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Wisconsin Department of Commerce SOIL AND SITE EVALUATION <br /> Division of Safety and Buildings Page of <br /> Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code <br /> l ttach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County <br /> include,but not limited to: vertical and horizontal reference point(BM),direction and <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Pa el I.D.# <br /> p32 <br /> S304- <br /> APPLICANT INFORMATION- Please print all information. Reviewed by Date / <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner / Property Location !!! <br /> A N \404 0 CxEy Govt.Lott El/Y W 1/1,S 3oA,T AJA ,N,R `(o E(oQ�) <br /> Property Owner's Mailing Address I Lot# Block# Subd.Name or CSM# <br /> ST. 4 Valr 203 CA WcN Nc� go. \Jo L�qP . <br /> City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road <br /> VolISS IN. AAVDGJ W )ZQ, <br /> New Construction Use: Residential/Number of bedrooms Addition to existing building <br /> ❑ Replacement NPublic or commercial-Describe: <br /> Code derived daily flow " jVo gpd Recommended design loading rate :.1 bed,gpd/ft2_t4&_trench,gpd/ft2 <br /> Absorption area regyired A28bed,ft2 37� tren/gh,ft2 Maximum design loading rate .� bed,gpd/ft2 • $ trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) 12 .� /ALT. 9 j• ft(as referred to site plan benchmark) <br /> Additional design/site considerations •' <br /> Parent material (aLALlA. _ DIFF`(' Flood plain elevation,if applicable NA ft <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT'Grade System in Fill Holding Tank <br /> U = Unsuitable for system I'S ❑ U s ❑ U S ❑ u �S ❑ U VS ❑ u ❑ S 13 U <br /> SOIL DESCRIPTION REPORT <br /> Boring # Horizon Depth Dominant Color Mottles TexturenConsistence Boundary Roots GPD/ft2 <br /> in. Munsell Qu.Sz.Cont.Color Bed Trench <br /> Ground 3 7.s K 54 .7 $ <br /> Depth to <br /> limiting <br /> factor <br /> Remarks: A <br /> Boring # <br /> L 2 33 7.$ <br /> Ground <br /> elev. <br /> Depth to <br /> limiting <br /> fac or <br /> 7 in. Remarks: <br /> CST Name (Please Print) Signature Telephone No. <br /> 7.je_4AP �XISG4�_� S — S <br /> Add ess l u F J 1 CST Number <br /> 0 <br />