the Register of Deeds office for St. Croix County. Grantor intends by this deed to convey all its lands in the said' Town 'of Somerset. Haw IN WITNESS WHEREOF, the said Grantor has caused these presents to be signed by William B. Randall, its President, and countersigned by Norman E. Swails, its Secretary, at St. Paul, Minnesota, this day of April, 1974. INDIANHEAD COUNCIL, BOY SCOUTS OF AMEBIC William B,--R-a-dal �, �PreSideat vz C� N man E. Swails, Secretary STATE OF MINNESOTA) ) ss RAMSEY COUNTY ) Personally came before me, this ,! day of April, 1974, William B. Randall, President, and Norman E. Swails, Secretary, of the above named Corporation, to me known to be the persons who executed the foregoing instrument , and to me known to be such President and Secretary of said Corporation, and acknowledged ' that they executed the foregoing instrument as such officers as the deed of said corporation, by )s authority. nk B. Spec .4 Q' Notary Public, set,"�rlindz. My Commission irbs This instrument drafted by: Hugh F. Gwin, Attorney Hudson, Wisconsin , 1 X STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER �cC� ROUTE/BOX NUMBER FIRE NO. CITY/STATE J°A W (-SC ZIP J5 yc�'�-'_Z PROPERTY LOCATION: _ZL 1/4 1//4,, Section T.=�O N, R a o W, Town of s �l �5 ��" , St. Croix County, Subdivision , Lot No h�A Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a LICENSED SEPTIC TANK PUMPER. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of $3000 of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of ALL NEW SYSTEMS agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Department of Natural Resources. Certification form must be completed and returned to the St.Croix Co ty Zoning Office within 30 days of the three year expiration date. owl SIGNED DATE St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 (715) 386-4680 Sign, Date, and Return to above address + APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. ------------------------- -------------------------------------------------- Owner of property -eQ 1�0� �a S �a ' g=ze Location of property AF /4 x_1/9, Section , T 3 N-Ro _M Township 57, A-a`�c Mailing address �'t �_ nc }5a� Go ��''''► Address of site ( Sa-mrz cc S Subdivision name i Lot number Af 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 resale (spec house)? Yes No Volume -5/0 and Page Number �! 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 OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing, process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. ------------------------------------------------------------------------------- PROPERTY OWNER CERTIFICATION I(We) certify that all statements on this form are true to the best of my (our) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed eca ded in the Office of the County Register of Deeds as Document No. �� j �0 ; and that I (We) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction f said system, and the same has been duly recorded in the Office of the Co Register of Deeds, as Document No. 1 . Sign ure of r Signature of Co-Owner (If Applicable) /. Date of Signature Date of Signature ST. CROIX COUNTY WISCONSIN �A ; ZONING OFFICE ST.CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON,WI 54016 -_ (715)386-4680 September 5, 1989 Division of Safety and Buildings Bureau of Plumbing P. O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation of the Fred C. Anderson, Scout Camp �► property located in the NE 1/4 of the NE 1/4 of Section 14, T30N- R20W, Town of St. Joseph, St. Croix County, revealed suitable soils at a depth of 3.83 feet, after which bedrock was noted. This site should be suitable for a mound system. