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040-1098-10-000
I I H p p 6 M ao m a) C o 0 o I CL y L 4 '� c co c c o.. BO O N O N 00_ H O > 3 a 'O C U C N c 3 m C ' O N 0 L U N a O y O O y V m r N 0c0 ?0.U) IM 0 �O) O U N C p > ; y r cc w L —0 p 7 L 0 C O L O m C "m" m � U y O` O)E C m � c p p O C y N C O C > U m O)-o y O c m u) CD o R o m oa.0 U-o M-- > vrn o cv o m ° °� w o Z 'o° m- w ti Z y U) mw m o C N c C N 01 7 f6 o U.6 O L m m o C'O p a) LL O U N N N LL •_0 4) y O N 4) cu U C 3 ? c 3 c c 3 u' o doEE O 'O O N N c •0 N m O O u Q U U axifq v Q w U EmZNH Q m c N O a) O w E E rn Z :. O _ p Z r y N 0 0 co to C14 CL co (L to I I O z �* � m a w c 'Or- y c E y E 0 C C O C C IL �. 00 O O O N-0 •�i � c r I � c L I 0 a� aQ o � aQ o i a d z a C) z N o ? d o � _ m £ N N m N y o d y '"- o p°' d N N E O O O a II = 000 a • m m m m CL C° fq J U 2 rn rn Z U) — co Z ^mil 000 N N 0 0 a o — M — E O O 00 O N N U0 C) 2 0 0 '6 p m O co a ao (� to N CO 0 �_ Q) y c ,.0 v 4 00 uyi c U o E Ai ++ w `o cg rn v O r V•O �.' O d W w m C w N N U c m 't O 0( c 0 C O M 3 •p C c N N N 0) O p 0 e° m - p 0 oCO C 't:: -0 U) o °' ` m o o N m p a z 2 Z Q i o z 21 x I- U dt :s E = E d R € a € a E .E am p � a � o c`0 3 oo 3 o r A uCL2 OmU 1 0 V1U I'A(A _1-_ G1 �- E PUMP CHAMBLK CKUSj SEC'f10f1 AKIU SI'LCII1('AIII)�1' VCWT CAP 4,C.I. VENT PIPE -WCA�fHL IC APKOVE LUCKING M PKOOF_ I P U JuUCTI0IJ bOXy J MAWHOLE CUVEK � 25' FROM U�UK. WINDOW OK I'KCSH 12"MID. I AIR INTAKE I GRADE ( Id'MIW. COQDUIT - ---- IWAIAI. -VAG ��� Ar t" IrEb EAL ( III `J� `,N�' 1 I III APPKO`/EU JGINT A $ I III APPROVED JOIWT: W/C.I. PIPE S ct ( III w/C.I. PIPE EXTENDING 3' ALA1lM EXTEUDIWG 3' OWTO SOLID SLIT. ONTO SOLID SOIL ow c S I I - PUMP OFF CONCRETE 5LOCK 4u ju�_... RISER EX11' PERMITTED GIJL`J IF TAIJK MANUFACTURCK HAS SUCH APPKOVAL4 SPCC IFICATIOUS =PTIC AND `iSE. `TAWKS MAWUFACTuRER: (J�1 .��Y _ �J 1�,r � WufA'BEK OF OOSES: " `ALPEK DAU, I'A"K �IZC : 0 GALLO►J5 DOSE VOLUME:���Q GALLO" S ALAKM MAWUFACTUKEk: _ V Ll,h CAPACITIES: A=__j'WLHES OR f`�- GALLO►JS MOI,CL ►JUMi3EK: rlOn(- J B= 011 UJL:HlS UK I GALLOWS SWITCH TYPE: �n-r�l)f� �1�Xa C 5IWLHES OR .^.� GALLOAIS I1 KIMI' MAWLIFA(A L1KLK: U= IULHES GR 11? GALLOWS MUIILL IJUMbLK. �S' t05� T- ►.1G'1'C: PUMP ANU ALAKM AKC TO BE Z)WIICH TYPE: -�C` f�•l)(U f-�C1C9�T IAI5TALLCD ON SLFAKATC CIRCUITS PUMP DISCHARGE RATE -JM GPM IOC VEKTICAL DIkf�ICEIJCE bF-'f WLLU PUMP OFF AUD D►STKIBUTIOIJ PIPC.. _ 1Z_ FEL"l + MIIJIMUM METWOKK SUPPLY PKESSuRE 2.5 FEET ♦ I3b FEET OF FORCE MAIN X �55 Fj�II-FKICTIOU FACTOR.. b.12 FEET 1 TOTAL OtlWAMIC HEAD = -s ue- FEET B4 IIJTEKIJAL_ DIME-WSoO►JS OF TAUK: LEIJGTH ;WIDTH �LIQU10 IDEPTIi- c �l2 Cornmu,��o� o-�' Sc�Iw-f s Cvhur�h c�J 44chct-) 7,5 x 5�vf 1 ,2 3438 -�-fz co Sehoo 1 c�/ rns boo k / ( ,2 -` 2000 ROBER 10 c 'm 1 t u�s �o x �0 1 ,2 L � � -� GU 4T -� a, 2 1 �n fi G R ViNG, j INN. C� c �ry ss' NAL Use Icon w/ `% kolas pac -7 C Fro r l iab1 14` dischor y 1s 0 1% f� G,-b Oc- (J/ e vet r U-Q n) a" I +0' io x o — - –- --- JUN 1984 rylom Cbrrn P.0 8 p n,,k y 5P i h�'e c nq ci I Boa � Fr>q . Come �osSCs 1-�O' 4 " ?10 DiSch0VbL 4C� COrrncvlGtY ton o Tecl —C1 10`�c�Q �1nC SS u Y e 14 o 11-7 85 5b noff'e : m 4o b - urn ishec� cY��,� sup -k�.►n ev,c��Q ►� i c� JYe '�ViCa�► e 0 Cox 7 .� x S90/4 z 10-:31 6.-e el 1<f'c h- cl i s 4 n b-t d I o L, V(4)vil 2 x Sb X 9 4 pyvip (J d O.Q 194 Lk -aa°► 0 i l PUMP CHAMBER Manufacturer: M, r-,fWj Liquid Capacity: ra. Pump Model: Pump/Siphon Manufacturer: _ Pump Size Elevation of inlet: 93�� Bottom of tank elevation: 37. 7� Pump off switch elevation: 9S. ar-2 Gallons per cycle: Alarm Manufacturer: S.5 r L,e 5 Alarm Switch Type: 1 Number of feet from nearest property line: Front, O Side,Rear, Ft. Number of feet from well: Number of feet from building: g Z/ (Include distances on plot plan) . SOIL ABSORPTION SYSTEM Bed: u-"- Trench: Width: �,�, Length:_ Number of Lines: — Area Built: 3816 i Fill depth to top of pipe: Number of feet from nearest property line: Front, Side, Rear, Ft . hw � Number of feet from well: -2� Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one) . HOLDING TANK Manufacturer: Capacity: u Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, O Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector' / Dated: Plumber on job: e d License Number. a/� 3/84:mj aC'r?- Form - S T C - 104 as r9 _ �l�b� f ° AS BUILT SANITARY SYSTEM REPORT •� i L �' �►� u-0 I a TOWNSHIP SEC.�,� T N-R W z . ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION N� LOT /U� LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H 63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM GjcrS f�^S �a55�-oOms lot rod °�J 5r� 3e� !DU v 87' rjy� N u' 6"( 10 �f 071__ roS`P11 P bs 4 INDIC NORTH ARROW BENCHMARK: Describe the vertical reference point us .-14�e (��f �;`k Elevation of vertical reference point: 104-2_0 Proposed slope at site: SEPTIC TANK: Manufacturer: Liquid Capacity: e7), Number of rings used: Tank manhole cover elevation: 9�c y Y.3, 7 y Tank Inlet Elevation: Tank Outlet Elevation: 93, rK s- Number of feet from nearest Road: Front Side Rear 14PP From nearest property line Front 10 SideQ-R'ear 1 0 as feet Number of feet from: well / 1175 building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) PUMP CHAMBER Manufacturer: ,! I,LItUPSw.rr� i'!'l���ubl Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: _ Pump Size Elevation of inlet: Bottom of tank elevation: 37�77 Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: 1 Number of feet from nearest property line: Front, Q Side, Rear,6 Ft. Number of feet from well: L-2, Number of feet from building: / (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: a/ Trench: Width: Length:_� � Number of Lines: Area Built Fill depth to top of pipe: Number of feet from nearest property line: Front] Side, O Rear,0 Ft Number of feet from well: Number of feet from building: / (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one) . HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, O Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: -- - - / Dated• ��� ��� Plumber on job: �( 'C '0 License Number: 3/84:mj r 3 PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size . Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: . Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear,0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: Length: Number of Lines: Area Built: .Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, O Rear,0 Ft . Number of feet from well: Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: I Number of rings used: Elevatiorr of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: , Dated: Plumber on job: License Number: l ' 3/84:mj Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER C?W\ MU n 10tH. �T .�e(���,OWNSHIP T c SEC. T N-R J Q W ADDRESS C� 3�-3 ST. CROIX COUNTY, WISCONSIN r SUBDIVISION LOT C"i LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I1,HR. 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM i T11A r _K(.5� LS ewe I ly i _. l 198, 77 _ j Ulu , arm_ 0q � '7 o ni BENCHMARK: . Describe the vertical reference point used .Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer: Liquid Capacity: Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front,0 Side,O Rear, O feet From nearest property line : Front,OSide,0 Rear,0 feet Number of feet from: well , building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) -- SEE REVERSE SIDE ST. CROIX COUNTY- NOTICE OF COMMITTEE MEETING TO: Norman E. Anderson , Chairman St . Croix County Board FROM: Thomas Dorsey, Chairman COMMITTEE TITLE: Comprehensive Zoning, Parks, & Planning Committee DATE: July 8, 1987 TIME: 8:00 P.M. LOCATION: County Board Room, East Courthouse CALL TO ORDER ROLL CALL ADOPTION OF .AGENDA DATE OF NEXT MEETING: July 15, 1987 ACTION ON PREVIOUS MINUTES UNFINISHED BUSINESS: NEW BUSINESS: 1. Presentation on Ag-Land Zoning and Farmland Preservation, David Fodroczi from Department of Agriculture--Farmland Preservation Section. 