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HomeMy WebLinkAbout032-2121-10-000 ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner 4 5 r JJ Property Ad ess ���5•c�_ 1 ,° . s � r LINT Y (C3llM F�1 6 � City /State rc Lega Description: j Lot `f' Block Subdivision/CSM # tZj4, Sec %E , T N-R1 W, Town of r PIN # SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION Tank manufacturer Size ST/PV, Setback from: House ;�<9 Well 4 P/L 7 2Z 7 Pump manufacturer Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location ,J SOIL ABSORPTION SYSTEM /��JJ Type of system: Width Length 7 _5�' — Number of Trenches O� Setback from: House Well /L s Vent to fresh air intake t� ELEVATIONS Description of benchmark Elevation --� Description of alternate benchmark Elevation Building Sewer 0' °2 /ST/HT Inlet r SST Outlet PC Inlet PC Bottom Header/Manifold Top of ST/PC Manhole Cover Distribution Lines Bottom of System (�Z) Final Grade go Date of installation / /1� Permit number State plan number Plumber's si natule �� License number ,22 O J� 7 Dated / Inspector Complete plot plan Or I NOTICE Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. P LAN VIEW J • I L 4 �t? C i INDICATE NORTH ARROW II • Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count y Safety and Buildings Division INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 353134 Permit Holder's Name: ❑ City ❑ Village Q Town of: State Plan ID No.: Town of Somerset CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: Orb .0 t • 0 V c� =CST 032- 2121 -10 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 2:� Benchmark OS• K ov Dosing Alt. BM . 3 p ` - c Aeration Bldg. Sewer 1 344 / p2.3 Holding St/Ht Inlet oo r TANK SETBACK INFORMATION St/ Ht Outlet , �g too. if 7 TANKTO P/L WELL BLDG. Air to I ntake ROAD e ir Septic 7sp a - NA Dt --- Dosing NA Header / Man. "' Z R9 13 Aeration NA Dist. Pipe ' to >!! . it it Holding Bot. System � }0 B-10 s PUMP/ SIPHON INFORMATION Final Grade /00,8 Manufacturer Demand St cover OZ-o5 Model Number GPM TDH Lift Friction Syestem TDH Ft L oss Forcemain Length Dia. HH Dist. To well SOIL ABSORPTION SYSTEM TRENC Width Length No. f T enches PIT No. Of Pits Inside Dia. Liquid Depth DIME DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING Manuf c u er: INFORMATION Type of n , f /_ �• CHAMBER odp, Nu ber: System: l� . s 9 W OR UNIT DISTRIBUTION SYSTEM Header / Manifold �� Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only k 3 3 Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) Inspection #1: /// /IM Inspection #2: Location: 838 165th Avenue, Somerset, WI (SE1 /4, NW1 /4, Section 12 T30N -R19W) - 12.30.19.1093 ofjo W& Plan revision required? ❑ Yes rI No Use other side for additional information. YC SBD -6710 (R.3/97) Date Inspector's Signature Cert. No ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: n r j x ( k € t ° e E t F _ t € E ° Y e t f S S 4 � a >�m n i e a a ! 1 E E .....,- .x -- I � } _, - f ° S , y...<. , -._ � e 3 � � x � � t E z E 7 p 3 F t i a € m A # t _° .. � e i a e r e F � 3`" e a Vi sconsin Safety and Buildings Division SANITARY PERMIT Z 201 W. Washington Avenue ".,A P O Box 7302 Department of Commerce In accord with Comm 83.0 Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the sy etrl on paottoq des Couh,ty t than 8 1/2 x 11 inches in size. t • See reverse side for instructions for completing this apple at +bn 1 State anitary Permit Number - is Sr `, Personal information you provide may be used for secondary purposes ,,{� ❑ j k if revisiofi lb a vi us application (Privacy Law, s. 15.04 (1) (m)). Staxe Plan I.D. Number . I. APPLICATION INFORMATION - PLEASE PRINT ALL I TI Property Ow Name ' d Props yotat % c /4, S T 3� , N, R E (o Property Owner's Mail in A ress Lot Number Block Number 3 - oZ Cit State Zip Code Phone Number