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Wisconsin Department of Commerce SOIL AND SITE EVALUATION <br /> Division of Safety and Buildings ,, IPage_of <br /> Bureau of Mtegrated 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.# 4D l2 CCZ-903 <br /> APPLICI�iNT INFORMATION- Please print a//inio'rmatidn:! �'!`} ��Z-O CZ`✓f03 <br /> eviewed by / Date <br /> Personal informatiertyou pr6vide rnaj be used for-secondary purposes(Privacy Lewis.16.04(1)(m)). <br /> Property C�wr)er .�.i,.1 c ' 1. }, Property Location Cl 1 <br /> • :lL4r ?z EcLA�S Govt.Lot 2 1/4 1/4,S !Z Tal a ,N,R !.f E(or)OD� <br /> Property Owner's Mailing Address Lot# [91000 Subd.Name or CSM# <br /> 13 (0 ►.�cHAgAn SI' QE 11!3 PZOS <br /> City State Zip Code Phone Number ❑ <br /> City ❑ Village LZ Town Nearest Road <br /> �s Y►'1n u�Iia <br /> g New Construction Use: ••ICI Resildential f Number of bedrooms �_ Addition'to existing building <br /> ❑ Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow_300 gpd Recommended design loading rate 6 _bed,gpd/f(Z__-_(w_, _trench,gpd/ft2 <br /> Absorption area'required 400 beb,ft2,G _trencth,It ' Maximum desi n loading rate 'Sbed;god/f2' <br /> 46 trench,gpd/ft2 <br /> Recommandedfnfiltration surface elevation(g) 94.5• (ALT R3cS.� ft(as referred id site plan benchmark) <br /> Additional design/site considerations �M Clt�• OD. RtL i4. 1!'� ( K -3% sy p <br /> Parent material iiL'trla G14 i• Flood plain elevation,if applicable ft <br /> S = Suitable for system Coonnvenbonal Mound In-Ground Pressure AT-Grade System in Fillolding Tank <br /> U = Unsuitable for system O' ❑ U ZE ❑ U 0 S ElU ❑S OU ❑ S OUT❑ S 2T., <br /> L: SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles .Structure: GPD/ft2 <br /> in. Munsell Qu.Sz.Cont.Color Texture Gr.Sz.Sh. consistence Boundary Roots <br /> Bed Trench <br /> N .. ' <br /> a <br /> 3 `i. Q z• eyds. bK <br /> J d 3 .8 <br /> Ground <br /> elevi , Q. i2ie 8 <br /> .oft. .5 fy +nom vriSb r �—• <br /> Depth to <br /> limiting <br /> factor <br /> 43/-4D Remarks: 3.3' <br /> Boring# <br /> 2 -26 't.SYR.S s�r►e tr ceJ _51P K -S L <br /> -r SYR.yI cal .�► .'t •8 <br /> Ground <br /> pelev. <br /> l�cet <br /> Depth to <br /> limiting �Lv� <br /> factor <br /> 160 in. Remarks: S E• t 3.5' <br /> CST Name (Please Print) M & K Signa re Telephone No. <br /> SEPTIC & EXCAVATION <br /> Address no=counity LM Rd, <br /> �p"Mr, 54801 Date CST Number <br /> � � N aay 879 <br />