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Wisconsin Department of commerce SOIL EVALUATION REPORT Page / of� <br /> Division of Safety and Buildings <br /> in acoordance with Comm 85,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 Parcel I.D. <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. <br /> Please print all information. Reviewed by Date <br /> Panoral in/ormarion you Irmnda may M used for secondary purposes(Privxy Law.S.15.04(1)(m)). <br /> Property Dwner p Property Location <br /> PAkM Q Buda Gov.Lot Zc 1/4 /1X014 S G( T �V N R 16 E(ar) <br /> Property Owners Mailing AddressLot# IN # Subd.Name or CSM# <br /> 3637 Af,k Ave. Lonf-N-ydv- 4k S4bd. <br /> City State Zip Code Ptlone Number ❑City ❑Village ®Town Nearest Road <br /> n10LS M/W I S'S-g#7 (41J ) }q-0S 3£l lGl n Ot I Ha den a- ,V• <br /> ®'New Construction Use:21 Residential!Number of bedrooms 3 Code derived design flow rate 4S`O GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material_ 6/a4 1+I Dei f r Flood Plain elevation if applicable ft. <br /> General Commentsy/ <br /> 4/.1. G/<i,. /v <br /> and recommendations: <br /> © <br /> Boring <br /> ❑ Boring <br /> ® pit Ground surface elev. '77 '7 ft. Depth to limiting factor 7A in. <br /> Sod Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDnF <br /> in. Munsell Qu.Sz. Cont Collor Gr.Sz.Sh. I 'Eff#1 I 'Ef#r2 <br /> l • 0-6 7IM % /-f Ds5 M / C5 lee 7 /..A <br /> 7 1-37 7,.QA rets o3'5 PM SS d. m *7 1 /,A <br /> 37- 71, 7,5W r Pre S OS5 m l — ) l r/1 <br /> I , I Boring# ❑ Boring <br /> u ® Pit Ground surface elev. 97--L- ft. Depth to limiting factor in. <br /> Soil I�tipr1 Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDMF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> di-/j 7,3-yd� r`- /f DSS We l es 3W , 7 /,,4 <br /> J'37 7.9-1-4 ry — M S 035 m l 9S X Y -7 - <br /> ��-7J 7-S-M p — O5 3 / SS — 7 /r A <br /> I- <br /> ' I <br /> ' <br /> Effluent#1 =BOD >30<220 mg/L and TSS>10<150 mg/L 'EPuent A2=30D,<30 mg/L and TSS<30 mglL <br /> CST Name (Please Prat) ignature CST Number <br /> AMSf 3 - 0^1,,/ S 41-'A A-72 itol-0 <br /> Address Date Evaluation Conducted Telephone Number <br /> 7bo H 3S4vr wr 5-4,0 / -/- �- f 5-1- Lk <br />