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FORM - STC - 104
AS BUILT SANITARY SYSTEH REPORT
OWNER Oliver Humphrey TOWNSHIP
SECTION 36 T 28 N-R 19 W
ADDRESS 78 Highway 35 N ST. CROIX COUNTY, WISCONSIN
River Falls, WI 54022
SUBDIVISION LOT LOT SIZE
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
4, ap,
Q"`~ J'~OUSE
TEFL 114A'K 3~,
('rEME NT
t
INDICATE NORTH ARROW
l1~or ~o Sca~E
BENCHMARK: Elevation and description:.A'/, W CIO_ -r. of ~oA sfEP•
"CIO stfa
Alternate benchmark
SEPTIC TANK:Manufacturer: Liquid Cap.
Rings used: Manhole cover elev:Final grade elev:
Tank inlet elev.: Tank outlet elev.:
No. of feet from nearest roadsFront , side , Rear Ft.
From nearest prop. line:Front , Side , Rear Ft.
No* of feet from: Well Building:
(Include this information in the above plot plan)
(2 reference dimensions to septic tank)
SEE REVERSE SIDE
PUMP CHMMErt
Manufacturer: Liquid Capacity:
Pump Model:,Pump/Siphon Manufact.: Pump Size
Elevation of inlet:_ 'Bottom of tank elevation
Pump on elev.: Pump off elev.: Gallons/cycle:
Alarm: Man.: Switch Type: Location
Distance from nearest prop. line: Front,-, Side-, Rear-Ft.
Distance from: Well Building
SOIL ABSORPTION SYSTEM
Bed: Trench: Seepage Pit:
Width: _Length Number of Lines: Area Built
Exist. Grade Elev. Proposed Final Grade Elev.
Fill depth to top of pipe:
No. feet from nearest prop. line:Front , Side , Rear Ft.
4
No. feet from well:
No. feet from building
BOLDING TANK
Manufacturer: ' Capacity:- JsDD J-4/lo NS
No. of rings used: Elevation of bottom tank:
Elevation of.inlet:
No. feet from nearest prop. line:Front , Side Rear Ft.
No. feet from: Well, building , nearest road
Alarm Manufacturer: !~Z
INSPECTOR:
DATE: PLUMBER ON JOB:
LICENSE NUMBER:-.
6/90:cj
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
.LABOR & HUMAN RELATIONS
P.O. BOX 7969 PRIVATE SEWAGE SYSTEMS
DIVISION
MADISON, WI 53707 BUREAU OF PLUMBING
NE,,NE1%,Sec.36,T28-R19 CONVENTIONAL ❑ALTERNATIVE State Plan I.D. Number:
City of River Falls
y olding Tank 1:1 In-Ground Pressure El Mound I I asagned)
Hwy. 35
NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: A+Li -1
INSPECT IO DA E.
Oliver Humphrey 78 Hwy. 35 N, River Falls, WI kloh!o
BENCH MARK (Permanent reference Domtl DESCRIBE IF DIFFERENT FROM PLAN.
FIEF. PT. ELEV.: ST REF. PT. ELEV.
