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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
- INSPECTION REPORT Sanitary Permit No:
408249 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
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:
Joyce, Fran —I— Kinnickinnic Township 022 - 1054 -80 -300
CST BM Elev: sp. BM El v: BM I De
�
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septi # C S g� Benchmark '
Dosing Alt. BM
Aeration Bldg. Sewer
Holding SUHt lnl
TANK SETBACK INFORMATION St/Ht Ilet .9 • $G ,
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
50
Septic f 1(00, / Dt Bottom
Dosing Header /Man. r
�6. to
Aeration Dist. Pi
c•..tc ��2 , f o
Holding Bot. Syst M - 1 -
Final Grade 1
PUMP /SIPHON INFORMATION
Manufacturer Demand St Cov Z •.�- q q � t
GPM .2. Z "'e ! /
Model Number �
4 ► ) zi o, ' j, s`n `o23d
TDH Lift Frictio s System Head TDH Ft �
� la
Forcemain Length Dia. Dist. to Well G. G. 2.
SOIL PTION SYSTEM t
Bfl&fft 4dth iL Length ( No. OfTVnches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIME 7 Cie,
SETBACK SYSTE TO P/L - JBLDG IWELL LAKE /STREAM LEACHING Manufaaturqe. INFORMATION CHAMBER OR ,, t4P �
Type Of System: $>7 UNIT Model Number.
C�„L✓ ° o S
DISTRIBUTION SYSTEM
Header /Manifold c Distribution x Hole Size x Hole Spacing Vent to Air Intake
Pipe(s) t
'�} -.2. Length 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/rrench Edges Topsoil
[�] Yes [ No �] Yes f] No
COMMENTS: (Include c iscrepencies, persons present, etc.) Inspection #1:�/ k; �Z- lnspection #2: -4 f
-X &4z A -/ �FF9-L - -
Location: 230 Co. Rd SS River Falls, WI 54022 (NW 1/4 SE 1/4 19 T28N R18W) NA Lot Parcel No: 19.28.18.302A30
1.) Alt BM Description =
2.) Bldg sewer length = , �Gp1yQAQ � A j 0, �
- amount of cover -
3j d hselrt� tyeQ �. c Z _,_
t - -- - - - - - -- -- - T
Plan'revis
Use other side for additional �! Yes No
Re
information. �
Date L In s epctor'sSignature
SBD -6710 (R.3/97) Cart. No.
Safety and Build' gs Division County
` 201 W. Washington A .O. Box 7162 T' o i
S V
onsin Madison, WI 53707-7162 Site Address
Department of Commerce 73� aZ
Sanitary Permi Application SanitarypermitNumber Wq
In accord with Comm 83.2 1, W is. Adm. Code, personal information you Check if evis 8-
may be used for seconds purposes Privac La
I. Application Information - Please Print All Informado Kr State Plan I.D. Number
Prop ner's Name 1 $ Parcel Number
oaa- vsy 8� -.i•oo .302 30�
Prope Owner's Mail' Addre T. CRC FILE Property Location
A/!✓ Y. '' %; S / T./d N, R /J A Al
City, State Zip Code Phone Nu mber Lot Number Block Num
Subdivision Name
w•a �e ,� CSM Number
I zs -g: V.
/ 38aG
IL Type of Building (check all that apply) e*
I or 2 Family Dwelling - Number of Bedrooms
Public/Commercial - DescribeUse Townshipis j.✓ /a JAI
State Owned p ��y�� �/ /�� Nearest Road //JJ
III. Type of Permit: (Check only one box on li num a ng scheme for Internal use). Comp' applicable)
A. 1 New 2 Replacement System 3 Replacement of Addition to For Cop
System TankOnly Tisting System
13. Check if Sanitary Permit Previously Issued Permit Number y
IV. Type of Permit: (Check all that apply)(numbering scheme is for Internal use) / sP
Non - Pressurized In -Ground 21 Mound 47 Sand Filter
22 Pressurized In-Ground 41 Holding Tank 48 Single Pass
45 At -Grade 46 Aerobic Treatment Unit 49 Recirculating 30
V. Dispersalff reatment Area information:
Design Flow (gpd) Dispersal Area Dispersal r Soil Application Percolation Rate Syst,. Final Grade
Required (�) Proposed4-; -) Rate(Gals./Days/Sq.Ft.) (Min./lnch) Elevation
a?oa Soap ..�acs . 'S/ 95.
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Tanks Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Holding Tank
0
GOO o?�GG oZ NfiG r T �.✓�. L�
Doting Chamber
VII. Res onsibili Statement - L the undersi ne assume res onsib for installation of the POWTS shown on the attached lens.
Plumber's Name (P rint) Plumber' a MP /ltd Number Business Phone Number
Plumber's Address (Street, City, State, Zip Code)
Al a? Yx r Y. .?S A .✓D - Sy7P
VIII. !De artment Use Onl
Approve Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps)
Surcharge Fee)
Owner Given Initial Adverse � � 6V
Determination Z Z
IX Conditions paUReasons for Disapproval
tom.
Attat complete plans (to the Coo nty only) ror the system on paper not Itss than 81/2 ill In ekes In On
SRD -6.19R (R. 05/01)
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Private On -Site Wastewater Treatment System (POWTS)
Index and Title Sheet
Frl�- , -- , ^l C c--
Owner: f
Project Name and System Type: ���J °
c - <___ c, � r v ,
Location:
"ss
Street Address
iyA✓ se /Z
Legal Des ,,�� /
Uau.✓
Or x/�✓.✓ieoe<IA ✓ic Sr 4it /X C a
Township /County
Contents: Page 1: 1w ,v6x 0 - Lrl,,e �iyES r
Page 2: Ag r
Page 3: kac1 rs O,r✓,✓�� 's r�,o.✓�rot /yo.✓,or�.y�,✓c' �1 0,✓
Page 4:
Page S:
Page 6:
Page 7:
Page 8:
Page 9:
Attachments:
Plumber/Designer: Signed: ����, ✓' /�
Credential Number: jW - Date: 7 -1z -o z
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I'OWTS OWNER'S MANUAL AND MANAGEMENT PLAN
FILE INFORMATION SYSTEM SPECIFIC
Owner Cam_ Septic Tank Capacity d040 +dao ga l ❑ NA
Permit # c t I Septic Tank Manufacturer usFoorr ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer O NA
Number of Bedrooms 100 droom ❑ NA Effluent Filter Model ❑ NA
Number of Commercial Units NA Pump Tank Capacity 1 ❑ NA
Estimated flow (average)* I aWo g al/day Pump Tank Manufacturer ❑ NA
Design flow (peak), estimated x 1.5* ,70o al /da Pump Manufacturer ❑ NA
Pump Model ❑ NA
Soil Application Rate al/da ft Pretreatment Unit EWA
Influent/Efuent Quality (NA ❑) Monthly Average" ❑ Sand/Gravel Filter ❑ Peat Filter
Fats. Oil & Grease (FOG) 30 mg/L ❑ Mechanical Aeration 13 Wetland
Biochemical Oxygen Demand (BODD .220 mg/L Manufacturer: E3 Other:
Total Suspended Solids (TSS) Manufacturer: Model:
5 250 m Di., rsal Cell(s)
Pretreated Effluent Quality [3 Monthly Average*** G fn- ground (gravity) ❑ In-ground (pressurized)
Biochemical Oxygen Demand (BODD 5 30 mg/L ❑ At -grade ❑ Mound
Total Suspended Solids (TSS) 5 30 mg/L ❑ Drip-line ❑ Other:
Fecal Coliform (geometric mean) <_10 cfia/100m1 mrteacliing Chamber Manufacturer Alfie t'.r,e ro.c
Maximum Effluent Particle Size 1/8 inch diameter Model F'Aw , , mw Laying Length/Chamber
*Wastewater Flow Verification and Calculations: Soil Application Rate_,y gpd/ft Req. 3000 ft
(Other than bedroom based) Infiltrative Surface/Cliamber -ESIA Ratin 24 o ft
Minim N umber of Chambers
❑ Aggregate Desi n Flow/Loadin Rate= ft min
** Values typical for domestic (non - commercial wastewater Materials: all materials must comply with WI Adm. Code
and septic tank effluent. COMM84 and be installed per manufacturers specifications
** *Values typical for pretreated wastewater. and approva I letters.
DESIGN CRITERIA
❑ "Wisconsin At -grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.al.1990)
❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler.
Publication 15.22
❑ "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Publications 9.6
❑ "Design of Conventional Soil Absorption Trenches and Bcds ". R.J. Otis — ASAE Publications 5 -77 and "Design Manual —
Onsite Wastewater Treatment and Disposal Systems ". EPA 625/1- 80-012 October 1980
❑ SBD — 10570 —P (R.6/99) "At -Grade Component Manual Using Pressure Distribution"
❑ SBD — 10567 —P (8.6/99) "In Ground Absorption Component Manual'
GKSBD — 10705 —P (N.01 /01) "In Ground Soil Absorption Component Manual' Version 2.0
❑ SBD — 10628 —P (N.6/99) "Recirculating Sand Filter System Component Manual'
❑ SBD — 10656 —P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual'
• SBD - 10572 —P (R.6/99) "Mound Component Manual"
• SBD - 10691 —P (N.01 101) "Mound Component Manual' Version 2.0
❑ SBD - 10595 —P (8.6/99) "Single Pass Sand Filter Component Manual'
❑ SBD - 10657 —P (8.6199) "Drip -line Effluent Disposal Component Manual'
❑ SBD - 10573 —P (R 6/99) "Pressure Distribution Component Manual'
❑ SBD - 10706 —P (N.01 /01) "Pressure Distribution Component Manual' Version 2.0
❑ Drip -line Effluent Dispersal Component Manual for Multi -flo Onsite Wastewater Treatment Units
MAINTENANCE AND MANAGEMENT
MAINTENANCE MONITORING SCHEDULE
Service Event Service Frequenc
Inspect condition of tank(s) At least once every ❑ months 3 ear(s) (Maximum 3 yrs.
Pump out contents of tank(s) When combined sludge and scum equals one -third (1/3) of tank volume
Inspect dispersal cell(s) At least once eve ❑ months 3 ear(s) (Maximtun 3 yrs.)
Clean effluent filter At least once every IV 21nontlis ❑ year(s
Inspect pump, pump controls & alarm At least once every ❑ months ❑ earls ❑ NA
Flush laterals and pressure test At least once every ❑ months ❑ ear(s) ❑ NA
Valves At least once every ❑ months ❑ ear(s) [3 NA
Other: At ]cast once every ❑ months ❑ ears ❑ NA
Page , of .'
START UP ,
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that
may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the
tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
OPERATION
The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity
and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water - saving
appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water
softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface
whenever possible. Note: this does not include laundry waste, showers, dishwater, etc.
This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/fruit
peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only
paper that should be discharged into the system. Other non - biodegradable items such as baby wipes, tampons, sanitary napkins
condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint,
disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS
and contaminate your drinking water supply.
Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components.
Compaction of snow over the dispersal unit may cause it to freeze up.
0 Valves
Valves shall be operated in the following manner:
❑ Alarms
Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service
POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any
problems with the system are corrected to prevent back -up of sewage into the dwelling or surfacing.
INPECTIONS
Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master
Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per die attached Maintenance Schedule).
M(Septic Tanks Component
Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks
or leaks, measure the volume of combined sludge and scum and to check for any backup or ponding of effluent to the ground
surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any
defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective
locking device to prevent accidental or unauthorized entry into the tank.
When the combination of sludge and scum in any tank exceeds one -third (1/3) or more of the tank volume, the entire Contents
of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin
Administrative Code.
The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's
specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more
frequent intervals than stated in the maintenance schedule to keep the system operating.
❑ Pump Chamber/Treatment Tanks Component
The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be
made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of any filters.
Any service needs or repairs shall be promptly taken care of.
2(In- Ground Gravity Component Dispersal Cells
The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any
evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory
authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending
hydraulic failure necessitating more frequent monitoring.
Page y of S'
r
. ❑ Mound, At- Grade, In- Ground pressure
The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any
evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory
authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure
necessitating more frequent monitoring.
The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals
should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to
ensure that equal distribution of effluent is occurring to promote the longevity of the system.