2. Presentation by Dick Thompson regarding House Numbering 3. Solid Waste Status Report 4. Surveying Status Report - Jim Rusch ANNOUNCEMENTS & CORRESPONDENCE POSSIBLE AGENDA ITEMS FOR NEXT MEETING : ADJOURNMENT ( Agenda not necessarily presented in this order) Submitted by : Thomas C. Nelson, Zoning Administrator Date : June 25, 1987 Copies to : County Board Office County Clerk News t1edia/Notice hoard Committee oembers c at CY �• ql q `7 �" `� ADEPhRTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR& HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7969 BUREAU OF PLUMBING MADISON,WI 53707 SE`s, NEk, S25,T28N—R19W C�kONVENTiONAL ❑ IS,,,,Plan I.D.Number: ALTERNATIVE ,assigned) Town of Troy ❑Holding Tank gin-Ground Pressure 1:1 Mound Hwv. 35 NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Communion of Saints Church P.O. Box 335, River Falls, WI 54022 BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF,PT,ELEV.. Name of Plumber: MP/MPRSW No County Samtary Permit Number: Bennie Helgeson 3215 St. Croix 96058 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED. PROVIDED. ❑YES ONO OYES ONO BEDDING: VENT DIA.: VENT MATL.. 'HIGH WATER NUMBER OF .ROAD: PROPERTY WELL: BUILDING. JVENTTOFRESH ALARM FEET FROM LINE AIR INLET. E]YES ❑NO OYES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER BEDDING LIQUID CAPACPIU-P PUMP MIDI-1- JPUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO ❑YES ONO ❑YES ONO GALLONS PER CYCLE: CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL. BUILDING.I VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) JYES ❑NO NEAREST` SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing I LENGTH DIAMETER IMATIRIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until FORGE the soil is dry enough to continue.) MAI N CONVENTIONAL SYSTEM: WIDTH: LENGTH. NO.OF DISTR.PIPE SPACING. COVER INSIDE DIA #PITS. LIQUID BED/TRENCH TRENCHES MATERIAL: PIT: DEPTH'. DIMENSIONS GRAVEL DEPTH FILL DEPTH IDISTR.PIP' DISTR PIPE IDISTR.PIPE MATERIAL. NO.DISTR [NUMBER OF PROPERTY WELL: BUILDING. VENT TO FRESH BELOW PIPES ABOVE COVER. ELEV.INLET ELEV.END PIPES. FEET FROM LINE. AIR INLET: NEAREST; MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. DYES ONO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS El ❑NO OYES 1:1 NO DEPTH OVER TRENCHBED DEPTH OVER TRENCH'BED =TOPSOIL SODDED. SEEDED MULCHED. CENTER EDGES. El YES 1:1 NO 1:1 YES ONO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: EQ/TRIf�I�il'� WIDTH. LENGTH. TRENCHES LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER. 'Olt MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL'. NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING'. ELEV.. ELEV.. DIA.. ELEV.V.. PIPES. DIA.: E AVATIOW ANC/ t?ISTRIF IO[+I INFfl�RMi4TION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL PLANS LIFT CORRESPONDS TO APPROVED ❑YES El NO OYES ONO COMMENTS: PERMANENT MARKERS: JOBSERVATION WELLS: NUMBER OF 'PROPERTY WELL: BUILDING: FEET'FR®M LINE: ❑YES 1:1 NO OYES 1:1 NO NEAREST Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE. TITLE: DILHR SBD 6710(R.01/82) Zoning Administrator Parcel #: 040-1098-10-000 01/05/2006 04:32 PM PAGE 1 OF 2 Alt. Parcel#: 25.28.19.387E 040-TOWN OF TROY Current i 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 0-ABUNDANT LIFE,CHURCH CHURCH ABUNDANT LIFE 896 HWY 65 PO BOX 335 RIVER FALLS WI 54022 Districts: SC=School SP=Special Property Address(es): '=Primary Type Dist# Description SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 20.667 Plat: N/ -NOT AVAILABLE &`79 �-j y SEC 25 T28N R19W PARCEL IN SE 1/4 NE1/4 Block/Condo Bldg: AND THE NE1/4 OF SE1/4 DESC AS; COM AT E 1/4 COR OF SAID SEC 25,TH N 1313.16'TO Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) NE COR OF SE1/4 OF NEIIA ;THEN N 89 DEG 25-28N-19W W ON N LN 128.38 TO POB;TH S 21 DEG W 99.42';TH S 10 DEG E 134.30';TH S 29 more Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 895/63 07/23/1997 751/315 07/23/1997 747/376 2005 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/24/1995 Description Class Acres Land Improve Total State Reason OTHER X4 20.667 0 0 0 NO Totals for 2005: General Property 0.000 0 0 O Woodland 0.000 0 Totals for 2004: 0 General Property 0.000 0 0 0 Woodland 0.000 0 Lottery Credit: Claim Count: 0 Certification Date: Batch#: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel M 040-1098-10-000 ovosi2oos E 2 0 F PAGE 2 2 Legal Description: cont. DEG E 266.021 ; TH S 777.401 ; TH S 54 DEG W 378.52' ;TH S 22 DEG 244.461 ; TH S 42 DEG W ON N R.O.W. OF S.T.H. 65 A DIST. OF 73.08' ; TH LEAVING SAID R.O.W. GO N 22 DEG W 274.68' TH N 21 DEG W 1588.801 ; TH S 89 DEG E ON N LN OF SE1/4 OF NE1/4 848.25' TO POB. INCLUDES P396G I I 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 CONVENTIONAL E-1 ALTERNATIVE State Plan l.D.Number: 111184132901 ❑Holding Tank ❑ In-Ground Pressure El Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Communion of Saints Church P. 0. Box 335, River Falls, WI f-3,0-pv `dares BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF,PT.ELEV.: SE NE, Section 25, T28N-R19W, Town of Troy Name of Plumb er. MP/MPRSW No.. County Sanitary Permit Number: Ben Helgeson 3215 St. Croix 54967 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY. TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: DYES ❑NO ❑YES ❑NO BEDDING: VENT DIA.: I VENT MATL.: HIGH WATER REARE UMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM: EET.FROM LINE: AIR INLET: ❑YES ❑NO ❑YES ❑NO SY DOSING CHAMBER: MANUFACTURER. BEDDING: LIQUID CAPACITY JPUMP MODEL. JPUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: OYES ❑NO DYES ONO I OYES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF :PROPERTY WELL: BUILDING. VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF) OYES ONO NEAREST' SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing E LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until FORC the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH: LENGTH. NO.OF DISTR.PIPE SPACING. COVER INSIDE CIA.. #PITS. LIQUID TRENCHES. MATERIAL: PIT DEPTH: GRAVEL DEPTH FILL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL. NO.DISTR NUMBER OF i!PROPERTY WELL: BUILDING: VENT TQ FRESH BELOW PIPES. ABOVE COVER. EL IV INLET ELEV,END. PIPES. FEET FROM LINE: AIR INLET: NEAREST, MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. DYES ONO SOIL COVER ITEXTURE PERMANENT MARKERS: OBSERVATION WELLS OYES ❑NO DYES 1:1 NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED. SEEDED. MULCHED. CENTER. EDGES. OYES ONO DYES 1:1 NO DYES ONO PRESSURIZED DISTRIBUTION SYSTEM: -WIDTH. LENGTH. NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER: TRENCHES: MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL: NO.DISTR. DISTR.PIPE DIS"rRIBUTION PIPE MATERIAL&MARKING. ' ELEV.: ELEV.. DIA.. ELEV.: PIPES. DIA.: dE� YA'"I°l+�t AC�3 �f BU71fJN° HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS: ❑YES ❑NO OYES ONO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: N M13ER �RIO�ERTV WELL: BUILDING: FEE Fil OYES ❑NO ❑YES ❑NO NEAtE►T Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: TITLE. DILHR SBD 6710 (R.01/82) INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment,30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report,the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system,circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis.Adm. Code will be applicable. 