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Wisconsin Department of Industry, SOIL AND SITE EVALUATION <br /> Labor and Human Relations Page of <br /> Division of Safety and Buildings in accordance with s. ILHR 83.09,Wis. <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must County <br /> include,but not limited to: vertical and horizontal reference point(BM),direction and But2meTr <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <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 /> PAN SPENAiY Govt.Lot -749 1/4 1/4,S 7 T 46) ,N,R IS fells)W <br /> Property Owner's Mailing Address Lot# Block# rubd.Name or CSM# <br /> 280$ Ell-pct LjjtCA9AD Z CSA L•f Z <br /> City State Zip Code Phone Number Nearest Road <br /> MilifNCa ok MN. ( ) El City El Village1'4 rxp V ' 0ogGD7 L *61Sw666A RD <br /> ❑ New Construction Use: ❑Residential/Number of bedrooms Addition to existing building <br /> ❑ Replacement ❑Public or commercial-Describe: .S9 M)OLC- Lor Se r L Bo xjtiG <br /> Code derived daily flow gpd Recommended design loading rate bed,gpd/fl2 trench,gpd/ft2 <br /> Absorption area required bed,n2 trench,n2 Maximum design loading rate bed,gpd/flz trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) n(as referred to site plan benchmark) <br /> Additional design/site considerations <br /> Parent material Flood plain elevation,if applicable IViQ n <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U = unsuitable for system ❑ S ❑ u ❑ s ❑ U ❑S ❑ u ❑S ❑ U ❑ S ❑ U ❑ S ❑ U <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 <br /> in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed , Trench <br /> 13 I 6-4" 7,S YR 3/3 5fL <br /> 2 4 640 7.5 YR S/ S <br /> elev.und 40-So" 7.5 Y2 4/4 — C s <br /> _n. Q 50-72 7.S YR 411Aed S <br /> Depth to <br /> limiting <br /> factor <br /> in. <br /> Remarks: <br /> Boring# <br /> 13 <br /> Ground <br /> elev. <br /> n. <br /> Depth to <br /> limiting <br /> factor <br /> in. Remarks: <br /> CST Name (Please Print) Signature Telephone No. <br /> InArk E. Fi6l-429f <br /> Address Date CST Number <br /> Rok 99 WE99MR WIS . s44 s 3151?7 017/v <br />