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Wisconsin Department of SOIL AND SITE EVALUATION REPORT Page i of 3 <br /> Labor and Human Relations <br /> Division of Safety&Buildings in accord with ILHR 83.05,Wis.Adm. Code <br /> COUN .( <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must include,but b <br /> not limited to vertical and horizontal reference point(BM),direction and%of slope,scale or PARCE I.D.# <br /> dimensioned, north arrow,and location and distance to nearest road. 07- f- -03-60 <br /> APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIE ED DATE <br /> )O-L <br /> PROPERTYOWNER PROPERTY LOCATION mct 6 <br /> 6i Rm GOVT.LOT `JE 1/4 QxZ 1/4,S 34 T &ft ,N,R I`I' W <br /> PROPERTY OWNER:SMAI ING ADDRESS LOT# BLOCK# SUBD.NAMEOI1CSM# <br /> lirm Foy- zpd� V/6' P 61 <br /> CITY,STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE [KrOWN NEAREST ROAD <br /> 4onYleW "); 54$00 ) , <br /> M New Construction Use X Residential/Number of bedrooms 2- [ ] Addition to existing building <br /> [ I Replacement [ ] Public or commercial describe <br /> Code derived daily Flow _�s on gpd Recommended design loading rate , -z bed,gpd/ 2_>S trench,gpd/ft2 <br /> Absorption area required 12.Q bed,ft2 $7 S trench,ft2 Maximum design loading rate •"7 bed,gpd/ 2 • 8 trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) _ 9a.8ft (as referred to site plan bench ar f <br /> Additional design/site considerations : MOOD' A • �cP o �<< 1� <br /> Parent material of qct sx cC2 } Flood plain elevation,if applicable a. ft <br /> S=Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE ' <br /> EM IN FILL HOLDING TANK <br /> U=Unsuitable fors stem ®S ❑U El ®U IR S ❑U ❑S BU ❑S ®U E3 S FLU <br /> SOIL DESCRIPTION REPORT <br /> Depth Dominant Color Mottles Structure GPD/ft <br /> Boring# Horizon in. Munsell Qu.Sz.Cont Color Texture Gr. Sz. Sh. Consisten Koury Roots Bed Trench <br /> -7.SY R3/z_ ivLo"Ke Q.o) I AvL!w< mJ <br /> `' -7 8 <br /> Ground <br /> elev. <br /> 9_+._3 ft. <br /> Depth to <br /> limiting <br /> factor <br /> 7z" <br /> 558.3 <br /> Remarks: <br /> Boring # 3 y <br /> -7.5YL2 3/z /Hc„e ms rc tMN4e Cd I f -7 $ <br /> Q <br /> Ground <br /> elev. <br /> qth4 ft. <br /> Depth to <br /> limiting <br /> factor <br /> az" <br /> $&4' Remarks: <br /> CST Name:—Please PrintSEPTIC & IXCAVA I ILIN Phone: <br /> Address: , IJOX <br /> Sgnature: r SIXIGAGF-, <br /> T Number: <br /> (715)635-7482 Date: <br /> /D-i6,y5 �,m3fobrj' <br /> I <br />