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Wisconsin Department ofCommerce SOIL EVALUATION <br /> Division of Safety and Buildings REPORT - <br /> in accordance with Comm 85,Wis. Adm. Code Page L of� <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 U <br /> percent slope,scale or dimensions,north arrow, point(BM),direction and <br /> and location and distance to nearest road. Parcel LD. b7 O DD <br /> d T 7 Q�/Q VL <br /> lease print all information. j <br /> Penonar informationReviewed by <br /> you prw,tle may De used for faconaary purposaa(Privacy Date <br /> Prrvac Law,s.15.04(r)(m)1. <br /> Property Owner <br /> N Property Location I <br /> E L d N Govt.Lot 3 / <br /> PmpertyOwner's ail Address 1/4 1/4 S / T N R /4 <br /> 1, , let f-1 I) /J <br /> r Vv Lot tt Block tt Subd. Name or CSM# E(oro <br /> City State/v Tp Cotle Phone Number <br /> Afet i orf N �M Cl city ❑Vllage Town Nearest Road <br /> . r Z I cC-,5 I ) 6^ —60913 Seo t � J. <br /> C3NewConsRvction * l IrC <br /> Use:® Residential/Number of bedrooms <br /> 21 Replacement � Code denved design flow rate �J$D <br /> //'' ❑ Publ <br /> ic Orcommercial-Describe: Gpp I <br /> Parent material_ Gli c;fi Ur -r f <br /> Flood Plain elevation if applicable -- <br /> General comments 1 � J� I <br /> and recommendations: 5 y5f ems! EL 9,75 4. <br /> Boring# © Boring <br /> I <br /> ❑ Pit Ground surface elev.Al ft <br /> Depth to limiting factor 3 <br /> Horizon Depth �_in. <br /> p Dominant Color Redox Destsipbon Texture Soil Aoclitahon Rate <br /> in. Munsell Structure Consistence Boundary Roots <br /> U.Sz. Cont.Color Gr.Sz.Sh. Gp0lff <br /> 0-k <br /> 2,5, �- 15 s L G •Erf#1 I •E.#2 <br /> �+ � I.se / F 5 I L 65 F <br /> I r�L <br /> I I I <br /> I I ( I <br /> I � 1 <br /> I j I Bonino# _❑ Boring <br /> Pit Ground surface elev. h Depth to Irriting factor S <br /> Horizon Depth Dominant Color — in <br /> Redox Desc ption Texture Structure Consistence Boundary Roots Sod Application Rate <br /> in. Munsell Cu. Sz. Cont.Ccicr n1 GPD/? <br /> 1 Gr.Sz. Sh. <br /> l)-S 7IX3/2 LS Eµ1 <br /> Z 5-3 s . i <br /> �S-rfy -7,--j-/47 F SY/15-1r, �S run I • 7 1 <br /> 5 s I• y <br /> 2M�6 Iry FI Iv I - . 2 <br /> Effluent#1 =800 >30<220 mr/L and TSS>30< 150 m <br /> CST Nam (Please Print) - E rent tt2=BOD <30 mg/L and TSS<30 m L <br /> 4111. . gnature - <br /> / CST Number <br /> Addre 225•8 S1 <br /> �� / L_ f Date Evaluaucn Conducted D <br /> t7 w� G� W —1499j Telephone Number <br /> 0 z 7ts- <br />