Laserfiche WebLink
cs .24- IUL., ORIGINAL. <br /> Ws.Dept.of Safety and Professional Services SOIL EVALUATION REPORT Page of <br /> Division of Safety and Buildings <br /> in accordance with SPS 385,Wis. Adm. Code <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must County BURNETT <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. G 7 0,20 5/O /6 A0 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. '5'' $— po <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 Owner f Property Location <br /> k2, ii1 ,J Govt.Lot 1/4 1/4 S;Z0 T Q N R E(or®W <br /> Property Owner's Mailin Address Lot# Block# Subd.Name or CSNW <br /> Sa 39 M7--^ 3 v 2 4/ P aQ9 <br /> C'sty State Zip Code Phone Number ocity village own Nearest Road <br /> �i4N cZ8 3 <br /> D+' � c�i m� n7-�wnn K-7 ,vc1 L o.� ?,"Av e <br /> 'dew Construction UseOr Residential/Number of bedrooms� Code derived design flow rate 3d0 GPD <br /> Replacement 0 Public or com ercial-D`escribe: <br /> G �— <br /> Parent material GbR /A-1 71 j`t"r Flood Plain elevation if applicable /'04— ft. <br /> General comments <br /> and recommendations: /+r1 '5 1�!— <br /> Boring <br /> l <br /> l <br /> i <br /> TU.k.ID 331051 <br /> l Boring <br /> # <br /> Pit Ground surface elev. 2,E ft. Depth to limiting factor- in. <br /> Soil Application Rate <br /> Horizon I Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft z <br /> e <br /> in. Munseli Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 * ff#2 <br /> 'I �s s v,�r "71-"o l <br /> I <br /> Boring# tpit <br /> oring <br /> Ground surface elev. 7. ft. Depth to limiting factor 2-Z _in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Donsistence Boundary Roots GPD/ft 2 <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 ff#2 <br /> - 5]7 Bey s . 7 /•V <br /> Sys= `�. Bey - s . 7 is <br /> l <br /> F <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 /> CST Name(Please Print) Signature CST Number <br /> WADE RUFSHOLM G� 227691 <br /> Address Date Evaluation Conducted Telephone Number <br /> PO BOX 514,SIREN,WI 54872 (715)349-7286 <br /> L_ <br /> SBD-8330(Rl1/11) <br />