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Wisconsin Department of Commerce SOIL EVALUATION REPORT page----L Of 3 <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 81/2 x 11 inches in size.Plan must County <br /> indude,but not limited to:vertical and horizontal reference point(BM),direction and Pam I.D. D2o 90 ODI 3e0 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. o7- 02o-2-4o-/ - -5 /5•200-O!3= <br /> Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.01(1)(m)). r07 <br /> Property Owner Property Location <br /> DAh S'ij-s G I Govt.Lot 1/4 1/4 S 3 T 40 N R 16 E(or <br /> Property Owner's Mailing Address Lot# I Block# I Subd.Names CSM;i <br /> /7 /O Tea I Gfr :3 63 S GA, 4p Vp <br /> city State Zp Code Phone Number ❑city ❑Village ®Town Nearest Road <br /> Fyce-410, I 1"A! I J•SM I (cJ-CA) 4719- 5"976 6/4/cto"d Na Aen LK /?GP. <br /> New Construction Use:® Residential/Number of bedrooms t4 Code derived design flow rate 6 GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material G/k a / ��r: f''r Flood Plain elevation if applicable AV 14 fL <br /> om <br /> comments <br /> and recommendations: e-1e-1,961/r, i Ppv- 9't.'XJ (W4V 6v 170) <br /> and re <br /> /awe✓' 93.20 (93.20 tizb 9Y•1P) <br /> ukor Gan�</VC-- swrip <br /> Boring# [_] Boring <br /> © pit Ground surface elev. `if 9 ft. Depth to limiting factor > 701 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Bounds Roots GPDAF <br /> in. Munsell Ou.Sz. Cont Color Gr.Sz.Sh. •Eff#1 I •Ef#2 <br /> / °- 4 7.Syl7 '/f- — /S /, s6le- I G 5 7^; . 71 /, <br /> 4 1P 7.s•yR 4'/1j — A& d^A614 f G 5 3c° 7 !. e- <br /> 3 <br /> 3 1Q- VC 7.syr? "// _ S '*Sa- ,,, I '5f $ a M . 7 /. 6 <br /> ti g- 71. .srR'7y <br /> ® Boring# ❑ Boring <br /> © Pit Ground surface elev. 96''t ft. Depth to limiting factor ? 7 v in. Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Bounder. Roots GPD/fF <br /> In. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •E1N#1 I •Eff#2 <br /> / I&- ,y 7sfR '%s-- — /S /.. r6ic l Gs s..r . 7 / 6 <br /> S'-3.\ 6/< rvr 1 G 3 3ca . 7 J <br /> 31-c/(o 7.sY�? <br /> 141(.-7X ..�y� .— s os G.- wi i — — . 7 / L <br /> •Effluent#1 =BOD >30<720 mgt.and TSS>30<150 nV1 •Effluent#2=BOD <30 mgand TSS<30 mglL <br /> CST Name(Please Print) Signature / CST Number <br /> Wil CS S. Oa n/•e/s SOq� �.� 73 J61 0 <br /> Address Date Evaluation Conducted Telephone Number <br /> 760 S Web-41ee • tVZ SciG43 y-�?- a7 s-86ro- cr.s7 <br />