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Wisconsin Department of Industry, SOIL AND SITE EVALUATION <br /> _ Laborand Human Relations Page I of <br /> Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. <br /> Attach bomplete 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 point(BM),direction and 'tx� <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 Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). i�/3o Clr1 <br /> Property Owner Property Location <br /> tF 1PMSK1 Govt.Lot +i 5 1/4 L _ 1/4,S 24 T LtiD ,N,R 14 :Eft W <br /> Property Owner's Mailing Address FBIock# Subd.Name or CSM# <br /> 1'14B 1JoSen City` State Zip Code Phone Number Nearest Road <br /> u-+ocA bwf �n c� Z s ( ) ❑ Vill To bu+S <br /> ® New Construction Use: ®Residential/Number of bedrooms 2- Addition to existing building <br /> ❑ Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow 300 gpd Recommended design loading rate • 7 bed,gpd/ft2 •$ trench,gpd/ft2 <br /> 'Absorption area required 424 bed,ft2 167$ trench,ft2 Maximum design loading rate •7 bed,gpd/flz_'trench,gpd/ft2 <br /> Recommended infiltration surface eavation(s) g?6.U 052: 19d—) ft(as referred to site plan benchmark) <br /> Additional design/site considerations AA ?xyt Et a: I00.0m 1-e neA ©A►' 1r', o2n)u.c) <br /> Parent material Flood plain elevation,if applicable a.m I�it <br /> S = Suitable for system Conventional Mound In-Ground Pressure I AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system ®S ❑ U ❑ s u ®s ❑ u I ❑ S $I U ❑ S ® u ❑ S 541-1 <br /> Q (OA .4rl-t Dn� SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ftp <br /> in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed Trench <br /> _ I Z.SYZ�/s eol I m /n0ty' C01 3d F . 713 <br /> .8 <br /> 48 ?.5 4 cob t — 3rr. . 7 •8 <br /> Ground <br /> slev. <br /> Depth to <br /> limiting <br /> factor <br /> 78'4 Remarks: -Pa <br /> Boring# <br /> '7.!5Y'93/2. I•w QTr Coy -7 8 <br /> 2 2 -7 iz4j m 3 . -7 ,•$ <br /> Ground <br /> elev. <br /> Depth to <br /> limiting <br /> factor <br /> " Remarks: <br /> CST Name (Please Print) Si tura Telephone No. <br /> SEPTIC & EXCAVATION <br /> Address 2-0 ftwelly il Ad.Spooner, 164801 a CST Number <br /> 715)835-7482 ro s V --maa.ti <br />