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Wisconsin Department of Commerce SOIL AND SITE EVALUATION <br /> Division of Safety and Buildings Page of <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 81/2 x 11 Inches in size. Plan must County <br /> include,but not limited to: vertical and horizontal reference point(BM),direction and I <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Pam I.D.# <br /> -3 3--e5-)w <br /> APPLICANT INFORMATION- Please print all information. Reviewed by Dat <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). v �"' <br /> Property Owner Property Ltion <br /> 'DO'rt Q.1 5� Govt.Lot �'qV3 1/4 5W 1/4,S 13 T '-fi ,N,R (a( IR"W <br /> Property Owner's Mailing Address Lot# BI k# I Subd.Name o�ryCS/M# <br /> D- O G � 5I ,) V a <br /> City State Zip Code Phone Number ❑ City ❑ village W Town Nearest Road <br /> 0 Vj� le l+Aur I MI 1 45 ( L4 6 ) 853- I uk5►K 164 L;N.5en �:20*01 <br /> ® New Construction Use: ®Residential/Number of bedrooms Z- Addition to existing building <br /> ❑Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow 300 gpd Recommended design loading rate -7bed,gpd/ft2 •—Strench,gpd F <br /> Absorption area required 4ZTf bed,n2 WS trench,n2 Maximum design loading rate ' 7 bed,gpd/ft2 • 8 trench,gpd/ft2 <br /> Recommended infi traflon surface elevation(s) 94-to 634.4,A%X 1 n(as referred to site plan benchmark) <br /> Additional design/site considerations r Lohj-t%-_, --wbre. <br /> Parent material 4 n ayvm- A al i Flood plain elevation,if applicable 4-- ft <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system IK S ❑ U ❑s 14 U fKS ❑ u 1 ®s ❑ u ❑s QKU ❑s a U <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2- <br /> in. Munsell Qu.Sz.Cont Color Gr.Sz.Sh. ( Bed ,Trench <br /> YR•a/z t 3J • -7 . <br /> 0 <br /> Z 3- -1.5n.414 <br /> Ground <br /> elev. <br /> 48•z ft. ' <br /> Depth to <br /> limiting <br /> factor <br /> fl , <br /> Remarks: <br /> Boring# (� <br /> Z ?SV(t4 �aJ it+x 3F <br /> Ground <br /> Depth to <br /> limiting <br /> 1 r <br /> 93 _& ink R � <br /> CST Name (Please Print) off Telephone No. <br /> SEPTIC & EXCAVATIW <br /> Address Spooner,WI54801 Date CST Number <br /> (715)635-7462 4 /to 96 f"3(o/of <br />