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Wisconsin Department of commerce SOIL EVALUATION REPORT Page—L of -3 <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code /I ' <br /> Attach complete site plan on paper not less than 8 12 x 11 inches in size.Plan must County v!NC7T^ <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. <br /> n <br /> percent slope,scale or dimensions,north aow,and location and distance to nearest road. 03 Z Za O <br /> Please print all information. Reviewed by Date <br /> Persomd information you provide may be used for secondary purposes(Privacy Lew,s.15.04(1)(m)). / <br /> ob <br /> PropertyOwners / Property Location ,/ <br /> X0 7/ i/l GovL Lot � 1/4A/u)1/4 SZ T �f' N R E(or W <br /> Propsoy Ownees Mailing Address Lo # Block# Subd.Name or CSW <br /> 3' f Gs r/ 10 <br /> City State Zip Code Phone Number ❑city [:]Village Town Nearest Road <br /> l✓anipur <br /> Lit- i #wY35-- <br /> ® New Construction Use:❑ Residential/Number of bedrooms— Code derived design flow rate GPD <br /> Replacement / ❑ Public or commercial-Describe: <br /> Parent material r:1,2/' Flood Plain elevation if applicable <br /> a�r�mmmmendations: Gj y/ Ole PO 609Z1 . oo <br /> ❑( Boring# E] Boring /� l} <br /> ® Pit Ground surface elev. %�'0 ft. Depth to limiting factor 7 /� in. Sotl 'cation Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W <br /> in. I Munsell Qu.Sz. Cont Color Gr.Sz.Sh. •Eff#1 I 'Ef1#2 <br /> o 75-W712 /-5 Ldk y z . -7 1 i& <br /> —HV rjy/C9 — rn 0 lo,7 1— 7 /• <br /> - 0 7.5 ,esAl — 7 [.(v <br /> ❑Z Boring# ❑ Boring , <br /> Pit Ground surface elev. q3,`J' ft. Depth to limiting factor 7 o in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description KTe)dure Structure Consistence Boundary Roots GPD/If <br /> in. Munsell Qu.Sz. Cont.ColorGr.Sz.Sh. •Eff#1 •Eff#2 <br /> 1 0:y s Rai k ✓�� z 7 1 <br /> �- 04� . 7 <br /> •Effluent#1 =BOD >30<220 mgtL and TSS>30<150mg/L •E1Muent#2=BOD <30 mg1L and TSS<30 ng1L <br /> CST ) S' CST CST Number <br /> Address Date Evaluation Conducted Telephone Number <br /> 2-776,,,') w S We �(•r U, Syd9 -//-a6 7�5 866- r� <br />