Laserfiche WebLink
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1__Of 3__ <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,alis. Adm. Code <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must County Ga/ria- <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. .r� p <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. ,9 - / 5;63" OD <br /> Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner L vyf/� 1 Property Location <br /> /VO r�n 1ozbjs / rO G r'I l Govt.Lot Wv4 /VE1/4 s93 T yU N R /S E(or) <br /> Property Owners Mailing Address Lot# Block# St tbd. Name or CSS <br /> 395// S`�Ye � Fa7 tl Hl 1l dd <br /> City State Zip Code Phone Number ❑City ❑Village Town Nearest Road <br /> New Construction Use:❑ Residential/Number of bedrooms — Code derived design flow rate GPD <br /> ❑Replacement Public or commercial-Describe: <br /> Parent material rAG�R' 1 j t f LLRS I^ Flood Plain elevation if applicable //�Z R. <br /> General comments ,1 ( S <br /> p� boat (t O!� G 2LG /./V t& iL/' Z'r ' S 1*� <br /> and recommendations: t u ) q <br /> / <br /> I mvv-4. IS-3 S 5{en 2 JeV S <br /> Boring# ❑ Boring <br /> to pit Ground surface elev. 5-` ft. Depth to limiting factor /!__.in. <br /> Soil Application Rate <br /> HorizonLDethDominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2 <br /> / S �a nsrt� S / s „ _ / a <br /> 2, I' am✓ X4" , 73 YRy//O �✓GSbkMVrl /7r <br /> ® Boring <br /> F65-1 �ri�# R 7 <br /> ❑ pit Ground surface elev._ a ft. Depth to limiting factor �/�in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz. Cont Color Gr.Sz.Sh. 'Eff#2 <br /> 1 <br /> 0-3 7,5Yrzy/a n 657y - (s <br /> Syr-,6/y k%6y%-Q <br /> 5 ),s YP, Vee — _ 171 <br /> ee-( <br /> tilt5 <br /> Effluent#1 =BOD >30:!220 mg/L and TSS>30:E 150 mgA- 'Effluent#2=BOft3O and TSS_30 mg/L <br /> CST Name(Plsi Print) Signature CST Number <br /> cc UTT w-��� 3S-71 <br /> Address Date Evaluation Conducted Telephone Number <br /> a-Sa3- creek r, Ak66/&/v- "-5i?k3o / 7/S-o\-S9 ' 366 <br />