Laserfiche WebLink
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page_of_ <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> t^N <br /> Attach complete site plan on paper not less than B 112 x 11 inches in size.Plan must County <br /> include,but not limited to:vertical and horizontal reference point(8M),direction and paw I D <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 20 q322 el 116V <br /> Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)), I (�� <br /> Property Owner Property Location _( t� <br /> / r! h qel At,I rocir� Govt.Lot / 1/4 1/4 S / T lAq N R /X E( W <br /> Property Owner's Mailing Address Lot Block# I Subd.Name or CSM# <br /> -1,4A Ib/ 3 A <br /> City State Zip Code Phone Number C]City ❑Villa a X3 Town Nearest Road <br /> Mo% �G / (Pel ) 62- 11787 I. r,// r , <br /> ® New Construction Use:Z Residential/Number of bedrooms 3 Code derived design flow rate ySd GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material 122/ T.%/ Flood Plain elevation if applicable AM g <br /> General comments �c 5 <br /> and recommendations: <br /> 962 /17 5 &O yeJ,w <br /> arr J '/N''-• 5`y,�y�6 L 1.0 z,�/7W <br /> Boring# ❑ Boring 7 <br /> ® pit Ground surface elev. /_'/7- ft. Depth to limiting factor 7 70 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots I GPD/ff <br /> in. Munsell Ou.Sz. Cont.Color Gr.Sz.Sh. I F -Eff#1 I 'Eff#2 <br /> l <br /> 0-1 1,Ae12 L / /*IL /-1 . 7 <br /> Z -31 .5`Y L / 7 Z <br /> 3 1- 7P / <br /> y 70-77 <br /> Z5/y F5 0 �Ow/ 4 5 <br /> i <br /> Borina# ❑ Boring 975 <br /> l=J 92 Pit Ground surfaceelev. /7`5 ft. Depth to limiting factor _ 65 —in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO/ff <br /> in. Munsell Cu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 'Eff#2 <br /> o-k .s 'Slm44 mL 1 4'5 24 <br /> Z­65 76 ty OS 6 — . 6- <br /> 7Z �sYr-e f i 04< I /IZ GS <br /> i <br /> i <br /> Effluent 91 =BOD.>30<220 mg/L and TSS>30<150 mg/L Effluent 800 <30 mg/L and TSS<30 mg/L <br /> CST Name (Please Print) Signature CST Number <br /> o/ <br /> Address Date Evaluation Conducted Telephone Number <br /> ZI760 Xull 3 W 651e1^ QJ.- S` 3 <br />