Laserfiche WebLink
Wisconsin Department of Industry, SOIL AND SITE EVALUATION a Pa of <br /> Labor and Human flelations 9 <br /> Division of Safety and Buildings in accordance with s. ILHR 83.09,Wis. <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 . <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���`/ 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 /> Ft/1l�S Govt.Lot I ,V t✓ 1/4 1/eF1/4,S T 416 ,N,R E(or)CM <br /> Property Owner's Mailing Address Lot# Block# I Subd.Name or CSM# <br /> City State Zip Code Phone Number <br /> CitQ ageTownNearest Road <br /> RvCk `er � 4-t� `1DJ ( ed/ <br /> New Construction Use: P§Residential/Number of bedrooms Addition to existing building <br /> Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow gpd Recommended design loading rate i 7 bed,gpd/fl2 —,.V—trench,gpd/fl2 <br /> Absorption area required _bed,ft2 5 trench,n2 Maximum design loading rate bed,gpd/ft2___,_2_trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) 577, 6 n(as referred to site plan benchmark) <br /> Additional design/site considerations I <br /> Parent material 6y-1Ac-I A-� CA r,, f Flood plain elevation,if applicable /V/4 n <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system cgs [:iu MS El �s ❑ u O S ❑ u K s El [_] s ® u <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 <br /> in. Munsell ou.Sz.Cont.Color Gr.Sz.Sh. Bed Trench <br /> J r C s <br /> a -d9 7,3- X / — / a61 C0 <br /> Ground y-.7..2 i.1 /f <br /> elev. <br /> Depth to <br /> limiting <br /> factor <br /> ;,7,7 in. <br /> C)�,'d Remarks: <br /> Boring# p <br /> O— , t A � c- <br /> 13J ,_5- q y//, /S rns /c J S s1-c d� <br /> Ground <br /> elev. <br /> 2b- <br /> Depth to <br /> limiting <br /> factor <br /> 1171 <br /> in. Remarks: <br /> CST Name (Please Print) Signature Telephone No. <br /> Address , Date CST Number <br />