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Wisconsin Department of Commerce SOIL AND SITE EVALUATION <br /> Division of Safety and Buildings Page of <br /> B%weau of Integrated services in accordance with s. ILHR 83.09, Wis. Adm. Code <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must County <br /> include,but not limited to: vertical and horizontal reference point(BM),direction and <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Phrcel I.D.# <br /> APPLICANT INFORMATION- Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner Property Location <br /> FALPH Govt.Lot3t-I 1/4 1/4,s j3*2Qr 4D ,N,R IS E(or)(@ <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# PIA r Of C <br /> holo EVAR [4tLL5 D. AVE-Z3 VOL- 13 P- AS- 14 <br /> City State Zip Code Phone Number ❑ City ❑ Village Ipll Town Nearest Road <br /> MI IMS W KAI WL 5.53051 ( W-J54O- 7 SA6K olJ IZp . <br /> ❑ New Construction Use: CK Residential/Number of bedrooms 2 Addition to existing titrilding <br /> 54 Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow 300 gpd rte.`f� Recommended design loading rate •1 bed,gpd/ft2 •% trench,gpd/ft2 <br /> Absorption area required�9bed,ft 5 trench,ft2 Maximum design loading rate •7 bed,gpd/If - $ trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) q(v-3 ft(as referred to site plan benchmark) <br /> Additional design/site considerations <br /> Parent material 1�_�:1�1�11151�"r Flood plain elevation,if applicable NA ft <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Ti)nk <br /> U = Unsuitable for system AS El U Ps El ;4 S ❑ U XS ElU MS ❑ U F-1S �6rd,1 U <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Structure GPD/ft2 <br /> in. Munsell Qu.Sz.Cont.Color Texture Gr.Sz.Sh. Consistence Boundary Roots <br /> Bed , Trench <br /> R5bs Ml Ce B <br /> Z <br /> TA rAI .9 <br /> Ground <br /> peelev`. <br /> ID•V ft. <br /> Depth to <br /> limiting <br /> f9ptor <br /> in. <br /> Remarks: <br /> Boring# <br /> .7 •8 <br /> a <br /> 7 13 <br /> Ground SL <br /> ev , <br /> Depth to <br /> limiting <br /> factor <br /> ��in. Remarks: }�A>vn AuGEx BnarwrL <br /> CST Name (Please Print) Signature Telephone No. <br /> & - 6- 441S <br /> Add ss ate CST Number <br /> :7-077W�6st�ie 611, �F8R3 �- ?- R$ 58 <br />