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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 /> County <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must N <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. C12 011i0e') <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)). <br /> Property Owner Property Location <br /> 1"e' Govt.Lot 1/4 1/4 S 13 T 41C>N R /37 E(or <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> 49h ?f f a CSm J 3 . 14S Bpnnera <br /> Ciity State Zip Code Plane Number ❑City ❑Village XTowri Nearest Road <br /> New Construction Use: Residential/Number of bedrooms 3 Code derived design flow rate yS0 GPD <br /> ❑Replacement ❑ Public orcommercial-Describe: <br /> �4 c,x/ Qr 1 f't Flood Plain elevation if applicable A17- <br /> General mmcommentsdata SY5 <br /> and recommendations: p <br /> ' <br /> Boring# Boring <br /> ® pit Ground surface elev. �U fl. Depth to limiting factor 7 in. Soil APDfialhon Rate <br /> Horizon Depth Dominant Color Redox Description Texture iStructure Consistence Boundary Roots GPD/1f <br /> in. Munsell Cu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 •Eff#2 <br /> v:q .5yevz 7T- rWi L c5 Lm 7 .6 <br /> 7 75Y / O� m1 65 !F . 7 A 4- <br /> jj <br /> -7 75Y -1-l' m rah 65 I'VE . 7 Z,6 <br /> Z Boring# Ip❑IpI Boring 7 7 <br /> K'J pit Ground surfaceelev. 7 9S ft. Depth to limiting fades in. <br /> Soil liptbnRate <br /> Horizon Depth Dominant Color Redox Description Texture I Structure Consistence Boundary Roots GPDKf <br /> in. Munsell Cu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 I 'Eff#2 <br /> e-s 7.5 l / b� m C -7 t!d <br /> Z 5--y R / 65 F 7 LG <br /> 75 m 1112 G5 v 4 <br /> Effluent#1 =BOD >30:5 220 mg/L and TSS>30<150 mg/L 'Effluent#2=BOD <30 nqL and TSS 130 nxYL <br /> CST N (Plea Print)Print) fjigna lre CST Number <br /> Number <br /> O / !J <br /> Address Date Evaluation Conducted Telephone Number <br /> 77L6 //w w f— 8- -a 66- <br />