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WisoonsinDepartment ofCommerce SOIL EVALUATION REPORT <br /> Division of Safety and Buildings Page of 3 <br /> in accordance with Comm 85,Wis. Adm. Code //�� <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must County CJ t4.r h ' <br /> include-but not United to:vertical and horizontal reference point(BM),direction and11 <br /> Percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D. O d o <br /> 33 04 /do <br /> Please print all information. Review y nate <br /> Panoral iMomhafior you Provlda may b*used for snowdary Purpesas(Privacy Law.s.15.04(1)(m)), <br /> Property owner p Property Location l O <br /> P (�F Mal / ic.i t,'td.,f Govt_Lot � "<W 1/4 N�114 S 33 T qQ N R /6 E(or <br /> roPerty DMa1erS Mai Address Lot# Black# Slrbd Name a CSM# <br /> a�7��9 JeA-r-) ej Rd ) <br /> Gly Slate <br /> Zip Phone Number GS/h1 y <br /> W E L S'yr w ( ) �Ob� g736 ❑City ❑�Ilags ®Town Nearest Road <br /> P SY8`t.3 7 S` Ot?kland Sfvhe fe /��. <br /> ® New Construction Use:IN Residential/Number of bedrooms <br /> _ — Code derived design flow rate <br /> O Replacement ❑ Public ar commercial-Describe: G?0 <br /> Parent material 6-10-e-I eA/ /J r 4 <br /> General comments <br /> Flood Plain elevation if applicable <br /> ! <br /> and recommendations: 4?d"r^SS 3 /to a rr bands tfS SYR 1/t7 R. <br /> CIO <br /> Boring# nn❑ Boring <br /> l� Pit Ground surface elev. 93. R Depth to limiting factor > $'l in. <br /> Horizon Deprih Dominant Redox Description Texture Structure Consistence Bounds Roots Sad Application GPORale ! <br /> in. Munsell Qu.SZ. Cont Color Boundary GPD/fF <br /> Gr.Sz.Sh. 'Et?#1 •Eq>2 <br /> I o-4 7srRM.1, /s lry,s3k <br /> a, Y-30 7.SYR 4/ h 1 G S SCO 7 A I ; <br /> /S /mak, m (- S Seo 7 <br /> k G S d.rA <br /> ms/6r mS 1 <br /> Bonn# ❑ Boring y <br /> �'f q <br /> L - I Pit Ground surface eiev. / t. Depth to limiting fa Cor > f�_ <br /> 'n. <br /> Honzon Depth Dominant Colort Redox Descripticn I Texture Structure I I Sod?ecucat on Rate <br /> Consistence 9cundaryl Rats GPD/`F <br /> / in. Munsell I Cu.Sz. Cont.Coicr Gr. SZ. Sn. <br /> 7 S•r� 4//t_ <br /> I /ms.6k ; y,, 1 45 ! 3c'D <br /> -4J- <br /> 7-f /s I/in 1Z A- t 1 -6--5. 3 5 .7 ': I r oZ <br /> 3 I`/d-GNs/y I -- s74 ; al s6k ,y1� GS <br /> Y I/o�98 7.srR si +► I res �r l OS9 IYt � I �s I �- I r �] A o1 <br /> i <br /> Effluent X1 =BCD. >30<:20 mgiL and 73S >'0< i 50 m •c= <br /> - - g Ler,:a 30 <br /> 2 = _CD. <30 mgrL and'SS < mqL <br /> CST Name (Ple�c.. o.:.,.. Signatu <br /> J rg p"Es S• DAA/t,°& n CST Numoer <br /> Address 'r 'to S lJ�wuq,0 a 73 4 d CJ" <br /> .a <br /> . te cvaivauon Ccnducted tNto <br /> TeleneNumcer <br /> ZI X60 3 (iv 6h/e� W. 5` 3 (7/0 - 4rlf 7 <br />