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HomeMy WebLinkAbout022-1367-90-000 r Wisconsin Department of Commerce Safety and Build PRIVATE SEWAGE SYSTEM inss Division Count INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanita .. Personal information you provice may be used for secondary purposes [Privacy Law, %.15.04 (1)(m)). IT►il4 0 0 ❑City ❑ V gn(g imira: I Own hl State Plan ID No.: CST BM Elev.; Insp. BM Elev.: BM Description: Parcel t50.4) r 1 00.0 f ( � TANK INFORMATION ELEVATION DATA o� 2 8<1e9,.376 A TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic LO�r KIX Z&) B c rk x•98 qg 1 =• Dosing \7 Lo " -D1D1 r Aeration Bldg. Sewer L (D• 9� 90 . Holding St/ Ht Inlet (J— IPT ,99' TANK SETRA&K INFORM St/ Ht Outlet TANK TO P / L WELL BLDG. Air i to ntake ROAD Dt Inlet Air j Septic >3 }o' 2 - NA Dt Bottom 5-33 Dosing Z� NA Header / Man. r Aeration NA Dist. Pipe Holding Bot. System (P qb • S$ PUMP / SIPHON INFORMATION '3,15 Manufacturer �( 1 l Deemand `C �, -• �.� Model Number �� _ p , GPM ` p� 3 TDH Lift ��.'�� Friction System TDH Z..o Ft Forcemain Length 2 Dia. Z U Dist. To We11 SOIL ABSORPTION SYSTEM t; C�.a • -C�e�S �,, BED/TRENCH idjh Length ( N9.OtTrenches PIT No. Of Pits [inside Dia. Liquid Depth D IMENSIONS io2•SD 3 DIMENSION SYSTEM TO P / L BLDG WELL LAKE/ LEACHING M ur r: - S,Q9>`�•�Str S ETBACK CHAMBER Moe Numb r: INFORMATION Type O �I '>45 , - f OR UNIT t� — a System: �,��• DISTRIBUTION SYSTEM Header/Manifold r t( Distribution P x Hole Size x Hole Spacing Vent To Airintake Length ��S Dia. `� gtfi Dia. Sparing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched _(� Bed /Trench Center Bed/ Trench Edges Topsoil Insp # .Yes / No In 1@n # No � / " -{-rE�MMFNTS' uu cl de "s e�an 'e e n r��entsg .� /4 NW 1/4 24 T28N 18 1.) Alt BM Description= �(� � SAt . oca Ion: 'f 43� �a oa I er a 1 ) - 242818376A -Lot 1 6' 2.) Bldg sewer length= 4 s` a .a - amount of cover - ,�. / � :�, , �• 3 �, C J __n � � . Tqe o�� Ve � t lf � ° Ste Plan revision required? ❑ Yes tff No Use other side for additional information. (n;3 31 1 0 SBD -6710 (R.3/97) Date Inspector's Signature Cert. No 1 2 M y � ��.Y Safety & Buildings Division 201 W. Washington Ave. �� Sanitary Permit A plication Po Box 7302 lscons In accord with Comm 83.21, Wis. Adm. Code Madison, WI 53707 -7302 Department of Comm erce Personal information you provide may be used for secondary purposes (Submit completed form to county if not [Privacy Law, s. 15.04(l)(m)] state owned. Attach complete plans _ (to the county copy only) for the system, on p aper,not less than 8 -1/2 x 11 inches in size. County Q% State Sanita P r it Number ❑ Check if revision to previous application State Plan I. D. Number L Application Information - Please Print all Information Location: Property Or r Name Ct�`. Property U <a ion 1 /4�l4i�/4, S� A? ,N, lLeE (or) Property Owner's Mailing Address "a Lot Number Block Number xS City, State Zip Code hone Number Subdivisioi. \ame or CSM Number II Type of Building: (check one) / = I t ❑ City 916 1 or 2 Family Dwelling — No. of Bedrooms: ❑ Village • Public /Commercial (describe use): l FTown of • State -owned ( A.)VIGK/ JJA✓ /e III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest RoadDA(C �J � ,� 7 A) I. XNew System 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Addition to Parcel Tax Number(s) System Tank Only Existing System (J z —Gam B) Permit Number Date sued 11 A Sanitary Permit was previously issued pZ�i 1 3 76 IV. Type of POWT System: (Check all apply) JKNon- pressurized In-ground ❑ Mound ❑ Sand Filter ❑ Cons:r;cted Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip ''-ine ❑ At -grade ❑ A N Treatme it Ut it ❑ Recirculating ❑ Other: V Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil App ication S. Percolation Rate 6. System Elevation/! 