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Parcel #: 040 - 1249 -50 -000 05/07/2008 11:47 AM
PAGE 1 OF 1
Alt. Parcel #: 19.28.19.1297 040 - TOWN OF TROY
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner
O - GLASNAPP, SUE E
SUE E GLASNAPP
268 TROON CT
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): ' = Primary
Type Dist # Description ' 268 TROON CT
SC 4893 RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 1.102 Plat: 06- 089 -TROY VILLAGE 1997
SEC 19 T28N R19W SW NW LOT 55 TROY Block/Condo Bldg: LOT 55
VILLAGE
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
19- 28N -19W
Notes: Parcel History:
Date Doc # Vol /Page Type
01/03/2005 784005 2724/610 QC
05/15/2002 679011 1890/487 WD
05/15/2002 679010 1890/486 WD
01/07/1998 570911 1286/561 WD
more. -
2008 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07122/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.102 207,000 622,500 829,500 NO
Totals for 2008:
General Property 1.102 207,000 622,500 829,500
Woodland 0.000 0 0
Totals for 2007:
General Property 1.102 207,000 622,500 829,500
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch #:
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total p 0.00 p 0 00 q 0 00
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No: 408234 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID N
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village X Township Parcel Tax No: OLC0
Glasna , J.G. I Troy Townshi
CST BM Elev: I Insp. BM Elev: BM Description:
8% - SIo2 -3�
TANK INFORMATION EL@VA TION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Be mar -
w�t S��- 1296 G
Dosing Alt.
2 .sfl % g• `fo
Aeration Bldg. Sewer
Holding SUHt Inlet
St/Ht Outlet
TANK SETBACK INFORMATION 5 • $�r
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic 2S ! �`� _ � Dt Bottom
Dosing Header /Man. F-73
Aeration `' `\!6 -. % 3• ce
Holding 113of. System • v3 G/ '� g�, f
�I,D D Ov
PUMP /SIPHON INFORMATION Final Grad
Manufacturer Demand St Cover
GPM
Model Numb
TDH Lift F 'ction Loss System ad TDH Ft
Forcemain Length Dist. to Well
SOIL ABSORPTION SYSTEM
BEDITRENCH Width Length t No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 2 l
SETBACK SYSTEM TO a P/L BLDG WELL LAKEISTREAM LEACHING Manufac
Type Of System: /
INFORMATION CHAMBER OR �t b
,rZ� 3 � ) UNIT Model Number:
J t
DISTRIBUTION SYSTEM 4- S; A--(N, i
Header /Manifold Distribution x Hole Siz cing Vent to Air Intake
U Pip _ x „�- 6 S 1
Length Dia Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges Topsoil Yes ❑ No Yes No
COMMEN In Jude co dis epen ies, persons preswt, tc� ) t Insp ction # : Q� i' / Z LIJ
' � p�jysZn.�v P S r--
Location: 268 Troon Court Huds , WI 54016 (E 1/2 24 T28N R20W) Troy illage Lot 55 No: 24.28 .20.1297
Y
1.) Alt BM Description 13+,
2.) Bldg sewer length
amount of cover = 1
Plan revision Required. [l Yes No — — <-- -_ -__— � Sgnature -
J
Use other side for additional information.
SBD -6710 (R.3/97) Date Insepctor's Cart. No.