REPOR
Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative
Code.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service die following steps shall be taken to ensure that the system is
properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code.
- All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
- The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
- After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or other inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired die following measures have been, or must be taken, to provide a code compliant
replacement system:
oa suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system.
The replacement area should be protected from disturbance and compaction and should not be infringed upon by required
setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the
need for a new soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a
holding tank may be installed as a last resort to replace the failed POWTS.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation
must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed
as a last resort to replace the failed POWTS.
❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative
surface. Reconstructions of such systems must comply with the rules in effect at that time.
«WARNING»
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND /OR INSUFFICIENT
OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES.
DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR
IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALL R POWTS MAINTAINER G/„ir ,✓
Name Name
Phone 71s t 7d- s zit Phone
SEPTAGE SERVICING OPERATOR (Pumper) - LOCAL REGULATORY AUTHORITY
Name A enc r L . Zc.,�.✓a �f �icd'
Phone Phone 7 15 _r*Z - yLBo
KAWPDATMEMPOWTS OWNER'S MANUAL.doc
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Pelke Plumbing, Heating, & Well Drilling Inc.
N6298 State Hwy 25
Durand, WI 54736
715- 672 -5266
Fax 715- 672 -5267
July 15, 2002
St. Croix County Zoning Office
St. Croix County Government Center
1101 Carmichael RD
Hudson, WI 54016
RE: Fran Joyce — Addition To In- Ground
The original 6 bedroom system was installed in April, 2001, and is in working order.
The reason we are adding onto the existing system is because they are converting two
existing rooms into bedrooms_
*Please sw a ched DOn.
Herb Pelke
Pelke Plumbing, Heating, & Well Drilling Inc.
Nisoor" Department of Commerce PRIVATE SEWAGE SYSTEM C ount
Afety4ind Biodings (iivision St. Croix
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitart Wmit No.:
Personal Information you provice may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)j. 370367
Permit Holder's Name: City 0 Village .❑ Fown o State Plan ID No.:
Jo ce, Fran Kinnickinnic Townshi
T 8M Elev.:• Insp. BM Elev.: BM Description: Parcel Tax Nn
022- 1054 -80 -300
TANK INPOR1' IAT1'l7iCl` ELEVATION DA A
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Z� Benchmark Z ff 4 /
Alt. BM
ation Bldg. Sewer S p0 a
Holding dp/ Ht Inlet (o• (o r 9
TANK SETBACK INFORMATION Ht Outlet 7 io
TANK TO P / L WELL BLDG. Air I to ntake ROAD A# Inlet
Air I
Septic > �S >�; I I Z NA ?&n O 10 .2,0 9r. ( D
s
Doslfrg NA Header / Man. r, ?5 9, G
Ion Dist. Dist. Pipe
Holding Bot. System 95.3
PUMP / SIPHON INFORMATION Final Grade 2. Q Z 6
Ma rer Demand St cover 2
Model Number M .� ,
TDH. ift Friction TDN Ft O 2. .S
t _
Forcemain I Length Dia. Dist. To we
SOIL ABSORP TION SYSTEM 15 , rs I
BEDITR Width
1 Length , No.Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
IM 1.5' 1 DIMEN ION
SYSTEM TO P / L BLDG WELL LAKE/STREAM L G Manua rer:
SETBACK HAMBER
INFORMATION Type O �� , Moe Number: r
System: i) — t(U �� OR
DISTRIBUTION SYSTEM
Header /Manifold Distribution Pipe(s) x Hole Size x Hoe Spacing Vent To Air Intake
Length 3 3 Dia. ( Length / Dia. � Spacing � / N, > . "
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over Depth Over xx Depth Of xx
:,; se:, ded / Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges Topsoil ❑ es ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.) i" N q I D
Inspection #1: f Z /2 bl 00 Inspection #2: q l 1 / 0(
Location: 230 County Road SS, River Falls, WI 54022 (NW 1/4 SE 1/4 19 T28N 18W) - 192818302A30 -Lot 4
1.) Alt BM Description = `f•J,Ao ey (.�:`� �r `>` A" as ��c „fi r
2.) Bldg sewer length= 32 0 s �9
('�,
- amount of cover =
Plan revision required? ❑ Yes q No
Use other side for additional informbtion. k lC 116A
SBD -6710 (R.V97) Date Inspector's Sig6t Cert. No.
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w '230 CTf� - S S Sanitary Permit Application Safety & Buildings Division
��
' r 201 W. Washington Ave.
In accord with Comm 83.21, Wis. Adm. Code PO Box 7302
seonsin See reverse side for instructions for completing this application
Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302
Department of Commerce [ Privacy aw, s. 15.04 1 m (Submit completed form to county if not
y ()( )) I state owned.
Attach com lete plans (to the county copy only) for the s st t less than 8 -1/2 x 11 inches in size.
County C State Sanitary Permit Number ❑ Check ' re isle 'm pro iOU? a 'cation State Plan 1. D. Number
��'
I. Application Inf ormation - Please Print all Informat :' Location:
Property Owner Name Property Location
,� T `Q Y ��✓ 1/4 SeErl /4 S / fT,tB,N R i or
C
Property Owner's Mailing Address J — Lot Number Block Number
ST CROIX
CD,Z 64 t.vst ,GAJL UNTr
City, State Zip Code J Nugbp1[NGOF ebdirisio
Snfifame or CSM Number
II Type of Building: (check one) -
2( 1 or 2 Family Dwelling -No. of Bedrooms -,sir 15 Vill ge
O Public /Commercial (describe use): ff Town of
O State -owned A , 1AIWI <
III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Neare u
t Road a
A) 1. 10 New System 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Addition to Parcel Tax Number(s)
System Tank Only Existing System 4 - os - 8b — o u
B) Permit Number Batalssner}
❑ A Sanitary Permit was previously issued 2S . _ a ZA - 3
IV. Type of POWT System: (Check all that apply)
• Non - pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland
• Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line
• At -grade / ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other.
,Jdo ° s / fr t 7. 1Y a 7-3 - .✓,c tr s r.� .Tii rvi✓oi�• is s
• Dis ersal/Trea ment Area Information: : t - cY t4
1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade
Required Proposed Rate (Gad. /day /s (Min. /inch) Elevation /
p -1 can, /
5'
VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks Con- Con- glass
New Existing crete structed
Tanks Tanks
® ❑ ❑ ❑ ❑
,✓ .?oo0 000 ,►r
❑ ❑ ❑ ❑ ❑
VII Responsibility Statement
1, the undersigned assume res on ibility for installation of the POWTS shown on the att ached plans.
Plumber's Name (print) Plumber's Signature (no scam s): MP/N94ts No. Business Phone Number
7/ -1 - s' 6
Plumber's Address (Street, City, State, Zip Code)
,? Ae -S
VIII County/Department Use Only
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued ssul ent Si w ature (No stamps)
Approved ❑Owner Given Initial Adverse Surcharge Fee)
Determination ao� � �co l6 r 6C} /
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PELKE PLUMBING, HEATING, & WELL DRILLING INC
N6298 STATE HWY 25
DURAND, W154736
715- 672 -5266
MANAGEMENT PLAN:
This Private Onsite Wastewater Treatment System ( POWTS) has been designed, and is to
be installed and maintained according to Comm 83, Wis. Admin. Code, the In- Ground
Soil Absorption Component Manual for Private Onsite Wastewater Treatment
Systems(SBD- 10567 -P; June 11, 1999)
i
1. This POWTS has been designed to accommodate a maximum daily flow of
gallons of domestic wastewater — per day. _ number of
bedrooms
The quality of influent discharged into the POWTS treatment or dispersal
component shall be equal to or less than all of the following:
i
• a monthly average of 30 mg/L fats, oil and grease.
• A monthly average of 220 mg/L BOD5
• A monthly average of 150 mg/L TSS.
Wastewater shall not be discharged to the POWTS in quantities or qualities
that exceed these liwits or that result in exceeding the enforcement standards
and preventative action limits specified in ch. NR 140 Tables 1 & 2 at a point
of standards application, excepts as provided in Comm 83.03 (4), Wis. Admin.
Code.
2. The owner of this POWTS is responsible for system operation and
maintenance. The following maintenance shall occur within three (3) years of
the date of installation and at least once every three years thereafter.
1. The septic tank shall be pumped by a certified septic servicing
operator, licensed under s.281.48, Wis. Stats, unless inspection by
a licensed master plumber or other person authorized to make such
inspection, finds less than one -third (1/3) of the tank volume
occupied by sludge and scum. More frequent pumping may be
necessary to prevent solids from exceeding one -third (1/3) of the
volume of the tank.
Wastes shall be disposed of by the pumper in accordance with ch.
NR 113, Wis. Admin. Code.
At each pumping the pumper must visually inspect the condition of
the tank, baffles, risers and manhole cover and verify that any
required locks are present.
2. The tank filter (s) shall be inspected and cleaned to remove any
accumulated solids according to manufacturer's specifications. The
filter cartridge shall not be removed unless provisions are made to
retain solids in the tank. Cleaning of the filter at more frequent
intervals may be necessary.
3. Any pump, alarm or related electrical connections shall be visually
checked for defects and tested to confirm that they are operating
properly. (If Applicable)
3. No one should enter a septic or other treatment tank for any reason
without being in full compliance with OSHA standards for entering
confined space. The atmosphere within these tanks may contain lethal
gases, and rescue of a person from the interior of the tank may be difficult
or impossible.
4. No product for chemical or physical restoration or chemical or physical
procedures for POWTS may be used unless approved by the Department
of Commerce in accordance with Comm 84, Wis. Admin. Code.
5. If this POWTS is replaced, or its use discontinued, it shall be abandoned
in accordance with Comm. 83.33, Wis. Admin. Code.
Wisconsin Department of industry, SOIL AND SITE EVALUATION REPORT Page \ of
Labor and Human Relations g ---
Divi *p of Safety & Buifdngs in accord with ILHR 83.05, Wis. Adm. Code,
COU NTY
Atia� P an er no a 81/2 x n size. ut ►nclude, but- S'� ..
not limited to vertical and horizontal referenc int BM), and % o f 00pe., r P ARCEL I.D. #
Po (
dimensioned, north arrow, and location and distance to nearest road. ' p 'L Z - ) p S y _ B o
APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION IEWED BY DATE
0 -3o-
PROPERTY OWNER: PROPERTY LOCATION
- j�bSj L M S f�fv E6V t$T N1�l 1/4 S 1 /4,S 1 T Z8 ,N,R 1 b E (or W�'
PROPERTY OWNER':S MAILING ADDRESS • LOT # I BLOCK # SUBD. NAME OR CSM #
Z.zz b S Y — ;;c-- o s(m (:! s M
CITY, STATE ZIP CODE PHONE NUMBER (]CITY (]VILLAGE TOWN ' NEAREST ROAD
Tz IQe - z_ W) SLl,Zz n1.5) 4 z _ bG - I y �Cll� 1 N�C�cli�)fvlc �TZt' SS "
[xJ New Construction Use [J9 Residential / Number of bedrooms L 4 [ J AdditiQn to existing building
j J Replacement [ j Public or commercial describe
Code derived daily flow d WO gpd Recommended design loading rate bed, gpd/ft • S trench, gpd/ft
Absorption area required - bed, 1`1 \2,0o trench, ft Maximum design loading rate ' 4 bed, gpd /ft2 ' S trench, gpd/ft
Recommended infiltration surface elevation(s) S - Wa) - &_ cvj Pg 3 ft (as referred to site plan benchmark)
Additional design / site considerations -
Parent material L� S - o� T1 LL Flood plain elevation, if applicable t'3 • A, It
S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK
U= unsuitable for s stem ®S O u u s O U ®S O U I a O U 0S ®U O S to U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Botxxiary Roots GPD /ft
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed ITtrich
g- Z S 15 Z`FSb1C M`fl^ C-W `S `�
ew
Ground 3 26 .35 Yrt £L- e S ,`{ • S
elev. .S 31Y
qa. z ft y is �r - I -S r ?_ IV' — 1s 1 e-sbk ►n v'�l- . s i • �
Depth to
limiting
factor
>7
Remarks:
Boring #
n 1 0 9 tio�2 z Lz �> 1 z�sbk m`f►- erg . s.
