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022-2003-70-000
Wisconsin Department of Commf.rce PRIVATE SEWAGE SYSTEM County: St. Croix Safe%apd Building Division INSPECTION REPORT sanitary Permit No: 488210 0 -GENERAL INFORMATION (ATTACH TO PERMIT) to Plan ID No: Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. 2- - 70 f= T1194A) s • j� Permit Holder's Name: City Village X Township Parcel Tax No: Swenson, Eric Kinnickinnic, Town of 022 - 2003 -70 -000 CST BM / Insp. BM Elev: Description: nn Section/Town /Range/Map No: O /. BM K� C 7 1 36.28.18.564 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 5 ti ato V. $ / 5 /cry Septic , , w S Benchmark Dosing \\ Alt. BM 66 w.bb x,56 Aefetion Bldg. Sewer F 4 V )Z . l Holding SUHt Inlet �( � TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic �d l , �� 7 ! / Dt Bottom > 26 .'q - e5 X0 Dosing `7GY �/ 7/ � !� Header /Man. Aeration `X, Dist. Pip p /0 Holding Bot. Sys m _ A 3 8 ' Final L= IZ ~e+ (spar PUMP /SIPHON INFORMATION ' Manufacturer // Demand St Cover C D - tµa•.'L hip la C Ar C7 �` GPM � ii 1 I . 5 ° /L / L, `t 5 Voclel Number � � 2- �• �� C b�O � � � 5 O , v H Lift Friction Loss System Head TDH Ft �l / i q'0� z Ct+ (I •So 2$•6 Ak D.2 (o.z i�t) Forcemain Leng a r Dia. 2—' Dist. to Well > /5 / , 1 _- I SOIL ABSORPTION SYSTEM Width Length / No. Of ench s PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS S / O --- SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of S tem: 1 ! r > IS-0 UNIT Model Number: DISTRIBUTION SYSTEM aR72 Header /Manifold � Distributiio�n \ !! x Hole Size !! x Hole Spacing Vent to Air Intake Pipe(s Length 3 'Q / Dia 1- ngth 1 �.sC /Dia l , D Spacing �'y Ile 3r ri 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 El Yes Q No 0 Yes Fal No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: (O / $ / 0 �v nspection O1 2 Location: 1486 Cty. Rd. M River Falls, WI 54022 (SE 1/4 NE 1/4 36 T28N R1 8W) 40 acres Lot p ' a � '3'[ p Parcel o: 36.28.18.564 TZ 1.) Alt BM Description � _ i). r. rM�, It o�lt cs+�r �rvt5� � J••,. , 2.) Bldg sewer length = ! 2 - amount of cover = ft Plan revision Required? Yes Xon. No 04! -7 > other side for additional informs Date e �o� e Can. No. 10 (R.3/97) (o O J 4 J Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 iseonsin Madison, WI 53707 - 7162 Sanitary Permit be be Ailed in by Co.) Department of Commerce (608) 266 -3151 a f O Sanitary Permit Application State Plan I.D. Numberr7 In accord with Comm 83.21, Wis. Adm. Code, personal information you provide Z 7 q / d 1 may be used for secondary purposes Privacy Law, sl5.04(1)(m) Project Address (if different than [nailing address) I. Application Information — Please Print All Information SGT RECEIVED Property Owner's Na m Parcel # Lot M Block # r C eL15 JUN 0 1 2006 0 - -7D _ 9 OL Property Owner's M ailing Address Property Location mb ST. CROIX COUNTY U(3Q ( ''A, 1A,Section City, tate Zip Code ne um r (� Q� 1A t! V �! FO S 4 t P T IJ`V N R �v E o e e e) • �� II. Type of Building (check all that apply) or 2 Family Dwelling - Number of Bedrooms q Subdivision Name CSC /❑ Public /Commercial -Describe Use / ❑ State Owned - Describe Use 4 G1 , / nd-1 hne 0rt! Jl K.-4 RdW?3 116 4l,,4 ❑City_❑ pge �ro lip of n 14A C7 HI. Type of Permit: (Check only one box on line A. Complete line B if applicable) A, ❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner // -- ` 4 / rV. Type of POWTS System: (Check all that apply) ❑ Non - Pressurized In- Ground 4 Mound > 24 in. of suitable soi ound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑Holding Tank El Peat Filter Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leachin ber ❑ o prip Line Q Gravel -less Pipe ❑ Other (explain) s� SGj/ytGt �/ V. Dispersal/Treatment Area Information: k7q7 O. Design Flow ( ) Design Soil Appli ati on Rate( gpdsf) Dispersal Area Requi ed (sf) Dis rsal Area Proposed (sf) System Elevation 10 � 9 3. 1 1 � ./ �_7 q , VI. Tank Info Capacity id Total Number Manufacturer - P efab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber 0 VII. Responsibility Statement- 1, the' fined, assume respo ibility for ' POWT shown on the attached plans. Plumber's Na me (Print) PI s Si gnature M Num Business Phone Number 7hp,w.sA Plumber's Addre ss (Street, City , State, ip ode) 6 kle ) / k ) ', 5 dad VIII. otmt Department Use Onl pproved El Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Iss . g Agent igna re ps) Surcharge Fee) ❑ ` dU / 2 DI Owner Given Reason for Denial J `� ((� IX. Conditions of Approval /Reasons for Disapproval STEM OWNER; p lc an a uei ter and dispersal cell must all be serviced / main tained as per management plan provided by plumbei � (�✓ ' , \ 2. All setback requirements must be maintained as per applicable code /ordinances. Attach complete plans (to the County onl fo a syste on 61po not less thzitt 81/2 0 11 lncbgjd size SBD -6398 (R. 