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Wisconsin Department of Commerce SOIL AND SITE EVALUATION <br /> Division of Safety and Buildings Page of <br /> Bureau of Integrated 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 County <br /> include,but not limited to: vertical and horizontal reference point(BM),direction and 1tP14/E <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <br /> M$ <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 /> Pro 7-0"b <br /> e Cromer Property Location <br /> O b Fl,--G S Govt.Lot 2�; 1/4 5�'1/4,S/$ T74� ,N,R /* fir)W <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> 717 IYAeMPji�Ap <br /> City State Zip Code Phone Number ❑ City 1:1 Village Town Ne rest Road <br /> C/ inN 70 (71 7��� �47_ >yiA*w 4AX'E/V'� <br /> ❑ New Construction Use: Residential/Number of bedrooms 2—Addition to existing building <br /> Replacement Public or commercial-Describe: <br /> Code derived daily flow OL gpd Recommended design loading rate bed,gp&V r G trench,gpd/ftz <br /> Absorption area required 47 Ybed,ft27S= trencpfft2 Maximum design loading rate bed,gpd/ftz e CY trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) ft(as referred to site plan benchmark) <br /> Additional design/site considerations ` <br /> Parent material �,�Cy�-� © Flood plain elevation,if applicable� ft <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system ❑S X u ❑S U 0S ❑ U ❑s MU ❑S MU ❑S OU <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 <br /> j3 in. Munsell Qu.Sz.Cont.Color Gr,Sz.Sh. ?,A Bed Trench <br /> a <br /> Ground <br /> elev.f <br /> Depth to <br /> limiting <br /> fa or <br /> in. <br /> Remarks: <br /> Boring# „_ <br /> (3' Q ' U ep S & r � <br /> 7 0 ; rl <br /> — y� .rQ r7 ' r <br /> Ground —T C - — r <br /> Depth to <br /> limiting <br /> %ptor <br /> in. Remarks: <br /> CST Name (Please Print) Signatur Telephone No. <br /> KEN SCHMITZ INC. <br /> MPR"077 W1106 D CST Number <br /> Address U835 r3Chf11Itz Lt3ne 6 S <br /> (715) 4W2434 <br />