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Wisconsin Department of Commerce SOIL EVALUATION REPORT <br /> Division of Safety and Buildings Page/of 3 <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 County <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 /> © //L7 o V 1AD <br /> Please print all information. Re ' Date <br /> Personal information You Provide may be used for secondary purposes(Privacy Law,s.15.01(1)(m)). <br /> tProplertyOwnerProperty Location <br /> GovL Lot f f� 1/4 1/4 S /9T Y.9 N R /y E(orlfij <br /> ailing AddressState Z,p Code Ph/n�fJ ss <br /> ❑ New Construction Use: sidential/Number of bedrooms <br /> --. _ Code derived design flow rate 30 CJ <br /> eplacement l/ ❑ Public or mmmerda -Dgscnbe: GPD <br /> Parent material �li4 . .a-� �t- <br /> � f �,cFlood plain elevation if applicable <br /> General comments <br /> and recommendations: o <br /> Boring# 0Boring <br /> I�1 <br /> t rs pit Ground surface slay. 7 O ft. Depth to limiting factor 4 in. <br /> HorizonSoil ication Rate <br /> Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff <br /> in. Munsell Qu.Sz. ConL Color Gr.Sz.Sh. <br /> G 6 7, Eff#1 Eft#2 <br /> fG d r -moo /.Z <br /> d 7. ,Cs/ <br /> 3 7, �� cs� s <br /> Fal <br /> s <br /> Bones# �0�( Boring <br /> Pit Ground surface elev. ft. Depth to limiting factor�_(n, <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Sal G M Rate <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. <br /> p3/ 'Efr#1 '6#2 <br /> 3 G? Fl <br /> Effluent#1 =BOD >30<220 mgrL and TSS>30<150 nxA •Effluent#2=BOD c 30 mglL and TSS<30 nglL <br /> CST Name Pei ) �� glonahr — _ <br /> UOZIo� CST Nurlber . <br /> Address <br /> Date Evaluation CorWucted Telephone Number <br /> ,Bo S/y ,s iii e,-✓ o✓�Sy�7.Z �?-0 3 �yy-7-�8'� <br />