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Wisconsin Department of Commerce SOIL AND SITE EVALUATION <br /> Division of Safety and Buildings Page_L of <br /> Bureau of Integrated services in accordance with s. ILHR 83.09,Wis. Adm. Code <br /> Attach complete 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 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. parcel I.D.# <br /> Oz8- 5/i�S/- os ,Sao <br /> APPLICANT INFORMATION- Please print all information. Reviewed by Date <br /> Personal infonnation'you provide maybe used for secondary purposes(Privacy Law,s.15.04(1)(m)). 'J) 2�4 <br /> Property Owner Property Location <br /> -Z-#VV J Otit L Govt.Lot S/ 1/4 1/4,S SLI T efo ,N,R Cor)W <br /> Property Owner's Mailing Address Lot If Block# Name or CSM#l $ I/Subd. <br /> c / T <br /> Ci State rp Code Phone Number <br /> ❑ City ❑ Village ® Town Nearest Road <br /> VA I5512 ( ) I�o <br /> ® New Construction Use: ®Residential/Number of bedrooms _ Addition to existing building <br /> ❑ Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow 450 gpd Recommended design loading rate . 7 bed,gpd/flz •8 trench,gpd/ft2 <br /> Absorption area required bed,ft2 2k trench,ft2 <br /> Ma+x�,mum design loading rate JZbed,gpd/0 • g trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) 9 -�'� �l.T 9•z•6 It(as referred to site plan benchmark) <br /> Additional design/site considerations A3nt(�Ge+th im Mokii i w to" t;,r4e��,> XVt¢Q lee. (�µ,�,y Ct" QnrQtS) <br /> Parent material 1ARJMN. A. t 4 Flood plain elevation,if applicable ft <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system ®s ❑ u ❑s u IK S ❑ u ❑s CK u ❑s Mu ❑s IOU <br /> L' }o'^� SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Structure GPD/f12 <br /> in. Munsell Qu.Sz.Cont.Color Texture Gr.Sz.Sh. Consistence Boundary Roots <br /> ;' Bed , Trench <br /> 33" �5yQ3/z .�,. .P.� ..rsbr m✓�,- cd 3� .� ' <br /> 3-72 -75YR4 -eeb #"Sh4 e4) .7.7 .fJ <br /> Ground h 7-SYR + /.hsbt ✓�r .7 $ <br /> elev. <br /> I-2-ft. <br /> Depth to <br /> limiting <br /> fact r <br /> in. <br /> 9/.z Remarks: . Arco ro bg 4c;wep -F-oR mAx btt j 4et22A V4A<V2. <br /> Boring# <br /> 3'" 7.SYR b"sbKAt- CGd 3,vrr3; -7 <br /> L 2 3.76 7.5 (2'i /home .� �wrSliK /n J;✓ 3F30i -7 8 <br /> Ground <br /> elev. <br /> 97•f <br /> Depth to <br /> limiting <br /> factor qo•q� 1 <br /> ?8 in. Remarks: 3" af! tf k <br /> CST Name (Please Print) Si nate Telephone No. <br /> SEPTIC & EXCAVATICIA <br /> Address SpoonAd <br /> er,W154801 a Date CST Number <br /> 15 835-7482 5'7 �a'If 71 <br /> rf7 <br />