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WiscoMin'Department of Commerce SOIL AND SITE EVALUATION Page 1 of <br /> Division ofSafeNand Buildings in accord with Comm 83.05,Wis.Adm. Code <br /> Attach complete site plan on paper not less than 8'/x 11 inches in size. Plan must County <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Burnett <br /> percent t1ope,scale or dimensions,north arrow,and location and distance to nearest road. <br /> Parcel I.D.# <br /> APPLICANT INFORMATION - Please print all infonnation. 028-4105-02-300 <br /> Personal information you provide may be used for secondary purposes(Privacy Law,a.15.04(1)(m)). Reviewed Date <br /> Property Owner Property Location / T <br /> Larson,Warren Govt.Lot NW 114 NW 114,S 5 T 40 ,N,R 14 W <br /> Property Owner's Mailing Address Lot# Block# I Subd.Name or CSM# <br /> 10117 Abbott AV S 5 Posvic Hoizinger Long Lk <br /> city Stake Zip Code PhoneNumber ❑City Villa e Town Nearest Road <br /> Minneapolis MN 55431 E Long Lk Rd <br /> Z New Construction Use: Z Residential/Number of bedrooms 2 ❑Addition to existing building <br /> n Replacement � Public or commercial describe <br /> Code Derived daily flow 300 gpt Recommended design loading rate .7 bed,gpolfF .8 trench,gpo1f12 <br /> Absorption area required 429 bed,ft' 375 trench,ftz Maximum design loading rate .7 bed,gpd/ft2 .8 trench,gpolft' <br /> Recommended infiltration surface elevation(s) 93ft(as referred to site plan benchmark) <br /> Additional design I site considerations cony bed <br /> Parent materialGlacial outwash Flood plain elevation, if applicable N/A ft <br /> S=Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U=Unsuitable for system NS ❑ U ® S ❑ U ® S ❑ U ® S ❑ U El ® U ❑ S ® U <br /> SOIL DESCRIPTION REPORT <br /> Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ffs <br /> Bonng# in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench <br /> 1 1 0-4 7.5YR3/2 none 1s <br /> 2 5-72 7.5YR5/6 none s <br /> Ground <br /> elev <br /> Depth to <br /> limiting <br /> factor <br /> >72 <br /> Remarks: Hand augered bore <br /> 1 0-4 7.5YR3/2 none )s <br /> 2 5-72 7.5YR5/6 none s <br /> Ground <br /> elev, <br /> 95'-7"ft. <br /> Depth to <br /> limiting <br /> factor <br /> >72 r <br /> Remarks: fland liked Ybte7 <br /> r, <br /> CST Name(Please Print) Signature: Telephone No. <br /> Wayne Nutt �ay,—tom 715-259-7366 <br /> Address Date CST Number Ref# <br /> 1571 Wehh r'reAc T h ive Wehh T.nlre WT SdR'10 F/19/97 2571 I nA <br />