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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 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 5(Ar yt!Ef <br /> peree!"Powe scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <br /> 07-4-31Zg - <br /> APPLICANT INFORMATION - Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy law,s.15.04(1)(m)). <br /> Pro arty Owner \ Property Location <br /> Q - Govt.Lot c6 1/4 SC— 1/4,S +je T 30, ,N,R 14 0(or)W <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> ?_1 n W . S4\ fir- ,0• tQO� <br /> City State Zip Code Phone Number ❑ Ci ❑ Village 2]g Town Nearest Road <br /> VY1n. 145 q ( 50-7 )94 5- a 47k I P g 14W <br /> K New Construction Use: N Residential/Number of bedrooms Addition to existing building <br /> ❑ Replacement ❑Public or commercial-Describe: c3 <br /> Code derived daily flow�gpd �/ Recommended design loading rate �7 bed,gpd/ft2 �o trench,gpd/ft2 <br /> Absorption area required bed,ft2 c5&3 trench,ft2 . Maximum design loading rate s7 bed,gpd/ft2 "6 trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) 7+ro ft(as referred to site plan benchmark) ��-- �) <br /> Additional design/site considerations Cc t/YEn/T/Gnl�4 L W fi/ i/e u L TReT02 /�OOs� �a rIZEAIC.14 /f✓. <br /> Parent material pMCA 4— be/fT Flood plain elevation,if applicable ft <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-GradeSystem in Fill Holding Tank <br /> U = Unsuitable for system S LiU 1:1S ® U ❑ S ® u ❑ S ® U ElS ® U El S ® u <br /> SOIL DESCRIPTION REPORT <br /> Boring # Texture Consistence Boundary Roots in. Munsell Qu.Sz.Cont.Color z S PD ft2 <br /> Horizon Depth Dominant Color Mottles Structure G Ilf6nch <br /> i <br /> 0-3 /o 'i'L "ONG <br /> 7+ `MVV ST4 r -s yv.,Grou1 G w rr> + <br /> elev-nd 3 S Ye " I 13- c-S <br /> 4rrel'_ft. _74i 2 <br /> Depth to <br /> a <br /> limiting Q <br /> factor <br /> Win. 1� h <br /> Remarks: /2d 0. cc e= ea fC- �;ne Sub anIt, <br /> for 61C <br /> Boring# <br /> _ 1 0-S tou_ Y2- NE 1S -� k :Ll <br /> 2 `b- 7 75 2 41q r 0-m- <br /> rn 1 1-V►� f7 �6 <br /> L:- <br /> 3 313 S 4( " S O-C-S <br /> Ground <br /> elev. <br /> Depth to <br /> limiting <br /> factor <br /> >R3in. Remarks: <br /> CST Name (Please Print) Si Telephone No. <br /> 2 -lis7:G, 234 <br /> Address /-s Date CST Number <br /> /�o - ,bio �'Ut)/1J 9 ', �_Vg30- f 16 11 9ei 9;� <br />