Laserfiche WebLink
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page_�of <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> County <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must 6"r-n407`f <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/4 'd-104 - 65'706 <br /> Please print all information. Reviewed b Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner Property Location LV <br /> 7004 Gbu�'e GovL Lot SR- 1/4 /VWi14 S T 3 i N R /S E(or <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> 9,00 /K"r 70 -(;M V, g <br /> City State Zip Code Phone Number ❑city [:]Village ®Town Nearest Road <br /> Srreot 1 ws I S9g7d ( 711r) 3,91? ?SS /-A F"o/l'cfi�e- 1rluiy 70 <br /> ❑ New Construction Use:0 Residential/Number of bedrooms a Code derived design flow rate GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material L/,la,1a/ Flood Plain elevation if applicable —ft. <br /> General comments p <br /> and recommendations: S/'s' 9/• 7 (93,5(7 Eo 9/, 70) <br /> �O✓i X15' .Z <br /> /yer-:Z#n 4 r...:fl� %&rr 4?a,oPs s444ys <br /> Boring# <br /> ❑ Boring <br /> ® Pit Ground surface elev. ft. Depth to limiting factor in. <br /> 5oii'-Appiication Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDRP <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2 <br /> 01 9-oto 7..r rI? e/y — /s o s.r/ 6 S 3co ' 7 1.6 <br /> 3 0- Y8 7s'r/r `'/y -- /f s o r. / Gs al 01 S /.d <br /> Sr Yd'- 7/0 7.s 9,/P /mss o � / <br /> ® Boring# Boring <br /> ® Pit Ground surface elev. '170 ft. Depth to limiting factor n. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •EfW <br /> / 6- e4 7,s/� /,� — /S 10 w+ l cs 3m . 7 6 <br /> at <br /> Cr'? v� ics o r G S �.n .S` /,O <br /> •Effluent#1 =BOD >30<220 ng1L and TSS>30<150 mg/L •Effluent#2=BOD,:5 30 mg/L and TSS<30 mg1L <br /> CST Name(Please Print) Signature n CST Number <br /> JAift 0473 iVa <br /> Address Date Evaluation Conducted Telephone Number <br /> )7760 //r 3-5—U4e6S:`ee Gi/1 Sy�?3 /a-�a4 S/Ja.Kuh <br />