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t <br /> Wiscons)n Department of commerce SOIL EVALUATION REPORT <br /> Division of Safety and Buildings Page—L of 3 <br /> in accordance with Comm 85,Wis. Adm. code n <br /> Attach complete site an on County U tw a <br /> P plan paper not less than 8112 x 11 inches in size.Plan must <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and <br /> Percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D. o'k 0 309' O-�: /d e <br /> Please Print all information. Reviewed by Date <br /> Personal information you provide my be aced for Secondary Wr7osea(Privacy Law,S.15.01(1)(m)). /6 /, b7 <br /> Property � <br /> rty Owner Property Location <br /> /rr '',,rrs�11 dLrl Yt SCi t'r fiC GovL Lot 5 1/45x1/4 Sd T y0 N R /b E(orwyy� <br /> Property Owner's Mailing Address Lot# I Block# Subd Name o <br /> 7//0 G.b/rs RV- <br /> city State Zip Cole Phone Number ❑City ❑Village [NTown Nearest Road <br /> W ebsfrr 1✓t 54893 (7�S) gb6-ybog O.o k 14.d I 6.b/Ps <br /> LI New Construction Use:® Residential/Number of bedrooms y_ Code derived design flow rate Coo GPD <br /> ®Replacement ❑ Public or commercial-Describe: <br /> Parent material //a c i a / ,-rC+ Flood Plain elevation if applicable ft, <br /> General comments <br /> andrecommendations: SI-f. g/v V W - 10 (9203 ijo 71/ 30 <br /> Qa.%nf f ;2 3 f{e�%LenJ wi+i� S�Lr a.r•e v¢ry cor+pcaY; <br /> I144PAy A.% MM-lbAjM1 ,40AJ4V SND <br /> Boring# Boring <br /> © Pit Ground surface elev. 9G. d ft. Depth to limiting factor > db in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Colo Redox Description Texture Structure Cotsistence Bounder, Roots GPDW <br /> in. Munsell Qu.Sz. Cont Colo Gr.Sz.Sh. •Ef1#1 •Eft#2 <br /> / o- b 7•syyT �/� — ,s 1M.06A „ / cs 3'n 7 /• 6 <br /> d a-ax <br /> 7. C?, <br /> — /FS a,«r6k , l GS 3w p. <br /> 3 S'rRy/y c 5 - 7 /. 6 <br /> 4 Ya-S3 7.sYR4G — S/6. Of( w I G S — - 7 <br /> I. /e <br /> . 7 <br /> ® Boring# ❑ Boring <br /> © Pit Ground surface elev. 76. 7 ft. Depth to limiting facto .7 G in. <br /> Shc 'cation Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure an Roots GPD/R <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2 <br /> / a- 'i 7•sY173/x — iS /. sbk ,, / cs 3 . 7 / 6 <br /> 04 �/- 38 <br /> 3 3� 49 SYR `��aj S lr oSG �ytC G 5 n -7 6 <br /> G( 7G 7S)'/?r/N — s le <br /> U-i{•� /fo�rra1 '5 /F.S .ria sire <br /> Effluent#1 =BOD >30<220 ng1L and TSS>30<150 mglL •Effluent#2=SOD.<30 and TSS<30 n1gIL <br /> CST Name(Please Prim) Signature <br /> CST Number <br /> e-s S O n 2 If S oa'-L; t 73 W O <br /> Address Date Evaluation Conducted Telephone Number <br /> "47760 Wj-2- &53 S-/0,07 7/.S 866- elIs7 <br />