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wiseonsdnUbpar (Commerce <br /> Drision of SaSOIL AND SITE EVALUATION <br /> 'nfely and andB Buildings <br /> in accord with Comm 83.05,Wis.Adm. Code Page 1 of <br /> Attach complete site plan on paper not less than 8%x 11 inches in size. Plan must <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and County <br /> Percent slope,scale or dimemsions,north arrow,and location and distance to nearest road. <br /> Burnett <br /> APPLICANT INFORMATION- please print all infonnadon. Parcel I.D.# <br /> Personal information you provide maybe used for secondary purposesy 006-2414-Ol 800 <br /> (privacy Law,s.15.04(t)(m)). Reviewed By Date a <br /> [23976 <br /> ty Owner �� <br /> er,Tim Propertylocation <br /> Govt.Lot E ''-NE 1/4 NW 1/4 S 14 T 38 N,R 17 W <br /> Y Owner s Mailing7 Addre7ss Lot# Block# Subd.Name or CSMA <br /> m777 <br /> Tollander Rd State na naNa <br /> Zip Code PhoneNumber �City Lj village ®Town Nearet Road <br /> WI 54872 715-349-5192 <br /> Daniels Daniels 70 <br /> Z New Construction Residential/Number of bedrooms <br /> ❑ Replacement Use* Residential to existing building <br /> Public or commercial describe <br /> Code Derived daily flow gpd Recommended design loading rate bed, dlft° <br /> Absor tion area required bed, 9P trench,gpolit= <br /> Recommended infiltration surface elevation(s) trench,ftz n Maximum design loading rate bed,gpolfl° trench,gpolil$ <br /> Additional design/site considerations for Ffi,Y oni ft(as referred to site plan benchmark) <br /> EParent material <br /> table for system Conventional Mound Flood Iainelevation,if a licable ftsuitable for system In-Ground Pressure AT-Grade System in Fill <br /> ❑S ® U S 1 ❑ S ® U g ® U Holding Tank <br /> SOIL DESCRIPTION REPORT s ® u s ® u <br /> Boring# Horizon Depth Dominent Color Mottles Structure <br /> in. Munsell Qu.Sz.Cont Color Texture Consistence Boundary Roots GPS <br /> Gr.Sz.Sh. ry --T_ <br /> 1 1 0-8 l OYR 4/4 none si Bed Trench <br /> 2 8-15 10YR5/4 none <br /> Si <br /> Ground 3 15-30 l0YR 5/4 <br /> elev c2d 5YR 5/8 silcl <br /> 98.15 It <br /> Depth to <br /> limiting <br /> factor <br /> 15" <br /> Remarks: boring for privy only <br /> J.CST Name(Please Print) Signature: <br /> Joan E Daniels �� � Telephone No. <br /> Address PO Box 316,Siren,WI 54872 715-349-5533 <br /> Date CST Number Ref# <br /> 10/15/99 223463 163 <br /> S 1 <br /> rl V <br /> 6t <br />