01 /03)o CROIX CO U PLANNING &.. ZONING EROSION & SEDIMENT CONTROL PLAN r Site location: 1486 Cty. Rd. M, >40 acres existing house, Town of Kinnickinnic Owner(s): Eric Swenson Parcel ID # 36.28.18.564 Code Adminis 715- 386 -4680 Under St. Croix County Zoning Code 17.70(3)(b) 5: "The (Zoning) Administrator may attach reasonable erosion prevention conditions to a permit approved for issuance." Land Informarro Wisconsin Uniform Dwelling Code Comm. 21.125 requires the building permit applicant Planning and /or landowner to follow erosion control procedures and maintain them until the site has 715 - 386 - 4674 been stabilized (Uniform Dwelling Code Comm 21 is available on -line at: www. commerce. state. wi .us /SB /SB- DivCodesListing.htmi) Real Property 715- 386 -4677 The Owner of the above parcel is responsible for notification of all contractors performing construction activities on this site that an Erosion & Sediment Control Plan is in effect and the Recycling r following activities will be required in order to maintain compliance with the plan: 715 386 - �vl 1. Maintain existing vegetation wherever possible to minimize erosion and sediment ..r movement. The primary source for construction site runoff will be the house foundation excavation, driveway, and any soil stockpiled until final grading and stabilization is complete. Septic system installation adds to temporary disturbance, but establishing cover on exposed soils will prevent erosion. Apply seed and mulch as recommended in #5 below. Surface drainage is southwesterly and >100 feet from road ditch on Cty. Rd. M. The mound must be w stabilized immediately after completion. 2. Install construction entrance before any excavation begins!! Construction equipment and vehicles must utilize a stabilized driveway access off public road for heavy equipment; this includes cement trucks, well drillers, and other contractor's vehicles that require access to the property during construction. Avoid muddy, rutted conditions that may allow contaminated runoff to reach waterways and/or drainage ditches. Property owner must repair damage to ditches resulting from multiple access points and sediment tracked on public roadways must be removed at the end of each workday. 3. Do not allow diverted runoff to be directed onto neighboring property or into surface water conveyances. Contain runoff by installing temporary diversions graded ALONG CONTOUR between construction areas and any potential receiving waters (includes drainage ditches and retention basins). Temporary Diversions specification sheet is available from county. 4. If sediment cannot be contained on owner's property with temporary diversions and vegetative buffers, then installation of approved sediment control products (straw wattles, silt fence, erosion control matting) will be required. The POWTS inspector and/or building inspector will evaluate ESC plan effectiveness and make recommendations to owner for any action required to comply with applicable regulations. ST. CRO /X COUNTY GOVERNMENT CENTER 110 1 CARMICHAEL ROAD, HUDSON, Wt 54016 71 386.4686 FAA PZ9C0.5AINT- CR01X. W1. US WWW.CO.SAINT-CROIX. WI,US � l Page Two — ESC Plan Acknowledgement Form 5. Stabi tzze exposed soils (septic system included) with seed and mulch immediately after installation - do not wait , r final stabilization and/or landscaping of entire site to establish permanent cover on the site. When late - seas weather conditions will not permit seed germination, a heavy straw mulch cover will prevent erosion until veget n can be established. Erosion control matting can be applied any time of year and, if installed properly, will pro b protection even if seed germination is delayed. The owner rd during site construction will be responsible for compliance with state and county code requiremen ecified in this Erosion & Sediment Control Plan. Please feel free to contact me with questions regarding er n & sediment control product installation. PLAN PREPA ` D BY: PAM QUINN, CPESC #1622 SOIL EROSION INSPECTOR #6650 4 Owner ac owled ement of ESC Plan re uirements: _/_/2006 (Please n and return original ESC form to Planning & Zoning Dept. A copy is attached to the owner's permit and mtenance agreement, which is given to the plumber at time of permit issuance.) A ST.CROIX COUNTY GOVERNMENT CENTER 1 10 CARMICHAEL ROAD, HUDSON WI 54016 715 - 386 -4686 FAA PZCa SAINT- CROIX. W1. US W W W . CO. SAI NT -C ROI X. W I . U S r G Q � 0 1717 � - �- -�„�,` � / ��" ° x "N►J1-� `o � d TI `h v I" hr fe.F� H CLV IV a *Vak /�E. o` - �, 7h ©oft %�r.yi�CC�(�riawf --S' Qa u NO 44 v ir r o ro __- _ A, TCc� c t 1 ( i lot-/ A I 1 S c K Webster Soil Testing a Sewer System Design ��d ^� � Charlie Et Kris Webster, Owners �� , '?006' N5815 7701h Ellsworth, Wt 54011 Telephone: (715) 273 -3430 Fax: (715) 273 -4181 ` 4 ! WI Licenses: MP220673, ST220673, ST 