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HomeMy WebLinkAbout038-1120-20-050 \ ¥ )0 o� jk % 0 & � & � \ � � $ � $ � $ � � 7 2 @ % } U. ] D ) � ■ � / LU E � \ ' t § � IL co C-4 / \ B B 2 ] \ k k Q) z \ $ ) \ (D 9 - k ) Q) ) c / \ o / k z } � \ ® % ~ G a ƒ # E ■ \ .� _ a 7 3 2 a 2 o a ®£ j) � k Lo k 0 CO) \ y /§ .� E § § § ) 0 % . t a a a 2 0 § » a = 2 j L) g $ p 7 � ~ / _ . \ I 0 / § S e § $ ) I = E . \ 9 k e M 2 2 S c a Z o 0 § / 7 / ) § , { e e 2 �) 9 & M E § \§ R ■ � �_ § G 8 ® 2 a - o \ k �) \ o } / \ \ ca e , ©� 4) a. # � -a & a § $ 3 a 3 0& v c , ST. CROIX COUNTY ZONING DEPAR AS BUILT SANITARY REPORT 2� ; RECEIVED Owner c� l •�l r`Gy�- G /C� �., r �,_ Property Address 20 JUN 2 ' 8999 -� City/State /Z�cZcv , U a Ge� =� `L ©l 7 sT CF OX COUNTY C 7_ONINGOFFICE Legal DWription: Lot Block Subdivision/CSM # '/4 t /4, Sec., TN -RW, Town of <K r, z PIN # SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer lzle dZ,)5 Size ST/PC / ` -PC1 / Setback from: House - Well '¢ PAL 7e Pump manufacturer Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location OIL ABSORPTION SYSTEM: Type of system: Width Length Number of Trenches Setback from: House Well ILI P/L - F2 Vent to fresh air intake ELEVATIONS i 1�✓e L �� Description of benchmark rci� ��' ��': • Elevation Description of alternate benchmark a 4 Elevation Building Sewe q , � ST/HT Inlet ST Outlet 7 5 PC Inlet PC Bottom Header/Manifold 7 Top of ST/PC Manhole Cover !ff (7 a Distribution Lines () � k L I y t (� Bottom of System (�) h� u ' i () () Q�w �S�t� ���° Final Grade Date of installation Permit number _ State plan number -7 ' O ;> Date Plumbers signature r License number Inspector Complete plot plan � 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. r PLAN VIEW ` i r` r 9 1' ✓ �j�l (Tt1l r;c l�.L l r U ' + l T t INDICATE NORTH ARROW Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: ST. CR IX Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)J. 338903 Permit Holder's Name: ❑ City ❑ Village EK Town of: State Plan ID No.: MONDOR, RALPH STAR PRAIRIE CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: �C� of 038- 1120 -20 -050 TANK INFORMATION ELEVATION DATA A9900109 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic h0 0 Benchmark Z Z 3 02 - e (� v Dosing Z Aeration Bldg. Sewer 3 Holdin (2Y Ht Inlet TANK SETBACK INFORMATION--------- 01 Ht Outlet • 6 joej TANK TO P / L WELL BLDG. vent �t e ROAD Dt,-)Wat Septic —7 OI NA Dosing A Header /Man. Aeration I N Dist. Pipe Holding Bot. System I �' PUMP IPHON INFORMATION `- Final Grade (, Manufacturer Demand 5/ Model Number GPM TDH Lift Friction Syestem TDH Ft oss Forcemain Length Dia. FFii Dist.Towell SOIL ABSORPTION SYSTEM BED / REN Width / Lengt No. Of renches PIT No. Of Pits Inside Dia. Liquid Depth DIME N 3� DIMENSION SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEA Manufactur r, dr INFORMATION Type O / 0 Gd AM a Number: System: J �10l� �� l NIT C DISTRIBUTION SYSTEM Qa Header/ Manifold Distribution Pipe(s) / x Hole Size x Hole Spacing Vent To Air Intake Length Dia � Length � Dia. Spacing N- J 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 COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: STAR PRAIRIE 29.31 .18 , SW, S / E 967 192ND AVENUE — LOT 5 O I� bq` - - ��r.�+Y S ys `�G� �v ; ri �e & d (A) el VA I y ok � j tA -&ouer se W e i , Plan revision required? ❑ Yes ❑ No Use other side for additional information. I & Z3 f: SBD -6710 (R.3/97) Date Inspector's S ature Cert No ' Safety and Buildings Division SANITARY PERMIT APPLICATION 201 Box Washington Avenue Visconsin Department of Commerce In accord with tLHR 83.05, Wis. Adm. Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County , �� than 8112 x 11 inches in size. e /roi • See reverse side for instructions for completing this application State Sanitary PPerrmit Number Personal information you provide may be used for secondary purposes' ❑ Check if revis7on'fo preBioTis�plicarion [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATI N Property Owner Name Property Lo ration �� 0 `, /4� 1/4, S T , N, R (o Property Owner's Mailin S dress Lot Number B Ock Number Cl y State r / Zip Code Phone Number Subdivision Na Number II. TYPE OF BUILDING: (check one) ❑ State Owned �t� age 4r i'� 41 'L Nearest Road Public 1 or 2 Family Dwelling VII - No. of bedrooms Town III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 29 , 3(• g. 49'1/ ..1© 1 ❑ Apartment/ 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 box on line A. Check box on line B, if applicable) A) 1. (7I 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 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 []Holding Tank 1210Seepage Trench 22 ❑ In- Ground Pressure f 42 ❑ Pit Privy 13 ❑ Seepage Pit t / S� Z 3r 43 ❑ Vault Privy ❑ 14 System-In-Fill �/? �. VI. ABSORPTION SYSTEM INFORMATION:y-za , 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. ✓ `� v. 7. Final Grade 1� Q Requi d ft .) Proposed (sq. ft.) (Gals/day /s ft.) (Min_/inch) 7 Elevation �f �3 Feet _0 Feet VII. TANK Capacity in gallons Total # of Site INFORMATION Manufacturer's Name Prefab. Con Steel Fiber plastic Aper. New Existin Gallons Tanks Concrete structed glass App. it T nks Tanks e tic Ta p� v � ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ 1 ❑ I ❑ ❑ ❑ Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plu 's Name: (Prin r r---. Plu r Signature Sta ) MP /MPRSW No.: Business Phone Number: p " ® !� ,r��� Plu er's Address (Street, City, State, kip Code): , IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved anitary Permit Fee (Includes Groundwater a e ssue Issuin gent Signature (No Stamps) [Approved E] Surcharge Fee) Owner Given Initial Adverse Determination 0 22 �fl rOp< ►'t X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11 /97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber rev I t'LAN PROJECT die per+ ADDRES S PW 1/4J� 1 /4 /Sa�/T��N /R/.�W ' TOWN - 11 c �:�. COUNTY in e RS Byron Bird Jr. DATE o -� BEDROOM -� CLASS PERC .5 CONY NTIONALK IN -G OUND PRESSURE CONVENTIONAL LIFT MOUND_ HOLDING TANK SEPTIC TANK SIZE gi Z LIFT TANK SIZE DOSE TANK SIZE 100 HOLDING TANK SIZE ABSORPTION AREA PERC RATE _ L_ �_ B B E D SIZE o? 1► Benchmark V.R.P. Assume Elevation 100' Location of Benchmark / j * H.R.P. 0 Borehole Q Well Scale = Feet T� 0 Perc Hole System Elevatio e r fw rya r ' Gr a� S y�� /v 3 y IL pr Sara rr jd � y � ek ID wr I S � l ��,� 00f Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings d Page of Iii Bureau of Integrated Services sc�r r8 nO With s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less tkia 8 1 /2rxJ h in side County . n must ., include, but not limited to: vertical and h¢rizortal refeeYlce;�b�(� B M) , dkecti nand ��j G fr o percent slope, scale or dimensions, north arrpw, and location and di rice to arest road. Par I.D. # APPLICAW 'INFORMATION /ease prinflbltlft 7t�irmafloh ' COU R V S L d y Date �/j N t Personal information you provide may be used for secondarjr8koesvdcy Lave s 1 1" .04 (1) (m)). Qti Property Owner V l ,., � Property Location v a 1 Govt. Lot 1/4 ,j�9 /4,S� T�` ,N,R E (o� Property Owner's