10. A new permit will be needed if there is a change in,estimated wastewater flow, (number of bedrooms,etc.), location of the system, depth of the system,type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan,drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size,separating distances,distances between beds if appropriate,tank locations,effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years.Changes in your building plans or locations may require you to obtain a new permit.Private sewage systems must be properly maintained.Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years.If you have questions concerning your system,contact your local code administrator or the Bureau of Plumbing,DILHR,State of Wisconsin. �� wisconsin APPLICATION FOR SANITARY PERMIT ,/, � D I L H R COUNTY (PLB 67) UNIFORM SANITARY PERMIT# �OEPggTTEI"IT OF -InOUSTgV,LGIBOg6MUTqnqELRTIOns soy& Z —Attach complete plans in accord with s. H 63.05,Wis.Adm. Code for the system,on paper not less than 8'/2x 11 inches in size. —See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER 15 MAILING AD RRESS ��� W r� C©m � 4 PROPERTY LOCATION CITY: ds ,5,61/4 1/4, S 0,5, T�,?A N, R Iq E (o �IwN of LOT NUMBER BLOCK NUMBER JSDBDIVISION NAM E$T ROAD, LAKE LANDMARK STATE PLAN .D. NUMBER TYPE OF BUILDING OR USE SERVED ❑ 1 or 2 Family Number of Bedrooms: ublic (Specify): G�j 1, THIS PERMIT IS FOR A: New System ❑ Tank Replacement ❑ Repair Replacement Soil Absorption System ❑ Revision ❑ Privy t Alternate System ❑ Reconnection Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. ❑ Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank ❑ System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound In-Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber ov Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): 6, 4 —) 3W o o 361 Private ❑ Joint ❑ Public 1,the undersigned,hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name f Plumber (Print): Signature: MP/MPRSW No.: Phone Number: P"2.71' (77k _ Plumber's Address: Name of Designer: COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved &411-1a 0� �-�_FY, ❑ Owner Given Initial / Approved Adverse Determination Reason for Disapproval: Alternate course(s)of Action Available: DILHR-SBD-6398 (R.5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing,Owner,Plumber State of Wisconsin ` Department of Industry, Labor and Human Relations August 10, 1984 SAFETY&BUILDINGS DIVISION Bureau of Plumbing 201 East Washington Avenue !9 P.O, Box 7969 537137 Madison, Wisconsin Pastor Daniel Denn i son Lownunion of Saints Church P.O. Box 335 River Falls, WI 54022 Pet i t iorf No. 84-02901-P Clear Pastor Dennison: Re: Cwdamnjon of Saints Church Private Sewage System SE,NE,25,28,19W Town of Troy, St. Croix County, WI The subject petition for a vari acne to sect ioa ILFiR 83.15 (5) (d) of the Wisconsin Administrative Code was considered on August 18, 1984. It was approved. The rule requires that a pump tank have a erne-day nolding capacity above the high water &farm switch. The variance requested was to use duplex alternati{g puwps in lieu of the on+e-daJy holding capacity. All of the data and statements sutaitted on behalf of the petition were considered. This variance is specific to the subject petition and cannot be used for any additional modifications. Sincerely, James Quinlan, Acting Chief Section of Private Sewerage Jq:PEP:g cc: arold C. Barber, Zoning Aciministrator 5t. Lraix COuOty, WI Leroy Jansky, Private Sewage Consultant - district b, Chippewa Fal1s Roi>ert J. Guditis, Resigner D I L H R-SB D-6423(N.04/81) Safety and Buildings Division DILHR PLAN APPROVAL Bureau of Plumbing P.O Box 7%9 ❑ General Plumbing Plans Madison,WI 53707 Private Sewage Plans Telephone: (608)266-3815 kt mill Project Name c-- ��RC—k\ Project Location - Street No. or Legal Description. �aMt•I`U�. ©�-� c�F '�-�R� is 5 � - 'ate 1 g 1(9 W County ❑ City ❑ Village Town of: 7`�'�' ,Qt-� C-: Q X The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145,Wisconsin Statutes and the Wisconsin Administrative Code.The plans are stamped"conditionally approved".This approval is contingent upon compliance with any stipulations shown on the plans.All items that are noted must be corrected.All permits required by the city,village,township or county shall be obtained prior to construction.The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site.The installer shall notify the appropriate inspector when in can be made. ❑ FOR GENERAL PLUMBING PLANS: This approval will expire two years from the date approved below.If construction has not commenced before the expiration date,new plan approval must be obtained. FOR PRIVATE SEWAGE PLANS: �o� This approval will expire two years from the date approved below or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. Comments: By: James Sargent Bureau Director If Questions Plans Approved By: Date Approved: Contact ♦ " 8Z/ cc: OWS El DPS El H&R & Rec. San. Section County ❑ Local PI ❑ Facilities Need Analysis Section XUW-SSWMP ❑ Plumber ❑ Department of Agriculture DILHR-SBD-6099(R.01/84) ❑ Owner ❑ Other a ILHRSANITARY PERMIT Counter ,LA GROUNDWATER SURCHARGE _7 Sanitary Permit No. IqZ I On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more com- monly 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 Included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that is used in your building is returned to the groundwater through your soil absorption system or the disposal site used by your bolding tank pumper. The monies collected through these surcharges are credited to the groundwater fund tered by the Department of Natural Resources. These funds are used for monitoring round- s- water, groundwater contamination Investigations and establishment of standards. Groundwater, it's worth protecting. Siflnat n of Issulnfl Afl�nl: Ground Drou wabr FN: Dpa/s: 1NIsC0 } O �7_ iLHR SBD-7289(N.OS/44) buried i i I + t At- APPICATIODI PM SADIITARY PERMIT STC - 100 ,s y. 4 This application form 1s 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 perait issuance. Should this development be intended for resale by owner/contrac&QT, ("spec r. 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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4. Owner of Property r'OMML0\110A 61 �tS�1yTS �k1l IZC Location of Property N 14, Section o J� , T N R — W Township C) Mailing Address , CO< Subdivision Name Lot Number Previous Owner of Property �ON Samnpz Total Size of Parcel a 0. �61 Ac it //o �. 