Laserfiche WebLink
Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page_of <br /> Di)Jsion of Safety and Buildings <br /> Bureau of Mrtegrated Services in accordance with S. ILHR 83.09,Wis. Adm. Code <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must <br /> County <br /> include,but not limited to: vertical and horizontal reference point(BM),direction and 23 a <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <br /> 2sS . 0 208 <br /> APPLICANT INFORMATION- Please print all information. Reviewed by , h k- Date (j!� <br /> Personal information you provide may be used for secondary purposes(Privacy law,s.15.04(1)(m)). <br /> Property Owner Property Location <br /> S Govt.Lot 1/4 1/4,s `j T N,R fit} E(or <br /> Prop rty Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> 3L s ,�>z- � Apig lio V V• <br /> City State Zip Code Phone Number City ❑ Village Town Nearest Road <br /> u�1 OEST z 1153261 AwTr '�Fyj 06 6R2 <br /> New Construction Use: Residential/Number of bedrooms _ J , Addition to existingbuilding <br /> [� Replacement Public or commercial-Describe: <br /> Code derived daily flow gpd / Recommended design loading rate _bed,gpd/ft2�trench,gpd/ft2 <br /> Absorption area required_a3 _bed,ft25b�trench,ft Maximum design loading rate ! bed,gpd/fl2 .'g trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) qg ft(as referred to site plan benchmark) <br /> Additional design/site considerations <br /> �r <br /> Flood plain elevation,if applicable p ft <br /> Parent material 61. IA pgitrT' <br /> S = Suitable for system Conventional Mound In-Ground Pressure 1A,tT,-Grade System in Fill Holding Tank <br /> NN <br /> U = Unsuitable for system S ❑ U % S ❑ U S ❑ U S ❑ U S ❑ U ❑S <br /> SOIL DESCRIPTION REPORT <br /> Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 <br /> Boring# in Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed Trench <br /> AFIC <br /> �:. Cf Ail 4P 7 <br /> �Ground 71YA <br /> l�u.r • <br /> n. <br /> Depth to <br /> limiting <br /> factor <br /> �7in. <br /> Remarks: <br /> Boring # '� -g <br /> S <br /> •�— '� . <br /> Ground <br /> lev. <br /> Depth to i <br /> limiting <br /> factor <br /> .-ain. Remarks: <br /> Signature <br /> Telephone No. <br /> gna <br /> CST Name (Please Print) <br /> I LHARD ate <br /> �J J CST Number <br /> Addr s 0 <br /> �� syn W . ✓jig <br />