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Wisconsin Department of Safety and Professional Services R I G I NA L. Page of <br />Division of Industry Services <br />SOIL EVALUATION REPORT <br />In accordance with SPS 385, Wis. Adm. Code County <br />Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, ?,-- r n e t9 - <br />but not limited to: vertical and horizontal reference point (BM), direction and percent slope, Paar`ell I.D. d_ 4/ _ /� 7. 5• /S-_ y7L <br />scale or dimensions, north arrow, and location and distance to nearest road. c y 9G o p <br />Please print all information. Reviewe b QDate �y <br />Personal information you provide may be used for secondary purposes Privacy Law, s. 15.04 1 m . Elam, <br />Property Owner Property Location ❑ ❑ <br />K i l o G eta w i o S // ro K o w1 s Govt. Lot '/4 '/4 S of % T (.// N R l.�' E (or)® <br />Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# <br />7,t f IV ke S7`. <br />City State Zip Code Phone Number ❑ city [I Village [k�'Town Nearest Road <br />M P(S 1 M /V SS'/08 Sr..1.rS. 'h.< W <br />New Construction Use: X Residential/ Number of bedrooms �� Code derived design flow rate `/-f VGPD <br />Replacement ❑ Public or commercial — Describe: <br />Parent material _ G lk G r a ( (� N r fCt Flood Plan elevation if applicable ft. <br />General comments and recommendations: <br />Boring # ❑ Boring <br />2 Pit <br />Ground surface elev. 76.0 ft. Depth to limiting factor <br />7A in. <br />Horizon Depth <br />In. <br />Dominant Color Redox Description <br />Munsell Qu. Az. Cont. Color <br />Texture <br />Structure <br />Gr. Sz. Sh. <br />Consistence Boundary Roots <br />GPD/Ft2 <br />*Eff#1 *Eff#2 <br />O <br />5'Y/2.3/ <br />/S <br />/ins6/< <br />ti-+ / Cs 3A <br />.7 1l <br />o - Yo <br />7. s Yf7 `'li6 — <br />ss' <br />a.s G <br />r G s <br />.-7 /. <br />o - -7) <br />7s'1 /z % � <br />�" <br />o s <br />� <br />. 71,6 <br />7011 Boring # <br />❑ Boring Cis-. J- 70 <br />® Pit Ground surface elev. ft. Depth to limiting factor 7 in. <br />0,., <br />Horizon Depth Dominant Color <br />In. Munsell <br />Redox Description Texture <br />Qu. Az. Cont. Color <br />Structure <br />Gr. Sz. <br />Consistence <br />Boundary <br />Roots GPD/Ftz <br />*Eff#1 **Eff##2 <br />�J <br />-,4/ / • .�! / /� '�/ <br />—� S <br />/Sh. <br />/OM1 ..i {7 �� <br />%'b� f/ <br />.T <br />�� .'7 / r V <br />d Y- 3 p <br />7 A 6 <br />CST Name (Please Print) <br />JOLW s !J f <br />Signat re <br />s <br />CST Number <br />es G H , .4- s <br />/�G..,. <br />7s �r <br />Address <br />d -776 o /�/k- 3S <br />D e Evaluation Conducted <br />7-d 7 -i T <br />Telephone Number <br />71s- JG e-- vis <br />W.T— s—tf�icJ 3 SBD -8330 (R04115) <br />