Laserfiche WebLink
nt of <br /> Labor and Human <br /> SOIL AND SITE EVALUATION REPORT Page_of_ <br /> Labor and Human Relations <br /> Division of Safety&Buildings in accord with ILHR 83.05,Wis. Adm. Code <br /> COUNTY <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must include,but y'R <br /> not limited to vertical and horizontal reference point(BM),direction and%of slope,scale or PARCEL I.D.# <br /> dimensioned, north arrow,and location and distance to nearest road. I a— q&-7rjJRE <br /> APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION REVIEWED BY <br /> PROPERTY OWNER:rr PROPERTY LOCATION <br /> -FALPH C GOVT.LOT 1/4 1/4,S T O <br /> PROPERTY OWNERS MAILING ADDRESS LOT i BLOCK# SUB .NAME OR CSM# <br /> Rc}{ R b J- <br /> U IY,STATE ZIP CODE PHONE NUMBER 0 <br /> .r.-5640 4i� OS []CITY VILLAGE OWN NEAREST ROAD <br /> A" Mood Dg­ <br /> New Construction Use)4 Residential/Number of bedroomsA 1. <br /> [ ] Replacement [ ] Public or commercial describe [ 1 ddition to existing building <br /> Code derived dairy flowo0 gpd Recommended design loading rate •7 bed,gpd/ft2 .S trench,gpd/ft2 <br /> Absorption area required tF l bed,ft2�_tren f9,ft2 Maximum design loading rate .1 bed,gpd/ft2 . $ trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) q.S 9!r 1,> ft (as refeved to site plan benchmark) <br /> Additional design/site considerations <br /> Parent material AM(,& DQI f r Flood plain elevation,if applicable /(/g ft <br /> S=Suitable for system C VENTIONAL M iUND IN-GROUND PRESSURE AT-GRADE SY TEM IN FILL HOLDING TANK <br /> U=Unsuitable fors stem S ❑U S ❑U S ❑U Us ❑U VS ElU ❑S ;U <br /> SOIL DESCRIPTION REPORT <br /> Boring # Horizon Depth I Dominant Color Mottles Structure L GPD/ft <br /> in. Munsell Cu.Sz.Cont.Color <br /> Texture Gr. Consistence Boundary Roots <br /> Sz. Sh. Bed Trendl <br /> /S OMS M I 2v� .'T $ <br /> >`< 2 5, 7.5 K y <br /> /S M <br /> Ground <br /> elev. <br /> ILA ft. <br /> Depth to <br /> limiting <br /> fact r <br /> (65 <br /> Remarks: <br /> Boring# <br /> 7. S\. 3 Z <br /> Ground <br /> elev. <br /> q ft. <br /> Depth to <br /> limiting <br /> factor- <br /> ��� Remarks: <br /> CST Name:—Please Print kl�A D OPK! S Phone: <br /> Address: <br /> :i-7760 W/• 93 <br /> Signature: _ Date: CST Number: <br /> -1 G o <br />