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Wisconsin Department of Commerce SOIL AND SITE EVALUATION <br /> Division of Safety and Buildings Page I_of 3 <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 /> DO$, b5o 62 900 <br /> APPLICANT INFORMATION - Please print all information: Reviewed by /// Date <br /> Personal information you provide may be used for secondary purposes.(Pdvaby Law,s.15:04(1)(m)). <br /> Property Owner Property Location rL U <br /> O 56^1 nAIIE R. Govt.Lot 1/4 1/4,S 148 T 38 ,N,R 14 0*10 W , <br /> Property Owner's Mailin ddress Lot If Block# Subd.Name or CSM# <br /> sons I 104" (�i-Ace 1b 2. LwY4 ' BATHER <br /> City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road <br /> �n n 553t(a (InIZ >yz5-'.Y53 t�t�5HF5u�rn <br /> New Construction Use: Presidential/Number of bedrooms 5_ Addition to existing building <br /> ❑ Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow r'I'SD gpd Recommended loading design g g rate 7_bed,gpd/flZ_1--trench,gpd/ft2 <br /> Absorption area required 4+13 bed,ftz56 3trench,ft <br /> Maxi um design loading rate • 7 bed,gpd/ft2 -8 trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) 9 .el ft(as referred to site plan benchmark) <br /> Additional design/site considerations ' w lift a KTf S—t'vfo <br /> Parent material 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 ❑ s ❑ U 1 ❑ S ❑ U ❑S ❑ U ❑s ❑ u <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color ' Mottles Texture Structure Consistence Boundary Roots Gp /n2 <br /> in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench <br /> cei 3 .7 .8 <br /> rA <br /> 2. 5-B4 ,7_4RejZ4jq <br /> Ground ' <br /> elev. <br /> �_�ft. <br /> Depth to <br /> limiting <br /> fat r <br /> in. <br /> Remarks: 1?A <br /> Boring# <br /> 1 3 z•SY R 8/_ . a a� 3,, . -r •g <br /> z -23.2 -t.5 R.qI4 -7 . <br /> Ground <br /> elev. <br /> Depth to <br /> limiting q p <br /> fac(cr i. b•Remarks: Rt AP3 N a4' .5.E. 1.4.5f a `�.[0 <br /> CST Name (Please PPTIC & EXCAVATION Sign to Telephone No. <br /> 8 Coun Une Rd. <br /> ress $pmn,Irl Date CST Number <br /> d;Old 1 <br />