7. Fi;�al Grade 60 Re quired Proposed Rate (Gals. /day / . ft.) (Min. /inch) y` .Icvation VI Tank Capa ity to To al # of Mafiufacturer Prefab Site Steel j Fibcr - Plastic Information Gallons Gallons Tanks Con- Con- oiass New Existing crete structed Tanks Tanks 2 _ 12 2 1 G VII Responsibility Statement I, the undersigned, assume Tr es on ibility for installation of the POWTS shown on the attached plans, Plumber Name (print) Plumber's Signature (no s �nps): MP/1404IFS No. E a =.!Hess Firone Plumber's Address (Street, City, State, Zip Code VIII County /Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Agent Signature (No stamps) Approved 11 Owner Given Initial Adverse Surcharge Fee) Determination v IX. Conditions A p s of ��j oval /Re n for Disa roval: , dd __� p ����� .�nn / ,D � h-4 4 4 -�iF t��^^ A p p Ns SO - It4— jKlcn� (� C-1— .�"'� b4.tA0P J `ftlo W",L! QS pe ss11U / QQQ ,JJJ rower Car.�tr t o S ,I n s� (eG( li .s co. r.Q c�e�rra . D // (cffW j 90 - er's name San. Permit No. H63.05 PLOT PLAN Show: Location of building served Rj Dosing chamber Septic tank Vertical /horizontal reference point System elevation is Building sewer Effluent system Well Replacement system area Property lines w /in 50' bf system Distribution boxes Scale = " �� , or dimensioned Pump and controls: f �!- `a Mfr & Model No. Vertical Lift Size Force Main Friction Loss T. D. H. Vol. Dist. Pipe Gal. -per Min- Gal. er cycle Place check mark in appropriate box indicating item is shown on plot plan below: 0 4t/ N O �P 4 z _ C rgks ez A 0 s � By the granting or app vin V thd above - pla j n�' , �o u. n the event of a subsequent permit being issued, county and the eeCoty Zoning Administrator, does not assume or hold itself liable for any defects in plans or specifications, plan omission, examination oversight, construction, or any damage that may result in or after 'nstallat' L i cense er s s a ur icense o. 1Ta e -� Rev, 3/ (n m 0) mn co cr M CL 0 x TT wo p, OD 0 13) j -, .._ • • • • � I - c 0 N 0 r E CL ( CD - C: Tul r�� C) 0 (D C: ('-:) (C) I -n x :7 ID (D D 0 CD x cn W 0- - U � CD 0 � u r C/) (D LT t 5 0 0 3 0 ( * ID K) A =r (1) CQ x 3 (D cn cr CD O o W D < x (n (D C� (D (0 3 C: 0 Invert 11 (D (D cn 0 Combination Septic-'Tank and PUMP CHAMBER CRO55 SECTION AND SPECIFICATIONS -VEIJ CA? . WIATHE� iuur-Tlc:) -j' C. 1. V ?I?[ APPROVE LOCX111: .10 FROM COOK" -,jiQOOw OR FRL5H ALUiMTAKE v 7 ! I - -$..- PROVIDE I iJ L C T AiRTIt,'H SEAL APPROVED JO )J7 A T., WfC. pIPEDRP Tank construction I I I I " A L,`, M shall comply with I-'BW 83.15 and 83.20 T C I � 1 , P U M P D DUCRLTL K15CF, EXIT PF-FM)ITF-E) CIJL'J IF TAQ) MAJLJUFACTLJRZR HAS SUCH A?PRC)VAL . -L 2 L C)ID sip f 5PCCIFICATIQQS DOSE K t- A W U FA C. T LJ W Z F, ' -Q\ NUMBER OF DOSES: 11.1Z. -b TA�JK S IZE . -1-0 -75 G A LL 0 NJ S DOSE VOLUME ALARM /`%A►JUFACTUR.W.R: 1- 11 x)-1 1 KJ C I--J D I M & 5 A C K Ir L D W: C, L L D -I5, 1 MOOF-L KJL-IMBER: - CAPACITIES: A= -31— 5, ",, " SWITCH 5 z 2- PUMP MAQLJFACTUKFK. O R MODEL NIJMBEK S W I T C H TY I �Ic I i'l 3 OR 1. L L. �JOTE: PUMP AND ALAKI-� -,-,L To !,L MIQIMLJP D15cKARGE RATE GPM INSTALLED OQ 5E1j1;-RAT'L' VERTICAL DIFF EKZMCZ tLTWZCU PUMP OFF AQD.,DfSTRI2)U'r1OQ PIPE- I- - E T + M I - kJIMUM METWOKK SUPPLY FK[S$UKE . . . . . . . . . . . FEET + 1 FEET OF FORCE MAIN X --tWX FACTOR -... vCET TOTAL CyQA,MIC- HEAD —LE- FEET Pump chamber DIAMETER ILITIELKWAL OIMLI.Is►anj� Of TAN K: LENGTH ;LIQUID L)EPTH BOTTOM AREA 231= --:/AK/2-GAL/IN--H ME40 series 4/10 HP Effluent ` and Drain Water Pumps Performance Curve L ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 40 I 35 10 �i 30 .. _ i..1 Z 25 8 2 v �J 15 O 4 10 I 5 _ 0 J 0 10 20 30 40 50 60 70 60 90 IJO CAPACITY GALLONS PER MINUTE L �� - F. E. Myers, A Pentair Company • 1101 Myers Parkway, Ashland, Ohio 44805 - 