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Wisconsin Department of Commerce SOIL EVALUATION REPORT <br /> Division of Safety and Buildings of <br /> in accordance with Comm 85,Wis. Adm. Corfu <br /> Ahach oomplete site plan on paper not less than B 1/2 x 11 inches in size.Plan must County <br /> Include,but not limited to:vertical andhorizontalreference point(BMJ,direction and �— ---- <br /> percent slope,scale or dimensions,north arrow,and location and distanco to nearest road. Parcel I D, <br /> -odyo-Z <br /> Please print all information. Reviewed by Date <br /> Panonal Information you provide may be used for secondary purposss(Privacy Law,a, 15.00(1)(m)I. ��QFILGO/� <br /> Pro ertyOwner Property Location <br /> .arn I�. � s � ' <br /> GOA.Lot �� 1/4 � 1/4 S3 T� N R E fur) <br /> Property Owner's ailing Address \ Lot# Block# Subd, Name or CSM# <br /> _ <br /> City Stale ap code Ph umbar ❑city ❑Village ,tTown Nearest Rpad <br />❑ New Construction Use: esidential/Number of bedrooms_02 _ Code derived design flow rate O <br /> g GPD <br />❑ReplacementPublic or commercial-Describe. <br /> Parent materialG- ._. <br /> � \�.�—�1 _____ Flood Plain elevation d aPUlicable _� _... _ _ - It. <br /> General comments L30rrn9 j»r UenFGotraw of 6vS-6fn5 sd11 r (UWW, dot 6 SuQ/erf /dcaO&A op Ce q, <br /> and recommendations: 6Y SA, 97.,z6 60 98 00 <br /> /�Q� aS 39(0 8 - �teno(s�ir/_ f.G4,r•Esmr�h- Gra�llyg Co>aQJea <br /> Boring - <br /> 7 Boring# qp <br /> ® pit Ground surface elev.1_/(� It. Depth to limiting tactor 7 in. --- <br /> _ Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' <br /> in. Munsell Cu.Sz. Cont. Color Gr. Sz.Sh. 'Eff#1 'E1142 <br /> I o-b �� S n 6 pts' cs - - <br /> 577 2Y/6 cZ-TYe!IXF <br /> Boring X Boring <br /> pit Ground surface elev. n. Depth to limiting tactor In, Soil Application Rata_ <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistonce Boundary Roots GPM*! <br /> in. Munsell Cu. Sz. COnL Color Gr, Sz. Sri. 'Eff#1 'Eff#2 <br /> ' Effluent#2 =BOD <30 mg/L and TSS:S 30 mglL <br /> •Effluent#1 =BOD >30<22o mc and TSS>30!: 150 mglL - CST Number <br /> GST Nomo ( laaao riot) � � ��� <br /> SIOr�'1 �z76 9 t <br /> Dato Evaluation Conducted Tolophone Number <br /> Address r y/y.-7 Y,6 <br /> 0 - --- <br />