Laserfiche WebLink
Ws.Dept.of Safety and Professional Services SOIL EVALUATION REPORT Page of_ <br /> Divisbn of Safety and Ruildionx <br /> in accordance with SPS 385,Wis. Adm. Code <br /> Attach complete site plan on paper not less Than 8 1/2 x 11 inches in size.Plan must County BURNETT <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel IG O 7 0/>?' a 3 q /( a 5- <br /> percent slope.scale or dimensions.north arrow,and location and distance to nearest road. -p, o 2 o <br /> PleaSe print all IflfOrmatlOR, R.Newed by Dale <br /> Pantos ndormadoa yov Pmvma may ea used or secmmsry PmPosaa tpnwey Lav,,s. Is on Itl tm)7. <br /> Property Owner GK/F/G <br /> f r <br /> Property Location <br /> / - 2r' U x / GovL Lot 1/4 1/4 S,7-'T--T 3 y N R / E(«)W <br /> Property Owners Mailing Adtlress// Lot/p Block# Subd-NameorCSM# <br /> S. a -" // — V aD ZR`J <br /> City Slate Zip Code Phone Number <br /> ily ❑Village L21royn Nearest-Road <br /> p / <br /> GoIrfe Jd*� AIV SSYza (7d3 )a3Y-/ 03 a e- / Jo/J -rSYs /e�e <br /> New Construction Use®.Residential/Number of bedrooms .'� Code derived design flow rate Sod _GPD <br /> ❑Replacement ❑ Public or COMM e/rcial-Describe: <br /> Parent material (�/i9 G iA/ 4�' T"7` Flood Plnin elevation if applicable ///f/- ry, <br /> General commands; <br /> and recommendation: <br /> Bo ng# <br /> ❑ Baring <br /> apil Ground surface elev. 97 fl. Depth to limiting factor _in. <br /> Sail Application Rate <br /> Horizon I Depth Dominant not Redox Description Texture Structure onsistence oundary Roots GPD/t <br /> in. Munsell Ou,Sm Cont,Calor Gr.Sz.Sh. ff#1 R#2 <br /> 415 /r5 6 r /rcKi — 3 . Y <br /> Bonn # ® Boring <br /> [j pit Ground surface elev. 9&1, 7 ft. Depth to limiting factor— in. <br /> r - gSoil Application Rate <br /> Horizon Depth 1, Dominani Color . Boom,Description RTe.t�m Structure onsistence oundary Roofs GPDRt ° <br /> in. Munsell Qu.Sz. Cont.ColorGr.Sz.Sh. ff#1 ff#2 <br /> o - 7 3 . �-S <br /> 'Effluent 91 -BOD ,>30<220 rg)L add TSS>30 <150 mg/L 'Effluent#2=BOD <30 gA-and TSS <30 nVIL <br /> CST Name(Please Print) Signature CST Number <br /> WADERUFSHOLM ori 227691 <br /> Address Date aluation Conducted Telephone Number <br /> z9-4 <br /> sY�s72 y-mss- iy S'9'-� <br />