261669, PE18803 .i POWTS Index Sheet Page 1 of 8 Mound System fora 3 Bedroom Residence Property Owner/Project Name: Eric Swenson SE % NE % S36 T28 N R 18W Town of Kinnickinnic, St.Croix County, WI Page 1 of 8 Contents 1r. Sheet Page 2 of 8 Plot Plan Page 3 of 8 Plan View Cross Section Pam 4 of 8 Distribution Pipe L ayou t PaLre 5 of 8 Pum in Chamber La out Page 6 of 8 "-- - Performance Curve Page 7 &8 of 8 Management plan SCO r ' -CHARLES L WEBSTER Z 'a E-1080 CC '- Fs •.......y Via. yip N A NLI C01H onent manuals used: Name: Mound Component Manual for PO Version: 2.0 SBD- 10691 -P VVT'S i hajy Date: January 30, 2001 Name: Pressure Distribution Manual for POWTS "Gs Version: 2.0 SBD- 10706 -P Date: January 30, 2001 p���Ftic " Safety and Buildings PO BOX 7162 commerce.Wl.gov MADISON WI 53707 -7162 TDD #: (608) 264 -8777 i sconsin www•co www.wisconsin.go/ iscosin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary May 26, 2006 N 20 7 ATTN: POWTS Inspector OUST ID o 2 6 3 p CHARLES L WEBSTER ZONING OFFICE WEBSTER EXCAVATING, INC. ST CROIX COUNTY SPIA N5815 770TH ST 1101 CARMICHAEL RD ELLSWORTH WI 54011 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/26/2008 Identification Numbers Transaction ID No. 1274701 SITE• Site ID No. 713243 Eric Swenson - Dwelling Please refer to both identification numbers, 1486 CR M L above, in all correspondence with the agency, Town of Kinnickinnic, 54022 St Croix County SE1 /4, NE1 /4, S36, T28N, R18W FOR: Description: Replacement Mound System / 450 gpd Object Type: POWTS Component Manual Regulated Object ID No.: 1077151 Maintenance required; Replacement system; 450 GPD Flow rate; 15 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 /01); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. P I No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, Cona, stats. AUD A copy of the approved plans, specifications and this letter shall be on -site during construction and open tom F t I inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. EE CORRES In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. CHARLES L WEBSTER Page 2 5/26/2006 Sincerel ; % Fee Required $ 175.00 1 Fee Received $ 175.00 Balance Due $ 0.00 eter E Page Private Sewage Plan Re ewer, Integrated Services WiSMART code: 7633 (608)266-2889, M - F, 0630 - 1500 Hrs pete.pagel @wisconsin.gov cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 A P?k x �'N. / fe 6o cd �,��i v�� clr.peseA� H e �jv. /G h shsC� e.rp7 -Aa , ' Q `' � a i ! ✓ rti��� �r•1� i /ae��s d� 7 ifa��l�vdf 4 f+ f 5 o a r6 i tj ril GA ~ �► 0 C ea � � o n ?z o n D n - S I -*- q , _ AZ, T CkC 3 f SCu er . Y Page .Of Approved Synthetic Covering 1prs G 33 i Distribution Pipe Medium Sand H G Topsoil ._ -__ _ =_ = F Elev = /o'f -� � 3 E I p . % Slope Bed Of 2- 2 Force Moin Plowed Aggregate From Pump Layer Cross Section Of A Mound System Using E.7, j / I7� A Bed For The Absorption Area r _ /•/,, �t� �' G �•3 Ft. A S Ft. H /• O Ft. Li:,ear Loading Rate = a N FT g 9 Ft. Loa Az�� Design. ding Rate = '�.GPD /SQ FT j / �' Ft / 9'D 741ccss Nx \ J R Ft. 7 � j Tlt red ala A! 1 K / .aZ. Ft. 11 /tfe..! / L' I/ 4 Ft. W 30 Ft. j Observation Pipe 4 $ K A 3 ��A� W 1 _ l Distribution Bed Of 2 2 I ! Pipe Aggregate 6 Observation Pipe,, - Ir 1 _ (Anchor securely) i OLsr-fta�1'•'0� /� ,,rr•�PS f� Ii1YC' � Is? %h.iyrkt-., ;f.'c� y.,c.�'r+� a J' � �ho�,e/ �e Prav• of?Q�LU��� 4 �7L'r' Gt ceS� e 74hC6o �iyc�C1 Att sccu elf dl Plan View Of Mound Usitfg A Bed For The Absorption Area s M! t'rtsC Page Of r Perforated Pipe Detail 0 End View )Perforated o y' PVC Pipe �o ° � t� Notes Located On Bottom. Are Equally Spaced rye e / PVC Manifold Pipe e ii 1 Disi rn9ut ion S defi P - f 3 Ft Distribution Pipe Layout Q�� g/ S te a, Ft. e CP S U �t, p �� al X Inches Y Inches . Hole Diameter � Inch Lateral Inches) Manifold Inches _ Force Main Inches d ce esr # of holes /pipe ;,S - *4; pA, Invert E]Pvation of La terals Ft. Place 1st hole / Er,. from center of manifold with succeeding holes at3 intervals. / Page Of • C `�sn C. -r.ot (No Scale) S , - 4"( 4c> .Approved Locking Manhole Covers P�''s'" rerr •Pei ?ioj'f Wi th Warning Labels Attached �` "" ` °�: �"•�d or P e5h Weatherproof Approved ci Tr e ,:,, f.:+ /�y,✓✓ C% 96R, Junction Box Vent Cap ------7 12" Minimum F,-,j %!►�?ir�murn 4" Minimum 18" Minimum Quick Di sc4nect i d�..OeAedi. C'4vv4 1 /4" Weep ,9� _`�p'Sy Baffle Hole P° /Ale A A 1 a rm �+ On B pi G B:. C-A *APPROVED Off 6' o'P Coy ¢r * o JOINTS WITH APPROVED PIPE ro ?"'"p 3' ONTO D SOLID SOIL Conc. Block 3" of Bedding Under Tank --f ;d'u,'1� �w�„P �ck✓+�^� 0/1 �"'�°.� � ci �^cca•�'�S , Number of Doses: o5Z /Per Day Gallons Per Day /Fo{ Doses: 73- `•Gal Ions Tank Manufacturer: Volume of Backflow:3p�<-�1 C Gallons Total Dose Volume: ........ = Tank Size - Septic /Pump: /C � p Ga ons _ Gal 1 ons Alarm Manufacturer: / Model Number: bc`/ Capacities: A -Z1 Switch Type /K �ec�� p inches or -?S Gal Ions Pump Manufacturer: G + B .1 inches or 3 Gallons C nches or yodel Number: o� 2`� + i / Ga 11 ons �—� Minimum Discharge ate: + D inches or 1 t 36 Gallons - 6 Total .... inches or --� 46 Ga ) Ions lertical Difference Between Pump Off and Distributio Pipe Mi nimum Required Supply Pressure:. s -o C t3o I 5? C? FeeX of Force Main x /3$ Q " Friction Factor %100 Feet: + 2 �, Inch Diameter Force Main Total Dynamic Head: ... =:�7. Feet nterna) Tank Dimensions: Length ;Width lr' ; Liquid Depth 38 PCB t�., mJc Submersible r, s - wQ 3sa� Effluent Pump PE O SPECIFICATIONS MOTOR FEATURES Pump — General: General: ■ Corrosion resistant • Discharge: 1 Y? NPT • Single phase construction. • Temperature: 104 °F (40 °C) • 60 Hertz ■ Cast iron body. maximum, continuous when • 115 and 230 volts ■ Thermoplastic impeller and fully submerged. • Built -in thermal overload pro- cover. • Solids handling: Y�" tection with automatic reset, ■ Upper sleeve and lower maximum sphere. • Class B insulation. heavy duty ball bearing APPLICATIONS • Automatic models include a • Oil -filled design. construction. float switch. • High strength carbon steel IN Motor is permanently Specially designed for the • Manual models available, shaft. lubricated for extended following uses: • Pumping range: see PE31 Motor: service life. • Mound Systems performance chart or curve. • .33 HP, 3000 RPM ■ Powered for continuous • Effluent/Dosing Systems PE31 Pump: • 115 volts operation. • Low Pressure Pipe Systems • Maximum capacity: 53 GPM • Shaded pole design ■ All ratings are within the • Basement Draining • Maximum head: 25' TDH PE41 Motor working limits of the motor. • Heavy Duty Sump/ PE41 Pump: • .40 HP, 3400 RPM ■ Quick disconnect power Dewatering • Maximum capacity: 61 GPM • 115 and 230 volts cord, 20' standard length, of = � f- . �� / a •Maximum head: 'TDH • PSC design heavy duty 16/3 S1Tw with PE51 Pump: PE51 Motor. 115 or 230 volt grounding, " • Maximum capacity: 70 GPM • .50 HP, 3400 RPM plug. • Maximum head: TDH • 115 and 230 volts- IN Complete unit is heavy duty, • PSC des portable and compact. METERS FEET g ■ Mechanical seal is carbon, 4 ceramic, BUNA and stainless J , MODELS: PE31. PE41, PE51 steel. HP:33, .ao, .50 ■ Stainless steel fasteners. (. 1 y - �- - t �— —► 2 GPM `C 30 AGENCY NGS z 20 r f L..� L -. r �_ j C Us Tested to UL 778 and CSA 22.2 108 Standards �- _ - p � _ � � ,' - - - By canadwWe #L gssaiation F - r— -i- f � 1 10 =t Goulds Pumps is W 9001 Registered r r _ L 5 30 40 50 60 70 GPM 80 0 5 10 ,s man, Goulds Pumps © 2004 ITT water Technology, Inc. CAPACITY Ef fe t /411une, 2004 O Z q.� V <& ITT Industries POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 7 o f 09 BILE INFORMATfON — Owner SYSTEM SPECIFICATIONS 5ti. Septic Tank Capacity / p p Permit # S O al O Np Septic Tank Manufacturer � C ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer Number of Bedrooms PC, O NA ❑ NA Effluent Filter Model �z' 0 NA Number of Commercial Units NA Pump Tank Capacity 6'Y(::: g al O NA Estimated flow (average) �a O al/da Pump Tank Manufacturer lti,'ese, C.-c)-y O NA Design flow (peak), (Estimated x 1.5) q S S al/day . Pump Manufacturer ���. a/ ❑ NA Soil Application Rate O_ aVda /ffz Pump Model Influent/Effluent Quality P'� .5"/ O NA Monthly average" Pretreatment Unit NA Fats, Oil & Grease (FOG) 530 mgr O Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODS) -5220 mg/L ❑ Mechanical Aeration O Wetland Total Suspended Solids (TSS) 5150 m /L ❑ Disinfection ❑ Other. Pretreated Effluent Quality Monthly average~ Manufacturer (SOD.) Dispersal Cell(s) Biochemical Oxygen Demand ( s) 530 mg/L ❑ In -ground (gravity) ❑ In -ground (pressurized) Total Suspended Solids (TSS) 530 mg /L O At -grade Mound Fecal Coliform (geometric mean) 510` cfu/100ml ❑ Drip-line ❑ Other Maximum Effluent Particle Size Y inch diameter • Values typical for domestic (non - commercial) wastewater and septic tank effluent MAINTENANCE SCHEDULE Values typical for pretreated wastewater. Service Event Service Frequency Ehlaterrals ondition of tank(s) At least once every ,� O months )8(year(s) (Maximum 3 yrs.) contents of tank(s) t When combined sludge and scum equals one -third (X) of tank volume 9 q ispersal cell(s) At least once every 3 O months ;�year(s) (Maximum 3 yrs.) fluent filter At least once every ❑ months year(s) ump, pump controls 1 alarm At least once every ❑months ❑ year(s) O NA s Ah a tie rals and pressure test At least once every ❑ months 0 year(s) ❑ NA /I/� At least once every ❑ months 13 year(s) XNA At leas t once every D months El year(s) WNA MAINTENANCE INSTRUCTIONS 'Y., yecoJ "�`"" `� ° % �`� �'i /far o�►ec every 3ye ts.cveYec..