Mailin Address Lot # Block# Subd. Name or CSM# fps Zo a /Oc�� City State Zip Code Phone Number City Village � Town Nearest Road ❑ ❑ New Construction Use: Residential / Number of bedrooms Addition to existing building Replacement ❑ Public or commercial - Describe: Q Code derived daily flow �� gpd Recommended design loading rate _ bed, gpd/ft y trench, gpd/ft Absorption area required i l bed, ft ft Maximum design loading rate bed, gpd /ft gpd/ft Recommended infiltration surface elevatio .3. ft (as referred to site plan benchmark) Additional design /site considerations �/"` v ' a Parent material &fit Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system S❑ U X S ❑ U �R S ❑ U 0S ❑ U ❑ S ,R U ❑ S L 'U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench l - S l° -r te .�! r G ,✓�' -� Ground elev. Depth to limiting factor ,t _7. Remarks: Boring # ell, , s —,C 6 � - " Y Ground ele _ 177 9 ' tt. berth to E lle, limiting t 9 factor in. Remarks: CST Na (Please Print --� Signature Telephone No. Addr ��� %� tom— ����� � �. Date � CST Nu er B� Z o i- + SOIL DESCRIPTION REPORT PROPERTY OWNER Page of PARCEL I.D.# Borin # Horizon Depth Dominant Color Mottles Structure 2 g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench �j r- +r/ / Gro f e s��• ' Depth to limiting fa t /� Vin. Remarks: Boring # e Ground . Depth to limiting factor Remarks: o,?' J Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ff2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. l Bed , Trench Boring # � / - — Ground elev. Depth to limiting factor ,>l in. Remarks: Borg # 13 Ground elev. tt. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) Soil Test Plot Plan Project Name Z�s Z2 o Byron ird Jr. Address /16, -v0 CSfM #3479 Lot Subdivision Date /3 J l�1 /a / 4 S� T Township --5r Boring O Well PL Property Line County X BM or VRP Assume Elevation 100 ft. System Elevation �3 *HRP loa Aft J � f !f0 g 4, 1A Iry A 45 1 %A . r Scale 1/4" = 10 Ft. When Dimensions aren't stated ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer J , / Cc i� Mailing Address / S /dd f� i Property Address u_ (Verification required from Planning Department for new construction) < �� i _ City /State ��- � >��/�"� ��� ParEel Identification Number LE GAL DESCRIPTION Property Location' ' /,, 1 /4, Sec., T1�N -RVl1, Town of Subdivision , Lot # Certified Survey Map # , , Volume ✓�> , Page # W r � 0 arranty Deed # !� ,Volume ,Page # � Spec house f� yes ❑ no Lot lines identifiable yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system Pe Y P Y 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. I/we, 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 of the three year expiration date. / SYGNATVRE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of m our knowledge. I we a w Y (our) g ( ) m (are ) the o ner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF 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 VC•;..�'.�PAGE 537 601270 STATE BAR OF WISCONSIN FORM 3-1998 KATHLEEN H. WALSH UIT CLAIM DEED REGISTER OF DEEDS Document Number ST. CROIX CO., WI RECEIVED FOR RECORD Steven J. Biedler and Julie G. Biedler, husband and wife, quit - claims to 04 -15 -1999 9:15 AM Ralph S. Mondor and Mary K. Mondor, husband and wife, as survivorship marital property the following described real estate in St. Croix County, State QUIT CLAIM DEED of Wisconsin: CERT ERT C II 8 COPY FEE: COPY FEE: Part of the Southwest Quarter of the Southeast Quarter of Section 29, Township TRANSFER FEE: 31 North, Range 18 West, Town of Star Prairie, St. Croix County, Wisconsin, RECORDING FEE: 10.00 being part of Lot 4 of Certified Survey Map as described and recorded in Volume PAGES: 11, Page 3203, Document No. 554710, at the St. Croix County Register of Deeds office, described as follows: Lot 5 of Certified Survey Map filed August 5, 1998 in Vol. 12 of Certified Survey Maps at page 3498 as Document No. 584464. Recording Area N and Return Add=s 0 ,/0 1 r,2 16-2-41 Ac"I Pt 038 1120 -20 -000 Parcel Identification Number (PIN) This is not homestead property. 