7`..23 419/289-1144 FAX 418/289 -8658 Telex 98 -7443 1(3326 7/91 Fr ntod in U.S.A Wisconsin Department of Commerce � SOIL AND SITE EVALUATION Division of Safety and Buildings' Page of B u of Integrated S es in ordance with Co 0 ;1Rtii�dm. Code �l county ttac plete site p a on paper n t less than 8 1/2 x 11 riches in size I'dxyfnust J include, but not limited to: vertical and horizontal r ere point (BM), rat 'n and / p t sca � or � d ii ) mensions north arrow, and ation and distaqc�t, neares road. Parcel I.D. : APPLICANT INFORZTION - Please rint all informat n. T Revie bj P � v Date 3 2M 1 64, Personal information you provide may be used for secondary purposes (Privacy Lave, s. 15,04 (1) (m)) �)U"+T`_ Property OwnerProps Location �^ o4t, Lot ` *,1 N� /4,S T ,N,R E (or Property Owner's Mailing A&Wbss Lot Subd. Name or CSM# 3 Gam- 0 r'G -2� -I City State Zip Code Phone Number ❑City ❑ Village Town Nearest Ro d New Construction Use: Residential / Number of bedrooms Addition to existing building Replacement ❑ Public or commercial - Describe: Code derived daily flow 4� gpd Recommended design loading rate J bed, gpd/fi / � trench, gpd /ft Absorption area required _ bed, ft 760 trench, ft Maximum design loading d/ft b G� g g rate i bed, gp trench, gpolft Recommended infiltration surface elevation(s) / 2 © ft (as referred to site plan benchmark) Additional design /site , c o onsideration � ,UL� . 5,t u.--- 3tc (� Parent material Ci Flood plain elevation, if applicable /_ ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = unsuitable for system �[] S El �S ❑ U 'ns ❑ U El U El S _ El S Ste'\ SOIL DESCRIPTION REPORT f�).., A -573 I Z= : C • Bonn # Horizon Depth Dominant Color Mottles Structure GPD /ft Boring ure Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench f 0-/ ,►� C' �' a , S -� 5 Ground lev ' Depth to limiting t in. 32. `( ( -4 Remarks: �2 5 Boring # 0 5 y ,� l , a Ground elev. TN• / Depth to 1 I limiting M fact in. Remarks: CST Name (Please Print) Signature Telephone No. L .L �• f � �js � G� Address Date CST Number o z.t f S! SOIL DESCRIPTION REPORT PROPERTY OWNER Page of PARCEL 1.D.# Boris # Horizon Depth Dominant Color Mottles Structure 2 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench le Ground 3 S elev. Depth to limiting 39, IS-, (, factor `7-7J-in. Remarks: Boring # A Ground ft. Depth to limiting factor 7 Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # S s / r all Q a 2 Ail Ground ' elev. Depth to limiting factor 26i n. Remarks: Boring # Ground elev. ft. Depth to limiting factor ' Remarks: SBD -8330 (R.9/98) Soil Test Plot Plan Project Name Terry Gallentine Shaun Address 1436 Oak Drive River Falls Wi 54022 M #226900 Lot 1 Subdivision - - - - - -- Date 2/23/00 SE 1 /4 N W 1 /4S 24 T 28 N /R W Township IGnniddnnic Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1 " Pipe System Elevation 9 *HRP Same as Benchmark Alt. BM Base of Pine Tree with Orange Ribbon @ 99.7 440' Property Line Special note to plumber or designer: in the 4th horizon, traces of mottled sandstone were found, hence the shallow system elevation. Recommend a bed design due to the lack of system depth and loss of sidewall absorbtion. C' a ° B 5' .. M. 0 ° t 15' '' 200' -1 90' B=� o 20' 1 °I 40' B -3 20' 150' B -5 90 B -4 Oak Drive System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48 -tats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating conditior: of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleared as r.ecessey to ensure proper operation. The filter cartridge should not be removed unless provisions are made to r.;twin solids n t:ie tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the :;;'ter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impendi continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pump