Safety and Buildings Division County
201 W. Washington Ave., P.O. Box 7162
1 *hs Consin Madison, WI 53707 - 7162 olite Address --�'
Department of Commerce - 71 z
Sanitary Permit Application Sanitary Pe 't Number
In accord with Comm 83.21, Wis. Adm. Code, personal information you provide �
1 1 m ❑Check �Pe,- B on
may be used for secondary purposes Privacy Law, s 5
I. Application Information - Please Print All Information State P I.D. N umber
Property Owner's Name / Parcel Number • (29�
Q !i 04 - 219 p `m
Property Owner's Mailing Address kPro perty Location �c/
l Yvp- Si; S� ( T R -2®
City, State Zip Code Phone Number Lot Numbe r� Block Number
Subdivision Name CSM Number
H. Type of Building (check all that apply) 44 p - S w b ❑City
91 or 2 Family Dwelling - Number of Bedrooms ttw sp (� QVillage
❑ Public/Commercial - Describe Use � ownshipt
❑ State O Nearest Road
C' fly
III. Type of Permit: (Check only one box online A (numbering scheme for internal use). Complete line B if applicable)
A. 1 ONew 2 ❑ Replacemem System 3 ❑ Replacement of 6 ❑ Addition to For County use
stem I I Tank Only stem
B. ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued
IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) k
44 ion - Pressurized In -Ground 2111 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland
22 ❑ Pressurized In -Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip line
45 ❑ At -Grade 46 ❑ Aerobic Trgament UrN 49 C] 30 ❑ Other t
V. Dispe rsal/'IYea nt Area Informatio c x S
Design Flow (gpd) V Dispersal Area ispersal Soif Application Percolation Rate Systent Ele9fdon Final Grade
Required Proposed Rate(Gals./Days/Sq.FL) (Min./Inch) Elevation
2o ;r
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Tanks Concrete Constructed Glass
New Existing
I Tanks Tanks
1 \ Septic or Holding Tank
Dosing Chamber
VII. Responsibility Statement - I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber' a (Print) Plumber's Signature MP/MPRS Number Business Phone Number
Plumber's Address (Street, City, State, Zip Code)
3('op— Ael
VIII. County /De artment Use Onl
),Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps)
Surchar e`Fee)
❑ Owner Given Initial Adverse
Determination
17X. Conditions of for Disapproval _
vu.t►w.. tot pf� �'l.t c.ax+►�C�2 ( S.
cc "F:C.a�t
complete plans (to the County only) for the system on papa' not leas than 81/Z x 11 inches In size
SBD -6398 (R. 05101)
--tom
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Wisconsin; Department of Industry SOIL AND SITE EVALUATION REPORT Page of 3
Labor and Human Relations
G..iisior of safety a Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 8 111 `' hies• in Titer must include, but 5T. C1� `x
not limited to vertical and horizontal reference point direction %of, e, scale or PARCEL I.D. ff
dimensioned, north arrow, and location and dista eare -�
APPLICANT INFORMATION PLEASE PR - TALL INFO A� IAN REVIEWED BY GATE
'} PROPERTY OWNER: ' .,:; LOCATION E , 1 S ?Zg itl C.
1 6#11 ap.x } TI 0M AS 1� t�rx X VJ YZt74,S 1 4 7 2 N,R 19 JsW W
PROPERTY OWNER':S MAILING ADDRESS ` ` ' ,1
QNI O BLOCK SUED. NAME OR CSM #
T : ' F — - rRcy VtLL IE
CITY, STATE ZJP CODE PH �, f ITY OVILLAGE ®I NEAREST ROAD
h+Uzb wT 5 (0 - ray
CT N, F
New Construction Use PQ Residential ! Number of bedrooms 4 (j Addition to existing building
j ( Replacement [ I Public or commercial describe
Code derived daily flaw W D gpd Recommended design loading rate . 0 - ( ` bed, gpd/tt? b trench, gpdM
Absorption area required I tl.pp_ bed, ft x n trench, fit Maximum design loading rate _,,.7— gpd /ft gpolft
Recommended infiltration surface elevation(s) Tb t3F 1DmiEwftn 8 as referred to site plan benchmark)
Additional design/ site considerations --
Parent material 5A4NOSTON E I GL AC.I8L_ Tl LL_ Flood plain elevation, if applicable IUflr it
S =Sui T IN System TONAL MOUND IN*GROUND PRESSURE AT -GRADE SYSTEM IN RLL HOLDING TANK
U= Unsuitable for system S❑ U S❑ U w S O U 0 S ❑ U ❑ S lZ U 0S U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure ConsistanceI Boundary Roots GPD /ft
in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed Tmnch
1 a--rZ 10 1 1Z zIZ "' 51 1 mSb 5 — 0.
Z lZ -1cg low V12 511 Z YYI;SbK rx 4T Q5 0.
Ground 3 1$ -Z$ 3 s E . OS m 1 q - 0.7 0.
elev.
