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Wisconsin Department of Commerce SOIL AND SITE EVALUATION <br /> Division of Sikfety and Buildings Page / of <br /> Bureau of Integrated services in accordance with s. ILHR 83.09,Wis. Adm. Code <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County <br /> include,but not limited to: vertical and horizontal reference point(BM),direction and 1j 14.01nG tG <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <br /> APPLICANT INFORMATION- Please print all information. Reviewed byn Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). A ^'y/[` �/— 78 <br /> Property Owner Property Location V IV— <br /> f94ZK Z;4$Et1.79 Govt.Lot g4A) 1/4 17k)1/4,S 3(c T ilo ,N,R /A/ E=*4 W <br /> Property Owners Mailing Address Lot# Block# I Subd.Name or CSM# <br /> aGa 8 awa /mf. <br /> City State Zip Code Phone Number <br /> ❑ City [__1 Village 0 Town Nearest Road <br /> io t�i Y! O (7iS ).3�/9S/ 7Sfyo Mew�� <br /> New Construction Use: 0 Residential/Number of bedrooms Addition to existing building <br /> ❑ Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow 4So gpd Recommended design loading rate gibed,gpd/fF .,f trench,gpd/ft2 <br /> Absorption area required bed,ft2 'r(P3trench <br /> j ft`z Maximum design loading rate . 7 bed,gpd/ft2 •8 trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) 9.?./ ,t7 ><1 uhf W, z n(as referred to site plan benchmark) <br /> Additional design/site considerations A&W .QK17R/L iA, I e QQJQA+ L� 3% 5.0im <br /> Parent material AdtAM. Rt - Flood plain elevation,if applicable ft <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system ZS [:] U H S ❑ U Os ❑ u I ❑s B'u ❑s Cd'u ❑ s 0/6 <br /> A SOIL DESCRIPTION REPORT <br /> Boris # Horizon Depth Dominant Color Mottles Structure GPD/ft2 <br /> Boring in. Munsell Qu.Sz.Cont.Color Texture Gr.Sz.Sh. Consistence Boundary Roots Bed ,Trench <br /> 13, 0 '7 5 VR It"n rn✓ r CG/ 3✓1 V_4F .-7 :-9 <br /> 2- 5-$10 -7.6k 414 stone /m Ise✓� 3f .-7 ' .8 <br /> 51-7fi 7. Al i"&WC aw d) 19MAd rnz !'t 1 .7 <br /> Depth to <br /> limiting ; <br /> factor <br /> in. <br /> *79, Remarks: <br /> Boring# _ <br /> 7. `t y /j7os�t r 3pIm -7 , <br /> z YP014 -M — I •'7 ' r8 <br /> Ground <br /> Gr <br /> ZYy�t• <br /> Depth to <br /> limiting <br /> factor /reRrt <br /> �_in. ' Remarks: <br /> CST Name (Please Print) M at Irk s' nature Telephone No. <br /> SEPTIC & EXCAVATION <br /> AddressSpooner. I b4801 Dat CST Number <br /> 5)(71635-7482 f 8 <br />