Laserfiche WebLink
Allis.Dept.of S t gbfs3ssi�a 9�f ls ' <br /> y atd ,11 SOIL EVALUATION REPORT Page of <br /> Division of Saft a6d Buildings <br /> Burnett COui-tF accordan with SPS 385,Wis. Adm. Code <br /> County BURNE I-I <br /> Attach compl to si �rrRi apr=r'rifif' <br /> x 11 inches in size.Plan must <br /> include,but nit Imi a o:vertical and horizontal reference point(BM),direction and Parcel I.D.0 -• � <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Sr O 8'p OD o 8'90ot� O D OGG <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)). <br /> Property Qwngr �N c.e r �7 Property LocationI in q. M��`//j/�1 Govt.Lot 1/4 1/4 Sl TyQ S N R� E(or)W® <br /> Property Owner's Mailin Address 1- i Block# Subd.Name or CSM# <br /> C o ; L-A4,01e .2�" 11"D �,/ M V,, 14 <br /> C State Zip Code Phone Number ity Village own Nearest Road <br /> 9/�WsonJ rwJ' 15110110 1 (6 A ) �67-` A0 ifeolw'•a rl <br /> New Construction Useo Residential/Number of bedrooms ,3 Code derived design flow rate GPD <br /> F1 Replacement Public or co m erc aI-Describe: --` <br /> Parent material G/rf L, r4 1 O�/'/�'y' Flood Plain elevation if applicable //2A ft, <br /> General comments <br /> and recommendations: <br /> I <br /> i <br /> i <br /> D80 <br /> Boring# E] Boring <br /> i ! r pit Ground surface elev.7_ft. Depth to limiting factor 7:�_in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 ff#2 <br /> 7, 3/ — /S v,Fi- G,s /. <br /> 1 <br /> i <br /> E <br /> i <br /> ^� ®a I Boring# Boring <br /> Gp7 <br /> 4' I Pit Ground surface elev. //'Q ft. Depth to limiting factor /7 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure onsistence boundary Roots GPD/ft 2 <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 ff#2 <br /> 7,>'y, <br /> ' 7 1, 6 <br /> 'Effluent#1=BOD >30<220 mg/L and TSS>30 <150 mg/L 'Effluent#2=BOD <30 mg/L and TSS <30 mg/L <br /> ECST Name(Please Print) Signature CST Number <br /> WADE RUFSHOLM ac� 227691 <br /> Address 4D?a!tteEvaluation Conducted Telephone Number <br /> PO BOX 514,SIREN,WI 54872 (715)349-7286 <br /> SBD-8330(R11/11) <br />