�lo_7ft 'i Z.2 -Z lng!yk 7:: 0.�
Depth to
limiting
factor �
Remarks:
Boring # I o - 16 10 yK Z•/Z 15 I M--,b CS 0
> � 7 - io-25 101 K - St Z m5b '
Ground
elev. y 34
S�Zft
Depth to
limiting
factor
Remarks: ALL 401 =MS RAYr SOME Gg- ftgl.-
CS T Name:- Please P 0 E Phone: C715 42 S- qJ t
"63 ST 1V >A 2L
Sign
Date Ze .i�A, Q CI TNumber:
V . L�. Q M 0370
�PROPEU?OWNER 50HA SOIL DESCRIPTION REPORT Page Z of 3
PARCEL I.D. #
Depth Dominant Color Mottles Structure GPD /ft
Boring # Horizon in. Munsell Ou. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Bed Trerxt�
v
0- 2!z — S1 I rn — 0. QS
Z q -zo D 111 _ Sl 2m b K C-S -- 0.
Ground 3 ?D-r7 10 y K 41 b :5 rn
elev.
7( 7 ft
Depth to
limiting
f .7Y7 ,� 2
Remarks:
Boring #
0-q 1 fi y K Z m S IA A
<n' Z - Iqf 10 2 5 r rn l 0.7 iol
Ground Q — b.�
elev.
Depth to
limiting
factor
Remarks:
Boring #
; �. ► o -�► to �k 7-1 z_ I rnsbK m o S
M a
y90 Z. 1 10-1 K 14 4
Ground (7 m l — _
elev.
2.3ft.
Depth to
limiting
factor
� +t
Remarks: }-}OftZONS 3 1 . -DEAF- GIC,VEL
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
S604I 0(R.05/92)
Page 3 or 3
•' r PLOT PLAN
Property Owner �U ML -mac 0 - 5/QiEXC W �
Legend:
NdMO
Legal Description LDT � BM = ® SPIKE IN u SIDE OF 8V
V 1 " CDCM•ED IN`TfW �'lz SZq. Eoo�
TZSt (Lzovi W` /Z, S 14 - MZAJ� 1R 19W f:�VMIoN 173• If
- MWnl OFI - ftY,, St CMIX COUAMI Wr, = soil boring w /backhoe
�SZE S UXYF - Y MOP aX COrAW-T
Lar uNf: AN e- •)
O LOT
-5 4-
EL— goo.
d �
15 1- S(o I . Z 1'
49 4.
LOT �� 02r9i,�r�
SS E�SEir�Ei�/
O pQ T
4- 1
A(
®ern
v
a
35-
DoT
Signed =t
M05707
Date MOV. ?h)9%
) ay. ItfotC Z7, /997
4
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Private Onsite Wastewater Treatment System Management Plan
.Septic Tank And Gravity in- Ground Soil Absorption Component
Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment
System (POWYS) shall include information and procedures for mainta the s within
the parameters of Comm 83 and 84, and the conditions of approval by the department, agent,
or governmental unit. The approved plans and permits for system are on file at the county
zoning or health department.
This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground
Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD-
10567-P (R.6/99).
Tabl 1: System Des i n S eciflcetions
Sanitary Permit Number
Number of Bedrooms
Design Flow - Peak pd) o"11>
Estimated Flow - Avera o^d
Septic Tank Capacity (gal) 2s2
Soil Absorption Component Size (ft) S f
•
Type of Wastewater Domestic
Table 2: Soil Absorolo n Component - Limits of Reliable Operation
Septic Tank Component Soil Absorption Comporont
Design Flow - Peak / —';;� U Z- T 04 Ir"
Maximum influent Particle Size (in) 118
Maximum BOD m L 220
Maximum TSS (mg/Lj (mg/L 150
Table 3: Maintenance Schedule
Septic Tank Inspect and/or service once every 3 years
Outlet Filter Inspect once a year and dean at least once every 3 years
Soil Absorption Component Inspect once every 3 years
Septic Tank
The septic tank shall be maintained by an individual certified to service sep tic tanks
under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with
NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease
Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable
Restrooms).
The operating condition of'th se tic tank and outlet filter shall be assessed at least
once every 3 years by inspection. The outlet filte shad be cleaned as necessary to ensure
proper operatio The filter cartridge should not be removed unless provisions are made to
retain solids in the tank that may slough off the filter when removed from its enclosure. If the
Management Plan for a Septic Tank and Soil Absorption Component
filter Is equipped with an alarm, the filter shall be serviced if the alarm Is activated continuously.
Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The
septic tank shall have its contents removed when the volume of scum and sludge in the tank
exceeds 113 the liquid volume of the tank. if the contents of the tank are not removed at the
time of an assessment, maintenance personnel shall advise the owner of when the next service
needs to be performed to maintain less than maximum scum and sludge accumulation in the
tank.