Subdivisio ame or C M N tuber 7 Gt Cc t I. TYP&OF BUILDING: (check one) ❑ State Owned 0 Lit Nearest Road Public a 1 or 2 Family Dwelling - No. of bedrooms [] Vil wn OF a per III BUILDIN USE: (If building type is public, check all that apply) Parcel Tax Number(s) ) �► , 12 j0, % , 1 0 13 1 ❑ Apartment /Condo © 3, 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 box on line A. Check box on line B, if applicable) A) 1 ­54 New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5_ ❑ Repair of an System ___ System ------------- Tank Only______________ Existing System __,_____ Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 1 �FEKJ Seepage Bed 21 E] Mound 30 E] Specify Type 41 E] Holding Tank 1Seepage Trench 22 E] In-Ground Pressure / I _ ,�, 42 C] Pit Privy 1 Seepage Pit t ! S 43 [] Vault Privy 14 E] System -In -Fill �� / ` f g VI. ABSORPTION SYSTEM ORM TIO : 1. Gallons Per Day 2. Absorp. Area 3. AbsoF . �fea 4. Loading Rate 5. Pert. Rate 6. System Elev. h7. Final Grade equired (sq_ ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) in. /inch) Lc _ evation ��G� Feet — Feet C VII. TANK in a gallo Total # of r Prefab. Site Fiber- Exper. INFORMATION New Existing strutted Gallons Tanks Manufacturers Name Concrete Steel glass Plastic App Tanks Tanks Septic Tank ' t� ❑ ❑ ❑ ❑ ❑ F ❑ ❑ ❑ ❑ 1 ❑ I ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plum Name: (Print) Plu er' ignature=Stam MP /MPRSW No.: Business Phone Number: lum s Address (Street, City, State, Z Code): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate I ssued Issuing Agent Signature (No Stamps) A roved Surcharge Fee) pp ❑ Owner Given Initial Adverse Determination - . CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SBD -6398 (R. 4/99) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. ' 2. Your sanitary permit maybe renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years - 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 508- 266 - 3151. - To be complete and accurate this sanitary permit application must include: t. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. Il. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scab or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss' um performance curve um model and um manufacturer D cross section P PP P of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices'w can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. .F r L T. mi l' O PLAN ADllRESS 1 /4 S// /'1' �� N /R�� /G� W 'TOWN d COUNTY / y � MPRS Byron Bird Jr. 220527 _ DA�rE ��� BEDROOM CONVENTIONAL )= IN- GROUND RESSURE CONVENTIONAL LIFT HOLDING TANK IN1IOU 'IN i) SEPTIC 'TANK SIZE LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE ABSORPTION ARE -t of chambers `BE:A'CIiAIARK V.R.P. � ASSUi E E[,I VA 100 ❑ BOREHOLE (D WELL *H.R.P. Vent SYSTEM ELEVATION 1 2" Sidewinder High ! of Cover Capacity Leaching Chamber with 31.8 ftA2 per chamber 6' Lon, 16" 34" Grade at System Elevation ti � l/ 64 �n J��a Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor aro Human Relations bivision of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code FPARCEL Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but . Croix n6t limited to vertical and horizontal reference point (BIA,- direction'and % of slope, scale or dimensioned, north arrow, and location and distanc„e°to nearest road. 032- 2045 -20 -200 APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION R VIEW D BY DATE PROPERTY OWNER: PROPERTY LOCATION Gerald Smith GO q. LOT SE 1/4 NW v4SJ12___ 30 N,R 19 tic(or) W PROPERTY OWNERS MAILING ADDRESS LOT BLOCK # SUBD. NAME OR CSM # 11160 190th. Ave. NW. na N. Bass Lake Estates First Ad CITY, STATE ZIP CODE PHONE NUMBER ❑ ITY [ XXOWN NEAREST ROAD Elk River, M. 55330 612) 441 -8688 Somerset 85th. St. [x] New Construction Use �c ] Residential/ Number of bedrooms 4 [ ] Addition to existing building ( ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd /ft .8 trench, gpd /ft Absorption area required 858 bed, ft 750 trenCtl,.ft Maximum design loading rate .7 bed, gpd /ft .8 trench, gpd /ft Recommended infiltration surface elevations f ' 97.6 It . area =97.15 It (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable stem ® S ❑ U RI S ❑ U ® S El ® S El U ® S ❑ U E] S L U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ITirench ................. .................. 