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ORIGINAL <br /> Wis.Dept of Safety and Professional Services SOIL EVALUATION REPOR Pae of ORIGINAL <br /> Division of Safety and Buildings r � g <br /> in accordance with SPS 385,Wis. Adm. Code <br /> County BURNETT <br /> Attach complete site plan on paper not less than 8 112 x 11 inches in size.Plan must <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and paw I.D. 07-024-2-39-14-03-5 05-003-014000 <br /> percent slope,scale or dimensions, north arrow,and location and distance to nearest road. Tax#15603 <br /> Please print all information. Reviewed b Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). Z J.r <br /> Property Owner Property Location <br /> THOMAS M GREEN Govt.Lot 1/4 1/4 S 033939N R 14E(or)El <br /> Property Owners Mailing Address Lot# Block# Subd Name or CSM# <br /> 6341 CROSBY AVE V 1 P194 INGOVT LOT 3 .55 ACRES <br /> City State Zip Code Plane Number ity Village JDTown Nearest Road <br /> Inver Grove His MN 55076 ( 651 3156802 RUSK 1959 Eagle LN <br /> ® New Construction Usei] Residential/Number of bedrooms 3or 4 Code derived design flow rate 450 or 600 GPD <br /> Replacement Public or commercial-Describe: <br /> Parent material Galcial Drift Flood Plain elevation if applicable N/A ft. <br /> General comments LBM ELEV:100.0'(nail in 7"Norway 48" AG) <br /> and recommendations: SE CG @>=92.6'<=93.6'replacement below @ 91.6' <br /> Mjtl4t ds 439 G. neighboring well upslope 61'onsite well>50' <br /> G�•YG•1^' �/a�shgs�'Pidx. trees to be removed and upslope area to be altered prior to installation 13 to 20%slopes <br /> existing NON Conforming DW(a)1+64.1.6'Lake(a-),-- '6-0b(<3seperation) <br /> Boring# Q 0 Boring Pit Ground surface elev. 96.0' ft. Depth to limiting factor 90 R8.5 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft ' <br /> in. Munsell Qu.Sz. Cont Color Gr.Sz.Sh. ff#1 ft#2 <br /> 1 2" 7.5YR4/2 NONE Is Imsbk mvfr cs 3vff .7 1.6 <br /> 2 2-7" 7.5YR4,4 NONE Is I msbk mvfr cs 2f m 7 1.6 <br /> 3 7-90" 7.5YR4/4 NONE s Osg ml ----- 2f m .7 1.6 <br /> ` Boring# <br /> 11 Boring <br /> ElPit Ground surface elev. ft. Depth to limiting factor in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 tff#2 <br /> 1 4" 7.5YR4/2 NONE gr Is Imsbk mvfr cs 2vf f .7 1.6 <br /> 2 4-9" 7.5YR4/4 NONE gr is I msbk mvfr cs l f m .7 1.6 <br /> 3 9-36" 7.5YR4/4 NONE, s Osg ml as If to .7 1.6 <br /> 4 36-96" 7.5YR4/4 NONE AUGER BORING .7 1.6 <br /> 'Effluent#1 =BOO 5>30<220 mg/L and TSS>30 <150 mg/L Efflugq#2=BOD <30 mg/L and TSS <30 mg/L <br /> CST Name(Please Print)ill&K SEPTIC & EXCAVATION Signatur CST Number <br /> Mel Fergusn dba 224879 <br /> Addresslvv�$ w WW R, WI 54801 r%nte Eval on Conducted Telephone Number <br /> 715-635-7482 <br />