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Wisconsin Department of Commerce SOIL AND SITE EVALUATION <br /> Divi?ion�f Safety and Buildings Page�_of <br /> Bureau of Integrated Services in accordance with Comm 83.09, WIIS. 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. ua r <br /> Parcel I.D.# <br /> (2�0_ - Lla1'?- 63 - <br /> APPLICANT INFORMATION- Please print all information. Reviewed by {� Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(l)(m)). <br /> Property Owner Property Location <br /> L ot_TULVISK( Govt.Lot Si= 1/4 Sui 1/4,S 1-7 T ,4,9 ,N,R S E(or� <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> City State _Zi"C de Phone Number ❑ City ❑ Village E] Town Nearest Road <br /> (AY, 1 54 8 2q I ( rll S )87-z dor o <br /> 0 New Construction Use: Residential/Number of bedrooms Ptr-i V Addition to existing building <br /> ❑ Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow�k�gpd Recommended design loading rate . 7 bed,gpd/ft2 • trench,gpd/ft2 <br /> Absorption area required bed,ft2 trench,ft 2 Maximum design loading rate .7 bed,gpw •8 trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) <f4 o , > 95.o ft(as referred to site plan benchmark) <br /> Additional design/site considerations A &,-n E/¢,/• /00 D 4Hn .nJ /,2-, t,7/H /2.,,.t, <br /> Parent material /Aciiq+. dar ff Flood plain elevation,if applicable v 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 ❑S 9u ❑S '9U ❑S ® U <br /> P2rr SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Structure GPD/ft2 <br /> Texture Consistence Boundary Roots <br /> in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench <br /> " -7.SY 3 cne 1 rn J�i CpJ v -4 . 7 '.8 <br /> Ground <br /> elev. --T -7 SY 14 1 T �.9 <br /> ft. <br /> Depth to <br /> limiting <br /> factor <br /> Remarks: A <br /> Boring If <br /> 13 <br /> Ground <br /> elev. <br /> _ft. <br /> Depth to <br /> limiting <br /> factor <br /> in. Remarks: <br /> CST Name (Please Print Signature Telephone No. <br /> wSrM <br /> Address Date CST Number <br /> as �in� K1' J yb'n 7 <br />