1 0 -10 10yr3/3 none sicl 2msbk mfr 9W 2f .4 (.5 2 10 -20 10yr4 /4 none sicl lcsbk mfr gw if .2 .3 Ground 3 20 -84 7.5yr4/4 none co s Osg ml na na .7 .8 elev. 101 -, ft. Depth to limiting factor +841, 5 8� � Remarks: Boring # 1 0 -10 10yr3 /3 none sicl 2msbk mfr gw 2f .4 .5 2 << 2 10 -20 10yr4 /4 none sicl lcsbk mfr 9w if .2 .3 3 20 -84 7.5yr4/4 none cos Osc3 ml na _ .7 .8 Ground elev. ± 10 i Depth to limiting ! t• > >`° factor " t >> �Yl Remarks: N� °FF/Gi� CST Name: -- Please Print Gary L. Steel Phone: 715 246 - 6200 Address: 1554 200th. ye. New Richmood, WI 54017 Signature: O Date: 12 -1 -98 CST Number: m02298 PROPERTYOWNER Gerald Smith SOIL DESCRIPTION REPORT Page 2 • f 3 �o PARCEL I.D. # 032 - 2045 -20 -200 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft .................. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench ................. .................. ................. .................. 1 0 -15 10yr3 /3 none sici 2msbk mfr gw 2f .4 .5 2 15 -26 10yr4 /4 none sici lcsbk mfr gw if .2 .3 Ground 3 26 -84 7.5yr4/4 none co s Osg ml na na .7 .8 elev. 10 Depth to limiting factor +8 4 " L Remarks: Boring # 1 0 -9 10yr3 /3 none sici 2msbk mfr gw 2f .4 .5 4> 2 9 -19 10yr4 /4 none sici lcsbk mfr gw if .2 .3 3 19 -84 7.5yr4/4 none co s Osg ml na na .7 .8 ............... Ground elev. 9 - 4S ft. — Depth to - limiting factor +84" Remarks: Boring # 1 0 -12 10yr3 /3 none sici 2msbk mfr gw 2f .4 .5 ... <' S 2 12 -24 10yr4 /4 none sici lcsbk mfr gw if .2 .3 ................. 3 24 -84 7.5yr4/6 none co s Osg ml na na .7 .8 Ground elev. 10 Depth to limiting factor +84 61 Remarks: Boring # ................. Ground elev. j ft. Depth to limiting factor Remarks: SBD- 8330(R.05/92) STEEL'S SOIL SERVICE Gary L. Steel Gerald Smith 1554 200th Ave. CSTM2298 SE4Nw4 S12- T30N -R19w New Richmond, WI 54017 MPRSW -3254 town of Somerset (715) 246 -6200 lot #3 -N. BAss Lake Estates First Addn. a N 1 =40' BM.= top of 1 pvc pipe C el. 100' Alt. BM.= top of 1 pvc pipe C el. 98.95' j z �1 0 b S f ti a� �of< Gary L. Steel 12 -1 -98 9 -28 -1999 10 -54PM FROM GARY L STEEL 715 +246 +6200 P_1 STEEL'S SOIL SERVICE Gary L. Sreel Gerald Smith 1554 200th Ave. CSTM2298 SEV*A S12- T30N - -R19w New Richmond, WI 54017 MPRSW -3254 town of Severset (715) 246 -6200 lot *3 -N. BAss Lake Estates First Addn. 4 i • N 1'"=40 1 Bm.= top of 1" pvc pipe 0 el. 100' Alt. BN.= top of 1" pvc pipe 0 el. 98.95' U �a ,Iry ��� 8 * • 2 Bjlj 3 Gary L. Steel 12 -1 - 9B ST CROIX COUNTY SEPTIC'TANK MAINTENANCE AGREEMENT'` AND OWNERSHIP CERTIFICATION FORM Owner/Buyer �u r�!'� Mailing Address Property Address (Verification required from Planning Department for new construction) _� f ^ City /State Parcel Identification Number � 020? �� --0 0c) I LEGAL DESCRIPTION 1 Properly Location s V., 1&Z %, Sec. �, T ,_„ 2 0 , N -R_ , Town of t �r t jr e T Subdivision �4- of — • •.5� /� ` < . Lot # . Certified Survey Map # , Volume -- . Page # Warranty Deed #— 7 �� , Volume Page # Spec house ❑ yes J9 no Lot lines identifiable,0 yes ❑ no SYSTEM MAINTENANCE Improper use and maintenanceof your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days the three year expiration date. A 41 Dy /apl sg StMATURE P IC 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 owner(s) of the q perty described above, by virtue of a warranty deed recorded in Register of Deeds Office. Id7l SI NATURE bt APP ICANT 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 v9L 1458PAGE 193 • 610795 STATE BAR OF WISCONSIN FORM 2. 