($45.00 per hour/minimum two hours)
For Village Use
Permit Number:
Receipt Number:
Account Number:
Approved / Denied
Date Issued:
Project Address: _________________________________________________________ Date:___________
Lot: Block:____ Subdivision: _______________________________________________________________
Parcel Id #: _____________________________________________________________________________________
Name of Applicant: Applicant’s Telephone: __________________
Address of Applicant:_____________________________________________________________________________
Name of Mortgagee:______________________________________________________________________________
Mortgagee’s Telephone:___________________________________________________________________________
Address of Mortgagee:____________________________________________________________________________
Estimated Cost of Ditch Enclosure:_________________________________________________________________
Name of Design Engineer/Inspector:________________________________________________________________
Size of Driveway Culvert: _________________________________________________________________________
Size of Upstream Culvert: _________________________________________________________________________
Size of Downstream Culvert:_______________________________________________________________________
Length and Description of Area Proposed to be enclosed:_______________________________________________
(Applicant to supply Drawings of installation with cross sections)
Name of Installation Contractor:___________________________________________________________________
Contractor’s Insurance Carrier:____________________________________________________________________
Hold Harmless Agreement Signed: Yes: No:
Signature of Applicant
Village Engineer’s Signature
Date Approved: __________________________________________________
Date Installed:________________ Date of Backfill Inspection: Pass Fail By: _________________
Date of Final Grading Inspection: ___________________By: ___________________________________________
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1. Any or all of the following documents that are applicable are included in these
a. Standard Specifications for Sewer and Water Construction in Wisconsin,
herein referred to as “Standard Specifications”.
b. State of Wisconsin Standard Specifications for Road and Bridge
Construction herein referred to as “State Specifications”.
2. Pipe material, fittings and manholes shall conform to AASHTO M 294 and shall be of
equal or better quality as is ADS N-12 pipe. The pipe shall be the slotted or perforated type and
shall be double walled with the inside wall being smooth. The pipe diameter shall be specified
by the Village Engineer but in no case shall be less than 12 inches.
3. Pipe shall be carefully laid in a straight line and at the proposed elevation and all work
shall conform to Chapter 3 of the State Specification for Sewer and Water Construction except as
noted herein.
4. Bedding material conforming to 6.43.2 of the Standard Specifications shall be installed at
the following minimum thicknesses:
a. Bottom – Two inches below the pipe.
b. Side Six inches.
c. Top – Two inches.
5. Prior to covering the pipe, geotextile filter fabric conforming to Section 628.2.8.1 of the
State Specifications shall be wrapped over the top one-half of the pipe above the spring line .
6. All joints and connections are to be made with approved connectors and bands. Any
voids shall be wrapped with approved filter fabric. All lateral connections are to be made at or
above the spring line of pipe.
7. Driveway culvert end sections shall be removed prior to joining the enclosure pipe t o the
8. Each end of the enclosure shall be equipped with an animal guard grate. Grate bars shall
be spaced not less than three nor more than six inches.
9. Each end of the enclosure shall be equipped with a corrugated metal flared end section.
10. After the enclosure is installed the disturbed area shall be covered with a minimum of 3
inches or topsoil and seeded pursuant to Village Ordinances. The area shall be fine graded to
allow for good surface drainage to the appropriate inlets. The final elevation shall be a minimum
of 3 inches below the existing road shoulder.
1. The Engineering Department will inspect the site to determine if a Full Ditch
Enclosure is feasible. The criteria used in establishing the feasibility of a Full Ditch
Enclosure shall include the following items:
a. A ditch with a minimum depth of 2.5’, side slopes that are steeper than 4:1, and
non-maintainable slopes.
b. Potential depth of cover over the Full Ditch Enclosure shall be a minimum of half
of the diameter of the enclosure. In no instance shall the cover over an enclosure
be less than six (6”) inches. A Ditch must still be maintained over the enclosure
providing proper drainage from the yard and shoulder area to the ditch. This ditch
must be a minimum of one (1’) foot below the edge of pavement and have a
centerline slope of no less than 1.0%. Side slopes are not to exceed 4:1.