Name of Plumber MP/MPRSW No. r7"~St. $amlary Permit Number:
Paul R. Cudd 2739 Croix 149053
+4N ./HOLDING TANK:
MANUFACTURER 11 3 LIQUID CAPACITY TANK INLET ELEV TANK OUTLET ELEV WARNING LABEL LOCKING COVER
A PROV ID : JPRO~VID D
/C-~'✓ &A YES ❑NO CJYES ❑NO
BEDDING: VENT DIA.: VENT MAT( HIGHW EH NUMBER.OF ROAD: PROPERTY WELL . BUILDING. JVENTTOFRESH
/ Iff ALARM
❑YES NO FEET FROM 1 L'NE I " I AIR iNLE~
L~vES ❑NO NEAREST ~ ~~I~ y 7
DOSING CHAMBER:
MANUFACTURER B LIQUID CAPACI Ty PUMPMODEL PUMP,SIPHON MANU{ ACTI)HEH WARNING LABEL LOCKING COVER
PROVIDEDPROVIDED:
YES ❑NO ❑YES ❑NO ❑YES ❑NO
GALLONS PER CYO_: PUMP AND CONTROLS OPERATIONAL NUMBER`OF PROPER WELL BUILDING [VENT T FFRESH
(DIFFERENCE BETWEEN,
LINE AIR INLET
FEET FROM
PUMP ON AND OFF)
_L_ I ❑YES ❑N0 NEAREST-~►
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing UInMETER IIIIAIIHIAL AN1 M K WG
or excavation. (if soil can be rolled to a wire, construction shall cease until FORCE
the soil is dry enough to continue.) MAIN
CONVENTIONAL SYSTEM: WIDTH LENGTH NO OF UISTH PIPE SPACIN(, COVER
BED/TRENCH THE NCHFS INSIOL UTA rPITS LIOUID
DIMENSIONS elnrEHlnu PIT DEPTH
EL TN FILL DEPTH UISTH PIPE DIST A PIPE DISTR. PIP . MATERIAL NO DISTR NUMBER OF - PR RTY WELL BUILDING VENT TO FRESH
BELOW PIPES ABOVE COVER EI FV INlfl ELE V.EryU PIPES E
l FEET FROM AIR INLET
NEAREST
MOUND SYSTEM: `
Mound site plowed perpendicular to slope
Check,,the texture of the fill mat I for PROVIDE A DIAGRAM OFSYSTEM
and furrows thrown upslope: mound systems to make cer n that it ON REVERSE SIDE. SHOW ELEVA-
❑YES ❑NO meets the`c(ri~teria for mediu sand. TIONS MEASURED.
SOILCOVER TEXTURE [IIIIIIANINIMAH11flis OIiSEHVATIONWELLS
_ \ ❑YES ❑NO _DYES ❑NO
DEPTH OVER TNENCH BED DEPTH OVFH TRENCH HEU UFPT{I O{ i( IL 'ODUf I)
CENTER EDGES < SEE 0( I) MULCHED
❑YES. ❑NO ❑YES ONO ❑YES ❑NO
'PRESSURIZED DISTRIBUTION SYST
BED/TRENCH WI°T" T1/ NO.OF LA iENAL SPACING (;RAVEL UEPTH yEN ppj FILL DEPTH ABOVE COVER
TRENCHES.
DIMENSIONS
M (FOLD PUMP
EV MANIFOLD DISTR. PIPE - MANIFOLD MATERIAL NO DIST " UISTH. PIPE DISTHIBU TION PIPE MATERIAL & MARKING
ELEVATION AN . ELEV. DIA. ELEV. PIPES .,.+,~DIA:
DISTRIBUTIO
HOLE SIZE HOLE SPACING °HILLEUCORHECI Ly
INFORMATI COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
Via.. PLANS
❑YES ❑NO R„ -F-IYES ❑No
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: FNEARE
MBER OF PRO WELL: BUILDING:
T FROM LINE:
❑]YES ❑NO ❑YES ❑NO ST
a
4
'or
Sketch System on R rn county file for audit.
Reverse Side.
SIGNATU TITLE:
DILHR SBD 6710 (R. 01/82)
c
ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
ST. CROIX COUNTY COURTHOUSE
911 FOURTH STREET • HUDSON, WI 54016
(715) 386-4680
Dec. 16, 1991
Francis Ogden
113 West Walnut St.
River Falls, WI 54022
Dear Frank:
I am sending copies of the inspection report, a drawing done by
the inspector, and the state plans for Oliver Humphrey's holding
tank. Also enclosed is a copy of the holding tank agreement and
the form used to cancel the holding tank agreement. We didn't.
have any of the state forms, so this is copied from the
Administrative Code. As you will note, it does need to be signed
by someone from this office. When the tank has been properly
abandoned and the public sewer hooked up, let us know and someone
will come out and inspect it in order to sign the document to be
recorded.
If I can be of further help, please feel free to call this
office.