Zg Z 9 - lfl�`tQ_ L ZrnSb`R
Z�S 31y k mV ►r- �,� ,�j S-
Ground
elev. S � ► z 3[ s 1 eSb�c�
q '0-9 ft � b � l.S`�! I alb - l � P�
-, i
Depth to F P ii
limiting ST FOX �s
factor uNTY
ZONI OFFI
4
Remarks: Z
CST Name: - Please Print Arthur L. We erer Phone: 715- 425 -0165
e Soil Testing & Design Service -P.O. Box 74 River Falls WI 54022
Signature: l Date: CST Number:
1 -`'] 220254
1
PROPERTY OWNER SOIL DESCRIPTION REPOR Page of
Z
PARCEL W.# 0 Z 1 $ $O
Boring # Horizon Depth Dominant Color Mottles Structure
in. Munsell Qu. Sz. Cont. Color Texture Consistence Bound3y Roots GPD /ft
Gr. Sz. Sh. Bed ITrench
Z l Z
l3 -Z.b l O `1 R 31
..... Y
sll Z�nsbk
Ground 3 a -S O 7 •S `t R 31 y 1S I
elev. s1 � O-SbVT- �4 U'FI^ 0 �, ij ,S
S
ft. y So - So - I'S R- 3 y
Depth to
limiting
factor -
? 4v-
95.3a
33 •
i
Remarks:
Boring #
:_
�<,
3 33_� ��sbk
Ground ( 7 S `? [Z_ .
g ev
it.
\LS -8 1 • S `11z 31 y 1 S
—
Depth to
limiting '
factor 3 3 • �. �4• !
230h
Remarks:
Boring #
I2 z12 s t
Ground 3 26- 3 1 • $ 2
elev.
9 -3 ft. ), L ti V 6 1 s ti S 11>z
z
Depth to
limiting
fact
i
Remarks:
3oring #
z
around t
;lev.
ft.
)epth to
imiting
actor
Remarks: __ __
PLOT PLAN Pa of 3
SCALE 1 "= 50
r�1}Z- 'cTL�3.5' w Sot itN'
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( 4 ti (715 ) 425 -n7 r, s
CST Signature Date Signed Telephone No. CST #
F ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer 1 - j - o vce l
Mailing Address �6 Z l9��J L /7
Property Address 3 1 S
j (Verification required from Planning Department for new construction)
City /State l ��1�'l�it�yl� 2 �L Parcel Identification Number
LEGAL DESCRIPTION
Property Location /V Y V,, ' /�, Sec. , T_2Y -R L& Town of 4 1 ��� �` ' � 1 2
Subdivision Lot #.
Certified Survey Map # 15 , Volume Page #
Warranty Deed # (o 3 2 -51 4 , Volume I S 5 Page # 0
Spec house ❑ yes )1 no Lot lines identifiable % yes ❑ no
SYSTEM MAIN'T'ENANCE
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
can affect the fumetion 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
masterplumber, joumeymanplumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal 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
7IN—AWRE the three year expiration date.
OF CANT 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) of
y tffihe ope rty des? ve, by virtue of a warranty deed recorded in Register of Deeds Office. ATURE OANT DATE
* * * * ** Any inhat 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
STATE BAR OF WISCONSIN FORM 1 - 1998 f 632564
WARRANTY DEED KATHLEEN H. WALSN
REGISTER OF DEEDS
�-- ST. CROIX CO., WI
Document Number
VOL 1554PAGE 25 RECEIVED FOR RECORD
Harry This Deed, made between
N. Knott Bess J. Knott, 10 -27 -2000 4:30 PM
David D. Knott, Kathryn L. Knott and Korey A. Knott WARRANTY DEED
EXEMPT
N
Grantor, CERT COPY FEE:
and arpentry Services - Francis M. Joyce, LLC COPY FEE: 2.00
TRANSFER FEE: 142.50
RECORDING FEE: 10.00
Grantee.
Grantor, for a valuable consideration, conveys to Grantee the following
'! described real estate in St. CroiX County, State of Wisconsin
Recording Area
(the "Property "):
4i Name and Return Address
i
Davison & Vlack
!! Lot Four (4) of Certified Survey Map in Volume Fourteen (14), East Elm St.
,
of Certified.Survey Maps, Page 3806 as Document No. 618150 River Falls, WI 54022
filed in St. Croix County Register of Deeds office on l
February 9, 2000, being located in the Southwest Quarter
of the Southeast Quarter (SW 1/4 of SE 1/4) and the
Northwest Quarter of the Southeast Quarter (NW 1/4 of SE 1/4) 1054 -80 -000
Section Nineteen (19), Township Twenty -eight (28) North,
Range Eighteen (18) West, Town of Kinnickinnic, Parcel Identification Number (PIN)
St. Croix County, Wisconsin. This is not homestead property.
(C (is not)
i
Together with all appurtenant rights, title and interests.
Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except
''easements, restrictions, reservations, covenants if any of record, and highway rights
of way. r7
Dated this / day of October 2000
J p Vl IY Knott
c (SEAL) Zoe - ^, -!-�J (SEAL)
Harry Knott Kathryn L. Knott
4- V (SEAL) o- y� �'C/' _ (SEAL)
Bess J. Knott Korey A. Knott
AUTHENTICATION ACKNOWLEDGMENT
Signature(s)
State of Wisconsin,
ss.
County.
authenticated this day of Personally came before me this 97� day of
October 2000 , the above named
Harry N. Knott, Bess J. Knott,
David•D. Knott, Kathryn L. Knott
a nd Korey A. Kn
TITLE: MEMBER SIATE BAR OF WISCONSIN � p' to
(If not, me known to be the persons WW�iU.eA�t t ., • i, going
authorized by §706.06, Wis. Stats.) instrument and acknowledge the sark; t 4: ,t,—
THIS INSTRUMENT WAS DRAFTED BY
� Q
Edward F. Vlack Davison & Vlack
East Elm St. River Falls WI 54022
> > Notary Public State of Wisconsin
i ry
( 715) 425 -1525 M commission is permanent. If not, state exp iration date:
Y
P ( P
(Signatures may be authenticated or acknowledged. Both are not
necessary.)
' Names of persons signing in any capacity must be typed or printed below their signature.
STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc.
WARRANTY DEED FORM No. 1 - 1998 Milwaukee. Wis.
6 �adr�
D �
q 2 _ MA
L` R oP . 4 . � T. GROIX COUNTY
SURVEYOR'S RECORD
� CERTIFIED SURVEY MAP
Todd Larson
Located in the Southwest 1/4 of the Southeast 1/4 and the Northwest 1/4 of the Southeast 1/4, Section 19,
T 28 N R 18 W, Town of Kinnickinnic, St. Croix County, Wisconsin
NORTH QUARTER CORNER
SECTION /g 728 N,R /eW D.O.T. Approval# 55 -65- 2924 -1999
(BERNTSEN MONUMENT) UNPLATTED A,
1 I 6 0 kill LANDS
1 QWN €Q By X41, 23 a '0 10 31 CAUTION
M
FO s'io'�w a Is €M 4 � * Co High s etback restrictions
FRO N M 89 M 566.78 i T Z� �u �yF�s See i Slhoo
% O
4 1nI
4 70.03 "70' 2 aD 30/ 469.44' 3.Od' N 69 °37'23 "E 3 O
---
rj
5' 9 °fig 2 /ry41 l � 4 •�\
�2/ .O ' ' 0 6 / a. A (,G/ 7
NB9.38'20 "E N89 O�@ Oj �, ie06'•o /ONC`rc�'
y99.� q0 a N LOT / 3 � •�` \\ ���y� 4F T
LOT I o "� � :' �� ' -1
An erosion control plan �( �
i Will be required on - "' o' NOTE-
" �j / 9 ss• See Sheet 3 for
Z Lots 2, 3 and 4 • 32' 9 2 / �� �` individual /of areas.
� /
o prior to N r2
o COAStrllCt]OA. 0 ~; 4
�r 4 Q ? V� , 'h `o � �N�
� a
Ol ku
o y OWNERS ADDRESS
• y 220 HWY. 65 N.
� // e4
C131 x mJ : RIVER FALLS, Wl.
h 14/
a te►, syo s� _.'• � s� X
2i i i �q4 - o � / o �I / Scale in Feet I" =300'
ti l
A i l
r= `��►
E O 50 100 200 300 BOO
/ Bearings are referenced to the North-South
o ' k Quarter Section line of Section 19, assumed
�I R��F LEGEND bearing NO1 0 23 41 W.
Indicates I "x 24" Iron Pipe Set
J; /� (Min. Wt. -1.131b./lin. ft.)
• Indicates I" Iron Pipe Found
-�E- -X Indicates Fence
(R= ) Recorded as
QI /o � "•� ' °� • Proposed Driveway Location
ZI p Soil Boring ,��ttt
+ + % % / a ��i
34 / '
• o / y� k Dated June 17, 1999 m '• W LA NCE RPHY - On o
° m$ r' ht / v l Revised Sept. 17, 1999 Gs 1713 0
"' „�, Revised Oct. 5, 1999 °' N •' RIVER FALLS
J +
O 502 °47'00 "W FA '••••• '•••
'N`• ,. APPROVED g �•`
ST. CROIX COUNTY ei L ``,��
souT QUA ER CORNER Planning Zoning and Parks Cornmittee eetr li t %0
/9, r28 N R /B W
(SERNTSEN MONUMENT) FEB 0 9 Z00U�
This Instrument Drafted by Mark W. Peavey SHEET / OF
If not recorded within 30 days of
approval date approval shall be Vol 14 Page 3806
/ Updated 97 -98 Wis. Stats. Database 52
59.69 COUNTIES UNOFFICIAL TEXT
shall include the legal description of the lands, the nature and arrangements in the municipality reaches that total, the municipal-
extent of the uses therein, and the names and addresses of the ity may prohibit additional community living arrangements from
owner or occupant or both. Promptly on its completion the record locating in the municipality. In any municipality, when the capac-
shall be published in the county as a class 1 notice, under ch. 985. ity of community living arrangements in an aldermanic district in
The record, as corrected, shall be on file with the register of deeds a city or a ward in a village or town reaches 25 or 1 % of the popula-
60 days after the last publication and shall be prima facie evidence tion, whichever is greater, of the district or ward, the municipality
of the extent and number of nonconforming uses existing on the may prohibit additional community living arrangements from
effective date of the ordinance in the town. Corrections before the being located within the district or ward. Agents of a facility may
filing of the record with the register of deeds may be made on the apply for an exception to the requirements of this subdivision, and
filing of sworn proof in writing, satisfactory to the officer adminis- such exceptions may be granted at the discretion of the municipal -
tering the zoning ordinance. ity.
(e) The board shall prescribe a procedure for the annual listing 2. No community living arrangement maybe established after
of nonconforming uses, discontinued or created, since the pre- January 1, 1995, within 2,500 feet, or any lesser distance estab-
vious listing and for all other nonconforming uses. Discontinued lished by an ordinance of the municipality, of any other such facil-
and newly created nonconforming uses shall be recorded with the ity. Agents of a facility may apply for an exception to this require -
register of deeds immediately after the annual listing. ment, and exceptions may be granted at the discretion of the
(d) Paragraphs (b) and (c) shall not apply to counties issuing municipality. Two community living arrangements may be adja-
building permits or occupancy permits as a means ofenforcing the cent if the municipality authorizes that arrangement and if both
zoning ordinance or to counties which have provided other proce- facilities comprise essential components of a single program.
dures for this purpose. (bm) A foster home or a treatment foster home that is the pri-
(11) PROCEDURE FOR ENFORCEMENT OF COUNTY ZONING ORDI- mary domicile of a foster parent or treatment foster parent and that
NANCE. The board shall prescribe rules, regulations and adminis- is licensed under s. 48.62 or an adult family home certified under
trative procedures, and provide such administrative personnel as s. 50.032 (lm) (b) shall be a permitted use in all residential areas
it considers necessary for the enforcement of this section, and all and is not subject to pars. (a) and (b) except that foster homes and
ordinances enacted in pursuance thereof. The rules and regula- treatment foster homes operated by corporations, child welfare
tions and the districts, setback building lines and regulations agencies, religious associations, as defined in s. 157.061 (15),
authorized by this section, shall be prescribed by ordinances associations or public agencies shall be subject to pars. (a) and (b).
which shall be declared to be for the purpose of promoting the (br) 1. No adult family home described in s. 50.01(1) (b) may
public health, safety and general welfare. The ordinances shall be be established within 2,500 feet, or any lesser distance established
enforced by appropriate forfeitures. Compliance with such ordi- by an ordinance of the municipality, of any other adult family
nances may also be enforced by injunetional order at the suit of the home described in s. 50.01 (1) (b) or any community living
county or an owner of real estate within the district affected by the arrangement. An agent of an adult family home described in s.
regulation. 50.01 (1) (b) may apply for an exception to this requirement, and
(12) PRIOR oRDINANcEs EFFECTNE. Nothing in this section the exception may be granted at the discretion ofthe municipality.
shall invalidate any county zoning ordinance enacted under stat- 2. An adult family home described in s. 50.01 (1) (b) that
utes in effect before July 20, 1951. meets the criteria specified in subd. 1. and that is licensed under
(13) CONSTRUCT10N OF sEcnom The power; granted in this s. 50.033 (1m) (b) is permitted in the municipality without restric-
section shall be liberally construed in favor of the county exercis- tion as to the number of adult family homes and may locate in any
ing them, and this section shall not be construed to limit or repeal residential zone, without being required to obtain special zoning
any powers now possessed by a county. permission except as provided in par. (i).
