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Wisconsin Department of Commerce SOIL AND SITE EVALUATION <br /> Division of Safety and Buildings Page_t of 3 <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 rte <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <br /> its 03 Oeo <br /> APPLICANT INFORMATION- Please print all information. Reviewed by Date <br /> Personal infonnatiooyou provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). ✓f a y O <br /> Property Owner Property Location <br /> AL-7-0At K/g4DON Govt.Lot 9—;V 1/4$JE 1/4,S I+ T 3cf ,N,R I•I- 9*"W <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> City State Tp Code Phone Number <br /> ❑ City ❑ Village ® Town Nearest Road <br /> o.Jooal.� a1; I,SVD/3 ( 7,,-<A,5 yfyos� wsx '�ouc l Atter <br /> ® New Construction Use: ®Residential/Number of bedrooms Addition to existing building <br /> ❑ Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow 00 gpd Recommended design loading rate t bed,gpd/ft2 •1 trench,gpd/f12 <br /> Absorption area required 2.9 bad,ft2 375 trench,It Maximum design loading rate T bed,gpd/ft2 •8 trench,gpolt2 <br /> Recommended infiltration surface elevation(s) q44 31 <br /> tT 93.3 ft(as referred to site plan benchmark) <br /> Additional design/site considerationsA brn jer/: to0•o'/yjgr� (o" Qe�pt}x Tr«1 3yo �.00F <br /> Parent materialKJ-Q�Ac:M. ct2i T{ Flood plain elevation,if applicable ft <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system XS ❑ u ; s ❑ u ,® S ❑ u I ®s ❑ u ❑s ® U ❑S ® U <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Texture Gr. Roots Structure Consistence Boundary GPD/ft2 <br /> in. Munsell Qu.Sz.Cont.Color p Gr.Sz.Sh. o Bed ,Trench <br /> 1 I 3" -7.5YPV2- a X.O/ In.. M11r�i e4) 3✓T . '7 .8 <br /> Z $-Ib I and ,,,JLr ed 3��r^ 7 <br /> Ground 1 ? Z. R`il .vl v►.c Q --- <br /> elev. 3 <br /> Depth to <br /> limiting <br /> factor <br /> !2W—in. <br /> Remarks: <br /> Boring# <br /> Z 2- -aD R`I .-7 <br /> it 1-7 <br /> Ground <br /> 1.0 ft. <br /> Depth to ti q <br /> 3 0 <br /> limiting Ativ <br /> fa r <br /> in. Remarks:'._ <br /> CST Name (Please Print) -JY1 M IN Signature Telephone No. <br /> SEPTIC & EXCAVATION <br /> Address SPOon9r• 154801 ate CST Number <br /> 15 635-7482 q 7 <br />