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Wisconsin Department of commerce SOIL EVALUATION REPORT <br /> Division of Safety and Buildings Page_of_ <br /> in a ante with Comm 85,Wis. Adm. Code ..{.� <br /> ,1 /1 <br /> Attach complete site plan on paper not less t an 8 1/2 x 11 inches in size.Plan must County CA r `e <br /> Include,but not limited to:vertical and horizo ital reference point(BM),direction and Pel I.D. <br /> percent slope,scale or dimensions,north arr Yw,and location and distance to nearest road. Ll 0/ /0 <br /> Please print al infom►ation. Reviewed by Date D <br /> Personal information you provide may be used for secondary purposes(Privacy Law.e.15.04(1)(m))• ZrA 10 <br /> Prop"Owner Property Location /Z <br /> Ri4hard q- Ti, ere5i / Os"SG &/ Govt.Lot /t/LC 1/4 N6,11/4 S A4 T yD N R IS'- E(or <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM* <br /> 7175— 611e,S Gt f)l e5hl 13,0.q <br /> Cay State p ode NNumber ❑city El village ®Town Nearest Road u <br /> W'P-b5fr✓ I U/i 913 71r ) A6&-9H97 LA16/fSOvl 1 b'4.1nn-,r Ll� <br /> ® New Construction Use: Residential! umber of bedrooms_3 Code derived design flow rate 4S 0 GPD <br /> ❑Replacement ❑ Public or oorr mercial-Describe: <br /> Parent material !_14e is / o r/, 1" Flood Plain elevation if applicable ft. <br /> General commc c n 1t r+15 rn< iJlQ r'1 k rm eve rO C% ��e d: 61©5 y„17 <br /> and recommendations: rep/At r l r r r a C-3.3 <br /> 1. Boring# El Boring <br /> ® pit Ground surfacApelev._ ft. Depth to limiting factor in. <br /> Soilkation Rate <br /> Horizon 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 /> f 0--41 7.S--M -/d /S /M-4/<' m 1 e 1 3,-0 /r <br /> `!-yf/ 7,5 S n <0 / 5 5 3 M 17 11A <br /> 3 L <br /> Boring# ❑ Boring <br /> 0 Pit Ground surlao i elev.yb�—ft. Depth to limiting factor � � 7 in. Soil kation Rate <br /> Horizon Depth Dominant ColorR x Description Texture Structure Consistence Boundary Roots GPD/IF <br /> In. Munsell Qu. . Cont.Color Gr.Sz.Sh. `Eff#1 •Eff#2 <br /> �s-i d is /h, /c al i c S' -3 co- 7 6;k <br /> LI ria -f 7S-V s` 5 0.55 ev-1 ► 5 • -7 <br /> Effluent#1 =BOD >30:S 220 and TSS>30<150 mg/l. `Effluent#2=BOD.:< nV&and TSS 130 mg(L <br /> CST Nemo (Please Print) CST- tune CST Number <br /> tjitm,F-s 5, / NLS( 7 <br /> Address Date Evaluation Conducted Telephone umber <br /> ` o- 1 - d �/-,Q. /3&x 6Y L5-q 7s6 - sd- <br />