��, ��d tu rf 3/au c /eJn �i /fir SP CIA p� 164AWV -the Cl�r.h.h� k+J" -teh Inspections of tanks and dispersal cells sh everx A,; // all be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer, Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) 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 back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third ( or more of the tank entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance Wth NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechanical or pressurized pOWTS components, pretreatfinent components; and any other maintenance or monitoring at intervals of 12 months or less shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event START UP AND OPERATION 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 s ur f ace. p a �} Page During power outages pump tanks may till above normal higwater levels. When wastewater will be d' dispersal () h power is restored the excess rscharged to the dis rsal cells in one large dose, .overloading the cell(s) and may result in the backup or surface discharge of effluent To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWYS Maintainer to a I n I sist in manually operating the pump controls to restore normal levels within the pump tank. Db not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or eom act the area within 15 feet down slope of any mound or at -grade soil absorption area. p Reduction or. of the following from the wastewaterstream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps, medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONM JENT When the POWYS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system isproperiy 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 i • The contents of all tanks and pits shall be removed and prop p o parings sealed. • Auer pumping, all tanks and pits shall be excavated and removed or r covers removed and the void space fi with soil, gravel or another inert solid material. CONTINGENCY PLAN if the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code Compliant replacement system: ❑ A 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 and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that tim e. 0 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 POWYS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWYS 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. Ak 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 CONTAIN 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. DDITiONAL COMMENTS ) WTS INSTALLER Name (.0 � POWYS MAINTAINER i7 �4 aeon Name Phone ; -- f 2 1 _ g S' •Phone 'TAGS SERVICING OPERATOR PUMPER et* LOCAL REGULATORY AUTHORITY Name 'hone Agency S r s document was drafted Phone T/ j'— S ,! minimum requirements of 6 - $ . 0 by the staffs of the Green Lake, Marquette and Waushara County zoning and sanitation agencies. This document cartes the performance of the Conan a 22 ( 2 )(b)(1)(d) &(f) a meets Pow,is. nd 83.s4(1) & (3), Wisconsin Administrative Code. Use of this document does not GMW (2/01) SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 1�y i Mailing Address Property Address (Verification required from Planning & Zoning Department for new Qnstrjiction.) D � City /State //S W r Parcel Identification Number l � v -/d -400 LEGAL DESCRIPTION " " 5 DOD / ' Property Location � � '/a , � F ' /a , Sec. 6 , T ;d (, N R /LW, Town of , ) J j Subdivision _" `/D &CU-aJ , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # �>o � 5 � , Volume P , Page # Spec house yes no Lot lines identifiable ts SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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 function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(l) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my /our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms SIGNAT OF APPLICANTS) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) RECEIVED Wisconsin Department merce OIL EVALUATION REPORT Z Division of Safety and Bu ings Q �(� Page of J MAY 1 A aQor " Comm 85, Wis. Adm. Code Attach complete site pi on pp��eerr��r�gjSPM2 x 1 inches in size. Plan must . County S t CH a ' include, but not limited t : vertt?di aYrdKorizontal reference int (BM), direction and Parcel I.D. percent slope, scale or ensio ion and distance to nearest road. 0;U-2-&0.3- 7o - o p Q Please pdn t all information. Revie by Date / / Personrai information you provide may be used for secondary Purposes (Privacy Law, S. 15.04 (1) (m)). 