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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page ) of $ { <br /> Division of Safety and Buildings <br /> in accordancewim Comm 85,Wis. Adm. Code <br /> Attach complete site plan on paper not less than 8112 x 11 inches in size.Plan must Comity <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. 07 a 3d •t 141 G <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. s C4 9 a ••0LIIX'96601124 <br /> Please PllOt all infonnatlon. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Lew,s.15.04(1)(m)). <br /> Property Owner Property Location <br /> 6 fn r 1°tS end irt le Govt.Lot 1/4 1/4 S '35'T q1 N R l/o E(or)W <br /> Property Owner's Mating Address Lot-# - Subd.Naor CSM# V.9 <br /> .139 Ss Atlee Rio 1 me••tu 8l7sky /o+ T. "+/.f- A113 <br /> City State Zip Code Phone Number ❑City ❑V Ilage ©Town Nearest Road A 4 9p 9 <br /> at, l=Pale 0%W 1SS3/3 H ) ew14-4 Ne.-vw s». Rcl <br /> ❑ New Construction Use:® Residential/Number of bedrooms_l Code derived design flow rate GO GPD <br /> ®Replacement ❑ Public or commercial-Describe: <br /> Parent material I r<r Flood Plain elevation if applicable N ft <br /> General comments cJ y. 4 <br /> and recommendations: S e/e v' <br /> MaNtt OS /bo e - (ff-rayli� hd <br /> ❑/ Boring# <br /> ZBoring <br /> ❑ Pit Ground surface elev. 9�•d ft. Depth to limiting factor 7 8y in. Shc Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtfF <br /> in. Munsell Ou.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 I •Eff#2 <br /> e- 3 Zs&,/z 'P/d — /s , 7 / 6 <br /> s P4 7•sr S -7 /. <br /> Boring# ❑ Baring <br /> ❑ pit Ground surface elev. ft. Depth to limiting factor in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture StrucWre Consistence Boundary Roots GPDM <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Etf#1 I •Eff#2 <br /> •Effluent#1 =BOD >30 1220 mg/L and TSS>30<150 mg/L •Eftuent#2=BOD <30 nglL and TSS<_30 mg/L <br /> CST Name(Please Prim) Signature CST Nunber <br /> G/»es SL�nr�/S 73V,1p <br /> Address Date Evaluation Conducted Telephone Number <br /> 77G0fh. 3s Gc/ebs14 E-or- 5'4x3 If-�a-ro 7iS- rd`- v/5-7 <br />