c. The existing and future drainage area to be served by the Full Ditch Enclosure
shall be examined. The Full Ditch Enclosure will likely not be allowed if future
upstream development will likely require extensive modification of the proposed
enclosure because of increases in runoff, potential elevation or gradient problems
or if it is impossible to determine at this time, the best method of draining the
involved drainage area.
d. The installation of the Full Ditch Enclosure shall not be allowed if its construction
will reduce the hydraulic effectiveness of the existing drainage facilities or if such
installation will not conform to acceptable engineering standards. If the enclosure
is determined by the Village Engineer to be not feasible, the owner shall have the
right to appeal the decision to the Village Board.
e. The installation of the Full Ditch Enclosure may not be allowed if potential
damages or hazards exist due to a possible conflict or close proximity of another
utility lines or facilities.
2. If the Village Engineer determines that the Full Ditch Enclosure is feasible, the owner
shall hire a Professional Engineer to draw up design plans and specifications, which
conform to Village Standards.
3. Once the owner has obtained the design plans and specifications stamped by their
Professional Engineer, the owner must submit a completed Full Ditch Enclosure
Application Form along with 2 sets of stamped Plans and Specifications to the
Engineering Department. The owner must also supply the minimum permit fee of
$90.00. (Note: Prior to the permit being issued, an additional fee may be required
depending on the amount of review time on the project.)
Plan and Specifications shall show the following information:
a. Scaled plan view showing the location & elevations of the existing ditch,
existing driveway culverts, the closest upstream and downstream culverts,
existing edge and centerline of pavement, edge of shoulder, sump pump
and downspout leads, lot boundaries and proposed enclosure pipe.
b. Scaled profile view showing the existing road profile, ditch profile, lot and
adjacent culvert elevations for the top and invert of pipes, top of driveway
elevations, proposed top of ground elevations and proposed enclosure pipe
elevations, size and gradient. Cross sections showing existing and
proposed spot elevations (in USGS datum) must be provided at lot lines
extended, over the enclosure at break points, inlets, driveway culvert
/storm sewer connections and at other locations as deemed necessary by
the Village Engineering Department. Surveyor/design Engineer is contact
the Village Engineering Department for additional cross section and
grading plan requirements.
c. The plans shall depict the sizes, locations and depths of all nearby utilities
including, but not limited to, water, sewer, gas, electric and telephone
mains and services. Sanitary sewer manhole rims and inverts must be
shown upstream and downstream of the project.
d. Detailed drawings showing the type of manhole or catch basin
construction and type of connection for any tile, sump pump or downspout
laterals shall be provided. Details of the storm sewer / ditch enclosure
system must also be provided and must conform to Village requirements.
e. Systems must be constructed of corrugated metal pipe or reinforced
concrete pipe. End aprons are to be installed on the inlet and outlet ends of
the enclosure system.
f. Sketch showing existing and future contributing drainage areas.
g. Hydraulic calculations verifying the hydraulic capacity of the involved
h. Complete construction specifications which must conform to the State
Specifications for Sewer and Water Construction, Village Ordinances and
the Village Engineer’s Minimum Ditch Enclosure Specifications.
4. If another utility line or facility is in the immediate area of the enclosure, the
applicant shall provide written verifications from the involved utility that there are no
objections to the proposed enclosure.
5. Upon review and approval of the plans and specifications, the owner shall enter
into the standard agreement with the Village. The agreement shall run with the property
and shall be binding on the existing owner and all subsequent owners. Such agreement
shall hold the owner responsible for liability associated with the construction,
maintenance and operation of the enclosure. The agreement shall hold the Village
harmless for any and all damages which may result from the improper installation or
operation of the enclosure. It shall be understood that the Village will not be liable for
damages to or destruction of the enclosure from any cause whatsoever, including, but not
limited to, ditch work done by the Village.