Sinerely,
Ma J nk s
1 Assistant Zoning Administrator
cj
~ -o ,cam a-c,~d 4y 'ae'
,mow , AU
Arv-~, ae, Alzz-t 4L~0-6 dof
DILHR SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code COUNTY
St. Croix
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than / / QQ
8'f x 11 inches in size. ❑ Check if revision to vious application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION. S90-40470
PROPERTY OWNER PROPERTY LOCATION
Oliver A. Humphrey NE y4 NE S 36 T28 , N, R 19 :9)(ftW
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
78 Highway 35 N
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
River Falls WI 54022 715 25-952
11. TYPE OF BUILDING: Check one CITY NEAREST ROAD
( ) State Owned VILLAGE: River Fall Highway 35 North
❑ Public ®1 or 2 Fam. Dwelling-# of bedrooms -!--PARCEL AX NUMBE )
III. BUILDING USE: (If building type is public, check all that apply) - -
1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. ❑ New 2.0 Replacement 3. F 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 ❑ 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
300 REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
Feet Feet
VII. TANK CAPACITY Site
in allons Total #of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed -71
Septic Tank aF Holdin Tank 2 2
Lift Pump Tank/Si hon Chamber
VIII. RESPONSIBILITY STATEMENT
1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plumber's Signat re: o Stamps) MP/MPRSW No.: Business Phone Number:
Paul R. Cudd IMPRSW2739 715 425-2049
Plumber's Address (Street, City, State, Zip Code):
1047 S. Wasson La., River Falls, WI 54022
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater a e ssue issuing ent signature (No Star
Approved ❑ Owner Given Initial Surcharge Fee)
Adverse Determination 50?/ l
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
i•
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY &BUILDINGS
IiJ D US-f>!i!Y, CC DIVISION
N P.O. BOX H
LABOR UMAN RELATIONS PERCOLATION TESTS (11J) MADISON W 53707
(ILHR 83.09(1) & Chapter 145)
LOCATION: SECTION: TOWNSHI ICIPALIT • OT NO.:BLK. NO.: SUBDIVISION NAME:
NE1/►.) F-r y /Tz$N/R111YElo W CAVI of RIvEIR RII✓1-3 - -
COUNTY: MAILING ADDRESS: --?S 3S /VOIZ
sT-~R~uc 1 -1UQZ ~~~►►'~p ~-~-r ~Ztu(:FZ LLS w SVOzZ
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: R PERCOLATION TESTS:
Residence El New Replace
RATING: S= Site suitable for system U= Site unsuitable for system c~lU S LTA ~Y t l I vj' I PS d'v 7 - I Z- q~
CONVENTIONAL: MOUND: IN-GROUND•PRESSURE: SYSTEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM: (optional)
aS rL/` j\7'u EIS ,emu EIS Zu oS Egu PUS au
4 SIE'-z IJO,cz taw
If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the
under s. ILHR 83.09(5)(b), indicate: N - N I Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED EST. HEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
o"- ~1" to `{R-313 ~ S ~t~~ ; zy'' tb~rtz 2!z L s CoRlGnvrrc. 7oP.scuL),-
B- 1 6CS R6. ►V~>\1~ 3Z zN"-32`~lo4t2 3A. Is ;3z"_3~"IQ,1k3At. IS w/ f4u-,y1NC, 'FA-",Ur
-Sltit5le mor; 3~`'-LfS/ r -7•57tZ 315/ LteAQV S) w/a Mn]•
B- q L1 i'- (oo " -2 . S 1 R 3/y c S & G r
0-4 ` to~tR Z!L 1.. ; 10`12313 51 ; ~4- 3-7" /oY23/6
B_ Z 3~ 9 S, b 1~3 ~1llfV ZS V't`A-1p IrJ4\?, 2t'Z 1S L,/'7,S`tF- S/$ In07-
N Sot t_s u>u SU 1 LE Fvf: %ELOQ G tZ-I c E S 5cs77ZE)-l of A~vY `rte pt Dvt ['Qk S oc
B- `t'X1TTLt 1h V S >v O I/U LLL= -3 wl o V ! C S
B- B St of INS tct ~b L,6r UIUC-S, SELL 1QC.#"W)
~°d"'1P ru LAP(:Ls.
"Qrvlcl.Pt_ SEi~--jQ-SR tS fl lCIPItTL U ia_l l943 Z 12~cowr►~i~v~ A
PIT B- ~~n1 wG ~z !S St `
PERCOLATION TESTS
} EST DEPTH . WATER IN HOLE TEST TIME DROP I WATER LEVEL-INCHES RATE MINUTES
f NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH
P_ .1 .
P-
P-
P-
P-
P-
PLOT PLAN: Show locations /enccecpoint lat n tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation rand show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope.
