Laserfiche WebLink
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> County <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must <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. <br /> Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)1.)). 123,4V r07 <br /> Property_Owner Property Location <br /> rrP <br /> G r " GU Wej r) Govt.Lotib 114 11457 T 11 N R/5 (ortq <br /> Property Owner's Mailing Address Lot# I Block# ISubd.Name or CSM# <br /> IW,t6 Avon ck /a SV ir%1I D/nA'c e-Lb �Sm Uo% h p o-s <br /> CLBvy� .1 L State Zip Code Phone Number ❑City ❑Village QTown Nearest Road 2a817 <br /> /r 'In n27 GnFq 1411 S-53/Sl (gam-) 933-$30 Sc,cksw-j 1049 <br /> ® New Construction User Residential/Number of bedrooms;— Code derived design Bow rate� � GPD <br /> ❑Replacement ❑ Public or dal-Describe: _. <br /> Parent material G,IA c(a 0 Comm� Flood Plain elevation if applicableGeneral <br /> ments <br /> and recommendations: SL15 �^ �.��(/A l t D� R �'� ` a 83 93•aa] , <br /> 'jYtis Cp✓ 6e If rL¢e %v .rnka Grave ow� Gf <br /> a{pro G c�c,1-idtfuatGR 6m��. <br /> / Boring# ® Bor mg r „ nnGG <br /> ❑ pit Ground surface elev.q(( ft. Depth to limiting factor (_in. <br /> FSotiApOication Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPOM <br /> in. Munsell Ou,Sz. Cont Colo Gr.Sz.Sh. 'Eff#1 I 'EB#2 <br /> p-</ 15YlZ3 y,brc /S <br /> r16N/ S <br /> E] Boring <br /> Borim#ril ® Pit Ground surface elev. y" / ft. Depth to limiting factor /C• in. <br /> Soli Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIff <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 I •Eff#2 <br /> f V- 7.3YK3/ no-i,-a- LS w1 /f .7 /1 <br /> S-/o 7,5rrK Nse- S rvt n. /1-7- <br /> Effluent#1 =BOD >30<220 mg/L and TSS>30<150 mg/L 'Effluent#2-BOD <30 mg/L and TSS 130 mgt <br /> CST Name(Please Print) Signature CST Number <br /> Y1rc-c n2- A./14+�' S7/ <br /> Address V Date Evaluation Conducted Telephone Number <br /> oZs a3 I,We,66c.e z k lJr. /,/ m, 9-0 X59-73106 <br />