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2005/10/31 - SANITARY - SAN - Other
Burnett-County
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TOWN OF JACKSON
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7163
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2005/10/31 - SANITARY - SAN - Other
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Last modified
3/5/2020 10:40:51 PM
Creation date
10/4/2017 6:07:29 PM
Metadata
Fields
Template:
Property Files v2
Document Date
10/31/2005
Document Type 1
SANITARY
Document Type 2
SAN
Document Type 3
Other
Tax ID
7163
Pin Number
07-012-2-40-15-27-5 15-155-134000
Legacy Pin
012927516500
Municipality
TOWN OF JACKSON
Owner Name
ANGELIKA CEGIELSKI
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Wisconsin Department of commerce SOIL EVALUATION REPORT Page of 3 <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> Attach complete site plan on paper not less than 8 7/2 x 11 inches in size.Plan must Oo"h' 914rn ell <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and parcel I.D. rr // <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. U �� -1 a�.5'�l0 - (/J <br /> Please print all information. Rev Date <br /> P,usonal information you provide they be used for secondary purposes(Privacy Lae•,s.15.04(1)(m)). <br /> Property Owner0a Property Location <br /> To m 194 wa r4 Govt.Lot SE- 1/41VC 1/4 S T </p N R /S' E(orf <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSW <br /> &ct clq /S+h St. P/ace Al /rr� <br /> City State Zip Code Phone Number ❑City []Village ®Town Nearest Road <br /> Ookcia.le IM111 I S--S-/d.Ir I ((,r/ ) 7317- 97IS- ,Jeae.Eson (iron trail <br /> Q New Construction Use: Residential/Number of bedrooms Code derived design flow rate JO GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material 4(nc i a( D'-i><rt Flood Plain elevation if applicable � ft <br /> General comments s/,s• e/e✓. 9a • (� <br /> and recommendations: <br /> F/ <br /> Boring# ❑ Boring <br /> ® Pit Ground surface elev. 9-S 6 ft. Depth to limiting factor > 7� in. <br /> Soil Applicartiori Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM <br /> in. Munsell ou.Sz. Cont Color Gr.Sz.Sh. •Eff#1 I •Eff#2 <br /> O-q /Ms6k w / c 3ee7 7 <br /> d Y-A� /-.4Ak G S Seo '7 <br /> F-11Boring# ❑ Bourg 171- 7 7 <br /> ® pit Ground surface elev. F'•• Y ft. Depth to limiting feclor�/in. <br /> soil Applicartiont Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2 <br /> l b_ 4f /S //rr.56k- In l GS 3C0 . 7 <br /> .L <br /> '/- 3A 7.5-''/14/4 If lns/,� ( GS Sia . 7 l.aC <br /> 5-e--77 7 — s osc / '-_ 5 - .7 /.A <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30<150 mg/L •Effluent#2=B00 <30 mg/L and TSS<30 mg/L <br /> CST Name(Please Prim) Signature CST Number <br /> ') Es S. Qani-e(S S ot73c/t0 <br /> Address Date Evaluation Conducted Telephone Number <br /> ol, 7760 #t,-,Y3s `ve&7f w1 srtirf-? .tj�,' - sir> <br />
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