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Wis.,onsin Department ofConunarce SOIL AND SITE EVALUATION <br /> Division of Safety and Buildrtgs 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 81/2 x 11 laches in size. Plan must County <br /> include,but not limited to. vertical and horizontal reference point(BM),direction and <br /> percent dope,scale or dimensions,north arrow,and location and distance to nearest road. <br /> Parcel I.D./# <br /> O D o2 C5 l OCA <br /> APPLICANT INFORMATION-Pli ase print all information. Reviewed by j// Date <br /> I'MOnal kdomulion You pwide MW be used for secordoses wY PuP (Pnvacy Law,s.15.04(1)(m)). /( d-� I P'(/ <br /> 10 <br /> P _ Y Property Location <br /> C W E'_/ ,¢ p IJP 1L Govt.Lot ,A),L 1/4 /1)[ 14,So?V Tjg ,N.R 17 E(ocw�w� <br /> Property Owners Marg Address Lot# Block# Subd.Name or CSM# <br /> City State Zip Code Plane Number ❑ City ❑ Village fa Town Nearest Road <br /> S//E �J SS�Jd ( 13Yy-5335— 0 �1.'e �5 ✓��c o i 1+ <br /> ❑New Construction Use: EgResidential/Number of bedrooms -7 Addition to existing building <br /> Replacement ❑Pubic or commercial-Describe: <br /> - <br /> Code derived daily flow )c-) gpd _ Recommended design loading rate bed,gpdt t2 trench,gpd/it2 <br /> Absorption area required a '_0 bed,82 �J � trench,ft2 Maximum design loading rate � � bed,gpd/t2 f� trerx tr,gpd/1l2 <br /> Recommended infiltradon surface elevations) ft(as referred to site plan benchmark) <br /> Additional desigrVsite considerations i <br /> Parent materiel c7,/.4 C ift cr / �` Flood plain elevation,if applicable '-0/4- ft <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in FlII Holding Tank <br /> U unsuitable for system ❑s au fess ❑ u ❑s 91 u I ❑s [amu ❑s au ❑s nu <br /> SOIL DESCRIPTION REPORT <br /> Boring# mon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/112 <br /> in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench <br /> 13 Z 0-7 7,571 3? — 15ll"-501t, !si vFr <br /> Ground - <br /> 9. n ; <br /> Depth to <br /> limiting <br /> factor <br /> o2 f in. <br /> Remarks: <br /> Boring# <br /> 2 V-31 7,57W <br /> — <br /> Ground <br /> ArYft. <br /> Depth to <br /> limiting <br /> factor <br /> -2/Lin. Remarks: <br /> CST Name (Please Print) Signature Telephone No. <br /> Address r Date CST Number <br />