(14) LnvnTAnoN of AcnoNs. A landowner, occupant or other (c) Where the community living arrangement has capacity for
person who is affected by a county zoning ordinance or amend- 8 or fewer persons being served by the program, meets the criteria
ment, who claims that the ordinance or amendment is invalid listed in pars. (a) and (b), and is licensed, operated or permitted
because procedures prescribed by the statutes or the ordinance under the authority of the department of health and family ser-
were not followed, shall commence an action within the time pro - vices, that facility is entitled to locate in any residential zone, with -
vided by s. 893.73 (1), except this subsection and s. 893.73 (1) do out being required to obtain special zoning permission except as
not apply unless there has been at least one publication of a notice provided in par. (i).
of a zoning hearing in a local newspaper ofgeneral circulation and (d) Where the Community living arrangement has capacity for
unless there has been held a public hearing on the ordinance or 9 to 15 persons being served by the program, meets the criteria
amendment at the time and place specified in the notice. listed in pars. (a) and (b), and is licensed, or operated or permitted
(15) COMMUNITY AND OTHER uv[NG ARRANGEMENTS. For pur- under the authority of the department of health and family ser-
poses of this section, the location of a commune livin arran - vices, the facility is entitled to locate in any residential area except
men as defined in s. 46.03 (22), a os er tome, as defm d in s. areas zoned exclusively for single— family or 2— family residences,
48.02 (6), a treatment foster home, as defined in s. 48.02 (17q), or except as provided in par. (i), but is entitled to apply for special
an adult family home, as defined in s. 50.01 (1), in any municipal - zoning permission to locate in those areas. The municipality may
ity, shall be subject to the following criteria: grant special zoning permission at its discretion and shall make a
(a) No community living arrangement may be established after procedure available to enable such facilities to request such per -
March 28, 1978, within 2,500 feet, or any lesser distance estab- mission.
lished by an ordinance of a municipality, of any other such facility. (e) Where the community living arrangement has capacity for
Agents of a facility may apply for an exception to this require- serving 16 or more persons, meets the criteria listed in pars. (a) and
ment, and such exceptions may be granted at the discretion of the (b), and is licensed, operated or permitted under the authority of
municipality. Two community living arrangements may be adja- the department of health and family services, that facility is
cent if the municipality authorizes that arrangement and if both entitled to apply for special zoning permission to locate in areas
facilities comprise essential components of a single program. zoned for residential use. The municipality may grant special zon-
(b) 1. Community living arrangements shall be permitted in ing permission at its discretion and shall make a procedure avail-
each municipality without restriction as to the number offkcilities, able to enable such facilities to request such permission.
so long as the total capacity of the community living arrangements (f) The department of health and family services shall desig-
does not exceed 25 or I%ofthe municipality's population, which- nate a single subunit within the department to maintain approprl-
ever is greater. When the capacity of the community living ate records indicating the location and the capacity of each com-
Unofficial text from 97-98 Wis. Stats. database. See printed 97-98 Statutes and 99 Wis. Acts for official text under s. 35.18 (2)
stats. Report errors to the Revisor of Statutes at (608) 266 -2011, FAX 264 -6978, email bruce.munson@1egis- state -wl -us
53 Updated 97-98 Wis. State. Database COUNTIES 59.69
UNOFFICIAL TEXT
munity living arrangement, and the information shall be available An ordinance classifying land as agricultural when it is unfit for agriculture is unrea-
�t0 the p ublic. sonable and amounts to a taking of the land without compensation. Kmiec v. Town
P of Spider Lake, 60 Was. 2d 640, 211 N.W.2d 471.
(g) In this subsection, "special zoning permission" includes, A property owner does not acquire a " vested interest" in the continuance of non-
but is not limited to, the following: special exception, special per- conformin use, and such status willbe den iedif the specific use was casual and occa
mit conditional use, zoning variance conditional p ermit and
sional, or i f the use was merely accessory or incidental to the principal use. Walworth
g , P County v. Hartwell, 62 Wis. 2d 57, 214 N.W.2d 288.
words of similar intent. Under s. 59.97 [now s. 59.691 (5) (c), a county zoning ordinance becomes effective
shall take action, upon there nest of in a town upon approval of the text by the town board and the filing of the approving
(h ) The attorney general P q resolution with the town clerk and not when it merely adopts a zoning map. Racine
the department of health and family services, to enforce com- County v. Alby, 65 Wis. 2d 574 223 N.W.2d 438.
pliance with this subsection. Zoning ordinances, being in derogation of common law, are to be construed in
favor of the free use of vate property. Cohen v. Dane Co. Bd. of Adjustment, 74
�i (j) Not less than 1 I months nor more than 13 months after the w;a 2d s7, z46 N.w.2i Iz.
first licensure ofan adult family home under s. 50.033 or of a com- A municipality is not required to show irreparable injury before obtaining an
munity living arrangement and every year thereafter, the common injunction under s. 59.97 (now s. 59.69] (11). County of Columbia v. Bylewski, 94
Wis. 2d 153, 288 N.W.2d 129 (1980).
council or village or town board of a municipality in which a Under s. 59.97 (row s. 59.691(9) a county may rezone county - owned land con -
licensed adult family home or a community living arrangement is trary to town zoning laws and without town approval. Town of Ringle v. County of
located may make a determination as to the effect of the adult fam- Marathon, 104 Wis. 2d 297 311 N.W.2d 595 (1981).
ily home or community living arrangement on the health, safety Environmental zoning is discussed M & I Marshall Bank v. Town of Somers, 141
ali The determination Wis. r p rpo 414 N. 824 anon
or welfare of the residents of the municipality. tY• For purposes of determining a nonconforming use for a quarry site, all land that
shall be made according to the procedures provided under par. (1 ). contains the mineral and is integral to the operation is included, although a particular
If the common council or village or town board determines that the portion may not be under actual excavation. Smart v. Dane County Bd. of Adjust -
ali of a licensed adult fam home or inert, 177 Wis. re ulat no con N. 782 uses in .
existence in the municipality tY Y The power to regulate nonconforming uses includes the power to limit the exten-
a community living arrangement poses a threat to the health sion or expansion of the use if it results in a change in the character ofthe use. Wauke-
safety or welfare of the residents of the municipality, the common sha County v. Pewaukee Marina, Inc. 187 Wis. 2d 18, 522 N.W.2d 536 (Ct. App.
council or village or town board may order the adult amil home 1994).
$ Y dl f Y When a zoning ordinance is changed, a builder may have a vested right, enforce-
or community living arrangement to cease operation unless spe- able by mandamus, to build under the proviously existing ordinance if the builder has
cial zoning permission is obtained. The order is subject to judicial submitted, prior to the change, an application for a permit in strict and complete con -
review under s.68.13, except that a free co ofthe transcript ma formance with the ordinance then in effect. Lake Bluff Housing Partners v. South
P PY Y Milwaukee, 197 Was. 2d 157, 540 N.W.2d 189 (1995).
not be provided to the licensed adult family home or community Unless the zoning ordinance Provides otherwise, a court should measure the suffi-
living arrangement. The licensed adult family home or commu- ciency of a conditional use application at the time that notice of the final public hear -
nity living arrangement shall cease operation within 90 days after (199977 fir given. Weber v. Town of Saukville 209 Wis. 2d 214, 562 N.W.2d 412
the date of the order, or the date of final judicial review of the A permit issued fora use prohibited by a zoning ordinance is illegal per se. A con -
order, or the date of the denial of special zoning permission, ditional use peromt only allows a property owner to put the property to a use that is
whichever is later. expresslypernrttedaslongasconditionshavebeenmet. A use begun underan illegal
permit cannot be a prior non conforming use. Foresight, Inc. v. Bahl, 211 Wis. 2d 599,
(im) The fact that an individual with acquired immunodefi- 565 N.W2d 279 (Ct. App. 1997).
ciency syndrome or a positive test for the presence of HIV, as A nonconforming use, regardless of its duration, may be prohibited or restricted
if it also constitutes a public nuisance or is harmful to public health, safety, orwelfam.
defined in s. 252.01 (lm), antigen or nonantigeniC products of Town of Delafield v. Sharpley, 212 Wis. 2d 332, 568 N.W.2d 779 (CL App. 1997).
HIV or an antibody to HIV resides in a community living arrange- A county executive's powerto veto ordinances and resolutions extends to rezoning
ment with a capacity for 8 or fewer persons may not be used under petitions that are in essence ar000sed amendments to the county zoning ordinance.
that the existence of the community Irvin The veto is subject w n"
l'toalud'ici review. Schmeling v. Phelps 212 Wis. 2d 898,
par. i () to assert or prove tY $ 569 N.W.2d 784 (Ct. App. 1997).
arrangement in the municipality poses a threat to the health, safety Sub. (11) does not eliminate the traditional equitable power of a circuit court. It
or welfare of the residents of the municipality. is within the power of the court to deny a county's request for injunctive relief when
a zoning ordinance violation is proven. The court should take evidence and weigh
(j) A determination under par. (i) shall be made after a hearing equitable considerations inclu that of the state's citizens. Forest County v.
before the common council or village or town board. The munici- Goode, 219 ors. 2d 655 579 N.W.2d 715 (1998).
er s notice to the Licensed adult Construction in violation of zoning regulations, even when authorized by a volun-
P ali tY shall p rovide at least 30 days' tartly issued permit, is unlawful. Lake Bluff Housing Partners v. City of South Mil -
family home or the community living arrangement that such a waukee, 222 Was. 2d 222,588 N.W.2d 45 (Cr. App. 1998).
hearing will be held. At the hearing, the licensed adult family whale the has the authority to regulate the operation i� farms, its
not
authority does not negate the powerto enforce zoningo a game farms.
home or the community living arrangement may be represented Both are applicable. Willow Creek Ranch v. Town of Shelby, 224 Wis. 2d 269, 592
by counsel and may present evidence and call and examine wit N.W. 2d 15 (Ct. App. 1998).
nesses and cross — examine other witnesses called The common A conditional use permit did not impose a condition that the conditional use not
be conducted outside the permitted area. It was improper to revoke the permit based
council or village or town board may call witnesses and may issue on that use. An enforcement action in relation to the parcel where the use was not
subpoenas. All witnesses shall be sworn by the common council, permitted was an appro rem
town board or village Bet 16 (C f V. St. Croix County Board of
a board. The common council or village or Adjustment 2 is Wis. h 735, shown N.W.2d 916 change nge Ap use to ).