19 C 6. /-3 -Sy) Date Parcel was Created j Are all corners and lot lines identifiable? i( Yes No i Is this property being developed for resale (spec house) '' Yes J( No Volume , and Page Number _ as recorded with the Register, of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Cuntract J. Other rucordingu filed with the Wagieter of Deeds Office i 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 the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1 PROPERTY OWNER CERTIFICATION �\ I (We I e that aU 6 to temen t6 on .tkiA 6 orm ate t ute to the beat 06 my (uun) knowEedgrt ,.' (we) am l a4e) the owrnen(s) o 6 the p&o pen ty des eh ibed in th ,a �n6onmati by viAtue o6 a wamAn-ty deed %ecoiLded in the 066ice o6 the County RegiA'tA o6 Deeds as Document No. and that I (We) pneeent[.y own the proposed .bite 6o4 the s aye -&Z�pd-,6-aZ system (on I (we) have obtained an ucsemen.t, to nun with the above de6cAi.bed ptopehty, 6on. the eon6.ttuati.on o6 said system, and the same had been due. necoh.ded in .the 066ice 06 a County Regent o 6 eede, ad Document No. s��2 3—) . SI OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) : $ DATE hiONED Fes, x 1 f c r � Purchaser promisee to pay when due all taws and as.,, In it and to deliver.to Vendor on demand receipts showing sup i ,slit, � levied on the Property or upon Vendor's interest Purchaser shall keep the improvements on the Property insured against loss or damage occ tended coverage perils and such other hazards as Vendor may require, without co-insurance, through. insure by Vendor, in the sum of none— land only g asioned by fire, ex- than the balance owed under-this Contract. Purchaser shall insurers approved contain the standard clause in favor of the Venurcha Purchaser shall and, unless Vendor otherwise rmimes when du in h amount more Pay the insurance premiums when due. The policies shall j of all policies covering the Property shall be deposited with Vendor. Purchase j insurance companies and Vendor. Unless Purchaser and Vendor otherwise agree in writing g Insurance writing, proceeds original be applied to restoration or repair of the Property damaged, r shall promptly give nonce of lose to economically feasible, g , provided the Vendor deems the restoration or repair shall Purchaser covenants not to commit waste nor allow waste to be committed on the Property, keep In good tenantable condition and repair, to keep the Propert free to comply with all laws, ordinances and regulations affecting the Property. the Property Y from liens superior to the lien of this Contract, and Vendor agrees that in case the purchase price with Interest and other moneys shall be full paid shall be fully performed at the times and in the manner above specified, Vendor will on demand ea i the Purchaser, a Warranty Deed, in fee simple, of the Property, free and clear of all liens and execute and aver to any liens or encumbrances created b scu and deliver i of recor y the act or default of Purchaser, and ekes t• casements r to o_...wa . . ............a.........-----......__... '--•----•-.... ..........._.......................:......p .. -- ........................................and-r ih encumbrances, s• •pt .........................................................•--......--•-- Purchaser agrees-that time is ,_ ,_ - ........ _ o the essence and (a) in the event of a default in the payment an interest which continues for a period of .... 0-. y principal or days following the specified due date or (b) in the event of a default in performance of any other obligation of Purchaser which continues for a period of...30... days following written notice thereof by Vendor (delivered personally or mailed by certified mail),then the entire outstanding balance under this contract shall become immediately due and payable in full, at Vendor's option and without notice (which Purchaser waives), and Vendor shall also have the following rights and remedies (subject to any limitations addition to those provided bylaw or in equity: hereby rights, title and interest in the Property and recover the Property back through strict foreclosure pwithdany equity of 9 Y: (i) Vendor may, at his option, terminate this Contract and Purchaser's redemption to be conditioned upon Purchaser's full a the date of default at the rate in effect on such date and other amounts due hereunder(in which event all amounts previously I payment of the entire outstanding balance, with with thereon from paid by Purchaser shall be forefeited as liquidated damages for failure to fulfill this Contract and as rental for the Property it purchaser fails to redeem); or (ii) Vendor may sue for specific performance of this Contract l or th immediate and full payment of the entire outstanding balance, with interest thereon at the rate in effect on the date of default and other amounts due hereunder, in which event the Property shall be auctioned at judicial sale and Purchaser shall be liable for any deficiency; or (iii) Vendor may sue at law for the entire unpaid thereof; or (iv) Vendor may declare this Contract at an end and remove this Contract as a cloud on title in a quiet-title action if the equitable interest of Purchaser is insignificant; Purchase price or any portion of the Property and have a receiver appointed to collect any rents�issueador profs itsvduring hthe pendency of om any action under (i), (ii) or (iv) above.Notwit standing any oral or written statements or actions of Vendor, an election of any of the foregoing remedies shall only be binding upon Vendor if and when pursued in litigation and all costs and expenses including reasonable attorneys fees of Vendor incurred to enforce;any remedy hereunder (whether abated or extent not prohibited by law and expenses of title evidence shall be added to in- curred, and shall be included in an principal and paid by Purchaser, as y judgment. to the appointment the commencement or during the pendency of any action of foreclosure of this Contract, Purchaser consents I of a receiver of the Property, including homestead interest, to collect the rents, issues, and profits of the Property during the pendency of such action, and such,rents, issues, and profits when so collected shall be held I applied as the court shall direct. d and of Purchase's rights uunder this Contract or by option, long-term soi ins any other he wa ert assignment of any consent of Vendor unless either the outstanding balance payable under this Contract is first pad inyfull or he Interest conveyed is a pledge or assignment of Purchaser's interest under this Contract solely as security) itfor anhindebtednestof Purchaser. In the event of any such transfer, sale or conveyance without Vendor's written consent,the entire outstanding balance payable under this Contract shall become immediately due and Vendor shall make all payments when due under any mortgage pout outstanding lag nstethe Property on�tthet date 1C of this Contract (except for any mortgage granted by Purchaser) or under any note secured thereby, makes timely payment of the amounts then due under this Contract. Purchaser may make any such payments to the Mortgagee if Vendor fails to do so and all payments so made by Purchaser shall be considered payments made on this Contract, p Ym nta directly to Vendor may waive any default without waiving any other subsequent or prior default of Purchaser. All terms of this Contract shall be binding upon and inure to the benefits of the heirs, legal representatives, successors and assigns of Vendor and Purchaser. (If not an owner of the Property the spouse of Vendor for a valuable consideration joins herein to release homestead rights in the subject Property and agrees to join in the execution of the deed to be made in fulfillment he f.) Dated this ..1-�- �-••--•--•--- day of "-"""" November --•--•--._.......... ..November .._......__.._.._, 19_.83... COMMUNION OF SAINTS (jRCH, INC. ..............(SEAL) B "-' ,. • (SEAL) * Ronald P. Sumner ' ... ..........•---•-- 1, •---••---._.-._. . REV , {f, - : _I3A�IIEL G DENESSEN_ 1... (SEAL) -�'-'�:_ 1•.' ._5.._ . -�jj �l � --•--•. --`ary A. Sumner . ....................... H. PETER WE NBER:;, - (SEAL) _..._.--•............................G..._._......._.--•-•- i AUTHENTICATION ACKNOWLEDGMENT Signature(s) _____„___•__••_•_ ----------------------------- STATE STATE OF WISCONSIN St. C.... X . ,-- - .......authenticated this .....da y of. C ounty. . ........ 