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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 Comm 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 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <br /> D2-F- oZ0eo- 000 <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 /> Property Owner LOA,a*tZ VeATS -}a: Property Location <br /> _Dt<,te- t�tLAer Ggvt rot $ 1/4 1/4,S Zq T 41) ,N,R 14+ E(or�i <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> CityState Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road <br /> " ULYY) I Mn 1 560-73 1 ( 5o7)35 _ obe�rS <br /> 0 New Construction Use: OResidential/Number of bedrooms _ Addition to existing building <br /> ❑ Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow 6L[j2 gpd Recommmendpedd design loading rate. bed,gpd/f12�_trench,gpd/ft2 <br /> Absorption area required�.�bed,ft? -.��og trench,i nch,ft {�C M !rfiurF design loading rate . 7 bed,gpdttt2 • i� trench,gpd/ft2 <br /> `f <br /> Recommended infiltration surface elevation(s) 94, Ate$� /ft(as referred to site plan benchmark) <br /> Additional design/site considerations A_ 7�' E/C1/�/Oo.o�<�fAi�", /6"QqK 7�p",¢$d✓O�03cu,G�� �'�/fo / <br /> Parent material t'� Flood plain elevation,if applicable to ft <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system �S El El U ZS El EliJ S U ❑S z U ❑S Z U <br /> ),:s0rarKLmf SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Structure Q PD/fl2 <br /> in. <br /> Munsell Qu.Sz.Cont.Color Texture Gr.Sz.Sh. Consistence Boundary Roots <br /> y, Bed ,Trench <br /> +}" 7.5YR3fZ ono � M rnJ c-v t=T 7Co 2- 4-3o -7-SYP-L114 ZIA 0-n pe— )41 rK-MG j VF r aa) aF�.D^ <br /> 8 <br /> Ground -Z AIL&-A e 7 <br /> ev.q4aft. 47.5Y P-414, <br /> e 7 <br /> Depth to <br /> limiting <br /> factor <br /> 11(o in. <br /> ��I Remarks: �t 30 3o-SV <br /> Boring# V <br /> /� <br /> 1 '{'' ?. ft3/z e>, rns Cd/ 3✓t-3 -7. . <br /> Z 2 4• 7. vQv ino+a�? cob ( m ..rJ a ; -7 <br /> Ground 5 <br /> q1j, <br /> 00 <br /> lev 7 d <br /> n. ' p <br /> Depth to <br /> limiting <br /> factor 91.0' <br /> >2Lin. Remarks: <br /> CST Name (Please Print) Signatu �(a Telephone No.' <br /> ryl21,t f.`T r(IS -035=7' 32 <br /> Address Date CST Number <br /> 22_6 Co 1�►n� �rnX t Y, S4-8bi 8W957 S9 a?E;Wff71 <br />