Manhole risers, access risers and covers should be inspected for water tightness and
soundness. Access openings used for service and assessment shall be sealed watertight upon
the completion of service. Any opening deemed unsound, defective, or subject to failure must
be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by
an effective locking device to prevent accidental or unauthorized entry into the tank.
No one should enter a septic or other treatment or holding tank for
any reason without being in full compliance with OSHA standards for
entering a confined space. The atmosphere within the septic or other
trratnrent of holding tank may contain lethal gases, and rescue of a
person from the Interior of the tank may be difficult or impossible.
Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the
tank is no longer used as a POWTS component.
Soil Absorption Comoonent
The soil absorption component serving this structure is designed to accept domestic
wastewater from a residential facility. The limits of operation of this component are shown in
Table 2.
The longevity of a soil absorption component depends greatly on proper and timely
maintenance, and system use within or below the limits of reliable operation. Good water
conservation practices by all occupants and the installation of water conserving plumbing
fixtures are key factors in extending the useful life of this component.
The soil absorption component's operation must be assessed by inspection at least
once every three years. The inspection shall include recording the levels of ponding, if any, in
the observation pipes, and a visual Inspection for any evidence of surface seepage or discharge
from the component. On steeply sloping sites, areas of erosion should be identified and
reported to the owner for repair. The surface discharge of domestic wastewater or sewage
from the system Is prohibited and considered a human health hazard.
Traffic around or over the soil absorption component should be avoided particularly
during winter months. The compaction or removal of snow cover over the component may lead
to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or
impossible to repair until weather conditions improve. In general, soil compaction over this
component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to
more intense, and earlier, organic clogging of the soil.
2
CONTINGENCY PLAN
If the POWTS falls and cannot br repaired the following measures have been, or must be taken, W provide a code cOmpllant
replacement system.
A suitable replacement area has been evaluated and may be utilized for the location of a replacement $oil absorption
system. The replacement area should be protected from dls rbance and compaction and shoutid got be 1MrtM4 vpon by
required setbacks from exbting and proposed svucwre, Iot lines and wells. Failure to protect the replacement area will
result In the need for a new soil and site evaluation to escabllsh a sulwMe replacement area. Replacement systems roust
comply with the roles In effect at that dme.
Q A suitable replacement area is not available due to setback and/or soil llmlc2Wrd. part" advancts in POWTS techrwlop
a holding tank may be lnsuVed as a last resort to repfaoe the failed POINTS.
* The site has not been evaluated to Identify a suitable replacemirit area. Upon falturt of the POWTS a soli and site
evaluation must be performed to locate a suitable replacewwrtt irea. if n0 replacemunt area Is avaliaWe a holding unk may
be insulted as a last resort to replace the failed POWTS.
O Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biome at the
Infiltrative surface. Reconsuvctlons of such systems must comply with the rules in effect at that dme.
< <WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT
OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TRZATMENT TANK UNDER ANY CIRCUMSTANCES.
DEATH MAY RE$IJLT, RESCUE Of A PERSON FROM WE INTERIOR Of A TANK MAY It DIFFICULT Olt
IMPMURI i.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name � - �/ /, 7 Na me
Phone his - -/ -4 y Phone
SEPTAG€ $ERVICIKG OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Agency S C ro' �o a
one / 5 - Po
Mdnagomnt Plan for a Septic Tank and Soil Absorption Component
Plantings of deep-rooted trees and shrubs directly over or within ten feet of the
component should be avoided since root intrusion into the component may obstruct wastewater
flow.
3
. v. vat V al � V V V .. ► a
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CER'T'IFICATION FORM
Owner/Buyer L !�2uE 6L- U 1a'Pa
Mailing Address -
Property Address 2 fP � TAN � IZ ✓�
(Verification requ from Planning Department for new construction)
City /State ZQyW 0 C VKIT Parcel Identification Number �1 • �Z�
LEGAL DIESCRiPTION
Property Location !aW '/4, SE '/., Sec. T ?�R ja W, Town of "j�Y
Subdivision 1 f' ,6 V l l lrA= P e§E Z . Lot # ..�
Certified Survey Map # 52tfi5`l . Volume Cv . Page # =
Warranty Deed # 6P I Volume ��� Page # All
Spec house ❑ yes ?( no Lot lines identifiable yes ❑ no
SYSTEM MAANTENANCE
Improper use and maintenanceof your septic system could result in its premature failumto. handle wastes. Proper maintem
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the sysi
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and b
masterplumber, journeyman plumber, restactedplumber ora licensedpumperverifying that(1) the on -site wastewaterdisposal sysi
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 full of sludgy
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the star
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Cerdficat
stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within
days of the three year expiration date.