5 Property Owner Property Location epic - $ 7 r/C.s„S' .'r Govt Lot SF 1/4 114 S 3 T N R &(Q0 W Property Owners Mailing Address Lot # 113 lock # Subd. Name or CSM# /+9 C te W -- — N/4 City Slate Zip Code Phone Number ❑ City ❑ Yliage gTown Nearest Road Pd /6 s� (T ) 4 -5-- 618 ; nk; c K i ,`c C R M ❑ New Construction Use :O Residential /Number of bedrooms 3 Code derived design flow rate GPD Re Plment [] Public or commercial - Describe: Parent material Flood PlainAky anon if applicable N� ft General �� "¢dGIc �, �.. "f le and recommendations: l a El Boring 15r 3r-' Boring # 1 ✓ U Pit Ground surface elev. / 0 3- ft. Depth to liming factor 0 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munseli Ou. Sz. Cont Color Gr. Sz. Sh. *Eff#1 *042 t A ' !O lv,Pk y [ — S,' .Z - -4K n. P,- Q.. S e Z - Q_ 6` S -Z 0- 6 3 0 ' !a t-x el C a p 7s ' r,K 5 r c / Boring # [] Boring L Pit Ground surface elev. Q �� 1 it. Depth to limiting factor 5 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff in. Munseli Qu. Sz. Cont Color Gr. Sz. Sh. *01#1 1 *Eff#2 / G - 7 to YIK 3 6- -- s,'/ a •, q 4r 1 . Ph 6 Cl- 7- /s fdYAs/ s: ! Z «� S1 K ,,. �� a S' -Z 0- 9 3 /s 3.� 6 c 7 .. 5- YA.S lt�' s c l „7 .� a bK „, !'� -' O. `� 0. * Effluent #1 = SOD > 30 < 220 mg/- and TSS >30 15o rrg/L * Effluent #2 = BOD < 30 ng& and TSS _< 30 n & CST Name (Please Print) nature CST Number Ctiah k!e �4 r� - 06 73 Address Date EXaluation Conducted Telephone Number N'S -fre 77 o f4 S' : !ls ..0t r gut s4Q / I " /��f o yr Its - Z73.3g 30 [ITT M'1/ TM /Ml Property Owner EP 5w C4,roca ParcelID# 3 - 70 -o1sQ Page -?- of F -11 Bolin # El Boring � fa Pit Ground surface elev. �F'z- ft. Depth to limiting factor f in. Soli wbon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. *Efr#'I *Eff#2 b f - !o yo &AK c -t �s'�'R 5/� .� c / .Z «, 4.1,E Boring # ❑ Boring ❑ Pit Ground surface eiev. ft. Depth to limitirrg.factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh_ *Eff#1 *EfffJ;2 Boring # ❑ Boring ❑ Pit Ground surface elev. 1t Depth to limiting factor in. Sal A ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAF in. Munsell Qu. Sz Cont Color Gr. Sz. Sh. *Efr#1 *Eff#2 * Effluent #1 = BOD > 30 220 mo- and TSS >30 < 150 nV& * Effluent #2 = BOD, < 30 n and TSS < 30 nV L The Department of Commerce is an equal opportunity service provider and employer. if you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608- 264 -8777. SM -8330 (8.07100) r a a1 p/oF�X .'».J `o e d f�bn prp.seA� H ew o R7 % l ..,� c e .t r t c .� �' �•, d �r lC zX,s � � Q � �' / ✓'' �'Y ��%[C i s �o�+��» .� -�t�k Lo���'� �pr.y,�G. C��91h.wts lu o Rt rx ✓ w , `tl� �'r.r7� :/e e b er d 7S t T - i s, f, '+ sz a d x Q, fl Ila � I � o � � -• 'tr � o s e lk ' -VI\ O ({ P c R w . Parcel #: 022 - 2003 -70 -000 05/23/2006 10:02 AM PAGE 1OF1 Alt. Parcel M 36.28.18.564 022 - TOWN OF KINNICKINNIC Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co -Owner ERIC R & MICHELLE M SWENSON 0 - SWENSON, ERIC R & MICHELLE M 148 CTY RD W RIVER FALLS WI 54022 Districts: SC - School SP - Special Property Address(es): = Primary Type Dist # Description " 1486 CTY RD M SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 40.000 Plat: N/A -NOT AVAILABLE SEC 36 T28N R18W SE NE Block/Condo Bldg: Tract(s): (Sec- Twn -Rng 401/4 1601/4) 36- 28N -18W Notes: Parcel History: Date Doc # Vol /Page Type 01/13/2003 705538 2108/291 TD 02/05/1999 597393 1402/95 QC 2006 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 08/11/2005 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 33.000 3,000 0 3,000 NO UNDEVELOPED G5 2.000 200 0 200 NO AGRICULTURAL FOREST G5M 2.000 1,100 0 1,100 NO OTHER G7 3.000 40,000 156,100 196,100 NO Totals for 2006: General Property 40.000 44,300 156,100 200,400 Woodland 0.000 0 0 Totals for 2005: General Property 40.000 44,300 156,100 200,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 09/2912005 Batch #: 05 -25 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 7 dZIl 15 U 2 1 0$ P 2 9 1 KATHLEEN H. WALSH REGISTER OF DEEDS ' Document Number TRUSTEE'S DEED ST. CROIX CO., w RECEIVED FOR RECORD Betty J. Swenson, as sole Trustee of the Eugene P. and Betty J. Swenson 01/13/2003 09z30AK Revocable Trust, dated 02- 03-99, for a valuable consideration conveys EXEIPT 3 B without warranty to Eric R. Swenson and Michelle M. Swenson, husband and wife as survivorship marital property, Grantees, the following REC FEEz 11.00 J described real estate in St. Croix County, State of Wisconsin (hereinafter COPY called the "Property "): CERT COPY FEE-. PAGES.- 1 The E 3/4 of the SW% of NE %; The SE% of NE' /.; The NE'% of NE %; The E 3/4 of the NW% of NE %. All located in Section 36, Township 28 North, Range 18 West, Town of Recordina Area Kinnickinnic. Name and Return Address C. L. Gaylord Attorney at Law P. O. Box 46 River Falls, WI 54022 0 022- 2003 0-000 022- 2003 - 20-000 (Parcel Identification Numbers) This is and is not homestead property. Dated this 27th day of December , 200 ! (SEAL) /lol(4 (SEAL) ' *Betty wenson (SEAL) (SEAL) AUTHENTICATION STATE OF WISCONSIN Signature(s) PIERCE COUNTY Personally came before me this 77th day of December 200 the above named Betty authenticated this day of J. Swenson, as sole Trustee of the Eugene P. and Betty J. Swenson Revocable Trust, to me known to be the person who executed the foregoing instrument and acknowledge the Signature .+" . Type or print name 'Karen Engel, Notary Public, of, istc sin .