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Wisconsin Department of Commerce SOIL EVALUATION REPORT page_j of 7 <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> Attach complete site plan on paper not less than 812 x 11 inches in size.Plan must c"'y ~h e-77� <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. a-Y•a XPA-41-/!%,t 4 S•e� <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. a 0 A- O Sb eG p <br /> Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,S.15.01(1)(m)). 8��d 2a)0 <br /> Property Owner Property Location <br /> T »> Ross t <br /> Govt.Lot 1/4 — 1/4 Sof4 T 4/ N R (S E(orjv <br /> Property Owner's Mailing Address Lot# Block# %bd.Name or CSM# <br /> 16 to aS+fr five S• u' 3o v. 4 P.109 <br /> City State Zip Code Phone Number ❑City ❑Village QTown Nearest Road 144I? <br /> e"m 10;d a I IAN I SS60 8 1 (7(#)r) 689 - 'JrYJ -ru f .f I Z"'4 Jwww (Jr• <br /> (� New Construction Use: Residential/Number of bedrooms a Code derived design flow rate o GPD <br /> ❑Replacement ❑ Pudic or commercial-Describe: <br /> Parent material Gr'i 4!a / yr r fri Flood Plain elevation'd applicable Aft. <br /> General comments sZ70 .73. -'Z9 <br /> and recommendations: SYS . ¢/arc q/. <br /> a eat as 3RI D - G'a ht 544, <br /> Boring# ❑ Boring <br /> ® Pit Ground surface slay. `lY ft. Depth to limiting factor > 7 y in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 'Eff#2 <br /> M'c6,4-- I i s 3 nm 7 /. <br /> N-db 7.s 4Z 4/q _ /S Of^.r61-c n f 6 6 se-Is ? /. 6 <br /> 3 A�- so 7dyn`�c — S oSb n / GS d w 7 /. 6 <br /> ® Boring# ❑ Boring <br /> Pit Ground surface elev. 9#, 7 ft. Depth to limiting factor 76 in. <br /> Soil Applicalion Rate <br /> Horizon Depth Dominant Color Redox Description ae)durejCMsistenm Boundary Roots GPDM <br /> in. Munsell Qu.Sz. Cont.Color •E11#1 •Eff#2 <br /> o- Iry+z a/ —7. — — 7 /• 6 <br /> HIF I <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30<150 mg/L 'Effluent#2=BOD <30 rrxyL and TSS<30 nxA <br /> CST Name(Please Print) Signature <br /> James 506.1/@/,S _ - 7J4do <br /> Address rDate Evaluation Conducted Telephone Number <br /> � 7760ffc.. 3s GtJ�b3frr w2 S4&.3 7��— /O 7/d. Pdd- S'/S7 <br />