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wiscoasin 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 8 1/2 x 11 inches in size. Plan must County <br /> include,but not limited to: vertical and horizontal reference pant(BM),direction and <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. PAIrcel I.D.# <br /> 19 3 02 6,00 <br /> APPLICANT INFORMATION- Please print all information. Reviewed by Date V/jY Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner Property Location <br /> Govt.Lot 1/4 Nk/1/4,S I-, T-3q ,N,R I io E(or W� <br /> Property Owner's Mal ing Address Lot# Block# I Subd.Name or CSM# <br /> 210 oX ogp 5.S <br /> City State Zip Code Phone Number ❑ city ❑ Village U] Town Nearest Road <br /> 5'r• u>, tJ5���,,91103 ( BIZ )4%-320 FEENe Co. RD. x <br /> New Construction Use: yql Residential/Number of bedrooms 2 Addition to existing building <br /> Replacement ❑Public or commercial-Describe: <br /> Code derived daily How 3C>C> gpd Recommended design loading rate bed,gpd/ftz .(o trench,gpd/ft2 <br /> Absorption area required bed,ft2__";00 trench,ft2 Maximum design loading rate •S bed,gpd* •(o trench.gpd* <br /> Recommended infiltration surface elevation(s) /7 ft(as referred to site plan benchmark) <br /> Additional design/site considerations <br /> Parent materiel Flood plain'slevation,if applicable NA ft <br /> S = Suitable for system Conventional Mound In-Ground Pressure IAT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system El R) U �s U ❑s Q u ❑s O u ❑S & U ❑S P U <br /> _186, DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/f12 <br /> in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed '.Trench <br /> s 1 5 4 - s 6 <br /> 2 6-32 9 co <br /> Ground <br /> ft C2 d 5 rzs C ^-' P <br /> Depth to <br /> limiting <br /> factor <br /> 3Z_in. <br /> Remarks: <br /> Boring# <br /> -7 s ds l s 2Vf ' .6 <br /> 2 2 1 ' ,t4 i f Zco .S L <br /> 3 7 G2dWX <br /> nGround <br /> ft. <br /> Depth to <br /> limiting <br /> factor <br /> in. Remarks: <br /> CST Name (Please Print) Signature Telephone No. <br /> 91444420l✓s -1 <br /> Addrellm Date CST Number <br /> 27 v .Ss 1/. F—osTE12 \,•I1. S4$`i3 -Z4- JS 2476 <br />