Jr' / / 67
s A PLICANT DATE
OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners
the Property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
r I ATLIPLE^ APPLICANT DATE
* * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.
•* Include with this application. a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
I nVL r1CUULHI IUNS
UNIFORM DWELLING CODE (DEPT. OF COMMERCE)
PROJECTS AFFECTED • Straw bales, filter fabric fences or other barriers to
• All new 1 and 2 family dwellings in Wisconsin started protect on -site sewer inlets
on or after December 1, 1992. • Additional controls if needed for s
• Additions to dwellings built after June i, 1980. special conditions steep slopes or other
APPLICATION PROCESS MANMNANCE AN D WASTE DISPOSAL
lot • Sediment controls must be maintained until the site is
• Erosion control measures must be included on the
P stabilized by mulching and seeding, sodding or
plan submitted with the building permit application landscaping
the local building inspector in communities where the
dwelling code is enforced building waste must be properly disposed to pre -
• Plot plan must show: vent pollutants and debris from being carried off -site
— Location of the dwelling, other buildings, wells, sur- ENFORCEMENT
face waters and disposal systems on the site with • Erosion control inspections will be made during other
respect to property lines regular inspections footin and foundation rough inspections ( footing ugh con-
- Direction of all slopes on the site struction, final, etc.)
-- Location and type of erosion control measures • Violations must be corrected within 72 hours
• Stop work orders may be issued for noncompliance
CONTROLS REQUIRED FOR MORE INFORMATION, CONTACT
• Silt fences, straw bales, or other approved perimeter • Low building inspector
measures along downslope sides and side slopes • Department of Commerce, Safety and Buildings Divi-
• Access drive sion, P.O. Box 7969, Madison, Wisconsin 53707,
(608) 266 -2128.
STORMWATER PERMIT (DNR)
PROJECTS AFFECTED -- Proposed erosion and storm water pollution control
Any grading or construction project that disturbs 5 practices during and after construction
acres or more and is not covered by a building permit — Documentation that an erosion control and storm
• Smaller sites that are part of a planned development water management plan which meets DNR standards
involving 5 acres or more of land disturbance has been prepared (plan does not need to be submit-
• Effective October 1, 1992 for any new or continuing ted with the application)
project - -Other information related to site location and per-
• Exceptions: Indian tribal lands and work d mit holder
one by local
government staff
CONTROLS REQUIRED
APPLICATION PROCESS • Erosion control measures specified in the Wisco
• File a "notice of intent" application (Form #3400 -161) Construction Site Best Management Practice Handbook
with the Department of Natural Resources (DNR) 14 • Measures to control storm .water after construction
days before construction begins FOR MORE INFORMATION, CONTACT
• Application must include:
•
— Timetable for land disturbing activities and installa- qtr Department of Natural Resources, Storm Water Per-
, P.O. 7921, Madison, WI 53707 -7921, (608)
tion of erosion control measures including project mils, 78
start
and completion dates
LOCAL ORDINANCES
Check with your county, and city, village or town for any local erosion control ordinances including shoreland zoning
requirements. Except for new 1 & 2 family dwellings, local ordinances may be more strict than state regulations. They
may also require erosion control on c
ortstruction
projects not affected by state or federal regulations.
A publication of the University of Wisconsin - Extension in cooperation with the Wisconsin Department of Natural Resources and Department of
Commerce, Ron Struss, Water Quality Educator, UWEX Western Area and Carolyn D. Johnson, Urban Water Quality Educator, UWEX Southeast Area
UW- Extension provides equal opportunities in employment and programming. This publication is available from county UWEX offices or from Extension
Publications, 630 W. Mifflin St., Madison, WI 53706, (608) 262 -3346. Copyright 1997 by the Board of Regents of the University of Wisconsin System
doing business as Cooperative Extension, University of Wisconsin - Extension. Send inquiries about copyright permission to Director, Cooperative
Extension Publications, 201 Hiram Smith Hall, 1545 Observatory Drive, Madison, WI 537D6.
