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,nsin Department of Industry, SOIL AND SITE EVALUATION <br /> ar and Human Relations Page of <br /> ,Ivision 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 uRAJv 51r <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <br /> 02D �7,ZS 02-�dCi <br /> APPLICANT INFORMATION - Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Pdvacy Law,s.15.04(1)(m)). <br /> Property Owner Property Location <br /> �Ra+l� �R Govt.Lot 1/4 1/4,S37_ TA N,R �Fj E(or)© <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> 2-7 4-(p I O t4CO Lf✓ 5T. I C Z SEFFIZIE5 657z;95: <br /> City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road <br /> blEssr�R WI Sg893 t ) OAKLA10 1UlJco[_N s`r <br /> New Construction Use: Residential/Number of bedrooms Z Addition to existing building <br /> ❑ Replacement N Public or commercial-Describe: <br /> Code derived daily flow 340. gpd Recommended design loading rate •7 ' bed,gpd/ft2 •a trench,gpd/112 <br /> Absorption area required bed,ft2 trerh�,, 2 q 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/site considerations LJF7" Rawe,& 'FDr, AZT W /f <br /> Parent material 4WIAL VglI r Flood plain elevation,if applicable Nle ft <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system 1Z S ❑ u M S ❑ U 1A S ❑ U Ms ❑ U JAS ❑ U ❑ S 7�2 U <br /> SOIL DESCRIPTION REPORT <br /> Boring # Horizon Depth Dominant Color MottlesTexture Consistence Boundary Roots Structure GPD/ft2 <br /> in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed Trench <br /> O-S 7-5 R M1 f3 <br /> 2 5- 7•S a 4 NS bM 5 M1 �s e o '1 S <br /> Ground 7 4. f --— M5 <br /> Depth to <br /> limiting <br /> factor <br /> Remarks: <br /> Boring # <br /> �L 2 - ?• >z4 �— s .S <br /> r. 3 <br /> Ground <br /> elev. <br /> Depth to <br /> limiting <br /> factor <br /> ?�in. Remarks: A*k lfivgY �. <br /> CST Name (Please Print) Signature Telephone No- <br /> CST <br /> c )w o n/s 7/S-S66- -4157 <br /> AddressDate CST Number <br /> 27760 /4wY3s yJFBs7 >z tiJ1. 3�f893 6 _Z�. q� ro 0 <br />