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2022/05/19 - SANITARY - SAN - New HT - SAN-22-275
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2022/05/19 - SANITARY - SAN - New HT - SAN-22-275
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Last modified
1/5/2023 3:22:18 PM
Creation date
1/5/2023 3:19:38 PM
Metadata
Fields
Template:
Property Files v2
Document Date
5/19/2022
Document Type 1
SANITARY
Document Type 2
SAN
Document Type 3
New HT
County Permit Number
SAN-22-275
State Permit Number
640613
Tax ID
6030
Pin Number
07-012-2-40-15-35-5 05-008-018000
Legacy Pin
012423504300
Municipality
TOWN OF JACKSON
Owner Name
JAY WILLIAM HARMS
Property Address
4140 MALLARD LAKE RD
City
WEBSTER
State
WI
Zip
54893
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A:,(5),.1EIN <br /> fFrsonalServices gsio cam'✓ai_ r Page of <br /> D) <br /> Cab-zc g r SOIL EVALUATION REPORT <br /> A(Jb i b 2021 j In accordance with SPS 385,Wis. Adm. Code County <br /> Attac`''�o fete site plan on paper not Ie n 8 1/2 x 11 inches in size.Plan must include, ��r� N <br /> but rut limit d to:vertical and horizontal referent e point(BM),direction and percent slope, Parcel I.D. <br /> scalE or dimensioraLumitt Cou atynd location a Id distance to nearest road. 07-pa a-y0-1r-35- 0S'-(3b5-Of$O00 <br /> Land Services Demurs al information. 0,7 zew.• by oDat <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1 1(mv. <br /> Property Owner Property Location El <br /> Jay Ali,G`rin.S Govt.Lot Q '/, % S 3 T y0 N R /s' E (or) W <br /> Property Owner's Mailing Address Lot# �\ Block# Subd.Name or CSM# <br /> /3id IY) wrshall i1 v 3 Pie/ <br /> City State Zip Code Phone Number 0 City 0 Village [X]Town Nearest Road 4//1404 <br /> s-1- bawl Ira 15-.f 07/ L( ) 1 I .)Aci430,, 1 M6/1 and 4/4 !2 <br /> ® New Construction Use:®Residential/Numberof bedrooms .3 Code derived design flow rate `1r0GPD <br /> 0 Replacement / 0 Public or commercial-Describe: <br /> Parent material Cr/ .c- G•1 0►^ (4 Flood Plan elevation if applicable N/A ft. <br /> General comments and recommendations: 3'ys. &Itv op. 0 <br /> l Boring# ❑Boring 7 <br /> El Pit Ground surface elev. '-' ft. Depth to limiting factor 7 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description , Texture Structure Consistence Boundary Roots GPD/Ft2 <br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. <br /> / el-'-1 j7.51f /). — *Eff#1 *Eff#2 <br /> /5 hosb ie.. . _ .r., I CS 3h, , '7 /.6 <br /> q- 33 -7-5'113'VI? — /5 a1#41 s b IL pv i l G 3 3G© , -7 /, 6 <br /> 3 )3- 7.5`1 r2 1+4 / S d/05 ,/‘ u--.. i 1m , -7 (, e <br /> • <br /> 1 Boring# 0 Boring �� ' 7y <br /> ©Pit Ground surface elev. ft. Depth to limiting factor 7 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 <br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. <br /> *Eff#1 *Eff#2 <br /> / 0-y 7,s'`.t►Z 74 -- /5 I►n s b k /-i I G s _ 310 , - /, 6 <br /> 4- 35 -2.s- 7ir I'A 15 _Arr56 /L rvi i £ 5 Sec, . —7 / 6 <br /> 3 35- 7zi 7,5(1/2 `'/G_ /5 <br /> *Effluent#1 =BOD,>30 5 220 mg/L and TSS>30 s 150 mg/L *Effluent#2=BOD,>30 s 220 mg/L and TSS>30 5 150 mg/L <br /> SST Name(Please Print) Signat �J CST Number <br /> ...)4.WIti 5 S DAM /q- 1 s 5 7� ^j7 0)73 r 1,,A 0 <br /> address 77 0 Nwy 35- Date Eion <br /> ConductedtTelephone Number <br /> Ltd i s� WT. 5 �j 3 i f- i f 7/S- - y/S7 <br /> SBD-8330(R04/15) <br />
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