Tank ✓Up� The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and purr, -)s shaii be tested to I � fm effluent filter is installed within the tank it shall be inspected and serviced as necessary. ound a nd Pressure Distribution S stem ees or shrubs should be planted on the mound. Plantings may be made around the mound's perimet the mound shall seeded and mulched as necessary to prevent erosion and to provide some protection from penetration. Traffic (other than vegetative maintenance) on the mound is not recommended since soiomps may ninder aeration of the infiltrative surfac ' hin the mound and snow compaction in the winter will promote r ene tration Cold weather installations (October- ary) dictate that the mound be heavily mulched for protection. Influent quality into the mound system of exceed 220 mg /' S, 150 mg /L TSS, and 30 mg /L �CG. influent flow m y not exceed maximum design flow specified in it f r-t is installation. The pressure distribution system is provide a flushing point a d of each lateral, and it is recommended that e ch lateral be flushed of accumulated soli least once every 18 months. W suure test is performed it should be compared to the initial test whe system was installed to determine if orifice cloggin ccurre: and if orifice clean r,g is required to maintain equal ' ibution within the dispersal cell. Observation pi ithin the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to t e wrier, and any le s above 4 inches considered as an impending hydraulic failure requiring additional, mor,.� i'requent mor,itcrin . neral m shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained :n accordance wit its' component rnanua 9 and local or state rules a to system mg 'nt nano reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- !riches in diameter snail be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or cc, Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective com�)c ,ient , hall be immediately repaired or replaced with a component of the same or equal performance. If the component fails to accept wastewater or begins to discharge wastewater to the ground surace, i t wil' be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biolo;l.�ally clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to brircl the system into proper operating condition. Questions on the operation ^ or maintenance of this s stem nbu be directed to the County 'Zoning office at Y_ licensed plumber who installed the System. ou 6� 01 to the Standard Erosion Control Plan for 1 & 2 Family Dwelling Construction Sites According to Chapters ILHR 20 & 21 of the Wisconsin Uniform Dwelling Code, a soil erosion control plan needs to be 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 Stan- dard Erosion Control Plan is provided to assist in meeting this requirement. Instructions: 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._. k Water runoff patterns can change significantly as a site is reshaped. 3. Submit this plan at the time of building permit application. Site Diagram Scale: 1 inch = feet EROSION i CONTROL PLAN LEGEND PROPERTY LINE EXISTING ' DRAINAGE v TD TEMPORARY DIVERSION FINISHED -' DRAINAGE LIMITS OF GRADING SILT �-' FENCE STRAW BALES GRAVEL O VEGETATION SPECIFICATION TREE PRESERVATION STOCKPILED SOIL Please indicate north by completing the arrow below. —N— I PROJECT LOCATION K 6 ytZ f4 L07 # c' -C&\ BUILDER Lu 1>. � 1 6z - - -r 7 N' C OWNER R i C.K *A t1J (o i L7_ N;� tic j 1 WORKSHEET COMPLETED B Y_�_/d� ✓r DATE EROSION CONTROL PLAN CHECKLIST \� QU Check ( ✓) appropriate boxes below, and complete the site diagram with necessary information. Q Q � 2 0 Site Characteristics ' 2 North arrow, scale, and site boundary. Indicate and name adjacent streets or roadways. i i O C' Location of existing drainageways, streams, rivers, lakes, wetlands or wells. ❑ G31 Location of storm sewer inlets. El" Location of existing and proposed buildings and paved areas. Eel The disturbed area on the lot. 0" Approximate gradient and direction of slopes before grading operations. e!