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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page__I__of—,3- <br /> Division <br /> f _Division of Safety and Buildings <br /> In accordance with Comm e5,Wis. Adm. Code <br /> County <br /> Attach complete site plan on paper not lass than B 1/2 z 11 inches in size.Plan must A, <br /> Include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. D/Q $02700 <br /> Please print alt information. Reviewed by Date <br /> Personal Information you provide may be used for secondary purposes(Privacy Law,S.15.04(1)(m)). I 2//a,/o7 <br /> Property Owner Property location S17$A Ct U, 92G'FXHcvy <br /> e() POr- <br /> , E / Govt.Lot 1/4,S(,j 1/4 S,-� T N R 6 E(o W <br /> Property Owner's Mailing Address Lot# Block# �Subd_Name or CSM# <br /> — 1 z <br /> to <br /> City k State Zip Code Phone Number ❑City ❑village own 1 1 Jearest Roa <br /> eI Gf1 -45- ( ) e-� z.L) <br /> 0-New Construction User,Residential/Number of bedrooms_.5X-_ Code derived design flow rate GPD <br /> ❑Replacement //����❑ Public or commercial-Describe: <br /> Parent material�//�� ,4;C- �_( ' Flood Plain elevation if applicable ft. <br /> General comments <br /> and recommendations: _5yS164, oN 95.90 -60 17.00 <br /> O AS 6'jeer'tUA4 LOAMY SWb 34486 6.6% SLA , <br /> Boring <br /> Boring# Q � _ <br /> �. pit Ground surface elev._ ft. Depth to limiting factor Z in. <br /> Soil Application Rata <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary f tools GPDIff <br /> In. Munsell Ou.Sz. Cont.Calor Gr,Sz.Sh. 'Eff#1 'Eff#2 <br /> t S 6 z <br /> y k- <br /> Boring# ❑�7( Boring <br /> ® !tel pit Ground surface elev.� __fl. Depth to limiting facto in. <br /> in. Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Rocts GPD/fF <br /> in. 1 Munsell Out.Sz. Cont.Color Ga Sz.Sh. -Eff#1 'Eff#2 <br /> 3� lG G la y <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30 1150 mgA. 'Effluent#2-BOD <30 mgVL i nd TSS 130 mg/L <br /> CST Name (Pletwe Print Si nature CST Number <br /> Z 7 G / <br /> Addre s Date Evaluation Conducted Telephone Number <br /> 6oX s� s /��,-j <br />