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-Wisconsin Department of Commerce SOIL AND SITE EVALUATION <br /> Division of Safety and Buildings Page of s� <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 <br /> - <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <br /> o3-o3-7io <br /> APPLICANT INFORMATION- Please print all information. Reviewed by Date <br /> Personal information you provide maybe used for secondary purposes(Privacy Law,s.15.14(1)(m)). _ 96 <br /> Property Owner Property Location <br /> '�Ron - r r„Z,IGK`( Govt.Lot 2 1/4 1/4,S .3 T 3y ,N,R Bftl.W <br /> Property Owner's Mailing Address Lot# Block# I Subd.Name or sM# <br /> Z(oslo'i' E. ar.6, L.Ag ZA J? N Iy <br /> City State Zip Code Phone Number ❑ cityNearest Road <br /> brz ✓to7•py81 ❑ Village � Town �t <br /> I.Jr O ) 90- I.IOK E- eela;+ I FtKf <br /> ❑ New Construction Use: (a Residential/Number of bedrooms Addition to existing building <br /> Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow 45o gpd Recommended design loading rate�7 bad,gpd/f? _trench,gpd/ft2 <br /> Absorption area required L43 bed,ft2 Na trench,ft Maximum design loading rate •7 bed,gpd/f12� 8 trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) $1a.00 it(as referred to site plan benchmark) <br /> Additional design/site considerations 1 QVnQ&AI, 100.6' 0A#L•i 14" =5t- <br /> Parent material 4t 'U at, a(;t t ,- Flood plain elevation,if applicable tt <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system OS ❑ U 1:1 s B u ❑ S 25U <br /> ❑S ou ❑S ❑'U ❑S <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/fl2 <br /> in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench <br /> 1 4" 7.SYP.3/7- rno++e 1 e1. /MV.VVI C4) 3-If 7 8 <br /> z 4- T.6yp-`+/q ms •mir-�r 2LZM -rGro .8 <br /> e evu� 3 3B+o 7.sye.41,1 .47 Gg K /In Q_ 1 -7 ;•8 <br /> c'1 Oft. Hop <br /> Depth to <br /> limiting <br /> factor <br /> 1'10 in. <br /> $4.83! Remarks: k 4-o <br /> Boring# <br /> 4 p -i.SYRNz. e ),.� 4 CZ) 3v -7 ' . 8 <br /> 2 2 .' 7.5 R`+1� — m J Y �t . -7 <br /> b" -r.5YQ`I 14 � 8 <br /> Ground 110" <br /> Depth to <br /> limiting <br /> factor U•31 <br /> LID-in. Remarks: �o " <br /> CST Name (Please Print) M Signatur Telephone No. <br /> SEPTIC & EXCAVATION <br /> AddressDate CST Number <br /> Spooner,W154801 <br />