GW0001A Standard Erosion Control Plan for i & 2 Family Dwelling construction Sites DNR: VVT- 458-96
R -02-87 2M-10-S
EROSION CONTROL PLAN CHECKLIST
a Check (d) appropriate boxes below, and complete the site diagram with necessary information.
F
Site Characteristics
(� North arrow, scale, and site boundary. Indicate and name adjacent streets or roadways.
❑I Location of existing drainageways, streams, rivers, lakes, wetlands or wells.
❑ , Location of storm sewer inlets.
Location of existing and proposed buildings and paved areas.
The disturbed area on the lot.
App g APA g dient and direction of slopes before grading operations.
Approximate gradient and direction of slopes after final grading operations.
❑ Overland runoff sheet flow co
( min onto the '
9 site from adjacent areas.
Erosion Control Practices
❑ Location anon of temporary soil p
storage Iles.
Note: Soil storage Iles
9 p should be placed behind a sediment fence, a 10 foot wide vegetative strip, or should be
covered with a tarp or more t han 25 feet from any downslo road or draina
Pe geway.
Location of access drive(s).
Note: Access drive should have 2 to 3 inch aggregate
Drives 9g gate stone laid at least 7 feet wide and 6 inches Chic
es should extend k•
d from the roadway 50 feet or
y to the house foundation whichever is ( le ss).
J ❑ Location of sediment controls (filter fabric fence, straw bale fence or 10 -foot wide
vent eroded soil from i vegetative strips) that will re-
leaving the A
g site.
4 Location of sediment barriers around on -site storm sewer inlets.
❑ /Location of diversions.
it s
Note:
Although not specifically required by code, it is recommended that concentrated flow ( drainageways) be
diverted (re- directed) around disturbed areas. Overland runoff (sheet flow) from adjacent areas greater than
10, 000 sq. ft. should also be diverted around disturbed areas.
❑ Location of practices that will be applied to control erosion on steep slopes (greater than 12% grade).
Note: Such practices include maintaining existing vegetation, placement of P additional a sedim fences diversio
a re- vegetation by sodding or by seeding with use of erosion control mats. ns,
a
❑ PKLocation of practices that will control erosion in areas of concentr nt ated runoff flow.
Note: Unstabilized drainageways, ditches, diversions, and inlets should be protected from erosion th rough
such p ractice s rough use of
p es as in- channel fabric or straw a bale barriers, erosion control mats, staked sod and -
given in-channel rock rip rap.
When used, a
e barrier 9 should not receive drainage from more than two
area, or one acre of paved area. !n- channel practices should not be installed in perennial streams (streams
with year -round flow.)
❑ Location of other 1
e planned practices not already noted.
D
^�D e c� Indicate management strategy by checking (,") the appropriate box:
r Q
Z -Temporary Management Strategies
ED stabilization of disturbed areas.
Note: It is recommended that disturbed areas and soil piles left inactive for extended periods of time be stabilized
by seeding (between April Ist and September 15th), or by other cover, such as tarping or mulching,
�7 Permanent stabilization of site by re- vegetation or other means as soon as possible (lawn establishment).
Indicate re- vegetation method: Seed ❑ SodZi Other ❑
Expected date of permanent re- vegetation: 5Li f D2
Re- vegetation responsibility of: Builder ❑ Owner /Buyer
is temporary seeding or mulching planned if site is not seeded by Sept. 15 or sodded by Nov. 15? Yes ❑ No ❑
❑ ` Use of downspout and /or sump pump outlet extensions.
Nate: It is recommended that flow from downspouts and sump pump outlets be routed through plastic drainage
pipe to stable areas such as established sod or pavement.
❑ Trapping sediment during dewatering operations.
Note: Sediment -laden discharge water from pumping operations should be ponded behind a sediment barrier until
most of the sediment settles out.
Proper disposal of building material waste so that pollutants and debris are not carried off -site by wind or water.
Maintenance of erosion control practices.
Sediment will be removed from behind sediment fences and barriers before it reaches a depth that is equal to
half the barrier's height.
Breaks and gaps in sediment fences and barriers will be repaired immediately. Decomposing straw bates will be
replaced (typical bale life is three months).
• All sediment that moves off -site due to construction activity will be cleaned up before the end of the same workday.
