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--� <br /> Wepar_• I <br /> Safety and <br /> Buildings <br /> dings Commerce SOIL AND SITE EVALUATION <br /> Division of Safety and Buildings Page�_of�_ <br /> Bureau of Integrated services in accordance with s. ILHR 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 locatbn and distance to nearest road. pig)I.D. <br /> APPLICANT INFORMATION-Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,a 1s.04(1)(m)). <br /> Property Owner Property Location <br /> �4 vSSo.z Govt.Lot '/ 1/4 1/4,S /f T 440 ,N,R /.yG -fgdey W <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> 61 Lo Z ;Z 4 t`' 5T oRSi{' <br /> City State Zip Code Ph Number ❑ City ❑ Village ® Town Nearest Road <br /> t5kVVDr44.1 I rn, 55t7- ( `t2)'773 3?3U `J5ae 4 1.70.3-76 nb9m£ Qo <br /> ❑New Construction Use: EIResidential/Number of bedrooms Z- Addition to existing building <br /> ❑ R cementF-1Public or commercial-Describe: <br /> . ;-,o,. ' <br /> 0 F-t.,,...5 <br /> Code derived daily flow en4a-- gpd Recommended design loading rate • 7 bed,gpd/ft2 _I_trench,gpd/(tz <br /> Absorption area 1040 bed,ft2 trench,ft Maximum design loading rate . 7 bed,gpd4f---a_trench,gpd/ft2 <br /> ¢ere , <br /> Recommended infiltrati surface elevation(s)La is S•1-. °It.•o ft(as referred to site plan benchmark) <br /> Additional design/site considerations. A �8 100.0 CT'no ok (raAcs-1Ti <br /> �e cwnpaxg *K oL&I5 9F-Cowrie4- <br /> Parent material 01peolpe. ae;4 Flood plain elevation,if applicable �CA ft <br /> S - Suitable for system . Conventional . Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U r. Unsuitable for system 1ZS ❑ u ❑s o u ❑s o u ❑S ❑'u ❑S e u ❑S. d'u <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 <br /> In. Munsell Qu.SL Cont.Color Gr.SL Sh. Bed ,Tre;;h- <br /> all <br /> Or / �" 7• VOL'1/z a rns ✓�r ca 7 •8 <br /> 2 y-72 7, yR'114 <br /> Ground s,JAO72' <br /> Depth bD <br /> limiting <br /> factor <br /> 1V <br /> in. I � OX- / N St O O !n <br /> r <br /> l.5 Remarks: z- 11 Alc.#- C[W- 9G o' L. /S,aSo✓E si r,'rFyvc�d� <br /> Boring# <br /> Ground <br /> at". <br /> _ft. IF <br /> Depth to <br /> limiting ' <br /> factor <br /> --in. Remarks: <br /> CST Name (Please Print) M & K Sig re Telephone No. <br /> SEPTIC & EXCAVATION <br /> Address NGM County Una Rd. Dab CST Number <br /> Spooner,WI54801 ,to 2�5�87 <br />