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Wisconsin*anment of Commerce SOIL AND SITE EVALUATION <br /> Division of Safety and Buildings Page of <br /> Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code <br /> , <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County pp <br /> include,but not limited to: vertical and horizontal reference point(BM),direction and O Gc v-h e <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <br /> DI)- - /,SOU <br /> APPLICANT INFORMATION- Please print all Information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy law,s.15.04(1)(m)). �..1�✓ <br /> Property Owner Property Location <br /> & e ke r— ,er Govt.Lot J_ 9 SE,l4 WE' 1/4,S 16 T q 6,N,R 15J E(or)® <br /> Property Olvners Mailing Address Lot# BI k# Subd.Name or CSM# <br /> S✓r C 2 Yol fb 36 0'ar 0c ref <br /> City fState Zip Code Phone Number ❑ Nearest Road <br /> Aivr� 0,115 W,,5. 5 y od.A (7154�s- 630,3 City ❑ Village ® Town <br /> ZI New Construction Use: IZResidential/Number of bedrooms Addition to existing building <br /> ❑ Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow 3ab gpd Recommended design loading rate ✓ bed,gpd/f12 7 trench,gpd/ft2 <br /> Absorption area required bed,n2_qA_j_trench,ft2 Maximum design loading rate -� bed,gpcI1W • 7 trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) Gtt /fi• 3 n(as referred to site plan benchmark) <br /> Additional design/site considerations <br /> Parent material Z I A e- . ,. l Q r i T r Flood plain elevation,if applicable n <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system S ❑ u ❑s 0 U ❑s p U ❑s Z u ❑s ® u ❑s ELI <br /> SOIL DESCRIPTION REPORT <br /> Boris # Horizon Depth Dominant Color Mottles Structure GPD/ft2 <br /> 9 Texture Consistence Boundary Roots <br /> in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench <br /> 6-6 7 YR '/ -- /s osg hI l cs '3 (50 7 <br /> d- <br /> 9-a8 7.sYR y/y /S o5y n,1 9s 3 m 7 <br /> Ground 3 d$.v0 7 r7R s osy <br /> elev. s 0.65 �, ! 5 s 0 yt <br /> yin. <br /> Depth to <br /> limiting <br /> factor <br /> > bin. <br /> Remarks: <br /> Boring# <br /> 7.�5- �.sYR Y/ — I S CS5 <br /> 3 �r.yq 7.s Y/1 Y/6 <br /> Ground S'Yq 914 ✓h S 6S.9 <br /> elev. <br /> 9b•�n. <br /> Depth to <br /> limiting <br /> factor <br /> in. Remarks: <br /> CST Name (Please Print) Signature Telephone No. <br /> m v N f g 1-5 '7J-t=8'64- 9 12 `7 <br /> Address Date CST Number <br /> J-77240 w 3-5_ tvc,6vtty WZ7 .x$93 U <br />