1998 KATHLEEN H. WALSH Document N umber WARRANWDEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Forest Oaks Condos, Inc., a Minnesota RECEIVED FOR RECORD Corporation 09 -2''c -1999 9:30 AM Grantor, conveys and WARRANTY DEED warrants to Darin H. Marck EXEMPT t CERT COPT FEE: COPY FEE: TRANSFER FEE: 91.50 Grantee. RECORDING FEE: 10.00 Grantor, for a valuable consideration, conveys and warrants to Grantee PAGES: 1 the following described real estate in St. Croix County, State of Wisconsin (The "Property "): Recordinx Area N Return Address and OGLAND UZ, Estreen & Ogland P.O. Box 359 Hudson, WI 54016 032- 2121.60 Parcel Identification Number (PIN) This is not homestead property. Lot 24, North Bass Lake Estates First Addition. Exceptions to warranties: Easements, restrictions and rights -0f - -way of record, if any. Dated this _ day of September, 1999. orest Oaks C c., a Minnesota Corporation * ACKNOWLEDGMENT AUTHENTICATION STATE OF WISCONSIN ) ) Ss. Signatures) Forest Oaks Condos Inc., a Minnesota County ) Corporation Personally came before me this day of authenticated this September , 1999, the above named to the day of September, 1999. known to be the person(s) who executed the foregoing instrument 140'A and acknowledge the same. • K I In s a Og L � r TITLE: MEMBER STATE BAR OF WISCONSIN Notary Public, State of Wisconsin (If tot, My Commission is permanent. (If ant, state expiration date: authorized by § 706.06, Wis. Slats.) ) TFIIS INSTRUMENT WAS DRAFTED BY Attorney Kristin Ogland Hudson, WI 54016 (Signatures may be authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity should be typed or printed below their signatures ,,., DEED STATL era OF WISCONSIN FORM No. 2_L 93 INFORMATION PROFESSIONALS COMPANY FOND DU LAC. WI 800655 -2021 -- ------- - - - - -- I - - ,ZZ'C *9 M„ OZ,9Z.00S--------- - - - - -- ,�o•z�� ,�z•«s I I nd ' W I n r- Q I I N O tp J ,00 c N M M N N , M„OZ,8Z.00S 0I • ` I • I I z I O - I t �kVM3A180 i- I , O l LS M III N I I I 1 Mo W M I r .., N N 1 I I (n I N I Z I h N N F- U: �S O I u11 I I N ^_ W W m S I >I I Q N< N: J � I I ai I J I 3 N N W) o 0 : i h W) 3 I 1 LLJ M , N M 5: ZO NI O m: I M I I �b 1 F-: I a J yr N to I a ' I I (Oi I z rl :I I , lZ' l l5 M„ OZ,9Z.00S I i I I I I I M „ZZ,ZC.00S I ( I to N to _ I I W 0) �O vii Q o l Z _ N N M 61 �I I n O N 1 ) O N M Z I - � M I � I I ,OO L , I ZZ.LLg Ld�4 3 „ZZ,ZC.00N vl 1 ll 3`Yn70�1 \ 00'ZC6 =A31 £f 3 1 (' f NO/103S 30 00838 d01 112104HON39 7 3N17 1 S I FF I I b'3 / \ I / \ I - - - -� ✓- - --- - - - - -- S S d 8 \\ H 1 �J 0 N OI \ J JI \ Z ' -�•• • ,. '• . .. ..> >>i (• .. .,�. • � .��y.l�:�ft T.��t' '�•'>.', � � a ,• . - i 2, � rte' .,�,..c.i •�.:4±•`•�rf ■ 1 ' { •':.�..�: C: -a -. �. j ^� r +.:�. ;�• ..,'�. .. •i: . �. •�� �.' �7 /r: 1, ^ .t'ti pp� i !. _ c : ii�� ho; �'� �) L: y . � ':: •.. .." Standard Erosion Control Plan for 1 & 2 Family Dwelling Construction Sites - 1, k --77777777777 „ O. fSF . . •� ti )..•,'. ..•Y >.:'•' .;:'>.. '.• /•.• •r M.Yf. k (^Y .t..b y` .. >• _'{ •• f..♦ :According.to Cha lets II:HR 20 & 21.of the`Wtsconsin Unifoi i? velltng Code, °a soil erosion" control plz►n P . 