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Isconsm vepanmenc or�ommerce SOIL AND SITE EVALUATION Page of_•� <br /> Ifvisign or Safety and Buildings <br /> §bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code <br /> ' County <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must <br /> include,but not limited to: vertical and horizontal reference point(BM),direction and <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <br /> APPLICANT INFORMATION - Please print all information. Reviewed by oac''e11 <br /> Personil information you provide maybe used for secondary purposes(Privacy Law,s."!544(1)(m)). V�b <br /> Property Owrter Property Location <br /> �O,L Govt.Lot-3 1/4• 1/4,S <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> GL. 1 lWi Z• Voc.. 1 2J7 <br /> %City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road <br /> KI tJ, 5S43t c(�lZ)S85- 1 Co. Ko. 9- <br /> New Construction Use: Residential/Number of bedrooms 3 Addition to existing building <br /> Replacement Public or commercial-Describe: { <br /> Code derived daily flow gpd Recommended design loading rate J bed,gpd/tF trench,gpd/f 2 <br /> Absorption area requiredbed,ft2�trench,ftz Maximum design loading ratebed,gpd/ft2�_trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) IDI 3 ft(as referred to site plan benchmark) <br /> Additional design/site considerations Aftwo 3a.cr,4&9 A$ R RE'ALAC,,MWr_ !F& <br /> Parent material &�� t- �� <br /> Flood plain elevation,if applicable �� ft <br /> . <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade SystemricnrlFillds g U <br /> U = Unsuitable for system ❑ S ] U ® S ❑ U ❑ S U ❑ S U ❑S lol U <br /> SOIL DESCRIPTION REPORT <br /> Structure C__on/f(2 <br /> Boring # Horizon Depth Dominant Color Mottles Texture Consistence Boundary Roots Bed ,Trench <br /> in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. <br /> I I <br /> 0.5 .5 Z dl s ✓� . s .6 <br /> Ground <br /> ft. <br /> Depth to <br /> limiting <br /> f for <br /> in. <br /> Remarks: rr <br /> Boring # I p-S (Z 3 7- S QS Li J t "? .8 <br /> Al <br /> Ground S <br /> e <br /> ft. <br /> Depth to <br /> limiting <br /> f c t r <br /> in. Remarks: <br /> C <br /> Signature Telephone No. <br /> ST Name (Please Print) I <br /> ,e AR•I? 140041PJS866- <br />