Laserfiche WebLink
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of _ <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in sae.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. C <br /> Please print all information. Reviewed by Date- <br /> Personal <br /> atePersonal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Props Owner Property Location C. <br /> SAA) A-r GcvLLotN45- 1/4ItJ1/4 S,23T /O N R/5 E(o W <br /> Property Owner's rMailing AddressgqLot# Block# Subd.Name a CSM# / / <br /> /07 cuee/ /U� 'A GGA d , <br /> City State <br /> / State Zip Code Phone Number [I city ❑Village Nearest Roa <br /> pir `� 09A) SS3� c�G3 Ys /, �aYK s <br /> c 0 A-) Q-e 44VI-1 r <br /> SLNew Construction Use: Residential/Number of bedrooms _ Code derived design flow rate 5!�J d GPD <br /> ❑Replacement /7 ❑ Public pr commercial..Describe: r— <br /> Parent material Flood Plain elevation if applicable 10T/Y ft. <br /> General comments ,f <br /> and recommendations: 5�l S s� ��Cr ek�4in r, �� % 94.03 -(-o 9S <br /> T Boring# ElBoring p�/ <br /> Pit Ground surface elev. �ft. Depth to limiting factor 4 ( in. <br /> Soil Application Rate <br /> Horizon Depth Dorninant Cola Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 •Eff#2 <br /> a6� �' �e V r- k s ,z <br /> 0 i7 l, Z <br /> ® Boring# ❑ Boring <br /> ja Pit Ground surface elev. ft. Depth to limiting fade G in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDHF <br /> in. Munsell Qu.Sz. Cont.Cola Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> 7 Z- <br /> 3X,. <br /> Effluent#1 =BOD >30:5 220 mg/L and TSS>30<150 mg/L 'Effluent#2=BOD <30 mg/L and TSS<30 mg/L <br /> CST Name(Please ) Signatur CST Number <br /> '. - z- 711� <�/ <br /> Address Date Evaluation Conducted Telephone Number <br />