Laserfiche WebLink
Wisconsin Department of Commerce SOIL AND SITE EVALUATION <br /> Division of,Safety and Buildings Page I of 3 <br /> Bureau of Integrated Services in accordance with Comm 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 �6"Ir r1 e4 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. <br /> Parcel I.D.# <br /> APPLICANT INFORMATION- 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�JProperty Locat' <br /> Tlp-/1 ;C' LA W( �Y yl Govt.Lot 1/4 ► 1/4,S 36 TZ" ,N,R [If E(or�r <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> Z-5 177 C. Kt n 56-A L-n . <br /> City State Zip Code Phone Number [:1 city ❑ Village Town Nearest Road <br /> 4 a'k LJ; 1 5q gN$ ( 41610-222Z I K r•4. <br /> ® New Construction Use: ®Residential/Number of bedrooms Addition to existing building <br /> ❑ Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow I_/Z gpd Recommended design loading rate .7 bed,gpd/fl2• S' trench,gpd/ft2 <br /> Absorption area required A58 bed,ft2 r15O trench,ft2 Maximum design loading rate • 7 bed,gpd$ - g trench,gpd/fl2 <br /> I <br /> Recommended infiltration surface elevation(s) 9 . O /ACS_ Cr 9_ a pTft(as referred to site plan benchmark) <br /> Additional design/site considerations /eW! /O O��Amf.H-'SF?a u1h•fe 04j< Tree 11.V-0 SLo.K <br /> Parent material ki f' Flood plain elevation,if applicable /Je/Crr ft <br /> 7 <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system OS <br /> ❑ U 2rS El 2rS 1:1U ZfS El ❑ S ErU ❑S 011 <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 <br /> in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench <br /> I t' lo" 7.5kR�/z ,aQ �"k 1» r 3v, 5- <br /> .G <br /> 2 - -r•SYK n1 aQ d m5 lox 07 Ar- COV /F . 5' <br /> ' <br /> Groundy� �2 <br /> l8 <br /> ft. <br /> Depth to <br /> limiting <br /> factor <br /> J..o -in. ; <br /> SBF Remarks: <br /> Remarks: <br /> Boring# <br /> rpm I{� Ioena-Ae A-12 SbK caJ 3v� S'• b <br /> razz 7-sy9'114 a ,aQ �,.shk nr�r ca') zr'� a1. b <br /> 8L 7.5 A414 /►'tore �ru � .7 8 <br /> Ground <br /> elev. <br /> (2A n. <br /> Depth to <br /> limiting <br /> fact r 8'7 3r <br /> �t n. Remarks: <br /> CST Name (Please�Wnt) Signature Telephone No. <br /> Address tDate CST N mbar <br /> n �Z2� nelr S��o Z <br />