Laserfiche WebLink
Wisaoh6in Department of Commerce SOIL AND SITE EVALUATION J <br /> Division of Safety and Buildings Page of 3 <br /> Bureau of Integrated Services 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 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. <br /> APPLICANT INFORMATION- Please print all information. Reviewed by Dare <br /> Personal infomration you provide may be used for secordary purposes(Privacy Law,s.15.04(1)(m)). / 9 <br /> Property Owner Property Location (V I <br /> GovL Lot _Tr1/4 61/4,S /a T349 ,N,R E(or)® <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> 8a R Qf—'!t 7 NA- Z a / <br /> City State Tip Code Phone Number ❑ city ❑ Village Town Nearest Road <br /> L.a (7 )---3W- cz <br /> ❑ New Construction Use: residential/Number of bedrooms L Addition to existing building-A(Q= <br /> D4-Replacement ❑Public or commercial-Describe: Aa <br /> Code derived daily flow —gpd Recommended design loading rate 7bed,gpd/ft2 i�trench,gpd/ft2 <br /> Absorption area required 6V3 ad,ft2543✓trench,ft Maximum design loading rate--t-?—bed,gpd/flz—A4 trench,gpolft2 <br /> Recommended infiltration surface elevation(s) 93,o�--� ft(as referred to site plan benchmark) <br /> Additional design/site considerations 1 a�&54 z E�N <br /> Parentmaterial L(�&t A L 1721 Fn Flood plain elevation,if applicable <br /> S = Suitable for system Conventions] Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system VS El la's ❑ u I3s/ ❑ u I UPe❑ U ❑s OW ❑s <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Texture Structure <br /> Consistence Boundary Roots GPD/ft2 <br /> in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench <br /> xrg / 4;� OIL 65 2AI J: <br /> Groundt 1-- <br /> _ <br /> elev. <br /> Depth to <br /> limiting <br /> factor <br /> .;:115—in. <br /> Remarks: <br /> Boring# <br /> 7.j 3 nA LS FR G H7�?Ib Y y� L2y6 L — — <br /> Ground <br /> Agan. <br /> Depth to <br /> limiting <br /> factor <br /> 7 &--in. Remarks: <br /> CST Name (Please Print) Signa re Telephone No. <br /> nNU '-7Sa 15-x{68- 8 <br /> Address Date CST Number <br /> 61 <br />