Laserfiche WebLink
Wis.Dept.of Safety and Professional Services SOIL EVALUATION REPORT Page of <br /> Division of Safety and Buildings <br /> in accordance with SPS 385,Wis. Adm. Code County BURNETT <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. O <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. <br /> Please print all information. vi " by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). l <br /> Property Owner t / 7 Property Location <br /> C,A#rl e_5 rlel A) / / y �r4s Govt.Lot ;" 1/4 1/4 S rT�/ N R E(or)W <br /> Property Owner's Mailing Address Lot Block# Subd4lame or CSM# <br /> 1 / S-� i /s coo �� Loop — l3/ <br /> City State Zip Code Phone Number ity Village own Nearest Road 3 <br /> 7'l��d e5 3 ;Z I (a8/)3oy'7°- c 1-:5-5 LAC led <br /> New Construction UseEl Residential/Number of bedrooms�_ Code derived design flow rate GPD <br /> Replacement Public orp°m rclal- sc ibe: <br /> Parent material CS A-G/!�I 01 r Flood Plain elevation if applicable I� ft. <br /> General comments <br /> and recommendations: <br /> Q Boring# <br /> Boring <br /> Pit Ground surface elev. C�ft. Depth to limiting factor :;�'72 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 ff#2 <br /> ® /S A <br /> ,� �' y 4 <br /> .,4' <br /> Boring# ( Boring / <br /> Y Pit Ground surface elev. ft. Depth to limiting factor��in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 ff#2 <br /> as7,5V 51 — s 1 <br /> *Effluent#1=BOD >30<220 mg/L and TSS>30 <150 mg/L *Effluent#2=BOD 5<30 mg/L and TSS <30 mg/L <br /> CST Name(Please Print) $igna CST Number <br /> WADE RUFSHOLM 227691 <br /> Address Date Evaluation Conducted Telephone Number <br /> PO BOX 514,SIREN,WI 54872 J — 7 l (715)349-7286 <br /> SBD-8330(Rl1/11) <br />