� S 's TITLE: MEMBER STATE BAR OF WISCONSIN (If not, My commission expires June 19, 2005' Q- 0 authorized by § 706.06, Wis. Stats.) £ .�' : '�� v ' v s L1: Z 'f J0 : to 'Names of persons signing in any capacity s ' THIS INSTRUMENT WAS DRAFTED BY �� C. L. Gaylord printed bekrw their signatures. Attorney at Law �StAV�'' P. O. Box 46 River Falls, WI 54022 INFORMATION PROFESSIONALS COMPANY FOND DU LAC, WI 800. 655.2021 I I Parcel #: 022- 2003 -70 -000 06/01/2006 05:08 PM PAGE 1 OF 1 Alt. Parcel #: 36.28.18.564 2 - T I I 0 2 OWN OF K NNICK NNIC Current Xj ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner ERIC R & MICHELLE M SWENSON O - SWENSON, ERIC R & MICHELLE M 148 CTY RD W RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description * 1486 CTY RD M SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 40.000 Plat: N/A -NOT AVAILABLE SEC 36 T28N R1 8W SE NE Block/Condo Bldg: Tract(s): (Sec- Twn -Rng 401/4 1601/4) 36- 28N -18W Notes: Parcel History: Date Doc # Vol/Page Type 01/13/2003 705538 2108/291 TD 02/05/1999 597393 1402/95 QC 2006 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 08111/2005 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 33.000 3,000 0 3,000 NO UNDEVELOPED G5 2.000 200 0 200 NO AGRICULTURAL FOREST G5M 2.000 1,100 0 1,100 NO OTHER G7 3.000 40,000 156,100 196,100 NO Totals for 2006: General Property 40.000 44,300 156,100 200,400 Woodland 0.000 0 0 Totals for 2005: General Property 40.000 44,300 156,100 200,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 09/29/2005 Batch #: 05 -25 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 f ( \1 IV IV Ivi \IIN 1v 1 `/ ••'- -`tIliiiiw - • ""— 9 C rosEarY HEIGHT SEE PAGE 29 %end¢ cT �� /rrcC y Yfl . N Frederick G 4o Vae ore f Lawrence L at Hansen 6R6 Simonson, �Y S ' ., Ur rPay 65 e>'al eta/ V .pond y Ne o E.s Hato 4eS Lenerf� Yarsva /d v /aria 5rno /d H. t ( . °3 �tl /2 "y n • 116.71 Hsmussen >; Marc,/ /a tl F l V �Fv J99 Le /and LUeck t h tl 0 Q .z /975 S a w / N q v N i ./ • Fred<nck DI rf €" sTose .O ne 4E %en tl C� Rober! rro08 U .�, Sose e Re, r /. Thom ��' Laune Lener+ .i .Ba,9de�% ¢71.35 s 0t °7 Barbara /arlee 20,.88 .3 rR. kb 80 • cAaJneS J�ober"f v Ickler r % p � Af arbara • ,,, � /9145 ja � h h �.zB • Lubich, Ic/! /U /rB.7 • Q leo etal A5?6' z Le . . • N � °r*1f� 0 ^T ' d Arno /d Fl s �iero.kz BO ,Poberf K /20 M 'v /er Rorratd Rf k 0 Marce //a Bo Korth /e en Ito Lerch ter- • 56.31 M¢r A morn LLec.E .Oenson, Luc E.B :7e M ./o • f7lv:n n.4roHt - .1_ Mo- rviniT �SUmrre/' Ross le" ayJ57 Abrahamson ' o ,�, fre 2i7 //an .Be 43- v ., Johnson 16a 4f Rwse wR a N ✓ALLEY / 73.5 Vr 9. • / ! t . N . c u A/orthuLeste 140 0 • 7� Len / �N E %B • Kaone p'woich F? q0 /20 /2o Faun 2257 • 9 Farms; nc. S t .r a a . R • M�mt Co. At Caro/ � o� eu Gorda R Jr s �� Gr�ory� ©nheimer srEE�,E L roe f d �wi7 s Fe ereiseJ7 /r3.4 �b SS iR. a`. fMar yri Roza ;ne rQaXanne tarn- Phi / /ipps Ma se/J .-y b0V ycs b� _sM Tue di // Bse/ a arf Qise/ f Th Tr y CR eo /.5762 �� YR& m SZ 425 7Cl6 9 4 7 is ore 9.W 67 %\ r d E,Susan a s'q Hawa e7 e s s /54 ads 3 F� 37nc Z� IF �4 ¢pdi U 9 Ems of Lr C10#04 a tl l s y 9 ropomic y • s 140 y rl //7 . atilt Jlo8 iC�J 0 t r Q.m � y � tTulre 4 4 Ise '�°r" -� � .. , • s } " • J h� d\ Of RD`ntXy liven w n F a .? /39 ` a UZi s zm ✓a i7gronomres s • o: Phi //' O �E v 77 80 v 0 g � F / /en Inc. `� �' , e . `$ m ?14. u .174J /n Dana /d ,W tl cl Stirar / i53 szs sa.s `` Diane EUiJayn - to Vii/ ps u �'� tl uO f/r G/a is Mue/ %r • son �s r . 77Q Fami /y C e -0 itch- 40 l .,u O 7q 3, <:irr 4p .yonen P S� TiUSf : -t. ides • ° 4wt ' ,V 8 /)ergo W a V ��R h ?Re o. C1� fJrisJiansan Loko wick, yV C 2O /4/ W 8o tl-c ^s Thomas s • p BO B1 U Rpfendor/ • n "1� S Low etux �`,� H r� � A?.f�¢ a /zo a //L ay €O /i ve 5J 138.5 Da �> // vid Y V y a ¢ Fu / /"- W 290 f r ,F � UL / /en- rTacobson VU 2n/7 . d n 'C O QIK • 9 Luse u ' y ti-1 z zoeib rmo .h Ho rd set+ 5�• .Daniel eT s '� e z v,v A9 M a /0267 f W Honor 8 .r non flnn J v ?5� Pope . v'Y 4z • .° • Gordon k 0,flei XrLrmwlede LHarri t �"i 4 N� s /a S6 1557 Mara • 1557 Grt p /6c; E!ynck, yy b a, q o b Jame• e+ rt . Y `r hn na s t ,- O, Mar roen, h Try ° Pson 7 vo /4d `C 0 O • q y ' � McL hfin rb� n re /c O -ry in /L t\1 r7en - eiths R 8 G. a SMfaL4 • MQI /iJ7 T - J /rJ45n7; Inc. ewe area 117arfene ,/J r2ers qq Bb :w . °� Zvc. yo ir�+ VIA, g o . w a ::. 'gnu 70 Krea,r E R6REE /a.r n tCrox ceA€ � �. !✓ am D� 4d Lee '.. � �V 3 /B /7 C'ourltz�f. TL ��111 63 dab- / /2B Lrre � art N� 3 az z 2 �� rs364 c po s.a � r«,- 2 7 v 99 OIJan1elf s. B: a. L¢Moine vv?7 yairy L. an . 1 cS we ey F G. Krems 2 ode en 1Q � . 