$ $ Once a municipality has shown an illegal change in use to a nomconfomiing use,
town board shall take notes of the testimony and shall mark and the municipality is entitled to terminate the entire nonconforming rise. The decision
preserve all exhibits. The common council or village or town is not within the discretion of the court reviewing the order. Village of Menomonee
Falls v. Preuss, 225 Wis. 2d 746, 593 N.W2d 496 (Ct. App. 1999).
board may, and upon request of the licensed adult family home or To violate substantive due process guarantees, a zoning decision must involve
the community Irving arrangement shall, cause the proceedings to more than simple errors an law or an improper exercise of discretion, at must shock
be taken b stenographer or din device, the ex the conscience. The city violation of a purported agreement regarding zoning was
Y a gmP Y a recording expense not a violation. A court cannot compel a political body to adhere to an agreement
thereof to be aid b municipality. Within 20 days after the regrading oning if at has legitimate reasons for breaching. Etenialast Foundation,
hearing, the common council or village P Y the mun it Inc. v. City of Platteville, 225 Was. 2d 759, 593 N.W.2d 84 (CL App. 1999).
or town board shall ma
or deliver to the licensed adult family home or the community liv- The fact that a county is within a regional planning commission does not affect
ing arrangement its written determination stating the reasons county zoning power. 61 Arty. Gen. 220. The authority of a county to regulate mobile homes under this section
and other
therefor. The determination shall be a final determination. zoning questions are discussed. 62 Atty. Gen. 292.
History: 1971 c. 40 s. 93; 1971 c. 86,224; 1973 c. 274; 1977 c. 205; 1979 c. 233 Zoning ordinances utilizing definitions of "family" to restrict the number of unre-
ss. 2 to 5, 7 and 8; 1979 c. 323; 1981 c. 341, 354, 374; 1983 a 192 s. 303 (1); 1983 lated persons who may live in a single family dwelling are of questionable constitu-
a. 410; 1983 a. 532 s. 36; 1985 a. 29, 136, 1%, 281, 316; 1987 a. 161, 395; 1989 a. tionality. 63 Atty. Gen. 34.
80, 201; 1991 a. 255, 269, 316; 1993 a. 16, 27, 246, 327, 400, 446, 491; 1995 a. 27 Under s. 59.97 [now s. 59.69) (5) (c), town board approval of a comprehensive
as. 9130 (4),9126 (19); 1995 a 201 s. 475; Stars. 1995 s. 59.69; 1995 a. 225 s. 174; county zoning ordinance must extend to the ordinance in its entirety and may not
1995 a. 227; 1997 a. 3, 35; 1999 a. 9, 148, 185. extend only to parts of the ordinance. 63 Arty. Gen. 199.
A zoning ordinance may distinguish between foster homes and therapeutic homes A county that has enacted a countywide comprehensive zoning ordinance under
for the care of children. Browndale International v. Board of Adjustment, 60 Wis. 2d this section may not authorize the withdrawal of town approval of the ordinance or
182, 208 N.W.2d 121. exclude any town from the ordinance. 67 Arty. Gen, 197.
A plaintiffis not required to exhaust administrative remedies when his or her claim The effect of s. 91.73 (4) on procedures to amend county comprehensive zoning
is that a zoning ordinance is unconstitutional, but may ask for a declaratoryjudgment. ordinances under s. 59.97 [now a. 59.69] (5) (e) is discussed. 67Atty Gen. 290.
Unofficial text from 97-98 Ms. Slats. database. See printed 97 -98 Statutes and 99 Ma. Acts for official text under s. 55.18 (2)
state. Report errors to the Revisor of Statutes at (608) 266 -2011, FAX 2641- -6978, email bruce.munson@legls.state.wlus
5 Updated 97-98 Wis. Stats. Database
UNOFFICL4L TEXT SOCIAL SERVICES 46.03
rized to receive such payments in accordance with law and rules The department may promulgate such additional health and safety
of the department on behalf of the counties. Except for payments standards as it determines to be in the public interest.
provided under subch. III of ch. 49, the department may charge the (26) DATA PROCESSING PROJECTS. Submit a report each
counties for the cost of operating public assistance systems which December 31 to the joint committee on finance and to the chief
make such payments. clerk of each house of the legislature, for distribution to the appro-
(b) The department may make social service payments directly priate standing committees under s. 13.172 (3), regarding the data
to recipients, vendors or providers in accordance with law and processing projects under development. The report shall include:
rules of the department on behalf of the counties which have con- ( The schedule for implementation;
tracts to have such payments made on their behalf. (b) Estimates of development and operating costs; and
(c) The county department under s. 46.215, 46.22 or 46.23 ( Proposed methods of determining charges for service
shall provide the department with information which the depart- where applicable.
ment shall use to determine each person's eligibility and amount (29) MEDIA PHOTO. The department may use in the media a
of payment. The county department under s. 46.215, 46.22 or picture or description of a child in the guardianship of the depart-
he manner prescribed by the department. t shall provide the department all necessary information in ment for the purpose of finding adoptive parents for that child.
the
(d) The department shall disburse from state or federal funds (30) PRIMARY PSYCHIATRIC CARE CONTRACTS. (a) To provide
or both the entire amount and charge the county for its share under for an orderly reduction of state institutional primary psychiatric
s.46.495. services the department may approve the institutes entering into
contracts with county departments under s. 51.42 for providing
(22) COMMUNrrY LIvING ARRANGEMENTS. (a) "Community
living arrangement' means any ofthe following facilities licensed primary psychiatric care. If excess capacity exists l state oper-
ated mental health institutes, the department shall explore whether
or operated, or permitted under the authority of the department:
such excess facilities may be sold or leased to a county department
child welfare agencies under s. 48.60, group homes for children
under s. 51.42.
under s. 48.02 (7) and community—based residential facilities
under s. 50.01; but does not include adult family homes, as defined (b) contract maybe approved for a period of time greater
in s. 50.01, day care centers, nursing homes, general hospitals, than one e year, and no contract shall be approved except under par.
special hospitals, prisons and jails. (c)
(b) Community living arrangements shall be subject to the (c) The counties where the mental health institutes are located
same building and housing ordinances, codes and regulations of may contract with the institutes for primary psychiatric care on an
the municipality or county as similar residences located in the area ongoing basis, which contracts shall be approved by the depart-
in which the facility is located. ment and shall be renewed annually.
(c) The department shall designate a subunit to keep records (33) RELIEF; AMERICAN INDIANS. The department may negoti-
and supply information on community living arrangements under ate and enter into an agreement with any appropriate agency of the
ss. 59.69 (15) (f), 60.63 (7) and 62.23 (7) (i) 6. The subunit shall federal government for provision of relief to needy American
be responsible for receiving all complaints regarding community Indians.
living arrangements and for coordinating all necessary investiga- (34) FETAL ALCOHOL SYNDROME AND DRUG DANGER PAM -
tory and disciplinary actions under the laws ofthis state and under PHLETs. The department shall acquire, without cost if possible,
the rules of the department relating to the licensing of community pamphlets that describe the causes and effects of fetal alcohol syn-
living arrangements. drome and the dangers to a fetus of the mother's use of cocaine or
(d) A community living arrangement with a capacity for 8 other drugs during pregnancy and shall distribute the pamphlets
or fewer persons shall be a permissible use for purposes of any free of charge to each county clerk in sufficient quantities so that
deed covenant which limits use of property to single — family or each county clerk may provide pamphlets to marriage license
2— family residences. A community living arrangement with a applicants under s. 765.12 (1).
capacity for 15 or fewer persons shall be a permissible use for pur- (37) FIRST AID INSTRUCTION. In connection with first aid and
poses of any deed covenant which limits use of property to more cardiopulmonary resuscitation instruction to fitness center
than 2— family residences. Covenants in deeds which expressly employees required under s. 100.178, do all of the following:
prohibit use of property for community living arrangements are (a) Promulgate rules establishing standards and procedures
void as against public policy. under s. 100.178 (5) (a) to (c).
(e) If a community living arrangement is required to obtain (b) Approve individuals, organizations or institutions of
special zoning permission, as defined in s. 59.69 (15) (g), the higher education which teach fitness center employees basic fast
department shall, at the request of the unit of government respon- aid and basic cardiopulmonary resuscitation under s. 100.178 (2).
sible for granting the special zoning permission, inspect the pro- (39) ADOLESCENT PROGRAMMING RECOMMENDATIONS. Iden-
posed facility and review the program proposed for the facility. tify and provide ways to improve coordination of adolescent and
After such inspection and review, the department shall transmit to parent educational programs and services at the state and local
the unit of government responsible for granting the special zoning levels by doing all of the following:
permission a statement that the proposed facility and its proposed ( Identifying and recommending ways to eliminate govern-
program have been examined and are either approved or disap- mental barriers to local development of coordinated educational
proved by the department. programs and services for adolescents and parents of adolescents.
(25) UNIFORM REGULATION AND LICENSING. The department (b) Identifying and recommending ways to support and
shall promulgate rules to establish licensing and program com- involve parents of adolescents in the planning, coordination and
pliance standards for care and residential facilities, hospitals, delivery of services for adolescents.
hotels, restaurants and the vending of food and beverages after due
consideration of the relationship of a licensing code to other (4O) GRANTS FOR PILOT PROGRAMS OR DEMONSTRATION PRO -
related licensing codes, the need for uniform administration, the JECTs. Comply with all of the following whenever the department
need to maximize the use of federal funds and the need to encour- provides a grant after August 15, 1991, for a pilot program or dem-
age the development and operation of needed facilities statewide. onstration project:
In establishing licensing standards designed to ensure that the (a) State on the grant application that the funding for the pro -
facility qualifies for federal financial participation, the depart- gram or project will be provided by the department once or for a
ment shall establish federal regulations as the base requirement. limited period of time, whichever is applicable.
Unofficial text from 97-98 Ms. Stats. database. See printed 97-98 Statutes and 99 Wis. Acts for official team under s. 35.18 (2)
stats. Report errors to the Revisor of Statutes at (608) 266 -2011, FAX 264 -6978, emall bruce.munsonglegis.state.W.us
1 Updated 97 -98 Wis. Stats. Database UNIFORM LICENSURE 50.01
UNOFFICL4L TEXT
CHAPTER 50
UNIFORM LICENSURE
SUBCHAPTER 1 50.35 Application and approval.
CARE AND SERVICE RESIDENTIAL FACILITIES 50.355 Repotting.
50.01 Definitions. 50.36 Rules and standards.
50.02 Department; powers and duties. 50.37 Notification to accrediting organization.
50.025 Plan reviews. 50.38 Forfeitures.
50.03 Licensing, powers and duties. 50.39 Exemptions and enforcement.
50.032 Certification of certain adult family homes. 50.49 Licensing and regulation of home health agencies.
50.033 Licensure of certain adult family homes. 50.495 Fees permitted for a workshop or seminar.
50.034 Residential care apartment complexes. 50.498 Denial, nomenewal and revocation of license, certification or registration
50.035 Special provisions relating to regulation of community -based residential based on tax delinquency.
facilities. SUBCHAPTER III
50.037 Community -based residential facility licensing fees. RURAL MEDICAL CENTERS
50.04 Special provisions applying to licensing and regulation of nursing homes. 50.50 Definitions.
50.05 Placement of monitor and appointment of receiver. 50.51 Departmental powers.
50.053 Case conference. 50.52 Licensing procedure and requirements.
50.06 Certain admissions to facilities. 50.53 Inspections and investigations.
50.065 Criminal history and patient abuse record search. 50.535 Reporting.
50.07 Prohibited acts. 50.54 Prohibitions.
50.09 Rights of residents in certain facilities. 50.55 Penalties and remedies.
50.095 Resident's right to know; nursing home reports. 50.56 Applicability.
50.097 Registry. 50.57 Fees permitted for a workshop or seminar.
50.098 Appeals of transfers or discharges. SUBCHAPTER IV
50.10 Private cause of action. HOSPICES
50.11 Cumulative remedies. 50.90 Definitions.
50.12 Waiver of federal requirements. 50.91 Departmental powers and duties.
50.13 Fees permitted for a workshop or seminar. 50.92 Licensing requirements.
50.135 Licensing and approval fees for inpatient health care facilities. 50.925 Use of name or advertising prohibited.
50.14 Assessments on occupied, licensed beds. 50.93 Licensing procedure.
SUBCHAPTER II 50.94 Admission to and care in a hospice for certain incapacitated persons.
HOSPITALS 50.95 Rule-making authority.