( Approximate gradier,: and direction of slopes after final grading operations. ❑ 2 runoff (sheet flow) coming onto the site from adjacent areas. Erosion Control Practices ❑ G" 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. ef Location of gravel access drive(s). Note: Gravel 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). • Q 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. • ET e Location of sediment barriers around on -site storm sewer inlets. O 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. E ❑ 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. ❑ 8' 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.) ❑ fff Location of other planned practices not already noted. a Indicate management strategy by checking (./) the appropriate box: m 4ec 2 0 Management Strategies O V 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. 2 Permanent stabilization of site by re- vegetation or other means as soon as possible (lawn establishment). Indicate re- vegetation method: Seed F1'* Sod O Other O Expected date of permanent re- vegetation: Ste/ ;2' Re- vegetation responsibility of: Builder O Owner /Buyer i —' Is temporary seeding jr mulching planned ii site is not seeded by Sept. 15 or sodded by Nov. 15? Yes O No O O &> 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. [d' Maintenance of erosion control practices. Sediment will be removed from behind sediment fences and barriers before it reaches a depth that is equal to half the barrier's height. • Breaks and gaps in sediment fences and barriers will be repaired immediately. Decomposing straw bales will be replaced (typical bale life is three months). • All sediment that moves off -site due to construction activity will be cleaned up before the end of the same workday. • All sediment that moves off -site due to storm events will be cleaned up before the end of the next workday. I Gravel access drives will be maintained throughout construction. All installed erosion control practices will be maintained until the disturbed areas they protect are stabilized. i For more assistance on plan preparation, refer to Chapters ILHR 20 & 21 of the Wisconsin Uniform Dwelling Code, the DNR Wisconsin Construction Site Best Management Handbook, and UW- Extension publication Erosion Control for 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. k Erosion Control for Home Builders (GWO001) can be ordered through Cooperative Extension Publications, 608/262 -3 or the Department of Industry, Labor and Human Relations, 608/267 -9360. EROSION CONTROL REGULATIONS UNIFORM DWELLING CODE (DILHR) PROJECTS AFFECTED MAINTENANCE AND WASTE DISPOSAL • All new 1 and 2 family dwellings in Wisconsin started • Sediment controls must be maintained until the site is on or after December 1, 1992. stabilized by mulching and seeding, sodding or • Additions to dwellings built after June 1, 1980. landscaping APPLICATION PROCESS • All building waste must be properly disposed to pre- vent pollutants and debris from being carried off -site • Erosion control plan must be submitted with building permit application to the local building inspector in ENFORCEMENT communities where the dwelling code is enforced • Erosion control inspections will be made during other • Erosion control plan must show: regular inspections (footing and foundation, rough con - -- Location of the dwelling, other buildings, wells, sur- struction, final, etc.) face waters and disposal systems on the site with • Violations must be corrected within 72 hours respect to property lines • Stop work