,v sE N _ ~pr GE q ~I~tt 0'}'i~ LO F~l~
SYSTEM ELEVATI
ri ; _ r~ oo~P~.IrI fV ~orZHJ~ti2 Q>
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i ~ r ~ _ CcoLLf~YPS~I~~ E
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1, 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.
.1c `E TESTING
NAME printl: AND TESTS WERE COMPLETED ON:
L(-410
n-E-S-IGN SERVICE
ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional):
e3T'o%csc, o UZS-ot65
P - Q. POX 74 421 N. MAIN ST, RIVER FALLS. WI 54022 CST SI NAT RE:
715-425-0165
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 10/83) - OVER -
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
14DUST~ii Y, DIVISION
LABOR AND' PERCOLATION TESTS (115) MADISOP.O. BOX N WI 539069
HUMAN RELATIONS
(ILHR 83.09(1) & Chapter 145)
LOCATION: SECTION: TOWNSHI IPALIT OT NO.: BILK. NO.: SUBDIVISION NAME:
Na'1/,.a Y/ 3(- /TzaN/R 19E (o CAVI of R10EFI. Rul-3 - -
COUNTY: MAILING ADDRESS: glvY 3S NOIZTN
S7
-C~1)C OL1~1F3t ~Ul"1~ ~ 21Ue1L LLS W~ SVOZ-Z.
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DE RI TION: DESCRIPTIONS: 1PERCOLATIO
a ❑ New Replace I
RATING: S- Site suitable for system U- Site unsuitable for system d!U S ~Y PSG ~1 - I Z-- 90
CONVENTIONAL: MOUND: IN-GROUN RESSUR : YSTEM-1 TANK: RECOMMENDED SYSTEM: (optional)
DS 'V'-IU as IOU EIS Oil rEJS ®'U Os OU
set 1v01L e%4w
If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the
under s. ILHR 83.09(5) (b), indicate: N Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TOTAL DER H T R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERV D EST. HIGRTS TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
0" N-)' 104 L3)3 ) $ F-ILt- ; , 2t( 1p7t2 111 1 S CORIcS/NfK -MPSwtL)i
B- 6~ et 6. )v~>\)~ 3Z Zy'-32" c)4a M. Is 3-)"),Z),m3A. 1s w/¢ew,~`~Nt, FP,/,r
Z-S`ttZ 518 hffoT-; 3'7"- LIVI -7-S `1Q 3Jy Irt(-"Qy S) N-/k jnoT;
B- QL1~, 60" 7-S11t2 31y C s S Gr
0-4` lo~-LR Z!L i 9~~2j to4CZ313 51 i z-4-'3 7" loYR3/`
B- Z 3-7 QS. 0 I o'cZ Z!Z is/~.SyR 5/;3 >»~T.
:(F N : S01,LS PftE uW SU 1 LE Fv1Z ZELOQ G tl^t E S YSTze}l CF ^--e `T -y PC bQQ `N 5 of L
B- v-ATT` I 1A-t o S Y C°_ !v o /v 1 ~=1~ w t ew V I sv C CsS
B- C3 S t o F ~ N s ~Ft cc ~ r ~ ~ a u t= L-oT V ~v ~°S, ~l ~ L. ~-~`I-'~l o~V ,
L°Cy"'~P c rv c Pis -
i` w-,vn~lcCP s~ tS fl~tlCtPhl13U z4 1g43, = R~-cowlt^i~vD A
B- t~ `D,iw G `z is Is
PERCOLATION TESTS
,i DEPTH, WATER IN HOLE TEST TIME DROP I WATER LEVEL-INCHES RATE MINUTES
TEST f NUMBER INCHES AFTER SWELLING INTERVAL-MIN. I D 1 PERIOD PERIOD PER INCH
P-
P-
P-
P-
P-
P-
PLOT PLAN: Show locations /,nccecpoin lat n tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation rt and sho w their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope. Div St= N - a R GE 91 ~~~t1 LO N~
SYSTEM ELEVATI
i
t~p fi-p ro; 1
f- - - ±
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o
C.
- t
Jew
7 -4-1
Lt~C s
- _r r+t4s ~
t- KID
f
t_._._
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.
rrrG
NAME print : AND TESTS WERE COMPLETED ON:
L(-4117 -DES- IGN SERVICE ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional):
P - Q. RQX 74 421 N. MAIN 81, C.ST'oooS-fib "~1S-yZ3-W 65
RIVER FALLS; WI 54022 CST SI NAT RE:
715-425-0165
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 10/83) - OVER -
WIE~E~'CE~c I l.. T'ES~I` I hJG
AND
D►E~ I Ch!ER~.•" I GE
P.O. SOX 74 421 N. MAIN ST.
