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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page�af 3 <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> y <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must County <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. ©QI 6 ;Z 5o o c46 :200 <br /> Please print all information. Reviewed Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner / Property Location �C J <br /> 6rll/ !�e�s Govt.Lot J-5- 1/4 1/41 S.21 T 39 N R 1 7 E(o�W <br /> Property Owner's Mailing Address Lot# Block# Subd.N or CSWKiN S (0 ur 4r. <br /> City Srate Zip Cod6 Phone Number ❑City ❑Villa e � Nearest R d <br /> r� f►•� .yt.� <br /> j,— Construction Use:[:Nesidential/Number of bedrooms Z Code derived design flow rale GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material C ��9 C:A/ U/`j f rf Flood Plain elevation if applipbl <br /> General comments <br /> and recommendations: O N <br /> 5�¢v.L �CEril9>/aw S 9T. 60 60 97,215> A� <br /> Boring# I❑ Boring <br /> t m Pit Ground surface elev. Depth to limiting factor ->57 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence ndary Roots GPDW <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff ll 'Eff#2 <br /> I 0- 0 / r <br /> s i/-n d v 1--ea 5 <br /> Yy 7-Af sb , s , 'Y� <br /> ® Boring# ❑ Boring pn C <br /> Er—pit Ground surface elev. l�J/ ft. Depth to limiting factor> in. <br /> Sal Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 I Efl#2 <br /> 0-6 7 / S /)2:r`k tW S . 7 1-.6 <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30<150 mg/L 'Effluent#2=BOD 30 mg/L and TSS 130 mg/L <br /> CST Name(PleasePnCST Nunter <br /> � S' nature <br /> Address Date Evaluation Conducted Telephone Number <br /> Bo 5`/ sig e , �,✓� 5 872 8- -a 5— �S/ -7.2 d 6 <br />