19 1. Personally' y came before me this 11th ' .................... I ! i Novemb....................................r 83 •-•-------------day of il • --_' onald p. ' 19. _ .... the above named i .................................... .................................. - Communion ofS -._.. TITLE: MEMBER E_,_ ---"'""__,_,_. (If t STATE BAR OF WISCONSIN......_.. _. by...................... iltte-.Cf}u gh.,..;�ng.e..... ...... autho ized'by•§ is. . ..� .. --........ - - - .._.. -•- ...................•...... .... to me known to be the persons----------- who-executed the THIS INSTRUMENT WAS DRAFTED BY foregoing instrument and acknowledge the same. �. L. Gaylord, _Attorne ••--- ! River Fall.a., WI 54022 �........KINI M....tiEr1N> ................................................- •----•--•-••••-•-•- Notary Signatures may be authenticated or acknowledged. $oth pry (`nrnPinbftenn„��..+,rtit�nn,n1 IT+ �t,a._}e}'Qa x.__.....___.QOUTIty, W19. -. are not necessary.) „_� ` •i:.rn�•. _f t,,.: .., is ... I f DOCL1MENf No. STAfi�„� ,R OF WISCONSIN FORM 11-1882 i! \ / 'FACE RESERVED FOR RECORDING DATA LAND CONTRACT a individual ■ud Corporate I 3 o �3 (TO BF. USED FOR ALI, TRANSACTIONS WHERE OVER $26,000 1S FINANCED AND IN Uri, NON CONSUMER --- -----_----- ___-- ---— ACT.TnAN$AOTIoNs)_ Contract by and between .....Ronald..P.._Sumner.and_MarY.A. Sumner�•.husband'_and._wife • _• I • V I ---------------------- ---------------•------------------- - ..._......_...... - . ............. ("Vendor", whether one or more and.___.�ommunion of Saints Church Inc., P. 0. Box_.355,-more) and ("Purchaser", whether one or more). Vendor sells and agrees to convey to Purchaser, upon the prompt and full per- formance of this contract by Purchaser, the following property, together with the rents,profits,fixtures and other appurtenant interests (all called the"Property"), i t. Croix . County, State of Wisconsin: RETURN TO I� See attached description. I I� Tax Parcel No. .................. .... it l I �I I I ' it t I ' I This .......,i._s,,not homestead property. ._ pay to Vendor jl (is) (is not) such lace as reasonabl directed Purchaser agrees to purchase the Property and to j I I the sum of 4 4 - .................................�'._.......----I i j $--------------1 ,l Ar.QQ......_....__._......_...._. in the following manner: (a) $.......10 000.00 .................... at the execution of this Contract; and (b) the balance of $....... , together with interest from date hereof on the balance outstanding from time to time at the rate of.._.....ten..�1Q/0................. per cent per annum until paid in full, as follows: Monthly payments shall be amortized over 25 years, at the rate of $285.00 per month, with the first payment commencing December 15, 1983, and payable on the 15th day of each month thereafter. I I Sellers shall have the right to till the unused part of the described property for I' (five (5) years for. farm crop purposes. In the event Purchaser determines to allow tilling II of the property after said 5-year period, Sellers shall be given the first right to do so. I Provided, however, the entire outstanding balance shall be paid in full on or before the.,.......15th day of 1`14Y_1ri1 be—r................ 19..8$._ ( the maturity date). Following any default in payment, interest shall accrue at the rate of-AP....ova per annum on the entire amount !in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire j principal balance). I PAxo3raaed'xxx6es�eaoc>��+xSEo¢�dlaa�x�zoeac�t>xapxRx�ta�5exoa>nvxf000a€odxhoaeasimabdxnc 1 ��iKc1F>I �EDt:IeB�C i4�4Ii1Ktl E �goamxecp stamascwlltmcnluut�kXhrececati aaeic t X1€¢>:nlior, SEeladmA�,gRRCD[?t9[�IRN�IG�C�[4{1�1�A@[R�}84ft?RR�[}3'�5�lt7SIRDGX�Dt4�4C&'�4AtMD�1c7C�19G#��S�7t►X7�Qlt�li4�4,IJ[�7G1aX11�1R11tA�C tnxa�c�sxaes�scc�sc�lxdcria�axaa�cRx�iddxi,�calev�as�f�ci�cocxl��aoax�xfa�ctdxo¢xfr�c��s�kxal��t �>�t�cx>�x�x j nnlo�ltxl�b�si�nexocxvdxatbc6arc�tt I i t� Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any I' amount may be prepaid without premium or fee upon principal at any time atteyLxxxxxxxxxxxx :l x]( x bb,�eac�x�+bexaac�xs�xca�xs�c�x�a�s�x�bcxi�}asn�xl��rx>�ic�rxa��c3it' I I In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long as the unpaid balance of principal, and interest'(and in such,case accruing interest from month to month shall be treated j I. I as unpaid principal) is less than the amount that said indebteJness would have been had the monthly made as first specified- Payments been above;� P , provided that monthly payments shall be continued in the event of credit of any proceeds f of insurance or condemnation, the condemned premises being thereafter excluded herefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: None. i I Sellers', their�'helrs and assigns, and any other present owner or owners, shall have it unrestricted and unlimited access to adjacent property owned by Sellers or other owners, j over the access road, to the- above described property; and :this right shall be a covenant II running with the adjacent land and against the described parcel. (� II I jI Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall i i be retained by Vendor until the full purchase price is paid. Purchaser shall be entitled to take possession of the Property on..date of this agreement. 1x •crows Out One. ........................ ...... LAND CONTRACT—Individual and STATE, BAR OF WISCONSIN Corporate Wisconsin Legal Blank Co. Inc. P FOR51 No. 11—1982 Mllwaukee, Win. V That certain parcel of land located in the SEk of the is NEk and the NEk of the SEk of Section 25, Township 28 ' North, Range 19 West, Town of Troy, St. Croix County, Visconsin, more fully described as follows: i! Commencing at the Ek corner of said Section 25, Tax Parcel No: .............................. thence N00'00100 11E (assumed bearing on the East line of the NEk of said Section 25) a distance of 1310.70' to the NE corner of the SEk of the NEk of said Section 25; thence N89.10105"W on the North line of said SEk of the NEk a distance of 128.73' to the point of beginning of said parcel ; thence 521036'46" �. W 98.49' (recorded as S 21 3/4•); thence N90.00'00"W 24.75' ; thence S10'37'11"E 134.301 ; thence S29'44'42"E 266.061 ; thence S00'00'00"E 776.921 ; thence S55038'28"W 376.53' (recorded as S54.241W); thence S21002'50 11E 244.46' (recorded as S22.141E); !j thence S44.06146 11W on the North R.O.W. of S.T.H. 65 a distance of 72.731 ; thence leaving said R.O.W. go N2100215011W 275.01"; thence N21.10' 16 11W 1587.16' ; thence S89'10105 11E on the North line of the SEk of the NEk of said Section 25 a distance of 850.00' to the point of beginning, containing 20.667 acres, being subject to easementei of record and also being subject to an easement for roadway purposes for the benefit of the Grantor, his heirs, and assigns more fully described as follows: EASEMENT DESCRIPTION: Commencing at the Eli corner of said Section 25, thence N00°00100 11E (assumed bearing on the East line of the NEk of said Section 25) a distance of 1310.70' to the NE corner of the SEk of the NEk of said Section 25; thence, N89.10105 11W on the North line of said SEk of the NEk a distance of 128.73' ; thence S21.36146 11W 98.49' (recorded as S21 3/4• W); thence N90 000100"W 24.75' ; thence S10• 37111 11E 134.30' ; thence S29°44142 11E 266.06' ; thence S00°00'00"E 776.92' ; thence S55 038'28"W 376.53' (recorded as S54.241W) to the point of beginning of said easement; thence S21'02150"E 244.46' (recorded as S22'141E); thence S44°06146 11W on the North R.O.W. of S.T.H. 65 a distance of 72.73' ; thence leaving said R.O.W. go N21°02150 11W 275.011 ; thence N68.57110"E 66.00' to the point of beginning. i INSTRUCTIONS FOR