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Wisconsin Department of Commerce SOIL EVALUATION REPORTpage / a(. /) <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wm. Adm. Code <br /> Attach complete site Plan an paper not less than 812 x 11 Inures in size.Plan must County 8t,rn V- <br /> Inciude,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. o 7 oa 8 3- 40 a 1 13 J" IS- <br /> Percent slope,scale or dimensions,north arrow,and location and distance to nearest road. O 9 O/.5000 <br /> Please print all Information. Reviewed by Date <br /> Personal hdormaeon you provide may be used for sacwMary purposes(privacy Lew.S.15.04(1)(m)). <br /> Properly Owner - Property Location <br /> Freat' qF. Lori &4/¢rtl GovL Lot 1/4 1/4 S /3 T y0 N R [q E(or <br /> Property Owners Madhv Address Lot# I Bbck# Subd.Name or CSW <br /> 707 6i Y/'erark Lm 16' <br /> CF State Gu r sol i a'Fat <br /> Zip Code Phone Number ❑City ❑Village ®Town Nearest Road <br /> narwg a sIIS A/ j).7 ( ) ea .Yom 1U. <br /> [ New construction .Use:® Residential/Number of bedrooms _ Coda derived design flow rate ys0 GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material 0,'/A,-/A / 07 i e't Flood Plain elevation if applicable <br /> General comments alar <br /> and recommendations:. SY <br /> F Boring# {onng <br /> Pit Ground surface slay. 9Y•`/ ft. Depth to firniting factor--in. <br /> Soil Application Rate <br /> Hormon Depth Dominant Color Redox Description Texore Structure Consistence Boundary Roots GPDfif <br /> in. Munsell Qu.Sz. Cont Color Gr.Sz.Sh. 'Eff#1 'E892 <br /> 754/7 /nJ-Me- M / CJ 3M . 7 <br /> 7.0-45AP y/y — /PS m,( . 1 4 s Jeo S- <br /> /. o <br /> 3 35 SYP 5lv /FJ�6r /nS�/� rn / L J O <br /> Y 3f- 9G SYR "'/Y 4•�d SYi2� �FJ,/F. /rrsrJ s+..f% — — -r /. O <br /> F7jBorjng# Boring <br /> pit Ground surface elev. 43• of ft. Depth to limiting factor 41d in. <br /> Sal Applicatiori Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff <br /> In. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff/t1 'Eft#2 <br /> o- ,/ 7.SYR3lr — /s n sb/� / ex 3.e . 7 1. 6 <br /> 4--qt 7.. -VR `//y — JFS aMS6.N / GJ <br /> 3 Yj e:;Le,Xpe �7p A67 <br /> EfBuenl#1 a BOD >30<220 n9t and TSS>30<150 rrxyL •Eftluerd#2=BOD <30 nV&and TSS 130 mgl <br /> CST Name (Please Print) <br /> Signature CSTNumber <br /> Grnes SC6niA4S f m - 734)0 <br /> Address - Date Evaluation Conducted Telephone Number <br /> 760154.. 3s t v�G3 ft-, <br />