4 , .'needs to.be`sdtiniitied and. approVea -prlgr to the iss'u'ance of build tng per�itts for 1 & family dwelling amts to ? :those jurisdictioriswhere; the soil e pr&Astons`of the:Uniforui•`Dwelling Code are enforced This x : °:Standard Erosion Coatrol Plan is provided to.asstst in meeting this re'quiiement ° ,' < ; ' 3• Building nspectors have authoniy to request erosion. control measures not spectfically'requ� red by Coda when > such measures arc deemed necessary to meet the Code overall pecfoimance standard of keeping s'otl on site Cotutructiori projecu that disturb more than S acres, or are part of a develo that duturbs more th S �h� acres, are also required °to :obtain a construcuon site storm.water`discharge permit from the Wisco to '° Depamnent of Natarat Resources h >1 f . Applicant. cx. , V� Name Daytime telephone number 6 4t\ le A/E r,; ,//e, ss 3� Street address, city, zip code Landowner- o.Wl a s I. o b \I e Daytime telephone number Name Street address, city, zip code Location of the building site (complete as appropria SE •yy Nwyy • � , quarter of Section Y . Town 6 N., Range �_ Lot Block 4'V, OVA QaS S Street address gay xXX /65 g Instructions: 14 -5- A vP 1. Complete this plan by filling in requested information, marking appropriate boxes, and completing the site diagram• 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. Chapters ILHR 20 & 21 of the Wisconsin Uniform Dwelling Code, the DNR Iisconsin Construction Site Best Management Handbook, and UW - Extension publication Erosion Control for Honte Builders can be referred to for assistance in completing this plan. The Wisconsin Uniform Dwelling Cade and the Wsconsin Construction Site Best Management Handbook are available through State of Wisconsin Document Sales, 608/266 - 3358. Erosion Control for Home Builders (GW0001) can be ordered through Cooperative Extension Publications, 6081262.3346. 4. Submit this plan at the time of building permit application. .. i� ... � .. .. i".: .(. +j�s . .Y�! "•Y ✓�J �! A ;l J.��:'.l;•i.• - ' Standard Erosion for 1 & 2 Family Dwelling Construction Sites - - According to Chapters ILHR 208 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 8 2 lamily 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. _ 0 I nstructions: I. Complete this plan by filling in requested information, completing the site diagram and marking (/) appropriate boxes on the Inside of this form. ?. 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 5�e — EXISTING DRAINAGE 6� TO TELIPOnARY • DIVEnsioN � FINISHED On ;INAGE LIMITS OF GRADING qq -- w ■ - SILT (�1, SIp FENCE A b STRAw BALES GRAVEL .,., 5.,. : J. I I VEGETATION O SPECIFICATION 7.7 TREE L 'Adz PRESERVATION STOCKPILED Q \1 SOIL f� Please indicate north +° by completing the -- — -- — — — — — �. — — — arrow below. AN L T1 c• 'ROJECT LOCATION / �s 4 ye 3UILDER C l QC �` OWNER NOnI(SHEET COMPLETED BY c. `n os DATE �� ' *� .1 >� y r'�;�' -y .� :.4. • �, a. .+ �, i [ ,j; f� •�s� . r y�Q' �r \Ji. } <..'ij','J .i:�' .•�;�. ;�i�t� 'ar :��1. '5..•..r �J.. ,.•., �'a,- ;t"S "`:.i.���f v. /�✓!• • � - !,L .i -.. • i �. Pdicate management strategy by checidng the appropriate bor Management Strategics ❑ Temporary stabilization of disturbed areas. Note: Although not specifically required by Code, it is recommended that disturbed areas and soil piles left inactive for etrended periods of time be stabilized by seeding (between April 1st and September IS(h), or / by other cover, such as tarping or mulching. Permanent stabilization of site by re-vegetation or other means as soon as possible. ❑ Use of downspout and/or sump pump outlet eitensions. Note: Although not specifically required by Code, it is recommended that flow front downspouts and sump pump outlets be routed to stable areas such as established sod or paventenc ❑ Trapping sediment during dewatering operations. Note: Although not specifically required by Code, it is recommended that sediment -laden discharge water from pumping operations be ponded behind a sediment barrier until most of the sediment settles out I� Proper disposal of building material waste so that pollutants and debris are not carried off-site. / 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 bales 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. • Gravel access drives will be maintained throughout construction. • All installed -erosion control practices will be maintained until the disturbed areas they protect are stabilized. A * ...