Laserfiche WebLink
Wisconsin,Department of Commerce SOIL AND SITE EVALUATION <br /> divisiorrof Safety and Buildings Page of <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 <br /> u R .a <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <br /> o Z - Zas.- 033(70 <br /> APPLICANT INFORMATION-Please print all information. Reviewed by Date <br /> Personal infomration you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner Property Location <br /> '6'611,1— [ OGcJ Govt.Lot NW 1/4 5 1/4,S T ,N,R fjaitW <br /> Property Owner's Mailing A08ress Lot# Block# ubd.Name or CSM# <br /> 100, 6% 1 M/A- <)IA VIA <br /> City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road <br /> �,5flil/(3uRV k)/ 1 s'`o'361(71,51. –7&Y tJ"SS' PYWAe <br /> p,1 New Construction Use: 5n Residential/Number of bedrooms Addition to existing building <br /> ❑ Replacement u ❑Public or commensal-Describe: <br /> Code derived daily flow gpd Recommended design loading rate gybed,gpdMt2__,j trench,gpo1ft2 <br /> Absorption area required b y; bed,ft2 �6 3 _trer�h ft2 Maximum design loading rate bed,gpW--a—trench,gpd/ft2 <br /> Recommended infiltration surface elevations) /z ?✓ ft(as referred to site plan benchmark) <br /> Additional desigNsfte considerations ok, C5 Y,57-1/tt /C./�i�cu <br /> Parent material OUTW450. Food plain elevation,if applicable eA ft <br /> S = Suitable for system Conventional Mound In-Ground Pressure I AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system t S ❑ u 15n s ❑ u Us ❑ U I 4-s ❑ u ❑S J1 U Ds POU <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 <br /> in. Munsell Ou.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench <br /> l icy "/Z —o SL Z�,s6k .trd a u7 v� . <br /> ?� -87 SfR'7/( <br /> �--� -- -w ;.8 <br /> Grund 3 �59 7/6 61 .7 _$ <br /> eft. — ©-- CrK LS <br /> Depth to <br /> limiting <br /> factor <br /> Remarks: II <br /> Boring# j �—✓ 0YSV 24 —0 6-L dJ7v-) 3,46f <br /> 13 7- -tD ,3 Ry& -- ©-- 46 O�5a 2-Al <br /> Ground 7,S '� r—C? TIS _7 8 <br /> Depth to <br /> limiting <br /> factor <br /> in. Remarks: <br /> CST Name (Please Print) Signature Telephone No. <br /> Address Date CST Numbs <br /> 7 A ve L tS Y O c X48 77/ <br />