Laserfiche WebLink
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page ! of 3 <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code City <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D.[ <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. U �a <br /> Please print all information. Reviewed Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). o 40& '03 <br /> Property Owner Property Location <br /> _G e �jC / Govt.Lot SE 1/4 IV W114 S I S T St O N R I r E(or)W <br /> Property Owne s Mailing Address `4,-d <br /> ot,#,- Block# SuW. or M# /]�a rYKI 6 t! r <br /> 7 1 u /- �N C� V <br /> City State Zip Code Phone Number ❑city ❑Village Q Town Nearest Road <br /> ZA/ W 6q761 ( ) -0766 J)a4 6Vn I rex Ru G i"racrZ <br /> ® New Construction Use:(3 Residential/Number of bedrooms Code derived design flow rate GPD <br /> ❑Replacement / El Public or commercial-Describe: <br /> 4 <br /> Parent material 4Cr2, 0(-O-?Cf Flood Plain elevation if applicable <br /> General comments C/ <br /> and recommendations: �y y LG 92 5 <br /> Boring# Boring <br /> 1� G <br /> ' rrl Pit Ground surface elev. /y,s ft. Depth to limiting factor 7 7� in <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDffF <br /> in. Munsell Qu.Sz. Cont Color Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> 1 0-k 7-6Yr2 Z 5 o"k 2/7-/ /•z <br /> Z H-zs 74Y45 6 _---- m5 047 <br /> 65 /F Z <br /> Boring# Boring <br /> Pit Ground surface eiev. ft. Depth to limiting factor 7 ZY in. Sal ADplication Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Effn <br /> 1 0-3 7 5 ie / 5 &41- L C i� <br /> V-7 .5 '0-5 <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30<150 mg/L 'Effluent#2=BOD 130 mg/L and TSS 5 30 mg1L <br /> CST (Please Print) igna re CST Number <br /> / / , BS /� <br /> Address Date Evaluation Conducted Telephone Number <br /> 2740 114VWrrC IWr .Z - -o /S <br />