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Wisconsin Deperbrnent Of Camnerce SOIL EVALUATION REPORT Page <br /> Mvision of Safety and Buadings <br /> in accordance with Comm M Wis. Adm. Cade y <br /> Attach aorro to site plan on paper not bas than 8112 x 11 inches in size,Plan must _ ?y Y n C, !/ <br /> lncktds,but not felted to wertieah and horizontal reference point(BM),dyer" and <br /> percent slope.scab or dimensions.north snow.and location and distance to nearest road. Parcel I.D. M 3;–b <br /> Please pratt aN lidbMU l3fon. mowed by Y Date <br /> aasorol iiormI'm you provide maybe used tar secopropertyr�ry pupoees p3iraroy Law.s 1s oar(I)tm)1 / -� <br /> owner yytm)pww Location <br /> / G n Govt Lot ,S',e lm,5 W 114s 3 3 T . 9 N R / E( <br /> Property owne's Mailing Address Lot# Block# SudbdC".Now or C <br /> state zv code ❑0RtY ❑ ®Town Nearest Road <br /> one✓ <br /> ❑ New morn uswZA Residential/Number of bedrooms _ Coda dewed design Now rate S a <br /> GPD <br /> M RqAacummi ❑ Public or oabrrber>fat-Descraw <br /> Parent rnateial_ filQ,L ; ( nr,"{t Food plain dMVM n if applicable _ elft it <br /> General cooenernts <br /> and fecornmendationm <br /> DBoring <br /> # ® � Ground suface aim. 9 , a s fL DWlh to belting facwr� _inn <br /> swt Applicalim fbft <br /> Horum Oep1h Dominant ;GG be—= n Textus Structure Consistence Boundary Routs GPnW <br /> In. Liuned Qu.SL Cont Color Gr.Sz.Sh. 6Eft#1 'E1182 <br /> __ 3i s o 7.s l <br /> s `/ S / oL U f lYKr v <br /> 49!r, <br /> y'S <br /> dw.9 5• z & Deptln to irriing tactor in. <br /> 9ql b kmDmw*tien Texhbre Structure consistence Boundary Roots GFIEW <br /> R& CM*Color Gr.Sb:.ML `&i 'ew <br /> /S #nx .rlrF. s :L V f , 7 ./, <br /> „,s 6/s v <br /> C s o 17 ,Z <br /> 0 D <br /> 'r:fjjjawtq BOD a3gc22gmg&and MS g_< wmplt. Btiuot#Z=BODS<30mgLand TSS<30mg& <br /> CST Nemo(%sm Pdm) Signature CST Number <br /> Telephone Number <br /> Al 9 k. />'� s° - 3 715>y4'gf-.Z c� <br />