• All sediment that moves off -site due to storm events will be cleaned up before the end of the next workday.
• Access drives will be maintained throughout construction.
• All installed erosion control practices will be maintained until the disturbed areas .they protect are stabilized.
For more assistance on plan preparation, refer to Chapters ILHR 20 & 21 of the Wisconsin Uniform Dwelling Code,
the DNR Wisconsin Construction Site Best Management Handbook, and UW— Extension publication Erosion Control for
Horne Builders.
The Wisconsin Uniform Dwelling Code and the Wisconsin Construction Site Best Management Handbook are available
through State of Wisconsin Document Sales, 608/266 -3558.
Erosion Control for Home Builders (GW0001) can be ordered through Cooperative Extension Publications, 608/262 -3346
or the Department of Commerce, 6=267-4405.
Standard Erosion Control Plan
for 1 & 2 Family Dwelling Construction Sites
According to Chapters ILHR 20& 21 of the Wisconsin Uniform Dwelling Code, soil erosion control informa-
tion needs to be included on the plot plan which is submitted and approved prior to the issuance of building
permits for 1 & 2 family dwelling units in those jurisdictions where the soil erosion control provisions of the
Uniform 'Dwelling Code are enforced. This Standard Erosion Control Plan is provided to assist in meeting
this requirement.
Instructions:
1 . Complete this plan by filling in requested information, completing the site diagram and marking (✓) appropriate boxes
on the inside of this form.
2. In completing the site diagram, give consideration to potential erosion that may occur before, during, and after grading.
Water runoff patterns can change significantly as a site is reshaped.
3. Submit this plan at the time of building permit application.
Site Diagram Scale: 1 inch = feet
EROSION
CONTROL PLAN
LEGEND
PROPERTY
LINE
EXISTING
DRAINAGE
TD TEMPORARY
DIVERSION
FINISHED
DRAINAGE
LIMITS OF
GRADING
SILT
FENCE
♦ STRAW
BALES
GRAVEL
O VEGETATION
SPECIFICATION
TREE
PRESERVATION
STOCKPILED
SOIL
Please indicate north
by completing the
arrow below.
N—
I
PROJECT LOCATION 4�P
BUILDER OWNER �� f '
WORKSHEET COMPLETED BY In Q DATE I o O c7i
. U 1890N y8?
6790 1 I
STATE BAR OF WISCONSIN FORM 2 - 1999 REGISTER OF DEEDS
Document Number WARRANTY DEED ST. CROIX CO., MI
This Deed, made between Bruce Lenzeu Home Inc. RECEIVED FOR RECORD
05 -15 -2002 8:00 AN
WARRANTY DEED
EIEWT i
Grantor, and J.G. Glasnapp and Sue E. Glasnapp, husband a wife REC FEE t 11.80
TRAITS FEE: 480:08
COPY FEE:
CERT COPY FEE:
PAGES: 1
Grantee.
Grantor, for a valuable consideration, conveys to Grantee the
following described real estate in St. Croix County,
State of Wisconsin (if more space is needed, please attach addendum):
Recording Area
Name and Retum Address
Lot S toy Village Addition in the Town of Troy, St. Croix County, �'
sconsin.
? - S3/3'
040. 1249 - 50.000 • ` tq
Parcel Identification Number (PIN)
This /.l Ay6 hom teed property.
(is) (is not)
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any.
Dated this /77 day of May 20
Brnce nun. Homes, Inc.
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
a +/ ) ss.
County )
authenticated this day of J, C: Personally came before me this /,NQ day of
May 2002 the above named
—AA Bruce Lenzen, Home Inc.
BEVERB� A uma TITLE: MEMBER STATE BAR C+� hh OF �gt5 r a on(s) who executed the foregoing
(If not, h dged the same.