6. After the execution and recording of the agreement, the owner may begin work
after receiving notice to proceed from the Village Engineer. All work must conform to
the approved plans and specifications.
7. The Village Engineer’s office shall be contacted for inspections during the
following timeframes:
a. After the pipe is laid and just prior to any backfilling.
b. After the backfilling and rough grading and just prior to
topsoiling and seeding or sodding.
8. After the work is completed, the design engineer/inspector shall submit written
verification to the Village that all work has been completed pursuant to the plans and
9. After all work is accepted by the Village Engineering and design engineer, the
Village Engineer shall notify the owner in writing that the ditch enclosure has been
accepted by the Village.
Tony Bunkelman, P.E.
Caledonia Village Engineer
P:\ENGINEER\Ditch Enclosures\Full\2009\TotalDitchEnclosureApplicationProcedures2009 draft.doc
To: Village of Caledonia
I hereby acknowledge that I fully understand and agree to all of the conditions specified by the Village of
Caledonia Engineering Department in approving my request for permission to fully enclose the drainage
ditch / road ditch on my property. I understand and agree that the construction of the full ditch enclosure
must strictly conform to the standards specified by the Village Engineer’s office. I understand and agree
that the Village of Caledonia has no liability for any of the costs associated with this enclosure. I
understand and agree that the Village of Caledonia in no way warrants the proper operation of this
enclosure. I understand and agree that the Village of Caledonia has no liability for damage to, or
destruction of this enclosure from any cause whatsoever, including, but not limited to, ditch work by the
Village. If the system fails, is in need of repair, drainage is restricted, or if a drainage problem occurs as a
result of this installation, the Owner will be responsible to repair or remove the system at the direction of
the Village Engineer. Failure to do so in a timely fashion will result in the issuance of daily fines and or
payment of all removal / repair costs related to the removal /repair or damages caused by this system. If
payment is not received costs will be assessed to the tax roll. This agreement shall constitute a covenant
running with the land and shall be binding upon the parties hereto, their heirs, successors and assigns.
Property Location: _________________________________
Phone : ____________ : ______________
Parcel Tax Key Number: 51-104-04-____-____-_____-______
, being first duly sworn on oath says that he is the person who made
and signed the forgoing statement and agreement, and that all statements made therein are true.
Subscribed and sworn before me this day of , 20 .
Notary Public
, County, WI
My Commission Expires:
P:\ENGINEER\Ditch Enclosures\Full\2009\FulllDitchEnclosureHoldHarmlessAgreementSample2009.doc
1. Construction and maintenance operations shall be performed without closing the road to
traffic except as may be specifically authorized by the Village Highway Superintendent.
Unless otherwise authorized, two-way traffic shall be maintained at all times. Proper
barricades, signs, flags, lights, and flagmen shall be provided and maintained at all
locations where construction and maintenance work interferes with normal traffic use of
the road.
2. Laterals shall be augered under the traveled portion of all roads. The augered distance shall
include as a minimum 14’ from the centerline of the right-of-way whenever possible.
3. If open-cut is authorized by the Village Engineer, the pavement shall be cut in a straight
line and the trench backfilled with sand or a suitable material and topped with 10” of
crushed stone. After all settlement has stopped, the surface shall be replaced with the same
type and thickness as removed.
4. The contractor shall restore roadway ditches as soon as installation of the sewer or water
service is completed in order to maintain existing drainage patterns along or across all
5. The applicant agrees to accept liability to the traveling public for any damages occurring
during or as a result of issuing this permit
6. A copy of this approval along with any plans and special provisions shall be available on
the job site.
7. The applicant shall save harmless the Village of Caledonia from all suits, actions, or claims
brought on account of any injuries or damages sustained by any person or property in
consequence of the work by the applicant. The applicant shall protect and hold harmless
the Village and each and every of the Village’s elected and appointed officials, officers,
employees, agents, contractors and representatives from and against any and all injury,
payments, penalties and damages arising from any and all intentional and negligent
activities of the Applicant and the Applicant’s appointed officials, officers, employees,
agents, contractors and representatives.