COMPLETING FORM 115 - SB® - 6395 ' To be a cornplete an(i accurate soil test, your report must irrc,lude, 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3, MAXIMUM slumber of bedrooms or commercial use planned; 4. Is this a new or r-er)lacement systems; 5� Complete the suitability rating boxes.A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS, S. PLEASE rase the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A seParate sheet may be used if desired; 8, Make sure your benchmark and vertical elevation reference paint are clearly shown, and ale% permanent; 9, Cornlalele all amiiopriate boxes as to dates,names,addresses, flood plain data, percolation t£.st exeml, Lion, i f appropriate; 10 If the information (such as flood plain, elevation)does not apply, place, N.A. in the appropriate box; 1 1. Sign the for and place, your current address and your certification number; 12. Make legible conies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols St -- Stone (over 10") BR - Bedrock cob Ctk)ble (3 - 10") SS Sandstone gr - Gravel (under 3") LS Limestone 1s - Sand HGW - High Oromi(lwatci cs - £ m m-,i'Sand P{_=rc - Percolation Rare rat€>c s - Medk ,Sand V"J __. Well fs _ Firu� Sraad Bldcl Buildincl is - Lciarry Sand ,> -- ` neater Tha=t sl - Sandy Loam Less Than Loam art - Rrovm ., Silt si -- �a,ri L,><;rxi BI _ Black 6 - S(l try - Cray c Clay Loans Y - Y llov" scl - &r,'aiy C!ay. Loam R -- Rod sicI - Silty Clay Loarn mot - mottle's " ��r�, - ndy Clay vv - tiiils src - N—v vla, fI, __ tr vv' firic first c _. $.+a v rile Pc ruin - l',slany, rnediuni lF — pronilrei"1t SiY general s:3ii i£xwres surfacc;wo'er for li#quid waste disposal BM - Bonch Mark VRP - lertict€aP E' f�ro.r3€,rtif'cirtt TO THE OWNERS Tr s sort test r port is thr first stop in securing a sanitary permit.The county or the DR pa,rtrni r_, mayic<quest �i(fif„l;t;f3 R� c"f this soil test W, the field f"Irior to permit: issu we, A complete, se t of pljn_ ?i3r 't'lt I'}rlvaat f: ,I'.rE? v st mt i3!"rd a permit vapplic.atrran ntaSt. be srlbn}ltt{.off i(b ?.i'aEs c!(�I"�E"C}�.trf,ita:. local eat.rt.Il(7t,iy iYi order �e7lairt -I p"rIni',. I lie <k9Y txsry rl'?rrmt must tae ohtained and posted pliorto tf St?rt of ""my C#)��at,p�Ctton, � s DEPARTMENT OF REPORT ON SOIL BORINGS A FETY&BUILDINGS INDUSTRY, /j DIVISION LABOR AND PERCOLATION TESTS ( ) SF P.O.�Fi�F ADISON WI 3707 KA)MANOSLATIONS (11-1163.090)&Chapter 145.045) 10 IJ1 LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: O :BL r U ISI AME: SF I/ �'/ n /T28 N/R I Q E (o W 7RI6`( COUNTY: OWNER'S BL1YZE;5NAME: MAILINGADDRESS: R(v2✓ 02:L� , '(,r r; C.Omrn�rllon oar Sa�n-1T Ch�vc.Ml i�,0, 13ox 335 , USE DATES OBS DNS MADE LE NO.BEDRMS.: COMMERCIAL D�IESCRIPTION: (PROF E RI TI NS: R LA 10 TESTS: ❑Residence Church 7('1')001 ®New ❑Replace ��g�$3 9"IQ��a3 RATING:S=Site suitable for system U=Site unsuitable for system ONVENTIONAL: MOUND: IN-GROUND-PRESSURE S STE MNFFILLHO G RECOMMENDED ( t ) � 4j boxes Cf ❑ �S ❑U � ❑A ❑ JSa� C If Percolation DESIGN RATE:colation Tests are NOT required � If any portion of the tested area is in the 71 under s.H63.09(5)(b),indicate: t(b1 y� Floodplain indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARCTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH A NUMBER DEPTH IN, ELEVATION OBSERVED E T. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- 1 41 �to.15 None �� 15`t Bn 51�� 2(.� K S , Wh��c SS B-2 �l 3 9 .14 73 13 Bn gl 1 Z� g>7 L .) A 8 rnn+ B- 3 (04 100,14 0. )(64 1.2 It X11 Bn L) 3 ca a S +� rY►ot B- 81 S 1 -Slo ?61 1311 3 r sit , 16%1 Bn 1— ) 524 s e no VMh B- 5 75 IIADA9 j 75 ion an -91k 14° 13n L 4-1 II g r no mat B- (o �9 100. ($ �19 I3t1 1' r1 SII 3Z PnL 34 'S # r rio r%ai PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RAPER IINCH ES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIODI PERT D2 PERIOD P_ 2 10 3 , 0o 3 25 2. 40 6.06 P-2 3n 3AS 2.50 3, %,IS - -3.13 4.414 P-_+ 3� 3,50 3.5U 1 Z1lo P- 5 v 1 ,50 1 . tiS1 1 3�S I . So 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. (� 1 SYSTEM ELEVATION 2430" �e�oW �x►s��n Y jli_ ���Gwf,v.� e0✓U ou�S I � I � I - # _ { - _ A► j u 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 : TES S WERE COMPLETED ON: Rob¢.r�' J , Gu d ►-f i5 q-Ih- `83 , CERTIFICATION NUMBER: P�HION.`Ls UMBER4 o tn�1): ADDRESS: RC6 W1 h :,,T '3 O ''-O . QOk CS T , ,,�VATURE: DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) —OVER — f 13e�oc� Sc,-�� cavC'4. SU►�GL�I e or SeeT`� --�re�ch�s o� 1�eas 24'-30' bzloW Surface. Gg too \f3 1041.50 m 11� /O Not G4 ! `1 NOTE 1 X 900 S ;c 100 �X oQ A o 1 L j 9,,38 10Z,49 1.100-Z 160 O INp�C�TES �C4�1-koE- BO►Z',�1� � p Itvo�c�.r�s PF_tiZti TEST 101. �V I `1`i41 L i NOTE.s 94,10 1 , SV PPL�MENTA L 3 M EL= bolt driver\ in '44 T,OCC n� +\--rye X 2 - F1Ne W f C*OVSTo E �.Z- q1 -- x 93.95 `15,'?5 1 10o cy7 _ c 4 F `VRP FEN To (A(O 98 QAtt_ N AI�..ED TO L. Pow E R Pc-E EI 00, Oo CA 6, Pole_i6 9)2..s o ALPHA & OMEGA [WiNEEkING INC., P.O. BOX 388 (GLADSTONE BLDG.) 'R RED WING, MN 55066 TEL 612-388-4596 -IS- 83 ►��C, b fir G y ` r .•. „�,FAi s ''a*a ,�`'' r rte° �e ?EC TANK MAINTENANCE AQi�8EM1tNt ti Croix Gouty . Coaetunion of Saints Church itNE&/BIIYlgR - s ;K Pit* -V u?B/3161 NUMBE CITY/STA?E Rimier Falls Wi: EYf `•ry b� is SE k NE k, section 25 PROPERTY LOCATION ` < TROY St . Croix C,QWAtY `' Town of m Subdivision Lot number " Improper use and maintenance of your septic system could result 101. its premature" failure to handle wustes . Proper maintenance con- gists of pumping out the septic tank every three years or sooner, 1f needed, by a licensed septic tank up enper• What you pit into the system can affect the function of the septic tank as a treat- w ' went stage in the waste disposal system . s St . Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacewent of a failing system, which was in operation prior to July 1 , 1978 . St . Croix County -= �M accepted this program in August of 1980, with the requirement that all new s tems agree to keep their systems properly s owners of Y maintained . ;g The property owner agrees to submit to St . Croix. County ZoniAE certification form, signed by the owner and by a Roaster plumber , journeyman plumber, restricted plumber or a licensed pumper vu�rir fying that (1) the on-Rite wastewater disposal system id ;pro'A operating condition and (2) after, inspection and pumpin essary) , the septic tank is less than 1/ 3 full of slyd# ascum• Certification form will be sent approximately 30 days Nri' r , three year expiration. h'` I/WE, the undersigned, have read the above requlre�ccordeACx ° to maintain the private sewage disposal system in . ,, `y the standards set forth, herein, as set by the Wisconsin a,. Rent of Natural Resources. Certification form must be Coln ` + �r rF ..' and returned to the St . Croix County Luaing OffiFe withl tit of the three year expiration date . r' SIGNER ' August 139 1DATE 984 # t' f County UAIRE Office , R +Fa f� �\AII 7W xi iM .. ,•ty. ti x}, .,44 oil " 54015 b� or 715-W-6363 Eer. bpd return to.