6* (is not) Dated this—L4—day of ` , 1999. *Steven J. Bi ler *Julie G. Biedler AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) )ss. CKo '>< County ) authenticated this _ day of ' 19 — . Personally came before me this day of YZ 1 4.- , 1999 the above named S 7 y E Aj to me known to be tpe- pdii6#(s) executed the foregoing • instrument and aclniowledge the�same:-% TITLE: MEMBER STATE BAR OF WISCONSIN Q' Of not, r : authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY ry Public', Stale of W�isGpnain Ronald L. Siler My Commission is p'erffi'ahCilt. Ot. not, AL expiration date: VAN DYK, O'BOYLE & SILER, S.C. )� Post Office Box 127 New Richmond, WI 54017 (Signatures may be authenticated or acknowledge. Both are not n V FXED 8 A U G 0 5 1998 ► 2 584 KATHLEEN 11 w ROCIS181' ofD� M L a0wii'm '3 CERTIF RVEY MAP Located in part of the Southwest Quarter o ast Quarter of Section 29, Township 31 North, Range 18 West, Town of Star Prairie, St. Croix County, Wisconsin, being part of Lot 4 of Certified Survey Map as described and recorded in Volume 11 page 3203, Document No. 554710 at the St. Croix County Register of Deeds Office. Prepared for and at the request of: LINE DIRECTION DISTANCE OWNER: '1 a't� '�. 4 L 1 N00'00 43 E 24.17 Ralph Mondor �,►� gG�� r ++ '� R= NOO'17'41 "E 1854 100th Streete New Richmond, WI 54017 ✓�i< L2 N00'0011 21.21 Drafted by. Kristi A. Eylandt 1,22 9y R= S00'17 X41 "W R= 21.36' K.ONALD F �} ; L3 R.O.W. LOT 5 S89'47 ' 07 E 241.12 THIS MAP SUPERCEDES C.S.M. JOHNSON L4 R.O.W. LOT 6 S89 - E 66.00' VOL 12 PG. 3471 DOC. NO. 5 -1186 L5 TOTAL R.O.W. S89 47 - E 307.12' M F- 581239 A 9Y. Z ELEVATIONS BASED ON ASSUMED DATUM. % \ < - � .� A ; : "r BENCH MARKS: �OR / 1 BM . TOP IRON PIPE. ELEV= 100.00 r \I SEC ON129 31-1 + � *a � � � u ,�'�� BM �2• TOP IRON PIPE. ELEV= 120.40' o 2 N r 1 I I (ALUM. CO. MON.— CAPPED BERN7SEN) T U ° JOINT DRIVEWAY c ° ai U LANDS LOT 5 & 6— ° n u > NORTH LINE OF 7H£ SW 114 OF THE SE 114 SEE DETAIL m ° a o c 19 192nd Ave 192ND AVENUE R= N89 19" W ° - - I — S89'59'33'E 307.12 o — ° o —1. — .. —.. —.. . - -.. 241.12' -- _ "' o M JM I E >. c ° R.O.W. — — — �vs n�i — qC0 \ r7 ° I I A 1 j c 3 ° VI MI M 1 \ / 1 r 1 = ai J N 1 N / LO nl r�l I �i r{ i .1... . N I. L . ► I M N ° o c , ° 1 z� I �I N 1nm F w a W v o° J ol —C) M II ,n o -m I a° v a rc g r I ' N I I N Zj -jI j S89'50'02 "E�� Q o>I 11Z l l ^ I I N c v+r °I > 1 I Oi 139.78' �1 BM 2 \ / o 3 0, VI aI " ° ° v Cj I c v V) '�`� I i 3 1 N89'55'23'E I ° n I �I oI ° O ` ° �I in i ` W / m 209.95' 1 ' � Q l m �I 3 L CL.L)i a � r` ' Iri R= N89'42'19 "W 1 i °O I o ° ° , ° wi b T °� ° � 210.00' 3 i I N g� in 0 Q0 TO ADJOINING LAND OWNER N ° N ='o ► J 1 I '"'� °� m al 1 i 1 z\ �—J ° oo I I Sao to to v` a zI I S89'57'38 "E 657.34 A I \ ELEV =91.1 °o z 1 N89'59'33 "W \\ ci U v CIA: 240.82' 11 a .o- AL r 00 .i O 00 1- a O V 41 I 1 0b O 00 C L U TOTAL AREA: boo v 3 ►�i 61 c °a X y 979,445 SO. FT. o" 1 N X 6\ \ 0 0 0 c 22.48 ACRES W WETLAND SETBACK W �- ~ z ~ U m � = y I O t` AREA EXCLUD, R .o.w. L O T 6 �� o 6 W- I a L 977,979 SO. FT. (3 W to � .I zt N = 22.45 ACRES y a o (n v'i :X 2 b I. Q 0 Q m hNVm o rZ o 1 a��a SOUTH 114 CORNER S1B'42 46P 0.55' (ALUM. CO. O. MON.