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WiisconsinDepartment ofIndustry, SOIL AND SITE EVALUATION REPORT , - Page_Loft <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 <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. <br /> APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE <br /> PROPERTY OWNER: PROPERTY LOCATION <br /> 15 . 1 GOVT.LOT ty-3 1/4 f}E, 114,S IS T 39 ,N,R /yt lam)W <br /> PROPERTY OWNER':= ILI ADDRESS LOT If BLOCK# I SUED.NAN IE OR CSM# <br /> CITY,STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE MOWN NEAREST ROAD <br /> t Jt Soso/ I ) siert De srT�ft- <br /> ( ] New Construction Use [)Q, Residential/Number of bedrooms 3 [ ] Addition to existing building <br /> K Replacement [ ] Public or commercial describe <br /> Code derived daily Flow 46o gpd Recommended design loading rate 7 bed, pd/112 ,8 trench,gpd/112 <br /> Absorption area required eo4a bed,ft2 543 trench,112 Maximum design loading rate '7 bed, pd/ft2_trench,gpd/112 <br /> Recommended infiltration surface elevation(s) ft (as referred to site plan N nchmark) <br /> Additional design/site considerations A Bm EIeJ•Too. .F (•1e.+ <br /> Parent material�l ac IA L AR i Flood plain elevation,if appli le lea=ft <br /> S=Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE I AT-GRADE SYSTEM IN RLL HOLDING TANK <br /> U=Unsuitable for s stem 0 S ❑U JoS ❑U IK S ❑U In S ❑U ❑S D$U ❑S ELU <br /> SOIL DESCRIPTION REPORT <br /> Boring Horizon Depth Dominant Color Mottles Texture Structure Cons ceBourxisry Roots GPD/ft <br /> in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. Bed ITw& <br /> I 1 4•' 7.sYRs r in.-•,.e 4& l m rMIJAf a4.J 3J1P . -7 .8 <br /> 4-2 -7.sv2 <br /> Ground .71--7S w ohe <br /> elev. <br /> Depthto <br /> limiting <br /> factor <br /> Remarks: x <br /> Boring# <br /> Z 7, - ii6 7.541Aq/4 -73 <br /> • 8 <br /> Ground 3 11--73' 7.5 Y/2 '/ ir,. Q. n„aX . 7 ': •8 <br /> elev. <br /> 95�z ft. <br /> Depth to <br /> limiting <br /> 7d Remarks: <br /> T Name:--Please Print M & K Phone: <br /> SEPTIC & MINIMUM <br /> Address: HCR 59, BOX 4784 <br /> Signature: Spooner, WI W1 Date: CST Number: <br />