•abovw #,ddsess . � y I d e r WISCONSIN DEPARTMENT OF INDUSTRY, LABOR AND HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS, BUREAU OF PLUMBING P.O. BOX 7969, MADISON, WISCONSIN 53707 Verification of Exception Status for an Alternative Private Sewage System In the County of St. Cnotix Location SF 1/4, Ne 1/4, Sec. 25 T 28 N, R 19 W Town d+,K�? TUY Street Address Lot No. , Block Subdivision Landowner's Name: Communion ob Sainta Church The application for this site is for: © new construction use. ❑ replacement system use. If this is NEW CONSTRUCTION USE, the alternative private sewage system is: (..] to have one of the first five approvals guaranteed for this year. This is number - - of those applications. (Use one of the first five quota nu ers s uea—t—to—you.) i I. ]one of the applications needing a quota number. The quota number assigned to this application is - I far one additional homesite on a farm to be occupied by a parent, child, grandchild, sibling, niece, nephew, or first cousin. Flfor an individual lot for which a sanitary permit was issued but was later ruled unsuitable due to new or changed soil criteria established by the department. ' (... for an application on file prior to February 1, 1980. KA for a lot that meets the criteria for a conventional private sewage system. If this is a REPLACEMENT SYSTEM USE, the alternative private sewage system is replacing: ❑a failing conventional soil absorption system. 0a holding tank that was installed and in use prior to February 1, 1980. ❑ a privy that was installed and in use prior to February 1, 1980. If this is a REPLACEMENT SYSTEM USE and the lot meets the criteria for a conventional private 'sewage system, check here. lJ n I certify that the above information is true and accurate to the best of m knowledge. Name Thomab C. Nelson Signature County Official) Title Aaei6tant Zoning AdmLn.4tkaton Date June 14, 1984 DILHR-SRI')-6158 (R 12182) r I t < 4 fl .. S13D 66781M,98/83)(Plb 100a) (Wis Stats.S.'145.02) � i twh d Return Upper s :Pc r�r # This Farr» V -fth f� R tuirrr brrespan P.O.Box AA r F ,'W re GATE: -p7/10/84 I �9 PROJECT' per,` Communion of Saints Church 3b( ) SE,NE,25,28,19W Tn Troy fllptia & Omega Engineering, Inc. St. Croi x Wt PLO. Box 388 E 4 c Red.;Wing, MN 55066 PLAN ID.# ., 84-0290 •. � , DETACH HERE C PROJECT NAMPommunion of Saints .Church _ PLAN ID. � 84-02901: T receipt of your plow and speciliicatior s-for the ahov�indic ixiais�to at�nvwled ge r rY Q 90.00 �0 0Q _,� ` Pr kimina review indicates the required fee is.$ Fee Receive dls a #an accepted forreview. ❑Underpayment-Please submit additfonnl fee.Plans 4 btyatle +, Plans being returned. ❑Overpayment-Refund forthcoming f ` Additional information required. -SEE BELOW. ❑No fee has been remitted;Plans wilt be brad in abeystriCie �, Y # Plan Submission El soil boring and percolation tom. ,# �µ ❑ :AcddiiiohaI information shall be submitted in duplicate unless by Certified Soil Tester. specifically noted: ❑ Petition For,Uddifi"tion eigned,by.�'11 + ❑ Plansinot clear,.legible or permanent notarized.(1 copy) 3 �; ❑ All information submitted shall be signed,dated-and sealed or ❑ Complete data relative to anticipated use`of stamped in.accord with Section ILHR 83.08 (2) (a)Wisconsin El Deod restriction required.(1 copy) Administrative Code: ❑Affidavit enclosed. ❑ Condominium declaration.(t copy) ❑ . Plot plan showing location of land parcel (distance from ' nearest road intersection,etc:),lot size and all distances from IV., Holding Tanks private sewage system to buildings, 'lot lines; well, water ❑ Holding tank profile showing vent,ma{tim iota course,swimming pdols,water-service piping,all weather ser- and manufacturer if state ap0rove4-. g vice road,ems:•dhow benchiiiark with permanent elevation, construction details it sft tonstivolad. ❑ Holding tank agreement signed by owner and local, 11. Pressure Distribution Systems (Mound or Inground Pressure) unit of government(sample enclosed) ❑ Application for Use of an Alternative System signed by owner ❑ Reason for installing holding tank.Staterirct nt 6M, and notarized.(1 copy)' county or soil boring and percolation test 40111. I County onsite required.(1 copy) ❑ Design calculations. 115 completed by CST,showing that a soil absorj%oA system ❑ Soil boring and.percolation test data on 115 completed by cannot be installed on the land parcel. Certified Soil Tester.(1 copy) ❑ Affoevit for all-weather service road(enclosed). ❑ Cross section of system: ❑Pipe lateral layout. ❑ Plan view of system. V. Dosing Information ❑ Verification to Exception Status Form by county:(1 copy) ❑ Calculations for total dynamic head and ga►jo , pumped per cycle. III. Private Sewage Systems ❑ Size,length and depth of force main.. ❑ Ground slope with 2'contours in entire area of soil absorption ❑ Detail and model of pump or,automatic siphon,including system extending25'minimum on all sides. size,pump curves,drawdown,and average flow,lata(GPM). ❑ Location of area suitable for replacement system provide soil ❑ Cross section of dosing tank showing pumpls)or siphon(sk data. ❑ Construction details of septic,holding or dose tank if site VI. Systems in Fill (Fill must be placed prior to plan submiss n.) constructed,or tank manufacturer if state approved. Total area filled(fill to extend 2£I'beyond edge ' ❑ Construction details and cross section of,soil absorption of trench before side sk4m begin.) system. ❑ Depth and type of fiR. ' ❑ Copy of signed.onsrte report by county or, i. q�`•' L7": �j� �i a w" y .trs er' -. y g� { y �♦?`� xk s lt4t' �774w• A M { F y�7 ,�F AT Sg�yt 3`R Y. �' ��SYY �q 7��iav A/.r tt s. Y4L •.+ Ad` � z� L.L. 'a><���?��I�'� � �P�F..7"I r3 �x r 3,st fi, Fa i y �7`�' p. ,� �2 } r'a: `�r•�f y"� .yi"'=,:3 z•''C �s' .Cre� f f ,3,.,t t •," �"'', a - s � F 43T '44''k.,.. s9 . t' _5 ''a.'i'F , -f n,. 'G •,Y r'.:�s - "� �'`' �nT..� fas"a,y�' O=`� Er¢ �, ,' ' 1" •; s rYy' IA +wi y o- ,a ak s Ara" '+a t 'rie ♦i' k st y3 :` .ft i�: d jr � � F.:',n * x r 2�?f �' �vz:a••��. _ ��. ��'{r �s rol. �:3 A °17i!� ik "In K` F, }y„ I",''1 yam# ( YR r Y1 W.!2 v , r . wwwl, UK. F � 4d,t Jam,;.j .4y ;•%. Tyk n �4A4 to { # 4l,- 1t F.,:. �e - v. �` �,., E •y� a+. f N' #t�,, r:i' -'�kr' t J;,y� `'� :+R Er•—pa rr«w+�j.2b.FM�#�"^h rs'awh .i.. F {bw. �, ,... y �• `t 4 #.��' i G {'i X �: +41' 'i 4 Hsi rE 'tel I i J+ r } ", Eusii- .y)Om � OV ��' � � E3I4 �']�f'iaFxT�'��i At'f,�4'�'Y+1 '�'a°6 R7.^ � J. •. { '`''�i ,.,i €Y EFS �F� k'w y" S*r 3`! N3. #4'�. 400 { „:i*• a r l~ •+ f !'fie 3'. 3 } 6 ?`"` �. PAZ, �#Ft � •it, r .5�, gglyz �, k �° t gA .. °C' ? �cr �° z ,s 9 2� 2 F p� k - -'Y" "•.r+x-.a SK�i,. ig nY3`'> 1 €9'rt r3§}•+� tY 4 `'f., Y1 4, a ._ ter' if �#}�li ,„-` a �- C�-#tyaa� �. tY � r Y'i WV WI. gam !� , do +fir (}t i h .. z �$ s k typ e � ., ' "a $ F#."' i .=t' �€a.+Y t S t4A s z' {te'p': � t 41.xWI '9rs � t^:":a,,, °� a .g ?•t x �`��i N �+ t� t . rt1t"} € t s v.t'cu �Y32it - CxJ�` t s z , gjx a F �. "1# ✓c£ x s* w °J'f t r•twe ,:,'' a z i !' k' aC�'Ysa�4 �s -Yynrsst� a.r ° ll'+'°.,i�S.r'd!✓Se.. y �1 � �i>•„ E r kv I }��k a v y F� t_ r a Cpl r' A i+✓�i�E3 a s� {���At y��,.� - �Y+'��,r �°''s ry }'Y[�i".di �.. E� n.f t s�: 3E tfd #a t f '` ?; '���� { _ r �< -vpk ?4dF..art ' tx1£ rst�ta tF ft&S t max. , .ri� ¢ j,4i '3 4[3 f a+SL fT� -�� gi �2t ` vIb`% i tF'3 1 40 * #� s S,xi i,} r :3gF, ;t `� "' 3.fiG` t z•,. .*�£ �it r `�,;2 ,:,, yaGp��g?y 11tS gym. F V d ✓ 4 3� j u� ¢ ' � � ;,'�`a ti x s "`�� £< � ' rr a^.Y ,� ' 'd .,i�a"idYYt+• ;L L` #r �' t Ald 01343678 19/M(Ptb 100x) STATII:0 NO .And Return Upper DIVIVf31�I100 M- I'1C l N or t}f This Fors» With sua�au cif ptt.l MM , n Return Correa ndence po 1.0.sox MADISIDAls _,�=' � � "� � �•_i ^Irk-' t� DATE: 1Cy �G � PROJECT: 06/18/84' r loy2 19� ° Communion of Saints Church' x 3b(SE,NE:,25,28,191 1 n Troy Alpha & Omega-;Engineering, I e 5t. Croix WI ` P.O. Box 388 Red Wing, MN 55066 PLAN ID. 84-02901 DETACH HERE •PRQ:IECT NAME Communinn' of Saints: Church PLAN ID.