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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 84...,.erii <br /> Attach complete site plan on paper not less than 8 1/2 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. dad-- S3 35- o 41900 <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 <br /> p � Property Location <br /> Mari r ittier Govt.Lot ci. 1/4 1/4 S 3S I {a/ N R /6,E(or)g <br /> Property Owner's Mailing Address Lot# Block# Subd. Name or CSM# <br /> /01 FctI1er St• it/ <br /> City State Zip Code Phone Number ❑City D Village 1}Town Nearest Road <br /> SL,aleape )/1N J 6-s374I (?rd. ) A33- V763 Sa..rss IV <br /> )Cvrt.r6tirry L1c <br /> ❑ New Construction Use:at Residential/Number of bedrooms 3 Code derived design flow rate `-IS-o GPD <br /> Z Replacement ❑ Public or commercial-Describe: <br /> Parent material lr Ia c/c./ !_7r,•Ft- Flood Plain elevation if applicable NW/57 ft. <br /> General comments 93. O �o 9'r, toi <br /> and recommendations: Sys. ‘e /evT <br /> / Boring# <br /> Boring <br /> © pit Ground surface elev. 96.0 ft. Depth to limiting factor , 70( in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/If <br /> in. Munsell au.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 'Eff#2 <br /> / o-3 75-n?,/,, — / - I.., s 6 k /,,., / cj 3,vz . 7 /. 6 <br /> d, ,3- y8 7.SYi? vi, _ s p ... l 6 S 3e0 <br /> 7 /. 6 <br /> Sxe- S / S51? /y — s a w, t 6 S . 7 I. 6 <br /> z-1 S'9. 7.1. 7.SS-/?•r/y _ S o .4., / — — <br /> Boring# 0 Boringj. . <br /> ® pit Ground surface elev. 9S. 6 ft. Depth to limiting factor > 7� in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 'Eff#2 <br /> / O-3 7:S77? J/ti — is /.s,s6k rY, / r S 5•-, . '7 / <br /> so 75ri? `/y — s <br /> 3 SO- 7., 7 S7? s.4 S o .., l — . 7 /. <br /> *Effluent#1 =BODS>30<220 mg/L and TSS>30< 150 mg/L 'Effluent#2=BODS<30 mg./and TSS<30 mg/L <br /> CST Name (Please Print) Signature�1 CST Number <br /> 1-4,n Alt fr.,i t/S -S0cr,vvix:4 01.7 3 Qv'. <br /> Addre Date Evaluation Conducted Telephone Number - <br /> .z 770'0 ,Vw.y ems- k/el,s1<vr 1A-/T"s4 93 7- /SOS- 77s- SY - 4/6-7 <br />