Laserfiche WebLink
Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page_of _ <br /> Divislon of Safety and Buildings <br /> Bureau of Integrated services in accordance with s. ILHR 83.09,Wis.Adm.Code <br /> Attach complete site plan on paper not less tiler 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 ,,/`/iJ , / f <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <br /> o 'P <br /> APPLICANT INFORMATION- Please print all information. Reviewed by Date <br /> Pemonal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner / Property Location e_ <br /> GovL Lot fC 1/4 V&AI4,S T 3D ,N,R 7g E(00@ <br /> Property Owners Mailing Address ..L Lot# Block# Subd.Name or CSM# <br /> !/ ;2,=) e ✓' a s/ own/ �� �— <br /> Road <br /> City State Zip Code Phone Number E] City ❑ Ila ®-Town Nearest <br /> Gr14J 6/u w ss�BYo ( ) G✓vo�/ / ��e <br /> El Now Construction Use: C6tesidential/Number of bedrooms Addition to existing building <br /> Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow _17�O gpd Recommended design loading rate s-5bed,gpdO--.e. trench,gP� <br /> Absorption area required17 _bad,ft2 7S 0/trench,ft2 Maximum design loading rate �sbed,gpdtfF_e— rerdL 9P <br /> Recommended Infiltration surface elevation(s) 9 It(as referred to site plan benchmark) <br /> Additional design/site considerations <br /> Parent material Z,-E A'4-f Flood plain elevation,if applicable <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in FII Hiding Tank <br /> U = Unsuitable for system S ❑ U S ❑ U S ❑ U S ❑ U S ❑ U ❑S U <br /> SOIL DESCRIPTION REPORT <br /> Boring&3# Horizon Depth Dominant Color Mottles Texture Structure HConoistencedary Roots GPD/it2 <br /> in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed Trench <br /> 0-6 ,s yi? 3/ -- S �s�k5' f co , 7 ? <br /> Ground <br /> elev. <br /> Depth to <br /> limiting <br /> factor <br /> Remarks: <br /> Boring# 8 <br /> / p-4 7,Sy/f%a -- /S - � cs o , - <br /> a -,;� 5- /P 6 <br /> ,SSS/ Cam/ � fS AJs /�✓fi � — .5 .� <br /> Ground <br /> l <br /> ft. <br /> Depth to <br /> limiting <br /> factor <br /> in. Remarks: <br /> CST Name (Please Print) <br /> Signature Telephone No. <br /> Date q CST Number <br /> Address© X �/ S//'e� �3 <br />