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Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page_of_ <br /> Labor and Human Relations <br /> Division of Safety&Buildings in accord with ILHR 83.05,Wis.Adm. Code <br /> rPARCEL <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must include,but ` � e <br /> not limited to vertical and horizontal reference point(BM),direction and%of slope,scale or I.D.# <br /> dimensioned, north arrow, and location and distance to nearest road. q — 4 a 13— 03— 103� <br /> APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REI VJFDBY DA7E <br /> PROPERTY OWN R: PROPERTY LOCATION <br /> GOVT.LOT 1/4 1/4,S 13 T 4'/a ,N,R //�— E(oro <br /> PROPERTYOWNER:S AILI G DDRESS LOT# BLOC # SUBD.NAME ORC M# <br /> s �uo aJ A � . So, 3 N.4 sM�aa <br /> ITY,STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE ,®TOWN N REST GAD <br /> /y%hn. Sf�O (6ia) gas=sai6 ,iso A4 <br /> D<New Construction Use Residential/Number of bedrooms SZ [ I Addition to existing building <br /> I I Replacement [ ] Public or commercial describe <br /> Code derived daily flow 30U gpd Recommended design loading rate . 7 bed,gpd/ft2 . 8 trench,gpd/ft2 <br /> Absorption area required '5�)2 bed,ft2��ench,ft2 Maximum design loading rate bed,gpd/ft2 • 8 trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) 945. 0 U It (as referred to site plan benchmark) <br /> Additional design/site considerations <br /> Parent material 6 14c l e l C//­f7-7 7` FloDd plain elevation,if applicable-_ -ft <br /> S=Suitable for system CONVENTIONAL I MOUND IN-GROUND PRESSURE I AT-GRADESYSTEM IN FILL HOLDING TANK <br /> U=Unsuitable fors stem &S El ®'S 11U JRS ❑U RS ElU ❑S A'U ❑S ZU <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary RootsGPD/ft <br /> in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. Bed Trench <br /> 0-8' 7-EXR <br /> 7 .� <br /> Ground 3 s-'% 7-S-Y S — S G - /+ / — - 7 •8 <br /> elev. <br /> �1J0,3Cft. <br /> Depth to <br /> limiting <br /> factor <br /> Remarks: <br /> Boring# <br /> n, A. <br /> a �2- 34,291 7.SYR <br /> Ground 9// 7s -'16 r S <br /> elev. <br /> ft. <br /> Depth to <br /> limiting <br /> factor <br /> �76�1 <br /> Remarks: c� [ <br /> CST Name:—Please Print Q C e J. 1- c-"] l0 Phone: 71.5 S6G- 96/ <br /> Address: S 9 Ake <br /> /�f� <br /> /_ fhal L-/ r'/ s /_f.. <br /> PY Wil: 5 `fY3 <br /> Signaturejt / Vie/ �� CS CST Number: — <br />