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P /ERCE COUNTY 900 1000 1100 1200 1300 1400 1500 Caring professionals in FREEMAN your neighborhood DRUG INC. PRESCRIPTION SPECIALISTS 5t4�w � 4 �, % DELIVERY SERVICE Family Practice 104 South Main Street Nutrition R Pediatrics I General Surgery River Falls, Wisconsin OUR COMMUNITY OBIGYN 8 Nurse Practitioner Phone: River Falls Medical Clinic 425 -2255 Ellsworth Medical Clinic Seth Speerstra R.Ph. ELLSWORTH; 144 South Plum Street - Phone: (715) 213 -5041 Leah Gavin, R.Ph. RIVER FALLS: Spruce 8 Spring Sheets Phone: (715) 425-6701 oil I 0 ,Y CROIX CO UNTY PLANNING & ZONING JW EROSION & SEDIMENT CONTROL PLAN Site location: 1486 Cty. Rd. M, >40 acres existing house, Town of Kinnickinnic Owner(s): Eric Swenson Parcel ID # 36.28.18.564 Code Adminias 715- 386 -4680 Under St. Croix County Zoning Code 17.70(3)(b) 5: "The (Zoning) Administrator may attach reasonable erosion prevention conditions to a permit approved for issuance." Land Informatio Wisconsin Uniform Dwelling Code Comm. 21.125 requires the building permit applicant Planning and /or landowner to follow erosion control procedures and maintain them until the site has 715 -386 -4674 been stabilized (Uniform Dwelling Code Comm 21 is available on -line at: www. commerce. state. wi .us /SB /SB- DivCodesListing.htmi) Real Property 715 - 386 -4677 The Owner of the above parcel is responsible for notification of all contractors performing construction activities on this site that an Erosion & Sediment Control Plan is in effect and the Recycling following activities will be required in order to maintain compliance with the plan: 715 -386- 1. Maintain existing vegetation wherever possible to minimize erosion and sediment movement. The primary source for construction site runoff will be the house foundation excavation, driveway, and any soil stockpiled until final grading and stabilization is complete. Septic system installation adds to temporary disturbance, but establishing cover on exposed soils will prevent erosion. Apply seed and mulch as recommended in #5 below. Surface drainage is southwesterly and >100 feet from road ditch on Cty. Rd. M. The mound must be stabilized immediately after completion. 2. Install construction entrance before any excavation begins!! Construction equipment and vehicles must utilize a stabilized driveway access off public road for heavy equipment; this includes cement trucks, well drillers, and other contractor's vehicles that require access to the property during construction. Avoid muddy, rutted conditions that may allow contaminated runoff to reach waterways and/or drainage ditches. Property owner must repair damage to ditches resulting from multiple access points and sediment tracked on public roadways must be removed at the end of each workday. 3. Do not allow diverted runoff to be directed onto neighboring property or into surface water conveyances. Contain runoff by installing temporary diversions graded ALONG CONTOUR between construction areas and any potential receiving waters (includes drainage ditches and retention basins). Temporary Diversions specification sheet is available from county. 4. If sediment cannot be contained on owner's property with temporary diversions and vegetative buffers, then installation of approved sediment control products (straw wattles, silt fence, erosion control matting) will be required. The POWTS inspector and/or building inspector will evaluate ESC plan effectiveness and make recommendations to owner for any action required to comply with applicable regulations. ST. CRolx COUNTY GOVERNMENT CENTER 1101 CARMICHAEL ROAD, HUDSON, W1 54016 71X386 F PZ@CO. SAINT-CROIX. W1. US W W W . CO. SAI NT-C ROIX. W I . U S . y r Page Two — ESC Plan Acknowledgement Form 5. Stabi ze exposed soils (septic system included) with seed and mulch immediately after installation - do not wait r final stabilization and/or landscaping of entire site to establish permanent cover on the site. When late - seas weather conditions will not permit seed germination, a heavy straw mulch cover will prevent erosion until veget ' n can be established. Erosion control matting can be applied any time of year and, if installed properly, will pro protection even if seed germination is delayed. The owner rd during site construction will be responsible for compliance with state and county code requiremen ecified in this Erosion & Sediment Control Plan. Please feel free to contact me with questions regarding er & sediment control product installation. C PLAN PREPA . D BY: PAM QUINN, CPESC #1622, SOIL EROSION INSPECTOR #6650 4 e) O wner ac W 6 0 w o led2ement of ESC Plan re uirements: /2006 (Please n and return original ESC form to Planning & Zoning Dept A copy is attached to the owner's permit and ma' t nance agreement, which is given to the plumber at time of permit issuance.) ST. CRO /X COUNTY GOVERNMENT CENTER 110 1 CARMICHAEL ROAD, HUDSON, Wi 54016 7153B6-4686 FAA PZ @CO. SAINT- CR01X. Wi, US W W W. CO. SA INT -C ROIX. WI. U S I\ \\ M C � �� � �\ �� e r �'�' \� � q �� � `� v � \� � .- � � �� � ��� �� l�� �� �o��� � .� ti �� �, � /��