�� .. .: i:'t':• >; .. r,.'• ,�♦ < t ,•.fy. � r .i . x .< ,: -.�•. ,d ' '' ;`s '� r r , y •'.:. } ,.< :r. ?: :: .:... 2 ...' .. , ...:• r : y.. '.i . }'b. :f: ?Y y,e. r:x q • ` 2: • ...,.q..::.., •n.,; •; .:..:.:•., .. .... .: ?- .' x .:t .••k: ?':f::•+.. ?�bf ♦. ?i. f y i fY�., b <•i. . «...• ..,...�: '...a• .. . } ,•;.. ,, ; : �. . r• k. . + . ..,t •.:: .. < :`'. l 4, <% ,n. k: :., 5.:. . 7 '..y: T•�,^ 'i:; <•`. •' s ::.q a . C .+ .( : 2 y ... .. .. ..:.. 4... •.. . • - <: •.?, 'Y v.� 'i.::i.) :i., •:� . ^{ •.:� }. . Y+ ,. .. d p :. y < ••fir ",}• ''I.heretiy:certify that : I' iinderstand 'ttie:'constructton'site erosioncontiol,proi iBions bf,the Wisconsin LJnifortit ` : tiIhwelling: de, and that Lacceptrespoiisibiliry r carrying out.1b" above erosion con�rolplan byc,: the 'code e" fo�ccment authority: :: } :{ < , s A; 2 x <, i,. : Y `:, , .., v.... •.: .. . • , Si' atiire o[•a` plicate. �. X 4. .> Date`•: : k:, } :. �::::.: <. .<;�; :: +�.::� • Sign . • ......PP. • .. s Y:;Y <•< <. {t.�Yt4.k �, ` >, K } t t ., ... , �.>:,: ? A publication -of the University of Wisconsin- Extension, Ron Struss, UiVEX Water Quality Education Specialist (12193)• hit publication may be freely duplicated Additional copies are available through the UiVEX Environmental Resources Center, 716 Ao Mill IdIM l:...t... rl.;,.. A f...I:... -. Wr c»n.c AAQ1')4) '7.4" C'hedc a appropriate boxes below, and complete the site diagram with n fo�rmatioa:� :� PP P y Ia a C Site Characteristics North arrow, scale, and site boundary. Indicate and name adjacent streets or roadways. ❑ ® Location of existing drainageways, streams, rivers, lakes, wetlands or wells. ❑ 61 Location of storm sewer inlets. L� The gradient and direction of slopes before grading operations. 0 The gradient and direction of slopes after final grading operations. I Location of e.:dsting and proposed buildings and paved areas. ❑ l / Overland runoff (sheet flow) coming onto the site from adjacent areas. Erosion Control Practices ❑ ❑ Location of temporary soil storage piles. Note. Although not specifically required by Code, it is recommended that soil storage piles be placed behind a sediment fence or more than 2S feet from any downslope road or draihageway. >� Location of gravel access drive(s). Note: Recommended gravel drive design is 2 to 3 inch aggregate stone laid at least 7 feet wide and 6 inches thick Drives should extend from the roadway SO feet or to the house foundation (which ever is less). ' 0 ❑ Location of sediment fences filter fabric fence straw bale fence or v str p revent eroded s that will ( ) g P P soil from leaving the site. ❑ Location of sediment barriers around on -site storm sewer inlets. ❑ Se Location of diversions. Note: Although not specifically required by Code, it is recommended that concentrated flow (drainagefvays� 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. 3 [2 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 additional sediment fences, / diversions, and re- vegetation by sodding or by seeding with use of erosion control mats. ] U Location of practices that will control erosion in areas of concentrated runoff flow. Note: Unstabilized drainageways, ditches, diversions, and inlets should be protected front erosion through use of such practices as in- channel fabric or straw bale barriers, erosion control mats, staked sod, and rock rip -rap. Mien used, a given in- channel barrier should not receive drainage from more than two acres of unpaved area, or one acre bf paved area. In- channel practices should not be installed in perennial streams. I 0 Location of other planned practices not already noted. ,