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, I Thomas C. Nelson Zoning Administrator I S89 - 40343 ST. CROIX COUNTY K WISCONSIN 7+ k ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 September 5, 1989 Division of Safety and Buildings Bureau of Plumbing P. O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation of the Fred C. Anderson, Scout Camp property located in the NE 1/4 of the NE 1/4 of Section 14 , T30N- R20W, Town of St. Joseph, St. Croix County, revealed suitable soils at a depth of 3 . 83 feet, after which bedrock was noted. This site should be suitable for a mound system. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, Thomas C. Nelson Zoning Administrator I S89 - 40343 Mound system for Fred C. Anderson Scout Camp Boy Scouts of America NFr NE-4 S.14-T.30N.-R20W St. Joseph, township pages #1-----------plan approval application #2-----------St. Croix county verification of soils #3----------soil data (115) #4----------project detail data sheet #5----------plot plan-plan view #6----------work sheet #7----------system cross section #8----------pipe lateral layout #9----------dosing chamber #10---------pump curve C lvin P �ers Jr. R.R.#3 New Richmond, Wi. 54017 MPRSW 1563 8-31-89 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, G DIVISION BOX 76 HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 537907 9 53707 (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP) OCITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: NE �%4�TE 1/4 14 /T30 N1$O fdor)W St. Jose h n/a n/a n/a COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: St. Croix Fred C. Anderson, Scout Camp 1 186 Anderson scout Camp, Houlton, Wi. 54082 USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMM R DESCRIPTION: PR F PT NS: PERCOLATION TESTS: FEDE R esidence day Camp G&New ❑Replace 11-12-88 8-10-89 RATING:S-Site suitable for system U-Site unsuitable for system CONVENTI NAL:MIS ND: IN-GROUNDPRESSURE: S EM-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM:(optional) ❑S U ❑ ❑S gu ❑S PU I EJ&c9U I mound If Percolation Tests are NOT required DESIGN RATE: I If any y portion of the tested area is in the under s.H63.09(5)(b),indicate: n/a Floodplain, indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS page 33 ROE BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH Mb ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- 1 5.25 103.93 none >5.25 .83bl.1. 2.92bii.s.sil. 1.50bn. LS. B- 2 4.83 103.93 none >4.83 1.00bl.l. 2.83bn.s.sil. 1.00bn.1s. B 3 5.50 102.26 none >5.50 1.00bl.1. 3.00bn.s.1. 1.50bn.1s. B- B- B- decimal• PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER 7(000Q6 AFTER SWELLING INTERVAL-MIN, PERIOD 1 PER1002 PER INCH P- 1 2.00 none 30 3 3/4 3 3 10 P. 2 2.00 none 30 5 4-2 41 7 P- 3 2.00 none 30 2- 2 2 15 P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION 104 93 -71- --T-- �._.. 17 --- - It 14-� �. - yQ. I - - - t I r� �_�f.