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i <br />Wisconsin Department of Commerce SOIL EVALUATION RE I G I NAL <br />Pace cf <br />Division of Safety and Buildings <br />in accordance with Comm 85, Wis. Adm. Code <br />County <br />Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must Rr^ L' /1–r <br />include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel ! D - 0 td, d-�fb IS -/3 J rr <br />percent slope, scale or dimensions, north arrow. and location and distance to nearest road. C% 011000 <br />Please print all information.ev w by ate <br />Personal information you provide may Oe used for secondary purposes (Privacy Law, s. 15.04 (11(m)). <br />Property Owner Property Location <br />L�4"( C.. A r f -f ke h Govt. Lot 6 1/4 114 S /„? T yC \1 R /,S` E (or) <br />Property Owner's Mailing Address Lot » olock # Subd. Name or CSM* <br />9)6-0 Awtbler^ Dr <br />City State Zip Code Phone Numoer <br />❑ City C1 Village Q Town Nearest Road,�(� <br />lr� v 11 E w s S �lY (S`) j?G' - 47/(c ��� zlcsc+�1 ��►e rvr Rek. <br />I] New Construction Use: [9 Residential/ Number of bedrooms _3 — Code derived design flow rate GPD <br />(Replacement ❑ Public or commercial - Describe: <br />Parent material C+ 14c Lt <br />41 _�r i ef P?ood Plain elevatcn if applicable -t. <br />General comments <br />and recommendations: 5 yj & t * v'' Y+ <br />MBaring # p <br />Boring <br />® pit Ground surface elev. 9 s ` °� ft. Depth to limiting factor -1L_ in. <br />I I Boring # 11 Boring A <br />I I Pit Ground surface elev. 9 ` ft. <br />L Depth to limiting factor �� in. <br />Horizon <br />Horizon <br />Depth <br />in. <br />Dominant Color <br />Munsell <br />Redox Description <br />Qu. Sz. Cont. Color <br />Texture <br />i <br />Structure <br />Gr. Sz. Sh. <br />Consistence <br />I Boundary <br />i <br />Roots <br />I <br />you Arvicatlon Rate I <br />I GPD/ff <br />; 'Erf»; I •E.'f»2 <br />I I Boring # 11 Boring A <br />I I Pit Ground surface elev. 9 ` ft. <br />L Depth to limiting factor �� in. <br />Horizon <br />� c - ti <br />7,s�l� s/ <br />► _ <br />Texture <br />I /msA /,c <br />Consistence <br />Boundary <br />Roots <br />-7 <br />'Eff#1 <br />'Eff#2 <br />0- ti <br />7511/7X/, <br />Ams 6A <br />45 <br />/,Nsb /c <br />:+� / <br />i c s <br />3 <br />3;-y 9 <br />`1.s-Yhe <br />j_4 /C <br />3c49 <br />7sytzy/ <br />c d sy y- <br />//r.t <br />s6/4 <br />-:r— /.d <br />-7.5-717 <br />I I Boring # 11 Boring A <br />I I Pit Ground surface elev. 9 ` ft. <br />L Depth to limiting factor �� in. <br />Horizon <br />Depth <br />in. <br />Dominant Color <br />Munsell <br />Redox Description <br />Qu. Sz. Cont. Color <br />Texture <br />Structure <br />Gr. Sz. Sh. <br />Consistence <br />Boundary <br />Roots <br />na,ouvn r�atc <br />GPD/f? <br />'Eff#1 <br />'Eff#2 <br />0- ti <br />7511/7X/, <br />-- <br />45 <br />/,Nsb /c <br />:+� / <br />i c s <br />3 <br />+ -7 <br />i, 6 <br />3c49 <br />-7.5-717 <br />unuern K i = ovv - aU :� 4ZU mg/L ana I z)a ;-au < 15u mg(L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L <br />CST Name (Please Pont) Signature r_cT N„r,hi r <br />1 _�! <br />�.� s _s%��.N was s /7,3y� � <br />Address Uate Evaluation Conducted Telephone Number <br />i <br />277do �- C 13-19 S 6-X57 <br />