orders may be issued for noncompliance — Direction of all slopes on the site FOR MORE INFORMATION, CONTACT — Location and type of erosion control measures a Local building inspector CONTROLS REQUIRED • Department of Industry, Labor and Human Relations • Silt fences or straw bales along downslope sides and side (DILHR), Safety and Buildings Division, P.O. Box slopes 7969, Madison, Wisconsin 53707, (608) 267 -5113. • Gravel access drive • Straw bales, filter fabric fences or other barriers to protect on -site sewer inlets • Additional controls if needed for steep slopes or other special conditions STORMWATER PERMIT (DNR) PROJECTS AFFECTED — Proposed erosion and storm water pollution control • Any construction project that disturbs 5 acres or more practices during and after construction • Smaller sites that are part of a planned development — Documentation that an erosion control and storm involving 5 acres or more of land disturbance water management plan which meets DNR standards • Effective October 1, 1992 for any new or continuing has been prepared (plan does not need to be submit - project ted with the application) • Exceptions: Indian tribal lands and work done by local —Other information related to site location and per - government staff mit holder APPLICATION PROCESS CONTROLS REQUIRED • File a. "notice of intent" application (Form #3400 -161) a Erosion control measures specified in the Wisconsin the Department of Natural Resources (DNR) 30 Construction Site Best Management Practice Handbook i days before construction begins • Measures to control storm water after construction •Application must include: FOR MORE INFORMATION, CONTACT - Timetable for land disturbing activities and installa- a Department of Natural Resources, Storm Water Per - tion of erosion control measures including project mits, p O. 7921, Madison, WI 53707 -7921, (608) start and completion dates 266 -7078 ' 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 Imd ment of Industry, Labor & Human Relations, Ron Struss, UWEX Water Quality Specialist, Western Area, and Carolyn D. Johnson, UWEX i Water Quality Specialist, Southeast Area. + University of wisoonsin-Extension is an EEO /Affirmative Action employer and provides equal opportunities in employment and programming, including Tide IX requirements. 1 GWOWlA Standard Erosion Control Plan for 1 & 2 Family Dwelling Construction Sites 1-- /)6-93- 151611-%-S MAY -15 -01 08:28 AM LUND BOIL TRS INC. 7154259559 P.02 Ve N �.— �n w ` Vol ' ..... \J_�. .v Y .... /•...../N _r+ -yr•J• ._ a� . +.�- 41W_nw.� .? .��. ..._... .rn... n.. vin.. ��w.... ��r�n_.. w._.. ....�ww..._.rrr....._.......... r._ - - w..,`r..r._r.�a.r � S .. I .T ��. �M• w?. .�.r_. nr...�PTw.r.�'....rrMV.7 �Jt+:MR•n'/MM�.w�nrw.rWw y , Vb - ' Q, ST CROI.X COUNTY SEPTIC TANK MAIN'T'ENANCE AGREEMENT AND OWNERSHIP , R'I'IFICATION FORM Owner/Buyer Mailing ddress g Property Address � Q 0 a r� (Verification required from Planning Department for new construction) ' City /Slate ,ug r'aats w ; Parcel Identification Number OoKa = J0Io 9 0 - LEGAL DESCRIPTION Property Locatio ' /4, Sec. _ "I' N -R�W, Town of k' y )r; c k,1 nni C Subdivision C G?t % , Lot # . z Certired Survey Map # _ 6-z , Volume / , Page # 7 Warranty Deed # , Volume , Page # Spec house ❑ yes no Lot lines identifiable yes O no SYSTEM TENANCE Improper nse and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of paniping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the fiuiction of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating th your septic sy tem een maintained must be completed and returned to the St. Croix County Zoning Office within 30 d t t ree y r e �tioiite. /h SIGNATURE O PPLICANT AID TE E OWNER CERTIFICATION I (we) certify that all st ents on this form are tnie to the best of my (our) knowledge. I (we) am (are) the owner(s) of the pe y describe ab y v' tue a warranty deed recorded in Register of Deeds Office. � 'An l' IGNA "1UR F APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Inc►ude 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 vei.1582PAGE 373 to DOCUMENT NUMBER, 6 3 7 so C:3 co KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD Terrance L. Gallentine and Anita L. Gallentine, husband and wife, OZ-02-?OD1 ID:4D Q M Grantor, conveys and warrants to Richard S. Parnell and Angela J. Parnell, husband and wife, as survivorship marital property, Grantee, WARRANTY DEED the following described real estate in St. Croix county, state of EXEMPT A Wisconsin: CERT COPY FEE: COPY FEE: PART OF SEH OF NW'K OF SECTION 24, TOWNSHIP 28 NORTH, RANGE 18 WEST ST. TRANSFER FEE: 146,50 CROIX COUNTY, WISCONSIN DESCRIBED AS FOLLOWS: LOT 1 OF CERTIFIED RECORDING FEE: 10.00 SURVEY MAP FILED MAY 24, 2000 IN VOL. 14, PAGE 3857, AS DOCUMENT PAGES; 1 NO. 623600 NAME AND RETURN ADDRESS 022 - 1067 -90 -000 Parcel Identification Number This is not homestead property. Exception to warranties: All easements, restrictions and rights -of -way of record, if any. Dated this � � day of January, 2001. rd (SEAL) V L-r,.0 `G!! ' (SEAL) errance L. Gall ine Anita L. Gallentine (SEAL) (SEAL) AUTHENTICATION ACXN0WLEDGNENT Signature(s) STAT OF WISCONSIN ) ) ss. PP / COUNTY ) authenticated this _ day of 20_ Pers y came before me this 'I day of January, 2001 th ab v named Terrance L. Gallentine and Anita L. Is' c 1 G' le e, to me known to b he persons(s) who executed ,E he r going instrumen a ckn ge the same. Name Printed ar T etl �,�01 ^•r 'TT:,': MEMBER STATE BAR OF WISCONSIN ��•,, ���1 ' - G Isi nacure ff not, A , authorized by §706.06, wis. Stats.) r A vv vl2 1� (L /^ Name Pr,ncea or r ee TNIS INSTRUMENT J Krueger Stuart WAS DRAFTED BY: Q No ari Public 5 {.._ -l�� County, Wis. . uegg er ` 1. My 'ZOiignission is permanent. (If not, expiration date:) Rodli, Beskar, Boles & Krueger, S.C. P.O. Box 138 � c, River Falls, WI 54022 �0 s b CERTIFIED SURVEY MAP BEING TOWN S E KINNICKINNIC,1 O F SECTION COUNTY, WISCONSIN lBW., NORTH QUARTER CORNER - � PREPARED FOR SECTION 24 - FOUND 0O FOUND 1 • 1. P. TERRY GALLENTINE I" IRON PIPE o _ 1 N54 42' 49"E OF c., r.Al CED � POSITION.(LARGE FALLS 4' S. AND 12' UNPLATTED LANDS ^'-;" BOULDER OBSTRUCTS - W. OF OLD FENCE POST -CORNER POS I T IOM NORTH LINE OF THE St-NW"' " O A � m S89 31' 24" E' 1325.18' ._ NW COR. � NE COR. SE -NW SEPTIC SE -NW a WELL-0 HOUSE m LOT 2 o /- 28.22 ACRES q N 2 ~ p 1, 229, 285 SO. FT. - P A Q 27.99 AC. EXC. RiW :C 1,219,244 SO.FT. D�J� A N r W g :D r c 589 rn p I _ (A m m 440.00' •m n. w = y :r A� m rn : D Z n (A N N w I S89 19' E 49 ' N 1 • o :tA — 6. 60 ACRES $ LOT 3 rn a LOT I 287,338 S0. FT. m I ro 5. 00 ACR '� 0 6.35 AC. EXC. RiW 1 w - 2 T, 789 SO FALLS 1 1' W. w 276, 560 SOFT. S +11 0� o �► . . 4. TO AC EXC N - FENCE Q Te 204, 702 SO O w SHE S ro LINE m BUILDING a ° U SW COR. .?`. ................ o_... °.,. S895' S4'W $ v S � 7 ACK_ p - a° 1325. T9SE -NW e. 99' w - X90 81 o °D 484.9 9 19" W S89 ° 58' !9 "E — 495.00" 652. 31 * w 1325 83 — -- — — N89 ° 58' 19" W 1325. 83' SE CO. N 5303.97' SE -NW a' °. EASTiWEST OUARTER LINE w WEST QUARTER CORN R \ ry SECTION 24 - sET `� ATTED LANDS PK NAIL FROM N w TIES` UNPL .........._ "•""• ".... . 0 SOUTH QUARTER CORNER SECTION 24 - FOUND ALUM CAP f0 y te/. y -� LEGEND �u� /n d..o�� o SET : "X24" IRON 1'1PF WEIGHING `vn ".a urru 1. 13 L6S. PER LINEAR FOOT B Sc INS`�� JAMES M. {� WNESER. W1,804 81'FiM VWAIU.EX, Q BEARINGS REFERENCED TO THE EASTiWEST O S89 ° 58 R 19 f ST. CROIX U NTYCOORDS SYSTEM) 1" -300' -- �' - - -, JAMES M. WEBER -1804 p 150 300 600 SHEET I OF 2 NELSEN -WEBER I SURVEYING DATED 2000025A THIS INSTRUMENT DRAFTED BY JIM WEBER