RI'vER FALLS, NI 54022
715-425-0165
ATTN: _ ~1 1 1S DATE 8-13-a1~
CC:
SUBJECT: 01. LU L51Z mZ E
WE ARE ENCLOSING THE FOLLOWING ITEMS:
NO. OF
COPIES DESCRIPTION
ZZ~~p12.
SENT TO YOU FOR THE FOLLOWING REASONS:
❑ FOR APPROVAL ❑ APPROVED AS SUBMITTED ❑ INFORMATION DESIRED
[FOR YOUR USE ❑ APPROVED AS NOTED ❑ RETURN COPIES
❑ NOT APPROVED ❑ FOR REVIEW AND COMMENT ❑
X 1 {''1 - h DU L 1 >l~ S ~ 1-uiyL~ ~D C )L
WEGERER SOIL TESTING
AND
DESIGN SERVICE
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HOLDING TANK Page I of 3
For
A 2 Bedroom residence
I
LOCATED IN THE ME OF THE Nei OF SECTION 3G ~ T ZS N, RI? W.
IAM OF R~VETZ ~A t t,s , sT• ~Rg1X COUNTY, WISCONSIN.
C t'C`
INDEX
PAGE 1 of 3 TITLE SHEET
PAGE 2 of 3 PLOT PLAN
PAGE 3 of 3 HOLDING TANK SECTION
PREPARED FOR
OL1v 1;-:-IZ A. l~vw►~NR~`f.__
8 l1w1-1 3 S NcoR'T14
`'~,tvE=R ELLS, cv ~ S+~UZZ
PREPARED BY
fns E C E Fc E FR S
AND CM 11_ T E 13 T I t A G ~u~gi~~,~000~ p
DES I C-3 P4 E3 FEE FR W ICE ~0Pj
P.U. BOX 74 421 N. MAIN ST. ~ WEGE ER
RIVER FALLS, WI 54022 ELLSWORTH,
715'425-0165 I MG.
1 G N E4'
1L1, 1990
e PLOT PLAN
Page 2 of 3
/.~c..~~ Scale 1"=30'
Fwop~y„G
R~llV~ ETXI STlIJG CoLL.I~(pSL~
St~P)7 C 1Ytr1Z
ZO h~U
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CjNSiTE SEWAGE SYSTE M
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10
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~~.P'`, OF k0US1~UG Rti,p v23RN ~EV~.~Q1~jE~-~- ~-ooD '
z ~~2.p lov►~p Q+
NOTES:
1. Elevations shown are existing ground elevations unless otherwise noted.
2-~ jj--peEmaaent ma;~kerrs- at e~-$€ eaeh-l-erte .
3.
4. Sew tanksto be -ND17sLz.zso gallon capacity manufactured by
C S~ p6E 3 of 3
5. Bench Mark siL. 89% Z- OQ NW C-U2tiJQT C
R C7F ~jtZ-~'7~ FoRCN -
1,3 C:xT TO 1--*, L A i.XrE~R .
C o O
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State of Wisconsin ` Department of Industry, Labor and Human Relations
PRIVATE SEWAGE PLAN APPROVAL SAFETY & BUILDINGS DIVISION
Western Regional Office
2226 Rose Street
LaCrosse, Wisconsin 54603
i
I
WEGERER SOIL TES'T'ING & DESIGN Owner: OLIVER A. HUMPHREY
P.O. BOX 74 78 HIGHWAY 35 NORTH
RIVER FALLS, WI 54022 RIVER FALLS, WI 54022
RE: Plan Number: S90-40470 Date Approved: August 21, 1990
Gallons Per Day: 300 Date Received: August 20, 1990
Project Name: HUMPHREY, OLIVER A. -RESIDENCE Location: NE,NE,36,28,19W
City of RIVER FALLS County: ST CROIX
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
inspections can be made.
This approval will expire two years from the date approved or if a sanitary
permit is obtained, it will expire the day the initial sanitary permit expires.
