Laserfiche WebLink
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of�, <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code �7 <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must County (7'•r n t PE' <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and parcel I D Part e <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 03 d $.33 .SO 7000 <br /> Please print all information. Reviewed by� Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,S.15.04(1)(m)). I <br /> Property Owner Property Location V <br /> 3/ /l /uYN GOvL Lot 5W 1/45 1/4 S -'jST 4// N R /k E(or)© <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> ` qSS )e,. es /1ve g <br /> City State Zlp Code Phone Number ❑City ❑Village ka Town Nearest Road <br /> �'f, 10A. 1 &7N sS/O�1 ( 6S/) 31Y_ 3738 SS /2's <br /> ❑ New Construction Use:❑ Residential/Number of bedrooms <br /> Code derived design flow rate GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material Flood Plain elevation if applicable AIZI-ly ft, <br /> General comments ��7 <br /> and recommendations: f'•j" r V V ad; r ^ f• <br /> a d 95 - r fW <br /> 7 Boring# ® Boring <br /> ❑ Pit Ground surface elev. 9S- ft. Depth to limiting factor__',>gol y in. <br /> Sail icabon Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Ou.Sz. Cont.Color Gr.Sz Sh. •Eff#1 •Eff#2 <br /> / 0 - h 7•SYi23� _ /S <br /> 3 9 — 15 7 /•6 <br /> s <br /> ,7 <br /> ❑ Boring# ❑ Boring <br /> ❑ Pit Ground surface elev. R Depth to limiting factor in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture SWcture Consistence Boundary Roots GPDAF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 I •Eff#2 <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30 c 150 mg/L •Effluent#2=BOD <30 mg/L and TSS 130 nrA <br /> CST Name(Please Print) Signature CST Number <br /> James SC�cnyelS <br /> Address 7alldo <br /> Date Evaluation Conducted Telephone Number <br /> 7760 54 3s G(/e6s w2 S4as3 7-d °!- IJ lis- 456- v/sem <br />