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Wisconsin Department of Industry, SOIL AND SITE EVALUATION <br /> Labor and Human Relations Page of_ <br /> Division of Safety and Buildings in accordance with s. ILHR 83.09,Wis. Adm. Code <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County <br /> include,but not limited to: vertical and horizontal reference point(BM),direction and URdg <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <br /> bZo Z25 D3 9Do <br /> APPLICANT INFORMATION- Please print all information. Reviewed by ��y/ Date <br /> Personal information you provide may be usedfor secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner 1 Property Location <br /> W <br /> �Nn/lS USS 1.�JQ Govt.Lot 1/4 1/4,S 32 T I O ,N,R I E(or& <br /> Property Owner's Mailing Address Lot# I Block# Subd.Name or CSM# <br /> STT D. Gs I 13 JEEfRIEs E51Wre_S <br /> city Stat/e Zip Code Phone Number <br /> LC.S W j SyO� )5 ) ZS- 6802 ❑ City El Village Town Nearest Road <br /> !✓ RFA <br /> 7 `I 19Kt-l4 AID SEFFR)ES <br /> ❑ New Construction Use: AfResidentiall/Number of bedrooms y Addition to existing building <br /> Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow 300 gpd Recommended design loading rate .7 bed,gpd/f12__.2—trench,gpd/112 <br /> Absorption area required 4Z9 _bed,ft2375 trench,ft2 Maximum design loading rate •-7 bed,gpd/ft2 •% trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) ft(as referred to site plan benchmark) <br /> Additional design/siteconsiderations n <br /> Parent material QLAGIAL DRfPr Flood plain elevation,if applicable N ft <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system Cgs ❑ U MS ❑ U NS ❑ U I M S ❑ U RT S ❑ U ❑S XU <br /> SOIL DESCRIPTION REPORT <br /> Boris # Horizon Depth Dominant Color Mottles Structure 2 <br /> Boring Texture Consistence Boundary Roots GPD/ft <br /> in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed , Trench <br /> 0.5 7-S Raz <br /> 2 5.4f r•s R q/4 <br /> Ge and 44 7.sgp sly MS 7 .� <br /> IS-0 ft. <br /> Depth to <br /> limiting <br /> fayy r <br /> 7 fo in. <br /> Remarks: gArip Au4rk BoRnJG <br /> Boring # <br /> 7_51P a z 5 1 <br /> 7•5 U 4 N5 .1 S <br /> 3 iW 7-5YA s nes .-1 s <br /> Ground <br /> elev. <br /> CV—.0 ft. <br /> Depth to <br /> limiting <br /> factor <br /> 7-7,7-in. Remarks: fti'AAQ AU4151Z P'Ribl <br /> CST Name (Please Print) Signature Telephone No. <br /> Addre s Date CST Number <br /> 2'77to0 f{w 35 L.k smR 1,1/1 . 5�f8y3 15- 7 34 <br /> 0 <br />