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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> County <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must ()(iv e}t <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. 0).D 6-I 3;) 7 -Gj, ` 7G6' <br /> 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)). I <br /> Property Owner Q Property Location / <br /> �"0�4/� Q v i� Govt.Lot -,_ 1/4 1/4 S Z / T LjQ N R /6 E(or)l(1N) <br /> Prope ner's Mailing Address Lot# Block# Subd. Name or CSM# �S <br /> o� �o� S�Z <br /> City State Zip Code Phone Number ❑City ❑Village OTown Nearest dad <br /> elnil.e/- i U 15 r3 I (7/ ) 31/9 -8 '3 ogrklgtic/ 1IoivL V!a-eeA <br /> III New Construction Use:® Residential/Number of bedrooms 3 Code derived design flow rate '11 o GPD <br /> ❑Replacement 0 Public or commercial-Describe:/ <br /> Parent material 6/Lic/ � cr/i Flood Plain elevation if applicable /U✓¢ ft. <br /> General comments <br /> and recommendations: 5 /OA �y/ �2 s /d n 91J 55' ( Rctn e 4.25 to 96,•5 )Gz� <br /> 1 ivi/l.97.0 CP4 '5e cr2, o 6-0 ct )) <br /> f Boring# <br /> ❑ Boring Ull <br /> Pit Ground surface elev. �l5_•' ft. Depth to limiting factor 7 7`I in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary I Roots GPD/ft2 <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 'Eff#2 <br /> I o-S 7 5--y122 -- 24 /`ham r771 C5 2n •-7 -1 2 , <br /> 2 5--37 7 SYgy/Y /1-75 O4y r772 65 /f . 7 l-2 <br /> 3 3774 73 y in 66,- m4 G> (oF . 7 / z <br /> • <br /> • <br /> Boring# E Boring <br /> 01 Pit Ground surface elev. �6..-.t2 ft. Depth to limiting factor 7 6 7/? <br /> in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots , GPD/ft <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 <br /> I 0-5 757 3/2 -- -- . C� /07 6k 417/ c5 Zn, . 7 (az- <br /> Z S 39 7 5ye,iir m� 1-'74 65 /F . 7 1.2 <br /> 3 ;975Y/LS/ rn5 "pi_ 6, lvF . 7 /Z <br /> • <br /> `Effluent#1 =BODS>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BODS<30 mg/L and TSS<30 mg/L <br /> CST Nape (Please Print) ignature CST Number <br /> KO 16/tA,d�r- T� (6,57/9 <br /> Address Date Evaluation Conducted Telephone Number <br /> �776d /Vwy 3c t,.)e,6s/er t,J.- 5-'‘,93 /l-/`!-a4/ (7/5)866- .9/57 <br />