Laserfiche WebLink
Wisconsin Department of Commerce SOIL AND SITE EVALUATION <br /> Division of Safety 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 od 4,^ti <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <br /> O/� 33/2 d 7 o v <br /> APPLICANT INFORMATION - Please print all information. Reviewed byJ Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). [/ S�� <br /> Pro arty Owner Property Location <br /> 70,�. 4/L,) 6 Govt.Lot lotAJ 1/4^F 1/4,S j a T,39 ,N,R E(orc <br /> Property Owner's Mailing Address [;T# Block# Subd.Name or CSM# <br /> Y 13,C1 /";%.ik, - - <br /> City State Zip Code Phone Number <br /> ❑ City El Village a Town Nearest Road <br /> G,1 e 6 S er w <br /> �Alew Construction Use: 5�rBesidential/Number of bedrooms ca2 Addition to existing building --' <br /> ❑ Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow-:51e D gpd _ Recommended design loading rate bedtZ� <br /> ,gpd/fztrench,gpd/fl2 <br /> Absorption area required 60 ct bed,ft2 s dO trench,ft loading Maximum desi n <br /> g g rate <br /> :bed,gpd/ft2 ' C trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) y7, �t./J/i/ct �� ft(as referred to site plan benchmark) <br /> Additional design/site considerations id -- <br /> Parent material G/i4 C j i9- C/f-/ T' f Flood plain elevation,if applicable /!// - ft <br /> S = Suitable for system Conventional I Mound In_Ground Pressure IAT-Grade I System in Fill Holding Tank <br /> U = Unsuitable for system S El I (mss ❑ u 9S ❑ u 1 ,9S ❑ u I ❑ S (9 U <br /> SOIL DESCRIPTION REPORT <br /> Boris # Horizon Depth Dominant Color Mottles Structure GPD/ft2 <br /> Boring Texture Consistence Boundary Roots <br /> in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed , Trench <br /> Ground <br /> el� , <br /> ft. <br /> Depth to <br /> limiting <br /> factor <br /> ;_ Qin. <br /> Remarks: <br /> Boring# p <br /> 6 7,Sy/{ 3� �S J G S a2 .> <br /> �? ` 3' % S <br /> Ground <br /> �elev.14 <br /> Depth to <br /> limiting <br /> fa for <br /> in. Remarks: <br /> CST Name (Please Print) Signature Telephone No. <br /> 5e 6`i o/" O f5?-7 z k6 <br /> AddressJor Date CST Number <br /> Poe< 5� eN �� S� 8 a- `02 - .3�5-e73,o <br />