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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code n <br /> U I�/r l � <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County 44 h <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. (}Z O / S O;Z /0 C) <br /> Please print all information. Reviewed Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). 3 UnnCT 6,$ <br /> Property Owner Property Location <br /> I C k Q 2 Q , Govt.Lot 1/4 1/4 S/ T y0 N R /6 E(or 1N <br /> Property Owner's Mailing Address Lot# Block# Subd.Name er6SM#' <br /> /-,/7;7-4 /tJ // o7Ncj 4 d / +rA V .r ,de'/ irl� e� <br /> City State Zip Code Phone Number ❑City ❑Village [Town Nearest Road <br /> 11w2 o JAA) I 5TO:77 1 (ds/ ) a609� ® /ft, C4 E 4/%w 'e,uer <br /> New Construction Use: -Residential/Number of bedrooms Code derived design flow rate y5`O GPD <br /> ❑Replacement ❑ Public or commercial-Describe: ^— <br /> Parent material G lig G i 4/ Flood Plain elevation if applicable w - ft. <br /> General comments <br /> and recommendations: 5y$JR" eL� 93.4 60 95. 4 <br /> Boring <br /> Boring# / / <br /> -Pit Ground surface elev. W11 6 ft. Depth to limiting factor J�l in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 <br /> -6 7-� ,P�i S �i �k MI " e-- 5 -;�4a 2 /1z <br /> Boring# ❑ Boring p/ <br /> [a-Pit Ground surface elev. /6-9 ft. Depth to limiting factor in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 <br /> o--5� 7,JM% / 177 1,//,- c s -00 , '7 /, Z <br /> /1 ,-s '1� 1 <br /> Effluent#1 =BODS>30<220 mg/L and TSS>30_<150 mg/L 'Effluent#2=BOD5<30 mg/L and TSS<30 mg/L <br /> CS�TName(Please P-nt) Signature CST Number- <br /> r� <br /> Address Date Evaluation Conducted Telephone Number <br /> SBD-8330(1107/00) <br />