50.32 Hospital regulation and approval act. 50.97 Right of injunction.
50.33 Definitions. 50.98 Forfeitures.
50.34 Purpose. 50.981 Fees permitted for a workshop or seminar.
Cross - reference: See s. 46.011 for definitions applicable to chs. 46, 48, 50, 51, a kitchen, including a stove, and individual bathroom, sleeping
55 and 58. and living areas, and that provides, to a person who resides in the
place, not more than 28 hours per week of services that are sup -
SUBCHAPTER I portive, personal and nursing services. "Residential care apart-
ment complex" does not include a nursing home or a community-
CARE AND SERVICE RESIDENTIAL FACILITIES based residential facility, but may be physically part of a structure
that is a nursing home or communi"ased residential facility.
50.01 Definitions. As used in this subchapter: In this subsection, "stove" means a cooking appliance that is a
(1) "Adult family home" means one of the following: microwave oven of at least 1,000 watts or that consists of burners
(a) A private residence to which all of the following apply: and an oven.
1. Care and maintenance above the level of room and board (1 e) `Basic care" includes periodic skilled nursing services or
but not including nursing care are provided in the private resi- physical, emotional, social or restorative care.
dence by the care provider whose primary domicile is this resi- (1g) "Community-based residential facility" means a place
dence for 3 or 4 adults, or more adults if all of the adults are sib- where 5 or more adults who are not related to the operator or
lings, each of whom has a developmental disability, as defined in administrator and who do not require care above intermediate
s. 51.01 (5), or, if the residence is licensed as a foster home, care level nursing care reside and receive can:, treatment or services
and maintenance are provided to children, the combined total of that are above the level of room and board but that include no more
adults and children so served being no more than 4, or more adults than 3 hours of nursing care per week per resident. "Community-
or children if all of the adults or all of the children are siblings, or, based residential facility' does not include any of the following:
if the residence is licensed as a treatment foster home, care and (a) A convent or facility owned or operated by members of a
maintenance are provided to children, the combined total ofadults religious order exclusively for the reception and care or treatment
and children so served being no more than 4. of members of that order.
2. The private residence was licensed under s. 48.62 as a fos- (b) A facility or private home that provides care, treatment and
ter home or treatment foster home for the care of the adults speci- services only for victims of domestic abuse, as defined in s. 46.95
fled in subd. 1. at least 12 months before any of the adults attained (1) (a), and their children.
18 years of age. (c) A shelter facility as defined under s. 16.352 (1) (d).
(b) A place where 3 or 4 adults who are not related to the opera- (d) A place that provides lodging for individuals and in which
for reside and receive care, treatment or services that are above the all of the following conditions are met:
level of room and board and that may include up to 7 hours per
week of nursing care per resident. "Adult family home" does not 1. Each lodged individual is able to exit the place under emer-
include a place that is specified in sub. (I g) (a) to (d), (f) or (g). gency conditions without the assistance of another individual.
(1d) "Residential care apartment complex" means a place 2. No lodged individual receives from the owner, manager or
where 5 or more adults reside that consists of independent apart- operator of the place or the owner's, manager's or operator's agent
ments, each of which has an individual lockable entrance and exit, or employee any of the following:
Unofficial text from 97-98 Ms. Stats. database. See printed 97-98 Statutes and 99 W/s. Acts for official text under s. 35.18 (2)
stats. Report errors to the Revisor of Statutes at (608) 266 -2011, FAX 264 -6978, email bruce.munson @leg /s.state.wl.us
Updated 97 -98 Wis. Stats. Database 2
50.01 UNIFORM LICENSURE UNOFFICL4L TEXT
a. Personal care, supervision or treatment, or management, (4m) "Operator" means any person licensed or required to be
control or supervision of prescription medications. licensed under s. 50.03 (1) or a person who operates an adult fam-
b. Care or services other than board, information, referral, ily home that is licensed under s. 50.033 (lm) (b).
advocacy or job guidance; location and coordination of social ser- (4o) "Persona[ care" means assistance with the activities of
vices by an agency that is not affiliated with the owner, manager daily living, such as eating, dressing, bathing and ambulation, but
or operator, for which arrangements were made for an individual does not include nursing care.
before he or she lodged in the place; or, in the case of an emer- (4r) "Plan of correction" means a nursing home's response to
gency, arrangement for the provision of health care or social ser- alleged deficiencies cited by the department on forms provided by
vices by an agency that is not affiliated with the owner, manager the department.
or operator. (5m) "Recuperative care" means care anticipated to be pro -
(e) An adult family home. vided in a nursing home for a period of 90 days or less for a resi-
(f) A residential care apartment complex. dent whose physician has certified that he or she is convalescing
(g) A residential facility in the village of Union Grove that was or recuperating from an illness or medical treatment.
authorized to operate without a license under a final judgment (5r) "Registered nurse" means a nurse who is licensed under
entered by a court before January 1, 1982, and that continues to s. 441.06 or permitted under s. 441.08 or who is licensed as a regis-
comply with the judgment notwithstanding the expiration of the tered nurse in a party state, as defined in s. 441.50 (2) 0).
judgment. (6) "Resident" means a person who is cared for or treated in
(1m) "Facility" means a nursing home or community—based and is not discharged from a nursing home, community—based
residential facility. If notice is required to be served on a facility residential facility or adult family home, irrespective of how
or a facility is required to perform any act, "facility" means the admitted.
person licensed or required to be licensed under s. 50.03 (1). (6g) "Respite care" means care anticipated to be provided in
(1 r) "Home health agency" has the meaning given under s. a nursing home for a period of 28 days or less for the purpose of
50.49 (1) (a). temporarily relieving a family member or other caregiver from his
(i s) "Intensive skilled nursing care" means care requiring or her daily caregiving duties.
specialized nursing assessment skills and the performance of spe- (6r) "Short—term care" means recuperative care or respite care
cific services and procedures that are complex because of the resi- provided in a nursing home.
dent's condition or the type or number of procedures that are nec- (6v) "Skilled nursing services" means those services, to
essary, including any of the following: which all of the following apply, that are provided to a resident
(a) Direct patient observation or monitoring or performance of under a physician's orders:
complex nursing procedures by registered nurses or licensed prac- (a) The services require the skills of and are provided directly
tical nurses on a continuing basis. by or under the supervision of a person whose licensed, registered,
(b) Repeated application of complex nursing procedures or certified or permitted scope of practice is at least equivalent to that
services every 24 hours. of a licensed practical nurse.
(c) Frequent monitoring and documentation of the resident's (b) Any of the following circumstances exist:
condition and response to therapeutic measures. 1. The inherent complexity of a service prescribed for a resi-
(1 t) "Intermediate level nursing care" means basic care that is dent is such that it can be safely and effectively performed only by
required by a person who has a long —term illness or disability that or under the supervision of registered nurses or licensed practical
has reached a relatively stable plateau. nurses.
(1w) "Licensed practical nurse" means a nurse who is 2. The full recovery or medical improvement of the resident
licensed or has a temporary permit under s. 441.10 or who is is not possible, but the services are needed to prevent, to the extent
licensed as a licensed practical/vocational nurse in a party state, possible, deterioration of the resident's condition or to sustain cur -
as defined in s. 441.50 (2) 0). rent capacities of the resident.
(2) "Nurse's assistant" means a person who performs routine 3. Because of special medical complications, performing or
patient care duties delegated by a registered nurse or licensed supervising a service that is generally unskilled or observing the
practical nurse who supervises the person, for the direct health resident necessitates the use of a person whose licensed, regis-
care of a patient or resident. "Nurse's assistant" does not mean a tered, certified or permitted scope of practice is at least equivalent
person who is licensed, permitted, certified or registered under to that of a licensed practical nurse.
subch. XI of ch. 440 or ch. 441, 448, 449, 450, 451, 455 or 459 or (7) "Violation" means a failure to comply with any provision
a person whose duties primarily involve skills that are different of this subchapter or administrative rule promulgated thereunder.
than those taught in instructional programs for nurse's assistants. An alleged deficiency in a nursing home reported in writing to the
(2m) "Nursing care" means nursing procedures, other th department by any of its authorized representatives shall not be
personal care, that are permitted to be performed by a registered deemed to be a violation until the department determines it is a
nurse under s. 441.01 (3) or by a licensed practical nurse under s. violation by serving notice under s. 50.04 (4). If the facility con -
441.11 (3), directly on or to a resident. tests the department determination, the facility shall be afforded
(3) "Nursing home" means a place where 5 or more persons the due process procedures in this subchapter.
who are not related to the operator or administrator reside, receive History: c. 19 77 c. 170,418; 1979 c. 111; 1983 a. 189 s. 329 (18);1985
P a. 29, 276; 1985 85 a a. 332 32 s s. 251(1); 1987 a. 127, 161; 1989 a 31,136,199; 1991 a 39;
care or treatment and, because of their mental or physical condi- 1993 a. 327 446, 491; 1995 a. 27; 1997 a. 13, 27, 156,237; 1999 a. 22, 32.
tion, require access to 24 —hour nursing services, including limited UP to 7 hours of nursing care may be provided by a community -based residential
f Hacker v. DHSS, 197 Wis. 2d 441, 541. N.W.2d766(1995).
nursing care, intermediate level nursing care and skilled nursing
home" does not include an of the followi �1O department can constitutionally license and regulate re not community-based a er a
services. "Nursing y g dential facilities operated by religious organizations that a re not exempt empt under s.
(c) A convent or facility owned or operated exclusively by and 5o.01(1) 1985 stats. [now 50.01 (1g)] or s. 50.03 (9). 71. Atty. Gen. 112.
for members of a religious order that provides reception and care 50.02 Department; powers and duties. (1) DeP ARTMEN-
or treatment of an individual. TAL AUTHoRtTY. The department may provide uniform, statewide
(d) A hospice, as defined in s. 50.90 (1), that directly provides licensing, inspection and regulation of community —based resi-
inpatient care. dential facilities and nursing homes as provided in this subchapter.
(e) A residential care apartment complex. The department shall certify, inspect and otherwise regulate adult
(4) "Nursing home administrator" has the meaning assigned family homes, as specified under s. 50.032 and shall license adult
in s. 456.01 (3). family homes, as specified under s. 50.033. Nothing in this sub -
Unofficial text from 97-98 Wis. Slats. database. See printed 97 -98 Statutes and 99 Wis. Acts for official text under s. 35.18 (2)
stats. Report errors to the Revisor of Statutes at (608) 266 -2011, FAX 264 -6978, email bruce.tnunson @legls.state.wl.us
Rod Eslinger
From: Jansky, Leroy [Ijansky @commerce.state.wi.us]
Sent: Tuesday, October 24, 2000 1:26 PM
To: 'Rod Eslinger'
Subject: RE: Community Based Residential Facility (CBRF's)
I spoke with the state building inspector and he felt that all such
building
plans must be submitted for review to the department. In addition, if
this
building is not a one- or two- family residence then it would require
submittal to to the department for POWTS review.
• - - - -- Original Message - - - --
• From: Rod Eslinger [ SMTP:Rode @CO.Saint- Croix.WI.US]
• Sent: Tuesday, October 24, 2000 12:39 PM
• To: Leroy 7ansky (E -mail)
• Subject: Community Based Residential Facility (CBRF's)
> Greetings:
• Is there any thing special we should be aware of when issuing a septic
• permit that serves a community based residential facility? What
position
> has DComm taken with these structures?
> Thanks
• Rod Eslinger
• Zoning Specialist
• St. Croix County Zoning
• 1101 Carmichael Road
• Hudson, WI 54016
• phone 715 - 386 -4680
• fax 715 - 386 -4686
> rode @co.saint - croix.wi.us <mailto :rode @co.saint - croix.wi.us>
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DIVISION OF SUPPORTIVE LIVING
WESTERN REGIONAL OFFICE
Tommy G. Thompson BUREAU OF QUALITY ASSURANCE
Governor 610 GIBSON STREET, SUITE 1
State of Wisconsin EAU CLAIRE WI 54701 -3687
Joe Leean Telephone: (715) 836 -4752
Secretary Department of Health and Family Services FAX: (715) 836 -2535
wwwAlifs.state.m.us
August 23, 2000
Mr. James Newman
Aurora Community Services
406 Technology Drive East, Suite B
Menomonie, WI 54751
RE: Preliminary Review
Proposed 6 -Bed CBRF
Aurora Residential Alternatives, Inc
Facility License # Type CNA Capacity 6
Dear Mr. Newman:
In accordance with your request, please be advised that upon reviewing the schematic plans for the
proposed 6 -bed CBRF with you this morning, it appears that the project will comply with the
physical environment requirements of the Wisconsin Administrative Code HFS 83. You may wish to
contact your local municipality for any plan submission requirements and inspections for other
applicable state & local building codes.