The Section of Private Sewage has reviewed these plans for private sewage system code
requirements only. These plans have not been reviewed for the code requirements
set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the
Wisconsin Administrative code.
This approval is for the following components only:
- REPLACEMENT HOLDING TANK
Inquiries concerning this approval may be made by calling (608) 785-9348.-,
Sincerely,
E En
CEIV
_
4z
GERARD M. SWIM F
Section of Private Sewage
Division of Safety and Buildings
4PP039/0009n/40
cc: OLIVER A. HUMPHREY X Private Sewage Consul
SBD-6423 (R. 08/88)
8 78 PAGE621
Document No. This space reserved for recordin aTa a
HOLDING TANK AGREEMENT ~'~f "
461506 d `
a, ,?j
Agreement Date
This agreement is made between the REGISTERS ICEr _
County or Local Governmental Unit Holding Tank(s) Owner(s) ti`-;~i `
ST. CROIX C 14ari;^r~:c;
Recd for Rec
City of River' Falls Oliver A. Humphrey ,...i ;
(Called Municipality below) i er A U G 171990
We acknowledge that application is being made for the installation of (a) holding -'et, =/1~5 P . jj(ty~►
tank(s) on the following property, (Provide legal land description:) v amlw MJ~JC.
Regkfer of Deeds
See attached description,-.
Return To
or that continued use of the existing premises requires that a holding tank be installed on the property for the purpose of proper containment of
sewage. Also, the property cannot now be served by a municipal sewer, or any other type of private sewage system as permitted under
Ch. ILHR 83, Wis. Adm. Code, or Ch. 145, Stats.
As an inducement to the County of St . Croix to issue a sanitary permit for the above described property,
we agree to the following:
1. Owner agrees to conform to all applicable requirements of Ch. ILHR 83, Wis. Adm. Code relating to holding tanks. If the owner fails to have the
holding tank properly serviced in response to orders issued by the municipality to prevent or abate a nuisance as described in ss. 146.13 and
146.14, Stats. the municipality may enter upon the property and service the tank or cause to have the tank serviced and charge the owner by
placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by
s. 66.60, Slats.
2. Owner agrees to pay all charges and costs incurred by the municipality for inspection, pumping, hauling or otherwise servicing and maintaining
the holding tank in such a manner as to prevent or abate any nuisance or health hazard caused by the holding tank. The municipality shall notify
the owner of any costs which shall be paid by the owner within thirty (30) days from the date of notice. In the event the owner does not pay the
costs within thirty (30). days, the owner specifically agrees that all of the costs and charges may be placed on the tax roll as a special assess-
ment for the abatement of a nuisance, and the tax shall be dollected as provided bylaw.
3. The owner, except as provided by s. 146.20 (30) (d), Stats., agrees to contract with a person who is licensed under Ch. NR 113, Wis. Adm. Code to
have the holding tank serviced and to file a copy of the contract or the owner's registration with the municipality and with the county. The owner
further agrees to file a copy of any changes to the service contract or a copy of a new service contract with the municipality and the county within
ten (10) business days from the date of change to the service contract.
4. The owner agrees to contract with a person licensed under Ch. NR 113, Wis. Adm. Code who shall submit to the municipality and to the county a
report in accord with s. ILHR 83.18 (4) (a) 2., Wis. Adm. Code for the servicing on a semiannual basis. In the case of registration under
s. 146.20 (3) (d), Slats.. the owner shall submit the report to the municipality and the county.
5. This agreement will remain in effect only until the local governmental unit responsible for the regulation of private sewage systems certifies tha!
the property is served by either a municipal sewer or a soil absorption system that complies with Ch. ILHR 83, Wis. Adm. Code. In addition, thi;
agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permi
the existence of the certification to be determined by reference to the property.
6. This agreement shall be binding upon the owner, the heirs of the owner and assignees of the owner. The owner shall submit the agreement tc
the register of deeds and the agreement shall be recorded by the register of deeds in a manner which will permit the existence.of the agreemen
to be determined by reference to the property where the holding tank is installed.
Owner(s) Name(s) (Print) Owner(s) Signature(s)
Oliver A. Humphrey Subscribed and sworn to before me on this date
Au ust_ 16, 1990
1 i
I f
Municipal Official Name (Print) Municipal Official Signature Notary Public
My c
ommissio expires: ,12-26-93
John R. Griebler Q , Y, . tj~,
Municipal Official Title (Print)
Chief Code Enforcement Officer
SBD-6123 (R. 10/85) This instrument was drafted by the State of Wisconsin Department of Industry. Labor and Human Relations, Bureau of Plumbing.
