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Wisconsin Department Of Commerce SOIL EVALUATION REPORT <br /> Division of Safety and Buildings CommPage i of 3 <br /> in accordance with 85,Wis. Adm. Code DD <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must countyUµr A le/f <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and <br /> Percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D. <br /> Oj.0- 4/35'-o 900 <br /> Please Print all lnfOrnfaHOn. Reviewed by <br /> Personal information Date <br /> you Provide may De used for eewpose <br /> ndary purposes(Privacy Law,a.15.0/(1)(m)). ' D/ <br /> Property Owner <br /> Property Location �j <br /> Property✓a m CJ lar C (<lle3><rw,n GovL Lot rvr tl4 Sw <br /> Owner's Mailing Address 1/4 S <br /> 7 T 40 N R /b E(or)® <br /> A.ro G ax/n t..t Avc Lau Blom u sum.Name or Lsw <br /> City State ZIP Code Plena Number <br /> N. /ierev,eu� <br /> S S ❑City ❑Village OTom Nearest Road J JfrAt <br /> MN <br /> OAk/www(. f Ye//sa. {�rrer /S'� <br /> F <br /> w Construction Use:® Residential/Number of bedrooms�— Code derived design flow rate L oO <br /> placement ❑ Public or commercial-Describe: . GPDmatedalal commients Flood Plain elevation if applicable N//RS J. %✓ 8 recommendations: 1' r�.�/e� 'O.HD � `f0.33 6° 9�� <br /> /.We, <br /> MAN&O AS Vmromai SIs21Ea 383- <br /> Boring# ❑ Boring <br /> © Pit Ground surface elev. 9.�• s--n Depth to Gntiting factor > ry in. <br /> Horizon Depth Dominant Color Redox Description Soil icabon Rate <br /> D� Texture r-Sz. re Consistence Boundary Roots GPDM' <br /> in. Munsell flu.�. Cont Color <br /> Gr.Sz Sh. 'Eff#1 'EfM2 <br /> 30 7 S-Y!? V/F s <br /> /•'re 2 G <br /> .3 30. 40 7 s 11/? 14/1. S oS d <br /> 7 /. G <br /> PI ng# ❑ Boring <br /> ® Pit Ground surface elev. 93.O 1t <br /> Depth to limiting factor .> g! <br /> Horizon Depth Dominant Color Redox Description ,Texture StructureSoil ticafion Rate <br /> in. Munsell OU-SZ- Cont Color Consistence Boundary Roots GPD/IF <br /> Gr.Sz Sh. <br /> 0• �J 7•SYR -'/,4 'ER#1 'Etf#2 <br /> /S fiss� <br /> 3> 7.jr-4Ry/` <br /> 3 3,t- 1"4 7.S y/ Nf <br /> Effluent#1 =BOD >30<220 nxjt and TSS>30<150 <br /> CST Name(Phase Print) — 'Effluent#2=BOD <30 mglL and TSS<30 mgrL <br /> J•», Y s J Da„/2/f Signature <br /> f� CST Number <br /> Address `f'vw^"�< =I 73`1�?J <br /> 776 p <br /> Date Evaluation Condudad Telephone Number <br /> 3 t we6stc G,r y-yu,93 <br /> A-a7-cob <br />