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Wisconsin Department of Commerce SOIL AND SITE EVALUATION <br /> Division of Safety and Buildings Page 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. par el I.D.# <br /> APPLICANT INFORMATION - Please print all information. Reviewed by Date G <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15:04(1)(m)). <br /> Property Owner r� Property Location <br /> N G Govt.Lot 71/401/4,S Ill 140E(ore <br /> Prope Owner's Mailing Address ock# Subd.Name or CSM# <br /> 11? GREEK VD . Lot# BlM Acxg5 <br /> Ci Stat Zip Code Phone Number city ❑ Village IR Town Nearest Road <br /> ❑ Ci <br /> �$STEfZ Z i.'A'o93 ( `J 19 ea S SAC le 5 a t4 <br /> New Construction Use: Residential/Number of bedrooms Addition to existing binding <br /> Replacement ,y Public or commercial.-Describe: <br /> Code derived daily flow 450 gpd Recommended design loading rate .7 bed,gpd/fl2 •$ trench,gpd/ft2 . <br /> Absorption area required 443 bed,ft2. 56 tren ,ft2 Maximum design loading rate •7 bed,gpd/ft2'•$ trench,gpd/ft2 <br /> Recommended infiltration surface elevations i% 95.4 ALT /j4• I ft(as-Teferred to site plan benchmark) <br /> Additional design/site considerations At SdS. .�✓��• � <br /> Parent material 4LALIANA yiyer Flood plain elevation,if applicable ft . <br /> S = Suitable for system Conventional �M7lound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system N S E: U yw S ❑ U WS EIU 1i S ❑ U ®S ❑ u E1 19 U <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 <br /> in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed , Trench <br /> /f <br /> Is iA At 1. c s .7 . 4 <br /> Ground 3 ?f3, �� I`lf M1 Gy �"• ,7 <br /> ��h�eV_..-, <br /> Depth to <br /> limiting <br /> fElptor <br /> � in. <br /> Remarks: <br /> Boring# <br /> Z <br /> /0,10 7 I AE f /s <br /> Ground /"� s I ✓ ✓ . 7 ,8 <br /> elev. <br /> qL.Vft. <br /> Depth to <br /> limiting <br /> fact <br /> or5 C� <br /> y in. Remarks: ' <br /> CST Name (Please Print) Signature Telephone No. <br /> ,cHpP o K/1�l "" 15- ?4- 57 <br /> Addre s Date CST Number <br /> ;7_7740 35 W 8t551nc 1.Jt. 54893 S•24• g$ 225 351 <br />