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Wisconsin Department of Commerce SOIL AND SITE EVALUATION <br /> Division of Safety and Buildings Page of Z <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 %J" '1 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <br /> APPLICANT INFORMATION- Please print all information. Reviewed by ofs t 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 /> ploy( pt� Govt.Lot 5 1/4 1/4,S 13 T 3, ,N.R 14 f4*W <br /> Property Owner`4 Mailing Add ss Lot If Block# Subd.Name or CSM# _ <br /> 1507 1506-- Ave— 5 L(.ri 5 or ern otildo 5 <br /> City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road <br /> Ce-vt 'w I LA . I 54Sai 1 ( ) 6- 32 IZttiSK to t0 A2. LAKE <br /> ❑ New Construction Use: ®Residential/Number of bedrooms _3 Addition to existing building <br /> ® Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow AP30 gpd Recommended design loading rate gibed,gpd1W jdA. trench,gpd/f12 <br /> Absorption area required N.T. bed,ft2 9.7' trench,ft2 Maximum design loading ratebed,gpd/ft2-trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s)Hb .* r /l�T ft(as referred to site plan benchmark) <br /> 5 t'RA.T <br /> Additional design/site considerations le't WnA 0-114r1,t�wt.•� t• 0�11L1� <br /> Parent material w wet at, tt <br /> Flood plain elevation,if applicable *c__ ft <br /> S = Suitable for system I Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system ❑ s Ku ❑S C&U ❑ s S u IE] s Klu I ❑S Ku I Ms ❑ u <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Structure GPD/ft2 <br /> in. Munsell Qu.Sz.Cont.Color Texture Gr.Sz.Sh. Consistence Boundary Roots <br /> ��77 1r 1 Bed , Trench <br /> L.iR15 t+► i A-,p..LT�/ v TNf-rn kT pavN nrtwvKS <br /> l -ff 1 hll6 �1 ��Yp 1L.AI�t-�i ToQ <br /> elevGround i+t�T h-i%Qf �}�ymt tJt t_lrnt cYA o-K 4) s per' IpOI <br /> -N-4-ft- L0 Z leje I►ifLf:s LA L.t + A. Can j.,,kVX F►Pct <br /> Depth to 6+ t <br /> limiting <br /> factor�1 <br /> f - <br /> Remarks: <br /> Boring# <br /> 13 <br /> Ground <br /> elev. <br /> _ft. <br /> Depth to <br /> limiting <br /> factor <br /> _in. Remarks: <br /> CST Name (Please Print) M & K Signature Telephone No. <br /> SEPTIC & EXCAVATION <br /> Address Spooner, 154801 Date CST Number <br /> (715)635-7482 <br />