authorized by § 706.06, Wis. Stets.) THIS INSTRUMENT WAS DRAFTED BY
Attorney K Ogland e of Wisconsin
Hudson, Wi 54016 m'ssi is perm ent. (If not, state ex ' a' te:
(Signatures may be authenticated or acknowledged. Both are not necessary.) )
Names of persons signing in any capacity must be typed or printed below their sign re. trxo m.+ae rroa•do w• caep•nr. Fong mr ue, tM
aoo- asstoz+
WARRANTY DEED STATE BAR OF WISCONSIN
FORM No. 2 -1999
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* Labor Department of Industry SOIL A N D SITE EVALUATION REPORT Page o 3
Labor and Human AAlatons
G.Asion of Safety & Stbidings in accord with ILHR 83.05, Wis. Adm. Code
.COUNTY
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but CK� lx
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance t
`` yy r `'`" REVIEWED BY DATE
APPLICANT INFORMATION- PLEASE PRI �IFORAIATI�
PROPERTY OWNER: OPERTY LOCATION F- a, 5 24 TZ$ &I K-x vi
3644u u l °t:,�' V+IYZ ,S 14 T 2.g N,R lq W
PROPERTY OWNER':S MAILING ADDRESS AAR 1 � # BLOCK # SUBO. NAME OR CSM #
26 X ,, 19 - ._ 1 V1Lu46E
CITY, STATE ZIP C00 HONE X ITY QVILLAGE DOWN NEAREST ROAD
V}Uas wz 54016 Z. - r KO C; r. 4. F
New Construction Use PQ Residential 1 (] Addition to existing building
j ] Replacement ( ] Public or wmmer '
Code derived daily flow _I &M and Recommended design louring rate 0 - ( ` bed, glXW : trench, gpd/ft
Absorption area required I n n 0 bed, ft trench, 9 Maximum design loading rate _ bed, gpd/ft fti. L trench, gpd/R
Recommended infiltration surface elevation(s) Tb C3'E"7ETfxMtnl W Q g. f as sr referred to site plan benchmark)
Additional design / site considerations
Parent material SA4 OSMA4 / GLACIAL - rILL_ Flood plain elevation, if applicable N ft
S - Suitable for system wdNAI MOUND &GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U- unsuitable fors stem 0 S ❑ U S U 0 S ❑ U ZS ❑ U ❑ S jZ U ❑ S U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounck3y Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tmnc h
1 Z- i o -- 51 1 r"Sb 0-
S —
0 � zl z
2 lZ - )'q f or 311, -" 5 11 Z vn* rn 4 T c — 0.:5
Ground 3 1$ -Z$ 3 h - 0 rn 1 Q -' 0.7 0. V
elev.
JQJ-ft. y a - 8q iaw 05q 1 -- - n 1 10.1
Depth to
limiting
factor
Remarks:
Boring #
I 0 - 1(o 10` K z/z 15 1 msb c5
l a l Z b - 2 - 6 10 ' V 3 St 2 m CS
Ground - 0 ,3 S41 rn � 0,
elev. y 3 - 1 + m — .7 10-
S�Zft.
Depth to
limiting
factor
.q
Remarks: A LL 4=24 WS RAve S4MF- C,9M&=
T Name—Please P O E Phone: (� 5 1 42 S- 1 1 I(
19 �+. S t V SA ZZ --
Si Zy T Number:
n U, LL. tqQ M 05707
PROPERTYOWNER f�UEMM��,E St+�} SOIL DESCRIPTION REPORT Page? of 3
PARCEL I.D. #
Depth Dominant Color Mottles Structure GPO /ft
Boring # Horizon in. Munsell Ou. Sz. Cont Color Texture Gr. Sz. Sh. Cons Roots Bed Trerxfi
1 0- 21z — S1 1 rn 4 .S
z q - Zo 1 0YR V — St Z S 6 r n& 0.
Ground 3 120-r7 1 0 y K 4/ b yy\ , 7 0$
elev.
71 -7 ft.
Depth to
limiting
factor
5
Remarks:
Boring #
16 IC Z — S rn b K G 5 f 0,7 i
:489::2 Z - i 4 o U S r M I — 0.7 io.T
Ground
elev.
Depth to
limiting
fac
Remarks:
Boring #
I o -)► 1 \f K, msbK m as
y9D�a Z 11-x`6 1 o Y K 4 /q S Y OLsq M I i 0.
Ground 3 2`d 0 i o 14 S (� m 1 —
elev. 3ft.
Depth to
limiting
f ac tor t
Remarks: 1-- ouzi3N5 I 3 14MIe' .gyp. G; K44 el-
Boring #
f•
Ground
elev.
n
Depth to
limiting
factor
Remarks:
SB0- M0(R.05M2)
Page 3 0� .�
PLOT PLAY
Property Owner u = q61 &XC�w�E
Legend : — ,101-e-a
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