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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page i _of 3 <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code n�1 <br /> Uurn pYl' <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 Parcel I.D. <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. O d 7 dl,O <br /> Please print all information. Reviewed by „ Date t� <br /> Personal infannation you provide may be used for secondary W rposes(Privacy Law,a.15.04(1)(m)). I.Z Ai4 it j <br /> Property Owner Property Location <br /> Lori N- 7e 6d ZAegan Govt.Lot 1/4 1/4 S 8 T y0 N R /y E(or) <br /> Property Owner's Mailing Address Lot# I Block# I Subd.Name or CSM# <br /> `� O 1//s Wrew E. I CSL V' I'L 4 <br /> City State Zip Code Phone Number ❑city EI Village ®Town Nearest Road A 906 d <br /> Rose vitte 1 MN I SS / (6s / )98 - 8.13A Sea A/ I Lon LK Rao <br /> New Construction Use:® Residential 1 Number of bedrooms 3 Code derived design flow rate 4 so GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material G4r4r4 Flood Plain elevation if applicable /f/'//9 ft <br /> General comments <br /> and recommendations: Sys. e le✓. 910 (90. s 3 e5o 93.L <br /> / Boring# ❑ Boring <br /> ® Pit Ground surface slay. 96. 0 ft. Depth to limiting factor 9,V in. <br /> Soil Application Rate <br /> Hortzon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2 <br /> 0 -0 7.SYR % /J /msb/< / C 3.n . 7 /.6 <br /> d v- 40 7.srR 4/g — S OSS 1 G s 3co 7 /, 6 <br /> 3 40-`18 7.S-51,?r/q <br /> w;oh S•Yr?s/G /Ane//a. bw� .f fS oc5 Yn.,f� — — , $ J.o <br /> Bong# ❑ Boring <br /> © Pit Ground surface elev. ft. Depth to limiting factor /Ori` in. <br /> Soil icetionRate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'EB#1 •Eff#2 <br /> / <br /> -4, . 7>.sYi?3I� .� / <s s» . 7 /. 6 <br /> d y- 40 7.sy/� �/Y — S 0s6 .r11 4s 9c49 , 7 A <br /> 3 yo-/ea Y/? r/y S os e. / — — •7 /- 9 <br /> . rrr S-rR %` /4» c//4 64h Fs os, n,vFv — — S bo, <br /> =# <br /> Effluent#1 =BOD >30<220 mglL and TSS>30:5 150 nVL •EMuent#2=BOD,:5 30 mglL and TSS<30 mglL <br /> Nam CST Na (Please Prim) _ _ Signature p CST Number <br /> JAM es S rQ/S -.5- ,..te�j 73%L 0 <br /> Address V Date Evaluation Conducted Telephone Number <br /> 77 O w 3.4— tvebsder WS Sy993 S-d. — O(, 7/S- 966 — y/s'7 <br />