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Wisconsin Department of Commerce SOIL AND SITE EVALUATION <br /> Division of Safety and Buildings Page 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 !� 1 <br /> include,but not limited to: vertical and horizontal reference point(BM),direction and 'mak r rIC�1T <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <br /> ooFl- aj18- <br /> APPLICANT INFORMATION - please print all infdrmation. Reviewed by Date Qq <br /> Personal information you provide may be used for secondary purposes.(Privacy Law,.s.15.64(1)(m)). f <br /> Property Owner , �,� f Property Loocation - ; � , <br /> __R, +A LH`�)R& Govt.Lot? p 1/4 1/4,S /.,? T ,N,R I`f E(ori <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> bill- F. i5A_. <br /> City State Zip Code Phone Number ❑ City ❑ Village •❑ Town Nearest Road <br /> 4-b I MA ID ( fo17-)-7ZZ %8 ems, <br /> RrNew Construction Use: latResidential/Number of bedrooms Addition to existing building <br /> ❑ Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow 450 gpd r • &ecommended design loading rate • `7 bed,gpd/ft2 trench,gpd/ft2 <br /> Absorp14 area required IA'h bed,ft2 5123 trench,ft2 Maximum design loading rate 7 bed,gpd/fl2 • $ trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) < 9/•3 J�Rt0_rf0-I0 ft(as referred to site plan benchmark) <br /> Additional design/site considerations •I co•o'4 dan-u. "R;bboa ed rt `I Y -u-o 8 <br /> Parent material 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 �7 S ❑ U (�S ❑ U JZS ❑ U EJS 0 11 ❑S D U ❑ S ❑ U <br /> SOIL DESCRIPTION REPORT <br /> Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 <br /> ar. ' <br /> in. Munsell Cu.Sz.Cont.Color Gr.Sz.Sh. Bed , Trench <br /> P .t .5 R•3/z in .Qd ev%3ck IVA4Jre C-Q.) 3,,� �^ . 7 .8 <br /> 2 -1.5 <br /> qM /M- s' C4.) -F 1 t • -7 8 <br /> Ground T.S�eRM ^,erne 8 \ <br /> elev. <br /> Depth to <br /> limiting <br /> fWtor <br /> it. in. <br /> 87.1 Remarks: Jt <br /> Boring# <br /> {.:....< 3a 7 B <br /> ? • 8 <br /> m -, . .3 sR ! C <br /> Ground L <br /> elev. 15 <br /> 91Qan. O ?k <br /> Depth to <br /> limiting <br /> f ctor ,3 <br /> in. Remarks: ?J <br /> CST Name (Pleas Print nn Signature MK K Telephone No. <br /> NC <br /> A"MA&j SEPTIC A E=AWICIN <br /> Address N6228 Courtly Line Rd. Date CST Number <br /> 460 <br /> Spooner,WI 51 31 Z-1 I iq aa'l-9741 <br />