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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. Cade County <br /> '.7 4Yrr'e <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. O _ 1111 y _ 7/ 70 0 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 3 6 <br /> Please print all information. Reviewed Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,S.15.01(1)(m)). q1 A44, r <br /> Property Owner Property Location <br /> re- Y lJ e I S$ Govt.Lot SE 1/4 /t�1/4 S Sri T #0 N R /7 E(or� <br /> Property Owner's Mailing Address /� Lot# Block# Subd.Name or CSM# <br /> Fea-rfa e_ let' <br /> C' State Zip Code Phone Number [3 city ❑Village [kTown Nearest Road <br /> %leo/aL r✓1— 1 S0040 1 ( 7/,s-) 9y-33S9 UnlOn I N1e&h 17.1 <br /> ❑ New Construction Use:IN Residential/Number of bedrooms 3 Code derived design flow rate 4.5D GPD <br /> 2§Replacement ❑ Public or commercial.Describe: <br /> Parent material G/ac r a/ lei �� Flood Plain elevation if applicable <br /> General <br /> recommendations: <br /> commentsants <br /> and recocl/ 8 3 'L. -7 1 <br /> and mmendations: $�f e ev <br /> Baring# <br /> / Boring <br /> r-3 <br /> L[I Pit Ground surface elev. .SAO ft. Depth to limiting factor 7 76 in. Soil ication Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Cu.Sz. Cont.Color Gr.Sz.Sh. 'Eft#1 'Etf#2 <br /> / a - 6 7 srR -,/& — is /.dr'0 .Y / cr s s, /• 6 <br /> ,l <br /> I-- $I 7SY? l' — /S 65 31-0 17 /"G <br /> /..6 <br /> Boring# Boring <br /> ® Pit Ground surface elev. `)S. S ft. Depth to limiting factor 7 80 in. Sal ADDlication Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1fF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Ef1#1 I 'E1Ni2 <br /> a 1 — /S 10 -'6& .., l cS 3m 7 1 16 <br /> G-Sd, 17XW7 y/ — sbk / /. 6 <br /> 7 X,6 <br /> Effluent#1 =BOD >30<_220 ng/L and TSS>30<150 mg/L 'Effluent#2=BOD <30 mgtL and TSS 130 nxyL <br /> CST Name(Please Print) Signature CST Number <br /> J/+.r+ss S• Chan eIf S cwt �734pfo <br /> Address Date Evaluation Conducted Telephone Number <br /> oL7760 1r/r„y 3S u/ebsfei ws S*iIrfY 5-1 G- or 7%r lr('� - `,/s7 M <br />