IQQC', 8 / 8 PAGE 622
i
Recorde& in Volume 3 page 399
Part of the NE 1/4 of the NE 1/4 of Section 36, T28N, R19W,
lying South of the Kinnickinnic River described as follows,
to-wit: Beginning at the point of intersection of the South
line of the NE 1/4 of the NE 1/4 of the above Section 36 and
the centerline of the C.St.P.M.&O.R.R.Co. right-of-way; thence
West along the eighth line 141.7 feet; thence North on a line
making a deflection angle of 86°16' to the right to the center-
line of the Kinnickinnic River; thence Northeasterly along the
centerline of the Kinnickinnic River to the centerline of State
Trunk Highway 35; thence South along the centerline of State
Trunk Highway 35 to the South line of the NE 1/4 of the NE 1/4
of the above Section 36; thence West along said South line to
the point of beginning; excepting therefrom a strip of land 100
feet wide used as 'right-of-way by the C.St.P.M.&O.R.R.Co.
Also excepting the following described parcel as recorded in
Volume397 page 360.
Part of the NE 1/4 of the NE 1/4 of Section 36,T28N,R19W,
described as follows: Commencing on the South line of said NE 1/4
of the NE 1/4 and the centerline of State Trunk Highway 35; thence
N1°44'W on said centerline 83.5 feet; thence N85°24'W 237.6 feet;
thence N1°44'W 38 feet; thence N14°58'W to centerline of river;
thence SWly on said centerline to East line of right-of-way of
C.St.P.M.&O. Railroad; thence South on said East line to the
South line of the NE 1/4 of the NE 1/4; thence East on said'''
South line 451.4 feet to the place of beginning.Also commencing
on the South line of said Nel/4 of the NE 1/4 and the West
right-of-way line of the C.St.P.M.&O. Railroad; thence West on
said South line 91.7 feet; thence N3°45'W to the centerline of
the Kinnickinnic River; thence NEly on said centerline to the
West right-of-way line of Railroad; thence South on said West
fine to the place of beginning. St.Croix County, Wisconsin.-
OGOEN ENGINEERING COMPANY
CIVIL ENGINEERING AND LAND SURVEYING
113 WEST WALNUT STREET
RIVER FALLS. WISCONSIN 34022
OFFICE PHONE (715) 425-7631 FRANCIS N. OGDEN. P.C.
Jos 040. 90-1890
November 20, 1992
Tom Nelson
St. Croix County Zoning Office
824 Fourth Street
Hudson, WI 54016
Re: North Main Street Public Improvements Project, City of River Falls
i
Dear Tom;
This letter is to inform you that the private sewer systems for single
family residences owned by Carl Enstad, Amy Nelson and Oliver Humphrey
located in the E1/2 of the NE1/4 of Section 36, T28N, R19W, City of
River Falls were abandoned in August 1992 as required by Wisconsin
Administrative Code. The three homes are now connected to the public
sewer system of the City of River Falls.
Respectfull yours,
Francis H. Ogden
FHO/cn
19
4 f 1 [ JT
f
~4 1
Violation Number Form - S T C - 101
PRE SANITARY PERMIT ISSUANCE PROCEDURE
Location Section Township/Municipality Lot No. Blk. No. Subdivision
NYC ~4 1l 14 3( IT o~ b N R /9 W -/?/yc)?_ Fg1-i s I I l
Procedure prior to sanitary permit issuance where a septic tank must be replaced
during winter weather or other health emergency and soil evaluation or other sys-
tem evaluation cannot be conducted.
1. Obtain assurance that the property owner is aware of further requirements
for a system evaluation.
2. Obtain assurance that owner is aware that if system is found to be
failing, it will be their responsibility to replace it with a code
complying system.
AFFIDAVIT T//Oqq BE SIGNED BY PERSON REQUESTING THE SANITARY PERMIT:
I, the undersigned do hereby acknowledge
that I am receiving a sanitary permit to put in a 1500 gallon holding tank
without a soil and system evaluation due to inclement weather or health emergency.
