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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of--3 <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 8112 x 1 t inches in size.Plan must <br /> COunty l3u rA$T//t <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Pam I.D. 0 7 a J J 4! 1fe7 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. mee 0/.4 00, <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)(m)). B J I SID <br /> Property Owner //�� Property Location �f�'I" <br /> .S40-W 11.0 CN/N .GOA:bol NQ) 1/4 WVA14 S36 T 4/ N R /to E(or)® <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# 3 0 708 <br /> /0 S 70 – 6'744 sr. Al. 1 v,JA P 79 <br /> City State Zip Code Phone Number ❑City [-]Village [3Town Nearest Road ,?9965 <br /> $ft((W&f++ MN I I$W'490A I ( ) j'Wt 3 -SI ohpierv4 DAA R4@ <br /> EZ New Construction Use:® Residential/Number of bedrooms H Code derived design flow rate 6 0 0 GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material _ GILc t4 l f.7+'��' Flood Plain elevation if applicable N1/9 ft. <br /> General comments <br /> andrecommendations: SjJ, e16✓ 9/4Q (9/,17 & 9foo)e�. <br /> Papput ds /ooc - k4nelt a Sal <br /> © Boring# ❑ Boring <br /> m Pit Ground surface elev. I's" G ft. Depth to limiting factor > 82 in. Shc Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKF <br /> in. Munsell Ou.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 I 'Eff#2 <br /> 7.S1R 14% — /S /Mfb/c wr 1 <s -j . 7 /. 6 <br /> d - 3'j 7.d4R4/q — j S .lrrai/4 is+ 1 GS ace . 7 /. 4 <br /> 3y- Ja 7.S-YR — S asG. 1 G S A /. 6 <br /> -d} 17,4--re ' V — s Osu , , 1 — — ' 7 1. 6 <br /> a Boring# ❑ Boring <br /> © Pit Ground surface elev. 7S' 3 ft. Depth to limiting factor !6 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/1F <br /> in. Munsell Qu.Sz. Cont.Cola Gr.Sz.Sh. •Eff#1 I •Eff#2 <br /> d 7.SY1? a/A — /S /.n sbK ...r l G,f � . 7 /. 6 <br /> d s- 36 AjVR 'Yy — s et-$.Ad s s4 LV <br /> 3 3G--" 7.SYR ` e, — s n.t 6 ,.r f G S /.•+ 7 /, 6 <br /> N 574-�4 7•SYr?�4 r, S DS4 � / — / (o <br /> *Effluent#1 =BOD >30<220 mg/L and TSS>30<150 mg/L •Effluent#2=BOD <30 mgA and TSS<30 mgfL <br /> CST Name (Please Print) — — Signe re CST Number <br /> JC^N1 es 5L1,116 is fo 734)O <br /> Address Date Evaluation Conducted Telephone Number <br /> 04 77/00 ffc 3s 1. e4j)3 F� .54893 (a -A & - /o 7/S= 766- e//S7 <br />