Laserfiche WebLink
iconsinDepartment ofInd usby, SOIL AND SITE EVALUATION REPORT Page_of <br /> Wisconsin <br /> Human Relations <br /> inion of Safety&Buildings in accord with ILHR 83.05,Wis. Adm. Code <br /> COUNTY <br /> Attac'i complete site plan on paper not less than 81/2 x 11 inches in size.Plan must include,but U <br /> XdETr <br /> not limited to vertical and horizontal reference point(BM),direction and%of slope,scale or PARCEL I.D.# <br /> dime.sioned,north arrow,and location and distance to nearest road. N— o moo— �1 <br /> APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED a DATE <br /> PROPERTY OWNER: , PROPERTY LOCATION <br /> 'yo HN 0 $R lEtj GOVT.LOT 5 1/4 1/4,S IS T 3$ ,N,R iq E(or W) <br /> PROPEPTV OWNER':S MAILING ADDRESS LOT# BLOCK# SUSD.NAME OR CSM# <br /> Z ST. I2 I 1-u 'A <br /> CITY,STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE CWOWN NEAREST ROAD <br /> RulaSONt -9401 (a ITS) 3S1- 1194 . S <br /> XNew Construction Use DQ Residential/Number of bedrooms 3 [ ] Addition to existing building <br /> I ] Replacement [ ] Public or commercial describe <br /> Code derived daily flow ; gpd Recommended design loading rate •7 bed,gpd/ft2 .$ trench,gpd/ft2 <br /> Absorption area required ( 43 bed,ft2.51#S trench,9 Maximum design loading rate .7 bed,gpd/ft2 •$ trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) 99•(o It (as referred to site plan benchmark) <br /> Additional design/site considerations <br /> Parent material � .HGI A t- 'DfZ►4T Flood plain elevation,if applicable N13 It <br /> S=Suitable for system CO VENTIONAL J�1gUND IN- ROUND PRESSURE T-GRADE SY TEM IN FILL HOLDIN T K <br /> U-Unsuitable fors stem R'S El U Q9 S ❑U S ❑U �(S ❑U JoS ❑U Cl S U <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. Consistence Botndary Roots Bed. Trench <br /> S. p <br /> 0 - '7.$ R 317- �`— S M til 2-m -1 8 <br /> 2 (0- 105 -t.s R Lt ~� Ms Orfs <br /> Ground <br /> elev. <br /> 1q7--0 ft. <br /> Depth to <br /> limiting <br /> factor <br /> � L5 <br /> Remarks: <br /> Boring# <br /> I D G -7.5,18 a/7- ons M( CS 2�t 7 S <br /> 6-(,q7.S ft 4 ``_� MS QMS,t i,�I '�- 2M �] $ <br /> Ground <br /> elev. <br /> Depth to <br /> limiting <br /> factgr -• <br /> Remarks: `b <br /> T Name:—Please Printf clia)eDDazus Phone: _ p� <br /> Address: 2 .. 0 O�c <br /> Signature: Date: CST Number: <br /> -3 67D <br />