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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 7 — 9 IL 5- <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. -r c7 <br /> Please print all information. we by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). 9 ` <br /> Property Owner I_J Property Location <br /> h e J—U�1 vl Govt.Lot 1/4 1/4 ,�� T N R E(o©LLX <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or65M11: <br /> 1134 34 cry r fe A- — c-/A-� L.Ake P ,)es <br /> City ``,, f State Zip Code /Phone Number [:]City ®Village own Nearest Road S' p I <br /> l8, Y� l A �J r�7 (7/J' )"7.j�1—��� �rE? /�I7/;//0 .)A—) �1C� <br /> 0 New Construction Use Residential/Number of bedrooms_� Code derived design flow rate p C7 GPD <br /> %Replacement Public or ce mer al-Describe: <br /> Parent material G ' /�/ Flood Plain v ft. <br /> General comments AUGC,I< /,5 74q <br /> and recommendations: G 2 7 2021 9-9 <br /> Surr <br /> Boring# 11 Boring Land Sery ces DepArtmcnt <br /> 10 pit Ground surface elev. 7, l 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. 01 ff#2 <br /> o 3V r�s �Ulc� �s n1"7 1,6 <br /> DBoring# Boring <br /> 1Z Pit Ground surface elev.7 ft. Depth to limiting factor in. 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 f1#2 <br /> /P5%fs <br /> "Effluent#1=BOD >30<220 mg/L and TSS>30 1150 mg/L "Effluent#2=BOD <30 mg/L and TSS <30 mg/L <br /> CST Name(Please Print) Signature CST Number <br /> WADE RUFSHOLM �t 227691 <br /> Address Date Evaluation Conducted Telephone Number <br /> PO BOX 514,SIREN,WI 54872 p (715)349-7286 <br /> SBD-8330(R11/I1) <br />