In granting preliminary approval, the Division of Supportive Living does not hold itself liable for any
defects in the plans, specifications, plan omissions, or examination oversights, and reserves the
right to require changes or additions should conditions arise making them necessary for code
compliance.
Final construction plans and fire protection system plans must be submitted to this department for
final review and approval for compliance to Wisconsin Administrative Code HFS 83.
If you have any questions regarding this review, please contact me at (715) 836 -6751.
Sincerely,
Romaine Anderson, .Architect
Bureau of Quality Assurance
Eau Claire / Western Regional Office
Cc: Jim Radloff, Licensing Specialist- EC / WRO
Joseph Bronner, RFOD — EC / WRO
Susan Murphy, RFOS — EC / WRO
Sara Utzig — Health Services Section / Madison
EC/WRO construction file
I
r ` i,
46.03 SOCIAL SERVICES 9 ^ "'.� °.• 4'
s t
or guardian under s. 51.47, the department shall base the fee solely 46.23 shall provide the department all necessary inf `"- ' ^r •, • ` •., ^ ' •, (b)
on the minor's ability to pay. the manner prescribed by the department r °tianir._ i*�x d (c) 1
iz,ti'�ty al
who the opin de partme nt o the department is best abate irom the pay, giving due or both the entire amount mo
and charge�he county
r ��+ `?� ,' . A y '. w ' h (2 9 )
ty ritsi6l&
regard to the present needs of the person or of his or her lawful s.46.495.
!tt�da. ° , ' ; ,uC c
dependents - The department may bring action in the name of the (21) DAY CARE STANDARDS. Promulgate 'ivjes' estab for
department to enforce the liability established undorpar- (b). The standards for the certification of day care • (30)
department may not collect from the parent of a minor receiving 48.65I. p r O A ll '
«..., • ,• t' f an al
treatment for alcohol or
This aragraph does notapply to the recovery of fees for thelcato ( 22) t:onitwtrNrnr Li ARRAr►GP1NnNTS. (a) I 'Corpp b pd rt ~ y -: '•. �� ` p ct
living arrangement means any of the following faciup _� °°! )` '``- . •mart
and services specified under s. 46.10. or operated, or permitted under the authority of the r,!
(d) The department may compromise or waive all orpart of the child welfare agencies under s. 48 -60, group homes fore ' ' etch roc'
liability for services received. The sworn statement of the collet- under s. 48.02 (7) and community -based residential jacy iujo . l
lion and deportation counsel appointed under s. 46.10 (7) or the under s. 50.0 1 • but does not include adult family homes, as defined andcr
department secretary, shall be evidence of the services provided in s. 50 -01, day care centers, nursing homes, general lion • ' _ (b) l
and the fees charged for such services_ special hospitals, prisons and jails. "Community living arrange. ,;.•, than On
department (e) The department may delegate to county departments under mane' also includes a youth village program as described (in W.
s. 46.215, 46.22, 51.42 or 51.437 and other providers of care and 118.42. ,_ • (c)
services the powers and duties vested in the department by pars. (b) Community living arrangements shall be subject to rho ma y co
(c) and (d) as it deems necessary to efficiently administer this sub - same building and housing ordinances, codes and regulations of
section, subject to such conditions as the department deems the municipality or county as similar residences located in the area meat aI
appropriate. in which the facility is located. (33,
(f) Notwithstanding par. (a), any person who submits to an (c) The department shall designate a subunit to keep records ate and
assessment or driver safety plan under s. 23.33 (13) (e), 30.80 (6) and supply information on community living arrangements udder p' federal
(d), 343.16 (5) (a), 343.30 (lq), 343305 (10) or 350.11 (3) (d) ss• 59.69 (15) (f), 60.63 (7) and 62,23 (7) (i) 6. The subunit shall ' ladian
shall pay a reasonable fee therefor to the appropriate county be responsible for receiving all complaints regarding community. (34
department under s. 51.42 or traffic safety' school under s. 345.60. living arrangements and for cootdinatiog all necessary investiga.: PHLB11
A county may allow the person to pay the assessment fee in 1, 2, my and disciplinary actions under the laws of this state andunder patnpt
3 or 4 equal instalments. The fee for the driver safety plan may the rules of the department relating to the licensing of community drome
be reduced or waived if the person is unable to pay the complete living arrangements. I .: other c
fee, but no fee for assessment or attendance at a traffic safety (d) A community livins;arrargement with a cacseity 2fOr &_ free of
school under s. 345.60 may be reduced or waived Nonpayment or fewer o shall be a isstile use for ores o — @A - , - -
n each c
of the assessment fee is noncompliance with the court order that deed covenant which hmJ13 use of pro to sin lo- applic
required completion of an assessment and driver safety plan. 2_faau y resiacticci. A commumty living t wr a (31
Upon a fording that the person has the ability to pay, nonpayment - capacrtyrorl or wer persons shall be a permissible use for put- catdic
of the driver safety plan fee is noncompliance with the court order poses of any deed covenant which limits use of property to more empk
that required completion of an assessment and driver safety plan. than 2- family residences. Covenants in deeds which awrossly (
(fm) Notwithstanding par. (a), any person who submits to an prohibit use of property for co ng arrangem are udder
assessment under s. 961.472 shall pay a fee to the appropriate vole as agaves upup brie po r cy
coup i ' ''
department under s. 51.42 The department of health and (b '
county P (e) If a community living arrangement is required to ribtain bight
family services shall set fees for each county department under s. special zoning permission, as defined in s. 59.69 (15) (g), the aid ar
51.42 designed to offset all the costs to the county in providing the department shall, at the request of the unit of government respon 3
assessment program. The department of health and family ser- Bible for granting the special zoning permission, inspect the pro- sons
vices shall provide for the reduction or waiver of the fee for per- posed facility and review the program proposed for the facility-
sons who art unable to pay the complete fee. After such inspection and rcvicw, the department shall tratismitto gram
te
(g) The department shall return to county departments under the unit of government responsible for granting the special zoning bar.
s. 46.215, 46,22, 51.42 or 51.437 50% of eolleceiorts made by the permission a statement that the proposed facility and its proposed shall
department on and after January 1, 1978, for delinquent accounts program have been examined and are either approved or disap- their
previously delegated under par. (e) and then referred back to the proved by the dcparmsttt drnc
department for collections. (25) U NIFORM RwuLAT1oN AND LICEstsrsm Th department iden,
(19) PRoTEC IVISSMwICES. Administer the statewide program shall promulgate rules to establish licensing and pro tom'
of protective services under ch. 55. - pliance standards for care and residential facilities, hospitals, afy
(20) P AYMENT OF 11KNERT& (a) Except for payments provided hotels, restaurants and the vending of food and beverages after due pare
under subch. III of ch. 49. the department may make payments consideration of the relationship of a licensing code to other lave
directly to recipients of public assistance or to such persons autho- related licensing codes, the need for uniform administration. tho
rized to receive such payments in accordance with law and rules need to maximize the use of federal funds and the need to oncour- ('
of the department on behalf of the counties. Except for payments agc the development and operation of needed fatalities statewide. Riw
provided undersubch. lII of ch- 49, the departmentmay charge the in establishing licensing standards designed to ensure that the Pr
counties for the cost of operating public assistance systems which facility qualifies for federal financial participation, the depart -
make such payments. meat shall establish federal regulations as the base requireMeot• invc
(b) The department may make social service payments directly The department may promulgate such additional health and safety deli
to recipients, vendors or providers in accordance with law and standards as it determines to be in the public interest (
rules of the department on behalf of the counties which have con- (26) DATA PRoasswr, PROrl:c1's. Submit a report each ECT
tracts to have such payments grade on their behalf. December 31 to the joint committee on finance and to the chief pro
(c) The county department under s_ 46.215, 46.22 or 46.23 clerk of each house of the legislature, for distribution to the apps °m
shall provide the department with information which the depart- priate standing committees under s. 13.172 (3), regarding the data
ment shall use to determine each person's eligibility and amount processing projects under development- The report shall include: Fa
of payment. The county department under s. 46.215, 46.22 or (a) The schedule for implementation; hn
200 [A HINORONa4 V901MV 8892 5CZ 5TL T %V,3 W 9T 00/9V AT
10/25/00 16:44 FAX 1 715 295 2688 AtTRORA- MENOMONIE 16001
ACS
Aurora Community Services
"A new AVOW ning"
Cotnprised of Aumpa Aesidenffal Alternatives, hoc.. Aurora community Health. Ime— ACCESS, Inc
FAX (715) 235 -2658
TO: ORGANIZATION:
FAX NUMBER:
ATTENTION:
oil FROM: NAME:
DATE:
TYME: �/ • �/� s.m. p.m.
# OF PAGES: (including this page)
MESSAGE:
The docents accompanying this ttansrmssion contain information which may be confidential
and/or privileged_ This information is intended for the individual or entity named above. If you
a 'on or use of the
rc not the intended recipie be aware that an disclosure distribu P � Y > copying,
contents of this information is prohibitc4 and may constitute an invasion of the privacy of the
intended recipient If you have received this tiraasmission in error, please notify us immediately.
Thank you.
Main Of&= P. 0, Box 68. Ma CMMia W1 54751
PLana (715)235-1239 Fin- (715)235-2692
YTV: 1-US- 261 -5585
Equal Employment Oppoau W / Affinm alive Acfim r= p)oyw
i
Standard Erosion Control Plan
for 1 & 2 Family Dwelling Construction Sites
I
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.
I
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.
t
3. Submit this plan at the time of building permit application.
Site Diagram Scale: 1 inch = feet
I EROSION
i CONTROL PLAN
LEGEND
PROPERTY
j LINE
EXISTING
DRAINAGE
—lex X '� ) --� TD TEMPORARY
j 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—
PROJECT LOCATION Lo t q �r��erscc.� lo �w� 65 s ov 'ss
BUILDER C.a.r;2e_,n OWNER _V1ZQ N �«
WORKSHEET COMPLETED BY 6 D2AC_r1 br=' rk DATE foLzosAa
i
i
EROSION CONTROL PLAN CHECKLIST
�D 44 Check (✓) appropriate boxes below, and complete the site diagram with necessary information.
` j
Q Q�
Co4S 2 0 Site Characteristics
North arrow, scale, and site boundary. Indicate and name adjacent streets or roadways.
❑ X Location of existing drainageways, streams, rivers, lakes, wetlands or wells.
❑ Location of storm sewer inlets.
Location of existing and proposed buildings and paved areas.
X The disturbed area on the lot.
X Approximate gradient and direction of slopes before grading operations.
Approximate gradient and direction of slopes after final grading operations.
❑ Overland runoff (sheet flow) coming onto the site from adjacent areas.
Erosion Control Practices
Location of temporary soil storage piles.
Note Soil storage piles should be placed behind a sediment fence, a 10 foot wide vegetative strip, or should be
covered with a tarp or more than 25 feet from any downslope road or drainageway.
Location of access drive(s).
Note: Access drive should have 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 (whichever is less).
❑ �1 Location of sediment controls (filter fabric fence, straw bale fence or 10 -foot wide vegetative strips) that will pre -
/ ` vent eroded soil from leaving the site.
❑ X Location of sediment barriers around on -site storm sewer inlets.
❑ X
Location of diversions.
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.
❑ X 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.
❑l 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 rip -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 (streams
with year -round flow.)
❑ X Location of other planned practices not already noted.
a
c�a ` c °J Indicate management strategy by checking (./) the appropriate box:
R
Management Strategies
❑ X Temporary 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 1st and September 15th), or by other cover, such as tarping or mulching.
❑ Permanent stabilization of site by re- vegetation or other means as soon as possible (lawn establishment).
Indicate re- vegetation method: Seed ❑ Sod ❑ Other ❑
Expected date of permanent re- vegetation:
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.
Note: 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 bales will be
replaced (typical bale life is three months).
t
• 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.
i
• 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,
E the DNR Wisconsin Construction Site Best Management Handbook, and UW— Extension publication Erosion Control for
Home 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 (GWQ001) can be ordered through Cooperative Extension Publications, 608/262 -3346
or the Department of Commerce, 608/267-4405.