� 84-029{91 �� � : ,Tha is froknowled rip#of your plans and spifcations foa,the above-indicate&Projeft, 4- -Preliminary review indicates the required fee is$ . Fee Receive!'is$ Underpayment—Please spbmit•the additional fee. X � ❑ Overpayment— Refund#oFtht�rttu�. Plan accepted for review: Plans being returned. No fee.has-been rem�scl.Pans submitted with no feeswill be Additional information required r ` t .field in atieyance� V # i Submission ❑ Complete'data relative to ar ty Addttionat information-shall be ffiubrnittetl in tlupkicate un- 0:2 copies of PIL' i1indr : ❑•less sped eaIt; noted. .❑ Deed restriction Fequtred [� Plans n6t clear,legible'or'permanent. ❑ Condominium dectaratton.{1 [] All information submitted shall be signed,dated.'a' nd seated or stamped in accord with Section H 63.08(2)(a)Wisconsin y . Administrative Code. 0,Affidavit enclosed: IV. Holding yanks `+ ❑ Profile of holding tank sllolA►rrtg. s[fCl iartd manufacturer if,pry ast.:Ccanpt �r � if; Pressurize ze Distribution Systems(Mtound or In Ground Pressure) site constructed. Application for use:of an'alternative system signed by owner {] Holding tank agreement signed by owner a ioi uili# of and notarized. (1 copy) government (sample enclosed). County onsite required (1 copy), ❑ Design calculations ❑ Reason for mstauing hold F tart ar st tement, for pressurize distribution. ❑Soil boring&percolation from county (9yl , test data ❑ Plot.plan sh"gning toe tiQn of hat�it a}dial• ❑°Cross sOction of system. ❑Pipe lateral layout, antes to any`Mt #it , wells water vrter Plan view of system. :0 Plot plod. course, lot tines,swriitirrg pctotllrioe i ad. ❑ Verification of Exception'Status Form by County. (1 copy) Etc.Provide benchmartcviti0i 8 paint.., 1t 1. Private Seww Disposal Systems V. Lift Pump ❑ Ground slope with-2',contours in entire area.of soil absorp ❑ Calculations for total lift pump dis ++ , end gallons tion system extending 25'ortail.sides. pumped per cycle. Elevation of permanent reference'point (benehma.W.. ❑ Size,length&depth of forts main: ' ;❑ location of area suitable for replacement system - provide [] Detail & model of gyp.or auto tas including $oil data. size,pump curves,drawctcianiV17- z C3P6l. [ Plot plan showing lot size and all lateral distances from [] CrQSS section of lift pcpttptaak ttr sewage disposal system to buildings, lot lines,welt,water siphon(s), course,swimming pools,;water service piping,Etc. Construction detail of septic, holding or lift.amp mp tank if x ; ate constructed or tank"manufacturer if precast. " Vt. Systems to Fill (Fill rt -be�W-#tr r to ❑.Co nstruction detail and-cross lion of- soil abob ion. ❑ Total:area°filled (flit to fit' system. : before side slope.begitoj ❑ Sall boring and percolation test:on 115 cotnpteted by cer- ❑-Depth and type of fill, tified soil;taster(#Copy) Qi Copy of+a!> OR# R b , - k Y W 3 a : M A „� . ST. CROI X COUNTY WI SC0 N S I N COUNTY BOARD OFF ICE 386 5581 Ext. 50 COURTHOUSE HUDSON 54016 Juty 5, 1984 Div.iaion o6 Sajety and Buitdi.ng Bureau o 6 Pt wnbing P. 0. Box 7969 Madi4on, Wl 53707 Dean Si&: An on6.cte inveati.gat%on Jon the Communion of Saint6 Chutch pnopenty, tocated in the SB! of the NF% of Section 25, T28N-R19W, Town o6 Troy, St. Cn,o.ix County, nevea.2ed .6uitabZe Qoi" in exceAz o6 70 .ince6, below which .6ea6onab.t?e high ground water wa6 noted. Th.i.6 Ate -c,6 .6m table bon a conventi.onae .6ystem, however it -c.6 my necommendat.ion that the Q y6tem utilize the .in-g)cound pnea.6une Qy6#em. Shoued you have any qu"tion6, pte"e beef. Snee to contact tki-6 o66.ice. S.incene-y, Thoma6 C. Netz on A66.i.6.tan t Zoning Adm.ini6tnaton TCN:mj STATE OF WISCONSIN-DEPARTMENT OF INDUSTRY, LABOR & HUMAN RELATIONS ` DIVISION OF SAFETY & BUILDINGS - BUREAU OF PLUMBING P.O. BOX 7969 - MADISON, WI, 53707 APPLICATION FOR THE USE OF AN ALTERNATIVE SYSTEM Location: Township- SE ki NF 1t S 25 IT 28 N/R 19 XX.Ki w Tuy St. Cuix Street Address: Subdivision: County: Landowners Name: Mailing Address: Communion of Sain:tb Church P. 0. Box 335, R.i.veA FaM, W1 I (Me) , the undersigned, hereby make application for an alternative system on the above-described premises. I recognize that the above premises are not suited for a conventional private sewage system. If approval is granted, I agree to have the 'system installed in conformance with the Bureau's approval of plans and specifications. I further understand that an alternative system is more complex in nature than a conventional private sewage system and as such will require detailed inspection during construction and monitoring after the system is-put into use. I agree to permit both county officials charged with administering county sanitary ordinances and Bureau employes or other authorized persons to have access to the above described premises at any reasonable time for the purpose of inspection the construction of or monitoring of the system. I further agree to either personally or by my agent contact the proper county official to arrange the time and date to begin construction of the system. I understand that this application does not permit me (the applicant) or my agent (the contractor) to begin installation. If the system is approved, the Bureau will send the applicant a letter of approval which authorizes construction of the alternative System after all necessary permits have been obtained. I agree to give notice to any subsequent buyer that an application for an alternative system has been made and if installed, that the premises are served by an alternative system and further agree to give the buyer a copy of this application. The Bureau accepts this application subject to this understanding and subject to all the conditions and obligations set out in this application. Signature of Applicant Date STATE OF WISCONSIN Subscribed and sworn to before me SS. COUNTY OF This day of 19 Notary Public, State of Wisconsin DILHR-SBD-6413 (N. 05/81) My Commission Expires: WISCONSIN DEPARTMENT OF INDUSTRY, LABOR AND HUMAN RELATIONS ' DIVISION OF SAFETY & BUILDINGS, BUREAU OF PLUMBING P.O. BOX 7969, MADISON, WISCONSIN 53707 Verification of Exception Status for an Alternative Private Sewage System In the County of St. Cnoix Location SE 1/4, NF 1/4, Sec. 25 T 28 N, R 19 Xko(W� W Town .11> XMI AXXX XUyK f Tnoy Street Address Lot No. , Block Subdivision Landowner's Name: Communion oA Saint6 ChuAch The application for this site is for: ) new construction use. ❑ replacement system use. If this is NEW CONSTRUCTION USE, the alternative private sewage system is: Ito have one of the first five approvals guaranteed for this year. This is numher - - of those applications. (Use one of the first five quota num ers ssue -To you.) L `Ione of the applications needing a quota number. The quota number assigned to this application is - - C_]for one additional homesite on a farm to be occupied by a parent, child, grandchild, sibling, niece, nephew, or first cousin. [.-]for an individual lot for which a sanitary permit was issued but was later ruled unsuitable due to new or changed soil criteria established by the department. I _.1for an application on file prior to February 1, 1980. JX_�for a lot that meets the criteria for a conventional private sewage system. If this is a REPLACEMENT SYSTEM USE, the alternative private sewage system is replacing: ❑a failing conventional soil absorption system. [_la holding tank that was installed and in use prior to February 1, 1980. ❑ a privy that was installed and in use prior to February 1, 1980. If this is a REPLACEMENT SYSTEM USE and the lot meets the criteria for a conventional private sewage system, check here. I certify that the above information is true and accurate to the best of my knowledge. Name Thomas C. NeU on Signat County Official Title Aazistant Zoning A&n nizt4aton Date Jtuy 5, 1984 DILHR-SBD-6158 (R 12/82)