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Wisconsin Department of Commerce SOIL EVALUATION RE;County <br /> RT ` G �� of <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code ? <br /> Attach complete site plan on paper not less than 8 1/2 x 11 Inches in size.Plan must C �� <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 /> Please print all Information. Reviewed bb Date ,/ <br /> Personal information you Provide may be used for secondary purposes(Privacy Law.S.15.04(1)(m)). f t�Q (J4 <br /> Pro Owner Property Location <br /> \ GovL Lot 1/4 1/4 S T fj N R s E(or)i� <br /> Property Ownersp*ilmg A rens��\C� Lot i Block bd.Name or-GSC�# <br /> 3 o\\y ! i � <br /> ity State ip Code Phone Number <br /> o ❑&'41-� Village FATown Nearer oad <br /> © New Constru Use: Residential/Number of bedrooms Code derived design flow rate <br /> [;KRe lacement GPD <br /> P n Pu or merdal-Describe: <br /> Parent material CJ• 1i\\7a Flood Plain elevation if applicable <br /> General comments ft. <br /> and recommendations: � �C�vtTlo>u5 ; vppc�c CEu. 93.BO>✓o 45. 4,1 4-, <br /> s. <br /> Boring#IZIBoring n / <br /> ® Pit Ground surface elev. �l�. (�/ft Depth to limiting factor�_In, <br /> icafion <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Sal�GPD/ftz Rate <br /> In. Munsell .Sz. Cont Color Gr.Sz.Sh. •Eff#1 •Eff#2 <br /> 7254-! S 0s <br /> S <br /> �f yy c <br /> ' <br /> ® Boring# ❑ Boeing // <br /> ® Pit Ground surface elev. r 3b R Depth to limiting factor 4O'} in. <br /> Shc Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz <br /> in. Munsell Qu.Sz. Cont,Color Gr.Sz Sh. •Eff#1 I `Eff#2 <br /> Set <br /> A- - <br /> s <br /> Effluent#1 =BODS>30<220 mg/L and TS >3n'T . <br /> •Effluent#2=BODs<30 mg/L and TSS<30 mg/L <br /> CST Please q CST Number <br /> C <br /> ress Date Evaluation Conducted Telephone Number <br /> 4;Rn-R1i0! n7/fxll <br />