— I I W SECTION MO —16 FROM COMPUTED POS /T/ON I I y y \\ CAPPED BERN75'£N) 16 ' \\ SOU x —x —x —x - TH UNE OF THE 1 I \ SW 1/4 SE 1/4 r -1314.32' — `� -- ----- NB9'47'01'W 1314.32'- - -- LEGEN ____ Count Section Corner Monument — NB9'47'01'W 2628.64_ - - -- — Y R= S89'29'27 "E NCE L N£ of Record ZAL • Set 1" x 24" Iron Pipe weighing ---- - - ----- LANDS �° a minimum of 1.13 pounds per 66' q T l inear foot. O Found 1" Iron Pipe � j1L Denotes Wetland R= Recorded As Raw. / \ L� • • • • • •Building Setback (100' from R.O.W.) JOB #96127 (R14) ') of '�� 33io 250 D 250 F - o o NO TH Prepared by. 0 0 0 A & E 1 ( (0 GRAPHIC SCALE LAND SURVEYING & CIVIL ENGINEERING , • !1 • , �.-, V. SCALE IN FEET: 1 inch = 250 feet Phone No. (715) 246 -4319 DETAIL o BEARINGS ARE REFERENCED TO THE WEST LINE OF THE 109 East Third Street, P.O. Box 325 SE 1/4 OF SECTION 29, TOWNSHIP 31 N., RANGE 18 W. New Richmond, WI 54017 NO SCALE WHICH IS ASSUMED TO BEAR N00'02'55 "E. Sheet 1 of 2 vol 12 page 3498 `' . FROM PHONE NO. AFr . 13 1999 11: 28AM P2 J. TI j p, n � z jj t !I i ;ry Y I � F '•hk �� ,d - : ^ Ca j i/7 I Tl FROM PHONE HO. Apr. 13 1999 11:29AM P3 1 ,i !11 t ii I, i iii Standard Erosion Control Plan for I & 2 _ Family Dwelling Construction Sites f �4c0ori�itt,,tq IL 20 ,8c /2I of the`lascontnifot'm <lfirtg a EgilaCgSt41t cc?nirtti )'fin xtr s gktic subYiii; 4 :A approved prior t 0:106 10 1 uat ce �ilf�ii lil,�a S : ;:'tuts for l & 2 fa all .d... to "'idd h }� S' 8 xhx ttr"rCiigiitS iiv { It f �t s�ql +CrIQa cQittlZA1rAv15t4I1S . b�l aiQr, A1(ttig �tYd$ gtrfgrcd.,'X'#iS. 7fF Cry < / 3 r.: •• '::;:. }�.::.:•••>:: ?: , I <: Standaci: `asloja'ontclal.P,lans tovded to:assist '. < ': utremeat :. ....:..:.... p� l.. 7 /. •i:4: :. :.: r. , iY::: :: /.:: F'I{.;. 4.: }::•i.:::f::::•ii .i.: ..:... .... v:v ..vv:::,r,. r•I: /.,. ?:: :fir:.: /fC•i}:.w.v:::::f..�.: •. { ? ! 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Applicant: I / 6N jo fs 1y e.. Name Daytime telephone number d Street address, city, zip code Lan 1'!� o ry - Landowne �1© 3► Name Daytime telephone number Street address, city, zip code Con of the butV site (Complete as appropriate): �AAM o s w_ q 4194 Of quarter of Section ��, Town �_ N., Range Lot Block Street address Instructions: I. Complete this tan b fillip in r e q uested information marki a p p ropriate rid co Teti the site d � P Y 8 e9 g (� boxes, a com ram. g 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 Wisconsin Construction Site Best Management Handbook, and UW - Extension publication Erosion Control for Home Builders can be referred to for assistance in completing this plan. The Wisconsin Uniform Dwelling Code and the Wisconsin 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, 608/262 -3346. 4. Submit this plan at the time of building permit application. -Site Note: Any Any base map of useable scale can be substituted for this sheet. so VV4 ,s� — J /► cv b - - 4 z :..: >. 