Laserfiche WebLink
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code — <br /> County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must all"n el-r� <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. O/ —3 y 1.�� Q1,$D V <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 Property Location <br /> IF164A ra/ P FU&4h e>/e r Govt.Lot g w 1/4 N61/a S !S T 3 9 N R 17 E(or) <br /> Property Owner's Mailing Address Lot# Block# I Subd. Name or CSW <br /> I'M G/rn A lle <br /> City State Zip Code Phone Number ❑City ❑Village (NTown Nearest Road <br /> Q�/eitI L"-- s3s/1 ( 608)36ti - I Lf,ofk.L 1Fd. <br /> ❑ New Construction Use:ER Residential/Number of bedrooms Code derived design flow rate GPD <br /> ('Replacement ❑ Public or commercial-Describe: <br /> Parent material Flood Plain elevation if applicable w�i� ft. <br /> General comments s f, e/�✓• <br /> and recommendations: �O ��3 ,Z5 -(--o94.50) 4� <br /> I El Boring <br /> Boring# <br /> pit Ground surface elev. ft. Depth to limiting factor 7 Z in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/tf <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> I O-JI 7.-5Yfe3/2 IM64 MZ 65 /h'J 6 <br /> h^q6 05 Irl 4 <br /> 6- 71, 7 1-6 <br /> 77— Boring# [] Boring / <br /> ® pit Ground surface elev. 96. 0 ft. Depth to limiting factor 7711 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDNf <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> I <br /> o-j 1, Z -- Z 5 /mr , k. �l c 5 r . •7 /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 /> CST N (Please �qt) ,Sign'ature CST Number <br /> K/C � / <br /> Address Date Evaluation Conducted Telephone Number <br /> 27764 l,-Jf. .51f® -O /f 6 /57 <br />