��-� �,�•,; IMP f_; _ _.� fLB�-- ,�6� � - � � T_ - ----i N . 3 i� Ste, !l I boa m O VT I } { S 3 4 I _._ �_ { I I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME(print): TESTS WERE COMPLETED ON: Gary L. Steel 8-10-89 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): 988 N. Shore dr. New Richmond Wi. 54017 22 1715-248-6200 CST SIGNAT DIS T RIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. DI L;+:;-SBD-6395 (R.02/82) —OVER 6) Plb. # 60 1/78 PROJECT DETAIL DATA SHEET NAME OF BUSINESS Fred C. Anderson Scout Cam LEGAL DESCRIPTION NE4NFr S.14-T30N.-R.20W. OWNER Boy Scouts of America MAILING ADDRESS 186 Anderson Scout Camp Houlton, wi. ZIP 54082 ARCHITECT, ENGINEER, Calvin Powers jr. ADDRESS R.R.#3 PLUMBER OR DESIGNER New Richmond, Wi. ZIP 54017 TELEPHONE NUMBER 715-246-5135 1 . Check appropriate building usage(s) and fill in the information requested opposite each usage listed. Please consult Section H 62.20. Existing building x New building Addition x ( ) Apartments and condominiums . . . . Number of bedrooms ( ) Assembly hall . . Seating capacity ( ) Bar . . . . . Seating capacity # of meals served ( ) Bowling alley . . . . Number of lanes ( ) With bar ( ) Campground and camping resorts . . . Number of sewered sites Number of unsewered sites (x) Camps . . . • • . . Total number of sites • (x) Day use only Number of persons 32 ( ) Catchbasin ( ) Day and night Number of persons ( ) Church . . . ' ' • • • • Number • • • • • • • • ( ) No kitchen Number of persons ( ) Dance hall ( ) With kitchen Number of persons • • • • . . Number of persons ( ) Dining hall Number of meals served daily ( ) Dog kennels Number of enclosures ( ) Drive-in restaurant . . . . . . . . Inside seating capacity Car-service -- Number of car spaces ( ) Dump station . Number of dump stations ( ) Employees ( total of all shifts) . . Number of employees ( ) Hotel ( ) Motel ( ) Cottages . . . . Number of units with 2 Number of units persons per unit persons per unit ( ) Medical and dental office bldgs. Number of doctors ,tnurses , medical staff Number of office personnel ( ) Mobile home parks . . . . . Number of patients ( ) Nursing homes . • • • • Number of sites ( ) Parks Number of beds ( ) Restaurant . . • . . Number of persons ( ) Toilets ( ) Showers • • • • • • . . . Seating capacity ( ) Dishwasher and/or disposal? 4 ) Retail store ( ) 24-Hour service . ( ) Schools . . ' ' ' ' • Total number of customers ( ) Self service laundry . . • Number of classrooms __FT Meals ( ) Showers Y . • • • • • . . Total number of machines ( ) Service station . . . . Number of cars served daily ( ) Swimming pool bathhouse . Number of persons ( ) OTHER (Specify) . . . . . . COMPLETE OTHER SIDE 2. Indicate whether the following facilities are present. Floor drain yes x no Number of drains 2 Food waste grinder yes no x Dishwasher yes no x Automatic clothes washer yes no x Number of clothes washers 3. Septic tank capacity 1330 Holding tank capacity Powers Cement Pdts. Septic or holding tank manufacturer 4. SEEPAGE TRENCHES: total square feet width of trenches length of trenches depth number of trenches SEEPAGE BEDS: total square feet 484 width 8 length of bed 62 depth mound SEEPAGE PITS: total square feet - outside diameter depth below inlet total depth from top to bottom of pit Signature of person completing form: FOR DEPARTMENTAL USE ONLY Address R.R.0 New Richmond, Wi. Zip 54017 Telephone Number 715-246-5135 Date 8-31-89 J_/ ' ,�,/ �� � , . �l ,r °� z► �'�9 g:gib corner 0 360'�c.