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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 S 1/2 x 11 inches in size. Plan must County <br /> include,but not limited to: vertical and horizontal reference point(BM),direction and Burnett County <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <br /> 008-2106-04 500 <br /> APPLICANT INFORMATION- Please print all information. Reviewed by JJ Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner Property Location <br /> Rick Larson Govt.Lot SE 1/4 SE 1/4,S 6 T 38N ,N,R M $(or)W <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> 4082 County Road % <br /> City State Zi Code Phone Number E] City ❑ Village ® Town Nearest Road <br /> Flebster WI 54893 X715 ) 866-7178 Dewey I Oak Road <br /> ® New Construction Use: LgResidential/Number of bedrooms 3 Addition to existing building <br /> ❑ Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow 450 gpd Recommended design loading rate .7 bed,gpd/fl2 .8 trench,gpd/ft2 <br /> Absorption area required 643 bed,ft2—56-3--trench,ft2 Maximum design loading rate—_bed,gpd/ft2,a__trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) 96 / ft(as referred to site plan benchmark) <br /> Additional design/site considerations NA <br /> Parent material G1aF:141.1 Drift: Flood plain elevation,if applicable NA ft <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system [$S ❑ U J1 S ❑ U ® S ❑ U ® S ❑ U ®S ❑ U ❑S ® U <br /> SOIL DESCRIPTION REPORT <br /> Boris # Horizon Depth Dominant Color Mottles Structure GPD/ft2 <br /> Boring Texture Consistence Boundary Roots <br /> in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed , Trench <br /> 1 1 -8" 7.5 YR 3/2 ------------ is lmsbk mvfr esIf-co .7 .8 <br /> „.. � 2 8 '-26' 7.5 YR 5/4 ----------- is lmsbk mvfr gs If-M .7 .8 <br /> elev. <br /> Ground 3 26"-717.5 YR 5/6 ---------- s os ml — .7 .8 <br /> Y8—ft. <br /> Depth to <br /> limiting <br /> factor <br /> 73"in. <br /> Remarks: <br /> Boring # <br /> 1 0-9" 7.5 YR 3/2 ---------- is lmsbk mvfr cs3f-co .7 .8 <br /> 2 "-2817.5 YR 5/4 ----------- is lmsbk mvfr gs 3f-m <br /> .7 .8 <br /> 2 <' <br /> •;:..:..' 3 28"-72`7.5 YR 5/6 ----------- s osg ml -- — .7 .8 <br /> - <br /> round <br /> elev. <br /> Linuk _4 <br /> Depth to <br /> limiting <br /> fact9f <br /> >72 in. Remarks: <br /> CST Name (Please Print) Signature Telephone No. <br /> Wade Rufsholms(l715 <br /> Address Date CST Number <br /> 24702 Lind Road P.O. Box 514 Siren, WI 54872 9/22/98 3583 <br />