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Wiscon§in 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 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <br /> Deo- gv -el <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 Property Location <br /> TVEW 37Govt.Lot 1/4 1/4,S 20 T40 ,N,R Ib E(or)g)_ <br /> Property Owner's Mailing Address Lot# Bloc # Subd)Name or 7elka) <br /> # P 11 <br /> 3 Z ko ST. N V il4 I IK 9 <br /> City State Zip Code Phone Number ❑ City ❑ Village TOL Nearest Road <br /> MN 496%_ 1 (&91 )42q CA KLA 90 ifto6cr AV <br /> ❑ New Construction Use: (+Residential/Number of bedrooms- Z Addition to existing building <br /> C9 Replacement LJ Public or commercial-Describe: <br /> Code derived daily flow 3W gpd Recommended design loading rate •1 bed,gpd/ft2 •$ trench,gpd/ft2 <br /> Absorption area required A2Zq bed,ft2 *575 rench,ft2 Maximum design loading rate bed,gpd/ft2 - $ trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) 14.07 ft(as referred to site plan benchmark) <br /> Additional design/site considerations <br /> Parent material (itTLA_ua t flajf r Flood plain elevation,if applicable <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system r$;]S ❑ U 1MS ❑ U VS ❑ U [Ks ❑ U Vs ❑ U I ❑ S OU <br /> SOIL DESCRIPTION REPORT <br /> Boris # Horizon Depth Dominant Color Mottles Structure GPD/ft2 <br /> Boring in. Munsell Qu.Sz.Cont.Color Texture Gr.Sz.Sh. Consistence Boundary Roots Bed Trench <br /> 1 0-6 1.5qRz 9;1Z AAS 1.7 <br /> 2 <br /> 6-70 M s .7 , .8 <br /> �Ground <br /> ft. <br /> Depth to <br /> limiting <br /> factor <br /> 7 loin. <br /> Remarks: AW " Reet" <br /> Boring# <br /> 47 <br /> Ground bn <br /> e ev. <br /> .O ft. <br /> Depth to <br /> limiting <br /> fa <br /> for in. Remarks: UA142 Au4U Qc <br /> CST Name (Please Print Signatur Telephone No. <br /> ;K11,q,4PV www ;;� 115. +15 7 <br /> Address 3S F .S*?1 �I. .54'S" -3t- zDae ' CST� <br /> 2,-7-7& wqs <br />