�vzz pos4-, Sz► lot y► „ /Ooo bA 1 �� , �lAo pvl e 1)+ E4, X00, /YI fq r .35 KP �I 20` s -T-7�, INST,kLL WeLL. 4S FSF_ AO`( AND ALA. AM D.N.R. it0Lf_ � Reyu�.Ar�oNt 8z ' Gz ' of 10' Q9 3D�---j 3a`�— --� �- l o' 3 pi A-0 �yi I S� EE S IS ES cc) bar v�rh on P .�.. Plot plan-plan view , r OPTIONAL WORKSHEET 1. MOUND SYSTEM 11. IN-GROUND PRESSURE SYSTEM-Continued- 1. Wastewater Load,Total Daily Flow= `5a gal. 10. Force Main: Use s. ILHR 83. 15 3 3 7 ( ) (c) Minimum Dosing Rate= � 7--- gpm, Adm.Code and PROVIDE A DETAILED Diameter= in. LIST OF SIZING ON PLANS. e3 11. Total Dynamic Head: 2. Depth to Limiting Factor= 3 ft. System Head= 2.5 ft. 3. Landslope= '3 _ % Vertical Lift= ft, 4. Distance from Dose Chamber to , Friction Loss= t?- ft. Distribution System= ,�)- ft. TDH= 5. Elevation Difference Between / �_ 12. Pump Selection: f Pump and Distribution System= ft. Pump will discharge at least 7' gpm 6. Absorption Area Sizing: �`r7 i ��,-�-� at r-• ft.total dynamic head. Area Required= sq.ft. Pump model and manufacturer: __ = (! Bed or Trench Length(B)_ _ - ft, c i Bed or Trench Width(A)_ - ft. 13. Dose Volume: Trench Spacing(C)_ ft. 10 Times Void Volume of 7. Mound Height: Distribution Lines= Fill Depth(D)_ ft. Daily Wastewater Volume+ gal Fill Depth Downslope(E)_ -7'j ft. 4 Doses in 24 hrs._ �(`w� gal. Bed or Trench Depth(F)_ �9_ ft, Backflow= gal, Cap and Topsoil Depth(G)= _ ft. Minimum Dose Cap and Topsoil Depth(H)_ ��-r ft. 14• Dose Chamber: gal 8. Mound Length: Volume= �'( '" End Slope(K)_ � ft. gal./4; Total Mound Length(L)_ 17_.1 ft. 111. CONVENTIONAL PRIVATE SEWAGE SYSTEM 9. Mound Width: 1. Wastewater Load,Total Daily Flow= gal: Upslope Correction Factor= ' 9�16^ Use s. ILHR 83. 15 (3) (c) , Wis. Upslope Width(I)_ _ ft, Adm.Code and PROVIDE DETAILED Downslope Correction Factor= ! LIST OF SIZING ON PLANS. Downslope Width(1)_ _.._�_. ft. 2. Required Septic Tank Capacity= gal. Total Mound Width(W)_ `" ft. 3. Percolation Rate= min./in. 10. Basal Area: 4. Absorption Area Sizing: Infiltrative Capacity of Refer to Table 2 in ch.-'ILHR 83 Z_ Natural Soil= /' gal./sq.ft./day and PROVIDE A DETAILED.LIST OF Basal Area Required= !' sq,ft. SIZING ON PLANS. Basal Area Available= 2 n sq.ft. Required Area= sq.ft. 11. If Standard Tables from Chapter ILHR 83 Length= �� {t are'.iused, Indicate Table # Width= ft. 12. For the Distribution Network,Use Numbers 5.14 In Section 11. Number of Tr ft, riches Trench Spa th = = 11. IN GROUND PRESSURE SYSTEM i,� 5. Trench ystem: 1. Depth to Limiting Factor= _ ft. Later Length= {t 2. Landslope= '` % Nyrfiber of Laterals= 3, Percolation Rate= L, min./in. ,tateral Spacing= In- 4. Proposed System Elevation= �ti '�� ft. % Distance from Sidewail to Pipe= in, 5. Wastewater Load,Total Daily Flow: gal. (/ System Elevation= ft. Use s. ILHR 83. 