EROSION CONTROL REGULATIONS 4
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 steep slopes or other
• Additions to dwellings built after June 1, 1980. special conditions
MAINTENANCE AND WASTE DISPOSAL
APPLICATION PROCESS • Sediment controls must be maintained until the site is
• Erosion control measures must be included on the plot stabilized by mulching and seeding, sodding or
plan submitted with the building permit application to landscaping
the local building inspector in communities where the • All building waste must be properly disposed to pre -
dwelling code is enforced vent pollutants and debris from being carried off -site
• Plot plan must show: ENFORCEMENT
— Location of the dwelling, other buildings, wells, sur-
face waters and disposal systems on the site with •Erosion control inspections will be made during other
respect to property lines regular inspections (footing and foundation, rough con-
struction, final, etc.)
— Direction of all slopes on the site
—
• Violations must be corrected within 72 hours
Location and type of erosion control measures
• Stop work orders may be issued for noncompliance
FOR MORE INFORMATION, CONTACT
CONTROLS REQUIRED
'Local building inspector
• Silt fences, straw bales, or other approved perimeter
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 done by local mit holder
government staff CONTROLS REQUIRED
APPLICATION PROCESS • Erosion control measures specified in the Wisconsin
• 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: • Department of Natural Resources, Storm Water Per-
- Timetable for land disturbing activities and installa- mits, P.O. 7921, Madison, WI 53707 -7921, (608)
tion of erosion control measures including project 266 -7078
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 construction 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 1597 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 53706.
GW0001A Standard Erosion Control Plan for 1 & 2 Family Dwelling Construction Sites DNR: WT- 458-96 R -02- 97- 2M -1 0—S
I
EROSION CONTROL
FOR HOME BUILDERS
Controlling Erosion is Easy
Erosion control is important even for home sites of an
acre or less. The materials needed are easy to find and
relatively inexpensive —straw bales or silt fence, stakes,
rock, plastic tubes, and grass seed.
Putting these materials to use is a straightforward
process. Only a few controls are needed on most sites:
• Preserving existing trees and grass where possible to
prevent erosion;
• Revegetating the site as soon as possible;
By controlling erosion, home builders keep our streets • Silt fence or straw bales to trap sediment on the
downslope sides of the lot;
and waterways clean.
' • Soil piles located away from any roads or waterways;
Erosion Is a Costly Problem
Eroding construction sites are a leading cause of water •Access drive used by all vehicles to limit tracking of
quality problems in Wisconsin. For every acre under con- mud onto streets;
struction, about a dump truck and a half of soil washes
into a nearby lake or stream unless the builder uses ero- • Cleanup of sediment carried off -site by vehicles or
sion controls. Problems caused by this sediment include: storms; and
Local taxes— Cleaning up sediment in streets, sewers and • Downspout extenders to prevent erosion from roof
ditches adds extra costs to local government budgets. runoff.
Dredging —The expense of dredging sediment from lakes,
harbors and navigation channels is a heavy burden for
taxpayers. This fact sheet includes the diagrams and
Lower property values— Neighboring property values are step -by -step instructions needed by builders
damaged when a lake or stream fills with sediment. on most home sites. Additional controls
Shallow areas encourage weed growth and create may be needed for sites that have steep
boating hazards. slopes, are adjacent to lakes and streams,
Poor fishing —Muddy water drives away fish like north- receive a lot of runoff from adjacent land,
ern pike that rely on sight to feed. As it settles, sediment or are larger than an acre.
smothers gravel beds where fish like smallmouth bass find If you need assistance, contact your local
food and lay their eggs. building inspector or erosion control office.
Nuisance growth of weeds and algae— Sediment carries
fertilizers that fuel algae and weed growth.
GWO001 Erosion Control for Home Builders. Additional copies are available from Cooperative Extension Publications, 630 W. Mifflin St., Madison, WI
53703, 608/262 -3346 or Dept. of Commerce, Customer Service Center, P.O. Box 7969, Madison, WI 53707 -7969, 608/267 -2423.
Erosion Cont
STRAW BALE or SILT FENCE For Ho
• Install within 24 hours of land disturbance.
• Install on downslope sides of site parallel to contour of
land.
• Extend ends upslope enough to allow water to pond
behind fence.
• Bury 8 inches of fabric in trench (see back page).
• Stake (2 stakes per bale). SAMPLE EROSION
• Leave no gaps. Stuff straw between bales, overlap sec- C ONTROL PLAN '
tions of silt fence, or twist ends of silt fence together. FORM OR 2 ®�
FILY
• Inspect and repair once a week and after every %z inch DWELLINGS
i
rain. Remove sediment if deposits reach half the fence
height. Replace bales after 3 months. 0950 i
• Maintain until a lawn is established:
SOIL PILES i
• Locate away from any downslope street, driveway,
stream, lake, wetland, ditch or drainageway.
i
D
• Temporary seed such as annual rye or winter wheat is T
O
recommended for topsoil piles.
AREA TO BE TOPSOILED,
ACCESS DRIVE SEEDED AND MULCHED
BY OWNER AT THE HOUSE
COMPLETION OF I GARAGE
• Install an access drive using 2 to 3 inch aggregate prior CONSTRUCTION I TDI
to placing first floor decking on foundation.
• Lay stone 6 inches deep and at least 7 feet wide from
the foundation to the street (or 50 feet if less). \ O � ;�,. •M.:.
• Use to prevent tracking mud onto the road by all
TD L
vehicles.
• Maintain throughout construction.
• In clay soils, use of a geotextile under the stone is R /wLINE °K a
recommended.
SEDIMENT CLEANUP SOIL TYPE: SILTY CLAY STREET NAME
• By the end of each work day, sweep or scrape up soil
tracked onto the road. SLOPE: 3%
• By the end of the next work day after a storm, clean
up the soil washed off -site.
SEWER INLET PROTECTION WARNING! Extra measures may be needed if
• Protect on -site storm sewer inlets with straw bales, silt your site:
fences or equivalent measures. • Is within 300 feet of a stream or wetland
• Inspect, repair and remove sediment deposits after every • Is within 1000 feet of a lake
storm. • Has a waterway or ditch
• Is steep (slopes of 12% or more)
DOWNSPOUT EXTENDERS • Receives runoff from 10,000 sq. ft. or more of
• Not required, but highly recommended. adjacent land
• Install as soon as gutters and downspouts are completed • Has more than an acre of disturbed ground
to prevent erosion from roof runoff. For information on appropriate measures for
• Use plastic drainage pipe to route water to a grassed or these sites, call your local building inspector or
paved area. erosion control office.
• Maintain until a lawn is established.
I
I, . ' •
Practices ro
PRESERVING
',i e Si EXISTING VEGETATION
• Wherever possible, preserve existing trees, shrubs, and
other vegetation.
• To prevent root damage, do not grade, place soil piles,
or park vehicles near trees marked for preservation.
EROSION CONTROL PLAN • Place plastic mesh or snow fence barriers around trees
LEGEND to protect the area below their branches.
PROPERTY
N — – – — LINE REVEGETATION
I _ _ EXISTING Seed, sod or mulch bare soil as soon as possible.
TOPSOIL � DRAINAGE
Vegetation is the most effective way to control erosion.
TD TEMPORARY
DIVERSION
DRAINAGE FINISHED SEEDING AND MULCHING
�– SWALE ' DRAINAGE
LIMITS OF • Spread 4 to 6 inches of topsoil.
- — GRADING • Fertilize and lime if needed according to soil test (or
SILT apply 10 lb. / 1000 sq. ft. of 10 -10 -10 fertilizer).
=T- FENCE • Seed with an appropriate mix for the site (see table).
STRAW • Rake lightly to cover seed with t /4 " of soil. Roll lightly.
• BALES . Mulch with straw (70 -90 lb. or one bale per 1000
$` --' GRAVEL
sq. ft.).
CONSTRUCTION VEGETATION • Anchor mulch by punching into the soil, watering or
ENTRANCE /EXIT O SPECIFICATION by using netting or other measures on steep slopes.
! ® TREE • Water gently every day or two to keep soil moist. Less
PRESERVATION watering is needed once grass is 2 inches tall.
STOCKPILED
SOIL
SODDING
SCALE: 1 " = 40' • Spread 4 to 6 inches of topsoil.
PROJECT LOCATION: • Fertilize and lime if needed according to soil test (or
EXISTING CURB PROPERTY OWNER: apply 10 lb. / 1000 sq. ft of 10 -10-10 fertilizer).
AND GUTTER ANTICIPATED STARTING DATE:
CONTRACTOR: • Lightly water the soil.
ANTICIPATED COMPLETION DATE: • Lay sod. Tamp or roll lightly.
PREPARED BY: DATE: • On slopes, lay sod starting at the bottom and work
toward the top, laying in a brickwork pattern. Peg each
piece down in several places.
Typical Lawn Seed Mixtures • Initial watering should wet soil 6 inches deep (or until
water stands I inch deep in a straight -sided container).
Percent by Weight Then water lightly every day or two to keep soil moist
Grass Sunny Site Shady Site but not saturated for 2 weeks.
Kentucky bluegrass 65% 15 %u • Generally, the best times to sod or seed are early fall
Fine fescue 20% 70% (Aug. 15 -Sept. 15) or spring (May).
Perennial ryegrass 15% 15% If construction is completed after September 15, final
seeding should be delayed. Sod may be laid until
Seeding rate 34 4 -5 November 1. Temporary seed (such as rye or winter
(lb. / 1000 sq. ft.) wheat) may be planted until October 15. Mulch or mat -
ting may be applied after October 15, if weather permits.
Source. R. C. Newman, Lawn Establishment, UW- Extension, Ivan. Straw bale or silt fences must be maintained until final
seeding or sodding is completed in spring (by June 1).
Commonly Used Erosion Controls
Straw Bale Figure 2 —How to Install a Straw Bale Fence
Fences 1. Excavate a 4" deep trench. 2. Place bales in trench with bind-
ings around sides away from the
Figure 1 —Cross Section ,- bales d. Leave no gaps between
of Straw Bale Installation �r '
Staked and Entrenched
Binding Wire Straw Bale
Flow '1 M � ::'•...; •....: �tr�:
� �� Bale
or Twine Compacted Soil to Width
Prevent Pipin
Filte I p 9 3. Anchor bales usi two steel re- %--�
Sediment Laden g
III I I II I Runoff bars or 2 x 2 wood stakes per Flow
" " • :' ; • bale. Drive stakes into the ground
at least 8 ". 4. Backfill and compact the
l excavated soil.
Source: Michigan Soil Erosion and t . „ I i> 1i ! I' ~ ''.' ; 1 ;.�;f•
Sedimentat ion Control Guidebook, 1975.
Flow
Flow
Silt Fences Figure 4 —How to Install a Silt Fence
1. Excavate a 4 x 4" trench along 2. Stake the silt fence on downslope
Figure 3 —Cross Sections the contour. side of trench. Extend 8 of
of Trenches for Slit Fences �,,,
fabric into the trench.
Filter Fabric'
V Flow
4 1 4„ j
- I
-- —� i_ I II 3. When joints are necessary, over• %��� /
V•trench �� e lap ends for the distance between Flow
two stakes.
4. Backfill and compact the
excavated soil.
Filter Fabric --•► V
- 1111 =� 4 " ►II, � - � // %� ;�
Source: North Carolina Erosion and Flow
Sediment Control Planning and Design
Manual, 1988. Flow
Access Drive 1. Install as soon as possible after Figure 5 —How to Install an Access Drive
start of grading. � O
2. Use 2 to 3 inch aggregate stone Hard surface
road
3. Drive must be at least 7 feet wide 50' or distance
and 50 feet long or the distance to to foundation
the foundation, whichever is less.
6" minimum 7 ,
4. Replace as needed to maintain depth
6 inch depth.
A publication of the University of Wisconsin- Extension in cooperation with the Wisconsin Department of Natural Resources and Department of
Commerce, Carolyn D. Johnson, Urban Water Quality Educator, UWEX Southeast Area. UW- Extension provides equal opportunities in employment
and programming. 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 53706,
GWO001 Erosion Control for Home Builders DNR: WT- 457-96 R -02- 97- 10M -25-0