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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 81/2 x 11 inches in size. Plan must County <br /> include,but not limited to: vertical and horizontal reference dhection and Burnett <br /> percent SW%acalwardi lons,northiapvl,andk>ciiiitionand eet�®ed.s Parcel I.D.# <br /> 012-4234-02 800 <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 /> Property Owner Property Location GGG��� ✓ 7 <br /> Gary Ackerley Govt. Lot 2 1/4 1/4,S 34 T 40 'N,R 15 YE(or)W <br /> Property Owner's Mailing Address Lot If Block# Subd.Name or CSM# <br /> 1054 340th Avenue 7 CSM Vol. 5, Pg. 284 <br /> City State Zip Code Phone Number ❑ City ❑ Village [j Town Nearest Road <br /> Frederic WI 54872 ( 715 ) 653-4296 Jackson Pratt <br /> ® New Construction Use: ®Residential/Number of bedrooms 2 Addition to existing building <br /> ❑ Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow 300 gpd Recommended design loading rate .7 bed,gpd/ft2 .8 trench,gpd/ft2 <br /> Absorption area required 429 bed,ft2 375 trench,ft2 Maximum design loading rate�7 bed,gpd/ft'-___,.& _trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) 96 ft(as referred to site plan benchmark) <br /> Additional design/site considerations NA <br /> Parent material Glacial Drift Flood plain elevation,if applicable KA ft <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U Unsuitable for system [i s ❑ U L4 s ❑ U ® S ❑ u Cls ❑ u KI s ❑ u ❑ s JL_1 U <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Structure GPD/ft2 <br /> in. Munsell Qu.Sz.Cont.Color Texture Gr.Sz.Sh. Consistence Boundary Roots <br /> Bed , Trench <br /> 1 1 0-5" 7.5 YR 3/2 ----------- is lmsbk mvfr es 3f–co .7 .8 <br /> 2 11-27 '7.5 YR 5/6 --------- is lmsbk mvfr cs 3f–co .7 .8 <br /> Ground P"'-77"7_5 — <br /> -------- -- is osg ml — 13f–co .7 .8 <br /> elev. <br /> 97.6ft. <br /> Depth to <br /> limiting <br /> factor <br /> 7 77nin. <br /> Remarks: <br /> Boring# <br /> 1 0-6" 7.5 YR 3/2 ----------- is Imshk lnvfr MR 3f–rn <br /> 2 .; 2 „-29 '7.5 YR 5/6 ------------ is lmsbk mvfr cs 3f–co <br /> — ----------- s -- —co <br /> Ground <br /> v. <br /> Depth to <br /> limiting <br /> factor <br /> >lVht. Remarks: <br /> CST Name (Please Print) Signature Telephone No. <br /> Wade Rufsholm (715) 349-7 Rfi <br /> Address Date CST Number <br /> Box 514 24702 Lind Road Siren, WI 54872 5/13/98 358 <br />