Furthermore, I acknowledge that a soil and system evaluation will be conducted
as weather permits and that if the system is then found to be failing as defined
in Section I L H R 83.02 (18), Wisconsin Administrative Code, it will be replaced
with one that complies with Chapter I L H R 83 of the Wisconsin Administrative
Code. If temporary pumping is to be utilized for maintaining a newly installed
septic tank, due to failure of the system, the tank shall be maintained by a
licensed pumper in accordance with N R 113, Wisconsin Administrative Code.
SIGNED
, bL4~',
JIA~~
DATE Gl- j d
A copy of an affidavit in lieu of EH 115 along with the PLB 67 must be submitted
to the Plumbing Bureau for purposes of fee reimbursement.
-/990
Signature of Applica t D to
Subscribed and sworn to"before me
STATE OF WISCONSIN
This day of fGli. 19
SS.
COUNTY OF /E12 C
Notary Public, State of Wisconsin
CO 7 8 My Commission Expires:
y kit t
Jtfy L 1
1000
S . NGOFF
L r j ti a~ A~J~
f v
OGDEN ENGINEERING COMPANY
CIVIL ENGINEERING AND LAND SURVEYING
113 WEST WALNUT STREET
RIVER FALLS. WISCONSIN 54022
OFFICE PHONE (715) 425-7631 FRANCIS H. OGDEN. P.E.
roe No. 90-1890
November 20, 1992
Tom Nelson
St. Croix County Zoning Office
824 Fourth Street
Hudson, WI 54016
Re: North Main Street Public Improvements Project, City of River Falls
Dear Tom;
This letter is to inform you hzktr~-t•-he,. sewer---systems for single
family residences owned arl Ensta Amy Nelsond Oliver Humphrey
located in the E1/2 of t - `72 , R19W, City of
River Falls were abandoned In 1..1992 as required by Wisconsin
Administrative Code. The three homes are now connected to the public
sewer system of the City of River Falls.
Respectfull yours,
w n
Francis H. Ogden
FHO/cn
fill'
~
C Y.
9
r
OGOEN ENGINEERING COMPANY
CIVIL ENGINEERING AND LAND SURVEYING
113 WEST WALNUT STREET
RIVER FALLS. WISCONSIN 54022
OFFICE PHONE (715) 425-7631 FRANCIS H. OGDEN. P.E.
JOB CIO. 90-1890
November 20, 1992
Tom Nelson
St. Croix County zoning office
824 Fourth Street
Hudson, WI 54016
Re: North Main Street Public Improvements Project, City of River Falls
Dear Tom;
This letter is to inform you that the private sewer systems for single
family residences owned by Carl Enstad, Amy Nelson and Oliver Humphrey
located in the E1/2 of the NE1/4 of Section 36, T28N, R19W, City of
River Falls were abandoned in August 1992 as required by Wisconsin
Administrative Code. The three homes are now connected to the public
sewer system of the City of River Falls.
Respectfull yours,
n
Francis H. Ogden
FHO/cn
cr_^
~lJ
9
N
City of River Falls
River Falls, Wisconsin 54022 • 715-425-6715
City of River Falls
July 11, 1990
i
Oliver Humphrey
78 Highway 35 N
River Falls, WI 54022
Re: Temporary 1500 gallon holding tank
Dear Mr. Humphrey:
It has come to our attention that your septic tank has collapsed
causing a problem about whether or not you need to replace this
tank and field. As you are aware, you have been annexed to the
City of River Falls and it is anticipated that water and sewer
will be available to your property by 1993. It is also our
understanding that if you were to replace your septic system at
this time it would cost in the neighborhood of $10,000.00 and at
the time the City sewer and water becomes available you would be
required to hookup to these services.
Therefore, an inquiry has been made as to whether or not we would
allow a holding tank as a temporary measure to save these
expenses. At this time the City would approve the use of a
holding tank and would cooperate with you in any reasonable
manner to save you these expenses.
It is also our understanding that the proposed tank will be
properly abandoned at the time you hook up to City services, and
in the interim it will be pumped as needed.
If you need any further information or documentation please feel
free to contact me at City Hall, 425-0900. ,
sincerely,
-t JQ"
Joh14 Griebler
Chief Code Enforcement Officer
JG:mf
cc: Utility Department
Engineering Department
Planning Department