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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 c--t+-t- <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. 9 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. o y D • 3 t/p J — Q <br /> Please print all information. Review Date ..,/ <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). ¢'.,7 <br /> Property Owner ( Property Location p W <br /> I ' YVv I 1- _ VnQ,„ Govt.Lot 1/45W'114 S T3 f N R ' E(o <br /> Property Owner's Mailing Address Lot# Block# Subd. Name or CSM# <br /> IS SKo . <br /> ^City State ip Code Phone Number ❑City ElVillage ®Town Nearest Road <br /> �Or0.�t�SbVr u� 54gy (j )`! -�9a . M la a <br /> New Construction Use: Residenfial/Number of bedrooms_, Code derived design flow rate— Y50— _GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material_0-L2- -+-r+ Flood Plain e!evafionn if applicable _ 1 ft. <br /> General comments SVSS•CS� 3 rs�w1101�s, TC01%,L6 (.S� 1:0v- GC+-L� 4i*e <br /> and recommendations: <br /> , b 1 Na ba Se w e.x' — <br /> m s 1-2'3 o- 9 g. I TrG0..,0 r c>N Foo-1'.n 55 <br /> 60 be S cE o-t 9A ,22 <br /> Boring# I[J4 Boring 9 g.98 _,gyp _ <br /> Ip Pit Ground surface elev, ft. Depth to limiting factor O In. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz, Cont.Calor Gr.Sz.Sh. 'Eff#1 'Ef#F2 <br /> 0-9 PAL aFSbt2 MF-- aw d .4� <br /> QL 3 7.5400 — -- r5 cif-Qt44 VijF,- C11 IF . 5 11. D <br /> ' X87,5`1 FS df5 D2 wtaF.� w <br /> Y 8-75 IS`1 N ora sv� FS +5bat M fi- <br /> ® Boring# El Boring C 3 <br /> Pit Ground surface elev. D g. Depth to limiting factor S L� in. Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. `Eff#1 'Eff#2 <br /> b- MP-34a 6 L- aE5bll- WF,- aw F <br /> 31,-5 FK . 27 <br /> N16 c <br /> Effluent#1 =BOD >30 1220 mg/L and TSS>30<150 mg/L 'Effluent#2=BOD <30 mg/L and TSS<30 mg/L <br /> C Name (Please Print ��� i Signature CST N rn q <br /> {><ddf@ss -�� S* D to Evaluation Conducted Telephone Number <br /> oL_yb r:g -1 'C>S 71 <br /> S4oa� <br /> ase'ss s, <br />