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Wis.Dept.of Safety and Professional Services SOIL EVALUATION REPORT page of <br /> Division of Safer and Buildinns <br /> in accordance with SPS 385,Wis. Adm, Code <br /> County HURNFTT <br /> Attach complete site plan on paper not less than 8 112 x 11 inches in size.Plan must <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. roZ - O-/ -/ - G - -"ll"yo <br /> Please print all information. Reviewed by Date <br /> Personal mmrmaoon you provide maybe used fore¢wndan purposes(PrivacyLaw,s.15,U(1)fmUell /fir W77/n) 3: <br /> Property Owner -/ Property Location ❑ <br /> In <br /> G e r //•o Go Lot Sri 11d S 114 5 T y� N R yE(or)W. <br /> Propoo Owners ailing Address Lot Block# Se4d-Niiane or CSW <br /> e� l � uznJ. 3 - v/9 a � � <br /> Giry // Slate Zip Cotle Phone Number I LjCjy LjVillage own Nearest Road <br /> Lr Sri /n,>) �5yz� t l3)�S'6-`f Sca 6razie /Poi <br /> New Construction Use y Residential/Number of bedrooms 2— Code derived design flow,rate_ p r9 GPD <br /> ❑Replacement L�-JT Public or commercial-Describe!!: <br /> Parent matenal a�A-G�R � q/rr y'[- Flood Plain elevation if applicable ft. <br /> General comments <br /> and recommendations: <br /> csr-/v-/3 <br /> Boring <br /> Spring# �—� <br /> 1 ® pit Ground surface elev. 7F ft. Depth to limiting lactor, in. <br /> Soil ica4on Rate <br /> Horizon Depth Dominant Color RMox Description Texture Structure onsistence 3oundery Roots GPDIft a <br /> in, Munsell Ou.Sz. Cont.Color Gr.Sz.Sh. Jjjj R#1 ff#2 <br /> a d 7, ? /S ,E A dK- c s <br /> ,2 '1-5-0 7-�3.Py6 /><S ns6.E dfi 5 fro ,S <br /> '2 <br /> Boring# ® Boring p c <br /> ] pit Ground surface elev. / fl. Depth to limiting factor 7S� in. <br /> Soil Application Rate <br /> Horizon -Depth Dominant Color Rod..Description Texture Structure onsistence oundary Roots GPDtt ' <br /> f in. � Munsell V Qu.Sz. Cont.Color Gr.Sz.Sh. 01 ff#2 <br /> /5 <br /> Zli 1t, <br /> 'Effluent#1 =BOD >305220mgILaMTSS>30 <IMan L 'Effluent#2=BOD <30 mgf-and TSS <30 mi <br /> CST Name(Please Print) Signature CST Number <br /> WADE RUPSI IOLM -,/— 227691 <br /> Address . Dmill Evaluation Conducted Telephone Number <br /> Qa>S/y s.re ..J wT <br />