1 0 i t 1 Q � e o o U ' r it" OtAMNI 4 .ay v fifl aff 9 r? Y I • a 0 tl , Site Diagram Legend Please indicate north direction PROPERTY SILT LANE FENCE by- completing the arrow. �—' EXISTING STRAW DRAINAGE 13ALES TD TEMPORARY GRAVEL DIVERSION 91 N FINISHED TREE —' DRAINAGE PRESERVATION ' LIMITS OF STOCKPILED GRADING TOPSOIL VEGETATION 1O SPECIFICATION Scale: AREA 1 inch = feet Check (.):appropdate,boxes below,.and compieteahe site .diagram with neoessaty information: eM WV0 Site Characteristics 1� North arrow, scale, and site boundary. Indicate and name adjacent streets or roadways. ❑ 4 Location of existing drainageways, streams, rivers, lakes, wetlands or wells. ❑ Location of storm sewer Inlets. The gradient and direction of slopes before grading operations. '! The gradient and direction of slopes after final grading operations. Location of existing and proposed buildings and paved areas. ❑ 'I Overland runoff (sheet flow) coming onto the site from adjacent areas. F -axion 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 25 feet from any downslope road or drainageway. 3, Location of graver 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 50 feet or to the house foundation (which ever is less). ❑ Location of sediment fences (filter fabric fence, straw bale fence) or vegetative strips that will prevent eroded // soil from leaving the site. ❑ T$ Location of sediment barriers around on - site storm sewer inlets. ❑ Location of diversions. Note: Although not specifically required by Code, it is recommended that concentrated flow (drainageways) be diverted (redirected) 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 additional sediment fences, diversions, and re- vegetation by sodding or by seeding with use of erosion control mats ❑ Location of practices that will control erosion in areas of concentrated runoff flow. Note: Unstabilized drainageways, ditches, diversions, and inlets should be protected from erosion through use of such practices as in- channel fabric or straw bale barriers, erosion control mats, staked sod and rock tip -rap. When used a given in- channel barrier should not receive drainage from more than two acres of unpaved area, or one acre of paved area. In- channel practices should not be installed in perennial streams. ❑ 1$. Location of other planned practices not already noted. Indicate management strategy . by ehedang,(,O the-Appropriate-box: o� Managemen Strata es ❑ Temporary stabilization of disturbed areas. Now Although not specifically required by Code it is recommended that disturbed areas and soil piles left inactive for extended pmods of time be stabilized by seeding (between April 1st and September 131h), or by other cover, such as tarping or mulching. Permanent stabilization of site by re-vegetation or other means as soon as possible. • 41 Use of downspout and/or sump pump outlet extensions. Note: Although not specifically required by Code, it is recommended that flow from downspouts and sump pump outlets be routed to stable areas such as established sod or pavement. • V( Trapping sediment during dewatering operations. Note: Although not specifually 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. Proper disposal of building material waste so that pollutants and debris are not carried off -site. .1 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. Deeompos}tg 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�gteeme�t: ' f hereby certrfy that I understand the construction lice erosion control' provisions &4' i` W Uniform; , <Dwelltag r=ode, nnii ihaf iaccept responsibclity for ca rytng out the above etnston oontroi:p[anspQraued the code etiforcement authority Signature of applicant Date A publication of the University of Wisconsin - Extension, Ron Struss, UWEX Water Quality Education Specialist (12192). ?his publication may be freely duplicated Additional copies are available through the UWEX Environmental Resources Center, 216 Ag Hall, 1450 Linden Drive, Madison. 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