Laserfiche WebLink
Wisconsin Depattrnent of Commerce SOIL EVALUATION REPORT pap I 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 8112 x 11 inches in size.Plan must <br /> County <br /> .✓G <br /> 72'- <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. p /'P/ /S O <br /> Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.00(1)(m)). 2v/0 <br /> Prof��a\rty Owner k L Property Location <br /> `r.J . A-/N 2- e ivT I e- q Govt Lot N E vaf�[J 1/4 S /7 T39 N R) 6 E(or <br /> Property Owner's Mailing Address n Lot# Blod(# Subd.Name or fSM# <br /> City State Zi Phone Number ❑City ❑Village down Nearest Road <br /> ❑ New Construction Use.oResidential/Number of bedrooms -2 Code derived design flow rate 3 oy GPD <br /> [Replacement ❑ Public or comm1erc al-Describe: <br /> Parent material ��.4 C' dr <br /> d ri -Pf Flood Plain elevation if applicable /t/74ft. <br /> General comments <br /> and recommendations: <br /> Boring# [] Boring Ground surface elev..1z�ft. Depth to IimiBng h(tor in. <br /> SSI Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description kTe)dure Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz. Cont.ColorGr.Sz.Sh. •Eft#1 'Eff#2 <br /> a - k y — 4� <br /> 7.5rey4 Cis ,es <br /> -1 #Boring Ea pig Ground surface elev. 77,3111. Depth to limiting factor C2 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDHF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 I •ER#2 <br /> o— in k r,dfs 7 6 <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30 1 150 mg/L •Effluent#2=BOD <30 mg/L and TSS 130 mg/L <br /> CST Name(PleasePrint) _ - Signature CST Number <br /> w14 � ler��s�a/� GJ -Z 765'/ <br /> Address Date Evaluation Conducted Telephone Number <br /> �o-rSiS/ S/��.✓ w s5's�7s 9-/� �--o �y9-7>8'6 <br />