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Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT �I Page Of <br /> Labor and Human Relations <br /> Division of Safety a Buildings in accord with ILHR 83.05, Wis. Adm. Code <br /> COUNT <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include,but <br /> not limited to vertical and horizontal reference point(BM),direction and%of slope,scale or PARCE I.D.# <br /> dimensioned, north arrow,and location and distance to nearest road. OZ -v�p (- 04- <br /> APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION REVIE EDB DATE <br /> 4-1�-'ic <br /> PROPERTY OWNER: PROPERTY LOCATION <br /> Dan Michaels GOVT.LOT 364 1/4 1/4,S 2 1 T 37 ,N,R 18 Yi(or)W <br /> PROPERTY OWNERS MAILING ADDRESS LOT# BLOCK# SUBD.NAME OR CSM# <br /> 20920 Lakewood Drive 1 CSM V. 3, Pg. 190 <br /> CITY,STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE ®TOWN INEAREST ROAD <br /> Gratnsbur , WI 54840 (715 327-4510 Trade Lake lLakewood DR. <br /> [x] New Construction Use [ ij Residential/Number of bedrooms 2 [ ] Addition to existing building <br /> I ] Replacement [ ] Public or commercial describe <br /> Code derived daily flow 300 gpd Recommended design loading rate NA bed,gpd/ft2NA trench,gpd/ft2 <br /> Absorption area required NA—bed,112 NA—trench,ft2 Maximum design loading rate gybed,gpd/ 2 NA trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) NA ft (as referred to site plan bench ark) <br /> Additional design/site considerations NA <br /> Parent material C_larialnrifr Flood plain elevation,if applicable RA ft <br /> S=Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL I HOLDING TANK <br /> U=Unsuitable for s stem EIS 5 ❑S W U EIS W U I ❑S [,j U LIS 50 U 1 [I S ❑U <br /> SOIL DESCRIPTION REPORT <br /> Consistence-Boring# Horizon Boundary Roots <br /> Depth Dominant Color Mottles Texture Structure GPD/ft <br /> in. Munsell Du.Sz.Cont.Color Gr. Sz. Sh. Bed Trench <br /> 1 <br /> 1 0-9" 7.5 YR 2/0 --------- 12msbk mfr & co .5 <br /> — <br /> 2 9"-60' 7.5 YR 5/2 c2d 5 YR 5/8 cl To mfi --- if -- -- <br /> Ground <br /> elev. <br /> 93.7ft. <br /> Depth to <br /> limiting <br /> factor <br /> 9" LL <br /> Remarks: <br /> Boring# <br /> 1 0-10" 7.5 YR 2/0 --------- sl 2asbk mfr cs f—co .5 .6 <br /> 2 M 2 0"-38' 7.5 YR 5/2 c2d 5 YR 5/8 Cl m mfi --- if <br /> Ground <br /> elev. <br /> 91.4ft. <br /> Depth to <br /> limiting <br /> factor <br /> 10" <br /> L LL= <br /> Remarks: <br /> T Name:—Please Print Wade Rufsholm Phone: <br /> (715)349-7286 <br /> Address: 24702 Lind Road P.O. Box 514 Siren, WI 54872 <br /> Signature: / Date: 3/10/95 CST Number: 3583 <br />