15 (3) (c) , Wis. Adm.Code and PROVIDE A DETAILED IV- SYSTEM-IN•FILL LIST OF SIZING ON*PLANS. l All Items from Section III Required Septic Tank Capacity gal. 6. Absorption Area Sizing: V. SEPTIC TANK Percolation Rate= ` min./in. 1. Capacity= o Area Required= � sq.ft. 2. Manufacturer: - t`•" `, �, ` 1 `'gal i ,:., System Length= z ft. 3. Show Site Constructed Tank Details on Plan System Width ft. 7. Distribution Pipe Sizing: VI. DOSING TANK Hole Sbc= in y� O . gal. Hole Spacing ft. 2. Manufacturer: . { L:Ucr:d Length - _ ft, 3. Pump Manufacturer: +� Latcral Si/e 4. Pump Muriel: lJ b o Lalcr.il Spacing 3 1't S. Operating Head= >,� �/ SDistarlax from sidew.dl-lo Pipe ' in. 6. Flow Rate= 1714'4- gpm, K. Distribution Pipe Discharge R.i1e: 7. Show Site Constructed Tank Details on Plans Number of I lolcs Per Pipe low Per Pipe ,' gpm. VII. HULUING TANK 9. Manifold Siting: i. Capacity= gal. Type(center or unit) .. ( /1�;` t- 2. Manufacturer J i Length it. 3: _Sy aw_Site-CorMKtruc ed Tank Details on Plans Diameter= ( in. 1 -SHOW ALL INFORMATION ON PLANS- DILHR SBD-6761 (R.03/82) o Page Of Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Sand Topsoil H G -3 E 11 D .:.. .. c 7 F:5 1 „ c^ Slope Bed Of - 2 Force Main Plowed Aggregate Layer d Cross Section Of A Mound System Using E J , Ft. AF. . �..: *, .._ A Bed For The Absorption Area F 7�7 Ft.' G / Ft.� Signed: A _ 8 Ft.'-- H A Ft: . B (�Z . Ft: License Number: i1 i /5�h K Ft. Date: L Ft.� . J Ft.` I /,z Ft., a ; (3 W Z`1 Ft., -- i J 6 Jbservation Pipe--,.,, . K W �•----- --------------- --------------------- i ± Distribution Bed Of 'Z�— Z izr• Pipe Aggregate Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area Page _ Of Perforated Pipe Detail n End View )Perforolla End Cool ' PVC Pipe 1�1YL ar`� NOW Lecotod On Bottom, . J� Are Evuogr UecN C ,s 1 � Distribution Pipe Layout P ) Ft. S .� X8 Inches Y ? Inches ' Signed: Hole Diameter /4 Inch Lateral iZ -Inch(es) License Number: Manifold Z Inches Date: , Force Main 'z- Inches _ _ # of holes/pipe 0NSI ;r---VV�:qa X11ST M �-3 Invert Elevation of Laterals/0-S Ft. r 'RELATIONS . fig✓,� . PAG4: CF PUMP CHAMBER CROSS SECTIOIJ AKIG SPECIFICATIOkJS VELDT CAP 4"C.I. VENT PIPE _T WEATHER PROOF APPROVED LOCKING 25' JUNCTION) BOX MANHOLE COVER � FROM DOOR, WINDOW OR FRESH 12"MIN. wI W rif��'�S `'I bt AIR INTAKE GRADE 1 4"MM. I i IB"MIN. COIJDUIT -- _— _ 18"MIND. —-- � -- -- INLET PROVIDE I —--7 r '` AIRTIGHT SEAL ��� e � g p APPROVED JOINT A APPROVED JOINTS W/C.I. PIPE W/C.2. PIPE EXTENDING 3' I II ALARM EXTENDING 3' OIJTO SOLID SOIL ONTO SOLID SOIL I ON I • ,°6� .� OFF D �. M CONCRETE BLOCK RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E SPECIFICATIOUS DOSE- TANKS MANUFACTURER: r (�t�� t'' L'' N' KJUMBER OF DOSES: PER DAM TAWK SIZE:, J DOO GALLONS DOSE VOLUME f� ALARM MANUFACTURER' +A'- < INCLUDING 6ACKFLOW: � 7`�f> GALLONS MODEL MUMBEK: i01 (4 CAPACITIES: A= IUCAES OR GALLONS M SWITCH TYPE: ►I I � :' I �k"'/ t;i �! T g=_INCHES OR 80 GALLONS PUMP MANUFACTURER: `° U LL' (' C= 7'3 INCHES OR )LE GALLONS MODEL NUMBER: �e. en ✓ D=,L.7 INCHES OR 7'L GALLONS SWITCH TYPE: MOTE: PUMP A1JD ALARM ARE TO DE MINIMUM DISCHARGE RATE 7, GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF ANO DISTRIBUTION PIPE../' `' FEET + MINIMUM NETWORK SUPPLY PRESSUR��,E//. . . . . . . , . 2C75�' FEET + FEET OF FORCE MAIN X l' �?- F/oo r-EFRICTIOU FACTOR.._ FEET TOTAL OU JAMIC. HEAD = �'� FEET ' IUTERNAL. DIMEMSIONS of TANJK: LENGTH ;WIDTH —;LIQUID DEPTH _ 51GUED: LICENSE DUMBER: � DATE: ��� f . 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