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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of <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 81/2 x 11 inches in size.Plan must County Br"'' e <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 03j,— of 408 D 3 deo <br /> Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.06(1)(m)). <br /> Property Owner Property Location <br /> Dok SCn w1 id f- Govt.Lot/aa SF1/4 NE 1/4 S /y T 4/0 N R /-7 E(orfs <br /> Property Owner's Mailing Address Lot# Block# I Subd.Name or CSW <br /> 6,X6 A149m St. d C301 v.S- <br /> City State Zip Code Phone Number ❑city ❑Village g ®Town Nearest Road <br /> Osceola f wS IS40dQ (7/s)75's-a!?S C 010ki I W OIaFF`k RW <br /> ®'New Construction Use:❑ Residential/Number of bedrooms Code derived design flow rate GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material G/a c+w / D.:Ft Flood Plain elevation if applicable A11W ft. <br /> General cornments <br /> and recommendations: Sys• e%✓ 93.4 <br /> Boring# ❑ Boring <br /> © Pit Ground surface elev. 7-f 0 ft. Depth to limiting factor 60 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fff <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> /S /.ns6/e- <br /> n+ <br /> d, v- v8 7.SirI? %Y s 0 oil 6S 3 co . 7 /. 6 <br /> ye-'60 7s+tR `/ — /FS r"F' 6 .5 F/+'t . S` /. 0 <br /> �6-G4 SYR 4/y F/F SYr2 j9�i C- f <br /> Boring# ❑ Boring <br /> ❑ Pit Ground surface elev. ft. Depth to limiting factor in. <br /> Soil Application Rate <br /> Horizon Depth Dominant color Redox Description Texture Structure Consistence Boundary Roots GPD/W <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> Effluent#1 =BOD >30:<220 mg/L and TSS>30<150 mg/L 'Effluent#2=BOD,:5 30 mg/L and TSS:5 30 mg/L <br /> CST Name(Please Print) Signaturen CST Number,James S. O r7r /s 5400'� J,73v <br /> Address Date Evaluation Conducted Telephone Number <br /> ,•7760 Hr r. 3S Gvp {�,. tvr sygg3 S- 3 -0 S 7/s- 866-�/iS <br />